PMID- 2213814
TI  - Skin presentation of chronic myelomonocytic leukaemia resembling cutaneous
      lymphomas.

PMID- 2213815
TI  - Correlation between serum oncogene protein expression and the development of
      neoplastic disease in a worker exposed to carcinogens.

PMID- 2213816
TI  - Communicating information to patients.

PMID- 2213817
TI  - Pyrimethamine-sulphadoxine: how great the risk?

PMID- 2213818
TI  - Advanced trauma life support courses.

PMID- 2213819
TI  - Non-steroidal anti-inflammatory drugs (NSAIDs) and the ileum.

PMID- 2213820
TI  - Chronic somatizers and the Government White Paper.

PMID- 2213821
TI  - Antiatherosclerotic agents. A structurally novel bivalent inhibitor of
      acylCoA:cholesterol O-acyltransferase with systemic activity.

PMID- 2213822
TI  - Structure-based, C2 symmetric inhibitors of HIV protease.

PMID- 2213823
TI  - Synthesis and biological activity of 1,2,4-oxadiazole derivatives: highly potent
      and efficacious agonists for cortical muscarinic receptors.
AB  - The synthesis and biochemical evaluation of novel 1,2,4-oxadiazole-based
      muscarinic agonists which can readily penetrate into the CNS is reported.
      Efficacy and binding of these compounds are markedly influenced by the structure
      and physicochemical properties of the cationic head group. In a series of
      azabicyclic ligands efficacy and affinity are influenced by the size of the
      surface area presented to the receptor, at the active site, and the degree of
      conformational flexibility. The exo-1-azanorbornane 16a represents the optimum
      arrangement, and this compound is one of the most efficacious and potent
      muscarinic agonists known. In a series of isoquinuclidine based muscarinic
      agonists efficacy and affinity are influenced by the geometry between the
      cationic head.group and hydrogen bond acceptor pharmacophore and steric bulk in
      the vicinity of the base. The anti configuration represented by 22a is optimal
      for muscarinic activity. Ligands with pKa below 6.5 show poor binding to the
      muscarinic receptor as exemplified by the diazabicyclic derivative 42.

PMID- 2213824
TI  - Thiazole as a carbonyl bioisostere. A novel class of highly potent and selective
      5-HT3 receptor antagonists.
AB  - A novel structural class of highly potent and selective 5-HT3 receptor
      antagonists is described. The compounds in this new series contain a thiazole
      moiety linking an aromatic group and a nitrogen-containing basic region; the
      thiazole group appears to be acting as a carbonyl bioisostere in this system. An
      optimized member of this series, 4-(2-methoxyphenyl)-2-[[4(5)-methyl-5(4)
      imidazolyl]methyl]thiazole (5), exhibits oral activity in the Bezold-Jarisch
      reflex paradigm comparable to or better than the standard agents ondansetron (1)
      and ICS-205-930 (2). Several of the structure-activity relationships are
      rationalized in terms of a computer pharmacophore model for 5-HT3 receptor
      binding.

PMID- 2213825
TI  - Torsionally and hydrophobically modified 2,3-diarylindenes as estrogen receptor
      ligands.
AB  - 2,3-Diarylindenes are ligands for the estrogen receptor which display intrinsic
      fluorescence. In order to optimize the receptor binding affinity of these
      compounds while preserving their desirable fluorescence properties, a series of
      torsionally modified analogues were prepared. A fluorine or methyl group was
      introduced on either of the two phenyl substituents ortho to their attachment
      site to the indene nucleus, in order to increase the out-of-plane twist of the
      appended rings. The analogues were prepared by the benzylation of appropriate
      deoxybenzoins, followed by Friedel-Crafts cyclic alkylation-dehydration.
      Comparison of the X-ray crystal structure of one analogue with unsubstituted
      analogues confirms the torsional perturbation effected by the ortho substituent.
      The torsional disposition of the C-2 aryl group in the substituted
      diphenylindenes is further investigated by UV (absorbance maxima and molar
      absorptivities), fluorescence (Stokes' shift), and NMR (chemical shifts). These
      spectroscopic measurements indicate increasing twisting between the C-2 aryl
      substituent and the indene system according to the following order: 3-ring o-Me
      indene 9f less than diphenylindene 15 = 20 degrees less than 3-ring o-F-indene 9c
      less than 1-Me-indene 16 less than 2-ring o-F-indene 9b less than 2-ring o-Me
      indene 9e = 63 degrees. The binding affinity of these analogues to the estrogen
      receptor was evaluated by a competitive radiometric receptor binding assay. While
      o-fluoro or o-methyl substitution on the 3-ring increases binding only slightly,
      binding of the o-fluoro 2-ring analogue is increased ca. 6-fold and the o-methyl
      analogue 11-fold, giving, in the latter case, a compound with an affinity
      equivalent to that of estradiol. The increase in binding affinity afforded by
      ortho substitution correlates with the increase in the torsion angle of the C-2
      aryl ring. A thermodynamic evaluation of the receptor fit (Andrews, P. R.; Craik,
      D. J.; Martin, J. L. J. Med. Chem. 1984, 27, 1648) indicates that, for the o
      methyl 2-ring analogue, the effect of the ortho substitution on increasing
      receptor binding appears to be a combination of increased surface area due to the
      substituent itself, together with a change in surface area of the ligand that
      results from the increased torsion of the two aryl rings. An o-fluoro substituent
      on the 2-ring provides a compromise between the relative planarity required for
      high fluorescence intensity and the molecular shape needed for increased estrogen
      receptor binding affinity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2213826
TI  - Synthesis of acyclic and dehydroaspartic acid analogues of Ac-Asp-Glu-OH and
      their inhibition of rat brain N-acetylated alpha-linked acidic dipeptidase (NAALA
      dipeptidase).
AB  - The following structural and conformationally constrained analogues of Ac-Asp-Glu
      OH (1) were synthesized: Ac-Glu-Glu-OH (2), Ac-D-Asp-Glu-OH (3), Ac-Glu-Asp-OH
      (4), Ac-Asp-Asp-OH (5), Ac-Asp-3-aminohexanedioic acid (6), Ac-3-amino-3
      (carboxymethyl)propanoyl-Glu-OH (7), N-succinyl-Glu-OH (8), N-maleyl-Glu-OH (9),
      N-fumaryl-Glu-OH (10), and Ac-delta ZAsp-Glu-OH (11). These analogues were
      evaluated for their ability to inhibit the hydrolysis of Ac-Asp-[3,4-3H]-Glu-OH
      by N-acetylated alpha-linked acidic dipeptidase (NAALA dipeptidase) in order to
      gain some insight into the structural requirements for the inhibition of this
      enzyme. Analogues 4-6 and 9 were very weak inhibitors of NAALA dipeptidase (Ki
      greater than 40 microM), while 2, 3, and 7 with Ki values ranging from 3.2-8.5
      microM showed intermediate inhibitory activity. The most active inhibitors of
      NAALA dipeptidase were compounds 8, 10, and 11 with Ki values of 0.9, 0.4, and
      1.4 microM, respectively. These results suggest that the relative spacing between
      the side chain carboxyl and the alpha-carboxyl group of the C-terminal residue
      may be important for binding to the active site of the enzyme. They also indicate
      that the chi 1 torsional angle for the aspartyl residue is in the vicinity of 0
      degrees.

PMID- 2213827
TI  - Penta- and hexadienoic acid derivatives: a novel series of 5-lipoxygenase
      inhibitors.
AB  - The synthesis of a series of pentadienoic and hexadienoic acid derivatives is
      reported. These compounds were tested as inhibitors of 5-lipoxygenase (5 LO) and
      cyclooxygenase (CO) in vitro and as inhibitors of arachidonic acid (AA) induced
      ear edema in mice in vivo. Their potency is compared with that of the standard
      inhibitors nafazatrom, BW 755C, NDGA, KME4, quercetine, and L 652,243. The most
      potent compound in vivo, diethyl 2-hydroxy-5-(ethylthio)-2(Z),4(Z)
      hexadienedioate (20) inhibited AA-induced ear edema when administered topically
      or orally, with an ED50 value of 0.01 mg/ear and 20 mg/kg, respectively. Among
      the standard compounds tested, L 652,243 was the most active compound in this
      test with an ED50 value of 0.01 mg/ear and 1 mg/kg po, but unlike this compound,
      20 is a selective inhibitor of 5-LO (IC50 = 2 microM) without any significant
      activity against CO (IC50 greater than 50 microM). Most of the other compounds in
      this series are also selective 5-LO inhibitors.

PMID- 2213828
TI  - 4-Heterocyclyloxy-2H-1-benzopyran potassium channel activators.
AB  - The reaction of 2,4-dihydroxypyridine (2) with 3,4-epoxy-3,4-dihydro-2,2-dimethyl
      2H-1-benzopyran-6-carbonitrile (1) yielded the 4-[(1,2-dihydro-2-oxo-4
      pyridyl)oxy] compound 3a, accompanied by small amounts of the isomeric 4-(1,2
      dihydro-4-hydroxy-2-oxo-1-pyridyl) compound 4. This could also be prepared by
      hydrogenation of the benzyloxy derivative 5. Reaction of 3,6-pyridazinediol (10)
      with 1 (R = CN) gave the 4-[(1,6-dihydro-6-oxo-3-pyridazinyl)oxy] compound 11a,
      which in turn rearranged on heating with NaH in DMSO into the 4-(1,6-dihydro-3
      hydroxy-6-oxo-1-pyridazinyl) compound 12. A series of 6-substituted analogues (R
      = CO2Me, CSNH2, NO2, Br) of 3a and 11a were synthesized. N-Alkylation led to
      compounds 14a-c (R = Me, Et, CHMe2). The 4-heterocyclyloxychromenes 9 and 16a
      were obtained by alkaline hydrolysis of their 3-camphorsulfonates. The racemic
      pyridazinyloxy compounds 11a and 14a could be resolved via their diastereomeric
      camphorsulfonates or camphanates. The differences between the 4
      heterocyclyloxychromanols and the isomeric N-substituted compounds 4 and 12 were
      elucidated in the course of extensive NMR investigations. While in DMSO the
      former appeared to be conformationally flexible molecules the latter were rigid.
      All compounds were tested for oral antihypertensive activity in spontaneously
      hypertensive rats, using doses of 1 mg/kg. High and long lasting activities were
      found for the pyridyloxy compounds 3a and 3d, the pyridazinyloxy compound 11a,
      and its N-alkylation products, as well as for the 3S,4R-enantiomers 20a and 22a.
      (-)-(3S,4R)-3,4-Dihydro-4-[(1,6-dihydro-1-methyl-6-oxo-3- pyridazinyl)oxy]-3
      hydroxy-2,2-dimethyl-2H-1-benzopyran-6-carbonitrile (22a) was selected for
      further development.

PMID- 2213829
TI  - Anti-HIV-1 activity, toxicity, and stability studies of representative structural
      families of polyoxometalates.
AB  - The anti-HIV-1 activity and toxicity of representative structural families of
      polyoxotungstates in human lymphocytes was determined. The 21 compounds examined
      include those derived from the following structural families: [NaSb9W21O86]18-
      (HPA-23), Xn+W12O40(8-n)- (Keggin), P2W18O62(6-) (Wells-Dawson), W6O19(2-)
      (Lindqvist), [NaP5W30O110]14- (Preyssler), and W10O32(4-) (decatungstate). The
      molecular architecture of each of these structural families is constituted
      principally by a network of bonds between d0 WVI and oxide ions. Of these, 10
      show median effective concentration (EC50) values of approximately 1 microM and
      six have marked toxicity with a median inhibitory concentration (IC50) of less
      than 50 microM. Only compounds containing more than six metal atoms showed
      appreciable antiviral activity. Beyond this, however, no marked correlation
      existed between the molecular size, charge, or charge density of the
      polyoxometalates and their anti-HIV-1 activity. Examination of an exemplary class
      of polyoxotungstates, the phosphotungstates of formula A- and B-PW9O34(9-) under
      physiological conditions (buffered neutral aqueous media), illustrates that both
      isomers equilibrate rapidly to generate the same distribution of products and
      that this distribution depends principally on the buffer. These heretofore
      unappreciated complexities in the chemistry of these compounds under neutral
      aqueous conditions indicates interpretation or evaluation of these compounds in
      cell culture and other biological screens must be done with care.

PMID- 2213830
TI  - Binding of indolylalkylamines at 5-HT2 serotonin receptors: examination of a
      hydrophobic binding region.
AB  - Taking advantage of a proposed hydrophobic region on 5-HT2 receptors previously
      identified by radioligand-binding studies utilizing various phenylisopropylamine
      derivatives, we prepared and evaluated several N1 - and/or C7-alkyl-substituted
      derivatives of alpha-methyltryptamine in order to improve its affinity and
      selectivity. It was determined that substitution of an n-propyl or amyl group has
      similar effect on affinity regardless of location (i.e., N1 or C7). The low
      affinity of several N1-alkylpyrroleethylamines suggests that the benzene portion
      of the alpha-methyltryptamines is necessary for significant affinity. Whereas
      tryptamine derivatives generally display little selectivity for the various
      populations of 5-HT receptors, N1-n-propyl-5-methoxy-alpha-methyltryptamine (3h)
      binds with significant affinity (Ki = 12 nM) and selectivity at 5-HT2 receptors
      relative to 5-HT1A (Ki = 7100 nM), 5-HT1B (Ki = 5000 nM), 5-HT1C (Ki = 120 nM),
      and 5-HT1D (Ki greater than 10,000 nM) receptors. As a consequence, this is the
      most 5-HT2-selective indolylalkylamine derivative reported to date.

PMID- 2213831
TI  - Chemistry and structure-activity relationships of C-17 unsaturated 18-cycloalkyl
      and cycloalkenyl analogues of enisoprost. Identification of a promising new
      antiulcer prostaglandin.
AB  - A series of delta 17 unsaturated cycloalkyl and cycloalkenyl analogues of
      enisoprost was synthesized to investigate the effects of omega chain unsaturation
      on gastric antisecretory activity and diarrheogenic side effects. Of these, the
      17E, 18-cyclopentenyl analogue 5d displayed potent gastric antisecretory activity
      in dogs but very weak diarrheogenic properties in rats and is the most selective
      prostaglandin compound discovered in these laboratories. Structurally, 5d
      contains both a conjugated diene and tertiary allylic alcohol in the omega chain,
      and these chemical features impart some interesting oxidative and acid-catalyzed
      epimerization and allylic rearrangement reactivities, respectively.

PMID- 2213832
TI  - Pyrroloisoquinoline antidepressants. 3. A focus on serotonin.
AB  - A collection of hexahydropyrroloisoquinoline derivatives (1-22), which represent
      a class of compounds that inhibit the neuronal uptake of dopamine (DA),
      norepinephrine (NE), and serotonin (5-HT), was investigated in vivo for serotonin
      potentiating properties in the mouse head-twitch and rat serotonin syndrome
      assays. The p-methylthio compound 3b (McN-5652-Z) was found to possess
      exceptional activity in these assays, and the activity was attributable almost
      exclusively to the (+)-6S,10bR enantiomer. Ten closely related analogues were
      synthesized, tested, and compared among themselves and with some previously
      prepared compounds, both in vivo and in vitro. Several trans diastereomers
      exhibited strong inhibition of 5-HT uptake and substantial potentiation of 5-HT,
      while the cis diastereomers (3a, 4a, and 10a) tested were virtually devoid of
      such activity. Although 3b was only moderately selective in inhibiting the uptake
      of 5-HT vs NE, its 10-substituted analogues 4b, 7b-9b had improved 5-HT
      selectivity relative to NE, to the extent of 20-25 times (150-200 times relative
      to DA). Of these more selective compounds (in vitro), only 4b and 7b had
      substantial activity in vivo. Sulfoxide 11b appeared to function as a prodrug of
      3b in vivo.

PMID- 2213833
TI  - A Free-Wilson/Fujita-Ban analysis and prediction of the analgesic potency of some
      3-hydroxy- and 3-methoxy-N-alkylmorphinan-6-one opioids.
AB  - Herein we describe a Free-Wilson/Fujita-Ban QSAR (quantitative structure-activity
      relationship) analysis of the analgesic potency of over 50 semisynthetic opioid
      narcotics. The 3-hydroxy- and 3-methoxy-N-alkylmorphinan-6-ones of B/C-cis and 
      trans stereochemistry include compounds exhibiting structural variation at five
      positions [N-methyl (C17), oxygen at C3, C4-C5 oxygen bridge, alkyl substituents
      at C7 and C8]. The pharmacological parameter correlated was the analgesic potency
      (-log ED50) exhibited on abdominal contractions produced by acetylcholine
      injection in mice. A satisfactory correlation was obtained only by assuming
      interdependent contributions of the substituents on C17 and O(C3), with which it
      was possible to explain 75% of the variance. Phenolic compounds (3-OH) behave
      somewhat differently from the methyl ethers (3-OCH3), and in both series the
      substituents on C8 have a size-dependent negative contribution, implying steric
      hindrance at their contact point on the receptor. With use of this correlation
      the potency of five further members of the series was predicted. Subsequent
      testing fully confirmed the validity of the correlation since the measured
      potencies were, within experimental error, equal to those calculated. In a
      further refinement, phenolic compounds were considered separately from the
      ethers, and it was found that the contribution of the substituents on C17, C7,
      and C8 remained similar in sign and magnitude but not that of the furan oxygen.
      This analysis allows us to conclude that if both phenolic and nonphenolic members
      of this series act on the same receptor they must bind at different subsites or
      in alternate modes, supporting an earlier proposal in the literature.

PMID- 2213834
TI  - Imidazodiazepinediones: a new class of adenosine receptor antagonists.
AB  - A series of imidazo[4,5-e][1-4]diazepine-5,8-diones were synthesized from
      hypoxanthines. Certain of these cyclic homologues of caffeine, theophylline,
      theobromine, 3-isobutyl-1-methylxanthine, and enprofylline were inhibitors of
      binding of adenosine analogues to rat brain A1 and A2 adenosine receptors and
      were antagonists of A2 adenosine receptors stimulatory to adenylate cyclase in
      rat PC12 cell membranes. Activity at adenosine receptors was lower than the
      corresponding xanthines, perhaps because imidazodiazepinediones contain a boat
      shaped seven-membered ring rather than the planar heteroaryl ring system of the
      xanthines. The imidazodiazepinediones had low affinity for brain benzodiazepine
      sites.

PMID- 2213835
TI  - 7-Deaza-2-phenyladenines: structure-activity relationships of potent A1 selective
      adenosine receptor antagonists.
AB  - A series of derivatives of 7-deazapurines with varying substituents in the 2-, 6
      , and 9-position was synthesized in an attempt to improve the adenosine receptor
      affinity and A1 or A2 selectivity. The adenosine receptor affinities were
      assessed by measuring the inhibition of [3H]-(R)-N6-(phenylisopropyl) adenosine
      (R-PIA) binding to rat brain A1 and inhibition of [3H]-5'-(N
      ethylcarboxamido)adenosine (NECA) binding to rat striatum A2 adenosine receptors.
      A selected set of compounds representing the main structural variations was
      further examined in adenosine receptor coupled adenylate cyclase assays. All
      tested compounds antagonized the inhibition of adenylate cyclase elicited by
      interaction of R-PIA with A1 receptors in rat fat cell membranes and the
      activation of adenylate cyclase elicited by interaction of NECA with A2 receptors
      of pheochromocytoma PC12 cell membranes. The results indicate that 7
      deazahypoxanthines have a potential for A2 selectivity, while all 7-deazaadenines
      are A1 selective. Introduction of a phenyl residue in the 2-position of 7
      deazaadenines increases A1 activity tremendously. 2-(p-Chlorophenyl)-7,8-dimethyl
      9-phenyl-7-deazaadenine (29) is potent and specific for the A1 receptors of rat
      brain (Ki = 122 nM), having no affinity for the A2 receptors of rat striatum. The
      compound has low activity at the A2 receptors of rat PC12 cell membranes where it
      appears to act as a noncompetitive inhibitor. A 1-phenylethyl substituent at the
      9-position was found to be superior to a phenyl residue in terms of A1 affinity.
      The most potent A1 antagonist in the present series is the highly A1 selective
      (790-fold) (R)-7,8-dimethyl-2-phenyl-9-(1-phenylethyl)-7-deazaadenine (31, Ki =
      4.7 nM), which is 30-35 times more potent at A1 receptors than its S enantiomer.
      The solubility of six of the potent 7-deaza-2-phenyladenines was determined by
      means of an A1 binding assay. Chloro substitution of the 2-phenyl ring appeared
      to improve the solubility as well as the solubility over A1 affinity ratio of 9
      phenyl- and 9-(1-phenylethyl)-substituted 7-deazadenines.

PMID- 2213836
TI  - Synthesis and antimicrobial and cytotoxic activities of pyrrole-containing
      analogues of trichostatin A.
AB  - A number of aroylpyrroleacrylic acid derivatives were synthesized by standard
      procedures and evaluated for cytotoxicity in Vero cells and for capacity to
      inhibit the multiplication of viruses, bacteria, and fungi. While none of the
      test compounds showed any activity against bacteria and fungi, most of them
      inhibited the replication of some DNA viruses at concentrations allowing the
      exponential growth of uninfected cells. In particular three compounds (8, 9c, and
      10h) showed an antiviral activity at doses that were from 4- to greater than 8
      fold lower than the maximum nontoxic doses.

PMID- 2213837
TI  - 8-Substituted 5-[(aminoalkyl)amino]-6H-v-triazolo[4,5,1-de]acridin-6-ones as
      potential antineoplastic agents. Synthesis and biological activity.
AB  - A series of 8-substituted 5-[(aminoalkyl)amino]-6H-v-triazolo[4,5,1-de]acridin-6
      ones (2), structurally related to the imidazoacridinones (1), was synthesized and
      tested for cytotoxic and antineoplastic activity. Preliminary biological results
      indicated that the 8-OH derivatives possess the highest antitumor activity. No
      relationship has been found between the nature of the C-8 substituent and
      antitumor activity.

PMID- 2213838
TI  - Synthesis and anticonvulsant and sedative-hypnotic activity of 4-(alkylimino)-2,3
      dihydro-4H-1-benzopyrans and -benzothiopyrans.
AB  - A series of 4-(alkylimino)-5-hydroxy-7-alkyl-2,3-dihydro-4H-1-benzopyrans and 
      thiopyrans were synthesized and evaluated for anticonvulsant activity.
      Preliminary screening of these compounds revealed that 2,2-dimethyl-4-[(2
      hydroxyalkyl)imino]-5-hydroxy-7-pentyl-2,3- dihydro-4H-1-benzopyrans 19 and 29,
      the 7-butyl analogue 34, and the corresponding 7-pentyl-4H-1-benzothiopyrans 38
      and 39 had the most promising anticonvulsant activity. Synthesis of both
      enantiomers of 29 and 39 indicated that the R isomers 30 and 40 were the most
      active and showed very good protection against MES, pentylenetetrazole, and
      mercaptopropionic acid induced seizures after oral administration in mice. In the
      Irwin test these compounds showed a generalized depressant activity but at
      dosages higher than those showing anticonvulsant activity, whereas acute toxicity
      after oral administration was low (LD50 higher than 400 mg/kg).

PMID- 2213839
TI  - Nonsteroidal cardiotonics. 3. New 4,5-dihydro-6-(1H-indol-5-yl)pyridazin-3(2H)
      ones and related compounds with positive inotropic activities.
AB  - A series of substituted indolyldihydropyridazinones and related compounds 1-18
      were synthesized and evaluated for positive inotropic activity. In rats, most of
      these indole derivatives produced a dose-related increase in myocardial
      contractility with little effect on heart rate and blood pressure. Compound 13,
      4,5-dihydro-5-methyl-6-(2-pyridin-4-yl-1H-indol-5-yl)pyrazin-3(2H) -one (BM
      50.0430), was further investigated in cats. The increase in contractility in this
      animal model was not mediated via stimulation of beta-adrenergic receptors. After
      oral administration of 1 mg/kg to conscious dogs, compound 13 and pimobendan were
      still active after 6.5 h. However, the cardiotonic effect of 13 was at least 2
      fold that of pimobendan after this period of time. The structural requirements
      necessary for optimal cardiotonic activity within this novel class of indole
      derivatives are a heterocyclic aromatic ring in position 2, a hydrogen or a
      methyl group in position 3, and a dihydropyridazinone ring system in position 5
      of the indole.

PMID- 2213840
TI  - Genetics services in the community.

PMID- 2213841
TI  - Cystic fibrosis screening and community genetics.

PMID- 2213843
TI  - On the variable effect of mosaic normal/balanced chromosomal rearrangements in
      man.

PMID- 2213842
TI  - Genetics of congenital nemaline myopathy: a study of 10 families.
AB  - In order to investigate the inheritance in congenital nemaline myopathy (CNM), we
      studied the family histories and pedigrees of 13 patients with CNM from 10
      families, and the 20 patients, by physical examination, single fibre
      electromyography, ultrasonography of muscles, measurement of serum creatine
      kinase, muscle biopsy, and electrophoresis of muscle proteins. None of the
      parents was affected. In three families there were two affected children. Of the
      parents, 15 showed deficiency of type 2B muscle fibres, and all except one father
      showed some other minor neuromuscular abnormality. These may represent
      heterozygous manifestations of recessive gene. Most of the ancestors came from
      sparsely populated rural communities in the west of Finland. We conclude that in
      the Finnish CNM patients, the mode of inheritance appears to be recessive. Apart
      from a few instances of dominant inheritance, most cases published also seem
      compatible with recessive inheritance.

PMID- 2213844
TI  - Health visitors' awareness and perception of clinical genetic services.
AB  - A questionnaire was sent to 84 health visitors to assess their awareness and
      perception of genetic services and how they perceived their role in the referral
      of patients. The study showed that while health visitors had a reasonable
      knowledge of the more obvious aspects of genetic services, there were a number of
      areas in which they were unsure. The respondents did not identify themselves as
      prime initiators in the process of referring patients to a genetic service,
      although they appeared able to identify families on their caseloads for whom this
      service may be relevant. Health visitors viewed their own knowledge of genetics
      as poor, a factor which may account for the low referral rate initiated by this
      group of professionals. The respondents attached importance to genetic issues and
      76 (95%) wished to be better informed about the subject. It is suggested that the
      inclusion of genetics as part of an in-service training programme might fulfil
      this need and lead to greater advocacy of genetic services among the families in
      their care. These findings are of interest in view of the proposals within the
      recent Royal College of Physicians report (Prenatal screening and genetic
      counselling) suggesting that community genetic services should make use of
      primary health care workers such as health visitors.

PMID- 2213845
TI  - Dyggve-Melchior-Clausen syndrome.

PMID- 2213846
TI  - Partial duplication of the long arm of chromosome 6: a clinically recognisable
      syndrome.
AB  - Reciprocal translocations involving the short arm of acrocentric chromosomes can
      segregate to produce partial duplications without associated deletions. We
      present a case of an infant with a 46,XY,-15,+der(15),T(6;15)(q23;p12)pat
      chromosome complement. The infant had multiple congenital abnormalities including
      cranial anomalies, facial dysmorphism, anterior webbing of the neck, cardiac
      anomalies, and joint contractures. From a comparison of the infant's phenotype
      with 20 other patients with a similar duplication, it is evident that partial
      duplication of the long arm of chromosome 6 is a clinically diagnosable syndrome.

PMID- 2213848
TI  - Conference on gene therapy, Royal College of Physicians, London, 1 March 1990.

PMID- 2213847
TI  - A new apparently folate sensitive fragile site, 5q35.

PMID- 2213849
TI  - Pachygyria, joint contractures, and facial abnormalities: a new lethal syndrome.

PMID- 2213850
TI  - The CHARGE association.

PMID- 2213851
TI  - The Moebius syndrome: aetiology, incidence of mental retardation, and genetics.

PMID- 2213852
TI  - Relationship of serum total calcium and albumin and total protein in owl monkeys
      (Aotus nancymai).
AB  - A positive linear relationship was found between total calcium and albumin and
      between total calcium and total protein in the serum of 205 owl monkeys.
      Adjustment formulas for calcium were derived: adjusted calcium (mg/dl) = measured
      calcium (mg/dl) - 0.84 [albumin (g/dl)] + 3.8 and adjusted calcium (mg/dl) =
      measured calcium (mg/dl) - 0.82 [total protein (g/dl)] + 6.5. Adjusted calcium
      calculations for monkeys based on albumin concentration were similar to those for
      man and dogs, but different from those based on total protein.

PMID- 2213853
TI  - Intrauterine insemination with ultrasound guidance in the long-tailed macaque
      (Macaca fascicularis).
AB  - Techniques used for the artificial insemination of macaques have primarily
      involved instillation of the ejaculate into the vagina or cervical canal.
      Intrauterine insemination has been performed previously but only as a surgical
      procedure. The application of ultrasound-guided techniques for this purpose
      provides a method for efficiently inseminating macaques in a relatively
      noninvasive fashion. This report describes the successful transabdominal
      ultrasound-guided insemination of the long-tailed macaque and the potential
      application of this procedure to a variety of nonhuman primate species.

PMID- 2213854
TI  - New methodology for measuring blood pressure in awake baboons with use of
      behavioral training techniques.
AB  - Adult male baboons were behaviorally conditioned to extend an arm outside of the
      living cage and to accept repeated cuff inflations for manual auscultatory blood
      pressure measurements. Frequency distributions of systolic and diastolic blood
      pressure for both normotensive and renovascular hypertensive baboons generally
      were normally distributed. The procedure accurately tracked rapid changes in
      blood pressure after oral administration of antihypertensive drugs. Advantages
      over direct arterial cannulation for blood pressure measurement during extended,
      chronic experiments are discussed.

PMID- 2213855
TI  - Familial incidence of multiple births in a colony of chimpanzees (Pan
      troglodytes).
AB  - This paper describes the incidence of multiple births in the Yerkes Chimpanzee
      colony for a period of about 63 years. Pedigrees are presented for all multiple
      births. They demonstrate the recurrence of twins in relatively few family lines
      which can be traced back to a small number of ancestors. The findings suggest
      that twinning is a family trait in chimpanzees and they support the hypothesis
      that the incidence of multiple births is genetically influenced in this colony.
      In addition, a relatively high level of inbreeding may have enhanced the
      incidence of multiple births in these family lines. Similar findings are known
      from human populations.

PMID- 2213856
TI  - Control data on pre- and neonatal survival of captive chimpanzees.
AB  - Colony breeding records were analyzed in order to obtain information on pre- and
      neonatal survival in chimpanzees. Biweekly urinary chorionic gonadotrophin
      testing appeared suitable for determining pregnancy age. The probability of
      pregnancy termination was low (0.008 per 10 days) to a pregnancy age of 180 days.
      Between the ages of 180-210 days it was 0.080 per 10 days, and it steadily
      increased to one per 10 days after 240 days of age. There were no livebirths
      before 190 days of pregnancy age. Thereafter, the probability of a delivery to be
      a livebirth rapidly increased to about 0.90 after 210 days of pregnancy age.
      Infant mortality was less than 0.026 during the first two years of life.

PMID- 2213857
TI  - Increased carbon monoxide excretion in Bolivian squirrel monkeys with fasting
      hyperbilirubinemia.
AB  - Pulmonary carbon monoxide (CO) excretion rates (VeCO) were 50% greater, on
      average, in Bolivian squirrel monkeys (BoSMs) which exhibit a unique fasting
      hyperbilirubinemia (FH), than in fasted control Brazilian squirrel monkeys
      (BrSMs). Since the catabolism of heme produces equimolar amounts of CO and
      bilirubin, the increased VeCOs are consistent with concurrent increases in
      endogenous bilirubin production rates. Tin-protoporphyrin, a competitive
      inhibitor of heme oxygenase, significantly decreased both the VeCO and serum
      bilirubin level in fasted BoSMs. Overproduction of bilirubin may be responsible
      in part for the marked FH in BoSMs.

PMID- 2213858
TI  - The refractometer index as a correction factor for urinary estradiol in rhesus
      females.
AB  - Refractometer indexes were standardized and found to be highly correlated (r =
      0.831) to actual creatinine levels. Urinary estradiol corrected by creatinine
      levels and refractometer indexes were found to be highly correlated (r = 0.857).
      Predicted ovulation was the same day in 86% of the ovulatory cycles predicted by
      creatinine and refractometer corrected estradiol levels. Refractometer indexes
      may be used in place of creatinine levels to correct for urine concentration
      fluctuations when predicting ovulation in the rhesus female.

PMID- 2213859
TI  - Spontaneously occurring congenital polycystic kidney in a cynomolgus monkey
      (Macaca fascicularis).
AB  - Congenital polycystic kidney disease was diagnosed at necropsy in a stillborn
      male cynomolgus monkey (Macaca fascicularis). This case was very similar to
      infantile polycystic kidney disease in man and the rhesus monkey, except that no
      increase in number of intrahepatic bile ducts was observed.

PMID- 2213860
TI  - Extraosseous osteosarcoma in a nonhuman primate (Macaca mulatta).
AB  - A case of a very rare malignant bone-forming sarcoma, which was located in the
      soft tissue but had no anatomic attachment to bone, is presented. This tumor
      originated in the subcuticular tissue over the right scapula and was
      histologically composed of sheets of anaplastic spindle cells that produced
      osteoid. The tumor recurred twice before the animal was killed. The recurrent
      masses produced less osteoid and were generally less differentiated
      histologically than the initial tumor.

PMID- 2213862
TI  - Psychological profiles help select ideal dental teams.

PMID- 2213863
TI  - Finding and keeping good staff.

PMID- 2213861
TI  - K-Cl cotransport in LK sheep erythrocytes: kinetics of stimulation by cell
      swelling.
AB  - The effects of osmotic cell swelling were studied on the kinetics of Cl-dependent
      K+ influx, K-Cl cotransport, in erythrocytes from sheep of the low K+ (LK)
      phenotype. Swelling approximately 25% stimulated transport by increasing maximum
      velocity (Jmax) approximately 1.5-fold and by increasing apparent affinity for
      external K (Ko) nearly twofold. Dithiothreitol (DTT) was shown to be a partial,
      reversible inhibitor of K-Cl cotransport. It inhibited in cells of normal volume
      by reducing Jmax more than twofold; apparent affinity for Ko was increased by
      DTT, suggesting that DTT stabilizes the transporter-Ko complex. Cell swelling
      reduced the extent of inhibition by DTT: Jmax was inhibited by only about one
      third in swollen cells, and apparent affinity was only slightly affected. This
      result suggested that DTT does not act directly on the transporter, but on a
      hypothetical regulator, an endogenous inhibitor. Swelling relieves inhibition by
      the regulator, and reduces the effect of DTT. Reducing intracellular Mg2+, Mgc,
      stimulated cotransport. Swelling of low-Mg2+ cells stimulated transport further,
      but only by raising apparent affinity for Ko nearly threefold: Jmax was
      unaffected. Thus effects of swelling on Jmax and apparent affinity are separable
      processes. The inhibitory effects of Mgc and DTT were shown to be additive,
      indicating separate modes of action. There appear to be two endogenous
      inhibitors: the hypothetical regulator, which holds affinity for Ko, low; and
      Mgc, which affects Jmax, perhaps by holding some transporters in an inactive
      form. Swelling stimulates transport by relieving both types of inhibition.

PMID- 2213864
TI  - Hiring, firing and drug testing: a legal guide for the dentist as employer.

PMID- 2213865
TI  - Employee training: complying with occupational safety and health standards. 1.

PMID- 2213866
TI  - Motivating auxiliaries.

PMID- 2213867
TI  - Work stress, nonwork stress, and health.
AB  - This paper examines the interface between work stress and nonwork stress and how
      it relates to health. Results indicate that the way people feel at work is
      largely a function of conditions at work. Similarly, the way people feel outside
      of work is largely a function of things that occur outside the job. Both work and
      nonwork stress are independently associated with physical and mental health,
      although the relationship between nonwork stress and health is slightly stronger.
      Excessive demands or stresses in one domain can interfere with life in the other.
      Such conflict operates equally in both directions. When present it can be an
      added source of stress and adversely affect health. Taken together these findings
      suggest that the stress people experience at work is not simply a reflection of
      their "personal problems." This has implications for the design of health
      promotion and stress prevention programs in the workplace.

PMID- 2213868
TI  - Social and behavioral factors associated with high-risk sexual behavior among
      adolescents.
AB  - Relationships among risky sexual behaviors, other problem behaviors, and the
      family and peer context were examined for two samples of adolescents. Many
      adolescents reported behaviors (e.g., promiscuity or nonuse of condoms) which
      risked HIV or other sexually transmitted disease infection. Such risky behaviors
      were significantly intercorrelated. Consistent condom use was rare among those
      whose behavior otherwise entailed the greatest risk of infection. In both
      samples, an index of high-risk sexual behavior was significantly related to
      antisocial behavior, cigarette smoking, and illicit drug or alcohol use. Social
      context variables, including family structure, parenting practices, and friends'
      engagement in problem behaviors, were associated with high-risk sexual behavior.
      Finally, for sexually active adolescents, problem behaviors and social context
      variables were predictive of nonuse of condoms. Results were consistent across
      the two studies and regression weights held up well under cross-validation.

PMID- 2213869
TI  - Stressful life events, Type A behavior, and the prediction of cardiovascular and
      total mortality over six years. MRFIT Group.
AB  - The relationship between stressful life events and subsequent mortality and
      morbidity were determined prospectively over 6 years for 12,866 men participating
      in the Multiple Risk Factor Intervention Trial (MRFIT). Aslo evaluated was the
      impact of life events on cardiovascular outcomes for persons exhibiting and not
      exhibiting coronary prone (Type A) behavior. Subjects completed life events
      checklists at baseline and each of five annual visits. Participants were also
      administered the Jenkins Activity Survey measure of Type A behavior at baseline
      and a subsample of 3110 participants was categorized as to behavior type based on
      the structured interview assessment method. Cox proportional hazard analyses
      indicated that number of life events experienced during each of 6 years of follow
      up was unrelated to risk in the subsequent year of CHD death or fatal plus
      nonfatal MI and was inversely related to total mortality. The impact of life
      events on cardiovascular risk did not differ by behavior type category.

PMID- 2213870
TI  - The efficacy of social-influence prevention programs versus "standard care": are
      new initiatives needed?
AB  - This study evaluates the effects of a school-based smoking prevention program
      after 1 year, using school (22 middle/elementary schools, 15 high schools) as
      both the unit of randomization and the unit of analysis. The multigrade level
      (grades 6 through 9) intervention was designed to address comprehensively the
      social influence factors that encourage smoking. Teacher survey data indicated
      that treatment schools had a median of 10 classroom sessions devoted to
      tobacco/drug use education, 5 of which were the sessions designed for this
      evaluation, and control schools had also dedicated a median of 10 classroom
      sessions to tobacco/drug education. Thus, the study evaluated the incremental
      effects of the social influence intervention compared to "standard-care"
      curricula. Among those who reported smoking one or more cigarettes in the month
      prior to the intervention, there was a significant treatment effect on rate of
      smoking at one year, but no grade level, gender, or interaction effects. The 1
      year covariate-adjusted smoking rate among pretest smokers in the treatment
      schools was 76.6 cigarettes per month, compared to 111.6 cigarettes per month in
      control schools, a 31.4% difference. These effects were not accounted for by
      differential subject attrition. The analyses for nonsmokers, however, showed no
      significant effects, and the program did not affect self-reported alcohol or
      marijuana use. Taken together with the results of other prevention studies, these
      results point to the need for the development and evaluation of new initiatives
      to prevent substance use.

PMID- 2213871
TI  - Disease and symptom severity, functional status, and quality of life in chronic
      bronchitis and emphysema (CBE).
AB  - A path analysis model examined interrelationships among variables significantly
      associated with chronic dyspnea in chronic bronchitis and emphysema (CBE) and the
      relative influence of these variables on each other and on functional status and
      quality of life. Results from the 45 adults (mean age, 61) with moderate CBE
      disease severity showed that dyspnea severity has a sizable effect on functional
      status and quality of life. Disease severity was more strongly related to
      functional status than to quality of life. Depression and mastery had the
      strongest total effects on quality of life. Dyspnea severity had strong but
      separate effects on functional status and quality of life. From these preliminary
      results, it is suggested that a direct focus on psychologic interventions to
      ameliorate depression and improve mastery is likely to improve quality of life
      with some resultant positive effect on functional status.

PMID- 2213872
TI  - Dentists' technical competence, communication, and personality as predictors of
      dental patient anxiety.
AB  - Previous research has found that many factors influence patients' dental anxiety,
      many of which are related to the practitioner's technical and interpersonal
      skill. Unfortunately, a confirmatory factor analysis of scales used in dental
      anxiety research revealed numerous problems with the measurement devices. The
      Spielberger State-Trait Anxiety Inventory (STAI) split into two subscales:
      calmness and anxiety. The Corah Dental Anxiety Scale (CDAS) was unidimensional
      but was unable to detect relationships between anxiety and interpersonal or
      communication factors. Interestingly, patient satisfaction, dentist behavior, and
      empathy items did not load on independent scales, as previously reported in the
      literature. Instead, five clusters were detected: positive and negative
      communication, positive and negative interpersonalness, and perceived technical
      competence.

PMID- 2213873
TI  - Nicotine effects on biofeedback training.
AB  - Biofeedback involving hand warming has become a frequently used procedure in
      health and stress management programs. The present research examined the effects
      of smoking on the ability to learn temperature control during biofeedback
      training. Three groups of female college students were compared: groups of
      smokers who smoked prior to the biofeedback session were compared to smokers who
      did not smoke and to nonsmokers. The results showed that the greatest increase in
      skin temperature was for nonsmokers, followed by smokers who did not smoke for at
      least 1 hr before the biofeedback session. The group of smokers who smoked just
      prior to the biofeedback were not able to increase their skin temperature. The
      basal skin temperature measured before treatment was higher for smokers than
      nonsmokers. The results are discussed in terms of the paradoxical physiological
      arousing effects and the self-reported tranquilizing effects of smoking.

PMID- 2213874
TI  - Electrophysiologic monitoring of the facial nerve during basal cranial and
      posterior fossa surgeries.

PMID- 2213875
TI  - Oral contraceptive pills. Part I: Formulations, selection and common side
      effects.
AB  - Development of hormonal contraception as a safe and effective means of birth
      control has evolved during the past 50 years. The first effective oral
      contraceptive pill was Enovid which was introduced by Searle in 1960. Now, low
      dose OCP are the most popular reversible method of contraception. Some 50 million
      women worldwide and 10 million in the United States utilize them. Understanding
      effectiveness, side effects, complications, and benefits has led to substantial
      changes in these preparations. Part II of this article will be printed in the
      future. It will address serious complications and health benefits.

PMID- 2213876
TI  - What is a doctor's relative worth?

PMID- 2213877
TI  - Cocaine: a primer for providers of perinatal care.

PMID- 2213878
TI  - Government limits access to care.

PMID- 2213879
TI  - Crystallographic studies of 3-ketoacylCoA thiolase from yeast Saccharomyces
      cerevisiae.
AB  - Good diffracting crystals of 3-ketoacylCoA thiolase (EC 2.3.1.16) from yeast
      Saccharomyces cerevisiae have been obtained. The crystals diffract to at least
      2.4 A. The space group of these crystals is P2(1)2(1)2(1), with cell dimensions a
      = 71.8 A, b = 93.8 A and c = 119.9 A. There is one dimer per asymmetric unit.

PMID- 2213880
TI  - Crystallization and preliminary X-ray study of a recombinant cutinase from
      Fusarium solani pisi.
AB  - Recombinant cutinase from Fusarium solani pisi is expressed and excreted with
      very high yields in Escherichia coli cultures. Cutinase was crystallized at 20
      degrees C using the vapour diffusion technique, with polyethylene glycol 6000 as
      precipitant. Best crystals were obtained at pH 7.0 with polyethylene glycol 6000
      as precipitant. Best crystals were obtained at pH 7.0 with polyethylene glycol at
      15 to 20%. They are monoclinic, with space group P2(1) and cell dimensions a =
      35.1 A, b = 67.4 A, c = 37.05 A and beta = 94.0 degrees; they diffract beyond 1.5
      A resolution. The asymmetric unit contains one molecule of 22,000 Da (Vm = 1.98
      A3/Da; 38% water).

PMID- 2213881
TI  - Evolution of the autosomal chorion cluster in Drosophila. III. Comparison of the
      s18 gene in evolutionarily distant species and heterospecific control of chorion
      gene amplification.
AB  - We present a total of 6.1 x 10(3) base-pairs of DNA sequences, encompassing the
      s18 gene and flanking regions within the autosomal chorion cluster of three
      Drosophila species. Against a background of extensive divergence in the intron
      and even in parts of the coding region, islands of strong sequence conservation
      are evident. These are particularly notable in the 5' flanking DNA where they
      extend to approximately -600 base-pairs from the transcription start site. The
      most conserved segment of the entire chorion cluster is 71 base-pairs in the s18
      5' flanking DNA, which in D. melanogaster is part of a region defined
      functionally as containing amplification control elements (ACE3 region).
      Transformation analysis, using chimeric transposons of D. melanogaster and D.
      grimshawi DNA, revealed that amplification control elements of D. grimshawi can
      support amplification in D. melanogaster. The functionally defined ACE3 region of
      D. grimshawi includes the conserved 71 base-pair segment, but also non-conserved
      sequences further upstream, which apparently enhance amplification.

PMID- 2213882
TI  - Escherichia coli minichromosomes: random segregation and absence of copy number
      control.
AB  - Minichromosomes, i.e. plasmids that can replicate from an integrated oriC, have
      been puzzling because of their high copy numbers compared to that of the
      chromosomal oriC, their lack of incompatibility with the chromosome and their
      high loss frequencies. Using single cell resistance to tetracycline or ampicillin
      as an indicator of copy number we followed the development of minichromosome
      distributions in Escherichia coli cells transformed with minichromosomes and then
      allowed to grow towards the steady state. The final copy number distribution was
      not reached within 15 to 20 generations. If the minichromosome carried the sop
      (partitioning) genes from plasmid F, the development of the copy number
      distribution was further drastically delayed. We conclude that E. coli cells have
      no function that directly controls minichromosomal copy numbers, hence the
      absence of incompatibility in the sense of shared copy number control. We suggest
      that minichromosomes are subject to the same replication control as the
      chromosome but segregate randomly in the absence of integrated partitioning
      genes. This, combined with evidence that the lowest copy number classes are
      normally present despite high average copy numbers, can account for the high loss
      frequencies.

PMID- 2213883
TI  - Changes in conserved region 2 of Escherichia coli sigma 70 affecting promoter
      recognition.
AB  - We describe a mutation in rpoD, the gene encoding the sigma 70 subunit of RNA
      polymerase, which alters the promoter specificity of the holoenzyme in vivo. The
      mutant sigma causes a substantial and specific increase in the activity of mutant
      ant and lac promoters with a T.A to C.G substitution at position -12, the first
      position of the -10 hexamer. The rpoD mutation is a single base-pair substitution
      causing a Gln----His change at position 437, which is in a domain of conserved
      region 2.4 that is predicted to form an alpha-helix. Gln437 would lie one turn of
      the alpha-helix away from Thr440, which was previously implicated in recognition
      of position -12. The rpoD-QH437 mutation described here lends further support to
      the model that region 2.4 of sigma is involved in recognition of the 5' end of
      the -10 hexamer. In addition, two rpoD mutations with non-specific effects on
      promoter recognition are described.

PMID- 2213884
TI  - Quantitation of photochromism of sensory rhodopsin-I by computerized tracking of
      Halobacterium halobium cells.
AB  - The swimming behavior of Halobacterium halobium is controlled by light which acts
      through retinal photoreceptor proteins. The sensing of near-ultraviolet (u.v.)
      was proposed to be mediated by the thermally metastable intermediate SR-I373 that
      is formed upon orange light absorption by sensory rhodopsin-I (SR-I). In order to
      test the validity of this proposal, we analyzed the photochromic behavior of the
      functional near-u.v. receptor in situ by use of an automated cell tracking
      system. The system was specifically designed for detection of swimming reversals
      in individual cells and calibrated with a straight-swimming mutant of H.
      halobium. Quantitative analysis of the response of the cells to near-u.v.
      revealed that orange background light increased the number of active near-u.v.
      receptor molecules. The intensity-dependence of this effect fitted into the
      kinetic scheme of a photochromic receptor pigment. The half-life of the
      functional near-u.v. receptor species was determined under continuous orange
      background light and found to be similar to that of the SR-I373 intermediate of
      sensory rhodopsin-I in intact cells. These results clearly support the assignment
      of the near-u.v. receptor to SR-I373. The kind of kinetic analysis described
      here, might be a useful tool in assigning spectroscopic data of pigments to
      photoreceptor function also in other organisms.

PMID- 2213885
TI  - Cell surface changes of in situ macrophages induced by superimposed antigen.
AB  - Mice received an injection of sheep erythrocytes (SRBC) into the footpad "
      prepared" or "not prepared" with a 7-day-prior injection of a protein-bound
      polysaccharide from Coriolus versicolor (PSK; Krestin), and the ultrastructure of
      in situ macrophages was studied at various intervals after the injection. A
      single SRBC injection into the footpad induced linear cell arrangements of
      several macrophages. The macrophages showed no prominent morphological
      alterations after SRBC digestion. When PSK-stimulated subcutaneous macrophages
      were challenged by SRBC, they rapidly sent out numerous long cytoplasmic
      projections which radiated in all directions. Such projections of neighboring
      macrophages tended to contact one another. At the following stage, a pronounced
      sequential alteration was noted, characterized by the interlocking of elongated
      projections. This provided massive aggregations of "activated" macrophages. These
      observations suggest the possibility that intercellular communication among
      "activated" macrophages was elicited, particularly in the subcutaneous region,
      and maintained through an intensive interaction of cytoplasmic projections.
      Further, the present results histologically support our previous report which
      shows that the "PSK-prepared" footpad site but not the "prepared" one supports
      development of a splenic humoral immune response following injection of
      superimposed SRBC.

PMID- 2213886
TI  - Postnatal development of the skin of the marsupial native cat Dasyurus
      hallucatus.
AB  - Skin development of the Northern native cat was examined from birth to weaning at
      150 days post partum. An outer layer of cells, termed the periderm or
      epitrichium, is present on the epidermis of the newborn. This layer of cells is
      not discernible at 7 days post partum. Skin development of the native cat differs
      from that of the eutherian mammal. The periderm of the eutherian is no longer
      discernible when the developing hairs first penetrate the epidermis. In the
      marsupial, this loss of the periderm occurs well before the appearance of
      follicles. Melanocytes and Langerhans cells are seen at day 23 post partum,
      follicles at day 30, sebaceous glands at day 59, and sweat glands at day 67.
      Thus, when the mother first leaves her young in the nest at about days 60 to 70
      of lactation, the skin is at a stage of development that will assist the young
      with thermoregulation. The skin continues to develop throughout lactation and
      attains an adult appearance by day 150 post partum.

PMID- 2213887
TI  - Morphology and morphometry of motor endings on macaque intrafusal fibers.
AB  - The ultrastructural studies have shown three types of motor endings in the
      macaque intrafusal fibers: 1) unindented axon terminals with smooth or shallowly
      folded postsynaptic membrane; 2) indented terminals with few postsynaptic folds;
      and 3) indented terminals with heavily folded postsynaptic membrane. The
      terminals on bag 1 and chain fibers were generally more indented than those on
      the bag 2 fibers. Deeply indented terminals with highly folded postsynaptic
      membranes were noticed on the bag 1 and chain endings in spindles from lumbrical
      but not the biceps muscle. In the individual intrafusal fibers from the biceps
      and lumbrical spindles, the degree of indentation did not correlate with the
      extent of postsynaptic folding (P greater than .01). Endings on bag 1 and chain
      fibers in the lumbrical spindles showed a positive correlation between
      indentation of terminals and their distance from the primary sensory endings (P
      less than .01), whereas the lumbrical bag 2 endings and the biceps intrafusal
      endings did not (P greater than .01). The shape of the intrafusal motor endings
      thus is independent of their location but dependent on the type of intrafusal
      fibers.

PMID- 2213888
TI  - Nursing support of Healthy People 2000.

PMID- 2213889
TI  - National objectives for the year 2000.

PMID- 2213890
TI  - ATPO's support of Healthy People 2000. Association of Technical Personnel in
      Ophthalmology.

PMID- 2213891
TI  - Health promotion and disease prevention in ophthalmology.
AB  - There is a new trend in the US government's perception regarding health care
      today. It involves an increased awareness of how disease can be prevented and
      health promoted. The US government is supporting this concept with its Healthy
      People 2000 project. Specific pediatric concerns about health promotion and
      disease prevention in ophthalmology include amblyopia and strabismus, ophthalmia
      neonatorum, ocular trauma, radiation injury, xerophthalmia, herpes simplex,
      herpes zoster, infections and metabolic and genetic disorders. Adult health
      promotion/disease prevention priorities include glaucoma; trauma; diabetic
      retinopathy; corneal problems; iatrogenic infections; exposure keratitis; ocular
      toxicity from drugs, chemicals, and the environment; visual loss from neglect;
      and those mentioned in the pediatric area.

PMID- 2213892
TI  - The importance of early detection of diabetic retinopathy.
AB  - Diabetic retinopathy is the leading cause of blindness among people of ages 20 to
      44 and is the second leading cause of blindness between the ages of 45 to 74.
      Most patients are unaware of the changes within their eyes. Primary medical
      providers caring for diabetic patients should receive greater training in fundus
      examination techniques and the recognition of significant retinopathy. Primary
      medical providers should be encouraged to perform fundus examinations at 6-month
      or annual routine examinations of all diabetics, and be made aware of the value
      of detection and treatment of high risk eyes.

PMID- 2213893
TI  - Partners in prevention.
AB  - The National Society to Prevent Blindness, formed in 1908, is the oldest
      voluntary agency with the singular mission to preserve sight and prevent
      blindness through a broad program of public and professional education,
      industrial and community services, and research. The interventions used by NSPB
      to prevent blindness and preserve sight include awareness and advocacy efforts,
      education, community services, information, and referral. The process for
      planning and implementing blindness prevention programs parallels the nursing
      process and the scientific method. It begins with the identification of local
      needs and resources and is followed by establishing objectives and methods to
      achieve them.

PMID- 2213894
TI  - Glaucoma screening.
AB  - The ability to screen for any disease is based on several factors (established
      natural history, high prevalence rates, effective treatment, and available
      screening tests); however, the earliest psychosocial, clinical, or
      electrodiagnostic changes in glaucoma are presently unknown. Public awareness of
      glaucoma must be increased. Mass screenings not only aid in the detection of
      disease, but through their promotion by the local media, they also assist in
      augmenting the general public's awareness of eye health. The future of more
      effective screening may lie in more objective or automated testing that could be
      performed by lesser trained personnel.

PMID- 2213895
TI  - The Bright Eyes Project: a 20-year effort to prevent blindness.
AB  - The Bright Eyes Project is a unique collaboration between medicine, public
      government, and a non-profit society. The project was prompted by concern that
      there was a high prevalence of undetected or untreated eye problems in the
      elderly. The objective was to detect ocular pathology, especially in those
      patients not currently receiving eye care. The project succeeded in providing a
      mechanism for free full ophthalmic examinations to the elderly at risk. In
      addition, the vast numbers seen in the project provide valuable statistics on
      common eye pathology in the individuals over 55 years of age.

PMID- 2213896
TI  - Prevention of sports injuries.
AB  - The eye care professional has the responsibility to advise the patient of
      potential eye injuries in sports and the available methods of protection against
      injury. Polycarbonate is the lens material of choice, both plano and for
      prescription eye wear for athletes and other active people. Those who fabricate
      and dispense eye wear must be aware of the need for safety eye wear and advise
      patients appropriately. They should stock and distribute the material at
      reasonable prices.

PMID- 2213898
TI  - Noncontact tonometry.

PMID- 2213897
TI  - The nursing role in epidemiology, risk management, and patient-public education.
AB  - Epidemiology encompasses the identification of infectious disease, the vectors of
      transmission, the sources of contamination, the patient population exposed or
      involved, containment practices, and preventative measures to stop further
      transmission of the disease. Epidemic keratoconjunctivitis is a common infectious
      disease in ophthalmology. It can be contracted from interpersonal exposure,
      contact with contaminated items, or iatrogenic transmission from the health-care
      settings and providers. The interview process, plus patient education, is the
      method of epidemiologic assessment that acts as the format to dealing with the
      epidemic.

PMID- 2213899
TI  - Where have all the dropouts gone?

PMID- 2213900
TI  - Is the increased incidence of primary malignant brain tumors in the elderly real?

PMID- 2213901
TI  - Have transurethral resections contributed to the increasing incidence of
      prostatic cancer?

PMID- 2213902
TI  - Increasing annual incidence of primary malignant brain tumors in the elderly.
AB  - Between 1973 and 1985, total age-adjusted cancer incidence in the United States
      (all races, men and women) rose by 10.7%, with an average annual percentage
      change of +0.9%. Analysis of reported age-specific incidence of primary malignant
      brain tumors over the same years demonstrates that incidence rates increased
      dramatically between 1973/1974 and 1985. In 1985, incidence rates for persons
      aged 75-79, 80-84, and 85 years of age and over were 187%, 394%, and 501%,
      respectively, of rates in 1973/1974. Similar increases were found in both men and
      women, analyzed separately and combined. Average annual percentage changes in
      primary brain tumor incidence were +7.0%, +20.4%, and +23.4% in these age ranges,
      respectively. Reported incidence in younger persons varied little over the same
      period of time. The most common histologic type of primary brain tumor in the
      elderly was of glial origin, predominantly the glioblastoma multiforme and
      astrocytoma. These tumors are highly malignant and invariably fatal. Two possible
      causes may explain the increased incidence in the elderly: the introduction and
      extensive use of x-ray computed tomography since 1973 and/or a true increase in
      incidence occurring independently of diagnostic advances.

PMID- 2213903
TI  - Rise in prostatic cancer incidence associated with increased use of transurethral
      resection.
AB  - We examined the association between prostatic cancer incidence rates and the
      rates of transurethral prostatectomy to explore reasons for the nationally
      reported dramatic increases in incidence rates of prostatic cancer from 1973
      through 1986. There was a strong correlation between both incidence of all stages
      of prostatic cancer combined and of localized disease and the increasing use of
      transurethral resection, a common surgical procedure usually performed to relieve
      urinary obstruction due to benign enlargement of the prostate. Our analyses
      suggest that increased detection of existing tumors via transurethral resection
      was the primary reason for the observed increase in incidence rates of prostatic
      cancer. However, analyses of mortality trends, particularly among nonwhites, and
      laboratory studies of the histologic nature of clinically asymptomatic tumors
      suggest that part of the increase may reflect changes in the real risk of
      prostatic cancer.

PMID- 2213904
TI  - Methionine dependency of malignant tumors: a possible approach for therapy.
AB  - When methionine (Met), an essential amino acid, was substituted for by its
      precursor homocysteine (Hcy) in the culture medium, normal cells such as
      fibroblasts proliferated normally. In contrast, many tumor cells failed to grow
      or grew at a lower rate. Met dependency is acquired simultaneously with cell
      transformation, as observed with HBL 100, a human mammary epithelial cell line
      that acquired increased malignancy as a function of in vitro passage number, and
      NIH/3T3 (J10), a mouse fibroblast line transformed by transfection with the human
      HRAS oncogene. A relationship was observed between Met dependency and metastatic
      potential of the RMS-21, RMS-S4T, and RMS-J1 sublines derived from RMS-0, a rat
      rhabdomyosarcoma cell line: the higher the metastatic potential of the cell line,
      the higher the concentration of Met required to maintain its proliferation. Met
      independent cells derived from the RMS-0 line, obtained by a progressive decrease
      of Met in the culture medium lost their tumorigenicity when injected into rats
      fed with Met-deprived diets. In addition, the in vitro motility of RMS-S4T tumor
      cells, a marker of metastatic capability, decreased in Met-free Hcy-complemented
      (Met- Hcy+) medium. Similarly, RMS-0 tumor cells, preincubated in a Met- Hcy+
      culture medium for 24 hours, evidenced a decreased capacity to form lung colonies
      when injected into syngeneic rats: the median number of lung colonies was 27 and
      3 (P less than .05) for cells cultivated in Met+ Hcy- and Met- Hcy+ media,
      respectively. An amino acid-defined mixture reproducing casein composition was
      used as a protein source in the diets fed to RMS-J1 tumor-bearing rats. Dietary
      substitution of Hcy for Met (i.e., met deprivation) resulted in decreased tumor
      growth (from 44.4 +/- 1.0 to 40.6 +/- 1.4; P less than .05) and prevention of
      metastatic spread (from 37 to 0; P less than .05). In conclusion, exogenous Met
      can be substituted for Hcy to maintain the survival of normal cells but is
      essential for tumor cell growth in vivo as well as in vitro. Therefore, this
      defect of cancerous versus normal cells could be used for a therapeutic purpose.

PMID- 2213905
TI  - Low metastatic potential of clone from murine colon adenocarcinoma 26 increased
      by transfection of activated c-erbB-2 gene.
AB  - We investigated the effect of an activated c-erbB-2 gene (also known as ERBB2) on
      metastatic potential. The c-erbB-2 gene was activated by mutation of the valine
      at position 659 within the transmembrane domain to glutamic acid. The activated c
      erbB-2 expression vector was transfected into low-metastatic-potential NL-4
      cells, which were established from a metastatic variant of murine colon
      adenocarcinoma 26. All 10 clones produced lung metastases in BALB/c mice injected
      via the tail vein. Eight of the 10 clones expressed messenger RNA (mRNA) of
      activated c-erbB-2 and showed morphological alteration; seven of the eight
      produced significantly enhanced experimental metastatic activity compared with
      that of untransfected NL-4 or NL-4neo cells, and one had metastatic ability
      similar to that of NL-4 cells. Two clones did not express c-erbB-2 mRNA and did
      not show morphological alteration or highly metastatic phenotype. Five of the 10
      clones subcutaneously implanted in the flank failed to produce metastasis in the
      lungs or other organs of the mice. The metastatic ability of the other five
      clones was not determined. These results indicate that the activated c-erbB-2
      gene can enhance experimental but not spontaneous metastatic potential in NL-4
      cells, suggesting participation of the gene in the metastatic process after
      initial arrest and lodgement in the capillary bed.

PMID- 2213907
TI  - Realism myth or fantasy?

PMID- 2213906
TI  - Unexplained excess risk of bladder cancer in men.
AB  - In nearly all populations studied, the risk of bladder cancer is two to four
      times as great in men as in women. We estimated what the gender-specific
      incidence rates would be in the absence of exposure to known carcinogenic
      factors. The data used were obtained from interviews with 2,806 white individuals
      with bladder cancer and 5,258 white controls in the National Bladder Cancer Study
      and from incidence data for 1978 from the National Cancer Institute Surveillance,
      Epidemiology, and End Results Program. The total age-adjusted incidence of
      bladder cancer was 27.5 cases per 100,000 person-years for men and 7.0 for women,
      yielding a ratio of 3.9. Even in the absence of exposure to cigarettes,
      occupational hazards, or urinary tract infection, the gender-related risk
      persisted; the incidence of bladder cancer was 11.0 in men and 4.1 in women,
      yielding a ratio of 2.7. Possible explanations for the excessive risk in men
      include environmental and dietary exposures not yet identified and innate sexual
      characteristics such as anatomic differences, urination habits, or hormonal
      factors.

PMID- 2213908
TI  - Tumor infiltrating lymphocytes.

PMID- 2213909
TI  - Health and smoking: a national status report.

PMID- 2213910
TI  - Evolving perspectives on the exposure risks from magnetic fields.
AB  - Based on information from suggesting effects of positive and negative polarity on
      cancer cells, surveys were performed on magnetic resonance imaging devices, as
      well as other types of equipment capable of producing appreciable magnetic
      fields. These surveys were performed in areas where there was a potential for
      both occupational and general public exposure.

PMID- 2213911
TI  - Survey of nonphysician tasks performed by medicine residents at a municipal
      hospital.
AB  - In June 1988, the New York State Hospital Review and Planning Council approved
      major revisions in the state hospital code (Part 405). Among the most
      controversial of these changes were the recommendations of the Bell Commission
      concerning limitations on resident work hours, new emergency service
      requirements, and enhancements in ancillary staffing. The ancillary staffing
      mandated by the new code regulations for teaching hospitals include the provision
      at all times of intravenous services, phlebotomy services, messenger services,
      transport services, nurses aides, housekeeping services, and other ancillary
      support in a manner sufficient to meet patient care needs and to prevent adverse
      impact on the delivery of medical and nursing care. The intent of the new health
      code requirements is to reduce or eliminate many of the nonphysician tasks
      performed by residents so as to effectively reduce their workload. We conducted a
      survey of Medicine residents at Queens Hospital Center to assess the amount of
      time they presently devote to nonphysician tasks, their perceptions of the need
      for ancillary staff to relieve them of the burden of these nonphysician tasks,
      and their evaluation of the effectiveness of a recently instituted intravenous
      therapy team.

PMID- 2213912
TI  - Burn injuries during pregnancy: an African series.
AB  - Seven pregnant women aged 20 to 30 years were among the burn patients treated at
      Ahmadu Bello University Hospital in Zaria, Nigeria. Five suffered flame burns and
      two were scalded. The burned surface area ranged from 4% to 80%. One patient was
      in the first trimester, two in the second, and four in the third. Six (86%) of
      the mothers and five (71%) of the fetuses survived.

PMID- 2213914
TI  - Patient "dumping".

PMID- 2213913
TI  - The significance of gallstones in children with sickle cell anemia.
AB  - Infection is the most common cause of high morbidity, hospitalization, and
      mortality in children with sickle cell anemia. In this study of pediatric sickle
      cell anemia patients, aged 1 to 19, we explore the hypothesis that gallstones
      (usually pigment stones) create a nidus of infection, predisposing the affected
      patients to high morbidity. Our study involved 86 children with sickle cell
      anemia at the Howard University Center for Sickle Cell Disease, who had been
      followed at the clinic for a total of 602 patient years. Review of their records
      revealed that patients with gallstones had a mean number of 10.24
      hospitalizations and 25.35 ambulatory visits; those without gallstones had a mean
      number of only 4.26 hospitalizations and 13.41 ambulatory visits. In children
      with sickle cell anemia and gallstones, elective cholecystectomy (or, in the
      future, cholelithotripsy) could reduce the high morbidity caused by infection.

PMID- 2213915
TI  - Black Americans in crisis.

PMID- 2213916
TI  - Thoracolumbar compression fractures presenting with an acute ileus.
AB  - Corticosteroids are commonly used in the treatment of connective tissue diseases
      such as systemic lupus erythematosus. Although they are usually efficacious,
      osteoporosis leading to spine compression fractures is not uncommon. In this case
      report, we describe an elderly patient with systemic lupus erythematosus on long
      term corticosteroid therapy who presented with symptoms of acute abdomen with
      minimal low back symptoms. No intraabdominal process was found by abdominal
      studies and exploratory laparotomy. Increased lower back symptoms led to further
      skeletal spine studies, which initially demonstrated a compression fracture at
      the twelfth thoracic (T12) vertebra. Later, a T8 and a fourth lumbar (L4)
      compression fracture were also found. Her abdominal and lower back symptoms
      resolved on conservative therapy. Although the rate of these occurrences are
      unknown, compression spine fractures should be considered in elderly patients
      presenting with acute abdomen after being on long-term corticosteroid therapy.

PMID- 2213917
TI  - Tardive dyskinesia successfully treated with alprazolam.
AB  - Tardive dyskinesia is a disorder secondary to prolonged treatment (from 18 months
      to 3 years) with antipsychotic agents, affecting approximately 15% to 20% of
      patients. Tardive dyskinesia is characterized by difficulty controlling
      involuntary movements of the small muscle groups, producing tic-like reactions,
      muscle rigidity, and difficulty maintaining muscle tone. It is a chronic and
      unrelenting disorder which may be permanent if not successfully treated. The
      mechanism of action is thought to be secondary to dopamine hypersensitivity
      resulting from prolonged deprivation of dopamine on the part of dopamine
      sensitive receptors. Theoretically, these receptors have been deprived of the
      neurotransmitter by chronic treatment with antipsychotic drugs, which are
      recognized as dopamine-blocking agents. We present a case in which alprazolam was
      successfully used in treating tardive dyskinesia.

PMID- 2213918
TI  - Selenium status in workers handling aromatic nitro-amino compounds in a chemical
      factory.
AB  - The selenium status of workers handling aromatic nitro-amino (ANA) compounds was
      evaluated by measurement of their blood and urinary selenium concentrations and
      blood glutathione peroxidase (GSH-Px) activities. Forty-seven healthy Japanese
      male workers (42.7 +/- 12.1 yr) handling ANA compounds routinely in a chemical
      factory were studied as exposed workers, and 107 nonindustrial healthy Japanese
      males (39.3 +/- 10.0 yr) in the same region served as a control group. Urinary
      diazoreaction-positive metabolites and methemoglobin, both of which have been
      used as indices of exposure to ANA compounds, were significantly elevated in the
      exposed workers. Both plasma and erythrocyte selenium in the exposed workers
      showed 20% lower values compared to the control group. GSH-Px activities in
      plasma and erythrocytes were also significantly decreased in the exposed workers,
      but urinary selenium excretions were similar between the two groups.
      Questionnaire information obtained from each subject regarding intake habits of
      selenium-rich foods (bread, eggs, meat, and fish) indicated that the average
      dietary selenium intake was similar for the control group and the exposed
      workers. These results indicate that (1) the workers handling ANA compounds were
      surely exposed to these chemicals; (2) their selenium status was lower than that
      of the nonindustrial controls; and (3) the low selenium status was not associated
      with any dietary factor.

PMID- 2213919
TI  - Urinary mutagens in municipal refuse incinerator workers and water treatment
      workers.
AB  - Municipal refuse incineration workers may be exposed to mutagenic compounds from
      gaseous and particulate emissions and during ash removal operations. The
      frequency of urinary mutagens was measured by the Ames test among a sample of 104
      refuse incinerator workers in seven incinerator plants during March-May 1988. The
      frequency was compared to that observed in 61 water treatment employees in 11
      municipal water treatment facilities during the same period. Incinerator workers
      had a significantly higher risk for urinary mutagens and promutagens as compared
      to water plant workers after controlling for age. Among incinerator workers,
      increased risk of having urinary mutagens was associated with workers who wore
      protective clothing (defined as clothing other than masks or gloves) or whose job
      classification was equipment repair. It also showed a weak positive association
      with increasing age. There was an increased risk of urinary promutagens
      associated with not wearing gloves. The presence or absence of mutagenicity in
      workers' urine varied with plant location. Incinerator operating conditions
      affecting the production of toxicants and mutagens are discussed and the results
      of other studies involving toxicant exposure of humans near incinerators are
      cited.

PMID- 2213920
TI  - Effects of chlorine dioxide on the developing rat brain.
AB  - Male and female Long-Evans rat pups, exposed to an oral dose of 14 mg chlorine
      dioxide (CIO2)/kg/d (postnatal d 1-20), were examined for effects on brain
      development and for changes in thyroid activity. Body weight reductions were
      observed on postnatal (pn) d 11, 21, and 35. Forebrain weight and protein content
      were decreased on pnd 21 and 35, as were the DNA content on d 35 and the number
      of dendritic spines on cerebral cortical pyramidal cells, a marker for synapse
      formation. Otherwise, cell proliferation in the forebrain, cerebellum, and
      olfactory bulbs was normal, as were migration and aggregation of neuronal cells
      in three areas of the cerebral cortex. Histopathology of the forebrain,
      cerebellum, and brainstem showed no gross lesions, loss of myelin, or change in
      the cells staining positive for Nissl substance. Serum T3 and T4 levels, as well
      as hepatic mitochondrial alpha-glycerophosphate dehydrogenase activity, were
      unchanged by CIO2 treatment. The results indicated that CIO2 may have central
      neurotoxic potential. No underlying antithyroid activity was evident.

PMID- 2213921
TI  - Exposure to low levels of hydrogen sulfide elevates circulating glucose in
      maternal rats.
AB  - Although the lethal effect of hydrogen sulfide (H2S) has long been known, the
      results of exposure to low levels of H2S have not been well documented. Rat dams
      and pups were exposed to low levels of H2S (less than or equal to 75 ppm) from d
      1 of gestation until d 21 postpartum and analyzed for changes in circulating
      enzymatic activity and metabolites. Blood glucose was significantly elevated in
      maternal blood on d 21 postpartum at all exposure levels. This increase in
      glucose was accompanied by a possible decrease in serum triglyceride in the pups
      and in the dams on d 21 postpartum. There was no evidence of alterations in serum
      alkaline phosphatase, lactate dehydrogenase, or serum glutamate oxaloacetate
      transaminase.

PMID- 2213922
TI  - Surface morphology and morphometry of rat alveolar macrophages after ozone
      exposure.
AB  - As the ultrastructural data on the effects of ozone on pulmonary alveolar
      macrophages (PAM) are lacking, transmission (TEM) and scanning (SEM) electron
      microscopy were performed on rat PAM present in alveolar lavages following
      exposure to ozone. Rats were continuously exposed for 7 d to ozone concentrations
      ranging from 0.25 to 1.50 mg/m3 for 7 d followed by a 5-d recovery period.
      Additionally, morphometry on lung sections was performed to quantitate PAM. In a
      second experiment rats were continuously exposed to 1.50 mg O3/m3 for 1, 3, 5, or
      7 d. To study the influence of concurrent ozone exposure and lung infection, due
      to Listeria monocytogenes, rats were exposed for 7 d to 1.50 mg O3/m3 after a
      Listeria infection. The surface area of lavaged control PAM was uniformly covered
      with ruffles as shown by SEM and TEM. Exposure to 0.5 mg ozone/m3 for 7 d
      resulted in cells partly covered with microvilli and blebs in addition to normal
      ruffles. The number of large size PAM increased with an increase in ozone
      concentration. After 1 d of exposure, normal-appearing as well as many small
      macrophages with ruffles and scattered lymphocytes were seen. Lavage samples
      taken after 5 or 7 d of exposure showed an identical cell composition to that
      taken after 3 d of exposure. After Listeria infection alone, lavage samples
      consisted of mainly lymphocytes and some macrophages. Small quantitative changes,
      such as an increase in the number of polymorphonuclear neutrophils and large-size
      PAM, occurred in lavages after ozone exposure and infection with L.
      monocytogenes. Morphometric examination of lung sections revealed a concentration
      related increase in the number of PAM, even in animals exposed to 0.25 mg
      ozone/m3 for 7 d. Centriacinar regions were more severely affected than other
      regions of lung tissue. By 5 d after termination of exposure to ozone, the number
      of lysozyme-positive alveolar cells was still significantly increased in
      centriacinar areas of the lung. The results indicate that ozone exposure causes
      major changes in the number, size, and surface morphology of PAM in rat lung.
      Furthermore, the results presented here suggest that changes in alveolar
      macrophage function are reflected by morphological changes.

PMID- 2213923
TI  - Inhibition of replicative DNA synthesis and induction of DNA repair in human
      fibroblasts by the intercalating drugs proflavine and 9-aminoacridine.
AB  - The induction of unscheduled DNA synthesis (UDS) and the alteration of
      semiconservative DNA replication by the structurally related intercalating agents
      proflavine and 9-aminoacridine were studied in MRC-5 human fibroblasts in
      culture. Autoradiographic determinations of both parameters were carried out
      simultaneously in the same culture specimens. Proflavine affected DNA synthesis,
      but did not elicit any UDS. 9-Aminoacridine inhibited DNA synthesis only at the
      highest concentration and caused UDS to a low but significant extent. These
      results suggest that the ability to induce UDS is not a general property of the
      intercalating agents and that the alterations of the DNA structure, typical of
      the "pure" intercalative process, are not handled by pathways involving
      unscheduled synthesis.

PMID- 2213924
TI  - Chlorinated hydrocarbon insecticides in Colorado beef cattle serum--a pilot
      environmental monitoring system.
AB  - A pilot project was initiated to test an existing animal disease surveillance
      system for use in monitoring environmental pollutants. Eleven chlorinated
      hydrocarbon insecticides were assayed to provide an indication of environmental
      contamination. A total of 241 bovine serum samples from 53 Colorado beef ranches
      was tested; 123 samples (51%) were found to contain detectable concentrations of
      1 or more of 11 chlorinated hydrocarbons. There were a total of 203 occurrences
      of a compound being found at a level exceeding the detection limit. Heptachlor,
      heptachlor epoxide, lindane, and oxychlordane were the insecticides detected most
      frequently in bovine sera. This pilot study supports the use of domestic food
      producing animals as sentinels of environmental contamination with insecticides.

PMID- 2213925
TI  - Effect of acute exposure to boric acid on the male reproductive system of the
      rat.
AB  - Adult male rats were dosed orally on d 0 with 0 or 2000 mg/kg of boric acid and
      killed on posttreatment d 2, 14, 28, and 57, or dosed with 0, 250, 500, 1000, or
      2000 mg/kg of boric acid and killed on posttreatment d 14. At d 14, atypical
      structures that appeared to be enlarged irregular cytoplasmic lobes of Step 19
      spermatids were observed in Stage VIII seminiferous tubules of rats dosed with
      1000 and 2000 mg/kg. Abnormal retention of Step 19 spermatids and residual bodies
      was also observed in Stage IX-XIII tubules of these rats. The retained spermatids
      and residual bodies were seen in both the luminal and basal regions of the
      epithelium. A substantial increase in the testicular sperm head count occurred in
      animals dosed with 2000 mg/kg. Abnormal caput epididymal sperm morphology and
      reduced caput epididymal sperm reserves were observed at 1000 mg/kg and higher.
      Serum LH, FSH, TSH, and prolactin values were not affected at any dosage. At d
      28, rats dosed with 2000 mg/kg exhibited continued retention of Step 19
      spermatids into Stage X, abnormal caput and cauda sperm morphology, and decreased
      percentages of motile cauda spermatozoa with reduced straight-line swimming
      velocities. By d 57 substantial recovery was apparent; some retention of Step 19
      spermatids into Stage X tubules was still present in two out of six rats but the
      sperm parameters were comparable to controls. The study indicated that acute oral
      exposure to boric acid adversely affected spermiation and sperm quality in the
      adult male rat. At the dosages used the effects appeared reversible. The no
      effect level was 500 mg/kg.

PMID- 2213926
TI  - Effects of trifluoroacetic acid, a halothane metabolite, on C6 glioma cells.
AB  - Effects of trifluoroacetic acid (TFA) on cell growth, DNA, glycoprotein, and
      dolichol-linked oligosaccharides synthesis and ribonucleotide triphosphate
      concentrations were examined in exponentially growing C6 murine glioma cells. One
      day of treatment with TFA caused a slight concentration-dependent enhancement of
      cell growth and [3H]thymidine incorporation. Exposure for 1 or 5 d to TFA (0.5
      7.0 mM) elevated the [3H]leucine incorporation in a dose- and time-dependent
      manner. The results suggested that TFA stimulated cell growth and enhanced
      protein synthesis. TFA also affected [3H]mannose incorporation into glycoproteins
      and dolichol-linked oligosaccharides in a dose-dependent fashion. In addition, it
      was found that TFA accelerated lectin-induced cell agglutination. These data
      suggest that TFA, the principle halothane metabolite, alters plasmalemmal
      glycoprotein synthesis. These findings should form a basis for further
      understanding on the mechanism underlying halothane-associated neurotoxicity.

PMID- 2213927
TI  - Factors affecting levels of DDT and metabolites in human breast milk from
      Kwazulu.
AB  - Concentrations of p,p'-DDT, p,p'-DDE, and p,p'-DDD have been determined in breast
      milk of mothers residing in two different areas of KwaZulu. Annual
      intradomiciliary application of DDT was used for the interruption of malaria
      transmission in one area, while the other served as the control. Milk from
      mothers living in DDT-treated dwellings had significantly higher mean levels of
      DDT and metabolites (mean sigma DDT 15.83 mg kg-1 in milk fat) than those from
      the control area (0.69 mg kg-1). The highest recorded sigma DDT value was 59.3 mg
      kg-1 (milk fat). Primiparous mothers from the malarious area had significantly
      more sigma DDT and metabolites (sigma DDT 24.82 mg kg-1) than multiparous mothers
      from the same area (mean 12.21 mg kg-1). Parity was the best predictor of DDT in
      breast milk of the exposed group. The percentage DDT and the sigma DDT increased
      significantly with an increase in parity. The same, but not significant, trend
      was also found for the control group. It was hypothesized that the increase in
      percentage DDT that occurred with higher parities was due to the uptake of DDT
      and elimination via milk. This process was faster than the uptake and endogenous
      formation of DDE. Designing predictive models using multiple regression was not
      very successful. The recorded levels do not represent an appreciable health risk
      to the mothers. From the literature it was deduced that at the recorded levels, a
      well-founded risk to the infants, particularly the firstborns, exists in sprayed
      areas.

PMID- 2213928
TI  - Progress in characterizing anatomic injury.
AB  - A three-valued description of anatomic injury is presented. Anatomic profile (AP)
      components A, B, and C summarize serious injuries (greater than AIS 2) to the
      head/brain or spinal cord; to the thorax or front of the neck; and all remaining
      serious injuries. Relationships between AP components and survival rate reaffirm
      the seriousness of head injury. Logistic function models relating AP components
      and the Injury Severity Score (ISS) to survival probability were based on 20,946
      Major Trauma Outcome Study (MTOS) patients (9.2% mortality rate) submitted
      through 1986. Model performance comparisons were based on 5,939 MTOS patients
      (7.8% mortality rate) submitted during 1987. The AP better discriminated
      survivors from nonsurvivors and provided a 31% increase in sensitivity when
      compared with the ISS. Neither the ISS nor the AP alone reliably predict patient
      outcome. The predictive power of methods for estimating patient survival
      probability which include physiologic indices or profiles, patient age, and an
      anatomic profile should be compared with current methods. The AP, which is based
      on the severity and location of all serious injuries, provides a more rational
      basis for comparing patient samples than the ISS.

PMID- 2213929
TI  - Injured drivers and alcohol use: culpability, convictions, and pre- and post
      crash driving history.
AB  - The culpability, crash-related traffic convictions, and pre- and post-crash
      driving records of a group of injured impaired (blood alcohol level greater than
      80 mg/dl) drivers (N = 58) who were admitted to a Level I trauma center were
      compared with a group of admitted unimpaired drivers (N = 92). Both groups of
      drivers were 21 years of age or older, sustained moderate injuries (defined as
      having no injury of the brain, spinal column or cord, extremity, or pelvis with
      an Abbreviated Injury Score of greater than 2), and were discharged home. In the
      140 crashes in which culpability was clearly defined, the impaired drivers caused
      a significantly greater percentage of their crashes (92.7%) compared to
      unimpaired (64.7%) drivers (p less than 0.001). Of the 55 unimpaired drivers who
      were considered culpable of causing their crashes, 12.7% received a traffic
      conviction compared with 39.2% of the 51 culpable impaired drivers. The mean
      number of total pre-crash traffic violations was higher for impaired drivers than
      for unimpaired drivers (p less than 0.01). While the mean number of total post
      crash convictions for unimpaired and impaired was not significantly different,
      the mean number of pre- and post-crash alcohol convictions was significantly
      higher for impaired drivers compared to unimpaired drivers (p less than 0.02).
      The data suggest that injury protects from legal prosecution and does not alter
      impaired driving practices.

PMID- 2213930
TI  - The effect of prehospital fluids on survival in trauma patients.
AB  - The effect of prehospital intravenous fluids upon survival was studied in 6,855
      trauma patients. Mean prehospital time was 36 minutes in both the group of
      patients who received fluids and the group that did not. The volume of fluid
      administered was not significantly different in the group who survived compared
      to those who died. Eighty-five per cent of the patients had an Injury Severity
      Score (ISS) less than 25 and the mortality rate in the 56% of patients in this
      group who received fluids was similar to that of the patients who did not receive
      fluids (0.7% vs. 0.5%). Twelve per cent of the patients had an ISS between 25 and
      50. Sixty per cent of these patients received fluids and the mortality rates were
      similar to the patients who received fluids compared to those who did not (23%
      vs. 22%). Three per cent of patients had an ISS of greater than 50 and the
      mortality rate was highest in this group but was not influenced by the
      administration of fluids (90% vs. 86%). Comparison of groups with similar
      probability of survival according to the TRISS methodology also failed to show an
      influence of fluid administration on survival. The mortality rate in patients
      with an initial systolic blood pressure (BP) of 90 torr or greater was compared
      to the rate in patients with an admission BP less than 90 torr. Although
      hypotension was associated with a significantly higher mortality rate, the
      administration of fluids had no influence on this rate.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2213931
TI  - The prophylactic use of antibiotic impregnated beads in open fractures.
AB  - Four hundred four compound fractures were reviewed in 339 patients treated
      between August 1983 and November 1987. The 252 males and 87 females had a mean
      age of 33 years (range, 14-86). One hundred twenty-seven (31.4%) fractures were
      classified as Grade I, 153 (38.9%) as Grade II, and 124 (30.7%) as Grade III by
      Gustilo's classification. The mean Injury Severity Score was 15 (range, 9-57).
      Three hundred thirty-four of the open fractures (82.7%) were managed with
      antibiotic-impregnated bead chains (tobramycin) and systemic antibiotic
      prophylaxis (cefazolin, tobramycin, and penicillin). Seventy open fractures
      (17.3%) received systemic antibiotic prophylaxis (cefazolin, tobramycin, and
      penicillin) without supplemental use of the antibiotic beads. All open fractures
      underwent acute irrigation and debridement. In the 404 fractures 46.5% of wounds
      were closed primarily, 12.9% underwent delayed primary closure, 7.9% were left
      open, and 32.7% were temporized by the antibiotic bead pouch technique until
      definitive flap coverage and skin grafting were performed. Of the 404 fractures
      evaluated, 17 (4.2%) developed an acute wound infection. Of these wound
      infections, eight (11.4%) were in the group managed with systemic antibiotics
      alone. By comparison, nine (2.7%) of open fractures treated with combined
      systemic antibiotics and antibiotic-impregnated beads developed an infection.
      Chronic osteomyelitis developed in 18 of 404 open fractures (4.5%). Ten (14.3%)
      open fractures which developed osteomyelitis were managed with systemic
      antibiotics whereas eight (2.4%) fractures managed with systemic antibiotics and
      antibiotic-impregnated beads developed a chronic infection.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2213932
TI  - Blunt trauma in adults and children: a comparative analysis.
AB  - Trauma remains the major cause of death in children and young adults. Adult and
      pediatric patients differ significantly in both mechanism of and physiologic
      response to injury. We reviewed the records of all consecutive adult and
      pediatric blunt trauma patients admitted to a major metropolitan trauma center
      for a 10-year period. An extensive computerized database has been maintained for
      all patients since 1977. A comparative statistical analysis of mechanism of
      injury, specific organ injury, and clinical outcome was performed. Altogether,
      1,722 adults and 289 children were treated during the study period. Blunt trauma
      accounted for 82.8% of adult and 94.3% of pediatric injury (p = 0.00005), and
      only these patients were considered for analysis. Diagnostic peritoneal lavage
      was performed in 249 children and 1,464 adults, with a respective accuracy of
      99.6% and 97.2%. Mechanism of injury was comparable for both groups, although
      children were far more likely to be injured by falls, bicycle accidents, or
      struck by an automobile. Comparative analysis of specific injuries demonstrated
      significantly fewer pediatric chest (p = 0.001), spine (p = 0.03), and pelvic (p
      = 0.003) injuries. Central nervous system (CNS) injury in children was a strong
      determinant of outcome: serious pediatric CNS trauma was associated with a
      tenfold increase in mortality. Mortality for children in the absence of CNS
      injury was less than 3%. Spinal injury also appeared to be a predictor of poor
      outcome in the pediatric population, with an associated mortality of greater than
      50%. Overall, survival was age independent (82.5% of adults and 85.8% of children
      were survivors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2213933
TI  - Alcohol intoxication, injuries, and dangerous behaviors--and the revolving
      emergency department door.
AB  - Suicides, homicides, motor vehicle crashes, and other violent deaths and injuries
      are linked inextricably to alcoholism. The association of injury and alcoholism
      should be particularly obvious to Emergency Department (ED) physicians. We sought
      to determine the extent to which intoxicated patients in an ED were properly
      diagnosed, counselled, and referred for substance abuse care. We reviewed the
      charts of 153 consecutive patients seen in a teaching hospital ED who had blood
      alcohol levels above 100 mg%. Most were male (70%), white (62%), young (mean age,
      34 years) and severely intoxicated (mean BAL, 245; range, 109-558 mg%). Forty-six
      per cent of visits were for trauma; half of the patients were victims of violent
      assaults. The intoxicated patients received extensive medical and surgical
      management: an average of five tests or X-rays were performed per patient; 75%
      received at least one medication; at discharge 48% were referred for followup to
      medical or surgical clinics. In contrast, few patients were evaluated for
      dangerous behaviors or referred for treatment of alcoholism: only 19 patients
      (12.5%) were asked about depression, suicide, or homicide; 15% were advised to
      stop drinking; 13% received a referral to a psychiatrist, mental health worker,
      or alcohol rehabilitation facility. Forty-seven per cent of patients received
      "stat" intravenous thiamine (although the Wernicke-Korsakoff syndrome is rare).
      In contrast, only 16% received a stat on-site psychiatric consultation (although
      dangerous behaviors are common in alcoholics). There was a strong, statistically
      significant negative association between the occurrence of an injury and the
      decision to initiate treatment and referrals for alcoholism.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2213934
TI  - Oxygen delivery and consumption in head-injured and multiple trauma patients.
AB  - Critically ill patients often demonstrate that whole body oxygen consumption
      (VO2) is dependent on oxygen delivery (DO2). In this retrospective study, the
      relationship of VO2 to DO2 in patients with isolated head injury (HI, n = 18) was
      compared to that in patients with multiple trauma (MT, n = 60) without serious
      head injury. Mean pulmonary capillary wedge pressure, central venous pressure,
      arterial PCO2, cardiac index, and oxygen delivery were significantly lower in HI,
      but oxygen consumption was not different in the groups. In both groups, changes
      in DO2 (delta DO2) within each patient were significantly correlated with changes
      in VO2 (delta VO2) in that same patient. This relationship was not different
      between the HI patients, (delta VO2 = (0.20 +/- 0.02) delta DO2), and the MT
      patients (delta VO2 = (0.17 +/- 0.01) delta DO2). When these groups were further
      divided into those with high hematocrit (greater than 32%) and low hematocrit
      (less than 32%), HI patients with a low hematocrit demonstrated a steeper
      regression slope, with 26 +/- 3% of the DO2 change being reflected in the VO2
      change. This was significantly greater than the slope in HI patients with high
      hematocrit (13 +/- 3%) and the MT patients at high (19 +/- 2%) or low (16 +/- 2%)
      hematocrits. These data show a correlation between changes in oxygen delivery and
      consumption that is similar in both head-injury patients and multiple trauma
      patients without serious head injury. This relationship was greatest in head
      injured patients at low hematocrit. This relationship of VO2 and DO2 in both
      groups suggests an influence of neurohumoral factors rather than local tissue
      phenomena.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2213935
TI  - Splenectomy influences endotoxin-induced bacterial translocation.
AB  - To determine whether splenectomy affects the antibacterial defenses of the gut,
      experiments were performed using bacterial translocation (BT) as a marker of
      intestinal barrier failure. The incidence of BT was measured 8 days after
      splenectomy or sham-splenectomy in mice receiving or not receiving endotoxin (0.1
      mg IP). Splenectomy does not appear to promote BT from the gut, since the
      incidence of bacterial translocation after splenectomy or sham-splenectomy (5%)
      were not different. A second experiment was performed to determine whether the
      resistance to endotoxin-induced BT was modified after splenectomy. The incidence
      of endotoxin-induced BT was 73% in the unoperated control group, 59% in the sham
      splenectomy group, but 23% in the splenectomy group (p less than 0.002). Thus,
      splenectomy but not sham-splenectomy increased the resistance of otherwise
      healthy mice to endotoxin-induced BT.

PMID- 2213936
TI  - Skeletal transfixation in treatment of comminuted fractures of the distal end of
      the radius in the elderly.
AB  - Ninety-five patients (71 females and 24 males), average age, 69 years (35-92
      years), with comminuted distal radial fractures were treated with transfixation
      wires (Kirschner wires) through the bases of metacarpals II-V and an above-elbow
      plaster cast. Two cases of early infections and four of Sudeck's dystrophy (4.2%)
      were encountered. Followup studies which lasted an average of 24 months (9-50
      months) could be conducted on 77 patients. Using Sarmiento's ratings 27 patients
      fell into the very good category, 44, good, eight, fair, and two, poor. Although
      most of the cases were of the comminuted intra-articular fracture types, good
      results were achieved with this simple and quite straightforward method.

PMID- 2213937
TI  - A reassessment of the peritoneal lavage leukocyte count in blunt abdominal
      trauma.
AB  - Nine hundred and three patients undergoing diagnostic peritoneal lavage (DPL)
      over a 6-year period were retrospectively reviewed to evaluate the utility of the
      white blood cell (WBC) count in the lavage fluid. Eleven patients (1.2%) had
      dialysate WBC counts greater than 500/mm3, with erythrocyte counts less than
      10(5)/mm3. Nine of these patients who were lavaged within 4 hours of injury had
      no intra-abdominal pathology. Two patients, lavaged after 4 hours, demonstrated
      intra-abdominal injury. Two hundred twenty-three patients (24.7%) had grossly
      clear dialysate which was not sent for laboratory analysis. None of these
      patients required laparotomy. We conclude that the WBC count in DPL fluid is of
      no diagnostic value in victims of blunt abdominal trauma who are lavaged within 4
      hours of injury. In addition, laboratory analysis of clear dialysate is not
      required in these patients.

PMID- 2213938
TI  - Analysis of 46 intra-abdominal aortic injuries from blunt trauma: case reports
      and literature review.
AB  - Blunt trauma causing aortic injury is infrequent and primarily involves the
      thoracic aorta. Abdominal aortic injury after blunt trauma is much less frequent
      and has a varied presentation. Within a 3-month period, our trauma unit diagnosed
      and treated two cases of abdominal aortic injury secondary to blunt trauma. One
      was a belted passenger in a motor vehicle accident, and one was secondary to a
      crush injury. The addition of these two cases brings the number found in the
      literature to 46. Reviewing these cases has emphasized the need for prompt
      recognition and treatment of this vascular catastrophe.

PMID- 2213939
TI  - Concerning a blind-eyed view of the trauma patient impaired by alcohol.

PMID- 2213940
TI  - The debate goes on.

PMID- 2213941
TI  - Reduced dependency on arteriography for penetrating extremity trauma: influence
      of wound location and noninvasive vascular studies.
AB  - Indications for arteriography in penetrating extremity trauma remain
      controversial. We reviewed our clinical experience in 454 patients (514
      extremities) with penetrating trauma admitted during a prior 3 1/2-year period.
      Injuries were caused by stab wounds in 60 (11.7%) extremities and by gunshot
      wounds in 454 (88.3%) extremities. Thirty-three of the 60 stab wounds (55%)
      required urgent exploration, and 27 underwent arteriography. No arteriograms were
      positive for unsuspected arterial injury in this group. Forty-two of 454 gunshot
      wounds (9.3%) underwent mandatory exploration; arteriograms were performed on 412
      extremities. Forty-four arteriograms (10.7%) demonstrated evidence of unsuspected
      arterial injuries. During the last year, randomly selected extremities (n = 23)
      have been studied with B-mode ultrasonography and segmental Doppler pressure
      measurements. Using the subsequent arteriography as the "gold" standard,
      sensitivity was 83% and specificity was 100%. Gunshot wounds were categorized
      according to location and positive arteriograms. Injuries to the lateral thigh
      and arm resulted in no positive arteriograms, while positive studies were
      observed in 11% of medial and posterior arm, 14% of antecubital fossa, 25% of
      forearm, 7.5% of medial and posterior thigh, 8% of popliteal fossa, and 26% of
      calf injuries. We recommend arteriography for gunshot injuries to identified high
      risk areas, while clinical evaluation alone is accurate in all stab wounds to the
      extremities and gunshot wounds to the lateral thigh and outer arm. Preliminary
      data suggest expanded use of B-mode ultrasonography may further reduce our
      dependency on arteriography in these cases.

PMID- 2213942
TI  - The impact of volume on outcome in seriously injured trauma patients: two years'
      experience of the Chicago Trauma System.
AB  - The American College of Surgeons has stated that in considering the development
      of trauma systems it is important to ensure an appropriate volume of seriously
      injured patients be seen by each trauma center in order to achieve acceptable
      mortality rates. Clinical data supporting this recommendation are lacking. An
      analysis was performed on 1,643 seriously injured trauma patients to determine
      the relationship between volume and mortality rates. Three separate statistical
      methods were used: Pearson correlation coefficients, mortality odds ratios, and
      direct pairwise mortality comparisons. In addition, Tobit analysis was introduced
      as a method to analyze the relationship between volume and mortality. Mortality
      rates were adjusted for the confounding variable of serious head injury. Pearson
      correlation coefficients for volume vs. adjusted mortality was -0.65. Mortality
      odds ratios comparing the low-volume (less than 140 pts) trauma centers vs. the
      high-volume (greater than 200 pts) trauma centers was 1.3 for adjusted mortality
      rates (95% CI = 1.01-1.66; p = 0.04). Categorical analysis showed significantly
      different mortality rates in the centers before and after adjusting for patient
      mix. Tobit analysis showed the relationship between volume and mortality to be
      significant, accounting for 30-40% of the observed variation in mortality rates.
      In addition, Tobit analysis allowed construction of a model to predict mortality
      rates, given specific volumes of patients. Our data suggest that an inverse
      relationship exists between volume and mortality, and support the necessity of
      configuring trauma systems in a manner that will ensure designated trauma centers
      will see a high volume of seriously injured patients.

PMID- 2213943
TI  - Acute hospital costs of trauma in the United States: implications for
      regionalized systems of care.
AB  - As part of a larger effort to determine total direct and indirect costs of injury
      in the United States, national estimates of the numbers and expenditures
      associated with acute hospitalization due to traumatic injury were derived using
      data from the 1984, 1985, and 1986 National Hospital Discharge Surveys (NHDS).
      Estimates of the numbers of hospital episodes and total expenditures are reported
      in this paper for subgroups of patients defined by age, sex, and body region and
      AIS severity of the injuries sustained. In 1985 2.1 million individuals sustained
      a traumatic injury which resulted in hospitalization. Hospital expenditures
      totaled $11.4 billion inclusive of professional fees. Adolescents and young
      adults aged 15-44 years accounted for nearly one half of all discharges and total
      hospital costs. The elderly, who represent only 12% of the population, accounted
      for an additional one quarter of total discharges and hospital costs. Nearly
      three quarters of the hospitalizations and one half of total expenditures were
      for minor (ICD/AIS = 1, 2) injuries. Moderate (ICD/AIS = 3) and severe (ICD/AIS =
      4, 5), injuries respectively accounted for 23% and 3% of total episodes and 37%
      and 11% of total expenditures. Only 12% of patients and 25% of trauma care
      dollars involved injuries sufficiently severe to require treatment at a trauma
      center.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2213944
TI  - Endotoxin (LPS) increases mesenteric vascular resistance (MVR) and bacterial
      translocation (BT).
AB  - Endotoxemia is responsible for many of the pathophysiologic alterations that
      occur with Gram-negative sepsis. We utilized a chronic ovine model to determine
      the hemodynamic disturbances in the gastrointestinal tract during endotoxemia.
      Sheep with indwelling arterial, venous, and pulmonary arterial catheters were
      used. An ultrasonic flow probe was placed on the cephalic mesenteric artery. The
      animals were subjected to: 1) Ringer's lactate infusion (sham n = 6); or 2) 1.5
      mcg/kg E. coli endotoxin (n = 6) over over a period of one half hour and were
      monitored for 48 hours. They were then sacrificed and specimens of mesenteric
      lymph node, liver, spleen, kidney, and lung obtained for bacteriologic cultures
      and histologic analysis. Sheep receiving endotoxin showed more than 50% reduction
      in the mesenteric blood flow. Mesenteric vascular resistance increased while non
      mesenteric systemic vascular resistance decreased. The increase in the total
      systemic vascular resistance, noted during endotoxemia, was thus likely due to
      the increase in the mesenteric vascular resistance. At autopsy there were
      positive cultures for microorganism in the mesenteric lymph nodes in six out of
      six sheep with endotoxemia as compared to one out of six of control. Thus the
      vasoconstriction in the mesenteric areas may have resulted in bacterial
      translocation from the GI tract.

PMID- 2213945
TI  - Geographic patterns of urban trauma according to mechanism and severity of
      injury.
AB  - The purpose of this study was to investigate the distribution of various
      mechanisms of injury and the relative severity of such injury cases throughout
      the different geographic zones of a large urban area using a computerized
      emergency medical services (EMS) dispatch/patient record database. The study city
      (population, 2 million residents) was divided into 156 geographic grids (each 4.5
      by 3 miles) and the incidence and relative severity of various injury mechanisms
      were determined for each zone. RESULTS: In one year (1988), there were more than
      115,000 separate EMS incidents involving more than 150,000 patients, 26,000 of
      whom were transported for injuries incurred in 10,064 motor vehicle accidents,
      4,587 falls, 4,015 lacerations/stabwounds, 1,796 beatings, 1,270 gunshots, and
      952 auto-pedestrian accidents. Analysis of the 156 zones showed a
      disproportionate number of EMS responses in the city center with two centralmost
      grids accounting for about 25% of all responses. Call volume then progressively
      diminished toward the periphery of the city. However, with some very minor
      exceptions, the relative incidence and severity of the various injury mechanisms
      remained proportionally uniform within each zone, regardless of geographic
      location. Therefore, contrary to popular notoriety, the incidence and associated
      severity of any given injury type generally was not necessarily predicted by any
      particular neighborhood predilection for it, but rather by the overall demand for
      EMS in that zone of the city.

PMID- 2213946
TI  - The lap belt complex: intestinal and lumbar spine injury in children.
AB  - The "seatbelt syndrome" describes intestinal and spinal injury caused by lap
      style automotive restraints. More than 2,600 children were admitted to Children's
      National Medical Center with blunt injury in 3 years; 395 were involved in a
      motor vehicle crash. Ninety-five of the crash occupants (24%) were known to be
      wearing safety belts. Ten children sustained a "lap belt injury": five with
      lumbar spine injury, four with combined lumbar spine and intestinal injuries, and
      one child with intestinal injury. All ten children presented with a
      characteristic transverse abdominal ecchymosis. The CT scan was unreliable in
      evaluation of both spinal and intestinal injury. Lateral radiographs were
      required for definitive diagnosis in eight of nine children with lumbar spinal
      injury. CT scan was clearly diagnostic in only one of five children with
      intestinal injury. Children wearing lap belts are at risk of a "lap belt
      complex." Lateral spine X-rays, peritoneal lavage, and early laparotomy are
      recommended to establish an accurate diagnosis and to decrease morbidity.

PMID- 2213947
TI  - Alternative delivery system for controlled drugs in the surgical intensive care
      unit.
AB  - Faced with a serious shortage of qualified nurses for critically ill patients,
      methods to reduce the time required to deliver care without sacrificing quality
      are needed. A non-electronic device designed as a patient-controlled analgesic
      (PCA) was evaluated as a nurse-controlled device (NCA). Twenty-five intubated
      patients received morphine sulfate (MS) with the nurse-controlled device (NCA)
      and 12 by standard IV push policy. The average nursing time for narcotic dosing
      with the standard policy was 5 minutes/unit dose. A total of 1,183 NCA doses were
      given over 77 patient days. The average doses per patient day were 15 (2-38). The
      average nursing time was 22 seconds/NCA dose. The NCA saved 85 nursing
      minutes/patient day. Annual nursing labor costs were reduced by $77,000.00 with
      NCA. Total costs for standard IV push narcotic use were $36.43/patient day versus
      $35.45/patient day for NCA. Using this protocol, the NCA system saved $8,500.00
      annually. By increasing the duration of PCA use to 72 hours, the annual savings
      would become $49,500.00. These data indicate that a simple NCA can deliver
      controlled drugs rapidly and safely, save valuable nursing time, and decrease the
      cost of ICU care.

PMID- 2213948
TI  - The role of antibiotic therapy in the prevention of empyema in patients with an
      isolated chest injury (ISS 9-10): a prospective study.
AB  - The purpose of this study was to determine the impact of an antibiotic regimen on
      the incidence of empyema in patients admitted with isolated chest trauma (ISS
      9/10) and hemopneumothorax requiring tube thoracostomy. All patients with
      isolated chest trauma and hemopneumothorax (estimated ISS 9 or 10) seen in our
      trauma center were considered eligible for this study. Patients were excluded for
      the following reasons: age less than 18 years, presence of shock at the time of
      initial resuscitation, ongoing antibiotic therapy for unrelated disease,
      documented pre-existing infection or documented abnormal immune status. Ninety
      patients were randomized to two treatment limbs: antibiotics and tube
      thoracostomy or tube thoracostomy alone. All patients had the procedure performed
      in the trauma center in a standard fashion. Wound care and tube care were
      identical. Antibiotic therapy consisted of a first-generation cephalosporin
      (cefazolin), one dose given just before the procedure and then q 6 h into the
      tube removal. Injury Severity Scores were established as described by Schwab
      after the manner of Baker. Statistical analysis was performed using Fisher's
      exact test of binary outcome. In this study, antibiotics were able to reduce the
      incidence of empyema in patients with isolated chest trauma and for such patients
      antibiotic treatment appears justified. Further work is required to determine the
      effect on patients with more severe injury and multisystem involvement.

PMID- 2213949
TI  - Management of complex perineal soft-tissue injuries.
AB  - Debridement, fecal diversion, and rectal washout have been proposed as the
      primary therapy for complex perineal lacerations, but, in most series, survivors
      have a pelvic sepsis rate of 40-80%. In a retrospective study, six of 18 patients
      sustaining severe perineal lacerations died within the first few hours of injury
      due to exsanguination from pelvic injuries. The remaining 12 patients underwent
      sigmoidoscopy, diversion of the fecal stream with irrigation of the distal rectal
      stump, and radical initial debridement of necrotic soft tissue. Enteral access
      was obtained in two patients. In the patients with mandatory daily debridement
      and pulsatile irrigation, no pelvic sepsis occurred. In three patients without
      daily debridement, pelvic sepsis complicated recovery. The ability of patients to
      resume oral nutrition was significantly delayed, necessitating total parenteral
      nutrition in three patients. We conclude that sigmoidoscopy, total diversion of
      the fecal stream with irrigation of the distal rectal stump, enteral access for
      feeding, radical initial debridement of necrotic soft tissue, and mandatory daily
      debridement with pulsatile irrigation optimize recovery from this devastating
      injury.

PMID- 2213950
TI  - Intra-abdominal and retroperitoneal organ injuries diagnosed on dynamic computed
      tomograms obtained for assessment of renal trauma.
AB  - The efficacy of dynamic computed tomography in assessment of renal, intra
      abdominal, and retroperitoneal organ injuries is analyzed in some 444 patients.
      This technique contributed most valuable information toward the diagnosis of such
      coexistent injuries in patients who sustained blunt trauma. CT identified
      associated abdominal or retroperitoneal organ injuries in 85% of the patients
      (277 of 324), clinical examination in only 26%. CT proved invaluable for
      assessment of injury to bowel and mesentery, pancreas, and retroperitoneal
      vascular structures, giving rise to hematomas. CT diagnosed all such injuries,
      clinical examination from 0% (pancreas) to 11% (retroperitoneal hematomas). In
      patients with penetrating injury, dynamic CTs added valuable information on the
      status of viability of the injured organs. A relatively high number of false
      positive diagnoses resulted in only four unnecessary explorations. In all other
      patients, the erroneous diagnosis was revealed on repeat CTs undertaken because
      of inconsistency of the clinical course and clinical findings with the initially
      suggested CT diagnosis or at time of exploration undertaken for correction of
      other confirmed injuries. Discovery of associated intra- or retroperitoneal organ
      injuries, particularly in patients who sustained blunt trauma, has resulted in
      modification of treatment which prevented late sequelae and complications and
      thereby substantially reduced hospitalization time.

PMID- 2213951
TI  - Traumatic rupture of the aorta--critical decisions for trauma surgeons.
AB  - The diagnosis and initial stabilization of patients with traumatic rupture of the
      aorta (TRA) is performed by trauma surgeons. The resuscitations of 54 TRA
      patients at a Level I trauma center are reviewed. Although the survival of
      patients who underwent attempted repair was good (75%), 21/27 (78%) deaths
      occurred during phases of treatment controlled by a trauma surgeon. The
      techniques and sequencing of resuscitation can affect outcome. Pneumatic
      antishock garments were not beneficial in the prehospital setting for patients
      with TRA. In fact, PASG were on and inflated in all patients who presented in
      cardiac arrest. Awake, unanesthetized intubation caused fatal aortic rupture in
      three patients. Pharmacologic control of blood pressure during intubation is
      necessary. The amount of fluid, blood transfusion, and changes in blood pressure
      secondary to therapy did not statistically affect outcome. The average time from
      arrival in the ER to angiogram was 64.7 minutes. The average time ER to operating
      room was 159.7 minutes. Seven cases of TRA had delayed diagnosis usually for a
      misinterpreted CXR (5/7). Delay in diagnosis did not directly contribute to any
      deaths. Associated abdominal injuries are a common cause of preventable deaths.
      Fourteen patients with combined abdominal injuries and TRA were identified. Four
      of six deaths occurred with potentially reparable injuries. Operative and
      diagnostic sequences must be adjusted to allow rapid control of all potentially
      fatal injuries.

PMID- 2213952
TI  - Cordyceps Sinensis-I as an immunosuppressant in heterotopic heart allograft model
      in rats.
AB  - To investigate the inhibitory effects of Cordyceps Sinensis-I (CS-1) on the
      immune response responsible for the organ transplant rejection, we studied its
      effects of prolonging heterotopic heart allograft survival on rat model with
      heart graft; the effects of CS-1 were compared with those of cyclosporine A and
      glucocorticoid, and the possible pathological changes caused by CS-1 were
      observed. Our results showed that CS-1 can prolong the survival of grafted heart
      without causing infection, and it did not exert detrimental effects on vital
      organs. As a result, it proves to be a promising immunosuppressant in clinical
      organ transplantation in the future.

PMID- 2213953
TI  - A comparative experimental study on primary and secondary nerve grafting
      following inferior alveolar nerve injury.
AB  - The damaged inferior alveolar nerve of rabbit was repaired with autogenous
      ipsilateral greater auricular nerve grafting primarily and secondarily, and
      electrophysiological, ultrastructural, microvascular and histochemical
      investigations were performed in this study. The results indicated that the
      experimental effects of group 1 out of 3 groups (group 1 with immediate grafting,
      group 2 with grafting after 4 weeks, and group 3 with grafting after 8 weeks)
      were the best and those of group 2 were second only to group 1 with no obvious
      difference between these two groups (P greater than 0.05). However, the results
      of group 3 were not good enough, and there was significant difference from the
      other two groups (P less than 0.05). Therefore, we were led to conclude that the
      injury should be repaired at once or within 4 weeks after inferior alveolar nerve
      was damaged, or within 2 or 3 months thereafter, to improve the function of the
      injured nerve as greatly as possible.

PMID- 2213954
TI  - A study on hepatitis D virus infection in liver tissues of patients with
      hepatitis B in China.
AB  - 2346 liver samples from 17 areas in China were investigated for intrahepatic
      hepatitis D antigen (HDAg) by direct enzyme-labelled technique. HDAg was detected
      in 167 out of 1764 samples of HBsAg positive individuals with the detection rate
      of 9.47%. Hepatitis D virus (HDV) infection existed in all the examined areas
      without any significant difference regarding HDAg detection rate. A relationship
      of intrahepatic HDAg to the pathologic type of the liver disease was observed.
      The HDAg detection rate in chronic liver diseases and severe hepatitis was higher
      than in other liver diseases. It suggested that HDV infection was associated with
      the progression and chronicity of the liver disease. Studies on the relationship
      between HDV infection and HBV replication showed that HBV replication might be
      suppressed by HDV infection. Both HDV and HBV, however, could replicate in the
      same hepatocyte simultaneously.

PMID- 2213955
TI  - The cytoplasmic HBVDNA implication: HBV replication or non-replicative status.
AB  - Intrahepatocellular HBVDNA was investigated in patients with chronic hepatitis B
      by in situ hybridization assay, employing biotin-labelled HBVDNA as the specific
      probe. It was found that HBVDNA was predominantly present in the cytoplasm of
      hepatocytes. In general the cases with cytoplasmic HBVDNA could be grouped as
      follows: 1) cytoplasmic HBVDNA coinciding with intrahepatic envelope protein and
      nucleocapsid component expression, this pattern of the cytoplasmic HBVDNA would
      be replicative; 2) cytoplasmic HBVDNA accompanied by intrahepatic single HBsAg
      expression, common to HBVDNA integrated into host genome with only HBsAg being
      found frequently in liver; 3) with only cytoplasmic HBVDNA, with neither HBsAg
      nor HBcAg expression, representative for non-replicative status. It is speculated
      that the reason for the occurrence of the cytoplasmic hybridization signal in
      cases with non-replicative HBVDNA may be due to DNA-RNA transcript hybrid. The
      prudent way to evaluate the implication of the cytoplasmic HBVDNA is to consider
      the combination of HBVDNA location, intrahepatic gene product expression, and HBV
      markers in the serum.

PMID- 2213956
TI  - Investigation on the relation of impedance rheopneumogram with pulmonary
      hemodynamics and right ventricular function in patients with chronic obstructive
      pulmonary disease.
AB  - In order to investigate the relation of impedance rheopneumogram with pulmonary
      hemodynamics and right ventricular function in patients with chronic obstructive
      pulmonary disease (COPD), we measured impedance rheopneumogram and performed
      right heart catheterization on 150 COPD patients simultaneously both at rest and
      during exercise test. The results showed that impedance rheopneumogram was mainly
      influenced by right ventricular after-load while the influences of right
      ventricular pre-load, right ventricular contractivity, right ventricular work
      index and cardiac output were rather slight. These results also suggest that in
      COPD patients impedance rheopneumogram is of great value when used to predict
      pulmonary arterial pressure but of little value when used to measure the right
      ventricular function.

PMID- 2213957
TI  - Human pituitary somatotroph adenoma and prolactinoma: an ultrastructural and
      immunoelectron microscopical study.
AB  - 17 cases of pituitary somatotroph adenoma and 38 cases of prolactinoma were
      studied with electron microscopy and immunoelectron microscopy using protein A
      gold complex. 4 adenomas were shown by immunoelectron microscopy to contain
      simultaneously growth hormone (GH)-producing and prolactin (PRL)-producing cells.
      6 cases were classified as densely granulated GH adenomas and 11 as sparsely
      granulated variant, whereas only 3 adenomas out of 38 prolactinomas were
      identified as densely granulated adenomas. The present study showed that not all
      cells with fibrous bodies possessed secretory granules positive for GH, and in
      some cells with fibrous bodies PRL-producing granules were also detected.
      Misplaced exocytosis was found frequently in the sparsely granulated
      prolactinomas. From these findings it may be suggested that fibrous bodies are
      not a morphological feature characteristic of pituitary somatotroph adenomas.

PMID- 2213958
TI  - Microsurgical treatment of disorders of leg and foot--a report of 40 cases.
AB  - Since 1979, the authors have performed five types of microsurgical flap
      (including myocutaneous flap) graft to treat 40 patients with disorders of leg
      and foot. In the treatment of inflammatory diseases, good results were obtained
      owing to the following important points: 1) the operation was performed with
      inflammation well controlled or localized, particularly in chronic osteomyelitis;
      2) indication for each type of microsurgical flap was made carefully; 3)
      isolation of flap was carried out gently, bleedings were thoroughly stopped by
      ligation.

PMID- 2213959
TI  - Orthotopic homotransplantation of vascularized composite mandibular tissue in
      rabbits immunosuppressed with cyclosporine A.
AB  - To develop the surgical model, composite mandibular tissue was transplanted at
      the same site. Revascularization was accomplished by end-to-end anastomosis of
      the facial vessels using standard microvascular techniques. A total of 33
      vascularized composite mandibular tissue allografts were similarly performed
      between two incompatible strains of rabbit. In a control group of 9 animals, no
      immunosuppression was administered. All of these allografts were rejected acutely
      within 10 days after surgery. 7 allograft recipients were immunosuppressed with
      azathioprine and prednisone at 5 mg/kg.d and 2 mg/kg.d, respectively. Their
      allografts were also rejected acutely within 10 days. 17 allograft recipients
      were immunosuppressed with cyclosporine A (CsA). All allografts showed primary
      wound healing and hair growth and took on normal appearance. 8 of these
      recipients were given CsA at 5 mg/kg.d i.v. and their allografts were rejected at
      a mean time of 17.9 days. The remaining 9 recipients given CsA at 10 mg/kg.d i.v.
      rejected their allografts at a mean time of 36.1 days. In 3 of them, the
      rejection was reversed with CsA (20 mg/kg.d) injection for five days
      successfully, and one allograft survived more than 100 days. This pilot study
      suggests that the surgical model is reliable and that CsA will be useful as an
      immunosuppressive agent in the study of vascularized composite mandibular tissue
      allografts.

PMID- 2213960
TI  - [Bacterial flora of the external ear canal. 1. Cancer patients].
AB  - The bacterial flora of the external ear canal was investigated in a group of 64
      patients with head and neck cancer, to observe why otitis externa frequently
      occurs in cancer patients. Staphylococcus epidermidis (48.5%), Pseudomonas sp.
      (18.8%), and Flavobacterium sp. (16.8%) were the prominent isolates from ear
      samples, and Gram-negative organisms which rarely existed in normal canal, were
      found to be markedly increased (59.4%). Moreover, about half of all non-sterile
      ear canals were found to have more than one Gram-negative flora. We have
      concluded that cancer patients probably suffer from external otitis more
      frequently because of enhanced colonization by Gram-negative pathogens.

PMID- 2213961
TI  - Factors related to the willingness of nurses to care for AIDS patients in Taiwan.
AB  - Nurses' willingness to provide care for AIDS patients was studied using a self
      developed and evaluated anonymous questionnaire given to 258 nurses (a response
      rate 91.9%). The subjects were randomly sampled from three general hospitals in
      Taiwan and consisted of both nurses who have experienced providing care for AIDS
      patients and nurses who have not had the experience of caring for AIDS patients.
      As a result, 46.1% (119/258) of the nurses responded that they would accept
      caring for AIDS patient but 93.3% of them asked for extra pay as a condition.
      Among the 139 nurses who would refuse to care for AIDS patients, 48.2% of them
      would quit their jobs if giving such care was compulsory. The scores on knowledge
      of workplace risk and protection was higher among positive attitude nurses (p =
      0.0031). The odds ratio (OR) estimation was elevated in those whose attitudes
      were positive (OR = 4.4; 95% CI 3.2-6.1) as compared to those whose attitudes
      were negative about willingness to care for AIDS patients. But no relationships
      were found in age, educational levels, years of practice, marital status,
      religious beliefs, position status, and experience in providing care for AIDS
      patients with a willingness to care for AIDS patient. We suggest that if nurses
      have a better knowledge of workplace risk and protection regarding AIDS, then
      they have a more positive attitude and a greater willingness to care for AIDS
      patients.

PMID- 2213962
TI  - Tuberculous spondylitis: a clinical analysis.
AB  - Twenty-seven tuberculous spondylitis patients were reviewed. Eighteen were men
      and 9 were women, the average age being 52 years. The lower thoracic and lumbar
      spines were involved most frequently. Fever, progressive pain over the involved
      spine and tenderness were common clinical manifestations. The neurological
      deficits were due to direct compression of neural structures by the inflammatory
      products. Elevated ESR and the Mantoux test were valuable indicators. About one
      fourth of patients had coexisting pulmonary tuberculosis. Therefore, tuberculous
      spondylitis must be considered first in cases with progressive backache,
      tenderness, fever, elevated ESR and positive Mantoux test.

PMID- 2213963
TI  - The role of serum-supplements in organ culture for pre-damaged corneal
      endothelium.
AB  - Thirty-six pig corneas were shaken in 0.18% NaCl to induce disseminated corneal
      endothelial damage. After treatment, the corneas were divided and cultured in 3
      different combinations of media to study the effects of serum-supplements in
      corneal endothelial regeneration. There were MEM+10% FCS (FCS-group; n = 10);
      MEM+10% Nu-Serum (Nu-group; n = 10) and MEM only (control group; n = 16). After
      one week of culturing, most of the corneas in all 3 groups, despite the pre
      damage, kept intact endothelia. This means that the endothelia were repaired
      whether the sera were supplemented or not. The cell densities of each were 2,454
      +/- 450 cells/mm2, 2,776 +/- 476 cells/mm2 and 2,627 +/- 558 cells/mm2
      respectively. The differences between each group were statistically
      insignificant. The morphological findings were also without much difference. When
      considering the risk of serum induced hypersensitivity, FCS can be replaced by Nu
      Serum in the organ culture medium for corneal preservation. Since the advantage
      of serum-supplements in medium-term organ cultures seems limited, the necessity
      of serum supplements should be further reevaluated.

PMID- 2213964
TI  - Quantitative C-reactive protein in pulmonary infections.
AB  - A total of 207 cases were selected to evaluate the diagnostic value of C-reactive
      protein (CRP) in pulmonary infections. The mean +/- SD of CRP values in various
      pulmonary infections were as follows: 18.62 +/- 11.34 micrograms/ml for 32 cases
      of exudative-fibrotic tuberculosis; 15.98 +/- 16.66 micrograms/ml for 15 cases of
      tuberculous pneumonia; 25.61 +/- 18.96 micrograms/ml for 29 cases of tuberculous
      effusion; 16.66 +/- 10.18 micrograms/ml for 11 cases of tuberculous cavity; 81.1
      +/- 24.9 micrograms/ml for 10 cases of miliary tuberculosis; 36.4 +/- 22.1
      micrograms/ml for 19 cases of mycoplasmal pneumonia; 241 +/- 72 micrograms/ml for
      38 cases of bacterial pneumonia; 225 +/- 65 micrograms/ml for 30 cases of
      bacterial pneumonia with effusion; 169 +/- 50 micrograms/ml for 16 cases of lung
      abscess. The CRP values of other pulmonary infections were as follows: 20.6, 20.8
      micrograms/ml for two cases of Strongyloides stercoralis pneumonia; 7.4, 1.6
      micrograms/ml for two cases of aspergilloma; 11.2, 12.4, 7.6 micrograms/ml for
      three cases of Pneumocystis carinii pneumonia. Serial changes in CRP values in 13
      cases of well-treated bacterial pneumonia showed that values of CRP decreased to
      below half of the initial value on the 3rd to 4th day, and returned to about
      normal value on the 10th to 13th day. The study suggested that: a) various types
      of infections had different levels of CRP values, b) level of CRP values was
      determined both by the pathogen and the severity of inflammation, c) serial CRP
      values in bacterial infection could be used as a guide in treatment.

PMID- 2213965
TI  - [The individualized ANB angle of Chinese adults].
AB  - The ANB angle is commonly utilized to determine sagittal jaw relationships in
      cephalometric analysis. The ANB angle may be affected by other factors;
      therefore, its correlation to another measurement should be further recognized.
      This will eliminate the possibility of a biased interpretation. The individual
      variation of the ANB angle was investigated in 80 lateral radiographic
      cephalograms. The sample consisted of 40 Chinese male and 40 Chinese female
      adults. All of the sample had neutral molar relationships (Class I), and balanced
      profiles; none had previously undergone orthodontic treatment. ANB, SNA, SN-MP
      angles and SN were calculated for each gender. Multiple regression analyses and
      regression equation were performed and established. The results indicate that the
      variation of the ANB angle can be explained by the variations of the SNA and SN
      MP angles. The males had less mandibular divergency than females (p less than
      0.05); resulting in a different effective pattern. The derived equations are:
      ANBind = 0.42 x (SNA) + 0.31 x (SN-MP) - 41.1 for males; ANBind = 0.31 x (SNA) +
      0.20 x (SN-MP) - 28.9 for females. The explanation power also showed gender
      difference: males 56.2%, females 24.2%. The ANB angle for different facial types
      are presented through equation-produced lists of individualized norms. These
      norms aid the interpretation of the individual variations.

PMID- 2213966
TI  - Correction osteotomy of flexion deformity of cervical spine in ankylosing
      spondylitis--a case report.
AB  - It is well known that severe flexion deformities of the spine may occur in
      patients suffering from ankylosing spondylitis. The prevention of these
      deformities by early recognition of the disease process should be the main aim of
      the medical profession in handling patients with specific spinal involvements.
      Yet, we still see all too often patients with advanced kyphotic deformities of
      the trunk who are very grossly disabled and thus present a major problem to
      definitive surgical correction of their deformities. Correction of rigid kyphosis
      by establishing a compensatory lordosis can be carried out in the lumbar or
      cervical area. Surgical intervention in the cervical region enables the chin to
      be lifted off the sternum, but great care has to be taken of the relatively bulky
      spinal cord, which practically fills the spinal canal. Excessive correction runs
      the risks of fatally damaging the nerves and vertebral vessels. Therefore, most
      centers perform correction osteotomies of the cervical spine progressively, with
      day-by-day adjustment of the external fixators. We present a case of cervical
      osteotomy in which, under local anesthesia and with the aid of S.S.E.P., cervical
      kyphosis was corrected by a one-stage procedure. The results and difficulties are
      described here-in.

PMID- 2213967
TI  - Effect of unilateral vagotomy on capsaicin-induced neurogenic inflammation in the
      trachea of rats.
AB  - This study reports the effect of unilateral vagotomy on neurogenic inflammation
      in the trachea. Neurogenic inflammation was produced in the trachea of
      vagotomized rats by a venous injection of capsaicin, the pungent ingredient of
      red pepper. Monastral blue was used as tracer dye to label the affected blood
      vessels. Vagus nerves and tracheal tissues were processed for light and electron
      microscopy. The damaged right vagus nerve was found to have degenerated. However,
      unilateral vagotomy did not completely block neurogenic inflammation in the
      trachea ipsilaterally and contralaterally, as shown in the whole mount
      preparations. Microscopic observations of tracheal tissue sections showed that
      neurogenic inflammation did not evenly occur on both sides of the trachea. The
      possible reason for this is discussed.

PMID- 2213968
TI  - V-Y advancement flap for facial defects.
AB  - V-Y advancement flaps based on subcutaneous pedicles are an ideal option for
      closure of small to medium sized facial defects. This technique has been used to
      treat 69 patients with various lesions of the face, (30 basal cell carcinoma, 9
      squamous cell carcinoma, 18 nevus, 4 traumatic defect, 3 old scar and 5 others)
      during the past seven years. There was no necrosis of any single flap. All the
      designs could be planned so that the long axes of the flaps were parallel to the
      wrinkle line, contour line or line of dependency. All wounds healed uneventfully
      with fine or undelineated scar. There were no secondary operation for these
      cases. Clinical results of this series have shown advantages of this flap in
      reconstruction of facial defects. It is reliable in circulation and is easy to
      design and execute. It causes no distortion of critical features and offers
      excellent cosmetic satisfaction in color and texture matching. Therefore, the V-Y
      advancement flap is recommended for closure of properly selected facial defects.

PMID- 2213969
TI  - Prevalence of taeniasis and enterobiasis among aboriginal children in mountainous
      areas of Taiwan.
AB  - Children numbering 6,197 were tested for taeniasis. Those children were examined
      from May, 1981 to July, 1989. Sixty one primary schools, in eight mountainous
      districts provided the test group of children. The method used in these tests was
      the Scotch tape perianal swab. The overall infection rate of taeniasis was 1%. A
      total of 6,667 children were also examined for enterobiasis and the infection
      rate was 10%. There was no significant difference in the rate of taeniasis and
      enterobiasis by sex. The infection of taeniasis was highest in Tatung District
      (3%), Ilan County. However, there was no significant difference among the rates
      by district. The prevalence of enterobiasis was highest in Jenai District (17%),
      Nantou County and lowest in Lanyu District (2%), Taitung County. Taeniasis was
      not found among non-aboriginal school children, while 3% of aboriginal school
      children were infected with Taenia. However, the infection rate of Enterobius
      vermicularis among non-aborigines (39%) was much higher than that among
      aboriginal children (5%). These findings indicate that aboriginal children still
      eat raw meat and viscera of wild animals and acquire Taenia infection.

PMID- 2213970
TI  - Sequential changes of serum transaminase and abdominal sonography in patients
      with suspected dengue fever.
AB  - Southern Taiwan experienced a dengue (type 1) outbreak in the autumn of 1988. One
      hundred and thirteen febrile patients suspected as having dengue infection were
      seen in the emergency room of the Kaohsiung Medical College Hospital. These
      patients were recruited for this study. Two hundred and eighty-six sequential
      serum aspartate transaminase (AST) and alanine transaminase (ALT) data from these
      patients were analyzed. Data analysis showed serum AST had increased daily and
      all data were out of normal range from day 6 of the illness. Compared to the AST
      level on the first day of the illness, the AST level was noted to elevate to an
      average of 9.25 folds on day 6. The sequential changes of AST were as follows:
      AST had elevated since the third ill-day in most cases and reached a peak on the
      7th or 8th ill-day. It then declined gradually from the 8th ill-day and became
      normal about 3 weeks later. The changes of ALT level were about the same as AST
      but had later onset and lower peak. Abdominal sonographic examinations showed
      thickening of the gall bladder wall, splenomegaly and ascites in some patients
      during acute stage of the illness and recovered completely after patients
      recovered from the dengue attack. The sequential change of serum transaminase
      levels and sonographic findings were compatible. These findings may be used as a
      reference for the differential diagnosis among dengue fever, acute hepatitis and
      acute cholecystitis.

PMID- 2213971
TI  - Time spent and satisfaction of new out-patients in Department of Internal
      Medicine. Kaohsiung Medical College Hospital.
AB  - To assess the time spent and the degree of satisfaction of new clinic patients,
      one hundred and nine new out-patients from the Internal Medicine Clinic of
      Kaohsiung Medical College Hospital were studied from January 30th to February
      6th, 1985. Both accurate field recording and telephone interviews concerning the
      time spent for each procedure and satisfaction with the medical personnel and
      expense in their first visits were carried out. The total time spent was 152 +/-
      65 minutes (mean +/- SD) from questionnaire and 126 +/- 56 minutes from field
      recording. According to field recording, time spent in waiting for registration
      was 39.8 +/- 42.9 minutes. Most (55%) of study patients spent more than one hour
      in waiting for consultation. The time spent in waiting for filling prescription
      was 17 +/- 6 minutes. The accessibility of the paramedical examination units was
      good. The degree of satisfaction was measured by a five point rating scale for
      series of questions. The response were "very satisfied" or "satisfied" with
      professional services but not medical expense and cashier attitude. According to
      our results, some of our attempts to innovate service have been done including an
      appointment system, colored directional arrowheads, and changing our schedule to
      opening 30 minutes earlier.

PMID- 2213972
TI  - [Comparative study on the pharmacokinetics and bioequivalence of two brands of
      norfloxacin preparation].
AB  - The pharmacokinetics and bioequivalence of two norfloxacin, Gentle capsule and
      Baccidal tablet, were compared in eight healthy male volunteers. A 400 mg dose of
      norfloxacin was given orally after an overnight fasting to volunteers in a
      balanced two-way cross-over study. Blood samples were obtained at 0, 0.5, 1.0,
      2.0, 4.0, 8.0, 12.0 and 24.0 hours after the dosing. Norfloxacin concentration in
      serum was assayed by a high pressure liquid chromatographic method using an UV
      detector. All the data was processed by KMCP computer software and the
      pharmacokinetic parameters were calculated, based on one-compartment model. The
      results revealed that the maximal concentration (Cmax) of Gentle and Baccidal was
      0.96 +/- 0.089 and 0.99 +/- 0.110; the time to reach maximal concentration (Tmax)
      was 2.0 +/- 0.0 for both; the elimination constant (Kel) was 0.101 +/- 0.006 and
      0.098 +/- 0.005 hr-1; the elimination half life (T1/2, beta) was 6.909 +/- 0.483
      and 7.094 +/- 0.350 hr; the absorption constant (Ka) was 2.444 +/- 0.188 and
      2.490 +/- 0.096 hr-1; the absorption half life (T1/2, alpha) was 0.278 +/- 0.019
      and 0.277 +/- 0.010 hr; the area under curve (from 0 to 12 hours) (AUC0-12) was
      7.106 +/- 1.065 and 7.380 +/- 1.044 micrograms.hr/ml; and the area under curve
      (from 0 hour to infinity) (AUC0-infinity) was 9.183 +/- 1.257 and 9.550 +/- 1.300
      micrograms.hr/ml respectively. There were no significant difference found between
      the two groups after statistical analysis with two-way ANOVA (p greater than
      0.05). A series of statistical parameters including d%, delta, and 95% C.I. were
      calculated by a bioequivalence test computer software of Yamaoka Simi. In order
      to strengthen the statistical evidence, the power of the test (1 - beta) was also
      calculated. After evaluating all the parameters, there was no significant
      difference found between the two groups. Therefore, the high similarity of these
      two formulations is suggested by the authors.

PMID- 2213973
TI  - The variability of 24-hour, overnight 12-hour, and morning one-hour, urinary
      albumin excretion in normoalbuminuric and microalbuminuric hospitalized
      diabetics.
AB  - Albumin excretion rates (AER) of three consecutive days in different urine
      collection periods were measured in 7 hospitalized microalbuminuric diabetics (Ma
      DM) and 7 normoalbuminuric diabetics (Na DM). They were divided on the basis of
      an initial overnight urinary AER below or above 10 micrograms/min. The percentage
      of variation coefficients (% CV) of 24-hour, overnight 12-hour, and morning one
      hour urine collections in Ma DM were 29.9%, 31.8% and 50.9%, respectively; while
      in Na DM group were 60.0%, 60.3% and 74.5%, respectively. There was no
      significant difference in the variation of AER among the three different urine
      collection procedures in both Ma DM and Na DM groups, or for similar urine
      collection between the two groups. The initial AER was compared to the subsequent
      two AERs in overnight 12-hour collection. The results were that three Ma DM
      patients had a subsequent AER below 10 micrograms/min and two Na DM patients had
      a subsequent AER above 10 micrograms/min on a single occasion. Therefore, the
      high variability of both groups would be expected to result in category changes.
      Multiple urine collections are needed to detect the early diabetic nephropathy
      for the hospitalized diabetics.

PMID- 2213974
TI  - Taiwan's first case of perinatal transmission of HIV confirmed by a modified
      western blot test.
AB  - A 25-year-old Chinese woman, was found HIV antibody positive on December 14,
      1988. During our follow-up, we tested her American husband and found him to be
      seronegative. Unfortunately, her six-month-old infant was seropositive. The
      standard Western blot test was used in the first stage of analysis. The bands
      which appeared on the infant's strip were p15, p24, p31, p55 and gp120/gp160, but
      using the modified Western blot test the bands which appeared were p15, p24, p31,
      gp41, p53, p55, p64 and gp120/gp160. All the bands appearing on the infant's
      strips which used a modified Western blot test had higher intensities than those
      of a standard procedure. The mother was apparently infected with HIV through
      intercourse with her ex-boyfriend, who was a European. AZT was given to the
      mother because her T4 cell count was 338 per microliter and because of persistent
      cervical lymphadenopathy. The infant, which was bottle-fed and had been delivered
      by caesarean section, may have become HIV infected during the uterine stage.

PMID- 2213975
TI  - Looking beyond child survival.

PMID- 2213976
TI  - The features of sickle cell disease in Saudi children.
AB  - Using a prospective and retrospective approach, the features of sickle cell
      disease (SCD) were investigated in 137 SCD children from the south-western region
      of Saudi Arabia. The patients were followed for a period of 2-5 years, during
      which period the severity of the disease was assessed and a 'severity index', was
      calculated for individual patients. The patients with SCD were classified into
      five groups based on the absence of thalassaemia (sickle cell anaemia, SCA),
      presence of beta zero-thalassaemia (HbS/beta zero-thalassaemia), SCA with alpha
      thalassaemia.2 [heterozygotes (-alpha/alpha alpha) or homozygotes (-alpha/alpha)]
      and S/beta zero-thalassaemia with alpha-thalassaemia. The results showed a high
      prevalence of associated alpha-thalassaemia and variable levels of HbF in these
      patients. SCA patients with associated alpha-thalassaemia (-alpha/-alpha) and
      S/beta zero-thalassaemia patients with one alpha-gene deletion had the highest
      values for haematological parameters and lowest values of red cell indices. No
      specific difference could be identified in the clinical manifestations in the
      different groups with the exception that long bone crisis and hand-foot syndrome
      were not encountered in patients with associated alpha-thalassaemia. The
      frequency of hepatomegaly and splenomegaly was also lower in this group.

PMID- 2213977
TI  - Childhood peptic ulcer disease in Jamaica.
AB  - Thirty-one children with peptic ulcer disease (PUD) were diagnosed in two major
      hospitals in Jamaica between 1979 and 1988. There were 21 girls and 10 boys with
      a mean age of 9 years. There were 26 duodenal ulcers and 5 gastric ulcers. Five
      patients (19 per cent) with a duodenal ulcer had a family history of peptic
      ulcer. Recurrent abdominal pain was the predominant presenting feature in 68 per
      cent and pain was present for a mean of 20 months. Bleeding occurred in seven
      patients (23 per cent). Twenty-nine patients were successfully treated medically.
      Two with duodenal ulcers required surgery. The majority of patients have remained
      well after a mean follow-up of 14 months. Although uncommon in children peptic
      ulcers should be considered in patients with recurrent abdominal pain. The
      majority will respond to medical treatment.

PMID- 2213978
TI  - The bacteriology of intra-abdominal abscesses in Nigerian children.
AB  - The bacteriology of intra-abdominal abscess in 30 Nigerian children showed
      anaerobic bacteria constituted 52 per cent of total microflora with Bacteroides
      fragilis and anaerobic streptococci (19 per cent each) being predominant. E. coli
      and S. aureus were the predominant facultative bacteria isolated occurring in 24
      and 11 per cent, respectively. The incidence of abscess was higher in males than
      in females and these predominant bacteria were relatively resistant to
      penicillins, suggesting caution in the use of penicillins in the treatment of
      intra-abdominal infections.

PMID- 2213979
TI  - A simple system of nutrition surveillance for African communities.

PMID- 2213980
TI  - Causes of malnutrition in young children: Gilan, Iran.
AB  - Causes of malnutrition were investigated in agricultural area of Gilan, Iran.
      Family food availability and adult food intakes were adequate, but intakes of
      young children were deficient, in all socioeconomic groups, reflected in growth
      deficits. Associated factors were: late introduction and small quantities of
      solid food, poor maternal knowledge of child feeding, low dietary energy density
      due to rationing and high price of animal products, contamination of water
      supply, and use of sedative drugs.

PMID- 2213981
TI  - Neonatal mortality determinants in Jamaica.
AB  - The Jamaican Perinatal Survey included among its objectives the quantification of
      the island's neonatal mortality rate, the identification of the causes of these
      deaths (Wigglesworth Classification), and the determination of characteristics of
      both mother and infant that are associated with increased mortality. A death
      questionnaire was completed on babies who were born between September 1986 and
      August 1987, and who died in the neonatal period throughout the island of
      Jamaica. The neonatal mortality rate was 17.9 per 1000 live births with early and
      late rates of 16.0 and 1.9 per 1000, respectively. The major contributors to
      neonatal demise were prematurity and intrapartum asphyxia (74 per cent). Twins
      had a seven-fold greater risk of dying than singletons. Babies born to mothers
      under 15 years had a four-fold greater risk of dying than those of mothers 25-29
      years. The neonatal mortality rate for Jamaica is high, with room for
      improvement, particularly in the prevention of perinatal asphyxia.

PMID- 2213982
TI  - Epidemiological survey of the enteropathogenic Escherichia coli isolated from
      children with diarrhoea.
AB  - Escherichia coli was isolated in 382 (94 per cent) of 406 children from 0 to 3
      years of age who had been hospitalized for diarrhoea at the Hospital Municipal
      Salles Neto, Rio de Janeiro. Enteropathogenic Escherichia coli strains were
      isolated in 67 samples (18 per cent), distributed among the serogroups that were
      tested as follows: 0111 (33 per cent); 0125 (19 per cent); 0126, 0127, and 0142
      (9 per cent); 0128 and 0119 (8 per cent); 055 (5 per cent); 0114 (2 per cent). No
      strains of EPEC belonging to serogroups 086, 0126, and 0158 were found. Among the
      samples in which EPEC strains were isolated, 15.0 per cent were children living
      in dwellings which had piped systems of water supply and drain, whereas with
      regard to those living in houses without such facilities, this percentage raised
      to 24 per cent. Similar results were found when the availability of water supply
      of drainage were taken separately.

PMID- 2213983
TI  - Patterns of breast feeding in western Ethiopia and their relationship to acute
      diarrhoea in infants.
AB  - To determine the extent of protection from breast feeding against acute
      diarrhoea, a cross-sectional study was conducted in rural areas in a western
      region of Ethiopia, Gamo-Gofa. The standard cluster sampling technique promoted
      by WHO/CDD Program was used. We employed trained and supervised health workers
      (physicians nurses, and sanitarians) as interviewers, and a pretested
      questionnaire was utilized for the purpose. Among a total of 3002 children under
      the age of 5 years surveyed for diarrhoeal disease morbidity, mortality, and
      treatment rates, all those 6 months of age and less (n = 331) were taken as
      subjects to examine the trends of breast feeding and their association with the
      occurrence of acute diarrhoeal diseases. It was found that out of these 331
      infants, 217 (66 per cent) were exclusively breast-fed and 114 (34 per cent) were
      partially breast-fed. No one in the study group was fully weaned. Out of those
      who were exclusively breast-fed (n = 217), 25 (12 per cent) had diarrhoea which
      started within the past 2 weeks of the survey. Among those partially breast-fed
      (n = 114), 46 (40 per cent) had diarrhoea. The difference in the occurrence of
      diarrhoea among exclusively and partially breast-fed infants was statistically
      significant (P less than 0.0001). When infants with partial breast feeding were
      contrasted with those on exclusive breast feeding, a relative risk of developing
      diarrhoea of 5.2 (95 per cent confidence interval 3.00, 9.10) was obtained. It is
      recommended that breast feeding which tends to diminish with urbanization be
      promoted as one important intervention of the control of diarrhoeal diseases.

PMID- 2213984
TI  - The risk approach in preschool children suffering malnutrition and intestinal
      parasitic infection in the city of Sao Paulo, Brazil.
AB  - The association between parasitic infection and malnutrition in preschool
      children in the city of Sao Paulo, was studied according to degree of
      malnutrition, age, and income. Associations were assessed by risk analysis.
      Higher risks of malnutrition were found in children above 24 months of age
      infected with Ascaris, Trichuris or with more than three different parasites. The
      presence of more than three parasites per child affected nutritional status
      independently of income level. It is suggested that more attention should be
      given to intensity and chronicity of intestinal parasitic infection.

PMID- 2213985
TI  - Effect of ascariasis upon nutritional status of children.
AB  - One hundred children aged 24-72 months who had history of passing roundworms
      during the preceding 12 months were compared with 100 children without such
      history. The two groups were matched for age, sex, economic status, and birth
      order. Children who had ascaris were 2.1 cm shorter in height, 0.6 cm, thinner
      for mid-arm circumference, and 0.38 kg lighter in weight compared to the children
      who did not pass ascaris. The first two of these differences were statistically
      significant (P less than 0.005). It is concluded that: 1. ascariasis contributes
      significantly to malnutrition in communities where both coexist; 2. periodic
      deworming should form part of community nutrition programmes in areas where
      ascariasis is common; 3. future studies of a similar nature should include
      recording of height, arm circumference, and birth order.

PMID- 2213986
TI  - Association between weight for age and mid-upper arm circumference measurement:
      findings from Malawi.
AB  - Anthropometric methods involving measurement of weight-for-height, height-for
      age, weight-for-age, and mid-upper arm circumference have been extensively
      researched to identify an appropriate method of monitoring infant and child
      growth. Many countries have adopted weight for age as the main practical method.
      The Malawi Ministry of Health introduced weight for age based upon WHO
      recommended standards as a growth indicator in 1973. There are, however,
      difficulties in making the practice widely used at community level. In the
      present study, confined to the four urban areas of Malawi, a comparison was made
      between the weight-for-age (W/A) and mid-upper arm circumference (MUAC)
      measurements. A very good correlation was observed between the two methods of
      screening for identification of undernourished children from 4 months of age
      onwards. Correct use of MUAC was found to be as effective as W/A in detecting
      undernutrition.

PMID- 2213987
TI  - Doctor's declaration for breast feeding.

PMID- 2213988
TI  - Neonatal sepsis in Turkey: the comparison between penicillin plus aminoglycoside
      and ampicillin plus third-generation cephalosporin chemotherapies.

PMID- 2213989
TI  - The significance of socio-cultural factors in child malnutrition in urban Zambia.

PMID- 2213990
TI  - Breast feeding duration in Ethiopian women in southern California.

PMID- 2213991
TI  - Gender differences in health care.

PMID- 2213992
TI  - Tropical chronic calcific pancreatitis in children.

PMID- 2213993
TI  - Use of kanwa-cooked cowpea (Vigna unguiculata) in infant food formulation: effect
      on protein utilization and digestibility.

PMID- 2213994
TI  - Neurologic aspects of spasmodic dysphonia.
AB  - We discuss the etiology of 100 spasmodic dysphonia patients. Seventy-one patients
      had underlying essential tremor, 25 had Meige's syndrome, 12 were hypothyroid,
      and 27 had either a functional disturbance or focal dystonia. Six patients had
      intermittent breathy dysphonia. A large corpus of spasmodic dysphonia patients
      have organic neurolaryngeal disease.

PMID- 2213995
TI  - Histopathology of vocal cord palsy from recurrent laryngeal nerve damage.
AB  - The detailed postmortem laryngeal findings of a man with an established vocal
      cord palsy from an inoperable bronchial carcinoma is presented. Fine dissection
      of the monoblock specimen from skull base to superior mediastinum allowed
      sampling of vagus, recurrent and superior laryngeal nerves at different levels
      for fiber counts in order to compare the affected left and unaffected right side.
      Horizontal slicing of the whole larynx showed that the main cause of lateral
      displacement of the paralyzed left cord was gross atrophy of the underlying
      intrinsic laryngeal muscles. Cricothyroid muscle and superior laryngeal nerves
      were unaffected. Lateral cord drift due to underlying muscle atrophy is a better
      explanation of paralyzed cord position in this case than the Wagner and Grossmann
      theory of cord palsy.

PMID- 2213996
TI  - Comparison of surgical approaches to the skull base.
AB  - The surgical accessibility of many complex areas of the base of the skull has
      expanded rapidly in recent years, as has the literature on these procedures.
      Several routes to each anatomic region have been described, although little has
      been written or illustrated comparing and contrasting the different approaches to
      the skull base. Thirteen representative surgical approaches will be discussed,
      accompanied by diagrams of accessible anatomic regions. Key features of each
      procedure will be compared and contrasted. A uniform presentation will be used,
      showing the incision for each procedure as well as the accessible anatomic areas
      in three views. Modern imaging techniques permit CT and MR data to be viewed in
      similar projections, facilitating the choice of surgical procedures.

PMID- 2213997
TI  - Aberrant carotid artery: recognition on high resolution computed tomography.
AB  - In the investigation of a pulsatile retrotympanic mass it is important to
      recognize the high resolution computed tomography findings of an aberrant
      internal carotid artery. These include an absent exocranial opening of the
      carotid canal and a tubular density coursing along the medial wall of the middle
      ear in continuity with the horizontal carotid canal through a dehiscence of the
      lateral carotid plate. Our report highlights an unusual variation where two
      anomalous arteries, an aberrant internal carotid and an inferior tympanic to
      petrous carotid anastomoses, course through the middle ear.

PMID- 2213998
TI  - Spontaneous otoacoustic emissions: incidence and short-time variability in normal
      ears.
AB  - More than 50% of normal ears generate spontaneous otoacoustic emissions, which
      are sinusoidal tones originating in the cochlea. These faint sounds with levels
      typically at 10 dB to -30 dB are usually not recognized by the subjects who have
      them, but can be recorded by sensitive microphones in the ear canal. The clinical
      significance of having or not having spontaneous emissions are at present
      unknown. The emissions may be useful for non-invasive monitoring of cochlear
      physiology. A total of 307 spontaneous otoacoustic emissions from 59 ears have
      been examined. The short-time variability was small when as many as 300 averages
      were collected. High-frequency emissions showed better stability than low
      frequency ones. The ratio of frequency distance between neighboring emissions to
      critical bandwidth (Bark) was preferentially 0.3-0.5 for lower frequencies and
      0.2-0.4 for the higher ones. Amplitude dependence for one emission on its
      neighbors was difficult to demonstrate. Combination tones (different tones f2-f1
      and the cubic distortion product 2 x f1-f2) are probably rare among spontaneous
      emissions.

PMID- 2213999
TI  - The perilymphatic fistula: the end of an enigma?
AB  - While the existence of a perilymphatic fistula may be suggested on the basis of a
      patient's history and physical findings, at present the diagnosis can only be
      established by the identification of the actual fistula at the time of
      tympanotomy. In some cases, repeated reaccumulation of clear colorless fluid
      within the middle ear is interpreted as representing perilymph and has been
      considered to indicate the presence of a fistula that cannot be visualized. This
      subjective type of observation is made by the operating surgeon and is
      consequently subject to bias. At the present time there is no objective method,
      such as histopathology, to confirm the diagnosis of a perilymphatic fistula in
      this type of situation. As a result, there is some variation and controversy in
      the otology literature as to what surgical findings at tympanotomy should be
      considered as "proof" of a perilymphatic fistula. In this paper we will propose a
      new method for confirmation of the diagnosis of perilymphatic fistulas based on a
      unique biochemical property of perilymph.

PMID- 2214000
TI  - Self-induced vertigo.
AB  - Benign paroxysmal positional vertigo is the most commonly recognized form of self
      induced vertigo. This paper describes other means by which patients have been
      able to induce vertigo to the extent that at times it has been incapacitating.
      Hypotheses for the production of these phenomena are suggested in a number of the
      cases. Some of the features cannot be explained on the basis of our present
      knowledge of the vestibular system.

PMID- 2214001
TI  - Cervicofacial liposuction: results and controversies.
AB  - Obtaining ideal results with cervicofacial rhytidectomy has long frustrated
      facial plastic surgeons due to the difficulty of removing local excesses of
      adipose tissue in the parotid, melolabial, submental and submandibular areas.
      Open and closed liposuction techniques are being developed in conjunction with
      the facelift to improve definition of the facial, mandibular and cervical
      contours. A review of the senior author's (PAA) cases of cervicofacial
      liposuction and rhytidectomy is presented with emphasis placed on surgical
      techniques and results. Current literature is reviewed. Recommendations are made
      regarding analysis, surgical techniques and postoperative management of patients
      presenting for rejuvenation of the lower face.

PMID- 2214002
TI  - Septorhinoplasty in children: benefits of the external approach.
AB  - Following a series of septorhinoplasties performed on 28 children over a period
      of eight years as well as a review of the literature, the authors consider that
      the taboo on this sort of surgery would seem to have passed. Given that the
      septum plays a fundamental role in the projection of the nasomaxilliary complex,
      it is clear that certain surgical rules must be applied: the perichondrium must
      be left intact, no wide cartilaginous resections must be made, the areas of
      contact between the septum, the vomer, and the perpendicular lamina of the
      ethmoid must be reconstituted, and finally, the remodeled cartilage must be
      repositioned. For all of the above reasons, the external approach, performed on
      20 children, is the best suited for this sort of operation. No serious long-term
      complications were observed.

PMID- 2214003
TI  - Foregut duplication arising from the pharynx.
AB  - An unusual case of duplication of the foregut arising from the posterior
      pharyngeal wall is presented. Pertinent embryological and etiological
      considerations are discussed and a literature review included.

PMID- 2214004
TI  - Hodgkin's disease in the nasopharynx.
AB  - Nasal obstruction due to adenoid hypertrophy is extremely common in the pediatric
      age group and is generally successfully treated by adenoidectomy. The case report
      of the incidental finding of Hodgkin's disease in an adenoidectomy specimen will
      be presented. Overall, for all age groups and stages of disease, fewer than 75
      cases of Hodgkin's disease with nasopharyngeal involvement have been reported in
      the world literature. Further, fewer than 15 cases had isolated primary
      involvement. Although unusual, the occurrence of primary adenoidal Hodgkin's
      disease in our patient supports the submission of adenoidal tissue for
      micropathological examination when a relatively large amount of tissue is found
      at the time of surgery.

PMID- 2214005
TI  - Recurring giant-cell granuloma at the site of previous radiation therapy.
AB  - A 15-year-old girl presented with an aggressive giant-cell granuloma (GCG) of the
      maxilla with local invasiveness and bony destruction. The tumor recurred twice
      and attained a diameter of 6 cm. Previously, this patient had had two hematologic
      malignancies for which she had received therapeutic doses of radiation to the
      site where the GCG occurred. It is therefore possible that this tumor was
      radiation induced.

PMID- 2214006
TI  - Cavernous hemangioma of the internal auditory meatus.
AB  - A case is reported of angiomatous malformation involving the facial and
      vestibilocochlear nerves within the internal auditory meatus. The relative
      incidence of tumors and other space-occupying lesions occurring in this area is
      reviewed, along with the relative advantages of different imaging techniques.

PMID- 2214007
TI  - The carotid ghost. A color Doppler ultrasound duplication artifact.
AB  - Color Doppler ultrasound examinations of the neck frequently demonstrate an
      artifactual region of color assignment deep to the common carotid artery that
      simulates blood flow in deep cervical arteries. Based on analysis of imaging
      performed on 10 normal volunteers, it was shown that the pulsed Doppler waveform
      originating from the artifact was identical to that of the common carotid artery.
      It was also shown that the artifact was always located deep to the common carotid
      artery regardless of location and positioning of the transducer. In vitro
      modeling using a flow phantom confirmed that the appearance was artifactual in
      nature. The mechanism of production most likely is related to a mirroring
      phenomenon at the deep wall of the common carotid artery.

PMID- 2214008
TI  - Sonographically demonstrated intra-amniotic hemorrhage following transplacental
      genetic amniocentesis. Frequency, sonographic appearance, and clinical
      significance.
AB  - Over a 9-month period, 11 transplacental amniocenteses were performed. Following
      completion of amniocentesis, intra-amniotic hemorrhage occurred in all 11 cases.
      Amniotic masses and intra-amniotic strands occurred in three cases as a result of
      intra-amniotic hemorrhage. The 11 pregnancies in which transplacental
      amniocentesis were performed were uncomplicated, and they resulted in normal
      infants. Transplacental amniocentesis can yield unusual sonographic appearances
      but does not appear to have an adverse effect on pregnancy outcome.

PMID- 2214009
TI  - Detection of rejection in renal allografts. Evaluation with duplex sonography and
      DTPA renal scintigraphy with kidney/aorta perfusion ratios.
AB  - Duplex sonography and technetium-99m DTPA renal scintigraphy have been used to
      distinguish acute rejection from other forms of renal allograft dysfunction. In
      this study, duplex sonography and renal scintigraphy were compared as methods to
      detect rejection. Eighty-four episodes of renal allograft dysfunction that had
      concurrent duplex sonography and renal scintigraphy over a 17-month period were
      reviewed. During the duplex sonography examinations the resistive index (RI) was
      measured from the renal cortex. Scintigrams were evaluated for allograft
      perfusion and function. The kidney to aorta (K/A) ratio was calculated from the
      upstroke of the perfusion curve. All diagnoses were established by clinical
      criteria. Histologic proof was available in 49 cases. There were two episodes of
      hyperacute rejection, 30 episodes of acute rejection, 14 episodes of chronic
      rejection, and 38 episodes of dysfunction without rejection. Using an RI greater
      than or equal to 0.70, the sensitivity and specificity for detecting acute
      rejection were 90% and 76%, respectively, compared with 37% and 76% for renal
      scintigraphy. The K/A ratio was not helpful in the diagnosis of rejection.

PMID- 2214010
TI  - Single-needle insertion in twin amniocentesis.
AB  - Amniocentesis in twin gestation is an uncommon event for most medical centers.
      The current technique used for this procedure includes two or more needle
      insertions and the introduction of dye into the first sac. A new approach that
      consists of a single insertion is proposed. The advantages of this alternate
      technique are that it requires only one insertion, it is a swifter procedure, it
      does not require the injection of dye, and it offers positive proof of tapping
      the two gestational sacs. Although this technique may have some potential risks,
      in our judgment the advantages outweight the potential risks, and this technique
      should be considered and its feasibility evaluated in cases of twin gestation
      requiring two-sac tapping.

PMID- 2214011
TI  - Use of endo-vaginal ultrasound to optimize visualization of the distal fetal
      spine in breech presentations.
AB  - Endovaginal ultrasound was used to evaluate the spine of 13 second-trimester
      fetuses in which transbdominal images were considered equivocal due to suboptimal
      visualization of the distal spine and where the fetus was in a breech
      presentation. Endovaginal sonography demonstrated a small defect in the distal
      spine and a meningomyelocele in one of the 13 cases. In all of the remaining 12
      cases, endovaginal sonography resulted in improved visualization of morphologic
      detail, providing sufficient information regarding bony anatomy to exclude
      splaying of the posterior elements. Additionally, in 10 cases the intact skin
      surface overlying the distal spine, which was not seen by transbdominal
      sonography, was well demonstrated by endovaginal ultrasound. The authors
      recommend that endovaginal ultrasound be considered to optimize visualization of
      the distal fetal spine when transbdominal images are inconclusive and the fetus
      is in a breech presentation.

PMID- 2214012
TI  - Three-dimensional spatial registration and interactive display of position and
      orientation of real-time ultrasound images.
AB  - Ultrasound images may be difficult to interpret because of the lack of an image
      orientation display. To resolve this problem, a three-dimensional (3-D)
      ultrasound scanner has been constructed that provides spatial registration and
      display of position and orientation of real-time images while allowing
      unconstrained movement of the scanning transducer. It consists of a conventional
      sector scanner, a 3-D acoustical spatial locater, and a personal computer. It
      displays within each image the line of intersection of two image planes, a
      reference image, and a live image. This display guides and documents image
      positioning. The scanner's 3-D data also provide the potential for
      computergraphic modeling of organs, the ability to calculate volumes using
      nonparallel, nonintersecting image planes, and the capability for 3-D color flow
      mapping and measurement of Doppler angle.

PMID- 2214013
TI  - Sonographic appearance of Menetrier's disease in a child.

PMID- 2214014
TI  - Prenatal ultrasonographic appearance of "agenesis" of the ductus arteriosus and
      pulmonic valve hypoplasia. A case report and review of the embryogenesis.

PMID- 2214015
TI  - Disappearing fetal umbilical cord masses. Are these findings suggestive of
      urachal anomalies?

PMID- 2214016
TI  - Site-directed mutagenesis of the codon for Ile-25 in gPr80env alters the
      neurovirulence of ts1, a mutant of Moloney murine leukemia virus TB.
AB  - ts1, a spontaneous temperature-sensitive mutant of Moloney murine leukemia virus
      TB, causes hind-limb paralysis in mice. A Val-25----Ile substitution in gPr80env
      is responsible for temperature sensitivity, inefficient processing of gPr80env,
      and neurovirulence. In this study, the Ile-25 in gPr80env was replaced with Thr,
      Ala, Leu, Gly, and Glu by site-directed mutagenesis of the codon for Ile-25 to
      generate a new set of mutant viruses, i.e., ts1-T, -A, -L, -G, and -E,
      respectively. The phenotypic characteristics of these mutant viruses differed
      from those of ts1. For each mutant, the degree of temperature sensitivity was
      correlated with the degree of inefficient processing of gPr80env, and the
      following rank order was observed for both parameters: ts1-E greater than ts1-G
      greater than ts1-L greater than ts1-A greater than ts1 greater than ts1-T. In
      FVB/N mice, mutant viruses of low and intermediate temperature sensitivity and
      inefficiency in processing of gPr80env were neurovirulent and consistently caused
      mutant-specific disease profiles: ts1-T caused severe whole-body tremor, ts1-A
      generally caused hind-limb paralysis, and ts1-L generally caused a delayed-onset
      paraparesis. By 150 days postinfection, FVB/N mice that were infected with ts1-G
      and -E, mutants of high temperature sensitivity and inefficiency in processing of
      gPr80env, had lymphoid leukemia instead of a neurological disease. These results
      suggest that the dynamics of gPr80env processing are important in determining the
      neurovirulent phenotype in vivo.

PMID- 2214017
TI  - Binding of p53 and p105-RB is not sufficient for oncogenic transformation by a
      hybrid polyomavirus-simian virus 40 large T antigen.
AB  - To identify regions on the large T antigens of simian virus 40 (SV40) and
      polyomavirus which are involved in oncogenic transformation, we constructed
      plasmids encoding hybrid polyomavirus-SV40 large T antigens. The hybrid T
      antigens were expressed in G418 sulfate-resistant pools of rat F2408 cells, and
      extracts of such pools were immunoprecipitated with an antibody against p53. Two
      hybrid T antigens containing SV40 amino acids 337 to 708 bound to p53, whereas
      another hybrid T antigen containing SV40 amino acids 412 to 708 did not. This
      suggests that a binding domain on SV40 large T antigen for p53 is contained
      within amino acids 337 to 708, with amino acids 337 to 411 playing an important
      role. One of the two hybrids that bound to p53 was chosen for further study. This
      T antigen contained SV40 large T antigen amino acids 336 to 708 joined to
      polyomavirus large T antigen amino acids 1 to 521 (PyT1-521-SVT336-708).
      Immunoprecipitation with antibodies directed against the product of the
      retinoblastoma susceptibility gene, p105-RB, showed that this hybrid bound p105
      RB as well as p53. Pools expressing the hybrid PyT1-521-SVT336-708 did not grow
      in soft agar, nor did they form foci on confluent monolayers of nontransformed
      F2408 cells. The hybrid T antigen was expressed at levels comparable to those
      seen in retrovirus-infected F2408 cells expressing only SV40 large T antigen,
      which do show a transformed phenotype. Thus, this level of expression was
      sufficient for transformation by SV40 large T antigen but not for the hybrid
      large T antigen. These data, combined with genetic studies from other
      laboratories, suggest that complex formation with p53 and p105-RB is necessary
      but not sufficient for the oncogenic potential of papovavirus large T antigens.

PMID- 2214018
TI  - Construction and use of a human immunodeficiency virus vector for analysis of
      virus infectivity.
AB  - We constructed a recombinant human immunodeficiency virus (HIV) vector to
      facilitate studies of virus infectivity. A drug resistance gene was inserted into
      a gp160- HIV proviral genome such that it could be packaged into HIV virions. The
      HIV genome was rendered replication defective by deletion of sequences encoding
      gp160 and insertion of a gpt gene with a simian virus 40 promoter at the deletion
      site. Cotransfection of the envelope-deficient genome with a gp160 expression
      vector resulted in packaging of the defective HIV-gpt genome into infectious
      virions. The drug resistance gene was transmitted and expressed upon infection of
      susceptible cells, enabling their selection in mycophenolic acid. This system
      provides a quantitative measure of HIV infection, since each successful infection
      event leads to the growth of a drug-resistant colony. The HIV-gpt virus produced
      was tropic for CD4+ human cells and was blocked by soluble CD4. In the absence of
      gp160, noninfectious HIV particles were efficiently produced by cells transfected
      with the HIV-gpt genome. These particles packaged HIV genomic RNA and migrated to
      the same density as gp160-containing virions in a sucrose gradient. This
      demonstrates that HIV virion formation is not dependent on the presence of a
      viral envelope glycoprotein. Expression of a murine leukemia virus amphotropic
      envelope gene in cells transfected with HIV-gpt resulted in the production of
      virus capable of infecting both human and murine cells. These results indicate
      that HIV can incorporate envelope glycoproteins other than gp160 onto particles
      and that this can lead to altered host range. Like HIV type 1 and vesicular
      stomatitis virus(HIV) pseudotypes, gp-160+ HIV-gpt did not infect murine NIH 3T3
      cells that bear human CD4, confirming that these cells are blocked at an early
      stage of HIV infection.

PMID- 2214019
TI  - The P gene product of hepatitis B virus is required as a structural component for
      genomic RNA encapsidation.
AB  - Encapsidation of the pregenomic RNA into nucleocapsids is a selective process
      which depends on specific RNA-protein interactions. The signal involved in the
      packaging of the hepatitis B virus (HBV) RNA pregenome was recently defined as a
      short sequence located near the 5' end of that molecule (Junker-Niepmann et al.,
      EMBO J., in press), but it remained an open question which viral proteins are
      required. Using a genetic approach, we analyzed whether proteins derived from the
      HBV P gene play an important role in pregenome encapsidation. The results
      obtained with point mutations, deletions, and insertions scattered throughout the
      P gene clearly demonstrate that (i) a P gene product containing all functional
      domains is required both for the encapsidation of HBV pregenomic RNA and for
      packaging of nonviral RNAs fused to the HBV encapsidation signal, (ii) known
      enzymatic activities are not involved in the packaging reaction, suggesting that
      P protein is required as a structural component, and (iii) P protein acts
      primarily in cis, i.e., pregenomic RNAs from which P protein is synthesized are
      preferentially encapsidated.

PMID- 2214020
TI  - Vaccinia virus gene encoding a 30-kilodalton subunit of the viral DNA-dependent
      RNA polymerase.
AB  - Antibody was raised against purified vaccinia virus RNA polymerase and used to
      screen a recombinant vaccinia virus-lambda gt11 library. The DNA from several
      immunopositive clones was shown by Southern hybridization to originate from the
      vaccinia virus HindIII E fragment. The nucleotide sequence of the RNA polymerase
      subunit gene predicts a polypeptide 287 amino acids in length and 30,000 daltons
      in mass. An early transcript with a 5' terminus just upstream of the putative
      initiation codon was identified by S1 nuclease protection and primer extension
      analyses, demonstrating that this RNA polymerase subunit is expressed as an early
      viral gene product. The RNA polymerase subunit was synthesized by a bacterial
      expression vector to demonstrate that it corresponds to the previously described
      37,000-dalton RNA polymerase subunit.

PMID- 2214021
TI  - Env and Vpu proteins of human immunodeficiency virus type 1 are produced from
      multiple bicistronic mRNAs.
AB  - Three size classes of human immunodeficiency virus type 1 (HIV-1) mRNAs are
      produced in infected cells: full-length, intermediate, and small. Here we report
      that the intermediate-size class of viral mRNAs is heterogeneous, consisting of
      at least 12 differentially spliced species. This group contains nine bicistronic
      mRNAs producing Env and Vpu and three mRNAs expressing only the first exon of
      tat. In the latter mRNAs, Env and Vpu expression is blocked by the presence of
      the upstream tat open reading frame. We conclude that internal initiation of
      translation is not the mechanism for generation of the bicistronic env mRNAs.
      Translation of HIV-1 mRNAs is consistent with the scanning mechanism in which Env
      is produced by leaky scanning from mRNAs that contain env as the second or third
      reading frame. Env and Vpu proteins are expressed from the same mRNAs and are
      coordinately regulated by Rev. This arrangement may reflect a requirement for
      coordinate expression of Vpu and Env.

PMID- 2214022
TI  - The E2 signal sequence of rubella virus remains part of the capsid protein and
      confers membrane association in vitro.
AB  - The capsid (C) protein of rubella virus is translated from a 24S subgenomic mRNA
      as the first part of a polyprotein containing all three structural proteins of
      the virus. It is separated from the following protein (E2) by signal peptidase,
      which cleaves after the E2 signal sequence. We raised an antipeptide antiserum
      directed against the signal sequence and used the antiserum to show that this
      sequence is still a part of the C protein in the mature virion. Furthermore, we
      also showed that, when the C protein is synthesized by in vitro transcription and
      translation, the resultant protein is membrane associated. This association is
      not seen with a variant C protein which lacks the signal sequence, and a normally
      soluble protein (dihydrofolate reductase) becomes membrane associated when the
      signal sequence is placed at its carboxy terminus.

PMID- 2214023
TI  - Transcription factors NFI and NFIII/oct-1 function independently, employing
      different mechanisms to enhance adenovirus DNA replication.
AB  - Initiation of adenovirus DNA replication is strongly enhanced by two
      transcription factors, nuclear factor I (NFI) and nuclear factor III (NFIII/oct
      1). These proteins bind to two closely spaced recognition sequences in the
      origin. We produced NFI and NFIII/oct-1, as well as their biologically active,
      replication-competent DNA-binding domains (NFI-BD and the POU domain), in a
      vaccinia virus expression system and purified these polypeptides to apparent
      homogeneity. By DNase I footprinting and gel retardation, we show that the two
      proteins, as well as their purified DNA-binding domains, bind independently and
      without cooperative effects to their recognition sequences. By using a
      reconstituted system consisting of the purified viral proteins (precursor
      terminal protein-DNA polymerase complex (pTP-pol) and DNA-binding protein, we
      show that NFIII/oct-1 or the POU domain stimulates DNA replication in the absence
      of NFI or NFI-BD and vice versa. When added together, the enhancing effect of the
      two transcription factors was independent and nonsynergistic. Interestingly,
      stimulation by NFI or NFI-BD was strongly dependent on the concentration of the
      pTP-pol complex. At low pTP-pol concentrations, NFI or NFI-BD stimulated up to 50
      fold, while at high concentrations, the stimulation was less than twofold,
      indicating that the need for NFI can be overcome by high pTP-pol concentrations.
      In contrast, stimulation by NFIII/oct-1 or the POU domain was much less dependent
      on the pTP-pol concentration. These data support a model in which NFI enhances
      initiation through an interaction with pTP-pol. Glutaraldehyde cross-linking
      experiments indicate contacts between pTP-pol and NFI but not NFIII/oct-1. The
      site of interaction is located in the NFI-BD domain.

PMID- 2214024
TI  - Nucleotide sequence analysis and expression from recombinant vectors demonstrate
      that the attachment protein G of bovine respiratory syncytial virus is distinct
      from that of human respiratory syncytial virus.
AB  - Bovine respiratory syncytial (BRS) virus causes a severe lower respiratory tract
      disease in calves similar to the disease in children caused by human respiratory
      syncytial (HRS) virus. While there is antigenic cross-reactivity among the other
      major viral structural proteins, the major glycoprotein, G, of BRS virus and that
      of HRS virus are antigenically distinct. The G glycoprotein has been implicated
      as the attachment protein for HRS virus. We have carried out a molecular
      comparison of the glycoprotein G of BRS virus with the HRS virus counterparts.
      cDNA clones corresponding to the BRS virus G glycoprotein mRNA were isolated and
      analyzed by dideoxynucleotide sequencing. The BRS virus G mRNA contained 838
      nucleotides exclusive of poly(A) and had a major open reading frame coding for a
      polypeptide of 257 amino acid residues. The deduced amino acid sequence of the
      BRS virus G polypeptide showed only 29 to 30% amino acid identity with the G
      protein of either the subgroup A or B HRS virus. However, despite this low level
      of identity, there were strong similarities in the predicted hydropathy profiles
      of the BRS virus and HRS virus G proteins. A cDNA molecule containing the
      complete BRS virus G major open reading frame was inserted into the thymidine
      kinase gene of vaccinia virus by homologous recombination, and a recombinant
      virus containing the BRS virus G protein gene was isolated. This recombinant
      virus expressed the BRS virus G protein, as demonstrated by Western immunoblot
      analysis and immunofluorescence of infected cells. The BRS virus G protein
      expressed from the recombinant vector was transported to and expressed on the
      surface of infected cells. Antisera to the BRS virus G protein made by using the
      recombinant vector to immunize animals recognized the BRS virus attachment
      protein but not the HRS virus G protein and vice versa, confirming the lack of
      antigenic cross-reactivity between the BRS and HRS virus attachment proteins. On
      the basis of the data presented here, we conclude that BRS virus should be
      classified within the genus Pneumovirus in a group separate from HRS virus and
      that it is no more closely related to HRS virus subgroup A than it is to HRS
      virus subgroup B.

PMID- 2214025
TI  - Major histocompatibility complex-conferred resistance to Theiler's virus-induced
      demyelinating disease is inherited as a dominant trait in B10 congenic mice.
AB  - Intracerebral inoculation of Theiler's murine encephalomyelitis virus into
      susceptible strains of mice produces chronic demyelinating disease in the central
      nervous system characterized by persistent viral infection. Immunogenetic data
      suggest that genes from both major histocompatibility complex (MHC) and non-MHC
      loci are important in determining susceptibility or resistance to demyelination.
      The role of the MHC in determining resistance or susceptibility to disease can be
      interpreted either as the presence of antigen-presenting molecules that confer
      resistance to viral infection or as the ability of MHC products to contribute to
      pathogenesis by acting as viral receptors or by mediating immune attack against
      virally infected cells. These alternatives can be distinguished by determining
      whether the contribution of the MHC to resistance is inherited as a recessive or
      dominant trait. Congenic mice with different MHC haplotypes on identical B10
      backgrounds were crossed and quantitatively analyzed for demyelination,
      infectious virus, and local virus antigen production. F1 hybrid progeny derived
      from resistant B10 (H-2b), B10.D2 (H-2d), or B10.K (H-2k) and susceptible
      B10.R111 (H-2r), B10.M (H-2f), or B10.BR (H-2k) parental mice exhibited no or
      minimal demyelination, indicating that on a B10 background, resistance is
      inherited as a dominant trait. Although infectious virus, as measured by viral
      plaque assay, was cleared inefficiently from the central nervous systems of
      resistant F1 hybrid progeny mice, we found a direct correlation between local
      viral antigen production and demyelination. These data are consistent with our
      hypothesis that the immunological basis for resistance is determined by efficient
      presentation of the viral antigen to the immune system, resulting in local virus
      clearance and absence of subsequent demyelination.

PMID- 2214026
TI  - CD4 is retained in the endoplasmic reticulum by the human immunodeficiency virus
      type 1 glycoprotein precursor.
AB  - We analyzed coexpression of the human immunodeficiency virus type 1 glycoprotein
      precursor, gp160, and its cellular receptor CD4 in HeLa cells to determine
      whether the two molecules can interact prior to transport to the cell surface.
      Results of studies employing coprecipitation, analysis of oligosaccharide
      processing, and immunocytochemistry showed that newly synthesized CD4 and gp160
      form a complex prior to transport from the endoplasmic reticulum (ER). CD4
      expressed by itself was transported efficiently from the ER to the cell surface,
      but the complex of CD4 and gp160 was retained in the ER. This retention of CD4
      within the ER is probably a consequence of the very inefficient transport of
      gp160 itself (R. L. Willey, J. S. Bonifacino, B. J. Potts, M. A. Martin, and R.
      D. Klausner, Proc. Natl. Acad. Sci. USA 85:9580-9584, 1988). Retention of CD4 in
      the ER by gp160 may partially explain the down regulation of CD4 in human
      immunodeficiency virus type 1-infected T cells. Inhibition of CD4 transport
      appears to be a consequence of the interaction of two membrane-bound molecules,
      because a complex of CD4 and gp120 (the soluble extracellular domain of gp160)
      was transported rapidly and efficiently from the ER.

PMID- 2214027
TI  - Heterogeneity and evolution rates of delta virus RNA sequences.
AB  - To investigate the geographical divergence of delta virus RNA sequences, 868
      nucleotides (nt), including the delta antigen-coding region, were determined in
      isolates from two Japanese patients, M and S, by polymerase chain reaction and
      direct sequencing and compared with three previously reported nucleotide
      sequences. The sequence obtained for hepatitis delta virus RNA from patient M was
      approximately 92% identical to sequences previously obtained for two other
      strains of hepatitis delta virus, whereas the sequence of hepatitis delta virus
      RNA obtained from patient S was approximately 81% identical to the previously
      sequenced strains. This suggests that delta agent in Japan has a heterogeneous
      origin and the delta virus RNA sequence from Japanese patient S is the most
      divergent delta virus isolate yet analyzed. To study the evolution rate of delta
      virus RNA, viral isolates obtained 3 and 4 years apart from each of two patients
      were also sequenced. It was estimated that the substitution rate of viral RNA was
      0.57 x 10(-3) nt per site per year in patient M and 0.64 x 10(-3) nt per site per
      year in patient S for the delta antigen gene.

PMID- 2214028
TI  - Moloney murine leukemia virus integration protein produced in yeast binds
      specifically to viral att sites.
AB  - The integration protein (IN) of Moloney murine leukemia virus (MuLV), purified
      after being produced in yeast cells, has been analyzed for its ability to bind
      its putative viral substrates, the att sites. An electrophoretic mobility shift
      assay revealed that the Moloney MuLV IN protein binds synthetic oligonucleotides
      containing att sequences, with specificity towards its cognate (MuLV) sequences.
      The terminal 13 base pairs, which are identical at both ends of viral DNA, are
      sufficient for binding if present at the ends of oligonucleotide duplexes in the
      same orientation as in linear viral DNA. However, only weak binding was observed
      when the same sequences were positioned within a substrate in a manner simulating
      att junctions in circular viral DNA with two long terminal repeats. Binding to
      att sites in oligonucleotides simulating linear viral DNA was dependent on the
      presence of the highly conserved CA residues preceding the site for 3' processing
      (an IN-dependent reaction that removes two nucleotides from the 3' ends of linear
      viral DNA); mutation of CA to TG abolished binding, and a CA to TA change reduced
      affinity by at least 20-fold. Removal of either the terminal two base pairs from
      both ends of the oligonucleotide duplex or the terminal two nucleotides from the
      3' ends of each strand did not affect binding. The removal of three 3' terminal
      nucleotides, however, abolished binding, suggesting an essential role for the A
      residue immediately upstream of the 3' processing site in the binding reaction.
      These results help define the sequence requirements for att site recognition by
      IN, explain the conservation of the subterminal CA dinucleotide, and provide a
      simple assay for sequence-specific IN activity.

PMID- 2214029
TI  - Analysis of the junctions between human immunodeficiency virus type 1 proviral
      DNA and human DNA.
AB  - Integrated retroviral DNA is flanked by short direct repeats of the target DNA.
      The length of these repeats is specific for the provirus that is integrated (H.E.
      Varmus, in J.A. Shapiro, ed., Mobile Genetic Elements, 1983). For the human
      immunodeficiency virus type I (HIV-1), the length of the direct repeats in the
      target DNA was shown to be 5 bp in one case (Muesing et al., Nature [London]
      313:450-458, 1985) and 7 bp in another (Starcich et al., Science 227:538-540,
      1985). One possible explanation for this discrepancy is that the direct repeats
      flanking HIV-1 proviruses are variable. To investigate this, we analyzed the
      junctions between HIV-1 proviral DNA and human DNA from nine individual clones.
      In each clone the provirus was flanked by a 5-bp direct repeat of human DNA.
      Analysis of the proviral clone previously described as being flanked by a 7-bp
      direct repeat of target DNA (Starcich et al., op. cit.) revealed that this clone
      was flanked by a 5-bp repeat instead. Therefore, we conclude that HIV-1
      proviruses are flanked by 5-bp direct repeats of human DNA. The sequences of the
      5-bp duplications from the different proviral clones do not have any apparent
      similarity to each other or to HIV-1 DNA.

PMID- 2214030
TI  - Sequence requirements for integration of Moloney murine leukemia virus DNA in
      vitro.
AB  - Normal replication of Moloney murine leukemia virus (MoMLV) requires the
      integration of a DNA copy of the viral RNA genome into a chromosome of the host.
      In this work, we characterize the DNA sequences at the ends of the linear
      proviral precursor that are required for integration in the presence of MoMLV
      integration protein in vitro. We found that nine bases of MoMLV DNA at each end
      of a linear model substrate were sufficient for near-maximal levels of
      integration and that four bases of MoMLV DNA at each end were sufficient for low
      levels of correct integration. We also found that a 3'-terminal A residue was
      preferred for integration. We infer from the limited DNA sequence requirements
      for integration that factors in addition to DNA sequence direct integration
      protein to act at the ends of the viral DNA.

PMID- 2214031
TI  - Removal of 3'-OH-terminal nucleotides from blunt-ended long terminal repeat
      termini by the avian retrovirus integration protein.
AB  - The avian myeloblastosis virus integration protein (IN) was capable of removing a
      specific set of 3'-OH-terminal nucleotides from blunt-ended long terminal repeat
      (LTR) substrates which resembled linear viral DNA in vivo. The 3'-OH-recessed
      ends map to the in vivo site of integration on linear viral DNA. The linear DNA
      plasmid substrate was formed by the generation of a unique DraI restriction
      enzyme site (TTT/AAA) at the circle junction of a 330-bp tandem LTR-LTR insert.
      IN preferentially released the three T nucleotides from the minus strand of the
      U3 LTR substrate compared with its ability to remove the three T nucleotides from
      the plus strand of the U5 LTR substrate. It was also observed that IN was capable
      of cleaving a non-LTR DNA substrate containing sequence homology to the U5 LTR
      terminus.

PMID- 2214032
TI  - Determination of influenza virus proteins required for genome replication.
AB  - An artificial vaccinia virus vector-driven replication system for influenza virus
      RNA has been developed. In this system, a synthetic NS-like gene is replicated
      and expressed by influenza virus proteins supplied through infection with
      vaccinia virus recombinant vectors. The minimum subset of influenza virus
      proteins needed for specific replication and expression of the viral
      ribonucleoprotein was found to be the three polymerase proteins (PB1, PB2, and
      PA) and the nucleoprotein.

PMID- 2214033
TI  - Oligomeric organization of gp120 on infectious human immunodeficiency virus type
      1 particles.
AB  - The oligomeric structure of the human immunodeficiency virus type 1 envelope
      glycoprotein (gp120) was examined by treating infectious virions with chemical
      cross-linking agents and subjecting the protein to sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and velocity centrifugation. Immunoblots of
      cross-linked samples revealed three gp120 bands and an approximately threefold
      shift in gp120 sedimentation. Our finding of cross-linking solely between gp120
      suggests that the gp120 subunits are closely associated in the native envelope
      structure.

PMID- 2214034
TI  - The importance of routine surveillance of distal bypass grafts with duplex
      scanning: a study of 379 reversed vein grafts.
AB  - To assess the utility of routine duplex surveillance, 379 infrainguinal reversed
      vein grafts performed at two independent teaching hospitals were prospectively
      entered into a surveillance protocol from March 1986 through August 1989. An
      average of 3.2 postoperative duplex graft flow velocity (GFV) measurements per
      graft was obtained during a mean follow-up interval of 21 1/2 months. Only 2.1%
      of 280 grafts with GFV measurements greater than 45 cm/sec failed within 6 months
      of a normal surveillance examination. GFV measurements less than 45 cm/sec in 99
      grafts led to arteriography in 75 grafts, identifying 50 stenotic lesions in 48
      bypasses (12.6% of series). Inflow lesions were present in 5%, outflow stenoses
      in 2%, and intrinsic graft stenoses in only 6% of bypasses. Only 29% of grafts
      identified as failing by duplex scan were associated with a reduction in ankle
      brachial index of greater than 0.15. Secondary reconstructions were performed in
      48 grafts based on detection of a reduced GFV measurement; all such
      reconstructions are patent after a mean follow-up of 5 months. Duplex
      surveillance is more reliable in identification of failing vein grafts than is
      determination of ankle-brachial index.

PMID- 2214035
TI  - Recurrent thoracic outlet syndrome.
AB  - Recurrent symptoms develop in 15% to 20% of patients undergoing either first rib
      resection or scalenectomy for thoracic outlet syndrome. Over the past 22 years
      134 operations for recurrence were performed in 97 patients. Four operations were
      used: transaxillary first rib resection (26); supraclavicular first rib resection
      with neurolysis (15); scalenectomy with neurolysis (58); and brachial plexus
      neurolysis (35). Complications included temporary plexus injury (0.7%), temporary
      phrenic palsy (3.7%), and permanent phrenic palsy (1.4%). The combined primary
      success rate of all four operations for recurrence was 84% in the first 3 months.
      This fell to 59% at 1 to 2 years; 50% at 3 to 5 years; and 41% at 10 to 15 years.
      No significant difference was found in results between the four operations used
      for recurrence. When recurrence was caused by trauma the results of reoperations
      were better than when recurrence was spontaneous. The primary success rates of
      three initial operations for thoracic outlet syndrome were compared to their
      secondary success rates (improved after reoperation). By use of life-table
      methods, reoperation improved the 5- to 10-year success rate of transaxillary
      first rib resection from 69% to 86% and for scalenectomy from 69% to 84%.
      Reoperation is successful in most cases of recurrent thoracic outlet syndrome and
      better when recurrence is the result of a neck injury.

PMID- 2214036
TI  - Experimental and early clinical evaluation of vascular anastomoses with argon
      laser fusion and the use of absorbable guy sutures: a preliminary report.
AB  - This study investigated the feasibility of forming vascular anastomoses by use of
      argon laser tissue fusion and absorbable, monofilament polydimethylsiloxane guy
      sutures. In initial animal studies femoral arteriovenous fistulas approximately
      1.5 cm in length were created bilaterally in each of 10 dogs and were studied
      histologically at 2, 4, 8, 16, and 24 weeks (two animals in each interval). In
      each animal, one anastomosis (control) was formed with continuous 6-0
      polypropylene suture, and the contralateral anastomosis (experimental) was
      performed with an argon laser (0.5 watt, 5 to 7 minutes exposure, energy fluence
      1100 to 1500 joules/cm2 per 1 cm length) with stay sutures of 5-0
      polydimethylsiloxane at 0.5 to 0.65 cm intervals. At removal, all anastomoses
      were patent without hematomas, aneurysms, or luminal narrowing. Histologic
      examination at 2 to 16 weeks demonstrated resorption of the biodegradable suture
      material by a local inflammatory reaction. By 24 weeks, laser-fused specimens had
      no evidence of suture material at the anastomotic line, and healing consisted of
      a bond between artery and vein wall tissues. Control suture specimens at the same
      intervals exhibited an organized fibrous tissue response to the suture. Clinical
      adaptability of this technology has subsequently been evaluated in five patients
      at 10 to 27 months (21.6 +/- 5.8) by physical examination and duplex scanning and
      demonstrate no evidence of abnormal healing. This study establishes the
      experimental and preliminary clinical feasibility of laser-fused anastomoses
      aligned by biodegradable guy sutures and supports further investigation and
      refinement of the technique.

PMID- 2214037
TI  - Extraperitoneal endarterectomy for iliofemoral occlusive disease.
AB  - Sixty patients with iliofemoral occlusive disease were treated by autogenous
      anatomic reconstruction by endarterectomy. Endarterectomy was performed extra
      peritoneally by the eversion technique. The operative technique and its
      advantages and disadvantages are discussed. Six patients had postoperative
      complications of acute anastomotic hemorrhage (two patients), would hematoma (two
      patients), and atelectasis (two patients). Sixty patients discharged with patient
      arterial reconstruction were followed up from 5 months to 17 1/2 years, with a
      mean follow-up of 53 months. There were no other vascular complications. Seventy
      limbs were at risk during this period, with an accumulative patency rate of 80.4%
      at 5 years and 71.4% at 10 years. There were 11 occlusions of the external iliac
      artery and one stenosis of the common femoral artery. Failures occurred mainly in
      the external iliac artery, which appears to be the limiting factor in the
      continued patency of endarterectomy. There were 18 deaths (30%). Nine deaths were
      attributed to the complications of arteriosclerosis.

PMID- 2214038
TI  - The fate of residual saphenous vein after partial removal or ligation.
AB  - Duplex scanning was used to study residual greater and lesser saphenous vein
      segments in 14 limbs with previous partial distal greater saphenous vein removal,
      19 limbs with partial proximal greater saphenous vein removal, 29 limbs with
      total greater saphenous vein removal, 10 limbs with high greater saphenous vein
      ligation, as well as 37 contralateral unoperated and 8 other normal limbs.
      Partial distal removal showed better preservation of residual greater saphenous
      vein than partial proximal removal, with greater preservation of "usable" length
      and greater average diameter. Compared to contralateral unoperated legs, partial
      distal removal, partial proximal removal, and total removal all showed a similar
      degree of compensatory lesser saphenous vein enlargement. High ligation showed no
      lesser saphenous vein enlargement but showed the best greater saphenous vein
      preservation, none had less than 85% preservation of potential length. Combining
      residual greater saphenous vein and lesser saphenous vein segments of usable
      caliber, 100% of high ligation, 93% of partial distal removal, and 74% of partial
      proximal removal had greater than 60 cm total length, and most total removal had
      greater than 40 cm usable residual lesser saphenous vein. Previous saphenous vein
      surgery should not categorically exclude patients as having no usable residual
      ipsilateral vein for bypass. Partial distal removal allows better preservation of
      length and caliber of residual greater saphenous vein than proximal harvest, with
      both showing equivalent lesser saphenous vein enlargement to those with total
      greater saphenous vein removal. High ligation, performed for early tributary
      varicosities, in patients with saphenofemoral but no perforator incompetence,
      gives excellent preservation of residual greater saphenous vein length and
      caliber. Sclerotherapy to tributary varicosities did not obliterate distal
      greater saphenous vein segments.

PMID- 2214039
TI  - The influence of neutralizing heparin after carotid endarterectomy on
      postoperative stroke and wound hematoma.
AB  - The influence of neutralizing or not neutralizing heparin after carotid
      endarterectomy on postoperative stroke and wound hematoma is unknown. During the
      past 6 years some of the authors frequently gave protamine sulfate to neutralize
      heparin, whereas others did not unless a patch was used or wound hemostasis was
      not readily obtained. To determine the influence of protamine sulfate on stroke
      and wound hematoma the records of 697 patients having a carotid endarterectomy
      from January 1984 to September 1989 were reviewed. Protamine sulfate was given to
      328 patients, and 369 did not receive protamine sulfate. The incidence of stroke
      in the two groups was 1.8% (n = 6) and 2.7% (n = 10), respectively, and the
      difference was not significant (p = 0.6019). Excluding three strokes that could
      not be related to neutralizing or not neutralizing heparin, the difference
      remained insignificant (1.5% vs 2.2%, p = 0.7290). The incidence of wound
      hematoma was 1.8% (n = 6) in patients given protamine sulfate and 6.5% (n = 24)
      in patients not given protamine sulfate, and this difference was significant (p =
      0.0044). The difference remained significant when three hematomas not related to
      protamine sulfate were excluded (1.2% vs 6.2%, p = 0.0013). In patients not given
      protamine sulfate draining the wound lessened the incidence of wound hematoma
      (4.4% vs 8.6%), but this difference was not statistically significant (p =
      0.1475). In patients given protamine sulfate the dose of protamine sulfate (15 to
      45 mg vs 50 to 75 mg) had no statistically significant effect on the incidence of
      stroke (0.8% vs 2.0%, p = 0.6530) or wound hematoma (1.6% vs 1.0%, p = 1.000).

PMID- 2214040
TI  - Duplex scanning of normal or minimally diseased carotid arteries: correlation
      with arteriography and clinical outcome.
AB  - This study evaluated the role of duplex scanning in the management of patients
      with normal or minimally diseases carotid arteries. Carotid duplex scans were
      interpreted according to previously established criteria and considered normal
      when pulsed Doppler spectral waveforms showed laminar flow or only minor flow
      disturbances. Normal flow patterns were noted by duplex scanning in 100 carotid
      bifurcations of 72 patients who also underwent carotid arteriography. Neurologic
      symptoms (amaurosis fugax, transient ischemic attack, or stroke) were present in
      relation to 23 arteries and absent in relation to 77 arteries. On the 23
      symptomatic sides arteriography was interpreted as normal in eight, 1% to 15%
      stenosis in 14, and 16% to 40% stenosis in one. For the 77 asymptomatic sides,
      arteriography showed normal vessels in 15, 1% to 15% stenosis in 43, and 16% to
      40% stenosis in 19. One symptomatic patient was treated by carotid endarterectomy
      for an irregular 1% to 15% stenosis. None of the asymptomatic lesions were in the
      range of 80% to 99% stenosis, which would justify endarterectomy for asymptomatic
      disease. Clinical follow-up for a mean interval of 28 months on 20 of the 22
      symptomatic patients not undergoing surgery revealed no strokes and transient
      recurrent symptoms in two patients. Assuming that the single operation in this
      study was indicated, duplex scanning correctly identified lesions not requiring
      carotid endarterectomy in 96% (22/23) of the symptomatic patients. A normal
      duplex scan also predicted a benign clinical outcome without operation. Duplex
      scanning can reliably exclude surgically treatable carotid bifurcation lesions in
      asymptomatic patients, and endarterectomy is rarely indicated in symptomatic
      patients with normal duplex scan results. This study supports a nonoperative
      therapeutic approach for most patients with neurologic symptoms and a normal
      carotid duplex scan on the appropriate side.

PMID- 2214041
TI  - Propagation of deep venous thrombosis identified by duplex ultrasonography.
AB  - To investigate the efficacy of anticoagulation in preventing continuing
      thrombosis, we prospectively evaluated 24 patients with acute deep venous
      thrombosis using duplex ultrasonography. All patients were hospitalized with
      conclusive ultrasonic evidence of deep venous thrombosis identified in one of
      four levels: I, calf only; II, calf-popliteal; III, calf-popliteal-femoral; or
      IV, calf-popliteal-femoral-iliac. Duplex scans were obtained on admission and on
      three subsequent occasions during therapy. Progression of thrombosis was defined
      as advancement of thrombus to the more proximal venous level. Demographic data,
      symptoms, risk factors for deep venous thrombosis, physical findings,
      anticoagulation regimens, and hematologic variables were ascertained. Adequacy of
      anticoagulation was defined as elevation of baseline activated partial
      thromboplastin time by 150%. Nine patients (38%) had progression of thrombosis,
      and 15 (62%) had stable or improving duplex scans. Progression occurred as
      follows: I----II (2), I----III (2), II----III (1), and III----IV (4). Of the
      demographic and clinical variables examined, only smoking correlated with
      progression of thrombus (p = 0.04). Average heparin dose in the stable group was
      1214 +/- 294 units/hr and 1122 +/- 248 units/hr in the group that progressed (p =
      0.8): activated partial thromboplastin time was 45.6 +/- 7 seconds in the stable
      group and 49.8 +/- 9 seconds in the progression group (p = 0.7). Nine patients in
      the stable group had consistently adequate anticoagulation, whereas six did not;
      six in the progression group were consistently anticoagulated, and three were
      not. Two patients (one with stable thrombus and one with progressive thrombus)
      suffered nonfatal pulmonary emboli. Clot progression as determined by duplex
      scanning did not predict acute complications of deep venous thrombosis.

PMID- 2214042
TI  - Re-endothelialization of isolated segments of the canine carotid artery with
      reference to the possible role of the adventitial vasa vasorum.
AB  - This study was designed to determine if the adventitial vasa vasorum contribute
      to re-endothelialization of the canine carotid artery after removal of the
      endothelial flow surface. Casting studies demonstrated that vasa vasorum are
      present only in the adventitia of the canine carotid artery. Ninety autograft
      segments of the carotid artery from which the endothelium had been removed were
      implanted in both carotid arteries of 45 dogs. Glutaraldehyde-processed canine
      carotid allografts were positioned at each end to prevent pannus ingrowth and a
      Gore-Tex wrap to prevent periarterial tissue growth was placed into the outer
      wall. Three methods were used, with observations at 4 and 8 weeks. In method 1
      the test segment was treated with superficial endarterectomy. In method 2 a
      balloon catheter was used to remove the endothelium. In method 3 balloon catheter
      denudation of the flow surface was also employed and, in addition, the adventitia
      was removed surgically as completely as possible, although a few vasa vasorum
      were shown to remain in some grafts. In method 1 all the patent endarterectomized
      arteries were partially re-endothelialized at both the 4- and 8-week intervals.
      In method 2, 72% of the balloon-denuded patent arteries with intact adventitial
      vasa vasorum were partially re-endothelialized at 4 weeks and 84% at 8 weeks.
      However, in method 3 the flow surfaces had no endothelium at 4 weeks and 83%
      still had none at 8 weeks. These findings suggest that, in the absence of pannus
      ingrowth, re-endothelialization of the canine carotid artery depends on not only
      the presence but also the number of adventitial vasa vasorum.

PMID- 2214043
TI  - Clinical spectrum of symptomatic external iliac fibromuscular dysplasia.
AB  - External iliac fibromuscular dysplasia is a rare and usually asymptomatic
      disorder. We report eight symptomatic patients seen over a 15-year period and
      review pathophysiologic mechanisms accounting for the three following distinct
      lower extremity ischemic sequelae: (1) Emboli--episodic focal digital ischemia
      (blue toe) was seen in three patients. Resection and primary anastomosis of focal
      iliac ulcerative fibromuscular dysplasia (one patient) or resection and
      replacement (two patients) removed the embolic source and relieved the symptoms.
      (2) Chronic ischemia--gradual onset of full leg claudication in four patients was
      treated by operative graduated intraluminal dilation in three patients and
      prosthetic bypass in one. Arteriography subsequently showed a remodeled lumen in
      the three patients who underwent dilation. (3) Dissection--acute onset leg
      ischemia resulted from presumed dissection of the external iliac segment. After 4
      months of conservative management of antiplatelet agents and exercise, symptoms
      resolved completely, and arteriogram showed spontaneous restoration of a normal
      lumen in the dissected segment. The clinical presentation of fibromuscular
      dysplasia may mimic other arterial processes such as atherosclerosis. Diagnosis
      is made only by arteriography with specific magnification views of the external
      iliac arteries and careful surveillance of the renal arteries. Appropriate
      treatment should be tailored to the clinical presenting symptom. For microembolic
      disease, resection and replacement are required. For chronic ischemia,
      intraluminal dilation is generally sufficient and durable and has proved to be a
      simpler and acceptable alternative to replacement or bypass. In acute dissection,
      surgical intervention may be deferred if the limb is viable to allow spontaneous
      healing and remodeling. Persistent symptoms may be the only indication for
      intervention in this ischemic manifestation of external iliac fibromuscular
      dysplasia.

PMID- 2214044
TI  - Thrombus propagation and level of anticoagulation.

PMID- 2214045
TI  - Initial clinical evaluation of carotid artery laser endarterectomy.
AB  - Clinical study of carotid artery laser endarterectomy began April 15, 1988. This
      report describes the first 10 cases that were performed in nine patients (five
      men and four women, mean age 70 years). Indications were asymptomatic stenosis
      (5), transient ischemic attacks (4), and stroke in evolution (1). There were two
      emergency cases and eight elective cases (including one reoperative case).
      Surgical exposure, systemic heparinization, vascular control, and a longitudinal
      arteriotomy were used. The cleavage plane between atheromas and media was
      developed with argon ion laser radiation (488 and 514.5 nm) directed through a
      300 microns quartz fiber at power 1.0 W. Laser radiation was used to cut the
      atheromas out of the arteries and weld the end points. Residual atheromatous
      debris were vaporized with individual laser exposures. Arteriotomies were closed
      with sutures, and blood flow was restored. The endarterectomies were 3.9 +/- 1.1
      cm long and required 330 +/- 97 joules. Mean clamp time was 22.5 +/- 7.9 minutes.
      Shunts were used in two cases. There were no arterial perforations or injuries as
      a result of laser light. Complications were hematoma (1), respiratory arrest (1),
      and transient neurologic deficit (1). Carotid endarterectomy is technically
      feasible with argon ion laser radiation. In the present series, postoperative
      observations, averaging 12 months and ranging from 5 to 19 months, have shown
      satisfactory results. No angiographic follow-up examinations were carried out.

PMID- 2214046
TI  - Abdominal aortic aneurysm associated with aortic hypoplasia and polycystic
      kidneys.

PMID- 2214047
TI  - Safety of peripheral vascular surgery after recent acute myocardial infarction.

PMID- 2214048
TI  - Educators say MD-PhD degree programs make sense, but prove it.

PMID- 2214049
TI  - What goes up must come down, but hypertension experts worldwide differ about
      ways, means.

PMID- 2214050
TI  - Secretary of Health, Human Services to hear recommendations for improving
      immunization.

PMID- 2214052
TI  - From the Centers for Disease Control. Health benefits of smoking cessation.

PMID- 2214051
TI  - Cancer Institute takes a look at ascorbic acid.

PMID- 2214053
TI  - From the Centers for Disease Control. Smoking-related mortality decline among
      physicians--Rhode Island.

PMID- 2214054
TI  - From the Centers for Disease Control. Smokers' beliefs about the health benefits
      of smoking cessation--20 U.S. communities, 1989.

PMID- 2214055
TI  - The future of health care: military model? Canadian cost cutting.

PMID- 2214056
TI  - Benefits and harms: the balance sheet.

PMID- 2214057
TI  - Cytotechnologists' proficiency and laboratory regulations.

PMID- 2214058
TI  - Government studies of physician-owned laboratories.

PMID- 2214059
TI  - Informing physicians about promising new treatments for severe disease.

PMID- 2214060
TI  - Biopsy of occult breast lesions and professional liability.

PMID- 2214061
TI  - A piece of my mind. Taps.

PMID- 2214062
TI  - Changes in quality of care for five diseases measured by implicit review, 1981 to
      1986.
AB  - We measured quality of care before and after implementation of the prospective
      payment system. We developed a structured implicit review form and applied it to
      a sample of 1366 Medicare patients with congestive heart failure, acute
      myocardial infarction, pneumonia, cerebrovascular accident, or hip fracture who
      were hospitalized in 1981-1982 or 1985-1986. Very poor quality of care was
      associated with increased death rates 30 days after admission (17% with very good
      care died vs 30% with very poor care). The quality of medical care improved
      between 1981-1982 and 1985-1986 (from 25% receiving poor or very poor care to
      12%), although more patients were judged to have been discharged too soon and in
      unstable condition (7% vs 4%). Except for discharge planning processes, the
      quality of hospital care has continued to improve for Medicare patients despite,
      or because of, the introduction of the prospective payment system with its
      accompanying professional review organization review.

PMID- 2214063
TI  - Prospective payment system and impairment at discharge. The 'quicker-and-sicker'
      story revisited.
AB  - Since the introduction of the prospective payment system (PPS), anecdotal
      evidence has accumulated that patients are leaving the hospital "quicker and
      sicker." We developed valid measures of discharge impairment and measured these
      levels in a nationally representative sample of patients with one of five
      conditions prior to and following the PPS implementation. Instability at
      discharge (important clinical problems usually first occurring prior to
      discharge) predicted the likelihood of postdischarge deaths. At 90 days
      postdischarge, 16% of patients discharged unstable were dead vs 10% of patients
      discharged stable. After the PPS introduction, instability increased primarily
      among patients discharged home. Prior to the PPS, 10% of patients discharged home
      were unstable; after the PPS was implemented, 15% were discharged unstable, a 43%
      relative change. Efforts to monitor the effect of this increase in discharge
      instability on health should be implemented.

PMID- 2214064
TI  - From the Office of the General Counsel. Economic considerations in treatment
      decisions and the standard of care in medical malpractice litigation.

PMID- 2214065
TI  - Meet Kimberly Bergalis--the patient in the 'dental AIDS case'.

PMID- 2214066
TI  - Ultrasonic catheters give cardiologists boost in observing internal blood
      vessels.

PMID- 2214067
TI  - AMA Science Reporters' Conference explores wide range of clinical problems,
      approaches.

PMID- 2214068
TI  - From the Centers for Disease Control. Healthy people 2000: national health
      promotion, disease prevention objectives for the year 2000.

PMID- 2214069
TI  - The effects of polyunsaturated fat vs monounsaturated fat on plasma lipoproteins:
      the power of a study.

PMID- 2214070
TI  - Hip surgery and venous thrombosis: effect of anesthesia.

PMID- 2214071
TI  - Mother's milk turns toxic following fish feast.

PMID- 2214072
TI  - The effect of lay advertising on breast-feeding prevalence.

PMID- 2214073
TI  - Hope hype hit.

PMID- 2214074
TI  - Truth is stranger than fiction department: the surgeon, the radiologist, the
      authors, and JAMA got it right.

PMID- 2214075
TI  - Transcervical balloon tuboplasty. A multicenter study.
AB  - Transcervical balloon tuboplasty represents a noninvasive technique to treat
      proximal tubal occlusion. In a multicenter study, 77 women with confirmed
      bilateral proximal tubal occlusion underwent the procedure. In 71 patients (92%),
      at least one proximally obstructed fallopian tube was recanalized. Concomitant
      distal bilateral tubal occlusions were diagnosed after successful proximal tubal
      balloon recanalizations in 13 patients (17%). In the remaining 64 patients, 22
      clinical pregnancies (34%) have been confirmed during a median follow-up period
      of 12 months. Among those, 17 (77%) resulted in normal deliveries and five (23%)
      resulted in a first-trimester miscarriage. One patient was diagnosed with an
      ectopic pregnancy. Among 25 patients who had not conceived within 6 months of the
      procedure, 17 (68%) demonstrated continuing tubal patency on repeated
      hysterosalpingogram. We conclude that transcervical balloon tuboplasty is a safe
      outpatient technique that may represent an alternative to in vitro fertilization
      or microsurgical reanastomosis of fallopian tubes.

PMID- 2214076
TI  - Transmission of HIV-1 infections from mothers to infants in Haiti. Impact on
      childhood mortality and malnutrition. The CDS/JHU AIDS Project Team.
AB  - Of 4588 pregnant women in a high-risk Haitian population, 443 (9.7%) were
      serologically positive for the human immunodeficiency virus type 1 (HIV-1).
      Infants born to women who were HIV-1 seropositive were more likely to be
      premature, of low birth weight, and malnourished at 3 and 6 months of age than
      were infants born to women who were HIV-1 seronegative. Increased mortality was
      observed in infants born to women who were HIV-1 seropositive by 3 months of age.
      At 12 months of age, 23.4% of the infants born to women who were HIV-1
      seropositive had died compared with 10.8% of the infants born to women who were
      HIV-1 seronegative; at 24 months of age, the mortality rates were 31.3% and
      14.2%, respectively. Maternal HIV-1 infections resulted in an 11.7% increase in
      the overall infant mortality rate in this population. The estimated mother-to
      infant HIV-1 transmission rate in these breast-fed infants was 25%, similar to
      the rates reported for non-breast-fed populations in the United States and
      Europe.

PMID- 2214077
TI  - Acute sensorineural deafness in Lassa fever.
AB  - A prospective audiometric evaluation of 69 hospitalized febrile patients in
      Sierra Leone, West Africa, revealed a sensorineural hearing deficit (SNHD) in 14
      (29%) of 49 confirmed cases of Lassa fever and in 0 of 20 febrile controls. An
      SNHD was present in nine (17.6%) of 51 people who had evidence of previous Lassa
      virus infection. Twenty-six of 32 local residents who had previously sustained a
      sudden deafness had antibody titers to Lassa virus of 16 or greater, compared
      with six of 32 matched controls. Lassa fever is associated with an incidence of
      SNHD, which considerably exceeds that previously reported with any other
      postnatally acquired infection, and accounts for a prevalence of virus-related
      hearing impairment in the eastern province of Sierra Leone that is greater than
      that reported from anywhere else in the world.

PMID- 2214078
TI  - Apartheid medicine. Health and human rights in South Africa.
AB  - Human rights and health care under apartheid in South Africa were studied. Human
      rights violations, such as detention without charge or trial, assault and torture
      in police custody, and restriction orders, have had devastating effects on the
      health of persons experiencing them. These violations have occurred in the
      context of a deliberate policy of discriminatory health care favoring the white
      minority over the black majority. South Africa's medical societies have had mixed
      responses to the health problems raised by human rights violations and inequities
      in the health care system. The amelioration of health care for all and prevention
      of human rights violations depend on ending apartheid and discrimination and
      greater government attention to these problems.

PMID- 2214079
TI  - Does age affect outcomes of out-of-hospital cardiopulmonary resuscitation?
AB  - We examined the relation between age and outcomes in patients treated for out-of
      hospital cardiac arrest in Seattle, Wash. Considering all out-of-hospital cardiac
      arrests treated by paramedics over a recent 5-year period, 386 (27%) of 1405
      consecutive patients aged 70 years or older were resuscitated and admitted to a
      hospital vs 474 (29%) of 1624 younger patients; 140 elderly patients (10%) were
      discharged alive vs 223 younger patients (14%). Of the 140 elderly patients, 112
      went home and 28 went to a nursing home. Considering only patients whose initial
      rhythms were ventricular fibrillation, the percent of patients discharged alive
      was substantially higher: 120 (24%) of 493 for elderly patients and 194 (30%) of
      639 for younger patients. Elderly patients can benefit from attempted
      resuscitation from out-of-hospital cardiac arrest.

PMID- 2214080
TI  - Can employers exclude women to protect children?

PMID- 2214081
TI  - Life-sustaining therapies in elderly persons.

PMID- 2214082
TI  - Deafness associated with Lassa fever.

PMID- 2214083
TI  - A piece of my mind. Consoling Mrs Byrne.

PMID- 2214084
TI  - Late-night admissions: resident education and sleep patterns.

PMID- 2214085
TI  - Diagnostic and therapeutic technology assessment. Alpha-interferon and chronic
      myelogenous leukemia.

PMID- 2214086
TI  - Preoperative evaluation of young woman with an acute abdomen.

PMID- 2214087
TI  - John H. Talbott, MD: 10th JAMA editor.

PMID- 2214088
TI  - New allergy society, formed to advocate in vitro laboratory test, wins
      reimbursement victory.

PMID- 2214089
TI  - Nobel prizes emphasize clinical applications.

PMID- 2214090
TI  - From the National Institutes of Health.

PMID- 2214091
TI  - From the Centers for Disease Control. Progress toward achieving the 1990 high
      blood pressure objectives.

PMID- 2214092
TI  - Home births and minimal medical interventions.

PMID- 2214093
TI  - Latchkey children and guns at home.

PMID- 2214094
TI  - Homicide rates and firearm availability.

PMID- 2214095
TI  - Measles vaccination.

PMID- 2214096
TI  - Points of potential IQ lost from lead.

PMID- 2214097
TI  - Lead poisoning from the use of Indian folk medicines.

PMID- 2214098
TI  - 'Old man in a VA hospital': shock and dismay.

PMID- 2214099
TI  - Effects of Medicaid eligibility expansion on prenatal care and pregnancy outcome
      in Tennessee.
AB  - To investigate the effects of a 1985 Tennessee Medicaid regulatory change that
      expanded eligibility coverage specifically for married women during pregnancy, we
      studied vital statistics files linked to Medicaid enrollment files. The greatest
      Medicaid coverage increase in terms of an absolute difference in rates and the
      number of women covered occurred in white married women younger than 25 years
      with less than 12 years of education, where enrollment increased 18%. However, in
      that group of mothers, as well as for the total of all mothers studied, there
      were no concomitant improvements in use of early prenatal care, birth weight, or
      neonatal mortality. Analysis of the timing of enrollment relative to the
      beginning of pregnancy showed that more than two thirds of the women who enrolled
      did so after the first trimester.

PMID- 2214100
TI  - Intrapleural tetracycline for the prevention of recurrent spontaneous
      pneumothorax. Results of a Department of Veterans Affairs cooperative study.
AB  - This prospective, multicenter, randomized, "unblinded," controlled clinical trial
      was designed to determine if the intrapleural instillation of 1500 mg of
      tetracycline hydrochloride would be effective in diminishing the ipsilateral rate
      of recurrence for spontaneous pneumothorax. During the 4-year enrollment period,
      113 patients were assigned to the tetracycline group; 116 patients were assigned
      to the control group. During the 5-year study period, the recurrence rate in the
      tetracycline group (25%) was significantly less than that in the control group
      (41%). Use of tetracycline seemed to reduce the recurrence rates for patients
      with either primary or secondary spontaneous pneumothorax and for patients with
      either an initial or a recurrent pneumothorax. We conclude that the intrapleural
      administration of tetracycline in patients with spontaneous pneumothorax
      significantly reduces the rate of ipsilateral recurrence but is associated with
      intense chest pain. Intrapleural tetracycline therapy is indicated for patients
      with a spontaneous pneumothorax who are hospitalized and are treated with tube
      thoracostomy.

PMID- 2214101
TI  - Caffeine and ventricular arrhythmias. An electrophysiological approach.
AB  - Little information is known regarding caffeine's effect on the substrate
      supporting sustained ventricular arrhythmias. This prospective study evaluated
      the effect of coffee (275 mg of caffeine) on this substrate with programmed
      ventricular stimulation in 22 patients with a history of symptomatic nonsustained
      ventricular tachycardia, ventricular tachycardia, or ventricular fibrillation.
      Patients underwent electrophysiological testing before and 1 hour after coffee
      ingestion. Mean (+/- SEM) plasma caffeine level achieved after coffee consumption
      was 6.2 +/- 0.5 mg/L. Mean plasma catecholamine and potassium values were not
      altered significantly 1 hour following caffeine ingestion. The number of
      extrastimuli required to induce an arrhythmia was unchanged in 10 patients (46%),
      increased in six (27%), and decreased in six (27%). Rhythm severity was unchanged
      in 17 patients (77%), more severe in two (9%), and less severe in three (14%). In
      those patients with clinical ventricular arrhythmias, caffeine did not
      significantly alter inducibility or severity of arrhythmias, suggesting little
      effect on the substrate supporting ventricular arrhythmias.

PMID- 2214102
TI  - Life and death in the US Army. In Corpore sano.
AB  - Using standardized mortality ratios, this study compares the sex- and race
      specific, age-adjusted death rates for all US Army soldiers with those for the
      entire US population. Results show that soldiers are currently dying at a rate
      that is only half that of their civilian counterparts. The most striking
      difference in death rates by cause is a markedly lower homicide death rate for
      Army black men; homicides among the civilian black male population are 12 times
      more frequent than in the Army. Some factors that might account for these lower
      mortality rates in the Army are discussed.

PMID- 2214103
TI  - Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the
      United States, 1988.
AB  - In 1988, the Centers for Disease Control and the Oklahoma State Department of
      Health identified 40 patients who had a fourfold or greater change in antibody
      titer in response to Ehrlichia canis. The median age of these patients was 42
      years, 83% were male, 76% became ill between May and July, and 92% reported
      recent exposures to ticks. Patients resided in or were exposed to ticks in 14
      states, including five where ehrlichiosis had not been reported before 1988.
      Thirty-four patients (85%) were hospitalized, and many had serious complications,
      including acute respiratory failure (seven patients), encephalopathy (six
      patients), and acute renal failure (four patients). Pulmonary infiltrates were
      demonstrated in 14 patients, cerebrospinal fluid pleocytosis was seen in 10
      patients, and elevated levels of serum creatinine were demonstrated in eight
      patients. Two patients, both of whom had preexisting medical problems, died.
      Nonhospitalized patients received tetracycline therapy earlier in the course of
      their illness than hospitalized patients. There was no significant difference in
      the interval from initiation of antibiotic therapy to the first day of
      defervescence between patients treated with tetracyclines and those treated with
      chloramphenicol.

PMID- 2214104
TI  - Military medicine from World War II to Vietnam.

PMID- 2214105
TI  - Caring for the wounded in wartime.

PMID- 2214106
TI  - Medicaid and prenatal care. Necessary but not sufficient.

PMID- 2214107
TI  - Owl of wisdom.

PMID- 2214108
TI  - Nonotologic otalgia.

PMID- 2214109
TI  - Prophylaxis of steroid-induced purpura.

PMID- 2214110
TI  - Innovation in medical curricula: before and beyond 'new pathways'.

PMID- 2214111
TI  - Medical education: a symbolic ritual?

PMID- 2214112
TI  - The Hippocratic oath: a basis for modern ethical standards.

PMID- 2214113
TI  - Dequantifying the boards.

PMID- 2214114
TI  - Medicine and magic.

PMID- 2214115
TI  - [Cardiovascular effects of apnea test in the diagnosis of brain death].
AB  - Cardiovascular effects of apnea test were investigated in 12 patients suspected
      of brain death. Arterial blood gas and cardiovascular hemodynamics were measured
      just before and after 10-minute apnea. Apnea test induced respiratory acidosis
      without hypoxemia. Cardiac index increased by 34% (2.3 to 3.1 l.min-1.m-2; P less
      than 0.01) and systemic vascular resistance index decreased by 30% (3608 to 2519
      dynes.sec.cm-5.m-2; P less than 0.01), whereas heart rate and mean arterial
      pressure were unchanged. Significant increases in mean pulmonary arterial
      pressure (17.6 to 29.1 mmHg; P less than 0.01), pulmonary vascular resistance
      index (381 to 616 dynes.sec.cm-5.m-2; P less than 0.01) and right ventricular
      stroke work index (4.0 to 10.5 g.m.m-2; P less than 0.01) suggest that apnea test
      increases right ventricular afterload.

PMID- 2214116
TI  - [Skin blood flow measured by laser Doppler flowmetry under enflurane anesthesia
      or modified neuroleptanesthesia during abdominal surgery].
AB  - In 18 patients for abdominal operations, the skin blood flow of the sole was
      measured with a laser Doppler flowmeter under general anesthesia. The deep body
      temperature was also measured. During the induction of anesthesia with
      thiopental, an elevation of the skin blood flow was observed. The elevation was
      due to administration of thiopental. After the induction, the elevation appeared
      to be more prolonged under nitrous-oxide and enflurane anesthesia than under
      diazepam or droperidol, with nitrous-oxide and fentanyl anesthesia. The
      persistent elevation was observed for 104 +/- 10 minutes under enflurane
      anesthesia in 10 patients, but the elevation was 71 +/- 7 minutes under modified
      neuroleptanesthesia in 8 patients. This difference might be associated with the
      peripheral vasodilatation by enflurane and the short peripheral vasodilatation by
      droperidol or diazepam. Increases of the skin blood flow correlated well with the
      changes of the deep temperature of the sole. These results indicate that the
      peripheral skin blood flow is different during long operation between enflurane
      anesthesia and modified neuroleptanesthesia and the laser Doppler flowmetry is a
      useful tool as a monitor of peripheral circulation and body temperature.

PMID- 2214117
TI  - [The effects of a small dose of atropine upon sinus bradycardia during spinal
      anesthesia].
AB  - Positive or negative chronotropic effects of atropine and their magnitude are
      known to be determined by its dose given, concomitant sympathetic tone, and
      patient's age. Thus, the aim of the present study is to investigate the small
      effective dose of atropine for acceleration of heart rate in sedated bradycardic
      patients under spinal anesthesia, and to evaluate the relationship between the
      heart rate response to atropine and level of analgesia or patient's age.
      Significant increases in heart rate were observed in patients receiving
      intravenous atropine 4 micrograms.kg-1 (n = 21) or 6 micrograms.kg-1 (n = 35)
      except 2 micrograms.kg-1 (n = 18). However, there were wide variations in cardiac
      responses to atropine among patients in each group. Negative chronotropic
      responses to atropine were elicited in 10 (56%), 2 (9%), and 1 (3%) of the
      patients receiving 2 micrograms.kg-1, 4 micrograms.kg-1 and 6 micrograms.kg-1,
      respectively. Although there was no correlation between the heart rate response
      to each dose of atropine and the level of spinal anesthesia, the magnitude of
      positive chronotropic response to atropine of 6 micrograms.kg-1 related inversely
      with age. The present results suggest that atropine above 4 micrograms.kg-1 is
      required to accelerate the heart rate in most bradycardic patients under spinal
      anesthesia irrespective of the level of analgesia. However, it seems appropriate
      to administer atropine intravenously in a cumulative fashion, because of
      individual's variability including age in the chronotropic response to atropine.

PMID- 2214118
TI  - [Platelet catecholamine changes in patients with pheochromocytoma].
AB  - In patients with adrenal tumor, the importance of platelet catecholamine was
      examined. In patients with pheochromocytoma, not only preoperative catecholamine
      concentrations in blood and urine but also platelet catecholamine content were
      abnormally high as compared to patients with other adrenal tumors
      (pheochromocytoma for NE 3383 and E 311, no pheochromocytoma for NE 235 and E 24
      pg.mg-1 protein). In the patient with pheochromocytoma, plasma catecholamine
      concentration showed its peak during the manipulation of the tumor during
      operation, and it decreased rapidly and returned to normal level the day after
      operation. On the other hand, platelet catecholamine content showed its peak
      after operation and returned to normal range on the 7th postoperative day. These
      results suggest that determination of platelet catecholamine content is useful
      for pre-operative diagnosis of pheochromocytoma, and that catecholamine in
      platelet modulates sudden fluctuation in plasma catecholamine concentration.

PMID- 2214119
TI  - [Changes in platelets and blood coagulation during prolonged ECLA with a heparin
      bonded hollow fiber membrane lung].
AB  - Effects of the heparin bonded artificial membrane lung and circuit on blood
      coagulation were investigated during prolonged extracorporeal lung assist on
      goats. A veno-venous bypass ECLA was performed on 18 goats up to 10 days. Twelve
      of them (Group I) were with a heparin bonded device and the other six (Group II)
      were with the usual device. In Group I, heparin was continuously infused at a
      rate of 15.2 units.kg-1.hr-1 to maintain the activated coagulation time, ACT, at
      around 130 sec., while in Group II, 25.5 units.kg-1.hr-1 of heparin was necessary
      to maintain ACT at about 200 sec. to prevent blood coagulation in the bypass
      circuit. Platelets decreased significantly in Group I (by 50% of pre ECLA value)
      as well as in Group II, but aggregation activity in Group I was higher than in
      Group II. Fibrinopeptide A and antithrombin III showed no significant difference
      between the two groups. Autopsy showed no significant pathological findings.
      ECLA, with a heparin bonded surface, showed excellent blood compatibility and
      required only a little systemic administration of heparin. The heparin bonded
      bypass circuit will enable safer ECLA even in patients with some bleeding sites.

PMID- 2214120
TI  - [Marked changes in the core temperature during anaphylactic shock].
AB  - Three cases of anaphylactic shock were reported in which the core temperature was
      measured continuously. Two core temperature thermister probes were fixed on the
      forehead and the sole. Temperature dissociation between the core and the
      periphery disappeared in a few minutes after the administration of the causative
      agents. The clinical signs of the anaphylactic shock such as erythema, wheal and
      marked hypotension also developed in a few minutes after the disappearance of
      temperature dissociation. Thus treatment of anaphylactic shock could be started
      even before the patients develop severe hypotension. This clinical study suggests
      that a sudden disappearance of the temperature dissociation is a incipient sign
      of anaphylactic shock and to monitor the core as well as the peripheral
      temperature is a useful method for early diagnosis and treatment of anaphylactic
      shock.

PMID- 2214121
TI  - [Endocrine and hemodynamic responses to total body hyperthermia in humans].
AB  - We investigated effects of total body hyperthermia (TBH) on endocrine and
      hemodynamic responses. A total of five treatments were performed in five patients
      with gastric cancer under neuroleptanesthesia with morphine followed by 0.2 to
      0.4% enflurane. TBH was extracorporeally induced with veno-venous shunt
      incorporating with heat exchanger to keep their temperature between 41.5 degrees
      C and 42.0 degrees C for three hours. The patients were administered angiotensin
      to maintain tumor blood flow. Lactated Ringer's solution was administered at the
      rate of 10 to 15 ml.kg-1.hr-1 for five hours. Plasma cortisol levels decreased
      significantly to about one third of the control value after heating and the
      levels recovered to the control value after cooling. Plasma norepinephrine level
      increased significantly to about 7 to 9 times the control value following TBH,
      but this hormonal response was insufficient to reveal marked direct hemodynamic
      effects. The magnitude of fall in SVR was more significant in spite of the
      administration of angiotensin. Cardiac index increased significantly to about 2.0
      to 2.6 fold of control value, but mean arterial blood pressure (MAP) decreased
      significantly to about two thirds to four fifths of the control value. Morphine
      relieved the hormonal response in ACTH and cortisol strongly, but morphine
      suppressed hemodynamics by decreasing SVR. Neither norepinephrine released from
      sympathetic nerve endings nor even 50 to 200 ng.kg-1.min-1 of angiotensin
      administered failed to restore SVR or MAP during hyperthermia.

PMID- 2214122
TI  - [Investigation of 121 cases of spinal anesthesia with plain 0.5% bupivacaine].
AB  - Bupivacaine has been used for spinal anesthesia since 1982 in our department. We
      performed a retrograde investigation of 121 cases who had lower limb surgery and
      anesthetized with plain 0.5% bupivacaine solution during the year of 1987. Doses
      of bupivacaine, maximum spread of analgesia and spinal tap level were analyzed.
      We chose the bupivacaine doses from 2.5 ml to 4.0 ml depending on the condition
      of the patient and the specificity of the surgery. The patients were divided into
      3 groups by the dose of bupivacaine: i.e. 3.0, 3.5, 4.0 ml of plain 0.5%
      bupivacaine. Seventy percent of all patients had a spinal tap on L3/4 interspace.
      The average upper level of analgesia was T7 in each group and no patient had
      analgesia above T2 level. There was no correlation between the site of injection
      and volume of local anesthetics. However patient's physical status and surgical
      procedure are more important to obtain the good analgesic level. There was no
      significant respiratory depression nor hypotension during and after the surgery.
      It is concluded that 3-4 ml of 0.5% bupivacaine provided satisfactory spinal
      anesthesia for the lower limb surgery.

PMID- 2214123
TI  - [The effects of thiamylal, ketamine and nicardipine on the hippocampal theta
      waves produced by cerebral ischemia in cats].
AB  - Spontaneous hippocampal electroencephalogram (EEG) was recorded in the pyramidal
      cell layer (PCL) and dentate gyrus (DG) during and after ischemia produced by
      bilateral clamping of the common carotid arteries in cats. Hippocampal theta
      waves, approximately 180 degree out of phase in PCL and DG, appeared within 4.3
      +/- 2.3 seconds after the onset of bilateral carotid artery occlusion and
      continued for more than 60 minute. These hippocampal theta waves disappeared 34.2
      +/- 10.2 seconds after 4 vessel occlusion. We could not find the clear difference
      between the two areas in the appearance and disappearance of the hippocampal
      theta waves. We further investigated the effects of thiamylal, ketamine and
      nicardipine on the hippocampal theta waves during bilateral carotid artery
      occlusion. Thiamylal changed the two hippocampal theta waves to a similar pattern
      of EEG, which has irregular slow and fast waves, in both PCL and DG. Ketamine
      changed the two theta waves to irregular complex pattern of fast and slow waves
      and spike activity, which is independent at two areas. Nicardipine, a Ca
      antagonist, changed the theta waves to irregular slow waves which were similar to
      the pattern of EEG observed before carotid artery occlusion. These results
      indicate that thiamylal, ketamine and nicardipine have different effects on the
      ischemia of hippocampus.

PMID- 2214124
TI  - [A comparison of oral- and intramuscular-preoperative administration of
      ranitidine in children].
AB  - The effect of preoperative oral and intramuscular ranitidine administration on
      intragastric pH and volume was evaluated in children. Thirty healthy inpatients
      whose ages were 2-13 years, were randomly assigned to three groups. Twelve hours
      before the elective operation apple juice was given to the control group, and
      apple juice with 0.4 mg.kg-1 ranitidine to the second group (Oral group). For the
      third group (IM group) an intramuscular injection of 0.1 mg.kg-1 ranitidine was
      done. Intragastric pH was significantly elevated and gastric volume was also
      significantly reduced in IM group, and serum ranitidine concentration showed a
      high level of 359.4 +/- 85.6 ng.dl-1 (mean +/- SD). In oral group ranitidine
      effect on pH and volume was not significant, and the drug serum concentration was
      31.6 +/- 13.3 ng.dl-1 which was slightly lower than the effective level. Though
      the intramuscular injection guaranteed safer gastric content, a painful injection
      is stressful for children. With the knowledge of elimination rate of serum
      ranitidine we recommend oral ranitidine (0.4 mg.kg-1) six hours preoperatively
      for pediatric premedication.

PMID- 2214125
TI  - [Changes in arterial oxygen tension during and after enflurane or halothane
      anesthesia as well as epidural analgesia].
AB  - Recovery from inhalation anesthesia is often marked by the occurrence of
      postoperative hypoxemia. In this study, we compared the effects of enflurane or
      halothane anesthesia and epidural analgesia on arterial oxygen tension during and
      after the operation in 60 ASA physical status 1-2 patients who underwent
      cholecystectomy. Anesthesia was induced with thiopental and maintained with 66%
      N2O and -enflurane (1.5%), -halothane (1%), or -epidural lidocaine (1% solution,
      17.5 ml) in oxygen. Blood gas analysis was done before and 10, 30, 60 min after
      induction. PaO2 was measured on 1st and 3rd postoperative days in all patients
      breathing air spontaneously. PaO2 decreased during operation in all three groups
      of anesthesia. PaO2 values on first postoperative day were significantly lower
      than those before operation, and PaO2 value in enflurane group (PaO2 = 67 +/- 1
      mmHg) was significantly lower than that in halothane group (PaO2 = 72 +/- 2 mmHg,
      P less than 0.05).

PMID- 2214126
TI  - [Liquid crystal thermography; a reliable method for detecting soda lime
      exhaustion].
AB  - The dynamic and functional state of soda lime can be more precisely assessed by
      measuring changes in wall temperatures of the absorption chambers rather than
      observing color change of the soda lime granules. We demonstrated in this report
      that the liquid crystal thermometer is an inexpensive and reliable measuring
      device for this purpose.

PMID- 2214127
TI  - [Anesthetic management of a patient with progressive spinal muscular atrophy].
AB  - Various problems especially weakness of respiratory muscle and abnormal reaction
      to muscle relaxant exist during the management of anesthesia for the patients
      with neuromuscular disease with the disturbance of motor neurons. We had a
      patient for trans-urethral resection of prostate with spinal progressive muscular
      atrophy. Using nitrous oxide-oxygen with halothane, and without muscle relaxant,
      we succeeded in avoiding respiratory failure, aspiration and other serious
      complications. By measuring serum sodium, rapid discovery and treatment of water
      intoxication could be achieved.

PMID- 2214128
TI  - [A case of spinal anesthesia in a 104-year-old woman].
AB  - We gave spinal anesthesia for a super-aged patient (104 year-old female) who
      underwent insertion of prosthesis for femoral neck fracture. One point eight ml
      of 0.3% dibucaine was used as local anesthetic, and the analgesic below Th10
      level was obtained. To monitor the respiratory and circulatory functions during
      operation, pulse-oximeter and invasive arterial pressure were used. Dopamine and
      metaraminol were given to prevent hypotension and the operation was completed
      uneventfully. This anesthetic experience suggests that, for the anesthesia of a
      super-aged patient it is mandatory not only to clearly identify the complications
      and the physical features of the patient but also to explain to the patient the
      anesthetic as well as operative procedures. Besides, we have to manage elderly
      patients receiving spinal anesthesia carefully, considering intraoperative
      problems as well as the possibility of resorting to general anesthesia.

PMID- 2214129
TI  - [Determination of spinal or epidural anesthetic level in patients who cannot
      communicate well--finger or magnifying glass].
AB  - Difficulty to determine level of spinal or epidural anesthesia troubles us in the
      patients who can not communicate well, for example in patients with hearing loss,
      depressed CNS with or without depressants and in slowly replying patients with
      various reasons. We know that one can determine spinal or epidural anesthetic
      level with stroking the skin with finger with which we can detect different touch
      sensation, feeling as anesthetized smooth and unanesthetized rough. We thought
      that different touch sensation is due to perspiration at unblocked skin area. If
      cause of difference of touch sensation was due to perspiration at unanesthetized
      area as we thought, perspiration may be visible on unblocked area. We found no
      perspiration but texture change on the anesthetized skin. We photographed the
      texture of the blocked skin, before and after spinal anesthesia. The skin texture
      after the block became shallow and widened. These texture changes give us
      different touch sensation, rough and scratched before and smooth after the block.
      We can easily differentiate the blocked from the unblocked skin area with finger
      or by magnifying glass by which the skin texture change is visible.

PMID- 2214130
TI  - [37th meeting of the Japanese Society of Anesthesiology. Nagano City, 10-12 May
      1990. Abstracts].

PMID- 2214131
TI  - Increased cardiovascular responses to norepinephrine in patients with
      hypertrophic cardiomyopathy.
AB  - Sympathetic nerve-adrenergic receptor systems have been implicated in the
      pathogenesis of hypertrophic cardiomyopathy (HCM). We studied plasma
      norepinephrine (NE) levels during exercise and cardiovascular responses to NE in
      26 patients with nonobstructive HCM and 26 age- and sex-matched controls. There
      were no differences in the plasma NE levels at rest (201 +/- 84 vs 233 +/- 100
      pg/ml) or in the slope of the log NE-heart rate relationship during exercise
      between the HCM patient and control groups. When NE was infused intravenously,
      with increasing doses to 0.20 microgram/kg/min, HCM patients displayed
      significantly greater increases in mean blood pressure (29 +/- 7 vs 14 +/- 5%, p
      less than 0.001) and peripheral vascular resistance (39 +/- 7 vs 26 +/- 7%, p
      less than 0.001) than controls. Although the fractional shortening decreased
      during NE infusion in controls, it was unaffected in HCM patients, despite a
      greater elevation of systolic pressure. The responses of left ventricular
      contractility, estimated by a ratio of systolic blood pressure to end-systolic
      dimension, were significantly greater in patients with HCM (31 +/- 7 vs 13 +/-
      6%, p less than 0.001). These observations indicate that vasoconstrictive
      responses of the peripheral arteries and inotropic responses of the left
      ventricular muscle to NE were augmented in patients with HCM, while sympathetic
      nervous activity remained unchanged. Accordingly, we propose that increased
      activity of the cardiovascular adrenergic receptor systems, rather than enhanced
      sympathetic nervous function, may be related to the development of abnormal
      hypertrophy in HCM.

PMID- 2214132
TI  - Effects of a low, oral dose of nisoldipine on the systemic and coronary
      hemodynamics and the prostaglandin metabolism of ischemic heart disease patients.
AB  - This study investigated the effects of a low dose of nisoldipine (5 mg, p.o.) in
      10 patients with ischemic heart disease. The patients were subjected to a 90-min
      exercise regimen before and after a 5 mg dose of nisoldipine, using a supine
      bicycle ergometer adjusted to each patient's limitations. The mean blood plasma
      level of nisoldipine was 3.8 +/- 3.1 (SD) ng/ml. The drug significantly decreased
      the systolic arterial pressure in patients throughout the experimental session,
      whereas a change in the diastolic arterial pressure appeared only at the
      submaximal stage of the exercise. Additionally, at maximal exercise, nisoldipine
      caused a decrease in the mean coronary sinus pressure from 11.4 +/- 7 mmHg to 6.5
      +/- 5 mmHg (p less than 0.01). By contrast, while at rest, nisoldipine decreased
      the coronary vascular resistance from 1.5 +/- 0.7 mmHg/ml/min to 1.0 +/- 0.7
      mmHg/ml/min (p less than 0.05). After exercise, the drug decreased thromboxane B2
      levels from 1133 +/- 907 pg/ml to 720 +/- 379 pg/ml (p less than 0.05) in the
      coronary sinus blood, and increased the 6 keto-prostaglandin F1 alpha levels from
      465 +/- 135 pg/ml to 559 +/- 167 pg/ml (p less than 0.05) in brachial artery
      blood. This suggests that a low, oral dose of nisoldipine can moderately improve
      the systemic and coronary hemodynamics and afterloads, and may assist in
      improving the prostaglandin metabolism in ischemic heart disease patients.

PMID- 2214133
TI  - The effects of pacing-induced left bundle branch block on left ventricular
      systolic and diastolic performances.
AB  - To assess the effects of pacing-induced left bundle branch block on left
      ventricular (LV) systolic and diastolic performance, we performed digital
      subtraction ventriculography while simultaneously measuring LV pressure with a
      catheter tip micromanometer. The subjects included 10 patients with a sinus
      rhythm, a normal QRS duration and PR interval within 0.22 sec. LV performance was
      assessed during both right atrial pacing (AP) and atrioventricular sequential
      pacing (AVP) at the same pacing rate. The atrioventricular pacing interval during
      AVP was adjusted to be the maximal interval that showed the QRS configuration
      seen during complete right ventricular pacing. LV end-diastolic pressure and
      volume during AVP did not differ from those during AP. Peak positive and negative
      dp/dt during AVP were significantly lower than those during AP. Time constants
      were also significantly longer during AVP. The QRS duration during AVP
      significantly correlated with end-systolic volume and time constants, and
      inversely correlated with ejection fraction and +dp/dt. These observations
      indicated that conduction disturbance per se, induced by AVP, could not only
      impair LV systolic performance but also diastolic performance, possibly due to
      asynchronous contraction and relaxation of the left ventricle.

PMID- 2214134
TI  - Significance of left atrial pressure and left ventricular relaxation as
      determinants of left ventricular early diastolic filling flow in man.
AB  - We analyzed the relationships among parameters of left ventricular (LV) early
      diastolic filling flow (EDF) obtained with pulsed Doppler echocardiography, mean
      pulmonary wedge pressure (PCWP) and the time constant of LV pressure fall
      calculated by either Weiss' (Tw) or Thompson's (Tb) method. PCWP correlated with
      the peak velocity (R) (r = 0.537, p less than 0.05), acceleration (Ac) (r =
      0.545, p less than 0.05) and deceleration (Dc) (r = 0.606, p less than 0.01) of
      LVEDF. In contrast, Tb correlated only with the time to the peak of LVEDF (TPF)
      (r = 0.487, p less than 0.05), and Tw did not correlate with the Doppler-derived
      indices significantly. After correcting for the effect of PCWP, significant
      partial correlations between R and Tw (r = -0.535, p less than 0.05), and between
      Ac and both Tw (r = -0.606, p less than 0.01) and Tb (r = -0.569, p less than
      0.05) were found. Dc did not correlate with Tw or Tb. These results suggest that
      the level of left atrial pressure may mask the relationship between parameters of
      LVEDF and LV relaxation, and that the relations among these variables vary with
      individual indices of LVEDF.

PMID- 2214135
TI  - Right ventricular endomyocardial fibrosis. Diagnosis and management.
AB  - The clinical course, noninvasive and invasive diagnostic findings in 4 patients
      (pt) with endomyocardial fibrosis are reported. All patients (16-50 years) were
      in functional class III-IV (NYHA). Central venous pressure with large a- and v
      waves was elevated in all; liver enlargement and peripheral edema were also
      noticed in all pts, and ascites in 3. An apical 2/6 systolic murmur was present
      in 2, and a right parasternal pansystolic murmur 2-4/6 with positive Carvallo's
      sign in all pts. ECG was non-specific and chest x ray showed right atrial
      enlargement in every case. A right-sided diastolic plateau which was higher than
      left ventricular end-diastolic pressure was present in all pts. Echo-,
      angiocardiography and computed tomography of the heart revealed obliteration of
      the right ventricular cavity, predominantly localized at the apex. Two pts who
      underwent endocardial resection and tricuspid valve replacement are alive and
      well after 9 and 8 years, respectively. One pt died early in the postoperative
      period and one died waiting for surgical therapy. In conclusion, echo-,
      angiocardiography and computed tomographic findings are diagnostic. A
      satisfactory differentiation from other cardiac disorders with restrictive
      hemodynamics and right-sided heart failure is possible.

PMID- 2214136
TI  - Energetics of the time-varying elastance model, a visco-elastic model, matches
      Mommaerts' unifying concept of the Fenn effect of muscle.
AB  - It is generally believed that the Fenn effect contradicts all visco-elastic
      models of muscle, including the new elastic body and the time-varying elastance
      models. Although it is clear that the new elastic body model can be discarded,
      the Fenn effect does not preclude the time-varying elastance model. Although no
      visco-elastic models can simulate the extra energy utilization for work above the
      level of the energy utilized for the maximal isometric contraction, the extra
      energy observed by Fenn is not generally observed, even in skeletal muscles.
      However, work-related extra energy utilization, above the isometric energy
      utilization at equivalent force (Mommaerts' unifying concept of the Fenn effect),
      is generally observed in both skeletal and cardiac muscles. This unifying concept
      of the Fenn effect in cardiac muscle can be simulated by a simple time-varying
      elastance model. This study demonstrates the essential difference in energetics
      between the new elastic body model and the time-varying elastance model.

PMID- 2214137
TI  - Adenosine exacerbates ischemic myocardial injury during regional coronary
      hypoxemia in the dog.
AB  - To investigate the myocardial protective effect of adenosine (ADO), the left
      anterior descending artery of 10 dogs was cannulated and perfused at a pressure
      of 100 mmHg. Hypoxic coronary perfusion was conducted for 60 min followed by 60
      min of normoxic reperfusion (group 1, control, n = 5). In group 2 (n = 5), ADO
      was continuously infused at a rate of 40 micrograms/kg/min for 30 min before and
      during 60 min of hypoxic blood perfusion and for 60 min following normoxic
      reperfusion. In group 1, R wave amplitude and TQ segment of the epicardial
      surface electrocardiogram (EPIECG) were reduced, the ST segment was elevated, and
      a new Q wave developed during hypoxic blood perfusion. However, at 60 min of
      normoxic reperfusion, the R wave amplitude recovered to approximately 60% of its
      control value. Also, ST segment elevation was restored to normal and the new Q
      wave disappeared. The TQ segment returned to normal after approximately 20 min of
      hypoxic perfusion. Histological analysis showed myocardial infarction in the
      subendocardium, but not in the subepicardium. In group 2, EPIECG findings during
      hypoxic blood perfusion were similar to those observed in group 1. However, the
      recovery of ST segment elevation during normoxic reperfusion was slower than that
      observed in group 1. R wave restoration did not occur in group 2. Furthermore,
      the new Q wave remained present throughout the normoxic reperfusion period.
      Transmural infarction and severe congestion were observed histologically in this
      group. Obvious contraction bands were not demonstrated histologically in either
      group. These findings suggest that ADO did not protect myocardial viability
      during 60 min of hypoxic blood perfusion, but instead, ADO exacerbated ischemic
      injury during regional hypoxic perfusion.

PMID- 2214138
TI  - Structural and functional alterations of mesenteric vascular beds in
      spontaneously hypertensive rats.
AB  - The morphology and reactivity of mesenteric arteries from spontaneously
      hypertensive rats (SHR) and age-matched normotensive Wistar Kyoto rats (WKY) were
      investigated. Isolated, perfused mesenteric vascular beds were prepared from 6-,
      11- and 18-week-old SHR and WKY. At these ages, the walls and media of large
      mesenteric arteries were significantly thicker in SHR than in WKY. The number of
      smooth muscle cell layers in the media was significantly larger in SHR than in
      WKY. This difference between SHR and WKY increased as rats grew older, in
      parallel with differences in the blood pressure. Flow rate-perfusion pressure
      curves indicated that the vascular basal resistance to flow increased more
      profoundly in SHR preparations than in WKY preparations as rats grew older. This
      may be related to the structural alterations of the resistance vessel wall in
      SHR. The pressor responses to KCl were greater in SHR preparations than in WKY
      preparations as rats grew older. This may be caused partly by the increase of the
      number of smooth muscle cell layers in the media of SHR resistance vessels. The
      pressor response to norepinephrine (NE) was significantly higher in SHR
      preparations than in WKY preparations at all ages investigated. In marked
      contrast to the vascular basal resistance and the pressor response to KCl, the
      pressor response to NE was extremely exaggerated in SHR at the age of 6 weeks.
      This extremely high NE response in younger SHR may not be caused by the
      structural alteration in resistance vessels. It may be caused by a functional
      change, which is regulated by the signal transduction process in smooth muscle
      cells of resistance vessels. These results suggest that the development of
      hypertension in SHR may be caused by genetic structural and functional
      abnormalities of resistance vessels. Both abnormalities may be caused by the
      hyperreactivity to NE through an altered signal transduction process in smooth
      muscle cells of resistance vessels in SHR.

PMID- 2214139
TI  - Hypertrophic peripheral neuropathy (Dejerine-Sottas disease) associated with
      heart block. Case report presentation and review of the literature.
AB  - We present a case of a male suffering from hypertrophic peripheral neuropathy
      (Dejerine-Sottas disease) and severe involvement of the cardiac conductive tissue
      causing syncopal attacks. It is the first time that an association of this
      neuromuscular disease with cardiac involvement is described.

PMID- 2214140
TI  - A case of pure thrombus in a saphenous vein graft six years after bypass surgery.
AB  - A man showed a 90% narrowing at the origin of a saphenous vein graft (SVG) 6
      years after bypass surgery. After 4 days of intravenous thrombolytic therapy the
      narrowing in the SVG disappeared completely. Thus, late stenosis of SVG can be
      caused by thrombosis not superimposed on organic narrowing.

PMID- 2214141
TI  - Arrhythmogenic right ventricular dysplasia with sick sinus syndrome and
      atrioventricular conduction disturbance.
AB  - Although arrhythmogenic right ventricular dysplasia (ARVD) is believed to involve
      primarily the right ventricle, left ventricular abnormalities have also been
      described. We report a case of ARVD with abnormalities of the sinus node, right
      atrium and atrioventricular node. The biopsies taken from the right atrium and
      the right ventricle showed replacement of myocardium by fibrous tissue. The
      pathologic changes of this disease process may extend into the atrium and
      atrioventricular node.

PMID- 2214142
TI  - [Epidemiology of malignant tumors of the female genital organs].
AB  - Incidence, risk factors, prognosis and 5-year survival of the malignant tumors in
      the female genital organs, except the trophoblastic diseases, were described. The
      uterine cervical cancer is the most in Japan, but is already one the controlling
      cancer, though prognosis of the cervical adenocarcinoma is still poor. Incidence
      of the endometrial cancer is increasing. Ovarian malignant tumor is one of silent
      diseases and their 5-year survival rate is very low. Significant of the annual
      population screening against them was emphasized.

PMID- 2214143
TI  - [Pathological aspects of gynecological malignancies--early stage cancers and
      borderline lesions].
AB  - Pathology of gynecological malignancies including cancers of the uterus and ovary
      were described with a particular focus on early stage cancers and borderline
      lesions. Histological criteria appeared in this paper are mentioned in accordance
      with The General Rules for Clinical and Pathological Management of Uterine
      Cervical Cancer and Uterine Body Cancer and WHO Classification of Ovarian
      Tumours. Carcinogenesis of the uterine and ovarian cancers were also discussed.

PMID- 2214144
TI  - [Degrees of malignancy and biological behavior in gynecologic cancer].
AB  - Recently there has been a rebirth of interest in the grading of gynecologic
      cancers. The grading of malignant tumors was proposed initially to help
      clinicians to plan reasonable and effective therapy. Various schemata have been
      offered to differentiate degrees of malignancy. The grading system of malignant
      tumors should be simple and reproducible, and it should also be related to the
      biological behavior of tumors and prognosis. The importance of the grading in
      endometrial and ovarian cancers has been well accepted. Grading of cervical
      cancer seems to be of little value.

PMID- 2214145
TI  - [Histological and clinical classification of gynecological tumours].
AB  - Clinical classification of gynecological tumours according to UICC and FIGO, and
      their histological classification according to WHO and the Japanese general rules
      for clinical and pathological management of gynecological tumours are presented.
      We have discussed the following histological topics which have close correlation
      with the clinical staging of gynecological tumours. 1. Postoperative recording of
      definite diagnosis according to pTNM and FIGO. 2. Difference of diagnostic
      criteria between squamous cell and adenocarcinoma of Ia stage of cervical cancer.
      3. Differential diagnosis of atypical endometrial hyperplasia and carcinoma in
      situ in endometrial cancer. 4. Objective findings for corporeal cavity and
      myometrial invasion of corpus carcinoma. 5. Correlation between histological
      classification of ovarian tumours and their malignant potentials. 6. Clinical
      significance of histological diagnosis of ovarian tumours invasion and
      cytological diagnosis of ascitic fluids.

PMID- 2214146
TI  - [Diagnostic endoscopy for malignant uterine tumors].
AB  - A hysteroscope is a useful tool for detecting uterine tumors developed in the
      cervical canal and uterine cavity which are invisible areas. The hysteroscopy
      discloses easily the findings, location, size and extent of the lesions.
      Consequently more correct biopsies may be obtained than the conventional
      curettages which are blind procedures. This paper comprises the instrumentation,
      technique and hysteroscopic findings of the malignant uterine tumors. Observation
      of the cervical canal, namely cervicoscopy reveals mainly the appearance of
      normal cervical wall, preinvasive and invasive squamous cell carcinoma,
      adenocarcinoma and sarcoma. Hysteroscopy reveals the appearance of normal uterine
      cavity, endometrial carcinoma, sarcoma, metastatic uterine carcinoma, invasive
      carcinoma infiltrated from the adjacent organs and trophoblastic tumors. As a
      result, endoscopic features of each uterine malignant tumor are summarized as
      useful criteria for differential diagnosis.

PMID- 2214147
TI  - [Diagnostic cytology and histology in the gynecologic malignant tumors].
AB  - This report is on the exfoliative cytologic criteria in the diagnoses of uterine
      cervical, endometrial and ovarian cancer. It is of special importance to
      establish a differential diagnosis between ectocervical and endometrial lesions
      when considering adenocarcinomas. Cytological evaluation of ovarian cancers were
      performed on stump smears from excised surfaces. It is of great importance to pay
      special attention to the techniques used when obtaining cytologic specimens for
      evaluation.

PMID- 2214148
TI  - [Diagnosis: tumor marker].
AB  - We have reviewed the clinical usefulness of tumor markers in gynecologic
      malignancy. In cervical squamous cell carcinoma. SCC and CEA showed increase in
      frequency of elevated cases according to the clinical stages (FIGO), and the
      frequency was significantly higher in recurrent cases than in patients with no
      evidence of disease. In endometrial carcinoma, presently, no specific tumor
      marker has been found. The diagnostic efficiency of CA 125, CA 19-9 and TPA were
      25.2, 23.8 and 32.6, respectively. Further investigation must be necessary to
      establish markers sensitive enough. In primary ovarian malignancy, combination
      assay might be much more useful than single assay. The most effective
      combinations were TPA/CA 125/Ferritin in serous cystadenocarcinoma, and CEA/CA 19
      9/TPA in mucinous cystadenocarcinoma. In the monitoring of the disease, it seems
      to be essential to select suitable combination of markers in each case. In
      addition, recently, multivariate analysis systems, such as CAMPAS (computer-aided
      multivariate and pattern analysis system), have become available.

PMID- 2214149
TI  - [Screening for gynecologic cancer].
AB  - Results of mass screening for cervical cancer, endometrial cancer and breast
      cancer in Miyagi Prefecture were presented. Systems of screening for endometrial
      cancer and breast cancer are now arranging in Japan.

PMID- 2214150
TI  - [Surgical treatment of cancer of the uterine cervix].
AB  - As a standard therapy on cervical cancer in Japan, Surgical treatment is applied
      for stage 0-IIb and radiotherapy is applied for stage III and IV at present. In
      surgical treatment, the adequate surgical method is selected according to the
      extent of cancer in individual case in order to preserve the function.

PMID- 2214151
TI  - [Radical radiotherapy of cervical cancer].
AB  - At present, surgery and radiotherapy have been employed successfully to manage
      carcinoma of the cervix. Generally, the choice of treatment is determined
      primarily by the stage of the disease. Radiotherapy for cervical cancer must be
      consist ed of external radiotherapy and brachytherapy. Brachytherapy is a
      significant and important part of the overall management of the patients with
      cervical cancer. The selection of a given therapeutic modality depends on the
      general condition of the patients, gross characteristics of the tumor and
      availability of expertise to offer adequate radiation therapy.

PMID- 2214152
TI  - [Chemotherapy of cancer of the cervix].
AB  - Systemic chemotherapy has been widely used for the purpose of inducing remission
      of advanced cancer of the cervix. Almost all anti-cancer drugs have been applied
      to this way of chemotherapy, however, the high effectiveness of cisplatin is
      worthy of notice, and this drug plays a central role in combination chemotherapy.
      Local hyperthermia, drug-induced hypertension and intra-arterial infusion of anti
      cancer drugs are the representative methods to reinforce the effect of
      chemotherapy. Adjuvant chemotherapy has to be designed to adapt the extremely
      slow growing potential of residual microcarcinomas after surgery. Oral
      administration of tegafur for two years is a choice of maintenance chemotherapy
      preventive against postoperative recurrence.

PMID- 2214153
TI  - [Surgical treatment of endometrial cancer].
AB  - The main treatment of endometrial cancer is surgery. Total abdominal hysterectomy
      (TAH) and bilateral salpingo-oophorectomy (BSO) is the principal surgery for
      stage I disease. Recently, pelvic lymph node dissection and para-aortic node
      biopsy is also being performed. For stage II, many surgeons in Japan prefer to do
      radical hysterectomy, however, its validity is questioned. For stages III and IV,
      surgery, radiation, chemotherapy and/or hormone therapy are combined, however,
      TAH and BSO should be performed at least. In 1988, FIGO changed the endometrial
      cancer staging system from clinical to surgical. According to this new staging,
      laparotomy should be done first and treatment plans made depending on the result
      of surgical finding.

PMID- 2214154
TI  - [Radiation therapy in carcinoma of the endometrium].
AB  - A retrospective analysis of 146 patients with carcinoma of the endometrium was
      carried out. Several kinds of intracavitary irradiation methods has been changed
      during the past 28 years, the most favorable results was obtained by means of
      RALS packing method. Five year survival was 100% in stage I, 27.3% in stage II,
      18.2% in stage III and 21.5% in total patients treated with radiation therapy
      alone (33 patients) as compared to those patients who received postoperative
      irradiation (109 patients) where the survival was 91.4% in stage I, 76.6% in
      stage II, 71.5% in stage III and 79.8% in total, respectively. Complications of
      treatment were seen in 9% and 4.5% with radiation alone and postoperative
      therapy. From these results, an adequate dose distribution by intracavitary
      irradiation was emphasized for the improvement of local tumor control.

PMID- 2214155
TI  - [Chemotherapy and endocrine therapy of endometrial carcinoma].
AB  - The main treatment of recurrent and advanced endometrial carcinoma are
      chemotherapy and/or endocrine therapy. Some of the combination chemotherapy,
      including Cis-platinum are useful in advanced and recurrent endometrial
      carcinoma, and progestational agents are available for adjuvant chemo-endocrine
      therapy after operation of endometrial carcinoma. Authors consider the
      literatures of the chemotherapy and endocrine therapy for endometrial carcinoma
      and describe our own cases.

PMID- 2214156
TI  - [Surgical treatment of ovarian cancer].
AB  - Stage I a cancer among early ovarian cancers should be classified because of
      revision of FIGO classification in 1987, therefore preservation of fertility has
      become expected to date. Furthermore, a maximal debulking surgery as an initial
      operation, compared to a staging laparotomy, has yielded favorable results in the
      clinical outcome of advanced ovarian cancers in recent years. Surgical treatment
      will still make a major role in the future as one of the multiple therapeutic
      modalities in this disease, although a complete cure can not be obtained by only
      surgical treatment.

PMID- 2214157
TI  - [Significance of second look surgery in the therapy of ovarian cancer].
AB  - Second look surgery (SLO) has two kinds of significance in therapy of ovarian
      cancer. One is a diagnostic value in persistence or not of ovarian cancer. The
      other is a second cytoreductive surgery. SLO as a diagnostic value is very much
      valuable to determine prognosis and therapies. On the other hand, SLO as a second
      cytoreductive surgery prolonged survival periods, however did not affect long
      term survival rate. Hence, their significance of SLO is not established to
      acquired good prognosis in long term.

PMID- 2214158
TI  - [Chemotherapy of advanced ovarian cancer].
AB  - Cisplatin containing chemotherapy has provoked an epic making revolution in the
      treatment of advanced ovarian cancer. However, the impact to the long-term
      survival is still discouraging. In this article, standard regime for first line
      chemotherapy, dose, administration method, routes, number of cycles and the
      second line chemotherapy which is the most embraced problem are described.
      Strategy for the treatment of advanced ovarian cancer would be continued until
      the development of new drugs which are effective comparable with cisplatin and
      have no cross resistance with cisplatin. In order to get significant improvement
      of 5 year survival, complete response by chemotherapy or complete resection by
      operation or by both is indispensable and partial response is not sufficient.

PMID- 2214159
TI  - [A plan and a view for better prognosis].
AB  - Better prognosis of treatment depends on both the development of activity of
      early detection and the progress of treatment. There are two important factors
      for effective detection of endometrial cancer, one is the spread of endometrial
      cytology and another is the mobilization of examinee in high age. As to the
      treatment, many clinics are challenging extension of radical hysterectomy such as
      para-aortic nodes dissection. To avoid the irradiation on the medical stuffs,
      remote controlled local treatment system will be improved. The appearance of more
      effective anti-cancer agent is desired. The conditions of an adequate treatment
      have to realize not only better cure rate, but also healthy after-life.

PMID- 2214160
TI  - [Treatment and overview for the improvement of prognosis in ovarian cancer].
AB  - The current treatment for ovarian cancer introduced the improvement of survival
      rate by the chemotherapy based on cisplatin and maximum debulking surgery. The
      prognosis of ovarian cancer is affected by various kinds of factor as age, ps,
      stage, histology, histological grading and the volume of residual tumor. By our
      analysis it was shown whether tumor diameter is less than 2 cm or not was
      critical point. On the other hand, dose intensity of cisplatin is also important.
      We could show the improvement of survival rate of advanced cases by the treatment
      of maximum debulking surgery and high intensity of cisplatin.

PMID- 2214161
TI  - [Bone marrow transplantation as a treatment of accidental total-body irradiation;
      a review of past experiences].

PMID- 2214162
TI  - [Analysis of anti-platelet antibody].
AB  - Results obtained by analysis of anti-platelet antibody using flow cytometry (FCM)
      were as follows. The use of nest gating is useful in analysis of anti-platelet
      antibody and frequency of antibody production were 32.7% in patients with
      hematological disorders using FCM method. This method was much correlated to AHG
      LCT method. The rate of coincidence was 92.1%. And effective rate of platelet
      transfusion of cross match carried out only by FCM method was 81.3%.
      Concentration of globulin fraction in patient's serum and avidin-biotin assay are
      useful for increasing the sensitivity of detection of anti-platelet antibody.
      Elimination of HLA (Class 1) antigen from platelet's surface is effective in both
      chloroquine and acid treatment. Background of fluorescent intensity was tendency
      to low by the acid treatment than by chloroquine one. It is possible that high
      titer serum of allogeneic anti-platelet specific antibody is able to be
      identified by means of its fluorescent intensity.

PMID- 2214163
TI  - [Leukemic immunophenotyping with flow cytometry].
AB  - We have evaluated the clinical efficacy and problematic items of flow cytometric
      surface and intracellular immunophenotyping of leukemic cells. The multi
      parametric analysis on the results of leukemic phenotyping displayed a
      possibility of an independent phenotypical classification, but concurrently we
      recognized complementary relationships between the morphological and phenotypic
      approaches. Defective information on the morphology of leukemic cells
      unexpectedly introduced an insufficient quality in performance of leukemic
      phenotyping. On the other hand, the interpretations of phenotypic outcomes were
      complicated in cases with mixed leukemia and partial expression of a marker.
      Finally we hope further integration of the expression spectrum of markers,
      including the improvement of CD nomenclature system.

PMID- 2214164
TI  - [Analysis of DNA aneuploidy as a tumor marker].
AB  - DNA aneuploidy (DA) was examined in adult leukemia using flow cytometry, and the
      method and the clinical implication of DA as a tumor marker were evaluated. The
      method was simple, rapid, objective, quantitative and further did not need any
      mitotic cells, so was proved to be very useful for screening of DA. While, DA was
      detected in 50 (27%) out of 185 adult cases with various types of leukemia. The
      frequencies of DA in the subtypes of leukemia were 55% in ATL, 26% in ALL, 17% in
      ANLL, 26% in CML-BC and 6% in CLL, respectively. When compared with other
      subtypes, the frequency in ATL was significantly higher (p less than 0.01), which
      suggested a special entity of this disease. In general, however, the frequency of
      DA in leukemia was rather low, which indicated the difficulty in application of
      DA by itself in diagnosis of leukemia. While, in cases with DA, DA was very
      useful as a tumor marker in monitoring the clinical course, for example, in the
      detection of early relapse or recruitment of leukemic cells. Furthermore, DA was
      found to be a good prognostic factor which indicates a poor prognosis in cases
      with ANLL and CML-BC.

PMID- 2214165
TI  - [Anti-coagulant therapy--antithrombin III].
AB  - Biological properties and the efficacy of AT III concentrate for the treatment of
      thromboembolic disorders were evaluated in the patients with AT III deficiency.
      Commercially available AT III concentrates showed heterogeneity on agarose gel
      isoelectric focusing, however, they inhibited thrombin in the same manner. At III
      concentrates were infused to 11 patients with congenital AT III deficiency (4
      with thrombosis). Pharmacokinetic parameters of infused AT III were calculated as
      follows; half time 61.1 +/- 23.0 hr. (58.4 +/- 22.6 hr. in the cases with
      thrombosis), max increase rate 1.01 +/- 0.3%/U/kg and recovery rate 95.4 +/-
      33.3%. Simulation curves adjusted to the multiple administration were correlated
      well with the actually determined values in the patients and steady state
      concentration of AT III was achieved by the administration of this concentrate in
      12 or 24 hour intervals. Clinically, substitution with AT III concentrate was
      proved to be effective for the treatment of thromboembolism in these patients. 16
      patients with disseminated intravascular coagulation were treated with heparin
      (6,000 U/day) followed by AT III concentrate (1,500 U/day) administration.
      Clinical symptoms and laboratory findings were improved in 11 patients. From
      these results substitution with AT III concentrate was suggested to be beneficial
      for the prevention or the treatment of thromboembolic disorders in the patients
      with AT III deficiency.

PMID- 2214166
TI  - [Treatment of disseminated intravascular coagulation].
AB  - Early diagnosis and immediate treatment of the disease responsible for DIC are
      most important for successful therapy of DIC. Furthermore, it is also necessary
      to use anticoagulant agents in most cases of DIC. The agents may be classified on
      the basis of their mode of anticoagulant action into three groups: ones with
      antithrombin effect, ones with anti-Xa effect or ones with both effect, and each
      agent is hoped to be chosen appropriately for development of DIC in near future.
      At present, such anticoagulant agents as standard heparin, antithrombin-III
      concentrate, gabexate mesilate, nafamostat mesilate, MD-805, low molecular weight
      heparin, heparan sulfate, activated protein C, are known as drugs for DIC, and
      each of them was effective for improvement from DIC in our experience.
      Antifibrinolytic agents, which have been considered to be contraindicated for
      therapy of DIC, may be good indication for selected cases of DIC with enhanced
      fibrinolysis such cases as acute promyelocytic leukemia. Antiplatelet agents may
      be available for some cases of chronic DIC.

PMID- 2214167
TI  - [Quality control of ISI/INR system in oral anticoagulant therapy].
AB  - Ten controlled plasmas and 4 thromboplastin reagents were distributed to 75
      laboratories for measurement of prothrombin time (PT). The results were converted
      to prothrombin activity (PA). prothrombin ratio (PR) and international normalized
      ratio (INR). Among the 4 different ways of expression, the discrepancy between
      the results obtained by the different reagents was the smallest when the results
      were expressed by INR. However, the discrepancy of the results was still remained
      because of the different assay methods used routinely at these laboratories, even
      with the use of ISI/NR system (Instrumentation effects). In this study, reference
      curve of prothrombin time: INR was created using INR reference plasmas, which
      were selected from commercial control plasma using a standard thromboplastin
      reagent. INR's of 108 patients' plasmas were calculated by ISI/INR system on one
      hand, and by the use of the reference curve of the prothrombin: INR on the other
      hand. It was found that the discrepancy of the results obtained by different
      assay methods was significantly improved by the latter method, compared to those
      obtained by the conventional ISI/INR system.

PMID- 2214168
TI  - [Beneficial characteristics of protease inhibitor as an anticoagulant for
      extracorporeal circulation].
AB  - Clinical characteristics of protease inhibitor, nafamostat mesilate (FUT
      175:FUT), as an anticoagulant for extracorporeal circulation (ECC) were evaluated
      in hemodialysis and membrane plasmapheresis. FUT inhibited broad enzymatic
      systems including coagulation, platelet, complement, fibrinolysis and kinin
      cascades, which were commonly activated in the course of ECC. FUT showed regional
      anticoagulability, in which anticoagulating effects were firmly limited in
      extracorporeal circuit, and hemostatic time after ECC was significantly shortened
      by the use of FUT. FUT had no effects on lipid and bone metabolisms and FUT could
      not be adsorbed to anion exchange resin. These results indicate that FUT
      possesses superior characteristics as an anticoagulant for ECC to heparin, and
      FUT is very useful especially for ECC of patients with high bleeding risk.

PMID- 2214169
TI  - [Effects of anti-platelet agents on shear-induced platelet aggregation].

PMID- 2214170
TI  - [Clinical and cytogenetic features in childhood acute lymphoblastic leukemia with
      1; 19 translocation].
AB  - We studied the clinical and cytogenetic features of 14 acute lymphoblastic
      leukemia (ALL) patients with 1; 19 translocation. Ten patients had poor
      prognostic factors such as age over 10 years, hyperleukocytosis over 5 X
      10(4)/microliters or high serum lactic dehydrogenase levels over 5,000 IU/l. Two
      patients had relapsed within 12 months after the onset, but their 5-year survival
      rate was 84.6%. Cytogenetically, 6 of 14 patients had multiple subclones. Two had
      the clones with hyperdiploidy greater than 50 chromosomes, which was known to be
      one of the favorable prognostic factors in childhood ALL. These findings show ALL
      children with 1; 19 translocation have a more favorable outcome in spite of some
      high-risk features than hitherto been thought.

PMID- 2214171
TI  - [Electron microscopic cytochemistry of pseudo-Chediak-Higashi granules in 5 cases
      of AML].
AB  - Blasts from 5 cases of AML with pseudo-Chediak-Higashi granules were examined
      ultrastructurally and histocytochemically using peroxidase, acid phosphatase,
      high iron diamine (HID) and periodic acid-thiocarbohydrazide-silver proteinate
      (PA-TCH-SP) stainings. Pseudo-Chediak-Higashi granules, which appeared as vacuole
      like inclusions by light microscopy, generally contained electron-lucent
      materials. All pseudo-Chediak-Higashi granules were, positive for peroxidase but
      some were negative for acid phosphatase. Pseudo-Chediak-Higashi granules were HID
      positive, indicating that they contained sulfated glycoconjugates. Glycogen-like
      particles were observed in the pseudo-Chediak-Higashi granules with the PA-TCH-SP
      method, as occasionally observed in granules in drug resistant ALL blasts. In
      conclusion, the contents of pseudo-Chediak-Higashi granules, which seems to be
      formed by fusion of small granules, differed from those of normal azurophillic
      granules.

PMID- 2214173
TI  - [Acute lymphocytic leukemia with thrombophlebitis of lower limbs and
      translocation (4;11)].
AB  - On November 22, 1985, a 54-year-old male was admitted to the cardiovascular
      department of our hospital suffering from thrombophlebitis, with redness,
      swelling and pain around the right ankle and left knee. He was transferred to our
      department on Nov. 26, because of hyperleukocytosis. Peripheral blood examination
      revealed hyperleukocytosis with 93.0% blastic cells and thrombocytopenia. The
      bone marrow aspirate was hypercellular and almost all cells were consistent with
      peroxidase negative blastic cells. The blastic cells were Leu M1 positive and Leu
      M2, M3 and lymphocytic markers were negative. The patient was diagnosed to have
      acute lymphocytic leukemia with Leu M1 positive blast cells. BH-AC/DMP therapy
      was began on the 1st hospital day but he died of cerebral haemorrhage on the 4th
      hospital day. An autopsy revealed systemic infiltration of leukemic cells
      including thrombophlebitis of the legs. Chromosome analysis of the bone marrow
      cells showed t(4;11)(q21;q23).

PMID- 2214172
TI  - [Treatment of acute lymphoblastic leukemia in adults by the modified protocol of
      L-10M (Sloan-Kettering)].
AB  - We have treated 20 adult patients with acute lymphoblastic leukemia (ALL) and 2
      patients with lymphoblastic lymphoma with a protocol modified from L-10M of the
      Memorial Sloan Kettering Cancer Center. Eighteen patients (81.8%) entered
      complete remission (CR). Eight of them eventually relapsed (only 1 patient had a
      meningeal relapse) and died. Median CR duration was 19 months (median overall
      follow-up of 35 months and 50% remission duration was not yet determined. Median
      overall survival was 19 months. Three patients died of sepsis during remission
      induction, but all of other deaths were due to resistant or relapsed leukemia.
      The four patients who completed 3.5 year's modified L-10M protocol were free from
      relapse for 6-11 months (mean 8.7). Although further follow-up is necessary, we
      suggest that modified L-10M protocol is effective for adult ALL and long-term
      survival may be available.

PMID- 2214174
TI  - [A latent form of essential thrombocythemia presented as portal hypertension and
      associated with acquired von Willebrand syndrome].
AB  - A 32 year-old male patient was admitted to our hospital because of abdominal
      tumor. The examination on admission showed massive splenomegaly and esophageal
      varices although peripheral blood cell counts were within normal limits.
      Exploratory laparotomy was performed with the diagnosis of portal hypertension
      and revealed the multiple thrombus formations in the splenic vein and the
      extramedullary hematopoietic findings in the spleen by the microscopic
      examination. In vitro colony forming assay showed the formation of spontaneous
      erythroid colonies in cultures of progenitor cells (from peripheral blood
      mononuclear cells) in erythropoietin-poor medium. Increasing thrombocytosis was
      observed immediately after splenectomy, and hemorrhagic diathesis of nasal
      bleeding and gastrointestinal bleeding were also detected. The analysis of plasma
      von Willebrand factor (vWF) revealed the decrease of ristocetin cofactor activity
      and the lack of large multimeric components of vWF. These abnormal findings
      observed after splenectomy led to recovery through the administration of busulfan
      with the improvement of thrombocytosis. Accordingly, the course of the disease
      clearly indicated it to be the essential thrombocythemia represented as portal
      vein thrombosis and in latent form with normal cell counts in peripheral blood at
      the time of diagnosis, and subsequently, to develop into a full-blown form
      associated with acquired von Willebrand syndrome following splenectomy.

PMID- 2214175
TI  - [Nonproducing myeloma without evident bone lesion].
AB  - A 76-year-old female was admitted to our hospital because of anemia. Complete
      blood count was as follows: RBC 2.37 X 10(6)/microliters, Hb 7.7 g/dl, WBC
      2,600/microliters, Plt 105 X 10(3)/microliters. A bone marrow aspirate revealed
      40.8% plasmacytoid cells showing the characteristics of plasma cells by electron
      microscopy. Total serum protein was 5.4 g/dl. Monoclonal protein was not observed
      by electrophoresis. On immunoelectrophoresis, M-bow was not observed in the serum
      or in 50-fold concentrated urine. The plasma cells were negative for cytoplasmic
      IgG, M, A, E, D, kappa or lambda by immunoperoxidase studies. Although radiologic
      studies of the bones did not reveal destructive or punched out lesions, we
      diagnosed this case as a nonproducing myeloma and the patient responded to MP
      therapy. This case was considered interesting as regards the pathological entity
      of myeloma.

PMID- 2214176
TI  - [Complete remission in multiple myeloma with natural interferon-alpha (HLBI) and
      melphalan/prednisolone intermittent therapy].
AB  - A 46-year-old man was admitted because of lumbago and numbness of the left leg.
      Pelvic X-ray showed a large defect in the left sacrum and CT revealed multiple
      punched-out lesions. Serum IgA was 1,740 mg/dl with a monoclonal component of IgA
      kappa by serum electroimmunofixation. Bence Jones protein of kappa type was
      detected in urine. Diagnosis of myeloma was made on the basis of histology of the
      biopsied sacral tumor. Repeated melphalan/prednisolone intermittent therapy (MP)
      was done with concomitant administration of natural interferon-alpha (IFN-alpha)
      3 X 10(6) U intramuscularly for 67 days. Performance status including gait
      markedly improved. Normal bone marrow morphology and disappearance of M-protein
      by electroimmunofixation were achieved after 13 cycles of MP, when pelvic X-ray
      revealed prominent recalcification. No further treatment was instituted for
      subsequent 6 months, without any demonstrable M-protein. Complete remission of
      myeloma is rare with conventional therapies and thus new therapeutic modalities
      have been waited for. IFN-alpha may promise better responses if appropriately
      combined with other chemotherapies.

PMID- 2214177
TI  - [Acute myelomonocytic leukemia with Inv(16) (p13 q22) relapsed in transverse
      myelopathy].
AB  - We report a case of AML (M 4) with eosinophilia who developed meningeal relapse
      and transverse myelopathy. A 37-year-old woman was admitted to our hospital
      because of lymphadenopathy and ecchymosis. One week prior to admission, she
      noticed swelling of the cervical lymph nodes and bleeding tendency. On admission,
      low-grade fever, gingival swelling, generalized lymphadenopathy, and ecchymosis
      on the lower legs were found. A white blood cell count was 93,900/microliters
      with 82% blast cells, and a platelet count was 24,000/microliters. A bone marrow
      was composed of 45.3% myeloblasts, 27% monocytes and 7.1% eosinophils. Chromosome
      analysis revealed inv(16). The diagnosis of M4Eo was made. About one year after
      she gained complete remission, she was readmitted because of disturbance of
      urination. There was a sign of transverse myelopathy at the seventh vertebral
      level, and blast cells were detected in the cerebrospinal fluid. Despite of
      radiation and chemotherapy, paresis of lower extremities and sensory disturbance
      were persistent, and the patient died on 52th hospital day.

PMID- 2214178
TI  - [Successful ATG and bolus methylprednisolone therapy towards severe aplastic
      anemia with splenomegaly].
AB  - A 22-year-old female patient with severe aplastic anemia was treated by ATG.bolus
      methylprednisolone therapy. After the therapy, anemia and thrombocytopenia began
      to recover within a month. The frequency of blood transfusion decreased
      thereafter. Since anemia due to splenomegaly was certified, bolus
      methylprednisolone therapy was performed in good response. Suppressor T-cells
      towards hemopoiesis were confirmed in this case, and hemopoietic potential was
      augmented by ATG.bolus methylprednisolone therapy. In spite of discontinuation of
      any therapy in 1986, she is being in good health more than five years.

PMID- 2214179
TI  - [Atypical infiltration of megakaryocytes into the liver and spleen in a case of
      refractory anemia].
AB  - A 72-year-old man was admitted to our hospital because of general malaise. The
      peripheral blood showed pancytopenia (WBC 800/microliters, RBC
      970,000/microliters, Plt 95,000/microliters). The bone marrow smear revealed
      morphological abnormalities in three lineage without increase in blasts. He was
      diagnosed as having myelodysplastic syndrome (MDS). He was treated with
      recombinant human granulocyte colony-stimulating factor (rhG-CSF) for leukopenia,
      and with washed RBC transfusions for anemia. Eight months after diagnosis of MDS,
      blastic cells increased in peripheral blood and bone marrow showing overt
      leukemic state. He died of pneumonia. An autopsy revealed that atypical
      megakaryocytes increased in bone marrow and infiltrated into the spleen and
      liver. This case suggests that not only blasts but also megakaryocytes infiltrate
      into extramedullary organs in some cases of MDS.

PMID- 2214180
TI  - [Myelofibrosis associated with immunological abnormalities].
AB  - A 74-year-old man was admitted to the National Defense Medical College Hospital
      because of purpura on the extremities. The blood hemoglobin level was 11.5 g/dl,
      the white blood cell count 7. 3 x 10(9)/l with 3% blastic cells, and the platelet
      count 4.0 x 10(9)/l. There was leukoerythroblastosis with only mild teardrop
      appearance of erythrocytes. The blastic cells consisted of two types,
      megakaryoblast-like cells and myeloblast-like cells. There was a very mild
      hepatosplenomegaly, but no lymphadenopathies. The bone marrow aspirations yielded
      dry taps. The marrow biopsy specimen revealed myelofibrosis associated with
      trilineage hyperplasia, but no apparent infiltration of leukemic cells. Platelet
      associated IgG (PAIgG) had a high titer and the response to platelet transfusions
      was poor. On prednisolone and colchicine, the blastic cells in the peripheral
      blood disappeared and the platelet count increased. He died of pneumonia. The
      autopsy showed myelofibrosis with hyperplasia of myeloid and erythroid lineage in
      the bone marrow. Megakaryocytes were relatively few and there was no infiltration
      of leukemic cells.

PMID- 2214181
TI  - [One-year remission of chronic myelogenous leukemia (CML) after discontinuation
      of interferon-alpha].
AB  - A 53-year-old woman was admitted to our hospital on Nov. 16, 1987, because of
      general fatigue. On admission, she had hepatosplenomegaly and her peripheral
      blood profile showed a white blood cell count (WBC) of 309 x 10(3)/microliters
      with immature neutrophils, a hemoglobin level (Hb) of 7.6 g/dl, platelet count
      (PLT) of 536 x 10(3)/microliters, neutrophilic alkaline phosphatase (NAP) score
      of 44. Both Vitamin B12 and LDH levels were high. The bone marrow showed marked
      myeloid hyperplasia. In a cytogenetic study, Ph1 was found in 3 of 8 metaphases
      and Ph1 with an additional abnormality of 8 trisomy was noted in 5 of 8
      metaphases. She was diagnosed as having chronic myelogenous leukemia (CML) and
      treated by i.m. injection of interferon (IFN)-alpha at a daily dose of 6 x 10(6)
      U. Administration of IFN-alpha induced fever for a few days. WBC, PLT count and
      LDH level gradually decreased, and the NAP score and hepatosplenomegaly improved.
      She achieved remission in February, 1988. Administration of IFN-alpha was stopped
      in April, 1988, when the bone marrow showed hypocellularity and normal karyotype.
      She was treated with 20 mg of prednisolone daily from May until August, because
      of progressive pancytopenia. She had received no treatment until July, 1989. In
      May, 1989, the bone marrow again showed myeloid hyperplasia and Ph1 was found in
      all cells analyzed. Therefore, we resumed IFN-alpha treatment. It is interesting
      that remission of CML continues for more than one year after discontinuation of
      IFN-alpha in this case.

PMID- 2214182
TI  - [Blast crisis of chronic myelogenous leukemia with blasts expressing both
      immature B lymphocyte- and myelomonocyte-associated antigens and differentiating
      into basophils in vitro].
AB  - A 43-year-old woman with Ph1-positive chronic myelogenous leukemia (CML) was
      diagnosed as having blastic crisis. The phenotype of blasts was CD9+, CD10+,
      CD19+, CD11b+ and CD33+, suggesting the B Lymphoid and myeloid mixed lineage. Two
      color analysis of CD10 and CD33 revealed that 50% of blast cells had both B
      lymphocyte- and myelomonocyte-associated surface markers. Rearrangement of the
      immunoglobulin heavy chain gene was detected. After culturing blasts with 12-o
      tetradecanoyl-phorbol 13 acetate (TPA), basophilic granules appeared in cytoplasm
      of the cells. These granules were positive for toluidine blue staining. This
      finding that the biphenotypic blasts expressing both B lymphoid and
      myelomonocytoid features differentiated into basophils suggests that blasts of
      this case are derived from a common progenitor of B lymphoid and myeloid lineages
      including basophil.

PMID- 2214183
TI  - [Macrothrombocytopenia with deafness, nephritis, cataract, short small intestine,
      and double ureter].
AB  - A 23 year old female, born in 1957, was diagnosed as having idiopathic
      thrombocytopenic purpura at the age of 3 and treated with prednisolone during her
      childhood with no response. On her regular check-up in 1978, facial edema and
      proteinuria suggested renal disease. The family history was negative for bleeding
      diathesis or renal disease. Close examination revealed the following: WBC
      4,200/microliters without leukocyte inclusions, RBC 3.42 x 10(6)/microliters, Hb
      11.7 g/dl. PT 10.6 sec, APTT 28.9 sec. Platelet count 4,500/microliters by
      HEMATRAK 360, and 40 x 10(3)/microliters measured by microscopic method. Giant
      platelets were noted on peripheral blood smear with an average diameter of 6.1
      microns. Bleeding time (Duke) was 12.0 min. Number of megakaryocytes was
      increased although platelet production was remarkably decreased. Results of
      platelet aggregation and retention tests were normal. Platelet life span (T1/2)
      was 2.3 days. Sensory neural hearing loss, congenital cataract, double ureter and
      short small intestine were also found. Chromosome analysis showed 46XX. She
      underwent splenectomy resulting in increase of the platelet count to 226 x
      10(3)/microliters. The increased platelet count, however, gradually decreased to
      the initial count in 2 years although the bleeding tendency was improved. In
      1987, renal function deteriorated, causing intractable hypertension. The serum
      creatinine was 4.8 mg/dl. The following year she developed cerebral bleeding and
      died 4 days after the episode. The serum creatinine was 8.6 mg/dl.

PMID- 2214184
TI  - [Occurrence of breast cancer, renal cancer and multiple myeloma in a Nagasaki
      atomic bomb survivor].
AB  - A 60-year-old female, who was exposed to the Nagasaki atomic bomb at 18 years
      old, had renal cancer and subsequently was found to have multiple myeloma (IgG
      kappa). She underwent the left mastectomy for breast cancer at 43 years old but
      was not given chemotherapy and radiotherapy. The karyotype of bone marrow cells
      was 46, XX. The estimated radiation dose was under 10 rads. While the effect of
      such a low-dose of radiation is considered to be almost negligible, there would
      be a possibility that in this case the risk of carcinogenesis was enhanced as her
      age advanced.

PMID- 2214185
TI  - [Fetal survival after the corticosteroid and low-dose aspirin regimen in a case
      of anti-phospholipid antibody syndrome].
AB  - A 27-year-old woman with anti-phospholipid antibody syndrome, whose first
      pregnancy had ended in intrauterine fetal death, was treated with prednisolone
      0.6 mg/kg/day before second pregnancy. Suppression of anti-cardiolipin antibody
      activity was rapidly achieved and maintained during the pregnancy. After
      conception, low-dose aspirin 81 mg/day was started and continued until delivery.
      She gave birth to a normal live infant with natural full-term delivery. It is
      strongly suggested that the corticosteroid and low-dose aspirin regimen can lead
      to successful pregnancy in cases with anti-phospholipid antibody syndrome like
      the present case.

PMID- 2214186
TI  - [Increase of serum acidic isoferritins in patients with hemophagocytic
      histiocytosis].
AB  - We investigated serum isoferritin patterns in 2 patients with reactive
      hemophagocytic histiocytosis (HH) and 1 patient with neoplastic HH (malignant
      histiocytosis) whose serum ferritin levels were extraordinarily high. Serum
      ferritins in 2 patients with reactive HH were composed of mildly (pI 5.55 to
      5.10) to intermediately (pI 4.81 to 4.82) acidic isoferritins, while those in
      patient with neoplastic HH were composed of more acidic (pI 4.70 to 4.45)
      isoferritins. These results indicate that the main constituents of the increased
      serum ferritins in HH would be acidic isoferritins, and that more acidic
      isoferritins would be increased in neoplastic HH than reactive HH.

PMID- 2214187
TI  - [Diagnostic significance of the number of bone marrow megakaryocytes in cases
      with decreased platelet production evidenced by platelet kinetic study].
AB  - In 18 patients with decreased platelet production proved by reduced platelet
      turnover, the numbers of megakaryocytes in clot section of marrow aspirate were
      counted. Platelet counts ranged from 19,000 to 128,000/microliters. The sternal
      marrow showed decrease of megakaryocytes only in 3 out of 18 cases while
      megakaryocytes in the iliac marrow were reduced in 6 out of 11 cases. Only one of
      11 cases showed decrease of megakaryocyte in both marrows examined. On the
      contrary, four cases showed normal number of megakaryocytes at both sites. Of 9
      cases with normal or increased number of megakaryocytes in sternal and/or iliac
      marrow, no case showed morphologically abnormal megakaryocytes and only one case
      had the reduced number of platelet-forming megakaryocytes. Results suggested that
      the number of megakaryocytes in bone marrow especially in the sternum was not
      reliable for establishing the diagnosis of decreased platelet production, and
      that about 50% of patients with thrombocytopenia due to hypoproduction of
      platelets could be diagnosed pertinently only after the study of platelet
      kinetics.

PMID- 2214188
TI  - [bcl-2 gene rearrangement and its expression in tumor cells].
AB  - Both the rearrangement and the expression of the bcl-2 gene in Japanese
      hematopoietic tumor cells were studied by Southern and Northern blot
      hybridizations. The expression of the bcl-2 gene was studied in seven cultured
      cell lines and twenty clinical samples, including eleven non-lymphoid tumors and
      nine lymphoid tumors. All lymphoid tumors except one sample from a patient with
      ALL expressed the bcl-2 gene. The bcl-2 gene was strongly expressed in B cell
      tumors. This gene was also expressed in T-ALL samples studied, although the
      expression was not as marked as in the B cell tumors. Non-lymphoid tumors did not
      express bcl-2 gene. bcl-2 gene rearrangement was studied in five cultured cell
      lines and six clinical samples including four follicular lymphomas and two T
      ALLs. No abnormal bcl-2 gene configurations were found in any of the clinical
      samples. Among the cultured cell lines, the BALL-1 line showed two-fold
      amplification. The frequency of bcl-2 rearrangement in Japanese follicular
      lymphomas is reported to be lower than that seen in the American follicular
      lymphomas. Nevertheless, the increased expression of the bcl-2 gene seen in the
      Japanese B cell tumors studied supports the contention that the bcl-2 gene plays
      an important role in the pathogenesis of B cell tumors.

PMID- 2214189
TI  - [VAD chemotherapy of multiple myeloma].
AB  - Twelve patients with resistant or recurrent multiple myeloma were treated with
      VAD regimen (vincristine, adriamycin, dexamethasone), first reported by Barlogie
      B et al 1984. Of 11 evaluable patients, 7 responded (partial response [PR] 3,
      minor response [MR] 4), and the overall response rate was 63.7%. The median
      interval to achieve remission was 27 days, and the median duration of remission
      was 125 days. One course seemed sufficient for the assessment of effectiveness of
      the VAD chemotherapy, because in all responders, over 50% reduction of monoclonal
      protein was obtained in the first course of chemotherapy. We also administered
      verapamil or trifluoperazine in addition to VAD in two patients who had acquired
      resistance to VAD. Both had MR. Side effects included infections, gastro
      intestinal bleeding, congestive heart failure or severe malaise. In conclusion,
      the VAD chemotherapy is effective but the duration of remission is short and side
      effects cannot be disregarded. Perspective of VAD and improvement of the
      management of refractory multiple myeloma is discussed.

PMID- 2214190
TI  - [The relationship between responsiveness to splenectomy and clinical course after
      splenectomy in chronic idiopathic thrombocytopenic purpura (ITP)].
AB  - Fifty-four ITP patients were treated by the protocol proposed by Japanese
      Idiopathic Disease of Hematopoietic Organ Research Committee. Forty-eight
      patients were treated with corticosteroid (CS). Twenty-eight patients out of 30
      patients who were refractory to CS were splenectomized. To study natural courses
      of splenectomized patients, 25 patients were splenectomized without elevation of
      platelet counts at the operation and were followed up their platelet counts and
      PAIgG for one month without treatment. Clinical courses after splenectomy were
      classified into four types by the platelet increment followed by splenectomy and
      the platelet counts at one month after splenectomy; type I (markedly over-shooted
      platelet peak and normalized platelet counts), type II (moderate platelet peak
      and 50 approximately 100 x 10(3)/microliters platelets), type III (minimal
      platelet peak and less than 50 x 10(3)/microliters platelets), and type IV
      (elevation of platelet counts at day 7 or later of splenectomy and normalized
      platelet counts). The results of analyses from 25 patients indicated that the
      numbers of type I, II, III and IV were 10, 5, 6 and 4, respectively. The clinical
      course of type IV suggests that platelet production may be impaired by anti
      platelet antibodies.

PMID- 2214191
TI  - [Occurrence of cytoplasmic bridge between erythroblasts--morphology and frequency
      in hematological disease].
AB  - Peculiar cytoplasmic connection between erythroblasts was observed in the smear
      preparation of human bone marrow; a pair of erythroblasts in the resting stage
      was connected by "cytoplasmic bridge" which is very thin and sometimes long
      compared with the telophase bridge appeared in the usual cytokinesis. Electron
      microscopy revealed that small amount of microtubules were running along in the
      cytoplasmic bridge but mid-body was not seen. Plasma membrane about the middle of
      the bridge bulged to form "bulging ring". Erythroblasts in various
      differentiating stages were connected by the cytoplasmic bridge and the stage of
      each pair was almost the same. The occurrence of the cytoplasmic bridge between
      erythroblasts was evaluated in the smear preparations of human bone marrow with
      hematological diseases or normal conditions. In the normal bone marrow, the mean
      value was 8.1 +/- 3.6% (n = 33). In patients suffered from autoimmune hemolytic
      anemia, it was 4.3 +/- 2.3% (n = 12), aplastic anemia, 3.2 +/- 2.1% (n = 6) and
      paroxysmal nocturnal hemoglobinuria, 5.0 +/- 1.4% (n = 3). While in the
      erythroleukemia the occurrence was very low showing 0.2 +/- 0.1% (n = 3) of total
      erythroblasts. In MDS, RAEB (2.5 +/- 2.4%) and RA (2.9 +/- 2.2+%) showed
      statistically significant lower occurrence. In the normal bone marrow the
      occurrence was higher, so the formation of cytoplasmic bridge could be essential
      for a normal proliferation of erythroblasts.

PMID- 2214192
TI  - [Angio-immunoblastic lymphadenopathy with fibrosis of bone marrow, lymph node,
      liver and spleen, and proliferation of epithelioid cells in lymph nodes].
AB  - We report a 47-year-old man diagnosed as angio-immunoblastic lymphadenopathy with
      dysproteinemia (AILD) with fibrosis of the bone marrow, lymph node, liver and
      spleen, and proliferation of epithelioid cells in lymph node. He was admitted to
      a hospital in May, 1980 because of general fatigue, cough, fever and systemic
      lymphadenopathy. The diagnosis of AILD was based on a biopsy of right cervical
      lymph node. His symptoms were improved but recurred with the addition of icterus
      and progressive pancytopenia with decrement of prednisolone. He was referred to
      our hospital in July, 1980 and his physical examination revealed generalized
      lymphadenopathy, icterus and hepatosplenomegaly. Hemogram showed pancytopenia,
      and needle biopsy of the bone marrow disclosed fibrosis. Sections from the lymph
      node showed AILD with proliferation of epithelioid cells. Administration of 60
      mg/day of prednisolone improved the fever, lymphadenopathy and
      hepatosplenomegaly. However he died suddenly of acute respiratory failure on July
      30. Autopsy showed fibrosis of bone marrow, lymph node, liver and spleen with
      infiltration of abnormal lymphocytes, and pulmonary aspergillosis.

PMID- 2214193
TI  - [An erythremia with acquired HbH disease and chromosomal abnormality].
AB  - A 56-year-old male was admitted to the Nihon University Hospital because of
      general fatigue and anemia on September 21st, 1985. He had mild hepato
      splenomegaly. Hematological findings showed RBC 286 x 10(4)/microliters, Hb
      6.0/dl, reticulocyte count 2.5%, platelet count 9.3 x 10(4)/microliters and WBC
      2,400/microliters. An erythroblast per 100 leukocytes counted in a blood film was
      found. Bone marrow was erythroid hyperplasia with megaloblasts. The erythroblasts
      were PAS positive but not ringed sideroblasts. Other laboratory data including
      hemolysis were all negative. This case seemed to be diagnosed as refractory
      anemia (RA) according to the FAB classification. Chromosomal analysis of marrow
      cells, however, all revealed 46, XY, 20q- at diagnosis and 46, XY, 7q- 20q- after
      22 months. Furthermore, Hb electrophoresis ahd family study indicated the
      presence of acquired HbH disease. Neither erythroid bursts (BFU-e) nor late
      erythroid progenitors (CFU-e) were detected. He has had progressive anemia
      without proliferation of blasts for over 2 years. From these findings, we
      postulate that the entity of erythremia should be distinguished from RA including
      many heterogeneous diseases.

PMID- 2214194
TI  - [Bone marrow re-transplantation following a busulfan and cyclophosphamide
      regimen].
AB  - A 36-year-old man was diagnosed as having RAEB in 1986, and required blood
      transfusion regularly because of severe anemia. He received the first bone marrow
      transplantation following total-body irradiation and etoposide infusion in
      October 1987. He was found to be relapsed into RAEB on 106th day after BMT. And
      the second BMT was planned. According to the conditioning regimen of Tutschka, et
      al, we administrated busulfan and cyclophosphamide before re-transplantation. On
      26th day after BMT, the WBC count exceeded 1,000/microliters and anemia was
      improved, while thrombocytopenia persisted until 50th day. Normal hematopoiesis
      in the bone marrow was confirmed on the 29th day. No severe side effect except
      for a little fevering and bleeding was found during the clinical course.
      Unfortunately he died of pneumonia following graft versus host disease on the
      166th day after re-BMT. This new conditioning regimen is considered to be a
      choice for the high risk patients on re-transplantation.

PMID- 2214195
TI  - [Acute myeloblastic leukemia associated with 46, XY, del(5)(q22)].
AB  - A 38-year-old male admitted to the Internal Medicine of Surugadai Nihon
      University Hospital, complaining of general fatigue and throat pain. The
      laboratory examinations revealed leukocytosis (83, 900/microliters) and an
      appearance of myeloblasts (90.2%) in the peripheral blood. The nucleated cell
      count was 56 x 10(4)/microliters with 85.5% myeloblasts in bone marrow. He was
      diagnosed as acute myeloblastic leukemia (AML). Though he received two courses of
      combination chemotherapy with daunorubicin, BH-AC, 6 MP and prednisone, one
      course of combination with mitoxantrone, etoposide and cytosine arabinoside and
      one course of combination with aclarubicin cytosine arabinoside and prednisone,
      he could not achieved remission. A chromosome analysis revealed 46, XY
      del(5)(q22). The amount of DNA fragments hybridized to 4.5 Kb v-fms probe in
      blastoid cells was approximately a half amount of normal persons. It is not
      defined the relationship between the decrease of fms and leukemia in this case.
      He was diagnosed de novo AML, since he had not been received the therapy with
      potential mutagenic and carcinogenic agents and had not been exposed the
      irradiation on his works.

PMID- 2214196
TI  - [Myelodysplastic syndrome in a child which developed into megakaryocytic leukemia
      with late appearing Ph1 chromosome and rearrangement of breakpoint cluster
      region].
AB  - A 3-year-old boy was referred to our hospital in September 1985, because of
      pancytopenia. His bone marrow was normocellular with 18% blasts, which had Auer
      rod and were positive for peroxidase staining. A diagnosis of refractory anemia
      with excess blasts in transformation was made according to FAB criteria.
      Chromosome analysis of bone marrow cells showed normal male karyotype. He
      attained complete remission with aclarubicin and BH-AC and continued it until
      August 1987 when pancytopenia and hypoplastic bone marrow developed. Chromosome
      analysis of bone marrow cells showed normal male karyotype and gene analysis
      revealed germ-line configuration of breakpoint cluster region (bcr). Overt
      leukemia developed in May 1988 when his WBC count increased to 60,
      600/microliters with 91% blasts, which were negative for peroxidase staining,
      positive for anti-Ia and CDw 41 by cell surface analysis, and positive for
      ultrastructurally demonstrable platelet peroxidase. A diagnosis of megakaryocytic
      leukemia was made. Chromosome analysis of bone marrow cells showed 46, XY,
      t(9;22) (q34;q11) and gene analysis revealed rearrangement of bcr. He died in
      November 1988. Our results and review of literature suggest that late appearing
      ph1 chromosome and rearrangement of bcr may occur in a variety of hematologic
      malignancies and influence the course of disease.

PMID- 2214197
TI  - [Lymphoproliferative disorders].

PMID- 2214198
TI  - [Structures and heterogeneity of immunoglobulins].

PMID- 2214199
TI  - [General aspects of cytokines].

PMID- 2214200
TI  - [Complement and bio-phylaxis].

PMID- 2214201
TI  - [Review on the immune complex].

PMID- 2214202
TI  - [Concept of autoimmune disease].

PMID- 2214203
TI  - [Origin and differentiation of the cells operation immune functions].

PMID- 2214204
TI  - [Immunologic deficiency syndromes].

PMID- 2214205
TI  - [Protective immunity for infection].

PMID- 2214206
TI  - [Gene engineering].

PMID- 2214207
TI  - [Cell engineering].

PMID- 2214208
TI  - [Detection of bacterial toxin genes by the DNA colony hybridization].

PMID- 2214209
TI  - [DNA transformation].

PMID- 2214210
TI  - [DNA Data Bank].

PMID- 2214211
TI  - [Detection of DNA polymorphisms].

PMID- 2214212
TI  - [Genetic aspects of hyperlipidemia].

PMID- 2214213
TI  - [DNA diagnosis of amyloidoses].

PMID- 2214214
TI  - [Application of non-RI-labeled DNA probes to diagnosis].

PMID- 2214215
TI  - [Analysis of brain CT in 120 patients with human cysticercosis].
AB  - A study on brain CT was made in 120 patients of human cysticercosis, which is a
      rare disease in Japan and clinical symptoms and laboratory data for the diagnosis
      were also discussed. From the point of therapeutic view, we proposed a new
      differentiation on brain CT of human cysticercosis, which is divided into two
      groups according to the alive or dead parasite. Furthermore, we proposed a new
      type named multiple large and small cysts type on brain CT. The idea of
      diagnostic standard was made integrating brain CT image, clinical symptoms and
      laboratory data.

PMID- 2214216
TI  - [MR imaging of internal carotid artery occlusion].
AB  - Five patients with internal carotid artery occlusion were studied with MR imaging
      at 0.22 T. At the carotid siphon, occluded vessels showed absence of flow void in
      three patients. But two cases had "partial flow void" which mimicked small
      arterial caliber. In these patients angiography showed collateral circulation to
      the carotid siphon. So the partial flow void in the carotid siphon suggested
      internal carotid artery occlusion with collateral circulation.

PMID- 2214217
TI  - [A comparison study of SPECT and MRI in remote effects of chronic cerebrovascular
      disease].
AB  - A comparison study of SPECT and MRI was performed to investigate remote effects
      in 10 patients with chronic cerebrovascular disease. Hypoperfusion in the
      cerebellar hemisphere contralateral to supratentorial lesions, the overlying
      cerebral cortex ipsilateral to subcortical lesions, the thalamus ipsilateral to
      cortical lesions, and the visual cortex distant to optic radiation lesions was
      demonstrated using SPECT with 123I-IMP. Although hypoperfusion in these remote
      areas was considered to be related to irreversible degenerative processes in the
      chronic phase, MR images did not reveal any abnormalities.

PMID- 2214218
TI  - [CT in colon cancer].
AB  - CT pictures from 59 lesions of advanced colon cancer including rectal cancer were
      reviewed to evaluate a role of CT in preoperative staging diagnosis. CT findings
      were recorded following general rules for clinical and pathological studies on
      cancer of colon, rectum and anus, proposed by Japanese Society for Cancer of
      Colon and Rectum. 1) Tumors were detected in 90% of advanced colon cancers. 2)
      Sensitivity in local extension (S factor) was 58.0%. 3) Sensitivity in lymph node
      involvement (N factor) was 50.0%. 4) Sensitivity in final staging diagnosis,
      dividing colon cancer into two groups below st II and above st III, was 63.3%. 5)
      Further study should be necessitated to provide useful information for
      preoperative staging diagnosis of colon cancer.

PMID- 2214219
TI  - [Studies on the roentgenological differentiation between complex and simple bowel
      obstruction].
AB  - We studied 81 cases of organic bowel obstruction. In complex obstruction 7 cases
      out of 25 (28%) were diagnosed on the plain film before operation, although in
      simple obstruction 54 cases out of 56 (96%). But in retrospective evaluation of
      the plain films, we noticed that in some cases of complex obstruction, marked
      small bowel obstruction and ascites were seen from the onset, which were never
      seen in simple obstruction. We considered this finding as the key point for the
      roentgenological differentiation between complex and simple obstruction.

PMID- 2214220
TI  - [Diagnostic imaging of cystic pancreatic tumors].
AB  - Five cases of pathologically proved cystic pancreatic tumors were retrospectively
      reviewed. Mucinous cystadenocarcinoma tends to have uneven wall or solid mass
      component. All cystic lesions without history of acute pancreatitis or trauma
      should be surgically removed, even when considered as benign on imaging
      modalities.

PMID- 2214221
TI  - [Diagnosis of the pelvic fracture which requires TAE on plain pelvic radiograph].
AB  - We reviewed the initial emergency-room plain pelvic radiographs of 75 patients
      with pelvic fracture. In thirty-six patients transcatheter arterial embolization
      (TAE) was performed for retroperitoneal hemorrhage associated with pelvic
      fracture (TAE group) and in 39 patients (non-shock group) TAE was not required.
      In TAE group, fractures involving iliosacral region and pubic symphysis were more
      dominant than in non-shock group. Specific soft tissue abnormal shadow of TAE
      group was not present. It may be impossible to determine the necessity of TAE in
      pelvic fracture on the basis of plain pelvic radiograph.

PMID- 2214222
TI  - [Insufficiency fracture of the sacrum].
AB  - Three cases of insufficiency fracture of the sacrum are reported. Cortical
      disruption and linear sclerosis with or without linear fracture line at the upper
      sacral segment parallel to the sacroiliac joint are characteristic. Bone
      scintigram is suitable for screening, but plain radiographic and CT findings are
      diagnostic. Insufficiency fracture of the sacrum should not be confused with
      other conditions, such as metastatic disease.

PMID- 2214224
TI  - [Fractionated irradiation with special reference to head and neck tumors].

PMID- 2214223
TI  - [Azygous continuation of the inferior vena cava (a congenital defect of the
      inferior vena cava)].

PMID- 2214225
TI  - [Atypical computed tomographic appearance of herpes simplex encephalitis].
AB  - In cases of herpes simplex encephalitis, a low density lesion in the temporal
      lobe is a common CT finding, whereas hemorrhagic lesion is rarely observed on CT
      in this disorder despite the frequent occurrence on pathologic studies. Two cases
      of hemorrhagic lesion observed on CT in herpes simplex encephalitis are reported,
      and atypical CT findings of herpes simplex encephalitis is discussed.

PMID- 2214226
TI  - [Interhemispheric cyst of an adult associated with partial agenesis of the corpus
      callosum].
AB  - The authors report an adult patient with an asymptomatic interhemispheric cyst
      demonstrated by computerized tomography (CT), magnetic resonance imaging (MRI)
      scan and angiography. Partial agenesis of the corpus callosum is associated.

PMID- 2214227
TI  - [A case of pseudoinfarct of the liver (Zahn's infarct)].
AB  - We reported a case of pseudoinfarct (Zahn's infarct) of the liver caused by the
      inflammatory pseudotumor. A dense segmental staining in the area of Zahn's
      infarct, which was thought to be characteristic finding, was found on the hepatic
      angiography. This finding was supposed to be consistent with sinusoidal hyperemia
      according to the pathological finding.

PMID- 2214228
TI  - [A case of giant cavernous hemangioma with hemoperitoneum due to blunt abdominal
      trauma; CT findings].
AB  - A 55-year-old woman with a giant cavernous hemangioma in the liver with
      hemoperitoneum due to blunt abdominal trauma was reported. CT findings of the
      liver at first thought to be hepatic injuries. But serial studies revealed that
      the CT findings were dependent on giant cavernous hemangioma and apart from
      hepatic injury.

PMID- 2214229
TI  - [Transarterial embolization of metastatic pheochromocytoma].
AB  - We successfully controlled hypertension of a 48-year-old female by embolizing
      metastatic pheochromocytoma of the liver. Although transarterial embolization of
      the hepatic artery was uneventful, the patient soon developed severe hypertension
      and tachycardia which were controlled medically. Symptoms subsided within 10-20
      days. Follow-up CT showed reduction of the liver mass.

PMID- 2214230
TI  - [A case of extramedullary plasmacytoma of the mesenteric lymph nodes].
AB  - Reported here is a extremely rare case of extramedullary plasmacytoma which
      occurred in the mesenteric lymph nodes and could be diagnosed before operation.
      The ultrasound examination showed a multilobular mass, the CT examination a
      multilobular, homogeneous mass, and angiography a hypervascular lesion. M-protein
      decreased after operation.

PMID- 2214231
TI  - [A case of myxadenoma of the renal capsule].
AB  - We reported the case of a 69-year-old man who had resection of a myxadenoma of
      the renal capsule. The tumor measured 28 x 24 x 6.5 cm and weighed 3,000 grams
      including the left kidney. CT was useful in suggesting the diagnosis of the renal
      capsular tumor.

PMID- 2214232
TI  - [A case of bilateral adrenal myelolipoma].
AB  - We reported a case of bilateral adrenal myelolipoma. Low height, obesity and and
      elevation of 17-KS were found in this case. Tumors were hypovascular adrenal
      masses with low attenuation numbers on CT. MRI was useful in demonstrating the
      relation of tumors to adjacent organs. It should be considered that, although
      very rare, bilateral myelolipoma is possible.

PMID- 2214233
TI  - [The development of a modified J-shaped long sheath and its application].

PMID- 2214234
TI  - [Fibronectin binding to Staphylococcus aureus in experimental staphylococcal skin
      infection in mice].
AB  - Staphylococcus aureus infection of skin was produced in cyclophosphamide-treated
      mice by intracutaneous inoculation of a strain in this organism clinically
      isolated from a carbuncle. Deposition and binding of fibronectin in initial stage
      of the infection were followed by immunohistochemistry and immunoelectron
      microscopy. Fibronectin began to deposit in a fine granular pattern in the dermis
      and musculocutaneous layer at 2 minutes after the inoculation and gradually
      increased with time. Fibronectin binding on the surface of staphylococcal cells
      was seen after 12 hours of inoculation. At 24 hours two patterns of binding were
      seen. In one pattern, fibronectin was bound to a part of the cell surface of the
      microorganisms. The fibronectin binding parts were seen very close or attached to
      the fibrin-like-structure and dermal connective tissues. This suggests that
      fibronectin helped staphylococcus cells to attach to fibrin or connective
      tissues. The other pattern of fibronectin binding was the binding of fibronectin
      all around the cells. This pattern could be interpreted as inhibition by
      fibronectin of staphylococcus attachment to the fibrins and the tissues.

PMID- 2214235
TI  - [A sensitization effect of hematoporphyrin oligomer (HpO) and caffeine for X-ray
      radiation of skin cancer].
AB  - Human malignant melanoma cells (G-361) were irradiated with X-ray for different
      irradiation times. The amount of DNA damage was much increased by the treatment
      of the cells with HpO before X-ray irradiation. Furthermore, it was found that
      the caffeine inhibited effectively the repair of the damaged DNA. Furthermore,
      HpO was administered before X-ray irradiation of transplantable skin tumor in C3H
      mice and/or caffeine+ was to be given the mouse after X-ray irradiation. The
      growth of the tumor irradiated with HpO and/or caffeine was more inhibited and
      the necrotic area was more expanded than that of the tumor irradiated X-ray only.
      Labeling Index utilizing bromodeoxyuridine (BrdU) in the viable area of the
      treated tumor decreased when HpO and/or caffeine were administered. The amount of
      DNA damage more increased in the tumor cells irradiated with HpO than that
      irradiated only. And, the repair of the damaged DNA was more delayed in the tumor
      cells irradiated with HpO and caffeine than that irradiated with the other
      treatments. In conclusion, it was considered that HpO might be a radioactive
      sensitizer and caffeine enhanced the inhibition of the repair of DNA damaged. We
      hope that the treatment of X-ray radiation with HpO and caffeine is useful for
      clinical treatment of human malignant tumor.

PMID- 2214236
TI  - [The correlations of respiratory function tests, chest roentgenographic
      manifestations and respiratory symptoms in the patients with systemic sclerosis,
      using a scoring-method for symptoms].
AB  - Analytical studies were performed on the respiratory symptoms in 31 systemic
      sclerosis cases. Respiratory symptoms were expressed by scores from 1) coughs, 2)
      difficulties in walking, 3) difficulties in ascending, 4) dyspnea . In early
      stage cases with slight clinical symptoms, %VC was always normal, but %DLco was
      generally reduced. Because of good correlation between respiratory functions and
      clinical symptom scores, it is available to use the scores as well as %DLLco and
      %VC to diagnose slight lung involvement in systemic sclerosis. Also the clinical
      symptom scores are related to the roentgenographic manifestations of lung
      fibrosis which are characteristic in systemic sclerosis. Therefore we felt that
      this system of clinical symptom scores was useful to follow-up the patients.

PMID- 2214237
TI  - [Histological study of the oral mucosa of PSS].
AB  - Histological examination was performed on the oral mucosa of 25 patients with PSS
      which consisted of 16 cases of Acrosclerotic type (A type) and 9 cases of Diffuse
      type (D type). Results obtained were as follows: (A) Sclerotic change of
      connective tissue were found in the submucosal area (a type) and in the salivary
      peri-glandular++ area (b type) and also in the both areas (c type). (1) In A type
      of PSS, sclerotic changes was found in 14 out of 16 cases (87.5%) and (2) In D
      type, 9 out of 9 cases (100%). (3) In D type, sclerotic changes were marked and,
      moreover, found in the earlier stage of disease more than in A type. (B)
      Inflammatory change of salivary gland based on the criteria of Chisholm and
      Mason. (1) Moderate and marked salivary gland adenitis were found in 6 out of 16
      cases of A type (37.5%) and 2 out of 9 cases of D type (22%). (2) Adenitis were
      found more frequently in the early stage of disease in both types. From above
      described findings, it is concluded that 1) as to sclerotic change, the early and
      marked changes were found in D type and 2) as to inflammation of salivary gland,
      no significant difference was found between both types.

PMID- 2214238
TI  - [Cutaneous atypical mycobacteriosis due to Mycobacterium kansasii--a case report
      and a review of the literature].
AB  - A case of cutaneous atypical mycobacteriosis due to Mycobacterium (M.) kansasii
      is reported. A 41-year-old man, who had lived in Kawasaki city, was seen in April
      1988 because of sores on the dorsum of left forefinger which had been present for
      one month. Physical examination revealed an erythematous, edematous plaque
      approximately 2 and 4 cm overlying proximal and middle phalanx of left index
      finger. Otherwise his physical findings were normal. Laboratory studies including
      X-ray examinations of the chest and left hand were normal. The histopathology
      revealed a mixed cellular infiltration consists of mononuclear cells and
      neutrophils with necrosis in the dermis. No granuloma formation was observed. In
      the deep dermis, some acid fast bacilli (AFB) were demonstrated. The culture for
      AFB was positive with the following characteristics: Acidfastness (+), Niacin (
      ), Photochromogenecity (+), Growth at 37 degrees C (+), at 42 degrees C (+), at
      45 degrees C (-), Nitrate reduction (+), Catalase (+). These tests were
      diagnostic of Group I photochromogen, M. kansasii. We reviewed 19 cases of
      cutaneous atypical mycobacteriosis due to M. kansasii in the world literature
      including our case and found that there were three types of the disease: (1)
      Cutaneous chronic granulomatous type, (2) Disseminated acute pyogenic type and
      (3) Cutaneous pyogenic type.

PMID- 2214239
TI  - [A case of mixed connective tissue disease associated with uncommon acute
      myopathy caused by isolated muscle epithelioid granuloma].
AB  - The patient is 48 year-old female who has been followed as MCTD with nonsteroidal
      therapies for 18 years. Sometimes she has been attached by focal severe muscle
      pain. One year ago, she had general myalgia associated with high fever and
      arthralgia. The results of the examination, aldolase, GOT, GPT, gamma-GTP, CRP
      and leucocyte were increased. Muscle biopsy showed noncaseating epithelioid
      granuloma being in contact with enlarged injected vessels. Out of tough with
      granuloma, a few fibre necroses, fibrosis of muscle, and degeneration of collagen
      fiber were recognized. After treatment of nonsteroidal antiinflammatory agents,
      her every complain was removed. Her muscle looks normal herself. MCTD has
      myopathy caused by inflammatory infiltrates and fibre necroses. But granulomatous
      myositis is very rare. It is difficult to differentiate our case from
      sarcoidosis, especially acute isolated muscle sarcoidosis.

PMID- 2214240
TI  - [The purification of high molecular weight protease from the rat's skin].
AB  - In this study, the purification of a high molecular weight protease from Wistar
      Rats' skin was investigated. A high molecular weight protease from Wistar Rats'
      skin was purified by successive (NH4)2SO4 fractionation, Phenylsepharose CL-4B,
      and HPLC gel filtration chromatographies. The activity of the enzyme was
      determined using a synthetic substrate, succinyl-leucyl-leucyl-valyl-tyrosine
      methylcoumarinamide (SLLVT-MCA). The molecular weight of the purified enzyme was
      estimated to be 750,000 by gel filtration. With SDS-PAGE the purified enzyme was
      dissociated into several bands of which the majority fell into the range of
      20,100-36,000 daltons. These findings suggest that high molecular weight protease
      in rat's skin consists of various subunits.

PMID- 2214241
TI  - [Clinical features of male SLE patients--summary of our 22 cases].
AB  - We investigated clinical features of our 22 male SLE patients with main respect
      to 11 articles of ARA criteria for diagnosis of SLE (1982). As for skin lesions,
      14 cases (64%) manifested wide spread discoid lupus erythematosus as their first
      symptoms, however, rather rare lesions could be seen as follows: 3 cases with
      nodular cutaneous lupus mucinosis, 1 with vesiculobullous LE. As to visceral
      manifestations, renal involvements could be seen in 11 cases (50%), among which 6
      showed nephrotic syndromes. In immunological examinations, 1 case revealed C4A
      deficiency. The clinical tendency of male SLE cases has not been settled by now,
      for the disease is uncommon in men. Each of our 22 cases manifested a variety of
      features respectively, indicating that rather atypical cases as SLE can be more
      often seen in males than females. In addition, many of our cases showed
      remarkable changes clinically during their courses, which suggests that we should
      follow them carefully from now.

PMID- 2214242
TI  - [A study on the therapy and prognosis of pemphigus vulgaris].
AB  - The treatment and, in particular, the prognosis of 32 patients with pemphigus
      were studied. All cases were classified according to treatment, for example,
      corticosteroid only, corticosteroid + immune-suppressive agents, plasma exchange
      + corticosteroid and/or immune-suppressive agents, and other treatments. Results
      showed that with the plasma exchange group skin lesions disappeared the quickest,
      the percentage of disappearance was the highest and a long standing remission was
      able to be maintained. With the plasma exchange group, many cases were severe and
      had complications which were not able to be resolved by corticosteroid or immune
      suppressive agents. Therefore, plasma exchange may be considered as a very
      significant form of treatment of pemphigus vulgaris.

PMID- 2214243
TI  - [The study on the specific eruptions of malignant lymphoma. II. Clinical and
      pathological interesting points, electron microscopic study, immune state and
      treatment].
AB  - We investigated 31 cases of cutaneous malignant lymphoma diagnosed by skin biopsy
      during about 11 years at the University of Tsukuba hospital. The interesting
      points are the followings; the difference of cell morphology between the primary
      lesion and the secondary skin lesion was found in one case diagnosed of Lennert's
      lymphoma. The erythrophagocytosis of tumor cells was found at the relapse of one
      case of TCL. Eosinophils were increased in number in accordance with the severity
      in a case of MF. The electron microscopic study revealed the LC approaching to
      the tumor cells in ATL and MF, and TRS in ATL. Group A maintained better immunity
      of PPD and DNCB skin test than Group B. Non-specific eruptions in Group A were
      found frequently at the late stage, about half of which were cutaneous/mucous
      fungous infection. In the treatment of Group A, soft X-ray therapy was an
      excellent method at the point of the responsiveness, the painlessness, the
      interval of relapse and side effects.

PMID- 2214244
TI  - [Nutritional condition of epidermolysis bullosa patients assessed from body
      height and weight].
AB  - Exact body height and weight data of patient with epidermolysis bullosa simplex
      (EBS) and recessive dystrophic epidermolysis bullosa (RDEB) were collected
      through a nation-wide epidemiologic investigation concerning epidermolysis
      bullosa (EB) patients. This data was then compared with the averaged body height
      and weight of age and sex matched normal controls. The nutritional condition of
      the EB patients was evaluated statistically. The data showed that height of
      female EBS patients was less than the controls (p less than 0.01), and
      furthermore, that height and weight of male and female RDEB patients was also
      less than the controls (p less than 0.01). These results indicated that EB,
      especially RDEB patients, were in the poor nutritional condition, and that the
      adequate nutritional management might significantly influence the prognosis of
      these patients.

PMID- 2214245
TI  - Detection of specific proteins in the aqueous humor in primary open-angle
      glaucoma.
AB  - To elucidate the mechanism of increased intraocular pressure in primary open
      angle glaucoma (POAG), the protein profiles of aqueous humor obtained from POAG
      patients were compared with those of cataract patients as a control group.
      Aqueous humor proteins were analyzed by sodium dodecylsulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) and detected by the ultrasensitive silver staining
      technique. In 79% of the samples taken from POAG patients, protein bands of
      140,000 or 160,000 daltons were stained, but none were stained from cataract
      patients. The presence of these protein bands revealed statistically significant
      differences between the two groups. Protein bands of 140,000 or 160,000 daltons
      were evenly visible at all ages in POAG patients, and the positivity of bands had
      no correlation with sex or initial intraocular pressure level. It is possible
      that the ultrastructural changes of the aqueous outflow pathway in POAG may be
      related to the changes in the aqueous protein, presence of 140,000 or 160,000
      daltons protein bands.

PMID- 2214246
TI  - Detection of early visual field change in ocular hypertension using STATPAC.
AB  - Perimetric tests were performed on 32 ocular hypertensive eyes (17 patients) with
      the C-30-2 threshold program of the Humphrey Visual Field Analyzer. The global
      indices of 32 ocular hypertensive eyes were compared with those of 34 normal eyes
      (17 controls). None of the 34 normal eyes had visual field sensitivity loss.
      However, three out of 32 ocular hypertensive eyes, which is 0.4%, had visual
      field sensitivity loss. Of these three eyes, two eyes showed generalized
      depression (MD, P less than 5%) and one eye showed paracentral scotoma.

PMID- 2214247
TI  - Detection of glaucomatous visual field defect using a screening program of
      Humphrey Field Analyzer.
AB  - To evaluate its clinical efficacy, we report the results of Armaly central field
      screening test in comparison with those of central 30-2 threshold test of
      Humphrey Field Analyzer. In 83 cases of normotensives, ocular hypertensives, and
      glaucoma patients with open-angle or narrow-angle enrolled in this study, a total
      of 143 eyes were examined. Fifty-four out of 61 patients (88.5%) and 73 out of 81
      eyes (90.1%) with visual field defects were detected by the Humphrey Field
      Analyzer screening test. Eight eyes out of 81(9.9%) with visual field defects
      detected by the screening test were confirmed as false positive. All points of
      false positive were solitary, which tended to occur more frequently on superior
      visual field. A false negative of eight eyes out of 62 (12.9%) detected by the
      screening test was confirmed by the threshold test, which was more frequent on
      superior field and shown to be located more peripherally from the fixation point.
      There was no significant difference in either central sensitivity or age of the
      false positive and negative.

PMID- 2214248
TI  - Intraocular pressure and axial length in children.
AB  - The intraocular pressure and the anteroposterior length of the eye are of great
      clinical importance for the diagnosis and management, before and after surgery,
      of congenital glaucoma. It is well-known that normal intraocular pressure in
      children is different from the normal levels in adults. We performed measurements
      of intraocular pressure and axial length in 141 children who had been admitted
      for eye problems other than glaucoma. The intraocular pressures were measured
      with the Perkins hand-held applanation tonometer at the beginning of general
      anesthesia. Simultaneously, A-scan ultra-sound measurements of the axial lengths
      of the eyes were made. In 10 children under the age of two years, the intraocular
      pressure was 11.85 +/- 1.35 mmHg. In 79 children from two to seven years, the
      intraocular pressure was 12.80 +/- 1.73 mmHg. In 52 children from seven to 15
      years, the intraocular pressure was 13.31 +/- 1.79 mmHg. The axial lengths of the
      eyes in children under the age of two years, from two to seven years, and from
      seven to 15 years, were 21.31 +/- 0.97 mm, 22.04 +/- 0.92 mm, and 23.22 +/- 1.00
      mm, respectively. These results were considered to be guidelines for measuring
      intraocular pressure and axial length in children suspected of having congenital
      glaucoma. The differences of intraocular pressures stated by other authors are
      due to early measurement of the intraocular pressure at the beginning of general
      anesthesia.

PMID- 2214249
TI  - Non-contact tonometry: an ideal method for mass screening.
AB  - We evaluated one of the new non-contact tonometers, the Pulsair non-contact
      tonometer, to assess its accuracy and reliability. Measurements on 101 eyes were
      used to assess its accuracy against Goldmann tonometry measurements, and another
      24 eyes were used to assess its reliability (reproducibility). The results showed
      the instrument to be highly accurate and reliable in measurement.

PMID- 2214250
TI  - Lysis of vitreous strands with neodymium: YAG laser.
AB  - Eighteen eyes with vitreous strands adherent to the corneoscleral wounds of
      previous cataract surgery were treated with neodymium: YAG laser to lyse those
      strands. Twelve eyes were treated for management of cystoid macular edema (CME
      group); six eyes were treated for prophylaxis of possible CME (prophylactic
      group). In the CME group, visual acuity improved two or more lines in nine eyes
      (75.0%), and seven eyes had a post laser visual acuity of 0.5 or better (One eye
      had a pre-treatment visual acuity of 0.5 or better). In the prophylactic group,
      visual acuity was either maintained at the pre-treatment visual acuity of 0.5 or
      better. In the prophylactic group, visual acuity was either maintained at the pre
      treatment level or improved in five eyes (83.3%) 18 months later following laser
      treatment. This procedure was complicated by retinal detachment in one case and
      the elevation of intraocular pressure over 10 mmHg in another case.

PMID- 2214251
TI  - Oscillatory potentials of local macular ERG in diabetic retinopathy.
AB  - The oscillatory potentials (OPs) in electroretinogram (ERG) have clinical values
      in measuring retinal functions of the early stage of diabetic retinopathy.
      However, OPs have, until now, been evaluated as components of total ERG recorded
      with a full field stimulus over the entire retina. Therefore, little information
      could be obtained about the macular condition (diabetic retinopathy). Using focal
      stimuli, we successfully recorded OPs in the human macular region. We modified
      our previously reported system for recording local macular ERG under the fundus
      monitor with an infrared television fundus camera. We evaluated macular OPs with
      simultaneously recorded a- and b-waves in many patients with diabetic
      retinopathy. In some kinds of early diabetic maculopathy, the macular OPs were
      selectively reduced, leaving the a- and b-waves intact. The macular OPs can be a
      valuable indicator in assessing the macular function in diabetic maculopathy.

PMID- 2214252
TI  - Early surgical management in bilateral acute retinal necrosis.
AB  - One patient with bilateral acute retinal necrosis underwent encircling scleral
      buckle, vitrectomy, and intravitreal acyclovir on both eyes. This procedure was
      performed on the right eye while the retina was attached. The retina of the right
      eye was reattached by performing fluid-gas exchange and modified panretinal
      photocoagulation when the retina subsequently detached. Soon after the
      development of retinal detachment in the left eye, the above surgical procedures
      were performed on the left eye, and the retina was successfully reattached.
      Bilateral acute retinal necrosis with significant vitreous opacification, which
      is a devastating ocular disease causing possible blindness in both eyes, requires
      more aggressive, early surgical management.

PMID- 2214254
TI  - Atherosclerosis and glomerulosclerosis in WHHL rabbits and obese Zucker rats.
AB  - The aorta and the kidney of 12 month old hyperlipidemic WHHL and obese Zucker
      rats, were examined morphologically. The WHHL developed severe and premature
      atherosclerosis but did not develop glomerulosclerosis. In contrast, the Zucker
      rats did not manifest atherosclerosis of the aorta, but developed
      glomerulosclerosis. These two animal models could be useful in understanding the
      roles of heterogeneous lipoprotein particles, genetic susceptibility, hemodynamic
      stress, and mesangial interactions with lipoproteins in the development of
      glomerulosclerosis.

PMID- 2214253
TI  - Topical fibronectin treatment in persistent corneal epithelial defects and
      corneal ulcers.
AB  - Topical fibronectin, autologous and homologous, was used to treat nine patients
      (eleven eyes) with persistent corneal epithelial defects and corneal ulcers that
      failed to improve with standard therapy. The fibronectin was purified from
      autologous and homologous plasma by gelatin-Sepharose 4B affinity chromatography
      and administered topically, 500 micrograms/ml five times a day, for three weeks.
      Complete or nearly complete reepithelialization was achieved in all patients
      regardless of the source of fibronectin, autologous or homologous. But healing
      times varied. The average healing time was 41.7 +/- 14.7 days (35.7 +/- 12.4 days
      for autologous, 50.8 +/- 14.4 days for homologous). Ocular symptoms were relieved
      significantly, and no side effects were observed. Over an average follow-up
      period of 5.2 months, no recurrences were noted. The results showed that
      homologous, as well as autologous, fibronectin was effective in patients with
      persistent corneal epithelial defects and corneal ulcers.

PMID- 2214255
TI  - Studies on the chironomid midges (Diptera, Chironomidae) of the Nansei Islands,
      southern Japan.
AB  - The Nansei Islands are located in the subtropical zone of the western Pacific
      Ocean between Kyushu and Taiwan, and are composed of the two main island groups,
      the Amami and the Ryukyu Archipelagoes. This area has been known for the presence
      of a number of indigenous animal species. Prior to the present studies,
      collections of the chironomids mainly in the urban areas of the three main
      islands of the Ryukyus were carried out by Sasa and Hasegawa, and a total of 42
      species, including 25 new species, were recorded. Additional collections of the
      chironomids mainly in the mountainous areas of this region were carried out by
      the present author during 1988 and 1989, and a total of 26 species (including 12
      new species) were recorded from Amami Island, and a total of 27 species
      (including 10 new species) were recorded from the Ryukyu Islands. Eight species
      among them, including 3 new species, were common to the two archipelagos.

PMID- 2214256
TI  - Synergy of OK-432 and recombinant interleukin 2 in the antitumor immunity
      induction and the cytotoxic T-lymphocyte generation.

PMID- 2214257
TI  - Synthesis of hepatitis B virus core antigen polypeptide in E. coli using pKK223-3
      plasmid, a vector for expression, with tac promoter.
AB  - A hybrid plasmid was constructed by insertion of the HBc gene encoding HBcAg into
      the pKK223-3 plasmid at the SmaI cleavage site in the correct direction just
      downstream from the tac promoter and upstream from the rrnB terminator. The
      recombinant plasmid carrying the HBc gene was introduced into E. coli and cloned.
      HBcAg was synthesized in E. coli by using the expression plasmid under the
      regulation of the tac promoter and rrnB terminator. The tac promoter, derived
      from sequences of trp and lac UV5 promoters, has identical sequences in two
      domains (-35 and -10 regions) with optimal distance, and the Shine-Dalgarno
      sequence, which enables protein synthesis to start at the ATG of the adjacent HBc
      gene. The nucleotide sequence of the HBc gene and its predicted amino acid
      sequence were almost identical to those previously reported. Purified HBcAg has a
      molecular weight of 21,500. This polypeptide gave a positive reaction with anti
      HBcAg and anti-HBe antibodies, and was assembled into spherical particles 37 nm
      in diameter. The recombinant plasmid, carrying the HBc gene between the tac
      promoter (trp-lac hybrid promoter) and the rrnB terminator in expression plasmid
      pKK223-3, was useful for efficient expression of the HBc gene and production of
      HBcAg particles in E. coli.

PMID- 2214258
TI  - [Study on the usefulness of haptoglobin used on endoscopic injection
      sclerotherapy].
AB  - The effect of haptoglobin (Hp) used on endoscopic injection sclerotherapy (EIS)
      was evaluated by examining the increase of serum free hemoglobin (FHb) and the
      changes of renal function. In control group, the increase of serum FHb (delta
      FHb) was paralleled with the volume of 5% ethanolamine Oleate (EO) injected
      intravariceally, and free Hp (FHp) was disappered in this group soon after EIS.
      On the contrary, in the group treated with Hp, neither the increase of FHb nor
      decrease of FHp were recognized. The significant increase of urine beta 2
      microglobulin and NAG was recognized in control group. Therefore, if Hp is used
      at initial EIS, it would be prevented that serum FHb due to intravascular
      hemolysis increases, consequently the possibility of renal dysfunction.

PMID- 2214259
TI  - [Relation between localization of gastric mucosal lesions and microvascular
      disturbance].
AB  - Acute gastric mucosal lesions in the rats were produced by intermittent
      electrical stimuli to a main trunk of the left gastric artery (LGA), right
      gastroepiploic artery (RGEA) or a posterior branch of the left gastric artery
      (PLGA). The image processing analysis was applied to determine the relation
      between distribution of the lesions and perfusion area of the supplying artery to
      which electrical stimuli were given. Electrical stimuli of 50 Hz, 5 msec, 100
      microA was supplied to the artery for 30 sc three times with 10 sec interval. A
      series of these stimuli was repeated three times. The mucosal blood flow measured
      with the laser doppler method in each perfusion area was reduced to less than 35%
      of the control value during the electrical stimuli for 30 sec. After the repeated
      electrical stimuli to LGA, 85.8 and 95.4% of the mucosal lesions were found in
      the mean and maximum perfusion area of LGA, respectively. Electrical stimuli to
      PLGA caused 84.5% and 95.3 of the lesions in the mean and maximum area of PLGA,
      respectively. Stimuli to RGEA caused 53.4% and 74.1% of the lesions in the mean
      and maximum perfusion area of RGEA. In the antrum, electrical stimuli to LGA,
      PLGA or RGEA produced 0%, 5.4% or 5.0% of the mucosal lesions. It is concluded
      that the corpus mucosal lesions induced by regional ischemia are distributed in
      the ischemic area.

PMID- 2214260
TI  - [Effect of endothelin on gastric mucosal lesion in rats].
AB  - Gastric mucosal blood flow and gastric mucosal prostaglandin E2 (PGE2) and
      prostacyclin (PGI2) were investigated in male Wistar rats intraarterially
      injected with endothelin (ET), an endothelium-derived vasoconstrictor peptide.
      Immediately following ET (4 nmol/kg) administration, gastric mucosal blood flow
      decreased. Then 30 min later, the blood flow reached the minimum, but PGE2 and
      PGI2 showed the highest value. PGE2 showed a tendency to decrease 90 min later,
      while PGI2 continued to show high value. There were redness and hemorrhagic
      damage in the gastric mucosa. Endogenous PGs were presumed to be relate to the
      regulation of the development of the mucosal damage owing to decrease in the
      blood flow after ET administration.

PMID- 2214261
TI  - [Effect of the lateral hypothalamic area-lesions on the development of gastric
      mucosal damages by water immersion restraint stress in rats].
AB  - The role of the lateral hypothalamic area (LHA) in the development of gastric
      mucosal damages induced by water immersion restraint stress was evaluated in
      bilateral LHA-lesioned rats. The ulcer index of lesions (M +/- SEM, mm) was
      significantly higher in LHA-lesioned rats (21.6 +/- 2.8) than in both thalamus
      lesioned rats (9.8 +/- 2.0) and non-treated rats (10.2 +/- 1.5). The gastric acid
      and pepsin outputs during water immersion for 5 hours were significantly lower in
      the LHA-lesioned rats than in both the control rats. In the LHA-lesioned rats,
      PAS-positive mucus content of gastric corpus without lesions was significantly
      decreased after water immersion restraint stress for 5 hours. All these results
      suggest that lateral hypothalamic area plays an important role in the process of
      stress ulcer formation mainly through the disturbance of mucosal defensive
      mechanism such as changes in gastric mucus contents.

PMID- 2214262
TI  - [Effects of dopamine on stress ulcer].
AB  - Preventive effect of dopamine on stress ulcer formation was investigated in rats.
      Dopamine 1-10 micrograms/kg/min suppressed the elevation of ulcer index
      significantly after water immersion and restraint stress in a dose-dependent
      fashion, however ulcer indices of 25 micrograms/kg/min of dopamine were higher
      than 10 micrograms/kg/min. Dopamine 1-10 micrograms/kg/min suppressed the
      decrease of gastric mucosal blood flow, gastric mucosal prostaglandin E2 content
      and gastric transmucosal potential difference during stress loading in a dose
      dependent manner, although the suppression of them in 25 micrograms/kg/min of
      dopamine was smaller than in 10 micrograms/kg/min also. Dopamine suppressed the
      increase of gastric acid secretion and gastric motility during stress loading in
      a dose-dependent fashion up to 25 micrograms/kg/min. These results indicates that
      dopamine suppresses the formation of stress ulcer by increasing defensive factors
      and decreasing aggressive factors.

PMID- 2214263
TI  - [Clinical and epidemiological study on factors of serious development of viral
      hepatitis type A].
AB  - In order to investigate the factors that make viral hepatitis type A serious,
      clinical pictures were analyzed in 269 patients with viral hepatitis type A
      broken out during the past 8 years. In 1986 incidence of patients with severe
      hepatic dysfunction was higher and the average age of them was as high as 36.8 +/
      12.8 years old. The percentage of patients over 40 years of age was increasing
      from 1979 to 1986. Moreover in 6 patients with fulminant hepatitis type A, 4 of
      them (66.7%) were older than 50 years. Analysis of the clinical courses of 9
      patients associated with underlying chronic liver disease disclosed serious
      hepatic dysfunctions in 7 out of 9. And the prolonged course of abnormal
      transaminase levels was observed in one of them. Therefore, aging and underlying
      chronic liver disease were considered as main factors that make viral hepatitis
      type A severe.

PMID- 2214264
TI  - [Studies on metabolic characteristics of cirrhotic rat hepatocytes using primary
      culture].
AB  - To assess the metabolic characteristics of cirrhotic hepatocytes, a primary
      culture of hepatocytes was established using rat liver induced cirrhosis by CCl4
      administration. Using this system, cell responsiveness to different metabolic and
      excretory stimuli was investigated and compared with a primary culture of normal
      healthy rat hepatocytes. Cirrhotic hepatocytes showed reduced protein synthesis
      in response to insulin and reduced urea synthesis in response to glucagon.
      However, DNA synthesis stimulated by insulin and EGF was significantly enhanced
      in cirrhotic hepatocytes. No significant difference was observed in the
      fluorescein diacetate excretion rate. Cirrhotic hepatocytes showed impairment of
      antipyrine metabolism and conjugation and excretion of unconjugated bilirubin.
      These results suggest indirectly that cirrhotic hepatocytes may be less
      functionally mature than normal healthy hepatocytes.

PMID- 2214265
TI  - [Eosinophilia in primary biliary cirrhosis].
AB  - The numbers and the percent of eosinophils in peripheral blood of thirty patients
      with primary biliary cirrhosis were serially measured and were compared with
      their clinical data. eosinophils of 22 patients at non icteric stage (total
      bilirubin less than 2.0 mg/dl) were significantly higher (P less than 0.05) than
      those of 8 patients at icteric stage (total bilirubin more than 2.0 mg/dl). Seven
      patients (23.3%) showed eosinophilia with value of 6% or more and in which four
      patients (13.3%) showed eosinophilia more than 8%. These eosinophilia was found
      in non icteric patients alone but not in icteric. In two patients who have shown
      eosinophilia at their non icteric stage, numbers of their eosinophils decreased
      gradually following the increment of their total bilirubin levels. These results
      would indicate that eosinophils in the peripheral bloods of PBC patients could
      reflect some clinical conditions at their non icteric stage.

PMID- 2214266
TI  - [Hepatic and systemic hemodynamics in compensated cirrhosis--effect of posture
      change].
AB  - The effect of changes in body posture on estimated hepatic blood flow (EHBF) and
      various hemodynamic parameters was examined in 15 patients with compensated
      cirrhosis. EHBF and various hemodynamic parameters were first measured with the
      patients in the supine position, and then again 10 min after tilting to 45
      degrees. EHBF was 1089 +/- 315 ml/min at supine and 1065 +/- 328 after tilting;
      the difference was not significant. However, the patients were then divided into
      two groups according to the magnitude of the decrease in EHBF after tilting, with
      those showing a decrease of 10% of more assigned to group B, and those showing a
      decrease of less than 10% assigned to group A. It was found that ICG (R15) and
      BSP (R45) were significantly higher in group A. Meanwhile, among hepatic and
      systemic hemodynamics, wedged hepatic venous pressure, hepatic venous pressure
      gradient, free hepatic venous pressure, cardiac index, systolic blood pressure,
      systemic vascular resistance, and stroke volume were found to have changed
      significantly after tilting. These results suggest that posture change has no
      effect on EHBF in compensated cirrhotic patients.

PMID- 2214267
TI  - [Metabolism of sulfobromophthalein in jaundiced rat].
AB  - We observed previously in humans that loading with BSP in obstructive jaundice
      resulted in elevated blood levels, of cysteine-conjugated BSP (Cyst-BSP). In
      order to clarify the mechanism of this phenomenon, an investigation was made into
      the origin of Cyst-BSP in rats with experimentally produced obstruction of bile
      duct (O-J). Using untreated rats as controls, the animals were determined for
      glutathione content and glutathione S transferase activity (GST) in liver
      cytosol. The influence of nephrectomy upon and the role of liver cell membrane in
      biodisposition of BSP were also investigated. The results are summarized as
      follows: 1) In the O-J group, the excretion in bile of glutathione-conjugated BSP
      (GSH-BSP) was markedly decreased. 2) O-J livers were found to have higher
      glutathione content and GST activity as compared to control livers. 3)
      Nephrectomy in O-J rats was followed by no gross change in the proportion of Cyst
      BSP in blood and liver cytosol. 4) Following administration of individual liver
      cell membrane components change from GSH-BSP to Cyst-BSP was noted to occur only
      in O-J rats. These results led us to surmise that GSH-BSP accumulated in the
      liver in O-J is hydrolyzed to Cyst-BSP in the liver cell membrane.

PMID- 2214268
TI  - [Effect of continuous arterial infusion of protease inhibitor on experimental
      acute pancreatitis induced by closed duodenal loop obstruction].
AB  - The effectiveness of continuous arterial infusion of protease inhibitor on acute
      experimental pancreatitis was investigated. Acute hemorrhagic pancreatitis was
      induced by closed duodenal loop obstruction using mongrel dogs. The obstruction
      was released at 16 hr, and dogs were divided into three groups; Group I: non
      treated control, Group II: nafamostat mesilate (FUT-175) was admitted
      intravenously (5 micrograms/kg/min), Group III: FUT-175 was admitted via celiac
      artery. At 24 hr, the concentration of FUT-175 in the pancreatic tissues in group
      II and III were 905 and 4453 ng/g, respectively. The trypsin like activities in
      the pancreatic tissues in group I, II and III were 2.1, 1.4 and 0.7 nmol/min/mg
      protein, and the extent of necrosis of pancreatic parenchyma in each group were
      49.5, 25.6 and 12.4%, respectively. Serum calcium, amylase and lipase levels were
      significantly improved in group III. These results suggest that continuous
      arterial infusion of protease inhibitor markedly decreases the extent of
      pancreatic necrosis in severe acute pancreatitis.

PMID- 2214269
TI  - [Three cases of esophageal or upper gastric varices due to invasion of malignant
      tumor to the portal vein].

PMID- 2214270
TI  - [A case of Vasculo-Behcet syndrome with portal vein occlusion].

PMID- 2214271
TI  - [A case of lupus peritonitis diagnosed by the immunological findings in the
      peritoneal fluid].

PMID- 2214272
TI  - [Histopathological analysis of 73 autopsy cases of "acute-on-chronic" in Japan-
      influence of alcohol abuse on exacerbation of chronic liver disease].
AB  - Cases of acute exacerbation in chronic liver disease ("acute-on-chronic") in
      Japan were surveyed by questionnaire method since 1986 and 220 cases were
      collected. 73 pathological specimens of 102 cases which were autopsied were
      subjected to morphological analysis. The cases were divided according to causes
      of acute exacerbations: namely super-imposed viral infection or drugs (Group I),
      unknown causes or post immunosuppressant therapy (Group II), alcohol abuse (Group
      III), operation, digestive tract hemorrhage or post TAE etc, (Group IV). Area of
      hepatic necrosis was large and regeneration of hepatocytes were significantly
      strong in Group I and II compared with cases of Group IV. Regeneration was also
      inhibited in liver of habitual alcohol drinker. Significant difference was shown
      in cases of Group IV. Pathologically liver of 10 cases of Group III divided to
      florried cirrhosis (3 cases), alcoholic liver cirrhosis (4 cases) and alcoholic
      hepatitis combined with post hepatitic liver cirrhosis (3 cases, all HBV
      carriers).

PMID- 2214273
TI  - [Studies on binding sites of epidermal growth factor in rat gastric mucosa].

PMID- 2214274
TI  - [The significance of measurement of serum sialic acid in patients with Crohn's
      disease].

PMID- 2214275
TI  - [Degeneration of interfoveolar cells of the rat gastric mucosa by 16,16-dimethyl
      prostaglandin E2].

PMID- 2214276
TI  - [Study of acute gastric mucosal lesion induced by endotoxemia].
AB  - Acute gastric mucosal lesion (AGML) was induced six hours after the
      administration of endotoxin. The decrease of gastric mucosal blood flow, used to
      be supposed as an important factor of the formation of AGML, was not found, but
      thiobarbituric acid (TBA) reactants in the gastric mucosa were increased three
      hours after endotoxin injection, 198 +/- 18.2 (vs control 130 +/- 18.2). The
      administration of platelet activating factor (PAF) inhibitor, CV3988, reduced the
      formation of AGML and increase of the TBA reactants. These results suggested that
      the chemical mediator like PAF and free radicals may play an important role in
      the pathogenesis of gastric mucosal injury induced by endotoxemia, without the
      decrease of mucosal blood flow.

PMID- 2214277
TI  - [A study on the new measurement of gastric lesions with an electronic endoscope].
AB  - We carried out measurement of gastric lesions in the inner surface of the stomach
      with a measuring system, which is composed of a stereo endoscope and a personal
      computer. Basically, the length on a flat board from 10 mm to 50 mm was measured
      by varying the distance between the lens and the board and the angles of the
      endoscope at first. The error of the measurement was less than 8.5%. Secondly,
      ten physicians of our clinic attempted the measurement of the pasted discs on the
      inner wall of a stomach model with the endoscope. The average measurement error
      and the average time required for endoscopy became more better using the newly
      developed system than a measuring rod. Clinically, we measured the length of
      stomach lesion and of normal mucosa in six patients and compared the values
      obtained with those of resected fresh specimens. The length of stomach lesions
      could be measured more accurately than that of normal mucosa of stomach. From our
      observations, it can be said that this system is as available as the basic
      examination procedures in use at present and worth using in clinical procedure
      for it's high reliability.

PMID- 2214278
TI  - [A study on endoscopic hemostasis from the viewpoint of morphologic traits of
      Dieulafoy ulcer--an attempt at endoscopic hemostasis by local injection of
      aethoxysklerol and ethanol].
AB  - Characteristics of the vascular course of ruptured vessels in the submucosal
      layer of Dieulafoy ulcer were studied, and endoscopic hemostatic treatment was
      performed using Aethoxysklerol and ethanol. 1) Observations of vessel courses in
      serial sections revealed that ruptured vessels in Dieulafoy ulcer exhibit rhexis
      in the lateral portions of the vessel and long courses over the ulcer margin in
      the submucous layer. 2) More dependable hemostasis seemed to be provided by
      thrombosis not only at the source of bleeding. i.e., at the site of vessel
      rupture, but also in the region of the whole ruptured vessel in the submucous
      layer. 3) Hemostatic treatment by local injection of Aethoxysklerol and ethanol
      was performed in 4 patients with Dieulafoy ulcer, and complete hemostasis was
      achieved in all 4 patients.

PMID- 2214279
TI  - [Evaluation of intrahepatic distribution of inferior mesenteric blood flow by
      transrectally administered 123I-IMP].
AB  - Intrahepatic distribution of the inferior mesenteric blood flow was evaluated
      with scintigraphy with transrectally administered 123I-iodoamphetamine (IMP).
      Twelve patients without liver diseases were studied. The IMP image was divided
      into 3 types; bilateral, left lobar predominant and right lobar predominant.
      Bilateral, left lobar predominant and right lobar predominant types were observed
      in 5, 5 and 2 patients respectively. Furthermore, uneven distribution pattern in
      the left or right lobe was observed in 2 of 5 patients with bilateral lobar type,
      4 of 5 patients with left lobar predominant type and 1 of 2 patients with right
      lobar predominant type. In one patient with left lobar predominant type, repeat
      examination demonstrated bilateral lobar type. These results suggest that
      intrahepatic distribution of the inferior mesenteric blood flow is not uniform
      and consistent.

PMID- 2214280
TI  - [Clinical investigation of 10 patient with amebic dysentery].
AB  - Data were obtained in 10 patients with amebic dysentery at Osaka Socio-Medical
      Center hospital during the period from April 1985, to April 1989. All of the
      patients were male, and their average age was 41 years old. In the past history,
      all of them had never gone to foreign country, and 7 patients had the habit of
      homosexual love. In the serological test, positive rate of antiamebic antibody
      was 100% (6/6) by agar gel diffusion, that of antibody of Toreponema pallidum was
      60% (6/10) by TPHA, but anti AIDS antibody was not detected (0/3) by HIV.
      Detectability of Entoamoeba hystolitica was 70% (7/10) in stool, 50% (2/4) in
      liver abscess, 25% (1/4) in biopsied specimens of rectal mucosa. Then, we fund
      that the serological test for antiamebic antigen was useful for diagnosis of this
      disease, and suspected that homosexual contact contributed to the infection of E.
      hystolitica.

PMID- 2214281
TI  - [Immunohistochemical study on epidermal growth factor and its receptor in human
      pancreatic carcinoma].
AB  - We investigated immunohistochemical expressions of the epidermal growth factor
      (EGF) and the epidermal growth factor receptor (EGFR) in 25 cases of pancreatic
      carcinoma, including 13 cases of metastatic lymph nodes. EGF and EGFR were
      stained mainly in the cytoplasm and on the surface of some pancreatic carcinoma
      cells, with positive rates of 18/25 (72%) and 9/25 (36%) respectively. In all
      cases EGFR was noted only when EGF was also detected. EGF and EGFR were stained
      frequently in differentiated types. In metastatic lymph nodes, EGF and EGFR were
      found in 54% and 15% respectively, and they were detected only when they were
      also noted in the same patient's primary lesions. EGF and EGFR were found more
      frequently in Stages III and IV than in Stage II. These results emphasize that
      EGF and EGFR may promote both the proliferation and the differentiation of human
      pancreatic carcinoma cells, as in other sites.

PMID- 2214282
TI  - [A heterotopic Brunner's adenoma in the stomach: a case report].

PMID- 2214283
TI  - [A case of malignant lymphoma with multiple lymphomatous polyposis of the colon
      associated with chylothorax and chylous ascites].

PMID- 2214284
TI  - [A case of liver cirrhosis with vesical and mesenteric varices who complained
      gross hematuria].

PMID- 2214285
TI  - [Primary sclerosing cholangitis mimicking bile duct carcinoma at porta hepatis. A
      case report and review of Japanese literature with special reference to the
      feature of associated jaundice].

PMID- 2214287
TI  - [Examination of distribution of Helicobacter pylori on gastric mucosa using dye
      endoscopy].

PMID- 2214286
TI  - [A case of double choledochus with ectopic drainage into the body of the
      stomach].

PMID- 2214288
TI  - [Estimation of portosystemic shunt index in superior mesenteric vein by duodenal
      administration of 123I-IMP].

PMID- 2214289
TI  - [32nd meeting of the Japanese Society of Gastroenterology. Nara City, 25-27
      October 1990. Abstracts].

PMID- 2214290
TI  - [Effect of S-adenosylmethionine on methylation of inorganic arsenic].
AB  - We studied the role of S-adenosylmethionine (SAM) as a methyl group donor in the
      methylation of inorganic arsenic in mammalians. The SAM and S
      adenosylhomocysteine (SAH) levels in the livers of untreated hamsters were 74.3
      +/- 8.2 and 40.0 +/- 6.4 nmol/g, respectively. The SAM level was 63.9 +/- 6.5
      nmol/g following oral administration of 1.5 mg/kg of arsenic trioxide, which was
      14% lower than the control level (t-test, p less than 0.05). This fall of the SAM
      level in the liver presumably derived from the SAM having acted as a methyl group
      donor. Oral administration of 1.5 mg/kg of arsenic trioxide once only to hamsters
      pretreated intraperitoneally with 2.0 mg/kg of SAM once only gave the following
      arsenic levels in the liver and urine. The dimethylated arsenic (DMA) levels in
      the livers of hamsters treated with SAM plus arsenic trioxide were significantly
      high, that is, 2 times as high as the control value at 6 hours, and 1.5 times as
      high as the control value at 24 hours after the administration of arsenic
      trioxide. The urinary DMA excretion rate was significantly higher, that is,
      higher by 36%, than the control value. The urinary DMA excretion rate following
      pretreatment with SAM was not dose-dependent. Pretreatment with methionine failed
      to exert any significant acceleratory effect on the methylation of arsenic
      trioxide. The decreasing pattern of the SAM level in the liver following
      administration of arsenic trioxide and the DMA behavior in the liver and urine
      following administration of SAM and arsenic trioxide revealed that SAM
      accelerated the methylation of inorganic arsenic. In other words, it appeared
      that SAM could be a very potent methyl group donor to inorganic arsenic.

PMID- 2214291
TI  - [Fatigue and performance of divers during a simulated, non-saturated oxygen
      helium dive to 180 meters].
AB  - A non-saturated mixed-gas dive to 180 meters depth was carried out at JAMSTEC,
      using diving simulator (hyperbaric chamber) facilities. Compression started at
      10:00 h with helium and oxygen and was carried out at a rate of 12 m/min.
      Decompression started at 11:15 h using the Comex Helox 180 Diving Manual.
      Decompression to 1 ATA required 49.2 h. A survey of subjective symptoms, sleep
      feelings and ball-bearing tests were performed. All night electrophysiological
      recording of subjects' sleep was performed and polygraphic analysis of nocturnal
      sleep was done with visual scoring. The results were as follows: Arriving at 180
      meters, the complaint rate was 39.2% and fatigue was greater. The type of fatigue
      that was based on the composition + ratio of symptoms was that of mental fatigue.
      During the decompression it was recovery. The performance in the ball-bearing
      test decreased about 20% at a depth of 180 meters because of tremors and
      disturbance of attention as well as other factors showing symptoms of high
      pressure nervous syndrome. The sleep feelings were different in experienced
      persons and non-experienced persons. The non-experienced persons had markedly
      decreased REM stages and slept badly all night. Based on these results, fatigue
      and the performance of divers were discussed.

PMID- 2214292
TI  - [Ion chromatographic determination of inorganic anions in human serum].
AB  - The ion chromatographic method is a rapid and reliable technique for the
      simultaneous determination of inorganic anion concentrations in serum. We are
      investigating the effects of various diseases on the serum levels of the
      following inorganic anions: phosphate, bromide, nitrate, and sulphate. In this
      paper, we tested the intra- and intermeasurement reproducibility of the ion
      chromatographic method using pooled normal human serum. We found a good
      intrameasurement reproducibility for all of the above inorganic anions. The
      intermeasurement reproducibility was good for three of the inorganic anions but
      not for nitrate. We measured the serum levels of these inorganic anions in 241
      inhabitants in one rural area. Using sera of normal inhabitants chosen from the
      above group, we used the mean value plus or minus two standard deviations as the
      normal range of each inorganic anion. Our values are in agreement with previously
      published reports. We found that the serum levels of nitrate and sulphate tended
      to be increased in inhabitants with liver or kidney disfunction respectively.

PMID- 2214293
TI  - Study on digestibility and energy availability of daily food intake in Japanese
      (Part 3. Cereals).
AB  - Four male Japanese were fed a semisynthetic diet including egg and soy powder as
      protein source for seven days (Basal-diet period), and in the following seven
      days 200 g of polished rice, wheat flour and buckwheat flour added at the expense
      of part of the corn starch and sugar in the basal diets (Test-diet period). Urine
      and feces were collected throughout both periods and the contents of nitrogen,
      fat and energy in these excreta were determined. Digestibility of protein (N),
      fat and carbohydrate (by difference) was calculated. The protein digestibilities
      of the polished rice (in the form of cooked grains), wheat flour (in the form of
      cooked powder) and buckwheat flour were 89.6 +/- 5.0%, 93.4 +/- 2.9% and 85.1 +/-
      2.5%, respectively. The fat digestibilities of the polished rice, wheat flour and
      buckwheat flour were 93.6 +/- 1.8%, 70.8 +/- 13.5% and 103.1 +/- 8.4%,
      respectively showing relatively large variation (This results may be caused by an
      errors in measurement). The carbohydrate digestibility was close to 100%. The net
      energy availabilities of the polished rice, wheat flour and buckwheat flour were
      100.6 +/- 1.4%, 96.5 +/- 1.1% and 96.0 +/- 1.1%, respectively.

PMID- 2214294
TI  - [Evaluation of waist size as a health risk indicator for obesity].
AB  - The purpose of this study is to evaluate waist size as an indicator of health
      risk among subjects considered to have normal body construction based on height
      weight obesity indices. For estimating standard waist sizes based on height, a
      regression equation was formulated from 46 male subjects who had no abnormal
      findings in their health checkups. The regression equation was as follows:
      Standard waist size (cm) = 0.8 X height (cm)-57.7. The ratio of measured waist
      size to standard waist size was defined as the "waist ratio". The correlation
      coefficient between the waist ratio and the modified Broca's obesity index was
      0.898 (N = 207, p less than 0.01). To clarify the meaning of the waist ratio, 95
      male subjects were divided into three groups on the basis of the difference
      between their waist ratio and their obesity index. The group whose waist ratios
      were larger than their obesity indices had significantly worse findings than the
      group whose waist ratios were not in the following medical categories: systolic
      blood pressure, glutamic oxaloacetic transaminase levels, gamma glutamyl
      transpeptidase levels, uric acid levels, total bilirubin, electrocardiogram
      readings and optic funduscopic observation. Accordingly, the waist ratio derived
      from waist size might be useful for assessing obesity-related health risks even
      for subjects judged to be normal from the height-weight obesity index.

PMID- 2214295
TI  - [Effect of zirconium on immunological reactions of T cells and macrophages in
      mice].
AB  - The effects of zirconium (Zr) on T cells and macrophages in mice were studied in
      vitro using the indexes of immunological reactions, mitogenesis of C3H/HeJ mouse
      thymocytes induced by PHA and the production of interleukin-1 of C3H/He mouse
      intraperitoneal macrophages (MIL-1). The mitogenesis of thymocytes induced by PHA
      when stimulated with Zr solutions at various concentrations or culture
      supernatants of macrophages stimulated with LPS and Zr, or Zr alone, ware as
      shown below. 1. The mitogenesis of thymocytes by PHA was enhanced in the presence
      of Zr at 0.625-2.5 microM, and suppressed in the presence of Zr at 5-10 microM in
      culture 2. This reaction was enhanced by the addition of supernatants of
      macrophages stimulated with LPS and Zr. The most activation by LPS and Zr was
      shown at concentrations of 0.625-1.25 microM in culture, and the degree activated
      corresponding to 12.5-25 I.U. of MIL-1. 3. On the other hand, this reaction was
      inhibited by addition of supernatants of macrophages stimulated with Zr alone.
      From these results, it is suggested that Zr serves various functions such as an
      activator or inhibitor of T-cell mitogenesis by PHA, and that this may depend
      upon the Zr concentration in culture. In regard to the effect of Zr on MIL-1
      production, Zr may activate this reaction by LPS, and Zr alone may induce MIL-1
      production from macrophages.

PMID- 2214297
TI  - [Secular changes of the mean birth weight and the mean gestational day at an
      obstetric clinic in Naha].
AB  - In our previous study we reported that the secular change of the mean birth
      weight (MBW) of Okinawa was different from that of Japan as a whole, that is, the
      MBW of Okinawa was lower, but the annual increase rate of the MBW of Okinawa was
      larger than that of Japan as a whole. Through analyses using birth records of
      several obstetric facilities in Naha, we concluded that this phenomenon must be
      due to the remarkable improvement of the socioeconomical environment of Okinawa.
      In this report we analyzed secular changes of mean birth weight (MBW) and mean
      gestational day (MGD) of 15,847 singleton babies born at an obstetric clinic in
      the city of Naha for the 33 years from 1955 to 1987. To avoid fluctuations of
      annual changes in MBW and MGD caused by a small number of babies born in a single
      year, we also used the moving average of three years. In analyzing birth weight
      we stratified birth weight by sex, parity and the number of gestational weeks. It
      is considered that birth weight stratified by the number of gestational weeks
      reflects the intrauterine growth rate of infants. According to our results, both
      the MBW of infants with 40 gestational weeks, which reflects the intrauterine
      growth rate, and the MGD increased during the period from the 1950s to the early
      1970s in this clinic. On the basis of these results we concluded that the
      increase of birth weight in this clinic until the early 1970s was due to
      increases in both the intrauterine growth rate and the gestational period. Our
      results also show that the mean height of mothers who delivered at this clinic
      also increased, which might reflect the development of the socioeconomical
      environment during their childhood. During the period when MBW increased, the
      economic growth rate of Okinawa was higher than that of other prefectures. From
      these results we concluded that the MBW can be used as a community health
      indicator reflecting the total health condition in a given community.

PMID- 2214296
TI  - [Factors contributing to the difference of hair mercury concentrations between
      the sexes].
AB  - Scalp hair samples were collected by mail from 97 married couples who were living
      in several places in Okinawa-prefecture and supposedly had no specific exposure
      to mercury compounds. They were selectively analysed for organic and inorganic
      mercury content and the difference of hair mercury concentration between the
      sexes was discussed in relation to the frequency of fish intake, fish species,
      drinking habits and permanent-wave hair treatment. Results obtained were as
      follows: 1) The increase in hair levels of organic and inorganic mercury
      concentrations was roughly proportional to the dietary intake of fish in the
      range from none or low to moderate frequencies for both husbands and wives.
      However, this increase was not proportional to the dietary intake of fish in the
      range from moderate to high frequencies, showing almost the same level
      irrespective of the frequency of fish intake. 2) Though husbands and wives had
      dietary consumption patterns quite similar to each other, husbands were found to
      have higher hair organic mercury levels than wives, the average values being 6.40
      ppm with a standard deviation of 4.69 ppm for husbands and 2.86 ppm with a
      standard deviation of 1.97 ppm for wives, respectively. The difference was
      statistically significant. No significant difference between the sexes was
      detected for inorganic mercury concentrations. However, a highly significant
      positive correlation coefficient for organic mercury and also a significant
      positive correlation coefficient for inorganic mercury were found between
      husbands and wives. 3) Hair without permanent-wave treatment showed higher levels
      of organic mercury concentrations than hair with permanent-wave treatment for
      both husbands and wives. Drinkers also had higher levels of hair mercury as
      compared to non-drinkers. However, the lower levels of organic mercury
      concentrations in women's hair than in men's hair were not fully explained by
      these factors. 4) Both men and women who showed higher hair levels of organic
      mercury had a preference for highly predatory fish such as tuna and bonito, which
      probably contributed most to the human intake of mercury.

PMID- 2214298
TI  - [Difference of iron stores represented in bimodal distribution of erythrocyte
      values among a healthy male group].
AB  - The distributions of erythrocyte values (red cell count, hemoglobin
      concentration, etc.) of healthy male workers working in a certain factory were
      studied in order to evaluate the usefulness of the variables as health
      indicators. In addition to the estimation of erythrocyte values, anamneses
      concerning chronic bleeding, smoking habit and alcohol consumption were
      questioned and serum Fe, Cu, TIBC, ferritin, plasma erythropoietin, and serum
      enzymes (GOT, GPT, gamma-GTP) were measured. Two-dimensional frequency
      distributions with axes for the red cell count and hemoglobin concentration, and
      frequency distributions of the score calculated from principal component
      analysis, showed bimodal patterns. Using nonlinear curve fitting methods, the
      distributions of principal component scores were fitted to a mixture of two
      different Gaussian distributions. The workers were then divided into two groups
      corresponding to the Gaussian distribution he belongs. Then the frequencies of
      the items and mean values of the variates were compared between them. There were
      no differences in the incidences of diseases that caused iron deficiencies, but
      the mean serum ferritin level was significantly lower in one group than in the
      other, in other words the workers belonging to the group with low serum ferritin
      level had smaller iron stores than the other. The mean serum erythropoietin level
      and the mean serum copper level were higher in that group than in the other. As a
      result, this analysis gives a new evaluation of the health status of a man who
      belongs to the so-called healthy male group.

PMID- 2214299
TI  - [Peripheral circulatory responses to sustained handgrip in workers using
      vibrating tools].
AB  - In order to study the effects of static force such as a handgrip in detail, the
      peripheral circulatory function and the autonomic nervous function of workers who
      used chain-saws were examined in a handgrip test at 30% of maximum voluntary
      contraction (30% MVC). Workers using chain-saws were divided into three groups:
      group A without any symptoms, group B with numbness and/or pain but without
      Raynaud's phenomenon and group C with Raynaud's phenomenon. The results obtained
      were as follows: 1. The finger blood flow (FBF) of all groups significantly
      decreased during the handgrip and significantly increased after the end of the
      handgrip as compared with the initial value. There was a tendency for the FBF
      decrease of group C to be less than that of group A. 2. The mean value of both
      maximum FBF decrease and maximum FBF increase during handgrip tests fell in
      alphabetical order (A, B, C). The maximum FBF increase of group C was
      significantly less than that of group A. 3. The finger skin temperature (FST) of
      each group significantly fell during the handgrip but there was no significant
      difference among the three groups. FST returned to the level of the initial value
      one minute after the end of the handgrip, and significantly rose two minutes and
      three minutes after the end of the handgrip as compared with the initial value.
      4. Both the systolic blood pressure and the diastolic blood pressure of all
      groups significantly rose during the handgrip but there was no significant
      difference among the three groups. Concerning the maximum rise of diastolic blood
      pressure, which is an indicator of autonomic nervous function, there was no
      significant difference among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214300
TI  - [Relative weight and mortality during a five-year follow-up study in an aged
      population--a study of aged inhabitants of a rural area in Japan].
AB  - The present study, a follow-up study for 669 aged examinees of a health check
      performed in July 1983 in a rural area in Fukushima Prefecture, was conducted to
      clarify the relationship between relative weight and mortality among aged
      individuals living in a Japanese rural area. Using the standard body weights
      calculated from Japanese mean body weights by sex, age class (60-69 and 70 or
      more) and height cited from the data of the Ministry of Health and Welfare from
      1966, mortalities during the five year follow-up were compared among four groups
      different in relative weight at baseline. The results are as follows. 1) The
      mortalities in the group of 'Relative weight less than or equal to -10% the
      leanest group among the four groups, were highest in both sexes, 52.8 per 1000
      person-years for males and 33.2 per 1000 person-years for females. On the other
      hand, those in the group of '+10% less than or equal to Relative weight less than
      +20%' were lowest in both sexes, 23. 1 per 1000 person-years for males and 7.0
      per 1000 person-years for females. In females, the difference in the mortality
      between these two groups was statistically significant at the 0.05 level,
      provided age structures in both groups were taken into consideration. 2) In both
      sexes, the mortalities of cancer and cerebrovascular disease in the group of
      'Relative weight less than or equal to -10%' were highest among the four groups,
      whereas such mortalities in the group of '+10% less than or equal to Relative
      weight less than +20%' were lowest.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214302
TI  - [On the life span and aging].

PMID- 2214301
TI  - [Effects of methylmercury on ethanol-induced sleeping time of mice].
AB  - This study was carried out to clarify the effects of methylmercury intoxication
      on the ethanol-induced sleeping time of mice. The mice were injected with
      methylmercury chloride (MMC) (10 mgMMC/kg body weight) subcutaneously for 1, 5
      and 10 successive days (1, 5 and 10 inj.), and control mice received only saline.
      Twenty-four hours, after the last injection, these mice were treated with ethanol
      (4.5 mgEtOH/kg body weight) intraperitoneally and subsequent sleeping time was
      observed. After 24 hours, mice were sacrificed to measure the concentration of
      MMC in various brain regions and liver. A similar experiment with ethanol
      treatment was also performed to assay the biogenic monoamines in various brain
      regions and alcohol dehydrogenase (ADH) activity in liver. The results can be
      summarized as follows: 1) Ethanol-induced sleeping time was 170 min. in the 10
      inj. and it was significantly longer than saline, 1 and 5 inj. However, other
      experimental groups showed no change when compared with saline. 2) Norepinephrine
      levels increased in white matter and pons + medulla after 1 inj. 3) Dopamine
      levels increased only in white matter of the 10 inj. when compared with saline.
      No changes were shown in the other groups. 4) Serotonin levels increased in all
      the regions after 1 inj. 5) ADH activity in liver did not show any alteration
      during the experimental period when compared with saline.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2214303
TI  - [Neuronal death and neurotrophic factors in Alzheimer's disease].
AB  - Progressive neuronal death in cerebral cortex and subcortical regions may lead to
      dementia in Alzheimer's disease (AD). The neuronal death is accompanied by
      accumulation of senile plaques, neurofibrillary tangles and curly fibers. Recent
      immunocytochemical studies have suggested that abnormal sprouting responses,
      occurring in AD brain, may be involved in the formation of these lesions. The
      hypothesis concerning the lack of neurotrophic factors cannot explain abnormal
      sprouting responses in AD brain. We have investigated the mechanism of abnormal
      sprouting responses in AD brain, using primary culture of rat cerebral cortical
      neurons. In AD brain, loss of growth-inhibitory factors led to an apparently
      higher level of neurotrophic activity. One of the growth-inhibitory factors in
      normal aged brain was a 5 kDa heat-stable acidic protein. These results suggest
      that loss of inhibitory factors may induce abnormal sprouting responses in AD
      brain. In consequence, neurons might be exhausted and die.

PMID- 2214304
TI  - [Studies of the location in the focus of dementia syndrome with PET and MRI].

PMID- 2214305
TI  - [The diagnostic criteria of dementia and screening tests].

PMID- 2214306
TI  - [Early diagnosis and prevention of dementia in the aged].
AB  - From the view point of prevention and treatment of dementia, dementia can be
      classified into three main groups. The first is treatable or preventable
      dementia. Unfortunately, this group occupies only 10 or 20% of all demented
      patients. However, early diagnosis and treatment of diseases belonging to this
      group are particularly important. The other two groups are Alzheimer-type
      dementia (ATD) and vascular dementia. Early diagnosis of ATD is still rather
      difficult. We recently have found that alpha 1-antichymotrypsin (alpha 1-ACT)
      increases significantly in the serum and cerebrospinal fluid in ATD. Thus, alpha
      1-ACT can be used as an antemortem biological marker of ATD. Positron emission CT
      (PET) is also useful for the early diagnosis of ATD, because decrease in CMRO2 in
      the unilateral temporo-parietal region occurs in a relatively early stage of this
      disease. On the other hand, vascular dementia can be said to be becoming one of
      the treatable or preventable dementias. Vascular dementia is mainly based on
      cerebral infarction. Therefore, prevention of initial stroke is most essential.
      For this purpose, correction of risk factors and use of antiplatelet agents in
      those cases suffering a transient ischemic attack or subjective symptoms are
      necessary.

PMID- 2214307
TI  - [Prevention and treatment of senile dementia].

PMID- 2214308
TI  - [Support system for the demented elderly--the viewpoint of community care].
AB  - Judging from the features of senile dementia, it is desirable for the demented
      elderly to receive care at their places to which they are accustomed and to be
      surrounded by affectionate families, if possible. Year by year, however,
      sufficient intrafamilial care is becoming more and more difficult because of
      increasing numbers of nuclear families, women's into society, the deteriorating
      housing situation and the like. Accordingly, the importance of community care is
      increasing; an integrated care system with close cooperation of medical facility
      services and at-home services needs to be established. Three important measures;
      i.e. home helper dispatching, short stay activity and day service activity as
      well as close cooperative work for health activities, medical care and welfare
      are still far from satisfactory, though these problems have begun to be tackled
      actively. Various types of advanced models and regional network systems exist
      fulfilling several necessary conditions for effective functioning. The need of a
      three-layer structure was emphasized based on a practical study of Matsubara
      City, Osaka.

PMID- 2214309
TI  - [The problems of care in elderly institutions].

PMID- 2214310
TI  - [Care for dementia patients by their families and home care].
AB  - Present problems concerning home care for the aged including the following three
      points: 1. The extent of the period during which care is needed has been
      prolonged as the aged live longer than in previous times. 2. The range of need
      for home care has increased. 3. As a result of the increase of the individual
      dependent "life support infrastructure" due to the decreased role of the family
      dependent "life support infrastructure", the aged, who were more self-supporting
      in past, have become more dependent on care both in quality and quantity. In
      particular, dementia patients gradually worsen, therefore care for them becomes
      increasing by difficult with time. This reports attempts to clarify the actual
      conditions of care for dementia patients by long term stay, short term stay and
      day care. At present it is difficult to ensure sufficient human terminal care. To
      overcome this problem, some families caring for dementia patients have formed
      "self-help groups" and give mutual support while attempting to approach to
      professional aid groups. While the family is the core of the home care system, it
      is not necessarily home care per se. Medical and nursing systems should improve
      home care by creating a system by which professionals are able to approach to
      families caring for dementia patients through two ways of "waiting" and
      "visiting" community programs, and by building closer connections with the
      welfare service.

PMID- 2214311
TI  - [Hemodynamic changes during dietary salt loading in elderly patients with
      essential hypertension].
AB  - Hemodynamic changes with dietary salt loading were assessed by Doppler
      echocardiography during different sodium intake (7 g/day for 8 weeks, 20 g/day
      for 1 week) in 29 elderly patients with essential hypertension (81.6 +/- 6.7
      years, 4 men, 25 women). With salt loading, 24 patients whose mean blood pressure
      (MBP) increased by 10% or more were defined as salt sensitive (SS) group, and 5
      patients whose MBP did not change, or increased by less than 10% were defined as
      non-salt sensitive (NSS) group. Based on the mitral flow velocity integral,
      cardiac output (CO) was calculated, and total peripheral resistance (TPR) was
      calculated as MBP divided by CO. Nine of the 24 SS patients were termed "SS
      (COdep)" whose CO increased significantly with salt loading. In the remaining 15
      SS patients termed "SS (TPRdep)", TPR increased significantly with sodium
      repletion. Blood flow in the common carotid, superior mesenteric, or terminal
      aorta was calculated from each flow velocity integral. The percent change in
      peripheral resistance calculated by dividing MBP by each blood flow was obtained.
      There were no significant percent changes in the common carotid resistance in SS
      (COdep), SS (TPRdep) or NSS groups. The superior mesenteric resistance increased
      significantly in all three groups. The terminal aortic resistance increased in
      the SS (TPRdep) group, but decreased in the SS (COdep) or NSS group. These
      results indicate that salt sensitivity is ascribable to changes in regional
      vascular resistances.

PMID- 2214312
TI  - [Effect of aging on bone mineral content. Part VII. The evaluation of
      osteoporosis treatment by the measurement of total body bone mineral content
      using dual photon absorptiometry].
AB  - In order to evaluate the degree of accuracy of measurement of total body bone
      mineral content (TBBMC) by dual photon absorptiometry (DPA), the TBBMC in four
      healthy male volunteers were measured serially for 3 to 12 months. In three to
      six determinations of TBBMC in various stage of radiation source (153-Gd), the
      coefficients of variation in four subjects were 1.59, 0.74, 1.25 and 1.27%. Thus,
      the mean CV was 1.22 +/- 0.35% (mean +/- SD). This indicates that the measurement
      of TBBMC using DPA is an accurate tool for long-term follow up of bone mineral
      content and up to 1.6% change of TBBMC might be considered to be a significant
      change in TBBMC. No apparent drift of TBBMC associated with source decay was
      noticed in the present study. Subsequently, fifteen females with osteoporosis
      were studied to evaluate the efficacy of certain therapeutic modes. The patients
      were divided into two groups. Group 1 (n = 10) given 10 to 40 U of elcatonin (eel
      calcitonin derivative) intramuscularly every week for 3 to 6 months. Group 2 (n =
      5) were treated with 0.5 mu/day of oral 1-alpha-OHD3 for 3 to 6 months. The TBBMC
      of these fifteen patients were followed by DPA (Lunar DP-4). Seven patients out
      of ten treated with elcatonin (70%) showed significant (up to 1.6% change in
      TBBMC compared with baseline) increase in TBBMC after 3 to 6 months treatment.
      The mean percentage change in TBBMC in group 1 was 101.9 +/- 2.7% (mean +/- SD)
      when the initial TBBMC was taken as 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214313
TI  - [Monoclonal antibody analysis of glomerular, tubulo-interstitial infiltrating
      immune cells in various glomerulonephritis].
AB  - To investigate the role of cell-mediated immunity (CMI) in glomerulonephritis
      (GN), we identified the infiltrating immune cells both within the glomerulus and
      in the interstitium. Frozen sections from 103 patients with various forms of GN:
      10 with minor glomerular abnormality (MGA) as control, 10 with minimal change
      nephrotic syndrome (MCNS), 10 with membranous nephropathy (MN), 9 with focal
      glomerulosclerosis (FGS), 30 with IgA nephropathy (IgAN), 22 with acute post
      streptococcal glomerulonephritis (APSGN), and 2 with rapidly progressive
      glomerulonephritis (RPGN) were examined using monoclonal antibodies (MoAb) by
      indirect immunoalkaline-phosphatase labelling. In most glomerulonephritis,
      monocyte/M phi and helper/inducer T cells were predominantly infiltrating in the
      interstitium, but intraglomerular infiltration was rare, except for APSGN. This
      interstitial infiltration increased proportionally to the level of serum
      creatinine, and was most prominent in RPGN. Apparently different distribution was
      seen in APSGN, that is, prominent increase in total number of intra-glomerular
      monocyte/M phi infiltration with slightly increased T cells. The change was
      correlated with time after onset; namely the more leucocytic infiltration was
      observed when the tissue was taken earlier. These data suggest that in APSGN,
      monocyte/M phi accumulate in glomeruli via cell mediated immunity in addition to
      humoral immune mechanism resulting in glomerular hypercellularity, whereas in
      most chronic glomerulonephritis interstitial leucocyte infiltration, particularly
      helper T cells and monocyte/M phi may play an important role in the progression
      of glomerulonephritis.

PMID- 2214314
TI  - [Measurement of the charge on red blood cells in patients with various
      glomerulopathies].
AB  - Red blood cells have a negative charge on their surface which prevents Rouloau
      formation. This charge may reflect the charge on glomerular capillaries. Using
      alcian blue, we measured the negative charge on red blood cells in patients with
      IgA nephropathy (IgAN), membranous nephropathy (MN), minimal change nephropathy
      (MCN) and focal glomerular sclerosis (FGS), for which the diagnosis was
      determined by renal biopsy. The alcian blue values for the normal control, IgAN,
      MCN (nephrotic phase), MCN (remission) and MN were 155.3 +/- 12.3, 140.9 +/-
      23.9, 101.7 +/- 18.4, 152.9 +/- 11.2 and 140.9 +/- 23.6 ng per 1 x 10(6) red
      blood cells, respectively. The charge was more significantly decreased in MCN
      during nephrotic phase than other renal diseases and the normal control. The
      charge in MCN was within the normal range on remission. When we studied the
      correlation between the charge on red blood cells and proteinuria during steroid
      therapy, the charge in MCN was found to increase with reduction of proteinuria,
      while there was no change in MN and FGS with reduction of proteinuria, i.e. it
      was usually within normal range. The reduced charge was associated with the
      nephrotic phase in MCN. The difference in the charge on the red blood cells
      between MCN and FGS during nephrotic phase seems to suggest a different etiology
      of proteinuria. Measurement of the charge on red blood cells could be an useful
      method for differentiating MCN from other renal diseases in the nephrotic phase.

PMID- 2214315
TI  - [Correlations among the renal parenchymal components and renal function with IgA
      GN; age related changes].
AB  - To clarify and evaluate the changes by aging to renal parenchyma of IgA
      nephropathy with normal renal function (serum creatinine levels less than or
      equal to 1.5 mg/dl), we compared morphological findings and renal function in 100
      adult patients with IgA nephropathy similarly distributed in each decade of age
      including over 60 y.o.. The following histological parameters were investigated;
      glomerular sclerotic index calculated a mean for total glomeruli,
      tubulointerstitial damage or interstitial volume measured by the point-counting
      method, luminal narrowing index by intimal thickening of arterioles determined
      morphometry. Tubulointerstitial damages were significantly correlated to aging
      with a direct linear worsening. Luminal narrowing of arterioles rapidly worsened
      with age after 40 y.o. who were frequently associated with chronic hypertension.
      The patients over 60 y.o. had a significant correlation between luminal narrowing
      of arterioles and glomerular sclerotic index, though those were statistically no
      related in patients less than 60 y.o.. Glomerular sclerotic index was
      significantly related with tubulointerstitial damage at all decades except for
      thirtieth decade. Serum creatinine level was well correlated with glomerular
      sclerotic index and tubulointerstitial damage, respectively; increase of those
      indices may indicate poor prognosis. We concluded that ischemic glomerular
      sclerosis by mean narrowing of afferent arterioles may appear after 60 y.o.,
      probably due to insufficiency of autoregulation for glomerular circulation.
      Luminal narrowing of arterioles in patients less than 60 y.o. may not reflect to
      be a main cause for ischemic damage of glomerulus. Therefore it may not be a
      indicator for renal prognosis in patients with IgA nephropathy less than 60 y.o.

PMID- 2214316
TI  - [Ristocetin induced platelet aggregation in children with nephrotic syndrome].
AB  - In 22 children with steroid responsive nephrotic syndrome (SRNS), we examined
      platelets aggregability to ristocetin, and the data obtained wre compared with
      negative charge on platelet membrane based on the binding of cationic dye alcian
      blue 8GX (AB) or plasma levels of von Willebrand factor antigen (vWF:Ag) and
      ristocetin cofactor (Rcof) activity. At the initial or relapse stage of SRNS, the
      enhanced platelet aggregation to ristocetin was observed, and correlated with the
      decreased alcian blue binding to platelets. Ristocetin-induced vWF:Ag binding to
      platelets by using 125I-vWF was significantly increased. In addition, ristocetin
      induced platelets aggregation (RIPA) using washed nephrotic platelets still
      enhanced as found in the patient's platelets rich plasma (PRP), even when it was
      resuspended into normal plasma. These results suggest that the decrease of
      platelet surface negative charge play an important role of heighten RIPA found in
      children with SRNS.

PMID- 2214317
TI  - [Study on the pathogenetic factors of the progression of renal insufficiency,
      with special reference to the effects of dietary protein intake].
AB  - The effects of dietary protein intake on the progression of renal insufficiency
      were studied in daunomycin (DMC) induced nephrotic rats (DMC rats) and also
      patients with chronic renal diseases. In the first study, the author examined
      which treatment among enalapril (E) and indomethacin (I) and dietary protein
      restriction was the most effective to prevent proteinuria and glomerulosclerosis,
      and then the effect of dietary protein restriction on renal content of
      malondialdehyde (MDA) and superoxide dismutase (SOD) in DMC rats. These rats were
      divided into four groups as follows: group PL and group PH were isocaloric diets
      containing either 5% or 24% protein, respectively and group PE and PI were given
      orally E (100 mg/l drinking water) or I (50 mg/l drinking water) with diets of
      24% protein, respectively. In group PL, urinary protein excretion (U-Protein)
      rates and renal damage index were significantly lower than those in other three
      groups. In group PE, renal damage index was significantly improved although U
      Protein showed no reduction in contrast with these in group PH. Renal MDA in
      group PL was lower than that in group PH was significantly lower than that in
      group PL. In this study dietary protein restriction was the most effective
      treatment for the prevention of progressive renal insufficiency. In the second
      study, patients with chronic renal diseases were divided into two groups
      according to their Ccr: group I; Ccr greater than or equal to 60 ml/min, group
      II; Ccr less than 60 ml/min. All patients orally received diets of high protein
      (1.4 g/kgBW) and subsequently of low protein (0.7 g/kgBW). Ccr, U-Protein, serum
      MDA and serum SOD were estimated at the end of each dietary period. In group I,
      Ccr was significantly lower on low protein diet than that on high protein diet,
      although these were no significant changes in Ccr in group II. The low protein
      diet caused a significant decrease in U-Protein in both groups. Serum MDA in
      group I was significantly lower on low protein diet than that on high protein
      diet, but not in group II. Serum SOD activity showed no changes. It is suggested
      that dietary protein restriction might reduce oxidant stress to the kidney, in
      addition to renal hemodynamic changes induced by prostaglandin and renin
      angiotensin system, resulting in the prevent of progress of renal insufficiency.

PMID- 2214318
TI  - [The criteria for indication of plasma exchange on lupus nephritis].
AB  - Although many reports have been made on the effectiveness of plasma exchange (PE)
      in active systemic lupus erythematosus (SLE), but there are no clear-cut criteria
      of indication for lupus nephritis (LN). In order to determine the criteria for
      indication of LN, 35 patients with LN treated by PE were studied with respect to
      renal function (F), proteinuria (P), immunological activity (A) and renal
      histology. The patients were divided into 4 groups according to the severity of
      renal function: F1 (stable chronic renal failure (CRF) or stable renal function n
      = 13), F2 (relapse type n = 9), F3 (rapidly progressive LN; creatinine clearance
      (Ccr) less than 40 ml/min n = 7) and F4 (acute renal failure; Ccr less than 10
      ml/min n = 6). Proteinuria was also studied in 4 groups: P1 & P2 (without
      nephrotic syndrome (NS], P3 (acute type NS n = 15), and P4 (chronic type NS n =
      7). These patients were divided into 3 groups to study immunological activity: A1
      (chronic stage n = 6), A2 (relapse stage n = 12) and A3 (active stage n = 17).
      Comparison was made in each parameter. Renal histological classification
      according to WHO criteria of LN, activity score (AS) and chronicity score (CS)
      were evaluated and compared. As a result, the following indication was obtained.
      1) ABSOLUTE INDICATION: 1. Rapidly progressive LN with high immunological
      activity; elevated serum creatinine (SCr) greater than 1.0 mg/dl/month or
      decreased Ccr from normal renal function to less than 40 ml/min within 1-2 months
      after onset. 2. Acute type NS within 1 year after onset. 3. histological AS
      greater than 20. 2) RELATIVE INDICATION: 1. Relapse LN with moderate
      immunological activity, decreased Ccr from normal function to 40-50 ml/min within
      3-6 months, the rise in SCr of greater than 1.0 mg/dl/month. 2. Proteinuria is
      1.0-3.5 g/day within 1 year after onset. 3. Such complication as CNS, serositis,
      thrombocytopenia and leukopenia, steroid resistance and/or severe side effects of
      steroid. 3) NO INDICATION: 1. CRF or stable renal function (Ccr greater than 50
      ml/min). 2. Chronic type NS over 1 years with past history of NS and/or edema. 3.
      Low immunological activity and mild renal histology.

PMID- 2214319
TI  - [The diagnostic critical value in DFO low dose loading test on patient with
      aluminum accumulation compared to each parameter of ROD].
AB  - One hundred two hemodialyzed patients were examined to determine the standard
      level of delta Al value which is the difference of serum Al concentrations
      between pre and post DFO loading test. We applied low dose of DFO 15 mg/kg in
      this loading test. Some significant negative correlations were found between
      delta Al and MCI, sigma GS/D, osteocalcin, free-Hydroxyproline (dialysate) and
      free-gamma-Carboxyglutamic acid (dialysate). Each correlation rate was -0.58, 
      0.44, -0.76, -0.57 and -0.51 respectively. In addition tendencies of correlation
      were found between delta Al and ALP and between delta Al and %QCT (QCT/mean QCT
      in patient's age x 100). And statistical significant differences were found
      between (0 less than delta Al less than or equal to 150 micrograms/l) group and
      (150 micrograms/l less than delta Al) group in each osteobiochemical parameter.
      These results indicate that 150 micrograms/l is the lower diagnostic standard
      level of delta Al in 15 mg/kg DFO loading test.

PMID- 2214320
TI  - [High deposition rate of aluminum in tissues in diabetic hemodialysis patients].
AB  - Aluminum (Al) accumulation in bone is a serious problem in patients on
      hemodialysis. We studied deferoxamine infusion test (DFO test) in 14 diabetic
      patients on hemodialysis (HDDM) and 23 hemodialysis patients originated from
      glomerulo nephritis (HDCGN) to determine whether Al accumulation is different
      between the two groups or not. There was no difference in hemodialysis duration
      and total oral intake of Al containing drugs between two groups. Serum C-terminal
      parathyroid hormone (C-PTH) in HDDM was lower than that in HDCGN group (1.82 +/-
      1.30 vs. 3.80 +/- 1.82 ng/ml; P less than 0.01). However serum Al (s-Al) levels
      were comparable (61.9 +/- 53.0 vs, 45.0 +/- 32.3 micrograms/l). A significant
      correlation was observed between duration of dialysis period and s-Al in HDDM (r
      = 0.806, p less than 0.01), but in HDCGN, the relation was not significant. The
      patients in HDDM whose cumulative aluminum intake was less than 2.0 kg showed the
      higher serum A1 concentrations before DFO and greater increases in s-Al after DFO
      test, as compared with those in HDCGN with matched aluminum intake (93.8 +/- 67.6
      vs. 35.9 +/- 23.6 micrograms/l; p less than 0.001 and 141.2 +/- 81.8 vs. 70.3 +/-
      41.1 micrograms/l; p = 0.035). These results indicate that in uremic diabetic
      patients with lower intake of Al containing drugs, an early accumulation of Al in
      the whole body occurs possibly because of the enhanced absorption rate of Al at
      an intestine and/or the low PTH level.

PMID- 2214321
TI  - [Acute renal failure with lactic acidosis].
AB  - This study examined the acid base disturbances in 18 adults with acute renal
      failure (ARF) from one of new aspects, which is lactate metabolism and
      pathophysiology. 10 patients (55%) of them were accompanied by lactic acidosis
      and 9 patients (90%) of those with lactic acidosis also had severe hepatic
      failure. Mortality of patients with lactic acidosis was 80%, and much higher than
      that of ARF (66.7%). Lactate, pyruvate, lactate-to-pyruvate ratio (L/P) were 76.7
      +/- 15.66 mg/dl, 3.30 +/- 0.74 mg/dl and 19.9 +/- 1.41, respectively. All of them
      significantly raised, compared to values of healthy adults, patients with liver
      cirrhosis, chronic renal failure and diabetes mellitus. Arterial pH and HCO3-
      levels were 7.20 +/- 0.04 and 10.6 +/- 1.20 mEq/l. Anion gap (AG) was 30.0 +/-
      3.66 mEq/l. Significant correlations of lactate with pH, HCO3-, AG and L/P were
      demonstrated, while correlations of lactate with BUN, CR and prothrombin time
      were not significantly observed. Lactic acidosis results from two mechanisms. One
      is lactate overproduction (e.g tissue hypoxia) and the other is lactate
      underutilization (e.g severe liver and/or renal failure). Whenever lactic
      acidosis occurred, both mechanisms were present simultaneously and continuously.
      Especially, the latter mechanism had a very important role on it, and seemed to
      decide the prognosis of the patients with lactic acidosis. Therapy of lactic
      acidosis was very difficult. First of all, we tried to improve the circulatory
      failure and severe acidemia (pH less than 7.20) not to fall into vicious cycle.
      Then, CAVH, if combined with alkali infusion, seemed to be the most useful
      technique in managing lactic acidosis with ARF.

PMID- 2214322
TI  - [Unfolded map of coronary artery territories by myocardial SPECT].
AB  - Coronary artery territories were evaluated precisely by Bull's-eye and unfolded
      map generated from myocardial SPECT. In addition, unfolded maps including apical
      information were also developed. The coronary artery territories were determined
      by 54 cases of typical single vessel disease (more than 75% stenosis) with
      myocardial infarction and angina pectoris. There were 12 of right coronary artery
      disease, 24 of left anterior descending coronary artery disease, 5 of diagonal
      coronary artery disease, and 13 of left circumflex artery disease. Each diseased
      region was summed and normalized using the standard pattern (21 cases of normal
      male and 13 cases of normal female). Apical information was simply obtained using
      the anterior and posterior count from short and long axial image. Then, their
      data were added to the unfolded map. In conclusion, unfolded map was proven to be
      useful for the determination of coronary artery territory, since this map
      expressed the extent and site of myocardial damage precisely compared to Bull's
      eye. The unfolded map to contain the apical information was also useful for the
      evaluation of left anterior descending coronary artery involvement.

PMID- 2214323
TI  - [Clinical evaluation of coronary territory map by using unfolded map of Tl-201
      myocardial SPECT].
AB  - Coronary territory map was developed on unfolded map of exercise Tl-201
      myocardial SPECT. Each coronary territory was determined by summing the each
      unfolded map of 54 cases of single vessel disease respectively, and standardizing
      with normal pattern obtained from normal patients. The diagnostic accuracy of
      coronary territory map to identify the diseased coronary artery was analyzed in
      104 clinical cases and was compared with that of planar and SPECT visual
      diagnosis, simple unfolded map (raw map) and extent & severity map. The results
      were as follows; 1) Territory map showed excellent diagnostic accuracy in single
      or double vessel disease, especially in diagnosis of left circumflex coronary
      artery lesion. 2) In triple vessel disease, the diagnostic accuracy of territory
      map or other unfolded maps was 30% at best, and was inferior to planar or SPECT
      visual analysis. The cause of this inferiority seemed that the quantitatively
      analyzed map had no information about the degree of Tl-uptake into lung or
      myocardium, which give useful information in visual diagnosis. 3) The diagnostic
      agreement ratio in two observers was the highest in territory map diagnosis, so
      that the territory map diagnosis seemed to be the most objective one. 4) The
      unfolded map diagnosis with apical display obtained from long-axis tomogram was
      useful to diagnose left anterior descending coronary (LAD) lesion, which improve
      not only the sensitivity of LAD but also specificity of right coronary artery
      single vessel disease.

PMID- 2214324
TI  - [Relationship between the occurrence of late potential and the location and size
      of myocardial infarction evaluated by thallium-201 SPECT].
AB  - High-frequency, low amplitude signals, late potentials (LPs), in the terminal
      portion of the body surface QRS of the signal-averaged ECG were frequently
      observed in ventricular tachycardia (VT) following myocardial infarction (MI). In
      this study, we evaluated the correlation between the occurrence of LPs and the
      size and location of MI estimated by Thallium-201 myocardial SPECT in 30 MI
      patients. The positive LPs were identified by the value of %RMS 40, the percent
      ratio of the root mean square voltage in the last 40 msec of the QRS complex to
      that of the total filtered QRS from the signal averaged ECG using bipolar X, Y, Z
      leads. The spatial distributions of LPs were evaluated by the LP30 area maps
      obtained by the body surface mapping using forty-five unipolar electrodes. Sixty
      projections were obtained over 180 degree by rotating gamma camera after 5
      minutes intravenous injection of 74 MBq of Thallium-201. After low-pass
      filtering, images were reconstructed into short-axis, horizontal long-axis and
      vertical long-axis tomograms. The maximum count circumferential profiles for each
      short-axis cuts were generated from the apical to basal cut and they were
      expressed into two-dimensional polar functional maps (apex to the center), Bull's
      eye map, to represent myocardial Tl distribution. Normal limits of myocardial Tl
      distribution were established as the mean minus 2 standard deviation from those
      of normal subjects. The MI size was estimated as defect volume ratio (DVR), the
      percent ratio of abnormal region to that of total volume of left ventricle.
      Significant differences in DVR were observed among MI with LPs and without
      LPs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214325
TI  - [Experimental study on liver accumulation of N-isopropyl-p-iodoamphetamine].
AB  - In order to clarify the mechanism of N-isopropyl-p-iodoamphetamine (IMP) liver
      accumulations, liver dynamic study by the portal injection of 123I-IMP and liver
      microautoradiography by 125I-IMP were performed using 5, 2 male rats,
      respectively. The initial uptake of 123I-IMP in the liver was very high and
      thereafter 123I-IMP showed relatively rapid wash-out (count ratio of lung to
      liver at 10 min after the injection was 0.12, 0.15). On the other hand, the
      addition of 5 mg, 8 mg ketamine hydrochloride decreased the initial 123I-IMP
      liver uptake and its lung accumulation was noted immediately after the injection
      (count ratio of lung to liver at 10 min was 0.20). Microautoradiography of the
      liver using 125I-IMP showed grain density in the central vein and sinusoids, but
      not in the liver parenchymal cell. These results suggest that non-specific amine
      receptor (binding site) may exist in the endothelial cell in the central vein,
      although the number of experimental rats in this series was small for conclusion.

PMID- 2214326
TI  - [Assessment of myocardial damage in cardiomyopathy using 111In-antimyosin Fab
      myocardial scintigraphy].
AB  - 111In-antimyosin Fab (AM) myocardial scintigraphy was carried out in (A) 10
      patients with idiopathic dilated cardiomyopathy, (B) 7 with dilated phase of
      hypertrophic cardiomyopathy and (C) 8 with normal (control) individuals. Imaging
      was taken 48 hours after intravenous injection of 74 MBq of AM. Myocardial uptake
      of AM was evaluated qualitatively and quantitatively. Positive uptake was
      observed in 9/10 (90%), 7/7 (100%) and 0/8 (0%) in group A, B and C,
      respectively. AM index (heart/lung ratio) in group A and B were 2.04 +/- 0.24 and
      2.46 +/- 0.49, values significantly higher than that obtained in the control
      patient without cardiomyopathy (1.51 +/- 0.13) (p less than 0.01). Positive
      monoclonal antimyosin antibody studies were highly prevalent in dilated
      cardiomyopathic and dilated phase of hypertrophic cardiomyopathic patients, even
      in the presence of negative right ventricular biopsy. It is suggested that this
      method was useful for the noninvasive assessment of active myocardial damage in
      these patients.

PMID- 2214327
TI  - [Remote effects in cerebral infarction--123I-IMP SPECT study].
AB  - We studied the remote effects in 29 patients with middle cerebral artery
      territory infarction by using single photon emission computed tomography (SPECT)
      with N-isopropyl-p-[123I]iodoamphetamine. SPECT demonstrated a reduction in blood
      flow in the cerebellar hemisphere contralateral to the cerebral infarct, the
      cortex ipsilateral to the subcortical infarct, the visual cortex distal to the
      optic radiation lesion, and the thalamus ipsilateral to the cortical infarct. In
      addition to transient neuronal depression identified with diaschisis, our results
      indicated that persistent phenomena were apparently involved in these remote
      effects. The degenerative processes might be related to irreversible effects in
      remote areas. Clinical symptoms corresponding to the areas of hypoperfusion
      remote from infarcted lesions were not necessarily present.

PMID- 2214328
TI  - [Regional myocardial blood flow measurements in resting and dipyridamole induced
      vasodilative state by Xenon-133 clearance method].
AB  - Myocardial imaging with Xenon-133 and a gamma camera was employed to evaluate the
      relationship between angiographically demonstrated coronary artery stenosis and
      regional myocardial blood flow (r-MBF) in 22 patients with ischemic heart disease
      and 9 control subjects. After a left anterior oblique cineangiogram was obtained,
      the cinecamera was replaced by the mobile gamma camera in the same plane and
      location over the pericardium of patients. Then, 370 MBq (10 mCi) of 133Xe was
      injected into the left coronary artery as a bolus. After the first measurement of
      r-MBF in resting state, a second injection was made 3 minutes after intravenous
      injection of 0.56 mg/kg of dipyridamole for 4 minutes. The r-MBF in different
      regions of the heart was calculated by Kety formula. Coronary flow reserve (CFR)
      was defined the rMBF ratio between resting and dipyridamole induced vasodilative
      state. In the resting state, good correlation (r = 0.711) was observed between
      pressure rate product and the r-MBF at the areas perfused by non stenotic
      vessels. The r-MBF of the areas perfused by severe stenotic vessels (greater than
      90%) was smaller than that of the areas perfused by non stenotic vessels, however
      there was overlapping of flow. In the dipyridamole induced vasodilative state,
      the r-MBF of the areas perfused by intact vessels increased approximately 2.4
      times of the resting state, and showed good correlation with pressure rate
      product. In contrast, the r-MBF of the areas perfused by stenotic vessels did not
      correlate with pressure rate product, but depended on the degrees of coronary
      stenosis (50-75% stenosis; 1.9 times, greater than 90% stenosis; 1.3 times,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214329
TI  - [Brain glucose metabolism in a patient with Creutzfeldt-Jakob disease measured by
      positron emission tomography].
AB  - Sequential measurements of local cerebral glucose metabolism were performed in a
      case with Creutzfeldt-Jakob disease. The diagnosis was based on the
      characteristic clinical symptoms and EEG. Cerebral glucose metabolism (CMRGlc)
      was measured by positron emission tomography (PET) and 18F-fluorodeoxyglucose.
      CMRGlc was decreased to about 45% of the normal value. At that time, X-ray CT
      revealed little brain atrophy. The decrease of CMRGlc was prominent in cerebral
      cortices, but the metabolic decrease was slight in striatal body, cerebellum, and
      brainstem. The motor cortex and occipital lobe showed relatively preserved
      metabolism among the cerebral cortices. Six months after the first PET
      measurement, X-ray CT showed marked brain atrophy. Decrease of cerebral glucose
      metabolism advanced furthermore. However, the progress of the decrease was
      relatively small in the basal ganglia, brainstem, and cerebellar nucleus. These
      findings differ from the findings that was known by pathological study. These
      results suggest that measurement of CMRGlc by PET is useful for the early
      detection and for understanding of the pathophysiology of this disease.

PMID- 2214330
TI  - [Fundamental and clinical evaluation of ELSA CA 72-4 kit for serum CA 72-4
      antigen].

PMID- 2214331
TI  - [Anthropological research method. Commentary: anthropological research method of
      clinical problems].

PMID- 2214332
TI  - [Anthropological research method. How to use anthropological methods in nursing
      research].

PMID- 2214333
TI  - [Anthropological research method. Ethnonursing: the nursing research method to
      generate transcultural nursing knowledge].

PMID- 2214334
TI  - [Anthropological research method. A description of the diet habits and and their
      related factors among people who keep a special diet "Syoku-youjou"].

PMID- 2214335
TI  - [Anthropological research method. Facing life transitions in an alien culture:
      the case of American women giving birth in Japan].

PMID- 2214336
TI  - [Anthropological research method. Cultural construction of the menopausal
      syndrome: the Japanese case].

PMID- 2214337
TI  - [Anthropological research method. Research and the process about "modern
      midwives"].

PMID- 2214338
TI  - [The approach to the English monograph. To challenge your translation: to
      discover your mistakes (5)].

PMID- 2214339
TI  - Calcium and disease.

PMID- 2214340
TI  - Complete atrioventricular block following radiation therapy for malignant
      thymoma.
AB  - Complete atrioventricular block following radiation is very rare. We present a
      case which developed after radiation therapy for malignant thymoma. The etiology
      of conduction disturbances due to radiation is unknown. In our case, serial
      electrocardiograms showed stepwise progression of the conduction disturbance, and
      His bundle electrocardiograms revealed new prolongation of the H-V interval.
      Endomyocardial biopsy specimens demonstrated occlusion in small arteries and
      diffuse degenerative changes in the myocardium. We therefore attributed the
      complete atrioventricular block in our patient to secondary damage to the
      conduction system, caused by radiation-induced occlusive changes in the small
      arteries supplying the conduction system.

PMID- 2214341
TI  - Spontaneous fall in blood pressure and reactivity of sympathetic nervous system
      in hospitalized patients with essential hypertension.
AB  - We evaluated whether reduction in sympathetic reactivity plays a major role in
      the spontaneous falls in blood pressure (BP) experienced during hospitalization
      by patients with essential hypertension. In the present case BP fell on the 2nd
      day of hospitalization. The responses of plasma catecholamines (CA) and BP to
      both handgrip and tilting were not altered during either the first 24 hours or
      the entire 7 days of hospitalization. The effect of phentolamine on BP was
      similar on the 1st, 2nd and 7th days. However, the resting levels of plasma
      norepinephrine before handgrip, tilting and phentolamine were significantly
      diminished on the 7th day, but not on the 2nd day. In conclusion, the diminution
      of sympathetic activity may be partly responsible for the hospitalization-induced
      fall in BP in the late stages.

PMID- 2214342
TI  - Beta 0-thalassemia due to a nonsense mutation at beta 90 (GAG----TAG) in human
      hemoglobin gene.
AB  - We studied a patient with severe anemia and jaundice who exhibited a high
      hemoglobin A1 (HbA1) level secondary to an increase in HbF despite normal glucose
      tolerance. The red blood cells showed anisocytosis, poikilocytosis and
      polychromasia; target cells, Howell-Jolly bodies, Heints bodies and punctate
      basophilia were observed. No defect or reduction in activity was observed in 19
      red cell enzymes. A family history of similar anemia in the patient's daughter
      and cousins on the mother's side indicated an involvement of genetic factors.
      Gene cloning and DNA analysis showed that the condition is a new type of beta 0
      thalassemia caused by a nonsense mutation (GAG----TAG) in codon 90 of the beta
      globin gene.

PMID- 2214343
TI  - A case of a clinically "silent" pheochromocytoma.
AB  - A case of a clinically "silent" pheochromocytoma is presented. The adrenal mass
      was incidentally discovered by abdominal ultrasonography and computed tomography.
      In the course of hospitalization, the patient was normotensive and asymptomatic.
      Plasma catecholamine levels were nearly normal, whereas urinary levels of
      catecholamine metabolites were slightly elevated. A glucagon provocative test and
      131I-metaiodobenzylguanidine scintigram were useful for diagnosing such an
      atypical pheochromocytoma. A discussion of clinically-unsuspected
      pheochromocytoma is also presented.

PMID- 2214344
TI  - Primary osteogenic sarcoma of pulmonary artery.
AB  - A 44-year-old woman was hospitalized for nonproductive cough. Chest
      roentogenogram revealed a calcified nodular mass at the right hilum. The patient
      was treated as tuberculosis of the hilar lymph node, however, her symptoms
      exacerbated within a year. A tumor obstructing the right main stem bronchus was
      demonstrated on bronchofiberscopic examination. Thoracotomy was carried out and
      tumor was diagnosed as primary osteogenic sarcoma of the pulmonary artery by
      pathological examination of the resected specimen. There was no clinical finding
      of osteogenic sarcoma throughout the bones.

PMID- 2214345
TI  - A case of polymyositis associated with chronic thyroiditis presenting as
      hyperthyroidism.
AB  - We describe a case of polymyositis associated with hyperthyroidism (Graves'
      disease). Clinical findings and thyroid function tests revealed hyperthyroidism.
      On histological examination, it was found that the thyroid gland was involved in
      chronic thyroiditis, and no appearance of Graves' disease was noted. This case
      suggested that the patient's muscle weakness might have been related to a
      disturbance of thyroid function, that is, coexistence of subclinical thyrotoxic
      myopathy. There were fluctuations in the levels of various antibodies during the
      clinical course of this overlap syndrome.

PMID- 2214346
TI  - Water intoxication and rhabdomyolysis.
AB  - A 44-year-old woman was admitted because of stupor. She had consumed 3 liters of
      water due to thirst after drinking alcohol. Laboratory findings on admission
      revealed marked hyponatremia (sodium: 115 mEq/l). She was diagnosed as having
      water intoxication. She recovered from her hyponatremia upon excretion of a large
      amount of hypotonic urine. Subsequently, however, her serum creatine
      phosphokinase was markedly elevated at 28,650 IU/l, and her serum myoglobin
      reached 2,760 ng/ml. The relationship between the occurrence of hyponatremia
      secondary to water intoxication and rhabdomyolysis was suggested.

PMID- 2214347
TI  - An adult case of acute lymphoblastic leukemia with necrotizing
      leukoencephalopathy.
AB  - A 19-year-old man with common acute lymphoblastic leukemia (ALL) developed
      necrotizing leukoencephalopathy (NL) after extensive chemotherapy and
      irradiation. Clinicians should exercise care in the treatment of leukemia, since
      chemotherapy has shown a trend of becoming more intensive, and the survival time
      of patients with leukemia is being extended.

PMID- 2214348
TI  - Familial amyloidotic polyneuropathy in Hokkaido: a case report.
AB  - A 54-year-old man began to feel numbness in his hands at the age of 42 (1975).
      His condition became progressively worse accompanied by muscle weakness of the
      lower limbs and glove and stocking paresthesia of the extremities. The patient
      was admitted to our hospital on March 23, 1987. Neurological examination revealed
      distal dominant muscle weakness, sensory disturbance and areflexia.
      Electrocardiogram and ultrasound-cardiogram strongly suggested cardiomyopathy. A
      biopsy of the rectal wall and the cardiac muscle revealed amyloid deposits. The
      patient, his elder brother and one of his daughters had abnormal serum
      transthyretin (TTR, a protein referred as prealbumin). Therefore, the diagnosis
      of familial amyloidotic polyneuropathy (FAP) was confirmed. The patients's
      brother and daughter mentioned above, however, had no abnormal findings on
      physical examination and they were thus considered to be asymptomatic carriers.
      There may be more cases of asymptomatic carriers, if examination of abnormal TTR
      is more frequently analyzed.

PMID- 2214349
TI  - Vitiligo with primary hypothyroidism and hypoacusis: a case report.
AB  - A 48-year-old female patient with vitiligo developed primary hypothyroidism and
      hypoacusis. The signs and symptoms of hypothyroidism improved with thyroid
      hormone replacement therapy but hypoacusis did not. The coexistence of vitiligo
      and thyroid disease is uncommon and the additional association of hypoacusis is
      very rare. There may be a common autoimmune pathogenesis for the three disorders.
      Vitiligo may be a diagnostically useful sign which suggests the presence of
      multiple autoimmune diseases.

PMID- 2214350
TI  - Presence of Philadelphia (Ph) chromosome-negative cells in Ph-positive chronic
      myelogenous leukemia.
AB  - Six cases of chronic myelogenous leukemia (CML) with coexistence of cells with a
      Philadelphia (Ph) translocation and a normal karyotype are described. Molecular
      analyses were performed in 3 of the 6 cases at two phases with different
      cytogenetic findings. Among the 6 cases, 4 cases were late appearance of a Ph
      chromosome. Two of the 3 patients analyzed had major breakpoint cluster region
      (Mbcr) rearrangements; aberrant Mbcr fragments were observed whether the cells
      had a Ph translocation or not. The remaining one did not show any rearrangements
      within the Mbcr DNA sequences.

PMID- 2214351
TI  - Transplacental passage of autoantibodies from a mother with diabetes and Graves'
      disease to her infant.
AB  - Antibodies to islet cells and thyroid gland were examined in a mother with
      insulin-dependent diabetes mellitus and Graves' disease and in her infant. Islet
      cell antibodies (ICA), complement-fixing ICA, islet cell surface antibodies
      (ICSA) and anti-microsomal antibodies (MAb) persisted in the mother during
      pregnancy. At birth, ICA, ICSA and MAb could be detected in the infant. ICSA and
      ICA in the infant disappeared by the 3rd and 7th months, respectively. There was
      no clinical or laboratory evidence of diabetes in the infant. These data suggest
      that anti-islet cell antibodies themselves may have no significant effect on
      islet cells.

PMID- 2214352
TI  - Two cases of Reiter's syndrome.
AB  - Two characteristic cases of Reiter's syndrome are reported. One (case T.M) was a
      64-year-old female with ulcerative colitis and the other (case O.M) was a 20-year
      old male with serum antistreptococcal lysine O (ASLO) and antistreptokinase (ASK)
      titers of 480x and 2560x, respectively. These cases were both histocompatibility
      antigen HLA-B27 positive. The ulcerative colitis and iritis were inactive in case
      T.M. However, case O.M required aggressive treatment for fever and arthralgia.
      These patients have recently shown no evidence of Reiter's syndrome; however,
      case T.M has had recurrent bowel hemorrhages due to ulcerative colitis.

PMID- 2214353
TI  - Overwhelming pneumococcal pneumonia in a patient receiving ofloxacin for
      antimicrobial prophylaxis.
AB  - A case of severe bacteremic pneumococcal pneumonia which developed in a patient
      with lung cancer, who was taking ofloxacin for chemoprophylaxis, is presented.
      Pneumonia resolved well with intravenous penicillin G. Infection by and
      colonization with Streptococcus pneumoniae might become a problem with increasing
      use of the fluoroquinolones.

PMID- 2214354
TI  - A case of relapsing polychondritis associated with hemolytic anemia.
AB  - Relapsing Polychondritis (RPC) is a rare disorder of unknown etiology which
      affects mucopolysaccharide-rich tissues such as cartilage. A 64-year-old man
      developed auricular and nasal chondritis with complaints of arthralgia of the
      hands and cervical pain. The auricular biopsy established the diagnosis of RPC.
      The hematological data revealed normocytic, slightly hypochromic anemia, a
      persistently elevated reticulocyte count, slightly increased bilirubin, and
      decreased haptoglobin. The presence of hemolytic anemia was confirmed by the
      shortened half-life of erythrocytes and erythroid hyperplasia of the bone marrow.
      This case illustrates the coexistence of RPC and hemolytic anemia which has been
      only rarely reported. The pathogenesis of RPC is also discussed may elucidate the
      pathogenesis of this disease.

PMID- 2214355
TI  - Carnitine deficiency following massive intestinal resection: a morphological and
      biochemical study.
AB  - A 65-year-old man with progressive muscle weakness and liver dysfunction
      following massive small bowel resection showed myriad lipid-filled vacuoles in
      type I muscle fibers. Carnitine was significantly decreased in muscle, serum and
      urine. Carnitine supplementation was followed by clinical improvement and
      decreased lipid droplets in biopsied muscle. He had been receiving carnitine
      deficient total parenteral nutrition. This form of carnitine deficiency may be
      due to a defect in carnitine biosynthesis, as well as dietary carnitine
      deficiency.

PMID- 2214356
TI  - Herpes zoster ophthalmicus with delayed contralateral hemiparesis.
AB  - A 35-year-old previously healthy woman developed left hemiparesis sixteen weeks
      after the onset of right herpes zoster ophthalmicus. Cerebral angiography showed
      complete occlusion of right middle cerebral artery at the origin and segmental
      narrowing of the right posterior cerebral artery. Computerized tomography (CT)
      and magnetic resonance imaging (MRI) also revealed a right hemispheric lesion
      consistent with angiographic findings. Reports from the literature along with the
      present case suggest that arteritis followed by cerebral infarction is the most
      probable cause of delayed contralateral hemiparesis.

PMID- 2214357
TI  - Fluid movement across the blood-retinal barrier: a review of studies by vitreous
      fluorophotometry.
AB  - Vitreous fluorophotometry was used to study the fluid movement across the blood
      retinal barrier. The effect of plasma osmolality and intraocular pressure on the
      movement of the fluorescent tracer confirmed the interaction between the tracers
      and the fluid flow across the blood-retinal barrier. The measurement of outward
      and inward permeabilities to carboxyfluorescein revealed the existence of a
      posteriorly directed fluid flow in the vitreous cavity of cynomolgus monkey eyes
      with retinal detachment. Fluid movement across the blood-retinal barrier was
      shown to be inhibited by furosemide and enhanced by acetazolamide. Furthermore,
      vitreous fluorophotometry proved to be useful in estimating the in vivo fluid
      dynamics in the vitreous and across the human retina.

PMID- 2214358
TI  - Flash electroretinograms and pattern visually evoked cortical potentials in
      Behcet's disease.
AB  - Behcet's disease with posterior uveitis was studied in 12 cases by flash
      electroretinography (FERG) and pattern visually evoked cortical potential
      (PVECP). Disappearance of oscillatory potentials was the initial change noted in
      FERG. Subnormal FERG and a delay in peak latency of the P100 component of PVECP
      were observed in patients with poor visual acuity and long-standing Behcet's
      disease. Amplitudes of PVECP were significantly decreased in these patients. It
      was suggested that FERG together with PVECP were good indicators for monitoring
      posterior segment changes and visual prognosis in Behcet's disease.

PMID- 2214359
TI  - Studies of experimentally induced retinal degeneration: 2. Early morphological
      changes produced by lipid peroxides in the albino rabbit.
AB  - When pure, synthetic lipid hydroperoxides (LHP) were injected into the vitreous
      body of albino rabbits, electrical activity was decreased in all components of
      the electroretinogram (ERG) in a progressive and time-related manner. In the
      early phase morphological changes occurred at the interface between the
      photoreceptor outer segments and the retinal pigment epithelium (RPE) in response
      to LHP. These findings commenced within a few hours after injection and continued
      during the following 2-3 weeks, when the ERG was completely extinguished. Two
      days after injection, the rod outer segments (ROS) were swollen and damage of the
      RPE apical villi was observed. This initial event was followed by additional
      changes in the RPE which embraced swelling, accumulation of residual bodies,
      complete loss of ROS and enlargement and disruption of Bruch's membrane. The
      precursors of residual bodies appeared to result from focal, peroxidative damage
      to ROS discs which apparently rendered these materials undegradable by the RPE.
      As ROS degeneration continued, the RPE showed hypertrophy and modification. These
      studies provided evidence for a sequential destruction of the neural retina and
      RPE during oxidative damage involving lipid peroxidation. The mechanism appeared
      to differ from that produced by other toxic compounds or those which resulted
      from vitamin E or A deficiency. This new model system is thought to be useful in
      1) explaining differences in susceptibility of inner ROS disks versus other
      membranes, 2) determining how the RPE metabolizes abnormal ROS, 3) studying RPE
      reactivity following trauma and/or retinal detachment, and 4) determining factors
      which produce degeneration of Bruch's membrane.

PMID- 2214360
TI  - Retinal nerve fiber layer analysis by a computerized digital image analysis
      system.
AB  - A computerized digital image analysis system was developed to evaluate the
      retinal nerve fiber layer (RNFL) by red-free fundus photography. The image
      intensity of the RNFL was computed for 30 degrees between the disc and macula.
      Thirty early open-angle glaucoma patients and 30 normal age-matched subjects were
      examined. The coefficients of variation in the reproducibility of the
      measurements in normal subjects were 7.3 to 9.9% for the interphotographic
      studies, and 4.1 to 5.1% for the intraphotographic studies. Using this new image
      analysis system, the RNFL changes were detected easily and the glaucomatous eyes
      were distinguished from normal eyes with high sensitivity and specificity, 95%
      and 80%, respectively. This method will be useful for diagnosis of glaucoma at a
      very early stage.

PMID- 2214361
TI  - Pseudopodia of capillary endothelium in ocular tissues.
AB  - The frequencies of pseudopodia projecting from capillaries of various parts of
      the eye were observed in 16 human eyes with a transmission electron microscope.
      The pseudopodia were found mainly projecting from the choriocapillaris and rarely
      seen in the retina, iris or ciliary body. The frequencies of pseudopodia from the
      choriocapillaris were not correlated with the localization in the fundus (macular
      area or peripheral fundus), age, sex, time elapsed between death or enucleation
      and fixation. The significance of pseudopodia from the choriocapillaris is
      unknown. However, there is the possibility that pseudopodia are related to
      choroidal neovascularization or have other physiological functions.

PMID- 2214362
TI  - H2O2-dependent NADH oxidation activity in senile cataractous human lens: its
      relation to glutathione redox cycle.
AB  - The present study has demonstrated that H2O2-dependent NADH oxidation activity in
      aged transparent and senile cataractous human lenses is due to a glutathione
      redox cycle which consists of reduced glutathione, oxidized glutathione,
      glutathione peroxidase and glutathione reductase. Especially, the NADH oxidation
      activity was proportional to the content of free glutathione (reduced plus
      oxidized forms) under our assay conditions. Employing this simple assay method,
      the present report has also shown that in the aged and cataractous lenses with
      pale yellow, yellow or dark yellow nucleus, the free glutathione contents tend to
      decrease with the increase of insoluble protein contents. However, lens protein
      was remarkably insolubilized in the lenses with cataracta brunescens, regardless
      of their exhibiting low or high glutathione contents. The relationship among
      protein aggregation, coloration and glutathione concentration in the cataractous
      lenses has been discussed from these findings.

PMID- 2214363
TI  - Histochemical studies of mitochondrial activities of cultured corneal endothelial
      cells of cat during wound-healing.
AB  - The corneal endothelial cells of the cat were cultured, and in 3 weeks the cells
      became confluent and formed a cell sheet. The cells were stained with rhodamine
      123 and nitroblue tetrazolium (NBT). The frequencies of cells stained by these
      two methods changed during the 3-week culture, but at the end of the culture the
      frequencies were stabilized at 58 +/- 3.9 (mean +/- SD) % for the rhodamine 123
      staining method and 35 +/- 3.7% for the NBT method. An oval wound of 600 X 400
      microns was made in the center of the cultured endothelial cell sheet, and the
      cell migration was observed by phase contrast microscopy. Six hours after the
      wounding, the cells began to migrate toward the center of the wounded area, and
      in 24 hours the denuded area was almost completely covered by migrated cells. In
      48 hours the wound was tightly covered by the migrated cells. One hour after the
      wounding, the cells in the wound margin were strongly stained by rhodamine 123,
      but not by NBT. The cultured cell sheet was divided into 4 concentric areas, ie,
      S1 was the center of the wound, S2 was the 100-microns-wide zone inside the
      original wound edge, S3 was the 100-microns-wide zone outside the original wound
      edge, and S4 was the 100-microns-wide zone outside the S3 zone. Topographical
      changes in rhodamine- and NBT-stained cells were observed over a 48-hour period.
      Rhodamine-positive cells increased in the S1 area, while a decrease occurred in
      the S2 and S3 areas. NBT-positive cells peaked at 12 hours after the wounding and
      decreased thereafter. It was concluded that the endothelial cells migrating to
      cover the wounded area showed a significant enhancement of mitochondrial
      activity, as indicated by the rhodamine 123 staining, but the succinic
      dehydrogenase activity revealed by NBT staining was rather suppressed.

PMID- 2214364
TI  - Characterization of water-insoluble proteins in normal and cataractous human
      lens.
AB  - The mechanism of lens protein aggregation with age and/or cataract formation was
      investigated using the peptides resolubilized from the insoluble protein fraction
      of normal and cataractous human lenses. The insoluble fraction was treated with
      reductants for cleaving disulfide bonds, or with chelating agents for removing
      calcium ions from the aggregates. This study demonstrates that the insoluble
      protein aggregates consist of an approximately 400 Kd complex, which is formed by
      the peptides with lower molecular weight. Protein aggregation in the cataractous
      lens might be caused by disulfide bonds whereas, in aging, the aggregate might be
      preferentially formed by calcium ion bridges rather than by disulfide bonds. It
      was observed that the aggregate from the cataractous lenses involved a peptide
      with a molecular mass lower by 1 Kd or 2 Kd than the peptides found in the normal
      lens. The composition of crystallins in aggregating proteins and their secondary
      structures were also different in the normal and the cataractous lenses. Such
      changes of molecular weight, conformation, and/or crystallin species in the lens
      may lead to the disintegration of the orderly arrangement of crystallins,
      resulting in the diffused reflection and lens opacities which are seen in senile
      cataract.

PMID- 2214365
TI  - Layer-by-layer analysis of macular diseases with objectively measured visual
      functions.
AB  - New methods were developed to measure layer-by-layer visual function in macular
      diseases objectively and quantitatively. A prototype apparatus for foveal cone
      densitometry that combines a modified fundus camera, independent optic pathways
      and a personal computer was assembled. Using a two-way density technique, the
      density and regeneration time of the foveal cone pigment can be measured
      objectively. Data on layer-by-layer visual function can be obtained when a-wave,
      b-wave and oscillatory potentials are recorded by focal macular
      electroretinography (FMERG). Since the retinal origin of each component is
      different, the comparative measurement of these components indicates which layer
      of the macula is disturbed. The simultaneous recording of FMERG and visual evoked
      response (VER) might be useful in determining which part of the visual pathway is
      impaired. These methods of measurement were reviewed and some examples of layer
      by-layer analysis were shown.

PMID- 2214366
TI  - Objective visual acuity testing by optokinetic nystagmus suppression.
AB  - The features of optokinetic nystagmus (OKN) suppression were investigated in
      various kinds of visual disturbances including those of optical, retinal, higher
      cortical and psychogenic etiologies. A new OKN suppression device was developed,
      modifying the principle of Ohm. Objective visual acuities were calculated using
      the visual angle of OKN suppression dots which were arranged in 12 steps
      corresponding to the visual acuity from 0.03 to 1.0 as determined by Landolt's
      method. A total of 286 cases were tested. Results were classified into four types
      of coincidence between objective and subjective visual acuities. The first group
      showed equivalent acuities. Normal subjects, cases of corneal opacity, aphakia
      with intraocular lens implantation and functional amblyopia belonged to this
      category. In the second group, objective acuity could not be determined because
      of fixation disturbance due to cortical lesion. The subjective acuity better than
      the objective acuity was obtained in the third group which consisted of cases
      with macular hole, central serous retinopathy and optic neuritis with central
      scotoma. Disturbance of foveal fixation to the OKN suppression dot seemed to be
      the reason for this difference in the acuities. In the fourth group, the
      objective acuity was better than the subjective acuity. This occurred in cases of
      psychogenic visual disturbance and malingerer.

PMID- 2214367
TI  - Effects of lidocaine, disopyramide and verapamil on the in vivo triggered
      ventricular arrhythmia in digitalized canine heart.
AB  - Triggered activity due to delayed after depolarization has been postulated to be
      one of the generation mechanisms of some arrhythmias, especially that due to
      digitalis toxicity. The present experiment demonstrates an in vivo canine model
      of ventricular arrhythmias that were triggered by ventricular stimulation during
      administration of low doses of ouabain. Ventricular ectopic beats could be
      induced by stimulation before the occurrence of spontaneous ventricular
      arrhythmia, and the coupling interval of the first ectopic beat was shortened as
      the stimulation rate increased. Verapamil (0.2 mg/kg, i.v.) was ineffective in
      suppressing the occurrence of the triggered ventricular ectopic beats, but
      lidocaine (1 and 3 mg/kg, i.v.) and disopyramide (0.3 and 1 mg/kg, i.v.) were
      effective in suppressing these digitalis-induced triggered ventricular ectopic
      beats in a dose-dependent fashion.

PMID- 2214368
TI  - Evaluation of drugs for treatment of urinary bladder dysfunction in conscious
      rats with intact pelvic nerve and after resection of the left pelvic nerve.
AB  - We studied the effects of drugs used for treatment of bladder dysfunction in
      conscious rats with intact pelvic nerves and also in rats at one or two weeks
      after nerve decentralization on the left side. Bladder contraction accompanying
      micturition was continuously induced by infusion of solution at a constant rate.
      When the effects of oxybutynin (3 mg/kg, i.p.) and terodiline (3 and 10 mg/kg,
      i.p.) on the cystometrogram were studied for about 2 hr, these drugs shortened
      and then prolonged the micturition interval (MI), but atropine (1 and 5 mg/kg,
      i.p.), butylscopolamine (20 mg/kg, i.p.) and nifedipine (3 mg/kg, i.p.) exhibited
      only a shortening effect on the MI. After injection of oxybutynin (10 mg/kg,
      i.p.), solution dribbled from the urethra for about 30 min. Terodiline (3 mg/kg)
      caused ischuria in the rats one week after resection of the left pelvic nerve,
      but not in the rats two weeks after surgery. Physostigmine (0.3 mg/kg, i.p.)
      improved micturition in the rats one week after surgery, but the effect was not
      evident in the rats with intact pelvic nerves. It was found that the drugs used
      for treating failure to store or expel urine exhibited a beneficial effect on
      micturition in rats with intact pelvic nerves and also in rats one week after
      nerve decentralization, respectively.

PMID- 2214369
TI  - Physical dependence potential of an enkephalin analog, EK-399, in rats.
AB  - The physical dependence potential of Tyr-D-Met(O)-Gly-EtPhe-NHNHCOCH3.AcOH (EK
      399), a novel enkephalin analog with a potent analgesic effect, was assessed in
      rats. The animals were given EK-399 (0.008, 0.032, 0.125, or 0.5 mg/kg), morphine
      (0.125, 0.5, or 2 mg/kg), pethidine (2 or 8 mg/kg), or pentazocine (2 or 8 mg/kg)
      every hour through an implanted intravenous cannula. After 3 days of treatment,
      precipitated withdrawal tests were conducted: naloxone (5 mg/kg) was administered
      subcutaneously. Rats treated with morphine showed withdrawal signs such as
      hyperirritability, salivation, diarrhea, and weight loss. Rats treated with
      pethidine, pentazocine, or EK-399 showed similar signs, but they were less
      evident than those in morphine-treated rats. In abrupt withdrawal tests after 7
      days of treatment, rats treated with morphine, pethidine, or pentazocine showed
      weight loss, whereas rats treated with EK-399 showed little or no weight loss. In
      substitution tests, EK-399 suppressed the withdrawal signs in morphine-dependent
      rats, and vice versa. These results show that EK-399 has a morphine-like physical
      dependence potential that is weaker than that of morphine, pethidine, or
      pentazocine in rats.

PMID- 2214370
TI  - Specific metabolic activation of FK973, a new antitumor antibiotic, in L1210
      leukemia cells.
AB  - FK973 (11-acetyl-8-carbamoyloxymethyl-4-formyl-14-oxa-1,11-
      diazatetracyclo[7.4.1.O2,7O10,12]tetradeca-2,4,6-trien -6,9-diyl diacetate), a
      new substituted dihydrobenzoxazine, has potent cytotoxic and antitumor effects on
      murine and human tumors in vivo and in vitro, and forms interstrand DNA-DNA and
      DNA-protein cross-links after being activated in the cytoplasm. In this study,
      the mechanism(s) by which FK973 is activated in the cytoplasm of in vitro
      cultured murine L1210 leukemia cells were studied using compounds that affect
      monoamine oxidase. When the cells were incubated with an antitumor drug and the
      compounds, tranylcypromine, benzylamine, phenylethylamine and tyramine of the
      many compounds tested reduced the cytotoxicity of FK973, but not that of
      mitomycin C or cisplatin. These compounds also suppressed the formation of
      interstrand DNA-DNA cross-links with FK973 in the cells, but did not suppress
      cross-links with mitomycin C or cisplatin. The incorporation of 14C-FK973 into
      the cells was not affected by these compounds. The results suggest that FK973 is
      activated by some drug-metabolic system(s) in the cytoplasm to form interstrand
      DNA-DNA cross-links, and induces cytotoxicity against the cells. This activation
      of FK973 in the cytoplasm is discussed in connection with the drug-metabolic
      system(s) in relation to the structures of the compounds.

PMID- 2214371
TI  - Effects of intracerebroventricular administration of magnesium sulphate on blood
      pressure and heart rate in anesthetized normotensive and hypertensive rats.
AB  - Intracerebroventricular (i.c.v.) injection of magnesium sulphate (MgSO4:2.5, 5
      and 10 mumol in 5 microliters) decreased blood pressure and heart rate in both
      anesthetized normotensive (WKY) and hypertensive rats (SHR). The effects were
      greater in WKY than in SHR. Moreover, a pretreatment with hexamethonium (2 mg/kg,
      i.v.) significantly blunted the hypotensive and bradycardic effects induced by
      i.c.v. injection of 10 mumol of MgSO4 in both WKY and SHR. Our data suggest that
      MgSO4 produces hypotensive and bradycardic effects when injected i.c.v. in both
      WKY and SHR.

PMID- 2214372
TI  - Effects of antihypertensive drugs on experimental cerebral ischemia in
      spontaneously hypertensive rats.
AB  - The effects of antihypertensive drugs on ischemic cerebral damage were
      investigated using the bilateral carotid artery occlusion (BCAO) model in SHR.
      Oral budralazine and nifedipine, at doses that increased cerebral blood flow
      (CBF) in SHR in our previous study (Tanaka, S. et al., Folia Pharmacol, Japan,
      87, 1986), significantly improved cerebral energy failure after the BCAO, but
      prazosin which does not increase CBF had no effect on the energy failure. These
      results suggest that the amelioration by these antihypertensive drugs of the
      energy failure after the BCAO results from its CBF-increasing effects in SHR.

PMID- 2214373
TI  - Inhibitory modulation of the reflex tracheal constriction induced by afferent
      vagal stimulation.
AB  - Afferent cervical vagal electrical stimulation caused a reflex tracheal
      constriction. Atropine changed the tracheal constriction into a tracheal
      dilatation that was almost inhibited by propranolol. In the hypertonic trachea
      with 5-hydroxytryptamine, a reflex dilatation following a constriction was
      observed by afferent vagal stimulation. The reflex dilatation was inhibited about
      50% by propranolol and was abolished by hexamethonium. These results suggest that
      the adrenergic and nonadrenergic inhibitory innervations may mediate the reflex
      tracheal dilatation, especially in a hypertonic tracheal condition.

PMID- 2214374
TI  - Reduced erythrocyte deformability in anemic rats with adjuvant arthritis.
AB  - Erythrocytes in anemic rats with adjuvant arthritis (AA) were less deformable
      compared with normal rats. Swelling of the spleen was noticed in anemic rats with
      AA. The treatment of anemic rats with recombinant human erythropoietin (r-HuEPO;
      30 and 100 U/kg, i.v., for 5 days) resulted in a normalization of both the anemia
      and erythrocyte deformability. It is suggested that erythrocytes with reduced
      deformability may be sequestered by endothelial slits of the spleen, which may
      play a causative role in the anemia in rats with AA.

PMID- 2214375
TI  - Dissociation between sympathetic purinergic response and ATP response in the
      mesenteric artery of the dog.
AB  - In the presence of prazosin and propranolol, electrical transmural stimulation of
      isolated dog mesenteric artery produced a sympathetic purinergic contraction,
      which was followed by a relaxation in PGF2 alpha-contracted arteries. Such
      purinergic responses were mimicked by brief exposure to alpha, beta-methylene ATP
      (alpha, beta-Me ATP) and were completely inhibited after desensitization of P2x
      purinergic receptors. However, exogenous ATP predominantly evoked a relaxation in
      PGF2 alpha-contracted artery. These results suggest that the sympathetic
      purinergic response may be caused by a P2x-purinergic receptor-selective
      mechanism or substance, rather than ATP.

PMID- 2214376
TI  - Greater contraction is induced by pilocarpine than by carbachol at the same
      levels of cytosolic Ca2+ concentration in isolated longitudinal muscle of guinea
      pig ileum.
AB  - Pilocarpine, which activates propylbenzilylcholine mustard (PrBCM)-sensitive
      cholinoceptors, and carbachol, which activates PrBCM-resistant ones, induced an
      increase in cytosolic Ca2+ concentration ([Ca2+]i) and tension development in a
      concentration dependent manner in isolated longitudinal muscle of guinea pig
      ileum. A positive correlation between [Ca2+]i and tension development due to both
      of the agonists was noted. The slope of regression line between two values for
      pilocarpine was steeper than that for carbachol, suggesting that pilocarpine
      induced carbachol. Thus an activation of PrBCM-sensitive cholinoceptors might
      enhance the Ca2(+)-sensitivity of the contractile elements.

PMID- 2214377
TI  - [General concepts and the history of chronic obstructive pulmonary disease].
AB  - There is no general agreement on the concepts of chronic obstructive pulmonary
      disease (COPD) yet in Japan, although there have been significant advances in the
      understanding of its concepts in the United States and Europe. The purpose of
      this presentation as the opening remark to this panel discussion is to review the
      concepts and history of chronic obstructive pulmonary disease (Tables 1, 2), and
      also to summarize the general concepts concerning COPD in Japan at present. More
      than 30 years ago, a Ciba Guest symposium first proposed the main subdivisions of
      chronic non-specific lung disease (CNSLD), consisting of chronic bronchitis and
      generalized obstructive lung disease (GOLD). Many papers addressed this theme
      focusing on the definition and concepts of COPD for a long period after the Ciba
      Guest Symposium. The ATS and ACCP joint committee on pulmonary nomenclature
      (1975) reported that the term of COPD refers to diseases of uncertain etiology
      characterized by persistent slowing of airflow during forced expiration, and the
      committee recommended that chronic obstructive bronchitis or chronic obstructive
      emphysema be used, whenever possible. However, in many patients it is still
      difficult determine what extent the airway obstruction result from emphysema and
      to what extent it results from an accompanying chronic obstructive bronchitis, as
      Burrows described. Fishman (1980) and Burrows (1981) suggested that if the
      patient is thought to have a combination of chronic obstructive bronchitis and
      pulmonary emphysema, the case should be so diagnosed.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2214378
TI  - [The relationship between alveolar apertures and alveolar size and smoking
      history in humans, and experimental studies on air pollutants].
AB  - Using surgical specimens from patients with lung tumor, alveolar apertures and
      alveolar sizes were quantitatively assessed using scanning electron microscopy.
      Compared with smoking habits, increased apertures, defined as alveolar
      destruction were observed in patients smoking more than 35 years, whereas
      alveolar size was increased in patients, with a 15-year smoking history.
      Experimental studies with exposure to NO2, O3 and H2SO4 mist showed that exposure
      of NO2 and H2SO4 could induce epithelial injury such as disappearance of cilia in
      the central airways.

PMID- 2214379
TI  - [Comparison of immunological aspects in diffuse panbronchiolitis and cystic
      bronchiectasis].
AB  - We examined immunological parameters in 35 patients with diffuse panbronchiolitis
      (DPB) and 20 patients with cystic bronchiectasis (CBE) to analyze the relation
      between local immune responses and subsequent clinical courses. Patients with DPB
      showed more impaired cell-mediated immunity than those with CBE. On analysis of
      peripheral blood lymphocytes from DPB and CBE, the significant increase in CD4
      positive T-cells and Fc alpha R positive T-cells and decrease in Leu-11 positive
      cells were recognized. The observation of humoral immunity revealed a tendency
      for local immunity to be accelerated such as increases of IgA and IgG2 in both
      diseases. The titer of serum cold agglutinin and rheumatoid factor were elevated
      in DPB. However, these fluctuations of immunological factors were normalized
      according to improvement of inflammatory processes by chemotherapy. The analysis
      of the distribution of lymphocyte subsets in lung tissues taken from DPB showed
      that CD4 positive T-cells always overwhelmed CD8-positive T-cells and that
      secretary IgA-positive B-cells were abundant in bronchioles. On the other hand,
      bronchiolitis was recognized in about 80% of cases with CBE, although to a less
      striking degree than DPB. Lymphocyte subsets were similarly distributed in the
      respiratory tract. DPB and CBE could be considered as the same disease entity in
      the spectrum of chronic respiratory tract infection based on mucociliary
      disorder. Sinusitis and immunological abnormalities are often complicated by both
      diseases. However, precise analysis demonstrated that there are some obvious
      differences of systemic and local immune responses between DPB and CBE, probably
      due to the conditions of each diseases such as primary focus, severity and
      causative microorganism.

PMID- 2214380
TI  - [Chronic bronchitis and related disorders].
AB  - Chronic bronchitis was a disease which attracted much attention in the U.K. in
      the 1950's. It was classified into three forms known as simple chronic
      bronchitis, recurrent or mucopurulent bronchitis, and chronic obstructive
      bronchitis and it was thought that the disease progressed from one form to the
      next in accordance with their order as listed here. Later, however, it was
      realized that the disease did not progress according to this order and that
      chronic bronchitis actually included three kinds of the disease. Furthermore, in
      the U.K., with the prohibition of the use of coal and the reduction of air
      pollution and with the decline of infectious disease in child age, recurrent or
      mucopurulent bronchitis underwent an extreme reduction. Chronic obstructive
      bronchitis is known to be caused by smoking and is now called chronic bronchitis
      and emphysema or COPD. Simple chronic bronchitis may in fact be only a simple
      physical response to smoking. Now in Japan the disease called chronic bronchitis
      is often recognized when written on receipts for health insurance, but patients
      of chronic bronchitis as were seen in the U.K. in the 1950's are extremely rare.
      Diffuse panbronchiolitis is seen in Japan but is a disease not found in the West.
      Diffuse bronchiectasis and its differentiation become the point of question for
      this disease. With the effectiveness of erythromycin, we can expect a decline in
      the number of patients and an improvement in prognosis.

PMID- 2214381
TI  - [The epidemiology of obstructive lung diseases].

PMID- 2214382
TI  - [Evaluation of diffuse lung uptake of 201Tl in bronchopulmonary diseases].
AB  - 201Tl scintigraphy was performed in various bronchopulmonary diseases. Applying
      semiquantitative and visual assessments of grade of 201Tl was observed in various
      broncho-pulmonary diseases with multiple or numerous abnormal shadows in the lung
      fields, and obvious lung uptake was also shown even in some cases with few or no
      abnormal shadows. Positive results of moderate and marked lung uptake of 201Tl
      more than 60.0% were obtained in diffuse interstitial pneumonia, hypersensitivity
      pneumonitis, silicosis, the disseminated type of pulmonary tuberculosis and
      primary lung cancer. The ratio of radioactivity of the lung (maximum) to the
      upper mediastinum was 1.04 +/- 0.24 in healthy controls, and more than 2.0 in
      diffuse interstitial pneumonia, hypersensitivity pneumonitis and silicosis. The
      ratio of radioactivity of the right lung to the administered dose of 201Tl was
      1.5 +/- 0.9% in healthy controls, and more than 3.0% in diffuse interstitial
      pneumonia, silicosis, the disseminated type of pulmonary tuberculosis and primary
      lung cancer. Lung uptake of 201Tl was diffuse, homogeneous and marked in diffuse
      interstitial pneumonia and hypersensitivity pneumonitis, while it was scattered
      and slight in chronic obstructive lung diseases. 201Tl scintigraphy seems to be
      useful for detecting interstitial disorders of the lung including edema,
      inflammatory and granulomatous changes, especially in cases with slightly
      abnormal or normal chest X-ray films.

PMID- 2214383
TI  - [Correlation between slopes of pulmonary blood flow-driving pressure curve and
      routine pulmonary function].
AB  - In 91 preoperative cases of lung cancer, an attempt was made to correlate the
      slopes of pulmonary blood flow-driving pressure curve (delta DP/delta CI), as
      constructed from unilateral pulmonary arterial occlusion (UPAO) test values and
      pulmonary blood flow fraction values as measured by scintigraphy, with total
      pulmonary vascular resistance index (TPVRI) and pulmonary vascular resistance
      index (PVRI) and routine pulmonary function. FVC and FEV per unit body surface
      (BSA) were found to correlate, to same degree, with delta DP/delta CI, TPVRI and
      PVRI (p less than 0.05). delta DP/delta CI correlated significantly with FRC/BSA,
      whereas TPVRI and PVRI did not. 3) The inverse of the cardiac index (1/cardiac
      index) was shown to significantly correlate with TPVRI and PVRI (r = 0.64, 0.48),
      but poorly with delta DP/delta CI (r = 0.32). These results suggest that delta
      DP/delta CI might possibly provide a more useful quantitative index for the
      pulmonary vascular bed than TPVRI and PVRI.

PMID- 2214384
TI  - [Treatment of spontaneous pneumothorax by electrocoagulation via a fiberoptic
      bronchoscope with a hysteroscope irrigation outer sheath as a thoracoscope].
AB  - Since 1981 in Yamagata Prefectural Central Hospital, the authors performed
      electro-coagulation therapy for air leakage from bullae (blebs) via a rigid
      thoracoscope in 31 patients with spontaneous pneumothorax. Among these patients,
      this treatment was unsuccessful in 14 patients (45.2%) because of 5 multiple or
      giant bullae and 9 cases in which it was impossible to visualize the bullae in
      the mediastinum or because of pleural adhesion. In order to widen the visual
      field and increase the mobility of the thoracoscope, we employed a fiberoptic
      bronchoscope with a hysteroscope outer sheath used for irrigation as a flexible
      thoracoscope. This method makes it possible to examine both mediastinal pleura
      and adhesive pleural space, and to electrocoagulate bullae which cannot be
      visualized by a rigid thoracoscope. It was possible to visualize the blebs in all
      13 cases with spontaneous pneumothorax in which this examination was attempted.
      This therapeutic procedure causes the patients less pain and the hospitals more
      economical because no new thoracoscope is necessary. This method of thoracoscopic
      therapy of spontaneous pneumothorax using a fiberoptic bronchoscope is more
      successful, effective, economical and painless than by rigid thoracoscope and
      should be attempted before thoracotomy.

PMID- 2214385
TI  - [The role of chemotactic factors in the pathogenesis of sarcoid granuloma
      formation].
AB  - There is evidence suggesting that macrophages and epithelioid cells, predominant
      cells in sarcoid granuloma, are derived from circulating monocytes on a gradient
      of chemotactic factors between the lesion and the circulation. A previous study
      by the author showed that epithelioid cells and lymphocytes from sarcoid
      granulomas released chemotactic factors to attract blood-derived mononuclear
      cells. The present study was undertaken to further explore the role of
      chemotactic factors in the pathogenesis of sarcoid granuloma formation. Twenty
      two sarcoid patients, 14 patients with active pulmonary involvement and 8
      patients without pulmonary involvement, were lavaged and the bronchoalveolar
      lavage (BAL) fluids were evaluated for chemotactic activity. Chemotactic activity
      was detected in BAL fluid from sarcoid patients with active pulmonary disease,
      but not from those without pulmonary involvement. Chemotactic activity for
      mononuclear cells in the BAL fluid correlated with the percentage of lymphocyte
      numbers (r = 0.702, p less than 0.05) and number of CD4+ lymphocytes (r = 0.796 p
      less than 0.02) present in the BAL fluids, which has been proved to reflect
      disease activity. Chemotactic activity was independent of the amounts of albumin
      in BAI fluid (r = 0.271, p less than 0.10). Chemotactic factors in BAL fluid were
      eluted in 4 different regions on molecular sieving and were stable at 56 degrees
      C for 30 min. However, chemotactic activities were abolished completely by
      treatment at 100 degrees C for 30 min or trypsinization. Our observations suggest
      that chemotactic activity in BAL fluid from sarcoid patients reflects the disease
      activity contributing to formation of sarcoid granulomas.

PMID- 2214386
TI  - [Nutritional assessment of chronic pulmonary emphysema and the significant
      relation of malnutrition to pulmonary function and respiratory muscle function].
AB  - We assessed nutritional status in 30 patients with pulmonary emphysema and 60
      healthy controls. The relationship between nutritional status, pulmonary function
      and respiratory muscle function was also studied. Anthropometric measures,
      visceral proteins such as PA and RPB, and the Fischer ratio (BCAA/AAA), an index
      of imbalance of amino acids were significantly lower in the patients. The
      incidence of moderately malnourished patients with less than 80% of IBW was 40%.
      The incidence of hyporetinol-binding protein was 40%. 48% of the patients were
      found to show an amino acid imbalance. These findings suggested that protein
      energy malnutrition in association with amino acid imbalance occurred commonly in
      patients with pulmonary emphysema. FEV1% correlated significantly with some
      anthropometric indices and the Fischer ratio. Respiratory muscle function,
      assessed by P1 max, correlated significantly with some anthropometric indices and
      grasp strength. These results suggested that the degree of airway obstruction and
      respiratory muscle function was associated with malnutrition characterized by the
      reduction of the Fischer ratio.

PMID- 2214387
TI  - [Ferruginous bodies in the lungs of the general population during a 45-year
      period and mineralogical examination].
AB  - In order to determine the level of asbestos pollution in the lungs of members of
      the general population in and around Tokyo, the incidence of ferruginous bodies
      in autopsied or resected lungs during 5 periods over the 45 years from 1937 to
      1981 was studied by a light microscopy. Core fibres, after removal of their
      ferruginous coatings with oxalic acid, and uncoated fibres were analyzed using a
      scanning electron microscope equipped with a Kevex energy-dispersive X-ray
      spectrometer. The incidence of ferruginous bodies in 5 g (wet) of digested lung
      tissue was shown to be 10% in period I (1937-1941), 18% in period II (1947-1951),
      70% in period III (1958-1963), 74.4% in period IV (1970-1973) and 81.0% in period
      V (1980-1981). The major types of core fibres of ferruginous bodies were found to
      be asbestos, including amosite, crocidolite, chrysotile and the tremolite
      actiolite series, but a small number of fibers of materials other than asbestos
      were also detected. In contrast, a large number of short fibers less than 5
      microns in length in 1 g of wet lung tissue were classified as belonging to Mg +
      Si fibers (the ratio of Mg to Si components being 30% or over) and presumed to be
      chrysotile. Thus an annual increase in asbestos deposition in lungs of people
      living in and around Tokyo has been demonstrated and fine chrysotile fibers less
      than 5 microns in length seem to be the main type of deposited fibers.

PMID- 2214388
TI  - [Foreign body-induced bronchial actinomycosis with severe stenosis that must be
      distinguished from lung cancer].
AB  - A 59-year-old woman who accidentally swallowed a foreign body (fish bone) 9
      months ago was admitted to our hospital because of cough, hemosputum and sleep
      wheezing for two months. Chest roentgenograms and chest CT scanning revealed
      severe stenosis of the right lower lobe bronchus and truncus intermedius,
      suggesting lung cancer. Bronchoscopic examination revealed an intrabronchial
      foreign body. The biopsy specimen from granulation tissue revealed bronchial
      actinomycosis. The foreign body was removed bronchoscopically after an extensive
      chemotherapy with penicillin G (for actinomycosis) and prednisolone (for
      granulation tissue of the bronchus). This was considered to be a rare case of
      bronchial actinomycosis without a pulmonary lesion produced by a foreign body.

PMID- 2214389
TI  - [A case of adult T-cell leukemia with diffuse panbronchiolitis].
AB  - We have reported an adult T-cell leukemia (ATL) patient with a 3-year history of
      diffuse panbronchiolitis (DPB). The patient, a 62-year-old woman, had been
      complaining severe cough and purulent sputa for 2 years. In 1984, she was
      admitted to Saga Medical School, where her clinical diagnosis, DPB, was made. One
      year later, it was revealed that she suffered from ATL, confirmed by the presence
      of ATL cells in peripheral blood and anti-ATLA antibody. This case suggests that
      ATL may play an important role in the pathogenesis of some DPB patients.

PMID- 2214390
TI  - [A case of bronchiolitis obliterans organizing pneumonia in a patient with
      rheumatoid arthritis].
AB  - A 54-year-old man with rheumatoid arthritis visited his general practitioner
      because of fever and cough. Chest X-ray showed an infiltrative shadow in the
      right lower field. Antibiotic treatment was not effective, and the specimens
      obtained by transbronchial lung biopsy was not diagnostic. The patient was
      transferred to our hospital for further examination and treatment. Previously he
      had been treated with prednisolone in the knee joint for rheumatoid arthritis.
      Open lung biopsy was performed. The specimen obtained showed bronchiolitis
      obliterans organizing pneumonia (BOOP) histologically. The patient recuperated
      and the chest X-ray shadow decreased with no therapy except the previous
      treatment with prednisolone.

PMID- 2214391
TI  - [A case report of mediastinal malignant lymphoma with long survival following
      combination chemotherapy using adriamycin, vincristine and cyclophosphamide].
AB  - Mediastinal B-cell malignant lymphoma of a 22-year-old female was successfully
      treated by combination chemotherapy including Adriamycin, Vincristine and
      Cyclophosphamide. She suffered from dyspnea and axillary tumor in September 1984.
      Roentgenological examination revealed a large anterior mediastinal tumor. Biopsy
      of the axillary tumor yielded a diagnosis of metastatic undifferentiated
      carcinoma from thymus by hematoxylin and eosin. Radiotherapy and chemotherapy
      including CDDP and ACNU resulted in a symptom-free period of only 2 months.
      Superior vena cava syndrome and massive pleural effusion recurred. Salvage
      chemotherapy including Adriamycin, Vincristine and Cyclophosphamide resulted in
      rapid therapeutic effect. Six courses of chemotherapy were administered, and she
      is alive and well 4 years after the first salvage chemotherapy. A definitive
      diagnosis of B-cell lymphoma was made after review of biopsy specimens using
      immunohistochemical procedures. To select adequate treatment for mediastinal
      malignant lymphoma, reliable diagnostic procedures including immunohistochemistry
      are needed. Intensive chemotherapy with appropriate drugs may obtain good
      response even in advanced cases, such as this.

PMID- 2214392
TI  - [A case of essential thrombocythemia with pulmonary hypertension and bilateral
      pleural effusions].
AB  - A 79-year-old woman was admitted with general fatigue. Chest roentgenogram showed
      diffuse reticular shadows and bilateral pleural effusion. Peripheral blood
      studies revealed an elevation of platelet count (203.3 X 104/mm3). The case was
      diagnosed as essential thrombocythemia and treated with ACNU. The platelet count
      decreased. Bilateral pleural effusions increased gradually and their
      characteristics changed from bloody exudate to transudate. Biopsy of her pleura
      and thoracoscopy were carried out without significant results. Later, systemic
      edema, which suggested right heart failure, developed. The diagnosis of pulmonary
      hypertension and right heart failure was made by echocardiogram and right cardiac
      catheterization. Because perfusion scan of the lung revealed some perfusion
      defects, complication of pulmonary embolism was suspected. Bilateral pleural
      effusion and pulmonary artery pressure decreased with treatment by nifedipine,
      furosemide and isosorbide dinitrate. This is the first case report of essential
      thrombocythemia, pulmonary hypertension, right heart failure and bilateral
      pleural effusion.

PMID- 2214393
TI  - [Second serogroup of Legionella pneumophila isolated from a patient with
      fulminant pneumonia].
AB  - A 67-year-old female was admitted to our hospital, because of high fever and dry
      cough. She had undergone semiradical hysterectomy and radiation therapy for
      carcinoma of the uterine cervix one year previously. Her chest roentgenograms on
      admission showed lobar consolidation of the left upper lobe. Antibiotics were
      administered but her general condition and pulmonary consolidation did not
      improve. As Legionellosis was highly suspected, we performed bronchoscopic
      examinations. Bronchial mucosa was almost normal with no secretion, and
      Legionella was isolated from the specimen obtained bronchoscopically. Six days
      later, L. pneumophila serogroup 2 was isolated and identified from an
      intratracheal aspiration, and serological diagnosis was made by indirect
      immunofluorescence antibody. We could also detect the bacteria in the BALF by
      immunofluorescence microscopy and in the tissue of the TBLB specimen with the ABC
      method.

PMID- 2214394
TI  - [A case report of endobronchial lipoma].
AB  - Endobronchial lipomas are rare benign tumors of the lung. Nineteen cases have
      been reported in Japan. We present a case of endobronchial lipoma obstructing the
      left B4b and chronic saccular bronchiectasis throughout the left upper lobe. A 42
      year-old man, 174 cm tall and weighing 47 kg, was referred for investigation of
      an abnormal chest X-ray film. He had a history of pneumonia and pyothorax in
      infancy. The chest X-ray film showed linear densities and ill-defined, irregular
      opacities in the upper-middle lung field. CT scan and tomographic studies showed
      multiple cystic spaces in the left upper lobe in which the volume was diminished.
      An angiogram of the left bronchial artery showed peripheral hypervascularity in
      the left upper lobe and systemic-to-pulmonary artery shunt. Fiberoptic
      bronchoscopy revealed a smooth, pink mass obstructing B4b. Biopsy specimens were
      insufficient for histological diagnosis. Preoperatively, an inflammatory polyp in
      association with chronic saccular bronchiectasis was suspected. Left upper
      lobectomy was performed on January 13, 1989. Gross examination of the resected
      specimen showed a pedunculated polypoid mass, 1.5 X 1.2 X 0.6 cm, attached to the
      bronchial mucosa of B4bii and saccular ectatic changes of bronchi not only in the
      lingular division but also in upper division. Microscopically, the endobronchial
      tumor consisted of mature adipose tissue covered with columnar bronchial
      epithelium. The fat was fairly well localized in the submucosa, but was not
      encapsulated and did not enclose glands or smooth muscle fibers. The
      endobronchial lipoma was thought to originate in the bronchus of chronic saccular
      bronchiectasis.

PMID- 2214395
TI  - [A case of plasma cell granuloma showing rapid growth and elevation of serum
      CEA].
AB  - A 67-year-old man was admitted with complaints of cough and hemosputum. Chest X
      ray examination revealed enlargement of a coin lesion in the right upper lobe,
      which had been pointed out about one year previously and had been followed up.
      Although the histology of TBLB specimens and the cytology of sputum and materials
      showed no malignancy and chest CT showed calcification at the edge of the coin
      lesion, the mass shadow in the right upper lobe rapidly enlarged and the serum
      level of CEA gradually elevated. Therefore, it seemed to be impossible to neglect
      the possibility of lung cancer and right upper lobectomy was performed. The
      dissected specimen was diagnosed as plasma cell granuloma. Because the histology
      of the plasma cell granuloma is multifarious, TBLB shows various results. It is
      therefore difficult to diagnose such inflammatory tumors by TBLB. The increase of
      the mass shadow in size and the elevated serum level of CEA made it difficult to
      diagnose this case.

PMID- 2214396
TI  - [A case of invasive thymoma displaying endobronchial polypoid growth].
AB  - A 58-year-old woman was admitted due to an abnormal shadow on chest X-ray film
      and two episodes of hemoptysis during the past two years. Chest radiography
      showed a mass with calcification in the left upper lobe of the lung. A white
      polypoid lesion in left B3b + c bronchus was discovered by fiberoptic
      bronchoscopy. Biopsy specimen of the polypoid lesion demonstrated fungi like
      aspergilli in the necrotic tissue. We suspected pulmonary aspergillosis combined
      with old tuberculosis and treated with antifungal and antituberculous drugs.
      After nine months, however, we recognized that the mass had become larger
      radiologically. A polypoid tumor with a brown, glossy surface in the left B3
      bronchus was again noted endoscopically. Histologic findings of the biopsy
      specimen obtained from this tumor were suggestive of thymoma. Thymectomy and left
      upper lobectomy were performed. The cross-section of the surgical specimen
      revealed that the tumor extended not only in the mediastinum but also in the
      pulmonary parenchyma with polypoid growth into the lumina of bronchi.
      Microscopically, the tumor was an invasive thymoma composed of both epithelial
      and lymphocytic elements.

PMID- 2214397
TI  - [A case report of psittacosis and chlamydial isolation from a dead pet bird].
AB  - A 33-year-old previously healthy woman was seen at this hospital after a week of
      fever and nonproductive cough. A roentgenogram of the chest showed consolidation
      in the left upper and middle lung fields. Transbronchial lung biopsy from left S1
      + 2 revealed an increase of mononuclear leukocytes within the interstitial spaces
      and slight cell infiltration with in the alveoli. Bronchoalveolar lavage cellular
      constituents showed 47% alveolar macrophage, 38% lymphocytes and 15% neutrophils.
      She had kept a parakeet, which died just after her illness. We could isolated
      organisms from the liver, spleen, kidney, lung, heart and bowel of her pet bird
      revealing C. psittaci by Giemsa stain, three days after it was buried in the
      ground. She was given three hundred mg of ofloxacin per day orally for fourteen
      days and the clinical effect was good. The in vitro activity of ofloxacin was
      0.75 microgram/ml.

PMID- 2214398
TI  - [Bronchiectasis with normal paranasal sinus roentgenogram].
AB  - Bronchiectasis has come to be considered as a type of sinobronchial syndrome in
      Japan, but there exist some cases without chronic sinusitis. We studied the
      clinical features of 14 cases of bronchiectasis with definitely normal paranasal
      sinus roentgenogram, diagnosed during the past ten years. There were eleven
      middle-aged women and three men. Ten patients (71%) complained of hemoptysis, one
      (7%) of dry cough, one (7%) of productive cough, and the two (14%) had no
      complaint. In seven patients (50%) CT and bronchography showed localized
      cylindrical bronchiectasis in the right middle lobe and/or left upper lobe
      lingular division. They were considered to be middle lobe lingular syndrome.
      Three patients (22%) with localized varicose or cystic bronchiectasis had a
      history of pneumonia or pertussis in their infancy, so their bronchiectasis were
      considered secondary to infantile bronchopulmonary disease. Two patients (14%)
      had diffuse cystic bronchiectasis and were almost asymptomatic. They might be
      cases congenital bronchiectasis or Williams-Campbell syndrome. Pulmonary function
      tests were normal in most of the cases and sputum culture revealed no cases of
      persistent bacterial infection. These clinical features are quite different from
      those of bronchiectasis reported as sinobronchial syndrome, in which chronic
      productive cough, poor pulmonary function, persistent bacterial infection, etc.
      are significant. So we conclude that there are two distinct groups in
      bronchiectasis.

PMID- 2214399
TI  - [Membranous and respiratory bronchiole disease in patients with normal air-flow
      and mild air-flow limitation].
AB  - In order to evaluate the role of membranous (MB) and respiratory bronchioles (RB)
      in patients with normal and mild airflow limitation, we quantitatively assessed
      the pathological change of MB, RB and alveoli in the pathological specimens of 42
      patients who required surgery for removal of a solitary pulmonary nodule. We also
      measured the destructive index (DI), to evaluate the destruction of alveolar
      walls. High resolution CT scan and pulmonary function tests were performed within
      1 month of resection. Results of the pulmonary function tests correlated with
      pathological changes of RB better than with MB. Significant correlation between
      the emphysema score of resected lung and the pathological change of MB and RB was
      observed. There was also significant correlations between the CT score or DI and
      RB changes. However, there was no significant correlation between the CT score or
      DI and the change of MB. There were significant differences between smokers and
      nonsmokers in the results of pulmonary function test, pathological changes of RB
      and severity of emphysema. We postulate that RB is responsible for subtle
      functional abnormalities in the early stages of chronic obstructive pulmonary
      disease.

PMID- 2214400
TI  - [Airway occlusion pressure during sleep in normal subjects].
AB  - Sleep has been shown to be associated with a variety of changes in ventilatory
      mechanics. Recently, airway occlusion pressure (P0.1) has come to be widely used
      as an index of the neural output of the respiratory center, and is considered to
      be independent of lung mechanics. The purpose of this study was to analyze neural
      output of the respiratory center during sleep, utilizing an airway occlusion
      pressure procedure. Nine normal male subjects, 19 to 32 yrs of age, were used.
      Each subject was fitted with a face mask, and the area between the mask and the
      face was sealed with medical silicone rubber. They breathed through the mask,
      which was attached to a "J" valve that separated the inspiratory from the
      expiratory line. A radio-controlled camera shutter was joined to the "J" valve on
      the inspiratory line. The volume of dead space of this system was about 150 ml.
      Inspiratory pressure developing in the oral cavity was measured using a pressure
      transducer and a photocorder. Flow rate, tidal volume (VT) and inspiratory time
      (TI) were measured using a hot wire flow meter. Airway occlusion pressure (P0.1)
      was measured 0.1 second after the onset of the inspiratory effort by occluding
      the shutter on the inspiratory line during expiration. The onset of inspiration
      and expiration was detected by changes in airway pressure. Great care was taken
      to make the subjects as comfortable as possible during the procedure. Continuous
      recordings were made on a polygraph recorder of EEG, EOG, EMG and
      cardiorespiratory variables. Sleep stages were determined using the standard
      criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214401
TI  - [Variety of neutrophil chemotactic factors in the respiratory tracts in patients
      with respiratory diseases].
AB  - We measured NCF activity and examined the characteristics of NCF in
      bronchoalveolar lavage (BAL) fluid, sputum and culture media of alveolar
      macrophages. Several kinds of NCF were detected in BAL fluid obtained from normal
      volunteers, and at least a part of these NCF was thought to be derived from
      alveolar macrophages. NCF activity, especially complement-derived NCF, was
      increased in BAL fluid and in sputum obtained from patients with chronic
      respiratory tract infection. In patients with idiopathic interstitial pneumonia,
      alveolar macrophage-derived NCF as well as complement derived NCF were increased
      in BAL fluid. These results indicate that different types of NCF may increase in
      response to the disease state or pathogenesis, and play important roles in
      neutrophil accumulation in the respiratory tract.

PMID- 2214402
TI  - [Lung surfactant apoprotein (LSP) content of sputum samples from patients with
      chronic airway diseases].
AB  - LSP contents of sputum samples from patients with chronic airway diseases were
      measured by an enzyme-linked immunosorbent assay (ELISA) kit which was designed
      by Kuroki et al to examine whether a substance identical to lung surfactant
      contained in alveolar lining layer, is also contained in respiratory tract fluid
      or not in the ELISA kit. One antibody to LSP was conjugated to peroxidase and
      another one to LSP was fixed onto a bead. A neo-anionic detergent, Triton X-100
      and an anionic detergent, sodium dodecyl sulfate (SDS) were added to extraction
      medium to separate LSP from lung surfactant, and LSP reaction of sputum sample
      was maximal when the ratio of Triton X-100 to SDS was in range of 1 to 4. Airway
      mucous glycoprotein (AMG) purified from sputum sample did not show any LSP
      reaction. In CsCl density gradient ultracentrifugation of whole sputum, the LSP
      reaction was detectable only in the top fraction with density of about 1.40 and
      AMG was located in the fraction with a density of about 1.50. These results
      indicate that the LSP reaction of sputum sample is not due to false reaction
      caused by nonspecific binding of viscous AMG to the two antibodies to LSP, but to
      the existence of LSP. Therefore it was concluded that lung surfactant is
      contained in respiratory tract fluid. In general, the LSP concentrations in
      sputum samples were lower in purulent sputa than in mucoid or mucopurulent sputa,
      and lower in patients with diffuse panbronchiolitis and bronchiectasia than in
      those with pulmonary emphysema and chronic bronchitis. It was shown that LSP was
      hydrolyzed by neutrophil leucocyte homogenate. These results suggest that LSP
      content of sputum is influenced by various factors such as infection and disease
      in the respiratory tract, and thus is useful to estimate pathological states of
      chronic airway diseases.

PMID- 2214403
TI  - [A case report of high plasma renin activity in chronic pulmonary disease and the
      effect of angiotensin-II-analogue (1-sarcosine, 8-isoleucine-angiotensin-II)].
AB  - Five patients with chronic pulmonary diseases (3 pulmonary emphysema, 1 chronic
      respiratory failure caused by old tuberculosis, 1 diffuse panbronchiolitis)
      showed a marked increase of plasma angiotensin-I and PRA level, which was
      accompanied by an increase of angiotensin-II level, however, whose systemic blood
      pressure was not elevated. The intravenous infusion of angiotensin-II-analogue (1
      Sarcosine, 8-Isoleucine-Angiotensin-II) elicited an antagonistic blood pressure
      response resembling Bartter's syndrome.

PMID- 2214404
TI  - [Significance of superior vena cava reconstruction with EPTFE grafts in the
      surgical treatment of superior and anterior mediastinal invasive malignant
      tumors].
AB  - The objective of this study is to demonstrate the significance of superior vena
      cava (SVC) reconstruction in the surgical treatment of superior and anterior
      mediastinal invasive malignant tumors, by using a total of 48 cases consisting of
      36 invasive thymomas, 3 thymic cancers, 3 carcinoids, 2 germ cell tumors, 2
      malignant lymphomas, 1 intrathoracic thyroid cancer and 1 malignant melanoma. In
      22 of 48 cases there was only mediastinal pleural invasion or tumor capsule
      invasion, on the other hand, 26 cases had high ratios of invasion to adjacent
      organs, including lung, pericardium, great veins and the phrenic nerve. Sixteen
      of 26 cases had invasion to 1-2 adjacent organs, but 10 had 3-6 organ invasion.
      Among 12 cases invading SVC or brachiocephalic veins, 9 cases during the last 7
      years underwent SVC resection and reconstruction with EPTFE grafts. The patency
      was good in the grafts with external ring support and no SVC symptoms were
      observed in all cases postoperatively. The longest patent and functional graft is
      40 months postoperative. No statistically significant difference were
      demonstrated in the survivals between cases with SVC reconstruction and those
      with resections of other adjacent organs, furthermore, remarkable difference of
      survival was demonstrated in SVC reconstructed cases with complete resection and
      incomplete resection. The survivals in cases with combined resection of 1-2
      adjacent organs was statistically significantly better than those with combined
      resection of 3-6 adjacent organs (p less than 0.05, Cox-Mantel test).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2214405
TI  - [Double filtration plasmapheresis in case of Goodpasture's syndrome].
AB  - This article describes a case of Goodpasture's syndrome controlled by double
      filtration plasmapheresis (DFPP) combined with steroid and immunosuppressant
      therapy. A 48-year-old male, clerk, complaining of fever, dry cough and
      macroscopic hematuria, was admitted to our hospital. Microscopic hematuria was
      first pointed out at age 40 on an annual check up. His laboratory data on
      admission revealed severe anemia, azothemia, macroscopic hematuria and
      proteinuria. His chest radiograph and CT revealed diffuse nodular densities in
      bilateral lung fields. Specimens obtained by transbronchial lung biopsy and open
      renal biopsy revealed linear deposition of IgG by direct immunofluorescent
      antibody methods. Circulating antiglomerular basement membrane antibody level
      determined with radioimmunoassay was 1.8% on admission, but one week later it
      elevated to 5.6% with progression of dyspnea, hypoxemia, and renal failure.
      Steroid pulse therapy and a total of 6 double filtration plasmaphereses were
      performed in the first month. Subsequently hypoxemia and dyspnea disappeared, and
      the chest radiograph of the 40th hospital day showed no abnormal shadows. Two
      months later recurrence of pulmonary hemorrhage was noticed. Immunosuppressant
      administration (Cyclophosphamide 100 mg/day) and a total of 10 DFPP procedures
      were performed with success. By DFPP, circulating anti-GBM antibody fell rapidly
      to within normal ranges, and anti-GBM antibody level elevated in removed plasma.
      We think DFPP is effective to remove circulating anti-GBM antibody in
      Goodpasture's syndrome.

PMID- 2214406
TI  - [A case of Goodpasture's syndrome with IgA antibasement membrane antibody].
AB  - This is a very rare case report of Goodpasture's syndrome with IgA antibasement
      membrane antibody. A 43-year old male was admitted because of severe dyspnea with
      slight hemoptysis. Chest X-ray demonstrated extensive bilateral infiltrates with
      air bronchogram, predominantly in the right lung. Laboratory data on admission
      showed severe anemia and moderate renal impairment. The pulmonary infiltrates
      resolved spontaneously within 10 days. Goodpasture's syndrome or collagen
      vascular disease was suspected and he underwent a percutaneous renal and
      transbronchial lung biopsy. The renal biopsy showed crescent formation affecting
      70-80% of glomeruli. Linear IgA deposits, but not IgG, were demonstrated along
      the glomerular basement membrane by the direct immunofluorescence procedure. The
      lung biopsy contained many hemosiderin-laden macrophages in the lumen of the
      alveoli and showed mild thickening of alveolar walls. However, linear
      immunoglobulin deposits on the alveolar capillary basement membrane were not
      demonstrated by direct immunofluorescence. The diagnosis of Goodpasture's
      syndrome with IgA antibasement membrane antibody was made. His serum was negative
      for antibasement antibody by indirect immunofluorescence. He was treated with
      prednisone, 30 mg daily. His pulmonary symptoms and anemia improved markedly, but
      his renal function did not change. Thirteen months after his first admission, he
      suffered from severe bacterial pneumonia, which was complicated by disseminated
      intravascular coagulation. He died of respiratory failure. Autopsy was rejected.

PMID- 2214407
TI  - [A case of Pryce's type I intralobar pulmonary sequestration diagnosed by
      noninvasive techniques].
AB  - The patient was a female who came to our hospital with a chief complaint of
      hemoptysis. Radiography of the chest demonstrated a funicular shadow, and CT of
      the chest also revealed a similar shadow in contact with the thoracic aorta
      enhanced by the contrast material. Pulmonary arteriography and aortography showed
      that the left S8, S9 and S10 areas were supplied by abnormal blood vessels
      bifurcating from the thoracic aorta, rather than the pulmonary artery. This
      finding was supported by scintigraphy of the pulmonary blood flow and pulmonary
      RI angiography. Since bronchography revealed no obvious abnormality in the
      bronchial system, the diagnosis of Pryce's type I intralobar pulmonary
      sequestration was established, and left lower lobectomy was carried out. While
      the evidence of abnormal blood vessels is important for the definitive diagnosis
      of pulmonary sequestration, concurrent image processing of the results of
      scintigraphy of the pulmonary blood flow and pulmonary RI angiography permits
      noninvasive demonstration of the fact that the sequestral pulmonary tissue is
      regulated by the systemic circulatory system, rather than the pulmonary
      circulatory system and thus is a useful technique.

PMID- 2214408
TI  - [A case of desquamative interstitial pneumonia (DIP) suggesting a relationship to
      chronic eosinophilic pneumonia (CEP)].
AB  - A 43-year-old man was admitted to our hospital because of cough and dyspnea. His
      chest X-ray showed bilateral basal infiltrative shadows. The increased
      eosinophils in BAL suggested chronic eosinophilic pneumonia (CEP), whereas the
      TBLB specimens showed findings compatible with desquamative interstitial
      pneumonia (DIP). The open lung biopsy specimens showed typical findings of DIP
      with a peripheral zone, suggestive of CEP. These two diseases may be only phasal
      differences of reaction to the same extrinsic stimulation.

PMID- 2214409
TI  - [A case of pulmonary nocardiosis diagnosed by percutaneous aspiration].
AB  - A 71-year-old man complained of mild dyspnea, and his chest X-ray showed a
      cavitating lesion accompanied by infiltrative changes in the right middle lobe.
      Percutaneous aspiration revealed numerous gram-positive and acid-fast branching
      rods. Morphological examination and biochemical tests of the colonies confirmed
      the diagnosis of pulmonary nocardiosis caused by nocardia asteroides. The patient
      was treated successfully with sulfamethoxazole-trimethoprim. It has been reported
      that approximately half of the patients with pulmonary nocardiosis have
      immunodeficiency, but our patient had no underlying disease. This disease has no
      characteristic clinical features, so diagnosis is difficult. As nocardia may
      involve the central nervous system leading to a poor prognosis, early diagnosis
      and prompt treatment are required to improve survival.

PMID- 2214410
TI  - [Computed tomographic-pathologic correlation of centriacinar emphysema].
AB  - Centriacinar emphysema (CAE) is in principle defined and diagnosed
      pathologically. However, recently, computed tomography (CT) has been advocated in
      the diagnosis of emphysema because of the high degree of anatomic details it can
      provide. In order to assess the reliability and detectionability of CT in CAE
      detection, as well as evaluation of the severity, a CT-pathologic correlative
      study of CAE was performed. To study direct one-to-one CT (in vivo)-pathologic
      correlation, 20 lung lobes with CAE from autopsies and resections were inflated
      and fixed by the method of Heitzman et al and then sectioned along the plane
      equivalent to the CT images. The degree of CAE was graded pathologically by the
      point-counting method. The CT scans were assessed visually for low-attenuation
      areas by 3 independent physicians. A significant correlation was found between
      the CT and pathologic scores of the studied lobes (r = 0.94). Detectionability of
      CAE on lung slices by CT were 74%, 91%, and 100% for mild, moderate, and severe
      cases respectively. The smallest size of the diameter of emphysematous spaces
      which could be detected by CT with 10 mm collimation was 3-4 mm. We concluded
      that CT extremely useful in assessing the extent of CAE, however there are
      limitation in the diagnosis of mild cases. Moreover, visual scoring of low
      attenuation areas on CT images was found to be clinically useful in the
      quantitative evaluation of CAE.

PMID- 2214411
TI  - [Correlation of CT and pathologic findings of pulmonary
      lymphangioleiomyomatosis].
AB  - The X-ray CT findings of two cases of pulmonary lymphangioleiomyomatosis were
      reported. The correlation between high-resolution CT findings and inflated biopsy
      specimens was studied. The X-ray CT findings are 1) multiple low attenuation
      areas, 2) diffuse areas of slightly increased density and 3) irregular
      enlargement of pulmonary vascular images. Each low attenuation are turned out to
      correspond to emphysematous lesions. Slightly increased densities on CT images
      seemed to be caused by a summation of many small nodules of a proliferation of
      smooth muscle cells located in the wall of respiratory bronchioles and alveolar
      ducts, with or without intraalveolar hemosiderosis. Some nodular lesions in
      bronchiolar walls were so close to neighboring vessels that they could not be
      separated from vascular images on CT, so peripheral vascular images were
      irregularly thickened. X-ray CT reflected more actual pathological findings than
      routine chest radiographs. As low attenuation areas on CT images have been
      reported to be representative of pulmonary emphysema, it is thought that the
      above CT findings must be differentiated from those of pulmonary emphysema. While
      pulmonary vascular images were thin and stretched on the CT in patients with
      emphysema, they were irregularly thickened on the CT of patients with LAM.
      Furthermore, while CT of emphysema often revealed overinflation or decreased
      density, diffuse areas of slightly increased density were never found in
      emphysema.

PMID- 2214412
TI  - [The effect of short-term nasal CPAP therapy in cases of obstructive sleep apnea
      syndrome].
AB  - Recent studies have shown that nasal CPAP is very effective in the treatment of
      patients with obstructive sleep apnea syndrome (OSA). To clarify the
      characteristics of pulmonary function testing and to evaluate the effect of short
      term nasal CPAP therapy in 13 cases of OSA patients, nasal CPAP was used for 10
      to 14 days and polysonography was performed on two consecutive nights without
      nasal CPAP and at one night with nasal CPAP. Pulmonary function tests and the
      Uchida-Kraepelin test were performed before the initiation of nasal CPAP therapy
      and also 7 to 14 days after the nasal CPAP therapy. Apnea index reduced
      significantly in all cases from 5.10 +/- 19.6 episodes/hour without therapy to
      3.1 +/- 3.5 with nasal CPAP (p less than 0.001). Nasal CPAP significantly reduced
      the frequency of obstructive (p less than 0.001) and mixed apnea (p less than
      0.01), but the frequency of central apnea did not change with nasal CPAP. During
      the nasal CPAP, mean nadir SaO2 rose from 87.3 +/- 2.9% to 92.7 +/- 1.1% (p less
      than 0.001) and the lowest SaO2 rose from 73.3 +/- 6.4% to 92.0 +/- 2.1% (p less
      than 0.001). Before the nasal CPAP therapy, daytime PaO2 was 80.6 +/- 6.4 Torr
      and closing capacity (CC)/FRC ratio was higher when patients were in a supine
      than in a sitting position. After short term nasal CPAP therapy, daytime PaO2
      increased significantly (p less than 0.001), and FRC/TLC in a supine position
      increased and CC/FRC in a supine position decreased in some patients.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2214413
TI  - [Immunohistochemical analysis of T-lymphocyte subsets on the sarcoid lymph nodes
      using the computerized analytic system for the light microscopic figures: the
      relation to the histological maturation stages of the lymph nodes].
AB  - Lymph nodes obtained from 19 patients with sarcoidosis were classified into four
      groups according to their histological maturation stages, which were the early
      stage, the former mature stage, the late mature stage and the healing stage.
      Immunohistochemical analysis of CD4 positive cells and CD8 positive cells were
      performed using monoclonal antibodies to these lymph nodes. Then the number of
      the positive cells per square millimeters of a granuloma was estimated using a
      computerized analytic system for light microscopic figures. The number of CD4
      positive cells per square millimeter of a granuloma was almost constant from the
      early stage to the mature stage, but inclined to decrease in the healing stage;
      on the other hand, the number of CD8-positive cells per square millimeter of
      granuloma decreased extremely in the mature stage, compared with the early stage
      and the healing stage. Moreover the CD4/CD8-positive cell ratio in granulomas,
      calculated from these data, was elevated in the mature stage, compared with the
      early and the healing stages. From the above results, the CD4/CD8-positive cell
      ratio in a granuloma was demonstrated to be a valuable index for evaluating the
      histological activity of the granuloma of sarcoid lymph nodes. Furthermore, the
      decrease of CD8-positive cells in mature stage granuloma was considered to be
      related to the maturation of the epithelioid cell granulomas in sarcoidosis.

PMID- 2214414
TI  - [Lung injuries and serial bronchoalveolar lavage findings in patients with summer
      type hypersensitivity pneumonitis].
AB  - To evaluate acute lung injuries and their persistence in patients with summer
      type hypersensitivity pneumonitis, repeated bronchoalveolar lavage (BAL) and
      pulmonary function tests were performed. BAL was performed on 36 occasions in 17
      patients with hypersensitivity pneumonitis. Nineteen BAL procedures in 16 cases
      were done during the active phase within the three hospital day and BAL was
      repeated in 8 cases during inactive phase. Anti-Trichosporon cutaneum antibodies
      were detected in all of 15 cases examined using the Ouchterlony method and
      indirect immunofluorescent methods. The number of total BAL cells, lymphocyte and
      neutrophils were increased in the active phase, and OKT4/OKT8 was quite low
      (0.39). As the disease became inactive, the number of total BAL cells,
      lymphocytes and neutrophils decreased. On the other hand OKT4/OKT8 increased
      quickly. Significantly negative correlations were recognized between the number
      of BAL lymphocytes and %VC, and lymphocytes and %DLCO4. More improvements in BAL
      findings, %VC and %DLCO one year after acute episodes were seen in cases that
      moved house than cases that did not move, and these often relapsed. We concluded
      that complete clearing of the patient's house or moving out, if necessary, were
      needed to avoid relapse and persistent lung injuries.

PMID- 2214415
TI  - [Improvement in alveolar macrophage function after therapeutic lung lavage in
      pulmonary alveolar proteinosis].
AB  - Alveolar macrophage (AM) function was investigated in 4 cases of pulmonary
      alveolar proteinosis (PAP). Therapeutic bronchoalveolar lavage (BAL) with a
      flexible bronchofiberscope was done 7-13 times during periods of 4-24 weeks. In
      the initial BAL, the total cell count was only 0.18-0.92 x 10(5)/ml. Also low AM,
      lymphocytosis and eosinophilia values were noted. The phagocytic activity of AM
      was only 3-14% and nitroblue tetrazonium (NBT) reduction of AM was under 5%
      before therapeutic BAL. However, the phagocytic activity was from 25-63% and NBT
      reduction from 15-35% after therapeutic BAL, AM function with periods of
      remission of PAP was normal but AM function decreased during relapse and
      exacerbation of PAP. After therapeutic BAL, two patients have been in remission
      for three years, one patient with incomplete restoration of AM function relapsed
      after one year, and one patient without restoration of AM function showed further
      deterioration after developing pulmonary tuberculosis. These findings indicate
      that the defect in AM function found in PAP is reversible with therapeutic BAL,
      and that the severity of PAP is closely associated with AM function.

PMID- 2214416
TI  - [Their titers and recognized molecules of IgG class anti-BCG antibody in sera
      from patients with tuberculosis].
AB  - Hypergammaglobulinemia is a frequent complication of tuberculosis. Serum levels
      of each class of immunoglobulin were analyzed among tuberculosis patients. Adult
      patients had high levels of IgG and IgA, but IgM levels were not elevated. These
      data suggested that antibody responses to mycobacterial antigens might be
      influenced by individual immune responses. In order to analyze the specific
      antibody responses to mycobacterial antigens, IgG class antibodies reactive with
      BCG proteins were enumerated by an enzyme-linked immunosorbent assay (ELISA).
      Patients were shown to have significantly higher a mount of IgG antibodies than
      healthy controls. Sera from patients with active tuberculosis had high
      consistently titers of antibodies. Antibody titers returned to a normal range
      after effective treatment, suggesting that the measurement of IgG anti-BCG
      antibodies would be useful for the diagnosis and follow-up of tuberculosis. In
      addition, serum antibody profiles were analyzed by immunoblotting. Sonicated
      whole BCG proteins were electrophorased and transferred to nylon sheets by
      Western blotting. Then the sheets were developed with sera from patients or
      controls. Mycobacterial cell wall contains a vast array of proteins so that
      comparison of the antibody profiles from different sera revealed striking
      individual variations. However two kinds of proteins, whose molecular sizes were
      65KDa and 16KDa, were considered to be significant. The 65 KDa protein was
      recognized in most sera from both patients and controls. The protein may be
      related to a "common antigen" present in a wide variety of bacteria. These
      observations may shed a new light on the role of 65KDa protein in the regulation
      of the immune systems, for example a individual highly primed to 65KDa protein
      may amount an exaggerated and potentially harmful response to cross-reactive
      antigens from other essentially non-pathogenic bacteria.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2214417
TI  - [Ultrasonographic analysis of splenomegaly in patients with sarcoidosis].
AB  - Thirty seven patients with sarcoidosis were examined using ultrasound (US) to
      determine the size of the spleen. A Spleen Index (SI) was employed to evaluate
      splenomegaly and the SI was calculated using long (a) and short (b) dimensions on
      the sectional splenotomogram (SI = a x b). In 21 (57%) of these patients the
      spleen was judged ultrasonographically to be enlarged (SI 30), but in only 3 was
      it palpable. The clinical records of patients with and without splenomegaly
      detected by US were compared. There were no differences between patients with or
      without splenomegaly in hematologic findings (peripheral blood and bone marrow)
      or blood chemistry; furthermore no patients with hypersplenism were seen. In
      immunological parameters, the serum immunosuppressive acid protein level was
      significantly (p less than 0.05) higher in patients with splenomegaly than in
      those without splenomegaly; however, there were no differences in serum
      angiotenins converting enzyme activity, serum lysozyme level, PPD skin test or
      bronchoalveolar lavage fluid analysis. The patients with splenomegaly had
      significantly higher evidence of increased uptake of 67-Gallium in lung fields
      and positive lung infiltrates in chest X-ray than those without splenomegaly (p
      less than 0.01, p less than 0.05). These data suggest that ultrasound is a
      promising diagnostic tool for the assessment of the size of the spleen and is
      useful to detect disease activity and extent of disease in sarcoidosis. Patients
      with sarcoidosis who had splenomegaly had more disseminated disease, especially
      pulmonary parenchymal disease, than did those without splenomegaly.

PMID- 2214419
TI  - [A resected case of endobronchial metastasis from breast carcinoma].
AB  - A 54-year-old woman, who had received left radical mastectomy 12 years
      previously, was admitted with persistent cough and hemoptysis. Plain chest X-ray
      film showed no abnormality but fiberoptic bronchoscopy revealed that a polypoid
      lesion occluded the right truncus and the surrounding bronchial mucosa was firm
      and edematous. Biopsy specimen demonstrated adenocarcinoma. Right middle and
      lower sleeve bilobectomy was performed. The tumor occupied mainly the outer and
      submucosal layer of the bronchial wall. Histologically, this tumor showed
      scirrhous adenocarcinoma with the same pathologic appearance as the primary
      breast lesion. It is considered that endobronchial metastasis from breast
      carcinoma is not particularly uncommon, therefore any patient with a past history
      of breast cancer and respiratory symptoms should undergo fiberoptic bronchoscopy,
      particularly when the chest X-ray is normal or shows non-specific changes.

PMID- 2214418
TI  - [Two cases of budgerigar breeder's lung].
AB  - We report 2 patients with Bird breeder's lung associated with keeping
      budgerigars. Patient 1 kept a budgerigar indoors for 13 years. Histological
      examination revealed fibrosis and granulomatous changes in the alveolar septa.
      Among T lymphocyte subsets in BALF, helper T cell were increased. In the serum,
      precipitating antibodies to budgerigar dropping extract were observed. Patient 2
      had kept Budgerigar for 7 months. Histologically, alveolitis was the primary
      finding, and suppressor T cell in the BALF were increased. Precipitating
      antibodies to budgerigar dropping extract was observed only in the BALF but not
      in serum. In patient 1 who showed a chronic course and granuloma formation,
      helper T cell in the BALF were increased while in patient 2 who showed an acute
      course and alveolitis, suppressor T cell in the BALF were increased, and
      precipitating antibody was observed only in the BALF. These findings suggest that
      T lymphocyte subsets in the BALF differ depending on the stage of
      hypersensitivity pneumonitis, and specific local antibody production precedes
      systemic antibody production.

PMID- 2214420
TI  - [A case of obstructive sleep apnea syndrome remarkably improved by gastric
      restriction surgery].
AB  - A 23-year-man with morbid obesity and obstructive sleep apnea syndrome (OSAS) was
      admitted. He was 170 cm in height and 170 kg in weight. He underwent dietary
      treatment several times, but his weight returned to its original level, or even
      higher, within a short period. A diagnosis of OSAS was made by nocturnal
      polysomnography. In this morbidly obese patient with OSAS a nocturnal sleep apnea
      study was performed before and after weight reduction surgery (gastric
      restriction). The postoperative findings revealed a dramatic body weight
      reduction. At the same time, the results of apnea and oxygen desaturation were
      remarkably improved too. These results indicate that weight reduction surgery is
      a definitely effective treatment for morbid obesity associated with OSAS.

PMID- 2214421
TI  - [A case report of diaphragmatic flutter].
AB  - A 18-year-old female complained of a dyspneic sensation and involuntary movements
      in the epigastrium. On physical examination, fine rhythmic movements in the
      epigastrium were observed on each inspiration with a rate of 5-10 per breath.
      Arterial blood gas analysis was normal. Recording of the respiratory parameters
      and the EMG of respiratory muscles were performed. Analysis of the respiratory
      flow revealed that her spontaneous inspirations consisted of short inspirations
      (i.e., flutter wave) (150-170 beats per minute). EMG of respiratory muscles
      demonstrated that these flutter waves were driven by intercostal muscles and
      diaphragm. The flutter waves were not suppressed by breath holding at the maximal
      inspiration. With intravenous injection of 200 mg of diphenylhydantoin, flutter
      waves disappeared within 10 minutes. There were no abnormal findings on chest
      roentgenogram, electrocardiogram, head CT scan and MRI of the cervical spine.
      During one year's follow up no attack developed again. We have encountered 3
      cases of the syndrome since 1981. In two of them, the spontaneous respiration was
      superimposed on a high-frequency wave throughout the whole respiratory cycle
      while in one case the high-frequency wave developed only in the inspiratory phase
      of spontaneous respiration. In the present case the respiratory flow pattern was
      similar to the last mentioned and the EMG-analysis of respiratory muscles
      confirmed that the flutter waves were driven by intercostal muscles and
      diaphragm. Furthermore, synchronization of activities of the two respiratory
      muscles suggests that the syndrome is of central origin.

PMID- 2214423
TI  - [A morphometric study in ordinary lungs of bronchial dimensions throughout the
      airway tree as a basis for the analysis of COPD].
AB  - A morphometrical method was established to estimate the initial dimensions of
      bronchi in the state in which they are strongly deformed due to narrowing or
      ectasis, and to enable the determination of the grade of deformity. In ordinary
      lungs from 16 autopsy cases, the dimension of airways were correlated with that
      of the accompanying pulmonary arteries to establish a standard for the estimation
      of the former from the latter. In each case, cross-sectioned pairs of an airway
      and an artery were sampled so as to cover the entire range from segmental bronchi
      to respiratory bronchioles. The varyingly constricted state of airways and
      arteries was standardized by measuring the perimeter length L of the epithelial
      basement membrane (BM) for airways and the internal elastic membrane (IEM) for
      arteries with a digital image analyzer, and reducing these into a circular state
      with completely stretched BM and IEM, where D(br), the anatomical diameter of
      airway, and D(pa), that of artery, were calculated from L. In addition, the
      sectional area of the epithelium was measured to calculate Rs, the ratio of
      luminal stenosis by epithelial thickening. In every case, a close correlation was
      shown to exist between D(br) and D(pa) on bilogarithmic coordinates: When all the
      measurements from 671 pairs of D(br) and D(pa) were pooled, the correlation
      coefficient proved to be as high as 0.91 (p less than 0.001). This allows
      estimation of the dimension of an airway from that of the accompanying artery,
      even when the airway is severely deformed like in COPD. The range of D(br) for
      the bronchi (B), that for the membranous bronchioles (MB) and the respiratory
      bronchioles (RB), were shown to overlap between the neighboring ranges.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2214422
TI  - [A case of acute lupus pneumonitis followed by high-resolution CT].
AB  - A 43-year-old woman was admitted to our hospital because of fever and dyspnea.
      She had facial rash, hair-loss, arthralgia, urinary casts, thrombocytopenia,
      lymphocytopenia, and deposits of IgG, IgM, C3 in the epidermis. SLE was
      diagnosed. She also had severe dyspnea, which gradually progressed. In spite of
      steroid pulse therapy and cyclophosphamide, she eventually died about two months
      after admission. Chest X-ray film showed bilateral ground-glass shadow and volume
      loss. High-resolution CT of the lung showed marked high density area with
      airbronchogram in the posterior part and a gradually enlarging slight high
      density area in the anterior area. Pathological findings of the posterior area
      were atelectasis and dense fibrosis. The findings of the anterior area were
      collapsed alveoli and dilated alveolar ducts. These findings might suggest that
      alveolar collapse play a major role in the course of pulmonary fibrosis of this
      patient.

PMID- 2214424
TI  - [The nature, severity and distribution of obstructive airway lesions in COPD
      studied by morphometry and computer-assisted 3-D reconstruction].
AB  - The severity of obstructive bronchial lesions and their distribution in the
      airway tree were studied in autopsy lungs from ten patients with various types of
      chronic obstructive pulmonary disease (COPD), where the changes of bronchial
      dimension were studied by morphometry and the 3-D distribution of obstructive
      lesions by computer-assisted 3-D reconstruction. A case of paraquat intoxication
      was added in order to study the airway changes in lungs with early fibrotic
      changes. In each case, morphometry was performed on microscopic lung sections
      where the initial diameter of bronchi was estimated from that of the accompanying
      pulmonary arteries. The varyingly constricted airways and arteries were
      standardized into a circular state by measuring the perimeter length L of the
      epithelial basement membrane (BM) and the internal elastic membrane (IEM) with a
      digital image analyzer; D(br), the anatomical diameter of an airway, and D(pa),
      that of an artery, were calculated at this state of completely stretched BM or
      IEM. Rs, the ratio of luminal stenosis by thickened epithelia, was also
      determined from the area of epithelium simultaneously measured. Three-D
      reconstruction of airway was performed in cases typically representing different
      types of obstruction; from microscopic, sometimes macroscopic serial sections,
      where the 2-D images were inputted into a computer which integrated in its
      display a 3-D picture. It was shown that in lungs with chronic bronchitis, the
      bronchial dimension did not significantly differ from that of ordinary lungs.
      Overt shrinkage of bronchial dimension was demonstrated in chronic obstructive
      bronchiolitis; in both diffuse panbronchiolitis (DPB) and broncho-bronchiolitis
      obliterans (BBO), narrowing of the peripheral airways combined with ectasis of
      the proximal bronchi proved to be a common feature. However, reconstruction
      disclosed an essential difference between these in the distribution of occlusive
      lesions, which mainly involved the respiratory bronchioles in DPB, while in BBO,
      the site of obstruction was from the terminal to slightly upper bronchioles. Also
      in pulmonary emphysema, the pattern of bronchial dimension was a narrowing in the
      periphery, both in the centrilobular and panlobular types. Especially worth of
      attention was that the study disclosed the presence of a type of COPD hitherto
      poorly defined. In a patient who had a 25-year history of COPD and died of
      respiratory failure, the lungs, only mildly emphysematous, were shown to have
      uniformly narrowed bronchioles; also mucus hypersecretion and elevated Rs
      appeared to have contributed to the obstruction.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2214425
TI  - [Usefulness of a protease inhibitor (urinastatin) in ARDS with infectious
      diseases].
AB  - The usefulness of urinastatin (UST) for adult respiratory distress syndrome
      (ARDS) induced by gram-negative sepsis was evaluated in clinical and experimental
      studies. Twelve cases of clinical septic ARDS were treated with combination
      therapy of UST and methylprednisolone (M-PSL). Ten out of 12 responded favorably.
      This result was considered to some extent to be better than that of our previous
      experience with single administration of M-PSL for patients with septic ARDS.
      Pathophysiologic experiments on UST in endotoxic status were then performed.
      Immediately after the intravenous administration of endotoxin to rats, serum
      levels of beta-glucuronidase and elastase released from PMNs were increased and
      pulmonary edema was observed at 48-hours after the endotoxin injection. Various
      degrees of pulmonary edema were also observed by the intravenous administration
      of beta-glucuronidase and PMNs-elastase. These changes induced by the endotoxin
      were significantly inhibited by the intraperitoneal administration of UST, and
      they were inhibited more by the combination therapy of UST and M-PSL. In an in
      vitro study, significantly large amounts of beta-glucuronidase and elastase were
      released from PMNs by incubating human PMNs with endotoxin. By adding UST to this
      system, the release of these PMNs proteases was inhibited. These results
      suggested that UST neutralizes the PMNs-elastase release in the status
      endotoxemics, and consequently resulted in a better prognosis in cases of septic
      ARDS.

PMID- 2214426
TI  - [Lung cancer associated with idiopathic interstitial pneumonia].
AB  - Idiopathic interstitial pneumonia (IIP) is known to have a tendency to be
      associated with lung cancer. Clinical characteristics of lung cancer associated
      with IIP are discussed in this article. Thirteen cases of lung cancer associated
      with IIP were examined from 1975 to 1988. A total of 590 cases of lung cancer and
      38 cases of IIP were observed during that period. The 13 cases of lung cancer
      were found to be associated with IIP during the follow-up observation of our
      patients. Of these 13 patients, 12 men and a woman, the average age was 68.0
      years old. All these 13 cases were ex- or present smokers. Five cases of lung
      cancer had no symptoms, but were detected by abnormal shadows on chest X-ray.
      Eight cases were detected symptoms. The duration from the onset of IIP to the
      onset of lung cancer was 36.5 +/- 23.5 months. Primary sites of lung cancer were
      distributed as follows. Nine cancers were in the left lung (64%) and five cancers
      were in the right lung (36%). Three cancers were in the hilar region (21%) and 11
      cancers were in the peripheral lung field (79%). The numbers of lung cancers were
      equal in upper and lower lobe. The most common histological type was squamous
      cell carcinoma, followed by adenocarcinoma. Most cases were in stage III or IV.
      Three cases were operated, 4 were treated with chemotherapy, 4 were treated with
      chemotherapy plus irradiation, and 2 cases were treated by BRMs. The frequency of
      weight loss or finger clubbing in these patients was higher than in IIP patients
      without lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214427
TI  - [The role of thoracoscopy in pleural biopsy in cases with pleural effusion].
AB  - Between April 1985 and July 1989, 125 cases with pleural effusion were admitted
      to our department. The causes of pleural effusion were carcinomatous pleurisy in
      47 cases, infection without tuberculosis in 34 cases, tuberculous pleurisy in 17
      cases, cardiac insufficiency and hypoproteinemia in 11 cases, trauma and
      pneumothorax in nine cases, collagen disease in two cases and unknown origin in
      five cases. Carcinomatous pleurisy and tuberculous pleurisy, the differential
      diagnosis of which is very important, comprised 37% and 14% of all cases,
      respectively. These diseases can be definitively diagnosed by pleural biopsy,
      effusion cytology and/or effusion culture. In July 1987, we introduced
      thoracoscopy to improve the ratio of definitive diagnoses. The ratio for
      carcinomatous pleurisy in the previous term, when thoracoscopy was not being
      used, was 59%, while that in the latter term, when it was used, was 73%. The
      ratio for all cases with tuberculous pleurisy was 47%. Prior to June 1987,
      pleural biopsies in our department were performed with a Cope needle. Using that
      procedure, a low positive ratio of 50% was obtained. For thoracoscopic pleural
      biopsies, a high positive ratio of 84% was achieved (in carcinomatous pleurisy,
      13 out of 15 cases; in tuberculous pleurisy, three out of four cases). This
      procedure was performed with minimal patient discomfort and no serious
      complications. Therefore, thoracoscopic pleural biopsy is recommended as a
      diagnostic procedure for cases with pleural effusion.

PMID- 2214428
TI  - [Activated pulmonary intravascular macrophages increase pulmonary microvascular
      permeability in sheep].
AB  - Pulmonary intravascular macrophages (PIMs) reside in the alveolar capillaries of
      sheep lung. However, the role of PIMs activation in the mechanism of increasing
      pulmonary microvascular permeability is not clear. We determined, using awake
      sheep with chronic lung lymph fistulas, the effects of intraarterial infusion of
      latex beads emulsion (1 microns in diameter) on lung lymph-dynamics. Sheep were
      divided into 3 groups; control, low dose latex and high dose latex groups. In
      control group, their lymph-dynamics were stable during the experimental period.
      In low dose latex group (5.46 x 10(9) beads/kg), lung lymph flow increased during
      the infusion period, but lung lymph protein clearance did not change. In high
      dose latex group (5.46 x 10(10) beads/kg), lung lymph flow began to increase
      during the infusion period and remained high, and lung lymph protein clearance
      increased significantly during and after the infusion of latex beads emulsion.
      The latex beads mainly distributed to lungs, and 70% of the beads were caught by
      PIMs in their phagosomes. These findings suggest that the activation of PIMs
      through their phagocytic uptake of circulating microparticles increases pulmonary
      microvascular permeability.

PMID- 2214429
TI  - [A case of asthma exacerbated by sulfite contained in betamethasone].
AB  - Adverse reactions to preservatives contained in food and medications have been
      recognized with increasing frequency. We have recently seen an asthmatic patient
      in whom wheezing and dyspnea increased after injection of betamethasone. The
      patient was a 26-year-old woman who had had bronchial asthma since 1980. She was
      treated at another hospital for moderate wheezing and betamethasone injections
      were given in May 1988. After this treatment her condition deteriorated acutely
      and she was transferred to our hospital. To confirm the possible relationship
      between betamethasone (sulfite) and asthmatic attack, provocation challenge tests
      were conducted. Intradermal skin test revealed an immediate positive reaction to
      sodium bisulfite at a concentration of 100 mg/L. Challenge test with increasing
      amounts of sodium bisulfite showed a 52% decrease in FEV1, 50 min after
      inhalation of 5 mg/ml solution. In addition, another inhalation challenge was
      conducted by use of an Astograph. Rrs immediately increased during inhalation of
      10 mg/ml solution. These results suggested that sulfite contained in
      betamethasone preparation provoked exaggerated bronchospasm in this patient.

PMID- 2214430
TI  - [Severe bronchial reaction induced by hydrocortisone sodium succinate in an
      aspirin-sensitive asthmatic patient].
AB  - This is a report of a female patient who had an anaphylaxis-like reactions to
      hydrocortisone sodium succinate (Saxizon). A 31-year-old female with intrinsic
      bronchial asthma and aspirin sensitivity was admitted to our hospital because of
      an episode of asthmatic attack. The patient had had episodes of dyspnea since
      1976, and had been treated with oral bronchodilators and intermittent
      corticosteroids. After admission, she was given 100 mg of hydrocortisone sodium
      succinate intravenously. A few minutes later she developed severe bronchospasm
      and lost consciousness. An endotracheal tube was inserted and she was
      mechanically ventilated for 2 hours. The patient recovered after 1 hour. An
      inhalation challenge test with Sulpyrin was positive. When the provocation
      challenge test with 100 mg of hydrocortisone sodium succinate (Saxizon) injection
      was performed, she developed subjective and objective evidence of bronchospasm.
      Intradermal skin test revealed positive immediate reactions to Saxizon, Solu
      cortef, Predonine. It is suggested that she had immediate hypersensitivity to
      hydrocortisone sodium succinate, but the mechanism of this anaphylaxis-like
      reaction to steroids is not certain.

PMID- 2214431
TI  - [An open lung biopsy case of follicular bronchiolitis in rheumatoid arthritis].
AB  - A 49 year-old Japanese female with a clinical history of rheumatoid arthritis for
      15 years developed fever, cough, sputa and exertional dyspnea. A chest x-ray
      showed right-sided pleural lesions in addition to persistent hyperinflation of
      the lungs for about four years. Pulmonary function tests showed combined
      obstructive and restrictive dysfunction, increased residual volume and reduced
      diffusing capacity. After an improvement of the pleural lesions, she underwent a
      right open lung biopsy in December 1988 which revealed follicular bronchiolitis
      and fibrino-fibrous pleural thickening. The pulmonary lesion of follicular
      bronchitis/bronchiolitis was reported in 1985 as a newly recognized pulmonary
      disorder among open lung biopsy cases. The present case was the second biopsy
      proven case of follicular bronchiolitis among the Japanese.

PMID- 2214432
TI  - [A case of bronchial asthma complicated with mediastinal, subcutaneous,
      peritoneal and epidural emphysema].
AB  - A case of a 16-year-old female with bronchial asthma complicated with
      mediastinal, subcutaneous, peritoneal and epidural emphysema was reported. The
      patient was admitted to our hospital because of dyspnea. Chest and abdominal X
      ray films revealed mediastinal emphysema with peribronchial air sheath,
      subcutaneous emphysema in the neck and chest, and peritoneal emphysema. CT-scan
      revealed severe mediastinal, subcutaneous and epidural emphysema. These findings
      disappeared about 10 days after recovery from the attack. Diagnostic methods and
      the pathogenesis of air leak were also discussed.

PMID- 2214433
TI  - [Study on local recurrence of squamous cell carcinoma of the lung on hilar
      lesion].
AB  - The study population consisted of 62 patients with squamous cell carcinoma of the
      lung on hilar lesion who underwent curative or relative curative resection during
      the seven year period between January, 1980 and December, 1986. We studied the
      correlation between local recurrence and the distance from the surgical margin of
      the trachea or bronchus to the tumor. 1) As the classification of the T and N
      factors increased, the incidence of local recurrence became higher. 2) In order
      to prevent local relapse, we need to completely resect the hilar and mediastinal
      lymph nodes, and we must maintain a distance of 16 mm or more between the
      surgical margin of the trachea or bronchus and the tumor.

PMID- 2214434
TI  - [Respiratory function on exercise as a predictor of complications after lung
      resection].
AB  - We studied the correlation between the complications after pulmonary resection
      and the results of exercise testing and others. The exercise testing was
      performed preoperatively on 64 patients; 44 lobectomies, 6 bilobectomies and 14
      pneumonectomies. The results which had the correlation with postoperative
      complications were RV/BSA (p less than 0.001), RV/TLC (p less than 0.005),
      VE/VCO2 (p less than 0.001) and VO2/VE (p less than 0.001). Men had more
      complications than women (p less than 0.001). And the patients with the past
      histories concerning cardiovascular disease, pulmonary disease and/or diabetes
      had more chances of complications than the patients without those histories (p
      less than 0.05). Judging from these results we concluded that the patients with
      one or more of the following results had more chances of postoperative
      complications. 1. maximum VO2/VE was less than 40 ml/l. 2. VE/VCO2 was more than
      4.0 l/ml. 3. RV/BSA was more than 1.5 l/m2. 4. RV/TLC was more than 45%.

PMID- 2214435
TI  - [A case report of the reinforcing technique with collared prosthesis for the
      prosthetic valve endocarditis in mitral position].
AB  - A 58-year-old female was admitted to our hospital because of the prosthetic valve
      endocarditis in mitral position. In the past, this patient was undertaken double
      valve replacement in mitral and aortic position. Nevertheless, postoperative
      course was not in stable condition, showing persistent sign of the infection. The
      appearance of mitral regurgitant murmur and regurgitant signal by colour Doppler
      cardiography could make sure of the diagnosis for prosthetic valve endocarditis
      (PVE) in mitral position. The operation for PVE in mitral prosthesis was
      undertaken as follows. As there was extensive annular infection around the mitral
      valve, the new mitral prosthesis (Duromedics valve) with the Gore-tex flange, so
      called collared prosthesis, was revised. The collared prosthesis was implanted in
      the mitral annulus by using the suture ring of the Duromedics valve as well as
      possible, furthermore, the Gore-tex flange were sutured in the left atrial wall 2
      cm above the mitral ring. Postoperatively, the infection sign and congestive
      heart failure were completely subsided. This patient has been in very healthy
      condition these days and restored to the daily life.

PMID- 2214436
TI  - [Surgical treatment of cor triatriatum: report of four cases].
AB  - Four cases of cor triatriatum are reported. Cases 1 and 2 had IIA, case 3 had IA,
      and case 4 had IIIB 1 type of cor triatriatum according to Lucas-Schmidt
      classification. Cases 1 and 2 were diagnosed by echocardiography preoperatively.
      They were not performed cineangiocardiography because of pulmonary congestion.
      Case 3 had type IA so called classical type, which is hemodynamically identical
      to mitral stenosis and supravalvular stenosing ring. The clinical features are
      depend on the size of the communication between accessory chamber and true left
      atrium. As case 4, he had been diagnosed of simple atrial septal defect
      preoperatively, careful echocardiographic examination was essential for accurate
      diagnosis. In case 2 with hypoplastic left heart, secondary surgical repair is
      considered to be desirable followed by balloon dilatation of two atrial septal
      defects communicated to accessory chamber and to true left atrium. Thus, we
      expect development of hypoplastic left ventricle.

PMID- 2214437
TI  - [Giant cell tumor of the bony thorax].
AB  - Two cases of giant cell tumor of the bony thorax are described. Case 1 presents a
      21-year-old female with a recurrent giant cell tumor of the third and the fourth
      thoracic vertebrae that directly compressed the membranous portion of the trachea
      and brought about severe air way obstruction. The tumor was completely resected
      and the patient remains healthy without recurrence 30 months after surgery. Case
      2 presents a 18-year-old female with a giant cell tumor invading transverse
      process of the seventh thoracic vertebra and the seventh rib and making a big
      mass in the thoracic cavity on the right side. This patient was first seen with
      hemothorax and treated just by tube drainage three months before undergoing total
      resection of the tumor. She remains well nine months after surgery.

PMID- 2214438
TI  - [Eleven cases of ASD in individuals aged over 50 years].
AB  - Eleven cases of ASD were experienced in subjects aged more than 50 years. The
      ages ranged from 50-68 years (mean: 57.1 years), and there were 6 males and 5
      females. The preoperative NYHA class was I in three cases, II in six cases, and
      III in two cases. The pulmonary arterial pressure ranged from 20-46 mmHg (mean:
      30.9 mmHg), the PP/PS 0.19-0.42 (mean: 0.25), the QP/QS 1.4-3.5 (mean: 2.3), and
      the left to right short circuit rate was 38-73% (mean: 58.6). A patch closure
      operation was performed in all cases except two. After operation, the NYHA class
      improved in all cases except one. The CTR decreased from 59.3 +/- 6.05% to 54.1
      +/- 5.07, and the pulmonary arterial pressure from 30.3 +/- 6.65 mmHg to 21.4 +/-
      5.04 mmHg (improving in all cases).

PMID- 2214439
TI  - [Dissecting aortic aneurysm in siblings without Marfan's syndrome].
AB  - The occurrence of dissecting aortic aneurysm in 2 or more family members is rare.
      We reported two cases of dissecting aortic aneurysm in one family. Case 1.
      Brother. A 49-year-old male, was diagnosed to have acute dissecting aortic
      aneurysm (DeBakey type I) with mild aortic regurgitation. He was operated on by
      valvuloplasty and closure of the false lumen, and is alive and well at the
      present time. Case 2. Sister. A 60-year-old female, was diagnosed to have chronic
      dissecting aortic aneurysm (DeBakey type II). She underwent replacement of the
      ascending aorta with a Dacron graft. She is alive and well. Neither of these 2
      patients nor other family member had any features of the Marfan's syndrome.
      Histological examination of 2 cases showed the degeneration of smooth muscle in
      the media. Among their family, mother died of unidentified heart disease.

PMID- 2214440
TI  - [A successful surgical repair of ventricular septal perforation following acute
      myocardial infarction in a 83-year-old man].
AB  - A 83-year-old man, who experienced a sudden severe malacia 13 days before, was
      admitted, complaining of dyspnea since 8 hours before. A loud systolic murmur of
      Levine IV/VI was audible on the left sternal border of the 4th intercostal space.
      The chest X-ray film demonstrated severe pulmonary congestion. The ECG showed
      abnormal Q waves in II, III, a VF and V1-5. The right heart catheterization
      revealed an intraventricular shunt from left to right and thus ventricular septal
      perforation (VSP) 13 days after acute anteroseptal-inferior myocardial infarction
      was diagnosed. Continuing an aggressive medical treatment with the intraaortic
      balloon pumping, an emergency operation for VSP was performed 2 days after the
      onset. A single Teflon patch was sutured on the left side of the septum around
      VSP (2.5 x 2.5 cm) and the ventricular free wall was closed including the patch
      with two felt strips. The patient survived through the operation and is doing
      well at the 11 months of follow-up. Twenty patients above 70 years old have been
      surgically treated with success for VSP after acute myocardial infarction in
      Japan. Our patient was the oldest.

PMID- 2214441
TI  - [Two cases of supposed metastasizing leiomyosarcoma of the uterus].
AB  - Case 1. A 57-year-old female had hysterectomy 10 years ago because of leiomyoma
      uteri. She was recently found to have a clear-cut round mass shadow in the right
      middle lung field on her chest X-ray film 3. The mass was resected and
      microscopically diagnosed as metastatic leiomyosarcoma. Re-examination of the
      pathological specimen of the uterine tumor resected 10 years ago revealed 5-9
      mitosis per 10 high-powered fields (/10 HPF). Case 2. A 54-year-old female who
      had undergone hysterectomy for myoma uteri 9 years previously was found to have a
      well-defined oval shadow in the left lower lung field which was resected and
      pathologically diagnosed as metastatic leiomyosarcoma. Her uterus lesion
      microscopically revealed 1-2 mitosis/10 HPF. The relationship between metastatic
      leiomyosarcoma of the lung and mitotic activity of leiomyoma uteri was discussed.

PMID- 2214442
TI  - [A malignant thymoma combined with sarcoidosis].
AB  - A case of 69-year-old female of malignant thymoma with sarcoidosis was
      experienced. Although many diseases such as myasthenia gravis are associated with
      thymoma, sarcoidosis is a rare thymoma-associated disease. Only one case of
      thymoma with sarcoidosis was reported all over the world, and our case is the
      first case in Japan. As thymus is essential for the development of T lymphocytes,
      thymoma may cause T lymphocytes disorder and sarcoidosis. So, we consider thymoma
      with sarcoidosis as a syndrome rather than as a spectrum of coincidental disease.

PMID- 2214443
TI  - [A case report of coronary artery fistula into the left ventricle].
AB  - Communication of the right coronary artery with the left ventricle is
      considerably rare. We report a case of congenital fistula of the left ventricle.
      Closure of the fistula was successfully done by Symbas' modification. Thirty
      cases with coronary artery fistula to the left ventricle reported in Japanese
      literatures, including our case were reviewed in regard to its surgical
      treatment.

PMID- 2214444
TI  - [Right ventricular thrombosis due to familial heparin cofactor II deficiency].
AB  - This case report was with regard to familial heparin cofactor II (HC II)
      deficiency. The patient was a 14-years-old female, having complaints of chest
      pain, fever and swelling of right lower extremity. Echocardiography and DSA
      showed a pediculated mass at the right ventricular outflow tract which highly
      suggested a ventricular myxoma. At surgery, a large pediculated thrombus was
      removed from the RV conus septum aun pulmonary valve. The mass was identified as
      thrombus by histological examination. Two months later, the RV thrombi recurred
      with additional pulmonary embolus to the left lung. HC II was discovered by hemo
      coagulation tests. Her HC II antigen value was 48%, and 32% on repeat study. Her
      brother's HC II antigen value was 53%. At reoperation, small thrombi less than
      phi 10 mm, were removed from the RV outflow tract and pulmonary valve. Fresh
      frozen plasma was given and intravenous urokinase therapy was taken. She is doing
      well with therapy of oral warfarin, aspirin and ticlopidine for anticoagulation.

PMID- 2214445
TI  - [A case of chondrosarcoma arising from the left first rib].
AB  - A 46-year-old female was admitted to our hospital because of a left
      supraclavicular tumor. The chest CT scan and MR imaging revealed that the tumor
      arose from the left first rib and developed into the supraclavicular region. In
      this case, we tried to resect the tumor using the so-called "trap-door"
      thoracotomy. Although removal of subclavian vessels and brachial plexus from the
      tumor was easily performed, we could not enough treat the vertebral side of the
      first rib through this thoracotomy without the T1 nerves injury. In cases of
      superior sulcus tumors developing into the posterior chest wall, a posterior
      incision combined with an anterior one will be useful to remove these tumors
      safely.

PMID- 2214446
TI  - [A successful surgical case of ruptured thoracoabdominal aneurysm].
AB  - A successful surgical case of ruptured thoracoabdominal aortic aneurysm was
      reported. The patient was a 77-year-old male. He entered our hospital and was
      diagnosed ruptured Crawford type 3 thoracoabdominal aortic aneurysm by chest X
      ray, CT scan and aortography. Operative procedure was tube graft insertion into
      thoracoabdominal aorta with celiac artery reconstruction. Postoperative course
      was excellent and discharged on 55th postoperative day.

PMID- 2214447
TI  - [A case report of descending thoracic aortic aneurysm associated with anterior
      spinal artery syndrome despite no marked ESP changes].
AB  - A 67-year-old man underwent graft replacement for the descending thoracic aortic
      aneurysm with the aid of temporary external bypass. Intraoperative evoked spinal
      potentials (ESPs) were monitored to detect the spinal cord ischemia. Incomplete
      paraplegia with sensory dissociation was developed in this patient after surgery,
      despite well maintained ESPs throughout the aortic cross-clamping. ESPs have been
      widely used as a mean of detecting early impairment of spinal neural conduction
      during aortic surgery. However, ESPs are principally mediated through posterior
      and lateral column pathways and they are not always a reliable monitor to predict
      paraplegia in aortic surgery.

PMID- 2214448
TI  - [Surgical salvage of cardiac rupture: a case report].
AB  - A 39-year-old man suffered from acute myocardial infarction. Echo cardiography
      showed the presence of intra-pericardial fluid. We had emergent operation. We
      successfully salvaged cardiac rupture with fibrin glue and oxy-cellulose without
      cardiopulmonary bypass. His post-operative course was uneventful. The patient was
      discharged on the seventh week after the operation. The problems of acute cardiac
      rupture were discussed.

PMID- 2214449
TI  - [Long-term follow-up studies in 211 patients with tetralogy of Fallot after
      corrective surgery over 10 years].
AB  - A total number of 427 patients with tetralogy of Fallot who underwent corrective
      surgery between 1960 and March 1990, in whom 211 patients who survived the
      surgery over 10 years were evaluated for the follow-up studies. Hemodynamic and
      cardiac function studies were carried out in 101 patients at the mean interval of
      15.7 years (ranges 2 to 21 years). Three methods indicated that patients with
      muscle resection and pulmonary valvulotomy without patch enlargement (NP) had
      worse results than the groups with RV patch below valve (RP) and with
      transannular patch (TP). Also, Holter ECG revealed ventricular arrhythmias in
      patients with NP were more common than the groups with RP and TP. Sixteen
      patients (13 with NP, 2 with TP and one with RP) were required reoperation for
      residual ventricular shunt in 13, residual pulmonary stenosis in 11 and tricuspid
      regurgitation in 2. All of these 16 patients survived operation and obtained
      excellent clinical status. It is concluded that patients with TOF after
      corrective surgery should be carefully followed with short term interval to
      prevent sudden death and postoperative complications.

PMID- 2214450
TI  - [Long-term follow-up after repair of tetralogy of Fallot].
AB  - One hundred sixty-six patients with tetralogy of Fallot including 15 extreme type
      patients repaired since 1971 were analyzed with respect to their physical
      activities, school or social life, hemodynamics, ECG, reoperation and late
      mortality. Follow-up period ranged from 1 to 19 years with an average of 9.1.
      There were 9 late deaths including 4 sudden deaths. Actuarial survival rates at
      10 and 19 years were 95.2% and 90.5%, respectively. Eighty-five patients (72.0%)
      of 118 replied were in NYHA functional class I, 31 (26.3%) in class II and 2
      (1.7%) in class III. Thirteen patients (7.8%) demonstrated right ventricular/left
      ventricular systolic pressure ratio over 0.80 because of inadequate relief of the
      pulmonary stenosis or obstruction, hypoplasia of the pulmonary artery or external
      conduit stenosis. Although the left ventricular ejection fraction was maintained
      at normal range (0.65 +/- 0.09), that of the right ventricule was below normal
      level (0.52 +/- 0.09). Two patients developed complete heart block
      postoperatively and underwent pacemaker implantations. Complete right bundle
      branch block was observed in 85 patients including 6 with left axis deviation. It
      is concluded that early correction even in the early infancy, adequate
      enlargement of the right ventricular outflow tract and minimal right
      ventriculotomy should be applied for correction of tetralogy of Fallot.

PMID- 2214451
TI  - [Exercise tolerance after correction of tetralogy of Fallot].
AB  - Twenty-six postoperative patients with tetralogy of Fallot (TF) were evaluated by
      exercise stress test with an upright cycle ergometer. Oxygen uptake was assessed
      at the anaerobic threshold and the peak achieved work load. Oxygen uptake at the
      anaerobic threshold (VO2AT) was in the normal range regardless of the existence
      of residual stenosis (PS) or pulmonary regurgitation (PR). However, oxygen uptake
      at the peak achieved workload (VO2max) was subnormal in patients with PS or PR.
      Maximal heart rate in TF patients was lower than normal. Patients with PR showed
      significantly reduced VO2max as compared with those without PR (p less than
      0.05). This is found to be resulted from limitation of the oxygen pulses
      increase.

PMID- 2214452
TI  - [Postoperative long-term quality of life at present after total correction of
      tetralogy of Fallot].
AB  - We performed a questionnaire study in 47 patients who underwent corrective
      surgery for tetralogy of Fallot (TF) more than 10 years previously. To evaluate
      quality of life, we used well-being score advocated by Kaplan. 12 patients whose
      well-being score was 1.0 were in entirely good health without any complaints.
      Well-being score of patients averaged 0.773 with the range from 0.58 to 1.0. The
      patient with high RV/LV pressure ratio or large CTR tended to have a low well
      being score. Grade of Lown classification did not correlate to well-being score.

PMID- 2214453
TI  - [Longterm result of standardized patch infundibuloplasty and its application to
      conotruncal repair in tetralogy of Fallot].
AB  - Longterm result more than 10 years of standardized patch infundibuloplasty which
      had started in 1974 was reviewed. Thirty four cases were categorized into three
      groups. Group A: patch infundibuloplasty less than 45% of RV length. Group B:
      patch infundibuloplasty more than 45%, Group C: non-cusped transannular patch.
      Group B had longer patch infundibulolasty than group A and C. RV/LV pressure
      ratio of group C was higher than that of group A and B. There was no significant
      difference in CTR. However, when the cases with CTR more than 55% were precisely
      compared, enlarged CTR was related to high RV pressure and pulmonary
      regurgitation in group C while it might result from residual shunt in group A and
      B. Although longterm result of standardized patch infundibuloplasty was good,
      even small pressure and volume load in RV should be avoided as much as possible.
      Based on this longterm result, the conotruncal repair has been introduced and its
      better longterm result would be expected.

PMID- 2214454
TI  - [Late results after open repair of tetralogy of Fallot: a 13-24 year follow-up].
AB  - Late results in 139 patients undergoing open repair of tetralogy of Fallot from
      1965 to December 1975 were analyzed. Their ages ranged from 1 year to 35 years.
      All patients were repaired through a right ventricular approach. One hundred two
      patients had infundibulectomy alone (non-patch group) and 14 required right
      ventricular outflow patch (RV-patch group) and 23 trans-annular patch. The
      hospital mortality rate was 18.7% (26 cases) and 103 patients were discharged and
      have been followed until death or for 13-24 years. Cardiac catheterizations were
      performed in 80 patients an average of 1.8 years after correction. Right
      ventricular systolic pressure was 49.8 +/- 22.4 mmHg in non-patch group, 41 +/-
      16.5 mmHg in RV-patch group and 54.5 +/- 14.2 mmHg in PA-patch group. Seven in 11
      patients of PA-patch group had over an 8 mmHg of right ventricular end diastolic
      pressure. Six patients died during the follow up: four deaths in the first 5
      years, 2 between 5 and 15 years. The causes of death were congestive heart
      failure (3), sudden (1), pneumonia (1) and accidental (1). Late complications
      were 3 arrhythmias and 2 reoperations. Event free rate at 24 years was 74.8 +/-
      3.8%.

PMID- 2214455
TI  - [Long-term (10 to 23 years) clinical evaluation of quality of life in patients
      following open heart repair of tetralogy of Fallot].
AB  - The quality of life of 78 patients out of 79 (99% follow-up rate) was evaluated
      10 to 23 years following intracardiac repair of tetralogy of Fallot. Mean age at
      operation was 6 years of age. Their present ages ranged from 12 to 35, averaging
      21 years old. Eighty three percent of patients are assessed to be in good quality
      of life so far in terms of physical development, life style, CTR values, Ekg
      findings and so on. Pregnancy and delivery in 5 patients were uneventful. On the
      other hand, 17% showed various degree of morbidity including significant residua
      necessitating reoperation in 3 patients, complications such as complete A-V Block
      requiring pacemaker implantation in 7 and sequela like postoperative life
      threatening cardiomyopathy in 3. There were 2 deaths due to this sequela
      comprising 2.6% of mortality rate. Although excellent results are reported in
      recent years, further efforts will be necessary to minimize residuum,
      complication and sequela after surgery especially for this particular disease
      with broad morphological spectrum.

PMID- 2214456
TI  - [Long-term follow-up (20 to 25 years) of tetralogy of Fallot after correction].
AB  - Eighty patients with tetralogy of Fallot who underwent corrective surgery between
      1965 and 1970 were followed and evaluated. Late death was observed in 8 patients,
      and 3 of them were cardiac deaths. The survival rate at 10-year was 96.2%, at 20
      year was 91.7%, and at 24-year was 89.0%. Of the surviving patients, 78% to 85%
      are spending normal social life. Twenty female patients experienced 31
      deliveries, and no babies with cardiac anomaly were born. Most of the complaints
      come from late arrhythmias, and this is the main problem in the long-term period.
      Right ventricular function is considered to be moderately reduced by catheter
      analysis. The importance of preservation of right ventricular function during the
      surgery should be stressed.

PMID- 2214457
TI  - [Late results after total correction of tetralogy of Fallot: over 10 year follow
      up].
AB  - Late results after total correction of tetralogy of Fallot over ten year follow
      up of 84 patients were discussed. No late death was experienced and 95.1% of
      these patients are now in NYHA class I. Reoperations were performed in 7 cases
      (8.3%) in which six had had residual shunt and one had had sick sinus syndrome
      and had VVI pacemaker implantation. Ten cases had over 90% of ratio of right
      ventricular pressure to systemic pressure in systole in their cardiac
      catheterization about 40 days after correction. In spite of this high pressure
      ratio, all cases are now in NYHA class I. We conclude that there is a possibility
      of enabling to preserve pulmonary valve function by adopting smaller criteria
      than the Pacifico's criteria.

PMID- 2214458
TI  - [Long-term results after total correction of tetralogy of Fallot].
AB  - One hundred sixty-two patients underwent total correction of tetralogy of Fallot
      from 1962 to 1979. 130 of these were hospital survivors. We studied the current
      status of the hospital survivors by questionnaires which were sent to 93
      patients. An excellent long-term result was maintained by 87.3% of the 63
      hospital survivors who answered to the questionnaires. Although there was a trend
      toward a higher incidence of symptoms in patients with a higher late
      postoperative RV/LV pressure ratio and in patients with older age at repair, it
      did not reach statistical significance. Six patients in this series have
      undergone reoperation. The most common cardiac problem which required reoperation
      was residual of the VSD. There was one late sudden death postoperatively. The
      RV/LV pressure ratio of the patient was 0.7 and the electrocardiogram at rest
      showed no abnormality except CRBBB. The ventricular dysarrhythmia was supposed as
      the cause of sudden death. The patients who underwent total correction of
      tetralogy of Fallot should be followed up by exercise ECG or 24 hours
      electrocardiographic monitoring.

PMID- 2214459
TI  - [Long-term evaluation after correction of tetralogy of Fallot].
AB  - The long-term survivors of the patients who underwent corrective surgery for
      tetralogy of Fallot between 1956 and 1988 were analyzed with respect to symptoms,
      late death, reoperation, and ventricular arrhythmias. For analysis, these 380
      patients were separated into three periods, April 1956-December 1968 (Period 1),
      January 1968-May 1978 (Period 2), and June 1978-December 1988 (Period 3). In
      Period 3, the intracardiac procedures were performed with or without minimal
      right ventriculotomy. There were 24 late deaths (6.3%), and 10 of them were
      sudden. Nine patients (2.4%) required reoperation. Actuarial reoperation free
      survival rate was 93.8% at 10 years, 90.0% at 20 years, and 85.3% at 30 years.
      There were no differences in the actuarial curve between 3 periods though there
      was no late death in Period 3. NYHA functional class was I in 229 (80%) out of
      all 287 patients whose symptoms were clear to follow up, II in 50 (17), and III
      in 8 (3%). There was no patient in NYHA class IV. The incidence of NYHA class II
      and III was significantly higher in Period 1 (23%) and 2 (28%) than Period 3 (7%)
      (p less than 0.01, p less than 0.01). Ventricular arrhythmias were evaluated in
      155 patients with ambulatory electrocardiography. Significant ventricular
      arrhythmias of Lown's grade 2 to 4 were detected in 52 patients (34%). The
      incidence of significant ventricular arrhythmias of Lown's grade 2 to 4 was
      significantly higher in Period 1 (50%) and 2 (53%) than Period 3 (15%) (p less
      than 0.01, p less than 0.01). Thus symptoms and ventricular arrhythmias increased
      when the follow-up interval exceeded 10 years or in patients with large
      ventriculotomy.

PMID- 2214460
TI  - [Long-term result of total correction of tetralogy of Fallot].
AB  - Long-term result of total correction of tetralogy of Fallot was investigated in
      51 patients who underwent operation at least 10 years previously. Ninety percent
      of the patients who responded to the questionnaires expressed his daily life as
      satisfactory and 4% of the patients had no exercise limitation even in strenuous
      sports like swimming and running. It was disclosed that the exercise capacity in
      long-term period was thought to be prescribed by the developmental state of the
      pulmonary vascular bed at the time of operation which was expressed by the
      preoperative hemoglobin level and the PA/Ao diameter ratio and no correlation was
      found with the RV/LV pressure ratio recorded immediately after correction. Three
      patients died after discharge, 2 years, 2 years and 6 months and 21 years after
      operations respectively and the cause of death was supposed to be arrhythmia. In
      case of postoperative complete right bundle block associated with an extreme
      right axis deviation or left axis deviation, prophylactic pacemaker implantation
      was recommended.

PMID- 2214461
TI  - [Late postoperative results after repair of tetralogy of Fallot].
AB  - Two hundred and eighty two survivors after complete correction of tetralogy of
      Fallot were analyzed in late follow up periods. The method of the reconstruction
      of right ventricular outflow tract was non-transannular path (NTAP) in 110
      patients and transannular patch in 172. In the group of TAP, pulmonary
      regurgitation occurred in all and the cardio-thoracic ratio was larger than the
      ratio in the group of NTAP (p less than 0.05). Postoperative ECG at rest showed
      complete right bundle branch block (CRBBB) in 224 patients and 6 of them showed
      sudden death in their follow up period. However, there were no sudden deaths in
      41 patients without CRBBB. The rate of reoperation after intracardiac repair was
      4.25% and the causes were residual pulmonary stenosis and residual ventricular
      septal defect, and there were no significant differences of the reoperation rate
      between NTAP-group and TAP-group.

PMID- 2214462
TI  - [Clinical and pathological study on 47 cases of renal pelvic and ureteral
      tumors].
AB  - 47 cases including 24 renal pelvic tumors, 20 ureteral tumors and 3 renal pelvic
      and ureteral tumors treated in our hospital from January, 1980 to December, 1987,
      were studied clinico-histopathologically. The patients ranged in age from 38 to
      81 years (average 65 years) the sex ratio was 3:1 with male predominance over
      female. Tumor occurred on the right side in 19 cases, on the left side in 27
      cases and bilaterally in 1 case. The most frequent sign was hematuria which was
      observed in 40 cases (85%). The interval from the onset of initial symptoms to
      the first visit was within one month in 9 cases (19.1%). The major findings of
      excretory urograms were filling defect in 21 cases (47.1%) and non-visualizing
      kidney in 15 cases (33.8%). Positive urinary cytology was obtained in 21 cases
      (44.7%). Operative therapy as performed in 45 cases, namely, nephroureterectomy
      and partial cystectomy in 30 cases (66.7%) and nephroureterectomy in 9 cases
      (20%). Histopathologically, all cases but two cases of squamous cell carcinoma
      and to cases of mixed type carcinoma are transitional cell carcinoma. Subsequent
      bladder tumors were found in 8 cases (17.7%). The overall survival rate at 1, 3
      and 5 years were 80.2%, 41.1% and 41.1%, respectively by Kaplan-Meier method. In
      this series, the interval from the onset of initial symptoms, the grade and stage
      of tumor and metastasis of lymph nodes were to be considered in developing
      prognosis.

PMID- 2214463
TI  - [Therapeutic evaluation of male infertility--the increase of seminal transferrin
      level and the improvement in sperm concentration following administration of
      clomiphene citrate].
AB  - This study was designed to evaluate the functional changes of Sertoli cells
      following the administration of clomiphene citrate for male infertility. Sperm
      count and seminal transferrin level were measured before and after the treatment
      in 22 cases of oligozoospermia (sperm count: less than 20 X 10(6)/ml) and 14
      cases of subnormal sperm count group (sperm count: 20-30 X 10(6)/ml). Clomiphene
      citrate was administered per os for more than 3 months consecutively in a dose of
      25 mg/day. Seminal transferrin concentration increased more than 1.5 times
      compared with pre-treatment level in 6 cases (16.7%). Among these patients, sperm
      count markedly increased (20 X 10(6)/ml or more than the pre-treatment level) in
      3 cases (50%) and slightly increased (10 X 10(6)/ml or more than pre-treatment)
      in 1 case (16.7%). In 30 cases, in which seminal transferrin level did not
      increase, sperm count markedly increased in 6 cases (20%) and slightly increased
      in 6 cases (20%). Thus, sperm count was improved more frequently in the cases in
      which seminal transferrin level remained elevated than the cases with no
      elevation of serum transferrin level. Serum FSH level of patients whose seminal
      transferrin level remained elevated after the treatment was significantly higher
      than that of patients with no elevation of serum transferrin level (mean +/- SD =
      32.8 +/- 18.0 mIU/ml v.s. 14.4 +/- 11.7 mIU/ml, respectively). These data
      suggested that the activation of Sertoli cells may contribute to the increase of
      sperm count following the administration of clomiphene citrate and the elevated
      seminal transferrin secretion may be related to the increase of serum FSH level
      following this treatment.

PMID- 2214464
TI  - [Effect of age on the amount of autonomic receptors in the rabbit prostate
      homogenate].
AB  - The amount of autonomic receptors in the old and young rabbit prostate homogenate
      was measured in order to study the effect of age on the autonomic receptors of
      the prostate using radioligand binding techniques. For measuring the adrenergic
      alpha-1, alpha-2, beta-receptors and cholinergic muscarinic receptors, 3H
      Prazosin (3H-PZ), 3H-Yohimbine (3H-YOH), 3H-Quinuclidinylbenzilate (3H-QNB) were
      used, respectively. It was found that both the young and old rabbit prostate has
      a single class of binding sites for each ligand examined. There was an age
      related difference in the distribution of these autonomic receptors (young: alpha
      1 = muscarinic greater than alpha 2 greater than beta, old: alpha 1 greater than
      muscarinic greater than alpha 2 greater than beta). There were more alpha-1 and
      alpha-2 receptors in the old rabbit prostate, although these differences were not
      statistically significant. There was no age-related differences in the amount of
      beta adrenergic and muscarinic receptors. These results demonstrate that the age
      may affect the distribution of autonomic receptors but not significantly the
      amount of autonomic receptors of rabbit prostate.

PMID- 2214465
TI  - [Treatment in 50 cases of transitional cell carcinoma in renal pelvis and
      ureter].
AB  - A total of 50 cases of primary tumors in the renal pelvis and ureter were treated
      in Tokyo University Branch Hospital (20 cases in 1966-1982) and in Tranomon
      Hospital (30 cases in 1977-1987). They were composed of 42 men and 8 women
      (5.3:1) with a mean age of 61 years. 31 patients suffered from renal pelvic
      tumors, 15 ureteral tumors and 4 tumors in both sites. The tumors were located in
      the left side in 33 cases, right in 16, and both sides in 1.86% of patients
      showed gross hematuria. The findings on IVP were filling defect (42%) and
      nonvisualization (33%). Positive urine cytology was obtained in 12 of 25 cases
      (48%). Surgery was performed in 47 cases. The remaining 3 cases were with
      advanced diseases. The surgeries were total nephroureterectomy plus ipsilateral
      retroperitoneal lymph node dissection in 26 cases, total nephroureterectomy
      without node dissection in 7, total nephroureterectomy and total cystectomy in 3,
      nephrectomy in 9, partial nephrectomy in 1 and segmental excision of ureter with
      ureteroureterostomy in one. Histologically, all tumors were transitional cell
      carcinoma. Over-all survival rates (Kaplan-Meier's method) of the operated
      patients at 1, 3, 5 years were 84.2%, 73.1% and 69.4%, respectively. The stage
      and grade of the tumors affected the prognosis. N factor at lymph node dissection
      was the most determining factor of prognosis. 3 advanced cases who did not
      receive surgery for primary site were treated with 5FU in 2, and with CAP in 1.2
      of them died of the disease within 1 year after diagnosis, one patient was lost
      in follow up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214466
TI  - [Urinary incontinence in children with primary vesicoureteral reflux--urinary
      incontinence and function of refluxing kidney].
AB  - The interrelation among urinary incontinence (nocturnal enuresis, urge
      incontinence), history of urinary tract infection and renal function was
      investigated in 153 children with primary vesicoureteral reflux who were more
      than three years old. Of them, 98 children (64%) had the chief complaint of
      urinary tract infection (UTI) and 43 children (28%), urinary incontinence. Of the
      children whose chief complaint was UTI, 44 (45%) had incontinence. Thus, 87
      children (57%) with VUR had urinary incontinence. Almost all the children who had
      urinary incontinence and no previous UTI had good renal function. Renal
      dysfunction was found in children with previous UTI history. These studies on
      children with primary VUR more than three years old indicate that, although
      urinary incontinence could be a factor for recurrence of UTI and a probable cause
      of worsening of renal function, there is no direct correlation between urinary
      incontinence and renal dysfunction accompanied by VUR.

PMID- 2214467
TI  - [Clinical study of penile carcinoma in 38 cases].
AB  - We retrospectively reviewed 38 patients with primary penile squamous cell
      carcinoma (stage 1 in 22, stage 2 in 7 and stage 3 in 9) who were treated in our
      institution from 1963 through 1987. The incidence of regional nodal metastasis
      was correlated with tumor category, local infiltration and tumor grade. The
      incidence rate of nodal metastasis of G2 and G3 tumors was statistically higher
      than that of G1 tumors. Of 27 patients initially treated by radiotherapy and/or
      chemotherapy, 11 patients achieved complete response. G1 tumors and T1 to 2
      tumors had such high response rates as 58 and 50 per cent, respectively, but 5
      patients (45 per cent) had local recurrence at an average of 74 months after
      initial treatment. The 5-year survival rates of over-all, stage 1, 2 and 3 were
      73, 90, 75 and 25 per cent, respectively. Patients with stage 3 disease had a
      statistical lower survival rate than those with stage 1 or 2 disease. Among 13
      patients with regional nodal metastasis, none with G2 tumor survived three years,
      although 3 patients (60 per cent) of those with G1 tumor survived five years.
      These results suggest that tumor grade is the most prognostic factor for the
      regional nodal metastasis, the response of conservative treatment and the
      survival of metastasized patients.

PMID- 2214468
TI  - [Study on adoptive immunotherapy on patients with renal cell carcinoma. I.
      Functional characteristics of peripheral blood mononuclear cells and serum
      immunosuppressive factors in patients with renal cell carcinoma].
AB  - The immune responses in patients with renal cell carcinoma were evaluated from
      the production of interleukin-2 (IL-2), the expression of IL-2 receptors and the
      activity of lymphokine activated killer (LAK) cells. In addition, the effect of
      the patient's serum on the expression of IL-2 receptors and LAK activity were
      investigated. The production of IL-2 by peripheral blood mononuclear cells (PBM)
      from patients with renal cell carcinoma was not suppressed, when compared with
      that in controls. However, the expression of IL-2 receptors tended to decrease
      with the progression of clinical stage. The LAK cells generated by PBM of
      patients with renal cell carcinoma had significant cytotoxic activity against
      Daudi cells, ACHN cells and autologous tumor cells, while autologous serum
      suppressed the expression of IL-2 receptors and the induction of LAK cells in
      patients with renal cell carcinoma. Furthermore, serum from patients with renal
      cell carcinoma suppressed the cytotoxic activity of LAK cells generated by PBM
      from a normal volunteer. These results indicated the presence of
      immunosuppressive factors in the serum of patients with renal cell carcinoma
      which impaired the clinical effect of treatment using IL-2 or LAK cells.

PMID- 2214469
TI  - [Study on adoptive immunotherapy in patients with renal cell carcinoma. II.
      Plasmapheresis with adoptive immunotherapy using LAK cells and IL-2].
AB  - The existence of immunosuppressive factors which impair the clinical effect of
      treatment using IL-2 or lymphokine activated killer (LAK) cells has been reported
      in the serum of patients with renal cell carcinoma. For the purpose of
      eliminating these immunosuppressive factors, plasmapheresis combined with
      adoptive immunotherapy using LAK cells was performed in ten patients with stage
      IV renal cell carcinoma. Immunological examinations revealed that the number of
      peripheral blood lymphocytes, NK activity and the ratio of Leu 11 positive cells
      were increased during the treatment. Of the 9 evaluable patients, one has a
      partial response, 5 showed no change and 3 had progressive disease. In addition
      to the one partial response, the size of some metastatic lesions in the lungs
      decreased in 2 patients during the treatment. As serious side effects, brain
      edema progressed in 2 patients with brain metastases and acute hepatitis due to
      plasmapheresis was noted in one patient. Moreover, transient and reversible renal
      dysfunction developed in most patients. These results indicated that
      plasmapheresis combined with adoptive immunotherapy using LAK cells is a useful
      therapy for patients with advanced renal cell carcinoma.

PMID- 2214470
TI  - [The effect of glycosaminoglycans on calcium oxalate crystal formation].
AB  - The effect of glycosaminoglycans on calcium oxalate crystal formation in the
      supersaturated solution was studied by examining the size and shape of calcium
      oxalate crystals generated under an optical microscope. It was found that heparan
      sulfate and heparin were more effective growth inhibitors than chondroitin
      sulfate and hyaluronic acid at concentrations within their respective urinary
      range. With increasing calcium and/or glycosaminoglycans concentration in the
      solution, the degree of growth inhibition caused by glycosaminoglycans was
      enhanced. Calcium oxalate crystal shapes generated with various
      glycosaminoglycans varied with glycosaminoglycan species. One of the causes of
      those differences in the shape and degree of growth inhibition might be the
      structural differences between them, that is, the number of sulfate residue and O
      or N-form they contain. Calcium oxalate crystal shapes in the presence of
      heparin or heparan sulfate at higher concentrations were similar to those of
      calcium oxalate monohydrate crystals in the urinary sediments of hyperoxaluric
      patients. These facts might suggest the possibility that heparin and/or heparan
      sulfate were present in the crystal forming region.

PMID- 2214471
TI  - [Micturition and uroflowmetric analysis of adult females].
AB  - Voiding parameters on the Uroflow Diagnostic Interpretation (UDI) were analysed
      in relation to the voided volume in 58 micturitions of 36 healthy adult females.
      The maximum flow rate (Qmax) and the mean flow rate during central 90% of the
      voided volume (QM90) increased linearly up to the voided volume of 400 ml. The
      voiding time (T100) took a value within a certain range independently of the
      voided volume from 100 to 400 ml and never exceeded 21 seconds in all
      micturitions. Voiding time for the central 90% of the voided volume (T90), time
      to Qmax (TQmax) and time from Qmax to 95% of the voided volume (Tdesc) were
      independent of the volume voided. The maximum rate of increase of flow rate
      (dQ/dT max) and the estimated bladder wall contraction velocity at 40 ml bladder
      contents (dL/dT 40) showed a tendency to increase depending on the volume voided.
      T100 showed a prolongation in 84.0% of 25 micturitions in 20 neurogenic bladder
      patients and in 66.7% of 27 in 21 chronic cystitis patients, always accompanied
      by a prolongation of T90. No other parameters were clearly different between
      healthy women and patients and/or between the two groups of patients. Voiding
      time is a useful parameter representing female micturition.

PMID- 2214472
TI  - [Treatment of asynchronous bilateral renal cell carcinoma. On our experience of
      enucleation for two cases].
AB  - In patients with either bilateral renal malignancies or with carcinoma occurring
      in a solitary kidney, the principle of en bloc removal of the tumor-bearing
      kidney cannot be applied. Recently we have performed surgical enucleation in two
      cases of asynchronous bilateral renal cell carcinoma. Case 1. A 60-year-old woman
      was hospitalized with diagnosis of left renal tumor 10 years tumor 10 years after
      right nephrectomy for renal cell carcinoma. The tumor was enucleated while
      occluding the renal vessels. Pathological examination revealed that the tumor (a
      nodule of 35 g) was renal cell carcinoma of grade I and perfectly covered by
      pseudocapsule. Hemodialysis was not required. The patient has been well for more
      than 11 months postoperatively and Ccr is 65 ml/min. Case 2. A 62-year-old man
      with slight elevation of serum GOT and GPT level was examined by CT, which
      revealed a space occupying lesion in the left kidney. He had undergone
      nephrectomy for renal cell carcinoma of right kidney 11 years ago. Three nodules
      of 56 g, 6 g and 3 g were removed by in situ enucleation. They were renal cell
      carcinoma of grade II and there was no malignant penetration of the pseudocapsule
      pathologically. After surgery hemodialysis was required 10 times for 21 days.
      Renal function has been refined gradually and the patient is well with 47.3
      ml/min of Ccr at 4 months postoperatively. Before this report of 2 cases there
      were 22 cases of asynchronous bilateral renal cell carcinoma in Japanese
      literature.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214473
TI  - [Neurogenic bladder dysfunction due to spina bifida and sacral dysgenesis
      manifested itself in middle age. Report of a case].
AB  - Congenital neurogenic bladder dysfunction with spina bifida and sacral dysgenesis
      manifested itself at middle age is reported. A 48-year-old male who had urinary
      retention and suprapubic cystostomy one year and a half before in another
      hospital was seen, asking for removal of the cystostomy. He had never had any
      neurologic or bladder dysfunction in his childhood and adulthood. X-ray
      examination revealed a bifid spine and sacral dysgenesis, bilateral
      hydronephrosis, bilateral VUR and urethral stricture. Uroflowmetry showed a
      severe dysuric pattern (voided volume 5 ml, residual urine 230 ml) and the
      cystometrogram revealed a hyperactive bladder. Optical urethrotomy for stricture
      yielded some improvement i.e. recovery of voluntary voiding with large amount of
      residual urine. TUR of the bladder neck resulted in almost complete voiding.
      Cohen's antireflux operation yielded favorable improvement of hydronephrosis. The
      bladder and renal function remained favorable in the follow-up period of about
      two years. The clinical course of this patient suggested that his bladder
      dysfunction was due to late manifestation of congenital neurogenic bladder.

PMID- 2214474
TI  - [Basic and clinical research of impotence--its present situation and problems
      involved].
AB  - From detailed investigation of the vascular structure of the penis, it has been
      proposed that there exists a valvular structure, consisting of smooth muscle,
      located at a point immediately before the helicine artery, bifurcated from the
      deep artery, opens to the cavernous sinuses, an area where autonomic nerves are
      densely distributed, participating in opening and closing the valve. On the other
      hand, there is said to be no valvular structure in the vein outflowing from the
      cavernous sinuses, and blood flows into the dorsal penile vein by penetrating the
      albuginea obliquely or vertically after running parallel in the region
      immediately below the albuginea. It is considered that, when the valve of the
      helicine artery opens, blood flows into the cavernous sinuses, expanding them,
      and as a result the outflowing vein is compressed between the sinuses and the
      albuginea, or the albuginea itself, acting like a valve and therefore assuming an
      important function in maintaining erection by disturbing the reflux of blood
      flow. It is also presumed that the contracting of ishiocavernous muscle plays a
      part in developing the rigidity of the penis. It is considered, moreover, that
      the trabecula of the cavernous body consisting of smooth muscle also plays a part
      in the promotion and disappearance of erection. It is very important to run
      functional tests of erection when diagnosing impotence, and today many tests are
      available for differential diagnosis; including papaverine test, dynamic
      cavernosometry and cavernosography. As for therapy, treatments involving
      vasoactive agent infusion, such as papaverine or prostaglandin E1 into the
      cavernous body, have become common. For cases with venous impotence, ligation of
      the penile deep vein and crus of the penile cavernous body have come to be
      attempted. Furthermore, revascularization of penile artery can be performed to
      treat arterial impotence. For cases in whom these methods are not effective,
      implantation of various penile prostheses into the penis has been shown to be
      successful.

PMID- 2214475
TI  - [Spontaneous resolution of reflux in children with primary VUR].
AB  - Although the adverse effects of vesicoureteral reflux on the renal function and
      renal growth have been well documented, there is still controversy regarding the
      factors for spontaneous cure of reflux and the time required for the resolution.
      We performed a retrospective analysis of 829 ureters in 541 children who have
      been followed for more than 3 years since 1973. Reflux was judged as
      spontaneously cured only after 2 micturition cystourethrograms (MCU) had shown no
      reflux. In total reflux resolved in 220 ureters (26.5%) of 182 children (33.6%).
      Resolution rate was 39.5% in boys and 28.0% in girls, and there was statistically
      significant difference between both sexes. In children who had underwent
      urethrotomy on congenital urethral stenosis, e.g. bulbous urethral stenosis in
      the boy and distal urethral stenosis in the girl, resolution rate was 43% in boys
      and 23% in girls. Resolution rate according to VUR-grade was 85.5% in grade I and
      II reflux, 45.8% in grade III, and 6.7% in grade IV and V. Of 92 children who
      underwent urodynamic evaluations, 37% showed findings of unstable bladder. Renal
      scarring was observed in 7.3% of renal units which was significantly less
      frequent than the incidence among total renal units with reflux. Reflux was
      resolved in 30% of renal units without scarring and 10% of renal units with
      scarring. The incidence of small kidney in the spontaneously resolved group was
      3.6%, which was significantly lower compared to the total renal units with
      reflux. The mean age at resolution of reflux was 5.7 years in boys and 7.5 years
      in girls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214476
TI  - [A clinical evaluation of lymphography in bladder tumor].
AB  - A study was conducted in a total of 51 patients with urinary bladder tumor who
      had received surgical operation associated with removal of regional lymph nodes
      after lymphography. Abnormal findings were observed in lymphogram of 22 patients.
      The other 29 patients showed no such abnormality. After the operation
      pathological metastasis was confirmed in 7 patients. Lymphograms of these
      patients ith positive lymphatic metastasis revealed filling defects in 85.7% and
      collaterals in 57.4%. There as correlation between the occurrences of these two
      findings based on quantification analysis III of multivariate analysis.
      Lymphography before operation showed 87.5% of sensitivity, 65.1% of specificity
      and accuracy of 68.6%, not having higher accuracy compared to other studies.
      These results suggest that lymphography, which may have clinical significance, is
      not a decisive method in exploration of bladder tumor. Comprehensive analysis of
      diagnostic imaging should be performed, including CT after lymphography.

PMID- 2214477
TI  - [The study of BBN induced bladder cancer in mice. Influence of Freund complete
      adjuvant and associated immunological reactions in mice].
AB  - To evaluate the genetic difference in induction of bladder cancer by N-butyl-N-(4
      hydroxybutyl) nitrosamine (BBN), BBN was given to two different strains of mice,
      i.e. A/J (BCG resistant) strains and C57BL/6 (BCG susceptible) strains. The
      influence of Freund complete adjuvant (FCA), which includes BCG, was similarly
      examined along with associated cellular immunity as evaluated by footpad reaction
      (FPR). The results were as follows: 1. The incidence of bladder cancer was
      significantly higher in C57BL/6 strains (90.0%) than A/J strains (54.5%). 2. FCA
      reduced the incidence of bladder cancer significantly in C57BL/6 strains. 3. FPR,
      which reflects the delayed type hypersensitivity, was activated significantly in
      FCA treated C57BL/6 strains. These data suggest that the strain differences in
      mice probably explains the inhibition of carcinogenesis by FCA and cellular
      immunity.

PMID- 2214478
TI  - [Intravesical bacillus Calmette-Guerin (BCG) in the treatment of superficial
      bladder cancer. Prospective randomized study for prophylactic effect].
AB  - We report the results of prospective randomized study which was designed to
      evaluate prophylactic effects of intravesical bacillus Calmette-Guerin (BCG) in
      the treatment of superficial transitional cell carcinoma of the bladder. A total
      of 44 cases who had no previous treatment of bladder cancer were randomly
      assigned to BCG or control groups after TUR. BCG group (23 cases) received
      intravesical instillation of 80 mg BCG (Tokyo strain) at one week intervals for 6
      weeks, at two week intervals for 12 weeks, and at one month intervals for 20
      months. In BCG groups, 3 cases had recurrence at 6 months and 1 case at 9 months,
      while the other 19 cases had no recurrent disease for 3 to 34 months (average
      20.3 months) of follow-up. Control group (21 cases) had no further treatment
      after TUR. In control group, recurrence was seen at 3 months in 3 cases, at 6
      months in 5 cases, at 9 months in 2 cases, at 12 months in 3 cases and at 21
      months in 1 case. Only 7 cases in the control group were free of recurrence for 8
      to 45 months (average 32.3 months) of follow-up. One and two year-recurrence
      rates in BCG group (18.4%, 18.4%) was significantly (p less than 0.01) lower than
      those in control group (63.2%, 68.9%). Among the complications of intravesical
      BCG were cystitis (76.2%), low grade fever (13.0%), and several days' persistent
      gross hematuria (13.0%). Most of these signs were self-limited and only in 2
      cases instillation of BCG was discontinued.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214479
TI  - Annual list of emergency nursing graduate programs.

PMID- 2214480
TI  - "Benign" treatments: be critical, and first, do no harm.

PMID- 2214481
TI  - Emergency services, emergency nursing, and the consumer.

PMID- 2214482
TI  - "Management of stress and prevention of burnout" conclusions questioned.

PMID- 2214483
TI  - Reye's syndrome reminder.

PMID- 2214484
TI  - More information sought on case review.

PMID- 2214485
TI  - Data regarding methylprednisolone therapy for acute spinal cord injuries needs to
      be disseminated: emergency nurses can help.

PMID- 2214486
TI  - Case review. A 27-year-old woman with verapamil overdose.

PMID- 2214487
TI  - Rural trauma: the Oregon experiment.

PMID- 2214488
TI  - Student internship in emergency nursing: one answer to the nursing shortage.

PMID- 2214489
TI  - HIV testing of sexual assault populations: ethical and legal issues.

PMID- 2214490
TI  - October: a harbinger of pediatric trauma.

PMID- 2214491
TI  - Law and the emergency nurse. Death in the ED holding area--liability?

PMID- 2214492
TI  - Nurse educator. "Teddy bear clinic".

PMID- 2214493
TI  - Triage decisions. A 59-year-old woman with acute dyspnea.

PMID- 2214494
TI  - Four little stitches.

PMID- 2214495
TI  - Emergency Nurses Association position statement. The use of nonregistered nurse
      (non-RN) care givers in emergency departments.

PMID- 2214497
TI  - Emergency Nurses Association position statement. Integration of emergency nursing
      concepts in nursing curricula.

PMID- 2214496
TI  - Emergency Nurses Association position statement. Injury prevention.

PMID- 2214498
TI  - Laryngostrobovideography using a flexible laryngofiberscope performed in
      conjunction with the phonatory examination.
AB  - The phonatory examination was performed while monitoring vocal fold vibration by
      laryngostrobovideography. Vocal fold vibration was video-taped by a
      laryngostroboscope and flexible laryngofiberscope inserted through the nasal
      cavity. Simultaneously, the phonatory examination was conducted with a phonation
      analyzer. The data were entered into a personal microcomputer via an A/D
      converter and analyzed to obtain the parameters of sound pitch, sound intensity
      and mean expiratory air flow volume, which were superimposed on the color video
      monitor screen.

PMID- 2214499
TI  - Plummer-Vinson syndrome complicated by gastric cancer: a case report.
AB  - Plummer-Vinson syndrome has been brought to attention as a precancerous lesion of
      hypopharyngeal and cervical lesions of the esophagus, but that involving the
      stomach is uncommon. We report a case of Plummer-Vinson syndrome with gastric
      cancer. A brief literature review of this disorder is presented, and possible
      causes in this unusual case are discussed.

PMID- 2214500
TI  - Preliminary study on the microbiology of Campylobacter pyloridis and gastric
      histopathology.
AB  - Biopsy samples were taken endoscopically from the antral-mucosa of 693 patients
      with peptic ulcer and chronic gastritis presenting dyspepsia symptoms.
      Campylobacter pyloridis cultures were positive in 59 of 98 (60.2%) cases and
      histopathologically the organisms were found in 411 of 693 cases (59.3%).
      Pathologically, Campylobacter pyloridis was positive in 273 out of 300 patients
      with chronic superficial gastritis (91.0%), in 102 of 249 patients with chronic
      atrophic gastritis (40.9%), in 36 out of 144 patients with chronic atrophic
      gastritis with intestinalization or dysplasia (25.0%). We found that there was a
      significant association between the presence of Campylobacter pyloridis and
      chronic superficial gastritis, also the degree of lymphocyte infiltration showed
      a strong inverse association with the presence of Campylobacter pyloridis,
      suggesting that a local immune response might exert an important action in the
      eradication of this organism. These findings support the view that Campylobacter
      pyloridis, may be etiologically related to chronic gastritis and peptic
      ulceration, even though its role still remains to be determined.

PMID- 2214501
TI  - Surgical treatment of arch-type dissecting aortic aneurysms.
AB  - We have proposed calling dissecting aortic aneurysm with entry of the dissection
      in the aortic arch "arch-type". We described the procedures and results of
      surgery for 12 cases of this disorder. The dissection was localized (type a) in
      six cases, and extended (type b) in the other six. Seven cases were treated by
      patch or direct closure of the entry, with one operative death and two later
      deaths. Five cases were treated by reconstruction of the ascending aorta and the
      aortic arch with a prosthetic graft, with two operative deaths and one later
      death. Efforts must be directed towards improving the outcome of the latter
      operation.

PMID- 2214502
TI  - Ether lipids in cancer chemotherapy.
AB  - There is considerable evidence that certain ether lipids such as 1-0-octadecyl-2
      0-methyl-rac-glycero-3-phosphocholine represent a new class of antineoplastic
      agents. These ether lipids have been shown to be cytotoxic for a wide variety of
      tumors. The site of action of ether lipids appears to be the cell membrane, where
      they inhibit the biosynthesis of phosphatidylcholine as well as the activity of
      protein kinase C. However, it remains uncertain that these effects represent the
      only mechanism for the cytotoxic action of these ether lipids. Further
      experiments to elucidate the molecular mechanisms of the cytotoxic action of
      these compounds are necessary. Clinical phase I pilot trials have been completed
      showing encouraging tumor response in a small number of patients treated. Some of
      these ether lipids are selectively cytotoxic to leukemic cells sparing of normal
      cells within a certain dose range. Thus, they are uniquely suitable for purging
      residual leukemic cells from remission marrow used for autologous bone marrow
      transplantation. A phase I/II study of autologous bone marrow transplantation in
      acute leukemia using bone marrow cells treated with ether lipids is in progress.

PMID- 2214503
TI  - Expression of hepatitis B surface antigen in Chang cells transfected with
      hepatitis B virus DNA.
AB  - To investigate hepatitis B virus (HBV) biology in vitro, the transfection of
      recirculized HBV DNA into Chang cell line was performed. Linear HBV DNA was
      isolated from recombinant HBV DNA, pHBR105, which includes the whole genome of
      HBV and was recirculized. Chang cells were transfected with this recirculized HBV
      DNA by the two different procedures of calcium/phosphate coprecipitation and
      electroporation. After the transfection, the presence of large nucleated cells
      with multinuclei and ground-glass cytoplasma were noticed and these cells seemed
      to proliferate faster than untreated Chang cells. Transient expression of
      hepatitis B virus surface antigen (HBsAg) was demonstrated in cytoplasma of
      transfected cells by indirect immunofluorescence. HBsAg was not detected in the
      culture supernatants by radioimmunoassay. The extra-chromosomal HBV DNA was
      detected in the transfected cells by both procedures 7 weeks after the
      transfection by Southern blot analysis but it was lost 4 weeks after that. It was
      demonstrated that it was possible to transfect Chang cells with HBV DNA and that
      DNA was functioning to express HBsAg transiently.

PMID- 2214504
TI  - Assessment of procedures and instruments for intracordal injection: evaluation of
      the syringe for periodontal ligament anesthesia (CITO JECT).
AB  - The intracordal injection technique was first introduced by Brunings in 1911.
      This technique has been accepted as vocal rehabilitation for dysphonia caused by
      deficiencies of glottal closure. Although various injection materials have been
      evaluated, the injection procedure itself has not been studied. In this study, we
      measured the mechanical force required to perform intracordal injection by using
      a certain amount of substance, when varying the needle size and syringe type.
      Although a large needle can reduce the mechanical force for injection, leakage
      from the pinhole can not be prevented. We modified this technique by introducing
      a CITO JECT, a syringe, which is used for the anesthesia of the periodontal
      ligament, to perform the collagen injection. With this technique, the mechanical
      force required for the injection can be reduced to 1/2 to 1/4 of the force by the
      conventional technique. We conclude that the introduction of this syringe enable
      us to use the needle with smaller diameter to facilitate the intracordal
      injection.

PMID- 2214505
TI  - Family therapy for juvenile delinquents in a reformatory, K-Institute.
AB  - The number of juvenile delinquents detained by police for shoplifting, glue
      sniffing, and automobile and bicycle theft reached its highest level in Japan in
      1980 since world war II. The incidence of delinquency has fluctuated up and down
      somewhat between 1981 and 1988 but has remained slightly below the 1980 peak. In
      1988 the number of juvenile detainees between the ages of 14 and 18 was 187,172.
      Juvenile delinquents currently undergoing training and treatment at the K
      Institute in Kanagawa Prefecture will be discussed. The K-Institute for the
      training and correction of juvenile delinquents is a public institution which was
      established in 1900. It has a holding capacity for 100 male offenders. We have
      interviewing and treating inmates by psychotherapeutic and psychopharmacological
      methods since 1975. The institute has recently begun to practice a form of
      inclusive family therapy where the parent comes and stays with the child in the
      institute for a short period of time. The treatment program has shown a success
      so that so far none of the participants have returned to the institute, while 30%
      of non-participants have returned to the institute.

PMID- 2214506
TI  - [The sequelae of tuberculosis].
AB  - During the 20th century, tuberculosis has been the most prevalent and most
      harmful disease in Japan. Enormous medical researches have ever been performed to
      conquer the disease. Nevertheless tuberculosis has left various somatic and
      psychological residues on vast convalescents. On the other hand, researches to
      conquer tuberculosis have made considerable contribution to other fields of
      medicine. 1. Somatic and psychological residues on convalescents from
      tuberculosis. Chest x-ray findings, cardio-pulmonary disturbance, secondary
      infection, serum-hepatitis due to mass transfusion during the chest surgery,
      streptomycin-deafness and psychological disorder. 2. Sequelae of phthisiology. a.
      In the field of basic medicine. Respiratory physiology, immunology and genetic
      pharmacology. b. In the field of epidemiology. Methodology to control the
      disease. c. In the field of clinical medicine. Chest x-ray diagnostics,
      bronchoscopy, thoracoscopy, randomized controlled trial, regimens of
      chemotherapy, open chest surgery, anesthesiology, treatment of respiratory
      failure, informed consent, terminal care and cooperative study system. d. In the
      field of rehabilitation. Medical, vocational and social rehabilitation of the
      handicapped. e. In the field of public health. Comprehensive control system of
      the chronic disease. Smallpox has been eradicated, but the elimination of
      tuberculosis is still far away. Studies as excellent as past ones should
      intensively be carried out.

PMID- 2214507
TI  - [Tuberculin skin test among medical college students].
AB  - The incidence of active tuberculosis in Japan has markedly decreased in the past
      few decades. It is also reported that the prevalence of tuberculosis infection in
      young population has been decreasing in accordance with the decline in the
      overall occurrence of tuberculosis. The above mentioned facts indicate that the
      younger population has a greater risk of developing tuberculosis once exposed to
      tuberculosis infection. Actually, the epidemics of tuberculosis among the
      adolescent population have often been reported in recent years. We performed a
      tuberculin skin test on our medical college students, who might be exposed to
      tuberculosis infection during their student clinical internship, in order to
      obtain the information about their present status of reaction to the tuberculin
      skin test. The data obtained from students between 18 and 25 years old were
      analyzed using Student's t test and Kruskal-Wallis's method. The mean size of
      erythema in the group of 23, 24 and 25 years old were significantly greater than
      that in the group of 20, 21 and 22 years olds. Similarly the latter was
      significantly greater than that in the group of 18 and 19 years olds.
      Furthermore, it was proven by the Kruskal-Wallis's method that the older a group
      was, the greater the chance of a large erythema. One explanation for this fact
      might be a decrease in the prevalence of tuberculosis infection in the younger
      generation as described above. Another explanation seems to be related to the
      revision of the Tuberculosis Prevention Law in 1974.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2214509
TI  - [Determination of the susceptibilities to antituberculosis agents in
      Mycobacterium avium-Mycobacterium intracellulare complex].
AB  - The determination of the susceptibilities to antituberculosis agents in
      Mycobacterium avium-Mycobacterium intracellulare complex (MAI complex) is
      influenced by the size of inoculation used in the determination. Such influences
      differ greatly according to the drugs. By increasing the number of colony-forming
      units (CFU) of the inoculation to 10(6)-fold, minimal inhibitory concentrations
      (MICs) of rifampicin and cycloserine have increased only 2-to 3-fold. However,
      MICs of ethionamide, streptomycin, enviomycin and ethambutol have increased 4-to
      9-fold. In contrast, MICs of isoniazid and sulfadimethoxine have increased 30-to
      35-fold. Since the determination of MICs of isoniazid and sulfadimethoxine are so
      greatly influenced by the size of inoculation, the determinations of MICs of
      these two drugs should be carried out by use of the "actual count" method (6, 7,
      9) or the proportion method (8). In the actual count method, the MIC is
      determined by inoculating 20-100 CFU. The determination of isoniazid
      susceptibility of M. tuberculosis (H37Rv) was influenced only slightly by the
      size of inoculation, but that of M. bovis (BCG) was influenced greatly as
      occurred in the determination of MAI complex strains.

PMID- 2214508
TI  - [The significance of subpleural mononuclear cell infiltration in the differential
      diagnosis of pleurisy showing nonspecific histological findings].
AB  - To determine whether or not patients who showed abundant lymphocytes in pleural
      effusion without any specific findings by pleural biopsy could be
      histopathologically differentiated between those with tuberculous and
      nontuberculous origin, we reexamined histology of pleural biopsies of all
      patients whose pleural effusion showed predominantly lymphocytes and did not
      contain malignant cells from January, 1984 to March, 1989. A total of 45 patients
      with a nonspecific histology of pleural biopsy were categorized based on their
      final diagnosis into three groups; tuberculous (n = 20), carcinomatous (n = 10)
      and nontuberculous, benign pleurisy (n = 15). Pleural biopsy of patients with
      nontuberculous, benign pleurisy frequently showed band-like infiltration of
      mononuclear cells in the subpleural adipose tissue (11 out of 15 patients), while
      the finding was significantly less frequent in those with tuberculous pleurisy (1
      out of 20, p less than 0.01) and pleurisy associated with carcinoma (3 out of 10,
      p less than 0.05). Based on these findings, the presence of band-like
      infiltration of mononuclear cells in the subpleural adipose tissue in pleural
      biopsy of patients with abundant lymphocytes in pleural effusion strongly
      suggests that the pleurisy is nontuberculous origin.

PMID- 2214510
TI  - [Serum adenosine deaminase (ADA) activity in patients with active pulmonary
      tuberculosis].
AB  - To clarify the immunological aspect of tuberculosis, we investigated serum
      adenosine deaminase (ADA) activity, T and B cell percentile in total peripheral
      mononuclear cells, peripheral T cell subpopulation and their relationship with
      other inflammatory parameters in 20 patients with active pulmonary tuberculosis.
      Serum ADA activity showed abnormal high level in all patients in nontreated phase
      with significant regression after three months treatment by anti-tuberculous
      drugs (P less than 0.05). In addition, significant positive correlation was
      observed between serum ADA activity and erythrocyte sedimentation rate at 1 hour
      (r = 0.56). Concerning about peripheral T cell subpopulation studied by two
      colour flow cytometry with FITC-conjugated anti-CD4 and phycoerythrin-conjugated
      anti-HLA-DR antibody, there was positive correlation between CD4(-) HLA-DR(+) T
      cell and serum ADA activity (r = 0.59) without any abnormal frequency of each T
      cell subpopulation. Additionally, after the treatment of pulmonary tuberculosis,
      significant increase of T cell percentile in total peripheral mononuclear cells
      were observed (P less than 0.005). In conclusion, these results may suggest serum
      ADA activity could be a parameter of activity of pulmonary tuberculosis and
      reflect the function of activated suppressor/cytotoxic T cell.

PMID- 2214511
TI  - [An operated case of Mycobacterium fortuitum infection with hemoptysis].
AB  - An operated case of M. fortuitum infection on the bronchiectatic lung was
      presented. A 68-year-old female had had hemoptysis due to bronchiectasis since
      she was 44 years of age. She had a history of pulmonary tuberculosis at the age
      of 58 and treated by anti-tuberculosis drugs for a year. She was referred to the
      National Sanatorium Hiroshima Hospital in March 1986 for surgical treatment, when
      M. fortuitum infection was found. Lobectomy of the right middle lobe, right S6
      Segmentectomy and partial resection of right S2 were performed on December 1st
      1986. After the operation, hemoptysis disappeared but M. fortuitum was still
      found in sputum. Chest X-ray examination revealed some new abnormal shadows. When
      radical surgical treatment for secondary M. fortuitum pulmonary infection is
      considered careful attention should be given to its indications including the
      extent of resection and the predicted post-operative pulmonary function.

PMID- 2214512
TI  - [Hemolytic activity of Mycobacterium kansasii].
AB  - Mycobacterium kansasii has a strong virulence as compared with those of
      "mycobacteria other than tubercle bacilli". In this study, hemolytic activities
      of several strains of M. kansasii were investigated. Secretion of hemolytic
      factor from these strains was not observed, since no hemolytic zone was found
      around the colonies grown on the 7H11 agar plate when 5% rabbit blood agar was
      overlayed. On the other hand, weak hemolytic activities were detected after
      treatment of sonication and trypsin-digestion of M. kansasii cells. They were
      also heat-resistant. These results indicate that endogenous nonproteinaceous
      factor was involved in the hemolytic activity of M. kansasii. Moreover, these
      activities were not species-specific in respect to the kind of target
      erythrocytes used for the assay. However, hemolytic activity of M. kansasii was
      not increased in spite of the change of culture conditions or supplement of
      nutrients into the medium. It is unlikely that this hemolytic activity is
      directly associated with a pathogenesis of M. kansasii, but detailed studies were
      needed to clarify on this point.

PMID- 2214513
TI  - [Bactericidal activities of rifampicin, ethambutol, enviomycin and streptomycin
      on Mycobacterium avium-Mycobacterium intracellulare complex strains].
AB  - Bacteriostatic and bactericidal activities of rifampicin, ethambutol, enviomycin
      and streptomycin on Mycobacterium avium-Mycobacterium intracellulare complex (MAI
      complex) strains were determined. The susceptibility testings were made in Ogawa
      egg medium, and minimal inhibitory concentrations (MICs) were determined as the
      lowest concentration of drugs, in which the growth of 20 to 100 colony-forming
      units was completely inhibited. The MICs correspond to the MICs that can inhibit
      the growth of 95 to 99% of bacterial population. Bactericidal activity was
      determined in a modified Dubos liquid medium (1.3 g of Dubos TB Broth Base were
      dissolved in 180 ml of distilled water and this solution was supplemented by 20
      ml of bovine serum). A one ml-sample of bacterial suspensions (10 mg wet weight
      per ml) was added to 9 ml of the Dubos liquid medium, and the medium was
      incubated at 37 degrees C for 0, 1, 3 and 7 days under shaking condition (56
      strokes per minute; 8 cm amplitude). The bactericidal activity was measured as
      the number of colony-forming units contained in a 0.02 ml-sample of the medium.
      The bactericidal activities of rifampicin and ethambutol were weak or absent even
      in strains 13008 and 13016, which were very susceptible to all four drugs.
      However, the bactericidal activities of streptomycin and enviomycin could be
      observed in these strains.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214514
TI  - [Present aspect of infection and incidence of tuberculosis in youth registered in
      Aichi Prefecture].
AB  - In this study, 151 school children and students with tuberculosis registered in
      Aichi Prefecture during 1983 to 1987 were investigated. The results were as
      follows: 1) The extent of lesions were not so advanced, as shown by the fact that
      27.2% were cavitary and 31.8% were bacteriologically confirmed. 2) They were
      detected mainly by symptomatic visit to physicians (39.1%), periodic mass
      radiography (31.8%) and contacts survey (20.6%). The proportion of the former
      symptomatic visit was comparatively lower than in other age groups. 3) Patient's
      delay in cases detected by symptomatic visit was not so evident, however, there
      is a certain grade of doctor's delay; for instance, 22.0% of them took 2 months
      and more to be diagnosed. 4) 77.5% of them were vaccinated with BCG once or more,
      in most cases more than 5 years before their detection. 5) Sources of infection
      were specified in 52.3% of the cases. Most of them were found in their household
      and were bacteriologically confirmed at the time of detection. In some students
      their classmates were suspected as their possible source of infections.

PMID- 2214515
TI  - [A case of pulmonary tuberculosis associated with adult respiratory distress
      syndrome during corticosteroid treatment of rheumatoid arthritis].
AB  - We reported a case of 64 year-old female patient of pulmonary tuberculosis
      associated with ARDS during corticosteroid treatment of Rheumatoid Arthritis. On
      admission her chief complaints were fever, fatigue and dyspnea. A chest
      roentgenogram showed diffuse alveolar infiltration consistent with pulmonary
      edema. Arterial blood gas studies showed severe hypoxemia. We clinically
      diagnosed so-called ARDS. Smears of sputum for acid fast bacilli were negative,
      but transbronchial lung brushing by bronchofiberscope revealed many acid fast
      bacilli. Intensive therapy with anti-tuberculosis drugs (INH, RFP, SM), high dose
      corticosteroid (methylprednisolone) therapy and mechanical ventilation was
      started. During the following 2 weeks, the PaO2 rose gradually and the alveolar
      infiltration on the chest roentgenogram disappeared. The experience of this case
      to emphasized the importance of suspecting this condition because pulmonary
      tuberculosis is a potentially curable cause of ARDS and it should also be
      emphasized that the good treatment effect could be expected with combined use of
      high dose corticosteroid and mechanical ventilation.

PMID- 2214516
TI  - The good, the bad, and the ugly. Nursing continuing education: a providers
      perspective.

PMID- 2214518
TI  - [Heart murmurs in Sneddon's syndrome].

PMID- 2214517
TI  - [Early ventricular repolarization syndrome in diseases of the cardiovascular
      system].

PMID- 2214519
TI  - [Association of coronary atherosclerosis, congenital coronary fistulas and
      Fallot's triad in a middle-aged man].

PMID- 2214520
TI  - [Case of latent Wolff-Parkinson-White syndrome with various supraventricular
      arrhythmias].

PMID- 2214521
TI  - [Intravital diagnosis and successful surgical treatment of cardiac rhabdomyoma].

PMID- 2214522
TI  - [Long-term monitoring of blood pressure].

PMID- 2214523
TI  - [Metabolites of anti-arrhythmia agents, their pharmacodynamics and
      pharmacokinetics].

PMID- 2214524
TI  - [Disorders of hemodynamics and pulmonary gas exchange in the acute period of
      myocardial infarct].
AB  - In 40 patients with massive myocardial infarction, the central hemodynamics was
      examined by probing the right-sided chambers of the heart and the pulmonary
      artery. The cardiac output was measured by thermodilution. The gas exchange
      (respiratory minute volume, capnography, gas analysis of arterial and mixed
      venous blood) was explored. Arterial hypoxemia was found to be associated with
      increased intrapulmonary blood shunting in patients with acute myocardial
      infarction complicated by congestive heart failure. Deterioration of arterial
      hypoxemia was promoted by a combination of increased overall pulmonary shunting
      and decreased residual venous oxygenation. Abnormalities in the ventilation
      perfusion relations are of great importance.

PMID- 2214525
TI  - [Primary angina pectoris: significance of clinical, bicycle ergometric and
      coronarographic data in the prognosis of ischemic heart disease remission].
AB  - By the first year of a follow-up, spontaneous clinical remissions (no anginal and
      ischemic episodes as evidenced by Holter monitoring, negative bicycle ergometric
      tests) in 52 (26%) out of 200 patients with primary angina pectoris. Possible
      predictors such as clinical signs, bicycle ergometric and coronary angiographic
      parameters were examined. A multifactorial stepwise discriminant analysis showed
      that the independent predictors of the clinical remission were heart rate and
      exercise power attained on bicycle ergometry, number of diseased coronary artery
      segments with 70% of more stenoses, disease pattern in the first month, existing
      and prior smoking, and myocardial infarction in the first 3 months of the disease
      onset.

PMID- 2214526
TI  - [Hemodynamics and its control in patients with thyrotoxicosis and in healthy
      persons according to the data of anapriline and graded exercise tests].
AB  - The study was undertaken to examine effects of anapriline on bicycle ergometric
      and echocardiographic parameters and catecholamine excretion in 17 patients with
      thyrotoxicosis and 21 healthy subjects. A single dose of anapriline contributed
      to transition of hyperkinetic central hemodynamics to eukinetic one and a more
      saving regimen of heart performance at rest and submaximal exercise levels in the
      healthy subjects. In contrast, the patients maintained hyperkinetic hemodynamics
      and had a high energy demand during exercise and showed a reduction in left
      ventricular systolic and diastolic function and a significant decrease in
      catecholamine excretion. Disintegration of regulatory mechanisms in
      thyrotoxicosis was found to be due to the function interrelationship between
      thyroid hormones and catecholamines.

PMID- 2214527
TI  - [Comparative analysis of the significance of transesophageal stimulation of the
      left atrium and bicycle ergometry in the detection of residual myocardial
      ischemia during the early period of myocardial infarct].
AB  - The study was undertaken to compare transesophageal left atrial pacing (TLAP) and
      bicycle ergometry (BE) in the detection of residual myocardial ischemia (RMI) in
      187 patients with myocardial infarction in the early periods of the disease (on
      days 20 to 26). The intensity of TLAP and BE was increased up to the threshold
      and submaximal levels according to the conventional criteria. Among the patients,
      RMI was detected in 71% with TLAP and in 55% with BE (p less than greater than
      0.01). Thus, this suggests that TLAP has advantages over BE in the detection of
      RMI in patients with myocardial infarction in the early periods of the disease.

PMID- 2214528
TI  - [Anaerobic threshold levels in the assessment of central and peripheral
      hemodynamics].
AB  - A treadmill test involving a noninvasive evaluation of cardiac pump function and
      the anaerobic threshold (AT) was performed to examine 110 patients with cardiac
      malformations, 31 with atherosclerotic lesions in arteries of the lower limbs,
      and 49 normal subjects. The results were compared with those of direct
      measurement of blood lactate concentrations. Simultaneously, changes in
      transcutaneous O2 tension (TcpO2) were recorded in the recovery periods after
      each exercise stage, recovery of continuous blood flow (td). TcpO2 and td were
      indicated to reflect AT resulted just from decompensation of cardiac pump
      function in patients with impaired central hemodynamics. It was ascertained that
      TcpO2 and td might be objective measures for severity of central or peripheral
      hemodynamic abnormalities and reflected the levels of AT at systemic, organic,
      and microcirculatory levels.

PMID- 2214529
TI  - [Significance of visual-scanning Doppler detection in the diagnosis of early
      stages of cardiac insufficiency in patients with ischemic heart disease].
AB  - A method was developed for visual monitoring myocardial structures in the mode of
      continuous Doppler location by using a commercial Soviet device. The method
      proposed measures the velocity of mobility of well-defined cardiac structures.
      Clinical examinations showed that myocardial contractile abnormalities could be
      detected earlier by visual-prospecting Doppler echocardiography than by routine
      Doppler location and echocardiography. The IVth standard location position is the
      most informative in the detection of impaired contractility. When the Doppler
      echocardiogram in the first additional position is analyzed, the appearance of P
      wave may serve as a reliable criterion for diminished myocardial contractility.

PMID- 2214530
TI  - [Body impedance recording in the assessment of stroke volume].
AB  - The first derivative of the integral tetrapolar rheogram of the body, body
      impedance recording, was found to show changes in blood flow in the arterial
      compression chamber. Evidence was given for a close relation of the distance
      between the electrodes while recording an integral rheogram of the body and the
      examinees' height. The relation of the distance to the examinees' height was
      equal in males and females and proved to be lower than that previously applied.
      For calculation of the stroke blood volume from the body impedance recording, the
      Kubicek equation was proposed to be used by introducing the height of an examinee
      instead of the distance between measuring electrodes. There was a good
      coincidence of results while calculating the stroke volume by impedance recording
      and Doppler echocardiography.

PMID- 2214531
TI  - [Use of coronary thrombolysis and coronary balloon angioplasty in patients with
      myocardial infarct].

PMID- 2214532
TI  - [Relations between the duration of coupling interval and frequency fluctuations
      in ventricular ectopic complexes].
AB  - An attempt was made to electrocardiographically assess the likely mechanisms
      responsible for the occurrence of arrhythmias. The frequency of ventricular
      ectopic complexes was compared with fluctuations of coupling interval duration.
      An examination of 36 patients provided evidence for preliminary considerations
      concerning the causation between the frequency of ventricular ectopic complexes
      and the duration of coupling interval. The findings are promising from clinical
      and predictive points of view.

PMID- 2214533
TI  - [Criteria for a pathogenetic approach to antiarrhythmic therapy in paroxysmal
      supraventricular reciprocal tachycardia].
AB  - An electrophysiological study using programmed transesophageal atrial pacing was
      performed in 106 patients with abnormalities in the myocardial conduction system,
      of whom 102 suffered from paroxysmal supraventricular reciprocal tachycardia
      and/or paroxysmal atrial fibrillation. The electrophysiological properties of the
      myocardial conduction system were demonstrated to be labile. The factors
      determining the frequency and length of palpitations were outlined. The
      conditions for an onset of supraventricular reciprocal tachycardiac paroxysm and
      for existence of a reentrant chain were found to be minimal in the effective
      refractory period of the accessory pathway, which was less or equal to the
      effective refractory period of the atrioventricular junction. An approach to
      antiarrhythmic therapy was proposed, which was based on modifying the ratio of
      the effective refractory periods of normal and abnormal excitation pathways.

PMID- 2214534
TI  - [Experience with long-term outpatient use of cordarone in the prevention of
      paroxysms of atrial fibrillation (flutter)].
AB  - In a group of 250 patients suffering from frequent paroxysms of atrial
      fibrillations (flutters), the application of cordarone for 1 to 5 years prevented
      the occurrence of arrhythmic paroxysms in 23.6%, contributed to a reduction of
      their numbers up to 1 a year in 35.6%, up to 2-3 a year in 20.4%. Good and
      satisfactory results were obtained nearly in 80% of the patients. Cordarone
      failed to act in 10.4%. In 12.8%, the "escape" phenomenon was observed, i.e. loss
      of the agents' action following its long-acting effect when the patients were on
      a maintenance dosage. The results of the preventive usage of cordarone were not
      clearly related to the degree of atrial dilatation and the pattern of cardiac
      disease.

PMID- 2214535
TI  - [Functional state of atrioventricular conduction and inducibility of
      atrioventricular reciprocal tachycardia].
AB  - Programmed transesophageal electrical stimulation was used to examine 733 rural
      inhabitants aged 16 to 70 years. Conduction dissociation along the
      atrioventricular node was revealed in 65 (8.8%) of the examinees, out of them 12
      had induced paroxysms of atrioventricular nodal tachycardia. Atrioventricular
      tachycardia involving the accessory anomalous pathways was provoked in 10
      subjects. Among them 2 had apparent, 1, latent, and 7, obscure forms of the Wolff
      Parkinson-White syndrome. The induced paroxysms of atrioventricular tachycardias
      were sustained in 45.5% of the cases. Only 50% of the subjects had clinical signs
      of tachycardia in their medical histories.

PMID- 2214536
TI  - [Chronic nonparoxysmal supraventricular tachycardia in children and adolescents].
AB  - An examination was performed in 111 children and adolescents with recurrent and
      sustained chronic nonparoxysmal tachycardias (CNPT). ECG and electrophysiological
      studies showed that ante- and retrograde conduction along the accessory
      atrioventricular junction was the most common mechanisms of arrhythmia. Holter
      monitoring revealed a high rigidity of cardiac rhythm in patients with sustained
      CNPT. Criteria for the development of arrhythmogenic cardiac dilatation were
      developed. In recurrent CNPT, there was a correlation between the paroxysms of
      ECG slow-wave activity and the "salvos" of tachycardia and a predominance of
      vagal effects on the heart. A new approach to the treatment of children with CNPT
      was proposed, which involved the correction of pathogenetic mechanisms.
      Indications for the usage of antiarrhythmic agents such as cordarone and a
      cardiac surgeon's advice were formulated. The efficiency of the therapy was
      achieved in 82% of the children as shown by a follow-up.

PMID- 2214537
TI  - [Disorders of myocardial metabolism in sudden coronary death in the presence of
      coronary atherosclerosis: findings of quantitative histoenzymologic studies].
AB  - The activity of human myocardial enzymes in sudden coronary death (SCD) was
      quantitatively histochemically examined. The activity of succinate dehydrogenase
      (SDH), lactate dehydrogenase (LDH), beta-oxybutyrate dehydrogenase (beta-OBDH),
      alpha-glycerolphosphate dehydrogenase (alpha-GPDH), NAD-diaphorase (NAD-ase), and
      glucose-6-phosphate dehydrogenase (G-6-PDH) was measured on prompt autopsies (up
      to 3 hours of death onset). beta-OBDH and LDH showed an increase in activity in
      the myocardium from the subjects who had suddenly died from coronary heart
      disease without evident changes in the heart. In SCD in the presence of small
      cardiosclerosis, the activity of the enzymes characterizing the major processes
      of energy generation was also enhanced, which was caused by moderately severe
      myocardial hypertrophy. In the myocardium from the subjects who had died from
      coronary heart disease in the presence of large postinfarction cardiosclerosis,
      the activity of the enzymes was directly related to the degree of myocardial
      hypertrophy and the signs of chronic heart failure. As myocardial hypertrophy
      progressed, the enzymatic activity rose, but there were signs of chronic heart
      failure, it fell. The findings suggest that the changes in myocardial enzymatic
      activity in SCD are heterogeneous and associated with the type of prior
      abnormalities in the cardiovascular system.

PMID- 2214538
TI  - [Several aspects of early ventricular repolarization syndrome].
AB  - An epidemiological study was undertaken to examine the prevalence of the early
      ventricular repolarization syndrome (EVRS) among 3,105 subjects. An analysis was
      made of 796 ECG showing EVRS. The genesis of EVRS was interpreted in terms of
      vector-scalar and chronotopographic analyses of myocardial de- and
      repolarization. The syndrome was also characterized from clinical and
      electrophysiological points of view.

PMID- 2214539
TI  - [Early ventricular repolarization syndrome in patients with heart defects].
AB  - The prevalence of the early ventricular repolarization syndrome (EVRS) was
      examined in 129 patients with congenital and acquired heart diseases. Dynamic ECG
      values were assessed. The most prevalence rate was found in patients with
      congenital heart disease (100%), aortic (80%), mitral (51%), and aorto-mitral
      valvular (60%) diseases. The prevalence of EVRS, the mechanisms of its occurrence
      were associated with the performance of accessory pathways and the manifestation
      of the competitive nature of the functional interaction between the basic and
      accessory pathways.

PMID- 2214540
TI  - [Ultrasonic diagnosis of congenital membraneous subvalvular aortic stenosis].
AB  - The paper reviews a 10-year experience with complex ultrasonic diagnosis of
      membraneous subvalvular aortic stenosis, a rare congenital defect. Fifteen
      subjects operated on for this abnormality were examined. Profound systolic
      closure of the aortic cusps, concentrated left ventricular myocardial
      hypertrophy, linear-shaped echo signals generated by the membrane in the
      subaortic area, turbulent systolic blood flow in the ascending aorta are the most
      significant signs for the diagnosis of the membraneous subvalvular aortic
      stenosis.

PMID- 2214541
TI  - [Role of genetic and environmental factors in the determination of body weight
      and skinfold thickness in children having different blood pressure (a familial
      study)].
AB  - Based on intrafamilial correlations, a component genetic analysis was used to
      evaluate the contribution made by genetic and environmental factors to variance
      in body weight and skin fold thickness in children who had various blood
      pressure. In children with initially elevated and normal blood pressures, the
      phenotypic variation in the body weight and adipopexia is largely determined by
      genetic factors, whereas in those with initially lower blood pressure, the
      phenotypic variation in the above parameters is greatly affected by environmental
      factors, mainly by those of occasional nature. The findings provide evidence for
      a differential approach to the primary prevention of hyper- and hypotension in
      children and adolescents.

PMID- 2214543
TI  - [Entropy of heart rhythm, one of the parameters of a rhythmogram, in the clinical
      evaluation of patients with chronic ischemic heart disease].

PMID- 2214542
TI  - [Evaluation of the effectiveness of thrombolytic therapy using streptodecase in
      patients with myocardial infarct].

PMID- 2214544
TI  - Update on vitamin D: 1990.

PMID- 2214545
TI  - New active analogues of vitamin D with low calcemic activity.
AB  - In conclusion, a number vitamin D analogues have been developed that have very
      low calcemic activity but retain several other properties of 1,25-(OH)2D3,
      including the ability to differentiate leukemia and skin cells, to enhance the
      immune response, and to suppress parathyroid hormone levels. Although the
      mechanism of this selective activity is not yet clear, these analogues may
      provide new insights into the differences in action of 1,25-(OH)2D3 in various
      target tissues. Most importantly, the selective action of these analogues may be
      exploited for the treatment of diseases such as leukemia, psoriasis and
      hyperparathyroidism.

PMID- 2214546
TI  - Extrarenal production of calcitriol.
AB  - Under normal circumstances extrarenal sources of calcitriol probably constitutes
      a microendocrine system involved in cell differentiation and local intercellular
      communication with no influence on systemic calcium homeostasis. Under
      pathological conditions such as chronic renal failure, extrarenal sources have
      the potential to normalize serum calcitriol after adequate stimulation (such as,
      25(OH)D administration). Extrarenal 1,25-(OH)2D3 synthesis is controlled by
      physiological levels of calcitriol. However, in sarcoidosis and other
      granulomatous diseases, 1,25-(OH)2D3 production by macrophages is deregulated,
      causing severe alterations in systemic calcium homeostasis.

PMID- 2214547
TI  - Effects of 1,25(OH)2D3 administration on bone in patients with renal failure.

PMID- 2214548
TI  - Use of oral and parenteral calcitriol in the treatment of renal osteodystrophy.

PMID- 2214549
TI  - Parathyroidectomy in chronic renal failure: indications, surgical approach and
      the use of calcitriol.
AB  - The appropriate use of phosphate binders, calcium supplements and especially
      calcitriol therapy has significantly decreased the incidence of overt secondary
      hyperparathyroidism in dialysis patients. Nevertheless some patients may still
      need parathyroidectomy, especially in the event of severe clinical signs and
      symptoms such as persistent hypercalcemia, pruritus, calcifilaxis, or extensive
      extra-skeletal calcification. Since aluminum-induced bone disease may resemble
      hyperparathyroidism in dialysis patients, whenever parathyroidectomy is
      contemplated the diagnosis of secondary hyperparathyroidism must be firmly
      established. Thus, a bone biopsy is mandatory prior to parathyroidectomy. It is
      our experience that once the patient goes to surgery the most important factor in
      the surgical approach is the presence of a skilled surgeon who has extensive
      experience in parathyroid gland surgery. The data comparing subtotal
      parathyroidectomy with total parathyroidectomy and autotransplantation are
      similar. The most important shortcoming is the lack of long-term follow-up.
      Recently, new data by several investigators has been advanced reintroducing total
      parathyroidectomy. Long-term observations in patients who despite total
      parathyroidectomy still have normal PTH levels are of special interest. In
      addition, long-term follow-up of these patients has shown that normal plasma
      calcium and phosphorus levels may be maintained without the use of Vitamin D;
      this occurred in the presence of active mineralization. However, our major
      objection to this procedure is the risk of aluminum-induced bone disease. At the
      present time we feel that the relative high incidence of recurrent
      hyperparathyroidism following subtotal parathyroidectomy is a reasonable trade
      off for the risk of aluminum bone disease which may develop in absence of
      PTH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214550
TI  - [Micturition and urinary tract infection in girls. 4. Various aspects of age
      factors].
AB  - First affection with urinary tract infection, relapses, and micturition pattern
      were analyzed depending on age. It is demonstrated that the decreased UTI rate
      after the 12th year rather depends on the micturition habit than on puberty.

PMID- 2214551
TI  - [Sonographic diagnosis of gastroesophageal reflux in infancy].
AB  - The gastroesophageal reflux is a common problem in the pediatric clinical
      practice in the 1st year of life. Its diagnosis is mainly based on the x-ray and
      the measurement of the esophageal pH. Our investigation shows the possibility of
      the ultrasonographical diagnosis of this disturbance. We could demonstrate a good
      correlation between the x-ray and the ultrasonographical findings. A continuous
      lasting gastroesophageal reflux which takes more than 5 minutes points to a
      pathologic reflux pattern with the well known complications. Thus,
      ultrasonographical investigation should perform before an extensive diagnostic is
      taken into consideration.

PMID- 2214552
TI  - [Diagnostic evaluation of skeletal scintigraphy in comparison to roentgen studies
      in histiocytosis X in childhood. Case report].
AB  - We have compared whole body skeletal scintigraphy with X-ray examination in 15
      children suffering from histiocytosis X, 14 of whom also showed involvement of
      the skeleton. In 9 of 20 cases, relapses, included, involvement of the skeleton
      was found both in scintigraphy and X-ray examination. In 7 cases only X-ray
      examinations have revealed lessons, which could not be proved by scintigraphy.
      Vice versa, in 4 cases scintigraphy was positive alone. These results confirm the
      necessity to use both methods for an exact documentation of the extent of the
      disease before undertaking any therapy. Dispensing with one of the two methods
      may cause incorrect therapeutic decisions and increase the risk of relapses and
      late complications.

PMID- 2214553
TI  - [The differential diagnosis of hemarthrosis--septic arthritis in patients with
      hemophilia].
AB  - A 12-year-old boy with severe hemophilia A fell ill with high fever and painful
      swelling of joints. There was a delay of four days in the diagnosis of septic
      arthritis. The course of the disease shows some important distinguishing
      criteria, speaking in favour of septic arthritis: 1. longlasting temperature
      above 39 degree C; 2. an elevated peripheral leukocyte count; 3. increasing
      complaints despite normalisation of the coagulation defect.

PMID- 2214554
TI  - [Social indication for hospitalization. Annual analysis of the pediatric
      department of the Magdeburg district hospital].
AB  - The patients' data of 156 children hospitalized on account of social indication
      were analysed at the Clinic for Pediatrics of Magdeburg District Hospital.
      Reasons for socially indicated hospitalization were: proved or imminent
      neglecting of children (49%), insufficient nursing of sick children (31%),
      suspected ill-treatment (8%), serious family troubles temporarily preventing
      nursing and safety of children (12%). Neglected hygienic condition of the body,
      improper nutrition of malnutrition, physical and mental lagging behind might be
      evidence for the social sufferings of children. Mothers of children obtaining in
      patient treatment as a result of social indication predominantly lack lasting
      partnerships. They are Less qualified concerning vocational training or gave
      birth to their first child at a comparatively early age. There is an urgent
      necessity of closely cooperating between the Clinic for Pediatrics, the Maternity
      Advisory Centre, the Youth Well-Fare Service and the Department of Youth-Well
      Fare in order to detect the children concerned in time to be able to find the
      best possible solution for the future life of the children without delay.

PMID- 2214556
TI  - [Transplantation of immature allogeneic testis].
AB  - Experimental and clinical studies (109 rat and 17 dog experiments and four
      clinical transplantations of a neonatal testis to children with the
      postcastration syndrome and postnatal hypoplasia of their own testes) showed that
      transplantation of an immature testis makes it possible to reduce to maximum its
      damage on exposure to the effect of unspecific and specific factors of
      transplantation. The transplantation ensures prolonged viability and function of
      the allogeneic male sexual gland, which is confirmed by the maintenance of its
      specific structures (the ultrastructural level among others) in the late-term
      postoperative period, the ability of immature allogeneic transplants to restore
      the sexual behaviour of castrated animal recipients, and by the positive results
      of clinical test of the method.

PMID- 2214555
TI  - [Use of Nichrome suture material].
AB  - The suture material and the method of its application play an important role in
      the prevention of wound complications. With the use of Nichrome wire thread as
      the suture material in surgical interventions, the number of postoperative
      complications significantly was decreased. The Nichrome thread is also used
      expediently in operative interventions on patients with purulent diseases of the
      soft tissues, including cases after primary surgical treatment of purulent foci
      by carbon dioxide laser.

PMID- 2214557
TI  - [Treatment of diabetic angiopathies of the lower extremities].
AB  - Patients with diabetes mellitus accounted for 7% of all hospitalized patients.
      The authors analyse the treatment of 126 patients in whom diabetes mellitus was
      complicated by angiopathies of the lower limbs. Patients over 60 years of age
      accounted for 60.3% of cases. Concomitant diseases were found in 87 patients. The
      article shows the main principles of the complex management of patients, which is
      based on correction of carbohydrate and other types of metabolism, treatment of
      concomitant diseases, and timely operation. When surgery was necessary in stage
      IV of the disease, preference was given to economical operations. It is shown
      that if amputation of the limb cannot be avoided, an effort should be made to
      preserve the knee. The mortality rate was 10.3%.

PMID- 2214558
TI  - [Treatment of patients with nodular goiter].
AB  - The authors discovered nodular patterns in the thyroid gland of 18.8% of persons
      among many thousands subjected to periodical medical examination. The high
      detection rate of nodular patterns in the thyroid corresponds completely to the
      findings of post-mortem examinations. The number of nonpalpable nodules detected
      by the ultrasonic method exceeds the number of those palpated (55.2% and 44.8%,
      respectively). Ultrasonic examination with thin-needle aspiration biopsy followed
      by cytologic examination is the most informative method by which new malignant
      growths are identified. Patients with nonpalpable patterns measuring less than 1
      cm in diameter which are revealed by ultrasound must be kept under active dynamic
      observation if there are no signs of malignancy. Patients with larger patterns
      and suspected cancer must be treated by operation.

PMID- 2214559
TI  - [Activation of immunity in patients with recurrent goiter].
AB  - The authors studied the morphological pattern of the thyroid gland in patients
      with goiter and in those with a recurrence of the disease. They found lymphoid
      infiltration and autoimmune thyroiditis twice more frequently in patients with
      recurrent goiter. Dynamic study of features of the immune and thyroid status of
      patients with recurrent goiter after the operation led to the isolation of a
      group of patients with an increase in the relative content of T and B lymphocytes
      and thyroxine. These changes preceded the recurrence of goiter.

PMID- 2214560
TI  - [Laboratory and instrumental diagnosis of echinococcosis during conducting mass
      screening and surgical treatment].
AB  - In the course of 15 years the authors conducted a comprehensive examination of
      over 13,000 patients for establishing the diagnosis and surgical treatment of
      hydatid disease; among these patients there were more than 3,000 who underwent
      operation, 1,280 who were examined for recurrence of the disease, and 5,000 who
      were subjected to periodical medical examination. The enzyme immunoassay and
      indirect hemagglutination test are the most reliable in the diagnosis of primary
      and recurrent hydatid disease and in periodical examination; the latex fixation
      test remains false-positive (16.9%) up to 3 years. Combination of laboratory and
      instrumental methods (computed tomography, ultrasonic examination, scanning and
      multi-view X-ray examination) makes it possible to establish not only the topical
      diagnosis but also the state of the hydatids, which helps in the choice of the
      operative method.

PMID- 2214561
TI  - [Oblique terminal-lateral gastroduodenoanastomosis in surgery of stomach ulcer].
AB  - The authors analyse the results of surgical treatment of 316 patients with peptic
      ulcer after gastric resection completed by the formation of terminolateral
      gastroduodenoanastomosis after the Haberer-Finney techniques. In 189 patients
      vagotomy was carried out in addition to the operation. The postoperative
      mortality rate was 0.3% (due to incompetence of the sutures of the anastomosis).
      The incidence of nonfatal complications was 9.4%. The late-term results were good
      (according to Visick's grading) in 98.65% of patients.

PMID- 2214562
TI  - [A device for irrigation of suppurative cavities].

PMID- 2214563
TI  - [Combined injuries of the organs of the small pelvis and abdominal cavity].

PMID- 2214564
TI  - [Migration of foreign body from the small pelvis through the organs of the
      urinary system].

PMID- 2214565
TI  - [Adenocarcinoma of the cecum simulating acute appendicitis].

PMID- 2214566
TI  - [Diagnosis and surgical treatment of hepatic hemangioma (review of the
      literature)].

PMID- 2214567
TI  - [Results of clinical and experimental use of cyclosporin A (review of foreign
      literature)].

PMID- 2214568
TI  - [Changes in acid-base equilibrium of blood after intravenous laser irradiation
      (experimental study)].
AB  - Experiments were conducted to study the acid-base equilibrium of blood in
      pancreatitis and in combination with laser irradiation of venous blood by the
      intravascular method through a light guide. Irradiation of blood was attended by
      inhibition of metabolic acidosis development, which was evidently linked with
      improved blood oxygen transport function in response to exposure to the laser
      beam.

PMID- 2214569
TI  - [Treatment of fissure in ano by the method of laser coagulation].
AB  - The article analyses the results of treatment of acute and chronic anal fissures
      with the use of the method of laser photocoagulation in 181 patients, in 87 of
      them the fissures were combined with other proctological diseases. The essence of
      the operation is three-fold laser treatment (CO2 laser) of the edges and floor of
      the fissures. The pathologically changed tissues are evaporated and coagulated in
      this case with the formation of a coagulation film on the wound surface.
      Histological examination of bioptic material collected from the zone exposed to
      the effect of the laser shows complete disappearance of the pathological tissue.
      The operation is simple and sparing in the treatment of anal tissues, ensures
      improvement of the immediate results, as well as a decrease of the frequency of a
      recurrence to 1.4%. The method may be introduced successfully into outpatient
      surgical practice.

PMID- 2214570
TI  - [Use of laser irradiation in the complex ambulatory treatment of
      arthrosoarthritis].
AB  - The article discusses experience with the treatment of 60 patients with
      arthrosoarthritis deformans of various large joints by the traditional
      conservative methods and with the use of laser radiation by an Uzor biomedical
      laser device. The authors noted a positive effect of laser radiation on the
      pathological processes developing in the region of the involved joint, which
      reduced the terms of treatment from 24.4 to 10.4 days and considerably reduced
      the number of recurrences in the immediate period.

PMID- 2214571
TI  - [Surgical debridement of gunshot wounds].
AB  - The authors conducted experimental (130 rabbits) and clinical studies (249
      persons) in gunshot wounds of the soft tissues. It was found that in 29% of
      cases, primary surgical debridement of the gunshot wound failed to be a radical
      intervention because zones of secondary necrosis of the tissues developed on days
      3-4. In view of this, gunshot wounds must be examined without fail on days 3-5 to
      determine the indications for repeated surgical debridement. The indications for
      repeated surgical debridement are as follows: foci of necrotic tissues, unopened
      pockets, the presence of foreign bodies. Repeated surgical debridement of a
      gunshot wound, when indicated, reduces the number of purulent complications by 4
      times and the duration of treatment by 1.5 times.

PMID- 2214572
TI  - [Laser surgery in occlusive diseases of peripheral arteries].
AB  - The first experience with the use of an excimeric laser in the treatment of 24
      patients with segmental occlusion of the peripheral arteries is discussed. It
      proved possible to recanalize the obstructed segment of the vessel for its whole
      distance in 13 patients. Analysis of the complications shows that further
      technological development of the method is necessary. Hemodynamic adequacy of
      restoration of the vascular lumen by laser recanalization in combination with
      balloon dilatation is demonstrated. Significant decrease of the risk of operative
      intervention, accelerated rehabilitation of patients, and an essential economical
      effect may be the advantages of the method.

PMID- 2214573
TI  - [Treatment of patients with thermal lesions with ointments on water-soluble
      base].
AB  - Treatment of patients with thermal burns by ointments prepared on a water-soluble
      base (Dioxidine and Dioxicol) makes it possible to reduce the bacterial
      dissemination within a short time and prepare the wound for autodermoplasty
      which, in turn, reduces the danger of the development of infectious
      complications. In addition to a marked antimicrobial effect, the ointment possess
      high hydrophobic and hydrophilic properties and do not induce allergic reactions
      and side effects.

PMID- 2214574
TI  - [Pathogenetic mechanisms of the effect of vacuum therapy on the course of the
      wound process].
AB  - On the basis of the analysed results of treatment of 248 patients with abscesses,
      phlegmons, and purulent wounds who received vacuum therapy and 215 patients with
      the same diseases treated by the traditional incision-drainage-method, as well as
      on the grounds of additional examination findings, the authors show the
      mechanisms of the effect of vacuum therapy on the course of the wound process.
      They substantiate pathogenetically the marked therapeutic effect of this method
      in patients with acute purulent diseases of the soft tissues and purulent wounds.

PMID- 2214575
TI  - [Clinical significance of non-fermentative bacteria isolated from the environment
      of a surgical department].
AB  - The article deals with the frequency of isolation of non-fermentative gram
      negative bacteria, potential causative agents of postoperative infection, from
      objects found in the environment of various departments of a surgical inpatient
      clinic. The species composition of the grown culture was determined. The relation
      of the isolation rate of certain species of nonfermentative bacteria to the
      object of the examination, the department of the clinic, and the disinfection
      method applied was revealed. The authors point out that it is necessary to
      undertake systematically the investigations to determine of the activity of
      antiseptics and disinfectants in relation to the microorganisms indicated in
      order to choose the effective methods for the prevention of postoperative
      infection induced by nonfermentative bacteria.

PMID- 2214576
TI  - [Active methods of correction of endotoxemia in generalized suppurative
      infection].
AB  - The characteristics of the natural history of acute sepsis and the nature of the
      intoxication syndrome are analysed an on ample material (120 patients), and
      microbiological and immunological diagnostic findings are shown. Endotoxicosis in
      sepsis is attended by marked disorders of the immune status in the form of
      varying degrees of immunodeficiency. The authors generalize their experience with
      the management of endotoxicosis in sepsis. The article first shows the results of
      the combined use of various methods of endotoxicosis correction (homosorption,
      hemodiafiltration, plasmapheresis, endolymphatic therapy, ultraviolet irradiation
      of autoblood, hyperbaric oxygenation, application sorption) in the treatment of
      120 patients with sepsis of various etiology. Active methods of detoxification
      via the blood and lymphatic system were first applied in the management of
      endotoxicosis in patients with sepsis.

PMID- 2214578
TI  - [Surgical treatment of phlegmons of the maxillofacial region].
AB  - A method was developed for active surgical treatment of phlegmons of the
      maxillofacial region with the application of intraarterial regional drug therapy.
      The suggested method was used in operations on 75 patients. The results were
      compared with those in 65 patients who were treated by the traditional method-
      opening of the phlegmon. In 95.7% of patients in whom the active method of
      surgical treatment was applied, the postoperative wound healed by first
      intention. The treatment produced the best clinical and aesthetic effect. The
      period of incapacity of the patients reduced almost by half.

PMID- 2214577
TI  - [Lipid regulation in suppurative infectious diseases].
AB  - The paper discusses the results of study of lipid peroxidation (LP) in patients
      with various forms of purulent surgical infection. A conclusion is drawn from the
      analysis of the obtained data that the difference in the forms of the pyoseptic
      processes is determined to a great measure by the concrete state of free-radical
      lipid oxidation which acts as a regulatory mechanism of the inflammatory
      reaction, changing the permeability of biomembranes at the tissue, cell, and
      organism levels. The conducted research holds promise for the creation of modern
      and progressive variants of pathogenetic intensive therapy.

PMID- 2214579
TI  - [Free transplantation of skin flaps with axial blood supply in IV degree burns].
AB  - The article analyses the results of free transplantation of skin grafts with
      axial blood supply in 45 patients with IV degree burns and their sequelae.
      Bearing in mind the peculiarities of damage to the tissues and vessels in a
      thermal trauma, it is advisable to anastomose the vein grafts with the large
      subcutaneous veins. Skin grafts with a long vascular pedicle are preferable. The
      difficulties which are encountered in the choice of the surgical tactics and in
      planning the operative intervention in patients with multiple areas with IV
      degree damage or their combination with extensive III degree burns insistently
      dictate the need for stricter indications for microsurgical transplantations, and
      rational and substantiated combination of plasty by free grafts and skin flaps
      with an axial blood supply type.

PMID- 2214580
TI  - [Cutaneo-fascial flaps in restorative and reconstructive surgery of burns].
AB  - On the basis of experience with the treatment of more than 1,500 patients with
      post-burn defects, deformities, and trophic ulcers, the authors distinguished
      types of affection in which the traditional methods are ineffective. These 133
      patients were subjected to plasty with ++cutaneo-fascial grafts; the zones of
      donor areas from which the grafts are taken are determined. Plasty with ++cutaneo
      fascial grafts is indicated in defects of the face, deformity of the neck, total
      adduction contracture of the arm, defect of the breast, and affections of the
      hand, leg, and foot. Concrete grafts and the site from which they are taken for
      restoration of certain regions of the body are suggested. ++Cutaneo-fascial
      grafts make it possible to restore the shape, function, and the skin of the
      involved region.

PMID- 2214581
TI  - [Surgical treatment of extensive and deep defects of crural soft tissues using
      the gastrocnemius muscle and skin flaps].
AB  - The article discusses a method for surgical treatment of extensive and deep
      defects in the soft tissues of the leg by plasty with a gastrocnemius
      musculocutaneous graft taken from the contralateral limb. The operation was
      conducted in two stages. It is emphasized that if all the described technical
      details are followed, the postoperative period will be uncomplicated and the
      outcome of the operation will be good.

PMID- 2214582
TI  - [Treatment of pustular lesions of the perineum and sacrococcygeal region].
AB  - The results of treatment of 316 patients with chronic pustular lesions of the
      perineum and sacrococcygeal region are discussed. It is shown that the only
      radical measure in this category of patients is total excision of the involved
      tissues and, in combined variants, simultaneous performance of typical operations
      for rectal fistula or coccygeal pilonidal fistula. In localized and mostly in
      regional forms of the disease one-stage surgical interventions are expedient.
      Many-stage operations are indicated in extensive and, less frequently, in
      regional forms. Postoperative complications occurred in 5.3% of cases and were
      associated with wound suppuration. The late-term results were studied in 71.7% of
      patients who underwent operation: recurrences developed in 3.7% of cases.

PMID- 2214583
TI  - [Guided punctures in the treatment of hepatic and perihepatic abscesses under
      ultrasonic control].
AB  - The authors discuss the possibilities of ultrasonic tomography and subsequent
      performance of purposeful punctures for establishing the precise diagnosis of
      hepatic and perihepatic abscesses. In most cases the method helps in revealing
      the cavities measuring no more than 1.5-2.0 cm. The indications are determined,
      as well as the techniques of topical treatment with the use of single and
      multiple punctures and prolonged percutaneous drainage. Seventy-three patients
      (32 with hepatic and 41 with perihepatic abscesses) underwent clinical
      examination. Topical therapy was applied in 21 patients with discovered hepatic
      abscesses, 17 of them recovered. Operations were avoided in 25 in a group of 34
      patients with perihepatic abscesses (in 7 the abscesses were not identified). The
      success of this treatment is determined by exact diagnosis and precise
      manipulations.

PMID- 2214584
TI  - [Evaluation of the adequacy of heparin administration during hemosorption].
AB  - The article discusses the results of using the activated coagulation time in
      hemosorption for the first time to determine the level of heparinization in 60
      patients with obstructive jaundice and myasthenia++. The method made it possible
      to control the blood heparinization level during hemosorption, reduce the dose of
      heparin administered before the perfusion to 1.2-1.5 mg/kg, prevent the
      development of thrombosis in the mass exchanger and, simultaneously, avoid the
      neutralization of heparin with protamine sulphate.

PMID- 2214585
TI  - [Changes in immunological indicators in patients with surgical endotoxemia after
      UV-irradiation of blood].
AB  - Changes in the values of the immune status during UV autohemotherapy were studied
      in 22 patients with surgical endotoxicosis of various genesis. Maximum tension of
      immunogenesis was found in all patients. The time course of changes in the
      general pool of rosette-forming and separate populations of neutrophils, as well
      as in the index of immunocompetent cell ratios are evidence of the high
      informativeness of these tests in determining the severity of the immune system
      dysfunctions.

PMID- 2214586
TI  - [Comparative evaluation of various methods of initial hypothermic perfusion of
      donor kidneys].
AB  - The authors discuss three various methods of initial hypothermic perfusion
      applied in 160 donors. The function of the donor kidneys was evaluated according
      to the results of clinical transplantation. The advantage of high-current
      perfusion in situ is shown, it allows the number of donor kidneys which are unfit
      for transplantation to be reduced to minimum. The method of in situ perfusion of
      organs in multiorganic collection ensures the most adequate antiischemic
      protection of all organs removed for transplantation, particularly in donors
      after circulatory arrest.

PMID- 2214587
TI  - [Use of perfluorocarbon emulsion in kidney transplantation].
AB  - Intravenous infusion of perfluorocarbon emulsion (PFCE) during
      autotransplantation of kidneys which had been stored for 24 hours led to a rapid
      normalization of intraorganic hemodynamics in dogs, and restoration of ionic
      homeostasis, energy potential, and functional activity of the transplants. It was
      shown that the protective effect of PFCE is associated with inhibition of free
      radical lipid peroxidation, and the establishment of a stable protein-lipid
      conformation of the membrane structures of the cells of ischemic organs. It was
      established that the use of PFCE in the stage of stored kidney transplantation
      may be an effective method for the prevention of reperfusion damage to the
      transplant.

PMID- 2214588
TI  - [BCG-induced inflammation during childhood and in pregnancy. Additionally a
      contribution to BCG-induced necrotising cerebral arteritis].
AB  - In the third year of life of a girl vaccinated neonatally against tuberculosis an
      abscess of the associated lymph nodes appeared which contained acid-fast bacilli.
      After extirpation of the lymph nodes weeks later an intestinal BCG-dissemination
      was observed which seemed to be cured under a brief tuberculostatic therapy. At
      the age of 22 years a left sided hemiplegia due to aneurysms and thrombosis of 2
      cerebral arteries was seen. At autopsy in the adventitia of the arteria basilaris
      macrophages were discovered which showed intracellular acid-fast bacilli. A
      paralysis of the oculomotor nerve appearing later was also caused by this brain
      lesion. Towards the end of a pregnancy a serious BCG-dissemination in the
      intestines relapsed. A healthy premature child was born. Massive tuberculostatic
      therapy was inefficient. The woman died in her 27th year of life. A defective
      function of the macrophages is suggested for the immunological abnormality.

PMID- 2214589
TI  - [BCG-vaccination and its complications. How great are the benefits of vaccination
      today?].
AB  - This paper intends to present an overview concerning the risks and benefits of
      BCG-immunisation basing on a research of the actual literature. The historical
      controversy is well known, but regarding the epidemiological situation with
      respect to morbidity and mortality of tuberculosis in Middle and Western Europe
      by now it seems to be necessary again to reflect on vaccination recommendations.
      While complications after vaccination may be serious or even life-threatening,
      immunization with BCG seems to have a beneficial effect on the incidence of
      infantile leukemia. Nevertheless, this effect is discussed controversially on
      recent research. In addition there should be drawn special attention to the
      problem of life-vaccines, in particular of BCG under the view of the increasing
      number of children with acquired immunodeficiencies.

PMID- 2214590
TI  - Protein supplementation of human milk for the nutrition of VLBW-infants: human
      milk protein vs. meat protein hydrolysate.
AB  - In 25 very low birth weight infants appropriate for gestational age the
      influences of different human milk (HM) preparations on weight gain, gross
      indices of nitrogen metabolism and energy balance were studied during the second
      month of postnatal life. HM was fortified either by HM-protein (HMP) or by an
      enzymatic meat protein hydrolysate (PH) to protein concentrations between 1.5 and
      1.7 g/100 ml. The caloric densities of both HM preparations were similar between
      62 and 68 kcal/100 ml. There were no differences in weight gain (MM + HMP: 18.6
      +/- 3.4 g/kg/day; HM + PH: 16.5 +/- 4.1 g/kg/day), nitrogen retention (HM + HMP:
      31.5 +/- 3.1 mmol/kg/day; HM + PH: 30.0 +/- 3.2 mmol/kg/day), and the preprandial
      estimated essential amino acid profiles between the both feeding groups. In
      contrast the serum concentrations of alpha-amino-nitrogen 60 minutes
      postprandially were elevated in the infants fed HM + PH in comparison to the
      infants fed HM + HMP. This high postprandial amino acid concentrations in serum
      in the group fed HM + PH were accompanied by increased bile acids concentrations
      in serum, higher renal amino acid excretion and increased fecal fat losses. The
      results suggest that due to the more rapid intestinal absorption of amino acids
      from PH than from HMP the concentrations of amino acids increase postprandially
      which results in a detectable increase of the newborn cholestasis in these
      infants. Nevertheless, the scale of these metabolic responses to feeding protein
      hydrolysates is small and without detectable influences on nitrogen retention or
      weight gain.

PMID- 2214591
TI  - [Indications for proton spin tomography in central nervous system diseases in
      childhood. A 4-year experience report on 164 cases].
AB  - 1. Magnetic Resonance Tomography (MRT) is the method of choice for precise,
      comprehensive and reproducible imaging of congenital malformations and space
      occupying lesions. 2. MRT indicates inflammatory processes of the CNS earlier
      than CT by which extension and localization are visualized more precisely. MRT
      gains particular importance for follow-up studies because there is no radiation
      burden. In cases of disseminated inflammatory lesions or concerning early
      diagnosis of Herpes-encephalitis an exact and rapid diagnosis is possible. 3. In
      patients suffering from convulsions with or without focal lesions in EEG MRT
      instead of CT should be applied as MRT allows three-dimensional imaging not
      influenced by bone artifacts. 4. CT is superior to MRT if small calcifications or
      acute hemorrhage are looked for. MRT enables us to differentiate several stages
      of bleeding. 5. In patients with cerebral AV-malformations angiography can be
      replaced by MRT. However, angiography is indispensable for small aneurysms and AV
      malformations in the spinal canal. 6. Due to high soft tissue contrast MRT is the
      imaging modality of choice in patients with metabolic and degenerative diseases
      and disturbances of brain maturation. 7. In infants sonography should be done
      first and supplemented by MRT and/or CT.

PMID- 2214592
TI  - [Psychosomatic, sedative and hemodynamic reactions following preoperative
      administration of midazolam in children].
AB  - Since children's intellectual perception is limited, the preoperative visit by an
      anesthesiologist alone can rarely help to free the small patients from fear and
      restlessness prior to elective surgery. In order to relieve anxiety which should
      be the primary goal of premedication in any patient - children need anxiolytic
      premedication agents. Drugs for premedication administered by intramuscular or
      rectal route in children often cause pain, fear and discomfort. The present study
      was performed in order to investigate oral given midazolam in the premedication
      of children with special regard to the practical suitability of this method. 100
      children, 0.5 to 10 years of age (group A: 0.5-4 years, group B: 5-10 years)
      undergoing elective urological surgery received 0.4 mg/kg midazolam orally about
      20 minutes prior to the arrival in the operation unit. After insertion of a
      venous cannula into a forearm vein anesthesia was induced with thiopental and
      maintained by inhalation with Isoflurane, nitrous oxide and oxygen (fi O2:0.3).
      Degree of sedation, state of mind and behaviour (for 100 children) as well as
      blood pressure and heart rate (separately for group A and B) were registered
      preoperatively at defined, comparable and representative circumstances. Side
      effects prior and during induction phase of anesthesia were documented. The
      personal data are representative for a normal population of children with typical
      urological diseases. Oral administered midazolam had only a mild or non sedative
      effect in 76-84% of the children 70-84% of the small patients showed an
      indifferent or euphoric state of mind and 67-88% behaved cooperatively or
      passively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214593
TI  - [Metabolic disorders of branched-chain amino acids: most common forms of organic
      aciduria in the neonatal period].
AB  - Defects in the branched chain amino acid metabolism are the most common forms of
      organic aciduria. Two thirds of the cases manifest themselves during the neonatal
      period, most of them with an acute onset. Prompt diagnosis of organic acidurias
      is a task of the pediatrician and the neonatologist and depends on their early
      identification of children with suspect clinical symptoms. Between 1984 and 1987
      9 patients presented with an organic aciduria at the Pediatric Department of the
      University of Innsbruck, 7 of them were neonates. 4 of these 7 children had a
      defect in the branched chain amino acid metabolism, 3 with propionic acidemia,
      one with maple syrup urine disease. The remaining 3 children presented with
      lactic aciduria. In all our patients diagnosis was performed by combined gas
      chromatography and mass spectrometry of spontaneous urine samples. Diagnostic
      procedures and therapeutic measures applied in the acute metabolic crisis are
      presented. Continuous arteriovenous hemofiltration has been found to be an
      efficient method for eliminating toxic metabolites in intractable metabolic
      acidosis.

PMID- 2214594
TI  - [The effect of methotrexate pharmacokinetics and of leucovorin rescue on the
      prognosis of osteosarcoma].
AB  - A total of 129 high-dosage methotrexate therapies performed in 19 patients with
      osteosarcoma were retrospectively analyzed. Serum methotrexate peak
      concentrations were found to vary widely, both inter-individually as well as in
      the same patient. The measured MTX peak concentrations correlated closely with
      pharmacokinetic data such as area under the curve and total body clearance. No
      correlations were found between the serum MTX correlations and different times
      after methotrexate administration. Increase in leucovorin rescue or low MTX peak
      concentrations were associated with poor prognosis. High-dosage methotrexate
      therapies with leucovorin rescue need to be further optimized in accordance with
      biochemical knowledge of the mode of action and the individual pharmacokinetic
      data of methotrexate. Such optimization may be expected to improve the prognosis
      for osteosarcoma. Serum methotrexate concentrations should be determined not only
      24, 48, and 72 hours after methotrexate administration, in order to avoid
      elevated toxicity of the therapy, but also at the start of methotrexate infusion,
      in order to influence MTX peak concentrations at an early stage if necessary.
      Measurement of L-leucovorin in serum will be necessary, to enable a restrictive
      leucovorin rescue to be performed safely.

PMID- 2214595
TI  - [Partial trisomy 10p in combination with partial monosomy 20p--a syndrome with
      muscular hypotonia, psychomotor retardation, dwarfism and craniofacial
      dysmorphia].
AB  - The clinical syndrome resulting from deletion of 20p in combination with
      duplication of 10p, seen in two male members of the same family, is reported for
      the first time. The sister of one and the mother of the other patient are
      asymptomatic carriers of a balanced translocation. The two patients have multiple
      stigmata including dwarfism and pronounced psychomotoric retardation. The
      syndrome corresponds largely to an addition of the symptoms seen in cases with
      deletion of 20p and duplication of 10p reported hitherto.

PMID- 2214596
TI  - [Primary hyperlipoproteinemia Type I in the neonatal period].
AB  - Newborn infants with inborn errors of lipid metabolism are relatively rare. There
      are only a few reports of hyperlipoproteinemia in infancy. In a six-day-old
      "healthy" newborn infant with a weight of 2960 gm a milky blood serum was found.
      Diagnosis of primary hyperlipoproteinemia type I was established by exclusion of
      other diseases and by analysis of blood lipids. Lack of lipoprotein lipase
      activity in postheparin plasma confirmed the diagnosis. The parents of the
      patient were normolipemic but showed reduced lipoprotein lipase activity. Thus,
      they were recognized as heterozygotes. A low fat (6-19 gm fat/d, 2-3 gm fat/kg
      bodyweight/d) diet with a high proportion of medium-chain triglycerides (78% MCT)
      lowered the initially extremely high serum triglyceride level (3674 mg/dl)
      significantly (214-711 mg/dl). Until the age of 7 months body weight and length
      followed the 10. percentile, head circumference followed the 50. percentile.
      Unexpectedly the patient died of pulmonary infection at the age of 8 months.

PMID- 2214597
TI  - [Dentato-rubro-pallido-luysium atrophy in an infant].
AB  - After an uneventful pregnancy and labour one hour post partum a tonic-clonic
      seizure occurred in a female infant. In the following time a muscular
      hypertonicity developed and the statomotor development ceased. No clue for a
      neurometabolic disease was found and the child died of an aspiration pneumonia at
      5 months of age. Neuropathological examination disclosed a Dentato-Rubro-Pallido
      Luysium-Atrophy (DRPLA). Apart from two healthy siblings an older sister had died
      six months old after an almost identical clinical course. No autopsy was done in
      this first case. DRPLA is a rare systemic degeneration and begins to our
      knowledge always in adolescence or adult age. The nosological classification of
      this unusual case is discussed and the literature is reviewed.

PMID- 2214598
TI  - [Fatal course of juvenile chronic arthritis].
AB  - Case report of a young man suffering from seropositive juvenile arthritis who
      succumbed to the consequences of cerebral vasculitis. Postmortem generalised
      arteritis was found affecting mainly brain and kidneys. There were no laboratory
      signs of an inflammatory process during the months before his death nor
      hypergammaglobinaemia or decrease of complement. The generalised arteritis
      manifested itself solely as mononeuritis multiplex with eosinophilia. Thus even
      with discrete signs such as these severe vasculitis ought to be considered for
      appropriate treatment to be instituted.

PMID- 2214599
TI  - [Spectral analysis of the ECG for detecting late potentials as risk factors of
      life-threatening cardiac arrhythmias].
AB  - Late potentials in the terminal phase of the QRS and early S-T segment are looked
      upon as a risk marker in patients prone to sustained ventricular tachycardia
      after myocardial infarction. Since the amplitude of late potentials at the body
      surface is very low (1-5 microV), most studies use signal averaging of the ECG to
      increase the signal-to-noise ratio. Two different approaches are generally used
      to analyze the signal-averaged ECG. In the time domain, the individual channels
      are combined into a vector magnitude and high-pass filtered in a bidirectional
      mode. Late potentials are suspected if the filtered QRS duration is greater than
      120 ms and/or the amplitude in the terminal 40 ms of the QRS complex is less than
      or equal to 25 microV. The limitations of this method are that the definition of
      abnormality differs from one study group to another, highpass filters may
      introduce artificial signals, patients with bundle branch block in general have
      to be excluded, and the definitions depend upon the noise level. More recently,
      spectral analysis of the ECG with Fast Fourier Transform (FFT) has been
      performed. Late potentials are characterized by a higher frequency content in the
      otherwise low-frequent S-T wave. We analyzed 25 overlapping segments of the
      terminal QRS and early S-T wave time shifted in steps of 2 ms with FFT (spectro
      temporal mapping). This method was shown to overcome some of the limitations of
      conventional time domain analysis: no highpass filters have to be applied, noise
      interference can be detected by a characteristic spectral pattern, and patients
      with bundle branch block need not be excluded.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214600
TI  - [Behavior of the renal functional reserve in type I diabetic patients: effect of
      ACE-inhibition].
AB  - Renal functional reserve capacity was evaluated in 19 normotensive type I
      diabetics without microalbuminuria. All patients had normal basal renal function
      as assessed by 24-hour creatinine clearances higher than 120 ml/min. PAH, inulin,
      and creatinine clearances were carried out every hour before, during, and after
      infusion of an amino acid (AA) solution. The same experiment was repeated after
      ACE inhibition with captopril (25 mg). Two groups of patients were found: Group A
      (responders) showed a significant rise in GFR after AA infusion (inulin
      clearances from 117 +/- 8 to 138 +/- 10 ml/min) (p less than 0.05), whereas in
      Group B (non-responders) no significant change in GFR was observed. Groups were
      comparable in age, duration of diabetes, metabolic control, and mean arterial
      blood pressure. Group B, however, had a significantly higher basal inulin
      clearance (167 +/- 17 ml/min) than Group A (117 +/- 8 ml/min). In Group A ACE
      inhibition completely blocked the AA-induced rise in GFR, while basal GFR in
      Group B was significantly reduced (167 +/- 17 to 148 +/- 8 ml/min) after
      captopril administration. In both groups renal plasma flow was enhanced by ACE
      inhibition. A rise in glucagon was observed in all patients during AA infusion.
      It is concluded that type I diabetics with normal basal renal function already
      have reduced (Group A) renal functional reserve capacity, which is completely
      abolished (Group B) when concomitant hyperfiltration occurs. ACE inhibition
      reduces hyperfiltration and is capable of blocking the AA-induced rise in GFR in
      these patients.

PMID- 2214601
TI  - [24-hour blood pressure measurement in normal pregnancy in hypertensive pregnant
      patients].
AB  - Noninvasive 24-hour ambulatory blood pressure monitoring was performed in 17
      normotensive and 19 preeclamptic pregnant women. The normotensive women showed a
      significant nightly decline in their systolic and diastolic blood pressure. In
      contrast, the preeclamptic women demonstrated either an attenuated circadian
      rhythm or no circadian rhythm at all. This result was even more pronounced in
      patients with severe hypertension, some of whom had a nocturnal increase in blood
      pressure in spite of being treated with antihypertensive drugs in an evening
      dose. The lack of nocturnal blood pressure decrease was also found 24 hours post
      partum. In summary, these results suggest that preeclamptic women are endangered
      by hypertensive emergencies mostly during the night. Therefore blood pressure
      controls should be extended into the night, and antihypertensive drugs should
      also be given in a sufficient evening dose.

PMID- 2214602
TI  - [Plasma endothelin in normal probands and patients with nephrologic-rheumatologic
      and cardiovascular diseases].
AB  - Plasma concentrations of the recently isolated potent vasoconstrictory peptide
      endothelin were measured in 382 patients. The investigations were performed by
      means of a sensitive radioimmunoassay specific for Endothelin-1, 2. The results
      from 110 healthy volunteers displayed a normal range of 44.67 +/- 3.51 pg/ml.
      Significantly raised levels were found in 33 patients with chronic end-stage
      renal failure both before and after hemodialysis. In contrast, 35 patients with
      compensated renal insufficiency did not differ from the normals. Sixty-five
      patients after kidney transplantation revealed significantly elevated levels, as
      did 27 patients with acute myocardial infarction, 8 after coronary bypass
      surgery, and 5 with liver cirrhosis. The mean values of 27 patients with
      untreated hypertension, 22 with secondary hypertension, of various causes and 16
      with coronary artery disease were comparable to the normal population. The values
      were significantly decreased in 9 pregnant women with hypertension and
      proteinuria. A marked decline was found in 5 patients with systemic lupus
      erythematodes, while 20 patients with rheumatoid arthritis demonstrated only a
      slight decrease. The pathophysiological role of endothelin as a local or
      circulating hormone in regulating systemic blood pressure or release of other
      hormones remains to be determined.

PMID- 2214603
TI  - Cystic neoplasms of the pancreas: a clinical and radiological study of eight
      cases.
AB  - Four patients with benign serous cystadenoma, one with mucinous cystadenoma, and
      three with mucinous cystadenocarcinoma treated in the university hospital of
      Gottingen between 1985 and 1988 were investigated. The main initial symptoms of
      these cystic tumors were abdominal pain (7/8), weight loss (3/8), maldigestion
      (3/8), and palpable abdominal mass (3/8), while laboratory investigations
      revealed nonspecific alterations (elevated ESR, mild hypochromic anemia). CA 19-9
      was elevated in two patients, one of whom had cystadenocarcinoma; CEA also was
      elevated in this patient only. In all cases size, localization, and cystic
      character of the tumors were shown clearly by sonography and computed tomography;
      fine needle biopsy helped to distinguish between serous and mucinous cystadenoma
      in four of six cases. Because of their malignant potential, total extirpation of
      mucinous cystic tumors is the treatment of choice, while serous cystadenomas are
      benign and therefore may be treated conservatively in uncomplicated cases or high
      risk patients.

PMID- 2214605
TI  - Duplex sonography in the diagnosis of renovascular hypertension.
AB  - Duplex sonography (DS) has become a well established method for diagnosing
      peripheral vascular diseases. Technical developments (higher resolution of
      transducer and deeper penetration) have made also abdominal and retroperitoneal
      vessels, including renal arteries, accessible for duplex sonography. This method
      provides the opportunity to recognize renal artery stenoses causing renovascular
      hypertension without invasive procedures. We therefore examined 86 hypertensive
      patients with a high likelihood of renovascular hypertension. Due to technical
      problems (bowel gas, adipositas) we excluded 7 patients. 79 patients (17-79
      years) were included in our study. Flow patterns of several renal vascular areas
      were evaluated while the renal artery was demonstrated on a B-scan. A spectrum
      analysis included the evaluation of the frequency pattern (widening of the
      frequency band and loss of a frequency free window below the systolic rise?), the
      sloping of the diastolic shoulder, and the calculation of different parameters
      like acceleration index, deceleration index, resistance index, acceleration time,
      and systolic peak velocity. The accuracy of DS in diagnosing renal artery
      stenoses was compared with arterial digital subtraction angiography (DSA). Renal
      artery stenoses was diagnosed in 21 out of 158 renal arteries (13%). Except for
      the systolic peak velocity no significant correlations could be found of any of
      the indices from spectrum analysis with hemodynamically significant stenoses
      (greater than 50%). However, the following 3 criteria proved to be valuable signs
      of a hemodynamically significant stenoses: 1) Maximal systolic acceleration
      greater than 3 m/s, 2) Steep sloping diastolic shoulder, and 3) Turbulence of all
      frequency ranges without a frequency free window below the systolic rise.
      Compared with DSA the sensitivity of DS was 84.0%, the specificity was 98.5%, and
      the predictive value 91% in significant stenoses.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2214604
TI  - Effects of long-term treatment with simvastatin on plasma lipids and lipoproteins
      in patients with primary hypercholesterolemia.
AB  - We investigated long-term hypolipidemic effects and clinical safety of
      simvastatin, a new competitive inhibitor of 3-hydroxy-methylglutaryl coenzyme A
      reductase in 24 patients with familial and non-familial hypercholesterolemia.
      Patients received up to 40 mg simvastatin for a period of 30 months. Significant
      decreases were noted in plasma cholesterol (30%), plasma triglycerides (25%),
      very low density lipoprotein-cholesterol (26%), and low density lipoprotein
      cholesterol (40%), whereas an increase in plasma high density lipoprotein
      cholesterol (11%) was observed. Furthermore, the percentage decrease in plasma
      low density lipoprotein cholesterol was independent of individual baseline
      concentrations. Simvastatin did not alter the composition of low density
      lipoproteins or high density lipoproteins. The percentage decrease in total
      plasma and low density lipoprotein-cholesterol was independent of apoprotein E
      isoforms and low density lipoprotein-receptor activity as assayed in cultured
      fibroblasts. The drug therapy was well tolerated and clinical examinations
      revealed no adverse effects. Clinical chemistry indices and hematological, as
      well as endocrinological parameters remained within normal limits and ranges.

PMID- 2214606
TI  - [Studies on cultured rat mesangial cells using cyclosporin A and magnesium--is
      magnesium nephroprotective in cyclosporin A therapy?].
AB  - One serious side effect of Cyclosporine A therapy is its acute nephrotoxicity
      characterized by a marked decrease in the glomerular filtration rate. A main
      determinant of the glomerular filtration rate is the ultrafiltration coefficient
      which is thought to be regulated by the contractile state of the cells of the
      mesangium. Cyclosporine A enhances contractions of mesangial cells elicited with
      angiotensin II. By way of lowered ultrafiltration coefficient this effect of
      Cyclosporine A may be partly responsible for its acute nephrotoxicity.
      Hypomagnesaemia is often associated with Cyclosporine A therapy. Profound tubular
      magnesium wasting by Cyclosporine A has been claimed its cause. We have
      investigated the effect of low and high magnesium concentration on the
      contractility of mesangial cells pretreated with Cyclosporine A. Without
      magnesium 80% of the cells contracted upon addition of angiotensin II. A marked
      decrease in the contractility was seen when the magnesium concentration was
      elevated to 2 mmol/l (34%). From these observations we conclude that magnesium
      serum levels even in the high normal range might be protective against the
      decrease of the glomerular filtration rate seen with CsA therapy.

PMID- 2214608
TI  - Influence of splenectomy on platelet morphometry and function.
AB  - Functional and morphometric platelet abnormalities may be influenced by
      splenectomy and thus contribute to postoperative thrombohaemorrhagic
      complications, especially in patients with splenomegaly and/or platelet defects.
      We investigated platelet function, platelet secretion, and platelet morphometry
      before and one week after splenectomy in seven patients with normal platelet
      production and normal spleen size (Hodgkin's disease) and five patients with
      splenomegaly and platelet abnormalities (4 with myeloproliferative disorders and
      1 with chronic myelomonocytic leukemia). Severe postoperative thrombohaemorrhagic
      complications occurred only in patients with myeloproliferative disorders,
      although platelet count and mean platelet volume increased in almost all patients
      after splenectomy. Four patients with myeloproliferative disorders had impaired
      platelet aggregation before splenectomy that improved in only one patient after
      surgery. Platelet buoyant density in this patient group was decreased before
      splenectomy and normalised thereafter. Concomitantly, intraplatelet
      concentrations of alpha-granular proteins increased. Before splenectomy, there
      was a positive correlation between platelet density and platelet volume in
      patients with Hodgkin's disease (r = 0.59, p less than 0.001), but not in
      patients with myeloproliferative disorders. There was no correlation between
      platelet density and platelet volume after splenectomy in either patient group.
      In conclusion, morphometric platelet abnormalities were found in all patients
      after splenectomy. In patients with myeloproliferative/myelodysplastic disorders,
      decreased platelet buoyant density normalised and intraplatelet concentrations of
      alpha-granule proteins were elevated after splenectomy. However, platelet
      function defects in this patient group were not corrected and may have been a
      major cause of thrombohaemorrhagic complications in the postoperative period.

PMID- 2214607
TI  - Tumor necrosis factor: an update on basic research and clinical applications.
AB  - Tumor necrosis factor is one of the recently cloned cytokines with pleiotropic
      effects on normal and malignant cells. Our knowledge about the scope of cells
      producing or responding to this cytokine has enormously expanded. In critically
      ill patients with acute hepatic failure, acute graft-versus-host disease, or
      septic shock, circulating tumor necrosis factor can be measured and useful
      prognostic correlations do exist. Despite promising in vitro results, early
      clinical trials with tumor necrosis factor for the treatment of cancer have
      failed thus far to reveal major antineoplastic activity in cancer patients.
      However, more clinical trials are necessary, since different routes of
      administration and combinations with other cytokines may lead to favorable
      results.

PMID- 2214609
TI  - Highly variable clinical course in severe alpha 1-antitrypsin deficiency--use of
      polymerase chain reaction for the detection of rare deficiency alleles.
AB  - Among 20 individuals with severe alpha 1-antitrypsin (alpha 1AT) deficiency we
      observed extremely variable clinical phenotypes ranging from rapidly progressive
      lung disease fatal at the age of 42 years to an asymptomatic individual with
      normal lung function at the age of 50 years. Eighteen subjects, including the
      asymptomatic one, carried the deficient Pi ZZ phenotype as determined by
      isoelectric focusing (IEF). Their mean alpha 1AT serum level was 36.7 +/- 7.7
      mg/dl. DNA restriction analysis showed that all of them had the classical Pi Z
      allele-associated DNA haplotype, thus confirming the IEF data. Obviously not all
      Pi ZZ individuals will have clinical sequelae caused by this genotype. The
      important differences in clinical course observed could not be explained by
      smoking habits alone. Probably additional factors are pertinent to the
      pathogenesis of the lung disease associated with alpha 1AT deficiency (defects in
      other genes, environmental influences other than smoking). In two patients with
      very low alpha 1AT serum levels definitive phenotyping by IEF was not possible.
      Therefore we investigated the molecular basis of their deficiency using
      polymerase chain reaction (PCR) amplification of the coding exons of their alpha
      1AT genes and direct sequencing of the amplification products. Sequence data
      analysis showed that one of these patients, who had initially been phenotyped as
      Pi ZZ by IEF, had in fact the genotype Pi QObellinghamZ, thus explaining her low
      alpha 1AT serum level of 20 mg/dl. The other patient (alpha 1AT serum level 3.7
      mg/dl) exhibited the rare genotype Pi MheerlenQOgranite falls. Despite his nearly
      complete alpha 1AT deficiency, he suffered from only moderately severe pulmonary
      disease at the age of 42 years.

PMID- 2214610
TI  - [HIV-1 antigenemia and T-cell activation in HIV-1 infected patients].
AB  - In order to study a supposed association between T-cell activation in vivo and
      HIV-1-antigenemia in HIV-1-infected patients, the detection of p24-antigen in
      sera was correlated to serum levels of beta-2-microglobulin and C1q-binding
      immune complexes. Anti-p24-antibodies and the urinary excretion of neopterin were
      also analysed. In 24 of 80 patients (30%) p24-antigen could be detected, and in
      15 of 59 (25.4%) there was a loss of anti-p24-antibodies. Tests revealed elevated
      serum levels of beta-2-microglobulin in 58 of 80 patients (72.5%), elevated
      levels of C1q-binding immune complexes in 15 of 66 (22.7%), and increased
      excretion of neopterin in 52 of 60 (86.7%). Detection of p24-antigen, loss of
      anti-p24-antibodies, serum levels of beta-2-microglobulin, and urinary excretion
      of neopterin were significantly correlated to advanced stages of HIV-1 infection.
      Patients with p24-antigen in the serum showed significantly more frequently
      elevated serum levels of beta-2-microglobulin and no significant association with
      increased urinary excretion of neopterin. Because of the high proportion of
      patients with elevated serum levels of beta-2-microglobulin and increased
      excretion of urinary neopterin in the absence of detectable p24-antigen in serum,
      we could not correlate HIV-1-antigenemia to T-cell activation in vivo.

PMID- 2214611
TI  - Urinary excretion of N-acetyl-beta-D-glucosaminidase in patients after
      cyclosporin-treated corneal grafting.
AB  - Allograft rejection occurs in up to 70% of high-risk keratoplasty patients. For
      this reason short-term Cyclosporin treatment was administered for three months to
      prevent graft loss. Of 23 renal healthy patients, 19 enjoyed long-term graft
      acceptance. We evaluated in these patients N-acetyl-beta-D-glucosaminidase (NAG)
      excretion as a marker of renal tubular damage. All patients, except one, showed
      urinary NAG excretion to be within the normal range. From this we conclude that
      no renal tubular damage occurs after short-term Cyclosporin treatment.

PMID- 2214612
TI  - Ciclosporin-propafenone interaction.

PMID- 2214613
TI  - Improvement of the exercise capacity of a patient with primary orthostatic
      hypotension (primary sympathetic insufficiency) by programmed subcutaneous
      noradrenaline administration via microdosing pump.

PMID- 2214614
TI  - Acute uric acid nephropathy in two gouty patients with moderate hyperuricemia and
      high urine acidity.
AB  - Acute uric acid nephropathy has been described almost uniformly in patients with
      massive uric acid overload (malignancies with rapid cell destruction, epileptic
      seizures). Severe hyperuricosuria and intratubular uric acid precipitation
      result. Here we present two patients with gout, normal uric acid production, and
      moderate hyperuricemia, both of whom developed acute uric acid nephropathy.
      Because of pronounced urine acidity (pH values of 4.6 and 5.0 in morning fasting
      urines), supersaturation with respect to undissociated uric acid exceeded
      solubility (0.54 mmol/l), despite basal urate secretions of less than 2.2 mmol/24
      hours. Additional predisposing factors, such as uricosuric treatment, heavy beer
      drinking, over-consumption of purine-rich foods, and hot environment, were
      superimposed in both cases.

PMID- 2214615
TI  - Severe granulomatous giant cell myocarditis in Wegener's granulomatosis.
AB  - A 28-year-old male patient suffering from Wegener's granulomatosis died suddenly
      with signs of cardiac failure after clinical symptoms had basically subsided
      under chemotherapy. Autopsy revealed pulmonary granulomata, necrotizing
      vasculitis of the lungs and kidneys, focal and segmental necrotizing
      glomerulonephritis, and diffuse granulomatous and necrotizing giant cell
      myocarditis. Histological confirmation of inflammation of the heart in Wegener's
      disease has rarely been reported. Although cardiac involvement in Wegener's
      granulomatosis sometimes is suspected, it is usually thought to have no major
      impact on the course of the disease. By its dramatic clinical and morphologic
      presentation this case illustrates that the heart, in addition to the lungs and
      kidneys, may determine the outcome of the idiopathic granulomatous vasculitis of
      Wegener.

PMID- 2214616
TI  - [Campylobacter pylori in patients with peptic ulcer and chronic gastritis:
      immunologic response].

PMID- 2214617
TI  - [Colonoscopy in the diagnosis and follow-up of colonic polyps].
AB  - Out of 5000 patients examined endoscopically colon polyps were detected in 64%.
      The polyps were characterized by: higher incidence in 70-79-year-olds, high
      percentage of tubular adenomas (79%), large sizes of polyps with complex
      structure and their prevalence in the left colon, signs of malignancy in 0.64% of
      the removed polyps. The chance to develop cancer from tubular adenoma was 0.28%,
      tubular-villous, 1.4%, villous 3%. Recurrent polyps following polypectomy arose
      in 65% of cases. Tumor relapses emerging mainly within the first postoperative
      year occurred in 14% of cases. In 4 patients with cancer its onset was registered
      at the site of the removed large adenomas of complex histological structure.
      Colonoscopy proved an adequate method of diagnosis and follow-up of colon polyps.
      Endoscopic polypectomy can be considered as a measure to prevent colon cancer.

PMID- 2214618
TI  - [Use of xenobiosorption in the treatment of a severe form of brucellosis].
AB  - Brucellosis sepsis was treated by xenosorption involving the porcine spleen.
      Compared to standard therapy ineffective in protracted sepsis, the biosorption
      provided good results leading to a rapid arrest of the infectious process and
      eventual elimination of the organisms. As the data on related experience are not
      available in the literature, the above technique of brucellosis treatment is
      believed fresh.

PMID- 2214619
TI  - [Immunoreactive trypsin in the blood serum of patients with endogenous
      hypercorticism].
AB  - Radioimmunoassay (RIA) was used to measure the response of serum trypsin to
      intravenous secretin and pancreozymin in 16 subjects with adrenocortical
      hyperfunction (group I) versus 6 subjects with hypercorticism (group II). In
      group I the enzyme reaction to the peptides was active and long-term. A similar
      rise in trypsin level occurred equally in patients free of chronic pancreatitis
      often present in Itsenko++ -Cushing syndrome. In group II patients RIA trypsin
      values comply with normal levels. The data obtained suggest an affected
      pancreatic status in adrenal hyperfunction both in the presence and absence of
      chronic pancreatitis which minimizes the informative value of the test in
      identification of chronic pancreatitis in endogenic hypercorticism.

PMID- 2214620
TI  - [The role of glucocorticoid receptors and HLA antigens in the pathogenesis of
      Cushing's syndrome].
AB  - Lymphocytic levels of glucocorticoid receptors were evaluated in 114 patients
      suffering from Icenko-Cushing's syndrome. Incidence of HLA antigens was
      determined in 94 of them. A significant rise of A10 and B27 antigen incidence
      compared to that in normal subjects allows these antigens to be considered
      genetic markers of Icenko-Cushing's syndrome. The levels of glucocorticoid
      receptors in lymphocytes of the patients are lower than in normal subjects both
      in the active stage of the disease and following bilateral total adrenalectomy.
      The patients carrying B27 antigen had lymphocytic receptor concentrations under
      the levels of such in patients free of the antigen carriage. Antigen B27 seems to
      be a cause of lower levels of glucocorticoid receptors in blood lymphocytes.

PMID- 2214621
TI  - [A case of left-atrial myxoma].

PMID- 2214622
TI  - [Developmental defect of the pulmonary artery in a patient with bronchial
      asthma].

PMID- 2214623
TI  - [HLA antigens in monozygotic twins with the concordance of appendicitis and
      complicated duodenal ulcer].

PMID- 2214624
TI  - [Pharmacological basis of thrombolytic therapy].

PMID- 2214625
TI  - [Current approach to the treatment and secondary prevention of peptic ulcer in
      different settings].
AB  - The authors believe that gastroduodenal ulcer can be treated efficiently in the
      outpatient setting and day hospitals. Indications are suggested to treatment
      under either conditions. Arguments are proposed in favor of correcting standard
      regimens, diet, chemotherapy, optimal terms of control endoscopy dependent on the
      ulcer size and depth and of preventive treatment with regard to different ulcer
      courses, etc.

PMID- 2214626
TI  - [Comparative effectiveness of the treatment od patients with hyperglycemic coma
      in diabetes mellitus with small and large doses of insulin].
AB  - The results of the study involving 123 patients suffering from hyperglycemic
      diabetic coma lead to the conclusion on ineffectiveness of high-dose insulin.
      Treatment of hyperglycemic coma by low-dose insulin is more preferable as
      warranting continuous decrease of glycemia without its transformation into
      hypoglycemia, ++post-hypoglycemia hyperglycemia, brain edema.

PMID- 2214627
TI  - [Phases of recurrence of peptic ulcer].

PMID- 2214628
TI  - [Various methodological aspects of patient interviewing].
AB  - The paper recommends a number of rules useful in interviewing patients, draws
      attention to some typical mistakes made by physicians gaining clinical
      information from their patients. It is thought advisable to provide medical
      students with advanced guidelines how to manage a valid and informative interview
      of patients.

PMID- 2214629
TI  - [Principles of teaching the methods of differential diagnosis in internal
      medicine].

PMID- 2214630
TI  - [Use of the rating system in the evaluation of professional competence of
      therapists and surgeons].

PMID- 2214631
TI  - [Observation of the physician and talent of the writer (on the novel by A.P.
      Chekhov "The steppe")].

PMID- 2214632
TI  - [Aleksandr Efimovich Rabukhin (on his 90th birthday)].

PMID- 2214633
TI  - [Pathogenesis of diabetic nephroangiopathies].

PMID- 2214634
TI  - [Cardiomyopathies: nosological entities, classification and the
      pathomorphological aspect of diagnosis].

PMID- 2214635
TI  - [Actual problems of clinical hemostasis].

PMID- 2214636
TI  - [Sneddon syndrome: cardiac pathology and anti-phospholipid antibodies].
AB  - Besides cerebrovascular pathology and livedo, cardiac affections are introduced
      in clinical manifestations of Sneddon's syndrome. They involve coronary heart
      disease (up to development of MI), murmur (usually mitral), occasional cardiac
      arrhythmia. Patients with coronary disease and cardiac murmur show antibodies to
      cardiolipin significantly more frequently. The role of antibodies to cardiolipin
      in the genesis of cardiac alterations in Sneddon's syndrome is open to
      discussion.

PMID- 2214637
TI  - [Secondary amyloidosis in elderly patients with rheumatoid arthritis].
AB  - Examination of rheumatoid arthritis (RA) patients (52 males and 35 females)
      revealed secondary amyloidosis (SA) in 44.2% and 48.6% of patients, respectively.
      The disease was confirmed by amyloid deposits in biopsy specimens of gingival
      mucosa. As far as age-specific SA incidence is concerned, SA was more prevalent
      in elderly age-groups: 29.7% and 80% in males under and over 50, respectively;
      15.4% and 68.2% in relevant women. The disease history in old patients was not
      long: 4.6 +/- 1.0 yr and 3.3 +/- 0.7 yr for males and females, respectively. Not
      a single case of amyloid deposit occurred in patients with systemic lupus
      erythematosus at the age over 60. The contribution of sex hormones and other
      factors to SA onset in RA is under discussion. An old age of RA patients and
      associated infection, especially urogenic, can predispose to SA development.

PMID- 2214638
TI  - [Hemostatic disorders in patients with Schoenlein-Henoch syndrome].
AB  - Several indices of coagulation and fibrinolysis were studied in 54 patients
      suffering from Schonlein-Henoch disease. A significant prolongation of platelet
      aggregation was found in parallel with a decrease of AT III and plasminogen and
      an increase of the fibrin monomer complexes. Consequent to heparin treatment
      controlled by measurements of residual thrombin activity, the indices showed a
      trend towards normalization. The dynamic monitoring of the above indices can be
      used for an overall assessment of the heparin treatment.

PMID- 2214639
TI  - [Immunological and rheological parallels in patients with autoimmune
      thrombocytopenic purpura treated with antilymphocyte globulin].
AB  - When assessed in 20 patients with autoimmune thrombocytopenic purpura (ATP),
      immunologic and rheologic characteristics demonstrated shifts in the presence of
      hemorrhagic syndrome. These correlated shifts emerged upon 4-5 infusions of
      antilymphocytic globulin (ALG) and could contribute to the onset of hemorrhagic
      syndrome observed in 25% of the patients. To arrest or prevent unwanted
      hemorheologic and immunologic effects, 5 ATP patients received pathogenetic
      treatment promoting removal from the circulating blood of antithrombocytic
      antibodies, cell destruction products, circulating immune complexes.
      Plasmapheresis included as such treatment in multimodality ATP treatment led to
      correction of rheologic and clinico-hematologic++ alterations and eventual
      compensation of the disease. Plasmapheresis is proposed as monotherapy and as an
      adjuvant to ALG treatment of ATP.

PMID- 2214640
TI  - [Functional and morphological characteristics of a hematuric form of chronic
      glomerulonephritis].
AB  - Clinical evidence has been analyzed for 325 patients with chronic
      glomerulonephritis confirmed histologically. It was established that chronic
      glomerulonephritis (CG) associated with hematuria exhibits some specific
      characteristics: great ability for maximal osmotic concentration and partial
      ability for ammonium excretion in membranoproliferative CG without sclerotic
      lesions, maximal occurrence in membranoproliferative form of the disease;
      fibroplastic transformation of the glomeruli is a rare finding. CG with hematuria
      is worth mentioning in CG diagnosis.

PMID- 2214641
TI  - [Clinical, immunological and morphological evaluation of nephrotic syndrome].
AB  - The results are available of combined examination of the kidneys in 84 patients
      with manifest nephrotic syndrome varying in etiology: 57 had glomerulonephritis,
      18 amyloidosis, 9 diabetic nephropathy. The study covered lipid metabolism,
      immunological status, lifetime morphological investigation of the kidneys. The
      latter procedure proved advantageous over biochemical and immunological studies
      in deciding upon nosological diagnosis of nephrotic syndrome and its prognosis.
      Destruction of podocytic miner processes revealed in all the syndrome cases can
      serve a uniform morphological substrate underlying massive proteinuria.

PMID- 2214642
TI  - [Effect of therapeutic plasmapheresis on the system of hemostasis in patients
      with chronic glomerulonephritis].
AB  - Coagulative and thrombocytic hemostasis as well as the fibrinolytic system were
      studied in 20 patients with chronic glomerulonephritis on plasmapheresis (PA). It
      is shown that PA promotes activation of platelet aggregation which can be related
      to their contact activation. Coagulation enhances, antithrombic potential
      reduces, fibrinogen is mechanically removed as well as fibrin-monomer soluble
      complexes, fibrin degradation products. In view of the importance of the
      fibrinolytic system in chronic glomerulonephritis, measures should be taken to
      correct the disturbances detected.

PMID- 2214643
TI  - [Immunoglobulin and lysozyme levels in bronchoalveolar lavage fluid from patients
      with acute pneumonia in acute leukemia and bronchogenic carcinoma of the lung].
AB  - The study of immunoglobulins and lysozyme in acute pneumonia patients suffering
      from acute leukemia and bronchogenic cancer of the lungs elicited impairment of
      local specific and nonspecific body defences. This fact should be taken into
      consideration when planning immunotherapy in combined treatment of relevant
      patients.

PMID- 2214644
TI  - [Bronchoconstrictive and bronchodilating effects of acetylsalicylic acid in
      patients with bronchial asthma].
AB  - An aspirin test has been performed in 100 asthma patients. The response of the
      bronchi appeared contradictory: aspirin asthma on the one hand, and
      bronchodilatation on the other occurred in 31 and 28 patients, respectively; 41
      patients appeared nonresponders. Maximum effect of the drug was noted in the
      small bronchi. Desensitization to aspirin and hemosorption reduced asthma
      patients sensitivity to nonsteroid antiinflammatory drugs.

PMID- 2214645
TI  - [Pathogenetic variants of the obstructive syndrome in patients with bronchial
      asthma].
AB  - The study is made of the causes underlying a variety of obstruction syndrome
      presentation in bronchial asthma sufferers. Heterogenic pathogenesis of the
      disease is related to predominance of one of the three obstruction components:
      bronchospasm, inflammatory edema of the mucosa and sputum obturation of the
      airways as a result of defective expectoration. To quantify the components
      objectively, a special program of the patients' examination has been devised
      involving: 1) analysis of clinical symptoms, 2) pharmacological testing with
      selective and nonselective sympathomimetic agents and cholinolytics, 3)
      registration of the duration of the bronchial sputum evacuation (time of
      expectoration). Basing on relevant results, three variants of the obstruction are
      distinguished: bronchospastic, inflammatory-edematous++, obturation. The severity
      of bronchial obstruction progresses from the first to the third variant.
      Moreover, the efficacy of bronchospasmolytic drugs diminishes as shown by
      pharmacological tests: first of selective beta 2-agonists and cholinolytics
      followed by non-selective sympathomimetic agents which may be attributed to their
      additional alpha-stimulating action. In view of this the question of clinical
      significance of alpha-stimulated bronchial constriction is discussed with
      reference to original and literature data.

PMID- 2214646
TI  - [Effectiveness of depin-E in patients with chronic bronchitis].
AB  - Acute course and long-term regimens of depin-E administration were evaluated
      clinically and pharmacologically in 50 patients with chronic obstructive
      bronchitis (COB) and chronic cor pulmonale (CCP). The drug has three mechanisms
      of action: arteriolovenodilating, bronchodilating, direct pulmonary vascular.
      Therapeutic effect was achieved in 80% and 60% of COB and CCP patients,
      respectively. No response was demonstrated for patients with severe cardiac
      failure. Depin-E can be recommended for prophylaxis and treatment of CCP, to
      arrest hypertension crises in lesser circulation, to improve pulmonary
      circulation, central hemodynamics, exercise tolerance.

PMID- 2214647
TI  - [Respiration and bronchial patency in patients with bronchial asthma during
      physical exercise].

PMID- 2214648
TI  - [Effectiveness of endobronchial administration of granulocyte concentrate in
      patients with various forms of chronic bronchitis].
AB  - The paper concerns the efficacy of endobronchial introduction of fresh donor
      leukocytic mass which was studied in 56 patients with chronic obstructive
      bronchitis and compromised immunity in hypoactivity of alveolar macrophages. The
      above treatment promoted correction of the immunity shifts, activation of
      alveolar macrophages and eventually better prognosis in relevant patients.

PMID- 2214649
TI  - [Experience with individual corticosteroid therapy of bronchial asthma in middle
      aged and elderly patients (controlled by monitoring of blood tyrosine level)].
AB  - Blood level of tyrosine as a new clinical and laboratory indicator has been
      studied in bacterial asthma patients of advanced age. Tyrosine is known to affect
      metabolism of glucocorticoid hormones (GHs) thus reflecting GHs status of the
      body and permitting valid evaluation of the need in corticosteroid therapy.

PMID- 2214650
TI  - [Nursing care for the adolescent (II). Suicide in adolescents].

PMID- 2214651
TI  - [Factors influencing one's ability to adapt to chronic illness].

PMID- 2214652
TI  - [A case study on a facial palsy patient].

PMID- 2214653
TI  - [The effect of various cleansing methods for total fiber optic colonoscopy].
AB  - It is a fact that there are recent increasing trends of incidence of the
      colorectal carcinoma among other colorectal diseases. In such trend, the early
      detection remain to be most important by the air contrast barium enema and total
      fiber optic colonoscopy There are several ways to prepare the colon for barium
      enema and fiber optic colonoscopy which include several agents. The mechanical
      cleansing have been used most frequently since Brown's method was adapted to be
      most perfect for colon cleansing. The ideal laxatives and enema solutions were
      limited to adequate dose, it's effectiveness, patient's diet and bowel habit,
      minimal side effect, low cost and simple to perform. In order to compare the
      effectiveness of various cleansing solutions, six experimental methods were
      formed as shown; 1. normal saline enema, 2. castor oil with normal saline enema,
      3. castor oil with soapsuds enema, 4. magnesium citrate with normal saline, 5.
      magnesium citrate with soapsuds enema and 6. ingestion of Golyetly solution. The
      authors have compared and determined the degree of cleanliness by an experienced
      endoscopist The total number of patients was 247, age distribution was 43 +/- 15
      years old, and sex distribution was 133 males and 114 females. The grade I and II
      represented no difficulties at performing the fiber optic colonoscopy+, but grade
      III and IV had some difficulties, even unable to perform the fiber optic
      colonoscopy. The effectiveness the cleansing agents, represented with grade I and
      II was 95.9% (47/49) in method 6, 93.2% (54/58) in method 2, 83.3% (30/33) in
      method 3, 70.0% (28/40) in method 5, 66.7% (16/24) in method 1, and 45.7% (18/40)
      in method 4. Method 2 and 6 were the most effective in normal bowel habit
      patients. In constipated patients, method 6 was the most effective and all method
      except method 4 were effective in diarrhea patients. The degrees of less mucosal
      irritation by various bowel cleansing method were in the order of method 6(100%),
      1(100%), 5(74%), 2(69%). In subjective symptoms and cleansing groups, abdominal
      distension, pain, nausea and vomiting were complained, and that's subject
      symptoms were in the order of method 3(88.9%), 6(79.6%), 1(75%), 5(72.5%),
      2(72.4%), 4(67.5%). In conclusion, we believe that the Golytely of the mechanical
      cleansing solution for fiber optic colonoscopy was the most effective, but others
      depended on the patient's condition and bowel habit.

PMID- 2214654
TI  - [A study on the effect of waiting time for operations in the operating room on
      preoperative patients].
AB  - This study was attempted to provide us with basic information on how to improve
      understanding with patients for operation, and to offer them better nursing and
      treatment. This kind of study will help scientific application to nursing
      practice and operating room. The data was collected by interviewing 29 patients
      who underwent the elective surgery under the general anesthesia at Y hospital in
      Seoul. The interview ran from October 15 to December 15, 1989. The research
      instrument was a anxiety measurement device (SAAI) originally developed by
      Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing
      Hypothesis one was that there would be a difference in state anxiety level
      according to a time difference in waiting for operation. This hypothesis was
      rejected (state anxiety level one hour before operation P greater than .05, r =
      .747, State anxiety level half an hour before operation P greater than .05, r =
      .1550, state anxiety level just before operation, P greater than .05, r = .1099).
      However, state anxiety level appeared to be associated with a longer waiting
      period, like one day before operation (P less than .05, r = .4628). Hypothesis
      two was that there would be a difference according to state anxiety level of
      patients for operation. This was rejected. (Change of blood pressure in systolic
      P greater than .05, r = -.1082. Change of blood pressure in diastolic P greater
      than .05, r = -.088, Change of pulse rate, P less than .05, r = 1.909) 2.
      Examining trait anxiety and state anxiety levels, the average level of trait
      anxiety was 42.034, and the average level of state anxiety one day before
      operation was 43,000. The average level of state anxiety was averaged 42.356 in a
      waiting room for operation. 3. Examining the state anxiety level by time period,
      the level one hour before was 42.379, the level half an hour before 42.276, and
      the level just before operation 42.414. The low level of state anxiety was due to
      the fact that premedication was not eliminated. 4. Age and time period like one
      day before operation was related to state anxiety level (F = 5.271, P less than
      .001) and blood pressure in waiting room for operation. That is, state anxiety
      level and blood pressure of patients one day before operation appeared high. Sex
      was related to changes of blood pressure; the blood pressure of male patients
      appeared higher than that of female patients.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2214655
TI  - [Health belief model and sick role behavior of Korean chronically ill patients].
AB  - This article reviewed & analyzed 33 studies of the Health Belief Model applied to
      korean chronic ill patients which were published from 1975 to 1990. The findings
      of analysis are as follows. The subjects of researchs are patients with various
      chronic illness including Pulmonary Tb., DM., Hemodialysis & Kidney
      Transplantation, Hypertension, etc. The type of research is retrospective survey
      in all studies. The measurement of health belief in all studies & sick role
      behavior in most studies have relied on self report. The analysis of the
      relationship between health belief and sick role behavior was done using
      correlation coefficient in most studies. To analyze empirical support for the
      relationship between health belief and sick role behavior, Significance ratio was
      computed. This ratio is value wherein the number of statistically significant
      findings with relationship in the expected direction for an HBM dimension are
      divided by total number of studies which reported significance levels for that
      dimension. Examination of this ratio across the 33 studies reveals susceptibility
      (30.3%), severity (34.4%), benefit (65.6%), barrier (50%). The following
      suggestions are based on the above findings and literature review. 1. It is
      necessary to develop the reliable, valid and standardized instrument for
      measurement of health beliefs. 2. In the further measurement of perceived
      susceptibility of the chronic ill patients. It is considering that the perceived
      susceptibility and perceived severity are measured together or the measurement of
      perceived susceptibility is eliminated. 3. Relationship between perceived
      severity and sick role behavior is suggested to be analized using ANOVA, chi 2
      square instead of correlation coefficient. 4. Sick role behaviors should be
      measured by both self report and objective measurement. 5. Prospective,
      longitudinal survey should be needed. 6. Other factors influencing sick role
      behaviors of chronic ill patients should be investigated further.

PMID- 2214656
TI  - [Nursing care for the adolescent (II). Drug abuse in adolescents].

PMID- 2214657
TI  - [A study on third-trimester gravidas' knowledge of infant care activity].
AB  - The purpose of this study was to measure the degree of gravidas' knowledge of
      infant care activity, and to identify the factors influencing the difference of
      gravidas' knowledge. The subjects of this study consisted of 159 gravida visited
      2 general hospitals, 2 OB/GY clinics and 2 midwives' clinics in J city for
      antenatal care. The data were collected from December 1 to 30, 1989. The
      instrument used for this study was true false type question which was developed
      by investigator through literature review. Data were analyzed by percentage,
      mean, t-test and ANOVA on significant difference with SPSS program. The results
      of this study were summarized as follow: 1) The degree of gravidas' knowledge of
      infant care activity was 36.75, the degree of gravidas' knowledge of physical
      care activity was 16.70, and the degree of gravidas' knowledge of psychosocial
      care activity was 20.05. 2) Among the physical care activity knowledge items, the
      diaper should be changed whenever it is soiled, shortly after feeding is over,
      bathing is bad, gently patted or stroked on the back when bubbling, 10 minutes
      time in bathing is appropriate, infant is crying whenever he is hungry per 3-4
      hours, and room humidity controlled 60 percent, more or less were over a
      percentage of 80 of right answer. Among the physical care activity knowledge
      items, a reason for burping was the air he has swallowed will rise to the top of
      his stomach and be eructated, burping is advisable after the feeding, dressing of
      umbilical area is not necessary, the thermometer should not be boiled for
      disinfection, it is important that the infant grasp the whole nipple within his
      mouth, using alcohol sponge is bad whenever diaper is soiled, and when
      temperature is taken by the rectal method, infant legs should be grasped firmly
      were less than a percentage of 60 of right answer.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2214658
TI  - [Problem of automated evaluation of the functional state of the body in current
      aerospace and preventive medicine].
AB  - The methodology of evaluating the health status of the normal man is discussed.
      Special attention is given to the boundary states between the norm and pathology,
      i.e. ++pre-nosological and premorbid states. The development of automatic systems
      for evaluating the functional state of the human body is described. A motor-borne
      automatic system "Autosan-82" is described as a ground-based analog of a space
      system of medical monitoring. Also, a description of present-day automatic
      systems "Control", "Vita", and "Rhythm" is given. They can provide health
      evaluation at three levels: 1) preliminary assessment and identification of
      subjects in different health conditions; 2) diagnosis of functional states,
      identification of risk factors, and potential profiles of pathology; 3) medical
      examinations by specialists in different medical disciplines of subjects with
      potential pathologies or detailed evaluation of reserve capabilities of health
      subjects.

PMID- 2214659
TI  - [Hormonal regulation of calcium metabolism after space flights of different
      duration].
AB  - This paper presents the results of examinations of 19 cosmonauts, 12 of whom made
      7-day flights and 7 took part in space flights of 150, 211 or 237 days. In
      plasma, parathyrin, calcitonin and gastrin concentrations were measured. A
      complex mosaic of hormonal regulation of bone metabolism reflects multifactorial
      and flexible patterns of calcium homeostasis, with individual variations
      included. It is probable that the specific weight of different components of the
      system maintaining calcium homeostasis varies depending on the exposure time and
      activity of related regulatory systems.

PMID- 2214660
TI  - [Study of the musculoskeletal system of the spine in humans after long-term space
      flights by the method of computerized tomography].
AB  - By computer tomography, mineral density of lumbar vertebrae and their segments as
      well as back muscle (++ilio-costal, extensor and ++inter-spinal) density and mass
      were measured in four Salyut-7 crewmembers before and after extended flights (of
      5 and 7 months in duration). These findings are in good agreement with the
      results of prolonged bed rest studies in which trabecular bone of vertebral
      bodies was investigated: mineral density diminished only in some (approximately
      10%) of the test subjects. At the same time mineral density loss was seen in the
      vertebral elements where muscles were attached. Also, muscle mass was reduced. It
      is emphasized that the level of changes was not correlated with flight time.
      Further investigations in this area are discussed.

PMID- 2214661
TI  - [Studies of the morphology of the thyroid gland and thyroid hormone levels in the
      blood of rats in experiments on "Kosmos-1667" and "Kosmos-1887"].
AB  - Using histological, electron microscopic, and biochemical (measurement of total
      thyroxine, free thyroxine and triiodothyronine in plasma) method, thyroid glands
      of 17 male rats of the Wistar SPF strain flown for 7 days on Cosmos-1667 and for
      13 days on Cosmos-1887 were investigated. It was found that a longer exposure to
      space flight effects (for 13 days) led to a thyroid activity decline (significant
      reduction of thyrocyte size and nuclear area, accumulation of colloid drops in
      the cytoplasm, decrease of iodinated thyroglobulins in the colloid, etc.)
      together with a substantial decrease of T4 and T3 in plasma. The above structural
      and functional changes in the thyroid gland and hormonal status are
      characteristic of a moderate stress-reaction and reflect variations of the early
      and intermediate stages of adaptation to microgravity during 7- and 13-day space
      flights.

PMID- 2214662
TI  - [Functional activity of the pituitary-thyroid gland system during 370-day anti
      orthostatic hypokinesia].
AB  - The concentrations of the thyrotrophic hormone (TTH). bound thyroxine (T4), free
      thyroxine (FT4), and triiodothyronine (T3) were measured by RIA in the blood of
      10 test subjects during a 370-day head-down tilt study and a 250-day recovery
      period after it. The concentrations of TTH, FT4, and T3 decreased during bed rest
      and did not return to norm during recovery. It can be assumed that during bed
      rest TTH stimulation of the thyroid gland declines, which can act as an adaptive
      response to lower physical load.

PMID- 2214663
TI  - [Changes in the rheological indicators of the blood and hemodynamics during 14
      day anti-orthostatic hypokinesia].
AB  - Nine essentially healthy subjects, aged 25 to 42 years, were exposed to head-down
      bed rest (-8 degrees). On bed rest days 3, 7 and 14 the following rheological and
      hemodynamic parameters were measured: blood dynamic viscosity, Caisson viscosity,
      yield limit, red blood cell aggregation, stroke volume, cardiac output, and total
      peripheral resistance. Rheological parameters were measured by means of a
      rotation viscosimeter at 25 degrees C +/- 0.1. Hemodynamic parameters were
      measured by the method of integrated rheography. Blood was withdrawn from the
      cubital vein. The results give evidence that dynamic and Caisson viscosity
      increased significantly, reaching a peak by bed rest day 14. The sequence of
      hemodynamic changes followed the same pattern as rheological changes. Analysis of
      the results shows that there is a good correlation between the above parameters,
      especially by bed rest day 14. Thus, it can be concluded that there is a vascular
      mechanism involved in the compensatory restructuring of the vascular system at
      the tissue level in response to blood redistribution and fluid loss during bed
      rest.

PMID- 2214664
TI  - [Study of the changes in electric parameters of the rat skin after irradiation].
AB  - This paper presents the results of measuring electric parameters of the skin of
      rats exposed to gamma-irradiation. Skin resistance increased, especially 7 and 14
      days after exposure at a dose of 8.3 Gy and 3 days after exposure at a dose of 15
      Gy. Skin resistance reached its peaks 1-2 days before the onset of postradiation
      death of animals. The fact that skin electrical properties vary after irradiation
      makes it possible to use them as biological predictors.

PMID- 2214665
TI  - [Study of the audiogenic reactions in rats after UV-irradiation of their eyes].
AB  - Female rats of the Wistar strain with a mean weight of 222 g were exposed to 96
      dB sound according to L.V. Krushinsky. Their eyes were irradiated with a high UV
      dose in order to reveal potential disorders in high nervous activity. After 3, 7
      and 35 days of exposure to UV irradiation at a dose of 10 kJ/m2 with a maximum
      wavelength of 302 nm the following changes were observed: the amount of
      "inhibited" rats grew, the latency time of I degree attacks and the duration of
      inhibition states increased, and the duration of seizure fits decreased. It is
      postulated that inhibition effects may enhance and stimulation effects may
      attenuate as a result of reduction of afferent pulses entering the central
      nervous system from the visual organ due to keratoleukoma.

PMID- 2214666
TI  - [Physiological characteristics of posture maintenance by dogs during immediate
      reaction to irradiation].
AB  - The ability of dogs to maintain a vertical posture during the first hours after
      irradiation at a dose of 10 or 80 Gy was investigated. Two experiments were
      performed. In the first experiment, during 5 hours after irradiation the vector
      stabilogram area, peak muscle efforts and sensorimotor coordination were measured
      10 times every 30 min. In the second experiment, postural responses to
      perturbations were measured before and after irradiation at a dose of 10 Gy.
      During exposure to 10 Gy maximum values of the vector stabilogram area reflected
      initial excitation and motor unrest, that preceded vomiting, while minimum values
      of the parameter were related to hypodynamia during 3-5 hours after exposure.
      During exposure to 80 Gy minimum values of the vector stabilogram area reflected
      the hypodynamic phase while maximum values were related to the phase of distinct
      cerebral lesions. A reliable indicator of the quality of vertical posture
      maintenance, that correlates with the post-irradiation quality of purposeful
      actions, including intermittent physical acts, or actions, requiring highly
      precise coordination, is the rate of posture recovery after instantaneous
      platform displacement. This parameter declined after irradiation, the maximum
      decrease being during the 4-5th hour.

PMID- 2214667
TI  - [Hemodynamic types in pilots and their clinical and expert-evaluation
      significance].
AB  - At the present time two approaches to the hemodynamics types can be distinguished
      in the literature: some authors maintain that they are variants of the norm,
      while others claim that they emerge in the course of disease. The purpose of the
      present investigation was to study the different viewpoints and to clarity the
      clinical and diagnostic role of hemodynamics types in aviation medicine.
      Altogether 293 pilots were examined, 49 of which were essentially healthy and 244
      had various cardiovascular pathologies. It was found that the percentage ratio of
      the hemodynamics types in the subjects with neurocirculatory dystonia of the
      hypertensive type, stage I hypertensive disease, myocardiodystrophy and
      myocarditic myocardiosclerosis was the same (p less than 0.05) as in the healthy
      pilots. This indicates that hemodynamics types do not originate during disease,
      being rather variations of the norm. During orthostatic tests some subjects
      exhibited transition of one hemodynamic type to the other (e. g., hyperkinetic-to
      eukinetic type transition, p less than 0.05); however, during the very first
      minute after exposure 90% of the subjects displayed their inherent types which
      pointed to their stability. Identification of the hemodynamics types in
      combination with measurement of central and peripheral circulation as well as
      bioelectric activity of the heart at rest and during orthostatic tests can
      improve the sensitivity of methods used to detect pathological changes at early
      stages and help to choose adequate rehabilitation procedures.

PMID- 2214668
TI  - [Cytogenetic effects of hyperbaric oxygenation].
AB  - This paper presents cytogenetic data obtained from peripheral blood of patients
      who were treated with hyperbaric oxygenation (HBO) at 0.15-0.2 MPa for 40 min
      daily during 10 days. The patients showed a significant increase of chromosome
      aberrations mainly caused by chromatid and chromosome breaks. The level of
      induced aberrations showed individual variations. These results suggest that HBO
      may have an indirect effect on the genetic apparatus of human somatic cells.

PMID- 2214669
TI  - [Epidural and subdural recording of intracranial pressure during postural tests].

PMID- 2214670
TI  - [Effect of hypergravitation on mammals during labor and nursing of their
      offspring].

PMID- 2214671
TI  - [Protective effect of mexamine on rats exposed to electromagnetic radiation].

PMID- 2214672
TI  - [Biochemical aspects of the adaptation of humans to combined effects of anti
      orthostatism, lowered barometric pressure and increased O2 level].

PMID- 2214673
TI  - [Rosette formation in the peripheral blood of rats during hypokinesia].

PMID- 2214674
TI  - [Relation between annual biorhythms of the erythrocyte number in the peripheral
      blood of healthy persons and the annual rhythms of the changes in solar
      activity].

PMID- 2214675
TI  - An experimental model for advanced ovarian cancer.
AB  - Intraperitoneally transplanted tumors implanted and began developing with ascites
      in about 62% of the female rats within 4 to 6 weeks after transplantation. The
      tumor used in this study was an adenocarcinoma and which originated from a
      primary ovarian cancer in rats of the same strain (Wistar). The morphology and
      biological behavior of the tumor were very similar to the tumor in humans.
      Moreover, the preliminary results with cisplatin therapy indicate that
      intraperitoneal cancer corresponding to stage III or IV in the FIGO
      classification is a promising model for experimental therapeutic studies of
      common epithelial carcinoma at an advanced stage.

PMID- 2214676
TI  - Increased gallium-67 citrate uptake in the breast of a patient with gynecomastia.
AB  - Although the accumulation of Ga-67 citrate in gynecomastia has been described, no
      researchers have reported that Ga-67 citrate accumulates in a "doughnut" pattern.
      Basically, gynecomastia is due to an increase of estrogens. Since estrogens
      accelerate the proliferation of lactiferous ducts in the center of breast, Ga-67
      citrate may accumulate in it. On the hand, prolactin increases the proliferation
      of the glandular lobules and the acinus. When the serum prolactin increases after
      child birth or renal insufficiency, the image from the accumulation of Ga-67
      citrate in the breast may have a "doughnut" pattern. A patient with gynecomastia
      had high levels estrogens because he was being treated with an estrogen
      medication. He was referred for liver cirrhosis. The results of the present
      report indicate that the "doughnut" pattern occurs in the margin of the
      hyperplasic glandular lobule.

PMID- 2214677
TI  - Tc-99m RBC imaging for demonstrating intermittent intestinal bleeding.
AB  - A case of intestinal bleeding caused by multiple ulcerations near the terminal
      ileum is presented. Abdominal scanning with Tc-99m tagged red blood cells (Tc-99m
      RBC) demonstrated the intermittent bleeding in short intervals. Selective
      angiography did not demonstrate the bleeding site. Exploratory laparotomy showed
      3 ulcers on the ileum at a site near the terminal ileum, with bleeding from one
      site. Tc-99m RBC abdominal scanning was very useful in this case for localization
      of the site of gastrointestinal bleeding before laparotomy.

PMID- 2214678
TI  - Abdominal scanning using autologous human red blood cells labeled with Tc-99m:
      detection of a horseshoe kidney.
AB  - A horseshoe kidney was incidentally diagnosed while performing an abdominal scan
      using autologous human red blood cells labeled with Tc-99m (Tc-99m RBC) on a
      patient with suspected gastrointestinal bleeding. This patient repeatedly tested
      positive on occult blood stool examinations. In the first scintigram, an increase
      in well-defined activity was found on the right side under the liver. This could
      have been caused either by bleeding of the gastric antrum or the duodenal bulb. A
      second abdominal scan with Tc-99m RBC revealed faint radionuclide accumulation in
      the shape of a horseshoe with symmetrical, well-defined activity. However, the
      well-defined activity decreased with time on both images, and on this basis a
      horseshoe kidney was diagnosed.

PMID- 2214679
TI  - Subcloning and trial of expression of the protein kinase catalytic domain of RSV
      src gene.
AB  - The gene of catalytic domain of the protein kinase of RSV-scr was cloned into the
      BamHI cloning site of translation vector pET-8c which containing T7 RNA
      polymerase promotor, and transformed BL21 (DE3) pLys S (Studier and Moffatt,
      1986). The putative molecular weight of the protein was about 33 kd as evaluated
      on the basis of its nucleotide size showed the identical mobility in SDS
      polyacrylamide gel electrophoresis. However, yield of protein production was not
      high, probably, because of its instability in Escherichia coli.

PMID- 2214680
TI  - Coronary artery bypass surgery in the elderly.
AB  - In order to place the issue of CABG surgery in the elderly in a personal
      perspective, we have reviewed our series of 250 consecutive patients 70 years or
      greater in age at the time of surgery and have noted a very acceptable (3.6%)
      operative mortality. Good short and long term survival has been documented. A
      modest but important elevation of postoperative CNS morbidity has been documented
      and remains of concern. We have continued to offer CABG to those patients with
      acceptable risks who have either intractable angina, intractable ischemic heart
      failure and multi-vessel disease. Left main obstruction of a significant degree
      or those with threatening three vessel anatomy in association with a sentinel
      ischemic event are candidates for the CABG procedure. Substantial preoperative
      evaluation to include the family support substrate must be an important part of
      the decision process as well as open communication with concerned family members.
      We feel that the improved life style and enhanced survival justifies CABG in
      those elderly patients identified with severe coronary artery disease.

PMID- 2214681
TI  - Distribution of major dementias by race and sex in South Carolina.
AB  - Preliminary data from the newly implemented Registry for dementing illnesses was
      used to examine the distribution of four types of dementia in black and white
      residents of South Carolina. The data for 1464 subjects were abstracted by field
      research nurses in state mental health facilities. Overall, 649 patients (44.3%)
      were black and 765 (52.3%) were white. Women comprised 53.8% of all cases of
      dementia in this study. The overall distribution included 66% Alzheimer's disease
      (AD), 12% multi-infarct dementia (MID), 10% alcoholic dementia (ALC), nine
      percent other-medical and three percent other-unspecified. Though the proportion
      of blacks does not exceed one-third of the total population of S.C., blacks
      comprised 44.3% of all cases of dementia. AD accounted for 79% of all cases of
      dementia in women, but only 51% of such cases in demented men, who showed an
      apparent preoponderance of MID and alcoholic dementia. The frequency distribution
      of MID was equal in blacks and whites. Educational level had no discernible
      effects. Though not directly comparable, these preliminary findings are similar
      to those of the Copiah County Study, including a higher frequency of AD with
      advancing age.

PMID- 2214682
TI  - The need for an Alzheimer's disease patient registry in South Carolina.
AB  - There has been considerable interest in establishing a statewide registry of
      Alzheimer's disease patients. The need for such a registry, how it could be
      effectively organized, and the potential benefits from such a registry are
      discussed. The current status of the South Carolina Registry for Dementing
      Illnesses is reported.

PMID- 2214683
TI  - First among the C's.

PMID- 2214684
TI  - New found feelings as to our place and obligations in patient contact (care)

PMID- 2214685
TI  - Human immunodeficiency virus and the surgeon.
AB  - To assess the exposure risks for surgeons and nurses treating HIV infected
      patients at the Medical University Hospital and the Charleston Memorial Hospital,
      a retrospective review of HIV positive patients who underwent surgical procedures
      from 1985-1988 was undertaken. During that period, 150 patients tested positive
      for HIV of which 30 (20%) underwent 19 surgical procedures. The prevalence of HIV
      infected patients at our institution has been increasing over the last two years.
      5.3% of the patients tested were positive for the virus. Evidence of drug abuse
      was not a predictive factor of HIV infection but homosexuality was present in 57%
      of our patients. The mean age of the surgical group was 34 years. Seventy-three
      percent of the patients underwent minor operations and 27% had major surgical
      procedures. Almost half of the operations were performed to treat an AIDS-related
      complication or as a diagnostic aid in the workup of the AIDS patient. Major
      operations performed were for treatment of a co-morbid condition not related to
      the HIV infection. Only two patients had operations for trauma. Operative
      mortality was 10% but no death was directly related to surgical intervention. In
      addition to universal precautions in the pre and postoperative period, operating
      room personnel must follow established protocols in the conduct of the operation
      to ensure the safety of all staff.

PMID- 2214686
TI  - Recent trends in neonatal mortality in South Carolina.
AB  - This study examines some of the primary factors responsible for the decline in
      South Carolina's neonatal mortality rate during the 1980s. Essentially all of the
      observed decline between 1980-82 and 1984-86 could be attributed to improved
      birthweight-specific survival rather than improvements in the infant birthweight
      distribution. Improved survival of 500-1,499 g infants accounted for 64% of the
      decline in white neonatal mortality and 70% of the decline among blacks. Also,
      during this period, the percentage of 500-1,499 g infants delivered at Level III
      hospitals increased significantly for both race groups. Comparisons with other
      southeastern states suggest that further reductions in South Carolina's neonatal
      mortality rate are possible through continued efforts aimed at improving
      birthweight-specific survival. Existing state-supported programs such as regional
      perinatal referral networks and the High Risk Channeling Project will continue to
      play an important role in maintaining the decline in the state's neonatal
      mortality rate.

PMID- 2214687
TI  - Compression plate osteosynthesis for the treatment of mandibular fractures.

PMID- 2214688
TI  - Anxiety and the human family unit: a perspective.

PMID- 2214689
TI  - HIV, surgeons, and ... all of us.

PMID- 2214690
TI  - Treatment of industrial wounds with DuoDERM Bordered: a report on medical and
      patient comfort aspects.
AB  - In a prospective study 30 patients with minor industrial wounds were treated with
      DuoDERM Bordered. Medical aspects, patient comfort and the possibility of
      continuing activities of daily life are described in this report.

PMID- 2214691
TI  - Medical kits for business travellers.
AB  - A survey of occupational physicians of the Food Industry Medical Officers Group
      was undertaken to establish details of medical kits supplied by their
      organizations to business travellers. The most common approach was an in-house
      medical kit with instructions emphasizing self treatment of the common ailments
      of travellers such as motion sickness, sleeplessness, diarrhoea, indigestion and
      headaches. The majority of kits included a small supply of needles, syringes, IV
      cannulae etc either in a commercial 'Aids Kit' or as inhouse supplies.
      Antimalarials were provided either as a standard kit item or as required. About
      half provided antibiotics for the self treatment of infections. Very few provided
      a telephone number for use in the event of medical emergencies. A standard
      medical kit specification is proposed.

PMID- 2214692
TI  - Simulator sickness in an army simulator.
AB  - Simulator sickness describes a symptom reported by aircrew during or after flight
      simulator training. Some features are common to motion sickness but others, which
      are unusual during real flight, are believed to result specifically from the
      simulator environment. This paper describes the results of a questionnaire study
      examining the incidence and factors influencing simulator sickness in any army
      training system. Case histories are described and conclusions drawn with respect
      to health and safety, training and the effect on flight operations. One hundred
      and fifteen aircrew were registered in the questionnaire study. Data were
      collected from a history questionnaire, a post-sortie report and a delayed report
      form. Sixty-nine per cent of aircrew gave a history of symptoms in the simulator
      and 59.9 per cent experienced at least one symptom during the study period
      although few symptoms were rated as being other than slight. Only 3.6 per cent of
      subjects reported symptoms of disequilibrium. Comparative analysis of the results
      was performed after scoring symptoms to produce a sickness rating. This showed:
      association between simulator-induced sickness and greater flying experience;
      adaptation to the simulator environment; a history of sea sickness may predict
      susceptibility to simulator sickness; and no association of crew role and
      simulator sickness. Although some authorities believe simulator sickness to be a
      potential flight safety hazard there was little evidence from this study.
      Guidelines for the prevention of the problem are presented now that many factors
      have been identified. A general policy to 'ground' aircrew for a period following
      simulator training is not necessary, but severe cases should be assessed
      individually.

PMID- 2214694
TI  - Classification of audiometric results.

PMID- 2214693
TI  - Health problems among spice grinders.
AB  - Sixty-one male spice grinders from 14 factories were studied to determine if they
      had any skin problems, respiratory symptoms or hearing loss associated with their
      work. All subjects were interviewed and examined. Audiometric examinations were
      arranged for those with significant noise exposure. Assessments of dust and noise
      levels were conducted. Symptoms of upper respiratory tract irritation, such as
      sneezing and runny nose, during work were experienced by 49.2 per cent of
      workers. These symptoms were maximal in the first few weeks of employment in
      spice grinding and did not recur in half of the affected workers. Over 26 per
      cent of the workers experienced a warm or burning sensation of the skin when
      grinding chili or pepper. None of the spice grinders had symptoms or evidence on
      physical examination of allergic skin disease or asthma. Noise-induced hearing
      loss was detected in 21 per cent of the workers examined but none had severe
      disabling deafness. Dust levels ranged from 0.03 to 0.82 mg/m3, with a mean value
      of 0.15 mg/m3. Noise exposure was significant, with levels of between 87 and 98
      dBA. Control measures to reduce the noise and dust exposure are discussed.

PMID- 2214695
TI  - Body counting and behaviour.

PMID- 2214696
TI  - Death of the LD50.

PMID- 2214697
TI  - Peer review audit in occupational medicine.
AB  - There is an increasing awareness of the need for medical audit. A method for peer
      review medical audit that has been applied to two large industries is described.
      Occupational physicians act as auditors of randomly selected case notes from
      their colleagues' list of consultations using an agreed proforma as a guideline.
      Open discussion by the occupational physician of the auditor's comments
      identifies needs, such as for a change on policy or further education.
      Implementation of the agreed changes and subsequent review completes a cycle of
      audit.

PMID- 2214698
TI  - Resource needs of an occupational health service to accommodate a hepatitis B
      vaccination programme.
AB  - The administrative, organizational and clinical commitment of an occupational
      health department to implement the DHSS recommendation for a hepatitis B
      vaccination programme for the health care workers in a District General Hospital
      was reviewed to evaluate the resource implications needed to accommodate the
      additional workload. The deficiencies observed in the existing DHSS guidance in
      implementing the plan are described. It is suggested that the Department of
      Health, while making future recommendations for vaccination, should be more
      precise in identifying those at risk, in describing the desired titre to be
      achieved after vaccination, and in describing the follow-up plan for those who
      accept the vaccination, those who refuse and those who do not seroconvert. The
      recommendation should describe the commitment of the Health Authorities and must
      include recommendations for appropriate and adequate resources to support such a
      programme. Vaccination for 1000 employees at risk required 4000 additional
      consultations necessitating 16 additional hours of occupational health commitment
      per week. Eighteen months after initiating the vaccination programme, 677
      employees had accepted the vaccine. After receiving 3 vaccines 508 (75 per cent)
      recipients had protective seroconversion (anti-Hbs greater than 100 I.U.) and a
      further 61 (9 per cent) converted after the 4th injection, thereby offering
      protective immunity to 84 per cent of the recipients. During the period 84 (12.4
      per cent) were lost to follow-up. Recommendations have been made to accommodate
      the additional commitment through the vaccination programme to standardize our
      care and prevent disruption of the existing service.

PMID- 2214699
TI  - Infection risks in hospital staff from blood: hazardous injury rates and
      acceptance of hepatitis B immunization.
AB  - A questionnaire survey of 1800 clinical health care staff was undertaken to
      determine hazardous injury rates and uptake of hepatitis B vaccination. The
      overall sharps injury rate was 116 injuries per 100 staff per year. Full-time
      doctors had the highest rates. Surgical procedures were the commonest cause of
      accidental injury (58 per cent) and 30 per cent of all sharps injuries were
      attributable to careless handling. Injuries caused by bites and scratches from
      patients occurred mainly in nurses and auxilliaries in psychiatric and geriatric
      wards (115/100 staff per year). Twenty-four per cent of respondents had received
      a full course of hepatitis B vaccine and 51 per cent of the remainder were
      planning to have, or were in the process of receiving, a course. The most
      frequent reason given for not being vaccinated was lack of information about
      vaccination. This survey reveals injury rates higher than those observed in
      previous reports, particularly in doctors, and shows a need for more information
      and advice about hepatitis B infection and vaccination to be targeted to health
      care workers at risk.

PMID- 2214700
TI  - An investigation of the neurobehavioural effects on workers exposed to organic
      solvents.
AB  - Forty-five workers exposed to the solvents xylene and toluene in varnishing
      processes in a major heavy electrical industry were studied to find the effect of
      this exposure on different parameters of behaviour. These were immediate and
      delayed memory, visual ability, visual learning and psychomotor ability. The
      findings were compared with those from subjects who were not exposed. Immediate
      memory and delayed memory were affected among both directly and indirectly
      exposed workers as compared with those in the controls which remained unaffected.
      Visual intelligence and memory were most affected by exposure. Psychomotor
      ability was significantly affected among the directly exposed workers, as
      compared with the occasionally exposed group which did not show any significant
      difference from the control workers.

PMID- 2214701
TI  - Food poisoning--a major threat to airline operations.
AB  - In the spring of 1984, British Airways was involved in a major food poisoning
      outbreak which affected nearly 1000 passengers, aircrew and ground personnel. The
      operational impact was worldwide and could have resulted in the cessation of the
      airline's day-to-day operations. The investigation paralleled a major aircraft
      disaster in the number of national and international agencies involved and in the
      variety of disciplines engaged. Although the causative organism was rapidly
      identified (salmonella), and its introduction into the food chain proved to be a
      key factor, the scale of the outbreak was the result of an interaction of other
      factors. As with a major aircraft accident, none of the factors alone would have
      caused the near disaster that occurred.

PMID- 2214702
TI  - Cell biomechanics.

PMID- 2214703
TI  - Cell biomechanics: a brief overview.
AB  - In this issue of the Journal of Biomechanical Engineering, there are eleven
      papers and one technical brief in the general area of "Cell Biomechanics." In
      general, the work in these papers focuses on measuring and characterizing the
      mechanical and adhesive properties of cells and membranes. Included are studies
      of lipid membranes, erythrocytes, endothelial cells, and neutrophils.
      Characterizing and measuring the properties and behavior of cells in both passive
      and active states present a major challenge to investigators in this field. In
      this paper in the comments to follow, a simple overview of the field is presented
      and the principles and techniques used in the studies of cell biomechanics are
      discussed.

PMID- 2214704
TI  - Bilayer membrane bending stiffness by tether formation from mixed PC-PS lipid
      vesicles.
AB  - Recently, a new approach to measure the bending stiffness (curvature elastic
      modulus) of lipid bilayer membrane was developed (Biophys. J., Vol. 55; pp. 509
      517, 1989). The method involves the formation of cylindrical membrane strands
      (tethers) from bilayer vesicles. The bending stiffness (B) can be calculated from
      measurements of the tether radius (Rt) as a function of the axial force (f) on
      the tether: B = f.Rt/2 pi. In the present report, we apply this method to
      determine the bending stiffness of bilayer membranes composed of mixtures of SOPC
      (1-stearoyl-2-oleoyl phosphatidyl choline) and POPS (1-palmitoyl-2-oleoyl
      phosphatidyl serine). Three different mixtures were tested: pure SOPC, SOPC plus
      2 percent (mol/mol) POPS, and SOPC plus 16 percent POPS. The bending stiffness
      determined for these three different lipid mixtures were not significantly
      different (1.6-1.8 x 10(-12) ergs). Because POPS carries a net negative charge,
      these results indicate that changes in the density of the membrane surface charge
      have no effect on the intrinsic rigidity of the membrane. The values we obtain
      are consistent with published values for the bending stiffness of other membranes
      determined by different methods. Measurements of the aspiration pressure, tether
      radius and the tether force were used to verify a theoretical relationship among
      these quantities at equilibrium. The ratio of the theoretical force to the
      measured force was 1.12 +/- 0.17.

PMID- 2214705
TI  - Extensional recovery of an intact erythrocyte from a tank-treading motion.
AB  - Normal human erythrocytes suspended in shear flow are stretched into quasi
      ellipsoidal forms while their membranes rotate smoothly (tank-treading).
      Following abrupt cessation of shear the cells recover their discoidal shapes
      approximately exponentially, in the manner of a Kelvin-Voigt (K-V) solid. To test
      the hypothesis that the recovery process is membrane-controlled, the effects of
      initial deformation, cytoplasmic viscosity and membrane surface-to-volume ratio
      were studied. It was concluded that the membrane dynamics dominates the transient
      shape recovery, and that the characteristic recovery time is dependent on the
      initial deformation. Hence, the usual simplified analysis based on retraction of
      a plane sheet of K-V material with constant moduli appears to be an inadequate
      treatment of transient whole cell recovery.

PMID- 2214706
TI  - Effects of cell lysis on the rheological behavior of red blood cell suspensions.
AB  - Rheological studies of lysed cell suspensions are performed with a magneto
      acoustic ball microrheometer. Two methods for lysing the cells are developed in
      order to provide cell volume concentrations identical to control intact cell
      suspensions. The first uses a freeze-thaw technique and the second uses
      sonication. It is found that cell suspensions disrupted by sonication have a
      lower viscosity than intact suspensions, whereas cell suspensions lysed by the
      freeze-thaw method exhibit a higher viscosity. Sonication is discovered to have a
      detrimental impact on the cell membrane, and to cause complete destruction of the
      cell membrane structure. Measurements of the steady state viscosity show that
      indeed the presence of the membrane is not detected, and that what is measured is
      mainly the viscosity of the hemoglobin solution. On the other hand, freeze-thaw
      results indicate that at least two phenomena occur. The first phenomenon,
      occurring during the first freeze-thaw cycle, produces an increase in viscosity
      and in viscoelasticity. The second one, taking place after subsequent freeze-thaw
      cycles, induces a decrease in the bulk rheological properties. Several possible
      mechanisms are presented to explain the observed phenomena.

PMID- 2214707
TI  - Application of the micropipette technique to the measurement of cultured porcine
      aortic endothelial cell viscoelastic properties.
AB  - The viscoelastic deformation of porcine aortic endothelial cells grown under
      static culture conditions was measured using the micropipette technique.
      Experiments were conducted both for control cells (mechanically or trypsin
      detached from the substrate) and for cells in which cytoskeletal elements were
      disrupted by cytochalasin B or colchicine. The time course of the aspirated
      length into the pipette was measured after applying a stepwise increase in
      aspiration pressure. To analyze the data, a standard linear viscoelastic half
      space model of the endothelial cell was used. The aspirated length was expressed
      as an exponential function of time. The actin microfilaments were found to be the
      major cytoskeletal component determining the viscoelastic response of endothelial
      cells grown in static culture.

PMID- 2214708
TI  - Rapid flow of passive neutrophils into a 4 microns pipet and measurement of
      cytoplasmic viscosity.
AB  - Neutrophils from five different individuals are isolated with a density
      separation technique. A total of 151 unactivated (passive) cells are rapidly
      aspirated at constant suction pressure and at room temperature into a pipet with
      a diameter of 4 microns. The suction pressures in excess of an initial yield
      threshold are 0.5, 1 and 2 kPa and are comparable to those encountered in the
      microcirculation. These pressures are well in excess of the small suction
      pressure of approximately 20 Pa that is required to form a static hemispherical
      bump on the cell. At a given aspiration pressure, the leading edge of an
      individual cell is "tracked" as it flows into the pipet. A theory based on the
      flow of a Newtonian liquid from either a hemisphere or a spherical segment into a
      cylinder is used to model the entry process. Both theory and experiment show that
      during most of the entry process the leading edge of the cell moves at a nearly
      constant velocity with a rapid acceleration at the end. For cells from five
      different individuals at the three different excess aspiration pressures,
      Newtonian theory gives a cytoplasmic viscosity of 135 +/- 54 Pa.s and overall
      entry times of 3.3s (0.5 kPa), 1.6s (1 kPa) and 0.82s (2 kPa). These results and
      those of Evans and Yeung at lower aspiration pressures indicate that the complex
      cytoplasm inside unactivated neutrophils behaves as a nearly Newtonian fluid with
      a viscosity on the order of 10(2) Pa.s over almost a two order of magnitude range
      in aspiration pressure and, thus, rate of deformation.

PMID- 2214709
TI  - The behavior of human neutrophils during flow through capillary pores.
AB  - The passage times of individual human neutrophils through single capillary-sized
      pores in polycarbonate membranes were measured with the resistive pulse
      technique, and results were compared to those obtained from the micropipette
      aspiration of entire cells. Pore transit measurement serves as a useful means to
      screen populations of cells, and allows for protocols that measure time dependent
      changes to the population. Neutrophils exhibited a highly linear pressure/flow
      rate relationship at aspiration pressures from 200 Pa to 1,500 Pa in both the
      pore and pipette systems. Cellular viscosity, as determined by the method of
      Hochmuth and Needham, was 89.0 Pa.s for the pore systems and 134.9 Pa.s for the
      pipette systems. These results are in general agreement with recent values of
      neutrophil viscosity published in the literature. Extrapolation of the observed
      linear flow response revealed an apparent minimum pressure for whole cell
      aspiration significantly above the threshold pressure predicted by Evans' liquid
      drop model. However, whole cell aspiration was achieved in both the pore and
      pipette systems at pressures below this extrapolated minimum, although the
      calculated cellular viscosity was greatly increased. The implications of these
      two regimes of cell deformation is unclear. This behavior could be explained by
      shear thinning of the material in the cell body. However the origin of this
      phenomenon may be in the cortical region of the cell, which exhibits an elastic
      tension that may be deformation rate dependent.

PMID- 2214710
TI  - Determination of cellular mechanical properties by cell poking, with an
      application to leukocytes.
AB  - In this paper we review the cell-poking technique as an approach for
      investigating the mechanical properties of living cells. We first summarize the
      rationale for the technique and the mainly qualitative results obtained so far.
      Then we provide a technical description of the instrument as it is configured at
      present. This is followed by a discussion of the current status of analytical
      results available for interpreting cell-poking measurements. In the final section
      we apply these results to an analysis of unmodulated and modulated lymphocytes
      and neutrophils, and conclude that the mechanical response of these leukocytes to
      indentation is not consistent with simple models developed by previous
      investigators on the basis of micropipette-aspiration experiments.

PMID- 2214711
TI  - Passive deformations and active motions of leukocytes.
AB  - The purpose of this paper is to review the development of continuum mechanics
      models of single leukocytes in both passive deformations and active motions and
      to indicate some future directions. Models of passive deformations describe the
      overall rheological behavior of single leukocytes under externally applied forces
      and predict the average mechanical properties from experimental data. Various
      "apparent" viscoelastic coefficients are obtained depending on the models assumed
      and the types of test used. Models of spontaneous motions postulate active
      driving mechanisms which must be derived internally from the cell itself and
      probably have different bases for different kind of motions. For pseudopod
      protrusion on leukocytes, energy transduction from chemical potential to
      mechanical work associated with actin polymerization at the tip of the projection
      is assumed to supply the motive power. For pseudopod retraction, active
      contraction due to actin-myosin interaction is assumed to be the driving force.
      The feasibility of the hypotheses are tested via numerical examples and
      comparison of the theoretical results with experimental measurements.

PMID- 2214712
TI  - Kinematics of cytoplasmic deformation in neutrophils during active motion.
AB  - A procedure is proposed to measure the cytoplasmic deformation in active motile
      neutrophils in the form of cytoplasmic strains and strain rates. Three
      neighboring microspheres in a local region of the cytoplasm serve as markers for
      local motion. Their positions are tracked by means of a high resolution light
      microscope and serve to compute nonlinear measures of strains and strain rates
      together with the principal strains and principal directions. Active neutrophils
      exhibit large cytoplasmic strains both during periodic pseudopod projections and
      during continuous locomotion in a polarized shape. The cytoplasmic motion is
      often synchronized with the whole cell deformation. The local cytoplasmic strains
      exceed the strains estimated for the whole cell and are not reversible except in
      some cases of single pseudopod projections. Large strains are observed both in
      attached and freely suspended cells. Strain rates are relatively constant but
      show an increase during the pseudopod retraction phase. Local cytoplasmic strains
      in neutrophils are inhomogeneous and reach large values during passage of the
      contraction rings. Neutrophils rendered passive by treatment with cytochalasin or
      EDTA show a random motion of microspheres with much smaller displacements. These
      observations suggest that the cytoplasm of active neutrophil exhibits large
      cytoplasmic strains and strain rates in the absence of an external stress
      resulting in a high degree of intracellular mixing. The proposed technique may be
      applied to a wide range of problems in cell biology.

PMID- 2214713
TI  - Cell-cell, cell-substrate adhesion: theoretical and experimental considerations.
AB  - Cell-cell adhesion plays a fundamental role in tissue and organ development, cell
      mediated immunity and blood flow. In the present study a micro-mechanical model
      of specific adhesion is presented. Analytical expressions are derived for the
      adhesive energy density (gamma) at zero speed of peeling for the cases of
      immobile (trapped) as well as laterally mobile bonds. It is shown that gamma
      increases in both cases with the increasing density of bonds and with the binding
      of affinity of unstressed bonds. In the case of laterally mobile bonds gamma also
      increases with the extent of peeling. The analytical results are shown to be
      valid whether or not one takes into account of the bending stiffness of adhering
      membranes. It is also shown that gamma does not depend on the functional form of
      bond elasticity. The effect of the speed of peeling on the number density
      distribution of attached bonds is considered next. Numerical solutions for the
      energy required to separate conjugated cell pairs are presented. The theoretical
      predictions are then used to analyze experimental data on red cell aggregation
      and adhesion between a cytotoxic-T cell and its target cell. The results show
      that the binding affinity of unstressed bonds and their number density before
      conjugation can be obtained from data on slow peeling of cell-pairs. The
      information on the diffusivity of bonds, their stiffness and their rates of
      attachment and detachment are more difficult to obtain, requiring a set of
      experiments with increasing rates of separation (conjugation) of cell-pairs.

PMID- 2214714
TI  - Intermediate filaments may prevent buckling of compressively loaded microtubules.

PMID- 2214715
TI  - Forward and backward running waves in the arteries: analysis using the method of
      characteristics.
AB  - The one-dimensional equations of flow in the elastic arteries are hyperbolic and
      admit nonlinear, wavelike solutions for the mean velocity, U, and the pressure,
      P. Neglecting dissipation, the solutions can be written in terms of wavelets
      defined as differences of the Riemann invariants across characteristics. This
      analysis shows that the product, dUdP, is positive definite for forward running
      wavelets and negative definite for backward running wavelets allowing the
      determination of the net magnitude and direction of propagating wavelets from
      pressure and velocity measured at a point in the artery. With the linearizing
      assumption that intersecting wavelets are additive, the forward and backward
      running wavelets can be separately calculated. This analysis, applied to
      measurements made in the ascending aorta of man, shows that forward running
      wavelets dominate during both the acceleration and deceleration phases of blood
      flow in the aorta. The forward and backward running waves calculated using the
      linearized analysis are similar to the results of an impedance analysis of the
      data. Unlike the impedance analysis, however, this is a time domain analysis
      which can be applied to nonperiodic or transient flow.

PMID- 2214716
TI  - Estimation of the rotational undamped natural frequency of bileaflet cardiac
      valve prostheses.
AB  - The angular momentum balance is solved numerically for a size 29 mm CarboMedics
      prosthetic heart valve. The lift force is estimated from potential flow theory,
      while the drag force is estimated from the lift force and a blunt body
      empiricism. Buoyancy and gravitational effects are calculated based on the
      assumption of homogeneous leaflets. Other assumptions include uniform flow,
      negligible friction at the pivot axis, negligible viscous damping and fluid
      inertance, and a symmetry flow condition. Oscillations are predicted in the
      opening dynamics in the range of 2-25 Hz, for flow rates through one-half of the
      orifice in the range of 0.1-10.0 l/min. The frequency of these oscillations is
      dependent upon the orientation of the leaflet in relation to the gravitational
      field and the magnitude of the flow rate. In vivo and in vitro measurements by
      other investigators demonstrate similar effects of gravity and flow rate, with
      flutter frequencies of the order of 10-100 Hz. Excitation frequencies, based on
      vortex shedding, are estimated to be of the order 2-200 Hz, for the range of flow
      rates of the theoretical model. These results suggest that the natural frequency
      of this rotational second order system may, in theory, be a contributing factor
      to the flutter observed in bileaflet cardiac valve prostheses. The clinical
      significance of this finding is yet to be established.

PMID- 2214717
TI  - Determination of a constitutive relation for passive myocardium: I. A new
      functional form.
AB  - The specific aim of this study is to determine a constitutive relation for non
      contracting myocardium in terms of a pseudostrain-energy function W whose form is
      guided by both theory and experiment. We assume that the material symmetry of
      myocardium is initially and locally transversely-isotropic, and seek a W which
      depends upon only two coordinate invariant measures of the finite deformation.
      The specific functional form of such a W is inferred directly from experimental
      protocols in which one invariant is held constant while the other is varied, and
      vice versa. On the basis of data from families of these "constant invariant"
      tests on thin slabs of myocardium taken from the mid-walls of six canine left
      ventricles, we propose a new polynomial form of W containing only five material
      parameters.

PMID- 2214718
TI  - Determination of a constitutive relation for passive myocardium: II. Parameter
      estimation.
AB  - In the first paper of this series, we proposed a new transversely isotropic
      pseudostrain-energy function W for describing the biomechanical behavior of
      excised noncontracting myocardium. The specific functional form of W was inferred
      directly from biaxial data to be a polynomial function of two coordinate
      invariant measures of the finite deformation and five material parameters. In
      this paper, best-fit values of the material parameters are determined from
      biaxial data using a nonlinear least-squares regression. These values of the
      parameters are shown to be well-determined, and the final constitutive relation
      is shown to have good predictive capabilities. Since the proposed constitutive
      relation describes much broader classes of in-vitro biaxial data than previously
      proposed relations, it may be better applicable to analyses of stress in the
      passive heart.

PMID- 2214719
TI  - Design optimization of a prosthesis stem reinforcing shell in total hip
      arthroplasty.
AB  - The use of a perforated, titanium funicular shell to support the proximal femoral
      cortex in total hip arthroplasty was evaluated with the aid of both analytical
      and numerical techniques. The principal interactions between the femoral cortex,
      the metal shell, the implant stem and the acrylic bone cement were modeled using
      beam on elastic foundations theory and two-dimensional elasticity theory.
      Subsequent formulation of this model as a nonlinear design optimization problem
      enabled the determination of the dimensions of the implant and reinforcing shell
      which minimized an objective function based on a simplified material failure
      criterion. Two cases were examined, each with two cervico-diaphyseal angles: case
      A: with a rigid contact between a proximal prosthesis collar and the calcar
      femorale and case B: no collar contact (a collarless prosthesis or post-operative
      loosening). Case A achieved an optimal solution at a stem diameter 11-23 percent
      of the cortex inner diameter, a stem length to diameter ratio of 12-40, shell
      diameter 22-53 percent and thickness 0.2-7.2 percent of the cortex inner diameter
      and thickness, respectively. Case B achieved an optimal solution at a stem
      diameter 67-92 percent of the cortex inner diameter, length to diameter ratio of
      4-6, and no shell. In case A the collar support makes the type of internal
      fixation unimportant, while in the more realistic case B, the shell is not
      recommended.

PMID- 2214720
TI  - Nonlinear analysis of intervertebral disk under dynamic load.
AB  - This study pertains to the response of intervertebral joint under dynamic axial
      load. The numerical model represents two vertebral bodies with an interposed disk
      and uses three-dimensional elements. A transversely isotropic material law is
      adopted for cortical bone and an isotropic law for cancellous bone. Annulus
      collagen fibers are modelled using truss elements with no compressive resistance.
      The disk material is assumed hyperelastic, using a mixed finite element approach,
      allowing a representation of the disk involving the incompressibility
      characteristics for the material. The analysis considers finite displacement and
      strain fields under dynamic load. Intensity, trend and distribution of loads on
      the vertebral body are deduced from the literature. The problem is investigated
      with reference to different compressibility levels of disk material related to
      disk degenerationn phenomena.

PMID- 2214721
TI  - The joint distribution problem with multiple articular contact forces.
AB  - The single joint distribution problem with two or more unknown bony contact
      forces is considered, and an optimal solution procedure free of ad hoc
      assumptions is described. If two bony contact forces are present, a strictly
      muscle force dependent equality constraint exists that allows for initial
      independent estimation of muscle forces, followed by unique estimation of all
      bony contact force components perpendicular to the straight line connecting their
      known points of application. However, if three or more bony contact forces are
      present, no strictly muscle force dependent equality constraint exists, solution
      separability is lost, and optimal muscle and bony contact forces are obtained
      simultaneously.

PMID- 2214722
TI  - Impedence osteography: clinical applications of a new method of imaging
      fractures.
AB  - Fracture healing usually proceeds without difficulty. However, the diagnosis of
      delayed or non-union is not simple and can present difficulties in management.
      Normal fracture healing is briefly reviewed along with some methods of assessing
      the progress of union. The results of using the technique of impedence
      osteography in a preliminary study of fracture healing are presented. These
      indicate that the technique can clearly show a fracture and differentiate between
      normal bone, a united fracture and a non-union.

PMID- 2214723
TI  - Prosthetic heart valves: waveform comparisons and average value disposition for
      pulsatile flow in vitro.
AB  - With the development of the in vitro testing of heart valves, the standardization
      of the test methods becomes increasingly important and they should also be
      improved continuously. This paper discusses the problems of waveform comparison
      and average value dispositions. In the pulsatile model driven by pneumatics, the
      pressures before and after the valve, and the flow through it, are measured as
      three one-dimensional variates. The mean values are calculated according to the
      FDA and the ISO. A comparison and analysis of experimental waveforms indicate
      that, for basically the same ranges of pressures and flow rate, the flow curves
      of different types of valve are clearly different. The mean values and the
      waveforms in the time domain should be taken into consideration synthetically so
      that the pusatile characteristics of the valve can be more completely reflected.
      Using numerical filtering methods to treat the waveforms allows for better
      comparisons between the measured results taken from the different devices. By
      means of the constellation graphical method for treating mean values as
      multivariates, it is feasible to classify the valves and to judge their qualities
      under conditions of pulsatile flow.

PMID- 2214724
TI  - Stress analysis of the proximo-medial femur after total hip replacement.
AB  - Stress-induced bone loss in the proximo-medial femur has been identified as a
      factor leading to loosening in the artificial hip joint. In an effort to develop
      a quantitative understanding of the stress distribution that causes bone loss,
      axial and hoop stresses in the medial calcar of the femur have been determined
      after total hip replacement, using finite element stress analysis. Stress
      distributions for a high and a low Young's modulus prosthesis material are
      compared for both collared and uncollared prosthesis designs. The use of a low
      modulus material, and of a collar, are predicted to be advantageous, giving rise
      to proximo-medial stress patterns similar to those of the normal, intact femur.

PMID- 2214725
TI  - A microcomputer-based video vector system for clinical gait analysis.
AB  - A microcomputer-based video vector system has been developed to display the
      resultant ground reaction force vector on a television image of the subject in
      real-time. For each television field the force platform signals are acquired and
      processed and the resultant force vector superimposed on the video image of the
      walking subject. The force platform results are stored on disc and the composite
      video signals recorded on video tape for further analysis. The system is easy to
      set up and use and the results can be readily interpreted. The external moments
      produced at the joint centers by the ground reaction forces can be observed
      visually and, if required, quantification of the external moments can be achieved
      following data collection. The spatial resolution of the system is 0.342%
      vertically and 0.156% horizontally. The force vector visualization technique has
      routine applications in orthotics and prosthetics. It is also a useful technique
      for the teaching of biomechanics.

PMID- 2214726
TI  - Automated three-dimensional finite element modelling of bone: a new method.
AB  - Three-dimensional finite element stress analysis of bone is a key to
      understanding bone remodelling, assessing fracture risk, and designing
      prostheses; however, the cost and complexity of predicting the stress field in
      bone with accuracy has precluded the routine use of this method. A new, automated
      method of generating patient-specific three-dimensional finite element models of
      bone is presented--it uses digital computed tomographic (CT) scan data to drive
      the geometry of the bone and to estimate its inhomogeneous material properties.
      Cubic elements of a user-specified size are automatically defined and then
      individually assigned the CT scan-derived material properties. The method is
      demonstrated by predicting the stress, stain, and strain energy in a human
      proximal femur in vivo. Three-dimensional loading conditions corresponding to the
      stance phase of gait were taken from the literature and applied to the model.
      Maximum principal compressive stresses of 8-23 MPa were computed for the medial
      femoral neck. Automated generation of additional finite element models with
      larger numbers of elements was used to verify convergence in strain energy.

PMID- 2214727
TI  - Mechanical characteristics of micro-switches adapted for the physically disabled.
AB  - The object of this study was to measure the mechanical characteristics of several
      commonly used adapted switches in order to demonstrate the feasibility of
      collecting quantitative descriptions of switch performance. A stepping motor was
      used to drive a digital micrometer vertically towards the tested switch and
      proving-ring strain gauges recorded the operating force. Measures of activation
      and deactivation forces, travel and switch compliance were compared; several
      clinical examples illustrate the functional application of these results. It is
      anticipated that this information will permit clinicians to prescribe switches in
      a more accurate manner.

PMID- 2214728
TI  - Measured and modelled static and dynamic axial trunk torsion during twisting in
      males and females.
AB  - Study of the mechanics of trunk twisting is of special interest given
      epidemiological evidence linking occupational twisting to increased incidence of
      low back pain. An anatomically detailed, three-dimensional model of the trunk
      (rib cage, pelvis, five lumbar vertebrae and 50 muscles), was used to predict
      maximum axial trunk torque. Predicted axial torques were compared with measured
      torques. Thirty-one (10 male and 21 female) subjects performed maximum effort
      isometric twisting exertions, at 0 degrees of twist and +/- 30 degrees of twist
      together with dynamic exertions, at 30 degrees s-1 and 60 degrees s-1. Females
      were able to generate approximately two-thirds of the torque of males (males,
      97Nm; females 60Nm, isometric at 0 degrees). When the trunk was prerotated to 30
      degrees, subjects were able to generate greater torque when the effort was toward
      the 0 degree position (approximately 105Nm by males and 68Nm by females).
      Experimental data indicated that velocity of rotation and amount of twist are
      important modulators of axial torque. Changes in muscle length were demonstrated
      to be minimal from model output as most muscle length changes during a twist from
      0 degrees to 30 degrees, measured between the pelvis and the shoulder harness,
      were less than 1%, although some portions of the abdominal obliques underwent a
      length excursion of 5%. The small changes in the individual muscle force
      components that contribute to twist, i.e. the muscle unit vector about the axial
      twist axis and its moment arm that change as a function of twisted position, do
      not entirely account for the measured differences in torque, suggesting that
      additional mechanisms influence axial torque generation.

PMID- 2214729
TI  - Influence of magnetic fields on calcium salts crystal formation: an explanation
      of the 'pulsed electromagnetic field' technique for bone healing.
AB  - In the search for a mechanism by means of which a magnetic field deparalyses non
      unions and enhances bone tissue formation, the influence of continuous magnetic
      fields on the formation of calcium phosphate crystal seeds has been investigated.
      From this perspective, an explanation is given of a working mode in conventional
      equipment for pulsed electromagnetic field treatment; this is compared with
      multifunction equipment.

PMID- 2214730
TI  - Symmetry of FES responses in the lower extremities of paraplegic patients.
AB  - Due to natural or artificial obstacles, gait is a less automatic and periodic
      process than it would appear when studying normal walking on the level. Pre
      programmed functional electrical stimulation (FES) sequences, therefore, do not
      appear to be a suitable approach to the control of multichannel electrical
      stimulators in the restoration of paraplegic walking. Walking in paraplegic
      subjects must be, to a large extent, under voluntary control. To lessen the
      burden of this control, the symmetry of walking can be taken into account.
      Symmetric motion of the legs requires symmetric FES actuation. Symmetry of FES
      responses was studied in a group of 10 paraplegic subjects who had all undergone
      the FES training program. Recruitment curve, fatigue index and twitch delay were
      assessed. An average 80% symmetry was found in all parameters measured, thus
      allowing a reduction of complexity of control approach for FES locomotor aids.

PMID- 2214731
TI  - Simulation study of the fluid dynamics of aorto-coronary bypass.
AB  - It is well known that local fluid dynamic phenomena are the main factors
      affecting the failure of aorto-coronary bypass procedures. With the aim of
      investigating the influence of bypass geometrical parameters on the fluid
      dynamics around the anastomosis, a two-dimensional finite element model of a
      stenosed coronary artery with an aorto-coronary bypass has been developed. The
      geometrical parameters on which the study focused were the degree of coronary
      stenosis, the bypass diameter and the bypass angle. The fluid dynamic equations
      have been solved using the finite element method. The results show the
      development of a recirculation area immediately downstream of the anastomosis and
      its relationship with the investigated parameters. In particular, the magnitude
      of the recirculation increases with the bypass angle, the bypass diameter and the
      degree of coronary stenosis.

PMID- 2214732
TI  - Study of normal and cancerous urine using photoacoustic spectroscopy.
AB  - Photoacoustic spectroscopy (PAS) is a valuable technique, increasingly applied in
      clinical and biological analysis. Light absorption properties of urine and body
      tissue can be obtained more easily by the PAS technique because of its high
      sensitivity, than by the conventional optical techniques. By observing their
      absorption properties it is possible to diagnose some diseases and in this study
      we have used PAS to assess cancerous changes in urine and tissue. Three groups
      were studied: normal individuals; patients with cancer; and patients with cancer
      and subsequent inflammation; and the characteristic light absorption peaks
      obtained for a certain band (240-420 nm). These results were compared with the
      clinical diagnosis and proved consistent and reliable for the diagnosis of
      urinary tract cancer subsequently confirmed by operation. This method will
      probably be a useful tool for the early clinical diagnosis of cancer of the
      urinary system.

PMID- 2214733
TI  - Simulation of coronary circulation with special regard to the venous bed and
      coronary sinus occlusion.
AB  - The vascular beds of the left circumflex and the left anterior descending
      coronary arteries are modelled by means of coupled differential equations that
      consider an arterial, a capillary and a venous section. In a stepwise procedure,
      experimental data from normal coronary perfusion and coronary sinus occlusion are
      used to assess the model parameters. For venous distensibility, a non-linear form
      of pressure-volume relationship proved vital to reproduce the characteristics of
      the rise in venous pressure after the onset of coronary sinus occlusion.
      Numerical integration was carried out for normal perfusion and for coronary sinus
      occlusion, yielding time courses of flows, volumes and pressures within large
      coronary arteries, capillaries and coronary veins. Coronary sinus occlusion
      reduces total mean flow by 18% and divides intramyocardial flow between the
      capillaries and the veins into a forward component of 3.03 mls-1 and a backward
      component of -1.54 mls-1. This result represents a prediction for a haemodynamic
      quantity which is therapeutically important but inaccessible to measurement.
      Varying degrees of systolic myocardial squeezing are studied to display the
      impact of myocardial contractility and vessel collapse on the mean values and
      phasic components of intra-myocardial flows.

PMID- 2214734
TI  - Pressure measurements during automatic breast compression in mammography.
AB  - Breast compression during X-ray mammography results in improved image quality at
      a lower radiation dose to the patient, and, as a consequence, the Department of
      Health recommends that automatic breast compression devices are fitted to
      mammographic X-ray units. However, the degree of breast compression is not
      standardized and can vary depending on the size of the patient, the particular
      mammography X-ray unit and the conditions of its use. A pressure measuring system
      was used to determine accurately the pressure on the breast. This system takes
      the form of a fluid-filled neonatal cuff connected to a pressure transducer by a
      fluid line. The pressure measuring system was calibrated and tested, first
      without and then with the patients, to assess its practical feasibility. The
      elements of the pressure measuring system, the techniques involved in its
      calibration and its use on patients in the clinical environment are described
      here. The system has proved to be a quick and simple method of relating the
      pressure on the breast to the pressure reading of the mammography X-ray unit.

PMID- 2214735
TI  - End-cap for the biomechanical testing of spinal segments.
AB  - Precise mechanical loading is essential in the in vitro evaluation of spinal
      fixation instrumentation, but the control of experimental variables is difficult
      because of variations in specimen morphology, size and end conditions, and gross
      specimen flexibility. This paper describes an end-cap which is simple in design,
      time efficient in its attachment to the spine and which provides precise
      positioning and rigid control of the end fixation points, resulting in excellent
      experimental control. It is easily adapted to human or animal specimens and
      provides a reliable load application unit, which permits specific physiological
      end conditions to be applied.

PMID- 2214736
TI  - New method for motion measurement and control.
AB  - A simple, inexpensive and novel method is proposed to acquire information on the
      motion characteristics of a patient during ambulation, by assuming the earth's
      magnetic field as reference.

PMID- 2214737
TI  - Effect of histamine antagonists on myocardial carcinine metabolism during
      compound 48/80-induced shock.
AB  - Carcinine (beta-alanylhistamine) is an imidazole dipeptide that exists in
      mammalian hearts, increases cardiac contractility, and is metabolically linked to
      carnosine (beta-alanylhistidine), a non-mast cell histidine and histamine
      precursor during stress. We have previously shown that tissue carnosine levels
      are regulated by H1 and H2 receptors. This study evaluated the effects of H1, H2,
      and mast cell degranulation blockers on metabolism of carcinine and related
      imidazoles during shock induced by compound 48/80, a mast cell degranulator.
      Fifty 125-g male Sprague-Dawley rats were divided into nine ip treatment groups:
      saline, 48/80, lodoxamide (LOD, mast cell degranulation inhibitor),
      diphenhydramine (DPH, H1 antagonist), cimetidine (CIM, H2 antagonist), LOD +
      48/80, CIM + 48/80, DPH + 48/80, or DPH + CIM + 48/80. Heart tissue was analyzed
      at 30 min by HPLC. 48/80 caused decreases in myocardial carnosine (P less than
      0.01) and histidine (P less than 0.0001) levels and concomitant increases in
      carcinine (P less than 0.01), histamine (P less than 0.01), and 3-methylhistamine
      (P less than 0.05) compared to those of controls. These changes were inhibited by
      LOD or DPH. Treatment with CIM significantly increased myocardial carcinine
      levels compared to 48/80 alone (P less than 0.001) without an additional effect
      on the other compounds. These data indicate that carcinine is involved in the
      cardiac response to stress via the carnosine-histidine-histamine pathway.
      Compound 48/80-induced shock increases histamine metabolism via this pathway
      resulting in mobilization of myocardial carnosine and histidine to carcinine and
      histamine; this effect is increased by H2 receptor blockade.

PMID- 2214738
TI  - Protein intake and 5-fluorouracil toxicity in tumor-bearing animals.
AB  - The administration of chemotherapy is limited in clinical situations by lack of
      selective antineoplastic activity resulting in significant host toxicity.
      Although it has been suggested that nutrition support can reduce chemotherapy
      related toxicity, few controlled studies exist to document this clinical
      impression. This study was performed to determine the effect of enteral protein
      intake on 5-fluorouracil toxicity in tumor-bearing animals. Seventy-nine female
      Lewis/Wistar rats with subcutaneous mammary tumor implants (AC-33) were
      randomized to receive either standard protein (22.0% protein; 4.27 kcal/g) or an
      isocaloric, protein-depleted diet (0.03% protein; 4.20 kcal/g). One-half of the
      animals in each group received daily injections of 5-fluorouracil (15- or 25
      mg/kg ip) or placebo (saline) for 4 or 5 days. Standard protein intake
      significantly increased host body weight and decreased leukopenia at low (15
      mg/kg) and high (25 mg/kg) 5-fluorouracil therapy. At high-dose 5-Fluorouracil
      (25 mg/kg), the incidence and duration of diarrhea were decreased in animals
      receiving standard protein intake. Thus, enteral protein intake significantly
      reduced clinical and objective 5-fluorouracil toxicity and improved body weight
      in this tumor-bearing animal model.

PMID- 2214739
TI  - Alpha 1-antitrypsin phenotypes in patients with abdominal aortic aneurysms.
AB  - The alpha 1-antitrypsin phenotypes were determined in 47 patients with abdominal
      aortic aneurysms. The MM phenotype was present in 85%, the MS phenotype in 4%,
      the MZ phenotype in 11%, and the ZZ phenotype not present in any patients. The MZ
      phenotype occurred significantly more often in patients with aneurysms than would
      be expected in the general population. The current data would support a genetic
      mechanism of either autosomal-dominant or multifactorial influences but not an X
      linked mechanism for families with a history of abdominal aortic aneurysms.

PMID- 2214740
TI  - The effect of intraperitoneal administration of sodium tolmetin-hyaluronic acid
      on the postsurgical cell infiltration in vivo.
AB  - Intraperitoneal administration of sodium tolmetin-hyaluronic acid reduced the
      formation of adhesions at early postsurgical time points. In addition, at 6, 48,
      72, and 96 hr following surgery, there was a significant reduction in the number
      of red blood cells (RBC) recovered from peritoneal lavage. This effect was not
      the result of fluid or viscous solution in the peritoneal cavity since
      intraperitoneal administration of Ringer's lactate or Hyskon (a 32% solution of
      Dextran 70) did not affect RBC recovery. In contrast, the influx of leukocytes
      into the peritoneal cavity was elevated at 12 hr after surgery, but suppressed at
      96 hr. These data may suggest a mechanism by which sodium tolmetin in hyaluronic
      acid reduced adhesion formation.

PMID- 2214741
TI  - Effect of prostaglandin E in multiple experimental models. IV. Effect on
      resistance to endotoxin and tumor necrosis factor shock.
AB  - Administration of a long-acting prostaglandin E, 16,16-dimethyl-PGE (dPGE), to
      rats improves their survival of bacterial peritonitis. We examined the mechanism
      of this protective effect with reference to its interaction with the release of
      cachectin (TNF). Sixty rats received saline, 20 micrograms/kg dPGE, or 80
      micrograms/kg dPGE 12 hr prior to endotoxin and continuing for 48 hr. Survival
      rates for the saline, 20 micrograms/kg dPGE, and 80 micrograms/kg dPGE groups
      were 0, 40, and 85%, respectively. Forty rats received saline or 80 micrograms/kg
      dPGE, with the initial dose being 3 hr following endotoxin challenge and
      continuing for 48 hr. Survival rates for both groups were 0%. Sixty rats received
      saline or 80 micrograms/kg dPGE at 12 and 1 hr prior to endotoxin. Two hours
      after challenge, they were sacrificed and plasma TNF levels were assayed. The
      plasma TNF level in saline-treated rats was 22.72 +/- 0.83 ng/ml and in the dPGE
      treated group, 16.03 +/- 1.13 ng/ml (P less than 0.001).

PMID- 2214742
TI  - An improved technique for his bundle recording and ablation in dogs.
AB  - Many physiological investigations of cardiac function require accurate control of
      heart rate. To examine heart rate effects at values lower than the intrinsic
      heart rate requires the ability to prevent an accelerated junctional rhythm from
      becoming dominant even after the sinus node is eliminated. A new method for the
      simple and reliable production of complete atrioventricular heart block in open
      chest dogs is presented. It consists of two bonded parallel 22-gauge needles, one
      containing a bipolar recording electrode for localization at its tip and the
      other used for immediately adjacent formalin injection. The catheter is easily
      constructed, sterilizable, reusable, and durable, and can also provide a stable
      means of recording the His bundle electrical activity. Initial experiments
      performed in the first five dogs using this technique produced complete heart
      block with a stable ventricular escape rhythm in all five cases.

PMID- 2214743
TI  - Vascular response to cyclosporine and verapamil in the rat pancreas.
AB  - Marked elevation of vascular resistance in the rat pancreas is shown after
      systemic infusion of cyclosporine. Verapamil administration after cyclosporine
      reversed this effect and allowed maintenance of baseline vascular resistance and
      blood flow to the pancreas despite additional infusions of cyclosporine.
      Cyclosporine toxicity in rat pancreas may be directly related to increased
      vascular resistance. Verapamil might offer protection from this effect.

PMID- 2214744
TI  - Changes in mucosal nutrient transport in small and large ileal reservoirs after
      endorectal ileal pullthrough.
AB  - It has been hypothesized that, following colectomy and endorectal ileal
      pullthrough with ileal reservoir (PTR), reservoir tissue might lose some of its
      normal nutrient transport capacity and assume properties of the colon. Whether
      reservoir size influences the expected alterations in normal mucosal absorption
      and thus contributes to changes in intraluminal ecology has not previously been
      investigated. To study this, the everted intestinal sleeve technique was used to
      measure uptake of four nutrients in two groups of dogs who underwent PTR: five
      with a small (5 cm) lateral reservoir and five with a large (18 cm) reservoir.
      Mucosal samples were taken from normal ileum and colon and from reservoirs 3
      months postoperation. Active uptake of carbohydrates (glucose), amino acids
      (proline), and bile acids (taurocholate) and passive uptake of short chain fatty
      acids (propionate) were markedly decreased in mucosa of both reservoir sizes
      compared to normal ileum (P less than 0.05, t test) and more closely approximated
      that of normal colon. Uptake of glucose, proline, and taurocholate in large
      reservoirs was significantly less than that in small reservoirs (P less than
      0.05). We conclude that (1) ileal reservoir mucosa has a significantly reduced
      capacity for nutrient uptake, (2) ileal mucosa in small reservoirs shows higher
      nutrient uptake rates than mucosa in large reservoirs, and (3) short, well
      emptying reservoirs appear best suited to optimizing the intraluminal environment
      and thus enhance reservoir function when performing PTR.

PMID- 2214745
TI  - Lactic acidosis increases tumor necrosis factor secretion and transcription in
      vitro.
AB  - Lactic acid has been shown to affect numerous biologic processes. We investigated
      the role of lactic acidosis as a signal for the production of TNF by macrophages
      in vitro. Male F344 rats were administered thioglycolate media intraperitoneally.
      Macrophages were recovered 7 days later, cultured for 24 hr in complete media
      (CM), or CM with L-lactic acid (5, 10, or 15 mM), or with endotoxin (LPS) (10
      micrograms/ml). TNF levels were measured in the supernatants. Female C57BL/6 mice
      were similarly treated, and macrophages were harvested and cultured in CM or CM
      containing lactic acid (15 mM), or LPS (10 micrograms/ml). RNA was extracted
      after 24 hr, separated by electrophoresis, and transferred to nitrocellulose.
      Human 32P-cDNA TNF and actin probes were used to determine relative TNF gene
      expression. Gel densitometry was used to calculate the TNF expression index (EI)
      in lactic acid and LPS treated cells as described. pH levels of the supernatant
      indicated that increasing concentrations of lactic acid caused increasing
      acidosis. Trypan blue exclusion demonstrated that lactic acidosis did not reduce
      cell viability. LPS significantly increased secretion of TNF relative to control
      (P less than 0.001). Each concentration of lactic acid significantly increased
      TNF secretion (P less than 0.05), but not in a dose-dependent manner. TNF gene
      transcription was elevated in macrophages cultured with lactic acid and LPS
      relative to control (EI = 1.13 and 1.18, respectively). This suggests that lactic
      acid concentration can regulate TNF secretion at the level of transcription, and
      is consistent with the hypothesis that local levels of lactic acid (lactic
      acidosis) may be a regulator of cytokine secretion.

PMID- 2214746
TI  - Hemodynamic effects of glucagon after acute mesenteric ischemia in rats.
AB  - We have previously shown that iv glucagon improved survival in rats from 33 to
      83% when given after, but not during, superior mesenteric artery (SMA) occlusion.
      This study investigated potential hemodynamic mechanisms of this effect. In Part
      1, cardiac output (CO) was measured in 12 male Sprague-Dawley rats with an
      electromagnetic flow-probe that had been placed around the ascending aorta 5 days
      previously. Under pentobarbital anesthesia, the SMA was occluded for 85 min. All
      rats received normal saline (NS, 15 ml/kg/hr) for 1 hr before and after SMA
      declamping. Control rats (n = 6) received only NS. Treated rats (n = 6) received
      NS plus glucagon (1.6 micrograms/kg/min iv) for 1 hr postocclusion. CO decreased
      50% during the first hour after SMA declamping in control rats, but only 11% in
      glucagon-treated rats (P less than 0.02). Systemic vascular resistance (SVR)
      increased by 90% in control rats by 1 hr after declamp, but only 9% in glucagon
      rats (P less than 0.04). Systemic blood pressure and heart rate were not
      different in the two groups. In Part 2, relative distribution of visceral blood
      flow was measured with radiolabeled microspheres injected in the aortic root
      before clamping, before declamping, and 1 hr postdeclamping in 10 rats (5
      glucagon, 5 control) using the above protocol. After SMA clamping, the proportion
      of visceral blood flow distributed to the intestine fell from 45 to 20% (P less
      than 0.05). During reperfusion, the proportion of intestinal flow exceeded
      baseline (P less than 0.05), but was not different in control (64%) and glucagon
      treated rats (56%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214747
TI  - Radical splenopancreatectomy with duodenal loop conservation in rats.
AB  - In an attempt to find a reproducible method of total splenopancreatectomy (TSP)
      with duodenal loop conservation in rats, we used the technique recently described
      by S. Houry and M. Huguier (Eur. Surg. Res. 15: 328, 1983) but were not able to
      induce a true diabetes. We therefore developed a more radical
      splenopancreatectomy (RSP) in rats and compared this technique with the TSP. RSP
      involves a more extensive dissection of the common bile duct, a short
      choledocoduodenal anastomosis, and total excision of the retroportal pancreatic
      lobules with the aid of a dissecting microscope. In rats who had undergone the
      TSP technique, blood glucose levels were maximal 8 hr after operation (270 +/- 16
      mg/dl), and thereafter recovered baseline values. In contrast, after the RSP
      technique all the rats became diabetic as documented by persistent hyperglycemia
      (347 +/- 20 mg/dl at 8 hr, P = 0.01 compared to TSP; 500 +/- 20 mg/dl at 8 hr, P
      less than 0.0001). Eight hours after the operation, blood lipase levels increased
      more significantly after TSP than after RSP (847 +/- 247 IU/liter and 130 +/- 37
      IU/liter, respectively, P = 0.01), and then decreased to 92 +/- 19 IU/liter at 24
      hr in the TSP group and less than or equal to 30 IU/liter in the RSP group (P =
      0.003), suggesting a more radical dissection of pancreatic tissue with the RSP
      technique. At sacrifice at 48 hr, no complications were found with either
      technique on macroscopic and microscopic examination, except for marked gastric
      distension with RSP. A third group of rats underwent RSP and were followed until
      natural death.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214748
TI  - En bloc simultaneous pancreas and kidney allotransplantation in the pig.
AB  - The pig is a large animal suitable for experimental pancreas transplantation due
      to its anatomy and transplant immunology, both of which are similar to humans. We
      established a model of en bloc simultaneous pancreas and kidney transplantation
      that decreases preservation time, operation time, and clamp time. The donor aorta
      -with celiac axis, superior mesenteric artery, and left renal artery--is
      anastomosed en bloc to the recipient's aorta in a side-to-oblique fashion. The
      portal vein is anastomosed end-to-side to the distal vena cava, and the left
      renal vein end-to-side to the left common iliac vein. The donor duodenum is
      anastomosed to the bladder to allow monitoring of the urinary amylase for
      rejection. En bloc transplantation is preferable for separating pancreas and
      kidney anastomoses in pigs. This technique could be used in humans, especially in
      adult uremic diabetic patients who receive a combined pancreas/kidney transplant
      from a pediatric cadaver donor.

PMID- 2214749
TI  - Veneered osseous graft. Case report and technique.
AB  - Attempts to develop a predictable method of osseous regeneration evolved into the
      veneered osseous graft. The author has taken advantage of and incorporated
      several different aspects of regenerative periodontal therapy. Having treated
      several hundred cases with good to excellent results, success is directly related
      to meticulous detail. Flap design, root surface preparation, bony wall therapy
      and graft placement are all equally important in predicting success. By
      introducing into a clean bone cavity against a clean root an osteogenic base
      material protected by a veneer to prevent down growth of epithelium one can
      expect improvement of an osseous lesion. This one-step procedure is a cost
      effective answer to the two-step procedure. Osseous grafting with a variety of
      materials has become an established part of regenerative periodontal therapy.
      Most reports comparing grafting to surgical debridement has demonstrated an
      advantage with grafting no matter what the material. Successful osseous grafting
      does require a biologically compatible material, preferably with osteogenic
      potential, which would prevent a down growth of epithelium until the graft has
      established a "home." Equally important is site preparation. Most reports in the
      literature describe site preparation as "thorough root planing." This description
      is inadequate as actual procedures can vary widely. Specifics are missing so
      duplication is difficult. Chemical root conditioning was introduced as an adjunct
      to effective root preparation. The frequency of osseous graft success began to
      improve with the addition of citric acid conditioning to very mechanical root
      preparation regardless of the grafting material used. The development of the
      veneered osseous graft technique over the years has taken advantage of and
      incorporated several different aspects of regenerative therapy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2214750
TI  - AV nodal reentrant tachycardia.
AB  - During the past decade, the mechanisms of SVT have been discovered by
      intracardiac electrophysiologic studies. The differentiation of the various forms
      of tachycardia allows a more rational approach to therapy. Bedside maneuvers and
      the 12-lead ECG will identify the correct mechanism of SVT in the majority of
      patients. Diagnostic clues from the surface ECG include the position and
      morphology of the P wave, heart rate, change in rate with bundle-branch block,
      presence of AV block, and the initiation and termination of the SVT. With the use
      of bedside maneuvers and clues from the surface ECG, an intracardiac
      electrophysiologic study would be indicated only for recurrent SVT that is
      refractory to medical therapy and is potentially life-threatening.

PMID- 2214751
TI  - Infant botulism in Tennessee.

PMID- 2214752
TI  - A brief history of pneumonia.

PMID- 2214753
TI  - Blunt intestinal trauma.

PMID- 2214754
TI  - A case of headache and amnesia.

PMID- 2214755
TI  - Hypokalemia and weight loss in a young woman.

PMID- 2214756
TI  - Blacks and high blood pressure.

PMID- 2214757
TI  - The loser finally wins.

PMID- 2214758
TI  - Antiandrogen ICI 176,334 does not prevent development of androgen insensitivity
      in S115 mouse mammary tumour cells.
AB  - Many forms of endocrine therapy for steroid-sensitive tumours involve regimes of
      steroid agonist deprivation by administration of steroid antagonists. The partial
      or short-lived response to such therapy results from the inevitable progression
      of the tumour cells to a state of steroid insensitivity. Several cell culture
      systems have shown that steroid ablation results in loss of steroid sensitivity
      and we have used an in vitro model here to study the influence of steroid
      antagonists on this progression. Growth of androgen-responsive S115 mouse mammary
      tumour cells in the long-term absence of steroid results in a loss of androgen
      sensitivity. We have studied here the effects of the pure antiandrogen ICI
      176,334 on the growth of S115 cells and on their progression to steroid autonomy.
      Although a pure antiandrogen in its action on these cells with very low toxicity,
      it had no protective effect against loss of cellular or molecular androgen
      responsive parameters. The clinical implications for endocrine therapy are
      discussed.

PMID- 2214759
TI  - Hydroxylated triphenylacrylonitriles adopt a unique orientation within the
      binding site of the estrogen receptor.
AB  - The relative binding affinities of a series of twelve para-hydroxylated
      triphenylethylenes (TPEs) for the estradiol receptor (ER) of calf uterus cytosol
      were measured by a competition method. The results obtained under equilibrium
      conditions support the hypothesis of the additivity of the energies corresponding
      to each of the hydrogen-bond type interactions of di- or tri-hydroxylated TPEs
      with the estradiol binding site of ER and strongly suggest that, whichever ring
      is hydroxylated, the orientation of the TPE in the steroid binding site is always
      the same. A hydroxyl group in a given position always interacts with the same
      location within the site. Mono-hydroxylation of the highly hydrophobic non
      substituted TPE skeleton led to a large increase in relative binding affinity for
      ER which could be explained by a dual mechanism whereby the interaction specific
      to the hydroxyl is accompanied by a temperature- or time-dependent binding
      process that is not related to the hydroxylation position.

PMID- 2214760
TI  - Methandrostenolone metabolism in humans: potential problems associated with
      isolation and identification of metabolites.
AB  - Methandrostenolone dose (amount and duration) and methods of isolation from urine
      can influence the identification and quantitation of methandrostenolone
      metabolites. Long-term use of methandrostenolone at high dosages led to the
      appearance of unmetabolized drug in the urine and contributed to the
      identification of a previously unreported metabolite, 3 beta, 6 section, 17 beta
      trihydroxy-17 alpha-methyl-5 section-1-androstene. Exposure of methandrostenolone
      in vitro to acid conditions induced a retropinacol rearrangement in the D-ring of
      the methandrostenolone molecule, causing the formation of 18-nor-17,17-dimethyl
      1,4,13(14)-androstatrien-3-one in large amounts. The same acidic conditions led
      to the addition of a hydroxyl at the 6 position of the B-ring of either the
      retropinacol rearrangement products or native methandrostenolone resulting in the
      formation of 6 beta-hydroxy-18-nor-17,17-dimethyl-1,4,13(14)-androstatrien-3-one,
      6 alpha- hydroxy-18-nor-17,17-dimethyl-1,4,13(14)-androstatrien, 6 beta-17 alpha
      methyl-1,4-androstadien-3-one and 6 alpha,17 beta-dihydroxy-17 alpha-methyl-1,4
      androstadien-3-one. Hydroxylation of native methandrostenolone at the 6 position
      also occurs endogenously. However, no evidence of an endogenous retropinacol
      rearrangement was found. Silylating agents alone can induce the formation of
      small amounts of 6 beta-17 beta-dihydroxy-17 alpha-methyl-1,4-androstadien-3-one.
      Discrepancies between previously published reports on methandrostenolone
      metabolism in man are discussed and compared with an animal model.

PMID- 2214761
TI  - Specific nuclear uptake of intracellularly-produced estrogen by rat granulosa
      cells.
AB  - Granulosa cells of the ovarian follicle are unique in that they both synthesize
      steroid hormones and respond to exogenously-administered steroids. Isolated
      granulosa cells from ovaries of gonadotropin-primed rats were incubated in the
      presence of [3H]testosterone, which the cells convert to [3H]estradiol. Nuclear
      extracts of these cells were analyzed by high-performance liquid chromatography
      in a system of 40% acetonitrile. When cells were incubated in the presence of
      [3H]testosterone alone, a significant portion of the radioactivity present in
      nuclei co-eluted with authentic estradiol. The nuclear binding was considered to
      be specific, since 50-75% of total binding was suppressed when the incubation
      medium contained excess unlabeled estrogen. Moreover, when an antibody to
      estradiol was included in the medium, specific nuclear uptake of [3H]estradiol
      was not abolished, but rather was increased. Granulosa cells may, therefore,
      directly utilize endogenously-produced estradiol, a mechanism which may play a
      role in the regulation of ovarian cells.

PMID- 2214762
TI  - Modulatory actions of the new antiprogestins ZK 98.299 and ZK 98.734 and of RU
      486 on luteinizing hormone secretion and progesterone effects in pituitary
      gonadotrophs.
AB  - The effects of the antiprogestins (APs) ZK 98.299, ZK 98.734 and RU 486 on GnRH
      stimulated LH secretion and their antagonistic activity on progesterone (P)
      actions were investigated in cultured pituitary cells from adult female Wistar
      rats. P (100 nM) was able to exert a facilitatory effect on GnRH (1 nM)-induced
      LH secretion after short-term (4 h) treatment of estradiol-primed (1 nM, 48 h)
      rat pituitary cells. When the APs (10 pM-10 microM) were introduced during the 4
      h incubation period with P the facilitatory effect of P was totally abolished at
      concentrations greater than 10 nM (ZK 98.299, ZK 98.734) and greater than 1 nM
      (RU 486). Also the APs were shown to block the inhibitory action of P which
      occurs after long-term incubation of pituitary cells with this steroid. However
      at concentrations greater than 10 nM (ZK 98.734, RU 486) and greater than 100 nM
      (ZK 98.299) this antagonistic action of the APs was lost. To evaluate whether the
      APs have direct effects on GnRH-induced LH secretion in the absence of exogenous
      P pituitary cells cultivated for 48 h with or without 1 nM estradiol were
      incubated for 4 or 24 h with increasing concentrations of the APs (10 pM-10
      microM). Four hour treatment of non-estradiol-primed cells with ZK 98.299 or ZK
      98.734 was without any effect on the LH response to a 1 nM GnRH-stimulus. Only
      the highest concentration of RU 486 (10 microM) reduced the LH response. Twenty
      four hour treatment of the cultures with the APs led to enhancement of GnRH
      stimulated LH secretion by up to 113, 37 and 33% for ZK 98.734, ZK 98.299 and RU
      486, respectively. When estradiol-primed cells were used for the same experiments
      we observed exclusively inhibitory effects on GnRH-induced LH secretion after 4
      and 24 h treatment periods. It is concluded that these new APs are potent
      inhibitors of P-actions, but also per se they induce diverse effects on GnRH
      stimulated LH secretion in cultured rat pituitary cells which have to be taken
      into account.

PMID- 2214763
TI  - Progestin binds to the glucocorticoid receptor and mediates antiglucocorticoid
      effect in rat adipose precursor cells.
AB  - The binding of progestin and glucocorticoid hormones was examined in the cytosol
      of rat adipose precursor cells. Progestin binding sites of high affinity and
      limited capacity were present in the cytosol of adipose precursor cells from
      female rats, but not from male rats, by using [3H]R5020 as radioligand.
      Glucocorticoid binding sites of high affinity and limited capacity were present
      in the cytosol of these cells from both male and female rats by using
      [3H]dexamethasone and [3H]triamcinolone acetonide as radioligands. The
      dissociation constants were in the physiological concentration range. Studies of
      competitive binding showed that progestin could compete with glucocorticoids at
      glucocorticoid binding sites. In a serum free medium glucocorticoid effect on
      cellular differentiation, monitored by glycerophosphate dehydrogenase (GPDH), was
      effectively counteracted by progesterone which by itself had no effect. These
      results demonstrate that progestin receptor exists only in rat adipose precursor
      cells from female rats, while glucocorticoid receptor exists in rat adipose
      precursor cells of both sexes. Glucocorticoid effects on cellular differentiation
      in these cells are mediated by the glucocorticoid receptor. Progestin binds to
      the glucocorticoid receptor and antagonizes glucocorticoid effect on cellular
      differentiation in these cells.

PMID- 2214764
TI  - Luteolytic effect of the antiprogestin and antiglucocorticoid agent RU486 in
      rats.
AB  - Ovarian cells of pregnant rats were cultured with synthetic progestins (R5020,
      R2323), dexamethasone and RU486. Progesterone and 20 alpha-hydroxy-pregn-4-en-3
      one (20 alpha-dihydroprogesterone) in the medium were measured by specific
      radioimmunoassay. Both R5020 and R2323 increased concentrations of these
      intrinsic progestins. RU486 decreased concentrations of progesterone, however,
      the addition of R5020 or R2323 counteracted this action. Immature
      hypophysectomized rats treated with pregnant mare serum gonadotropin (PMS) and
      human chorionic gonadotropin (hCG) were administered with RU486; the serum levels
      of progesterone and 20 alpha-dihydroprogesterone tended to decrease. R5020 and
      R2323 inhibited the effect of 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD),
      whereas RU486 did not. Inhibition of the cholesterol side chain cleavage enzyme
      (CSCC) by RU486 was more marked than that by R5020 or R2323. These results show
      that RU486 decreases progesterone synthesis in cultured ovarian cells. A part of
      the mechanism may involve an inhibition of CSCC.

PMID- 2214765
TI  - A novel lanosterol isomer produced in response to azole antifungals.
AB  - Gas chromatography-mass spectrometry has revealed the existence of a novel
      lanosterol-like sterol which is produced by fungi in response to treatment with
      azole drugs. The significance of this finding may be related to the changes in
      fungal sterol synthesis as a consequence to prolonged exposure to azoles and
      consequent development of resistance to these agents.

PMID- 2214766
TI  - Differences in the form of the salt-transformed estrogen receptor when bound by
      estrogen versus antiestrogen.
AB  - Our laboratory has previously reported that antiestrogen binding to molybdate
      stabilized non-transformed estrogen receptor results in a larger form of the
      receptor in 0.3 M KCl when compared with estrogen bound receptor. Estradiol
      promoted the formation of monomers in the presence of 0.3 M KCl whereas
      antiestrogen appeared to promote dimer formation. We have extended these studies
      examining the rabbit uterine salt-transformed estrogen receptor partially
      purified by DEAE-cellulose chromatography. We previously demonstrated that
      estrogen receptor prepared in this way bound to different sites on partially
      deproteinized chromatin subfractions or reconstituted chromosomal protein/DNA
      fractions when the receptor was complexed with estrogen vs antiestrogen. Analysis
      of these receptor preparations indicated that DEAE-cellulose step-elution
      resulted in a peak fraction which sedimented as a single 5.9S peak in 5-20%
      sucrose density gradients containing 0.3 M KCl for receptor bound by the
      antiestrogens H1285 and trans-hydroxytamoxifen. However, receptor bound by
      estradiol sedimented as 4.5S. These receptor complexes bound DNA-cellulose
      indicating that these partially purified receptors were transformed. DEAE
      rechromatography or agarose gel filtration of the partially purified antiestrogen
      receptor complexes resulted in significant dissociation of the larger complex
      into monomers. Incubations of 5.9S antiestrogen-receptor complexes with
      antibodies against nontransformed steroid receptor-associated proteins (the 59
      and 90 kDa proteins) did not result in the interaction of this larger
      antiestrogen-receptor complex with these antibodies (obtained from L. E. Faber
      and D. O. Toft, respectively). Our results support the concept that antiestrogen
      binding induces a different receptor conformation which could affect monomer
      dimer equilibrium, thus rendering the antiestrogen-receptor complex incapable of
      inducing complete estrogenic responses in target tissues.

PMID- 2214767
TI  - Inhibitory effect of a new androstenedione derivative, 14 alpha-hydroxy-4
      androstene-3,6,17-trione (14 alpha-OHAT) on aromatase activity of human uterine
      tumors.
AB  - The development of human uterine estrogen-dependent tumors is considered to be
      closely related to estrogen biosynthesis. This study examined whether or not 14
      alpha-hydroxy-4-androstene-3,6,17-trione (14 alpha-OHAT), a new 4-androstene-3,
      17-dione derivative synthesized microbiologically, inhibits estrogen
      biosynthetase (aromatase) activities of human uterine tumors (i.e. uterine
      endometrial cancer, uterine leiomyoma and uterine adenomyosis tissues). 14 alpha
      OHAT inhibited aromatase activity in all uterine tumors, dose-dependently (0.1-10
      microM). Moreover, 14 alpha-OHAT did not show the binding affinity to rabbit
      uterine cytosol-sex steroids, and it was not converted to estrogen in human
      placental preparations. Thus, 14 alpha-OHAT, an aromatase inhibitor, may be
      useful clinically as an endocrine chemotherapy for peri- or post-menopausal women
      with uterine estrogen-dependent tumors.

PMID- 2214768
TI  - Ovarian function in premenopausal women affected by breast cancer: the
      measurement of glucuronoconjugate metabolites of 17 beta-estradiol and
      progesterone throughout one entire menstrual cycle.
AB  - For many years, hypersecretion of estrogens has been suspected of being one of
      the major risk factors of breast cancer for premenopausal women. Seventeen
      premenopausal women, who had undergone lumpectomy because of breast cancer (T1a
      No Mo) 3 yr before entering the study, were compared to 9 normal women of similar
      age, parity and body weight. A chemiluminescent method was used for the
      determination of estrone-3-glucuronide (E1-3G) and pregnanediol-3-glucuronide (Pd
      3G) in early morning urine samples collected for an entire menstrual cycle of
      each of the 26 subjects. During the follicular phase, no significant differences
      in E1-3G and/or Pd-3G excretion were found between the two groups. During the
      luteal phase the E1-3G/Pd-3G ratio in the early, middle and late luteal phase had
      significantly increased in the women with breast cancer, in spite of normal Pd-3G
      excretion. Therefore, the measurement of glucuronoconjugate metabolites of
      ovarian hormones in overnight urine might be conveniently applied to the study of
      ovarian function in subjects with breast cancer. Furthermore, the results of this
      study may indicate that an estrogen/progesterone imbalance is an additional risk
      factor for the premenopausal breast cancer patient.

PMID- 2214769
TI  - In vitro synthesis of 16 alpha-hydroxyestrone by female rat liver microsomes: its
      possible role in the etiology of breast cancer.
AB  - Liver homogenates from female rat strains (Sprague-Dawley, Wistar and Fisher)
      were incubated in a NADPH regenerating medium in the presence of labelled and
      unlabelled estrone. Liver microsomes isolated from male rats and female mice were
      used as positive controls. Using HPLC and paper chromatography, under the
      experimental conditions used it was found that liver homogenates from female rats
      were able to convert estrone to various metabolites such as 16 alpha
      hydroxyestrone. In a mutagenicity assay (Ames test), with 16 alpha
      hydroxyesterone as test substance, two strains (TA98 and TA1538) of the five
      strains tested showed a 2-3-fold increase in the number of his+ revertants
      relative to the control values. Estrone did not cause any mutagens in the test
      used. It is concluded that female rats are able to synthesize 16 alpha
      hydroxyestron in vitro. Whether this compound is risk factor for breast cancer
      remains unclear.

PMID- 2214770
TI  - 7-substituted 1,4,6-androstatriene-3,17-diones as enzyme-activated irreversible
      inhibitors of aromatase.
AB  - 7-Phenyl-1,4,6-androstatriene-3,17-dione (4), 7-benzyl-1,4,6-androstatriene-3,17
      dione (5) and 7-phenethyl-1,4,6-androstatriene-3,17-dione (6) were synthesized
      and evaluated in vitro in human placental microsomes as enzyme-activated
      irreversible inhibitors of aromatase. The compounds were synthesized from
      appropriate 7-substituted 4,6-androstadiene-3,17-diones by reaction with DDQ
      under neutral conditions. All the compounds produced a first order inactivation
      of aromatase in the presence of NADPH but not in the absence of NADPH. Substrate
      4-androstene-3,17-dione protected the enzyme from inactivation by the inhibitors.
      Furthermore, cysteine failed to protect aromatase from inactivation by compounds
      5 and 6. In contrast, cysteine partially protected aromatase from inactivation by
      compound 4. Irreversibility studies illustrated the covalent nature of the
      inactivation by 4, 5 and 6. The above experimental evidence demonstrated that
      compounds 5 and 6 are effective enzyme-activated irreversible inhibitors of
      aromatase.

PMID- 2214771
TI  - Genetic polymorphism of the human sex hormone-binding globulin: evidence of an
      isoelectric focusing variant with normal androgen-binding affinities.
AB  - Human sex hormone-binding globulin (hSHBG) is a plasma glycoprotein composed of
      two identical subunits. The protein, which has high affinity for testosterone and
      estradiol has been purified to homogeneity. In this study we have investigated,
      on neuraminidase-treated serum samples, the presence of genetic variations of
      hSHBG by polyacrylamide gel isoelectric focusing (IEF). Based on IEF analyses of
      110 serum samples from adult Mexican individuals we have identified two distinct
      IEF-patterns. The most frequent phenotype (95.45%) was characterized by two IEF
      bands with pIs of 6.50 and 6.63, respectively. In five serum samples, a different
      4-band pattern with pIs of 6.50, 6.63, 6.70 and 6.76 was identified. Family
      studies showed that this pattern was genetically determined. The frequency of
      this variant was 4.55%, and the observed phenotypes were consistent with the
      expression of an autosomal genetic system. The estimated gene frequencies for
      both alleles were shown to be in genetic equilibrium. Affinity constants, binding
      kinetics and serum concentrations of hSHBG from individuals having a 4-band
      pattern were similar to those obtained in individuals with a 2-band pattern, thus
      suggesting that the mechanism responsible for the generation of polymorphic
      variants of hSHBG reported herein did not involve the steroid binding site of the
      molecule. These findings may be of broad interest, as other serum binding
      proteins express genetic variants, which may permit their further structural and
      functional subclassification.

PMID- 2214772
TI  - A comparative study of the selectivity and efficiency of target tissue uptake of
      five tritium-labeled androgens in the rat.
AB  - A comparative study of the tissue distribution of five tritium-labeled androgens
      was done in rats to determine the efficiency and selectivity of their uptake by
      target tissue. Testosterone (T), 5 alpha-dihydrotestosterone (DHT), 19
      nortestosterone (nor-T), mibolerone (Mib) and methyltrienolone (R1881) all showed
      selective uptake by the ventral prostate in one-day castrated rats (250 g) that
      was 61-90% displaceable by co-injection of an excess of unlabeled steroid. The
      greatest uptake was with R1881 (0.69% injected dose per gram prostate tissue
      (%ID/g) at 1 h), and Mib (0.56% ID/g); the other three showed lower uptake
      (approx. 0.4% ID/g). The target tissue activity remained high for all compounds
      up to 4 h after injection, and at 2-4 h the prostate to blood ratio for Mib and
      R1881 exceeded 10 and 20, respectively. The uptake efficiency and selectivity of
      these five androgens appear to be related to their affinity for the androgen
      receptor and their resistance to metabolism. Mib and R1881 have substantial
      affinity for other steroid receptors, which might account for some of their
      prostate uptake. However, co-administration of triamcinolone acetonide, which has
      high affinity for progesterone and corticosteroid receptors but not for the
      androgen receptor, failed to block their uptake significantly, whereas co
      administration of DHT, the most selective ligand for the androgen receptor,
      blocked their uptake as completely as the unlabeled tracer itself. The prostate
      uptake of Mib and R1881 in intact animals was significantly lower than in
      castrated animals, but treatment of the intact animals with diethylstilbestrol
      restored their uptake nearly to the level seen in castrated animals. These uptake
      patterns are consistent with earlier studies of in vivo androgen uptake and with
      known changes in androgen receptor content and occupancy as a result of
      castration or diethylstilbestrol treatment. They further suggest that high
      affinity androgens labeled with suitable radionuclides--particularly derivatives
      of mibolerone (Mib) or methyltrienolone (R1881)--may be effective receptor-based
      imaging agents for androgen target tissues and tumors, even when patients are
      already receiving hormonal therapy.

PMID- 2214773
TI  - Selective inhibition of cytochrome P-450 in rat testicular microsomes: effect of
      cobalt-protoporphyrin on progesterone metabolism.
AB  - Cobalt-protoporphyrin (CoPP) administration to adult male rats results in a
      profound reduction in hepatic cytochrome P-450 concentration and activity, and
      decreased plasma concentrations of testosterone and luteinizing hormone (LH). The
      metabolism of progesterone by rat testicular microsomes isolated 48 h after
      treatment in vivo with CoPP was compared to that in microsomes from control rats.
      The conversion of progesterone to 17 alpha-hydroxyprogesterone and 4
      androstenedione, which is NADPH-dependent, was reduced by approximately 40% in
      testicular microsomes following treatment with CoPP (50 mumol/kg body weight) and
      this inhibition was dose-dependent. The concentration of cytochrome P-450 in
      testicular microsomes and the activity of 7-ethoxycoumarin de-ethylase (a
      cytochrome P-450 dependent function) were also reduced following treatment with
      CoPP in contrast to two other functional assays of cytochrome P-450, aryl
      hydrocarbon hydroxylase and ethylmorphine demethylase, which were unaffected by
      treatment with CoPP. Thus, the profound effect of CoPP on androgen homeostasis
      has been extended to include decreased testicular synthesis of 4-androstenedione
      in addition to increased hepatic metabolism of testosterone, attenuated pituitary
      LH release in response to luteinizing hormone-releasing hormone, and failure of
      testicular response to LH.

PMID- 2214774
TI  - 17 Beta-hydroxysteroid oxidoreductase activity: age-dependent profile in rat
      liver and kinetic properties of the hepatic microsomal enzyme in relation to
      cytochrome P450-dependent steroid hydroxylation.
AB  - The functional relationship between the microsomal cytochrome P450 and 17 beta
      hydroxysteroid oxidoreductase (HSOR) enzymes involved in steroid metabolism was
      investigated in rat liver. In male and female rat hepatic microsomes the NADPH
      dependent conversion of androstenedione (AD) to testosterone (T) was approx. 4
      fold greater at 6 weeks of age than in 1 week old animals. In hepatic microsomes
      from 15 week old rats the activity of the HSOR pathway was greater in males than
      in females (1.51 compared to 0.80 nmol T formed/min/mg protein). However,
      oestradiol administration to intact adult male rats did not decrease HSOR
      activity. Thus, androgen is not essential for maintenance of HSOR enzymes.
      Instead, it is likely that irreversible androgen imprinting of the HSOR enzyme
      occurs during the prepubertal period. The in vitro characteristics of HSOR
      activity were also assessed. The Km for NADH-dependent reduction of AD to T was
      9.2 microM and the Vmax was 3.0 nmol/min/mg protein but the NAD-mediated
      formation of AD from T did not follow Michaelis-Menton kinetics. pH markedly
      influenced HSOR-mediated AD/T interconversion with 17-ketosteroid reduction
      facilitated at low pH, and 17 beta-hydroxysteroid dehydrogenation about 2-fold
      more efficient at pH 8.0 than at pH 5.5. Product steroid activation of HSOR
      activity was noted. 17 beta-Hydroxysteroids, including T and oestradiol,
      activated the rate of conversion of AD to T and 17-ketosteroids such as oestrone
      and AD activated the NAD-dependent dehydrogenation of T. Activation was not
      observed at low steroid substrate concentrations so that it was not possible to
      analyse this phenomenon by a conventional kinetic approach.

PMID- 2214775
TI  - Regulation of plasma corticosteroid-binding globulin in adult cynomolgus monkey
      (Macaca fascicularis) during different reproductive states.
AB  - The plasma concentration of the corticosteroid-binding globulin (mCBG) has been
      measured in Macaca fascicularis, during different stages of reproduction and
      under hormonal treatments. The mCBG level was determined by a specific
      electroimmunoassay. There was no difference between females in the follicular
      phase and intact males; mCBG concentrations were respectively (mean +/- SEM) 469
      +/- 53 and 443 +/- 25.6 nmol/l. The mCBG levels levels were similar during both
      the luteal (469 +/- 33.5 nmol/l) and the follicular phase (469 +/- 53 nmol/l).
      Compared to intact males, the mCBG levels were higher (P less than 0.05) in
      castrated males (527 +/- 6.6 nmol/l). During gestation, no systematic variations
      were found and the mCBG levels were not statistically different from the values
      found during the follicular phase. When estradiol benzoate was administered to
      castrated animals, the mCBG concentrations increased rapidly. In contrast, the
      values were reduced slightly by testosterone treatment. The sex-steroid action on
      the mCBG levels was discussed and compared with the mSBP levels. We question
      also, the mechanisms involved in the regulation of the mCBG levels during
      pregnancy.

PMID- 2214776
TI  - Greater conversion of testosterone to 5 alpha-dihydrotestosterone, reflecting
      increased peripheral 5 alpha-reductase activity in nude mice treated with high
      doses of cyclosporine A.
AB  - Following cyclosporine A (CsA) immunosuppressive therapy in kidney grafts,
      increased body hair growth (hypertrichosis and/or hirsutism) without significant
      variation in normal circulating plasma androgen levels (as observed in idiopathic
      hirsutism) has been reported by several authors. Other authors have described
      increased hair growth in nude mice treated with CsA. In order to evaluate the
      action of this drug in target tissues, using dorsal skin homogenates from nude
      mice treated with various doses of CsA, we measured the metabolic conversion of
      testosterone (T) to its 5 alpha-reduced products, reflecting 5 alpha-reductase
      activity (5 alpha-RA). Three groups of 5 female nude mice were treated with an
      oral suspension containing CsA 5 mg/kg (group 1), 25 mg/kg (group 2) and 100
      mg/kg (group 3), respectively, and the results, including 5 alpha-DHT and Adiol
      formation, were compared with those obtained in a control group (n = 5) receiving
      only the olive oil vehicle. Cutaneous metabolic conversion of T was determined
      using tritiated T as substrate. After 1 h of incubation, 5 alpha-DHT and other 5
      alpha-reduced products formed were separated and quantified using a reverse-phase
      chromatography column fitted to a flow-through radioactivity detector. Mean +/-
      SD 5 alpha-DHT formation (expressed as pmol per 100 mg of protein per h) was
      found to be increased in the treated groups (group 1: 3.17 +/- 0.37, group 2:
      3.10 +/- 0.13, group 3: 4.26 +/- 0.20), respectively 7.5% (NS), 5.10% (NS) and
      44.4% (P = 0.01) higher than in the control group (2.95 +/- 0.13). In addition to
      5 alpha-DHT, enhanced formation of delta 4-androstenedione (delta 4), 5 alpha
      androstan-3 beta,17 beta-diol (3 beta-diol) and 5 alpha-androstan-3 alpha,17 beta
      diol (3 alpha-diol) were also observed in the treated groups. These results show
      a significantly increased formation of 5 alpha-DHT (and Adiol) in nude mice
      treated with high dose-levels of CsA.

PMID- 2214777
TI  - Ethanol-induced inhibition of testosterone biosynthesis in rat Leydig cells:
      central role of mitochondrial NADH redox state.
AB  - The mechanisms by which ethanol (EtOH) inhibits the human chorionic gonadotropin
      (hCG)-stimulated testosterone synthesis was studied in isolated rat Leydig cells
      in vitro. EtOH inhibited steroidogenesis, but this inhibition was reversed by L
      glutamate (Glu) and an uncoupler of the oxidative phosphorylation, 2,4
      dinitrophenol (DNP). The mechanism of EtOH-induced inhibition was studied by
      measuring steroidogenic precursors and comparing them with the cytosolic and
      mitochondrial NADH redox states during uncoupling or in the presence of Glu. DNP
      had a dual effect. Low concentrations abolished the EtOH-induced inhibition of
      progesterone to testosterone formation suggesting that the inhibitory step was at
      or before progesterone formation. A large concentration led to an overall
      decrease in steroidogenesis indicating toxic effects on steroidogenesis. The
      mitochondrial NADH/NAD+ ratio, measured as the 3-hydroxybutyrate/acetoacetate
      ratio, decreased simultaneously when steroidogenesis was stimulated, either
      during uncoupling or in the presence of Glu, whereas cytosolic NADH/NAD+ ratio,
      measured as lactate/pyruvate ratio showed no response. These results demonstrate
      that the rise in the mitochondrial NADH/NAD+ ratio rather than in the cytosolic
      one is connected with the inhibition of testosterone synthesis by EtOH in
      isolated Leydig cells. The EtOH-induced high mitochondrial NADH/NAD+ ratio may
      deplete mitochondrial oxalacetate concentrations. This can decrease the activity
      of several transport shuttles and interrupt the flow of mitochondrial citrate
      into the smooth endoplasmic reticulum, which then reflects to decreased rate of
      steroidogenesis in the presence of ethanol.

PMID- 2214778
TI  - Estrophilic 3 alpha,3 beta,17 beta,20 alpha-hydroxysteroid dehydrogenase from
      rabbit liver--I. Isolation and purification.
AB  - A procedure for isolation of a highly-purified estrophilic hydroxysteroid
      dehydrogenase (EHSD) from rabbit liver, including ammonium sulphate
      fractionation, gel filtration, ion-exchange and affinity chromatography on
      estradiol-Sepharose, has been developed. The enzyme possesses NADP-dependent 3
      alpha,3 beta,17 beta,20 alpha-HSD activities with a wide spectrum of androgenic,
      progestagenic, and estrogenic substrates. EHSD is a monomeric protein whose
      molecular mass determined by different methods is 35,000-39,000. The protein
      exhibits microheterogeneity due to the differences in molecular surface charge.
      The catalytic and hormone-binding properties and molecular sizes of the two
      protein fractions obtained by chromatography on DEAE-Toyopearl are close or
      identical. The enzymatic activity of EHSD is minor as compared to other HSDs from
      rabbit liver. However, the low values of Km, the high affinity for steroid
      ligands, and high tissue levels of EHSD suggest the protein to play a role in the
      biodynamics of sex hormones.

PMID- 2214779
TI  - Estrophilic 3 alpha,3 beta,17 beta,20 alpha-hydroxysteroid dehydrogenase from
      rabbit liver--II. Mechanisms of enzyme-steroid interaction.
AB  - Binding of [3H]estradiol, [3H]testosterone and [3H]progesterone to purified NADP
      dependent estrophilic 3 alpha,3 beta,17 beta,20 alpha-hydroxysteroid
      dehydrogenase (EHSD) from rabbit liver cytosol has been examined. The three
      steroids bind to the enzyme with moderate [corrected] affinity (Ka congruent to
      10(7) [corrected] M-1 at 4 degrees C) and equal binding capacity. High-rates were
      shown for both association and dissociation processes. The steroids competitively
      inhibited the binding of each other to EHSD. At the same time, their relative
      binding affinities (RBA) were dependent on the nature of [3H]ligand. The results
      of RBA determinations for 72 steroids and their analogues by inhibition of
      [3H]progesterone binding to EHSD suggest that androgens and gestagens bind
      preferentially to the same site on EHSD molecule, while estrogens (at least by
      their D-ring) bind to another site. The assumption that EHSD molecule has more
      than one binding site for steroids is corroborated by (i) substrate inhibition
      revealed for a number of steroids; (ii) the estrogen ability to potentiate 20
      alpha-reduction of progesterone; (iii) stimulatory effect of 5 alpha (beta)
      androstane-3 alpha (beta), 17 beta-diols on [3H]testosterone and progesterone
      binding; and (iv) reciprocal effect of NADP on [3H]estradiol and [3H]testosterone
      binding to EHSD. Significant differences in sensitivity to pH and changes in NaCl
      concentration upon metabolism and binding of various steroids have been found. At
      concentrations of 16 mM dithiothreitol potentiated catalytic conversion of some
      steroids and had no effect on metabolism of others. Both the affinity for
      steroids and binding capacity of EHSD are found to be cofactor-dependent. It is
      speculated that EHSD has a complex active center including at least two mutually
      influencing steroid-binding sites tightly related with cofactor-binding site. The
      polyfunctionality of EHSD may be due to both the excess of functional protein
      groups that form individual constellations upon binding of any steroid and also
      to conformational lability of EHSD molecule implying alternative orientations of
      steroids at the binding site.

PMID- 2214781
TI  - Serum cortisol in adrenal hirsutism as estimated by five different methods.
AB  - Serum cortisol had been estimated in 152 hirsute women complaining of fertility
      problems, of whom 36 were subsequently diagnosed as having adrenal hirsutism and
      10 as having congenital adrenal hyperplasia (steroid 21-hydroxylase deficiency),
      using five methods: an in-house tritium radioimmunoassay after extraction with
      ethanol; the Diagnostic Products Corp. "Coat-a-count" iodinated direct
      radioimmunoassay; the Pharmacia-LKB "DELFIA" lanthanum-enhanced
      fluoroimmunoassay; the Amersham "Amerlite" luminescence immunoassay; and the
      Walker "Synelisa" enzyme-linked immunoassay. Although stripped pool serum samples
      containing weighed amounts of cortisol produced acceptable values in all assays,
      the patient samples showed a number of high results, much greater than the
      accepted normal upper limit of 250 ng/ml (25 micrograms/dl, 690 nmol/l). This was
      especially so in 21-hydroxylase deficiency, when cortisol values should be very
      low. Only the luminescence and iodinated assays produced very low values after
      dexamethasone suppression. After the outliers had been excluded, only the
      iodinated assay showed a good statistical agreement with the more elaborate
      tritium assay. The most specific assay was the luminescence method, which
      produced generally lower results in most cases. This was selected as the new
      routine method. The unreliable cortisol results in adrenal hirsutism are
      attributed to high cross-reaction of the antiserum in each of the assays with 17
      hydroxyprogesterone, progesterone and 21-deoxyderivatives of cortisol and
      deoxycorticosterone. In general, all standard and commercially available cortisol
      assays appears to be unsuitable for cortisol estimation in 21-hydroxylase
      deficiency, and probably also for neonates.

PMID- 2214780
TI  - Potential bile acid precursors in plasma--possible indicators of biosynthetic
      pathways to cholic and chenodeoxycholic acids in man.
AB  - The plasma concentrations of 3 beta-hydroxy-5-cholestenoic acid, 3 beta,7 alpha
      dihydroxy-5-cholestenoic acid and 7 alpha-hydroxy-3-oxo-4-cholestenoic acid have
      been compared with that of 7 alpha-hydroxy-4-cholesten-3-one in healthy subjects
      and in patients with an expected decrease or increase of the bile acid
      production. In controls and patients with liver disease, the level of 7 alpha
      hydroxy-3-oxo-4-cholestenoic acid was positively correlated to that of 3 beta,7
      alpha-dihydroxy-5-cholestenoic acid and not to that of 7 alpha-hydroxy-4
      cholesten-3-one. In patients with stimulated bile acid formation the levels of
      the acids were not correlated to each other but there was a significant positive
      correlation between the levels of 7 alpha-hydroxy-3-oxo-4-cholestenoic acid and 7
      alpha-hydroxy-4-cholesten-3-one. These findings indicate that the precursor of 7
      alpha-hydroxy-3-oxo-4-cholestenoic acid differs depending on the activity of
      cholesterol 7 alpha-hydroxylase. Since the activity of this enzyme is reflected
      by the level of 7 alpha-hydroxy-4-cholesten-3-one in plasma the findings are
      compatible with a formation of 7 alpha-hydroxy-3-oxo-4-cholestenoic acid from 3
      beta,7 alpha-dihydroxy-5-cholestenoic acid when the rate of bile acid formation
      is normal or reduced and from 7 alpha-hydroxy-4-cholesten-3-one under conditions
      of increased bile acid synthesis. In support of this interpretation, 7 alpha,26
      dihydroxy-4-cholesten-3-one was identified at elevated levels in plasma from
      patients with ileal resection or treated with cholestyramine. The levels of 7
      alpha,12 alpha-dihydroxy-4-cholesten-3-one were also higher than normal in these
      patients. Based on these findings and previous knowledge, a model is proposed for
      the biosynthesis of bile acids in man. Under normal conditions, two major
      pathways, one "neutral" and one "acidic" or "26-oxygenated", lead to the
      formation of cholic acid and chenodeoxycholic acid, respectively. These pathways
      are separately regulated. When the activity of cholesterol 7 alpha-hydroxylase is
      high, the "neutral" pathway is most important whereas the reverse is true when
      cholesterol 7 alpha-hydroxylase activity is low. In cases with enhanced activity
      of cholesterol 7 alpha-hydroxylase, the "neutral" pathway is connected to the
      "acidic" pathway via 7 alpha,26-dihydroxy-4-cholesten-3-one, whereas a flow from
      the acidic pathway to cholic acid appears to be of minor importance.

PMID- 2214782
TI  - The state transitions of normal and mutant androgen-receptor complexes in human
      genital skin fibroblasts.
AB  - We have incubated cells from controls and subjects with receptor-defective
      androgen resistance with 3H-labelled testosterone (T), methyltrienolone (MT),
      dihydrotestosterone (DHT) or mibolerone (MB) and studied the temperature
      dependence of the dissociation rate constants of these various androgen-receptor
      (A-R) complexes both within cells and after they were extracted from them. In
      control cells, Arrhenius plots for T-, MT-, DHT- and MB-R complexes were linear
      and formed a hierarchy of dissociation states with energies of state IV greater
      than III greater than II, greater than I, respectively. Relative to this
      hierarchy, the dissociation states of the MB-, DHT- and MT-R complexes in mutant
      cells were displaced to higher, androgen-inappropriate energies in a mutant
      distinctive pattern. When extracted from cells control or mutant T- or MT-R
      complexes, and mutant (but not control) DHT- or MB-R complexes lowered their
      respective dissociation rates by undergoing state transitions in conformity with
      the hierarchy. Hence we propose that different A-R complexes reach different
      dissociative states by undergoing sequential transitions along a common pathway,
      and that these transitions are co-regulated both by the chemical characteristics
      of the bound androgen and by other cellular non-receptor factors.

PMID- 2214783
TI  - Testing for fluoxymesterone (Halotestin) administration to man: identification of
      urinary metabolites by gas chromatography-mass spectrometry.
AB  - Fluoxymesterone, an anabolic steroid, is metabolized in man primarily by 6 beta
      hydroxylation, 4-ene-reduction, 3-keto-reduction, and 11-hydroxy-oxidation. These
      pathways of metabolism are suggested by the positive identification of 4
      metabolites and the tentative identification of 3 other metabolites. Detection of
      the drug in urine is possible for at least 5 days after a single 10 mg oral dose
      to previously untreated adult males, by monitoring the presence of 2 metabolites,
      since the parent drug is not detectable more than 1 day after the dose.

PMID- 2214784
TI  - In vitro inhibition by ketoconazole of human testicular steroid oxidoreductases.
AB  - An oral antimycotic agent, ketoconazole has been demonstrated to be an inhibitor
      of cytochrome P-450-dependent monooxygenases. To investigate its effect on
      steroid oxidoreductases, in vitro studies were carried out using subcellular
      fractions of human testes. Ketoconazole competitively inhibited activities of 3
      beta-hydroxy-5-ene-steroid oxidoreductase/isomerase and NADH-linked 20 alpha
      hydroxysteroid oxidoreductase for steroid substrate and the Ki values were 2.9
      and 0.9 microM, respectively. In contrast, ketoconazole inhibited neither 17 beta
      hydroxysteroid oxidoreductase nor NADPH-linked 20 alpha-hydroxysteroid
      oxidoreductase, indicating that the two 20 alpha-hydroxysteroid oxidoreductases
      are distinct. Further, ketoconazole inhibited non-competitively the above enzyme
      activities for the corresponding cofactors of NAD and NADH. From the binding mode
      of ketoconazole to cytochrome P-450 and the present findings, it appears likely
      that the agent binds to a site which is different from that of steroids or
      pyridine nucleotides.

PMID- 2214785
TI  - Alterations in the binding characteristics of glucocorticoid receptors from obese
      Zucker rats.
AB  - Obese Zucker rats appear to lack a circadian rhythm of serum corticosterone and
      maintain relatively high concentrations throughout the 24-h day. The binding
      characteristics of glucocorticoid receptors in lean and obese Zucker rats were
      examined in three tissues suggested to be involved in the feedback inhibition of
      corticosterone: the anterior pituitary, hypothalamus and hippocampus. Hepatic
      glucocorticoid receptors were also examined to determine if receptor alterations
      exist in a peripheral tissue. The dissociation constant (Kd) of glucocorticoid
      receptors in the anterior pituitary of obese rats was 50% greater than the Kd of
      receptors derived from lean rats. This suggests a decrease in the affinity of
      these receptors and could indicate a reduced feedback inhibition of
      corticosterone at the anterior pituitary. Hepatic glucocorticoid receptors of
      obese rats also showed an increase (150%) in the Kd of binding and a reduction
      (40%) in the number of receptors. No difference was observed in the Kd or maximal
      binding of receptors from the hypothalamus or hippocampus of lean and obese rats.
      It appears that glucocorticoid receptor alterations exist in obese Zucker rats
      and that these alterations may affect the drive of the pituitary-adrenal axis and
      possibly the expression of obesity.

PMID- 2214786
TI  - Properties of estrogen and hydroxysteroid sulphotransferases in human mammary
      cancer.
AB  - Partial purification (approximately x 140-fold) of estrogen sulphotransferase (EC
      2.8.2.4) in human mammary estrogen receptor positive cancer tissue was achieved
      by affinity chromatography on adenosine-3',5'-diphosphate-agarose. It had a Mr of
      approximately 70,000 by gel filtration and upon electrophoresis on concave
      gradient polyacrylamide gels, showed a major (Mr 70,000) and a minor (Mr 200,000)
      peak of activity. Kinetics of this preparation (estradiol-17 beta and estrone as
      substrates), and also that of hydroxysteroid sulphotransferase (EC 2.8.2.2)
      contained in the cytosol of human mammary cancer MCF-7 cells (5-androstene-3
      beta,17 beta-diol and dehydroepiandrosterone as substrates), were compared. The
      enzymes showed very similar behaviour, characterized by high affinity for their
      steroid substrates (low nM range) and co-operativity in their binding. For
      hydroxysteroid sulphotransferase, the adrenal-derived estrogen 5-androstene-3
      beta,17 beta-diol was the preferred substrate compared to dehydro-epiandrosterone
      in the 0-40 nM concentration range. Such properties of the enzymes might be
      designed to limit the exposure of nuclear receptor to free ligand. Alternatively,
      a defined subcellular location would perhaps involve the enzymes in the
      elimination of estrogen after processing of the ligand-bound receptor.

PMID- 2214787
TI  - Preferential nuclear binding of estrogen in the formalin-fixed rat uterus.
AB  - Rat uterus fixed overnight in buffered formalin retains the ability to
      specifically bind estradiol. However, the estrogen binding property of fixed
      tissue appears preferentially localized in the nuclear fraction regardless of
      hormonal status. Furthermore, the quantity of the nuclear estrogen receptor in
      fresh or fixed uterus is virtually identical in the presence or absence of
      estrogenic hormone. Yet, while both tissue preparations exhibit equivalent
      increases in the total nuclear receptor occupancy after hormone exposure, only
      the fresh uterus contains a major cytosolic estrogen binder which decreases in
      availability upon the estrogen-induced elevation of the nuclear bound steroid.
      However, the cytosolic estrogen receptor exhibits a significant loss in its
      ligand binding property after formalin exposure. Thus, the preferential
      localization of estrogen binding in the nuclear fraction of fixed whole tissue
      may just reflect that only the tightly bound nuclear estrogen receptor's
      functional and/or structural integrity survives long-term formation fixation. Our
      observation of estrogen binding in preserved tissue may also be a clinically
      useful tool in therapy analysis.

PMID- 2214788
TI  - Immune reactivity in bronchogenic carcinoma and its relation to 5-year survival
      rate.
AB  - We performed a prospective study on the correlation of various parameters of the
      immune response with the 5-year survival rate in patients with bronchogenic
      carcinoma. Parameters were initially examined before starting treatment. Delayed
      hypersensitivity skin tests, lymphoblastogenesis, natural killer (NK) cell
      activity, and interleukin-2 (IL-2) production were employed to assess immune
      competence. Each reaction was classified into four or five grades in accordance
      with intensity; the 5-year survival rate of the patients showing each grade of
      the immune response was calculated. A correlation between response before
      treatment and the survival rate was most clearly noted for lymphoblastogenesis.
      The skin tests and the NK cell activity showed poorer correlations, and no exact
      correlation was noted between the IL-2 production and the immune response.

PMID- 2214789
TI  - Malignant melanoma occurring during pregnancy: a report of the Northern Israel
      Oncology Center (1968-1988).
AB  - Medical records of seven patients treated within a 20 year period for malignant
      melanoma during pregnancy were reviewed. No significant detrimental prognostic
      effects could be attributed to pregnancy. The current literature on melanoma and
      pregnancy is discussed. Based on this, pregnancy seems not to be contraindicated
      in melanoma patients.

PMID- 2214790
TI  - Symptomatic pericardial effusion in lung cancer patients: the role of fluid
      cytology.
AB  - During the years 1975-1988, twenty lung cancer patients with symptomatic
      pericardial effusion were treated conservatively at our center. Echocardiography
      demonstrated small pericardial effusion in 2 patients, medium size effusion in 3
      patients and large amount of fluid in 15 patients. Fifteen patients developed
      cardiac tamponade; in three of these patients, this was the presenting
      manifestation of lung cancer. Pericardiocentesis resulted in prompt, though
      temporary, symptomatic relief in all patients. Fluid cytology demonstrated
      suspected malignant cells in 2 patients and malignant cells in 13 patients. Based
      on cytology, the diagnosis of adenocarcinoma was established in six patients,
      small cell carcinoma in three patients, and epidermoid carcinoma in one patient.
      All patients were dead within 9 months from the time of diagnosis of pericardial
      effusion; 17 died within less than 3 months. It is concluded that pericardial
      effusion in lung cancer is indicative of rapid tumor progression and short
      survival. Fluid cytology provides an immediate and accurate means of diagnosis.

PMID- 2214791
TI  - Renal vein leiomyosarcoma.
AB  - The 11th case of primary leiomyosarcoma of the renal vein is reported. Unique
      features of this case included concomitant resection of an isolated hepatic
      metastasis, intraoperative radiation therapy, and the use of electron microscopy
      and immunohistochemical stains in confirming the diagnosis. A review of the
      previously reported cases shows a tendency toward slow tumor growth and
      infrequent recurrence (18%). Metastases are common (82%), primarily to the lung
      and liver. Aggressive surgical resection and adjuvant radiation therapy,
      including intraoperative radiation therapy, are recommended. Adjuvant
      chemotherapy should be considered, although its benefits at present are unclear.

PMID- 2214792
TI  - Adrenal carcinosarcoma.
AB  - The clinical and pathologic features of a case of adrenal carcinosarcoma are
      reported. Although synchronous malignancy of the adrenal gland has been
      described, no case of an adrenal tumor combining both carcinomatous and
      sarcomatous elements has been previously documented. This neoplasm is extremely
      aggressive with distant metastasis arising from the sarcomatous component, and
      rapid progression despite multimodal therapy.

PMID- 2214793
TI  - Has preoperative radiation therapy for resectable rectal cancer been proven
      effective?

PMID- 2214794
TI  - Distinguishing malignant mesothelioma from pulmonary adenocarcinoma: an immuno
      histochemical approach using a panel of monoclonal antibodies.
AB  - A panel of six monoclonal antibodies (MAbs) was employed to evaluate antigen
      expression in pulmonary adenocarcinomas and mesotheliomas. Monoclonal anti-human
      milk fat globulin (HMFG-2), anti-carcinoembryonic antigen (NP-2), anti-epithelial
      membrane antigen (EMA), anti-cytokeratin (PKK-1), anti-tumor-associated antigen
      72 (B72.3), and anti-human myelomonocytic antigen (Leu M-1) antibodies were used
      to localize their respective antigens in formalin-fixed, paraffin-embedded tumors
      by using the avidin-biotin-complex immunoperoxidase technique. In all, 28
      mesotheliomas obtained from Ohio State University Anatomic Pathology files and
      from a Southwest Oncology Group (SWOG) protocol were compared to 22 pulmonary
      adenocarcinomas by using this MAb panel. None of the mesotheliomas demonstrated
      positive staining with MAbs NP-2 (anti-CEA) or Leu M-1. However, 95% (21/22) of
      adenocarcinomas stained with one of these two antibodies. Although neither of
      these two MAbs stained all adenocarcinomas, each antibody demonstrated positive
      immunostaining in more than 90% of the adenocarcinomas studied. Therefore, MABs
      NP-2 and Leu M-1 are, individually, quite useful for distinguishing mesothelioma
      from adenocarcinoma. However, in our study, no single MAb could be used to
      distinguish these two tumor types in every case. MAb B72.3 stained 91% (20/21)
      adenocarcinomas but also stained 7% (2/28) of mesotheliomas. MAb HMFG-2 reacted
      positively with 95% of adenocarcinomas, but also stained 39% of the
      mesotheliomas, usually in a membranous pattern. MAbs EMA and PKK-1 were not found
      useful in distinguishing mesothelioma from adenocarcinoma. We conclude that MAbs
      Leu M-1 and NP-2 were both useful in distinguishing mesothelioma from pulmonary
      adenocarcinoma in that positive staining was demonstrated in adenocarcinomas and
      not mesotheliomas.

PMID- 2214795
TI  - Clinicopathological features of elevated lesions of the duodenal bulb.
AB  - We present here our findings on patients with an elevated lesion of the duodenal
      bulb. All these patients were treated in our clinics between the years 1984 and
      1988. These lesions were present in 36 of 8,802 patients who underwent upper
      gastrointestinal pan-endoscopy. Two patients had a duodenal carcinoma, 2 an
      adenoma, and 1 a Brunner's gland adenoma. There were 15 with a hyperplastic
      polyp, 3 with a heterogenic gastric mucosa, 3 with Brunner's gland hyperplasia, 6
      with duodenitis, and 4 with regenerative mucosa. Among these 36 lesions, only 69%
      (25 lesions) were evident on the upper gastrointestinal X-ray series. Adenoma and
      Brunner's gland adenoma were of a pedunculated form of the gross type and had an
      irregular surface mucosa. Both duodenal carcinomas were detected by endoscopic
      biopsy and were resected. Histologically, these lesions were limited to the
      submucosal layer and were of the non-pedunculated polypoid form, but there were
      no other characteristic endoscopic features, in comparison with other elevated
      lesions. Thus, upper gastrointestinal endoscopy with routine observations of the
      duodenal bulb plus endoscopic biopsy will lead to a definite diagnosis of these
      elevated lesions and to the early detection and treatment of this rare malignant
      lesion.

PMID- 2214796
TI  - Utility of surgical margins in the radiotherapeutic management of soft tissue
      sarcomas.
AB  - Seventy-four adult patients with localized soft tissue sarcomas were treated with
      radiation therapy following surgery between 1965 and 1988. Fifty-three were
      treated after the first excision of their tumor with 6 (11.3%) local recurrences.
      Twenty-one received radiation after excision of recurrent disease with 11 (52.4%)
      local failures (P less than .0005). Metastatic disease occurred in 14 (26.4%) of
      the primary tumors and 8 (38.1%) with multiple previous excisions (P less than
      .48). Of those patients treated for primary sarcoma, there were no local failures
      with pathologically wide margins or if a single margin was microscopically
      positive. Local failure occurred in 4 of 26 (15.4%) if the tumor was merely
      enucleated and in 2 of 11 (18.2%) who had grossly positive surgical margins (P
      not significant). Local failure was also more common in truncal locations (33.3%)
      as compared with extremity locations (8.7%, P = .1359). Additional factors
      analyzed which adversely affected prognosis included tumor grade, stage, and
      inadequate radiation dose.

PMID- 2214797
TI  - Acral melanoma: a review of 185 patients with identification of prognostic
      variables.
AB  - One hundred eight-five patients with acral melanoma treated since 1972 were
      reviewed. These included 53 subungual lesions, 123 plantar lesions, and 9 palmar
      lesions. Eighty percent presented with stage I disease. Mean age was 57 years.
      Males outnumbered females 1.1:1. Seventeen percent (17%) were blacks. Actuarial
      10-year survival was 58% for stage I patients and 35% for stage II patients.
      Univariate Cox regression analyses identified 5 prognostic variables affecting
      survival: stage at diagnosis (P less than 0.001), race (P less than 0.001),
      ulceration (P = 0.012), Clark's level (P = 0.014), and thickness of the primary
      lesion (P = 0.013). Factors unrelated to survival included sex of the patient,
      site (volar vs. subungual), histology, and treatment with amputation.
      Multivariate analysis for patients with stage I lesions identified race (P =
      0.001) and ulceration (P = 0.018) as significant variables, with thickness
      approaching significance (P = 0.094). In an additional series of 71 patients with
      melanomas arising from extremity sites near the junction of glabrous and non
      glabrous skin, survival was significantly poorer for those arising from glabrous
      skin (P = 0.024), and reflects a higher incidence of metastatic disease at
      diagnosis. Specific active immunotherapy was the principal adjuvant used for
      these patients, and survival was comparable to that reported with regional
      perfusion therapy. Acral melanoma a) has a strong racial predilection, b) carries
      a grave prognosis, and c) arises from glabrous skin. It is a clinical entity
      distinct from other extremity melanomas. Surgical management with either wide
      excision or amputation is appropriate for the primary lesion.

PMID- 2214798
TI  - Long-term experience with a totally implanted catheter system in cancer patients.
AB  - Long-term experience with totally implanted catheter systems (TICS) is limited.
      We retrospectively evaluated the performance and long-term complications of TICS
      for intravenous infusion in cancer patients; 134 systems were implanted in 128
      patients. The median duration of implantation was 144 weeks with 49 systems
      implanted for more than one year. Complications related to surgical factors
      included malposition of reservoir (2%), skin perforation or wound dehiscence
      (1.5%) and pneumothorax (less than 1%). Complications not related to surgical
      factors included: drug extravasation (1.5%), mechanical malfunction (1.5%), vein
      thrombosis (less than 1%), clotting of the reservoir or catheter (2%), skin
      infection (1.5%), and sepsis (less than 1%). The total complication rate was 13%.
      Most complications resolved spontaneously or with medical treatment and only 6
      patients (4.6%) required re-implantation of a second system. We conclude that
      with long-term usage of TICS, the complication rate remains low, making it a safe
      and viable alternative for patients requiring long-term intravenous therapy.

PMID- 2214800
TI  - Simple method to produce acute heart failure by coronary vessel embolization in
      closed chest rats with microspheres.
AB  - Changes in left ventricle (LV) function, systemic, and regional hemodynamics as a
      result of coronary artery embolization by 15 microns microspheres were studied in
      rats. Selective coronary embolization was produced by injection of microspheres
      during ascending aorta occlusion animals by using an "L"-shaped wire in closed
      chest animals. Maximal developed LV systolic pressure (LVSPmax) was determined
      during ascending aorta occlusion. Coronary embolization evoked reductions in
      LVSPmax and +dP/dtmax and then decreased in basal LVSP, dP/dtmax, dP/dtmax/P,
      with a parallel increase in LV end-diastolic pressure (LVEDP). The number of
      microspheres accumulating in the heart following coronary embolization was about
      40% of the total amount of the injected microspheres (300,000-400,000). In
      conscious rats 48 hr after coronary vessel embolization (in LV myocardium 100,003
      +/- 4,334 microspheres per gram) the cardiac index, mean arterial pressure, 
      dP/dtmax and stroke volume were reduced by 35.6%, 20%, 17.2%, and 26.7%,
      respectively, when compared with sham-operated rats. LVEDP was increased by 40%,
      when compared with sham-operated rats. These results show that in this rat model
      of coronary vessel embolization heart failure develops. The model created may be
      used for the studies of pathophysiology of acute heart failure as well as for
      screening new compounds potentially effective in heart failure.

PMID- 2214799
TI  - New chronic gastric cannula for feeding ethanol liquid diet to young and old
      rats.
AB  - Fifty-eight male Fischer-344 rats ages 5 and 23 mo were fed a liquid diet
      containing ethanol for 6 wk by means of a newly designed chronic gastric cannula
      that permitted maximum allowable freedom with minimum stress. Rats were weaned
      onto the Lieber-DeCarli diet and fed 10 mL three times daily by bolus injection.
      With or without ethanol, the minimum daily intake of calories necessary to
      maintain body weight was determined to be approximately 150-160 kcal/kg/day for
      the young adult rats and 120-125 kcal/kg/day for the aged animals.

PMID- 2214801
TI  - Cecectomized rat. A model of experimental secretory diarrhea in conscious
      animals.
AB  - Evaluation of antisecretory antidiarrheal agents in animal models is limited
      primarily to extrapolations of efficacy from enteropooling studies in vivo,
      isolated intestinal loops in situ, and Ussing flux chamber preparations in vitro.
      While these standard techniques are useful, they do not mimic secretory diarrhea.
      Our studies indicate that in rats, the cecum may serve a "reservoir" function in
      response to secretagogue administration. Thus, diarrhea is not observed
      consistently and reliably in this species to allow valid evaluation of potential
      antidiarrheal agents. Therefore, we have developed a reproducible model of
      secretory diarrhea utilizing conscious cecectomized rats by surgical resection of
      the cecum, without compromising ileocecal patency, and by the use of potent
      intestinal secretagogues. Animals quickly recover and maintain normal growth and
      other physiologic parameters for as long as 60 days. After 48 hr on standard
      chow, secretory diarrhea can be induced by oral administration of standard
      intestinal secretagogues (dimethyl prostaglandin E2, cholera toxin, or
      carbachol). Dimethyl prostaglandin E2 (300 micrograms/kg, p.o.) induces diarrhea
      within 1 hr that continues for approximately 3.5 hr. Oral administration of known
      antidiarrheal agents chlorpromazine (10 mg/kg), clonidine (1 mg/kg), or morphine
      (10 mg/kg) all significantly reduce fecal output within 30-60 min following
      administration. These studies indicate that in the rat, the cecum may serve as a
      fluid reservoir during periods of small intestinal hypersecretion and that the
      cecectomized rat serves as a useful, accurate, and reliable tool for evaluating
      new compounds with proposed antidiarrheal activity.

PMID- 2214802
TI  - Computer-based quantitative morphometric analysis of the dynamic characteristics
      of indomethacin and ethanol-induced gastric lesions in the rat.
AB  - A computerized morphometric analysis was used to measure the gastric lesions in
      rats induced by oral administration of 2 mL of 100% EtOH or indomethacin 80
      mg/kg. In both cases, the lesions were followed over a period of several days to
      determine their time course characteristics. Indomethacin lesions were present 1
      hr after the administration of the drug and reached a peak after 6 hr. Ethanol
      lesions appeared as early as 1 min after administration and were fully expressed
      after 1 hr. Recovery of the gastric mucosa was observed after 2 and 6 days,
      respectively. The use of this computerized systems allows precise measurements of
      gastric lesions and facilitates the evaluation of the effect of drugs in the
      gastrointestinal tract.

PMID- 2214803
TI  - Screening procedure for assessment of ototoxicity in the common marmoset.
AB  - Detection of drug-induced ototoxicity in safety evaluation studies of novel
      chemical entities is rarely attempted. Where such examinations are included, they
      usually rely on reflex testing. The Brainstem Auditory Evoked Response can be
      measured with the use of externally positioned electrodes, and it monitors
      electrophysiologic responses to sound from the cochlear nerve and associated
      structures of the 8th cranial nerve. These responses have been reproducibly
      measured in sedated marmosets and the method shown to be a sensitive detector of
      hearing loss caused by loop diuretics or aminoglycoside antibiotics.
      additionally, where hearing damage is reversible, recovery can also be monitored.
      It is proposed that where a sensitive marker for ototoxicity is considered
      necessary as part of a multifaceted study investigating in vivo drug safety, this
      procedure may prove advantageous over existing methods.

PMID- 2214804
TI  - Kinetics of the trypsinogen activation by enterokinase and trypsin.
AB  - A global kinetic analysis of the mechanisms of the trypsinogen activation by
      enterokinase and trypsin is presented. The kinetic equations of both the
      transient-phase and the steady-state of these mechanisms are presented. In
      addition, we here derive the corresponding kinetic equations for the case in
      which the condition of rapid equilibrium prevails and we propose a kinetic data
      analysis. The significance of this approach to the treatment of other zymogen
      activation processes is discussed.

PMID- 2214805
TI  - Resistance of native protein shapes to random single point mutations in their
      genes.

PMID- 2214806
TI  - Movement of actin filaments along tracks of myosin heads.

PMID- 2214807
TI  - When to copy or avoid an opponent's strategy.
AB  - Models of two-player games are analyzed in which contestants strive to maximize
      relative success (market share). Each contestant divides its resources among a
      set of investment strategies. For a particular investment strategy the
      contestants may receive different expected rates of return. Each strategy also
      returns to both contestants an additional payoff that is unpredictable. Depending
      on particular assumptions, a contestant may maximize relative success by copying
      or avoiding its opponent's allocation pattern. In other cases a contestant may be
      favored to diversify its investments equally among strategies and minimize its
      total variance in returns, or to invest only in one strategy and maximize its
      total variance in returns.

PMID- 2214808
TI  - Kinetics of the classical complement activation cascade.
AB  - Transient-phase and steady-state equations have been derived for the classical
      complement activation mechanism. From these equations the corresponding ones for
      the rapid equilibrium conditions have been derived. We propose an experimental
      design to determine the kinetic parameters.

PMID- 2214809
TI  - Nash equilibrium and evolutionary stability in large- and finite-population
      "playing the field" models.
AB  - This paper studies the correspondence between Nash equilibrium and evolutionary
      stability in large- and finite-population "playing the field" models. Whenever
      the fitness function is sufficiently continuous, any large-population ESS
      corresponds to a symmetric Nash equilibrium in the game that describes the
      simultaneous interaction of the individuals in the population, and any strict,
      symmetric Nash equilibrium in that game corresponds to a large-population ESS.
      This correspondence continues to hold, approximately, in finite populations; and
      it holds exactly for strict pure-strategy equilibria in sufficiently large finite
      populations. By contrast, a sequence of (mixed-strategy) finite-population ESSs
      can converge, as the population grows, to a limit that is not a large-population
      ESS, and a large-population ESS need not be the limit of any sequence of finite
      population ESSs.

PMID- 2214810
TI  - Testing and characterizing the two-stage model of carcinogenesis for a wide range
      of human cancers.
AB  - The age dependence of incidence for 45 cancer types in three populations is
      analyzed on a two-stage kinetic model containing three determinable parameters:
      (i) the fraction of population at risk for a cancer; (ii) the product of the
      frequencies of cancer-producing mutations, and (iii) the growth rate of the
      transformed clone from which a cancer ultimately evolves. The model, simplifying
      that proposed by others, fits many cancers. Data are easily handled in terms of
      the derived parameters, providing the basis for epidemiological analysis, here
      applied in detail to liver, cervix and testis cancers for nearly 50 world-wide
      populations. We identify 12 cancers for which only a limited fraction of the
      population is at risk. We argue that the appearance of most cancers requires at
      least three mutational events. For child, youth, or early adult cancers, one
      mutation may be congenital. We arrange the various cancers in a descending scale,
      defining six groups that differ in the derived mutation frequencies. A cancer
      appearing later in life, for which the whole population can be at risk, shows a
      low mutation frequency, consistent with background spontaneous mutation. The
      other cancers require increases in mutation frequency, arising from an increased
      rate of cell division and/or mutation rate.

PMID- 2214811
TI  - Mucilaginous plants and their uses in medicine.
AB  - Throughout the world but especially in the tropical and subtropical zones, there
      are succulent and non-succulent plants which harbor readily releasable mucilage
      in their tissues, on the surface of their seeds or in their bark. This mucilage
      may have diverse practical uses. Among these, it functions as a healing agent,
      casually or in the practice of traditional-folk or conventional medicine. The
      mucilage of some of these plants is well known to science and has been studied by
      pharmacologists and found to possess biologically active principles. However,
      they all have in common a beneficial effect on burns, wounds, ulcers, external
      and internal inflammations and irritations, diarrhea and dysentery. This paper
      presents examples of such plants belonging to 19 botanical families, with a view
      to calling attention to the similar uses of easily extracted plant mucilages and,
      particularly, their ability to provide protection from fire, a feature which has
      already been demonstrated in Australia.

PMID- 2214812
TI  - Ginger (Zingiber officinale) in migraine headache.
AB  - Migraine is considered as a neurological disorder with little convincing evidence
      of the involvement of some vascular phenomenon. Recent understanding of the
      mechanisms behind migraine pain generation and perception have considerably
      helped the development of modern migraine drugs. Most migraine drugs in use,
      i.e., ergotamine and dihydroergotamine, iprazochrome, pizotifen and diazepam; and
      non-steroidal antiinflammatory drugs (i.e. aspirin, paracetamol, persantin, etc.)
      have side-effects and are prescribed with caution for a limited duration. Ginger
      is reported in Ayurvedic and Tibb systems of medicine to be useful in
      neurological disorders. It is proposed that administration of ginger may exert
      abortive and prophylactic effects in migraine headache without any side-effects.

PMID- 2214813
TI  - New experimental model for the evaluation of adaptogenic products.
AB  - A new animal model for evaluating improvement in physical work performance and
      endurance in an adverse environment is described. In this model, rats in
      restraint were exposed to 5 degrees C at 480 mmHg atmospheric pressure. Results
      were compared to an animal forced to swim in water at 23 degrees C. In both the
      models, colonic temperature (Tr) of the rats was continually monitored during
      exposure to adverse environment and during recovery at 32 degrees C and normal
      atmospheric pressure. The time and pattern for Tr fall to 23 degrees C and its
      recovery to 37 degrees C were used as measures of endurance. The cold-hypoxia
      restraint model was found to provide more precise results compared with the cold
      swimming model. Panax ginseng root and Ginkgo biloba leaf extracts were compared
      for their positive endurance-promoting properties using both models.

PMID- 2214814
TI  - New procedure for direct bioautographic TLC assay as applied to a tincture of
      Ranunculus bulbosus.
AB  - A new procedure for TLC bioautographic assay using a flooding method to inoculate
      the developed plates is described. Details about several microbiological
      parameters allow good reproducibility for this method which appears rapid, easy
      to perform and requiring no specialized equipment. Significantly results obtained
      with a commercial tincture of Ranunculus bulbosus illustrate this method which
      can be extended to complex mixtures of natural products in order to isolate
      active fractions.

PMID- 2214815
TI  - Topical antiinflammatory effects of Euphorbia prostrata on carrageenan-induced
      footpad oedema in mice.
AB  - The ethyl acetate extract and a fraction, KSE-23, isolated chromatographically
      from the ethyl acetate extract of Euphorbia prostrata, showed significant
      antiinflammatory activity when topically applied in a murine model of carrageenan
      footpad oedema. KSE-23 was found to be more potent than indomethacin given in the
      same manner.

PMID- 2214816
TI  - Plants used in traditional medicine in eastern Tanzania. IV. Angiosperms
      (Mimosaceae to Papilionaceae).
AB  - Sixty-nine Angiosperms (Mimosaceae to Papilionaceae) are listed, which are used
      by traditional healers in five regions of Eastern Tanzania; namely, Coast, Dar es
      Salaam, Kilimanjaro, Morogoro and Tanga. For each species listed, the botanical
      name, vernacular name, collection number, locality, habit, distribution and
      medicinal uses are given. Additionally, information from the literature on
      medicinal uses, chemical constituents, and pharmacological effects are also
      provided.

PMID- 2214817
TI  - Antifungal activity of Cassia alata leaf extract.

PMID- 2214819
TI  - Plants in the traditional medicine of the Ubaye Valley.
AB  - The study of the traditional pharmacopoeia in the Ubaye Valley (in the Alpes de
      Haute Provence department) enabled us to draw up a table showing 136 medicinal
      plants, their vernacular names, their suitable parts, the instructions for use,
      the medical purposes and the principal pharmacological and therapeutical
      properties. This study points out the close connection between plants, pathology
      and the living conditions of an agro-sylvo-pastoral civilization.

PMID- 2214818
TI  - Intestinal motility enhancing effect of Atractylodes lancea rhizome.

PMID- 2214820
TI  - Intestinal smooth muscle spasmolytic actions of the aqueous extract of the roots
      of Taverniera abyssinica.
AB  - A room temperature aqueous extract of the roots of Taverniera abyssinica
      antagonized the contractile responses of the guinea-pig ileum to acetylcholine
      and histamine. The extract also relaxed the smooth muscle of the rabbit duodenum,
      abolished the pendular contractions and antagonized the effects of acetylcholine
      and histamine on this tissue. The results confirm that there may be a sound
      pharmacological basis for the ethnomedical use of the roots of this plant to
      treat stomach ache.

PMID- 2214821
TI  - Tabernaemontana crassa as a traditional local anesthetic agent.

PMID- 2214822
TI  - Effects of an aqueous extract of Ferula ovina on rabbit and guinea pig smooth
      muscle.
AB  - The effects of an aqueous extract of Ferula ovina were tested in vitro using
      isolated segments of rabbit and guinea pig intestine, trachea and aorta. The
      extract inhibited the spontaneous movements of rabbit jejunum and guinea pig
      ileum and the contractions induced by acetylcholine. The aqueous extract also
      inhibited the contractions of rabbit trachealis muscle induced by acetylcholine
      and the contractions of guinea pig trachealis muscle induced by histamine. These
      inhibitions were dose-dependent and reversible. However, the aqueous extract did
      not inhibit the contractions of rabbit and guinea pig aortic rings induced by
      norepinephrine. These data suggest that this plant has non-specific
      anticholinergic and antihistaminic antispasmodic effects.

PMID- 2214824
TI  - Plants used in Guatemala for the treatment of gastrointestinal disorders. 1.
      Screening of 84 plants against enterobacteria.
AB  - Gastrointestinal disorders are important causes of morbidity in developing
      countries. Natural healing is the traditional way of treating these diseases in
      Guatemala. Ethnobotanical surveys and literature reviews showed that 385 plants
      from 95 families are used in Guatemala for the treatment of gastrointestinal
      disorders. The activity of 84 of the most commonly used plants was screened in
      vitro against five enterobacteria pathogenic to man (enteropathogenic Escherichia
      coli, Salmonella enteritidis, Salmonella typhi, Shigella dysenteriae and Shigella
      flexneri). Results indicate that 34 (40.48%) plants inhibit one or more of the
      enterobacteria tested. The most commonly inhibited bacterium was S. typhi
      (33.73%) and the most resistant was E. coli (7.35%). The plants of American
      origin which exhibited the best antibacterial activity were: Byrsonima
      crassifolia, Diphysa robinioides, Gnaphalium stramineum, Guazuma ulmifolia,
      Psidium guajava, Sambucus mexicana, Simarouba glauca, Smilax lundelii, Spondias
      purpurea and Tagetes lucida. These results indicate a scientific basis for use of
      these medicinal plants for attacking enterobacterial infections in man.

PMID- 2214823
TI  - Pharmacology of an Indian-snuff obtained from Amazonian Maquira sclerophylla.
AB  - The powdered bark of Maquira sclerophylla is consumed as snuff in north Brazil.
      Both the crude and the purified hydrosoluble extract (WP) injected i.p. in the
      dose range of 0.05-0.5 g/kg induced hyperexcitability, tremors, motor
      incoordination, ataxia, quietness and muscle relaxation in rats. The effects were
      progressive, dose-related and reversed after 30 min. Anesthetized rats, guinea
      pigs and dogs injected with the purified extract (10-50 mg/kg, i.v.) showed a
      biphasic change of carotid blood pressure. The early and transient hypotension
      was blocked by atropine but not by vagotomy: the secondary hypertension was long
      lasting and sustained for over 30 min. The hypertension was shortened but not
      blocked after ganglionic blockade or reserpine treatment. Either pithing or alpha
      receptor blockade with yohimbine reduced both effects of the extract. Guinea-pigs
      and dogs were more responsive than rats and died by heart arrest. Incubation of
      WP (20 micrograms/ml) increased both the rate and force of contraction of
      isolated guinea-pig right atria by 2 and 5 times, respectively. Propranolol (4
      micrograms/ml) blocked the chronotropic effect but did not decrease the inotropic
      effect. In electrically driven guinea-pig left atria, WP (10 micrograms/ml)
      increased the force of contraction by 80% and the maximum rate of force
      development by 60%, but did not change the time to peak tension, the time to 50%
      relaxation, or the rate of relaxation. These cardiovascular effects resemble
      those of digitalis-like drugs. Cardenolides were detected in WP by phytochemical
      screening.

PMID- 2214825
TI  - Quantitative estimation of Holarrhena antidysenterica bark total alkaloids in
      crude drugs and in the body fluids of man and rat.
AB  - A turbidimetric method was developed for the quantitative estimation of the total
      alkaloids of kutaj bark (Holarrhena antidysenterica) in crude medicinal
      preparations and in the body fluids of man and rat. The alkaloids were
      colloidally precipitated with Dragendorff's reagent as complex salts of potassium
      iodobismuthate in extremely dilute solutions. The finely subdivided orange-brown
      precipitate gave a coloured, clear homogeneous suspension in the presence of gum
      arabic. Optical density of such suspensions changed linearly with the change in
      alkaloid concentration, when prepared within the standardized experimental
      conditions that included control of ion concentration and temperature of the
      reaction mixture. Observations revealed the reversible nature of the alkaloid
      reagent reaction. Crude medicinal preparations from three different
      pharmaceutical sources contained varying concentrations of the alkaloids.
      Complete recovery of the alkaloids was possible from plasma and urine, while
      significant amounts of the alkaloids were lost to blood cells and faecal contents
      in man and rat.

PMID- 2214826
TI  - Induction of neutrophil accumulation by Chinese herbal medicines "hochu-etsuki
      to" and "jyuzen-daiho-to".
AB  - "Hochu-etsuki-to" (HT) and "Jyuzen-daiho-to" (JT) are Chinese herbal medicines
      that have been used for the treatment of weakened physical strength and asthenic
      persons. Intraperitoneal injection of boiled water extracts in mice of HT and JT
      were found to induce a high accumulation of neutrophils 6 h after injection in a
      manner similar to that seen with the biological response modifier lentinan. The
      neutrophil accumulation by intraperitoneal injection of HT and JT increased dose
      dependently.

PMID- 2214827
TI  - Effect of Melothria maderaspatana on carbon tetrachloride-induced changes in rat
      hepatic microsomal drug-metabolizing enzyme activity.
AB  - Treatment with an aqueous extract of the aerial parts of Melothria maderaspatana,
      before or after CCl4 administration in rats markedly decreased CCl4-mediated
      reductions in aniline hydroxylase and p-aminopyrine N-demethylase activities.
      Phenobarbital-induced sleeping time in rats and kinetic enzyme studies showed
      that the effect of the plant was neither due to an induction of the drug
      metabolizing enzymes nor due to an alteration in the Km values of the enzymes.

PMID- 2214828
TI  - Extracorporeal membrane oxygenation for the circulatory support of children after
      repair of congenital heart disease.
AB  - We have treated 39 infants and children with congenital heart disease with
      extracorporeal membrane oxygenation during the past 5 years. Thirty-six were
      treated for low cardiac output or pulmonary vasoreactive crisis after repair of
      congenital heart defects. Twenty-two (61%) survived. Most patients were
      cannulated from the neck via the right internal jugular vein and the right common
      carotid artery. Six patients were cannulated from the chest, including three who
      had separate drainage of the left side of the heart with a left atrial cannula.
      Two of these patients survived and were the only survivors of the nine patients
      cannulated in the operating room because they could not be weaned from
      cardiopulmonary bypass after open cardiac operations. We also reviewed 312
      patients (the predictor study series) having open cardiac operations before the
      availability of extracorporeal membrane oxygenation; 27 of these patients died.
      Data were collected at 1 and 8 hours postoperatively to determine if any
      parameters might predict early mortality. With these parameters used as criteria,
      patients who went on extracorporeal membrane oxygenation were as sick as those
      who died before extracorporeal membrane oxygenation was available. The most
      common complication was bleeding related to heparinization. The mean transfusion
      requirement in survivors was 1.50 +/- 1.13 ml/kg/hr, 5.63 +/- 7.0 ml/kg/hr in the
      nonsurvivors, and 7.46 +/- 8.29 ml/kg/hr in those cannulated in the operating
      room because they could not be weaned from bypass. Four children had intracranial
      hemorrhage, and two of them died. There was one late death. Nine of the 22
      survivors are entirely normal. All survivors who do not have Down's syndrome are
      considered to have normal central nervous system function. We conclude that
      extracorporeal membrane oxygenation can improve survival in patients with both
      pulmonary artery hypertension and low cardiac output after operations for
      congenital heart disease.

PMID- 2214829
TI  - Long-term results of the Belsey Mark IV antireflux operation in relation to the
      severity of esophagitis.
AB  - A retrospective analysis of the results of the Belsey Mark IV operation has been
      conducted, relating these to the degree of esophagitis present preoperatively.
      Analysis of 89 patients showed a 91.7% success rate in patients without
      esophagitis. Good results diminished steadily as the severity of esophagitis
      increased, giving 76.5%, 75%, 66.7%, and 50% success rates for first-, second-,
      third-, and fourth-degree esophagitis, respectively. We believe that shortening
      of the esophagus is an important factor in this. Shortening is obvious in third-
      and fourth-degree esophagitis but subtle in first- and second-degree esophagitis.
      We conclude that the Belsey operation is adequate for patients without
      esophagitis, but for patients with any degree of esophagitis more effective
      reflux control is needed.

PMID- 2214830
TI  - The metabolic consequences of a "washed" cardiopulmonary bypass pump-priming
      fluid in children undergoing cardiac operations.
AB  - The substrate load of the pump-priming fluid, especially glucose and lactate, has
      a major influence on the metabolic response of children during cardiac operations
      and may be detrimental neurologically. It is possible to cleanse the priming
      fluid of these excess substrates by ultrafiltration followed by the addition of a
      balanced electrolyte solution. We have used this technique in the bypass
      management of nine children over 1 year of age and weighing less than 18 kg who
      were studied from induction of anesthesia to 6 hours postoperatively. Frequent
      blood samples were taken for measurement of electrolytes, intermediary
      metabolites, and stress-related hormones. Throughout the study period electrolyte
      concentrations were maintained within the physiologic range and changes in blood
      glucose and lactate were minimized compared with those of matched historical
      controls from previous studies. During the period of cardiopulmonary bypass mean
      serum glucose concentrations varied between 4.4 and 7.7 mmol/L and peaked at 10.7
      mmol/L just before skin closure. The mean serum lactate concentration did not
      exceed 2.3 mmol/L during the period studied. Thus ultrafiltration of the priming
      fluid and replacement with a balanced electrolyte solution results in the
      delivery to the patient of a reasonably physiologic substrate load, which is
      reflected in improved control of mean plasma intermediary metabolite
      concentrations. The method may form the basis of further clinical studies to
      determine specific aspects of the metabolic stress response in children.

PMID- 2214831
TI  - Prostacyclin and prostaglandin E2 mediate reduction of increased mean arterial
      pressure during cardiopulmonary bypass by aspiration of shed pulmonary venous
      blood.
AB  - Increased mean arterial pressure during the aortic crossclamp period while on
      cardiopulmonary bypass was usually treated by us with hypotensive drugs. We
      noticed, however, that aspirating shed excess pulmonary venous blood from the
      open pleural cavities causes an immediate reduction in mean arterial pressure,
      obviating the need for any further pharmaceutical intervention. In this study we
      investigated the relationship between the reduction in mean arterial pressure and
      the levels of prostacyclin and prostaglandin E2 in the peripheral and pulmonary
      venous blood. Ten men undergoing coronary bypass operations had 21 episodes of
      increased mean arterial pressure (106.9 +/- 11.4 mm Hg) during aortic
      crossclamping, which was reduced to 67.4 +/- 11.4 mm Hg (p less than 0.001) only
      by aspirating a mean of 490 ml (range 150 to 1100 ml) of pulmonary venous blood
      from the pleurae back into the circulation. Mean peripheral prostacyclin level,
      measured as 6-keto-prostaglandin F1 alpha, and prostaglandin E2 level, both
      measured by radioimmunoassay technique, were significantly lower at peak mean
      arterial pressure (419 +/- 180 and 59.5 +/- 21.2 pg/ml) than at lowest mean
      arterial pressure (632 +/- 271 and 96.7 +/- 52.4 pg/ml for 6-keto-prostaglandin
      F1 alpha and prostaglandin E2, respectively; p less than 0.001). Prostaglandin F1
      alpha and prostaglandin E2 levels in the aspirated pulmonary venous blood were
      2309 +/- 3098 pg/ml and 749 +/- 909 pg/ml, respectively. The hypotensive effect
      of shed pulmonary venous blood that is aspirated back from the pleurae into the
      circulation seems to be mediated by the high levels of prostacyclin and
      prostaglandin E2, both powerful vasodilators.

PMID- 2214832
TI  - Myocardial temperature during cardiac operations: influence on right ventricular
      function.
AB  - Maintenance of right heart integrity is frequently neglected during coronary
      operations. Right ventricular dysfunction sometimes limits the success of the
      surgical procedure, however. In addition to the use of cardioplegic solutions,
      myocardial hypothermia during ischemic cardiac arrest seems to be an important
      factor for guaranteeing right ventricular performance thereafter. This study was
      designed to measure myocardial temperature in patients with coronary artery
      disease who have significant stenosis of the right coronary artery in comparison
      with those who do not have stenosis of the right coronary artery and to evaluate
      the influence of myocardial temperature on right ventricular hemodynamics after
      cardiopulmonary bypass. Right ventricular function was assessed by thermodilution
      technique, which allows measurement of right ventricular ejection fraction, right
      ventricular end-diastolic volume, and right ventricular end-systolic volume.
      Right ventricular temperature differed significantly between the two groups, with
      the lowest value of 15.1 degrees +/- 1.8 degrees C in the group without stenosis
      of the right coronary artery and a value of 22.2 degrees +/- 2.1 degrees C in the
      group with stenosis of the right coronary artery. Left ventricular and septal
      temperatures were without group differences within the investigation period.
      Right ventricular hemodynamics were impaired only in the group with stenosis of
      the right coronary artery with a decrease in right ventricular ejection fraction
      from 44.2% to 34.1% immediately after termination of bypass and an increase in
      right ventricular end-diastolic volume index (+38%) and right ventricular end
      systolic volume index (+70%). Cardiac index decreased only in this group, too (
      22.5%). Analysis of covariance revealed a significant correlation only between
      changes in right ventricular ejection fraction, right ventricular end-diastolic
      volume, and right ventricular end-systolic volume and the course of right
      myocardial temperature. It is concluded that right ventricular hypothermia is
      more difficult to achieve in patients with a diseased right coronary artery.
      Constant myocardial hypothermia, however, seems to be important in guaranteeing
      right ventricular function, which easily can be evaluated by the thermodilution
      technique.

PMID- 2214833
TI  - Functional consequences of the right ventricular isolation procedure.
AB  - The right ventricular free wall was surgically isolated from the remainder of the
      heart in eight dogs to evaluate the functional consequences of this procedure.
      Each dog was instrumented with ultrasonic dimension transducers in the right and
      left ventricular free walls, intracavitary micromanometers, and pulmonary artery
      flow probes. Volume loading and vena caval occlusions were performed to assess
      diastolic compliance and systolic function. Right ventricular unstressed
      myocardial segment length increased from 14.2 +/- 0.7 to 15.0 +/- 0.8 mm (p less
      than 0.5). There was an accompanying significant postoperative loss of right
      ventricular diastolic compliance (p less than 0.005). Regional right ventricular
      systolic function and regional left ventricular diastolic compliance and systolic
      function were preserved after the procedure. Postoperatively, when the right
      ventricular free wall was not paced and left silent, right ventricular stroke
      work decreased from 7.0 +/- 0.8 to 2.7 +/- 0.5 gm-m/m2 (p less than 0.05). These
      data demonstrate that the diastolic compliance of the right ventricular free wall
      decreases significantly after right ventricular isolation. However, there were no
      changes in regional right ventricular systolic or regional left ventricular
      function. The isolated right ventricular free wall contributes significantly to
      postoperative cardiac performance.

PMID- 2214834
TI  - Is cutting stress responsible for the limited durability of heart valve
      bioprostheses?
AB  - The limited durability of the valve bioprostheses made from calf pericardium is
      partially due to the calcification of this biomaterial and to mechanical fatigue
      of the tissue. The object of this study is to determine the harmful effect on the
      pericardial membrane of cutting caused by the suture thread by showing the
      different elastic behaviors of the biomaterials employed. This cutting stress is
      established during the process of molding the valve leaflet, creating a
      vulnerable point from the very moment of construction, which is an important
      factor in the limited duration of the bioprosthesis.

PMID- 2214835
TI  - Development of a new surgical procedure for repairing tracheobronchomalacia.
AB  - We have developed a new surgical method for repairing tracheobronchomalacia. In
      experiments on dogs we tried external fixation of Marlex mesh (Bard Cardiosurgery
      Division, Bellerica, Mass.) on the trachea. We first made models of
      tracheomalacia by making fractures or resections in intrathoracic tracheal
      cartilages and then made an external fixation of Marlex mesh on the malacic
      segments of the trachea. In 11 dogs Marlex mesh was sutured onto the trachea with
      absorbable thread. The trachea was firmly supported after 2 to 6 months, compared
      with three controls in which no external fixation was made. However, mucosal
      defects associated with ischemia caused by the suture developed in four of the
      11. In 13 more dogs Marlex mesh was bonded to the trachea with fibrin glue. After
      3 to 8 months the supporting strength of the trachea increased up to the level of
      the normal trachea. There was no evidence of inflammation or of mucosal defects.
      Therefore Marlex mesh was applied to a 44-year-old-man who had experienced
      frequent attacks of cough syncope. After the operation the attacks of cough
      syncope and collapsing of his airway disappeared completely.

PMID- 2214836
TI  - Prediction of risk in noncardiac operations after cardiac operations.
AB  - To determine the preoperative variables affecting the mortality rate and the
      development of severe complications in patients who have had myocardial
      revascularization or a valve replacement and who then undergo a noncardiac
      operation, we retrospectively studied data from 120 such patients over the 5
      years from 1982 through 1986. Thirty-six percent of patients had a noncardiac
      operation during the first month after the cardiac operation. The mortality rate
      was 11%, and the morbidity rate was 56%. The statistical comparison of the
      predictive accuracy of postoperative complications of three simple, widely used
      classifications (American Society of Anesthesiologists physical status, New York
      Heart Association classification, Massachusetts General Hospital cardiac risk
      index) demonstrated the superiority of the simplified three-class cardiac risk
      index (Massachusetts General Hospital-cardiac risk index; predictive accuracy of
      84%). In a multivariate discriminant analysis of 21 variables in this population,
      five variables (myocardial infarction in previous 6 months, S3 gallop or jugular
      vein distention, arrhythmia on last preoperative electrocardiogram, emergency
      operation, delay between cardiac and noncardiac operation) were identified as
      being the most predictive of a postoperative complication. When these variables
      were used in the function (DF3) obtained by linear discriminant analysis, the
      prediction accuracy of a postoperative complication reached 83%. Performance of
      the new models in a prospective validation population remained satisfactory (75%
      for Massachusetts General Hospital-cardiac risk index three-class index and 72%
      for DF3). Extensive statistical analysis of our data tested by a validation study
      provided simple predictive models based on clinical variables easily available
      even in emergency situations.

PMID- 2214837
TI  - Intraoperative coronary artery endarterectomy with excimer laser.
AB  - Compared with continuous-wave lasers, excimer lasers exhibit several in vitro
      advantages: nonthermal ablation process and linear relation between the number of
      pulses and the depth of the crater. A 308 nm, 20 nsec pulse duration, 1 to 5
      repetition rate laser was specifically designed for clinical application. At the
      time of cardiopulmonary bypass in 10 symptomatic patients, before bypass
      grafting, a 1 mm diameter core specifically ultraviolet-tipped fiberoptic scope
      was introduced via the coronary arteriotomy and placed upstream (seven patients)
      and downstream (three patients) in contact with the stenosis. Laser power was
      increasingly delivered up to the clearing of the stenosis or occlusion. Quality
      of angioplasty was controlled by calibration of the neolumen, cardioplegic
      solution output through the laser-treated segment, and an eighth day or sixth
      month coronary arteriogram. In the first three patients studied on the eighth
      day, all laser-treated coronary artery segments showed an early parallel-linked
      patent neolumen despite competitive bypass graft flow. In the patients studied
      after 6 months, all recanalized segments were patent except one; in one patient
      the venous graft was occluded, but the upstream laser angioplasty was patent. The
      main limitation of the method lies in the fact that laser coronary recanalization
      is confined to the fiber core diameter. We conclude that (1) excimer laser
      angioplasty may be safe and efficient during surgical procedure and (2) as
      catheter flexibility remains the most critical problem, we are now assuming an
      appropriate tool with a multifiber system that is suitable for intraoperative as
      well as percutaneous routes.

PMID- 2214838
TI  - Pleuroperitoneal shunt for persistent pleural drainage after Fontan procedure.
AB  - Persistent effusions of chylous fluid may prolong the hospitalization period of
      many patients who have had a Fontan procedure. Herein we report the case
      histories of two patients in whom use of a pleuroperitoneal shunt to control the
      effusion shortened the hospital stay by several weeks.

PMID- 2214839
TI  - Invited letter concerning: Long-term results of the Belsey Mark IV antireflux
      operation in relation to the severity of esophagitis.

PMID- 2214840
TI  - Medtronic Intact porcine valve thrombosis.

PMID- 2214841
TI  - Functioning paraganglioma (pheochromocytoma) of the thorax: preoperative
      embolization.

PMID- 2214842
TI  - Reply to invited letter concerning: Endothelial preservation in human saphenous
      veins (J Thorac Cardiovasc Surg 1990;100:149-50)

PMID- 2214843
TI  - Reply to: Amiodarone and quinidine for postoperative atrial arrhythmias (J Thorac
      Cardiovasc Surg 1990;99:942)

PMID- 2214844
TI  - Straddling tricuspid valve.

PMID- 2214845
TI  - Electrocautery for parenchyma-sparing pulmonary resection: fast and easy.

PMID- 2214846
TI  - Volvulus of the intrathoracic stomach after total esophagectomy.

PMID- 2214847
TI  - [Subpopulations of immunocompetent cells in the placenta in normal pregnancy and
      in EPH gestosis].
AB  - An effort of cellular element investigations in placentas of 8 physiological
      pregnancies and 7 EPH gestoses is performed with the aid of specific monoclonal
      antibodies by the indirect immunohistochemical method. The average mean of
      parturient ages (primiparae and pluriparae) was 24 years in EPH gestoses. By the
      aid of monoclonal antibodies OKT4, OKT8, OKT11, OKT6 and OKDR, Dako-macrophage,
      2H4 (Coulter) murine type, immunocompetent cells were identified in the decidua,
      in the stroma of chorionic villi, in the intervillous space, and in the fibrinoid
      masses. The semiquantitative indirect method of the immunohistochemical cellular
      investigation was performed by the aid of optic microscopy in 20 fields per every
      cutting (section) of the placental tissue. The immunocompetent active cell
      distribution did not reveal any special difference in the frequency of placental
      tissues of physiogical pregnancies and EPH gestoses, but OKT11+ cells were
      present in the major number in gestoses (in decidua). OKT8+ and OKDR+ cells were
      found in a similar number in both populations, while OKT6+ were not found at all
      in any investigated tissue.

PMID- 2214849
TI  - [Bacterial flora in the reproductive system in the intra-amniotic infection
      syndrome].
AB  - By the bacteriological aerobic analysis of the cervical swabs of 64 pregnant
      women with a subacute syndrome of intraamniotic infection in the 16th and 28th
      gestation weeks, pathogenic bacteria were isolated in 59 women (92.2%) and out of
      the swabs of 30 young girls with less sexual experience, 8 (26.7%) showed the
      presence of pathogenic bacteria, the difference being statistically highly
      significant (X2 V 56.9, p less than 0.001). From the ejaculates of the husbands
      of the same pregnant women, pathogenic bacterial were isolated in 57 of them
      (89.1%) and from the ejaculates of the controlled groups of young adolescents,
      pathogenic bacteria were isolated in 5 of them (16.7%), the difference being
      again statistically highly significant (X2 = 62.2, p less than 0.001). Comparing
      bacteria from the swabs of pregnant women with the syndrome of intraamniotic
      infection with those from the semen of their husbands, it has been found that the
      bacteria were identical in 40.6% if only one kind of bacteria was isolated and in
      68.7% if several kinds of bacteria were isolated from the swab or ejaculates. In
      the group of 30 young girls a statistically significant dependence of pathogenic
      bacteria on the number of partners in their sexual life was observed (X2 = 4.54,
      p less than 0.05); pathogenic bacteria were isolated only once from the swabs of
      girls with only one partner and 6 times from the swabs of girls with two or more
      sexual partners.

PMID- 2214848
TI  - [Dysplasia and carcinoma in situ of the uterine cervix in pregnancy].
AB  - During a 3-year period, 167 women with an abnormal cytological finding (112-IIIA,
      41-IIIB and 14-IV) were followed up cytologically and colposcopically in six
      weeks' intervals. They were evaluated during pregnancy, vaginal delivery and the
      puerperal period, and the cytological findings showed no progression of
      intraepithelial lesions into the invasive ones. Definitive postpartum
      pathohistological findings in 53 patients showed that 32 had in situ carcinoma,
      12 severe and 7 light dysplasias, and 2 benign changes. The possibility of the
      false negative cytological assessments or invasive cervical carcinoma was
      excluded. Patholhistological and cytological findings matched in 77% of cases,
      whereas the degree of the former was lower in 21% and higher in 2% of the
      patients. In as many as 40.7% of patients the first post-delivery control
      cytological finding was negative. The reversible nature of these findings is
      emphasized, as well as the need to follow up these patients for at least one
      year.

PMID- 2214850
TI  - [Fetal death in the 20th to the 36th week of pregnancy].
AB  - In the period from 1986 to 1988, intrauterine fetal deaths from 20-36 weeks of
      gestation and 500 gm and more birth weight were analysed in a prospective study
      from the clinical and pathomorphological point of view. There were 57 such fetal
      deaths or 7.96% of the total number of 716 births till the 36th week of
      gestation, while 42.4% of women with the intrauterine fetal loss were cigarette
      smokers during pregnancy vs. 29.1% of such women among all those who gave birth
      during the same period. Smokers faced a relative risk of 1.8 for the fetal loss
      between the 20th and the 36th week of gestation. From the clinical standpoint,
      the cause of death was presumed in 40 or 71.4% of cases, while only in 24 or
      42.1% of autopsies could the pathomorphological disorder be considered the cause
      of the intrauterine death. In 47 or 82.5% of cases, the observed
      pathomorphological disorders of the placenta, fetal membranes or the umbilical
      cord could also have contributed to the fetal death. Most often, i.e. in 20 or
      35.1% of cases, chorioamnionitis was diagnosed and in 13 (22.3%) cases disorders
      of the placental circulation. In 7 cases (12.3%) neither clinical nor
      pathomorphological potential cause of death could be found. From the health care
      point of view it is important to find out those risk factors of fetal mortality
      which are preventable. Smoking during pregnancy could be the most preventable
      risk factor of fetal death.

PMID- 2214852
TI  - [Development of mechanisms for evaluation of the quality of perinatal care].
AB  - Published evidence of the actual efforts for the development of mechanism for the
      quality assessment and assurance of perinatal care in the USA, Belgium,
      Netherlands and West Germany is presented. The choice of countries was determined
      by the availability of evidence. Despite known differences in the health care
      systems, every country developing mechanisms for the quality assessment in a
      particular field of health care involves in this process its respective
      professional associations. In the case of perinatal care it is the association of
      gynecologists and obstetricians. The administration of the process lies within
      the JCAH in the US and the ministries of health and universities in other
      countries.

PMID- 2214851
TI  - [Prevention of thromboembolic disease in gynecologic surgery].
AB  - The authors present the results of their blind prospective comparative study of
      the postoperative thromboembolic protection of 490 gynecologic patients. Among
      them 250 (51%) were protected by a low dose heparin (LDH) subcutaneously in 12
      hour intervals, 240 (49%) received heparindihydergot (HDHE). Thromboembolisms
      diagnosed by the 125J fibrinogen uptake test appeared in 26 (10.4%) patients
      protected by LDH and 23 (9.6%) by HDHE. The most frequent risk factors in
      patients with thromboembolisms were malignant diseases, obesity, varicose veins,
      hypertension and a history of deep vein thrombosis or pulmonary embolism.
      Haemorrhages appeared in 7 (2.8%) patients protected by LDH and 8 (3.3%) by HDHE.

PMID- 2214853
TI  - [HIV infection and human reproduction].
AB  - Problems connected with HIV infection, especially with its transmission, problems
      of HIV infection as an indicator of the termination of pregnancy, the role of
      pregnancy in the activation of latent HIV infection, and the possibility of the
      transmission of HIV infection by breast feeding are put forward and discussed.
      The authors present the results of their own studies of the presence of HIV
      antigen in the genital secretion, fetal tissue, and amniotic fluid in 4 anti-HIV
      positive pregnant women, in whom pregnancy was interrupted because of HIV
      infection. HIV antigen was positive in the cervical secretion and fetal tissue of
      one of the four pregnant women, whose diagnosis was ab. imminens. The presence of
      HIV virus, probably also of HIV antigen, in the cervical secretion appears
      significant for the transmission of infection from mother to child and for the
      occurrence of spontaneous abortion. When it is not possible to apply the method
      of HIV virus isolation, the determination of HIV antigen could have a prognostic
      importance of the effect of HIV on the course and outcome of pregnancy.

PMID- 2214854
TI  - [The amazing neonate].
AB  - According to a questionnaire including 78 general practitioners, specialists in
      pediatrics and obstetrics, physicians specializing pediatrics and obstetrics, and
      43 students of a High Nursing School, 21.8% of physicians and 58% of nurses think
      that the newborn does not see, 17.9% of physicians and 18.6% of nurses think that
      the newborn does not hear, and 44.9% of physicians and 79.1% of nurses think that
      the newborn has no feeling of the position of the body in space and of its
      movements. The existence of the sense of smell in the newborn is denied by 66.7%
      of physicians and 55.8% of nurses, and of the sense of taste by 44.9% of
      physicians and 41.9% of nurses. All the nurses know that the newborn has the
      sense of touch, while 3.8% of physicians think the opposite. Two thirds of those
      included in the questionnaire think that the newborn can memorize and the three
      quarters of them think it can learn. Much fewer nurses than physicians
      (32.4%:61%) consider the newborn a passive receiver of external stimuli. As many
      as 97% of physicians think that an early stimulation of the newborn helps its
      psychomotor development and a high percentage of them positively assess the
      majority of measures implementing it. Yet, only 66.7% of physicians consider it
      necessary for parents to be near the hospitalized premature infant, while 24.4%
      of all the questioned do not consider the prevention of the birth of undesirable
      children a measure by which the quality of the parent-child relation could be
      influenced.

PMID- 2214855
TI  - [Time factors and trends in the onset of the menarche, sex maturation and
      experience of orgasm in a questionnaire administered to 971 women in Vojvodina].
AB  - A questionnaire and interview of 971 women aged 15-80 years or more from three
      Voivodina communes (Becej, Veternik, Mali Idos) have supplied the following
      information: the arithmetic mean of the age of women during menarche is 13.459 +/
      1.523 years, the median being 13.872 years. Menarche appears earlier in the town
      (13.334 +/- 1.373) than in villages (13.668 +/- 1.61). The arithmetic mean of
      menarche recedes towards younger age groups (y = 12.90 +/- 0.106; r = 0.890, p
      less than 0.01), so that below 20 years is 1.4 years, and this is more pronounced
      in the town than on villages. The arithmetic mean of the age of women at sexarche
      (the first sexual intercourse) is 19.088 +/- 2.495 years, and the median is
      18.964. The interval between the arithmetic mean of menarche and sexarche is 5.6
      years, smaller in the urban (5.0) than in the rural environment (6.4). Sexarche
      recedes towards younger age groups (y = 18.136 +/- 0.130; r = 0.540), more
      intensively than the acceleration of menarche. In the course of their sexual
      life, 16.4% of women rarely experienced orgasm, 11.2% never did. The experience
      of orgasm "rarely" or "never" is statistically significantly more frequent in
      women over 40 years of life in relation to younger women (X2 = 6.893, p less than
      0.01).

PMID- 2214856
TI  - [Brenner's tumor of the ovary].
AB  - A retrograde analysis of surgically treated women for ovarian tumours in the last
      20 years was performed. Out of a total of 1741 such patients, only 4 developed
      Brenner tumour (0.23%). Three of them were in the fifth decade and one in the
      eighth decade of life. All these four tumours were unilateral. Three of them were
      benign and one "proliferating". One patient had a mucinous cystadenoma in the
      other ovary and one a malignant cystadenocarcinoma in the same ovary with the
      benign Brenner tumour. Two patients had an atrophic endometrium and two had
      adenomatoid, i.e. atypical hyperplasia. The size of tumours varied from 2 to 20
      cm in diameter.

PMID- 2214857
TI  - [Preoperative administration of dinoprost gel for termination of early pregnancy
      in primigravidas].
AB  - A total of 60 primigravid women due to undergo early pregnancy termination (6.5
      to 10 weeks) were randomly selected for the intracervical application of 0.5 mg
      dinoprostone in the form of intracervical gel (Prepidil gel, Upjohn). The gel was
      inserted 6 hours prior to vacuum aspiration. Before application all women had the
      cervix closed, i.e. dilated less than Hegar #3. After 6 hours there was noticed a
      marked cervical softening and dilatation (mean 9.28 mm) in all 60 cases (100%).
      Twelve (20%) women needed an additional mechanical dilatation which was performed
      very easily and atraumatically. An incomplete abortion occurred in 14 (23.33%)
      cases; 35 (58.33%) women had uterine cramps, and in 28 (46.66%) gastrointestinal
      side effects were recorded. There were no significant changes in the blood
      pressure or body temperature. During the procedure there were no complications.

PMID- 2214858
TI  - [Bacteriological analysis of the cervical canal in uterine cervix insufficiency].
AB  - A bacteriological analysis was made of pyogenic agents from the cervical canal of
      260 pregnant women with cervical incompetency, in whom the cerclage of the cervix
      was performed. Pyogenic agents were found in 139 (53.5%) pregnancies. The most
      frequently isolated pathogenic agent was Enterococcus--in 19.2% of all pregnant
      women and in 36.0% in those with a pathologic swab. E. coli was isolated in 16.5%
      of all pregnant women and in 30.9% of those with the pathologic swab. A
      significantly higher number of pathologic swabs were found in women with colpitis
      and the cleanliness 3 degree of the vaginal discharge and without colpitis
      (6.4%). In pregnant women with a pathologic swab, in spite of the cervical
      cerclage, spontaneous abortions and premature deliveries were significantly more
      frequent (8.2% and 16.4% respectively) than in pregnant women with a sterile swab
      (1.8% and 6.1% respectively).

PMID- 2214859
TI  - [Intracerebral hemorrhage in a grand multipara with EPH gestosis].
AB  - A 43-year-old multiparous woman (ninth childbirth) with the EPH-gestosis not
      observed during pregnancy, first came to the hospital in the 40th week of
      gestation due to the rupture of membranes and weak labor pains. Having lain down
      in the delivery room, the patient immediately lapsed into a coma and developed
      hemiplegia on the right side of the body. Suspecting a cerebrovascular insult
      caused by hypertension within the pre-existing EPH-gestosis, the C-section was
      performed in the best interest of both mother and child. Following the operation,
      the CT of the brain showed massive intracerebral and intraventricular hemorrhage.
      The patient was moved to the Intensive Care Unit, where she died six days after
      the insult.

PMID- 2214860
TI  - [Dr. Lazar Nenadovic, gynecologist-obstetrician and founder of balneology and
      physical medicine in Serbia].
AB  - Prof. Dr. Lazar-Laza Nenadovic specialist in obstetrics and gynaecology (Modos,
      1870--Beograd, 1939), the founder of advanced physical medicine and balneo
      climatology in Serbia. Prof. Nenadovic, besides a series of papers on obstetrics
      and gynaecology, is the author of a monograph on obstetrics and gynaecology
      published in Novi Sad in 1912, being the first of this kind in Serbia. Its title
      is Diseases of the female, their origin, causes and treatment. He was also one of
      the pioneers of gynecologic balneology in Yugoslavia and one of the founders of
      the Belgrade School of Obstetrics and Gynaecology, as well as a close
      collaborator and friend of Prof. Dr Milos Bogdanovic, the first head and
      professor of the Department of Obstetrics and Gynaecology of the School of
      Medicine in Belgrade.

PMID- 2214861
TI  - [Validity of the direct immunofluorescent monoclonal antibody test in the
      diagnosis of chlamydial infection].
AB  - The sensitivity and specificity of direct fluorescent monoclonal antibody
      staining were compared with the isolation of the organisms in McCoy cells. For
      both diagnostic methods cervical smears were taken in 120 women. Of 120 women 25
      (20.8%) were infertile, 60 (50.0%) healthy fertile women and 35 (29.8%)
      adolescents who came for control gynecological examination. C. trachomatis was
      isolated in 5/25 (20.0%) of infertile women, in 5/60 (8.3%) of healthy fertile
      women and in 4/35 (11.4%) adolescents. With the cell culture as the reference
      method, the antigen detection test had a sensitivity of 92.8%, a specificity of
      98.1%, a positive predictive value of 86.7% and a negative predictive value of
      99.1%.

PMID- 2214862
TI  - Department of Health and Hospital's final regulations on infectious waste.

PMID- 2214863
TI  - A recruitment and marketing plan for Louisiana State University School of
      Dentistry.

PMID- 2214864
TI  - Virus dissemination via the lymphomyeloid complex.
AB  - In the previous AIDS symposium organized by the Society, Witte and Witte (1) made
      a number of predictions, one of which was that in AIDS patients, "Lymph from the
      thoracic duct should be strongly positive for HIV." Though direct evidence for
      this is lacking, some early experiments of ours with vaccinia virus (2) are fully
      in accord with this prediction, to which they lend indirect support. In rabbits,
      nasally instilled vaccinia virus spreads via the lymphatic pathway (afferent
      peripheral lymph--deep cervical gland--efferent lymph--thoracic duct) in as short
      a time as nine hours. Virus is transported mainly in cells, for when the efferent
      lymph is centrifuged virus is found only in the cell sediment. It seems
      reasonable to assume that other viruses, including HIV, are similarly
      disseminated. Paradoxically, the lymphomyeloid complex both greatly facilitates
      the spread of virus, and at the same time, mounts the immunological defenses
      against the virus which it so effectively helps to disseminate. Whatever the
      portal of entry of the virus, its transport by migrating cells ensures its
      dissemination throughout the lymphomyeloid complex, including the bone marrow.
      The bone marrow is an integral part of the complex, as the prime source of B
      lymphocytes, T lymphocyte precursors, and many of the antigen-presenting cells as
      well as the granulocytes. There is some evidence concerning possible ways in
      which the bone marrow can contribute to the development of immune deficiency in
      AIDS patients. The bone marrow merits further study in this context.

PMID- 2214865
TI  - The relevance of lymphoid cell migration to immunodeficiency syndromes.
AB  - It has been known for some time that antigen stimulation can alter lymphocyte
      traffic patterns and that viruses are particularly potent in this respect; such
      alterations may be a consequence of host-derived factors. The retention of
      lymphocytes in lymph nodes can be sustained for several hours with locally
      administered interferon (IFN)alpha. The extravasation of lymphocytes from blood
      into non-lymphoid tissues can be induced in the skin with IFN gamma and
      particularly tumor necrosis factor (TNF)alpha. Recent evidence supports the
      concept that the migratory capacity of CD4+ cells differs from the capacity of
      CD8+ cells. Agents (cytokines?) which differentially affect the traffic of these
      two sub-sets have not yet been described but such a possibility has not been
      adequately tested. Several new molecules have been defined which alter the
      interactions between lymphocytes and blood vascular endothelial cells, and these
      may be important in the critical adhesive event in lymphocyte traffic. In both
      rat and sheep, it has been possible to cultivate post-capillary endothelial cells
      from lymphoid tissue, and this may be a helpful approach to studying the
      mechanisms and molecules involved in adhesion. New cell tracking dyes recently
      available (Zynaxis Cell Science) permit more significant, long-term studies on
      the life span of lymphocyte sub-sets and their migratory status. In our
      experiments, labeled lymphocytes can be followed in vivo for over 30 days.
      Traffic alterations may explain some of the abnormalities in immunodeficiency
      states.

PMID- 2214866
TI  - AIDS, Kaposi sarcoma, and the lymphatic system: update and reflections.
AB  - Based on ongoing basic and clinical investigations, further evidence is presented
      that the AIDS-Kaposi sarcoma (AIDS-KS) complex involves a progressive disturbance
      of the blood-lymph circulatory loop of fluid, macromolecules, and migrating
      cells. We first surveyed the spectrum of vascular abnormalities including Kaposi
      sarcoma (KS) found in the AIDS/ARC population, then non-invasively imaged
      lymphatic system abnormalities in AIDS-KS by whole body lymphangioscintigraphy,
      and finally examined the biologic behavior of AIDS-KS cells in long-term tissue
      culture. These observations are viewed in terms of the lymphatic and blood
      vascular route of entry and transport of free and cell-associated virus and other
      opportunistic pathogens as well as poorly understood host endothelial-immune
      system interactions.

PMID- 2214867
TI  - Grip and stick and the lymphatics.
AB  - Kaposi sarcoma is a common, though not inevitable consequence of AIDS. There is a
      body of opinion that believes that this sarcoma is derived from lymphatic
      endothelium, or at least from a failure of vascular endothelium to distinguish
      between whether it is attempting to be a blood vessel or a lymphatic. While
      immunodeficiency and its consequences have proved to be the most significant area
      of research, the general biology of endothelium, and especially angiogenesis, has
      perhaps been neglected. I predict that the most important new concept in the
      biology of endothelium is the recognition of mechanico-receptors as a determinant
      of its behavior. The concept is illustrated by articles from Oxford (Ryan 1989),
      from Boston, Massachusetts (Ingber & Folkman 1989), and from Moscow (Shirinsky et
      al 1989). Most authors studying endothelium have concentrated on blood vascular
      endothelium and ignored the rich lymphatic bed. Since the lymphatic is par
      excellence a mechanical receptor, this is perhaps surprising. The lymphatic
      functions by its responsiveness to mechanical forces, it is a fine control for
      hydrostatic pressure within the interstitium, and morphologically, its flat and
      attenuated endothelium linked to strong anchoring fibers is biologically exactly
      the kind of behavior required of a cell that is responsive to mechanical factors.
      Perhaps the best known mechanical receptor is the stretch receptor in the muscle
      fiber. The linkage of this receptor to the enzyme protein kinase C has been
      described. Ryan has also pointed out that protein kinase C may be an important
      mechanico-receptor in the fibroblast and possibly also universally in all cells,
      including lymphatic endothelium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2214868
TI  - Development of immunomodulators for treatment of HIV infection.
AB  - Although considerable attention has been devoted to development of antiviral
      drugs for therapy of HIV infection, relatively little priority has been directed
      to correction of the progressive immunologic defect that develops in these
      patients. We described the development of the therapeutic effect of an
      immunosupportive biological agent (IMREG-1) derived from human leukocytes.
      Specifically, IMREG-1 reduced the risk of progression from advanced AIDS-related
      complex (ARC) based on a randomized double-blinded control trial over a six month
      period of the laboratory and clinical parameters predictive of a high risk of
      progression from ARC to AIDS. The comparative value of CD4+ cell numbers, anergy
      to recall antigens and symptomatology in assessing risk of progression were also
      examined.

PMID- 2214869
TI  - High resolution magnetic resonance spectroscopy in clinical biology.

PMID- 2214870
TI  - In vivo recruitment of GM-CSF-response myelopoietic progenitor cells by
      interleukin-3 in aplastic anemia.
AB  - Previous studies have indicated that colony-stimulating factors may stimulate
      myelopoiesis and thus increase the number of circulating white blood cells in
      patients with hematopoietic failure including aplastic anemia. However, long-term
      administration of the factor was required to maintain its response. In the
      present article we report on a patient with severe aplastic anemia undergoing
      treatment with recombinant human (rh) granulocyte-macrophage colony-stimulating
      factor (GM-CSF). After an initial response, the patient became refractory to GM
      CSF. However, treatment with interleukin (IL)-3 restored responsiveness to GM
      CSF, suggesting that IL-3 may have replenished the bone marrow with myelopoietic
      progenitor cells sensitive to the action of GM-CSF. This observation suggests the
      value of application of sequentially acting hematopoietic growth factors in
      aplastic anemia patients.

PMID- 2214871
TI  - c-fms expression in acute leukemias with complex phenotypes.
AB  - The c-fms proto-oncogene product, which is the receptor for the macrophage colony
      stimulating factor CSF-1, is always found expressed in acute myeloid leukemia
      cells, irrespective of their stage of differentiation according to the FAB
      classification (Dubreuil P, Torres H, Courcoul M, Birg F, Mannoni P. Blood
      1988;72:1081-1085). We have extended this study and looked for c-fms expression
      in poorly differentiated myeloid leukemias, in a series of acute leukemias of
      either T or B origin and in biphenotypic leukemias. We now report that expression
      of c-fms is still related to the myeloid origin of the leukemic proliferation,
      but that it can also be found in some acute leukemias presenting clonal
      rearrangements of the T cell receptor gene. Thus expression of the c-fms/CSF-1
      receptor may not be exclusively a marker for myeloid proliferations.

PMID- 2214872
TI  - First intron and M-bcr breakpoints are restricted to the lymphoid lineage in
      Philadelphia positive acute lymphoblastic leukemia.
AB  - Knowledge of the level of commitment of the target cell in hematological
      malignancies may have important therapeutic and prognostic implications. Cell
      lineage involvement was investigated in two cases presenting with acute
      lymphoblastic leukemia diagnosed on clinical and immunological findings and
      having the Philadelphia translocation t(9;22)(q34;q11). DNA from cells separated
      into mononuclear (lymphoid) and granulocytic fractions was hybridized with
      Philadelphia breakpoint-specific probes. This revealed that the breakpoint giving
      rise to the Philadelphia chromosome in case 1 was within the major breakpoint
      cluster region and in case 2 was in the first intron of the BCR gene.
      Rearrangement was found in the lymphoid but not the granulocyte fraction in each
      case. It is therefore concluded that the target cell for chromosomal change in
      these cases was a lymphoid committed progenitor cell, irrespective of breakpoint
      location.

PMID- 2214873
TI  - Association of protein tyrosine phosphorylation with B cell differentiation
      induced by 12-O-tetradecanoylphorbol-13-acetate (TPA).
AB  - We have assessed whether tyrosine protein kinase (TPK) is involved in B cell
      differentiation. In vitro phosphorylation of an endogenous substrate in B cell
      leukemias showed that leukemic B cells at different stages of differentiation had
      specific endogenous substrates in tyrosine phosphorylation as well as distinct
      TPK activity. To clarify the relationship between TPK and the process of B cell
      differentiation, we studied protein tyrosine phosphorylation in two kinds of
      leukemic B cells, which showed distinct responses to TPA (12-O
      tetradecanoylphorbol-13-acetate) in B cell differentiation. TPA-treated leukemic
      B cells from patients with B cell chronic lymphocytic leukemia (B-CLL)
      differentiated into cytoplasmic immunoglobulin (clg)+ plasmacytoid cells, while
      TPA-treated leukemic B cells from patients with hairy cell leukemia (HCL) did not
      differentiate into clg+ cells, but showed a peculiar morphological change,
      spreading. Untreated B-CLL cells and HCL cells showed similar TPK activities and
      tyrosine protein phosphorylation. When treated with TPA, enhanced phosphorylation
      was seen in B-CLL cells, while a clear reduction in phosphorylation was found in
      HCL cells. However, using 4-hydroxycinnamide derivatives which reduce TPK
      activity, we found that only the reduction of TPK activity did not lead HCL cells
      to spreading. These data suggest that protein tyrosine phosphorylation and/or
      dephosphorylation might be involved in B cell differentiation, but only the
      change of TPK activity in HCL cells is not sufficient to induce effects.

PMID- 2214875
TI  - Trisomy 8 in acute lymphoblastic leukemia (ALL): a case report and update of the
      literature.
AB  - A case of acute lymphoblastic leukemia (ALL) cytogenetically characterized by
      trisomy 8 as a sole aberration is described. The patient, one of 116 adults with
      ALL investigated cytogenetically, was a 36-year-old male with leukocyte count
      12.3 x 10(9)/liter with 90% blasts of FAB type L1 and common ALL immunological
      phenotype. Remission was achieved with the current U.K. treatment trial. The
      patient recovered from an autologous bone marrow transplant (BMT) in first
      remission but relapsed 15 months later. BMT, in second remission, from an
      unrelated donor, was rejected. Autologous reinfusion failed and he died 26 months
      after diagnosis. Molecular investigation of immunoglobulin gene rearrangement
      identified the same B cell clone at diagnosis and in relapse. The clinical and
      cytogenetic findings of six published cases of ALL with trisomy 8 have been
      reviewed with updates supplied by the authors. These reveal an heterogeneous
      group of patients ranging in age from 9 months to 39 years with no apparent
      association with a particular immunophenotype. Four patients were alive after 10
      108 months follow-up. Two patients died, in relapse, 7 and 17 months after
      diagnosis. Thus trisomy 8 occurs in ALL with an incidence of 1-2%. The prognostic
      significance of this remains to be determined.

PMID- 2214874
TI  - Early and long term follow-up with minisatellite probes in bone marrow
      transplanted patients.
AB  - Twenty-five patients who received bone marrow transplantation (BMT) for chronic
      granulocytic leukemia (CGL), acute leukemia and severe aplastic anemia were
      studied before and after BMT in order to document and characterize the events
      following transplantation. DNA analysis was performed using minisatellite probes,
      which give rise to extremely polymorphic Southern blot band patterns specific to
      each individual and are regarded as "genetic fingerprint." Sensitivity studies
      using a mixture of donor and recipient cells could distinguish the presence of 1%
      of cells from one individual. Blood specimens were obtained from donor recipient
      before BMT and at days 10, 30, 90, and 270 after BMT. Karyotype analysis was also
      performed in CGL patients at the same time of DNA analysis. Engraftment was
      identified by DNA analysis as early as 10 days posttransplant and correlated with
      cytogenetic findings. This confirmed that a single hybridization filter is
      informative in 100% of patients and is easily applicable for early and long term
      studies of chimerism in BM transplanted patients.

PMID- 2214876
TI  - Pleural involvement in hairy cell leukemia--development under alpha-interferon
      and remission upon pentostatin therapy.

PMID- 2214877
TI  - Mayo and the antigravity suit.

PMID- 2214879
TI  - Rehabilitative techniques for athletes after reconstruction of the anterior
      cruciate ligament.
AB  - A wide spectrum of protocols is available for rehabilitation after anterior
      cruciate ligament reconstruction, and little agreement exists on the specifics of
      strengthening exercises or the sequence of activities. In this article, we
      discuss the current rehabilitative techniques used at the Mayo Clinic for
      athletes who have undergone anterior cruciate ligament reconstruction. These
      techniques are based on established principles of rehabilitation, clinical
      experience, and new information about the related biomechanics of the knee. An
      illustrative case reflects the benefits of this rehabilitation program, which
      lasts up to 1 year and is divided into five stages. The early stages focus on
      protected mobilization and a strengthening program that emphasizes closed rather
      than open kinetic chain exercises. Later, neuromuscular-proprioceptive training
      and sport-specific agility training redevelop the reaction time and the
      "coordination engrams" necessary for athletic competition. High-quality surgical
      care and a closely supervised rehabilitation program, based on kinesiologic and
      biomechanical factors as they pertain to the anterior cruciate ligament, are
      necessary for a successful outcome.

PMID- 2214878
TI  - Cutaneous malignant melanoma in Rochester, Minnesota: trends in incidence and
      survivorship, 1950 through 1985.
AB  - In Rochester, Minnesota, 107 incidence cases of cutaneous malignant melanoma (in
      46 male and 61 female patients) were diagnosed during the years 1950 through
      1985. Overall crude incidence rates were 6.0 and 6.6 per 100,000 males and
      females, respectively. Evaluation of trends in 9-year periods showed that the
      rates increased from 3.2 to 8.9 for males (P = 0.015) and from 4.4 to 11.7 for
      females (P less than 0.001). Age-specific rates suggested that the highest
      incidence occurs in the age-groups 50 to 59 years and 70 years or older for males
      and 40 to 49 years and 70 years or older for females. Lesions were most common in
      the head and neck area among males (P = 0.044) and on the lower extremities among
      females (P = 0.018). The most frequent histologic type was superficial spreading
      melanoma (61%). Five-year survival was diminished overall for patients with
      cutaneous malignant melanoma--0.72 in comparison with 0.88 expected for the
      general population. Statistically significant risk factors for survival were
      depth of invasion of the lesion (Clark level), thickness of the lesion,
      histologic type, and age of the patient.

PMID- 2214880
TI  - Long-term versus short-term treatment with recombinant interferon alfa-2a in
      patients with chronic hepatitis B: a prospective, randomized treatment trial.
AB  - We conducted a prospective, randomized trial to study the efficacy and tolerance
      of long-term versus short-term treatment with recombinant interferon alfa-2a in
      patients with chronic hepatitis B. Ten patients were randomly assigned to a 6
      month interferon regimen, and 10 patients were assigned to a 3-week interferon
      trial. Eleven patients (five assigned to long-term treatment and six to short
      term treatment) did not complete interferon therapy: eight had either severe
      thrombocytopenia or neutropenia; one had pronounced fatigue in relationship to
      administration of interferon; one had spontaneous bacterial peritonitis and
      sepsis and died; and one had a massive fatal variceal hemorrhage during
      interferon therapy. Most of the serious hematologic complications occurred in
      patients with cirrhosis and hypersplenism. In one patient, seroconversion to
      hepatitis B virus DNA negativity occurred before the onset of treatment. Four of
      the five patients able to complete the 6-month interferon regimen and only one of
      four patients able to complete the 3-week trial had seroconversion to hepatitis B
      virus DNA negativity. Thus, we conclude that the therapeutic response was better
      among patients who were able to complete a 6-month interferon trial. In patients
      with cirrhosis and hypersplenism, development of either severe thrombocytopenia
      or leukopenia associated with interferon therapy precluded completion of
      treatment.

PMID- 2214881
TI  - Fast computed tomography for quantitative cardiac analysis--state of the art and
      future perspectives.
AB  - Two fast computed tomographic scanners, designed primarily for imaging cardiac
      structures and function, have been in use since the early 1980s. The technical
      aspects of both systems have been described previously in detail, and a
      considerable body of scientific literature now documents the biomedical
      capabilities of these scanners. This review examines these biomedical
      capabilities as applied to quantitative analysis of the heart and pulmonary
      circulations. On the basis of this overview, some speculations about the current
      strengths and possible further developments of the fast computed tomographic
      approach in these applications are made.

PMID- 2214882
TI  - Transcranial Doppler ultrasonography: clinical applications in cerebrovascular
      disease.
AB  - Transcranial Doppler ultrasonography was introduced in 1982 as a noninvasive
      procedure for assessment of the intracranial cerebral circulation. The
      lightweight and portable equipment used for transcranial Doppler examination
      facilitates its use in the bedside assessment of critically ill hospitalized
      patients and outpatients. Clinical applications include the diagnosis of
      vasospasm in patients with subarachnoid hemorrhage, assessment of intracranial
      collateral flow in patients with extracranial arterial occlusive disease,
      detection of intracranial arterial stenosis, identification of the feeding
      arteries of arteriovenous malformations and monitoring the hemodynamic effects of
      their treatment, confirmation of the clinical diagnosis of brain death, intensive
      care unit monitoring of brain-injured patients, and intraoperative and
      postoperative monitoring of neurosurgical patients. Transcranial Doppler
      technology is also providing new insights into the pathophysiologic mechanisms of
      a variety of cerebrovascular conditions. Clinicians will find transcranial
      Doppler technology most helpful if they have a specific question about the status
      of the intracranial circulation. Further investigations may expand the clinical
      and research utility of this technology.

PMID- 2214883
TI  - Unsuspected syphilitic hepatitis in a patient with low-grade proteinuria and
      abnormal liver function.
AB  - A 25-year-old patient was found to have cholestatic liver enzyme abnormalities
      during assessment for asymptomatic low-grade proteinuria at the US Naval Hospital
      in Portsmouth, Virginia. These abnormalities persisted for a 6-month period, and
      an extensive workup, including viral serologic studies, rapid plasma reagin test,
      iron studies, ceruloplasmin, antimitochondrial, antinuclear, and anti-human
      immunodeficiency virus antibodies, endoscopic retrograde
      cholangiopancreatography, and liver biopsy, was unrevealing until serologic tests
      for syphilis were repeated to evaluate a new onset of urethral discharge. The
      patient had none of the more characteristic signs of secondary syphilis. The
      liver enzyme abnormalities rapidly resolved after treatment with penicillin.
      Syphilis remains the great impostor and still must be considered in the
      differential diagnosis of unexplained liver enzyme abnormalities, even in a
      patient with no symptoms or signs of early syphilis.

PMID- 2214884
TI  - The melanoma epidemic thus far.

PMID- 2214885
TI  - Benedykt Dybowski--physician, explorer, scientist, political prisoner.

PMID- 2214886
TI  - Is the nurse practitioner in? A day in the life of.

PMID- 2214887
TI  - Noise and hearing loss.

PMID- 2214888
TI  - A school nurse in Moscow.

PMID- 2214889
TI  - Age-dependent changes of the sympathetic innervation of the rat kidney.
AB  - The influence of aging on the sympathetic innervation of the kidney was studied
      in 3- (considered to be young), 12- (considered to be adult) and 24- (considered
      to be old) month-old male Sprague-Dawley rats by means of high pressure liquid
      chromatography with electrochemical detection, catecholamine histofluorescence
      and acetylcholinesterase (AChE) histochemistry. Body and kidney weights were
      significantly increased in adult in comparison with young rats. No further
      increase of either body or kidney weight was appreciated in old rats.
      Noradrenaline levels were increased by about 48% in adult rats and were decreased
      in old rats (by approx. 22% vs. young and 60% vs. adult). The density of
      perivascular noradrenergic fibres was significantly increased in adult rats and
      decreased in old animals. The percentage of kidney glomeruli supplied by AChE
      positive nerve fibres is also remarkably increased in 12-month old rats and
      decreased in 24-month-old rats. The present data indicate that there is a
      striking increase in the expression of sympathetic innervation of rat kidney at
      12 months of age followed by a significant decrease in the expression of
      innervation in old age. These changes are discussed in relation to the age
      dependent impairment of renal function.

PMID- 2214890
TI  - Hypoxia and pharmacological treatment in differently aged rats: effect on
      muscular metabolite concentrations.
AB  - Metabolite concentrations in gastrocnemius and soleus muscles were compared in
      young-adult (4 months), mature (12 months) and senescent (24 months) rats after
      continuous (72 consecutive hours) exposure to normobaric hypoxia or normoxia with
      the intraperitoneal administration of the vasodilator naftidrofuryl or saline
      solution for 30 days consecutively before hypoxia. The following metabolites were
      assessed in gastrocnemius muscle in relation to: (a) energy mediators: ATP, ADP,
      AMP; (b) energy store: creatine phosphate; (c) anaerobic glycolysis: glycogen,
      glucose, glucose 6-phosphate, pyruvate, lactate; (d) Krebs' cycle: citrate, alpha
      ketoglutarate, malate; (e) free amino acids related to Krebs' cycle: aspartate,
      glutamate, alanine; and (f) ammonia. In the soleus muscle only ATP, creatine
      phosphate, glycogen, glucose, glucose 6-phosphate, pyruvate, lactate, citrate,
      alpha-ketoglutarate malate, aspartate and glutamate were assessed. Aging does not
      seem to affect soleus and gastrocnemius muscles in the same way. Some
      gastrocnemius muscle metabolites show linear changes in their concentrations with
      aging, while for the soleus muscle the only linear change relates to glucose 6
      phosphate. As regards the influence of hypoxia on muscular metabolism, all the
      most important changes observed in metabolite concentrations in comparison with
      control values take place at the age of 4 and 24 months. Furthermore, as regards
      naftidrofuryl action, the most important variations observed concern only 4-month
      old animals. Finally our data show that only in certain cases has pharmacological
      treatment been able to modify the influence of hypoxic conditions on the
      concentration of muscle metabolites, regardless of the age of the animals.

PMID- 2214891
TI  - Protein secretion by rat submandibular glands in response to isoproterenol, alpha
      methylnoradrenaline and clonidine during aging.
AB  - Changes in salivary volumes and the three types of proteins secreted by the
      submandibular salivary gland (SMG) of male rats at 3.5, 5.5, 8, 12, 13, 14, 15,
      19, 21 and 24 months of age in response to the beta 1-, alpha 1- and alpha 2
      adrenoceptor agonists, isoproterenol (IPR), alpha-methylnoradrenaline (alpha-mNA)
      and clonidine (Clonid), were studied and compared by measuring the weight and by
      isoelectric focusing electrophoresis with the Phast System on both the gradient
      pH 3.5-5 and 3.5-9 gels with silver staining. A protein (protein A, tentatively
      termed in this study) purified by FPLC from saliva elicited by IPR was also
      analyzed by SDS-polyacrylamide gel electrophoresis, the immuno-thermoblotting
      method, carbohydrate determination and neuraminidase treatment. Unexpected
      findings were observed that salivary volumes, but not the protein concentration,
      were substantially increased by Clonid-, but not IPR-, stimulation with ages up
      to 24 months of age and that the three types of proteins elicited by each agonist
      were different during aging. The gamma-type of proteins elicited by Clonid was
      not greatly changed during aging, whereas several proteins at about neutral pI in
      the alpha-type, elicited by alpha-mNA, at 5.5 to 21 months of age and a protein A
      in the beta-type, elicited by IPR, at 13 to 24 months of age were greatly
      increased. This protein A without any carbohydrate and sialic acid, located only
      in the acinar cells, but not in any duct system, had a molecular weight of 16,000
      and a pI of 4.05. We conclude that the secretory function of the SMG in the aged
      animals is in general little changed.

PMID- 2214892
TI  - Longitudinal Gompertzian analysis of adult mortality in the U.S., 1900-1986.
AB  - Analysis of mortality data for the United States from 1900 through 1986
      demonstrates near perfect Gompertzian mortality rate distributions for adult
      American men and women. In the U.S. between 1900 and 1986, annual age-adjusted
      mortality rate distributions were determined by a fixed common intersect point
      (for men, the mortality rate at age 87.41 years was 18,810/100,000; for women,
      the extrapolated mortality rate at age 108.69 years was 75,365/100,000) and a
      variable environmental factor. Despite living in the same environment, the
      environmental factor contributing to adult mortality is at present significantly
      less for women than men. However, analysis predicts that in an environment less
      conducive to human survival than has existed in the United States during this
      century, the environmental factor contributing to adult mortality was less for
      men than women. The study further implies that as the environment becomes more
      favorable for human survival, men will experience an effective lowering of their
      theoretical maximal life span toward a limit of 87.4 years. The calculated
      maximal life span for men has already decreased 7 years during this century. This
      negative effect of a more favorable environment also occurs in women, although
      the theoretical maximal life span in women is lowered only toward a limit of
      108.7 years.

PMID- 2214894
TI  - Clonal lifespans cultured in chemically defined medium and conventional
      bacterized medium in Paramecium octoaurelia.
AB  - The unicellular ciliate, paramecium, reproduces by binary fission, but can not
      continue to divide unlimitedly without sexual reproduction. We examined the
      clonal life span of Paramecium octaurelia stock 299 cultured in conventional
      bacterized medium (BM) and a chemically defined medium (DM). The cells that lived
      in BM divided 300 times. Although the cells in DM divided more slowly, some cells
      continued to divide more than 100 times. The mean life span of 90 cell lines
      cultured in BM was 151 +/- 49 fissions and that of 84 cell lines in DM was 68 +/-
      28. When some older cells, which had been cultured in DM, were transferred to BM,
      most of them showed much longer life spans than those remaining in DM. The
      results showed that the life spans of cell clones were affected by the culture
      conditions.

PMID- 2214893
TI  - Ageing of procaryotes. Acholeplasma laidlawii as an object for cell ageing
      studies: a brief note.
AB  - It was established that A. laidlawii cell viability in the stationary phase of
      culture development decreases according to the Gompertz law. It was shown that
      the "stationary" ageing of A. laidlawii cells is accompanied by the lower
      intensity of phosphorus-containing compounds biosynthesis, decreased rate of
      membrane proteins synthesis and degradation and also by accumulation of DNA
      single-strand breaks. The biochemical changes found in ageing A. laidlawii cells
      are similar to ageing manifestations of resting eucaryotic cells. According to
      the authors opinion, the received data show that the A. laidlawii cell culture
      may be used as an object for investigation of the cell ageing mechanisms.

PMID- 2214895
TI  - Patient judgements of hospital quality. Report of a pilot study.

PMID- 2214896
TI  - Patient judgments of hospital quality. A taxonomy.

PMID- 2214897
TI  - Patient judgments of hospital quality. Pilot study methods. Design of study.

PMID- 2214898
TI  - The Patient Judgments of Hospital Quality (PJHQ) Questionnaire.

PMID- 2214900
TI  - The PJHQ questionnaire. Exploratory factor analysis and empirical scale
      construction.

PMID- 2214899
TI  - Patient judgments of hospital quality. Response to questionnaire.

PMID- 2214901
TI  - Further evaluations of the PJHQ scales.

PMID- 2214902
TI  - Patient evaluations of hospital care. A review of the literature.

PMID- 2214903
TI  - Patient judgments of hospital quality. Conclusions and recommendations.

PMID- 2214904
TI  - [Prevalence of nosocomial infections in Catalonia. II. Microorganisms and
      antimicrobial agents].
AB  - In the prevalence study of infections carried out in 33 hospitals from Catalonia
      in 1988, where 7,434 patients were included, information about the responsible
      microorganisms and the prescribed antimicrobials was collected (in addition to
      the data on community and hospital infections and risk factors) and is reported
      in the present article. The microbiological diagnosis was made in 43% of hospital
      infections and in 31.9% of community infections. Gram negative organisms
      predominated (57.3% of isolates in hospital and 46.5% in community infections).
      The most prevalent organisms in hospital infections were Escherichia coli and
      Pseudomonas aeruginosa; the most common Gram positive organisms were
      Staphylococcus aureus and Streptococcus faecalis. 31.7% of the studied patients
      received antimicrobials. The health care area with the highest prevalence was
      Intensive Care (46.6%), and General Surgery had the lowest one (26.8%). There
      were no significant prevalence differences between the three types of hospitals
      depending on their size. The most commonly used antimicrobial was gentamicin. The
      empirical indication rate was remarkably high (58.6%), the rate of antimicrobials
      with a specific indication was low (16%), and the rate of use of prophylactic
      antimicrobials was high (25.4%). There also was a remarkable disparity and
      extension of the types of drugs used.

PMID- 2214905
TI  - [Features of Paget's disease of bone in a new high-prevalence focus].
AB  - We report the features of a group of 41 patients with Paget's disease (PD) who
      were identified in a cross sectional study in the "Sierra de la Cabrera"
      (Madrid). As the screening test, we used serum alkaline phosphatase
      quantification, and the diagnosis was confirmed by radiological study. This
      biochemical parameter shows an excellent diagnostic performance, with a
      sensitivity of 98% and a specificity of 85%. The prevalence in the population
      over 40 years of age is 6.37% (95% CI 4.79-7.95) which, comparing it with that
      from other areas, suggests that this region is a "focus" of PD. 51% of cases had
      the characteristic symptoms of the disease, bone pain being the most common
      (44%). We compared the abnormalities in the patients with those of a control
      group with strictly comparable features, and we found that bone deformity (34%)
      and a localized increase in skin temperature (27%) were the most discriminative
      data, while cranial symptoms (26%) were nonspecific. Cataracts and actinic
      keratosis were associated with PD in the crude analysis (p less than or equal to
      0.01). When age was controlled for, the statistical significance of cataracts
      disappeared, whereas that of actinic keratosis was maintained (odds ratio 4.08, p
      less than or equal to 0.01). A high family incidence was found, with 15 proven
      cases (36.5%) in 6 families. Apart from a marked increase in alkaline phosphatase
      (mean: 407 mU/ml), other abnormalities or biochemical differences with the
      control were not found. These results suggest an interaction of genetic and
      environmental factors, and is wholly consistent with the multifactorial
      etiological hypothesis of PD.

PMID- 2214906
TI  - [High incidence of ampicillin resistance in Salmonella spp non typhi].
AB  - Salmonella spp non typhi is a common cause of gastroenteritis and, more rarely,
      extraintestinal infections in humans. The type of syndrome determines the choice
      and duration of antibiotic therapy. Extraintestinal infections by this organism
      require correct antibiotic therapy. In the present study, the susceptibility to
      antibiotics of 59 strains of Salmonella spp non typhi from clinical sources,
      isolated during a period of three and a half months, were evaluated. Fifty one of
      them were S. enteritidis, 7 S. typhimurium and 1 S. schwarzengrund. A high
      frequency (45.8%) of resistance to ampicillin (MIC greater than 256
      micrograms/ml) was found. Other antibiotics had good or excellent in vitro
      activity: 90% of strains were sensitive to tetracyclines, 93% to chloramphenicol,
      97% to co-trimoxazole, and 100% to cefotaxime and ciprofloxacine. It was
      concluded that the high frequency of ampicillin resistance to ampicillin
      precludes its use as first choice antibiotic in our area for suspected
      extraintestinal infections caused by Salmonella spp non typhi.

PMID- 2214907
TI  - [Epidemiology of type 1 diabetes mellitus. A way to its prevention?].

PMID- 2214908
TI  - [Diving accidents. 2. Respiratory barotrauma: a pulmonary over-pressure
      syndrome].

PMID- 2214909
TI  - [A 31-year-old woman with a tumor mass in the left leg].

PMID- 2214910
TI  - [Morphological differences in the vascularization of tuberculoma and tuberculous
      brain abscess].

PMID- 2214911
TI  - [Symptomatic hypomagnesemia in a patient treated with cisplatin].

PMID- 2214913
TI  - [Neoplasms associated with chronic lymphatic leukemia].

PMID- 2214912
TI  - [Secondary prevention of pneumocystis carinii pneumonia by intravenous
      pentamidine].

PMID- 2214914
TI  - [Prevalence of infections and use of antimicrobial agents in a district
      hospital].

PMID- 2214915
TI  - [Symmetrical peripheral arthritis as expression of multiorgan extrapulmonary
      tuberculosis].

PMID- 2214916
TI  - HyperShell: an expert system shell in a hypermedia environment--application in
      medical audiology.
AB  - HyperShell is an expert system shell developed in a hypermedia environment.
      Several artificial intelligence techniques such as frames and semantic networks
      are used in an original interpretation to enhance the interaction between the
      user and the program. The typical navigation tools of hypermedia such as
      clickable buttons and text search are extended to the semantic structure of
      HyperShell, creating a set of new tools. Examples from a medical expert system
      (Audex HM) developed in HyperShell are described.

PMID- 2214917
TI  - Variables processing in expert system building: application to the aetiological
      diagnosis of infantile meningitis.
AB  - We describe a method for the analysis and quantitative synthesis of information
      in a clinical data file using as an example the aetiological diagnosis of
      infantile meningitis. The results obtained together with the qualitative
      knowledge of experts in the field have enabled an experimental system to be
      constructed. This is performing sufficiently well to be introduced into a
      hospital environment to assist young doctors facing an emergency situation.

PMID- 2214918
TI  - Detection of the B waves in the oscillation of intracranial pressure by fast
      Fourier transform.
AB  - Intracranial pressure (ICP) oscillation consists of a cardiac-induced component,
      a respiration-induced component and fluctuation of the base level of ICP.
      Lundberg reported three types of fluctuations of the base level of ICP with
      increasing ICP which were referred to as A, B and C waves. Computer algorithms
      for sampling, processing and displaying ICP data were investigated to depict the
      power spectrum of ICP oscillations by fast Fourier transform (FFT), thus enabling
      the B wave to be automatically detected. A power peak was found in the ICP power
      spectrum between 30 and 120 s, which corresponds to the frequency of the B wave.
      The maximum power, corresponding to the B-wave amplitude was above 0 dB. An
      appropriate sampling interval for FFT inputs was about 8 s for real-time
      processing of the ICP data. The mean ICP value was found useful for making the B
      wave peak clearer by reducing the cardiac and respiratory components of ICP
      oscillations; the window function had no effect on B-wave detection in the ICP
      power spectrum.

PMID- 2214919
TI  - Robust multivariate methods in laboratory techniques and in assisting medical
      diagnosis.
AB  - The usefulness of robust multivariate methods in medical applications, for
      example, the indirect estimation of total lung capacity by robust regression and
      the assistance of medical diagnosis in obstructive airways disease using robust
      discriminant functions, is discussed. The results of robust methods that consist
      in downweighting the influence of the multivariate outliers are compared with the
      outcomes of classical procedures. The advantages of modern robust algorithms are
      proved in the present study. It is planned to include the methods in the system
      for the computerized consulting unit for respiratory diseases that is being set
      up in Wroclaw.

PMID- 2214920
TI  - Graphical output of health testing data.
AB  - A new indicator to evaluate the health status of an examinee by computerizing
      selected health screening data has been devised and designated as a disease
      score. By employing such an index, it is possible to display to some extent the
      functional status of organs in simple, easily understood, computer-generated
      cartoons. Thus a computer program has been developed for a desk-top personal
      computer to calculate the disease score index from screening data and to generate
      an output in an easily understandable graphic and pictorial format. The disease
      score index with a graphic display (i.e., a disease map), a score graph and short
      comments are incorporated in the report form. This type of output should be
      especially useful in communicating with subjects who are screened and in helping
      them to understand selected aspects of their own state of health better. The
      index could also be helpful in screening and selecting subjects who require
      further detailed clinical examinations but this assumption needs full clinical
      evaluation to prove its efficacy.

PMID- 2214921
TI  - A menu-driven knowledge base browsing tool.
AB  - Conventional computer-assisted medical decision-making systems have had limited
      impact on routine clinical practice. This has stimulated an alternative approach
      to the utilization of medical knowledge bases. Centering on the storage and
      retrieval of medical information, it aims to provide clinicians with computerized
      medical reference systems. In this paper we describe the development of a
      prototype menu-driven browsing tool, which allows clinicians to browse through
      the contents of a knowledge base in a number of ways. Operations include
      interrogation via disease classes, names or attributes; hierarchical display of
      all or part of a disease profile; printing of a disease profile; construction of
      differential diagnosis lists and comparison of two diseases. We discuss how the
      use of a menu-driven interface can help to overcome some of the problems
      encountered with previous designs of medical reference systems.

PMID- 2214922
TI  - [Angioimmunoblastic lymphadenopathy with dysproteinemia. The first reported case
      at the "Santo Tomas" Hospital].
AB  - Description of the first case of angio-immunoblastic lymphadenopathy with
      dysproteinemia diagnosed in a male patient 64 years old and which preceded the
      development of a lymphoma. The importance of this study is the association that
      may exist between certain drugs and the development of angioimmunoblastic
      lymphadenopathy, which occurred in our patient with the use of diphenylhydantoin.
      This disease can present itself up to 22 years after exposure to the agent.

PMID- 2214923
TI  - [Effect of minoxidil on DNA synthesis in cultured fibroblasts from healthy skin
      or keloids].
AB  - A potential therapeutic role of minoxidil in fibrotic or sclerotic conditions,
      such as keloids, has been suggested on the basis of its reported ability to
      inhibit the proliferation of human dermal fibroblasts. We have studied the effect
      of minoxidil on 3H-deoxythymidine uptake in cultures of human dermal fibroblasts
      derived from lesional and non-lesional skin from patients with keloids. The
      effect of the addition of fetal bovine serum, plasma and growth factors (insulin,
      EGF, PDGF, FGF and beta-TGF) to the medium has also been studied. Minoxidil, at
      concentrations ranging from 500 to 1,000 microM., caused an increase in DNA
      synthesis, which was proportional to the initial degree of fibroblast activation.
      Concentrations higher than 1,000 microM. caused a cytotoxic effect. Some
      reservations arise on the potential therapeutic use of minoxidil in conditions
      characterized by increased fibroblast proliferation, given the narrow margin
      between activation of DNA synthesis and cytotoxicity we have found in our
      experimental model.

PMID- 2214924
TI  - [Evaluation of immune response in experimental sporotrichosis using T and B
      lymphocyte count].
AB  - The effector cells of the immune response are involved in the clinical course of
      bacterial, viral and mycotic infections. Previous publications have reported that
      some mycotic infections, including sporotrichosis, can produce a negative
      modulation of the immune response unfavorable for the host. In this work T and B
      lymphocytes capable to form direct and indirect rosettes respectively with sheep
      erythrocytes in gerbils with experimental sporotrichosis, were measured. It was
      found a significant rise in the number to T and B lymphocytes which means normal
      immunological reactivity. These results are not in accordance with the idea that
      sporotrichosis can depress the immune response of the host.

PMID- 2214925
TI  - [Multiple familial trichodiscoma].
AB  - Trichodiscomas are hamartomas of the pilar apparatus, and have been described
      alone or associated to other benign proliferations of the pilar complex. Two
      familial cases of trichodiscomas not associated to pilar alterations or systemic
      manifestations are described.

PMID- 2214926
TI  - [Tubular apocrine adenoma. Description of 4 cases].
AB  - We present four new cases of tubular apocrine adenoma. Clinical histopathological
      and ultrastructural findings are discussed. The presence of carcinoembryonic
      antigen (CEA) has been studied in three cases of tubular apocrine adenoma. This
      antigen was found predominantly in the lumen of the ducts and in the apical
      portion of the luminal cells. This pattern is similar to the distribution
      described in normal sweat glands and in other adnexal tumors.

PMID- 2214927
TI  - [Recurrent intertrigo as initial manifestation of histiocytosis X].
AB  - Letterer-Siwe disease is the acute and usually fatal form of histiocytosis X. We
      describe here a patient with this process, which serves as a reminder of the
      presenting features of histiocytosis X.

PMID- 2214928
TI  - [Amelanotic melanoma. Study of 18 cases].
AB  - The authors analyze a retrospective study of 18 cases of amelanotic melanoma,
      coming from 7 Departments of Dermatopathology, and 3 from private clinics in
      Brazil, during the period from 1980 through 1987. Nine of the 18 patients were
      men, and seven were women; 14 of the 18 were caucasian and 2 were blacks. Their
      average combined age was 56 years, varying from 24 years to 86 years. The average
      size of the lesions was 2.7 cm. and the location was: extremities = 7, thoracic
      wall = 5, upper limb = 2, and lower limb = 2. Only 2 cases included in this
      analyses, didn't have any other additional information about color, age, sex and
      location. The authors found that amelanotic melanoma is rare, in accordance with
      the literature. They point out, that the rarity or the lack of the melanic
      pigment within the tumors cells, makes the clinical diagnosis much more complex.

PMID- 2214929
TI  - [Perforating annular granuloma in an atypical location].
AB  - We report a case of perforating granuloma annulare characterized by a scare
      number of lesions, that were located around breast areola. The patient was a
      young female without personal or family remarkable history.

PMID- 2214930
TI  - [Treatment of condylomata acuminata using liquid nitrogen].
AB  - We treated 105 patients with anogenital warts with cotton swabs soaked in liquid
      nitrogen. 90.1% of the patients were cured, but recurrences were observed in
      19.5%. With this method we obtained better clinical results than those obtained
      with the cryoprobes system. Good results were obtained when the lesions were
      accessible for treatment, but neither the time of evolution nor the size
      influenced the cure.

PMID- 2214931
TI  - [Treatment of skin ulcer using oil of mosqueta rose].
AB  - Oil rose of mosqueta (Rosa aff. Rubiginosa L.) is a concentrated solution in
      linoleic (41%) and linolenic acid (39%), that offers benefit therapeutic effects
      in the wound healing. Ten patients affected of leg ulcers and post-surgical
      wounds were treated by 26% oil concentrated rose of mosqueta with very notable
      improvement on its healing compared with the control group. Due to the lack of
      side effects, we believe rose of mosqueta oil is very usefull to these
      conditions. Mechanism of actions and others indications are discussed.

PMID- 2214932
TI  - [Apocrine nevus].
AB  - We present the case of a 32-year-old woman with a congenital lesion on her left
      cheek that histopathologically was composed of numerous mature apocrine glands.
      The diagnosis of pure apocrine nevus, a rare lesion of that our case probably
      represents the sixth described in the literature, was made.

PMID- 2214933
TI  - [Skin and ungual pigmentation caused by ftorafur].
AB  - We report the case of a sixty-seven-years-old male diagnosed of a gastric
      adenocarcinoma that presented brown pigmentation in the dorsal of his both hands
      and fingernails while being on treatment with ftorafur, an analogous of 5
      fluorouracil. To our knowledge this side effect has not been previously reported
      for ftorafur.

PMID- 2214934
TI  - [Pedal papules in newborn infants].
AB  - Four cases of newborn children who presented pedal papules since birth, are
      reported. They showed the following features, different from the ones seen in
      adults: a solitary lesion, bigger size, localization on medial plantar region
      aspect of the heel, presence at birth, absence of an obvious piezogenic factor,
      physiopathogenic model that explains the development of lesions in adults, which
      are compared to those appearing in the newborn, are proposed.

PMID- 2214935
TI  - [Pseudoatrophic pityriasis versicolor].
AB  - The pseudoatrophic pityriasis versicolor is an atypical form of this disease with
      cutaneous atrophy provoked by the prolonged application of topical
      corticosteroids. The term "pseudoatrophic" is indicative of its reversible
      character.

PMID- 2214936
TI  - [Cystic lymphangioma].
AB  - A case of clinical and dermopathological characteristic cystic lymphangioma is
      reported. The atypical localization of the tumor and its delayed apparition were
      pointed out. A relation with any precipitating factor could not be established.
      Treatment was surgical remove.

PMID- 2214937
TI  - [Vascular nevus. A study of its frequency, types and course].
AB  - It is presented a prospective study of vascular nevus during a year, with the
      finality to know its frequency, types and evolution. In twelve months of study,
      we founded in 1,485 borns that 14.14% presented those lesiones salmon stain 86%,
      oport wine 1.35%, capilar hemangioma or in strawberry the 10.81%, cavernous
      hemangioma the 0.45% and mixed hemangioma the 1.35%. Where more frequent in
      females that in males as well as from the urban zone in almost more than the half
      of the cases. Dimensions were between 0 to 5 cm. range, 98% in salmon stain, 95%
      in strawberry hemangioma, 66.3% mixed hemangioma, 66.6% in oport wine stain
      distributed in the head in more proportion. There was salmon stain in the nape in
      61.7%, 15% in the forehead and in the superior eyelids 14.3%. The familiar
      antecedents of vascular nevus in brothers was of 4.76%, 5.71% in uncle, 2.98% in
      parents and 1.43% in grandparents. The evolution was not concluded because of
      desertion in almost the totality of patients, finalizing with only the 6.66%. Our
      findings are different from those published in the literature. The total
      frequency is more in our experience in salmon, oport wine stains and hemangiomas.

PMID- 2214938
TI  - [Cutaneo-visceral leishmaniasis: a new opportunistic infection in patients
      infected by HIV].
AB  - A HIV infected patient was admitted to hospital with fever diarrhoea and a
      cutaneous nodule on his left groin. Histopathological exam was diagnostic of
      cutaneous leishmaniasis. Subsequent exams disclosed Visceral Leishmaniasis. Three
      cycles of treatment (antimonials, pentamidine and metronidazole) were required
      for the clearance of lesions. The relation between immunosuppression and
      leishmania infection is commented and its role as an opportunistic pathogen is
      suggested. In these patients the infection takes a more aggressive course and has
      a worse response to the classic treatment with antimonials. These facts have made
      necessary the introduction of other alternative drugs.

PMID- 2214939
TI  - [Wells syndrome (3 cases)].
AB  - This report describes three cases of eosinophilic cellulitis (Wells' syndrome)
      observed during six years. In the author's opinion this condition is not
      frequent, but neither exceptional. A revision of clinico-pathological,
      etiopathogenic and therapeutics aspects is carried out.

PMID- 2214940
TI  - [Eosinophilic cellulitis (Wells syndrome)].
AB  - There is a 37 years old patient with a erythemato-nodular pathology on her lower
      limbs, which has relapsed during three years. The characteristics of the
      eosinophilic cellulitis are observed in the microscopic study. The clinical and
      laboratory attributes of this entity are discussed, according to the world
      medical literature.

PMID- 2214941
TI  - [Hypersensitivity in patients with Hebra's prurigo caused by flea bite].
AB  - The authors present a study of hypersensitivity of patients with Hebra's prurigo
      (HP) to feleabites. Thirty six patients were studied. With the results obtained
      the following conclusions are held: 1. Among the probable responsible factors
      found in the history of patients with HP, the flea bite is the principal factor.
      2. Almost all the patients with HP who were studied show hypersensitivity to flea
      bites. 3. With the flea bites on the patients with HP, one can observe the
      clinical and histopathology similarity of both the experimental and elementary
      lesions of the disease. 4. It was possible to show humoral antibodies in the
      serum of the patients with HP immunodiffusion technique to the 1:40 flea extract.

PMID- 2214942
TI  - [Idiopathic skin calcinosis with transepithelial elimination].
AB  - A case of universal cutaneous calcinosis developed without apparent cause is
      reported. It had an evolution towards epidermic perforation and was treated with
      aluminium hydroxide. A discussion was made on the rarity of the idiopathic
      calcinosis as well as on the interesting phenomenon of transepidermal
      elimination.

PMID- 2214943
TI  - [Sea-blue histiocytes in a patient with mycosis fungoides].
AB  - The syndrome of the sea-blue histiocyte is a multisystemic infiltration by a
      special kind of macrophages which contain a ceroid material within its cytoplasm.
      We report herein a patient with mycosis fungoides, hyperlipidaemia type IIB and
      sea-blue histiocytes on bone marrow. Moreover, the cutaneous histopathology
      showed focus of eosinophilic spongiosis, that have not been previously described
      in mycosis fungoides, as far as we know.

PMID- 2214944
TI  - [Subungual keratoacanthoma].
AB  - We present a case of subungueal keratoacanthoma. The tumor recurred three months
      after extirpation and didn't resolve spontaneously. The patient need a new
      surgery a year later. We revised the literature and comment the clinical and
      histological features that define this distinct entity and differentiate it from
      common keratoacanthoma and subungueal squamous cell carcinoma.

PMID- 2214945
TI  - [Systemic calciphylaxis and acquired perforating disease in a uremic patient].
AB  - We show the case of a patient suffering from a chronic renal failure in
      hemodialysis. He had a ischemic necrosis that was quickly progressive in his
      fingers and toes. It was necessary to amputate them. Diffuse vascular
      calcifications were recorded so radiologically than pathologically. PTH and
      phosphocalcic product were raised. Parathyroidectomy was practised with a quick
      initial improvement but immediately new distal ischemic lesions and keratotic
      papules with histologic perforation, that became necrosed, appeared in his
      buttocks and inferior extremities. The coexistence of acquired perforating
      disease and calciphylaxis in uremic patients has not been reported until now.

PMID- 2214946
TI  - [Dowling-Degos disease].
AB  - We report two cases of Dowling-Degos' disease, one affecting the vulvovaginal
      semimucose, and one associated to a terminal malignant neoplasia. We remark the
      importance of this knowledge in order to distinguish it from malignant acanthosis
      nigricans or other patterns of melanosis or lentiginosis when located within
      mucose or semimucose, specially at the genitals. All cases associated to
      malignant neoplasia described are emphasized. However Dowling-Degos' disease is
      considered to be a nonparaneoplasic genodermatoses, this association should be
      taken into account.

PMID- 2214947
TI  - Physicians at the Ottoman court.

PMID- 2214948
TI  - The anodyne necklace: a quack remedy and its promotion.

PMID- 2214950
TI  - Medical complications associated with security and control of prisoners of war in
      the ancient Near East.

PMID- 2214949
TI  - Wagner-Jauregg and fever therapy.

PMID- 2214951
TI  - Robert Pulvertaft's use of crude penicillin in Cairo.

PMID- 2214953
TI  - [The highest risk of sport injuries at school affects inactive children].

PMID- 2214952
TI  - The Eugenics Society archives in the Contemporary Medical Archives Centre.

PMID- 2214954
TI  - [Long-term lithium treatment has side effects].

PMID- 2214955
TI  - [Improved medical care, even if only for half of the population].

PMID- 2214956
TI  - [Mechanical ventilation at home: Multidisciplinary care is crucial for optimal
      treatment].

PMID- 2214957
TI  - [Remember the physiopathology when treating patients with chronic venous
      insufficiency].

PMID- 2214958
TI  - [Relationship between volume and results--does it exist in the Swedish vascular
      surgery?].

PMID- 2214959
TI  - [Separation of Siamese twins. Neither child was given preference].

PMID- 2214961
TI  - [A case of lethal theophylline poisoning. Slow-release preparation gave
      treacherous and late symptoms].

PMID- 2214960
TI  - [Sven-Ivar Seldinger. Severe attack of common sense resulted in a revolutionary
      catheterization technique].

PMID- 2214963
TI  - [SBU report: shockwave lithotripsy of renal stones is recommended. In the case of
      gallstones more clinical trials are necessary].

PMID- 2214962
TI  - [Dietary therapy in practice. Advice on food--more than just knowledge of human
      nutrition].

PMID- 2214964
TI  - [Falsified prescriptions--a widespread way of acquiring drugs?].

PMID- 2214965
TI  - [Comparison of 2 surveys: medical competence at the casualty departments in our
      country].

PMID- 2214966
TI  - [Ready-for-discharge patients--an unnecessary scourge?].

PMID- 2214967
TI  - [Heart-lung transplantation--indications, results, need].

PMID- 2214968
TI  - [Should normal short stature be treated with drugs?].

PMID- 2214969
TI  - [Bone lengthening in short stature individuals--not without problems].

PMID- 2214970
TI  - [Gastric tube insertion without discomfort of the patient].

PMID- 2214971
TI  - [Small changes in cancer mortality. Time for a bigger prevention drive?].

PMID- 2214972
TI  - [Preoperative calculation of eyeglass lens power after cataract surgery].

PMID- 2214974
TI  - [New medical therapy of neuroendocrine gastrointestinal tumors].

PMID- 2214973
TI  - [Leg lengthening--historical review and current techniques].
AB  - The techniques earlier used for leg lengthening were notorious for their
      complications, and as late as the 1960s some authorities would not consider
      lengthening unless amputation was the alternative. The method introduced by
      Wagner in the 60s had the advantage of a stable external fixation, permitting the
      patients to be mobilized. The drawback was that at least three operations were
      needed: external fixation and osteotomy, bone grafting and internal fixation,
      and, finally, removal of the plate. With the Ilizarov technique, no bone grafting
      is needed and bone lengthening up to at least 15 cm is possible. The main
      problems in leg lengthening are related to joints and soft tissue. Every surgeon
      performing leg lengthenings should be familiar with the possible problems and
      complications. He must establish very good relations with the patient and be
      ready to spend a considerable amount of time with the patient during the process.

PMID- 2214975
TI  - [Dyslexia, a serious disability].

PMID- 2214976
TI  - [The late effects of nuclear weapons will destroy the human immune system].

PMID- 2214977
TI  - [Health care in Australia. Easy, convenient and inexpensive to consult a
      physician].

PMID- 2214978
TI  - [Anamnesis and elimination are corner-stones in the diagnosis of hypersensitivity
      reactions].

PMID- 2214979
TI  - [Cholesterol screening in a healthy father of 4 children--an ethical dilemma for
      the district physician].

PMID- 2214980
TI  - [Medical examination for driver's licence. The government disagrees with medical
      experts regarding the driver's licence of insulin-dependent diabetics].

PMID- 2214981
TI  - [Basic medical education--who cares?].

PMID- 2214982
TI  - [400,000 donation cards for transplantation available in Sweden].

PMID- 2214983
TI  - [Laser--a well-established medical routine sometimes with doubtful applications].

PMID- 2214984
TI  - [Hepatitis B is less and less common in spite of the increased number of new
      HBsAg carriers].

PMID- 2214986
TI  - [While the number of carriers with hepatitis B is increasing the number of acute
      cases decline].

PMID- 2214985
TI  - [An electrochemical instrument ineffective for capillary blood glucose
      determination].

PMID- 2214987
TI  - [Measurement of smoking habits and other life style factors should be adjusted].

PMID- 2214988
TI  - [HBsAg positive children in child day care centers--experience from Gothenburg].

PMID- 2214989
TI  - [Self administration of antibiotics in traveller's diarrhea. Advantages are not
      in balance with the risks].

PMID- 2214990
TI  - [Cancer treatment can be "tailor-made" with laser surgery and photochemistry].

PMID- 2214992
TI  - [A conservative method of laser surgery for urinary tract tumors].

PMID- 2214991
TI  - [A successful laser method in vascular changes and post-cataract surgery].

PMID- 2214993
TI  - [Calcification was dissolved as sugar in hot water].

PMID- 2214994
TI  - [From knife to light beam for more conservative conization].

PMID- 2214995
TI  - [Swift development of neurology].

PMID- 2214996
TI  - [Almost 3 million fatal injuries are caused by accidents yearly].

PMID- 2214998
TI  - [Cefuroxime has a good effect in severe infections in children].

PMID- 2214999
TI  - [Is levamisole combined with fluorouracil efficient in colorectal cancer?].

PMID- 2214997
TI  - [How strong is the defense for dynamic psychology?].

PMID- 2215000
TI  - [Fear of boycott keeps companies from registering early abortion drugs].

PMID- 2215001
TI  - [Maidenhood--mostly a myth].

PMID- 2215002
TI  - [Early diagnosis of pons angle tumors can rescue the hearing].

PMID- 2215004
TI  - [Erythromycin caused liver injury and gallbladder inflammation].

PMID- 2215003
TI  - [Maternal health care must improve its tracing of hepatitis B virus carriers].

PMID- 2215005
TI  - [Glycosylated hemoglobin, a useful test in screening for diabetes mellitus].

PMID- 2215006
TI  - [Intrauterine infection an important cause of pregnancy complications].

PMID- 2215008
TI  - [May we live until retirement?].

PMID- 2215007
TI  - [Life situation is crucial for well-being of women after hysterectomy].

PMID- 2215009
TI  - [An inquiry on sexual habits among students causes concern for wider transmission
      of HIV].

PMID- 2215010
TI  - [Chemical structure of the Candida receptor is surveyed. A potential for
      treatment and vaccination].

PMID- 2215011
TI  - [The autopsy law and the probable cause of death].

PMID- 2215012
TI  - [After hysterectomy. Few postoperative complications. The sexual function is
      unchanged or improved].

PMID- 2215013
TI  - [Scleroma is a granulomatous infectious disease starting with diffuse respiratory
      tract symptoms].

PMID- 2215014
TI  - [Artificial insemination in involuntary sterility. A consensus statement against
      expert-based facts--IVF is banned, microsurgery praised].

PMID- 2215016
TI  - [A government survey and program of the medical society: tobacco policy in the
      1990's].

PMID- 2215015
TI  - [The man behind the syndrome. Hans Asperger and the unknown autism. The Asperger
      man--a reserved outsider exposed to enormous psychological strain].

PMID- 2215017
TI  - [Health situation in Eastern Europe is severe--is the gap between East and West
      going to diminish?].

PMID- 2215018
TI  - [Health care societies against the death penalty].

PMID- 2215019
TI  - [Trauma with septicemia. Time to reevaluate treatment with antibiotics?].

PMID- 2215020
TI  - [Chlamydia infection--a sexually transmitted disease in the shadow of AIDS].

PMID- 2215021
TI  - [New guidelines for the treatment of hypertension--what has really happened since
      the last time?].

PMID- 2215022
TI  - [European cooperation for health education in schools].

PMID- 2215023
TI  - [A revival of inhalation anesthesia. Reduced risk of liver toxicity].

PMID- 2215025
TI  - [Macular degeneration--a treatable disease?].
AB  - Age-related macular degeneration (AMD) is the most common cause of blindness over
      the age of 50. The patho-physiological changes and clinical findings in AMD are
      outlined. Recent findings indicate that some cases of AMD-related choroidal
      neovascularization can be successfully treated with argonlaser. These results are
      discussed from a Swedish perspective, and the need of a meticulous work-up is
      emphasized.

PMID- 2215024
TI  - [New discoveries in joint disease etiology. Biochemical markers are promising].

PMID- 2215026
TI  - [Transoral microsurgery as effective treatment of craniocervical diseases].

PMID- 2215027
TI  - [Trauma surgery in the USA (I): Many severe accidents--high working pace].

PMID- 2215028
TI  - [Trauma surgery in the USA (II): Restricted use of antibiotics in septic reaction
      after multiple trauma].

PMID- 2215030
TI  - [Medical ethics and ethical rhetoric--analysis of arguing makes the debate on
      ethics better].

PMID- 2215029
TI  - [Recommendations from a meeting of experts: treatment of urinary tract
      infections].

PMID- 2215031
TI  - Conservation surgery for glomus jugulare tumors: the value of early diagnosis.
AB  - The results of lateral cranial base surgery for glomus jugulare tumors are
      gratifying when normal anatomy and function can be preserved. The goal of
      conservation surgery is to preserve normal ear anatomy and cranial nerve
      function. In general, conservation surgery is tumor-size dependent. Thus,
      excellent states of functional recovery depend upon accurate early diagnosis.
      This paper reviews the technical aspects of transtemporal conservation skull base
      tumor surgery while also reviewing our experience with nearly 100 glomus jugulare
      patients. Adjuvants to early diagnosis will be highlighted from a review of
      presenting symptoms, clinical signs, and related diagnosis. Our objective is to
      provoke a high index of suspicion in physicians charged with the responsibility
      of diagnosing these tumors. Diagnostic guidelines are proposed.

PMID- 2215032
TI  - The location of the maxillary os and its importance to the endoscopic sinus
      surgeon.
AB  - As functional endoscopic sinus surgery continues to gain popularity and support,
      the necessity for a clear and accurate understanding of the anatomy of the
      ostiomeatal complex becomes essential. To clarify this anatomy, serial cadaver
      dissections were performed and the anatomy of the ostiomeatal complex was
      detailed in three dimensions, with an emphasis on precise localization of the
      internal os of the maxillary sinus as it relates to the orbit, natural antronasal
      canal, and ethmoid infundibulum. Measurements of the position of the internal os
      relative to the position of the anterior and posterior walls of the maxillary
      sinus and the position of the orbit were taken. The dimensions and configuration
      of the antronasal canal and its relationship to the infundibulum were also
      detailed. These measurements and relationships must be understood for an
      endoscopic sinus surgeon to locate the natural ostia without injuring the orbit.

PMID- 2215033
TI  - Surgery for sinusitis and aspirin triad.
AB  - An 11-year retrospective study was conducted to evaluate the surgical treatment
      of sinusitis in aspirin-triad patients. Twenty-five patients were selected for
      surgery when their sinus disease and asthma progressed despite intense medical
      treatment. Sixteen patients had radiographic evidence of severe ethmoid disease,
      and their initial surgical procedures were limited (i.e., bilateral intranasal
      ethmoidectomies). Of these 16 patients, 6 required subsequent surgery for
      recurrent sinusitis. Nine of the 25 patients had radiographic evidence of severe
      antral, as well as ethmoid, disease. Their initial surgical procedures were
      radical, i.e., bilateral Caldwell-Luc operations with intranasal and transantral
      sphenoethmoidectomies. None of these 9 patients required further surgical
      treatment for control. This review indicates that if antral and sphenoid disease
      are detected in association with ethmoid involvement, a radical surgical approach
      is the operation of choice.

PMID- 2215034
TI  - Local control of auricular, periauricular, and external canal cutaneous
      malignancies with Mohs surgery.
AB  - Three hundred ninety-seven patients with 407 cutaneous malignancies of the
      auricle, periauricular region, and cartilaginous external ear canal were
      reviewed. Tumors were most commonly located in the preauricular and postauricular
      regions, followed by the helix, concha, antihelix, and ear canal. All lesions
      were excised with Mohs microscopic control of margins. For lesions requiring
      lateral temporal bone resection, an adaptation of fresh-tissue microscopic
      control was used to analyze deep and anterior margins suspected of harboring
      residual tumor. Two-year minimum follow-up of 229 patients with periauricular and
      auricular tumors (N = 231 tumors) and 14 patients with cartilaginous ear canal
      tumors (N = 14 tumors) revealed recurrence rates of 6.9% and 14.3%, respectively.
      Recurrences were most common in cases of large tumors (greater than 2.5 cm),
      basal cell carcinomas with morphea elements, and multiply recurrent lesions. We
      conclude that Mohs surgery is comparatively effective, though not uniformly
      curative, and can be adapted to supplement excision of large tumors in these
      regions.

PMID- 2215035
TI  - Olfactory neuroblastoma: clinicopathologic and immunohistochemical
      characterization of four representative cases.
AB  - Olfactory neuroblastomas are rare tumors whose clinical prognosis is not
      predictable by assessment of initial stage or grade. The pathologic diagnosis is
      often difficult because of the wide range of the patient's age and histologies.
      In this report, we document that the diagnosis of olfactory neuroblastoma can be
      clarified by immunohistochemical demonstration of a unique antigenic profile that
      can be obtained in routinely processed biopsies. We describe four cases of
      olfactory neuroblastoma diagnosed and treated from 1979 to 1989, each confirmed
      by immunohistology. One of our patients was misdiagnosed twice at an outside
      institution, first as having nasopharyngeal carcinoma and then as having small
      cell, undifferentiated "oat cell" carcinoma. Despite accurate tumor diagnosis and
      appropriate therapy, we found that there was no apparent correlation of clinical
      outcome with Kadish clinical stage or histologic grade of tumor.

PMID- 2215036
TI  - Lidocaine in the middle ear.
AB  - Anesthesia of the ear canal is produced by injection of lidocaine hydrochloride
      into the skin of the lateral external ear canal. Ear canal, tympanic membrane,
      and middle ear surgeries are performed with this injection. The fluid found in
      the middle ear during tympanotomy was collected and analyzed. The percentage of
      lidocaine in the fluid was calculated by an enzyme immunoassay technique. Fifteen
      surgical cases were undertaken in which perilymphatic fluid in the middle ear
      would not be suspected, such as tympanotomy for otosclerosis. Lidocaine was found
      in all middle ears in which there was sufficient fluid to collect. The authors
      question the validity of using the presence of clear fluid in the middle ear,
      even with reaccumulation, as the sole criterion for identifying perilymph and
      cerebrospinal fluid.

PMID- 2215037
TI  - Managing segmental facial nerve injuries by surgical repair.
AB  - This report describes our experiences and evolving philosophy with regard to
      managing segmental facial nerve injuries. We present the results of 13 facial
      nerve repairs of traumatic injury to a segment of the facial nerve. All
      peripheral facial nerve branches contribute essential elements to normal mimetic
      facial movement; therefore, we recommend early, appropriate repair of the nerve
      segment. This recommendation is based on principles established for managing
      disruptions of the main trunk of the facial nerve. It offers the patient the
      chance for complete recovery of facial function.

PMID- 2215038
TI  - Effects of uvulopalatopharyngoplasty on sleep architecture and patterns of
      obstructed breathing.
AB  - In this retrospective study, 72 obstructive sleep apnea patients with
      polysomnograms taken before and after uvulopalatopharyngoplasty were evaluated.
      Postoperatively, there was a significant improvement of sleep architecture and
      respiratory indices. In addition, a second group of 17 patients also had position
      recordings with their polysomnograms. Time spent in supine and lateral sleep
      positions changed postoperatively. There was significant decrease of the apnea
      plus hypopnea index in the lateral position. This study indicates that there is
      significant improvement of sleep architecture and respiratory indices in the
      majority of patients after uvulopalatopharyngoplasty, particularly in the lateral
      sleep position.

PMID- 2215039
TI  - Imaging of pharyngeal and laryngeal carcinomas with indium-111-labeled monoclonal
      anti-CEA antibodies.
AB  - Localization of primary tumors, metastases, or recurrences in 13 consecutive
      patients with histological verification of squamous cell or adenocarcinoma was
      made with radioimmunodetection using monoclonal radiolabeled anti-CEA antibody.
      All surgical specimens stained immunohistochemically, except one, were positive
      for CEA. Of the known 19 tumor sites 17 were visualized in antibody scans. There
      were two positive findings that did not prove to be positive during 12 month
      follow-up. The scintigram findings did not correlate with CEA serum
      concentrations that, with one exception, were normal in all patients.

PMID- 2215040
TI  - The role of the facial nerve latency test in the prognosis of Bell's palsy.
AB  - Eighty patients with idiopathic facial nerve palsy were evaluated by the facial
      nerve latency test. Depending on the latency time, the patients were classified
      into the following four groups: group A patients had normal latency times (3.25
      msec); group B patients had slightly extended latency times (4 to 7 msec) and a
      mean of 5.6 msec; group C patients had extended latency times (10 to 14 msec) and
      a mean of 10.2 msec; and group D patients displayed complete disappearance of
      evoked compound muscle action potential (no responses). Under the same
      therapeutic regimen, it was determined that, when the latency time was normal or
      close to normal, the functional recovery of the nerve was complete or almost
      complete, and the recovery time was short. When the latency time was extended or
      there was no response, the functional recovery of the nerve was either incomplete
      or absent.

PMID- 2215041
TI  - Surgical therapy of the eyelids in patients with facial paralysis.
AB  - Patients with facial paralysis have a degree of lagophthalmos and paralytic
      ectropion. We present our experience in the surgical management of 25 consecutive
      patients treated for these problems. Paralytic lagophthalmos was corrected using
      gold weights inserted into the upper eyelid. The advantages and disadvantages of
      this surgical technique are reviewed. Medial canthoplasty and lateral
      canthoplasty were performed to rectify paralytic ectropion. Ancillary procedures
      included browpexy, upper-lid blepharoplasty, and temporalis sling. The results
      were excellent in 23 of 25 patients and good in the remaining two. After a
      minimum of 6 months' follow-up, there were no complications. The authors believe
      that the above procedures will yield consistently excellent cosmetic and
      functional results in patients with paralysis of the eyelids.

PMID- 2215042
TI  - Stapedotomy technique and results: ten years' experience and comparative study
      with stapedectomy.
AB  - Fifty of the 810 patients who underwent stapedotomy for otosclerosis from 1969
      through 1988 were randomly chosen for follow-up of at least 5 years. Most of the
      patients (65%) had follow-up of 10 years after stapedotomy, but another 50
      patients who underwent stapedectomy had follow-ups of longer than 10 years. In 50
      patients, stapedectomy under local anesthesia was performed by removal of the
      footplate of the stapes, using an endaural incision, and covering the oval window
      with Gelfoam. In the other 50 patients, stapedotomy was performed under general
      anesthesia, using an endopreauricular incision, making a small hole in the
      footplate, and covering the hole only with blood from the surgical area. Although
      both groups showed improvement in hearing after the operation, the air-bone gap
      in the stapedotomy group was significantly better than that in the stapedectomy
      group. The use of the endopreauricular incision under general anesthesia was
      preferable to endaural incision under local anesthesia because the operative
      field was wider, more convenient for the surgeon, and conducive to patient
      safety. There were no significant complications in either group.

PMID- 2215044
TI  - Clinical classification and staging for primary malignancies of the maxillary
      antrum.
AB  - A study of 51 patients with primary malignant maxillary sinus neoplasms was
      conducted. None of the patients had neck nodes and/or metastases, and each had 5
      year follow-up. The tumors were staged according to the 1983 and 1988 American
      Joint Committee on Cancer staging systems for maxillary sinus cancers. There were
      13 early stage (T1, T2) and 38 advanced (T3, T4) tumors in both systems. Cox
      regression analyses of survival curves showed increasingly worse prognoses for
      advanced tumors in both T-staging systems. Further analyses showed a significant
      difference in survival between T3 and T4 in the 1988, but not in the 1983 system.
      There were no significant differences in survival according to treatment modality
      or histological type of malignancy. We conclude that the 1988 system
      prognosticates successfully for T-stage (1 to 4) and demonstrates significant
      improvement in detecting T3 versus T4 differences compared to the 1983 system.
      The 1988 system applies equally for epidermoid cancer and other malignancies of
      the antrum.

PMID- 2215043
TI  - Endoscopic laser surgery for early glottic carcinoma: a clinical and experimental
      study.
AB  - The purpose of this study is to define the indications for using the CO2 laser
      for the treatment of early glottic cancer. For this purpose, 52 consecutive laser
      resections of Tis to T2 vocal cord carcinomas were studied prospectively. In
      addition, laser resection was performed in eight human cadaver larynges, which
      were then examined histologically using whole organ sections. Both tumor size and
      tumor location had important influences on tumor resectability by laser. All of
      the Tis, 78% of T1, and one of four T2 carcinomas were successfully treated by
      laser surgery alone. Of the 10 carcinomas involving the anterior commissure, only
      four could completely be resected with the laser; of these four, two recurred in
      the anterior commissure. This finding is corroborated by the histologic study,
      which clearly shows that anterior commissure resection poses problems. The only
      laser resection complication of early glottic cancer was persistent hoarseness in
      one third of the patients. It is concluded that CO2 laser resection is a safe and
      effective alternative treatment for patients with Tis and T1 glottic carcinoma,
      provided the anterior commissure is free of tumor.

PMID- 2215045
TI  - Gentamicin iontophoresis in the treatment of bacterial otitis externa in the
      guinea pig model.
AB  - Pseudomonas otitis externa is one of the most common infections treated by
      otolaryngologists. Infections induced in 30 guinea pigs appeared similar to that
      seen in humans. The ears were then placed into four treatment groups: group A,
      which received a single cleaning; group B, which received a single cleaning
      followed by gentamicin drops 4 times daily; group C, which received a single
      cleaning followed by a single gentamicin iontophoresis treatment; and group D,
      the control group, which received no treatment. Infections were analyzed by
      grading edema, purulence, and erythema. An average of 10.2 days was required for
      control group to return to normal appearance. Groups A, B, and C had mean
      resolution times of 5.9, 4.7, and 4.3 days, respectively. Gentamicin
      iontophoresis appears to be promising, with results as good as drop therapy in
      otitis externa in the guinea pig model.

PMID- 2215046
TI  - Verbal communication for the ventilator-dependent patient: voice intensity with
      the Portex "Talk" tracheostomy tube.
AB  - A patient's ability to communicate is critical to overall medical care,
      psychological functioning, and social interactions. Voice intensity levels
      produced by 20 patients with Portex "Talk" cuffed speaking tracheostomy tubes
      were investigated at three different airflow rates. Results indicated that
      audible and intelligible speech was produced with significantly greater intensity
      (P less than .001) over ambient room noise at 5 l/minute, 10 l/minute, and 15
      l/minute of airflow. Also, significantly greater voice intensity (P less than
      .001) was noted as airflow increased from 5 l/minute to 10 l/minute and from 10
      l/minute to 15 l/minute. The criteria, rationale, and importance of using a
      speaking tracheostomy tube with cognitively intact ventilator-dependent patients
      are discussed. The specific advantages and disadvantages of the Portex "Talk"
      tracheostomy tube are delineated. A case study is included.

PMID- 2215047
TI  - Data management without data managers: an effective standardized system of
      otolaryngologic operative reporting.

PMID- 2215048
TI  - A new method of needle-electrode placement in the posterior cricoarytenoid muscle
      for electromyography.
AB  - In 1979 the authors developed a new method of needle-electrode placement in the
      posterior cricoarytenoid muscle (PCA) for electromyography. The PCA muscle is
      easily reached by inserting a needle electrode through the cricothyroid membrane
      at the midline and penetrating the lamina of the cricoid cartilage in the
      subglottic cavity. Access to the PCA muscle for electrode insertion was best
      afforded by a percartilaginous approach. This report details the new technique
      used at our laboratory. To our knowledge, this is the first report of needle
      electrode placement in the PCA muscle by a percartilaginous approach. This new
      electrode insertion technique has been applied to more than 100 dogs for research
      purposes and to 1200 patients with laryngeal motor disorders for clinical
      diagnosis. This is a simple technique requiring the usual skills. Reliable
      electromyographic recordings have been obtained by this new method. No untoward
      effects, such as hematoma or infection from repeated placements were observed in
      approximately 3200 examinations performed to date. It is reasonable to assume
      that the percartilaginous route for electrode insertion in the PCA muscle is
      feasible in man. Techniques of electrode placement in the intrinsic laryngeal
      muscles are reviewed and compared.

PMID- 2215049
TI  - An improved stent method for choanal atresia repair.
AB  - Short intranasal stents secured sublabially have a number of advantages. They
      provide secure fixation without an external ligature across the columella. The
      short length of the stents allows them to sit only in the operative area where
      the atretic plate had been removed. This lessens the chance of intranasal
      syechiae formation and eliminates the possibility of erosion in the anterior
      septal and nasal alar region from pressure exerted by a stent. Since the stents
      do not protrude from the nose, they cannot be grasped by infants or young
      children and are not visible externally. School-aged children who have undergone
      repair of a unilateral choanal atresia can attend school without having to suffer
      the embarrassment of being teased about a tube protruding from the nose. When
      compared with other stenting methods, the posterior stent is more secure and less
      likely to become dislodged.

PMID- 2215050
TI  - Hearing levels of railroad trainmen.

PMID- 2215051
TI  - Non-ossicle homograft bone prostheses in the middle ear.
AB  - This thesis proposes the use of human cadaver non-ossicle temporal homograft bone
      as middle ear reconstructive material. Bone obtained from the otic capsule
      histologically resembles that of the ossicles more so than any other bone in the
      body. The otic capsule, due to its proximity to the middle ear, can be harvested
      with the middle ear structures when bone cores are obtained, making it easily
      accessible. These prostheses are cost effective because multiple prostheses can
      be sculptured from one temporal bone core. This paper further proposes the use
      and introduction of non-ossicle homografts in primary stapedectomy, as well as in
      selected cases to bypass the incus and the superstructure of the stapes.
      Audiological data is provided. Some of the grafts have been in the middle ear for
      up to 5 years. There have been no extrusions and no complications. The method of
      harvesting, preservation, and sterilization is presented, as well as a pictorial
      illustration of the finished product and its relation to the natural ossicles.
      One histological specimen is presented. On the basis of the audiologic results,
      as well as the fact that no ossicles have extruded and none have been resorbed,
      it is proposed that non-ossicle temporal bone homografts have a place in
      transplantation surgery.

PMID- 2215052
TI  - Dermatology--global planning in relation to leprosy management.

PMID- 2215053
TI  - Armauer Hansen Research Institute 1970-1990.

PMID- 2215054
TI  - The evolution of antibody response in armadillos inoculated with Mycobacterium
      leprae.
AB  - Plasma from 30 armadillos (Dasypus novemcinctus) was collected prior to
      inoculation and at approximately 3-month intervals for a period of 1-3 years.
      These animals were inoculated intravenously with 6.1 x 10(8) +/- 2 x 10(8) (x +/-
      SD) armadillo-derived Mycobacterium leprae. These samples were analysed for
      antibodies of IgM and IgG class to phenolic glycolipid-I (PGL-I) and to sonicated
      M. leprae components using ELISA and immunoblotting techniques, respectively. We
      had previously observed among a group of 11 armadillos, that some animals
      produced and maintained a high IgG antibody response to PGL-I. In this study, an
      animal's ability to produce and maintain an elevated IgG anti-PGL-I response was
      significantly correlated with their ability to delay dissemination of the
      infection and their ability to survive longer. When the animals were moribund, a
      significant decrease in the IgG anti-PGL-I absorbance value was observed. The
      detection of PGL-I in the plasma samples collected from moribund armadillos
      suggested that high concentrations of PGL-I in the plasma may have contributed to
      a drop in absorbance values by the formation of non-lattice-type immune complexes
      in vivo. As detected by immunoblotting, the IgM and IgG response to antigens
      derived from sonically disrupted M. leprae was directed towards molecules with
      broad bands of immunoreactivity ranging from 21- to 45-kDa. There were no
      distinguishing features of these antibody responses among armadillos as was
      evident with the IgG anti-PGL-I responses.

PMID- 2215055
TI  - Low-magnification electron micrography of leproma in human skin based on semithin
      and ultrathin sectioning.
AB  - Low-magnification electron micrography of leprosy lesions is described. The
      various cell types in the lesions, the relationships to leprosy bacilli and the
      distribution of bacilli in the lesions of lepromatous leprosy, are neatly
      demonstrated in the low-magnified pictures.

PMID- 2215056
TI  - Histoid lesion in nerve of a lepromatous patient.
AB  - This report pertains to a patient who had untreated diffuse lepromatous disease
      of 8- to 10-years' duration. Two peripheral nerves were beaded, which on biopsy
      showed histoid features. Because of its rarity, the case is reported.

PMID- 2215057
TI  - The anatomical distribution of single leprosy lesions in an African population,
      and its implications for the pathogenesis of leprosy.
AB  - Data on the anatomical sites of single leprosy lesions found in 635 newly
      diagnosed and biopsy-confirmed leprosy patients are presented. These patients
      were found during total population surveys carried out by the Lepra Evaluation
      Project, a prospective longitudinal study of the epidemiology of leprosy in
      Karonga District, Northern Malawi. There was a striking excess of single lesions
      on the face and the back of the arms, compared to the distribution of skin
      surface area, and a deficit on the legs, regardless of age. There is some
      evidence for a sex difference in lesion distribution among adults, with facial
      and arm lesions being relatively more common in females and back lesions being
      more common in males. The excess of lesions on the face compared to the lower
      limbs is similar to data from Uganda, but very unlike data from Burma and
      elsewhere in Asia. Overall, the distribution of lesions does not suggest a
      pattern reflecting entry of Mycobacterium leprae, nor does it suggest an
      association with anatomical distribution of the nervous or vascular system. It is
      argued that the distribution reflects the influence of some 'local' environmental
      or behavioural factors.

PMID- 2215058
TI  - Effect of treatment on immune responsiveness in lepromatous leprosy patients.
AB  - This study was performed in order to analyse whether the immune unresponsiveness
      to Mycobacterium leprae, largely seen in lepromatous patients, persisted after
      discharge from treatment. Lymphoproliferation and skin tests were performed using
      two mycobacterial antigens (M. leprae and BCG) in three groups of lepromatous
      patients grouped by treatment status. Forty-seven per cent of the lepromatous
      patients tested acquired reactivity to M. leprae after long-term treatment.

PMID- 2215059
TI  - Epidemiological pattern of leprosy in Ethiopia: a review of the control
      programmes.
AB  - Leprosy control started in a limited area of Ethiopia in 1956. Extended coverage
      of the country was achieved in the early seventies. Review of the data from the
      control projects since 1976 revealed that leprosy is a disease of the Ethiopian
      highlands where prevalence rates as high as 7 per thousand have been recorded in
      some provinces, while the cumulative national average for the last 13 years was
      2.6 per thousand. The paucibacillary form was predominant. However, unlike other
      African countries, a relatively high proportion of multibacillary leprosy was
      found in Ethiopia. The male-to-female ratio was 2:1 with the highest prevalence
      in the 15-44 years age bracket. Detection rates for new cases have shown a
      gradual decline since 1982, a year before multiple drug therapy (MDT) was
      introduced into the country. For the last 5 years the number of new cases has
      stabilized at 4700/year. These trends probably reflect a general reduction in the
      prevalence of leprosy in the country, while the conspicuous decline in 1982 is
      most likely related to discharge of cases during screening before MDT. The new
      villagization policy of Ethiopia with its effective reorganization of the
      populations is believed to make control programmes and supervision of MDT easier
      and presumably more effective. Similarly, more reliable prevalence and incidence
      studies could be undertaken with success.

PMID- 2215061
TI  - New cases of leprosy in the Cross River Region, Nigeria.
AB  - Rates of leprosy cases newly reporting during 1986 are examined for a region of
      south-eastern Nigeria. Figures reveal that in the part of the region which was
      designated in 1987 as a new state, half of the administrative units had new case
      reporting rates higher than in adjacent areas, while the other half had very few
      cases reporting in 1986. Possible explanations are offered and the implications
      of the pattern for leprosy control in the new state are examined.

PMID- 2215062
TI  - Clofazimine-induced lymphoedema.

PMID- 2215060
TI  - Carvable silicone rubber prosthetic implant for atrophy of the first web in the
      hand.
AB  - Muscular atrophy of the first web space in the hand is a common finding following
      ulnar nerve palsy and this deformity is very stigmatizing among leprosy patients
      in some countries and cultures. We present our experience with the carvable soft
      silicone rubber block implant to correct this deformity. We discuss the
      procedure, results and advantages over other techniques. Fifteen operations were
      performed at the 'Lauro de Souza Lima' Research Institute, Bauru, Brazil during a
      period of six years. One complication was encountered due to an implant that was
      too large. The results were considered good in twelve instances and fair in
      three.

PMID- 2215063
TI  - Protective footwear for leprosy patients: a rapid method for the cutting out of
      sandal components.

PMID- 2215064
TI  - Protective footwear for leprosy patients with loss of sole sensation: locally
      made canvas shoes, deepened for a 10-MM rubber insert.

PMID- 2215065
TI  - Comment: the use of histopathology in leprosy diagnosis and research.

PMID- 2215066
TI  - Comment: value of thermal sensibility testing in leprosy diagnosis in the field-
      field trial of a pocket device.

PMID- 2215067
TI  - Comment: rifampicin pharmacology.

PMID- 2215069
TI  - Secretion of platelet-activating factor by periovulatory ovine follicles.
AB  - Secretion of platelet-activating factor (PAF) in vitro by ovine follicles and
      ovarian interstitium obtained at various times before, during and after the
      endogenous preovulatory surge of luteinizing hormone (LH) and ovulation was
      quantified by radioimmunoassay. Release of PAF by the preovulatory follicle
      increased within 2 h after initiation of the surge of LH. Capacity for secretion
      of PAF was greatest at the time of ovulation, then declined thereafter.
      Production of PAF by ovarian interstitium throughout the periovulatory period was
      relatively low and did not change with time. It appears that PAF could act as an
      intrafollicular mediator in the mechanisms of ovulation and(or) luteinization.

PMID- 2215068
TI  - N-substituted derivatives of 4-piperidinyl benzilate: affinities for brain
      muscarinic acetylcholine receptors.
AB  - N-Substituted derivatives of 4-piperidinyl benzilate were synthesized and their
      affinities for central muscarinic cholinergic receptors determined using an in
      vitro radioligand binding assay. 4-Piperidinyl benzilate exhibited a Ki value of
      2.0 nM. N-Substitution with a methyl or an ethyl group increased the affinity to
      0.2 nM, whereas substitution with a n-propyl or isopropyl group decreased the
      binding affinity over 100 fold. Compounds with aralkyl substitutions at the
      nitrogen atom of piperidinyl benzilate were also synthesized and evaluated. The
      Ki values (nM) obtained for these compounds were: benzyl, 0.2; p-nitrobenzyl,
      13.0; p-fluorobenzyl, 3.0; phenethyl, 8.0; p-nitrophenethyl, 15.0. These data
      suggest that a binding region near the piperidinyl nitrogen may tolerate bulky
      aromatic substitutions (e.g., benzyl or phenethyl) as well or better than
      straight chain or branched alkyl substitutions (e.g., n-propyl or isopropyl).

PMID- 2215071
TI  - Effect of a synthetic platelet activating factor on steroidogenesis of cultured
      porcine granulosa cells.
AB  - An embryo-derived platelet activating factor has been demonstrated to play an
      important role in reproduction. This report examined the effect of various doses
      of a synthetic platelet activating factor on the production of progesterone by
      porcine granulosa cells in culture. Granulosa cells aspirated from ovarian
      follicles of prepubertal gilts were grown for 24 hours in Dulbecco's Modified
      Eagles Media: Ham's F-12 with 5% fetal bovine serum and 1 micrograms/ml insulin.
      Cells were washed once in serum-free media and then cultured for an additional 48
      hours with 0 to 5000 ng/ml of the platelet activating factor in media containing
      either 0.25% bovine serum albumin or 1% fetal bovine serum. Cells grown with
      fetal bovine serum produced 50% of the amount of progesterone that was produced
      in the absence of serum. Low doses of the platelet activating factor caused a
      slight decrease in progesterone production. Higher doses (greater than 500 ng/ml)
      in serum-free media caused a marked decrease in progesterone production. Serum
      had a protective effect at high doses of platelet activating factor which was
      probably mediated by enzymatic degradation of the platelet activating factor. In
      summary, platelet activating factor had no stimulatory effect on production of
      progesterone by porcine granulosa cells in culture.

PMID- 2215070
TI  - Prevention of immunosuppression in stressed mice by neurotropin(NSP).
AB  - It is well known that the immune function can be compromised by stress. To
      investigate immune function in mice stressed by experimental restraint or
      unavoidable and opioid dependent stress, we evaluated the changes in total body
      weight and in organ weights (liver, spleen and thymus) of these animals, as well
      as the phagocytic activity of macrophages, the cytotoxicity of T cells and
      inhibitory effects on tumor growth and changes in T cell subset populations. At
      the same time we evaluated the effects of Neurotropin (NSP), a substance
      extracted from the inflamed skin of rabbits inoculated with the vaccinia virus
      and which appears to possess neuroimmunomodulating activity. The experimentally
      stressed group exhibited a reduction of phagocytic activity of macrophages,
      cytotoxicity of T cells and inhibitory effects on tumor growth. In addition there
      were changes in the population of T cell subsets. In those animals pretreated
      with NSP, the immunosuppression induced by stress was ameliorated. As compared
      with several agents which influence phagocytosis, neurotropin exhibited effects
      similar to that of agents that blocked the adrenaline receptor and an opioid
      antagonist rather than tranquilizer (diazepam) and a cholinergic receptor
      blocker. The pharmacologic effects of neurotropin support a relationship between
      the actions of the central nervous system and the immune system.

PMID- 2215072
TI  - Antibodies to morphine in workers exposed to opiates at a narcotics manufacturing
      facility and evidence for similar antibodies in heroin abusers.
AB  - According to the International Narcotics Control Board, over 45,000 kg of
      morphine and 54,000 kg of codeine were ethically manufactured in 1986 at three
      facilities in the United States. Little information exists about possible adverse
      health effects associated with workplace exposure to opiate compounds in this
      industry. Because there are no specific federal standards for workplace exposure
      to narcotic dusts, exposure-control defaults to the nuisance dust standard (10
      mg/m3, as an 8 hr time-weighted average). Narcotics manufacturing workers were
      evaluated for anti-morphine IgG before and 10 mo. after the implementation of an
      improved respiratory protection program (RPP). Significantly elevated IgG levels
      were measured before the improved RPP (P less than 0.005). After the improved
      RPP, a significant reduction was observed (P less than 0.001), suggesting that
      specific antibody levels could be used as biomarkers of exposure. Inhibition
      studies showed that the antibodies were specifically directed against morphine
      with some cross reactivity with morphine derivatives. Preliminary results are
      also shown which indicate that similar anti-morphine antibodies are present in
      the sera of intravenous heroin abusers. Elevated levels (P less than 0.05) of
      anti-morphine antibodies were detected in sera from heroin abusers, providing
      evidence that similar antibodies may be produced from non-occupational exposure
      to opiates. These finding have potentially far-reaching implications for
      addiction research and drug testing.

PMID- 2215073
TI  - Hypoglycemic action of Salvia lavandulifolia Vahl. spp. oxyodon:a contribution to
      studies on the mechanism of action.
AB  - Having previously demonstrated the hypoglycemic action of Salvia lavandulifolia
      Vahl, subspecies oxyodon, the mechanism of action was further investigated. The
      hypoglycemic action may be the result of several synchronous mechanisms: a)
      potentiation of insulin release induced by glucose, b) increased peripheral
      uptake of glucose, c) decreased intestinal absorption of glucose and d)
      hyperplasia of the pancreatic islet beta cells (seen after chronic treatment).

PMID- 2215074
TI  - Brain corticotropin-releasing factor acts as inhibitor of stress-induced gastric
      erosion in rats.
AB  - Gastric lesions are known to be caused by stress. Corticotropin-releasing factor
      (CRF) is a key peptide initiating various stress response. This study was
      designed to investigate how brain CRF is involved in the occurrence of stress
      induced gastric erosion in rats. Intracerebroventricular (icv) administration of
      CRF suppressed the occurrence of gastric erosion induced by water-immersion
      restraint stress, and its suppressive effect was blocked by coadministration of a
      CRF receptor antagonist in rats. The peripheral administration of CRF had no
      influence on the occurrence of erosion. The icv administration of a CRF receptor
      antagonist or anti-rat CRF gamma-globulin increased gastric erosion induced by
      the stress. Ganglionic blockade with chlorisondamine, muscarinic blockade with
      atropine, or bilateral adrenalectomy by itself significantly inhibited the
      occurrence of stress-induced gastric erosion, and no additional effect of CRF on
      these treatments-induced inhibition of erosion was found. These results,
      therefore, suggest that the occurrence of stress-induced gastric erosion is
      mediated by the autonomic nervous system- and adrenal-dependent pathway, and that
      brain CRF reduces the occurrence of stress-induced gastric lesions by acting on
      its specific receptor within the central nervous system, probably through the
      autonomic nervous system- and adrenal-dependent mechanism.

PMID- 2215075
TI  - Dietary fat-induced changes in protein and carbohydrate selection are not
      explained by alterations in neuronal membrane fatty acid composition.
AB  - We previously showed changes in protein and carbohydrate selection in response to
      qualitative differences in dietary fat. Alterations in macronutrient selection
      were specifically related to changes in dietary saturated fat, but not to
      relative or absolute differences in dietary essential fatty acids. Three
      experiments were conducted to determine if changes in specific fatty acids in
      bulk phase neural membranes were associated with differences in macronutrient
      selection. For each experiment, specific fatty acid profiles were achieved by
      blending dietary fat sources. Rats consumed 20% (w/w) fat diets varying only in
      their fatty acid composition. After 2 weeks, rats were challenged with a
      selection paradigm. Each experiment showed a significant effect of dietary fat on
      neural membrane fatty acid composition (p less than 0.05) and alterations in
      individual fatty acids were correlated with changes in dietary fatty acids (p
      less than 0.05). However, dietary fat had no consistent effect with respect to
      which particular neural membrane fatty acids were modified, and there was no
      correlation between changes in specific membrane fatty acids and macronutrient
      selection. These findings suggest that alteration of specific fatty acids in bulk
      phase neural membranes do not mediate macronutrient selection behavior.

PMID- 2215076
TI  - Phosphorylation of chicken growth hormone.
AB  - The possibility that chicken growth hormone (cGH) can be phosphorylated has been
      examined. Both native and biosynthetic cGH were phosphorylated by cAMP-dependent
      protein kinase (and gamma -32P-ATP). The extent of phosphorylation was however
      less than that observed with ovine prolactin. Under the conditions employed,
      glycosylated cGH was not phosphorylated. Chicken anterior pituitary cells in
      primary culture were incubated in the presence of 32P-phosphate. Radioactive
      phosphate was incorporated in vitro into the fraction immunoprecipitable with
      antisera against cGH. Incorporation was increased with cell number and time of
      incubation. The presence of GH releasing factor (GRF) increased the release of
      32P-phosphate labelled immunoprecipitable GH into the incubation media but not
      content of immunoprecipitable GH in the cells. The molecular weight of the
      phosphorylated immunoreactive cGH in the cells corresponded to cGH dimer.

PMID- 2215077
TI  - Interaction between lipids and bovine brain calmodulin: lysophosphatidylcholine
      induced conformation change.
AB  - We have monitored the interaction of several lipids with the bovine brain
      calmodulin(CaM) and analyzed the effect of lysophosphatidylcholine(lyso-PC, 2-50
      micrograms/ml) on conformation of CaM and the interaction between CaM and CaM
      binding protein(CaMBP), using a fluorescence signal of 1
      (dimethylamino)naphthalene-5-sulfonate-labeled CaM(DNS-CaM). Lyso-PC(egg, 20
      micrograms/ml), among various natural lipids including phosphatidylserine(PS),
      phosphatidylinositol(PI), phosphatidylethanolamine (PE) and their lyso forms,
      greatly and dose-dependently enhanced the intensity of DNS fluorescence of DNS
      CaM in the presence (100 microM CaCl2) and absence (1 mM EGTA) of Ca2+. Apparent
      dissociation constants calculated from the fluorometric titrations of binding of
      lyso-PC to DNS-CaM were 0.6 and 3.7 micrograms/ml in the presence and absence of
      Ca2+, respectively. Lyso-PC remarkably prevented both trypsin-induced quenching
      of the fluorescence of DNS-CaM and tryptic digestion of native CaM in the absence
      of Ca2+. Enhancement of DNS fluorescence of DNS-CaM by CaMBP was observed only in
      the presence of Ca2+ and lyso-PC could further increase the fluorescence
      intensity of the complex. These all results suggest that lyso-PC can modulate the
      interaction between CaM and CaMBP as a result of its direct effect on
      conformation of CaM.

PMID- 2215078
TI  - Injected tryptophan increases brain but not plasma tryptophan levels more in
      ethanol treated rats.
AB  - In previous studies, long term treatment with ethanol has been shown to enhance
      brain 5-hydroxytryptamine 5-(HT) metabolism by increasing the activity of the
      regulatory enzyme tryptophan hydroxylase and or availability of circulating
      tryptophan secondarily to an inhibition of hepatic tryptophan pyrrolase. In the
      present study ethanol treatment given for two weeks decreased hepatic apo
      tryptophan pyrrolase but not total tryptophan pyrrolase activity in rats.
      Tryptophan levels in plasma and brain did not increase significantly. But there
      was a marked increase of 5-HT but not 5-hydroxyindoleacetic acid (5-HIAA)
      concentration in brain, suggesting a possible increase in the activity of
      tryptophan hydroxylase. The effect of a tryptophan load on brain 5-HT metabolism
      was therefore compared in controls and ethanol treated rats. One hour after
      tryptophan injection (50 mg/kg i.p.) plasma concentrations of total and free
      tryptophan were identical in controls and ethanol treated rats, but the increases
      of brain tryptophan 5-HT and 5-HIAA were considerably greater in the latter
      group. The results are consistent with long term ethanol treatment enhancing
      brain serotonin metabolism and show that brain uptake/utilization of exogenous
      tryptophan is increased in ethanol treated rats and may be useful to understand
      the role and possible mechanism of tryptophan/serotonin involvement in mood
      regulation.

PMID- 2215079
TI  - Effect of acute ethanol on beta-endorphin secretion from rat fetal hypothalamic
      neurons in primary cultures.
AB  - To characterize the effect of ethanol on the hypothalamic beta-endorphin
      containing neurons, rat fetal hypothalamic neurons were maintained in primary
      culture, and the secretion of beta-endorphin (beta-EP) was determined after
      ethanol challenges. Constant exposure to ethanol at doses of 6-50 mM produced a
      dose-dependent increase in basal secretion of beta-EP from these cultured cells.
      These doses of ethanol did not produce any significant effect on cell viability,
      DNA or protein content. The stimulated secretion of beta-EP following constant
      ethanol exposure is short-lasting. However, intermittent ethanol exposures
      maintained the ethanol stimulatory action on beta-EP secretion for a longer time.
      The magnitude of the beta-EP response to 50 mM ethanol is similar to that of the
      beta-EP response to 56 mM of potassium. Ethanol-stimulated beta-EP secretion
      required extracellular calcium and was blocked by a calcium channel blocker; a
      sodium channel blocker did not affect ethanol-stimulated secretion. These results
      suggest that the neuron culture system is a useful model for studying the
      cellular mechanisms involved in the ethanol-regulated hypothalamic opioid
      secretion.

PMID- 2215080
TI  - Effect of age on contractile response to angiotensin II in rat aorta.
AB  - The effects of aging on contractile response to angiotensin II and tachyphylaxis
      to it were investigated using aortic strips from rats aged 1.5, 4 and 22 months.
      Whether the endothelium was present or not, the contractile response to
      angiotensin II was greater and tachyphylaxis to it was less in 1.5-month-old rats
      than in 4- and 22-month-old rats. The differences between 4- and 22-month-old
      rats were not significant. Removal of the endothelium enhanced angiotensin II
      induced maximal contraction and depressed the tachyphylaxis, these endothelial
      effects being greater in 4- rather than in 1.5-month-old rats. When the
      contractile force of angiotensin II was adjusted to a similar level for 1.5- and
      4-month-old rats, the endothelial effect on the tachyphylaxis was greater in the
      4-month-old rats, but no significant difference was noted in the endothelial
      effect on the contractile force. These results suggest that during growth, the
      contractile response of rat aorta to angiotensin II decreases while the
      endothelial effect on it increases.

PMID- 2215081
TI  - Brain and cerebrospinal fluid uptake of zidovudine (AZT) in rats after
      intravenous injection.
AB  - Uptake kinetics of zidovudine into cerebrospinal fluid (CSF) and brain tissue
      were determined in adult Sprague Dawley male rats after single intravenous
      injection of 6.7 mg/kg (25 mumol/kg). The drug kinetics in plasma followed
      biexponential disposition with an initial distribution half-life of approximately
      11 minutes and an elimination half-life of 40 minutes. Over the plasma
      concentration range of 0.2 to 10 micrograms/ml, the cerebrospinal fluid to plasma
      ratio averaged 14.8 +/- 1.9% whereas the mean brain tissue to plasma ratio was
      8.2 +/- 1.2% (uncorrected) or 2.3 +/- 1.8% (corrected) for the brain vascular
      space contribution. Simultaneous nonlinear regression analysis of brain, CSF and
      plasma concentration data indicate that the overall rate constant for efflux of
      drug from brain is approximately 75-fold higher and from CSF is 8-fold higher
      than the respective rate constants for influx. Thus, the ratio of the efflux to
      influx appears to be the predominant factor in determining the net accumulation
      of drug into CSF and brain parenchymal tissue.

PMID- 2215082
TI  - Depletion of cardiac norepinephrine but not brain catecholamines by MPTP-N-oxide
      in mice.
AB  - After a single dose in mice, MPTP-N-oxide caused a dose-dependent depletion of
      cardiac norepinephrine which was similar although less pronounced than that
      caused by MPTP itself. After repeated daily doses, MPTP-N-oxide depleted cardiac
      norepinephrine, but did not deplete norepinephrine in the frontal cortex or
      dopamine in the striatum of mice. MPTP-N-oxide differed from MPTP, which depleted
      cardiac norepinephrine, cortical norepinephrine and striatal dopamine after
      repeated daily doses, but was similar to MPP+, another metabolite of MPTP, which
      depleted only cardiac norepinephrine. These data suggest that MPTP-N-oxide may
      contribute to the peripheral catecholamine-depleting effects after MPTP
      injection.

PMID- 2215083
TI  - The effect of SCH 23390 against toxic doses of cocaine, d-amphetamine and
      methamphetamine.
AB  - The effect of SCH 23390, a dopamine-one (D1) antagonist, in preventing acute
      toxicity induced by lethal doses of cocaine, d-amphetamine, and methamphetamine
      was studied in the rat. Animals were first pretreated with SCH 23390 (0.0, 0.5,
      1.0, and 2.5 mg/kg, i.p.) and then were challenged with cocaine (70 mg/kg, i.p.,
      an LD85), d-amphetamine (75 mg/kg, i.p., an LD95), and methamphetamine (100
      mg/kg, i.p., an LD90). SCH 23390 did not alter the incidence of stimulant-induced
      seizures compared to the vehicle controls. Significant protection against cocaine
      induced death was afforded only by the lowest dose of SCH 23390 tested.
      Significant protection against d-amphetamine-induced death was provided by all
      doses, with a dose dependent effect noted so that the incidence decreased from
      95% for vehicle to 30% (p less than or equal to 0.01) with 2.5 mg/kg SCH 23390
      pretreatment. No statistically significant reduction in the incidence of
      methamphetamine-induced death was seen with SCH 23390 pretreatment. The ability
      of SCH 23390 to protect against d-amphetamine, but apparently not against
      methamphetamine-induced death, suggests that different mechanisms of toxicity may
      exist between these drugs at high doses.

PMID- 2215084
TI  - Acetylcholine release detected by trans-striatal dialysis in freely moving rats
      correlates with spontaneous motor activity.
AB  - In vivo acetylcholine (ACh) release from the anterior, middle, or posterior
      striatum and the level of spontaneous motor activity were determined
      simultaneously using trans-striatal dialysis in freely moving rats. Spontaneous
      ACh release from the middle striatum was higher than from either the anterior or
      posterior striatum and correlated with the level of spontaneous motor activity.
      These findings indicate that drug-induced striatal ACh release could be modified
      by changes of the level of motor activity in freely moving rats.

PMID- 2215086
TI  - Hydrolysis of fluorescent pyrene-acyl esters by human pancreatic carboxylic ester
      hydrolase and bile salt-stimulated lipase.
AB  - Fluorescent esters containing pyrenedecanoic acid (P10) or pyrenebutanoic (P4)
      acid (P4cholesterol, P10cholesterol, P4- and P10-containing triacylglycerols)
      were synthesized and used as substrates for human pancreatic carboxylic ester
      hydrolase and bile salt-stimulated lipase from human milk. Both enzymes were
      purified by immunoaffinity chromatography. All fluorescent pyrene derivatives
      were hydrolyzed by pancreatic carboxylic ester hydrolase and bile salt-stimulated
      lipase, but at different rates. The hydrolytic rates of the "short" acyl esters
      (P4-containing esters) were higher than those of the "long" ones (P10-containing
      esters). Conditions were optimized for sensitivity of the assay using fluorescent
      cholesteryl esters. The pH optimum was 7.5-8.0. Sodium cholate exhibited a
      stronger activating effect than taurocholate or taurodeoxycholate (maximal
      activation was achieved with 5 mmol/L cholate and with a molar ratio cholesteryl
      ester/cholate around 1:10). Both pancreatic carboxylic ester hydrolase and bile
      salt-stimulated lipase from milk were strongly inhibited by the other amphiphiles
      tested, namely phosphatidylcholine and Triton X-100, and were inactivated by low
      concentrations (10 mumol/L) of the serine-reactive diethyl-paranitrophenyl
      phosphate (E600). Both enzymes were strongly inhibited by relatively low
      concentrations of plasma low density lipoproteins. These studies indicate that
      the fluorescent esters containing pyrene fatty acids can be used as substrates
      for assaying and investigating the properties of pancreatic carboxylic ester
      hydrolase as well as bile salt-stimulated lipase from milk.

PMID- 2215087
TI  - The association of lysophosphatidylcholine with isolated cardiac myocytes.
AB  - The ability of exogenous lysophosphatidylcholine to produce electrophysiological
      derangements and cardiac arrhythmias in the heart has been documented. The action
      of lysophosphatidylcholine is thought to be mediated via its association with the
      membrane. The present study examined the nature of the association of
      lysophosphatidylcholine with isolated rat myocyte membrane. The association was
      studied by incubating myocytes in a lysophosphatidylcholine-containing medium.
      The association of lysophosphatidylcholine with the myocyte sarcolemma was not
      affected by palmitic acid and glycerophosphocholine but was reduced by platelet
      activating factor (PAF). The addition of albumin (5 mg/mL) at the end of the
      incubation period effectively removed the lysophosphatidylcholine from the
      myocytes. Our results suggest that most of the lysophosphatidylcholine in
      isolated myocytes was associated preferentially with the outer leaflet of the
      myocyte sarcolemma. This type of association might be responsible for the
      lysophosphatidylcholine-induced electrophysiological alterations in the heart.

PMID- 2215088
TI  - Influence of dietary linoleic acid and trans fatty acids on the fatty acid
      profile of cardiolipins in rats.
AB  - Cardiolipins (CL) have unique fatty acid profiles with generally high levels of
      polyunsaturated fatty acids, primarily 18:2n-6, and low levels of saturated fatty
      acids. In order to study the effect of dietary fatty acid isomers on the fatty
      acid composition of cardiolipins, rats were fed partially hydrogenated marine
      oils (HMO), rich in 16:1, 18:1, 20:1, and 22:1 isomeric fatty acids, supplemented
      with linoleic acid at levels ranging from 1.9% to 14.5% of total fat. Although
      the dietary fats contained 33% trans fatty acids, the levels of trans fatty acids
      in CL were below 2.5% in all organs. The fatty acid profiles of cardiolipins of
      liver, heart, kidney and testes showed different responses to dietary linoleic
      acid level. In liver, the contents of 18:2 reflected the dietary levels. In heart
      and kidney, the levels of 18:2 also paralleled increasing dietary levels, but in
      all groups fed HMO, levels of 18:2 were considerably higher than in the reference
      group fed palm oil. In testes, the 18:2 levels were unaffected by the dietary
      level of 18:2 and HMO.

PMID- 2215085
TI  - Lipids in gap junction assembly and function.
AB  - Gap junctions (GJ) are important regulators of cellular function. They provide
      channels for the direct movement of small molecules between cells and thus
      control cell-to-cell transfer of metabolites and the transmission of various
      stimuli. Gap junctions have been shown to be involved in a multitude of cellular
      processes ranging from cell synchronization and neuronal function to cell
      differentiation and carcinogenesis. Much knowledge has been gained in recent
      years concerning the structure and molecular organization of GJ proteins; yet,
      the mechanisms that control and modulate gap junction assembly and function are
      still not well understood. Although it is quite apparent that the GJ proteins
      assemble in the lipid milieu of the plasma membrane, and that the cluster of
      proteins assembled in the junction do function in a lipid environment, there is a
      general paucity of information on the role of lipids in the gap junction assembly
      process and in the function of gap junctions. The present review is a
      comprehensive account of current knowledge on gap junction lipids. We also
      discuss what is known to date on the involvement of lipids in gap junction
      formation. Special emphasis is being placed on the potential role of membrane
      cholesterol in gap junction assembly and function.

PMID- 2215089
TI  - Synthesis and characterization of cytochrome P-450 epoxygenase metabolites of
      eicosapentaenoic acid.
AB  - Eicosapentaenoic acid, a major component of fish oil extracts, was recently shown
      to be metabolized to vicinal diol regioisomers by renal and hepatic cytochrome P
      450 epoxygenases. The diol products were also found in the urine of people
      ingesting fish oil. In the present report, we developed a chemical method of
      making milligram amounts of the epoxide intermediates and their diol products.
      Eicosapentaenoic acid was reacted with 0.1 eq. m-chloroperoxybenzoic acid for 15
      min. After normal- and reverse-phase high performance liquid chromatography plus
      capillary gas chromatography and electron impact mass spectrometry, the products
      were identified as 17,18-cis-epoxy-eicosa-5,8,11,14-tetraenoic, 14,15-cis-epoxy
      eicosa-5,8,11,17-tetraenoic, 11,12-cis-epoxy-eicosa-5,8,14,17-tetraenoic, 8,9-cis
      epoxy-eicosa-5,11,14,17-tetraenoic and 5,6-cis-epoxy-eicosa-8,11,14,17-tetraenoic
      acids. The total epoxide yield from eicosapentaenoate was 10% per incubation. By
      reincubating (cycling) the unused substrate 10-20 times, the total epoxide yield
      could be increased to 66-88%. Epoxide regioisomers were not produced in equal
      amounts; epoxygenation was facilitated as the distance between the target double
      bond and carbomethoxy group increased. Upon hydrolyzing the epoxides, the gas
      chromatographic retention times and mass spectra of the diol products were found
      to match those of biological metabolites. In addition, each of these standards
      was rapidly and quantitatively synthesized in an amount (milligram) adequate for
      biological tests.

PMID- 2215092
TI  - Streaming liver. VI: Streaming intra-hepatic bile ducts.
AB  - Thirty male adult rats, weighing 250-300 g, were injected with 0.5 muCi [3H]
      thymidine. The rats were killed in groups of five, at the following times: 1 h,
      14, 30, 60, 90 and 120 days. The livers were fixed in formalin, embedded in
      paraffin and cut into 5-microns-thick sections, which were then dipped into
      liquid emulsion for autoradiography. Bile ducts were evaluated in all portal
      tracts of a section. Obliquely cut bile ducts were excluded. The number of cells
      paving the duct lumen was defined as bile duct class. Class is roughly
      proportional to bile duct size. One hour after labelling, labelling index was
      3.39 +/- 0.06% (the second number is one standard error of the mean). With time
      it declined, reaching 0.22 +/- 0.15 on day 60. Initially labelled cells were
      found in narrow bile ducts and the mean labelled cell was located at class 7.48
      +/- 0.63. With time, labelled cells proceeded into wider bile ducts advancing
      daily 0.122 +/- 0.025 classes. Intra-hepatic bile duct epithelium renews its
      cells continuously in the same way as epidermis or gastro-intestinal mucosa do.
      It consists of two kinetic compartments, a progenitor (P) and a functional (Q)
      compartment. P feeds Q with cells.

PMID- 2215091
TI  - Mouse strain differences in susceptibility to sporidesmin-induced biliary tract
      injury.
AB  - Biliary tract injury was examined in four inbred strains of mice orally dosed
      with 500 micrograms of the fungal toxin sporidesmin. Semiquantitative
      histological analysis was used to assess the grade of necroinflammatory changes
      in the gall bladder, intra- and extrahepatic biliary tree and lobular parenchyma.
      Injury was greatest in the C57BL/6 and C3H strain mice and was least in SJL/J
      mice. In these strains injury was greatest at 4 days and had regressed by 10
      days. In BALB/c mice the damage, although similar to that in SJL/J mice at 4
      days, persisted at the same severity at day 10 and was accompanied by periductal
      fibrosis and occasionally by obliteration of ducts typical of sclerosing
      cholangitis. Analysis of the time-course of development of the lesions in C57BL/6
      mice showed that the primary target for the toxin is the biliary epithelium. The
      severity of the lesions within the liver increased centripetally and the worst
      affected ducts were found at the confluence of the lobar ducts with the common
      bile duct. The variation in the degree of damage and rate of healing between
      strains may be due to differences in sporidesmin excretion in bile or
      interactions with biliary epithelial cells and/or efficacy of protective cellular
      repair mechanisms.

PMID- 2215090
TI  - Uptake, incorporation and metabolism of (3H)triolein in the isolated perfused
      rabbit heart.
AB  - The purpose of these experiments was to study the uptake and metabolism of
      exogenous triglyceride in the isolated perfused rabbit heart. When infused into
      the rabbit heart, [9,10-3H(N)]triolein was retained and incorporated into a lipid
      fraction that had the chromatographic mobility of authentic triolein.
      Incorporation of labeled triolein was not likely to be the result of a
      lipoprotein lipase-mediated lipolysis/resynthesis cycle, since: (i) The
      distribution of radioactivity following administration of [3H]oleic acid was
      markedly different from the distribution of radioactivity following the
      administration of [3H]triolein; (ii) heparin was administered to the rabbits at
      the time of sacrifice; and (iii) the hearts were perfused with a protein-free
      buffer for 20 min prior to the labelling period. When isoproterenol was
      administered to hearts labelled with [3H]triolein, there was an increased output
      of total radioactivity, composed of labelled free fatty acids, diacylglycerol and
      monoacylglycerol. In these same hearts, there was an increased output of glycerol
      in response to isoproterenol. However, following the administration of bradykinin
      or angiotensin II, neither the radioactivity nor the glycerol content of the
      perfusate was changed. These data suggest that [3H]triolein is selectively
      incorporated into the triglyceride pool of the isolated perfused rabbit heart.
      Furthermore, this [3H]triolein is available to hormonally-activated lipolytic
      enzymes.

PMID- 2215093
TI  - Surecut 0.6 mm liver biopsy in the diagnosis of cirrhosis.
AB  - Liver biopsy with the 0.6 mm (23 gauge) Surecut needle was compared to
      conventional Menghini biopsy in the diagnosis of cirrhosis. Seventy-seven
      consecutive patients (mainly alcoholics) with a clinical indication for liver
      biopsy had both biopsies performed simultaneously. In 71 patients sufficient
      material for a morphological diagnosis concerning liver architecture was obtained
      with both biopsy techniques (Surecut insufficient in 5 cases and Menghini
      insufficient in 2 cases). The biopsies were classified as cirrhosis or non
      cirrhosis. There was agreement in 69 cases (97%, confidence limits 90-100%).
      Using the result of the Menghini biopsy as the final diagnosis, the predictive
      values for a positive and negative diagnosis for the Surecut needle were 96% and
      98%, respectively. There were no complications to either of the biopsies. It is
      suggested that the 0.6 mm Surecut biopsy may be used in the diagnosis of
      cirrhosis in cases where conventional Menghini needle biopsy is contraindicated.

PMID- 2215094
TI  - Liver disease among Polish alcoholics. Contribution of chronic active hepatitis
      to liver pathology.
AB  - A group of 70 chronic alcoholics--65 men and 6 women--has been studied. HBsAg was
      found in 11 (16%), and at least one marker of HBV infection was present in sera
      from 31 (44%) persons, these results being significantly higher than in a matched
      control population. The commonest single histological patterns were: steatosis
      (18 cases), and alcoholic hepatitis (18 cases), followed by normal liver (14
      cases) and chronic active hepatitis (12 cases). Cirrhosis was diagnosed in only 4
      cases. Five cases of chronic active hepatitis could be attributed to infection
      with HBV or HDV; in the remaining 7 cases the etiology was unclear. Infection
      with HBV seems to play an important role as the cause of liver disease among
      alcoholics in Poland, and chronic active hepatitis of various etiology may be an
      important form of liver pathology among them.

PMID- 2215095
TI  - Liver damage in juvenile inflammatory bowel disease.
AB  - During a 12-year period, 46 children and adolescents with inflammatory bowel
      disease were followed from the time of diagnosis with regular biochemical tests
      of liver function. Thirty-four patients had ulcerative colitis and 12 had Crohn's
      disease. Mean age at the time of diagnosis was 10.2 years (range 7 months-17
      years) and the mean follow-up period was 5.2 years (range 1-11 years).
      Pathological liver function tests were found in 60% of the 34 patients with
      ulcerative colitis: 9 of these 20 patients demonstrated more severe disturbance,
      usually at the time of diagnosis. Liver damage was most frequent in patients with
      total colitis. Liver biopsy was performed in eight patients, demonstrating
      "pericholangitis", fibrosis and in one case cirrhosis. Morphometry of electron
      microscopical pictures revealed a significantly increased number of lysosomes and
      dilated cisternae of the rough endoplasmic reticulum. ERCP was performed in two
      patients, verifying primary sclerosing cholangitis in one. Four of the 12
      patients with Crohn's disease had mildly pathological liver function tests. No
      correlation was found to the extent, duration or treatment of bowel disease. In
      our series of juvenile inflammatory bowel disease, liver damage occurred
      frequently, especially in ulcerative colitis. The more severe changes tended to
      coincide with the onset of bowel disease.

PMID- 2215096
TI  - Integrity of the cytoskeletal system is important for phagocytosis by Kupffer
      cells.
AB  - The mechanism of phagocytosis by Kupffer cells is believed to involve the Ca2(+)
      calmodulin system. However, the role of myosin in this system is still unknown.
      In this study, we found that myosin light chain kinase inhibitor (ML-9) inhibited
      phagocytosis by cultured Kupffer cells using polystyrene beads, a time-lapse VTR
      system and fluorescent staining techniques. The inhibitory effects of ML-9
      suggest that myosin may be involved in this complex cellular function and that
      the integrity of the cytoskeletal system is essential for normal phagocytosis.

PMID- 2215097
TI  - Study of plasma neuropeptide Y (NPY) and catecholamines levels during spinal
      anesthesia.
AB  - Plasma levels of neuropeptide Y (NPY) and catecholamines were investigated during
      spinal anesthesia. Ten ASA physical status I-II patients were studied after
      obtaining institutional approval and informed contents. All patients were free
      from endocrine and metabolic disease underwent elective low risk operation. No
      premedication was given before operation. Spinal anesthesia was performed on
      lateral position from L3-4 interspace with 15 mg tetracaine without added
      epinephrine. The analgesic level was about at T6 dermatone. Blood samples were
      obtained from radial artery catheter, 15 minutes before spinal anesthesia and 5',
      15', 30', 60', 120', during operative period and 30' after operation in
      postanesthesia recovery room. The results showed that there were significant
      elevation in plasma level of NPY during spinal anesthesia compared with the level
      before anesthesia. However, no statistically significant changes of plasma
      catecholamines were found.

PMID- 2215098
TI  - Suppression of hemodynamic change before extubation--lidocaine through modified
      endotracheal tube.
AB  - Twenty females, aged 31 to 49 years, scheduled for abdominal total hysterectomy
      were randomly divided into two groups in this study. An epidural catheter was
      placed at T11-12 before general anesthesia. All patients receive the combination
      of epidural anesthesia and general anesthesia for the operation and relief of
      pain postoperatively. The modified endotracheal tube we used is shown in Fig. 1.
      For patients in group I (Lidocaine group), 2 mL 4% lidocaine solution was
      injected through the catheter to desensitize the tracheal mucosa around the cuff
      after the surgeon had removed the uterus. In group II (Control group), no special
      management was made. All patients were not extubated until they were considered
      to be awake. Systolic blood pressure at three and one minute before extubation
      and pulse rate recorded at one minute before extubation showed in patients of
      group I were statistically smoother than those recorded in group II (p less than
      0.01). All patients had gag reflex just after awake extubation.

PMID- 2215099
TI  - Activation of epileptogenic activities by etomidate in
      electrocorticoencephalography (ECoG) during operation for epilepsy.
AB  - Epileptic surgery is a radical and ablative treatment for medically refractory
      epilepsy. Electrocorticoencephalography (ECoG) obtained by subdural strip
      electrodes should always be used during operation for precise localization of
      epileptic focus and mapping the extent of its involvement. But difficulties and
      ambiguities exist when the patient's ECoG is suppressed, either owing to the
      anticonvulsant used, being at the stage of posterictal period, or the effects of
      anesthetics during operation. Then, intentional activation of epileptogenic
      activity should be performed to locate the pathological focus in order to
      accomplish a successful surgical treatment. Etomidate has been considered as an
      abnormal electroencephalogram (EEG) activator and its use is not recommended in
      patients with epilepsy. But lesser dose of etomidate as an activator for ECoG has
      not been investigated. The study reported here established that etomidate as an
      hypnotic has not only anesthetic properties but, paradoxically, also activates
      epileptogenic activity. With the latter pharmacologic characteristic, etomidate
      can be used to deliberately activate the spikes of the potentially epileptogenic
      tissue, the delineation and localization of which may help the surgeon determine
      to what extent the pathological cortex be resected in surgical treatment of a
      refractory epilepsy. The current recommended dosage of etomidate at veterans
      General Hospital-Taipei for ECoG in epileptic surgery is 0.1-0.15 mg/kg/iv.

PMID- 2215100
TI  - Early detection of cerebral dysfunction by quantitative EEG during
      cardiopulmonary-bypass period for open-heart surgery.
AB  - Neuropsychiatric complications are well known risks of open heart surgery. In
      this regard cerebral damage is caused either by microembolism or insult from low
      perfusion pressure as a consequence of extracorporeal circulation. It seems
      probable that monitoring of the quantitative electroencephalography (QEEG) during
      the surgical procedure can help minimize the incidence of neurological sequelae
      through early detection. Moreover, it seems important to establish whether the
      pre-operative EEG has a predictive value for the possible neurological outcome
      and whether the post-operative EEG has conclusive value for the neurological
      outcome and, above all to ascertain whether the peri-operative QEEG contains
      information valuable on the diagnosis of final neurological outcome. To elucidate
      the feasibility of QEEG as a means to monitor the cerebral function a study was
      thus undertaken. Twenty-five ASA II-IV patients with age ranging from 25-79 y/o
      undergoing cardiac surgery under extracorporeal circulation were enrolled for
      study. The types of surgery varied from coronary artery by-pass graft (CABG),
      valvular replacement, and excision and grafting for aortic dissecting aneurysm.
      16-channel EEGs were recorded with a Cadwell Spectrum 32 in accordance with the
      international 10-20 system. 48 epochs (1 epoch = 2.5 seconds) of EEG recordings
      of pre-bypass and post-bypass periods were measured and quantitatively analyzed.
      Pre- & post-operatively, psychoneurological assessments were performed and
      correlated with the QEEG. The parameters employed in the study were absolute
      power, relative power, power asymmetry, and coherence. All the results of two
      session comparisons were transformed into z score values. Our preliminary study
      revealed that there exists a specific multivariate profile of QEEG for specific
      disease entity. And all the patients with z score less than or equal to 3.0
      turned out to be free from any significant sequelate.

PMID- 2215101
TI  - [Dose-response relationships of propofol in Chinese].
AB  - Propofol is a new intravenous anesthetic which possesses the rapid induction and
      recovery of anesthesia. It has been approved to be used in clinical anesthesia
      and critical care medicine since 1989. From the dose-response study of propofol,
      we can get the ED50 and induction dose of propofol and compare those with other
      anesthetics. Sixty young patients, ASA I-II, both sexes, were allocated into six
      groups of ten patients. All of patients did not receive premedicants. Groups I-VI
      were given intravenously over 25 sec 1.0 mg/kg, 1.2 mg/kg, 1.4 mg/kg, 1.6 mg/kg,
      1.8 mg/kg and 2.0 mg/kg, respectively. Blood pressure and heart rate were
      monitored and recorded before and 1 min, 3 min, 5 min after the injection of
      propofol. Induction of anesthesia by propofol is considered to be successful as a
      patient closes his eyes and does not response to simple command. As a patient
      obeys the order to open his eyes, he is judged to emerge from anesthesia.
      Induction and recovery times were recorded in each successfully-induced patient.
      Data were analyzed using Litchfield and Wilcoxon, and Student's t tests. The ED50
      of propofol was found to be 1.46 mg/kg (95% confidence interval: 1.35 mg/kg to
      1.58 mg/kg). Induction and recovery times at 1.0 mg/kg, 1.2 mg/kg, 1.4 mg/kg, 1.6
      mg/kg, 1.8 mg/kg and 2.0 mg/kg were 40 sec and 5.6 min, 38 sec and 6.0 min, 38
      sec and 6.2 min, 36.8 sec and 6.7 min, 36.3 sec and 7.2 min, 35.5 sec and 7.2
      min, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2215102
TI  - Sacroepidural analgesia for post-operative pain relief in children.
AB  - For evaluation of the practicality of epidural analgesia for alleviation of post
      operative pain, 66 class I or II patients with age ranging from 6 months to 12
      years undergoing elective surgical procedures below the lower abdomen were
      enrolled for study during the period from January to April 1989. Before
      termination of general anesthesia a single dose of 0.25% bupivacaine,
      respectively at 0.25 mL/kg (Ideal body weight), 0.5 mL/kg, 0.75 mL/kg, 1.0 mL/kg
      and 1.25 mL/kg was given sacroepidurally to 5 groups of patients. Our results
      showed that for surgery below the lower abdomen a dose at 1.0 mL/kg was
      sufficient to suffice the need for relief of post-operative pain. At this dosage
      it achieved a neural block up to T8-T6 and provided with an analgesia that could
      last 6.0 +/- 2.1 hours. During the entire course there were no untoward effects
      such as hypotension, bradycardia, vomiting and shivering to come about.
      Therefore, sacroepidural analgesia with 0.25% bupivacaine at fitting single dose
      is safe and feasible in children as far as relief of post-operative pain for
      procedures below the lower abdomen is concerned.

PMID- 2215103
TI  - [Infusion speed as a factor to influence the analgesic level of spinal anesthesia
      -hypobaric solution of tetracaine].
AB  - In spinal anesthesia, as known, the injection speed of local anesthetic drug is a
      factor which influences the analgesic level. For study it, automatic infusion
      apparatus was available to control as 5 kinds of infusion speed (0.02-0.51 mL/s),
      and 78 patients were divided into 6 groups. The results of the painless level was
      discussed by T-test and distribution analysis (F-test). The mean of painless
      level in each group was found to be no significant difference as discussed by T
      test. But the largest distribution was found in the group of 0.04 mL/s, and high
      analgesic level as rise up to T6 was occasionally found in groups of 0.04 mL/s &
      0.02 mL/s. It means, the infusion speed is not an important factor, but extremely
      slow infusion is more dangerous than high speed infusion, which will take a risk
      of high level spinal anesthesia.

PMID- 2215104
TI  - Rectal ketamine versus intranasal ketamine as premedicant in children.
AB  - The effects of ketamine administered per nasus (PN) or per rectum (PR) as pre
      anesthetic medication for day surgery was studied in 70 ASA class I children with
      age ranging from 6 months to 6 years. Before study they were divided into 3
      groups. Group A (n = 25) received no premedicant, while group B (n = 25) and
      group C (n = 20) received ketamine 6 mg/kg PR and 3 mg/kg PN as premedicant
      respectively. It was demonstrated that patients in group B and group C accepted
      the facemask during induction of anesthesia more willingly and peacefully than
      those in group A. In group B and group C there was accompaniment of analgesic
      effect seen postoperatively. The incidence of adverse reactions (nausea,
      vomiting, laryngospasm, salivation, respiratory depression) was low following the
      use of PR or PN ketamine although the children in these two groups emerged more
      belatedly from anesthesia and stayed in the post-anesthetic recovery room (PARR)
      for a longer time than in group A.

PMID- 2215105
TI  - Cardiovascular responses to tracheal intubation after thiopentone or propofol.
AB  - The hemodynamic responses to laryngoscopy and intubation were compared in forth
      patients of ASA class I-II undergoing various surgical procedures without
      premedication were randomly divided into two groups and given propofol (2.5
      mg/kg) or thiopentone (5 mg/kg) for induction, and succinylcholine (1.5 mg/kg)
      for facilitating laryngoscopy and intubation. Each group consisted 20 patients.
      Baseline data has no significant difference between the two groups. After
      induction systolic blood pressure (SBP), diastolic blood pressure (DBP), mean
      blood pressure (MBP) heart rate (HR), cardiac output (CO), cardiac index (CI)
      were all lower in the propofol group than thiopentone group. It indicate that
      propofol (2.5 mg/kg) has more cardiovascular depressive effects than thiopentone
      (5 mg/kg). Local injection pain was complained by every patient.

PMID- 2215106
TI  - Intrathecal morphine's effect on somatosensory impulses transmission-studied with
      posterior tibial nerve SSEP.
AB  - In order to investigate neurotoxic potential of spinally injected morphine
      solution, somatosensory evoked potential (SSEP) was utilized to detect the change
      of electrophysiologic activity of spinal neurons after long term application of
      intrathecal morphine. Eight patients received intrathecal morphine injection
      regularly after CHEMO-PORT implantation were studied with posterior tibial nerve
      SSEP. Patients received SSEP examination just before and right after first
      episode of morphine injection and were followed up at 30 minutes, 60 minutes, 2
      hours, 8 hours, and the 7th day and the third month of regularly injection. The
      results showed that there were no definite change of latencies and amplitudes of
      impulses generated by lumbar spinal cord (N22) and cortex (P40). We therefore
      suggest that electrophysiologic activities of spinal cord and cortex are not
      affected by chronic intrathecal morphine injection. Possible mechanism and
      proposed pathway of morphine's action were also discussed.

PMID- 2215107
TI  - Simple management of poor cervical progression during labor by continuous
      epidural analgesia.
AB  - A series of 112 primiparous parturients in labor with poor cervical progression
      were managed according to the double-lined labor nomogram. These patients all had
      labor progression beyond the alert line which were defined as poor cervical
      progression. Continuous low concentrated marcaine (0.125%) epidural analgesia
      were then offered to these indicated patients. These 112 poor labors were
      compared with 143 poor cervical progression labors without epidural analgesia in
      terms of mode of delivery and maternal morbidities. The results showed a decrease
      in cesarean section rate in cases with epidural analgesia (20.5% vs 34.3%, p less
      than 0.05) but no increase use of instrumentation was noted, also, maternal
      morbidities were much less in epidural cases compared to poor labors without
      epidural analgesia (6 in 112 vs 19 in 143, p less than 0.05). Continuous epidural
      analgesia performed on labors with poor progression improved the labor outcome
      and decrease maternal morbidities satisfactorily.

PMID- 2215108
TI  - Epidural anesthesia for spine surgery.
AB  - Over the last 2 years, the authors have had experience with epidural anesthesia
      for a variety of spine operations in 20 patients. It is proved to be safe,
      reliable, and effective. Perioperative complications were minimal and could be
      easily treated. No patient had a new neurologic deficit as a result of the
      epidural technique. Thus, epidural anesthesia should not be excluded from the
      anesthesiologist's consideration simply because of the presence of spine disease
      or neurologic deficit.

PMID- 2215109
TI  - [Cerebral infarction after resection of epidermoid carcinoma of buccal mucosa
      under general anesthesia--report of one case].
AB  - A 60 year-old hypertensive male was operated with resection of epidermoid
      carcinoma of buccal mucosa. He was expired postoperation complicated with left
      middle cerebral artery infarction. The cerebral infarction may be induced by
      acute hypotension, improper position during operation and underlying disease
      associated with old age. Prevention methods included preoperative evaluation,
      immediately injection vasopressor when acute hypotension occurred during
      anesthesia, and avoidance of improper position to compress vertebral or carotid
      artery which may leading to cerebral perfusion insufficiency.

PMID- 2215110
TI  - Unexpected high level of epidural analgesia during labor--report of one case.

PMID- 2215111
TI  - Increased sensitivity to atracurium in a child with Duchenne's muscular
      dystrophy.

PMID- 2215112
TI  - Intraoperative malignant hyperthermia--report of one case.

PMID- 2215113
TI  - A suspicious malignant hyperthermia--report of one case.

PMID- 2215114
TI  - [Transfusion-induced severe allergic reaction--report of one case].
AB  - Recently, improved cross-matching techniques have reduced the frequency of
      adverse reactions of blood transfusion less the 2%, but allergic reactions (non
      hemolytic) occur in about 3% of patients receiving properly typed and
      crossmatched blood. Allergic reactions to blood or drugs administered during
      anesthesia represent an unpredictable and occasionally life-threatening event.
      When a severe allergic reaction develops, an aggressive and prompt treatment,
      including intravenous epinephrine, is necessary to minimize morbidity and
      mortality. We experienced a case of intraoperative shock due to blood
      transfusion. The case manifested with hypotension, tachycardia, cutaneous rash
      and bronchospasm during blood transfusion and then the aggressive treatment was
      given to resume normal vital signs. The rest of anesthesia and surgery as well as
      the recovery was uneventful and the patient was discharged on the 18th
      postoperative day.

PMID- 2215115
TI  - Treatment of intra-operative penile tumescence--report of six cases.

PMID- 2215116
TI  - Acute upper airway obstruction secondary to the retropharyngeal bleeding after
      pharyngeal punch biopsy.

PMID- 2215117
TI  - Necrotizing enterocolitis. Part II. Treatment and nursing care.

PMID- 2215118
TI  - [The clinical quality evaluation of radiopharmaceutical preparations for
      diagnostic use].
AB  - The authors issued some recommendations for assessment of new
      radiopharmaceuticals (RP) at the stage of clinical trials. The most decisive
      thing is to determine the clinico-diagnostic efficacy of a radiopharmaceutical
      and its safety. Direct extrapolation of the results of experimental investigation
      of biodistribution of labeled compounds on man was shown to be fraught with
      serious errors. Differences in RP pharmacokinetics necessitate a planned,
      methodologically correct and clinically substantiated study of a RP in selected
      groups of patients taking into account the functional purpose of a drug. The
      assessment of RP quality is based upon a study of functional suitableness
      resulting from pharmacokinetic data and the determination of optimum
      methodological conditions and safety of a new RP, including the calculation of
      radiation a patient is exposed to during a diagnostic procedure. The stages of
      clinical trials are given in detail, their unification is aimed at raising their
      quality and improved clinical assessment of a RP.

PMID- 2215119
TI  - Analexia nervosa: coping with the medical literature.

PMID- 2215120
TI  - Donations wanted for Soviet-American Exchange Program.

PMID- 2215121
TI  - Input technology.

PMID- 2215122
TI  - Coding: why and how.
AB  - Codes are used in every aspect of our daily lives, and many of the coding schemes
      in use are inappropriate, poorly implemented, or too fragmented in their
      coverage. This paper describes various approaches to coding, pointing out their
      strengths, weaknesses, and most appropriate applications. Those attempting to set
      up a coding scheme are strongly advised to analyze their needs, select the
      approach that is best for the application at hand, and carefully monitor the
      implementation of the coding system they choose. Only by understanding and
      monitoring our coding schemes can we minimize the amount of inappropriate and
      exasperating codes in our daily lives.

PMID- 2215123
TI  - Choosing an office computer: preliminary steps.

PMID- 2215124
TI  - CD-ROM products from CMC ReSearch.

PMID- 2215125
TI  - The seventh annual directory of medical hardware and software companies.

PMID- 2215126
TI  - Coding diagnoses with a microcomputer.

PMID- 2215127
TI  - Estimated creatinine clearance.

PMID- 2215128
TI  - [The prevention of fatigue in young children].

PMID- 2215129
TI  - [The problems of sex education among students].

PMID- 2215130
TI  - [The work experience of a general hospital].

PMID- 2215131
TI  - [The use of phonophoresis with ophthalmic drug films of apilak].

PMID- 2215132
TI  - [The characteristics of managing a repeat pregnancy and labor in women with a
      history of eclampsia].

PMID- 2215133
TI  - [Posttraumatic keratitis].

PMID- 2215134
TI  - [Cysts of the kidneys].

PMID- 2215135
TI  - [Sinusoidal modulated currents in the combined rehabilitation of patients after
      operations on the stomach for peptic ulcer].

PMID- 2215136
TI  - [The laser therapy of duodenal peptic ulcer in children].

PMID- 2215137
TI  - [Echoencephalography in clinical practice].

PMID- 2215138
TI  - [Patient care in a hemodialysis ward].

PMID- 2215139
TI  - [Static diseases of the foot].

PMID- 2215140
TI  - [The characteristics of the work of the nurse anesthetist when patients are
      admitted with severe combined trauma].

PMID- 2215141
TI  - [Therapeutic procedures in diseases of the ear, nose and throat].

PMID- 2215142
TI  - [Recipe cards on dietary dishes].

PMID- 2215143
TI  - [The incompatibility of antihistamine preparations with other drug agents].

PMID- 2215144
TI  - [Deontology in dental practice].

PMID- 2215145
TI  - [Sof'ia Stepanovna Shcherbatova].

PMID- 2215146
TI  - [What the nurse should know about working with children's parents].

PMID- 2215147
TI  - [Against tobacco smoke].

PMID- 2215148
TI  - [The healthy life style office].

PMID- 2215149
TI  - [The prevention of road traffic traumatism].

PMID- 2215150
TI  - [The personality characteristics of nurses that influence the quality of their
      work activities].

PMID- 2215151
TI  - [Nurses in the front ranks of the "Health for All" movement].

PMID- 2215152
TI  - [Postoperative treatment in Dupuytren's contracture].

PMID- 2215153
TI  - [The optimal form for the use of narcotic preparations in a general hospital].

PMID- 2215154
TI  - [The work experience of the geriatrics department of a psychiatric hospital with
      the rendering of care by the Moscow Church of Evangelical Christian Baptists].

PMID- 2215155
TI  - [Eye involvement in toxocariasis].

PMID- 2215156
TI  - [Skin lesions as a reaction to the development of malignant tumors of the
      internal organs].

PMID- 2215157
TI  - [Modern transfusion science and the paths for its further development].

PMID- 2215158
TI  - [Care of the oral cavity in treating mandibular fractures].

PMID- 2215159
TI  - [The acute schizophrenic attack].

PMID- 2215160
TI  - [Recipe cards for dietetic dishes].

PMID- 2215161
TI  - [The clinical picture and treatment of lesions caused by scorpion fish venom].

PMID- 2215162
TI  - [Patient preparation for general anesthesia].

PMID- 2215163
TI  - [The prevention of AIDS in therapeutic institutions].

PMID- 2215164
TI  - [The use of vitamins in respiratory organ diseases in children].

PMID- 2215165
TI  - [Smoking shortens human life].

PMID- 2215166
TI  - [A perfusion apparatus for extracorporeal purification of the blood].
AB  - Requirements for modern perfusion equipment intended for extracorporeal blood
      clearance are reviewed and possible trends in the improvement of the equipment in
      the BP-02 perfusion unit are defined. In that unit, one- or two-needle perfusion
      is maintained by a gearless drive, microprocessor control, concentrated data
      representation on a linear display in tabular form, and self-adjustment of the
      arterial and venous pressure control.

PMID- 2215167
TI  - [The technical requirements of simulating cardioplegia and perfusion of an
      isolated heart].
AB  - A testing unit for simulating cardioplegia and restorative perfusion of an
      isolated heart is described. The testing unit is fitted out with a chamber for an
      isolated heart, an oxygenator, a heat exchanger, the perfusion system and organs
      controlling heart work under different conditions of perfusion and cardioplegia.
      The system approximates the physiological condition of the experiment and allows
      changing and controlling them on a broad enough scale.

PMID- 2215168
TI  - [Characteristics of the work of blood membrane oxygenators with porous
      membranes].

PMID- 2215170
TI  - [Methodology of choosing blood-compatible biomaterials in vitro for artificial
      organs].

PMID- 2215169
TI  - [Choosing the structure of the control system for an external counterpulsation
      complex].
AB  - The paper is concerned with the principles of choosing the structure of the
      external counterpulsation control on an a.c. hydrodrive. An autonomous control
      mode and the control principles using a specialized microprocessor as well as
      computer-aided feedback control have been investigated.

PMID- 2215171
TI  - [Medical and technical aspects of replacing the lost functions of internal
      organs].

PMID- 2215172
TI  - [Hemodiafiltration with preparation of the replacement solution using a dialysis
      apparatus without volumetric control of ultrafiltration].
AB  - The authors describe a method of hemodiafiltration with preparing the replacement
      solution from dialysis liquid by means of the AK-10 apparatus (Gambro Company,
      Sweden) and a sterilizing hemofilter. The studies attest to the high efficacy and
      safety of the procedure. An opportunity is provided of increasing the replacement
      velocity, with the rate of filtration being stable and even reduced, which is of
      paramount importance in cases of unstable hemodynamics. Such a scheme enables one
      to simplify the procedure and decrease the cost of hemodiafiltration, thus
      forming the basis for its broad-scale application.

PMID- 2215174
TI  - [A portable, movable pneumatic drive for an artificial heart with an autonomous
      electrochemical source of energy].
AB  - The authors have designed a pneumatic drive, which differs from the known ones in
      that it contains two electromagnetic two-linear and two-positioned air
      distributors while the motor operates in the mode excluding the change of its
      axis direction. This affords using a standard crank mechanism as a transformer of
      rotary motion to translational motion and reducing several times the power
      consumed. Besides, the two-linear and two-positioned air distributors allow a
      possibility of exercising a separate control over the time of the systole
      diastole phases of the left and right ventricles. In this case both ventricles
      can work at 100% filling whereby maintaining the capacity of the artificial heart
      without additional energy consumption.

PMID- 2215173
TI  - [The control and regulation of gas exchange in membrane oxygenators of the MOST
      122 stationary type during open heart surgery].
AB  - A system of controlling the perfusion parameters and the efficacy of
      extracorporeal gas exchange is described. The system has been developed and
      employed for the control and regulation of gas exchange in the MOST-122
      oxygenators manufactured in the USSR and based on selective composition
      membranes. The system allows an expeditious assessment of gas exchange disorders
      which may occur during AC and extracorporeal oxygenation as well as their high
      accuracy correction, reaching optimal modes of ventilation.

PMID- 2215176
TI  - [The AIK-6.06 (ISL-6) artificial circulation apparatus].

PMID- 2215175
TI  - [Results of test-bed and clinical trials of DIP-03-02 dialyzers manufactured by
      the West German firm Frezenius using polysulfone hollow fibers].
AB  - The authors provide the results of the clinical trial of the dialyzers DIP-03-02
      manufactured by the USSR in cooperation with the FRG (Frezenius Company). In
      accordance with clearances of low-, medium- and high-molecular compounds as well
      as with the ultrafiltration characteristics, DIP-03-02 are similar to the modern
      capillary dialyzers from hollow fibers on the basis of cellulose membranes with
      an analogous surface. During manufacture of the dialyzers DIP-03-02, the
      polysulfone membrane possessing low permeability for liquid was obtained for the
      first time. The tentative data on biocompatibility (the complement activation
      test) are positive.

PMID- 2215177
TI  - [The EUS-8-1 Uterostim-1 electrostimulator].

PMID- 2215178
TI  - [The BP-02 perfusion unit].

PMID- 2215180
TI  - [The technical requirements for artificial life support systems].
AB  - The author advances a summarized concept of the bioartificial organism consisting
      of an operator, equipment and biological medium. Formulates the principle of man
      made life support, reviews a model of the bioartificial organism and a
      classification of processors that ensure the control of the physiological status
      of the biological medium.

PMID- 2215179
TI  - [A modification of the x-ray diagnostic units based on Roentgen-40 and
      manufactured by the Sevkavrentgen plant].

PMID- 2215181
TI  - [Thermodynamic principles and physiologic criteria for the use of heat engines to
      drive the ventricles of an artificial heart].
AB  - The authors review the thermodynamic bases and physiological limitations of the
      applicability of thermal engines for driving artificial heart ventricles. Show
      that the thermodynamic characteristics of Stirling and Brighton cycles do not
      make it possible to effectively use cycle-based engines in the artificial heart.
      A steam engine operating in accordance with the Rankine cycle may be regarded as
      an optimum type engine for that purpose. Demonstrate that according to the rules
      of physiology, use should be made of a separate driving of artificial heart
      ventricles by two independently operating steam engines. Provide the
      characteristics of the Soviet artificial heart "MIKRON" acceptable for
      implantation into the orthotopic position.

PMID- 2215182
TI  - Anti-adhesive activity of human casein against Streptococcus pneumoniae and
      Haemophilus influenzae.
AB  - The casein fraction of human milk was found to inhibit the attachment of
      Streptococcus pneumoniae and Haemophilus influenzae human respiratory tract
      epithelial cells. The inhibitory activity for S. pneumoniae remained after heat
      and trypsin treatment of the casein and was found in oligosaccharides released
      from casein. kappa-Casein, which is the most highly glycosylated casein
      component, inhibited pneumococcal attachment at concentrations similar to the
      whole casein fraction. The results are consistent with the known recognition of
      GlcNAc beta 1-3Gal by S. pneumoniae, since human milk and bovine colostrum, which
      contain GlcNAc, inhibited attachment, but mature bovine milk lacking GlcNAc did
      not. The effect on H. influenzae was similar to that on S. pneumoniae in that the
      attachment was inhibited by human casein and bovine colostrum, but not by either
      mature bovine milk or by the bovine casein fraction. The kappa-casein component
      of human milk was a less efficient inhibitor of H. influenzae attachment than the
      whole casein fraction and the free oligosaccharides were inactive. This anti
      microbial effect of human casein represents a new mechanism for the protection by
      breast-milk against respiratory tract infection.

PMID- 2215183
TI  - Covalent linkage between the capsular polysaccharide and the cell wall
      peptidoglycan of Streptococcus pneumoniae revealed by immunochemical methods.
AB  - The attachment of capsular polysaccharide to Streptococcus pneumoniae was
      examined using monoclonal and polyclonal antibodies. Among the strains examined,
      the capsular polysaccharide of types 2, 4, 6A, 6B, 7F, 8, 14, 19F and 23F was
      bound to the pneumococci whereas that of a type 3 strain was not. Sequential
      treatment with 2% SDS at 100 degrees C, pronase, and EDTA did not dissociate the
      capsular polysaccharide from the pneumococci. Treatment of the cells with
      mutanolysin, a muramidase that degrades the cell wall peptidoglycan of
      pneumococci and other streptococci, released both the capsular and the cell wall
      C-polysaccharide (C-Ps). Type 6A capsular polysaccharide released from cell walls
      by mutanolysin treatment, was fractionated by high performance liquid
      chromatography and examined by immunoelectrophoresis. It was found to be bound to
      both the C-Ps and the peptidoglycan. The bond between the capsular polysaccharide
      and the peptidoglycan has not yet been identified but is probably covalent, as
      the two components could not be dissociated after boiling in SDS. Based on our
      studies with type 6A, we propose that capsular polysaccharide and C-Ps of the
      pneumococcus are linked to the peptidoglycan at different sites and, thereby,
      indirectly to each other. Studies in mice showed that the peptidoglycan enhanced
      the serum antibody response to C-Ps but not to type 6A polysaccharide.

PMID- 2215184
TI  - Yersinia enterocolitica serotype O:3 is arthritogenic for mice.
AB  - It is shown, for the first time, that Yersinia enterocolitica serotype O:3 is
      experimentally arthritogenic. Moreover, it is arthritogenic for the mouse, an
      optimal model for human yersiniosis. This arthritis can be induced by the oral
      route, the most common route in man. The pattern of joint disease closely
      parallels that of human reactive arthritis associated with this pathogen.

PMID- 2215185
TI  - An in vivo method for studies of traumatic vasospasm.
AB  - A study was undertaken to develop a model for investigations of traumatically
      induced vasospasm. The left ear of the rabbit was denervated under short
      anesthesia. With the animal under light sedation, spasm of the central ear artery
      was repeatedly induced with a clip applying forceps. To evaluate the vasospasm,
      the vessel was transilluminated with cold light, and the internal diameter was
      continuously measured. The spasm was assessed in terms of its duration, intensity
      (reduction of initial diameter) and severity (integrated change in diameter over
      time). Repetitive application of the forceps on the same vessel segment shortened
      the spasm duration. With prolonged pinch duration, the spasm duration was
      lengthened. The preparation was stable for at least 3 hours. This model was
      effective for manipulating small vessels and producing spasm and is of potential
      value for studying the treatment of vasospasm by topical local intra-arterial and
      systemic methods.

PMID- 2215186
TI  - Vasodilator action of prostaglandin E1 on microcirculation of rat cremaster
      muscle.
AB  - Vascular spasm is often present after microsurgical procedures, and its presence
      or absence can greatly influence the success rate of such operations.
      Prostaglandin E1 (PGE1) is known to be a potent vasodilator and antiaggregator of
      small blood vessels. Using intravital videomicroscopy in the rat cremaster model,
      this study visually and quantitatively monitored changes in vessel diameter to
      observe the effect of PGE1 on the microcirculation and compared its action with
      that of 1% lidocaine. The results suggest that PGE1 (10 micrograms/ml) can
      significantly relieve epinephrine-induced vasoconstriction at the terminal
      arteriole, arteriole, and small artery level (vessel diameters 10-50 microns).
      The vasodilatory action of PGE1 is reflected by an increase in vessel diameter,
      and PGE1 may have a role in reversing vascular spasm after microsurgery,
      enhancing the survival rate of replanted extremities.

PMID- 2215187
TI  - Time of low-dose acetylsalicylic acid administration influences in vivo platelet
      function and thrombus formation following arteriotomy and intimectomy; an
      experimental study in small arteries of rabbits.
AB  - To investigate if low-dose acetylsalicylic acid (ASA), 4 mg/kg b.w., infused
      peroperatively or 10 hours preoperatively has antithrombotic effects, the central
      arteries of rabbit ears were prepared and 32P-labeled platelets injected.
      Arteriotomy and intimectomy were performed and blood flow was restored. Bleeding
      times at the sites of arteriotomy/intimectomy, in vivo accumulations of isotope
      labeled platelets, amounts of red thrombotic material, and patency were recorded.
      Bleeding times following arterial puncture and the effect of ASA on thromboxane
      production were studied separately. Ten hours after ASA administration, bleeding
      times were shortened at the sites of arteriotomy/intimectomy but were prolonged
      following arterial puncture. Platelet accumulations were lower in patent vessels
      in this group than in an untreated control group. Peroperative ASA treatment
      increased but treatment 10 hours prior to blood flow restoration did not
      significantly affect the number of occlusions. Thromboxane production in ASA
      treated rabbits is largely inhibited even 14 hours after administration.

PMID- 2215188
TI  - Soft tissue coverage of the hand with a free digital fillet flap.
AB  - A free digital fillet flap was used to achieve soft tissue coverage of the ulnar
      border of the hand in a 38 year old man with an industrial fan blade injury to
      the dominant hand. The use of a digital fillet flap from an unsalvageable ring
      finger allowed for a one-stage procedure avoiding donor site morbidity or need
      for additional reconstructive surgery.

PMID- 2215189
TI  - Angled side wall microarteriotomy scissors: a new end-to-side microvascular
      anastomosis instrument.
AB  - Creation of a smooth side wall arteriotomy for an end-to-side microsurgical
      anastomosis can at times be difficult and time consuming. To facilitate this
      maneuver, a new end-to-side microarteriotomy scissor was designed for creation of
      recipient vessel openings from 0.5-2 mm in size. These new scissors and their
      recommended use are described.

PMID- 2215190
TI  - Replantation 1990.

PMID- 2215191
TI  - Frontiers in microsurgery: replantation.

PMID- 2215192
TI  - Philosophy of replantation 1976-1990.

PMID- 2215193
TI  - Macroreplantation: an overview.

PMID- 2215194
TI  - Union Memorial Hospital experience with replantation: patterns of change.
AB  - The experience with replantation of amputated or devascularized parts of the
      upper extremity distal to the wrist was reviewed for 1976-1980 and again in a
      similar way for 1986-1989. Comparisons between the two groups were made to look
      for similarities and differences. Analysis of this experience may help treating
      physicians, patients, and third-party payers to make decisions about management
      of these injuries.

PMID- 2215195
TI  - Sensory recovery following digital replantation.
AB  - The recovery of sensibility following digital replantation is essential in the
      restoration of hand function. We reviewed 12 series of digital replantations
      between 1977 and 1989. Three hundred sixty-seven fingers and 87 thumbs were
      successfully replanted. Mean age was 32.5 years. Mean follow-up was 33.5 months.
      Mean static two-point discrimination (S2PD) was 9.3 mm in clean thumbs vs. 12.1
      mm in crush/avulsion thumb replantations. Mean S2PD was 8 mm in clean finger vs.
      15 mm in crush/avulsion finger replantations. Overall mean S2PD was 11 mm in
      thumb and 12 mm in finger replantations. Sixty-one percent of replanted thumbs
      and 54% of replanted fingers regained useful S2PD (less than 15 mm or greater
      than or equal to S3 +). Factors that influenced digital sensibility following
      replantation included patient's age, level and mechanism of injury, digital blood
      flow, cold intolerance, and postoperative sensory reeducation. Recovery of
      sensibility in the replanted digit is comparable to simple nerve repair and to
      nerve grafting techniques. Further emphasis should be on elucidating the
      mechanism of cold intolerance, which was a significant complaint for most
      replanted digits. The universal practice of postoperative sensory reeducation
      will continue to improve digital sensibility following replantation.

PMID- 2215196
TI  - One hundred eleven thumb amputations: replantation vs revision.
AB  - One hundred eleven patients who sustained isolated, complete thumb amputation
      between 1971 and 1985 were reviewed to assess results of replantation and to
      compare these with results of amputation revision. Routine postoperative
      evaluation was performed in 69 successful replant patients and in 42 with
      revision. Twenty-five of the replant group and 18 of the revision group returned
      for additional testing that consisted of interview and physical examination, test
      of activities of daily living, Jebsen test of hand function, and both static and
      dynamic testing on the BTE work simulator. Ninety percent of replantations were
      between the metacarpophalangeal (MCP) joint and the proximal third of the distal
      phalanx. Shortening averaged 11 mm, and range of motion was 42% +/- 28% that of
      the uninjured thumb. One-half of the patients could touch the MP of their ring
      finger, and one-fourth could touch the proximal interphalangeal (PIP) joint.
      Twenty-one percent had 7 mm or less two-point discrimination, and 38% had between
      8 and 20 mm. Eighty percent of both groups were able to perform activities of
      daily living at 80% of their uninjured side. Grip strength was approximately 84%
      of that of the uninjured hand in each group. Lateral pinch averaged 68% +/- 26%
      of that of the normal side in the replant group and 91% + 9% in the amputation
      group. Work simulator assessment of lateral and three-point pinch was better in
      the revision group. Scores on Jebsen testing were slightly better for those with
      replanted thumbs, but in general neither replant nor revision patients functioned
      as well as did Jebsen's normals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2215198
TI  - Techniques of bone fixation in replantation surgery.

PMID- 2215197
TI  - Microvascular anastomoses in replanted fingers: do they stay open?
AB  - Replantation of fingers is a well established procedure following traumatic
      amputation. Several studies have documented the functional results of replanted
      digits. Studies have not documented the long-term (greater than 5 yrs) patency of
      the microvascular anastomosis in the replanted digit. Duplex imaging, a
      combination of B-mode ultrasound and bidirectional Doppler ultrasound has been
      shown to visualize vessels 1 mm in diameter. Color enhancement of the ultrasound
      image is now possible. We evaluated 18 patients with 24 replanted fingers to
      assess vascular patency. A minimum of five years follow-up was required for
      inclusion in the study group. Examination showed a patent anastomosis in every
      case and a Digital-Brachial Index within normal limits in 71% of the digits.
      Microvascular anastomoses in vessels as small as 1 mm in diameter remain open as
      long as 11 years following completion. The sophisticated techniques of color
      enhanced Duplex imaging makes long-term evaluation of these procedures possible
      in a non-invasive and accurate fashion. The use of such imaging modalities will
      have an important role in the evaluation of replanted digits and microvascular
      procedures in general.

PMID- 2215199
TI  - [Evaluation of the nervous system in workers in the furnace and coal divisions of
      the coke-producing plants].
AB  - 240 workers of coking plant exposed to noxious chemical compounds released at
      coke production and control group consisting of 76 persons including 48 workers
      without direct contact with coke production process and 28 randomly selected
      healthy subjects were examined. No characteristic syndrome of subjective changes
      was found in workers of productive sphere. However, defective neurological
      symptoms were more prevalent in this group as compared to the controls. The
      workers from the group exposed developed neurotic syndromes with vegetative
      disregulation symptoms two times more frequently than the controls. The changes
      in EEG were significantly more prevalent in the workers occupationally exposed.
      The prevalence of diffuse changes in EEG depended on the level of exposure to
      BaP.

PMID- 2215200
TI  - [Study of social acceptance of periodic examinations by machine industry
      workers].
AB  - Social acceptance of periodical examinations was evaluated via a survey conducted
      among a group of 530 machine industry workers. A questionnaire for prophylactic
      examinations was used which was worked out at the Department of Epidemiology and
      Statistics of the Nofer Institute of Occupational Medicine in Lodz, with
      additional questions concerning the level of acceptance of a new medical
      examination mode. In order to determine the letter the subject area was limited
      to elicit an answer to a question whether a new examination instrument at a
      periodical check-up meets the needs of the workers. The paper discusses the
      method of the study, characteristics of the population examined, including age,
      occupational exposure and work strenuousness. The findings revealed that 96.8% of
      subjects had accepted the new mode of periodical examinations which allows a
      conclusion that the method satisfies the workers' expectations as they find it
      suitable for managing their health problems. It is suggested that the form of
      periodical examinations should be modified since those presently applied do not
      facilitate early diagnosis or comprehensive evaluation of workers' health
      conditions.

PMID- 2215201
TI  - [Rhythm disorders of basic bioelectric activity of the brain in alcoholism and
      exposure to carbon disulfide (CS2)].
AB  - A visual and computer-assisted analysis was made of basic brain biological
      function in 45 EEG recordings of alpha waves alone or mostly alpha waves. The
      study revealed abnormal frequency of alpha waves in patients with chronic
      alcoholism (60%) and in people chronically exposed to carbon disulphide (73.4%).
      The abnormalities most probably reflect dysfunction of the CNS.

PMID- 2215202
TI  - [Biological testing of fibrogenic effect of dust from the "Gliwice" mine on the
      lung tissue].
AB  - Animal study was carried out to determine biological aggressiveness of mining
      dust by means of pulmonary tests. Dust samples, 50 mg settled dust, a mixture
      from 3 different mine layers (sample A) and 50 mg dust collected by the
      gravimetric method from different mine layers (sample B) were administered in two
      respective test groups by a single intratracheal injection. Silica content,
      determined according to Polezhayev, was found to range from 4.6% (sample A) to
      12.7% (sample B). In months 3 and 6 of the experiment lung content of
      hydroxyproline was determined following Stegemann. Biochemical tests for
      hydroxyproline content revealed highest increase in the lungs of Group 2 animals
      6 months after the onset of the experiment (10.312 mg). Very similar result was
      obtained in Group 1, with injected settled dust mixture: hydroxyproline level
      amounted to 10.214 mg. Both sample A and sample B induced elevated level of lung
      hydroxyproline although silica content in dust sample differed considerably. The
      study revealed that the biological aggressiveness of settled dust was not
      proportionate to the content of pure silica. It is thought that increased
      fibrogenic potentials of the settled dust may have resulted from defected
      crystalline structure of silica due to the grinding of the mineral in a hand
      mill.

PMID- 2215203
TI  - [Chemical safety (III)--its prospects in Poland].
AB  - The paper discusses principles of the chemical safety system to be introduced in
      Poland. It is thought that the system should be based on a doctrine comprising
      theoretical considerations, definitions of concepts and scope of activity.
      Moreover, the organizational and legal background of the future system was also
      considered. According to the main principle of the chemical safety system, any
      activity, involving the use of chemicals gives rise to a risk of adverse health
      and environmental effects. The numerical value that can be assigned to such risk
      ranges between 0 and 1. Thus an essential activity related to chemical safety
      seems to be the determination of a socially acceptable risk. Chemical safety has
      been defined as an environmental state where the chemical substances of different
      origin pose either no risk of adverse health and environmental effects or the
      risk whose level is socially acceptable. The chemical safety system aims at
      limiting or preventing the risk arising from the use of chemicals. It is
      suggested that the activities of the future system should be supervised by the
      National Coordinating Committee for Chemical Safety which would stimulate both
      the research work on risk assessment and management as well as other activities
      pertaining to chemical safety.

PMID- 2215204
TI  - [Evaluation of the need of specialization of physicians in the field of
      occupational medicine].
AB  - Analysing the trends in obtaining specialization in occupational health during
      last 15 years an evident deterioration of formal qualifications of physicians
      employed in occupational health service (OHS) was observed. These data were
      confronted with the needs resulting both from the present model of workers health
      care as well as with those arising from ratification of ILO Convention No 161 of
      1985. It was stated that discrepancy between the need for specialists and the
      actual possibilities of their training cannot be removed without radical reform
      of the Polish health care system in general and health service reform in
      particular.

PMID- 2215205
TI  - [Psychological effects of chronic exposure to organophosphate pesticides--review
      of the literature].
AB  - One of the occupational hazards is exposure to organophosphorous pesticides in
      agriculture. With 8.5% of all occupational poisonings in Poland organophosphate
      poisonings hold one of the topmost positions. Organophosphorous chemicals induce
      inhibition of AChE activity thus leading to nervous system impairment. Chronic
      exposure does not bring about acute poisoning, however it produces various
      disorders within the system. Only a few studies on chronic exposure consider
      psychological dysfunctions as a possible effect. The parameters examined most
      frequently include short-term memory, learning, eye-hand coordination, reaction
      time in simple and complex reactions. The findings reveal impairments of these
      functions due to chronic exposure to organophosphates. However, in view of the
      limited samples of test groups the conclusions can only be tentative.

PMID- 2215206
TI  - [Protoporphyrin level in erythrocytes of workers in coke-producing plants].
AB  - Peripheral blood samples from workers of a coke factory were examined to
      determine protoporphyrin content in erythrocytes and haemoglobin concentration.
      Statistically significant increase of protoporphyrin level was found in the coke
      factory workers, as compared with the control group whereas haemoglobin content
      was very similar in both the groups. The results indicate that the working
      environment of coke factory may induce protoporphyrin synthesis in erythrocytes
      as well as inhibit generation of iron porphyrins.

PMID- 2215207
TI  - [Effect of work in the coke-producing plant on the circulatory system of
      workers].
AB  - 253 coke ++ plant workers employed for over 5 years were subject to examination.
      From among them 207 were exposed to very high concentrations of benzo-a-pyrene
      (BaP) and tar substances as well as to benzene, its homologues and carbon
      monoxide. However, none of these concentrations exceeded MAC value. Apart from
      routine medical examinations resting ECG was made and when necessary propranolol
      test, exercise test or even coronarography. In addition, polycardiographic and
      ultrasonocardiographic examinations were carried out. Comparing the results
      obtained in the group exposed with the controls it was found that arterial
      hypertension, coronary insufficiency and pathologic polycardiograms were more
      prevalent in the workers exposed. Chronic exposure to CO, BaP and smoking habit
      were considered to be factors exerting a deteriorating effect on cardiac muscle.

PMID- 2215208
TI  - Hepatic gene function in health and disease.

PMID- 2215209
TI  - Prospects for gene therapy of familial hypercholesterolemia.
AB  - Familial hypercholesterolemia is an inherited disease in humans that is caused by
      a deficiency in the receptor that mediates the internalization and degradation of
      low density lipoprotein. Patients that inherit two abnormal low density
      lipoprotein receptor alleles have severe hypercholesterolemia, advanced
      atherosclerosis, and life-threatening coronary artery disease that is refractory
      to conventional therapies. In this review, we discuss the prospects for gene
      therapy in the treatment of familial hypercholesterolemia.

PMID- 2215210
TI  - Integration host factor affects expression of two genes at the conjugal transfer
      origin of plasmid R100.
AB  - Integration host factor (IHF) binds to two sites near the origin of transfer of
      the conjugative antibiotic resistance plasmid, R100. DNase I footprinting shows
      that one site is immediately adjacent to oriT and the gene X promoter, and
      another is adjacent to the traM promoter. A third site, known only from
      retardation gels, is near the traJ promoter. The relative promoter activities of
      genes X, traJ and traM are reduced in himA mutants (IHF-), as measured by
      chloramphenicol-resistance assays. Transcript analyses by Northern blots showed a
      reduction in size of the principal gene X and traJ transcripts in the absence of
      IHF.

PMID- 2215211
TI  - Sequence of the peh gene of Erwinia carotovora: homology between Erwinia and
      plant enzymes.
AB  - Polygalacturonase (Peh) and other pectolytic enzymes play a crucial role in the
      maceration of vegetables by soft rot Erwinia spp. We have sequenced the peh gene
      of Erwinia carotovora subsp. carotovora, and identified its product as a
      precursor of molecular weight 42,639, and a mature protein of molecular weight
      42,200. A putative KdgR-binding site was identified in the region 5' to the peh
      gene. The Peh protein showed significant homology with Peh from tomato. In
      addition, we have found homologies between pectin methylesterase and pectate
      lyase from Erwinia and their counterparts in tomato. These homologies are
      described, and their significance discussed.

PMID- 2215212
TI  - Structural analysis of the pehA gene and characterization of its protein product,
      endopolygalacturonase, of Erwinia carotovora subspecies carotovora.
AB  - A clone producing a polygalacturonase (EC 3.2.1.15) in Escherichia coli was
      isolated from a genomic library of Erwinia carotovora subspecies carotovora
      constructed in PUC18. The DNA segment carrying the corresponding structural gene,
      named pehA, contained an open reading frame (ORF) encoding a 402-amino-acid (aa)
      polypeptide with an Mr of 42,849. In E. carotovora the polygalacturonase was
      synthesized with a 26-aa cleavable signal peptide. The mature 376-aa PehA had a
      calculated Mr of 40,064 and a pl of 10.19. The pH optimum of the enzyme was about
      5.5 and the temperature optimum was in the range 35-45 degrees C. Analysis of the
      reaction products of polygalacturonic acid hydrolysis indicated that the PehA
      protein is an endopolygalacturonase. No similarity was observed between the aa
      sequences of PehA and other pectic enzymes of erwinias. However, substantial
      similarity was detected within the C-terminal portions of PehA and a previously
      described tomato polygalacturonase, suggesting that the bacterial and eukaryotic
      polygalacturonases may have a common origin.

PMID- 2215213
TI  - Recent advances in peptide chain termination.
AB  - Peptide chain termination occurs when a stop codon is decoded by a release
      factor. In Escherichia coli two codon-specific release factors (RF1 and RF2)
      direct the termination of protein synthesis, while in eukaryotes a single factor
      is required. The E. coli factors have been purified and their genes isolated. A
      combination of protein and DNA sequence data reveal that the RFs are structurally
      similar and that RF2 is encoded in two reading frames. Frame-shifting from one
      reading frame to the next occurs at a rate of 50%, is regulated by the RF2
      specific stop codon UGA, and involves the direct interaction of the RF2 mRNA with
      the 3' end of the 16S rRNA. The RF genes are located in two separate operons,
      with the RF1 gene located at 26.7 min and the RF2 gene at 62.3 min on the
      chromosome map. Ribosomal binding studies place the RF-binding region at the
      interface between the ribosomal subunits. A possible mechanism of stop-codon
      recognition is reviewed.

PMID- 2215214
TI  - Intron-associated splicing reactions in bacteriophage T4.
AB  - Group I introns are present in at least three bacteriophage T4 genes: td, nrdB
      and sunY. The transcription products of these three genes have similar intron
      consensus regions and secondary structures, which render them capable of
      guanosine-mediated in vitro autocatalytic splicing reactions. Moreover, it has
      been shown that the 245-amino-acid protein encoded in the td intron expresses an
      endonuclease that cleaves near the joining site for the two exons in the intron
      deleted thymidylate synthase gene. The intron-containing td gene is resistant to
      the enzyme. As in the case of other group I intron-containing genes that have
      been described in eukaryotes, which also encode site-specific endonucleases, the
      td intron is highly mobile and can insert into the intron-less td gene by a
      process initiated by endonuclease cleavage near the insertion site. Whether
      intron transposition reactions have any physiological significance to the phage,
      or represent an early imprint on the evolution of introns, remains to be
      determined.

PMID- 2215215
TI  - Homologous DNA sequences on the virulence plasmids of pathogenic Yersinia and
      Salmonella dublin lane.
AB  - Yersinia and Salmonella harbour plasmids that encode traits important for
      virulence, enabling both pathogenic genera to survive and grow in cells of the
      reticulo-endothelial organs during systemic infections. We have detected DNA
      homology between the Salmonella dublin virulence plasmid pSDL2 and the plasmids
      of the pathogenic Yersinia species pestis, pseudotuberculosis, and
      enterocolitica. Three regions of pSDL2 were found to share homology with the
      virulence plasmid pIB1 of Yersinia pseudotuberculosis. Two separate hybridizing
      segments mapped within the previously characterized 6.4 kb vir region of pSDL2 in
      the SalI B fragment. The third homologous region involved the replicon of pIB1,
      which hybridized to the SalI C2 fragment of pSDL2. The virulence plasmid pCD1
      from Y. pestis showed similar homology with the three regions of pSDL2.
      Homologies to the vir and SalI C2 regions of pSDL2 were also found on plasmids
      from Yersinia enterocolitica serotypes 0:9, 0:3 and 0:5, 27. The discovery of
      separate homologous regions on the virulence plasmids of Salmonella and Yersinia
      suggests a distant evolutionary relationship.

PMID- 2215216
TI  - Analysis of three nodD genes in Rhizobium leguminosarum biovar phaseoli; nodD1 is
      preceded by noIE, a gene whose product is secreted from the cytoplasm.
AB  - In a strain of Rhizobium leguminosarum biovar phaseoli, three copies of the
      regulatory nodulation gene nodD were identified on the Sym plasmid and sequenced.
      Two were closely linked to each other and the third was near, but not adjacent,
      to the nodABC genes. Each of these nodD genes could correct the Nod- defect of a
      nodD mutant strain of R. leguminosarum biovar viciae on peas. A truncated form of
      nodD2 could also correct this mutant, indicating that the C-terminus of NodD2 is
      not needed for inducing activity. Upstream of nodD1 and in the same operon is a
      newly described gene, noIE, whose product appears to be exported into the
      periplasm. Close to nodD2 is another gene, noIP, with no known counterpart in
      other rhizobia. Both noIP and noIE-nodD1 are preceded by 'nod-box' sequences and,
      in the former case, there appear to be two tandemly repeated nod-box sequences.
      Mutations in each of the nodD genes and in the noIE and noIP genes did not
      abolish nodulation or nitrogen fixation on beans.

PMID- 2215217
TI  - Octanoylation of the lipoyl domains of the pyruvate dehydrogenase complex in a
      lipoyl-deficient strain of Escherichia coli.
AB  - The overexpression of a subgene encoding a hybrid lipoyl domain of the
      dihydrolipoamide acetyltransferase component of the pyruvate dehydrogenase
      complex of Escherichia coli has previously been shown to result in the formation
      of lipoylated and unlipoylated products. Overexpression of the same subgene in a
      lipoic acid biosynthesis mutant growing under lipoate-deficient conditions has
      now been shown to produce domains modified by octanoylation as well as unmodified
      domains. It was concluded from the mass of a lipoyl-binding-site peptide that the
      modification involves N6-octanoylation of the lysine residue (Lys244) that is
      normally lipoylated, and this was confirmed by the trypsin-insensitivity of the
      corresponding Lys244-Ala-245 bond, and the absence of modification in a mutant
      domain in which Lys244 is replaced by Gln. This novel protein modification raises
      interesting questions concerning the pathway of lipoic acid biosynthesis and the
      mechanism of enzyme lipoylation.

PMID- 2215218
TI  - The Min DNA inversion enzyme of plasmid p15B of Escherichia coli 15T-: a new
      member of the Din family of site-specific recombinases.
AB  - Plasmid p15B is a bacteriophage P1-related resident of Escherichia coli 15T-.
      Both genomes contain a segment in which DNA inversion occurs, although this part
      of their genomes is not identical. This DNA segment of p15B was cloned in a
      multicopy vector plasmid. Like its parent, the resulting plasmid, pAW800,
      undergoes complex multiple DNA inversions: this DNA inversion system is therefore
      called Min. The min gene, which codes for the p15B Min DNA invertase, can
      complement the P1 cin recombinase gene. The Min inversion system is thus a new
      member of the Din family of site-specific recombinases to which Cin belongs. The
      DNA sequence of the min gene revealed that Min is most closely related to the Pin
      recombinase of the e14 defective viral element on the E. coli K12 chromosome.
      Like other members of the Din family, the min gene contains a recombinational
      enhancer element which stimulates site-specific DNA inversion 300-fold.

PMID- 2215219
TI  - The identification, characterization, sequencing and mutagenesis of the genes
      (hupSL) encoding the small and large subunits of the H2-uptake hydrogenase of
      Azotobacter chroococcum.
AB  - The structural genes (hupSL) of the membrane-bound NiFe-containing H2-uptake
      hydrogenase (Hup) of Azotobacter chroococcum were identified by oligonucleotide
      screening and sequenced. The small subunit gene (hupS) encodes a signal sequence
      of 34 amino acids followed by a 310-amino-acid, 34156D protein containing 12
      cysteine residues. The large subunit gene (hupL) overlaps hupS by one base and
      codes for a predicted 601-amino-acid, 66433D protein. There are two regions of
      strong homology with other Ni hydrogenases: a Cys-Thr-Cys-Cys-Ser motif near the
      N-terminus of HupS and an Asp-Pro-Cys-Leu-Ala-Cys motif near the carboxy-terminus
      of HupL. Strong overall homology exists between Azotobacter, Bradyrhizobium
      japonicum and Rhodobacter capsulatus Hup proteins but less exists between the
      Azotobacter proteins and hydrogenases from Desulfovibrio strains. Mutagenesis of
      either hupS or hupL genes of A. chroococcum yielded Hup- phenotypes but some of
      these mutants retained a partial H2-evolving activity. Hybridization experiments
      at different stages of gene segregation confirmed the multicopy nature of the
      Azotobacter genome.

PMID- 2215220
TI  - Strain specific variation of outer membrane proteins of wild Yersinia pestis
      strains subjected to different growth temperatures.
AB  - Three Yersinia pestis strains isolated from humans and one laboratory strain
      (EV76) were grown in rich media at 28 degrees C and 37 degrees C and their outer
      membrane protein composition compared by sodium dodecyl sulphate polyacrylamide
      gel electrophoresis (SDS-PAGE). Several proteins with molecular weights ranging
      from 34 kDa to 71 kDa were observed to change in relative abundance in samples
      grown at different temperatures. At least seven Y. pestis outer membrane proteins
      showed a temperature-dependent and strain-specific behaviour. Some differences
      between the outer membrane proteins of full-pathogenic wild isolates and the EV76
      strain could also be detected and the relevance of this finding on the use of
      laboratory strains as a reference to the study of Y. pestis biological properties
      is discussed.

PMID- 2215221
TI  - Short- and long-term effects of azadirachtin A on development and egg production
      of Rhodnius prolixus.
AB  - Azadirachtin A was given through a blood meal to 4th-instar larvae and to adult
      females of Rhodnius prolixus. Development (ecdysis) and egg production were
      inhibited in a dose-dependent manner. Long-term experiments with subsequent four
      feedings on azadirachtin-free blood were performed with 4th-instar larvae and
      with adult females. Only in the low-dose azadirachtin larval groups (0.01 and 0.1
      microgram/ml of blood), development was partially restored; after a single 1.0
      microgram/ml treatment about 50% of the treated larvae were still alive 120 days
      later without any adult emergence. Similarly fed females had a dose-dependent
      lower survival and egg deposition rate. The results are discussed in relation to
      the mode of azadirachtin A action.

PMID- 2215223
TI  - Biomphalaria amazonica Paraense, 1966 in the state of Mato Grosso do Sul, Brazil
      (Mollusca, Pulmonata, Planorbidae).

PMID- 2215222
TI  - Monoclonal antibodies against brain neurosecretory A cells of Panstrongylus
      megistus inhibit moulting and egg production in triatomines.

PMID- 2215224
TI  - Report of an epidemic outbreak of tegumentary leishmaniasis in a coffee-growing
      area of Colombia.

PMID- 2215225
TI  - Standardization of the IL-1 comitogenic assay using thymocytes from LPS-sensitive
      mouse strains.

PMID- 2215226
TI  - Occurrence of molluscs in aquaria of ornamental fishes in Belo Horizonte, Minas
      Gerais, Brazil.

PMID- 2215228
TI  - Amazonian visceral leishmaniasis--distribution of the vector Lutzomyia
      longipalpis (Lutz & Neiva) in relation to the fox Cerdocyon thous (linn.) and the
      efficiency of this reservoir host as a source of infection.

PMID- 2215227
TI  - Human, canine and equine (Equus caballus) leishmaniasis due to Leishmania
      braziliensis (= L. braziliensis braziliensis) in the south-west region of Sao
      Paulo State, Brazil.

PMID- 2215229
TI  - Influence of Trypanosoma cruzi strain on the pathogenesis of chronic
      myocardiopathy in mice.
AB  - The murine model of chronic Chaga's myocardiopathy was developed in 201 inbred
      and outbred mice. The experimental groups consisted of 1st: 73 inbred AKR and A/J
      mice inoculated with one of the following Trypanosoma cruzi strains: Peruvian
      (Type I), 12 SF (Type II) or Colombian (Type III); 2nd: 128 outbred Swiss mice,
      chronically infected either with Type II or Type III strains isolated from human
      patients from different geographical areas. All T. cruzi strains were previously
      characterized by their morphobiological behaviour in mice and by isoenzymatic
      patterns. For the 1st group the inoculum was 5 x 10(4) for the Peruvian strain
      and 1 x 10(5) for the 12 SF and Colombian strains. In the 2nd group-Swiss mice
      the inoculum size varied from 2 x 10(4) to 2 x 10(5). The inbred animals were
      killed at a 3 time-point scale (90, 180 and 240 days) post-infection. The Swiss
      mice were killed from 180 to 660 days after infection. The evaluation of
      parasitemia and serology (xenodiagnosis and indirect immunofluorescent test) was
      performed. The incidence of macroscopic alterations of the heart and cardiac
      index were evaluated. Histopathological lesions of the myocardium were graded.
      The influence of T. cruzi strain on the intensity of cardiac lesions was
      evaluated by the Chi-square test; the incidence of inflammatory lesions and its
      relationship to the parasite strain was evaluated by the Fisher test. The
      influence of the duration of infection was evaluated by using the Gamma
      Coefficient of Kruskal and Goodman and its measure of significance. Slight to
      severe microscopic alterations occurred in 85% of the chronically infected mice.
      There were a clear predominance on the incidence and intensity of inflammatory
      and fibrotic alterations for the mice infected with Type III strains. Statistical
      analysis has shown significant differences among the infected groups, in the
      inflammatory and fibrotic lesions. Macroscopic alterations (right cavities
      dilatation and apex aneurism of left ventricle), differed in incidence according
      to mice strains; in Swiss and AKR mice, significant differences were seen in mice
      infected with different T. cruzi strains, but the A/J mice failed to show
      significant differences correlated with different parasite strains. The duration
      of infection, from 90 to 240 days, could not be correlated with the degree of
      lesions in the several groups.

PMID- 2215231
TI  - Biological control of Biomphalaria tenagophila (Mollusca, Planorbidae), a
      schistosomiasis vector, using the fish Geophagus brasiliensis (Pisces, Cichlidae)
      in the laboratory or in a seminatural environment.
AB  - In order to investigate a possible method of biological control of
      schistosomiasis, we used the fish Geophagus brasiliensis (Quoy & Gaimard, 1824)
      which is widely distributed throughout Brazil, to interrupt the life cycle of the
      snail Biomphalaria tenagophila (Orbigny, 1835), an intermediate host of
      Schistosoma mansoni. In the laboratory, predation eliminated 97.6% of the smaller
      snails (3-8 mm shell diameter) and 9.2% of the larger ones (12-14 mm shell
      diameter). Very promising results were also obtained in a seminatural
      environment. Studies of this fish in natural snail habitats should be further
      encouraged.

PMID- 2215230
TI  - Prevalence of human T cell leukemia virus-I (HTLV-I) antibody among populations
      living in the Amazon region of Brazil (preliminary report).
AB  - Forty-three (31.4%) out of 137 serum samples obtained from two Indian communities
      living in the Amazon region were found to be positive for HTLV-I antibody, as
      tested by enzyme-linked immunosorbent assay (ELISA). Eighty-two sera were
      collected from Mekranoiti Indians, yielding 39% of positivity, whereas 11 (20.0%)
      of the 55 Tiriyo serum samples had antibody to HTLV-I. In addition, positive
      results occurred in 10 (23.2%) out of 43 sera obtained from patients living in
      the Belem area, who were suffering from cancer affecting different organs. Five
      (16.7%) out of 30 ELISA positive specimens were also shown to be positive by
      either Western blot analysis (WB) or indirect immunogold electron microscopy (IIG
      EM).

PMID- 2215232
TI  - Studies on sandfly fauna (Diptera: Psychodidae) in a foci of cutaneous
      leishmaniasis in mesquita, Rio de Janeiro State, Brazil.
AB  - In a study on vectors of cutaneous leishmaniasis in Mesquita, Rio de Janeiro
      State, Brazil, eleven species of sandflies were found: Lutzomyia longipalpis, L.
      fischeri, L. quinquefer, L. intermedia, L. whitmani, L. shannoni, L. cortelezzii,
      L. edwardsi, L. migonei, L. lanei and L. firmatoi. Lutzomyia intermedia was the
      predominant species. It was collected indoors but in much higher numbers
      outdoors, in the close vicinity of houses. In comparative captures it was found
      to feed more frequently on equines, and less frequently on man and dogs. Studies,
      using man and animals as baits, showed that blood-feeding started in the evening,
      and remained stable during the night, until early morning. June, August and
      October were the months of highest density.

PMID- 2215233
TI  - Human leptospirosis in a slum area in the city of Rio de Janeiro, Brazil--a
      serological and epidemiological study.
AB  - A serologic survey was carried out on slum dwellers in the city of Rio de
      Janeiro. A total of 259 serum samples from male and female individuals of
      different age groups were tested for the presence of antileptospire antibodies by
      microagglutination. Prevalence data were analyzed in relation to the major risk
      factors present at the site, mainly represented by the presence of carrier
      animals and the occurrence of frequent floods. Of the samples tested, 25% reacted
      with antigens of different serogroups at titres ranging from 1:100 to 1:6400,
      with a predominance of titres less than or equal to 1:400; 35% of positive sera
      reacted with leptospirae of the Icterohaemorrhagiae serogroup. Reactions with
      Djasiman, Panama, Javanica, Canicola, Pyrogenes, Australis, Ballum, Sejroe,
      Bataviae, Grippotyphosa, Autumnalis and Cynopteri were also detected, though at
      lower frequencies. There was no statistically significant difference between
      sexes, but higher prevalence rates were found to be associated with increasing
      age. A focus of infection was characterized, in which social and economic factors
      contribute to the persistence of leptospirae by favoring the proliferation of the
      main reservoir.

PMID- 2215234
TI  - Distinct ultrastructural aspects in different biopsies of a single patient with
      diffuse cutaneous leishmaniasis.
AB  - The authors investigated the relation between parasites and host-cells in active
      and regressed lesions of a patient with diffuse cutaneous leishmaniasis,
      evaluating the frequency of different cell types, and the location and integrity
      of amastigotes. No correlation was found between parasite integrity and size of
      parasitophorous vacuoles. They observed ultrastructural findings characterizing a
      cell mediated immune response: macrophages lysis, parasitic destruction inside
      macrophages, close contact between parasitized macrophages and lymphocytes and
      between parasites and lymphocytes, lymphocytic infiltration and fibrosis. They
      suggest that in DCL there is a limited cellular immune response, although
      insufficient to control infection.

PMID- 2215235
TI  - Serotyping of Candida albicans isolated from clinical specimens.
AB  - A specific antiserum to Candida albicans serotype A was prepared absorbing a
      total antiserum with Candida albicans serotype B cells. This specific antiserum
      was used for serotyping C. albicans strains obtained from patients in different
      hospitals of Havana City, Cuba. Two hundred strains (95.2%) were serotype A, the
      remaining 10 (4.8%) were serotype B. Results were also correlated with strains
      isolated from the specimen origin, sex and race of the patient. The usefulness of
      this specific antiserum to determine C. albicans serotypes and its therapeutic
      value are pointed out.

PMID- 2215236
TI  - Technique for the detection of Toxoplasma gondii antigens in mouse urine.
AB  - A simple and rapid staphylococcal coagglutination test for the detection of
      Toxoplasma gondii antigens in mice urine is described. A suspension of protein-A
      containing Staphylococcus aureus coated with rabbit hyperimmune serum was used as
      reagent. The sensitivity of the antigen assay was found to be at least 118 ng of
      the antigen protein per ml. No coagglutination was observed when the reagent was
      challenged against antigenic solutions of other parasites. The suitability of the
      method for detecting antigens of T. gondii in urine samples was studied by
      experimental toxoplasma infection in mice. Before the staphylococcal test, the
      urine samples were double serially diluted in 0.1 M PBS. From the second day on
      all samples from infected mice were positive at 1/16 dilution. At this dilution,
      all samples from non infected mice were negative or did not produce
      coagglutination. This method might be used in the rapid etiological diagnosis
      also in human cases of acute toxoplasmosis.

PMID- 2215237
TI  - Human and dogs Toxocara canis infection in a poor neighborhood in Bogota.
AB  - Prevalence of Toxocara canis antibodies was studied in a poor community of
      Bogota, Colombia. Two-hundred-seven patients, from both sexes and all age groups,
      were studied. Positive ELISA titers were found in 47.5% of the population, a high
      prevalence compared with reports from developed countries. T. canis ova were
      positive in 43.6% of fecal samples from dog puppies. An endemic pattern of the
      disease is described: socioeconomic status, weather, pollution, poor hygiene and
      a significant population of infected dogs. Neither the physical examination nor
      ELISA titers could detect any case of T. canis disease.

PMID- 2215239
TI  - The Omnibus Budget Reconciliation Act-1987. An opportunity to institute a minimum
      data set for persons with developmental disabilities.

PMID- 2215238
TI  - Mechanism of action of a nitroimidazole-thiadiazole derivate upon Trypanosoma
      cruzi tissue culture amastigotes.
AB  - Megazol (CL 64,855) a very effective drug in experimental infections by
      Trypanosoma cruzi, and also in in vitro assays with vertebrate forms of the
      parasite, had its activity upon macromolecule biosynthesis tested using tissue
      culture-derived amastigote forms. Megazol presented a drastic inhibition of [3H]
      leucine incorporation, and only a partial inhibition of [3H]-thymidine and [3H]
      uridine incorporation, suggesting a selective activity upon protein synthesis.
      Comparing the three drugs, megazol was more potent than nifurtimox and
      benznidazole in inhibiting protein and DNA synthesis. Megazol showed a 91% of
      inhibition of [3H]-leucine incorporation whereas nifurtimox and benznidazole, 0%
      and 2%, respectively. These latter two drugs inhibited the incorporation of all
      the precursors tested at similar levels, but the concentration of benznidazole
      was always three times higher, suggesting different mechanisms of action or, more
      probably, a greater efficiency of the 5-nitrofuran derivate in relation to the 2
      nitroimidazole. So, we conclude that the mode of action of megazol is different
      from the ones of nifurtimox and benznidazole and that its primary effect is
      associated with an impairment of protein synthesis.

PMID- 2215240
TI  - Historical and contemporary issues in nursing home reform.
AB  - Historical developments leading to the enactment of nursing home reform
      legislation (P.L. 100-203) were discussed. The results of the nursing home
      component of a nationwide University of Illinois at Chicago study of public
      mental retardation/developmental disabilities spending were also presented.
      Approximately 51,000 individuals with mental retardation and related conditions
      resided in nursing homes in 1989. The cost of their care was approximately $900
      million annually. Within the first 12 months of the enactment of P.L. 100-203, 46
      states had requested an extension to the original mandated services deadline
      imposed under that legislation. Under P.L. 100-203 guidelines, state agencies
      estimated that nearly 40% of all nursing home residents with mental retardation
      might need to be relocated to alternative settings. Implementation issues were
      also discussed.

PMID- 2215241
TI  - Mental retardation research in the Soviet Union.
AB  - Twenty-six studies on mental retardation conducted in the Soviet Union in the
      1970s and 1980s were reviewed: 8 focused on etiological questions; 15, on
      psychoeducational issues; and 3, on vocational or social policy concerns. The
      findings, which tend to support general trends found in the United States for
      individuals with mental retardation, were: higher risk factors for mental
      retardation for children if the mother rather than the father had mental
      retardation; lower levels of education, lower occupational status, and a larger
      number of children for families of children with mental retardation (a
      significant finding in a society traditionally described as classless); and
      significantly higher number of males than females among persons with dual
      diagnoses.

PMID- 2215243
TI  - Effects of case manager feedback on the quality of individual habilitation plan
      objectives.
AB  - The functional relation between feedback by a case manager and improved writing
      of Individual Habilitation Plan (IHP) objectives in adult service agencies was
      assessed. Feedback on seven features of IHP objectives was delivered by the local
      case manager to program staff of four agencies providing residential or
      vocational support to adults with moderate to severe disabilities. The results
      demonstrate that each of the four agencies improved the quality of their written
      objectives after receiving feedback from the case manager and maintained those
      gains 18 months after feedback was terminated. Implications for case managers as
      feedback agents were discussed.

PMID- 2215244
TI  - Sheltered workshops: financial and philosophical liabilities.
AB  - Some of the economic and philosophical reasons why sheltered workshops remain
      liabilities within the field of special education were discussed. Low wage rates,
      the unavailability of work, changing industrial forecasts for blue collar
      employment, financial dependence, tax returns, segregation, and normalization
      issues, along with other factors, were examined to provide support for the
      assertion that sheltered workshops are not providing clients with appropriate
      work experiences.

PMID- 2215242
TI  - Follow-up study of family attitudes toward deinstitutionalization: three to seven
      years later.
AB  - The attitudes of 32 families who had their relative with mental retardation
      deinstitutionalized and living in the community for 3 to 7 years were examined.
      Preplacement data on these families indicated a high level of satisfaction with
      institutional services and strong opposition to community placement.
      Postplacement data revealed a significant change toward more positive family
      attitudes toward deinstitutionalization. However, families were still concerned
      about high staff turnover rates, inadequate community services, and future
      relocations.

PMID- 2215245
TI  - Residential placement of individuals with mental retardation: factors influencing
      court decisions.
AB  - Pennsylvania law mandates that involuntary commitment of persons with mental
      retardation be reviewed by the court system in order to assure due process. Fifty
      such cases in Philadelphia were reviewed in court over a period of one year and
      subsequently examined to determine current court trends toward institutional
      placement. Factors evaluated included characteristics of the individual, the
      presiding court, the impact of a court-appointed Child Advocate or Public
      Defender, and availability of residential alternatives. Results indicate that
      children were committed to institutional settings less frequently than adults.
      Other critical factors were prior placement, recommendations of advocates, and
      availability of alternative services.

PMID- 2215246
TI  - A reply to Professor Zeph.

PMID- 2215247
TI  - Thrombin stimulates the production of immunoreactive endothelin-1 in cultured
      human umbilical vein endothelial cells.
AB  - The present study was designed to examine the effect of thrombin on endothelin
      production by cultured human umbilical vein endothelial cells (HUVEC) by
      radioimmunoassay. Cultured HUVEC released immunoreactive endothelin-1 (ir
      endothelin-1) into the medium in a time-dependent manner. This release was
      inhibited completely by 10 micrograms/mL cycloheximide and is, therefore,
      directly related to de novo protein synthesis. Further endothelin release was
      stimulated by the addition of thrombin to the culture medium. Thrombin-induced ir
      endothelin-1 release also was inhibited completely by 10 micrograms/mL
      cycloheximide. These results suggest that HUVEC in culture produce ir-endothelin
      1 slowly, but continuously, and that this production is stimulated by thrombin.

PMID- 2215248
TI  - Insulin resistance and acanthosis nigricans: evidence for a postbinding defect in
      vivo.
AB  - Acanthosis nigricans (AN) with insulin resistance has been traditionally
      attributed to insulin receptor abnormalities. To further clarify the postbinding
      defects of in vivo insulin action in this state, we applied the euglycemic
      insulin clamp technique, combined with the glucose trace infusion method, to 26
      subjects: 12 AN patients (eight normoglycemic and four hyperglycemic), eight
      obese, and eight lean control subjects. The normoglycemic AN group exhibited
      fasting hyperinsulinemia (666% of control), 160% elevated hepatic glucose
      production (HGP), 425% increased posthepatic insulin delivery rate, and only
      slightly reduced (19%) insulin clearance rates, compared with controls. Except
      for the latter, all these abnormalities were statistically significant (P less
      than .05), and could not be accounted for by body overweight. AN patients with
      diabetes mellitus (AN + DM) exhibited a further decreased insulin responsiveness
      (30%) and clearance (38%), together with a major increase in HGP (320%). All AN
      patients showed a significant right-shift in the insulin dose-response curve,
      indicating a decrease in insulin sensitivity. In conclusion, AN is characterized
      by increased basal rates of HGP, and peripheral insulin resistance, which can be
      partially attributed to postbinding defects. In AN + DM, a worsening of these
      abnormalities may be responsible for unmasking the existence of diabetes.

PMID- 2215249
TI  - Urinary organic acid profiles in fatty Zucker rats: indications for impaired
      oxidation of butyrate and hexanoate.
AB  - The urinary excretion of 45 organic acids, monitored by gas-liquid
      chromatography, was compared in fatty (fa/fa) and lean (Fa/?) Zucker rats
      maintained on a chemically simplified diet. At the age of 6, 16, and 22 weeks,
      fatty rats excreted more of the various organic acids than their lean
      counterparts. However, the greatest difference was in the excretion of
      ethylmalonate, even when excretion data were normalized to body weight. The next
      highest excretion difference was in adipate and an unknown compound, and the
      third highest in pyruvate. A second group of rats examined at 7 weeks also
      excreted an excess of these four acids, as well as glucuronate and indole-3
      acetate. The excessive excretion of ethylmalonate and adipate, which is
      characteristic of human genetic defects in short- and medium-chain fatty acid
      oxidation, suggested that the oxidation of butyrate and hexanoate might be
      impaired in the fatty rat. Thus, as a test of their capacity to oxidize medium-
      and short-chain fatty acids, two groups of fatty and lean rats were transferred
      to diets enriched with either trioctanoylglyceride, a medium-chain triglyceride
      (MCT), or sodium butyrate, a short-chain fatty acid. Both lean and fatty rats on
      the MCT diet, but only the lean rats on the butyrate-enriched diet, increased
      their excretion of adipate. However, on both the MCT and butyrate diet,
      ethylmalonate excretion increased only in lean rats, almost reaching amounts
      found previously in fatty rats. These results suggest that the fatty rat has an
      impairment of the beta-oxidation of butyrate and hexanoate, a defect that might
      increase intracellular concentrations of butyryl-CoA, the optimal primer for the
      synthesis of long-chain fatty acids.

PMID- 2215250
TI  - Metabolism of adipose tissue in intraabdominal depots in severely obese men and
      women.
AB  - In groups of obese men and women with an abdominal type of fat distribution, we
      measured fat cell size, lipoprotein lipase (LPL) activity and lipolysis
      stimulated by norepinephrine (NE) or isoproterenol (ISO) or inhibited by insulin,
      in subcutaneous abdominal and retroperitoneal (nonportal), as well as in omental
      and mesenteric (portal) adipose tissues. Both men and women had large
      intraabdominal adipocytes. No differences were found between the two groups of
      obese subjects in fat cell size or LPL activity in the different adipose tissue
      regions. Women had as high NE- or ISO-stimulated lipolysis in the portal as in
      nonportal fat tissues, equally high as that found in men. In comparisons with a
      previous study in nonobese men and women, these results show an increased fat
      cell size in all tissues in obese women and an increased lipolysis in portal
      tissues in obese women and in nonportal tissues in obese men. Taken together,
      these results might mean that obese men and abdominally obese women have a large
      potential to release free fatty acids (FFA) from intraabdominal depots. This
      might be followed by metabolic derangements seen in such groups of obese
      subjects.

PMID- 2215251
TI  - Metabolism of ketone bodies by skeletal muscle in starvation and uncontrolled
      diabetes.
AB  - Previous studies have suggested that skeletal muscle may be responsible for as
      much as 25% of ketone body (KB) production in poorly controlled diabetes. In the
      present studies, acetoacetate (AcAc) and beta-hydroxybutyrate production was
      quantitated in the canine hindlimb from surgically placed arterial and venous
      catheters in conscious insulin-withdrawn diabetic (n = 5) and 4-day fasted (n =
      7) dogs. A two-pool modeling technique, using simultaneous infusions of 13C
      acetoacetate and 14C beta-hydroxybutyrate (beta OHB) was employed to quantitate
      total body and hindlimb KB kinetics. Total KB production was 9.4 and 39.3
      mumol.kg-1.min-1 in the fasted and diabetic animals, respectively. Hindlimb KB
      production was negligible in both groups. The two-pool model estimates of
      hindlimb KB utilization were similar to the values obtained by an arterial-venous
      difference calculation. In conclusion, the hindlimb does not contribute to de
      novo synthesis of KBs in either fasted or diabetic dogs. Since species
      differences in KB metabolism occur, it is possible that muscle may be a site for
      KB production in humans.

PMID- 2215252
TI  - Abdominal obesity is associated with an impaired fibrinolytic activity and
      elevated plasminogen activator inhibitor-1.
AB  - Recent epidemiologic studies have shown that abdominal obesity, characterized by
      a high waist to hip circumference ratio (WHR), is associated with increased
      cardiovascular morbidity and mortality. The present study examines components of
      the fibrinolytic system in obese and lean middle-aged women with a high and low
      WHR. Ten women in each group were carefully matched with respect to age, body
      weight, lean body mass, and body fat. Fibrinogen and endothelial type of
      plasminogen activator inhibitor -1 (PAI-1) were significantly elevated in the
      obese women with a high WHR compared with the obese women with a low WHR or with
      both groups of lean women. In addition, obese women with a high WHR exhibited a
      greater metabolic risk profile (elevated glucose, insulin, and triglyceride
      levels). When all subjects were pooled for the analyses, both fibrinogen and PAI
      1 levels correlated positively with glucose and insulin levels. PAI-1 was also
      negatively related to degree of insulin sensitivity measured with the euglycemic
      clamp technique. In the obese groups, WHR but not body mass index (BMI),
      correlated with PAI-1 levels. No such correlations were seen in the lean groups.
      In conclusion, the data show that a high WHR in obese, but not lean middle-aged
      women, is associated with an impaired fibrinolytic activity. This perturbation
      becomes enhanced when it is associated with hyperinsulinemia and insulin
      resistance, which is a typical feature of abdominal obesity.

PMID- 2215253
TI  - Impaired glucose tolerance and diabetes in obesity: a 6-year follow-up study of
      glucose metabolism.
AB  - To investigate the time course of glucose metabolism in obesity 33 patients (21
      to 69 years old; body mass index [BMI], 25.7 to 53.3 kg/m2) with different
      degrees of glucose intolerance or diabetes who had been studied initially and 6
      years later were submitted to the same 100-g oral glucose tolerance test (OGTT)
      with indirect calorimetry. From a group of 13 obese subjects with normal glucose
      tolerance (NGT), four developed impaired glucose tolerance (IGT); from a group of
      nine patients with IGT, three developed non-insulin-dependent diabetes mellitus
      (NIDDM); five of six obese NIDDM subjects with high insulin response developed
      NIDDM with low insulin response. Five patients had diabetes with hypoinsulinemia
      initially. As previously seen in a cross-sectional study, the 3-hour glucose
      storage measured by continuous indirect calorimetry remained unaltered in
      patients with IGT, whereas it decreased in NIDDM patients. A further decrease in
      glucose storage was observed with the lowering of the insulin response in the
      previously hyperinsulinemic diabetics. These results confirm cross-sectional
      studies that suggest successive phases in the evolution of obesity to diabetes:
      A, NGT; B, IGT (the hyperglycemia normalizing the glucose storage over 3 hours);
      C, diabetes with increased insulin response, where hyperglycemia does not correct
      the resistance to glucose storage anymore; and D, diabetes with low insulin
      response, with a low glucose storage and an elevated fasting and postload
      glycemia.

PMID- 2215254
TI  - Repeated ingestion of aspartame-sweetened beverages: further observations in
      individuals heterozygous for phenylketonuria.
AB  - Six adults heterozygous for phenylketonuria (PKU) ingested eight successive
      servings of unsweetened and aspartame (APM)-sweetened beverage at 1-hour
      intervals in a randomized, balanced, crossover design. In one part, the eight
      beverage servings were not sweetened. In the other, each of the eight beverage
      servings provided 600 mg of APM, a dose equivalent to the amount provided by 36
      oz of an APM-sweetened diet beverage. Plasma aspartate concentration was not
      significantly increased after ingestion of unsweetened or APM-sweetened beverage.
      Similarly, ingestion of the unsweetened beverage had no significant effect on
      plasma phenylalanine concentration. However, ingestion of APM-sweetened beverage
      significantly increased plasma phenylalanine concentrations 2.35 to 4.03 mumol/dL
      above baseline 30 minutes after ingestion. Plasma phenylalanine values reached a
      steady-state after administration of five servings of APM-sweetened beverage and
      were slightly, but significantly higher than usual postprandial values for adults
      heterozygous for PKU. Similarly, the ratio of the plasma phenylalanine
      concentration to the sum of the concentration of the large neutral amino acids
      was significantly higher than usual postprandial values. Blood methanol and
      formate concentrations remained within normal limits. These data indicate that a
      fasting adult heterozygous for PKU could consume the equivalent of 24 12-oz
      servings of APM-sweetened beverage over an 8-hour period and only increase plasma
      phenylalanine concentration to a modest degree.

PMID- 2215255
TI  - Dual effect of metformin in cultured rat hepatocytes: potentiation of insulin
      action and prevention of insulin-induced resistance.
AB  - The ability of the biguanide hypoglycemic agent metformin to improve the acute
      effects of insulin on glucose and/or lipid metabolism was investigated in both
      insulin-responsive and insulin-resistant cultured rat hepatocytes: (1) metformin
      (20 micrograms/mL, 16 hours) increased the insulin-dependent stimulation of
      glycogen and lipid synthesis through an exclusive enhancement of the
      responsiveness without modification of the cell sensitivity to the hormone; (2)
      metformin neither altered basal glycogenesis from [U-14C]glucose and basal
      lipogenesis from [1-14C]acetate nor insulin binding. These results indicate the
      ability of this drug to selectively potentiate the acute action of insulin at a
      postreceptor step in normal liver cells. A prolonged incubation with insulin (16
      hours, 5 x 10(-7) mol/L) led the hepatocytes to a state of resistance evidenced
      by a 50% decrease in their maximal responsiveness and sensitivity to a subsequent
      acute stimulation by the hormone, as assessed on lipogenesis. Addition of
      metformin (20 micrograms/mL) during the overnight incubation of hepatocytes with
      insulin prevented the decrease in cell responsiveness and sensitivity to the
      hormone for the stimulation of lipogenesis, thus showing that metformin was able
      to hamper the development of the resistant state to the hormone in this pathway.
      These results strongly suggest that metformin improves type 2 diabetes through an
      effect at the hepatic level on both insulin action and insulin-induced
      resistance.

PMID- 2215256
TI  - Insulin-mediated glucose uptake by individual tissues during sepsis.
AB  - Gram-negative hypermetabolic sepsis has been previously reported to produce whole
      body insulin resistance. The present study was performed to determine in vivo
      which tissues are responsible for the sepsis-induced decrease in insulin-mediated
      glucose uptake (IMGU), and whether that decrease was related to a change in
      regional blood flow. Vascular catheters were placed in rats and sepsis was
      induced by subcutaneous injections of Escherichia coli. Insulin action was
      assessed 20 hours after the first injection of bacteria by the combined use of
      the euglycemic hyperinsulinemic clamp and the tracer 2-deoxyglucose (dGlc)
      technique. Insulin was infused at various rates in separate groups of septic and
      nonseptic rats for 3 hours to produce steady-state insulin levels between 70 and
      20,000 microU/mL. Rats were injected with [U-14C]-dGlc 140 minutes after the
      start of the euglycemic hyperinsulinemic clamp for the determination of the
      glucose metabolic rate (Rg) in selected tissues. The maximal response to insulin
      was decreased 30% to 40% in the gastrocnemius, and in the red and white
      quadriceps. The former two muscles also showed a decrease in insulin sensitivity.
      However, the insulin resistance seen in hindlimb muscles was not evident in all
      muscles of the body, since IMGU by abdominal muscle, diaphragm, and heart was not
      impaired by sepsis. The basal Rg by skin, spleen, ileum, and lung was increased
      by sepsis, and was higher than the insulin-stimulated increases in Rg by these
      tissues in nonseptic animals. Cardiac output was similar in septic and nonseptic
      rats and did not change during the infusion of insulin. Under basal conditions,
      sepsis appeared to redistribute blood flow away from the red quadriceps and skin,
      and increased flow to the liver (arterial), lung, and small intestine. When
      plasma insulin levels were elevated, hepatic arterial blood flow was increased,
      and flow to the red quadriceps and skin was decreased in nonseptic animals.
      Hyperinsulinemia did not produce any consistent change in regional blood flow in
      septic animals. The results of this study indicate that a decrease rate of IMGU
      in muscle is primarily responsible for the whole body insulin resistance seen
      during hypermetabolic sepsis, and that the impairment of insulin action in
      skeletal muscle is not dependent on fiber type or to changes in blood flow.

PMID- 2215257
TI  - Hospital information systems and the quality of therapeutics.

PMID- 2215258
TI  - Using connectionist modules for decision support.
AB  - A connectionist model for decision support was constructed out of several back
      propagation modules. Manifestations serve as input to the model; they may be real
      valued, and the confidence in their measurement may be specified. The model
      produces as its output the posterior probability of disease. The model was
      trained on 1,000 cases taken from a simulated underlying population with three
      conditionally independent manifestations. The first manifestation had a linear
      relationship between value and posterior probability of disease, the second had a
      stepped relationship, and the third was normally distributed. An independent test
      set of 30,000 cases showed that the model was better able to estimate the
      posterior probability of disease (the standard deviation of residuals was 0.046,
      with a 95% confidence interval of 0.046-0.047) than a model constructed using
      logistic regression (with a standard deviation of residuals of 0.062, with a 95%
      confidence interval of 0.062-0.063). The model fitted the normal and stepped
      manifestations better than the linear one. It accommodated intermediate levels of
      confidence well.

PMID- 2215259
TI  - A method for the acquisition of formalized knowledge in pathology.
AB  - A tool is introduced for the acquisition of pathology knowledge in a formalized
      form, directly by the expert. Formalization of the knowledge is intended to make
      descriptive pathology knowledge more suitable for computerized diagnostic support
      since a formal representation of knowledge allows more extensive indexing, hence
      more flexible access. The knowledge acquisition (KA) tool also provides a useful
      research instrument to investigate to what extent pathology knowledge can be made
      explicit, to what degree ambiguity is present, in what way experts differ when
      formalizing knowledge, and whether it is feasible to incrementally acquire
      decision criteria on the basis of the formalized descriptive knowledge. Crucial
      in the design of the KA tool is the incorporated meta-knowledge, which is
      reflected by the knowledge-base structure and is used to elicit knowledge from
      the expert. Knowledge is acquired from the expert via a menu-driven user
      interface, which follows the general steps of the pathologist when describing a
      case. The paper discusses the considerations underlying the design, the
      implementation of the KA tool, and the research goals.

PMID- 2215260
TI  - BRAINDEX: an interactive, knowledge-based system supporting brain death
      diagnosis.
AB  - BRAINDEX (Brain-Death Expert System) is an interactive, knowledge-based expert
      system offering support to physicians in decision making concerning brain death.
      The physician is given the possibility of communicating in almost natural
      language and, therefore, in terms with which he is familiar. This updated version
      of the system is implemented on an IBM-PC/AT with the expert system shell PC-PLUS
      and consists of about 430 rules. The determination of brain death is realized
      with backward chaining and for the optional coma-scaling a forward-chaining
      mechanism is used.

PMID- 2215261
TI  - Cluster analysis of antigenic profiles of tumors: selection of number of clusters
      using Akaike's information criterion.
AB  - A basic problem of cluster analysis is the determination or selection of the
      number of clusters evinced in any set of data. We address this issue with
      multinomial data using Akaike's information criterion and demonstrate its utility
      in identifying an appropriate number of clusters of tumor types with similar
      profiles of cell surface antigens.

PMID- 2215262
TI  - Use of a hospital database to determine the characteristics of diagnostic tests.
AB  - Test indices are often determined by comparing test results of healthy persons
      with test results of patients known to have the disease. However, the patient
      population for which the test is ordered in clinical practice often differs from
      the study population on which the test indices are based. Hence, these indices
      are not applicable to clinical practice and should be recalculated using data
      from daily clinical practice. Two major problems of using routinely collected
      data are discussed: the assessment of the final health status and tracing the
      reason for ordering the test. Prior considerations are given to the use of
      hospital information systems (HIS) to sample the patient population that is
      desired and to collect the necessary data for calculating test indices. We
      investigated whether the HIS of Leiden University Hospital (which is presented as
      an example) can be used to calculate the indices of clinical laboratory tests,
      histopathologic examinations and radiodiagnostic investigations. The results
      indicate that the registration of diagnoses must be improved and that a way must
      be found to capture the implicit reasoning for ordering diagnostic tests.

PMID- 2215263
TI  - Sensitivity and specificity of acid phosphatase to detect prostate cancer using
      data from a hospital information system.
AB  - Indices of diagnostic tests, such as sensitivity and specificity, should be
      determined using diagnostic test results of patients tested in clinical practice.
      Hospital information systems that store data on diagnostic tests and diagnoses
      might be used for sampling the desired study population and in the actual process
      of collecting the data. This paper presents, as an example, a study calculating
      the sensitivity and specificity of the prostate-specific acid phosphatase test.
      All data needed in the study were obtained from the hospital information system
      of Leiden University Hospital. The final health status of each patient was
      assessed by the cancer registry of the system. The reason for ordering the test
      was deduced from data on histopathological examinations of prostatic tissue. The
      actual selections made from the central database are described in dataflow
      diagrams. The sensitivity of the test was found to be 0.34 and the specificity
      0.88, using a discrimination value of 1.00 U/l. The impact of the reason for
      ordering the test on the specificity is illustrated. Possible biases of these
      measured values are discussed.

PMID- 2215264
TI  - Converting the representation of medical data: criteria to code the underlying
      cause of death.
AB  - This study deals with a set of coding directives that were conceived for trained
      coding clerks and rely upon knowledge of their cultural background. These
      directives were formalized and adapted for computer use and in this form must
      rely upon a background of explicit medical knowledge. Medical data on death
      certificates are an invaluable source of information regarding prevention of
      major causes of death. These causes are coded and tabulated worldwide by means of
      the International Classification of Diseases (ICD). The ICD manual issues
      directives to achieve uniformity of coding throughout the world. The coder is
      required to trace back the flow of events which caused death and to single out
      the most significant concept from the statistical point of view. After
      emphasizing the problems encountered in the formalization, the methodological
      contribution of this work to the identification of a modular architecture for a
      system which represents and "reshapes" knowledge from medical documents is
      presented. Therefore we focus on the features of the two kinds of knowledge that
      must be supplied to a knowledge-based system, in order to enable it to perform
      semantic conversions on given medical data, namely: i) generic guidelines; ii)
      detailed medical knowledge.

PMID- 2215265
TI  - Detection of aberrant observations in a background of an unknown multidimensional
      Gaussian distribution.
AB  - An exploratory iterative technique for the detection of aberrant observations on
      a background of a multidimensional Gaussian distribution is described. Its
      development was motivated by the analysis of a set of three measurements
      reflecting the acid-base metabolism in the blood of 2,402 intensive care
      patients. This new, three-dimensional treatment of such data yields a meaningful
      description. A technical evaluation of the method, using artificially generated
      data is also presented. It is shown that the model parameters of the underlying
      Gaussian distributions are determined with good accuracy and that the accuracy
      with which the contamination is estimated increases with increasing distance of
      the contaminating observations from the mean.

PMID- 2215266
TI  - Planning the size of clinical trials with allowance for patient noncompliance.
AB  - Various approaches are considered for adjustment of clinical trial size for
      patient noncompliance. Such approaches either model the effect of noncompliance
      through comparison of two survival distributions or two simple proportions.
      Models that allow for variation of noncompliance and event rates between time
      intervals are also considered. The approach that models the noncompliance
      adjustment on the basis of survival functions is conservative and hence requires
      larger sample size. The model to be selected for noncompliance adjustment depends
      upon available estimates of noncompliance and event rate patterns.

PMID- 2215267
TI  - 25 years of hormonal replacement therapy.

PMID- 2215268
TI  - The history and rationale of hormone replacement therapy.
AB  - Robert Wilson rendered women aged over 45 a great service. He provoked a line of
      research which has in 25 years resulted in a sensible approach towards the use of
      medication in treating the climacteric and post-menopausal oestrogen deficiency.
      The history of hormone replacement therapy (HRT) is described, as is the current
      approach to rational HRT. Some ideas are outlined for future development.

PMID- 2215269
TI  - Clinical use of oestrogens and progestogens.
AB  - Oestrogens cure climacteric complaints and prevent the late sequelae of oestrogen
      deficiency. Prevention of myocardial infarction and of osteoporosis is now the
      main argument for long-term substitution of oestrogens and progestogens in the
      post-menopause and leads to a reduction of overall morbidity and mortality in
      users. Indications, contraindications, some side effects, risk-benefit and cost
      benefit considerations are discussed and practical advice for oestrogen
      medication with regard to doses, preparations and the addition of progestogens is
      given.

PMID- 2215270
TI  - Hormonal replacement therapy and the skeletal system.
AB  - The two most important risk factors for maintaining skeletal health are the bone
      mass obtained at skeletal maturity (peak bone mass) and the subsequent bone loss.
      Those women with a low peak bone mass and a rapid bone loss are thus at increased
      risk of developing osteoporosis in the future, and should be identified. This may
      be accomplished by determination of the bone mass combined with an estimate of
      the rate of the postmenopausal bone loss. The bone mass can be accurately
      assessed in the forearm by single photon absorptiometry. The postmenopausal bone
      loss can be estimated by three or four biochemical markers of bone turnover. The
      women at highest risk of developing osteoporosis should be offered preventive
      therapy, e.g., hormonal replacement therapy (HRT). HRT arrests the bone loss not
      only in early, but also in elderly postmenopausal women. The effect lasts as long
      as the therapy is continued. Several epidemiological studies have demonstrated
      that HRT decreases the number of osteoporotic fractures.

PMID- 2215271
TI  - Ovarian hormones and the circulation.
AB  - Ovarian steroids have effects on blood circulation involving the mechanisms which
      control blood flow and the changes that occur in the pathogenesis of
      atherosclerosis. Estrogens appear to protect women from cardiovascular disease
      through their effects on lipid metabolism as well as more direct effects on
      arterial walls which appear to inhibit atherosclerotic plaque formation. There is
      increasing evidence that estrogen replacement after menopause can markedly reduce
      female mortality due to vascular disease. Effects of hormone imbalance and
      deficiency on vasomotor control are clinically significant and hormone treatment
      appears to be effective in the management of a variety of conditions due to
      abnormal blood flow including vasomotor instability, migraine, vaginal dryness
      and, perhaps, some forms of angina. Most review articles have focused on the
      effects of ovarian steroids and lipid metabolism as well as the findings of
      recent epidemiologic studies. This is understandable as those investigations have
      proved so valuable in understanding the protective effects of estrogens. The
      present discussion, in contrast, focuses on the effects of ovarian steroids,
      estrogens in particular, on circulatory mechanisms. At the present time there is
      increasing interest in these studies. Findings thus far appear to contribute to
      understanding estrogen cardioprotection and also raise awareness of a variety of
      clinical conditions in which estrogen treatment could be indicated because of its
      effects on circulation.

PMID- 2215272
TI  - Emotional well-being, sexual behaviour and hormone replacement therapy.
AB  - Improvements in the design of epidemiological studies of the climacteric and
      postmenopause have been made in the past 25 years. But more complex theoretical
      models are necessary if we are to give due emphasis to the influence of
      psychological, social, cultural and hormonal factors and their interactions. The
      majority of studies show that emotional problems are not more prevalent during
      the climacteric and postmenopause and that psychosocial factors, such as
      stressful life-events, are more likely causes of emotional distress during mid
      life. Vaginal dryness increases in postmenopausal women but there are varied
      reasons for changes in other aspects of sexual behaviour which require further
      research. While estrogen may have a "mental tonic" effect when prescribed in high
      doses, HRT does not appear to have a significant effect upon mood or sexual
      behaviour over and above placebo effects and the relief from vasomotor and
      vaginal symptoms.

PMID- 2215273
TI  - The value of the menopause clinic, a personal opinion.

PMID- 2215274
TI  - Policyholder seeks fair payment from the Blues.

PMID- 2215275
TI  - Physician office reimbursement problems. Help is at hand.

PMID- 2215276
TI  - Michigan physicians to face growing numbers of HIV-positive patients.

PMID- 2215278
TI  - MSMS Medicaid Liaison Committee--an independent voice for physicians.

PMID- 2215277
TI  - Kevin Seitz--working to build a healthier Medicaid system.

PMID- 2215279
TI  - Michigan Orthopedic Society. Delivery of care has become a serious issue.

PMID- 2215280
TI  - When it comes to health insurance, MSMS members have many lessons to learn.

PMID- 2215281
TI  - Government must address increase in repetitive motion injuries.

PMID- 2215282
TI  - Informed consent: an update.

PMID- 2215283
TI  - [The composition of a population of cloned cultures of revertant Vibrio cholerae
      L forms].
AB  - The process of L-transformation and L-transformed state duration have been
      studied for their effect on variability of main characters of revertant cultures
      of choleric vibrions L-forms at the population level with the use of cloned
      cultures of the choleric vibrions. The study was conducted on two strains of the
      choleric vibrion of the eltor biovar in different periods of storage in the L
      transformed state (1, 3, 6 months). It has been revealed that characters of the
      species and biovar remained stable despite the influence of L-transforming
      agents. The characters of clone cultures characterizing virulence (sensitivity to
      KhDF phages, hemolytic activity, toxin production and virulence for sucking
      rabbits proved to be subjected to variability to the greatest extent with
      simultaneous preservation of the toxin-production gene. A resistant change of the
      serovar (from Inaba to Ogava) is observed only in one revertant-subculture of the
      virulent strain.

PMID- 2215284
TI  - [A comparative study of the oxidation processes in the cells of typical forms and
      L forms of Vibrio cholerae].
AB  - A comparative study of metabolic processes in cells of typical forms and L-forms
      of cholera vibrios has determined a change in the intensity of oxidative
      processes demonstrated through a decrease in the activity of respiration enzymes
      (dehydrogenases and diaphorases) and through a restricted transport of electrons
      along the respiration chain. The facts established evidence for the transition of
      L-transformed cells into a physiological state with a deficit of substrates and
      energy as well as with retarded processes of vital activity and repressed
      mechanisms of reparation of structural elements of a cell.

PMID- 2215285
TI  - [The characteristics of the biosynthesis of surface-active lipids by a Bacillus
      sp. culture].
AB  - It is established that the Bacillus sp. C-14 strain is able to produce the
      biosurfactant of lipopeptide nature which decreases the surface and interfacial
      tension to 29.5 and 2.0 mH/m, respectively. The biosurfactant synthesis is shown
      to depend on the substrate nature, N:C ratio in the medium as well as on the
      presence of sodium citrate as a stimulator of lipogenesis.

PMID- 2215286
TI  - [An immunological analysis of the hemagglutinin from the influenza A virus (H1N1)
      isolated by using various detergents].
AB  - Immunogenic properties of influenza virus hemagglutinin, isolated by new
      detergents O-14 (desintegron-O) and B-14 (desintegron-B) have been studied.
      Hemagglutinin isolated by desintegron-O has been found to be more immunogenic
      than virions. It has been shown that hemagglutinin isolated by desintegron-B
      induces a lower humoral immune response than the influenza virus.

PMID- 2215287
TI  - [The possibilities for enhancing the immunogenicity of adenovirus hexon].
AB  - Synthetic polyelectrolytes and muramyldipeptide derivatives are tested as
      immunostimulators. It is established that the level of antibody-forming cells and
      specific (virus-neutralizing and precipitating) antibodies considerably rises
      during the immunization of human adenovirus I hexon in the combination with N
      acetylglucosaminyl-muramyldipeptide and conjugation with a copolymer including
      acrylic acid and N-vinylpyrrolidone. A more expressed intensification of the
      antibody-formation is observed with the use of polyelectrolytes.

PMID- 2215288
TI  - [The mitogenic properties of Fusarium graminearum and Rhodococcus erythropolis
      enzymes].
AB  - Blast transformation of peripheral blood lymphocytes in healthy people is studied
      by enzymes of the microbic origin possessing the lectin activity. Galactose
      oxidase of Fusarium graminearum IMV-F-1060 is shown to be mitogenically active
      with respect to the lymphocytes in the culture in vitro and may be one of home
      sources of lymphocytic mitogens for the laboratory investigations.

PMID- 2215289
TI  - [The virulence and antibiotic resistance of Escherichia isolated from man].
AB  - The virulence and antibiotic resistance of the same 75 strains of pathogenic
      Escherichia (PE) has been studied. Simultaneous determination of virulence in
      three tests (keratoconjuctival, intranasal and with the infection of cell
      culture) has permitted increasing detection of virulence strains to 97.4%.
      Differences of PE in O-antigen as well as differences of strains depending on the
      source of their isolation (a sick or a healthy carrier) have not an essential
      effect on the PE virulence. Drug resistance of PE was induced by neomycin (the
      highest degree) and by other antibiotics (arranged in the descending order):
      mycin, streptomycin, laevomycetin, polymyxin, tetracyclin and gentamycin.

PMID- 2215290
TI  - [The adhesion of lactic acid bacteria to the intestinal epithelium of
      agricultural animals].
AB  - The lactic acid bacteria isolated from different ecological niches are
      established to be able to adhere in vitro to the intestine epithelium of pigs and
      cattle. The studied strains of enterococci have a higher index of adhesiveness
      (5.7-2.24) as compared to lactic acid bacilli (3.34-1.08). Detection of the
      lactic acid bacteria ability to adhere to intestine enterocytes of agricultural
      animals served as a premise to use those bacteria when constructing preparations
      of the directed action on the basis of living cultures.

PMID- 2215291
TI  - [Proteus adhesion to intestinal epithelium].
AB  - The adhesive properties of Proteus strains isolated from different sources have
      been studied under conditions similar to the real interaction of microorganisms
      with the epithelial cells of intestine. A comparison of the adhesive properties
      of Proteus and of colon Bacillus has shown that the value of the strong adhesion
      to the mucosa of Proteus isolated under enterocolitis at the same bulk
      concentrations of the infectious suspension is 2-3 order less than that of E.
      coli. The adhesion of Proteus to the surface of epithelial cells begins at bulk
      concentrations exceeding those for the colon Bacillus by 3-4 orders. Besides, a
      toxic effect of number of freshly isolated Proteus strains on the epithelial
      cells of intestine mucosa is observed. Strains isolated from patients with
      diarrhea and from environment differed from each other in the studied criteria. A
      conclusion is drawn that at the initial stage of the interaction with the
      intestine mucosa the Proteus strains differ considerably from the indigenous
      strain of the colon Bacillus in the ability to colonize the epithelial surface.

PMID- 2215292
TI  - [The extracellular lectins of bacteria].

PMID- 2215293
TI  - Development of continuing medical education in Europe: a review.
AB  - This short review sets out some general facts and features concerning the
      development of continuing medical education (CME) in Europe. The review is
      intended as a basis for proposing plans and action for CME in the future. Europe,
      as it happens, was the birthplace and cradle of both scientifically based medical
      education in general and CME in particular. Three stages of development are
      distinguished: (1) Development of CME from the 19th century up to the beginning
      of the Second World War; (2) After 1945; (3) CME in the present.

PMID- 2215294
TI  - Quantitative assessment of diagnostic ability.
AB  - This paper describes variables critical to diagnostic thinking that are based on
      research by Bordage and Grant & Marsden on the diagnostic thinking of medical
      students and experienced doctors. The purpose of the study is to use their
      findings to develop an inventory of diagnostic thinking. A 56-item diagnostic
      thinking inventory was initially developed; each item contains a stem followed by
      a 6-point, semantic differential scale. The inventory is designed to measure two
      aspects of diagnostic thinking: the degree of flexibility in thinking and the
      degree of knowledge structure in memory. The specific goal of the study is to
      determine which items discriminate best between weaker and stronger
      diagnosticians and to reduce the inventory to only those items which
      significantly contribute to the overall score. Thirty subjects from nine groups,
      each representing a distinct phase of medical education and clinical practice,
      participated, namely first- and third-year clinical medical students, house
      officers, senior house officers, registrars, senior registrars, consultants,
      trainees in general practice, and general practitioners, all from the UK (n =
      270). Discrimination indices were calculated for each item. The revised version
      of the inventory contains 41 items. All the subjects found the exercise
      meaningful and the resulting scores showed variance and discrimination. The
      inventory will eventually be used to assess individual student's and clinician's
      diagnostic thinking and to plan ways of improving their diagnostic thinking.

PMID- 2215295
TI  - Self-directed learning in anatomy: incorporation of case-based studies into a
      conventional medical curriculum.
AB  - This paper reports an attempt to develop self-directed learning skills in second
      year medical students by introducing case-based projects into the gross anatomy
      course at a long-established medical school. The programme and students'
      responses to a questionnaire completed at the end of the year are presented.
      Information on the various resources used by students to find information is
      given. The performance of students in the case-based components of the course has
      been evaluated and also in the more traditional end-of-year written examination.
      The data confirm that students have recognized that the projects were about
      obtaining a deeper understanding of the anatomy, and the programme appears to
      have promoted the use and study of library texts.

PMID- 2215296
TI  - Communication skills and clinical methods: a new introductory course.
AB  - In the revised medical curriculum at Sheffield University, a new 4-week
      introductory clinical course has been introduced to teach communication skills,
      clinical history-taking and physical examination. There is no formal examination
      for the course, which has been evaluated by feedback from students and tutors
      with questionnaires and group discussion.

PMID- 2215297
TI  - Early diagnosis of substance abuse: evaluation of a course of computer-assisted
      instruction.
AB  - A computer-assisted, experiential course of instruction on early diagnosis of
      substance abuse was developed and compared to three existing substance abuse
      curricula for third-year medical students on family medicine clerkships. The
      experimental course, requiring 2 hours of teacher contact, consisted of three
      computer-assisted instruction modules, active discussion, role play,
      opportunities for applying new knowledge and clinical skills, and modelling of
      clinical interest by a family doctor. The three comparison educational programmes
      were a one-week immersion experience on a substance abuse in-patient unit, 1-4
      hours of lecture, and no formal teaching. For 6 months, all third-year medical
      students at Jefferson Medical College were exposed to one of these courses, and
      to the same required readings on substance abuse, on their required family
      medicine rotations at different clerkship sites. They completed end-of-rotation
      questionnaires assessing their knowledge, satisfaction with substance abuse
      teaching, and motivation for continued learning. Groups were similar with regard
      to demographic variables, academic performance, and previous curricular and extra
      curricular exposure to substance abuse. Despite a possible selection bias
      favouring the immersion experience, the computer-assisted course resulted in
      higher levels of knowledge on early diagnosis, but similar attitudes and
      satisfaction. The computer-assisted and immersion courses produced more
      favourable outcomes than lecture-based teaching and no formal teaching. Compared
      to no formal teaching, lecture did not produce measurable effect. The results
      suggest that a computer-assisted, experiential substance abuse course, based on
      relevant and practical goals, can efficiently augment knowledge and motivation
      for further learning of third-year medical students.

PMID- 2215298
TI  - Televised paediatric consultations: a student evaluation of a multipurpose
      learning strategy.
AB  - Since 1984, each student in the sixth-year paediatric rotation in the Department
      of Paediatrics and Child Health at the University of the Witwatersrand has been
      videotaped while undertaking a comprehensive paediatric primary care
      consultation. Video replay of the consultation by each individual student was
      evaluated by the student together with medical and social work tutors. This
      incorporated psychosocial aspects, communication skills, doctor-mother-child
      interactions, as well as essential medical content, clinical examination
      techniques, and management strategies. The student was expected to provide
      comprehensive health care, viz. dealing with the presenting health problems,
      identifying any possible hidden agenda, giving due attention to nutrition,
      immunization, development, optimal use of available records, health surveillance
      and appropriate education. This teaching programme was introduced in 1984. In
      1988, 68 consecutive final-year medical students completed an anonymous Likert
      type evaluation form scoring their perceived learning. They affirmed that the use
      of television in medical education provides a unique multipurpose learning
      strategy and in particular enhances awareness of self and of patient/family
      needs. The time, cost and effort invested in this programme are considered
      justified.

PMID- 2215299
TI  - Changes in attitudes towards psychiatry among medical students: correlation of
      attitude shift with academic performance.
AB  - This study investigates the changes in attitudes to psychiatry and level of
      psychiatric knowledge among medical students before and after formal teaching on
      psychiatry. Teaching led to the development of more favourable attitudes
      (particularly among women) towards psychiatry, but doubt remained after teaching
      about the 'scientific' status of the discipline. Initial attitudes did not relate
      to academic performance but, those developed after teaching showed a significant
      positive correlation with it.

PMID- 2215300
TI  - Evaluating family counselling skills training for family practice.
AB  - Educational programmes for family practice should develop family counselling
      skills of students to moderate levels of competence. Few specific training
      programmes are part of the regular curriculum and of these few are evaluated.
      Twenty-three residents enrolled in a 2-year family practice programme in Toronto,
      Canada participated in a non-randomized control intervention study to assess a
      specific training programme. Pre-training counselling skills, and ability were
      assessed using two types of generally recognized measurement instruments, the
      Carkhuff Stems of Communication Skills and the Carkhuff Discrimination Index. The
      treatment group entered the training programme which involved supervised family
      counselling 8 half-days each week for one month as part of their usual rotations.
      They completed a second set of instruments following this course to assess
      immediate within-group change and then both they and the control group completed
      a set about one year later to measure differences. Initial scores for all
      residents showed a less than 'minimally facilitative' level of counselling
      response on both empathy and warmth dimensions. Following the course, the
      treatment group scored above this level and significantly better than the control
      group. Furthermore, the former showed a 20% improvement in ability to
      discriminate between effective and ineffective helping responses which was
      sustained over one year, while the control group's scores became worse. Teaching
      of counselling skills can be effective.

PMID- 2215301
TI  - Medical education for the prevention of torture.
AB  - The United Nations Convention against Torture came into force on June 1987 and
      the European Convention for the Prevention of Torture on 1 February 1989. The two
      Conventions are complementary and do not overlap in any respect, including their
      relevance to training of health personnel. The United Nations Convention calls
      for education of all doctors and other health personnel. Education should
      therefore be at the undergraduate level and should provide an insight into
      torture methods, the goal and objectives of torture and the sequelae of torture
      so that doctors can identify victims of torture. Refugee victims of torture
      should not be sent back to countries where they are at risk of torture. The main
      principles of treatment must also be taught. The European Convention makes no
      demands for education of doctors in general and thereby no demands for
      undergraduate training. However, the activities of the Committee necessitate
      special postgraduate training of a limited number of persons: members of the
      committee, experts and interpreters.

PMID- 2215302
TI  - Tropical doctors and statistics.

PMID- 2215303
TI  - Human embryo experimentation and surrogacy.

PMID- 2215304
TI  - Fetal ultrasound for entertainment?

PMID- 2215305
TI  - Swallowing disorders in stroke.

PMID- 2215306
TI  - The incidence and distribution of RSI in South Australia 1980-81 to 1986-87.
AB  - Despite the human and financial cost of repetition strain injury (RSI),
      comprehensive incidence data have been lacking. A unique opportunity exists to
      obtain such data in South Australia, where since 1980-81 the Australian Bureau of
      Statistics has assigned all injuries, not explicitly diagnosed as diseases but
      stated as having been caused by repetitive movement, to a unique "type of
      accident" code, and has subclassified them according to bodily location. The
      statistical profile of diseases and accidents affecting the upper limb resulting
      from repetitive movement is not simply one of a keyboard operators' epidemic.
      Rather, it has revealed a problem which is endemic in sections of the blue-collar
      workforce, in whom both the numbers and the incidence rates are higher than in
      keyboard operators, and were higher even when the incidence in keyboard operators
      peaked in 1984-85. These conditions have been especially frequent in particular
      sections of the female blue-collar workforce, and interventions which have
      resulted in (or coincided with) benefits to keyboard operators have failed to
      improve the situation in the former group. It is suggested that the groups most
      at risk are female workers performing unfulfilling, unskilled tasks, and that
      interventions to benefit these workers will have to give attention to more
      fundamental issues than those hitherto addressed.

PMID- 2215307
TI  - Prevalence of maternal HIV infection based on anonymous testing of neonates,
      Sydney 1989.
AB  - The presence of antibody to human immunodeficiency virus (HIV) in post-partum
      women may be inferred by screening the blood of their newborn babies, since
      maternal IgG antibodies freely cross the placenta. We tested a sample of 10,217
      newborns from 10 hospitals covering three areas in Sydney and other metropolitan
      centres in New South Wales from April to July, 1989. None of the specimens gave a
      positive test for antibody to HIV. Thus, the prevalence of HIV positive serology
      in this sample of newborns was found to be zero. It was estimated that the
      seroprevalence of antibody to HIV among all neonates in the study area was
      between zero and 0.045% (99% confidence interval). Because newborns are an
      accessible group for the study of HIV, and can act as surrogates for their
      mothers, anonymous testing of this sentinel group will remove some of the
      limitations generalizing the information in the present database of HIV infection
      in Australia. This study provides baseline data and suggests that there is not a
      widespread epidemic of HIV infection among heterosexual persons in Australia at
      the present time and that routine antenatal testing of women for antibody to HIV
      may not be cost-effective. However, it will be important to repeat this study at
      regular intervals to detect any increase in HIV seroprevalence.

PMID- 2215308
TI  - Predicting the course of AIDS in Australia.
AB  - There have been urgent demands for knowledge about the epidemic of the acquired
      immunodeficiency syndrome (AIDS) in Australia. Accurate predictions are important
      for efficient allocation and planning of limited health-care resources. Ideal
      data for this purpose would be reliable knowledge of the past and present
      incidence of human immunodeficiency virus (HIV) infection. However, since the
      incidence of the infection is unknown predictions can only be based on historical
      data of the incidence of AIDS. In this article, we show the limitations of such
      predictions by examining a broad range of mathematical models that successfully
      track the observed data (1187 cases diagnosed to December 31, 1988). In addition,
      we describe a simple method for prediction in subgroups where the numbers of
      cases observed so far are small. Four models representing different forms of
      departure from the simple exponential model provide the best fits to the
      Australian AIDS data. Regional variability and a possible effect resulting from
      the introduction of zidovudine were incorporated into the models. Significant
      regional variability in the course of the epidemic was observed between New South
      Wales, Victoria and the rest of the country. For Australia as a whole, the
      doubling time changed from less than one year before mid 1987 to more than two
      years after this time. Model fits were improved by fitting the models to just the
      four years of data from 1985. The models give comparable predictions for the
      first year (1989) of around 600 new cases. However, by 1993 the predictions vary
      considerably, ranging from 500 to 2300 new cases. It is predicted that between
      3100 and 6700 cases are likely to be diagnosed in Australia between 1989 and
      1993. The results from the subgroup prediction demonstrate that when the observed
      number of cases is small, then the range of predictions for a future time
      interval is very wide. For reliable long-term predictions that are necessary for
      public health planning, basic information on the past and present incidence of
      HIV infection is urgently needed.

PMID- 2215309
TI  - Measuring the HIV epidemic: the Western Australian experience.
AB  - Previous discussion about sources of error in measuring the human
      immunodeficiency virus (HIV) epidemic has tended to emphasise errors which
      underestimated the number of HIV infected persons. Data are provided from Western
      Australia illustrating potential errors which may result in overestimating the
      size of the epidemic. Duplication of persons notified in more than one State and
      multiple notifications by doctors and laboratories of single cases may give rise
      to substantial errors in over-estimation.

PMID- 2215310
TI  - Clinical assessment and management of swallowing difficulties after stroke.
AB  - The purpose of this study was to investigate the frequency of swallowing
      disorders in patients with stroke referred for speech pathology, and to determine
      the outcome of therapeutic intervention based on presenting symptoms ascertained
      from clinical bedside assessment. The study was conducted over a 12-month period
      (1988) in a 191-bed acute-care hospital. Data on referral of patients with stroke
      to the Speech Pathology Department and frequency of swallowing disorders were
      analysed, and showed a referral rate of 61% for patients with stroke, with a 54%
      prevalence of swallowing disorders among referred patients. On discharge, 75.5%
      of patients who had exhibited swallowing disorders were on full oral diets.

PMID- 2215311
TI  - Pain 1990: VIth World Congress on pain.

PMID- 2215312
TI  - Mercury pigmentation and high mercury levels from the use of a cosmetic cream.
AB  - A 42-year-old woman presented with facial mercury pigmentation, raised levels of
      mercury in the blood and urine and possible neuropsychiatric toxicity after the
      topical application of 17.5% mercuric ammonium chloride. The patient purchased a
      mercury-containing cream without prescription from Victorian pharmacies for many
      years to lighten her complexion. She was unaware of any health risk. No warning
      appears on the package or insert of the cream she used. Health workers,
      particularly pharmacists and medical practitioners, should be aware that over-the
      counter mercury-containing creams may raise the concentrations of mercury in the
      blood and urine to potentially toxic levels. A warning on the package should be
      considered and use of the cream restricted.

PMID- 2215313
TI  - Eosinophilic enteritis presenting as surgical emergencies: a report of six cases.
AB  - Eosinophilic enteritis is now commonly diagnosed in northern Queensland, and
      cases have been seen elsewhere. The patients present with acute abdominal
      symptoms, which may mimic appendicitis, and many cases are managed by surgery. To
      facilitate the diagnosis of this unusual syndrome, six surgically treated cases
      are reported here. Blood eosinophilia may be a helpful diagnostic feature, but in
      some cases it does not develop until after the acute abdominal episode. Most
      cases resolve satisfactorily with conservative management.

PMID- 2215314
TI  - An acute pain service in an Australian teaching hospital: the first year.
AB  - The Acute Pain Service began at the Royal Adelaide Hospital in April 1989.
      Funding, education programmes, policies, procedures, protocols, techniques
      (particularly patient-controlled analgesia, epidural opioid analgesia and
      subcutaneous morphine therapy) and daily organisation of the service are
      described in this article, and the experience with the 1053 patients referred to
      the Service during the first year of operation is reported. The occurrence of
      major complications was small. Mild-to-moderate respiratory depression occurred
      in four (0.5%) of the 747 patients who received patient-controlled analgesia and
      in none of the 177 who received epidural opioids. Five patients receiving patient
      controlled analgesia had persistent nausea/vomiting; 320 (35%) of all patients
      receiving patient-controlled analgesia or epidural opioids suffered
      nausea/vomiting that required no treatment or was alleviated by treatment with an
      antiemetic. Around 13% of patients reported mild-to-moderate itching. In our
      experience, the combination of appropriately trained nursing and medical staff,
      standardised orders and procedures, and proper supervision can lead to safe, more
      effective management of acute pain.

PMID- 2215315
TI  - Nystagmus retractorius and progressive ataxia in a young man: clinicopathological
      conference.

PMID- 2215316
TI  - Mammography and the diagnosis of palpable breast cancer.

PMID- 2215317
TI  - Medical and government response to child abuse.

PMID- 2215318
TI  - The diagnosis of breast cancer.

PMID- 2215319
TI  - The changing scene of liver surgery.

PMID- 2215320
TI  - Sun protection in Illawarra schoolchildren.

PMID- 2215321
TI  - Oestrogen deficiency following pelvic inflammatory disease.

PMID- 2215322
TI  - Risk of transmission of the human immunodeficiency virus in the prison setting.

PMID- 2215323
TI  - Hepatitis B infection--a proxy measure of risk factors for HIV infection in
      IVDUs?

PMID- 2215324
TI  - General practitioners and "problem" drinkers.

PMID- 2215325
TI  - General practitioners' knowledge of HIV infection and AIDS.

PMID- 2215326
TI  - Abused doctors.

PMID- 2215327
TI  - Hair replacement surgery.

PMID- 2215328
TI  - Lymphoedema Association of Victoria.

PMID- 2215329
TI  - Thiamine in our bread and wine.

PMID- 2215330
TI  - The ethics of resource allocation.

PMID- 2215331
TI  - Problems facing the teaching hospitals.

PMID- 2215332
TI  - Selection of medical students.

PMID- 2215333
TI  - Are dietary goals and guidelines enough?

PMID- 2215334
TI  - Sociodemographic determinants in Australia of the intake of food and nutrients
      implicated in cancer aetiology.
AB  - In recent years, there has been a growing awareness of the role that diet can
      play in the promotion, retardation or amelioration of the cancer process. This
      has led to the development of dietary guidelines for cancer prevention by health
      authorities in several Western societies. However, there is still limited
      information about the sociodemographic determinants of intake of foods and
      nutrients of interest in many of these countries. A study of the dietary intake
      of a random sample of residents of the State of Victoria in Australia showed that
      women, those in the older age groups and in the higher occupational ranks, had
      diets more in line with current recommendations for cancer prevention--the most
      marked differences being between men and women. However, the sociodemographic
      differences were relatively small compared with the low rate of overall
      compliance with the guidelines.

PMID- 2215336
TI  - Emergency and after-hours work performed in country hospitals.
AB  - Country doctors perform emergency work in addition to their conventional general
      practice role. Over a one-month period 17 general practitioners in four Hunter
      Region towns recorded all emergency calls describing the time they were called,
      the severity of the patients' conditions, the skills used and the time taken. A
      scale to measure severity of illness was devised and tested for this purpose.
      There were 1197 emergency calls, mostly seen at the local hospital, either in the
      outpatients department or on the wards. They were unevenly distributed in time,
      with fewer calls at night, but the doctors were disturbed during nearly half of
      their nights on call. Of the calls 15% were for trivial reasons, 34% were for
      patients who needed standard general practice care, and 50% were for patients who
      needed the services of the hospital or were already inpatients. Most attendances
      were brief, but 15% took more than 30 minutes and some much longer. Counselling
      skills were used for 47% of patients and technical skills in 22%. The strain of
      the work involved and the disturbance of personal life justify extra payments to
      country doctors, and the adequacy of current pay schedules is questioned.
      However, the peculiarities of funding result in the State Health Department
      underwriting most emergency costs in country towns, whereas in the cities the
      Commonwealth Department of Health pays for a larger proportion, leading to
      concern about the high apparent costs of country hospitals. The information in
      this survey may help improve planning for training and remuneration of country
      doctors to help ease the current shortage.

PMID- 2215335
TI  - Ultrasound diagnosis of lower limb deep venous thrombosis.
AB  - Venous ultrasound imaging was compared with ascending contrast venography for the
      diagnosis of suspected deep vein thrombosis (DVT) in the femoral, popliteal and
      calf vein segments of 44 limbs in 44 patients. One femoral and one calf vein
      segment could not be imaged (1.5% of the segments examined), but during the same
      period venography failed in six patients because of an inability to cannulate a
      swollen limb. Ultrasound imaging compared with venography as a means of
      diagnosing DVT showed an overall sensitivity of 95% and a specificity of 92%. The
      sensitivity and specificity of ultrasound imaging for the diagnosis of both
      femoral and popliteal vein thromboses were 100% and 97%, respectively, and for
      calf vein thrombosis were 85% and 83%, respectively. This study supports the
      recommendation that ultrasound imaging is now the investigation of choice for the
      diagnosis of DVT provided that the scan is performed by an experienced vascular
      technologist. Ultrasound imaging may also define other pathological conditions
      presenting in the differential diagnosis of DVT, such as superficial
      thrombophlebitis and Baker's cyst.

PMID- 2215337
TI  - Infection with Mycobacterium avium complex in Australian patients with AIDS.
AB  - Data supplied by tuberculosis reference laboratories in Australia indicate that
      from mid-1985 to the end of 1988, 202 patients with the acquired immunodeficiency
      syndrome (AIDS) were diagnosed as having concomitant infection caused by
      organisms of the Mycobacterium avium complex. This figure represents 17.3% of all
      AIDS cases diagnosed. Serotyping showed that the majority of isolates were
      serovars of M. avium, namely serovars 1, 4 and 8. There is evidence of geographic
      differences in the dominant serovar. Of 45 patients with isolates from more than
      one site of the body, 17 (38%) were infected with at least two different
      serovars. The findings show the importance of disseminated atypical
      mycobacteriosis in patients with AIDS, and they provide data for use in defining
      the epidemiology and natural history of such infections.

PMID- 2215338
TI  - Prolactin and breast cancer risk.
AB  - A study of 424 women was undertaken to determine whether there was an association
      between serum prolactin levels and breast cancer; whether prolactin levels would
      reflect degrees of risk of developing breast cancer; and whether associations
      between known risk factors for breast cancer and serum prolactin concentrations
      could be demonstrated. Prolactin levels higher than the median value in control
      subjects were found to be associated with a more than two-fold increase in the
      risk of breast cancer (relative risk, 2.1; confidence interval [CI], 1.0-4.5).
      Moreover, a relative risk of 1.7 (CI, 0.9-3.3) for a group of women with benign
      epithelial hyperplasia (high risk of developing breast cancer), and a relative
      risk of 1.0 (CI, 0.6-1.8) for a group with benign fibrocystic disease (low risk
      of developing breast cancer), provided supportive evidence that prolactin plays a
      role in the development of breast cancer. A considerable fall in the
      concentration of prolactin at menopause was noted, so those women who have an
      early menopause have a reduced period of exposure to high concentrations of
      prolactin. Similarly, there was a considerable reduction in prolactin
      concentration after the first pregnancy. Finally, our results showed that, in
      premenopausal women, a high intake of saturated fats was associated with a high
      prolactin concentration. Our study supports the concept that parity, menstrual
      status, and saturated fat consumption influence a woman's exposure to prolactin
      and therefore the risk of developing breast cancer.

PMID- 2215339
TI  - Hypotension: assessment and management.

PMID- 2215340
TI  - Eosinophilia-myalgia syndrome associated with L-tryptophan use.
AB  - A young, previously healthy woman presented with increasing muscle pain, lower
      limb swelling, fatigue and eosinophilia. She had consumed L-tryptophan tablets
      (one to two at night) over the preceding five months for management of her
      insomnia. Her condition slowly deteriorated and she developed generalised oedema
      and severe lethargy. A white blood cell count was 21.3 x 10(9)/L with 43%
      eosinophils (Normal range: 4.0-11.0 x 10(9)/L with 1-6% eosinophils. A biopsy
      specimen of the deep fascia and gastrocnemius muscle demonstrated fasciitis and
      myositis. The patient failed to recover after cessation of L-tryptophan use but
      her condition improved rapidly without significant sequelae after systemic
      treatment with corticosteroids.

PMID- 2215341
TI  - The turtle's revenge: a case of soft tissue Mycobacterium chelonae infection.
AB  - A case of cutaneous Mycobacterium chelonae infection with sporotrichoid spread
      and extensive antibiotic resistance is presented. Control of this problem was
      only achieved after extensive debridement and grafting of the involved limb. The
      importance of surgery in management is discussed and the literature is reviewed.

PMID- 2215342
TI  - Lightning strikes.
AB  - Lightning strike is a natural phenomenon with potentially devastating effects.
      The physics of lightning strike and the physiology of lightning injury are
      discussed. Three cases are reported and the clinical features are described.
      Aspects of the management of such patients are discussed with particular emphasis
      on assessment and resuscitation in the Emergency Department.

PMID- 2215344
TI  - Highly selective vagotomy in the treatment of complicated duodenal ulcers.

PMID- 2215343
TI  - Aconite poisoning.

PMID- 2215345
TI  - Some solutions to the shortage of general practitioners in rural Australia.

PMID- 2215346
TI  - Which anti-smoking programme?

PMID- 2215347
TI  - Alcohol taxes: the case for reform.

PMID- 2215348
TI  - Reducing agents and AIDS--why are we waiting?

PMID- 2215349
TI  - Pertussis notification.

PMID- 2215350
TI  - Risk of parasitic infections from sandpits.

PMID- 2215351
TI  - The injecting and sexual behaviour of intravenous drug users in Sydney.

PMID- 2215352
TI  - Sudden infant death syndrome and consumptive coagulopathy.

PMID- 2215353
TI  - Acute reactions to drugs of abuse.

PMID- 2215354
TI  - Efficient expression of chicken alpha 1(VI) collagen chain in transiently
      transfected mammalian cells.
AB  - Type VI collagen is a component of the extracellular matrix made of three
      subunits, alpha 1(VI) and alpha 2(VI) (Mr = 140,000), and alpha 3(VI) (Mr =
      greater than 300,000). Triple helical monomers assemble intracellularly into
      disulfide-linked dimers and tetramers, with the tetramers being the "building
      blocks" that give rise to higher order extracellular structures by head-to-head
      association, the microfilaments. To study the pattern of assembly and the
      structure-function relationships of type VI collagen, we transfected mammalian
      cells with a full-length cDNA coding for chicken alpha 1(VI) under the control of
      SV40 early and late promoters and assayed the expression, secretion, and assembly
      of the protein by immunoperoxidase and immunoprecipitation of metabolically
      labeled cells. First, conditions were determined that allowed efficient
      transfection both in African monkey kidney COS-1 and CV-1 cells and in mouse
      fibroblasts. In our hands the late promoter was most efficient in CV-1 cells;
      whereas the early promoter was efficient in L cells at three days post
      transfection. Chicken alpha 1(VI) could be isolated from cell extracts as well as
      from cell medium. Both the intracellular and the secreted forms of alpha 1(VI)
      are present as a monomer polypeptide and as disulfide-linked dimers and trimers
      that migrate in SDS gels with apparent Mr of about 130,000, 240,000 and 360,000,
      respectively. In L cells, endogenous mouse type VI collagen also was isolated by
      immunoprecipitation with specific antibodies. However, heterologous molecules
      made of the chicken alpha 1(VI) chain and the mouse alpha 2(VI) and alpha 3(VI)
      chains were not detected in the present experiments. Digestion with pepsin of the
      non-reduced chicken alpha 1(VI) polypeptides immunoprecipitated from the cell
      medium resulted in the disappearance of the bands, suggesting improper or non
      stable assembly of alpha 1(VI) homotrimers. These data support predictions from
      sequence analysis that type VI collagen heterotrimeric molecules are more stable
      than other assembly alternatives.

PMID- 2215355
TI  - Effect of static stretching on elastin production by porcine aortic smooth muscle
      cells.
AB  - An in vitro model was developed to assay the effects of static stretching on
      soluble elastin (tropoelastin, TE) synthesis by porcine aorta smooth muscle cells
      (SMC). Culture dishes containing SMC adherent to the deformable bottoms were
      placed over hard convex templates. Stress was applied by placing a weight on the
      dish covers. Measurement of TE was accomplished by a specific ELISA assay. With
      this model we demonstrated reproducible stimulation of TE synthesis by stretched
      SMC. Significant results (161.4% of control; p = less than 0.003 by Student's t
      test) were obtained by stretching passage 2 SMC for 3 days with a medium change
      after the first 18-24 hours, use of 5% newborn calf serum in cultures during
      stretching, and 50-g weight. DNA content in stretched cultures did not increase
      over control values. Thus, stretching alone did not cause hyperplasia or
      hyperploidy in these SMC and, in the absence of other vascular cell elements, was
      sufficient to increase production of this extracellular matrix protein.
      Transduction of mechanical force into elastin gene expression by SMC may
      contribute to the development of thickened arterial tunica media characteristic
      of hypertensive vessels.

PMID- 2215356
TI  - A highly specific and quantitative method for determining type III/I collagen
      ratios in tissues.
AB  - The distribution of type I and type III collagens in rat, bovine and human skin
      were examined by a quantitative 2-D CNBr peptide mapping method. The procedure
      involved the solubilization of tissues by digestion with CNBr, radioactive
      labeling in vitro by [3H]-NaBH4 in dimethylformamide, reduction by
      mercaptoethanol, a second CNBr digestion and 2-D (isoelectric focusing and
      NaDodSO4 electrophoresis) mapping. The amounts of type I and type III collagen
      peptide spots in the fluorographs of 2-D maps were analyzed by 2-D scanning
      densitometer/analyzer. Mixtures containing various ratios of purified type I and
      type III collagen were used to obtain a standard curve. Using this procedure we
      were able to determine that in adult human skin (age range 35-65 years) 22%
      (+1.3%) of the labelled collagen is type III. This value is significantly higher
      than that was previously estimated by less accurate methods.

PMID- 2215357
TI  - Alteration of collagen composition and cross-linking in keloid tissues.
AB  - Collagen composition and cross-linking in human keloid and normal skin tissues
      were analyzed biochemically. CNBr peptides were separated by 2-dimensional (2-D)
      mapping and high performance liquid chromatography (HPLC). The amounts of type I
      and type III collagen was quantified by 2-D scanning densitometry of fluorographs
      of 2-D maps derived from samples radioactively labelled in vitro by [3H]-NaBH4 in
      dimethylformamide. Keloid tissues contained 31.6 +/- 2.2 percent type III
      collagen as compared to 21.4 +/- 2.7 percent type III present in normal human
      skin dermis. HPLC profiles of CNBr peptides showed that approximately 5 percent
      of the high molecular weight material in keloids is mercaptoethanol reducible,
      compared to insignificant amounts in normal skin. 2-D maps derived from CNBr
      peptides of keloid collagen demonstrated thiol reduction sensitive alpha 1(III)
      CB9 dimer as well as 24,000- and 32,000-dalton CNBr peptides, which were not
      mercaptoethanol reduction sensitive in normal skin due to cross-linking via the
      lysyl oxidase pathway. Also, a group of 20,000- to 25,000-dalton CNBr peptides,
      in the alpha 1(I)-CB6 cross-linking region were prominent in keloid tissues.

PMID- 2215358
TI  - The susceptibility of elastin-fatty acid complexes to elastolytic enzymes.
AB  - Elastin in vivo is likely to be complexed with amphipathic ligands such as
      lipids. The susceptibility of stable [3H] elastin-fatty acid complexes to the
      action of porcine pancreatic elastase (PPE) and to human neutrophil lysates over
      time was assessed. Elastolysis by PPE of substrates prepared with oleic or
      linoleic acids was initially higher (for up to 2 hours) than that of uncomplexed
      elastin. Stearic acid and elaidic acid (the trans isomer of oleic acid) did not
      enhance the elastolytic rate above control. The stimulatory effect of oleic and
      linoleic acids appeared to derive from increased adsorption of PPE onto elastin;
      the loss of stimulatory activity over time occurred in parallel with a
      progressive decrease in adsorption. All fatty acids tested inhibited elastolysis
      by neutrophil lysates, the effect being particularly marked with oleic and
      elaidic acids. These results indicate that 1). Complexed fatty acids can modulate
      the rate of elastin breakdown by elastases; 2). The effects observed with PPE are
      due to differences in adsorption of enzyme onto substrate, possibly as a result
      of steric considerations; 3). Since elastolysis by neutrophil lysates is
      inhibited by all fatty acids, the properties of different elastolytic enzymes
      should be considered in in vitro model systems of connective tissue breakdown.

PMID- 2215359
TI  - Moderately severe osteogenesis imperfecta: biochemical studies showing variable
      defect localization in the triple-helical domain of type I collagen.
AB  - This report describes the biochemical investigations on six patients affected by
      a moderate form of Osteogenesis Imperfecta (type IV according to the Sillence
      classification). Biochemical characterization of type I collagen produced by skin
      fibroblasts showed considerable heterogeneity: in three patients out of six,
      collagen appeared normal; while in the three others a structural defect in the
      protein was present. In these probands the mutations were localized in different
      regions of the triple helix domain (corresponding to peptides alpha 1(I)CB6 and
      alpha 1(I)CB7). In two probands showing the defect in alpha 1(I)CB7, a decrease
      of the thermal stability of the protein was present.

PMID- 2215360
TI  - Preparation of a hospital rehabilitation system for war and other disasters.
AB  - A large number of casualties caused by war are in need of medical rehabilitation.
      Rehabilitation facilities are unable to cope adequately with them without advance
      planning and preparedness. Guidelines are suggested for the planning and
      preparation of a hospital rehabilitation system for war, including the
      formulation of policies, expanding and strengthening of existing rehabilitation
      facilities, and converting institutions, as well as securing the necessary human
      and material resources. It is also suggested that such plans and preparations
      should be adapted to form a basis for meeting rehabilitation needs caused by
      natural and civil disasters.

PMID- 2215361
TI  - Low-level radiation--how dangerous is it?
AB  - The main delayed effect of ionizing radiation in the individual is the induction
      of cancer. However, for low doses (less than 100 mSv effective dose equivalent),
      there is no direct evidence of radiation-induced cancer, with the possible
      exception of childhood cancer following prenatal exposure to X-rays. The risk at
      low doses has to be estimated from the observed risk at high doses; there are
      considerable uncertainties in this extrapolation. Direct study of those exposed
      to low doses does not produce any more precise information, although it does
      impose boundary conditions on the risk. Currently the most important problem in
      environmental radiation exposure is the increased incidence of childhood
      leukaemia observed around some nuclear installations; the explanation for this
      remains unclear.

PMID- 2215362
TI  - The Nazi doctors and the Nuremberg Code: relevance for modern medical research.

PMID- 2215363
TI  - The condition of health services in the Gaza Strip.
AB  - The Association of Israeli and Palestinian Physicians for Human Rights was
      established during the first months of the uprising, against the background of a
      severe situation in which people were killed and wounded daily. AIPPHR works for
      the protection of human dignity and human life; defending physicians and patients
      in a state of political conflict out of loyalty to the principles of universal
      morality which constitute an inseparable part of the medical profession. This
      report, which is the result of months of research and investigation, is aimed,
      among other purposes, at bringing reliable information to the knowledge of the
      medical community in Israel and the Israeli Medical Association (IMA)--the body
      which organizes them. The silence of the medical community in the face of the
      phenomena described above is foreign to the spirit of doctors and medicine. The
      association's activity is aimed at creating a change in this situation out of the
      belief that the silence on the part of a large section of the medical community
      in Israel stems from a lack of regular and reliable information. In order to
      describe the situation of the medical services in the Gaza Strip, one must note
      two contrasting trends: on one hand, there is advancement in the population's
      health conditions, which is expressed by a decline in the infant mortality rate
      (from 86/1000 in 1970 to 28.1/1000 in 1988); a decline in the number of cases of
      whooping cough among children (30.1 in 1970 in contrast to 0 in 1988); and a
      decline in the number of cases of polio (14.3 in 1970 in contrast to 1 in 1980).
      On the other hand, the tendency of stagnation must be noted, especially in the
      development of independent local health services. Medicine in the Gaza Strip has
      been during the entire period of the occupation, and remains, completely
      dependent on Israeli medicine. Modern equipment and modern medical technology
      have been at the service of the residents of the Gaza Strip in Israeli hospitals,
      but they were not given the chance to develop high-standard medicine in their own
      hospitals. The Gaza Strip population has no representation at the decision-making
      level on issues of budget, development and distribution of resources--which are
      completely in the hands of the Civil Administration and the Israeli authorities.
      During the uprising there was a steep rise in medical needs. Residents in need of
      medical services are completely dependent on the decisions of the military
      government and the state leadership and the giving of these services is tied to
      political, not medical/professional policy. Since the beginning of the uprising
      in the Occupied Territories, a new tendency has appeared; the use of medicine as
      an additional means of repression against the population. This means that
      medicine has been removed from the status of a basic human right and recruited as
      a means of punishment. This is a phenomenon which no physician or person of
      conscience can accept.

PMID- 2215364
TI  - Joseph Riviere: physician and peaceworker.
AB  - In 1905, Dr Joseph Riviere, a graduate of the Paris Medical Faculty, founded the
      International Medical Association against War (IMAW). By 1914 IMAW had members in
      over 40 countries. This paper looks at the work of Dr Riviere, both as physician
      and peaceworker.

PMID- 2215365
TI  - [An experimental quantitative assessment of the efficiency of Borrelia persica
      transmission by Ornithodoros papillipes ticks. 1. 2 forms of borreliemia in
      guinea pigs].
AB  - Experimental borreliosis in guinea pigs caused by ticks' bites assumed two forms-
      typical and mild, the latter being encountered in 40% of cases. Mild form
      significantly differs from the typical one in some indices of borreliemia:
      intensity, duration, time of onset and cessation, absence of fluctuations in the
      number of borrelia. The form is not easily diagnosed by the analysis of animal
      blood preparations, which should be taken into consideration in experimental and
      clinical practice. In mild form of borreliemia the agent should be searched for
      in the blood of guinea pigs daily from days 6 to 12 after the infection, with the
      following control till day 20.

PMID- 2215366
TI  - [The lysozyme of Ixodes persulcatus ticks].
AB  - Using a technique based on specific enzyme sorption by chitin (beta-1-4-N
      acetylglucosamine), lysozyme with a molecular mass of 15,000 has been isolated
      from homogenates of the Ix. persulcatus ticks. Micrococci and staphylococci
      proved to be most sensitive to lysozyme from the Ix. persulcatus ticks, while E.
      coli and Salmonella were less sensitive. The minimum inhibitory concentration of
      lysozyme from Ix. persulcatus was 2-4 times lower than that of egg lysozyme.
      Lysozyme from the Ix. persulcatus ticks is resistant to heating in acid medium
      and loses some of its activity in alkaline medium. The loss of the activity in
      the both media is somewhat lower than that of egg lysozyme in analogous
      conditions.

PMID- 2215367
TI  - [The achievements and outlook in the control of helminthiases in Bulgaria].
AB  - The paper describes organization and achievements of the struggle against human
      helminthiases over a 30-year period in Bulgaria. Over this period, in Bulgaria
      Taenia solium was eradicated, while the incidence of taeniasis, ascariasis,
      trichocephaliasis, hymenolepiasis, enterobiasis and ascariasis,
      trichocephaliasis, hymenolepiasis, enterobiasis and echinococcosis was reduced
      several-fold. The authors suggest effective measures for the struggle against
      other helminthiases in the following 5-10 years.

PMID- 2215368
TI  - [The structure of the geographic range of opisthorchiasis and the tasks in
      controlling this invasion].
AB  - Our own investigations in the Yenisei, Ob, Dnieper, Northern Dvina river basins
      and the analysis of the literary data served as the basis for establishing the
      relationship between the area of the pathogen dissemination and the area of
      opisthorchiasis distribution (the map scheme is attached). 4 degrees of
      endemicity characterized by quantitative indices of general affection, children's
      infestation, the invasion intensity and manifestation have been suggested as a
      criterion for division of territories into regions. The map of 3 territories in
      the Dnieper River basin (the Ukraine) most unfavourable for opisthorchiasis is
      presented. According to the endemicity, differential anti-invasion goals and
      measures are suggested.

PMID- 2215369
TI  - [Ecological approaches to the study of natural-focus diseases].
AB  - Changes in the epidemiology and epizootiology of diseases with natural foci due
      to anthropogenic influence on biosphere necessitate thorough studies of
      ecological specific features of agents, carriers and vertebral hosts reflecting
      their adaptation to various natural geographical and social conditions. The
      attention should be focussed on geographical variability of agents, changes in
      populations of arthropod carriers and their feeders, monitoring of natural
      territorial complexes and scientifically grounded prognosis for diseases with
      natural foci.

PMID- 2215370
TI  - [The effect of specific treatment on the function of the small intestine in
      opisthorchiasis].
AB  - The anthelminthic agents chloxylum and prasiquantel were examined for their
      effects in patients with an above 5-year history of Opisthorchis invasion. The
      van de Kamer procedure revealed that chloxylum produced an inhibitory effect on
      absorption of d-xylose and fat. Prasiquantel failed to impair the absorptive
      function of the small intestine. Helminthological curing in patients with chronic
      opisthorchiasis was not shown to normalize dysfunction of the small intestine.

PMID- 2215371
TI  - [The similarity of the biological effects from the parenteral administration of
      ascarid antigenic complexes and Salmonella typhi endotoxins].
AB  - The experiment with rabbits showed that it was basically possible to develop
      local and generalized Shwartzman's phenomenon under the combined effect of
      ascaris antigens and typhoid bacterial endotoxins. Intracutaneous (0.2 ml.) or
      intravenous (0.1 ml/kg) sensitization of animals by ascaris antigens or microbe
      endotoxins after repeated intravenous crossover, intravenous injection of the
      antigens used to result in the development of classical local and generalized
      Shwartzman's phenomenon.

PMID- 2215372
TI  - [Antibody-dependent cell-mediated immune reactions in experimental
      trichinelliasis in mice].
AB  - The experiments on mice experimentally infected with Trichinella larvae have
      established that in mild infection adhesive and killer cell reactions developed
      on day 14, reached their maximum on days 21-30 and began to attenuate on day 45.
      The cells from animals with moderate infection showed a higher immune activity
      which remained unchanged till day 90 of infection. The cells from mice with
      severe infection showed inhibition of immune activity which was most marked on
      days 21 and 30 of the infection. Eosinophiles and neutrophils are characterized
      by IgE-dependent cell adherence and killing activity, the involvement of
      macrophages in the responses seems to be insignificant.

PMID- 2215373
TI  - [Obstructive jaundice in a rupture of echinococcal cysts into the bile ducts].
AB  - 130 patients with obstructive jaundice were examined for break of liver hydatids
      into the biliary ducts. Types of jaundice and break, frequency of fistula sites
      and clinical picture are described. The surgical interventions are outlined, and
      the results of their application are studied.

PMID- 2215374
TI  - [The problem of the carcinogenicity of parasites].
AB  - Based on the reported data and their own experience the authors defined the role
      of carcinogenic parasites in tumorigenesis as promoters. The investigators
      supposed that a many-year invasion that caused a permanent proliferation of
      cellular elements and immune suppression were the criteria for carcinogenicity of
      parasites.

PMID- 2215375
TI  - [The status and outlook of the study of blood-sucking Diptera in the Urals and
      adjacent territories].
AB  - The knowledge accumulated in the course of studies of bloodsucking dipterans:
      mosquitoes, horseflies, Heleidae, midges in the Urals and the adjacent
      territories is reviewed. The prospects of complex approaches to problems of
      bloodsucking insects are discussed.

PMID- 2215376
TI  - [Factors that determine the possibility of tick-borne encephalitis infection. 3.
      The probability of human contact with an infected vector in the central taiga
      forests of Khabarovsk Territory].
AB  - Contacts with Ixodes persulcatus Sch. and the carriers' infestation with
      encephalitis virus have been studied for many years in middle taiga forests of
      the Khabarovsk Territory. The results of the studies have been compared. The risk
      of contacts with ticks invaded with varying virus doses has been assessed. It has
      been established that clinical forms of the disease develop upon bites of highly
      infected ticks. The number of such ticks in the natural focus is an important
      index of its potential danger. This must be taken into consideration as the most
      important factor of possible infection and used as a real index in the modelling
      of an epidemic process.

PMID- 2215377
TI  - [Ways and methods of searching for new anthelmintics].
AB  - The ways of searching for new anthelminthic agents among diverse chemical
      compounds are analysed. The most promising chemical groups are presented. It is
      recommended to test every drug using as many as possible experimental models. For
      drug screening it is advisable to apply a multi-stage investigation method as the
      most economic and perspective one. The drug selection technique, experimental
      study procedure and ways of increasing anthelminthic efficiency are outlined.

PMID- 2215378
TI  - [New data on tick-borne rickettsiosis in Novosibirsk Province].
AB  - New, so far unknown epidemically active natural foci of tick-borne rickettsiosis
      have been identified in Suzun District, Novosibirsk Province. The patients had a
      typical clinical pattern and epidemiological history of the disease. The cases
      were recorded in a number of communities in the northern forest-steppe zones. The
      results of the epidemiological survey and rickettsial studies of Ixodes ticks and
      blood sera of farm animals demonstrate the existence of clear-cut natural foci of
      tick-borne rickettsiosis, with its main vectors being ticks D. silvarum. The
      infestation of ticks was proved by biotests in passive hemagglutination tests,
      using an immunoglobulin diagnostic kit. Some measures for the monitoring of foci
      and disease prevention are suggested.

PMID- 2215380
TI  - [The first cases of Lyme borreliosis in Lithuania].
AB  - In 1987, 3 typical fresh cases of Lyme's borreliosis were first diagnosed in
      Lithuania. The cases were serologically confirmed and cured. Brief clinical
      description of the cases is presented.

PMID- 2215379
TI  - [Antigen isolation from the blood of patients with malaria for its serological
      diagnosis].
AB  - A relatively high sensitivity and specificity of indirect enzyme immunoassay
      using the antibody obtained from the blood of patients with P. falciparum-induced
      malaria in the acute period have been demonstrated. The substrate for antigen
      isolation is available and can be easily obtained in sufficient quantities.

PMID- 2215382
TI  - [On the centenary of the birth of M. G. Rashina (1889-1989)].

PMID- 2215381
TI  - [The first cases of human cryptosporidiosis in Moscow].
AB  - Feces samples received from 438 children, aged 1 month to 10 years, from Moscow
      who were admitted to hospital in June-August 1989 for acute intestinal disease,
      were examined for cryptosporidium oocysts. Cryptosporidium oocysts were found in
      16 samples (8 boys and 8 girls), which accounted for 3.65%. The smears were
      stained by a modified Ziehl-Neelsen technique, concentration methods were not
      applied.

PMID- 2215383
TI  - [The epidemic manifestation of natural foci of tick-borne encephalitis in the
      Maritime Territory. 1. The range structure of the morbidity].
AB  - Using a computed mapping technique, specific features of the epidemic process
      have been established in the Maritime Territory endemic for tick-borne
      encephalitis. The most active natural foci of tick-borne encephalitis have been
      discovered in the Sikhote-Alin Mountain range.

PMID- 2215384
TI  - [Stereological analysis of the vascular network of the ganglionic eminence and
      the corpus striatum during brain development in man].
AB  - A study of the volume density of the ganglionic eminence vascular network and the
      constituent parts of the corpus striatum was performed on 8 chosen foetal brains,
      which were well-injected with a mixture of India ink and gelatin, aged from 14-25
      postovulatory weeks. The volume density of the ganglionic eminence vascular
      network amounts to 0.0209-0.0300 mm0, of the caudate nucleus to 0.0131-0.0181
      mm0, of the putamen to 0.0136-0.0159 mm0, and of the globus pallidus to 0.0121
      0.0159 mm0. The comparison of the results obtained, shows that the volume density
      of the ganglionic eminence vascular network is higher than the volume density of
      the other examined structures and that this difference is statistically highly
      significant (p less than 0.01). The augmented volume density of the ganglionic
      eminence vascular network points to a possibility of slow blood flow through its
      vascular bed, which was experimentally demonstrated on animals. This slow blood
      flow, among other factors, may be the cause of a ganglionic eminence venous
      infarction in premature newborns of low birthweight.

PMID- 2215385
TI  - [Inhalation scintigraphy in the diagnosis of pulmonary thromboembolism].
AB  - The purpose of this report is to realize the role of inhalation scintigraphy in
      the diagnostics of the pulmonary thromboembolic disease, as an addition to
      perfusion lung scintigraphy in the assessment of the nature of perfusion
      disturbances discovered by the perfusion scintigram. Perfusion lung scintigraphy,
      in itself, is a very sensitive indicator of a recent pulmonary thromboembolism
      but it is not sufficiently specific. The combining of perfusion and inhalation
      lung scintigraphy increases the specific quality of scintigraphic examinations in
      the diagnostics of lung thromboembolism.

PMID- 2215386
TI  - [Histochemical characteristics of the adrenal glomerular zone 180 days after
      discontinuing the effects of a detergent].
AB  - The substance of this paper is the study of the histochemical characteristics of
      the glomerular zone 180 days after the termination of detergent influence. The
      presence of neutral lipids, triglycerides, phospholipids and nucleic acids was
      analyzed. The decreased quantity of certain fatty substances, as well as the
      increased quantity of nucleic acids were considered, in the light of our previous
      studies, as the first signs of glomerular zone cell function normalization in the
      adrenal cortex.

PMID- 2215387
TI  - [Case report of pheochromocytoma with an atypical localization].
AB  - One of the endocrine causes of arterial hypertension is pheochromocytoma, usually
      located in the adrenal gland medulla. Extra-adrenal tumor locations are seldom
      encountered, and this can considerably complicate the diagnostic procedure. If a
      distinct clinical manifestation exists, supported by the finding of elevated
      catecholamine values, it is essential to persistently and carefully search for
      the place of their increased production. Such an attitude is completely justified
      in regard to the knowledge that this endocrinologically conditioned hypertension
      can be permanently and successfully solved with a surgical procedure. A case of
      pheochromocytoma has been presented with an atypical mediastinal location,
      prolonged and complicated diagnostic procedure, which has been successfully
      solved by surgery.

PMID- 2215388
TI  - [Case report of a patient with psychomotor epilepsy and paranoid psychotic
      episodes].
AB  - This paper gives a brief review of psychomotor epilepsy, one of the most common
      forms of epilepsy manifestations. The psychopathology which is seen with
      psychomotor epilepsy includes the greatest part of known pathological psychic
      manifestations with epilepsy in general. Here, a patient is presented with
      psychomotor epilepsy since his youth. In the last eight years, psychotic
      manifestations appear with him from time to time, they are not related with
      epileptic seizures, and phenomenology-wise, the clinical manifestation is that of
      paranoid schizophrenia. In the end there is a stress on differential diagnosis
      hardships in the telling apart of epileptic psychoses without mind disorders from
      endogenic psychoses.

PMID- 2215389
TI  - [Determination of nutritional levels in patients on chronic hemodialysis programs
      using anthropometric methods].
AB  - The results of a number of methods used in the cross-sectional nutritional
      assessment differ markedly in patients on regular hemodialysis (RHD).
      Correlations of nutritional parameters were investigated in 31 patients on RHD
      and in 31 control subjects with similar sex and age structure without any
      considerable difference in any of the examined nutritional parameters. In the
      patient group on RHD, beside a high mutual correlation of general nutritional
      parameters and a high correlation of general parameters with fat compartment
      parameters and the fat free compartment (protein) parameter, there is also a high
      correlation of fat parameters with the protein parameter which does not occur in
      the control group. This can possibly explain the difficulties in the nutritional
      assessment of patients on RHD. Out of this reason we suggest the usage of the
      RBM/F classification which is a combination of relative body mass values (RBM)
      and the body fat content (F) percentage.

PMID- 2215390
TI  - [Characteristics of psychomotor organization in children].
AB  - In the neurological examination of the child, there is a growing significance of
      subclinical semiotics and graphomotor expression. These discrete neurological
      signs give information about the maturity of complex motor organization and
      enable the following of cortical structure organization. Subclinical neurological
      semiotics in the form of muscular hypotonia, synkinesis and disturbed reciprocal
      coordination of movements at a certain age, present a physiological,
      developmental appearance, while at a later age they are a sign of immaturity, or
      of an organic neurological structure damage.

PMID- 2215391
TI  - [Methodologic characteristics of the radioreceptor test for insulin on
      erythrocytes].
AB  - Presented, are the results of the characteristics testing of the radioreceptor
      test for insulin on erythrocytes (precision, reproductiveness and linearity). Our
      own modification of the method was used. Testing was done on erythrocytes from
      the same bottle of preserved blood. The following results were received: the used
      method is precise enough (correlation coefficient from 3-15%), reproductive
      (correlation coefficient about 15%), and linear (linear correlation coefficient
      0.83) in a wide range of erythrocytes. These characteristics allow the use of the
      applied radioreceptor test in practice.

PMID- 2215392
TI  - [Smell perception in smokers].
AB  - The author studied the changes of olfactory function in smokers. He established
      the fact that the threshold of the perception of smell increases in smokers. By
      studying the subjective experience of the intensity of smell he established an
      appearance which he named olfactory recruitment, the increased growth of smelling
      sensitivity, which points out the changes, not only on the olfactive mucous
      membranes, but on the olfactive paths as well. The author concludes that smoking
      influences the decrease of the function of smell and emphasizes the necessity of
      advising the stopping of smoking in the treatment of all types of smelling
      disorders, as one of the important elements of treatment.

PMID- 2215393
TI  - [Tissue damage caused by neutrophil granulocytes].

PMID- 2215394
TI  - [Surgical treatment of cervical and vaginal cancer by means of the synchronized
      extraperitoneal-vaginal radical operation and the neovagina technic using the
      peritoneum].
AB  - In the period from 1976 to 1986 we operated 350 cases by the technique of
      combined extraperitoneal-vaginal radical synchronized hysterectomy in cases of
      uterus and vagina cancer. We analyzed 236 cases and compared them with the
      control group operated by the technique of Wertheim and modifications. There is a
      considerable difference in operative and post-operative complications. There are
      less complications in the examined group of patients operated by the technique of
      combined synchronized extraperitoneal-vaginal radical operation. We introduced
      the technique of partial neovagina formation at the place of the resected one, by
      means of the anterior and posterior plica peritoneum by which we are able to
      preserve the normal length of the vagina. By the means of this technique we
      operated 21 patients; out of that 15 were with cancer of the uterus cervix, 6
      with vagina cancer, and in 3 of them, a complete vaginectomy was performed, and a
      complete neovagina made.

PMID- 2215395
TI  - [Results of multiphasic oncology screening of the population in the community of
      Beej 1986-1987. II. Questionnaire screening].
AB  - In the framework of the multiphase oncologic population screening in the
      community of Becej in the period from 1986-1987, the inquiry screening comprised
      16,895 persons, whereby the following results were obtained: two malignant breast
      neoplasms, one uterine corpus neoplasm, one carcinoma of the larynx, and out of
      the non-target locations, not included in the specific questionnaire, there was
      one carcinoma of the lower lip and one malignant neoplasm of the salivary gland.
      Besides, 10 benign breast neoplasms and 12 benign uterine neoplasms were also
      detected. These specific results lagged behind the expected ones on the basis of
      the known average incidence and mortality in locations of Vojvodina included by
      this questionnaire. The elucidation of all possible causes leading to this
      disaccordance, was the task of specific studies intended for the improvement of
      this questionnaire as a method for the early detection of malignant and
      premalignant lesions. Other numerous mass pathological states were detected
      during the screening of either the characteristic signs of specific malignant
      neoplasm locations, or of risk factors of particular importance for the
      appearances of these malignant neoplasms. These health problems with clarified
      epidemiological dimensions in the population studied, necessitated planned
      solution according to the accepted doctrinary principals (protocols). Data on
      these diseases gave new dimensions to the inquiry (and the overall multiphase)
      oncologic population screening. The target-health educational effect of this
      inquiry which reached every man over 40 years of age in the population studied
      should not be neglected, either.

PMID- 2215396
TI  - [The significance of the determination of apoproteins in the diagnosis of
      lipoprotein metabolism disorders].
AB  - The study, in the first place, describes the basic physical, chemical and
      biological characteristics of the most important apoprotein classes and their
      role in the metabolism of certain lipoprotein fractions. Special regard is given
      to the significance of determining particular apoproteins in the serum and in
      some lipoprotein fractions for the detection of particular disorders in
      lipoprotein metabolism.

PMID- 2215397
TI  - [Morbidity and mortality in adolescents in Vojvodina].
AB  - Adolescents. The aim of this study was to analyze the morbidity and mortality of
      adolescents in SAP Vojvodina. For the analysis, data was used from the
      statistical yearbooks on the health protection of the population and data from
      individual statistical reports. The period from 1980 to 1986 was observed. In
      order to more easily follow the morbidity and mortality, and for a better insight
      into the pathology, the adolescents were divided into 2 age groups; the younger
      one from 10 to 14 years of age, and the older one from 15 to 19. Adolescents in
      Vojvodina mostly ail from respiratory diseases, illnesses of the digestive tract,
      and infective diseases, but a significant role in the morbidity is also taken by
      injuries and poisoning. Adolescents of the age group from 10 to 14 years, get
      sick more often. In SAP Vojvodina 156 adolescents die annually. The highest
      mortality is due to injuries and poisoning (16.36/1,000,000), and after that
      comes the mortality due to neoplasms (5.84/1,000,000), and the diseases of the
      respiratory and circulatory system (3.5/1,000,000). Mortality is higher in the
      adolescent group from 15 to 19 years of age. With this study only a partial
      insight was achieved into the pathology of the adolescent age group. In order to
      attain a full insight, it is absolutely necessary to actively and prospectively
      follow the health state of adolescents and the conditions of environment.

PMID- 2215398
TI  - [Occupational damage and risk of occupational damage in personnel working with
      "Amerika" and IGK "Polet" drying kilns in Novi Becej].
AB  - The paper briefly presents the technological process and professional noxiousness
      in the working environment, exposed to which are the workers employed in the
      smoke house type "America" IGK "Polet" in Novi Becej. Described is a case of
      accidental poisoning of 28 working women with carbon-monoxide, which happened
      because of a malfunctioning valve, and the letting through of gases into the air
      for the smoke house. A presentation is given of all the undertaken preventive
      measures for preventing the possibility of the exiting of gases into the smoke
      house air by introducing a system for the continuous measurement of carbon
      monoxide concentrations in the working environment with sound and light
      signalization; the necessity of conducting periodical medical examinations of
      employees and examining of working environment conditions.

PMID- 2215399
TI  - [Doyne's honeycomb choroiditis].
AB  - This paper describes the retinal changes of 11 parents whose children had the
      typical clinical manifestation of Doyne's honeycomb choroiditis. In 7 cases, the
      nonexudative ("dry") form of senile macular degeneration was discovered, 3 of
      these had increased number of drusen, and 4 of them were with large and confluent
      drusen, often with scattered pigmentation. Three parents had the exudative
      hemorrhagic form, and 1 parent had a cicatricial form of senile macular
      degeneration. Since Doyne's honeycomb choroiditis is transmitted with the
      autosomal dominant trait of inheritance, it is indirectly established that
      Doyne's honeycomb choroiditis progresses into one form of senile macular
      degeneration, and that senile macular degeneration is partly genetically
      determined.

PMID- 2215400
TI  - [Prevention of decubitus, edema, contractures].
AB  - This paper presents a historical reminder of the development of medical care, a
      contemporary consideration of the division of care, as well as the definition of
      the term-quality medical care, and a review of the preventive measures for bed
      sore, edema and contracture. In regard to the fact that care and therapy are a
      tightly bound process, they must also be applied as such. The definition of the
      term-quality medical care is an open question. The prevention of bed-sore, edema
      and contracture is the element of quality care.

PMID- 2215401
TI  - [The first scientific meeting in Subotica--August 27-31 1899].
AB  - The author brings out a brief survey of the development of Subotica as a city,
      and the development and achievements in it on a social and cultural scale during
      the 18th and 19th century. He states, that in the last decades of the past
      century, Subotica was a very strong economic and cultural center of this part of
      Vojvodina. Such a surrounding was offered, and afterwards it was decided upon, to
      organize an elite, professional and scientific manifestation--The Annual Meeting
      of Physicians and Naturalists of that--time Hungary. Here is an account of this
      First Scientific Meeting in Subotica, which was just the 30th Jubilee Meeting of
      the Physicians and Naturalists of Hungary. About 100 scientists took part in the
      work of this meeting, and 74 reports were presented. The holding of such a
      meeting in Subotica is, no doubt, an important moment in the cultural life of
      Subotica, and an especially important date in the development of the health
      service and science within it.

PMID- 2215402
TI  - [New possibilities in the semiquantitative examination of urine].

PMID- 2215403
TI  - On the technique of extrapolation to obtain wall correction factors for ion
      chambers irradiated by photon beams.
AB  - Wall correction factors, which correct ion chamber response for photon
      attenuation and scatter, can differ by as much as 1.0% for spherical chambers
      depending on whether they are obtained experimentally by extrapolation
      measurements or by Monte Carlo simulation. This difference is not explained by
      experimental or calculational statistics which lie in the range 0.05%-0.2%. In
      this paper it is demonstrated that linear extrapolation of experimental data for
      spherical chambers is inappropriate, owing to the curvature of the chamber walls.
      A simple nonlinear theory is constructed that resolves the difference. The Monte
      Carlo calculations and the nonlinear theory are compared with extrapolation
      measurements for the NIST (formerly NBS) spherical chambers. It is concluded that
      wall correction factors should be obtained by Monte Carlo calculation for
      spherical chambers and that linear-extrapolation techniques should be regarded
      with suspicion for all chambers.

PMID- 2215404
TI  - Extending the concept of primary and scatter separation to the condition of
      electronic disequilibrium.
AB  - A major deficiency of current photon calculation methods that are based on the
      concept of primary and scatter separation is their inability to handle the
      condition of electronic disequilibrium. This deficiency is examined and it is
      shown that the limitation is not inherent in the algorithms themselves but is, at
      least in part, in the data which the algorithms use. A new concept of primary and
      scatter separation is developed to cover the condition of electronic
      disequilibrium. This new concept requires little change to the existing
      algorithms and only additional data are required, which are generated using Monte
      Carlo calculation methods. The new concept is tested using programs in the
      Theratronics Theraplan treatment-planning system, and two calculation examples
      illustrate the ability to model electron transport and also the improvement over
      the existing algorithms. Close analogy of the extended concept with the
      convolution/superposition method of dose calculation is also indicated.

PMID- 2215405
TI  - Comparison of ferrous sulfate (Fricke) and ionization dosimetry for high-energy
      photon and electron beams.
AB  - Dose measurements using Fricke and ionization methods were compared for 60Co
      gamma rays, 4-25-MV photons, and 10-25-MeV electrons. Fricke derived doses based
      on a constant yield (epsilon mG) were in good agreement with ionization derived
      doses based on the American Association of Physicists in Medicine Task Group 21
      protocol and the National Research Council of Canada (NRC) ND calibration or the
      NRC proposed Nx. These measurements also confirmed the validity of the double
      voltage technique in the collection efficiency correction, even for swept
      electron beams. Assuming the correctness of the ionization derived doses, the
      radiation yield appeared to be 1% higher and to increase with photon energy when
      irradiation vessels were made of Pyrex but not with polystyrene cells. These
      glass wall effects could be due to the scattering perturbation of electrons
      between inhomogeneous materials and, in particular for photon beams, due to the
      mismatch in mass energy absorption ratios and mass collision stopping power
      ratios between the Fricke dosimeter and the wall materials.

PMID- 2215406
TI  - Theoretical and experimental evaluation of a temperature controller for scanned
      focused ultrasound hyperthermia.
AB  - Maintenance of the controlled temperatures at their target levels in the face of
      disturbances, a uniform temperature distribution within the treatment region, an
      acceptable temperature rise outside that volume, a fast temperature rise, and
      stability are desirable characteristics of an optimal hyperthermia treatment
      control system. This paper presents a proportional-integral-derivative plus bang
      bang (power on at either a maximum value or at zero) feedback control system
      designed to meet the above requirements for a scanned focused ultrasound
      hyperthermia system. Treatment stimulations and analytical results for a first
      order approximation of a tumor show that the controller is stable for a wide
      range of gains and sampling times. It was also found that there is an optimal
      controller gain which minimizes the peak temperature overshoot and the settling
      time when a step function input is applied to the system. Both the simulation
      results and experimental animal results show that the controlled region can be
      rapidly heated to the target temperature with a small overshoot and maintained at
      that level in the face of disturbances. The effects of temperature fluctuations
      due to both the periodic changes caused by the scanning and due to measurement
      noise can be reduced by the use of an auto regressive moving average approach. In
      vitro dog kidney model and in vivo dog thigh experiments show that the controller
      works well in practice, and verify that it can compensate for spatial and
      temporal blood perfusion variations. As shown in both these experiments and in
      simulations the controller can be used for controlling a single temperature or
      multiple temperature points simultaneously, thus allowing relatively uniform
      temperature fields to be created.

PMID- 2215407
TI  - The development of intracavitary ultrasonic applicators for hyperthermia: a
      design and experimental study.
AB  - This study investigated the design concepts and development of a multielement
      intracavitary ultrasound applicator for use in hyperthermia. A necessary
      condition imposed on these applicators is that each transducer element be
      separately powered and produce collimated beams. This way, the power deposition
      within the target volume can be controlled by varying the power to each element.
      Theoretical computer simulations (acoustic and thermal) and bench experiments
      were used to determine the constraints on the transducer element size and the
      spacing between them. These have shown that the length of the cylindrical
      segments (or subsections of) must be greater than approximately 10 lambda for
      proper collimation and that the spacing between them must be less than
      approximately 1.5 mm for uniform heating. With these design principles in mind,
      applicators were constructed using sections of cylindrical transducers (wall
      thickness resonance). These were surrounded by temperature-controlled circulating
      water which was enclosed by a latex membrane. This allowed for acoustic coupling
      and additional control over the depth of the maximum temperature from the cavity
      wall. This depth could be varied between the cavity surface and up to 1.5 cm for
      circulating water temperatures between 5 and 42 degrees C, respectively. These
      applicators were tested in vivo and were able to induce controlled transrectal
      heating, at depths of 2-3 cm, in the canine rectum and prostate gland.

PMID- 2215408
TI  - Surface dose in intracavitary orthovoltage radiotherapy.
AB  - Radiotherapy with orthovoltage techniques is often the prime treatment for
      localized superficial malignancies. Surface doses and depth doses measured with
      cylindrical and end-window Farmer chambers are presented for various orthovoltage
      x-ray beams in the range from 80 to 300 kVp, both for open beams and beams
      collimated with commercial intracavitary leaded-glass cones. For radiation fields
      collimated by a diaphragm positioned at a distance from the patient surface (open
      beams) there is a small skin-sparing effect. On the other hand, the surface doses
      with commercial leaded-glass intracavitary cones can exhibit a fivefold increase
      compared to the open-beam dose maxima. Beyond a depth of approximately 0.2 mm in
      a tissue-equivalent phantom, the doses measured for open beams and beams
      collimated with intracavitary cones are essentially identical. The increase in
      the surface dose observed with intracavitary cones is attributed to
      photoelectrons and recoil electrons produced in the cones. The high surface doses
      are measured by thin-wall parallel-plate ionization chambers but cannot be
      measured with cylindrical Farmer chambers since these chambers have wall
      thicknesses too large for the transmission of electrons produced in the cone.
      Since cylindrical Farmer chambers are typically used for calibration of radiation
      output, the high surface doses produced by the intracavitary cones may be
      overlooked; they can, however, be reduced to open-beam values by simple
      modifications to the cones.

PMID- 2215409
TI  - Dosimetry of Sr-90 ophthalmic applicators.
AB  - Sr-90 ophthalmic applicators are commonly used for the treatment of superficial
      eye disorders. Although a variety of dosimetric devices such as film,
      thermoluminescent dosimeters (TLD's), ion chambers, and radiochromic foils have
      been used to measure the peak dose at the applicator surface, there is no
      internationally agreed upon calibration procedure. Recently, large discrepancies
      among calibrations of the same applicator at three institutions have been
      reported. Here we describe a technique to obtain the peak dose rate at the
      applicator surface using LiF TLD's. The technique can be used for the calibration
      of flat as well as curved surface applicators. Results for two flat and three
      concave applicators are presented. Our measurement of the surface dose rate for
      one of the flat applicators is compared with those obtained by four other
      institutions, each using different dosimetric devices.

PMID- 2215410
TI  - X-ray spectral reconstruction from attenuation data using neural networks.
AB  - An artificial neural network using input data derived from attenuation
      measurements was trained to generate spectral profiles (relative number of
      photons versus energy). Once the relative spectral distribution is reconstructed,
      absolute spectra (number of photons per unit exposure spectral distribution is
      reconstructed, absolute spectra (number of photons per unit exposure versus
      energy) can be calculated. A neural network was trained on spectra generated
      mathematically using the Birch-Marshall model, combined with attenuation data,
      calculated from the spectra by numerical integration. Whereas attenuation data
      can be calculated in a straightforward manner from the x-ray spectra, the reverse
      is not true. Several neural networks were successfully taught to reconstruct the
      spectra, given the attenuation data. The networks were tested using kV/inherent
      filtration combinations that were not in the training set, and the performance of
      the reconstruction was excellent. Noise in the attenuation data was simulated to
      test the effects of noise propagation in the reconstruction. The effects of
      network architecture and data averaging on noise propagation were investigated.
      Experimentally determined spectral data complied by Fewell were also used to
      train a neural network, and the results of the reconstruction were also found to
      be excellent.

PMID- 2215411
TI  - Studies of performance of antiscatter grids in digital radiography: effect on
      signal-to-noise ratio.
AB  - We developed a theoretical model which describes the improvement of signal-to
      noise ratio (SNR) by a grid in digital radiography. The model takes into account
      the effects of spatial variations in the scatter-to-primary ratio and in the
      large-area contrast over an image with structured background on quantum noise,
      and the effects of noise in the imaging system such as electronic noise and
      digitization noise. Based on the theoretical model, we analyzed the effects of
      these factors on the SNR when a grid is employed. We performed experimental
      measurements to evaluate the improvement in the SNR by a grid when quantum noise
      is the dominant noise source. It was found that the measured SNR improvement
      factor due to quantum noise agreed closely with that determined from the measured
      transmission values of a grid, as predicted from our theoretical model. In order
      to evaluate the relative performance of grids with various geometric design
      parameters for digital radiographic systems, we employed Monte Carlo calculations
      and determined the transmission values of a number of grids under various scatter
      conditions. The calculated SNR improvement factor, due to quantum noise,
      correlated well with the measured improvement of the SNR by the grids. Our model
      predicts that the SNR improvement factor depends strongly on the local contrast
      ratio and also on the scatter-to-primary ratio. The SNR improvement factor is
      higher in the underpenetrated regions than in the well-penetrated regions of an
      image.

PMID- 2215412
TI  - Dual-energy mammography: a detector analysis.
AB  - Dual-energy mammography acquisition scenarios employing single-shot techniques
      are examined using computer simulation. A figure of merit of the signal-to-noise
      ratio squared over the glandular dose was chosen for the optimization task due to
      its exposure independence. Doses were evaluated using Monte Carlo techniques. The
      effects of kilovoltage, prepatient filtration, front detector thickness, mid
      detector filtration thickness and composition were studied. Of the six detector
      pairs studied (Y2O2S/Gd2O2S, SrFBr/BaFBr, Y2O2S/LaOBr, Y2O2S/CaWO4, Y2O2S/YTaO4,
      and Y2O2S/LuTaO4), Y2O2S/Gd2O2S and SrFBr/BaFBr were found to be the best
      combinations. The effects of scatter and signal quantization were also examined.
      An alternative display technique whereby the tissue-subtracted (i.e., calcium)
      image is colorized and overlaid onto the conventional mammogram is introduced.

PMID- 2215413
TI  - Logistic representation of the sensitometric response of screen-film systems:
      empirical validation.
AB  - An empirical logistic model that linearizes the sensitometric response data of
      screen-film systems over the entire dynamic range of exposures is presented. This
      linearization is evident when the net optical densities are scaled as fractions
      of the net saturation density and plotted on commercial logit, probit, or double
      log paper, except under conditions of reciprocity law failure. Weighted linear
      regression analysis shows that the intercept, but not the slope, depends on the
      screen-film system used. Previous work indicates that the slope is also
      independent of development time and photon energy. The model is verified through
      an analysis of tabulated sensitometric data published by the Center for Devices
      and Radiological Health.

PMID- 2215414
TI  - Digital TV tomography: description and physical assessment.
AB  - A digital TV tomography system, capable of retrospective reconstruction of
      multiple digital tomographic images, has been developed and its basic physical
      characteristics have been evaluated. The multiple tomographic images were formed
      through retrospective reconstruction of digital data acquired on a linear
      tomographic x-ray unit and an image intensifier-television system. Digital data
      were obtained with a series of 30 pulsed exposures during linear motion of the
      system. A distortion correction algorithm for the convex surface of the image
      intensifier was developed in order to reduce image distortion. A phantom study
      showed that the square-wave response at the fulcrum plane was slightly inferior
      to that in conventional tomography. There was also a slight decrease in the
      square-wave response away from the fulcrum plane and upon application of a
      correction algorithm, as compared with the response of the original reconstructed
      image at the fulcrum plane. The exposure dose for a single image was
      approximately half that in conventional tomography. Because of many advantages,
      including low exposure, short examination time, digital image manipulation, and
      applicability to picture archiving and communication systems, this is likely to
      become an important method in radiology when further technical refinements have
      been made.

PMID- 2215415
TI  - Harmonic structure of cylindrical imaging coils.
AB  - Presented is a derivation of an exact closed-form expression for the spectra of
      resonant frequencies for magnetic resonance imaging birdcage coils in the limit
      of long coils with many elements. Results of the analysis are compared with
      observation in a variety of birdcage coils where it is shown that for even
      relatively short coils the progression of resonant frequencies are of the form
      omega m = omega 1m +/- 1/2 + low pass; -high pass, with m integer and omega 1 the
      primary resonance.

PMID- 2215416
TI  - Problems associated with simulated light sensitometry for low-crossover medical x
      ray films.
AB  - Over the past ten years the evolution of medical x-ray films has been toward
      films with reduced intensifying-screen light crossover in order to reduce blur
      and obtain higher spatial resolution. For films with very low crossover,
      misleading and incorrect sensitometric data may be obtained for film contrast
      evaluation and processor control if a simulated light sensitometer with a single
      sided, light-exposing device is used. Screen light exposures were made using an
      inverse square, intensity-scale sensitometer. Simulated light exposures were made
      using a widely used single-sided, simulated-light sensitometer commonly used for
      film processor quality control, and a new simulated-light sensitometer capable of
      producing either single- or double-sided sensitometric exposures. The films used
      included one single-emulsion film and three double-emulsion medical x-ray films
      with light-crossover values ranging from approximately 3% to 30%. Sensitometric
      data showed a significant distortion (bump) in the characteristic curve for the
      3% light-crossover film exposed with the single-sided, simulated-light
      sensitometer.

PMID- 2215417
TI  - Light equalization radiography.
AB  - An electro-optical, photographic dodging technique, called light equalization
      radiography (LER), has been developed. The use of LER extends the dynamic range
      of radiographic film by enhancing the film contrast in the "toe" region of a
      radiographic film. Contrast recorded above some predetermined optical density is
      unaffected. The use of LER permits high-contrast films to be used in radiographic
      exams where low-contrast, "latitude" film types have been used traditionally,
      e.g., in chest radiography.

PMID- 2215418
TI  - Evaluation of captive bolus applicators.
AB  - Three square (L, M, MS) and one rectangular (HN) applicators with captive boluses
      were provided by the Clini-Therm Corporation for evaluation. Surface cooling is
      achieved by attaching a mineral oil captive bolus to the built in water
      circulating tubes at the aperture of the applicators. These applicators were
      tested on a phantom with a 2-cm fat slab over 10-cm-thick muscle. Surface and
      sagittal heating patterns were obtained using a thermograph. All captive-bolus
      applicators have heating patterns similar to that of the regular Clini-Therm
      applicators. Due to hot spots at the edges of the applicators where the E fields
      terminate, these modified applicators should not be placed in direct contact with
      patients when boluses are not used. Tests with Clini-Therm regular water bolus
      instead of the captive oil bolus indicated that the orientation of water flow
      should be parallel to the E field to minimize perturbation of the heating
      patterns. Thermal conduction studies showed that the captive bolus reacts too
      slowly for skin temperature control. The modified captive bolus applicators did
      not improve the performance of the system.

PMID- 2215419
TI  - Radiation leakage through electron applicators on Clinac-1800 accelerators.
AB  - Radiation leakage through electron applicators by 6-, 9-, 12-, 16-, and 20-MeV
      electron beams from Varian Clinac-1800 has been measured with films. High levels
      of leakage were found under the corners of applicators and the touch-plate
      mounting port holes. The radiation leakage, relative to the central-axis dose at
      dmax, was found to be up to 13% on the patient plane [100-cm source-to-film
      distance (SFD)] and up to 35% beneath the corners of applicators (96-cm SFD). Up
      to 18% radiation leakage was measured beneath the touch plate near the mounting
      port holes (96-cm SFD). The extent of radiation leakage in all electron beams was
      investigated and some simple shielding solutions to reduce the leakage are
      suggested.

PMID- 2215420
TI  - PET genes of Saccharomyces cerevisiae.
AB  - We describe a collection of nuclear respiratory-defective mutants (pet mutants)
      of Saccharomyces cerevisiae consisting of 215 complementation groups. This set of
      mutants probably represents a substantial fraction of the total genetic
      information of the nucleus required for the maintenance of functional
      mitochondria in S. cerevisiae. The biochemical lesions of mutants in
      approximately 50 complementation groups have been related to single enzymes or
      biosynthetic pathways, and the corresponding wild-type genes have been cloned and
      their structures have been determined. The genes defined by an additional 20
      complementation groups were identified by allelism tests with mutants
      characterized in other laboratories. Mutants representative of the remaining
      complementation groups have been assigned to one of the following five phenotypic
      classes: (i) deficiency in cytochrome oxidase, (ii) deficiency in coenzyme QH2
      cytochrome c reductase, (iii) deficiency in mitochondrial ATPase, (iv) absence of
      mitochondrial protein synthesis, and (v) normal composition of respiratory-chain
      complexes and of oligomycin-sensitive ATPase. In addition to the genes identified
      through biochemical and genetic analyses of the pet mutants, we have cataloged
      PET genes not matched to complementation groups in the mutant collection and
      other genes whose products function in the mitochondria but are not necessary for
      respiration. Together, this information provides an up-to-date list of the known
      genes coding for mitochondrial constituents and for proteins whose expression is
      vital for the respiratory competence of S. cerevisiae.

PMID- 2215421
TI  - Genetics of Candida albicans.
AB  - Candida albicans is among the most common fungal pathogens. Infections caused by
      C. albicans and other Candida species can be life threatening in individuals with
      impaired immune function. Genetic analysis of C. albicans pathogenesis is
      complicated by the diploid nature of the species and the absence of a known
      sexual cycle. Through a combination of parasexual techniques and molecular
      approaches, an effective genetic system has been developed. The close
      relationship of C. albicans to the more extensively studied Saccharomyces
      cerevisiae has been of great utility in the isolation of Candida genes and
      development of the C. albicans DNA transformation system. Molecular methods have
      been used for clarification of taxonomic relationships and more precise
      epidemiologic investigations. Analysis of the physical and genetic maps of C.
      albicans and the closely related Candida stellatoidea has provided much
      information on the highly fluid nature of the Candida genome. The genetic system
      is seeing increased application to biological questions such as drug resistance,
      virulence determinants, and the phenomenon of phenotypic variation. Although most
      molecular analysis to data has been with C. albicans, the same methodologies are
      proving highly effective with other Candida species.

PMID- 2215423
TI  - Microbial degradation of hydrocarbons in the environment.
AB  - The ecology of hydrocarbon degradation by microbial populations in the natural
      environment is reviewed, emphasizing the physical, chemical, and biological
      factors that contribute to the biodegradation of petroleum and individual
      hydrocarbons. Rates of biodegradation depend greatly on the composition, state,
      and concentration of the oil or hydrocarbons, with dispersion and emulsification
      enhancing rates in aquatic systems and absorption by soil particulates being the
      key feature of terrestrial ecosystems. Temperature and oxygen and nutrient
      concentrations are important variables in both types of environments. Salinity
      and pressure may also affect biodegradation rates in some aquatic environments,
      and moisture and pH may limit biodegradation in soils. Hydrocarbons are degraded
      primarily by bacteria and fungi. Adaptation by prior exposure of microbial
      communities to hydrocarbons increases hydrocarbon degradation rates. Adaptation
      is brought about by selective enrichment of hydrocarbon-utilizing microorganisms
      and amplification of the pool of hydrocarbon-catabolizing genes. The latter
      phenomenon can now be monitored through the use of DNA probes. Increases in
      plasmid frequency may also be associated with genetic adaptation. Seeding to
      accelerate rates of biodegradation has been shown to be effective in some cases,
      particularly when used under controlled conditions, such as in fermentors or
      chemostats.

PMID- 2215425
TI  - The quality of the last year of life of older persons.
AB  - Researchers have begun devising measures of the quality of the entire last year
      of life of older community residents. Investigators in Philadelphia surveyed 150
      living elderly on features of their quality of life, and matched the responses
      with 200 retrospective estimates obtained from relatives of decedents who had
      resided in the community much of the year. Most indicators showed declines for
      the decreased over their final year when compared with persons still alive; 82
      percent of the decedents, however, experienced a majority of "positive-quality"
      months in their last year. Debates on the costs and ethical aspects of treatment
      and care need to take account of "positive" and "negative" aspects of quality of
      life reflecting individuals' multifaceted existence.

PMID- 2215426
TI  - Medicaid in the inner city: the case of maternity care in Chicago.
AB  - The growing concentration of lower-income groups, including Medicaid patients, in
      homogeneous inner-city areas such as Chicago casts considerable doubt on the
      effectiveness of expanding Medicaid eligibility and raising physician
      reimbursement to improve access to maternity care. There are few private office
      based physicians providing prenatal care in these areas, and most pregnant women
      and infants are treated by private-office-based physicians in very high-volume
      practices, prompting concern about the quality of care. Increasing the supply of
      providers is required to enhance access to maternity services in inner cities.
      Expanding eligibility and raising reimbursement rates are more apt to benefit
      "near-poor" women, who are more spatially dispersed, than clustered-poor female
      populations.

PMID- 2215422
TI  - The fungal vacuole: composition, function, and biogenesis.
AB  - The fungal vacuole is an extremely complex organelle that is involved in a wide
      variety of functions. The vacuole not only carries out degradative processes, the
      role most often ascribed to it, but also is the primary storage site for certain
      small molecules and biosynthetic precursors such as basic amino acids and
      polyphosphate, plays a role in osmoregulation, and is involved in the precise
      homeostatic regulation of cytosolic ion and basic amino acid concentration and
      intracellular pH. These many functions necessitate an intricate interaction
      between the vacuole and the rest of the cell; the vacuole is part of both the
      secretory and endocytic pathways and is also directly accessible from the
      cytosol. Because of the various roles and properties of the vacuole, it has been
      possible to isolate mutants which are defective in various vacuolar functions
      including the storage and uptake of metabolites, regulation of pH, sorting and
      processing of vacuolar proteins, and vacuole biogenesis. These mutants show a
      remarkable degree of genetic overlap, suggesting that these functions are not
      individual, discrete properties of the vacuole but, rather, are closely
      interrelated.

PMID- 2215427
TI  - Choices in prescription-drug benefit programs: mail versus community pharmacy
      services.
AB  - Pharmaceutical price increases and greater coverage of outpatient prescription
      medications have stimulated interest in containing drug benefit-program costs.
      While mail pharmacy services (MPS) may achieve savings through volume purchasing,
      high usage of generic drugs, and dispensing larger quantities of medication per
      prescription, efforts are also underway to adapt community-pharmacy-based
      services to keep costs down in these areas. No controlled studies document a
      difference in quality between the two types of services. Third-party
      administrators and benefit managers need to consider factors such as providing
      information to patients, monitoring drug therapy, dispensing patients' correct
      medication, and cost-control incentives when assessing MPS's role in prescription
      drug programs.

PMID- 2215428
TI  - 5th European Congress of Clinical Neurophysiology. Paris, 9-12 September 1990.
      Abstracts.

PMID- 2215429
TI  - Nursing in the 1990s--developing policies for nurse education.

PMID- 2215430
TI  - Nurse Education Tomorrow Conference theme paper--section A. The path to nursing
      knowledge--personal reflections.
AB  - The author provides a definition of nursing knowledge, reviews the critical
      literature up to 1989 and discusses the current trends. She concludes her paper
      with her reflections upon the path to true nursing knowledge.

PMID- 2215424
TI  - Parvovirus replication.
AB  - The members of the family Parvoviridae are among the smallest of the DNA viruses,
      with a linear single-stranded genome of about 5 kilobases. Currently the family
      is divided into three genera, two of which contain viruses of vertebrates and a
      third containing insect viruses. This review concentrates on the vertebrate
      viruses, with emphasis on recent advances in our insights into the molecular
      biology of viral replication. Traditionally the vertebrate viruses have been
      distinguished by the presence or absence of a requirement for a coinfection with
      a helper virus before productive infection can occur, hence the notion that the
      dependoviruses (adeno-associated viruses [AAV]) are defective. Recent data would
      suggest that not only is there a great deal of structural and genetic
      organizational similarity between the two types of vertebrate viruses, but also
      there is significant similarity in the molecular biology of productive
      replication. What differs is the physiological condition of the host cell that
      renders it permissive. Healthy dividing cells are permissive for productive
      replication by autonomous parvoviruses; such cells result in latent infection by
      dependoviruses. For a cell to become permissive for productive AAV replication,
      it must have been exposed to toxic conditions which activate a latent AAV genome.
      Such conditions can be caused by helper-virus infection or exposure to physical
      (UV light) or chemical (some carcinogens) agents. In this paper the molecular
      biology of replication is reviewed, with special emphasis on the role of the host
      and the consequences of viral infection for the host.

PMID- 2215431
TI  - A review of two theories of learning and their application in the practice of
      nurse education.
AB  - From the range of learning theories which may be applied in the practice of nurse
      education, two contrasting theories have been selected. The 'conditions of
      learning and theory of instruction' (Gagne, 1985) derives from the behaviourist
      perspective in psychology, and Rogers' (1983) description of learning has evolved
      from the Humanistic School. This discussion initially focuses on Gagne's work
      beginning with a review of his 'conditions of learning', and is followed by a
      consideration of Rogers' approach through the 'facilitation of learning' (Rogers,
      1983). The respective strengths and limitations of the two theories as applied in
      nurse education are then compared.

PMID- 2215432
TI  - The conceptual basis of mental health nursing.
AB  - This paper traces the historical roots of mental health nursing relating these to
      contemporary practice in the case of people with all forms of mental illness. An
      attempt is made to explain the current interest in the nurse's interpersonal role
      with reference to specific theoreticals models and the development of care
      practices which emphasise social systems or social relationships. Emphasis is
      given to reports in the British literature, although some reference is made to
      North American nursing commentators. It is argued that although research evidence
      is weak, strong indications exist to suggest that the nurse's primary role lies
      in the imagination of their interpersonal relationship with the patient in an
      attempt to effect lasting change in the patient's capacity to live an ordinary
      life.

PMID- 2215433
TI  - Nurse Education Tomorrow Conference theme paper--section D. The student
      experience: adult learning and mentorship revisited.
AB  - Nursing education is being cited frequently as an example of adult education.
      Mentorship is also a concept that has been adopted as an approach to enhancing
      learning in the clinical setting. This paper examines, critically, the notions of
      adult learning, andragogy and mentorship and explores their relationship to
      modern nursing educational practice.

PMID- 2215434
TI  - An innovation in a diploma program: the future potential of mentorship in
      nursing.
AB  - This paper reports on the processes used to facilitate the implementation of a
      mentored elective placement for final year nursing students and the results of
      the evaluative phase of this innovation. The mentors were experienced clinical
      practitioners who formed mentored relationships with final year students in a
      selected area of nursing practice and had been prepared for their role by a
      program organized and conducted by the Faculty. The evaluation phase incorporated
      the multi-method approach of triangulation to gather data during the
      implementation phase of the mentored placement. The results tend to be strongly
      supportive of a continuation of this innovation and were based on data gathered
      from both the mentor and mentee perspectives. The final evaluation tool aimed to
      assist in clarifying the role of the mentor and was administered to the mentees
      at the completion of the placement. Factor analyses of the mentees' responses
      generated four underlying constructs to mentorship, namely, the quality of the
      relationship, professional role acquisition, socialisation into the work role,
      and a need to promote mentor relationships in nursing.

PMID- 2215435
TI  - Change in nursing and the introduction of the support worker.
AB  - Many changes have occurred in the British nursing profession over the last 15
      years, including the introduction of the nursing process, the change in emphasis
      to holistic care, the contemporary focus on wellness rather than illness, models
      of nursing, primary nursing and Project 2000. These changes are discussed as the
      outcome of the interaction between groups of nurses of various ideological
      persuasions. Firstly, the ideologies of professionalism, bureaucracy and
      paramedicine are identified and described. Next, the historical relationship
      between these ideological groups is discussed. The paramedical ideology, as an
      expression within nursing of the controlling power of the medical profession,
      dominated nursing for many years. Its position was maintained through means that
      included the division of labour (as seen in task allocation) and the control of
      knowledge (as seen in a medically modelled nursing curriculum). More recently,
      however, the professionalists have gained the upper hand. In the paper, each of
      the changes identified above is seen as part of a strategy of
      professionalisation. The main thrust of this strategy has been to reunite the
      divided nursing function, and to redefine the nature of nursing knowledge through
      the development of nursing theory. The introduction of the support worker grade
      is an attempt to consolidate professionalist control by re-dividing nursing
      labour between the stages of the nursing process, with professional nurses being
      responsible for care planning, while support workers undertake its delivery. The
      professionalists can now be described as an occupational hegemony.

PMID- 2215436
TI  - The perceptions of students and teachers regarding the introductory module of an
      enrolled nurse conversion course.
AB  - This study sets out to explore the perceptions of students' and their teachers'
      regarding the Introductory Module of a course to convert Enrolled Nurses to
      Registered General Nurses. The course has been developed as a joint venture with
      two local Schools of Nursing as an experiment in joint course management. An
      illuminative evaluation approach has been adopted utilising the techniques of
      observation, questionnaires and interviews, in order to provide information by a
      variety of means upon which the course management team can base their future
      decisions regarding the course. The findings suggest that the introductory module
      was perceived by the students and teachers as a valuable learning experience.
      Issues specific to the course which were highlighted included the need for the
      involvement of the course teachers from each School of Nursing in the teaching
      programme, the introduction of negotiated student learning, a joint approach to
      the assessment of theory and practice and a modification of the maternity and
      community care experience. General issues related to the students as mature
      learners included the need for pre-course preparation for the students, the
      assessment of individual learning needs, the inclusion in the content of essay
      writing skills and stress management and the need for a comprehensive staff
      development programme for the teaching staff. The study highlighted the need for
      evaluation of nurse education programmes and teaching methods in order to provide
      professional accountability and to ensure nurse education practice is research
      based.

PMID- 2215438
TI  - From Project 2000 to diploma of higher education curriculum and course
      development.

PMID- 2215437
TI  - Nurse education initiatives--making Project 2000 a reality. Managing the dynamic
      organisation.

PMID- 2215439
TI  - Project 2000: the higher education context.

PMID- 2215440
TI  - District general manager's perspective.

PMID- 2215441
TI  - Prenatal diagnosis and congenital disease: role of the clinical nurse specialist.
AB  - Birth defects reflect the infant's genetic constitution and are generally divided
      into four major categories: multifactorial, single-gene, chromosomal, and
      environmental. The etiology of the specific disorder is directly related to its
      risk of occurrence/recurrence, which can be theoretically or specifically
      calculated. Suspicion of genetic disease in an unborn child is heightened by a
      history of disease in blood relatives and by the presence of multiple
      miscarriages and/or increased maternal age. Current prenatal screening tools
      include maternal/fetal sampling (tissue, cells, amniotic fluid) and fetal
      visualization. All these tests have specific complications and limitations.
      Families undergoing prenatal testing are likely to experience anxiety, which may
      continue throughout the pregnancy despite a diagnosis of an unaffected fetus.
      Such anxiety can interfere with attachment to the unborn child. The aware
      clinical nurse specialist is in a position to help all parents by providing clear
      and accurate information, sensitive emotional support, and by optimizing social
      support systems.

PMID- 2215442
TI  - Minimal handling protocol for the intensive care nursery.
AB  - Use of a conceptual model of nursing for the minimal handling protocol provides
      organization and a theoretical basis for nursing care standards. Levine's
      principles of conservation of energy, structural integrity, personal integrity,
      and social integrity provide a concrete approach for making nursing care
      judgments. Through individualized adaptation and implementation of the minimal
      handling protocol, neonatal intensive care nurses will be able to deliver high
      quality therapeutic and supportive care in the least stressful and most
      protective manner possible to high-risk infants.

PMID- 2215443
TI  - How reliable are scales for weighing preterm infants?

PMID- 2215444
TI  - Early experience with the neonatal resuscitation program.

PMID- 2215445
TI  - Childbearing and childrearing practices in Mormonism.

PMID- 2215446
TI  - Standardized care plan: extracorporeal membrane oxygenation.

PMID- 2215447
TI  - Perspectives on newborn male circumcision.
AB  - Routine newborn circumcision cannot be widely advocated until large prospective
      studies thoroughly document its prophylactic value. When circumcision is
      performed properly, it represents a low-risk surgical procedure. The nursing
      profession plays a pivotal role in counseling and educating parents. A nurse can
      adeptly intervene in the psychosocial dynamics of the family to facilitate a
      truly informed parental decision.

PMID- 2215448
TI  - Neonatal Bill of Rights.

PMID- 2215449
TI  - Applying the decision-making model: case study 1.
AB  - The options for decision making in this situation are reviewed in step 8. As you
      select one of these options or add one not listed, ask yourself the following
      questions: Why did I select that particular option? Is this option I selected
      consonant with my own personal and professional values? If not, where are the
      conflicts? Have I considered all the evidence in a logical sequence, or did I
      jump to my conclusion when I first read through the case? Have I had experience
      caring for a mother and infant in a similar situation? If so, to what extent did
      my previous experience influence my choice of action in this situation? Can I
      implement the decision? If not, why? This series of questions can assist the
      nurse or other health professional in actually making a decision and thinking
      about their personal reaction to implementing it (accountability). Critical
      thinking and taking time to analyze one's decision-making process are important
      tools that help each of us make morally appropriate decisions in clinical
      practice. The results are better patient care and the personal satisfaction of
      knowing you have done your best to promote the best interests of infants assigned
      to your care.

PMID- 2215450
TI  - Surfactant replacement therapy: a second look.

PMID- 2215451
TI  - The not-so-ancient history of neonatal research.

PMID- 2215452
TI  - Fentanyl citrate.

PMID- 2215453
TI  - Pediatric neurology.

PMID- 2215454
TI  - Peroxisomal disorders.
AB  - Although peroxisomes were once considered a vestige, their importance in cellular
      metabolism is clearly established by the many inherited diseases that have been
      described in the past two decades. Unfortunately there is no definitive treatment
      for the various disorders, but based on the recognition of the biochemical
      abnormalities, prenatal testing and appropriate genetic counseling can be
      provided. It is essential for clinicians to be aware of this group of diseases,
      as diagnosis and further study of these patients are essential in understanding
      the basic etiologic mechanisms underlying these complex groups of disorders.
      Clearly, there is much to be learned about the relationship between biochemical
      abnormalities and the phenotypic variability of the peroxisomal disorders.

PMID- 2215455
TI  - The IVH complex of lesions: cerebrovascular injury in the preterm infant.
AB  - The term intraventricular hemorrhage has become associated with a variety of
      cerebrovascular insults in preterm infants. Because of a shared pathophysiology
      and timing, these are the neurologic lesions to search for when evaluating sick
      preterm infants. This complex of lesions is common and, when parenchymal injury
      occurs, likely to result in neurologic sequelae. A review of the variety of
      injuries, their pathophysiology, their diagnosis by cranial ultrasonography, and
      their prognosis is offered. Emphasis is placed on the need for assessment over
      time when evaluating parenchymal lesions in preterm infants.

PMID- 2215456
TI  - The molecular biology of occlusive stroke in childhood.
AB  - It is very likely that many of the same factors involved in occlusive disease in
      the adult are operative in the child. The major difference may be in the factors
      that damage endothelium in these two age groups and thereby initiate this
      catastrophe (atherosclerosis versus "other" causes of endothelial changes). Our
      task in this next decade is the rational exploration of the effects of
      endothelium-mediated kinins, endothelial secretory products, angiospasm, platelet
      aggregration, prostaglandins, and lipoproteins on pediatric stroke.

PMID- 2215457
TI  - AIDS and pediatric neurology.
AB  - Human immunodeficiency virus type 1 (HIV-1), the etiologic agent of AIDS, causes
      a wide spectrum of disease in children owing to its selective tropism for the
      immune system, nervous system, and perhaps other organs. By 1991, there may be as
      many as 10,000 to 15,000 children with symptomatic HIV-1 infection in the United
      States. This article reviews the current knowledge of the clinical,
      neuroradiologic, and neuropathologic features of HIV-1-related central nervous
      system involvement in infants and children with symptomatic HIV infection.

PMID- 2215458
TI  - Bacterial meningitis: an update.
AB  - Antibiotics and improvements in supportive care have greatly reduced the
      mortality from bacterial meningitis. Nevertheless, the incidence of
      neurodevelopmental sequelae remains unacceptably high. Ampicillin and
      chloramphenicol remain the standard for antimicrobial therapy against which other
      agents must be compared. A number of adjunct therapies are being investigated for
      their possible effectiveness in reducing hearing loss and other neurologic
      effects of this disease. There continues to be a need for carefully performed
      follow-up studies to assess any possible benefit of these agents. A significant
      percentage of children surviving an episode of bacterial meningitis have obvious
      or subtle neurodevelopmental deficits. The role of the pediatric neurologist
      should not end with management of acute problems such as seizures but should be
      expanded to aid in close developmental monitoring of these high-risk children.

PMID- 2215459
TI  - The classification of childhood seizures and epilepsy syndromes.
AB  - The classification of seizures and the epileptic syndromes is particularly
      relevant to those who treat children, as most syndromes are age related, with
      onset between the neonatal and adolescent periods. Whereas seizures are
      characterized by ictal behavior and EEG findings, epilepsy syndromes are defined
      by seizure type, etiology, age of onset, natural history, possible genetic
      factors, and prognosis. Limitations exist, but attempts to use these
      classifications typically lead to a better understanding of the patient and allow
      for more precise evaluation and treatment.

PMID- 2215460
TI  - Infantile spasms.
AB  - Infantile spasms are a seizure disorder in young infants with diverse etiologies,
      suggesting that they arise from any disturbance of central nervous system
      function during susceptible periods of development. The prognosis for normal
      intellectual and neurologic development parallels that of the underlying
      etiology. Early and appropriate treatment with ACTH may lead to seizure control
      in a majority of patients. The treating physician must anticipate the side
      effects of this modality.

PMID- 2215461
TI  - Status epilepticus in infancy and childhood.
AB  - Status epilepticus implies a prolonged seizure or recurrent seizures with
      persistent decreased consciousness, lasting at least 30 minutes. Both convulsive
      and nonconvulsive forms exist, either of which may lead to death or additional
      neurologic deficit. Therapy involves careful supportive care plus some
      combination of benzodiazepines, phenytoin, or phenobarbital. The outcome depends
      first on the etiology and second on the rapidity with which seizures are
      controlled.

PMID- 2215462
TI  - Rett syndrome and the autistic disorders.
AB  - Rett syndrome is a disorder noted to date only in females and characterized by a
      pervasive developmental disability following apparently normal early infancy. In
      addition to gait difficulties, stereotypic hand movements, and loss of
      communication and purposeful hand skills, autistic-like behavior is an early sign
      that often results in misdiagnosis. Despite these significant clinical
      abnormalities, neuropathologic features are modest, and no consistent laboratory
      abnormality or diagnostic marker has been identified. The current status of
      research in RS is considered within the context of autism and other disorders in
      which autistic features may occur, such as the fragile X syndrome. The concept of
      autism as neurobiologically based behavior is developed. As such, autism is
      regarded as an umbrella category containing an ever-expanding list of specific
      disorders.

PMID- 2215463
TI  - Pediatric behavioral neurology: an update on the neurologic aspects of
      depression, hyperactivity, and learning disabilities.
AB  - The high incidence of poor social adjustment in long-term follow-up studies of
      depressed children seems to relate to the inadequacy of the pharmacotherapy
      necessary to sustain long-lasting remission or possibly to repetitive
      inappropriate stresses. Insufficient antidepressant therapy with resultant
      intermittent depression-induced dysfunction of the socialization functions
      performed by the right cerebral hemisphere would not permit the child to develop
      appropriate interpersonal skills (causing failure in most social situations), and
      associated cognitive difficulties would complicate academic performance. Repeated
      school failure and chronic social ineptitude preclude development of the skills
      necessary for successful independent living in society. Thus, if symptoms of
      depression are found, it is imperative that the learning-disabled or behaviorally
      disturbed child or adolescent receive adequate antidepressant therapy to ensure
      complete long-term remission of the depression. In addition, learning-disabled
      individuals, even without apparent diagnosable depressive illness, must be
      offered appropriate methods for learning and communication which reduce stress.
      When such appropriate educational strategies are offered and poor performance
      still ensues (or continues), a trial of antidepressant therapy should be
      considered. Recognition of the depressive nature of symptoms may not be possible
      until treatment-induced improvement has occurred and depression-associated
      learning disability has resolved. Improvement in academic performance associated
      with improved cognitive function after treatment-induced remission of a
      depressive episode can be dramatic, with resolution of apparent learning
      disability. Poor educational achievement associated with chronic learning
      difficulties ultimately affects adult social functioning, and untreated or
      improperly treated chronic depression may result in the development of later
      personality disturbances. Therefore, before attributing school problems in
      children to untreatable conditions, depressive disorder must be excluded, and
      appropriate antidepressant therapy (along with removal of all apparent
      inappropriate stress, including inappropriate demands on brain function) should
      be provided to children and adolescents with evidence of depression.

PMID- 2215464
TI  - Tourette syndrome: recent advances.
AB  - Clinical and genetic studies have allowed the limits of Tourette syndrome to be
      broadened. There is now strong evidence that chronic motor tics and Tourette
      syndrome are different manifestations of an autosomal dominant gene with high
      penetrance. A genetic link with obsessive-compulsive disorder also appears to
      have been established. Up to 10% of cases of Tourette syndrome may be nongenetic
      phenocopies, however. There is also an association between Tourette syndrome and
      attention deficit hyperactivity disorder. This complicates therapy, as
      psychostimulant drugs may precipitate or exacerbate tics in some individuals. A
      high proportion of patients with Tourette syndrome also has neuropsychological
      deficits and learning disabilities. The pathophysiology is incompletely
      understood. The best supported hypothesis is that there is dopamine receptor
      supersensitivity, although there are strong suggestions of abnormalities in
      serotonin metabolism. The possibility of abnormalities in neuropeptide systems is
      being explored. Treatment of tics relies primarily on neuroleptics with dopamine
      receptor blocking activity. Clonidine may be useful in some patients, especially
      those with behavior problems. Obsessive-compulsive symptoms can be treated using
      appropriate pharmacologic agents. The treatment of attention deficit disorder in
      patients with tics should begin with behavioral strategies. Clonidine can be
      tried as the first-line drug, and psychostimulants should be used only if
      necessary and with great caution. In rare instances it may be necessary to
      combine a psychostimulant and a neuroleptic.

PMID- 2215465
TI  - The floppy infant: recent advances in the understanding of disorders affecting
      the neuromuscular junction.
AB  - The clinician is often asked to evaluate the floppy infant. Numerous conditions
      that cause hypotonia in infancy are briefly outlined in this article. These
      conditions may affect the brain, spinal cord, or motor unit. Several disorders of
      neuromuscular transmission, including four distinct and recently described
      congenital myasthenic syndromes and infant botulism, are discussed thereafter.

PMID- 2215466
TI  - Magnetic resonance in pediatric and adolescent neuroimaging.
AB  - With improved availability and a practical understanding of the principles of
      utilization, MRI will continue to replace CT and US in pediatric neuroimaging,
      just as it has impacted upon the more invasive modalities. In general, US remains
      the procedure of choice for screening of fetal and infant CNS abnormalities, and
      CT continues as the principal screening modality beyond infancy and especially
      for acute, emergent presentations. MRI has now emerged as a primary option for
      screening as well as for more definitive assessment of many intracranial and most
      intraspinal conditions.

PMID- 2215467
TI  - The use of ultrasound in evaluating neurologic diseases of childhood.
AB  - Real-time cranial sonography, intracranial Doppler, and neuromuscular sonography
      are the sonographic techniques that are applicable to the neurologic evaluation
      of infants and children. Although limited by age, specificity, and operator skill
      and experience, the advantages of real-time cranial and intracranial Doppler
      sonography make them useful techniques in the evaluation of the young infant,
      particularly in the serial assessment of ventricular size and in the study of the
      critically ill infant. The use of neuromuscular sonography in the assessment of
      the floppy infant and in the guidance of biopsy makes this an increasingly
      valuable tool.

PMID- 2215468
TI  - Refusing life-sustaining medical treatment.

PMID- 2215469
TI  - Cancer and the ozone hole.

PMID- 2215470
TI  - Immunization.
AB  - Scheduled immunization is one of the most important ways that individuals can
      protect themselves and their children from preventable communicable disease.
      Through diligent public health efforts, diseases that were once considered common
      have been mostly eradicated, sparing millions from not only the disease
      themselves, but their potentially devastating after-effects.

PMID- 2215471
TI  - Efforts in primary-care practice to control tobacco use.
AB  - In this article, the authors findings lead them to conclude that because of the
      devastating effects of smoking on health, the public could experience widespread
      health benefits if primary care physicians became more active in encouraging
      patients to stop smoking.

PMID- 2215473
TI  - Age at death: a three hospital urban, suburban, and small town study.
AB  - Comparison of the ages of patients dying at three interrelated St. Louis
      hospitals in 1988 has been used to study the results of similar high-quality
      acute hospital care when provided to dissimilar populations. The data presented
      by the authors leads them to conclude that in this era of mounting health costs,
      we have not, at least as recently as 1988, realized that an ounce of prevention
      if worth a pound of cure.

PMID- 2215472
TI  - Current management of primary breast cancer. Part I: Screening, diagnosis,
      staging and local treatment of stage I and II disease.
AB  - In the first of two parts, the authors present an overview of screening, staging,
      diagnosis, and treatment of primary breast cancer. In next month's issue, the
      aspects of adjuvant therapy, treatment of locally advanced breast cancer, and
      management of carcinoma in situ will be presented.

PMID- 2215474
TI  - Educating Missouri health professionals about HIV/AIDS: the Missouri MATEC
      Program.

PMID- 2215475
TI  - Public health burden of vaccine-preventable diseases among adults: standards for
      adult immunization practice.

PMID- 2215476
TI  - Resistance to the pore-forming protein of cytotoxic T cells: comparison of target
      cell membrane rigidity.
AB  - Cytotoxic T lymphocytes (CTL) release from their granules a 70 kDa protein,
      called PFP, perforin or cytolysin, which inserts into the target cell plasma
      membrane in its monomeric form. Here it polymerizes into a macromolecular complex
      forming pores as large as 20 nm. Although purified PFP/perforin can effectively
      lyze all target cells tested. CTL are refractory to lysis. The mechanism
      underlying the resistance of CTL is currently unknown. This study represents a
      search for membrane structural properties that could confer resistance to CTL
      against PFP/perforin-mediated lysis. The fluorescent dye merocyanine 540 was used
      to measure the lipid head group packing of CTL and several target cells, and 1-[4
      (trimethylamine)phenyl]-6-phenylhexa-1,3,5-triene was used to estimate the
      fluidity of the membrane hydrocarbon region. The resistance against PFP/perforin
      mediated lysis was determined by the 51Cr release assay. A comparison of the
      membrane rigidity with cell resistance led to the conclusion that the membrane
      lipid structure cannot account for the unusually high resistance of CTL. In
      particular, the resistant CTL line CTLL-2 has a lipid head group packing that is
      looser than that of Yac-1, and the sensitive target cells Jy-25 and EL-4 have
      membrane acyl chains that are less fluid than those of the effector CTLL-R8.

PMID- 2215477
TI  - The importance of electrostatic interactions in the binding of paraquat to its
      elicited monoclonal antibody.
AB  - In this study the pH-dependent interactions interactions between a paraquat
      specific murine monoclonal antibody and two antigens: paraquat (1,1'-dimethyl
      4,4'-bipyridinium dichloride), and a p-nitrophenol analogue (1-(N-methyl-4,4'
      bipyridinium)-1-(2-hydroxy-5-nitrophenyl)methane dichloride; PQNP) were
      determined by ELISA. In each case the KAS-pH profile reflected the titration of a
      single amino acid residue. pK'a values derived from these plots were 8.90
      (paraquat) and 8.13 (PQNP). Increasing pH led to a significant increase in the
      association constant for each antibody complex. A spectrophotometric titration of
      PQNP in the presence and absence of excess antibody indicated the presence of
      another charged amino acid residue at the binding site, which could be assigned
      as a carboxylic acid. From these studies, a model for paraquat-antibody binding
      has been proposed.

PMID- 2215478
TI  - The molecular basis of IgE antibody binding to thiopentone. Binding of IgE from
      thiopentone-allergic and non-allergic subjects.
AB  - Thiopentone-specific IgE antibodies from the sera of subjects who experienced a
      life-threatening anaphylactic reaction to the drug and IgE antibodies that cross
      react with thiopentone via substituted ammonium groups in either cyclic or
      acyclic form, were studied by direct binding immunoassays and quantitative hapten
      inhibition methods. Findings provided an explanation for the apparent 'non
      specific' nature of some IgE antibody reactions with thiopentone and reinforce
      the conclusion that the thiopentone IgE immunoassay is a valuable aid in the
      diagnosis of immediate allergic reactions to the drug.

PMID- 2215479
TI  - Rat polymeric IgA binds C1q, but does not activate C1.
AB  - Immune complexes, prepared with monoclonal rat IgA antibodies directed against
      DNP, activate the alternative pathway of the complement system in rat serum. In
      this study, the interaction of these monoclonal IgA antibodies with the classical
      pathway of complement was investigated. Monoclonal polymeric IgA (p-IgA) was
      shown to inhibit the IgG2b-mediated classical pathway-dependent lysis of TNP
      coated sheep red blood cells. In addition, the binding of C3 to solid phase IgG2b
      immune complexes was inhibited by p-IgA. Monoclonal monomeric IgA (m-IgA) was
      much less efficient in this respect. To further analyse the effect of p-IgA on
      the activation of the classical pathway by IgG2b immune complexes, the
      interaction of p-IgA with C1 was studied. It was found that p-IgA antibodies bind
      C1q. No species-specificity was observed, since both rat and human C1q were
      bound. Whereas binding of C1q in C1 to IgG2b resulted in activation of C1,
      binding to p-IgA did not. The binding of C1q to both p-IgA and IgG2b could be
      inhibited by monoclonal antibodies directed against the globular heads of C1q,
      but not by monoclonal antibodies directed against the collagen tail. The
      formation of insoluble p-IgA immune complexes was inhibited in the presence of
      rat serum or C1. These studies indicate that C1q binds to p-IgA by its globular
      heads, and thereby may modulate classical pathway-mediated reactions such as the
      inhibition of immune precipitate formation.

PMID- 2215480
TI  - Structural comparison of murine T-cell (B151K12)-derived T-cell-replacing factor
      (IL-5) with rIL-5: dimer formation is essential for the expression of biological
      activity.
AB  - T-cell-replacing factor (TRF)/IL-5 is a T-cell-derived glycoprotein which has
      pleiotropic activity on lymphoid and myeloid cells. IL-5 polypeptide translated
      into Xenopus oocytes are heterogeneous in molecular size (40,000 to 60,000 under
      nonreducing conditions) and yields a monomeric form (Mr of 25,000 to 30,000)
      under reducing conditions (J. Immun., 140, 1175-1181, 1988). We purified T-cell
      derived TRF and rIL-5 using anti-TRF/IL-5 antibody-coupled affinity column from
      supernatants of a T-cell hybridoma B151K12 and supernatants of HeLa cells,
      respectively, which had been transfected with murine IL-5 cDNA, and determined
      their partial N-terminal amino acid sequence (27 residues for B151-TRF and 13
      residues for rIL-5). A single amino acid sequence of each sample obtained
      beginning from methionine that was identical to that predicted from IL-5 cDNA.
      This finding supports the notion that secreted B151-TRF polypeptide consists of
      113 amino acids. Purified B151-TRF supported eosinophilopoiesis of human bone
      marrow cells as effective as mouse rIL-5 and human rIL-5. B151-TRF competitively
      inhibited 35S-labeled rIL-5 binding to target cells to the same extent at rIL-5.
      Treatment of purified rIL-5 and B151-TRF with reducing reagents such as 2-ME,
      sodium borohydride or dithiothreitol produced a monomeric form of IL-5 which did
      not exert a biological activity. Reduction and alkylation of rIL-5 caused the
      loss of binding to its target cells. These results strongly suggest that B151-TRF
      exists as a homodimer and its primary structure and secondary structures are
      identical to those of rIL-5. Moreover, the formation of inter-molecular disulfide
      bond(s) linked by two pairs of cystein residues is essential for the expression
      of the biological activity of mouse IL-5.

PMID- 2215482
TI  - [Electrognathographic imaging of the articular click].
AB  - The study of TMJ phisiopathology by means of computerizing devices is necessary
      in order to make a correct diagnosis and verify the therapeutic programme. In
      this study the Authors analyse articular click that is one of the first and
      characteristic symptom of the internal derangement. The Authors show by means of
      elettrognatography, chewing cicles and mandibular border movements of patients
      affected with this particular pathology. Trascing of 135 patients suffering from
      tmj reciprocal click have been examined in the department of maxillary-facial of
      Roma "La Sapienza", surgery during the period 1987-88.

PMID- 2215483
TI  - [Mandibular laterodeviation of surgical significance].
AB  - The Authors look at the mandibular laterodeviations and their classification.
      They speak about the combined surgical-orthodontic treatment of this pathology
      and show some clinical cases from their clinical experience.

PMID- 2215481
TI  - [Functional anterior limits of the dentition].
AB  - The Authors propose a further evaluation, during diagnosis which can allow us to
      label the subject not only from static point of view but also from the functional
      one. They think that it would be very helpful to conduct a study for evaluation
      the eminence angle or better, the condylar guide.

PMID- 2215484
TI  - [Kinesiographic neuromuscular orthognathodontics: kinesiographic method after the
      Attinas].
AB  - The Authors, after a brief mention to the historical evolution of the stream of
      thought and of the several operative approaches towards the gnatological problem,
      illustrate the main principles of Attina's new kinesiographic methodology. They
      underline the integrative value regarding the one adopted at present and its
      capacity to be able to enlarge the power of kinesiographic instrument.

PMID- 2215485
TI  - [Extreme simplification of treatment of Class II. Critical review after 15
      years].

PMID- 2215486
TI  - [Diagnostic evaluation of the soft tissue profile].
AB  - The Authors report a cephalometric analysis of soft tissues profile to help the
      orthodontist to do a correct treatment plane referred to the three thirds of the
      face and not limited to the lower one only. This analysis is related to adult
      patients, and because the well known considerations about development of the soft
      tissues, it should be a predictable analysis of soft tissues profile at the end
      of growth.

PMID- 2215487
TI  - [Radiographic screening of asymmetry and postural changes in orthodontic
      patients].
AB  - The role of OPM and of the teleradiography in the diagnosis of the asymmetries
      and of the postural problems of the orthodontic patients, is pointed out from
      this analysis on the group of 204 patients from mixed dentition to the adult age
      with different types of malocclusion. The evidence of a significant amount of
      patients with asymmetries and incorrected posture shows the utility of this
      radiological screening and gives advises for a therapeutic approach more
      corrected.

PMID- 2215488
TI  - [Epidemiological aspects of mandibular asymmetry in the developmental period].
AB  - The prevalence of mandibular asymmetry in developmental age has been evaluated by
      a clinical and photographic survey. The signs of dysfunction increased with age
      from 14 to 34.5%. The heterogeneous predisposing or concurrent factors are
      discussed, with special attention for postural and breathing problems.

PMID- 2215489
TI  - [Echographic prenatal diagnosis of cleft lip and palate: orthodontic
      implications].
AB  - The study of two cases of ultrasound prenatal diagnosis of cleft lip and palate
      and cleft lip, led the Authors to suggest the usefulness of first istance
      precocius correttive surgery in the immediate postnatal period. This correttive
      surgery not only allows the infant to be fed by natural vias, but it also
      facilitates the coordinated programming of successive final correttive surgeries
      by the plastic, the maxillofacial surgeons and the orthodontist.

PMID- 2215490
TI  - [Orthodontics and prosthetics: finishing dysfunctional cases].
AB  - The Authors present the pathogenetic factors involved in the dysfunction of TMJ
      following the agenesia of permanent teeth. In these cases is very important to
      find and to maintain the therapeutic position by a repositioning splint. After
      this first stage it is necessary to correct the position and the relationship of
      the teeth in order to rearrange the space for the prosthetic reconstruction.

PMID- 2215491
TI  - [Medico-legal aspects of orthodontics].
AB  - The deep technological innovations undergone by the medical profession, the
      changed relationships between physician and patient, the ever-growing attention
      given by public opinion to sanitary problems, as well as the growing expectation
      for the positive results of all me actions have determined, specially in these
      last years, medico-legal problems connected to the different spestic medico
      surgery activities, so that also the ortodo is called to a constant comparison
      not only with ethical deontological problems, but with the juridical ones too.

PMID- 2215492
TI  - [Evaluation of psychological factors in the etiopathogenesis of craniomandibular
      dysfunction in preadolescent and adolescent patients].
AB  - The Authors have studied the psychological characteristics of 48 subjects of whom
      17 with signs and symptoms of dysfunction, 12 only with signs of dysfunction and
      19 without any dysfunction. From the data collected in our investigation it's
      possible to assume that there isn't difference (F test) about the psychological
      profile between this 3 groups of subjects.

PMID- 2215493
TI  - [Clinico-radiographic evaluation of relations between the spinal curve and
      malocclusion].
AB  - Authors examined 36 children with kyphosis, lordosis and malocclusions. Taking
      also radiographs into account, a statistical study has been done. Three
      significant correlations were found: between lordosis and ANB, lordosis and SNA
      and between FR and CV Angle. The last one was a confirmation of a previous study
      by Solow.

PMID- 2215494
TI  - [New directions in cranio-cervico-mandibular cephalometry].
AB  - A pilot survey has been conducted on a sample of 22 adolescents in order to
      correlate the cranio-facial morphology and the condylar position with the
      mandibular posture, cranio-cervical posture and airway adequacy. Cephalograms
      extended to the cervical column and oblique lateral trans-cranial X-Rays with the
      standard projection has been adopted. The use of specific cephalometrics
      parameters allowed to separate the sample in sub-groups with similar variables
      and to obtain diagnostic indications. The utility of an analysis not only cranio
      basal but extended to the cranio-cervical, intercervical, cervico-mandibular and
      hyoid parameters has been demonstrated.

PMID- 2215495
TI  - [Relationship of the articular eminence and the occlusal plane in TMJ
      dysfunction].
AB  - Previous cephalometric studies do not adequately evaluate or determine anatomical
      features that characterize patients who are affected by temporomandibular
      dysfunction. The findings from this research appear to document a distinct
      correlation between the articular eminence and the posterior occlusal plane
      between symptomatic or asymptomatic patients. The eminence-occlusal plane angle
      is statistically smaller in the dysfunctional TMJ group than in the normal TMJ
      group. No other distinctive features are found in conventional cephalometric
      measurements between the two groups. The use od the eminence-occlusal plane angle
      could be necessary in the orthodontic practice and in the temporomandibular
      management to evaluate potential or actual TMJ problems.

PMID- 2215496
TI  - [Histology of the cartilage of the human fetal condyle].
AB  - The Authors have examined with optical microscopy the articular cartilages from
      the supero-posterior area of the mandibular condyles of ten TMJ of 5 human
      fetuses. In this study have been shown the cellular components of the 3 outer
      areas of the condyle. Further it has been pointed out that the fibrous lining of
      the cartilage is not only composed of collagen fibrils, proteoglycans and
      fibroblasts but also contains elastic fibers.

PMID- 2215497
TI  - [Interceptive treatment of Class III in the deciduous dentition].

PMID- 2215498
TI  - [The possible influence of bad habits on tooth morphogenesis. Clinical case].
AB  - Thumb sucking, if continued beyond the age of two, is commonly acknowledged to
      compromise correct craniofacial development, with consequent dental malposition.
      The observation of a deciduous central incisor morphology, lost traumatically by
      a thumb-sucking three years old boy with an apparent open-bite, makes us think
      this bad habit can influence teeth morphogenesis too.

PMID- 2215499
TI  - [Cephalometric study of skeletal-facial changes in oral respiration from
      obstruction].

PMID- 2215500
TI  - [Gnathologic-orthodontic protocol for Class II, division 1 with TMJ dysfunction].
AB  - The Authors present a case of Class II Division I malocclusion associated with
      TMJ dysfunction and treated with a gnathologic-orthodontic approach. The protocol
      involves five steps: extraction of third molars because not useful in the
      orthodontic treatment, placement of a edgewise appliance following the Tweed
      technique, use of a neuromuscular deprogramming appliance, an orthopedic
      appliance associated with physiotherapy.

PMID- 2215501
TI  - [Why not try to move on ankylosed tooth orthodontically?].
AB  - Due to presence of rigid inorganic matrix, mechanical perturbations cannot affect
      the bone blood supply or deform osteocytes. Because convincing evidence that bone
      can directly perceive mechanical forces in lacking, we hypothesize that
      mechanical perturbations can only elicit remodeling by acting through a soft
      tissue envelope. These soft tissue envelopes are the periodontal ligament,
      periosteum, fibrous tissues that can form around implants, sutures and the like.
      Fibroblast, preosteoblast, and mesenchymal cells are composing the envelopes. It
      is possible that these cells are indeed responsible for bone remodeling
      subsequent to forces application.

PMID- 2215503
TI  - [Colon sonography--a new method in the diagnosis of Crohn disease and ulcerative
      colitis].
AB  - The entire length of the colon, starting at the recto-sigmoid junction and ending
      at the cecum, can be visualized sonographically following retrograde water
      instillation into the colon. Using this method it is possible to evaluate in
      detail the lumen, the intestinal wall and the surrounding connective tissue.
      Severe active colonic Crohn's disease and ulcerative colitis can be detected by
      diagnostic sonography of the colon with a sensitivity of 91% and 89%
      respectively. Crohn's disease can be differentiated from ulcerative colitis in
      86% of the cases by means of colonic sonography. Transabdominal sonography of the
      fluid-filled colon is a new diagnostic procedure especially in children with
      Crohn's disease and ulcerative colitis.

PMID- 2215502
TI  - [Circulatory monitoring in very low birth weight infants using Doppler
      sonography].
AB  - Doppler-ultrasonography measures blood flow velocity, which is proportional to
      blood flow if the vessel's diameters remain constant. Perfusion of brain, kidneys
      and gut can thus be estimated by transcutaneous ultrasonography at specific
      locations on the internal-carotid artery, renal artery and upper mesenteric
      artery. Cardiac output can be derived from measurements taken on the ascending
      aorta. The procedures of measurement are easy to learn, but interpretation is
      more critical. Doppler-ultrasonography has been applied in persistent ductus
      arteriosus, asphyxia, hyperventilation, brain death, impact of drugs on brain
      circulation, seizures, hydrocephalus, and shock. Future aims are the development
      of miniaturized doppler-sensors with low energy output for continuous monitoring,
      and the definition of guidelines for clinical applications.

PMID- 2215504
TI  - [Sonographic neonatal screening of the hip joint--luxury or necessity?].
AB  - Based on the ultrasound investigation of 19,666 babies (1981-1988), 6341 of them
      directly at the maternity ward, we picked out the group of sonographically
      unstable or decentered hip joints, which must be treated instantly. Almost 50% of
      these hips did not show any clinical signs of instability! At follow-up the
      subgroup of sonographically screened hip joints showed optimal results after
      consequent earliest treatment: 100% physiological results of CE-angle (Wiberg and
      Engelhardt), no femoral head necrosis. Ultrasound screening is the only tool to
      detect definitely all newborn hips requiring therapy. Earliest treatment is the
      pre-condition of anatomical healing up. Thus--a general sonographic newborn
      screening is indispensable.

PMID- 2215505
TI  - [Direct genetic diagnosis in cystic fibrosis].
AB  - The recent cloning of the cystic fibrosis gene and the simultaneous
      identification of the predominant mutation enabled direct gene diagnosis in the
      majority of all CF families. We demonstrate the superiority of now available
      direct genotyping in five individual cases.

PMID- 2215506
TI  - [Analysis of alpha 1-antitrypsin deficiency using DNA methods].
AB  - Deficiency of alpha 1-antitrypsin can be diagnosed by DNA methods that are quick
      and also give reproducible results. Direct DNA analysis of the M, S, and Z
      alleles of the alpha 1-antitrypsin gene is possible when two molecular biology
      techniques are combined: a part of the gene is enzymatically replicated according
      to the pattern of the human DNA that is to be investigated. On hybridization with
      the various allele-specific pieces of synthetic DNA the copies that have come
      about in this way give a signal corresponding to the genotype. Only a small
      amount of material (0.5 microgram DNA) is needed for the investigation. This
      method is thus suitable for prenatal diagnosis when this is requested by members
      of a family known to be affected. A total of 53 samples were typed and
      investigations were carried out in six families.

PMID- 2215507
TI  - [Determination of C-reactive protein (CRP) in capillary blood--a comparison with
      the CPR level in venous serum].
AB  - C-reactive protein (CRP) has served as a reliable indicator of infectious and
      inflammatory diseases for a long time. Sequential CRP determinations offer a
      useful means of monitoring clinical courses and therapeutic effects in patients
      of any age as its serum concentrations correlate well with clinical symptoms.
      Especially in pediatric patients, however, venous blood sampling causes many
      problems. Thus, in our study a new method of CRP analysis from capillary plasma
      samples was tested and compared with CRP determinations from venous serum
      samples. 101 pairs of samples simultaneously obtained from 64 pediatric and
      neonatal patients (mean age of 5.8 months: min. 1 day, max. 5.5 years) were
      analyzed and compared. A good correlation (r = 0.967) was found for the whole
      range of measured CRP-concentrations (5-175 mg/l), showing a linear relationship
      between both methods. Results were analyzed by chi 2-test. Using a cutoff level
      of 5 mg/l, a sensitivity of 96%, a specificity and a positive predictive value of
      98% each and an efficiency of 97% was found. Thus, the CRP determination from
      capillary blood samples offers a reliable method and a useful alternative for
      conventional analysis from venous serum.

PMID- 2215508
TI  - [Acquired dysfibrinogenemia in a child in the course of a liver disease].
AB  - This report documents the results of coagulation studies in a 15-year old boy
      with hepatic disease of possibly autoimmune origin. Thrombin- and reptilase
      clotting times were prolonged. The results of fibrinogen determinations with
      different methods (heat precipitation, kinetic assay according to Clauss) lead to
      the assumption of a qualitative anomaly of fibrinogen (dysfibrinogenaemia).
      Investigations with purified fibrinogens from the patient and a healthy control
      confirmed this assumption. The thrombin clotting time of purified fibrinogen from
      the patient was clearly prolonged in comparison to the purified fibrinogen from a
      healthy control. The fibrin monomers of the patient exhibited impaired
      polymerization. No structural abnormalities were detected by electrophoretic
      techniques, particularly the thrombin-induced release of fibrinopeptides was
      found to be normal. The coagulation abnormalities resolved after glucocorticoid
      administration.

PMID- 2215509
TI  - [Tuberous sclerosis--rare pulmonary manifestations].
AB  - We report on a twenty year old female patient with pulmonary involvement in
      tuberous sclerosis. According to the literature these patients seem to represent
      a unique subtype of tuberous sclerosis because of female predominance, age at
      diagnosis and especially the course of the disease, which comes to an end by the
      pulmonary changes.

PMID- 2215510
TI  - [Fulminant autoimmune cold-type hemolysis with marked elevation of monothermic
      cold agglutinins. Successful therapy with membrane plasmapheresis].
AB  - Autoimmune hemolytic anemia associated with cold autoantibodies is rare in
      infancy. In a 7 months old infant with severe hemolysis, a hemoglobin of 5.9 g/dl
      and a cold agglutinin titer of 1:8000, even the transfusion of warmed, packed red
      cells (37 degrees C) lead to hemolysis. Hemoglobin fell to 2.8 g/dl despite
      prevention of exposure to cold, parenteral steroids and immunoglobulins. Cold
      agglutinin titer fell to 1:8 after plasma separation. Subsequent transfusion did
      not lead to hemolysis and permanent remission was achieved.

PMID- 2215511
TI  - [The 86th annual meeting of the German Society of Pediatrics, September 16-19,
      1990, Koln together with the 28th annual meeting of the German Society of
      Pediatric Surgery, September 17-19, 1990, Koln and 42nd annual meeting of the
      German Society of Social Pediatrics, September 18-19 1990, Koln].

PMID- 2215512
TI  - Interleukin-2, killer cells and cancer therapy: an overview.

PMID- 2215513
TI  - Lessons from the clinical trials of interleukin-2.
AB  - The initial results of interleukin-2 (IL-2) therapy in man are reviewed from the
      perspective of how they conform to predictions from preclinical studies. These
      preclinical models predict that tumors will vary in their susceptibility to IL-2
      therapy and will be most successfully treated at lower tumor burdens. In
      addition, the dose and schedule of IL-2 are important for successful therapy.
      Host-related factors, including the presence of suppressor activities, may also
      be important. In these models, the addition of other cytokines, including
      interferon-alpha or tumor necrosis factor, to IL-2 can enhance antitumor
      activity. The concomitant administration of ex vivo IL-2-activated lymphokine
      activated killer cells or tumor-infiltrating lymphocytes also enhances the IL-2
      antitumor effect. Clinical trials addressing all of these issues have been
      completed or are underway; the results suggest overall that the preclinical
      models are predictive, with both host- and tumor-related factors as well as such
      IL-2-therapy-related factors as dose, schedule, route and the use of additional
      agents all playing a role in the success of therapy. A more complete
      understanding of the mechanisms of response and resistance involved in this
      therapy will facilitate the rational development of more effective and less toxic
      IL-2-based therapy of human malignancy.

PMID- 2215514
TI  - Role of human circulating and tumor-infiltrating lymphocytes in cancer defense
      and treatment.
AB  - We have analyzed the anticancer efficacy of various subsets of human circulating
      and tumor-infiltrating lymphocytes (TIL). These studies showed that circulating
      natural killer (NK) cells mediate the most potent oncolytic activity against a
      variety of tumor targets, after enrichment or stimulation with interleukin-2 (IL
      2). Interestingly, NK cell oncolytic activity was directed also against tumor
      targets frequently designated as 'NK-resistant'. This indicates that NK cells
      display a broader spectrum of killing than is commonly recognized. TIL did not
      display any tumoricidal activity when unstimulated, but acquired cytotoxic
      potential after activation with IL-2. Comparative studies of TIL and circulating
      lymphocytes from patients with ovarian cancer demonstrated that these two groups
      of lymphocytes manifested similar levels of cytotoxicity and the same spectrum of
      target cell killing. No specificity in autologous tumor cell killing was
      displayed by TIL; instead, TIL were effective against autologous as well as
      allogeneic tumor targets. The lack of TIL tumor specificity was not detected only
      in ovarian tumors, but was manifested also in renal- and squamous-cell cancers.
      Characterization studies demonstrated that the primary oncolytic cells in the
      periphery and among TIL are NK cells. T lymphocytes displayed some, but rather
      negligible cytotoxic activity. In contrast, when IL-2-activated NK and T cells
      were analyzed for lytic activity against normal hematopoietic cells, T cells
      displayed high levels of bone marrow killing. The anti-bone marrow lytic activity
      of IL-2-activated T lymphocytes may be harmful after therapy with conventionally
      prepared lymphokine-activated killers. In light of these observations, new
      directions to adoptive immunotherapy are discussed.

PMID- 2215515
TI  - Involvement of granule proteins in T-cell-mediated cytolysis.
AB  - Cytolytic T lymphocytes (CTL) and large granular lymphocytes contain dense
      cytoplasmic granules which, when isolated, are lytic for a variety of target
      cells. Granule proteins are released from the effector cell upon target cell
      interaction, further suggesting that they play a role in the cytolytic mechanism.
      Major proteins in CTL granules are a family of serine esterases (granzymes) and a
      pore-forming protein called perforin (cytolysin). Despite structural similarities
      between functionally conserved regions of perforin and the ninth component of
      complement (C9), these two lytic molecules are clearly distinct in their mode of
      target cell recognition. Perforin, unlike C9, is not dependent on a protein
      receptor molecule but binds to the target cell membrane via phosphorylcholine in
      a Ca2(+)-dependent manner. Here, we discuss the stimulus-secretion model for T
      cell-mediated cytotoxicity with respect to our current understanding of perforin
      and the granzyme proteases.

PMID- 2215516
TI  - Sensitivity of ovarian tumor cells to effector cells generated by various
      biological response modifiers.
AB  - The sensitivity of freshly derived human ovarian tumors (FOT) to various
      allogeneic cytotoxic effector cells stimulated by recombinant interleukin 2 (rIL
      2), recombinant interferon alpha 2 (rIFN-alpha 2), OK-432, and concanavalin A was
      examined using the 51Cr release assay. Peripheral blood lymphocytes (PBL) of
      normal female donors were used as source of effector cells. Incubation of PBL
      with these biological response modifiers for 24 h generated effector cells with
      high natural killer activity, and only 20% (1/5) of the FOT examined were
      susceptible to lysis. By contrast, 83% (5/6) of the FOT were sensitive to
      lymphokine-activated killer (LAK) cells generated by rIL-2. OK-432 and
      concanavalin A activation of PBL also generated cytotoxic cells, though the
      cytotoxic activity against FOT was much less than that obtained by LAK cells. The
      addition of OK-432 to LAK culture medium containing rIL-2 generated effector
      cells with higher cytotoxicity against FOT than cultures with IL-2 alone.
      However, the addition of rIFN-alpha 2 in LAK culture medium resulted in the
      generation of effector cells with lower cytotoxicity. The addition of rIL-2, rIFN
      alpha 2, or OK-432 to LAK cells during the in vitro cytotoxicity assay had no
      significant effect. When FOT target cells were pretreated with OK-432 they became
      more sensitive to LAK than nontreated tumor cells. However, pretreatment with rIL
      2 or rIFN-alpha 2 did not influence cytolysis. These results suggest that the
      generation of LAK cells in vitro using rIL-2 plus OK-432 may be a more effective
      way to prepare these cells for adoptive immunotherapy in the treatment of ovarian
      cancer.

PMID- 2215517
TI  - [Phototherapy of endogenous depression. A contribution to chronobiologic research
      in psychiatry].

PMID- 2215518
TI  - [DNA distribution in fractions differing in the strength of association with
      nuclear matrix during activation of DNA endonucleases in cell nuclei and
      treatment with nuclease S1].
AB  - Influence of activation of Ca2+/Mg2(+)-dependent, Mn2(+)-dependent, Mg2(+)
      dependent and acidic endogenous DNAses on distribution of DNA in fractions
      differing in tightness of association with the nuclear matrix has been
      investigated. In the intact cell nuclei all types of DNA-protein bonds were
      obscured by a tight bonding of DNA with the proteins of replicative complex.
      Activation of endogenous nuclease activities caused detachment of a significant
      chromatin fraction from the nuclear matrix, fraction of DNA remained attached to
      the replicative complex, small fraction of DNA was bound to the nuclear matrix
      with a less tight bond. The endogenous nucleases are supposed to make cuts mainly
      in distal parts of the chromatin loops and do not affect the replicative complex,
      where the tight DNA-matrix bond is localized. Single-strand DNA-specific S1
      nuclease preferably attacks the latter site.

PMID- 2215519
TI  - [Transduction of chromosome and plasmid markers of bacteriophage P1 in
      pseudotuberculosis pathogen].
AB  - A clone of bacteriophage P1 clr100 cml has been isolated capable of the general
      transduction in the cells of pseudotuberculosis causative agent. The genetic
      transfer of the 6 Md pesticinogenicity plasmid by the bacteriophage has been used
      as a model to demonstrate the possibility of transduction. The bacteriophage used
      has been shown to be efficient in interspecies transduction between yersinia.

PMID- 2215520
TI  - [Construction of recombinant genes coding for products containing the fragment of
      Staphylococcus aureus protein A and the fragment of Pseudomonas aeruginosa
      exotoxin A].
AB  - The genes coding for Pseudomonas aeruginosa exotoxin-A and Staphylococcus aureus
      A-protein have been cloned. Different fragments of the genes were subcloned on
      the plasmid vestors. The plasmids pAPA4 and pAPA42 have been constructed. The
      plasmids are coding for the hybrid protein which consists of the immunoglobulin
      binding A-protein domain at its NH2-terminus and the catalytically active
      fragment of exotoxin-A at its COON-terminus. The hybrid gene is expressed in
      Escherichia coli cells under the control of lambda cro-gene expression elements
      (pAPA42) or lac-operon expression elements (pAPA4). The latter proved to be most
      productive.

PMID- 2215521
TI  - [Genetic determinants of restriction-modification systems in bacteria].
AB  - The recent data on the molecular arrangement and functioning of the genetical
      determinants for the enzymes of restriction-modification systems are discussed.
      The problems of restriction endonucleases and methylases genes localization,
      regulation of activity of the genes for enzyme systems of the II type restriction
      modification, characteristics of the primary structure of the genes and phylogeny
      of restriction endonucleases and methylases are reviewed.

PMID- 2215523
TI  - Fundamental and molecular mechanisms of mutagenesis.

PMID- 2215522
TI  - Persistence of drug-induced chromosome aberrations in peripheral blood
      lymphocytes of the rat.
AB  - We have studied the persistence of pre-clastogenic lesions, detected as induced
      chromosomal aberrations, in rat peripheral lymphocytes at various time intervals
      after acute treatment with 3 different antineoplastic drugs: cyclophosphamide
      (CPA), 5-fluorouracil (5-FU) and adriamycin (AM). Single i.p. doses were
      administered to groups of rats and heart blood samples from each group were taken
      after 3, 12, 24 or 48 h or weekly up to 20 weeks later. The cytogenetic analysis
      was performed on lymphocytes cultured for 33 h after sampling. The results for
      CPA exposure (10 mg/kg) show that the yield of chromosome aberrations is maximal
      3 h after the treatment (20 times the control level). For up to 8 weeks the
      values remain about 6 times the baseline; afterwards a decrease is observed and
      the control level is reached after 20 weeks. For 5-FU (50 mg/kg) a remarkable
      increase (13-fold) in chromosomal damage is observed at the first sampling time.
      Within 48 h the effect is drastically reduced but persistent (3 times the control
      level), and the level returns to spontaneous values 1 week later. AM treatment (2
      mg/kg) induced an increase of about 8 times the control level at 3 h post
      exposure. The clastogenic effects remained at a detectable level for 1 week
      (about 6 times the control level at all sampling times); 2 weeks after the
      treatment the control level was found. A parallel analysis was performed on bone
      marrow cells. In this tissue the clastogenic effects of the treatments were
      maximal, as in lymphocytes, at the first sampling time (20-25 times the control
      level) and were no longer detectable within 72 h after exposure, irrespective of
      the administered drug.

PMID- 2215524
TI  - DNA polymerase alpha from HeLa cells synthesizes DNA with high fidelity in a
      reconstituted replication system.
AB  - To determine the contribution that DNA polymerase alpha makes to the overall DNA
      replication fidelity in mammalian systems, we measured the fidelity of
      replication of the SV40-based shuttle vector, pZ189, in a reconstituted in vitro
      DNA replication system which contained purified HeLa DNA polymerase alpha (in
      addition to single-stranded DNA binding protein, topoisomerase II, DNA ligase, 5'
      ---3' exonuclease, ribonuclease H, and SV40 T-antigen). We found that DNA
      polymerase alpha is highly accurate when carrying out bidirectional replication
      in this system. This high fidelity of replication by DNA polymerase alpha in the
      reconstituted replication system contrasts with a relatively low fidelity of gap
      filling DNA synthesis on the same target gene by purified HeLa cell DNA
      polymerase alpha in the absence of other replication factors. The fidelity of DNA
      replication by DNA polymerase alpha, although relatively high in the
      reconstituted system, is about 4-fold lower than DNA replication in a crude HeLa
      cell extract which contains additional replication factors including DNA
      polymerase delta. These results demonstrate that DNA polymerase alpha has the
      capacity to replicate DNA with high fidelity when carrying out semiconservative
      DNA replication in a minimal reconstituted replication system, but additional
      cellular factors not present in the reconstituted system may contribute to the
      higher replication fidelity of the crude system.

PMID- 2215525
TI  - The DNA cleavage induced by a chromium(V) complex and by chromate and glutathione
      is mediated by activated oxygen species.
AB  - The number of strand breaks induced by the combination of chromate and
      glutathione (GSH) in PM2 DNA was effectively reduced upon addition of the
      hydroxyl radical scavengers dimethyl sulphoxide (DMSO), formate and benzoate.
      Administration of catalase also led to a depression of DNA degradation whereas
      superoxide dismutase (SOD) had very little influence. Essentially the same
      results were obtained in experiments employing a chromium(V) complex
      Na4(GSH)4Cr.8H20, which is an intermediate chromium species isolated from the
      reduction of chromate by glutathione. DNA cleavage was dependent on the presence
      of iron (FeCl3). When compared with the number of breaks produced by FeCl3 and
      GSH alone, chromate stimulated the generation of single-strand breaks. These
      findings suggest that hydroxyl radicals are one ultimate DNA cleaving agent in
      both reactions. A reaction scheme for the production of hydroxyl radicals is
      proposed.

PMID- 2215526
TI  - Localization of deletion breakpoints in radiation-induced mutants of the hprt
      gene in hamster cells.
AB  - DNA was analysed from a large set of hamster hprt gene mutants, some induced by
      ionising radiations and others occurring naturally, to identify those with large
      alterations in part of the gene. DNA from these mutants was restricted further
      with different endonucleases and probed to establish the patterns of restriction
      fragments remaining. Of 15 mutants characterized, one showed a duplication of
      part of the 5' end of the gene, and the remainder showed deletions of various
      sizes. It was possible to approximately locate the breakpoints of the deletions
      by comparison of fragment patterns to a recently-established map of the hamster
      gene. The relatively small number of mutants examined precludes rigorous analysis
      of the distribution of breakpoints in the hprt gene, but taken with other recent
      studies of deletion mutagenesis it is suggested that non-random induction or
      selection of this type of mutation may occur.

PMID- 2215527
TI  - Molecular characterization of X-ray-induced mutations at the HPRT locus in
      plateau-phase Chinese hamster ovary cells.
AB  - CHO-K1 cells were irradiated in plateau phase to determine the effect of dose,
      dose fractionation, and delayed replating on the type, location and frequency of
      mutations induced by 250 kVp X-rays at the hypoxanthine-guanine phosphoribosyl
      transferase (HPRT) locus. Independent HPRT-deficient cell lines were isolated
      from each group for Southern blot analysis using a hamster HPRT cDNA probe. When
      compared with irradiation with 4 Gy and immediate replating, dose fractionation
      (2 Gy + 24 h + 2 Gy) the entire gene. Since an increase in survival was noted
      under these conditions, these data suggest that repair of sublethal and
      potentially lethal damage acts equally on all premutagenic lesions, regardless of
      type or location. Differences in the mutation spectrum were noted when cells were
      irradiated at 2 Gy and replated immediately. The location of the deletion
      breakpoints was determined in 15 mutants showing partial loss of the HPRT locus.
      In 12 of these cell lines one or both of the breakpoints appeared to be located
      near the center of the gene, indicating a nonrandom distribution of mutations.
      These results indicate that damage induced by ionizing radiation results in a
      nonrandom distribution of genetic damage, suggesting that certain regions of the
      genome may be acutely sensitive to the mutagenic effects of ionizing radiation.

PMID- 2215528
TI  - Studies on the effect of ascorbic acid and selenium on the genotoxicity of
      nitrofurans: nitrofurazone and furazolidone.
AB  - The genotoxic properties of nitrofurazone and furazolidone were studied using the
      Ames test and SOS-chromotest. Both compounds were found to act as strong mutagens
      on the TA97 and TA102 strains of S. typhimurium and to induce the SOS-repair
      system in the PQ37 strain of E. coli. A good concordance was found between the
      mutagenic activity and the ability to induce the SOS system. Ascorbic acid and
      sodium selenite only very slightly lowered the genotoxic effect of the 2
      nitrofurans studied both in the Ames test and in the SOS-chromotest.

PMID- 2215529
TI  - Several known indole compounds are not important precursors of direct mutagenic N
      nitroso compounds in green cabbage.
AB  - In this study we investigated the role of indole-3-acetonitrile, indole-3
      carbinol, indole and tryptophan in the formation of N-nitroso compounds in green
      cabbage extracts. Green cabbage extracts were separated by gel permeation
      chromatography. Fractions were treated with nitrite, tested for mutagenicity and
      analysed for total N-nitroso content. Fractions in which spiked indole-3
      acetonitrile, indole-3-carbinol, indole and tryptophan eluted appeared to be low
      in mutagenic activity and contained relatively small amounts of N-nitroso
      compounds. To detect indole compounds other than the ones used in the gel
      permeation chromatography experiments, high-performance liquid chromatography and
      gas chromatography-mass spectrometry analyses were performed of green cabbage
      extracts. Indole-3-carboxaldehyde was found to be the most commonly occurring
      indole compound, but it did not show direct mutagenic activity upon nitrite
      treatment. Indole-3-acetonitrile was the second most common compound; although it
      was mutagenic after nitrite treatment, its contribution to the mutagenicity of
      nitrite-treated green cabbage was roughly estimated to be only 2%. No other
      indole compounds were detected. From this study we conclude that neither the
      tested indole compounds nor indole-3-carboxaldehyde play a significant role in
      the formation of direct mutagenic N-nitroso compounds in nitrite-treated green
      cabbage extracts.

PMID- 2215530
TI  - Induction of dominant lethal mutations by combined X-ray-acrylamide treatment in
      male mice.
AB  - The induction of mutations following combined treatment with acrylamide (AA) plus
      X-rays has been determined using the dominant lethal mutations test in Pzh:SFISS
      male mice. Combinations of a mutagenic dose of both agents (1.00 Gy, 125 mg/kg
      b.w.) and a non-mutagenic dose, i.e., a dose that alone does not produce dominant
      lethals (0.25 Gy, 25 mg/kg b.w.), were used. For the discussion of the effects of
      combined action of X-rays and acrylamide the term 'enhancement in risk' was used
      whenever the effects observed after combined exposure significantly exceeded the
      sum of the effects produced separately by the agents. Such an enhanced risk has
      been observed in late spermatids after combined action of X-rays and AA at non
      mutagenic doses, and in spermatozoa, spermatids and late spermatocytes after
      exposure to mutagenic doses.

PMID- 2215531
TI  - A 5-fold reduction in sister-chromatid exchange following implantation of mouse
      embryos is not directly related to the expression of embryonic genes responsible
      for oxygen radical metabolism.
AB  - We studied the spontaneous sister chromatid exchange (SCE) frequencies in mice at
      different stages of development; early preimplantation: 2 days post conception
      (p.c.); late preimplantation: 4 days p.c.; post implantation: day 10 and 13 p.c.
      The SCE level in preimplantation embryos is 5 times higher than any of the stages
      following implantation. The explanation for such observations may include a
      direct impact of maternal circulatory system as a result of implantation or onset
      of expression of a set of embryonic genes. Here, we studied the expression and
      developmental profile of the three enzymes of oxygen radical metabolism
      (superoxide dismutase, glutathione peroxidase, and catalase) during development.
      Our results suggest that the onset and increase in the activity of these enzymes
      with in-utero differentiation, development and growth is not directly associated
      with the drop in SCEs/cell following implantation of the embryos. This unique
      developmental phenomenon may be mediated by the maternal circulatory system or
      expression of some other embryonic genes, possibly the genes involved in DNA
      repair.

PMID- 2215532
TI  - Chromosome aberrations, sister-chromatid exchanges and cell-cycle kinetics in
      human peripheral blood lymphocytes exposed to organoselenium in vitro.
AB  - The ability of 2 synthetic organoselenium compounds, a dimer of p
      methoxybenzeneselenol (DPMBS) and benzylselenocyanate (BSC), to induce sister
      chromatid exchanges (SCE) and chromosome aberrations (CA) as well as to alter the
      progression of the cell through mitosis has been investigated in cultured human
      lymphocytes. Cultures treated with the highest concentration (2.27 x 10(-5) M) of
      the 2 compounds exhibited about a 3-fold increase in the level of SCE and about 2
      3-fold increase in the incidence of CA. In addition, the 2 selenium compounds led
      to an inhibition of cell proliferation as was evidenced by the depression of the
      proliferation rate index (PRI).

PMID- 2215533
TI  - Structure-activity relationships for the mutagenic activity of tricyclic
      intercalating agents in Salmonella typhimurium.
AB  - A total of 25 different tricyclic DNA-intercalating chromophores bearing a common
      -CONH(CH2)2N(CH3)2 solubilizing sidechain have been compared with the 'classical'
      frameshift mutagen 9-aminoacridine for their ability to induce revertants in
      Salmonella typhimurium strain TA1537 (sensitive to frameshift mutation by
      acridine mutagens). The compounds showed varying levels of activity in this
      strain. For the fused linear and fused angular tricyclics, activity varied from
      zero to similar levels to 9-aminoacridine, but with no discernable relationship
      between activity and either structure or the measured physico-chemical
      properties. However, the '2-1' tricyclic compounds had essentially no mutagenic
      activity. Since several of these compounds have high in vivo antitumor activity,
      this is useful knowledge.

PMID- 2215535
TI  - Use of a composite polyfunctional model electrophile as a probe to analyze the
      performance of an artificial intelligence structure-activity method.
AB  - The CASE structure-activity relational method was applied to the model
      polyfunctional electrophile proposed by Ashby and associates. The predicted
      activities from data bases of 'structural alerts', mutagenicity in Salmonella and
      rodent carcinogenicity were compared. It was thus found that the predictive
      efficacy of CASE was increased when it employed a combination of human and
      artificial intelligence, as exemplified by the CASE analysis of 'structural
      alerts.

PMID- 2215536
TI  - Chromosome-type exchange aberrations are induced by inhibiting repair of UVC
      induced DNA lesions in quiescent human lymphocytes.
AB  - Human lymphocytes in the quiescent stage were UVC-irradiated and then incubated
      for 90 min in the presence of the DNA-repair inhibitor ara-C. The cells were then
      cultured and analyzed for chromosome aberrations. A single treatment with UVC or
      ara-C gives rise to a very low yield of dicentrics, whereas the combined
      treatment can induce a high frequency of these chromosome-type aberrations. The
      yield in the combined treatment is approximately proportional to the square of
      the UVC fluence in the range 1-3 J/m2. In addition, the experiments demonstrate
      that synergistic effects arise when cells are treated with UVC + ara-C and then
      exposed to X-rays. The results can be explained on the assumption that the UVC +
      ara-C treatment induces DNA double-strand breaks which, to the first
      approximation, are randomly distributed over the chromosomes. These breaks are
      able to interact with each other as well as with X-ray-induced DNA double-strand
      breaks to form a chromosome-type exchange aberration.

PMID- 2215534
TI  - Metabolic activation of quercetin mutagenicity.
AB  - The mutagenicity of quercetin was reinvestigated using the Salmonella/microsome
      test. The mutagenicity of quercetin was enhanced by the cytosolic fraction of
      liver extract (S100), or by ascorbate, and even more by the complete liver
      supernatant (S9) in the presence of cofactors (NADP and glucose-6-phosphate). The
      formation of metabolites by the S9 enzymes was demonstrated by reverse-phase
      HPLC.

PMID- 2215537
TI  - On the time course of the interactions between DNA breaks in the production of a
      radiation-induced chromosome exchange aberration.
AB  - Quiescent human lymphocytes were X-irradiated and allowed to repair for various
      times at 37 degrees C before the cells were challenged with the DNA-repair
      inhibitor ara-C. The observed yield of chromosome exchange aberrations
      (dicentrics) was about twice the yield induced by X-rays alone, if ara-C was
      added immediately after irradiation. The yield as a function of the repair time
      between X-irradiation and ara-C treatment decreased with a half-life of 15-30 min
      and was almost down to the baseline yield for X-rays alone after 1 h. This shows
      that an exchange aberration can be formed from a short-lived DNA break. In
      contrast, previously published results from dose-split experiments demonstrate
      that the half-life of the interacting DNA breaks is of the order of several
      hours. A model is proposed which can account for the different estimates of the
      time course of the interactions involved in the process which leads to an
      exchange aberration.

PMID- 2215538
TI  - The load of genetic and partially genetic diseases in man. III. Mental
      retardation.
AB  - This paper summarizes estimates of detriment associated with different etiologic
      categories of mental retardation (MR) in Hungary. The basic data derive from an
      earlier study carried out in Budapest on 1276 school-age mentally retarded
      children (with some etiologic reclassification based on recent studies).
      Detriment associated with these different categories of MR is expressed in terms
      of years of lost and impaired life. About 30 per 10(3) school-age children in
      Hungary are mentally retarded (mild + severe MR), one-tenth of whom have severe
      MR (IQ less than or equal to 50); 50% of the latter are institutionalized. The
      breakdown on the basis of etiology is as follows: gene mutations and chromosomal
      abnormalities, about 4 per 10(3); 'familial' (multifactorial) causes, 12 per
      10(3); adverse pre-, peri- and post-natal causes, 11 per 10(3); and 'causes as
      yet unknown', the remainder. The estimates of mean number of years of lost life
      range from 42 to 68 (depending on the etiologic category), with an overall mean
      of 58. The total number of years of lost life is about 36,000 per 10(4) live
      births of which over 70% is due to pre-, peri- and post-natal causes, 18% due to
      'familial' causes and the remainder due to Mendelian and chromosomal diseases.
      The total number of years of impaired life is about 7300 per 10(4) livebirths,
      50% of which is due to 'familial' causes. While admittedly approximate, these
      estimates suggest that detriment associated with MR-related causes is not
      inconsiderable. Additionally, they provide some indication of causes of MR which
      are minimizable.

PMID- 2215539
TI  - Analysis of interactions between mutagens, I. Heat and ultraviolet light in
      Saccharomyces cerevisiae.
AB  - A new mathematical approach to the description of interaction data (Ager and
      Haynes, 1987) is applied here to the interaction between heat and ultraviolet
      light (UV) in Saccharomyces cerevisiae. A strong synergism for cell killing is
      found to be associated with large increases in gene conversion (of up to 8-fold),
      and mutation (of up to 14-fold). Analysis of the interaction data for both wild
      type and repair-deficient strains indicates that the heat-UV synergism arises via
      the inhibition of two different repair pathways. Unambiguous conclusions
      regarding the molecular mechanisms by which these repair processes are inhibited
      cannot be drawn on the basis of dose-response data alone. However, this approach
      does enable one to make well defined, empirical comparisons of the nature and
      kinetics of such interactions.

PMID- 2215540
TI  - Analysis of interactions between mutagens, II. Ethyl methanesulfonate and
      ultraviolet light in Saccharomyces cerevisiae.
AB  - The results of this study indicate the existence of a strong interaction between
      ethyl methanesulfonate (EMS) and ultraviolet light (UV) for cell killing in the
      yeast Saccharomyces cerevisiae. Conversely, mutation and gene conversion
      frequencies observed for the combined treatment of EMS and UV do not deviate
      significantly from that expected on the basis of simple additivity. Studies
      involving repair-deficient mutants (rad mutants) reveal that the synergistic
      interaction for cell killing depends on RAD52 function (recombinational repair),
      but not on RAD3 function (excision repair). On the basis of this analysis, the
      interaction between EMS and UV in S. cerevisiae might arise from the inhibition
      of double-strand break repair by one, or both agents.

PMID- 2215541
TI  - The mutagenic effects of diacridines and diquinolines in microbial systems.
AB  - Two series of difunctional DNA-intercalating agents (diacridines and
      diquinolines) were tested for mutagenic properties in Salmonella typhimurium
      strain TA1537, and for 'petite' mutagenesis activity in Saccharomyces cerevisiae,
      and also compared in terms of their structural, lipophilic and DNA-binding
      properties. Diacridines with only a short chain length were monointercalators,
      while those with an alkyl linker chain longer than C6 were bisintercalators.
      Although the bisintercalators especially bound very tightly to DNA, none of these
      compounds was as effective a frameshift mutagen in TA1537 as the parent
      chromophore 9-aminoacridine. However, the two (monointercalating) diacridines of
      shortest chain length were still able to cause frameshifts, and this ability
      returned (albeit weakly) in the bisintercalators of longest chain length.
      Although 9-aminoacridine showed no ability for 'petite' mutagenesis, the
      diacridines of longer chain length were very effective in causing this
      mitochondrial event. In the quinoline series, both the parent chromophore (4
      aminoquinoline) and all the diquinolines were weak monointercalators. None of
      these compounds showed any ability for frameshift mutagenesis, although some were
      very weak mitochondrial mutagens. It is concluded that linking two acridines
      produces compounds whose mutagenic properties might have been predicted from our
      current knowledge of the parent molecules. However, despite a similar ability to
      intercalate DNA, the diquinolines show no resemblance to acridines in their
      mutagenic properties.

PMID- 2215542
TI  - Kinetochore identification in micronuclei in mouse bone-marrow erythrocytes: an
      assay for the detection of aneuploidy-inducing agents.
AB  - An in vivo micronucleus assay using mouse bone marrow for identifying the ability
      of chemicals to induce aneuploidy and/or chromosome breaks is described.
      Micronucleus formation in bone-marrow erythrocytes of mice is commonly used as an
      index for evaluating the clastogenicity of environmental agents. However,
      micronuclei may also originate from intact lagging chromosomes resulting from the
      effect of aneuploidy-inducing agents. We have used immunofluorescent staining
      using anti-kinetochore antibodies to classify micronuclei for the presence or
      absence of kinetochores. Micronuclei positive for kinetochores are assumed to
      contain intact chromosomes and result from induced aneuploidy; while those
      negative for kinetochores contain acentric chromosomal fragments and originate
      from clastogenic events. The assay was evaluated using X-irradiation (a known
      clastogen) and vincristine sulfate (an aneuploidy-inducing agent). A dose-related
      response for the induction of micronuclei was observed for both agents.
      Micronuclei induced by X-irradiation were negative for kinetochores while the
      majority of the micronuclei resulting from vincristine treatment contained
      kinetochores. Thus, the micronucleus assay in combination with immunofluorescent
      staining for kinetochores may provide a useful method to simultaneously assess
      the ability of chemicals to induce aneuploidy and/or chromosome breaks.

PMID- 2215543
TI  - Knowledge-based battery design of short-term tests based on dose information.
AB  - A construction of batteries of short-term tests (STTs) is described which is
      based on a classification of 73 chemicals in regard to their carcinogenicity. The
      73 chemicals were studied within the U.S. National Toxicology Program (Ashby and
      Tennant, 1988). The batteries are validated using the classification of 35
      additional chemicals. They are defined by logically structured combinations of
      rules. The single rules are defined by the z-scores of the logarithmic values of
      the limiting doses obtained from the 4 in vitro STTs used in the study by Ashby
      and Tennant. The limiting dose is defined as the lowest effective dose or the
      highest ineffective dose (Waters et al., 1987). The batteries are constructed by
      minimizing the number of disagreements with the classification by Ashby and
      Tennant. Compared with the results obtained from single STTs, 2 batteries of 3
      STTs have higher concordances with the carcinogenicity data, namely 70% for the
      NTP data and 74-77% for the independent test data. In addition, a theoretical
      result shows that the proposed battery design, for a large enough learning set of
      chemicals, leads to results which are replicated with high probability on a large
      enough validation set. Based on the first results obtained with a limited number
      of chemicals it is concluded that the knowledge-based battery design is worth
      further development.

PMID- 2215544
TI  - Salmonella test: relation between mutagenicity and number of revertant colonies.
AB  - This paper describes a model that relates the actual effect measured in the
      Salmonella test, i.e., the number of revertant colonies, to the mutation rate
      induced by a stable test compound having no side effects and acting without a
      time-lag. A maximum-likelihood estimator for the mutation rate is derived.
      Furthermore some side effects (mortality, increase in generation time, other
      mutations) are included in more extensive models. Side effects can cause a non
      linear dose-response relation. Factors delaying the effect of the compound lead
      to an apparently higher mutation rate if a higher histidine dose is applied or a
      smaller inoculum is used. Factors slowly decreasing the effect of the compound
      reverse this result. Secondary effects of the test compound on the bacteria
      result in a non-linear dose-response relationship.

PMID- 2215545
TI  - Detection of aneuploidy and aneuploidy-inducing agents in human lymphocytes using
      fluorescence in situ hybridization with chromosome-specific DNA probes.
AB  - The feasibility of utilizing fluorescence in situ hybridization with chromosome
      specific DNA probes as the basis of an assay to detect aneuploidy and aneuploidy
      inducing agents in interphase human lymphocytes has been investigated. The assay
      involves counting the number of hybridization regions in interphase cells to
      determine the number of copies of a specific chromosome of interest, 22,000
      interphase nuclei from untreated 72-h lymphocyte cultures were examined following
      hybridization with probes for chromosomes 1, 7, 9, 17, X or Y. The combined
      frequencies of nuclei containing 0, 1, 2, 3 and 4 hybridization regions for the
      various autosomal chromosomes were 0.004, 0.084, 0.909, 0.003 and 0.001,
      respectively. Based on these frequencies, scoring 1000-2000 cells should allow
      detection of aneuploid cells with a 0.012 frequency of hyperdiploidy or a 0.11
      frequency of hypodiploidy for a specific chromosome of interest (alpha = 0.05,
      beta = 0.80). This difference in test sensitivity is related to the higher
      frequency of cells with one apparent spot. A comparison of the ratio of
      hybridization region to nuclear area in the two-dimensional images used for this
      analysis indicates that an overlap of the two regions probably accounts for the
      high frequency of apparent monosomy observed in normal cells. Treatment with the
      aneuploidy-inducing chemicals, colchicine, vincristine sulfate and
      diethylstilbestrol resulted in significant dose-related increases in the number
      of nuclei containing 3 or more hybridization regions. Treatment with the
      clastogen sodium arsenite produced only a minor increase in apparently
      hyperdiploid cells whereas treatment with ionizing radiation, another potent
      clastogen, resulted in a significant increase in nuclei containing multiple
      hybridization regions. These results suggest that ionizing radiation is an
      aneuploidy-inducing agent under these conditions although chromosomal breakage
      within the hybridization region may account for a portion of the increased
      frequency of nuclei with multiple hybridization regions. These results indicate
      that the use of fluorescence in situ hybridization with DNA probes is capable of
      detecting aneuploid cells occurring at relatively low frequencies within a
      population of cells. Assays based on these techniques should facilitate a more
      rapid identification of aneuploidy-inducing environmental and therapeutic agents.

PMID- 2215546
TI  - Enhanced assays detect increased chromosome damage and sister-chromatid exchanges
      in heroin addicts.
AB  - To refine previous studies of chromosome damage (CD) and sister-chromatid
      exchanges (SCE) in heroin addicts, we applied new methods developed in our
      laboratory to enhance detection of the cytogenetic effects of low-level radiation
      exposure in hospital workers. For CD analysis, we applied our thymidine
      fluorodeoxyuridine-caffeine (TFC) enhancement procedure in which cells at setup
      receive 1 x 10(-7) M fluorodeoxyuridine to inhibit thymidylate synthetase and 4 X
      10(-5) M thymidine to satisfy the induced requirement, and then in G2 receive 2.2
      mM caffeine to modulate DNA repair. For SCE enhancement, caffeine treatment was
      initiated in G1 at 19 h before harvest. Using both standard and enhanced
      procedures for CD and SCE analysis, blood samples were evaluated from 20 street
      heroin addicts and 22 controls. Standard 2-day CD and 3-day SCE assays showed
      small, insignificant genotoxic increases in addicts while the enhanced CD and SCE
      assays showed highly significant increases. Most CD events were in the form of
      chromatid and chromosome breaks. There were no rings and only a few dicentrics
      were observed in the TFC-enhanced cultures. Although quadriradials are rare, 10
      were found in addict TFC-cultures and 3 in control TFC-cultures. With the
      standard CD assay, the mean number of chromosome breaks per 100 cells was 0.727
      for controls and 1.056 for addicts (not significant). With the TFC-enhanced
      assay, the same measure showed 1.483 chromosome breaks for controls and 5.143 for
      addicts (highly significant, ANOVA: p less than 0.0001). A highly significant
      difference was also observed for chromatid-type damage with the TFC-enhanced
      assay (chromatid breaks per 100 cells: 16.793 for controls; 48.191 for addicts).
      The SCE data also showed significant differences with the enhanced assay. Scoring
      25 cells/condition, standard SCE cultures showed 10.892 SCE/cell for controls and
      11.732 SCE/cell for addicts (not significant). With CAF enhancement there were
      13.08 SCE/cell for controls and 17.05 SCE/cell for addicts (ANOVA: p less than
      0.008). These findings indicate that detection of CD and SCE effects can be
      significantly enhanced by the use of these new procedures. The finding of greatly
      increased chromatid damage in the addicts with the TFC procedure suggests that at
      least part of the CD detected occurred in vitro and is not a product of prior in
      vivo damage. Therefore exposure to this drug and perhaps other environmental
      agents may not only leave a residue of DNA or chromosome damage but may also
      induce a sensitivity to further genotoxic damage that is revealed by using the
      enhanced procedures.

PMID- 2215547
TI  - Sensitive method for the detection of mutagenic nitroarenes and aromatic amines:
      new derivatives of Salmonella typhimurium tester strains possessing elevated O
      acetyltransferase levels.
AB  - Acetyl-CoA: N-hydroxyarylamine O-acetyltransferase is an enzyme involved in the
      intracellular metabolic activation of arylhydroxylamines derived from mutagenic
      nitroarenes and aromatic amines. The acetyltransferase gene of Salmonella
      typhimurium TA1538 was cloned into pBR322 and the plasmids harboring the gene
      were introduced into TA98 and TA100. The resulting strains (YG1024 and YG1029)
      had about 100 times higher 2-hydroxyamino-6-methyldipyrido[1,2-a:3',2'-d]
      imidazole (N-hydroxy-Glu-P-1) O-acetyltransferase activity than TA1538 containing
      pBR322, and were extremely sensitive to the mutagenic actions of 2-nitrofluorene,
      1-nitropyrene, 1,8-dinitropyrene, 2-amino-6-methyldipyrido[1,2-a:3',2-d)
      imidazole (Glu-P-1), 2-aminofluorene and 2-aminoanthracene. These results
      indicate that the new strains permit the efficient detection of the mutagenicity
      of environmental nitroarenes and aromatic amines.

PMID- 2215548
TI  - The development of the U.S. EPA health effects research laboratory frozen blood
      cell repository program.
AB  - We have suggested that proper blood-cell freezing and storage is necessary in
      longitudinal studies with reduced between tests error, for specimen sharing
      between laboratories and for convenient scheduling of assays. Our present purpose
      is to describe the design and use of a prototype computer program, Cryovial, for
      data-based management of frozen cell repositories. We are pleased to provide,
      free of charge upon request, a 5.25" (specify 0.36 or 1.2 MB) disk containing all
      files required to run Cryovial.

PMID- 2215549
TI  - The International Association of Environmental Mutagen Societies (IAEMS).

PMID- 2215550
TI  - Ratio of acentrics to dicentrics in human lymphocytes exposed to X rays and
      misonidazole.
AB  - A 0.8 mM concentration of misonidazole was added to human blood samples before
      exposure to graded X-ray single doses, in order to investigate the dependence of
      the frequency ratio of acentrics to dicentrics, produced in lymphocytes, on
      treatment with radiation, the substance and the combination of the 2 agents. The
      results confirm the findings of a previous experiment carried out using sodium
      iothalamate, showing that this ratio is markedly influenced by the relative
      action of the physical and the chemical agents, especially at low radiation
      doses, because of the enhancement of the frequency of acentrics, and not of
      dicentrics, caused by the presence of the drug compared to the spontaneous level.

PMID- 2215551
TI  - Genotoxic effects of thiram evaluated by sister-chromatid exchanges in human
      lymphocytes.
AB  - The purpose of this investigation was to study the genotoxic potential of thiram
      (CAS No. 137-26-8) using an in vitro sister-chromatid exchange (SCE) assay with
      human lymphocytes. The results indicate that thiram and its metabolites increase
      the SCE frequencies 2-fold over those observed in the negative controls. The
      standard inducers cyclophosphamide and ethyl methanesulfonate increased SCE
      frequencies 10- and 4-fold, respectively, over untreated levels.

PMID- 2215552
TI  - Chromosomal aberrations, sister-chromatid exchanges, cell-cycle kinetics and
      satellite associations in human lymphocyte cultures exposed to vanadium
      pentoxide.
AB  - Treatment of human lymphocytes with vanadium pentoxide (V2O5) was not found to
      increase the frequency of structural chromosomal aberrations (CA) and sister
      chromatid exchanges (SCE). However, V2O5 significantly increased polyploid cell
      frequency; also, the mitotic index (MI) was significantly decreased, and the
      average generation time (AGT) was significantly increased. Finally, the frequency
      of cells with satellite associations (SA), the frequency of SA per cell, and the
      frequency of chromosomes associated increased in treated cultures.

PMID- 2215553
TI  - Preventive action of thioethers towards in vitro DNA binding and mutagenesis in
      E. coli K12 by alkylating agents.
AB  - Thioethers are effective scavengers of electrophilic metabolites derived from the
      hepatocarcinogen N-hydroxy-2-acetylaminofluorene (van den Goorbergh et al.,
      1987). In this study 2 of these thioethers, 4-(methylthio)benzoic acid (MTB) and
      its methylester, methyl 4-(methylthio)benzoate (MMTB), have been tested for their
      ability to prevent in vitro DNA binding and mutation induction in E. coli K12 by
      the direct alkylating agents ethylnitrosourea (ENU), methylnitrosourea (MNU),
      ethyl methanesulfonate (EMS) and methyl methanesulfonate (MMS). In addition to
      MTB and MMTB, the thioether L-methionine (Met), and the thiols glutathione (GSH)
      and L-cysteine (Cys) were included for reasons of comparison. MTB was able to
      (partially) prevent DNA binding and mutation induction by ENU. However, this
      thioether was ineffective with EMS. DNA binding and mutagenesis by EMS were
      (partially) prevented by GSH and Cys, while these thiols could not prevent DNA
      binding and mutation induction by ENU. MMTB was unable to prevent mutation
      induction by these ethylating agents. With the methylating agents, similar
      effects of MTB were observed: MTB effectively prevented mutation induction by MNU
      while it was much less effective towards MMS. GSH and Cys were comparably
      effective as antimutagenic agents towards both methylating agents. Met was unable
      to prevent either DNA binding or mutation induction by these agents. Taken
      together, the results show that aromatic thioethers are able to trap genotoxic
      electrophiles derived from the nitrosoureas ENU and MNU, and may therefore act as
      potential anticarcinogens towards these agents, which are only poorly detoxified
      by GSH.

PMID- 2215554
TI  - Unscheduled DNA synthesis in growing roots and stored embryos of Vicia faba after
      the action of maleic hydrazide and methyl methanesulphonate.
AB  - Growing roots of Vicia faba were treated with MH for 5 h, washed for 2 h and
      exposed to 3H-thymidine (3H-TdR) for additional 2-h periods at 7 h, 24 h and 32 h
      after the onset of MH treatment, to label DNA. As the replicative DNA synthesis
      was suppressed by HU, an enhancement of 3H-TdR incorporation into nuclear DNA
      above the control, as determined by microautoradiography, was considered to be
      due to unscheduled DNA synthesis induced by the mutagen. A significantly higher
      incorporation of 3H-TdR into DNA of MH-treated roots occurred, when labelling was
      applied 7 h after the MH action, whereas at 24 h only slight and at 32 h no
      enhancement of DNA labelling above control was registered. A 3-14-day storage
      with 50% water content of V. faba seeds exposed to MH or MMS resulted in a
      recovery from mutagen-induced chromosomal damage and a significantly higher
      incorporation of 3H-TdR into nuclear DNA. This supports the hypothesis that
      recovery from MH- and MMS-induced chromosomal damage is mediated by excision
      repair during seed storage.

PMID- 2215555
TI  - Sensitivity of Salmonella typhimurium YG1024 to urine mutagenicity caused by
      cigarette smoking.
AB  - Salmonella typhimurium YG1024, an O-acetyltransferase-overproducing derivative of
      TA98, was found to be more sensitive in detecting mutagenicity in human urine
      caused by cigarette smoking, than the conventional strain TA98, in Ames test in
      the presence of S9 mix. YG1021, another derivative of TA98 with elevated
      nitroreductase levels, did not show increased sensitivity. These results suggest
      that the mutagenic compounds concentrated by Blue Rayon from smokers' urine are
      aromatic amino compounds.

PMID- 2215556
TI  - Investigations on mutagenicity and genotoxicity of pentamidine and some related
      trypanocidal diamidines.
AB  - Pentamidine, DAPI and some related compounds (DAI, 6-Br-AI, DPTN, DIPI, 3-Am-DAI,
      DiaPBF) were investigated in 2 different screening test systems for their
      potential mutagenic and cytotoxic effects, in the light of their binding to DNA.
      In the Ames test using Salmonella typhimurium strains TA98 and TA100 with and
      without metabolic activation no mutagenic effects could be observed. All
      diamidines tested, except DAI, were toxic at concentrations of 0.5 and 1.0
      mumole/plate. In the sister-chromatid exchange (SCE) assay with human peripheral
      lymphocytes all compounds tested were growth-retarding particularly in the G0
      phase. A significant induction of SCEs could only be seen after treatment with
      the monoamidino compound 6-Br-AI at a concentration of 100 mumole/l. It is
      concluded from the data obtained that pentamidine and related diamidines in the 2
      assays tested show no mutagenic or genotoxic effects, in spite of their tight
      binding to DNA.

PMID- 2215557
TI  - Antimutagenic action of cobaltous chloride on radiation-induced mutations in
      cultured Chinese hamster cells.
AB  - The effects of cobaltous chloride on 8-azaguanine (8AG)-resistant mutations
      induced by gamma-rays or ultraviolet (UV) light in cultured Chinese hamster V79
      cells were examined. Cobaltous chloride alone had no significant effects on
      survival and mutations of V79 cells at concentrations less than 1 x 10(-5) M.
      Cobaltous chloride at a concentration of 3 x 10(-6) M had a marked effect in
      reducing 8AG-resistant mutations induced by gamma-rays of 2-6 Gy, when cells were
      incubated for 6-7 days in the presence of cobaltous chloride after gamma-ray
      irradiation (posttreatment). The pretreatment of cells with cobaltous chloride
      for 6 days before gamma-ray irradiation reduced 8AG-resistant mutations induced
      by gamma-rays. Pre- or post-treatment with cobaltous chloride had no such effect
      on UV-induced mutations, however. The difference in responsiveness to cobaltous
      chloride between bacterial and mammalian cell systems is discussed.

PMID- 2215558
TI  - Nurses have political clout: let's exercise it.

PMID- 2215559
TI  - Certification and you.

PMID- 2215560
TI  - Effect of long-term monitoring of glycosylated hemoglobin levels in insulin
      dependent diabetes mellitus.
AB  - BACKGROUND: The value of routine measurements of glycosylated hemoglobin
      (hemoglobin A1c) in the care of patients with diabetes mellitus is uncertain. We
      undertook this study to determine whether knowledge of hemoglobin A1c values
      would result in improved metabolic control in a group of patients with insulin
      dependent diabetes mellitus (IDDM). METHODS: We randomly assigned 240 patients
      with IDDM to one of two groups that were comparable in age, sex, duration of
      diabetes, and initial hemoglobin A1c levels. The patients were followed for a
      year, and the hemoglobin A1c concentration was measured at three-month intervals.
      The hemoglobin A1c values were used in assessing glycemic control and modifying
      therapy in one of the two groups. In the other, care givers were not aware of the
      hemoglobin A1c levels and relied on blood or urine glucose measurements to
      monitor treatment. RESULTS: Among the 222 patients still being followed after one
      year, the mean hemoglobin A1c value decreased significantly--from 10.1 to 9.5
      percent (P less than 0.005)--in the group whose hemoglobin A1c level was
      monitored (n = 115), whereas the initial and one-year values in the control group
      (n = 107) were 10.0 and 10.1 percent, respectively. The proportion of patients
      with poor control, defined as those having a hemoglobin A1c value above 10.0
      percent, decreased from 46 to 30 percent (P less than 0.01) in the group whose
      hemoglobin A1c level was monitored but did not change significantly (45 to 50
      percent) in the control group. The patients in the group whose hemoglobin A1c
      level was monitored were seen and their insulin regimens changed more often, but
      they were hospitalized for acute care of their diabetes less often than those in
      the control group. A similar decrease in hemoglobin A1c values occurred in the
      control group in the following year, when their care givers knew their hemoglobin
      A1c values. CONCLUSIONS: Regular measurements of hemoglobin A1c lead to changes
      in diabetes treatment and improvement of metabolic control, indicated by a
      lowering of hemoglobin A1c values.

PMID- 2215561
TI  - Coffee, caffeine, and cardiovascular disease in men.
AB  - BACKGROUND: For many years, an association between coffee consumption and the
      risk of coronary heart disease has been suspected. Although based on small
      numbers of end points, a prospective study has suggested a particularly strong
      association between recent coffee drinking and the incidence of cardiovascular
      disease. METHODS: We examined prospectively the relation of coffee consumption
      with the risk of myocardial infarction, need for coronary-artery bypass grafting
      or angioplasty, and risk of stroke in a cohort of 45,589 U.S. men who were 40 to
      75 years old in 1986 and who had no history of cardiovascular disease. RESULTS:
      During two years of follow-up observation, 221 participants had a nonfatal
      myocardial infarction or died of coronary heart disease, 136 underwent coronary
      artery surgery or angioplasty, and 54 had a stroke. Total coffee consumption was
      not associated with an increased risk of coronary heart disease or stroke. The
      age-adjusted relative risk for all cardiovascular disease among participants who
      drank four or more cups of coffee per day was 1.04 (95 percent confidence
      intervals, 0.74 to 1.46). Increasing levels of consumption of caffeinated coffee
      were not associated with higher risks of cardiovascular disease. Higher
      consumption of decaffeinated coffee, however, was associated with a marginally
      significant increase in the risk of coronary heart disease (relative risk, 1.63;
      95 percent confidence interval, 1.02 to 2.60). Finally, we observed no pattern of
      increased risk across the subgroups of participants with increasing intakes of
      caffeine from all sources. Adjustment for major cardiovascular-risk indicators,
      dietary intake of fats, and cholesterol intake did not materially alter these
      associations. CONCLUSIONS: These findings do not support the hypothesis that
      coffee or caffeine consumption increases the risk of coronary heart disease or
      stroke.

PMID- 2215562
TI  - Eosinophilic inflammation in asthma.
AB  - BACKGROUND AND METHODS: The importance of eosinophils in the pathogenesis of
      bronchial asthma is not established. In an attempt to evaluate the role of
      eosinophilic inflammation in asthma, we compared 10 normal subjects with 43
      patients with chronic asthma, 19 of whom had severe disease as assessed by a
      clinical scoring method described by Aas and by pulmonary-function tests.
      Eosinophils were counted in peripheral blood and bronchoalveolar-lavage fluid,
      and in biopsy specimens obtained from the patients and post mortem from 8
      subjects without asthma, but not from the 10 normal controls. Eosinophil cationic
      protein was titrated by radioimmunoassay in the bronchoalveolar-lavage fluid from
      all subjects and studied by immunohistochemistry in the biopsy specimens.
      RESULTS: There was a significant increase in the number of peripheral-blood
      eosinophils in the patients that was correlated with the clinical severity of
      asthma (P less than 0.001) and pulmonary function (P less than 0.03). Levels of
      eosinophils and eosinophil cationic protein were increased in the bronchoalveolar
      lavage fluid from the patients and were also correlated with the severity of
      asthma (P less than 0.001 and P less than 0.002, respectively). Hematoxylin-eosin
      staining of bronchial-biopsy specimens showed that intraepithelial eosinophils
      were present only in patients with asthma. Immunohistochemical analysis of
      eosinophil cationic protein revealed that normal subjects had only a few
      nondegranulated eosinophils deep in the submucosa, whereas all the patients had
      degranulated eosinophils beneath the basement membrane and among epithelial
      cells. In some patients there was a relation between the presence of degranulated
      eosinophils and epithelial damage. CONCLUSIONS: Eosinophilic inflammation of the
      airways is correlated with the severity of asthma. These cells are likely to play
      a part in the epithelial damage seen in this disease.

PMID- 2215563
TI  - Outcomes of pregnancy in a national sample of resident physicians.
AB  - BACKGROUND: Physically demanding, highly stressful work during pregnancy has been
      reported to cause a variety of adverse outcomes. It has been difficult, however,
      to separate the effects of work from those of socioeconomic status. METHODS: By
      means of a national questionnaire-based survey, we studied the outcomes of
      pregnancy during residency for 4412 women who graduated from medical school in
      1985 and for the wives of 4236 of their male classmates, who served as controls.
      RESULTS: The rate of response to our survey was 87 percent (4412 of 5079) for the
      women residents and 85 percent (4236 of 4968) for the wives of the male
      residents. There were no significant differences in the proportion of pregnancies
      ending in miscarriage (13.8 percent for residents vs. 11.8 percent for their
      classmates' wives, P = 0.12), ectopic gestations (0.5 percent vs. 0.8 percent, P
      = 0.69), and stillbirths (0.2 percent vs. 0.5 percent, P = 0.20). There were 989
      women residents and 1238 residents' wives whose first pregnancy during residency
      resulted in the live birth of a singleton infant. Although during each trimester
      the women residents worked many more hours than the wives of the male residents,
      the frequency of preterm births (less than 37 weeks' gestation) was similar: 6.5
      percent for residents and 6.0 percent for residents' wives (odds ratio = 1.1; 95
      percent confidence interval, 0.7 to 1.5). Infants who were small for gestational
      age (with birth weights less than the 10th percentile for gestational age) were
      born to 5.3 percent of the residents and 5.8 percent of the residents' wives
      (odds ratio = 0.9; 95 percent confidence interval, 0.6 to 1.3). Adjustment for
      factors that differed between the women residents and the wives of male residents
      resulted in odds ratios of 1.2 (95 percent confidence interval, 0.8 to 1.7) for
      preterm delivery and 0.9 (95 percent confidence interval, 0.6 to 1.3) for the
      delivery of an infant who was small for gestational age. However, the women
      residents more frequently reported having had preterm labor (11 percent vs. 6
      percent), but not preterm delivery (6.5 percent vs. 6.0 percent); preeclampsia
      was also more common among the women residents (8.8 percent vs. 3.5 percent).
      CONCLUSIONS: These results suggest that working long hours in a stressful
      occupation has little effect on the outcome of pregnancy in an otherwise healthy
      population of high socioeconomic status.

PMID- 2215564
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 41-1990. A 66-year-old woman with rapidly deteriorating renal
      function.

PMID- 2215565
TI  - Hemoglobin Alc--infatuation or the real thing?

PMID- 2215566
TI  - Why can't a woman be more like a man?

PMID- 2215567
TI  - Heritability of weight gain and obesity.

PMID- 2215568
TI  - Erythropoietin for zidovudine-induced anemia.

PMID- 2215569
TI  - Beta 2-microglobulin amyloidosis in chronic renal failure.

PMID- 2215570
TI  - Illicit drug and alcohol use during pregnancy.

PMID- 2215571
TI  - Anaphylactic reaction to "Heartwise".

PMID- 2215572
TI  - Informing physicians of charges for tests.

PMID- 2215573
TI  - Thoughts as I watched the Peabody Building fall, March 31, 1990.

PMID- 2215574
TI  - Experiences with conversion to Systeme international units.

PMID- 2215575
TI  - The diagnosis and prognosis of autosomal dominant polycystic kidney disease.
AB  - BACKGROUND: Autosomal dominant polycystic kidney disease is usually caused by a
      mutant gene at the PKD1 locus on the short arm of chromosome 16, but in about 4
      percent of families with the disorder it is caused by unknown mutations elsewhere
      in the genome. The natural course of the disease in both genetic forms is not
      well characterized. METHODS: We studied 17 families with autosomal dominant
      polycystic kidney disease to compare presymptomatic diagnosis by ultrasonography
      with diagnosis by genetic-linkage studies and to relate clinical variation of the
      disease to whether the PKD1 mutation was implicated. RESULTS: In 10 families the
      disorder was found to cosegregate with polymorphic DNA markers flanking the PKD1
      locus, in 2 families it did not, and in 5 families linkage could not be
      determined. In the 10 families with the PKD1 mutation, 46 percent of the members
      less than 30 years old who had a 50 percent risk of inheriting a mutation had
      renal cysts, as compared with 11 percent of the members of the two families
      without linkage (P less than 0.001). In the PKD1 families, all 67 diagnoses made
      by ultrasonography were confirmed by determination of the genotype as inferred
      from linkage. Forty of 48 members (83 percent) less than 30 years old who
      inherited the PKD1 mutation had renal cysts. All 27 members 30 years old or older
      who inherited the mutation had renal cysts, suggesting that the probability of a
      false negative diagnosis did not exceed 0.13 in this age group (P less than
      0.05). The mean (+/- SE) age at the onset of end-stage renal disease among
      members of the PKD1 families was 56.7 +/- 1.9 years, as compared with 69.4 +/-
      1.7 years among members with cysts in the families without linkage (P = 0.0025).
      Hypertension and renal impairment were less frequent and occurred later in the
      families without the PKD1 mutation. CONCLUSIONS: At present, in most persons with
      a 50 percent risk of autosomal dominant polycystic kidney disease, imaging
      techniques are the only mode of reaching a diagnosis before symptoms appear. In
      such persons a negative ultrasonographic study during early adult life indicates
      that the likelihood of inheriting a PKD1 mutation is small. In the few who
      inherit a non-PKD1 mutation for polycystic kidney disease, renal failure is
      likely to occur relatively late in life.

PMID- 2215576
TI  - The renin-angiotensin-aldosterone system and autosomal dominant polycystic kidney
      disease.
AB  - BACKGROUND: A high incidence of hypertension (50 to 75 percent) occurs early in
      the course of autosomal dominant polycystic kidney disease. Cyst enlargement,
      causing bilateral renal ischemia and subsequent release of renin, is proposed as
      the cause of this form of hypertension. METHODS: To investigate this hypothesis,
      we measured plasma renin activity and aldosterone concentrations during short
      term and long-term converting-enzyme inhibition in 14 patients with hypertension
      due to polycystic kidney disease, 9 patients with essential hypertension, 11
      normotensive patients with polycystic kidney disease, and 13 normal subjects. The
      groups were comparable with respect to age, sex, body-surface area, degree of
      hypertension, sodium excretion, and renal function. RESULTS: During the short
      term study, the mean (+/- SE) plasma renin activity was significantly higher in
      the hypertensive patients with polycystic kidney disease than in the patients
      with essential hypertension, in the supine (0.36 +/- 0.06 vs. 0.22 +/- 0.06 ng
      per liter.second, P = 0.05) and upright positions (1.03 +/- 0.14 vs. 0.61 +/-
      0.08 ng per liter.second, P less than 0.03) and after converting-enzyme
      inhibition (1.97 +/- 0.28 vs. 0.67 +/- 0.17 ng per liter.second, P less than
      0.0006). The mean arterial pressures measured in the supine and upright positions
      and the plasma aldosterone concentrations measured in the upright position were
      significantly higher in the normotensive patients with polycystic kidney disease
      than in the normal subjects. After six weeks of converting-enzyme inhibition,
      renal plasma flow increased (P less than 0.005), and both renal vascular
      resistance (P less than 0.007) and the filtration fraction (P less than 0.02)
      decreased significantly in the hypertensive patients with polycystic kidney
      disease but not in the patients with essential hypertension. CONCLUSIONS: The
      renin-angiotensin-aldosterone system is stimulated significantly more in
      hypertensive patients with polycystic kidney disease than in comparable patients
      with essential hypertension. The increased renin release, perhaps due to renal
      ischemia caused by cyst expansion, probably contributes to the early development
      of hypertension in polycystic kidney disease.

PMID- 2215577
TI  - Mercury exposure from interior latex paint.
AB  - BACKGROUND: Many paint companies have used phenylmercuric acetate as a
      preservative to prolong the shelf life of interior latex paint. In August 1989,
      acrodynia, a form of mercury poisoning, occurred in a child exposed to paint
      fumes in a home recently painted with a brand containing 4.7 mmol of mercury per
      liter (at that time the Environmental Protection Agency's recommended limit was
      1.5 mmol or less per liter). METHODS: To determine whether the recent use of that
      brand of paint containing phenylmercuric acetate was associated with elevated
      indoor-air and urinary mercury concentrations, we studied 74 "exposed" persons
      living in 19 homes recently painted with the brand and 28 "unexposed" persons
      living in 10 homes not recently painted with paint containing mercury. RESULTS:
      The paint samples from the homes of exposed persons contained a median of 3.8
      mmol of mercury per liter, and air samples from the homes had a median mercury
      content of 10.0 nmol per cubic meter (range, less than 0.5 to 49.9). No mercury
      was detected in paint or air samples from the homes of unexposed persons. The
      median urinary mercury concentration was higher in the exposed persons (4.7 nmol
      of mercury per millimole of creatinine; range, 1.4 to 66.5) than in the unexposed
      persons (1.1 nmol per millimole; range, 0.02 to 3.9; P less than 0.001). Urinary
      mercury concentrations within the range that we found in exposed persons have
      been associated with symptomatic mercury poisoning. CONCLUSIONS: We found that
      potentially hazardous exposure to mercury had occurred among persons whose homes
      were painted with a brand of paint containing mercury at concentrations
      approximately 2 1/2 times the Environmental Protection Agency's recommended
      limit.

PMID- 2215578
TI  - Plasma prorenin activity and complications in children with insulin-dependent
      diabetes mellitus.
AB  - BACKGROUND: Renin, secreted into the blood by the juxtaglomerular cells of the
      kidneys, is derived from a larger precursor, prorenin. Plasma prorenin activity
      is increased in patients with insulin-dependent (Type I) diabetes mellitus who
      have microvascular complications of their disease. We undertook this study to
      determine prospectively whether rising prorenin activity can predict the
      development of complications in young patients with Type I diabetes. METHODS AND
      RESULTS: Plasma prorenin was measured in 135 children and adolescents with Type I
      diabetes. The mean (+/- SE) plasma prorenin activity among the 32 patients over
      the age of 10 years who had had uncomplicated diabetes for 0.1 to 5 years was
      8.43 +/- 0.58 ng of angiotensin I per liter.second, as compared with 7.06 +/-
      0.32 in 37 control subjects of the same age (P less than 0.05). In the 9 patients
      older than 10 who had retinopathy or overt albuminuria, the mean plasma prorenin
      activity was 13.09 +/- 1.43 ng of angiotensin I per liter.second (P less than
      0.0001). In 34 patients 10 years old or older with uncomplicated diabetes, 3 to
      13 measurements of plasma prorenin activity were taken during a follow-up period
      of 6 to 39 months. Urinary albumin was determined at each visit, and the patients
      had regular retinal examinations. Only 1 of the 20 patients who had consistently
      normal plasma prorenin values had overt albuminuria (ratio of urinary albumin to
      creatinine, greater than 0.017) or retinopathy, whereas one or both of these
      complications appeared in 8 of the 14 who had at least one high prorenin value.
      The plasma prorenin value was significantly higher in these eight patients at
      least 18 months before a complication was found. CONCLUSIONS: Increased plasma
      prorenin activity identifies a group of young patients with diabetes who are at
      high risk for retinopathy or nephropathy.

PMID- 2215579
TI  - The value of lowering cholesterol after myocardial infarction.

PMID- 2215580
TI  - Lassa fever in the United States. Investigation of a case and new guidelines for
      management.

PMID- 2215581
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 42-1990. A previously healthy 41-year-old man with
      meningoencephalitis and the rapid development of coma.

PMID- 2215582
TI  - Renin--from beginning to end.

PMID- 2215583
TI  - Mercury--an element of mystery.

PMID- 2215584
TI  - Imported Lassa fever--reexamining the algorithms.

PMID- 2215585
TI  - Sexually transmitted diseases and rape.

PMID- 2215586
TI  - Short-term reductions in serum lipids through diet and exercise.

PMID- 2215587
TI  - Obesity and risk of coronary heart disease in women.

PMID- 2215588
TI  - Growth of African Pygmies in early childhood.

PMID- 2215589
TI  - Acute fatal leukoencephalopathy after interleukin-2 therapy.

PMID- 2215590
TI  - Myocardial infarction after inhalation of methamphetamine.

PMID- 2215591
TI  - The case of Baby L.

PMID- 2215592
TI  - Pregnancy potential of human oocytes--the effect of cryopreservation.
AB  - BACKGROUND: In vitro fertilization, sometimes involving the cryopreservation of
      human embryos, has become a routine procedure for the treatment of infertility.
      Even though there are embryos available for transfer in about 85 percent of the
      treatment cycles, the rate of pregnancy rarely exceeds 25 percent per cycle. We
      designed this study to investigate two questions: Does this high rate of failure
      result from inadequate technique, or does it simply reflect the maximal potential
      of a cohort of aspirated eggs to produce a pregnancy? And to what extent does
      cryopreservation affect the capacity for implantation of embryos? METHODS: The
      study was conducted among patients enrolled in an egg-donation program. Aspirated
      eggs from a given cohort were distributed to the donor herself and a few
      recipients. The recipients were prepared by a standard protocol of hormone
      replacement and were assigned at random to the transfer of either fresh or frozen
      and thawed embryos. The donors received only fresh embryos. RESULTS: Forty cycles
      of donation were studied. In 25 cycles (63 percent) pregnancy was established in
      the donor, in the recipient (or recipients), or in both. Of the fresh embryos
      that were transferred to the recipients, 24 percent were successfully implanted,
      as compared with only 7.7 percent of the frozen and thawed embryos (P less than
      0.01). A pregnancy success rate of 37 percent per recipient cycle was observed in
      the recipients of fresh embryos, as compared with a rate of only 16 percent in
      those receiving frozen and thawed embryos (P less than 0.05). CONCLUSIONS: The
      majority of egg cohorts evidently possess the potential to produce a pregnancy,
      but cryopreservation of human embryos significantly reduces their capacity for
      implantation.

PMID- 2215593
TI  - The epidemiology and clinical aspects of the hemolytic uremic syndrome in
      Minnesota.
AB  - BACKGROUND: The frequency of the hemolytic uremic syndrome, characterized by
      microangiopathic hemolytic anemia, thrombocytopenia, and renal failure, is
      increasing. Although Escherichia coli serotype O157:H7 has been implicated as a
      causative agent, more information is needed about the basic epidemiology and
      clinical aspects of this syndrome. METHODS: We conducted a retrospective
      population-based study of hemolytic uremic syndrome in Minnesota residents less
      than 18 years of age from 1979 through 1988 to assess trends in disease
      occurrence, describe the clinical illness, and identify predictors of disease
      severity and outcome. We also conducted a case-control study of patients with
      onsets of illness from 1986 through 1988 to examine risk factors. RESULTS: One
      hundred seventeen patients were identified. The mean annual incidence increased
      from 0.5 case per 100,000 child-years among children less than 18 in 1979 (6
      cases) to 2.0 cases per 100,000 in 1988 (26 cases) (P = 0.000004). E. coli
      O157:H7 was isolated from 13 of 28 patients (46 percent) who had stool specimens
      submitted for testing. For those who presented with typical hemolytic uremic
      syndrome, an elevated polymorphonuclear-leukocyte count on hospital admission, a
      shorter duration of prodrome, and the presence of bloody diarrhea were predictive
      of severe disease. In the case-control study, the patients were more likely to
      attend large daycare centers (more than 50 children) than were the controls (odds
      ratio, 10.2; P = 0.03), suggesting that day-care attendance may be a risk factor.
      On the basis of the population-attributable risk, however, this factor could
      account for no more than 16 percent of the cases. CONCLUSIONS: This study
      provides evidence for an increase in the incidence of hemolytic uremic syndrome,
      which is probably related to an increased incidence of E. coli O157:H7
      infections. Hemolytic uremic syndrome has become an important pediatric and
      public health problem.

PMID- 2215594
TI  - A prospective study of the development of diabetes in relatives of patients with
      insulin-dependent diabetes.
AB  - BACKGROUND: The presence of cytoplasmic islet-cell autoantibodies has been
      recognized as a risk factor for the development of diabetes mellitus in relatives
      of patients with insulin-dependent diabetes mellitus (IDDM), but the magnitude of
      the risk is unknown, as is the influence of other factors, such as age, sex, and
      race. METHODS: From 1979 through 1989, we studied 4015 initially nondiabetic
      relatives of 1590 probands with IDDM to determine the risk of IDDM according to
      the presence and titer of autoantibodies, as well as other factors. RESULTS: Of
      the 4015 nondiabetic relatives, 125 (3.1 percent) had islet-cell antibodies in
      their initial serum samples, and 40 contracted IDDM. Islet-cell antibodies were
      most frequent (4.3 percent) in relatives who were under 20 years of age (P =
      0.001) and in those (4.8 percent) from families with more than one affected
      member (a multiplex pedigree) (P = 0.003). Independent risk factors for the
      development of diabetes in the relatives included age of less than 10 years at
      the time of the initial study (P = 0.001), membership in a multiplex pedigree (P
      = 0.02), and a positive test for islet-cell antibodies in the initial serum
      sample (P = 0.0001). Twenty-seven of the relatives in whom diabetes developed
      (67.5 percent) had positive tests for islet-cell antibodies before the diagnosis
      of IDDM, giving a relative risk of IDDM of 68 (95 percent confidence interval, 34
      to 134) for antibody-positive relatives. Islet-cell-antibody titers of 20
      Juvenile Diabetes Foundation units or higher were associated with an increasing
      risk of diabetes. CONCLUSIONS: Nondiabetic relatives of probands with IDDM who
      are in the first two decades of life, are members of multiplex pedigrees, and
      have increased titers of islet-cell antibodies are the most likely to contract
      IDDM themselves.

PMID- 2215595
TI  - Predicting the appropriate use of carotid endarterectomy, upper gastrointestinal
      endoscopy, and coronary angiography.
AB  - BACKGROUND AND METHODS: In a nationally representative population 65 years of age
      or older, we have demonstrated that about one quarter of coronary angiographies
      and upper gastrointestinal endoscopies and two thirds of carotid endarterectomies
      were performed for reasons that were less than medically appropriate. In this
      paper we examine whether specific characteristics of patients (age, sex, and
      race), physicians (age, board-certification status, and experience with the
      procedure), or hospitals (teaching status, profit-making status, and size)
      predict whether a procedure will be performed appropriately. RESULTS: In general,
      we found that little of the variability in the appropriateness of care (4 percent
      or less) could be explained on the basis of standard, easily obtainable data
      about the patient, the physician, or the hospital. For all three procedures,
      however, performance in a teaching hospital increased the likelihood that the
      reasons would be medically appropriate (P = 0.09 for angiography, P = 0.30 for
      endoscopy, and P less than 0.01 for endarterectomy). In addition, angiographies
      were more often performed for appropriate reasons in older or more affluent
      patients (P less than 0.01 for both). Being treated by a surgeon who performed a
      high rather than a low number of procedures decreased the likelihood of an
      appropriate endarterectomy by one third, from 40 to 28 percent (P less than
      0.01). CONCLUSIONS: Appropriateness of care cannot be closely predicted from many
      easily determined characteristics of patients, physicians, or hospitals. Thus,
      for the present, if appropriateness is to be improved it will have to be assessed
      directly at the level of each patient, hospital, and physician.

PMID- 2215596
TI  - Treatment of hypertensive crisis.

PMID- 2215597
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 43-1990. A 3 1/2-year-old boy with pharyngitis, fever, rash, and
      prominent cervical lymphadenopathy.

PMID- 2215598
TI  - Outcomes research, cost containment, and the fear of health care rationing.

PMID- 2215599
TI  - Neonatal circumcision.

PMID- 2215600
TI  - T-cell receptors in ataxia-telangiectasia.

PMID- 2215601
TI  - Case 51-1989: the tamoxifen advantage.

PMID- 2215602
TI  - Microwave popcorn--ocular injury caused by steam.

PMID- 2215603
TI  - Miliary tuberculosis after extracorporeal shock-wave lithotripsy.

PMID- 2215604
TI  - A proposal to provide health insurance to all children and all pregnant women.

PMID- 2215605
TI  - Spinal bone loss and ovulatory disturbances.
AB  - BACKGROUND: Osteoporosis develops in women with estrogen deficiency and
      amenorrhea who lose bone at an accelerated rate. It is not known to what extent
      bone loss differs between ovulatory women with regular menstrual cycles who are
      training intensely and those who are sedentary. METHODS: We measured the density
      of cancellous spinal bone from the 12th thoracic vertebra to the 3rd lumbar
      vertebra by quantitative computed tomography on two occasions one year apart in
      66 premenopausal women 21 to 42 years of age. All the women had two consecutive
      ovulatory cycles immediately before entering the study. Twenty-one women were
      training for a marathon, 22 ran regularly but less intensively, and 23 had normal
      levels of activity. The lengths of the women's menstrual cycles and luteal
      phases, diet, exercise levels, and hormonal levels were also determined. We
      defined ovulatory disturbances as anovulatory cycles and cycles with short luteal
      phases. RESULTS: The mean (+/- SD) spinal bone density in the 66 women decreased
      3.0 +/- 4.8 mg per cubic centimeter per year (2.0 percent per year) (P less than
      0.001). Amenorrhea did not develop in any woman during the year of observation
      (only 2.7 percent of the cycles were greater than 36 days long). Ovulatory
      disturbances occurred in 29 percent of all cycles, however. Bone loss was
      strongly associated with these disturbances (r = 0.54, 24 percent of the
      variance). The 13 women who had anovulatory cycles lost bone mineral at a rate of
      6.4 +/- 3.8 mg per cubic centimeter per year (4.2 percent per year). The women
      training for a marathon had menstrual cycles similar to those of the women in the
      other two groups. CONCLUSION: Decreases in spinal bone density among women with
      differing exercise habits correlated with asymptomatic disturbances of ovulation
      (without amenorrhea) and not with physical activity.

PMID- 2215606
TI  - Ulcerative colitis and colorectal cancer. A population-based study.
AB  - BACKGROUND: The risk of colorectal cancer is increased among patients with
      ulcerative colitis. The magnitude of this increase in risk and the effects of the
      length of follow-up, the extent of disease at diagnosis, and age at diagnosis
      vary substantially in different studies. METHODS: To provide accurate estimates
      of the risk of colorectal cancer among patients with ulcerative colitis, we
      studied a population-based cohort of 3117 patients given a diagnosis of
      ulcerative colitis from 1922 through 1983 who were followed up through 1984.
      RESULTS: Ninety-two cases of colorectal cancer occurred in 91 patients. As
      compared with the expected incidence, the incidence of colorectal cancer in the
      cohort was increased (standardized incidence ratio [ratio of observed to expected
      cases] = 5.7; 95 percent confidence interval, 4.6 to 7.0). Less extensive disease
      at diagnosis was associated with a lower risk; for patients with ulcerative
      proctitis, the standardized incidence ratio was 1.7 (95 percent confidence
      interval, 0.8 to 3.2); for those with left-sided colitis, 2.8 (95 percent
      confidence interval, 1.6 to 4.4); and for those with pancolitis (extensive
      colitis, or inflammation of the entire colon), 14.8 (95 percent confidence
      interval, 11.4 to 18.9). Age at diagnosis and the extent of disease at diagnosis
      were strong and independent risk factors for colorectal cancer. For each increase
      in age group at diagnosis (less than 15 years, 15 to 29 years, 30 to 39 years, 40
      to 49 years, 50 to 59 years, and greater than or equal to 60 years), the relative
      risk of colorectal cancer, adjusted for the extent of disease at diagnosis,
      decreased by about half (adjusted standardized incidence ratio = 0.51; 95 percent
      confidence interval, 0.46 to 0.56). The absolute risk of colorectal cancer 35
      years after diagnosis was 30 percent for patients with pancolitis at diagnosis
      and 40 percent for those given this diagnosis at less than 15 years of age.
      CONCLUSIONS: Close surveillance and perhaps even prophylactic proctocolectomy
      should be recommended for patients given a diagnosis of pancolitis, especially
      those who are less than 15 years of age at diagnosis.

PMID- 2215607
TI  - Increased high-density lipoprotein levels caused by a common cholesteryl-ester
      transfer protein gene mutation.
AB  - BACKGROUND AND METHODS: The plasma cholesteryl-ester transfer protein (CETP)
      catalyzes the transfer of cholesteryl esters from high-density lipoprotein (HDL)
      to other lipoproteins. We recently described a Japanese family with increased HDL
      levels and CETP deficiency due to a splicing defect of the CETP gene. To assess
      the frequency and phenotype of this condition, we screened 11 additional families
      with high HDL levels by means of a radioimmunoassay for CETP and DNA analysis.
      RESULTS: We found the same CETP gene mutation in four families from three
      different regions of Japan. Analysis of restriction-fragment-length polymorphisms
      of the mutant CETP allele showed that all probands were homozygous for the
      identical haplotype. Family members homozygous for CETP deficiency (n = 10) had
      moderate hypercholesterolemia (mean total cholesterol level [+/- SD], 7.01 +/-
      0.83 mmol per liter), markedly increased levels of HDL cholesterol (4.24 +/- 1.01
      mmol per liter) and apolipoprotein A-I, and decreased levels of low-density
      lipoprotein cholesterol (1.99 +/- 0.80 mmol per liter) and apolipoprotein B.
      Members heterozygous for the deficiency (n = 20), whose CETP levels were in the
      lower part of the normal range, had moderately increased levels of HDL
      cholesterol and apolipoprotein A-I and an increased ratio of HDL subclass 2 to
      HDL subclass 3, as compared with unaffected family members (1.5 +/- 0.8 vs. 0.7
      +/- 0.4). CETP deficiency was not found in six unrelated subjects with elevated
      HDL cholesterol levels who were from different parts of the United States.
      CONCLUSIONS: CETP deficiency appears to be a frequent cause of increased HDL
      levels in the population of Japan, possibly because of a founder effect. The
      results that we observed in heterozygotes suggest that CETP normally plays a part
      in the regulation of levels of HDL subclass 2. There was no evidence of premature
      atherosclerosis in the families with CETP deficiency. In fact, the lipoprotein
      profile of persons with CETP deficiency is potentially antiatherogenic and may be
      associated with an increased life span.

PMID- 2215608
TI  - The effect of ursodiol on the efficacy and safety of extracorporeal shock-wave
      lithotripsy of gallstones. The Dornier National Biliary Lithotripsy Study.
AB  - BACKGROUND: In the treatment of gallstones with extracorporeal shock-wave
      lithotripsy, the bile acid ursodiol is administered to dissolve the gallstone
      fragments. We designed our study to determine the value of administering this
      agent. METHODS: At 10 centers, 600 symptomatic patients with three or fewer
      radiolucent gallstones 5 to 30 mm in diameter, as visualized by oral
      cholecystography, were randomly assigned to receive ursodiol or placebo for six
      months, starting one week before lithotripsy. RESULTS: The stones were fragmented
      in 97 percent of all patients, and the fragments were less than or equal to 5 mm
      in diameter in 46.8 percent. On the basis of an intention-to-treat analysis of
      all 600 patients, 21 percent receiving ursodiol and 9 percent receiving placebo
      (P less than 0.0001) had gallbladders that were free of stones after six months.
      Among those with completely radiolucent solitary stones less than 20 mm in
      diameter, 35 percent of the patients receiving ursodiol and 18 percent of those
      receiving placebo (P less than 0.001) were free of stones after six months.
      Biliary pain, usually mild, occurred in 73 percent of all patients but in only 13
      percent of those who were free of stones after three and six months (P less than
      0.01). There were few adverse events. Only diarrhea occurred with a significantly
      different frequency in the two groups: 32.6 percent were affected in the ursodiol
      group, as compared with 24.7 percent in the placebo group (P less than 0.04).
      Severe biliary pain occurred in 1.5 percent of all patients, acute cholecystitis
      in 1.0 percent, and acute pancreatitis in 1.5 percent; endoscopic sphincterotomy
      was performed in 0.5 percent, and cholecystectomy in 2.5 percent. CONCLUSIONS:
      Extracorporeal shock-wave lithotripsy with ursodiol was more effective than
      lithotripsy alone for the treatment of symptomatic gallstones, and equally safe.
      Treatment was more effective for solitary than multiple stones, radiolucent than
      slightly calcified stones, and smaller than larger stones.

PMID- 2215609
TI  - Lymphangioleiomyomatosis. Clinical course in 32 patients.

PMID- 2215610
TI  - Premenopausal bone loss--a risk factor for osteoporosis.

PMID- 2215611
TI  - Repair in utero of a fetal diaphragmatic hernia.

PMID- 2215612
TI  - Location of met locus on chromosome 7--a correction.

PMID- 2215613
TI  - Effect on physician-scientists of the low funding rate of NIH grant applications.

PMID- 2215614
TI  - Forgiveness of coinsurance.

PMID- 2215615
TI  - Regression of coronary artery disease as a result of intensive lipid-lowering
      therapy in men with high levels of apolipoprotein B.
AB  - BACKGROUND AND METHODS: The effect of intensive lipid-lowering therapy on
      coronary atherosclerosis among men at high risk for cardiovascular events was
      assessed by quantitative arteriography. Of 146 men no more than 62 years of age
      who had apolipoprotein B levels greater than or equal to 125 mg per deciliter,
      documented coronary artery disease, and a family history of vascular disease, 120
      completed the 2 1/2-year double-blind study, which included arteriography at base
      line and after treatment. Patients were given dietary counseling and were
      randomly assigned to one of three treatments: lovastatin (20 mg twice a day) and
      colestipol (10 g three times a day); niacin (1 g four times a day) and colestipol
      (10 g three times a day); or conventional therapy with placebo (or colestipol if
      the low-density lipoprotein [LDL] cholesterol level was elevated). RESULTS: The
      levels of LDL and high-density lipoprotein (HDL) cholesterol changed only
      slightly in the conventional-therapy group (mean changes, -7 and +5 percent,
      respectively), but more substantially among patients treated with lovastatin and
      colestipol (-46 and +15 percent) or niacin and colestipol (-32 and +43 percent).
      In the conventional-therapy group, 46 percent of the patients had definite lesion
      progression (and no regression) in at least one of nine proximal coronary
      segments; regression was the only change in 11 percent. By comparison,
      progression (as the only change) was less frequent among patients who received
      lovastatin and colestipol (21 percent) and those who received niacin and
      colestipol (25 percent), and regression was more frequent (lovastatin and
      colestipol, 32 percent; niacin and colestipol, 39 percent; P less than 0.005).
      Multivariate analysis indicated that a reduction in the level of apolipoprotein B
      (or LDL cholesterol) and in systolic blood pressure, and an increase in HDL
      cholesterol correlated independently with regression of coronary lesions.
      Clinical events (death, myocardial infarction, or revascularization for worsening
      symptoms) occurred in 10 of 52 patients assigned to conventional therapy, as
      compared with 3 of 46 assigned to receive lovastatin and colestipol and 2 of 48
      assigned to receive niacin and colestipol (relative risk of an event during
      intensive treatment, 0.27; 95 percent confidence interval, 0.10 to 0.77).
      CONCLUSIONS: In men with coronary artery disease who were at high risk for
      cardiovascular events, intensive lipid-lowering therapy reduced the frequency of
      progression of coronary lesions, increased the frequency of regression, and
      reduced the incidence of cardiovascular events.

PMID- 2215616
TI  - Congenital syphilis presenting in infants after the newborn period.
AB  - BACKGROUND AND METHODS: There has been a recent, dramatic increase in the
      incidence of congenital syphilis, particularly in urban areas. We describe seven
      infants seen during one year who were first given a diagnosis of congenital
      syphilis at 3 to 14 weeks of age, when symptoms developed. We reviewed these
      infants' charts in order to ascertain the reasons for the failure to diagnose
      syphilis at birth and to identify the signs and symptoms of congenital syphilis
      in this group of infants. RESULTS: At delivery, four of the infants and their
      mothers had negative qualitative rapid-plasma-reagin tests for syphilis. The
      other three mothers had been seronegative during the pregnancy and were therefore
      not tested at delivery; two of their infants were seronegative at birth, and one
      was not tested. When the infants became symptomatic between 3 and 14 weeks of age
      and were admitted to the hospital, all seven infants and the five mothers
      available for testing were found to be seropositive for syphilis. Four infants
      presented with a characteristic diffuse rash; the other three presented with
      fever and were found on admission to have aseptic meningitis. All these infants
      had multisystem disease, as evidenced by hepatomegaly, increased aminotransferase
      and alkaline phosphatase levels, anemia, and monocytosis. In all the infants
      syphilis responded to parenteral penicillin. CONCLUSIONS: Congenital syphilis may
      be missed if serologic tests are not performed for both the mother and her infant
      at the time of delivery. Even when these tests are performed, some infants are
      not identified as having syphilis, probably because the infection is very recent
      and there has been insufficient time for an antibody response to develop. Some
      infants with congenital syphilis of later onset do not present with a typical
      rash; therefore, at least in areas where the disease is prevalent, serologic
      tests for syphilis should be included in the evaluation of all febrile infants,
      even those with negative results on serologic testing at birth.

PMID- 2215617
TI  - Mutations within the rhodopsin gene in patients with autosomal dominant retinitis
      pigmentosa.
AB  - BACKGROUND: Night blindness is an early symptom of retinitis pigmentosa. The rod
      photoreceptors are responsible for night vision and use rhodopsin as the
      photosensitive pigment. METHODS AND RESULTS: We found three mutations in the
      human rhodopsin gene; each occurred exclusively in the affected members of some
      families with autosomal dominant retinitis pigmentosa. Two mutations were C-to-T
      transitions involving separate nucleotides of codon 347; the third was a C-to-G
      transversion in codon 58. Each mutation corresponded to a change in one amino
      acid residue in the rhodopsin molecule. None of these mutations were found in 106
      unrelated normal subjects who served as controls. When the incidence of these
      three mutations was added to that of a previously reported mutation involving
      codon 23, 27 of 150 unrelated patients with autosomal dominant retinitis
      pigmentosa (18 percent) were found to carry one of these four defects in the
      rhodopsin gene. All 27 patients had abnormal rod function on monitoring of their
      electroretinograms. It appears that patients with the mutation involving codon 23
      probably descend from a single ancestor. CONCLUSIONS: In some patients with
      autosomal dominant retinitis pigmentosa, the disease is caused by one of a
      variety of mutations of the rhodopsin gene.

PMID- 2215618
TI  - Hypercalcemia and ectopic secretion of parathyroid hormone by an ovarian
      carcinoma with rearrangement of the gene for parathyroid hormone.

PMID- 2215619
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 45-1990. A 68-year-old man with recurrent hemoptysis and a
      pulmonary cavity containing a mass.

PMID- 2215620
TI  - Regression of coronary atherosclerosis.

PMID- 2215621
TI  - Congenital syphilis--breaking through the safety net.

PMID- 2215622
TI  - Design considerations for AIDS trials.

PMID- 2215623
TI  - Prognostic indicators in node-negative breast cancer.

PMID- 2215624
TI  - HLA-A11-associated resistance to skin cancer in renal-transplant recipients.

PMID- 2215625
TI  - Effect of tumor necrosis factor in normal subjects.

PMID- 2215626
TI  - Cyclosporine in primary biliary cirrhosis.

PMID- 2215627
TI  - Allopurinol-induced orotidinuria.

PMID- 2215628
TI  - Aminoaciduria due to vinyl-GABA administration.

PMID- 2215629
TI  - Competent patients and irrational choices.

PMID- 2215630
TI  - Editorial review of protocols for clinical trials.

PMID- 2215631
TI  - Our patient earth.

PMID- 2215632
TI  - Occupational exposure to HIV among house staff.

PMID- 2215633
TI  - Name changes in fungi of microbiological, industrial and medical importance. Part
      4.
AB  - This is the fourth in a series of reports bringing changes in the names of fungi
      of microbiological, industrial and medical importance to the attention of workers
      in these fields. The series is sponsored by the Division of Mycology of the
      International Union of Microbiological Societies (IUMS) and prepared under the
      auspices of the International Commission on the Taxonomy of Fungi (ICTF). The
      first of this series of reports included an introduction to the series explaining
      the need for name changes.

PMID- 2215634
TI  - High-Tc brain scan.

PMID- 2215635
TI  - French research. Keeping faith in technology.

PMID- 2215636
TI  - HIV infection. Haemophiliacs win right to sue.

PMID- 2215637
TI  - Animal patents. Australian law finds balance.

PMID- 2215638
TI  - A woman's place.

PMID- 2215639
TI  - Porcine problem now.

PMID- 2215640
TI  - Drug trade. Attacking the mainline.

PMID- 2215641
TI  - HIV and AIDS.

PMID- 2215643
TI  - Snow and cholera.

PMID- 2215642
TI  - Risky arguments about chemicals.

PMID- 2215644
TI  - Molecular evolution. Old dead rats are valuable.

PMID- 2215645
TI  - Developmental biology. The promise of gene ablation.

PMID- 2215646
TI  - Embryology. Activins and induction.

PMID- 2215647
TI  - Blood in ancient human bone.

PMID- 2215648
TI  - More light on PCR contamination.

PMID- 2215649
TI  - High specificity of a phosphate transport protein determined by hydrogen bonds.
AB  - Transport of the essential nutrient phosphorus--primarily in the form of
      orthophosphate--into cells and organelles is highly specific. This is exemplified
      by the uptake of phosphate or its close analogue arsenate by bacterial cells by
      way of a high affinity active transport system dependent on a phosphate-binding
      protein; this system is unable to recognize other inorganic oxyanions and is,
      moreover, distinct from the one for sulphate transport. The phosphate-binding
      protein is a member of a family of periplasmic proteins acting as initial high
      affinity receptors for the osmotic shock-sensitive active transport systems or
      permeases for various sugars, amino acids, oligopeptides, and oxyanions. We
      report here the highly refined 1.7 A resolution X-ray structure of the liganded
      form of the phosphate-binding protein. The structure reveals the atomic features
      responsible for phosphate selectivity, either in monobasic or dibasic form, and
      the exclusion of sulphate. These features are fundamental to understanding
      phosphate transport systems and molecular recognition of charged substrates or
      ions in other biological processes.

PMID- 2215650
TI  - In vitro genetic analysis of the Tetrahymena self-splicing intron.
AB  - The availability of methods for the amplification of nucleic acid sequences
      allows the genetic analysis in vitro of the structural and functional properties
      of many nucleic acids. We have now developed an in vitro selection and
      amplification system, and used it to analyse the self-splicing Tetrahymena
      ribozyme. A much wider range of selective conditions can be used in vitro than is
      possible with standard in vivo methods, and many more variants can be handled in
      vitro than in vivo. This method can be used to isolate the wild-type ribozyme,
      and structural variants that are as active as the wild type, from a pool of over
      250,000 variants in only three cycles of selection and amplification.

PMID- 2215651
TI  - Dutch cure for AIDS is discredited.

PMID- 2215652
TI  - Soviet accident. Under a cloud.

PMID- 2215653
TI  - Biomedical research. Sharing a shrinking budget.

PMID- 2215654
TI  - AIDS research. Study will break new ground.

PMID- 2215655
TI  - Doubts over 'wonderdrug'.

PMID- 2215656
TI  - Clinical trials.

PMID- 2215657
TI  - MRC and peer review.

PMID- 2215658
TI  - No cancer link.

PMID- 2215659
TI  - Cell line ownership.

PMID- 2215660
TI  - Doctor who?

PMID- 2215661
TI  - Origins of fetal handedness.

PMID- 2215662
TI  - The scid mutation in mice causes a general defect in DNA repair.
AB  - Mice homozygous for the scid mutation on chromosome 16 have a severe combined
      immune deficiency as a result of their inability to correctly rearrange their
      immunoglobulin and T-cell receptor genes. In scid mice, when precursors for B and
      T lymphocytes reach the stage of development requiring expression of these
      surface receptors, a defective recombinase system aberrantly cuts and rejoins the
      receptor gene segments greatly reducing the efficiency of producing functional
      receptors. As a result, most scid mice have no detectable B or T lymphocytes. We
      have demonstrated that the scid defect is not specific to lymphocyte development.
      Myeloid cells and fibroblasts from scid mice show a marked increase in
      sensitivity to ionizing radiation, indicating that the scid mutation leads to an
      inability to repair DNA damage induced by ionizing radiation as well as
      interfering with rearrangement of the immunoglobulin and T-cell receptor genes.

PMID- 2215663
TI  - Small rearrangements in structures of Fv and Fab fragments of antibody D1.3 on
      antigen binding.
AB  - The potential use of monoclonal antibodies in immunological, chemical and
      clinical applications has stimulated the protein engineering and expression of Fv
      fragments, which are heterodimers consisting of the light and heavy chain
      variable domains (VL and VH) of antibodies. Although Fv fragments exhibit antigen
      binding specificity and association constants similar to their parent antibodies
      or Fab moieties, similarity in their interactions with antigen at the level of
      three-dimensional structure has not been investigated. We have determined the
      high-resolution crystal structure of the genetically engineered FvD1.3 fragment
      of the anti-hen egg-white lysozyme (HEL) monoclonal antibody D1.3, and of its
      complex with HEL. On comparison with the crystallographically refined FabD1.3-HEL
      complex, we find that FvD1.3 and FabD1.3 make, with minor exceptions, very
      similar contacts with the antigen. Furthermore, a small but systematic
      rearrangement of the domains of FvD1.3 occurs on binding HEL, bringing the
      contacting residues closer to the antigen by a mean value of about 0.7 A for VH
      (aligning on VL) or of 0.5 A for VL (aligning on VH). This is indicative of an
      induced fit rather than a 'lock and key' fit to the antigen.

PMID- 2215664
TI  - RNA polymerase II C-terminal repeat influences response to transcriptional
      enhancer signals.
AB  - The large subunit of RNA polymerase II contains a highly conserved and essential
      heptapeptide repeat (Pro-Thr-Ser-Pro-Ser-Tyr-Ser) at its carboxy terminus.
      Saccharomyces cerevisiae cells are inviable if their RNA polymerase II large
      subunit genes encode fewer than 10 complete heptapeptide repeats; if they encode
      10 to 12 complete repeats cells are temperature-sensitive and cold-sensitive, but
      13 or more complete repeats will allow wild-type growth at all temperatures.
      Cells containing C-terminal domains (CTDs) of 10 to 12 complete repeats are also
      inositol auxotrophs. The phenotypes associated with these CTD mutations are not a
      consequence of an instability of the large subunit; rather, they seem to reflect
      a functional deficiency of the mutant enzyme. We show here that partial deletion
      mutations in RNA polymerase II CTD affect the ability of the enzyme to respond to
      signals from upstream activating sequences in a subset of promoters in yeast. The
      number of heptapeptide repeats required for maximal response to signals from
      these sequences differs from one upstream activating sequence to another. One of
      the upstream elements that is sensitive to truncations of the CTD is the 17-base
      pair site bound by the GAL4 transactivating factor.

PMID- 2215665
TI  - Identification of an actin-binding protein from Dictyostelium as elongation
      factor 1a.
AB  - Indirect evidence has implicated an interaction between the cytoskeleton and the
      protein synthetic machinery. Two recent reports have linked the elongation factor
      1a (EF-1a) which is involved in protein synthesis, with the microtubular
      cytoskeleton. In situ hybridization has, however, revealed that the messages for
      certain cytoskeletal proteins are preferentially associated with actin filaments.
      ABP-50 is an abundant actin filament bundling protein of native relative
      molecular mass 50,000 (50K) isolated from Dictyostelium discoideum.
      Immunofluorescence studies show that ABP-50 is present in filopodia and other
      cortical regions that contain actin filament bundles. In addition, ABP-50 binds
      to monomeric actin in the cytosol of unstimulated cells and the association of
      ABP-50 with the actin cytoskeleton is regulated during chemotaxis. Through
      complementary DNA sequencing and subsequent functional analysis, we have
      identified ABP-50 as D. discoideum EF-1a. The ability of EF-1a to bind reversibly
      to the actin cytoskeleton upon stimulation could provide a mechanism for
      spatially and temporally regulated protein synthesis in eukaryotic cells.

PMID- 2215666
TI  - Antibodies from Escherichia coli.
AB  - Use of Escherichia coli as an expression host has opened up new possibilities in
      antibody research and its applications. It greatly facilitates rational
      engineering and random mutagenesis.

PMID- 2215667
TI  - Genetic engineering. Glasnost for UK release information.

PMID- 2215668
TI  - Research lobbies. Industry fights back.

PMID- 2215669
TI  - Research lobbies. New research lobby draws fire.

PMID- 2215670
TI  - Nobel Prize. Transplantation wins again.

PMID- 2215671
TI  - Scientific misconduct. Science meets forensic science.

PMID- 2215672
TI  - UK biotechnology. Biotechnology no longer Wellcome.

PMID- 2215673
TI  - Radiation exposure. Sellafield under scrutiny.

PMID- 2215675
TI  - Science sells its soul.

PMID- 2215674
TI  - Early case of AIDS in the USA.

PMID- 2215676
TI  - Transcriptional control. Scissors and helical forks.

PMID- 2215677
TI  - Phospholipid transfer market.

PMID- 2215678
TI  - Leukaemia risk and plutonium.

PMID- 2215679
TI  - HIV mutation rate.

PMID- 2215680
TI  - Monophyletic origin of Lake Victoria cichlid fishes suggested by mitochondrial
      DNA sequences.
AB  - Lake Victoria, together with its satellite lakes, harbours roughly 200 endemic
      forms of cichlid fishes that are classified as 'haplochromines' and yet the lake
      system is less than a million years old. This 'flock' has attracted attention
      because of the possibility that it evolved within the lake from one ancestral
      species and that biologists are thus presented with a case of explosive
      evolution. Within the past decade, however, morphology has increasingly
      emphasized the view that the flock may be polyphyletic. We sequenced up to 803
      base pairs of mitochondrial DNA from 14 representative Victorian species and 23
      additional African species. The flock seems to be monophyletic, and is more akin
      to that from Lake Malawi than to species from Lake Tanganyika; in addition, it
      contains less genetic variation than does the human species, and there is
      virtually no sharing of mitochondrial DNA types among species. These results
      confirm that the founding event was recent.

PMID- 2215681
TI  - Transparency and the uniqueness constraint in human and computer stereo vision.
AB  - The sensation of depth that is obtained with human binocular vision results from
      the differences in the projection of the world onto the two retinae. The process
      entails solving the problem of stereo correspondence, which involves choosing the
      correct matches between left and right image features. Many computational models
      of stereo vision assume a uniqueness constraint on stereo matching-that is, each
      feature identified in one image should eventually be matched with only one
      feature in the other image. This constraint would seem to be justified, as
      allowing non-unique matches would be tantamount to supposing that the scene
      entities to which matches relate are in two places at once. The value of the
      uniqueness constraint for eliminating false matches has been demonstrated in a
      variety of stereo algorithms. Yet on the basis of psychophysical results
      Weinshall concluded that it was not used by humans in dealing with certain types
      of ambiguous random-dot stereograms. We have now tested how Weinshall's
      stereograms are dealt with by PMF, a stereo algorithm which uses a unique-matches
      selection procedure in conjunction with a purely local similar-disparity support
      scheme. We found that PMF produces results that are closely analogous to the
      psychophysical results. This suggests that Weinshall's experiments should not be
      interpreted as evidence that the human stereo mechanism establishes non-unique
      matches.

PMID- 2215682
TI  - An essential role for a phospholipid transfer protein in yeast Golgi function.
AB  - Progression of proteins through the secretory pathway of eukaryotic cells
      involves a continuous rearrangement of macromolecular structures made up of
      proteins and phospholipids. The protein SEC14p is essential for transport of
      proteins from the yeast Golgi complex. Independent characterization of the SEC14
      gene and the PIT1 gene, which encodes a phosphatidylinositol/phosphatidylcholine
      transfer protein in yeast, indicated that these two genes are identical.
      Phospholipid transfer proteins are a class of cytosolic proteins that are
      ubiquitous among eukaryotic cells and are distinguished by their ability to
      catalyse the exchange of phospholipids between membranes in vitro. We show here
      that the SEC14 and PIT1 genes are indeed identical and that the growth phenotype
      of a sec14-1ts mutant extends to the inability of its transfer protein to effect
      phospholipid transfer in vitro. These results therefore establish for the first
      time an in vivo function for a phospholipid transfer protein, namely a role in
      the compartment-specific stimulation of protein secretion.

PMID- 2215684
TI  - End now in sight for Gallo investigation?

PMID- 2215683
TI  - Phylogenetic and genetic evidence for base-triples in the catalytic domain of
      group I introns.
AB  - Understanding the mechanisms by which ribozymes catalyse chemical reactions
      requires a detailed knowledge of their structure. The secondary structure of the
      group I introns has been confirmed by comparison of over 70 published sequences,
      by chemical protection studies, and by genetic experiments involving compensatory
      mutations. Phylogenetic data can also be used to identify tertiary interactions
      in RNA molecules. This was first done by Levitt, who predicted tertiary
      interactions in transfer RNA, which were subsequently confirmed by X-ray
      crystallography. More recently, sequence comparison data have been used to
      predict tertiary interactions in ribosomal RNA. We have searched a complete
      alignment of the core regions of group I introns for evolutionary covariations
      that could not be ascribed to classical Watson-Crick or wobble base pairings.
      Here we describe two examples of phylogenetic covariation that are most simply
      explained by postulating hydrogen-bonded base-triples similar to those found in
      tRNA. Genetic experiments with the Tetrahymena and sunY introns confirm the
      importance of these interactions for the structure of the ribozyme.

PMID- 2215685
TI  - Cancer around nuclear plant.

PMID- 2215686
TI  - Biotechnology. Money no object.

PMID- 2215687
TI  - AIDS treatment. WHO concern over new drug.

PMID- 2215688
TI  - Mouse patent a step closer.

PMID- 2215689
TI  - Medical science. Psychiatric abuses revealed.

PMID- 2215690
TI  - BSE susceptibility.

PMID- 2215691
TI  - Human genetics. Deficiencies in sight with the candidate gene approach.

PMID- 2215692
TI  - Evolution. Between biology and culture.

PMID- 2215693
TI  - Domestic mercury pollution.

PMID- 2215694
TI  - Sex-ratio biased organisms.

PMID- 2215695
TI  - Molecular dynamics simulations in biology.
AB  - Molecular dynamics--the science of simulating the motions of a system of
      particles--applied to biological macromolecules gives the fluctuations in the
      relative positions of the atoms in a protein or in DNA as a function of time.
      Knowledge of these motions provides insights into biological phenomena such as
      the role of flexibility in ligand binding and the rapid solvation of the electron
      transfer state in photosynthesis. Molecular dynamics is also being used to
      determine protein structures from NMR, to refine protein X-ray crystal structures
      faster from poorer starting models, and to calculate the free energy changes
      resulting from mutations in proteins.

PMID- 2215696
TI  - Intrinsic segmental identity of segmental founder cells of the leech embryo.
AB  - Segmentation occurs in several animal phyla, and the cellular mechanisms
      generating this structural periodicity vary considerably. In the leech, an
      annelid worm, segmental founder cells arise through a fixed cell lineage (Fig.
      1), and come together in a longitudinally repeating array through a stereotyped
      pattern of morphogenesis. In this paper we demonstrate that founder cells forced
      to differentiate in a foreign segmental environment give rise to their normal,
      segment-specific clones of neuronal descendants, even in segments in which those
      neuronal phenotypes would not normally be observed. These findings indicate that
      the individual founder cells possess segmental identity at or shortly after the
      time of their birth, and further suggest that such identities are established by
      a mechanism in which the parent stem cell 'counts' mitotic cycles.

PMID- 2215697
TI  - Cloning of a gene that is rearranged in patients with choroideraemia.
AB  - Choroideraemia (tapetochoroidal dystrophy, TCD), a common form of X-linked
      blindness, is characterized by progressive dystrophy of the choroid, retinal
      pigment epithelium and retina. Previous studies have assigned the TCD gene to a
      small segment of the Xq21 band. By making use of reverse genetics strategies we
      have isolated eight overlapping complementary DNA clones from the same
      chromosomal region. The corresponding gene is expressed in retina, choroid and
      retinal pigment epithelium. The cDNAs encompass an open reading frame of 948 base
      pairs that is structurally altered in eight TCD patients with deletions, and in a
      female patient with a balanced translocation involving Xq21. These findings
      provide strong evidence that we have cloned the gene underlying choroideraemia.
      Elucidation of its function should provide new insights into the molecular
      mechanisms responsible for this disorder and other hereditary retinopathies.

PMID- 2215698
TI  - X-ray structure of phospholipase A2 complexed with a substrate-derived inhibitor.
AB  - Phospholipases A2 play a part in a number of physiologically important cellular
      processes such as inflammation, blood platelet aggregation and acute
      hypersensitivity. These processes are all initiated by the release of arachidonic
      acid from cell membranes which is catalysed by intracellular phospholipases A2
      and followed by conversion of arachidonic acid to prostaglandins, leukotrienes or
      thromboxanes. An imbalance in the production of these compounds can lead to
      chronic inflammatory diseases such as rheumatoid arthritis and asthma. Inhibitors
      of phospholipase A2 might therefore act to reduce the effects of inflammation, so
      structural information about the binding of phospholipase A2 to its substrates
      could be helpful in the design of therapeutic drugs. The three-dimensional
      structure is not known for any intracellular phospholipase A2, but these enzymes
      share significant sequence homology with secreted phospholipases, for which some
      of the structures have been determined. Here we report the structure of a complex
      between an extracellular phospholipase A2 and a competitively inhibiting
      substrate analogue, which reveals considerable detail about the interaction and
      suggests a mechanism for catalysis by this enzyme.

PMID- 2215699
TI  - Mandelate racemase and muconate lactonizing enzyme are mechanistically distinct
      and structurally homologous.
AB  - Mandelate racemase (MR) and muconate lactonizing enzyme (MLE) catalyse separate
      and mechanistically distinct reactions necessary for the catabolism of aromatic
      acids by Pseudomonas putida. The X-ray crystal structure of MR, solved at 2.5 A
      resolution, reveals that the secondary, tertiary and quaternary structures of MR
      and MLE are remarkably similar; also, MR and MLE are about 26% identical in
      primary structure. However, MR has no detectable MLE activity and vice versa.
      Thus, MR and MLE constitute the first example of enzymes that catalyse different
      reactions, as opposed to mechanistically identical reactions on different
      substrates, yet possess sufficient structural and sequence identity that they are
      likely to have evolved from a common ancestor. The discovery that MR and MLE
      catalyse different reactions but share a common structural framework has broad
      implications for the natural evolution of enzymes and metabolic pathways, as well
      as for the rational modification of enzyme activities.

PMID- 2215700
TI  - [Transcultural surgical obstetrics].

PMID- 2215701
TI  - [Carpal tunnel syndrome].

PMID- 2215702
TI  - [Vitamin K prophylaxis necessary in young infants].

PMID- 2215703
TI  - [Antithrombotic agents in coronary bypass surgery in The Netherlands].

PMID- 2215704
TI  - [Analysis of the urinary sediment].

PMID- 2215706
TI  - [Administration of vitamin K to neonates and infants].
AB  - The Committee on Infant Nutrition of the Dutch National Cross Association and the
      Education Bureau on Food and Nutrition, and the Dutch Paediatric Association
      recommend the administration of a single oral dose of 1 mg vitamin K1 at birth to
      all healthy infants in order to prevent haemorrhagic disease of the newborn
      (HDN). Parenteral administration of vitamin K1 at birth is recommended for
      newborn especially at risk. For infants who are wholly or largely breastfed a
      daily dose of 25 micrograms vitamin K1 orally is recommended for the first three
      months, to be increased to 50 micrograms per day in case of additional risk
      factors. Literature on causes of vitamin K deficiency, incidence of HDN and
      trends in prophylaxis is summarized and issues which require further
      clarification are indicated.

PMID- 2215705
TI  - [Carpal tunnel syndrome].
AB  - The results of operative treatment of 117 patients with carpal tunnel syndrome
      (CTS) are reported. CTS occurred four to five times more frequently in women than
      in men. It occurred predominantly in the age group 40 to 60 years. Information on
      the results of operative treatment and residual complaints were obtained by
      written inquiry (response: 117/126 = 93%). All patients who were dissatisfied or
      still had complaints were seen in the outpatient department. The duration of
      follow-up averaged 15 months: 75% of all patients reported good results. In 89%
      of the patients the preoperative complaints had disappeared. Dissatisfaction with
      the operative result was often caused by factors not related to the carpal tunnel
      syndrome. Factors favouring good results were typical complaints, defined as
      nocturnal paraesthesias on the volar aspect of the hand and abnormal nerve
      conduction studies. The results obtained with operation under local anaesthesia
      in the outpatient department are equivalent to those reported of patients
      operated in the clinical setting. One-third of the patients felt able to return
      to work or to resume full normal daily activities within 6 weeks, and 2/3 of the
      patients within 3 months of the operation.

PMID- 2215708
TI  - [The pneumoportogram, a rare finding in septicemia due to an intra-abdominal
      abscess].
AB  - A man aged 73 is described with radiologically revealed air in the portal vein, a
      peumoportogram, on the basis of intra-abdominal sepsis. Characteristic of this
      finding are the air shadows extending far into the periphery of the liver in
      contrast to an air cholangiogram. It is an ominous sign, mostly secondary to
      severe intra-abdominal pathology such as ischaemic bowel necrosis, peritonitis or
      abscesses. Treatment should be aimed at these causes. Prognosis depends on the
      underlying pathology.

PMID- 2215707
TI  - [Reliability of blood pressure measurements; comparison of an electronic meter
      and a mercury manometer in family practice].
AB  - The Riva-Rocci indirect method of measuring the blood pressure carries a number
      of sources of error. A report is presented of a study of the serviceability of an
      electronic blood pressure meter as compared with the conventional mercury
      manometer. Seventy-six paired measurements were carried out in patients selected
      at random using an electronic blood pressure meter and a mercury manometer
      meeting all Health Council requirements. The systematic error and the incidental
      error in both measuring procedures were compared. The differences found were so
      slight as to be negligible in practice. It is concluded that the electronic blood
      pressure meter in practice constitutes an acceptable substitute for the
      conventional mercury manometer.

PMID- 2215709
TI  - [Anti-neuritis vitamin and beriberi. Nobel prize paper. 1929].

PMID- 2215710
TI  - [100 years ago discovery of vitamins by Eijkman].

PMID- 2215711
TI  - [Biliary ascariasis as complication after cholecystectomy for cholelithiasis].

PMID- 2215712
TI  - [The treatment of dog and cat bites].

PMID- 2215713
TI  - [Premenstrual syndrome].

PMID- 2215714
TI  - [Too much haste is not good either with vitamin K].

PMID- 2215715
TI  - [Hippocrates and our hypocrisy].

PMID- 2215716
TI  - [Current viewpoints concerning the surgical treatment of aortic coarctation in
      infants and children].

PMID- 2215717
TI  - [The adjuvant treatment of colonic and rectal carcinoma: a step forward].

PMID- 2215718
TI  - [Shock wave lithotripsy of gallbladder stones: the initial 54 patients treated in
      Rotterdam-Dijkzigt].
AB  - From April 1988 till May 1990 54 patients with symptomatic gallbladder stones
      were treated in the University Hospital Rotterdam-Dijkzigt with extracorporeal
      shock wave lithotripsy (ESWL) followed by oral administration of bile acids (urso
      and chenodeoxycholic acid). These patients on average underwent 2 sessions of
      ESWL with an electromagnetic lithotriptor (Lithostar and Lithostar Plus, Siemens
      AG, Erlangen, FRG). Ultimate disintegration of stones was achieved in 50/54 (93%)
      patients. The best results were achieved in patients with a solitary gallstone
      (56% of these patients were stone-free 12 months after ESWL). Four per cent of
      the patients with 2-10 stones were free of stones 12 months after ESWL). Thirty
      seven per cent of the patients suffered from biliary colics after ESWL and three
      patients developed pancreatitis. The administration of oral bile acids were
      complicated by transient diarrhoea in 20% of the patients. ESWL followed by oral
      bile acid therapy is a relatively effective and safe therapy for a highly
      selected population of patients with gallbladder stones.

PMID- 2215719
TI  - [Hyperostosis cranialis interna; a new syndrome with autosomal dominant
      inheritance].
AB  - A family is described which currently comprises nine individuals, spanning three
      generations, who are affected with a bone disorder which is confined to the skull
      and is accompanied by impaired function of the cranial nerves. Radiological
      examination showed intracranial hyperostosis and osteosclerosis of the calvaria
      and the base of the skull, without involvement of the mandible or other skeletal
      bones. Invariably, the main presenting symptom was recurrent facial nerve
      paralysis from late childhood onwards, but concurrent and variable involvement of
      the olfactory, optic, vestibular and acoustic nerves was seen; this could be
      attributed to nerve compression by the bony encroachment into the cranial
      foramina. Morphological investigations revealed increased formation of bone
      tissue with a normal structure. The pedigree suggests an autosomal dominant mode
      of heredity. A review of the literature did not disclose any previous reports on
      this disorder.

PMID- 2215720
TI  - [The treatment of ankle edema in the elderly in family practice; when and how
      often are diuretics used?].
AB  - It has long been recommended that one should be careful in prescribing drugs for
      the elderly. However, it has been shown that more than 20% of those over 65 use
      diuretics. With advancing age this percentage increases. The sign of ankle oedema
      appears to be an important factor in the decision to prescribe diuretics. If the
      oedema is not caused by heart failure, chronic renal failure or hypoproteinaemia,
      the use of diuretics in ankle oedema is controversial. We used a questionnaire
      survey to obtain information on the opinions of Dutch general practitioners about
      the differential diagnosis and treatment of ankle oedema in the elderly. In the
      questionnaire we presented the case of a 68-year-old woman who complained of
      ankle oedema without any symptom or sign of heart failure. The questionnaire was
      sent to 200 Dutch general practitioners (response rate 64%). Chronic venous
      insufficiency was mentioned by 86% and heart failure by 12% of the responders as
      the most probable cause of the oedema. The treatment proposed by 59% was advice
      and (or) compression therapy without drugs, while 40% would have prescribed
      diuretics.

PMID- 2215721
TI  - [Risks of diazepam in newborn infants].
AB  - In children there is a good effect of diazepam on convulsions after intravenous
      or rectal administration. This is not the case in neonates. We describe a newborn
      to whom diazepam was given because of a convulsion and who exhibited serious side
      effects: coma, hypotonia and feeding difficulties. We point out the risks of
      using diazepam in neonates.

PMID- 2215722
TI  - [Indications for an increased possibility of neural tube defects in pregnancies
      following ovulation induction and/or in-vitro fertilization].

PMID- 2215723
TI  - [When the heart beats in the throat].

PMID- 2215724
TI  - [Children and trauma: decreasing mortality, different care].

PMID- 2215725
TI  - [Immunology and virology of HIV infection: current concepts in the pathogenesis
      of AIDS].

PMID- 2215726
TI  - [(Chemo)prevention and second primary tumor of the head and neck region].

PMID- 2215727
TI  - [Cervical epidural spinal cord stimulation in infantile encephalopathy].
AB  - The effect of Cervical Epidural Spinal cord Electrical Stimulation (E.S.E.S.) was
      studied in 15 patients with cerebral palsy. Spasticity and dyskinesia, daily
      functioning and the emotional and physical burden of this therapy for the
      patients were examined. Twelve patients did not continue the treatment after
      completing the study, because of lack of symptomatic or functional improvement
      and many complications due to broken or migrated electrodes. Two patients still
      continue E.S.E.S. and a third is awaiting replacement of a broken electrode. None
      of these three patients showed a clear improvement of the ADL scale or the
      disability score. E.S.E.S. cannot be recommended as a symptomatic treatment for
      cerebral palsy patients.

PMID- 2215728
TI  - [Percutaneous transluminal coronary angioplasty in patients older than 70 years;
      short- and long-term results].
AB  - PTCA was performed in 166 patients older than 70. The primary angiographic and
      clinical success rates were 85% and 86%, respectively. A total of 15 major
      complications occurred in 10 patients (6%): 4 patients died (2%), 6 patients
      underwent urgent bypass surgery (4%), the incidence of acute myocardial
      infarction was 3% (5 patients). The 4-year survival rate was 84 +/- 8%. During
      the follow-up period 8 patients (5%) sustained a nonfatal myocardial infarction,
      21 patients (13%) underwent a second and (or) third balloon dilatation and 17
      patients (10%) underwent bypass surgery. At the end of the observation period 68%
      of the survivors had a sustained improvement of the functional class. This was
      associated with a significant reduction of the antianginal therapy. These data
      demonstrate that PTCA can be performed safely and effectively in patients over
      70.

PMID- 2215729
TI  - [Analysis of antibodies against human immunodeficiency virus on a voluntary basis
      in healthy persons in Amsterdam 1988 and 1989].
AB  - At the Municipal Health Service of Amsterdam it is possible to be tested for HIV
      antibodies after signing an informed consent. In 1988, 1247 persons were tested
      (797 men, 450 women) and in 1989, 1400 persons (869 men, 531 women). Fifty-eight
      persons were identified as HIV-seropositive for the first time (1988: 24 men, 3
      women; 1989: 28 men, 3 women). All but one woman belonged to a risk group or had
      had sexual contact with a person from a known risk group. In 1989 no increase in
      the percentage of HIV-seropositive persons was seen. In our (selected) group of
      persons in 1988 and 1989 we saw no transmission of HIV outside the known risk
      groups.

PMID- 2215730
TI  - [Children and accidents: decreasing mortality, different care].
AB  - In order to explore the demand for trauma care facilities for children with
      severe injuries in the University Hospital of Rotterdam, the departments of
      Paediatric Surgery and Epidemiology initiated a study of mortality, morbidity and
      patterns of trauma care. The standardized mortality rate in the region declined
      by 40% between 1979 and 1986, as did the clinical prevalence of trauma injuries,
      expressed by the number of days spent in hospital per 100,000 children. This was
      in agreement with the national epidemiological data. The number of hospital
      admissions for childhood injuries in the University Hospital of Rotterdam
      stabilized in recent years, which may be considered a relative increase. Moreover
      the number of children with severe injuries admitted to Intensive Care Units
      increased by 46%, which was mainly due to Intensive Care admissions of children
      living outside Rotterdam. Obviously, another pattern of referral of these
      patients has developed in the south-west of The Netherlands. The decrease of the
      number of severe injuries in childhood together with the complexity of trauma
      care and the increasing number of physicians raises questions on the maintenance
      of skills. This is an argument for centralization of trauma care for severely
      injured children, which to some extent has already been implemented in this
      region.

PMID- 2215731
TI  - [Gynecomastia in testicular tumors].
AB  - The incidence of gynaecomastia among 224 patients treated between 1981 and 1989
      for testicular cancer was studied retrospectively. Gynaecomastia was present as
      an initial symptom in 25 (11%) patients and developed after chemotherapy or
      radiotherapy in 19 (9%) patients. Gynaecomastia was mainly seen in patients with
      high tumour stages. It therefore points to an unfavourable prognosis.

PMID- 2215733
TI  - [Eurothemes. Physicians and patients without borders].

PMID- 2215732
TI  - [Cardiomyoplasty: a new alternative in chronic heart failure].
AB  - The technique of cardiomyoplasty to support the failing heart as applied in the
      first two patients in The Netherlands is reported. Indications are presented for
      the selection of patients who might benefit from a cardiomyoplasty procedure,
      considering its experimental nature.

PMID- 2215734
TI  - [Aspirin and pregnancy].

PMID- 2215735
TI  - [Bavaroise and an epidemic of Salmonella enteritidis].

PMID- 2215736
TI  - [Emergency care for severely injured patients].

PMID- 2215737
TI  - [Consensus about consensus].

PMID- 2215738
TI  - [Serum creatinine level as a measure of kidney function].

PMID- 2215739
TI  - ['Globus'; real or virtual?].

PMID- 2215740
TI  - [Brain tumors do not metastasize?].

PMID- 2215742
TI  - [Symptoms and injuries of the locomotor system in dancers].

PMID- 2215741
TI  - [Current viewpoints on the risks of various types of fat distribution].

PMID- 2215743
TI  - [Prolonged pregnancy and management: what is on time?].

PMID- 2215744
TI  - [Critical illness polyneuropathy].
AB  - Critical illness polyneuropathy is a syndrome of neuromuscular complications
      after artificial respiration. The authors present the data of their own 22
      patients all suffering from severe flaccid tetraparesis, areflexia and muscle
      atrophy, after an average of two weeks on artificial respiration. The prognosis
      is relatively favourable. The multi-conditional causes are discussed with
      emphasis on the combination of polyneuropathy and myopathy. The role of plasma
      factors such as cachectin, which is identical to tumour necrosis factor (TNF), is
      described. Attention is drawn to this important illness which occurs especially
      in patients in the intensive care unit with problems in the weaning from
      artificial respiration.

PMID- 2215745
TI  - [Generalized histoplasmosis in 3 patients with an HIV infection].
AB  - Three patients with generalized histoplasmosis and the acquired immunodeficiency
      syndrome (AIDS) are described. Symptoms of generalized histoplasmosis in patients
      with AIDS are not specific and concomitant opportunistic infections frequently
      occur. Two patients suffered from an infection by Mycobacterium tuberculosis, one
      patient had Pneumocystis carinii pneumonia, and one had cerebral toxoplasmosis.
      One patient had serological results positive for Histoplasma capsulatum. Two of
      the three patients showed rapid clinical improvement on amphotericin B but this
      was temporary and all patients died within 5 months.

PMID- 2215746
TI  - [Long-term results of the Swanson prosthesis for the treatment of lunate
      osteomalacia].
AB  - From 1972 to 1982 a silicone implant arthroplasty was performed in 18 patients
      with Kienbock's disease grade III. In May 1988 all patients had a clinical and
      radiological re-examination. In the course of time reoperations were performed in
      4 patients because of (sub)luxation of the prosthesis. Because of this operation
      most of the patients had less pain and retained an acceptable function of the
      wrist. Influence on working circumstances had been considerable in 8 patients.
      One patient received a disability pension because of this disease. Radiological
      examination often revealed increased degenerative changes in carpo-radial and
      intercarpal joints as well as proximal migration of the capitate. There was no
      clear relationship between residual complaints and function at the follow-up
      examination and the radiological findings.

PMID- 2215747
TI  - [Medical decisions around life's end, the study by instruction of the Commission
      Remmelink].

PMID- 2215748
TI  - [Proposal of legislation Medical Management Contract and patients' rights].

PMID- 2215749
TI  - [Orthostatic hypotension in the elderly].

PMID- 2215750
TI  - [Deep venous thrombosis in pregnancy: diagnosis, treatment and prevention].

PMID- 2215751
TI  - [The Douglas abscess].

PMID- 2215752
TI  - [Status and future of autopsies].

PMID- 2215753
TI  - [Arterial insufficiency of the legs: pathophysiological basis of the physical
      diagnostic examination].

PMID- 2215754
TI  - [AIDS, intervention studies and pressure from patients].

PMID- 2215755
TI  - [Measurement of undesirable urine loss in women].

PMID- 2215756
TI  - [Galactorrhea].

PMID- 2215757
TI  - [Dissection of cervical arteries as a cause of cerebral ischemia or cranial nerve
      dysfunction].
AB  - Nine patients with dissections of the cervical arteries are presented.
      Dissections cause approximately three per cent of non-haemorrhagic stroke and are
      usually observed in young and middle-aged patients. Dissections very often give
      rise to head or neck pain. Carotid artery dissection may lead to lower cranial
      nerve dysfunction and an incomplete Horner's syndrome in case of subadventitial
      dissection, and to cerebral ischaemia in case of subintimal spread. Vertebral
      artery dissection may cause brain stem ischaemia (subintimal dissection) or in
      rare cases a subarachnoid haemorrhage (subadventitial spread). The history
      frequently reveals a (trivial) traumatic event. Diagnosis is usually established
      by angiography or MRI. The prognosis is good and recurrences are rare. Treatment
      with anticoagulants or acetylsalicylic acid seems recommendable, though
      scientifically unproven.

PMID- 2215758
TI  - [Aspiration cytology of palpable breast lesions: testing of the results using the
      PALGA data (Pathological Anatomical National Automated Archives)].
AB  - For the testing of the results of 1233 breast punctures performed on 1132 women
      in the period 1985-1988, the question was studied whether a less time-consuming
      procedure than status examination might be used. The national computerized record
      office where all data on cytological and histological diagnostics per patient are
      centralized (PALGA) offered the possibility of determining whether and, if so,
      with what results histological examination of the breast had been carried out.
      Histological follow-up examination proved to be available of 476 punctates. In
      case of abnormal cytological findings without subsequent histological
      examination, the final diagnosis was made on the basis of the clinical findings
      (53 punctates; 4.6% of the women examined). In case of non-abnormal cytological
      findings without subsequent cytological or histological follow-up examination,
      the lesion was regarded as benign. It proved technically feasible with use of
      these final diagnoses to arrive at a numerical evaluation of aspiration cytology
      for the laboratory. These characteristics are valuable in making the decision
      whether, given a particular result of puncture biopsy, women with a palpable
      breast tumour should or should not be operated, provided the characteristics are
      always used only in combination with clinical and mammographic diagnostics. The
      method is also appropriate for evaluation of other forms of cytodiagnostic
      examination.

PMID- 2215759
TI  - [The use of a mixture of citrated erythrocytes and heparin plasma for exchange
      transfusions].
AB  - In 1985 a mixture of red cells collected in citrate anticoagulant with plasma
      derived from heparinized blood was introduced in Amsterdam to perform exchange
      transfusions in newborns. This heparin mixture has physiological levels of
      electrolytes, calcium and glucose, can be delivered on short notice and carries a
      minimal risk of transmission of infectious diseases because all blood components
      are tested for hepatitis B antigen and antibodies against syphilis and the human
      immunodeficiency virus. Retrospectively we evaluated 54 children treated in 1986
      and 1987 with exchange transfusions using this heparin mixture. An adequate
      decrease in bilirubin values when necessary was observed while neither changes in
      sodium, potassium, calcium or glucose values nor adverse effects on the pH value
      were recorded. However, a remarkable transient thrombocytopenia was found
      following exchange transfusion with a decrease of the platelet count to an
      average of 39% of the initial value.

PMID- 2215760
TI  - [From the history of the Emma Pediatric Hospital].

PMID- 2215761
TI  - [Drugs after 1992; a comparison with yet many unknowns].

PMID- 2215762
TI  - [Herpes zoster and acyclovir in normal and dysfunctional general immunity, also
      that due to AIDS].

PMID- 2215763
TI  - [Clinical importance of selective decontamination in patients in the intensive
      care unit].

PMID- 2215764
TI  - [Arterial circulatory disorders; not just smoking or cholesterol].

PMID- 2215765
TI  - ['You should be that one exception'; risk perception and choice behavior in
      medical technology].

PMID- 2215766
TI  - [Pharmaco-morbidity linking: a potential instrument for post-marketing
      surveillance].

PMID- 2215767
TI  - [The value of animal models for clinical studies of antimicrobial agents].

PMID- 2215768
TI  - [Transposition of the posterior tibial tendon in neuropathic talipes
      equinovarus].
AB  - Equinovarus foot deformity as seen in neurologic disease is often caused by
      imbalance in muscle tone. One of the possible operative procedures to correct
      this deformity is transposition of the posterior tibial tendon. The effect of
      this intervention is disputed in the orthopaedic literature. The results of this
      procedure are presented in a retrospective study of 9 children (11 feet). The
      mean follow-up period was 19 months (8-40). In all cases but one the results were
      satisfactory. The indications and complications of this operation are discussed.

PMID- 2215769
TI  - [With decreasing mortality does the incidence of acute myocardial infarct
      decrease also?].
AB  - It is unknown how many cases of acute myocardial infarction, fatal or non-fatal,
      are treated non-clinically. Using various approaches to the available figures
      from hospital records and statistics of causes of death, it appears possible,
      however, to conclude that apart from the number of deaths the number of cases,
      also, has decreased fairly markedly in the last few years.

PMID- 2215771
TI  - [Pharmaco-morbidity linking: a pilot study of its technical possibilities in The
      Netherlands].
AB  - The feasibility has been studied of linking pharmacy-based dispensing data and
      hospital-based morbidity data by using as a linkage key a combination of gender
      and birth date of the patient and of his general practitioner (GP) code. Firstly,
      the records of one pharmacy (14,686 patients) and those of one hospital (8475
      admissions in 1987) were linked on the basis of date of birth and gender. This
      resulted in 3,715 matching record pairs. To a random sample of 1,713 of these
      pairs the GP code was added. Subsequently these pairs were validated by reference
      to the original medical and pharmaceutical records with a procedure that
      guaranteed that only the name and address of the patients could be compared
      without having access to the clinical or pharmaceutical record of an individual.
      We were able to link records with a sensitivity of 91.4% (95%-confidence
      interval: 88.8-94.0) and a specificity of 96.0% (95%-confidence interval: 94.5
      97.5). In conclusion, probabilistic linkage of pharmaceutical and medical data
      with the combination of gender, date of birth and GP code facilitates successful
      record linkage.

PMID- 2215770
TI  - [Waist-to-hip ratio in Dutch women and its relationship with self-reported
      diabetes mellitus, hypertension and cholecystectomy].
AB  - The waist-to-hip circumference ratio is recognized as a measure of body fat
      distribution and as a risk indicator of premature mortality. The distribution of
      waist-to-hip ratio values in 12,000 Dutch women aged between 40 and 75 years is
      presented. In addition, the statistical associations between the waist-to-hip
      ratio and the degree of overweight as well as the prevalence of self-reported
      diabetes mellitus, hypertension, and cholecystectomy are described. The odds
      ratios for the prevalence of these disorders increased progressively with
      increasing waist-to-hip ratio. The age-adjusted odds ratios for women with a
      waist-to-hip ratio greater than 0.85 in comparison to those with a waist-to-hip
      ratio less than 0.70 were 4.8, 4.6 and 5.8 for diabetes mellitus, hypertension,
      and cholecystectomy respectively. The presented data on waist-to-hip ratio can,
      in combination with Quetelet's index, serve as a guide in the interpretation of
      measured waist-to-hip ratios in women between 40 and 75 years of age.

PMID- 2215773
TI  - [Oxybuprocaine drops and eyedrops should not be given to patientson
      prescription].

PMID- 2215772
TI  - [Histoplasma capsulatum infection, a manifestation of AIDS unusual for The
      Netherlands].
AB  - The history of 29-year-old male from Surinam with antibodies to HIV-1 and long
      lasting fever, lymphadenopathy, pain in the right upper abdomen and a
      granulomatous hepatitis is described. The patient suffered from disseminated
      histoplasmosis, a fungal disease rare in The Netherlands, which is the indicator
      disease for the diagnosis of AIDS (CDC-IVCI). It is stressed that in seropositive
      patients coming from endemic areas, including Surinam, the possibility of this
      disease should be considered.

PMID- 2215775
TI  - [Reported patients with infectious diseases in 1989].

PMID- 2215774
TI  - [Inefficacy of oral contraceptives during administration of minocycline].

PMID- 2215776
TI  - Toward a kinder, gentler practice.

PMID- 2215777
TI  - Spinal cord compression--an oncologic emergency.
AB  - Spinal cord compression secondary to epidural metastatic tumor is an emergency
      clinical situation that requires prompt diagnosis and treatment if permanent
      neurologic damage is to be prevented. Physicians caring for patients with cancer
      must maintain a high index of suspicion for this problem. Back pain is a common
      clinical situation in the general population but in the cancer patient, one
      should consider this sign indicative of possible spinal cord compression even
      though a long tumor-free interval has occurred since the original diagnosis of
      neoplasm. The diagnosis is established by thorough neurologic examination, plain
      x-rays, myelography, CT and MRI scanning. Once the diagnosis is established,
      treatment is instituted with steroids, decompressive surgery and postoperative
      irradiation or external irradiation alone depending upon the emergent nature of
      the clinical situation. Regardless of the initial treatment, patients with spinal
      cord compression require management in a multi-disciplinary fashion. Early
      therapy will result in the best relief of symptoms and maintenance of the ability
      to walk. The ultimate prognosis of such patients is very dismal in view of the
      metastatic nature of their disease but prompt diagnosis and treatment is
      necessary to prevent devastating sequelae for the patients and their families.

PMID- 2215778
TI  - Cytogenetic confirmation of clinical diagnoses in Nebraska.

PMID- 2215779
TI  - Periparturitional shigellosis.
AB  - A case is reported in which Shigella sonnei induced both maternal disease
      (chorioamnionitis) and neonatal disease (pneumonia) in the immediate
      periparturitional period. The role of Shigella sonnei as a periparturitional
      pathogen is discussed.

PMID- 2215780
TI  - Right aortic arch with aberrant left subclavian artery demonstrated by MR
      imaging: case report.

PMID- 2215781
TI  - Physician reimbursement update.

PMID- 2215782
TI  - Can residents of nursing homes be freed from restraints?

PMID- 2215783
TI  - Registered nurse license renewal.

PMID- 2215784
TI  - NNA-PAC update.

PMID- 2215786
TI  - Advanced education for nursing administration: MSN, MBA, or MPA?

PMID- 2215785
TI  - Nurses training educates Doctor. Interview by JoAnne Young.

PMID- 2215787
TI  - Physicians' and nurses' attitudes toward AIDS.

PMID- 2215788
TI  - [Position of removable partial dentures within prosthetic dentistry].
AB  - Recent developments in restorative dentistry resulted in a shift towards elderly
      patients with regard to the application of removable partial dentures (RPD). The
      half life time of a metal frame RPD is ten years. Negative effects of a RPD on
      the remaining dentition can be prevented by adequate oral hygiene, which is
      supervised in a recall program with an individually adjusted interval.
      Periodontal factors seem to be more important in the design of a RPD than
      biomechanical factors. Simplicity is a prime guideline in the design, especially
      in free-end situations.

PMID- 2215790
TI  - [Rapid maxillary suture expansion].
AB  - Rapid maxillary expansion is a technique with an old but controversial history.
      Bio-mechanics and apparatus have largely involved over the years and the
      procedure is generally accepted. Discussion concerns only the patient age range
      on which the therapy is applicable. Fourteen to eighteen seems the accepted age
      limit. Three essential parameters determine the success of the expansion: degree
      of interlocking, synostosis and skeletal resistance from the surrounding osseous
      tissues.

PMID- 2215789
TI  - [Mandibular atrophy and metabolic bone loss].
AB  - Radiological studies in edentulous patients with and without atrophy of the
      mandible and radiological, histomorphometrical and endocrinological studies in
      edentulous patients with a severe atrophy of the mandible and treated by ridge
      augmentation has shown that: metabolic bone loss, histologically and
      endocrinologically characterized as a secondary hyperfunction of the parathyroid
      glands, is a causal factor in the pathogenesis of mandibular atrophy.

PMID- 2215791
TI  - [Fragmentation of sialoliths].
AB  - An in vitro experiment proved that a sialolith can be disintegrated, but that
      also serious damage is caused to the teeth and dental restorations. Therefore, no
      experiment was carried out on a patient, although it proved to be possible to
      position a patient on a lithothriptor in a way that the shock wave of the
      apparatus would hit the sialolith without passing the brain, eyeballs and
      laryngeal skeleton.

PMID- 2215792
TI  - [Dentist in an information society].
AB  - Many commentators say that at present we are living in an information society, a
      society in which the main sources of national income are communication and
      information. This article aims at the question how the dentist's practice will be
      influenced by the information society. The dentist's role in the information
      society is described as an information broker between the dental science and the
      public, the patients. In that role the dentist is confronted with two
      developments, i.e. 'information overload' and 'rising expectations as to the
      possibilities of medical help'. The article concludes with a plea for 'good
      health education'. Against the background of the developments at the side of the
      public 'good health education' is not to be understood as 'more health
      information' for the public, but as 'more quality in health information'.

PMID- 2215794
TI  - [Periodontal care in The Netherlands].
AB  - The dental care in The Netherlands is unable to cope with the threat resulting
      from periodontal diseases. Changes resulting from alterations within the dental
      care system will, however, enable larger groups within the population to receive
      periodontal therapy in the near future.

PMID- 2215793
TI  - [Dentist and scientific dental information in mass media].
AB  - Mass media, such as newspapers and magazines and to a lesser degree TV and radio
      can provide the public with a lot of scientific information about dental
      diseases. Especially when it concerns research results with news value or
      controversial issues. Dentists regarded by the public as the most reliable
      sources of scientific information about dentistry, can get into problems by the
      publication of such issues in mass media. Particularly when patients ask
      questions about developments in certain fields of dentistry (for example
      periodontology or implantology) covered by the mass media. In this article the
      importance and the value of communication of scientific information are
      discussed. The relevance for dentistry is illustrated by means of a series of
      articles on scientific dental subjects published, during fifteen years, in a
      Dutch national newspaper. Finally the responsibility of dental faculties and
      professional organisations when they provide research results to the press and
      other mass media is pointed out.

PMID- 2215795
TI  - [Periodontal diseases in The Netherlands].
AB  - The extend and severity of periodontal diseases in The Netherlands are discussed
      using data of a large epidemiologic oral health survey in 1986. The perspective
      on treatment is presented with some notes on the basic issues in health and
      disease. The often heard statement, that the periodontal disease problem is much
      more severe in developing countries compared with the industrialized countries,
      could not be confirmed.

PMID- 2215796
TI  - [Non-plaque related periodontal diseases].
AB  - Non-plaque related periodontal diseases are rather rare, and may be based on a
      wide range of lesions, both benign and malignant. The clinical and radiographic
      signs often mimic those of the common plaque-related diseases and, therefore, may
      significantly postpone proper diagnosis and treatment.

PMID- 2215797
TI  - [Diagnosis of plaque related periodontal diseases].
AB  - Plaque related periodontal diseases include the area of slight gingivitis and
      advanced destructive periodontitis featuring loss of periodontal attachment and
      alveolar bone destruction. The progression of periodontitis may vary from rapid
      progressive disease, to stable condition but also remission of the disease. Not
      all patients are equally susceptible to destructive periodontal disease.
      Therefore, the 'risk concept' was introduced. The diagnosis of periodontal
      diseases is based on the assessment of periodontal inflammation and loss of
      attachment. The diagnostic parameters are described as well as their prognostic
      value.

PMID- 2215798
TI  - [Treatment planning for patients with periodontal disease].
AB  - The planning and execution of dental treatment in patients suffering from
      (severe) periodontal disease has to be carried out thoroughly and systematically.
      Based on a proper diagnosis and prognosis (problem analysis), a temporary
      treatment plan (problem solution) will be formulated. The initial (periodontal)
      treatment is concluded with a reevaluation. After this new diagnosis, and if
      necessary adjustment of the original goal of the treatment plan, a definite
      treatment plan can be effected. Also in this plan, the therapy must be carried
      out in separate phases with evaluations in between. Primarily, the periodontal
      therapy must be finalized, after which the definite restorative-prosthetic
      treatment can be carried out. A good cooperation between the dentist, dental
      hygienist and patient is of prime importance to achieve a permanent result. The
      principles of periodontal treatment planning are discussed in this contribution.

PMID- 2215799
TI  - [Microbiological aspects in the treatment planning of periodontal disease].
AB  - A large number of bacterial species are found in the periodontal pocket. It has
      been shown that the composition of the subgingival microbiota can differ
      significantly between individual pockets in one patient, as well as between
      different subjects. These different types of microfloras can be characterized by
      indicator bacteria. These indicator bacteria are strongly associated with active
      periodontal breakdown. Therefore, these microorganisms can be useful in the
      periodontal treatment of individual patients. It also supports the use of
      antibiotics in specific forms of periodontal disease. The application of
      microbiological data in diagnosis and treatment planning in four severe
      periodontitis patients is illustrated.

PMID- 2215801
TI  - [Dentist periodontist].
AB  - In this article criteria and procedures are discussed that are being used to
      qualify dentist-periodontists (Tandarts-Parodontologen). Also a description is
      given of the tasks of such a periodontist: consultation, treatment and education.
      Furthermore figures are presented with respect to experiences of the first group
      of dentists that have recently been qualified as dentist-periodontist.

PMID- 2215800
TI  - [Guided tissue regeneration in periodontology: an overview].
AB  - Conventional periodontal treatment consisting of scaling and rootplaning with or
      without flap surgery, with or without bone grafting, does not lead to
      regeneration of the periodontium. Experiments based on the principle of guided
      tissue regeneration have shown that the formation of 'new attachment' is no
      longer impossible.

PMID- 2215802
TI  - [Patient education in periodontal health].
AB  - To achieve a successful periodontal treatment result, a good and lasting co
      operation between therapist and patient is essential. For this reason, the
      patient must be adequately informed about the development, symptoms and treatment
      of periodontitis and about the necessity of a high level of self performed oral
      hygiene. Individual information and instruction by the dentist and dental
      hygienist is most suited in these cases.

PMID- 2215804
TI  - [Sharpening of periodontal instruments].
AB  - Sharp hand instruments are the first pre-requisite for scaling and root planing.
      Different sharpening techniques are reported, and the time at which an instrument
      is evaluated for its sharpness or dullness is indicated. The shape and form of
      several instruments are described together with the appropriate sharpening
      technique.

PMID- 2215803
TI  - [Four years experience with a periodontal health education program for 12-15-year
      old Dutch schoolchildren].
AB  - A dental health education program on periodontal disease for 12-15-years-old
      schoolchildren during a period of four years (1986-1989) was organised. A course
      package was developed for secondary schools, whereby an evaluation of the course
      material was carried out both quantitatively and qualitatively. The amount of
      material requested by the schools exceeded the expectations. The content of the
      material appeared to be adequate for both the pupils as well as teachers. The
      education strategy was successful in reaching the target group. The school
      appears to be an excellent place for this type of dental education program. For
      the future it may be advisable to focus more on a target group with a low
      education level.

PMID- 2215805
TI  - [Treatment planning in partial prosthodontics].
AB  - The aim of the initial treatment is to eliminate active complicating factors from
      the partial edentulous mouth, such as caries, periodontal disease and occlusal
      discrepancies. After evaluation of the results of the initial treatment the
      prosthetic treatment can be started. A specific preparation of the mouth is
      necessary to accommodate the remaining dentition to the design of the removable
      partial denture.

PMID- 2215806
TI  - [Expert systems in orthodontics].
AB  - A review and concept is given of possible applications of expert and other
      information systems in orthodontics. The key to success probably lies in the fact
      that all relevant problems can be expressed in a formal system. Informatization
      projects can be an exciting and useful aspect in the field of orthodontics, if
      one proceeds with a modular approach.

PMID- 2215807
TI  - [Beagle dogs in periodontal research: a review].
AB  - This review intends to focus on the role dogs play in periodontal research. Dogs
      have given insight in the occurrence, the etiology, the pathogenesis and the
      treatment of periodontal diseases although some differences with humans exist.
      The occurrence of root resorption, the better healing capacity and the
      progression rate of periodontitis are among those differences. Knowledge of the
      periodontal conditions in dogs is required to be able to evaluate the obtained
      results and its implications for humans carefully. This seems especially true for
      the ongoing research in tissue regeneration.

PMID- 2215808
TI  - [Dental aspects of snoring and the obstructive sleep apnea syndrome].
AB  - An overview is presented of causes, consequences and treatment possibilities of
      snoring and the obstructive sleep apnea syndrome. Snoring and the obstructive
      sleep apnea syndrome are widespread sleep disorders, which may result in serious
      physical and psychosocial problems. The contribution of oral surgery and
      orthodontics to the team management of these patients is discussed.

PMID- 2215809
TI  - [Dental self care of the dentate Dutch population: oral hygiene].
AB  - This paper is part of a series on national oral health survey in The Netherlands
      (LEOT-project). It presents the results as for the oral hygiene behavior and its
      determinants of the dentate Dutch population. Nearly all dentate Dutch people
      (97.5%) reports to clean their teeth with an average of nearly two times a day.
      The use of other cleaning means is not very common. There is a fair amount of
      knowledge about dental hygiene. The great majority (about 85%) indicates that
      toothbrushing for them is an automated behavior, a habit.

PMID- 2215810
TI  - [Classification of edentulous mandibles in preventive implantology].
AB  - The aim of preventive implantology is to prevent or delay the resorption of
      edentulous alveolar ridges. The classifications of the resorption stages of the
      mandible which are now in use, are not applicable to preventive implantology.
      After anatomic research it was concluded that the resorption of the alveolar
      ridge of the mandible should be classified in three stages. Loaded as well as
      unloaded implants can function as tooth root analogues in maintaining the volume
      of the edentulous ridge.

PMID- 2215811
TI  - [Revised recommendations about the use of fluoride].
AB  - At the end of 1989 the organisation for dental health education in The
      Netherlands 'Ivoren Kruis' presented new recommendations about the use of
      fluorides. The advice was based on a report of an expert committee and was put in
      a definite form in consultation with representatives of a number of dental and
      medical professional organisations. For children below the age of five a
      toothpaste with 250 ppm F- is recommended. Fluoride tablets (with 0.25 mg F-) are
      recommended for children below the age of 12. The advised number of fluoride
      tablets is reduced compared with the former recommendations.

PMID- 2215812
TI  - [Clinical procedures in removable partial prosthodontics].
AB  - Restoring oral function with removable partial dentures includes treatments
      running along several steps and procedures. These treatments should be carefully
      planned. The dentist should know the steps to be taken to achieve the desired end
      result.

PMID- 2215813
TI  - [The (post)graduate training of orthodontists].

PMID- 2215814
TI  - [Solitary bone cyst of the jaws: report of 22 cases].
AB  - A retrospective study of 22 solitary bone cysts was made. Almost all lesions were
      detected as an incidental finding on the radiographs. The dentist should be aware
      of this asymptomatic radiolucency which is most commonly seen in the mandible, in
      order to avoid redundant dental treatment.

PMID- 2215815
TI  - [Gardner's syndrome: report of a case].
AB  - Gardner's syndrome consists of multiple polyposis of the large intestine and soft
      and hard tissue tumors. The syndrome should be considered in case of
      supernumerary teeth, odontomas, osteoma and soft tissue tumors. These findings
      often precede colonic involvement. Careful attention should be directed towards
      the family history. The importance of this syndrome lies in the great tendency of
      the polyps to become malignant. Dentist and oral surgeon play an important role
      in the early detection of this syndrome and thus prevention of malignant
      degeneration of the intestinal polyps.

PMID- 2215816
TI  - [Dental fluorosis in relation to the use of fluoride tablets].
AB  - The prevalence of dental fluorosis on the buccal tooth surfaces was investigated
      in 15-year-old children in the towns Tiel and Culemborg, using the Tylstrup
      Fejerskov scoring system. A study done in 1980 revealed that at the age of six,
      53% of the children in Tiel and 30% of the children in Culemborg took one or more
      fluoride tablets (0.25 mg F-) daily. In Tiel the tablets were provided free of
      charge in a centre for child dental care. On the basis of the number of tablets
      supplied in the age period 1.5-6 years, most of the 15 year olds in Tiel could be
      classified as regular, irregular or non-tablet user. Only mild fluorosis (TF
      score 1, 2 or 3) was found. The percentage of children with one or more buccal
      surfaces affected with fluorosis was 24 in Tiel and 22 in Culemborg. The
      percentages of buccal surfaces with fluorosis were 6 (Tiel) and 7 (Culemborg). In
      Tiel the percentages of surfaces with fluorosis in the groups regular, irregular
      and non-tablet users were 12%, 5% and 2% respectively.

PMID- 2215817
TI  - [Simultaneous removal of lower wisdom teeth with local anaesthesia: a pilot
      study].
AB  - To determine whether it is justified to remove both mandibular third molars in
      one session, 69 patients were treated single-sided and 53 patients double-sided
      using local anaesthesia (Ultracain D-S forte). All patients were healthy. The
      mean age was 24.0 years. No significant differences in complaints were found.
      Therefore, it seems justified to remove mandibular third molars double-sided in
      one session in healthy young patients.

PMID- 2215818
TI  - [Tooth replacement in the anterior region: specific problems and standard
      options].
AB  - The problems involved in the loss of anterior teeth differ essentially from those
      in the premolar/molar region. Firstly, missing anterior teeth result in
      unacceptable changes in appearance and speech, making treatment mandatory.
      Secondly, the dentist has to consider specific aspects, such as aesthetics,
      resorption of the alveolar bone, loading of the abutment teeth, form of the
      clinical crown and incisal guidance. Treatment options comprise orthodontic
      closure, periodontally supported removable and fixed appliances and appliances
      supported by implants. The advantages and disadvantages of the different options
      are indicated.

PMID- 2215819
TI  - [Replacement of anterior teeth by implants].
AB  - The replacement of anterior teeth by implants and crowns is the most recent one
      of the available treatment possibilities. The most important advantage of this
      method is the prevention of resorption of the alveolar bone and undisturbed
      integrity of the remaining other teeth.

PMID- 2215820
TI  - [Esthetics and removable partial dentures: a contradiction?].
AB  - Although modern developments in dentistry constrict the indication of removable
      partial dentures, there is still a number of situations in which a partial
      denture may contribute to the re-establishment of function, esthetics included.
      Thereto it is a necessity that all parts of the construction are carefully
      designed, with special attention for color and form. Choice of the artificial
      teeth (material), the handling of the acrylic and an adequate anchoring are all
      important factors in reaching an optimal result.

PMID- 2215821
TI  - [Replacement of anterior teeth with bridges].
AB  - Missing incisors and canines may be replaced with preferably gold-porcelain
      bridges. To be acceptable in an esthetical sense, the bridge demands, apart from
      a correct colour and shape, a healthy periodontium, the latter being the subject
      of this paper. The way in which the outline is prepared, the relationship between
      depth of the preparation and marginal gingiva and the prevention of periodontal
      trauma are discussed.

PMID- 2215822
TI  - [Replacement of anterior teeth and maintenance care].
AB  - A study undertaken in a general dental practice shows post-operatively a
      beneficial effect of regular subgingival scaling. A relative short time
      investment, once to thrice a year, appears to stabilize the periodontal situation
      of abutment teeth, even periodontally weak ones.

PMID- 2215823
TI  - [Glass ionomer cement used as a retrograde filling material after apicoectomy: a
      review].
AB  - When an apicoectomy is performed, using retrograde sealing with amalgam, the
      healing of the periapical area is not always perfect. In a number of cases the
      cause of this imperfect healing may be due to the improper sealing ability and
      the moderate tissue compatibility of amalgam. A literature study has been carried
      out, based on the assumption that glass ionomer cement will provide a better
      sealing and will cause less tissue reaction. It appeared that, at least in
      theory, glass ionomer cement is to be preferred to amalgam when it comes to
      apical sealing properties and tissue reaction. In terms of usability, resorption,
      hardness and costs no significant differences were found. The conclusion is drawn
      that glass ionomer cement is an equal or perhaps even better alternative for
      retrograde amalgam.

PMID- 2215824
TI  - [Plax more effective than water?].
AB  - Ten persons participated in a cross-over study in which the effect of rinsing
      with Plax and subsequent toothbrushing was compared with water rinsing and
      subsequent toothbrushing. Plaque was evaluated at baseline and after rinsing and
      toothbrushing. Bacterial and epithelial cells were counted in the material that
      was removed by rinsing and brushing. In addition the dry-weight of this material
      was determined. The differences between Plax and water in plaque reduction, the
      number of bacterial and epithelial cells in the material removed from the mouth
      were statistically not significant. The weight of the material removed by the
      rinsing and brushing was higher after rinsing with Plax. This was caused by the
      more vigorous removal of epithelial cells by Plax than by water.

PMID- 2215825
TI  - Serotonin receptor antagonists: a novel class of anti-emetics.

PMID- 2215827
TI  - Is there a relationship between thyroid function and serum osteocalcin in women
      with multinodular goitre? A preliminary report.
AB  - The relationship between thyroid function and serum osteocalcin was studied in a
      population of 27 women with multinodular goitre and normal serum concentrations
      of thyroid hormones. Seven patients were found to have suppressed TSH levels
      (less than 0.1 mU/l) as measured by an immunoradiometric assay. Osteocalcin was
      statistically significantly correlated with serum free thyroxine (FT4), both in
      the total population and in the subpopulation of patients with TSH greater than
      or equal to 0.1 mU/l (r = 0.61; P less than 0.001, resp. r = 0.51; P less than
      0.05). Mean (+/- SEM) serum osteocalcin and FT4 were higher in the patients with
      suppressed TSH than in those with TSH greater than or equal to 0.1 mU/l (10.6 +/-
      1.9 vs. 7.1 +/- 0.6 micrograms/l; P less than 0.05, resp. 16.3 +/- 1.4 vs. 13.3
      +/- 0.5 pmol/l; P less than 0.02). This study suggests that women with
      multinodular goitre who proceed to autonomous function are at risk of developing
      osteoporosis even when thyroid hormone concentrations are in the normal range.

PMID- 2215826
TI  - Effect of calcitonin on gastric emptying and on postprandial gastrin and insulin
      release in patients with type I gastric ulcer.
AB  - In a double-blind placebo-controlled study, the effect of calcitonin on gastric
      emptying and on serum concentrations of gastrin, insulin, glucose, calcium and
      phosphorus after a mixed solid-liquid meal was examined in six patients with type
      I gastric ulcer. Synthetic salmon calcitonin 415 pmol i.v. was given as a bolus
      followed by a 90-min infusion to reach an overall dose of 62.25 pmol.kg-1.
      Gastric emptying of a radiolabelled meal was measured with a gamma camera.
      Calcitonin suppressed gastric emptying in all patients examined. The mean gastric
      transit time, MTT90, increased from 38.1 +/- 0.4 min after placebo to 43.1 +/-
      0.6 min after calcitonin (P less than 0.001). Calcitonin significantly blunted
      the postprandial gastrin release: AUC0-90 10,398 +/- 2886 ng. l-1 min (placebo)
      and 8238 +/- 2573 ng. l-1 min (calcitonin), P less than 0.05, and abolished the
      postprandial insulin release--AUC0-90 2244 +/- 230 mU.l-1 min (placebo) vs. 638
      +/- 198 mU.l-1 min (calcitonin), P less than 0.01. A steady increase in the serum
      glucose during calcitonin infusion, reaching up to 5.6 +/- 0.31 mmol.l-1 at the
      end of the infusion, was observed. Calcitonin did not significantly affect serum
      calcium or phosphorus concentrations. The authors conclude that a delayed gastric
      emptying is to be expected in patients undergoing calcitonin treatment.

PMID- 2215828
TI  - Ursodeoxycholic acid treatment in a patient with primary biliary cirrhosis.
AB  - A women with stage I-II primary biliary cirrhosis was treated with
      ursodeoxycholic acid (UDCA). During UDCA treatment a notable improvement in
      biochemical liver profile was achieved. Liver histology did not deteriorate after
      one year UDCA. UDCA offers a promising non-toxic alternative in the treatment of
      PBC.

PMID- 2215829
TI  - An unusual case of cystic lymphangiomatosis of the spleen.
AB  - Isolated lymphangiomatosis of the spleen is rare. When present, it is usually
      considered to be accompanied by splenomegaly. We describe a case of cystic
      lymphangiomatosis in a patient with a normal-sized spleen. While ultrasound,
      angiography and computed tomography are considered to complement each other in
      reaching a preoperative diagnosis of splenic lymphangiomatosis, in the present
      case, magnetic resonance imaging proved to be an additional helpful non-invasive
      diagnostic method.

PMID- 2215830
TI  - Valsalva termination of ventricular tachycardia in myocardial infarction.
AB  - A 66-yr-old patient with recurrent monomorphic ventricular tachycardias
      subsequent to a previous myocardial infarction is reported. The tachycardia could
      repeatedly be terminated by the Valsalva manoeuvre. Procainamide, infused shortly
      before, possibly had an additional effect. As far as we know, this is the first
      report of ventricular tachycardias, as a result of an old myocardial infarction,
      that could be terminated by the Valsalva manoeuvre.

PMID- 2215831
TI  - Fatal acute liver failure associated with pirprofen. Report of a case and a
      review of the literature.
AB  - This report is about a 71-yr-old woman who suffered from acute liver failure,
      induced by the nonsteroidal antiinflammatory drug, pirprofen. She presented with
      jaundice 6 weeks after starting treatment with 800 mg pirprofen daily. She is the
      fifth patient described in the literature to die from pirprofen-induced
      hepatotoxicity.

PMID- 2215832
TI  - Chromosome 14: a breakpoint in non-Hodgkin's lymphomas.
AB  - In non-Hodgkin's lymphoma, chromosome abnormalities are found that are
      characteristic for the type of the lymphoma. These chromosomal abnormalities
      provide a tumour-specific marker and seem to play a role in the oncogenesis of
      the lymphoma. Chromosome 14 is involved in many lymphomas. The immunoglobulin
      heavy chain gene and the alpha and delta chain genes for the T cell receptor are
      located on this chromosome, genes which are essential for the function of B or T
      lymphocytes. These genes are involved in the specific translocations seen in non
      Hodgkin's lymphoma. Their role and the role of oncogenes in the oncogenesis of
      non-Hodgkin's lymphoma are discussed. The oncogene tcl-1 is also located on
      chromosome 14.

PMID- 2215833
TI  - Results in patients with Graves' disease.

PMID- 2215834
TI  - Sweet's syndrome.

PMID- 2215835
TI  - Pancreatitis: an unusual manifestation of late syphilis?

PMID- 2215836
TI  - The relationship between densitometry of the radius and vertebral fractures.
AB  - In 105 postmenopausal women with clinical suspicion of osteoporosis single photon
      absorptiometry (SPA) of the forearm and fracture percentage of the thoracic and
      lumbar spine were estimated. SPA was performed on the commonly used mid-radius
      site as well as on a modified distal radius site where radius and ulna are
      separated by five mm. Spine fracture percentage was inversely correlated with mid
      radius SPA (r = -0.49) but more closely with distal radius SPA (r = -0.61). With
      bone mineral density values above 0.400 g/cm2 on the distal radius, no fractures
      were found. Between 0.325 and 0.400 g/cm2, 35% of the patients showed vertebral
      fractures but only up to a maximum of 30%. Below 0.325 g/cm2, 89% of the women
      had crushed vertebrae, often more than 30% of those measured. In conclusion,
      these results indicate that modified distal radius densitometry is superior to
      the commonly used mid-radius measurement and has some predictive value for the
      presence of vertebral fractures.

PMID- 2215837
TI  - Thrombocytopenic purpura as first manifestation of human immunodeficiency virus
      type I (HIV-1) infection.
AB  - We report three cases of thrombocytopenic purpura associated with HIV-1
      infection. The clinical picture is indistinguishable from classic autoimmune
      thrombocytopenic purpura (AITP). All three patients initially responded to
      treatment with high dose methylprednisolone. One patient had an incomplete
      remission on low dose prednisone, while another responded to zidovudine
      treatment. The third patient underwent splenectomy because he showed no response
      to treatment with low dose prednisone or zidovudine. The pathogenesis of HIV
      associated thrombocytopenic purpura (HIV-TP) is still controversial. Two
      hypotheses are frequently mentioned: non-specific deposition of circulating
      immune complexes and complement versus specific auto-antibodies against platelets
      are suggested to be the cause of the increased clearance of platelets. In cases
      of severe thrombocytopenia, the therapy of first choice is initial high dose
      methylprednisolone, followed by either low dose prednisone in the presence of a
      relatively unaffected cellular immunity, or zidovudine, when the cellular
      immunity is already severely impaired.

PMID- 2215838
TI  - Thrombocytopenia associated with mycoplasma pneumoniae infection.
AB  - The case of a patient with immune thrombocytopenia associated with mycoplasma
      pneumoniae infection is described. The thrombocytopenia was considered to be
      provoked by the infection and disappeared gradually after antibiotic treatment.

PMID- 2215840
TI  - Methodological problems of clinical trials in dementia.

PMID- 2215839
TI  - Postprandial blood pressure reduction.
AB  - Recently it has been shown that, after a meal, blood pressure may fall in the
      elderly, in patients with autonomic failure and in patients on haemodialysis.
      This review deals with the available data on postprandial blood pressure
      reduction, the clinical significance and some pathophysiological hypotheses. The
      mechanism is not fully understood, but postprandial blood pressure reduction
      seems to be related to glucose related factors, since blood pressure only falls
      after oral glucose loading, but not after oral fructose, fat or protein loading.
      Vasoactive gastrointestinal peptides may play a role in the glucose induced
      vasodilation of splanchnic vasculature, but attempts to identify such peptides
      have been unsuccessful. The role of insulin in postprandial blood pressure
      reduction remains to be elucidated, but it does not appear to have any influence
      on systemic vasodilation or baroreflex response. Although the clinical
      significance of postprandial blood pressure reduction remains uncertain, patients
      can be advised in several ways on how to avoid this symptom. Treatment of
      hypertension, small carbohydrate meals, caffeine and treatment with the
      somatostatin analogue SMS 201-995 may have a beneficial effect. Patients on
      haemodialysis with symptomatic hypotension should not consume meals during the
      procedure.

PMID- 2215841
TI  - Dimensional versus nosographic approach to Alzheimer's disease: therapeutic
      implications.
AB  - Negative results in therapeutic trials in Alzheimer's disease (AD) usually
      account for the nonefficacy of the presently tested drugs. However,
      methodological flaws in the design of these studies, related to the commonly used
      nosographic approach, can also be implicated in the lack of demonstration of
      beneficial results. With regard to the heterogeneity of clinical manifestations
      of AD, the interest of the dimensional, transnosographic approach to cognitive
      deficits and behavioral disturbances in dementia is suggested for these trials.
      Both approaches can also be combined, according to the presumed biochemical
      action of the tested drug in the preclinical studies and the aim of the trial.

PMID- 2215842
TI  - Assessment of functional changes in Alzheimer's disease.
AB  - Functional difficulties occur in all patients with Alzheimer's disease.
      Instrumental skills (shopping, handling money) are involved first, then self-care
      activities (toileting, dressing). Drug trials in intermediate stage Alzheimer's
      disease should monitor self-care activities with structured diaries and rating
      scales.

PMID- 2215843
TI  - Neuropsychological assessment of cognitive change in dementia.
AB  - The problem of long-term assessment of cognitive change in dementia is defined as
      that of avoiding floor and ceiling effects in testing. Unlike diagnosis, the
      establishment of norms is viewed as secondary. This perspective allows the
      formulation of strategic guidlines in devising test batteries for longitudinal
      studies of cognitive change in dementia. A number of tests complying with these
      guidelines are described, tapping a wide range of cognitive abilities such as
      semantic analysis of verbal and visual material, semantic memory, object
      recognition, visuoconstruction and serial planning.

PMID- 2215844
TI  - Comparison of seven psychometric instruments used for evaluation of treatment
      effect in Alzheimer's dementia.
AB  - Standards of assessment of treatment effect in Alzheimer's disease have been
      wanting. We report here a comparison of seven methods of assessment of the
      severity of Alzheimer's disease used in demented subjects (n = 18) and in
      nondemented controls (n = 18). The instruments tested were the Names Learning
      test, the Orientation test, the Mini-Mental State Examination, the Alzheimer's
      Staging Scale (the AZSS), the Global Deterioration Scale, the Clinical Dementia
      Rating Scale, and the Alzheimer's Deficit Scale (ADS). Two examiners did the
      testing per telephone methodology, and test/retest design. Results showed all
      tests to be reliable. A ceiling and/or basement effect was noted in all but the
      AZSS and the ADS.

PMID- 2215845
TI  - Objective assessment in dementia: automated psychometric tests and the P3.
AB  - Event-related potentials have been shown to be closely correlated with cognitive
      functioning and it has been suggested that one such potential, the P3, can act as
      an objective and sensitive measure of the degree of dementia. The P3 is no longer
      thought of as a diagnostic tool in dementia; however, longitudinal changes in the
      P3 latency can be used to follow the course of a dementing illness or to assess
      effects of therapy. It is possible that the measurement of P3 latency may prove
      useful in the selection of patients with early dementia. Automated psychometric
      tests are also of considerable value in assessing large numbers of cognitively
      impaired subjects. The advantages of using these tests and their usefulness in
      multicentre drug trials is discussed.

PMID- 2215847
TI  - Methodological problems of clinical trials in multi-infarct dementia.
AB  - In about 30% of the cases suffering from MID an unequivocal diagnosis can be made
      only on the basis of histopathological evidence. The imperfect diagnosis has a
      relevant impact on the methodology to be followed in therapeutic trial. The
      following points have to be considered in a therapeutic trial: (1) distribution
      of the patients expected to come to the observation, (2) the expected
      effectiveness of the treatment, (3) the likelihood of obtaining statistical
      significant results and (4) the required size of the study. The diagnostic
      inaccuracy gives rise to a decrease in the chance of yielding a statistically
      significant result and on the other hand produces an increase in the required
      number of subjects to be submitted to the trial.

PMID- 2215846
TI  - Assessment of outcome in clinical trials in Alzheimer's disease.
AB  - Assessment instruments used to measure psychological outcome in clinical trials
      in dementia include rating scales of activities of daily living and scales of
      cognitive function. Each has specific advantages and limitations. The popularity
      of certain dementia scales results from their demonstrated correlation with
      measures of pathological change, implying that they accurately reflect dementia
      severity. It is argued that the inference of test validity on the basis of such
      clinicopathological correlation may be unfounded. Alzheimer's disease is a
      heterogeneous disorder, encompassing varying profiles of cognitive disability.
      Dementia scales, which are weighted in favour of specific areas of dysfunction,
      may be differentially sensitive to the deficits of certain patients relative to
      others, thus yielding a spurious measure of dementia severity.

PMID- 2215848
TI  - Long-term experience of a trial in multi-infarct dementia.
AB  - A report is given on the natural history of multi-infarct dementia (MID) in 94
      patients over a period of 5 years and describes neuroimaging criteria that may be
      used in order to more reliably separate vascular (VD) from primary degenerative
      types of dementia (DTD). The annual mortality rate of MID patients was 13%. Age
      and nocturnal confusion were found to be the most efficient predictors for fatal
      prognosis. Psychosocial adjustment, in contrast, indicated better outcome. In
      respect to differential diagnosis MRI revealed infarcts, basal ganglia lacunes
      and confluent white matter lesions as the most effective discriminators between
      VD and DTD. The typical patchy pattern found in almost half of the patients with
      VD, and significant differences in 5-7 Hz range as shown by EEG mapping can also
      be used for increasing the accuracy of the clinical diagnosis.

PMID- 2215850
TI  - Studies on new, centrally active and reversible acetylcholinesterase inhibitors.
AB  - We have synthesized the tertiary amines of pyridostigmine and neostigmine, 3
      pyridinol dimethylcarbamate (norpyridostigmine) and 3-dimethylaminophenol
      dimethylcarbamate (norneostigmine) respectively, and we have tested their
      abilities to cross the blood-brain barrier and inhibit mouse brain AChE activity.
      The in vivo inhibition of AChE activity by norpyridostigmine reaches 72% at 10
      minutes which is comparable to that seen with physostigmine (73% at 10 minutes).
      Inhibition by norneostigmine is less effective (50% at 10 minutes) and approaches
      that obtained with tetrahydroaminoacridine (57% at 10 minutes). These data show
      that both norpyridostigmine and norneostigmine cross the blood-brain barrier and
      that they are effective inhibitors of mouse brain AChE activity. These drugs
      could be useful in the treatment of memory impairment associated with Alzheimer's
      disease, and other memory disorders.

PMID- 2215849
TI  - The serotonin 5-HT1D receptor: a progress review.
AB  - Most of the known neurotransmitters interact with more than one type of receptor.
      Some of them even dispose of receptor subtypes to exert their actions. Serotonin,
      far from being an exception to that, possesses at least 3 classes of receptors,
      which have all been reported to be heterogeneous, although convincing data only
      exist for the 5-HT1 class. This name has been proposed in 1979, two years before
      the introduction of 'A' and 'B' in the nomenclature to account for the observed
      heterogeneity of these sites. The 5-HT1C receptor subtype was first described in
      1984 and the last member of the family, named 5-HT1D, was characterized in 1987.
      The pharmacological profiles, the signal transducing systems and the anatomical
      localizations, both at the regional and cellular levels, of all these subtypes
      have been investigated and possible functions have been proposed for each of
      them. Moreover, last and most definitive demonstration of the subtype
      individuality, the gene or complementary DNA coding for the 5-HT1A and 5-HT1C
      (and 5-HT2) receptors have been cloned and sequenced. Such data are still missing
      for 5-HT1D (and 5-HT1B) receptors, but will certainly be provided in the next few
      years. However and waiting for this decisive clue, the characterization of the 5
      HT1D subtype leaves no doubt concerning its significance as a function 5-HT
      receptor. This review will concentrate on the characteristics of this subtype of
      5-HT receptor.

PMID- 2215851
TI  - Effect of phosphatidylserine on the basal and GABA-activated Cl- permeation
      across single nerve membranes from rabbit Deiters' neurons.
AB  - The permeation of labeled Cl- ions across single plasma membranes from Deiters'
      neurons has been studied in the presence of various concentrations of
      phosphatidylserine (PS) on their extracellular side. PS reduces significantly
      basal Cl- permeation only at 10(-5) M on the membrane exterior. No effect was
      found at other concentrations. GABA activable 36Cl- permeation is heavily reduced
      and almost abolished at 10(-11) - 10(-5) M phosphatidylserine. This exogenous
      phosphatidylserine effect is difficult to interpret in relation to the function
      of the endogenous phospholipid. However, it may be involved in the epileptogenic
      effect in vivo of exogenous phosphatidylserine administration to rats.

PMID- 2215852
TI  - Acetyl-L-carnitine as a precursor of acetylcholine.
AB  - Synthesis of [3H]acetylcholine from [3H]acetyl-L-carnitine was demonstrated in
      vitro by coupling the enzyme systems choline acetyltransferase and carnitine
      acetyltransferase. Likewise, both [3H] and [14C] labeled acetylcholine were
      produced when [3H]acetyl-L-carnitine and D-[U-14C] glucose were incubated with
      synaptosomal membrane preparations from rat brain. Transfer of the acetyl moiety
      from acetyl-L-carnitine to acetylcholine was dependent on concentration of acetyl
      L-carnitine and required the presence of coenzyme A, which is normally produced
      as an inhibitory product of choline acetyltransferase. These results provide
      further evidence for a role of mitochondrial carnitine acetyltransferase in
      facilitating transfer of acetyl groups across mitochondrial membranes, thus
      regulating the availability in the cytoplasm of acetyl-CoA, a substrate of
      choline acetyltransferase. They are also consistent with a possible utility of
      acetyl-L-carnitine in the treatment of age-related cholinergic deficits.

PMID- 2215853
TI  - Effects of acute and subacute cocaine administration on the CNS dopaminergic
      system in Wistar-Kyoto and spontaneously hypertensive rats: I. Levels of dopamine
      and metabolites.
AB  - Effects of acute and subacute cocaine administration on dopamine (DA) and its
      metabolites in striata and nucleus accumbens of nine week-old Wistar-Kyoto and
      spontaneously hypertensive rats were studied. Levels of DA,3,4
      dihydroxphenylacetic acid (DOPAC) and homovanillic acid (HVA) were determined by
      HPLC-EC. There were no differences in DA levels in striata and nucleus accumbens
      between control WKY and SHR. Levels of DA in two brain regions were unaffected in
      groups treated acutely with cocaine. Both strains showed a significant increase
      in striatal HVA 2 hr after cocaine injection. Seven day treatment declined DA
      levels in striatum of WKY and in nucleus accumbens of SHR. However, only WKY
      treated subacutely with cocaine showed significantly increased HVA either with or
      without changes in DOPAC in nucleus accumbens and striatum, respectively.
      Increased DOPAC/DA and HVA/DA ratios appeared only in striatum of WKY and in
      nucleus accumbens of SHR following subacute treatment. These results suggest that
      subacute cocaine administration affects DA levels in striata and nucleus
      accumbens differently between WKY and SHR.

PMID- 2215854
TI  - Effects of acute and subacute cocaine administration on the CNS dopaminergic
      system in Wistar-Kyoto and spontaneously hypertensive rats: III. Dopamine uptake.
AB  - The characteristics of dopamine uptake after acute and subacute cocaine
      administration were determined in striata from WKY and SHR. In acutely-treated
      (40 mg/kg, s.c.) rats, significant increases in the Vmax of dopamine uptake were
      observed 30 min after the cocaine injection in both strains, without changes in
      Km values. The in vitro IC50 for cocaine was significantly decreased at 30 min in
      WKY and at 2 h in SHR. However, the in vitro IC50 for GBR-12909 was significantly
      increased at 30 min and at 2 h in both strains following cocaine administration.
      In both strains, the density (Bmax) of the [3H]GBR-12935 binding site was
      significantly increased at 30 min and at 2 h with no changes in Kd. In subacutely
      treated (20 mg/kg, twice daily for 3 or 7 days) rats, a significant increase in
      the Km for dopamine uptake was observed in 7 day treated SHR. The in vitro IC50
      for GBR-12909 was significantly increased in 3 day treated WKY. The results
      suggest that cocaine administration alters dopamine uptake and characteristics of
      dopamine uptake sites in the rat brain.

PMID- 2215855
TI  - Transport of valproate and its effects on GABA uptake in astroglial primary
      culture.
AB  - The antiepileptic drug Na(+)-valproate (VPA) is a broadspectrum anticonvulsant.
      It has been proposed to be involved in the inhibitory mechanisms of GABA-ergic
      systems. In this study, transport of the drug and possible influence on the GABA
      uptake were investigated in primary astroglial cell cultures from newborn rat
      cerebral cortex. The results show a Na+ and K+ independent high affinity uptake
      for VPA, with km and Vmax not significantly different from those observed for the
      GABA uptake. In the presence of the drug, the Km-value of the GABA uptake
      increased. The GABA uptake inhibitors guvacine, (RS)-Cis-4-OH-nipecotic acid and
      4,5,6,7-tetrahydroisoxazolo (4,5- c) pyridin-3-ol (THPO) did not influence upon
      the uptake of VPA, suggesting a transport mechanism for the drug, separated from
      the GABA uptake carrier.

PMID- 2215857
TI  - Binding of flunitrazepam to differentiating neurons cultured in a chemically
      defined, hormone-supplemented medium.
AB  - [3H]Flunitrazepam (FNZ) binding to cortical neurons from fetal rat brain was
      investigated in vitro. The use of a synthetic medium specific for neurons made it
      possible to plot a developmental curve of 3H-FNZ binding in an almost pure
      neuronal culture. Detectable specific binding was present in vitro at time 0
      (that is, the 16th gestational day). A progressive increase of binding, due to an
      increment in the number of recognition sites, was observed on the subsequent
      days. The affinity of the specific binding sites to 3H-FNZ was enhanced by the
      addition of exogenous GABA, whereas the density was not affected.

PMID- 2215858
TI  - Supra-additive activation of guinea-pig superior cervical ganglion adenylate
      cyclase by PGE2 and D-Ala2-Met-enkephalinamide: role of GTP.
AB  - The effects of guanine nucleotides were tested on basal and agonist-modulated
      adenylate cyclase in guinea-pig superior cervical ganglion crude membrane
      preparations. GTP gamma S and Gpp(NH)p dose-dependently stimulate, while GDP beta
      S inhibits, both the basal and the prostaglandin E2-stimulated enzyme activity.
      Low GTP doses, up to 10(-5) M, stimulate, while higher doses inhibit, the
      ganglionic adenylate cyclase. The GTP-induced diphasic pattern is maintained also
      in the presence of prostaglandin E2, D-Ala2-Met-enkephalinamide, or a combination
      of the two drugs. However, the opioid inhibits the enzyme activity, but only at
      high GTP doses, while the prostaglandin stimulates the enzyme at all GTP
      concentrations. The effect is potentiated by a combination of prostaglandin and
      enkephalin. The enhancing effect of the prostaglandin and of the combination with
      enkephalin is maximally expressed at high, almost physiological, GTP doses.

PMID- 2215856
TI  - Red cell phenylalanine is not available for transport through the blood-brain
      barrier.
AB  - The possibility that red cell-sequestered amino acids such as phenylalanine are
      available for transport through the brain capillary wall, i.e., the blood-brain
      barrier (BBB), in vivo was investigated in the present studies with the carotid
      artery injection technique. Control studies included the examination of the
      availability of red cell-sequestered solutes such as phenylalanine or D-glucose
      to liver cells in vivo using a portal vein injection technique. The results show
      that red cell-sequestered phenylalanine is not available for transport through
      the BBB or into rat liver in vivo, but human red cell-sequestered D-glucose is
      available for uptake by liver following portal injection. Therefore, given
      favorable kinetics it is possible for red cell-sequestered solute to be available
      for uptake by tissues. However, in the case of neutral amino acids such as
      phenylalanine, red cell-sequestered amino acid is not available for transport
      through the BBB in vivo.

PMID- 2215859
TI  - Thiobarbituric acid-reactive material content and enzymatic protection against
      peroxidative damage during the course of cryogenic rabbit brain edema.
AB  - The relationship between free radicals reactions and the cell detoxifying system
      was investigated during the development of brain edema following a cryogenic
      lesion in the rabbit cerebral cortex. The amount of TBA-reactive material present
      six hours after freezing was less than in the controls, then increased at 48 and
      96 hours. The activity of superoxide dismutase (SOD) decreased 6 hours post
      injury; at the same time, we observed a stimulation of catalase activity. The
      glutathione peroxidase activity (GSH-Px) rose 96 hours post-lesion. The decrease
      of TBA-reactive products could result from an elimination rate that exceeds
      generation.

PMID- 2215860
TI  - Effect of short- and long-term exposure to low environmental temperature on brain
      regional GABA metabolism.
AB  - Single exposure of adult male rats to low environmental temperature (LET, 12 +/-
      0.5 degrees C) for 2 h significantly increased the hypothalamic and striatal GABA
      levels without affecting those in other regions of brain. The activity of
      glutamate decarboxylase (GAD) was elevated in hypothalamus (H) and corpus
      striatum (CS) under these conditions. GABA accumulation rate (measured with
      ethanolamine-O-sulfate, an inhibitor of GABA-transaminase) was also increased in
      both H and CS of rats exposed to LET for 2 h. Unlike after a single exposure, the
      repeated exposure (2 h/day) for 7, 15, and 30 consecutive days did not change the
      hypothalamic GABA metabolism. No change in GABA metabolism was observed in CS
      when rats were repeatedly exposed to LET for 7 consecutive days. Prolongation of
      repeated exposure to LET (2 h/day) for 15 and 30 consecutive days decreased the
      striatal GABA level and increased the activity of GABA-transaminase, although GAD
      activity was not altered under these conditions. These results suggest that
      single exposure to LET accelerates GABA synthesis and may reduce the GABAergic
      activity in both H and CS; whereas repeated exposure to LET for 15 or 30
      consecutive days enhances GABAergic activity with the stimulation of GABA
      utilization only in CS without affecting its synthesizing process. Thus, it may
      be suggested that the hypothalamic and striatal GABA system may play a
      characteristic role in response to short- and long-term exposure to LET.

PMID- 2215861
TI  - Regional excitatory and inhibitory amino acid levels in epileptic El mouse brain.
AB  - Inbred mutant El mice are highly susceptible to convulsive seizures upon
      "tossing" stimulation. The levels of excitatory (e.g. glutamate and aspartate)
      and inhibitory amino acids [e.g. gamma-amino-butyrate (GABA)] were examined in
      discrete regions of stimulated El mice [El(+)], non-stimulated El mice [El(-)]
      and ddY mice, which do not have convulsive disposition. In comparison with ddY, a
      general increased levels of aspartate, glutamate, glutamine, and taurine were
      detected in brain regions of El(-). The levels of GABA and glycine were almost
      the same in ddY and El(-). Compared to El(+), the levels of aspartate, glutamate,
      glutamine, and GABA in El(-) were either the same or higher. In the case of
      taurine and glycine, the levels in El(-) were either the same or lower than
      El(+). Alanine is special in that El(-) have a higher level than El(+) in
      hippocampus but lower in cerebellum. Furthermore, while marked changes were
      registered in several brain regions, none of the amino acids investigated showed
      any significant differences in the hypothalamus of three different groups of
      mice.

PMID- 2215863
TI  - [Accessory nerve decompression for the treatment of spasmodic torticollis].

PMID- 2215862
TI  - Sodium dependency of GABA uptake into glial cells in bullfrog sympathetic
      ganglia.
AB  - The kinetics of sodium dependency of GABA uptake by satellite glial cells was
      studied in bullfrog sympathetic ganglia. GABA uptake followed simple Michaelis
      Menten kinetics at all sodium concentrations tested. Increasing external sodium
      concentration increased both Km and Vmax for GABA uptake, with an increase in the
      Vmax/Km ratio. The initial rate of uptake as a function of the sodium
      concentration exhibited sigmoid shape at 100 microM GABA. Hill number was
      estimated to be 2.0. Removal of external potassium ion or 10 microM ouabain
      reduced GABA uptake time-dependently. The effect of ouabain was potentiated by
      100 microM veratrine. These results suggest that at least two sodium ions are
      involved with the transport of one GABA molecule and that sodium concentration
      gradient across the plasma membrane is the main driving force for the transport
      of GABA. The essential sodium gradient may be maintained by Na+, K(+)-ATPase
      acting as an ion pump.

PMID- 2215865
TI  - [Dissecting aneurysm of the vertebral artery as a cause of Wallenberg's
      syndrome].
AB  - Although it is well known that Wallenberg's syndrome is caused by occlusion of
      the vertebral artery (VA) or the posterior inferior cerebellar artery (PICA), the
      etiology of the occlusion is rarely documented. During the course of Wallenberg's
      syndrome, patients often complain of headache. We thought that these headaches
      might be caused by dissecting aneurysm (DA) of the vertebral artery, and so we
      studied the incidence of DA in our cases with Wallenberg's syndrome. Although
      many variants exist, Wallenberg's syndrome encompasses several neurological
      symptoms due to a disorder of the nucleus and nerve tracts located in the lateral
      part of the medulla. We diagnosed our patients as having Wallenberg's syndrome on
      the basis of symptoms such as loss of pain and temperature sensation in the
      unilateral face and contralateral body, cerebellar ataxia, and dysphasia. We
      investigated 22 cases of Wallenberg's syndrome over a five-year period, and
      excluded patients who developed subarachnoid hemorrhage upon onset of the
      syndrome. Our cases can be divided into two groups; one with severe stenosis or
      occlusion of VA (n = 15) and the other with occlusion of PICA (n = 5). The
      angiograms of the two remaining patients showed no abnormal findings. The mean
      age of the VA group (42.5 yrs.) was younger than that of the PICA group (64.2
      yrs.). The age distribution of the PICA group is similar to that of other
      occlusive cerebrovascular diseases. Seven cases of the VA group demonstrated
      aneurysmal dilatation and luminal stenosis, and so they were diagnosed as having
      dissecting aneurysm of VA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2215864
TI  - [Management results of primary intracranial malignant lymphoma].
AB  - Nineteen cases of primary malignant lymphoma of the central nervous system were
      reported. The clinical characteristics, diagnostic procedure and therapeutic
      method, especially concerning chemotherapy, were analysed. The following
      conclusions were obtained: 1) histological classifications and surgical
      procedures were not factors involved in prognosis. 2) radiotherapy was regarded
      as an effective but a palliative treatment. 3) combined chemotherapy for systemic
      malignant lymphoma, such as VEMP, VEP, COPP, seemed to be of little use for
      intracranial malignant lymphoma. 4) intra-arterial administration of high-dose
      methotrexate, ACNU and intravenous administration of high-dose cytosine
      arabinoside can be expected to be a useful chemotherapeutic approach.

PMID- 2215866
TI  - [Epilepsy after operation for ruptured intracranial aneurysm].
AB  - Fifty-five patients who underwent surgery for ruptured aneurysm of the anterior
      circulation were evaluated with respect to postoperative epilepsy. Prophylactic
      treatment with anticonvulsants had been carried out in all patients. The overall
      incidence of the postoperative epilepsy was 23.6% (13/55). The mean latency
      between the operation and the first seizure was 11 months (range, 8 days to 5
      years). The most important risk factors by statistical analyses were multiple
      aneurysms, preoperative severity, severe subarachnoid hemorrhage, intracerebral
      hematoma, normal pressure hydrocephalus, EEG abnormalities in the chronic stage,
      intracerebral low density area on CT-films and neurological deficit. Other risk
      factors were aneurysm of MCA and early operation for aneurysm. Our opinions
      concerning postoperative anticonvulsant therapy for aneurysmal patients are as
      follows. 1) Prophylactic treatment with anticonvulsant should be administered to
      all patients who have undergone aneurysm surgery. 2) The risk factors should be
      considered in determining the duration of medication with the anticonvulsant. 3)
      The treatment with the anticonvulsant should be performed while monitoring the
      clinical course, EEG findings, plasma concentration level of the anticonvulsant
      and side effects of the drugs.

PMID- 2215867
TI  - [Encapsulated chronic intracerebral hematoma caused by venous angioma of the
      basal ganglia: a case report].
AB  - A case is reported of venous angioma at the right basal ganglia simulating the
      encapsulated chronic intracerebral hematoma. A 29-year-old man was admitted to
      our hospital on July 14, 1988 with a two-month history of headache. Neurological
      examination revealed left homonymous lower quadrantic anopsia. CT scans showed a
      mosaic high density lesion at the right basal ganglia with extensive adjacent
      edema. MRI revealed that the high density lesion on CT scans was the combination
      of a reticulated core of mixed signal intensity with a surrounding rim of
      decreased signal intensity. The lesion was accompanied with extensive edema.
      Followed up CT scans showed the transformation of the lesion and ring-shaped
      enhancement. A right frontotemporal craniotomy was performed on August 9, 1988.
      After thorough dissection of the sylvian fissure and small corticotomy to the
      insula, a tough capsule was seen. There was blood in various stages of
      organization in the capsule. A histological examination gave a diagnosis of
      venous angioma in the membrane similar to the outer membrane of chronic subdural
      hematomas. Postoperatively, the patient showed slight left motor weakness, but it
      gradually improved and he was discharged on foot, on October 19, 1988. There have
      been a lot of reports about angiographically occult intracranial vascular
      malformation (AOIVM). But AOIVM at the basal ganglia is rare, and to our
      knowledge, only 8 cases have been reported. In our case, the presence of adjacent
      extensive edema, and ring-shaped enhancement on CT scans confused the
      preoperative diagnosis. Those findings might have been caused by encapsulation.
      By using CT scans and MRI, a complete and accurate diagnosis was
      impossible.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2215868
TI  - [Intracranial hematoma associated with acquired immunodeficiency syndrome (AIDS):
      case report].
AB  - The authors report a case of intracranial hematoma associated with AIDS. A male
      aged 21 had been treated with infusion of factor VIII to control hemophilia A. He
      fell down and hit his right occipital region. Immediately after the impact, he
      became comatose. When he was hospitalized 30 minutes after the injury, a
      herniation sign was recognized. CT scan revealed right acute subdural hematoma
      that showed mixed density. This hematoma was successfully removed with HITT
      (hematoma irrigation with trephination therapy) and he recovered almost
      completely. However he died when the intracerebral hematoma bled suddenly on the
      20th day after surgery. We assumed the hematoma was related to vasculitis induced
      by AIDS. Three points in this case impressed us. First, HITT is very useful for
      treating acute subdural hematoma associated with AIDS. Second, the patient's
      condition may deteriorate suddenly through intracerebral hematoma originating
      from AIDS-related vasculitis, although the coagulation factors are well
      maintained. Third, a manual for management of cases of AIDS is necessary to avoid
      confusion among the medical staff.

PMID- 2215869
TI  - [Meningioma of pineal region].
AB  - A 58-year-old man was admitted to our hospital upon his request for an operation
      on a hemifacial spasm that had developed twelve years ago. The hemifacial spasm
      on the left side was the only positive neurological findings at the time of
      admission. However, a pre-operative neuroradiological examination revealed a
      meningioma originating in the falco-tentorial junction. Left neurovascular
      decompression was initially performed and was followed by the excision of the
      tumor through a right parietooccipital approach. The pathological diagnosis was
      meningothelial meningioma. The patient was discharged with no neurological
      deficit. There have been only a few reports on pineal meningioma and even now
      this type of tumor is considered to be rare. Some similar cases reported in the
      literature are reviewed. The clinical aspects, clinical features and the
      pathological entity are discussed.

PMID- 2215870
TI  - [An adult case of malignant choroid plexus papilloma in the lateral ventricle and
      the cerebellopontine angle revealed simultaneously].
AB  - An adult case of malignant choroid plexus papilloma is very rare. This report is
      an adult case of malignant choroid plexus papilloma revealed in the lateral
      ventricle and in the cerebellopontine (CP) angle simultaneously. A 37-year-old
      man was admitted to the hospital complaining of headache, nausea, and a floating
      sensation on August 29, 1984. Neurological examination on admission revealed
      bilateral papilledema, left dysmetria and horizontal nystagmus. CT scan revealed
      a slightly high density round mass in the right lateral ventricle and a cystic
      mass with mural nodule in the left CP angle. The intraventricular mass and mural
      nodule were enhanced moderately and homogeneously. The initial surgery was for
      removal of the CP angle tumor, and 8 days later removal of the lateral ventricle
      tumor was carried out. The histology of these tumors was the same and revealed
      malignant choroid plexus papilloma. Postoperative radiation therapy was carried
      out 70Gy to the brain (whole brain; 50Gy, focal; 20Gy) and 30Gy to the whole
      spine. About 2 years later paraparesis, lower cranial nerve palsy, and
      disturbance of consciousness had progressed gradually. He died of the severe
      recurrence of the tumor in the brain stem, and multiple dissemination in the
      spinal cord on September 6, 1987. There was no recurrence of tumor in the right
      lateral ventricle. This is a very rare case of malignant choroid plexus papilloma
      which was revealed in both the supra- and infratentorial regions simultaneously.
      They may have developed independently or they may have arisen through
      subarachnoid seeding. Radical removal of the tumor is important to prevent
      recurrence of malignant choroid plexus papilloma.

PMID- 2215871
TI  - [Intraventricular arachnoid cyst appearing with attacks of orbital pain: case
      report and review of the literature].
AB  - While there have been 5 cases of intraventricular arachnoid cyst published in the
      literature, the occurrence in the anterior horn of the lateral ventricle has not
      been reported. We report a case of intraventricular arachnoid cyst of the
      anterior horn causing attacks of orbital pain. A 30-year-old man was admitted
      with frequent attacks of orbital pain on his right side. Neurological examination
      revealed no abnormality. Plain CT showed a cystic dilatation of the anterior horn
      of the right lateral ventricle, and enhanced CT showed a deviation of the septal
      veins to the left side. T1-weighted MRI demonstrated a low-intensity mass in the
      anterior horn of the right lateral ventricle, and T2-weighted image demonstrated
      the mass as having high intensity. PEG in the sitting position showed no filling
      of air into the right lateral ventricle due to obstruction of the right foramen
      of Monro. The patient underwent an operation under a diagnosis of
      intraventricular benign cyst. The cyst wall was subtotally removed and the right
      foramen of Monro was opened. Histological examination of the specimen showed an
      arachnoid membrane with prolific collagen fibers. From an embryological point of
      view, the arachnoid membrane is derived from the arachnoid cell. We think
      intraventricular arachnoid cysts to originate from the remnants of the arachnoid
      cell on the tela choroidea or on the choroid plexus like intraventricular
      meningiomas.

PMID- 2215872
TI  - [A case of chronic subdural hematoma associated with idiopathic thrombocytopenic
      purpura (ITP)].
AB  - A 41-year-old male was admitted to our service with right occipital pain as his
      chief complaint. CT and MRI examinations revealed bilateral chronic subdural
      hematomas. The patient had also been affected with ITP since the age of 28. Since
      emergency operation was thought to be dangerous, he was transferred to Tokushima
      University Hospital, and treated preoperatively by administration of steroids and
      a large dose of immunoglobulin. When his platelet count had returned to
      146,000/mm3, evacuation of the hematoma through burr holes was performed
      successfully under local anesthesia. The postoperative course was uneventful. So
      far as we have been able to find in the literature, only 3 cases of ITP
      complicated by chronic subdural hematoma have been reported. The characteristic
      clinical feature of these 4 cases including our own case was noted as the absence
      of a history of trauma. However, the etiological relationship between ITP and
      chronic subdural hematoma was controversial. Occurrence of chronic subdural
      hematoma in patients with ITP and in patients under hemodialyzer treatment is
      very rare. However, intracerebral hemorrhages are rather common among such
      patients. So it was suggested that the tendency to bleeding among patients with
      ITP, and among hemodialyzer patients may contribute little as an etiological
      factor in the evolution of chronic subdural hematoma.

PMID- 2215873
TI  - [A case of pineal epidermoid cyst showing an interesting magnetic resonance
      imaging].
AB  - A case of pineal epidermoid cyst with interesting findings of magnetic resonance
      imaging (MRI) is reported referring to the literature. In our case, homogeneous
      high density area is seen on CT and high signal intensity is recognized on T1
      weighted MRI and low signal intensity on T2-weighted MRI.

PMID- 2215874
TI  - [A case of achondroplasia showing diffuse spinal canal stenosis].
AB  - A rare case of achondroplasia showing diffuse spinal canal stenosis is presented.
      A 39-year-old woman was admitted to our hospital because of numbness of lower
      extremities and intermittent claudication. The patient's height was 121cm and she
      had the typical clinical features of an achondroplastic dwarf. Neurological
      examination revealed spastic paraparesis, and sensory impairment below the level
      of T11 in the left side and L1 in the right. A plain X-ray feature of the spine
      showed spinal canal stenosis. The interpedicular distances were short in all
      vertebrae, and especially more prominent in the caudal lumbar region. The sacrum
      laid horizontally and the sacral angle was narrower than normal case. Myelography
      and computed tomographic myelography demonstrated severe stenosis of the
      subarachnoid space at the level of T9-11. Laminectomy was performed from the
      inferior half of T9 to T11. The yellow ligaments were prominently hypertrophic
      and these were removed as far as possible. Postoperatively, the weakness of the
      lower extremities was improved immediately, but numbness remained. Five months
      after the operation, she suffered from urinary dysfunction, so further
      laminectomy from T12 to L5 was performed. Also in this operation, hypertrophic
      yellow ligament was pathognomonic. Following this operation the patient had a
      good recovery course and returned to work.

PMID- 2215876
TI  - Individual variation in line bisection: a study of normal subjects with
      application to the interpretation of visual neglect.
AB  - Investigations of left visuo-spatial neglect are reviewed with special reference
      to line bisection performance. Attention is then drawn to inconsistencies in the
      direction and magnitude of transection displacements in group studies of normal
      controls. We argue that the lack of reliable information about normal mechanisms
      for line bisection makes it impossible to interpret pathological performance in
      neglect. Accordingly, we report a case-series of 22 normal young adults, each of
      whom bisects 10 lines of differing lengths 10 times each. There is very
      substantial between-subject variation in both the magnitude and direction of the
      linear regression of transection displacement on line length; there are likewise
      considerable differences in the magnitude of the linear regression of standard
      deviation on line length. These two sources of individual variation are
      uncorrelated. We propose a psychophysical theory of line bisection, and suggest
      that the basic mechanisms responsible for task-performance are qualitatively
      intact in visuo-spatial neglect, albeit quantitatively impaired.

PMID- 2215875
TI  - Effect of response programming on hemispheric differences in lexical decision.
AB  - A lateralized tachistoscopic lexical decision task with concrete nouns and
      orthographically regular nonwords was administered to normal subjects in three
      conditions using unimanual responses: Yes-No, Go-NoGo with nonword targets, and
      Go-NoGo with word targets. There was an overall right visual field advantage in
      accuracy and sensitivity, an interaction between visual hemifield and wordness in
      latency, and an overall "word" bias. No effect interacted with experimental
      conditions, showing that response programming did not affect hemispheric
      asymmetries. The data suggest independent lexical access and similar response
      programming in each hemisphere. These results are examined in light of three
      psycholinguistic models of lexical access and are interpreted to support instead
      a fourth one which posits separate and parallel computations for word decisions
      and for nonword decisions in each hemisphere.

PMID- 2215877
TI  - Cross-modal matching by amnesic subjects.
AB  - The present study examined the performance of two groups of amnesic subjects on a
      cross-modal identification task. It was found that subjects with Korsakoff's
      disease did not differ from alcoholic controls on their ability to match the
      tactile feel of an arc with the visual appearance of the full circle from which
      the arc was taken. The postencephalitic subjects were, however, impaired on this
      same task. All groups performed normally on two intramodal control tasks. The
      postencephalitic group, like the Korsakoff subjects, were also poor at
      identifying common objects from tactile cues. The results are consistent with the
      notion that limbic regions in the temporal lobe are important for cross-modal
      associations.

PMID- 2215878
TI  - Immune and autoimmune diseases in dyslexic children.
AB  - One hundred and five dyslexic and 105 control children were compared for
      frequency of immune diseases, autoimmune diseases, and non-right-handedness in
      the light of the Geschwind-Behan (1982) "testosterone hypothesis". The results
      showed significantly more immune- and autoimmune-diseases int he dyslexic group.
      There were no differences between the groups in the frequency of non-right
      handedness. There were no interactions with gender, although there were more non
      right-handed boys than girls in the total sample. Mothers of children who were
      dyslexic experienced significantly more negative life-events during pregnancy,
      they also experienced the pregnancy as more difficult, and they had more
      spontaneous abortions. In conclusion, the results support some aspects of the
      "testosterone hypothesis", but they also point to a more complex pattern of
      interaction between the factors that still remain unanswered.

PMID- 2215879
TI  - Handedness, clumsiness and developmental language disorders.
AB  - Hand preference and relative hand skill were assessed in 83 8 1/2-year-olds who
      had first been enrolled in a longitudinal study of specific language impairment
      at 4 years of age. There was no evidence that hand preference or relative skill
      of the two hands differed from normal in this population, although skill of both
      hands was poor in children with persisting language difficulties.

PMID- 2215880
TI  - Event-related potential evidence of sex differences in verbal and nonverbal
      memory tasks.
AB  - ERPs were recorded from 19 scalp electrodes while 48 subjects (24 females)
      performed visual recognition tasks for recurring verbal items and recurring
      abstract figures. Reaction times were longer in the figures than verbal task; the
      latencies of the ERP components (P2, N4, P3, P4) were also longer for the
      figures. A nonreversing asymmetry (R greater than L) was seen in both tasks.
      Significant task by electrode interactions (for P3, P4) were found, due to larger
      amplitudes anteriorly for the figures, but larger amplitudes posteriorly for the
      verbal task. All ERP latencies were longer for males than females. There were sex
      by task by electrode interactions in the amplitudes, due to larger ERPs (P2, N4)
      for females anteriorly for the figures, but slightly larger posteriorly for the
      verbal task. These results suggest that sex differences in cognitive abilities
      may be based on differences in biological mechanisms.

PMID- 2215881
TI  - Elaborative strategies in word pair learning--DC-potential correlates of
      differential frontal and temporal lobe involvement.
AB  - Cortical DC potentials were recorded while subjects were learning word pairs. The
      use of an elaborative mnemonic strategy resulted in a left frontal sustained
      negative shift. Its amplitude was independent of whether imagery mnemonics or
      semantic mnemonics were used. By contrast, posterior temporal potentials differed
      according to strategy: with imagery mnemonics, subjects had more symmetrical
      potentials over posterior temporal areas whereas with a semantic strategy, there
      was a left hemispheric preponderance of the DC potential. An interpretation
      within Stuss and Benson's theory on the frontal lobes is given.

PMID- 2215882
TI  - Asymmetries in hand movement during block design construction.
AB  - Changes in patterns of hand use were examined as a function of task demand
      characteristics. Using blocks, right- and left-handed male and female subjects
      were asked to simultaneously construct two replicas of presented patterns, one
      with each hand. With the presentation of visual-spatial patterns, a shift toward
      use of the left hand from baseline was observed. This change was least evident
      among right-handed females. The observed shift in hand use toward the left on a
      visuo-constructive block design task might suggest differential involvement of
      the right hemisphere with changes in task demand characteristics.

PMID- 2215883
TI  - Contrast sensitivity and low spatial frequency discrimination in hemi-neglect
      patients.
AB  - Contrast sensitivity for sinusoidal gratings of different spatial frequencies and
      low spatial frequency discrimination of high contrast squarewave gratings were
      measured in 26 right brain damaged patients, 15 of whom showed symptoms of
      spatial hemi-neglect. No difference was present between neglect and non-neglect
      patients in either task. A difference in contrast sensitivity restricted to low
      spatial frequencies was present between controls and patients, independent of
      neglect. Overall, results indicated that spatial vision at threshold and
      suprathreshold levels is not selectively impaired in patients with hemi-neglect,
      a finding consistent with theories which postulate a post-perceptual locus of
      impairment in this syndrome.

PMID- 2215884
TI  - Comparing the cerebral hemispheres on the speed of spatial shifts of visual
      attention: evidence from serial search.
AB  - We compared the speed at which visuo-spatial attention may be shifted from one
      stimulus to another as a function of the visual hemifield in which the items were
      displayed in a visual search task requiring serial processing. The increase in
      response time with the number of items displayed was similar for left- and right
      hemifield presentations. This suggests that the rate at which visuo-spatial
      attention can be shifted from one stimulus to another during visual search does
      not differ between the cerebral hemispheres.

PMID- 2215885
TI  - Verbal fluency in Parkinson's disease.
AB  - This study compares the performance of Parkinson's disease patients with age
      matched controls on semantic and letter-initial verbal fluency tests. An analysis
      of variance revealed that Parkinsonian patients showed impaired word production.
      However when the covariates of age, present verbal ability (Mill Hill Synonyms)
      and severity of depression (Geriatric Depression Screening Scale) were included
      in an analysis of covariance, the significant effect of Parkinson's disease on
      verbal fluency disappeared. Instead, age and present verbal ability were revealed
      to be the significant sources of between subject variation in total verbal
      fluency performance; results indicated that increased age and lower present
      verbal ability resulted in poorer performance on the verbal fluency tests.
      Depression score was not a significant source of between subject variation. The
      results are discussed in relation to those recently reported by Gurd and Ward
      (1989).

PMID- 2215886
TI  - Relationships between the direction of movements and handedness in children.
AB  - It has been proposed that human handedness can be deduced from the direction of
      voluntary movements. To test this assumption, children of an elementary school
      were observed as they performed several tasks with their dominant hand; drawing
      circles on a piece of paper, making circular movements in the air with their
      index finger, drawing a human profile, boring and drawing a horizontal line. Both
      handedness of the children and the directionality of their drawings and movements
      were assessed. It appeared that the direction of drawing a horizontal line is the
      only variable that differentiates well between handedness groups. While this
      variable was hardly influenced by age, other variables were. Circling, for
      instance, was predominantly clockwise in the youngest and counter-clockwise in
      the older children. It was argued that the handedness of individual subjects
      cannot safely be determined from these measures.

PMID- 2215887
TI  - Differences in feminine and masculine characteristics in women as a function of
      handedness: support for the Geschwind/Galaburda theory of brain organization.
AB  - The Geschwind/Galaburda testosterone theory successfully predicted differences in
      feminine sex role identification and behavior between women with anomalous
      dominance and standard dominance. The women with anomalous dominance (consisting
      of left-handed and ambidextrous as well as right-handed women with first-degree
      non-right-handed relatives) were compared to women with standard dominance (right
      handed women with all right-handed first-degree relatives) on the Bem Test of Sex
      Role Identity and a tomboy scale. Across three samples, handedness
      classifications were related to both tomboy characteristics and sex role
      identification. In addition, the study showed that the anomalous dominance women
      had a higher masculine sex role identification as compared to the college
      normative sample for the Bem, while the standard dominance women had a higher
      feminine identification than the normative sample.

PMID- 2215889
TI  - Analysis of "scalp potential fields" and three-dimensional localization of the
      sources of epileptic activity of the human brain.

PMID- 2215888
TI  - Electrophysiological investigation of the hippocampal projections to the
      neurosecretory cells of the supraoptic nucleus of the rat hypothalamus.
AB  - The impulse activity of antidromically identified neurosecretory cells of the
      supraoptic nucleus of the hypothalamus of rats in response to stimulation of the
      ventral hippocampus was investigated. Short-latency phasic excitation reactions
      were identified, and inhibition reactions were not found. The presence of
      excitatory synaptic inputs from the hippocampus to other neurons of the nucleus
      and of the perinuclear zone, which are predominant by comparison with analogous
      projections to the neurosecretory cells, was demonstrated. The features of limbic
      hypothalamic relationships are discussed in the context of afferent control of
      the activity of the neurosecretory cells.

PMID- 2215890
TI  - Segment-by-segment histological analysis of the cervical division of the spinal
      cord and of the roots of the spinal nerves and ganglia in severe craniocerebral
      trauma.

PMID- 2215891
TI  - Some principles of the organization of the preterminal and terminal ramifications
      of the afferent conductors in the neuropil of the dorsal ganglia of the edible
      snail.

PMID- 2215892
TI  - "Reflexes of purpose and freedom" in the comparative physiology of higher nervous
      activity.
AB  - The most complex unconditioned "reflexes of aim and freedom," discovered by I.P.
      Pavlov, are compared with the "competence drive" and the "motivation of the
      resistance to coercion," respectively, described by contemporary ethologists. On
      the basis of the unconditioned "reflex of purpose," conditioned reflexes were
      developed in which positive emotions arising in connection with the perfection of
      a skill, irrespective of its pragmatic significance at a given moment, serve as
      the reinforcement. The unconditioned "reflex of freedom" is regarded as a
      phylogenetic precursor of the will, and its acute extinction as the physiological
      mechanism of hypnosis. It was demonstrated experimentally that the appearance of
      the state of "animal hypnosis" (immobilization catatonia) in rabbits is
      accompanied by the predominance of electrical activity and heat production in the
      right hemisphere, i.e., by symptoms which are found in hypnosis in man.

PMID- 2215893
TI  - Features of the systemic organization of cortical neurons with different forms of
      the manifestation of a conditioned reflex to time.
AB  - A conditioned food-procuring reflex to time (2-min interval) was developed in
      cats. The coupled activity of neurons in microareas and between microareas of the
      motor cortex was compared by cross correlation analysis in different forms of the
      manifestations of the conditioned reflex: decrease in the amplitude of
      respiratory movements, increase in amplitude, and food-procuring movement of the
      paw for several seconds prior to the delivery of the reinforcement. Differences
      were manifested in the degree of increase in the number of functional
      associations in the second half of the interval as compared with the first, and,
      to a still greater degree, also in the frequency with which intervals were
      encountered with altered structure of the interrelationship between the neurons.
      The changes observed did not always correlate with the change in the frequency of
      impulse activity of individual neurons, which was noted substantially less
      frequently.

PMID- 2215894
TI  - Coherence analysis of the electrical activity of the rabbit brain in the process
      of the formation of the polarization dominant.
AB  - It has been demonstrated by means of the method of spectral coherence analysis in
      rabbits, under conditions of a chronic experiment, that when a motor "dominant"
      reaction is still absent in the early stages of the dominant, interhemispheric
      asymmetry appears in the Coh spectra of the electrical activity of the
      sensorimotor cortex and the VPL nucleus of the thalamus. On the other hand,
      interhemispheric asymmetry appears in the Coh spectra of the electrical activity
      of the sensorimotor cortex and the CA3 field of the dorsal hippocampus only at
      the stage at which the motor "dominant" reaction is recorded. The asymmetry in
      the alpha and beta ranges of the frequencies in the Coh spectra of the
      biopotentials of the investigated regions, which coincides with the attainment of
      the motor "dominant" reaction, is associated with the processes of the
      organization of movement.

PMID- 2215895
TI  - Influence of dominant motivation on the functional organization of auditory input
      to the sensorimotor cortex of the cat brain.
AB  - The results of experiments reviewed in this article demonstrate the possibility
      of the transformation of the frequency tuning of the auditory input into the
      sensorimotor cortex (SMC) of the cat under the influence of a dominant
      motivation. Similar changes took place in the parietal cortex (PC) but they were
      significantly less in absolute magnitude. The identified transformation of the
      frequency tuning of the auditory input into the SMC and the PC is in agreement
      with a change in the biological significance of the auditory signals of kittens
      for females in the period of lactation, and corresponds for each cat to the
      spectral composition of the vocalizations of its own kittens.

PMID- 2215896
TI  - Blood-flow and pO2 in the posterior hypothalamus of cats during paradoxical
      sleep.
AB  - It was found in chronic experiments in cats, using the recording of local blood
      flow and oxygen tension (pO2) in the anterior and posterior hypothalamus in the
      sleep-wakefulness cycle, that when the phases of sleep are alternated, the
      changes in these parameters are in different directions: the level of blood flow
      and the frequency of fluctuation of the pO2 during paradoxical sleep increase in
      the posterior hypothalamus, while they decrease in the anterior hypothalamus. On
      the other hand, the opposite pattern is observed during slow-wave sleep. The
      multidirectionality of the changes in local blood flow level and in the frequency
      of fluctuations of pO2 in one and the same sleep phase indicate that they are of
      local origin and must be governed by functional-metabolic shifts in these
      structures; the functional state of the posterior hypothalamus during paradoxical
      sleep is assessed on this basis.

PMID- 2215897
TI  - Electrophysiological analysis of the conditioned reflex activity of cats during
      thirst.
AB  - The EEG of the cerebral cortex and the electrohypothalamogram (EHG) was recorded
      in cats with a salt load and water deprivation during the performance of runs
      conditioned to non-salty and salty food signals. The non-salty food signal
      against the background of thirst was accompanied only by the activation of the
      cerebral cortex, whereas the hypothalamus in addition to the cortex was involved
      in the activation in relation to the salty food signal. In those cases in which
      the non-salty signal was reinforced by salty food and the animal has eaten it
      (although it had rejected it in the presence of thirst), a strong activation of
      the cortex was observed, with involvement of the paraventricular divisions of the
      hypothalamus. The remodeling of the signal role of the conditional signals was
      achieved in accordance with the new quality of the food reinforcement. The
      hypothalamo-cortical mechanisms of the dominant motivation and its conditioned
      reflex effectuation are discussed.

PMID- 2215898
TI  - Influence of extirpation of the sensorimotor area of the cortex on the formation
      of conditioned reflexes in response to a complex signal in the ontogenesis of the
      cat.
AB  - The influence of the extirpation of the sensorimotor cortex (SMC) on the
      formation and maintenance of a previously developed alimentary conditioned reflex
      to a simultaneous complex stimulus (light + sound) with extinction of the
      reaction to unreinforced components of the complex signal was studied in kittens
      aged 39 days to 4 months. The extirpation of the SMC prior to 2.5 months of age
      had no influence on either the formation or maintenance of the conditioned reflex
      to the complex signal developed prior to the operation. The extirpation of the
      SMC in preliminarily trained kittens aged 3.5 months and older leads to
      disinhibition of the differential components when the positive conditioned reflex
      to the complex signal is maintained. In untrained kittens of the same age the
      extirpation of the SMC was manifested in the animals' incapacity to inhibit the
      motoric reaction to the differential signal. The question of the role of the SMC
      in ontogenesis during the formation of adequate forms of behavior which require
      the achievement of intersensory interactions is discussed.

PMID- 2215899
TI  - Mapping of normal brain maturation in infants on phase-sensitive inversion-
      recovery MR images.
AB  - It is illustrated that phase-sensitive inversion-recovery MR images are
      particularly well suited for the monitoring of brain maturation and myelination
      in the neonate and young infant. Provided appropriate timings are applied with
      the inversion-recovery MR pulse sequence, the myelinated areas show up as bright
      spots in the phase-sensitive images. The chronology of the appearance, and the
      location of these hyperintense zones correlate well with the chronology of brain
      maturation, as assessed by other means. In particular, the progressive functional
      capabilities of the infant correlate well with the progress of myelination, as
      exhibited by the MR images.

PMID- 2215900
TI  - Morphology of cerebral lesions in children with congenital hemiplegia. A study
      with computed tomography.
AB  - This study has analysed the results of CT scans of the brains in children with
      congenital hemiplegia. The material consists of 111 out of a total of 151
      children with this cerebral palsy syndrome in a population-based series. We have
      classified the morphological findings in five groups. The groups are designed to
      reflect the phase of maturation of the brain when the insult happened. The groups
      are: 1. Maldevelopment, 2. Periventricular atrophy, 3. Cortical-/subcortical
      atrophy, 4. Miscellaneous, 5. Normal. In contrast to previous reports we found a
      high proportion (17%) with maldevelopment. However the dominating morphological
      pattern was periventricular atrophy, consistent with a hypoxic-ischemic insult to
      the immature brain, seen in 42%. Cortical and/or subcortical atrophy was found in
      12%. Three children (3%) presented with morphological patterns not possible to
      classify. The group with no pathology according to CT was 26%.

PMID- 2215901
TI  - MR imaging of spastic diplegia. Comparative study between preterm and term
      infants.
AB  - Eighteen children (eleven preterm birth and seven term birth) with clinical
      evidence of spastic diplegia (SD) were studied to clarify the differences of the
      lesions between preterm and term SD on MR imaging. All with preterm birth showed
      similar abnormalities of the periventricular white matter represented by high
      intensity in T2-weighted imaging and low intensity in T1 imaging. It seemed that
      the lesions were periventricular leukomalacia (PVL) and dysmyelination
      pathologically and correlated well clinically with spastic diplegia. SD with term
      birth group showed various lesions, two brain anomalies (schizencephaly and
      corpocephaly), one PVL, four showed no lesions. We suggested that SD with preterm
      birth is not only a clinical but also a pathological entity.

PMID- 2215902
TI  - MR imaging of wallerian degeneration in the human brain stem after ictus.
AB  - Magnetic resonance (MR) imaging of wallerian degeneration in the brain stem was
      studied in 30 hemiplegic patients within 12 months of ictus. As early as 25 days
      after the ictus, decreased signal intensities on proton-density(PD)-weighted
      images were observed in the brain stem ipsilaterally. This hypointensity
      gradually approached an isointense stage during 70-80 days after the ictus,
      abnormal intensities were not detected in any pulse sequence. We termed this
      phenomenon "Fogging effect of wallerian degeneration". In later stages, at least
      81 days after the ictus, increased signal intensities on T2-weighted images, with
      or without decreased signal intensities on T1-weighted images, were observed in
      the brain stem, ipsilaterally. Finally, at least six months after the ictus, mild
      shrinkage of the ipsilateral brain stem was newly detected on the T1-weighted
      images. MR imaging has proven to be a sensitive diagnostic modality for
      evaluating wallerian degeneration in the brain stem.

PMID- 2215903
TI  - Does the washout phenomenon of Tc-99m HM-PAO correlate to the "filling-in"
      phenomenon of I-123 IMP with brain SPECT?
AB  - Using SPECT, the time course of brain uptake was compared between N-isopropyl-p
      [I-123]-iodoamphetamine (I-123 IMP) and Tc-99m d,l hexamethyl-propyleneamine
      oxime (Tc-99m HM-PAO). Of 14 patients with cerebrovascular disease showing areas
      of the "filling-in phenomenon" (i.e. delayed uptake) with I-123 IMP brain SPECT,
      7 exhibited persistent defects with Tc-99m HM-PAO (Group I), and 7 showed early
      washout after the initial uptake (Group II). The filling-in of I-123 IMP did not
      always correlate to the washout region of Tc-99m HM-PAO. The temporal changes
      were also confirmed by semiquantitative analysis. While the filling-in of I-123
      IMP was affected by many factors, the washout of Tc-99m HM-PAO was attributed to
      significant reduction of Tc-99m HM-PAO in the plasma. Delayed imaging of the
      brain with Tc-99m HM-PAO using SPECT may give a more accurate estimate of
      regional cerebral blood flow in cerebrovascular disease, because it should be
      lees effected by cerebral blood volume.

PMID- 2215904
TI  - Putaminal hemorrhage: clinical-computed tomographic correlations.
AB  - Ninety-two percent of 100 patients with putaminal hemorrhage were hypertensive.
      Of the eight normotensive patients, seven were substance abusers or had bilateral
      putaminal hemorrhages. The one other normotensive patient was less than 40 years
      old. The 100 hemorrhages had the following locations: 1. medial putaminal (17
      cases; six were normotensive and less than 40 years old and five were substance
      abusers); 2. lateral putaminal extending through the external capsule (eleven
      cases); 3. putaminal-capsular and subcortical white matter (32 cases); 4.
      putaminal cerebral hemispheric (19 cases); 5. putaminal-thalamic (19 cases); 6.
      bilateral (two cases). A disproportionate number of black patients suffered
      hematoma extension to the cerebral hemispheres or thalamus (46%) compared to
      Caucasians (23%). Overall mortality was 20% (17 blacks and three Caucasians) and
      occurred in patients with hematoma extension to the thalamus or cerebral
      hemispheres. Contrast-enhanced CT was performed in all 100 patients and provided
      no additional diagnostic yield. This indicates limited use for enhanced CT in
      hypertensive patients with putaminal hemorrhage who have a characteristic
      appearance of the acute hemorrhage on the nonenhanced CT.

PMID- 2215905
TI  - Multiple cerebral arteriovenous malformations (AVMs). Review of our experience
      from 203 patients with cerebral vascular lesions.
AB  - From our series of 203 patients with cerebral vascular lesions, 18 (9%) could be
      included in the multiple arteriovenous malformation category. There were five
      patients with Rendu-Osler-Weber, one with Wyburn-Mason syndromes and two with
      concurrent arteriovenous malformations. The remaining ten patients (4%) had
      multiple brain arteriovenous malformations. Careful angiography with
      magnification is necessary to try to diagnose multiple brain AVMs, since these
      sometimes become apparent only after embolization of a larger dominant AVM. The
      incidence of multiple brain arteriovenous malformations is likely to have been
      underestimated due to the failure to recognize micro-arteriovenous malformations
      associated with larger arteriovenous malformations.

PMID- 2215906
TI  - Cranial MRI in Wilson's disease.
AB  - Thirty-eight patients with biochemically proven Wilson's disease underwent
      magnetic resonance-imaging (MRI) of the brain as well as neurological
      examinations. The patients were scanned using spin-echo (SE) sequences; the
      neurologist was looking for typical symptoms: dysarthria, tremor, ataxia,
      rigidity/bradykinesia and chorea/dystonia. Pathological MR findings believed
      secondary to this uncommon inherited disorder of copper metabolism were found in
      twenty-two subjects. Focal abnormalities were seen in the lenticular, thalamic
      and caudate nuclei as well as in brain stem and white matter; these lesions were
      best demonstrated on T2-weighted sequences as hyperintense areas. In eight
      patients we found diffuse brain atrophy with consecutive widening of the
      ventricular system. Five subjects showed mild, nineteen severe neurologic
      deficits. Generally there was no correlation between MR findings and clinical
      neurological symptoms; the impairment of cell-metabolism causing functional
      alterations of the brain precedes morphological changes. During treatment with
      the copper chelator D-penicillamine there seemed to be a phased course of
      disease. Shortening of T1-relaxation due to paramagnetic influence of copper was
      not seen; a possible explanation could be intracellular deposition--a proton
      electron-dipolar-dipolar-interaction would therefore be impossible.

PMID- 2215907
TI  - Regression of an internal carotid artery pseudoaneurysm after therapeutic
      embolization of a post-traumatic carotid-cavernous fistula secondary to gunshot
      injury.
AB  - A case is reported of a 53-year-old woman who was hit by a bullet which
      penetrated the skull base and caused a left carotid-cavernous fistula of the
      direct type and a pseudoaneurysmal dilation of the high cervical portion of the
      left internal carotid artery. The fistula was successfully embolized by
      positioning a balloon into the fistula itself by means of the Debrun technique:
      unexpectedly the size of the pseudoaneurysm decreased after the embolization; the
      possible explanations for this event are discussed.

PMID- 2215908
TI  - Pseudoaneurysm of the cervical internal carotid artery with associated
      hypoglossal nerve paralysis. Demonstration by CT and angiography.
AB  - A case of pseudoaneurysm of the cervical internal carotid artery with associated
      hypoglossal nerve paralysis resulting from trauma is presented. CT and
      angiographic manifestations of this pseudoaneurysm and the resulting hypoglossal
      nerve paralysis are discussed. Correlative CT and angiographic findings of this
      association have not previously been described in the literature.

PMID- 2215909
TI  - Focal pachygyria with unusual vascular anomaly.
AB  - A case of focal pachygyria with an unusual vascular anomaly is reported.
      Preoperative magnetic resonance imaging demonstrated few and broad gyri, and an
      abnormally thickened cortex of the right frontal lobe. In addition, T2-weighted
      imaging showed a high intensity lesion beneath the thickened cortex. In the
      pachygyric cortex, the peripheral portions of the arteries were tortuous and
      irregularly dilated, and prominent deep medullary veins were found draining into
      the subependymal veins. Histological examination revealed a decreased number of
      neurons with no tendency towards lamination, and degenerative changes with
      gliosis in the white matter. These findings suggest that the etiology of this
      anomaly may be gradual perfusion failure restricted to the territory of the
      anomalous vessels through the period of neuronal migration to the post-migratory,
      perinatal stage.

PMID- 2215910
TI  - Neurinoma of the jugular foramen.

PMID- 2215911
TI  - Magnetic resonance imaging of an intraventricular craniopharyngioma.
AB  - A case of a craniopharyngioma confined entirely to the third ventricle is
      reported. MRI revealed an isointense and high signal lesion on T1- and T2
      weighted images, respectively, with homogeneous enhancement by Gd-DTPA. The tumor
      was reduced by 90% in 4 months after 60 Gy radiation therapy. Intraventricular
      craniopharyngioma is unusual and is not associated with tumoral calcification or
      cyst formation.

PMID- 2215912
TI  - Primary myxoma of the posterior fossa.
AB  - A rare case of primary intracranial myxoma of the posterior fossa is described in
      a 32-year old woman. The patient presented with a history of headaches,
      disequilibrium, nausea and abnormal vision for several months. Computed
      tomography (CT) showed a well-demarcated hypodense mass. After contrast
      administration the mass appeared as an inhomogeneously enhancing lesion
      surrounded by a small rim of edema. The mass was surgically excised with
      histological examination revealing a true myxoma. Echocardiography revealed no
      evidence of a cardiac myxoma. The CT appearance of other case reports of non
      cardiac myxomas in the literature is reviewed.

PMID- 2215913
TI  - Cerebral atrophy in Lyme disease.

PMID- 2215914
TI  - The thresholds of the jaw-opening reflex and trigeminal brainstem neurons to
      tooth-pulp stimulation in acutely and chronically prepared cats.
AB  - Electrical stimuli were applied to tooth-pulp in cats and the thresholds of the
      jaw-opening reflex and of neurons in the trigeminal sensory nuclei were
      determined. The effects of the method of preparation of the animal for
      stereotaxic recording were determined by making observations on animals set up in
      one of three ways: acutely in the usual manner; chronically, three to five days
      before recording; and acutely with precautions to minimize nociceptive input to
      the central nervous system. The threshold of the jaw-opening reflex increased
      progressively during the setting up of the normal, acute preparations and at the
      time brainstem recording began was significantly higher in these than in either
      the chronic or low-trauma acute preparations. Previous studies have shown that
      the increase in threshold is maintained for several hours and is not due to the
      effects of the anaesthetic. In normal acute preparations, few units (27/154) were
      found that had thresholds below 50 microA, 0.1 ms, whereas many units were
      encountered that responded to such a stimulus in chronic (147/152) and low-trauma
      acute (99/127) animals. In the chronic and in low-trauma acute preparations,
      there was no significant difference between the thresholds of the units in the
      main sensory trigeminal nucleus and spinal subnucleus oralis compared with those
      in subnucleus caudalis. Thus the preparation of an animal for stereotaxic
      recording can cause a severe and long-lasting depression in the excitability of
      neurons in the trigeminal sensory nuclei and an increase in the threshold of the
      jaw-opening reflex. This effect will have influenced the results of previous
      studies on the responses evoked in central neurons by stimulation of tooth-pulp,
      and may have similarly affected recordings from other regions.

PMID- 2215916
TI  - Neurotoxic effects of L-alpha-aminoadipic acid on the carp retina: a long term
      observation.
AB  - The hypothesis has been tested that the enantiomers of alpha-aminoadipic acid
      have different target effects; the L-isomer has both glio- and neurotoxic
      actions, while the DL-isomer has a gliospecific action in the CNS.
      Electrophysiological and morphological studies were carried out on the retina of
      the carp (Cyprinus carpio) for one to two months after intraocular injection with
      alpha-aminoadipic acids at various doses. Intracellular recording from horizontal
      cells and extracellular recording of spike discharges from ganglion cells in
      isolated retinal preparations were made from control and pretreated retinas at
      various intervals after intraocular injection with the enantiomers. In control
      retinas, application of 15 mM L-alpha-aminoadipic acid in the superfusate
      resulted in hyperpolarization of all horizontal cells and in a decrease in
      amplitude of their light responses (S-potentials). In the retinas pretreated with
      L-alpha-aminoadipic acid (8 mumol), low amplitude S-potentials were seen during
      an early phase 2-4 h after ocular injection, but the normal appearance of S
      potentials was restored one day after injection. In control retinas, a brief
      period of iontophoretic application of L-alpha-aminoadipic acid resulted in a
      slight activation of the spontaneous spike firing of ganglion cells but a slight
      decrease in the rate of light-induced firing. In retinas pretreated with
      intraocular L-alpha-aminoadipic acid (4 mumol) 4 h prior to eye removal, however,
      light-induced spike discharges were abolished from nearly all spontaneously
      firing ganglion cells (greater than 90%). Their unresponsiveness to light stimuli
      lasted for more than two months after injection, and was accompanied by
      insensitivity to iontophoretically applied putative neurotransmitters.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2215915
TI  - Organization of radial glia and related cells in the developing murine CNS. An
      analysis based upon a new monoclonal antibody marker.
AB  - A monoclonal antibody, RC1, has been generated which provides a selective and
      sensitive immunohistochemical marker of radial glial cells and related cell forms
      during development of the mouse CNS. Beginning on embryonic day E10,
      immunocytochemistry performed on cryostat sections stains throughout the CNS a
      subpopulation of cells in the ventricular zone with radial processes that
      terminate with endfeet at the pial surface. These processes become fasciculated
      and attain maximal densities by E12-14 in the spinal cord and lower brainstem and
      by E14-16 in the midbrain, cerebellum and forebrain. Fasciculation is especially
      prominent for a subclass of these cells at the midline of the brainstem and
      spinal cord. As nuclear and cortical structures develop, the trajectories of the
      radial fiber fascicles undergo systematic and region-specific distortions in
      their initially simple linear configuration, in the process maintaining a
      consistent spatial registration of germinal ventricular zones with distal sites
      of assembly of post-migratory neurons. In the late fetal period, radial glial
      progressively disappear and scattered immature astrocytes bearing multiple fine
      processes appear in most regions of the CNS. In the spinal cord, a transitional
      unipolar radial form is identified in the emerging ventral and lateral funiculi
      between E13 and E17. In the cerebellum, precursors to the unipolar Bergmann glial
      cell are identified by E15, and in the retina, precursors of the bipolar Muller
      cell are identified by E16. Postnatally, RC1-stained radial glia become sparse,
      and after one week, immunoreactive cells include only ependymal cells,
      hypothalamic tanycytes, Bergmann glia, Muller cells, a unipolar radial form in
      the dentate gyrus, and a subpopulation of white matter astrocytes. These results
      suggest that radial cells of astroglial lineage comprise a diverse set of cell
      classes which subserve multiple functions in the developing and adult brain.

PMID- 2215918
TI  - Subpopulations of corticotropin-releasing hormone neurosecretory cells
      distinguished by presence or absence of vasopressin: confirmation with multiple
      corticotropin-releasing hormone antisera.
AB  - Parvocellular corticotropin-releasing hormone neurosecretory cells in the
      hypothalamic paraventricular nucleus project axons to the portal capillary plexus
      in the external zone of the median eminence. Immunocytochemical studies have
      identified two approximately equal subpopulations of these corticotropin
      releasing hormone neurons in normal rats, distinguished by the presence or
      absence of co-existent vasopressin, and different responses to stress. However,
      it was recently proposed that the vasopressin deficient cells do not contain
      corticotropin-releasing hormone, but have been misidentified due to cross
      reactivity of the corticotropin-releasing hormone antiserum to peptide histidine
      isoleucineamide. It is shown here that the same set of corticotropin-releasing
      hormone neurons (including both vasopressin expressing and vasopressin deficient
      subtypes) was labeled with multiple corticotropin-releasing hormone antisera.
      These included two antisera that did not cross-react with peptide histidine
      isoleucineamide: one against ovine corticotropin-releasing hormone, and one rat
      corticotropin-releasing hormone antiserum absorbed with peptide histidine
      isoleucineamide. The results provide further support for the hypothesis of
      functionally distinct compartments of the corticotropin-releasing hormone
      neurosecretory system that can modulate the ratio of vasopressin to corticotropin
      releasing hormone in portal blood.

PMID- 2215917
TI  - Pattern adaptation in cat visual cortex is a co-operative phenomenon.
AB  - The effects of microiontophoretic application of glutamate, GABA and the GABA
      antagonist, bicuculline methiodide were tested on the degree of adaptation
      exhibited by striate cortical cells to moving sin wave grating patterns.
      Application of GABA, which prevents firing of the cell and thereby any fatigue of
      the cell, did not reduce the degree of adaptation. Administration of either
      glutamate or GABA, without simultaneous exposure to the adapting high-contrast
      gratings did not reduce the sensitivity of the cell to subsequent exposure of a
      low-contrast grating, showing that adaptation is not caused by the excitatory or
      inhibitory activity of the cell itself. Application of the GABA antagonist,
      bicuculline did not prevent pattern adaptation, indicating that the lowered
      sensitivity of the cell is not mediated by a GABAergic inhibition acting on the
      cell. Thus adaptation of a striate neuron is not due to altered sensitivity of
      the cell to a constant input but depends upon changes in the input itself. It is
      most likely that these changes occur in a co-operative cortical network, whose
      effect on individual cortical cells is mediated by intracortical excitatory
      connections.

PMID- 2215920
TI  - Fine structural changes in the superior cervical ganglion of adult rats after
      long-term administration of baclofen, a GABAB receptor agonist.
AB  - The aim of the present study was to examine the fine structural changes in the
      superior cervical ganglion of adult rats following baclofen treatment. On the
      addition of this GABAB receptor agonist there was a transient increase in the
      number of coated vesicles and pits in the dendrites of principal sympathetic
      neurons. As compared to the control ganglia, we found a significantly higher
      number of synapses which had coated pits attached to the postsynaptic densities.
      In interpreting these observations it is suggested that the GABAB receptors play
      some role in mediating the synaptogenetic action of GABA, although the formation
      of vacant postsynaptic densities and spines was not seen after baclofen
      treatment.

PMID- 2215919
TI  - Ontogeny of the neuronal intermediate filament protein, peripherin, in the mouse
      embryo.
AB  - The expression of peripherin, a type III neuron-specific intermediate filament
      protein, and the middle neurofilament subunit were studied in the mouse embryo
      using immunofluorescence staining. The earliest staining for both proteins is
      seen at embryonic day 9 in the myelencephalon, initially as fiber staining
      followed by cell body staining in the developing facial and acoustic nuclei. As
      the embryo develops, there is rostral as well as caudal extension of peripherin
      and staining is seen in the trigeminal ganglia, nerve fibers and in the enteric
      nervous system. As the spinal cord forms there is anti-peripherin staining in
      developing motoneurons of the anterior horns while little cell body staining is
      seen for the middle neurofilament subunit. Both antibodies stain the developing
      dorsal root and its entry zone, but peripherin is found in the secondary sensory
      and commissural fibers while the middle neurofilament subunit is not. While both
      proteins are found in the neurons of the dorsal root ganglia, their distribution
      varies. The larger peripheral cells of the ganglia contain both proteins while
      the smaller more central cells, constituting over 60% of the cells in the
      ganglia, contain only peripherin. A similar picture is found in the sympathetic
      ganglia where there are cells which contain peripherin. middle neurofilament
      subunit or both, but where the majority of the neurons have only peripherin in
      their cell bodies. Peripherin is not found in the developing retina or in the
      adrenal medulla. Peripherin is also completely absent from cell bodies in the
      cerebral and cerebellar cortices. These results indicate that peripherin is found
      in development only in regions in which it is found in the adult. It can either
      co-exist with neurofilaments in the same neuron or the two may be independently
      expressed.

PMID- 2215921
TI  - Continuous presence of nerve growth factor is required for maintenance of
      cholinergic septal neurons in organotypic slice cultures.
AB  - In co-cultures of rat septum and hippocampus, cholinergic neurons, identified by
      immunocytochemical techniques using antibodies against choline acetyltransferase,
      were found to be exclusively located in septal tissue. The presence of nerve
      growth factor during the entire growth period of four weeks increased the
      activities of acetylcholinesterase and choline acetyltransferase about 10-fold
      and strongly increased the number of acetylcholinesterase-positive neurons.
      Application of nerve growth factor yielded different effects depending on the age
      of the cultures. During the first two weeks in vitro, nerve growth factor
      enhanced the number of acetylcholinesterase-positive neurons, an effect which was
      no longer observed following later applications of nerve growth factor. Nerve
      growth factor increased the activities of cholinergic enzymes during all phases
      of in vitro development, but the effects of one-week applications were always
      considerably smaller than those observed following continuous application of
      nerve growth factor. The results of different application schedules suggest that
      the continuous presence of nerve growth factor is needed for maximal increases in
      cholinergic enzyme activities and maintenance of cholinergic neurons in
      septohippocampal co-cultures.

PMID- 2215922
TI  - Transected spinal cords grafted with in situ self-assembled collagen matrices.
AB  - The purpose of this work was to evaluate if the implantation into the gap of a
      transected spinal cord of a biomaterial providing a scaffolding structure for
      tissue ingrowth would favor the permeation and the growth of regenerating axons
      across the spinal-bioimplant interface. The interstump gap of rat transected
      spinal cords was injected with an ice-cold neutral solution of collagen, either
      alone or mixed with glyoxal, a harmless tanning agent. Upon warming to the
      temperature of the tissue, the fluid implant self-assembled forming a loose
      fibrillar network which simultaneously re-established a physical continuity to
      the transected organ. At various post-implantation timepoints, the bioimplants
      were studied by light microscopy, with the picrosirius-polarization method and
      with scanning electron microscopy. We observed that the bioimplants evolved
      following three overlapping phases: first a massive inflammatory response
      characterized by the invasion of cells of heterogeneous nature, then, a phase
      where microcysts predominated and during which, there is a major remodeling of
      the biomatrix by the deposition of newly synthesized collagen and of a periodic
      acid Schiff-positive material. Finally, a regeneration phase occurred where
      astroglial processes followed by regenerating axons invaded the biomatrix. Three
      months after implantation, spinal axons had grown from the two spinal stumps and
      penetrated the bioimplant across at least one lesion interface. However, the
      glyoxal-tanned collagen matrices showed a better biostability and durability than
      collagen alone. We conclude that the histopathological reaction of the mammalian
      lesioned spinal cord, when adequately directed by a scaffolding structure can be
      beneficial for the expression of the intrinsic regenerative capacity of the
      spinal cord tissue.

PMID- 2215924
TI  - Changing patterns of c-fos induction in spinal neurons following thermal
      cutaneous stimulation in the rat.
AB  - Patterns of neuronal activity in the lumbar spinal cord of the anaesthetized rat
      were mapped by immunocytochemical localization of the c-fos gene product, Fos
      protein, at different timepoints following brief noxious stimulation of one
      hindpaw (20 s immersion in water at 52 degrees C). After 2 h, Fos-immunoreactive
      neurons were seen mainly in the superficial laminae of the ipsilateral dorsal
      horn, with maximum somatotopic organization in lamina II. Subcutaneous injection
      of dilute formalin produced a similar pattern of immunostaining at 2 h, with a
      greater proportion of Fos-positive neurons in laminae III-VIII than with heat.
      With a survival time of 8 h following formalin injection, Fos immunoreactivity
      was virtually absent from the spinal cord. Eight hours after heat stimulation,
      however, the superficial pattern had given way to the appearance of a population
      of immunoreactive cells in the deeper laminae. The pattern of this "second wave"
      of heat-induced Fos-positive cells had a marked contralateral component, and was
      still present after 24 h, having become even more diffuse and symmetrical. The
      number of Fos-positive cells seen at 8 h was increased by local anaesthetic
      blockade of the peripheral nerve after stimulation, and reduced by continuous
      barbiturate anaesthesia. These findings suggest that the early stages of thermal
      injury trigger a complex pattern of molecular events within the spinal cord,
      which are initially monosynaptic and closely related to primary afferent terminal
      depolarization, and in the longer term the result of an induced pattern of
      synaptic activity set up within the spinal cord.

PMID- 2215923
TI  - Topographical localization of neurons containing parvalbumin and choline
      acetyltransferase in the medial septum-diagonal band region of the rat.
AB  - The normal morphology and distribution of parvalbumin-containing neurons (shown
      in a previous study to be GABAergic nerve cells) of the medial septal-diagonal
      band region of the adult rat brain have been studied, and the findings compared
      with observations on choline acetyltransferase-immunoreactive neurons. The two
      antigens were visualized either in the same sections using a double-label
      immunohistochemical procedure for the simultaneous localization of parvalbumin
      and choline acetyltransferase, or in immediately adjacent sections. In double
      stained sections of the whole medial septal-diagonal band complex, about 34% of
      the total neurons showed immunoreactivity to parvalbumin; the proportion of
      parvalbumin-labelled neurons was slightly higher in the medial septal-vertical
      limb of the diagonal band region, and much lower in the horizontal limb of the
      diagonal band region. The distribution of parvalbumin- and choline
      acetyltransferase-containing neurons also varied markedly between different
      mediolateral subdivisions of the medial septum: about 30, 65 and 2% of the
      parvalbumin-immunoreactive neurons were present in the midline, medial and
      lateral part of the medial septum, respectively. At different rostrocaudal
      levels, the proportion of parvalbumin- and choline acetyltransferase-positive
      neurons varied in a consistent manner, and the largest number of parvalbumin
      containing neurons was found at the level 1.9 mm anterior to the bregma. In the
      absence of reliable immunocytochemical methods for the localization of glutamate
      decarboxylase and GABA, parvalbumin may serve as a good marker for studying the
      distribution of GABAergic neurons in the medial septum-diagonal band region.
      Moreover, the precise maps reported in the present study of the topographic
      localization of parvalbumin-containing GABAergic and choline acetyltransferase
      immunoreactive cholinergic nerve cells in the medial septal-diagonal band complex
      will serve as a useful guide in future morphological and electrophysiological
      studies on the septum and its efferents.

PMID- 2215925
TI  - The brain and the immune system: an intact immune system is essential for the
      manifestation of withdrawal in opiate addicted rats.
AB  - Gamma irradiation (500 rad) is often used to suppress the immune system in mice,
      rats and man. Recently, it was shown that irradiation prior to chronic morphine
      treatment, dramatically reduces the severity of naloxone-precipitated withdrawal
      in morphine-dependent animals. In the present study adoptive transfer of 2-6 x
      10(8) splenocytes to irradiated rats prior to chronic morphine treatment restored
      the severity of all withdrawal signs precipitated by naloxone. In contrast,
      adoptive transfer of fractionated splenocyte subpopulations only partially
      restored withdrawal severity; and transfer of irradiated splenocytes, red blood
      cells or diluted numbers of normal splenocytes did not have any observed
      restorative effect. These findings suggest that specific cellular activities or
      factors derived from lymphoid cells are required for the expression of opiate
      withdrawal.

PMID- 2215926
TI  - Cerebellotectal pathways in the macaque: implications for collicular generation
      of saccades.
AB  - The cerebellum is thought to modulate saccadic activity in the primate in order
      to maintain targeting accuracy, and the cerebellotectal pathway has been posited
      to play a role in this modulation. However, anatomical descriptions of this
      pathway in primates are sketchy and conflicting. To determine whether the
      organization of the cerebellotectal projection in primates is similar to that
      found in other species, neuroanatomical tracer transport techniques were utilized
      in two species of macaque monkey to label cerebellotectal somata and fiber
      terminations. Two pathways were found. One, the fastigiotectal pathway, is
      derived from cells in the caudal fastigial nucleus and projects bilaterally to
      the rostral end of the intermediate gray layer. The other pathway is derived from
      cells in the posterior interposed nucleus and the adjacent posterior wing of the
      dentate nucleus, and it terminates contralaterally throughout the ventral half of
      the intermediate gray and the deep gray layers. Both of these pathways terminate
      within the layers of the superior colliculus containing premotor, saccade-related
      neurons, but the differences in the distribution of their terminals and cells of
      origin suggest that these two pathways have different functions. Furthermore, the
      pattern of connections of these two pathways indicates that they do not function
      as a traditional feedback circuit. We suggest that the cerebellotectal pathways
      may instead modulate collicular activity in a more complex manner. For example,
      it may provide signals necessary for corrective saccades or for maintaining
      spatial registry between the different sensory representations supplied to the
      superior colliculus and its presaccadic output, which is organized into a motor
      map.

PMID- 2215927
TI  - Acetylcholine release in the rat hippocampus as studied by microdialysis is
      dependent on axonal impulse flow and increases during behavioural activation.
AB  - Changes in extracellular levels of acetylcholine and choline in the hippocampal
      formation were measured using intracerebral microdialysis coupled to high
      performance liquid chromatography with post-column enzyme reaction and
      electrochemical detection. Various pharmacological and physiological
      manipulations were applied to awake unrestrained normal rats and rats subjected
      to a cholinergic denervation of the hippocampus by a complete fimbria-fornix
      lesion (1-2 weeks previously). Low baseline levels of acetylcholine (about 0.3
      pmol/15 min sample) could be detected in the absence of acetylcholinesterase
      inhibition in all animals. However, in order to obtain stable and more readily
      detectable levels, the acetylcholinesterase inhibitor neostigmine was added to
      the perfusion medium at a concentration of 5 or 10 microM and was used during all
      subsequent manipulations. Addition of neostigmine increased acetylcholine levels
      approximately 10-fold (to 3.7 pmol 15 min) in the normal rats, which was about 4
      fold higher than the levels recovered from the denervated hippocampi.
      Depolarization by adding KCl (100 mM) to the perfusion fluid produced a 3-fold
      increase in the extracellular acetylcholine levels, and the muscarinic antagonist
      atropine (3 microM) resulted in a 4-fold increase in the normal rats, whereas
      these drugs induced only small responses in the denervated rats. Neuronal impulse
      blockade by tetrodotoxin (1 microM) resulted, in normal rats, in a 70% reduction
      in extracellular acetylcholine levels. Sensory stimulation by handling increased
      acetylcholine levels by 94% in the normal rats, whereas this response was almost
      totally abolished in the denervated hippocampi. Behavioural activation by
      electrical stimulation of the lateral habenula resulted in a 4-fold increase in
      acetylcholine release in normal animals, and this response was totally blocked by
      a transection of the lateral habenular efferents running in the fasciculus
      retroflexus. The levels obtained by lateral habenula stimulation were reduced by
      about 95% in the rats with fimbria-fornix lesions. Following an acute knife
      transection of the fimbria-fornix performed during ongoing dialysis,
      acetylcholine levels dropped instantaneously by 70%, indicating that the
      extracellular acetylcholine levels in the hippocampus are maintained by a tonic
      impulse flow in the septohippocampal pathway. The extracellular levels of choline
      were reduced by about 30% after the addition of neostigmine in the normal rats,
      and increased by about 50% in both normal and denervated rats after addition of
      KCl to the perfusion fluid. No changes could be detected after atropine,
      handling, lateral habenula stimulation, or acute fimbria-fornix or fasciculus
      retroflexus transection.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2215928
TI  - Membrane properties of interneurons in stratum oriens-alveus of the CA1 region of
      rat hippocampus in vitro.
AB  - The membrane properties of interneurons situated near the border of stratum
      oriens and the alveus of the CA1 region were examined with intracellular
      recording and staining in rat hippocampal slices in vitro. Cellular staining with
      Lucifer Yellow indicated that the somata of these interneurons were multipolar
      and their dendrites projected horizontally along the alveus and vertically toward
      stratum lacunosum-moleculare. Intrinsic properties (input resistance, action
      potential amplitude, time constant) and spike after-potentials were typical of
      non-pyramidal cells. Action potential duration, however, was of relatively medium
      duration (1.15 ms) and slow afterhyperpolarizations followed depolarization
      induced trains of action potentials. Spontaneous activity of interneurons was
      prominent and of either of two types: single action potentials or high frequency
      bursts of action potentials. Interneurons displayed marked, voltage- and time
      dependent inward rectification and anodal break excitation. Analysis of the slope
      of the charging function of hyperpolarizing transients, suggested that these
      interneurons were electrically compact (dendrite to soma conductance ratio, p
      approximately 2.7; and electrotonic length constant, L approximately 1.1).
      Characteristically, interneurons sustained high frequency repetitive firing
      during long depolarizing pulses. The slope of the frequency-current relation was
      442 Hz/nA for the first interspike interval and 117 Hz/nA for later intervals
      (no. 60), suggesting the presence of spike frequency adaptation. Physiologically,
      these interneurons resembled more closely basket cells of stratum pyramidale than
      stellate cells of stratum lacunosum-moleculare.

PMID- 2215930
TI  - Quantitative autoradiographical analysis of the age-related modulation of central
      dopamine D1 and D2 receptors.
AB  - Quantitative autoradiography of [3H]SCH 23390 and [3H](-)-sulpiride binding was
      performed in the brain of rats of various ages (3, 11 and 24 months) in order to
      study the changes in D1 and D2 receptor density with age. Binding of [3H]SCH
      23390 in the caudate-putamen decreased progressively and markedly at rostral
      levels in 11- and 24- compared with 3-month-old rats (max. decrease -63%) while
      at caudal levels significant decrease was observed only in 24-month-old rats.
      [3H](-)-Sulpiride binding progressively decreased during aging in the caudate
      putamen at rostral levels and the decrease was more pronounced laterally (-70% at
      24 months), while at caudal levels no significant decrease was observed. D1 and
      D2 binding sites also decreased in the nucleus accumbens and olfactory tubercle
      of aged rats, while in the substantia nigra only the D1 receptors appeared to be
      modified with aging. No change was found in the entopeduncular nucleus, amygdala,
      frontoparietal, suprarinal-prefrontal and anterior cingulate cortex. The results
      indicate that the age-associated decrease of D1 and D2 receptors is not
      widespread, being confined to dopaminergic areas with high density of dopamine
      receptors.

PMID- 2215929
TI  - Immunocytochemical localization of cholinergic terminals in the region of the
      nucleus basalis magnocellularis of the rat: a correlated light and electron
      microscopic study.
AB  - The cholinergic circuitry in the nucleus basalis magnocellularis of the rat was
      investigated in a correlated light and electron microscopic study by using
      monoclonal antibodies against the acetylcholine-synthesizing enzyme, choline
      acetyltransferase, following the unlabelled antibody peroxidase-antiperoxidase
      immunocytochemical procedure. After the immunocytochemical approach, large
      cholinergic cells and a few immunoreactive fibres exhibiting a varicose
      appearance, were detected by light microscopy in portions of the nucleus basalis
      magnocellularis located within the anatomical limits of the globus pallidus,
      mostly in its ventromedial part. Cholinergic neurons and fibre-like structures
      were also found within the substantia innominata on the edge of globus pallidus.
      The same material studied by light microscopy was analysed with the electron
      microscope. At the ultrastructural level, the immunopositive neurons showed the
      same cytological characteristics and pattern of synaptic input as cholinergic
      basal forebrain cells. Additionally, scarce immunoreactive preterminal axons and
      terminal boutons were detected in the region. The immunoreactive terminals were
      scattered or formed occasional clusters and appeared as heavily immunostained
      vesicle-filled boutons making exclusively axodendritic synaptic contacts
      principally with immunonegative distal dendrites. Both symmetric and asymmetric
      synaptic contacts established between these structures were detected, although
      the symmetric contacts were the more numerous. The surface of postsynaptic
      immunonegative dendrites in asymmetric synaptic contact with immunoreactive
      terminals was generally covered by terminals that lacked detectable
      immunoreactivity. In contrast, those in symmetric synaptic contact with labelled
      terminals showed much sparser input from immunonegative terminals, suggesting
      that they may belong to interneurons. Very rarely, cholinergic terminals were
      detected in asymmetric synaptic contact with dendrites which also contained
      positive immunoreaction product. Asymmetric contacts were frequently
      characterized by the presence of subjunctional dense bodies. The detection of
      cholinergic terminals in the region of the nucleus basalis magnocellularis of the
      rat indicates that this region not only contains cholinergic projecting neurons,
      but receives a cholinergic input itself. Results of this study provide evidence
      of the existence of a cholinergic transmission in the basal forebrain of the rat,
      and also that acetylcholine might play a role in the regulation of the extrinsic
      cortical cholinergic innervation. The possible sources of this innervation are
      discussed.

PMID- 2215931
TI  - Uptake and metabolism of [3H]choline mustard by cholinergic nerve terminals from
      rat brain.
AB  - The objective of this study was to measure the uptake and metabolism of
      [3H]choline mustard aziridinium ion in rat brain synaptosomes. In previous
      investigations, we showed that this compound binds irreversibly to the choline
      carrier thereby inhibiting choline transport into nerve terminals; it also acts
      as both a substrate and inhibitor of the acetylcholine biosynthetic enzyme
      choline acetyltransferase. We now report that [3H]choline mustard aziridinium ion
      was transported into purified rat brain synaptosomes by a hemicholinium-sensitive
      mechanism, but at only a fraction of the rate of uptake of [3H]choline. Following
      5 min incubation with the nerve terminal preparation, uptake of [3H]choline
      mustard aziridinium ion was 20% of that of [3H]choline transport, but this fell
      to 10% of [3H]choline accumulation at 30 min incubation. Apparent Michaelis
      constants derived from double reciprocal plots of velocity of transport versus
      substrate concentration revealed that the apparent affinity constants (Km) of the
      high-affinity choline carrier for [3H]choline mustard aziridinium ion and
      [3H]choline were not different (1.44 +/- 0.15 and 2.14 +/- 0.80 microM for
      choline and choline mustard aziridinium ion, respectively). Increasing the
      incubation time from 5 to 30 min, during which time a proportion of the high
      affinity choline carriers were irreversibly inactivated by choline mustard
      aziridinium ion, did not alter the binding affinity for this compound. The
      maximum velocity of transport (Vmax) for the two compounds were significantly
      different with the maximum uptake of [3H]choline mustard aziridinium ion being
      19.5% of that for choline at 5 min incubation, and falling to only 10.6% of the
      maximum rate of choline transport by 30 min incubation. [3H]Choline mustard
      aziridinium ion transported into synaptosomes on the high-affinity choline
      carrier was metabolized, with 27% being recovered as [3H]acetylcholine mustard
      aziridinium ion, 27% as [3H]phosphorylcholine mustard aziridinium ion, 7% as
      unmetabolized [3H]choline mustard aziridinium ion and 16% recovered as an
      unidentified metabolite. In parallel samples, [3H]choline taken up into
      synaptosomes was recovered as [3H]acetylcholine (71%) and unmetabolized
      [3H]choline (18%) with no net production of [3H]phosphorylcholine. Acetylation of
      [3H]choline mustard aziridinium ion amounted to only 7.6% of [3H]acetylcholine
      synthesized under the same conditions. These results show clearly that choline
      mustard aziridinium ion was accumulated into the cholinergic nerve terminals by
      the high-affinity choline carrier, but the amount was small relative to the
      uptake of choline and probably restricted by progressive inactivation of the
      transporters through covalent bond formation.

PMID- 2215933
TI  - Sensory responses of caudal trigeminal neurons to thermal and mechanical stimuli
      and their behavioural correlates in the rat.
AB  - Behavioural experiments in the freely moving rat were carried out to determine
      thermal and mechanical nociceptive thresholds to ramp stimuli applied to the
      face. The mean thermal escape threshold was 43.5 degrees C, and the mean
      mechanical escape threshold was 179.2 g/mm2. In a parallel set of experiments
      recordings were made from single neurons in the caudal trigeminal nucleus of the
      anaesthetized rat. Neurons were classified according to their responses to a
      range of thermal and mechanical stimuli applied to the face. Three classes of
      neuron responded exclusively to mechanical stimuli and four classes responded to
      thermal stimuli (usually in addition to responding to mechanical stimuli). The
      mean thermal threshold of neurons responsive to warming stimulation was 44.4
      degrees C. Neurons responsive to innocuous warming were located in deeper
      laminae. Many of the neurons responsive to noxious heat appeared to show an
      exponential relation between temperature and firing rate. An argument is made for
      a direct role of exponentially responding neurons in thermal nociception. The
      distribution of all neuronal response thresholds was left-skewed compared with a
      normal distribution, whereas the behavioural escape thresholds approximated a
      normal distribution.

PMID- 2215932
TI  - Neuropeptide Y co-exists with vasoactive intestinal polypeptide and acetylcholine
      in parasympathetic cerebrovascular nerves originating in the sphenopalatine,
      otic, and internal carotid ganglia of the rat.
AB  - Neuropeptide Y co-exists with noradrenaline in the majority of the sympathetic
      nerves supplying cerebral blood vessels. However, after sympathectomy in the rat
      the number of cerebrovascular neuropeptide Y nerve fibers are only reduced in
      number despite a complete disappearance of the adrenergic markers. The origin of
      these non-sympathetic neuropeptide Y fibers was studied by nerve transections and
      retrograde axonal tracing utilizing True Blue. Three days after bilateral
      superior cervical sympathectomy, the number of neuropeptide Y-containing nerve
      fibers decreased to about 40% of that in non-treated animals. One week after True
      Blue application on the proximal portion of the middle cerebral artery, the
      tracer accumulated in neurons of the sphenopalatine, otic, and internal carotid
      ganglia. Of these cells 80%, 95% and 5%, respectively, were neuropeptide Y
      positive. Some of the True Blue/neuropeptide Y-positive cells displayed
      immunoreactivity for vasoactive intestinal polypeptide and some were positive for
      choline acetyltransferase. Two weeks after bilateral removal of the
      sphenopalatine ganglion or transection of postganglionic fibers from the ganglion
      reaching the pial vessels through the ethmoidal foramen, together with subsequent
      sympathectomy, no neuropeptide Y-containing nerve fibers could be observed on the
      anterior cerebral and internal ethmoidal artery or the distal portion of the
      middle cerebral artery, whereas a few nerve fibers remained on the proximal
      portion of the middle cerebral artery, internal carotid artery, and the rostral
      portion of the basilar artery. In conclusion, neuropeptide Y in cerebrovascular
      nerves is co-stored not only with noradrenaline in sympathetic nerves from the
      superior cervical ganglion, but also with acetylcholine (reflected in the
      presence of choline acetyltransferase) and vasoactive intestinal polypeptide in
      parasympathetic nerves originating in the sphenopalatine, otic, and internal
      carotid ganglia.

PMID- 2215934
TI  - Implementation plan for the decade of the brain: executive summary.

PMID- 2215935
TI  - The transformation of neurologic practice.

PMID- 2215936
TI  - Pre-trigeminal neuralgia.
AB  - Eighteen patients who subsequently developed typical trigeminal neuralgia
      experienced a prodromal pain termed "pre-trigeminal neuralgia." These patients
      described their prodromal pain as a toothache or sinusitis-like pain lasting up
      to several hours, sometimes triggered by jaw movements or by drinking hot or cold
      liquids. Typical trigeminal neuralgia developed a few days to 12 years later, and
      in all cases affected the same division of the trigeminal nerve. Six additional
      patients experiencing what appeared to be pre-trigeminal neuralgia became pain
      free when taking carbamazepine or baclofen. Recognition of pretrigeminal
      neuralgia makes it possible to relieve the pain with appropriate medications and
      avoid unnecessary irreversible dental procedures.

PMID- 2215937
TI  - Hemiplegia in posterior cerebral artery occlusion.
AB  - We report 4 patients with hemiplegia due to a posterior cerebral artery
      occlusion. Associated clinical signs were aphasia, alexia or a neglect syndrome,
      hemianopia, and hemisensory loss. Hemiplegia was due to infarction in the lateral
      midbrain. The level of the occlusion in the posterior cerebral artery may be
      located distal to the junction with the posterior communicating artery.

PMID- 2215938
TI  - Capsular genu syndrome.
AB  - We report 5 patients with unilateral infarct and 1 with hemorrhage limited to the
      genu of the internal capsule. The most prominent finding was contralateral facial
      and lingual hemiparesis with dysarthria. Three patients also showed unilateral
      mastication-palatal-pharyngeal weakness, and 1 had unilateral vocal cord paresis.
      Mild limb involvement was limited to hand weakness in 4 patients. Our findings
      suggest that the majority of motor corticopontine and corticocobulbar fibers are
      located in the genu of the internal capsule. The faciolingual syndrome and its
      variants are highly suggestive of capsular genu stroke.

PMID- 2215939
TI  - Tonic contraversive ocular tilt reaction due to unilateral meso-diencephalic
      lesion.
AB  - We studied 4 patients with tonic contraversive ocular tilt reactions due to
      unilateral, paramedian, mesodiencephalic lesions. This is in contrast to the only
      2 previously reported patients with ocular tilt reactions due to unilateral
      mesodiencephalic lesions, each of whom had a paroxysmal ipsiversive ocular tilt
      reaction. This new finding is considered in the context of previous clinical and
      experimental data on the various types of ocular tilt reactions that follow
      stimulation or destruction of the peripheral and central vestibular system.
      Otolithic inputs to the interstitial nucleus of Cajal from the contralateral
      vestibular nucleus and motor outputs from the interstitial nucleus of Cajal to
      cervical and ocular motoneurons could be involved in the ocular tilt reaction. We
      propose that in patients with unilateral meso-diencephalic lesions, a tonic
      contraversive ocular tilt reaction could be due to persistently decreased resting
      activity of ipsilateral interstitial nucleus neurons, whereas a paroxysmal
      ipsiversive ocular tilt reaction could be due to transiently increased activity
      of the same interstitial nucleus neurons. Cases of ocular tilt reaction due to
      unilateral meso-diencephalic lesion point to the existence of a crossed
      graviceptive pathway between the vestibular nucleus and the contralateral
      interstitial nucleus of Cajal.

PMID- 2215940
TI  - Acute naming deficits following dominant temporal lobectomy: prediction by age at
      1st risk for seizures.
AB  - Age at 1st risk for seizures may predict anomia following dominant anterior
      temporal lobectomy. We assessed confrontation naming before and 2 to 3 weeks
      after surgery in 45 right-handed patients grouped by side of focus and presence
      or absence of early (less than or equal to 5 years) risk factors. After left
      lobectomy, 6 of 10 (60%) patients with no early risks demonstrated significant
      decline (greater than or equal to 25%) in naming, but none of the patients with
      early risks showed this decline. After right lobectomy, there was no change.
      Cerebral representation of naming may be atypical in patients with early risks.

PMID- 2215941
TI  - An estimate of the incidence of dementia in idiopathic Parkinson's disease.
AB  - The proportion of patients with idiopathic Parkinson's disease (PD) who are
      considered demented ranges from 10% to 15%. Because dementia may affect survival
      in PD, the incidence rate of dementia, rather than proportion, would be a more
      accurate measure of disease frequency. We previously estimated the proportion of
      patients with PD and dementia to be 10.9% from the records of a cohort with the
      idiopathic form of PD in a major medical center. We reviewed the clinical records
      of this cohort after 4 years and 9 months to estimate the incidence rate of
      dementia. We identified 65 new cases of dementia from the 249 patient-records
      available. Using the number of person-years of follow-up for each case as the
      denominator, we estimated the overall incidence rate to be 69 per 1,000 person
      years of observation. The mean age of this cohort was 71.4 years. The cumulative
      incidence of dementia increased with age. By 85 years of age, over 65% of the
      surviving members of the cohort were demented. The age-specific incidence rates
      for dementia in this cohort of PD were significantly greater than for a similarly
      aged cohort of healthy elderly people. The age-specific standard morbidity ratios
      indicated that, compared with people of similar ages, patients with PD have the
      highest increase in risk for dementia between ages 65 and 75.

PMID- 2215942
TI  - Reliability of NINCDS-ADRDA clinical criteria for the diagnosis of Alzheimer's
      disease.
AB  - Although the NINCDS-ADRDA Work Group has recently developed uniform clinical
      criteria for the diagnosis of Alzheimer's disease (AD), inter-rater reliability
      studies of these criteria are few. We report a study in which 2 neurologists and
      2 psychiatrists independently reviewed clinical data abstracted from the records
      of 30 demented subjects and 10 nondemented control subjects participating in a
      longitudinal study of AD at the University of Pittsburgh. We recorded the
      clinical data on a standardized form; the subjects' identity and clinical and
      pathologic diagnoses were omitted. Each physician diagnosed each case according
      to the NINCDS-ADRDA criteria. We calculated the inter-rater agreement for all
      possible 2-way combinations of clinicians with the Kappa statistic, which ranged
      from 0.36 (fair agreement) to 0.65 (substantial agreement). We conclude that
      current NINCDS-ADRDA criteria enable moderate levels of agreement among
      clinicians in general.

PMID- 2215943
TI  - Variable expression of Parkinson's disease: a base-line analysis of the DATATOP
      cohort. The Parkinson Study Group.
AB  - The DATATOP database, which includes clinical information on 800 patients with
      early untreated Parkinson's disease (PD), is well suited to explore clinical
      heterogeneity in PD. Patients with early-onset PD (less than or equal to 40
      years, N = 33) reached the same level of disability as the late-onset PD (greater
      than or equal to 70 years, N = 85) group at a significantly slower rate (2.9 vs.
      1.7 years). Early-onset PD patients functioned cognitively better than late-onset
      PD patients. Bradykinesia, and postural instability and gait difficulty (PIGD),
      were more common at onset in patients with a rapid rate of disease progression
      ("malignant PD"; duration of symptoms less than 1 year and Hoehn/Yahr stage of
      2.5, N = 11) as compared with those with a relatively slow rate of progression
      ("benign PD"; duration of symptoms greater than 4 years, N = 65). Comparisons of
      tremor-dominant PD (mean tremor score/mean PIGD score less than or equal to 1.5,
      N = 441) with the PIGD-dominant type (mean tremor score/mean PIGD score greater
      than or equal to 1.0, N = 233) provided support for the existence of clinical
      subtypes. The PIGD group reported significantly greater subjective intellectual,
      motor, and occupational impairment than the tremor group. Stage II patients had
      higher depression scores than stage I patients. Among the patients participating
      in the DATATOP, older age at onset with bradykinesia, or with the PIGD form of
      PD, is associated with more functional disability than when the symptoms are
      dominated by tremor or begin at a younger age.

PMID- 2215944
TI  - Borrelia burgdorferi infection of the brain: characterization of the organism and
      response to antibiotics and immune sera in the mouse model.
AB  - To learn more about the neurologic involvement in Lyme disease, we inoculated
      inbred mice with the causative agent of Lyme disease, Borrelia burgdorferi. We
      cultured brains and other organs, and measured anti-B burgdorferi antibody
      titers. We further studied a brain isolate for its plasmid DNA content and its
      response in vitro to immune sera and antibiotics. One strain of B burgdorferi,
      N40, was consistently infective for mice, and resulted in chronic infection of
      the bladder and spleen. SJL mice developed fewer culture-positive organs and had
      lower antibody titers than Balb/c and C57Bl/6 mice. Organism was cultured from
      the brain early in the course of infection, and this isolate, named N40Br, was
      further studied in vitro. The plasmid content of N40Br was different from that of
      the infecting strain, implying either a highly selective process during infection
      or DNA rearrangement in the organism in vivo. N40Br was very sensitive to
      antibiotics, but only after prolonged incubation. Immune sera from both mice and
      humans infected with B burgdorferi were unable to completely kill the organism by
      complement-mediated cytotoxicity. These data demonstrate that B burgdorferi
      infects the brain of experimental animals, and is resistant to immune sera in
      vitro but sensitive to prolonged treatment with antibiotics.

PMID- 2215945
TI  - Chinese-white differences in the distribution of occlusive cerebrovascular
      disease.
AB  - The distribution of cerebrovascular lesions is affected by race. Blacks and
      Japanese have more intracranial occlusive cerebrovascular disease, while whites
      have more extracranial disease. Despite a high incidence of stroke in China,
      there are few formal studies of the distribution of vascular occlusive disease in
      Chinese populations. We compared clinical and angiographic features of 24 white
      and 24 Chinese patients with symptomatic occlusive cerebrovascular disease. In
      symptomatic vascular territories, whites had more severe (greater than or equal
      to 50% stenosis) extracranial lesions, while Chinese had more severe intracranial
      lesions. When we counted mild and severe lesions in a symptomatic territory,
      whites had more extracranial lesions while Chinese had more intracranial lesions.
      When we combined symptomatic and asymptomatic territories, whites had more
      extracranial lesions, while Chinese had more intracranial lesions. White patients
      reported more transient ischemic attacks. The distribution of lesions, however,
      was not explained by differences in incidence of transient ischemia,
      hypertension, diabetes, hypercholesterolemia, or ischemic heart disease between
      the groups. The preponderance of intracranial vascular lesions in Chinese
      patients is similar to that seen in blacks and Japanese. Racial differences in
      the occurrence of extracranial and intracranial lesions raise the possibility of
      a different underlying pathophysiology for the 2 locations.

PMID- 2215946
TI  - Multiple sclerosis sibling pairs: clustered onset and familial predisposition.
AB  - We evaluated 48 relapsing-remitting multiple sclerosis (R/R MS) sibling pairs
      derived from 44 families for age and date of onset of MS symptoms, clinical
      course, and family history of MS. Age- and sex-matched R/R MS clinic patients
      provided a statistical comparison group. The age of onset tended to cluster
      within multiplex families. The initial symptom of MS occurred within 5 years of
      age in 30/48 sibling pairs compared with 16/48 controls. A positive family
      history of MS (other than siblings) was present in 43% of the multiplex families
      compared with 20% among simplex controls. In 1st-, 2nd-, and 3rd-degree relatives
      who had lived into the age at risk, 22/1,134 family members of multiplex sibling
      pairs had probable or definite MS compared with 10/1,215 control family members.
      Age of onset clustering in siblings concordant for R/R MS and an increased risk
      of MS in other family members suggest that factors influencing disease onset may
      be in part inherited in these kindreds.

PMID- 2215947
TI  - Abnormal pulsatile secretion of luteinizing hormone in men with epilepsy:
      relationship to laterality and nature of paroxysmal discharges.
AB  - We compared the pulsatile secretion of luteinizing hormone (LH) between 13 men
      with clinically and electrographically documented temporal lobe seizures and 8
      age-matched controls. Serum for LH measurement was drawn every 15 minutes during
      8 hours of EEG telemetry in both groups. The 2 groups did not differ
      significantly in average mean baseline LH secretion, total LH secretion, or
      average pulse amplitude. The group with seizures, however, showed a significantly
      greater (p less than 0.05) variability of baseline LH secretion and pulse
      frequency. Among the men with unilateral paroxysmal EEG findings, pulse frequency
      was significantly greater (p = 0.05) with right epileptiform discharges or left
      slowing (6.4 +/- 0.4) than with left epileptiform discharges or right slowing
      (3.0 +/- 1.3). The relationship of pulse frequency to the nature and laterality
      of paroxysmal discharges makes it unlikely that endocrine abnormalities can be
      attributed to medication alone and strengthens the notion that temporal lobe
      epileptiform discharges may disrupt hypothalamic regulation of pituitary
      secretion.

PMID- 2215948
TI  - Cortical tremor: a variant of cortical reflex myoclonus.
AB  - Two patients with action tremor that was thought to originate in the cerebral
      cortex showed fine shivering-like finger twitching provoked mainly by action and
      posture. Surface EMG showed relatively rhythmic discharge at a rate of about 9
      Hz, which resembled essential tremor. However, electrophysiologic studies
      revealed giant somatosensory evoked potentials (SEPs) with enhanced long-loop
      reflex and premovement cortical spike by the jerk-locked averaging method.
      Treatment with beta-blocker showed no effect, but anticonvulsants such as
      clonazepam, valproate, and primidone were effective to suppress the tremor and
      the amplitude of SEPs. We call this involuntary movement "cortical tremor," which
      is in fact a variant of cortical reflex myoclonus.

PMID- 2215949
TI  - Topographic mapping of electrophysiologic measures in patients with homonymous
      hemianopia.
AB  - We analyzed electroencephalographic (EEG) activity and spatial distribution of
      the pattern-reversal visual evoked potential (PVEP) in 20 patients with
      unilateral lesions in the retrochiasmal visual pathways. Focal abnormalities that
      were consistent with lesion location were present in the topographically analyzed
      EEG or VEP of 85% of the patients, compared with a 70% detection rate for
      conventional analysis techniques. Quantitative analysis of spectrally analyzed
      EEG revealed focal abnormality in 7 patients whose conventional EEG was
      interpreted as either normal or diffusely slow. However, focal paroxysmal spikes
      present in the EEG of 1 patient were missed by EEG mapping, and a false
      localization of quantitative EEG abnormality contralateral to the lesion occurred
      in 1 patient. Topographic analysis of the PVEP was no more sensitive to
      retrochiasmatic lesions than conventional analysis of 2 lateral occipital
      electrodes. We conclude that topographic mapping is a valid technique in the
      detection of localized cerebral lesions.

PMID- 2215950
TI  - Dystonia in Parkinson's disease, multiple system atrophy, and progressive
      supranuclear palsy.
AB  - Adult-onset dystonia-parkinsonism is a syndrome in search of a pathology. We
      therefore reviewed the literature on dystonic manifestations in autopsy-proven
      cases of multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and
      idiopathic Parkinson's disease (PD). Only 6 of 140 autopsy reports of MSA
      remarked on the presence of dystonia in life, but personal observations suggest
      prominent antecollis may develop at some stage in up to 1/2 of sufferers.
      Similarly, very few (15/118) clinicopathologic observations on PSP included
      convincing dystonic manifestations, in contrast to some clinical reports where
      blepharospasm and early limb dystonia were prominent. Virtually any form of focal
      and segmental dystonia may sometimes occur with clinically diagnosed PD, with
      occasional descriptions of hemidystonia-hemiparkinsonism. However, there is
      pathologic confirmation of this diagnosis in only 1 case. With many patients
      thought clinically to have PD proving pathologically to have another cause for
      their parkinsonism, the true frequency and the range of dystonic manifestations
      acceptable in PD remain unknown.

PMID- 2215951
TI  - Borderzone hemodynamics in cerebrovascular disease.
AB  - To investigate the possible existence of chronic selective hemodynamic impairment
      in the arterial borderzone regions of the brain, we used positron emission
      tomography (PET) to measure regional mean vascular transit time (rt, equal to the
      ratio of regional cerebral blood volume to cerebral blood flow) and regional
      oxygen extraction fraction (rOEF) in 32 patients with either severe internal
      carotid artery stenosis or occlusion and 11 normal controls. Twenty-four of the
      patients had had TIAs or amaurosis fugax from 1 to 60 days before PET; all had
      normal brain CT. We used a stereotactic localization method to locate the
      anterior and posterior borderzone regions of the middle cerebral artery (MCA)
      territory. We then calculated ratios of each borderzone to the ipsilateral MCA
      territory for both rt and rOEF. There was no significant difference from control
      ratios in any patient subgroup including those with greater than or equal to 75%
      stenosis or occlusion, those with or without contralateral greater than or equal
      to 50% stenosis, or those with abnormal hemodynamics in the MCA territory. We
      therefore found no evidence for selective borderzone hemodynamic impairment in
      this group of patients with severe carotid artery disease.

PMID- 2215952
TI  - Diffuse CNS involvement in systemic lupus erythematosus: intrathecal synthesis of
      the 4th component of complement.
AB  - In extracerebral systemic lupus erythematosus (SLE), the complement system plays
      a prominent pathogenic role, and decreased serum concentration of the 4th
      component (C4) is a reliable indicator of systemic disease activity. In diffuse
      CNS-SLE, however, the pathogenic role of complement is less clear. In 12 patients
      with active diffuse CNS-SLE presenting with delirium (4), organic personality
      syndrome (3), or generalized seizures (5), we determined the CSF indexes of the
      complement components C3, C4, and factor B, and of IgG, IgA, and IgM. There was a
      significant increase of the C4 index in these patients compared with controls and
      a significantly higher CSF C4 index in patients with an increased IgM index. We
      conclude that intrathecal C4 is being produced in diffuse CNS-SLE.

PMID- 2215953
TI  - Fresnel prisms improve visual perception in stroke patients with homonymous
      hemianopia or unilateral visual neglect.
AB  - We randomly assigned 39 patients with stroke and homonymous hemianopia or
      unilateral visual neglect to treatment with 15-diopter plastic press-on Fresnel
      prisms (n = 18) or to serve as controls (n = 21). Baseline evaluations of visual
      perception and activities-of-daily-living (ADL) function were similar for both
      groups. After 4 weeks, the prism-treated group performed significantly better
      than controls on the following: (1) Motor Free Visual Perception Test; (2) Line
      Bisection Task; (3) Line Cancellation Task; (4) Harrington Flocks Visual Field
      Screener; and (5) Tangent Screen Examination. There was no significant difference
      in Barthel ADL assessment at 4 weeks. Thus, treatment with 15-diopter Fresnel
      prisms improves visual perception test scores but not ADL function in stroke
      patients with homonymous hemianopia or unilateral visual neglect.

PMID- 2215955
TI  - Gadolinium-MRI in acute transverse myelopathy.
AB  - A patient with acute transverse myelopathy (ATM) had serial magnetic resonance
      imaging (MRI) studies before and after administration of gadolinium (Gd-DTPA). Gd
      DTPA-MRI was useful in estimating the pathologic extent and residual deficit
      expected in ATM.

PMID- 2215954
TI  - Comparison of algorithms of testing for use in automated evaluation of sensation.
AB  - Estimates of vibratory detection threshold may be used to detect, characterize,
      and follow the course of sensory abnormality in neurologic disease. The approach
      is especially useful in epidemiologic and controlled clinical trials. We studied
      which algorithm of testing and finding threshold should be used in automatic
      systems by comparing among algorithms and stimulus conditions for the index
      finger of healthy subjects and for the great toe of patients with mild
      neuropathy. Appearance thresholds obtained by linear ramps increasing at a rate
      less than 4.15 microns/sec provided accurate and repeatable thresholds compared
      with thresholds obtained by forced-choice testing. These rates would be
      acceptable if only sensitive sites were studied, but they were too slow for use
      in automatic testing of insensitive parts. Appearance thresholds obtained by fast
      linear rates (4.15 or 16.6 microns/sec) overestimated threshold, especially for
      sensitive parts. Use of the mean of appearance and disappearance thresholds, with
      the stimulus increasing exponentially at rates of 0.5 or 1.0 just noticeable
      difference (JND) units per second, and interspersion of null stimuli, Bekesy with
      null stimuli, provided accurate, repeatable, and fast estimates of threshold for
      sensitive parts. Despite the good performance of Bekesy testing, we prefer forced
      choice for evaluation of the sensation of patients with neuropathy.

PMID- 2215956
TI  - Right-left disorientation in dementia of the Alzheimer type.
AB  - We demonstrated that right-left orientation (R/L-O) on a confronting subject is
      more impaired in patients with dementia of the Alzheimer type than in patients
      with multi-infarct dementia of comparable degree of dementia. The impairment in
      R/L-O is independent of aphasia and spatial disorientation.

PMID- 2215957
TI  - Effect of plasmapheresis on serum and CSF autoantibody levels in CNS
      paraneoplastic syndromes.
AB  - We compared the effect of plasmapheresis on antineuronal autoantibody titers in
      the serum and CSF of 3 patients with CNS paraneoplastic syndromes. Plasmapheresis
      reduced the serum autoantibody titer to 20% of the initial levels in the 3
      patients, but the CSF autoantibody titer decreased only in the patient with
      severe damage of the blood-brain barrier.

PMID- 2215958
TI  - Aggravation of human and experimental myasthenia gravis by contrast media.
AB  - After observing a 72-year-old myasthenic patient develop an acute myasthenic
      exacerbation following the administration of routine diagnostic IV contrast
      material, an observation rarely described in the literature, we used the
      experimental autoimmune myasthenia gravis model in rabbits injected with a
      contrast agent to simulate the situation. There was significant worsening of the
      decremental response to 3 Hz repetitive nerve stimulation from 40 +/- 29% to 55
      +/- 27% following the IV administration of contrast agent at doses similar to
      those used in humans. IV calcium partially reversed this aggravation. Caution is
      merited when myasthenic patients are administered contrast media.

PMID- 2215959
TI  - Dopamine beta-hydroxylase activity in cerebrospinal fluid of idiopathic torsion
      dystonia.
AB  - Since a postmortem biochemical study and a genetic linkage study of idiopathic
      torsion dystonia suggested possible involvement of dopamine beta-hydroxylase
      (DBH), we determined CSF DBH activities of Jewish and non-Jewish patients with
      childhood-onset idiopathic torsion dystonia and found no differences from a
      control population.

PMID- 2215961
TI  - Inconsistent response to divalproex sodium in hemichorea/hemiballism.
AB  - We report 6 patients with hemichorea/hemiballism of vascular origin who were
      treated with divalproex sodium (Depakote). Four of 6 responded initially. Marked
      improvement was seen in 2 patients only and in 1 of these hemiballism recurred
      despite continuing therapy. Divalproex sodium is not uniformly effective in the
      treatment of hemichorea/hemiballism.

PMID- 2215960
TI  - L-tryptophan-induced eosinophilia-myalgia syndrome and myopathy.

PMID- 2215962
TI  - Mononeuropathy multiplex in tryptophan-associated eosinophilia-myalgia syndrome.

PMID- 2215963
TI  - Coincidence of myoclonus and multiple sclerosis: dramatic response to clonazepam.

PMID- 2215964
TI  - Isolated complete post-traumatic trigeminal neuropathy.

PMID- 2215965
TI  - Trigeminal neurotrophic ulceration with Wallenberg's syndrome.

PMID- 2215966
TI  - The Denny-Brown collection.

PMID- 2215967
TI  - 'Monocular' versus 'uniocular'.

PMID- 2215968
TI  - PSP risk factors.

PMID- 2215969
TI  - Dysphagia in Chiari malformations.

PMID- 2215970
TI  - Paraneoplastic motor neuron disease.

PMID- 2215971
TI  - Do environmental toxins cause Parkinson's disease? A critical review.

PMID- 2215972
TI  - Oxidation reactions in Parkinson's disease.
AB  - Free radicals generated from oxidation reactions may contribute to the
      pathogenesis of Parkinson's disease (PD). Free radicals are capable of reacting
      almost instantaneously with membrane lipids and causing lipid peroxidation,
      membrane injury, and cell death. Dopamine is metabolized by oxidation reactions
      capable of generating free radicals. Recent evidence indicates that the
      substantia nigra of patients with PD contains increased iron, which enhances
      oxidation, and decreased glutathione, which protects against the formation of
      free radicals. Further, the end products of lipid peroxidation are increased in
      the substantia nigra of patients with PD, supporting the notions that free
      radicals are being generated and may contribute to dopamine neuronal death. This
      hypothesis suggests that antioxidant therapies may slow the rate of progression
      of PD and raises concern that metabolites of levodopa therapy may accelerate the
      rate of neuronal degeneration.

PMID- 2215973
TI  - Levodopa therapy in Parkinson's disease.

PMID- 2215974
TI  - The genetics of Parkinson's disease: a reconsideration.

PMID- 2215975
TI  - Predicting Parkinson's disease.

PMID- 2215976
TI  - [ARDS in MOFS (multiple organ failure syndrome). How to direct the therapy? A
      case report of MOFS in AIDS].
AB  - A young AIDS patient was admitted to the Intensive Therapy ward of our hospital
      with ARDS. The case raised the question of how medical and nursing personnel
      should face the problem of "suitable treatment for a terminally ill patient".
      Therapy was based on invasive methods such as mechanical ventilation and the
      insertion of catheters to monitor vital parameters. The evolution of ARDS in MOFS
      revealed the difficulty of sustaining vital parameters and avoiding pluriorganic
      damage.

PMID- 2215977
TI  - [Loco-regional anesthesia in minor surgery of the breast].
AB  - Breast minor surgical operations, either demolitive or reconstructive, are more
      frequently effected by day-hospital modalities, to obviate to room scarcity and
      to meet patients requirements. Several patients, due to age or to concomitant
      pathologies, show risks caused by premature dismissal after having general
      anaesthesia. This problem led Authors to find an alternative loco-regional
      anaesthesia. Good results encouraged them to extend this method.

PMID- 2215978
TI  - [Effectiveness of topical selective decontamination, without systemic antibiotic
      prophylaxis, in prevention of pulmonary infection in intensive care].
AB  - Forty-seven patients admitted in our general ICU and treated with Selective
      Digestive Decontamination (SDD) without any systemic antibiotic prophylaxis, were
      prospectively studied and compared with an historical group of 50 non treated
      subjects. The 2 groups were no different as to underlying disease, age, sex and
      prognostic index (SAPS). In the treated group was recorded an important and
      statistically significant reduction in the incidence of pneumonia and in the
      frequency of pulmonary infections caused by enterobacteriaceae and pseudomonceae.
      Gram-positive identification in tracheal aspirates was not significantly
      different in the two groups as well as the incidence of "early pneumonia". In the
      treated group, a sharp decrease of the total amount of fever-days through ICU
      stay was observed. The antibiotic consumption resulted to be an overall 28.3%
      lower in the group treated with, SDD with particular regard to broad-spectrum
      ones.

PMID- 2215979
TI  - [Cerebral perfusion pressure in endocranial hypertension in comatose head-injured
      patients].
AB  - The aim of the intensive care of the injured is the coupling of the availability
      and the requirement of the cerebral metabolic substates. The measurement of the
      cerebral blood flow is not currently available at the bedside and less direct
      monitoring is required. The cerebral perfusion can be estimated looking at the
      cerebral perfusion pressure (CPP), that can be easily measured using intracranial
      pressure (ICP) and the systemic arterial pressure (MAP) monitoring. Hundred
      twenty-one consecutive head injured admitted to an Intensive Care Unit were
      studied assessing the severity of the neurological injury, the CT-Scan diagnosis
      of the intracranial lesion, the Trauma Score and the behavior of the ICP and MAP.
      The outcome was classified according to a modified version of the Glasgow Outcome
      Scale. More than 77% of the patients suffered raised intracranial pressure above
      20 mmHg and 16 of them had a CPP less than 60 mmHg for more than 5 minutes. The
      outcome was directly related to the degree of intracranial hypertension and to
      the severity of insufficient CPP. The treatment of the severe head injured must
      be aimed at maintaining a good CPP, because of the close relationships between
      this value and the prognostic result. The monitoring of the ICP is a reliable and
      relatively safe procedure in this series, where the rate of infections
      complicating the intracranial recording is less than 3%.

PMID- 2215980
TI  - [Propofol and tetanus].

PMID- 2215981
TI  - [Strychnine poisoning. A clinical case].
AB  - A patient was admitted following ingestion of 300 mg of strychnine. Early
      diagnosis and timely reanimation treatment led to his full recovery though he had
      swallowed a quantity of strychnine greater than the medium lethal dose (50-100 mg
      for adult).

PMID- 2215982
TI  - [Acute tubular necrosis after renal transplantation. Multifactoral analysis].
AB  - Acute Tubular Necrosis (ATN) is a relatively common complication occurring after
      cadaver kidney transplant. In 64 human renal grafts performed in our center the
      influence of some factors on the incidence of ATN, related to donor and
      recipient, was evaluated. The total incidence of ATN was 26.5%. As far as factors
      related to donor are concerned, the donor's provenance (our medical center versus
      other centers) resulted statistically significant (p less than 0.01). The
      incidence of ATN was 17% when the donor came from our intensive care unit,
      compared with 52% of incidence observed when donor came from other medical
      centers. As far as factors related to recipients are concerned, the mean and
      systolic arterial pressure (both measured at the time of unclamping the renal
      vessels) resulted statistically significant (p less than 0.01 and 0.05
      respectively). The influence of mean arterial pressure on the incidence of ATN
      suggests the administration of inotropic and vasopressant drugs in selected
      patients before and after organ reperfusion in order to maintain an adequate
      renal perfusion.

PMID- 2215983
TI  - [Microbiologic flora in two different periods in intensive care units].
AB  - Bacterial examinations performed in two periods (Nov. 1985-Feb. 1986) and Nov.
      1988-Feb. 1989) on materials taken from patients admitted into two similar
      Intensive Care Units (ICU) of the same hospital were evaluated. Excluding
      oropharyngeal swab cultures, which were performed only in the second period, Gram
      positive bacteria were 45.3% in 1985-1986 and 62.3% in 1988-1989 and Gram
      negative fell from 41.9% to 29%. The percentage of fungi remained unchanged.
      Microorganisms did not grow in 33.3% of tracheal aspirate specimens in 1985-1986
      and in 54.3% in 1988-1989, probably depending on the larger number of patients
      with decompensated chronic respiratory failure treated in the second period.
      Usually the microorganisms found in the trachea was also in the oropharynx; Gram
      negative were only 5.1% of the microorganism collected in the oropharinx. The
      authors emphasize the increase of Gram positive bacteria in ICUs and suggest that
      the low rate of pneumonia observed in this study depends mostly on the good
      neurologic state of their patients.

PMID- 2215984
TI  - [Peridural anesthesia and narcosis with propofol in thoracic surgery].
AB  - Twelve patients undergoing elective thoracic surgery because of lung cancer, have
      been studied. The anesthetic management included: continuous epidural anesthesia
      with bupivacaine (T6-T7), continuous infusion of propofol and vecuronium,
      mechanical ventilation with an oxygen/air mixture. We evaluated the perioperative
      analgesia and the cardiovascular side effects of two groups of patients differing
      for the position (supine or lateral) selected to administer the local anesthetic.
      We also analysed the most important characteristics of the recovery from
      anesthesia (degree of analgesia and consciousness, respiratory function and
      cooperation with physiotherapeutic manoeuvres). The authors conclude that,
      although the number of patients studied is limited, there are no significant
      differences between the two groups for intraoperative analgesia and hemodynamic
      imbalance; the anesthetic technique employed is a reliable alternative to classic
      balanced anesthesia, because seems to reply very well to the mayor purposes of
      thoracic surgery. Moreover it makes the operative room free from pollution caused
      by volatile anesthetics.

PMID- 2215985
TI  - [Propofol-ketamine vs propofol-fentanyl in short gynecologic surgery].
AB  - The study was performed to investigate efficacy and tolerability of the
      association propofol-ketamine as alternative to propofol-fentanyl. Forty female,
      classified ASA I-II, aged 18-50 years and scheduled for short gynecologic
      procedures under general anesthesia were included in a comparative, randomized,
      single blind study. Patients were divided in two groups; in group K anesthesia
      was induced with propofol 1.5 mg/kg and ketamine 1 mg/kg i.v. In group F
      anesthesia was induced with propofol 2.5 mg/kg and fentanyl 1.5 micrograms/kg.
      Arterial blood pressure (BP), heart rate (HR), respiratory rate (RR) and arterial
      O2 saturation (SATO2) were measured. Though preliminary, our data suggest that
      the association propofol-ketamine reach an adequate level of anesthesia with few
      and negligible effects on cardiorespiratory system, thus allowing a better
      operability and safety. The incidence of post operative psychotic disturbances
      seems to be low and moderate. We can't draw any definitive conclusion, but we
      think that other studies should be performed to clarify the possible role of
      ketamine in propofol anesthesia.

PMID- 2215986
TI  - [Atracurium with halothane and isoflurane in pediatric anesthesia].
AB  - The study was carried out to assess the effects of atracurium neuromuscular
      blockade in children anaesthetized with N2O:O2: halothane vs N2O:O2: isoflurane.
      Thirty-two ASA I-II children, age 1-13 yr, undergoing elective surgery, were
      divided into two groups according to age and the mode of anaesthesia induction.
      Anaesthesia was induced in the younger children (group 1: 1-6 yr) with nitrous
      oxide and inspired halothane or isoflurane in oxygen via a face mask. Intravenous
      thiopental (6-7 mg/kg-1) was used to induce anaesthesia in older children (group
      2: 7-13 yr). Each group of patients was randomly allocated to two groups each
      receiving halothane (group A: n = 8) or isoflurane (group I: n = 8). Halothane
      0.8% end-tidal and isoflurane 1% end-tidal as anaesthesia maintenance. A bolus
      dose of atracurium 0.35 mg/kg-1 was administered. Premedication consisted of oral
      flunitrazepam (0.04 mg/kg-1) and bellafoline (0.02 mg/kg-1). Heart rate (by
      electrocardiography), arterial pressure (by auscultation) were monitored. Then
      end-expired carbon dioxide concentration was maintained at 30-40 mmHg.
      Neuromuscular transmission was evaluated by response to indirect stimulation
      (TOF) of the ulnar nerve at the wrist via surface electrodes. Conditions for
      endotracheal intubation were excellent in 25 of the children, good in 6 and poor
      in 1. The intubation was carried out within 112 s (group 1A), 130 s (group 1 I),
      112 s (group 2A) and 135 s (group 2 I) following the administration of
      atracurium. The maximum twitch depression was recorded in the isoflurane
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2215988
TI  - [Anesthesiologic problems in transluminal balloon dilatation of esophageal
      stenosis in children].
AB  - The authors report their anesthesiological experience in 88 cases of transluminal
      balloon dilatation of esophageal strictures in children. The most serious
      problems are caused by the need to repeat the dilatation process (up to a maximum
      of 24 times in one patient) and to the risk of extrinsic mechanical compression
      of the trachea with consequent transient anoxia. Good sedation was achieved using
      premedication with haloperidol and diazepam, but was not sufficient to avoid the
      child's anxiety on entering the operating theatre. Anesthesia using ketamine plus
      fentanyl, combined with tracheal intubation gave good results in almost all
      cases, but marked bradycardia was observed in several patients during balloon
      dilatation. In conclusion, although the technique itself is simple to perform,
      very careful anesthesia is required to avoid the risk of serious intraoperative
      complications.

PMID- 2215987
TI  - [Propofol for the induction and maintenance of anesthesia in ophthalmic surgery].
AB  - After brief mention of the chemical and pharmacodynamic properties of
      diisopropylphenol, personal experience on the administration of propofol for
      induction and maintenance of anaesthesia for ophthalmic surgery is reported. The
      results have shown that induction of anaesthesia by propofol injection is
      associated with a significant and useful reduction of IOP more than TPS
      induction. Continuous infusion of Diprivan provides satisfactory conditions for
      intraocular surgery and could be a real choice to thiopentone combined with
      enflurane.

PMID- 2215989
TI  - [Paravertebral block of the lumbar plexus. Variations of the original technic].
AB  - After studying a hundred or so abdominal CT scans carried out at L5 level and
      having verified that the interfascial compartment between the quadrate muscle of
      the lumbi and the psoas muscle is relatively fixed (1.8-2.3 cm), it is proposed
      to utilise this datum (introduction of the 2 cm) needle after contact with the
      transverse apophysis of L5) to identify the psoas compartment which contains most
      of the nerves making up the lumbar plexus. Study of the series and results
      obtained confirm the value and simplicity of the proposed technique.

PMID- 2215990
TI  - [Impairment of diuresis in surgical intervention. Role of urinary
      prostaglandins].
AB  - In 8 patients who underwent abdominal surgery for non-neoplastic reasons, we have
      evaluated some parameters of renal function (PRP, NaU, GFR and diuresis) plasma
      levels of PRA and ADH and urinary prostaglandins PGE2 and 6-keto-PGF1 alpha. In 4
      patients we found that surgery per se was associated with enhancements of PRA,
      ADH and 6-keto-PGF1 alpha. In other 4 patients, Indomethacin, a specific
      inhibitor of prostaglandin synthesis was given and this was followed by
      impairment of natriuresis and RPF. These data confirm the central role of
      prostaglandins in the control of diuresis and natriuresis and suggest that use of
      drugs affecting prostaglandin synthesis should be avoided in patients who are
      undergoing surgery.

PMID- 2215991
TI  - [Axillary block of the brachial plexus and peripheral paresthesia: a technique to
      refuse at the outset? Clinical experience].
AB  - The axillary brachial plexus blockade by means of stimulating paresthesia and
      single local anesthetic injection was examined during one year long routine
      activity in a plastic surgery division. Two-hundred-five blocks were performed
      evaluating the success percentage, the execution mean time, a sedation utility
      and the sequelae incidence. The technique was confirmed usefull, easy to perform,
      well tolerated from the patients. The technique validity, versus the
      suspiciousness considered by several Authors, is confirmed.

PMID- 2215992
TI  - [Supraclavicular block of the brachial plexus].

PMID- 2215993
TI  - [Comparison of a combination of fentanyl and alfentanil with propofol in brief
      surgery].
AB  - We studied 96 patients undergoing short gynecological procedures. Anaesthesia has
      been induced with fentanyl 1.5 micrograms/kg (45 patients) or alfentanil
      micrograms /kg (51 patients) and a hypnotic dose of propofol, and maintained with
      70% N2O via facial mask. We observed a better and more rapid control of surgical
      analgesia with alfentanil, and an earlier recovery of postoperative
      psychophysical functions. Post-induction apnea has been more frequent and
      prolonged in the alfentanil group, but no difference in the time necessary to
      recover an adequate ventilation has been observed between the two groups.
      Alfentanil anaesthesia determined a more marked intraoperative bradycardia. By
      virtue of the speed of onset and the short duration of action, alfentanil is a
      suitable anaesthetic agent for short surgical procedures, particularly in day
      stay patients.

PMID- 2215994
TI  - [Electroencephalographic changes during anesthesia with low-dose propofol].
AB  - The electroencephalographic changes of 12 patients submitted to anaesthesia with
      low dosages of propofol (4-2 mg/kg/h + fentanyl) for peripheral vascular surgery
      have been studied. The standard induction dose of propofol was 2 mg/kg for all
      the patients. The EEG recording was carried out during the whole length of
      anaesthesia and the EEG changes were analysed during induction and maintenance
      phases. During surgical anaesthesia it was always easy to read EEG and also to
      detect eventual cerebral suffering. On the basis of our results we can suggest
      this anesthesiologic technique for surgery (for example: carotid surgery)
      requiring a continuous monitoring of the cerebral function during intra and
      postoperative phases.

PMID- 2215995
TI  - [Clinical evaluation of atracurium besylate in patients at risk: major burns].
AB  - Atracurium besylate 0.5 mg/kg-1, an intermediate-duration non-depolarizing
      neuromuscular relaxant, was administered slowly (over 75 sec) in anesthesia
      induction of 61 patients with major thermal injury undergoing surgical excision
      and immediate skin-grafting procedures. Patients' mean +/- SD age was 40 +/- 9,
      body weight 64 +/- 2, burn size ranging from 20% to 90% of body surface area
      (BSA), postburn day of surgery 5th and more. Induction of anesthesia was carried
      out with sodium thiopental 2-5 mg/kg-1 plus fentanyl 2.8 micrograms/kg-1 e.v. and
      after few minutes atracurium 0.5 mg/kg-1 e.v. Anesthesia was maintained with
      N2O/O2 (70%/30%), isoflurane and small amounts of fentanyl. The mean arterial
      pressure and heart rate were recorded at I, II, III, IV, V min post atracurium
      administration. The endotracheal intubation conditions were assessed by a "IOT
      score". Results are expressed as mean value +/- standard deviation. The
      significance of the difference in mean values was analysed by t-test. Little
      haemodynamic changes occurred; intubating conditions showed a relative
      hyposensitivity of burn patients to atracurium, more severely burned patients
      (greater than 50-60%) exhibiting greater resistance.

PMID- 2215996
TI  - [The activity of the "Hygrobac DAR 352" filter in resuscitation patients].
AB  - The Authors clinically evaluated the efficacy of the "Hygrobac DAR 352" filter as
      an antibacterial barrier in a group of patients during mechanical ventilation.
      After 24 hours of IPVV, a cultural sample has been taken on both sides of the
      filter introduced in the breathing circuit (patient's side; ventilator's side).
      While bacteria has been isolated on "the patient's side" of the filter, they were
      not present on the surface of the "ventilator's side" of the filter. Therefore,
      the Authors emphasize that the Hygrobac DAR 352 filter represents a good barrier
      against the passage of bacteria, as it avoids the contamination of the mechanical
      ventilator by keeping pathogenic organisms coming from patient's airways inside
      the filter itself.

PMID- 2215997
TI  - [Cost evaluation of various protocols of anesthesia].
AB  - The costs of various anaesthetic techniques are measured using the method
      suggested by Bailey. These costs are used as a basis for a discussion of the
      economies that might be practised in the conduct of anaesthesia.

PMID- 2215998
TI  - [The preventive minitracheotomy as support in difficult intubations: a
      proposition. Description of a clinical case].
AB  - The authors suggest preventive minitracheotomy as a support technique in
      difficult endotracheal intubation, and report their experience in a case of
      surgical operation to remove a bony neoformation of C1 and C2 posterior arcs.
      Endotracheal intubation, difficult because no part of the glottis could be seen,
      was made possible by preventive minitracheotomy. In this way sedation,
      myorelaxation and excellent oxygenation during following manoeuvre that resulted
      atraumatic, were obtained. The small cannula of minitracheotomy was maintained
      closed during the operation and open for 24 hours thereafter to prevent
      obstructive complications. It was then removed.

PMID- 2215999
TI  - [An unusual cause of obstruction of the anesthesia circuit ].
AB  - The authors report an unusual accident, uneventful for the patient, due to the
      mobilization of a foreign body (a piece of tape) inside the anaesthesia circuit,
      following Emergency Oxygen administration. The accident dynamics and the safety
      of anaesthesia equipment are discussed.

PMID- 2216001
TI  - [New methods of electrophysiologic investigation in the diagnosis of brain
      death].
AB  - In the event of suspected brain death it is vital to arrive at a diagnosis as
      rapidly as possible and with the least chances of error. The paper examines the
      potentially and possible value of BAER recordings. Results are in line with those
      of other published studies which underline the value of this method, in spite of
      the fact it is limited by the possible presence of numerous factors which might
      invalidate recordings.

PMID- 2216000
TI  - [Hemodynamic and respiratory aspects in orthotopic liver transplantation].
AB  - Intraoperative hemodynamic and respiratory data from one-year experience of
      orthotopic liver transplantation with veno-venous bypass (10 cases) were
      collected. Seven different phases of OLT was submitted to one way analysis of
      variance. Variability is due to degree and duration of liver disease. Basal
      conditions include high cardiac output with low SVRI, elevated Qs/Qt. and low
      oxygen consumption. Anhepatic phase shows a lower cardiac index due to reduction
      in ventricular performance too. The functioning graft raises body oxygen
      consumption above baseline. Last phases show diminution of MAP and LVSWI and a
      normal Qs/Qt.

PMID- 2216002
TI  - [Auditory evoked potentials of the brain stem in brain injury. Prognostic value].
AB  - The study of brain stem auditory way in severe head trauma patients with auditory
      evoked potentials is very important for giving elements about functional and
      anatomic situation of analyzed neuronal substratum; ABR will be normal or altered
      in conformity with the level and/or the gravity of the damage. Authors have
      examined 20 post-traumatic comatose patients pointing out the existence of a
      strict relation between auditory brain stem responses and prognosis. Authors, in
      accordance with the ample literature in existence, agree to point out the
      auditory brain stem responses such as a very effective instrument for the
      prognostic valuation of post-traumatic comatose patients.

PMID- 2216003
TI  - Effect of preoperative risk factors on the outcome after surgery for complicated
      diverticular disease.
AB  - The influence of age and severity of peritonitis was studied in 111 (16%) out of
      a total of 694 patients treated for diverticular disease. These 111 patients had
      complications of the disease and were operated upon by four different approaches.
      The outcome after surgery was expressed as 30 days mortality, number of
      operations and postoperative complications per patient, overall hospital stay and
      number of permanent colostomies in surviving patients. The overall hospital stay
      lasted significantly longer for patients older than 70 years compared to the
      younger patients (64 versus 41 days). The complications per patient increased
      significantly from 1.0 to 1.9 and from 1.1 to 2.7 respectively for an age above
      70 years and for peritonitis. Preoperative risk factors as age and peritonitis
      adequately predict the outcome after surgery for complicated diverticular
      disease. The type of surgery employed seems more dependent on the perioperative
      findings than on the superiority of one of the procedures.

PMID- 2216005
TI  - Acute mesenteric embolism: an appeal for a pro-active diagnostic approach.
AB  - Acute mesenteric ischaemia can be caused by arterial embolism. The initial
      aspecific symptoms mostly lead to late recognition of acute mesenteric ischaemia
      which leads to intestinal infarction. Intestinal infarction with signs of
      peritonitis has a very high mortality. Since 1982, a pro-active approach is
      followed in our department. After thorough exclusion of other causes, patients
      with serious acute abdominal complaints undergo an emergency angiography and/or
      emergency laparotomy. After confirmation of the diagnosis, primary vascular
      reconstructive surgery is performed if possible. We have treated eight patients
      with acute mesenteric embolism according to this policy. Per- and post
      operatively, three patients died of extensive intestinal infarction. The five
      surviving patients were on a normal diet and had normal bowel functions at the
      time of discharge from the hospital. This limited experience shows that a pro
      active approach in patients with acute mesenteric embolism can result in survival
      and preservation of a normally functioning alimentary tract.

PMID- 2216004
TI  - Early complications after surgery for Crohn's disease.
AB  - A group of 212 patients operated upon for Crohn's disease were studied and the
      early postoperative complications with related problems were assessed. The
      morbidity was 28.3 per cent, 60 patients had at least one complication, mainly of
      septic nature. The mortality was 3.3 per cent (7 patients), sepsis and deep vein
      thrombosis with pulmonary embolism were the most common causes of death.
      Postoperative complications were significantly higher (39.7%) (p less than 0.001)
      in patients with a pre-operative nutritional deficit and in those who had urgent
      surgery (44.4%) (p less than 0.001). Among patients with pre-operative sepsis,
      the morbidity was also higher (34.6%), but was not significant. Peri-anastomotic
      complications (dehiscence, abscess, fistula, bleeding) were apparently more
      frequent (45.4%) in patients with histological residual Crohn's disease at
      macroscopically free resection margins although this contrasts with previous
      series. A proper pre-operative diagnostic approach, adequate peri-operative
      protein-caloric repletion, antibiotic therapy, prevention of thromboembolism and
      elective surgery, are still the primary tools in reducing the morbidity and
      mortality after surgery for Crohn's disease.

PMID- 2216006
TI  - Haemodynamics and 'optimal' hydration in aortic cross clamping.
AB  - The effect of optimal hydration on haemodynamics and renal function during
      infrarenal aortic cross clamping was studied in 26 consecutive patients operated
      on because of an infrarenal aortic aneurysm. The patients were randomly divided
      over two groups. The patients of group B (n = 13) were optimally hydrated before
      the operation. The Starling curve was used as standard. Patients of group A (n =
      13) served as control. The pre-operative and postoperative renal functions of
      both groups were compared, as were the haemodynamic parameters. The haemodynamic
      parameters were measured at five minutes intervals during the entire procedure.
      During aortic clamping the heart rate was significantly lower in patients of
      group B, indicating a lower myocardial oxygen consumption. Neither the
      haemodynamic parameters nor the renal function showed other beneficial effects on
      optimal hydration.

PMID- 2216007
TI  - Left external iliac artery dissection and bilateral renal artery aneurysms
      secondary to fibromuscular dysplasia: a case report.
AB  - A case of acute lower limb ischaemia due to spontaneous dissection of the left
      external iliac artery and coincidental bilateral renal artery aneurysms is
      reported. Histopathological examination of the resected iliac artery showed
      features of fibromuscular dysplasia. Dissection of the external iliac artery
      without involvement of the aorta is extremely rare with only two previously
      reported cases. The aetiology and management of fibromuscular dysplasia is
      discussed.

PMID- 2216008
TI  - Antibiotic prophylaxis in biliary tract surgery--current practice in The
      Netherlands.
AB  - A questionnaire about the current practice of antibiotic prophylaxis in biliary
      tract surgery was sent to the chairmen of the departments of surgery of 175
      hospitals in The Netherlands. The Dutch hospitals are classified into three
      categories depending on the type of residency in general surgery. Overall, 80 per
      cent replied. Antibiotic prophylaxis in elective cholecystectomy is given in 76
      per cent of the clinics (100/132), and single-dose prophylaxis is employed in 28
      per cent of the clinics (28/100). In patients with acute cholecystitis, emergency
      surgery is the treatment of choice in 108 hospitals (82%). Differences in
      antibiotic prophylaxis between the three categories of hospitals include the
      omission of prophylaxis in elective cholecystectomy in 31 per cent of the C
      clinics (vs. 10% in A-clinics and 16% in B-clinics), and the use of single-dose
      prophylaxis in 13 per cent of the B-clinics (vs. 30% of the A-clinics and 31% of
      the C-clinics). Since prophylaxis for more than 24 hours has no additional effect
      and peri-operative prophylaxis in acute cholecystitis is mandatory, antibiotic
      prophylaxis in biliary tract surgery is inappropriate in at least 31 hospitals in
      The Netherlands (23%).

PMID- 2216009
TI  - Developmental shifts in Oedipal behaviors related to family role understanding.

PMID- 2216010
TI  - The Bears' Picnic: children's representations of themselves and their families.
AB  - The Bears' Picnic, a new test of preschoolers' representations of self and
      family, was given to four-year-olds who had been observed with their mothers at
      twenty months of age. Observed maternal sensitivity and the affective quality of
      both partners were related to the child's later valuing versus devaluing of self
      and others.

PMID- 2216011
TI  - Dialogues with children about their families.

PMID- 2216012
TI  - Five-year-olds' representations of separation from parents: responses from the
      perspective of self and other.

PMID- 2216013
TI  - Family relationships as represented in a story-completion task at thirty-seven
      and fifty-four months of age.

PMID- 2216014
TI  - [Doppler flowmetry in temporal arteritis. Indications and limitations].
AB  - Doppler test in temporal arthritis. Prescriptions and limits The paper describes
      the Authors' personal experience in using the Doppler test for the diagnosis of
      temporal arthritis in a small group of patients clinically suspected of the
      pathology. The method has proved useful in the diagnosis and follow-up of the
      disease, but the diagnosis is confirmed by a biopsy of the temporal artery which
      still plays an important role.

PMID- 2216015
TI  - [Changes in lymphocyte subpopulations induced by the administration of
      thymopentin].
AB  - Modifications of the levels of T-helper (T4) and T-suppressor (T8) lymphocytes
      were assessed, together with their ratio, in 17 subjects who had received
      thymopentine as an adjuvant to Hevac-B vaccination. Two months after treatment
      with the immunomodulating drug, T4 lymphocytes were considerably increased
      whereas absolute levels of T8 lymphocytes were decreased in the majority of
      patients: this led to a net increase in the T4/T8 ratio. This finding leads to
      the conclusion that all subjects produced anti-HBs antibodies as a means of
      protection.

PMID- 2216017
TI  - [Arthromyopathy caused by barbiturates. Description of a clinical case].
AB  - The study describes a rare case of arthromyopathy from phenobarbital which
      affected the right hand of a patient. The case is particularly interesting since
      symptoms developed after the drug had been taken for only one month.

PMID- 2216016
TI  - [Endocarditis on prosthetic valve caused by a diphtheroid insensitive to
      vancomycin].

PMID- 2216018
TI  - [External fixators in the treatment of fractures and fractures/luxations of the
      pelvis].
AB  - Combined fractures of the two pelvic arches and severe disjunction of the pubic
      symphysis are acute lesions which are difficult to treat; in order to avoid poor
      functional results, the use of external fixatives have now become a routine
      orthopedic surgical practice. Two cases are reported to illustrate the large
      numbers of patients treated by the Orthopedic and Traumatological Division of the
      Ospedale Civile in Alessandria.

PMID- 2216019
TI  - [Review of 64 cases of hallux valgus surgically treated with the Keller-Leviere
      technique].
AB  - Sixty four cases of hallux valgus treated using the Keller-Lelievre technique
      during the period from January 1982 to December 1987 are examined. The results
      achieved reveal the validity and limits of this surgical technique. Having
      established the prescriptions of the technique, it still represents the simplest
      and safest method for treating this affection in adult/old-aged patients.

PMID- 2216020
TI  - [Our experience in the use of Thompson's endoprosthesis in medial fractures of
      the femur neck].
AB  - The study reports the results of a study of a random sample of 40 patients with
      medial fractures of the collum femoris in whom the caput femoris was substituted
      by Thompson's cemented prosthesis, taken from a series of 189 operations
      performed between 1981 and 1987. In conclusion, Thompson's prosthesis is
      demonstrated to be still valid in patients over 75 years old.

PMID- 2216021
TI  - [A case of a fracture of the clavicle associated with an acromio-clavicular
      luxation].
AB  - The study reports a rate case of a girl with associated clavicular fracture and
      acromioclavicular dislocation following a care accident. The pathogenetic
      mechanism may be attributed to a trauma on the medial shoulder stump which having
      fractured the clavicle then provoked the acromioclavicular dislocation by
      continued pressure on that point. It is important to observe that the patient
      fully recovered, virtually without therapy.

PMID- 2216022
TI  - [A case of paralytic syndrome of the upper limb caused by tourniquet].
AB  - A case of paralytic syndrome of an upper limb in a healthy young man following
      the application of a tourniquet, accidentally inflated to a pressure of more than
      200 mmHg during an operation, is described in which motility was fully recovered
      after 3 months. The importance of checking equipment periodically is stressed.

PMID- 2216023
TI  - [Electric shock treatment of poisoning caused by animal venoms].
AB  - Poisoning through sting or bite by venomous animals constitutes a medical
      emergency which is potentially fatal and not easy to resolve. In this work the
      Authors describe the electric shock treatment (EST) to cure poisoning by animal
      venoms; such method has now been used for some years for this purpose in
      different parts of the world (Guderian et al., 1986). The Authors describe the
      suitability, the effectiveness of the method, the source and the type of electric
      current to apply; they give usage instructions and probable theory on its working
      mechanism: although the latter requires a more detailed and rigorous study. They
      wish for the usage of EST for this purpose to spread in Italy too, although fatal
      poisoning is rare here, and are devising a portable instrument with the right
      requirements.

PMID- 2216024
TI  - [Scorpion sting (Euscorpius, sp.) in Italy and review of scorpionism].
AB  - Although they are very common arachnids, the scorpions (Euscorpius, sp.) do not
      constitute a sanitary problem in Italy, given that their sting determines only
      local effects. Scorpionism can anyway verify itself following sting exemplaries
      in Italy with imported gaods or caused by Buthus occitanus, that lives in the
      south of France. In this review the Authors treat briefly the biology and the
      toxicology of scorpions, describing the clinical picture of Scorpionism and the
      relative therapy.

PMID- 2216025
TI  - [Review of latrodectism and Malmignatta sting (Latrodectus tredecimguttatus) in
      Italy].
AB  - The latrodectism is a rare poisoning rather unknown in Italy and some times
      fatal. The Authors in this latrodectism review intend to provide information
      about the Malmignatta spider Latrodectus tredecimguttatus: biology, Italian
      distribution and peculiarity of its venom. Here are reported the clinical picture
      of the toxic syndrome, with first principles of differential diagnosis.
      Afterwards, they face the treatment, illustrating the cases where they can use
      the antivenom, calcium gluconate or methocarbamol, with modalities, doses and
      administration stages.

PMID- 2216026
TI  - [List of abuse substances most requested by drug addicts, particularly in
      reference to the Alexandria province. Notes for the general practitioner].
AB  - The drugs in Italy most requested by addicts, who use them in their constant
      search for perceptive distortion are listed. The list refers principally to the
      figures collected in the province of Alessandria. The list is aimed at the
      general practitioner who usually receives the highest number of requests for
      prescriptions for such drugs. It is recommended how to behave so as to avoid
      errors punishable by law.

PMID- 2216027
TI  - [Assessment of rehabilitation in psychiatry. A study of 50 patients].
AB  - Following an analysis of the concept of rehabilitation in psychiatry, the results
      of the use of the "Disability Assessment Schedule II" in a group of 50 patients
      (24 males and 26 females), suffering from schizophrenic psychoses, are reported.
      The opportuneness of a rehabilitation intervention stressed, wherever medium
      severe disability levels are observed, in order to impede the affective and
      social destitution characteristic of chronic mental disease.

PMID- 2216028
TI  - [Preliminary experience in health education in a group of 52 diabetic patients].
AB  - The results of a study carried out in a random sample of patients who had filled
      out a questionnaire of selected questions are reported. The questionnaire was re
      presented after a cycle of health education and the replies compared so as to
      assess specific learning.

PMID- 2216029
TI  - [Hypoglycemia caused by partial deficiency of growth hormone. Description of a
      clinical case].
AB  - A clinical case of a female patient suffering from recurrent, especially
      nighttime, attacks of hypoglycaemia is reported. Clinical tests found these to be
      the consequence of partial hypophyseal deficiency of growth hormone.

PMID- 2216030
TI  - [Normal echography of the liver and the bile ducts].
AB  - On account of its high diagnostic precision, widespread availability, its use for
      the periodic monitoring of patients and its low cost, ectomography now occupies a
      leading position among the new diagnostic imaging techniques. The present study
      illustrates the ecostructure, seat, shape, size and relations between the liver
      and the bile ducts using ultrasonic analysis.

PMID- 2216031
TI  - [Changes in feeding behavior in anorexic individuals. Description of 2 clinical
      cases].
AB  - The change in the eating behaviour of anorexic individuals has been studied with
      particular attention to the case of two biovular heterozygotic twins. It is
      observed that dietetic treatment backed by careful psychiatric therapy is a
      decisive factor in the resolution of the pathology.

PMID- 2216032
TI  - [Long-term outcome of severe cranial injury].
AB  - Clinical data relating to the admission into hospital of patients who survived
      severe cranial traumas are reported and are compared with the long-term outcome
      in order to identify eventual significant prognostic parameters. No particular
      significant correlations were observed between the parameters in question, but,
      in accordance with other studies, a close correlation was observed between the
      duration of the state of coma and the incidence and severity of invalidating
      effects.

PMID- 2216033
TI  - [Intravenous anesthesia using propofol in surgical interventions in day hospital
      routines].
AB  - Having illustrated the importance of extending surgical treatment into day
      hospital situations, the paper underlines the need for anesthetics with short
      term effects. Two groups of 30 patients were included in the study and underwent
      anesthesia in day hospital using Propofol or Tiopentone-Enflurane. The results
      reveal comparable respiratory and hemodynamic effects for the two techniques, but
      Propofol is more reliable in terms of the lesser side-effects caused and above
      all the speed of the patient's psycho-physical recovery.

PMID- 2216034
TI  - [Hyperbaric oxygen therapy in acute carbon monoxide poisoning. Illustration of a
      treatment protocol].
AB  - After a brief digression on the etiopathogenesis of carbon monoxide poisoning,
      the paper underlines the importance of the timely use of hyperbaric oxygen
      treatment not only to impede the immediate effects of CO, but also to reduce the
      incidence of neurological complications. The paper illustrates the paroxysm
      protocol and hyperbaric oxygen treatment protocol used by the Authors.

PMID- 2216035
TI  - [Mediterranean boutonneuse fever. Analysis of 48 cases in the Alexandrian
      community].

PMID- 2216036
TI  - [Indigenous dirofilariasis in Alexandria].

PMID- 2216037
TI  - [Hymenolepis diminuta: a rare helminthiasis in humans. Description of a clinical
      case].
AB  - The paper describes a case of hymenolepis diminuta, a relatively uncommon
      helminthiasis in man. The patient examined displayed very particular aspects with
      regard to the course of the disease and its diagnosis.

PMID- 2216038
TI  - [Meningitis caused by Streptococcus morbillorum].
AB  - A rare case of meningitis from Streptococcus morbillorum is described in a middle
      aged man. A complete cure was achieved using a combination therapy of Ampicillin
      and Chloramphenicol.

PMID- 2216039
TI  - [A case of leiomyoblastoma of the stomach].
AB  - Following a brief analysis of the literature, a case of leiomyoblastoma of the
      stomach is described. The rarity of this form is stressed and the importance of
      an endoscopic examination for diagnostic purposes and to select the appropriate
      surgical treatment is underlined.

PMID- 2216040
TI  - [A rare skin tumor: Merkel cell carcinoma].
AB  - A rare case of skin tumour, Merkel cell carcinoma, is reported. The
      histopathological and clinical features and surgical treatment are reported.

PMID- 2216041
TI  - [HIV-associated myelodysplasia. Etiopathogenesis, clinical aspects and therapy].

PMID- 2216042
TI  - [Refractory anemia with excess of blasts in a HIV-positive patient].

PMID- 2216043
TI  - [Common variable agammaglobulinemia. Description of a clinical case].
AB  - Common variable agammaglobulinemia is characterized by a decrease in the levels
      of circulating immunoglobulins, a damaged antibody response to several antigens
      and an increased susceptibility to infection. A rare case of common variable
      hypogammaglobulinemia in a young woman who was brought to the authors' attention
      since she was suffering from meningitis is described.

PMID- 2216044
TI  - [Intestinal amebiasis in AIDS].

PMID- 2216045
TI  - [Type I diabetes mellitus and autoimmunity. Description of 9 clinical cases].
AB  - Diabetes mellitus type I can ben divided into two forms, IA and IB, with
      partially different clinical and pathogenetic characteristics. The present paper
      looks at type I diabetic patients presenting associated pathologies of autoimmune
      type, largely involving the endocrine system.

PMID- 2216046
TI  - [Blastocystis hominis infection in AIDS and correlated pathologies].
AB  - Blastocystis hominis may sometimes be found in feces in sufficient quantities to
      cause symptoms of diseases such as diarrhea abdominal pain, nausea, tenesmus,
      fever, itching and slight acidocytosis. Three cases of blastocysosis observed in
      patients with LAS are reported.

PMID- 2216047
TI  - [HIV-correlated antigens and antibodies in patients treated with zidovudine].
AB  - HIV-antigen is an important marker of the evolution of HIV infection and of the
      response to zidovudine therapy. The study aims to assess the course of HIV
      correlated antigens and antibodies in 4 patients affected by AIDS or ARC treated
      with this drug.

PMID- 2216048
TI  - [Nimesulide in the treatment of postoperative pain in minor orthopedic surgery].
AB  - The study assesses the effect of Nimesulide in the treatment of post-operative
      pain in minor orthopedic surgery. Twenty-five patients who had received regional
      peridural or subarachnoid anesthesia were included in the study. After a variable
      interval of 60 to 90 minutes, the average level of pain, evaluated using a "pain
      score", was considerably reduced. This effect lasted for an average of 360 +/-
      120 minutes. There were minimum side-effects.

PMID- 2216049
TI  - The normal microbial flora of the outer ear canal in healthy Norwegian
      individuals.
AB  - The microbial flora of the outer ear canal was determined for 77 healthy
      individuals (M = 44, F = 33). No growth of any microbe was found in 5% of males
      and 15% of females. Coagulase-negative staphylococci, dominated by Staphylococcus
      epidermidis, were the commonest microbe group found (83% of persons sampled).
      Staphylococcus aureus was found in 7% males and no females. Diptheroids were
      cultured from 32% of the samples. The only Gram-negative rod found was Hafnia
      alvei in 4% of individuals. No Vibrio spp. or anaerobic Gram-negative organisms
      were found. A variety of yeasts and moulds were seen, significantly (p = 0.02)
      more often in males. In a separate experiment, Malassezia furfur was found in 4/9
      males and 0/10 females sampled. Various sampling techniques (dry swab, second dry
      swab, moist swab) that were compared showed broadly similar results. The normal
      flora of the outer ear canal is predominantly Gram-positive and the use of a dry
      swab seems to be a satisfactory method for sample-taking from this area.

PMID- 2216050
TI  - Cultivation of Chlamydia trachomatis. Different methods of treating the
      specimens.
AB  - Specimens of Chlamydia trachomatis were treated either by five different
      detergents, by ultrasound sonication or by four different buffers before
      cultivation in cycloheximide-treated McCoy cells. The chlamydial yield by
      cultivation and the variance of the yield were compared to a standard method
      using 0.2 molar sucrose in phosphate buffered saline (2SP) without application of
      detergents or sonication. 2SP was superior to the other buffers. None of the
      detergents increased the chlamydial yield. Sonication at energy-levels above
      approximately 1200 Ws/ml reduced the chlamydial yield significantly. Sonication
      just below this threshold doubled the yield. None of the methods reduced the
      variance of the yield.

PMID- 2216051
TI  - Close tip-to-tip contacts between dendrites of transient amacrine cells in carp
      retina.
AB  - In isolated retinas of the carp (Cyprinus carpio) placed receptor side up in a
      plastic chamber, a subclass of amacrine cells, generating a fast ON-OFF transient
      response to spot and annular light stimuli, were intracellularly recorded and
      injected with a fluorescent dye, Lucifer yellow (LY). After brief fixation of the
      same preparations in aldehyde solution, the retinas were wholemounted vitreous
      side up in a tissue chamber. Under a fluorescence microscope, one LY-injected
      cell and several dye-coupled cells were seen; these cells belonged to type Fnd,
      having a fusiform soma, narrow dendritic field and bistratified dentrites in the
      inner plexiform layer (IPL). To reveal the interconnections between dendrites,
      one of such dye-coupled cells was further injected with LY. Close tip-to-tip
      contacts were predominantly found between dendrites of neighboring type Fnd cells
      in sublaminae a and b of the IPL, respectively.

PMID- 2216053
TI  - A double immunocytochemical and histochemical technique for demonstration of
      cholinergic neurons and microglial cells in basal forebrain and neostriatum of
      the rat.
AB  - Cholinergic neurons, and their relationship to microglial cells, have been
      examined by light and electron microscopy with an immunocytochemical and
      histochemical double-staining technique, in medial septum, diagonal band of
      Broca, nucleus basalis and neostriatum. This technique may be applied to
      experimental models of anterograde and retrograde degeneration of the cholinergic
      neurons of the basal forebrain in order to collect further information relative
      to the aetiology of degenerative diseases such as Alzheimer's disease.

PMID- 2216052
TI  - Calmitine: a calcium-binding mitochondrial protein specific for fast-twitch
      muscle fibers.
AB  - Mitochondrial fractions were isolated from fast-twitch (EDL), slow-twitch
      (soleus) and heart muscle of normal rat (WKY). Protein separation by
      electrophoresis and study of calcium-45 binding showed that a specific calcium
      protein (designated as calmitine) was present in the mitochondria of fast-twitch
      muscle but practically inexistent in slow-twitch and cardiac muscle. It seems to
      be related to calcium uptake by an energy-dependent mechanism.

PMID- 2216054
TI  - Immunocytochemical localization of manganese superoxide dismutase (Mn-SOD) in the
      hippocampus of the rat.
AB  - The immunocytochemical distribution of manganese superoxide dismutase (Mn-SOD)
      was determined in the rat hippocampus. The enzyme was localized in the
      mitochondria. CA1 pyramidal cells were weakly immunostained, whereas CA3
      pyramidal cells were strongly reactive. These differences in the intensity of the
      Mn-SOD immunostaining reactions may relate to variations in the sensitivity of
      subfields of the hippocampus to ischemia.

PMID- 2216055
TI  - MK-801-induced sprouting by CGRP immunoreactive primary afferent fibers in the
      dorsal spinal cord of the rat.
AB  - In the present study, rats received daily injections of the N-methyl-D-aspartate
      (NMDA) receptor antagonist, MK-801, over 30 consecutive days. The effects of MK
      801 on the distribution of calcitonin gene-related peptide (CGRP)-immunoreactive
      fibers in the dorsal spinal cord of the rat were subsequently examined. In
      addition to the normal immunostaining pattern in laminae I, II and lateral V, a
      dense network of CGRP-immunoreactive fibers was observed along the medial border
      of the dorsal horn and within the dorsal grey commissure. This marked increase in
      immunoreactivity was virtually eliminated following dorsal rhizotomy. These
      observations suggest that MK-801 induces intraspinal sprouting by CGRP
      immunoreactive primary afferent fibers in vivo.

PMID- 2216056
TI  - A specific 70 kDa protein induced in the epileptogenic cortex of rats elicits
      bursting activity and inactivation of potassium current in snail neurons.
AB  - The capability of a specific 70 kDa (P70) protein produced in cobalt-induced
      epileptogenic cortex of rat cerebrum in promoting epileptic bursting activity was
      examined in snail neurons, using the voltage clamp method in combination with the
      pressure injection technique. Injection of P70 into the neurons elicited bursting
      activity with paroxysmal depolarization shift together with a reduction in the
      delayed outward current which was suppressed by tetraethylammonium. These changes
      of membrane properties induced by P70 were dose-dependently inhibited by prior
      treatment with the anticonvulsant phenytoin. These findings indicate that P70
      causes an inactivation of potassium conductance which may generate epileptic
      bursting activity.

PMID- 2216057
TI  - Pre- and postganglionic sympathetic activity in white rami of rats.
AB  - Multifiber sympathetic activity was recorded from the central end of severed 13th
      thoracic communicating rami in urethane-anesthetized rats before and after
      ganglionic blockade by chlorisondamine. Ganglionic blockade decreased nerve
      discharge by 49 +/- 10% (n = 7) indicating that these rami are composed of
      postganglionic axons (other than gray rami fibers) as well as preganglionic
      axons. Histological examination of excised T13 rami showed that postganglionic
      cell bodies are located along the course of these nerves.

PMID- 2216058
TI  - A-fibers mediate mechanical hyperesthesia and allodynia and C-fibers mediate
      thermal hyperalgesia in a new model of causalgiform pain disorders in rats.
AB  - Unilateral tight ligation of about half of the sciatic nerve in rats rapidly
      produces sympathetically dependent neuropathic pain which lasts many months and
      resembles causalgia in humans. The sensory abnormalities detected at the plantar
      side of the hindpaws include: (1) nocifensive responses to repetitive light touch
      (allodynia); (2) bilateral reduction in withdrawal thresholds to repetitive von
      Frey hair stimulation (mechanical hyperesthesia); (3) bilateral reduction in
      withdrawal thresholds to CO2 laser heat pulses; and (4) unilateral increase in
      response duration to an intense laser heat pulse (thermal hyperalgesia). Using
      neonatal capsaicin treatment, we determined the type of afferent fiber remaining
      in the partially injured nerve, which mediates these disorders. Capsaicin, which
      destroys most C- and some A delta-fibers in peripheral nerves, had no effect on
      the touch-evoked allodynia and mechanical hyperesthesia that are produced by
      partial sciatic nerve injury. These disorders were, therefore, mediated by
      myelinated fibers. In contrast, thermal hyperalgesia failed to develop in
      capsaicin-treated rats following partial nerve injury. Thus, thermal hyperalgesia
      produced by partial nerve injury appears to be mediated by heat-nociceptive C
      fibers.

PMID- 2216059
TI  - Evidence for involvement of 5-HT2 and 5-HT1C receptors in the behavioral effects
      of the 5-HT agonist 1-(2,5-dimethoxy-4-iodophenyl aminopropane)-2 (DOI).
AB  - DOI (1-(2,5-dimethoxy-4-iodophenyl aminopropane)-2) has recently been suggested
      as a selective 5-HT2 receptor agonist, but its behavioral effects have not been
      previously reported. In naive rats, DOI induced dose-dependent shaking behavior,
      the novel behavior 'skin jerks' (paraspinal muscle contractions), and forepaw
      tapping of the 'serotonin syndrome'. These behaviors had a similar dose-response
      and time course and were blocked by the 5-HT2/5-HT1C antagonists mianserin,
      ritanserin, and methysergide. Skin jerks, unlike other behaviors, were not
      blocked by 1-propranolol or phenoxybenzamine, drugs with little activity at 5
      HT2/5-HT1C sites. Differences in the pharmacology and neuroanatomy between skin
      jerks and shaking behavior suggest that the 5-HT1C receptor may participate in
      skin jerks and the 5-HT2 receptor in shaking behavior, but drug coaffinities for
      5-HT2 and 5-HT1C receptors require further investigation.

PMID- 2216061
TI  - Diterpenoids.

PMID- 2216060
TI  - beta-Endorphin acts on the reproductive tract of female rats to suppress sexual
      receptivity.
AB  - Sexual receptivity was suppressed in female rats immediately after the male had
      ejaculated. The inhibition was prevented by intravaginal injection of naloxone
      (100 micrograms) before testing and intravaginal injection of beta-endorphin (1.0
      micrograms) inhibited sexual behavior in female rats in a manner comparable to
      that of ejaculation by the male. beta-Endorphin was present in ejaculatory plugs
      collected from the vagina of female rats (8.2 +/- 0.6 pM) and in seminal fluid
      collected from male rats (7.7 +/- 0.2 pM). The results suggest that beta
      endorphin in the ejaculate of the male rat can act on the reproductive tract of
      the female rat to suppress her sexual behavior.

PMID- 2216062
TI  - The biosynthesis of shikimate metabolites.

PMID- 2216063
TI  - Recent progress in the chemistry of indole alkaloids and mould metabolites.

PMID- 2216064
TI  - Beta-phenylethylamines and the isoquinoline alkaloids.

PMID- 2216065
TI  - Perspectives on academic dishonesty.
AB  - Academic dishonest behaviors, such as lying, cheating, and plagiarism, are
      destructive and must be recognized and addressed early in the development of
      professional nurses. Faculty must be concerned with the relationship between
      student integrity in the classroom and clinical or professional behaviors. The
      authors discuss student motivation and attitudes toward unethical practices,
      faculty responses, and responsibilities when these incidents arise, and
      strategies for preventing academic dishonesty.

PMID- 2216067
TI  - The Greek goddesses speak to nurses.
AB  - The Greek goddess myths are a uniquely creative medium to teach affirming
      feminine images to nurses learning about the impact of gender in their personal
      and professional lives. The author briefly reviews the stories of the goddesses
      and strategies for integrating goddess literature into nursing courses.

PMID- 2216066
TI  - Promoting critical thinking skills.
AB  - Educational accountability requires examination and justification of curriculum
      elements that will promote critical thinking skills. The authors review
      theoretical components of critical thinking and provides four examples of
      teaching strategies used to enhance this cognitive skill.

PMID- 2216068
TI  - Program evaluation. Part 1: Four generations of theory.
AB  - Program evaluation is necessary for understanding and improving educational
      programs in nursing, but it is frequently surrounded by a climate of unease and
      perplexity. This first article in a two-part series reviews and evaluates extant
      models of program evaluation using Guba and Lincoln's four generations of
      evaluation as a theoretical framework. The second article (November/December
      1990) examines the state-of-the-art of program evaluation in nursing education
      and proposes implementation of a responsive model of program evaluation in
      schools of nursing. The series aims to foster more dynamic, efficient program
      analysis, thereby enhancing the effectiveness of nursing's educational programs.

PMID- 2216069
TI  - Teaching students for whom English is a second language.
AB  - Nursing students for whom English is a second language (ESL) are now found in
      greater numbers in nursing schools. Their presence in nursing contributes to the
      diversity of the profession, but the language difficulties these students
      experience may influence academic achievement. Nurse educators can assist ESL
      students in reaching their career goal by being aware of the special language
      problems the students can encounter in academic settings and by instituting early
      and appropriate retention interventions.

PMID- 2216070
TI  - RN education: beyond the baccalaureate degree.
AB  - With an emphasis on post-baccalaureate education, the University of Kansas School
      of Nursing has restructured its program for registered nurse students. The
      resultant RN-MS track allows completion of both the baccalaureate and master's
      degrees in nursing in a 2-year time frame. Computer competencies,
      individualization of instruction, and substitution of classes are integrated into
      a streamlined curriculum.

PMID- 2216071
TI  - Retention of minority nursing students on predominantly white campuses.
AB  - Minority nursing students at predominantly white colleges may experience
      psychosocial and academic problems that together influence their decision to
      remain in the academic system. Estimates of attrition rates for minority nursing
      students range from a low of 15% to a high of 85%. Two theories for the extremely
      high attrition rates is that retention strategies frequently have a single focus
      (academics) and that faculty involved with minority students lack a sense of
      commitment to help these students. The author identifies academic and
      psychosocial factors that, singularly or in combination, may make academic
      success an impossible feat for the minority student. Suggested strategies for
      improving retention at the prenursing and nursing levels are outlined.

PMID- 2216072
TI  - The continuing case study.
AB  - A continuing case study highlighting one extended family was used with generic
      and RN baccalaureate nursing students to integrate basic nursing concepts,
      nursing theory, and health assessment content in an integrated curriculum. Unlike
      traditional case studies, the continuing case study allowed people and health
      states to change over time, providing a new dimension to case analysis. This
      method facilitated the application of theory to practice situations and helped
      students to understand the dynamics of family health.

PMID- 2216073
TI  - Confusion in older adults: assessment and differential diagnosis.
AB  - Confusion has long been considered a normal consequence of aging. The growing
      incidence and cost of this untreated symptom has unfairly condemned many elders
      to live out their lives at a low level of functioning and has placed unnecessary
      hardships on their families. This article offers a complete protocol to assess
      and differentiate arrestible and reversible causes of confusion from irreversible
      presenile dementia. The history is the most important aspect of the examination
      of the confused elder. Onset of symptoms, corresponding illness, medication use
      and time of day that the confusion occurs should be included. Objective data
      include mental-status exams, but only as a screening tool and stepping stone for
      other exams. Judgment and abstraction are examined by assessing the client's
      ability to interpret proverbs and plot a sensible course of action. Special
      cortical function is assessed by asking the client to draw a house, a clock and a
      person. A functional pattern assessment specific to the confused elder is
      included. The general assessment centers on ruling out systemic or mechanical
      problems in the brain. Possible pathological causes with corresponding lab
      results, symptoms and clinical data are presented. Confusion is a symptom of many
      different and often unrelated disease entities. Many of these diseases are
      preventable, curable or arrestible. A diagnosis of irreversible presenile
      dementia should never be made without thorough evaluation. The health care
      provider should refer clients suspected of having irreversible presenile dementia
      to neurological specialists for confirmation of clinical findings.

PMID- 2216074
TI  - Taking charge in the air.

PMID- 2216075
TI  - Mr. Tyler's miracle.

PMID- 2216077
TI  - Anistreplase for acute M.I.

PMID- 2216076
TI  - Night shift.

PMID- 2216078
TI  - A case of no consent.

PMID- 2216080
TI  - Helping nurses be nurses.

PMID- 2216079
TI  - Myra offered nothing but complaints.

PMID- 2216081
TI  - Knowing when to look for a new job.

PMID- 2216082
TI  - Making time work for you.

PMID- 2216083
TI  - Personal power: your key to success.

PMID- 2216084
TI  - From A to Z: tips & time-savers for career development.

PMID- 2216085
TI  - Kate's comeback.

PMID- 2216086
TI  - Action stat! Alcohol withdrawal syndrome.

PMID- 2216087
TI  - Understanding the fine line between law and ethics.

PMID- 2216088
TI  - Soldier boy.

PMID- 2216089
TI  - A new direction for dobutamine.

PMID- 2216090
TI  - Caring for the unwanted patient.

PMID- 2216092
TI  - Managing chronic pain with a permanent epidural catheter.

PMID- 2216091
TI  - Diabetes. Update 90.

PMID- 2216093
TI  - How managed care can work for you.

PMID- 2216094
TI  - Myocardial infarction. Pathophysiology, signs, and symptoms.

PMID- 2216095
TI  - Applauding the artistry of nursing.

PMID- 2216096
TI  - How a support group can help your chronically ill patient.

PMID- 2216097
TI  - 12 simple sensible steps for successful blood transfusions.

PMID- 2216098
TI  - Compulsive disorders. How to help when your patient has lost control.

PMID- 2216099
TI  - A.I.D.S. Update.

PMID- 2216100
TI  - Applying antiembolism stockings.

PMID- 2216101
TI  - [The World Conference on women, quite an event!].

PMID- 2216104
TI  - [Law 145: a major reform].

PMID- 2216102
TI  - [The point of Project 2000. Interview by Guylaine Chabot].

PMID- 2216103
TI  - [Professional inspection in community health: an appreciable and appreciated
      impact].

PMID- 2216106
TI  - The OIIQ: an organization for international cooperation.

PMID- 2216105
TI  - [Vulgarizing. Why? For whom? By whom? How?].

PMID- 2216107
TI  - [Motivation of nursing personnel, program of interventions].

PMID- 2216109
TI  - [Without a condom, the answer is no!].

PMID- 2216108
TI  - [When it snows on the family].

PMID- 2216110
TI  - [Bolivia. Few children survive].

PMID- 2216111
TI  - Which women seek help for their psychiatric problems?
AB  - The avenues of help used by adult women with minor psychiatric morbidity were
      investigated in a random community survey from five Otago electoral rolls. A
      random subsample (n = 314) was subsequently interviewed in their homes.
      Information on a wide range of sociodemographic items pertinent to women's social
      roles was collected. Psychiatric illness was determined using a recognised
      structured diagnostic interview. Some 7.8% of the original population was found
      to have depressive, anxiety or phobic disorders at the symptom intensity level
      likely to be found in a psychiatric outpatient clinic. Of these women, just over
      one-third only (35%) said that they had sought help for their illness from any
      source. Most (86%) getting help received it from their general practitioner.
      However, unlike overseas studies where virtually all persons with psychiatric
      disorder consult their general practitioners for some reason, 13% reported that
      they had not visited their general practitioners at all in the preceding six
      months. Alternative therapies were infrequently sought. There was no evidence
      that health services were being inappropriately used by women with nonmedical
      problems. The results show that the majority of women are not getting treatments
      they require for their psychiatric illnesses. The low level of help seeking was
      particularly marked for young women. The findings suggest poor community
      awareness of the symptoms of minor psychiatric morbidity and the associated
      psychosocial consequences.

PMID- 2216113
TI  - Psoriatic arthritis: the use of disease suppressing agents in its management.

PMID- 2216112
TI  - Coronary heart disease among Pacific Island people in New Zealand.
AB  - Coronary heart disease is the leading cause of death in New Zealand. Death rates
      are higher among the Maori than the European population but rates have been
      declining in both groups over recent years. The occurrence of coronary heart
      disease among the Pacific Island population in New Zealand is unknown. Data from
      the National Health Statistics Centre (NHSC) and the Auckland coronary or stroke
      (ARCOS) study were used to describe the occurrence of coronary heart diseases
      among Pacific Island people. Age standardised mortality rates show that coronary
      heart disease is an important cause of death among Pacific Island men. Death
      rates have declined between 1973-77 and 1978-82 but this trend did not continue
      among men in the 1983-86 period. Age standardised mortality rates from coronary
      heart disease from the ARCOS data are 175/100,000 and 52/100,000 for Pacific
      Island men and women compared with 325/100,000 and 141/100,000 for Maori men and
      women. Age standardised rates for European men and women are 154/100,000 and
      36/100,000 respectively.

PMID- 2216114
TI  - Hot water temperature in Dunedin homes with preschool children.
AB  - The mean temperature of the hot water supply of 62 randomly selected Dunedin
      homes with preschool children was 67.8 degrees C. More than 95% of the households
      visited had temperatures above the recommended temperature of 55 degrees C. The
      temperature was related to the socioeconomic status of the major earner of the
      household, the thermostat setting, the age of the water cylinder and its size.
      Accessible thermostats were of the water cylinder and its size. Accessible
      thermostats were only reliable in cylinders under 20 years old.

PMID- 2216115
TI  - Eye injuries in indoor cricket at Wellington Hospital: a survey January 1987 to
      June 1989.
AB  - About 30% of all sports injuries to the eye seen at Wellington Hospital are due
      to indoor cricket. An analysis of 29 eye injuries, January 1987 to June 1989 was
      carried out. Traumatic iritis, mydriasis and commotio retinae were the common
      injuries. There were eight blow out fractures of the orbit. Only two patients had
      permanent loss of vision due to choroidal tears with best vision in the damaged
      eye reduced to 6/9. A total of 88 eye clinic visits and 24 inpatient days were
      involved. The incidence of these injuries could be reduced by wearing eye and/or
      facial protection.

PMID- 2216116
TI  - Cycle helmet ownership in a birth cohort of children.

PMID- 2216117
TI  - The effect of benzalkonium chloride on the bronchodilator response to salbutamol
      nebuliser solution.

PMID- 2216118
TI  - Some gynaecological issues from a rural and Maori perspective.

PMID- 2216119
TI  - Contracts for general practitioners.

PMID- 2216120
TI  - Report on fitness of medical practitioners to defend charges.

PMID- 2216121
TI  - Lowering serum cholesterol levels.

PMID- 2216123
TI  - Specialist opinion and the ACC.

PMID- 2216122
TI  - Results of trials of screening.

PMID- 2216124
TI  - Annual practising certificate.

PMID- 2216125
TI  - Delays at the Medical Council.

PMID- 2216126
TI  - Conquest of the autoimmune diseases.

PMID- 2216128
TI  - Dietary intervention to reduce cot death.

PMID- 2216127
TI  - Rubella epidemic.

PMID- 2216129
TI  - Sarcoid myocarditis.

PMID- 2216130
TI  - Screening the elderly: a Christchurch study.
AB  - Two hundred and four people aged 65 year or older participated in a study to
      assess the merits of screening the elderly in a general practice. An average of
      4.6 (SD 2.2) problems per patient were found. There was a mean of 1.1 (1.0)
      previously unrecognised problems per patient. Visual and hearing impairment,
      prostatism, incontinence and some neurological conditions were the main
      unrecognised problems. Those with unrecognised problems were older, less mobile
      and received more community supports. There was also a trend towards lower mental
      status questionnaire and functional scores and to greater medication usage. The
      results of this study support the principle of screening or case finding in the
      elderly. Targeting those at risk is required in order to reduce the workload
      involved. However, the current at risk indicators identified only a proportion of
      those in need of screening. Further research is required as to how to correctly
      identify these patients.

PMID- 2216131
TI  - Is the prevalence of bulimia nervosa higher among tertiary education populations?
AB  - In this study the prevalence of bulimia nervosa was estimated among 243 women in
      a tertiary educational setting. The results showed 43.6% (95% CI, 37.4 to 49.8)
      to report binge eating, the cardinal feature of bulimia nervosa, at some stage in
      the past and 2.5% (95% CI, 1.0 to 5.6) the full criteria for current bulimia
      nervosa. These figures are significantly higher than those reported recently for
      a general population sample in the same age range. Despite methodological
      differences between the two surveys the results give some support to claims that
      women in these settings are at a greater risk of developing eating disorders.

PMID- 2216132
TI  - Behind the iron mask: the mental changes of Parkinson's disease.

PMID- 2216134
TI  - Alternatives to the admission of some elderly patients to acute medical beds.
AB  - There is evidence that admission to an acute medical ward is not the best way to
      look after many elderly patients. This study investigated 83 general
      practitioners' preferences for the management of 200 elderly patients admitted to
      the medical beds at Wellington Hospital. For 63.5% of the patients this admission
      had been by their own doctor and 84% of these patients had been cared for by this
      doctor for longer than one year. Admission to an acute medical bed was the
      preferred option for only 48% of patients. Augmented home care was considered a
      possible option for 31.5% of patients but was mentioned as one of the preferred
      options for only 9.0%. Admission to a general practitioner bed was the preferred
      option for 16.5% of patients. The results of this study suggest that area health
      boards should provide more choices for the management of acute illness in elderly
      patients.

PMID- 2216133
TI  - Breast cancer incidence and mortality in Auckland, 1981-6.
AB  - Age standardised incidence and mortality rates were calculated for breast cancer
      for the Auckland area. Incidence of female breast cancer for 1981-4 was
      significantly higher in Auckland compared with all New Zealand, with a
      standardised incidence ratio of 1.11. While total incidence was the same across
      the three Auckland districts, there were wide discrepancies in mortality rates.
      Women in Takapuna had a far lower risk of dying of breast cancer compared with
      all New Zealand for 1981-6 and had a standardised mortality ratio of 0.86.
      Central Auckland and south Auckland women had increased risks--1.10 and 1.18
      respectively. Similar discrepancies were evident in the important 45-64 age
      group. Possible reasons for the reported differences are discussed with
      socioeconomic factors seeming the most likely agency.

PMID- 2216135
TI  - Postviral myositis: case report.

PMID- 2216136
TI  - Blood glucose values in diabetic children at a camp.

PMID- 2216137
TI  - Selected problems in medical education.

PMID- 2216138
TI  - Risk factors for coronary heart disease in middle aged men.

PMID- 2216139
TI  - On sexually explicit questioning.

PMID- 2216140
TI  - Water associated infections.

PMID- 2216141
TI  - Spotting fad diets.

PMID- 2216142
TI  - Adverse drug reactions.

PMID- 2216143
TI  - Fluoridation and dental caries.

PMID- 2216144
TI  - The prescribing of mixtures.

PMID- 2216145
TI  - Trends in hepatitis B notifications.

PMID- 2216146
TI  - Psychologists and a code of ethics.

PMID- 2216147
TI  - Hours of work.

PMID- 2216148
TI  - Safe staffing.

PMID- 2216149
TI  - Party perspectives.

PMID- 2216150
TI  - Safety in the cancer ward.

PMID- 2216151
TI  - Nurses and equity issues.

PMID- 2216152
TI  - A social force.

PMID- 2216153
TI  - There is more than one use of SOAP. Subjective data, objective data, assessment
      and plan.

PMID- 2216154
TI  - Trends: shifting patterns of authority.

PMID- 2216155
TI  - What will physician payment reform mean for nurses?

PMID- 2216156
TI  - The impaired nurse--who is liable.

PMID- 2216157
TI  - What are user groups and how can they help you wield more power?

PMID- 2216158
TI  - Designing and implementing a supplemental staffing system.

PMID- 2216159
TI  - A hospital-based program for recovering chemically-dependent nurses.

PMID- 2216160
TI  - An agency-staffed nursing unit project.

PMID- 2216161
TI  - A program to manage nurse staffing costs.

PMID- 2216162
TI  - A psychiatric patient classification system.

PMID- 2216163
TI  - The excellence within.

PMID- 2216164
TI  - Recruitment: combining work and school.

PMID- 2216165
TI  - Traveling nurses--a valuable resource.

PMID- 2216166
TI  - Entry into practice.

PMID- 2216167
TI  - CC and med/surg nurses: another study.

PMID- 2216168
TI  - Policies and procedures: a synergistic approach.

PMID- 2216170
TI  - An innovative recruitment and retention scholarship program.

PMID- 2216169
TI  - Non-professional nursing staff attitudes about AIDS.

PMID- 2216172
TI  - Twelve-hour shifts: answer to job satisfaction?

PMID- 2216171
TI  - Clarifying resuscitation status: a new approach.

PMID- 2216173
TI  - Outpatient surgery: a case study.

PMID- 2216174
TI  - Watch your memo manners!

PMID- 2216175
TI  - Can LPNs start i.v.s in Ohio?

PMID- 2216176
TI  - OSHA and EPA--partners in our practice creating chaos.

PMID- 2216178
TI  - Dentistry 1980-89: a profession in transition. Percy T. Phillips memorial lecture
      1990.

PMID- 2216177
TI  - Living wills--your right to die.

PMID- 2216179
TI  - Iconodontalgia V.

PMID- 2216180
TI  - Aspirin shown to increase P.O. facial swelling.

PMID- 2216181
TI  - Neuromuscular occlusion: diagnosing TMJ.

PMID- 2216182
TI  - Radiopharmaceuticals and Product Licences of Right.

PMID- 2216183
TI  - The current cost of nuclear medicine.
AB  - In the light of the control of expenditure and changes in radiopharmaceutical
      costs, changes in study protocols, new investigation procedures and inappropriate
      placing in Korner categories, the BNMS Council set up a working party to derive
      an agreed set of costings for Nuclear Medicine techniques. Using data from three
      hospitals with additional information from another nine, we have agreed the 1988
      cost of individual nuclear medicine procedures in the UK. These figures include
      staffing (radiopharmacy, nursing, physics, medical including consultant),
      radiopharmaceuticals and other consumables, indirect costs (secretarial,
      administrative, portering), variable overheads (service contracts, stationery)
      and fixed overheads (rates, lighting, heating, building and engineering). Capital
      costs, equipment and buildings were not included. Because figures include salary
      and overhead costs they are difficult to compare with the majority of other
      previous nuclear medicine costings, apart from Bretland et al., or with data for
      other imaging modalities. Comparison of these costings with Korner schedules
      shows marked overlap between the Korner groups. Such groups therefore form a poor
      method of costing nuclear medicine procedures. We propose alternative groupings.

PMID- 2216184
TI  - Assessment of right ventricular function with nonimaging first pass
      ventriculography and comparison of results with gamma camera studies.
AB  - A new technique has been developed for measuring right ventricular function by
      nonimaging first pass ventriculography. The right ventricular ejection fraction
      (RVEF) obtained by non-imaging first pass ventriculography was compared with that
      obtained by gamma camera first pass and equilibrium ventriculography. The data
      has demonstrated that the correlation of RVEFs obtained by the nonimaging nuclear
      cardiac probe and by gamma camera first pass ventriculography in 15 subjects was
      comparable (r = 0.93). There was also a good correlation between RVEFs obtained
      by the nonimaging nuclear probe and by equilibrium gated blood pool studies in 33
      subjects (r = 0.89). RVEF was significantly reduced in 15 patients with right
      ventricular and/or inferior myocardial infarction compared to normal subjects (28
      +/- 9% v. 45 +/- 9%). The data suggests that nonimaging probes may be used for
      assessing right ventricular function accurately.

PMID- 2216185
TI  - The effect of forced expiration on the uniformity of 99Tcm-DTPA aerosol
      ventilation images in patients with excess sputum production.
AB  - This study examines the use of the forced expiratory technique (FET) as a means
      of improving the uniformity of radionuclide aerosol ventilation images in
      patients with excess sputum production. Ventilation images are objectively
      classified by two computer derived indices to characterize the degree of
      radioaerosol clumping and overall uniformity. In a series of twenty five patients
      with a long-standing history of daily sputum production, images acquired before
      and after forced expiration and again after a second ventilation immediately
      following FET showed no significant change in either index. The results obtained
      do not provide evidence to support the routine use of FET in conjunction with
      radioaerosol scintigraphy. The method of image classification correlates well
      with a visual assessment of image uniformity and has general application.

PMID- 2216186
TI  - Reclosure of disrupted abdominal incisions.
AB  - We evaluated prospectively a technique of delayed reclosure of disrupted
      abdominal incisions. Forty-one consecutive postoperative obstetric and
      gynecologic patients with abdominal incisions that had opened because of
      infection, hematoma, or seroma and had intact fascia participated in the study.
      All wounds were first managed identically, with surgical drainage and
      debridement, for a minimum of 4 days. The patients then were randomized to either
      wound reclosure by a standardized en bloc technique (35) or healing by second
      intention (six). Reclosure was successful in 30 of 35 cases (85.7%). The mean
      time to complete healing was 15.8 days in successful cases, 67.2 days in failed
      cases, and 23.2 days for all patients who were reclosed. Failure to heal after
      reclosure was due to subcutaneous infection in two patients and seroma in three;
      these women were significantly heavier than those in whom reclosure was
      successful. There were no other major complications of wound reclosure. Patients
      randomized to healing by second intention required a mean of 71.8 days of wound
      care. The time to complete healing in the wound-reclosure group was significantly
      shorter compared with the group that healed by second intention (P = .002, log
      rank test). We conclude that en bloc reclosure of disrupted surgical incisions,
      compared with nonsurgical treatment, significantly decreases the time required
      for wound healing and has minimal morbidity.

PMID- 2216187
TI  - Cefazolin for hysterectomy prophylaxis.
AB  - Efficacy data for single-dose cefazolin prophylaxis at hysterectomy are meager,
      and there are none evaluating the impact of route of administration on efficacy.
      For these reasons, 772 women undergoing elective abdominal or vaginal
      hysterectomy for benign diseases were given 1 g cefazolin either intramuscularly
      or intravenously in a randomized clinical trial. Preoperative diagnoses and
      clinical, surgical, and outcome variables were similar by route of administration
      for each surgical approach. Risk factors for infection after abdominal
      hysterectomy included younger age, lower postoperative hemoglobin concentration,
      and pelvic hematoma; women who developed infection after vaginal hysterectomy
      were heavier than those who remained uninfected and were more likely to have a
      pelvic hematoma. The overall incidence of major operative site infection
      requiring parenteral antimicrobial therapy in evaluable women was 7.2%: 7.6% for
      539 women undergoing abdominal hysterectomy and 6.3% for 207 women undergoing
      vaginal hysterectomy. Postoperative infection was unrelated to route of cefazolin
      administration.

PMID- 2216188
TI  - Intraoperative radioimmunodetection of ovarian cancer using monoclonal antibody
      B72.3 and a portable gamma-detecting probe.
AB  - To assess the value of radioimmunoguided surgery in the intraoperative detection
      of ovarian cancer, we used monoclonal antibody B72.3, radiolabeled with 125I, and
      a hand-held gamma-detecting probe in 13 women with ovarian cancer undergoing
      exploratory laparotomy. B72.3, which recognizes a tumor-associated glycoprotein,
      TAG 72, was injected 12-29 days preoperatively (intraperitoneally in four cases,
      intravenously in nine, and by both routes in one). Intraoperatively, the abdomen
      was surveyed with the probe and probe counts were correlated with biopsies and
      excised specimens studied by routine histologic stains. Probe counts were
      positive in four of seven evaluable patients with histologically confirmed
      disease. In three of these four patients, the probe detected cancer in specimens
      interpreted as normal on frozen histologic sections. The probe also identified
      microscopic cancer in the one patient who had no gross disease. The specificity
      of the probe was 70%. Preoperative computed tomography was normal in all
      patients, including those with tumors as large as 3 cm. This pilot study shows
      the ability of radioimmunoguided surgery to detect occult ovarian cancer.

PMID- 2216190
TI  - Prognostic factors for outcome of and survival after second-look laparotomy in
      patients with advanced ovarian carcinoma.
AB  - In ovarian cancer stages IIB-IV, pre-treatment variables and variables obtained
      intraoperatively at second-look laparotomy were investigated for their prognostic
      influence on the outcome of 109 patients and survival after second-look
      laparotomy in 131 patients. The subjects came from a randomized trial of
      sequential versus alternating combination chemotherapy. The overall median
      survival after second-look laparotomy was 62 months. Logistic regression analysis
      identified stage and hysterectomy plus bilateral salpingo-oophorectomy and
      omentectomy as significant prognostic covariates for second-look laparotomy
      outcome. Based on a Cox multivariate stepwise analysis, independent prognostic
      factors for survival after second-look laparotomy were secondary residual tumor
      size, pre-treatment histologic differentiation grade, and performance status. A
      high differentiation grade and a good performance status at the start of therapy
      thus still had a prolonging effect on survival after second-look laparotomy. The
      prognostic power of these pre-treatment variables was increased substantially by
      the addition of the secondary residual tumor size variable. The 3-year survival
      rate after second-look laparotomy for high- and low-risk patients was 15 and 87%,
      respectively. Second-look laparotomy thus provides prognostic information in
      patients with advanced ovarian carcinoma, but the benefit in terms of survival is
      still unclear.

PMID- 2216189
TI  - Computed tomography-guided fine-needle aspiration of retroperitoneal lymph nodes
      in gynecologic oncology.
AB  - Computed tomography-guided fine-needle aspiration was performed on 30
      retroperitoneal lymph nodes in 29 patients with gynecologic cancer. There were no
      serious complications. Review of the cytologic material demonstrated malignant
      cells in 83% of the aspirates. Because the predictive value of a positive
      aspirate approaches 100%, therapy for metastatic disease can be initiated in
      these patients with the need for an open biopsy. Among five aspirates in which
      malignant cells were not seen, the cellularity of the specimen appeared to be the
      critical factor determining the predictive value of the aspirate. Whereas neither
      of two patients with negative aspirates of adequate cellularity has developed
      recurrent disease, two of three patients with hypocellular negative aspirates
      have. Because a hypocellular negative aspirate from a retroperitoneal lymph node
      may not be a true reflection of disease status, either repeat aspiration or open
      biopsy is advisable.

PMID- 2216191
TI  - Ovarian metastases are rare in stage I adenocarcinoma of the cervix.
AB  - Over a 32-year period at the University of California, Los Angeles Medical
      Center, all cases of adenocarcinoma and adenosquamous carcinoma of the uterine
      cervix were reviewed to determine the incidence of ovarian metastases in stage I
      disease. One of 25 patients (4.0%) who underwent an exploratory laparotomy and
      radical hysterectomy had a microscopic ovarian metastasis. A literature review
      identified nine additional patients who had ovarian metastases and stage I
      adenocarcinoma of the cervix. Including our series, the overall reported rate of
      ovarian metastases is 1.8%. All ten patients had at least one of the following
      additional characteristics: They were postmenopausal, they had adnexal pathology,
      or they had positive pelvic lymph nodes. Thus, ovarian preservation is warranted
      in premenopausal patients who do not have ovarian pathology or evidence of other
      metastatic disease at surgery. Bilateral oophorectomy may be performed if frozen
      section examination of enlarged or suspicious nodes documents metastases. If the
      ovaries are left in the pelvis at the completion of the surgical procedure and
      microscopic spread to other pelvic tissues is documented, pelvic irradiation can
      be administered.

PMID- 2216192
TI  - The fallacy of the screening interval for cervical smears.
AB  - One hundred seventy-four women with invasive cervical carcinoma were interviewed
      about their cervical smear histories to assess the accuracy of self-reporting and
      to relate the smear history with patient and tumor characteristics. Patients
      reported significantly more frequent, more recent, and more normal smears than
      were documented in medical records. The interval between onset of cancer symptoms
      and previous smear correlated directly with advanced stage. Sixteen women with
      normal smears within 36 months had significantly more advanced cancers than did
      25 women with recent abnormal smears. Women with recent normal and abnormal
      smears had similar sociodemographic and behavioral characteristics. Because of
      inaccuracies in patients' self-reported smear histories and cancers developing in
      women with recent normal smears, we conclude that a specific screening interval
      should not be relied upon.

PMID- 2216193
TI  - Cold-knife and laser conization for cervical intraepithelial neoplasia.
AB  - In a 5-year study, 425 women had conization performed for cervical
      intraepithelial neoplasia (CIN) I, II or III. Conization was performed only in
      cases of positive endocervical curettage or when colposcopy was inconclusive. In
      all other cases, local destruction was the operation of choice. In the early
      years of the study, conization was done by the cold-knife method (N = 201),
      whereas CO2 laser was used in the latter part of the study (N = 224). Success and
      complication rates were the same for the two methods. Abnormal cytology after
      conization was found in a total of 53 cases (12.5%), but a histologic
      confirmation of residual or recurrent CIN was made in only 27 women (6.4%). This
      corresponds to a success rate of 92% after cold-knife and 95% after laser
      conization. The CIN grading of the residual or recurrent CIN was similar to or
      less than the CIN diagnosis of the cone. Because our success rate was comparable
      to that of other series with much less strict referral criteria, our policy seems
      adequate.

PMID- 2216194
TI  - Postoperative urinary tract infection in gynecology: implications for an
      antibiotic prophylaxis policy.
AB  - A prospective observational study of postoperative infection after gynecologic
      surgery assessed the need for antibiotic prophylaxis with special reference to
      the urinary tract. Catheterization requirements in the postoperative period were
      compared with the development of urinary tract infection after excluding both
      preoperative and postoperative bacteriuria. Forty-six of 115 patients (40%)
      developed a urinary tract infection in the postoperative period. Furthermore,
      this was not clearly related to the need for postoperative catheterization.
      Significant wound and vaginal vault infections were uncommon, indicating that
      antibiotic prophylaxis should be directed specifically at the urinary tract.

PMID- 2216195
TI  - Primary invasive carcinoma of the vagina.
AB  - A retrospective review was conducted of 53 women with invasive carcinoma of the
      vagina and without documented exposure to diethylstilbestrol who were seen at the
      University of California Irvine Medical Center, Long Beach Memorial Medical
      Center, and Saddleback Memorial Medical Center from 1976-1988. Forty-seven (89%)
      had squamous cell carcinoma and six (11%) adenocarcinoma. Thirty-seven (70%) were
      treated with whole-pelvis irradiation and brachytherapy, nine with surgery alone,
      and the other seven with a combination of treatments. The crude and corrected 2
      year survival rates for the entire group were 47 and 69%, respectively. Those
      with previous pelvic surgery were more likely to develop serious treatment
      related complications. There was a statistically significant correlation between
      previous hysterectomy and the diagnosis of primary invasive carcinoma of the
      vagina after the onset of symptoms. Women diagnosed during routine examination,
      before symptom onset, tended to have a survival advantage. All women, including
      those who have had hysterectomy, should be counseled to continue gynecologic
      cancer surveillance regardless of age.

PMID- 2216196
TI  - The effects of Chlamydia trachomatis on the female reproductive tract of the
      Macaca nemestrina after a single tubal challenge following repeated cervical
      inoculations.
AB  - The effects of repeated cervical infections followed by a single direct tubal
      inoculation with Chlamydia trachomatis, serovars D and F, were examined in 11 pig
      tailed macaques to test the hypothesis that tubal inoculation after cervical
      priming causes a more severe disease than primary tubal inoculation alone.
      Animals were cervically inoculated between two and five times. Fallopian tubes
      were inoculated with serovar D or F 1 week after the last cervical challenge.
      Three control monkeys received only one direct tubal inoculation without previous
      cervical inoculation. Infection was confirmed by isolating the microorganism from
      the endocervix in 13 of 14 monkeys and from the endosalpinx in four only after
      the tubal inoculation. Antibody was detected in post-infection sera of all 14.
      Tubal edema occurred in seven of 11 animals after the first cervical inoculation,
      and uterine erythema occurred in 11 of 11 after the second cervical inoculation.
      Peritubal adhesions were induced before the tubal inoculation in zero of seven
      given three or fewer cervical inoculations and four of four given five cervical
      inoculations (P less than .01). After direct tubal inoculation, peritubal
      adhesions became more prominent, and the 11 hysterectomy specimens showed plasma
      cell endometritis in nine and salpingitis in nine. Two control monkeys developed
      minor adhesions, the other none. One tube in two of three controls showed mild
      plasma cell infiltrates, whereas no evidence of endometritis was observed in
      controls. Histopathology in these monkeys was characteristic of chlamydial
      endometritis and salpingitis. However, the pathogenesis of these changes is
      uncertain because C trachomatis was not isolated from the endosalpinx after
      cervical inoculations alone.

PMID- 2216197
TI  - Torulopsis glabrata vaginitis: clinical aspects and susceptibility to antifungal
      agents.
AB  - Torulopsis glabrata is second only to Candida albicans in frequency of isolation
      from the vagina in both asymptomatic women and patients with yeast vaginitis. We
      retrospectively studied 33 patients from whom vaginal isolates of T glabrata were
      obtained. Torulopsis glabrata caused symptomatic vaginitis in 42% of the patients
      but was unassociated with symptoms in 30%; in 27% of patients, its importance was
      uncertain because of concomitant pathology. Antifungal susceptibility testing was
      performed on 39 T glabrata strains isolated from 39 patients. The minimal
      inhibitory concentrations (MICs) of the majority of T glabrata isolates fell
      within the sensitive range of the antimycotic drugs tested; however, no
      correlation was found between in vitro antifungal MICs and the response to azole
      drug therapy. Clinical success was achieved in 67% of the patients although
      mycologic cure occurred in only 33%. A small number of patients developed
      recurrent and often chronic Torulopsis vaginitis unresponsive to conventional
      therapy. Limited experience suggests that vaginal boric acid therapy may be of
      value in these recalcitrant cases.

PMID- 2216198
TI  - Topical podofilox for the treatment of condylomata acuminata in women.
AB  - The purpose of this study was to determine the efficacy and safety of 0.5%
      podofilox solution (Condylox) for the treatment of genital warts in women. Thirty
      seven women with anogenital warts applied the solution to the surface of these
      warts twice daily for 3 days, followed by 4 drug-free days. A minimum of two and
      a maximum of four treatment cycles were given. The subjects were evaluated weekly
      for the first 4 weeks and again at 6 and 10 weeks. At the end of 10 weeks, the
      mean number of warts per patient was reduced from 6.27 to 1.1, and half of the
      patients were completely cleared of warts. Only eight of 37 subjects (21.6%)
      developed new warts during the study period. Approximately 15% of patients
      reported "severe" local reactions to the treatment after the first treatment
      cycle, but this was reduced to only 5% by the last treatment cycle. During the
      same period, the patients reporting no side effects increased from 44 to 86%. The
      only woman who discontinued the study did so because of dizziness and epigastric
      discomfort, probably unrelated to drug use. Thus, 0.5% podofilox solution appears
      to be an effective treatment for condylomata acuminata, with acceptable side
      effects that are local and temporary.

PMID- 2216199
TI  - Does the treatment of genital condylomata in men decrease the treatment failure
      rate of cervical dysplasia in the female sexual partner?
AB  - Three hundred ninety women treated for cervical dysplasia by local tissue
      ablation were studied retrospectively to test the hypothesis that the treatment
      failure rate is lower if the male sexual partner is also treated. In 190 cases,
      the male sexual partner was examined and treated successfully for genital
      condylomata. Controls were 200 women treated during the same time period and
      closely matched to the study group regarding age, race, socioeconomic status,
      histologic grade of dysplasia, distribution of the lesions, and methods of
      therapy, but the male partner was neither examined nor treated. The treatment
      failure rate for women whose partners were also treated was not significantly
      different from that for women whose partners were not treated (6.8 versus 7.5%; P
      greater than .05), suggesting that treating genital condylomata in men does not
      affect the failure rate of cervical dysplasia in female sexual partners.

PMID- 2216200
TI  - Fetal acoustic stimulation as a possible adjunct to diagnostic obstetric
      ultrasound: a preliminary report.
AB  - Unfavorable fetal position during diagnostic obstetric ultrasound can interfere
      with visualization of certain structures, leading to prolonged or repeated
      examination. Fetal acoustic stimulation induces a fetal startle reflex and an
      increase in fetal movements. This report describes our experience with fetal
      acoustic stimulation to prompt fetal movement in an effort to improve fetal
      visualization. At gestational ages of 28 weeks or more a 94.1% success rate was
      noted, in 30 seconds or less in 70.6% of the cases. We conclude that fetal
      acoustic stimulation may be a valuable adjunct to diagnostic obstetric
      ultrasound.

PMID- 2216201
TI  - Premature rupture of membranes at term in nulliparous women: a hazard?
AB  - One hundred five consecutive women with premature rupture of the membranes (PROM)
      at term were managed expectantly for at least 24 hours. Seventy-six went into
      spontaneous labor, of whom 38 were augmented with oxytocin. Twenty-nine had labor
      induced. Subjects who delivered during the same study interval after artificial
      rupture of the membranes served as controls. There were no statistically
      significant differences in the frequency of amnionitis, endometritis, cystitis,
      neonatal infection, low Apgar score, low cord arterial blood pH, instrumental
      delivery, or cesarean delivery. Morbidity was seen most often in induced labor
      whether or not the membranes were ruptured for a long time. It is concluded that
      expectant management of PROM at term does not increase perinatal morbidity.

PMID- 2216202
TI  - Zinc status in women with premature rupture of membranes at term.
AB  - Zinc concentrations were measured by atomic absorption spectrometry in whole
      blood, scalp hair, pubic hair, and colostrum from patients at term with and
      without premature rupture of membranes (PROM). A maternal zinc index was
      established for each patient, expressed as an average ranking of the four
      determinations. The mean +/- SD value of the maternal zinc index in patients with
      PROM was significantly lower than in patients without this complication (4.33 +/-
      1.18 versus 5.97 +/- 1.39, respectively; P = .0002). The inverse relationship
      between maternal zinc index and parity was statistically significant (r = -0.61;
      P = .04). These results suggest that the subnormal tissue zinc content in
      pregnancy may play a role as a causative factor in PROM at term.

PMID- 2216204
TI  - Pre-induction cervical ripening with prostaglandin E2 gel: intracervical versus
      intravaginal route.
AB  - The aim of our study was to evaluate the best method for cervical ripening before
      a classical induction with amniotomy and oxytocin. One hundred term pregnant
      patients who presented an unfavorable cervix and an indication for the induction
      of labor were assigned randomly to either 0.5 mg prostaglandin (PG) E2 gel
      intracervically (N = 52) or 3 mg PGE2 gel intravaginally (N = 48). The
      intravaginal gel had a greater effect on cervical ripening according to a
      modification of the Bishop score than did intracervical gel, but it had a higher
      incidence of side effects.

PMID- 2216203
TI  - Stripping membranes at term: can it safely reduce the incidence of post-term
      pregnancies?
AB  - Membrane stripping has been used clinically for many years but has not been well
      studied. An investigation was undertaken to determine whether weekly membrane
      stripping beginning at 38 weeks could safely reduce post-term pregnancies. One
      hundred eighty patients with firm gestational dates were randomized to either a
      treatment or control group. Control subjects received a gentle cervicovaginal
      examination each week to assess Bishop scores, whereas the treatment group also
      underwent weekly stripping of membranes. Women who received treatment had earlier
      delivery (mean +/- SEM 8.60 +/- 0.74 versus 15.14 +/- 0.83 days; P less than
      .0001) and fewer post-term deliveries than those in the control group (three
      versus 14; P less than .004). The reduction of post-term pregnancies was most
      notable in nulliparous women with unfavorable Bishop scores. Complications were
      similar in both groups. Membrane stripping was safe and was associated with
      earlier delivery and a decreased incidence of post-term gestation.

PMID- 2216205
TI  - Evaluation of a perinatal autopsy protocol: influence of the Prenatal Diagnosis
      Conference Team.
AB  - This study was designed to evaluate changes in the perinatal autopsy following
      the adoption of a new autopsy protocol. The University of Utah Medical Center has
      a Prenatal Diagnosis Conference Team composed of obstetricians, pediatricians,
      geneticists, and other health care professionals. These individuals are involved
      in the care of patients whose pregnancies are at risk for congenital
      malformations. An autopsy protocol was designed to increase the interaction of
      the pathologist with the Prenatal Diagnosis Conference Team in the evaluation of
      perinatal death. Two years, 1982 and 1987, before and after the protocol was
      implemented, were selected for retrospective review. The autopsies in 1987 made
      more specific diagnoses compared with those in 1982. Additional congenital
      anomalies were diagnosed, and increased numbers of patients were found to have
      well-described congenital disorders. The number of attempted postnatal autopsy
      chromosome studies increased and more chromosomal abnormalities were detected.
      The final autopsy diagnoses made in 1987 have provided more information to the
      physician for genetic or other patient counseling. After the protocol was
      adopted, increased numbers of cases were referred to the Medical Center for
      evaluation at autopsy. More of those who came to autopsy had been evaluated
      during life by members of the Prenatal Diagnosis Conference Team. Premortem
      sonograms had been done at an earlier gestational age and a greater number of
      anomalies were detected. Fewer of the fetuses had intrauterine death and more had
      pregnancy terminated by induction of labor. The gestational age at delivery
      declined.

PMID- 2216206
TI  - Prenatal administration of indomethacin as a tocolytic agent: effect on neonatal
      renal function.
AB  - Renal function was evaluated in premature infants whose mothers received long
      term indomethacin for tocolysis. Creatinine, urine and serum osmolalities,
      fractional excretion of sodium, and glomerular filtration rate were compared
      during the first 10 postnatal days in 14 preterm infants exposed to indomethacin
      in utero and in ten control infants. Renal function in both groups was
      comparable, with no significant differences on any study date in serum urea
      nitrogen and creatinine, ratio of urine osmolality to serum osmolality,
      fractional excretion of sodium, or glomerular filtration rate. These data suggest
      that long-term intrauterine administration of indomethacin does not significantly
      alter renal function.

PMID- 2216207
TI  - Enhanced anaphylatoxin and terminal C5b-9 complement complex formation in
      patients with the syndrome of hemolysis, elevated liver enzymes, and low platelet
      count.
AB  - Complement activation was studied in ten consecutive pregnant women developing
      hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome) and
      ten other women with normal pregnancies. Blood samples for anaphylatoxin (C3a/C3a
      desArg and C5a/C5a desArg) and terminal C5b-9 complement complex determinations
      were drawn at delivery and 24 hours and 7 days later. Women developing HELLP
      syndrome had higher plasma levels of anaphylatoxins with delivery than did women
      with uneventful pregnancies. The plasma levels of terminal C5b-9 complement
      complexes at the time of delivery were increased as compared with levels 1 and 7
      days after delivery in women with HELLP syndrome. The plasma concentrations of
      the anaphylatoxins and the terminal C5b-9 complement complexes returned to normal
      levels within 1 week after delivery in the HELLP group. The formation of C5b-9
      complement complex indicates that the terminal part of the complement cascade has
      been activated and that C5a has been formed and eliminated. Complement activation
      with release of anaphylatoxins and terminal C5b-9 complement complexes may be one
      etiologic factor behind the elevated blood pressure, hemolysis, liver
      insufficiency, and platelet consumption seen in these patients.

PMID- 2216208
TI  - Correlation between first- and early third-trimester glucose screening test
      results.
AB  - One hundred twenty-four normal gravidas had paired first- and early third
      trimester (26-32 weeks) 1-hour oral glucose screening tests performed. First
      trimester oral glucose screening test values correlated significantly with third
      trimester glucose screening test results for the entire population, for whites
      and non-whites, and for normal-weight and obese patients. First-trimester oral
      glucose screening test values at or below 110 mg/dL were seldom associated with
      third-trimester oral glucose screening test results at or above 135 mg/dL and
      were not associated with abnormal 3-hour glucose tolerance test (GTT) results.
      Nine of the gravidas (7.3%) were diagnosed with gestational diabetes mellitus
      during the third trimester, all of whom had first-trimester glucose screening
      test results above 110 mg/dL. The difference in incidence of gestational diabetes
      mellitus between gravidas having first-trimester glucose screening test results
      at or below 110 mg/dL (0%) and those having values above 110 mg/dL (16.4%) was
      highly significant (P less than .0001). For patients with first-trimester glucose
      screening test values at or below 110 mg/dL, third-trimester glucose screening
      may be unnecessary. In contrast, for gravidas having first-trimester glucose
      screening test results at or above 135 mg/dL, there is a high positive predictive
      value for elevated repeat glucose screening test results during the early third
      trimester. Patients having elevated first-trimester glucose screening values at
      or above 140 mg/dL are at particularly high risk for elevated glucose screening
      test results later in pregnancy and should forego repeat 1-hour third-trimester
      glucose screening in favor of a direct third-trimester 3-hour GTT.

PMID- 2216209
TI  - The twin-twin transfusion syndrome.
AB  - Twin-twin transfusion syndrome is a complication of monozygotic-monochorionic
      twinning with serious perinatal implications. An extensive literature review
      revealed that our current understanding of the anatomy and pathogenesis of the
      syndrome has not changed over the last 3 decades. However, modern diagnostic
      modalities, such as sonography and Doppler studies, allow antenatal diagnosis and
      therefore may change the current definition of the syndrome. Based on these data,
      a new composite definition of the syndrome is suggested. This definition includes
      the following criteria: 1) sonographic signs (inter-twin differences in abdominal
      circumference greater than 18 mm, polyhydramnios-oligohydramnios, and signs of
      monozygosity), 2) Doppler velocimetry of the umbilical arteries (inter-twin
      difference in systolic/diastolic ratios above 0.4), 3) demonstration of a
      transplacental vascular shunt, 4) inter-twin birth weight difference of 15% or
      more, and 5) inter-twin hemoglobin difference of 5 g/dL or more. In addition,
      prenatal diagnosis may help in the management of this complication, and it seems
      that intrauterine treatment of the placental vascular anomalies may be more
      effective than other antenatal therapeutic options.

PMID- 2216210
TI  - Carbon dioxide laser vaporization of diaphragmatic metastases for cytoreduction
      of ovarian epithelial cancer.
AB  - Three patients with International Federation of Gynecology and Obstetrics state
      IIIC ovarian adenocarcinoma underwent CO2 laser vaporization of large-volume (5-6
      cm) and miliary right hemidiaphragmatic metastases at the conclusion of standard
      debulking surgery to effect optimal cytoreduction. Destruction of diaphragmatic
      metastases was accomplished rapidly with no added morbidity or blood loss. The
      hand-held CO2 laser is a useful modality for removal of isolated large- and small
      volume diaphragmatic disease, particularly if only the peritoneum is involved,
      and avoids the morbidity that may accompany entry into the pleural space.

PMID- 2216211
TI  - Enumeration of clue cells in rehydrated air-dried vaginal wet smears for the
      diagnosis of bacterial vaginosis.
AB  - Among 235 women attending an outpatient clinic, the diagnosis of bacterial
      vaginosis was made using three of the following four criteria: typical discharge,
      pH more than 4.5, positive amine sniff test, and clue cells in a wet smear. These
      findings were correlated with the finding of clue cells in air-dried wet smears
      rehydrated more than 1 month after the visit. The rehydrated specimens had the
      same microscopic appearance as a nonpreserved wet smear. The demonstration of
      clue cells in the rehydrated smears correlated with the composite diagnosis of
      bacterial vaginosis with a sensitivity of 96% and specificity of 98%. In a busy
      multi-physician setting, the scoring of clue cells in stored and rehydrated
      smears can be used to obtain consistent readings for wet-smear diagnostics, thus
      simplifying teaching and increasing the utility of wet smears in clinical
      research.

PMID- 2216212
TI  - Predicting preeclampsia.

PMID- 2216213
TI  - The length of uncomplicated human gestation.

PMID- 2216214
TI  - Transabdominal multifetal pregnancy reduction: report of 40 cases.

PMID- 2216215
TI  - Pregnancy complicated by preeclampsia-eclampsia with the syndrome of hemolysis,
      elevated liver enzymes, and low platelet count: how rapid is postpartum recovery?
AB  - The rapidity of postpartum disease recovery for severe preeclampsia associated
      with hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome)
      has not been well studied. Between January 1980 and March 1989, 158 pregnancies
      with preeclampsia-eclampsia complicated by HELLP syndrome were managed at the
      University of Mississippi Medical Center. The 70 patients with platelet nadir
      below 50,000/microL (class 1 HELLP syndrome) required as long as 11 days for all
      members to achieve a platelet recovery concentration of more than 100,000/microL,
      whereas all 88 gravidas with platelet nadir between 50,000-100,000/microL (class
      2 HELLP syndrome) exceeded this platelet concentration by the sixth postpartum
      day, a statistically significant difference (P less than .0001). The interval
      between delivery and the onset of diuresis (mean +/- SD) was significantly longer
      in class 1 than in class 2 patients with milder disease (22.7 +/- 18.9 compared
      with 15.9 +/- 11.1 hours). Significantly more postpartum days were required in
      class 1 than in class 2 HELLP parturients for the lactic dehydrogenase (LDH)
      concentration to decrease below 500 IU/L (4.2 +/- 4.9 compared with 3.2 +/- 2.7
      days). No women in the class 2 group required plasma exchange therapy to effect
      disease arrest and reversal, but 11 of 58 severely ill women in class 1 were
      treated with this modality. We conclude that the platelet count and LDH serum
      concentration, as indicators of HELLP severity and recovery, are clinically
      useful tools and that a more protracted postpartum recovery period should be
      expected for progressively severe expressions of HELLP syndrome.

PMID- 2216216
TI  - Low-dose aspirin does not influence the clinical course of women with mild
      pregnancy-induced hypertension.
AB  - The effect of low doses of aspirin on women with mild pregnancy-induced
      hypertension was investigated by means of a prospective, randomized, double-blind
      trial. Forty-seven women hospitalized at 30-36 weeks' gestation because of mild
      pregnancy-induced hypertension were treated by a daily dose of either 100 mg
      aspirin or placebo. The mean blood pressure values, rates of development of
      severe preeclampsia, gestational ages at delivery, newborn weights, and 5-minute
      Apgar scores were similar in the aspirin-treated and the placebo-treated groups.
      We conclude that low-dose aspirin is not curative but is essentially a preventive
      treatment which, in order to be effective, should be started weeks before
      clinical signs of preeclampsia are present.

PMID- 2216217
TI  - Minor congenital malformations in infants of insulin-dependent diabetic women:
      association with poor glycemic control.
AB  - A prospective study of 171 insulin-dependent diabetic pregnant women was
      undertaken to establish the relationship of glycemic control with minor
      congenital malformations. Each live-born infant was assessed systematically by
      two independent examiners using a standardized checklist. There were 32 infants
      with minor congenital malformations (18.7%). There were significant differences
      in mean glycohemoglobin A1 between the group with minor congenital malformations
      and the group without congenital malformations at 12, 16, and 20 weeks, but not
      at 8 or 24 weeks. Logistic regression analysis showed that maternal age, race,
      gravidity, White class, duration of diabetes, maternal vasculopathy, and
      cigarette smoking were not significant variables correlated with minor congenital
      malformations. Because glycohemoglobin levels from 12-20 weeks are believed to
      reflect glycemic control from approximately 6-20 weeks, we conclude that poor
      glycemic control during late embryogenesis and early fetal development is
      associated with an increased risk of minor congenital malformations. We speculate
      that improvement of glycemic control during this period should decrease the risk
      of minor congenital malformations.

PMID- 2216218
TI  - Vaginal birth after cesarean delivery: results of a 5-year multicenter
      collaborative study.
AB  - Cesarean delivery has become the most frequently performed major operation in the
      United States. Widespread use of vaginal birth after previous cesarean delivery
      could potentially eliminate up to one-third of cesareans. However, many
      physicians have been reluctant to adopt this policy without large studies
      conclusively demonstrating its safety. This study evaluated the maternal and
      perinatal outcomes of over 5000 cases of labor after previous cesarean delivery.
      This multicenter study began in 1984 and initially included nine California
      hospitals. During the first 2 years, there were 1776 trials of labor resulting in
      1314 vaginal births. In January 1986 two additional hospitals joined the
      collaborative project. Over the next 3 years, there were 3957 trials of labor
      resulting in 2977 vaginal births at the 11 participating hospitals. During the
      entire study period, 5733 patients opted for a trial of labor and 4291 (75%)
      delivered vaginally. There were no maternal deaths in the trial-of-labor group,
      and perinatal mortality was not significantly different from that of the general
      obstetric population. These results support the findings of numerous smaller
      studies that have concluded that the policy of routine repeat cesarean delivery
      should be abandoned.

PMID- 2216219
TI  - Real-time microcomputer-based analysis of spontaneous and augmented labor.
AB  - In an attempt to develop a reproducible, objective measure of adequate uterine
      activity in labor, real-time measurements of intrauterine pressure amplitude and
      contraction frequency, interval, duration, and integral were made in 54 patients,
      11 of whom received oxytocin augmentation. We determined the active pressure
      integral required per centimeter of cervical dilatation, expressed in kPa
      seconds, and the mean active pressure, expressed in kPa. The augmented group had
      a significantly higher mean active pressure integral per centimeter than those in
      normal labor (P less than .01). There was a trend, which did not reach
      statistical significance, for subjects who required oxytocin augmentation of
      labor to develop a higher mean active pressure than those in normal labor.
      However, the correlation of any uterine contractility index (Montevideo units,
      Alexandria units, mean active pressure) with progress in labor was poor. We
      conclude that women with dysfunctional labor require more uterine activity for
      progress in labor than women with normally progressing labor, and that the
      computer-derived "area under the curve" is not a better predictor of labor
      progress than Montevideo units.

PMID- 2216220
TI  - Accuracy and safety of transvaginal sonographic placental localization.
AB  - Transvaginal sonographic localization of the placenta was performed in 100
      patients suspected of having placenta previa. Except in one patient, the
      diagnosis was confirmed at cesarean delivery in all cases of placenta previa
      found by sonography before delivery, resulting in a 93.3% predictive value of a
      positive test. The predictive value of a negative test was 97.6%; in two patients
      a low-insertion placenta diagnosed by sonography was found to be a placenta
      previa at delivery. The sensitivity and specificity of the technique were 87.5
      and 98.8%, respectively. Although in some instances transvaginal sonography was
      performed during vaginal hemorrhage, aggravation of bleeding was never observed.
      Transvaginal sonographic localization of the placenta proved to be an accurate
      and safe diagnostic procedure.

PMID- 2216221
TI  - The relationship of unwed status to infant mortality.
AB  - We studied the impact of unwed status on infant mortality in the state of Iowa,
      where obstetric and newborn care is readily accessible. Our purpose was to
      document the extent of the contribution of unwed status to infant mortality and
      to compare unwed gravidas with their married counterparts. We hoped the
      comparisons would provide information that could be used for future programs of
      prevention. Our data encompassed a 10-year period (1977-1986) during which the
      incidence of infant deaths occurring in offspring of unmarried women was
      significantly greater than expected. The unwed population commonly consisted of
      younger, poorly educated, primigravid women who frequently did not seek prenatal
      care. We suggest that personal factors inherent in this group of women may be
      more operative than lack of access to perinatal care in determining pregnancy
      outcome. We believe our data underscore the need to redouble efforts to prevent
      unintended pregnancy.

PMID- 2216222
TI  - Prenatal diagnosis of congenital toxoplasmosis.
AB  - Prenatal diagnosis of congenital toxoplasmosis was attempted in 50 pregnant women
      at risk for giving birth to an affected child. Fifteen of these patients
      seroconverted during pregnancy and 35 had a high initial antibody level in their
      first serum sample. Prenatal diagnosis consisted of a combination of ultrasound
      screening, amniocentesis, and funipuncture at about 20 weeks' gestation.
      Diagnosis of congenital toxoplasmosis was based on a positive toxoplasma culture
      of amniotic fluid or fetal blood and on the presence of specific immunoglobulin M
      antibodies in fetal blood. In addition, alterations in fetal hematology, cellular
      immunology, and fetal liver tests were indicative of infection. Fetal infection
      was detected in six fetuses; two died in utero as a consequence of the infection
      and four were born after 37 weeks' gestation. Despite antibiotic treatment with
      pyrimethamine and sulfadiazine, one child has internal hydrocephalus and
      chorioretinitis and another has unilateral chorioretinitis. In the two other
      children, the disease is still subclinical. Of the 44 children born after a
      negative prenatal diagnosis, 35 have reached the age of 1 year; toxoplasma
      antibodies have disappeared in all of them. Investigation of the remaining nine
      children showed a decrease in toxoplasma antibodies, suggesting that none of them
      are affected. Prenatal diagnosis was never associated with fetal loss, and
      premature delivery occurred in only two cases. We conclude that prenatal
      diagnosis of congenital toxoplasmosis is safe and reliable.

PMID- 2216223
TI  - Fructosamine compared with a glucose load as a screening test for gestational
      diabetes.
AB  - Five hundred seven women were screened for gestational diabetes between 20-36
      weeks' gestation. All received a 100-g glucose (polycose) load at 28 weeks with
      measurement of plasma glucose 1 hour later. Fructosamine levels were measured at
      4-week intervals from 20-36 weeks. At 36 weeks, a full 100-g 3-hour glucose
      tolerance test was performed on all subjects. Eighteen women were diagnosed as
      having gestational diabetes. The glucose load had a sensitivity of 81% in
      detection of gestational diabetes, compared with 50% for fructosamine at 36
      weeks. Fructosamine is not useful as a screening test for gestational diabetes as
      currently defined.

PMID- 2216224
TI  - Production of prolactin by cultures of isolated cells from human first-trimester
      decidua.
AB  - An enriched fraction of first-trimester decidual cells that synthesize and
      release prolactin (PRL) was obtained by discontinuous Percoll gradient (20-50%)
      centrifugation of collagenase type I- and deoxyribonuclease I-dispersed cells (3
      mg/mL and 50 micrograms/mL, respectively). Centrifugation of the cell suspension
      yielded three major bands aggregating at the density interfaces. The fraction of
      the 30-40% Percoll interface contained enlarged decidual cells and constantly
      secreted significant amounts of PRL into the medium for at least 10 days. The
      fraction of the 40-50% Percoll interface contained fibroblastic cells and
      secreted a small amount of PRL into the medium. Cells in the other fractions did
      not attach to the plastic dishes in 48 hours. Under the influence of progesterone
      (100 ng/mL), the cultured decidual cells retained their capability of PRL
      production for at least 10 days because no decline of the secretion rate was
      observed. The culture system established by the present study is satisfactory for
      investigating decidual cell functions, including the regulatory mechanisms of PRL
      production.

PMID- 2216225
TI  - In vitro fertilization in unstimulated cycles: a clinical trial using hCG for
      timing of follicle aspiration.
AB  - In vitro fertilization (IVF) was performed in normally ovulatory women after the
      follicular phase of an unstimulated cycle. Twenty patients initiated 36 cycles of
      unstimulated IVF, with serial ultrasound examinations and hCG 10,000 IU given
      when the follicle was mature. Thirty aspirations were carried out under
      intravenous sedation with transvaginal ultrasound guidance. One or more oocytes
      were obtained in 29 aspirations (97%) for a total of 52 oocytes (average 1.7); 37
      fertilized (71%), two were polyspermic, and 35 cleaved (67%). Seventeen
      aspirations (57%) yielded multiple oocytes. All 25 oocytes obtained from dominant
      follicles fertilized (100%), and 12 of 27 oocytes from secondary follicles
      fertilized (44%) (P less than .05 versus dominant follicles), with one
      polyspermic fertilization in each group. Sixteen cycles resulted in a single
      embryo transfer (ET), eight had two embryos, and one had three embryos
      transferred (36% multiple ET). Five clinical pregnancies (20% per ET, 17% per
      retrieval) resulted in four ongoing pregnancies (16% per ET, 13% per retrieval),
      all singletons. Our results suggest that in selected cases, IVF in unstimulated
      cycles may be a clinically viable alternative to stimulated cycles, with
      preliminary success rates in the range of national averages for stimulated
      cycles.

PMID- 2216226
TI  - Effect of peritoneal fluid from endometriosis patients on endometrial stromal
      cell proliferation in vitro.
AB  - Late proliferative phase endometrial stromal cells grown in short-term culture
      were used as a model for the stromal component of endometriotic implants. Cells
      were grown in medium alone and in medium supplemented by 5, 10, and 20%
      concentrations of the cell-free fractions of peritoneal fluid obtained from
      patients with and without endometriosis. Nine fluid-sample pairs were matched
      based on the presence or absence of endometriosis at laparoscopy and the
      similarity of peritoneal fluid estradiol concentrations. Stromal cell
      proliferation as reflected by 3H-thymidine incorporation during sequential cell
      harvests over 72 hours was greater for cells exposed to endometriosis peritoneal
      fluid than for those exposed to non-endometriosis peritoneal fluid. This reached
      statistical significance with exposure to peritoneal fluid concentrations of 10
      and 20% (P less than .05). A linear dose-response relationship between 3H
      thymidine incorporation and peritoneal fluid concentration could be derived only
      for stromal cells exposed to fluid samples obtained from endometriosis patients
      (r = 0.51; P less than .001). In addition, proliferation over 72 hours was
      significantly greater for cells grown in 20% endometriosis peritoneal fluid than
      for those grown in nutrient medium alone (P less than .001). These data imply
      that factor(s) secreted into the peritoneal fluid of endometriosis patients may
      play a role in the proliferation or maintenance of disease implants.

PMID- 2216227
TI  - Control of immediate postoperative pain with topical bupivacaine hydrochloride
      for laparoscopic Falope ring tubal ligation.
AB  - Conflicting reports exist in the literature on the effectiveness of topical local
      anesthetic applied to the serosal surface of the fallopian tubes for the control
      of immediate postoperative pain after mechanical (band or clip) tubal ligation.
      Sixty-four patients were studied prospectively during outpatient laparoscopic
      Falope ring tubal ligation using the modified McGill Present Pain Intensity
      Scale. Patients randomly assigned to four groups received topical bupivacaine
      hydrochloride on both fallopian tubes, the right tube only, or the left tube
      only, or received none (controls). A unique study design was incorporated which
      allowed the untreated fallopian tube to serve as a within-subject control for
      each patient receiving unilateral treatment. Statistical analysis confirmed
      significant benefit when both fallopian tubes were treated as compared with no
      treatment (P less than .05). There was also consistent evidence of decreased
      immediate postoperative pain perception on the treated side for patients
      receiving unilateral treatment. The value of topical bupivacaine was demonstrated
      by both subjective patient response (McGill Pain Scale) and reduced need for pain
      medication before outpatient discharge. Our data support the value of topical
      bupivacaine applied to the serosal surface of the fallopian tubes for the
      reduction of postoperative pain after outpatient laparoscopic mechanical (band or
      clip) tubal ligation.

PMID- 2216228
TI  - Effect of a single dose of oral pseudoephedrine on uterine and fetal Doppler
      blood flow.
AB  - Pseudoephedrine, a stereoisomer of ephedrine with alpha- and beta-adrenergic
      properties, is the active ingredient in over-the-counter oral decongestants. Its
      safety during pregnancy has not been studied adequately. The purpose of this
      investigation was to evaluate the effects of pseudoephedrine on uterine and fetal
      Doppler blood flows. Twelve healthy pregnant women between 26-40 weeks' gestation
      ingested a standard 60-mg dose of pseudoephedrine. A pulsed Doppler system was
      used to perform blood flow measurements of the uterine arcuate artery, fetal
      aorta, and umbilical artery before dosing, immediately thereafter, and at 15
      minute intervals during the first 3 hours after drug ingestion. Blood flow
      velocities were not altered significantly after dosing in either the maternal or
      fetal circulation. In no case did absolute fetal or uterine blood flow velocities
      decrease significantly or systolic/diastolic ratios persistently elevate to
      abnormal values. We conclude that no significant alterations in the uterine or
      fetal circulations occur after the ingestion of a single dose of oral
      pseudoephedrine by healthy pregnant patients in the third trimester.

PMID- 2216229
TI  - Single dose of nifedipine in normotensive pregnancy: nifedipine concentrations,
      hemodynamic responses, and uterine and fetal flow velocity waveforms.
AB  - The short-term effect of 20 mg of oral nifedipine on maternal and fetal
      hemodynamics was investigated in ten healthy, normotensive women at 38 weeks'
      gestation admitted to the hospital for elective cesarean delivery. Within 1 hour
      after nifedipine administration, mean arterial pressure had decreased by 10% and
      a slight increase was observed in maternal heart rate. A statistically
      significant (P less than .01) decrease in the systolic-diastolic ratio was found
      in the flow velocity waveform from the uterine artery, but no change was seen in
      that from the arcuate artery. No changes were observed in the fetal heart rate
      pattern or in umbilical or thoracic aortic flow velocity waveforms. Nifedipine
      concentrations in the mother had no correlation with maternal or fetal
      hemodynamic responses. At delivery 2.5 hours after nifedipine ingestion, the
      umbilical venous-maternal ratio of nifedipine concentrations was 0.76.

PMID- 2216230
TI  - The development of fetal heart rate patterns during normal pregnancy.
AB  - Characteristics of the fetal heart rate (FHR) were studied longitudinally
      throughout the second and third trimesters in 43 low-risk singleton fetuses. The
      second trimester was characterized by an FHR pattern showing minimal differences
      between quiet and active intervals of fetal behavior. Few movements were
      accompanied by accelerations of small magnitude. Brief decelerations of variable
      magnitude exceeded the number of accelerations, and their frequency declined with
      advancing maturity. The percentage of body movements accompanied by FHR
      acceleration, the amplitude of these accelerations, and the rate of rise in heart
      rate increased with gestational age. Up to 30 weeks, the characteristics of the
      baseline FHR were similar in both periods of fetal rest and activity, with the
      baseline variability becoming significantly greater with advancing gestation.
      However, during quiet cycles of fetal behavior after 30 weeks, the baseline
      variability became progressively narrower, so that in late pregnancy different
      behavioral states could be determined reliably from characteristics of the
      baseline FHR alone.

PMID- 2216231
TI  - The occurrence of simultaneous fetal heart rate accelerations in twins during
      nonstress testing.
AB  - A prospective study was performed of 152 pairs of nonstress tests (NSTs) obtained
      simultaneously from both members of 52 twin gestations. Fifty-seven percent of
      the total fetal heart rate (FHR) accelerations occurred simultaneously in both
      twins. Between twins, the incidence of simultaneously occurring FHR accelerations
      was independent of gestational age, growth discordancy, or the type of placenta.
      For each twin, the number of FHR accelerations remained constant with increasing
      gestational age. These results may suggest that tactile communication exists in
      utero between twins.

PMID- 2216232
TI  - "Macrosomic" twinning: a study of growth-promoted twins.
AB  - We evaluated 56 twin pregnancies representing the tenth decile of the mean twin
      birth weight distribution to investigate whether larger twins face the same
      increased perinatal risk as do macrosomic singletons. Compared with pregnancies
      in the ninth decile, no significant difference was found between the means of
      maternal age, parity, and gestational age; between the rates of presentation
      combinations and cesareans; or between the neonatal sex ratios. However, the
      incidence of growth-discordant pairs was significantly higher in the heavier
      group (P = .034). Compared with the general twin population, the tenth-decile
      group contained significantly fewer primiparas (P = .0023). Maternal obesity and
      diabetes were infrequent and could not explain the increased birth weight. The
      neonatal outcome was excellent. Although the comparison revealed insignificant
      differences, it is possible that the combination of higher parity,
      malpresentation rate, and male-to-female ratio may be operative in the genesis of
      large twins.

PMID- 2216233
TI  - Increased cell adherence of group B streptococci from preterm infants with
      neonatal sepsis.
AB  - Most women with group B streptococcus cervical colonization have uncomplicated
      pregnancies, but about 1% experience preterm premature rupture of membranes
      (PROM) followed by neonatal group B streptococcal sepsis. In such cases,
      streptococcal adherence to and penetration of the membranes may be an important
      step in the pathogenesis. In the present study, chorionic epithelial cells were
      incubated with group B streptococci isolated from either children developing
      sepsis after preterm PROM (complicated pregnancies) or from uncomplicated
      pregnancies. Incubation periods varied. The numbers of adherent bacteria per
      chorionic epithelial cell were counted by microscopic examination. After 70
      minutes' incubation, the number of adherent group B streptococci in complicated
      pregnancies was 38, compared with 14 in uncomplicated pregnancies (P less than
      .001). This difference in vitro might reflect the virulence of group B
      streptococci.

PMID- 2216234
TI  - Antepartum and intrapartum events in women exposed in utero to
      diethylstilbestrol.
AB  - Using a retrospective cohort design, we analyzed the effects of intrauterine
      diethylstilbestrol (DES) exposure on various antepartum and intrapartum events.
      Gravidas exposed to DES had a higher likelihood of being delivered abdominally,
      undergoing manual removal of the placenta, and hemorrhaging in the postpartum
      period. The increased risk for these events remained after controlling for age,
      race, and parity. We also constructed labor curves in DES-exposed women by
      plotting cervical dilation against time. The curves were similar for nulliparous
      DES-exposed women and nulliparous controls, but DES-exposed parous women
      experienced prolonged labors. These findings suggest that, in addition to the
      well-known adverse effects of intrauterine DES exposure, the interaction between
      the uterus and placenta is altered in some DES-exposed patients.

PMID- 2216236
TI  - Quality assurance indicators and short-term outcome of hysterectomy.
AB  - Fifteen gynecologic quality assurance indicators recently published by The
      American College of Obstetricians and Gynecologists were applied to a previously
      reported hysterectomy data base. Chart reviews were performed for the most recent
      257 cases in the data base, representing an 18-month interval. The indicators
      were divided into two groups: those intended to identify morbidity and mortality
      and those intended to screen for appropriateness of care. Rates of actual
      morbidity and cases that failed to meet published criteria sets for hysterectomy
      were determined by chart review regardless of the presence of a quality assurance
      indicator. A total of 135 indicators were identified in 114 (44%) of the 257
      cases, including 64 patients (25%) with morbidity indicators and 50 (19%) with
      appropriateness indicators. Actual morbidity was correctly identified in all 64
      cases in which morbidity indicators were present. Three cases with significant
      morbidity were identified by chart review but not identified by the indicators,
      yielding positive and negative predictive values of 100 and 98%, respectively,
      and an overall accuracy of 99% for morbidity indicators. By contrast, 14 of the
      50 cases in which appropriateness indicators were present actually failed to meet
      published criteria sets. An additional seven cases failing to meet criteria sets
      were identified by chart review and not identified by the indicators, yielding a
      positive predictive value of 28%, a negative predictive value of 97%, and an
      overall accuracy of 83% for appropriateness indicators.

PMID- 2216237
TI  - Anatomy of anal sphincters and related structures in continent women studied with
      magnetic resonance imaging.
AB  - Five anally continent nulliparas of reproductive age were studied with magnetic
      resonance imaging. The internal and external anal sphincters could be easily
      delineated, as could the intervening longitudinal musculature, puborectalis
      muscle, anococcygeal raphe, anorectal lumen, vagina, uterus, bladder, urethra,
      coccyx, and pubis. The shape of the sphincters was nearly cylindrical, with an
      anterior component averaging 18.3 mm thick and 28.0 mm long. Fifty-four percent
      of this anterior thickness was attributable to the internal sphincter. The
      anorectal angle varied considerably, with a mean of 86.8 +/- 19.1 degrees (range
      60-112). The angle between the portion of the rectal lumen supported by the
      anococcygeal raphe, or levator plate, and the plane of the puborectalis muscle
      was consistent at 149.0 +/- 6.3 degrees (138-154). The finding of anterior anal
      sphincters with substantial thickness and length contrasts markedly with a view
      often pictured in the literature of a female anal sphincter that narrows
      anteriorly to half its posterior length and forms a small bundle of muscle rather
      than a broad band. Knowledge of these relationships is important in primary
      repair of obstetric sphincter lacerations as well as in surgical correction of
      anal incontinence.

PMID- 2216235
TI  - Removal of large symptomatic intrauterine growths by the hysteroscopic
      resectoscope.
AB  - Fifty-three patients underwent 55 procedures with a resectoscope for the removal
      of large symptomatic intrauterine growths. The presenting complaint was
      menorrhagia, menometrorrhagia, or heavy postmenopausal bleeding in 38 patients;
      excessive menses plus infertility in 13 patients; and infertility alone in two
      patients. Forty-three patients had pedunculated or sessile submucous myomas and
      ten patients had large endometrial polyps. The long-term results are based on 45
      patients followed for longer than 1 year. Excessive bleeding was controlled in 40
      of the 43 women (93%). Failure to control abnormal bleeding was apparent within
      the first year. Seven of the 12 infertility patients (58%) delivered live-born
      infants. Five patients have undergone subsequent hysterectomies (9%). Two
      patients had repeat resectoscopic removal of myomas and two had subsequent non
      resectoscope myomectomies. No major complications were encountered.

PMID- 2216238
TI  - Detection, prevalence, and prognosis of asymptomatic carcinoma of the cervix.
AB  - Between 1979-1986, 82 of 407 patients (20%) treated for infiltrative carcinoma of
      the cervix were asymptomatic at the time of diagnosis. Sixteen (20%) of these 82
      patients had stage IA, 60 (73%) had stage IB, and six (7%) had stage IIA disease.
      Asymptomatic patients represented 16 of 23 (70%) of stage IA, 60 of 196 (31%) of
      stage IB, and six of 77 (8%) of stage IIA. In the Netherlands, population
      screening for cervical carcinoma is conducted on women aged 35-55 years. To
      examine the prevalence of asymptomatic cervical carcinoma and the way in which it
      was detected in different age groups, we studied the patients referred to our
      department. Among the patients younger than 35 years with cervical carcinoma, 20
      of 70 (29%) were asymptomatic with disease detected by incidental screening,
      whereas eight of 177 (5%) in the group 55 years or older had been detected by
      incidental screening. In the age category 35-55 years, 54 of 160 (34%) were
      asymptomatic. Patients aged 35-55 years had undergone population screening or
      incidental screening. In the patients 55 years or older, asymptomatic disease was
      significantly less prevalent than in younger patients. Only one of the 66
      asymptomatic patients in stage IB or higher suffered tumor recurrence. Among
      symptomatic patients, 25 of 136 (18%) with stage IB and 17 of 71 (24%) with stage
      IIA had tumor recurrence. Despite the favorable prognosis of patients with
      asymptomatic carcinoma, asymptomatic presentation could not be shown to be a
      significant prognostic factor, as were tumor diameter and lymph node status.

PMID- 2216239
TI  - Primary mass closure of midline incisions with a continuous polyglyconate
      monofilament absorbable suture.
AB  - Mass closure of midline incisions with a running large-bore permanent
      monofilament polypropylene suture has been used in general surgery and gynecology
      patients with a reported small incidence of fascial dehiscence. Late-occurring
      wound sinus formation is one problem reported with the use of this permanent
      suture material. Over a 22-month period, 285 patients had midline incisions
      closed with a continuous, running no. 1 polyglyconate monofilament delayed
      absorbable suture. Closely spaced bites (about 1.5 cm apart) were taken and
      placed 2 cm lateral to the fascial edge. Over 60% of the patients had surgery
      because of gynecologic cancer. Other high-risk factors included obesity in 62%,
      diabetes in 19%, and previous irradiation or chemotherapy in 22%. An ovarian
      cancer staging procedure was done in 16% of the patients. Of the remaining
      patients, almost half had extensive operative procedures that ranged from
      exenterations to hysterectomies with lymph node dissection. Wound complications
      were noted in nine patients (3.2%). Seven had superficial infections, one had an
      evisceration, and one developed a ventral hernia. Wound sinuses did not occur.
      The closure technique is safe and expedient and distributes tension equally over
      a continuous line. It has the additional advantage of eventual absorption of the
      suture material, thereby avoiding the wound sinus problems occasionally reported
      with large-bore permanent sutures.

PMID- 2216240
TI  - Experimental and clinical studies with radiofrequency-induced thermal endometrial
      ablation for functional menorrhagia.
AB  - A method of ablating the endometrium has been introduced into clinical practice
      that uses radiofrequency electromagnetic energy to heat the endometrium, using a
      probe inserted through the cervix. Preliminary studies suggest that over 80% of
      patients treated will develop either amenorrhea or a significant reduction in
      flow. The advantages of radiofrequency endometrial ablation over laser ablation
      or resection are the avoidance of intravascular fluid absorption, simplicity (no
      special operative hysteroscopic skills are required), speed of operation, and
      reduced cost compared with the Nd:YAG laser. In this paper, we describe the
      experimental studies performed during development of this new technique.

PMID- 2216241
TI  - A rapid method for detection of group B streptococcal colonization: testing at
      the bedside.
AB  - Vertical transmission of group B streptococci, the most frequent cause of early
      neonatal sepsis, can be interrupted by intrapartum antibiotics. However, rapid
      methods for detecting colonized women must be developed to limit the
      administration of antibiotics to those who are at risk of delivering an infected
      infant. The accuracy of a colorimetric test using starch serum medium on vaginal
      and rectal specimens from women with preterm labor or prolonged rupture of
      membranes was evaluated. The test was interpreted by labor and delivery room
      nurses without special microbiologic training. Starch serum medium results were
      compared with those obtained from routine cultures. Thirteen of 29 positive
      vaginal cultures (45%) and eight of 18 positive rectal swabs (44%) were
      identified by nurses using the rapid method. This was significantly different (P
      less than .001) from sensitivities of 93 and 95%, respectively, for the same
      vaginal and rectal specimens interpreted by a bacteriology technologist. The
      specificity for the test from both sites was 95% for the nurses. The sensitivity
      was 53 and 36% for vaginal and rectal swabs, respectively, for a subgroup of
      mothers whose infants were assessed as clinically septic. The low sensitivity of
      starch serum medium as interpreted by nurses in the labor suite is inadequate to
      allow the test to replace cultures in identifying women colonized with group B
      streptococci. Efforts to increase the sensitivity should be directed toward
      improving nursing staff interpretation rather than improving the medium itself.

PMID- 2216243
TI  - Blood transfusion in contemporary obstetric practice.

PMID- 2216242
TI  - Window operation: an alternative treatment method for Bartholin gland cysts and
      abscesses.
AB  - Recently, we developed the "window operation" as a more effective way to treat
      Bartholin gland cysts and abscesses. The window operation was used to treat 25
      Bartholin cysts and 22 Bartholin abscesses during a 3-year period from October 1,
      1986 to September 30, 1989. Under local anesthesia, a small piece of skin
      including the cyst wall was excised in an oval shape, and suturing was performed
      along the excised margin. Postoperative antibiotics were given in cases of acute
      inflammation. A new mucocutaneous junction was observed at the 4-week
      postoperative checkup. No complications or recurrences have been observed during
      the study period. The window operation can be an alternative method of treatment
      for Bartholin gland cysts or abscesses.

PMID- 2216244
TI  - Acute pyelonephritis in pregnancy: a prospective study of oral versus intravenous
      antibiotic therapy.

PMID- 2216245
TI  - Transvaginal sonographic detection of the pseudogestational sac associated with
      ectopic pregnancy.

PMID- 2216246
TI  - Serum CA 125 levels in early pregnancy and subsequent spontaneous abortion.

PMID- 2216247
TI  - Variability of serum prolactin and progesterone levels in normal women: the
      relevance of single hormone measurements in the clinical setting.

PMID- 2216248
TI  - Amoxicillin therapy for Chlamydia trachomatis in pregnancy.

PMID- 2216249
TI  - Evidence of gonadal and gonadotropin antibodies in women with a suboptimal
      ovarian response to exogenous gonadotropin.

PMID- 2216250
TI  - Pregnancy after successful vaginoplasty and cervical stenting for partial atresia
      of the cervix.
AB  - We previously reported surgical correction of vaginal agenesis and partial
      cervical atresia in an 11-year-old girl with amenorrhea and a pelvic mass. This
      patient, the subject of this report, conceived 7 years later and delivered at
      term. An abdominal cerclage was placed at 12 weeks' gestation to protect the
      cervix, and delivery was by cesarean.

PMID- 2216252
TI  - Prolapse of a neovagina created by self-dilatation.
AB  - In patients with congenital absence of the vagina, a neovagina may be created by
      either operative or nonoperative techniques. A 25-year-old patient with a
      neovagina created by self-dilatation developed complete prolapse of the neovagina
      with an enterocele. A transabdominal sacral colpopexy successfully suspended the
      vaginal vault and allowed the patient to resume sexual function.

PMID- 2216251
TI  - Successful pregnancy after ZIFT in a patient with congenital cervical atresia.
AB  - We report the third patient with a successful pregnancy following operative
      correction of congenital cervical atresia. The pregnancy was achieved through
      zygote intrafallopian transfer (ZIFT). Although stenosis of the newly formed
      cervical canal causes considerable morbidity, therapy should be aimed at the
      creation of a conduit for menstrual blood and for possible future pregnancy. New
      techniques in assisted reproduction such as in vitro fertilization-embryo
      transfer, gamete intrafallopian transfer, and ZIFT increase the chances of
      pregnancy in patients with congenital cervical atresia. A hysterectomy, as
      advocated until very recently, should not, in our opinion, be the first treatment
      of choice.

PMID- 2216253
TI  - Vaginal mullerian cyst presenting as an anterior enterocele: a case report.
AB  - A case is discussed of an extremely large vaginal mullerian cyst that presented
      as an anterior enterocele. Sonographic and radiologic studies are described. The
      patient underwent operative excision of the cyst with reconstructive
      vaginoplasty.

PMID- 2216254
TI  - Ovarian suspension in massive ovarian edema.
AB  - Massive ovarian edema is an uncommon condition found in young women that is
      speculated to occur as a result of incomplete ovarian torsion. We present the
      second patient to our knowledge to undergo ovarian suspension as a treatment for
      this condition. This approach succeeded after ovarian wedge resection had failed.
      Our patient remained symptom-free at 1 year of follow-up. Ovarian suspension
      should be considered when this pathologic entity is diagnosed.

PMID- 2216255
TI  - Septic shock complicating drainage of a Bartholin gland abscess.

PMID- 2216256
TI  - Rectovulvar fistula in a child secondary to an unusual foreign body.
AB  - Foreign bodies in the female genital tract are well recognized as a cause of
      pain, discharge, secretions, and infection. In the small child, the presence of a
      vaginal discharge is usually associated with either a common object which has
      been inserted or sexual abuse complicated by a sexually transmitted disease. A 3
      year-old child presented with a recurrent labial secretion and drainage due to an
      unusual foreign body. It was only during a second operation that the possibility
      of a foreign body was entertained, and diagnostic testing was begun. A third
      operation permitted removal of the foreign body, a large bone probably of animal
      origin. The fistula tract was closed after a colostomy was performed. This
      represents the first reported case of a rectovulvar fistula not of a congenital
      nature.

PMID- 2216257
TI  - Combined vesicovaginal-ureterovaginal fistulas associated with a vaginal foreign
      body.
AB  - A case is presented of vesicovaginal-ureterovaginal fistulas associated with a
      neglected vaginal foreign body. The patient complained of a foul-smelling vaginal
      discharge and was found to have a 4-cm hard vaginal mass on examination. Urinary
      incontinence developed subsequently. Examination under anesthesia was performed,
      and an aerosol deodorant cap was operatively removed from her posterior
      vagina/perirectal space. Subsequent work-up demonstrated the presence of both a
      vesicovaginal fistula and a right ureterovaginal fistula. The patient underwent a
      combined vaginal repair of the vesicovaginal fistula and abdominal
      ureteroneocystostomy. The frequency, types, etiology, and treatment of
      genitourinary fistulas are reviewed with particular attention to those associated
      with a vaginal foreign body.

PMID- 2216258
TI  - Clomiphene citrate stimulation as an adjunct in locating ovarian tissue in
      ovarian remnant syndrome.
AB  - Ovarian remnant syndrome results from residual ovarian tissue after bilateral
      oophorectomy. The syndrome is associated with chronic pelvic pain and is
      suspected when premenopausal levels of FSH and LH are present in a patient with
      documented bilateral oophorectomy. Histologic demonstration of ovarian tissue at
      operation confirms the diagnosis. We treated a patient with ovarian remnant
      syndrome with a 10-day course of clomiphene citrate, 100 mg daily, to stimulate
      the residual ovarian tissue and facilitate localization. Preoperative ultrasound
      revealed a 5.0 x 3.5 x 6.2-cm cystic mass in the right adnexal region.
      Exploratory laparotomy easily localized the mass, and it was removed intact.
      Histologic slides demonstrated normal ovarian tissue with multiple follicles in
      various stages of development and a corpus luteum cyst. Clomiphene citrate is
      capable of stimulating an ovarian remnant, producing an enlarged, cystic
      structure easily localized by ultrasound. The increased size and preoperative
      knowledge of the location facilitated surgical removal.

PMID- 2216259
TI  - Giant-cell arteritis of the uterus with associated temporal arteritis: a case
      report.
AB  - Giant-cell arteritis involving the uterus was identified incidentally upon
      hysterectomy and anterior colporrhaphy for uterine prolapse. Subsequently, the
      patient was found to have giant-cell temporal arteritis presenting with fever of
      unknown origin. Fourteen previous cases involving the female genital tract have
      been reported. There appears to be an association between constitutional symptoms
      of fever, weight loss, malaise, headache, and polymyalgia rheumatica in elderly
      women with uterine prolapse and giant-cell arteritis of the genital tract. The
      rare presentation of giant-cell arteritis in the female genital tract does not
      support invasive costly evaluation in asymptomatic patients. However, a thorough
      investigation for involvement of other sites, including appropriate treatment for
      generalized disease, should be undertaken.

PMID- 2216260
TI  - Preoperative angiographic uterine artery embolization in the management of
      cervical pregnancy.
AB  - The diagnosis of a cervical ectopic pregnancy is often made intraoperatively in
      the presence of extensive hemorrhage during attempted evacuation. In some cases,
      hysterectomy has been the necessary treatment to control bleeding. We report two
      cases of cervical pregnancy detected by ultrasound. Before pregnancy termination,
      the uterine arteries were successfully embolized using angiographic techniques.
      As a result, surgical evacuation was performed with minimal hemorrhage;
      hysterectomy was not required and the patients' potential fertility was retained.

PMID- 2216261
TI  - Angiographic arterial embolization and computed tomography-directed drainage for
      the management of hemorrhage and infection with abdominal pregnancy.
AB  - Hemorrhage during or after surgery, pelvic abscess, bowel obstruction, and
      prolonged febrile morbidity can complicate the puerperal course of the gravida
      after removal of an extrauterine fetus with nondisturbance of the extrauterine
      placenta. In this report we describe the successful angiographic arterial gelfoam
      embolization of the placental vascular bed to control heavy postoperative
      hemorrhage in a mother suffering adult respiratory distress syndrome after
      removal of the fetal portion of her abdominal pregnancy. Six weeks later,
      computed tomography (CT)-directed drainage by catheter of a placental abscess was
      performed. Selective angiographic transcatheter embolization with gelfoam is a
      useful tool for the control of hemorrhage in the gravida who is an unfavorable
      operative candidate or who may present technical hemostasis problems peculiar to
      the placenta with abdominal pregnancy. Later use of CT-directed catheter drainage
      of the infected residual placental mass provided a nonoperative means of
      treatment.

PMID- 2216262
TI  - Monozygotic twins discordant for partial trisomy 1.
AB  - A 25-year-old primigravida delivered monozygotic twins discordant for multiple
      anomalies and partial trisomy 1 mosaicism. The phenotype of partial trisomy 1
      includes craniofacial, central nervous system, and ocular anomalies. The most
      likely explanation for these findings is that the translocation occurred after
      twinning occurred. This observation emphasizes that monozygotic twins are not
      necessarily genetically identical. They are identical at conception, but
      subsequent mutation and rearrangement of the genome may cause substantial
      phenotypic differences.

PMID- 2216263
TI  - Fetal posterior urethral valve syndrome: a prospective application of antenatal
      prognostic criteria.
AB  - A case of posterior urethral valve syndrome is presented. Four weeks after a
      normal 24-week ultrasound examination, diminished amniotic fluid, megacystis, and
      renal hyperechogenicity were observed. A repeat ultrasound examination at 30
      weeks' gestation identified oligohydramnios and increased renal echogenicity.
      These findings prompted the performance of a percutaneous cystocentesis to assess
      fetal renal function indirectly. The specimen was evaluated for osmolality and
      sodium and chloride concentrations. The urine electrolyte concentrations (sodium
      115 mEq/L; chloride 93 mEq/L) and the osmolality (230 mOsm/L) were elevated,
      suggesting impaired renal function and a poor prognosis. Despite these findings,
      aggressive management was used, including administration of antenatal
      corticosteroids and elective preterm delivery. A percutaneous cystocentesis was
      required during the infant's initial resuscitation, followed by a difficult
      urethral catheterization. Ultimately, a vesicostomy performed on day 4 of life
      was associated with prompt return of renal function (serum creatinine 0.7 mg/dL
      at the time of discharge). At 6 months of age, normal renal function has been
      documented and the vesicostomy has been closed. This case demonstrates the
      potential limitations of available prognostic criteria in evaluating fetal
      urinary obstruction and residual renal function. In selected cases (when the
      onset of obstruction is documented in the third trimester), refinement of these
      prognostic criteria may be indicated. Similar cases may be best managed by
      preterm delivery and prompt postnatal decompression.

PMID- 2216264
TI  - Congenital chyloperitoneum as a cause of isolated fetal ascites.
AB  - Isolated fetal ascites is an unusual prenatal finding and must be differentiated
      from immune and nonimmune hydrops. This entity is most commonly associated with
      gastrointestinal and genitourinary anomalies. Fetal chyloperitoneum, however,
      should be considered as a possible cause. Pulmonary hypoplasia and abdominal
      dystocia during attempted vaginal delivery are potential complications. We
      present a case of isolated fetal ascites due to congenital chyloperitoneum.

PMID- 2216265
TI  - Ascites not due to congestive heart failure in a fetus with lupus-induced heart
      block.
AB  - Hydrops developing in fetuses with lupus-associated heart block has usually been
      assumed to result from congestive heart failure. We present a case in which fetal
      ascites associated with complete heart block resolved promptly after
      administration of betamethasone and prednisone to the mother, who had anti-SSA
      and who developed clinical lupus erythematosus. This resolution occurred with no
      demonstrable change in fetal cardiac function. We conclude that an immune
      mechanism, rather than congestive heart failure, was responsible for the fetal
      ascites.

PMID- 2216266
TI  - TRAP sequence--successful outcome with indomethacin treatment.
AB  - A case of twin reversed arterial perfusion (TRAP) sequence (acardiac twin)
      complicated by hydramnios was managed by maternal administration of indomethacin.
      Successful outcome was achieved after 8.5 weeks of therapy with delivery of a
      normal live-born infant at 34 weeks.

PMID- 2216267
TI  - Contemporary management of a potentially lethal fetal anomaly: a successful
      perinatal approach to epignathus.
AB  - Prenatal diagnosis of epignathus (a teratoma originating in the oropharynx) has
      been reported previously. However, in many of these cases the neonates succumbed
      to acute respiratory distress secondary to airway obstruction at the time of
      birth. We describe a case of antepartum diagnosis of epignathus using
      ultrasonography and magnetic resonance imaging as complementary techniques. The
      ability to accurately define the fetal anomaly permitted us to plan a unique
      strategy for peripartum management. After cesarean delivery of the infant from
      the uterus, the umbilical cord was not clamped and the fetoplacental circulation
      was left undisturbed. A tracheostomy was then performed, after which the
      umbilical cord was clamped and the infant was stabilized. Several hours later, a
      debulking procedure was performed in the operating room to remove the tumor from
      its attachment to the bony palate. Both mother and infant did well
      postoperatively. The ability to plan and perform a controlled tracheostomy while
      the infant remained oxygenated and ventilated proved to be lifesaving in this
      case.

PMID- 2216268
TI  - Fetomaternal bleeding as a cause of recurrent fetal morbidity and mortality.
AB  - A woman had fetomaternal bleeding of unknown cause during at least three of five
      pregnancies. Each event was associated with significant fetal morbidity or
      mortality. Although fetomaternal bleeding has been reported as a cause of
      unexplained fetal death, its occurrence in subsequent pregnancies has not been
      described previously.

PMID- 2216269
TI  - Ongoing fetomaternal hemorrhage treated by serial fetal intravascular
      transfusions.
AB  - Nonimmune hydrops secondary to atraumatic, massive fetomaternal hemorrhage was
      diagnosed at 33.5 weeks' gestation by a maternal Kleihauer-Betke stain, confirmed
      by funipuncture. The initial fetal hematocrit was 6.5%. Kleihauer-Betke testing
      revealed a fetomaternal hemorrhage of approximately 230 mL. Fetal karyotype,
      total immunoglobulin M, and liver function tests were normal. Maternal parvovirus
      serology was negative. Treatment with two fetal intravascular transfusions
      provided only transient improvement because the fetomaternal hemorrhage proved to
      be unrelenting.

PMID- 2216270
TI  - Pregnancy associated with Friedreich ataxia.
AB  - The pregnancy of a woman with Friedreich ataxia was complicated by the onset of
      preterm labor and preeclampsia. Administration of magnesium sulfate (MgSO4.7H2O)
      in the usual intravenous dosage resulted in the dramatic development of profound
      motor weakness and respiratory distress. Magnesium acts to antagonize the action
      of acetylcholine at the motor end plate of the neuromuscular junction and may
      operate synergistically with underlying neuromuscular disorders. Therefore, the
      use of magnesium sulfate in patients with Friedreich ataxia and other similar
      neurodegenerative diseases is contraindicated.

PMID- 2216271
TI  - Successful pregnancy outcome in association with lipoatrophic diabetes mellitus.
AB  - Lipoatrophic diabetes mellitus is a rare syndrome characterized by lipoatrophy
      and insulin-resistant diabetes mellitus. Partial lipodystrophy without clinical
      diabetes mellitus has been associated with intrauterine growth retardation and
      fetal death. We report successful pregnancy outcomes in two women with
      lipoatrophic diabetes mellitus.

PMID- 2216272
TI  - Use of magnetic resonance imaging in the diagnosis of cortical blindness in
      pregnancy.
AB  - Magnetic resonance imaging (MRI) may be helpful in the assessment of eclampsia
      and preeclampsia with central nervous system symptomatology such as cortical
      blindness. We describe a rare case of complete binocular blindness postpartum
      with no other neurologic deficits, in which MRI abnormalities were undetected on
      computed tomography. The better soft-tissue discrimination of MRI may visualize
      important but subtle lesions which ultimately may help to explain the underlying
      pathophysiologic mechanism in such cases.

PMID- 2216273
TI  - Diabetes insipidus associated with craniopharyngioma in pregnancy.
AB  - A case is presented of a pregnancy complicated by a suprasellar mass diagnosed at
      27 weeks' gestation. This patient developed diabetes insipidus, which was
      successfully treated with 1-desamino-8-D-arginine vasopressin. Thyrotropin
      releasing hormone and ACTH stimulation tests were also abnormal, requiring the
      institution of thyroid and cortisol replacement therapy. The patient was
      delivered at 34 weeks' gestation secondary to worsening visual field testing. A
      craniotomy was performed in the postpartum period with removal of a
      craniopharyngioma. With successful medical treatment and careful observation,
      surgical intervention may be postponed until postpartum or until a gestational
      age with lower neonatal morbidity and mortality is reached.

PMID- 2216274
TI  - Immune hydrops fetalis attributable to anti-HJK.
AB  - We describe a new low-frequency antigen as the cause of immune hydrops fetalis in
      a fetus presenting at 27 weeks with a hematocrit of 6%. The fetus was treated
      successfully by intravascular transfusion. This antigen, temporarily identified
      as HJK, has been detected in only one family.

PMID- 2216275
TI  - Infant survival following delayed postmortem cesarean delivery.
AB  - A 19-year-old multipara was delivered of a living infant by postmortem cesarean
      22 minutes after documented maternal cardiac arrest and 47 minutes from the fatal
      injury. Neonatal follow-up at 18 months of age demonstrated no evidence of
      neurologic damage.

PMID- 2216276
TI  - Fetal levels of tobramycin following maternal administration.
AB  - A single dose of tobramycin 2 mg/kg was given intravenously to a woman who
      presented a 22-week heterotopic pregnancy with both intrauterine and ovarian
      gestations and two living fetuses. After excision of the adnexum, tobramycin
      levels were measured in the maternal serum and in the fetal fluids and tissues.
      Antibiotic levels were especially high in the fetal spleen and kidney.

PMID- 2216278
TI  - Worry over new HIV testing kit sales legislation.

PMID- 2216277
TI  - Umbilical cord hematoma following diagnostic funipuncture.
AB  - Major complications associated with funipuncture have been reported but are rare.
      This is a report of a diagnostic funipuncture performed on a 29-week fetus with a
      single umbilical artery and multiple malformations. Immediately after the
      procedure, a voluminous hematoma developed at the site of needle insertion in
      association with a severe fetal bradycardia. Fetal death was confirmed within 5
      minutes of needle insertion. It is hypothesized that the risk of complications of
      funipuncture may vary according to the clinical indication for the procedure and
      may be increased in the presence of certain fetal malformations. The rapid
      evolution of complications, as occurred in the present case, underlines the
      importance of having a clear plan of management in the event of mishap and
      discussing this plan with the parents before undertaking diagnostic funipuncture.

PMID- 2216279
TI  - Health promotion--the OHN's role.

PMID- 2216280
TI  - Cancer of the skin.

PMID- 2216281
TI  - BSE. An unlikely zoonosis.
AB  - It will probably be some years before we can be certain whether bovine spongiform
      encephalopathy (BSE) can be transmitted to humans. What steps should workers who
      come into contact with cattle take to protect themselves now?

PMID- 2216282
TI  - Absenteeism or ill health?--a fatal change of mind.
AB  - Following a fair and appropriate procedure before dismissing an employee is
      vitally important. The procedures for ill health dismissals are very different
      from those for absenteeism cases.

PMID- 2216283
TI  - First aid courses.

PMID- 2216284
TI  - Asbestos control buyer's guide.

PMID- 2216285
TI  - EPA study supports smoking ban.

PMID- 2216286
TI  - Surgical workers' AIDS risk studied.

PMID- 2216288
TI  - Workers entering confined spaces must choose appropriate respirator.

PMID- 2216287
TI  - Prevention of reproductive disorders requires more research, vigilance.

PMID- 2216289
TI  - Data systems help define relation between exposure, health effects.

PMID- 2216290
TI  - Gerontological certification.

PMID- 2216291
TI  - Breast cancer among women from Gothenburg with regard to age, mortality and
      coexisting benign breast disease or leiomyoma uteri.
AB  - The entire female population of Gothenburg, aged 20 years or above as of
      November, 1969 (n = 162,449), was studied for virtually all inpatient hospital
      admissions in 1970-1979 with breast cancer (n = 2,411). After the vital status as
      of December, 1984 had been traced, cases of fetal (n = 1,502) and of nonfatal (n
      = 909) breast cancer were separated. A search for coexisting benign breast
      disease and leiomyoma uteri yielded significant recordings of disease association
      exclusively with nonfatal breast cancer.

PMID- 2216292
TI  - Investigations of coagulation system and fibrinolysis in patients with
      disseminated adenocarcinomas and non-Hodgkin's lymphomas.
AB  - Indicating activation of coagulation fibrinopeptide A (FPA) was elevated in 80.1%
      (mean = 10.5 ng/ml; P less than 0.01) and thrombin-antithrombin III complexes in
      58.3% (TAT; mean = 5.3 ng/ml; p less than 0.05) in patients with adenocarcinomas
      (n = 57). In patients with non-Hodgkin's lymphomas (n = 30), however, elevation
      was observed only in 66.6% (FPA) and in 42.8% (TAT). Incidence of thrombosis is
      high only in the first group Local fibrinolysis explains elevated D-dimer in
      adenocarcinomas (1,818 ng/ml; p less than 0.01) and in non-Hodgkin's lymphomas
      (576 ng/ml; p less than 0.05). Significantly increased t-PA antigen was not
      committed by adequately increased t-PA activity in adenocarcinomas, because of
      high levels of the acute-phase protein, plasminogen activator inhibitor (mean =
      25.3; p less than 0.01), indicating systemic hypofibrinolysis. Hemostatic
      disorder in patients with malignancy can be attributed to a combination of acute
      phase reaction and an activation of coagulation.

PMID- 2216293
TI  - Cerebrospinal fluid content of manganese, platinum, and strontium in patients
      with cerebral tumors, leukemia, and other noncerebral neoplasms.
AB  - Electrothermal atomic absorption spectrophotometry was employed to measure the
      concentrations of manganese, platinum, and strontium in the cerebrospinal fluid
      (CSF) of 47 patients with brain neoplasms (34 benign and 13 malignant), 17
      leukemic patients, 10 patients with lymphoma or non-cerebral solid tumors, and 27
      control patients. According to the data obtained, manganese appears to be
      significantly (p less than 0.015) depleted from the CSF of leukemic patients,
      whereas platinum is diminished in CSF of patients with brain tumors, leukemia,
      lymphoma, or noncerebral solid tumors; the ratios for the mean CSF concentration
      of platinum in these tumor patients/control patients ranged between 0.52 and 0.7.
      There was no significant difference in CSF concentrations of strontium among the
      groups examined.

PMID- 2216294
TI  - Application of monoclonal antibodies in diagnosis of human breast cancer by fine
      needle aspiration cytology.
AB  - In the present study the authors have examined 100 breast nodules by fine-needle
      aspiration cytology (FNAC) using the avidin-biotin complex method of
      immunoperoxidase staining. The monoclonal antibodies (MAbs) employed, B 6.2 and B
      72.3, recognize two distinct molecules expressed by transformed breast
      epithelium. The authors have compared this immunocytochemical reaction with the
      conventional cytology and the histological examination as well. The data of the
      MAbs alone or in combination have been evaluated in terms of sensitivity,
      specificity, predictive value and test efficiency. The results show that tumor
      cells are strongly reactive with the MAbs. So the authors believe that this
      method in conjunction with conventional cytology may be useful in the diagnosis
      of breast tumor, especially in doubtful FNAC.

PMID- 2216295
TI  - Plasma melatonin in patients with breast cancer.
AB  - Daytime plasma melatonin values were measured by radioimmune assay in 86 patients
      with breast cancer; 280 assays were done and compared with the clinical status of
      the patients. Patients in the advanced disease group had significantly higher
      levels than those in the adjuvant treatment group, and patients with progressive
      disease had significantly higher values than those in remission or with stable
      disease. No significant differences were found between different dominant
      metastatic disease sites. Multiple-regression tests showed a significant inverse
      correlation between survival and melatonin values.

PMID- 2216296
TI  - A pilot study of metoclopramide, dexamethasone, diphenhydramine and lorazepam in
      prevention of nausea and vomiting in cisplatin-treated male patients.
AB  - In a pilot study we evaluated the efficacy and tolerability of a four-drug
      antiemetic combination (metoclopramide, dexamethasone, diphenhydramine and
      lorazepam) in cancer patients submitted to cisplatin chemotherapy at doses
      greater than or equal to 50 mg/m2. Fifty male patients entered the study.
      Complete protection from vomiting and nausea was obtained in 41 patients (82%)
      (95% confidence limits 71 and 93%). Toxicity was slight except for moderate
      sedation in 10% of patients necessitating their hospitalization. Only one
      extrapyramidal reaction (akathisia) was observed. When these results were
      compared to our previous experience in male patients treated with a combination
      of metoclopramide, dexamethasone and diphenhydramine without lorazepam, used at
      the same doses and schedule, no clear benefit and higher toxicity was observed.

PMID- 2216297
TI  - Clinical correlations with chemosensitivities measured in a simplified tritiated
      thymidine incorporation assay in patients with malignant effusion.
AB  - Utilizing a simplified tritiated thymidine incorporation assay, in vitro
      chemosensitivity of tumor cells obtained from malignant effusions was assessed
      and, in these patients, chemotherapeutic drugs were administered directly into
      the peritoneal or pleural cavity. Then, correlations between in vitro sensitivity
      and clinical response were investigated. Fifteen (88%) of 17 patients with
      various carcinomas gave evaluable chemosensitivity results. All 15 patients were
      evaluable for in vitro-in vivo correlations. This assay had an accuracy of 75%
      for prediction of response (3 of 4) and an accuracy of 82% for prediction of
      resistance (9 of 11), when the peak achievable plasma concentrations were
      selected as the concentrations used for in vitro sensitivity testing, adopting
      80% inhibition of thymidine incorporation as cutoff level.

PMID- 2216299
TI  - Comparative phase II study of idarubicin versus doxorubicin in advanced breast
      cancer.
AB  - The aim of the present study is to confirm the antitumor activity of orally
      administered idarubicin (IDA) in patients with advanced breast cancer.
      Doxorubicin (ADRIA) was chosen as control treatment and the patients were
      randomized to receive either IDA or ADRIA according to a 2:1 ratio. Sixty-three
      patients, 77% of whom were pretreated with chemotherapy excluding anthracyclines,
      entered the study. The doses were: IDA 45 mg/m2 orally on 3 consecutive days
      every 28 days: ADRIA 75 (60) mg/m2 intravenously every 21 days. A complete +
      partial response (CR + PR) was observed in 11/37 (30%) evaluable cases treated
      with IDA and in 6/19 (32%) cases treated with ADRIA. If all the patients were
      included, the CR + PR remission rates were 27.5 and 27%, respectively. There were
      no significant differences as regards time to remission, duration of remission
      and survival. None of 10 cases who crossed over the treatments responded to the
      second therapy. The most frequent side effects of IDA were myelosuppression and
      nausea/vomiting. The only significant statistical difference between the two
      anthracyclines was the lower incidence of alopecia after IDA. Although there were
      3 cases of cardiotoxicity after ADRIA, 2 of which severe, no case of clinical
      cardiotoxicity was observed after IDA. The present study confirms that orally
      administered IDA is an active agent in advanced breast cancer.

PMID- 2216298
TI  - 'Two-route chemotherapy' using cisplatin and its neutralizing agent, sodium
      thiosulfate, for intraperitoneal cancer.
AB  - The pharmacokinetics of intraperitoneal cisplatin (DDP) administered with
      simultaneous intravenous sodium thiosulfate (STS) were investigated by a bioassay
      system using the phytohemagglutinin (PHA) stimulation assay of human peripheral
      blood mononuclear cells (PBM). Active DDP in the plasma, assessed by the bioassay
      system, was almost completely inactivated, when the level of STS in the plasma
      was more than 500 times higher at molar STS/DDP ratios than that of DDP. However,
      the peak level of active DDP in the peritoneal cavity was not significantly
      decreased. Fourteen patients with intraperitoneal carcinoma were treated with
      intracavitary DDP chemotherapy in combination with STS in this setting. Of 8
      patients with malignant ascites who were evaluable for response, 4 patients
      experienced complete disappearance of ascites and the remaining 4 patients
      responded with apparent decrease in the volume of their ascites. No serious drug
      associated toxicity was encountered.

PMID- 2216300
TI  - Studies on the antineoplasticity of Schiff bases containing 5-nitrofuran and
      pyrimidine.
AB  - Antineoplastic properties of different Schiff bases obtained by the interaction
      of 5-nitrofuran with substituted pyrimidines have been examined both in vitro and
      in vivo. In vitro studies on L 5178Y/asparaginase sensitive, HL 60 and P 388 cell
      lines and in vivo studies on the P 388 cell line indicate that all the compounds
      are potential antineoplastic agents. However, 2-(5-nitro-2-furfurylidene-amino)
      pyrimidine (SBP1) is the most effective, and 2-(5-nitro-2-furfurylidene-amino)-6
      hydroxypyrimidine (SBP3) is the least effective agent. Doubling time, rates of
      protein and DNA synthesis inhibition and LD50 values-1,000 mg/kg body weight for
      SBP1 and 1,275 mg/kg body weight for 2-(5-nitro-2-furfurylidene-amino)-4-
      methylpyrimidine (SBP2)- in the oral route support the activity and use of SBP1
      and SBP2 as future anticancer agents.

PMID- 2216301
TI  - Relation between age and blast cell differentiation in acute myeloid leukaemia
      patients.
AB  - The relation between age and the cytological and cytochemical features of blast
      cell differentiation in 211 patients with primary acute myeloid leukaemia (AML)
      was investigated. Five cytological and cytochemical features of blast cell
      differentiation-the presence of Auer rods, the presence of granules, low
      nuclear/cytoplasmic ratio, Sudan black positivity and the maturation index-were
      studied in bone marrow smears of each AML patient. The results showed
      significantly more AML cases with both cytological and cytochemical features of
      blast cell differentiation in young patients (less than 60 years old) than in
      elderly patients (greater than 60 years old). These findings support the
      existence of two forms of primary AML: one more frequently detected in younger
      patients with more differentiated blast cells and the second with less
      differentiated blast cells mainly found in elderly patients.

PMID- 2216302
TI  - Influence of iron on proliferation and cell cycle kinetics on cultured malignant
      and nonmalignant cells.
AB  - The presence of an iron-containing complex (FSC, ferric sorbitol citrate) in
      medium inhibited proliferation of malignant (KB. GHC) cells: but did not
      appreciably alter the proliferation of normal (HBS, Vero) cells. Flow cytometric
      analysis showed considerable differences of malignant and normal cell growth
      kinetics. With addition of 200 microM Fe in FSC, malignant cell proliferation was
      suppressed. An increased number of cells in G1 and early S phase suggested that
      iron excess blocked the cell cycle before beginning of DNA synthesis.

PMID- 2216303
TI  - The problems in the arrangement of the azygos vein.
AB  - The azygos veins in thirty six cadavers (26 adult bodies, 10 human fetuses) were
      examined with special reference to the correlation with the midline of the
      vertebral column. The azygos veins were often observed to cross the middle of the
      ventral side of the vertebral column from right to left, and the occurrence of
      this crossing to the left is more frequent than that previously described-
      occurring in twenty two of the adult bodies. In three of the adult bodies, the
      vein ran upwards along the midline. In the remaining adult, the azygos vein
      ascended on the right side only of the vertebral column. In the fetuses, no
      azygos vein crossed the midline and the vein lay only on the right side or along
      the midline of the vertebral column. these results indicate the possibility of
      leftward displacement of the azygos vein during the aging process.

PMID- 2216304
TI  - The postnatal development of the mouse pericardium; the time and mechanism of
      formation of pericardial pores.
AB  - The mouse pericardium is a continuous serous membrane, up to postnatal day 6
      (P6), that consists of pericardial and pleural mesothelia with sparse connective
      tissue sandwiched in between. This study shows that on P7 the pericardium becomes
      fenestrated, and the pericardial and pleural cavities become continuous. We found
      that the number of pores per pericardium increased continuously with the advance
      of age and reached as many as 3000 on P21. Transmission electron microscopy of
      the pericardium revealed various structures of the pericardial and pleural
      mesothelia that may relate to the formation of the pericardial pores. The
      pericardial and pleural mesothelia were adjoined with cytoplasmic processes that
      extended toward the base of the opposing mesothelium. As a result of the
      adjoinment, a pair of U-shaped folds were formed. The two U-shaped folds were
      connected with tight junctions at their apices, and separation of these junctions
      may give rise to the pericardial pores.

PMID- 2216305
TI  - Differentiation of the brain stem reticular formation in the triturus, Triturus
      pyrrhogaster.
AB  - The brain stem of the triturus was observed to be initially composed exclusively
      of the mantle layer. A few days before hatching, a narrow marginal layer
      differentiated peripherally. At the time of hatching, the marginal layer was
      clearly visible throughout the brain stem, except for in a medial region of the
      optic tectum. Approximately one week after hatching, a few cells migrated into
      the marginal layer, and almost simultaneously, a few fibers in that layer were
      myelinated. Cells migrating into the marginal layer formed reticular neurons as
      well as the raphe nuclei and superficial cellular layers of the optic tectum. As
      the development proceeded, the number of myelinated fibers in the marginal layer
      increased, and cells in that layer, especially reticular neurons, were seen to be
      embedded among numerous myelinated fibers, assuming the characteristic features
      of the reticular formation.

PMID- 2216306
TI  - Fibrous structure of the joint capsule in the human shoulder.
AB  - The fibrous structure and arrangement of joint capsules of human shoulders [8
      males (7 right, 6 left), 4 females (4 right, 3 left)] were observed under a low
      magnification microscope as well as a polarized microscope on film preparations
      (Hautchen-Praparat, Vogt 1935) with reference to stained sections (mainly with H,
      E and orcein). The joint capsule is composed of synovial and fibrous layers and
      is classified into three types according to tissue composition [areolar (loose
      connective tissue-Fawcett, 1986) type, fibrous (dense fibrous- Fawcett, 1986)
      type and adipose type- (Key 1932)]. In the joint capsule of the shoulder, the
      areolar type was found in the anterior region, and the fibrous type in the
      posterior, superior and inferior regions; the adipose type was not found. The
      author found that the fibrous layer of the fibrous type basically has a 3 layered
      structure; the composition and arrangement of fibers differ depending on the type
      of layer. These three layers were named in order from the synovial layer as
      "Internal fibrous layer (IFL)", "Intermediate fibrous layer (MFL)" and "External
      fibrous layer (EFL)". The external fibrous layer can normally be directly
      visualized by peeling off the muscles. The EFL consists of external fascia,
      tendons and their transitional regions, which compose the joint of the shoulder.
      IFL and MFL can only be observed under a low magnification microscope and are
      distinguishable on film preparations. The IFL, which is located immediately under
      the stratum synoviale, consists of fibrous bundles approximately 20 microns
      thick. The MFL, which is adjacent to the IFL, consists of 100-400 microns thick
      fibrous bundles. The IFL and the MFL have a differently fixed arrangement. The
      fibrous bundle of EFL is slightly thicker than that of IFL and the arrangement of
      the fibrous bundle is like that of supraspinatus m., infraspinatus m. and teres
      minor m. in the superior and posterior regions of the joint capsule. The local
      existence as well as the arrangement of the fibrous layer of these three
      different types is discussed from the standpoint of mechanical movement of the
      shoulder joint.

PMID- 2216308
TI  - The rhomboideus capitis in man--correctly named rare muscular variation.
AB  - This is the third original report on the rhomboideus capitis muscle in man, as
      far as the author is aware. In the earlier descriptions, the muscle was named as
      the occipito-scapularis and the rhomboideus-occipitalis or capitis. The muscle
      was situated on the left side of the neck as a muscular band attached cranially
      to the occipital bone and caudally to the scapula and was closely related to the
      splenius capitis and the levator scapulae. A revision of previous descriptions
      and a brief comparative note on the rhomboideus muscle is given.

PMID- 2216307
TI  - Effect of whole pituitary extract on the corpuscles of stannius in Notopterus
      notopterus (Pallas).
AB  - Administration of pituitary extract brings important change in the cells of the
      corpuscles of stannius. Two variety of cells are found in the corpuscles of
      stannius of control group, one with dense cytoplasm while the other possess non
      reactive cytoplasm. Under the influence of whole pituitary extract, there is an
      intense cell activity in corpuscles of stannius suggesting more synthesis of
      hypocalcemic factor. Other possible reasons like stimulation of interrenal,
      thereby activating corpuscles of stannius have also been discussed. The possible
      involvement of ACTH or cortisol and synergistic effect of prolactin in promotion
      of hypercalcemia have also been suggested.

PMID- 2216309
TI  - Allometric growth of the adrenal gland in Brazilian fetuses.
AB  - The growth of the adrenal gland was studied in 60 brazilian fetuses (12-37 weeks
      post-conception). The right adrenal gland was quantitatively evaluated; its
      weight, length and thickness were correlated to the fetal body weight, to the
      Crown-Pump length and to the gestational age by the allometric method (LogY =
      kLogX + LogB). The width was the only linear measure with positive allometry, and
      was the one which presented the greatest relative growth, while the thickness had
      the smallest one. The adrenal weight presented positive allometry relating to the
      Crown-Rump length (k = 2.32) and to the gestational age (k = 2.40). The
      importance of these knowledges in the precocious ultrasonographic diagnosis of
      congenital adrenal pathologies is discussed.

PMID- 2216310
TI  - The intermediate epithelium lining the nasopharynx of the Suncus murinus.
AB  - In the adult Suncus murinus, the rostral part of the nasopharynx is lined with
      the ciliated columnar epithelium continuing from the nasal cavity, while the
      laryngopharynx with the stratified squamous epithelium; i.e., the epithelium
      lining the caudal part of the nasopharynx forms the transitional zone between the
      ciliated columnar epithelium and the stratified squamous one. The epithelium
      shows gradations ranging from ciliated stratified low-columnar through stratified
      cuboidal to stratified squamous type. It is suggested that the epithelium is
      identical with the "intermediate epithelium (Nakano, 1986)".

PMID- 2216311
TI  - Two types of thyrotropes (TSH cells) in the adenohypophysis of the untreated
      mouse.
AB  - Employing immunohistochemical techniques with OsO4 single fixation, we identified
      mouse pituitary thyrotropes (TSH cells). The cells stained with TSH antiserum are
      angular or slender with a small nucleus. These cells contain small secretory
      granules (about 120-200 nm in diameter) and numbers of cored vesicles, either
      attached to the cell membranes or lying free in a relatively electron transparent
      cytoplasm. In the untreated male mouse, the TSH cell modifies its morphology
      according to the functional phase. The first form of TSH cells [Type I] is small.
      The endoplasmic reticulum and the Golgi apparatus are not prominent, and
      secretory granules are very few. In the second hypertrophied form [Type II], the
      endoplasmic reticulum is very prominent and occurs as a series of grossly dilated
      sacs of irregular shape. The Golgi apparatus is greatly enlarged and a large
      number of electron-dense secretory granules and cored vesicles are observed. Type
      II thyrotropes are rarely encountered in normal tissue.

PMID- 2216312
TI  - Gut formation after transection of the midgut loop in the chick embryo.
AB  - The primitive gut in vertebrates can be divided into the foregut, midgut, and
      hindgut. The midgut forms the midgut loop or the intestinal loop, which rotates
      as it develops the small and large intestines. We examined the effects of
      transection of the midgut loop on the subsequent development of the intestine in
      chick embryos by their out-of-the-shell incubation. The development of the embryo
      and the intestines out of the shell was nearly identical to that usual in-the
      shell incubation. The rotation of the midgut loop began in stage 27 (5 days of
      incubation) and was completed in stage 36 (10 days of incubation) after
      counterclockwise rotation through 180 degrees. In experimental groups, the midgut
      loop was transected immediately before or in the early stages of rotation (stages
      27-33) proximally or distally to the apex of the loop. Transecting of the midgut
      loop caused little effects on its subsequent rotation regardless of the time or
      the site of transection although the secondary loop formation of intestine was
      poor in some cases. The stumps of the transected intestine were repaired and
      closed. After closure of the stumps, the proximal segment of the intestine was
      dilated in some cases. The secondary loop formation, or convolution of the
      intestine didn't occur in some dilated cases.

PMID- 2216313
TI  - Three dimensional arrangement of fibrocytes in the dermal papilla of the human
      sole skin.
AB  - The three dimensional arrangement of fibrocytes in the dermal papilla of the
      human sole skin was examined by the scanning and transmission electron microscopy
      after removal of the epidermis and collagenous fibers of the dermis by acidic
      maceration and enzymatic digestion with collagenase. Fibrocytes in the papillary
      layer were dendritic cells, consisting of bulky or flattened perikarya and
      numerous cytoplasmic processes of various size. The processes were anastomosed
      with those of neighboring cells forming a three-dimensional network. Fibrocytes
      around the blood capillaries were squamous and formed cellular sheaths, on which
      dendritic fibrocyte processes anchored. The outer surface of the papillae showed
      a fine villous appearance. It was composed of densely arranged tiny processes of
      fibrocytes, tops of which were almost at the same level. These processes may be
      sites for fibrillar attachment and play a role in dermal anchoring to the
      epidermis. In the reticular layer, fibrocytes were flattened, stellate cells
      which were anastomosed with neighboring cells and formed two-dimensional
      latticework. These cellular lattices were arranged in lamellae, oriented roughly
      parallel to the skin surface. Nerve bundles were often encountered in the
      labyrinthine space of the fibrocytic network.

PMID- 2216314
TI  - The posterior renal vein (new definition), together with its morphological
      significance.
AB  - A particular branch of the renal vein, which is detected behind the renal pelvis
      at the hilum at the rate of ca. 80%, and which is proposed as the posterior renal
      vein (PRV), may be remarked as morphologically significant. PRV may be divided
      into the typical and non-typical categories. But, in accordance with the
      bilateral asymmetry of the renal vein, PRV differs between the two sides. Thus on
      the right (82/270 = 30%), the first category of PRV directly joins the inferior
      vena cava (IVC) 1-3cm lower than the ordinary or anterior renal vein (ARV), and
      on the left (90/270 = 33%), it joins ARV after receiving the second lumbar vein
      in most of the examples. The other category of PRV (99/221 = 45%), which joins
      ARV near the hilum, is morphologically regarded to represent the former, which is
      degenerated to a certain extent. By considering the characteristics above and
      below the renal vein, the flowing level of PRV into IVC on the right will, above
      all, indicate the point of transition of the constituent portions of the
      developing IVC. In the meantime, in view of the assessment that the final portion
      of the left PRV represents IVC, PRV will afford a logical clue to understand the
      bilateral symmetry. The posterior veins as observed in the upper retroperitoneal
      cavity such as the suprarenal gland and diaphragm will constitute the posterior
      venous system related to PRV.

PMID- 2216315
TI  - Microvascular architecture of the hard palatine mucosa in the rabbit.
AB  - SEM studies on the microvascular architecture of the hard palatine mucosa,
      especially the transverse palatine plicae, and the morphological relations
      between the microvasculature and layers of the hard palate mucosa of the rabbit,
      were carried out by the acryl plastic injection method. The findings were
      compared with those obtained previously in the cat and Japanese monkey.
      Morphological differences and similarities between the papillae in the lamina
      propria and the capillary loops in the papillae were elucidated by SEM. A
      boneless area was found in the hard palate since the palatine fissures occupied a
      large area between the diastemata. The transverse palatine plicae numbered 14-16
      symmetrically in the hard palate, and were more developed than those in the cat
      and Japanese monkey. In sagittal sections of the hard palate, the transverse
      palatine plicae were observed to be serrated, since they were located close to
      each other with small narrow interplical regions. The plical branches were
      usually derived from the major and minor hard palatine arteries, and formed the
      primary arterial network in the submucous layer of the hard palate. Twigs
      diverging from this network formed the second arterial plexus in the lamina
      propria, and furthermore, a subepithelial capillary network was formed
      immediately beneath the epithelium. From this network, capillary loops sprouted
      into papillae. Similarities were found between the papillae and capillary loops
      with locational differences. The descending crus of the capillary loop drained
      into the venous site of the subepithelial capillary network which flowed into the
      primary venous plexus in the lamina propria, which finally poured into the second
      venous plexus in the submucous layer. This plexus was termed the palatine venous
      plexus, and was especially well-developed in the area covering the palatine
      fissures. The capillary loops in the plica displayed characteristic features
      according to the portions within it and the interplical regions.

PMID- 2216317
TI  - Immunohistochemical study of intestinal lamina propria cells in the rat, with
      special reference to Ia antigen expression.
AB  - A previous study by Osogoe and Yanagi (1987a) has demonstrated that a large
      proportion of the lamina propria cells (LPC), mostly reticulum cells, in the core
      of the rat jejunal villi exhibit a strong labeling with [14C]adenine [( 14C]A).
      To obtain further information on such LPC, immunohistochemical detection of
      either Ia antigen or IgA on intestinal LPC was carried out in adult rats. It was
      found that almost all the LPC in the villous core of the small intestine express
      Ia antigen, and that in this area IgA-containing B cells also occur in
      unexpectedly large numbers. However, the number of Ia-positive non-B cells was
      greater than that of IgA-containing B cells which are also Ia-positive. Since the
      Ia-positive non-B cell population is composed mostly of reticulum cells, the
      above findings indicate that a large number of LPC, mostly reticulum cells, not
      only exhibit a strong labeling with [14C]A but also express Ia antigen. The
      biological significance of Ia antigen expression is discussed in relation to the
      proliferative activity of the cells.

PMID- 2216316
TI  - Postnatal transformation and location of mitoses in the epithelium lining the
      mouse vomeronasal organ.
AB  - The structure and the postnatal transformation of the epithelium lining the
      vomeronasal organ of the mouse was observed. The medial wall of the middle
      segment of the organ was lined with the sensory epithelium similar to the
      olfactory epithelium, and was not undergone any transformation in the postnatal
      life. The lateral wall of the middle segment and the entire lumen of the rostral
      segment were covered with the stratified cuboidal epithelium in the newborn
      mouse. The stratified cuboidal epithelium transformed into the ciliated columnar
      epithelium with advancing ages, excepting in the vomeronasal duct where the
      epithelium changed into the stratified squamous one. In the mouse aged between 4
      and 10 days, mitotic figures were observed not only in the boundary between the
      sensory epithelium and the ciliated columnar one in the middle segment, but also
      in the rostral segment of which the entire lumen was covered with the ciliated
      columnar epithelium.

PMID- 2216318
TI  - The facial artery of the common marmoset (Callithrix jacchus).
AB  - The facial artery and its ramifications in 7 adult common marmosets (Callithrix
      jacchus) were studied by the plastic injection method. The findings obtained are
      discussed in comparison with those for other primates. In the submandibular
      region, the facial artery arose from the external carotid artery at the height of
      the atlas via the linguofacial trunk on 10 of the total of 14 sides examined and
      independently on the other 4 sides. This common trunk always gave rise to the
      superior thyroid artery. The facial artery passed anterolaterally between the
      styloglossus muscle and the intermediate tendon of the digastricus muscle, giving
      off the styloglossal and the submandibular glandular branches, and
      anteroinferiorly medial to the pterygoideus medialis muscle. In a position
      anterior to this muscle, the submental artery and masseteric branch were derived.
      The submental artery gave off the medial pterygoid, the digastric, the cutaneous,
      the sublingual glandular and the mylohyoid branches, and then continued up to the
      median line, where it terminated to supply the genioglossus muscle. In the facial
      region, the facial artery passed anterosuperiorly along the anterior margin of
      the masseter muscle on 12 sides and away from it forwards on 2 sides, giving off
      the premasseteric branch in one of these 2 sides. It gave rise to the cutaneous,
      the buccal and the buccinator branches, the inferior labial artery and the
      communicating branch with the zygomatic artery. It terminated to divide into the
      superior labial and the naris lateral arteries, although the latter was lacking
      on 4 sides. The inferior labial artery gave off the mandibular marginal, the
      inferior labial marginal and the inferior labial glandular branches and
      terminated to anastomose with the mental artery. The superior labial artery
      divided into the superficial and deep branches, each of which continued as a
      nasal septal branch. The facial artery of the common marmoset usually ascended
      along the anterior margin of the masseter muscle and did not reach the medial
      angle of the eye.

PMID- 2216319
TI  - Support for the recovering nurse within the employing agency.

PMID- 2216320
TI  - 'If caring were enough, anyone could be a nurse'.

PMID- 2216321
TI  - Annual meeting program of the American Academy of Optometry. Nashville,
      Tennessee, December 6-10, 1990. Proceedings.

PMID- 2216322
TI  - The change in the neutral point of dichromats with change in the angle of
      incidence of monochromatic light on the retina.
AB  - The hypothesis was tested that the change in the perceived color of monochromatic
      light with change in its angle of incidence on the retina can be accounted for
      completely by prereceptor factors alone. This was evaluated by measuring the
      change in the match of a monochromatic light to a fixed (and normally incident)
      white light as the monochromatic beam changed its traverse through the eye from
      chief ray to "off-axis" retina incidence at the margin of the exit pupil. Two
      protanopes and four deuteranopes were tested. In each case, the wavelength of the
      chief ray at the match was consistently, reliably, and (statistically)
      significantly larger than that of the match with the "off-axis" beam. The result
      cannot be accounted for by prereceptor factors alone.

PMID- 2216323
TI  - Directionalization of visual targets during involuntary eye movement.
AB  - Perceived visual direction with respect to one's self (egocentric direction)
      depends upon the retinal location of a target's image (its oculocentric
      direction) and concurrent information about the position of the eyes in the head.
      Information about eye position is presumably obtained from efference copy
      signals. However, in order to explain illusory target motion that can occur
      during reflexive eye movements (e.g., post-rotary nystagmus), these signals have
      been suggested to accompany only voluntary oculomotor responses. In the
      experiment reported here, manual pointing was used to assess the perceived
      direction of targets flashed during optokinetic afternystagmus, an involuntary
      movement of the eyes that occurs in darkness following optokinetic stimulation.
      Egocentric directionalization was essentially veridical, indicating that accurate
      eye position information is available during optokinetic afternystagmus. A model
      is proposed that accounts for illusory target motion during involuntary
      oculomotor responses by the cancellation of efference copy information about
      these eye movements with signals of oppositely directed head motion.

PMID- 2216324
TI  - Measuring visual acuity in children using preferential looking and sine wave
      cards.
AB  - Preferential looking using square waves is commonly used to measure visual acuity
      of infants. Since sine-wave gratings have the advantage of presenting only a
      single spatial frequency, we completed a study to develop and validate a set of
      acuity cards using sine waves. The subjects were 83 children (mean age = 41.5
      months, range = 3 to 69 months). The sine-wave cards were compared with Teller
      cards. Identical visual acuity was determined in 83% of the cases. Wilcoxon non
      parametric analysis provided no evidence to reject the null hypothesis of equal
      visual acuities between the two methods. We conclude that sine-wave cards may be
      used to measure the preferential looking acuity of children.

PMID- 2216325
TI  - Saturation and purity of near-threshold spectral increments on achromatic
      backgrounds.
AB  - Vector models of color vision predict that the chromatic saturation of near
      threshold incremental stimuli should grow with increasing achromatic adaptation.
      In contrast, colorimetric models predict that saturation should decrease with
      increasing adaptation in correspondence with excitation purity. An experimental
      test disagrees with both predictions, but is consistent with a two-process model
      of chromatic adaptation and contrast. Foveal monochromatic test stimuli 0.6 log
      unit above threshold were superposed on achromatic backgrounds with retinal
      illuminances of up to 5.3 log Td. Saturation and purity both decreased as
      background illuminance increased up to 2 log Td, but the saturation decrease was
      relatively small. As background illuminance increased above 2 log Td, purity
      remained nearly constant and saturation often increased, making the overall
      saturation function U-shaped. Thus, a purity of 0.1 at high background
      illuminance could sometimes elicit a higher saturation estimate than a purity of
      0.9 at low background illuminance.

PMID- 2216327
TI  - Is the relation between keratometric astigmatism and refractive astigmatism
      linear?
AB  - Javal's rule, which states that the total astigmatism of the eye--or refractive
      astigmatism--is equal to 1.25 (keratometric astigmatism) - 0.50 x 90, implies a
      linear relation between the two entities. Data published by Grosvenor, Quintero,
      and Perrigin (Am J Optom Physiol Opt 1988;65:292-7) show that for eyes having no
      more than 2.50 D of keratometric astigmatism, the slope of the regression line
      for refractive astigmatism plotted against keratometric astigmatism is less than
      1.00, rather than the 1.25 required by Javal's rule. When data compiled for eyes
      having greater amounts of keratometric astigmatism are plotted in the same
      manner, the slope of the regression line is greater than 1.00, suggesting that
      the relation between keratometric and refractive astigmatism may be non-linear.
      However when data for these highly astigmatic eyes are plotted in combination
      with data published by Grosvenor, Quintero, and Perrigin, they are adequately
      characterized by a straight-line relation.

PMID- 2216326
TI  - Effect of bleaching on the width and index of refraction of goldfish rod and cone
      outer segment fragments.
AB  - Data on goldfish rod and cone fragments were obtained before and after a strong
      bleach by using a Zeiss Jamin-Lebedeff infrared interference microscope and
      computer image processing techniques. The receptor fragments were fractured in
      the inner segment and were immersed in goldfish aqueous humor medium. On
      bleaching we found that: (1) there is a small increase in rod diameter. This
      effect is of the same magnitude reported earlier in Rana pipiens outer segments
      (Vision Res 1973; 13:171). (2) There is an inferred decrease in rod refractive
      index. (3) There is a decrease in cone width. (4) There is a slight increase in
      inferred cone refractive index. These data are presented.

PMID- 2216328
TI  - Physiological pseudomyopia.
AB  - Objective refraction through plus fogging lenses and base-in prisms revealed that
      normally accommodation is not completely relaxed when the stimulus to
      accommodation is zero. The myopic shift in the refractive error due to this focus
      error of accommodation was defined as physiological pseudomyopia. Two previously
      established features of accommodation are responsible for this behavior: (1)
      accommodation acts as a proportional control system for steady-state responses;
      and (2) the rest focus of accommodation is nonzero. It is proposed that the
      hyperopic shift in refraction observed in cycloplegia is the result of
      elimination of physiological pseudomyopia.

PMID- 2216329
TI  - Image evaluation of ophthalmic devices.
AB  - Methods used in the ophthalmic industry to evaluate the optical image quality of
      correcting lenses have remained the same over many years. This is especially true
      for single-vision ophthalmic lenses. With the development of new optical designs
      and materials for correcting refractive errors and presbyopia, new procedures for
      evaluating lens performance are being explored. One such method is the
      measurement of the modulation transfer function. Over the last 2 years, we have
      been measuring modulation transfer functions on a variety of single-vision and
      bifocal contact lenses, progressive addition spectacle lenses, holographic
      diffractive lenses, and intraocular lenses. In this article, the modulation
      transfer function procedure and its application and results from one study on
      safety goggles will be presented and discussed.

PMID- 2216330
TI  - The Video Display Terminal Eye Clinic: clinical report.
AB  - The Video Display Terminal Eye Clinic was designed to relieve the symptoms of
      video display terminal users by diagnosing and treating visual problems and by
      analyzing the patients' work station environment through an in-office simulation
      and making suggestions for improvements. The Clinic was open to the public and
      patients were therefore self-selected. The symptoms, diagnoses, and treatments
      were compiled retrospectively and reported for 153 patients. Vision problems were
      diagnosed in most patients. The most frequent diagnoses included: presbyopia,
      improper spectacle design for presbyopia, accomodative deficiencies, esophoria,
      exophoria, and hyperopia. The results suggest that proper visual care and work
      station arrangement can improve comfort.

PMID- 2216331
TI  - Detection of disparity motion by the human observer.
AB  - A single-line stimulus in a context-free visual environment presented for 250
      msec needs to move with a disparity velocity of 25 to 45 min of arc/s before the
      direction of depth motion can be correctly identified. Presence of a pair of
      flanking line stimuli improves this value severalfold, but even then the
      threshold is 18 to 28 times higher than for the detection of a static disparity
      difference.

PMID- 2216332
TI  - Variables related to the rate of childhood myopia progression.
AB  - This study was undertaken to examine the relations between the rate of childhood
      myopia progression and variables available in patient records. Data were obtained
      from four private optometry practices and two university-based longitudinal
      studies. Subjects were myopes with a minimum number of refractions between the
      ages of 6 and 15 years. Spectacle prescription types included single-vision
      lenses with exact distance correction or slight undercorrection, bifocal lenses,
      and single-vision lenses with overcorrection. Rates of progression were
      determined by linear regression. Three analyses were conducted: (1) for all
      patients, analysis of variance of rate as a function of heterophoria through the
      habitual nearpoint correction, an index of the amount of myopia at the initial
      examination age, sex, and clinical location; (2) for patients with esophoria
      through the distance ametropia correction, analysis of variance of rate as a
      function of correction type (full correction or slight undercorrection vs.
      bifocals), amount of myopia at the initial examination age, sex, and location;
      and (3) for patients with orthophoria or exophoria with ametropia correction,
      analysis of variance of rate as a function of correction type, amount of myopia
      at the initial examination age, sex, and location. The index of amount of myopia
      at the initial examination age was a significant variable, as was location.
      Patients with nearpoint esophoria through their habitual nearpoint correction had
      greater rates than patients with nearpoint orthophoria or exophoria with the
      habitual correction. For patients with nearpoint esophoria through the distance
      refractive correction, rates were less with bifocals than with full correction or
      slight undercorrection.

PMID- 2216333
TI  - Rates of childhood myopia progression with bifocals as a function of nearpoint
      phoria: consistency of three studies.
AB  - Three studies on the effect of bifocal lenses on childhood myopia progression are
      discussed and re-analyzed. In all three, the rates of progression were less with
      bifocals than with single-vision lenses in esophoria. Rates with the two types of
      correction were similar in patients who had nearpoint orthophoria or exophoria.

PMID- 2216334
TI  - Influence of rigid contact lens overall and optic zone diameters on tear pump
      efficiency.
AB  - To determine the effects of contact lens overall diameter on tear pump
      efficiency, oxygen uptake rates were measured for the open-eye condition and
      following steady-state periods of static (without blinking) and dynamic (with
      blinking once every 5 s) contact lens wear of oxygen-impermeable
      (polymethylmethacrylate) lenses of 5 overall diameters (8.2, 8.5, 8.8, 9.1, and
      9.4 mm). The optic zone diameters were 1.4 mm smaller than the overall diameters
      in each case, while all other parameters remained constant. Differences in
      corneal oxygen demand following the static and dynamic conditions are a
      quantitative index of the tear pump efficiency for each lens size on the same
      cornea, and the differences were found to increase with reduction in lens overall
      diameter. This indicated that a more efficient tear pump was associated with
      small diameter designs. In addition, subjects with large palpebral aperture size,
      relative to lens overall diameter, were found to demonstrate better tear
      exchange.

PMID- 2216335
TI  - Reactivation of ocular toxoplasmosis.

PMID- 2216337
TI  - Rose bengal staining before and after anesthetic.

PMID- 2216336
TI  - High and low contrast acuity.

PMID- 2216339
TI  - Ophthalmology sourcebook & reference guide 1990.

PMID- 2216338
TI  - Historical roots of 20/20 as a (wrong) standard value of normal visual acuity.

PMID- 2216340
TI  - Evaluation of the efficacy of anthelmintics against parafilariosis in cattle.
AB  - Parafilariosis was first described in South Africa in 1964, thereafter being
      discovered at numerous localities in the country. When it became obvious that
      Parafilaria bovicola, for which no treatment was known, caused considerable
      economic losses, trials involving a series of compounds were conducted to
      identify candidate remedies. This paper describes an anthelmintic test for
      evaluating the efficacy of compounds for registration for field use. Recovery of
      Parafilaria worms is impractical for anthelmintic testing, and consequently the
      lesion sizes of treated and control groups of cattle are compared statistically,
      using appropriate statistical tests. The seasonal incidence of mature worm
      infection in cattle in South Africa is such that trials should commence after
      June and be completed before the end of January, allowing a lapse of 70 days
      between treatment and slaughter for resolution of the lesions. The presently
      available parafilaricidal compounds while of value for treating slaughter stock,
      when used alone will probably not be effective for control of infection in the
      field.

PMID- 2216341
TI  - Pyridoxine (a vitamin B6) and its derivative pyridoxal as treatment for Albizia
      versicolor poisoning in guinea-pigs.
AB  - In the course of three experiments it was established that all the toxic effects
      of a lethal dose of Albizia versicolor pods (greater than 4.5 g/kg) in guinea
      pigs could be countered by concurrent subcutaneous injection of pyridoxine (10
      mg/kg). This treatment was also successful once severe symptoms had set in.
      Pyridoxal, on the other hand, was found to be ineffective as a therapeutic agent.
      The fact that pyridoxal does not counter the action of the toxin indicates an
      atypical site of action by the toxin as regards the normal pathways which require
      vitamin B6 as a co-factor.

PMID- 2216342
TI  - Fitting the Gompertz function to dose-response data of larval tick populations.
AB  - Samples of 6, 1st generation larval populations of Boophilus decoloratus,
      originating from field collected females, were subjected to increasing doses of
      the organophosphate acaricide, Dioxathion. The dose-response relationship for 3
      populations showed random heterogeneity, while systematic deviations from the
      linear probit lines were observed for the other 3 populations. Logistic and
      Gompertz regressions were also fitted for all 6 populations. Probit regressions
      fitted best for 2 populations exhibiting heterogeneous responses. The logistic
      regression fitted best for 1 population with heterogeneous responses and 1
      population with systematic deviating responses. The Gompertz regression fitted
      best for the 2 remaining populations exhibiting systematic deviating responses.
      The Gompertz function may be useful in describing the dose-response relationship
      obtained for certain acaricidal toxicity tests.

PMID- 2216343
TI  - A field strain of Trichostrongylus colubriformis resistant to levamisole and
      morantel in South Africa.
AB  - A strain of Trichostrongylus colubriformis from Nottingham Road, in Natal, was
      found to be solidly resistant to levamisole and morantel at the recommended dose
      levels. Untreated control sheep in fact harboured fewer worms at slaughter than
      either of the 2 treated groups. In contrast, the benzimidazoles and ivermectin
      were more than 99.9% effective against this worm strain. The possible
      implications of escalating resistance to anthelmintics in the gastrointestinal
      nematodes of sheep are discussed.

PMID- 2216344
TI  - On sampling tick populations: the problem of overdispersion.
AB  - Data collected on both free-living and parasitic tick populations are likely to
      be overdispersed. The use of means from few replicate samples of overdispersed
      data as quantitative estimators of tick population density is in turn likely to
      lead to inaccurate interpretations which may be scientifically misleading. In
      this paper ways of estimating overdispersion are listed and suggestions for the
      use of correct statistical tests for handling overdispersed data are given.

PMID- 2216345
TI  - The use of sensitivity discs in the identification of Campylobacter species.
AB  - Filter paper discs were impregnated with a solution containing 20 mg of
      triphenyltetrazolium chloride per millilitre, and used in the typing of catalase
      positive Campylobacter species. Also used were filter paper discs impregnated
      with cephalothin at 30 micrograms/ml, 60 micrograms/ml and 3 mg/ml and nalidixic
      acid at the same concentrations, as well as commercially available discs
      containing 30 micrograms of, respectively, cephalothin and nalidixic acid.
      Results obtained proved the technique to be reliable and easier to interpret than
      previously used methods, and laboratory prepared filter paper discs compared
      favourably with commercial discs.

PMID- 2216346
TI  - Effects of microclimatic variables on the availability and movement of third
      stage larvae of Ostertagia ostertagi on herbage.
AB  - Assessments were made of the influence of several microclimatic variables on the
      availability of third-stage larvae of Ostertagia ostertagi, on pasture herbage.
      Variables most closely related to recovery of larvae from the lower herbage
      samples were: maximum air, mat and dung temperatures. Recovery of larvae from the
      upper portion of the herbage was closely correlated with dung temperature,
      sampling-time air temperature and maximum air temperature. Bearing in mind that
      the moisture threshold was maintained throughout the trial the results of this
      study suggest that under field conditions, larval movement of third-stage O.
      ostertagi larvae on herbage is regulated primarily by temperature.

PMID- 2216347
TI  - Host cellular components adhering to the tegument of schistosomes from cattle,
      buffalo, hippopotamus and lechwe.
AB  - The teguments of adult Schistosoma mattheei from cattle and buffalo, S.
      hippopotami from hippopotamus and S. margrebowiei from lechwe were examined by
      means of scanning electron microscopy for cells possibly engaged in immunological
      action. Leukocytes were observed on the teguments of the schistosomes from all 4
      host species. Although certain of these cells seemed to be fused to the surface
      membrane of the worms, they did not display pseudopodia. The tegument of certain
      schistosomes from buffalo exhibited cells the size of platelets with dendritic
      structures connected to the tegument of the parasite. The results seem to
      indicate that, as with laboratory hosts, naturally infected domestic and wild
      hosts are unable to mount an effective cellular response against the tegument of
      live adult shistosomes. The possible role of platelets in immunology against
      schistosomes is mentioned.

PMID- 2216348
TI  - Feeding habits and flight range of blow-flies (Chrysomyia spp.) in relation to
      anthrax transmission in the Kruger National Park, South Africa.
AB  - Carrion-frequenting blow-flies (Chrysomyia albiceps and C. marginalis) were
      allowed 4 days of feeding on 32P-orthophosphate-labelled blood or an impala
      carcass (Aepyceros melampus) in the northern Kruger National Park, South Africa.
      The dispersal and density of fly faecal and discard droplets were then
      established using a Geiger-Counter, indicating that most droplets occurred
      between a height of 1 and 3 m on nearby leaves and twigs. This coincides with the
      preferred feeding height of kudu (Tragelaphus strepsiceros). During a previous
      anthrax epizootic kudu comprised 73.15% of a total medium to large mammal
      mortality figure of 1054. Further analysis of mortality shows browsers to have
      been most severely affected, and it is suggested that this is correlated with
      feeding habits of these animals. Trapping also yielded radioactively labelled C.
      albiceps up to 32.5 km and C. marginalis up to 25 km from the isotope source.

PMID- 2216349
TI  - The isolation and serology of Brucella melitensis in a flock of goats in central
      RSA.
AB  - Brucella melitensis biotype 1 was isolated in pure culture from the lungs, liver,
      spleen, kidney, stomach contents, abomasum and brain of an aborted caprine (Boer
      goat) foetus in the district of Cullinan near Pretoria. The 18 does and 1 ram in
      the flock of Boer goates were examined serologically by means of the complement
      fixation (CF) test, using Brucella abortus antigen. Six weeks later they were
      examined again, using B. abortus as well as B. melitensis biotype 1 antigens. No
      significant differences were found between the 2 CF tests using B. abortus
      antigen, or between the results obtained by using the B. abortus and B.
      melitensis antigens. Twelve goats, showing CF antibody titres, were slaughtered
      and examined bacteriologically. No relationship was found between the serological
      and bacteriological results.

PMID- 2216350
TI  - The modified superior based pharyngeal flap. Part I. Surgical technique.
AB  - The superior based pharyngeal flap operation for the correction of velopharyngeal
      incompetence is perhaps the most commonly employed operation used today in a
      majority of cleft palate centers. However, inconsistent results with this
      operation are commonplace. This is believed by most to be due to poor control of
      the lateral portals. Herein is a report of our approach to improve lateral portal
      control.

PMID- 2216351
TI  - The modified superior based pharyngeal flap technique. Part II. An anatomic
      study.
AB  - There is little in the literature on the topographic and/or applied surgical
      anatomy related to superior based pharyngeal flap surgery. Herein we report on
      the applied surgical anatomy of pharyngeal flap surgery, especially as it applies
      to critical anatomic relationships to vessels, muscles, and nerves.

PMID- 2216352
TI  - The modified superior based pharyngeal flap. Part III. A retrospective study.
AB  - A retrospective study of 31 patients who had diagnosed velopharyngeal
      incompetence and were surgically managed with the modified superior based
      pharyngeal flap was completed. The following were analyzed: age at time of
      operation, gender, physical status, diagnostic protocol, length of operation
      (length of total surgery) and length of superior based pharyngeal flap, length of
      postoperative hospital stay, length of total hospital stay, length of follow-up,
      speech results, complications, patient care, and medication. The result showed
      that the optimal timing for correction of velopharyngeal incompetence was between
      3 and 6 years of age. The mean length of total hospital stay was 2.7 days,
      postoperative complications were minimal, and speech results were generally good.

PMID- 2216353
TI  - Capillary hemangioma of the maxilla. A report of two cases in which angiography
      and embolization were used.
AB  - This article presents two clinical cases of capillary hemangiomas of the maxilla.
      Such lesions are rare, as demonstrated by the review of the literature included
      in this article. The presentation, differential diagnosis, histopathology,
      management, and follow-up for each case are discussed. Our rationale for
      approaching these types of lesions, as well as our opinion that microembolization
      should be considered as a first line approach to treatment, is presented.

PMID- 2216354
TI  - Oral squamous cell carcinoma arising in a patient with long-standing lichen
      planus. A case report.
AB  - The risk of malignant transformation of oral lichen planus remains a
      controversial point. Many previous reports have been discounted on the basis of
      inadequate information or lack of histologic confirmation of lichen planus. We
      report a well-documented case of long-standing cutaneous and oral lichen planus
      in which squamous cell carcinoma of the dorsal portion of the tongue occurred.
      There is an apparent difference in the sites of oral carcinomas in patients with
      lichen planus compared with the general population. This suggests that lichen
      planus increases the risk of oral cancer in affected sites.

PMID- 2216355
TI  - Premature alveolar bone loss in Erdheim-Chester disease.
AB  - Erdheim-Chester disease is a rare histiocytosis also known as lipoid
      granulomatosis. Oral findings have not been reported previously to our knowledge.
      This case report documents evidence of oral sequelae of Erdheim-Chester disease.
      A patient whose course was followed for 10 years at the National Institutes of
      Health had premature alveolar bone resorption. He underwent full-mouth extraction
      at age 29 years because of severe periodontitis. Histopathologic evidence of
      Erdheim-Chester disease was demonstrated in the periodontal soft tissues. In the
      ensuring years, accelerated resorption of the residual ridges precluded the use
      of conventional dentures. We recommend early preventive dental management for
      patients with Erdheim-Chester disease.

PMID- 2216356
TI  - Safe storage times for sterile dental packs.
AB  - Safe storage times were evaluated for three sterile packaging materials that are
      commonly used in dentistry. No significant differences were found among packaging
      materials. Only three packs of 300 produced positive cultures during the 1-year
      test period. There were no time-related trends. The contamination levels found
      were within the range that has been reported to occur as a result of inadvertent
      contamination during unpackaging and transfer of sterile instruments. The
      findings of this study support the proposal that contamination is event related,
      not time related; that is, sterile instrument packs remain sterile for at least 1
      year unless a specific event causes contamination.

PMID- 2216357
TI  - Dental abnormalities associated with familial expansile osteolysis: a clinical
      and radiographic study.
AB  - Familial expansile osteolysis is a rare and possibly unique form of hereditary
      bone dysplasia with dental manifestations that has affected 42 members of a
      Northern Ireland family for five generations. Twenty-seven family members, aged 3
      to 60 years, were examined clinically and radiographically, and it was found that
      cervical and/or apical root resorption is an early manifestation of the
      dysplasia. Of the 20 family members with skeletal manifestations of familial
      expansile osteolysis, 16 showed root resorption. Root resorption may therefore be
      a good prognosticator for later bone involvement.

PMID- 2216358
TI  - Differences between florid osseous dysplasia and chronic diffuse sclerosing
      osteomyelitis.
AB  - Florid osseous dysplasia (FOD) is confused in the literature with chronic diffuse
      sclerosing osteomyelitis. Two cases of each condition are presented to
      demonstrate the differences between them. In FOD, there are multiple lobulated
      sclerotic masses in several quadrants of the jaws, usually in black females. In
      some cases, the sclerotic masses are exposed to the oral cavity, resulting in a
      secondary osteomyelitis. Periapical cemental dysplasia is often found in
      association with FOD. Chronic diffuse sclerosing osteomyelitis is a primary
      inflammatory condition of the mandible. Patients have cyclic episodes of
      unilateral pain and swelling. The affected region of the mandible exhibits a
      diffuse opacity with poorly defined borders. Although women are affected more
      often than men, black persons are not particularly susceptible.

PMID- 2216360
TI  - Photoelastic stress comparison of warm (Endotec) versus cold lateral condensation
      techniques.
AB  - Stress generated during gutta-percha obturation of root canals can create
      microcracks and ultimately lead to failure. A new thermosoftening device, the
      Endotec, which develops a warm lateral condensation technique, was tested against
      the traditional lateral condensation procedure. The results indicated that the
      warm lateral condensation technique created less stress during obturation than
      did cold lateral condensation.

PMID- 2216359
TI  - Contiguous enlarged dental follicles with histologic features resembling the WHO
      type of odontogenic fibroma.
AB  - Defective odontogenesis and/or retarded eruption of teeth can be associated with
      histologic features akin to odontogenic fibroma in the dental follicles.
      Unerupted mandibular premolar and molar teeth of a 24-year-old man were
      surgically exposed, yet the teeth failed to erupt. About a year and a half later,
      radiographs indicated further enlargement of the follicle of the premolar, and
      both teeth were subsequently surgically removed. Histologically, the follicles
      were composed of mature collagenous tissue among which epithelial islands and
      numerous clusters of calcified bodies were present. Indirect immunofluorescence
      showed positive staining for type I and type III collagen, which exhibited a
      sparse distribution, but not for the aminoterminal propeptide of type III
      procollagen. The hamartomatous nature of the lesions is discussed with emphasis
      on their histologic resemblance to the WHO type of odontogenic fibroma.

PMID- 2216361
TI  - Effectiveness of ultrasonic files in the disruption of root canal bacteria.
AB  - The physical mechanisms of ultrasound, namely cavitation and acoustic streaming,
      generated by the Enac-Osada ultrasonic unit were investigated for effectiveness
      in disrupting Streptococcus mitis. In addition, the bactericidal effect of
      ultrasound in the presence of 2.5% sodium hypochlorite was examined. Bacterial
      suspensions were irradiated directly with ultrasound in simulated root canals,
      and the viability of bacteria was examined after growth on a blood agar medium
      under anaerobic conditions at 37 degrees C for 5 days. The results indicated that
      ultrasound per se failed to disrupt bacteria but resulted in increases in the
      viable counts; the former was considered to be because of the lack of cavitation
      and the latter because of the dispersal effects of acoustic streaming. The 2.5%
      sodium hypochlorite solution demonstrated powerful bactericidal activity.

PMID- 2216362
TI  - A dentist's dilemma: nonsurgical endodontic therapy or periapical surgery for
      teeth with apparent pulpal pathosis and an associated periapical radiolucent
      lesion.
AB  - First presented is a brief review of nonsurgical versus surgical treatment of
      radicular cysts. This is followed by a consideration of the use of radiographs
      for differential diagnosis of periapical radiolucent lesions. Some of the
      nonendodontic local and systemic lesions that can occur periapically are then
      presented. Next examined are the fallibilities of pulp vitality testing methods.
      The need for histopathologic examination of periapical lesions is the subject of
      the next discussion. The dentist's dilemma is then examined: should teeth with
      apparent pulpal pathosis and an associated periapical radiolucent lesion have
      routine surgical treatment including biopsy or should they be treated
      nonsurgically and have periodic follow-ups? A possible resolution of this dilemma
      is the final consideration.

PMID- 2216363
TI  - A new method of tooth replantation and autotransplantation: aluminum oxide
      ceramic for extraoral retrograde root filling.
AB  - After an initial clinical test phase, the new method of replantation and
      transplantation with the use of aluminum oxide ceramic for retrograde root
      filling may be viewed as possible differential indications to other methods, even
      to apicectomy in the molar region. Twenty-three of the twenty-five replantations
      and eight of the nine transplantations may be regarded as having been successful.
      Contraindications are cases of wide apical foramina and oval or octagonal root
      canal cross sections.

PMID- 2216364
TI  - A clarification on endodontic flare-ups.
AB  - In an article on endodontic flare-ups by Robert J. Matusow, our research and
      publications are discussed. Since we found what we consider to be distortions and
      misinterpretations of our work, it was decided to clarify the apparent
      discrepancies found in Matusow's article.

PMID- 2216365
TI  - The radiologic morphology of asymptomatic temporomandibular joints.
AB  - A high frequency of remodeling changes was demonstrated radiographically in a
      series of 200 female patients with asymptomatic temporomandibular joints. Fewer
      than 10% of joints were completely radiologically "normal". Generally, there was
      an increasing incidence of changes with increasing age and for edentulous
      patients, but these relationships were by no means direct or mutually exclusive.

PMID- 2216366
TI  - The radiologic morphology of painful temporomandibular joints.
AB  - A high frequency of remodeling changes was demonstrated radiographically in a
      series of patients having pain in the temporomandibular joint region. Radiologic
      morphologic differences between painful and asymptomatic temporomandibular joints
      were in frequency rather than type. Caution should be taken not to overestimate
      the significance of radiologic abnormality in patients with pain in the
      temporomandibular joint region.

PMID- 2216367
TI  - Unexpected dental caries.

PMID- 2216368
TI  - Calcified blood vessel.

PMID- 2216369
TI  - Devastated root.

PMID- 2216370
TI  - Peg-shaped mandibular second premolar.

PMID- 2216371
TI  - Silicone rubber fossa implant removal via partial arthrotomy followed by
      arthroscopic examination of the internal surface of the fibrous capsule.
AB  - Thirteen temporomandibular joints were examined arthroscopically for evaluation
      for fibrous encapsulation of silicone elastomer disk replacement implants.
      Partial arthrotomies were performed with removal of silicone rubber implants,
      followed by arthroscopic examination of the internal surfaces of the fibrous
      capsule as a pseudodisk and to verify the continuity of the fibrous barrier
      between the condyle and the fossa.

PMID- 2216372
TI  - A comparative study of temporomandibular symptoms following mandibular
      advancement by bilateral sagittal split osteotomies: rigid versus nonrigid
      fixation.
AB  - Rigid fixation to attach proximal and distal segments during bony healing of
      osteotomy sites has become increasingly popular. The effects of rigid fixation on
      the temporomandibular joints have been questioned. The purpose of this study was
      to evaluate the effects of rigid fixation after bilateral sagittal split
      osteotomies on temporomandibular dysfunction symptoms. Forty patients who had
      mandibular advancement surgery were evaluated for temporomandibular joint
      dysfunction. Twenty had received rigid fixation, and twenty had received nonrigid
      fixation. It was determined that there was no statistically significant
      difference in temporomandibular signs or symptoms between patients who were
      treated with rigid internal fixation for bilateral sagittal split osteotomies for
      mandibular advancement and those patients who were treated with nonrigid wire
      fixation.

PMID- 2216373
TI  - A retrospective evaluation of 301 TMJ Proplast-Teflon implants.
AB  - A retrospective review of 301 meniscectomies with Proplast-Teflon implants was
      performed. Factors such as interincisal opening, occlusion, joint sounds, joint
      degeneration, and patient satisfaction were examined. The overall surgical
      success rate was 88.7%, with an average follow-up period of 33 months. Although
      many patients demonstrated significant condylar degeneration at 1-year follow-up,
      such change did not necessarily result in symptomatology or joint dysfunction.
      Only 10% of implants resulted in removal. Surgical and postoperative procedures
      are contrasted with those of other clinicians experiencing lower success rates.

PMID- 2216374
TI  - Arthroscopic and histologic evidence of chondromalacia in the temporomandibular
      joint.

PMID- 2216375
TI  - A histologic evaluation of the accuracy of TMJ diagnostic arthroscopy.
AB  - Sixty-seven temporomandibular joints with internal derangement were examined with
      arthroscopy, and synovial biopsies were taken for histologic evaluation.
      Histologically, in 10 cases, the synovium appeared to be normal in appearance, 24
      cases had moderate to severe synovitis, 11 cases showed hyperplastic synovitis,
      13 cases showed synovial fibrosis, and foreign body granuloma was found in 9
      cases. Correlation between arthroscopic observation and histologic findings
      disclosed an 89.1% specificity and 100% sensitivity.

PMID- 2216376
TI  - A unique indexing splint for use in combined Le Fort and nasal injuries to avoid
      tracheostomy.
AB  - Midface fractures with associated displaced and/or comminuted nasal fractures can
      require tracheostomy for a general anesthetic airway if these fractures are to be
      reduced simultaneously. We describe a unique indexing splint that allows oral
      intubation yet also allows simultaneous reduction of midface and nasal fractures
      under one anesthetic. Furthermore, tracheostomy with its potential complications
      is avoided. The case report illustrates the technique, and alternative treatments
      for these injuries are discussed.

PMID- 2216377
TI  - Temporomandibular joint dysfunction and selected health parameters in the
      elderly.
AB  - Little research has focused on temporomandibular joint dysfunction (TMJD) in the
      elderly. The present study describes relationships between TMJD and selected
      health parameters in a population of 75- to 94-year-old Roman Catholic sisters
      (nuns). Mental, physical, and oral assessments made on 117 sisters identified 26
      with TMJD. Among all sisters, TMJD was not associated with age, education, mental
      impairments, hand coordination, handgrip strength, mobility, or use of walking
      aids. In 75- to 84-year-old sisters, TMJD was positively associated with self
      reported arthritis (p = 0.12), edentulism (p = 0.09), and the presence of
      complete dentures (p = 0.05), and negatively associated with the number of teeth
      present (p = 0.05), especially the posterior teeth. These associations were
      weaker in 85- to 94-year-old sisters. This study suggests that TMJD is associated
      with the presence of complete dentures and a low number of teeth, especially the
      posterior teeth.

PMID- 2216378
TI  - Diffuse sclerosing osteomyelitis of the mandible: a new concept of its etiology.
AB  - Diffuse sclerosing osteomyelitis of the mandible is a disease of unknown
      etiology. The clinical and radiographic findings suggest an infectious origin,
      but bacteriologic and histologic findings do not support this concept. Analysis
      of clinical symptoms, localization of the condition, and posttreatment findings
      in a group of 27 patients suggest a chronic tendoperiostitis due to muscular
      overuse as an etiologic factor in diffuse sclerosing osteomyelitis of the
      mandible. This hypothesis was supported by the initial results of muscle
      relaxation treatment in 13 of these patients.

PMID- 2216379
TI  - Patient compliance--a factor in facial trauma repair.
AB  - The clinical records of 25 consecutive patients who were treated for facial
      trauma were reviewed and analyzed to ascertain what effect patient cooperation
      had on the outcome of facial fracture repair. The study was designed to establish
      the incidence of complications and to discover what factors contributed to
      untoward sequela in such patients. Overall, 15 patients (60%) were noncompliant
      in one or more aspects of their care. Six patients (24%) had significant
      postoperative complications associated with their facial injuries. Four of these
      patients were not fully cooperative.

PMID- 2216380
TI  - Apparent regeneration of the mandibular canal in a free bone graft.

PMID- 2216381
TI  - More unusual pigmentations of the gingiva.
AB  - Three unusual types of oral pigmentation are presented. The first is a brown
      orange pigmentation caused by the habit of using the bark of Juglans regia for
      teeth cleaning. The second is a bright yellow pigmentation associated with the
      habit of chewing the seeds of Cola nitida. The third is a generalized mousy brown
      pigmentation related to the habit of chewing the leaves of Catha edulis. The
      purpose of this article is to describe the nature of these pigmentations and to
      present their clinical and histologic features.

PMID- 2216382
TI  - Adult linear immunoglobulin A disease manifesting as desquamative gingivitis.
AB  - Desquamative gingivitis is a manifestation of various dermatoses, particularly
      lichen planus and mucous membrane pemphigoid. A rare example of adult linear
      immunoglobulin A disease manifesting as desquamative gingivitis is presented.
      Although the initial clinical features were typical of desquamative gingivitis,
      the persistence of ulceration after dental extractions was unusual, and the
      management of the oral lesions proved difficult. The clinical, immunopathologic,
      and therapeutic aspects of linear immunoglobulin A dermatoses are reviewed.

PMID- 2216383
TI  - Peripheral giant cell granuloma: evidence for osteoclastic differentiation.
AB  - Nine cases of peripheral giant cell granuloma of the oral cavity have been
      immunohistochemically analyzed to assess the nature of the giant cells. Giant
      cells were unreactive when tested with antibodies recognizing myelomonocytic and
      macrophage markers (lysozyme, MAC 387, HAM 56) but showed strong immunoreactivity
      with MB1, an antibody reactive with osteoclasts. It is concluded that giant cells
      characterizing giant cell granuloma exhibit a phenotype distinct from other giant
      cells found in sites of chronic inflammation and may be true osteoclasts.

PMID- 2216384
TI  - Progressive osseous destruction as a complication of HIV-periodontitis.
AB  - A pathologic condition is described, characterized by rampant necrosis of
      gingival mucosa, periodontium, and related osseous structures associated with
      systemic infection with the human immunodeficiency virus (HIV). It is believed
      that this condition is an extension beyond the normal clinical course of HIV
      periodontitis (HIV-P) and manifests itself in three progressive stages: (1) HIV
      associated gingivitis, (2) HIV-P, and (3) an extension of HIV-P to osseous
      necrosis. Two cases of osseous destruction attending HIV-P are reported, one of
      which led to initial diagnosis of HIV infection. They represent the final stage
      of disease progression with localized necrosis of gingiva, periodontium, and
      alveolar bone.

PMID- 2216385
TI  - Tyrosine-rich crystalloids in a polymorphous low-grade adenocarcinoma.
AB  - A polymorphous low-grade adenocarcinoma with tyrosine-rich crystalloid deposits
      is reported. The literature is reviewed, and diagnostic and histogenetic
      implications of this finding are discussed.

PMID- 2216386
TI  - Periapical lesions of mandibular bone: difficulties in early diagnostics.
AB  - It is often difficult to establish a correct diagnosis on the basis of initial
      clinical and roentgenologic symptoms in mandibular bone disease. In this paper
      these problems are discussed, and some suggestions are made to overcome them. The
      discussion is based on cases of osteogenic sarcoma, histiocytic lymphoma, and
      chronic osteomyelitis. The patients were a boy and two middle-aged women, all of
      them with primary clinical symptoms of pain and swelling, diffuse roentgenologic
      changes in mandibular bone, uncertain response to treatment, and an unusual
      progress of the disease.

PMID- 2216387
TI  - Clinical factors associated with ledged canals in maxillary and mandibular
      molars.
AB  - No clinical studies have been done to explore the relationship of ledging to the
      clinical practice of endodontics. The purpose of this study was to examine 171
      cases completed by third-year dental students and to identify variables that were
      associated with ledging. A total of 336 canals were examined and tooth number,
      canal location, working length, the master apical file size, and root canal
      curvature were recorded. Of 336 canals, 46% were found to have been ledged.
      Analysis of variance revealed that No. 15 had a significantly higher incidence of
      ledging. Working lengths and master apical file sizes were not found to be
      significant variables. The main factor consistently related to the presence of
      ledges was canal curvature. The number of ledged canals increased significantly
      after 20 degrees and surpassed the number not ledged after 30 degrees. Multiple
      regression with the use of the five categories as the dependent variables and
      ledging as the independent variable resulted in an r = 0.397 and F = 12.216, p
      less than 0.0001. Curvature was found to have the highest significant t value
      (7.412) followed by "teeth" (2.471), whereas no other categories were identified
      as being significant. All the determinants for ledging were not identified with
      this study, and further research is indicated.

PMID- 2216388
TI  - Microleakage associated with retrofilling of the apical two thirds with amalgam.
AB  - In this investigation the effect of increasing the thickness of amalgam
      retrofilling on its sealing ability was studied and compared with the sealing
      ability of the laterally condensed gutta-percha with a sealer. The apical two
      thirds of the canals of 118 upper central incisors, filled with laterally
      condensed gutta-percha, were sealed with amalgam. Amalgam retrofills were also
      used to seal the apices of the roots of six teeth that had no other filling in
      their canals. The effectiveness of both techniques was determined by their
      ability to inhibit the penetration of methylene blue dye for the periods of 24
      hours, 1 week, and 1, 3, and 6 months. At 24 hours both materials showed
      comparable sealing ability. However, the sealing ability of laterally condensed
      gutta-percha was significantly better than that of amalgam from the 1-week period
      until the end of the study. The depth of marginal penetration around both
      materials increased with time. The amount of the dye penetration increased
      acutely around amalgam, whereas its increase around gutta-percha was more
      uniform. At the end of the study, specimens retrofilled with amalgam exhibited
      total dye penetration that exceeded the full thickness of amalgam (6 mm) and
      spread into the root canal space. On the other hand, the mean value for marginal
      penetration of the dye around the laterally condensed gutta-percha was 2.6 mm at
      the end of the study. The present investigation proved beyond doubt that the use
      of any thickness of retrograde amalgam to seal the apex, with no other filling
      within the canal, invites failure.

PMID- 2216389
TI  - Fine-detail panoramic radiography by free-focus radiography. A clinical
      demonstration of diagnostic radiographs.
AB  - Previous comprehensive clinical studies have shown that free-focus radiography
      (FFR) may be used to improve image detail and diagnostic value in panoramic
      radiography of the teeth and jaws. This study demonstrated the clinical image
      quality in fine-detail panoramic FFR surveys relative to conventional surveys
      made by rotational panoramic or intraoral radiography. Cases of particular
      diagnostic interest with respect to common dental disease and changes in the jaws
      were included. The radiographic area of diagnostic interest depicted in FFR
      surveys generally resembled that of conventional dental radiographic surveys with
      the use of intraoral films rather then those of conventional rotational panoramic
      surveys.

PMID- 2216390
TI  - Transcranial radiographic and tomographic analysis of the lateral and midpoint
      inclined planes of the articular eminence.
AB  - A radiologic study of the articular eminence was performed on 10 skulls by means
      of tomograms and transcranial radiographs. Angulation of the articular eminence
      at the lateral and midpoint inclined planes was measured from the radiographs and
      compared with direct anatomic measurements. With both radiographic methods, the
      results showed no significant difference between left and right side
      measurements. The mean angulation of the midpoint inclined plane was
      significantly greater than that of the lateral inclined plane with both
      techniques. With transcranial radiographs, the angulation values were the same as
      the direct anatomic measurements despite a 25-degree change in skull orientation
      required for the radiographic method. In the tomographic study, all measurements
      corresponded with the anatomic and transcranial measurements except that
      angulation of the lateral inclined plane differed slightly from the direct
      anatomic measurement. The results show that both tomography and transcranial
      radiography are adequate for visualization of the midpoint region. However,
      tomography is preferable for viewing the lateral aspect of the articular
      eminence.

PMID- 2216391
TI  - Rubber base impression material.

PMID- 2216392
TI  - Maxillary lateral incisor with two developmental grooves.

PMID- 2216393
TI  - Complication in nasogastric tube placement after a gunshot wound to the face.

PMID- 2216394
TI  - Fusion of a third molar with an invaginated supernumerary molar.

PMID- 2216395
TI  - Aerobic bacterial contamination in dental materials.
AB  - Current concern about disease transmission points out the need for better
      infection control in dentistry. The purpose of this study was to test samples of
      dental materials in factory-sealed containers for aerobic bacterial
      contamination. Multiple unopened containers of 12 different dental materials were
      obtained from the dental school dispensary. Samples were removed from each
      container and incubated at 38 degrees C in standard broth medium for 1 week.
      Those that exhibited visual signs of possible bacterial growth were subjected to
      a Gram stain for verification. The results of that test indicated that 20% to 30%
      of the samples of alginate, glass ionomer cement and base powders, and retraction
      cord contained bacterial contamination. The remaining eight dental materials
      exhibited no apparent bacterial growth. Thus viable aerobic organisms were found
      in samples from 4 of 12 dental material products.

PMID- 2216396
TI  - Prevalence of shovel-shaped incisors in Saudi Arabian dental patients.
AB  - The prevalence of maxillary incisor shoveling was studied radiographically in 990
      Saudi patients. According to the radiomorphologic characteristics, a new
      classification was developed and shovel teeth were categorized. The findings of
      this study showed 9% shovel-shaped incisors; among those, 4% were central
      incisors and 5% were lateral incisors. Frequency of dens invaginatus occurrence
      with the shovel-shaped incisors was also investigated. Eight percent of shovel
      shaped incisors showed presence of dens invaginatus. Prevalence was found to be
      4% in central shovel-shaped incisors, whereas that in lateral shovel-shaped
      incisors was 11%.

PMID- 2216397
TI  - Tibial defects. Reconstruction using the method of Ilizarov as an alternative.
AB  - Although used in the USSR since the 1950s, the method of Ilizarov has only
      recently been employed in North America to manage bone defects. Seven cases of
      patients with tibial bone defects are presented (five with deep infection) that
      were treated by gradual compression at the defect with one or two transported
      tibial segments that not only filled the tibial defect but preserved or regained
      the original bone length. Six of the seven patients had their defect obliterated
      while leg length was maintained. The method is minimally invasive, allows
      immediate weight-bearing and permits modifications in strategy while treating the
      bone defects but requires close attention to detail and has a steep learning
      curve.

PMID- 2216398
TI  - Nonunion and malunion of fractures.

PMID- 2216399
TI  - Tibial nonunions. Treatment tactics with the Ilizarov method.
AB  - The key to the success of the Ilizarov method is that the rigid systems, such as
      plates and traditional external fixators that bypass the nonunion, have been
      replaced by the axially elastic system of Ilizarov. The cyclic axial telescoping
      mobility, not rigidity, at the nonunion or fracture site is an important
      requirement for the formation of reparative callus. As we gain more experience
      with the method, we find ourselves capable of solving increasingly more difficult
      problems with a level of success rarely, if ever, achieved with more conventional
      methods.

PMID- 2216400
TI  - The use of the Ilizarov concept with the AO/ASIF tubular fixateur in the
      treatment of segmental defects.
AB  - For the treatment of segmental defects of less than 4 cm, cancellous autografting
      remains the treatment of choice. Pedicled or free cortical grafts (fibula, ribs,
      iliac crest) often are not strong enough, particularly when used in the femur.
      Allografts, especially appealing because of the theoretic unlimited supply,
      should not be considered for segmental diaphyseal defects because they remain
      dead spacers, remodelled only very slowly and incompletely, and are often
      complicated by late infection. The technique of distraction histogenesis used by
      Putti and Anderson, improved and further differentiated towards corticotomy and
      fragment transport by Ilizarov, is a further possibility of treating long,
      segmental bone defects. Already clinical and experimental data clearly show that
      the effect of distraction histogenesis can be obtained using many different types
      of external fixators. Therefore, we should use as simple a fixator construction
      as possible. The standard unilateral sagittal frame we suggest is derived from a
      two-tube AO fixator using only a few additional elements. The majority of cases
      with segmental defects and minor additional axial or rotational deformities
      (which can be corrected primarily) can be treated with such a fixator. The
      quality of the regenerate may be improved with a motorized, continuous transport
      system and by better soft-tissue coverage using early flaps. Interface healing is
      very probably improved by cancellous grafting and internal fixation after the
      transport period, thus decreasing the fixator time.

PMID- 2216401
TI  - Treatment of malunions and mal-nonunions of the femur and tibia by detailed
      preoperative planning and the Ilizarov techniques.
AB  - Internal fixation has been the mainstay of treatment for post-traumatic
      deformities. External fixation has been used for correction of deformity in
      malunions and mal-nonunions. Treatment goals of achieving complete deformity
      correction with restoration or improvement of function were successful in this
      very complex group of malunions despite the numerous problems, obstacles, and
      complications of treatment.

PMID- 2216402
TI  - Preoperative planning for the treatment of nonunions and the correction of
      malunions of the long bones.
AB  - A detailed analysis of the steps of preoperative planning as employed in our
      clinic has been presented. We have found these techniques to be of great value in
      anticipating the requirements that must be fulfilled to correct malalignments and
      obtain healing when the malalignments occur alone or are associated with
      nonunion. Besides helping one to decide where a malalignment is best corrected to
      anatomically match the normal extremity, tracings aid in allowing the surgeon to
      appreciate the kinetics of the operative procedure, as well as to define the best
      methods of stabilizing the resulting correction.

PMID- 2216403
TI  - Treatment of tibial malunions and nonunions with reamed intramedullary nails.
AB  - Reamed intramedullary nailing is an effective, relatively low-risk technique for
      the management of delayed union, nonunion, and malunion of the tibia. Closed
      technique should be used where possible and open realignment, when necessary,
      should be executed with minimal dissection. Bone grafting is rarely indicated.
      The use of interlocking nails provides an added degree of security in the control
      of rotation.

PMID- 2216404
TI  - The treatment of nonunions and pseudarthroses of the humeral shaft.
AB  - In summary, if one follows the AO/ASIF principles of open reduction and stable
      internal fixation of nonunions and pseudarthroses of the humerus, mostly with
      plate fixation supplemented by shingling or petaling, cement for loose screws
      when necessary, and bone grafting of defects or atrophic nonunions, then
      successful healing with one operative procedure can be achieved in over 95%, with
      almost full correction of preoperative deformity. Return of useful function and
      range of motion can also be achieved in 75% to 90% by early active exercises,
      physiotherapy, and occasional continuous passive motion, supported by hinged
      braces or cast braces in the postoperative period until union occurs. Union was
      achieved in an average of 6.6 months after the operative procedure.

PMID- 2216405
TI  - Intraarticular malunions and nonunions.
AB  - The principles of intraarticular fracture care and stable internal fixation, when
      applied to intra-articular nonunions and malunions, can result in the restoration
      of an amazing function to joints that seem almost totally doomed to either an
      arthrodesis or an arthroplasty. The high degree of success achieved in almost all
      cases illustrates the amazing recuperative powers of human joints once articular
      cartilage congruence and stability is re-established together with correction of
      axial deformities and the mobilization of joints.

PMID- 2216406
TI  - Pauwels osteotomy for nonunions of the femoral neck.
AB  - The concept of the Pauwels osteotomy seems to be a valuable method of treating
      nonunions of the femoral neck. If there is concomitant avascular necrosis, the
      involved area should be small and the patient younger than 60 years old.

PMID- 2216407
TI  - Diagnosis and treatment of nonunions and malunions of acetabular fractures.
AB  - The surgical treatment of nonunions and malunions of acetabular fractures is
      often a challenge. The diagnosis of a nonunion or malunion rests on clinical and
      radiologic examination. Apart from the union troubles involving only one column,
      all other cases justify the use of the extensile approach.

PMID- 2216408
TI  - Chemical activity of simple basic peptides.
AB  - Alternating all-L poly(leucyl-lysyl) increases markedly the rate of hydrolysis of
      oligoribonucleotides. Pure D poly (leucyl-lysyl) is as active as the all-L
      polymer. The homochiral polypeptides adopt a beta-sheet structure when complexed
      to the oligonucleotides. Alternating poly(D,L-Leu-D,L-Lys) made of racemic amino
      acids is much less efficient and is unable to adopt a beta-sheet structure. A set
      of alternating poly (leucyl-lysyl) ranging from the racemic to the homochiral all
      L polymer has been checked. Their conformations can be described as a mixture of
      random coil and beta-sheet conformations, the amount of beta-sheet increasing
      with the optical purity of the polymer. The hydrolytic activity follows the
      proportion of beta-sheets, suggesting that the chemical activity is related to
      the geometry of the chain. Short peptides were prepared in order to evaluate the
      critical chain length required for the hydrolytic activity. A decapeptide is long
      enough to present 90% of the activity of the corresponding polypeptide.

PMID- 2216409
TI  - Energy-rich glyceric acid oxygen esters: implications for the origin of
      glycolysis.
AB  - The apparent Gibbs free energy change of hydrolysis (delta G degrees', pH 7) of
      the 2- and 3-O-glyceroyl esters of 2- and 3-O-L-glyceroyl-L-glyceric acid methyl
      ester were measured at 25 degrees C. The 2- and 3-glyceroyl esters were found to
      be 'energy-rich' with delta G degrees' values of -9.1 kcal mol-1 and -7.8 kcal
      mol, respectively. This result indicates that the analogous 2- and 3-glyceroyl
      esters of polyglyceric acid are also 'energy-rich' and, therefore, could have
      acted as an energy source for primitive phosphoanhydride synthesis.

PMID- 2216411
TI  - The revised genetic code.
AB  - Recent findings on the genetic code are reviewed, including selenocysteine usage,
      deviations in the assignments of sense and nonsense codons, RNA editing, natural
      ribosomal frameshifts and non-orthodox codon-anticodon pairings. A multi-stage
      codon reading process is presented.

PMID- 2216410
TI  - Phylogenetic tree of tRNAs using a simple algorithm.
AB  - A simple method for phylogenetic tree construction is described. In this method
      each node is calculated considering the distance between the elements and the
      difference between these elements and an average element, allowing the selection
      of the most probable node. Two examples of tRNA phylogenies (E. coli set and Phe
      family) are analyzed, giving both reliable trees. Data from these dendrograms
      give support to the idea of an early cloverleaf arising.

PMID- 2216412
TI  - [Bone scintigraphy in breast cancer: a ten-year follow up study].
AB  - The value of bone scanning in the primary staging and clinical course of breast
      cancer was studied in a 10-years follow-up. Bone metastases (BM) were detected at
      the time of primary diagnosis in 6.8% of the patients. After primary therapy, the
      skeleton was the first site of the relapse in 42% of the cases. During the follow
      up, BM were revealed in 25% of 623 patients a mean of 22.3 months after the
      operation. BM were manifested in 17% of the cases with small primary (pT1) tumors
      and negative axillae. Forty-three percent of the patients had no symptoms at the
      time of BM diagnosis. The mean survival after the appearance of BM in 163
      patients was 18.2 months. Thirteen patients survived more than 5 years after the
      diagnosis of BM. The routine use of bone scanning is suggested at the time of
      primary diagnosis, and then yearly in a minimum 5-years period, independently of
      the symptoms.

PMID- 2216413
TI  - [Distribution of lymphocyte subpopulations and plasma cells in the colonic mucosa
      of children with ulcerative colitis].
AB  - The distribution of lymphocyte subpopulations and plasma cells of the colonic and
      rectal mucosae were studied in eight children with ulcerative colitis and 12
      healthy controls. In four patients the examinations were also carried out 3
      months after the beginning of treatment. No difference in the number of
      intraepithelial lymphocytes was found between the patients and controls. The
      majority of these cells were T-cells, and among them the suppressor/cytotoxic
      cells were preponderant. In the lamina propria of both untreated and treated
      patients the numbers of T-cells, helper T-cells, and B-cells were elevated
      compared to controls. In the patients the number of IgG-containing cells was
      three times that of the controls; the number of IgE positive cells was also
      elevated. The numbers of IgA- and IgM-containing cells were not different from
      that of the controls. The results suggest that in ulcerative colitis the place of
      primary immunological processes inside the large bowel mucosa is the lamina
      propria.

PMID- 2216414
TI  - [Prenatal ultrasonic diagnosis of a dicephalic fetus in the 18th week of
      pregnancy].
AB  - The authors report a case of conjoined twins (dicephalus) detected antenataly in
      the 18-th week of pregnancy by routine ultrasound screening. The pregnancy was
      terminated because this congenital malformation is incompatible with extrauterin
      life. The embriopathological examination confirmed the prenatal diagnosis. The
      ultrasonographic criteria are discussed and the importance of early diagnosis is
      stressed.

PMID- 2216416
TI  - [Thoughts on Orvosi Hetilap and other subjects. "Solvitur acris hiems..."
      (Horatius) (correction of Martialis)].

PMID- 2216415
TI  - [Prevention of rabies (experience of the past, possibilities of the future)].
AB  - The authors review the history of rabies prevention, the current national and
      international data. Neurologic adverse effects of the Hempt vaccine are
      discussed. Medical histories of two patients are demonstrated, one suffered of
      serious complication of the vaccine; the other died of rabies. Indications of
      vaccine Rabivac and issues about it's administration are outlined. The
      possibilities of the therapy are discussed in brief.

PMID- 2216417
TI  - [More efficiency!].

PMID- 2216418
TI  - [Protective action of allopurinol infusion against reperfusion arrhythmia during
      thrombolytic therapy of acute myocardial infarction].

PMID- 2216419
TI  - [Different sensitivity to acid reaction of the AIDS virus and virus-producing
      cells: clinical conclusions].
AB  - Sensitivity of the cell-free human immundeficiency virus type 1 (HIV-1) and its
      producer cells was Studied in acidic media between pH 7.4 and 4.9 vitro. The
      cytopathic effect, reverse transcriptase activity and p24 antigen production by
      survived viruses were monitored in indicator cell cultures. It was established
      that, the cell-free HIV-1 particles are very sensitive to acidity. Between pH 7.4
      and 6.0 they loose infectivity gradually, but this process is irreversible under
      pH 6.0 and subsequent neutralization cannot restore lost infectivity. However,
      viability, of virus producer cells is hardly affected between pH 7.4 and 4.9, but
      their ability to release infectious particles is lost gradually, similarly to the
      case of cell-free viruses. Neutralization of the media after treatment results in
      gradual restoration of releasing infectious viruses. These data explain that,
      cell-free HIV-1 looses infectivity in the acidic vagina or does on the skin, but
      infectivity is preserved in the blood, semen, rectum and breast milk being
      neutral or slightly alcalic. Virus carrier or producer lymphocytes by any route
      of infection can survive such protective mechanism of the body.

PMID- 2216420
TI  - [Gastrointestinal angiodysplasia].
AB  - 8 cases of gastrointestinal angiodysplasia are reported. It can be stated on the
      analysis of these cases, that the angiodysplasia can be the cause of unexplained
      GI hemorrhages, and in the majority of cases the visceral angiography provides
      diagnostic evidence. The angiodysplasia can be observed frequently in association
      with liver cirrhosis and aortic valvular stenosis. Surgery is regarded as the
      best method of treatment. Subsequently the careful resection rebleeding and
      development of newer angiodysplasia can occur.

PMID- 2216421
TI  - [Weather front sensitivity as an influencing factor in the onset of labor].
AB  - The connection between meteorological stimuli and the onset of labor was examined
      on the basis of the patients' front-sensitivity. Front-sensitivity was tested by
      a questionary containing 60 questions. Converse relation was observed between the
      degree of sensitivity and the gestational age. A sudden rise of onsets of labors
      could be shown during frontal changes, occurred after meteorologically quiet
      periods. During frontal changes the ratio of onsets of labors rose significantly
      among those patients who were sensitive tho the given front. This effect could be
      observed during a longer period of frontal influence. By the authors opinion also
      meteorological stimuli can be regarded as one of the factors, determining the
      actual date of onset of labor among front-sensitive women.

PMID- 2216422
TI  - [Primary lymphoma of the bladder].
AB  - The authors present the case of a 74-year-old man in whom bladder tumor was
      detected the reason for haematuria. The histological investigation of
      transurethral resected pattern showed lymphocytic lymphoma. In possession of the
      histological finding detailed haematological examination has been carried out,
      the patient was without evidence of lymphoma dissemination. He received
      multichemotherapy (6 courses) and locoregional cytostatic therapy and complete
      clinical remission was detected. The authors report our experience with
      extranodal bladder lymphoma included diagnostic and therapeutical notes as well
      as a review of the relevant literature.

PMID- 2216423
TI  - [Ignac Semmelweis--librarian of the faculty library at the Pest Medical School].

PMID- 2216424
TI  - [Public health in Israel].

PMID- 2216425
TI  - [To resuscitate of not?].

PMID- 2216426
TI  - [Problems of thrombotic thrombopenic purpura and hemolytic uremic syndrome].

PMID- 2216427
TI  - [Clinical aspects of zinc].
AB  - In the literature an increasingly large body of evidence has revealed
      disturbances of zinc metabolism and a consecutive zinc deficit in a broad
      spectrum of chronic diseases. The authors call attention to the therapeutic
      benefit of zinc substitution mainly in chronic hepatic diseases, pancreatitis and
      colitis, as well as in diabetes and in several cases of immunodeficiency with
      various complications. Since suitable preparations are not available on the
      market 'possibilities concerning zinc substitution are rather limited. There is a
      real need for completing our therapeutic arsenal with an up-to-date zinc
      preparate, possibly in combination with a magnesium compound.

PMID- 2216429
TI  - [CT anatomy of the sella turcica and its environment].
AB  - If MRI is not considered because of its limited capacity, computed tomography has
      become an exclusive diagnostic method in recent years in our country for the
      radiologic visualization of the sella turcica and its vicinity. Interpretation of
      the findings of this method lies on the knowledge of normal anatomical situations
      and variations. In direct coronal sections the hypothalamus, pituitary gland,
      suprachiasmatic cystern, optic chiasm, infundibular recess, sellar flor and the
      nerves transversing the cavernous sinus are visualised. The axial sections are
      more suitable for the visualization of the posterior lobe of pituitary gland and
      dorsum sellae. The Meckel's cavity, infundibulum and the blood vessels around the
      sella turcica are seen in both sections. The paper presents findings on the
      optimal CT evaluation of the above anatomical structures and variations as
      related to their diagnostic value.

PMID- 2216428
TI  - [Diagnosis and treatment of thromboembolic diseases of the right heart].
AB  - Right heart thrombosis (RHT) was found by 2D-echocardiography in 8 cases.
      Clinical suspicion of RHT could be documented in only 3 patients, while in the
      other 5 cases syncope, low output syndrome, essential pulmonary hypertension,
      cerebral embolism or congestive heart failure was the clinical diagnosis on first
      presentation. Out of the 4 cases of mobile RHT of extracardiac origin 1 patient
      had an emergency operation, 2 patients died shortly after the 2D-echo diagnosis
      before treatment could have been started and 1 patient improved on anticoagulant
      treatment. RHT of intracardiac origin was due to a central line or a
      ventriculoatrial shunt in 3 cases and no source could be found in 1 patient.
      Complete recovery was achieved in 2 cases by medical, in one case by surgical
      management and in 1 patient medical and surgical treatment resulted in clinical
      improvement. In conclusion authors 1. consider 2D echocardiography necessary in
      the clinical setting of acute or chronic pulmonary embolism or "primary"
      pulmonary hypertension and 2. they recommend emergency operation in case of
      mobile large RHT detected by 2D-echocardiography.

PMID- 2216430
TI  - [Possibilities of the use of lymphoscintigraphy in head and neck surgery:
      introductory studies].
AB  - The results of a pilot study of head and neck lymphoscintigraphy are presented.
      The study was performed in 35 cases with technetium-99m-labelled microcolloid.
      The scintigraphic observations of the intact and tumorous neck are presented. The
      results of this pilot study suggest that this method might create the base of a
      nonspecific additional diagnostic tool.

PMID- 2216431
TI  - [Subscapular liver hematoma and liver hemorrhage in neonatal age].
AB  - By analysing their newborn patients of 15 years the authors confirm the earlier
      observation, that the subcapsular haematoma is a common finding at postmortem
      examination of the newborns dying during neonatal period. The association of the
      pathological symptoms of hypoxic origin of the other organs observed at autopsy
      and the decreasing incidence of subcapsular haematoma as a results of obstetrical
      and neonatal intensive care make this disease of hypoxic origin probable. In
      spite of common subcapsular haematoma the haemorrhage of liver causing haemascos
      is relatively uncommon. In their five patients suffering from liver rupture they
      observed two types of this (immediate and delayed rupture of liver's capsule),
      which also differed from one another in their clinical picture. They are drawing
      attention to general use of ultrasound in diagnostics which means a new chance to
      diagnosis in alive of both types.

PMID- 2216432
TI  - [Simultaneous occurrence of lupus erythematosus and desquamative interstitial
      alveolitis].
AB  - Several subtypes can be distinguished within the disease lupus erythematosus
      according to the clinical appearance, serological and histological findings. With
      their case reports the authors wish to present that there is no definitive
      dividing line among them in practice, but transitional appearances and forms also
      exist.

PMID- 2216434
TI  - [Addenda to the article "Genetic and Ontogenic Analysis of Cases of Darier's
      Disease"].

PMID- 2216433
TI  - [Views of medical students on the development of public health and on medical
      ethics].

PMID- 2216435
TI  - [Current problems and complications of extensive uterine and pelvic lymph node
      excision for cancer of the uterus based on a 25-year case load].
AB  - The authors studied the complications and other current problems of surgery of
      212 cases subjected to Wertheim-Okabayashi operation. Of them 118 were cervix
      cancer in stage I and 90 in stage II and 4 were cancer of the uterus body in
      stage II. Two cases of operation death, 1 case of ureter injury and 1 case of
      large vessel injury occurred. Four ureteral and 1 late rectal-vaginal fistula
      developed. Difficulty of urination was observed in 49 cases. Those who consider
      surgical monotherapy best, hold the postoperative percutaneous irradiation
      necessary only in cases of metastases of the lymph nodes.

PMID- 2216437
TI  - [Laryngeal lipoma as a manifestation of lipomatosis].

PMID- 2216436
TI  - [Effect of physical training on children after reconstructive heart surgery].
AB  - The authors composed a programme of physical training for children with
      congenital valvular defect. The training programme was applied before and after
      the heart operation. Two years after a successful reconstructive heart operation
      the fitness condition of 40 children was examined. The average age of the
      children was 8.0 +/- 3.6 years. Twenty of the children participated and 20 did
      not participate in the programme. The physical condition of the children who took
      part in the training was found to be significantly better than that of the others
      without training.

PMID- 2216438
TI  - [Isolated right ventricular infarction].
AB  - Generally, right ventricle infarction is accompanied by left ventricle
      infarction. Isolated right ventricle necrosis is rare. Among 1707 patients with 6
      week-old myocardial infarction there were 2 cases with isolated right ventricle
      infarction. Diagnosis based on pathologic Q waves in right precordial chest wall
      leads, radionuclide and echocardiographic observations. In one case, diagnosis
      was supported by coronary angiography, too.

PMID- 2216439
TI  - [Ignac Semmelweis].

PMID- 2216440
TI  - [Centenary of the birth of Andras Daday].

PMID- 2216441
TI  - [The CELLADAM test and the physician's conscience].

PMID- 2216442
TI  - [The interleukins ].
AB  - Immune response is regulated by a number of soluble mediators. Interleukins
      belong to these mediators, as a well defined group of regulatory molecules.
      Interleukins are necessary for the differentiation and activation a T and B
      lymphocytes and other cells. They play an important role in inflammation: they
      cause fever, leukocytosis etc. Some interleukins are being used as therapeutic
      agents.

PMID- 2216443
TI  - [The Angelman or "happy puppet" syndrome].
AB  - A case of Angelman's or "happy puppet" syndrome is described and detailed
      analysed, first time in our country. The literature is reviewed. The diagnostic
      criteria are presented. Evoked potential study and more than two years long EEG
      follow-up results are discussed. The unusual clinical feature of the described
      case is that epilepsy presented itself very early, in age of two weeks, by
      infantile spasms. It changed later to focal secunder generalised epilepsy. The
      EEG has been always abnormal during the follow-up, and the pattern has been
      changing by the age of the patient. On the other hand, the evoked potentials were
      all normals (BAEPs, VEP, SSEP CCT) "O"n the basis of the electrophysiological
      dichotomy the authors suggest a predominantly gray matter's disorder in
      Angelman's syndrome. They emphasize, that Angelman's syndrome has to be keep in
      evidence in the differential diagnosis of early infantile epilepsies. In the
      presented case the familial accumulation of movement's dyscoordinations, the
      dysmorphic features and subnormal intelligence of the brother support the
      possibility of the role of an autosomal recessive gene with different penetrance
      in the pathogenesis of Angelman's syndrome.

PMID- 2216444
TI  - [Femoral head necrosis].

PMID- 2216445
TI  - [Pathological anatomy of femur head necrosis].
AB  - Aseptic necrosis of the femoral head appears to have a number of etiological
      factors. The last steps of the pathogenetic course of events, however, is
      unclear. Histologically, small foci of marrow necrosis form repeatedly,
      particularly in the upper and medial zone of charge, and then fuse secondarily to
      larger areas. Secondary reparation events with ingrowth of sprouts of granulation
      tissue and neoformation of bone predominantly in connection with necrotic
      trabeculi are followed by renewed waves of necrosis, resulting in a most
      variegated picture in which the different phases can no longer be clearly
      differentiated. After the articular cartilage has been sequestrated and torn
      away, the uncovered spongious bone is exposed to the transforming influence of
      direct charge, with subsequent secondary osteoarthrosis. From the histological
      picture follows the modern conception of its pathogenesis: an intraosseous
      increase in pressure primarily infringes on the venous outflow and secondarily on
      the arterial inflow. These cyclic circulatory disturbances provoke the focal
      appearance of necrosis. As a result of this, "core decompression" follows as a
      therapeutic intervention that is successful in many cases.

PMID- 2216446
TI  - [Imaging diagnosis in femur head necrosis with emphasis on skeletal scintigraphy
      and magnetic resonance tomography].
AB  - Early diagnosis and treatment of avascular necrosis (AVN) of the femoral heads
      improve the prognosis of this disorder. Of the different radiological studies
      available so far, none has been truly satisfactory. Conventional X-rays
      frequently show alterations in the femoral heads only in later stages. Early on
      these may be so subtle that they are overlooked by the examiner. Bone
      scintigraphy is more sensitive than conventional X-rays in the detection of early
      alterations, but there are still up to 18% negative studies in biopsy-proven
      femoral-head necrosis. The sensitivity of this method is also diminished when
      bilateral AVN is present. This is frequently the case even if only one hip joint
      is symptomatic. Computed tomography (CT) and single photon emission computed
      tomography (SPECT) are highly sensitive methods that are still not widely used
      for the diagnosis of AVN. With SPECT, clinical experience is still limited. A
      number of publications in recent years have revealed the excellent
      characteristics of magnetic resonance imaging (MRI) in showing the pathological
      processes in bone marrow and, in particular, AVN. This paper summarizes a few of
      these publications and our personal experience with MRI in AVN of the femoral
      head. Different cases examples are given.

PMID- 2216447
TI  - [Femur head necrosis in childhood].
AB  - The natural history of avascular necrosis of the femoral head in children and
      adolescents shows significant differences compared to the course of this disease
      in adults. Depending on the remaining growth potential, even extensive damage of
      the femoral head can regenerate, as long as the epiphyseal growth plate is not
      involved in the process. Otherwise, the deformity will increase with time.
      Current knowledge on the etiology, natural history, diagnosis and treatment is
      described on Perthes' disease and other possible causes of avascular necrosis,
      such as CDH, epiphyseolysis of the femoral head, femoral neck fracture and some
      uncommon diseases.

PMID- 2216448
TI  - [Clinical and therapeutic concepts in ischemic femur head necrosis].
AB  - Bone ischaemia can result from four mechanisms: (1) interruption of arterial
      inflow (e.g. after femoral neck fracture), (2) occlusion of venous outflow
      (possibly due to capsular distension), (3) intravascular arteriolar occlusion (as
      in sickle cell disease); (4) extravascular sinusoidal tamponade (e.g. in
      Gaucher's disease). Osteonecrosis following high-dosage corticosteroid
      administration or alcohol abuse could, theoretically, be due to either
      intravascular fat embolism or sinusoidal tamponade resulting from the marked fat
      deposition in the marrow. It is proposed here that, except in traumatic
      osteonecrosis, vascular insufficiency is part of a cycle of events resembling the
      familiar soft tissue compartment syndrome of the forearm or leg; no matter
      whether it started with venous stasis, arteriolar occlusion or capillary
      tamponade, the result is a diffuse and self-enhancing ischaemia involving all
      three haemodynamic abnormalities in a vicious circle. The very earliest stage of
      "idiopathic" osteonecrosis is characterised chiefly by marrow changes; for some
      (undetermined) period the ischaemic effects are potentially reversible-provided
      the vicious circle is broken by relieving the high intraosseous pressure.
      Effective management involves: (a) early diagnosis by MR imaging, measurement of
      intraosseous pressure and venography: (b) decompression of the bone, and (c)
      elimination of the etiological factor. Later stages of osteonecrosis cannot be
      treated by decompression and will need realignment osteotomy, prosthetic
      replacement or arthrodesis.

PMID- 2216449
TI  - [Joint-preserving osteotomy in segmental femur head necrosis].
AB  - Joint-preserving osteotomies for segmental necrosis of the femoral head are
      clinically important, as necrosis often occurs in relatively young people in whom
      one is hesitant to perform femoral head replacement. The principle in all joint
      preserving osteotomies is to remove the necrotic area from the zone subject to
      load, thereby guarding against indentation of the joint surface. The most
      universal and most frequently indicated osteotomy is intertrochanteric valgus
      flexion osteotomy with ventral capsule resection. The result of the operation
      depends mainly on the extent of the necrosis. If the angle of the necrosis is
      under 200 degrees, the hip joint can be preserved with great precision and in a
      good enough state to allow joint replacement to be postponed for many years.

PMID- 2216450
TI  - [Role of core decompression as treatment method for ischemic femur head
      necrosis].
AB  - Nontraumatic ischemic necrosis of the femoral head remains a source of much
      controversy. The etiology is also controversial. Possibilities are: hypertrophy
      of intraosseous structures (lipocytes, hematopoietic elements), creating
      intraosseous hypertension; alcohol and steroids as toxic agents; circulating fat
      globules embolizing the microcirculation of the metaphysis. The disease appears
      most frequently in young adults, but no satisfactory nonoperative treatment
      modalities have been reported as yet. In 1971, Ficat and Arlet published their
      results on core decompression performed in 100 patients, with a follow-up of from
      1 to 5 years. The results for those with stage I disease (n = 40) were good or
      excellent in 88% of the patients. The results for those with stage II disease (n
      = 16) were good or excellent in 69%. Based on current experience, the treatment
      is to be recommended for patients with pre-collapse stages 0, I and IIA of
      ischemic necrosis of the femoral head. For stage III disease, the procedure may
      reduce pain at night and at rest and can be considered in patients wishing to
      avoid total hip arthroplasty for a period of time.

PMID- 2216451
TI  - [Partial femur head necrosis in adults--results with intertrochanteric osteotomy
      and revascularization].
AB  - Osteotomy and revascularization have both been used for many years in the therapy
      of partial aseptic necrosis of the femoral head in the adult. We first attempted
      a combination of the two techniques in 1978. Stress on the necrotic sector was
      relieved by intertrochanteric osteotomy, and the necrotic part of the bone was
      revascularized with a pedicled iliac crest bone graft based on the deep
      circumflex iliac vessels. Long-term results are now available in 45 hips in 38
      patients, with a mean follow-up time of 32 months. Clinically, 71% of the hips
      were rated very good or good, and among those classed as stage II before surgery
      the results were rated as very good or good in as many as 90%. Subjective
      evaluation of the hips by the patients confirmed these results: 85% of the hips
      were judged to be optimal or markedly improved compared with before operation.
      Radiological evaluation showed further flattening of the femoral head in one
      case. A segmental collapse of the femoral head, i.e. stage III lesion according
      to Ficat, occurred in 2 hips with stage II preoperatively. In 6 hips with stage
      III necrosis preoperatively secondary arthritis developed. Computerized tomograms
      taken of all 25 hips from which metal implants had been removed showed signs of
      integration of the graft in 68%. Scintigraphy with 99-Tc-diphosphonate showed a
      homogeneous uptake in 42.8% and a non-homogeneous uptake in the remaining 57.2%
      of the cases. So-called photopenia was not observed in any of the hip joints
      treated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216452
TI  - [Sugioka's trans-trochanteric osteotomy. Results of interventions 1975-1983].
AB  - The long-term results of 46 Sugioka osteotomies are presented: In 22 patients no
      joint replacement had yet been necessary, and 17 hip joints had already been
      replaced by total hip prostheses. Of the 22 preserved joints, 12 were graded as
      clinically excellent and good, 10 as fair or poor. The radiological course showed
      worsening osteoarthritic changes in almost all cases. In the "survival curve" for
      the Sugioka osteotomy in the group with 17 total hip prostheses the most
      significant slope can be seen during the first 3 years postoperatively; between 5
      and 10 years there are no failures; and then the curve descends again. Fair and
      poor results are noted most frequently between 6 and 10 years after the operation
      in the group of 22 patients with no joint replacement. The preoperative extent of
      necrosis and the radiological stage are the main factors determining the result.
      Over the years it has been possible to define a narrow spectrum of indications:
      the greatest benefit is obtained in young, cooperative patients with necrotic
      sectors of about 90 degrees and good function of the hip joint.

PMID- 2216453
TI  - [Total prosthesis arthroplasty in femur head necrosis].
AB  - In young patients with advanced necrosis of the femoral head, the short- and
      medium-term results of total prosthesis arthroplasty are the most satisfactory.
      However, the prospect of aseptic loosening hangs over such arthroplasties like
      Damocles' sword. Reports from the literature suggest that, in addition to the age
      of the patient, there is also an endogenous factor that can be responsible not
      only for the etiology and pathogenesis of the necrosis, but also for the early
      loosening of the prosthesis. We have followed up 54 patients (73 hip joints) who
      had total hip replacement as a result of necrosis of the femoral head between
      1976 and 1988. Altogether, 3 acetabular and 5 femoral shafts had to be replaced
      (7 patients). This corresponds to a loosening rate of 10% after an average of 4.9
      years. Hence, the prosthesis changing rate is lower than that reported by other
      authors, but is still higher than in patients with coxarthrosis. Only 2 of 52
      cemented shaft prostheses had to be replaced; the average age of these patients
      was 61.4 years. Of the 21 cement-free shaft implantations, 3 had to be replaced,
      the average age of these patients being 42.9 years. The fact that the average age
      of the latter patients was lower may be the reason for the revision rate not
      being significantly higher for the non-cemented shafts. In view of the fact that
      necrosis of the femoral head can rapidly result in the patient becoming an
      invalid if it is allowed to follow its natural course, hip joint prostheses
      should also be offered to younger patients.

PMID- 2216454
TI  - Protein-binding elements in the promoter region of the mouse p53 gene.
AB  - p53 is a cellular protein whose expression plays a crucial role in the regulation
      of cell proliferation and of neoplastic processes. p53 mRNA levels in mouse
      fibroblasts can be elevated in response to TPA and to serum stimulation. The
      promoter region of the p53 gene contains a conserved element which is highly
      homologous to the consensus AP1 binding site (7/8 matching bases). This AP1-like
      site, denoted the PF1 site, confers upon a heterologous promoter ability to
      respond to elevated expression of c-jun. Furthermore, the PF1 site binds
      protein(s) in a specific and serum-induced manner. Unexpectedly, this factor is
      most probably not AP1, as evident from the inability of an authentic AP1 site to
      compete the binding efficiently, as well as from the failure of purified AP1 to
      bind to the PF1 site. Hence, PF1 may be a novel AP1-related transcription factor.
      In addition, the 5' region of the p53 gene also contains an NF1 binding site,
      whose location suggests a possible regulatory role.

PMID- 2216455
TI  - Specific expression of the ret proto-oncogene in human neuroblastoma cell lines.
AB  - The expression of the ret proto-oncogene (proto-ret), which possibly encodes two
      isoforms of a receptor-type tyrosine kinase, was examined in human tumor cell
      lines. Expression of the proto-ret mRNA was detected in all 11 neuroblastoma cell
      lines examined. The level of mRNA varied more than 100-fold in these
      neuroblastoma cell lines and was particularly high in three of them. On the other
      hand, 19 non-neuroblastoma tumor cell lines derived from solid tumors and a human
      diploid fibroblast cell line did not express any detectable levels of proto-ret
      mRNA. No remarkable amplification of the proto-ret or gross structural changes in
      the coding region were found in these neuroblastoma cell lines. The specific
      expression of the proto-ret in neuroblastomas suggests that the proto-ret product
      may have a role in cellular functions specific to neuroblastoma cells.

PMID- 2216457
TI  - tyk2, prototype of a novel class of non-receptor tyrosine kinase genes.
AB  - We previously identified a novel protein tyrosine kinase gene, tyk2, by screening
      a human lymphoid cDNA library with a tyrosine kinase domain specific c-fms
      restriction fragment under low stringency hybridization conditions. We have now
      isolated and sequenced a full length tyk2 cDNA clone; demonstrated that this gene
      is widely expressed in hematopoietic and non-hematopoietic cell lines; and mapped
      it to chromosome 19p13.2. The cDNA clone is 4176 nucleotides long and codes for a
      putative protein with a molecular weight of 134 kilodaltons. Hydrophobicity
      analysis of our sequence does not identify a transmembrane domain, which is found
      in all members of the receptor class of protein tyrosine kinases; nor can we
      detect an SH2 domain, found in all previously identified non-receptor protein
      kinases. We therefore propose that tyk2 is the prototype of a new class of non
      receptor protein tyrosine kinases.

PMID- 2216456
TI  - Mutation of the p53 gene in human soft tissue sarcomas: association with
      abnormalities of the RB1 gene.
AB  - Soft tissue sarcomas have been examined for alterations in the p53 gene. In six
      sarcomas, loss or rearrangement of both alleles of this gene was detected while
      in a further seven sarcomas, point mutation or absence of transcription of the
      p53 gene was observed. Abnormalities of the p53 gene were found in several
      classes of soft tissue sarcoma, including leiomyosarcomas, rhabdomyosarcomas and
      malignant fibrous histiocytomas. Our studies also show that abnormalities of the
      RB1 suppressor gene and of the p53 gene frequently occur together. These results
      are consistent with the idea that the p53 gene is a tumour suppressor gene and
      indicate that coincident inactivation of more than one tumour suppressor gene
      may, in some cases, be required for tumour development.

PMID- 2216458
TI  - The human ETS-2 gene promoter: molecular dissection and nuclease
      hypersensitivity.
AB  - The human ETS-2 gene is a homolog of the v-ets oncogene of the E26 virus, coding
      for a 56 kilodalton nuclear protein. Herein we characterize the ETS-2 gene
      promoter, using a series of deletion constructs. Analysis of the nucleotide
      sequences from -3600 bp to +141 bp reveal that the region -159 bp to +141 bp is
      absolutely essential for maximum promoter activity. This region includes half of
      the lengthy polypyrimidine (CT) tract of the ETS-2 promoter, one Sp1 binding site
      and the GC element proximal to the initiation site. This CT tract is able to
      increase in an orientation independent manner, the transcription from alpha
      globin promoter. Several S1 hypersensitive sites are found to be located in this
      promoter region, using chromatin and supercoiled DNA, in close proximity with cis
      regulatory elements. Our results indicate that an unusually long (approximately
      250 bp) CT tract is necessary for ETS-2 transcription and this tract can also
      serve as a transcription activator using a heterologous promoter.

PMID- 2216459
TI  - Amplification of the c-myc and the pvt-like region in human multiple myeloma.
AB  - Genetic alterations that lead to the clonal expansion of differentiated cells in
      multiple myeloma have still to be elucidated. Many chromosomal aberrations have
      been found, but until now, none of them is typically associated with multiple
      myeloma. In search for genetic defects in multiple myeloma we studied the
      structure and expression of the c-myc oncogene and the pvt-like region because of
      their frequent association with other B-cell malignancies. Here we report co
      amplification of the c-myc oncogene and the 5' part of the pvt-like region in two
      out of 26 cases of multiple myeloma. In both cases only kappa-light chains were
      produced. The amplification also manifested itself at the RNA level. Total RNA
      was analysed in one of these two cases showing abundant c-myc mRNA. In the same
      RNA sample we also detected a strong hybridizing band of about 7 kb, when the
      pSS.4 probe, representing the 5' part of the pvt-like region, was used. This band
      was not present in total RNA from normal bone marrow cells or bone marrow from
      multiple myeloma patients without the amplification of c-myc and the pvt-like
      region. Until now, transcripts of the pvt-like region were only found in a few
      human cell lines ranging in size from 1 to 11 kb. This is the first case in which
      a high expression of a +/- 7 kb transcript of the pvt-like region has been found
      in freshly obtained tumor material probably due to a pvt-amplification. The
      occurrence of abnormalities in the c-myc and the pvt-like region in multiple
      myeloma is a rare event and may be associated with the progression of this type
      of tumor.

PMID- 2216460
TI  - A raf/myc virus immortalized macrophage cell line which supports the growth of B
      cell and B-cell hybridomas.
AB  - Using a combination of raf and myc oncogenes co-expressed by the recombinant
      retrovirus J-2 we have generated and characterized a cell line which very
      efficiently supports the growth of B-cells and B-cell hybridomas. Murine spleen
      cells were cultured under in vitro immunization conditions favoring the short
      term proliferation of splenic B lymphocytes and infected with J-2 virus.
      Screening of immortalized spleen cell pools for the capability to support long
      term B cell growth in vitro led to the selection of a clonal cell line termed
      alpha ChyJ2. The presence of macrophage specific features and surface markers
      suggest that alpha ChyJ2 belongs to the macrophage lineage. alpha ChyJ2 cells
      constitutively produce low levels of IL-1 like activity and high levels of IL-6.
      Expression of specific mRNAs as well as production of IL-1 alpha, IL-1 beta and
      IL-6 are inducible with LPS. Expression or production of other cytokines
      including IL-2, IL-3, IL-4, IL-5, TGF beta and GM-CSF could not be detected. As
      the biological effects of alpha ChyJ2 supernatant cannot be fully explained by
      the described pattern of cytokine production, participation of other, yet
      uncharacterized, factors is possible. Using alpha ChyJ2 as feeder cells for in
      vitro as well as in vivo immunizations increased the number of antibody secreting
      B-cell clones 2 to 15 fold, respectively.

PMID- 2216461
TI  - Ability of the HPV16 E7 protein to bind RB and induce DNA synthesis is not
      sufficient for efficient transforming activity in NIH3T3 cells.
AB  - Previous studies have demonstrated that the HPV-16 E7 gene product encodes the
      major transforming activity of the virus in rodent cell systems. In this study we
      have generated a series of point mutations affecting the region of HPV-16 E7,
      which shows homology to adenovirus E1a conserved domain (CD)1. In conjunction
      with previously described mutants in the region of E7 with similarity to E1a CD2
      and SV40 LT, we have investigated three known activities of the E7 protein;
      transformation, association with the cellular RB protein and induction of
      cellular DNA synthesis. The results show that RB binding correlates with the
      ability of E7 to induce cellular DNA synthesis and mediate cell transformation.
      In addition an unidentified function of E7, which is necessary for transformation
      of NIH3T3 cells, but does not affect RB binding or the ability to induce cellular
      DNA synthesis, has also been demonstrated. This study therefore identifies two
      separate regions of the E7 gene necessary for transformation of established
      cells. One of these, in the region of E7 which shows similarity to E1a CD2 and
      LT, is required for RB binding and DNA synthesis. The other region important for
      transformation, in the N-terminus of E7, is separable from the RB binding/DNA
      synthesis function.

PMID- 2216462
TI  - Overexpression of matrix Gla protein mRNA in malignant human breast cells:
      isolation by differential cDNA hybridization.
AB  - Genetic alterations are involved in the development of human breast cancer. We
      sought to isolate genes that are differentially expressed or suppressed in
      cultured human breast carcinoma cells as compared to cultured normal human breast
      epithelial cells by employing differential screening of selected cDNA libraries.
      Analysis of several clones thus isolated revealed that the matrix Gla protein
      (MGP) gene is overexpressed in the breast cancer cell line 600 PEI, though is
      transcribed at lower levels in most other mammary derived cultures. MGP requires
      vitamin K dependent gamma-carboxylation for its known function and thus can be
      inhibited by vitamin K antagonists. This raises the possibility that MGP may be
      among those factors that when inhibited by vitamin K antagonists reduce
      metastases in experimental models. Among the gene whose transcription is
      consistently suppressed upon mammary transformation were fibronectin and the type
      I keratin, K14. Differential cDNA screening therefore is an effective method of
      identifying genes involved in various aspects of mammary cell transformation.

PMID- 2216463
TI  - Expression of P0- and P3-RNA from the normal and translocated c-myc allele in
      Burkitt's lymphoma cells.
AB  - We have studied the allele specific expression of c-myc P0- and P3-RNA in
      Burkitt's lymphoma (BL) cells. The steady state levels of P0-RNA show
      considerable variations in BL cells. Expression of P0-RNA was found to be
      restricted to the translocated allele, but could be induced by TPA from the
      normal allele. P0-transcription was particularly sensitive to inhibitors of
      protein synthesis compared to expression of P1-, P2- and P3-RNA. Transcription of
      P3-RNA is initiated in the first intron of the c-myc gene and has previously been
      described to be specific for translocated c-myc alleles in BL cells broken within
      exon 1 or intron 1. Here we show that P3-RNA is also expressed from an
      unrearranged c-myc gene. In the BL cell line Raji, substantial amounts of c-myc
      RNA are derived from the P3-promoter of the normal allele. This indicates that
      repression of the normal allele in BL cells does not include the P3-promoter. The
      potential coding capacity of P3-RNA is discussed.

PMID- 2216464
TI  - Human TRK proto-oncogene maps to chromosome 1q32-q41.
AB  - The chromosomal localization of TRK, a gene coding for a putative receptor
      molecule with an associated tyrosine kinase activity that we have found activated
      in 25% of patients with papillary thyroid carcinoma, was determined by Southern
      blot analysis of a panel of human-rodent somatic cells using a cDNA clone
      containing the entire human TRK proto-oncogene (Martin-Zanca et al., 1986). The
      TRK gene was assigned to chromosome 1. One hybrid that had retained only the
      short arm of the human chromosome 1 was negative. Subsequently, in situ
      hybridization of the same probe to human metaphase chromosomes localized the TRK
      gene to 1q32-q41.

PMID- 2216465
TI  - Malignant transformation of an infinite life span human fibroblast cell strain by
      transfection with v-Ki-ras.
AB  - To determine if human fibroblasts can be transformed into malignant cells by
      transfection of a K-ras oncogene, we transfected the provirus of Kirsten murine
      sarcoma virus (v-Ki-ras) into an infinite life span human cell strain, MSU-1.1,
      which has a normal morphology, is not anchorage independent, and has a stable,
      near-diploid karyotype. The transfected populations gave rise to distinct foci
      composed of morphologically-altered cells. The cells from several independent
      foci were isolated, propagated, and assayed for anchorage independence and/or
      tumorigenicity. They formed large-sized colonies in soft agar at a high
      frequency. Cell strains derived from colonies isolated from agar as well as focus
      derived cell strains were injected subcutaneously into athymic mice to test for
      tumorigenicity. One cell strain yielded myxoid fibromas, the rest produced well
      differentiated, progressively-growing, invasive, myxoid or spindle cell sarcomas.
      The karyotype of each of the cell strains tested, including cell strains derived
      from tumors, was identical to that of non-transfected MSU-1.1 cells. Two focus
      derived strains, and two cell strains derived from sarcomas produced from them,
      were tested and shown by DNA and RNA hybridization to contain and express the v
      Ki-ras oncogene. Radioimmunoprecipitation analysis showed that these strains
      expressed ras-specific p21 products not found in non-transfected MSU.1.1 cells.
      When injected intraperitoneally, a cell strain derived from a myxoid tumor gave
      rise to invasive myxoid tumors at various sites in the body. The same cell strain
      gave rise to invasive spindle cell sarcomas when injected into the tail vein of
      the animals.

PMID- 2216467
TI  - Mapping of the functional domains of the v-rel oncogene.
AB  - Previously, the v-rel oncogene was shown to code for a protein of 503 amino
      acids. The protein product of v-rel was identified as a 59 kDa protein (pp59v
      rel), phosphorylated predominantly on serine residues. Although the signal
      required for the nuclear localization of pp59v-rel in chicken embryo fibroblasts
      was identified, the regions of v-rel important for transformation have not been
      mapped. In this study, 12 linker insertion mutants of v-rel were constructed and
      tested for transforming activity. Seven linker insertion mutants which mapped
      between amino acid residues 29 and 275 abolished transformation. The remaining 5
      mutants which contained linker insertion mutations between amino acid residues
      332 and 459 transformed at wild type levels. The results of this analysis
      localize the functional domains of the v-rel oncogene to the N-terminus. Earlier
      reports have shown that pp59v-rel resides in a high molecular weight complex with
      several other cellular proteins. The transforming mutants co-precipitated the
      same set of cellular proteins when immunoprecipitated with v-rel antiserum. This
      indicates that all transforming mutants retained the ability to bind within the
      reported complex.

PMID- 2216466
TI  - Frequent activation of non-ras transforming sequences in neoplastic Syrian
      hamster cells initiated with chemical carcinogens.
AB  - Carcinogen-caused transformation of Syrian hamster embryo cells has been widely
      used as a model for experimental carcinogenesis. However, analysis of the
      molecular mechanisms of hamster cell transformation has been limited. To expand
      the understanding of the molecular basis of this system, 22 independently derived
      Syrian hamster neoplastic cell lines initiated with chemical carcinogens were
      screened for the presence of dominant transforming sequences by DNA transfection
      into mouse NIH3T3 cells. High molecular weight DNAs from 12 (55%) of these cell
      lines transformed NIH3T3 cells through serial transfection cycles. NIH3T3
      transformants contained hamster-specific repetitive sequences, which co
      segregated with the transformed phenotype in successive transfection rounds.
      Results from Southern hybridization analyses and p21ras mobility assays indicated
      the presence of N-ras oncogenes, presumably activated by point mutations at codon
      61, in 3 of the 12 (25%) transfection positive lines, all initiated with sodium
      bisulfite; non-ras transforming sequences were apparently activated in the
      remaining 9 (75%) lines. DNA prepared from NIH3T3 transformants derived from cell
      line 81C39 was analysed by Southern hybridization with a battery of 38 probes
      including non-ras oncogenes known to score as positive in the NIH3T3 assay as
      well as other retroviral and mammalian oncogenes. Each probe hybridized to DNA
      fragments showing the mobility characteristic of NIH3T3 protooncogenes, but
      failed to detect homolog sequences of hamster origin, even under hybridization
      conditions which allowed their detection in hamster DNA. Results show that ras
      activation occurs at a low frequency in hamster neoplastic transformation and
      strongly suggest that novel transforming sequences are activated, thus validating
      the use of this system for investigating the role of non-ras transforming
      sequences in neoplasia.

PMID- 2216468
TI  - Do long wavelength pass filters improve low vision performance?
AB  - It has been suggested that the wearing of band-pass tints may improve the
      contrast performance in certain ocular conditions. We examined this by measuring
      grating visual acuity (VA) for targets of various contrasts. The benefits of
      Corning CPF 511, 527 and 550 lenses, and neutral density (ND) filters were
      examined with and without the presence of glare. Generally, patients with
      anterior sector conditions showed improved performance with band-pass filters
      (not with ND filters). It is suggested that the filter reduces the scatter within
      the ocular media. People with retinitis pigmentosa or diabetic retinopathy rarely
      benefited. The CPF 511 most frequently improved VA followed by CPF 527 and 550
      respectively. We suggest that a condition of glare is incorporated when assessing
      suitability with tints.

PMID- 2216469
TI  - Efficiency in reading with closed-circuit television for low vision.
AB  - A closed circuit television (CCTV) magnifier was used to measure the reading
      rates of nine fluent low-vision subjects. Performance was found to be dependent
      on field width, character size, and the number of characters displayed in line. A
      field width of 70 degrees and a mean of 24 characters were commensurate with the
      fastest reading rate. The optimal character size that elicited the fastest
      reading was determined for each subject. In seven of the nine subjects, this
      differed from the character size selected by chance at their initial CCTV
      sessions, prior to these experiments. A clinical procedure is recommended, which
      avoids inappropriate choice, and guides the examiner in achieving directly the
      most efficient CCTV reading conditions for each individual patient.

PMID- 2216470
TI  - Ocular dimensions and refractive power in Malay and Melanesian children.
AB  - A cross-sectional study of 753 Melanesian children in Vanuatu and 904 Malay
      children in Malaysia included measurement of refractive error and ocular
      dimensions. All children were between the ages of 6 and 17 years. The prevalence
      of myopia in Malay children was 4.3% at 7-8 years and 25.6% at 15-16 years with
      corresponding figures of 0.8% and 4.3% for Melanesian children. The range of
      refractive error was greater for Malay children at all ages. Mean refractive
      error for Malay children showed greater hypermetropia, together with a shorter
      axial length at 6 years, than Melanesian children, but at 17 years the situation
      reversed and Malay children had more myopia and longer axial lengths than their
      Melanesian counterparts.

PMID- 2216471
TI  - Accommodation and the nerve pathway to the ciliary muscle: a review.
AB  - Evidence has accumulated recently which challenges the conventional description
      of the parasympathetic division of the oculomotor nerve pathway to intraocular
      smooth muscles. It is claimed that the pathway from the midbrain to the ciliary
      muscle is direct and uninterrupted by a synapse in the ciliary ganglion. A
      similar, separate claim has been made regarding the innervation of the sphincter
      muscle of the iris. The weaknesses in the arguments supporting the revised
      versions are discussed in this review and they are rejected in favour of the
      conventional pathway.

PMID- 2216472
TI  - Effects of stimulus distance on measurements of dark convergence.
AB  - Dark convergence is often measured psychophysically by aligning two dichoptic
      stimuli, which are briefly flashed in a dark surround. In the present study, the
      effect of different stimulus parameters on dark convergence measurements was
      investigated. Chief among these was the effect of viewing distance (50, 100 and
      500 cm) of the stimulus. Measured dark convergence was biased towards the actual
      viewing distance of the stimuli; this effect was stronger with bar stimuli than
      with point-and-line stimuli. Measured dark convergence depended on the viewing
      distance to a lesser extent if bar stimuli were observed through pin-holes (open
      accommodative feedback loop). The subject's knowledge of the viewing distance had
      a small but significant effect; the size of the nonius bars had none. To reduce
      artefacts due to the stimulus distance on psychophysical measurement of dark
      convergence, point-and-line stimuli should be used at a viewing distance of about
      1 m. In this case, the effect of stimulus distance can be about 0.25 meter angle
      (ma), averaged over subjects, but it may be as large as 0.5 ms in some
      individuals.

PMID- 2216473
TI  - Proximal and cognitively-induced accommodation.
AB  - The aim of this study was to investigate proximally-induced accommodation (PIA)
      at two levels of cognitive demand. PIA was assessed by comparing the open-loop
      accommodative responses to stimuli located at viewing distances of 6 m (0.17 D)
      and 0.33 m (3 D), respectively. The vergence and accommodation loops were opened
      by subjects monocularly viewing the targets through a 0.5 mm pin-hole. PIA was
      measured while subjects either were encouraged to relax and listened to popular
      music, or performed a relatively demanding mental arithmetic task (counting
      backwards in sevens). The results indicated that for 4 of the 12 subjects
      examined, increased cognitive demand produced a marked (greater than +/- 1.00 D)
      change in the magnitude of PIA. This finding suggests the presence of an
      interaction between the output of proximally- and cognitively-induced
      accommodation in these subjects. Such an interaction may hinder attempts to
      examine individual, non-optical components of accommodation.

PMID- 2216474
TI  - Binocular summation in visually evoked responses and visual acuity.
AB  - Monocular and binocular transient visually evoked responses (VER) were recorded
      on 50 adult subjects using a pattern reversal stimulus (check size 5.5 min arc).
      The peak-to-trough amplitude of the VER wave was measured and compared with the
      subjective visual acuity (Landolt C). The binocular amplitude enhancement over
      the monocular amplitude was around 26% across the acuity range studied, whereas
      the mean binocular subjective visual acuity improvement was around 11.3%, but
      this varied from 1% at the high acuity end to 17% at the low acuity end of the
      range.

PMID- 2216475
TI  - A gradient-index ophthalmic lens based on Wood's convex pseudo-lens.
AB  - Although the Varilux type varifocal has been and still is very popular, research
      has been carried out on other methods of providing a progressive addition lens.
      This paper deals with the field of gradient-index optics. It includes a review of
      the literature related to the production of a gradient-index element and the
      theoretical analysis of concentric varifocals. A procedure is described to
      construct a varifocal lens, after that described by Wood in 1905, to produce
      lenses known as 'non-homogeneous cylinders' or 'pseudo-lenses'. The method is
      based on a diffusion process, taking place in half of the lens, and creates steps
      in the refractive index of the material. Experimental data are also given on the
      change of the spherical and cylindrical power, which indicate that the lens
      constructed is an optical system having a rotational symmetry in power, around a
      fixed point.

PMID- 2216476
TI  - Effect of illuminance on the directions of chromostereopsis and transverse
      chromatic aberration observed with natural pupils.
AB  - The direction of chromostereopsis observed with a natural pupil and the direction
      of the monocularly perceived disparity between coloured targets (F and C lines -
      486 and 656 nm) have been measured in a sample of 30 subjects at 10 and 1000 lx.
      At both illumination levels approximately equal numbers of subjects perceived
      positive and negative chromostereopsis. When the ambient illumination was
      increased, a reversal in the direction of the chromostereopsis occurred for 16
      subjects. For six of them a change from a positive to a negative chromostereopsis
      was observed, a pattern not reported in previous studies. In most cases at both
      high and low illuminance, there was an absence of perception of a monocular
      disparity (transverse chromatic aberration), although chromostereopsis was
      reported, indicating that binocular information can be obtained from sub
      threshold monocular disparities. At low illuminance, the lack of correlation
      between the direction of chromostereopsis and transverse chromatic aberration
      (TCA) may indicate that there may be a supplementary binocular factor in
      chromostereopsis.

PMID- 2216477
TI  - Tri-meridional analysis using arbitrary meridians.
AB  - The evaluation of the sphero-cylindrical components of curvature or refraction
      from measurements taken along three distinct meridians has been solved for
      various sets of three fixed meridians. A constraint of those solutions has been
      that the meridians of measurement are necessarily predetermined, which introduces
      an unwelcome restriction in experimental or clinical applications of tri
      meridional analysis. A new solution is presented (in three formats: analogue
      computer, graphical and algebraic), which enables any set of three meridians to
      be used for tri-meridional analysis. A computer program listing (in BASIC) is
      included.

PMID- 2216478
TI  - A general numerical method evaluating three-dimensional eye rotations by scanning
      laser ophthalmoscopy.
AB  - A general computational method is described to specify completely the rotational
      state of the eye in three dimensions by scanning laser ophthalmoscopy (SLO). The
      method uses the simplex algorithm to fit the eye's rotational parameters to data
      given by n individually selected ocular fundus landmarks before and after the eye
      rotation. The rotational parameters are expressed as the rotation vector and
      three spherical Euler angles. The method, which was implemented in the C
      programming language, can be applied for various eye movement measurements in
      clinical and laboratory environments, including SLO.

PMID- 2216479
TI  - Eye-tracking infra-red optometer.
AB  - An eye-tracking infra-red optometer has been developed to measure dynamic
      refractive power during slow horizontal eye movement. It consists of two
      instruments: an optometer to measure the refractive power of the human eye, and
      an eye tracker. When measuring refractive power, the eye tracker is used to
      maintain automatically the optical axis of the optometer coincident with the
      visual axis of the human eye. The measurement range of the optometer is
      approximately -10 to +10 D; refractive power is measured with an accuracy of
      about 0.4 D and with a precision of 0.05 D over an eye movement range of 60
      degrees. The maximum trackable eye movement velocity is over 100 deg s-1, with a
      time delay of about 0.13 s. Furthermore it was confirmed that eye refraction
      measurement during vergence is possible using this eye-tracking infra-red
      optometer.

PMID- 2216480
TI  - Anthrax of the eyelid.
AB  - Anthrax is a rare infection that is transmitted to humans from animals or animal
      products. In its cutaneous form it may produce lesions of the eyelids which can
      lead to cicatricization and ectropion. Exophthalmos, optic atrophy and
      panophthalmitis have also been reported. A case of anthrax affecting the eyelid
      of a patient seen by the author in Kabul, Afghanistan, is presented.

PMID- 2216482
TI  - Etymology of the word 'saccade'.

PMID- 2216483
TI  - The Applied Vision Association: its foundation and early history. The Committee
      of Management of the AVA.

PMID- 2216481
TI  - Assessment of surface power and curvature by measurements along meridians at 60,
      120 and 180 degrees.

PMID- 2216484
TI  - Papers presented at the annual meeting of the Applied Vision Association Human
      Factors in Vision. Manchester, 2-4 April 1990. Abstracts.

PMID- 2216485
TI  - Tobacco control efforts strong on all fronts.

PMID- 2216486
TI  - Broadening our horizons.

PMID- 2216487
TI  - [Current opinions on the endolymphatic sac structure].
AB  - There were a lot of discussions about the role of endolymphatic sac in the
      regulatory mechanism of endolymphatic pressure during the decade 1960-70.
      Nowadays we know that the balance of metabolism in the inner ear depends on
      stabilization of fluids in the endolymphatic space. The histologic and anatomic
      examinations of petrous bone and endolymphatic sac were discussed.

PMID- 2216488
TI  - [Failures of histopathological verification in malignant tumors of the nasal
      cavity and paranasal sinuses].
AB  - In the years 1966-80, 96 patients with malignant tumors of nasal cavity and
      paranasal sinuses were operated upon at ENT Department, Medical Academy, Cracow.
      The frequency of failures in histopathologic confirmation and results of
      treatment were evaluated. The failures concerned tumors locally advanced.

PMID- 2216489
TI  - [Histological and electron microscopic examinations of laryngeal papilloma in
      children and adults].
AB  - The authors present the results of histologic and electron microscopic
      investigations of larynx papillomas in 11 children and 8 adults. Comparative
      estimation showed the characteristic changes for clinical and morphological
      division of papilloma into adult-type and juvenile one. Detailed morphological
      analysis in adult-type papilloma either with dysplastic changes or with
      hyperkeratosis was performed.

PMID- 2216490
TI  - [Zinc in the blood serum and tissues in patients with planoepithelial carcinoma
      of the larynx].
AB  - Serum and tissue zinc concentrations in 30 subjects with operable squamous cell
      carcinoma of the larynx, aged 36-56 were determined by atomic absorption
      spectrophotometry. The concentration of this cation in cancerous tissues and in
      unchanged homologous tissues do not differ significantly. Mean zinc serum level
      was lower before treatment.

PMID- 2216491
TI  - [Reaction analysis in the oscillating chair test in patients with cerebellar
      lesions].
AB  - The examinations were performed in a group of 53 cerebellar lesion patients. In
      pendular test the symmetric reaction were in 43, and asymmetrical in 10 patients.
      There were no symmetrical reactions giving evidence of vestibular hyper-reaction.

PMID- 2216492
TI  - [Clinical pathology of olfactory neurinomas in the light of current literature].
AB  - The modern views on histogenesis of olfactory neurinomas were described. The
      diagnostic difficulties and importance of ultrastructural and histochemical
      examinations were stressed.

PMID- 2216493
TI  - [Incidence and kinds of mycotic infections in the mouth cavity, throat, nasal
      cavity, maxillary sinus, larynx and ear].

PMID- 2216495
TI  - [New outlook on the problem of an anatomic barrier in the lymphatics of the
      laryngeal mucous membrane].
AB  - The authors describe the lymphatic net of the larynx mucosa membrane. The
      communications of the lymphatic vessels of the larynx and neighbouring organs are
      analyzed in hypertrophy and atrophy of the mucosa. The experiment performed by
      means of injections proved that the subglottic area is not a barrier between the
      two areas of laryngeal mucosa lymphatic system.

PMID- 2216494
TI  - [Organization of the nasal septum bone and its homologue. II. Os alare et systema
      palatinum axiale (in fish)].
AB  - The aim of these investigations was differentiation and systematization of
      elements of osseous medial palate and attempt to discover of spheno-orbital bone
      homologue in fish (os orbito-sphenoideum). 50 adults fish heads of carps, perch ,
      tench , common pikes and trout were examined. The methodology was described
      elsewhere. It was stated that in examined animals the pair premaxilla was divided
      into three parts: corps, palate and frontal process. The para-sphenoid bone was
      also a double biomechanical system, composed of septum homologue and transverse
      lamina , the same as in other vertebrates. All above mentioned parts create the
      palatal axial system. The orbital-sphenoidal bones in fishes are homologue to the
      sphenoidal bone in birds.

PMID- 2216497
TI  - [Hearing results of cholesteatoma middle ear surgery using open and closed
      techniques].
AB  - The author described an analysis of hearing results in open and closed
      tympanoplasties of ear cholesteatoma. 172 patients were operated upon. 73 have
      had open and 99 closed technique. The better hearing results were obtained in
      closed surgery, but not so good as expected. The unsuccessful hearing results
      were two times frequent in open surgery. We prefer the two step closed
      intervention after all pathologic lesions being eradicated.

PMID- 2216496
TI  - [Administration of prostacyclin in sudden deafness. Evaluation with the double
      blind method].
AB  - Prostacyclin (PGI2) connects all the pharmacologic properties of drugs being used
      till now in sudden deafness. 30 patients with sensori-neural sudden deafness were
      treated by prostacyclin and placebo in the double-blind test situation. In
      therapeutic group of 15 patients were 87% of complete recovery, but in placebo
      only 6%.

PMID- 2216499
TI  - [Use of fibrin tissue adhesive in an otolaryngological clinic. Preliminary
      report].
AB  - The tissue glue was used in post-tonsillectomy bleedings, tympanoplasties,
      cosmetic skin sutures and in prolonged laryngectomy fistulas. The initial
      evaluation pointed out its usefulness in ENT practice.

PMID- 2216498
TI  - [Surgical treatment of laryngotracheal stenosis].
AB  - In the ENT Clinic, Medical Academy, Cracow a joint ENT team accompanied by
      thoracic surgeon performed the segmentary resection of trachea in three patients
      with stenosis of the subglottal area and of the upper section of trachea. The
      connecting surgery of trachea and thyroid cartilage was successful in two
      patients, but failed in one. Advantages of this method and reason of failure were
      thoroughly discussed.

PMID- 2216501
TI  - [New TNM classification of cancer of the upper respiratory and digestive tracts].
AB  - The modified TNM classification of cancers in oral cavity, pharynx, larynx,
      maxillary sinuses was described. This classification was introduced in 1987 in
      agreement with UICC and AJCC. The criteria of classification were discussed.

PMID- 2216500
TI  - [Immunohistochemical examination of olfactory neuroblastoma].
AB  - The results of the immunohistochemical examinations by means of PAP method in 3
      olfactory neuroblastomas were described. In the neoplastic cells there were
      cytokeratin as well as neuronal enolase. The same was recently encountered in the
      merkel cell tumor, which have the analogous histogenesis. The usefulness of the
      immunohistochemical method of examinations are essential in correct diagnosis.

PMID- 2216502
TI  - [Computer analysis of the ENG signal in real time].
AB  - The theoretical basis of ENG signal analysis in real time was described as well
      as the equipment and the examination algorithm . 80 ENG examinations were
      analysed by means of the classical and computer automatic methods. The clinical
      usefulness of this equipment was presented.

PMID- 2216503
TI  - [Effect of ethyl ether of apovincaminic acid (Cavinton) on the ototoxic action of
      sisomicin in guinea pigs].
AB  - The aim of this work was to evaluate the protective effect of etyl ether of
      apovincaminic acid (Cavinton) against the ototoxic effect of sisomycin in the
      experimental condition. The first group of guinea pigs were given 14 days
      sisomycin. The second sisomycin and cavinton. The third was the control group.
      Hearing acuity was tested by the shivering audiometry. The spiral ganglion
      function was tested by the microphonic potentials and the integrity of cochlea
      was diagnosed by scanning microscopy. The results pointed out the ototoxicity of
      sisomycin. There were the deterioration of hearing acuity, lowering of
      microphonic potentials and degenerative changes in spiral ganglion. The damages
      were lowered by use of cavinton before the administration of sisomycin.

PMID- 2216504
TI  - [A case of glomus jugulare chemodectoma].
AB  - A case of glomus jugular chemodectoma is described in a 38 years old woman who
      was treated surgically. In the postoperative course a haemorrhage from the
      internal carotid artery appeared, needing a second surgical intervention, that
      was performed with good result.

PMID- 2216505
TI  - [Unusual pharyngeal foreign body removed by pharyngotomy].
AB  - The authors described the unusual pharyngeal foreign body extracted by the
      lateral pharyngotomy. It was the hoove for the calmars with two wreath of pins.
      The tracheostomy was difficult, because of the impossibility to lay down the
      patients.

PMID- 2216506
TI  - [A case of tuberculosis of the middle ear in a 4-year-old child].
AB  - The authors described a rare case of the middle ear tuberculosis in 4 years old
      child. It was the mastoiditis, which was operated upon. Two years without
      recurrency in observation.

PMID- 2216507
TI  - [Organization of the osseous nasal septum and its homologues. III. The sphenoid
      bone and the vomero-transversal system in Urodela].
AB  - In connection with the comparative anatomical examinations of the nasal septum in
      man, the urodela skulls were examined . The aim of these investigations of the
      osseous median palatal part and sphenoethmoidal bone were evaluated. 25 skulls of
      adults frogs were examined. It was stated that parasphenoid in these Amphibians
      consisted of two parts: agger vomeris and lamina transversalis. These elements
      were the homologue to the parasphenoideum seu vomero-transversale system in
      fishes. The premaxilla in frogs belonged (substituted) to the maxillary++ arch.
      The sphenoethmoidal bone in frogs were the same as the alar bone in birds (part
      I) and fishes (part II). In all frogs the author did not found any "mesoethmoid
      ". These precedential facts, observed in birds (I), fishes (II) and amphibians
      (III) led to further study in mammals and man.

PMID- 2216508
TI  - [Various forms of mycoses of the oral cavity, pharynx, nasal cavity, paranasal
      sinuses, larynx and ear].

PMID- 2216510
TI  - Insurance nightmare.

PMID- 2216509
TI  - [Primary cancer of the tongue treated at the Otolaryngological Clinic, Medical
      Academy, in Poznan 1963-1987].
AB  - The analysis of 191 patients with primary tongue carcinoma treated in ENT Clinic
      of Medical Academy in Poznan during the years 1963-1987 was presented. Since 1983
      there were the dramatic increase in patients number. The patients age was between
      20 and 87. Statistically significant was the males number. The half of the
      patients were in their 6th decade of life. In the last 5 years period the
      patients were younger of mean 5 years. Their symptoms lasted about 4 months. The
      earliest was the tongue pain. Tobacco smokers and alcoholics predominated. The
      localizations were in general on the edge and on the basal part of the tongue.
      Histologically the most frequent was the planoepithelial cancer in the second
      clinical stage. The 5 years survival rate was about 20%.

PMID- 2216511
TI  - Generic drug safety challenged.

PMID- 2216512
TI  - Trustee praises Pittsburgh reporter.

PMID- 2216513
TI  - Trends in Philadelphia lung cancer mortality rates.

PMID- 2216514
TI  - Approaching environmental medicine.

PMID- 2216515
TI  - Can safety belt laws be justified?
AB  - This article combines the researched sciences of logic, philosophy, and medicine
      to develop a perspective on safety belt laws. The positions of advocacy and
      opposition are examined primarily by a nonphysician in a reasonably unbiased
      manner. The result is an enhanced awareness of principles not commonly employed
      by physicians which may be useful to the medical profession in dealing with this
      controversy.

PMID- 2216516
TI  - Keep income division plan up to date. The Health Care Group.

PMID- 2216517
TI  - Physicians can meet needs of medical schools.

PMID- 2216519
TI  - Dr. Redman examines the challenges and issues facing ANA and nursing.

PMID- 2216518
TI  - Court to rule on settlement of sex discrimination case.

PMID- 2216520
TI  - There's no quick-fix for success.

PMID- 2216522
TI  - [Transverse extremity defects in a case of Adams-Oliver syndrome].
AB  - Report of a boy aged 15 years with ADAMS-OLIVER-Syndrome, which is associated
      with dysraphia and cardiomegalia. The differential diagnosis is regarded
      specially.

PMID- 2216521
TI  - [Clinical significance of the most important abnormalities of respiratory
      organs].
AB  - The incidence rate and the clinical significance of inborn abnormalities of
      respiratory organs frequently are still underrated. In the clinic for paediatrics
      of the Medical Academy of Dresden malformations of respiratory organs, situated
      below the larynx, were demonstrated in 18 per cent of patients who had been
      referred hither in the course of 20 years for bronchopulmonary diagnostics. The
      clinical symptoms are very different and often uncharacteristic. Not seldom
      malformations of that kind first of all remain silent till a superinfection or a
      striking roentgenogram will arise the suspicion on a malformation. Following
      symptoms may refer to: permanent or intermitting stridor in the stenoses of the
      large respiratory tract (trachea and main bronchi), that is diagnosed as the most
      frequent anomaly. In nearly 80 per cent of the patients suffering from stenoses
      of a main bronchus symptoms of a recurrent or chronically obstructive bronchitis
      stood in the foreground. Mostly a tachy- and a dyspnoe are the leading symptoms
      in case of a connatal lobar emphysema, the most frequent anmaly of the pulmonary
      parenchyma followed by the pulmonary hypolasia and -agenesis. Chronic or
      relapsing pneumonias respectively a persisting cough may appear as symptoms in
      pulmonary sequestrations and in isolated anomalies of the bronchial aborization
      that otherwise in the majority of the cases will rest clinically mute. The long
      term prognosis for children suffering from stenoses in the main bronchis is
      compared with those of tracheal stenoses relatively satisfactory.

PMID- 2216523
TI  - [Factor VII deficiency].

PMID- 2216524
TI  - [Chlamydia-induced pneumonia in children].
AB  - Three cases of pneumonia caused by Chlamydia were observed. The disease ran a
      protracted course and was refractory to treatment. Erythromycin was given
      initially intravenously and then orally, with improvement of the general
      condition of children and regression of inflammatory changes in the lungs. Such
      cases are worth of reporting in view of only isolated reports on respiratory
      infections caused by these organisms.

PMID- 2216525
TI  - [Risk factors of fitness for child day care in 2 independent studies].
AB  - The condition of the acute respiratory disease (ARD), conditions of exposure and
      disposition were found out with 245 and 83 children from 8 creches of a large
      town and from two creches of a little town. The children were from 6 to 36 months
      old. The prospective studies were performed independently of each other within a
      period of one year. Your problem circles were identical to a large extent. These
      are load factors in the perinatal period, time of stay in the creche, shift work
      of the parents, kind of the adaptation phase during the first admission in the
      creche. The employment of the linear function of discrimination found permits the
      general paediatrician to elaborate an additional information for the judgement of
      the possibility of attendance into the creche in general and for the time of
      convalescence after ARD.

PMID- 2216526
TI  - [Historic, social psychiatric, genetic and anthropologic aspects of
      turricephaly].
AB  - At first estimations of turricephaly from antiquity till modern times are
      exhibited and at last also results of own examination of over an average
      disturbed social behaviour and constitutional biological aspects of patients with
      turricephaly. The dominant inheritance of turricephaly and also peristatic and
      influences of races in the genesis of premature craniosyntosis are viewed by
      current literature.

PMID- 2216527
TI  - [Oculo-auriculo-vertebral dysplasia with abnormal social development].
AB  - Report of a 17-year-old boy with oculo-auricolo-vertebral dysplasia. He exhibited
      microphthalmos on the left and auricular deformity at hemifacial microsomia,
      scoliosis, dysraphia and other malformations of vertebras and ribs further other
      minor anomalies of face and hands. The disfiguring microphthalmia with ptosis was
      an essential cause of a social maldevelopment with temporary important
      aggressivity. Patients with oculoauriculovertebral dysplasia should be examined
      for associating cardial and renal dysplasias and cases of psychosocial disorders
      treated psychotherapeutically in time.

PMID- 2216528
TI  - [Blood level profile of valproate administration under therapeutic conditions in
      children].
AB  - The antiepileptic drug, valproic acid, was administered to 32 children (valproate
      calcium 8; valproate plus ethosuximide 10; valproate plus phenobarbitone 2;
      valproate plus primidone 8; valproate plus DPH, primidone and/or carbamazepine
      4). They received valproic acid three times daily (8.00 a.m., at noon, 6.00
      p.m.). Valproate blood levels were determined. The study revealed that, in
      contrast to international recommendations, (i) plasma levels were very high, (ii)
      unnecessary fluctuations occurred, and (iii) obviously valproic acid was too
      often administered in combined therapy with other antiepileptics.

PMID- 2216529
TI  - [Changes in the thyroid status of school children in relation to improved dietary
      iodine intake].
AB  - Five years after the introduction of the iodine prophylaxis examinations on the
      reaction of the thyroidal state were carried out in 150 children, 9 to 15 years
      of age in a district of the Erzgebirge in the south of the GDR. The results of
      the T3-, T4- and TSH-concentrations within the serum demonstrated in all the
      children an euthyroid metabolic condition. The medium renal iodine elimination of
      37.3 +/- 4.7 micrograms iodine/g creatinine still resulted in an ionic deficiency
      of 2nd degree. The thyroid volumes too measured by sonography and the thyroid
      masses figured out were significantly more voluminous than those of children of
      the same age in countries with a sufficient iodine supply since years. The
      incidence rate of struma in 13-15-year-old children amounted to 21 per cent. The
      systematic accomplishment of interdisciplinary iodine prophylactic measures will
      further on be essential during the next years in the GDR.

PMID- 2216530
TI  - [The experimental transmission of the tick-borne encephalitis virus by ixodid
      ticks (the mechanisms, time periods, species and sex differences)].
AB  - Females and males of ixodid ticks (Ixodes and Dermacentor) infected parenterally
      with the tick-borne encephalitis virus at the adult or nymphal phase and
      containing the virus in the saliva are able to transmit the agent in the first
      minutes after the bite of the sensitive animal host. Preservation of the cement
      conus produced by saliva in the animal skin enhances the infection intensity
      because the quantity of the virus in the conus is comparable with that in the
      tick's body. The virus quantity in the fluid saliva, excreted by I. persulcatus
      females and measured during different periods of bloodsucking (at least during
      the first three days), increases 10 to 100 times in comparison with a comparable
      volume of hungry ones.

PMID- 2216531
TI  - [The epizootiological significance of flea accumulation in aggregations of the
      female long-tailed suslik in the Tuva plague focus].
AB  - The formation of aggregations of related females is a peculiarity of the
      intrapopulational organization of long-tailed suslik that results in the
      accumulation of Citellophilus tesquorum, the main vector and keeper of the plague
      microbe in the Tuva plague nidus. The plague agent is adapted to the existence on
      the territory occupied by aggregations of females that manifests itself in the
      delay of the beginning and prolixity of block-formation periods in fleas. The
      transfer of the agent from one place to another takes place only at the high
      abundance of long-tailed suslik. When the number of the suslik is low the plague
      microbe circulates in the ranges of one or several neighbouring aggregations of
      females having no possibility for successful transfer to a new place.

PMID- 2216533
TI  - [Parasite-host relations in toxascariasis in Arctic foxes].
AB  - The effect of host infection doze (10, 100, 1000 eggs) and developmental stages
      of helminths (larvae, adult nematodes) on the relationships in the system
      "Toxascaris leonina-Alopex lagopus" was studied experimentally. It has been
      established that 100 eggs are the threshold dose for helminths and 1000 eggs for
      the host. More distinct changes in the indices are characteristic of the
      parasite. Dynamics of host-parasite relationships in the development of the
      parasitic process correspond to helminth developmental stage. Larvae of T.
      leonina are most pathogenic for the host.

PMID- 2216532
TI  - [Bound amino acids in local strains of Trichomonas vaginalis].
AB  - Amino acid composition of water-soluble and water-insoluble proteins of 8 strains
      of Tr. vaginalis is studied. 17 amino acids are found in both protein
      hydrolyzates. Despite the complete coincidence of their qualitative compositions
      there are reliable differences in the quantitative contents of some amino acids.
      Differences in the contents of main amino acids of water-soluble proteins of
      different strains reflect the belonging of the latter to different sero-groups.
      No reliable differences in the quantitative contents of amino acids of both water
      soluble and water-insoluble proteins in strains belonging to one sero-group are
      recognised.

PMID- 2216534
TI  - Nursing and politics: a profession comes of age.

PMID- 2216535
TI  - Factors that influence recovery from hip fracture during hospitalization.
AB  - Fracture of the hip is a major medical problem in the elderly. Of those elderly
      individuals who are hospitalized for repair of the fracture, only a few will
      recover and return home. Many will develop chronic disabilities and complications
      leading to prolonged hospitalization and recovery, and for some, death. This
      article reviews the literature and identifies positive and negative factors that
      influence the recovery of the elderly patient with a hip fracture. Nursing
      interventions to promote recovery are discussed.

PMID- 2216536
TI  - Crutch walking.
AB  - This article provides nurses with information on crutch walking which is helpful
      for patient teaching in a variety of settings. Two nursing diagnoses are
      discussed: knowledge deficit and potential for injury related to crutch walking.
      Preparatory exercises and measurement of the patient for crutches are explained,
      as well as types of weight bearing and point and swing gaits for crutch walking.
      Crutch maneuvers in and out of a chair or bed, and on stairs are also included. A
      discharge instruction sheet with tips on crutch walking is provided for use with
      patients.

PMID- 2216537
TI  - Clinical support workers: a help or a hindrance to the shortage crisis?

PMID- 2216538
TI  - Organizing and implementing an Ilizarov program.
AB  - The Ilizarov external fixator has made a profound impact on orthopaedic science.
      With its circular design, it allows correction of three-dimensional deformities
      including rotation, angulation, translation, shortening, and widening, as well as
      lengthening and soft tissue defects. Because this device is largely patient
      centered and patient operated, it has presented a new challenge and career
      investment for the orthopaedic nurse. A comprehensive Ilizarov program is
      necessary to address the total patient and his multiple needs in any facility
      where the Ilizarov method of treatment is adopted. The Ilizarov program is a
      multidisciplinary team approach that provides a structure for administering and
      providing total patient care for the Ilizarov patient and his significant
      other(s).

PMID- 2216540
TI  - An educational program for total hip and knee replacement patients as part of a
      total arthritis center program.
AB  - An outpatient and inpatient educational program was developed to meet the medical
      and surgical needs of arthritis patients undergoing a total hip or knee
      replacement. This program is one component of a total Arthritis Center Program
      that includes outpatient treatment, inpatient rehabilitation, and acute medical
      and joint surgery. The education program consists of five standard classes:
      Presurgical Total Joint Replacement; What is Arthritis?; Arthritis Medications;
      Pain, Stress and Coping; and Discharge Total Joint Replacement. The program
      attempts to prevent complications, decrease anxiety, decrease hospital length of
      stay, decrease pain, and address the underlying arthritis by preparing patients
      for the surgery, postsurgery, and discharge.

PMID- 2216539
TI  - A laser primer for orthopaedic nurses.
AB  - Laser therapy is an efficient surgical intervention that minimizes tissue
      manipulation and destruction; however meticulous nursing care is required to
      safeguard the patient from potential hazards inherent in the procedure. A solid
      grounding in basic laser concepts including biophysics, correct operation of the
      equipment, safety, and maintenance will assist the nurse in providing
      comprehensive, high quality care. The emphasis of nursing practice should be
      oriented toward comprehensive patient education, psychosocial support, and
      safeguarding the patient from potential laser hazards.

PMID- 2216541
TI  - National Association of Orthopaedic Nurses. Chapter presidents' listing 1990
      1991.

PMID- 2216542
TI  - Editing in the 90s.

PMID- 2216543
TI  - Closed intramedullary femoral shortening.
AB  - Twelve cases of adult anisomelia were treated with closed intramedullary femoral
      shortening. Follow-up was conducted at regular intervals until the osteotomy
      healed. This study reviewed hospital and office records, preoperative and
      postoperative roentgenograms, and telephone interviews of all patients. An
      average femoral shortening of 3.7 cm was attained; significant complications such
      as deep infection or nonunion did not occur. These results suggest that closed
      intramedullary shortening of the femur produces excellent results in cases of
      adult anisomelia.

PMID- 2216545
TI  - Tips of the trade #27. Traction assembly for shoulder arthroscopy.
AB  - Arthroscopy of the shoulder is facilitated by applying traction to the affected
      extremity. A sturdy, easily-constructed, and versatile traction assembly is
      described.

PMID- 2216544
TI  - Imaging rounds #103. Myositis ossificans in association with congenital
      radioulnar synostosis and congenital anterior radial head dislocation.
AB  - Although the initial trauma was minimal in this unusual case of bilateral
      congenital radioulnar synostosis and anterior radial head dislocation associated
      with myositis ossificans, a progressive decrease in elbow ROM ensued.
      Manipulation under general anesthesia was performed to improve flexion and
      extension of the involved elbow. This manipulation most likely initiated or
      enhanced the process of myositis ossificans in the elbow. Final treatment
      consisted of reassurance and active ROM exercises, with resolution of symptoms.

PMID- 2216546
TI  - Pediatric update #14. Functional rating system for evaluating the results of
      clubfoot surgery.
AB  - The results obtained in a study of 32 patients with 45 idiopathic clubfoot
      deformities treated by complete soft-tissue release between 1985 and 1986 were
      investigated retrospectively. The evaluation was based on a specifically designed
      functional rating system. The results were graded as follows: 51% excellent, 25%
      good, 18% fair, and 6% poor.

PMID- 2216547
TI  - The real importance of vision/eye screening: "The road to hell is paved with good
      intentions".

PMID- 2216548
TI  - A pediatrician's view.

PMID- 2216549
TI  - Maternal and perinatal issues regarding HIV infection.
AB  - A review of the information available regarding maternal and fetal factors
      involved in both protection from and infection with HIV raises more questions
      than answers. Although providing prevention of HIV infection in women and infants
      is the ultimate goal, the recent increases in HIV seroprevalence among women of
      childbearing age gives little hope that this approach will have an effect in the
      near future. Early detection of HIV infection in pregnant women may provide the
      opportunity to counsel, provide routine obstetric care, and consider early
      therapeutic intervention with antiretroviral therapy and active or passive
      immunotherapy. Identification of HIV-infected infants before they are symptomatic
      is an equally important goal, as similar therapeutic options may be used.

PMID- 2216550
TI  - Organ system involvement in HIV-infected children.

PMID- 2216551
TI  - Pediatric HIV infection.

PMID- 2216552
TI  - Sports medicine.

PMID- 2216553
TI  - Psychology of the young athlete. Stress-related maladies and remedial approaches.
AB  - This article has presented a theoretical framework for understanding the stress
      process. The conceptual model of stress specifies relations among situational,
      cognitive, physiologic, and behavioral factors. Each of these basic components of
      the model is assumed to be influenced by personality and motivational variables.
      At the situational level, stress involves the balance or imbalance between
      situational demands and the resources available to deal with them. However, these
      situational factors affect the person primarily through the intervening influence
      of cognitive processes. Among the most important of these processes are appraisal
      of (1) the situational demands, (2) available personal and social resources, (3)
      the possible consequences of failure to meet the demands, and (4) the perceived
      meaning of the consequences. A reciprocal relation exists between cognitive and
      physiologic processes; the nature of the appraisals influences the level of
      physiologic arousal that is likely to occur, and arousal in turn influences the
      ongoing appraisal process through physiologic feedback mechanisms. Finally, the
      behavioral component of the model includes the person's learned behavior
      tendencies, task-relevant skills, and social skills. Personality and motivational
      individual difference variables are important; they influence the kinds of
      situations to which people expose themselves, how they appraise themselves and
      the situations, how they react physiologically, and how they customarily respond
      at the behavioral level. With respect to the consequences of stress, mounting
      evidence suggests that a significant number of young athletes experience adverse
      psychological, behavioral, and health-related effects. In fact, because of
      anticipated stresses, some children decline to participate in the first place.
      Competitive stress detracts from enjoyment of sports, causes performance
      impairment, and contributes significantly to the drop-out rate in youth sports.
      Evidence also indicates that competitive stress can cause loss of sleep and put
      youngsters at greater risk for sustaining athletic injuries. However, although
      extremely high levels of stress are experienced by a minority of young athletes,
      the level of stress elicited by youth sports is generally no greater than that
      found in other achievement-oriented activities in which children participate. The
      conceptual model of stress not only provides a framework for identifying sources
      of stress, but also suggests foci for intervention strategies designed to reduce
      stress in youth sports. In this article, consideration has been given to
      prominent situational demands that contribute to competitive stress and to
      various approaches for counteracting the stress-inducing factors. Specifically,
      measures may be instituted that decrease situational demands associated with
      winning and losing, organization and administration of sport programs, coaching
      roles and relationships, and parent roles and responsibilities.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2216554
TI  - Orthopedic preparticipation screening examination.
AB  - The primary care physician is often called upon to perform a medical examination
      before the patient may participate in athletic activities. The examination should
      identify congenital and acquired musculoskeletal problems and the residuals of
      previous musculoskeletal injuries. This article and its illustrations show the
      steps of an orthopedic preparticipation screening examination and indicate how
      some problems may be identified.

PMID- 2216555
TI  - Body composition in adolescent athletes.
AB  - This article has set out to provide basic knowledge about body composition in
      athletic and nonathletic adolescents and young adults and to provide the
      practicing physician with methods of making body composition assessment. We
      suggest the physician approach the adolescent athlete who requests information
      about body composition in the following way: 1. Calculate the ideal body weight.
      2. Estimate the percentage of body fat, realizing the errors associated with each
      method. If a body composition laboratory is available, use that equipment. In the
      absence of this equipment, we recommend the equations of Slaughter et al, given
      earlier. 3. The athlete should be given a range of percentage of body fat values
      measured in other athletes of the same gender and sport. Health and performance
      should be monitored as the athlete attempts to achieve or maintain body
      composition in this range. 4. If the athlete has an interest in altering body
      composition, then recommend the athlete seek the advice of a professional who has
      expertise in nutrition and physiology.

PMID- 2216556
TI  - Heat illness. Fluid and electrolyte issues for pediatric and adolescent athletes.
AB  - The primary mechanism for maintaining normal body temperature during physical
      exercise in the heat is the evaporation of sweat. With profuse sweating, water
      loss far exceeds electrolyte loss. Rigorous exercise in the heat places the
      athlete at risk for thermoregulatory dysfunction from dehydration. Because
      children are inherently less efficient thermoregulators than adults, they are at
      even greater risk for heat illness. The three primary syndromes of heat illness
      are heat cramps, heat exhaustion, and heat stroke. Treatment of heat illness is
      based on reduction of body temperature and rehydration. Heat stroke is a true
      medical emergency with a high mortality rate; immediate reduction of body
      temperature is critical to the survival of these patients. Prevention of heat
      illness is based on reducing known risk factors. Physical activity should be
      modified in the face of high ambient temperature and humidity. The athlete should
      begin exercise well hydrated; frequent consumption of cold water during exercise
      decreases likelihood of significant dehydration. After exercise, the athlete
      should continue drinking to replace fluid losses. Clothing should be lightweight;
      the more skin exposed, the greater the available evaporative surface. A preseason
      conditioning program, when combined with an 8- to 14-day period of
      acclimatization, further reduces the risk of heat injury. Although athletes
      engaged in endurance sports may benefit from drinking carbohydrate/electrolyte
      containing solutions, for the majority of young athletes, cold water remains the
      preferred choice for fluid replacement during exercise. The relatively greater
      body surface area of young athletes also places them at risk for hypothermia.
      Special attention should be given when these athletes are competing under cold
      environmental conditions.

PMID- 2216557
TI  - Anabolic steroid use in adolescent athletes.
AB  - Anabolic steroids are being used by adolescents largely to improve athletic
      performance but also to improve their appearance and to obtain peer approval.
      With the appropriate knowledge about the effects and side effects of anabolic
      steroids, primary care physicians can adequately educate teenagers, parents,
      teachers, and coaches about them and can screen for steroid use, if necessary.

PMID- 2216558
TI  - Amenorrhea, osteopenia, and the female athlete.
AB  - Athletic amenorrhea is a problem because it is associated with an increased risk
      of injuries and potentially an increased risk of osteoporosis in later life. This
      article gives suggestions for the evaluation of the athlete with amenorrhea and
      for treatment protocols. Primary care physicians should routinely screen female
      adolescent athletes for amenorrhea and, if athletic amenorrhea is present,
      initiate treatment or referral for treatment for this important problem with
      short- and long-term complications.

PMID- 2216559
TI  - Nutritional intake in adolescent athletes.
AB  - Nutrition plays a critical role in the success of the competitive adolescent
      athlete. Some groups have stricter nutrition requirements than others. The
      authors summarize nutrition intake data on serious female gymnasts, ballet
      dancers, and high-school cross-country runners. This article also discusses the
      nutritional needs of young male wrestlers and weightlifters.

PMID- 2216560
TI  - Iron deficiency in the young athlete.
AB  - Although overt anemia is uncommon, depletion of body iron stores is common among
      adolescent female athletes. Poor dietary iron intake, menstruation, and increased
      iron losses associated with physical training all appear to be important factors.
      Whether nonanemic iron deficiency can impair exercise performance is uncertain.
      Nonetheless, athletes with low ferritin levels are at risk for impaired
      erythropoiesis and should receive therapeutic iron supplementation.

PMID- 2216561
TI  - A review of the use of prophylactic knee braces in football.
AB  - A review of nine studies of prophylactic knee braces worn by players in American
      tackle football lends some support for the use of double-hinged braces at the
      high-school level. Evidence for their use at the college level seems less
      persuasive. Caution should be exercised in interpreting these studies owing to
      the probable presence of bias and confounding variables and to difficulty in
      generalizing results beyond the study populations. The two studies that assigned
      braces randomly found lower injury rates for knees and knee ligaments among high
      school and high-school size players. Conversely, a large, multiteam collegiate
      study found a significantly higher rate of knee injuries among brace users, a
      difference that remained when controlled for position, skill, and previous
      injury.

PMID- 2216562
TI  - Strength training in children and adolescents.
AB  - Strength is the ability to exert muscular force against resistance. It is a
      fundamental requirement of most daily physical activities of children and of
      adults. Strength training is the use of progressive resistance exercise methods
      specifically to increase strength. Strength training for children and adolescents
      is not without risk. Proven medical concerns relate to back, shoulder, and other
      joint injuries and to hypertension and related diseases. However, the rate of
      injury is probably rather low, comparable to many youthful activities that are
      considered safe. Also, the incidence and severity of injury can probably be
      minimized by adherence to the guidelines presented. Children may be expected to
      become stronger with appropriate training. Increased strength can enhance their
      performance in those athletic activities in which strength, power, or speed are
      required. It may reduce the incidence and severity of overuse injury in sport.
      However, it cannot reasonably be expected to protect against serious, acute
      injury in sport.

PMID- 2216563
TI  - The child dancer. Medical considerations.
AB  - Ballet training is associated with various injuries in children, most of them
      overuse injuries. Errors in technique and abrupt changes in training are the most
      frequent causes of injury. Forcing turn-out is the most common technique error.
      The author presents background information about ballet training to help primary
      care physicians treat dancers and advise their parents.

PMID- 2216564
TI  - Education: first to get called, first to get axed.

PMID- 2216565
TI  - Changing patterns in offering solids to infants.
AB  - Factors influencing changing patterns in introducing nonmilk foods (beikost) to
      infants are reviewed. Currently, developmental readiness based on individual
      needs is favored. Caregivers may receive conflicting advice from women who cared
      for infants when very early introduction of beikost was widely practiced.

PMID- 2216566
TI  - Formula feeding in the first year of life.
AB  - Over 60% of all infants in the United States are completely formula-fed by 2
      months of age. A nursing diagnosis framework can aid nurses in supporting and
      guiding parents who formula-feed their infants.

PMID- 2216568
TI  - Accurate assessment of infant emesis volume.
AB  - When infants vomit, hospital nurses sometimes record these volumes in ccs. Fluid
      replacement is often based on these estimates. A review of the literature
      indicates that this subjective assessment is highly problematic.

PMID- 2216567
TI  - Sleep disturbances of the infant and toddler.
AB  - Two common sleep disorders of the infant and toddler stages of development are
      sleeplessness and arousal disorders. Effective methods are available to reduce
      the impact of these problems upon the family.

PMID- 2216570
TI  - Pediatric emergency review: a "hands-on" approach.
AB  - A "hands-on" approach to pediatric emergency review was developed to improve
      retention of psychomotor skills and instill critical thinking for pediatric
      nurses in anticipation of pediatric emergency situations.

PMID- 2216569
TI  - Concerns of mothers of low birthweight infants.
AB  - To provide more comprehensive follow-up care for low birthweight infants, it is
      important for nurses to know what concerns mothers of these low birthweight
      infants commonly experience and how concerns change over time. This descriptive,
      longitudinal study followed 65 mothers of low birthweight infants from birth
      until the infant was 6 months adjusted gestational age. Most concerns were raised
      the week following birth (109) and after infant discharge (72), although from 40
      weeks (62) to 6 months (40), the number of concerns raised were fairly
      consistent. The largest category of concerns was health related (253).

PMID- 2216572
TI  - What is EPO?

PMID- 2216571
TI  - Parenting growing preterm infants.
AB  - A convenience sample of 24 parents of growing preterm infants reported concerns
      related to their preterms' health and development, parenting abilities, family
      relationships, and finances.

PMID- 2216573
TI  - Retrovir approved for use in children.

PMID- 2216574
TI  - Develop your thinking skills for improved test taking.

PMID- 2216575
TI  - Comparison of therapeutic touch and casual touch in stress reduction of
      hospitalized children.
AB  - PURPOSE: To compare the effectiveness of therapeutic touch and causal touch for
      stress reduction of hospitalized children aged 2 weeks to 2 years old.
      METHODOLOGY: Stress reduction was measured by pulse, peripheral skin temperature,
      and galvanic skin response as observed on the GSR-II biofeedback instrument.
      RESULTS: An ANOVA measured effectiveness of the interventions of causal touch and
      therapeutic touch at 3 and 6 minute intervals. The results demonstrated a
      significant difference with the critical value of F = 4.18 p less than .05. The
      computed value of F = 26.98 at 3 minutes and F = 26.94 at 6 minutes. CONCLUSION:
      Therapeutic touch reduced time needed to calm children after stressful
      experiences.

PMID- 2216577
TI  - The Family Support Act: a potential for promoting the development of poor
      children.

PMID- 2216578
TI  - Pediatric management problem. Hand-foot-and-mouth disease.

PMID- 2216576
TI  - Maintaining the artificial airway: current concepts.
AB  - Artificial airways are a common treatment modality in neonatal and pediatric
      critical care units. Maintaining the integrity of artificial airways in infants
      and children requires accurate assessment of endotracheal tube (ETT) position and
      patency, adequacy of oxygenation and ventilation, and the identification and
      treatment of potential complications.

PMID- 2216579
TI  - Using videorecordings in pediatric nursing practice.
AB  - This article explores the innovative uses of videorecordings in pediatric nursing
      practice. Social learning theory and primary nursing concepts provide the
      conceptual orientation. Creative uses of videorecordings include: enhanced family
      education; continuity of care through caregiver modeling and staff communication;
      audiovisual progress recording; and potential behavioral development in the
      pediatric client. Suggestions regarding technical aspects of videorecordings in
      the clinical area may facilitate videorecording application.

PMID- 2216581
TI  - Using time effectively.
AB  - Managing your own time effectively is perhaps one of the most challenging
      responsibilities a nurse manager faces. This article describes several strategies
      to assist in time management for busy nurse managers.

PMID- 2216580
TI  - Cardiovascular screening programs: implications for school nurses.
AB  - Programs directed toward the identification, prevention, and intervention of
      blood pressure variations in children and their implications for school nurses
      are detailed.

PMID- 2216582
TI  - Diagnostic value of ultrasound in children with recurrent abdominal pain.
AB  - In order to investigate the diagnostic value of ultrasound in children with
      recurrent abdominal pain and to estimate the clinical relevance of rare organic
      causes of abdominal pain in these patients, we prospectively examined 93 children
      aged between 5.5 and 12 years by means of abdominal ultrasound. In 3 patients
      (3.2%) an anatomic abnormality was detected, which could not account for the
      abdominal pain. We conclude that many organic abnormalities, that could be
      diagnosed by ultrasound, are clinically irrelevant as a cause of recurrent
      abdominal pain in children and therefore ultrasound does not significantly
      contribute to the diagnosis. However, ultrasound can still play a role in the
      work-up of children with recurrent abdominal pain in avoiding unnecessary
      radiologic X-ray procedures.

PMID- 2216583
TI  - Dopplersonographic classification of brain edema in infants.
AB  - 25 infants, 23 newborns and 2 older infants with B-mode sonographic evidence of
      cerebral edema (gestational age of the newborns 39.1 +/- 2.1 weeks, weight 3270
      +/- 672 g) were examined by means of pulsed Doppler sonography. Pulsed Doppler
      recordings were obtained in the anterior cerebral, internal carotid, basilar, and
      middle cerebral arteries. In all measured arteries the peak systolic peak
      endsystolic, peak enddiastolic and the time averaged mean velocities, as well as
      the resistance index and the pulsatility index were determined. In addition to
      the flow parameters the pH, pCO2, pO2, oxygen saturation and the blood pressure
      were measured. The flow velocities were compared with the normal values
      established by our group. Three different types of flow profiles and velocities
      could be found: Group 1: 12 infants had normal flow velocities. Group 2: 7
      infants showed increased diastolic flow velocities. Group 3: 6 infants
      demonstrated decreased diastolic flow velocities. There were no significant
      differences according to gestational age, weight, pH, pCO2, pO2, oxygen
      saturation and blood pressure in the three groups. The outcome of the 12 children
      in group 1 was favourable: normal development 10; minor retardation 2. In group 2
      only 1 child showed normal development; 2 infants had minor, 1 major handicaps; 2
      infants died. Patients in group 3 had the worst outcome: no patient developed
      normally; 4 infants died; 2 severely handicapped infants showed polycystic
      leucomalacia and brain atrophy; 1 infant had minor psychomotoric problems.

PMID- 2216585
TI  - Coronary artery calcification in Kawasaki disease.
AB  - To evaluate the angiographic features of coronary lesions in Kawasaki disease
      with coronary artery calcification, cinefluoroscopy and cineangiography were
      retrospectively reviewed in 116 patients who had undergone coronary angiography
      between 1982 and 1989. Angiographic abnormalities of coronary arteries were
      demonstrated in 55 of the 116 patients. In 5 (9.1%) of the 55 patients, 9 with
      calcification were identified by cinefluoroscopy and chest x-ray. Eight of the 9
      calcified lesions showed a circular or ring-shape configuration. Coronary
      angiography revealed a total occlusion of the right coronary artery with
      collateral circulation from the distal left coronary artery in 2 patients and a
      severe stenosis of the right coronary artery in 2 patients, in whom anticoagulant
      therapy had not been continued during the follow-up periods. The remaining
      patient in whom anticoagulant therapy had been continued had bilateral aneurysms
      but no significant stenosis. These results indicate that a ring-shape
      calcification on chest x-ray in a patient with a history of Kawasaki disease may
      suggest an involvement by coronary artery stenosis even when anticoagulant drugs
      had been given. Therefore, coronary angiography should be performed to evaluate
      the stenotic lesions if this type of calcification is found by routine
      radiographic examination.

PMID- 2216584
TI  - Comparison of plain and Gd-DTPA-enhanced MR-imaging in children.
AB  - 40 children and adolescents (aged 1-16 years) were examined by MRI at 1.0 T. Gd
      DTPA was given intravenously at a dose of 0.1 mmol/kg body weight. In all cases
      T1-weighted SE sequences were used to demonstrate contrast enhancement. No
      adverse effects were seen. 30 patients had one or more lesions; in 20 patients
      contrast enhancement was seen. In 4 cases lesions were not observed by plain MRI
      and could only be detected after Gd-DTPA. In addition, contrast enhancement
      provided additional information about the differentiation of lesion from edema or
      necrosis in 13 patients. Normal brain matter did not show any changes in signal
      intensity. However, an age-dependent signal increase was found in the normal
      vertebral bone marrow in all children. Gd-DTPA should be used as a supplementary
      examination whenever a tumor or an infectious disease of the CNS is suspected and
      plain MRI is normal, or when origin and extent of a lesion cannot be adequately
      defined with plain MRI.

PMID- 2216586
TI  - Esophageal perforation with mediastinal abscess in child abuse.
AB  - A case of mediastinitis and mediastinal abscess due to cervical esophageal
      perforation in a 9/12 month old girl who was a victim of child abuse and possible
      sexual assault is reported. Injury to the hypopharynx or esophagus with child
      abuse as a possible etiology should be considered when an infant or young child
      presents with unexplained erythematous neck swelling, subcutaneous emphysema,
      pneumomediastinum and/or wide mediastinum.

PMID- 2216587
TI  - Gastric trichobezoars--sonographic and computed tomographic appearance.
AB  - We report two young girls with gastric trichobezoars in whom ultrasound, computed
      tomography and upper gastrointestinal contrast studies were done. Since
      sonography and, less frequently, computed tomography are usually the first
      studies obtained in a child with an abdominal mass it is important to recognize
      the rather distinctive appearance of a trichobezoar on these images.

PMID- 2216589
TI  - MR imaging of pancreas in cystic fibrosis.
AB  - The pancreatic regions of 18 patients with cystic fibrosis were analyzed with a
      1.5 Tesla MR unit. Signal intensity of the pancreas was correlated with clinical
      data and ultrasound. A hyperintense pancreas on T1-weighted image was consistent
      with fatty replacement of pancreatic insufficiency. A pancreas of normal soft
      tissue intensity was found in two asymptomatic and one symptomatic patient. A
      very hypointense pancreas on any pulse sequence was considered to be an
      intermediate stage of pancreatic degeneration.

PMID- 2216590
TI  - Urinoma formation in posterior urethral valves: relationship to later renal
      function.
AB  - A retrospective analysis of radiologically determined individual renal function
      was performed in five boys who presented in the neonatal period with posterior
      urethral valves, vesicoureteral reflux and documented urinoma formation. Renal
      function was evaluated with scintigraphy. There was reflux in eight of ten
      ureters. Six of these ureters had an associated urinoma and compromised renal
      function in the neonatal period. In two of the boys the kidney with urinoma
      functioned better than the contralateral kidney with reflux alone. In two other
      boys with unilateral urinoma the contralateral ureter did not reflux and the
      affected kidney functioned less well. In follow up (20 to 36 months) seven of the
      ten kidneys have a near normal appearance or function. Those kidneys which are
      now abnormal were noted to be abnormal in the neonatal period.

PMID- 2216588
TI  - Foetal hepatic calcification.
AB  - Thirty-three cases of 1,500 spontaneously-aborted foetuses showed hepatic
      calcifications. The exact location of these calcifications were confirmed by
      contrast studies, anatomic dissection, and further histology when necessary. Of
      them, 18 were calcified hepatic vein thrombi (CHVT), 12 were calcified portal
      vein thrombi (CPVT), 2 were parenchymal calcifications, and one was mixed.
      Associated anomalies were high (85% of cases). No significant difference was
      found between the type and percentage of anomalies of those with CHVT and those
      with CPVT. The most common anomalies encountered in all cases were meconium
      intraluminal calcification (27%), cystic hygroma (18%), and metaphyseal defect
      (18%). In view of this, it is suggested that a variety of severe foetal illnesses
      predispose to CHVT and CPVT. At correlation with maternal factors, it was found
      that the highest incidence was in the third decade. A significant high percentage
      of mothers (33%) had been on contraceptive pills, and there was interesting
      inverse relationship of hepatic calcification with gravidity. Practically, it is
      also hoped that the awareness of the presence of various types of hepatic
      calcifications will help in their detection prenatally by ultrasound.

PMID- 2216591
TI  - Eosinophilic granuloma of the temporal bone: radiological approach in the
      pediatric patient.
AB  - Eosinophilic granuloma is one of the three clinical variants of Histiocytosis-X
      (eosinophilic granuloma, Hand-Schuller-Christian and Letterer-Siwe disease).
      Involvement of the temporal bone is relatively rare and initially silent.
      However, it can erode the mastoid cortex, destroy the tegmen and extend into the
      cranial vault, as well as erode the semicircular canals or cochlea. It usually
      presents as an aural polyp or postauricular swelling. Chronic otorrhea is what
      brings the patient to the ORL-Clinic. It is frequently confused with infectious
      diseases or neoplastic conditions of the temporal bone. In this paper we report 6
      cases of eosinophilic granuloma in the temporal bone, discuss the plain
      radiological and CT findings and review the literature.

PMID- 2216592
TI  - MR and ultrasound findings in a case of cerebro-oculo-muscular-syndrome.
AB  - We report on a boy with type II lissencephaly and congenital muscular dystrophy.
      The patient presented with the features of a cerebro-oculo-muscular syndrome
      (COMS). We describe the clinical presentations and the characteristic sonographic
      and MR findings.

PMID- 2216593
TI  - MRI of mediastinal cavernous hemangioma.
AB  - A cavernous hemangioma of the anterior mediastinum was studied by CT and MRI. CT
      did not give the diagnosis of the vascular tumor but MRI demonstrated the
      morphology of the vascular tumor. MRI is very useful for detecting a vascular
      tumor in the mediastinum.

PMID- 2216594
TI  - CT of an actively-hemorrhaging liver laceration in a 9-year-old child.
AB  - A 9-year-old female with blunt abdominal trauma following a motor vehicle
      accident was referred from the Emergency Room for abdominal CT imaging. CT
      demonstrated the unusual and heretofore unreported finding of an actively
      hemorrhaging liver laceration.

PMID- 2216595
TI  - Pseudoascites: unusual presentation of omental cyst.
AB  - An unusual case of omental cyst is described. The child initially presented with
      a unilocular intraperitoneal fluid collection on CT. After paracentesis, CT
      showed freely layering peritoneal fluid, with eventual complete resolution of
      fluid. CT eight months later demonstrated re-appearance of a multi-septated
      cystic mass. At surgery, an omental cyst was found.

PMID- 2216596
TI  - Rhabdoid tumor of the kidney presenting as an abdominal mass in a newborn.
AB  - Rhabdoid tumor of the kidney is a highly malignant tumor seen in the neonatal
      population with a characteristic clinical course. There are no known radiologic
      features to differentiate rhabdoid tumor of the kidney from other renal tumors;
      however, this report presents a newborn infant with rhabdoid tumor of the kidney
      who had a normal prenatal ultrasound at ten days prior to birth, followed by an
      abnormal prenatal ultrasound one day prior to birth. Observation of such a rapid
      development of a tumor in the kidney in a fetus or an infant should raise the
      possibility of a highly malignant tumor such as a rhabdoid tumor.

PMID- 2216597
TI  - Unusual radiographic presentation of IgA nephropathy.
AB  - An adolescent male presented with hematuria and flank pain. Transient focal renal
      parenchymal defects were demonstrated by ultrasonography, radionuclide
      scintigraphy and computed tomography. Renal biopsy revealed IgA nephropathy with
      acute tubular necrosis. This peculiar radiographic pattern has not, to our
      knowledge, been previously described in IgA nephropathy and may relate to tubule
      cell damage by red blood cell casts or patchy renal ischemia.

PMID- 2216598
TI  - Sonographically detected costo-chondral dislocation in an abused child. A new
      sonographic sign to the radiological spectrum of child abuse.
AB  - A case of an abused child with fractures of the skull, ribs and long bones is
      presented. Sonographically a costochondral dislocation of the left lower ribs was
      detected, which has not been reported in the literature.

PMID- 2216599
TI  - The Hajdu-Cheney syndrome: a case report and review of the literature.
AB  - Hajdu-Cheney syndrome which is also known as type VI idiopathic osteolysis is a
      rare disease transmitted autosomal dominantly. In this syndrome, osteolysis
      involves primarily the terminal phalanges. We describe here a 18-year-old boy
      with typical clinical and radiological signs of Hajdu-Cheney syndrome.

PMID- 2216601
TI  - Physeal and epiphyseal involvement in chronic recurrent multifocal osteomyelitis
      (CRMO)

PMID- 2216600
TI  - Intrauterine dwarfism, peculiar facies and thin bones with multiple fractures--a
      new syndrome.

PMID- 2216602
TI  - IGG subclass deficiency: fact or fiction? Proceedings of a workshop. Sydney, New
      Wales, Australia.

PMID- 2216603
TI  - IgG subclass distribution of antibodies to bacterial and viral antigens.

PMID- 2216604
TI  - T cell regulation of immunoglobulin isotypes in health and disease.

PMID- 2216605
TI  - IgG subclass deficiency: a personal viewpoint.

PMID- 2216606
TI  - IgG subclass concentrations in absolute, partial and transient IgA deficiency in
      childhood.
AB  - Sixty-seven children with symptomatic IgA deficiency were studied on two separate
      occasions. Eighteen had aIgAd at presentation, and 49 had pIgAd. IgA
      concentrations had risen to the normal range for age in 22.2% of children
      presenting with aIgAd and 77.6% presenting with pIgAd when restudied at a median
      interval of 3.2 and 3.0 years, respectively. IgG subclass concentrations were
      measured by enzyme immunoassay in serum samples collected at enrollment from 12
      children with aIgAd and 22 children with pIgAd. IgG2 and IgG4 concentrations for
      these 34 children were below the 5th centile for age and sex more frequently than
      expected (IgG2: chi square 5.8, P less than 0.025; IgG 4: chi square 18.4, P less
      than 0.0005). The prevalence of IgG2 deficiency or IgG4 deficiency did not differ
      significantly between those with aIgAd and those with pIgAd. IgG2 concentrations
      remained below the 5th centile more frequently than expected when retested in 31
      children whose pIgAd had resolved (chi square 4.6, P less than 0.05). Children
      with aIgAd at presentation had IgG1 and IgG2 concentrations above the 95th
      centile more frequently than expected (IgG1: chi square 19.7, P less than 0.0005;
      IgG2: chi square 13.5, P less than 0.001) but this was not seen for IgG3 and IgG4
      concentrations. Children with pIgAd did not have elevated IgG1 or IgG2
      concentrations at presentation. High IgG1 and IgG2 concentrations in aIgAd may be
      a compensatory mechanism to afford protection from infection or could be part of
      a selective secondary response to repeated episodes of infection.

PMID- 2216607
TI  - IgG subclasses in acquired immunodeficiency.

PMID- 2216608
TI  - Immunoglobulin subclass abnormalities in patients with chronic fatigue syndrome.

PMID- 2216609
TI  - Aspects of immunoglobulin replacement therapy.
AB  - Immunoglobulin replacement therapy appears to benefit some patients who have IgG
      subclass deficiencies. Because some patients with subnormal trough concentrations
      of IgG subclasses remain well, because other patients who have borderline/low
      normal concentrations of an IgG subclass are abnormally infection-prone and
      helped by immunoglobulin therapy and because infection proneness in individual
      patients does not always appear to parallel their IgG subclass concentrations, it
      is evident that IgG subclass concentrations, while a helpful guide, are not an
      absolute determinant of the need for immunoglobulin replacement therapy in
      infection-prone patients. Low IgG subclass concentrations may indicate impaired
      ability to produce certain "specific" antibodies and antibody replacement is
      likely to be the crucial factor in treatment rather than merely maintaining
      concentrations of IgG subclasses at particular levels.

PMID- 2216610
TI  - Percentile ranges for IgG subclass concentrations in healthy Australian children.

PMID- 2216611
TI  - Initial evaluation of heart murmurs: are laboratory tests necessary?
AB  - Heart murmurs, most of them innocent, are the most common reason for referrals to
      a pediatric cardiologist. In the evaluation of murmurs, the electrocardiogram and
      echocardiogram are often included. The purpose of this study was to determine the
      utility of these examinations in the initial assessment of heart murmurs in
      children and adolescents. In a prospective series of 161 patients, the clinical
      diagnosis of heart murmurs by a pediatric cardiologist was compared with that
      obtained after electrocardiogram and echocardiogram (two-dimensional, M-mode,
      Doppler, and color-Doppler). On the basis of the clinical diagnosis the patients
      were classified as having "innocent murmur," "pathologic murmur," or "possible
      pathologic murmur." A total of 161 patients (51% males), aged 1 month to 17 years
      (median 3.2 years), were studied. After electrocardiogram, no diagnosis was
      changed. After echocardiogram, the clinical diagnosis of innocent murmur in 109
      patients changed in 2 to pathologic (small ventricular septal defect 1, small
      atrial septal defect 1); pathologic murmur in 46 changed to innocent in 3 and
      possible pathologic in 2; and possible pathologic in 6 changed to innocent in 3
      and to pathologic in 2. The clinical examination by an experienced pediatric
      cardiologist is an accurate means of assessing newly referred patients with
      murmurs. The clinical examination had a sensitivity of 96%, specificity of 95%,
      positive predictive value of 88%, and negative predictive value of 98%. The
      electrocardiogram, unlikely to disclose any unsuspected heart disease, may assist
      in reaching the lesion-specific diagnosis when there is underlying pathology.
      Echocardiography, although diagnostic when heart disease is suspected, is
      unnecessary in pediatric patients with clinically diagnosed innocent heart
      murmurs.

PMID- 2216612
TI  - Phenobarbital and cerebral blood flow during hypertension in the newborn beagle.
AB  - Phenobarbital sodium has been used in anticonvulsant concentrations (15 to 40
      micrograms/mL serum) in premature newborns in attempts to prevent periventricular
      and intraventricular hemorrhages. Although its clinical usefulness in this regard
      is controversial, phenobarbital treatment has been shown to reduce
      periventricular and intraventricular hemorrhages after hypertensive insult in
      newborn beagles. In this study cerebral blood flow values in steady state and
      during phenylephrine-induced hypertension with and without phenobarbital
      pretreatment were measured in newborn beagles. At anticonvulsant dosage,
      phenobarbital sodium decreased mean arterial blood pressure transiently during
      steady state and significantly reduced total cerebral blood flow during
      phenylephrine-induced hypertension without reducing mean arterial blood pressure.
      This phenobarbital sodium effect on cerebral blood flow was not as great in the
      presence of acidosis, and the initial hypotensive effect of phenobarbital sodium
      was sustained for a longer period of time during acidosis. Phenobarbital sodium
      may reduce the incidence of hemorrhages in the newborn brain by providing
      protection against isolated hemodynamic stresses characterized by acute increases
      in cerebral blood flow, with or without increased mean arterial blood pressure.

PMID- 2216613
TI  - Nebulized albuterol in acute childhood asthma: comparison of two doses.
AB  - Thirty-three children and adolescents from 5 to 17 years of age with moderate to
      severe acute asthma were given nebulized albuterol therapy in either a high (0.30
      mg/kg body weight) or standard (0.15 mg/kg) dose administered at three hourly
      intervals in a randomized double-blind study. The high-dose hourly regimen
      resulted in significantly greater improvement in the forced expiratory volume in
      1 second (FEV1). Furthermore, patients receiving the high dose showed a steady
      improvement in the FEV1 from the start to the end of the study, whereas FEV1
      plateaued after the second dose in the standard-dose group. Although a rise in
      heart rate and a fall in serum potassium level occurred, neither of these changes
      nor other side effects were different in the two groups. The high-dose therapy
      resulted in much higher serum albuterol levels than the standard dose. There was
      no correlation between the drug levels and side effects or initial and subsequent
      FEV1. It is concluded that occasional hourly high-dose albuterol therapy should
      be considered for some pediatric patients with acute asthma of moderate severity,
      especially those who relapse between doses.

PMID- 2216614
TI  - The UCLA-University of Utah epidemiologic survey of autism: prenatal, perinatal,
      and postnatal factors.
AB  - In a recent epidemiologic survey conducted in Utah, 241 autistic patients (DSM
      III criteria) were found. Medical records of 233 autistics were surveyed for the
      presence of 36 potentially pathologic prenatal, perinatal, and postnatal factors.
      These results were compared with those of an identical survey of 62 of their
      nonautistic siblings, with the results of four previously published surveys, and
      with normative data. No potentially pathologic factor or group of factors
      occurred significantly more frequently among the autistic patients. Also,
      previous observations of significant differences in the occurrence of certain
      factors in the histories single vs multiple siblings with autism were not
      confirmed, with the exception of increased viral-type illness during gestation in
      single-incidence cases. Thus, the etiology of the brain pathology that
      characteristically disrupts normal development and produces the syndrome of
      autism remains obscure. Other data from the epidemiologic survey, however,
      suggest that the role of genetic factors needs to be explored further.

PMID- 2216615
TI  - Intake and food sources of dietary fat among schoolchildren in The Woodlands,
      Texas.
AB  - To investigate the nutrient intake and food use patterns among schoolchildren,
      diet was assessed among 138 children and adolescents in grades 5 through 12 using
      three random, nonconsecutive, 1-day food records. Mean intake of total fat,
      saturated fat, and polyunsaturated fat as percent of calories was 35.6%, 13.4%,
      and 6.6%, respectively. Among all subjects, 17% consumed diets containing less
      than 30% of calories from fat, 34% consumed greater than or equal to 38% of
      calories from fat, 7% consumed less than 10% of calories from saturated fatty
      acids, and greater than 97% ate less than 300 mg of cholesterol per day. While
      intake of calories, sodium, and beta-carotene per 1000 kcal was higher in
      subjects consuming higher fat diets, intake of other micronutrients was either
      higher among those eating low-fat diets or did not differ by level of fat intake.
      Differences were seen in the amount of saturated fat and cholesterol that
      individual food sources contributed to the diets of subjects eating high and low
      fat diets. These cross-sectional data show that a substantial proportion of
      children and adolescents in this population are consuming diets low in fat and
      cholesterol without systematic differences in intake of other nutrients,
      suggesting that current dietary guidelines regarding fat intake are attainable
      within the current food use pattern of healthy, school-aged children and
      adolescents.

PMID- 2216616
TI  - Safety and immunogenicity of Haemophilus influenzae type b oligosaccharide-CRM197
      conjugate vaccine in infants aged 15 to 23 months.
AB  - A total of 268 infants aged 15 to 23 months received one dose of a vaccine
      composed of Haemophilus influenzae type b oligosaccharides covalently linked to
      the nontoxic diphtheria toxin variant CRM197 (HbOC; HibTITER). Side effects
      associated with vaccination were infrequent, transient, and mild. One month after
      a single vaccination, the anti-H influenzae type b capsular polysaccharide
      antibody concentration rose from a geometric mean prevaccination level of 0.20
      microgram/mL to 13.77 micrograms/mL. Of these infants, 99% had a postvaccination
      level greater than or equal to 1.00 microgram/mL, a level associated with long
      term protection. The immune response was long-lived: all of the children who were
      monitored 17 to 27 months after vaccination had concentrations greater than or
      equal to 1.00 microgram/mL. The anti-H influenzae type b capsular polysaccharide
      antibody generated was predominantly of the IgG isotype and IgG1 subclass. The
      immune sera had bactericidal activity in vitro and conferred passive protection
      in the infant rat meningitis model.

PMID- 2216617
TI  - Dietary protein source and plasma lipid profiles of infants.

PMID- 2216618
TI  - Chronic fetal hypoxia and sudden infant death syndrome: interaction between
      maternal smoking and low hematocrit during pregnancy.
AB  - To investigate the hypothesis that chronic fetal hypoxia contributes to the
      etiology of sudden infant death syndrome (SIDS), a possible interaction between
      the effect of maternal cigarette smoking and low hematocrit during pregnancy on
      the risk of SIDS was studied using the US Collaborative Perinatal Project cohort.
      The 193 SIDS cases identified in the cohort were analyzed with 1930 controls
      randomly selected from infants who survived the first year of life. After
      adjustment for maternal age, infants born to mothers who smoked 10 or more
      cigarettes per day and who were anemic (hematocrit less than 30%) during
      pregnancy were at a much higher risk of SIDS than infants born to mothers who did
      not smoke and were not anemic (odds ratio = 4.0; 95% confidence limits, 2.1 and
      7.4). Smoking 10 or more cigarettes per day vs none increased the risk of SIDS by
      70% among women with hematocrit at or above 30% but increased risk threefold
      among women with hematocrit below 30%. After adjustment for more potential
      confounders in a logistic regression model, the effect of smoking on SIDS
      continued to increase with lower levels of hematocrit during pregnancy. Birth
      weight accounted for very little of these associations. Low hematocrit was not a
      risk factor for SIDS among nonsmokers but became an important predictor among
      heavy smokers. These findings are in agreement with the hypothesis that chronic
      fetal hypoxia may predispose to SIDS, possibly by impairing the normal
      development of the fetal central nervous system.

PMID- 2216619
TI  - Early solid feeding and recurrent childhood eczema: a 10-year longitudinal study.
AB  - The relationship between early solid feeding practices and risks of recurrent or
      chronic eczema in childhood was examined in a birth cohort of New Zealand
      children studied to the age of 10. By the age of 10 years, 7.5% of children had
      chronic or recurrent eczema. There were clear and consistent associations between
      the diversity of the child's diet during the first 4 months and risks of eczema.
      Even when due allowance was made for a range of confounding factors--including
      parental atopic illness, atopic illness in siblings, the child's early milk diet,
      and family social background--children exposed to four or more different types of
      solid food before 4 months had risks of recurrent or chronic eczema that were 2.9
      times those of children who were not exposed to early solid feeding. It is
      concluded that early exposure to a diet diverse in potential food antigens may
      act to predispose susceptible children to recurrent or chronic childhood eczema.

PMID- 2216620
TI  - Substance abuse education in pediatrics.
AB  - Historically, physicians have received little formal education related to alcohol
      or other drug abuse and dependence. A survey of all pediatric programs in the
      United States was conducted to assess the current status of alcohol/drug
      education in pediatrics. At the medical student and residency training levels,
      only 44% and 40% of programs, respectively, required any formal instruction, and
      only 27% and 34%, respectively, offered an elective for medical students or
      residents. Although most respondents endorsed the inclusion of both required and
      elective alcohol and drug education in the curriculum, few programs that did not
      include it already had a future plan for it. Major impediments identified were
      curriculum time constraints (86% medical student level, 68% resident level) and
      the lack of a qualified instructor (55% medical student level, 50% resident
      level). The survey results suggest a strong need for development of faculty and
      structured alcohol and drug abuse educational plans specific to pediatrics.

PMID- 2216621
TI  - Open lung biopsy in the critically ill newborn.
AB  - Experience with 17 open lung biopsies in critically ill premature neonates was
      reviewed. Despite their small size, prematurity, and near maximal ventilator
      requirements, the infants suffered no significant complications. In three cases,
      an infectious agent was identified. In one case end-stage lung fibrosis
      associated with persistent (greater than 3 months), severe respiratory failure
      prompted termination of support. In the remainder of the cases, definitively
      ruling out infection allowed the confident trial of a course of steroids in an
      attempt to treat bronchopulmonary dysplasia. Unlike older patients, the
      definitive diagnosis of no infection in the premature neonate is just as
      informative as the diagnosis of an infection. Used judiciously, open lung biopsy
      can be performed in the premature infant with acceptable morbidity and mortality.

PMID- 2216622
TI  - Single- versus multiple-dose surfactant replacement therapy in neonates of 30 to
      36 weeks' gestation with respiratory distress syndrome.
AB  - To assess the efficacy of a multiple-dose protocol of surfactant replacement
      therapy in neonates of 30 to 36 weeks' gestation, 75 neonates were randomly
      assigned to control, single-dose surfactant, or multiple-dose surfactant groups.
      Neonates at less than 6 hours of age with a diagnosis of respiratory distress
      syndrome were eligible. Subjects were randomly assigned to receive either 100
      mg/kg of bovine surfactant or air placebo. Neonates in the multiple-dose group
      were eligible to receive up to three additional doses as indicated. Neonates in
      both surfactant groups showed a positive response to treatment, with marked
      improvement in oxygenation by 10 minutes postinstillation (P less than .0001).
      Both surfactant groups had better oxygenation than control subjects at lower
      ventilatory parameters over the first 24 hours. A deterioration in oxygenation
      and ventilatory requirements was seen in both treatment groups starting 6 to 12
      hours after the first dose. The deterioration in oxygenation could be minimized
      by the use of multiple doses; however, extra doses had no effect on diminishing
      ventilatory requirements or time to extubation. It is concluded that surfactant
      therapy at less than 6 hours of age is effective in acutely reducing oxygen and
      ventilatory requirements in neonates of 30 to 36 weeks' gestation with
      respiratory distress syndrome. It appears that multiple doses of surfactant have
      a greater effect on sustaining improvements in oxygenation than on ventilatory
      requirements. Further study is required to determine optimal dosage and
      retreatment strategy.

PMID- 2216623
TI  - Vancomycin-induced red man syndrome.
AB  - A total of 11 cases of red man syndrome collected among 650 children who had
      received vancomycin in our hospital between 1986 and 1988 (estimated prevalence
      1.6%) were retrospectively analyzed. These 11 children were compared with 11 age
      matched children who received vancomycin in whom red man syndrome did not
      develop. Of the patients with red man syndrome, 73%, and of the patients with no
      reaction, 45.4% received vancomycin for penicillin-resistant Staphylococcus
      epidermidis-positive cultures, or because of history of penicillin allergy. No
      difference was observed in the dose per kilogram given to both groups (12.9 +/-
      3.5 mg/kg per dose in those with red man syndrome vs 12.3 +/- 6.9 mg/kg per dose
      in control children. The duration (mean +/- standard deviation) of vancomycin
      infusion was 45.9 +/- 16.7 minutes (range 10 to 90 minutes) in patients with red
      man syndrome and 54.5 +/- 7.6 minutes (range 45 to 65 minutes) in the control
      group (P = .07). In the 5 children with red man syndrome rechallenged with
      vancomycin, slower infusion rates prevented or reduced the syndrome, which
      emphasized the fact that the rate of administration is the important determinant
      of red man syndrome in susceptible cases. Clinically, the syndrome developed at
      the end of the infusion in most patients, but appeared as early as 15 minutes
      after initiation of the infusion. It was mostly manifested as a flushed,
      erythematous rash on the face, neck, and around the ears. Less frequently, the
      rash was distributed all over the body. Pruritus was usually localized to the
      upper trunk but was also generalized (2 of 11 children).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2216624
TI  - Serial Munchausen syndrome by proxy.
AB  - Five cases of Munchausen syndrome by proxy (MSBP) are presented in which more
      than one child in the family was victimized. There was a high incidence of
      maternal psychiatric histories, marital difficulties, and Munchhausen syndrome in
      the mothers themselves. Seventy-one percent of the children in the families were
      known to be victims of MSBP; four of these children (31%) died. Multiple-child
      MSBP may reflect more significant maternal psychopathology than found in other
      cases of MSBP, or it may indicate the deteriorating consequences to the mother
      and other children in the family if this syndrome is not identified with the
      first child and effective interventions made.

PMID- 2216625
TI  - Outcome and predictors of outcome in pediatric submersion victims receiving
      prehospital care in King County, Washington.
AB  - Predictors of outcome in pediatric submersion victims treated by Seattle and King
      County's prehospital emergency services were studied. Victims less than 20 years
      old were identified from hospital admissions and paramedic and medical examiners'
      reports. The proportion of fatal or severe outcomes in patients were compared
      with various risk factors. Of 135 patients, 45 died and 5 had severe neurologic
      impairment. A subset of 38 victims found in cardiopulmonary arrest had a 32%
      survival rate, with 67% of survivors unimpaired or only mildly impaired. The two
      risk factors that occurred most commonly in victims who died or were severely
      impaired were submersion duration greater than 9 minutes (28 patients) and
      cardiopulmonary resuscitation duration longer than 25 minutes (20 patients). Both
      factors were ascertained in the prehospital phase of care. Submersion duration
      was associated with a steadily increasing risk of severe or fatal outcomes: 10%
      risk (7/67) for 0 to 5 minutes, 56% risk (5/9) for 6 to 9 minutes, 88% risk
      (21/25) for 10 to 25 minutes, 100% risk (4/4) for greater than 25 minutes. None
      of 20 children receiving greater than 25 minutes of cardiopulmonary resuscitation
      escaped death or severe neurologic impairment. Our rates for saving all victims,
      particularly victims in cardiopulmonary arrest, are considerably higher than has
      been reported before the children. Prompt prehospital advanced cardiac life
      support is the most effective means of medical intervention for the pediatric
      submersion victim. Prehospital information provided the most valuable predictors
      of outcome.

PMID- 2216626
TI  - Successful renal transplantation accelerates development in young uremic
      children.
AB  - To examine the impact of renal transplantation on subsequent development of
      children with chronic renal failure, 37 children undergoing primary renal
      transplantation at or before 30 months of age whose allograft functioned for at
      least 1 year were prospectively studied. Psychometric tests were performed an
      average of 4 months before transplantation; reevaluation was done an average of
      14 months after surgery. Comparison of individual pretransplantation and
      posttransplantation mental development scores in 33 patients, assessed by either
      Bayley Mental Development Index or Stanford-Binet Intelligence Quotient, revealed
      an average increase of 12.6 (P less than .001). After transplantation, there was
      a significant improvement in mental performance in 12 of 18 patients (P less than
      .02) from the range of mild delay (Mental Development Index or Stanford-Binet IQ
      score = 50 to 69) to the range of normal mental development (greater than or
      equal to 70). The Bayley Psychomotor Development Index scores were frequently
      lower than Mental Development Index scores and also increased an average of 14.4
      (P less than .01) after transplantation in all 12 patients with paired data.
      Significant individual improvement in occipital-frontal circumference standard
      deviation score (P less than .001) was noted in 24 children after
      transplantation. It is concluded that successful renal transplantation in young
      children with chronic renal failure is often associated with significant
      improvements in cognitive and psychomotor function, as well as improved cephalic
      growth.

PMID- 2216627
TI  - Exposure to a chloride-deficient formula during infancy: outcome at ages 9 and 10
      years.
AB  - A school-based survey of the 1978 to 1979 birth cohort of two metropolitan
      Washington, DC, counties was conducted to find children who had been exposed to
      the chloride-deficient formulas Neo-Mull-Soy and Cho-Free during infancy.
      Children who had ingested other soy formulas that had an adequate chloride
      content were also found and matched to the exposed children by sex, race, birth
      weight, the age of the child, the mixed feeding status of the child, and maternal
      education. One hundred seventy-one of the exposed children and 261 soy control
      children were given a battery of psychologic tests in their homes to determine
      whether there had been any effect on intellectual development as a result of
      exposure to the chloride-deficient formulas. There were no differences in scores
      between the groups on the Wechsler Intelligence Scale for Children-Revised, the
      Boston Naming Test, the Rey-Osterrieth Test, or the FAS Verbal Fluency Test.
      There was no correlation between duration of exclusive exposure to the chloride
      deficient formulas and the Wechsler Intelligence Scale for Children-Revised Full
      Scale IQ Score (Pearson product-moment r = -.0825, P = .28). These results cannot
      be extrapolated to exposed children with documented hypochloremic metabolic
      alkalosis. It is concluded that in children without documented evidence of
      hypochloremic metabolic alkalosis, exposure to the chloride-deficient formulas
      Neo-Mull-Soy or Cho-Free during infancy has not resulted in any long-term adverse
      effects on cognitive development.

PMID- 2216628
TI  - Febrile status epilepticus.
AB  - As part of a study of status epilepticus in children (Maytal J, Shinnar S, Moshe
      SL, Alvarez LA. Pediatrics. 1989; 83:323-331); 44 children with febrile
      convulsions lasting more than 30 minutes were followed for a mean of 28 months
      (range 4 to 72). Thirty children were followed prospectively. Children with prior
      afebrile seizures or evidence of acute central nervous system infection were
      excluded. Nine (20%) children had prior neurological deficits. The duration of
      the febrile seizure was 0.5 to 1 hour in 41 cases (85%), 1 to 2 hours in 5 (10%),
      and greater than 2 hours in 2 children (5%). No child died or developed new
      neurological deficits following the seizures. The risk of recurrent seizures was
      increased, but only in the group with prior neurological abnormality. Six (66%)
      of these children had subsequent febrile seizures compared with 12 (34%) of the
      normal children (P = .08). Three (33%) had recurrent febrile status epilepticus
      compared with only 1 (3%) normal child (P = .023). The 2 children in the
      prospective arm of the study with recurrent febrile status epilepticus were both
      neurologically abnormal (P = .035). All 3 of the children who subsequently had
      afebrile seizures (2 prospective) were neurologically abnormal (P = .006 overall,
      P = .035 for prospective only). It is concluded that the occurrence of febrile
      status epilepticus in a neurologically impaired child is a risk factor for
      subsequent febrile as well as afebrile seizures. The occurrence of febrile status
      epilepticus in an otherwise normal child does not significantly increase the risk
      for subsequent febrile (brief or prolonged) or afebrile seizures in the first few
      years following the episode.

PMID- 2216630
TI  - Real-time ultrasound and color-Doppler imaging in pulmonary sequestration.

PMID- 2216629
TI  - Haemophilus influenzae type b polysaccharide-diphtheria toxoid conjugate vaccine
      in vaccinated children who developed Haemophilus disease.

PMID- 2216631
TI  - Just say no! Drugs and febrile seizures.

PMID- 2216632
TI  - Prehospital care for victims of submersion.

PMID- 2216634
TI  - American Academy of Pediatrics Committee on Children with Disabilities and
      Committee on School Health: Children with health impairments in schools.

PMID- 2216633
TI  - Improving access to health care for children, youth, and pregnant women.

PMID- 2216635
TI  - American Academy of Pediatrics Committee on Substance Abuse: Drug-exposed
      infants.

PMID- 2216636
TI  - American Academy of Pediatrics Committee on Nutrition: Practical significance of
      lactose intolerance in children: supplement.

PMID- 2216637
TI  - Sex-specific dysanapsis and the effect of passive smoking among asthmatics.

PMID- 2216638
TI  - Clofibrate treatment of neonatal jaundice.

PMID- 2216639
TI  - Neonatal choreoathetosis following prenatal exposure to oral contraceptives.

PMID- 2216640
TI  - Bacterial flora of "normal" sinuses.

PMID- 2216641
TI  - Retinal hemorrhage after cardiopulmonary resuscitation.

PMID- 2216642
TI  - Aluminum and infants.

PMID- 2216643
TI  - American Academy of Pediatrics Report of the Subcommittee on Assessment and
      Methodologic Issues in the Management of Pain in Childhood Cancer.

PMID- 2216644
TI  - American Academy of Pediatrics Report of the Subcommittee on Disease-Related Pain
      in Childhood Cancer.

PMID- 2216645
TI  - American Academy of Pediatrics Report of the Subcommittee on the Management of
      Pain Associated with Procedures in Children with Cancer.

PMID- 2216646
TI  - Research priorities as defined by the subcommittees.

PMID- 2216647
TI  - Redundancy phenomena are affected by response requirements.
AB  - Results are reported for two go/no-go reaction time (RT) experiments, in which
      the redundant targets advantage was investigated. These experiments were
      replications of two earlier choice reaction time (CRT) experiments, in which
      letter stimuli were used. Important differences between the go/no-go RT
      experiments and the CRT experiments were obtained. Equal and significant
      redundancy advantages were obtained whether redundant targets were compared with
      a single target presented with a noise letter or without noise. In the CRT
      experiments, the advantage was not obtained in the comparison with a single
      target presented alone. Noise letters did not slow the RTs to single targets with
      which they were presented as was the case with CRT. Since the differing results
      of the two procedures depend on the response requirements, explanation of
      differing CRT data in terms of perceptual or attentional concepts is probably
      inappropriate. The presence and absence of response competition in the two
      situations may be the best interpretation. The results tend to support a
      conclusion of the parallel processing of two letter stimuli separated spatially
      by as much as 3 degrees.

PMID- 2216648
TI  - Auditory psychomotor coordination and visual search performance.
AB  - In Experiments 1 and 2, the time to locate and identify a visual target (visual
      search performance in a two-alternative forced-choice paradigm) was measured as a
      function of the location of the target relative to the subject's initial line of
      gaze. In Experiment 1, tests were conducted within a 260 degree region on the
      horizontal plane at a fixed elevation (eye level). In Experiment 2, the position
      of the target was varied in both the horizontal (260 degrees) and the vertical
      (+/- 46 degrees from the initial line of gaze) planes. In both experiments, and
      for all locations tested, the time required to conduct a visual search was
      reduced substantially (175-1,200 msec) when a 10-Hz click train was presented
      from the same location as that occupied by the visual target. Significant
      differences in latencies were still evident when the visual target was located
      within 10 degrees of the initial line of gaze (central visual field). In
      Experiment 3, we examined head and eye movements that occur as subjects attempt
      to locate a sound source. Concurrent movements of the head and eyes are commonly
      encountered during auditorily directed search behavior. In over half of the
      trials, eyelid closures were apparent as the subjects attempted to orient
      themselves toward the sound source. The results from these experiments support
      the hypothesis that the auditory spatial channel has a significant role in
      regulating visual gaze.

PMID- 2216649
TI  - Cross-gender perceptions of facial attributes and their relation to
      attractiveness: do we see them differently than they see us?
AB  - Examination of perceptions of human facial attributes revealed that individual
      attributes are similarly perceived by males and females. However, patterns of
      attribute interrelationships differ as a function of gender of the face.
      Undergraduate students (N = 280) rated pictures of 40 male or female Caucasians
      on 12 physical attributes (e.g., nose size, face width) and overall
      attractiveness. The four sets of attribute ratings (defined by rater gender and
      picture gender) were submitted to principal components analyses, and five-factor
      solutions were found for each condition (accounting for about 76% of the
      variance). Comparisons of the four component solutions using confirmatory factor
      procedures revealed that male and female raters share one factor structure when
      rating photographs of female faces and another factor structure when rating
      photographs of male faces. Multiple regression analyses revealed that the
      patterns of attribute interrelationships were not "perceptual units" in the
      perception of attractiveness, and that different "rules" are used to assess the
      attractiveness of male and female stimuli faces. The importance of these results
      for models of facial attractiveness and interfacial similarity judgements are
      discussed.

PMID- 2216650
TI  - Lack of evidence for a tactual Poggendorff illusion.
AB  - Lucca, Dellantonio, and Riggio (1986) reported large distortions in a tactual
      analogue of the visual Poggendorff illusion. They also reported large effects in
      the direction opposite to the visual illusion, which they termed "inversions."
      However, their evidence for such effects is questionable; they used what we
      consider to be inappropriate measurement and analysis procedures. In attempting
      to replicate their experiment, and in conducting four additional experiments, we
      found no evidence at all for their alleged tactual analogue of the visual
      Poggendorff effect. Instead, we demonstrated that "inversions" are likely due to
      the use of a raised stimulus display that causes artifactual mistracking, which
      is totally unrelated to normal mechanisms of alignment judgment. We also discuss
      the possible role of intersensory factors in the generation of tactual illusions.

PMID- 2216651
TI  - Voluntary allocation versus automatic capture of visual attention.
AB  - Is there a difference in the kind of attention elicited by an abrupt-onset
      peripheral cue and that elicited by an instruction (e.g., a central arrow cue) to
      move attention to a peripheral location? In Experiment 1, we found that
      peripheral cues are no more effective in orienting attention than are central
      cues. No evidence was found for separable attentional systems consisting of a
      volitional response to central cues and an automatic response triggered only by
      peripheral cues. Rather, an identical or similar attentional process seems to be
      activated by either type of cue, although perhaps in different ways. Peripheral
      cues seem to have an automatic component, however, in that once attention is
      engaged by a peripheral cue, it cannot easily be disengaged for refocus
      elsewhere. In Experiment 2, after several sessions of practice, subjects were
      able to circumvent automatic attentional capture by an abrupt-onset peripheral
      cue and to volitionally redirect the focus of attention. Thus, attentional
      capture by abrupt-onset stimuli is not strongly automatic.

PMID- 2216652
TI  - Mental retardation and perception of global motion.
AB  - We have found that mildly mentally retarded adults are impaired in their
      perception of global stereoscopic forms (Fox & Oross, 1988) in ways that cannot
      be attributed to peripheral visual deficits or failures to comprehend. To assess
      the generality of that result, we measured the ability of mentally retarded
      adults to perceive kinematographic forms. Mentally retarded and nonretarded
      adults were presented with a two-choice, forced-choice detection task requiring
      the location of a target's spatial position. The discriminability of the forms
      was varied by systematic reductions in both element density and temporal
      correlation. We found that, relative to nonretarded adults, mentally retarded
      adults exhibited large qualitative deficits in their ability to discriminate
      these kinematographic forms when either density or correlation was reduced. After
      considering a number of alternative interpretations of these data based on
      factors such as peripheral visual impairment and a failure to attend, we could
      find none more compelling than a perceptual interpretation, which posits a
      deficit within the short-range motion system.

PMID- 2216654
TI  - Visual-touch perceptual equivalence for shape information in children and adults.
AB  - Although there has been substantial developmental research which has compared
      shape information processing performance under visual and touch conditions, there
      has been little work that bears on the shape attributes that are routinely
      employed, or on the similarity between shape attributes employed by adults and
      those employed by children. The present research was carried out to investigate
      the visual-touch perceptual equivalence of young children, using multidimensional
      scaling techniques, and to compare the visual and touch perceptual structures of
      this age group with those of adults. The results provide evidence for adult-like
      perceptions of shape among 6-year-olds, in terms of both the patterns of
      interstimulus similarities and the shape attributes attended to by children using
      each modality. In addition, it was found that children have somewhat more visual
      touch perceptual equivalence than adults do.

PMID- 2216653
TI  - The role of discontinuities in the perception of subjective figures.
AB  - Recently we proposed a theory of visual interpolation (Kellman & Shipley, in
      press) that addresses a variety of unit formation phenomena, including the
      perception of partly occluded objects and subjective figures. A basic notion of
      the theory is that discontinuities in the first derivative of projected edges are
      the initiating conditions for interpolation of boundaries that are not physically
      specified. In this paper, we report four experiments in which this claim was
      tested in the domain of subjective figures. Experiments 1 and 2 demonstrate that
      discontinuities in the first derivative of the edges of inducing elements have a
      clear effect on the frequency of report and the perceived clarity of simple
      subjective figures. Similar effects are found when unfamiliar subjective figures
      and inducing elements are used (Experiment 3). Experiment 4 rules out the
      possibility that the discontinuities in the first derivative merely add to the
      clarity of subjective figures. These experiments suggest that first-order
      discontinuities play a central role in unit formation.

PMID- 2216655
TI  - The effects of position cues on the appearance of stimulus elements in a bistable
      apparent movement display.
AB  - A modified version of the Ternus display was used to assess the relative effects
      of element position cues on reports of group and end-to-end movement. In this
      display, two rows of stimulus elements are joined by connecting lines. In one
      version of the display, the connecting lines remain stationary across frames,
      facilitating the interpretation that the associated stimulus elements also remain
      stationary. In another version of the display, one end of the connecting lines
      shifts horizontally from frame to fame, facilitating the interpretation that the
      associated stimulus elements have also shifted. The experiment showed that when
      the connecting lines remain stationary, reports of end-to-end movement increase,
      regardless of the interstimulus interval (ISI) at which the frames alternate.
      When the connecting lines shift, reports of group movement increase, regardless
      of ISI. Theoretical interpretations of the results involving both relatively low
      level motion signals and higher order perceptual influences are considered.

PMID- 2216656
TI  - Alcohol impairs visual presence/absence detection more for females than for
      males.
AB  - Ninety subjects (45 males, 45 females) were given 0.0, 0.5, or 1.0 ml/kg body
      weight of 190-proof ethanol and tested for chance-level presence/absence
      detection thresholds with energy-masked presentations of traffic signs and blank
      inputs. Alcohol produced higher blood alcohol concentration (BAC) levels, and
      higher detection threshold durations, for females than for males. These results
      indicate that alcohol influences precortical visual processing and that the
      influence is greater for females than for males. The higher bioavailability of
      alcohol in women is likely due to less gastric oxidation of ethanol in women than
      in men.

PMID- 2216657
TI  - Methodological implications of interaural correlation: count heads not ears.
AB  - In a sample of 425 subjects, pure-tone hearing thresholds between the right and
      left ears were shown to have an average correlation of .885 (or .783 with age
      partialed out). This high interaural correlation is shown to invalidate the
      experimental procedure of entering data on the basis of "ears," where each
      subject can contribute one or two audiograms to the data pool, since such
      aggregation is demonstrated to produce spuriously high levels of apparent
      statistical significance in inferential statistical tests.

PMID- 2216659
TI  - Biomedical innovation and world health.

PMID- 2216658
TI  - Do we know the cause(s) of AIDS?

PMID- 2216660
TI  - A rationale for centuries of therapeutic bloodletting: antipyretic therapy for
      febrile diseases.

PMID- 2216661
TI  - The dynamics of free cholesterol exchange may be critical for endothelial cell
      membranes in the brain.

PMID- 2216662
TI  - Leisure for creative thought: planned respites from classroom and laboratory.

PMID- 2216663
TI  - Thoracic outlet syndrome and dysfunction of the temporomandibular joint: proved
      pathology or pseudosyndromes?

PMID- 2216664
TI  - Health and fitness.

PMID- 2216665
TI  - Vampires, porphyria, and the media: medicalization of a myth.

PMID- 2216666
TI  - The abused woman and her family of origin.
AB  - The abuse of women in significant heterosexual relationships is an important
      societal problem in the United States. Structural family therapy offers a useful
      perspective to nurse therapists working with abused women who have left the
      abusive relationship to rejoin their families of origin. Common errors are
      avoided if the abused woman and her family are diagnosed within the system's
      context of structural family therapy. Dysfunctional transactional patterns that
      originated in the abused woman's childhood or adolescent years can be challenged
      at their source.

PMID- 2216667
TI  - Counseling rape victims: the nursing challenge.
AB  - Rape and sexual assaults are a pervasive problem encountered by women in our
      society today. Treatment approaches specifically useful with rape victims have
      been identified by nursing staff at the Sexual Assault Resource Service (SARS).
      This nursing research demonstration treatment program funded by the National
      Institute of Mental Health identifies seven essential components of counseling
      during the initial crisis period, which are discussed in this article.

PMID- 2216669
TI  - A new level of inhumanity to helpless children.

PMID- 2216668
TI  - Hope and spiritual well-being: essentials for living with AIDS.
AB  - Without a cure on the horizon there is a need to identify ways to sustain hope
      and spiritual well-being in patients with AIDS. This article examines the impact
      of AIDS on the emotional and spiritual health of its victims and summarizes
      current research findings on spiritual well-being in the ill. It also summarizes
      the authors' study on hope and existential and spiritual well-being in a group of
      65 adult male patients who were either serum positive for the human
      immunodeficient virus or who had been diagnosed with AIDS Related Complex or
      AIDS.

PMID- 2216670
TI  - Interpersonal "dances": reflections of Harriet Goldhor Lerner, PhD. Interview by
      Deb Kirmer.

PMID- 2216671
TI  - Abstracts of posters. Drug utilization research and pharmacoepidemiology meeting.
      Utrecht (The Netherlands), 27 September 1990.

PMID- 2216672
TI  - Abstracts of papers. Optimizing clinical pharmacy practice. 19th European
      Symposium on Clinical Pharmacy. Barcelona (Spain), 24-26 October 1990.

PMID- 2216673
TI  - Abstracts of papers. Pharmacological meeting. Utrecht (The Netherlands), 7
      November-12 December 1990.

PMID- 2216674
TI  - Abstracts of papers. Biopharmaceutical meeting. Leiden (The Netherlands), 30
      November 1990.

PMID- 2216675
TI  - [How many teeth does a person need?].

PMID- 2216676
TI  - [Bone transplantation in combination with implants].

PMID- 2216677
TI  - [Telescopic prostheses].

PMID- 2216678
TI  - Interview with Hildegard E. Peplau. Interview by Shirley Smoyak.

PMID- 2216680
TI  - Implications of the Cruzan decisions for nurses.

PMID- 2216679
TI  - First, do no harm: healthcare workers with AIDS.

PMID- 2216682
TI  - Innovations in nursing education administration.

PMID- 2216681
TI  - Intercultural encounter: Filipino value system in the American workplace.

PMID- 2216684
TI  - [Regulation of the blood circulation: the significance of the renin-angiotension
      system].

PMID- 2216683
TI  - [Private and public health care--new patterns].

PMID- 2216685
TI  - [Treatment of hypertension using angiotensin-converting enzyme inhibitors].
AB  - Angiotensin conversion enzyme inhibitors (ACE inhibitors) comprise a relatively
      new group of potent antihypertensives. They are today among the most used
      preparations for reducing blood pressure. ACE inhibitors may be used for
      treatment of almost all forms and degrees of hypertension. By reason of the
      reduction of the resistance in the peripheral vessels the blood pressure drops by
      12-20 per cent, both at rest and during muscular effort, without diminution of
      the heart's pump function. The autonomic reflexes are unchanged and the
      circulation in the kidneys and the brain is retained. ACE inhibition does not
      result in fluid retention. In adequate doses the drugs are tolerated and give few
      side-effects provided that the patient is not dehydrated.

PMID- 2216686
TI  - [ACE inhibitors in the treatment of heart failure].
AB  - Cardiac insufficiency is a clinical syndrome which presents several distinctive
      findings but is nevertheless difficult to define both clinically and in the
      scientific literature. In this article we maintain that cardiac insufficiency is
      a clinical condition characterized by symptomatic fluid retention on a cardiac
      basis, combined with signs of impaired pumping in the form of reduced capacity
      and/or other organic effects such as reduced renal function. The renin
      angiotensin system is of cardinal importance once cardiac insufficiency is
      established and ACE inhibition is of essential significance for the treatment. It
      is not yet clear whether it is possible to prevent the onset of cardiac
      insufficiency in patients at high risk thereof. Current studies may answer this
      question.

PMID- 2216687
TI  - [ACE inhibitors' effect on kidney function].
AB  - ACE-inhibitors have many positive features, when treating patients with
      progressive renal failure. These patients have high mortality in cardiac and
      vascular complications. It is therefore important to treat hypertension in these
      patients with drugs which do not have negative effects on lipid-, glucose, or
      electrolyte-metabolism, and ACE inhibition fulfills these requirements. These
      drugs decrease left ventricular hypertrophy, which is a positive prognostic sign
      of hypertensive patients, too. Contrary to regular diuretics, ACE-inhibition does
      not cause the negative effects associated with activation of the renin
      angiotensin system. In many patients ACE-inhibitors decrease proteinuria to a
      higher degree than other antihypertensive drugs, and this may be an important
      clinical advantage, particularly in nephrotic patients. ACE inhibition might slow
      progressive renal failure. This effect may be associated with advantageous
      intraglomerular hemodynamic changes, but may also associate with inhibition of
      negative effects of angiotensin II on mesangial hypertrophy and matrix
      proliferation.

PMID- 2216688
TI  - [Skin pigmentation, nevi and sunshine as etiological factors in cutaneous
      malignant melanoma].
AB  - In this review, an attempt is made to provide a status on the current knowledge
      concerning the connection between skin pigmentation, naevi, sunshine and
      development of cutaneous malignant melanoma. Our knowledge is based partly on
      descriptive epidemiological reports, and partly on information obtained from case
      control investigations. The descriptive investigations have revealed
      characteristic geographical and ethnic differences in the distribution of the
      disease. Cancer registry data have revealed a rapid increase in the incidence
      among white populations during the past 30-40 years with particularly pronounced
      increase for the areas of the body normally covered with clothes. Lacking
      consistency between indicators for cumulative exposure to sunlight and
      descriptive epidemiological studies have led to the hypothesis that intermittent
      exposure to sunlight is particularly harmful. Case control investigations have
      provided further support to this hypothesis and have demonstrated that sunbathing
      is associated with an increased risk for development of melanoma, particularly
      during childhood and particularly if it leads to sunburn. In addition, the risk
      of development of melanoma is increased in persons with a tendency to freckle
      and/or with many naevi. On this background, certain risk groups may be informed
      about prophylactic measures with subsequent possibility of reducing the number of
      new cases of cutaneous melanoma in the future. Finally, it is emphasized that the
      disease is multifactorial in origin and that the pathogenesis is not fully
      elucidated.

PMID- 2216689
TI  - [Development and new private health care options--complement and challenge for
      Swedish public health care].

PMID- 2216690
TI  - [The private health care sector in Finland].

PMID- 2216691
TI  - [Strategic possibilities for private hospitals in the 90s in Denmark].

PMID- 2216692
TI  - [Scandinavian physicians' labor market balanced up till the turn of the century].

PMID- 2216693
TI  - What's new on the AIDS front?

PMID- 2216694
TI  - NM public health nursing changing with the times.

PMID- 2216695
TI  - Leading the way in international volunteerism.

PMID- 2216696
TI  - Knowledge and use of smokeless tobacco by visitors to a state fair oral health
      exhibit.

PMID- 2216697
TI  - Carpal tunnel syndrome among Minnesota dental hygienists.

PMID- 2216698
TI  - Profile of Dr. Richard Rossi.

PMID- 2216699
TI  - A recruitment strategy for dental hygienists and dental assistants in northern
      Minnesota and Wisconsin.

PMID- 2216700
TI  - Expression of the interleukin 6 gene in acute myeloid leukemia and
      myelodysplastic syndromes: a report on 49 cases.
AB  - We studied the expression of IL 6 gene in 49 patients, including 21 chronic
      myelomonocytic leukemias (CML), 9 other myelodysplastic syndromes (MDS), 18 acute
      myeloid leukemias (11 M2 or M3 and 7 M4 or M5) and 1 case of acute biphenotypic
      lymphoid monocytic leukemia. IL 6 was found expressed only in the latter patient
      and in one patient with M5 acute myeloid leukemia. DNA analysis by Southern blot
      revealed no rearrangement in these 2 patients and in 10 of the other patients who
      showed no IL 6 expression. These results do not support an autocrine role for IL
      6 in CMML or in other MDS. In acute myeloid leukemias, if expressed by leukemic
      cells, IL 6 seems to be restricted to cases with a monocytic component, although
      the number of patients was too small to draw any definite conclusion.

PMID- 2216701
TI  - Is translocation (8;21) a "favorable" cytogenetic rearrangement in acute myeloid
      leukemia?
AB  - Twenty-three patients with de novo acute myeloid leukemia (AML) and t(8;21)
      (q22;q22), including 2 children aged 7 and 14 and 21 adults aged 16 to 68 (median
      29), were treated with intensive chemotherapy and 22 (96%) achieved complete
      remission (CR). Three were allografted in first CR. Median actuarial disease-free
      interval (DFI) was 17 months in the 22 patients and 14 months when the 3
      allografted patients (who did not relapse) were excluded, as compared to 19.5
      months in our whole series of AML treated according to the same protocol. After
      relapse, most patients with t(8;21) reached a second CR, but it was short, except
      in the 4 patients who were then allografted, and for whom follow-up is
      insufficient to draw any conclusion. Our findings suggest that, although it is
      associated with a high CR rate, AML with t(8;21) has a high incidence of
      relapses, especially in the first year of CR. The term "favorable" cytogenetic
      rearrangement may be misleading in such cases, and we believe that these patients
      should receive intensive post-consolidation therapy, possibly including an
      allograft whenever feasible.

PMID- 2216702
TI  - High-dose etoposide and cisplatin in refractory or recurrent non-Hodgkin's
      lymphomas (NHL).
AB  - Thirty-one patients, 13 adults and 18 children, were included in a phase II study
      of combined treatment with CDDP 40 mg/m2 and VP16 100 or 200 mg/m2 for 5 days.
      Fourteen patients were primary refractory to front-line treatment and 17 were
      treated at relapse (9 on therapy, 8 off therapy). Four were low-grade follicular
      lymphomas, 7 intermediate grade lymphomas, and 20 high grade lymphomas. One of
      the 14 primary refractory cases responded (CR) whereas 3 PR and 10 CR were
      observed among the 17 relapses. Toxicity was acceptable. 9 patients are still
      alive after bone marrow transplantation (median survival, 16 months). This
      combination is an effective salvage regime before autologous bone marrow
      transplantation for relapsed NHL, but cannot be recommended for progression on
      front-line therapy.

PMID- 2216703
TI  - Evaluation of residual masses after lymphoma treatment: the contribution of
      gallium 67 tomoscintigraphy.
AB  - 19 tomoscintigraphies using gallium 67 were performed in 15 patients with
      Hodgkin's or non-Hodgkin's lymphoma who had a residual mass after treatment. The
      isotope was never fixed in fibrous masses but was always concentrated in actively
      growing masses. In five cases histology confirmed these findings. It is
      recommended that scintigraphy should be considered in every case with a residual
      mass after treatment, where a decision regarding further treatment is required.

PMID- 2216704
TI  - Comparative immunochemical analysis of membrane proteins from human platelets and
      endothelial cells.
AB  - We have studied the expression of immunochemically-related membrane proteins on
      human platelets and human umbilical vein endothelial cells (EC) by using cross
      immunoprecipitation of 125I, surface-labeled cell extracts by cell-specific
      antisera, coupled to one- or two-dimensional SDS-PAGE. From 125I-labeled EC, an
      anti-platelet antiserum was found to immunoprecipitate major surface polypeptides
      comigrating with platelet GPIa, GPIIa and GPIIIa, and a protein with relative
      molecular mass Mr = 54,000. On the other hand, anti-EC antisera precipitated
      mostly GPIa, GPIc, GPIIa and GPIIIa from 125I-labeled platelets. These results
      supported previous reports demonstrating shared major membrane glycoproteins on
      platelets and EC, and suggested that the similar antigenicities in platelets and
      endothelial cells could play an important role in the pathogenesis of thrombosis
      and hemostasis in some immunologic disorders.

PMID- 2216705
TI  - Use of Coulter VCS for differential leukocyte counts.
AB  - The Coulter VCS is a tridimensional flow cytometer designed for differential
      leukocyte counting on the basis of cell volume, light scatter and conductivity.
      The VCS differential performed on 192 non-flagged samples was compared with the
      blood smear, taken as the reference method. A good correspondence was found
      between the two methods. Two hundred and seventy pathological samples were
      studied by both the VCS and the reference method: 219 samples with no anomalies
      other than quantitative changes and 51 with abnormal cells. 41% of the
      quantitative changes presented without any flag; 59% were flagged: either
      isolated X5 flags (30%) or other flags needing blood smear review (29%). Samples
      with abnormal cells (51) were detected with one or more flags: X3 + X6 in
      myelocytic disease X2 + X7 in lymphocytic disease. Only two (1 hairy cell
      leukemia, 1 lymphoma) were not flagged; however in these cases the abnormalities
      were revealed by the presence of either a striking neutropenia or a
      lymphocytosis. This corresponded to a false-negative rate of 0.4% in the group
      studied. Further studies were performed on patients with X5 flagging only. The
      VCS differential was compared to the optical differential as a reference method.
      There was a good relationship between the two methods; thus X5 flagging could be
      established without further slide review provided the numerical values were
      within the range valid for the laboratory. Thus, in our system of working, both
      VCS flags (except isolated X5) and laboratory performance limits were taken into
      account as regards the need for blood smear review. This resulted in a review
      rate of 15%.

PMID- 2216706
TI  - IPTG-dependent vaccinia virus: identification of a virus protein enabling virion
      envelopment by Golgi membrane and egress.
AB  - A novel method has been developed to study the functional roles of individual
      vaccinia virus gene products that is neither limited by the possible essentiality
      of the target gene nor by the availability of conditional lethal mutants. The
      system utilises the E. coli lac repressor protein, the operator sequence to which
      it binds and the specific inducer IPTG. It allows the generation of recombinant
      viruses in which the expression of any chosen gene, and hence virus replication,
      can be externally controlled. In principle, this system is broadly applicable to
      the functional analysis of genes in any large DNA virus. This approach has
      demonstrated that the gene encoding the 14 kDa membrane protein of vaccinia virus
      is non-essential for the production of infectious intracellular virus particles,
      but essential for the envelopment of intracellular virions by Golgi membrane and
      for egress of mature extracellular viral particles. This is the first vaccinia
      virus protein shown to be specifically required for these processes. In vivo this
      system may prove useful as a means of attenuating recombinant vaccinia virus
      vaccines by preventing virus spread without reducing the amount of the foreign
      antigen expressed in each infected cell. Attenuation of other live virus vaccines
      may be developed in a similar way.

PMID- 2216707
TI  - The mouse rpL7a gene is typical of other ribosomal protein genes in it's 5'
      region but differs in being located in a tight cluster of CpG-rich islands.
AB  - The two major transcriptional start sites of the mouse ribosomal protein L7a gene
      (rpL7a) (formerly Surf-3) have been mapped to two cytidine residues separated by
      4 bp embedded in a polypyrimidine tract of 21 bp. The rpL7a gene contains a small
      first exon (25-29 bp) and a small 5' untranslated leader sequence (22-26 bp). Its
      transcriptional start sites are not preceded by a canonical TATA box motif and
      its 5' end is located in a CpG-rich island. These are all features found
      associated with the five other functional mammalian ribosomal protein genes which
      have been previously characterized. The mouse rpL7a gene is found within a very
      tight cluster of six genes associated with 4 CpG-rich islands located in 32 kb of
      genomic DNA. Unique DNA probes located both upstream and downstream of the mouse
      rpL30 and rpL32 genes used on Southern blots of mouse DNA cleaved with a variety
      of CpG-rich island specific restriction enzymes did not detect CpG-rich islands
      in the close vicinity of these ribosomal protein genes. Thus the clustering of
      CpG-rich islands associated with rpL7a does not appear to be a general feature of
      mammalian ribosomal protein genes.

PMID- 2216708
TI  - Uridine branch acceptor is a cis-acting element involved in regulation of the
      alternative processing of calcitonin/CGRP-l pre-mRNA.
AB  - The human calcitonin/CGRP-I (CALC-I) gene contains 6 exons and encodes two
      polypeptide precursors. In thyroid C-cells, calcitonin (CT) mRNA is produced by
      splicing of exons 1-2-3 to exon 4 (CT-encoding) and polyadenylation at exon 4.
      CGRP-I mRNA is produced in particular neural cells by splicing of exons 1-2-3 to
      exon 5 (CGRP-I-encoding) and the polyadenylated exon 6. We previously reported
      that model precursor RNAs containing the exon 3 to exon 5 region of the CALC-I
      gene are processed predominantly into CGRP-I mRNA in vitro, in nuclear extracts
      of several cell types (neural and non-neural). Using truncated precursor RNAs
      containing only the exon 3 to exon 4 region of the CALC-I gene it was shown that
      CT splicing is an inefficient reaction in which a uridine residue serves as the
      major site of lariat formation. Here we report that the low CT splicing
      efficiency and the dominance of CGRP-I splicing over CT splicing in vitro are
      primarily due to the usage of the CT-specific uridine branch acceptor. Mutation
      of this uridine residue into an adenosine residue resulted in a strong increase
      in CT splicing efficiency causing a reversal of the splicing pattern. In
      addition, it was shown that this point mutation also increased CT splicing
      efficiency in vivo. These results and data obtained from other experiments
      involving mutation of the CT splice acceptor site suggest that the uridine branch
      acceptor is a cis-acting element involved in regulation of the alternative
      processing of the CALC-I pre-mRNA.

PMID- 2216709
TI  - Evidence for a feedback regulated back-up promoter which controls permanent
      expression of a Dictyostelium gene.
AB  - We have previously described the elements of two overlapping promoters regulating
      differential expression of the Dictyostelium P8A7 gene. One promoter was
      constitutively active but stimulated during development (S-promoter), while the
      other (L-promoter) was found to be induced by a variety of stimuli. This effect
      was mediated by the induction (i-) element. By a series of antisense
      transformation experiments we here provide evidence that this element is the
      target of a feedback control circuit. In wild type cells, feedback regulation
      activates the L-promoter in unfavourable environmental situations when
      transcription from the S-promoter is insufficient to generate adequate amounts of
      protein. A model for the function of the feedback loop under natural and
      experimental conditions is presented.

PMID- 2216710
TI  - A single mutation in 16S rRNA that affects mRNA binding and translation
      termination.
AB  - A single base change in 16S rRNA (C726 to G) has previously been shown to have a
      dramatic effect on protein synthesis in E. coli (1). This paper more specifically
      details the effects of the mutation on mRNA binding and translation-termination.
      The in vitro technique of toeprinting (2) was used to demonstrate that 30S
      subunits containing the mutation 726G had an altered binding affinity for mRNA by
      comparison to the wild type. In addition, expression of the mutant ribosomes in
      vivo resulted in exclusive suppression of the UGA nonsense codon. This effect was
      supported by in vitro studies that showed the mutant ribosomes to have an altered
      binding affinity for Release Factor-2.

PMID- 2216711
TI  - Long (dA)n.(dT)n tracts can form intramolecular triplexes under superhelical
      stress.
AB  - Plasmids containing long tracts of (dA)n.(dT)n have been prepared and their
      conformations examined in linear and supercoiled DNA using a series of chemical
      and enzymic probes which are known to be sensitive to unusual DNA structures.
      Under superhelical stress and in the presence of magnesium the sequence T69.A69
      adopts a conformation at pH 8.0 consistent with the formation of an
      intramolecular DNA triplex. Site specific cleavage of the supercoiled plasmid by
      single-strand specific nucleases occurs within the A.T insert; the 5'-end of the
      purine strand is sensitive to reaction with diethylpyrocarbonate while the
      central 5-6 bases of the pyrimidine strand are reactive to osmium tetroxide. By
      contrast shorter inserts of A33.T33 and A23.T23 do not appear to form unusual
      structures.

PMID- 2216712
TI  - Removal of double-stranded contaminants from RNA transcripts: synthesis of
      adenovirus VA RNAI from a T7 vector.
AB  - Bacteriophage RNA polymerases are widely used to synthesize defined RNAs on a
      large scale in vitro. Unfortunately, the RNA product contains a small proportion
      of contaminating RNAs, including complementary species, which can lead to errors
      of interpretation. We cloned the gene encoding Ad2 VA RNAI into a vector
      containing a T7 RNA polymerase promoter in order to generate large quantities of
      VA RNA for the study of its interaction with the dsRNA-dependent protein kinase
      DAI. Exact copies of VA RNAI were synthesized efficiently, but were contaminated
      with small amounts of dsRNA which activated DAI and confounded interpretation of
      kinase assays. We therefore developed a method to remove the dsRNA contaminants,
      allowing VA RNAI and mutants to be tested for their ability to activate or
      inhibit DAI. This method appears to be generally applicable.

PMID- 2216713
TI  - Direct detection and automated sequencing of individual alleles after
      electrophoretic strand separation: identification of a common nonsense mutation
      in exon 9 of the human lipoprotein lipase gene.
AB  - Large-scale screening by direct sequencing of DNA to detect molecular variants
      remains a laborious endeavor whose difficulty is compounded by heterozygosity. We
      show that mobility shifts of single-stranded DNA electrophoresed under
      nondenaturing conditions can be used not only to detect variants (Orita,M. et
      al., 1989, Genomics, 5, 874-879), but also to separate and sequence directly
      individual alleles. In this manner, we have identified a common variant of human
      lipoprotein lipase resulting from a nonsense mutation in exon 9 of the gene.
      Whether this variant is of functional significance remains to be determined.

PMID- 2216714
TI  - Identification of a putative RNA helicase in E.coli.
AB  - The human p68 protein, an SV40 large T related antigen, is an RNA dependent
      ATPase and RNA helicase. It belongs to a new large and highly conserved gene
      family, the DEAD box proteins, whose members are involved in a variety of
      processes requiring manipulation of RNA secondary structure such as translation
      and splicing. Multiple DEAD box genes are present in S.cerevisiae, but only one
      has previously been described in E.coli. Low stringency screening of an E.coli
      genomic library with a p68 cDNA probe led to the identification of dbpA, a new
      E.coli DEAD box gene located at 29.6 minutes on the W3110 chromosome. We report
      here the nucleotide and deduced amino acid sequences of the gene. We have
      overexpressed dbpA from its own promoter on a high copy number plasmid and
      identified the gene product as a approximately 50 kD protein by immunoblotting
      with an anti-DEAD antibody.

PMID- 2216715
TI  - Site specific functionalization of oligonucleotides for attaching two different
      reporter groups.
AB  - The synthesis of an oligonucleotide functionalized to attach two different
      reporter groups at specific internucleotide linkages is described. To incorporate
      the amine specific reporter group the internucleotide linkage is modified to
      phosphoramidate (N-1-aminoalkyl) and for a thiol specific reporter group the
      internucleotide linkage is modified to a phosphorothioate diester. The synthetic
      cycle for introducing the modified internucleotide linkages at specific sites can
      be carried out using an automated DNA synthesizer. Combination of reporter groups
      have been attached successfully.

PMID- 2216716
TI  - Cloned origin of DNA replication in c-myc gene can function and be transmitted in
      transgenic mice in an episomal state.
AB  - The c-myc protein has recently been shown to interact with a region possessing
      putative origin of DNA replication and enhancer activities located 2 kb upstream
      of the c-myc gene itself. Transgenic mice were obtained by injecting constructs
      containing this region, termed pmyc(H-P), into fertilized mouse eggs. The
      transgenic elements were capable of efficient replication in all mouse tissues
      examined and were maintained in an episomal state even in highly differentiated
      cells. Moreover, pmyc(H-P) was transmittable to the progeny throughout several
      generations, which suggests that the fragment derived from the region upstream of
      the c-myc gene possesses sequences necessary for partition, stability and DNA
      replication of the plasmid in the cells. In addition, we have shown that the
      plasmid might be captured only by eggs, not by sperm.

PMID- 2216717
TI  - Chemical synthesis of biologically active oligoribonucleotides using beta
      cyanoethyl protected ribonucleoside phosphoramidites.
AB  - The preparation of fully protected diisopropylamino-beta-cyanoethyl
      ribonucleoside phosphoramidites with regioisomeric purity greater than 99.95% is
      described. It is demonstrated that the combination of standard DNA protecting
      groups, 5'-O-DMT, N-Bz (Ade and Cyt), N-iBu (Gua), beta-cyanoethyl for phosphate,
      in conjunction with TBDMS for 2'-hydroxyl protection, constitutes a reliable
      method for the preparation of fully active RNA. Average stepwise coupling yields
      in excess of 99% were achieved with these synthons on standard DNA synthesizers.
      Two steps completely deprotect the oligoribonucleotide and workup is reduced to a
      fifteen minute procedure. Further, it is shown that the deprotected
      oligoribonucleotides are free from 5'-2' linkages. This methodology was applied
      to the chemical synthesis of a 24-mer microhelix, a 35-mer minihelix and two
      halves of a catalytic 'Hammerhead Ribozyme'. These oligoribonucleotides were
      directly compared in two distinct biochemical assays with enzymatically (T7 RNA
      polymerase) prepared oligoribonucleotides and shown to possess equal or better
      activity.

PMID- 2216718
TI  - Pulse-field electrophoresis indicates full-length Mycoplasma chromosomes range
      widely in size.
AB  - Full-size linear chromosomes were prepared from mycoplasmas by using gamma
      irradiation to introduce one (on average) double-strand break in their circular
      chromosomes. Chromosome sizes were estimated by pulsed-field gel electrophoresis
      (PFGE) from the mobilities of these full-length molecules relative to DNA size
      references. Sizes estimated for Ureaplasma urealyticum T960 and 16 Mycoplasma
      species ranged from 684 kbp (M. hominis) to 1315 kbp (M. iowae). Using this
      sample, we found no correlation between the mobility of the full-size linear
      chromosomes and their G + C content. Sizes for A. laidlawii and A. hippikon were
      within the range expected from renaturation kinetics. PFGE size estimates are in
      good agreement with sizes determined by other methods, including electron
      microscopy, an ordered clone library, and summation of restriction fragments. Our
      estimates also agree with those from renaturation kinetics for both the largest
      and some of the smallest chromosomes, but in the intermediate size range,
      renaturation kinetics consistently provides lower values than PFGE or electron
      microscopy. Our PFGE estimates show that mycoplasma chromosomes span a continual
      range of sizes, with several intermediate values falling between the previously
      recognized large and small chromosome size clusters.

PMID- 2216719
TI  - The molecular basis for alternative splicing of the CABP1 transcripts in
      Dictyostelium discoideum.
AB  - We have determined the nucleotide sequence of the CABP1 gene from Dictyostelium
      discoideum. Together with previous data on cDNA sequences, we establish that
      alternative splicing of transcripts derived from this gene is responsible for the
      production of the two CABP1 subunits. RNA blot analysis suggested that
      alternative splicing of the CABP1 transcripts occurs during growth and throughout
      development. In addition, we have compiled the intron sequences of Dictyostelium
      pre-mRNAs and observed that the GUAAGU hexanucleotide at the 5' splice site is
      highly conserved. The 5' splice site of CABP1 deviates from the consensus
      hexanucleotide in having a sequence of GUAAUA. To assess the role of the modified
      5' splice on differential splicing, we have constructed an actin-CABP1 fusion
      gene and transformed it into Dictyostelium cells. Analysis by
      immunoprecipitation, with anti-CABP1 antibody and amplification of specific cDNAs
      by polymerase chain reaction show that the transcripts generated by the fusion
      gene are alternatively spliced. When the 5' splice site of the fusion gene is
      mutated to conform to the consensus sequence, the resulting transcripts are
      constitutively spliced. These observations suggest that changes in positions 5
      and 6 of the donor splice site are involved in the alternative splicing of the
      CABP1 transcripts.

PMID- 2216720
TI  - Developmentally regulated and erythroid-specific expression of the human
      embryonic beta-globin gene in transgenic mice.
AB  - Transgenic mice have proven to be an effective expression system for studying
      developmental control of the human fetal and adult beta-globin genes. In the
      current work we are interested in developing the transgenic mouse system for the
      study of the human embryonic beta-globin gene, epsilon. An epsilon-globin gene
      construction (HSII,I epsilon) containing the human epsilon-globin gene with 0.2
      kb of 3' flanking sequence and 13.7 kb of extended 5' flanking region including
      the erythroid-specific DNase I super-hypersensitive sites HSI and HSII was made.
      This construction was injected into fertilized mouse ova, and its expression was
      analyzed in peripheral blood, brain, and liver samples of 13.5 day transgenic
      fetuses. Fetuses carrying intact copies of the transgene expressed human epsilon
      globin mRNA in their peripheral blood. Levels of expression of human epsilon
      globin mRNA in these transgenic mice ranged from 2% to 26% per gene copy of the
      endogenous mouse embryonic epsilon y-globin mRNA level. Furthermore, the human
      epsilon-globin transgene was expressed specifically in peripheral blood but not
      in brain or in liver which is an adult erythroid tissue at this stage. Thus, the
      HSII,I, epsilon transgene was expressed in an erythroid-specific and embryonic
      stage-specific manner in the transgenic mice. A human epsilon-globin gene
      construction that did not contain the distal upstream flanking region which
      includes the HSI and HSII sites, was not expressed in the embryos of transgenic
      mice. These data indicate that the human epsilon-globin gene with 5' flanking
      region extending to include DNase I super-hypersensitive sites HSI and HSII is
      sufficient for the developmentally specific activation of the human epsilon
      globin gene in erythroid tissue of transgenic mice.

PMID- 2216721
TI  - Reactive site polymorphism in the murine protease inhibitor gene family is
      delineated using a modification of the PCR reaction (PCR + 1).
AB  - Murine protease inhibitor (alpha 1-PI) proteins are encoded by a multigene family
      which has undergone recent duplication. It has been suggested that the evolution
      of diversity within this gene family may be driven by unusual selection for novel
      function at the reactive site of the duplicated members (1,2,3). In an attempt to
      use polymerase chain reaction (PCR) to generate and sequence clones spanning the
      polymorphic reactive site region, a PCR artifact was identified and determined to
      result from heteroduplex formation during the co-amplification of the related
      sequences in this multigene system. This artifact results in sequences which are
      combinatorial mosaics of the template sequences. We present a simple and general
      method (PCR + 1) for overcoming this artifact and demonstrate its application in
      delineating five distinct alpha 1-PI reactive site sequences in C57BL/6 mice,
      thus providing sequence information to generate gene-specific probes. The
      significance of the reactive site diversity in this protease inhibitor gene
      family is discussed as well as the general applications and limitations of the
      PCR + 1 technique.

PMID- 2216723
TI  - Autonomous replication sequences in an extrachromosomal element of a pathogenic
      Entamoeba histolytica.
AB  - Entamoeba histolytica possesses a 24.5 kilobase plasmid-like molecule which
      encodes for the organism's ribosomal RNAs. Sequence analysis of this
      extrachromosomal element revealed the presence of AT rich sequences which show
      homology to the origin of replication of other lower eucaryotes. An 802 bp
      fragment containing these sequences was cloned into a yeast shuttle vector
      lacking the origin of replication and the construct tested for its ability to
      replicate autonomously in yeast. Mitotic stability tests as well as evidence for
      plasmid maintenance indicate that the transformed cells contained self
      replicating episomes and not stably integrated molecules. The nucleotide sequence
      of this ARS-containing fragment is presented.

PMID- 2216722
TI  - Astrocytes and glioblastoma cells express novel octamer-DNA binding proteins
      distinct from the ubiquitous Oct-1 and B cell type Oct-2 proteins.
AB  - The 'octamer' sequence, ATGCAAAT or its complement ATTTGCAT, is a key element for
      the transcriptional regulation of immunoglobulin genes in B-lymphocytes as well
      as a number of housekeeping genes in all cell types. In lymphocytes, the octamer
      binding protein Oct-2A and variants thereof are thought to contribute to the B
      cell specific gene expression, while the ubiquitous protein Oct-1 seems to
      control general octamer site-dependent transcription. Various other genes, for
      example interleukin-1 and MHC class II genes, contain an octamer sequence in the
      promoter and are expressed in cells of both the immune and nervous systems. This
      prompted us to analyze the octamer-binding proteins in the latter cells. Using
      the electrophoretic mobility shift assay, at least six novel octamer binding
      proteins were detected in nuclear extracts of cultured mouse astrocytes. These
      proteins are differentially expressed in human glioblastoma and neuroblastoma
      cell lines. The nervous system-derived (N-Oct) proteins bound to the octamer DNA
      sequence in a manner which is indistinguishable from the Oct-1 and Oct-2A
      proteins. The relationship of the N-Oct proteins to Oct-1 and Oct-2A was analyzed
      by proteolytic clipping bandshift assays and by their reactivity towards antisera
      raised against recombinant Oct-1 and Oct-2A proteins. On the basis of these
      assays, all N-Oct-factors were found to be distinct from the ubiquitous Oct-1 and
      the lymphoid-specific Oct-2A proteins. In melanoma cells that contain the N-Oct-3
      factor, a transfected lymphocyte-specific promoter was neither activated nor was
      it repressed upon contransfection with an Oct-2A expression vector. We therefore
      speculate that N-Oct-3 and other N-Oct factors have a specific role in gene
      expression in cells of the nervous system.

PMID- 2216724
TI  - Crystal and solution structures of the oligonucleotide d(ATGCGCAT)2: a combined X
      ray and NMR study.
AB  - A combined crystal-structure determination and NMR analysis of the octanucleotide
      d(ATGCGCAT)2 is reported. The X-ray analysis shows that the structure is A-form
      duplex in crystal state. The NMR study shows that in solution this sequence is B
      type. The conformational results from each technique are presented in detail. The
      implications of these findings in terms of conformational flexibility and ligand
      binding are discussed.

PMID- 2216725
TI  - Ternary interactions of spermine with DNA: 4'-epiadriamycin and other DNA:
      anthracycline complexes.
AB  - The recently developed anthracycline 4'-epiadriamycin, an anti-cancer drug with
      improved activity, differs from adriamycin by inversion of the stereochemistry at
      the 4'-position. We have cocrystallized 4'-epiadriamycin with the DNA hexamer
      d(CGATCG) and solved the structure to 1.5 A resolution using x-ray
      crystallography. One drug molecule binds at each d(CG) step of the hexamer
      duplex. The anthracycline sugar binds in the minor groove. A feature of this
      complex which distinguishes it from the earlier DNA:adriamycin complex is a
      direct hydrogen bond from the 4'-hydroxyl group of the anthracycline sugar to the
      adenine N3 on the floor of the DNA minor groove. This hydrogen bond results
      directly from inversion of the stereochemistry at the 4'-position. Spermine
      molecules bind in the major groove of this complex. In anthracycline complexes
      with d(CGATCG) a spermine molecule binds to a continuous hydrophobic zone formed
      by the 5-methyl and C6 of a thymidine, C5 and C6 of a cytidine and the
      chromophore of the anthracycline. This report discusses three anthracycline
      complexes with d(CGATCG) in which the spermine molecules have different
      conformations yet form extensive van der Waals contacts with the same hydrophobic
      zone. Our results suggest that these hydrophobic interactions of spermine are DNA
      sequence specific and provide insight into the question of whether DNA:spermine
      complexes are delocalized and dynamic or site-specific and static.

PMID- 2216726
TI  - Nucleotide sequence of the metapyrocatechase II (catechol 2,3-oxygenase II) gene
      mpcII from Alcaligenes eutrophus JMP 222.

PMID- 2216728
TI  - Nucleotide sequence and deduced amino acid sequence of new Lepidoptera-specific
      crystal protein gene from Bacillus thuringiensis.

PMID- 2216727
TI  - Nucleotide sequence of the bean leafroll luteovirus coat protein gene.

PMID- 2216729
TI  - Nucleotide sequence and deduced amino acid sequence of a cryIA(c) gene variant
      from Bacillus thuringiensis.

PMID- 2216730
TI  - Nucleotide sequence of the tolC gene of Escherichia coli.

PMID- 2216731
TI  - Full length cDNA sequence encoding canine pancreatic colipase.

PMID- 2216732
TI  - Sequence of a human liver cytochrome P-450 cDNA clone.

PMID- 2216733
TI  - Nucleotide sequence of the 18S ribosomal RNA gene from the Atlantic sea scallop
      Placopecten magellanicus (Gmelin, 1791).

PMID- 2216735
TI  - cDNA sequence of the 3'-coding region of PVY genome (the Chinese isolate).

PMID- 2216734
TI  - The sequence of Japanese quail ovalbumin cDNA.

PMID- 2216736
TI  - Nucleotide sequence of the gene encoding Clostridium botulinum neurotoxin type D.

PMID- 2216737
TI  - Nucleotide sequence of the cellobiohydrolase gene from Trichoderma viride.

PMID- 2216738
TI  - Sequence of the murine haemopoietic stem cell inhibitor/macrophage inflammatory
      protein 1 alpha gene.

PMID- 2216739
TI  - A plasmodial specific mRNA (plasmin C) from Physarum polycephalum encodes a small
      hydrophobic cysteine-rich protein.

PMID- 2216740
TI  - Gene sequence of feline tumor necrosis factor alpha.

PMID- 2216741
TI  - Gene sequence of porcine tumor necrosis factor alpha.

PMID- 2216742
TI  - Consensus sequence for HMG1-like DNA binding domains.

PMID- 2216743
TI  - Nucleotide sequence of the glyceraldehyde-3-phosphate dehydrogenase gene from
      Cryphonectria parasitica.

PMID- 2216744
TI  - Nucleotide and deduced amino acid sequence of the bovine adenovirus type 7
      proteinase.

PMID- 2216745
TI  - Nucleotide and deduced amino acid sequence of the bovine adenovirus type 3
      proteinase.

PMID- 2216746
TI  - Nucleotide sequence of the cDNA of a bovine 70 kilodalton heat shock cognate
      protein.

PMID- 2216747
TI  - The nucleotide sequence of the luxD gene of Xenorhabdus luminescens Hm.

PMID- 2216749
TI  - A simplified and improved method for the efficient double-stranded sequencing of
      mini-prep plasmid DNA.

PMID- 2216748
TI  - A new extraction procedure of autonomous DNA from eucaryotic cells, where DNA
      could be bound to proteins.

PMID- 2216750
TI  - A simplified method for in vivo footprinting using DMS.

PMID- 2216751
TI  - Identification of a factor IX point mutation using SSCP analysis and direct
      sequencing.

PMID- 2216752
TI  - Study of the sequence tagged site (STS) in the beginning of human apo A4 gene
      region.

PMID- 2216754
TI  - Structural and thermodynamic studies on the adenine.guanine mismatch in B-DNA.
AB  - The structure of the synthetic dodecamer d(CGCAAATTGGCG) has been shown by single
      crystal X-ray diffraction methods to be that of a B-DNA helix containing two
      A(anti).G(syn) base pairs. The refinement, based on data to a resolution of 2.25
      A shows that the mismatch base pairs are held together by two hydrogen bonds. The
      syn-conformation of the guanine base of the mismatch is stabilised by hydrogen
      bonding to a network of solvent molecules in both the major and minor grooves. A
      pH-dependent ultraviolet melting study indicates that the duplex is stabilised by
      protonation, suggesting that the bases of the A.G mispair are present in their
      most common tautomeric forms and that the N(1)-atom of adenine is protonated. The
      structure refinement shows that there is some disorder in the sugar-phosphate
      backbone.

PMID- 2216755
TI  - The involvement of base 1054 in 16S rRNA for UGA stop codon dependent
      translational termination.
AB  - The deletion of the highly conserved cytidine nucleotide at position 1054 in E.
      coli 16S rRNA has been characterized to confer an UGA stop codon specific
      suppression activity which suggested a functional participation of small subunit
      rRNA in translational termination. Based on this structure-function correlation
      we constructed the three point mutations at site 1054, changing the wild-type C
      residue to an A, G or U base. The mutations were expressed from a complete
      plasmid encoded rRNA operon (rrnB) using a conditional expression system with the
      lambda PL-promoter. All three altered 16S rRNA molecules were expressed and
      incorporated into 70S ribosomal particles. Structural analysis of the protein and
      16S rRNA moieties of the mutant ribosomes showed no differences when compared to
      wild-type particles. The phenotypic analysis revealed that only the 1054G base
      change led to a significantly reduced generation time of transformed cells, which
      could be correlated with the inability of the mutant ribosomes to specifically
      stop at UGA stop codons in vivo. The response towards UAA and UAG termination
      codons was not altered. Furthermore, in vitro RF-2 termination factor binding
      experiments indicated that the association behaviour of mutant ribosomes was not
      changed, enforcing the view that the UGA stop codon suppression is a direct
      consequence of the rRNA mutation. Taken together, these results argue for a
      direct participation of that 16S rRNA motif in UGA dependent translational
      termination and furthermore, suggest that termination factor binding and stop
      codon recognition are two separate steps of the termination event.

PMID- 2216756
TI  - T7 endonuclease I resolves Holliday junctions formed in vitro by RecA protein.
AB  - T7 endonuclease I is known to bind and cleave four-way junctions in DNA. Since
      these junctions serve as analogues of Holliday junctions that arise during
      genetic recombination, we have investigated the action of T7 endonuclease I on
      recombination intermediates containing Holliday junctions. We find that addition
      of T7 endonuclease I to strand exchange reactions catalysed by RecA protein of
      Escherichia coli leads to the formation of duplex products that correspond to
      'patch' and 'splice' type recombinants. Resolution of the recombination
      intermediates occurs by the introduction of nicks at the site of the Holliday
      junction. The recombinant molecules contain 5'-phosphate and 3'-hydroxyl termini
      which may be ligated to restore the integrity of the DNA.

PMID- 2216757
TI  - A homologous subfamily of satellite III DNA on human chromosomes 14 and 22.
AB  - We describe a new subfamily of human satellite III DNA that is represented on two
      different acrocentric chromosomes. This DNA is composed of a tandemly repeated
      array of diverged 5-base-pair monomer units of the sequence GGAAT or GGAGT. These
      monomers are organised into a 1.37-kilobase higher-order structure that is itself
      tandemly reiterated. Using a panel of somatic cell hybrids containing specific
      human chromosomes, this higher-order structure is demonstrated on chromosomes 14
      and 22, but not on the remaining acrocentric chromosomes. In situ hybridisation
      studies have localised the sequence to the proximal p-arm region of these
      chromosomes. Analysis by pulsed-field gel electrophoresis (PFGE) reveals that 70
      110 copies of the higher-order structure are tandemly organised on a chromosome
      into a major domain which appears to be flanked on both sides by non-tandemly
      repeated genomic DNA. In addition, some of the satellite III sequences are
      interspersed over a number of other PFGE fragments. This study provides
      fundamental knowledge on the structure and evolution of the acrocentric
      chromosomes, and should extend our understanding of the complex process of
      interchromosomal interaction which may be responsible for Robertsonian
      translocation and meiotic nondisjunction involving these chromosomes.

PMID- 2216753
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 2216758
TI  - Complex requirements for RNA polymerase III transcription of the Xenopus U6
      promoter.
AB  - The role of various sequences in determining the RNA polymerase III (pol III)
      specificity of the Xenopus U6 gene promoter has been investigated. A sequence
      closely resembling an RNA polymerase II (pol II) TATA box, which has previously
      been implicated in determining the pol III specificity of the U6 promoter, was
      analyzed in detail. The U6 TATA-like element, in a different promoter context, is
      shown to be capable of mediating RNA polymerase II transcription both in vitro
      and in oocyte microinjection experiments. Extensive mutagenesis of the TATA-like
      element in the context of the pol III and pol II promoters leads to the
      conclusion that the sequence requirements for function in the two contexts are
      dissimilar, suggesting that different factors may be involved in mediating pol II
      and pol III transcription. Further, as implied by the above results, it is shown
      that the polymerase III specificity of the U6 gene is not solely dependent upon
      the TATA-like element but rather reflects complex interaction between multiple
      components of the promoter.

PMID- 2216759
TI  - In vivo and in vitro analyses of an intron-encoded DNA endonuclease from yeast
      mitochondria. Recognition site by site-directed mutagenesis.
AB  - The pal 4 nuclease (termed I-Sce II) is encoded in the group I al 4 intron of the
      COX I gene of Saccharomyces cerevisiae. It introduces a specific double-strand
      break at the junction of the two exons A4-A5 and thus mediates the insertion of
      the intron into an intronless strain. To define the sequence recognized by pal 4
      we introduced 35 single mutations in its target sequence and examined their
      cleavage properties either in vivo in E. coli (when different forms of the pal 4
      proteins were artificially produced) or in vitro with mitochondrial extracts of a
      mutant yeast strain blocked in the splicing of the al 4 intron. We also detected
      the pal 4 DNA endonuclease activity in extracts of the wild type strain. The
      results suggest that 6 to 9 noncontiguous bases in the 17 base-pair region
      examined are necessary for pal 4 nuclease to bind and cleave its recognition
      site. We observed that the pal 4 nuclease specificity can be significantly
      different with the different forms of the protein thus explaining why only some
      forms are highly toxic in E. coli. This study shows that pal 4 recognition site
      is a complex phenomenon and this might have evolutionary implications on the
      transfer properties of the intron.

PMID- 2216760
TI  - Linearization of baculovirus DNA enhances the recovery of recombinant virus
      expression vectors.
AB  - Engineered derivatives of Autographa californica multiple nucleocapsid nuclear
      polyhedrosis virus (AcMNPV) possessing a unique restriction site provide a source
      of viral DNA that can be linearized by digestion with a specific endonuclease.
      Circular or linearized DNA from two such viruses were compared in terms of their
      infectivity and recombinogenic activities. The linear forms were 15- to 150-fold
      less infectious than the corresponding circular forms, when transfected into
      Spodoptera frugiperda cells using the calcium phosphate method. Linear viral DNA
      was, however, proficient at recombination on co-transfection with an appropriate
      transfer vector. Up to 30% of the progeny viruses were recombinant, a 10-fold
      higher fraction of recombinants than was obtained from co-transfections with
      circular AcMNPV DNA. The isolation of a recombinant baculovirus expression vector
      from any of the AcMNPV transfer vectors currently in use can thus be facilitated
      by linearization of the viral DNA at the appropriate location.

PMID- 2216761
TI  - Rat DNA polymerase beta gene can join in excision repair of Escherichia coli.
AB  - Though DNA polymerase I (poll) of Escherichia (E.) coli is understood to play a
      role in repair synthesis of excision repair, it is still obscure whether DNA
      polymerase beta (pol beta) plays a similar role in eukaryotic cells. To estimate
      the role of pol beta in excision repair processes, we inserted the rat pol beta
      gene into several mutant E. coli defective in a diverse set of enzymatic
      activities of poll. UV resistance was seen only when the 5'----3' exonuclease
      (exo) activity of poll molecules remained. Therefore it is suggested that 5'---
      3' exo activity as well as pol beta activity are essential for repair synthesis
      of excision repair in eukaryotic cells.

PMID- 2216762
TI  - An 'equalized cDNA library' by the reassociation of short double-stranded cDNAs.
AB  - The total number of genes in higher organisms is estimated to be under one
      hundred thousand. However, constructing a cDNA library containing a full set of
      genes expressed throughout the life time of an organism, without redundancy, is a
      major challenge for modern biology. Towards this goal, I have tried to make a
      library of mouse fibroblastoid Ltk- cells with nearly equal representations of
      cDNA clones. Double-stranded cDNAs (ds-cDNAs) are synthesized from mRNA using an
      oligo(dT)-Notl primer. After shearing to 200-400 bp, a synthetic linker-primer,
      which has one blunt and one sticky end and an internal EcoRl site, is ligated to
      the cDNAs. The cDNAs are amplified by the polymerase chain reaction (PCR) using
      the ligated linker-primer sequence. After denaturation and reassociation of the
      ds-cDNAs, and isolation of single-stranded cDNAs (ss-cDNAs) by hydroxylapatite
      chromatography, the ss-cDNAs are again amplified by PCR. The cDNAs are digested
      with EcoRl and Notl, and inserted into a plasmid vector. Colony hybridization
      with eight probes of different abundance showed a reduction in 'abundance
      variation' from at least 20,000-fold in the original library to 40-fold in the
      library constructed after three cycles of equalization. This indicates the
      usefulness of the current procedure for making equalized cDNA libraries.

PMID- 2216763
TI  - A single-stranded DNA-binding protein promotes the binding of the purified
      oestrogen receptor to its responsive element.
AB  - The purified human oestrogen receptor (hER) does not form a detectable complex
      with an oestrogen responsive element (ERE) under conditions where hER-ERE
      complexes are readily formed with crude extracts from Hela or yeast cells
      expressing the hER. This indicates that other factor(s) are necessary for ER-ERE
      binding. Such a ER DNA binding stimulatory factor (DBSF) has been purified from
      the yeast Saccharomyces cerevisiae. It is a 45 kDa single-stranded DNA-binding
      protein (SSB) which cannot be substituted for by the purified E. coli SSB.

PMID- 2216764
TI  - The binding site for the liver-specific transcription factor Tf-LF1 and the TATA
      box of the human transferrin gene promoter are the only elements necessary to
      direct liver-specific transcription in vitro.
AB  - We have studied the liver-specific transcriptional activity of the human
      transferrin gene promoter. Results of competition experiments, site-directed
      mutagenesis, and 5' deletion analysis have demonstrated that a TATA box and a
      binding site for the liver-specific protein Tf-LF1 are the only elements needed
      to direct hepatic-specific transcription in vitro. Thus, Tf-LF1 behaves as other
      previously described proteins, HNF-1, DBP and LF-A1, in that it is sufficient to
      confer liver-specific transcriptional activity to a promoter in vitro. This
      results contrast with observations made in transient expression experiments, in
      which Tf-LF1 binding alone cannot direct hepatic-specific expression, and the
      binding of at least one more protein, similar to C/EBP, is needed. Thus, as
      described for other hepatic genes, the number of elements necessary to confer
      tissue specificity is different in vivo and in vitro.

PMID- 2216765
TI  - Expression of a human O6-alkylguanine-DNA-alkyltransferase cDNA in human cells
      and transgenic mice.
AB  - A truncated human O6-alkylguanine-DNA-alkyltransferase (ATase) cDNA was ligated
      into an expression vector under the control of the mouse metallothionein-1 gene
      promotor and upstream of part of the human growth hormone gene to provide splice
      and polyadenylation signals. Transfection of this construct into human cells
      resulted in very high levels of ATase expression (more than 300 fmoles/mg protein
      versus less than 2 fm/mg protein in parent vector transfected control cells).
      Microinjection of a 4.2 kb fragment of this vector into B6D2F2 mouse embryos and
      implantation of survivors into pseudopregnant females has so far generated 35
      offspring. Southern analysis of tail tip DNA has shown that 11 of the offspring
      are transgenic for the human ATase gene, between 1 and at least 30 copies of the
      gene being detected. Human ATase transcripts were detected in total RNA extracted
      from liver obtained from two male transgenic mice by partial hepatectomy. Cell
      free extracts of liver samples from five transgenic mice showed up to 4 times
      higher ATase levels than control livers.

PMID- 2216766
TI  - Synthesis and characterization of oligodeoxynucleotides containing the mutagenic
      base analogue 4-O-ethylthymine.
AB  - A method for the preparation of oligonucleotides containing the mutagenic base 4
      O-ethylthymine is described for the first time. Use of p-nitrophenylethyl type
      base protecting groups together with phosphitetriester solid-phase methodology
      makes possible the rapid and efficient preparation of oligonucleotides bearing 4
      O-ethylthymine, while standard base protecting groups are not compatible with the
      presence of this base. Possible applications of this methodology are discussed.

PMID- 2216767
TI  - Sequence specificity of the human mRNA N6-adenosine methylase in vitro.
AB  - N6-adenosine methylation is a frequent modification of mRNAs and their
      precursors, but little is known about the mechanism of the reaction or the
      function of the modification. To explore these questions, we developed conditions
      to examine N6-adenosine methylase activity in HeLa cell nuclear extracts.
      Transfer of the methyl group from S-[3H methyl]-adenosylmethionine to unlabeled
      random copolymer RNA substrates of varying ribonucleotide composition revealed a
      substrate specificity consistent with a previously deduced consensus sequence,
      Pu[G greater than A]AC[A/C/U]. 32-P labeled RNA substrates of defined sequence
      were used to examine the minimum sequence requirements for methylation. Each RNA
      was 20 nucleotides long, and contained either the core consensus sequence GGACU,
      or some variation of this sequence. RNAs containing GGACU, either in single or
      multiple copies, were good substrates for methylation, whereas RNAs containing
      single base substitutions within the GGACU sequence gave dramatically reduced
      methylation. These results demonstrate that the N6-adenosine methylase has a
      strict sequence specificity, and that there is no requirement for extended
      sequences or secondary structures for methylation. Recognition of this sequence
      does not require an RNA component, as micrococcal nuclease pretreatment of
      nuclear extracts actually increased methylation efficiency.

PMID- 2216768
TI  - Thermodynamics of triple helix formation: spectrophotometric studies on the
      d(A)10.2d(T)10 and d(C+3T4C+3).d(G3A4G3).d(C3T4C3) triple helices.
AB  - We have stabilized the d(A)10.2d(T)10 and d(C+LT4C+3).d(G3A4G3).d(C3T4C3) triple
      helices with either NaCl or MgCl2 at pH 5.5. UV mixing curves demonstrate a 1:2
      stoichiometry of purine to pyrimidine strands under the appropriate conditions of
      pH and ionic strength. Circular dichroic titrations suggest a possible sequence
      independent spectral signature for triplex formation. Thermal denaturation
      profiles indicate the initial loss of the third strand followed by dissociation
      of the underlying duplex with increasing temperature. Depending on the base
      sequence and ionic conditions, the binding affinity of the third strand for the
      duplex at 25 degrees C is two to five orders of magnitude lower than that of the
      two strands forming the duplex. Thermodynamic parameters for triplex formation
      were determined for both sequences in the presence of 50 mM MgCl2 and/or 2.0 M
      NaCl. Hoogsteen base pairs are 0.22-0.64 kcal/mole less stable than Watson-Crick
      base pairs, depending on ionic conditions and base composition. C+.G and T.A
      Hoogsteen base pairs appear to have similar stability in the presence of Mg2+
      ions at low pH.

PMID- 2216769
TI  - Chromatin assembly on replicating DNA in vitro.
AB  - Replicating single-stranded DNA is preferentially assembled into chromatin in
      Xenopus egg extracts relative to non-replicating double-stranded DNA. We have
      examined the molecular basis of this phenomenon. Single-stranded DNA itself is
      not a favored template for nucleosome assembly in comparison to double-stranded
      DNA. Complementary strand synthesis is required for the rapid assembly of
      nucleosomes. We present evidence that the assembly of chromatin on replicating
      DNA is a two step phenomenon. The first step involves the replication of DNA and
      the assembly of an intermediate structure, the second step involves the
      sequestration of histones H2A/H2B onto DNA. Histones H2A/H2B are preferentially
      sequestered onto replicated DNA in comparison to non-replicated DNA incubated in
      the extract.

PMID- 2216770
TI  - Transcription of single-copy hybrid lacZ genes by T7 RNA polymerase in
      Escherichia coli: mRNA synthesis and degradation can be uncoupled from
      translation.
AB  - In Escherichia coli transcription of individual genes generally requires
      concomitant translation, and thus the decay of mRNAs cannot be studied without
      the complication of translation. Here we have used T7 RNA polymerase to
      transcribe in vivo lacZ genes carrying ribosome binding sites of variable
      efficiency. We show that neither cell viability nor growth rate is affected by
      the T7-driven transcription of these genes, provided that they are present as
      single chromosomal copy. Furthermore, transcription is now completely uncoupled
      from translation, allowing large amounts of even completely untranslated mRNAs to
      be synthesized. Taking advantage of these features, we discuss the influence of
      the frequency of translation upon the processing and degradation of the lac
      message.

PMID- 2216771
TI  - II-Q restriction endonucleases--new class of type II enzymes.
AB  - Unique restriction endonucleases Bpu 10l and Bsil have been isolated from
      Bacillus pumilas and Bacillus sphaericus, respectively. The recognition sequences
      and cleavage points of these enzymes have been determinated as 5'-CC1TNAGC-3'/3'
      GGANT1CG-5' for Bpu 10l and 5'-C1TCGTG-3'/3'-GAGCA1C-5' for Bsil. Restriction
      endonucleases Bpu 10l and Bsil represent a new class of enzymes which recognize
      non-palindromic nucleotide sequences and hydrolize DNA within the recognition
      sequence. Bpu 10l and Bsil recognition sequences may be regarded as
      quasipalindromic and the enzymes may be designated as type II-Q restriction
      endonucleases.

PMID- 2216772
TI  - HrpF, a human sequence-specific DNA-binding protein homologous to XrpFI, a
      Xenopus laevis oocyte transcription factor.
AB  - The identification in HeLa nuclei of a novel DNA-binding protein, designated
      HrpF, is presented. This factor recognizes and binds a sequence of the Xenopus
      laevis L14 ribosomal protein (r-p) gene promoter bound by the Xenopus r-p
      transcription factor I (XrpFI). We show here that XrpFI and HrpF share a
      conserved DNA-binding domain. We also present evidences suggesting that the two
      factors perform similar functions in the cell. We discuss the hypothesis that
      closely related factors might be involved in the control of rp-gene transcription
      in vertebrates.

PMID- 2216773
TI  - A 40 kilodalton rat liver nuclear protein binds specifically to apolipoprotein B
      mRNA around the RNA editing site.
AB  - Apolipoprotein (apo) B-48 mRNA is the product of RNA editing which consists of a
      C----U conversion changing a CAA codon encoding Gln-2153 in apoB-100 mRNA to a
      UAA stop codon in apoB-48 mRNA. In the adult rat, RNA editing occurs both in the
      small intestine and the liver. We have studied the ability of rat liver nuclear
      extracts to bind to synthetic apoB mRNA segments spanning the editing site. Using
      an RNA gel mobility shift assay, we found the sequence-specific binding of a
      protein(s) to a 65-nucleotide apoB-100 mRNA. UV crosslinking followed by T1
      ribonuclease digestion and SDS-polyacrylamide gel electrophoresis demonstrated
      the formation of a 40 kDa protein-RNA complex when 32P-labeled apoB-100 mRNA was
      incubated with a rat liver nuclear extract but not with HeLa nuclear extract.
      Binding was specific for the sense strand of apoB mRNA, and was not demonstrated
      with single-stranded apoB DNA, or antisense apoB RNA. The complex also failed to
      form if SDS was present during the UV light exposure. Binding experiments using
      synthetic apoB mRNAs indicate that the 40 kDa protein would also bind to apoB-48
      mRNA but not apoA-I, apoA-IV, apoC-II or apoE mRNA. Experiments using deletion
      mutants of apoB-100 mRNA indicate efficient binding of wildtype 65-nucleotide
      (W65), 40-nucleotide (W40) and 26-nucleotide (W26) apoB-100 mRNA segments, but
      not 10-nucleotide (or smaller) segments of apoB-100 mRNA to the 40 kDa protein.
      In contrast, two other regions of apoB-100 mRNA, B-5' (bases 1128-3003) and B-3'
      (bases 11310-11390), failed to bind to the protein. The 40 kDa sequence-specific
      binding protein in rat liver nuclear extract may play a role in apoB-100 mRNA
      editing.

PMID- 2216774
TI  - Translation of the Saccharomyces cerevisiae tcm1 gene in the absence of a 5'
      untranslated leader.
AB  - The role of eukaryotic 5'-untranslated messenger RNA leaders is not entirely
      clear, since they share little sequence similarity among each other. The
      importance of the leader in determining the efficiency of translation initiation
      was addressed here by examining the polyribosome distribution of several leader
      deletion alleles of the yeast tcm1 gene (coding for ribosomal protein L3).
      Shortening of this 22-nucleotide leader, or complete removal of it (the first
      nucleotide of the mRNA becoming the A of the translation initiation codon AUG)
      permitted translation, albeit reduced. Further deletion of as few as the first
      two nucleotides of the initiation codon leads to a substantial reduction in
      ribosome loading, which is compatible with inefficient initiation at the next
      downstream, out-of-frame, AUG triplet. A second measure of translation initiation
      was obtained by assaying qualitatively for the production of biologically active
      L3 protein using growth-resistance to trichodermin. This experiment indicates
      that ribosomes can recognize the correct initiation codon even in the complete
      absence of a leader. We conclude that the 5'-untranslated leader of the yeast
      tcm1 gene is not essential for accurate translation initiation, but enhances its
      efficiency.

PMID- 2216775
TI  - The mechanism of production of multiple mRNAs for human glycophorin A.
AB  - The major sialoglycoprotein in the human red cell surface membrane, glycophorin A
      is encoded by a single gene. However, this gene gives rise to three species of
      glycophorin A mRNA of sizes about 1.0, 1.7 and 2.8 kilobases in reticulocytes,
      foetal liver cells and erythroleukaemic K562 cells. In an investigation of how
      the three mRNAs originated, we showed by primer extension analysis that all three
      mRNAs in K562 cells had identical 5' termini and, by nucleotide sequencing of
      correlated cDNAs, that they had identical coding regions, except for the well
      known glycophorin AM-AN polymorphism. However, we found also by sequencing the
      cDNAs that the mRNAs apparently differed from each other in the lengths of their
      3' untranslated regions. This was confirmed by Northern blot analysis which also
      provided evidence that the three mRNAs originated by use of different
      polyadenylation signals of which seven were found in the longest cDNA we
      analyzed.

PMID- 2216776
TI  - Non-radioactive labeling of RNA transcripts in vitro with the hapten digoxigenin
      (DIG); hybridization and ELISA-based detection.
AB  - We have developed a system for the enzymatic in vitro synthesis of non
      radioactively labeled RNA which is derivatized with the hapten digoxigenin (DIG).
      The labeling reaction as well as the conditions for hybridization and detection
      of hybrids by an antibody-conjugate and a coupled colour reaction were analyzed
      and adapted for high sensitivity and low background. In addition, data on the
      performance and sensitivity of digoxigenin-labeled RNA probes in Southern and
      Northern blots are presented.

PMID- 2216778
TI  - Computer prediction of the exon-intron structure of mammalian pre-mRNAs.
AB  - A novel approach to the problem of prediction of protein-coding regions is
      suggested. This approach combines the site prediction methods to predict splicing
      sites and the global coding region prediction methods to choose the best variant
      of spliced mRNA. One of the advantages of the suggested algorithm is that the
      resulting mRNA or protein sequence may then be immediately analyzed further. The
      true mRNA either coincides with the predicted one or ranks high in the list of
      variants. In the latter situation the predicted mRNA usually differs from the
      true one in only one or two of several exons. The combined approach allows the
      use of a priori information (e.g. the putative protein length or the number of
      exons). It is possible to use additional parameters not considered here, such as
      the preferred lengths of exons and introns, and particularly the preferred
      position of introns in the reading frame and the preferred codon position of exon
      termini.

PMID- 2216777
TI  - A distal dimerization domain is essential for DNA-binding by the atypical HNF1
      homeodomain.
AB  - Hepatic Nuclear Factor 1 (HNF1, also referred to as LFB1, HP1 or APF) is a liver
      specific transcription factor required for the expression of many hepatocyte
      specific genes. We report here the purification of this rat liver nuclear protein
      and the cloning of its cDNA using a PCR-derived approach. Seven independent
      clones reveal 3 alternative polyadenylation sites and a unique open reading
      frame. Both a motif homologous to the homeodomain and a distal dimerization
      domain are required for specific DNA binding. Sequence comparisons reveal several
      atypical features at key positions in the segment corresponding to helices III
      and IV of the Antaennapedia homeodomain as well as a potential 24 amino acid loop
      in place of the universal turn between helices II and III. Together with its
      property to dimerize in the presence or absence of DNA, these features place HNF1
      as the prototype of a novel subclass of transcription factors distantly related
      to homeoproteins.

PMID- 2216779
TI  - Sequence of the TCR beta chain gene used by a T cell clone specific for the
      synthetic polymer, GAT.

PMID- 2216780
TI  - Nucleotide sequence of a gene from alkaliphilic Bacillus firmus RAB that is
      homologous to the fpg gene of Escherichia coli.

PMID- 2216781
TI  - cDNA cloning of ovine interleukin 2 by PCR.

PMID- 2216782
TI  - Complete nucleotide sequence of a gene coding for Aspergillus aculeatus cellulase
      (FI-CMCase).

PMID- 2216783
TI  - Nucleotide sequence of the virion protein gene of cacao yellow mosaic tymovirus.

PMID- 2216784
TI  - Nucleotide sequence of the envelope glycoprotein gene of a dengue-2 virus
      isolated during an epidemic of benign dengue fever in Tonga in 1974.

PMID- 2216785
TI  - Nucleotide sequence of a Ricinus communis 2S albumin precursor gene.

PMID- 2216786
TI  - Nucleotide sequence of the cDNA encoding L-histidine decarboxylase derived from
      human basophilic leukemia cell line, KU-812-F.

PMID- 2216787
TI  - Human nonsarcomeric 20,000 Da myosin regulatory light chain cDNA.

PMID- 2216788
TI  - Sequence of tRNA(Glu) and its genes from the chloroplast genome of Chlamydomonas
      reinhardtii.

PMID- 2216789
TI  - Nucleotide sequence of the arrestin-like 49 Kd protein gene of Drosophila
      miranda.

PMID- 2216790
TI  - Human N-cadherin: nucleotide and deduced amino acid sequence.

PMID- 2216791
TI  - Sequence of a histone H2A cDNA from parsley.

PMID- 2216792
TI  - Nucleotide sequence of rice waxy gene.

PMID- 2216793
TI  - The nucleotide sequence of gene 3 of the soybean chalcone synthase multigene
      family.

PMID- 2216794
TI  - Nucleotide sequence encoding the major glycoprotein (GP2) of rat pancreatic
      secretory (zymogen) granule membranes.

PMID- 2216795
TI  - PCR-aided DNaseI footprinting of single copy gene sequences in permeabilized
      cells.

PMID- 2216796
TI  - Transient expression of DNA after ballistic introduction into Drosophila embryos.

PMID- 2216797
TI  - An improved method for sequencing double stranded plasmid DNA from minipreps
      using DMSO and modified template preparation.

PMID- 2216798
TI  - Direct PCR from whole blood, without DNA extraction.

PMID- 2216799
TI  - Klenow polymerase is preferable to T4 polymerase in end-labeling reactions.

PMID- 2216800
TI  - High efficiency electroporation of ligated DNA into bacteria.

PMID- 2216801
TI  - Use of primer pools for specific gene amplification.

PMID- 2216802
TI  - Dinucleotide repeat polymorphism at the SIS locus.

PMID- 2216803
TI  - Dinucleotide repeat polymorphism at the D11S420 locus.

PMID- 2216804
TI  - Dinucleotide repeat polymorphism at the D11S35 locus.

PMID- 2216805
TI  - Sequence polymorphism in the human apoB gene at position 8344.

PMID- 2216806
TI  - Dinucleotide repeat polymorphism at the D21S168 locus.

PMID- 2216808
TI  - [99mTc-2-methoxy-isobutyl-isonitrile in the diagnosis of coronary heart disease:
      results of a multicenter study].
AB  - A total of 226 patients was studied in a phase-III multicenter trial to compare
      the results of stress/rest 99mTc-MIBI with 201TI scintigraphy and/or coronary
      arteriography. The evaluation of planar and SPECT imaging was based on a
      semiquantitative visual scoring. A congruent diagnosis was generated from all
      planar 201TI and 99mTc-MIBI scintigrams performed in 36 patients. In 62 of 63
      patients, SPECT-studies with 99mTc-MIBI and 201TI led to an identical diagnosis.
      In one patient a positive result was obtained with 201TI-SPECT whereas 99mTc-MIBI
      was negative. Segmental agreement for 1509 SPECT segments was 85.7%, for 554
      planar segments it was 86.6%. In comparison to coronary arteriography, performed
      in 180 patients, the overall sensitivity for the correct diagnosis of coronary
      artery disease (CAD) was 86% for planar MIBI scintigraphy or 92% for MIBI-SPECT.
      Overall specificity was 100% for planar imaging and 57% for SPECT. The low
      specificity of MIBI-SPECT was probably due to high prevalence of CAD in this
      study population. In a subgroup of 43 patients, who underwent coronary
      angiography, identical results were found with 99mTc-MIBI and 201TI. Only one
      patient showed a positive scintigraphic result with both 99mTc-MIBI and 201TI
      without angiographically proven stenosis greater than 50% or prior myocardial
      infarction. Vessel sensitivities in stenosed coronary arteries (greater than 50%
      stenosis) were 54% for the LAD and 87% for the RCX/RCA areas with MIBI-SPECT, or
      51% or 79% for planar scintigraphy, respectively. Vessel specificities for SPECT
      were 65% in the LAD or 52% in the RCX/RCA, or 90% or 83% in planar
      imaging.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216809
TI  - [The role of radionuclide ventriculograms in determining the indications for
      valve replacement in chronic aortic valve insufficiency].
AB  - Timing of aortic valve replacement (AVR) in chronic aortic regurgitation (AR)
      remains a difficult problem in clinical practice. Radionuclide ventriculography
      (RNV) yields information on the extent of valvular regurgitation, the enlargement
      and the systolic function of the left ventricle. A "well-timed" AVR is defined by
      1) postoperative improvement of clinical symptoms, decrease in left ventricular
      end-diastolic volume (EDV) and normalization of ejection fraction (EF) as well as
      by 2) greater improvement under surgical therapy as compared to conservative
      management. In "too early" AVR the latter condition is not fulfilled, while in
      "too late" AVR the first condition is not accomplished. In this study 54 patients
      with chronic aortic incompetence were evaluated by RNV to see whether these three
      groups ("too early", "well timed", "too late" AVR, resp.) can be separated by the
      relation between EDV and regurgitant volume (RV), the level of the EDV and the
      clinical status. The examination was based on pre- and postoperative RNV studies
      as well as on follow-up studies. A good postoperative result can be expected in
      cases with a preoperative EDV/RV-ratio similar to that observed in 30 patients
      with AR in whom AVR was not indicated. In contrast, in the majority of those
      cases with an EDV/RV-ratio exceeding this normal range the postoperative outcome
      will be unsatisfactory. If the EDV/RV-ratio is normal, AVR should be performed in
      cases with an EDV exceeding 400 ml, while in cases with an EDV between 300-400 ml
      AVR is only indicated in the presence of additional symptoms (NYHA greater than
      or equal to II).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216810
TI  - 201Tl myocardial SPECT and beta-endorphin levels in patients with suspected
      silent ischemia.
AB  - Today silent myocardial ischemia (SMI) is a well-recognized phenomenon. However,
      in the absence of clinical signs suggesting coronary artery disease (CAD), a
      streamlined diagnostic approach for precise clarification has proved to be
      difficult. Sensitivity and specificity of ergometric results are rather poor in
      symptom-free patients. Thus the question arises, whether the necessity of
      coronary angiography can be established more precisely by 201Tl myocardial SPECT
      in these patients. Treadmill exercise according to the Bruce protocol, 201Tl
      myocardial SPECT and coronary angiography were performed in a total of 106
      patients with suspected SMI. In group I (high probability of ischemia; n = 46),
      reversible defects detected by SPECT correlated well with significant stenoses
      and irreversible defects with subtotal stenoses or complete occlusions. SPECT
      sensitivity in the detection of ischemia was 91%, its specificity 96%. In group
      II (low probability of ischemia; n = 60), SPECT sensitivity was as high as in
      group I (94%) but due to a high number of false-positive results (e.g.
      cardiomyopathy) specificity was only 75%. However, SPECT was superior to exercise
      ECG (sensitivity 70%; specificity 56%) in the detection of SMI. In addition, beta
      endorphin levels were determined in 180 healthy subjects, 37 patients with
      symptomatic CAD and in 34 patients with SMI before and during maximum exercise.
      Exercise values in patients with SMI were significantly higher than in healthy
      subjects or in patients with symptomatic CAD.

PMID- 2216811
TI  - [Results of radioiodine therapy of manifest hyperthyroidism and autonomous struma
      with euthyroidism].
AB  - In 200 patients follow-up examinations were performed up to one year after
      radioiodine therapy (RITh) with individual dose calculation. The mean applied
      dose was significantly lower in patients with immunogenic hyperthyroidism
      (Graves' disease) as compared to patients with non-immunogenic hyperthyroidism
      (disseminated/multifocal autonomy, HYDA). In Graves' disease the rate of
      recurrent hyperthyroidism was significantly higher and that of posttreatment
      hypothyroidism lower. Considering the high recurrence rate in Graves' disease a
      higher dose, e.g. 150 Gy, seems to be appropriate. In patients with HYDA who
      received antithyroid drugs during RITh, recurrence of hyperthyroidism appeared
      slightly more, and posttreatment hypothyroidism slightly less, frequent. The
      efficiency of RITh was not significantly reduced by additional treatment with
      antithyroid drugs. Posttreatment hypothyroidism in patients with euthyroid goiter
      and disseminated/multifocal autonomy (EUDA) occurred significantly more frequent
      if the basal TSH level was greater than or equal to 0.5 muIE/ml before therapy.
      The goiter size was reduced independent of the basal TSH level. In this group
      protection by thyroxine could avoid posttreatment hypothyroidism without
      impairing the reduction of goiter. In HYDA patients after thyroid surgery
      recurrence appeared less, and in those with EUDA posttreatment hypothyroidism
      significantly more, frequent. A lower dose seems to be suitable in patients who
      underwent thyroid surgery before. In patients with focal autonomy after RITh no
      recurrence of hyperthyroidism was observed. In 9% a suppressed basal TSHh level
      indicating persistent autonomy was seen. Posttreatment hypothyroidism in focal
      autonomy appeared only in patients without manifest hyperthyroidism before RITh
      and was significantly more frequent in this group as compared to the other groups
      of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216812
TI  - [Scintigraphy using 111In-labeled antimyosin in Churg-Strauss vasculitis with
      myocardial involvement].
AB  - A case of Churg-Strauss vasculitis in a young woman is reported. Diagnosis was
      confirmed by muscle biopsy. Affection of lungs, kidneys and skin was evident. In
      addition, myocarditis was suspected on clinical evidence. A highly positive
      scintigraphy with 111In-antimyosin enabled diagnosis and assessment of damage to
      the myocytes. With a heart-to-lung ratio of 3.0 the accumulated activity in the
      myocardium was higher than usually found in myocarditis. This finding supports
      the hypothesis of an additional ischemic necrosis.

PMID- 2216807
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 2216813
TI  - [Immunoscintigraphy of the hematopoietic bone marrow in osteomyelofibrosis].
AB  - In planning the treatment of splenomegaly in primary or secondary
      osteomyelofibrosis it is necessary to know whether there is any significant
      hematopoiesis outside the spleen. In contrast to the measurement of iron kinetics
      with 59Fe, which is not suitable for imaging, immunoscintigraphy with the
      monoclonal antibody Bw 250/183 allows specific imaging of the hematopoietic bone
      marrow. The diagnostic use of this method in addition to iron kinetics is
      illustrated and discussed in a patient with primary osteomyelofibrosis.

PMID- 2216814
TI  - Chips with everything.

PMID- 2216816
TI  - Nursing Poland's future.

PMID- 2216815
TI  - Casualty encounters.

PMID- 2216817
TI  - Alternative questions.

PMID- 2216818
TI  - Monitor and evaluate.

PMID- 2216819
TI  - Green gauges.

PMID- 2216820
TI  - No way to leave.

PMID- 2216821
TI  - Shift work. Beat the clock.

PMID- 2216822
TI  - Shift work. Planning shift patterns.

PMID- 2216823
TI  - Reducing stress in the cancer ward.

PMID- 2216824
TI  - Music as therapy.

PMID- 2216825
TI  - Mental handicap. Adopting the family approach.

PMID- 2216827
TI  - Comic relief. Interview by Daloni Carlisle.

PMID- 2216826
TI  - Going Dutch.

PMID- 2216828
TI  - How to state your case.

PMID- 2216829
TI  - Nurse-managed care in a rehabilitation ward.

PMID- 2216830
TI  - Warning over HIV home testing kits.

PMID- 2216831
TI  - Keeping leg ulcers moist.

PMID- 2216832
TI  - Eusol and the law.

PMID- 2216834
TI  - Refuge and respite.

PMID- 2216833
TI  - Pressure sore practices.

PMID- 2216835
TI  - Save the children.

PMID- 2216836
TI  - Moral imperatives.

PMID- 2216838
TI  - Just a little amputation.

PMID- 2216837
TI  - Breathing easily.

PMID- 2216839
TI  - Eastern Europe. After the revolution.

PMID- 2216840
TI  - Eastern Europe. Gaining respect.

PMID- 2216841
TI  - Eastern Europe. Changing associations.

PMID- 2216842
TI  - Racism in nursing. Biting the hand.

PMID- 2216843
TI  - Sharing the pain of motherhood.

PMID- 2216844
TI  - Turning the tide.

PMID- 2216846
TI  - Responsibility without authority.

PMID- 2216847
TI  - Day case. Eye surgery.

PMID- 2216845
TI  - Community nursing. Gathering information from the field.

PMID- 2216848
TI  - Mental handicap. Evaluating the family approach.

PMID- 2216851
TI  - Mental health. Training to meet the new agenda.

PMID- 2216850
TI  - Mental health. Approaches to cultural awareness.

PMID- 2216849
TI  - Mental health. Caught between two cultures.

PMID- 2216853
TI  - Delivering equality.

PMID- 2216852
TI  - Mental health. A dying breed?

PMID- 2216854
TI  - Standing up for Pink.

PMID- 2216855
TI  - Happy anniversary?

PMID- 2216856
TI  - Aiding ignorance?

PMID- 2216857
TI  - The danger hours.

PMID- 2216858
TI  - A noble vocation.

PMID- 2216859
TI  - Homes fit for nurses?

PMID- 2216860
TI  - Bequeath, bury or burn?

PMID- 2216861
TI  - Taking the waters.

PMID- 2216862
TI  - Matching staff to patient dependency.

PMID- 2216863
TI  - A return to the medical model?

PMID- 2216864
TI  - Community nursing. Striving for fairer workloads.

PMID- 2216865
TI  - Looking death in the face.

PMID- 2216866
TI  - Shifting the blame.

PMID- 2216867
TI  - Increased violence in an acute psychiatric ward.

PMID- 2216868
TI  - Nurses' attitudes to patients with AIDS.

PMID- 2216869
TI  - Clinical problem-solving behaviour.

PMID- 2216871
TI  - How to ... review an article.

PMID- 2216870
TI  - Nurse education. Teachers in the firing line.

PMID- 2216872
TI  - Theatre nursing. New priorities.

PMID- 2216873
TI  - Theatre nursing. The process of change.

PMID- 2216874
TI  - Teamwork in the theatre.

PMID- 2216875
TI  - The lessons from Stepping Hill.

PMID- 2216877
TI  - Fighting for equality.

PMID- 2216876
TI  - GP takeover?

PMID- 2216878
TI  - Growing up in smoke.

PMID- 2216879
TI  - Low birthweight babies. Monitoring child development.

PMID- 2216880
TI  - Low birthweight babies. Testing neonatal care.

PMID- 2216881
TI  - If the cap fits.

PMID- 2216883
TI  - Why perpetuate the shaving ritual?

PMID- 2216882
TI  - Eastern Europe: children's haven. Interview by Joanna Trevelyan.

PMID- 2216884
TI  - Adopting the hospice ethic.

PMID- 2216885
TI  - The human face of genetics.

PMID- 2216887
TI  - Don't worry--it's only cancer.

PMID- 2216886
TI  - Nursing development units: a virtue in uniformity?

PMID- 2216888
TI  - Shared care for diabetes between hospital and GPs.

PMID- 2216890
TI  - Using experiential teaching methods.

PMID- 2216889
TI  - Nurses' knowledge of coma assessment.

PMID- 2216891
TI  - Snap decisions.

PMID- 2216892
TI  - The Brussels Nightingale.

PMID- 2216893
TI  - Computers. Taking care of clerical work.

PMID- 2216894
TI  - Computers. An Oscar winner.

PMID- 2216895
TI  - Computers. Square pegs into round holes.

PMID- 2216896
TI  - Influence of dietary fats and vitamin E on plasma and hepatic vitamin A and beta
      carotene levels in rats fed excess beta-carotene.
AB  - Effects of different dietary lipids and excess vitamin E on plasma and hepatic
      concentrations of beta-carotene were evaluated in rats fed diets containing a
      large excess (0.2%) of beta-carotene. Male weanling Wistar Kyoto rats were fed
      beta-carotene-supplemented diets containing various dietary lipids as follows:
      Group I, a saturated fat (coconut oil); Group II, a monounsaturated fat (olive
      oil); Group III, a polyunsaturated fat rich in omega-6 fatty acids (safflower
      oil); Group IV, same as Group III plus vitamin E; and Group V, a polyunsaturated
      fat rich in omega-3 fatty acids (menhaden oil). All diets contained 2% safflower
      oil to provide sufficient amounts of linoleic acid (an essential fatty acid).
      Rats were killed after six weeks of feeding the various diets, and the
      concentrations of beta-carotene and vitamin A were determined in plasma and
      liver. Plasma vitamin A levels were not altered by any of the dietary lipids or
      by an excess of vitamin E. The concentrations of beta-carotene in plasma were the
      lowest in rats fed the diet containing menhaden oil. The feeding of the diet
      containing an excess of vitamin E also resulted in a significant decrease in
      plasma beta-carotene concentration. Similarly, the hepatic beta-carotene
      concentration was also reduced to about one-half in rats fed the diet containing
      an excess of vitamin E. Liver beta-carotene concentration was higher in Groups II
      and III than in the other three dietary groups. Hepatic vitamin A concentrations
      were also affected by the type of dietary fat.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216897
TI  - Gastric lesions in rats fed salted food materials commonly eaten by Japanese.
AB  - A high intake of salted food is thought to be related to the high incidence of
      stomach cancer in Japan. In the present study, female F344 rats were divided into
      four groups. They were fed a nutritionally deficient purified diet (Group 1) and
      standard purified diet (Group 3) for 113 weeks and the same diets supplemented
      with salted cuttlefish guts, broiled, salted, dried sardines, pickled radish, and
      soy sauce (Groups 2 and 4). The incidence of papillomas and ulcers of the
      forestomach was highest in Group 4, which was given the standard diet
      supplemented with the salty food materials (p less than 0.05). These results
      suggest the importance of salted food as a suspicious causal factor in human
      stomach cancer in Japan.

PMID- 2216900
TI  - Prevention of melanoma.

PMID- 2216898
TI  - A case-control study of serum vitamins A, E, and C in lung cancer patients.
AB  - In a case-control study, serum levels of vitamins E, C, and A, carotenoids, total
      cholesterol, and retinol-binding protein along with smoking levels were studied
      on 59 persons newly diagnosed with lung cancer and also on matched hospitalized
      controls. The relative risk for smoking increased with the number of pack years
      of cigarettes smoked. Cases had significantly lower serum levels of carotenoids,
      vitamin E, and total cholesterol. Adjustment for serum cholesterol levels
      diminished the case-control difference for serum carotenoid levels and reduced
      the case-control difference for serum vitamin E levels. The results indicate that
      serum vitamin E may also be associated with lung cancer, possibly to a greater
      degree than serum retinol (vitamin A) is associated with lung cancer.

PMID- 2216899
TI  - Differential effects of Ca2+ on proliferation of stomach, colonic, and pancreatic
      cancer cell lines in vitro.
AB  - Calcium intake inhibits growth of colon cancer in vivo, the mechanisms of which
      are not fully elucidated. The objective of this study was to determine whether
      Ca2+ directly affects the growth of colon cancer cells in vitro and to compare
      the effects of Ca2+ on the growth of several gastroenteropancreatic cancer cells,
      including mouse colon cancer (MC-26), human colon cancer (LoVo and WIDR), human
      gastric cancer (AGS and SII), and human pancreatic cancer (PANC-1 and MIA) cells.
      All tumor cell lines tested grew in medium containing low concentration (approx
      0.16 mM) of Ca2+. Higher concentrations of Ca2+ significantly inhibited the
      growth of all three colon cancer cell lines tested but had no significant effect
      on proliferation of the stomach and pancreatic cancer cell lines. Growth of AGS
      cells, in the presence of 0.1 or 0.5 mM EGTA (resulting in the loss of the
      extracellular Ca2+) was similar to that observed in the absence of EGTA,
      indicating that AGS cells were relatively insensitive to loss of extracellular
      Ca2+. In the presence of TMB-8, an inhibitor of intracellular Ca2+ release, the
      growth of colonic cancer cell lines was inhibited in a dose-dependent manner,
      indicating that a minimum basal level of intracellular Ca2+ was required for
      continued proliferation of colon cancer cells. The stomach cancer cell lines
      (AGS) was once again less sensitive to the effects of TMB-8 than were the colon
      cancer cells, indicating an inherent difference in Ca2+ requirements and
      sensitivity to Ca2+ for growth of different gastroenteropancreatic cancer cells
      in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216901
TI  - Protease inhibitor content of human dietary samples.
AB  - A large body of experimental work has revealed that protease inhibitors (PI) are
      highly effective suppressors of carcinogenesis. Little is known about the level
      of PI activity in the diet of the US population. In the present study, we assayed
      the levels of PI activity in dietary samples from 31 free-living subjects who
      saved duplicate portions of all foods consumed over two 24-hour periods, six
      months apart. The majority of samples (90%) contained detectable PI activity; 82%
      contained trypsin inhibitory activity; 61% contained chymotrypsin inhibitory
      activity. Of those samples containing chymotrypsin inhibitory activity, 87% also
      contained trypsin inhibitory activity. The median concentration of soluble
      chymotrypsin inhibitory activity present in these samples was 6.5 micrograms/g
      food (range 0-150 micrograms/g food), whereas the median concentration of soluble
      trypsin inhibitory activity was 14.5 micrograms/g food (range 0-465 micrograms/g
      food). We conclude that a) human diet samples contain both chymotrypsin and
      trypsin inhibitory activity, b) the levels of PI in some of these samples was
      similar to that found to be anticarcinogenic in animal studies, and c) due to the
      large within-subject variation in PI intake, assessment of long-term dietary
      intake in epidemiological studies will be necessary to accurately classify
      subjects according to PI intake.

PMID- 2216902
TI  - Potassium inhibition of DMH-induced small intestinal tumors in rats.
AB  - This is a preliminary report that shows that supplemental potassium partially
      prevents 1,2-dimethylhydrazine (DMH) induction of tumors of the small intestine
      in Sprague-Dawley rats. Male rats were injected weekly with 20 mg DMH/kg body wt
      for 20 weeks. Potassium chloride was provided in the drinking water one week
      before the first DMH treatment and was continued until sacrifice 14 weeks after
      the last DMH treatment. There were four groups of rats and they were identified
      as follows: DMH, DMH + K, K, and untreated control. Based on 24-hour food and
      water consumption data and food and water compositions, rats provided 0.5%
      potassium (from KCl in the drinking water) were ingesting 287.5 +/- 9.2 mg
      potassium per 24 hours (K/Na = 4.18) and the unsupplemented groups were ingesting
      180.3 +/- 18.4 mg potassium per 24 hours (K/Na = 2.62). At sacrifice, the
      incidence of DMH-induced small intestinal tumors was significantly (p less than
      0.05) reduced from 46% (6/13) in the DMH group to 6% (1/17) in the DMH + K group
      (p less than 0.05). The potassium supplement also significantly (p less than
      0.05) reduced the cumulative small intestinal tumor incidence from 40% (8/20) in
      the DMH group to 5% (1/20) in the DMH + K group. The incidence of colon tumors
      and of zymbal gland tumors appeared to be reduced by the potassium supplement;
      however, these were not statistically significant observations (p greater than
      0.05). Based on the complete blood count and other blood parameters measured, the
      level of potassium supplement used induced no apparent toxic effects.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2216903
TI  - On predicting the future of dentistry.

PMID- 2216904
TI  - Sealing efficacy of therapeutic varnishes used with silver amalgam restorations.
AB  - The sealing abilities of three therapeutic varnishes were compared with that of a
      conventional copal varnish in vitro under Tytin silver amalgam restorations. The
      therapeutic varnishes comprised two commercial fluoride varnishes and one
      experimental chlorhexidine-containing varnish. Leakage was traced using a basic
      fuchsin dye and was found to be considerable, particularly on root surfaces. The
      therapeutic varnishes performed as well as, and in some cases better than, the
      control. It is suggested that the use of preventive therapeutic varnishes in
      operative dentistry merits attention and further study.

PMID- 2216905
TI  - A comparison of accuracy in seating and gap formation for three inlay/onlay
      techniques.
AB  - The accuracy (fit) of MOD inlays of three brands of composite resin was
      determined by measuring the axial discrepancy (marginal opening in the approximal
      area). The axial discrepancy varied between 17 and 121 microns. Directly
      manufactured inlays were more accurate (axial discrepancy: 17-26 microns) than
      indirectly manufactured inlays (axial discrepancy: 40-121 microns). Inlays of a
      microfilled resin, SR-Isosit, were less accurate than inlays of two hybrid
      materials, Brilliant and Estilux Posterior C VS (axial discrepancy: 121 microns
      vs 44 and 41 microns respectively). There was a tendency for 24-hour-old inlays
      to be less accurate than 10-minute-old inlays. The formation of marginal gaps due
      to contraction of the resin cement was assessed in a light microscope on cemented
      single-surfaced inlays. Gaps were not formed when enamel margins were etched or
      dentin margins treated with a dentin-bonding agent of high efficacy. Gaps (2.4
      5.6 micron) were formed, however, at untreated dentin margins and at margins
      treated with dentin-bonding agents of low efficacy.

PMID- 2216906
TI  - Microleakage of a new cavity varnish with a high-copper spherical amalgam alloy.
AB  - In a study in vitro Copalite and Barrier cavity varnishes were applied to the
      walls of class 1 prepared cavities before placing Tytin, a high-copper amalgam.
      Tests with 45Ca and autoradiographs showed that at six months only Copalite was
      effective in preventing microleakage. At one year neither Barrier nor Copalite
      was preventing leakage.

PMID- 2216907
TI  - An evaluation of marginal leakage of Class 2 combined amalgam-composite
      restorations.
AB  - Forty class 2 cavities were prepared in 20 permanent posterior teeth. In 20
      cavities the gingival margin was placed in enamel and in the other 20 cavities in
      cementum. In every tooth one of the cavities was filled with composite and the
      other with a combined amalgam-composite restoration. Microleakage at the various
      interfaces was assessed by dye penetration. It was concluded that microleakage of
      the combined amalgam-composite restorations was significantly lower than that of
      the conventional composite restorations.

PMID- 2216908
TI  - The evaluation of materials: relationships between laboratory investigations and
      clinical studies.

PMID- 2216909
TI  - [Allergic alveolitis--present knowledge].

PMID- 2216910
TI  - [Control of breathing in patients with mechanical disorders of the lung].
AB  - 22 normal volunteers, 57 patients with obstructive changes and 34 with
      restrictive type changes were studied. The following parameters were analyzed:
      maximal inspiratory and expiratory pressures, occlusion pressure and components
      of the breathing pattern. The patients were divided according to the degree of
      airway resistance and fall of vital capacity. All patients compared with the
      healthy volunteers demonstrated higher minute ventilation, and a higher neuro
      muscular respiratory drive as shown by the VT/Ti index and occlusion pressure.
      The breathing pattern did not correlate significantly with the different
      abnormalities of respiratory function in the studied groups. In the patients with
      obstructive changes a weak correlation was found between the occlusion pressure
      and airway resistance. In patients with restrictive type changes a weak
      correlation between occlusion pressure, static and specific compliance was found.
      The occlusion pressure was a more specific parameter characterizing respiratory
      drive compared with the VT/Ti index. Disturbances of pulmonary mechanics have a
      small but significant effect on respiratory control.

PMID- 2216911
TI  - [Analysis of respiratory parameters before and after working in manual laborers
      at a tobacco factory].
AB  - From the group of 102 workers of local cigarette factory 51 persons had a contact
      with tobacco leaves before fermentation and other 51 workers with after process
      of fermentation. Values of spirometric parameters before and after 8 hour lung
      occupational exposition to tobacco leaves were evaluated in both groups. Increase
      of obturation of both large and small airways was found after workshift. 31 of
      examined persons had more than 20% inferior values of FEV1, Raw and FEF 25/75.
      That hyperspasmatic reaction of bronchi was found both in subjects with signs of
      obturation and in persons with normal results in examination before workshift.
      This finding concerned mostly workers who inhaled dust of tobacco leaves prior to
      fermentation.

PMID- 2216912
TI  - [Pulmonary abscesses in material from tuberculosis and lung disease clinics of
      the Academy of Medicine in Gdansk].
AB  - 47 patients with pulmonary abscesses were analysed. The type of bacteria cultured
      from the sputum, type of chemotherapy and clinical outcome were assessed. Most of
      the patients (34) were already treated prior to admission to the Department. Most
      often with doxycycline and gentamycin. The following organisms were cultured:
      Streptococcus viridans, Escherichia coli, Staphylococcus aureus and Klebsiella
      pneumoniae. Antibiotic therapy was always instituted according to the
      antibiogram. Most often amikacin and cefamandole was given. The mean duration of
      hospitalization was 48 days. 44% of the patients were fully cured, in 40% only an
      improvement was seen. 7 patients expired (16%)--all of these patients were
      addicted to alcohol or had malignancy.

PMID- 2216913
TI  - [Bronchial tuberculosis in bronchoscopic examinations].
AB  - In 195 cases of pulmonary tuberculosis in 70% changes in the bronchi were found.
      They were either active (45%) or inactive (25%). In 10% of the cases severe
      changes were found, this percentage did not decrease in the past 15 years. Most
      often bronchial findings were seen in elder women. In 4 cases bronchial cancer
      was co-existent. Difficulties in differential diagnosis in such cases were
      underlined.

PMID- 2216914
TI  - [Bronchial tuberculosis in bronchoscopic material].
AB  - A retrospective analysis of 14,461 patients examined at the Bronchological Unit
      in the years 1978-1988 was carried out in order to assess the incidence of
      bronchial tuberculosis confirmed histopathologically. 46 cases met the selection
      criteria (19 females, age range 21-75 years, mean 56.2 +/- 18.8. years, 27 males,
      age range 21-85 yrs, mean 50.0 +/- 17.4 yrs). Only in 22 patients acid fast
      bacilli were cultured. Analysis of endoscopical changes was carried out according
      to the Jaroszewicz-Krakowka classification. Most often diffuse inflammatory
      changes were seen.

PMID- 2216915
TI  - [Post-traumatic chylothorax].
AB  - A case of post-traumatic chylothorax in a 84 year old man with ILD is presented.
      The chylothorax was successfully treated after 6 months, which was confirmed at
      post-mortem, during which a solitary plasmocytoma of the left kidney was also
      diagnosed.

PMID- 2216916
TI  - [Pulmonary aspergilloma caused by Aspergillus niger].
AB  - The authors present a case report of a 66 year old male that was admitted due to
      pulmonary lesions with cavitation localized in the upper left lobe. In the cavity
      an abnormal mass could be seen. In the differential diagnosis malignancy and
      tuberculosis were excluded. Fungi were cultured from the bronchial washings and
      sputum. Their morphological characteristics allowed them to be typed as
      Aspergillus niger. Slides from the thick, mucoid, black sputum demonstrated
      typical forms of the fungus. Polarized microscopy demonstrated calcium oxalate
      crystals. The final diagnosis was pulmonary aspergilloma caused by A.niger
      complicating a pulmonary abscess in the course of a pneumonia.

PMID- 2216917
TI  - [The role of airway infections in bronchial provocation reactions].

PMID- 2216918
TI  - Predictive value of visible lesions (cheeks, lips, oropharynx) in suspected
      caustic ingestion: may endoscopy reasonably be omitted in completely negative
      pediatric patients?
AB  - The relationship between absence or presence of grossly visible lesions in the
      cheeks, lips, and oropharynx (C.L.O. burns) and the incidence, site, and degree
      of visceral burns was evaluated in all children referred to our hospital for a
      suspected caustic ingestion during a 10-year period. All children underwent eso
      gastro-duodenoscopy within 24 hours. Of the 156 children, 96 (61.6%) showed no
      visible signs of contact with the caustic substance; however, in 36/96 (37.5%),
      endoscopy revealed burns in one or more visceral sites. Eight of 36 children
      (22.2%) sustained potentially dangerous lesions (second to third degree). Sixty
      of 156 children (38.4%) showed visible lesions; in 30/60 (50%), endoscopy
      revealed other burns in one or more visceral sites. Fourteen of 30 patients
      (46.6%) sustained potentially dangerous lesions (second to third degree). A total
      of 50 esophageal burns have been recorded: first degree (E1), 32; second degree
      (E2), 12; third degree (E3), 6. Two of 12 patients with E2 lesions and 6/6 with
      E3 lesions developed esophageal stenosis. One patient in this latter group died
      because of complications related to a tracheostomy. A total of 31 gastric burns
      have been recorded: G1 (22), G2 (6), G3 (3). One gastric perforation was observed
      in the G3 group, whereas the remaining two lesions healed with residual
      asymptomatic scarring. Minimal scarring was observed in two of six patients with
      G2 burns. A total of eight lesions have been recorded in the larynx [L1 (3), L3
      (1)] and in the duodenum [D1 (2), D2 (2)].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216919
TI  - Acute respiratory infections during the first three months of life: clinical,
      radiologic and physiologic predictors of etiology.
AB  - The usefulness of clinical, radiologic, and physiologic characteristics to
      identify pathogens was assessed in 90 infants aged two through 12 weeks,
      presenting to an outpatient clinic with an acute respiratory infection. Eighty
      four cases had cultures or rapid diagnostic tests for RSV, of which 25 were
      positive. Eighty-two infants had cultures or rapid diagnostic tests for
      Chlamydia, of which 16 were positive. Additional respiratory pathogens identified
      included parainfluenza (6 cases), rhinovirus (3 cases), pertussis (2 cases), and
      CMV (1 case). Multiple pathogens were identified in four cases: Chlamydia and RSV
      (2 cases), Chlamydia and parainfluenza (1 case), and Chlamydia and CMV (1 case).
      Clinical characteristics other than the need for hospitalization were not useful
      predictors of specific pathogens. X-rays were obtained in 20 (80%) of the RSV
      infections, 13 (81%) of the Chlamydia infections, six of the parainfluenza
      infections, two pertussis infections, and 25 cases without identification of the
      pathogen. X-ray findings could not distinguish between patients with or without a
      pathogen or between the pathogens. Severe findings were present in 28% (11/40) of
      cases with a pathogen identified, compared to 12% (3/26) of cases without a
      pathogen identified (NS). Moderate findings were present in 58% (23/40) of cases
      with a pathogen identified compared to 62% (16/26) of cases without a pathogen
      identified. Slight/negative findings were present in 15% (6/40) of cases with a
      pathogen identified, compared to 27% (7/26) of cases without a pathogen
      identified. Pulse oximetry was done in 30 cases, 22 of which had a pathogen
      identified (RSV 14, Chlamydia 7, pertussis 1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216920
TI  - Poor compliance with universal precautions: a universal phenomenon?
AB  - An anonymous survey was conducted in order to examine compliance with universal
      precautions in the Department of Pediatrics at Loyola University Medical Center
      in Maywood, Illinois. Completed questionnaires were returned by 23 faculty
      members, 29 residents, and 22 medical students. Gloves were worn consistently
      during venipuncture or intravenous catheterization by 13, 7, and 18% of attending
      physicians, residents, and students, respectively. Most physicians wear gloves
      only occasionally and cite presence of high-risk factors as their selection
      criterion. Interference with the performance of procedures is the most common
      cause of noncompliance. In view of poor compliance with universal precautions,
      further efforts are needed in order to decrease the incidence of preventable
      exposure to blood-borne infections.

PMID- 2216921
TI  - Rapid intravenous rehydration in the pediatric emergency department.
AB  - Children suffering from mild to moderate (3 to 6%) dehydration likely caused by
      viral gastroenteritis are often hospitalized because they are unable to tolerate
      oral fluids. We studied 17 such children, aged one to six years, who were
      otherwise healthy. All had isonatremic dehydration and were treated with 30 ml/kg
      of 3.3% dextrose and 0.3% saline over a period of three hours in the emergency
      department before being discharged. No patient required admission to the
      hospital. Only one patient required another course of rapid intravenous
      rehydration and subsequently improved without hospitalization. Although all our
      patients experienced vomiting before treatment, 65% had no vomiting after
      treatment. Rapid intravenous rehydration is an effective treatment, for children
      with mild to moderate dehydration secondary to presumed viral gastroenteritis,
      that obviates the need for hospitalization.

PMID- 2216922
TI  - Status epilepticus following the oral ingestion of cocaine in an infant.

PMID- 2216923
TI  - Absent or minimal cerebrospinal fluid abnormalities in Haemophilus influenzae
      meningitis.
AB  - A case of Haemophilus influenzae type b (Hib) meningitis in which the diagnosis
      and treatment were delayed because of normal cerebrospinal fluid analysis is
      presented. A retrospective review was conducted at two children's hospitals to
      determine the frequency and clinical characteristics of patients with Hib
      meningitis whose spinal fluid had a normal total white blood cell count, normal
      chemistries, and negative Gram stain, but subsequent growth of Hib in culture. Of
      379 cases of Hib meningitis, two had completely normal CSF, and two had CSF
      containing small numbers of polymorphonuclear cells as the sole abnormality. In
      three of the four cases, the duration of symptoms was less than 24 hours, and
      appropriate therapy was significantly delayed because of benign-appearing CSF.
      Normal CSF cell counts, chemistries, and Gram stain do not exclude the
      possibility of bacterial meningitis, and one should remain suspicious when a
      child has clinical findings suggesting meningitis.

PMID- 2216924
TI  - Emergency intraosseous infusion in severely burned children.
AB  - Severely burned patients require rapid administration of large volumes of
      isotonic fluids. Obtaining adequate intravenous (IV) access in children with
      greater than 70% total body surface area burns may be difficult, time-consuming,
      and sometimes impossible. This report describes the use of intraosseous infusion
      technique as a life-saving means of establishing IV access in two severely burned
      children.

PMID- 2216925
TI  - Avulsion of the rectus femoris tendon: an unusual type of pelvic fracture.
AB  - We present the case of a 15-year-old boy evaluated in the emergency department
      after sustaining an acute hip injury during track and field practice. Pelvic
      radiograph demonstrated an avulsion fracture of the anterior inferior iliac
      spine. Review of the literature reveals this to be a well recognized, yet unusual
      and interesting injury.

PMID- 2216926
TI  - Pediatric HIV infection for the emergency physician: epidemiology and overview.

PMID- 2216927
TI  - What is a pediatric emergency physician?

PMID- 2216928
TI  - Abdominal trauma with hematuria.

PMID- 2216929
TI  - Outpatient management of burns in children.
AB  - The majority of burn wound management can be performed on an outpatient basis by
      the primary care physician or emergency physician. The physician, however, needs
      to know when to refer the patient for surgical evaluation and must be reasonably
      certain that the family will be compliant with wound care and follow-up. Fire
      prevention counselling still remains one of the most important aspects of burn
      management.

PMID- 2216930
TI  - Child-proof containers.

PMID- 2216931
TI  - Administration of succinylcholine via the intraosseous route.

PMID- 2216932
TI  - A case of bilateral radial head subluxation.

PMID- 2216933
TI  - [Effect of acute biliary pancreatitis on liver metabolism of phenazone].
AB  - In 22 patients with acute pancreatitis caused by biliary calculi and 9 healthy
      controls the rate of hepatic elimination of phenazone was measured. The aim of
      the study was evaluation of the oxidative-detoxicating action of the liver in
      this disease in relation to its severity. In pancreatitis patients the half-time
      (T2) of phenazone was significantly (p less than 0.01 longer than in healthy
      subjects (23.6 +/- 10.5 vs 13.2 +/- 7.2 hrs). The T2 of phenazone was not
      correlated with the concentrations of transaminases, bilirubin and prothrombin,
      but was correlated positively with the concentration of hepatic lactic
      dehydrogenase (p less than 0.001). In the initial stage of pancreatitis the T2 of
      phenazone was without prognostic significance and showed no agreement with
      Ranson's clinical-laboratory classification of the severity of the disease. The
      degree of impairment of the hepatic metabolism of phenazone measured with the
      percent difference between T2 of phenazone in both tests was significantly (p
      less than 0.05) greater in the group of patients with complications than in those
      without pancreatitis complications (70.7 +/- 64.4% vs 21.4 +/- 16.2%). Biliary
      pancreatitis impairs the oxidative-reductive function of the liver proportionally
      to the degree of hepatic lactic dehydrogenase in the serum. Evaluation of the
      rate of hepatic elimination of phenazone in the initial stage of this
      pancreatitis was without prognostic importance for the severity of the disease.

PMID- 2216934
TI  - [Selected parameters of calcium and phosphate metabolism in patients after kidney
      transplantation and administration of azathioprine or cyclosporin A].
AB  - The influence was studied of the type of immunosuppression on calciuria,
      phosphaturia, and on the levels of parathyroid hormone (PTH), calcitonin (CT), 25
      hydroxycholecalciferol (25/OH/D), total calcium, magnesium, and alkaline
      phosphatase activity in 24 patients after renal transplantation. Twelve of these
      patients received cyclosporin with prednisone (group CyA) and other 12 were
      treated with azathioprine and prednisone (group Aza). Independently of the type
      of immunosuppression used, in both groups a significantly higher concentration of
      PTH, CT, 25/OH/D and greater activity of alkaline phosphatase were demonstrated
      in relation to healthy controls. In both studied groups the patients had also a
      significantly reduced calciuria and phosphatemia than controls. In group Aza the
      patients had a significantly lower phosphaturia and significantly higher
      magnesemia than in group CyA. The results of these investigations suggest a
      certain influence of the type of immunosuppression on the intensity of calcium
      phosphate metabolism in renal graft recipients.

PMID- 2216935
TI  - [Effect of physical exercise and heat on energy expenditure in obesity].
AB  - The effect of exercise and thermal stress on energy expenditure was studied in
      obese and lean subjects. The group of obese subjects comprised 20 women with body
      weight 81-159 kg, and the control group included 12 lean women weighing 51-58 kg.
      The energy expenditure was assessed by the method of indirect calorimetry with a
      Spirolyt II apparatus. The heart rate, the systolic and diastolic pressure were
      measured. The tested subjects were subjected to a 60 W (60 J/s) exercise on a
      cycle ergometer during 10 minutes, and immediately after it they were exposed to
      hot air in a chamber at about 60 degrees for 30 min. On the following day this
      sequence was reversed, with exercise following heat exposure. In the obese women
      the energy expenditure at rest was 93.4 +/- 17.5 W, and during exposure to heat
      after exercise it was 124.0 +/- 21.3 W. During exercise preceded by heat exposure
      it was 436.3 +/- 51.6 W. In lean subjects the corresponding values were lower:
      77.5 +/- 6.5 W, 104.0 +/- 14.8 W, 376.8 +/- 36.1 W. After calculation of energy
      expenditure per 1 m2 of body area this expenditure was, however, lower in the
      group of obese subjects. The exposure to physical exercise before thermal stress
      increased significantly the energy expenditure in relation to that caused by each
      of these exposures separately. The heart rate and the systolic and diastolic
      blood pressures were higher in obese subjects. In both groups thermal stress
      increased the heart rate and systolic pressure but decreased the diastolic
      pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2216936
TI  - [Effect of adrenergic beta receptor blockaders and thiazide diuretics on gastric
      acid and gastrin secretion in patients with essential hypertension].
AB  - The purpose of the study was to evaluate the effect of 6 weeks treatment with
      hydrochlorothiazide or propranolol on gastric acid and gastrin secretion in
      essential hypertension. The study was carried out in 10 patients receiving
      propranolol and 10 treated with hydrochlorothiazide. Acid and gastrin secretion
      were determined during histamine stimulation tests (Kay's test). Before the
      treatment the patients with essential hypertension were not significantly
      different from healthy controls with respect to acid secretion and gastrinemia
      profile after histamine stimulus. In both groups of patients no significant
      effect was observed of hypotensive treatment on basal acid output, but a
      significant inhibitory effect on gastrin secretion was noted. This effect was
      significantly greater in patients treated with propranolol than in the
      hydrochlorothiazide group. Moreover, in propranolol-treated patients a
      significant fall of histamine-induced acid secretion was found.

PMID- 2216937
TI  - [Cigarette smoking and pathophysiology of diseases of the digestive system--facts
      and hypotheses. I. Cigarette smoking and physiology of the digestive system].

PMID- 2216938
TI  - [Activation and functions of blood platelets in patients with diabetes mellitus
      type 1 before and during the treatment with indobufen].
AB  - In 18 patients with type I diabetes the effect was studied of 10 days of
      Indobufen administration in daily doses of 400 mg on the activation and function
      of platelets. Spontaneous and ADP and adrenaline-induced aggregation,
      adhesiveness, platelet factors 3 and 4, and generation of malonyldialdehyde (MDA)
      in platelets were investigated. The results were compared with similar results in
      the same group prior to the treatment and in a control group of 19 healthy
      subjects. Highly significant inhibition was noted of spontaneous inhibition and
      that evoked by adrenaline and ADP, and a considerable reduction of MDA generation
      by platelets. These results indicate that the new platelet inhibitor--Indobufen,
      effectively inhibiting platelet activation and function may prevent development
      of thrombotic complications of diabetes.

PMID- 2216939
TI  - [The role of free radicals in human pathology].

PMID- 2216940
TI  - [Left-ventricular systolic time intervals in constrictive pericarditis. Effect of
      decortication and inspiration on the ejection time].

PMID- 2216941
TI  - [Serum apolipoprotein B level and other parameters of lipid metabolism in
      patients after myocardial infarction].
AB  - Total cholesterol, triglycerides, cholesterol HDL, and apolipoproteins B were
      determined in 117 patients including 87 patients with recent myocardial
      infarction. Cholesterol LDL was calculated from Friedewald-Frederickson 's
      equation. Calculated mean values of the above parameters of lipid metabolism were
      within normal values. In the group of patients with recent myocardial infarction
      the following subgroups were distinguished: male patients who under went
      myocardial infarction under 40 years of life (subgroup A), male patients who
      underwent myocardial infarction at the age over 40 years (subgroup B), and female
      patients (subgroup C). No statistically significant differences between male and
      female patients were noted. A sole lipid index differentiating subgroups A and B
      was serum apolipoprotein B level (1.5 g/L in subgroup A, and 1.16 g/L in subgroup
      B). Discrimination analysis has shown also a higher value of this parameter in
      distinguishing the subjects who underwent myocardial infarction in the young age.

PMID- 2216942
TI  - [Practical value of Frank's leads in electrocardiographic diagnosis of myocardial
      infarction].
AB  - Authors' own modification of Frank's leads is discussed. Potentials from these
      leads are recorded simultaneously with routine ECG. Frank's leads are used to
      increase possibility to diagnose myocardial infarction. Proposed leads in x, y,
      z, axis of Frank system enable to differentiate pathological QS wave in chest V1
      V3 leads between myocardial infarction of the anterior wall and detectable
      intraventricular potentials in patients with emphysema. A lack of physiologic Q
      wave in "z+"-lead always indicates anterior wall infarction. Pronounced Q wave of
      "infarctional" character in y-lead x-lead--in the lesions to the lateral wall.
      Pathologies present in the posterior wall infarction while from cal Q wave from
      "z+"-lead facilitates diagnosis of the posterior wall infarction.

PMID- 2216943
TI  - [Echo- and electrocardiography in myocardial infarction--accordance and
      discrepancies].

PMID- 2216944
TI  - [Platelet aggregation in patients with coronary disease treated with nifedipine].
AB  - The effect of nifedipine on the aggregation of blood platelets has been studied
      in patients with coronary heart disease. The study involved 78 males, aged
      between 36 and 64 years (mean age 51 years). The level of aggregation was
      evaluated before and after a single nifedipine dose of 10 mg (in 15 patients) and
      of 20 mg (in 34 patients) as well as before and after the treatment with
      nifedipine (of 29 patient) with a daily dose of 30 mg for two weeks. Aggregation
      of blood platelets induced by adenosine--diphosphate in of concentrations 1
      microM/ml and of 5 microM/ml were estimated by the Born method. It was found that
      nifedipine reduces the aggregation of the blood platelets in patients with
      coronary heart disease following single and long-term treatment.

PMID- 2216945
TI  - [Etiological analysis of arrhythmia among sailors].

PMID- 2216946
TI  - [Latent ischemic heart disease].

PMID- 2216948
TI  - [Prospects of using calcium channel blockers in the treatment of alcoholism].

PMID- 2216947
TI  - [Advances in pharmacotherapy of arteriosclerosis].

PMID- 2216949
TI  - [Hypotensive effectiveness and metabolic effects of indapamide in patients with
      primary arterial hypertension].
AB  - Indapamide--a non-thiazide diuretic agent--was given to 28 patients with mild and
      moderate hypertension in a daily dose of 2.5 mg for 12 weeks. Statistically
      significant decrease in both systolic and diastolic blood pressure and complete
      normalization of the arterial blood pressure were achieved in 82% of the treated
      patients. Adverse reactions were mild and transient. However, low but
      statistically significant decrease in blood serum potassium and changes in the
      carbohydrate metabolism were seen. No significant effect of the-drug on lipid
      metabolism was found except the low but statistically significant increase in
      total cholesterol. Indapamide is an efficient and well tolerated hypotensive
      agent. However, biochemical indices should be checked up during the treatment due
      to the potential adverse reactions.

PMID- 2216950
TI  - [Effectiveness of nifedipine in the treatment of arterial hypertension in various
      types of diabetes mellitus].
AB  - Selection of indications and the general tactics of nifedipine monotherapy of
      hypertension in diabetic subjects is not clearly established, as yet. It refers
      specifically to different forms and phases of diabetes mellitus. This was the
      reason to carry out a respective study. In 4 groups of hypertension: 1) in
      diabetics without vascular complications, 2) in diabetic nephropathy, 3) in
      diabetics type II without nephropathy, and 4) in comparative group of subjects
      without diabetes mellitus, a 6-week controlled, open trial was performed. Before,
      during and after nifedipine (3 X 10-20 mg p.d.), the following parameters were
      monitored: 1) systolic, diastolic and mean blood pressures, 2) glycaemic indices
      of diabetes control, 3) serum cholesterol: total, HDL, LDL, triglycerides, 4)
      daily albuminuria and GFR, 5) adverse reactions to nifedipine. It could be
      concluded that nifedipine therapy was relatively most effective and safe in
      hypertensive diabetics type II without nephropathy. It was less effective in
      diabetics type I without nephropathy and failed in diabetics type I with
      nephropathy.

PMID- 2216951
TI  - [New thrombolytic drugs].

PMID- 2216952
TI  - [Pharmacokinetics of phenazone in patients with fast and slow euthyroidism after
      methimazole treatment].
AB  - Hyperthyroidic patients treated with methimazole were retrospectively divided
      into two groups, depending on the period of time required for euthyreosis: these
      attaining euthyreosis up to 28 days of therapy (A) and these in whom thyroid
      gland functioning is normalized after a 35-day therapy with full dose of
      methimazole (B). The study aimed at investigating whether clinical euthyreosis is
      related to the activity of microsomal enzymes in the liver using phenazone
      elimination test for this purpose. Phenazone elimination test was performed just
      before the treatment and after 8 weeks of methimazole administration. A decrease
      in kel and Clt as well as an increase in AUC were noted. These changes were more
      pronounced in patients of group A than those of group B. It might be concluded
      that phenazone pharmacokinetics is different in patients quickly attaining
      euthyreosis. The difference is probably due to the difference in
      biotransformation of methimazole in the liver in which microsomal enzymes play
      some role.

PMID- 2216954
TI  - [Interactions of antineoplastic agents with other drugs].

PMID- 2216953
TI  - [Effect of disorders of thyroid function on phenazone pharmacokinetics].
AB  - Phenazone elimination test, as a marker of metabolic efficiency of the liver, was
      carried out in 11 hypothyroid patients. 20 hyperthyroid patients, 10 persons
      after hyperthyroidism treatment and in 20 healthy persons as a control group. In
      hyperthyroid patients the acceleration, and in hypothyroid patients the delay of
      phenazone elimination, in comparison with a control group was observed. Moreover,
      the impairment of phenazone gastrointestinal absorption was shown in hypothyroid
      patients and in persons after hyperthyroidism treatment. Similar alterations may
      be expected in persons with thyroid dysfunctions to whom the drugs with
      pharmacokinetic properties similar to phenazone are administered.

PMID- 2216955
TI  - [Effect of liver diseases on pharmacokinetics of drugs].

PMID- 2216956
TI  - [Progress in the field of peptide hormones through the eyes of an internist].

PMID- 2216958
TI  - [The provocation test in children with cow-milk protein and gluten intolerance:
      evaluation of the clinical response and lesions in the mucous membrane of the
      small intestine].
AB  - Provocation test (re-introduction of the noxious protein) was carried out in two
      groups of patients: (a) with intolerance to the cow-milk proteins (41 children)
      treated with milk-free diet for 6-24 months, and (b) with gluten intolerance (26
      children) treated with gluten-free diet for 6-36 months. The following parameters
      were compared: type and frequency of the clinical symptoms seen in these patients
      prior to the introduction of allergen-free diet. Moreover, the type of observed
      morphological changes in the small intestine mucosa following provocation test
      were analysed in the groups of 7 patients. A two-year elimination of milk from
      the diet produces milk tolerance in about 61% patients; clinical symptoms in the
      remaining children are diversified. Re-introduction of gluten with the diet
      (provocation test) produces recurrence of gluten intolerance in 96% of children
      treated with gluten-free diet for 2-3 years. Recurrence of the disease was
      accompanied by the atrophy of the intestinal villi.

PMID- 2216957
TI  - [The effect of in vitro theophylline on T lymphocytes from patients with ulcers].
AB  - An increase in the interest in the cellular immunity in patients with peptic and
      duodenal ulcers dates back to the detection of histamine H2 receptors on T-cells.
      In vitro effect of theophylline on T-cells in patients with peptic and duodenal
      ulcers was investigated. The experiment included 107 patients: 60 with peptic and
      duodenal ulcers and 47 controls. The experiment was carried out with theophylline
      test enabling to divide the whole population of T-cells forming active and "late"
      rosettes (ARCF and TRCF, respectively) into three subpopulations: theophylline
      resistant, theophylline-sensitive, and theophylline-dependent T-cells. Increased
      number of theophylline-dependent T-cells and significantly reduced baseline value
      of rosette-forming T-cells (p greater than .02) were found in patients with
      duodenal ulcer. Theophylline-dependent lymphocyte number was the highest in TREC
      rosette fraction in patients with duodenal ulcer. Statistically significant (p
      greater than .01; p greater than .05) and independent of patients' age tendency
      to an increase in the number of theophylline-sensitive T-cells in TRFC rosettes
      was seen in both peptic and duodenal ulcers. Theophylline-resistant lymphocytes
      ratio to theophylline-sensitive ones in TRFC rosettes was also significantly
      lower in patients with peptic ulcer. No correlation between these results and
      patients age was found in both the control group and patients with the ulcerative
      disease. An increase in theophylline-dependent T-cells in patients with duodenal
      ulcer suggests an increase in the number of immature forms of T-cells and
      indicate an important role of T-cells maturation disorders in the pathogenesis of
      duodenal ulcer.

PMID- 2216959
TI  - [Humoral response of the immunologic secretory system of the small intestine in
      children infected with Giardia intestinalis].
AB  - Local humoral response of the intestinal mucosa was determined with secretory IgA
      levels and secretory component activity in enterocytes and duodenal content of 15
      children infected with G. intestinalis. The obtained results were compared to
      those in 5 children with coeliac disease and 12 children with diarrhoea without
      lambliasis. Secretory IgA was increased in about 50% of children with lambliasis
      (in the remaining groups in 25% of children) to the values higher than that in
      the comparative groups. Secretory component activity was relatively high in the
      intestinal epithelium. Secretory component activity in the duodenal content was
      high in about 40% of children independently of the examined group. No correlation
      between the said variables was noted except positive correlation of secretory IgA
      levels and secretory component activity in the bile.

PMID- 2216961
TI  - [Leiomyosarcoma of the stomach and small intestine].
AB  - Three cases of leiomyosarcoma are presented. The primary lesion to the stomach
      was seen in 2 patients while the small intestine in the remaining patient. Two
      patients underwent radical surgery. All patients were treated with multiple drug
      regimens. Radiotherapy was additionally carried out in one patient. One patient
      who underwent radical surgery and given maintaining chemotherapy is alive in the
      complete remission since 6 years while two remaining patients died within 3 and 6
      years because of recurrence and haematopoietic proliferation.

PMID- 2216960
TI  - [Role of alcoholism in the development of upper gastrointestinal tumors].
AB  - A preliminary report on the results of studies on the relationship between
      alcohol abuse and upper gastrointestinal tumours is presented. Alcohol abuse was
      measured with the aid of a questionnaire. GGTP and mean MCV were determined.
      Within the 1st September, 1986--30th September, 1987, 75 patients with the cancer
      of the upper gastrointestinal tract and 107 patients with benign lesions to this
      area were examined. Alcohol abuse was found in 33% of patients with the cancer
      and 19% of patients with benign lesions to the upper gastrointestinal tract. This
      difference is statistically significant (p greater than 0.05). The results of
      GGTP and MCV values were statistically insignificant in both groups. The authors
      have found more marked correlation of alcohol abuse with the cancer of the upper
      gastrointestinal tract in relation to the oral cavity and pharynx than the
      stomach. Further studies including larger groups of patients are recommended.

PMID- 2216962
TI  - [Long-term follow-up of a patient with early diagnosis of untreated stomach
      cancer].
AB  - A case of the patient with type IIc carcinoma of the stomach is presented. The
      patient was followed-up for 7 years, and did not agree to the operation.
      Endoscopic examination has shown that the ulcer did not change within 6 years. No
      data suggesting generalization of the neoplastic process were available during 7
      years following the diagnosis. The authors review the literature on the kinetics
      of the carcinoma of the stomach proliferation in both experimental and clinical
      investigations.

PMID- 2216963
TI  - [A rare case of colonic perforation in a sole site of latent lung cancer
      metastasis].
AB  - A rare case of the perforation of the colon at the site of isolated micro-cancer
      of the lung in a 81-year old male is presented. A primary focus of the cancer was
      found during microscopic examination of the fibroserous mass collected from the
      apex of the right lung. The patient died because of the disseminated peritonitis.

PMID- 2216964
TI  - [Ormond's disease: difficulties with diagnosis and treatment].
AB  - A case of a female patient is presented. The patient was treated for
      retroperitoneal fasciitis. An emphasis is on the diagnostic, differential, and
      therapeutic problems in this entity. Close cooperation of various specialists is
      needed in such a case.

PMID- 2216965
TI  - [Role of pancreatic peptides--neuropeptide Y, polypeptide YY and neurotensin,
      vasoactive intestinal peptide, and substance P in the body].

PMID- 2216966
TI  - [Campylobacter pylori and its role in the pathogenesis of selected diseases of
      the stomach and duodenum].

PMID- 2216967
TI  - [Esthetic improvement of the R.P.D. in mixed prosthodontics].

PMID- 2216968
TI  - [Test of the efficacy of a plaque disclosing gel].

PMID- 2216969
TI  - [The mandibular plane as an orientation plane in complete dentures. Computer
      assisted analysis].

PMID- 2216970
TI  - Tony Pasquale's triumph.

PMID- 2216971
TI  - Vaginitis. Systematically solving a bothersome problem.
AB  - Vaginitis is a common cause of patient visits to primary care physicians. Causes
      include allergic and irritative factors and infectious agents. Diagnosis is
      readily made with use of simple office procedures such as wet smears, stains, and
      cultures. Treatment with appropriate antibiotics or vaginal preparations is
      usually effective.

PMID- 2216972
TI  - Hemolytic-uremic syndrome in children. A serious hazard of undercooked beef.
AB  - Hemolytic-uremic syndrome is the leading cause of acute renal failure in
      childhood. Its incidence in North America is increasing. Escherichia coli O157:H7
      is the most common infectious trigger and is spread by contaminated beef products
      as well as from person to person. Antibiotics or antidiarrheal medications should
      not be used in the treatment of E coli hemorrhagic colitis or hemolytic-uremic
      syndrome. Mortality in children with the syndrome has fallen to less than 10% in
      North America, largely because of careful attention to nutrition, maintenance of
      a normal fluid and electrolyte balance, and careful monitoring. Education and
      emotional support of the family are important aspects of the treatment program.

PMID- 2216974
TI  - What if you are called to military service?

PMID- 2216973
TI  - Chest pain in teenagers. When is it significant?
AB  - Chest pain in teenagers often has no obvious organic cause. Onset of symptoms
      with an emotionally stressful situation may indicate psychogenic chest pain. The
      differential diagnosis also includes cardiac, musculoskeletal, gastrointestinal,
      and respiratory disorders. Routine testing generally does not help to establish a
      diagnosis and may even do harm by reinforcing a patient's unspoken fear of
      serious illness. Most teenagers with chest pain have no such illness, and
      symptoms usually resolve without therapy. An important role for primary care
      physicians is to provide support during evaluation and follow-up.

PMID- 2216975
TI  - Bell's palsy. Ensuring the best possible outcome.
AB  - Bell's palsy is thought to be an idiopathic polyneuritis and must be
      distinguished from other disorders that cause facial weakness. In most cases,
      differentiation can be accomplished on the basis of the history, physical
      examination, and clinical course. Routine follow-up care ensures that recovery is
      occurring. Electrodiagnostic testing often helps to assess prognosis. Eye care
      and corticosteroid therapy are recommended.

PMID- 2216976
TI  - Infectious diarrhea. Managing a misery that is still worldwide.
AB  - Infectious diarrhea is the largest single cause of morbidity and mortality in the
      world. Bacteria, viruses, and protozoan parasites are the most common causative
      agents. Treatment in most cases of bacterial and viral diseases consists of
      correcting fluid loss and electrolyte imbalance by oral or parenteral
      rehydration. Antimicrobial therapy is reserved for very ill patients only. With
      the exception of Cryptosporidium, for which no effective agent is yet available,
      all protozoan infections are treatable with metronidazole.

PMID- 2216977
TI  - Reactions to iodinated radiographic contrast agents. How to identify and manage
      patients at risk.
AB  - Systemic adverse reactions to iodinated radiographic contrast material are
      infrequent but can be dramatic. The number of patients experiencing such
      reactions can be minimized by selecting the most appropriate diagnostic study for
      each patient and by identifying patients at increased risk. Pretreatment with
      corticosteroids and use of low-osmolality contrast materials can minimize the
      number of severe reactions in high-risk patients.

PMID- 2216978
TI  - The infant with a reddish diaper.
AB  - The infant with a reddish diaper presents a diagnostic challenge to the primary
      care physician. As described by Dr Baumgardner, the cause may be benign, but more
      ominous disorders must be ruled out.

PMID- 2216979
TI  - Mood disorders. Is your primary care patient depressed?
AB  - Treatment of patients with mood disorder can be one of the most rewarding
      experiences in medicine. Optimal treatment is contingent on accurate diagnosis
      according to current criteria and terminology. Major depression needs further
      categorization in reference to atypical or psychotic features, seasonal aspects,
      melancholia, mania, or dysthymia. Most patients with major depression need
      pharmacotherapy, often in combination with psychotherapy. A number of therapeutic
      regimens using various antidepressant agents are available.

PMID- 2216980
TI  - Bacterial or viral meningitis? Measuring lactate in CSF can help you know
      quickly.
AB  - Measurement of cerebrospinal fluid (CSF) lactate is a useful test when properly
      applied to the appropriate clinical situation and can offer information other CSF
      parameters cannot provide. Except for Gram's stain of CSF, lactate level is the
      most important CSF parameter in the early differentiation of viral (aseptic) and
      bacterial purulent meningitis.

PMID- 2216982
TI  - Using the electric larynx to enable patients to communicate after tracheostomy.

PMID- 2216981
TI  - Two magic questions.

PMID- 2216983
TI  - Aluminum toxicity and Alzheimer's disease. Is there a connection?
AB  - Similarities between Alzheimer's disease and aluminum toxicity have led to the
      suggestion that a causal relationship may exist. However, the two disorders
      differ in many respects. The author reviews the evidence concerning the
      relationship between aluminum toxicity and Alzheimer's disease and answers the
      question, is there a connection?

PMID- 2216984
TI  - How to help your patient choose the right wheelchair.
AB  - For a disabled patient, a wheelchair can be the key to a more enjoyable, useful,
      and independent life--provided it is carefully chosen and suited to his or her
      needs. In this article, Dr Blocker describes how to decide when a wheelchair is
      needed and how to match the patient with the best chair.

PMID- 2216985
TI  - Understanding dizziness. How to decipher this nonspecific symptom.
AB  - Dizziness is a common but often nonspecific symptom. Through careful history
      taking and physical examination, primary care physicians can usually determine
      the type of sensation (vertigo or light-headedness) and its source. Although most
      causes of dizziness are benign, disorders of the central nervous system tend to
      be ominous and require immediate referral to a specialist.

PMID- 2216986
TI  - Thank you, Dr Heimlich.

PMID- 2216987
TI  - Healthcare crisis. As I see it. What would you do to close the checkbook on
      runaway healthcare costs?

PMID- 2216988
TI  - Clinical recognition and evaluation of peptic ulcer disease.
AB  - When a patient has epigastric pain that worsens 1 to 3 hours after meals, the
      possibility of peptic ulcer disease should be considered. Completely typical
      clinical presentations in patients younger than age 50 justify empirical therapy
      when no physical or laboratory findings suggest a mimicking disorder.
      Esophagogastroduodenoscopy should be undertaken when response to therapy is
      incomplete, symptoms recur quickly, or dyspeptic symptoms present for the first
      time in a patient older than age 50. When gastric ulcers are diagnosed
      radiographically, endoscopy and biopsy at multiple sites should be done to
      exclude malignant disease. Intractable duodenal ulcers may necessitate endoscopic
      biopsy of antral and duodenal mucosa to rule out an associated Helicobacter
      pylori infection, which may modify therapeutic approaches. Zollinger-Ellison
      syndrome is rare but should be suspected when ulcer disease presents atypically
      or aggressively or in families. Diagnosis is not difficult to confirm.

PMID- 2216989
TI  - Medical treatment and prevention of peptic ulcer disease.
AB  - Many agents seem to be equally effective for the treatment of peptic ulcer
      disease. This is true despite the drugs' varied mechanisms of action, and this
      observation has caused investigators to shift their focus from aggressive to
      defensive factors when studying ulcer pathogenesis. Patients with a healed ulcer
      are always at risk for recurrence, and guidelines are available for management of
      these patients. Ulcer prevention becomes a crucial issue in intensive care units
      where critically ill patients have many known risk factors. Maintaining a gastric
      pH above 4.0 appears to reduce the morbidity and mortality associated with such
      stress-induced ulcers. Use of nonsteroidal anti-inflammatory drugs increases
      ulcer risk and complications in the elderly, in women with rheumatoid arthritis,
      and in smokers and abusers of alcohol. Prophylaxis with the synthetic
      prostaglandin analogue misoprostol (Cytotec) appears to reduce this risk.

PMID- 2216990
TI  - New findings in treatment of colon cancer.
AB  - Patients with colon cancer involving regional lymph nodes (stage C disease) have
      a 5-year survival rate of only 30% to 40%, and the majority die of recurrent
      disease. Recent trials have shown increased survival rates with postoperative use
      of fluorouracil plus levamisole. The authors discuss these findings and the
      implications on treatment recommendations for stage C colon cancer.

PMID- 2216991
TI  - Initial management of trauma. The first 5 minutes.
AB  - Trauma is the leading cause of death in young Americans and is responsible for
      the loss of more productive years of life than heart disease and cancer combined.
      Initial management of trauma consists of the establishment or maintenance of a
      patent airway, ensurance of adequate breathing, and resuscitation of the
      circulation. All of these are accomplished simultaneously with a cursory survey
      to identify immediately life-threatening injuries and to prevent permanent
      disability.

PMID- 2216992
TI  - Initial management of trauma. The next 60 minutes.
AB  - If and when hemodynamic stability has been achieved in a trauma patient, a
      detailed physical examination and appropriate diagnostic studies are performed.
      The successful management of trauma demands that immediately life-threatening
      problems receive top priority and that patients be continuously reexamined and
      problems reprioritized as conditions change. Finally, it is imperative that
      appropriate surgical evaluation and treatment be undertaken as soon as possible.
      Trauma patients should not be allowed to languish or undergo extensive
      examination in a hospital lacking surgical or other specialists trained to treat
      the problems identified. Transfer to another facility, whether for specialized
      diagnostic tests or for evaluation and treatment by surgical specialists, should
      be accomplished as quickly as possible.

PMID- 2216993
TI  - Gastroenterology.

PMID- 2216994
TI  - Efficacy of enalapril in essential hypertension and its comparison with atenolol.
AB  - The effect of enalapril was evaluated in 67 patients with essential hypertension,
      and its therapeutic efficacy was compared with atenolol in a placebo run-in,
      single-blind, cross-over trial. Enalapril significantly reduced blood pressure in
      all grades of essential hypertension. As monotherapy it 'normalized' blood
      pressure in 88%, 50% and 25% of patients with mild, moderate and severe
      hypertension respectively. Optimal dose for most of the patients was 20 to 40
      mg/day. Comparison with atenolol revealed almost parallel efficacy of the two
      drugs, although enalapril produced a significantly greater reduction in systolic
      blood pressure in patients with mild and moderate hypertension (P less than 0.01
      in each group). No serious side effects were encountered with either drug.
      Enalapril, therefore, has a potent and slightly superior antihypertensive effect
      to that of atenolol, and may be used as a 'first-step' drug in the treatment of
      hypertensive patients.

PMID- 2216996
TI  - Facial nerve palsy associated with underwater barotrauma.
AB  - This report describes a case of facial nerve palsy following barotitis media
      sustained at shallow depth. The neuropraxia is likely to have been due to the
      direct effect of pressure, facilitated by a congenital hiatus in the bony canal
      protecting the facial nerve in the middle ear.

PMID- 2216995
TI  - A gastrectomy population: 25-30 years on.
AB  - Prior to 1960 a Polya gastrectomy was the most frequent operation for duodenal
      ulcer. The majority of these patients now have reached the age of sixty or older.
      A prospective longitudinal study of a cohort of patients who underwent
      gastrectomy between 1955 and 1960 was undertaken. Twenty five to thirty years
      later the study has revealed the extent of the nutritional problems that may
      arise with the passage of time and shows that these numerically far outweigh the
      mechanical post-gastrectomy syndromes and weight loss which tended to dominate
      the earlier post-gastrectomy scene. By the end of the first decade, iron
      deficiency was the commonest nutritional problem. Vitamin B12 deficiency assumed
      more importance in the second decade. During the third decade both reached equal
      prevalence, being found in some 90% of the female and 70% of the male residual
      population. Vitamin D deficiency and early osteomalacia was a lesser problem,
      reaching its climax in the second decade. Evidence suggested a high incidence of
      osteoporosis and this requires further investigation. Overall, women fared worse
      than men with a higher and earlier incidence of iron deficiency, particularly in
      the pre-menopausal group. This study emphasizes the increasing need for regular
      screening of post-gastrectomy patients to detect early iron, vitamin B12 and
      vitamin D deficiencies as patients grow older.

PMID- 2216997
TI  - Cat-scratch disease presenting as the oculoglandular syndrome of Parinaud: a
      report of two cases.

PMID- 2216999
TI  - Raised dopamine metabolites in a case of malignant paraganglioma.
AB  - This paper describes the case of a malignant retroperitoneal paraganglioma with
      extensive metastases. The patient presented with a supraclavicular mass and an
      absence of hypertension. Exclusively raised dopamine metabolites were detected
      which may be a marker of a malignant process and account for the lack of
      hypertension.

PMID- 2216998
TI  - Successful late treatment of venous air embolism with hyperbaric oxygen.
AB  - A case of haemodialysis-associated venous air embolism is described. The patient
      commenced hyperbaric oxygen therapy 21 hours after the event when, despite
      appearing decerebrate, he made a complete recovery. This case underlines the
      importance of all clinicians being aware of those centres with facilities for
      hyperbaric therapy and the need to refer all patients with cerebral air embolism
      even following a prolonged delay.

PMID- 2217000
TI  - Acquired von Willebrand's disease and hypothyroidism: report of a case presenting
      with menorrhagia.
AB  - A 17 year old woman presented with severe anaemia due to menorrhagia. On
      investigation, she was shown to have abnormalities of her haemostatic mechanism
      consistent with von Willebrand's disease Type I, although there was no family
      history of this disorder. In addition, she was shown to have severe primary
      hypothyroidism. On correction of hypothyroidism with oral thyroxine, her
      coagulation defects returned to normal and menorrhagia ceased. This is consistent
      with acquired von Willebrand's disease secondary to hypothyroidism.

PMID- 2217003
TI  - Conversation piece--the Voluntary Service Overseas Director. Interview by P. D.
      Welsby.

PMID- 2217001
TI  - Primary plasmacytoma of the thyroid.
AB  - Primary plasmacytoma of the thyroid is a very rare tumour. We report a case and
      emphasize the importance of excluding multiple myeloma which may present as an
      extramedullary plasmacytoma. Histological diagnosis has been simplified by the
      use of immunohistochemical techniques.

PMID- 2217002
TI  - Multiple Salmonella enteritidis leg abscesses in a patient with systemic lupus
      erythematosus.
AB  - We describe a 19 year old woman with systemic lupus erythematosus on
      corticosteroid therapy, who developed bilateral, multiple, gas-forming Salmonella
      enteritidis leg abscesses and osteomyelitis mimicking deep vein thrombosis. The
      infection was treated successfully by a combination of surgical drainage and
      intravenous ceftriaxone, followed by prolonged oral pefloxacin. This rare case of
      gas-producing S. enteritidis emphasizes the difficulty in diagnosing such
      complications in active systemic lupus erythematosus.

PMID- 2217004
TI  - Poisoning from Thevetia nerifolia (yellow oleander)

PMID- 2217005
TI  - Are we missing atypical bacterial meningitis in the elderly?

PMID- 2217006
TI  - The chronic fatigue syndrome: a return to common sense.

PMID- 2217008
TI  - Dipyridamole echocardiography: the bedside stress test for coronary artery
      disease.
AB  - Identification of dipyridamole-induced regional wall motion abnormalities by
      echocardiography has recently been proposed as an alternative diagnostic stress
      test for coronary artery disease. This study evaluates this new technique by
      comparing the results obtained (overall, regionally and by abnormality type) with
      those of thallium-201 myocardial imaging after dipyridamole stress in 25
      patients. Acceptable echocardiograms were obtained in 20 patients (80%).
      Concordance of echocardiographic abnormalities for both overall and regional
      thallium abnormalities was 85%. Sensitivity, specificity and predictive value of
      dipyridamole echocardiography for overall and regional thallium defects were 92%,
      71% and 85%, and 91%, 81% and 85% respectively. However, concordance between the
      two for abnormality type (i.e. ischaemia versus infarction) was only 66% and the
      sensitivity, specificity and predictive value of dipyridamole echocardiography
      for identifying ischaemia as opposed to infarction were only 43%, 82% and 63%,
      respectively. There was substantial agreement between thallium and
      echocardiographic imaging after dipyridamole infusion in the diagnosis of
      coronary artery disease. Echocardiography appears less well able to distinguish
      infarction from active ischaemia. Dipyridamole echocardiography provides a highly
      versatile, noninvasive bedside stress test for the detection and localization of
      coronary artery disease.

PMID- 2217009
TI  - Acanthosis nigricans in obese women with the polycystic ovary syndrome: disease
      spectrum not distinct entity.
AB  - Fasting and stimulated insulin concentrations in four patients with acanthosis
      nigricans and polycystic ovary syndrome were compared with four patients, matched
      for weight and ovarian morphology, without acanthosis. The median fasting serum
      insulin concentrations were 114.2 and 25.1 mU/l in the respective groups (P =
      0.02). One additional patient was investigated before and after an 18% increase
      in weight which resulted in a 170% increase in fasting insulin concentrations and
      the development of acanthosis nigricans. These observations suggest that there is
      variation between individuals in the degree of obesity that results in the
      development of acanthosis and that obese patients with this skin condition
      represent the severe end of the spectrum of the polycystic ovary syndrome.

PMID- 2217010
TI  - An evaluation of combining thiopentone and etomidate for the induction of
      anaesthesia.
AB  - The characteristics of three combinations of thiopentone and etomidate [in the
      ratios of thiopentone (mg):etomidate (mg) of 5:1, 13:1 and 25:1] have been
      compared with the individual agents alone for the induction of anaesthesia. The
      incidence of pain on injection and abnormal movements was less with the
      combination containing the highest ratio of thiopentone to etomidate, when
      compared to etomidate alone. The mixtures did not otherwise confer any advantages
      over the individual agents.

PMID- 2217011
TI  - Analgesic nitrous oxide for alcohol withdrawal: a critical appraisal after 10
      years' use.
AB  - We describe a method of treating the mild to moderate alcohol withdrawal state
      which has been used successfully for 10 years in over 7,000 cases. It is now the
      standard therapy at the largest dedicated alcoholic rehabilitation centre in
      Southern Africa. The technique uses analgesic (subanaesthetic) concentrations of
      nitrous oxide, which in most cases is administered on a single occasion for 20
      minutes only. This results in the most rapid detoxification presently available,
      such that within an hour of the commencement of therapy the patient is so
      improved that they can eat the next ward meal. Provided the correct equipment and
      simple training is used this non-anaesthetic treatment is completely free of any
      serious side effects and the patient is at all times conscious and cooperative.
      Apart from this the amounts of sedative medication, such as benzodiazepines, are
      drastically reduced during detoxification. Because of the rapidity of the
      therapeutic response this technique is useful also as a screening test for
      assessing those patients requiring intensive therapy for the alcohol withdrawal
      state. There is evidence of the usefulness of analgesic nitrous oxide therapy for
      treating other addictive withdrawal states including opioid and nicotine.

PMID- 2217013
TI  - The history of sneezing.

PMID- 2217012
TI  - Venepuncture for calcium assays: should we still avoid the tourniquet?
AB  - Blood was collected by venepuncture from nine healthy subjects over a ten minute
      period before applying a standard tourniquet, and over a ten minute period
      afterwards. Plasma ionised calcium was unaltered by the tourniquet, whereas total
      calcium, total protein and albumin in serum increased modestly. However, there
      was no effect on total calcium adjusted for albumin. Even without albumin
      adjustment the change in total calcium was negligible within one minute of the
      application of the tourniquet. We consider that in ordinary clinical practice,
      there is no need to perform venepuncture for calcium assays without a tourniquet.

PMID- 2217007
TI  - Nephrology, dialysis and transplantation.

PMID- 2217014
TI  - Cerebellar syndrome with hydrocephalus due to Mycoplasma pneumoniae infection.
AB  - A 27 year old woman developed a cerebellar syndrome with serological evidence of
      recent Mycoplasma pneumoniae infection. The cranial computed tomographic scan
      showed effacement of the fourth ventricle, enhancement of the basal meninges and
      hydrocephalus affecting the lateral and third ventricles. Clinical and
      radiological recovery occurred over 5 weeks. We propose that this was a
      manifestation of immune-mediated encephalomyelitis induced by the infection
      rather than direct invasion of the central nervous system.

PMID- 2217015
TI  - Mefenamic acid-induced neutropenia and renal failure in elderly females with
      hypothyroidism.
AB  - We report mefenamic acid-induced non-oliguric renal failure and severe
      neutropenia occurring simultaneously in two elderly females. The neutropenia was
      due to maturation arrest of the myeloid series in one patient. Both patients were
      also hypothyroid, but it is not clear whether this was a predisposing factor to
      the development of these adverse reactions. However, it would seem prudent not to
      use mefenamic acid in hypothyroid patients until the hypothyroidism has been
      corrected.

PMID- 2217016
TI  - Electrical shock sustained in pregnancy followed by placental abruption.
AB  - The case of a pregnant woman suffering a large placental abruption following
      electric shock at 32 weeks' gestation is reported. No other such cases have been
      published in the literature.

PMID- 2217018
TI  - Extrinsic duodenal obstruction and halitosis.
AB  - Two siblings with extrinsic duodenal obstruction caused by congenital peritoneal
      bands are reported. Attention is drawn to the unusual physical sign of halitosis
      as a presenting feature. It is suggested that this physical sign may be an
      indication for barium studies.

PMID- 2217017
TI  - Retinal periphlebitis in ulcerative colitis.
AB  - A man presented with unilateral visual blurring associated with bilateral retinal
      periphlebitis which was felt to be a complication of his biopsy-proven active
      ulcerative colitis. Retinal periphlebitis has been associated rarely with some
      forms of colitis but we can find no report of its occurrence in association with
      ulcerative colitis although other ocular inflammatory disorders are well
      recognized.

PMID- 2217019
TI  - An unusual case of adrenal cortical carcinoma.
AB  - We describe a case of non-functioning adrenal cortical carcinoma, which recurred
      16 years after surgical adrenalectomy. In addition, the patient was successfully
      treated for two anatomically separate and histologically different, primary
      malignant tumours. This case highlights the importance of lifelong follow-up
      after apparently curative surgical excision of an adrenal tumour.

PMID- 2217020
TI  - Heparin-associated skin necrosis.
AB  - A case of skin necrosis at the sites of injection of subcutaneous heparin is
      described. The patient went on to develop heparin-induced thrombocytopenia and
      pulmonary embolism. Review of the previously described cases of heparin
      associated skin necrosis reveals that this sequence of events is not uncommon.

PMID- 2217021
TI  - Irradiation-induced penile angiosarcoma.
AB  - We report a case of angiosarcoma of the glans penis in a 77 year old male
      Caucasian. The tumour developed 18 years after a course of radiotherapy for a
      penile ulcer which was an intra-epidermal squamous carcinoma. The differential
      diagnosis and the concept of radiotherapy-induced angiosarcomas are discussed.

PMID- 2217022
TI  - Bilateral adrenal lymphoma presenting as Addison's disease.

PMID- 2217023
TI  - Loperamide related toxic megacolon in Clostridium difficile colitis.

PMID- 2217024
TI  - Silent nocardia cerebral abscesses in treated dermatomyositis.

PMID- 2217025
TI  - Discharge from osteomyelitis sinus with heparin therapy.

PMID- 2217026
TI  - Metyrapone-induced alopecia.

PMID- 2217027
TI  - Neurothanatology--clinical significance of cerebrally induced cardiac changes.

PMID- 2217029
TI  - An audit of the usage of operating theatre time in a peripheral teaching surgical
      unit.
AB  - A recent report by the National Audit Office found that only 50% to 60% of
      weekday operating time was being used. This report was examined by the Committee
      of Public Accounts and much of the blame for underutilization of operating
      theatres was attributed to poor working practices among surgeons. We investigated
      theatre utilization in our hospital and found underutilization on the same scale
      as the National Audit Office. Twenty-five per cent of theatre sessions were not
      allocated for use, 23% of general surgical lists were cancelled and, of the lists
      which did take place, a further 23% of theatre time was not utilized. The single
      largest cause of underutilization was understaffing. To increase theatre
      utilization higher levels of staffing and expenditure are needed rather than
      changes in the working practices of surgeons.

PMID- 2217031
TI  - Medical training in the European Community.
AB  - The free movement of doctors within the European Community demands harmonization
      of standards of medical practice and carries major implications of an
      undergraduate and postgraduate educational kind. These have begun to be addressed
      by the first three Medical Directives and also by a series of reports produced by
      the Advisory Committee on Medical Training to the European Community. This
      Committee was established in 1975 in order to provide informed agreed advice to
      the Commission. Many tasks remain to be tackled. A system of mutual inspection of
      the examination processes and standards in Member States should be established.
      Control must be exercised over the numbers of doctors produced since educational
      resources, including numbers of patients available for study, are limited. Thus,
      excellent standards of medical practice can only be developed and maintained if
      the primacy of clinical skills derived from the study of patients is recognized
      as essential in this respect. In some Member States at the present time there are
      many unemployed and therefore presumably deskilled doctors.

PMID- 2217030
TI  - Lornoxicam, indomethacin and placebo: comparison of effects on faecal blood loss
      and upper gastrointestinal endoscopic appearances in healthy men.
AB  - Forty-five healthy men aged 21-34 years took part in a double-blind, parallel
      group, placebo-controlled study of the effects of 28 days' treatment with
      lornoxicam 4 mg twice daily or indomethacin 50 mg twice daily on faecal blood
      loss and the endoscopic appearances of gastric and duodenal mucosa. After an
      initial endoscopic examination, subjects received, intravenously, on day 0,
      autologous erythrocytes labelled with 51Cr. Complete daily faecal collections
      were then made from days 6-12, 20-26 and 34-40. The drug treatments or placebo
      were given from days 13-41. Faecal blood loss was calculated from 51Cr-specific
      activity of blood and faeces. Endoscopy was repeated 4-8 hours after the last
      dose of medication; mucosal appearance was graded on a 5-point scale. Lornoxicam
      caused no more adverse events than placebo; indomethacin caused more indigestion
      and central nervous system effects, and one subject in this group was withdrawn
      from the study. Median total blood losses during the pre-treatment and the second
      and fourth weeks of treatment were respectively 3.33, 3.95 and 5.71 ml for
      lornoxicam, 2.87, 7.04 and 7.75 ml for indomethacin, and 4.55, 3.64 and 4.13 ml
      for placebo. Differences between treatments were not statistically significant (P
      = 0.081 for second week of treatment, P = 0.383 for fourth week of treatment;
      Kruskal-Wallis test). The effect of chlortenoxicam on faecal blood loss in this
      study was thus intermediate between placebo and indomethacin, but within- and
      between-subject variability was such that the differences were not statistically
      significant. Endoscopic findings were normal in most subjects before and after
      all treatments, but indomethacin was associated with a slightly greater
      deterioration in endoscopic score and was the only treatment associated with
      Grade 3 appearance (in a single patient) in post-treatment endoscopy.

PMID- 2217032
TI  - Pulmonary infiltrates and fever induced by isoniazid.
AB  - An 88 year old woman with bacteriologically confirmed pulmonary tuberculosis was
      first treated with isoniazid, rifampicin and pyrazinamide. Two weeks later she
      developed pulmonary infiltrates with fever. A drug-induced reaction was suspected
      but the reaction recurred three times until isoniazid was identified as the
      cause. The reaction became worse each time, finally being nearly fatal.

PMID- 2217028
TI  - Haematology.

PMID- 2217033
TI  - Fibroadenosis of the breast does not require excision biopsy.

PMID- 2217034
TI  - Specialized gastrointestinal units for the management of upper gastrointestinal
      haemorrhage.
AB  - In 1986, 292 patients were admitted to a joint medical-surgical gastrointestinal
      unit with upper gastrointestinal haemorrhage. Fourteen patients died (4.8%) a
      mortality considerably lower than recorded in most series. The low mortality may
      result from the use of a specialized gastrointestinal unit to which all patients
      with upper gastrointestinal haemorrhage are admitted and managed with strict
      protocols for resuscitation, transfusion and surgery.

PMID- 2217035
TI  - Haemorrhagic pancreatitis--a cause of death in severe potassium permanganate
      poisoning.
AB  - Severe potassium permanganate poisoning (more than 10 g of potassium
      permanganate) is invariably associated with massive systemic upset and death.
      Multiple organ damage has been recognized as an inevitable consequence of such an
      overdose, although pancreatitis has not been previously reported. Death due to
      cardiovascular collapse and profound hypotension is a common end point in those
      who reach hospital, but the pathogenesis is uncertain. We report a case of
      haemorrhagic pancreatitis following an overdose of potassium permanganate and
      suggest that this complication may be an unrecognized factor contributing to the
      extremely high mortality rate associated with this condition.

PMID- 2217036
TI  - Body packing--a case report and review of the literature.
AB  - Drug smuggling by internal bodily concealment is a growing international problem.
      The management of a patient who swallowed packages containing heroin is
      described. The medical management, indications for surgery and the ethical
      dilemmas of treating patients with drugs concealed within the gastrointestinal
      tract are discussed.

PMID- 2217037
TI  - Early diagnosis of Graves' optic neuropathy using visual evoked responses.
AB  - A 27 year old woman with Graves' disease developed progressive ophthalmopathy and
      was noted to have abnormal visual evoked responses (VER). She was treated with
      high dose prednisone with clinical improvement and return of the visual evoked
      responses to normal. On withdrawal of steroids symptoms recurred and VER again
      were abnormal. Orbital irradiation was given with improvement in the
      ophthalmopathy and VER again normalized. To our knowledge this report represents
      the first demonstration of improvement in VER with treatment in Graves' optic
      neuropathy.

PMID- 2217038
TI  - Multiple sclerosis associated with water intoxication.
AB  - We present a case of well documented multiple sclerosis which presented with the
      syndrome of inappropriate antidiuretic hormone secretion, following an
      exacerbation of the disease. This is a poorly documented association.

PMID- 2217039
TI  - Chronic bronchial suppuration and antineutrophil cytoplasmic antibody (ANCA)
      positive systemic vasculitis.
AB  - Two patients with long-standing chronic bronchial suppuration developed
      antineutrophil cytoplasmic antibody (ANCA) positive Wegener's granulomatosis and
      microscopic polyarteritis respectively. There is published evidence of an
      association between previous suppurative respiratory disease and Wegener's
      granulomatosis. We believe that our cases provide further evidence that chronic
      lung infection may play an aetiological role in the development of ANCA-positive
      systemic necrotizing vasculitis in some individuals.

PMID- 2217040
TI  - Diagnostic aspiration of an iatrogenic hydrothorax following subclavian
      catheterization.
AB  - Central venous catheterization is not without hazard. Inadvertent placement in
      the pleural space can occur without the development of a pneumothorax and
      pressure measurements may appear misleadingly normal. This case report
      illustrates an effective method of diagnosing and draining an iatrogenic
      hydrothorax which resulted in this way.

PMID- 2217041
TI  - Spontaneous rheumatoid fistula of the elbow joint.
AB  - A case of rheumatoid arthritis, whose presenting problem was a non-infective
      fistula of the elbow joint, is described. Penicillamine therapy was ineffective,
      but synovectomy led to healing.

PMID- 2217042
TI  - Subcutaneous sarcoidosis mimicking carcinoma of the breast.
AB  - A 65 year old woman presented with bilateral breast lumps. Clinical examination
      suggested a diagnosis of mammary carcinoma, but a histological diagnosis of
      sarcoidosis was made. Subsequent investigations revealed evidence of pulmonary
      sarcoidosis.

PMID- 2217043
TI  - An unusual omental hernia.
AB  - A unique case of a type of omental hernia is presented, which caused small bowel
      obstruction. The hernia is described and possible aetiological factors discussed.

PMID- 2217044
TI  - Large bowel obstruction due to an impacted barolith--a delayed complication of a
      barium study.
AB  - Complications of barium sulphate studies abound in the literature but there are
      very few recorded instances of large bowel obstruction due to inspissated barium
      and faeces forming a 'barolith'. A patient who suffered this complication is
      reported.

PMID- 2217045
TI  - Iron deficiency in autoimmune chronic gastritis.

PMID- 2217046
TI  - Retinal infarcts and haemorrhages due to scurvy.

PMID- 2217047
TI  - Hyperparathyroidism and cerebral haemorrhage.

PMID- 2217048
TI  - Partially reversible nerve deafness due to vincristine.

PMID- 2217050
TI  - Academic schizophrenia.

PMID- 2217049
TI  - Chemical de-bulking of desmoid tumours.

PMID- 2217052
TI  - Cultural diversity: a resource in planning and implementing nursing care.
AB  - America's cultural diversity challenges the ability of nurses to respond with
      sensitivity to client needs. Enhancement of the client's health practices is
      contingent on the nurse's ability to use the individual's culturally based
      beliefs and values as an integral component in the design of nursing
      interventions. Nurse and client engage in a truly collaborative planning and
      implementation of care only after there is mutual understanding of the special
      meaning of beliefs and values from which health behaviors are derived.
      Educational preparation with experience in applying cultural knowledge is
      essential to the development of sensitive nursing practice. Integrating such
      information and experiences into baccalaureate nursing curricula through a
      sociocultural project will enhance student awareness of client values and beliefs
      and their potential nursing implications. Strategies exist for helping students
      recognize, accept, and use these features in planning and implementing nursing
      care.

PMID- 2217051
TI  - The dependency at discharge instrument as a measure of resource use in home care.
AB  - The dependency at discharge instrument, developed to evaluate the needs for care
      of hospitalized patients on the day of discharge, was tested for its usefulness
      in measuring resource consumption in home health care. The instrument evaluates
      dependency in relation to bathing/hygiene, activity, technical procedures, and
      monitoring signs and symptoms. The sample used in this study consisted of 150
      subjects admitted to one of three types of home health care agencies. Interrater
      reliability and internal consistency of the instrument were high. Factor analysis
      produced results similar to those of the developers for three of the four scale
      items. The item concerning need for assistance with procedures had a much lower
      loading, indicating that it had little in common with the other items. Criterion
      based validity was measured by testing the instrument's ability to predict the
      number of registered nurse and home health aide visits, and length of enrollment.
      Findings indicated that the instrument had a modest level of criterion-based
      validity in predicting the use of registered nurse and home health aide services
      for the hospital-affiliated agency, but was relatively ineffective for public
      health and for-profit agencies.

PMID- 2217053
TI  - Core curriculum for master's-level community health nursing education: a
      comparison of the views of leaders in service and education.
AB  - This study identified core components of the curriculum for master's-level
      community health nurses (CHNs) and assessed whether leaders in service agreed
      with leaders in education on the importance of these components. Through a mailed
      survey, 588 leaders in CHN service and education identified the following as the
      most important to include in the core CHN curriculum: a practicum experience;
      epidemiology; community health assessment and diagnosis; administration and
      management, including public health administration, management theory, program
      planning and evaluation, financial management and budgeting, and quality
      assurance; research methods and biostatistics; health promotion and disease
      prevention; intervention at the aggregate level; and leadership theory. These
      leaders also indicated that skills in both administration and direct care are
      essential for CHN practice. While there was remarkable agreement between service
      and education leaders in many areas, notable disagreements were seen in the
      importance accorded administrative skills. Service leaders rated these skills
      much more highly than did leaders in education.

PMID- 2217054
TI  - External family structure and cohesion: nursing perspectives.
AB  - The family is recognized as a basic unit in the delivery of many nursing
      services. The dimensions of its structure and cohesion may be important in the
      development of many family problems and should be assessed in planning nursing
      interventions in family-based care. This paper examines the impact of external
      family structure on the cohesion of a family encountered during a community-based
      student clinical experience in communications. External structural factors were
      considered in planning nursing interventions to alleviate stress-related symptoms
      and conflicts, and to enhance cohesion in clinical work with this family.

PMID- 2217056
TI  - Public health nurses and family planning.
AB  - Unintended pregnancy is a health problem that is particularly important in the
      practice of public health nurses (PHNs). Data from 844 PHNs showed that they were
      likely to practice in settings that incorporate family planning services and were
      knowledgeable about specific family planning methods. They favored family
      planning services and an expanded supportive government role in both family
      planning and abortion. Since PHNs are an important resource for the community
      activism required to build the consensus needed to expand these services, a
      multiple-regression analysis was performed to determine predictors of activism.
      Political participation was the major predictor for activism on both family
      planning and abortion.

PMID- 2217055
TI  - Symbiotic and synergistic community-based volunteer home visiting program for
      postpartum families.
AB  - Community health nurses who focus on the needs of the community as client, and
      not simply individual and family services, are aware of the demand for increased
      services. This demand, however, is usually coupled with the absence of resources
      to deliver the needed services. Therefore, leaders in community agencies must
      consider attracting nurses as volunteers to augment resources. Volunteer service
      can be highly synergistic when a symbiotic relationship exists between the agency
      and the volunteer. A one-year volunteer home visiting program was developed to
      provide services to families with new infants at one U.S. Army installation in
      the western United States. We assume the program methodology would be successful
      in civilian communities as well as other client populations.

PMID- 2217057
TI  - Public health nurse salaries: associations with nurse, agency, and community
      characteristics.
AB  - This study applied an economic framework to the analysis of public health nurse
      (PHN) salaries, assessing their relationships to nurse qualifications, agency
      resources, community economic base, and area competition for the nurse supply.
      Data were obtained through interviews with 125 Ohio health departments and from
      various state and local reports. Associations between salaries and explanatory
      variables were analyzed through correlations and stepwise regression models. The
      PHN salaries were significantly lower and more compressed than salaries for
      nurses in area hospitals. Agency and community characteristics were more
      important than nurse education and experience in explaining salary variations.
      Maximum PHN salary attainable was significantly related to level of health
      department funding and community unemployment rate. Health departments in rural
      locations paid lower salaries at both minimum and maximum levels. Evidence
      suggested the presence of entry-level wage competition by health departments with
      both area hospitals and other community nursing agencies. Each 1% increase in
      minimum hospital nurse salaries was linked to a 0.66% increase in PHN salaries.
      Findings support the need to improve competitive positions of health departments
      as nurse shortages intensify.

PMID- 2217059
TI  - Computers demystified.

PMID- 2217058
TI  - Malignant melanoma of the foot.

PMID- 2217060
TI  - Why GPs need to use the computer.

PMID- 2217061
TI  - The consulting room computer--friend or foe?

PMID- 2217063
TI  - Computer use and the new contract.

PMID- 2217062
TI  - Computers in the practice. Facilitating clinical care.

PMID- 2217064
TI  - Choosing a computer system.

PMID- 2217065
TI  - The doctor's bag.

PMID- 2217066
TI  - A request for a strong analgesic.

PMID- 2217068
TI  - Immunisation by health visitors.

PMID- 2217067
TI  - The internal examination.

PMID- 2217069
TI  - Recovery from a heart attack.

PMID- 2217070
TI  - Anaemias.

PMID- 2217071
TI  - Abnormal white blood cell count.

PMID- 2217072
TI  - Sickle cell disease in the UK.

PMID- 2217073
TI  - Polycythaemia.

PMID- 2217075
TI  - Abstracts of the XX Annual Nordic Meeting on Biological Alcohol Research. 13.
      15.5.1990, Espoo, Finland.

PMID- 2217074
TI  - Bone marrow transplantation.

PMID- 2217076
TI  - Immunocytochemical localization of peroxisomal beta-oxidation enzymes in human
      fetal liver.
AB  - In the majority of congenital peroxisomal disorders, beta-oxidation of very long
      chain fatty acids is deficient. We have investigated the appearance and
      localization of the three peroxisomal beta-oxidation enzymes in normal fetal
      liver (fertilization age between 5 and 18 weeks) with protein A-gold
      immunocytochemistry and silver enhancement for light microscopic visualization.
      With specificity-tested polyclonal antibodies, acyl-CoA-oxidase, bifunctional
      enzyme, and 3-oxoacyl-CoA thiolase were localized in the peroxisomes of the
      parenchymal cells, which appear as brown or black granules. In the youngest
      specimen, no immunopositive reaction was obtained. A weak reaction with anti
      thiolase was obtained at the age of 6-7 weeks. At a fertilization age of 8 weeks,
      peroxisomes could be distinctly visualized after immunostaining for all three
      enzymes. From a staining series with anti-thiolase on simultaneously treated
      slides, it appears that the amount of antigen per peroxisome and the organelle
      size increase between the seventh and eighteenth weeks. These data should enable
      a more specific diagnosis in fetal liver biopsies from pregnancies at risk and
      after termination of pregnancy.

PMID- 2217077
TI  - Genetic amniocentesis: 505 cases performed before the sixteenth week of
      gestation.
AB  - Between May 1987 and November 1988, 505 early amniocentesis within the 15th week
      of gestation were performed at the First Department of Obstetrics and
      Gynaecology, 'L. Mangiagalli' of the University of Milan and at the Department of
      Obstetrics and Gynaecology of 'Gaslini' hospital in Genoa. A total number of ten
      abnormal fetal karyotypes were diagnosed. In addition, one case of
      pseudomosaicism (not confirmed on fetal blood) and one case of osteogenesis
      imperfecta type II (observed at ultrasound examination) were also detected.
      Eleven pregnancies were therefore terminated because of an abnormal fetus. Out of
      494 pregnancies (excluding terminated pregnancies) there were 16 fetal losses
      within the 28th week; ten of these occurred in the 2 weeks following the
      procedure. There were 475 live-births, of which 447 were term deliveries and the
      other 28 deliveries occurred before the 37th week of gestation.

PMID- 2217078
TI  - Simultaneous placentacentesis and amniocentesis for prenatal karyotyping: report
      on 250 cases.
AB  - The efficacy and risks of simultaneous transabdominal chorionic villus biopsy
      (placentacentesis) and amniocentesis in the second and third trimesters were
      evaluated in 250 singleton pregnancies. The major indications were advanced
      maternal age (36.0 per cent), abnormal ultrasound findings (23.2 per cent), and
      low maternal AFP value (17.6 per cent). Nine abnormal karyotypes were found in
      placental tissue (3.6 per cent). The karyotypes of placental and amniotic cells
      were different in three cases, including two cases of false-positive mosaicism
      (0.8 per cent) and one case of a false-negative result (0.4 per cent) obtained by
      placental karyotyping. The problem of discrepant karyotypes in embryonic and
      extra-embryonic tissue does not seem to be restricted to the first trimester. The
      post-procedure fetal loss rate was estimated as approximately 1.8 per cent. We
      conclude that the procedure presented here combines the advantages of rapid
      karyotyping (placentacentesis) and high diagnostic reliability (amniocentesis).
      It does not seem to be necessary to restrict its use to late presentations and
      suspicious ultrasound findings.

PMID- 2217080
TI  - Spontaneous resolution of cystic hygroma in a 46,XX normal female.
AB  - We report a case of nuchal cystic hygroma with spontaneous resolution detected by
      ultrasound examination at 13 weeks' gestation. Fetal karyotype and amniotic fluid
      alpha-fetoprotein levels were normal. Extreme caution in evaluating this
      situation is stressed.

PMID- 2217079
TI  - Megacystis-microcolon-intestinal hypoperistalsis syndrome in two male siblings.
AB  - Two male sibs with severe congenital megacystis-microcolon-intestinal
      hypoperistalsis syndrome (MMIHS) are presented. Both had enlarged bladder and
      hydronephrosis due to reduced bladder emptying, decreased bowel motility, and
      malrotation of the colon. Repeated careful ultrasound examination of the urinary
      tract in the second sib failed to show significant bladder enlargement prior to
      25 weeks' gestation, which has been considered to be a reliable prenatal
      diagnostic sign for MMIHS. Slight bilateral enlargement of the renal pelves was
      noted at 21 weeks' gestation, and this may represent the earliest prenatally
      detectable observation in this disease. Although more females than males with
      this condition have been reported, our cases provide support for an autosomal
      recessive mode of inheritance with a similar recurrence risk for both sexes.

PMID- 2217081
TI  - Delta F508 gene deletion and prenatal diagnosis of cystic fibrosis in Italian and
      Spanish families.

PMID- 2217082
TI  - Fermentation of pearl millet flour with yeasts and lactobacilli: in vitro
      digestibility and utilisation of fermented flour for weaning mixtures.
AB  - Single as well as mixed culture fermentation by yeasts (S. diastaticus; S.
      cerevistiae) and lactobacilli (L. brevis; L. fermentum) at 30 degrees C for 72 h
      improved the starch and protein digestibility (in vitro) of pearl millet flour
      significantly. The flour fermented by Saccharomyces diastaticus, a starch
      hydrolysing yeast, had the highest starch digestibility whereas fermentation by
      Saccharomyces cerevisiae enhanced the in vitro protein digestibility of the flour
      significantly. Weaning mixtures prepared from the fermented flour were also found
      to be organoleptically acceptable.

PMID- 2217083
TI  - Biological evaluation of pearl millet protein: effect of different treatments and
      storage.
AB  - Whole grain flour of one variety (HC-4) of pearl millet (Pennisetum americanum L.
      Leeke) after giving different treatments (defatting, butylated hydroxyanisole,
      ascorbic acid and thermal) was stored in earthen pots at prevailing room
      temperature (28-34 degrees C) and relative humidity (70-80%) for 30 days. The
      flour samples were evaluated for protein quality using rats. Storage of flour for
      30 days markedly reduced the protein quality. The values of protein efficiency
      ratio, true digestibility, biological value, net protein retention and net
      protein utilisation were significantly (P less than 0.05) higher in fresh and
      treated flour than untreated flour. Among treated flours, defatted flour showed
      best growth followed by butylated hydroxyanisole, thermal and ascorbic acid
      treated flour.

PMID- 2217084
TI  - Irradiation and germination effects on phytate, protein and amino acids of
      soybean.
AB  - Influence of irradiation (0.05-0.20 kGy) and germination (24-120 hours) in
      distilled and tap water on phytate, protein and amino acids of soybean, was
      studied. Phytate values significantly decreased with increasing germination
      period and irradiation dose (P less than 0.01). Irradiation independently
      decreased the original phytate (212.0 mg/100 g) to a range value of 205.0-190.0
      mg/100 g depending upon dose level. Germination of unirradiated seeds for 120
      hours in distilled and tap water lowered the phytate to 55.0 and 94.9 mg/100 g
      (74.1 and 55.2% reduction) respectively. Maximum destruction of phytate to levels
      of 20.5 and 50.9 mg/100 g (90.3 and 76.0% reduction) occurred during germination
      of 0.20 kGy samples for 120 hours in distilled and tap water respectively. Total
      protein content significantly increased during germination (P less than 0.05) and
      the increase was more in tap than distilled water. Germination for 120 hours of
      untreated seeds in tap water increased the essential and decreased non-essential
      amino acids while in the 0.10 kGy sample, increases in both cases were observed.

PMID- 2217085
TI  - Seed protein yield from some Crotalaria spp and in vitro nutritional quality of
      that from C. juncea.
AB  - Seed Protein Concentrates (SPC) of 6 species of Crotalaria were extracted and the
      extractabilities of SPC, total N and protein N determined. SPC of high yielding
      species (C. Juncea) was analyzed for the contents of amino acids, ash,
      phosphorus, sugar, starch, fibre and calories, as well as for in vitro
      digestibility. Results indicate the promising potential of C. juncea for SPC
      yield.

PMID- 2217087
TI  - [Bronchial carcinoma--a challenge for pneumology].

PMID- 2217086
TI  - Effect of processing on the nutritive value of Canavalia Jackbeans (Canavalia
      ensiformis L).
AB  - A comparative study of roasting, cooking with and without calcium hydroxide and
      extrusion cooking on the protein quality of Canavalia was conducted. The results
      suggested both extrusion and pressure cooking with lime to be equally effective
      in improving the protein quality of Canavalia and superior to pressure cooking
      alone and roasting, the latter effective possibly in destroying the
      antiphysiological factors in Canavalia but possibly also damaging its protein
      quality. The individual effects of roasting, cooking with different levels of
      calcium hydroxide, and with water under pressure at different times on the
      protein quality of Canavalia were also studied. These indicated a beneficial
      effect of calcium hydroxide added at a level of 0.45% by weight of seed, for 30
      minutes under pressure. Cooking in water under pressure for 30 minutes with and
      without lime added was slightly better than cooking for longer periods of time.
      Roasting was also effective in improving the quality of Canavalia particularly
      when the T was adjusted at 170 degrees C, and roasting conducted for 15 minutes.
      A significant improvement in the protein quality of processed Canavalia was
      obtained by methionine supplementation.

PMID- 2217088
TI  - [Early diagnosis of bronchial carcinoma].

PMID- 2217090
TI  - [Lung function diagnosis using multi-frequency oscillometry with reference to
      lung volume].
AB  - The ranking of various oscillometry parameters was to be tested in patients with
      a broad spectrum of disturbances of pulmonary function, objectified by body
      plethysmographic and technical oesophageal pressure measurement of the
      respiratory resistance, lung volumes and lung elasticity. For this purpose the
      oscillatory resistance Rfo and the phase angle phi were measured at 8, 12 and
      16Hz and phi was measured as it changed, depending on the lung volume V. It was
      found that enhanced respiratory resistance values are satisfactorily represented
      by Rfo for the purposes of preliminary and basic diagnostics. Besides, enhanced
      Rfo values are markedly dependent on the frequency, phi being shifted to negative
      values. Difference between Rfo values at 8 and 16 Hz (delta R8-16) less than 0.7
      hPa/l/s phi greater than or equal to -10 degrees can be considered as being still
      normal with the employed measuring principle and are a valuable supplement for
      assessing the degree of obstruction. The difference between phi in the medium
      respiratory position and at 90 or 100% total capacity (delta phi) is less than 5
      degrees during slow inspiration in 80% of the patients suffering from emphysema.
      In 80% of the persons with healthy lungs and those suffering from fibrosis there
      is an inspiratory negativation of phi (delta phi greater than 5 degrees) so that
      the phi-V relationship appear suitable for distinguishing patients with
      restricted vital capacity in respect of emphysema and fibrosis. Patients
      suffering fron fibrosis differ from healthy subjects by slightly more negative
      phi values. The borderline values for delta R8-16, phi and delta phi were
      confirmed in two further series of examinations on children and adolescents.

PMID- 2217089
TI  - [Unilateral lung transplantation--a new perspective in the treatment of pulmonary
      fibrosis].
AB  - In patients with pulmonary fibrosis and progressive respiratory failure despite
      conservative treatment, unilateral lung transplantation offers a new therapeutic
      alternative. At the Medical School in Hannover, five patients--the first to be
      thus treated in Central Europe--with terminal pulmonary fibrosis of the lung have
      so far been successfully treated with unilateral lung transplantation. All five
      patients are still alive, and all experienced a marked improvement in their
      pulmonary function parameters, such that they have been enabled to lead a normal
      life again.

PMID- 2217091
TI  - [Prognosis in cor pulmonale: predictive value of two-dimensional
      echocardiography].
AB  - Cor pulmonale is a common complication and frequent cause of death in COLD. No
      published records are as yet available on the prognostic ranking of two
      dimensional echo-cardiography in this group of patients. In 79 of 85 (93%)
      consecutively echocardiographically examined COLD patients it was possible to
      effect apical imaging of the four-chamber view to assess the size of the right
      ventricle, as well as a subcostal imaging to analyse the respiratory performance
      of the vena cava inferior (vci). Among the exclusion criteria of this prospective
      series were a diseased condition of the left heart or other associated cardiac
      diseases. The patients were classified into two risk groups (RG 0 and RG 1)
      depending upon whether they had a normal-sized right ventricle or a complete
      inspiratory collapse of the vci, or not. In RG 1 the pO2 values were lower (56.8
      +/- 9.2 vs 66.0 +/- 8.8 mmHg, p less than 0.0005) whereas the values for the
      respiratory passage resistance were higher (8.01 +/- 3.92 vs 6.22 +/- 2.87 cm
      H2O/l/s; p less than 0.025) than with RG 0, the values for the intrathoracic gas
      volume not being significantly different from each other. Fatal cardiopulmonary
      results were covered over a period of 2-48 months (median 24 months) to perform
      life table analyses according to Breslow and Mantel. Patients with an enlarged
      right ventricle or incomplete respiratory collapse of the vci have a lower
      survival rate (43.7% respectively 61.9%) than patients with a normal-size right
      ventricle or complete respiratory collapse of the vci (90.5% respectively
      88%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2217092
TI  - [Determination of theophylline serum level: comparison between a rapid test
      (enzyme-immuno-chromatography) and conventional fluorescence polarization
      immunoassay].
AB  - To evaluate the reliability and accuracy of a rapidly performed enzyme
      immunochromatography method for measuring the serum concentration of
      theophylline, we compared it with a conventional technique (fluorescence
      polarisation immunoassay). We investigated 103 venous blood samples from children
      and adolescents with bronchial asthma, medicated with sustained-release
      theophylline preparations. There was a highly significant correlation of the
      measured values; with a few exceptions, the individual values scattered only
      narrowly around the regression line. Based on this close correlation, the
      investigated enzyme immunochromatography test can be recommended for rapid
      theophylline serum level determinations in clinical practice.

PMID- 2217093
TI  - [Sicca syndrome in sarcoidosis--an overlap syndrome?].
AB  - This is a case report on a 66-year old woman who suffered from chronic
      polyarthritis for 15 years and developed a sicca syndrome pattern for 2 years. 2
      years later epithelioid cell granulomas were found from a submandibular lymph
      node as well as from a suspicious area at the epiglottis and the mucosa of the
      upper lip. Moreover, there was a chronic keratoconjunctivitis and discrete lung
      involvement. The sarcoidosis on the lip and at the epiglottis disappeared, and
      lung involvement and conjunctivitis improved under corticosteroid therapy. In
      spite of above therapy, the sicca syndrome pattern and the rheumatic complaints
      (osteoporosis) persisted.

PMID- 2217094
TI  - [Pneumologie 44(1990), 74-77, G. Pothoff et al. Difficulties in the diagnosis of
      an AIDS-associated intrapulmonary Kaposi sarcoma].

PMID- 2217095
TI  - [Drug safety, characteristic of dosed aerosols].

PMID- 2217096
TI  - [The use of argon laser coagulation in the combination treatment of patients with
      tuberculous chorioretinitis].
AB  - The outcomes of argon laser coagulation (ALC) of active tuberculous chorioretinal
      foci (mainly of exudative and hemorrhagic nature, macular and paramacular
      localization) in 26 patients are illustrated. The coagulation was performed
      concurrently with a combined general and local antituberculosis therapy (with 48
      patients as controls). The developed direct ALC technique was used together with
      antibacterial therapy of the total surface of the inflammation focus itself. The
      examination findings prove that the effectiveness of the above technique is high,
      since the disappearance of the clinical signs of the inflammatory activity is
      achieved in a relatively short time (45 days); acute conditions and relapses are
      prevented; complications are excluded; and an evident economic effect is produced
      (the shorter period of hospitalization, less duration of the main therapeutic
      regimen and lower frequency of relapses).

PMID- 2217097
TI  - [Tuberculosis among socially predisposed groups of the population].
AB  - Low incidence rates of tuberculosis are directly related to social factors,
      including higher morbidity among such groups as migrants, vagabonds, ex-convicts
      and alcohol abusers. In view of that it seems necessary to solve a problem of
      organizing tuberculosis-oriented treatment-and-labor preventoria to render health
      care to the vagabonds and other patients refusing medical intervention. Since
      presently there exists a wide diversity of tuberculosis morbidity rates among
      different community groups, tuberculosis control tactics should be based on the
      awareness of the associated risk factors, the existing level of epidemiological
      data and social and economic situation in a certain region.

PMID- 2217098
TI  - [The interrelation of bovine and human tuberculosis].
AB  - For the last 5 years, the examination of the farms in the Ukrainian SSR revealed
      the following distribution of Mycobacterium cultures isolated from cattle: M.
      bovis, 50.5%, M. hominis, 0.4%; M. avium, 1.8%; and atypical bacilli, 47.3%. In
      31% of the farms considered to be safe enough in relation to tuberculosis,
      tuberculin-sensitive cattle was identified, thus totalling 47.3% of these farms
      where as many as 15 types of atypical Mycobacteria were shown to cause its
      sensitization. Photochromogenic Myco. cultures were not isolated either from the
      cattle or from the environmental objects. Single cases of tuberculous cattle
      infected by the human hosts were found as a consequence of the violation of the
      rules adopted in the farms to prevent this disease. Bovine tuberculosis-infected
      people were not detected.

PMID- 2217099
TI  - [Differential diagnosis of tuberculosis of the intrathoracic lymph nodes in
      children and adolescents].
AB  - Case histories and clinico-roentgenologic symptoms of 103 children with
      intrathoracic lymphatic tuberculosis and 66 with non specific intrathoracic
      adenopathies were analysed. As a result, considerable differences were revealed
      both in the natural history of intrathoracic adenopathies of tuberculous and
      nonspecific etiology and in the clinical symptoms and X-ray picture, making it
      possible to ascertain a nosologic diagnosis of the disease. A diagnosis-rating
      table for the most common diseases with underlying hyperplasia of the
      intrathoracic lymph nodes has been developed.

PMID- 2217100
TI  - [An experimental study of the chemotherapeutic efficacy of flurenizid, a new
      antitubercular pharmaceutical].
AB  - The efficacy of a chemotherapeutic effect of flurenizid, a new antituberculous
      drug, was experimentally demonstrated. Flurenizid is an aromatic heterocyclic
      derivative. As estimated on the models of hematogenic disseminated and
      destructive pulmonary tuberculosis, a chemotherapeutic dose of the drug was 20
      and 50 mg per kg body weight of an animal. Phagocytotic stimulation and
      fibrillogenetic intensification represent one of the mechanisms of its action.
      The most pronounced efficacy of flurenizid was noted when it was combined with
      isoniazid.

PMID- 2217101
TI  - [Hormonal shifts in adolescents in the initial period of infection with
      tuberculosis].
AB  - In 78 adolescents aged 13-17 years, the functions of the pituitary body, adrenal
      and thyroid glands and pancreas were examined by means of radioimmunoassay. The
      controls were represented by 31 subjects with non-infected tuberculosis; in 47
      adolescents, tuberculin test was seen to turn positive. The initial period of the
      tuberculosis infection in adolescents is marked by the following changes:
      inhibited pituitary function (other than adrenocorticotropic hormone); higher
      adrenal activity, elevated cortisol levels, altered (predominantly depressed)
      thyroidal function; and increased pancreas functional activity. The above changes
      indicate the inhibition of human defense forces and its comparatively high energy
      consumption. The presence of deviations in the physical development of
      adolescents, most frequently leading to an excessive weight, and pronounced
      tuberculin sensitivity aggravate the disturbance of the hormone equilibrium.

PMID- 2217102
TI  - [The results of antibacterial therapy combined with prodigiozan in children with
      tuberculosis].
AB  - The paper presents the findings of a clinico-roentgenologic and immunologic
      follow-up of 100 children aged 3-14 years. The efficacy of the antibacterial
      treatment of children with different forms of intrathoracic tuberculosis
      supplemented by prodigiosan as well as that of prodigiosan alone were analysed by
      means of clinical, X-ray, laboratory and immunologic methods. By increasing the
      body reactivity, prodigiosan can promote higher rates of resolution of pathologic
      changes in the lungs. The data of this study permit one to recommend prodigiosan
      as an effective non-specific impact method in the combined treatment of
      tuberculosis in children.

PMID- 2217103
TI  - [The efficacy of sanatorium treatment of adolescents with destructive
      tuberculosis of the lungs].
AB  - Compared to the urban population, tuberculosis morbidity among adolescents living
      in the rural areas means a greater number of serious cases prone to decomposition
      and dissemination processes as a consequence of their late detection. Sanatorium
      and health resort treatment of adolescents with destructive pulmonary
      tuberculosis appears to be highly effective in the institutions situated along
      the southern shore of the Crimea.

PMID- 2217105
TI  - [Characteristics of the phagocytic reaction of the neutrophils in healthy
      children and children with acute bronchitis and varying sensitivity to
      tuberculin].
AB  - The feature of blood neutrophils to phagocyte BCG Mycobacterium and
      Staphylococcus in healthy children and those with acute bronchitis having both
      positive and negative tuberculin tests was analysed. Healthy children with an
      altered tuberculin response demonstrate an intensified phagocytic Myco. reaction
      and a relative inhibition of staphylococcal phagocytosis. In case of acute
      bronchitis, there is no increase in the overall absorbing capacity of
      neutrophils, typical of the tuberculin-negative children, and consequently, the
      detected feature of the phagocytosis is eliminated. The absence of variations in
      the total phagocytic response of the affected children is considered as a
      decrease of their adaptation potential. It is presumed that such an immunological
      status can predetermine the course of respiratory diseases and be the cause of
      tuberculous infection reactivation with intercurrent diseases.

PMID- 2217104
TI  - [The application of a temporary occlusion of the bronchi to restore their
      hermetic state following resection of the lung].
AB  - A temporary occlusion of the bronchi to restore their tightness in the
      postoperative period was carried out in 106 persons aged 18-65 years. The
      indications of occlusion were determined on the basis of the air outflow volume
      along the pleural drainage, subcutaneous emphysema presence and residual pleural
      cavity dimensions. In 90 patients, a temporary bronchial occlusion lasting for 2
      4 days was performed 1-2 days after the operation. In 16 other patients, it was
      done on postoperative days 10-15 (with an occlusion period of 15-30 days and the
      obturator being replaced every 5-7 days). Due to the occlusion, the desired
      effect was achieved in 77 patients by completely restoring lung suture tightness
      and eliminating residual pleural cavity. A partial effect was produced in 18
      subjects which manifested as a 2-3-fold reduction in the residual pleural cavity
      dimensions as compared to the initial one. In 11 persons, the occlusion happened
      to be ineffective.

PMID- 2217106
TI  - [Thrombohemorrhagic and acute circulatory complications of the surgical treatment
      of tuberculosis].
AB  - The results of a number of studies on the hemostasis system in pulmonary
      tuberculosis patients are presented, and the analysis of pathophysiological
      processes of great importance in the development of intravascular hemocoagulation
      is made. It is clearly proved that an indispensable condition for the development
      of a complex of measures to increase the effectiveness of preventive treatment of
      thrombohemorrhagic and acute dyscirculatory complications after surgical
      management of tuberculosis patients is to define concrete biochemical mechanisms
      fundamental for intravascular hemocoagulation when certain hemostatic
      abnormalities occur during operation.

PMID- 2217107
TI  - [The state of the liver in rabbits during combination chemotherapy of
      experimental disseminated tuberculosis].
AB  - Functional and morphologic changes in the liver condition of experimental rabbits
      were studied in the process of the disseminated tuberculosis development and
      treatment. Medication of the animals was started 2 weeks after the infection at
      the peak of the process and continued for 60 days. In Group 1 of the rabbits,
      isoniazid and rifampicin were administered enterally in combination with
      intramuscular streptomycin, and in Group 2, isoniazid and rifampicin were given
      intravenously plus intramuscular streptomycin. The doses of the antibacterial
      drugs were adequate, as compared to the clinical ones. It was shown that an
      intravenous administration of isoniazid and rifampicin supplemented by
      intramuscular streptomycin resulted in more pronounced normalization of processes
      in the liver morphologic and functional changes caused by tuberculosis than an
      enteral route of administration of the drugs.

PMID- 2217108
TI  - [The efficacy of 6 months' chemotherapy of newly diagnosed patients with
      pulmonary tuberculosis].

PMID- 2217109
TI  - [Morphological manifestations of secondary immunodeficiency].

PMID- 2217110
TI  - [Indirect pharmaco-angioscintigraphy of the kidneys in patients with cavernous
      renal tuberculosis].
AB  - Radionuclide examination findings of the renal hemodynamics of 70 patients with
      cavernous tuberculosis of the kidney are presented. Before the indirect
      radionuclide pharmacoangiography, 58 of these patients received two groups of
      drugs having different impact on renal vessels. The indirect radionuclide
      pharmacoangiography method is atraumatic and highly informative, and allows one
      to evaluate a morphofunctional status of the renal vessel channel in patients
      with tuberculosis of the kidney for the purpose of treatment tactics assessment
      and complex therapy efficacy monitoring. The sensitivity and accuracy of the
      method are 81 and 86%, respectively.

PMID- 2217111
TI  - [Generalized tuberculosis today].

PMID- 2217112
TI  - [The treatment of tuberculosis of the lungs complicated by bronchial pathology in
      elderly patients].

PMID- 2217113
TI  - Growth, morphology and division of flagellates of the genus Trypanoplasma
      (Protozoa, Kinetoplastida) in vitro.
AB  - Nine strains of trypanoplasms were grown in axenic culture. Cultures of
      Trypanoplasma borreli Laveran and Mesnil, 1901 from fish hosts Blicca bjoerkna,
      Cyprinus carpio, Scardinius erythrophthalmus and Tinca tinca and of T.
      guerneyorum Minchin, 1909 from Esox lucius and Trypanoplasma spp. from the leech
      Piscicola geometra were maintained in biphasic blood-agar medium SNB-9
      supplemented with vitamins and antibiotics. In culture, the flagellates
      transformed into smaller, elongated stages with a little-developed undulating
      membrane and into short flagella that were morphologically similar to stages in
      the leech vector. The cultures were passaged weekly at 17-20 degrees C, but they
      also grew at 4 degrees C. The flagellates divided by binary fission, which was
      initiated by the formation of two new anterior flagella. The original anterior
      flagellum of the mother individual was gradually apposed to the cell surface and
      became the recurrent flagellum of one of the daughter individuals. In the
      meantime, nuclear division took place, followed by transverse cleavage of the
      kinetoplast. The division was completed by longitudinal fission of the mother
      individual into two offspring. Multiple fission that resulted in rosettes, which
      then cleaved into several daughter cells, was also observed, as well as some
      dyskinetoplastic and other anomalous forms. In cultures isolated from tenches
      with high parasitaemia, non-dividing, long filiform stages were observed. Culture
      stages were not infective for susceptible fishes.

PMID- 2217114
TI  - Exocytosis of Toxoplasma gondii dense granules into the parasitophorous vacuole
      after host cell invasion.
AB  - Tachyzoites of Toxoplasma gondii have been shown to exocytose the contents of
      dense granules into the parasitophorous vacuole after host cell invasion. A
      monoclonal antibody specific for a 27-kDa protein was used to locate the dense
      granules by immunoelectron microscopy. The same antibody also reacted with the
      tubular network found in the parasitophorous vacuole, which confirmed that the
      dense granules were exocytosed by tachyzoites.

PMID- 2217115
TI  - Isolation of the pellicle of Toxoplasma gondii (Protozoa, Coccidia):
      characterization by electron microscopy and protein composition.
AB  - Two methods were compared for the isolation of the Toxoplasma gondii pellicle:
      centrifugation using a discontinuous sucrose gradient and affinity purification
      by microspheres activated with protein A. Electron microscopy showed that these
      two means of purification gave similar results, although better yields were
      obtained with the former than with the latter. Proteins of membrane fractions
      isolated using sucrose gradient were identified by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE). Bands in the molecular-weight
      regions of 19, 22, 35, and 79 kDa appeared to be associated with the T. gondii
      pellicle.

PMID- 2217116
TI  - A new method for purification of Eimeria tenella merozoites.
AB  - A rapid and simple method for purifying second generation merozoites of Eimeria
      tenella was developed using a host tissue digestion fluid, containing 0.25%
      trypsin and 0.5% taurodeoxycholic acid, to liberate merozoites grown in chick
      embryos or from parasitized ceca. After filtration, the digestion procedure
      yielded 1.4 x 10(7) or 8.33 x 10(7) merozoites per embryo or cecum, respectively.
      These yields were nine-fold for embryos and three-fold for ceca in comparison to
      previous reports. Viability of the merozoites was normal as assessed by their
      ability to reinfect embryos and cell cultures. The new method has advantages in
      that large numbers of pure, viable merozoites can be obtained quickly and easily,
      and the procedures require minimal effort and supplies.

PMID- 2217118
TI  - Evidence for surface-coat localisation of a monoclonal antibody-isolated
      merozoite antigen of Babesia divergens.
AB  - The localisation of monoclonal antibody-derived merozoite antigens of Babesia
      divergens was examined using immunogold electron microscopy and
      immunoprecipitation of the monoclonal antibody with both biosynthetically and
      surface-labelled parasites. Immunogold labelling provided evidence that the
      antigens are components of the surface coat of the merozoite. Immunoprecipitation
      with biosynthetically labelled parasites showed the antigens to be of parasite
      origin, whereas surface labelling confirmed that the antigens form part of the
      surface coat.

PMID- 2217117
TI  - The effect of ascaridole on the in vitro development of Plasmodium falciparum.
AB  - Ascaridole is a terpene isolated from the plant Chenopodium ambrosioides
      (American wormseed); it is one of the few naturally occurring endoperoxidases.
      Artemisinin, which also belongs to this group, is a potent antimalarial. We
      therefore undertook a study to determine the effect of ascaridole, a known
      anthelmintic, on the in vitro development of Plasmodium falciparum. Ascaridole
      was found to be a potent inhibitor of plasmodial growth; after 3 days,
      development was arrested by a drug concentration of 0.05 microM, and at 0.1
      microM no parasites were visible in the culture. At lower concentrations the
      effect was observed mainly at the trophozoite stage, whereas the ring stage was
      marginally affected. However, even at these lower concentrations, the ring
      culture could not continue normal development and ceased to grow at a later
      stage. The peroxide group is essential for the antimalarial activity of
      ascaridole, as judged from the fact that cineol, which bears an epoxide group
      instead of the peroxide group found in ascaridole, was totally inactive at
      identical concentrations.

PMID- 2217119
TI  - Characterization and purification of culture-derived soluble glycoproteins of
      Babesia canis.
AB  - The addition of [14C]-glucosamine to media of Babesia canis cultures causes the
      appearance of labeled glycoproteins in the culture supernatants. These
      radioactive soluble glycoproteins were separated according to their molecular
      weight by gel filtration and according to their (acidic) pI by preparative
      electrofocusing. The labeled fractions were then analyzed by SDS-PAGE (sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis). The results showed three
      series of glycoproteic antigens. The molecular weights for the three antigens
      determined by gel filtration and by SDS-PAGE were approximately 100, 40, and 12.5
      kDa, and the preparative gel electrofocusing suggested that the antigens focus in
      the pH range of 3-5.

PMID- 2217120
TI  - Adherence and multiplication of Giardia intestinalis on human enterocyte-like
      differentiated cells in vitro.
AB  - This report describes a technique for studying the adherence and growth of
      Giardia intestinalis trophozoites (strains PARIS/86/LCF/1, PARIS/86/LCF/2 and
      PARIS/88/LCF/8) using the human colon carcinoma cell line Caco2. Giardia
      trophozoites were cultured with Caco2 cells in a modified HSP3 culture medium.
      The biochemical differentiation of Caco2 cells was established by an increase in
      sucrase isomaltase activities to values of 4.51 +/- 0.90 and 10.39 +/- 3.00
      milliunits/mg protein for 8- and 12-day-old cultures, respectively. Giardia,
      adherence to 8- and 12-day-old Caco2 cells reached a value of greater than 75%
      after 60 and 30 min, respectively. Adherence diminished significantly at 24
      degrees C and was almost undetectable at 4 degrees C. Depletion of divalent
      cations reduced the proportion of adherent trophozoites by up to 46%. Adherence
      was pH-independent between pH 6.0 and 7.6. Parasite growth increased when Caco2
      cell monolayers were used instead of axenic cultures. This in vitro human cell
      model may contribute to the study of the mechanisms and factors involved in the
      host-parasite interaction.

PMID- 2217122
TI  - Species variation in mosquito flight-muscle damage resulting from a single
      filarial infection and its repercussions on a second infection.
AB  - Serial sections of females of two highly filaria-susceptible mosquitoes, Aedes
      togoi and Ae. aegypti, were examined by light microscopy. Following a single
      Brugia pahangi infection, the predominant reaction of flight muscles of Ae.
      aegypti was degeneration, whereas that in Ae. togoi was nuclear enlargement, a
      putative repair response. This also holds true following mechanical injury
      (Beckett 1990), suggesting an inherent species difference in flight-muscle
      response to injury. The filariae of a second B. pahangi infection, initiated
      after muscle damage had been established, usually avoided degenerate muscle
      fibres (which cannot support larval development) but entered similar proportions
      of normal fibres and those with enlarged nuclei. Filariae of a second infection,
      initiated whilst first-infection larvae were still within the muscle fibres,
      entered similar proportions of already-parasitized and non-parasitized fibres.
      The sole change in muscle fibres detectable by filarial larvae is therefore
      degeneration.

PMID- 2217121
TI  - Mechanisms of eosinophil accumulation around eggs of Schistosoma japonicum: role
      of two purified components, allergen and eosinophil chemotactic factor, from
      soluble egg antigens measured on sensitized guinea pig skin.
AB  - Mechanisms of eosinophil response induced by soluble egg antigen (SEA) in
      Schistosoma japonicum-infected guinea pig tissues were analyzed using two
      purified components of SEA: major allergenic components (JEAL) and a major
      eosinophil chemotactic component (ECF-SjE). Eosinophil response to the crude SEA
      of S. japonicum was detected at the injection site mainly at 2-8 h after the
      antigenic challenge; this response consisted of two different phases of
      eosinophil attraction. An early phase (2 h) was mediated by an immediate-type
      hypersensitivity reaction; JEAL played an important role in mediating this phase
      of eosinophil response. A late phase (8 h) was mediated by ECF-SjE. Therefore,
      this phase of eosinophil response was caused by direct eosinophilotactic activity
      of SEA. These two types of eosinophil response must be important processes in the
      formation of S. japonicum egg-associated eosinophilic granuloma.

PMID- 2217123
TI  - Loperamid, an efficacious drug against fish-pathogenic acanthocephalans.
AB  - A total of 20 drugs were tested for their efficacy in the treatment of infections
      involving the two major acanthocephalans infesting rainbow trout in European
      trout farms. In in vitro experiments, the antidiarrhoeic loperamid and the well
      known anthelminthic drug niclosamide showed the best efficacy. Worms treated with
      loperamid contracted the posterior end of their body, in which severe necrosis of
      the tegument caused the death of the worms. In in vivo experiments, loperamid was
      the most efficacious drug: 50 mg/kg given to rainbow trout on 3 consecutive days
      led to a complete cure. According to preliminary tolerance tests in water baths,
      the toxicity of this drug is low as compared with that of niclosamide, which is
      very toxic. Thus, loperamid can be recommended as the drug of choice for therapy
      of acanthocephalan infections in fish.

PMID- 2217124
TI  - Loperamid, an efficacious drug against the acanthocephalan Macracanthorhynchus
      hirudinaceus in pigs.

PMID- 2217126
TI  - A cyst-specific component of Pneumocystis carinii.

PMID- 2217125
TI  - Protective immunity to Leucocytozoon caulleryi in chickens by a killed vaccine.

PMID- 2217127
TI  - The nervous system of Diplostomum pseudospathaceum Niewiadomska, 1984 (Trematoda,
      Diplostomidae). IV. Nervous system and distribution of sensilla in the daughter
      sporocyst.

PMID- 2217128
TI  - The influence of Hymenolepis diminuta infection on IgA bound to mouse blood
      platelets.

PMID- 2217129
TI  - Praziquantel treatment of brain and muscle porcine Taenia solium cysticercosis.
      2. Immunological and cytogenetic studies.

PMID- 2217130
TI  - Determination of reliable regions in protein sequence alignments.
AB  - Judging the significance of alignments is still a major problem in sequence
      comparison. We present a method to delineate reliable regions within an
      alignment. This differs from standard approaches in that it does not attempt to
      attribute one significance value to the alignment as a whole, but assesses
      alignment quality locally. An algorithm is provided that predicts which residue
      pairs in an alignment are likely to be correctly matched. The predictions are
      evaluated by comparison with alignments taken from tertiary structural
      superpositions.

PMID- 2217131
TI  - Sequence requirements for cytochromes P450IIA1 and P450IIA2 catalytic activity:
      evidence for both specific and non-specific substrate binding interactions
      through use of chimeric cDNAs and cDNA expression.
AB  - Cytochrome P450s IIA1 and IIA2, encoded by the CYP2A1 and CYP2A2 genes, display
      88% amino acid sequence similarities. The dissimilarities of sequence between
      these two enzymes are primarily localized within four discrete regions of the
      polypeptides that are separated by regions of absolute sequence identity. IIA1
      specifically hydroxylates the prototype substrate testosterone at the 7 alpha and
      6 alpha position with a predominance of 7 alpha metabolite. IIA2, on the other
      hand, hydroxylates this steroid at eight positions on the molecule, with one of
      the most abundant metabolites being 15 alpha-hydroxytestosterone. To determine
      those amino acids responsible for the difference in testosterone hydroxylation
      specificities, chimeras were constructed between IIA1 and IIA2 cDNAs and
      expressed in cell culture using vaccinia-virus-mediated cDNA expression.
      Chimeras, in which the first 355 amino acids correspond to a single enzyme,
      maintain the specificity associated with that enzyme. Of six chimeras which have
      substitutions between amino acids 161 and 276, two are inactive and the remaining
      four give similar metabolite profiles, in which both 7 alpha and 15 alpha
      hydroxylation specificities have been lost. Two of these four chimeras are
      diametric apposites, suggesting that modification of either the N-terminal or
      central regions of the enzymes results in conformational changes that prevent the
      specific binding interactions responsible for the narrow regioselectivity
      associated with IIA1 and 15 alpha-hydroxytestosterone formation associated with
      IIA2.

PMID- 2217132
TI  - Alignment of protein sequences using secondary structure: a modified dynamic
      programming method.
AB  - A method for comparison of protein sequences based on their primary and secondary
      structure is described. Protein sequences are annotated with predicted secondary
      structures (using a modified Chou and Fasman method). Two lettered code sequences
      are generated (Xx, where X is the amino acid and x is its annotated secondary
      structure). Sequences are compared with a dynamic programming method (STRALIGN)
      that includes a similarity matrix for both the amino acids and secondary
      structures. The similarity value for each paired two-lettered code is a linear
      combination of similarity values for the paired amino acids and their annotated
      secondary structures. The method has been applied to eight globin proteins (28
      pairs) for which the X-ray structure is known. For protein pairs with high
      primary sequence similarity (greater than 45%), STRALIGN alignment is identical
      to that obtained by a dynamic programming method using only primary sequence
      information. However, alignment of protein pairs with lower primary sequence
      similarity improves significantly with the addition of secondary structure
      annotation. Alignment of the pair with the least primary sequence similarity of
      16% was improved from 0 to 37% 'correct' alignment using this method. In
      addition, STRALIGN was successfully applied to seven pairs of distantly related
      cytochrome c proteins, and three pairs of distantly related picornavirus
      proteins.

PMID- 2217134
TI  - Protein engineering of chymosin; modification of the optimum pH of enzyme
      catalysis.
AB  - The aspartic proteinase chymosin exhibits a local network of hydrogen bonds
      involving the active site aspartates and surrounding residues which may have an
      influence on the rate and optimal pH of substrate cleavage. We have introduced
      into chymosin B the following substitutions: Asp304 to Ala (D304A), Thr218 to Ala
      (T218A) and Gly244 to Asp (G244D, chymosin A), using oligonucleotide-directed
      mutagenesis. Kinetic analysis of these active mutants shows shifts in their pH
      optima to 4.4 D304A, 4.2 T218A and 4.0 G244D compared with 3.8 for chymosin B
      using a synthetic octapeptide substrate. The upward shift of the D304A and T218A
      may be due to the loss of hydrogen bond interactions indirectly affecting the
      catalytic aspartates 32 and 215. The G244D mutation which is in a flexible loop
      on the surface of the enzyme may alter the conformation of the specificity
      pockets on the prime side of the scissile bond.

PMID- 2217133
TI  - Influence of size and polarity of residue 31 in porcine pancreatic phospholipase
      A2 on catalytic properties.
AB  - Residue 31 of porcine pancreatic phospholipase A2 (PLA2) is located at the
      entrance to the active site. To study the role of residue 31 in PLA2, six mutant
      enzymes were produced by site-directed mutagenesis, replacing Leu by either Trp,
      Arg, Ala, Thr, Ser or Gly. Direct binding studies indicated a three to six times
      greater affinity of the Trp31 PLA2 for both monomeric and micellar substrate
      analogs, relative to the wild-type enzyme. The other five mutants possess an
      unchanged affinity for monomers of the product analog n-decylphosphocholine and
      for micelles of the diacyl substrate analog rac-1,2-dioctanoylamino-dideoxy
      glycero-3-phosphocholine. The affinities for micelles of the monoacyl product
      analog n-hexadecylphosphocholine were decreased 9-20 times for these five
      mutants. Kinetic studies with monomeric substrates showed that the mutants have
      Vmax values which range between 15 and 70% relative to the wild-type enzyme. The
      Vmax values for micelles of the zwitterionic substrate 1,2-dioctanoyl-sn-glycero
      3-phosphocholine were lowered 3-50 times. The Km values for the monomeric
      substrate and the Km values for the micellar substrate were hardly affected in
      the case of five of the six mutants, but were considerably decreased when Trp was
      present at position 31. The results of these investigations point to a versatile
      role for the residue at position 31: involvement in the binding and orientating
      of monomeric substrate (analogs), involvement in the binding of the enzyme to
      micellar substrate analogs and possibly involvement in shielding the active site
      from excess water.

PMID- 2217136
TI  - Increased biological activity of a recombinant factor IX variant carrying alanine
      at position +1.
AB  - In attempts to improve the post-translational modification and processing of
      recombinant factor IX (FIX) we have altered the cDNA sequence encoding pre-pro
      FIX using site-directed mutagenesis and have expressed the variant cDNAs in BHK21
      cells using a vaccinia-virus-derived vector. We find that substitution of the
      tyrosine residue at +1 for an alanine increases the biological activity of the
      recombinant molecules 2-fold. On the other hand, substitution of the proline at 
      3 for a valine results in no significant change to the specific activity of the
      protein. Other alterations to the N-terminus of the FIX proteins, in attempts to
      mimic other vitamin-K-dependent proteins, result in the failure to produce a
      secreted polypeptide. N-terminal sequence analysis of purified recombinant
      molecules reveals a correlation between specific activity and the efficiency of
      correct pro-sequence cleavage. gamma-Carboxylation analysis of purified
      recombinant proteins indicates that each molecule including unmutated FIX is
      completely gamma-carboxylated in this system. Thus the observed increase in
      biological activity of FIX variants containing an alanine at position +1 is not
      due to increased gamma-carboxylation but, at least in part, to more efficient pro
      peptide cleavage.

PMID- 2217135
TI  - Sequential protection-modification method for selective sulfhydryl group
      derivatization in proteins having more than one cysteine.
AB  - The method of Smith and Hartman [J. Biol. Chem., 263, 4921-4925 (1988)] for
      introducing the non-natural lysine analog, S-(2-aminoethyl)cysteine, into
      specific sites in proteins by alkylation of a genetically introduced cysteine
      with 2-bromoethylamine has been generalized to be applicable to proteins
      containing one or more endogenous cysteines. The target cysteine residue
      introduced at the active site of aspartate aminotransferase is protected by bound
      cofactor. The enzyme is partially unfolded in low concentrations of urea, and the
      non-active site cysteine residues derivatized by a reversible thiol protecting
      reagent. The active site cysteine is then exposed and alkylated in 6 M urea.
      Enzyme activity is regenerated by removal of the thiol protecting groups and
      refolding of the protein.

PMID- 2217137
TI  - Expression, purification and crystallization of penicillin G acylase from
      Escherichia coli ATCC 11105.
AB  - The penicillin acylase gene (pac) from Escherichia coli ATCC 11105 was cloned
      into pUC 9 and the resulting vector (pUPA-9), when transformed into E. coli
      strain 5K, allowed the constitutive overproduction of mature penicillin acylase
      when grown at 28 degrees C. The enzyme was purified from the periplasmic fraction
      of E. coli pUPA-9 by hydrophobic interaction chromatography and anion exchange.
      Crystals of penicillin acylase were grown in batch using polyethylene glycol 8000
      as a precipitant. The crystals (space group P1) diffracted to beyond 2.3 A.

PMID- 2217138
TI  - Incorporation of crystallographic temperature factors in the statistical analysis
      of protein tertiary structures.
AB  - A method to identify statistically significant differences between equivalent
      atoms in two closely related protein X-ray crystallographic structures is
      described. This method uses the linear relationship found between the logarithm
      of the distance between equivalent atoms and their mean temperature factor to
      determine, by linear regression, the expected difference and variance.

PMID- 2217139
TI  - Predicting surface exposure of amino acids from protein sequence.
AB  - The amino acid residues on a protein surface play a key role in interaction with
      other molecules, determined many physical properties, and constrain the structure
      of the folded protein. A database of monomeric protein crystal structures was
      used to teach computer-simulated neural networks rules for predicting surface
      exposure from local sequence. These trained networks are able to correctly
      predict surface exposure for 72% of residues in a testing set using a binary
      model, (buried/exposed) and for 54% of residues using a ternary model
      (buried/intermediate/exposed). In the ternary model, only 11% of the exposed
      residues are predicted as buried and only 5% of the buried residues are predicted
      as exposed. Also, since the networks are able to predict exposure with a
      quantitative confidence estimate, it is possible to assign exposure for over half
      of the residues in a binary model with greater than 80% accuracy. Even more
      accurate predictions are obtained by making a consensus prediction of exposure
      for a homologous family. The effect of the local environment of an amino acid on
      its accessibility, though smaller than expected, is significant and accounts for
      the higher success rate of prediction than obtained with previously used
      criteria. In the absence of a three-dimensional structure, the ability to predict
      surface accessibility of amino acids directly from the sequence is a valuable
      tool in choosing sites of chemical modification or specific mutations and in
      studies of molecular interaction.

PMID- 2217140
TI  - Prediction of the disulfide-bonding state of cysteine in proteins.
AB  - The bonding states of cysteine play important functional and structural roles in
      proteins. In particular, disulfide bond formation is one of the most important
      factors influencing the three-dimensional fold of proteins. Proteins of known
      structure were used to teach computer-simulated neural networks rules for
      predicting the disulfide-bonding state of a cysteine given only its flanking
      amino acid sequence. Resulting networks make accurate predictions on sequences
      different from those used in training, suggesting that local sequence greatly
      influences cysteines in disulfide bond formation. The average prediction rate
      after seven independent network experiments is 81.4% for disulfide-bonded and
      80.0% for non-disulfide-bonded scenarios. Predictive accuracy is related to the
      strength of network output activities. Network weights reveal interesting
      position-dependent amino acid preferences and provide a physical basis for
      understanding the correlation between the flanking sequence and a cysteine's
      disulfide-bonding state. Network predictions may be used to increase or decrease
      the stability of existing disulfide bonds or to aid the search for potential
      sites to introduce new disulfide bonds.

PMID- 2217141
TI  - The interpretation of site-directed mutagenesis experiments by linear free energy
      relations.
AB  - Fersht and co-workers have applied a linear free energy relation (Bronsted
      equation) to analyze site-directed mutagenesis experiments involving the enzyme
      tyrosyl-tRNA synthetase and have suggested that the Bronsted exponent is linearly
      correlated with the value of the reaction coordinate at the transition state. We
      point out that when the mutants differ solely through the formation or deletion
      of a hydrogen bond away from the reaction center, a linear free energy relation
      is expected only in limiting cases for which the Bronsted relation exponent is 0,
      1 or infinity. The results may be correlated with a conformational coordinate but
      not with the development of the reaction coordinate per se.

PMID- 2217142
TI  - Molecular dynamics simulations of active site mutants of triosephosphate
      isomerase.
AB  - Molecular dynamics simulations of triosephosphate isomerase (TIM) and of some
      active site TIM mutants were performed in an attempt to elucidate possible
      interactions important for catalytic activity and binding. A variety of active
      site residues in TIM have been altered, resulting in all cases in decreases in
      catalytic activity. Second-site suppressor mutants were characterized for two of
      these active site mutants. The pseudorevertants have increased activity compared
      to the single mutant from which they were derived and, surprisingly, in both
      cases the increase in activity is a result of the replacement of an active site
      serine for proline. We performed simulations of wild-type TIM and the active site
      mutants with the substrate dihydroxyacetone phosphate bound both noncovalently
      and covalently. The noncovalent complexes were used to examine interactions
      important to binding while the covalent complexes are models of the transition
      state structure for enolization, which is the rate-determining step for the
      mutants. The difference between these two states, then, is related to the
      catalytic activity. We found various protein-substrate interactions that improved
      in the noncovalent mutant complexes, which correlates with the experimentally
      observed increase in binding affinity upon mutation. In the covalent complexes we
      observed improved electrostatic stabilization of the transition state upon
      introduction of Pro, which is also consistent with the experimental data. Our
      simulations reproduce the highly co-operative nature of the interactions in the
      active site and suggest that this approach may be useful for identifying
      particularly promising sites for mutation.

PMID- 2217143
TI  - Invariant amino acid replacement affects the dihydrofolate reductase function and
      its gene expression.
AB  - Three different forms of dihydrofolate reductase (DHFR) from Escherichia coli
      with amino acid replacements Thr35----Asp, Asn37----Ser and Arg57----His, and one
      form containing all three of these changes were obtained by oligonucleotide
      directed mutagenesis. These amino acids are on the surface of the protein and two
      of them (Thr35 and Arg57) are invariant for known sequences of DHFR. Conversion
      of Asn37----Ser has no effect on the functional activity or the protein level in
      the cells. The Thr35----Asp replacement leads to a sharp decrease in the protein
      level, while the addition of a DHFR inhibitor, trimethoprim (Tmp), to the growth
      medium increases the level of DHFR in the cells. There is a very small quantity
      of DHFR with all three amino acid changes. The addition of Tmp to the growth
      medium also leads to an increase in the mutant protein levels. The mutant with
      the Arg57----His replacement renders the cells sensitive to Tmp, but the level of
      DHFR is the same as for the wild-type protein. It is suggested that the invariant
      Thr35 is important for the stable conformation of DHFR whereas Arg57 is essential
      for protein activity. Various structural and functional aspects of these results
      are discussed.

PMID- 2217144
TI  - Mutational analysis of structure--activity relationships in human tumor necrosis
      factor-alpha.
AB  - To determine the region of human tumor necrosis factor-alpha (TNF-alpha),
      essential for cytotoxic activity against mouse L-M cells, single amino-acid
      substituted TNF-alpha mutant proteins (muteins) were produced in Escherichia coli
      by protein engineering techniques. An expression plasmid for TNF-alpha was
      mutagenized by passage through an E. coli mutD5 mutator strain and by
      oligonucleotide-directed mutagenesis. Approximately 100 single amino-acid
      substituted TNF-alpha muteins were produced and assayed for cytotoxic activity.
      The cytotoxic activities of purified TNF-alpha muteins, e.g. TNF-31T, -32Y, -82D,
      -85H, -115L, -141Y, -144K and -146E, were less than 1% of that of parent TNF
      alpha. These results indicate that the integrity of at least four distinct
      regions of the TNF-alpha molecule is required for full biological activity. These
      regions are designated as follows: region I, from position 30 to 32; region II,
      from position 82 to 89; region III, from position 115 to 117; region IV, from
      position 141 to 146. In addition, TNF-141Y could not completely compete with
      parent TNF-alpha for binding to the receptor. This demonstrates that region IV,
      and at least aspartic acid at position 141, must be involved in the TNF receptor
      binding site.

PMID- 2217145
TI  - Alteration in folding efficiency and conformation of recombinant human tumor
      necrosis factor-alpha by replacing cysteines 69 and 101 with aspartic acid 69 and
      arginine 101.
AB  - An analog of human tumor necrosis factor-alpha (TNF-alpha) was created involving
      the replacement of Cys69 with Asp and Cys101 with Arg. The solution structure and
      behavior of this analog were compared with the native protein. The analog
      exhibited a greatly decreased folding efficiency following dilution from urea,
      but essentially identical circular dichroic spectra in both the folded and
      unfolded states. The Stokes radius of the native and analog TNF-alpha in the
      folded state were identical, with the analog exhibiting a slight broadening of
      the eluting peak. The fluorescence emission spectrum of the native protein
      exhibits a plateau from 320 to 328 nm, while the spectrum of the analog consisted
      of a single peak with a maximum at 335 nm. The analog also had a 1.4-fold
      increase in the fluorescence intensity. Limited proteolysis of the analog
      resulted in only one of the two peptides seen following digestion of the native
      protein, and this product was less stable than the equivalent native protein
      fragment. The analog exhibited a 10-fold lower cytolytic activity than the native
      protein. These results demonstrated that the disulfide bond is not necessary for
      folding and activity, but are consistent with the analog having a looser, more
      flexible structure in solution than the native TNF-alpha.

PMID- 2217146
TI  - Improvement of nutritional value and functional properties of soybean glycinin by
      protein engineering.
AB  - Glycinin is one of the predominant storage proteins of soybean. To improve its
      functional properties (heat-induced gelation and emulsification) and/or
      nutritional value, the A1aB1b proglycinin subunit was modified on the basis of
      genetically variable domains suggested from the comparison of amino acid
      sequences of glycinin-type globulins from various legumes and nonlegumes and the
      relationships between the structure and the functional properties of glycinin.
      Thus, nucleotide sequences corresponding to each of the variable domains were
      deleted from the cDNA encoding the A1aB1b proglycinin, and a synthetic DNA
      encoding four continuous methionines was inserted into the cDNA region
      corresponding to each of the variable domains. Expression plasmids carrying the
      modified cDNAs were constructed and expressed in Escherichia coli strain JM105.
      Some of the modified proteins were accumulated as soluble proteins in the cells
      at a high level and self-assembled. They exhibited functional properties superior
      to those of the native glycinin from soybean, which establishes the possibility
      of creating theoretically designed novel glycinins with high food qualities.

PMID- 2217148
TI  - Closing in on the Aschoff body.

PMID- 2217147
TI  - Construction of a novel artificial-ribozyme-releasing plasmid.
AB  - A novel 'active-ribozyme-releasing system' was constructed, taking advantage of
      the consensus sequence of a new class of ribozyme. An active ribozyme sequence,
      targeted for the SFL1 gene (a yeast suppressor gene for flocculation) was fused
      just downstream of the T7 promoter. The 3' terminus of the first ribozyme was
      designed to be trimmed by the second ribozyme connected to the downstream of the
      first active ribozyme. In vitro experiments revealed that the active ribozyme
      targeted to SFL1 was successfully released by the action of the second ribozyme,
      subsequently cleaving the SFL1 mRNA at the predetermined site. Since the first
      active ribozyme with a defined 3'-terminus can be produced even when a circular
      DNA is used as a template, this kind of construct has a potential to release an
      'active ribozyme' tailored to destroy a target gene (RNA) in vivo. Moreover, the
      second ribozyme in this construct can be utilized as a universal pseudo
      terminator for generation of any RNA transcripts inserted in place of the
      cassette portion of the first ribozyme.

PMID- 2217149
TI  - Splenic amyloidosis: correlations between chemical types of amyloid protein and
      morphological features.
AB  - Sixty-one autopsy cases of splenic amyloidosis were reviewed to assess the
      relationship between the morphological patterns and chemical types of amyloid
      protein. On the basis of immunohistochemical reactions of amyloid protein, the
      cases were classified into 34 cases of AA and 27 of AL amyloidosis. Amyloid
      deposition in the spleen was divided into three major sites: the red pulp, the
      white pulp, and blood vessels. Red pulp involvement by amyloid was noted in 52%
      of the AL cases but in none of the AA cases. White pulp amyloid deposition was
      found in 70% of the AL and 35% of the AA cases. This difference was statistically
      significant (P less than 0.001). On the other hand, vascular deposition of
      amyloid was invariably noted in all cases with AA or AL amyloidosis, affecting
      the AA cases rather severely. These results strongly suggest that the widely held
      concept of deposition of amyloid as predominantly vascular in AL amyloidosis and
      parenchymal in AA amyloidosis requires revision. Our findings indicate that
      parenchymal, especially the red pulp, involvement is a consistent feature of AL
      amyloidosis, whereas vascular involvement is a finding common to both types of
      systemic amyloidosis.

PMID- 2217150
TI  - Immunophenotypic and genotypic characterization of primary non-Hodgkin's lymphoma
      of the gastrointestinal tract.
AB  - Antigen receptor gene rearrangement studies have been applied to gastrointestinal
      (GI) lymphoid proliferations in only a limited number of cases, and their use and
      contribution to the diagnosis and characterization of GI lymphomas is unknown. We
      retrospectively studied 17 cases of primary GI lymphoma using fresh/frozen tissue
      with a combination of immunophenotypic and genotypic techniques. The vast
      majority of the neoplasms were B-cell lymphomas (88%) with rare T-cell tumors.
      The most common B-cell immunophenotype was IgM-kappa (40%), while five of the B
      cell lymphomas (33%) lacked surface light chain immunoglobulin. Immunophenotypic
      evidence of histiocytic differentiation was not identified. Clonality was
      confirmed in 59% (10/17) of the neoplasms by immunophenotyping and 88% (15/17) by
      antigen receptor gene rearrangement studies. All of the 15 B-cell lymphomas
      (100%) demonstrated clonally rearranged immunoglobulin gene rearrangement. The
      two lymphomas with T-cell immunophenotypes did not demonstrate T-cell receptor
      beta-chain gene rearrangement. Antigen receptor gene rearrangement data can be
      useful and may even be necessary in certain cases for the proper classification
      and/or diagnosis of GI lymphoid proliferations.

PMID- 2217151
TI  - Immunohistochemistry of Pneumocystis carinii infection.
AB  - Pneumocystis carinii is the pre-eminent pulmonary pathogen and leading cause of
      death in patients with acquired immunodeficiency syndrome (AIDS). The diagnosis
      of this organism depends upon the morphologic demonstration of the cyst wall,
      trophozoite, or sporozoite in specimens from the lower respiratory tract. A
      variety of histochemical stains have been used to identify P. carinii, each with
      considerable limitations in specificity. Extrapulmonary spread and unusually
      destructive pulmonary patterns associated with P. carinii, although once
      considered rare, are seen occasionally in patients with AIDS. Traditional stains
      have proven to be less reliable in extrapulmonary sites. In 13 patients with
      AIDS, we stained formalin-fixed paraffin-embedded autopsy lung and other visceral
      organ sections using monoclonal antibody 3F6 (Dako, Santa Barbara, CA) to P.
      carinii. The antibody stained P. carinii in the lungs of seven patients with P.
      carinii pneumonia by Gomori methenamine silver stain (GMS). Numerous aggregates
      of P. carinii cysts were marked within alveoli, as is usually seen with other
      stains. No antibody staining was present in autopsy lung sections from non-AIDS
      patients with viral, fungal, or bacterial pneumonia. Clinically occult
      extrapulmonary P. carinii infection was seen in 4/7 (57%) patients with P.
      carinii pneumonia at autopsy. Monoclonal antibody to P. carinii stained organisms
      in all four (100%) patients with disseminated disease, as compared with 1/4 (25%)
      staining with GMS. Antibody staining of P. carinii was demonstrated in sections
      of thyroid, adrenal, and carinal lymph node (one patient), esophagus (one
      patient), kidney (one patient), and heart, thyroid, kidney, adrenal, liver,
      stomach, pancreas, spleen, and bone marrow (one patient).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2217152
TI  - Distribution pattern of follicular dendritic cells in low grade B-cell lymphomas
      of the gastrointestinal tract immunostained by Ki-FDC1p: a new paraffin-resistant
      monoclonal antibody.
AB  - This study surveyed 97 cases of low grade B-cell lymphoma (LGBL) of the
      gastrointestinal tract (GIT) by conventional morphology and immunohistochemistry,
      focusing on the most frequent subtype: the so-called LGBL of the mucosa
      associated lymphoid tissue (MALT). Special reference was made to the follicular
      dendritic cells (FDCs) selectively visualized by a new paraffin-resistant
      monoclonal antibody Ki-FDC1p. LGBL of the MALT accounted for 83 cases. The
      diagnosis was based on (a) a characteristic cytology, which included centrocytoid
      cells, a varying degree of plasma cell differentiation, and some blasts; (b) the
      presence of lymphoepithelial lesions; and (c) the occurrence of two types of
      follicles easily detectable with Ki-FDC1p. Some were restricted to the mucosa,
      contained normal germinal center cells, and were indistinguishable from reactive
      follicles. Others consisted of small clusters of FDCs, were randomly distributed
      throughout the tumor, and escaped detection in conventional stainings. Such small
      clusters of FDCs were found to be restricted to LGBL of the MALT, not occurring
      in other types of LGBL, and were interpreted as tumor-associated abortive
      follicles discernable from residues of reactive follicles due to their cellular
      constituents, localization, and distribution pattern. Eight cases showed closed
      sheets of blasts and were classified as high grade malignant lymphoma secondary
      to LGBL of the MALT. In two cases the LGBL of the MALT were restricted to the
      mucosa, in 31 cases the submucosa was also infiltrated, and in the remaining 50
      cases the infiltration also involved deeper wall layers of the GIT.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2217153
TI  - Neural patterns in inflammatory bowel disease: an immunohistochemical survey.
AB  - The differential diagnosis of inflammatory bowel disease remains a significant
      diagnostic problem for surgical pathologists. Neural abnormalities, such as
      hypertrophy of nerve plexi, hyperplasia of ganglion cells, and ultrastructural
      axonal degeneration have been described in patients with regional enteritis. We
      performed an immunohistochemical survey of forty cases of regional enteritis,
      ulcerative colitis, nonspecific colitis, and normal colon. A panel of antibodies,
      directed against neuron-specific enolase, S-100 protein, synaptophysin,
      neurofilament protein, and nerve growth factor receptor, was utilized to evaluate
      the distribution of nerve fibers in paraffin-embedded tissue. Anti-synaptophysin
      and anti-nerve growth factor receptor highlighted small, arborizing nerve fibers
      in the mucosa, not apparent in the routinely stained sections. Intense staining
      of these fibers was observed in regional enteritis with antinerve growth factor
      receptor. This antibody may aid the discrimination of inflammatory bowel disease
      from other causes of colonic inflammation and facilitate the identification of
      regional enteritis in endoscopic biopsies.

PMID- 2217154
TI  - Typical and atypical carcinoid tumors of lung: a clinicopathologic and DNA
      analysis of 20 tumors.
AB  - Twelve typical carcinoid tumors (TCT) and eight atypical (malignant) carcinoid
      tumors (ACT) of the lung were studied for quantitative DNA content by image
      analysis in order to identify prognostic features. No correlation of any
      histologic variables of the TCTs and ACTs with abnormal DNA content were noted.
      Furthermore, it was concluded that although abnormalities of DNA content,
      particularly aneuploidy, are common in ACTs, DNA ploidy cannot be used
      independently to assess malignant potential.

PMID- 2217155
TI  - Asbestos bodies in pulmonary hilar lymph nodes.
AB  - Asbestos bodies (AB) have long been recognized in light microscopic (LM) sections
      of pulmonary hilar lymph nodes (LN) from patients with asbestos-related diseases,
      but the presence of AB on LM has not been correlated with the lung AB burden. The
      purpose of the present study was to determine whether AB in histologic sections
      of LN are indicative of heavy lung asbestos burdens. Twenty cases (17 with
      asbestosis, 15 with carcinoma of the lung, and two with malignant pleural
      mesothelioma) with at least one AB on a hilar LN section were identified. Bleach
      digestion of lung tissue in 15 cases demonstrated a median of 24,000 AB/g by LM
      and 44,000 AB/g by scanning electron microscopy. Digestion of hilar nodes
      demonstrated 21,800, 15,500, and 3,200 AB/g by LM in three cases which had lung
      burdens of 22,000, 481,000, and 5470 AB/g, respectively. A fourth LN specimen
      contained 322,000 AB/g in a case with no lung available to digest. Mean AB
      lengths in the LN in three cases were 48, 45, and 27 microns. Fourteen control
      cases of men over 50 without known asbestos exposure or asbestos-related disease
      had no AB in LN sections even after staining for iron. Among fourteen patients
      with parietal pleural plaques and an elevated lung asbestos body content, AB were
      observed in iron-stained LN sections in only two cases. These two patients had
      3240 and 610 AB/g lung tissue, respectively (normal range 0 to 20 AB/g). We
      conclude that the finding of AB on a histologic section of hilar LN is generally
      indicative of a heavy lung AB burden.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2217156
TI  - Methods in pathology. Immunophenotype of hairy cell leukemia in paraffin
      sections.
AB  - The immunophenotype of hairy cell leukemia (HCL) was investigated using 20
      routinely fixed paraffin-embedded tissue sections (12 bone marrows, six spleens,
      one liver, one lymph node) from 12 patients known to have this disease. A panel
      of antibodies was used, including anti-leukocyte common antigen (anti-LCA), B
      lineage antibodies (LN2, MB2, L26), T-lineage reagents (MT1, UCHL1), monocytic
      (anti-cathepsin B) and myelomonocytic (anti-lysosyme, Mac 387) antibodies, and
      other less lineage-specific markers (anti-S-100, anti-alpha-1-antichymotrypsin
      (anti-alpha 1-ACT), anti-alpha 1-antitrypsin (anti-alpha 1-AT), anti-vimentin).
      Anti-LCA stained hairy cells in seven of the 12 bone marrows and consistently
      recognized hairy cells in the spleen, liver, and lymph nodes. Hairy cells
      generally reacted with B-lineage antibodies and were not labeled by T-lineage
      markers. No reactivity was noted with myelomonocytic antibodies, anti-S-100, anti
      alpha 1-ACT, or anti-alpha 1-AT. Vimentin was expressed in the majority of cases.
      Tartrate-resistant acid phosphatase reactivity was demonstrated in three of the
      20 routinely processed tissue sections. These data suggest that
      immunohistochemical studies of hairy cell leukemia in routinely processed tissue
      may be useful in diagnostic hematopathology and surgical pathology.

PMID- 2217157
TI  - Current concepts of immunodeficiency disorders.
AB  - The technical developments in immunology and molecular biology during the 1970s,
      the growing use of organ transplantation during this period, and the abrupt
      emergence of AIDS in 1981 made the 1980s a fruitful period for investigating
      basic mechanisms of immunodeficiency. Now armed with powerful molecular biologic
      techniques, such as the polymerase chain reaction, we can identify specific genes
      and viruses that result in immunodeficiency. Complications associated with
      immunodeficiency, such as malignant lymphoma and opportunistic infections, have
      provided pathologists with opportunities for investigating the pathogenesis of
      this and other related diseases. An impetus for developing new diagnostic
      immunologic and molecular biological methods will be sustained during the 1990s.
      Pathologists working in the 21st century will be participants in the use of gene
      therapy for primary immunodeficiency diseases and for conquering AIDS. Perhaps
      with the declining threat of thermonuclear annihilation, we will tackle the
      largest cause of acquired immune deficiency, protein-calorie malnutrition.

PMID- 2217158
TI  - Leiomyomatous neoplasms of the lung.

PMID- 2217159
TI  - Molecular interactions in protein crystals: solvent accessible surface and
      stability.
AB  - The accessible surface areas of 58 monomeric and dimeric proteins, when measured
      in the crystalline environment, are found to be simply related to molecular
      weight. The loss of accessible surface when the proteins go from a free to their
      crystalline environment is well defined, implying that the hydrophobic
      interaction, which has been found to contribute to protein folding and stability
      in living systems, also contributes to protein crystal stability.

PMID- 2217160
TI  - Energetics of the structure and chain tilting of antiparallel beta-barrels in
      proteins.
AB  - The preferred structural pattern of antiparallel beta-barrels in proteins,
      described as the right-handed tilting of the peptide strands with respect to the
      axis of the barrel, is accounted for in terms of intra- and interchain
      interaction energies. It is related to the preference of beta-sheets for right
      handed twisting. Conformational energy computations have been carried out on
      three eight-stranded antiparallel beta-barrels composed of six-residue strands,
      in which L-Val and Gly alternate, and having a right-handed, a left-handed, or no
      tilt. After energy minimization, the relative energies of these structures were
      0.0, 8.6, and 46.1 kcal/mol, respectively; i.e., the right-tilted beta-barrel is
      favored energetically, in agreement with anti-parallel beta-barrels observed in
      proteins. Tilting of the barrel is favored, relative to the nontilted structure,
      by both intra- and interstrand interactions, because tilting allows better
      packing of the bulky side chains. On the other hand, the energy difference
      between the left- and right-tilted barrels arises essentially from intrachain
      interactions. This is a consequence of the preference of beta-sheets for a right
      handed twist. Space limitations inside the barrel are satisfied if there is an
      alternation of bulky residues and residues with small or no side chain
      (preferably Gly) in neighboring positions on adjacent strands. Such a pattern is
      seen frequently in antiparallel beta-barrels of globular proteins. The
      computations indicate that a structure with Val...Gly pairs can be accommodated
      in a beta-barrel with no distortion.

PMID- 2217161
TI  - Protein stability and electrostatic interactions between solvent exposed charged
      side chains.
AB  - To investigate the contribution to protein stability of electrostatic
      interactions between charged surface residues, we have studied the effect of
      substituting three negatively charged solvent exposed residues with their side
      chain amide analogs in bovine calbindin D9k--a small (Mr 8,500) globular protein
      of the calmodulin superfamily. The free energy of urea-induced unfolding for the
      wild-type and seven mutant proteins has been measured. The mutant proteins have
      increased stability towards unfolding relative to the wild-type. The experimental
      results correlate reasonably well with theoretically calculated relative free
      energies of unfolding and show that electrostatic interactions between charges on
      the surface of a protein can have significant effects on protein stability.

PMID- 2217163
TI  - Crystallographic refinement of human serum retinol binding protein at 2A
      resolution.
AB  - Human serum retinol binding protein (RBP) in complex with retinol has been
      crystallographically refined to an R-factor of 18.1% with 2A resolution data. The
      protein topology results in an anti-parallel beta-barrel that encapsulates the
      retinol ligand. A detailed description of the protein and the binding site is
      provided. Our structural work has helped to define a family of proteins, many of
      which are carrier proteins for smaller ligand molecules. We describe the
      structural basis for the conservation of sequence within the family.

PMID- 2217162
TI  - Prediction of homologous protein structures based on conformational searches and
      energetics.
AB  - A "knowledge-based" method of predicting the unknown structure of a protein from
      a homologous known structure using energetics to determine a sidechain
      conformation is proposed. The method consists of exchanging the residues in the
      known structure for the sequence of the unknown protein. Then a conformational
      search with molecular mechanics energy minimization is done on the exchanged
      residues. The lowest energy conformer is the one picked to be the predicted
      structure. In the structure of bovine trypsin, the importance of including a
      solvation energy term in the search is demonstrated for solvent accessible
      residues, while molecular mechanics alone is enough to correctly predict the
      conformation of internal residues. The correctness of the model is assessed by a
      volume error overlap of the predicted structure compared to the crystal
      structure. Finally, the structure of rat trypsin is predicted from the crystal
      structure of bovine trypsin. The sequences of these two proteins are 74%
      identical and all of the significant changes between them are on external
      residues. Thus, the inclusion of solvation energy in the conformational search is
      necessary to accurately predict the structure of the exchanged residues.

PMID- 2217164
TI  - Hydrophobicity of amino acid subgroups in proteins.
AB  - Protein folding studies often utilize areas and volumes to assess the hydrophobic
      contribution to conformational free energy (Richards, F.M. Annu. Rev. Biophys.
      Bioeng. 6:151-176, 1977). We have calculated the mean area buried upon folding
      for every chemical group in each residue within a set of X-ray elucidated
      proteins. These measurements, together with a standard state cavity size for each
      group, are documented in a table. It is observed that, on average, each type of
      group buries a constant fraction of its standard state area. The mean area buried
      by most, though not all, groups can be closely approximated by summing
      contributions from three characteristic parameters corresponding to three atom
      types: (1) carbon or sulfur, which turn out to be 86% buried, on average; (2)
      neutral oxygen or nitrogen, which are 40% buried, on average; and (3) charged
      oxygen or nitrogen, which are 32% buried, on average.

PMID- 2217165
TI  - Revised 2.3 A structure of porcine pepsin: evidence for a flexible subdomain.
AB  - A revised three-dimensional crystal structure of ethanol-inhibited porcine pepsin
      refined to an R-factor of 0.171 at 2.3 A resolution is presented and compared to
      the refined structures of the fungal aspartic proteinases: penicillopepsin,
      rhizopuspepsin, and endothiapepsin. Pepsin is composed of two nearly equal N and
      C domains related by an intra dyad. The overall polypeptide fold and active site
      structures are homologous for pepsin and the fungal enzymes. The weak inhibition
      of pepsin by ethanol can be explained by the presence of one or more ethanol
      molecules, in the vicinity of the active site carboxylates, which slightly alter
      the hydrogen-bonding network and which may compete with substrate binding in the
      active site. Structural superposition analysis showed that the N domains aligned
      better than the C-domains for pepsin and the fungal aspartic proteinases: 107-140
      C alpha pairs aligned to 0.72-0.85 A rms for the N domains; 64-95 C alpha pairs
      aligned to 0.78-1.03 A rms for the C domains. The major structural difference
      between pepsin and the fungal enzymes concerns a newly described subdomain whose
      conformation varies markedly among these enzyme structures. The subdomain in
      pepsin comprises nearly 100 residues and is composed of two contiguous segments
      within the C domain (residues 192-212 and 223-299). the subdomain is connected,
      or "hinged," to a mixed beta-sheet that forms one of the structurally invariant,
      active site psi-loops. Relative subdomain displacements as large as a 21.0
      degrees rotation and a 5.9 A translation were observed among the different
      enzymes. There is some suggestion in pepsin that the subdomain may be flexible
      and perhaps plays a structural role in mediating substrate binding, determining
      the substrate specificity, or in the activation of the zymogen.

PMID- 2217166
TI  - The three-dimensional structure of recombinant bovine chymosin at 2.3 A
      resolution.
AB  - The crystal structure of recombinant bovine chymosin (EC 3.4.23.4; renin), which
      was cloned and expressed in Escherichia coli, has been determined using X-ray
      data extending to 2.3 A resolution. The crystals of the enzyme used in this study
      belong to the space group I222 with unit cell dimensions alpha = 72.7 A, b = 80.3
      A, and c = 114.8 A. The structure was solved by the molecular replacement method
      and was refined by a restrained least-squares procedure. The crystallographic R
      factor is 0.165 and the deviation of bond distances from ideality is 0.020 A. The
      resulting model includes all 323 amino acid residues, as well as 297 water
      molecules. The enzyme has an irregular shape with approximate maximum dimensions
      of 40 x 50 x 65 A. The secondary structure consists primarily of parallel and
      antiparallel beta-strands with a few short alpha-helices. The enzyme can be
      subdivided into N- and C-terminal domains which are separated by a deep cleft
      containing the active aspartate residues Asp-34 and Asp-216. The amino acid
      residues and waters at the active site form an extensive hydrogen-bonded network
      which maintains the pseudo 2-fold symmetry of the entire structure. A comparison
      of recombinant chymosin with other acid proteinases reveals the high degree of
      structural similarity with other members of this family of proteins as well as
      the subtle differences which make chymosin unique. In particular, Tyr-77 of the
      flap region of chymosin does not hydrogen bond to Trp-42 but protrudes out in the
      P1 pocket forming hydrophobic interactions with Phe-119 and Leu-32. This may have
      important implications concerning the mechanism of substrate binding and
      substrate specificity.

PMID- 2217167
TI  - Human kidney amiloride-binding protein: cDNA structure and functional expression.
AB  - Phenamil, an analog of amiloride, is a potent blocker of the epithelial Na+
      channel. It has been used to purify the porcine kidney amiloride-binding protein.
      Synthetic oligonucleotides derived from partial sequences have been used to
      screen a human kidney cDNA library and to isolate the cDNA encoding the human
      amiloride-binding protein. The primary structure was deduced from the DNA
      sequence analysis. The protein is 713 residues long, with a 19-amino acid signal
      peptide. The mRNA was expressed in 293-S and NIH 3T3 cells, yielding a
      glycoprotein (i) that binds amiloride and amiloride analogs with affinities
      similar to the amiloride receptor associated with the apical Na+ channel in pig
      kidney membranes and (ii) that is immunoprecipitated with monoclonal antibodies
      raised against pig kidney amiloride-binding protein.

PMID- 2217168
TI  - Prenylated proteins: synthesis of geranylgeranylcysteine and identification of
      this thioether amino acid as a component of proteins in CHO cells.
AB  - Prenylated proteins, labeled in the isoprenoid residue by growing CHO cells in
      medium containing [5-3H]mevalonate, were degraded by three different proteolytic
      procedures, enzymatic or alkaline hydrolysis as well as hydrazinolysis. The
      products thus obtained were analyzed by HPLC with chemically prepared all-trans
      geranylgeranylcysteine as a standard. About 10% of the radioactive products
      released by each lytic procedure showed the same chromatographic properties as
      geranylgeranylcysteine. This verifies the earlier conclusion, based on less
      direct evidence, that this thioether derivative of cysteine is a component of
      naturally occurring proteins. The finding of this modified amino acid as a
      product of hydrazinolysis indicates that it is a carboxyl-terminal amino acid and
      that it is not carboxyl-methylated.

PMID- 2217169
TI  - Down-regulation of a calmodulin-related gene during transformation of human
      mammary epithelial cells.
AB  - A human cDNA library obtained from cultured normal mammary epithelial cells
      (HMECs) was searched by subtractive hybridization for genes whose decrease in
      expression might be relevant to epithelial transformation. One clone identified
      by this procedure corresponded to a 1.4-kilobase mRNA, designated NB-1, whose
      expression was decreased greater than 50-fold in HMECs tumorigenically
      transformed in vitro after exposure to benzo[a]pyrene and Kirsten sarcoma virus.
      Sequence analysis of NB-1 cDNA revealed an open reading frame with a high degree
      of homology to calmodulin. NB-1 expression could be demonstrated by polymerase
      chain reaction amplification in normal breast, prostate, cervix, and epidermal
      tissues. The presence of NB-1 transcripts was variable in primary breast
      carcinoma tissues and undetectable in tumor-derived cell lines of breast,
      prostate, or other origins. NB-1 mRNA expression could be down-regulated in
      cultured HMECs by exposure to reconstituted extracellular matrix material, while
      exposure to transforming growth factor type beta increased its relative
      abundance. The protein encoded by NB-1 may have Ca2+ binding properties and
      perform functions similar to those of authentic calmodulin. Its possible roles in
      differentiation and/or suppression of tumorigenicity in epithelial tissues remain
      to be examined.

PMID- 2217170
TI  - Worldwide differences in the incidence of type I diabetes are associated with
      amino acid variation at position 57 of the HLA-DQ beta chain.
AB  - The presence of an amino acid other than aspartic acid at position 57 of the HLA
      DQ beta chain (non-Asp-57) is highly associated with susceptibility to insulin
      dependent diabetes mellitus (IDDM), whereas an aspartic acid at this position
      (Asp-57) appears to confer resistance to the disease. We hypothesize that the 30
      fold difference in IDDM incidence across racial groups and countries is related
      to variability in the frequency of these alleles. Diabetic and nondiabetic
      individuals were evaluated in five populations, including those at low, moderate,
      and high risk. HLA-DQ beta genotype distributions among the IDDM case groups were
      markedly different (P less than 0.001), as were those among nondiabetic controls
      (P less than 0.001). Non-Asp-57 alleles were significantly associated with IDDM
      in all areas; population-specific odds ratios for non-Asp-57 homozygotes relative
      to Asp-57 homozygotes ranged from 14 to 111. Relative risk information from the
      case-control study and population incidence data were combined to estimate
      genotype-specific incidence rates for the Allegheny County, PA, Caucasians. These
      rates were used to predict the overall incidence rates in the remaining
      populations, which were within the 95% confidence intervals of the actual rates
      established from incidence registries. These results are consistent with the
      hypothesis that population variation in the distribution of non-Asp-57 alleles
      may explain much of the geographic variation in IDDM incidence.

PMID- 2217171
TI  - Pretreatment with cyclosporine and anti-interleukin 2 receptor antibody abrogates
      the anti-idiotype response in rat recipients of cardiac allografts.
AB  - A 10-day course with ART-18, a mouse monoclonal antibody (mAb) directed against
      the rat interleukin 2 receptor (IL-2R), prolongs the survival of (LEW x BN)F1
      cardiac allografts in LEW recipients to approximately 3 weeks (acute rejection =
      8 days, P less than 0.001). We examined host responses against ART-18 idiotype
      (Id) and mouse immunoglobulin in recipients immunomodulated with ART-18 mAb.
      Treatment with ART-18 elicited high titers of anti-Id antibodies 14 days after
      transplantation. However, naive rats given ART-18 before transplantation showed
      strong anti-Id responses as early as day 4 after engraftment, coinciding with
      abrogation of the treatment effect (graft survival, approximately 10 days).
      Preimmunization with irrelevant mouse IgG, which elicited high titers of anti
      IgG, did not influence the efficacy of ART-18 upon graft survival (17 days). The
      use of cyclosporin A (CsA) in conjunction with ART-18 prior to transplantation
      suppressed the anti-Id response and led to dramatic graft prolongation (greater
      than 58 days), with two of five grafts surviving indefinitely. This striking
      effect of CsA plus ART-18 pretreatment did not depend upon CsA per se, as grafts
      were rejected within 12 days in animals pretreated with CsA alone; in both groups
      CsA trough levels were comparable. Moreover, administration of CsA before
      transplantation in concert with control IgG (instead of ART-18) prompted
      rejection within 2-4 weeks. Thus, discrete interaction(s) between anti-IL-2R mAb
      and CsA prior to engraftment induces partial host unresponsiveness/tolerance to
      anti-IL-2R mAb treatment following transplantation and suppresses the
      neutralizing anti-Id responses, which results in long-term/permanent graft
      acceptance. This study provides a strategy to overcome the anti-Id response
      mounted by graft recipients that otherwise limits the efficacy of anti-IL-2R mAb
      treatment.

PMID- 2217172
TI  - Localization of phosphatidylinositol signaling components in rat taste cells:
      role in bitter taste transduction.
AB  - To assess the role of phosphatidylinositol turnover in taste transduction we have
      visualized, in rat tongue, ATP-dependent endoplasmic reticular accumulation of
      45Ca2+, inositol 1,4,5-trisphosphate receptor binding sites, and
      phosphatidylinositol turnover monitored by autoradiography of [3H]cytidine
      diphosphate diacylglycerol formed from [3H]cytidine. Accumulated 45Ca2+, inositol
      1,4,5-trisphosphate receptors, and phosphatidylinositol turnover are selectively
      localized to apical areas of the taste buds of circumvallate papillae, which are
      associated with bitter taste. Further evidence for a role of phosphatidylinositol
      turnover in bitter taste is our observation of a rapid, selective increase in
      mass levels of inositol 1,4,5-trisphosphate elicited by low concentrations of
      denatonium, a potently bitter tastant.

PMID- 2217173
TI  - Chitin synthase I and chitin synthase II are not required for chitin synthesis in
      vivo in Saccharomyces cerevisiae.
AB  - In Saccharomyces cerevisiae, the polysaccharide chitin forms the primary division
      septum between mother cell and bud. Two related enzymes, chitin synthase I and
      chitin synthase II (UDP-acetamido-2-deoxy-D-glucose:chitin 4-beta
      acetamidodeoxyglucosyltransferase, EC 2.4.1.16), have been identified and their
      structural genes, CHS1 and CHS2, respectively, have been cloned and sequenced.
      Gene disruption experiments led to the conclusion that CHS2 is essential for cell
      division [Silverman, S.J., Sburlati, A., Slater, M.L. & Cabib, E. (1988) Proc.
      Natl. Acad. Sci. USA 85, 4735-4739], whereas CHS1 is not. We repeated the
      disruption of CHS2 and determined that it is not essential for vegetative growth.
      The viability of chs1::HIS3 chs2::TRP1 spores is influenced by strain background
      and germination conditions. The double disruption mutant has no detectable chitin
      deficiency in vivo, as judged by quantitative assay and by staining cells with
      Calcofluor. Assay of membrane preparations from the double disruption mutant
      indicates the presence of chitin synthetic activity. Unlike the CHS gene
      products, this third activity is not stimulated by trypsin. Characterization of
      the double disruption mutant revealed abnormalities in morphology and nuclear
      migration.

PMID- 2217174
TI  - Productive human immunodeficiency virus infection levels correlate with AIDS
      related manifestations in the patient.
AB  - Mononuclear cells were obtained from 71 human immunodeficiency virus type 1 (HIV
      1) seropositive subjects presenting and first visit either as asymptomatic or
      with minor symptoms and with CD4 lymphocytes greater than 550 per mm3 (group A,
      35 patients) or as patients with AIDS, AIDS-related illnesses, or CD4 lymphocytes
      less than 400 per mm3 (group B, 36 patients). After 1-5 years of follow-up, 13
      patients of group A had essentially retained their initial status
      (asymptomatics); the 22 others had suffered clinical or immunological
      deterioration (progressors). Frozen cells were thawed and submitted to lethal
      gamma-irradiation in vitro (4500 rads; 1 rad = 0.01 Gy) before they were cultured
      with normal phytohemagglutinin-stimulated lymphocytes to determine radiation
      resistant HIV expression ex vivo (R-HEV). HIV antigenemia correlated with R-HEV
      values in 142 samples (r = 0.92, P less than 0.001) but was a less sensitive
      predictor of disease than R-HEV. R-HEV was detected in all specimens from
      patients with major AIDS-related illnesses or HIV-associated CD4 lymphopenia. In
      77% of the progressors from group A, R-HEV detection preceded the onset of AIDS
      associated disease or CD4 lymphopenia by 1 year (average). Conversely, R-HEV was
      low or was not detected in 36 sequential specimens from the 13 patients who
      remained asymptomatic over the following 2-5 years. Thus, persistently low HIV
      expression in vivo predicted a nondiseased state, whereas higher HIV expression
      levels seemed necessary for disease to occur. These data indicate that R-HEV is
      related to productive HIV infection in vivo, the latter acting as a determinant
      of AIDS-related illnesses. In view of this, measurement of HIV expression levels
      in the patient should be useful in antiviral efficacy trials.

PMID- 2217175
TI  - Incomplete synthesis of N-glycans in congenital dyserythropoietic anemia type II
      caused by a defect in the gene encoding alpha-mannosidase II.
AB  - Congenital dyserythropoietic anemia type II, or hereditary erythroblastic
      multinuclearity with a positive acidified-serum-lysis test (HEMPAS), is a genetic
      anemia in humans inherited by an autosomally recessive mode. The enzyme defect in
      most HEMPAS patients has previously been proposed as a lowered activity of N
      acetylglucosaminyltransferase II, resulting in a lack of polylactosamine on
      proteins and leading to the accumulation of polylactosaminyl lipids. A recent
      HEMPAS case, G.C., has now been analyzed by cell-surface labeling, fast-atom
      bombardment mass spectrometry of glycopeptides, and activity assay of
      glycosylation enzymes. Significantly decreased glycosylation of
      polylactosaminoglycan proteins and incompletely processed asparagine-linked
      oligosaccharides were detected in the erythrocyte membranes of G.C. In contrast
      to the earlier studied HEMPAS cases, G.C. cells are normal in N
      acetylglucosaminyltransferase II activity but are low in alpha-mannosidase II
      (alpha-ManII) activity. Northern (RNA) analysis of poly(A)+ mRNA from normal,
      G.C., and other unrelated HEMPAS cells all showed double bands at the 7.6
      kilobase position, detected by an alpha-ManII cDNA probe, but expression of these
      bands in G.C. cells was substantially reduced (less than 10% of normal). In
      Southern analysis of G.C. and normal genomic DNA, the restriction fragment
      patterns detected by the alpha-ManII cDNA probe were indistinguishable. These
      results suggest that G.C. cells contain a mutation in alpha-ManII-encoding gene
      that results in inefficient expression of alpha-ManII mRNA, either through
      reduced transcription or message instability. This report demonstrates that
      HEMPAS is caused by a defective gene encoding an enzyme necessary for the
      synthesis of asparagine-linked oligosaccharides.

PMID- 2217176
TI  - Contraction of myofibrils in the presence of antibodies to myosin subfragment 2.
AB  - In a muscle-based version of in vitro motility assays, the unloaded shortening
      velocity of rabbit skeletal myofibrils has been determined in the presence and
      absence of affinity-column-purified polyclonal antibodies directed against the
      subfragment-2 region of myosin. Contraction was initiated by photohydrolysis of
      caged ATP and the time dependence of shortening was monitored by an inverted
      microscope equipped with a video camera. Antibody-treated myofibrils undergo
      unloaded shortening in a fast phase with initial rates and half-times comparable
      to control (untreated) myofibrils, despite a marked reduction in the isometric
      force of skinned muscle fibers in the presence of the antibodies. In antibody
      treated myofibrils, this process is followed by a much slower phase of
      contraction, terminating in elongated structures with well-defined sarcomere
      spacings (approximately 1 micron) in contrast to the supercontracted globular
      state of control myofibrils. These results suggest that although the unloaded
      shortening of myofibrils (and in vitro motility of actin filaments over
      immobilized myosin heads) can be powered by myosin heads, the subfragment-2
      region as well as the myosin head contributes to force production in actively
      contracting muscle.

PMID- 2217177
TI  - Increased expression of a 58-kDa protein kinase leads to changes in the CHO cell
      cycle.
AB  - We have isolated and characterized cDNA encoding a human 58-kDa protein kinase
      that is homologous to the cell division control (CDC) protein kinases. This
      protein kinase also contains a unique N-terminal domain that may potentially
      regulate its function. Due to its relatedness to p34CDC2, the human p58 cDNA was
      overexpressed in CHO cells to determine the effect on the cell cycle. Elevated
      expression of p58 in these cells resulted in prolonged late telophase and early
      G1 phase of the cell cycle. These p58 overexpressors showed a significantly
      increased frequency of tubulin midbodies as well as significant increases in
      mitotic abnormalities. Thus, proper regulation of p58 protein kinase is essential
      for normal cell cycle progression in these cells.

PMID- 2217178
TI  - An inhibitor of the protease blocks maturation of human and simian
      immunodeficiency viruses and spread of infection.
AB  - The activity of the human immunodeficiency virus (HIV) protease is essential for
      processing of the gag-pol precursor proteins and maturation of infectious
      virions. We have prepared a peptidomimetic inhibitor, U-75875, that inhibited HIV
      1 gag-pol protein processing in an essentially irreversible manner. Noninfectious
      virus particles produced in the presence of the drug contained gag precursors and
      were morphologically immature. In human peripheral blood mononuclear cells and in
      a continuous cell line, U-75875 completely blocked HIV replication; in the latter
      case, no spread occurred over a period of 4 weeks. U-75875, on a molar basis, was
      as potent as 3'-azido-3'-deoxythymidine in blocking HIV-1 replication in human
      lymphocytes and also inhibited HIV-2 and simian immunodeficiency virus proteases,
      demonstrating that it has broad activity. These results provide further evidence
      for the therapeutic potential of protease inhibitors in HIV infection.

PMID- 2217179
TI  - Cloning of the cDNA for human 12-lipoxygenase.
AB  - A full-length cDNA clone encoding 12-lipoxygenase (arachidonate:oxygen 12
      oxidoreductase, EC 1.13.11.31) was isolated from a human platelet cDNA library by
      using a cDNA for human reticulocyte 15-lipoxygenase as probe for the initial
      screening. The cDNA had an open reading frame encoding 662 amino acid residues
      with a calculated molecular weight of 75,590. Three independent clones revealed
      minor heterogeneities in their DNA sequences. Thus, in three positions of the
      deduced amino acid sequence, there is a choice between two different amino acids.
      The deduced sequence from the clone plT3 showed 65% identity with human
      reticulocyte 15-lipoxygenase and 42% identity with human leukocyte 5
      lipoxygenase. The 12-lipoxygenase cDNA recognized a 3.0-kilobase mRNA species in
      platelets and human erythroleukemia cells (HEL cells). Phorbol 12-tetradecanoyl
      13-acetate induced megakaryocytic differentiation of HEL cells and 12
      lipoxygenase activity and increased mRNA for 12-lipoxygenase. The identity of the
      cloned 12-lipoxygenase was assured by expression in a mammalian cell line (COS
      cells). Human platelet 12-lipoxygenase has been difficult to purify to
      homogeneity. The cloning of this cDNA will increase the possibilities to
      elucidate the structure and function of this enzyme.

PMID- 2217180
TI  - Determinants of the B-cell response against a transgenic autoantigen.
AB  - The failure to induce self-tolerance of simian virus 40 large tumor antigen (T
      antigen) expressed in the pancreatic beta cells of transgenic mice results in an
      autoimmune response against this protein and the cells that synthesize it. In
      every transgenic mouse with delayed onset of T-antigen expression and consequent
      nontolerance, B cells, T cells, and macrophages are attracted to and infiltrate
      the pancreatic islets. In contrast, the incidence, onset, and intensity of the B
      cell response to produce anti-T-antigen autoantibodies vary considerably with
      genetic background. Thus the initial attraction of lymphocytes to the cells
      synthesizing a non-self antigen can be separated from the activation of a B-cell
      response against it. Haplotypes of the major histocompatibility complex (MHC)
      differentially influence the character of the autoimmune response, with H-2d and
      H-2k conferring a high incidence of humoral autoimmunity. Additional non-MHC
      linked genes are also implicated in control of the B-cell response.

PMID- 2217181
TI  - Growth hormone and adipose differentiation: growth hormone-induced antimitogenic
      state in 3T3-F442A preadipose cells.
AB  - An additional activity for pituitary growth hormone is described--i.e., the in
      vitro induction of an antimitogenic state in murine 3T3-F442A preadipocyte
      fibroblasts. We previously developed a serum-free, hormonally defined medium
      permissive for the adipose differentiation of 3T3-F442A cells. When 3T3-F442A
      fibroblasts were maintained in serum-free medium without insulin but with growth
      hormone (2 nM), typical adipose differentiation did not occur. However, we found
      that growth hormone induced a state of cellular refractoriness to the mitogenic
      stimulus of fetal bovine serum as assayed by de novo DNA synthesis. The mitogen
      refractory condition (i.e., the antimitogenic state) was time-dependent (half
      maximal at approximately 2.5 days) and growth hormone concentration-dependent
      (half maximal and maximal at approximately 0.05 and 2.0 nM, respectively). The
      antimitogenic state was specifically induced by growth hormone and was not
      mediated by insulin-like growth factor I or prolactin. The growth hormone-induced
      antimitogenic state was completely reversible. The antimitogenic state was not
      induced by growth hormone in 3T3-C2 cells, a sister clone of 3T3 cells that
      exhibits essentially no adipose conversion. The kinetics for growth hormone
      dependent commitment to adipose differentiation and induction of the
      antimitogenic state were similar. We suggest a relationship of growth hormone
      induced antimitogenic state and the growth hormone-induced adipose
      differentiation of 3T3-F442A cells.

PMID- 2217182
TI  - Reassociation with beta 2-microglobulin is necessary for Kb class I major
      histocompatibility complex binding of exogenous peptides.
AB  - T lymphocytes recognize endogenously produced antigenic peptides in association
      with major histocompatibility complex (MHC)-encoded molecules. Peptides from the
      extracellular fluid can be displayed in association with class I and class II MHC
      molecules. Here we report that mature Kb class I MHC molecules bind peptides upon
      dissociation and reassociation of their light chain. Intact Kb heterodimers,
      unlike class II MHC molecules, are relatively unreceptive to binding peptides.
      This property may maintain segregation of class I and class II MHC-restricted
      peptides and has implications for the use of peptides as vaccines.

PMID- 2217183
TI  - A 140-base-pair repetitive sequence element in the mouse rRNA gene spacer
      enhances transcription by RNA polymerase I in a cell-free system.
AB  - We show that the repetitive 140-base-pair (bp) elements present in the spacer of
      mouse rRNA genes function as enhancers for RNA polymerase I. Attachment of these
      elements to the rDNA promoter stimulates rRNA synthesis both in vivo and in
      vitro. The cis-activating effect of the spacer repeats is orientation-independent
      and increases with increasing numbers of the 140-bp elements. Competition
      experiments demonstrate that the spacer repeats bind one or more of the
      transcription factors interaction with the rDNA promoter. Both the 140-bp
      elements and the core promoter act cooperatively and thus are functionally
      linked. The 60/81-bp enhancer repeats from Xenopus laevis rDNA compete for a
      murine transcription factor(s) and stimulate transcription often fused to the
      mouse rDNA promoter. The results indicate that despite the marked species
      specificity of rDNA transcription initiation, common factors may interact with
      both the rDNA promoter and the enhancer.

PMID- 2217184
TI  - Identification and preliminary characterization of protein-cysteine
      farnesyltransferase.
AB  - Ras proteins must be isoprenylated at a conserved cysteine residue near the
      carboxyl terminus (Cys-186 in mammalian Ras p21 proteins) in order to exert their
      biological activity. Previous studies indicate that an intermediate in the
      mevalonate pathway, most likely farnesyl pyrophosphate, is the donor of this
      isoprenyl group. Inhibition of mevalonate synthesis reverts the abnormal
      phenotypes induced by the mutant RAS2Val-19 gene in Saccharomyces cerevisiae and
      blocks the maturation of Xenopus oocytes induced by an oncogenic Ras p21 protein
      of human origin. These results have raised the possibility of using inhibitors of
      the mevalonate pathway to block the transforming properties of ras oncogenes.
      Unfortunately, mevalonate is a precursor of various end products essential to
      mammalian cells, such as dolichols, ubiquinones, heme A, and cholesterol. In this
      study, we describe an enzymatic activity(ies) capable of catalyzing the
      farnesylation of unprocessed Ras p21 proteins in vitro at the correct (Cys-186)
      residue. This farnesylating activity is heat-labile, requires Mg2+ or Mn2+ ions,
      is linear with time and with enzyme concentration, and is present in all
      mammalian cell lines and tissues tested. Gel filtration analysis of a partially
      purified preparation of protein farnesyltransferase revealed two peaks of
      activity at 250-350 kDa and 80-130 kDa. Availability of an in vitro protein
      farnesyltransferase assay should be useful in screening for potential inhibitors
      of ras oncogene function that will not interfere with other aspects of the
      mevalonate pathway.

PMID- 2217185
TI  - Mutagenesis of essential functional residues in acetylcholinesterase.
AB  - The cholinesterases are serine hydrolases that show no global similarities in
      sequence with either the trypsin or the subtilisin family of serine proteases.
      The cholinesterase superfamily includes several esterases with distinct functions
      and other proteins devoid of the catalytic serine and known esterase activity. To
      identify the residues involved in catalysis and conferring specificity on the
      enzyme, we have expressed wild-type Torpedo acetylcholinesterase (EC 3.1.1.7) and
      several site-directed mutants in a heterologous system. Mutation of serine-200 to
      cysteine results in diminished activity, while its mutation to valine abolishes
      detectable activity. Two conserved histidines can be identified at positions 425
      and 440 in the cholinesterase family; glutamine replacement at position 440
      eliminates activity whereas the mutation at 425 reduces activity only slightly.
      The assignment of the catalytic histidine to position 440 defines a rank ordering
      of catalytic residues in cholinesterases distinct from trypsin and subtilisin and
      suggests a convergence of a catalytic triad to form a third, distinct family of
      serine hydrolases. Mutation of glutamate-199 to glutamine yields an enzyme with a
      higher Km and without the substrate-inhibition behavior characteristic of
      acetylcholinesterase. Hence, modification of the acidic amino acid adjacent to
      the serine influences substrate association and the capacity of a second
      substrate molecule to affect catalysis.

PMID- 2217186
TI  - Direct determination of phospholipid lamellar structure at 0.34-nm resolution.
AB  - Low-dose, high-resolution electron microscopy combined with conventional direct
      phasing methods based on the estimates of triplet-structure invariants are used
      to determine phase values for all observed electron-diffraction-structure factor
      magnitudes from epitaxially oriented multilamellar paracrystals of the
      phosphospholipid 1,2-dihexadecyl-sn-glycerophosphoethanolamine. The reverse
      Fourier transform of these phase-structure factors is a one-dimensional
      electrostatic potential map that strongly resembles the electron-density maps
      calculated from similar x-ray-diffraction data. Determination of the phase values
      for the electron-diffraction data with structure invariants alone is nearly as
      successful as the combined use of two separate methods, assigning values to 13 of
      the 16 reflections--i.e., the electrostatic potential map closely resembles the
      one calculated with all data.

PMID- 2217187
TI  - Do voltage-dependent K+ channels require Ca2+? A critical test employing a
      heterologous expression system.
AB  - Removal of Ca2+ from the solution bathing neurons is known in many cases to alter
      the gating properties of voltage-dependent K+ channels and to induce a large,
      nonselective "leak" conductance. We used a heterologous expression system to test
      whether the leak conductance observed in neurons is mediated by voltage-dependent
      K+ channels in an altered, debased conformation. Voltage-dependent K+ channels
      were expressed in an insect cell line infected with a recombinant baculovirus
      carrying the cDNA for Drosophila Shaker "A-type" K+ channels. These expressed
      channels respond to low Ca2+ identically to voltage-dependent K+ channels in
      native neuronal membranes; upon removal of external Ca2+, Shaker K+ currents
      disappear and are replaced by a steady, nonselective leak conductance. However,
      control cells devoid of Shaker channels were free of any voltage-dependent
      conductances and did not generate a leak when external Ca2+ was removed. These
      results show that Ca2+ is essential for proper function of voltage-dependent K+
      channels and is required to stabilize the native conformations of these membrane
      proteins.

PMID- 2217189
TI  - Purification and characterization of recombinant Rev protein of human
      immunodeficiency virus type 1.
AB  - Recombinant Rev protein of human immunodeficiency virus type 1 has been expressed
      in Escherichia coli and purified by ion-exchange and gel-filtration
      chromatography. Specific binding of the purified protein to the Rev-responsive
      element of the viral RNA is demonstrated. Physical characterization of the
      purified protein by circular dichroism and intrinsic fluorescence spectroscopy
      indicate that the protein preparation is suitable for structural analysis.
      Circular dichroism measurements show that the protein is approximately 40-45%
      alpha-helix. Tryptophan fluorescence measurements suggest that the single
      tryptophan residue is located near the surface of the protein. Gel-filtration
      chromatography of the protein indicates that it has an apparent molecular mass of
      33,000 daltons. This suggests that the protein in solution forms a stable
      tetramer consisting of monomers having molecular mass of 13,000 daltons.

PMID- 2217188
TI  - Regulation of human renin expression in chorion cell primary cultures.
AB  - The human renin gene is expressed in the kidney, placenta, and several other
      sites. The release of renin or its precursor, prorenin, can be affected by
      several regulatory agents. In this study, primary cultures of human placental
      cells were used to examine the regulation of prorenin release and renin mRNA
      levels and of the transfected human renin promotor linked to chloramphenicol
      acetyltransferase reporter sequences. Treatment of the cultures with a calcium
      ionophore alone, calcium ionophore plus forskolin (that activates adenylate
      cyclase), or forskolin plus a phorbol ester increased prorenin release and renin
      mRNA levels 1.3- to 6-fold, but several classes of steroids did not affect
      prorenin secretion or renin RNA levels. The transfected renin promoter (584 or
      100 base pairs of 5'-flanking DNA) initiated at the correct start site in these
      cells and forskolin increased its expression 2.5- to 4-fold. Constructs
      containing renin 5'-flanking DNA linked to a heterologous promoter cotransfected
      into HeLa cells with either glucocorticoid or estrogen receptor expression
      vectors were not regulated by dexamethasone or 17 beta-estradiol. These results
      suggest that (i) the first 584 base pairs of the renin gene 5'-flanking DNA do
      not contain functional glucocorticoid or estrogen response elements, (ii)
      placental prorenin release and renin mRNA are regulated by calcium ion and by the
      combinations of cAMP with either C kinase or calcium ion, and (iii) the first 100
      base pairs of the human renin 5'-flanking DNA direct accurate initiation of
      transcription and can be regulated by cAMP. Thus, some control of renin release
      in the placenta (and by inference in other tissues) occurs via transcriptional
      influences on its promoter.

PMID- 2217190
TI  - U1 small nuclear RNA plays a direct role in the formation of a rev-regulated
      human immunodeficiency virus env mRNA that remains unspliced.
AB  - rev-regulated expression of HIV-1 envelope proteins from a simian virus 40 late
      replacement vector was found to be dependent on the presence of a 5' splice site
      in the env mRNA in spite of the fact that this mRNA remains unspliced. When the
      5' splice site upstream of the env open reading frame was deleted or mutated,
      expression of envelope protein was lost. RNA analysis of cells transfected with
      5' splice-site mutants showed a dramatic reduction in the steady-state levels of
      env mRNA whether or not rev was present. Envelope expression could be restored in
      one of the 5' splice-site mutants by cotransfection with a plasmid expressing a
      suppressor U1 small nuclear RNA containing a compensatory mutation. These
      experiments show that U1 small nuclear RNA plays a direct and essential role in
      the formation of an unspliced RNA that is subject to regulation by rev.

PMID- 2217191
TI  - Direct detection of linker DNA bending in defined-length oligomers of chromatin.
AB  - Linker DNA, which connects between nucleosomes in chromatin, is short and,
      therefore, may be essentially straight and inflexible. We have carried out
      hydrodynamic and electron microscopic studies of dinucleosomes--fragments of
      chromatin containing just two nucleosomes--to test the ability of linker DNA to
      bend. We find that ionic conditions that stabilize the folding of long chromatin
      cause linker DNA in dinucleosomes to bend, bringing the two nucleosomes into
      contact. The results uphold a key prediction of the solenoid model of chromosome
      folding and suggest a mechanism by which proteins that are separated along the
      DNA can interact by direct contact.

PMID- 2217192
TI  - Counting dinosaurs: how many kinds were there?
AB  - Dinosaurs figure prominently in discussions of mass extinctions and evolutionary
      metrics, but their usefulness is hampered by archaic taxonomy, imprecise
      biostratigraphy, and imperfect preservation that bias our understanding of
      dinosaur diversity. A critical evaluation shows that of 540 genera and 800
      species of dinosaurs proposed since 1824, 285 genera and 336 species are probably
      valid. Nearly half of all genera are based on a single specimen, and complete
      skulls and skeletons are known for only 20% of all dinosaurs. Dinosaurs are known
      from every continent. Countries with the greatest known diversity of dinosaurs
      are (in descending order) the United States, Mongolia, China, Canada, England,
      and Argentina; the greatest future increases may be expected from Argentina and
      China. Nearly half of all dinosaur genera are of latest Cretaceous age (Campanian
      or Maastrichtian). Estimates of the average duration of a dinosaur genus range
      from 5 million to 10.5 million years, with the most likely value about 7.7
      million years. Dinosaurs evolved as rapidly as Cenozoic mammals. Global dinosaur
      diversity during the Campanian and Maastrichtian is estimated at 100 genera per
      stage, using a logistic model to estimate future discoveries. A model of
      increasing diversity and a bottleneck model compensate for the biasis in the
      preserved fossil record. The number of dinosaurs that have ever lived is
      estimated at 900-1200 genera. The fossil record of dinosaurs is presently about
      25% complete. Dinosaurs disappeared in the Maastrichtian near the peak of their
      historic diversity.

PMID- 2217193
TI  - Adoptive transfer of autoimmune diabetes and thyroiditis to athymic rats.
AB  - We describe the induction of autoimmune diabetes, insulitis, and thyroiditis in
      athymic rats following injections of major histocompatibility complex compatible
      spleen cells. Lymphocytes with these capabilities were found in normal rats of
      the YOS, WAG, PVG, and diabetes-resistant BB strains, and in diabetes-prone BB
      rats. Adoptive transfer was facilitated by prior in vivo depletion of RT6.1+
      regulatory T cells and in vitro mitogen activation of donor spleen cells. By RT6
      depleting diabetes-resistant donors and using nude recipients, transfer of
      diabetes and thyroiditis was accomplished by using fresh, unstimulated spleen
      cells. The data suggest that organ-specific autoreactive cells may be present to
      various degrees but suppressed to a variable extent in many rat strains. The
      equilibrium between autoreactive and regulatory cells appears to determine the
      expression of autoimmunity.

PMID- 2217194
TI  - Wound-induced accumulation of mRNA containing a hevein sequence in laticifers of
      rubber tree (Hevea brasiliensis).
AB  - Hevein is a chitin-binding protein that is present in laticifers of the rubber
      tree (Hevea brasiliensis). A cDNA clone (HEV1) encoding hevein was isolated by
      using the polymerase chain reaction with mixed oligonucleotides corresponding to
      two regions of hevein as primers and a Hevea latex cDNA library as a template.
      HEV1 is 1018 base pairs long and includes an open reading frame of 204 amino
      acids. The deduced amino acid sequence contains a putative signal sequence of 17
      amino acid residues followed by a 187-amino acid polypeptide. This polypeptide
      has two striking features. The amino-terminal region (43 amino acids) is
      identical to hevein and shows homology to several chitin-binding proteins and to
      the amino termini of wound-inducible proteins in potato and poplar. The carboxyl
      terminal portion of the polypeptide (144 amino acids) is 74-79% homologous to the
      carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as
      application of the plant hormones abscisic acid and ethylene, resulted in
      accumulation of hevein transcripts in leaves, stems, and latex but not in roots.

PMID- 2217195
TI  - Uric acid is a major antioxidant in human nasal airway secretions.
AB  - Airway mucosal surfaces are potentially subjected to a variety of oxidant
      stresses. Airway submucosal glands secrete a variety of compounds that may
      protect the airways from injury. Cholinergically induced nasal submucosal gland
      secretion has recently been found to contain a low molecular weight nasal
      antioxidant. In this report, the isolation and identification of this nasal
      secretory antioxidant are described. Concentrated, cholinergically induced human
      nasal secretions were fractionated through a 10-kDa sieve and subjected to DEAE
      anion-exchange chromatography. Fractions containing antioxidant activity were
      subjected to gel filtration with Bio-Gel P-2 gel (resolution range, 200-2000 Da).
      The resultant antioxidant fractions were then desalted by gel filtration over the
      same column equilibrated in HPLC-grade water, yielding only a single peak with
      antioxidant activity. The absorption spectrum of the purified antioxidant
      revealed peaks at 238 and 292 nm at pH 7. These peaks shifted to 230 and 280 nm
      in 0.1 M HCl and 226 and 296 nm in 0.1 M NaOH. Sodium borohydride reduction of
      the antioxidant had no effect on the UV absorption, whereas platinum-catalyzed
      hydrogenation ablated all absorption peaks. Uric acid had identical absorption
      peaks and showed the same chromatographic behavior as the nasal antioxidant
      activity on both gel filtration and DEAE columns. Uricase (which degrades uric
      acid) metabolized both uric acid and the purified antioxidant. Uric acid was
      shown to have antioxidant activity at concentrations greater than 1.5 microM.
      These data indicate that nasal secretions contain uric acid that serves as an
      antioxidant.

PMID- 2217196
TI  - Detection of heteroduplex DNA molecules among the products of Saccharomyces
      cerevisiae meiosis.
AB  - We have used denaturant-gel electrophoresis to provide a physical demonstration
      of heteroduplex DNA in the products of yeast meiosis. We examined heteroduplex
      formation at arg4-nsp, a G.C----C.G transversion that displays a moderately high
      level of postmeiotic segregation. Of the two possible arg4-nsp/ARG4 mismatches
      (G.G and C.C), only C.C was detected in spores from mismatch repair-competent
      (Pms1+) diploids. In contrast, C.C and G.G were present at nearly equal levels in
      spores from Pms1- diploids. These results confirm previous suggestions that
      postmeiotic segregation spores contain heteroduplex DNA at the site of the marker
      in question, that C.C is repaired less frequently than is G.G, and that the PMS1
      gene product plays a role in mismatch correction. Combined with the observation
      that Pms1+ ARG4/arg4-nsp diploids produce 3 times more 3+:5m (wildtype:mutant)
      tetrads (+, +, +/m, m) than 5+:3m tetrads (+, +/m, m, m), these results indicate
      that, during meiosis, formation of heteroduplex DNA at ARG4 involves preferential
      transfer of the sense (nontranscribed) strand of the DNA duplex.

PMID- 2217197
TI  - Major histocompatibility complex haplotype studies in Ashkenazi Jewish patients
      with pemphigus vulgaris.
AB  - Of 26 Ashkenazi Jewish patients with pemphigus vulgaris, 24 (92.3%) carried the
      major histocompatibility complex (MHC) class II alleles HLA-DR4, DQw3, of which
      all were of the subtype DR4, DQw8. From studies of the patients and their
      families, haplotypes were defined. It was found that, of the patients who carried
      HLA-DR4, DQw8, 75% carried one or the other (and in one case, both) of two
      haplotypes [HLA-B38, SC21, DR4] or HLA-B35, SC31, DR4. The former is a known
      extended haplotype among normal Jews, with a frequency of 0.102, and the latter
      may also be an extended haplotype in this ethnic group, with a frequency of 0.017
      among normal haplotypes from Jews. Of the remaining DR4-positive patients, all
      but one had a presumed D-region segment (defined as SC21, DR4, DQw8 or SC31, DR4,
      DQw8 with variable HLA-B) of these haplotypes. Only one patient had DR4, DQw8
      without any other markers of the extended haplotypes. The number of homozygotes
      and heterozygotes for DR4, DQw8 was consistent with dominant but not recessive (P
      less than 0.01) inheritance of a class II or a class II-linked susceptibility
      gene for the disease. Since the disease is entirely attributable to the presence
      of an antibody to an intraepidermal intercellular cement substance, it is likely
      that the class II susceptibility gene (on [HLA-B38, SC21, DR4, DQw8], HLA-B35,
      SC31, DR4, DQw8, or their segments, in Jewish patients) controls the production
      of the antibody as a dominantly expressed immune response gene.

PMID- 2217198
TI  - DNA polymerase II is encoded by the DNA damage-inducible dinA gene of Escherichia
      coli.
AB  - The structural gene for DNA polymerase II was cloned by using a synthetic inosine
      containing oligonucleotide probe corresponding to 11 amino acids, which were
      determined by sequencing the amino terminus of the purified protein. The labeled
      oligonucleotide hybridized specifically to the lambda clone 7H9 from the Kohara
      collection as well as to plasmid pGW511 containing the SOS-regulated dinA gene.
      Approximately 1400 base pairs of dinA sequence were determined. The predicted
      amino-terminal sequence of dinA demonstrated that this gene encoded DNA
      polymerase II. Sequence analysis of the upstream region localized a LexA binding
      site overlapping the -35 region of the dinA promoter, and this promoter element
      was found to be only two nucleotides downstream from the 3' end of the araD gene.
      These results demonstrate that the gene order is thr-dinA (pol II)-ara-leu on the
      Escherichia coli chromosome and that the DNA polymerase II structural gene is
      transcribed in the same direction as the araBAD operon. Based on the analysis of
      the predicted protein, we have identified a sequence motif Asp-Xaa-Xaa-Ser-Leu
      Tyr-Pro-Ser in DNA polymerase II that is highly conserved among a diverse group
      of DNA polymerases, which include those from humans, yeast, Herpes and vaccinia
      viruses, and phages T4 and PRD1. The demonstration that DNA polymerase II is a
      component of the SOS response in E. coli suggests that it plays an important role
      in DNA repair and/or mutagenesis.

PMID- 2217199
TI  - Secondary structure of the ribosome binding site determines translational
      efficiency: a quantitative analysis.
AB  - We have quantitatively analyzed the relationship between translational efficiency
      and the mRNA secondary structure in the initiation region. The stability of a
      defined hairpin structure containing a ribosome binding site was varied over 12
      kcal/mol (1 cal = 4.184 J) by site-directed mutagenesis and the effects on
      protein yields were analyzed in vivo. The results reveal a strict correlation
      between translational efficiency and the stability of the helix. An increase in
      its delta G0 of -1.4 kcal/mol (i.e., less than the difference between an A.U and
      a G.C pair) corresponds to the reduction by a factor of 10 in initiation rate.
      Accordingly, a single nucleotide substitution led to the decrease by a factor of
      500 in expression because it turned a mismatch in the helix into a match. We find
      no evidence that exposure of only the Shine-Dalgarno region or the start codon
      preferentially favors recognition. Translational efficiency is strictly
      correlated with the fraction of mRNA molecules in which the ribosome binding site
      is unfolded, indicating that initiation is completely dependent on spontaneous
      unfolding of the entire initiation region. Ribosomes appear not to recognize
      nucleotides outside the Shine-Dalgarno region and the initiation codon.

PMID- 2217200
TI  - The gamma subunit of transducin is farnesylated.
AB  - Protein prenylation with farnesyl or geranylgeranyl moieties is an important
      posttranslational modification that affects the activity of such diverse proteins
      as the nuclear lamins, the yeast mating factor mata, and the ras oncogene
      products. In this article, we show that whole retinal cultures incorporate
      radioactive mevalonic acid into proteins of 23-26 kDa and one of 8 kDa. The
      former proteins are probably the "small" guanine nucleotide-binding regulatory
      proteins (G proteins) and the 8-kDa protein is the gamma subunit of the well
      studied retinal heterotrimeric G protein (transducin). After deprenylating
      purified transducin and its subunits with Raney nickel or methyl iodide/base, the
      adducted prenyl group can be identified as an all-trans-farnesyl moiety
      covalently linked to a cysteine residue. Thus far, prenylation reactions have
      been found to occur at cysteine in a carboxyl-terminal consensus CAAX sequence,
      where C is the cysteine, A is an aliphatic amino acid, and X is undefined. Both
      the alpha and gamma subunits of transducin have this consensus sequence, but only
      the gamma subunit is prenylated. Therefore, the CAAX motif is not necessary and
      sufficient to direct prenylation. Finally, since transducin is the best
      understood G protein, both structurally and mechanistically, the discovery that
      it is farnesylated should allow for a quantitative understanding of this post
      translational modification.

PMID- 2217201
TI  - Transforming growth factor beta stimulates mammary adenocarcinoma cell invasion
      and metastatic potential.
AB  - The experimental metastatic potential of 13762NF mammary adenocarcinoma clone
      MTLn3 was tested after pretreatment in serum-free medium containing transforming
      growth factor (TGF) beta 1 at 0-5000 pg/ml. Lung colonies were measured 2 weeks
      after inoculation in syngeneic F344 rats, and a bell-shaped dose-response curve
      with 2- to 3-fold increase in number of surface lung metastases was seen. Maximal
      enhancement occurred at the 50 pg/ml dose level. The effect was specific because
      addition of neutralizing anti-TGF-beta antibody blocked the stimulatory activity
      at all levels of TGF-beta 1 pretreatment, but when antibody was given alone,
      neutralizing anti-TGF-beta antibody had no effect on untreated cells. Increased
      metastatic potential appears to be from an increased propensity of cells to
      extravasate as tested in the membrane invasion culture system. MTLn3 cells
      penetrated reconstituted basement-membrane barriers 2- to 3.5-fold more than did
      untreated control cells, depending upon length of TGF-beta 1 exposure. Increased
      invasive potential is apparently due, in part, to a 2- to 6-fold increase in type
      IV collagenolytic (gelatinolytic) and a 2.4-fold increase in heparanase activity.
      TGF-beta 1 treatment of MTLn3 cells did not alter their growth rate or morphology
      in the presence of serum; however, growth was inhibited in serum-free medium.
      Likewise, adhesion to human umbilical vein endothelial cell monolayers or to
      immobilized reconstituted basement membrane or fibronectin matrices was
      unchanged. These results suggest that TGF-beta 1 may modulate metastatic
      potential of mammary tumor cells by controlling their ability to break down and
      penetrate basement-membrane barriers.

PMID- 2217202
TI  - Conservation of the primary structure, organization, and function of the human
      and mouse beta-globin locus-activating regions.
AB  - DNA sequences located in a region 6-18 kilobases (kb) upstream from the human
      epsilon-globin gene are known as the locus-activating region (LAR) or dominant
      control region. This region is thought to play a key role in chromatin
      organization of the beta-like globin gene cluster during erythroid development.
      The beta-globin LAR activates linked globin genes in transiently or stably
      transfected erythroleukemia cells and in erythroid cells of transgenic mice.
      Since the human beta-globin LAR is functional in mice, we reasoned that critical
      LAR sequence elements might be conserved between mice and humans. We therefore
      cloned murine genomic sequences homologous to one portion of the human LAR (site
      II, positions -11,054 to -10,322 with respect to the human epsilon gene). We
      found that this murine DNA fragment (mouse LAR site II) and sequences homologous
      to human LAR sites I and III are located upstream from the mouse beta-like globin
      gene cluster and determined that their locations relative to the cluster are
      similar to that of their human counterparts. The homologous site II sequences are
      70% identical between mice and humans over a stretch of approximately 800 base
      pairs. Multiple core sequences with greater than 80% identity were present within
      this region. Transient and stable transfection assays of K562 erythroleukemia
      cells demonstrated that both human and mouse LAR elements contain enhancer
      activity and confer hemin inducibility on a linked human gamma-globin promoter.
      These results suggest that primary structural elements--and the spatial
      organization of these elements--are important for function of the beta-globin
      LAR.

PMID- 2217203
TI  - Purification of a 110-kilodalton cytosolic phospholipase A2 from the human
      monocytic cell line U937.
AB  - The major dithiothreitol-resistant phospholipase A2 activity present in the
      cytosol of U937 cells has been purified greater than 200,000-fold by sequential
      chromatography on phenyl-5PW, heparin-Sepharose CL-6B, high-performance
      hydroxylapatite, TSK-gel G3000-SW, and Mono Q columns. This 110-kDa cytosolic
      phospholipase A2 is distinct from the relatively small (14-kDa) dithiothreitol
      sensitive phospholipases A2 that are secreted from many cell types. This
      additional phospholipase A2 selectively hydrolyzes fatty acid at the sn-2
      position of the glycerol and favors phospholipids containing arachidonic acid,
      which is the rate-limiting precursor for prostaglandin and leukotriene
      production. Interestingly, a greater than 5-fold increase in phospholipase A2
      activity is noted as the calcium concentration increases from the levels found in
      resting cells to those observed in activated macrophages. We suggest that this
      enzyme and not the previously described secretory phospholipase A2 is activated
      by cytosolic effectors such as GTP-binding regulatory proteins and protein
      kinases to initiate the production of prostaglandins, leukotrienes, and platelet
      activating factor. To distinguish this cytosolic enzyme from the previously
      described secretory ones, we suggest referring to it as cPLA2 for cytosolic
      phospholipase A2 and collectively referring to the secretory phospholipases A2 as
      sPLA2s.

PMID- 2217204
TI  - Exocytic transport vesicles generated in vitro from the trans-Golgi network carry
      secretory and plasma membrane proteins.
AB  - We have developed a cell-free assay that reproduces vesicular budding during exit
      from the Golgi complex. The starting preparation for the in vitro system was a
      rat liver stacked Golgi fraction immobilized on a magnetic solid support by means
      of an antibody against the cytoplasmic domain of the polymeric IgA receptor.
      Vesicular budding was ATP, cytosol, and temperature dependent and was inhibited
      by 1 mM N-ethylmaleimide. Budding was maximum within 10 min and originated
      preferentially from the trans-Golgi. Exocytic transport vesicles immunoisolated
      from the total budded population were enriched in the mature forms of secretory
      and membrane proteins destined to the basolateral plasma membrane and were
      depleted in lysosomal enzymes and galactosyl-transferase activity. The finding
      that a major proportion (greater than 70%) of newly synthesized, siaylated
      secretory and transmembrane proteins is contained in a single population of post
      Golgi transport vesicles implies that, in a constitutively secreting cell,
      basolaterally destined proteins are sorted and packaged together into the same
      exocytic transport vesicles.

PMID- 2217205
TI  - Inhibition of tyrosine phosphorylation prevents T-cell receptor-mediated signal
      transduction.
AB  - The binding of antigen to the multicomponent T-cell receptor (TCR) activates
      several signal transduction pathways via coupling mechanisms that are poorly
      understood. One event that follows antigen receptor engagement is the activation
      of inositol phospholipid-specific phospholipase C (PLC). TCR activation by
      antigen, lectins, or anti-TCR monoclonal antibody has also been shown to cause
      increases in tyrosine phosphorylation of TCR-zeta and other substrates,
      suggesting stimulation of protein tyrosine kinase (PTK) activity. A critical
      question is whether these two pathways, PLC and PTK, are independently activated
      or whether one initiates and/or regulates the other. In the former case, PLC
      activation could be coupled to the TCR via a GTP-binding protein (G protein). We
      have reported, however, that tyrosine phosphorylation of intracellular substrates
      precedes detection of PLC activation and intracellular calcium elevation,
      suggesting that inositol phospholipid turnover in T cells is initiated by a PTK
      pathway. In this study, we test this hypothesis by treating T cells with the drug
      herbimycin A. We demonstrate that this agent inhibits substrate tyrosine
      phosphorylation, TCR-mediated inositol phospholipid hydrolysis, and calcium
      elevation. In contrast, under these conditions G-protein-mediated PLC activity,
      as tested by addition of aluminum fluoride, remains intact. Furthermore, whereas
      herbimycin treatment prevents TCR-mediated interleukin 2 production and
      interleukin 2 receptor expression, phorbol ester-induced effects are
      substantially resistant to herbimycin. The drug thus appears to abrogate TCR
      mediated signaling without affecting distal signaling mechanisms.

PMID- 2217206
TI  - Evidence for susceptibility of intrathymic T-cell precursors and their progeny
      carrying T-cell antigen receptor phenotypes TCR alpha beta + and TCR gamma delta
      + to human immunodeficiency virus infection: a mechanism for CD4+ (T4) lymphocyte
      depletion.
AB  - Individuals infected by the human immunodeficiency virus type 1 (HIV-1)
      demonstrate progressive depletion and qualitative dysfunction of the helper T4
      (CD4+) cell population. Mechanisms proposed for attrition of CD4+ T cells include
      direct cytopathicity of these mature cells following infection as well as
      infection of early T-lymphocyte progenitors. The latter mechanism could lead to
      failure to regenerate mature functioning CD4+ T cells. The present study
      determines the susceptibility of thymocytes at various stages of maturity to
      infection with HIV-1. Various normal thymocyte populations were inoculated with
      HIV-1, including unfractionated (UF), CD3- CD4- CD8- ["triple negative" (TN)],
      CD4+ CD8+ ["double positive" (DP)] thymocytes, and thymocyte populations obtained
      by limited dilution cloning. Cultures were studied for the presence of HIV-1 DNA
      by polymerase chain reaction in addition to examination for reverse transcriptase
      activity. We determined that transformed T-cell and thymocyte cell lines
      completely lacking CD4 were not susceptible to infection by HIV-1, whereas all of
      the following lines were: UF thymocytes (70-90% CD4hi+); DP thymocytes (99%
      CD4hi+); TN thymocytes (0% CD4hi+); and TCR alpha beta +, TCR gamma delta +, or
      CD16+ CD3- (natural killer) thymocyte clones expressing variable levels of CD4
      and representing the progeny of TN thymocytes. [TCR alpha beta + and TCR gamma
      delta + refer to the chains of the T-cell antigen receptor (TCR), and CD4hi
      refers to a strong rightward shift (greater than 30 linear channels) of the CD4
      curve on flow cytometric analysis compared with control.] Monoclonal antibodies
      (mAbs) to CD4 (T4a epitope) but not to CD3 (T3) were capable of blocking
      infection of mature and immature CD4hi+ thymocytes. Moreover, anti-CD4(T4a) mAbs
      also inhibited infection of CD4hi- TN thymocytes, indicating that these T-cell
      precursors--despite their apparent "triple negativity" (CD3- CD4hi- CD8-)-
      expressed sufficient CD4 molecules to become infected. Cell sorter analysis with
      a panel of CD4 mAbs demonstrated a mean shift of the mean fluorescence channel
      (MFC) with CD4 mAbs on TN thymocytes of 6 +/- 4 MFC units. Thus, intrathymic T
      cell precursors and their progeny representing many stages of T-cell ontogeny are
      susceptible to infection by HIV-1, including early TN thymocytes, which express
      very low levels of CD4. Infection of multiple stages and multiple subsets of the
      T-cell lineage in man, mediated via the CD4 molecule, may explain the inability
      of the T-cell pool to regenerate in the setting of progressive HIV infection.

PMID- 2217207
TI  - Identification of three related human GRO genes encoding cytokine functions.
AB  - The product of the human GRO gene is a cytokine with inflammatory and growth
      regulatory properties; GRO is also called MGSA for melanoma growth-stimulatory
      activity. We have identified two additional genes, GRO beta and GRO gamma, that
      share 90% and 86% identity at the deduced amino acid level with the original GRO
      alpha isolate. One amino acid substitution of proline in GRO alpha by leucine in
      GRO beta and GRO gamma leads to a large predicted change in protein conformation.
      Significant differences also exist in the 3' untranslated region, including
      different numbers of ATTTA repeats associated with mRNA instability. A 122-base
      pair region in the 3' region is conserved among the three GRO genes, and a part
      of it is also conserved in the Chinese hamster genome, suggesting a role in
      regulation. DNA hybridization with oligonucleotide probes and partial sequence
      analysis of the genomic clones confirm that the three forms are derived from
      related but different genes. Only one chromosomal locus has been identified, at
      4q21, by using a GRO alpha cDNA clone that hybridized to all three genes.
      Expression studies reveal tissue-specific regulation as well as regulation by
      specific inducing agents, including interleukin 1, tumor necrosis factor, phorbol
      12-myristate 13-acetate, and lipopolysaccharide.

PMID- 2217208
TI  - Promoter deletion and loss of retinoblastoma gene expression in human prostate
      carcinoma.
AB  - Mutational inactivation of the retinoblastoma gene (RB) is found in all
      retinoblastomas and in a subset of other human neoplasms, including sarcomas of
      bone or soft tissue and carcinomas of lung or breast. Exogenous copies of wild
      type RB have been shown to suppress the tumorigenicity of several types of tumor
      cells with endogenous RB mutations, including a previously described human
      prostatic carcinoma cell line. To further support a role for RB inactivation in
      the genesis of prostate cancer, seven primary or metastatic prostate carcinoma
      specimens were examined for evidence of RB mutation. By the use of immunoblot
      analysis and immunostaining of histologic sections, RB-encoded protein was
      readily detected in tumor cells of five specimens, was equivocally detected in
      one specimen, and was apparently absent from tumor cells of one specimen. RB
      mutations in the latter case were precisely characterized as (i) a deletion of
      103 nucleotides containing transcriptional start sites and (ii) loss of the
      second RB allele. The 103-base-pair deletion was sufficient to abolish the
      promoter activity of upstream DNA sequences in a heterologous expression system.
      These results (i) demonstrate that RB can be inactivated in vivo by mutation of
      its promoter, (ii) confirm the existence of RB mutations in some human prostate
      carcinomas, and (iii) suggest the use of immunohistochemical methods to screen
      for RB mutations in clinical samples of common adult neoplasms.

PMID- 2217209
TI  - Chemical carcinogenesis: too many rodent carcinogens.
AB  - The administration of chemicals at the maximum tolerated dose (MTD) in standard
      animal cancer tests is postulated to increase cell division (mitogenesis), which
      in turn increases rates of mutagenesis and thus carcinogenesis. The animal data
      are consistent with this mechanism, because a high proportion--about half--of all
      chemicals tested (whether natural or synthetic) are indeed rodent carcinogens. We
      conclude that at the low doses of most human exposures, where cell killing does
      not occur, the hazards to humans of rodent carcinogens may be much lower than is
      commonly assumed.

PMID- 2217210
TI  - Dietary pesticides (99.99% all natural).
AB  - The toxicological significance of exposures to synthetic chemicals is examined in
      the context of exposures to naturally occurring chemicals. We calculate that
      99.99% (by weight) of the pesticides in the American diet are chemicals that
      plants produce to defend themselves. Only 52 natural pesticides have been tested
      in high-dose animal cancer tests, and about half (27) are rodent carcinogens;
      these 27 are shown to be present in many common foods. We conclude that natural
      and synthetic chemicals are equally likely to be positive in animal cancer tests.
      We also conclude that at the low doses of most human exposures the comparative
      hazards of synthetic pesticide residues are insignificant.

PMID- 2217211
TI  - Nature's chemicals and synthetic chemicals: comparative toxicology.
AB  - The toxicology of synthetic chemicals is compared to that of natural chemicals,
      which represent the vast bulk of the chemicals to which humans are exposed. It is
      argued that animals have a broad array of inducible general defenses to combat
      the changing array of toxic chemicals in plant food (nature's pesticides) and
      that these defenses are effective against both natural and synthetic toxins.
      Synthetic toxins such as dioxin are compared to natural chemicals, such as indole
      carbinol (in broccoli) and ethanol. Trade-offs between synthetic and natural
      pesticides are discussed. The finding that in high-dose tests, a high proportion
      of both natural and synthetic chemicals are carcinogens, mutagens, teratogens,
      and clastogens (30-50% for each group) undermines current regulatory efforts to
      protect public health from synthetic chemicals based on these tests.

PMID- 2217213
TI  - Isothermal, in vitro amplification of nucleic acids by a multienzyme reaction
      modeled after retroviral replication.

PMID- 2217214
TI  - We must begin to value our part time nurses.

PMID- 2217215
TI  - From text book to reality. Student nurse training needs in stoma care.
AB  - Student nurses on a stoma care placement can feel out of their depth. Guidance
      from experienced nurses can help them acquire the practical and emotional skills
      required, and gain new confidence.

PMID- 2217212
TI  - Steroid-receptor fusion of the human immunodeficiency virus type 1 Rev
      transactivator: mapping cryptic functions of the arginine-rich motif.
AB  - The human immunodeficiency virus type 1 (HIV-1) transactivator Rev is a nuclear
      protein that regulates expression of certain HIV-1 transcripts by binding to an
      RNA target element (the RRE) present in these transcripts. A short arginine-rich
      sequence in Rev contains the signals required to direct this protein into nuclei,
      where it associates preferentially with nucleoli. We created a steroid-inducible
      transactivator by fusing Rev with the steroid-binding domain of the
      glucocorticoid receptor (GR). This Rev/GR protein remains inactive in the
      cytoplasm when steroids are absent, but it enters the nucleus and initiates
      transactivation within minutes after exposure to dexamethasone. Although the GR
      moiety is sufficient to transport Rev/GR into nuclei, mutation of certain
      residues in the arginine-rich region blocks nucleolar localization and also
      inhibits transactivation. We find that other mutations in this region, however,
      can abolish the function of Rev/GR without affecting its localization; the latter
      phenotype may reflect a specific defect in binding of the RRE.

PMID- 2217216
TI  - We must assess the care we give. Nursing practices in invasive procedures.
AB  - Hospital acquired infections are a common phenomenon, particularly in patients
      who are undergoing invasive procedures. However, the rate of infection can be cut
      down by thorough assessment of nursing care.

PMID- 2217217
TI  - Opioids: routes of administration.

PMID- 2217218
TI  - When should you take your tablets? Teaching elderly people about their
      medication.
AB  - In the last issue it was shown that many elderly people fail to comply with
      medication. Here, a framework is suggested to educate hospital patients before
      discharge.

PMID- 2217219
TI  - A major contributor. Evaluation of Comfeel Pressure Relieving Dressing.

PMID- 2217220
TI  - Mums and Dads need care too. Supporting parents of babies in neonatal units.
AB  - New parenthood can be traumatic and stressful at the best of times, but for
      parents with a baby in a neonatal unit, the experience can be much more difficult
      to deal with. The support received from unit staff can make all the difference.

PMID- 2217221
TI  - The three levels of nursing care.

PMID- 2217222
TI  - Obliteration of the circadian rhythm of intraocular pressure in Graves'
      ophthalmopathy.

PMID- 2217223
TI  - Chronobiology in laboratory medicine: principles and clinical applications
      illustrated from measurements of neutral steroids in saliva.
AB  - A number of chronobiological principles, as they pertain to the practice of
      laboratory medicine, have been discussed. Without doubt, salivary steroid assays
      are valuable tools for use in clinical studies, not necessarily as a single time
      qualified sample but more often as a series of samples that will describe the
      underlying endocrinological time-structure. It is also important to appreciate
      that melatonin, certain drugs, and many dietary constituents such as phyto
      oestrogens, are among the myriad of substances that can be monitored, and so hold
      great promise for the chronobiologist interested in the use of saliva as a
      sampling medium, both in the present and in the future.

PMID- 2217224
TI  - Improved therapeutic index of cisplatin analogue: B-85-0040 by circadian timing.
AB  - 1. B-85-0040 is a new cisplatin analogue with dose limiting myelosuppression. 2.
      The maximum tolerated dose ranges between 300 and 525 mg/kg for single i.p. bolus
      injection in mice. 3. Its toxicity is circadian-stage dependent with optimal
      tolerance between 16 and 17 hours after lights on. 4. B-85-0040 is active in
      L1210 leukemia. Anti-tumor activity seems to be unrelated to the circadian stage
      of treatment. Optimal drug timing can therefore increase its therapeutic index.

PMID- 2217225
TI  - Potential value of salivary steroids in chronoepidemiological and endocrine
      related studies.
AB  - Experience from Institute studies has clearly demonstrated the advantages of
      salivary steroids in clinical endocrinological research and their potential value
      in chronoepidemiological studies of many kinds that may involve hormones. Of
      course, the examples and suggestions for areas of research involve many more
      covariates than those mentioned; but sufficient evidence has been presented to
      indicate the chronobiological potential of salivary steroid assays in studies of
      mental health, aggression and behaviour, stress, the endocrine changes occurring
      from birth to old age and those relating to endocrine cancer. The pioneering
      studies of Halberg et al (1981) and Haus et al. (1987) have demonstrated the
      feasibility of carrying out international epidemiological studies as they relate
      to breast cancer risk and studies of the general population. The potential value
      of salivary steroid assays in clinical, physiological and epidemiological studies
      is judged to be considerable.

PMID- 2217226
TI  - Lack of circadian variation in renal function in the obese rat: influence of
      continuous food and water intake.

PMID- 2217228
TI  - Circadian rhythm of glucocorticoid receptors in human peripheral leukocytes and
      their reactivity to glucocorticoids.
AB  - 1) There exists a CR of GR in human leukocytes, PMN, and monocytes with the peak
      values from 0400 to 0800 hr and the trough values between 2300 and 0000 hr. The
      difference between them was significant statistically. 2) The FI of the
      chemotactic migration rate of PMN by cortisol also showed diurnal changes which
      were synchronous with that of GR. This indicates that the CR of GR may be of
      functional significance. 3) In Cushing's syndrome, the CR of GR was normal in
      spite of the fact that the CR of plasma cortisol was disturbed. This indicates
      the independency of the CR of GR from that of cortisol. 4) In apoplexy caused by
      brain ischemia, the CR of GR was abolished in patients with basal lesions but
      preserved when the lesions were located in the cerebral cortex. These results
      strongly suggest that the main "circadian pacemaker" of GR is located in the
      basal brain, most probably in the suprachiasmatic nuclei as has been suggested
      for rodents.

PMID- 2217229
TI  - A circaoctohoran rhythm of urine epinephrine excretion in man.

PMID- 2217227
TI  - Circadian rhythms of total renin and active renin concentrations in normotensive
      young subjects.

PMID- 2217230
TI  - Circadian parameters of 17-hydroxycorticosteroids and electrolyte rates during
      the menstrual cycle.

PMID- 2217231
TI  - Thyroid volume variation during the menstrual cycle in healthy subjects.

PMID- 2217233
TI  - Chronobiological evaluation of 24-hour lipid and lipoprotein changes in middle
      aged males.

PMID- 2217232
TI  - A circaseptan rhythm (about 7 day) in some metabolic circulating variables.

PMID- 2217234
TI  - Serum cholinesterase (CE) activity and lipid levels in hyperlipidemic rats.

PMID- 2217235
TI  - Possible relationship between intergroup variability in circadian, circamensual
      and circannual rhythms in man.

PMID- 2217236
TI  - The effects of time of trauma patient presentation on emergency department
      utilization.
AB  - All three posed temporal questions have now been answered as being positive
      factors in ED utilization: 1) Major and minor trauma patients should be expected
      to present at ED in largest numbers around 17.67 hr each day and especially
      during the month of August. Some types of major trauma (i.e., medical, surgical,
      psychiatric patients) require longer periods for stabilization in the ED before
      being discharged to the appropriate care unit. Such patients also tend to arrive
      later at the ED than do patients destined for MICU, SICU, or CCU. 2) Changing the
      trauma ordinance did not affect the temporal effects noted above but did produce
      a strikingly large influx of minor trauma presents relative to major trauma
      presents during the post-ordinance period. 3) The nature and number of the ED
      staffing should be reviewed and probably changed in order to reflect the large
      influx of trauma presents during the 1600 to 2400 hr shift. The third question
      has the most impact on ED utilization during the "Golden Hour of Trauma".
      Individual emergency departments must cope with the fact that the maximum demand
      on facilities and professional health expertise will normally occur during the
      hours from 1600 to 2400 each day. Some EDs have recognized this increased demand
      and have responded by maximizing the quantity and quality of their staff on the
      1600 to 2400 hr shift. These data indicate that more EDs should follow suit as
      soon as possible.

PMID- 2217237
TI  - Nonparametric testing of melatonin characteristics as potential markers of breast
      cancer risk.
AB  - On the average, the circadian A of ML is larger in clinically healthy women at
      high vs. low RDBC. The original finding was made without numerical sampling on
      data from a relatively small group of women sampled systematically around the
      clock and the year. It was hence of further interest to see whether the risk
      related difference can be corroborated by numerical resampling, i.e., by BS, a
      fairly general, usually computerintensive technique used for estimating the
      sampling distribution of an estimator or statistic (i.e., a quantity computed
      from the data). For BS of circannual parameters, one here assumes that 1)
      circadian As (obtained by the fit of a 24-hour cosine curve by linear least
      squares) are correlated for any given subject from season to season; and 2)
      deviations of each circadian A from the average are random. The method then
      estimates the characteristics of harmonic components, ordered by P-values
      obtained by linear least-squares analysis involving a test of the assumption of
      zero A for each special component. Results from BS validate differences in
      circadian A of ML between the low and high RDBC groups throughout the year. The
      use of BS serves to introduce inferential considerations into discriminant
      analysis and to test results obtained with very limited samples sizes, before
      embarking upon the actual labor-intensive, costly resampling required in
      circannual and circadian work. BS is a procedure recommended for broad routine
      use in non-parametric hypothesis testing and biomedical signal simulation. The re
      evaluation of ML data by BS provides further inferential statistical validation
      of the finding as a first complement, not substitute, for additional sampling in
      order to assess a possibly important component of a test battery for breast
      cancer risk.

PMID- 2217238
TI  - Circadian rhythm disturbances in neurological patients with chronic hypothermia.
AB  - 1) We investigated the circadian rhythms of BT and sleep-wakefulness in 8
      neurological patients who showed chronic low BT. Their etiologies were varied. 2)
      Their thyroid functions were normal, but their hypothalamic functions were
      disturbed endocrinologically to various degrees. 3) Their temperature-elevation
      system was able to function when they suffered from infectious disease. 4) Six
      patients had circadian rhythm disturbances of BT and sleep-wakefulness. This fact
      suggests that there is a close relationship of BT regulation and control of its
      rhythm, and also a close association of 2 pacemakers, namely, that of sleep
      wakefulness and that of BT.

PMID- 2217239
TI  - Nocturnal asthma, its pathogenesis and treatment.
AB  - Many chronobiologic and cyclic environmental factors are implicated in the
      pathophysiology of nocturnal asthma. A better understanding of these
      interrelating processes is essential for an optimization of medications for
      asthma. A reasonable therapeutic approach for the management of nocturnal asthma
      is the use of inhaled beta-agonists routinely, on a daily basis, and if symptoms
      persist, the use of an appropriate SR theophylline scheduled once-daily in the
      evening. Inhaled cromolyn sodium and corticosteroid therapy, properly timed to
      rhythms, may be warranted to control inflammation and stabilize the airways.

PMID- 2217240
TI  - Structural and ultrastructural circadian features in rat exocrine pancreas.

PMID- 2217241
TI  - Ambulatory cardiovascular monitoring of healthy adults in Rochester, Minnesota:
      chronobiologic assessment.
AB  - To serve as a tentative reference group for clinical health, 107 adults measured
      their systolic (S) and diastolic (D) blood pressure (BP) with an ambulatory Del
      Mar Avionics monitor (Irvine, California). Data were collected over approximately
      24 hours at 7.5-minute intervals during waking and at 15-minute intervals during
      sleep. An echocardiogram served to determine the left ventricular mass (LVM),
      septal wall thickness (SWT), posterior wall thickness (PWT), ejection fraction
      (EjFr), and left atrial size (LAS). Each data series was analyzed by single
      cosinor. A statistically significant circadian rhythm (P less than 0.05) was
      found in 96 subjects (89.7 percent) for SBP and in 86 subjects (80.4 percent) for
      DBP. A population-mean cosinor reveals a highly significant circadian rhythm (P
      less than 0.001) for both variables in men (n = 44) as well as in women (n = 63),
      with an acrophase around 14:15. The double circadian amplitude, a measure of the
      total predictable change within a day, averages 10 (women) and 11 (men) mm Hg for
      DBP and 14 (women) and 17 (men) mm Hg for SBP. The midline-estimating statistic
      of rhythm (MESOR) of SBP is found to be higher for men (125 mm Hg) than for women
      (120 mm Hg), P = 0.018, whereas no difference in MESOR is found for DBP (71 mm
      Hg). A statistically significant correlation with age is found for the MESOR of
      SBP in both men (r = 0.352; P = 0.018) and women (r = 0.336; P = 0.007). The
      MESOR of SBP is also found to correlate with LVM in men (r = 0.300; P = 0.046),
      but not in women (r = 0.181; P = 0.153), whereas the MESOR of DBP correlates with
      LVM in women (R = 0.316; P = 0.011) but not in men (r = 0.117; P = 0.543). A
      positive correlation is also found between the MESOR of SBP and SWT as well as
      with EjFr, which is more prominent in women; between the MESOR of DBP and LAS,
      which is more prominent in men; and a negative correlation is found for women but
      not men between the circadian amplitude of both SBP and DBP and EjFr. Blood
      pressure excess (in mm Hg x h; hyperbaric index, briefly HBI; Halberg et al.,
      1984) was computed by comparing each profile to the upper 95 percent time-varying
      prediction limit of healthy peers.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2217243
TI  - Agreement between consecutive ambulatory 24-hour blood pressure and heart rate
      profiles in Japanese hospital staff.

PMID- 2217242
TI  - Chronobiological blood pressure assessment of 334 normotensive Japanese.

PMID- 2217244
TI  - Peri-awakening rise of blood pressure revisited: a linear "speed" of increase in
      unit time.

PMID- 2217245
TI  - Enhancement of respiratory sinus arrhythmia by moderate exercise.

PMID- 2217246
TI  - Chronobiologic assessment of deviant human blood pressure: an invitation for
      improvements.

PMID- 2217247
TI  - Secular or circannual effects of placebo and melatonin on murine breast cancer?

PMID- 2217248
TI  - Clinical evaluation of chronobiological blood pressure data validated by
      echocardiogram.

PMID- 2217249
TI  - A two-dimensional index for the assessment of elevated blood pressure.

PMID- 2217250
TI  - Chronobiological characteristics of 75 patients with essential hypertension.

PMID- 2217251
TI  - Relationship between circadian rhythm of blood pressure and left ventricular
      function in hypertensive patients.

PMID- 2217252
TI  - Enhancing the physiologic effectiveness of cardiac stimulators in heart rhythms'
      management using chronobiology.

PMID- 2217253
TI  - Twenty-four hour TXB2 production in unstable angina.

PMID- 2217254
TI  - Chronobiologic evaluation of the efficacy of a new calcium antagonist,
      nicardipine hydrochloride, in 'essential hypertension'.

PMID- 2217255
TI  - Chronesthesia to cardiac glycosides of patients with cardiac failure.

PMID- 2217256
TI  - Circadian characteristics of cardiovascular rhythms in pregnancy.

PMID- 2217257
TI  - Chronobiologic approach to pregnancy-induced hypertension and individualized
      assessment of low-dose aspirin for pre-eclampsia prevention.

PMID- 2217258
TI  - Can the chronobiological approach better evaluate the relationship between
      diabetes mellitus and arterial hypertension?
AB  - This work evaluates by a chronobiological approach the relationship between
      arterial hypertension and diabetes mellitus. Sixteen type II (non-insulin
      dependent) diabetic hypertensive males (age 50-60 years, BMI 26 +/- 1, without
      nephropathy) were selected for the study. Blood pressure (BP) was considered
      borderline, mild or moderate, systolic and/or diastolic by a single measurement
      (occasional measurement) according to the Report of the Joint National Committee
      on Detection, Evaluation and Treatment of High Blood Pressure (1984). Then both
      dynamic ambulatory BP through a 24-hr span (5300 ABPS Spacelabs) and an oral
      glucose-tolerance test (100 gm) with serum glucose and insulin measures were
      carried out. Total insulin area (TIA) and total glucose area (TGA) were computed.
      Blood-pressure values were analyzed by the Cosinor method, and then percent time
      of elevation (PTE) and the hyperbaric impact (HBI) were calculated. A
      statistically significant positive correlation was found between TIA and the
      mesors of both systolic BP/diastolic BP (p less than 0.05) and HBI (p less than
      0.05 and p less than 0.01, respectively).

PMID- 2217259
TI  - Menstrual-cycle-synchronized circaseptan rhythms of temperature in cancer
      associated breast tissue.

PMID- 2217260
TI  - Relationship of heart rate, respiratory rate, and arterial blood pressure rhythms
      in a mechanically ventilated patient to environmental variables in an intensive
      care unit.

PMID- 2217261
TI  - Circadian rhythm of ischemic episodes in patients with and without previous
      myocardial infarction.

PMID- 2217262
TI  - Ultradian and infradian components in onset of acute myocardial infarction (AMI).

PMID- 2217263
TI  - Stroke incidence: circadian and circaseptan (about weekly) variations in onset.

PMID- 2217264
TI  - Circadian rhythm alteration in HIV infected subjects.

PMID- 2217266
TI  - Further extensions of the cosinor approach to problems of the pharmaceutical
      industry.
AB  - The resolution of a more complex time structure than that described by the useful
      first approximation of a single cosinor is suggested herein. The cosinor serves
      the purpose of parsimony in the case of sparse and short time series, yet it can
      be usefully extended by assessing the variations in rhythm characteristics for
      treatment timing in the clinic rather than only for research.

PMID- 2217265
TI  - Persistence of circadian rhythms in hematologic and biochemical functions except
      for melatonin, following a single 12 hour prolongation of the light span.

PMID- 2217267
TI  - Loss of the progesterone-associated metabolic rhythm in cancer-associated breast
      tissue.

PMID- 2217269
TI  - Chronotoxicologic studies on dichlorphos in mice and humans.

PMID- 2217268
TI  - A preliminary report of circadian effects of interleukin-2 (IL-2) on the activity
      of enzymes of intermediary metabolism of mice.
AB  - Since it previously has been reported that IL-2 has profound circadian dependent
      effects upon DNA synthesis in the liver of mice (Scheving et al., 1988; Tsai et
      al., 1988) the effects of IL-2 on enzyme activities were studied. The objective
      was to determine the effect of IL-2 when administered at different times to mice
      who were fed ad libitum, and standardized to 12 h of light alternating with 12 h
      of dark. Three groups were injected intraperitoneally with either 1 or 4 mg/kg of
      IL-2, one group was given the vehicle only. The treatment time for each dose and
      the vehicle was a 2 h into the light for one group and the other was at 2 h into
      the dark span. Subgroups of 5 mice were killed 4, 8, 12, 16, 20, 24, and 30 h
      after each treatment, livers were taken and frozen to await preparation and
      analysis of enzyme activities by our standard procedures. When treatment was in
      the light span IL-2 had no statistically significant effect on enzymes of lipid,
      carbohydrate or amino acid metabolism. On the contrary when treatment was given
      in the dark span IL-2 produced statistically significant increases in enzymes of
      glycolysis, and lipid synthesis beginning 8 h after treatment (changes ranged
      from 20 to 43%) with both the higher and lower doses (higher doses always yielded
      higher activities), and these activities continued to increase through the 24 h
      post-treatment span (changes ranged from 42 to 64%). At 30 h, activities were
      returning to normal levels. Amino acid metabolism, on the other hand, was
      decreased during these post-treatment times (the range of decrease was from 18 to
      44%). Thus, we report for the first time that the duration of time, pathway
      affected, as well as the magnitude of the effect seen and the dosage of IL-2 were
      all circadian-stage dependent even with two time point samplings. We believe,
      however, that these two time points represent different critical extremes in
      liver metabolism, but studies with denser sampling are planned. Interleukin-2 was
      generously supplied by Cetus Corp. of Emeryville, CA.

PMID- 2217270
TI  - Circannual rhythm in response of renin release to calcium deprivation in isolated
      rat glomeruli.

PMID- 2217271
TI  - Calcitonin: chronotherapeutic effect on osteopenia in the ovariectomized rat.
AB  - This chronotherapeutic study has revealed no clear evidence to support the
      concept that calcitonin promotes bone formation in intact or OVX'd rats. Rather,
      the efficacy of CT-impaired bone resorption appeared to be optimal in OVX'd rats
      treated during the daytime, and least effective during the first half of the
      environmental dark span. These findings indicate a benefit for calcitonin
      chronotherapy in this animal model where the cellular kinetics resemble those
      documented in early development of postmenopausal osteoporosis.

PMID- 2217272
TI  - Circadian stage dependent 125I-insulin binding in the liver and epididymal fat of
      the mouse.

PMID- 2217273
TI  - Circadian rhythms of T lymphocyte subpopulations and cortisol in kidney and heart
      transplantation.

PMID- 2217274
TI  - Menstrual amplitude reduction in averaged basal body temperature data from pre
      menopausal breast cancer patients.

PMID- 2217275
TI  - The treatment of mild hypertension with mepindolol: a chronobiological
      evaluation.

PMID- 2217276
TI  - Blood pressure and heart rate in pregnancy: comparison between health and
      pathologic conditions.

PMID- 2217277
TI  - Chronobiologic approach to blood pressure during pregnancy and early extrauterine
      life.

PMID- 2217278
TI  - Circadian rhythms of tumor markers in breast cancer patients.

PMID- 2217279
TI  - Endpoints of chronobiologic cardiovascular monitoring during pregnancy for
      planning exercise and assessing effects.
AB  - The chronobiologic question is raised whether exercise may be indicated for the
      pregnant woman as a general prophylactic measure and, if so, whether it should be
      timed according to rhythms and stage of pregnancy. This question, recently
      considered by others without chronobiologic focus, is here reviewed against the
      background of results from ongoing chronobiologic studies of blood pressure (BP)
      and heart rate (HR) in pregnancy. During pregnancy, the MESORs and circadian
      amplitudes of systolic (S), mean arterial (MA) and diastolic (D) BP are
      correlated with a questionnaire-assessed cardiovascular risk score. Such results
      were found under noisy ordinary conditions of life without accounting for effects
      of activity. They are group results, and as such require further work before they
      can contribute to identifying individuals at high risk in particular need of
      intervention, such as exercise. The dependence of exercise effects upon circadian
      rhythms should also prompt the use of rhythmometry at all ages for timing
      exercise, for gauging its effects and eventually for the optimization of fitness
      training for the population as well as for peak performance.

PMID- 2217280
TI  - Individualized assessment of blood pressure and heart rate late in human
      pregnancy.

PMID- 2217281
TI  - Reference limits for 24 hour patterns of gestational blood pressure in
      normotensive pregnant women monitored under standardized conditions.

PMID- 2217282
TI  - Circaseptan and circannual modulation of circadian rhythms in neonatal blood
      pressure and heart rate.

PMID- 2217283
TI  - Human neonatal infradian, notably circannual, blood pressure and heart rate
      rhythms, gender and cardiovascular disease risk.

PMID- 2217284
TI  - Spontaneous motor activity and sleep-wake cycles in low-risk preterm infants.

PMID- 2217285
TI  - Oral temperature rhythmometry and substantial within-day variation in zidovudine
      levels following steady-state dosing in human immunodeficiency virus (HIV)
      infection.

PMID- 2217286
TI  - Circadian frequency synchronization with difference in phase of maternal and
      neonatal blood pressure.

PMID- 2217287
TI  - Sleep duration preferences in 4 to 14 month old babies.

PMID- 2217289
TI  - Circadian rhythms of total renin and active renin concentrations in normotensive
      young subjects.

PMID- 2217288
TI  - Circadian and seasonal variation in iodine excretion in children in an endemic
      goiter area.

PMID- 2217290
TI  - Seasonal characteristics of and age at menarche.
AB  - Several patterns in menarche are evident over time and across populations which
      vary by ethnicity, socioeconomic status and altitude of residence: peak
      occurrence of menarche in January and August with a possible minor peak in April;
      troughs in the occurrence of menarche to either side of the peak months; and
      secular trends in season and age patterns of menarche. Contradictory patterns in
      season of menarche with respect to age at menarche and season of menarche with
      respect to season of birth are still unresolved. Further research is yet required
      to evaluate the role of the variety of endogenous and exogenous variables and
      their interactions on menarche in order to more fully develop an appropriate
      understanding of the chronobiology of developmental and reproductive phenomena in
      women and their dependence upon environmental quality and temporal cues.

PMID- 2217291
TI  - Circannual rhythm of plasma growth hormone in girls (but not boys) with
      constitutional short stature.
AB  - GH concentrations (in ng/ml) were determined by radioimmunoassay in plasma
      obtained at about 3-hour intervals during a 24-hr sampling span from 40 boys and
      14 girls of short stature, 6-14 years of age, living on a diurnal waking
      (approximately 07:00 to approximately 22:00), nocturnal resting routine.
      Circadian rhythm parameters were first computed by the single and population mean
      cosinor fits of a 24-hour cosine curve. Circadian parameter comparisons revealed
      an intergroup difference between the genders in A (P = .012) and, perhaps, in M
      (P = .078), but not in 0 (P = .957). In the search for circannual variability,
      individual circadian Ms were fitted by LLS with a 1 year cosine curve. The LLS
      harmonic analysis shows a circannual rhythm for the girls (P = .037; M = 8.54; A
      = 5.38; 0 = -214 degrees from January 1), but not for the boys. Moreover, a 3.5
      months prominent component was also found for both the individual circadian Ms (P
      = .010) and As (P = .012) when all subjects are considered for analysis
      irrespectively of gender. These infradian characteristics complement circadian
      differences in GH between boys and girls and must be taken into account in the
      development of any protocol for studies of GH responses to GH-releasing hormone
      in children with short stature.

PMID- 2217292
TI  - Temporal patterns of hot flashes in natural and surgically-induced menopause.

PMID- 2217293
TI  - Seasonal variation in the incidence of congenital malformations in San Miguel de
      Allende, Mexico.

PMID- 2217294
TI  - Similar circadian characteristics of serum glucose in boys and girls of short
      stature.
AB  - In the absence of any gastroenterologic complaint, circadian variations
      characterize serum GL in 22 boys and 7 girls of short stature, 6-14 years of age,
      living on a diurnal waking (approximately 07:00 to approximately 22:00),
      nocturnal resting routine, consuming the usual hospital diet. Blood was drawn at
      about 3-hour intervals during a 24-hour sampling span and serum stored frozen at 
      60 degrees C until radioimmunoassay for GL concentration (in mg/dl). Circadian
      rhythm parameters were computed by the single and population mean cosinor fits of
      a 24-hour cosine curve. A parameter-comparison of data from the two genders
      indicates similar circadian M, A and 0 for both groups. The Ps for a comparison
      of Ms, As, 0s and (A,0) pairs are .635, .183, .385 and .308, respectively. The
      larger differences between genders were found for the circadian A. In human
      beings, differences in the A of a rhythm are associated with differences in the
      probable development of several civilization diseases. In this sense, evaluation
      of risk by appropriately designed questionnaires should next complement blood
      sampling in groups of children differing in age, gender, health or ethnicity,
      with the purpose in mind of deriving prediction regions for assessment of health,
      risk or disease.

PMID- 2217295
TI  - Infradian characteristics of plasma cortisol in children of short stature.
AB  - CT concentrations (in micrograms/dl) were determined by radioimmunoassay in
      plasma obtained at about 3-hour intervals during a 24-hour sampling span from 42
      boys and 16 girls of short stature, 6-14 years of age, living on a diurnal waking
      (approximately 07:00 to approximately 22:00), nocturnal resting routine.
      Circadian rhythm parameters were first computed by the single and population mean
      cosinor fits of a 24-hour cosine curve. A parameter-comparison shows similar
      circadian rhythm parameters for both genders, the Ps for a comparison of Ms, As,
      0s and (A,0) pairs being .69, .14, .73 and .32, respectively. In the search for
      infradian variability, individual circadian Ms were first fitted by LLS. The LLS
      harmonic analysis shows prominent components with periods of 8, 7, 4, 3 and 1
      months, with ordering P-values of .031, .011, .009, .018 and .024, respectively.
      The rhythm parameters thus obtained were used as initial values for the NLLS
      method. This approach only detects the circaseptrigintan (7 months) component,
      with estimated period, M, A and 0 of 5023.96 hours, 10.32 micrograms/dl, 3.34
      micrograms/dl and -273 degrees, respectively. These not anticipated infradian
      characteristics of the adrenal cortisol cycle may constitute quantitative
      parameters in dealing with risk in health and may serve to monitor any possible
      progression of a condition into a disease.

PMID- 2217296
TI  - Circadian rhythm in human activity objectively quantified by actigraphy.

PMID- 2217297
TI  - Circadian reference data for men in fifth decade of life.
AB  - These results are meant to serve as chrono-biologically-defined reference values
      for healthy adult men in their fifth decade of life. A thorough statistical
      analysis of these data is being prepared for presentation elsewhere. A rigorous
      comparison with results obtained when these same men were in their 20's and again
      in their 30's may help us to document the kinds and extent of changes in
      circadian rhythm characteristics (MESOR, amplitude and/or acrophase) which may
      occur with aging.

PMID- 2217299
TI  - Circannual variation of human mortality in Texas.

PMID- 2217298
TI  - Chronobiological evaluation of heart rate characteristic as a possible predictor
      of biological aging.

PMID- 2217301
TI  - Circaseptan-circadian rhythmic changes in corneal mitoses of Louvain rats.

PMID- 2217300
TI  - Effects of high and low protein diets on circadian rhythms in %S and %G2+M stages
      of the cell cycle in rat corneal epithelium studied by DNA flow cytometry.

PMID- 2217302
TI  - Human psychological circadian rhythms as behavioral messengers.

PMID- 2217303
TI  - On the frequency of "diurnal variations of mood" in psychiatric patients-
      seasonal aspects.

PMID- 2217305
TI  - Evidence that the pacemaker controlling activity rhythms is shortened in male
      thyroparathyroidectomized (TPX) rats: similarities to the effects of estradiol in
      females.
AB  - The experiments described here demonstrate that TPX and TX male rats display
      shorter free-running activity rhythms and higher activity levels compared to
      intact males. Neither effect could be duplicated in TPX females. The patterns in
      activity period, range of entrainment, and levels of activity observed in TPX
      males closely resembles that reported in intact females or OVX females treated
      with estradiol. These data suggest the possibility of a common mechanism linking
      circadian alterations produced by estradiol and thyroid state. This hypothesis
      needs to be tested, as does the question of whether thyroid hormones or
      calcitonin are responsible for the TPX and TX results. If thyroid hormones prove
      to be the causal agents, opposing effects of thyroid hormones and estradiol on
      adrenergic receptors provide a possible common mode of action for these agents on
      the circadian system. Disparate results from rat and hamster studies concerning
      the influence of thyroid state on activity rhythms suggest the possibility of
      species differences in this level of circadian organization. Thus, caution should
      be exercised in extrapolating results to other species, including humans.

PMID- 2217304
TI  - Chronoendocrine assessment of the risk of developing depressive disorders.
AB  - Chronoepidemiology studies alterations of biologic rhythms with several
      frequencies as harbingers and possibly determinants of the risk of developing
      certain diseases. Along these lines, a method for pattern discrimination, the so
      called "monotest", involving the leave-one-out technique for the estimation of
      the PM, is here used in the search for classifiers of personality. By this
      method, chronoendocrine relations of a DPP are explored in 12 plasma hormones
      sampled around the clock in 4 seasons on a small number of clinically and
      psychologically healthy women, 29-36 years of age. Subjects were separated in two
      groups by scores for DPP of the Mini-Mult, an abbreviated version of the
      Minnesota Multiphasic Personality Inventory. Discriminant analysis singles out
      plasma aldosterone as the primary classifier for DPP in winter. In spring, the
      best classifiers include 17-OH progesterone and insulin, whereas in the summer
      the circadian amplitude of 17-OH progesterone classifies best. Finally, the
      identified classifiers in the fall are DHEA-S, estradiol and estrone. In clinical
      health, hormones are thus sensitive in ordering people who, according to
      questionnaires, are at different risk of developing emotional disorders. Results
      also illustrate the need to consider the intermodulation of circadian and
      circannual rhythms, whenever endocrine variables are being determined in human
      plasma.

PMID- 2217306
TI  - Circadian rhythm of melatonin release from pineal hypothalamus and pituitary in
      hypertensive rats.

PMID- 2217307
TI  - Evidence that therapeutic alterations of a circadian rhythm for gastric emptying
      response may be possible.

PMID- 2217308
TI  - Rhythms of stimulated gastric acid secretion in duodenal ulcer (DU).

PMID- 2217309
TI  - Effect of chronic caloric restriction on hepatic enzymes of intermediary
      metabolism in aged B6C3F1 female mice.
AB  - Caloric restriction (CR) extends maximum life span and significantly retards the
      rate of occurrence of most age-associated degenerative diseases. The effect of CR
      in female mice on several hepatic enzymes was examined after 33 month old mice
      were killed at either the onset of dark, the onset of light or the mid-dark span.
      Animals had been singly caged with 12 hr of light followed by 12 hr of dark. All
      feeding was in the early dark span. CR mice were given 60% of the caloric intake
      of ad libitum fed mice throughout their lives (CR was initiated at 14 weeks of
      age). Livers were frozen to await preparation and then analysis for 14 enzymes of
      intermediary metabolism by our standard procedures. Enzymes of gluconeogenesis
      and amino acid metabolism were increased at all times due to CR. Enzymes of
      glycolysis and lipid metabolism were decreased at all times. However, maximum
      differences between ad libitum and CR mice occurred during the mid-dark span
      (this is the time of normal acrophase in younger mice). Circadian variation was
      lost and mesors changed for nearly all enzymes measured from mice that had been
      fed ad libitum. CR mice were found to maintain circadian variation of activities
      and activity profiles were similar to those seen in younger ad libitum fed mice.
      These observations suggest that the mechanism through which CR elicits its
      effects may involve a circadian component.

PMID- 2217310
TI  - Circadian periodicity of gastrointestinal peptides in male rats after
      orchidectomy and hormone replacement.

PMID- 2217311
TI  - Impact of time and feeding habits on lipid levels in Zucker obese rats.
AB  - The influences of time and hyperphagia on cholesterol, triglyceride, glucose and
      insulin levels were compared in the obese Zucker rat and compared to its lean
      litter-mates. Following a 28 day acclimation period in a 12 hr light/dark cycle
      (08-20-08) animal facility, blood samples were obtained every 2 hr in both obese
      and lean rats over a 24 hr period (N = 48; Dec 1988); serum was measured
      enzymatically for cholesterol, triglyceride and glucose and by radioimmunoassay
      for insulin and cortisol levels. Synchronization with other animal studies was
      established by endogenous serum cortisol measurements (acrophase 18-20 HALO in
      both groups). Cholesterol, triglyceride, insulin and glucose concentrations were
      significantly greater per time interval in obese vs. lean rats. No circadian
      pattern was observed in glucose concentrations in either rat group. Insulin
      levels peaked in both rat groups during the dark cycle; however, glucose and
      insulin levels were not correlated. Cholesterol concentrations were unchanged
      over time in obese as well as lean rats. Although triglyceride levels showed an
      acrophase at 13 HALO in lean rats, no circadian pattern was found in obese rats.
      Triglyceride levels remained elevated throughout the 24 hour period in obese rats
      whereas significant increases were observed in lean rats during the dark cycle.
      The present results suggest that triglyceride levels, and not insulin and
      cholesterol levels, are most likely dependent on feeding and activity patterns.

PMID- 2217312
TI  - Circadian rhythm of gastric pH in patients with healed ulcer under placebo and
      constant-rate ranitidine infusions.

PMID- 2217313
TI  - Infradian variation in the incidence of giardiasis assessed by linear-nonlinear
      rhythmometry.
AB  - The analysis of biological time series necessarily involves mathematical and
      physiologic techniques for purposes of data collection and interpretation,
      respectively. To assess a biologic rhythm in a given time series, one can first
      fit a cosine curve with a fixed period to the data by LLS. When the period is
      unknown or when there is more than one significant period, with no integral
      relation among them, LLS have to be replaced by NLLS. In applying the NLLS
      method, initial values for all the parameters in the model are first estimated by
      LLS. These are usually the overall M and the periods, As and 0s corresponding to
      each component found to be statistically significant by LLS. This combined
      approach was used in the search for infradian variability in the incidence of GD,
      the most common gastrointestinal parasitic disease in the USA at the present
      time. Monthly totals in ten consecutive years (1977 to 1986) of cases of GD
      detected in Minnesota (USA) were first fitted by LLS. The linear harmonic
      analysis shows the anticipated 1-year synchronized circannual rhythm with a
      period of 8766 hours (P less than .001) and other prominent components with
      periods of 7 (P = .038), 6 (P = .003), 5 (P = .001) and 3 (P less than .001)
      years, which were not anticipated. The rhythm parameters thus obtained are then
      used as initial values for the nonlinear method. Components of 5, 3. and 1 years
      are then detected by the NLLS approach, that also gives estimates and 95%
      confidence intervals for the period, the M, the A, and the 0 of each significant
      component. Of very great interest are infradian changes also seen time
      macroscopically in other data on numbers of waterborne cases and outbreaks of GD.
      Awareness of the thus detected predictable variability in the incidence of GD
      with frequencies lower than a year may be important in the diagnosis and
      treatment of this infectious disorder.

PMID- 2217314
TI  - Circadian periodicity of the time of onset of acute lower gastrointestinal
      bleeding.
AB  - We investigated the chronobiological parameters of acute gastrointestinal (GI)
      bleeding in 51 patients able to time-specify the onset of bleeding within 30 min
      of occurrence. Bleeding was determined to be either from the upper or lower GI
      tract. The upper GI bleeding group consisted of 32 patients (22 male, 10 female)
      who bled from peptic ulcer disease (16), Mallory-Weiss tear (4), gastritis (3),
      esophageal varices (3), gastric neoplasm (2), Dieulafoy's lesion (1), and unknown
      (3). The lower GI bleeding group consisted of 19 patients (9 male, 10 female) who
      bled from diverticulosis coli (5), hemorrhoids (2), arteriovenous malformations
      (2), colonic polyps (2), cecal ulcer (1), antibiotic-associated colitis (1), and
      unknown (6). Rhythmicity was evaluated by inferential statistics. The time of
      onset of lower GI bleeding (34 episodes) displayed significant circadian
      periodicity (p = 0.014) with its peak at 1100 h. Single cosinor analysis
      revealed: MESOR-1.42 (95% CI = 0.86- 1.97); amplitude = 1.22 (0.44-1.99); phase
      angle = -165.12 (-201.66 -128.58). Upper GI bleeding (42 episodes) displayed no
      circadian periodicity (p = 0.46). When both upper and lower GI bleeding were
      evaluated together, no circadian rhythm was evident (p = 0.07). We conclude that
      there is a circadian periodicity in the time of onset of only acute lower GI
      bleeding with its peak at 1100 h. The pacemaker of this periodicity remains
      unknown.

PMID- 2217315
TI  - Differential diurnal photosynthetic function in a psbA plastid gene chronomutant
      of Brassica napus.

PMID- 2217316
TI  - Temporal effects of pinealectomy, melatonin, and photocycle reversal on age
      related behavioral changes.

PMID- 2217317
TI  - Are tidal rhythms ultradian, circadian, or infradian?

PMID- 2217318
TI  - Blue light both synchronizes and inhibits growth of Schizosaccharomyces pombe at
      low temperatures.

PMID- 2217319
TI  - Chronobiologically deviant blood pressure in shift working police on metropolitan
      street duty.

PMID- 2217320
TI  - Chronobiological analysis of 1000 miles walked in 1000 hours.

PMID- 2217322
TI  - Is an eastbound circumpolar flight accompanied by phase advance of biological
      rhythms?
AB  - In the circumpolar region, the light-dark environment, which is the most potent
      Zeitgeber among others, and to which polar route travelers are exposed, varies
      greatly with the season and the time of day. Hence, resynchronization following
      an eastbound flight through this region will not necessarily be attained by phase
      advance of the biological rhythms. To prove this by simulation, a computer
      program was produced so as to locate the sun at any moment on any day and at any
      point on the earth. Rats were exposed to the changing pattern of light-dark
      condition which simulated flight schedules of polar, great circle and southern
      routes. Observation was made on the progress of biological resynchronization to
      the local time. The polar route simulation with an advance of 15 hours followed
      by a delay of the same hours resulted in phase delays on both trips. The great
      circle route simulation with a shift of 9 hours back and forth gave the same
      results. Another polar route simulation with an advance of 18 hours also resulted
      in a delay, while on their way back home some showed delay and some did advance.
      These findings suggest that the light-dark pattern after arrival works more
      rather than that during the trip, and that the resynchronization is apt to be
      achieved by delaying rather than by advancing, particularly when advancing of the
      phase by 6 hours or more is required. The critical limit seems to be subject to
      difference in species.

PMID- 2217321
TI  - Can athletic performance be statistically predicted? A follow-up study.

PMID- 2217323
TI  - Irregular work schedule: a case of a steward.

PMID- 2217324
TI  - Day-night patterns in workplace accidental deaths: role of alcohol abuse as a
      contributing factor.

PMID- 2217325
TI  - Circadian periodicity of performance in athletic students.

PMID- 2217326
TI  - Chronobiology of exercise: the influence of scheduling upon glycemic responses of
      control and of subjects with diabetes mellitus.
AB  - Exercise programs contribute significantly to: a) improve cardiovascular fitness;
      b) lower blood pressure in hypertension; and c) facilitate glycemic control in
      subjects with Diabetes Mellitus (DM). The mechanisms involved in promoting the
      above responses remain undetermined. Circadian phases at which exercise is
      applied could play a major role in optimizing the individual's physiological
      responses to exercise. In a pilot study, controls and a subject with Insulin
      Dependent Diabetes Mellitus (IDDM) were exercised at 0800 and 2000 hours:
      pedaling on an exercycle for 30 minutes at rates that maintained tachycardia at
      70% of maximum reserve heart rates (Karvomen et al., 1957). All subjects were on
      "standard" rest-activity schedules (rest 2300-2400 to 0600-0700) and were allowed
      a single 360 ml Sustacal meal either at 2400 hours or at 1200 hours; i.e., 8
      hours preceding the exercise program. Blood samples were obtained for
      determinations of glucose (finger tip) just before exercise (0 time) and at 10,
      20, 30, 40 and 60 minutes of exercise/post exercise periods. The results suggest
      that non-diabetics experience a rapid decrease in blood glucose levels which does
      not recover during the 60 minute sampling time when exercise was in the morning.
      However, when these individuals exercised during the evening, glucose levels did
      not fall as much on a percentage basis and full recovery was obtained within 40
      60 minutes. In the case of the diabetic patient, after morning exercise, glucose
      levels did not decline and after 40 minutes had risen above resting glucose
      levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2217327
TI  - Melatonin and phototherapy in premenstrual depression.

PMID- 2217328
TI  - Seasonal and circadian trends in occupational injuries.

PMID- 2217329
TI  - Influence of a rapidly rotating shift system on the fatigue of female workers.

PMID- 2217330
TI  - Digestive disturbances in shift-workers: a clinical statistical investigation.
AB  - In order to give a clarifying contribution about the probable relationship
      between shift-work and digestive diseases the authors have conducted a clinical
      and anamnestical investigation on digestive disturbances and alimentary habits of
      shift-workers comparing them with non shift-workers. The former group of subjects
      is engaged in very different activities conducted in variable working
      environments, with shift rhythms which are always disordered, sometime are
      imposed by the working Companies and sometimes chosen on the basis of personal
      necessities. The most interesting result of this study is represented by the
      confirmation of statistical significance among the larger incidence percentage of
      digestive disturbances between shift and non shift-workers. Moreover, statistical
      differences have been remarked among the different groups of shift-workers
      examinated. For these reasons the authors believe that shift-work is per se
      responsible of digestive diseases in the workers engaged to it and they also
      think that it is very important to distinguish the kind of shift work which may
      produce environmental, psychological and motivational differences.

PMID- 2217332
TI  - Recording of rhythms in organisms using video-digitizing.

PMID- 2217331
TI  - Toward a chronobiologic pacemaker.

PMID- 2217333
TI  - Day-night variations of normal number of computed tomography at several areas in
      human brain.

PMID- 2217334
TI  - Bounded limits and statistical inference in chronobiometry.

PMID- 2217335
TI  - Inferential sphygmochron to optimize the diagnosis and staging of arterial
      hypertension.

PMID- 2217336
TI  - Computing for clinical chronobiology, for bibliography compilation and for data
      storage, graphical presentation and statistical analysis.

PMID- 2217338
TI  - ChronoBioNet: global and local area networking in the chronobiological sciences.

PMID- 2217337
TI  - Meaning of the basic rest-activity cycle for psychohygiene.

PMID- 2217340
TI  - A mathematical model to explain the evolution of motor activity rhythm in rats.

PMID- 2217339
TI  - Chronobiologic blood pressure and heart rate assessment of patients with heart
      transplants.

PMID- 2217341
TI  - Caregiving merged with chronobiologic outcome assessment, research, and education
      in health maintenance organizations.

PMID- 2217343
TI  - Circadian rhythms of common laboratory profiles in serum and urine of healthy
      Indians.

PMID- 2217342
TI  - Circadian variations of blood and urinary constituents in renal stone formers.

PMID- 2217344
TI  - About-yearly pattern of cancer deaths, 1942-1987, in patients of a San Francisco
      hospital.

PMID- 2217345
TI  - Desynchronization of oral temperature and grip strengths: circadian rhythms in
      healthy subjects with irregular sleep-wake behavior.

PMID- 2217346
TI  - Genetic heterogeneity in control mechanisms of human reproduction: significance
      for isolation of patient subgroups.

PMID- 2217347
TI  - Chronobiological aspects of ischemic heart disease.

PMID- 2217348
TI  - Chronobiologic characteristics of ventricular ectopy in cardiac diseases.

PMID- 2217350
TI  - Diurnal variations of cardiac output in healthy young people.

PMID- 2217349
TI  - Longitudinal chronobiologic blood pressure monitoring for assessing the need and
      timing of antihypertensive treatment.
AB  - To examine the need for antihypertensive therapy and its timing, a 46 year-old
      woman with a 10-year history of "mild to moderate hypertension," treated for that
      span with 50 mg of hydrochlorothiazide per day, usually taken before retiring,
      carried out a study in a series of stages. Throughout the first 8 stages, she
      monitored her blood pressure and heart rate at 15-minute intervals around the
      clock for 70 consecutive days. In the first two stages, her medication was
      continued for a total of 10 days, of which the last 7 days constituted a double
      blind study start. For the next 25 days, she was placed on a placebo once in the
      evening. For the ensuing week, she received three tablets per day (in the
      morning, noon and evening), with all three being placebo. Thereafter, for
      consecutive 7-day spans, she was placed on treatment, only in the morning, only
      at noon or only in the evening, with placebo at other times. The desirability of
      one vs. another treatment was assessed by a comparison of slopes fitted to the
      daily MESORs; on that basis, the morning or noon treatment appeared to be
      possibly superior to the evening treatment. Eventually the patient was taken off
      medication; 5 months later her sphygmochrons, based on two-to-six day monitoring,
      were acceptable by current standards. The slope of MESORs may be a useful
      endpoint to assess the need for medication, to optimize its timing or to
      establish the likelihood that medication is not needed. This approach should,
      however, be based on several (rather than a single) double-blind alternation of
      drug and placebo treatments for spans that are the longer the smaller the extent
      of apparent blood pressure elevation. Thus, in the case of apparent mild MESOR
      hypertension, the blood pressure MESOR changes following the change in medication
      should be assessed during spans longer than one week. In the particular case
      studied, it seems possible that the patient had taken medication for 10 years,
      perhaps without justification. In cases of very mild blood pressure elevation, it
      seems desirable, by self-measurement or preferably automatic measurement, to take
      the patient off medication for spans measured in weeks or preferably months
      rather than days, in order to rule in or rule out the need for treatment, on the
      basis of repeated blood pressure profiles, to be compared eventually with
      reference standards from peers at low familial and personal risk of developing
      high blood pressure.

PMID- 2217351
TI  - Circadian sensitivity of soybean to a light activated herbicide.

PMID- 2217352
TI  - Chronobiological parameters as indicators of a disturbed organism-environmental
      relation in fish.

PMID- 2217353
TI  - Different best-fit multiples in lengths of incubation for altricial and precocial
      birds.

PMID- 2217354
TI  - Circadian variations in pigeon cropsac responses to prolactin determined at 3
      hour intervals.

PMID- 2217355
TI  - Treatment of adolescent patients with sleep-wake schedule disturbances who
      complain of non-attendance at school.

PMID- 2217356
TI  - Circadian system in the insect testes controls the rhythmic release of sperm.

PMID- 2217358
TI  - Effect of photoperiod on development and fitness of a polymorphic leafhopper,
      Stirellus bicolor (Homoptera: Cicadellidae).

PMID- 2217359
TI  - Daily and seasonal flight activity of Tabanidae (Diptera) in the North Dakota
      sandhills.

PMID- 2217360
TI  - Evidence for ultradian rhythmicity in an intertidal crab.

PMID- 2217357
TI  - Circadian rhythm in the cat flea, Ctenocephalides felis (Siphonaptera:
      Pulicidae).

PMID- 2217361
TI  - Lighting schedule shifts prolong survival of enucleated Acetabularia.

PMID- 2217362
TI  - Circadian locomotor activity in an isolated cell of Paramecium.

PMID- 2217363
TI  - Differences in circannual characteristics of the incidences of amebiasis and
      giardiasis.
AB  - Entamoeba histolytica is the most common pathogenic intestinal parasite in
      Mexico. Prevalence rates of AM vary widely from place to place, being higher in
      areas with poor sanitation, households and institutions, and among male
      homosexuals. Early recognition and treatment may be necessary to prevent its
      spread in the community. Intervention by preventive health education is
      indicated. The timing of such educational endeavours may be adjusted to any
      rhythmic and to that extent predictable changes in the incidence of AM and of any
      other possibly related gastrointestinal parasitic disease, such as GD.
      Accordingly, monthly totals of cases of AM and GD detected in Monterrey, (Mexico)
      between November, 1985, and October, 1987, were fitted by linear least-squares
      with a 1-year cosine curve. The no-circannual rhythm assumption in the incidence
      of AM and GD was rejected in both cases (P = .006 and .049, respectively). A
      comparison of circannual parameters shows differences in M, A and phi between the
      incidences of AM and GD, the Ps for those comparisons being less than .001, .014
      and .041, respectively. A high incidence of GD (above the yearly mean)
      consistently observed in April could be, however, related to the circannual
      pattern of AM, showing higher incidences in the spring. The timing of any
      preventive intervention should take into consideration the circannual variability
      in the incidence of AM and the differences or correlations with the circannual
      patterns of other gastrointestinal parasitic diseases.

PMID- 2217364
TI  - Is there a morning-evening difference in egg production of bloodworms, strongyle
      parasites of equines?
AB  - To test a claim that counts of the eggs of large strongyles or bloodworms,
      parasites of equines, are greater in morning fecal samples than in those from
      later in the day, and therefore, may be indicators of circadian variations in
      these worms, samples from one pony and nine horses were analyzed for strongyle
      eggs. Samples were collected twice per day, about 7:30 and again about 19:30,
      during two, 24-day periods. Individual counts varied from 0 to 1184. The mean of
      all 7:30 counts was 212.52; that of 19:30 counts was 236.03. The difference is
      not significant, and does not support the idea of circadian differences in egg
      production of these nematodes.

PMID- 2217365
TI  - Rat testicular growth and an infradian behavioral cycle of anxiety.

PMID- 2217366
TI  - Circadian and ultradian rhythms in ruminants: relevance to farming and science.

PMID- 2217367
TI  - Paleochronobiology circadian rhythms, gauges of adaptive Darwinian evolution;
      about 7-day (circaseptan) rhythms, gauges of integrative internal evolution.

PMID- 2217368
TI  - Oviposition rhythms in Biomphalaria spp. (Mollusca: Gastropoda). 1. Studies in B.
      glabrata, B. straminea and B. tenagophila under outdoor conditions.

PMID- 2217369
TI  - Oviposition rhythms in Biomphalaria spp. (Mollusca: Gastropoda). 2. Comparative
      studies in B. glabrata under natural and artificial light cycles.

PMID- 2217370
TI  - Biological oscillations and agriculture: a brief introduction.

PMID- 2217371
TI  - Covariance of daylight, sport participation and sleep patterns.

PMID- 2217372
TI  - Chronobiology and agroecosystems.
AB  - Influences of seasonal changes on the circadian system were observed in studies
      of feeding activity in four species of ducks and of feeding and locomotor
      activity in two species of mammals kept in captivity in the natural LD cycle.
      Feeding and locomotor oscillators had different sensitivities to exogenous
      synchronizers. Changes from a circadian to an ultradian feeding rhythm occurred
      as a result of courtship and breeding behavior in two duck species. Different
      phases of feeding rhythms in ducks were shown to have important ecological
      consequences for establishing the species in appropriate time niches in
      agricultural wetlands. Detailed study of annual, seasonal and daily rhythms of
      feeding and locomotion measured simultaneously in captivity and in free-ranging
      animals is necessary to elucidate the structure and function of food chains and
      webs. Activity rhythms of both producers and consumers (predators and prey)
      during daily and annual cycles is of special concern. This contribution of
      chronobiology will further our understanding of the niche of selected species in
      agricultural ecosystems.

PMID- 2217373
TI  - Effects of biological and environmental factors on activity rhythms of wild
      animals.
AB  - This paper reviews information on the effects of biological and environmental
      factors on activity rhythms of wild animals monitored by radio telemetry.
      Variations in radio signals received from free-ranging animals are used to
      determine the pattern of activity and rest. Telemetry is especially effective for
      obtaining activity data from wild animals at night and from those living in dense
      vegetation or underground. Biological factors such as breeding behavior, care of
      young, time of last eating, and food storage cause changes in daily activity
      patterns. Similarly, environmental factors such as temperature, snow cover, food
      supply and disturbance caused by humans in an urban setting also cause changes in
      daily activity patterns. The observed modifications of activity rhythms show that
      controlling mechanisms allow wild animals to quickly respond to changing
      biological and environmental factors.

PMID- 2217374
TI  - Oscillations in plant metabolism.

PMID- 2217375
TI  - Growth rhythms in higher plants.

PMID- 2217376
TI  - Photoperiodic and thermoperiodic regulation of assimilate partitioning into
      storage carbohydrates (starch and sugar) in leaves of crop plants.

PMID- 2217377
TI  - Modified behavior oscillations in diseased plants and its implication to
      epidemiology and crop loss assessment.

PMID- 2217378
TI  - Phase response curve evoked by fusaric acid and pulses of light and darkness on
      the circadian leaf movement rhythm of the cotton plant.

PMID- 2217379
TI  - A self-assessment questionnaire for the determination of morningness-eveningness
      types in Brazil.

PMID- 2217380
TI  - Rhythmic responses to hormones and herbicides in plants.

PMID- 2217381
TI  - Chronobiology and aquaculture: neglected opportunities.

PMID- 2217382
TI  - Relation of mesor to circadian amplitude as a criterion of mental load.

PMID- 2217383
TI  - Mutagens and carcinogens in food.

PMID- 2217385
TI  - Aberrant crypt foci in the detection of colon carcinogens.

PMID- 2217384
TI  - Polycyclic aromatic hydrocarbon carcinogens.

PMID- 2217387
TI  - Genotoxic mechanisms of fecapentaene-12 in human cells.
AB  - Fecapentaenes are mutagenic to both bacterial and human cells and can
      morphologically transform murine Balb/c 3T3 cells. DNA damage induced by
      fecapentaene-12 includes DNA cross-links, DNA protein cross-links and single
      strand breaks. Oxy- and alkyl-radicals have been detected in aqueous solution
      using spin traps coupled with EPR. Oxy-radicals thus formed can then directly
      damage DNA to form DNA SSB's or 80HdG. Radiolabeling studies suggest that
      fecapentaene-12 may also form specific adducts either directly or after aldehyde
      formation. Hence fecapentaene-12 may cause DNA damage by two distinct mechanisms
      i.e., directly (alkylation) or indirectly (via free radicals). Reactions of
      fecapentaene-12 with GSH tend to support this hypothesis. Possible synergistic
      interactive effects of DNA damage caused by direct and indirect mechanisms are
      currently under investigation.

PMID- 2217386
TI  - Dietary factors affecting spontaneous chromosomal damage in man.
AB  - The data summarized above demonstrate that dietary and nutritional factors can
      influence spontaneous rates of chromosomal damage in laboratory animals, and
      suggest strongly that certain of these dietary factors may exert a quantitatively
      significant influence on spontaneous chromosomal damage frequencies in human
      populations. Among a total of 77 splenectomized human subjects examined in two
      separate studies, consumption of caffeinated beverages, mild folate deficiency,
      and consumption of calcium supplements by older women were statistically
      associated with higher frequencies of micronucleated cells. Subjects who reported
      taking dietary supplements of vitamins C, E, or A had significantly lower values.
      Age was strongly associated with micronucleus frequency when other factors were
      not considered, but was only weakly associated when all factors were included in
      a multiple regression analysis. Followup studies in laboratory animals
      established that caffeine is a strong inducer of micronuclei in marginally folate
      deficient mice, but not in folate-sufficient mice. Deficiencies of magnesium or
      zinc, two metals required for DNA synthesis and/or maintenance of chromatin
      structure, increase the rate of spontaneous chromosomal damage in laboratory
      animals. These and other data discussed above suggest that dietary deficiencies
      of nutrients required for nucleotide synthesis, such as folate, vitamin B12, and
      magnesium, may increase spontaneous chromosomal damage, and may strongly
      influence the genotoxic response to other dietary factors. It is critically
      important to systematically investigate the quantitative importance of the above
      factors in man, using 1) human cross-sectional epidemiology and supporting animal
      data to identify potentially significant risk factors and to elucidate the
      mechanisms of interaction among these factors, and 2) controlled intervention
      studies in man to determine the quantitative significance of these factors in
      human populations. We feel the use of splenectomized populations, in which
      chromosomal damage is easily monitored and in which the marker of damage is
      temporally responsive to removal of risk factors, will play an important role in
      the intervention phase of such studies.

PMID- 2217388
TI  - Metabolic activation of food hepatocarcinogens in hepatitis B virus-infected
      humans and animals.

PMID- 2217390
TI  - New mutagens from cooked food.

PMID- 2217391
TI  - Antimutagenic/anticarcinogenic food components.

PMID- 2217389
TI  - Mechanisms of oxidant carcinogenesis.

PMID- 2217392
TI  - Conjugated dienoic derivatives of linoleic acid: mechanism of anticarcinogenic
      effect.

PMID- 2217393
TI  - Antimutagenic heat stable antioxidants.

PMID- 2217394
TI  - Soybeans inhibit mammary tumors in models of breast cancer.

PMID- 2217395
TI  - Chemoprevention and chemotherapy of mammary tumors by monoterpenoids.

PMID- 2217397
TI  - Diet and cancer: regulatory perspectives in Europe.

PMID- 2217396
TI  - Opportunities for nutritional scientists in cancer prevention.

PMID- 2217398
TI  - Mutagens and carcinogens in the diet. Regulatory perspective: Japan.

PMID- 2217399
TI  - Regulation of carcinogens and mutagens in foods in the United States.

PMID- 2217400
TI  - Mutagens and carcinogens in the diet: summary and perspectives.

PMID- 2217401
TI  - Metabolism and biodisposition of heterocyclic amines.
AB  - The metabolic pathways of activation and detoxification of heterocyclic aromatic
      amines are similar to those reported for other aromatic amines. In vitro studies
      have shown that oxidation of the exocyclic amine group by cytochrome P450 results
      in formation of the mutagenic N-hydroxylamine derivatives. However, metastable
      conjugates of the hydroxyamino metabolites have not been identified in biological
      fluids such as bile or urine of rodents. This is in contrast to the aromatic
      amines 2-acetylaminofluorene and 4-aminobiphenyl in which both the hydroxamic
      acid and the N-glucuronide of the hydroxylamine have been identified (Miller et
      al., 1960; Radomski et al., 1973). This suggests that either very low levels of
      the N-hydroxyamino metabolites of heterocyclic amines are formed or that they are
      not stable and react rapidly. Phase II conjugation reactions include N
      glucuronidation and the unusual pathway of sulfamate formation for several of
      these amines including IQ and MeIQx. Conjugation to glutathione has not been
      reported to be a major route of in vivo metabolism and detoxification of
      heterocyclic amines. Studies conducted in vitro are few and inconclusive. One
      study has shown that glutathione may serve both to activate as well as to
      detoxify hydroxyamino-Trp-P-2 (Saito et al., 1983). While a second study
      demonstrated that depletion of cellular glutathione increased the binding of Trp
      P-2 metabolites to DNA in hepatocytes (Mita et al., 1982). Thus the role that
      glutathione plays in protecting the cell against this class of genotoxins merits
      further investigation. Much data has been gathered on human exposure to
      heterocyclic amines and mechanisms of genotoxicity have been elucidated, however,
      risk estimation of cancer development in humans by these carcinogens is still
      uncertain. There may be differences between man and rodents in the absorption,
      metabolism and activation versus detoxification as well as rates of excretion of
      heterocyclic amines. Humans also are exposed to many other carcinogens and
      potential tumor promoters (Sugimura, and Sato, 1983). Tumor promoters may enhance
      the effects of carcinogens. Fortunately, there also are tumor inhibiting factors
      in the diet which may weaken the biological activity of carcinogens (Wattenberg,
      1985). Such variables make it difficult to extrapolate carcinogenicity data from
      animal experiments to assess risk to human cancer development.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2217402
TI  - Preferential activation and genotoxicity of food derived heterocyclic amine
      mutagens by recombinant cytochrome P4501A2.

PMID- 2217403
TI  - Mutagens from model systems.

PMID- 2217405
TI  - Chemotherapy for invasive bladder tumors.
AB  - The presently reported phase II trials are not comparable but do provide leads.
      The need for chemotherapy is based on the original urologic assessment. Those
      patients requiring radical surgery can be considered, but the aim of therapy must
      be defined. For those with minimally advanced (T2, T3a) disease, bladder
      preservation is possible. For those with higher stage tumors, therapy is directed
      more for the treatment of micrometastases, with bladder preservation as a
      secondary goal. While bladder preservation is possible in selected cases,
      chemotherapy does not eliminate the need for definitive local therapy. The more
      widespread adaptation of ileo neo-bladders may eliminate the reluctance of some
      patients and physicians to proceed with definitive therapy. However, it must be
      emphasized that neo-bladders alone will not alter the natural history of this
      disease, but may improve quality of life. The results from advanced disease
      studies clearly show that selected patients can achieve long term survival using
      chemotherapy alone. These data make survival a valid endpoint for clinical trials
      recognizing the large number of patients required and that progress in cancer
      generally comes in comes in small steps. However, more effective systemic therapy
      is required before a significant impact on the natural history of invasive
      bladder cancer can be realized. For these reasons, neo-adjuvant chemotherapy must
      be considered investigational and physicians are urged - despite their reluctance
      to enter patients on clinical trials.

PMID- 2217404
TI  - Carcinogenicity of mutagens from cooked meats.

PMID- 2217407
TI  - Southwest Oncology Group Study 8710: trial of cystectomy alone versus neo
      adjuvant M-VAC and cystectomy in patients with locally advanced bladder cancer
      (Intergroup Trial 0080).

PMID- 2217406
TI  - Randomised intercontinental trial of locoregional therapy with or without
      neoadjuvant chemotherapy.

PMID- 2217408
TI  - Neoadjuvant chemotherapy in invasive bladder cancer. Trial design.

PMID- 2217409
TI  - Extended experience of neo-adjuvant M-VAC chemotherapy for T1-4 N0 M0
      transitional cell carcinoma of the urinary bladder.

PMID- 2217410
TI  - Neoadjuvant medium-dose methotrexate, cisplatin in category T3b-T4a (N0M0)
      bladder cancer.
AB  - Between July 1985 and December 1988, 31 consecutive patients with category T3b
      T4a (NOMO) urothelial cancer of the urinary bladder were entered into a phase II
      study of neoadjuvant chemotherapy with medium-dose methotrexate (300 mg/m2
      followed by folinic acid rescue), cisplatin (100 mg/m2 continuous i.v. infusion)
      every 4 weeks for a total of 4 courses. Six patients did not respond to the first
      two courses of neoadjuvant chemotherapy and another 3 were considered non
      responders after 4 courses. Three of these 9 patients progressed and could not
      undergo salvage cystectomy. Only 4 patients (13%) entered complete remission, and
      one of them refused surgery. All the 18 (58%) partial responders underwent
      radical cystectomy. The overall 2-year disease-free survival is 72%: it is 100%
      for the 4 complete responders, 76% for the 18 partial responders and 56% for the
      9 nonresponders. A longer follow-up is necessary to evaluate the impact of the
      neoadjuvant chemotherapy on survival of category T3b-T4a (NOMO) bladder cancer.

PMID- 2217411
TI  - Phase II trial of pre- and postoperative cisplatin, methotrexate and vinblastine
      in infiltrating bladder cancer: a three year experience.

PMID- 2217412
TI  - Neo-adjuvant M-VAC (methotrexate, vinblastine, adriamycin, and cisplatin) for
      infiltrating bladder cancer: initial results in Italy.

PMID- 2217413
TI  - Neo-adjuvant intra-arterial chemotherapy in locally advanced bladder cancer.

PMID- 2217414
TI  - Radical TUR and chemotherapy aiming at bladder preservation.

PMID- 2217415
TI  - Neoadjuvant M-VAC chemotherapy and partial cystectomy for treatment of locally
      invasive transitional cell carcinoma of the bladder.

PMID- 2217416
TI  - Bladder sparing approach to muscle invasive carcinoma of the bladder.

PMID- 2217418
TI  - Evaluation of tumor response and prognostic factors in patients with bladder
      cancer undergoing combined radiotherapy and chemotherapy.

PMID- 2217420
TI  - Sensitivity to short-term chemotherapy in patients with bladder cancer evaluated
      by computed tomography of the primary tumor.

PMID- 2217419
TI  - Combination chemotherapy followed by surgery: the case for a marker lesion.

PMID- 2217417
TI  - M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) and bladder
      preservation.

PMID- 2217421
TI  - EORTC Group Study 30851: a phase II study of neoadjuvant chemotherapy in patients
      with invasive bladder cancer.

PMID- 2217422
TI  - The prognostic value of the pT-category after combination chemotherapy for
      patients with invasive bladder cancer who underwent cystectomy. EORTC-GU group.

PMID- 2217423
TI  - Criteria of response to neo-adjuvant chemotherapy in the treatment of invasive
      bladder cancer: a critical assessment.
AB  - In this paper, we have addressed the difficulties of the assessment of response
      in clinical trials of pre-emptive or neo-adjuvant chemotherapy for bladder
      cancer. We have attempted to set guidelines that can be applied to this problem.
      It is clear that, in order for real progress to be made in this field,
      considerable attention must be paid to the design of the appropriate trials, and
      that innovations must be tested against standard treatments. To date, many phase
      II or pilot studies have been effected and reported, but without a clear
      determination of a resulting survival benefit compared to standard treatment.
      Although we have discussed the assessment of response in this paper, it should
      not be forgotten that there is no consensus that response is a useful endpoint in
      this setting. In the randomized assessment of the role of pre-emptive intravenous
      Cisplatin plus radiotherapy versus radiotherapy alone for invasive bladder
      cancer, carried out by the West Midlands and Australian Bladder Cancer Study
      Groups, response was not regarded as an important endpoint, and the trial
      assessed survival as the most important index, with documentation of toxicity as
      a secondary goal (Raghavan, 1989). Future phase III trials should address
      survival as the primary endpoint.

PMID- 2217424
TI  - The role of radiotherapy in the treatment of muscle invasive bladder cancer.
AB  - The treatment of muscle invasive bladder cancer still remains controversial. It
      is becoming more clear, however, that attempts to retain the functional capacity
      of the urinary bladder by the use of non-surgical methods may be of benefit in
      the long-term. Studies using radiotherapy in combination with chemotherapeutic
      agents or intravesicle sensitizers, or the use of radiotherapy alone, but
      optimized (i.e., brachytherapy and altered fractionation) may be able to achieve
      improved local control whilst retaining a functional bladder. Attempts to couple
      this with improved survival due to the sterilization of occult metastases is
      still subject to much debate.

PMID- 2217425
TI  - The role of surgery in initial staging and follow up.

PMID- 2217426
TI  - Pathology of bladder cancer: assessment of the primary lesion and response to
      therapy.

PMID- 2217427
TI  - Neoadjuvant chemotherapy in invasive bladder cancer. Trial design and statistics.

PMID- 2217428
TI  - Endpoints of clinical trials for muscle-invasive bladder cancer.

PMID- 2217430
TI  - The integration of chemotherapy, radiotherapy and transurethral surgery in
      bladder-sparing approaches for patients with invasive tumors.

PMID- 2217429
TI  - The NCI-Canada trial of concurrent cisplatin and radiotherapy for muscle invasive
      bladder cancer.

PMID- 2217431
TI  - Neo-adjuvant cisplatinum in locally advanced urothelial bladder cancer: a
      prospective randomized study of the group CUETO.

PMID- 2217432
TI  - An overview of megakaryocytopoiesis.

PMID- 2217433
TI  - Use of in situ hybridization to study human megakaryocyte gene expression.

PMID- 2217435
TI  - The regulatory control of hemopoietic populations.
AB  - The identification and mass-production by recombinant technology of twelve of the
      regulatory glycoproteins controlling hemopoiesis has represented a major advance
      in understanding hemopoiesis and introduces the possibility of being able to
      correct major disease states involving hemopoietic cells. Information so far on
      the control of megakaryocyte formation indicates that this follows the general
      pattern operating for other hemopoietic subpopulations and the present conference
      will review the new knowledge of specific factors influencing megakaryocyte
      formation and function.

PMID- 2217434
TI  - Megakaryocytopoiesis in man and laboratory animals. Conclusions derived from
      comparative studies and recently discovered animal models with megakaryocyte
      anomalies.

PMID- 2217436
TI  - Studies on paracrine regulation of murine megakaryocytopoiesis.

PMID- 2217437
TI  - Regulation of in vitro human megakaryocyte maturation.

PMID- 2217438
TI  - Regulation of human megakaryocytopoiesis by interacting cytokines.

PMID- 2217439
TI  - Role of thrombopoietin in controlling blood platelet production.

PMID- 2217440
TI  - Control and implications of polyploidization in human megakaryocytes.

PMID- 2217441
TI  - Platelets contain several inhibitors of megakaryocyte growth and ploidization.

PMID- 2217442
TI  - Delivery of platelets from megakaryocytes.

PMID- 2217443
TI  - Growth and differentiation of two human megakaryoblastic cell lines; CMK and UT
      7.
AB  - We showed that these two cell lines obviously expressed megakaryocytic
      phenotypes, such as multilobular, hyperploid nuclei, expression of GPIIb/IIIa
      complex, GPIb and PPO, although they have been originated from patients with
      leukemia. Furthermore, these cells had following characteristics. First, they
      responded to various kinds of hemopoietic factors. Especially, UT-7 cells were
      solely dependent on GM-CSF, IL-3 or Ep. Therefore UT-7 cells are useful to the
      assay of these factors as megakaryocytic cells. These facts provide us with new
      questions: why they are dependent on plural number of factors? How are the
      expressions of their receptors controlled. Is there an "autocrine" mechanism
      controlling their growth? Among these questions, we have just started with the Ep
      receptors, and most of the problems remain to be clarified. Second, PMA treatment
      suppressed their growth, but enhanced their differentiation and maturation. Among
      the megakaryocytic phenotypes, increase in GPIIb/IIIa complex, determined by a
      biochemical method, PPO by ultrastructural study, and the increase in cellular
      ploidy were clearly observed by PMA treatment. The phorbol ester PMA is well
      known to induce the differentiation of various kinds of leukemic cells (Rovera et
      al., 1979). Detailed molecular basis to clarify why the same PMA treatment causes
      differentiation into different cell lineages, dependent on cellular origin of the
      target cells, should be further studies. Third, the cells produced hemopoietic
      growth factors by PMA treatment, the majority of which was GM-CSF. Humoral
      control of megakaryopoiesis still remains unsettled. Our study may shed a light
      on its "multistep" regulatory mechanisms. Availability of a large amount of
      homogeneous megakaryocytic populations, which are responsive to hemopoietic
      factors and phorbol ester, will provide us with a great deal of informations
      concerning the molecular insight of megakaryocytopoiesis and thrombocytopoiesis.

PMID- 2217444
TI  - Retroviral antigen expression on megakaryocytes and platelets: possible
      implications in the pathogenesis of thrombocytopenia.

PMID- 2217445
TI  - Analysis of c-sis/PDGF-B mRNA expression in megakaryocytic cells of patients with
      myeloproliferative disorders.

PMID- 2217447
TI  - Megakaryocytes and thrombopoiesis in vascular disease.

PMID- 2217446
TI  - Flow cytometric analysis of megakaryocytes (Mks) from patients with platelet
      disorders.

PMID- 2217448
TI  - Inherited disorders of platelets and megakaryocytes.

PMID- 2217449
TI  - Circulating megakaryocytes and platelet production in the lungs.

PMID- 2217450
TI  - Platelet GPIIb as a marker for megakaryocytopoiesis.

PMID- 2217451
TI  - Molecular biology of the megakaryocyte-specific gene platelet factor 4.

PMID- 2217452
TI  - Molecular biology of human platelet membrane glycoprotein Ib.

PMID- 2217453
TI  - Proteoglycans in megakaryocyte development.

PMID- 2217454
TI  - The diagnosis and management of localized prostate cancer.

PMID- 2217455
TI  - Peptide growth factors: a new frontier in prostate cancer.

PMID- 2217456
TI  - Retinoic acid and prostatic cancer cell growth.

PMID- 2217457
TI  - Morbidity of modified pelvic lymphadenectomy and external beam radiation therapy
      for prostatic cancer.

PMID- 2217458
TI  - History and physical examination in prostate cancer. Which information is
      essential in diagnosis and follow-up?

PMID- 2217459
TI  - Biopsy techniques and cytology in prostate cancer.

PMID- 2217460
TI  - Staging of the primary.

PMID- 2217461
TI  - Lymph node staging of potentially curable prostatic carcinoma.

PMID- 2217462
TI  - The staging of M+ disease.
AB  - Patients with newly diagnosed prostatic cancer should be investigated with regard
      to the presence or absence of distant metastases by: (1) Clinical history
      especially of weight loss, recent pain, or analgesics intake. (2) Physical
      examination, looking especially for hepatic enlargement, peripheral lymph nodes,
      local bone tenderness. (3) Performance status. (4) Hemoglobin, creatinine, PSA
      and/or PAP, alkaline phosphatases, liver tests, testosterone. (5) Bone scan with
      X-ray of doubtful hot spots. (6) Chest X-ray. (7) Ultrasound scans (liver,
      kidney, lymph nodes) or CT scan may be indicated if abnormal blood parameters or
      in specific situations. (8) Other investigations are only indicated in special
      circumstances. Follow-up should include: (1), (2), (3), (4) every 3 months. For
      patients in clinical trials, depending on the end point, bone scan should be
      repeated every 6 months or possibly depending on the prognostic group (good:
      every 12 months; bad: 3 to 6 months). For routine clinical management, it could
      be repeated only when markers (PAP, PSA, alkaline phosphatase) show significant
      (25-50%) increase and provided the result will influence treatment. Other
      investigations should only be repeated or performed if abnormal at the start of
      if clinical data require them.

PMID- 2217463
TI  - Objective response criteria in prostate cancer.

PMID- 2217464
TI  - Assessment of quality of life and subjective response criteria in patients with
      prostatic cancer.

PMID- 2217466
TI  - Progress and controversies in the management of seminoma.
AB  - A series of controversies in the management of testicular seminoma were raised in
      this paper. Some of these issues have been discussed in more detail while others
      such as the optimal dose of radiation in stage II disease, and the management of
      residual masses post-chemotherapy are discussed in the consensus statement
      generated from the conference. It is important to consider these controversies in
      the context of the excellent outcome of current therapy. It is extremely unusual
      in the management of neoplastic disease to be attempting to refine therapy when
      the expected cure rate is 97% as it is in seminoma. It is only when our
      understanding of the disease process is so good, and our treatments so effective,
      that we can afford to direct investigative effort to minimizing the morbidity of
      our therapies.

PMID- 2217465
TI  - Time-dependent prognostic factors in advanced prostatic cancer.

PMID- 2217467
TI  - The role of lymph node dissection in testicular cancer.

PMID- 2217468
TI  - Testis cancer. Aggressive therapy for advanced disease.

PMID- 2217469
TI  - Aetiology and epidemiology of testicular cancer: report of consensus group.

PMID- 2217470
TI  - Basic principles of clinical trials as applied to testicular cancer.

PMID- 2217471
TI  - Consensus on pathological classifications of testicular tumours.

PMID- 2217472
TI  - Consensus statement on the investigation and management of testicular seminoma
      1989.
AB  - In the past 10 years, many developments have allowed us to understand more fully
      the natural history and routes of spread of testicular seminoma. The development
      of radiological tests such as CT scanning has allowed us to better assess the
      extent of disease. The availability of serum tumor markers AFP and beta HCG has
      facilitated the recognition of the presence of occult non-seminomatous elements.
      These developments plus the knowledge that seminoma is sensitive to cisplatin
      containing chemotherapy and that it is exquisitely sensitivity to radiation
      therapy resulted in further improvement in therapy. Overall we now expect 97 to
      98% of patients will be cured of their disease. Currently, a number of issues in
      the management of seminoma remain controversial. These controversies however
      impact on very small proportion of patients with seminoma. Between 5 and 10% of
      patients have stage IID, III, or IV disease and 10 to 20% of these patients ie: 1
      or 2% of the total population actually die from testicular seminoma. Thus it is
      for patients with advanced disease that we seek to define the nature of optimal
      chemotherapy, that is the most effective yet least toxic regimen. For those 1 or
      2% of patients dying of seminoma we seek to identify prognostic factors to
      identify these patients and better treatments for them. Refinements in the
      application of radiation therapy for early stage disease, should allow some
      reduction in the morbidity of radiation without compromising control rates.
      Testicular seminoma its investigation and management, serves as a model for
      understanding other malignant processes and for orderly ways in which to refine
      the therapeutic ratio in the management of disease.

PMID- 2217473
TI  - Second line treatment of hormone refractory prostatic cancer patients.

PMID- 2217474
TI  - Surgery in advanced disease for testicular cancer.

PMID- 2217475
TI  - Long-term side effects after treatment of testicular cancer.

PMID- 2217476
TI  - The management of end-stage carcinoma of the prostate: philosophy and fact.

PMID- 2217477
TI  - What is new in endocrine therapy of prostatic cancer?

PMID- 2217478
TI  - The value of the bone scan.

PMID- 2217479
TI  - Prognostic factor analysis from EORTC trials in advanced prostatic cancer. EORTC
      GU Group.

PMID- 2217480
TI  - Scientific background of hormonal treatment of prostate cancer.

PMID- 2217481
TI  - EORTC Genitourinary Group: prostate cancer studies.

PMID- 2217482
TI  - M.R.C. trials in prostate cancer.

PMID- 2217483
TI  - Response criteria in research protocols for prostatic cancer.
AB  - This paper highlights some problems in the application of different response
      criteria for prostatic cancer and discusses what the most practical response
      criteria is. In this paper, we present some results of a multi-institution
      collaborative clinical study which employed response criteria developed by a
      Japanese study group (the Japanese Response Criteria for Prostatic Cancer; JRCPC)
      are reported. The JRCPC assesses response of a number of foci of disease
      independently, i.e., primary prostatic lesion, bone metastatic lesions and serum
      PAP level as well as bidimensionally measurable lesions. The overall response is
      evaluated on the basis of the response for each of the above parameters. In the
      present study, the serum PAP level was found to be, at present, the most
      sensitive parameter for predicting survival of patients with prostatic cancer. If
      the response is evaluated and recorded as a function of each parameter, as in the
      case of the JRCPC, it is relatively easy to re-evaluate the results using other
      criteria, thereby making it possible to compare the results with the results of
      other studies which employ different criteria. In the future, it will be
      important to improve the accuracy of measurement of the response of a variety of
      parameters specific for prostatic cancer in order to establish reliable response
      criteria to evaluate therapy.

PMID- 2217484
TI  - Oncogene expression in prostate cancer.
AB  - Molecular biology has proven to be instrumental in studies on the onset and
      progression of cancer. Reasoning that tumorigenesis can be considered as a
      multistep process in which a normal cell gradually escapes from its delicately
      regulated growth pattern, one might describe this process in terms of gene
      expression. The group of genes that are good candidates for investigation in this
      context are the proto-oncogenes. Recent progress in oncogene research, has led us
      to believe that the group of oncogenes is much greater in number than the fifty
      so far characterized, since all growth factor-, growth factor receptor-, signal
      transducer- and transcription regulating genes have a potency to become
      oncogenic. Recessive genes, such as tumor suppressor genes might be equally
      relevant to the onset and progression of cancer. In this paper we confine
      ourselves to the role of protooncogenes in urological cancers, in particular
      prostate cancer. The usefulness of these genes as markers of progression in
      prostate cancer will be discussed.

PMID- 2217485
TI  - The peritoneum and its response to surgical injury.

PMID- 2217486
TI  - Can a pro-coagulant substance prevent adhesions?

PMID- 2217488
TI  - Staging of adnexal adhesions: a brief history.
AB  - Arriving at a system for staging adnexal disease is a scientific, clinical and
      political process which has already begun. Gynecologic oncologists started this
      process in 1967, and are still arriving at refinements and adjustments in the
      staging of cancer after 22 years. To rigorously evaluate new medical and surgical
      technologies in the treatment of adhesions it is important for infertility
      surgeons to continue the process of working towards a classification system,
      keeping in mind that it will take a long time.

PMID- 2217487
TI  - Nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of postsurgical
      adhesion.

PMID- 2217489
TI  - Interceed (TC7) as an adjuvant for adhesion reduction: animal studies.

PMID- 2217490
TI  - Alternative reproductive technologies vs. adhesiolysis.

PMID- 2217491
TI  - Adhesion formation/reformation.

PMID- 2217493
TI  - Preventing adhesions--electrosurgery: advantages and disadvantages.
AB  - Though electrosurgery has been with us for decades, few surgeons have received
      formal training in its potential uses. The erroneous belief that electrosurgery
      techniques increase scar formation or impair healing processes, has led surgeons
      to other methods to deliver energy to the living cell. At the cellular level, a
      watt, is a watt, is a watt -- knowing how to calculate and administer that energy
      is the challenge. Laser technology has forced the bioelectrical engineers to
      develop improved electrogenerators and accessories that are easier to understand
      and control. The use of digital reader boards, displayed in watts rather than an
      arbitrary dial setting is one example. A current flow meter for bipolar forceps
      will now tell the surgeon when all of the tissue has been desiccated. Soon I hope
      the power density and wattage delivered at the electrode tip will be easily
      displayed for the biogynecologic surgeons. Who knows, one day we may have a
      "laser-electrode" system to meet all of our needs.

PMID- 2217492
TI  - Microsurgical adhesiolysis.

PMID- 2217494
TI  - Laser surgery and adhesion formation.

PMID- 2217495
TI  - Gore-Tex surgical membrane.

PMID- 2217496
TI  - Impaired hoarding and olfactory learning in DSP-4-treated rats and control
      cagemates.
AB  - The possibility that variables affecting rats' home-cage odor preferences also
      influence hoarding behavior was examined. Neonatal male rats were injected SC
      with the noradrenergic neurotoxin, N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine
      (DSP-4), or with vehicle. At weaning, rats were assigned to control-only, DSP-4
      only, or mixed groups of DSP-4 and control rats. For the next 10 days, half the
      rats in each social condition were housed in cedar shavings, and remaining rats
      were housed in pine. Exposure to cedar significantly increased preference for the
      odor in control-only groups, but not in DSP-4-only or mixed treatment groups.
      Control-only groups also hoarded significantly more pellets per animal than rats
      in the other two social conditions. The results suggest that both olfactory
      adaptation and hoarding can be impaired by either neonatal NE depletion or an
      abnormal social environment.

PMID- 2217497
TI  - Initiation and execution of locomotion elicited by diencephalic stimulation:
      regional differences in response to nembutal.
AB  - At moderate levels of Nembutal, within the anesthetic range, locomotor stepping
      can be elicited by brain stimulation. We determined if Nembutal (7, 14 and 28
      mg/kg) had different effects on locomotion elicited by stimulation at different
      brain regions. Two regions were compared: the medial forebrain bundle (MFB, 13
      sites) and the areas medial and dorsal to it (MED/DORSAL, 20 sites). Locomotion
      was produced by electrical stimulation (50 microA, 0.5 msec pulses, 10 to 160 Hz)
      of unrestrained rats in a rotary runway. The latency to initiate locomotion and
      the time to complete 1 revolution of the rotary were measured. With no drug, MFB
      locomotion was initiated sooner but took longer to complete than MED/DORSAL
      locomotion. Nembutal at 7 mg/kg did not affect initiation of MFB or MED/DORSAL
      locomotion. Nembutal at 14 mg/kg shortened MFB initiations, but this dose
      prolonged MED/DORSAL initiations. Initiations with both types of sites were
      blocked with 28 mg/kg. The 7 and 14 mg/kg doses prolonged the locomotor
      completion times of the MFB sites but not of the MED/DORSAL sites. The results
      indicate that the response to Nembutal differs qualitatively for locomotion
      elicited by stimulation of the MFB and locomotion elicited by stimulation of the
      medial and dorsal hypothalamus. The mechanisms underlying the difference remain
      to be elucidated; they may relate to nonlocomotor behaviors also elicited by
      stimulation or to the motivational states reflected in those behaviors.

PMID- 2217498
TI  - Latency to initiate locomotion elicited by stimulation of the diencephalon
      positively correlates in awake and anesthetized rats.
AB  - Locomotor stepping can be elicited by brain stimulation at various diencephalic
      sites under moderate levels of Nembutal. This study determined if locomotor
      initiation measured under anesthesia provides a valid measure of the intersite
      factors which determine initiation in the awake condition. We compared the
      latencies to initiate locomotor stepping elicited by electrical stimulation (50
      microA, 0.5-msec pulses, 10 to 160 Hz) by rats tested while awake and
      unrestrained in a rotary runway or anesthetized and held in a stereotaxic
      apparatus. In the latter tests, initial anesthesia was provided by Nembutal (25
      mg/kg) and 2% halothane and maintenance anesthesia was provided by 7 mg/kg as
      needed and local injections of lidocaine. For 30 sites in 16 rats, average
      locomotor initiation latency in the awake condition and the shortest latencies in
      the anesthetized condition were positively correlated (r = .78). Locomotion at
      sites with long latencies in the awake condition was frequently blocked in the
      anesthetized condition, but sites with short latencies were rarely blocked. The
      results indicate that the shortest locomotor latencies in the anesthetized
      condition approximate the latencies measured in the awake condition. It is
      concluded that the anesthetized condition can provide valid initiation measures,
      but sites with long latencies in the awake condition are prone to depression
      under anesthesia.

PMID- 2217499
TI  - Criterion for learned helplessness in the rat: a redefinition.
AB  - Numerous investigators have reported difficulty obtaining reliable learned
      helplessness. Various laboratories have used differing test environments and
      criteria, making comparisons among experiments difficult. Some use an escape
      deficit criterion, in which escape is slowed down in a shuttle box, while others
      have used an escape failure criterion, in which rats do not escape at all on most
      test trials. Little work has been done to test the validity of LH, i.e., the
      prediction of persistence of escape failure after exposure to uncontrollable
      shock. The present studies demonstrate that the reliability and validity of
      learned helplessness can be improved by 1) modifying the shuttle box to increase
      task difficulty and decrease random escape behavior and 2) adopting a new escape
      failure criterion for helpless behavior which is based on statistical prediction
      of the persistence of escape deficits.

PMID- 2217500
TI  - Antagonism of cocaine, amphetamine, and methamphetamine toxicity.
AB  - The effect of diazepam, haloperidol, MK-801, and propranolol in antagonizing
      behavioral symptoms induced by lethal doses of cocaine, amphetamine, and
      methamphetamine were studied in a rat model. Animals were first pretreated IP
      with potential antagonists, diazepam (2, 5, and 10 mg/kg), haloperidol (5, 10,
      and 20 mg/kg), propranolol (5, 10, and 20 mg/kg), MK-801 (0.5, 1.0, and 2.5
      mg/kg), and then were challenged IP with cocaine (70 mg/kg) (LD85), d-amphetamine
      (75 mg/kg) (LD100), and methamphetamine (100 mg/kg) (LD90). Diazepam, at all
      doses, provided significant protection against cocaine- (p less than or equal to
      0.01) and methamphetamine- (p less than or equal to 0.05) induced seizures and
      produced a dose-dependent effect against amphetamine-induced seizures. MK-801, at
      all doses, reduced seizures in all groups (p less than or equal to 0.01).
      Propranolol altered the incidence of methamphetamine-induced seizures.
      Significant protection against cocaine-induced death was afforded by diazepam (p
      less than or equal to 0.01) and propranolol (p less than or equal to 0.05).
      Significant protection against amphetamine-induced death was provided by
      haloperidol (all doses, p less than or equal to 0.1), MK-801 (all doses, p less
      than or equal to 0.1), and propranolol (10 and 20 mg/kg, p less than or equal to
      0.1). No agent reduced the incidence of methamphetamine- (50 or 100 mg/kg)
      induced death. The failure of d-amphetamine antagonists to protect against
      methamphetamine-induced toxicity and death suggest that different mechanisms of
      toxicity may exist between these drugs.

PMID- 2217502
TI  - Associative influences on tolerance to decreased fixed-interval responding by
      clonidine.
AB  - Responding of rats was maintained under a 5-min fixed-interval schedule of food
      presentation. One group of animals (n = 5) received the alpha-2-agonist clonidine
      (0.1 mg/kg/day) before experimental sessions for 16 weeks. Additional animals (n
      = 5) also received 0.1 mg/kg/day for 16 weeks but experienced drug administration
      after sessions for 4 weeks, before sessions for 4 weeks, after sessions for 4
      weeks, and then finally, before sessions for 4 weeks. Animals receiving clonidine
      before daily experimental sessions for the entire period developed tolerance to
      decreased responding within 3 weeks, and their responding remained near control
      levels except when clonidine was occasionally preceded by the alpha-2-antagonist
      yohimbine. Animals receiving clonidine after sessions did not develop tolerance,
      and responding was markedly suppressed during the first exposure to presession
      clonidine. When these animals subsequently received clonidine again after
      sessions, responding was disrupted (increased) in spite of continued drug
      administration as if animals were "dependent" on clonidine in specific
      circumstances. When these animals again received clonidine before sessions,
      responding was partially suppressed in spite of uninterrupted drug administration
      as if animals had "lost" tolerance in specific circumstances. Tolerance to the
      behavioral effects of clonidine on fixed-interval responding was not determined
      by the presence of drug alone, but by the associative influence of drug-related
      effects in the presence of specific environmental stimuli.

PMID- 2217501
TI  - Adenosine receptor antagonism accounts for the seizure-prolonging effects of
      aminophylline.
AB  - The mechanism of action of aminophylline in prolonging seizures was tested in
      amygdala-kindled rats. Aminophylline prolonged the afterdischarge duration of
      kindled seizures. This seizure-prolonging action of aminophylline was strongly
      antagonized by the adenosine A1 agonist cyclohexyladenosine and partially
      antagonized by the benzodiazepine partial agonist RO 15-1788. However, the
      specific benzodiazepine antagonist CGS 8216 did not affect the seizure-prolonging
      action of aminophylline. Also, the potent anticonvulsant effect of diazepam on
      kindled seizures, which was completely antagonized by CGS 8216, was unaffected by
      aminophylline. Furthermore, a range of benzodiazepine inverse agonists, GABA
      antagonists, phosphodiesterase inhibitors and xanthines did not prolong
      afterdischarge durations. These results demonstrate that the seizure-prolonging
      action of aminophylline is due to block of A1 adenosine receptors since it is
      prevented by adenosine A1 agonists.

PMID- 2217503
TI  - Vasopressin does not mediate the inhibition of ethanol drinking by the renin
      angiotensin system.
AB  - Manipulations which are known to enhance activity in the renin-angiotensin system
      (RAS) have been found to reduce the voluntary consumption of ethanol in rats.
      Since angiotensin II is a potent stimulus for the release of vasopressin (VP), it
      is possible that the RAS modulates ethanol (ETOH) consumption through a mechanism
      involving VP. The present investigation examined the effect of peripheral
      injections of arginine-VP (AVP) and desglycinamide-AVP (DGAVP) on ETOH
      consumption in rats given daily one-hour access to ETOH. Daily subcutaneous
      treatment with AVP or DGAVP had no effect on ETOH consumption at doses ranging
      from 2 to 200 micrograms/kg (SC). Blood pressure was substantially elevated
      following a single 20 microgram/kg injection of AVP, indicating that AVP was
      biologically active at doses which failed to alter ethanol consumption. These
      findings indicate the VP does not affect established ETOH drinking and
      furthermore is not likely a critical factor in the reduction of ETOH intake by
      the RAS.

PMID- 2217504
TI  - Adinazolam both prevents and reverses the long-term reduction of daily activity
      produced by inescapable shock.
AB  - The behavioral consequences of exposure to stressors such as inescapable shock
      are usually quite transitory if testing is conducted in an environment different
      from that in which the stressor was administered. Daily running activity is an
      exception in that it remains depressed for several weeks following experience
      with inescapable shock. In the present experiments we found the administration of
      the triazolbenzodiazepine adinazolam able to both reduce this long-term activity
      reduction produced by inescapable shock when acutely administered before the
      inescapable shock, and to reverse the effect when chronically administered after
      the inescapable shock. Classic 1,4-benzodiazepines such as diazepam have been
      able to prevent such effects when acutely administered before inescapable shock,
      but cannot reverse these effects when provided after the inescapable shock.
      Conversely, classic antidepressants such as desipramine have been unable to
      prevent these behavioral effects when given before inescapable shock in acute
      form, but can reverse the effects with chronic administration following the
      inescapable shock. Our observations that adinazolam can both prevent and reverse
      the effects of inescapable shock are consistent with reports that this agent has
      both anxiolytic and antidepressant effects in clinical use.

PMID- 2217505
TI  - Bright light blocks the capacity of inescapable swim stress to supersensitize a
      central muscarinic mechanism.
AB  - Clinical and basic researchers have proposed that muscarinic cholinergic
      mechanisms mediate some effects of chronic stress. Chronic inescapable (forced)
      swim stress depletes brain biogenic amines and is used to produce learned
      helplessness in rats. Behavioral and biochemical characteristics of animals in
      the state of learned helplessness lead some investigators to believe this
      condition provides a useful animal model of depression. Inescapable swim stress
      also produces supersensitivity to the hypothermic effect of the muscarinic
      agonist oxotremorine in the rat. The authors previously demonstrated that bright
      light potently induces subsensitivity of a central muscarinic mechanism involved
      in the regulation of core temperature under a variety of circumstances. They now
      report using a repeated measures design that inescapable swim stress of five days
      duration produces supersensitivity to oxotremorine (increase in thermic response
      of 405%). This supersensitivity is reversed within five days by treatment with
      bright light, despite continuation of daily swim stress. Daily inescapable swim
      stress was continued beyond cessation of treatment with bright light. Five days
      later, supersensitivity to the hypothermic effect of oxotremorine was once again
      evident.

PMID- 2217506
TI  - Sensitivity of EEG in young rats to toluene exposure.
AB  - Effects of toluene on the electroencephalogram (EEG) and its power spectra were
      measured during a 2-hr exposure in a dynamic inhalational chamber in young rats
      (30-53 days old) and compared to those in adult rats (63-77 days old). Rats were
      exposed to one of the three concentrations [low (108-111 ppm), medium (160-163
      ppm), and high (407-432 ppm)] of toluene on different days. In tests on sleep
      wake cycle, in the young animals the duration of the wake stage (W) was increased
      with decreases of rapid eye movement (REM) and non-REM (NREM) sleep during hr 1
      and hr 2 of exposure to the low concentration. These effects were marked at the
      medium and the high concentrations. In adult rats, at the low concentration the
      increase of W and the decrease of REM were observed only at hr 1; however, at
      medium and high concentrations these changes of W and REM sleep were marked along
      with a decrease of NREM. Comparison of the changes of duration of different
      states in rats of two age groups showed that there was a significant difference
      in the increase of W and the decrease of NREM sleep in young rats at hr 2 of
      exposure to low concentrations only compared to those in adult rats. Tested on
      power spectrum in young rats during REM sleep recorded from the visual cortex,
      the power of delta waves increased at the medium and high concentrations and that
      of theta wave decreased at the high concentration during hr 2 of exposure
      compared to the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2217507
TI  - Central effect of morphine pretreatment on short- and long-term habituation to a
      danger stimulus in the crab Chasmagnathus.
AB  - Morphine is believed to inhibit the crab's escape response to a danger stimulus
      due to central drug action. To test alternative explanations of such an effect in
      terms of afferent and/or efferent impairment, experiments were conducted using
      the crab's optokinetic response as indicator. Doses of morphine with maximal
      detrimental effect on the escape response (75-100 micrograms/g) showed no effect
      on the optokinetic response, both by measuring the crab's eyestalk displacement
      and by recording its body rotation, supporting the hypothesis of a morphine
      central action on the danger-induced escape response. As regards the effect on
      habituation, a 75 micrograms morphine/g injection administered 30 min before the
      first trial produced a parallel shift of the short-term (within-session)
      habituation curve, suggesting a modulatory central drug action that would mimic a
      putative endogenous opioid action. A 100 morphine micrograms/g dose injected 30
      min before training sharply reduced reactivity during training and impaired the
      acquisition of long-term (between-session) habituation. It may be speculated that
      the decrease in the danger meaning of the stimulus due to morphine explains both
      effects in terms of a stimulation impairment during training.

PMID- 2217508
TI  - Antidepressant-like action of nicardipine, verapamil and hemicholinium-3 injected
      into the anterior hypothalamus in the rat forced swim test.
AB  - Male Wistar rats, chronically implanted with cannulas into the anterior
      hypothalamus, were acutely injected with the calcium channel inhibitors,
      diltiazem, nicardipine and verapamil, or the choline uptake blocker hemicholinium
      3 and tested in the forced swim test. Hemicholinium-3, nicardipine and verapamil
      markedly increased the duration of active swimming. This antidepressant-like
      effect did not appear to reflect merely a hyperactive state as the drug-treated
      rats did not differ from vehicle-injected controls in their open field motility
      scores. Diltiazem failed to influence rats' performance in either test. Since
      nicardipine and verapamil, but not diltiazem, share choline uptake property with
      hemicholinium-3, it seems that this action plays a role in the antidepressant
      like effect of all three drugs in the forced swim test.

PMID- 2217509
TI  - Haloperidol impairs classically conditioned nictitating membrane responses and
      conditioning-related cerebellar interpositus nucleus activity in rabbits.
AB  - Rabbits, chronically implanted with recording electrodes in the cerebellar
      interpositus nucleus and following acquisition of a classically conditioned
      eyelid response, were injected with haloperidol (HAL, 250 micrograms/kg). HAL
      significantly reduced the number of conditioned responses when a 75 and 85 dB
      tone conditioned stimulus (CS) was presented but not when a 95 dB tone CS was
      used. There was a corresponding decrease in interpositus activity at the 75 and
      85 dB CS intensities but not at the 95 dB intensity. HAL appeared to disrupt CRs
      and interpositus activity by increasing the intensity threshold of the tone CS
      for eliciting conditioned responses. Possible mechanisms for the effect of HAL on
      neural circuitry involved in classical eyelid conditioning are discussed.

PMID- 2217511
TI  - Differential effects of psychotropic drugs on feeding in rats: is histamine
      blockade involved?
AB  - The present animal studies tested the hypothesis that drug-induced blockade of
      histamine-1 receptors leads to appetite stimulation. Test agents included the
      antipsychotic promazine which has very potent antihistaminic effects, as well as
      the antipsychotic haloperidol and the antidepressant desipramine which both have
      negligible antihistaminic effects. In support of the hypothesis, significant
      appetite stimulation occurred only with promazine, while the other two test
      agents did not increase feeding, and even produced some suppression in food
      intake.

PMID- 2217510
TI  - Effects of Mel B arsobal and alpha-difluoromethylornithine on the awakening
      electroencephalogram of humans with gambiense trypanosomiasis disease:
      preliminary report.
AB  - Five males and three females, at the encephalic stage of sleeping sickness, were
      submitted to trypanocide therapies. Three of the patients were treated with the
      Mel B Arsobal drug, the five others with difluoromethylornithine, using different
      protocols. Awakening electroencephalographic data were obtained prior to
      treatment and, at regular intervals, during and after treatment. Prior to
      treatment the awakening tracings showed important abnormalities (slow delta waves
      were superimposed on theta background rhythms). During treatment (except in one
      patient treated with Arsobal) recordings returned gradually to fast rhythms and
      several days after therapy, tracings returned to the normal awakening patterns.
      The use of the awakening electroencephalogram as a tool to test effects of
      curative drugs in the sleeping sickness syndrome is discussed.

PMID- 2217512
TI  - SCH 23390: D-1 modulation of oral dyskinesias induced in snakes by Xenopus skin
      mucus.
AB  - The granular gland skin secretion of Xenopus laevis induces seven involuntary
      oral dyskinesias and climbing behavior in the water snake Nerodia sipedon. In a
      previous study the D-2 receptor antagonist, haloperidol (HAL), selectively
      potentiated mucus-induced yawning and chewing but attenuated fixed gaping; other
      oral behaviors were unaffected; HAL alone induced no dyskinesias and failed to
      modify mucus-induced decreases in tongue flicking, cage climbing and activity. As
      skin compounds have neuroleptic properties known to induce human and animal
      dyskinesias, we hypothesized that D-1 receptor antagonism may modulate the four
      of seven mucus-induced dyskinesias and the climbing not altered by HAL. We found
      that, like HAL, SCH 23390 (SCH) potentiated mucus-induced yawning, attenuated
      fixed gaping and had no effect on climbing. Unlike HAL's potentiation of chewing,
      SCH attenuated chewing and potentiated writhing tongue movements. SCH alone, like
      skin mucus, attenuated tongue flicking and activity but, given with mucus, SCH
      increased tongue flicking and activity to control levels. Compared to the HAL
      study, results suggest that mucus-induced yawning and fixed gaping are similarly
      modulated by both HAL and SCH, while these drugs have opposite effects on
      writhing tongue and chewing. SCH given alone or with frog mucus had unique
      effects on activity and normal tongue flicking.

PMID- 2217514
TI  - Tonic nociception in neonatal rats.
AB  - The issues of whether infants detect noxious stimuli and whether their
      nociceptive responses are suppressed by analgesics has been the focus of
      considerable controversy. Therefore, to more completely assess the nociceptive
      responses of neonatal rat pups to tonic pain, we tested 3-day-old rat pups using
      the formalin test. The responses of the young pups to formalin-produced injury
      were similar to those observed in adult rats, both behaviorally and in terms of
      their responsivity to morphine-induced antinociception. These results provide the
      first clear-cut evidence of integrated tonic pain responses in the neonate.

PMID- 2217513
TI  - Physostigmine facilitation of lordosis in naturally cycling female rats.
AB  - Both systemic and intracerebral administrations of the cholinergic muscarinic
      antagonist, scopolamine, have been shown to inhibit naturally occurring sexual
      behavior in intact, cycling female rats. The present study examined the
      facilitative effects of the acetylcholinesterase inhibitor, physostigmine
      (eserine), on sexual behavior in intact, cycling female rats. Cycling was
      determined by daily monitoring of sexual behavior and vaginal cytology. When
      administered during either early proestrus or proestrus, physostigmine activated
      lordosis 15 min and 1 hr after intraventricular infusion (10 micrograms
      bilaterally). However, infusion of physostigmine failed to facilitate lordosis 15
      min after administration during either diestrus I, mid-diestrus, or diestrus II.
      The administration of this cholinergic agent did not interrupt cyclicity
      patterns. Because estrogen levels are highest during proestrus and cholinergic
      facilitation appears to be limited to this time, it is suggested that estrogen
      priming of central cholinergic systems is necessary for the cholinergic
      regulation of sexual behavior in intact, cycling female rats.

PMID- 2217515
TI  - Microinfusion of bombesin into the hypothalamic paraventricular nucleus produces
      hypothermia in the insulin-pretreated rat.
AB  - Bombesin-like peptides are widely distributed in the mammalian central nervous
      system and participate in the regulation of a variety of autonomic functions.
      Central injection of bombesin produces hypothermia at normal ambient
      temperatures, but only if the rat has been food-deprived or made hypoglycemic
      with insulin. Two experiments were conducted to reevaluate the impact of bombesin
      microinfusion into the hypothalamic paraventricular nucleus (PVN) on core body
      temperature and feeding behavior. In Experiment 1, bombesin (0.05 and 0.1
      microgram/1.0 microliter) produced hypothermia, but not hypophagia, in rats (n =
      5) pretreated with insulin (10 U/kg; IM). Since a similar response was observed
      in rats with injection sites adjacent to the PVN, a smaller injection volume was
      evaluated in Experiment 2. Hypothermia, but not hypophagia, was observed in rats
      (n = 5) pretreated with insulin following bombesin (0.025 and 0.05 micrograms/0.5
      microliter). Bombesin did not produce hypothermia in rats with injection sites
      outside of the PVN. These findings suggest that the PVN is a sensitive site for
      bombesin-induced hypothermia.

PMID- 2217516
TI  - The effects of cocaine on food intake of baboons before, during, and after a
      period of repeated desipramine.
AB  - Food intake of five adult male baboons (Papio c. anubis) was monitored during
      daily 22-hr experimental sessions. Food was available under a chain schedule with
      two components. Following completion of the "procurement" component, the first
      response requirement, access to food, i.e., a meal, became available under the
      second, "consumption" component, during which each response produced a 1 g food
      pellet. After a 10-min interval in which no response occurred, the consumption
      component was terminated. Complete dose-response functions for cocaine (0.50-4.0
      mg/kg, IM) and desipramine (0.50-4.0 mg/kg, IM), were determined before, during,
      and after a period of repeated administration of desipramine. Cocaine produced
      dose-dependent increases in the latency to initiate feeding and decreases in food
      intake during the first eight hr of the session. Compensatory feeding occurred
      later in the session so that cocaine had no effect on total daily intake. There
      was no interaction between repeated desipramine and the acute effects of cocaine.
      Desipramine produced dose-dependent decreases in intake during the first two hr
      of the session, the size of the first meal and intake during the entire session.
      These measures, as well as number of meals and second meal size, remained below
      baseline during repeated desipramine. Thus, repeated desipramine, while having
      significant effects on feeding behavior itself, did not influence the effects of
      cocaine administration on food-maintained responding.

PMID- 2217518
TI  - Sensitization versus tolerance to haloperidol-induced catalepsy: multiple
      determinants.
AB  - The effects of dose, administration frequency, and behavioral testing conditions
      on the development of tolerance versus sensitization to haloperidol-induced
      catalepsy were tested in rats. Animals received daily or weekly injections of
      haloperidol (0.05-5.00 mg/kg SC) for up to 22 days. Catalepsy assessments were
      made either once or repeatedly using two tests: the horizontal bar and the
      inclined screen. Tolerance was found only in animals treated daily with
      haloperidol (1.5 mg/kg) and tested repeatedly on the horizontal bar. In contrast,
      sensitization was observed with various haloperidol doses, daily or weekly
      administration schedules (for most doses), either horizontal bar or inclined
      screen catalepsy tests, and repeated or single testing. Sensitization developed
      most strongly following weekly drug administration and repeated testing on the
      horizontal bar. No single experimental variable produced a definitive pattern of
      change in catalepsy over time. Dose, drug administration schedule, and behavioral
      test conditions all influenced the evolution of catalepsy during chronic
      haloperidol treatment.

PMID- 2217517
TI  - Sodium arsanilate-induced vestibular dysfunction in rats: effects on open-field
      behavior and spontaneous activity in the automated digiscan monitoring system.
AB  - Vestibular dysfunction was chemically induced in Long-Evans rats by intratympanic
      injections (30 mg per side) of sodium arsanilate (atoxyl). Following a one-week
      recovery period the rats were behaviorally assayed for integrity of the
      labyrinthine systems. All subjects were tested for presence of the air-righting
      reflex, the contact-righting reflex (by lightly holding a sheet of Plexiglas
      against the soles of the rat's feet), and body rotation-induced nystagmus. All
      animals were then tested for their ability to remain on a small (15 x 15 cm)
      platform. Next, the subjects were given two 10-min open-field tests during which
      ambulation, rearing, grooming, and defecation responses were recorded. Four to
      five weeks later all rats were tested twice (60 min per session) in the automated
      Digiscan Activity Monitor which provides a multivariate assessment of spontaneous
      motor activity. The rats with vestibular dysfunction (Group VNX) took
      significantly less time to fall off the platform (p less than 0.01). They also
      exhibited significantly more open-field ambulation but fewer rearing responses
      (ps less than 0.01). An examination of group correlation coefficients for open
      field variables and the platform test scores revealed some interesting group
      differences (ps less than 0.05). In the Digiscan tests the atoxyl-treated rats
      exhibited fewer number of horizontal movements, but increased speed for these
      movements (ps less than 0.05). Vertical movements did not differ significantly in
      incidence, but these movements were greatly reduced in duration (p less than
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2217520
TI  - Chronic stress and memory: implication of the central cholinergic system.
AB  - Restraint stress for ten days (two times two hours daily) induces a
      hypersensitivity of the central cholinergic system, reflected by antagonism to
      amnesia induced by scopolamine at 0.1 mg/kg in a passive avoidance test and by
      hypersensitivity to the hypothermic effect of oxotremorine at 1 mg/kg. A
      restraint stress for 30 days, on the other hand, diminishes animal retention in
      the passive avoidance test and causes a hyposensitivity to oxotremorine-induced
      hypothermia, reflecting a hypoactivity of the central cholinergic system. An
      acute 24-hour stress causes no change. The relationship between chronic stress
      and associated memory deficits is discussed.

PMID- 2217519
TI  - Cocaine and body temperature in the rat: effect of exercise.
AB  - The laboratory rat is being studied as a model to determine if abuse of cocaine
      constitutes a risk factor in the pathogenesis of stress or exertion induced
      heatstroke. During running on a treadmill for 60 min under thermoneutral
      conditions (Ta 22 degrees C) a rise in core temperature of approximately 1 degree
      C was recorded. Injection of cocaine (10 or 20 mg/kg IP) or its vehicle (0.9%
      NaCl solution) did not modify the running behavior or the core temperature
      change. Cocaine (30 mg/kg IP) led to a significant increase in the core
      temperature (compared to animals treated with saline or the lower doses of
      cocaine) at 45 and 60 min. The rats recovered rapidly following cessation of
      exercise. Repeated (3) injections of cocaine (30 mg/kg) at 7-day intervals did
      not alter the magnitude of the final hyperthermia, i.e., neither tolerance nor
      potentiation were in evidence.

PMID- 2217521
TI  - Ethanol reduces tolerance, sensitization, and up-regulation of D2-receptors after
      subchronic haloperidol.
AB  - To study the interrelationships between dopamine D2-receptor density and
      behavioral responses after chronic treatment with neuroleptics female Wistar rats
      received haloperidol (HP; 14 mg/l), ethanol (ETOH; 5 vol.%), a combination of
      both, or tap water as drinking fluids for one or two weeks. Mean intake doses
      ranged between 1.28 and 1.48 mg/kg/day (HP) and between 3.7 and 4.8 g/kg/day
      (ETOH). HP administered for one or two weeks raised the number of
      [3H]spiroperidol binding sites in the striatum by 55%. Concomitant administration
      of ETOH diminished the increase of Bmax to 23%. The up-regulation was even
      reversed when ETOH was added with a delay of one week, although the drug alone
      had no effect on dopamine-D2-receptor density. KD values were not substantially
      affected. During HP treatment the rats established a tolerance to the motor
      sedation which was measured by circadian motility recordings. Coadministration of
      ETOH reduced the development of tolerance, the activity remained at a depressed
      level. Acute applications of HP (0.3, 0.6, and 0.9 mg/kg, or saline,
      respectively) also revealed tolerance to the drug for various behavioral
      responses (exploratory locomotion, rearing, rotarod performance, catalepsy). The
      tolerance was reduced in all those animals which had received combinations of
      ETOH and HP. The reduction was most pronounced for the cataleptic response.
      Pretreatment with ETOH alone had no effect. Sensitization to dopamine agonists
      was studied by apomorphine-induced stereotypies (licking, sniffing, and forepaw
      scratching). As expected, chronic HP enhanced the responses. The increased number
      of stereotypies was reduced in rats pretreated with the combination, although
      ETOH alone did not affect the response. The reduction was most pronounced for
      licks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2217522
TI  - Differential actions of RO 15-1788 and diazepam on poikilothermia, motor
      impairment and sleep produced by ethanol.
AB  - In adult male Sprague-Dawley rats kept at an ambient temperature of 23-25 degrees
      C, ethanol was injected intraperitoneally in a dose of 4.0 g/kg to produce a
      clear-cut impairment of autonomic and motorial functions. Following the injection
      of ethanol, motor coordination, measured on a rotorod, behavioral sleep, righting
      reflex and colonic temperature were monitored at predetermined intervals for 5.0
      7.0 hr. In the first experiment, either 1.0 mg/kg RO 15-1788 (flumazenil), a
      benzodiazepine (BZ), receptor antagonist, or 1.0-5.0 mg/kg diazepam, a classical
      benzodiazepine receptor agonist, were injected intraperitoneally either alone or
      concurrently with ethanol's administration. In the second study, either RO 15
      1788 (1.0 or 2.0 mg/kg) or diazepam (1.0 or 5.0 mg/kg) was injected at the nadir
      of the fall of body temperature induced by ethanol. Although RO 15-1788 alone
      failed to affect the rats' temperature, it did not prevent the characteristic
      ethanol-induced hypothermia but rather potentiated it in a dose-dependent manner.
      Further, this BZ receptor antagonist exacerbated motor incoordination and other
      behavioral effects when given either simultaneously with ethanol or at the nadir
      in the animals' core temperature. Although diazepam evoked a dose-dependent
      hypothermia, it did not enhance ethanol-induced hypothermia when both drugs were
      administered simultaneously. However, diazepam augmented motor incoordination and
      other effects and served to delay their recovery. When given to the rats at the
      nadir of ethanol hypothermia, diazepam did not potentiate ethanol's thermolysis
      but retarded the recovery from hypothermia; it caused also a dose-dependent delay
      in the recovery of motor coordination and other responses.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2217523
TI  - Learning abilities of rats in multiple T-mazes of two degrees of complexity under
      the influence of d-amphetamine.
AB  - The effect of d-amphetamine on the learning capacity of male Wistar rats was
      investigated in multiple T-mazes in two experiments of increasing or decreasing
      degree of difficulty. Running speed, distance covered and the number of errors
      were scored to indicate proficiency and success of learning. These parameters, as
      well as the distribution of errors (goal-directed orientation), correction of
      errors (situational orientation) and latency at the decision points
      (discrimination time) were considered to represent cognitive components. The
      results demonstrated an experiment effect in that the rats showed more difficulty
      in learning, as exhibited by a slower running speed and more errors, in the maze
      with successively increasing demands than in the one with decreasing demands.
      Oral self-administered d-amphetamine in a dosage of 3-4 mg/kg/day or 7-8
      mg/kg/day significantly increased the running speed in a dose-dependent manner.
      By contrast, success of learning and goal-directed orientation decreased.
      Situational orientation was, however, dose-dependently improved, at least in the
      experiment with the increasing demand.

PMID- 2217524
TI  - Dose effects on heart rate conditioning when pentobarbital is the CS and
      amphetamine is the US.
AB  - If sodium pentobarbital is injected into rats 30 min prior to d-amphetamine
      sulphate on four or five occasions, there is a learned effect of pentobarbital on
      heart rate. The conditioned response is a higher heart rate than found in rats
      with a control history of exposure to the same drugs. In Experiment 1, when the
      pentobarbital dose was 32 mg/kg throughout, this effect was obtained with
      amphetamine doses of 2, 4, 8, or 16 mg/kg. In Experiment 2, when the amphetamine
      dose was 12 mg/kg throughout, pentobarbital doses of 16 and 32 mg/kg yielded
      conditioning, while 8 mg/kg yielded equivocal results.

PMID- 2217525
TI  - Pentobarbital attenuates stress-induced increases in noradrenaline release in
      specific brain regions of rats.
AB  - To examine whether anxiolytic action of drugs acting at the GABA/BZD-chloride
      channel complex may be related to the brain noradrenergic system, we investigated
      the effect of pentobarbital, a typical barbiturate which has potent GABA
      modulating properties, on increased NA release in nine brain regions of stressed
      rats. Pentobarbital (10 and 25 mg/kg) was injected IP 65 min before sacrifice (5
      min before one-hour immobilization stress). Levels of 3-methoxy-4
      hydroxyphenylethyleneglycol sulfate (MHPG-SO4), the major metabolite of brain
      noradrenaline (NA), and of plasma corticosterone, were fluorometrically
      determined. Pentobarbital treatment by itself increased MHPG-SO4 levels in the
      thalamus, locus coeruleus (LC) region, midbrain and basal ganglia of nonstressed
      rats. Stress produced increases in MHPG-SO4 levels in all brain regions examined
      and elevation of plasma corticosterone levels. Pentobarbital attenuated, in a
      dose-dependent manner, stress-induced increases in MHPG-SO4 levels in the
      hypothalamus, thalamus, anterior cerebral cortex, LC region and basal ganglia and
      also attenuated the stress-induced elevation of plasma corticosterone levels.
      These data suggest that pentobarbital can attenuate both stress-induced increases
      in NA release in specific brain regions as well as activation of the hypothalamo
      pituitary-adrenocortical system. These attenuating effects may be related to the
      anxiolytic action of barbiturates.

PMID- 2217526
TI  - Comparison of DuP 996, with physostigmine, THA and 3,4-DAP on hypoxia-induced
      amnesia in rats.
AB  - DuP 996, 3,3-bis(4-pyrindinylmethyl)-1-phenylindolin-2-one, physostigmine (PH),
      tetrahydroaminoacridine (THA) and 3,4-diaminopyridine (3,4-DAP) were compared for
      their ability to protect against hypoxia-induced performance deficits in a
      passive avoidance (PA) task. The ability to retain PA response was found to
      decrease as the oxygen concentration decreased with the largest retention deficit
      occurring at 6.5% oxygen. DuP 996 (0.01-0.1 mg/kg SC), 3,4-DAP (0.1-10.0 mg/kg
      SC), THA (0.3-5.0 mg/kg SC) and PH (0.001-0.1 mg/kg SC) administered one minute
      after PA training produced dose-dependent increases in retention latencies
      following exposure to 6.5% oxygen. In comparing each compound for side effects,
      DuP 996 induced tremor and mortality at 10 and 40 mg/kg SC, respectively, and PH
      at 0.3 and 0.8 mg/kg SC, respectively. With PH the 0.3 mg/kg SC dose also
      produced hypersalivation and a decrease in lift strength. THA produced tremor and
      mortality at 6.0 and 40 mg/kg SC, respectively, and 3,4-DAP at 50 and 200 mg/kg
      SC, respectively. 3,4-DAP also produced chromodacryorrhea and hypersalivation at
      50 mg/kg SC. Dividing the dose necessary to produce mortality by the highest
      effective dose active in the hypoxia test yielded a safety ratio for DuP 996 of
      400, for 3,4-DAP 20, for PH 8, and for THA 8, showing a greater safety margin for
      DuP 996 than the other cholinergic agents. These results suggest that DuP 996 may
      be of use in the treatment of diseases associated with cognitive impairment and
      may have a greater safety margin than other cholinergic agents.

PMID- 2217527
TI  - Effects of an extract of Ginkgo Biloba (EGB 761) on "learned helplessness" and
      other models of stress in rodents.
AB  - The effects of repeated oral administration of an extract of Ginkgo Biloba (EGB
      761) on various behavioral models of stress in rodents were investigated. The
      models in rats included "learned helplessness," shock-suppressed licking (Vogel
      conflict test) and forced swimming-induced immobility ("behavioral despair"). The
      models in mice included shock-suppressed exploration (four plates test),
      spontaneous exploration (staircase test) and food consumption in a novel
      situation (emotional hypophagia). Further tests in rats examined the effects of
      EGB 761 on memory (passive avoidance test) and responsiveness to shock to
      determine whether the preventive effects observed with EGB 761 in the learned
      helplessness procedure were due either to drug-induced impairment of memory or to
      reduced shock sensitivity. In all experiments EGB 761 was administered over 5
      days at daily doses of 50 and 100 mg/kg PO. In some experiments (Vogel test, four
      plates test, staircase test, emotional hypophagia) the effects of acute
      administration were also investigated. The results showed that repeated
      administration of EGB 761 (50 and 100 mg/kg/day) before exposure to unavoidable
      shock (preventive treatment) clearly reduced the subsequent avoidance deficits in
      the learned helplessness procedure but was less effective when first administered
      after "helplessness" induction (curative treatment). EGB 761 did not affect
      performance in the passive avoidance task or alter the animals' response to
      electric shock, suggesting that the effects observed in the learned helplessness
      procedure were not due to impaired memory or reduced shock sensitivity.
      Anxiolytic-like activity was also seen in the emotional hypophagia test in mice
      where repeated administration of EGB 761 increased the amount of food
      consumed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2217528
TI  - Ouabain injected into the hypothalamus elicits pressor responses in anaesthetized
      rats: a mapping study.
AB  - Cardiac glycosides are known to have a narrow therapeutic index, due in part to
      their effects on the brain. Injections of cardiac glycosides into the ventricles
      of the brain elicit activation of the autonomic nervous system, and may even
      elicit cardiac arrhythmias. However, the specific brain regions responsible for
      such action are unknown. The hypothalamus receives chemo- and baro-receptive
      innervation from the cardiovascular system. In turn, there are both direct and
      indirect effector pathways from the hypothalamus accessing the sympathetic
      preganglionic and parasympathetic ganglia regions. This suggests that the
      hypothalamus may be a prime candidate for the central toxic effects of cardiac
      glycosides. The purpose of this experiment was to map the rostral diencephalon to
      determine sites at which injections of a low dose of the cardiac glycoside,
      ouabain, resulted in altered cardiovascular responses in the anaesthetized rat.
      Microinjections of 20 ng of ouabain in 200 nl were made into sites throughout the
      rostral diencephalon of urethane (1.2 g/kg) anaesthetized rats while monitoring
      heart rate and blood pressure. Injections into the nucleus medianus,
      paraventricular, anterior and posterior hypothalamic nuclei produced increases in
      pressure of from 5 to 25 mmHg. These data suggest that part of the toxicity
      resulting from the cardiac glycoside administration may be due to the direct
      action of the glycosides on these hypothalamic structures. The paraventricular
      region has the greatest sensitivity and may be a primary target due to its direct
      connections with the preganglionic sympathetic regions in the spinal cord.

PMID- 2217529
TI  - Effects of fixed-ratio requirement on observed tolerance to decreased responding
      by clonidine.
AB  - Responding of rats was maintained under either a 10- or a 40-response fixed-ratio
      schedule, and "local" rates of responding were 0.29-0.37 responses per sec for
      both schedules. Clonidine decreased responding for both schedules in a similar
      and dose-dependent manner, and the largest dose tested (0.3 mg/kg) completely
      suppressed behavior. When 0.1 mg/kg was administered immediately prior to 30
      daily experimental sessions, FR10 responding recovered to control levels within
      15 sessions, whereas FR40 responding recovered only to approximately 60% of
      control level at asymptote. These results continue to identify boundary
      conditions for the influence of reinforcer loss on tolerance development, and
      they emphasize the overriding influence of behavioral processes on observed
      tolerance to the behavioral effects of drugs.

PMID- 2217530
TI  - Pharmacology of drugs that alter multidrug resistance in cancer.

PMID- 2217531
TI  - Antiepileptic drugs: pharmacological mechanisms and clinical efficacy with
      consideration of promising developmental stage compounds.

PMID- 2217532
TI  - The roles of nurses' associations and individual nurses in promoting health by
      safeguarding the environment.

PMID- 2217533
TI  - Twelve tips to protect your environment and your health (World Health
      Organization).

PMID- 2217534
TI  - Philippine population development: a nursing concern.

PMID- 2217535
TI  - In vivo measurement of total body carbon using 238Pu/Be neutron sources.
AB  - Total body carbon has been measured by in vivo neutron activation analysis
      (IVNAA) in 278 surgical gastroenterological patients and 29 normal volunteers.
      This is based on the inelastic scattering reaction [12C (n,n') 12C*] for neutrons
      with energy above 4.8 MeV, producing 4.43 MeV gamma rays. Since only part of the
      body is scanned, total body carbon is estimated as the ratio of the gamma ray
      emission from carbon to the emission from hydrogen, using hydrogen as the
      internal standard. The precision of the estimate is +/- 1.6 kg for a whole body
      dose of 0.3 mSv. There is a significant difference between the estimates of total
      body water from IVNAA measurements of carbon and nitrogen and measurements of
      body water in these subjects by tritium dilution (t = 3.1, p less than 0.005).

PMID- 2217536
TI  - Automatic computer detection of clustered calcifications in digital mammograms.
AB  - The automatic detection of clusters of calcifications in digital mammograms has
      been investigated using image analysis techniques. The calcifications were
      segmented from the background of normal breast structure in the mammogram using a
      local area thresholding process. This procedure also identified other breast
      structures and the digital image properties of all segmented objects were
      analysed to extract clusters of calcifications. Seventy five clinical mammograms
      were digitised. These were divided into training and test sets of 25 and 50 films
      respectively. The results for the test set of 50 complete clinical mammograms
      show that the computer system achieves a 25/25 true positive film classification
      (i.e. those containing clusters of calcifications) with false positive clusters
      detected in 4/50 films. There were no false negative film classifications.

PMID- 2217537
TI  - The distribution of induced currents in magnetic stimulation of the nervous
      system.
AB  - Magnetic stimulation of the nervous system is being used as an alternative to
      electrical stimulation, principally because it is painless. The spatial
      distribution of induced currents from the stimulating coil is calculated from a
      computer model with graphical output. Two configurations of a plane circular coil
      are considered: parallel to the tissue surface and perpendicular to the surface.
      The surface is assumed planar and infinite in extent. The tissue is modelled as a
      uniform, isotropic volume conductor. A quasi-static approximation is made in
      calculating the electric field. Maps of current density, J, as a function of
      position, including depth, are shown. In both configurations, J is always
      parallel to the surface, and is maximum at the surface. There is no perpendicular
      (vertical) current. For a one-turn 10 cm diameter coil, spaced 1 cm from
      conducting tissue and parallel to it, with rate of change of current 10(8) A s(
      1), Jmax = 6.8 A m(-2) (assuming conductivity 0.2 omega -1 m(-1)). In the
      perpendicular configuration Jmax = 4.1 A m(-2). These results suggest that nerve
      fibres running parallel to the skin surface are more likely to be stimulated than
      those running obliquely; and that it is extremely difficult to stimulate nerve
      fibres running perpendicularly. This model can be used to characterise the
      performance of other shapes of stimulating coils and the dependence on fibre
      orientation.

PMID- 2217538
TI  - Explosive onset of continuous wave laser tissue ablation.
AB  - The phenomena at the onset of and during tissue ablation using continuous wave
      lasers were studied. Aortic and myocardial bovine tissues were exposed in air and
      in water to Nd-YAG (10 to 60 W) and argon (3.5 W) laser light. The transmitted
      light was measured, the surface of the tissue was filmed and the tissue was
      processed for histology. Three distinct phases were observed. Phase A was tissue
      denaturation. Phase B started with explosive vaporisation ('popcorn') in
      conjunction with a drop of about 50% in light transmission due to enhanced
      reflection and scattering. The 'popcorn' is possibly associated with a layered
      structure of the tissue. Phase C started with carbonisation of the tissue
      beginning in the centre and expanding in a cyclic fashion while the tissue was
      vaporised leaving a crater. Forward light transmission did not decrease. Thin
      layers of carbon (20 microns) and vacuoles (30 microns) suggested a large
      temperature gradient along the tissue ablation front. The ablation velocity was
      constant (r greater than 0.92) and tissue dependent. Reported models on laser
      tissue ablation need to be extended to include explosive vaporisation ('popcorn')
      at the onset and cyclic carbonisation during steady-state crater formation.

PMID- 2217539
TI  - Concurrent and construct validity of the Pediatric Evaluation of Disability
      Inventory.
AB  - The purpose of this study was to determine the validity of the Development
      Edition (pilot version) of the Pediatric Evaluation of Disability Inventory
      (PEDI) in groups of disabled and nondisabled children. The PEDI is a new
      functional assessment instrument for the evaluation of disabled children aged 6
      months to 7 years. The PEDI has been developed to identify functional status and
      change along three dimensions: 1) functional skill level, 2) caregiver
      assistance, and 3) modifications or adaptive equipment used. The PEDIs were
      administered as a parental-report questionnaire, and the results were compared
      with data obtained by the Battelle Developmental Inventory Screening Test
      (BDIST). The BDIST is a standardized assessment with developmental and adaptive
      content. Subjects were 20 children between the ages of 2 and 8 years with
      arthritic conditions and spina bifida and 20 nondisabled children matched for age
      and sex. All subjects' scores on the BDIST cognitive domain were no greater than
      1.50 standard deviations below the mean for their age group. Concurrent validity
      was supported by moderately high Pearson product-moment correlations between
      BDIST and PEDI summary scores (r = .70-.80). Construct validity was supported by
      significant differences between the disabled and nondisabled groups' PEDI scores
      and by discriminant analysis identifying the PEDI scores as better group
      discriminators than the BDIST scores. Results validate the Developmental Edition
      of the PEDI and support the further development and standardization of the final
      version. Use of the PEDI in clinical pediatric physical therapy practice is
      discussed.

PMID- 2217541
TI  - Preservation of force output through progressive reduction of stimulation
      frequency in human quadriceps femoris muscle.
AB  - The purpose of this study was to determine the effects of a reduction in the
      pulse frequency on the fatigue rate of human quadriceps femoris muscle during
      intermittent (8-second) contractions. Twelve healthy subjects each participated
      in two experimental sessions. Thirty cycles (cycle time: 8 seconds "on"/12
      seconds "off") were applied during each session. During one session, a frequency
      of 60 pulses per second (pps) was used for all trains. During the other session,
      the subjects were stimulated with 60 pps for the first train. The stimulating
      frequency of each train was then progressively reduced, in 5-pps steps, for
      contractions 2, 3, 5, 8, 12, and 20. By the fifth contraction, the differences in
      average force produced by the 60-pps trains and the reduced-frequency trains were
      significant. The difference between the two conditions increased, with the
      variable-frequency protocol producing 46% more force than the constant-frequency
      protocol during the last contraction. These results showed that, compared with a
      constant pulse frequency, reducing the pulse frequency during a fatiguing
      contraction can markedly decrease the rate of force fatigue of skeletal muscle.
      This finding suggests that a variable-frequency protocol, similar to the one used
      in this may prove to be a more effective pattern of stimulation for activation of
      skeletal muscle than the traditionally used constant-frequency protocol.

PMID- 2217540
TI  - Lumbar curvature in standing and sitting in two types of chairs: relationship of
      hamstring and hip flexor muscle length.
AB  - A purpose of this study was to determine the difference in the lumbar curves of
      subjects while they stood compared with while they sat in two chairs with
      different seat angles--the Balans Multi-Chair (BMC) and a standard conventional
      chair (SCC). An additional purpose was to determine the relationship between
      lumbar curvature and 1) anthropometric factors and hamstring and hip flexor
      muscle length during standing and during sitting in the two chairs and 2) amount
      of time spent sitting. Sixty-one men between 20 and 30 years of age served as
      subjects. Lumbar curve measurements were taken with a flexible ruler with the
      subjects first standing and then sitting in the two chairs. Hamstring and hip
      flexor muscle lengths were indicated by range-of-motion measurements taken with a
      gravity goniometer. Age, number of hours spent sitting per day, upper body
      length, and right leg length also were recorded. Subjects had significantly more
      lumbar extension when they sat in the BMC than when they sat in the SCC. Hip
      flexor length was the only factor that appeared to relate significantly to the
      difference between the standing lumbar curve and the lumbar curves in the BMC and
      the SCC.

PMID- 2217542
TI  - Effects of neuro-developmental treatment and orthoses on knee flexion during
      gait: a single-subject design.
AB  - The interactive effects of neuro-developmental treatment and inhibitive ankle
      height orthoses on gait were examined via a single-subject research design. Knee
      flexion during gait at initial contact, mid-stance, heel-off, and mid-swing were
      measured in a 2-year-old girl with diplegia by use of a goniometer and freeze
      frame videography. During the treatment and treatment/orthoses phases, a decrease
      in excessive knee flexion was noted. Changes in trend over time were greater in
      the 3-week treatment phase than in the 3-week treatment/orthoses phase. Changes
      in level at the initiation of the treatment/orthoses phase were greater than in
      the treatment phase. The described neuro-developmental treatment activities were
      conducted correctly 92% of the time according to an independent observer. The
      interrater reliability of goniometric data measured by videography was .93 using
      intraclass correlation coefficients. The results of this study suggest that both
      methods of treatment can be used to decrease excessive knee flexion during gait
      in a child with diplegia.

PMID- 2217544
TI  - Conditioning of the spinal stretch reflex: implications for rehabilitation.
AB  - The purpose of this article is to describe a new technique that can potentially
      be applied to patients with hyperactive spinal stretch reflexes (SSRs). The
      progression of clinical research from conditioning of individual muscles or
      muscle groups (electromyographic biofeedback) to conditioning SSRs is explained.
      Research data from subhuman primates in addition to the first human experiments
      are reviewed. Potential applications of SSR conditioning are discussed, as are
      the issues requiring further delineation and research before the specificity of a
      training effect can be ascertained.

PMID- 2217545
TI  - Body-composition assessment using underwater weighing techniques.
AB  - Health care professionals recommend that assessment of body composition be
      included as a part of an adult fitness program. Underwater weighing, based on
      Archimedes' principle, is the most valid technique for assessment of percentage
      of body fat and lean tissue in a clinical setting. This article presents a
      computer program written in BASIC that performs all of the decision-making
      calculations and provides the user with a tabular and a graphical summary of
      current body composition in addition to recommendations for changes in body
      composition that will enhance the subject's health.

PMID- 2217543
TI  - Whole-body movements during rising to standing from sitting.
AB  - Rising to a standing position from a sitting position is one of the most
      important activities of daily life. We present a total-body analysis of rising
      from a chair as performed by nine healthy individuals under controlled
      conditions. We describe four phases of this activity. Phase I is a flexion
      momentum phase used to generate the initial momentum for rising. Phase II begins
      as the individual leaves the chair seat and ends at maximal ankle dorsiflexion.
      Forward momentum of the upper body is transferred to forward and upward momentum
      of the total body. Phase III is an extension phase during which the body rises to
      its full upright position. Phase IV is a stabilization phase. Kinetics and
      kinematics of the phases are analyzed. The phases are differentiated in terms of
      momentum and stability characteristics. Clinical implications of the mechanics of
      rising are discussed.

PMID- 2217546
TI  - Cell membrane DNA: a new target for psoralen photoadduct formation.
AB  - The effects of 8-methoxypsoralen plus long wavelength ultraviolet radiation on
      cell membrane DNA were examined. Treatment of human lymphocytes with 100 ng/ml 8
      methoxypsoralen and 5 J/cm2 UVA led to the formation of 7.1 +/- 3.8 photoadducts
      per million bases. A monoclonal antibody, specific for 8-methoxypsoralen 4',5'
      monoadducts, was used to detect photoadducts in the cell membrane DNA of human
      lymphocytes and three lymphoblastoid cell lines. Treatment of lymphocytes with 8
      MOP and UVA reduced the lymphocyte DNA binding capacity by 56%. Cell membranes of
      normal lymphocytes were shown to contain three high affinity DNA binding proteins
      of 28, 59, and 79 kDa, respectively.

PMID- 2217547
TI  - Quinone sensitized electron transfer photooxidation of nucleic acids: chemistry
      of thymine and thymidine radical cations in aqueous solution.
AB  - The 2-methyl-1,4-naphthoquinone (MQ) sensitized photooxidation of nucleic acid
      derivatives has been studied by laser flash photolysis and steady state methods.
      Thymine and thymidine, as well as other DNA model compounds, quench triplet MQ by
      electron transfer to give MQ radical anions and pyrimidine or purine radical
      cations. Although the pyrimidine radical cations cannot be directly observed by
      flash photolysis, the addition of N,N,N',N'-tetramethyl-1,4-phenylenediamine
      (TMPD) results in the formation of the TMPD radical cation via scavenging of the
      pyrimidine radical cation. The photooxidation products for thymine and thymidine
      are shown to result from subsequent chemical reactions of the radical cations in
      oxygenated aqueous solution. The quantum yield for substrate loss at limiting
      substrate concentrations is 0.38 for thymine and 0.66 for thymidine. The
      chemistry of the radical cations involves hydration by water leading to C(6)-OH
      adduct radicals of the pyrimidine and deprotonation from the N(1) position in
      thymine and the C(5) methyl group for thymidine. Superoxide ions produced via
      quenching of the quinone radical anion with oxygen appear to be involved in the
      formation of thymine and thymidine hydroperoxides and in the reaction with N(1)
      thyminyl radicals to regenerate thymine. The effects of pH were examined in the
      range pH 5-8 in both the presence and absence of superoxide dismutase. Initial
      C(6)-OH thymine adducts are suggested to dehydrate to give N(1)-thyminyl
      radicals.

PMID- 2217549
TI  - Theoretical study of electronic spectra and photophysics of uracil derivatives.
AB  - The changes that the UV absorption spectrum and the photophysics of uracil
      undergo under hydrogen substitution or deprotonation, were studied theoretically
      within the CS-INDO/CI scheme. First of all this method was tested on uracil. It
      was then used for the calculation of the electronic structure of excited states
      (Sn, Tn) of a large number of uracil derivatives (1-, 3- and 5-methyluracil; 1,3
      , 1,5- and 3,5-dimethyluracil; 5-fluoro- and 5-chlorouracil), including some
      anions (1- and 3-methyluracil anion). The excited states were obtained in the
      singly-excited configuration interaction approximation (S-CI) and the correlation
      effects on (pi pi*) states were studied by including the most important doubly-
      and triply-excited configurations in the CI. The S-CI wavefunctions were used for
      the calculation of the most important electronic matrix elements for spin-orbit
      coupling. The photophysics of these compounds is discussed using Jablonski
      diagrams.

PMID- 2217548
TI  - Anthralin-derived transients--II. Formation of the radical by spontaneous
      fragmentation of both singlet and triplet states of the 10,10'-dehydrodimer:
      radical pair multiplicity effects.
AB  - The singlet and triplet states of the anthralin (1,8-dihydroxy-9-anthrone)
      dehydrodimer have been produced selectively in benzene via pulsed laser
      excitation and pulse radiolysis respectively. The lifetime of S1 is less than or
      equal to 30 ps, that of T1 short but unspecified. Both states fragment
      spontaneously to yield a pair of anthralin radicals. The singlet radical pair
      predominantly undergoes geminate recombination within the solvent cage. In
      contrast, the corresponding triplet radical pair undergoes essentially exclusive
      cage escape to give the anthralin free radical (lambda max 370, 490 and 720 nm)
      which recombines under normal diffusive conditions. Both recombination processes
      lead, at least in part, to one or more species which have been assigned as
      tautomeric forms of the original dimer. The anthralin free radical in benzene is
      insensitive to the vitamin E model 6-hydroxy-2,2,5,7,8-pentamethylchroman and
      reacts only slowly with oxygen.

PMID- 2217550
TI  - Ultraviolet light induces double-strand breaks in DNA of cultured human P3 cells
      as measured by neutral filter elution.
AB  - Neutral filter elution at pH 7.2 and 9.6 was used to measure the induction of DNA
      lesions in human P3 teratocarcinoma cells by monochromatic 254-, 270-, 313-, 334
      , 365-, and 405-nm radiation and by 60 gamma rays. In this assay DNA double
      strand breaks (dsb) increase the rate of elution of DNA from cell lysates on a
      filter. Yields of dsb as measured by this procedure were determined by using a
      calibration of the assay that correlates elution parameters with number of dsb
      caused by disintegration of 125I incorporated into the DNA. Analysis of fluence
      responses obtained by using the calibrated assay indicated that the number of dsb
      induced per dalton of DNA as measured by this assay is proportional to the square
      of the fluence at all the energies of radiation studied, implying that the
      induction of these lesions may be a two-hit event. Analysis of the relative
      efficiencies for the induction of dsb by ultraviolet radiation, corrected for
      quantum efficiency, revealed a spectrum that coincided closely with that for the
      induction of single-strand breaks (ssb) in the same cells, having a close fit
      with the spectrum of nucleic acid in the UVC and UVB region below 313 nm, and a
      shoulder in the UVA region. It was calculated, however, that there may be too few
      ssb for dsb to result from randomly distributed closely opposed ssb.

PMID- 2217552
TI  - Time-resolved luminescence spectroscopy of photosensitizers of biomedical
      interest.
AB  - Studying the fluorescence decay of chromophores, either used as fluorescent
      labels to stain specific biomolecules or as photosensitizers to produce
      irreversible chemical or physico-chemical modifications on biological substrates,
      is being demonstrated to be a valuable method of investigating the interactions
      underlying a variety of phenomena. In fact, all possible primary steps in a
      photosensitized biological system are phenomena that may occur during the
      chromophore S1 lifetime and act as quenching mechanisms of the S1 state. Thus
      they can be identified, and the relative importance of the corresponding
      transient species quantitatively determined, with suitable techniques of time
      resolved fluorescence spectroscopy. The examples discussed in this paper concern
      both tumor photosensitizing drugs, such as anthracyclines and porphyrins, and
      skin sensitizers (e.g. furocoumarins).

PMID- 2217553
TI  - The use of fluorescent probes in immunochemistry.
AB  - The limitations and advantages of particular dyes for labelling proteins and
      other biological materials are discussed. Methods available for conjugating dyes
      to proteins are outlined. Following a discussion of double labelling methods the
      use of photoactivatable fluorochromes and time resolved fluorescence
      methodologies are outlined. The reasons for the photoinstability of some
      fluorochromes are discussed and methods for overcoming the problem are described.

PMID- 2217551
TI  - Characterization of RAD4 gene required for ultraviolet-induced excision repair of
      Saccharomyces cerevisiae propagated in Escherichia coli without inactivation.
AB  - The previously isolated RAD4 gene designated as pPC1 from the genomic library of
      Saccharomyces cerevisiae (Yoon et al., 1985, Korean J. Genetics 7, 97-104)
      appeared to propagate in Escherichia coli and yet retained its complementing
      activity to rad4 mutants without inactivation. The subcloned RAD4 gene was found
      to be localized within a 2.5 kb DNA fragment flanking Bg1II and BamHI sites in
      the insert DNA, and was shown to have the same restriction map as a yeast
      chromosomal DNA, as determined by Southern hybridization. Tetrad analysis and
      pulse-field chromosome mapping have revealed that the cloned RAD4 gene can be
      mapped and integrated into the yeast chromosome V, the actual site of this gene.
      DNA-tRNA hybridization has shown that the isolated RAD4 gene did not contain a
      suppressor tRNA gene. These results have indicated that the pPC1 is a functional
      RAD4 gene playing a unique role involved in the nucleotide excision repair of
      yeast without any genetic change during amplification in E. coli.

PMID- 2217554
TI  - Photosensitized processes in vivo: proposed phototherapeutic applications.
AB  - The use of photosensitizing dyes having intense absorption bands in the 600-900
      nm spectral interval opens up new prospects in the field of photochemotherapy,
      because it allows the illumination of relatively large tissue volumes with no
      significant damage to photosensitizer-free tissues. Special interest is currently
      focused on the photodynamic therapy of solid tumors, because of the property of
      several dyes with a macrocyclic chemical structure (porphyrins, chlorins,
      phthalocyanines, xanthenes) to accumulate in significant amounts and be retained
      for prolonged periods of time by neoplastic lesions. Strategies are being
      developed for enhancing the selectivity of tumor targeting by photosensitizers
      through the exploitation of functional or biochemical differences between normal
      and malignant cells.

PMID- 2217555
TI  - Morphology, physiology, and molecular biology of renin secretion.

PMID- 2217556
TI  - Micromechanical foundations of pulmonary elasticity.

PMID- 2217557
TI  - Facilitated diffusion of glucose.

PMID- 2217558
TI  - Developmental mechanisms underlying pathology of arteries.
AB  - This review tries to provide a general, and very speculative, view of growth
      control mechanisms that may be common to the development of blood vessels and to
      pathological processes including cell proliferation. From a developmental point
      of view, vascular growth is most likely to include local autocrine or paracrine
      mechanisms that permit the two cells of the vessel wall to grow, organize into
      the characteristic tubular and layered structures of the vessel wall, and
      eventually achieve a return to quiescence. The "real" mechanisms controlling
      growth in vivo are difficult to ascertain from studies in culture. For example, a
      large list of angiogenesis molecules must be able to generate endothelial
      replication, but in culture many of these molecules are inhibitory for each
      endothelial replication. Similarly, in culture, we have a long list of smooth
      muscle mitogens, but none of these have as of yet been proven to control smooth
      muscle growth in vivo. Endothelial growth control has been attributed to the
      presence of membrane molecules able to inhibit endothelial replication and to the
      actions of soluble growth factors and their receptors. Unfortunately for the
      former hypothesis we still lack specific molecules with the properties of contact
      inhibition of replication. The data discussed here, however, suggest that
      modulation of expression or function of cell-cell adhesive molecules could be
      critical both to morphogenic changes and to mitogenesis by release of cells from
      cell-cell contact. Moreover, our data and data from other laboratories suggest
      that angiogenic factors, including the HBGFs and TGF-beta, may function in
      angiogenesis by altering cell-cell and cell-cell substrate interactions rather
      than via a primary effect on cell replication. This view of angiogenesis is
      consistent with the absence of a mitogenic effect of some angiogenic factors.
      Although endothelial cell replication is obviously necessary to angiogenesis, the
      lack of mitogenic effect of some factors suggests a need for a more general
      explanation of the actions of angiogenic factors. Endothelial injury may be
      interrelated with smooth muscle growth. The simplest possibility is that a
      failure of the endothelial cell barrier function, due either to denudation or an
      increase in adhesivity for leukocytes, would permit access of platelets or
      leukocytes to the vessel wall. These extrinsic cells, in turn, would stimulate
      smooth muscle cell replication by release of growth factors. The second
      possibility is that the endothelial cell may itself release growth factors into
      the vessel wall.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2217561
TI  - Caring is risky.

PMID- 2217559
TI  - Structure and function of small arteries.
AB  - The small arteries (prearteriolar vessels with lumen diameter less than
      approximately 500 microns) contribute importantly to and participate actively in
      the regulation of the peripheral resistance. New techniques, building on the
      classic histological and hemodynamic techniques, have enabled detailed in vitro
      investigation of small arteries. At present, research in small arteries is in its
      infancy, and our understanding of the heterogeneity of small arteries within
      vascular beds, between vascular beds, and between species is extremely limited.
      This review attempts to describe the current status of the field. New techniques,
      based primarily on a wire myograph (where the vessels are mounted as ring
      preparations) and a pressure myograph (where vessels are cannulated and pressure
      lumen relations are determined), have allowed in vitro investigations of small
      arteries. The more physiological arrangement of the pressure myograph allows, for
      example, investigation of the vasoconstrictor response to raised intravascular
      pressure (the Bayliss response), whereas the less-sophisticated wire myograph is
      similar to use and may be more useful in certain situations where particular
      mechanisms are being investigated. Both techniques allow simultaneous
      measurements of vessel tone and a variety of parameters (e.g., membrane potential
      and intracellular ion activities) and thus allow precise determination of the
      relation between small artery structure and function. The vessels appear to
      remain fully viable with regard to the contractility of their smooth muscle cells
      as well as to the function of their perivascular nerves and their endothelium.
      The evidence suggests that the monovalent transport mechanisms in the plasma
      membrane, in particular potassium channels, play an important role in the
      determination of the membrane potential in small arteries, although the relation
      is more complex than indicated by the Goldman equation. Confirmation of these
      findings requires, however, simultaneous determinations of ion transport and
      vascular tone under conditions where vessels are subjected to mechanical loading.
      The membrane potential, through its effect on potential-dependent calcium
      channels, plays an important role in the determination of vascular tone. With
      regard to calcium homeostasis, current knowledge is hampered by the lack of
      direct measurements of the relation between cytoplasmic calcium and vascular
      tone. The evidence, however, suggests that besides potential-dependent calcium
      channels, receptor-operated calcium channels are present in the plasma membrane,
      although this still requires confirmation. The role of the sarcoplasmic reticulum
      is not clarified.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2217562
TI  - Trust is strengthened through commitment.

PMID- 2217560
TI  - Microlymphatics and lymph flow.
AB  - A careful review of several different organs shows that with the information
      available today the beginnings of the microlymphatics in the tissue consist of
      endothelialized tubes only. Lymphatic smooth muscle within the collecting
      lymphatics appears further downstream, in some organs only outside the
      parenchyma. This particular anatomic picture has been observed in many different
      mammalian organs and in humans. The nonmuscular, so-called initial, lymphatics
      are the site of interstitial fluid absorption that requires only small and
      transient pressure gradients from the interstitium into the initial lymphatics. A
      fundamental question concerns the mechanism that causes expansion and compression
      of the initial lymphatics. I presented several realistic proposals based on
      information currently on hand relevant to the tissue surrounding the initial
      lymphatics. To achieve a continuous lymphatic output, periodic (time variant)
      tissue stresses need to be applied. They include arterial pressure pulsations;
      arteriolar vasomotion; intestinal smooth muscle contractions and motilities;
      skeletal muscle contraction; skin tension; and external compression, such as
      during walking, running, or massage, respiration, bronchiole constriction,
      periodic tension in tendon, contraction and relaxation of the diaphragm, tension
      in the pleural space during respiration, and contractions of the heart. The
      nonmuscular initial lymphatic system drains into a set of contractile collecting
      lymphatics, which by way of intrinsic smooth muscle propel lymph fluid. The exact
      transition between noncontractile and contractile lymphatics has been established
      only in a limited number of organs and requires further exploration. Retrograde
      flow of lymph fluid is prevented by valves. There are the usual macroscopic
      bileaflet valves in the initial and collecting lymphatics and also microscopic
      lymphatic endothelial valves on the wall of the initial lymphatics. The latter
      appear to prevent convective reflow into the interstitium during lymphatic
      compression. Many of the lymph pump mechanisms have been proposed in the past,
      and most authors agree that these mechanisms influence lymph flow. However, the
      decisive experiments have not been carried out to establish to what degree these
      mechanisms are sufficient to explain lymph flow rates in vivo. Because individual
      organs have different extrinsic pumps at the level of the initial lymphatics,
      future experiments need to be designed such that each pump mechanism is examined
      individually so as to make it possible to evaluate the additive effect on the
      resultant whole organ lymph flow.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2217564
TI  - Tissue expansion for the treatment of keloids.

PMID- 2217565
TI  - Medicare payment reforms: implications for the nursing specialties.

PMID- 2217563
TI  - Lasers in plastic surgery: applications and nursing interventions.

PMID- 2217566
TI  - Neck masses.

PMID- 2217568
TI  - Case study: subcutaneous mastectomy. Part I.

PMID- 2217567
TI  - False negative HIV tests--who should be protected?

PMID- 2217569
TI  - "Patient education" series debuts in this issue.

PMID- 2217570
TI  - Physical map and properties of a 90-MDa plasmid of Azospirillum brasilense Sp7.
AB  - Homology was previously detected between the DNA restriction fragments containing
      Rhizobium meliloti nodulation genes and the 90-MDa plasmid, p90, of Azospirillum
      brasilense Sp7. Two DNA loci from Sp7 genome that complement mutations in the
      exopolysaccharide synthesis genes, exoB and exoC, of R. meliloti were also shown
      to be present on the plasmid. A more detailed characterization of the plasmid was
      undertaken to establish its physical map and to localize the nod homologies and
      other specific regions. Six loci were mapped, the region homologous to the
      nodulation genes, nodPQ, of R. meliloti, the exoB and exoC mutation-correcting
      loci, a locus for Ap resistance, a bla homology region different from the Ap
      resistance locus, and a region necessary for the maintenance of p90 as an
      independent replicon. Mobilization into Agrobacterium tumefaciens of p90-Tn5-Mob
      was obtained at a frequency of 10(-4), with the plasmid helper pJB3JI. Self
      transfer of p90 was not demonstrated. Fragments of p90 hybridized with a plasmid
      of 90 MDa present in most A. brasilense and some A. lipoferum strains, suggesting
      a plasmid family in Azospirillum.

PMID- 2217571
TI  - Behavior of the hybrid plasmid pNSW301 in Zymomonas mobilis grown in continuous
      culture.
AB  - The stability of the plasmid pNSW301 which was formed by cointegration of the Inc
      W R plasmid Sa and the 14.5-kb pNSW1 plasmid of Zymomonas mobilis ZM6100 was
      investigated in ZM6100(pNSW301) grown in continuous culture without antibiotic
      selection. The cointegrate plasmid, pNSW301, was found to be structurally
      unstable and a total reduction in the size of pNSW301 of approximately 21 kb
      occurred during growth in continuous culture. Following a systematic study, a
      number of deletion derivatives of pNSW301 were isolated and used to transform
      Escherichia coli HB101, with the exception of pNSW312. The plasmid pNSW312 was
      100% stable in ZM6100(pNSW312) in continuous culture but was unable to replicate
      in E. coli.

PMID- 2217572
TI  - Isolation of the replication DNA region from a Rhizobium plasmid and examination
      of its potential as a replicon for Rhizobiaceae cloning vectors.
AB  - The DNA region essential for replication and stability of a native plasmid (pTM5)
      from Rhizobium sp. (Hedysarum) has been identified and isolated within a 5.4-kb
      PstI restriction fragment. The isolation of this region was accomplished by
      cloning endonuclease-restricted pTM5 DNA into a ColE1-type replicon and selecting
      the recombinant plasmids containing the pTM5 replicator (pTM5 derivative
      plasmids) by their ability to replicate in Rhizobium. DNA homology studies
      revealed that pTM5-like replicons are present in cryptic plasmids from some
      Rhizobium sp. (Hedysarum) strains but not in plasmids from strains of other
      Rhizobium species or Agrobacterium tumefaciens. The pTM5 derivative plasmids were
      able to replicate in Escherichia coli and A. tumefaciens and in a wide range of
      Rhizobium species. On the basis of stability assays in the absence of antibiotic
      selective pressure, the pTM5 derivative plasmids were shown to be highly stable
      in both free-living and symbiotic cells of Rhizobium sp. (Hedysarum). The
      stability of these plasmids in other species of Rhizobium and in A. tumefaciens
      varied depending on the host and on the plasmid. Most pTM5 derivative plasmids
      tested showed significantly higher symbiotic stability than RK2 derivative
      plasmids pRK290 and pAL618 in Rhizobium sp. (Hedysarum), R. meliloti, and R.
      leguminosarum by. phaseoli. Consequently, we consider that the constructed pTM5
      derivative plasmids are potentially useful as cloning vectors for Rhizobiaceae.

PMID- 2217573
TI  - Cloning of the determinants for microcin D93 production and analysis of three
      different D-type microcin plasmids.
AB  - Three different microcin plasmids coding for D-type microcins were analyzed. Two
      of the plasmids (pMccD93 and pCP101) were small, multicopy plasmids and were
      closely related. The third plasmid (pCP106) was a conjugative, antibiotic
      multiresistance plasmid. Although plasmids pCP101 and pCP106 were previously
      classified as A-type microcin plasmids, we have determined that they are, in
      fact, D type. Furthermore, the determinants for microcin D93 production were
      cloned from plasmid pMccD93, and a DNA probe for the region implicated in the
      synthesis of microcin was obtained. This probe hybridized to plasmid C from
      Escherichia coli strain V517, indicating that this plasmid might be involved in
      the synthesis of a D-type microcin. The characteristics of replication of plasmid
      pCP106 were analyzed and appeared to be similar to those of ColEl plasmids,
      although pCP106 is a conjugative single-copy plasmid.

PMID- 2217574
TI  - Nocardioform arsenic resistance plasmids and construction of Rhodococcus cloning
      vectors.
AB  - One of a number of large nocardioform plasmids previously obtained by a primarily
      genetic approach was reduced in size to about approximately 11 kb. This smaller
      plasmid possessed determinants for resistance to sodium arsenate and sodium
      arsenite, as well as immunity to nocardiophage Q4. It was joined to an
      Escherichia coli-positive selection vector constructed by M. Zabeau and
      colleagues, which had the EcoR1 endonuclease gene placed under the control of the
      PR promoter of lambda as well as a bla determinant. The resulting shuttle vector
      of about 14.6 kb was maintained in E. coli and in several strains of Rhodococcus.
      The vector was efficient in cloning DNA without prior alkaline phosphatase
      treatment, as a result of the presence of the positive selection function. This
      function was not significantly expressed in Rhodococcus, and the presence of the
      nocardioform resistance determinants led to no increase in arsenate or arsenite
      resistance in E. coli. The presence of the bla gene resulted in an increase of
      about threefold in ampicillin resistance in Rhodococcus strains.

PMID- 2217575
TI  - Physical and genetic analyses of IncI2 plasmid R721: evidence for the presence of
      shufflon.
AB  - A physical map of the 75.1-kb IncI2 plasmid R721 was constructed by using 15
      restriction enzymes, and the regions of several genetic determinants including
      the origins of replication and of conjugal DNA transfer were located on the
      physical map. It was found that R721 bears a DNA region which undergoes DNA
      rearrangement similar to the shufflon of R64.

PMID- 2217576
TI  - Insertion of plasmids into the chromosome of Streptomyces griseofuscus.
AB  - The results demonstrate a general method for randomly integrating plasmids into
      the genome by a single crossover between a cloned DNA fragment and homologous DNA
      in the chromosome. The integrated plasmid is flanked by directly repeated copies
      of the cloned homologous DNA sequence. Two protocols, "replica plating" and
      "liquid transfer," yielded strains with integrated plasmids.

PMID- 2217577
TI  - The Le Fort III advancement osteotomy in the child under 7 years of age.
AB  - This is a longitudinal study of 12 patients with craniofacial synostosis
      syndromes (Crouzon's, Apert's, Pfeiffer's) who underwent Le Fort III advancement
      under the age of 7 years (average age 5.1 years, range 4.0 to 6.7 years). The
      average follow-up was 5.0 years and included clinical, dental, and cephalometric
      examinations according to a prescribed protocol. The study demonstrated that the
      procedure could be safely performed in the younger child with an acceptable level
      of morbidity. There was a remarkable degree of postoperative stability of the
      maxillary segment. However, although vertical (inferior) growth or movement of
      the midfacial segment was demonstrated, there was minimal, if any, anterior or
      horizontal growth. Any occlusal disharmony developing during the period of follow
      up could be attributed to anticipated mandibular development and could be
      corrected by orthognathic surgery. The roles of surgical overcorrection and
      anterior-pull headgear therapy after release of intermaxillary fixation are also
      discussed. The Le Fort III osteotomy is justifiably indicated during early
      childhood for psychological and physiologic reasons.

PMID- 2217579
TI  - Surgical correction of Tessier number 8 cleft.
AB  - The number 8 Tessier cleft can be a discrete horizontal shadow at the level of
      the lateral canthus of the palpebral fissure or a true coloboma with absence of
      the commissure between the upper and lower eyelids. A surgical technique, which
      has been used in eight patients, is described to correct this congenital defect.
      Four flaps are created and transposed as two Z-plasties. The lateral canthal
      ligament is fixed to the lateral orbital rim, and the orbicularis muscle is
      interdigitated to restore its continuity. This procedure reconstructs the depth
      of the conjunctival fornix, provides proper form and length to the palpebral
      fissure, and restores continuity and an anatomic angle to the malformed canthus.

PMID- 2217578
TI  - Geometrical planning for the correction of orbital hypertelorism.
AB  - Orbital hypertelorism may be associated with a variety of deformities affecting
      several elements of the craniofacial skeleton. Shortness of the central portion
      of the face represented by a wide, short nose and anterior open bite is
      frequently combined with the exaggerated interorbital distance. With the
      mobilization of the two halves of the face it is possible to approximate the
      orbits, simultaneously elongating the center of the face and normalizing the
      maxillary alveolar ridge. A technique is described to plan the operation
      geometrically in order to predict accurately the skeletal correction, the change
      of the inclination of the eye slant, and the modification of the axis of the
      teeth.

PMID- 2217581
TI  - One-stage closure of the entire primary palate.
AB  - Timing of the closure of the anterior palate and alveolus is a subject of debate.
      Late repair of this defect is complicated by high fistula formation and subjects
      the patient to the problems of palate fistula for extended periods of time. We
      have utilized a single procedure performed when the child is 3 months of age that
      completely closes the anterior hard palate and alveolus along with the cleft lip.
      Our series consisted of 61 consecutive patients with unilateral clefts of the
      primary and secondary palate. Mucosal turnover flaps from the vomer along with
      lateral nasal mucosal flaps provide the nasal lining. A buccal sulcus flap with a
      Veau flap completes the oral repair. Ninety-five percent (58 of 61) of the
      patients had complete and stable closure of their anterior palate and alveolus
      after 1 year. The incidence of fistula formation in our series (3 of 61) is much
      lower than that reported with the utilization of other protocols. Excellent
      exposure of the anterior palate and alveolar defect during lip repair, early
      restoration of anatomic relationships, establishment of a good nostril floor and
      sill, and very low fistula formation are among the benefits of this procedure.
      The increase in operative time is considered minimal in light of aforementioned
      advantages.

PMID- 2217580
TI  - Histologic investigation of vascular malformations of the face after
      transarterial embolization with ethibloc and other agents.
AB  - Twenty-one vascular malformations located in the facial area, 11 high-flow
      arteriovenous malformations and 10 slow-flow malformations, underwent combined
      treatment by embolization and later surgery. Embolization was performed
      simultaneously with superselective angiography of the branches of the external
      carotid artery. The new biodegradable fibrosing agent Ethibloc was used in 16
      cases. Histologic examination of the surgical specimens confirmed the good target
      orientation by the transarterial injection of Ethibloc. Limitations of this
      technique are discussed. The agent proved to have thrombogenic and fibrogenic
      properties. Some of the vascular walls degenerated and ruptured following the
      embolization, but there were no instances of necrosis of interstitial tissue or
      skin. Embolization treatment of vascular malformations of the face was not
      curative, but it facilitated subsequent surgery in all examined cases.

PMID- 2217582
TI  - Retro-orbicularis oculus fat (ROOF) resection in aesthetic blepharoplasty: a 6
      year study in 63 patients.
AB  - Sixty-three nonconsecutive patients have undergone resection of the retro
      orbicularis oculus fat (ROOF) in conjunction with aesthetic blepharoplasty. In
      these patients, a consistent and useful ability to soften and flatten heaviness
      and bulkiness in the lateral upper orbital region was seen. Two patients
      developed postoperative hematoma, and two different patients had transient dry
      eye symptoms following blepharoplasty. Twenty percent of patients had a transient
      degree of numbness in the lateral supraorbital nerve region, and all patients
      noted some transient numbness over the lateral upper brow region. No patient
      demonstrated significant paralysis of the orbicularis oculus or corrugator
      muscle. From this experience, retro-orbicularis oculus fat resection would appear
      to be a useful adjunct to standard blepharoplasty techniques in selected
      patients.

PMID- 2217583
TI  - The submuscular aponeurotic system (SMAS): a histologic and comparative anatomy
      evaluation.
AB  - The submuscular aponeurotic system (SMAS) has been steeped in controversy. The
      goal of our anatomic study was to further clarify the existence of the SMAS. With
      an operating microscope, we performed dissections in 10 fresh cadaver heads (20
      hemiheads) exposing the SMAS through a face lift incision. Through the operating
      microscope we were able to identify the SMAS and its relationship to other
      anatomic structures. Full-thickness longitudinal sections were obtained for
      routine histologic studies along various surgically relevant regions of the SMAS.
      In addition, dissections were accomplished with the operating microscope on 12
      rhesus monkey fetuses ranging in age from a few weeks to 8 months. Data obtained
      from the fresh cadaver microdissections, topographic histology, and comparative
      anatomy revealed the presence of the SMAS as a distinct fibromuscular layer
      composed of the platysma muscle, parotid fascia, and fibromuscular layer covering
      the cheek.

PMID- 2217585
TI  - Augmentation mammaplasty by means of the transrectus route.
AB  - A new operative technique has been developed for augmentation mammaplasty.
      Through an inframammary incision, the anterior rectus sheath is entered, and the
      pocket is dissected in an entirely submuscular plane. We have performed this
      procedure in 112 patients to date. Complications have been few. The capsular
      contracture rate in 90 patients followed for greater than 1 year is 7 percent.
      The inframammary crease can be lowered using this technique, making mastopexy
      unnecessary in most patients with moderate ptosis.

PMID- 2217584
TI  - Long-term survival after chest-wall reconstruction with musculocutaneous flaps.
AB  - Reconstruction of chest-wall defects with musculocutaneous flaps permits
      resection of advanced chest-wall tumors and of tissues severely damaged by
      radiotherapy in patients who in a previous era were not surgically treatable. To
      determine the long-term outcome from this surgery, the records of 96 patients who
      had undergone chest-wall resection with musculocutaneous flap reconstruction were
      reviewed. Median survival for the entire group was 20.5 months, but a more
      accurate prediction of outcome could be obtained by dividing the patients into
      three groups. In group I, patients free of known malignancy and undergoing
      resection of radionecrotic tissues, median survival was 60.0 months. In group II,
      patients with resectable disease and free of tumor following surgery, median
      survival was 31.1 months. In group III, patients incompletely resected or known
      to have metastatic disease following surgery, median survival was only 12.5
      months. Even in group III, however, some individuals achieved prolonged survival
      and lasting benefits from the surgery, so these data should not be used to
      exclude patients from undergoing necessary palliative procedures.

PMID- 2217586
TI  - Polyurethane foam-covered implants and capsular contracture: a laboratory
      investigation.
AB  - Experiments were conducted in rabbits comparing polyurethane foam-covered
      implants with otherwise identical smooth silicone gel implants. Using five
      objective methods of measurement of capsular contracture, no significant
      difference could be identified. The foam-covered implants consistently developed
      capsular contracture, although in most cases this was of mild degree and would
      not have been clinically significant. In the two foam-covered implants with hard
      contractures, there was no evidence of hematoma or separation of the foam.

PMID- 2217587
TI  - Evaluating breast parenchymal maldistribution with regard to mastopexy and
      augmentation mammaplasty.
AB  - Mammary parenchymal maldistribution or lower-pole hypoplasia, a first cousin of
      the tubular breast deformity, is a common condition complicating the selection of
      patients for retropectoral augmentation mammaplasty and/or mastopexy. The
      eccentric mammary parenchyma must be released from the pectoral fascia to obtain
      good results with augmentation mammaplasty and to minimize the necessity for
      mastopexy.

PMID- 2217588
TI  - Stretching skin: undermining is more important than intraoperative expansion.
AB  - The efficacy of intraoperative expansion in reducing the tension of wound closure
      was tested in young pigs. The young piglet as a model for studying human skin was
      characterized by finding a close similarity between the modulus of elasticity of
      young piglet skin and human abdominoplasty and mammaplasty skin (range 12.8 to
      23.7 N/mm2 for piglet skin, 14.3 to 19 N/mm2 for human skin). The tension
      required to close a standardized wound was determined before undermining, after
      undermining, and finally after intraoperative expansion. These measurements were
      performed in 10 young pigs with an average weight of 11.5 kg. Undermining the
      wound edges resulted in a significant decrease in the force required to close the
      wounds (p less than 0.0001). Intraoperative expansion did not significantly
      decrease the tension. Previous work showing the importance of site and direction
      of pull on the tension for wound closure was confirmed in this study. Analysis of
      variance demonstrated that the tension required to close a standard wound is
      greater high on the pig's back than near the belly and near the shoulder as
      opposed to the hip for midflank wounds (p less than 0.0001). Increasing the
      extent of undermining from 62 to 136 cm2 significantly decreased the tension for
      wound closure (p less than 0.05). Further undermining did not result in a
      significant decrease in wound closure tension. In this model, intraoperative
      expansion offers no advantage over simple undermining. We suggest that the
      benefit reported by clinicians using intraoperative expansion may derive from an
      increase in the extent of undermining required to place expanders under the wound
      margins.

PMID- 2217589
TI  - Surgical augmentation of skin blood flow and viability in a pig musculocutaneous
      flap model.
AB  - A porcine rectus abdominis musculocutaneous (TRAM) flap model was designed and
      validated in nine pigs. This TRAM flap was based on the deep inferior epigastric
      (DIE) vessels with an 8 x 18 cm transverse skin paddle at the superior end of the
      rectus abdominis muscle. The model was subsequently used to test our hypothesis
      of surgical augmentation of flap viability by vascular territory expansion.
      Specifically, we observed that ligation of the superior epigastric (SE) vessels
      at 4, 7, 14, and 28 days (N = 6 to 8) prior to raising the TRAM flaps
      significantly increased (p less than 0.05) the length and area of the viable skin
      in the transverse skin paddles of the treatment flaps compared with the
      contralateral shammanipulated control flaps. This significant increase in skin
      viability was seen to be accompanied by a significant increase (p less than 0.05)
      in skin and muscle capillary blood flow in the treatment TRAM flaps compared with
      the controls (N = 9). The mechanism of vascular territory expansion is unclear.
      We postulate that hypoxia resulting from the ligation of the superior epigastric
      vessels prior to the flap surgery may play a role in the triggering of the deep
      inferior epigastric artery to take over some of the territory previously perfused
      by the superior epigastric artery. This would then increase the skin and muscle
      capillary blood flow in the transverse paddle when the TRAM flap was raised on
      the deep inferior epigastric vascular pedicle.

PMID- 2217590
TI  - Critical ischemia times and survival patterns of experimental pig flaps.
AB  - Previous work on critical ischemia time suggested (1) a greater susceptibility of
      myocutaneous flaps over skin flaps to the ischemia reperfusion injury and (2)
      that duration of ischemia may affect the survival area of a flap. Using a pig
      model, 55 animals were operated on and the critical ischemia times and survival
      patterns of the buttock skin (n = 85) and latissimus dorsi myocutaneous (n = 88)
      island flaps were determined after being submitted to 0, 2, 4, 6, 8, 10, 12, 14,
      and 16 hours of normothermic ischemia. The average critical ischemia times
      (CIT50) were determined to be 9 and 10 hours for the buttock skin and latissimus
      dorsi myocutaneous flaps, respectively. Percentage of total area surviving (%TAS)
      in those flaps which did survive was adversely affected by increases in the
      ischemic interval in both flap models. A statistically significant decrease in
      percentage of total area surviving was found after 6 and 8 hours of ischemia for
      the buttock skin and latissimus dorsi myocutaneous flaps, respectively.

PMID- 2217591
TI  - Flap failure after microvascular free-tissue transfer: the fate of a second
      attempt.
AB  - In most cases, the loss of a free-tissue transfer is a disaster for both the
      patient and the surgeon. Seven patients received a second microvascular free
      tissue transfer after loss of the first. The indications for free-tissue transfer
      included chronic osteomyelitis of the lower leg (four patients), acute traumatic
      defect of the leg (one patient), acute traumatic defect of the arm (one patient),
      and esophageal defect after surgical excision (one patient). In three patients,
      the interval between the first and second procedures was less than 2 weeks. The
      remaining four patients had their second free-tissue transfer performed 5 weeks
      to 21 months after the first. Six of the seven free flaps were successful. Two
      patients with venous obstruction occurring after the second free-tissue transfer
      were salvaged by reexploration. Partial loss of the flap was noted in one of
      these patients. It is concluded from this select group of patients that failure
      of a free-tissue transfer does not contraindicate a second microtissue transfer
      does not contraindicate a second microvascular free-tissue transfer.

PMID- 2217592
TI  - Comparison of lymphatic and venous interpositional autografts in experimental
      microsurgery of the canine lymphatics.
AB  - In mongrel dogs, 56 autologous lymphatic and vein grafts were interpositioned to
      bridge a defect in the femoral collecting lymphatics. In one group, 26 lymphatic
      autografts were interpositioned with good results. No obstruction was observed
      over 6 months. In another group, 20 venous autografts were interpositioned after
      irrigation with heparinized saline and another 10 autografts were interpositioned
      without irrigation. After 1 week, four irrigated grafts were partially occluded
      with a red thrombus; after 6 months, all grafts were totally occluded. In a third
      group, 15 lymphaticolymphatic anastomoses were enveloped by a silicone sheet to
      provoke prolonged devascularization. None of the vessels was patent. Anastomotic
      patency was inspected in vivo postoperatively. The specimens were studied with
      light microscopy and scanning and transmission electron microscopy. Prolonged
      devascularization damaged the endothelial cells. The results show that the
      lymphatic vessel autograft is the best choice for an interpositional autografting
      to bridge a defect in lymphatic vessels.

PMID- 2217593
TI  - No room at the trough: an epitaph for the eighties.

PMID- 2217595
TI  - Congenital lateral cleft palate: a new anomaly?
AB  - A case of atypical cleft palate abnormality that had not been identified before
      in a 9-year-old girl is presented. The cleft was localized laterally and in an
      oblique position at the soft palate. The patient had cleft palate repair.
      Finally, she had acceptable soft palate movements and speech.

PMID- 2217594
TI  - Intracerebral hematoma complicating split calvarial bone-graft harvesting.
AB  - A case is reported of an intracerebral hematoma following the harvest of split
      calvarial bone. Full recovery by the patient occurred. Complications following
      calvarial bone graft harvest are reviewed. Potential devastating complications
      warrant serious consideration of alternative sources of bone, especially in the
      purely elective surgical candidate.

PMID- 2217596
TI  - Contour correction of the vermilion of the upper lip by island flap of the lower
      lip.
AB  - A method is shown to correct contour defects of the upper lip vermilion by an
      island of vermilion of the lower lip. A muscle bundle of the orbicularis oris is
      used to carry the island. It is tunneled around the commissure to the upper lip
      defect. Three cases are shown.

PMID- 2217597
TI  - Recurrent anterior dislocation of the ulnar nerve at the cubital tunnel.
AB  - Recurrent anterior dislocation of the ulnar nerve at the cubital tunnel is
      reported in two patients. This was due to traumatic attenuation of the flexor
      carpi ulnaris retinaculum. The mechanism of injury in both patients was a fall
      with the shoulder abducted and the elbow acutely flexed. Both patients had relief
      of their neurologic symptoms following anterior submuscular transposition of the
      ulnar nerve.

PMID- 2217598
TI  - New treatment for frontal sinus hypertrophy.
AB  - A new treatment of frontal sinus hypertrophy is described. The anterior wall is
      removed, inverted, and attached again. The resulting depression is filled with
      bone dust. Details are discussed, and a case is presented.

PMID- 2217599
TI  - A trilaminar skin coverage technique for treatment of severe degloving injuries
      of the extremities and torso.
AB  - A 60 percent degloving injury involving the torso and lower extremities of an 8
      year-old boy is described. Successful management employed the use of a new
      trilaminar skin coverage technique. With the avulsed flap still attached to its
      bed, a 0.14-inch split-thickness graft of epithelium and superficial dermis is
      raised with a power-driven dermatome. From the same harvest site, one level
      deeper, a second layer consisting of split-thickness dermis (0.14 inch) is taken.
      Both the first and second layers are meshed and expanded. The remaining degloved
      flap is excised and, on a sterile bench, defatted to produce a third layer of
      deep dermis. In our case, this third layer was ultimately lost, but it functioned
      well as a temporary biologic dressing. Depending on donor-site morbidity, other
      potential applications of this method (i.e., major burn injuries) may be
      feasible.

PMID- 2217601
TI  - In defense of intrauterine repair of cleft lip.

PMID- 2217600
TI  - Historical studies: should you believe the results?

PMID- 2217602
TI  - Internal fixation of malar fracture.

PMID- 2217603
TI  - Definitive diagnosis of breast implant rupture by ultrasonography.

PMID- 2217604
TI  - An aid for interosseous wiring in mandibular fractures.

PMID- 2217605
TI  - Keloids and hypertrophic scars.

PMID- 2217606
TI  - The "zipper" stitch for intradermal closure.

PMID- 2217607
TI  - Treating the short nose.

PMID- 2217608
TI  - Unaesthetic horizontal lip incisions.

PMID- 2217609
TI  - The functional pectoralis major musculocutaneous island flap for head and neck
      reconstruction.

PMID- 2217610
TI  - Total implant tracking system.

PMID- 2217611
TI  - Decreasing mobility of cheek implants.

PMID- 2217612
TI  - Treatment of capsular contracture around retromammary implant.

PMID- 2217613
TI  - The omentum as coverage in mediastinitis.

PMID- 2217614
TI  - Nasal tip augmentation with cartilage graft in aesthetic rhinoplasty: an accurate
      placement.

PMID- 2217615
TI  - The "clean" wound.

PMID- 2217616
TI  - Keep an eye open for glaucoma.

PMID- 2217617
TI  - [Inflammation of the bronchial mucosa as the basis for airway hyperreactivity].
AB  - The mechanisms that are involved in asthma pathogenesis have been the subject of
      intensive research in the last few years. Numerous studies have shown involvement
      of inflammatory cells and their mediators in the damage of the bronchi.
      Inflammation leads to morphological changes in the bronchial wall: damage of the
      epithelium, increased deposition of collagen beneath the epithelial basement
      membrane, oedema and infiltration of the mucosa with inflammatory cells,
      hyperplasia of the mucous glands and hypertrophy of the bronchial smooth muscles.
      The relationship between inflammation and bronchial hyperresponsiveness is
      complex and remains unclear. This review article will encompass the current
      understanding of inflammatory mechanisms in asthma and their association with
      morphological changes in the airways and the syndrome of bronchial
      hyperresponsiveness.

PMID- 2217618
TI  - [Results of bronchodilation tests in workers exposed to occupation respiratory
      noxae].
AB  - In order to detect and assess the spastic components in airway obstruction of
      workers exposed to inhalation of different nonorganic and organic dusts, 129
      workers of metal industry and 135 workers of textile industry were examined. The
      workers of metal industry were exposed to the following respiratory noxa: toluol,
      paint aerosol, mineral dusts (SiO2 up to 10%), asbestos dust, metalic dust and
      several chemical noxa (acetone, CO, CO2, ZnO, FeO and petrol). In textile
      industry the dust of vegetal origin was detected with unfavourable micro climatic
      factors. In both groups the similar results were found with very high percent of
      spastic components. After bronhodilatatory testing the most significant
      differences were found in the following tests: Raw, FMF25-75, FEF75-85,
      components. Several significant spastic components were present in workers of
      metal industry which are due to the polluted working area. In relation to the
      mean values of tests, the greatest number of different results was found in FEF75
      85 and Raw tests. It is suggested that the workers with these results should be
      tested as well.

PMID- 2217619
TI  - [Evidence of the harmful effects of eosinophils in bronchial asthma].
AB  - Fifteen asthmatic patients were prospectively selected. If they had more than 450
      eosinophils in peripheral blood on admission to hospital treatment and if before
      BAL had been performed they were not treated by corticosteroids. No associated
      disease was found which could cause the increased number of eosinophils in
      peripheral blood except bronchial asthma. BAL was performed when the subjects
      tested had no dyspnea, usually 1-3 days after the hospital admission. In contrast
      to blood eosinophilia, increase of eosinophils number in BAL was found to
      correlate to impairment of clinically measured parameters such as: ventilation
      level of blood gases and duration of hospitalisation. On the contrary there was
      no correlation between the level of blood eosinophilia and gas disturbance and
      duration of hospitalisation. Eosinophilic proteins (MBP, ECP, EPX, EPO) are not
      the only that harmfully effect the lung cells in the asthmatic attack but the
      fact that their level in lavage fluid correlates to eosinophilia degree in BAL is
      evident so the correlation between the number of eosinophils in BAL and
      impairment of clinically measured parameters is clear.

PMID- 2217620
TI  - [The role of bronchoscopy with a flexible bronchoscope in the diagnosis of
      pulmonary tuberculosis].
AB  - Bronchoscopy with flexible bronchoscope has been proved as a useful method that
      has been applied also in the diagnostics of pulmonary tuberculosis during the
      recent years. In order to evaluate its role and use at the Institute for Diseases
      of the Chest and Tuberculosis Golnik documentation of 51 patients treated during
      1985 and 1986 was surveyed. Prior to the examination from all patients the sputum
      on Mycobacterium tuberculosis was obtained at least three times and it was
      negative. Aspirations were obtained from 40 patients and the diagnosis was
      confirmed in 21 patients by recovery from tubercle bacilli specimens (52.5%).
      Transbronchial biopsy was performed in 34 patients and it was positive in 27
      (79.4%), out of them in 7 patients the biopsy sample of the lungs was
      bacteriologically (38.9%) and in 23 patients histologically positive (67.6%). By
      bronchoscopy with flexible bronchoscope the final diagnosis was confirmed in 40
      patients (78.4%). Bronchoscopy with flexible bronchoscope as well as
      transbronchial biopsy have proved to be a successful method in the diagnostics of
      active pulmonary tuberculosis. It should be used in patients in whom the sputum
      smear for acid fast bacilli were frequently negative yet there is a suspicion of
      pulmonary tuberculosis.

PMID- 2217621
TI  - [A computer program for the interpretation of the acid-base status and
      respiratory gases].
AB  - A computer program for analysing the parameters of the acid-base status and
      respiratory gases has been designed. The program separates cases which are
      included into classical picture of certain respiratory, metabolic and mixed
      disorders. Out of a test series of 200 findings, 93% findings have been
      accurately interpreted. The program is written in BASIC, translated into machine
      code and occupies about 25 Kbyte computer memory. The main parts of the program
      use commands which do not favorize any version of BASIC increasing the program
      portability to other systems. The classification of respiratory gases and acid
      base status was based on the already known facts.

PMID- 2217622
TI  - [Analysis of hospitalized tuberculosis patients at the Institute for Pulmonary
      Diseases and Tuberculosis in Belgrade, Serbia during 1988].
AB  - The report presents the analysis of TB patients treated at the Institute for lung
      diseases and tuberculosis of SR of Serbia during 1988--a total of 567 or 10.18%
      of discharged patients. There were 77% TB patients from Belgrade and 23% from the
      province. Tuberculosis retains the characteristics of a social disease with a
      morbidity peak in the fourth decade of age. There were 93% of cases discovered
      due to disease symptoms. In 82% of patients it was a case of newly discovered
      specific process, 7.5% had a recurrent disease and 10.5% of patients had a
      chronic form of the disease. The patients had almost all forms of the specific
      process: primary tuberculosis 0.35%, postprimary phthisis 84.4%, specific
      pleuritis 10.6%, tuberculom 1.9%, miliary tuberculosis 1.8%, lymphoglandular
      tuberculosis 0.9%, while 1.4% had extrathoracic specific lesions associated with
      pulmonary lesions. Cavernous tuberculosis was observed in 89% of TB patients and
      extensive phthisis in 14% of cases. Atypical forms of parenchymal specific
      process were observed in 12% patients. Bacteriological or histological
      confirmation of tuberculosis existed for 82%. In 13% of patients treatment lasted
      longer than 3 months. Six or 1% of patients died due to pulmonary tuberculosis.

PMID- 2217624
TI  - [Modulation of nonspecific bronchial hyperreactivity].
AB  - Nonspecific bronchial hyperresponsiveness (NBHR) is a typical characteristic of
      asthmatic patients. The impairment of NBHR is due to the airway inflammations
      caused by the viruses, irritants from the air and especially by specific
      allergens from natural and working environment. NBHR is diminished by elimination
      of inflammatory triggers as well as by antiinflammatory measures, the most
      important being inhalatory glucocorticoids which should be administered for long
      term period in order to achieve the successful decrease of NBHR.

PMID- 2217623
TI  - [The role bronchial circulation in the etiopathogenesis of increased bronchial
      reactivity].
AB  - The relationship between pathoanatomical changes in bronchial arteries and
      occurrence of chronic obstructive bronchitis (COB) and bronchial asthma (BA) was
      studied. Pathoanatomical changes in bronchial arteries were more frequently found
      in patients with COB and BA than in patients with other bronchopulmonary
      diseases, i.e. that bronchial circulation in patients with COB and BA is
      impaired. Due to these findings a theory of vasculary-metabolic explanation of
      pathogenesis of bronchial hyperresponsiveness is based on hypoperfusion and
      hypoxia of cellular structures in the bronchial wall. Hypoxia is supposed to be
      an endogenous change in the bronchial wall which causes bronchial
      hyperresponsiveness in various exogenous stimulants.

PMID- 2217625
TI  - [Nonspecific bronchial response in asymptomatic female smokers and nonsmokers].
AB  - In 20 female smokers aged 21-58 yrs and 20 nonsmokers aged 22-48 yrs the effect
      of smoking on bronchial responsiveness was studied. In the study only those
      subjects were included who had no asthma and who had been without symptoms of any
      of the pulmonary disease and they had normal mean values of pulmonary function
      testing. In no subject the increase of bronchial responsiveness after maximal
      dose of 4 mg of metacholine was found. Since the statements in the literature are
      contradictory, further studies are necessary in order to clear up the effect of
      smoking on bronchial responsiveness.

PMID- 2217626
TI  - [Nonspecific bronchial reactivity in chronic bronchitis].
AB  - In a segment of the population of Zagreb, Crnomerec, which was included in the
      epidemiological study on chronic bronchitis in Croatia (1969-1972-1982-1989) the
      values of ventilatory function and non-specific reactivity of airways were
      examined. The sample consisted of 34 women and 29 men with chronic bronchitis.
      The control group consisted of 34 men and 33 women--without cough. The average
      age was 58.6 (M) and 59.4 (F). Investigation of non-specific reactivity was
      carried out on the dosimeter apparatus APTA-Jaeger, Wurtzburg, W. Germany (by
      using histamine dehydrochloride (1-30 mg/ml dose) with expressed reactivity PC 40
      Raw. PC 40 in subjects with chronic bronchitis amounted to 7.79 mg/ml in men and
      8.89 mg/ml in women, which is significantly lower than the control group (14.04
      M, 17.8 F). We did not determine significant difference between smokers and non
      smokers with regard to PC 40. By factor analysis in an orthogonal projection a
      link was noted between symptoms of chronic bronchitis, basic values of
      ventilatory function and PC 40. This is in agreement with known results.

PMID- 2217628
TI  - [Normal reactivity and hyperreactivity in the bronchi induced by respiratory
      irritants].
AB  - The influence of age, sex, atopy, baseline spirometry and smoking habit on the
      presentation of airway reactivity (AR), and the prevalence of hyperreactive
      subjects was assessed in 176 normals and 143 subjects occupationally exposed to
      respiratory irritants. The study protocol comprised: a respiratory disease
      questionnaire, physical examination, skin prick-test to 13 common inhalant
      allergens, IgE level, spirometry. The nonspecific bronchoprovocation test (NBPT)
      was performed by the cumulative method proposed by Chai et al. (J Allergy Clin
      Immunol 1975; 56: 323-327). The results are expressed as PC20FEV1, PC25FEF50,
      PC25FEF25 and PC25FEF25/75. Age, sex, atopy, baseline spirometric values and
      smoking are not significantly correlated with indeces of AR. There are no
      hyperreactors among healthy subjects--according to the criterion: PC20FEV1 less
      than or equal to 2.17 micromoles of histamine. When the response was measured by
      flow-volume parameters, there were between 5.1% and 9% hyperreactors. In both
      examined groups AR has proved to be a highly variable feature. Among workers
      exposed to irritants there were 5.6% hyperreactors according to PC20FEV1 and
      between 11.1% and 13.9% when flow-volume parameters were applied. A significant
      correlation between AR and smoking habit of subjects occupationally exposed to
      irritants was not found. The level of AR when monitored by flow-volume parameters
      of subjects continuously exposed to irritants was found to be significantly lower
      than in normals. The chosen criterion separates successfully airway normo- from
      hyperreactives. It is a useful diagnostic method in occupational medicine.

PMID- 2217627
TI  - [Bronchial responsiveness in hops processing workers].
AB  - In small group of workers (n = 17) who had been during their working process
      (storing and packing of hop) exposed to the inhalation of hop dust, the bronchial
      responsiveness with metacholine was studied according to cumulative method.
      Although 70% of examined subjects had clinically pronounced signs of bronchial
      irritation and 50% of them the signs of chronic bronchitis, the moderately
      increased bronchial responsiveness was found in only 12.5% of examined subjects
      (n = 2) which is--due to the data from the literature--the normal percent for
      healthy population.

PMID- 2217629
TI  - [The role of nonspecific nasal reactivity in the evaluation of induced bronchial
      hyperreactivity].
AB  - The excitation of the irritant receptors in the upper respiratory tract may
      result in reflex bronchoconstriction. Does the raised reactivity of the nasal
      mucus membrane--the place of the first contact with respiratory irritants--play
      an important role in the expression of IBH? The level of NNR and the existence of
      relation between NNR and IBH have been assessed in 32 healthy subjects and 28
      workers exposed to irritants with respiratory disorders. Nonspecific nasal
      provocation was performed by spraying of doubled concentrations of histamine
      solution in saline (0.03-16 mg/mL) in both nostrils in three minute intervals.
      The reaction was monitored by measurement of nasal peak inspiratory flow, nasal
      resistance, nasal forced expiratory volume in first second and nasal forced
      expiratory mid-flow. The level of NNR was expressed as provocation concentrations
      of histamine solution that produced significant change of all four measured
      parameters. Nonspecific bronchial provocation with histamine was performed by the
      modified method of Chai H. et al. The criterion for hyperreactivity was PC20FEV1
      less than or equal to 8 mg/mL of histamine. There was statistically no
      significant correlation between NNR and IBH.

PMID- 2217630
TI  - [The intensity of bronchial hyperreactivity and the evolution of pulmonary
      function].
AB  - The relationship between the degree of the bronchial hyperreactivity (BH) and
      evolution or prognosis of the bronchial asthma is determined in this prospective
      study. BH has been examined in 108 asthmatic children and after a long period of
      time (average 5.5 years), the pulmonary function (VC, FEV1, FEF25-75, Raw, IGV,
      RV/TLC, flow-volume curve was evaluated. Impaired pulmonary function was found
      not to correlate with the degree of the BH. It is concluded that the degree of
      the BH might predict the evolution and the prognosis of the bronchial asthma.

PMID- 2217631
TI  - [An apparatus for producing aerosols and depositing aerosols in the bronchial
      tree].
AB  - The technical characteristics of most frequently used devices for the production
      of aerosol have been described together with their effect on deposition of
      aerosol in tracheobronchial system. However, there are many reasons to prefer jet
      nebulisers for everyday application.

PMID- 2217632
TI  - [Provocation agents for the evaluation of nonspecific bronchial responsiveness].
AB  - Different pharmacological and nonpharmacological provocative agents used in the
      assessment of nonspecific bronchial responsiveness are presented. Their
      advantages and disadvantages as well as the attempt of the evaluation of their
      clinical applicability are discussed. The choice of provocative agent has still
      been the matter of personal judgement.

PMID- 2217633
TI  - [Etiopathogenic mechanisms of increased airway responsiveness].
AB  - Views on mechanisms of increased airway responsiveness in patients with bronchial
      asthma and other respiratory tract are presented. The data have been divided into
      three parts: mucosal and submucosal changes, changes in airway regulations and
      effector cells. In the first part the etiopathological mechanisms of inflammatory
      processes in airways are explained. The second part views the neurogenic and
      other airway disorders (vagus reflex arc, local axon reflex, epithelial relaxing
      factor) while the third focuses on the receptor activity changes and cellular
      mechanisms known to cause airway hypersensitivity and hyperreactivity.

PMID- 2217635
TI  - [Use of the Astograph in nonspecific bronchoprovocation tests].

PMID- 2217634
TI  - [Preventive measures in bronchial provocation tests].
AB  - The author's own experiences together with the data from the literature are
      presented for application the bronchial provocation tests in the hospital and in
      out-patient's department for pulmonary disease. Contraindications and side
      effects in testing the nonspecific provocative agents are presented (metacholine,
      histamine, carbachol), in specific provocative agents as well as in exercise
      testing. These tests are relatively harmless if the preventive measures are taken
      into account.

PMID- 2217636
TI  - [Simultaneous recording of spirometric parameters and total respiratory
      resistance on the Astograph in nonspecific bronchial provocation tests using
      methacholine].
AB  - Parallel study results of spirometric parameters (S.P.) FEV1, FEF50, FEF25 and
      total respiratory resistance (Rrs) measured by Astograph in nonspecific
      metacholine bronchoprovocation test were analyzed in 378 patients suspected of
      bronchial asthma. The patients were divided into 7 groups based on Astograph and
      S.P. instances criteria. Of 92 patients with positive test results, 91% met the
      set Astograph criterium; 72% met all three S.P. criteria, 1% one criterium and
      12% failed to meet any of the S.P. criteria. It was noted that the patients met
      more the FEF50 and FEF25 criteria (87%) than FEV1 (73%). Also, there was no
      significant increase in respiratory resistance for those with a predominant
      reaction in small airways (9%). This fact points to the need of introducing
      appropriate complementary Astograph methods.

PMID- 2217637
TI  - [Simultaneous recording of nonspecific bronchial response using continuous
      measurement of total respiratory resistance and oxygen saturation of arterial
      blood].
AB  - In 78 patients with bronchial asthma symptoms undergoing nonspecific bronchial
      response test with bronchoprovocation inhalation of progressively increased
      methacholine concentrations, total respiratory resistance (Rrs) and oxygen
      saturation (SaO2) of arterial blood were continually measured. An average Rrs
      increase was 153% when compared to the initial values and it correlated with SaO2
      decrease (5.5% of the initial values). In 45 patients along with continual Rrs
      and SaO2 measurements, bronchoprovocation test and spirogram flow-volume curve
      were periodically done. Ten of these patients had no significant Rrs or FEV1
      changes, but there was a considerable drop in FEF50, FEF25 and SaO2. These
      results, associated with dyspnea and physical pulmonary findings in the course of
      BPT, as well as history of patients with similar difficulties in every-day life
      and in work environment, point to the need of expanding diagnostic criteria for
      positive BPT and for patients who did not have Rrs increased double the initial
      values nor sufficient FEV1 20% drop. Spirometry and oximetry as complementary
      methods, increase Astograph sensitivity to methacholine test. Oximetry has an
      advantage of enabling continual SaO2 monitoring and increased patient's safety
      during the BPT.

PMID- 2217638
TI  - [Recommendations for the standardization of bronchial provocation tests using
      bronchoconstriction agents].
AB  - The author is resuming part of the reports and discussions from the 26th Golnik
      symposium with the main topic "The measurement of nonspecific bronchial
      responsiveness." The indications for nonspecific bronhcoprovocation tests,
      different methods for production of aerosol and ways of inhalation of
      bronchoconstrictory agent are discussed. Further on the procedures for
      measurement of bronchial response, shorter one by inhalation of one dose and
      longer one by increased quantities of metacholine or histamine together with the
      interpretation of the results have been introduced as well.

PMID- 2217640
TI  - [Tuberculosis of the peripheral lymph nodes].
AB  - An analysis of 2.414 fine needle aspiration specimens, obtained from peripheral
      lymph nodes, was done in 2.287 patients during the period from 1979 till the end
      of 1989. This investigation was performed at the Cytologic Laboratory of the
      Clinic for Lung Diseases "Jordanovac" in Zagreb. Totally, there were 150 (6.2%)
      aspirates which, cytomorphologically, appeared to have a granulomatous reaction
      with necrosis. Of 150 aspirates, Mycobacterium tuberculosis was found
      microscopically and/or by culture in 73 (3.02%) of them. The patients were less
      than 40 years of age in 63% of the cases. As to the localization, the highest
      rate of tuberculous lymph nodes (91.8%) was found in the neck and supraclavicular
      areas.

PMID- 2217639
TI  - [Legionnaires' disease in Yugoslavia (an epicritical review of patients)].
AB  - A review of patients with Legionnaires' disease hospitalized in our Clinic from
      the first cases recorded in 1978 up to now has been given. The diagnosis was
      confirmed by indirect immunofluorescent method in 23 patients with pneumonia,
      using antigen and method of the Center for Disease Control Biological Products
      Division, Atlanta, Georgia, USA (Dr Wilkinson). Most of the patients (16) were
      sporadic cases and twice as less cases were from two epidemics (7). Two patients
      among sporadic cases developed a very severe form of the disease during the
      immunosuppressive therapy after kidney transplantation. Clinical, epidemiological
      and laboratory data of 10 patients hospitalized and treated during the last three
      years (1986-1988) were analyzed in details. Two thirds of these patients were
      above 40 years of age and the youngest one was 29 years old. Except the advanced
      age no other firm disposable factor was found in patients belonging to sporadic
      cases. In cases from epidemics the source of infection was probably water from
      water-pipes i.e. hotel devices (bathrooms, douches, drinking water, air
      conditioning units, water used in kitchen for cooking etc). All patients
      recovered after a longer symptomatic and antibiotic treatment. Erythromycin and
      rifampicin were applied the most frequently. In some patients treatment with
      chloramphenicol was effective.

PMID- 2217641
TI  - [Dressler's syndrome during radiotherapy in bronchial carcinoma].
AB  - A case of Dressler's syndrome which has developed in a patient with bronchogenic
      carcinoma during radiotherapy is presented. Diagnosis is established according to
      symptomatology, clinical findings, chest X-ray, laboratory analysis and
      immunological findings. Existence of metastatic deposits in heart is excluded by
      the method of echocardiography. Short-term cardiologic therapy with
      antiflogistics is completely sufficient for maintaining the stability of
      "cardiologic status".

PMID- 2217642
TI  - [Pulmonary silicosis complicated by systemic vasculitis].
AB  - A patient is described who had been--as a cutter of crystal--for 40 yrs exposed
      to the silica dust. At regular medical examinations at out-patients' department
      for pulmonary diseases first stage of pulmonary silicosis had been found and
      confirmed at the Institute for Occupational Health. Nine years after the
      retirement the clinical symptoms of febrility, cough, joint and muscular pains
      appeared together with the difficulties in swallowing and dyspnea even at minor
      physical activities. During the treatment the systemic vasculitis, probably
      visceral erythematodes, was established with satisfactory response to the
      corticosteroid therapy.

PMID- 2217643
TI  - [Primary mucociliary transport insufficiency].
AB  - Case histories of 3 patients with primary mucociliary transport failure are
      described. Two of them had immotile cilia syndrome and one cystic fibrosis. In
      all three patients the same clinical picture was found and they had the same
      treatment, although the etiology of diseases was not the same. The treatment in
      two patients was not much successful since they had associated respiratory
      failure.

PMID- 2217644
TI  - [Pulmonary damage during amiodarone therapy].
AB  - Pulmonary toxicity is a side effect associated with amiodarone therapy. Mechanism
      of lung injury remains speculative. Lung biopsy specimens reveal changes
      consistent with interstitial pneumonitis and alveolitis. Clinical picture is
      nonspecific. Diagnostic algorhythm for evaluation of patients receiving
      amiodarone together with a case report are discussed.

PMID- 2217645
TI  - [Neuron-specific enolase in pleural effusions of various etiologies].
AB  - The concentration of neuron-specific enolase (NSE) was measured in the serum and
      pleural fluid of 42 patients with pleural effusions of different etiology. High
      levels (above 13.0 micrograms/l) of NSE in pleural fluid of 9 patients with
      malignant disease were observed (sensitivity 57%). However, pleural fluid NSE
      levels were also increased in 14 with non-malignant diseases (specificity 45%).
      Increased pleural fluid NSE activity is not specific for malignancy.

PMID- 2217646
TI  - [Analysis of immunocompetent cells in bronchoalveolar lavage in patients with
      sarcoidosis].
AB  - Bronchoalveolar lavage through fiberoptic bronchoscope was performed in the right
      middle lobe or lingula of 8 patients with clinically and radiologically active
      sarcoidosis and 5 healthy persons. Pellet cells were analysed. Lymphocyte subsets
      were detected with monoclonal antibodies by fluorescent microscopy or flow
      cytometry (EPICS-C, Coulter). In patients with sarcoidosis lymphocyte proportion
      is elevated (29.88 +/- 4.32) as compared to healthy persons (5.2 +/- 3.4). We
      detected an increase of CD 3 lymphocytes (86.38 +/- 6.71) and CD 4 helper-inducer
      T lymphocytes compared to the total number of lymphocytes and, likewise, of the
      CD 4/CD 8 ratio--5.62 +/- 0.94. CD 8 suppressor-cytotoxic T lymphocytes are
      decreased (13.0 +/- 1.3 as compared to the healthy persons 22.0 +/- 3.84), which
      is a relative decrease because due to an increase of the total lymphocyte number,
      an increase of CD 8 T lymphocytes (3.85 +/- 0.41 as compared to the healthy
      persons 1.09 +/- 0.59) still exists, compared to the total number of pellet
      cells.

PMID- 2217647
TI  - [The effect of positive end-expiratory pressure on gas exchange and
      hemodynamics].
AB  - The effects of positive end-expiratory pressure (PEEP) on arterial and mixed
      venous blood oxygenation as well as the effects on systemic and pulmonary
      circulation were studied in 15 patients with adult respiratory distress syndrome
      (ARDS) on mechanical ventilation. The measurements of arterial and mixed venous
      blood oxygen pressure (PaO2, PvO2), heart rate (HR), central venous pressure
      (CVP), pulmonary wedge pressure (WP), mean pulmonary arterial pressure (Ppa),
      mean systemic arterial pressure (Psa) and cardiac output (CO) were performed at
      0, 5, 10 and 15 cm H2O PEEP. The positive effect of + 10 cm H2O on arterial
      oxygenation was found (PaO2 raised from 11.49 +/- 3.5 kPa to 13.3 +/- 3.3 kPa).
      Ppa raised too, from 23 +/- 7.6 mm Hg to 26 +/- 7 mm Hg. Psa and CO lowered at +
      15 cm PEEP. Psa from 85 +/- 17 mm Hg to 73 +/- 17 mm Hg as well as CO from 8.22
      +/- 1.1 l/min to 6.91 +/- 1.40 l/min. Authors conclude that PEEP can be accepted
      form of therapy in the treatment of refractory hypoxemia in patients with ARDS.
      Despite this beneficial effect, PEEP may adversely affect cardiovascular
      function. As with any therapy, the optimum PEEP "dose" should be tailored to each
      patient according to his needs and response.

PMID- 2217648
TI  - Interaction regulations used by schizophrenic and psychosomatic patients: studies
      on facial behavior in dyadic interactions.
AB  - This paper is part of an extensive research project that is trying to examine
      transference and countertransference processes objectively. We have used a
      methodology that describes and analyzes interactive behavior patterns observed
      between different groups of patients with psychic disturbances and their
      interaction partners, who are uninformed about their problems. Thus far, we have
      completed several studies centered around the question of whether it is possible
      to identify specific interaction strategies in groups of patients of different
      nosological categories. Related to this question was the investigation of the
      specificity of the response patterns of their interaction partners. The patients
      consisted of stutterers (stuttering openly or not, Krause 1982a), schizophrenics
      (Krause et al. 1989), and psychosomatic patients (Sanger-Alt et al. 1989). This
      line of inquiry has rather severe consequences for the research strategies, which
      have been described elsewhere (Krause et al. 1989). In this paper, we will
      present for the first time a synopsis of patterns of facial behavior observed in
      different groups of patients and their healthy partners, and in healthy subjects
      interacting with each other.

PMID- 2217649
TI  - Children of perpetrators of the Holocaust: working through one's own moral self.
AB  - The present study tests stages in the ability of some children of perpetrators of
      the Holocaust in Germany to work through emotional and moral issues regarding
      their fathers' perpetrating role during the Third Reich. The following questions
      are raised: Did they try to distance themselves by playing down the Holocaust and
      the moral meaning of their fathers' involvement in it? Did any children try to
      work through issues relating to their fathers' impaired morality? Did any
      children successfully reach the stage of integration? Fifty-seven persons were
      contacted by the author between September 1985 and June 1987, of whom 9 refused
      to be interviewed. Thirty interviewees were children whose fathers had taken an
      active part in the implementation of the euthanasia program, in the
      Einsatzgruppen, in the extermination camps or in related activities. The fathers
      of the remaining 18 interviewees were affiliated with SS units at times and in
      places where the atrocities took place, but what they actually did or did not do
      was not proven. In general, there was an almost total silencing of accounts of
      the extermination process in homes and schools. Acknowledgment, if any, of the
      atrocities appeared through accounts of trials and friends and in newspapers or,
      only recently, through the children's active searching. When children who learned
      what their father-perpetrator had done during the war also came to understand the
      moral implications, they usually experienced severe emotional conflict, which
      they had to confront on their own. Only a few succeeded in walking across a very
      narrow bridge to a working through of the related issues and emotions. The
      implications of the present analysis for future research on the prevention and
      outcomes of genocide are discussed.

PMID- 2217650
TI  - Psychiatric practice and the exigencies of the state: an ethnomedical view.
AB  - The purpose of this paper is to illustrate the powerful role that the state has
      in the practice of psychiatry in contemporary American society. An ethnomedical
      frame of reference is adopted, which is to say that psychiatric practice is
      looked at culturally and comparatively. In any society social and cultural
      characteristics condition and structure medical practice. In this sense,
      psychiatric practice provides an example to be analyzed in relation to other
      systems of medical practice. The ways in which the modern state, an omnipresent
      and compelling social structure, can intrude into the dynamics of psychiatric
      practice is illustrated by means of two case analyses. These draw attention to
      unique ethnomedical properties of psychiatric practice and to the potentially
      tragic effect that the state can have on its conduct. Analysis of the material
      presented is conducted against the background of information from the
      anthropological and social historical study of medicine and from medical practice
      in the Soviet Union.

PMID- 2217651
TI  - Violence and social structure on mental hospital wards.
AB  - Significant differences in the incidence and distribution of violent behavior in
      mental hospital wards exist even when the diagnoses and other characteristics of
      patients are essentially the same. In an effort to compare the structure and
      predictability provided by organizational and interpersonal processes in violent
      and peaceful wards, the senior author spent 38 months in participant-observation
      and interviewing on six wards in three state mental hospitals. Patterns emerged
      in ward social organization and staff behavior that were associated with varying
      levels of violence. These patterns reinforced previous observation that violence
      is a symptom of disorder not only in the biological and psychological field but
      also in the sociocultural field. Violence was more frequent and more extreme in
      wards in which staff functions were unclear, and in which events such as
      activities, meetings or staff-patient encounters were unpredictable. Violence was
      less frequent and less extreme in wards characterized by strong psychiatric
      leadership, clearly structured staff roles, and events that were standardized and
      predictable. Ward social organization characterized by standardized, repeated,
      predictable behavioral and procedural rituals provided stability and autonomy
      that supported efforts to develop a therapeutic milieu.

PMID- 2217652
TI  - The Numbers Man.

PMID- 2217653
TI  - Personality development in traditional Maori society and the impact of
      modernization.
AB  - This paper is an attempt to integrate the available research, clinical data and
      literary information concerning the developmental experiences of the New Zealand
      Maori. The Maori developmental pattern in the traditional society is compared
      with that of the Caucasian, mostly Anglo-Saxon, New Zealander (Pakeha),
      highlighting the contrasting elements while at the same time accommodating
      considerable overlap between the two postulated developmental patterns. The Maori
      personality development is seen as being characterized by an indulgent and
      permissive infancy, a withdrawal of this succorance during childhood, which is
      characterized by prominent peer-orientation, and a reintegration into adult
      society during adolescence with gradual maturation of social roles subsequently.
      The disruption of this pattern as a result of urbanization and Westernization is
      discussed, along with its adverse consequences. The recent initiatives by the
      Maori community to preserve the old traditions take the developmental issues into
      consideration, and although it is too early to judge their success or otherwise,
      they look quite promising.

PMID- 2217654
TI  - Cross-cultural views of self in the treatment of mental illness: disentangling
      the curative aspects of myth from the mythic aspects of cure.
AB  - This paper compares Eastern and Western concepts of self within the context of
      the healing process. I draw upon the work of Sudhir Kakar and Heinz Kohut to
      illustrate differences in how mental illness is expressed and treated in India
      and the United States. I propose that cultural variances in the way that illness
      is expressed and treated relate to differences in culturally determined "myths"
      of the self. In India, where Kakar lives and works, the self is conceived as
      fluid and interdependent; in the West, the self is conceived as more solid and
      autonomous. The therapeutic methods employed by the Western-trained psychoanalyst
      and psychotherapist make use of the Western myth of self. Likewise, in India the
      shaman heals in accordance with the myths available to him. No matter what our
      cultural background, such myths lend coherence to our experience and influence
      the way in which we solve our problems, including the problem of "mental
      illness." Finally, I suggest that these "myths" of self are not static and point
      out ways in which the Western myth of self is evolving. As these myths change, so
      do our methods of treating mental illness.

PMID- 2217655
TI  - Improving treatment for the severely mentally ill: implications of the decade
      long Italian psychiatric reform.
AB  - Recent reviews of the results of the important Italian Psychiatric Reform have
      been unusual in that they have ranged from very enthusiastic to very negative. No
      recent report has focused on extrapolating from the Italian experience the pluses
      and minuses that might be applicable to the U.S. system of delivery of mental
      health services so as to improve the care of the seriously mentally ill. In this
      paper I will summarize my observations and clinical research during 6 months in
      Italy, emphasizing what has not been reported by others; I will analyze the
      impact of the Italian changes on Italian practice and try to identify in a
      balanced way any inferences that can be drawn from the Italian experience that
      add to ideas now current in the United States about treatment of the severely
      mentally ill.

PMID- 2217656
TI  - Birth-cohort changes in the rates of mania.
AB  - Secular changes in the rates of mania have been reported in the relatives of
      affectively ill patients, and the present study is an independent replication of
      these findings in a large probability sample of a community. Data from the five
      U.S. sites of the National Institute of Mental Health's Epidemiologic Catchment
      Area study (ECA), a community survey of adults, are presented. A total of 17,827
      respondents were divided into eight birth cohorts, each spanning a 10-year
      interval. Actuarial life-table analyses showed a greater cumulative risk of mania
      for white men and women from the three most recently born cohorts (i.e., those
      born after 1935). The Wilcoxon test for homogeneity indicated an overall
      significant difference by birth cohort. These findings in a community sample are
      consistent with those previously reported in relatives of affectively ill
      patients. The results support the hypothesis that birth cohort changes have
      occurred in the risk of mania and that the risk was greatest in the post-1935
      cohorts.

PMID- 2217657
TI  - Risk factors in unipolar depression: II. Relation between proband REM latency and
      cognitions of relatives.
AB  - In an ongoing study of risk factors for depression in first-degree relatives of
      unipolar depressed probands, we have assessed cognitive variables (beliefs,
      attributional style, and moment-to-moment thinking) in relatives of reduced REM
      (rapid eye movement) latency unipolar probands, nonreduced REM latency unipolar
      probands, and normal control probands. Relatives of reduced REM latency probands
      had more negative cognitions; the effect of REM latency of the proband was
      independent of the effect of a personal history of depression in the relative. It
      appears that both biological and psychological factors can be identified as
      predictors for lifetime rates of depression and may be useful in identifying high
      risk individuals.

PMID- 2217658
TI  - Predictors of hospital outcome without antidepressants in major depression.
AB  - Fifty-two consecutive inpatients with nonpsychotic unipolar major depression were
      assessed for response to 1 week of hospitalization without antidepressants. Each
      was rated at admission and at 1 week using the Hamilton Rating Scale for
      Depression (HRSD). Fifteen of 52 responded (HRSD score less than or equal to 12),
      10 of whom improved by greater than or equal to 50% change in the HRSD score.
      Five variables were correlated with lack of hospital response: DSM-III
      melancholia, panic disorder, the DSM-III-R item "absence of personality
      disorder," admission severity, and age. Multiple regression showed an independent
      association between hospital outcome and the first three variables. Response to 1
      week of hospitalization was found in 70% (14 of 20) of the patients who had none
      of the three identified predictors: melancholia, panic, and absence of
      personality disorder. In patients with one or more of these predictors, only 3%
      (1 of 32) responded.

PMID- 2217659
TI  - Psychological stress and phorbol ester inhibition of radiation-induced apoptosis
      in human peripheral blood leukocytes.
AB  - Apoptosis is a process of genetically programmed alterations of cell structure
      that lead to failure of proliferation and differentiation, and eventual cell
      death. Apoptosis is induced by a variety of toxic insults including growth factor
      deprivation and ionizing radiation. This process may function to protect against
      the appearance of heritable phenotypic changes in cells and may be a critical
      factor in normal cellular immune function. Phorbol esters inhibit apoptosis, but
      little is known about factors that regulate this process physiologically. In this
      study, we demonstrate an association between an acute psychological stressor,
      taking examinations, and the induction of substantial and reversible changes in
      the response of peripheral blood leukocytes to gamma irradiation and to phorbol
      ester treatment. These data suggest that psychological stress may induce
      physiological changes that regulate the ability of immune cells to initiate
      apoptosis.

PMID- 2217660
TI  - Neuropsychological performance in children with Tourette's syndrome.
AB  - Neuropsychological performance was examined in a sample of 100 children between
      the ages of 6 and 18 years who met DSM-III-R criteria for Tourette's syndrome.
      Neuropsychological test scores were converted to age-corrected t scores based on
      published normative data. Ratings of Tourette's symptoms were also obtained. The
      mean IQ of the sample was approximately 100. Most of the subjects performed
      within normal limits, although approximately 20% obtained scores suggesting
      impairment on a summary neuropsychological performance measure. There were no
      differences attributable to medication effects. Later age at onset and the
      severity of complex tics were related to performance below normal levels on a
      number of neuropsychological measures. There was no specific evidence of frontal
      lobe dysfunction. The pattern of neuropsychological performance was virtually
      identical to a previously reported independent sample of patients. These data
      suggest a relatively characteristic pattern of neuropsychological performance
      abnormalities in a subgroup of patients with Tourette's syndrome. In general,
      most patients appear to perform within normal limits. Directions for future
      investigation are considered.

PMID- 2217661
TI  - Motor/vocal tics and compulsive behaviors on stimulant drugs: is there a common
      vulnerability?
AB  - The occurrence of abnormal movements or perserverative/compulsive behaviors was
      noted in 34 (76%) of a group of 45 hyperactive boys during a double-blind
      crossover treatment trial of methylphenidate and dextroamphetamine given in a
      wide range of doses. These adverse effects were often subtle and transient, and
      they usually occurred only on one drug. There was only one case where treatment
      was discontinued due to the severity of the tic the subject developed during his
      initial treatment phase. Dextroamphetamine tended to produce more compulsive
      behaviors, which were also more likely to resemble clinical obsessive-compulsive
      disorder (OCD), than did methylphenidate. Abnormal movements and compulsive
      behaviors tended to co-occur on methylphenidate only; no general "Tourette-OCD
      diathesis" was found for this population.

PMID- 2217662
TI  - Bureau of National Affairs nursing shortage review.

PMID- 2217663
TI  - Haemopoietic growth factors.
AB  - The availability of recombinant haemopoietic growth factors has permitted more
      precise in vitro experiments and human in vivo studies to be performed. In
      general, the results have been in accord with expectations from previous in vitro
      studies. The clinical exploitation of the haemopoietic growth factors offers
      great promise but careful studies are required to define their value. The effects
      of some growth factors are multiple and complex, and it cannot be assumed that
      improvements in blood cell counts are per se beneficial to the patient under all
      circumstances. Randomized controlled trials with clinical end-points are now
      essential. In the situation of chemotherapy-induced neutropenia, large studies
      would be required to show an improvement in mortality although lesser morbidity
      would be easier to demonstrate. In the field of cancer therapy the major benefit
      of the haemopoietic growth factors will be if they permit dosage escalation and
      there is a consequent improvement in response rate and long-term survival. This
      will require careful patient selection and large, probably multicentre, trials.
      It is also likely that such studies will be limited by the development of severe
      thrombocytopenia and an effective means to ameliorate this (perhaps the elusive
      thrombopoietin) will be required. The possibility of using haemopoietic growth
      factors as an adjunct to the treatment of severe infections is enticing, but
      designing a trial to evaluate this possibility is fraught with difficulties.
      Finally, it must be noted that all the studies reported to date use single
      factors. This is just the beginning and the use of other factors and synergistic
      combinations may give greater efficacy without increased toxicity.

PMID- 2217664
TI  - Clinicopathological features of childhood nephrotic syndrome in northern Nigeria.
AB  - The clinicopathological features of childhood nephrotic syndrome in northern
      Nigeria were studied in 100 consecutive patients. The patients presented with
      gross anasarca and very low serum albumin, which was less than 15 g/l in 30
      patients. The three most frequent histological diagnoses in 98 renal biopsies
      were membranoproliferative glomerulonephritis (25), quartan malarial nephropathy
      (20), and proliferative glomerulonephritis (19): together they accounted for 65
      per cent of all biopsies. Only nine patients had minimal change nephropathy.
      Antigens were detected by immunofluorescence in the glomeruli of 70 of 76
      biopsies (92 per cent): Plasmodium malariae was detected in 25 per cent and
      hepatitis B surface antigen in 24 per cent. The disease was characterized by
      progressive deterioration in renal function and a high mortality rate of 13 per
      cent. Nine of the 13 deaths occurred within one year of diagnosis.

PMID- 2217665
TI  - Wilson's disease: 35 years' experience.
AB  - Thirty-seven Chinese patients fulfilling the criteria for Wilson's disease seen
      during a 35-year period were reviewed. Males and females were equally affected.
      Twenty-two patients were symptomatic and 15 asymptomatic; most of them presented
      before the third decade. Thirty-one per cent of the relatives screened showed
      evidence of disease, and parents were rarely affected (13 per cent). Half of the
      adult symptomatic females presented with primary amenorrhoea. Liver laboratory
      tests were abnormal in only 50 per cent of patients, with gamma
      glutamyltranspeptidase being the most sensitive index. Renal disease was
      infrequent. Serum caeruloplasmin level was the single biochemical parameter of
      prognostic significance (p = 0.0001). Seventy per cent of the symptomatic
      patients showed an improvement after treatment with penicillamine.

PMID- 2217666
TI  - The cutaneous manifestations in children with familial Mediterranean fever
      (recurrent hereditary polyserositis). A six-year study.
AB  - In a six-year study of 46 children with familial Mediterranean fever (recurrent
      hereditary polyserositis), 20 children (43 per cent) developed cutaneous
      manifestations. Ten children had 18 episodes of erysipelas-like erythema which
      proved to be specific for the disease. Twelve children (26 per cent) had 31
      episodes of non-specific purpuric rash and six children (13 per cent) had nine
      episodes of Henoch-Schonlein purpura. Other manifestations included diffuse
      erythema of the face, and/or trunk, angioneurotic oedema, diffuse erythema of the
      palms and soles followed by mild desquamation of the skin, Raynaud's phenomenon
      and a subcutaneous nodule. The mean frequency of the cutaneous lesions was
      1.6/patient/year before colchicine therapy and 0.4/patient/year after colchicine
      therapy (p = 0.0005). The high incidence of cutaneous manifestations and their
      response to colchicine strongly suggest that skin involvement is an integral part
      familial Mediterranean fever.

PMID- 2217667
TI  - Clinical, autonomic and therapeutic observations in two siblings with postural
      hypotension and sympathetic failure due to an inability to synthesize
      noradrenaline from dopamine because of a deficiency of dopamine beta hydroxylase.
AB  - A brother and sister with long-standing symptoms of postural hypotension are
      described. They were considerably worse in the morning, after exercise and in
      warm weather. In the male, erection was unaffected but ejaculation was prolonged
      or absent. Both had nocturia, but there were no urinary bladder, bowel or
      sweating abnormalities. Autonomic function tests confirmed sympathetic adrenergic
      failure with spared sympathetic cholinergic and intact parasympathetic function.
      There were no other neurological abnormalities. Noradrenaline and adrenaline were
      undetectable in the plasma, but plasma dopamine was elevated. Urinary levels of
      noradrenaline and adrenaline metabolites were below detection limits, but
      dopamine metabolites were normal or elevated. Dopamine beta-hydroxylase activity
      was undetectable in the plasma. Immunohistochemical studies of perivascular
      cutaneous tissue confirmed normal peptidergic and tyrosine hydroxylase
      immunoreactivity, with absent dopamine beta-hydroxylase immunoreactivity. The
      findings were consistent with an enzymatic deficit in the conversion of dopamine
      to noradrenaline. The parents were clinically and biochemically normal. Treatment
      of both patients with the synthetic amino acid, d-l-threo-dihydroxyphenylserine,
      which contains a hydroxyl group and is converted to noradrenaline by dopa
      decarboxylase, reduced symptoms and signs of postural hypotension and increased
      levels of plasma noradrenaline and its urinary metabolites. In the male,
      ejaculation became possible. Behavioural changes included a feeling of confidence
      and optimism, with a tendency to be argumentative. The laevo isomer also raised
      blood pressure and plasma noradrenaline levels. The drug had no direct pressor
      effects, as its actions were prevented by the dopa-decarboxylase inhibitor,
      carbidopa.

PMID- 2217668
TI  - Progression of diabetic autonomic neuropathy over a decade in insulin-dependent
      diabetics.
AB  - The prognosis for diabetics with autonomic neuropathy is little known. We
      therefore studied the progress of young insulin-dependent diabetics, first
      identified as having abnormal autonomic function 10-15 years ago. We have shown
      that the mortality of diabetics with symptomatic autonomic neuropathy is
      increased, but is less than previously reported. Mortality in asymptomatic
      diabetics with an isolated abnormality in autonomic function tests is not
      increased. The heart rate variability declines at 1.02 +/- 0.47 (SD) per annum in
      diabetics with an initially normal heart rate variability. While symptoms of
      autonomic neuropathy do not usually remit even over a decade, they do not
      commonly progress. Three groups of young insulin-dependent diabetics had heart
      rate variability tested between 1972 and 1977 and have been reviewed 10-15 years
      later. Group A (n = 49) had symptomatic autonomic neuropathy and an abnormal
      heart rate variability (less than 12), Group B (n = 24) were asymptomatic yet had
      an abnormal heart rate variability and Group C (n = 38) were asymptomatic and had
      a normal heart rate variability (16-26). The 10-year survival in Group A (73.4
      per cent) was less (P less than 0.05) than in Groups B (91.7 per cent) or C (89.5
      per cent) which did not differ from each other. The 18 Group A deaths were due
      predominantly to renal failure (n = 4), myocardial infarction in patients with
      nephropathy (n = 3) and sudden unexpected death (n = 3). The chief symptoms of
      autonomic neuropathy--diarrhoea, postural hypotension and gustatory sweating,
      were very persistent but did not necessarily deteriorate or become disabling in
      the majority of patients. The development of autonomic symptoms in asymptomatic
      patients with abnormal heart rate variability was uncommon over a decade.

PMID- 2217669
TI  - A study to assess the efficacy of chemoprophylaxis in the prevention of endoscopy
      related bacteraemia in patients aged 60 and over.
AB  - Five hundred and fifteen patients aged 60 and over (mean age 74.7; 278 men and
      237 women) underwent routine endoscopic procedures (gastroscopy, bronchoscopy and
      cystoscopy). Alternate patients were given antibiotics before the procedure, as
      currently recommended, and blood was taken for culture from all patients within
      five minutes of completion of the procedure. Of 74 patients who underwent
      bronchoscopy, only one culture, from one of 37 controls was positive. Of 262 who
      underwent gastroscopy, cultures were negative in the 130 who received antibiotics
      but positive in 13 of the 132 controls (9.8 per cent p less than 0.001).
      Cystoscopy was performed in 179; one culture was positive in the 88 given
      antibiotics (1.1 per cent) compared to 25 in the 91 controls (27.5 per cent; p
      less than 0.001). Bacteraemia rates appear to be low following bronchoscopy (less
      than 5 per cent) but higher with gastroscopy (10 per cent) and cystoscopy (28 per
      cent). Chemoprophylaxis was effective in reducing these rates in this patient
      group.

PMID- 2217670
TI  - The mouth in human immunodeficiency virus (HIV) infection.

PMID- 2217671
TI  - Rehabilitation after stroke.

PMID- 2217672
TI  - Hyponatraemia in patients with cirrhosis.
AB  - Hyponatraemia occurs in nearly half of patients in hospital with cirrhosis and
      ascites, and is due to the excessive retention of free water which results from
      the kidney's inability to excrete it normally. The morbidity and mortality
      associated with hyponatraemia is largely attributable to central nervous system
      disturbances. The degree to which brain water content increases depends on the
      duration of hyponatraemia and on compensatory mechanisms. Altered steroid and
      peptide hormones in cirrhotic patients may contribute to the development of
      hyponatraemic encephalopathy, symptoms of which overlap with hepatic
      encephalopathy and uraemia. The occurrence of central pontine myelinolysis is
      unrelated to the rate of correction of hyponatraemia. The appearance of
      hyponatraemia in cirrhotic patients, long regarded as a poor prognostic sign, may
      be a function of unrecognized underlying impaired renal function. Therapy for
      hyponatraemia remains suboptimal.

PMID- 2217673
TI  - Prognostic factors in acute renal failure following aortic aneurysm surgery.
AB  - This study analyses the prognostic factors associated with survival in 70
      patients who developed acute renal failure following surgery for an aortic
      aneurysm. Forty-nine patients (70 per cent) had surgery for a ruptured aortic
      aneurysm and 21 patients (30 per cent) had an elective procedure. Fifty-nine
      patients received haemodialysis. Thirty-three patients (47 per cent) survived the
      episode of acute renal failure. Six of these thirty-three patients died within
      three months of recovering from acute renal failure, giving an overall survival
      of 27/70 (39 per cent). A stepwise logistic regression analysis showed that the
      following factors significantly adversely affected survival: a need for inotropic
      support, ventilation for more than three days and age over 65 years. A model
      developed using these variables provided a basis for predicting outcome.

PMID- 2217674
TI  - Alpha 1-antitrypsin granules in the liver--always important?
AB  - We have studied the clinical histories and liver biopsy findings in 1951
      consecutive adult patients with suspected chronic liver disease, and in four
      known PiZ-homozygous alpha 1-antitrypsin-deficient patients with emphysema
      (candidates for lung transplant) and no known liver disease, in order to assess
      the importance of periportal alpha 1-antitrypsin granules in the liver and their
      possible causal role in liver disease, and to assess the value of possible
      screening tests. Periportal granules were found in 30 (1.5 per cent) of the 1951
      liver biopsies and in all four known PiZ-homozygous subjects. They were the sole
      putative aetiological agent in eight of 85 patients (9.4 per cent) with otherwise
      cryptogenic cirrhosis and present in 2.5 per cent of patients with cirrhosis of
      known aetiology (alcohol, autoimmune etc.). All but one were Z phenotype (seven
      homozygotes, 22 heterozygotes). alpha 1-Antitrypsin granules were seen in 12
      patients (including three of four lung transplant candidates) with no
      histological chronic liver disease. Determination of serum alpha 1-antitrypsin
      levels was quite unhelpful in identifying these patients. This study does not
      support the concept that periportal alpha 1-antitrypsin granules are necessarily
      pathogenic, but in some cases they may be causally related to otherwise
      cryptogenic liver disease. The presence of granules gave no important diagnostic,
      therapeutic or prognostic information.

PMID- 2217675
TI  - Final outcome of ursodeoxycholic acid treatment in 126 patients with radiolucent
      gallstones.
AB  - One hundred and twenty-six patients with radiolucent gallstones in 'functioning'
      gallbladders were treated with 8-10 mg ursodeoxycholic acid (UDCA) kg/day and
      followed to a treatment conclusion. Complete or partial gallstone dissolution was
      achieved in 74 (59 per cent). However, only 22 achieved complete gallstone
      dissolution, as judged by two normal oral cholecystograms; ultrasonograms were
      performed in 16 of these patients, and all were normal. UDCA was stopped in 76
      patients: because of cystic duct obstruction (n = 12), severe biliary pain (n =
      13), non-response (n = 25) or partial stone dissolution with arrested progress (n
      = 26). Life-table analysis showed that complete gallstone dissolution rates at
      four years were 25-30 per cent (two normal oral cholecystograms) and 17-19 per
      cent (two normal oral cholecystograms plus one ultrasonogram). All patients with
      complete gallstone dissolution had shown partial stone dissolution at 6-12
      months; of those with partial stone dissolution at six months, only 25 per cent
      went on to complete gallstone dissolution, and then always within two years.
      Efficacy correlated inversely with stone size but not with age, sex, obesity or
      on-treatment saturation indices. Acquired surface gallstone calcification
      developed in 13 patients (life-table analysis 22 +/- 7 per cent at four years);
      none of these patients achieved complete gallstone dissolution and only five
      achieved partial stone dissolution. Thus, despite relatively high partial
      gallstone dissolution rates, the ultimate efficacy of UDCA in achieving complete
      gallstone dissolution is low.

PMID- 2217676
TI  - Natural history and cardiac manifestations of homozygous familial
      hypercholesterolaemia.
AB  - Forty-nine patients with homozygous familial hypercholesterolaemia (diagnosed on
      the basis of family history, xanthomatosis, total serum cholesterol and low
      density lipoprotein receptor status) were studied over a period of 13 years, and
      underwent cardiovascular assessment. Eleven died, nine of myocardial infarction.
      Seven underwent coronary artery bypass, and another five had surgery to relieve
      supravalvular and valvular aortic stenosis. A distinctive pattern of disease was
      noted. Coronary ostial stenosis (four patients) and aortic root stenosis (six
      patients), both consequences of aortic root cholesterol deposition, were the
      typical manifestations of heart disease in childhood and adolescence. Adults
      developed severe coronary artery disease with a high incidence of main stem
      lesions (four of five patients). Surgery provided effective treatment for
      coronary artery disease and aortic outflow tract stenosis. Overall survival
      appeared to be better than reported in other studies which may reflect the
      'receptor-defective' status of this group of patients.

PMID- 2217677
TI  - Oral findings in HIV-infected patients attending a department of internal
      medicine: the contribution of intraoral examination towards the clinical
      management of HIV disease.
AB  - The occurrence of oral mucosal lesions was studied in 70 consecutive human
      immunodeficiency virus (HIV)-infected patients, including 35 patients with AIDS,
      who had been admitted to a Department of Internal Medicine. Lesions of the oral
      mucosa were observed in 52 patients (74 per cent). Oral candidiasis (50 per
      cent), hairy leukoplakia (14 per cent), periodontal disease (13 per cent), and
      oral Kaposi's sarcoma (4 per cent) were the most common lesions. Oral mucosal
      lesions suggestive of HIV infection were present in ten of 12 patients of unknown
      HIV status in whom Pneumocystis carinii pneumonia was suspected. Close
      cooperation between the medical and dental professions is recommended since
      accurate intraoral examination can make a valuable contribution towards the
      clinical management of HIV-infected patients and may influence the CDC
      classification of this disease.

PMID- 2217678
TI  - A predominantly adrenaline-secreting phaeochromocytoma.
AB  - A 61-year-old woman who presented with diabetes, nausea, weight loss and sweating
      was found to have a phaeochromocytoma secreting adrenaline, with a small amount
      of N-methyladrenaline. There was no significant increase in noradrenaline
      secretion. She was normotensive, and developed profound hypotension in response
      to the alpha-adrenergic antagonist phenoxybenzamine. These features are unusual
      in phaeochromocytoma, but similar features occurred in the very few previous
      reported cases of pure adrenaline-secreting phaeochromocytoma. We conclude that
      it is important to identify such patients, so that they should not be given alpha
      adrenergic antagonist drugs.

PMID- 2217679
TI  - Endocarditis in the 80s in a general hospital in Auckland, New Zealand.
AB  - The clinical and investigative features of 102 episodes of infective endocarditis
      were analysed retrospectively. The most frequent presenting symptoms (malaise,
      fever, sweats, myalgia, weight loss) were non-specific. Fever, cardiac murmur,
      tachycardia, vascular phenomena and a change in mental state were the most common
      physical signs at admission. Anaemia was present in half the episodes and renal
      and liver dysfunction in about one-third. Streptococci (61) and staphylococci
      (31) were the causative organisms in all but 10 episodes. The commonest
      predisposing factors were underlying cardiac disease (52 per cent) and a
      preceding focus of infection (14.6 per cent). Left ventricular failure (33 per
      cent) and focal neurological disease (29 per cent) occurred frequently. Valvular
      surgery was performed in 20 episodes, with two in-hospital deaths. Overall
      hospital mortality was 27.5 per cent and death was most commonly neurological
      (11/28). A higher mortality was associated with elevated total white blood count,
      microscopic haematuria, renal or liver dysfunction at admission, S. aureus
      endocarditis, the development of left ventricular failure or focal neurological
      disease, age greater than or equal to 60 years and persistence of fever after one
      week of antibiotic therapy. The absence of both renal dysfunction at admission
      and subsequent microscopic haematuria identified a group with a very low hospital
      mortality (4.7 per cent). The three-year mortality of the entire group was 43.5
      per cent.

PMID- 2217680
TI  - Clinical diagnosis of tamponade in Malawi.
AB  - A consecutive series of 25 Malawian patients with tamponade secondary to
      tuberculosis were compared to 25 patients with congestive cardiac failure,
      without pericardial effusion in a retrospective study. More patients with
      tamponade had an impalpable apex beat (21/1), pulsus paradoxus (13/0), soft heart
      sounds (13/2), paradoxical rise in jugular venous pressure (6/0), and fewer had a
      murmur (1/14). All these results are significant (p less than 0.05) by the chi 2
      test with Yates' correction. The presence of two or more of these discriminating
      physical signs has a positive predictive value of 75 per cent, and a negative
      predictive value of 99.5 per cent for the diagnosis of tamponade. Clinical
      diagnosis of tamponade by primary health care personnel in Malawi should be
      possible, and lead to earlier treatment.

PMID- 2217681
TI  - Diabetic nephropathy.

PMID- 2217682
TI  - Properties of parathyroid hormone-related protein and its role in malignant
      hypercalcaemia.

PMID- 2217683
TI  - Diagnosis and management of pulmonary thromboembolism.

PMID- 2217684
TI  - Double-blind randomized study of prolonged higher-dose oral amoxycillin in
      purulent bronchiectasis.
AB  - Thirty-eight patients with bronchiectasis and daily expectoration of purulent
      sputum despite conventional antibiotic courses were randomly allocated to receive
      a sachet of amoxycillin (3 g) or matched placebo twice daily for 32 weeks in a
      double-blind study. Nine patients (four amoxycillin, five placebo) were withdrawn
      from the study treatment; the response of the two patients (both on amoxycillin)
      withdrawn within the first six weeks was not assessed. The pretreatment
      characteristics of the two groups were similar. Independent assessment of overall
      response based on patients' diary cards showed that a higher proportion improved
      in the amoxycillin group (11 of 17) than in the placebo group (four of 19; p =
      0.02). Patients in the amoxycillin group spent significantly less time confined
      to bed and away from work during treatment. The frequency of exacerbations during
      the study treatment phase was similar in the two groups but they were less severe
      than before study treatment in the amoxycillin group. There was a greater
      reduction in purulent sputum volume between exacerbations during the study
      treatment in the amoxycillin group to 20 per cent of pretreatment volume than in
      the placebo group (88 per cent of pretreatment volume, p = 0.008), although the
      concentrations of Haemophilus spp. in sputum between exacerbations was similar in
      the two groups. Adverse effects experienced were minor except in one patient
      (amoxycillin) withdrawn after developing a rash and in six patients (three
      amoxycillin, three placebo) who had diarrhoea lasting more than one week
      necessitating withdrawal of two patients (one amoxycillin, one placebo) from
      study treatment. Sputum and stool cultures collected regularly during the study
      showed no important changes in the bacterial flora in either group. Prolonged
      higher-dose antibiotic therapy in these patients with severe purulent
      bronchiectasis significantly reduced the host (patient) inflammatory response to
      colonizing microorganisms and reduced morbidity.

PMID- 2217685
TI  - Defect in thermoregulation in malnutrition reversed by weight gain. Physiological
      mechanisms and clinical importance.
AB  - Previous studies in infants and in the elderly have shown that a low body weight
      is associated with a defect in thermoregulation and an increased risk of
      hypothermia. In the present study, thermoregulatory responses to a cooling
      stimulus were measured in 10 young and middle-aged patients who lost at least 10
      per cent of their body weight during illness. Investigations were performed
      before and after restoration of body weight (mean weight gain 7.2 kg, SE 1.2 kg,
      p less than 0.001). The cooling stimulus was provided by a special suit perfused
      with water at 28 degrees C and then at 23 degrees C. Before weight gain, there
      was no increase in metabolic rate in response to cooling, despite a fall in core
      temperature. Following weight gain, the thermogenic response to cooling was
      restored towards normal. Peripheral vasoconstriction, the principal mechanism for
      heat conservation, was similar before and after weight gain. The thermogenic
      response to an infusion of adrenaline (25 ng/kg/min) was not abolished by weight
      loss, suggesting that the defect in cold-induced thermogenesis following weight
      loss is due to a change in central control mechanisms of thermoregulation, and
      not to tissue unresponsiveness. The phenomenon of abnormal thermoregulation
      following weight loss and the return to normal with subsequent weight gain may be
      clinically important, particularly in the elderly, since quite small falls in
      core temperature may impair both neuromuscular coordination and cerebral
      function.

PMID- 2217686
TI  - The prevalence and risk factors associated with the onset of diabetic nephropathy
      in juvenile-onset (insulin-dependent) diabetics diagnosed under the age of 17
      years in Leicestershire 1930-1985.
AB  - The prevalence of diabetic nephropathy was studied in a population of 847
      juvenile-onset (insulin-dependent) diabetics diagnosed under the age of 17 years
      who attended diabetic clinics in Leicestershire between 1930 and 1985. Seven
      hundred and eighty-nine patients (93.2 per cent) were traced. Eight patients with
      non-diabetic proteinuria and four classified as maturity-onset diabetics of the
      young were excluded from further analysis. The mean age at onset was 9.3 +/- 4.2
      years (mean +/- SD) and the mean duration of diabetes 17.0 +/- 10.6 years (range
      3-63 years). Overall, 28 patients (3.6 per cent) developed persistent proteinuria
      and 39 patients (five per cent) intermittent proteinuria. End-stage renal failure
      developed in eight patients. In patients with diabetes of 20 years duration (n =
      254) the prevalence of persistent proteinuria was 9.1 per cent and of
      intermittent proteinuria, 7.9 per cent. Systolic and diastolic blood pressures
      were elevated in diabetics with persistent proteinuria compared to patients
      without proteinuria (154/89 +/- 27/15 vs 123/76 +/- 15/9 mm Hg mean +/- SD; p
      less than 0.001). Systolic blood pressure was also raised in patients with
      intermittent proteinuria (133/77 +/- 17/12, p less than 0.005). In addition,
      proteinuria (intermittent and persistent) was significantly associated with the
      use of once-daily insulin therapy in childhood and poor clinic attendance. This
      study suggests that twice-daily insulin therapy from diagnosis in childhood and
      regular contact with the diabetic clinic decreased the prevalence of diabetic
      nephropathy in this population.

PMID- 2217687
TI  - Subacute sclerosing panencephalitis in black children--a review of 18 cases.
AB  - Despite the fact that measles is severe and presents in very young Black children
      in Natal, South Africa, no case of subacute sclerosing panencephalitis was
      reported from this region prior to 1982. A retrospective study was therefore made
      over the six-year period 1982-1987 of 18 patients who presented to the King
      Edward VIII teaching hospital, Durban, with clinical and laboratory features of
      subacute sclerosing panencephalitis. The majority of patients (66 per cent) were
      between 8 and 12 years of age. The mean age of onset was 9.3 years, the youngest
      patient being four years nine months and the oldest 14 years. The male to female
      ratio was 1.25:1. A previous history of primary measles infection was obtained in
      44.4 per cent of cases; 62.5 per cent occurred before the second birthday. The
      commonest mode of presentation was personality, intellectual and behaviour
      disorders (83 per cent) followed by myoclonic seizures (61 per cent) and
      choreiform movements (28 per cent). Measles antibody was present in the CSF in
      all cases. The EEG was abnormal in all recorded cases with pathognomonic periodic
      complexes being found in 56.2 per cent. Confirmation of the diagnosis was
      provided by brain biopsy in two cases and by necropsy in one case. The findings
      of this study suggest that subacute sclerosing panencephalitis may not be as
      uncommon in Black children as has hitherto been thought.

PMID- 2217690
TI  - [Amalgam--material and clinical aspects].

PMID- 2217688
TI  - Studies on the pathogenesis of hypertension in Cushing's disease and acromegaly.
AB  - The pathogenesis of the hypertension associated with Cushing's syndrome and with
      acromegaly is poorly understood. We have investigated the possible roles of
      sodium retention, activation of the renin-angiotensin system and increased
      sympathetic nervous system activity in untreated patients. In 11 patients with
      Cushing's disease, seven of whom were hypertensive, total exchangeable sodium was
      normal despite increased levels of the mineralocorticoid hormones, 11-deoxy
      corticosterone and corticosterone. The renin-angiotensin system was also normal.
      Cardiac sensitivity to the beta-receptor agonist isoprenaline was increased, but
      this was not due to an increase in beta-adrenoceptor density. Hypertension in
      Cushing's disease is neither sodium-dependent nor angiotensin II-mediated, but
      increased cardiac sensitivity to catecholamines, by increasing cardiac output,
      may contribute to the pathogenesis of hypertension. In nine patients with
      acromegaly (three of whom were hypertensive) total exchangeable sodium was
      elevated. Although no correlation between blood pressure and exchangeable sodium
      was found, hypertension in acromegaly is probably sodium dependent. No evidence
      was found for a pathogenetic role for either the renin-angiotensin-aldosterone or
      the sympathetic nervous system.

PMID- 2217689
TI  - [Effect of force and torque on Branemark implants].

PMID- 2217691
TI  - [Adhesive bridges today].

PMID- 2217692
TI  - [Metal ceramic and full ceramic restorations (2)].

PMID- 2217693
TI  - [Modified plate apparatus and its different applications (4)].

PMID- 2217694
TI  - [Investigation of periodontal condition of orthodontic patients under various
      conditions in Periotest procedures].

PMID- 2217695
TI  - [Interpretation of radiographs].

PMID- 2217696
TI  - [ABC of practice management: E--effective decisions].

PMID- 2217697
TI  - [Comparative investigations of anesthetic activity of 2- and 4% Articain].

PMID- 2217698
TI  - [Modern amalgams--polishing and corrosion prevention in in vitro study. 1.
      Material and methods].

PMID- 2217699
TI  - [Procedures with Khoury's bone cover method for mandibular molar root resection
      in everyday practice].

PMID- 2217700
TI  - [Two-year clinical study of Luxafill filling material for fissure filling and
      Class I composite fillings].

PMID- 2217701
TI  - [Prosthetic rehabilitation after jaw tumor resection--case report].

PMID- 2217702
TI  - [Molar distalization with intraoral molar distalization bow--method for
      controlled position of 6-year molars in Class I relation (1)].

PMID- 2217704
TI  - [Modern dental photo system with autofocus function].

PMID- 2217703
TI  - [Action of different mouthwash solutions on infection rate of gingiva --study
      with army recruits].

PMID- 2217705
TI  - [Interpretation of radiographs].

PMID- 2217706
TI  - [ABC of practice management: L--leadership].

PMID- 2217707
TI  - [Germ colonization from dental treatment procedures with and without disinfection
      processes].

PMID- 2217709
TI  - [Dental assistant as office manager].

PMID- 2217708
TI  - [Modern amalgams--polishing and corrosion prevention in in vitro study. 2.
      Results].

PMID- 2217710
TI  - [Situation of dental assistant in Greece].

PMID- 2217711
TI  - [Success, what is it? Four years prevention in Hamburg kindergarten (1)].

PMID- 2217712
TI  - [Applied psychology in the dental office (6)].

PMID- 2217713
TI  - [Material comparison. 3. Endodontic instruments and materials (2)].

PMID- 2217714
TI  - [Ludwig's technic. 4. Placement of middle value articulator and positioning of
      Ludwig's-Technic-Cap].

PMID- 2217715
TI  - [Anchor technic with system].

PMID- 2217716
TI  - [Single unbiased procedure for control of precision dental casting].

PMID- 2217717
TI  - [Preparation of ceramic blended bridges with Sunrise metal-ceramic system].

PMID- 2217718
TI  - [From deciduous teeth to a beautiful permanent dentition--main issues of
      correction of deciduous teeth (2)].

PMID- 2217719
TI  - [Impression aids for synthetic resin prostheses using injection procedure].

PMID- 2217720
TI  - Modulation of intercellular communication during radiation and chemical
      carcinogenesis.
AB  - Carcinogenesis is a multistep process, involving the irreversible conversion of a
      stem cell to a terminal-differentiation-resistant cell ("initiation"), followed
      by the clonal expansion of this cell ("promotion") and by the acquisition of
      other genetic alterations leading to malignancy ("progression"). The initiation
      and progression steps seem to be facilitated by mutagenesis. Promotion has been
      associated with agents and conditions that cause mitogenesis. Gap junctional
      intercellular communication, a fundamental biological process regulating cell
      growth and differentiation, has been postulated to play a major role in
      carcinogenesis. The hypothesis is supported by the fact that many cancer cells
      have some dysfunction in gap junctional intercellular communication, many tumor
      promoting chemicals and several oncogenes (i.e., ras, src, mos, neu, but not myc)
      reduce gap junctional intercellular communication, and several growth factors
      (i.e., EGF, TGF-beta, bovine pituitary extract) inhibit gap junction function.
      This integrative concept postulates that chemical promoters, oncogenes coding for
      growth factors, receptors, or transmembrane signaling elements, and growth
      factors can isolate an initiated cell from the suppressing influence of
      surrounding normal cells by down-regulating the transfer of ions and small
      molecules through gap junctions.

PMID- 2217721
TI  - Role of gap junctional cell/cell communication in the control of proliferation
      and neoplastic transformation.
AB  - The C3H/10T1/2 cell system has been widely used as a quantitative assay for
      neoplastic transformation. Following exposure to chemical or physical
      carcinogens, there is a dose-dependent induction of neoplastic transformation in
      a small percentage of surviving cells. The ability of carcinogen-initiated cells
      to undergo transformation is highly dependent upon the effects of cell population
      density and is also inhibited by cancer chemopreventive retinoids. It is proposed
      that these observations are functionally related. Inhibition of transformation by
      retinoids correlates strongly with their ability to up-regulate intercellular gap
      junctional communication in normal and carcinogen-initiated cells while
      inhibition due to density effects correlates with the proximity of initiated
      cells to normal cells. It is hypothesized that junctional communication allows
      the transfer of signal molecules which suppress neoplastic transformation.

PMID- 2217722
TI  - Concepts for describing the interaction of two agents.
AB  - This paper reviews general concepts for understanding the effects of two or more
      agents. Models describing exposures to mixed fields of radiation are developed on
      the basis of very general postulates, and some of their consequences are examined
      against a set of experimental data.

PMID- 2217723
TI  - Effect of gamma radiation on membrane fluidity of MOLT-4 nuclei.
AB  - These experiments measured the effect of gamma radiation on the nuclear envelope
      using doxyl-fatty acid spin-label probes. Nuclei were isolated from cultured MOLT
      4 cells, a radiation-sensitive human T-cell lymphocyte. Membrane fluidity was
      measured from the electron paramagnetic resonance spectra of the probes. MOLT-4
      cells were grown under standard conditions, and suspensions were exposed to 60Co
      gamma radiation at room temperature. The spectra of 5-doxylstearic acid in the
      nuclei were those of a strongly immobilized label. A difference in the membrane
      fluidity was detected in a series of experiments comparing labeled irradiated and
      nonirradiated nuclei. The change in fluidity was measured by comparing the
      changes in the order parameter, S, of the spin label in irradiated nuclei with
      those in control nuclei. The change in the S ratio is dependent on radiation
      dose, increasing with doses up to 15 Gy. The maximum change of the order
      parameter with time after irradiation occurs 16-20 h after radiation exposure.
      These observations are correlated with changes in cell viabilities.

PMID- 2217724
TI  - Radiation-induced binding of DNA from irradiated mammalian cells to
      hydroxyapatite columns.
AB  - In experiments designed to measure radiation-induced DNA damage using the DNA
      unwinding-hydroxyapatite chromatography technique, we observed that under some
      experimental conditions a significant proportion of the test DNA became tightly
      bound to the hydroxyapatite (HA) and could not be released even with a high
      concentration of phosphate buffer. Approximately 5-10% of DNA from unirradiated
      cells binds to the HA. With increasing radiation doses in air, the fraction of
      bound DNA increases, reaching about 30% at about 35 Gy. The binding exhibits many
      of the characteristics of a radiation-induced cell lesion: the proportion of DNA
      retained by the HA is less when cells are irradiated under hypoxic conditions or
      in the presence of the thiol radioprotector dithiothreitol; and the binding
      decreases when an incubation period is allowed between irradiation and harvest of
      the cells for assay. Studies to determine the nature of the lesion responsible
      for the binding demonstrated that lesion production requires a component found in
      cells since no binding was observed with irradiated isolated DNA or nuclear
      matrix; the binding is not a result of the production of DNA-protein crosslinks;
      and the bound DNA is single-stranded, based on its sensitivity to nuclease S1.
      Because of the dose dependence of the binding of DNA to HA, the slopes of the
      dose-response curves for DNA damage determined with this assay depend on the
      method used to calculate the fraction of double-stranded DNA. Our demonstration
      that the bound DNA is single-stranded guides the choice of the method for data
      analysis.

PMID- 2217725
TI  - Allowing for random errors in radiation dose estimates for the atomic bomb
      survivor data.
AB  - The presence of random errors in the individual radiation dose estimates for the
      A-bomb survivors causes underestimation of radiation effects in dose-response
      analyses, and also distorts the shape of dose-response curves. Statistical
      methods are presented which will adjust for these biases, provided that a valid
      statistical model for the dose estimation errors is used. Emphasis is on
      clarifying some rather subtle statistical issues. For most of this development
      the distinction between radiation dose and exposure is not critical. The proposed
      methods involve downward adjustment of dose estimates, but this does not imply
      that the dosimetry system is faulty. Rather, this is a part of the dose-response
      analysis required to remove biases in the risk estimates. The primary focus of
      this report is on linear dose-response models, but methods for linear-quadratic
      models are also considered briefly. Some plausible models for the dose estimation
      errors are considered, which have typical errors in a range of 30-40% of the true
      values, and sensitivity analysis of the resulting bias corrections is provided.
      It is found that for these error models the resulting estimates of excess cancer
      risk based on linear models are about 6-17% greater than estimates that make no
      allowance for dose estimation errors. This increase in risk estimates is reduced
      to about 4-11% if, as has often been done recently, survivors with dose estimates
      above 4 Gy are eliminated from the analysis.

PMID- 2217726
TI  - Radiosensitivity increases with differentiation status of murine hemopoietic
      progenitor cells selected using enriched marrow subpopulations and recombinant
      growth factors.
AB  - The radiosensitivity of populations of colony-forming cells (CFC) in murine bone
      marrow was investigated using different recombinant colony-stimulating factors
      (CSFs; murine IL-3 and granulocyte-macrophage CSF and human granulocyte CSF), or
      purified murine macrophage CSF. With unfractionated normal bone marrow the CFC
      increased in radiosensitivity as they progressed through the granulocyte lineage.
      The D0 values ranged from 129 +/- 12 cGy for CFC stimulated with GM-CSF down to
      42 +/- 2 cGy after stimulation with G-CSF. IL-3 stimulated a CFC population which
      gave the only survival curve with a shoulder (n = 1.9 +/- 0.3). With semipurified
      populations of primitive or bipotential CFC, D0 values were generally lower with
      respect to the equivalent values for unpurified bone marrow (range 62 +/- 7 cGy
      to 135 +/- 7 cGy). Changes in cluster/colony ratio and colony morphology together
      possibly with products of accessory cells influence the interpretation of the
      radiosensitivity parameters.

PMID- 2217727
TI  - Immunoprecipitation of pyrimidine(6-4)pyrimidone photoproducts and cyclobutane
      pyrimidine dimers in uv-irradiated DNA.
AB  - Biological studies suggest that a significant proportion of the cytotoxicity
      observed in mammalian cells after uv irradiation may be due to damage other than
      cyclobutane dimers in DNA. Although pyrimidine-pyrimidone (6-4) photoproducts
      have been implicated as major contributors to cell lethality, their induction has
      been measured at considerably less than cyclobutane pyrimidine dimers when
      measured by chromatographic techniques. Because the yield of (6-4) photoproducts
      may be reduced by their lability to extreme heat and pH, we have advised an
      alternative, immunological quantification which does not require DNA hydrolysis.
      Affinity-purified rabbit antisera were used to precipitate low molecular weight
      32P-labeled PM2 DNA irradiated with increasing fluences of uv light. DNA of known
      molecular weight was used to determine rates of induction for antibody-binding
      sites associated with (6-4) photoproducts and cyclobutane dimers. These rates
      were calculated to be 0.6 (6-4) photoproducts and 1.2 cyclobutane dimers/10(8)
      Da/J/m2. At low uv fluences (6-4) photoproducts were induced at one-half the rate
      of cyclobutane dimers, whereas at higher fluences (6-4) photoproducts
      predominated.

PMID- 2217728
TI  - Radiobiology of alpha particles. I. Exposure system and dosimetry.
AB  - A 238Pu alpha-particle exposure apparatus was designed and constructed for use in
      radiobiological studies with cultured cell systems. The system provides a wide
      dynamic range of absorbed doses and a uniform radiation field. Average dose rate
      in air was measured with a small-volume ionization chamber. Estimates of dose
      rate at the cell surface were obtained from measurements taken with a silicon
      surface barrier detector. Particle fluence uniformity and fluence rate were
      measured using track etch procedures. The design and dosimetric characterization
      of the apparatus are discussed.

PMID- 2217729
TI  - Constraints to DNA unwinding near radiation-induced strand breaks in Ewing's
      sarcoma cells.
AB  - Ewing's sarcoma cell lines were compared to other cell lines for induction of DNA
      strand breaks by ionizing radiation and their ability to repair those breaks. The
      alkali-unwinding assay and alkaline sucrose gradient analysis were used for these
      studies. The alkali-unwinding assay revealed that the amount of DNA unwound per
      strand break in Ewing's sarcoma cells was less than for other cells and was not
      influenced by high-salt denaturation conditions. Ewing's sarcoma cells had
      similar induction and repair rates for strand breaks compared with other cell
      lines. The kinetics of unwinding suggests there are constraints to DNA unwinding
      in the chromatin of Ewing's sarcoma cells, possibly related to high levels of
      poly(ADP-ribose) polymerase in these cells.

PMID- 2217730
TI  - Cancer mortality following radium treatment for uterine bleeding.
AB  - Cancer mortality in relation to radiation dose was evaluated among 4153 women
      treated with intrauterine radium (226Ra) capsules for benign gynecologic bleeding
      disorders between 1925 and 1965. Average follow up was 26.5 years (maximum = 59.9
      years). Overall, 2763 deaths were observed versus 2687 expected based on U.S.
      mortality rates [standardized mortality ratio (SMR) = 1.03]. Deaths due to
      cancer, however, were increased (SMR = 1.30), especially cancers of organs close
      to the radiation source. For organs receiving greater than 5 Gy, excess mortality
      of 100 to 110% was noted for cancers of the uterus and bladder 10 or more years
      following irradiation, while a deficit was seen for cancer of the cervix, one of
      the few malignancies not previously shown to be caused by ionizing radiation.
      Part of the excess of uterine cancer, however, may have been due to the
      underlying gynecologic disorders being treated. Among cancers of organs receiving
      average or local doses of 1 to 4 Gy, excesses of 30 to 100% were found for
      leukemia and cancers of the colon and genital organs other than uterus; no excess
      was seen for rectal or bone cancer. Among organs typically receiving 0.1 to 0.3
      Gy, a deficit was recorded for cancers of the liver, gall bladder, and bile ducts
      combined, death due to stomach cancer occurred at close to the expected rate, a
      30% excess was noted for kidney cancer (based on eight deaths), and there was a
      60% excess of pancreatic cancer among 10-year survivors, but little evidence of
      dose-response. Estimates of the excess relative risk per Gray were 0.006 for
      uterus, 0.4 for other genital organs, 0.5 for colon, 0.2 for bladder, and 1.9 for
      leukemia. Contrary to findings for other populations treated by pelvic
      irradiation, a deficit of breast cancer was not observed (SMR = 1.0). Dose to the
      ovaries (median, 2.3 Gy) may have been insufficient to protect against breast
      cancer. For organs receiving greater than 1 Gy, cancer mortality remained
      elevated for more than 30 years, supporting the notion that radiation damage
      persists for many years after exposure.

PMID- 2217731
TI  - Frequency of micronuclei in hepatocytes following X and fast-neutron irradiations
      -an analysis by a linear-quadratic model.
AB  - The usefulness of the micronucleus assay for investigating the radiation response
      of hepatocytes was examined. The frequency was defined as the ratio of the total
      number of micronuclei to the number of hepatocytes examined. The dose-response
      curves were curvilinear after X rays and linear after neutrons. These dose
      response curves were analyzed by a linear-quadratic model, frequency = aD + bD2 +
      c. The a/b ratio was 3.03 +/- 1.26 Gy following X irradiation. This value is
      within the range of the alpha/beta ratios reported by others using the clonogenic
      assay of hepatocytes. While the a/b value for neutrons was 24.3 +/- 11.7 Gy, the
      maximum relative biological effectiveness of neutrons was 6.30 +/- 2.53. Since
      the micronucleus assay is simple and rapid, it may be a good tool for evaluating
      the radiation response of hepatocytes in vivo.

PMID- 2217732
TI  - On the recommendations of ICRP/90/G-01.

PMID- 2217733
TI  - [Radiobiology and the lessons of Chernobyl].
AB  - The Chernobyl accident has marked the beginning of a new stage of radiobiology
      development and revealed scantiness of old concepts. One should (1) search for
      effective protectors against the long-term influence of low-level radiation and
      means of removal of radionuclides using criteria that differ principally from
      those used previously in selecting among nontoxic antioxidants, immunomodulators,
      and adaptogens; (2) study systematically the synergism of low doses of harmful
      agents and review the hygienic standardization system with due regard for the
      risk from their combinations; (3) consider comprehensively, on the basis of the
      experimental and clinical experience, the problem of "hot" particles and remote
      consequences of their influence on the respiratory and digestive systems; (4)
      study independently the problem of chronic stress as a combination of radiation
      effects and psycho-emotional consequences of the accident and living in the
      exposed areas; (5) consider it inadmissible to include in the B category the
      population of the districts influenced by the accident and to use the concept:
      "35 rads during the lifetime" in standardizing the radiation load; (6) organize a
      comprehensive analysis of the Chernobyl accident consequences for public health
      within the contaminated areas as well as for animals and plants using a single
      approved methodology and programme, the principle of "other equal conditions"
      being provided.

PMID- 2217734
TI  - [Reciprocal translocations in mice found in the vicinity of the Chernobyl nuclear
      power station].
AB  - A study was made of the incidence of genetic damage to germ cells of male mice
      taken from or exposed within the thirty-kilometer zone of Chernobyl, the
      contaminated no-man's-land around the reactor that failed. At all contamination
      levels mouse spermatocytes exhibited reciprocal translocations, a relatively low
      frequency of which increased with increasing dose rate. Heterozygotes, with
      respect to reciprocal translocations (5%), were found among males exposed to
      enhanced radiation background as early embryos.

PMID- 2217735
TI  - [Monitoring the seeds of chronically irradiated indigenous populations of
      Plantago lanceolata L. Variability in the progeny].
AB  - The results of the morphometric study of Plantago lanceolata L. grown, in
      nursery, from seeds of the first and second post-accident reproductions within
      the thirty-kilometer zone around the crippled Chernobyl reactor show no
      relationship between the alterations in some quantitative indices and the
      variability of gamma-radiation background in places where maternal plants grow.

PMID- 2217736
TI  - [Partial sterility of the pine tree in 1986 and 1987 in the vicinity of the
      Chernobyl nuclear power station].
AB  - Reproductive potency of Pinus silvestris was studied in 1986, and 1987 within the
      zone of Chernobyl accident by the estimates of the survival rate of seed-buds
      during the gametophyte and embryonal development. At the radiation level of 4 Gy
      a partial female pine sterility was manifested by the decreased gametophyte
      survival rate of seedbuds, pollinated in 1986, and by the diminished embryonal
      survival rate of seed-buds pollinated in 1985.

PMID- 2217737
TI  - [A possible molecular mechanism of the impairment of the stability of the genome
      in cells capable of replicating DNA in acute and chronic forms of radiation
      sickness].
AB  - On the basis of the experimentally grounded concept concerning the functional
      antagonism of various domains of chromosomal SSB-proteins, that play a major role
      in the implementation of the contrary processes which either provide stability of
      DNA macromolecules or bear the responsibility for their degradation, a possible
      molecular mechanism of the disturbance of cell genome stability upon acute and
      chronic radiation sickness is discussed.

PMID- 2217738
TI  - [Specialized radiation-induced heritable nonstochastic damage at the cellular
      level of the organization].
AB  - In addition to widely known stochastic mutation effects, radiation also induces
      qualitatively different threshold (nonstochastic) changes that influence the
      genome but are not conditioned by mutations. The main characteristics of these
      changes are: spasmodic occurrence in virtually 100% of cells; independence of
      radiation dose (with regard to the degree of manifestation); low inducing doses;
      absence of repair throughout the indefinitely large number of cell generations;
      nonspecificity to mutagen agents, etc. The occurrence of the above changes among
      objects of different organization is demonstrated and the necessity of taking
      them into account in estimating a radiation danger is indicated.

PMID- 2217739
TI  - [Morphofunctional characteristics of the liver in the cerebral form of acute
      radiation sickness].

PMID- 2217740
TI  - [The development of neurocytes of the arcuate nucleus of the hypothalamus
      following whole-body gamma-irradiation of newborn rats].
AB  - The results of karyometric and cytometric studies show that gamma-irradiation
      inhibits the growth and development of arcuate nucleus neurocytes of
      hypothalamus. The secretory function of neurocytes is also inhibited which is
      particularly important with regard to the formation of adenohypophysis functions
      as a major regulator of the adaptation response development. A radiation-induced
      disturbance of the latter aggravates the radiation injury to critical organs or
      systems of young animals thus influencing their viability.

PMID- 2217742
TI  - [The microlocalization of natural uranium in bone tissue].
AB  - The author experimentally confirms the presence of a large share of uranium
      within the organic matrix of bone tissue and its uniform distribution within the
      bone mineral. It was shown in the powder-typed stratum bone cuts that the bone
      uranium is uniformly distributed within the bone mineral. The same is with the
      organic fraction of bone where uranium is uniformly distributed as well. This
      conclusion simplifies the calculation of the dose rate of irradiation of bone
      cells and red bone marrow cells with alpha-particles from the incorporated
      uranium, the event that these cells are plunged into a "cloud" of alpha-particles
      being proposed.

PMID- 2217741
TI  - [The interrelation of the levels of glucocorticoids and insulin in the blood of
      irradiated animals].
AB  - Similar changes in blood levels of immunoreactive insulin (IRI) and
      glucocorticoids (GC) were observed in rats, mice and dogs after X-irradiation
      with lethal doses. The use of the blood GC/IRI ratio indices in estimating the
      functional status of the exposed organism is discussed.

PMID- 2217743
TI  - [Permissible level of laser radiation of wavelength 10.6 microns].
AB  - In a four-month experiment with 102 male rabbits and 42 HRS/U mice and 30 days
      after termination thereof, study was made of local and general response of an
      organism to the effect of laser radiation (10.6 microns wave length and energy
      exposition 1/7 of the threshold). The radiation tolerance level was estimated.

PMID- 2217744
TI  - [Protein degradation during the interphase death of thymocytes induced by
      radiation and dexamethasone].
AB  - A study was made of protein degradation in rat thymocytes after exposure to
      ionizing radiation and dexamethasone. The pattern of degradation of 35S
      methionine labelled proteins in gamma-irradiated cells and in those incubated in
      the presence of dexamethasone did not vary from that in control cells. No
      essential increase was noted in the intracellular protein degradation during
      interphase death of thymocytes.

PMID- 2217745
TI  - [Spontaneous motor activity and physical endurance of rats during acute radiation
      sickness developing against a background of the use of a radioprotective agent].
AB  - Cystamine given to rats prior to irradiation with a dose of 8 Gy (LD77/30)
      ameliorates significantly the severity of radiation sickness and restores
      spontaneous motor activity by the time of clinical recovery. However, movements
      that require physical efforts as well as physical endurance remain decreased.

PMID- 2217746
TI  - Axillary shoulder with exaggerated rotation: the Hill-Sachs defect.
AB  - One of the most common fractures of the humeral head resulting from an anterior
      dislocation is the Hill-Sachs defect. Other special radiographic positions to
      demonstrate this injury may prove difficult for the patient to assume and
      maintain. An axillary shoulder projection with exaggerated external rotation is
      easy to position and clearly demonstrates the Hill-Sachs defect.

PMID- 2217747
TI  - A consistent method to produce lateral knee radiographs.
AB  - Performing lateral radiography of the knee can be challenging for the
      technologist because of the problem with superimposing the femoral condyles.
      There is an alternate method of imaging the knee in the lateral position so that
      the bony structures are projected to better advantage. For this method, the
      central ray is angled 5 degrees cephalad and the beam is aligned with the long
      axis of the lower leg.

PMID- 2217748
TI  - Interrelationship of the mind, body and emotions in the cancer fight.
AB  - There is an interrelationship between the mind, body and emotions in the fight
      against cancer. Stress seems to play a key role in the generation and
      continuation of cancer and there appear to be cancer-prone personality patterns
      associated with the propagation of increased stress levels. Psychological
      intervention methods have been developed to help patients cope, and the health
      care team can make a difference.

PMID- 2217750
TI  - Use of an OSCE in education for radiation therapists.
AB  - Concern about current clinical evaluation methods assuring attainment of basic
      clinical skills by radiation therapy students stimulated a project to design,
      develop, implement and evaluate an Objective Structured Clinical Exam (OSCE). The
      results suggest that the OSCE is a worthwhile, practical and effective clinical
      evaluation method for assessing basic clinical skills of radiation therapy
      students.

PMID- 2217749
TI  - Post-myelogram CT and the incidence of headache.
AB  - CT following myelography is superior to myelography alone in the diagnosis of
      spine disease. When using water soluble contrast, post myelogram orders include
      keeping the patient's head elevated. Examination by computed tomography
      necessitates the patient's head be lowered. This study demonstrates that post
      myelographic CT does not produce a significant increase in headache.

PMID- 2217751
TI  - Big job requires staff.

PMID- 2217752
TI  - Questions about questioning?

PMID- 2217753
TI  - [Conventional diagnosis of carpal luxation and instability].
AB  - The recognition of ligament disruption in carpal dislocation and the early
      diagnosis of carpal instability have had implications for the therapy since the
      evolution of differentiated surgical treatment concepts including ligament
      reconstruction. Plain radiography and the carpal instability series are helpful
      in the detection of ligament disruption. The radiological analysis is based on
      the configuration and arrangement of the carpals, the setting of their axes, and
      the detection of intercarpal gaps. Mechanisms and characteristic radiological
      findings in the different types of carpal dislocation and instability
      (scapholunate dissociation, palmar or dorsal intercalated segment instability)
      are demonstrated in relation to physiological appearance, and the value of
      conventional films in the diagnosis of carpal dislocation and instability is
      discussed.

PMID- 2217754
TI  - [Computed tomography of the wrist].
AB  - CT is a diagnostic tool that allows imaging of the wrist, wrist joint and distal
      radioulnar joint in the axial plane without superimposition. The differentiation
      of bone, joint space and soft tissue is possible in a single examination. This is
      helpful in the diagnosis of traumatic, degenerative or malignant lesions of bones
      together with the soft tissue reactions. Further information can be obtained by
      means of three-dimensional reconstructions.

PMID- 2217755
TI  - [The examination technique and normal morphology of the ligaments in MRT of the
      wrist].
AB  - The normal ligamentous anatomy and an efficient examination technique for the
      wrist are demonstrated with reference to examinations conducted in healthy
      volunteers. Only the ulnar complex, the radial collateral ligament, the distal
      intercarpal ligaments and the radial parts of the palmar and dorsal V-ligaments
      are adequately visualized. Thus, limited specificity means that static high
      resolution MRI of the wrist cannot at present be considered an adequate
      examination method for the evaluation of unexplained wrist pain and instability.
      So far MRI can only play a key role in the diagnosis of lesions of the ulnar
      complex.

PMID- 2217756
TI  - [A comparison of arthrography and magnetic resonance tomography in painful
      limited movements of the hand].
AB  - In 18 patients with unclear pain in the wrist limiting hand movement,
      arthrography and magnetic resonance imaging (MRI) were compared. The FISP
      gradient echo sequence turned out to be superior to the T1 weighted spin-echo
      sequence in the imaging of the triangular fibrocartilage complex. MRI is very
      sensitive in detecting triangular fibrocartilage lesions and therefore represents
      a suitable non-invasive screening method. It is, however, not possible to assess
      the degree of the lesion. Ruptures in carpal tendons could only be diagnosed by
      means of arthrography.

PMID- 2217757
TI  - [X-ray and ultrasonic diagnosis of rheumatic-inflammatory diseases of the elbow].
AB  - The X-ray anatomy and ultrasound appearance of the normal elbow joint are
      described. The ultrasound testing procedure for visualizing the soft tissue layer
      and the intra-articular inflammatory substrate is presented. The general X-ray
      signs of arthritis in the elbow joint are presented, and then the radiological
      particularities and characteristics of the various forms of arthritis are
      discussed with reference to their different etiologies.

PMID- 2217758
TI  - [Spinal infarct? Cervical spinal stenosis? Cervical epidural hematoma].

PMID- 2217759
TI  - The role of US in breast imaging.

PMID- 2217760
TI  - Cervical disk disease.

PMID- 2217761
TI  - Cloacal malformations and exstrophy syndromes.

PMID- 2217762
TI  - Diffusion/perfusion MR imaging of the brain: from structure to function.

PMID- 2217763
TI  - Sonographic determination of tubal rupture in patients with ectopic pregnancy: is
      it feasible?

PMID- 2217764
TI  - Intervertebral disk: normal age-related changes in MR signal intensity.

PMID- 2217765
TI  - Mammography in the eighties.
AB  - Mammography has experienced the greatest change of any existing radiologic
      examination in recent years. In 1985, as a part of the Nationwide Evaluation of X
      Ray Trends (NEXT) program, a national survey was conducted of a statistically
      selected sample (n = 232) of facilities performing mammography examinations in
      the United States. By 1988, the number of mammography facilities in the United
      States had increased to over 6,400, an increase of over 60% from the 1985 level.
      To assess the consequence of this expansion as well as the impact of recent
      technological and other significant developments on mammography, a NEXT survey of
      mammography facilities was repeated in 1988 (n = 226). Screen-film mammography
      accounted for 83% of the facilities surveyed in 1988, and dedicated equipment
      dominated screen-film systems (99%). There was a 26% increase in the overall mean
      phantom image score, over 45% increase in the use of grids, and 10% increase in
      mean glandular dose for systems using grids.

PMID- 2217766
TI  - Average radiation exposure values for three diagnostic radiographic examinations.
AB  - National surveys of more than 600 facilities that performed chest, lumbosacral
      spine, and abdominal examinations were conducted as a part of the Nationwide
      Evaluation of X-Ray Trends program. Radiation exposures were measured with use of
      a set of standard phantoms developed by the Center for Devices and Radiological
      Health of the Food and Drug Administration, U.S. Public Health Service. X-ray
      equipment parameters, film processing data, and data regarding techniques used
      were collected. There were no differences in overall posteroanterior chest
      exposures between hospitals and private practices. Seventy-six percent of
      hospitals used grids, compared with 33% of private practices. In general,
      hospitals favored a high tube voltage technique, and private facilities favored a
      low tube voltage technique. Forty-one percent of private practices and 17% of
      hospitals underprocessed their film. Underprocessing in hospitals increased from
      17% in 1984 to 33% in 1987. Average exposure values for these examinations may be
      useful as guidelines in meeting some of the new requirements of the Joint
      Commission on Accreditation of Healthcare Organizations.

PMID- 2217767
TI  - Pulmonary neoplastic and lymphoproliferative disease in AIDS: a review.
AB  - Kaposi sarcoma and lymphoma are the most common forms of neoplastic disease
      encountered in patients with acquired immunodeficiency syndrome (AIDS). Pulmonary
      involvement is fairly common with Kaposi sarcoma, while lymphoma only rarely
      involves the lungs. There has been a significant increase in the number of AIDS
      patients who develop Kaposi sarcoma, especially male homosexuals. There has also
      been an increase in the incidence of high-grade (aggressive) lymphoma in male
      homosexuals (and young men in general). Lymphoid interstitial pneumonia is a
      chronic condition that primarily affects adults and is becoming more common in
      patients with AIDS. When present in children less than 13 years old, lymphoid
      interstitial pneumonia is considered to be an indication of AIDS. Bronchus
      associated lymphoid tissue and a condition resembling angioimmunoblastic
      lymphadenopathy are also being found in children with AIDS. A review of the
      literature on neoplastic and lymphoproliferative disease in AIDS suggests that a
      variety of lymphoproliferative disorders in AIDS can be expected in the future.

PMID- 2217768
TI  - Pinch-off syndrome: a complication of implantable subclavian venous access
      devices.
AB  - Implantable central venous access devices placed via the subclavian vein may
      become obstructed by thrombosis, impingement against a vein wall, or compression
      between the clavicle and first rib. The latter has been termed pinch-off syndrome
      (POS). Eleven patients with POS were studied, including one whose catheter had
      fractured and one whose catheter had fragmented. They were compared with 22
      matched control patients and 100 consecutive routine clinic patients. Each
      catheter was graded: 0 = normal, 1 = abrupt change in course with no luminal
      narrowing, 2 = luminal narrowing, and 3 = complete catheter fracture. POS was
      present in most (eight of 11) cases within 3 weeks after placement. A grade 1
      catheter was common (33%) among control subjects, but grades 2 and 3 were
      uncommon (1%). Catheter fracture or fragmentation was seen in two of five cases
      with long-term (greater than 3 weeks) pinching (grade 2 catheter). The following
      conclusions were reached: Grade 2 represents significant catheter compression and
      the potential for serious complications. Grade 1 is of uncertain clinical
      significance, due to its high prevalence in control subjects.

PMID- 2217769
TI  - Hemoptysis: CT-bronchoscopic correlations in 58 cases.
AB  - Computed tomographic (CT) and chest radiographic findings were retrospectively
      correlated with those found at fiberoptic bronchoscopy (FOB) in 58 patients
      presenting with hemoptysis. Abnormalities involving the airways were depicted by
      CT in a total of 28 cases (48%). In 18 of these (31% of the total group of 58),
      focal abnormalities involving the central airways were identified (17 were
      subsequently proved to be malignant) and in 10 (17% of the total), CT showed
      bronchiectasis. Focal airway abnormality was shown by FOB in 18 cases (31%); all
      of these were depicted with CT. Malignancy was diagnosed in 24 patients,
      including three in whom results of FOB were normal but malignant cells were
      identified at transbronchial biopsy. CT abnormalities were identified in all
      cases of malignancy. In 10 of 21 cases (48%) of non-small cell lung cancer, CT
      allowed definitive staging by documenting either direct mediastinal invasion
      and/or metastatic disease, while FOB allowed definitive staging in only three
      cases. CT studies provided no false-negative results. It is concluded that when
      carefully performed, CT may be an effective modality for evaluating patients
      presenting with hemoptysis.

PMID- 2217770
TI  - Coal worker's pneumoconiosis: CT assessment in exposed workers and correlation
      with radiographic findings.
AB  - To study the signs of coal worker's pneumoconiosis (CWP) at computed tomography
      (CT), the authors obtained thoracic CT scans in 170 coal-dust-exposed workers who
      were concomitantly evaluated with conventional posteroanterior and lateral
      radiography. The profusion and extent of disease was assessed by means of CT in
      two groups of miners: group 1 (n = 86), miners with worker's compensation and
      radiographic evidence of CWP, and group 2(n = 84), miners who had applied for
      compensation without radiographic evidence of CWP. The CT signs of CWP consisted
      of micronodules, nodules, and progressive massive fibrosis. The comparative
      analysis demonstrates the superiority of an optimal CT technique over chest
      radiography in the evaluation of simple silicosis, with improved sensitivity in
      the detection of small parenchymal opacities. CT provides additional information
      on the stage of the disease but also clarifies some ambiguities of the ILO
      classification of small opacities. CT was equivalent to radiography for
      complicated silicosis, except in the identification of necrosis. CT evaluations
      are complementary to plain radiography in the assessment of CWP, and the addition
      of high-resolution CT is useful in achieving a more accurate evaluation of the
      small parenchymal opacities.

PMID- 2217771
TI  - Persistent and recurrent hyperparathyroidism: assessment with gadopentetate
      dimeglumine-enhanced MR imaging.
AB  - The effect of gadopentetate dimeglumine on signal intensity of abnormal
      parathyroid glands was assessed in 14 patients with persistent and recurrent
      hyperparathyroidism. Non-contrast material-enhanced T1- and T2-weighted spin-echo
      images were compared with T1-weighted images obtained 1 minute and 10 minutes
      after administration of gadopentetate dimeglumine. Percentage of contrast between
      the abnormal gland and surrounding tissue was determined with the use of skeletal
      muscle, subcutaneous fat, and thyroid gland as reference tissues. All 11 abnormal
      parathyroid glands showed low to intermediate signal intensity on T1-weighted
      images and high signal intensity on T2-weighted images. Gadopentetate dimeglumine
      significantly increased the signal intensity enhancement ratio of all abnormal
      parathyroid glands, causing increased percentage of contrast relative to the
      thyroid gland and skeletal muscle on T1-weighted images. However, the percentage
      of contrast relative to these tissues was even greater on nonenhanced T2-weighted
      images. Thus, gadopentetate dimeglumine can substantially enhance the signal
      intensity of abnormal parathyroid glands and improve differential contrast with
      some neighboring tissues on T1-weighted images, but it does not improve contrast
      with surrounding tissue beyond that achieved on T2-weighted images.

PMID- 2217772
TI  - Cervical lymph node metastasis: assessment of radiologic criteria.
AB  - To estimate the accuracy of different radiologic criteria used to detect cervical
      lymph node metastasis in patients with head and neck carcinoma, seven different
      characteristics of 2,719 lymph nodes in 71 neck dissection specimens from 55
      patients were assessed. Three lymph node diameters, their location, their number,
      the presence of a tumor, and the amount of necrosis and fatty metaplasia were
      recorded. The minimal diameter in the axial plane was found to be the most
      accurate size criterion for predicting lymph node metastasis. A minimal axial
      diameter of 10 mm was determined to be the most effective size criterion. The
      size criterion for lymph nodes in the subdigastric region was 1 mm larger (11
      mm). Groups of three or more borderline nodes were proved to increase the
      sensitivity but did not significantly decrease the specificity. Radiologically
      detectable necrosis (3 mm or larger) was found only in tumorous nodes and was
      present in 74% of the positive neck dissection specimens. Shape was not a
      valuable criterion for the radiologic assessment of the cervical lymph node
      status.

PMID- 2217774
TI  - Normal pituitary gland: coronal MR imaging of infundibular tilt.
AB  - To determine the prevalence of pituitary infundibular deviation or tilt as a
      normal variant, coronal magnetic resonance (MR) images of 50 patients who had
      been examined for reasons other than pituitary disease were evaluated
      retrospectively. Forty-six percent of the patients had a more or less pronounced
      tilt of the pituitary stalk. This tilt was due to developmental lateral
      eccentricity of the pituitary gland in relationship to the midline of the brain
      in 34% and to ontogenic eccentric insertion of the pituitary infundibulum off the
      midline of the gland in the other 12%. This high frequency of stalk deviation in
      patients without pituitary disease suggests that such displacement by itself
      should not be used to support the presence of pituitary microadenoma on MR images
      or computed tomograms.

PMID- 2217773
TI  - Intervertebral disk: normal age-related changes in MR signal intensity.
AB  - The effect of age on the signal intensity of normal lumbar intervertebral disks
      was studied. Twenty-seven cadavers ranging in age from newborn to 79 years were
      studied with use of a 1.5-T magnetic resonance (MR) imager within 48 hours of
      death. The signal intensity in the central area of the disk was measured on a
      sagittal image obtained with a long repetition time (TR) and a long echo time
      (TE) and correlated to the age. A significant correlation between the decrease in
      signal intensity and age was found, although signal intensity changed less than
      6% in 80 years. The decrease in signal intensity is concomitant with decreases in
      water and glycosaminoglycans and increases in collagen in the disk.

PMID- 2217775
TI  - Gd-HP-DO3A in clinical MR imaging of the brain.
AB  - As part of a phase II clinical trial, 14 patients with presumed intracranial
      neoplastic disease underwent magnetic resonance (MR) imaging before and after
      intravenous injection of gadolinium 1,4,7-tris(carboxymethyl)-10-(2'
      hydroxypropyl)-1,4,7,10-tetraazacycl ododecane (HP-DO3A). This neutral (nonionic)
      gadolinium chelate has lower osmolality, when formulated at equimolar
      concentrations, and superior in vitro stability compared with gadopentetate
      dimeglumine. The safety profile of Gd-HP-DO3A permitted administration of doses
      up to 0.3 mmol/kg, three times the dose of gadopentetate dimeglumine approved by
      the U.S. Food and Drug Administration. In this limited clinical trial, Gd-HP-DO3A
      proved to be a safe and efficacious agent in MR imaging of the head. The only
      change documented in patient monitoring was that of slight skin redness at the
      injection site immediately after administration in two patients. No statistically
      significant changes due to administration of the agent were noted in laboratory
      evaluations. These results differ from those obtained with gadopentetate, which
      induces a transient rise in serum iron and bilirubin levels in up to 26% of
      patients. Administration of higher doses of Gd-HP-DO3A, either 0.2 or 0.3
      mmol/kg, appeared to provide improved enhancement. No decrease in efficacy at
      these high doses was noted.

PMID- 2217776
TI  - Anisotropic diffusion in human white matter: demonstration with MR techniques in
      vivo.
AB  - Quantitative measurements of perfusion and molecular diffusion were made in human
      white matter in two orientations of the motion-sensitization gradient to document
      anisotropy of these parameters. Measurements were localized to a 10 X 10-mm
      tissue column oriented in an anterior-to-posterior direction in the left cerebral
      hemisphere just above the body of the left ventricle. This region was selected
      because of the relatively high directionality of white matter fibers. In this
      study of five healthy volunteers, strong diffusion anisotropy was observed in all
      cases. Twofold or greater anisotropy was commonly observed, with the higher
      diffusion value associated with motion sensitivity along the fiber directions. By
      combining data from both gradient orientations in all cases, diffusion values of
      solid tissue ranged from 0.38 X 10(-3) mm2/sec to 1.12 X 10(-3) mm2/sec, and
      measured perfusion fractions were in the range of 2%-5% (excluding areas highly
      contaminated by cerebrospinal fluid). Little or no perfusion-fraction anisotropy
      was observed; however, perfusion measurements were limited by noise. Data were
      collected without cardiac gating by using a technique that offers good immunity
      to bulk tissue motion artifacts.

PMID- 2217777
TI  - Echo-planar imaging of intravoxel incoherent motion.
AB  - The recently established single-shot technique of echo-planar imaging of
      intravoxel incoherent motion (IVIM) for determining and imaging the variations of
      microscopic motions of water has been applied to studies of water perfusion in
      phantoms and to in vivo studies of diffusion and perfusion in cat and human
      brains. The phantom results demonstrate that perfusion levels comparable with
      those found in vivo have easily observable and reproducible effects on signal
      amplitude that are consistent with previous IVIM theory. Reliable measurements of
      the diffusion coefficient in various types of brain tissue have been obtained.
      The results for white matter are consistent with the existence of anisotropic
      diffusion in oriented bundles of myelinated nerve fibers. The results for gray
      matter can be fitted to the IVIM theory and suggest a value of up to 14% for the
      fraction of the signal contributed by randomly perfusing fluid in normal cerebral
      cortex.

PMID- 2217778
TI  - Lumbar facet joint capsule: appearance at MR imaging and CT.
AB  - The joint spaces and synovium of the lumbar facet joints extend beyond the
      articular surfaces of the joint in the majority of adults. The authors correlated
      magnetic resonance (MR) imaging, computed tomographic (CT), and axial
      cryomicrotome sections of 66 facet joints in nine cadavers. Extensions of the
      synovium and joint space along the superior and inferior articular processes,
      under the ligamentum flavum, and into the ligamentum flavum could be recognized
      with use of MR and, less successfully, CT. The injection of a paramagnetic
      contrast medium into the facet joint facilitated visualization of the capsule on
      MR images. On the ventral aspect of the lumbar facet joint, MR images showed
      regions of high signal intensity where the joint space extended into the
      ligamentum flavum or between the ligamentum flavum and lamina. On the dorsal
      aspect of the joint, MR demonstrated prominence of the fibrous joint capsule
      where the joint space extended under it along the inferior articular process or
      along the superior articular process. The variable appearance of the ventral and
      dorsal aspects of the lumbar facet joint on CT and MR images is due to extension
      of the synovium and joint space.

PMID- 2217779
TI  - Temporal bone: three-dimensional CT. Part I. Normal anatomy, techniques, and
      limitations.
AB  - Three-dimensional (3D) surface renderings of the temporal bone were created from
      routine axial computed tomographic (CT) images in 15 subjects and in cadaver
      specimens. The displayed anatomy was correlated with these specimens, as well as
      with images from the routine study. Six sets of viewing angles were derived for
      optimal display of surgically important surface landmarks, such as the
      suprameatal triangle and supramastoid crest. The 3D CT images were found to be of
      excellent quality and permitted a global view of the temporal bone surface
      anatomy. Bone depletion artifacts ("pseudoforamina") posed a potentially serious
      problem in evaluating the tegmen and wall of the sigmoid sulcus, being present in
      eight of 20 cases. Three-dimensional CT may be a useful adjunct to routine
      temporal bone imaging.

PMID- 2217780
TI  - Development of the human cerebellum observed with high-field-strength MR imaging.
AB  - A retrospective study of 160 pediatric subjects, aged 32-410 weeks after
      conception, was conducted to determine the normal developmental patterns of the
      human cerebellum by means of magnetic resonance (MR) imaging. On the basis of
      axial T2-weighted spin-echo images (repetition time, 3,000 msec; echo time, 120
      msec), which provided the best contrast between gray matter and white matter,
      five distinct developmental stages were defined. At term, the medial lemnisci as
      well as the parasagittal cerebellum were myelinated. The appearance of myelin in
      the middle cerebellar peduncles and the basilar pons preceded that in the corpus
      medullare of the cerebellum. The normal age ranges for the different stages were
      defined with statistical analysis. These ranges are applicable to the daily
      routine of image interpretation. The sequence of myelination in the cerebellum
      observed at MR imaging correlates with the known patterns observed in pathologic
      studies but lags behind by an average of 6 months.

PMID- 2217781
TI  - Phenylketonuria: MR imaging of the brain with clinical correlation.
AB  - Fifteen patients with biochemically documented phenylketonuria (PKU) were studied
      with use of magnetic resonance (MR) imaging with spin-echo T2-weighted pulse
      sequences. The resulting images demonstrated varying degrees of symmetric high
      signal intensity of the white matter within the posterior cerebral hemispheres.
      Involvement of the anterior hemispheres was seen only in cases with severe signal
      intensity changes. There was no involvement of the cerebral cortex, brain stem,
      or cerebellum. Moreover, no anatomic structural abnormalities were observed. Mild
      cortical atrophy was observed in eight of the 15 patients. There was no
      significant correlation between the patients' IQ scores and the level of MR
      signal intensity changes. Although MR imaging routinely shows relatively distinct
      abnormalities in patients with PKU, the clinical severity of the disease does not
      parallel its imaging severity.

PMID- 2217782
TI  - The cloacal malformation: radiologic findings and imaging recommendations.
AB  - The imaging studies and records of 65 patients with the cloacal malformation seen
      from 1969 to 1989 were reviewed. The malformations were described according to
      cloacal configuration (urethral, vaginal), type of urinary-cloacal communication
      (urethral, vesical), and level of rectal communication (vaginal, cloacal,
      vesical, other). Lower urinary tract abnormalities were frequent (reflux,
      ureteral ectopia, bladder diverticula, bladder duplication, urachal remnants,
      urethral duplication), as were genital abnormalities (uterine duplication,
      vaginal duplication, uterine atresia, vaginal atresia), abnormalities of the bony
      pelvis (partial sacral agenesis, pubic diastasis), and renal abnormalities
      (agenesis, obstruction, horseshoe kidney). Contrast material studies of the
      cloaca and the distal limb of the colostomy with fluoroscopy in various
      projections were essential for diagnosis. Voiding cystourethrography was
      important for detecting vesicoureteric reflux. Sonography was of limited value
      for evaluation of the malformation but was valuable for imaging the kidneys. MR
      imaging revealed that spinal cord abnormalities cannot be predicted based on the
      appearance of the lumbosacral spine and are more common than previously thought.

PMID- 2217784
TI  - Ligaments of the lateral aspect of the ankle and sinus tarsi: an MR imaging
      study.
AB  - The normal anatomy of the lateral ankle and subtalar ligaments seen at magnetic
      resonance (MR) imaging was studied in four cadaver ankles. Sixteen ankles of 11
      healthy volunteers were imaged with four different MR imaging protocols to
      optimize technique. The anterior talofibular ligament was identified in 100% of
      the ankles of the volunteers in the axial plane, the calcaneofibular ligament in
      81% of the ankles in the coronal plane, the cervical ligament in 69% of the
      ankles in the coronal plane and in 88% of the ankles in the sagittal plane, and
      the talocalcaneal ligament in 56% of the ankles in the coronal plane and in 62%
      of the ankles in the sagittal plane. It is concluded that thin-section (1-3-mm)
      MR imaging techniques, especially the one in which data are acquired with three
      dimensional Fourier transform, are best for visualization of the ligaments. These
      techniques may play a role in the evaluation of patients with chronic ankle pain
      and instability.

PMID- 2217783
TI  - Primary Ewing sarcoma: follow-up with Ga-67 scintigraphy.
AB  - While avid accumulation of gallium-67 citrate and technetium-99m methylene
      diphosphonate (MDP) occurs initially in most cases of primary Ewing sarcoma,
      uptake after therapy is less well defined. Thirty patients with Ewing sarcoma who
      underwent Ga-67 and bone scintigraphy at diagnosis, at completion of therapy, and
      at relapse from 1978 to 1988 were evaluated. All 30 patients showed less primary
      site Ga-67 activity following therapy. Twenty-three of 28 patients who underwent
      corresponding bone scintigraphy showed less uptake, but residual activity was
      usually more intense than with Ga-67. Avid reaccumulation of Ga-67 occurred in
      four of five patients with primary site relapse, while patients who underwent
      bone scintigraphy showed less change. It was concluded that a greater decrease in
      Ga-67 than in Tc-99m MDP uptake often occurs in patients successfully treated for
      primary Ewing sarcoma. Information obtained at Ga-67 scintigraphy is most likely
      to be helpful if results of bone scintigraphy remain abnormal or if occult
      relapse is suspected.

PMID- 2217786
TI  - Meniscal abnormalities in the asymptomatic population at MR imaging.
AB  - Two hundred eighty meniscal horns in 64 asymptomatic volunteers in the 2nd to 8th
      decades of life were analyzed for meniscal abnormalities. Grade 1, 2, and 3
      changes were present in essentially all decades. There was at least a 25%
      prevalence of meniscal signal abnormalities as early as the 2nd decade. The
      prevalence of meniscal abnormalities increased sharply with age. The prevalence
      of all signal abnormalities correlated with age, grade 2 changes having the
      highest correlation coefficient (+.88). The correlation coefficient for grades 1
      and 3 changes were +.60 and +.71, respectively. The posterior horn of the medial
      meniscus had a significantly higher (P less than .02) prevalence of abnormalities
      than did the other meniscal locations. There was no significant correlation
      between subject weight or sex and meniscal signal. The authors conclude that
      there is a baseline prevalence of meniscal signal in the asymptomatic population.

PMID- 2217785
TI  - Scapholunate advanced collapse: a common wrist abnormality in calcium
      pyrophosphate dihydrate crystal deposition disease.
AB  - Scapholunate advanced collapse (SLAC) is a pattern of wrist malalignment that has
      been attributed to posttraumatic or spontaneous osteoarthritis of the wrist. Its
      features, however, also have been observed in patients with idiopathic calcium
      pyrophosphate dihydrate (CPPD) crystal deposition disease. To determine the
      frequency and characteristics of SLAC in this disease, the authors reviewed wrist
      radiographs in 168 well-documented cases of this disorder. Forty-four of the
      cases (26%) revealed wrist abnormalities typical of SLAC. Associated findings
      included bilateral involvement (63%); calcification in or near the triangular
      fibrocartilage (70%); scapholunate widening or dissociation (70%); and
      arthropathies of the trapezioscaphoid (57%), metacarpophalangeal (second through
      fifth) (52%), first carpometacarpal (40%), and radiolunate (14%) joints. Results
      strongly suggest that CPPD crystal deposition disease is one of the major causes
      of SLAC. Furthermore, radiolunate arthropathy was found in 14% of the patients
      with SLAC and CPPD crystal deposition disease, which is different from other
      observations.

PMID- 2217787
TI  - Vertebral hemangiomas: fat content as a sign of aggressiveness.
AB  - Thirty-two vertebral hemangiomas (VHs) were evaluated with nonenhanced computed
      tomography (CT), T1-weighted magnetic resonance (MR) imaging, CT enhanced with
      contrast material, and selective spinal arteriography. The stroma between the
      osseous trabeculae was found to correspond to either fatty tissue or soft tissue
      or both. All 11 asymptomatic VHs showed complete fatty stroma at CT and increased
      signal intensity at MR imaging. In contrast, all four compressive VHs had soft
      tissue attenuation at CT. Three compressive VHs showed low signal intensity on MR
      images. Predominantly fatty stroma at CT and increased signal intensity at MR
      imaging were associated with normal or only slightly increased vascularization at
      selective spinal arteriography or contrast-enhanced CT, while soft-tissue stroma
      at CT and low signal intensity at MR imaging were associated with distinct
      hypervascularization. The authors' experience suggests that fatty VHs may
      represent inactive forms of VH, while soft-tissue content at CT and low signal
      intensity at MR imaging may indicate a more active vascular lesion with potential
      to compress the spinal cord. CT and MR imaging may be especially valuable for
      evaluating patients with clinical signs or symptoms of uncertain origin and
      findings compatible with VH at plain radiography.

PMID- 2217788
TI  - Dermatomyositis: correlative MR imaging and P-31 MR spectroscopy for quantitative
      characterization of inflammatory disease.
AB  - Magnetic resonance (MR) imaging and phosphorus-31 MR spectroscopy were used to
      examine four patients with dermatomyositis and five control subjects. T2-weighted
      images of the thigh muscles of patients showed increased signal intensity, with
      focal and inhomogeneous involvement predominantly in the vastus lateralis and
      secondarily in the vastus intermedius and vastus medialis. T1 and T2 values of
      the vastus lateralis in patients were significantly higher than those of the
      control subjects. T1 values of the rectus femoris and biceps femoris with more
      generalized inflammation were moderately elevated but still significantly higher
      than those of the control subjects. P-31 MR spectra of the quadriceps muscles
      were obtained during rest, during exercise at two graded levels, and in recovery.
      Concentrations of adenosine triphosphate and phosphocreatine (PCr) in the
      diseased muscles were 30% below normal values, and the inorganic phosphate/PCr
      ratios were increased in the patients' muscles at rest and throughout exercise.
      The T1 and T2 values as well as the P-31 metabolite data correlated with symptoms
      and clinical assessment.

PMID- 2217789
TI  - Can the status of tubal pregnancy be predicted with transvaginal sonography? A
      prospective comparison of sonographic, surgical, and serum hCG findings.
AB  - Results of transvaginal sonography were compared prospectively with surgical
      findings and levels of serum human chorionic gonadotropin in 120 women with a
      proved tubal pregnancy. The most common sonographic finding was a saclike adnexal
      ring, which was seen in 74 of the women (61.7%). This finding was strongly
      associated with functioning trophoblasts and with an intact fallopian tube. In 39
      of the women (32.5%) an adnexal mass with a complex texture was found. Of these
      39 women, 20 had a tubal hematoma and six had a ruptured fallopian tube. The size
      of the tubal mass created by ectopic pregnancy was predicted precisely (r = .91,
      P less than .001), and transvaginal sonography enabled detection of
      hemoperitoneum with a sensitivity of 91% (68 of 75 women). This study suggests
      that the status of a tubal pregnancy can be predicted reliably on the basis of
      transvaginal sonographic findings.

PMID- 2217790
TI  - Hypointense renal cell carcinoma: MR imaging with pathologic correlation.
AB  - In two pathologically documented cases of renal cell carcinoma, the appearance of
      the tumors at magnetic resonance (MR) imaging was markedly hypointense relative
      to normal renal parenchyma on both T1- and T2-weighted spin-echo images.
      Pathologic examination of both tumors revealed diffuse iron scattered throughout
      the tumors. The paramagnetic effect of the iron may account for this unusual
      hypointense appearance at spin-echo imaging, independent of pulse sequence.

PMID- 2217791
TI  - Intrauterine growth retardation: diagnosis based on multiple parameters--a
      prospective study.
AB  - A scoring system has previously been developed to diagnose intrauterine growth
      retardation (IUGR) based on three parameters: estimated fetal weight, amniotic
      fluid volume, and maternal blood pressure status. To test the IUGR score
      prospectively, the authors computed the score in 356 third-trimester fetuses, 39
      growth retarded and 317 normal, scanned within 2 weeks prior to delivery. The
      IUGR score identified three groups, each with a distinct probability of IUGR: A
      score below 50 virtually excludes IUGR (3% probability), a score above 60 allows
      confident diagnosis (74% probability), and score of 50-60 is indeterminate (13%
      probability). The IUGR score performed best in patients with accurate dating by
      early ultrasound (US), but even among patients lacking accurate dating, the
      performance of the IUGR score was superior to that previously reported for any
      single sonographic parameter. The IUGR score can be used in any US facility to
      diagnose or exclude third-trimester IUGR.

PMID- 2217792
TI  - Lower extremity venography with iohexol: results and complications.
AB  - The frequency of side effects of a nonionic contrast agent (iohexol) was studied
      in 463 consecutive patients who underwent venography for clinically suspected
      deep-vein thrombosis (DVT) and compared with the frequency of adverse reactions
      of another series in which patients received either the same contrast material or
      a high-osmolar ionic compound. Minor side effects, including local pain and
      discomfort, nausea and vomiting, dizziness, skin reactions, superficial
      phlebitis, and edema, occurred in 83 patients (17.9%; 95% confidence interval
      [CI], 15%-22%). The only serious adverse reaction (bronchospasm) was seen in two
      patients (0.4%; 95% CI, 0.1%-1.4%). Postvenographic thrombosis confirmed by means
      of repeat venography occurred in one of 41 consecutive patients with a previous
      normal venogram (incidence, 2%; 95% CI, 0%-13%). The frequency of side effects
      appears to be significantly less than when conventional high-osmolar contrast
      agents are used. Use of iohexol for venography is associated with minor side
      effects in approximately one-fifth of patients, and serious adverse reactions
      necessitating therapy are rare.

PMID- 2217793
TI  - Biliary lithotripsy: in vitro analysis of gallstone fragmentation for equivalent
      stone volumes.
AB  - The relationship between gallstone fragmentation during extracorporeal shock wave
      lithotripsy (ESWL) and gallstone volume is poorly understood. Clinical results of
      ESWL show that the highest stone-free rate at 6 months occurs with radiolucent
      single gallstones 20 mm or less in diameter. In an in vitro study, individual
      gallstones from cholecystectomy specimens were divided by size and composition
      into nine single- and nine multiple-stone groups; the stones were then paired on
      the basis of similar volume. ESWL was performed in a phantom and the size of the
      largest fragment was measured at 500, 1,000, and 1,500 shock waves. At 1,500
      shock waves, sandlike particles were present in six of nine single stones versus
      two of nine multiple stone groups; the mean size of the largest fragment at 1,500
      shock waves was 2.1 mm (single) and 4.4 mm (multiple) in diameter. When corrected
      for volume, the authors' data suggest that single stones are more easily broken
      into fragments smaller than 5 mm in diameter than multiple gallstones. The
      implication, especially when spark-gap technology is used, is that more shock
      wave energy (ie, an increased number of shock waves at a higher kilovoltage) will
      be necessary to achieve the same results when treating patients with multiple
      stones versus a single gallstone with a similar stone volume.

PMID- 2217794
TI  - Rectal carcinoma: CT staging with water as contrast medium.
AB  - Computed tomography (CT) was used to study 42 patients with rectal carcinoma.
      Water was used as a contrast medium for studying the local extent of tumor in all
      patients. Scans were read prospectively without knowledge of the histologic
      staging and then compared with pathologic specimens. CT depicted the tumor in all
      patients. Comparison of CT and histologic results (following the Dukes
      classification) showed that disease was correctly staged as A in three of four
      patients, as B in eight of 12, as C in 15 of 17, and as D in nine of nine.
      Overall, carcinoma was correctly staged with CT in 35 of 42 patients (diagnostic
      accuracy, 83.3%). The accuracy in the assessment of local invasion was 97.6% (41
      of 42). In the detection of lymph node involvement, the accuracy was 78.6%
      (sensitivity, 88%; specificity, 64.7%). CT is recommended in the preoperative
      staging of rectal carcinoma and as an aid in choosing the appropriate therapy.
      The use of water enema and complete distention of the rectum are reliable
      techniques for improving the accuracy of CT in the assessment of local invasion
      by cancer.

PMID- 2217795
TI  - Intrahepatic portal venous system: variations demonstrated with duplex and color
      Doppler US.
AB  - Seventeen cases of variations of the intrahepatic portal venous system were
      investigated with use of duplex and color Doppler ultrasound (US). Seven cases
      involved absence of the horizontal segment of the left portal vein, with portal
      supply to the left lobe arising from the right lobe. The 10 remaining cases
      involved variations of intrahepatic portal branching resulting from absence of
      the right portal vein, taking four patterns. It is thought that these findings
      represent variants of normal. These variants are important in two settings: in
      planning hepatic surgery and in the differential diagnosis of chronic portal vein
      thrombosis.

PMID- 2217796
TI  - Cardiac and vascular imaging with an MR snapshot technique.
AB  - Real-time vascular and cardiac magnetic resonance (MR) imaging has been reported
      only with echo-planar imaging. In this study, the fast low-angle shot (FLASH) MR
      imaging sequence was reduced to repetition times of 3 msec and echo times of less
      than 1.3 msec with use of an improved MR imaging system. The resulting 200-msec
      MR images (64 X 128 pixels) are called snapshot FLASH images. They allow
      measurements from dynamic series of MR images depicting processes such as
      relaxation behavior and the cardiac cycle in the absence of motion and flow
      artifacts. In animal studies (at 4.7 T) and in studies of human volunteers (at
      2.0 T), vascular and cardiac snapshot FLASH images were obtained as a single
      shot, as reconstructed motion, and as real-time movies. The arbitrary and fast T1
      contrast of these images and the reduction of motion artifacts result in
      favorable applications for the depiction of myocardial and great-vessel anatomy.
      These clinical applications can be performed on conventional MR imagers with
      minor technical modifications.

PMID- 2217797
TI  - Vena caval flow: assessment with cine MR velocity mapping.
AB  - The authors used cine magnetic resonance (MR) velocity mapping to study flow in
      the superior vena cava (SVC) and inferior vena cava (IVC) of 13 healthy control
      subjects and 13 patients with right-sided cardiac disease. In the control
      subjects, peaks of flow in systole and diastole were observed, and mean SVC flow
      was 35% of the cardiac output. Respiratory gating was used in six control
      subjects to acquire images at end inspiration and end expiration, and although
      the systolic peak was reduced at end expiration, total flow was unchanged. A
      reduced systolic peak and retrograde flow in the IVC were observed in patients
      with tricuspid regurgitation. A reduced diastolic peak was seen in patients with
      pulmonary hypertension, pericardial constriction, and right ventricular
      dysplasia, reflecting reduced diastolic compliance of the right ventricle. In the
      patient with obstruction of the SVC, absence of flow was confirmed, and
      retrograde flow was seen in the azygos vein. The authors believe that cine MR
      velocity mapping is a reliable method of studying vena caval flow noninvasively
      and that it has important potential applications for the investigation of
      disorders of the right side of the heart.

PMID- 2217798
TI  - Evolution of deep venous thrombosis: a prospective evaluation with US.
AB  - Forty-six patients with a diagnosis of acute deep venous thrombosis (DVT)
      established by means of duplex ultrasound (US) were prospectively followed up
      with serial duplex US examinations during a 6-month period to assess the
      persistence of venous abnormalities. All patients were asymptomatic. Isolated
      popliteal DVT was found to be more likely to revert to normal at duplex
      compression US than thrombosis involving both the femoral and popliteal systems
      (P less than .05). Increased venous diameter was a sign of acute clot (P less
      than .005). Clot echogenicity did not help to enable distinction of acute DVT and
      chronic DVT. At compression US, 10 of 21 patients (48%) who initially had
      occlusive thrombosis had persistent abnormalities that mimicked findings
      consistent with acute DVT. Chronic venous changes that persisted after 6 months
      consisted of either lumen recanalization (with resultant intimal thickening) or
      persistent venous occlusion. Both of these conditions can result in incomplete
      compression, the major US indication of acute DVT. This appearance should not be
      confused with that of acute DVT. Follow-up examinations to establish a baseline
      appearance can be obtained as early as 6 months after an acute episode of DVT.

PMID- 2217799
TI  - Renal artery stenosis in patients with aortic dissection: increased prevalence.
AB  - The authors retrospectively analyzed the prevalence of renal artery stenosis in
      63 consecutive patients with aortic dissection who underwent thoracic and
      abdominal aortography. Ten patients (16%) had renal artery stenosis, five with
      atherosclerosis and five with fibromuscular lesions. Risk factors for aortic
      dissection were Marfan disease in nine patients, bicuspid aortic valve in one,
      and hypertension in 54 (including seven patients with Marfan syndrome). If the
      patients with Marfan syndrome and the patient with the bicuspid aortic valve are
      excluded, renal artery stenosis was present in 10 of 53 patients (19%) when the
      cause of dissection was presumably hypertension. This finding suggests that
      renovascular hypertension is a greater risk factor for aortic dissection than is
      essential hypertension. The success of angiotensin converting enzyme inhibitors
      and percutaneous transluminal renal angioplasty (PTRA) in controlling
      renovascular hypertension has been proved. In this series, emergent PTRA
      successfully controlled the hypertension in one patient with a type B dissection,
      resulting in an excellent clinical outcome. Angiography should be routinely
      performed on patients with aortic dissections to evaluate for renal artery
      stenosis.

PMID- 2217800
TI  - Therapeutic embolization: enhanced radiolabeled monitoring.
AB  - Radiolabeling of Ivalon (polyvinyl alcohol sponge) particles permits localization
      of injected particles during embolization through the use of a portable gamma
      camera and provides a means to prevent potentially fatal complications such as
      pulmonary embolization. A more efficient technique of labeling Ivalon particles
      with technetium-99m sulfur colloid was developed. An increase in labeling
      efficiency allowed more accurate determination of the distribution of injected
      Ivalon particles. Scanning electron microscopy demonstrated the stability of the
      Ivalon particles during this new labeling process. Two patients with
      arteriovenous malformations underwent therapeutic embolization with radiolabeled
      Ivalon particles; gamma camera imaging of the lesion and chest was performed
      throughout the procedure.

PMID- 2217801
TI  - MR imaging of the bird's nest filter.
AB  - The appearance of the Bird's Nest inferior vena cava filter on magnetic resonance
      (MR) images of 11 patients is described. No complication or symptomatic filter
      displacement was encountered as a result of MR imaging performed at 1.5 T. The
      filters created significant local artifact and distortion on MR images. However,
      diagnostic MR images of the pelvis, spine, and brain may still be obtained.

PMID- 2217802
TI  - Irrigation device for neuroangiographic procedures.
AB  - A simple irrigation device for use in diagnostic and interventional
      neuroangiographic procedures is described. The device is used to flush bubbles
      and blood clots from catheter hubs. The authors also describe a technique in
      which this device can be used to prevent filling a catheter with air when a guide
      wire is removed.

PMID- 2217803
TI  - Synovial membrane: percutaneous biopsy.
AB  - With use of fluoroscopy, new techniques of percutaneous synovial biopsy (PSB) of
      large joints of limbs (other than the knee) were developed. PSB was performed on
      outpatients with the use of local anesthesia. Eighty-four biopsies (hip, 57;
      shoulder, 10; elbow, six; wrist, five; and ankle, six) were performed. With
      experience, modifications evolved in the PSB technique. The main technical
      refinements were use of a Tru-Cut needle introduced through a Jamshidi trephine
      needle, placement of the cutting window parallel to the anterior aspect of the
      joint, and selection of an optimal approach and biopsy site. With these
      improvements, the success rate for obtaining synovial membrane was raised from
      48% to 81%. No complications were encountered.

PMID- 2217804
TI  - Performance of quality assurance audits by students.

PMID- 2217805
TI  - Monitoring sedated pediatric patients during MR imaging.

PMID- 2217806
TI  - Patient confidentiality in radiology.

PMID- 2217807
TI  - Professional quality assurance for mammography screening programs.

PMID- 2217808
TI  - Nonsurgical fallopian tube recanalization for treatment of infertility.

PMID- 2217809
TI  - Cervical myelography.

PMID- 2217810
TI  - Sisera's death: an afterword.

PMID- 2217811
TI  - 76th scientific assembly and annual meeting: Radiological Society of North
      America including sessions in joint sponsorship with the American Association of
      Physicists in Medicine. November 25-30, Chicago. Abstracts.

PMID- 2217812
TI  - Nurse makes "anonymous call": freedom of speech.

PMID- 2217813
TI  - Doctor "did not know what he was doing": death results. Case in point: Robinson
      v. Kaiser Foundation Hosps. (269 Cal. Rptr. 468--CA 1990).

PMID- 2217814
TI  - Legal case briefs for nurses. MI.: "at will" employment: termination for cause;
      CA.: nurse blows whistle: Dr.'s privileges suspended.

PMID- 2217815
TI  - Nurse orders objecting patient to "shut up". Case in point: Roberson v. Provident
      House (559 So. 2d 838--LA (1990)).

PMID- 2217816
TI  - Nurse resigns over urine specimen issue.

PMID- 2217817
TI  - Is there a nurse-patient privilege? Case in point: Roberson by Isaac v. Liu (555
      N.E. 2d 999--IL (1990)).

PMID- 2217818
TI  - Legal case briefs for nurses. GA.: nursing home supervision: negligence or
      malpractice? TN.: student challenges "grades admissions policy".

PMID- 2217819
TI  - The agency nurse: employee or independent contractor? Case in point: trauma
      nurses v. Board of Review (576 A. 2d 285--NJ (1990)).

PMID- 2217820
TI  - Axotomy-induced alterations in the electrophysiological characteristics of
      neurons.
AB  - The electrophysiological alterations provoked by axotomy have now been studied
      for almost half a century, in a number of different cell types. Consequently, it
      is now possible to detail some common mechanisms underlying these changes and to
      sort out certain trends in the data. The major phenomena reviewed in this section
      and some possible future directions are summarized below. (1) It is now possible
      to advance a unified hypothesis for the effects of axotomy on the conduction
      velocity of myelinated fibers. The key is that axon diameter, which is directly
      correlated with conduction velocity, is regulated, at least in part, by
      neurofilament protein gene expression and transport into the axon. Thus, the
      largest myelinated axons, with the fastest conduction velocities, have the
      highest neurofilament contents, and in turn, experience greater or faster
      declines in neurofilament content, axon caliber, and conduction speed following
      nerve injury. This regulation of neurofilament gene expression also appears to be
      target- and/or accessory cell-dependent. In fact, Hoffman and colleagues (1988)
      have hypothesized that neuron interactions with specific targets (via as yet
      unknown target-induced signals) may either specify or permit specification of the
      level of neurofilament gene expression in neurons. Imposed on this primary size
      determinant is an influence of activity, which also underlies the differential
      atrophy and decrement in conduction velocity exhibited by motor and sensory
      fibers of comparable diameters in the same lesioned nerve. Unmyelinated axons,
      whose structures are not dominated by neurofilament content and metabolism, react
      very differently to axotomy. The structural and metabolic basis of their reaction
      is not known. (2) Passive membrane properties, in particular neuronal input
      resistance, remain relatively stable in the majority of neurons after axotomy.
      The major exceptions, vertebrate spinal motoneurons, lamprey dorsal interneurons,
      and mammalian vagal motoneurons, all show an increase in input resistance after
      axotomy. This change in input resistance appears to be correlated with structural
      or geometric simplification of dendritic trees and real or apparent changes in
      specific membrane resistance in one case and with a reduction in cell body size
      in the other two; however, changes in specific membrane resistance cannot be
      excluded even in the latter two cases. In the spinal motoneurons, input
      resistance changes may be more pronounced in those neurons with the most
      extensive or complex dendritic geometries (i.e. F-type motoneurons). More
      combined electrophysiological (ideally under voltage or patch clamp conditions)
      and morphological investigations of single neurons need be done to resolve these
      questions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2217821
TI  - The effects of antihypertensive drugs on the cerebral blood flow and its
      regulation.

PMID- 2217822
TI  - Pharmacologically active pyridazine derivatives. Part 1.

PMID- 2217823
TI  - Medicinal chemistry of 1-benzazepines.

PMID- 2217824
TI  - Peptide regulation of mast-cell function.

PMID- 2217825
TI  - Biological effects of mercuric chloride, nickel sulphate and nickel chloride.

PMID- 2217826
TI  - The fluoroquinolone antibacterial agents.
AB  - In summary, the last decade has been a highly fertile and productive period in
      quinolone medicinal chemistry, resulting in major improvements in potency,
      antibacterial spectra, oral absorption and pharmacokinetic properties as well as
      an increased knowledge of the molecular features important to conferring these
      various properties. Very recent discoveries concerning replacements for the 3
      carboxylic acid moiety, previously thought to be uniquely essential for activity,
      to give highly potent antibacterials such as (83) illustrate the potential for
      new breakthroughs in this field. Among the major goals for future research
      remains the understanding of the potential cartilage toxicity associated with
      this class of agents, such that an agent useful for pediatric indications may be
      developed. Future studies can also be expected to further enhance and refine the
      level of current insight into the manner by which these agents inhibit the target
      enzyme on a molecular level.

PMID- 2217827
TI  - Developments in the antiemetic area: chemistry, pharmacology and therapy.

PMID- 2217828
TI  - Antagonists of platelet-activating factor: chemistry, pharmacology and clinical
      applications.

PMID- 2217829
TI  - Photodecomposition of drugs.

PMID- 2217830
TI  - Prostaglandin E2 and gestational hypotension in rabbits.
AB  - Arterial levels of 13,14-dihydro-15-keto-PGE2 (PGE2-M), a stable metabolite of
      prostaglandin E2 (PGE2) were compared between unanesthetized pregnant (n = 12)
      and nonpregnant (n = 8) rabbits with the aim of elucidating the role PGE2 in the
      development of physiological hypotension associated with pregnancy. On the 20th
      and 22nd days of the 30 day gestation period the mean arterial concentrations of
      PGE2-M were about 10-times higher (p less than 0.05) and largely variable as
      compared to that of nonpregnant rabbits. Mean arterial pressure was not lower on
      either the 20th (69 +/- 4 mmHg, mean +/- SD) or the 22nd (70 +/- 3 mmHg) days of
      gestation (dg) than in nonpregnant rabbits (69 +/- 4 and 73 +/- 6 mmHg,
      respectively). On the 23rd dg hypotension was invariably present (61 +/- 5 mmHg
      vs 72 +/- 4 in nonpregnants, p less than 0.001), but arterial levels of PGE2-M
      (31.0 +/- 31.6 ng/ml) did not overcome those measured on earlier, normotensive
      days of gestation. Hypotension was also evident in a subgroup of pregnant rabbits
      (n = 4) with low PGE2-M concentrations in the nonpregnant range (3.2 +/- 1.5
      ng/ml vs 1.9 +/- 1.2 in nonpregnant rabbits, ns). Since the arterial level of
      PGE2-M proved to correlate (p less than 0.001) with both the uteroplacental
      venous and renal venous PGE2 concentrations, we suggest that a key role of
      uteroplacental and renal PGE2 played in the development of gestational
      hypotension is not probable in rabbits.

PMID- 2217831
TI  - A preliminary double-blind cross-over trial of lipo-PGI2, a prostacyclin
      derivative incorporated in lipid microspheres, in cerebral infarction.
AB  - Lipo-PGI2 is a drug preparation of a PGI2 analogue (isocarbacyclin methylester)
      which is incorporated into lipid microspheres with a diameter of 0.2 mu. Lipo
      PGI2 has been shown to accumulate at the vascular wall, particularly those of
      arteriosclerotic lesions, and it has a much stronger inhibitory activity on
      platelet aggregation than free isocarbacyclin. In this study, a preliminary
      double-blind cross over trial of lipo-PGI2 in cerebral infarction was carried
      out. Seventeen patients with chronic cerebral infarction received 2 micrograms of
      lipo-PGI2 and placebo daily for one week each in a cross-over double blind test.
      A significant improvement was noted for lipo-PGI2 compared with placebo in the
      overall improvement in neurological and mental symptoms (p less than 0.01). The
      patient's preference also indicated the effectiveness of lipo-PGI2 (p less than
      0.05). Adverse reactions were noted in 3 patients receiving placebo, but not in
      any receiving lipo-PGI2. These results show that lipo-PGI2 at a very low dose
      would be beneficial as a treatment for relieving the clinical symptoms of chronic
      cerebral infarction and that lipid microspheres are a useful drug carrier for
      PGI2 analogue therapy.

PMID- 2217833
TI  - Electrophilic levuglandin E2-protein adducts bind glycine: a model for protein
      crosslinking.
AB  - Prevention by glycine of protein crosslinking which accompanies binding of
      levuglandin E2 (LGE2) is shown to involve binding of glycine with the protein
      LGE2 adduct. With ovalbumin, the LGE2 adduct initially binds nearly 2 equivalents
      of glycine, but the capacity to bind glycine decreases with time reflecting a
      competition, inter alia, with crosslinking.

PMID- 2217832
TI  - Common bile ligation in the rabbit: an appropriate model for investigating the
      relationship of endogenous gallbladder prostanoid synthesis with evolving acute
      inflammation.
AB  - Gallbladder prostanoid (PG) synthesis and histologic inflammatory changes were
      compared after 6, 24, and 72 hours of bile duct ligation (BDL) or cystic duct
      ligation (CDL) in the male rabbit. At each time interval the gallbladder was
      scored for degree of acute inflammation, examined by radiochromatography for
      endogenous PG synthesis and analyzed by ANOVA. BDL induced progressive increases
      in acute inflammation whereas prostanoid synthesis significantly increased only
      after the 6 and 72 hour groups. Indomethacin treatment inhibited PG synthesis in
      all BDL groups but only decreased the inflammation score in the 6 and 24 hour BDL
      groups. CDL did not induce progressive gallbladder inflammatory changes or
      prostanoid synthesis. These data show that prostanoids are intimately involved
      with the development of early acute gallbladder inflammation following BDL.
      Inhibition of PG synthesis could attenuate or retard the progression of early
      acute gallbladder inflammation if started prior to development of established
      disease.

PMID- 2217834
TI  - [Differential diagnosis of allergic and non-allergic dermatitis by measuring the
      levels of acid phosphatase in neutrophils and peripheral blood lymphocytes].
AB  - Using the cytoenzymatic method acid phosphatase was determined in peripheral
      blood neutrophils and lymphocytes in 25 patients with allergic eczema, 31
      patients with eczema due to irritants and 18 clinically healthy subjects. In
      patients with allergic eczema the percent of neutrophils and lymphocytes
      containing acid phosphatase was decreased and the activity of this enzyme in
      neutrophils was reduced. In patients with non allergic eczema these values were
      normal. The method of determination of acid phosphate in neutrophils and
      lymphocytes is regarded as useful for the differentiation between both types of
      eczema.

PMID- 2217835
TI  - [Fungal flora in mycoses among the population of the south-eastern Poland 1978
      1988].
AB  - In the years 1978-1988 a group of 2257 subjects was examined for the presence of
      fungal infection. In 785 cases positive results of cultures were obtained
      yielding 468 dermatophytes (60.1%) and 317 yeast-like fungi (39.9%). The most
      frequently isolated fungi were: Candida albicans (27.3%), Trichophyton
      mentagrophytes v. interdigitale (27.0%) and Trichophyton rubrum (20.6%). In the
      subgroup of dermatophytes anthropophilic fungi accounted for 87.5%.

PMID- 2217836
TI  - [Microsporum infection in patients treated at the Dermatological Clinic, Medical
      Academy, in Gdansk 1984-1988].
AB  - In the years 1984-1988 in the Department of Dermatology, M. A. in Gdansk 80 cases
      of microsporum mycoses were diagnosed. The cases were due to Microsporum canis.
      Among 80 cases of this mycosis we found 59 children aged from 2 to 15 years and
      21 subjects aged over 15 years. In children the most cases were diagnosed in the
      age group 4-7 years. In 40 cases (50%). M. canis produced lesions of hairless
      skin and in 36 cases (45%) the scalp was involved.

PMID- 2217837
TI  - [Incidence and enzymatic properties of yeast-like fungi. Examination of workers
      of various departments of the District Meat-Processing Industry in Bialystok].
AB  - In a group of 111 workers of the District Meat Processing Plant clinical
      examination of the skin and cultures for Candida organisms were performed. The
      proteolytic and lipolytic properties of these fungi were analysed. From the
      interdigital spaces of hands 42 strains were isolated, with the species Candida
      albicans accounting for 13.5% of the strains (15). Case history and the character
      of skin lesions on the hands and forearms suggested that they were caused by skin
      contact with meat and internal organs producing the so called "gut eczema" while
      Candida was secondary agent causing exacerbation of skin changes.

PMID- 2217838
TI  - [Sensitivity and specificity of the Chlamydiazyme test in comparison with tissue
      culture in the light of our studies].
AB  - The Chlamydiazyme Test was used in the laboratory examination of 1139 patients
      (716 women, 368 men, 55 children) hospitalized in the departments of urology,
      nephrology and gynaecology. Urethral and cervical smears were examined. In
      comparison with the culture method for C. trachomatis on McCoy cells the
      Chlamydiazyme test had a 91.6% agreement of the positive and negative results.
      The disagreeing results, that is only Chlamydiazyme test positive or only culture
      positive, accounted respectively for 2.1% and 6.2% of the results. The
      sensitivity of the Chlamydiazyme test was 74.6% and its specificity was 97.2%.

PMID- 2217839
TI  - [Eosinophilic pustular folliculitis (Ofuji)].
AB  - A case of eosinophilic pustular folliculitis is described. The patient was a man
      aged 28 years with typical clinical and histological findings. The disease
      developed after an insect sting. Evident improvement was obtained after
      administration of sulphones with corticosteroids.

PMID- 2217840
TI  - [Results of desensitization using household dust mite in patients with atopic
      dermatitis].
AB  - The HDM vaccine Bencard of housedust mite was used for desensitization by
      generally used methods of 17 patients with atopic dermatitis. Very good
      improvement was achieved in 6 cases, medium improvement in 10, and no improvement
      in 1 case. The possible role of psychogenic factors in this improvement is
      discussed.

PMID- 2217842
TI  - [Results of 5-day ofloxacin (Tarivid) treatment of chlamydial urethritis in men].
AB  - The examined group of men with urethritis comprises 40 patients at age 20-50 yrs.
      Diagnosis of Chlamydia trachomatis infection was based on the positive results of
      two of three techniques: culture on McCoy cells, direct immunofluorescent
      (Chlamyset) and immunoenzymatic (Chlamydiazyme) methods. The patients with CT
      urethritis were treated with Tarivid given orally 2 X 200 mg daily for 5 days.
      Five days later they were reexamined with the same methods. The results were as
      follows: 36 out of 40 patients were negative by culture and Chlamydiazyme and
      were clinically cured. Four were positive by both methods and still had symptoms
      of urethritis.

PMID- 2217841
TI  - [Evaluation of the methods of treatment of epithelioma basocellulare at the I
      Dermatology Clinic, Silesian Medical Academy, in Katowice].
AB  - The therapeutic results are presented in cases of basocellular epithelioma
      treated by three methods. The best and most radical results were obtained by the
      surgical method, followed in the order of effectiveness by radiotherapy (45-55
      kV) in a total dose of 4500-6000 R. In case of contraindications to these methods
      local chemotherapy was applied which was associated with a high proportion of
      failures (28.6%).

PMID- 2217843
TI  - [Treatment of head pediculosis. Comparative studies of a shampoo containing 0,33%
      Pyrethrum extract and shampoo containing 1% malathion].
AB  - The insecticidal effect was tested of a shampoo with 0.33% of pyrethrum extract
      and a shampoo with 1% malathion. The study was carried out in 222 patients and
      better results were observed with the pyrethrum shampoo which required only one
      application.

PMID- 2217844
TI  - [General-action antifungal drugs--trends in their development and use].

PMID- 2217845
TI  - [Changes in various apolipoprotein levels in psoriasis].
AB  - In 104 patients with common psoriasis the patterns of apolipoproteins A and B
      were studied in serum depending on the course of the disease, extent of skin
      changes and infection preceding the appearance of eruptions. The highest
      concentrations of apo A and apo B were found in the group with generalized
      psoriatic changes independent of the activity of the disease.

PMID- 2217846
TI  - [Staging the psychoanalytic situation in supervision].
AB  - Fantasies, parapraxes, and associations that figure significantly in the
      transference-countertransference process between patient and analytic candidate
      also work their way into the relationship between the candidate and the
      supervisor--sometimes in disguised fashion. The author illustrates this
      observation with vignettes and shows how, with the help of Lorenzer's concept of
      scenic understanding, the interaction pattern observable in the supervision can
      be utilized for the understanding of the material presented by the patient.

PMID- 2217848
TI  - [Reclaiming the feeling of shame].
AB  - The author resorts to Bleger's conception of regression to ambiguity in order to
      achieve an understanding of patients who have suffered from extreme situations
      such as torture, disappearance, concentration camp. The regression to ambiguity
      that helped these patients to survive and that elicits extreme feelings of shame
      must be gradually diminished so that older intact ego components as well as the
      original feelings of shame can be reclaimed.

PMID- 2217847
TI  - [Ego and narcissism theory between 1914 and 1922 as it appears in the
      International Journal of Medical Psychoanalysis].
AB  - The publication of Freud's essay on narcissism in 1914 set off a discussion about
      the psychoanalytic concepts of the ego and of narcissism. The author reviews this
      discussion by reference to articles appearing in the Int. Z. arztl. Psa. between
      1914 and 1922. She highlights the theoretical and technical modifications
      corresponding to this discussion and demonstrates that apparently modern theories
      of the ego and of narcissism have their roots largely in that period.

PMID- 2217849
TI  - [Edgar Degas, photography and voyeurism].
AB  - Degas has drawn his paintings in a voyeuristic perspective. This voyeurism is not
      due to the painter's personal psychopathology. Instead, Degas has recognized the
      voyeuristic change of visual perception as a result of the development of
      photography as a new medium; meanwhile this change has become unconscious. Degas'
      paintings thus confront us with the historicity of visual perception and of the
      visual partial instinct.

PMID- 2217850
TI  - [Those who praise me..., those who fault me...D. E. Zimmer, H. Platta and
      psychoanalysis].

PMID- 2217851
TI  - [Selected problems of diagnosis, natural course and prognostic significance of
      borderline arterial hypertension. III. Long-term studies of borderline
      hypertension in children and adolescents].
AB  - Cardiological reevaluation was carried out in a group of subjects aged 19-28
      years in whom elevated (n = 80) or normal blood pressure (n = 69) had been found
      10 years earlier. Control physical examination was extend to 24 hour ambulatory
      blood pressure monitoring. In both groups differences in systolic and diastolic
      blood pressure levels after 10 years are characterized by significant (p less
      than 0.001) negative correlation with its initial values. Elevated blood pressure
      (greater than 140/90 mmHg) was found in 21 patients of the studied group (23.3%)
      and in 4 controls (5.8%, p less than 0.001). The results of blood pressure
      monitoring are in accordance with traditional measurements and confirm
      equalization of mean blood pressure values, maintenance of group differences in
      diastolic pressure and correctness of diagnosis (at 10 years) of borderline or
      mild arterial hypertension. Complaints reported by the patients as well as ECG
      studies do not suffice for verification of young persons with elevated blood
      pressure and risk of hypertension. In this respect it is more useful to repeat
      measurements by using continuous automatic recording devices although
      considerable variations in blood pressure levels in longterm observations in
      young subjects indicate the need of careful prognosis concerning evolution of the
      disease.

PMID- 2217852
TI  - [Selected problems of diagnosis, natural course and prognostic significance of
      borderline arterial hypertension. IV. Evaluation of the usefulness of diagnostic
      methods].
AB  - In 80 subjects, aged 19-28 years with elevated blood pressure 10 years earlier,
      compared with a group of normotensives (n = 69) family history of hypertension
      and the results of echocardiography, dynamic exercise stress testing and cold
      pressor test were evaluated. Pathogenic role of family history was shown by the
      diagnosis of arterial hypertension in 84% of the parents of children and
      adolescents with initially elevated blood pressure. The effects of elevated blood
      pressure on its further course are confirmed by the incidence of borderline
      hypertension in 26.3% of the studied group as compared with 5.8% of the controls.
      The patients with elevated blood pressure were characterized by hyperkinetic
      cardiac state manifested by a significantly higher heart rate, higher ejection
      fraction and cardiac output. The results of bicycle exercise test and cold
      pressor tet proved useless in the prognosis. However, despite the lack of
      prognostic value it was found that in studied population an exercise induced rise
      of systolic blood pressure correlated with echocardiographic parameters of
      cardiac size and mass. Similarly a positive correlation was found between the
      highest blood pressure during exercise and left ventricular mass in patients with
      borderline hypertension. The studies showed prognostic difficulties in the early
      stage of primary hypertension emphasizing the usefulness of modern methods
      providing an insight into the state of labile at that age cardiovascular system.

PMID- 2217853
TI  - [Acetylation phenotype as a risk factor of diabetic neuropathy].
AB  - Acetylation phenotype was determined in 184 diabetics: 102 patients with Type I
      (insulin-dependent) and 82 patients with Type II (non-insulin-dependent) diabetes
      mellitus, who underwent complex investigations to assess the development of
      sensorimotor and autonomic neuropathy. The control group consisted of 121 healthy
      subjects of the same age distribution. The results obtained imply that the slow
      acetylation phenotype may be considered as a significant risk factor of diabetic
      neuropathy.

PMID- 2217854
TI  - [Effect of alcohol on the lymphocyte system. V. Evaluation of blast
      transformation and rosette formation of peripheral blood lymphocytes in
      alcoholics].
AB  - Transformation and rosette formation of peripheral blood lymphocytes were
      studied. We have observed decrease in lymphocyte response to the mitogen as well
      as in spontaneous ability to the transformation. The percent of B-rosettes was
      diminished, while T-rosettes were in normal ranges. Lower index of completely
      transformed ones in men indulged to freely in alcohol may be consequence of
      altered cell membrane fluidity of shifts in T lymphocyte subpopulations.

PMID- 2217855
TI  - [Clinical and electrophysiological studies of the organ of hearing of newborn
      infants. III. Evaluation of the organ of hearing of newborn infants from high
      risk pregnancy using brain stem evoked response audiometry (ABR)].
AB  - In a group of 130 tested newborns, pathological brain stem responses derived from
      acoustic stimulus was achieved in 28 cases (21.5%). 85.2% of newborns in this
      group of birthed babies comprised a high-risk pregnancy group. Based on criteria
      evaluating monitoring and parameters achieved ABR responses: conduction hearing
      disorders were found in 7 newborns, sensori-neural in 12 cases, and neurological
      dysfunction was observed in 9 cases. Control testing was carried through for
      three months following the initial evaluation allowing for the elimination of 12
      children in a group of 19 for further testing and observation. This represents
      42.85% of children initially evaluated as possessing a hearing disorder and 9.2%
      from the total of those tested. Results obtained during successive control
      testing were carried-out in a 3-6 month period following the initial examination
      and allowed for decisions to be made. Conforming to: 4 children (3.07%) were
      supplied with hearing aids and hearing rehabilitation begun, 1 child (0.76%) was
      referred to rehabilitation the deaf, whereas the 2 remaining children (1.53%) are
      currently under neurological observation. Nonetheless, testing older children
      eliminates cases that present with lack of success at the initial evaluation or
      transitory hearing impairment that is self-limited, although ABR testing, while
      the child is on the unit, allows for the introduction of hearing-organ controls
      of newborns based on population testing.

PMID- 2217856
TI  - [Natural defense mechanisms of the respiratory tract in the otolaryngological
      aspect].

PMID- 2217857
TI  - [Use of impedance plethysmography in the studies of cardiac function].

PMID- 2217858
TI  - [Medical experiments on humans and Purkinje's self-observations].

PMID- 2217859
TI  - [Myasthenic reaction in polymyositis].

PMID- 2217860
TI  - [Dr. Franciszek Mehrer, a prominent Lvov urologist in the inter-war period].

PMID- 2217861
TI  - Clinical evaluation of digital TV tomography.
AB  - A unit for digital TV tomography (DTT) was constructed on the basis of
      retrospective reconstruction of digital data acquired during a linear tomographic
      motion of an X-ray tube and an image intensifier with a television camera (I.I.
      TV) assembly. Following descriptions of the basic principle and system, clinical
      results obtained with this unit are presented. Comparison with conventional
      tomography of the chest, skull, abdomen, and bones and joints showed equal
      diagnostic information in more than 50% of cases. Application to intra-arterial
      and intravenous DSA provided excellent images, but no new information was
      obtained. DTT has the advantages of technical simplicity, short examination time,
      low exposure dose, and compatibility with a PACS system. This technique will
      become an important part of a modern radiology department.

PMID- 2217862
TI  - Radiological findings of vanishing tumor of the stomach.
AB  - Four lesions in three patients with so-called vanishing tumor of the stomach are
      described. Two patients had one lesion each and the third patient two lesions.
      The lesions were localized in the gastric cardia, angle, and antrum. Radiological
      findings of these tumors showed a round tumor with smooth surface and regular
      margins. The edges of the tumors were gently sloping, while the mucosa
      surrounding the tumor was edematous. The time interval until these tumors
      disappeared was five days, 20 months, 12 months and seven months, respectively.
      When the soft appearance of a gastric tumor is suspected in UGI examination, the
      patient should be re-examined after a month or more, to avoid unnecessary
      surgery.

PMID- 2217863
TI  - Computerized three-dimensional normal atlas.
AB  - This paper presents our ongoing project in which normal human anatomy and its
      quantitative data are systematically arranged in a computer. The final product,
      the Computerized Three-Dimensional Normal Atlas, will be able to supply
      tomographic images in any direction, 3-D images, and coded information on organs,
      e.g., anatomical names, CT numbers, and T1 and T2 values.

PMID- 2217864
TI  - Multiseptate gallbladder: computed tomographic appearance.
AB  - We report a case of multiseptate gallbladder in a 43-year-old female with
      ultrasonographic and computed tomographic (CT) findings. The postcontrast CT
      delineated multiple septations with honeycomb appearance in the gallbladder. This
      finding should raise the suspicion of multiseptate gallbladder.

PMID- 2217865
TI  - Asymptomatic Bochdalek hernia diagnosed by magnetic resonance imaging.
AB  - An asymptomatic mass at the base of the left lung was examined by computed
      tomography (CT) and magnetic resonance (MR) imaging. Coronal and sagittal T1
      weighted MR images provided a definitive diagnosis of Bochdalek hernia.

PMID- 2217867
TI  - Management of malignant thymoma.
AB  - Six cases of malignant thymoma were treated by various methods, i.e., surgery,
      radiotherapy and chemotherapy. The combination of surgery and radiotherapy seems
      to be the most effective method of treatment. Histology does not seem to
      influence survival.

PMID- 2217866
TI  - Bone mineral density of the lumbar spine by dual photon absorptiometry: age
      related regression in normal Japanese subjects and fracture threshold in
      osteoporotics.
AB  - The bone mineral density (BMD) of the lumbar spine was determined by DPA in 280
      normal Japanese volunteers and 11 osteoporotic women with compression fractures.
      In women, bone loss started from the mid thirties and accelerated after the age
      of 50 years at the rate of 0.75% (0.0074 g/cm2) per year. In men, bone loss
      started from the mid twenties and occurred linearly at the rate of 0.30% (0.0032
      g/cm2). The overall diminutions in vertebral BMD throughout life in men and women
      were 13.0% and 24.3%, respectively. The mean vertebral BMD of the osteoporotic
      women with recent compression fractures was 37.5% lower than that of age-matched
      controls. The 90th percentile for vertebral BMD in this group was 0.584 g/cm2. By
      the age of 80 years, approximately one-fifth of normal Japanese women have BMD
      values less than this.

PMID- 2217868
TI  - The selection of patients for accelerated radiotherapy on the basis of tumor
      growth kinetics and intrinsic radiosensitivity.
AB  - Mathematical modeling was used to reach qualitative conclusions concerning the
      relative rate of local tumor control that might be achieved by using accelerated
      fractionation to treat only the patients with the most rapidly growing tumors,
      compared with the control rates that could be expected from either conventional
      or accelerated radiotherapy alone. The results suggest that concomitant boost
      therapy is equally or more effective than conventional dose fractionation for all
      tumors, regardless of their growth kinetics. For tumors with very short clonogen
      doubling times, CHART (continuous hyperfractionated accelerated radiotherapy) may
      be even more effective than concomitant boost treatment, but CHART is less
      effective than conventional or concomitant boost therapy for tumors with longer
      clonogen doubling times. Thus, there is a rationale for using a predictive assay
      of tumor clonogen doubling times to identify the patients who should be treated
      with CHART. However, improvements in local tumor control resulting from
      concomitant boost treatment or the selective use of CHART are not likely to be
      apparent in the population as a whole, because the overall control rates are
      largely determined by refractory tumors having little chance of control with any
      of the treatments and by highly responsive tumors that are likely to be
      controlled regardless of the treatment choice. Differences in control rates with
      different treatment strategies are most apparent in the stochastic fraction of
      the population, which excludes those patients for whom there is either very
      little chance (e.g. less than 1%) or a very high chance (e.g. greater than 99%)
      of achieving local control with both treatments. The stochastic fraction can be
      approximated by excluding those patients with the most radioresistant and the
      most radiosensitive tumors, since intrinsic tumor radiosensitivity appears to be
      the single most important factor determining treatment outcome.

PMID- 2217869
TI  - Radiation-induced brachial plexus injury: follow-up of two different
      fractionation schedules.
AB  - All 449 breast cancer patients treated with post-operative radiotherapy to the
      breast and lymph nodes between 1982 and 1984 have been followed for 3-5.5 years.
      In this group two different fractionation schedules were used, one five times a
      fortnight and one daily, both over 6 weeks. The calculated dose to the brachial
      plexus was 45 Gy in 15 fractions or 54 Gy in 30 fractions. These schedules are
      equivalent doses using the standard NSD formula. The diagnosis of a brachial
      plexus injury was made clinically and computed tomography was used to distinguish
      radiation injury from recurrent disease. The actuarial incidence of a radiation
      induced brachial plexus injury for the whole group was 4.9% at 5.5 years. No
      cases were seen in the first 10 months following radiotherapy. The incidence
      rises between 1 and 4 years and then starts to plateau. When the large fraction
      size group is compared with the small fraction size group the incidence at 5.5
      years is 5.9% and 1.0%, respectively (p = 0.09). Two different treatment
      techniques were used in this group but were not found to contribute to the
      probability of developing a brachial plexus injury. It is suggested that
      radiation using large doses per fraction are less well tolerated by the brachial
      plexus than small doses per fraction; a commonly used fractionation schedule such
      as 45 Gy in 15 fractions may give unacceptably high brachial plexus morbidity;
      and the use of small doses per fraction or avoiding lymphatic irradiation is
      advocated.

PMID- 2217870
TI  - Treatment of extremity soft tissue sarcomas with surgery and radiotherapy.
AB  - The results of treatment with a combination of surgery and radiotherapy of 102
      patients with nonmetastatic extremity soft tissue sarcoma are reported. Seventy
      nine patients were previously untreated and 23 had locally recurrent disease.
      Sixty-six tumours were situated in the lower limb and 16 in the limb girdles.
      Fifty-nine were high grade lesions, and 64 were over 5 cm in length. Surgical
      clearance was "good" (wide or radical) in only 34 cases. Sixty-eight patients
      received post-operative irradiation, 23 pre-operative irradiation and 11 both pre
      and post-operative radiotherapy. Seventeen patients subsequently developed local
      recurrence and 9 of these remain disease-free after further surgery. Actuarial 5
      year local control and disease-free survival rates for new cases were 87 and
      65.4%; and for previously recurrent cases these figures fell to 75 and 54.8%.
      Following a univariate analysis of patient, tumour, surgical and radiotherapeutic
      factors only previous local recurrence (p less than 0.1 greater than 0.05) was
      found to significantly increase the risk of further local relapse. Multivariate
      analysis found high tumour grade [relative risk (RR) 8.4], tumour size greater
      than 15 cm (RR 3.66), previous local recurrence (RR 6.47) and proximal site (RR
      12.7) to be independent poor risk factors for survival.

PMID- 2217871
TI  - Methemoglobinemia induced by topical anesthetic (benzocaine).
AB  - Methemoglobinemia is a condition in which more than 2% of the hemoglobin of the
      blood has been oxidized to the ferric form, a molecule which is incapable of
      binding oxygen or carbon dioxide. Clinically, the patient appears lethargic,
      cyanotic, and does not respond to oxygen. We describe a patient with esophageal
      carcinoma who developed severe methoglobinemia following application of
      benzocaine in spray for local anesthesia prior to intraluminal irradiation.
      Review of the literature is presented.

PMID- 2217873
TI  - American way.

PMID- 2217872
TI  - Case #5. Dentigerous cyst.

PMID- 2217874
TI  - Who are the watchdogs?

PMID- 2217875
TI  - Panic attacks are real events.

PMID- 2217876
TI  - Quest for knowledge.

PMID- 2217878
TI  - Are your patients safe?

PMID- 2217877
TI  - Patient #3. Surmontil.

PMID- 2217879
TI  - Case #8. Periapical cyst.

PMID- 2217880
TI  - Hospital hygienists.

PMID- 2217882
TI  - Breaking away from the education log jam.

PMID- 2217883
TI  - Case #9. Squamous cell carcinoma.

PMID- 2217881
TI  - Assure quality patient care.

PMID- 2217884
TI  - All in the family.

PMID- 2217885
TI  - Determining what makes you happy.

PMID- 2217886
TI  - Duties and rights.

PMID- 2217887
TI  - Sterilization: the first choice.

PMID- 2217888
TI  - The right issues to tackle and win.

PMID- 2217890
TI  - Identification of inhibin and inhibin-related proteins in human follicular fluid.
AB  - Inhibin-related proteins were identified in human follicular fluid following
      fractionation by gel permeation chromatography under neutral and acidic
      conditions, reversed-phase high performance liquid chromatography (HPLC) and
      preparative polyacrylamide gel electrophoresis. A number of molecular mass forms
      of inhibin (30-36 and 59-66 kDa) based on their in vitro biological and
      immunological activities were identified, of which 59-66 kDa inhibin was the
      predominant form. Bioactive fractions devoid of inhibin immunoactivity were also
      identified with molecular masses of 46 and 55 kDa. Based on their retention
      positions on reversed-phase HPLC and their lack of inhibin immunoactivity, these
      proteins are likely to be follicle stimulating hormone (FSH) suppressing
      proteins/follistatins previously identified in bovine and porcine follicular
      fluids. In addition, an immunoactive inhibin fraction devoid of bioactivity was
      identified in large amounts in the 50-70 kDa region of the gel permeation
      chromatogram at neutral pH. This material, based on previous findings with the
      fractionation of bovine follicular fluid, is likely to be the alpha-inhibin
      subunit precursor protein. No FSH stimulating activity (activin) was identified
      in any of the chromatograms, suggesting that the levels of activin in human
      follicular fluid are low. In conclusion, inhibins of molecular mass 30, 36, 59
      and 66 kDa have been identified in human follicular fluid. Proteins with inhibin
      bioactivity devoid of immunoactivity and vice versa have also been detected and
      these proteins are probably FSH suppressing protein and an alpha-inhibin subunit
      precursor protein. Activin could not be identified.

PMID- 2217889
TI  - A comparison of the effects of bilateral efferent duct ligation and of partial
      epididymectomy on the testes of rats.
AB  - Testis weight as a percentage of body weight did not change following bilateral
      ligation of the efferent ducts (EDL) close to the epididymis, whereas following
      removal of part of the epididymis between the site of ligation and a point close
      to the junction between the caput and corpus (PCE), testis weight first rose
      linearly until Day 4 and then showed an exponential decrease between Days 4 and
      28. After EDL, the perimeter of the seminiferous tubules rose for the first 7
      days and then remained elevated, whereas after PCE, there was a linear decrease
      between Days 4 and 28. Following EDL, the percentage of altered and degenerated
      tubular cross-sections rose to about 30% and 10%, respectively, during the first
      7 days after operation and then remained constant; after PCE, the percentage of
      altered tubules reached a maximum of 54% by 4 days and then fell, whereas the
      percentage of degenerated tubules continued to rise to 95% by 28 days. It would
      appear that all the effects of removal of a portion of the epididymis cannot be
      explained by blockage of the excurrent ducts, and a specific endocrine effect of
      the epididymis on the testis is proposed.

PMID- 2217891
TI  - Effect of beta-endorphin on steroidogenesis by bovine luteal cells.
AB  - To determine if opioid peptides have a local effect on the modulation of
      progesterone (P4) synthesis, a study was made of the effect of beta-endorphin and
      leu-enkephalin on P4 production by pure preparations of small luteal cells and
      dissociated luteal cells comprising both small and large cells from cows 2-3
      months pregnant. Corpora lutea were dispersed by collagenase, and the large and
      small luteal cells were separated using Percoll gradients. Viable luteal cells (5
      x 10(5)) were incubated in 0.5 mL of Eagle medium for 2 h at 37 degrees C, in an
      atmosphere of 5% CO2. Cells were treated with 8-bromoadenosine 3',5'
      monophosphate (8Br-cAMP), hCG, beta-endorphin (BE) and leu-enkephalin (LE) alone
      or in combination. When small luteal cells were used, P4 synthesis was
      significantly enhanced in the presence of opioid peptides alone (P less than
      0.01); there was an additive effect with 8Br-cAMP and with hCG. For dissociated
      luteal cells, opioid peptides alone had no effect on P4 production but the
      stimulation of P4 production induced by 8Br-cAMP or hCG was significantly (P less
      than 0.01) inhibited in the presence of opioid peptides. In contrast, dissociated
      luteal cells that were preincubated with PGF2 alpha (degranulation) responded to
      the presence of BE with increased P4 synthesis similar to that seen with the pure
      preparation of small luteal cells. It is concluded that opioid peptides play an
      auto/paracrine role in both basal and tropic hormone-induced stimulation of
      steroidogenesis by the bovine luteal cell.

PMID- 2217892
TI  - Maximum survival of frozen goat embryos is attained at the expanded, hatching and
      hatched blastocyst stages of development.
AB  - Embryos were collected 5, 6 and 7 days after ovulation to determine their optimum
      stage of development for cryopreservation. The embryos were frozen using either
      glycerol or dimethyl sulfoxide (DMSO) as cryoprotectant, and then thawed and
      cultured to determine their viability. The rate of survival increased as the
      stage of development of the embryos increased. All hatched blastocysts survived
      freezing regardless of which cryoprotectant was used, whereas none of the 22
      morulae frozen with DMSO survived, and only 12 of the 63 morulae frozen with
      glycerol survived. At the early blastocyst stage there was a significantly
      different result between freezing procedures (P less than 0.05) with greater
      survival rates obtained using DMSO rather than glycerol. The viability of goat
      embryos obtained at the early to hatched blastocyst stages, when collected 7 days
      after ovulation, was assessed by transferring half the embryos singly to
      recipients and freezing the remainder before transfer. When pregnancy was tested
      at the 7th week of gestation, the survival rate of fresh embryos was 67/111 (60%)
      compared with 64/109 (59%) for frozen-thawed embryos.

PMID- 2217893
TI  - Salivary oestradiol and progesterone after in vitro fertilization and embryo
      transfer using different luteal support regimens.
AB  - Salivary oestradiol (E2) and progesterone (P) levels have been shown to reflect
      the biologically active fractions in the serum. The luteal-phase status of
      stimulated cycles was investigated after in vitro fertilization and embryo
      transfer (IVF-ET). Thirty patients were randomly allocated to one of three luteal
      therapy groups: group A had no support, group B had intramuscular P and group C
      had intramuscular P and human chorionic gonadotrophin (hCG). One pregnancy was
      achieved in group A, two in group B and three in group C. Significant
      correlations between salivary and serum levels of E2 and of P in matched samples
      during luteal phase were found. Salivary E2 levels from luteal day 8 through day
      14 and P levels from day 3 through day 14 were significantly higher in the
      pregnant than in the nonpregnant cycles. Among the nonpregnant cycles, salivary
      E2 and P levels were significantly higher in group C than in group A or B. These
      findings suggest that, in stimulated cycles for IVF-ET, determination of salivary
      E2 and P levels may be used as reliable alternatives to serum concentrations for
      assessing the luteal phase. Also, the additional hCG has an enhanced luteotrophic
      effect, as reflected by the higher salivary E2 and P levels, which may lead to a
      better pregnancy rate.

PMID- 2217894
TI  - Granulocyte macrophage colony stimulating factor (GM-CSF) in the murine
      reproductive tract: stimulation by seminal factors.
AB  - The activity of GM-CSF during early pregnancy in the murine uterine lumen in vivo
      and in media conditioned by uterine cells in vitro has been assessed. GM-CSF was
      detected in uterine luminal fluid recovered by lavage on the morning after
      syngeneic mating (median level 5.7 CFUc U/uterus) and following mating with
      vasectomized (5.1 U/uterus) or allogeneic males (4.4 U/uterus), with
      significantly lesser (P less than 0.05) amounts recovered from the uteri of
      superovulated, mated mice. By contrast, GM-CSF was only detectable (greater than
      0.5 U/uterus) in the luminal fluid of three of 22 unmated oestrous mice examined.
      No activity was detected in secretions from male accessory glands including
      seminal vesicle, epididymis, prostate and coagulating gland (less than 0.5
      U/gland). GM-CSF was found at higher levels in supernatants from cell monolayers
      prepared by tryptic digest of the uteri of Day 1 mated mice than those from
      unmated oestrous mice (P less than 0.05). Little GM-CSF was detected in
      supernatants from ovariectomized mice. An alpha-GM-CSF polyvalent antibody
      neutralized the FD5/12 bioassay response confirming the identity of the
      lymphokine. The interleukins IL-2 and IL-3 were not detected in uterine luminal
      fluid nor in media conditioned by cell monolayers. We postulate that elevated
      uterine GM-CSF activity after mating is elicited by a non-sperm associated, non
      MHC component of the ejaculate and synthesized by a hormone-responsive
      endometrial cell population. This cytokine may have an embryotrophic role or
      contribute to priming of the uterus for implantation.

PMID- 2217895
TI  - Production of interspecies chimeric calves by aggregation of Bos indicus and Bos
      taurus demi-embryos.
AB  - Two experiments were conducted to produce interspecific chimeric calves by
      aggregation of B. indicus and B. taurus demi-embryos. In the first experiment,
      morulae, compacted morulae, and early blastocysts were collected nonsurgically
      from Brahman (B. indicus) and Friesian (B. taurus) donors. Embryos were bisected
      and one demi-embryo from each species was placed in a single zone pellucida. In
      the second experiment, Brahman (B. indicus) and Hereford-Shorthorn (HS) (B.
      taurus) demi-embryos were aggregated. The resulting 'chimeric embryos' were
      transferred nonsurgically to synchronous recipients immediately following
      microsurgery. Of 112 recipients of 112 chimeric embryos, 29 (26%) were pregnant
      at 60 days. Of these, 24 (83%) produced full-term calves and 5 (17%) aborted
      between 2 and 5 months' gestation. From the 24 full-term pregnancies, two sets of
      twins and 22 singleton calves were born. Of the 22 singletons, 15 were chimeric
      including six bull calves (one Brahman-Friesian and five Brahman-HS) that were
      overt chimeras. All the overt chimeras resulted from aggregation of halves of
      early morulae (precompaction).

PMID- 2217896
TI  - Effects of a monoclonal antibody against progesterone, on embryo transport,
      development and implantation in laboratory mice.
AB  - A monoclonal antibody against progesterone (11P27) given on Day 2 of pregnancy
      interrupted pregnancy in BALB/c mice but not in BCF1 mice. The reason for this
      strain difference remains unclear, although it may involve discrimination by the
      recipient's immune system. The effects in BALB/c mice were reversed by progestin
      treatment. A dose of 5 nmol, which completely blocked implantation, had no
      significant effects on embryo transport and development on Day 4. A dose of 10
      nmol did not increase the proportion of abnormal embryos, even though it
      accelerated tubal transport and increased embryo loss. No tubal retention was
      evident; most remaining embryos reached the uterus at the normal time. The
      transformation of morulae to blastocysts was only slightly delayed in 11P27
      treated mice, and transfer experiments showed no decrease in embryo viability.
      The antibody appeared to act by blocking actions of endogenous progesterone on
      the uterus: uteri of 11P27-treated mice failed to develop a decidual cell
      reaction to intrauterine oil, and embryos from untreated donors failed to implant
      in 11P27-treated recipients. Antagonism of progesterone by antibody treatment
      prevented implantation in BALB/c mice apparently by actions on the uterus rather
      than on the embryo.

PMID- 2217898
TI  - The ovarian hyperstimulation syndrome and in vitro fertilization--strategies for
      prevention and management.

PMID- 2217897
TI  - Preimplantation development in the streptozotocin-induced diabetic mouse.
AB  - Streptozotocin (STZ) was used to develop a diabetic mouse model in which to study
      the development of the preimplantation embryo. STZ doses of 0, 160, 190, 210 and
      240 mg kg-1 were given; 190 mg kg-1 was found to be the most suitable as the
      standard diabetogenic dose, providing about 60% mice with plasma glucose greater
      than 20 mM. The STZ-diabetic mice responded to superovulation with 10 i.u. of
      gonadotrophin in the same manner as control mice, producing similar embryo
      numbers at 48 h, 72 h and 96 h post-hCG. Furthermore, the proportion of 2-cell
      embryos collected from STZ-diabetic mice which developed to blastocysts in vitro
      was similar to that of 2-cell embryos from control mice. The STZ-diabetic mouse
      model after superovulation thus produced normal early preimplantation embryos
      whose development can be examined in detail in a diabetic environment.

PMID- 2217899
TI  - Infusion of epidermal growth factor in mice: organ distribution and urinary
      excretion.
AB  - Anesthetized mice were infused into the tail vein with 7.5% mannitol in saline
      (0.1 ml/min for 60 min) alone or with EGF at 0.5 microgram/min. Urine was
      collected every 10 min starting 20 min after the beginning of the infusion and
      ending 20 min after its termination. EGF concentration in the serum of mice
      infused with EGF increased from the baseline level of 0.6 +/- 0.4 to 70.7 +/-
      16.0 ng/ml at 80 min. Total excretion of EGF for 80 min was 117 +/- 49 ng with
      mannitol alone and 1916 +/- 420 ng (6.4% of the EGF infused) after mannitol with
      EGF. Serum and urine EGF was indistinguishable from the native mouse EGF by its
      radioimmunoassay and HPLC characteristics. Intact labeled EGF was also found in
      urine when mice were infused with 125I-EGF (1 x 10(6) cpm/ml) in mannitol. After
      5 min infusion with 125I-EGF (6 x 10(6) cpm/ml in saline), more than 80% of the
      label was found in the liver and kidneys and more than 90% of it was intact EGF.
      However, 30 min after infusion more than 95% of the labeled EGF was degraded. We
      conclude that at least part of the urinary EGF in mice originates in blood and
      that liver and kidneys are the main organs of EGF degradation.

PMID- 2217900
TI  - Ontogeny of glucagon messenger RNA and encoded precursor in the rat intestine.
AB  - The ontogeny of proglucagon mRNA and encoded precursor was studied in rat
      intestine from day 11 of fetal gestation (E11) to maturity. The earliest time
      point for detection of proglucagon antigenic determinants by immunocytochemistry,
      and of proglucagon mRNA by in situ hybridization histochemistry, was day 14 of
      fetal gestation (E14), suggesting this time as the point of onset of intestinal
      proglucagon gene expression and mRNA translation. Between day 17 and 18 of
      gestation (E17 and E18) there was a significant 10 fold increase in intestinal L
      cell density, indicating that this time in gestation is one of increased L cell
      differentiation and/or proliferation. Proglucagon mRNA abundance in developing
      rat intestine showed a major 8 fold increase between E17 and E18. Similar
      magnitude of increases in L cell density and proglucagon mRNA abundance suggests
      that the increase in proglucagon mRNA abundance reflects an increase in L cell
      numbers rather than increases in proglucagon gene transcription or mRNA stability
      per cell.

PMID- 2217901
TI  - Comparative studies on the release of vasopressin and 7B2 from isolated
      hypothalami.
AB  - A new protein, 7B2, has been found in the anterior, intermediate and posterior
      pituitary and the hypothalamus. It has been previously suggested that 7B2 is
      synthesized in the hypothalamus and is transported to the posterior lobe in a
      similar way to vasopressin (AVP). We examined the in vitro release of AVP and
      7B2, using rat hypothalami in a perifused column system. Membrane depolarization
      with KCl (56 mM) caused a marked stimulation of AVP release (from 116% to 263%
      above basal values). Release of 7B2 was also stimulated by potassium from 106% to
      212% above basal values. Potassium pulses in calcium-free medium failed to
      release AVP or 7B2. Osmotic and cholinergic stimulation increased AVP secretion
      by 205% and 282% above basal values, respectively, but had no significant effect
      on 7B2 secretion. Chromatographic profiles of perifusion media revealed one
      immunoreactive 7B2 peak eluting at a coefficient of 0.34 corresponding to that of
      rat hypothalamic 7B2. Similarly AVP coeluted with AVP standard. Thus AVP and 7B2
      are differentially released by cholinergic and osmotic stimuli in vitro.

PMID- 2217902
TI  - VIP-containing nerve fibres in the submandibular gland of the dog and protein
      secretion in vitro in response to VIP.
AB  - Previously, administration of VIP has been shown to elicit no flow of saliva from
      the submandibular gland of the dog. However, in the present study we found VIP to
      cause release of protein in vitro from canine submandibular gland tissue.
      Furthermore, VIP-containing nerve fibres were demonstrated in large numbers in
      association with acini. Thus, VIP may be involved in the nervous regulation of
      salivary protein secretion in the dog.

PMID- 2217903
TI  - Differential effects of neuropeptides on coeliac and superior mesenteric blood
      flows in conscious rats.
AB  - The effects on coeliac and superior mesenteric blood flows of intravenous bolus
      doses of arginine-8-vasopressin (0.7 and 7.0 pmol) porcine neuromedin U-25 (0.01
      and 1.0 nmol), rat alpha-calcitonin gene-related peptide (0.05 and 0.5 nmol),
      bombesin (0.06 and 0.6 nmol), and rat corticotropin-releasing factor (1.0 and 5.0
      nmol) were investigated in conscious, Long-Evans rats chronically instrumented
      with pulsed Doppler flow probes. The peptides investigated were chosen on the
      basis of the range (vasoconstrictor-vasodilator) of their effects on superior
      mesenteric blood flow. With the exception of rat corticotropin-releasing factor
      (which increased coeliac and superior mesenteric flows) all peptides caused
      directionally opposite changes in coeliac and superior mesenteric blood flows.
      The results are consistent with the proposition that endogenous neuropeptides
      could influence blood flows to different abdominal viscera selectively.

PMID- 2217905
TI  - Insulin inhibits lipolytic activity and degradation of beta-lipotropin in rabbit
      adipose tissue.
AB  - beta-Lipotropin, a pituitary peptide, is a potent stimulator of lipolysis in
      rabbit adipose tissue in vitro and in vivo. Insulin inhibited the beta-lipotropin
      (1-100 nM)-stimulated glycerol release from rabbit adipocytes and fat pads
      significantly at concentrations of 10 and 100 microM. Both these concentrations
      of insulin also decreased the degradation of beta-lipotropin in intact adipose
      tissue to the same extent as the lipolytic activity. Furthermore, insulin reduced
      the degradation of beta-lipotropin in rabbit adipose tissue homogenate. Like
      insulin, several lysosomotropic agents also decreased significantly the
      degradation and the lipolytic activity of beta-lipotropin. On the other hand,
      insulin-like growth factor I in lower concentrations (1-100 nM) did not effect
      degradation and lipolytic activity of beta-lipotropin in rabbit adipose tissue.
      Thus, a direct influence of insulin on lysosomal enzymes degrading beta
      lipotropin in rabbit adipose tissue can be suggested.

PMID- 2217904
TI  - Isolation and structures of xenopsin-related peptides from rat stomach, liver and
      brain.
AB  - Using radioimmunoassay for detection, a mammalian counterpart to amphibian
      xenopsin (XP) was isolated and sequenced from pepsin-treated extracts of three
      different rat tissues and shown to be H-Phe-His-Pro-Lys-Arg-Pro-Trp-Ile-Leu-OH.
      This peptide, which shares six of the eight residues in XP, existed primarily in
      large molecular form(s) in the rat from which it could be liberated by the
      enzyme, pepsin. The XP-related sequence was differentially distributed through
      tissues, with concentrations ranging from ca. 80 pmol/g in diaphragm and skeletal
      muscle to ca. 800 pmol/g in stomach, liver and intestine. Like XP, the mammalian
      peptide potently crossreacted in a radioreceptor assay for neurotensin. These
      results prove the existence of radioreceptor-active XP-related sequences in
      multiple tissues of the rat.

PMID- 2217906
TI  - Distribution of neuropeptide Y in the spinal cords of cat, dog, rat, man and pig.
AB  - Regional distribution of neuropeptide Y (NPY) in spinal cord, dorsal root ganglia
      (DRG) and peripheral nerves was quantitated in rat, cat, dog, pig, and man.
      Spinal cords were harvested post mortem and dissected into regions or individual
      segments. A further dissection into dorsal and ventral horns was carried out, and
      DRG were harvested in all species except rat. Tissues were extracted into boiling
      0.1 M HCl, and NPY was measured by radioimmunoassay using a specific antibody and
      I125-labeled NPY. Highest concentrations of NPY were consistently found in the
      dorsal horn of the lumbo-sacral cord (200-800 ng/g). DRG concentrations, in
      contrast, were routinely low or undetectable. Sciatic nerve concentrations in rat
      and pig were considerable. High performance liquid chromatography (HPLC)
      confirmed that the NPY immunoreactivity measured in dorsal horns of each species
      coeluted with authentic NPY (1-36) as a single peak.

PMID- 2217908
TI  - Effects of oxytocin on in vivo release of insulin and glucagon studied by
      microdialysis in the rat pancreas and autoradiographic evidence for [3H]oxytocin
      binding sites within the islets of Langerhans.
AB  - In the present investigation it was studied whether oxytocin administered
      directly in the pancreas of the rat stimulates the release of insulin and
      glucagon. In order to study such effects in vivo, a new experimental model
      applying the microdialysis technique was developed. To test the validity of the
      method, glucose or arginine were infused i.v. and it was shown that perfusate
      concentrations of insulin and glucagon increased significantly to 344 and 292% of
      basal overflow, respectively. Administration of oxytocin via the dialysis probe
      into the splenic portion of the pancreas resulted in significant elevations of
      insulin and glucagon concentrations to 210 (P less than 0.05) and 528% (P less
      than 0.01), respectively. The present study also includes a combined
      autoradiographic and immunohistochemical investigation of binding sites for
      oxytocin in the rat pancreas. A high density of [3H]oxytocin binding was present
      in the periphery of the islets of Langerhans, corresponding to the localization
      of the glucagon-producing alpha-cells. Both oxytocin and arginine(A)-vasopressin
      displaced [3H]oxytocin. The IC50 values were 10 and 180 nM, respectively. In
      conclusion, the oxytocin-induced release of insulin and glucagon as previously
      demonstrated in a number of species, may be due to a stimulation exerted by the
      peptide directly within the pancreas.

PMID- 2217907
TI  - The mechanism of action of bombesin on cat lower esophageal sphincter.
AB  - The effect of bombesin on the tone and the responses of strips from the lower
      esophageal sphincter (LES) to field electrical stimulation (FES) (2 Hz, 0.2 ms,
      supramaximal current intensity, 20 s duration) was studied. Bombesin dose
      dependently increased the LES tone. The threshold for this effect was 10(-14) M
      and was particularly pronounced with a concentration of 10(-8) M. The response
      reached maximum between the 3rd and the 5th min after application, persisted for
      15-20 min, and was followed by a slight time-dependent decrease. Bombesin
      increased FES-produced relaxation of LES by 39% as compared to the control. The
      potentiating effect of bombesin on the LES relaxation was also observed after
      cholinergic and adrenergic receptor blockade. It is concluded that bombesin may
      modulate the release of cholinergic, adrenergic and noncholinergic, nonadrenergic
      inhibitory neurotransmitters.

PMID- 2217909
TI  - Purification of bovine cholecystokinin-58 and sequencing of its N-terminus.
AB  - Molecular cloning of cholecystokinin (CCK) mRNA from porcine brain and gut has
      demonstrated that CCK is synthesized as an identical precursor in both tissues.
      The sequence for porcine CCK-58 predicted from CCK cDNA was identical with the
      amino acid sequence of the peptide purified from different lots of animals.
      However one group did report that there were differences in the N-terminus of CCK
      58 purified from the intestines of two different lots of mongrel dogs. In the
      current report it is demonstrated that the amino acid sequences of CCK-58
      purified separately from three bovine brains are identical through the first 19 N
      terminal amino acid residues. The peptides were sequenced for ten additional
      steps and were shown to be identical with the previously reported sequences for
      the N-terminus of CCK-39. The N-terminus of bovine CCK-58 has the following
      sequence: AVPRVDDEPRAQLGALLAR.

PMID- 2217910
TI  - Peptide biology: the value of non-mammalian models. Bayliss & Starling 10th
      annual meeting. Egham, 2-3 September 1990. Abstracts.

PMID- 2217911
TI  - [New portable spectrometry recording system].
AB  - The variations of environmental gamma radiation flux were observed by using a new
      portable spectrometry recording system for 1 year. Spectrum analyses by the
      response matrix method have provided much information, and the artificial
      contribution can be separated from natural back ground dose by using the Th
      method or the three component method.

PMID- 2217912
TI  - [Chemical constituents of some biodegradable liquid scintillators].
AB  - Chemical constituents of the commercially available "biodegradable" liquid
      scintillator solvents were elucidated by means of GC/MS analysis etc., as either
      the mixture of monosubstituted benzenes with the alkyl chain of carbon 10 to 13,
      or 1-(3,4-dimethylphenyl)-1-phenyl-ethane.

PMID- 2217913
TI  - [Food irradiation: global aspects and future prospects].

PMID- 2217914
TI  - [Measurement of radiation energy and its application. IV. Measurement of beta-ray
      energy and its application (6). Liquid scintillation spectrometry].

PMID- 2217915
TI  - Quantitative factors in chemical carcinogenesis: variation in carcinogenic
      potency.
AB  - The quantitative assessment of toxicological data on the carcinogenic potential
      of chemicals requires consideration of a number of factors, including
      mathematical models of the mechanism of carcinogenic action and pharmacokinetic
      models for the metabolic activation of the parent compound to its reactive
      metabolite. In this article, the use of such models in estimating carcinogenic
      potency and in predicting risks at low levels of exposure is discussed, along
      with other factors involved in the evaluation of carcinogen bioassay data. The
      Carcinogenic Potency Database (CPDB) established by Gold et al. (1984, Environ.
      Health Perspect. 58, 9-322) is used to illustrate the application of quantitative
      approaches to carcinogenic risk assessment and to examine the variation in the
      potency of chemical carcinogens. Based on an analysis of 585 experiments selected
      from the CPDB, the risk-specific (10(-6) doses (RSDs) obtained by linear
      extrapolation from the TD50 were generally within a factor of 5-10 of those
      derived from the linearized multistage model. The RSDs obtained by linear
      extrapolation from the TD50 are roughly log-normally distributed with a median of
      about 20-90 ng/kg/day, depending on the subset of the CPDB considered. This
      distribution has been used by Rulis (1986, in Food Protection Technology (C. W.
      Felix, Ed.), pp. 29-37, Lewis, Chelsea, MI) to explore the concept of a threshold
      of regulation for chemical carcinogens present in the environment at low levels.

PMID- 2217916
TI  - Safety assessment procedures for indirect food additives: an overview. Report of
      a workshop.

PMID- 2217917
TI  - Screening procedures for evaluating the potential carcinogenicity of food
      packaging chemicals.

PMID- 2217918
TI  - Mechanistic considerations in chemical carcinogenesis.

PMID- 2217919
TI  - Consumer perception of cigarette yields: is the message relevant?
AB  - Over 1200 randomly selected subjects from the U.S. and key European countries
      were interviewed by telephone, to establish how consumers perceive the meaning
      and relative value scale of tar yields of commercial cigarettes. Some 50% of
      respondents interpreted numerical tar yields as being precise quantitative
      predictors of intake related to health effects. A less precise quantitative
      intuition is shown by 20-30% of respondents. The remaining respondents had little
      or no interest in, or understanding of, tar yield meaning. Despite local
      differences, the aggregate responses from the U.S. were analogous to European
      responses and were not significantly affected by age, sex, or socioeconomic
      status. The results show that consumers expect a cigarette grading message
      predictive of actual intake from different brands. The current message based on
      standard analytical yields does not meet this requirement and needs modification.
      Cigarette ratings based on the tar-to-nicotine ratio of standard yields could
      offer the basis for an acceptable message.

PMID- 2217921
TI  - Preliminary adult soil ingestion estimates: results of a pilot study.
AB  - Six adults were evaluated for the extent to which they ingest soil. This study
      was originally part of a large childhood soil ingestion study and was used to
      validate part of the analytical methodology used in that larger study. The adult
      study followed the soil tracer methodology of the children's study. The principal
      findings of the adult study revealed that the four most reliable tracer elements
      based on recovery studies in a mass balance assessment [aluminum (Al), silicon
      (Si), yttrium (Y), and zirconium (Zr)] yielded the following mean daily adult
      soil ingestion estimations: Al (77 mg), Si (5 mg), Y (53 mg), and Zr (22 mg). The
      median daily soil ingestion estimations based on these same tracer elements were:
      Al (57 mg), Si (1 mg), Y (65 mg), and Zr (-4 mg). These findings represent the
      first published quantitative estimates of soil ingestion by adults.

PMID- 2217922
TI  - Biotechnologies and food: a summary of major issues regarding safety assurance.

PMID- 2217920
TI  - Acute toxicity testing in the nonlethal dose range: a new approach.
AB  - A new modification of acute toxicity testing of chemicals in rats is presented.
      Instead of using death as the principal criterion of toxicity, it is based on a
      careful, standardized clinical assessment of toxic signs measured in the
      nonlethal dose range. Test compounds are administered to groups of rats at four
      dose levels, selected on the basis of pilot experiments. General indices of
      toxicity, i.e., body weight gain, food and water consumption, and body
      temperature, are recorded at regular intervals; activity in the home cage is
      monitored continuously with a newly developed passive infrared device;
      neurobehavioral dysfunctions are assessed repeatedly with a checklist; and
      routine hematology is done on the 4th day after administration of the test
      compounds. All measured signs of toxicity are scored in relation to the control
      groups so that the absolute magnitude of the score increases as a function of the
      deviation from the normal conditions of the animals. In order to take into
      consideration the course of intoxication and the rate of recovery, toxicity
      scores are added over the duration of the whole experiment. For each variable
      measured, the resulting total scores are converted into a relative point system,
      scaling from 0 to 10 points. These points are added to a single "total ToxScore"
      value for each dose group. A regression line is calculated for these total
      ToxScore points, and the dose giving 15 total ToxScore points is determined.
      Based on the results obtained with nine reference substances, a classification
      system is proposed that is comparable to that based on LD50 values. It is
      concluded that the proposed test procedure provides much more information on the
      signs of acute toxicity, the course of the intoxication, the slope of the dose
      effect curve, and the rate of recovery than does the standard LD50 test. In
      addition, the degree of distress and suffering of the animals is reduced.

PMID- 2217923
TI  - [Radiologic study of osteopenic syndromes. Between tradition and innovation].

PMID- 2217924
TI  - [Emphysematous cholecystitis. Description of a case].

PMID- 2217925
TI  - [Peripyelic and peri-ureteral non-Hodgkin's lymphoma].

PMID- 2217927
TI  - [Magnetic resonance of the heart: imaging and spectroscopy].

PMID- 2217926
TI  - [A case of death following the intravenous administration of an organo-iodinated
      contrast media of low osmolality].

PMID- 2217928
TI  - NMR assessment of valvular disease.

PMID- 2217930
TI  - [Magnetic resonance in hypertrophic cardiomyopathy].

PMID- 2217929
TI  - [Magnetic resonance in dilated, restrictive and arrhythmogenic cardiomyopathies].

PMID- 2217931
TI  - [Magnetic resonance in the study of cardiac dysplasia].

PMID- 2217932
TI  - [Computerized tomography and magnetic resonance in the study of the pericardium].

PMID- 2217933
TI  - [Magnetic resonance of tumors of the heart].

PMID- 2217934
TI  - [Fundamental aspects of magnetic resonance spectroscopy in vivo].

PMID- 2217935
TI  - Magnetic resonance spectroscopy of the heart.

PMID- 2217936
TI  - Localized 31P-spectroscopy of the human heart.

PMID- 2217937
TI  - MR imaging and MR spectroscopy of the heart: present and future possibilities and
      limitations.

PMID- 2217938
TI  - [Modular project of the Picture Archiving and Communication System (PACS).
      Preliminary clinical experience. II].
AB  - In the previous paper in this volume the PAC System installed in the Radiology
      Department of the University of Trieste has been described and its advantages and
      limitations have been analyzed, mainly from an operational point of view. This
      paper deals with the clinical evaluation of the system in ordinary operative
      conditions. A series of cases with specific characteristics was monitored in
      order to reveal different performances in both diagnostic process and conclusions
      using the PACS viewing console (DW) vs. conventional CRT film images on
      alternators. In a first test, 100 routine (not pre-selected) brain CT cases were
      independently analyzed by 4 radiologists, each of them giving 2 interpretations
      of the same case, one based on film and the other on PACS. The data were analyzed
      by conventional statistical methods, showing a substantial agreement of the
      results obtained with the 2 modalities. A second test concerned the evaluation of
      100 lumbar intervertebral disks by CT, with the same procedure as above. Four
      radiologists were again asked to decide on film and PACS images about normality,
      protusion, or herniation of the disks. The results demonstrate the possibility of
      adequately reporting on the PACS monitor and stress the need of an adequate
      training period and the efficacy of the image processing capabilities of the
      system.

PMID- 2217939
TI  - [Radiologic picture of the thorax in acute asphyxia caused by near drowning. A
      caseload contribution].
AB  - One hundred-fifteen drowning and near-drowning patients were hospitalized in
      Jesolo and Mestre over the last 10 years. A correlation between radiological
      patterns and clinical features was thoroughly investigated by the authors. A
      close relationship was found between clinical findings and the X-ray pattern of
      the first radiography, taken immediately after the rescue. The longer the
      hospitalization (or when SNC is assessed) the less significant the correlation.
      According to the author's experience, prognosis is good when the first radiograph
      does not demonstrate any lesions. On the contrary, when lesions are seen on the
      first radiograph the patient is to be carefully monitored in order to treat every
      complication promptly, including ARDS (10% of all cases). Chest radiographs are
      also useful to explain autopsy findings. No typical radiological pattern was
      found: however, four signs were observed, which were very frequently associated
      i.e., bilateral parenchymal shadows, pneumothorax, pneumopericardium, and
      gastrectasia. These findings appear to be characteristic of near-drowning.

PMID- 2217941
TI  - [Magnetic resonance in the evaluation of mediastinal masses].
AB  - Thirty-three patients with mediastinal masses were examined by means of MRI to
      obtain elements for lesion characterization, to evaluate lesion extent, and to
      assess the relationship of the mass to the surrounding structures, especially the
      great vessels (accuracy: 84.84%), mediastinal structures (accuracy: 76.78%), and
      lung parenchyma (accuracy 69.69%). MR data were compared to CT findings;
      sensitivity, specificity and accuracy were subsequently compared to surgical and
      histologic findings. The results have shown MRI to be a very reliable method in
      the evaluation of mediastinal masses.

PMID- 2217940
TI  - [Diagnostic reflections on lung lymphangioleiomyomatosis].
AB  - Two cases of histologically proven pulmonary lymphangiomyomatosis were studied by
      means of an adequate combination of the current imaging modalities. After an
      anatomical survey of the secondary pulmonary lobule, the authors discuss the
      pathologic appearance, the pathogenetic factors (mainly hormones), and the
      diagnostic problems concerning this pathologic condition. Finally, the authors
      emphasize the decisive role of high-resolution CT (HRCT) in the evaluation of
      pulmonary lymphangioleiomyomatosis.

PMID- 2217942
TI  - [First experience with the combination of ultrasonics and pulsed Doppler (Duplex
      system) in the study of venous pathologies of the legs].
AB  - Over a 2-year period the authors examined 400 patients affected with different
      types of phlebopathies with combined real-time US and pulsed Doppler (Duplex
      system). Ninety-eight patients had deep phlebothrombosis, 45 had superficial
      phlebothrombosis, and 110 primitive or secondary vein insufficiency. The obtained
      data, supported in 171 cases by contrastographic findings, allowed both the
      semeiological study and the evaluation of the indications for Duplex US in the
      various phlebopathies. The combination of high-resolution US morphological data,
      dynamic tests, and the functional data from pulsed Doppler have particular
      interest in the study of: a) the diagnostics of superficial or deep thrombosis
      and adhesive or floating thrombi; b) post-thrombotic syndrome; c) primitive or
      secondary vein insufficiency; d) the ostium of the superficial venous system
      (location, morphology, functionality). Duplex US is a non-invasive technique for
      the examination of the superficial and the deep venous systems, which reduces the
      indications for phlebography, an exam which requires radiation exposure, and is
      not always safe or possible. Duplex US is however limited by the difficult
      assessment of the venous system below the knee, because of too many trunks and
      variants.

PMID- 2217943
TI  - [Injury of the large vessels of the neck caused by radiation of neoplasms of the
      otorhinolaryngologic region: a study using Doppler echography].
AB  - Twelve patients undergoing radiotherapy for pharyngo-laryngeal neoplasms were
      compared to a control group by means of duplex-Doppler US in order to evaluate
      early and late radiation-induced damage to the main arterial vessels in the neck
      region. On first examination the case distribution regarding the presence/absence
      of preexisting vascular lesions was: no lesions (8.3%), mild (33.3%), moderate
      (16.6%), and severe (41.6%) atherosclerotic lesions. The subjects included in the
      control group presented with similar characteristics, so that they had similar
      features to the patients undergoing radiotherapy. While no early complications
      were demonstrated, development and/or progression of parietal lesions were
      detected 1 year after the first examination in 58% of patients. No variations
      were observed in the control group. Radiation-induced damage to the arterial wall
      was subdivided into 2 groups: moderate (42%) and severe (16%). Damage to neck
      vessels, though allowing for the small number of patients and the short follow
      up, has to be referred to radiotherapy, since no changes were detected in the
      control group. In the authors' opinion, follow-up by means of hematochemical
      exams and duplex-Doppler US of the neck is advisable to evaluate general risk
      factors and to select those patients who can fruitfully undergo surgical
      treatment.

PMID- 2217944
TI  - [Intra-arterial digital angiography using a trans-humeral approach in the
      assessment of ambulatory patients].
AB  - The authors report their experience with intraarterial digital subtraction
      angiography (DSA) performed on outpatients via brachial artery catheterization. A
      total of 120 outpatients were studied for cerebral and lower limbs vascular
      diseases. Transbrachial catheterization was performed with 5F or, preferably,
      with 4F angiographic catheters. Success rate was high and the transbrachial
      approach was always easy. In the course of cerebral examination (18/120 cases)
      the catheter was always easily positioned in the ascending thoracic aorta,
      through right transbrachial approach. In the course of abdominal aorta and lower
      extremities examination (102/120 cases), the ideal catheter positioning--in the
      descending aorta--was performed in 95/102 cases, by left transbrachial approach,
      while in 7/102 patients the catheter was placed in the ascending aorta. The
      complication rate was low: 7/120 ecchymosis, 4/120 small hematomas spontaneously
      resorbed, and 2/120 transient spasms of brachial artery. The authors suggest
      trasbrachial intraarterial DSA as an alternative to intravenous DSA in
      outpatients.

PMID- 2217945
TI  - [The enhancement phenomenon of serous cavity effusions].
AB  - The enhancement of ascites following a high dose of contrast medium has been
      recently described. The CT behavior of 26 peritoneal, pleural or pericardial
      effusions has been studied in 23 patients after the administration of a high dose
      of urographic contrast medium. The effusions were enhanced in all patients but
      one. No difference between malignant and non-malignant effusions could be
      observed with ionic and non-ionic contrast medium. Low molecular weight of the
      urographic contrast medium (600-800 daltons) can explain the free passage of the
      solute through peritoneum, pleura, and pericardium. The knowledge of such a
      phenomenon is mandatory to avoid misdiagnosing hematic effusion or urinary
      peritoneal fistula.

PMID- 2217946
TI  - [Creation and management of a data bank in oncologic radiotherapy].
AB  - Clinical, scientific and technological development has greatly widened the scope
      and range of oncological radiotherapy. As for database management, favorable
      conditions come from new available hardware and software facilities and from well
      consolidated and universally accepted classifications. The authors' aim was to
      create and to verify an original database management system for oncological
      radiotherapy, proved with internationally accepted classifications and directly
      interfaced to a new package for clinical and epidemiological statistics. An
      ordinary personal computer was used and a 802-subject statistics was analyzed
      relative to 1987-1988 series from the Istituto del Radio "O. Alberti", General
      Hospital and University - Radiotherapy Department, Brescia, Italy. The system
      seems to be suitable for routine use as well as for research, with good
      potentials for multicentric use.

PMID- 2217947
TI  - [Preoperative localization using a bidimensional mammographic technique of non
      palpable lesions of the breast].
AB  - It is widely known how the early diagnosis and treatment of breast cancer may
      lead to better prognosis. When a non-palpable breast lesion detected with
      mammography is correctly localized with fine-needle biopsy under X-ray guidance,
      the surgeon can easily remove the lesion while preserving normal breast tissue.
      In such cases, histology is also possible. The authors describe an easy
      bidimensional technique for the preoperative localization of occult nonpalpable
      breast lesions with a fine-needle. The procedure is feasible also with out-of
      date equipment and does not cause any discomfort to the patients. It should be
      performed on all women with mammographic suspicion of non-palpable breast lesion.
      From January through December 1989 the authors performed 64 preoperative fine
      needle biopsies of clinically-occult breast lesions. The presence of a lesion
      associated with microcalcifications was found to be indicative of malignancy more
      often than in the case of microcalcifications or lesions alone. Of 64 cases,
      histology demonstrated malignancy in 31 patients.

PMID- 2217948
TI  - [Modular project of the Picture Archiving and Communication System (PACS).
      Preliminary operational experience. I].
AB  - Since september 1988 a PAC System (Comm View by AT & T and Philips) has been
      operating in the Radiology Department of the University Hospital, Trieste. A
      research project is presently in progress aiming at providing factual evidence
      for the evaluation of this kind of systems as far as operational, technical,
      clinical and economic aspects are concerned. The general approach to this
      research consists in implementing and monitoring a PACS in a stepwise way,
      starting with a small system connected to some digital modalities only, in order
      to test the feasibility and effectiveness of the system within a Radiology
      Department, and to test the possibility of matching the PACS to the Radiological
      System. The present paper describes in detail the present configuration of this
      entry-level system and its technical features. The planned development (october
      1989) is also depicted. Further developments devise at managing in an integrated
      way all the radiological images of the four hospitals of Trieste. At present, the
      PACS is currently used to manage and store on optical disks all the images
      acquired from the connected modalities plus the related reports, and to perform
      the reporting sessions for CT examinations (brain and abdomen). The present
      research effort is devoted to two main areas: clinical evaluation and operational
      analysis. The object of the operational analysis was the assessment of the impact
      of PACS on the operations of a Radiology Department. The general approach
      followed for this research consists in analysing the procedures as they are
      performed in the conventional way (manual operations), and comparing them to the
      way they are, or could be, performed using a PACS System (automatic operations).
      This stage of the project is divided into three phases, concerning respectively
      the analysis of the organization and operations before PACS, the analysis of the
      impact of PACS in its initial configuration and the forecast of the influence of
      PACS in its future setting. A first evaluation concerned the activities carried
      out from the moment the images are generated to the moment they are ready to be
      achieved. They include image acquisition, reporting, delivering and returning of
      images from the departments. The time required to carry out each of the
      activities involved was recorded, both in the manual and in the automatic
      version; furthermore, a more detailed analysis was performed on the reporting
      procedure. The conclusions reached through this analysis are that this kind of
      operation is mostly affected by the way the Radiology Department is managed,
      rather than by the tools employed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2217949
TI  - [Chiasmal hernia in secondary empty sella. Magnetic resonance images in an
      asymptomatic patient].

PMID- 2217950
TI  - [Pneumopathy caused by amiodarone. Description of a case].

PMID- 2217951
TI  - [A case of giant fibrolipoma of the esophagus. Diagnosis using computerized
      tomography and double-contrast esophagography].

PMID- 2217952
TI  - [Maternal and neonatal plasma concentrations of bupivacaine during peridural
      anesthesia for cesarean section].
AB  - Many anesthesiologists prefer epidural anesthesia for cesarean section because of
      the potential risks of general anesthesia such as Mendelson's syndrome. For this
      indication, the local anesthetic of first choice is the long-acting substance
      bupivacaine. The aim of the following study was to determine maternal and
      neonatal plasma concentrations of bupivacaine 0.5% following epidural anesthesia
      for cesarean section in order to give critical statements about the systemic
      toxicity of the local anesthetic. MATERIALS and METHODS. Central venous blood
      samples were collected for bupivacaine analysis (gas chromatography) in 15
      patients (Table 1) undergoing cesarean section with epidural anesthesia over a
      period of 60 min after injection of 14 to 23 ml bupivacaine 0.5%. Six of these
      patients had received the epidural anesthesia earlier to relieve labor pain.
      Before administering the anesthetic dose, a blood sample was taken to determine
      the baseline value. Immediately after cord clamping, blood sampling was done to
      determine bupivacaine concentrations in the umbilical artery and vein. Apgar
      scores and blood gases were also checked and compared with those of neonates born
      by cesarean section under general anesthesia. RESULTS. Ten to 15 min following
      epidural application of 70 to 115 mg bupivacaine (mean = 99 mg), peak plasma
      concentrations occurred (mean = 0.41 micrograms/ml) The maximum plasma level of
      0.7 micrograms/ml bupivacaine was found in a patient who had received epidural
      anesthesia for pain relief during labor. In this case, the baseline bupivacaine
      level after several epidural injections (125 mg in 15 h) before the anesthetic
      dose for cesarean section was 0.2 micrograms/ml. Immediately after delivery the
      mean plasma bupivacaine concentrations in the umbilical vein and artery were 0.11
      micrograms/ml and 0.07 micrograms/ml respectively. Apgar scores and blood gas
      analyses showed no significant difference between neonates born by cesarean
      section under regional or general anesthesia. DISCUSSION. Using bupivacaine 0.5%
      for epidural anesthesia for cesarean section, we found maternal and neonatal
      plasma concentrations of the local anesthetic far below the accepted threshold
      level for producing systemic toxic reactions. In contrast to others, we obtained
      good analgesia and sufficient motor blockade accompanied by low plasma levels. In
      our opinion, there is no need to use 0.75% bupivacaine, especially since peak
      plasma concentrations of more than 2 micrograms/ml occur shortly after its
      epidural administration.

PMID- 2217953
TI  - [Transient medium- and deep-tone hearing disorders following spinal anesthesia].
AB  - In a prospective study, 100 patients who underwent general surgical or urological
      operations under spinal anesthesia were examined to determine whether there was a
      relation between the anesthesia and postoperative hearing loss. Audiograms were
      performed preoperatively and as the 1st, 2nd, 3rd, and 5th postoperative days. It
      was found that 16 patients had impairment of hearing. The average ages of these
      patients were similar to those of the total population. The hearing loss was
      typical: only the frequencies between 125 and 2000 Hz were affected. It began on
      the 2nd day after spinal anesthesia and disappeared within 3 days without special
      therapy. The cause of this typical hearing loss after spinal anesthesia is a drop
      in cerebrospinal fluid pressure transmitted to the perilymph via the cochlear
      aqueduct. The change in the endoperilymphatic pressure difference results in a
      change in the oscillation of the basilar membrane. Because 16% of patients may
      suffer hearing loss after spinal anesthesia, it seems reasonable from a
      medicolegal point of view to explain the possibility of defective hearing to the
      patient.

PMID- 2217954
TI  - Osteoarthritis.
AB  - In summary, the relationship between risk factors and OA may differ across
      joints. For knees, obesity and knee injury either due to acute events or to
      repetitive impact loading may be the most important preventable causes of
      disease. Hand OA is probably also caused by repetitive use, but its association
      with other risk factors is unknown. Hip OA is probably different from OA in other
      joints, in that many cases are due to congenital and developmental abnormalities.
      Current inquiry focuses on generalized OA and its predictors. Future studies will
      look at the long-term course of OA and will focus especially on as-yet
      unidentified risk factors.

PMID- 2217955
TI  - Epidemiology of rheumatic disease.

PMID- 2217956
TI  - Rheumatoid arthritis.
AB  - RA is a common disease with a worldwide prevalence of about 1% with an annual
      incidence of about 3/10,000 adults. It is two to three times more common in
      women. There is some evidence that over the last few decades the disease is
      declining in incidence or severity. Patients with RA have a reduced life
      expectancy and a one in three chance of becoming disabled, depending on the
      severity of the disease at onset. The cause of the disease is unknown, although
      genetic factors account for up to 30% of disease susceptibility. The most
      important genetic factors are related to HLA-DR4 and DR1, which may have
      identical regions conferring the risk of disease. Many infectious agents have
      also been implicated in the etiology of RA, although there is no good
      epidemiologic evidence to support the laboratory findings. Hormonal and
      reproductive factors are known to play a major role in disease pathogenesis. Both
      pregnancy and the oral contraceptive pill are believed to be protective against
      development of the disease, although they may act by delaying or modifying the
      course of the disease rather than conferring "immunity".

PMID- 2217957
TI  - Gout and hyperuricemia.
AB  - The prevalence of gout in the United States has been rising steadily for the past
      two decades. Hyperuricemia is considered a necessary but not sufficient
      precondition for gout. Known risk factors for gout include male sex,
      hypertension, renal insufficiency, obesity/weight gain, diuretic use, lead
      exposure, and family history. The association of gout and hyperuricemia with
      coronary artery disease is controversial. Current evidence from the Framingham
      Study suggests that gout is in fact an independent risk factor for CHD. These
      data suggest that patients with gout should be screened for modifiable risk
      factors for CHD, and that early intervention in such patients may be worthwhile.
      Finally, the effect of AHU as risk factor for CHD remains unclear but is probably
      a weak one.

PMID- 2217958
TI  - Ankylosing spondylitis and other spondyloarthropathies.
AB  - Ankylosing spondylitis and related spondyloarthropathies show a remarkable
      association with a genetic marker--HLA-B27--and also illustrate the relationship
      between host and environmental factors. HLA-B27 has revitalized the epidemiology
      of spondyloarthropathies and has helped to broaden the clinical spectrum of these
      diseases. These and other aspects of descriptive and genetic epidemiology are
      reviewed.

PMID- 2217959
TI  - Rheumatic diseases of childhood.
AB  - Development of diagnostic criteria for juvenile rheumatoid arthritis, systemic
      lupus erythematosus, a juvenile dermatomyositis, as well as advances in molecular
      biology, have assisted epidemiologic study of the rheumatic disorders of
      childhood. It may be misleading to extrapolate the incidence and prevalence of
      pediatric forms of arthritis from population studies of adults. Additional study
      of the frequency of childhood musculoskeletal disorders is very much needed.
      Classification criteria for Kawasaki syndrome, fibrositis in children, and the
      juvenile spondyloarthropathies are also desirable.

PMID- 2217960
TI  - Lyme disease.

PMID- 2217962
TI  - Systemic sclerosis.
AB  - Systemic sclerosis is a disease characterized by several distinctive features.
      This disease spares children, and its incidence increases steadily with age.
      Women are affected more than men, especially during childbearing years. Although
      there is no overall racial predilection, SSc occurs most frequently and severely
      in young black women. Family and genetic studies suggest only a weak genetic
      predisposition, but there are many occupational agents that may be implicated in
      the pathogenesis. The disease with its involvement in many organ systems results
      in a significant reduction in lifespan. Improvement in survival of renal crisis
      has been dramatic with the use of ACE inhibitors. Further epidemiologic studies
      using subsets of patients with more homogeneous clinical and laboratory features
      will lead to a better understanding of this complex disease.

PMID- 2217961
TI  - Systemic lupus erythematosus.
AB  - Descriptive epidemiologic studies of SLE have been conducted worldwide; the most
      extensive data are available for Scandinavia, especially Sweden, and the United
      States. In the United States, blacks have threefold higher incidence, prevalence,
      and mortality rates compared with whites; the reasons for this excess, however,
      remain unknown. Analytic and genetic epidemiologic studies suggest a
      multifactorial etiology of SLE; results support a polygenic mode of inheritance
      including important roles for an autosomal dominant "autoimmune" gene and female
      sex hormones. Although a viral etiology remains attractive, there is little
      evidence to support such a hypothesis. Rather, other environmental factors
      including chemical exposures may be important as "triggers" of disease. Finally,
      observational epidemiologic studies demonstrate an increasingly favorable
      prognosis for patients with SLE, allowing a better understanding of long-term
      morbidity and impact on overall health status. Future epidemiologic studies
      should focus on identifying noninfectious environmental etiologic factors and
      improving the quality of life for all patients with SLE.

PMID- 2217963
TI  - Idiopathic inflammatory myopathies.
AB  - The idiopathic inflammatory myopathies are a heterogeneous group of uncommon
      diseases. The incidence rate of IIM is approximately 5 cases per million
      population, but there appears to be an increase in the rate over the last two
      decades, particularly in black females. This may be a true increase or due to
      renewed interest and awareness of the disease and improvement in our ability to
      diagnose mild disease. There has also been progress in decreasing the mortality
      rate in IIM perhaps secondary to better treatment and/or the diagnosis of mild
      disease. The discovery of anti-Jo-1 antibodies has renewed the investigation of a
      possible viral etiology of IIM. Studies of quantitative slot blot hybridization
      with coxsackievirus probes and RNA from IIM muscle biopsies and in situ
      hybridization of biopsies with a Theiler's virus probe have revealed a few
      positive hybridizations in each study. Although there are some fundamental
      problems with these studies, these intriguing results bear confirmation. These
      results continue to implicate picornaviruses as the primary suspects in the
      pathogenesis of IIM. HIV has now been associated with a number of rheumatologic
      syndromes, including a polymyositis that is indistinguishable from IIM, and we
      can expect additional changes in the epidemiology of this family of disorders in
      coming years. Study of these patients may provide insight into the
      etiopathogenesis of IIM.

PMID- 2217964
TI  - Polymyalgia rheumatica/giant cell arteritis and other vasculitides.
AB  - The epidemiology of vasculitic syndromes encompasses a broad spectrum of diverse
      clinical syndromes. Almost all lack identified etiologic agents, and their
      clinical characteristics are determined predominantly by the size of the involved
      vessel and the end organs damaged. With the exception of giant cell
      arteritis/polymyalgia rheumatica in the elderly, and Henoch-Schonlein purpura and
      Kawasaki disease in the pediatric population, the vasculitic syndromes are
      infrequently observed diseases.

PMID- 2217965
TI  - Fibromyalgia.
AB  - There has been confusion surrounding regional medical conditions, primary
      psychological conditions, and fibromyalgia in practice and in the literature.
      Confusing terminology and inappropriate use of diagnostic criteria have
      contributed to this problem. Use of the 1990 ACR Criteria for the Classification
      of Fibromyalgia together with the symptom and physical examination definitions in
      that report should go far to correct these problems. Problems of selection and
      identification bias filter patients with the syndrome, and almost all reports
      concerning the disorder have been obtained from subspecialty clinics. Almost
      nothing is known about fibromyalgia in the community, and characteristics of
      patients noted in the clinic may be a primary function of these biases. In
      general, in the clinic, about 90% of patients are women of a mean age slightly
      less than 50 years. Onset is noted in childhood and in old age, but most commonly
      in middle life. Trauma, surgery, and infection have been noted in association
      with development of the syndrome in some reports. More than 10% of patients
      attending general medical clinics and 15-20% attending rheumatology clinics have
      the syndrome. Chronicity is the rule. Work disability occurs, but most patients
      seem to be able to work, although some have changed jobs to accomplish this.
      Psychologic abnormalities are noted in most, but not all, reports, but may
      reflect selection bias and could be absent in the community.

PMID- 2217966
TI  - Osteoporosis and hip fractures.
AB  - Epidemiologic studies have contributed to our understanding of osteoporosis
      through identification of groups at high risk of fracture and through discernment
      of factors associated with increased risk of low bone density and fracture. Many
      of the questions remaining can be addressed only through the use of epidemiologic
      methods in human populations. These include longitudinal studies in large cohorts
      to better delineate factors associated with bone loss and fracture and randomized
      clinical trials to adequately assess therapies. Particularly needed are studies
      in adolescents to assess determinants of peak bone mass and the effect of
      subsequent bone loss with aging.

PMID- 2217967
TI  - Design and conduct of collaborative international epidemiologic studies of
      rheumatic diseases.
AB  - Collaborative international epidemiologic studies are important endeavors for
      improving our understanding of health and disease. They can help answer questions
      relating to genetic and environmental factors that may plan a role in the
      etiology and pathogenesis of the disease under study. These studies are
      challenging but can be very rewarding. There are many opportunities for
      collaborative international epidemiologic studies in rheumatology which can be
      explored.

PMID- 2217968
TI  - Rheumatic diseases in the U.S.S.R.
AB  - Despite our inability to precisely prognosticate disease, accumulation of
      knowledge about risk factors allows us to form a real basis for attempts at
      primary prevention of rheumatic disease. Because rheumatic diseases are
      multifactorial in nature, it may be suggested that the more factors an individual
      has the higher is the risk of disease. Relative risk values are certain to have a
      known limitation, since they are not independent. In addition, the number of risk
      factors may be significantly more than that known today. Increasing our knowledge
      in disease etiology and pathogenesis will definitely increase the number of risk
      factors. At the same time, available data may serve as a basis for developing a
      system for individual and group prognosis, the latter being to a certain degree
      tentative for the majority of diseases. All factors affecting disease development
      and course are divided into the controllable and the uncontrollable. The majority
      of the factors mentioned--especially, the environmental--are controllable ones.
      So the challenge facing practitioners and scientists involves development of a
      comprehensive system of recommendations aimed at elimination or maximum lessening
      of unfavorable risk factors, which is the only real basis for primary rheumatic
      disease prophylaxis.

PMID- 2217969
TI  - RadioGraphics update: announcements and new features.

PMID- 2217970
TI  - Techniques for color flow sonography of the lower extremity.
AB  - Color flow sonography permits noninvasive examination of the deep venous system
      in the lower extremity. In many patients, the modality is sufficiently accurate
      to serve as the sole diagnostic procedure for suspected deep venous thrombosis.
      Over 1,500 color flow sonographic examinations of the lower extremity have been
      performed at our institutions with various scanning techniques. For the
      inexperienced sonographer, we describe our current technique, which is easy,
      quick, accurate, and well tolerated by patients.

PMID- 2217971
TI  - Ethanol embolization of vascular malformations.
AB  - Absolute ethanol was used to treat 20 patients with symptomatic vascular
      malformations (SVMs) (ie, venous malformations, arteriovenous malformations, and
      congenital and posttraumatic arteriovenous fistulas) in whom previous surgery or
      standard embolotherapy had failed or who were not candidates for surgery. All
      large complex lesions required multiple embolizations as staged procedures.
      Immediate thrombosis was achieved in all patients; complications (13% of cases)
      were generally minor and were treated conservatively. Follow-up studies,
      performed in 19 of 20 patients, showed persistent occlusion of the SVM in all
      cases. Ethanol embolization of SVMs, performed according to strict techniques,
      has proved efficacious in SVM management and is emerging as a definitive form of
      therapy.

PMID- 2217972
TI  - CT and MR imaging of the central skull base. Part 2. Pathologic spectrum.
AB  - The radiologist must have a thorough knowledge of the normal anatomy and the
      pathologic spectrum of the skull base to determine the extent of abnormality and
      to help plan the surgical approach. The authors describe and present examples of
      congenital, benign, and malignant lesions that affect this region, including
      cephalocele, fracture, fistula, juvenile angiofibroma, meningioma, chordoma,
      pituitary adenoma, chondrosarcoma, nasopharyngeal carcinoma, and
      rhabdomyosarcoma. Metastatic, infectious, and other miscellaneous processes are
      also discussed. Imaging strategies with computed tomography and magnetic
      resonance imaging to aid in the diagnosis are suggested.

PMID- 2217973
TI  - Otic capsule dysplasia: clinical and CT findings.
AB  - Many congenital dysplasias of the osseous labyrinth have been identified.
      Differentiation of these dysplasias is essential for patient management. High
      resolution computed tomography (CT) was used to identify individual malformations
      in 32 patients. Thirty patients had six previously described forms, while two
      patients had a form that has not previously been reported to our knowledge.
      Review of patient histories revealed clinical characteristics that were specific
      for certain forms of otic capsule dysplasia. CT enabled detailed analysis of each
      lesion and helped direct proper treatment of each patient. The characteristic CT
      appearance and clinical presentation of each form of dysplasia are presented.

PMID- 2217974
TI  - CT of thoracic aortic aneurysms.
AB  - Aneurysms of the thoracic aorta are most often the result of arteriosclerotic
      disease. Other causes include degeneration of the medial layer of the aortic
      wall, either idiopathically or due to genetic disorders such as Marfan syndrome;
      aortic dissection; trauma; syphilis and other bacterial infection; noninfective
      aortitis; and congenital anomaly. We review normal anatomy of the aorta and
      discuss our technique and interpretation of computed tomography (CT) in the
      evaluation of the thoracic aorta. We illustrate the CT appearance of different
      types of aortic aneurysms as well as discuss the use of CT for assessing
      complications of aneurysms, for postoperative follow-up, and in the
      differentiation of aortic aneurysm from a paraaortic mass.

PMID- 2217975
TI  - Internal mammary lymphadenopathy: imaging of a vital lymphatic pathway in breast
      cancer.
AB  - The prognostic significance of metastases to the internal mammary lymph nodes in
      patients with breast carcinoma has long been recognized. While ipsilateral
      dissection of axillary nodes remains a popular staging strategy for breast
      cancer, surgical sampling of the upper anterior intercostal spaces, a tedious
      procedure, has been largely abandoned. Diagnostic imaging of the parasternal
      lymphatic pathway is a useful and noninvasive alternative to surgical staging.
      This report reviews the pertinent regional anatomy and illustrates the criteria
      for diagnosing internal mammary lymphadenopathy by means of lateral chest
      radiography, computed tomography, high-resolution sonography, magnetic resonance
      imaging, and radionuclide lymphoscintigraphy.

PMID- 2217976
TI  - Nonosseous accumulation of bone-seeking radiopharmaceuticals.
AB  - Bone scintigrams are usually obtained for evaluation of skeletal abnormalities;
      soft-tissue abnormalities are often an unexpected finding. However, the
      recognition of specific conditions with extraskeletal accumulation of bone
      seeking radiopharmaceuticals greatly enhances the diagnostic value of the study.
      Several examples of abnormal nonosseous uptake in both neoplastic and
      nonneoplastic processes involving the brain, lung, heart, breast, bowel, liver,
      spleen, skeletal muscle, kidney, and bladder are presented. Examples of
      artifactual uptake in the soft tissues are also described. Causes for nonosseous
      accumulation are discussed.

PMID- 2217977
TI  - Image interpretation session.

PMID- 2217978
TI  - Primary Ewing sarcoma of rib.
AB  - Ewing sarcoma is a relatively common, highly malignant bone tumor that typically
      occurs in adolescents and young adults aged 10-25 years. Our archives contain 328
      cases of histologically proved and radiologically correlated Ewing sarcoma
      collected in consultation over 40 years. From this series, we identified 34
      lesions (10%) arising in ribs. Radiographically, the affected rib was
      predominantly lytic in most (82%) cases, but mixed lytic-sclerotic (9%) and even
      predominantly sclerotic (9%) patterns were also encountered. The affected rib was
      "expanded" in 35% of cases, although the contour change was usually mild.
      Abnormalities of the affected ipsilateral hemithorax varied from subtle, isolated
      rib involvement to solitary rib involvement accompanied by complete opacification
      of the hemithorax. We describe the spectrum of radiologic findings of primary
      Ewing sarcoma of rib, augmented where appropriate by accompanying pathologic
      material.

PMID- 2217979
TI  - Introduction to the history of musculoskeletal radiology.

PMID- 2217980
TI  - Cases of the day. Pediatric. Myositis ossificans circumscripta.

PMID- 2217981
TI  - Cases of the day. Pediatric. Amniotic band syndrome.

PMID- 2217982
TI  - Cases of the day. Ultrasound. Focal nodular hyperplasia of the liver.

PMID- 2217983
TI  - Cases of the day. General. Benign thymic cyst complicated by hemorrhage.

PMID- 2217984
TI  - [Osseous biocompatibility of Endomethasone(R)].
AB  - The root canal filling paste "Endomethasone" was tested, following the F.D.I.
      criterions by bone implants on rabbits. The tissue reaction after four weeks can
      be appreciated as moderate and as mild after twelve weeks. Taking in count the
      criterions selected and the experimental conditions of this study, the
      "Endomethasone" can be considered as a root canal cement with acceptable in vivo
      tolerance.

PMID- 2217985
TI  - [Study of the section of different brands of K files and broaches].
AB  - The authors of this article observed the cross section of different brands of K
      file and reamer, in order to compare the reality to the square or triangular
      symbol. On an other hand, they defined the ideal cross section of the endodontic
      instrument according to the user's requirements, and studied the most approaching
      one.

PMID- 2217986
TI  - [In vitro evaluation of the antibacterial activity of endodontic drugs].
AB  - The antibacterial activity of camphorated phenol, iodine-potassium iodide,
      aqueous 2% glutaraldehyde, Rockles 4, Cresophene and Terra-Cortril has been
      tested in vitro against 21 species of bacteria. After 2 minutes of contact
      between medication and bacteria, Rockles 4, Cresophene, IKI and camphorated
      phenol inhibited completely all the tested bacteria. Terra-Cortril and aqueous
      glutaraldehyde 2% even pures were ineffective against all the bacteria species.
      Only Cresophene remained effective against 4 bacteria species when diluated 100
      times.

PMID- 2217987
TI  - [A more efficient lateral condensation].
AB  - Advantages and inconvenients of the lateral condensation technique are reviewed
      in this paper. Different ways to gain more efficient lateral condensation are
      studied: plugger and gutta-percha points selection and adaptation, combination
      with thermomecanical technique or assistance by ultrasonic or thermal systems.
      The study of these various methods and combinations leads to the concept of an
      thermolateral-assisted condensation.

PMID- 2217988
TI  - [Fistula and localization of dental origin].

PMID- 2217989
TI  - [Design and fabrication of a complete removable denture opposing a fixed denture.
      2].

PMID- 2217990
TI  - [New hydrophilic silicones in clinical/laboratory relations].

PMID- 2217991
TI  - [Influence of die preparation quality on the precision of fixed prosthodontics].

PMID- 2217992
TI  - ["Opal" effect of the natural tooth in ceramometal].

PMID- 2217993
TI  - [Photopolymerization through ceramic].

PMID- 2217994
TI  - [Yesterday's dentures. 1].

PMID- 2217995
TI  - [Multiple impressions one model].

PMID- 2217996
TI  - [Yesterday's dentures. 2].

PMID- 2217997
TI  - [New upper school of dental prosthodontics].

PMID- 2217998
TI  - [Technical problems with dentures on implants].

PMID- 2217999
TI  - [Fabrication of a ceramo-metal bridge with a Sunrise interface].

PMID- 2218000
TI  - The hitch-hikers guide to nasal airway patency.

PMID- 2218001
TI  - Advances in our understanding of the pathogenesis of fibrotic lung disease.

PMID- 2218002
TI  - Primary pulmonary hypertension: diagnosis, medical and surgical treatment.
AB  - Primary pulmonary hypertension continues to present both diagnostic and
      therapeutic challenges to the physician, reflecting the lack of understanding
      about the basic mechanism of the disease. The natural history of the condition
      has been described only recently, and this has allowed a reasonably accurate
      prognosis for the individual patient to be determined. New treatments have been
      found effective, including heart-lung transplantation, which can now offer
      improved survival. Long-term intravenous infusion of prostacyclin has a place in
      the treatment of severely affected patients awaiting heart-lung transplantation.
      However, the major impact of prostacyclin has been, perhaps, to concentrate
      research upon the role of the endothelial cell in the development of this
      disorder, in particular the potential role of an impairment of release of the
      recently described endothelium-derived relaxing factor in certain forms of
      pulmonary hypertension. We have attempted in this review to focus on the problems
      of diagnosis and treatment together with current developments in the
      understanding of primary pulmonary hypertension.

PMID- 2218003
TI  - Nocturnal oxygen desaturation in patients using long-term oxygen therapy for
      chronic airflow limitation.
AB  - Nocturnal oxygen desaturation in patients receiving long-term oxygen therapy is
      described despite adequate daytime oxygenation (PaO2 greater than 8 kPa).
      Domiciliary oximetry overnight was performed on ten patients receiving long-term
      oxygen treatment for chronic airflow limitation: six patients were well saturated
      throughout the night with a fall in SaO2 to below 90% for only 1% of the
      monitoring time; four showed significant desaturation with a fall in SaO2 to
      below 90% for periods of 15-47% of the monitoring time.

PMID- 2218004
TI  - Concentration of tobramycin given by aerosol in the fluid obtained by
      bronchoalveolar lavage.
AB  - Whereas previous studies have used only bronchial secretions and sputum, in the
      present study, bronchoalveolar (BAL) fluid was analysed for tobramycin levels
      after aerosolization of this antibiotic. In 20 adult patients with a variety of
      lung disorders, the concentration of tobramycin obtained in the first aliquot of
      the bronchoalveolar fluid varied from less than 0.1 to 9.2 micrograms ml-1 (mean
      2 +/- 2.26 micrograms ml-1) with 18 samples above 0.4 micrograms ml-1. In most of
      the cases, the concentration of tobramycin achieved values of tobramycin in
      excess of the minimal inhibitory concentration for most of the microorganisms.
      Thus, sampling fluids by the bronchoalveolar technique offers a suitable method
      to study antibiotic levels at the site of broncho-pulmonary infection. These
      results may help explain why aerosol antibiotic treatment appears to be useful in
      selected patients, especially in cystic fibrosis patients chronically infected
      with Pseudomonas aeruginosa.

PMID- 2218005
TI  - Forced expiratory flow and oscillometric impedance measurement in evaluating
      airway obstruction.
AB  - The application of forced oscillations has been introduced as a noninvasive
      method to measure the impedance of the respiratory system. Impedance can be
      partitioned into a real part or resistance and an imaginary part or reactance.
      The reactance depends on the elastic and inertial properties of the respiratory
      system. In the present study, resistance and reactance obtained in a frequency
      spectrum between 4 and 52 Hz were compared with maximal forced expiratory
      spirometry in 100 out-patients, aged 18-70 years. Resonant frequency and
      frequency dependence of resistance correlated significantly with selected
      parameters of the forced expiratory flow volume curve: correlation coefficient
      values ranged from 0.492 between frequency dependence and FVC and 0.668 between
      resonant frequency and FEV1. No correlation between average resistance and
      spirometric parameters reached a statistically significant level. No marked
      difference was observed between spirometric parameters depending on the early or
      effort-dependent portion and those parameters depending on the late or effort
      independent portion of the maximum forced expiration. It can be concluded that
      each measurement procedure reveals different but characteristic information about
      the mechanical behaviour and properties of the respiratory system.

PMID- 2218007
TI  - Risk factors for hydrocortisone myopathy in acute severe asthma.
AB  - In one hospital over a 15-month period, four out of nine patients ventilated for
      acute severe asthma developed acute hydrocortisone myopathy. All patients had
      received less than 1.0 g day-1 hydrocortisone. Affected patients had severe
      generalized weakness which recovered over 1-6 weeks. When myopathic and
      unaffected subjects were compared, there was no clearcut difference with respect
      to age, sex, types of drug used, serum potassium levels, duration of ventilation
      and muscle paralysis, total dose of vecuronium bromide, or mean daily doses of
      hydrocortisone. The main difference between the two groups was in the total doses
      of hydrocortisone. The myopathic patients all received greater than 5.0 g
      hydrocortisone (range 5.4-10.2 g) and the others less than 4.0 g (range 0.9-3.5
      g). The possibility that neuromuscular blockade might predispose to the
      development of myopathy is discussed. Hydrocortisone myopathy can occur when less
      than 1.0 g day-1 is used, and even with as little as 5.4 g given over 6 days.

PMID- 2218008
TI  - How well do the general public read Heaf skin tests?
AB  - The ability of 550 consecutive patients attending a tuberculosis clinic to grade
      their own Heaf skin test reaction, using an illustrated card designed for such
      self-reporting, was assessed. Individuals were asked to grade their own Heaf skin
      reaction and at the same attendance the reaction was formally graded by a
      respiratory health visitor. There was overall excellent agreement with only 58
      (10.5%) disparate gradings. We conclude that self-reporting of Heaf skin tests
      using an illustrated card is simple, usually accurate and may preclude an
      otherwise unnecessary early reattendance. This study also validates an often used
      system of self-reporting.

PMID- 2218006
TI  - Comparative assessment of enprofylline and theophylline for chronic obstructive
      airways disease in the elderly.
AB  - Enprofylline, a recently developed xanthine derivative, is a more potent
      bronchodilator than theophylline. This study compares the efficacy and safety of
      enprofylline with theophylline for chronic obstructive airways disease (COAD) in
      elderly subjects. The study was of a randomized double-blind parallel design and
      commenced with a 1-week reference period when oral bronchodilators were
      withdrawn. Patients were then treated with either enprofylline or theophylline
      150 mg bd for 2 weeks (period 1) followed by 300 mg bd for a further 3 weeks
      (period 2). Patients recorded peak expiratory flow rate (PEFR) and adverse
      experiences, if any, in a diary, daily. Of 111 patients recruited for the study,
      85 entered active treatment (theophylline, n = 44; enprofylline, n = 41). Mean
      age was 72 years and mean bronchodilator reversibility was 22%. Enprofylline
      increased mean morning PEFR by 11% (period 1) and 19% (period 2) whereas
      theophylline increased PEFR by 13% and 19%, respectively. From the enprofylline
      group 29% were withdrawn from the study due mainly to headache and
      nausea/vomiting and from the theophylline group 7% were withdrawn due mainly to
      nausea/vomiting. Mean plasma concentrations of enprofylline were 2.0 mg l-1 and
      3.4 mg l-1, and with theophylline 5.4 mg l-1 and 10.0 mg l-1 at the end of
      periods 1 and 2, respectively. Enprofylline and theophylline produced similar
      improvements in lung functions and symptoms of chronic obstructive airways
      disease, but enprofylline was less well tolerated than theophylline.

PMID- 2218009
TI  - Allergic Aspergillus sinusitis: an Indian report.

PMID- 2218010
TI  - Tension pneumothorax and empyema as a consequence of gastro-pleural fistulae.

PMID- 2218011
TI  - Diffusing capacity in pulmonary embolism.

PMID- 2218012
TI  - [The Revista Cubana de Enfermeria has reached its 5th year of work].

PMID- 2218013
TI  - [The nurse's work in the care plan for families in the mountains].
AB  - In this investigation is demonstrated that the nurse needs, in order to carry out
      a successful work, to learn about the composition of the population of the area
      under her care. In Patana, a Maisi municipality with 165 inhabitants, 93 male and
      72 females, prevailing ninth grade school level and an initial low hygienic
      culture level, which is considered as regular at the present time, intestinal
      parasitism and malnutrition are the main diseases in the zone. It is well
      demonstrated that there is a wide relationship between hygienic conditions at
      home and community and the incidence of the fore-mentioned diseases and that the
      educational work performed by the nurse in the area under her care exerts a
      positive influence, but the support of grassroot mass organizations is required.

PMID- 2218014
TI  - [The level of knowledge about different aspects of health of the population
      served in the Pedro Borras health area in the city of Pinar del Rio].
AB  - A prospective study in order to determine level knowledge of the population about
      health, before and after the implantation of the Integral Medical Attention
      Programme to the Family, was carried out at the outpatient services in the "Pedro
      Borras" Teaching Community Polyclinic Health Area. Of the population attending to
      this outpatient area, 917 individuals older than 15 years, were selected at
      random. These individuals were surveyed at the beginning of the study (November
      1986), in order to collect data of main necessary aspects that the population
      must be acquainted with on health condition and health promotion, and were
      surveyed again after six months of the performance of the system (May 1987), and
      results of both surveys were compared and shown in tables with statistical data.
      The main programmes for health promotion before the implantation of the new
      system were, known, effectively, by the population in ratios ranging 0.26-0.49.
      After the performance of the new programme it was observed how the level of
      knowledge raises to 0.31-0.70, and knowledges on obesity and sedentary habits
      (0.69) and on prevention of accidents (0.70) becomes significative. We consider
      all these changes depending on a greater educational work by the physician and
      nurse in charge of the plan.

PMID- 2218016
TI  - [Nursing care in the urticaria syndrome].
AB  - A study of urticarial syndrome is carried out at the "Ciro Redondo Garcia"
      Municipality General Hospital, Artemisa. The clinical history of children
      hospitalized during 1988 in the Miscellaneous Ward were reviewed. Nurse care is
      valued. It was found that 9.4% of hospitalization corresponded to such disease
      and that urticaria was the most frequent form of presentation and in the group
      aged 5-14 years. Mean hospital stay was 5 years. Food was the prevailing cause of
      this disease and there was not chronic clinical forms.

PMID- 2218015
TI  - [Nursing and the smoking habit].
AB  - A survey of 323 students from the first, second, and third year of Baccalaureate
      Nursing of the Higher Institute of Medical Sciences of Havana is made. A
      questionnaire is used for identifying the prevalence of smoking according to sex,
      age, marital status, and schooling. It is concluded that there is a high
      prevalence of smokers in this group. Recommendations are made.

PMID- 2218017
TI  - [Professor-student relations in teaching-educational development and its
      influence on the formation and development of the qualities of the communist
      personality].
AB  - A research is carried out at the Polytechnic Health Institute, Psychiatric
      Hospital, Havana, surveying 48 students of Plan III General Nursing, in order to
      analyze relationship between professors and students, their influence on the
      development of educational-teaching process and acquisition of behavioral habits
      by the student, according to: professor-student relationship; professor-student
      reliability; influence of the professor on the formation of habits, discipline
      and right behaviour; place where influence of professor is exerted; influence of
      professor-student relationship on quality of classes; influence of professor on
      students' tasks, and opinions about how the image of professors is and how must
      be. An information that will allow us to raise the quality of educational
      teaching process as result of a harmonious relationship between professors and
      students, was obtained.

PMID- 2218018
TI  - [Psychogeriatrics and psychoballet].
AB  - Third age within humanity has a very important place at world level and it is 11%
      of total population in our country. Because of the importance that our Ministry
      of Public Health gives to this determined population move us to carry on this
      paper, therefore, 26 psychogeriatric patients were selected at random, to who
      direct attention was offered in elemental ballet techniques. These patients are
      under the medical care required because of their mental affection, but they also
      attend to the occupational therapeutical area at the Psychiatric Hospital,
      Havana, where an adequate therapeutical treatment is given to them, from Monday
      to Friday at 8:00 a.m. until 10 a.m., and during the year in the performance of
      this activity we were able to observe a remarkable improvement in such patients,
      who have improved their interpersonal relationships, and doses of
      psychopharmaceuticals have been decreased.

PMID- 2218019
TI  - [The work of the Villa Clara Cardiac Center and the participation of the nurse in
      the surgical unit].
AB  - The work carried out in the Cardiocenter, in Villa Clara, during the period
      comprised from October 1986 to October 1987, is related in this paper.
      Statistical data were taken from the Service of Cardiovascular Surgery,
      expressing them in tables with analysis given in percentage. Opinions of the
      working team, which allowed us to research Nursing Care during the transoperative
      period, as well as some considerations that must be fulfilled in the operating
      rooms of this type of unit, were collected and enriched such aspects with
      bibliographies on the theme. Results obtained and the most frequent complications
      are stated.

PMID- 2218021
TI  - [Nursing bottle caries].

PMID- 2218020
TI  - [Multiprogrammable pacemakers. Complications. Nursing care].
AB  - This paper deals with the study of 927 patients of both sexes, with
      multiprogramable pacemakers implanted during 1987-1988 period, at the "Comandante
      Manuel Fajardo" Teaching Hospital and the Institute of Cardiology and
      Cardiovascular Surgery. Complications accounted for 14.9% and the most frequent
      were, in decreasing order, as follows: sepsis of the pocket (46.7%), hematoma of
      the pocket, increased threshold and, in a lower percentage, aseptic necrosis
      (5.7%). Emphasis is made in the role of the nurse in front of a patient with
      pacemaker and of the different complications presented.

PMID- 2218022
TI  - [Fluoride in preventive cariology].

PMID- 2218023
TI  - [Constitutional slow growth with delayed adolescence, presentation of 3 clinical
      cases].
AB  - Constitutional delay of growth and puberty is a constitutional delay of growth
      occurring in otherwise healthy adolescents with stature reduced for chronological
      age but generally appropriate for bone age and stage of pubertal development,
      both of which are usually delayed; psychological distress is the predominant
      consequence. The analysis of three cases shows that hand and wrist X-ray to study
      bone age is very important in patients with short stature, because we can make a
      better orthodontic treatment due to this bone age delay. The maturation stage
      investigation can be made in both hands because there are not significant
      differences between right and left one.

PMID- 2218024
TI  - [Role of Actinobacillus actinomycetemcomitans in human infection].
AB  - Actinobacillus actinomycetemcomitans (AA), is a cocobacillus thin and small, non
      motile, uncapsulate and capnophilic. AA, is: one of the species encountered in
      the mouth's comensal flora being able to be isolated in gingival crevices culture
      and oral mucosa in a 20% of the healthy population. An important number of
      pathogenic factors make it well equipped, to protect itself from host's defense
      mechanisms, and to destroy the periodontal tissue. Between the most important we
      find lipopolisacarides and leucotoxines which promote tisular invasion and
      destructive qualities of this microorganism. Since 1912, there are numerous
      reports of infectious process associated to it, between which we find:
      endocarditis in native and prothesic valve, soft tissues abscess, pneumonia,
      brain's abscess, urethritis, vertebral osteomielitis, thyroid's abscess,
      pericarditis and periodontal juvenile illness, being this one in which its
      isolation is more frequent. In vitro, AA is very susceptible to tetracicline.
      This antibiotic reaches high concentrations in gingival crevices, has significant
      affinity to the alveolar bone and contributes to protect the collagen. These
      special feature make them the election drug in periodontal disease produced by
      this microorganism.

PMID- 2218025
TI  - [Computerization and dentistry].

PMID- 2218026
TI  - [Restorative treatment in pediatric dentistry].

PMID- 2218027
TI  - [Effect of fluoridated dentifrice on root and coronal caries in a group of older
      adults].

PMID- 2218028
TI  - [Preventive plan for orthodontic patients].

PMID- 2218029
TI  - The acute effects of dexamethasone on some haematological parameters and serum
      biochemistry in the camel (Camelus dromedarius).
AB  - The effects of dexamethasone at different dose regimens on some haematological
      parameters and serum biochemistry were studied in the camel. Dexamethasone
      increased the serum concentration of glucose as well as neutrophils and total
      leukocyte count in the blood. Conversely, the serum concentrations of potassium
      and phosphorus and lymphocyte count in blood were decreased by dexamethasone
      treatment. Dexamethasone, however, had no effect on the activities of CPK and
      gamma-GT, on the serum concentrations of creatinine, BUN, total bilirubin,
      cholesterol and Na and on PCV, Hb, ESR, MCV and MCHC values.

PMID- 2218030
TI  - [Descriptive epidemiology of Rift Valley fever in small ruminants in Southern
      Mauritania after the 1988 rainy season].
AB  - Epidemiological investigation on Rift Valley fever in small ruminants was carried
      out in Southern Mauritania after 1988 rainy season. Relationships were found
      between the incidence rate and the edaphic and climatic parameters. Propositions
      are made to study epidemiology of this disease in this area.

PMID- 2218031
TI  - [Seroconversion to bovine respiratory syncytial virus in goats with pneumonia in
      Zaire].
AB  - Coupled sera were taken among goats suffering from pneumonia in Zaire. The
      presence of antibodies to bovine syncytial respiratory virus was investigated by
      a seroneutralization test. Out of 26 animals, 9 already had antibodies at the
      time of the first blood sampling, 9 presented a seroconversion and 8 remained
      seronegative during the two months of observation. These results suggest it would
      be useful to study the frequency of the infection of small ruminants with this
      virus and its clinical and economical impact in Central Africa.

PMID- 2218032
TI  - [Prevention of cowdriosis and cases of sheep diseases in the Niayes region of
      Senegal].
AB  - Sheep originating from an heartwater-free area were immunized by the infection
      and treatment method, using long-acting oxytetracycline. The animals were then
      exposed, together with control sheep to natural infection in an enzootic area.
      Tick counts were made to monitor the infestation and establish a correlation
      between infestation by certain tick species, in particular Amblyomma variegatum,
      and the occurrence of cowdriosis. In some cases of death associated with
      ehrlichiosis and anaplasmosis in the group immunized against cowdriosis, groups
      of Cowdria ruminantium were found in smears of the cerebral cortex, which leaves
      question marks as to the real nature of immunity to cowdriosis. Furthermore,
      these losses show the necessity of an integrated approach to the control of
      diseases of livestock in a given area. The presence of Rhipicephalus e. evertsi,
      formerly absent from this area, was significant in this respect.

PMID- 2218033
TI  - Serological prevalence of bovine leptospirosis in Plateau State, Nigeria.
AB  - Serum samples obtained from 1.537 cattle in the 14 local government areas (LGAs)
      of Plateau State of Nigeria were screened for the presence of leptospiral
      antibodies using 13 serovars in a modified microscopic agglutination test (MAT).
      Two hundred and twenty-two (14.4 p.100) of the cattle tested had leptospiral
      antibody titres of 1:100 or higher to one or more of the test antigens. The
      prevalence rates of antibodies to individual serovars were: hardjo (35.6 p.100),
      pomona (11.7 p.100), pyrogenes (11.7 p.100), canicola (9.5 p.100), grippotyphosa
      (7.7 p.100), bratislava (5.9 p.100), icterohaemorrhagiae (5.9 p.100), ballum (4.5
      p.100), autumnalis (3.6 p.100), bataviae (2.3 p.100) and tarassovi (1.8 p.100).
      The serological prevalence of bovine leptospirosis in the various local
      government areas of Plateau State of Nigeria differed significantly (P less than
      0.05; X2).

PMID- 2218034
TI  - [Clinical note on an outbreak of foot rot in N'Dama cattle imported from
      Senegambia into Gabon, at the Ngounie ranch].
AB  - The author reports the observations on an outbreak of foot rot among N'Dama
      cattle imported from Senegambia into Gaboon, at the Ngounie's ranch, during
      November 1987. The rate of morbidity is high and economic losses are not
      negligible as well as therapeutic costs.

PMID- 2218035
TI  - [A note on the first case of dry gangrene of the limbs in cattle, caused by
      Salmonella typhimurium in Ghana].
AB  - Ischaemia and terminal tissue dry gangrene are among the sequels of Salmonella
      infection. Up to now, these lesions had been described in Europe and in Chile, on
      calf exclusively. This time, the syndrome was observed on adult cattle reared in
      the Accra Plains (Ghana) and infected by S. typhimurium. This case give evidence
      of the spreading of salmonellosis on the African continent and should foster the
      search of adequate control measures.

PMID- 2218036
TI  - Prevalence of mastitis in imported Friesian cows in Sudan.
AB  - Three hundred twenty-two lactating Friesian cows were examined for mastitis by
      different diagnostic techniques. The predominant pathogens encountered were
      Staphylococci, Streptococci, Corynebacterium and Escherichia coli spp.

PMID- 2218037
TI  - Preliminary observations on ovine paratuberculosis (Johne's disease) in Zambia.
AB  - In an imported flock of sheep from South Africa, an ewe became partially anorexic
      and gradually losing weight and conditions. The paratuberculosis (Johne's
      disease) was confirmed on clinical, faecal and histopathological examination.
      Cultural examination remained doubtful. Serological investigation of other sheep
      in the flock and at other farm reacted to antibodies of Mycobacterium
      paratuberculosis on complement fixation test. The study suggests that the disease
      is actively spreading. This is the first report of ovine paratuberculosis in the
      Republic of Zambia.

PMID- 2218038
TI  - [Ticks and hemoparasitic diseases in cattle in Senegal. IV. The southern Sudan
      area].
AB  - The authors report on the results of an investigation on ticks and
      hemoparasitoses of cattle, sheep and goats in the South Sudanian area of Senegal.
      Systematic routine dipping against ticks of cattle, 40 sheep and 40 goats was set
      during 15 months, with a view to determine the population dynamics together with
      an acurate localization of the different species concerned. The following
      parasites were collected from these ruminants: Amblyomma variegatum, Boophilus
      geigyi, Hyalomma truncatum, H. m. rufipes, Rhipicephalus lunulatus, Rh. sulcatus,
      Rh. e. evertsi, Rh. senegalensis. At the same time joint research was conducted
      on hemoparasitoses by mean of blood smears and of splenectomy. In cattle were
      found Theileria velifera, Th. mutans, Anaplasma marginale, Babesia bigemina,
      Ehrlichia bovis, and microfilaria of Setaria labiatopapillosa. Anaplasma ovis,
      Theileria ovis, Ehrlichia ovina, Trypanosoma vivax, T. congolense are involved in
      infections detected in goats and sheep. Among grown up and found apparently
      healthy animals, the hematocrite values have been studied as well as the seasonal
      variations of the haematological parameter.

PMID- 2218039
TI  - [Blood biological constants in the deer Rusa (Cervus timorensis russa) in New
      Caledonia. I. Hematologic constants].
AB  - Since the beginning of year 1987, the deer "Rusa" breeding has been developing in
      New Caledonia. In 1988, during a slaughter operation amidst the herds, nearly
      ninety blood samples were collected in order to define the blood biological
      parameters (or constants) of this species. Regarding haematology, the study
      concerns the following parameters: erythrocyte count (9.32 x 10(12)/l), leucocyte
      count (4.51 x 10(9)/l), various leucocyte lines and their formula, i.e.
      (neutrophile polymorphonuclear: 2.08 x 10(9)/l [46.6 p. 100]; lymphocytes: 1.75 x
      10(9)/l [38.4 p. 100]; monocytes: 0.33 x 10(9)/l [7.5 p. 100]; eosinophiles
      polymorphonuclear leucocytes: 0.4 x 10(9)/l [7.46 p. 100]; basophile
      polymorphonuclear leucocytes: 0.01 x 10(9)/l [0.28 p. 100]), hematocrite (36.8
      l/l), hemoglobin ratio (14.1 g/dl), mean corpuscular volume (40.3 dl), mean
      corpuscular hemoglobin rate (15.3 pg/cell), mean corpuscular hemoglobin
      concentration (38.7 g/dl). In the course of the study, variations of these
      parameters were detected according to various physiological criteria and to the
      sampling conditions as deer is a stress sensitive animal.

PMID- 2218040
TI  - [Blood biological constants in the deer Rusa (Cervus timorensis russa) in New
      Caledonia. II. Biological constants].
AB  - Since the beginning of the year 1987, the deer "Rusa" breeding has been
      developing in New Caledonia. In 1988, during a slaughter operation in the herds,
      nearly 90 blood samples were collected in order to define the blood biological
      parameters (or constants) of this species. As for biochemistry, the following
      parameters have been search for: urea (6.8 mmol/l), creatinin rate (151.7
      mmol/l), the activity of the creatin kinase (295.2 U/l), transaminase (ALAT: 60.1
      UI/l; ASAT: 22.3 UI/l) and alcalin phosphatases (115.1 U/l), total bilirubin rate
      (2.76 mumol/l), total proteins rate (61.4 g/l) and albumin (32.6 g/l), calcium
      (2.42 mmol/l) and phosphorus (3.08 mmol/l). In course of the study, fluctuations
      of these parameters were detected, according to various criteria and to sampling
      conditions.

PMID- 2218041
TI  - [Clinical evaluation of Plax. Its efficiency in reducing supra-gingival plaque].
AB  - A double-blind, controlled, parallel desing clinical trial was conducted to
      determine the affect of PLAX prebrushing rinse on supra gingival plaque levels.
      The results of this study suggest that using PLAX as prebrushing rinse is the
      same as using a placebo.

PMID- 2218042
TI  - [Sensitivity of the tooth cervix. A new therapeutic alternative].
AB  - The cervical hypersensitivity tooth was analysed and treated by application of a
      varnish with high fluoride ions content (Duraphat) and of a glass ionomer cement
      usually indicated to cavity lining (XR-ionomer-Kerr). This technique was applied
      in sixty-seven teeth of Clinic Graduation patients (Faculdade de Odontologia de
      Aracatuba) and demonstrated a high index of satisfactory results. The clinical
      findings of this study relate that, this technique is more one method of choose
      by clinicians.

PMID- 2218043
TI  - [Methods of X-ray protection. Comparative analysis of conditions of radiographic
      protection utilization by dental professionals].
AB  - In this work, the authors examined the condition and uses of the relation to
      radiation protection. The authors personally gave a questionnaire to about
      seventy dentists, of all specialities marking up almost 12% of the dentists of
      the state. This questionnaire was compared to other questionnaires from Sao Paulo
      and Joao Pessoa cities. According to the data obtained we can present the
      following conclusion: The acknowledge level of safety in relation to radiation
      protection with patients, dentists and attendants here is similar to Sao Paulo
      city but this below standard. A better understanding and stricter observation of
      the recommendation of FEDERATION DENTAIRE INTERNATIONALE is necessary.

PMID- 2218044
TI  - [Relationship between growth and tooth eruption. Relationship between growth and
      physical development and eruption of first permanent molars in Sao Paulo
      students].
AB  - In order to verify the relationship between the children's growth and their
      teeth's emergence the authors surveyed 1278 school children in Sao Paulo's
      Ipiranga District, 1024 from government controlled schools and 254 from a private
      school, finding their weight and height anthropometric measures related to the
      emergence of permanent molars. Their ages were four (completed) to eight
      incompleted). It was verified that the children from the private school presented
      in average higher weight and height than those from government controlled schools
      as well as higher percentages of first permanent molars erupted, in both the
      sexes and in all the age groups and that there was a positive association between
      the children's growth and their teeth's emergence.

PMID- 2218045
TI  - [Incidence and treatment of cysts].
AB  - The records of 78 patients (1978-1987 period) submitted to surgical treatment of
      cysts, were analysed to verify the cyst location, etiology, types of cysts, and
      surgical techniques. There were made commentaries and orientations on the
      necessity of radiography, cytological and histopathological examination and post
      operative radiological control.

PMID- 2218046
TI  - [Total crowns in natural teeth].

PMID- 2218047
TI  - [Perforating internal resorption of the root. Surgical treatment using a hybrid
      obturation technic].
AB  - This article relates a clinical case of internal root resorption with root
      perforation treated with a new surgical proceeding. The Tagger et alii technique
      was used for root canal filling and root resorption area.

PMID- 2218048
TI  - [Atypical total implants for screws].
AB  - By screws total, atypical implants. For cases of total edentates, the author
      relates and commends the use of endosseous screws not parallel between
      themselves, but unites by a small bar or threads of soldered titanium. Thus on
      this created "wall" the prosthesis is finished and fixed. Illustrative cases are
      presented.

PMID- 2218049
TI  - [Indirect bonded prosthesis. Use of an impacted central incisor].
AB  - The authors presents a case about right central superior incisor impacted. After
      surgical remotion of the retain tooth, this was utilized like pontic in the
      confeccion of the indirect adhesive prosthesis for the patient.

PMID- 2218050
TI  - [Influence of static flow (CREEP) on amalgam hardness. Effect of alloys and
      measured areas].
AB  - The authors studied the CREEP of 5 amalgam alloys (1 conventional and 4 with high
      cooper) by the application os static load of 36 MPa in 478 mm specimens, 7 days
      old. After CREEP test, the samples were included in acrylic resin and Vickers
      hardness determined by three penetrations for each portion (cervical, medium and
      occlusal). Samples not submitted to the creep test was used with control. They
      concluded that no statistic difference was found in creep test but in Vickers
      test all the studied materials showed different hardness averages. The load
      application to samples increased the hardness of all the studied materials.

PMID- 2218051
TI  - [Anterior open bite. Concept, etiology, characteristics, classification and
      clinical cases].
AB  - The preoccupation with vertical abnormalities, and particularly anterior open
      bites, led the authors to establish its concept, to review the literature
      concerning aetiology and treatment, to propose a classification and to present
      three case reports of this condition.

PMID- 2218052
TI  - [Esthetics in metal-ceramics].
AB  - A rational and simple esthetical guideline is presented; In order to obtain this
      aim, seven steps are suggested.

PMID- 2218053
TI  - [Dentinal surface of root canals. Study of human permanent upper central
      incisors, using scanning electron microscopy technic].
AB  - Dentinal surfaces of the root canal in the human permanent incisors were studied
      by using scanning electron microscope. The teeth were sectioned and fractured
      longitudinally. Dehydration were made in ethanol, dried, coated with gold and
      examined in a Jeol scanning electron microscope. The results revealed that the
      dentinal surface of the root canal of central upper incisor presents numerous
      foraminae of dentinal tubules. These possess variable diameters being that the
      smallest ranges from 1 to 2 microns and the greatest ranges from 2.5 to 4
      microns. The intertubular dentinal surface is uniform in aspect and the
      peritubular dentine show several lines on the walls.

PMID- 2218054
TI  - [Determination of centric relation. Study of the lateral position of the mandible
      in relation to the facial median line, using 2 methods of determination].
AB  - The authors studied the lateral positional desviations of the mandible, in
      relation to the facial median line in 30 (thirty) full edentulous patients, with
      the purpose to verify the influence of the unstrained guided (chinpoint guidance)
      and deglutition methods for the determination of centric relation. According the
      results obtained they conclude that the unstrained guided method produced a
      mandibular lateral desviation with a mean value of the 0.752 mm and in the
      deglutition method the mean value observed was 1.109 mm. The statistical analysis
      of the results revealed for the unstrained guided method a proportion of the
      "points" to the right and left of the median line not statistically significant,
      while for the deglutition method the difference was statistically significant at
      a level of 5%.

PMID- 2218056
TI  - Immune-associated abortion: human vs mouse model.

PMID- 2218055
TI  - Modulation of gut wall paf-acether and precursors by intestinal microflora.
AB  - Comparison between holoxenic and axenic mice led to the conclusion that the
      presence of an intestinal microflora produced a decrease in wall paf in
      conventional mouse caecum, whereas an increase in wall lyso-paf and alkyl-acyl
      glycerophosphocholine (A-A-GPC) content was noticed. By contrast, the presence of
      flora had no significant incidence on wall paf, lyso-paf and A-A-GPC content of
      conventional mouse jejunum. Thus, the modulation of gut wall phospholipid
      composition by intestinal microflora is evidenced for the first time.

PMID- 2218057
TI  - On "the immunology of spontaneous abortion".

PMID- 2218058
TI  - Additional arguments for the key role of "smart" autolysins in the enlargement of
      the wall of gram-negative bacteria.
AB  - Because the wall of Gram-negative bacteria is thin, the mechanism for safe
      enlargement of the cell is subject to strong constraints. Several models for wall
      growth have been proposed; in the order that they have been proposed, these
      include: 1) an "allosteric" model in which the critical autolysin is only
      functional if the bond to be cleaved is near a covalently cross-linked, but
      unstretched oligopeptide; 2) a model in which the cell wall is thick enough to
      enlarge by the "inside-to-outside" mode characteristic of Gram-positive rods; 3)
      a "patches" model, recently proposed by Holtje, in which only parts of the cell
      wall are thickened at any one time; 4) a new multienzyme model in which the
      transpeptidase/autolysin complex cleaves one cross-linked oligopeptidoglycan
      chain for every two nascent chains covalently polymerized to the sacculus. These
      models are considered and contrasted. While none can be rigourously excluded, no.
      4 is favoured. All models as applied to the Gram-negative rod-shaped bacteria
      require special, extraordinary features for their autolysins. These features have
      not been found with any other class of enzymes, but are essential to permit safe
      cell expansion.

PMID- 2218059
TI  - Immunolabelling of Shiga toxin in macrophages infected with Shigella dysenteriae
      1.
AB  - Immunolabelling of Shiga toxin in macrophages infected with a non-invasive
      Shigella dysenteriae 1 isolate showed that bacteria remained alive for 3 h after
      ingestion within the phagocytic vacuole and synthesized Shiga toxin. The normal
      process of toxin secretion was, however, impaired by the phagosomal environment
      and toxin molecules accumulated within the bacterial cytoplasm.

PMID- 2218060
TI  - Characterization of Mycobacterium paratuberculosis and "wood-pigeon" mycobacteria
      by isoenzyme profile and selective staining of immunoprecipitates.
AB  - Cell-free extracts of various strains belonging to Mycobacterium paratuberculosis
      (Ptb) and "wood-pigeon" (WP) mycobacteria were compared by polyacrylamide gel
      electrophoresis and the various protein bands obtained were tested for peroxidase
      enzyme activity. One strain of Mycobacterium avium served as a control. Bacterial
      extracts were also analysed by crossed immunoelectrophoresis (CRIEP) and fused
      rocket immunoelectrophoresis (FRIEP) using antisera raised in rabbit against M.
      paratuberculosis and WP mycobacteria. The immunoprecipitates obtained both in
      CRIEP and FRIEP plates were subsequently stained for selective peroxidase enzyme
      staining. Our results showed that, although Ptb and WP mycobacteria shared common
      peroxidase isoenzymes and antigens, they also had specific immunoprecipitates
      showing the differences between the two groups of bacteria.

PMID- 2218061
TI  - Competitive erythroimmunoassay for detecting Clostridium perfringens type A
      enterotoxin in stool specimens.
AB  - A competitive erythroimmunoassay (ERIA) is described for Clostridium perfringens
      enterotoxin (CPE) detection in stools. This technique uses sheep red blood cells
      sensitized by CPE and an anti-CPE-antibody-coated plate in which the results are
      read by eye. ERIA is simple, rapid, economic and more sensitive (2 ng/ml) than
      the enzyme-linked immunosorbent assay used for evaluation. ERIA is suitable for
      CPE detection in stool samples protected with phenylmethylsulphonylfluoride.

PMID- 2218062
TI  - Utilization of aromatic substances by Azotobacter chroococcum.
AB  - Azotobacter chroococcum utilized catechol, protocatechuic acid and gentisic acid
      as sole carbon source. Rothera's test indicated the ortho cleavage of phenols.
      The cells displayed high levels of dioxygenase activity. Catechol was cleaved by
      the ortho pathway mediated by catechol 1,2-dioxygenase. Protocatechuate and
      gentisic acid were also cleaved by the ortho pathway and cells grown in
      protocatechuate and gentisic acid displayed protocatechuate, 3,4-dioxygenase and
      gentisate dioxygenase activity, respectively.

PMID- 2218063
TI  - [Chemotaxonomy of gram-positive bacteria metabolizing beta-caryophyllene].
AB  - Chemotaxonomic identification of coryneform bacteria metabolizing b-caryophyllene
      was attempted. The following phospholipids were identified as main components of
      the bacterial extracts: cardiolipids, phosphatidylethanolamine,
      phosphatidylinositol and mannosides of phosphatidylinositol. Saponification of
      the lipid extracts gave a mixture of hydroxylated and nonhydroxylated fatty
      acids. Among the latter, oleic and tuberculostearic acids were identified. The
      hydroxylated fatty acids were analysed by thin-layer chromatography and mass
      spectrometry (as methyl esters). From the results thus obtained, the strains
      appeared to be more closely related to the genus Rhodococcus than to the genus
      Nocardia.

PMID- 2218064
TI  - Effects of static magnetic fields on membrane permeability of a cultured cell
      line.
AB  - To clarify the effects of magnetic fields on plasma membrane permeability of
      "living cells", we measured the accumulation and efflux of adriamycin (ADR) in a
      cell line, TALL-1, using flow cytometric techniques. The amount of ADR
      accumulated in the cells for 15 minutes under a static magnetic field (0.4
      Tesla(T), 1T = 10000 gauss) was less than 5-10% that in the control cells without
      magnetic fields within a temperature range of 41-46 degrees C corresponding to
      the phase transition temperature. It is interesting that ADR efflux from magnetic
      field-exposed cells increased compared with unexposed cells at 41-44 degrees C.
      These results suggest that lipid clustering, which occurs at the phase transition
      temperature, may take place in "living cells" as well as in artificial membranes
      and play an important role in increasing the ADR efflux from the cell membrane
      under magnetic fields.

PMID- 2218065
TI  - Enhancement of skeletal muscle fatigue by the calcium channel antagonist
      diltiazem.
AB  - This study sought to determine the effects of diltiazem on normal muscle twitches
      and on twitches evoked during repetitive stimulation. Initial experiments showed
      that diltiazem (5 and 30 microM) had slight, but insignificant, effects on peak
      twitch tension and the time course of the twitch. When muscles were stimulated at
      1 or 5 Hz, 30 microM diltiazem significantly depressed the height and time course
      of the staircase period and increased the rate and magnitude of fatigue. Contrary
      to control, diltiazem caused a complete loss of developed tension during both
      stimulation protocols. Results suggest that although diltiazem has little effect
      on single twitches, it has marked inhibitory effects on twitches evoked during
      repetitive activity; the result being enhancement of the fatigue process.

PMID- 2218066
TI  - Prevention of acetaminophen-induced hepatotoxicity by endotoxin in mice.
AB  - A preliminary trial was conducted to determine if endotoxin would prevent
      acetaminophen (APAP)-induced hepatic toxicity. When mice were pretreated with
      endotoxin (1, 2 and 4 mg/kg, i.p.), the clinical chemistry profile and
      pathological alterations caused by APAP were reduced with a dose dependent
      manner. The efficacy of endotoxin in preventing APAP-induced hepatic necrosis
      should be further studied.

PMID- 2218067
TI  - Isoniazid potentiation of acetaminophen hepatotoxicity in the rat and 4
      methylpyrazole inhibition of it.

PMID- 2218068
TI  - Effects of chloroquine and hepatic stimulator substance on cellular accumulation
      and nuclear binding of 125I-epidermal growth factor in primary culture of adult
      rat hepatocytes.
AB  - The effects of chloroquine and hepatic stimulator substance (HSS) on cellular
      accumulation and nuclear binding of 125I-epidermal growth factor (EGF) were
      examined in primary culture of adult rat hepatocytes. When intact hepatocytes
      were incubated at 37 degrees C with 125I-EGF, the cellular accumulation and the
      nuclear binding reached a peak at 1 h and declined thereafter, where the nuclear
      binding was 2.49% at 1 h and 2.53% at 2 h. Chloroquine resulted in a time
      dependent increase in the cellular accumulation and the nuclear binding was 3.37%
      at 1 h and 3.72% at 2 h. In contrast, HSS produced no change in each value,
      suggesting that HSS does not modulate EGF receptors in plasma membrane and
      nucleus.

PMID- 2218069
TI  - The effect of phenobarbital and dexamethasone on hepatic cytochrome P-450 and
      alpha 1-acid glycoprotein in maternal and fetal guinea pigs.
AB  - The effects of phenobarbital (PB) and dexamethasone (DX) on maternal and fetal
      hepatic cytochrome P450 content, benzphetamine (BzP) demethylation activity, the
      plasma concentration of alpha 1-acid glycoprotein (AGP), and the binding of
      propranolol (PPL) were examined in guinea pigs. In maternal guinea pigs, PB
      increased AGP-specific PPL binding by 131%, P450 by 94%, and BzP demethylation by
      261%. DX only increased maternal AGP-specific PPL binding (122%). In fetal guinea
      pigs, neither PB nor DX resulted in significant increase for any of these
      parameters. The combination of PB and DX synergistically increased fetal P450
      content (153% increase) and BzP demethylation (84% increase). In contrast, this
      combination treatment did not increase maternal P450 and BzP demethylation to a
      greater extent than by PB treatment alone nor did it increase the binding of PPL
      in PCA-treated fetal plasma. The synergy of P450 induction found in the fetus
      implicates glucocorticoids as important regulators of fetal hepatic microsomal
      enzyme maturation.

PMID- 2218070
TI  - Comparative effects of three dithiocarbamates on tissue distribution and
      excretion of cadmium in mice.
AB  - The effects of sodium N-benzyl-D-glucamine dithiocarbamate (BGD), sodium N-p
      hydroxymethylbenzyl-D-glucamine dithiocarbamate (HBGD), and sodium N-p
      carboxybenzyl-D-glucamine dithiocarbamate (CBGD), which were newly synthesized,
      on the distribution and excretion of cadmium were compared in mice exposed to
      cadmium. Mice were injected with 109CdCl2 (1 mg Cd/kg and 74 KBq of 109Cd/one
      animal) and 30 min or 24 h later, they were injected with the dithiocarbamates
      (400 mumols/kg). At 30 min after treatment with cadmium, these chelating agents
      significantly enhanced the biliary excretion of cadmium, and HBGD and CBGD
      significantly increased the urinary excretion of the metal. At 24 h after cadmium
      injection, BGD and HBGD significantly increased the biliary excretion of cadmium
      and HBGD was the most effective on the biliary excretion of the metal. These
      chelating agents were effective in mobilizing cadmium from the liver and kidney
      at 30 min after cadmium treatment. HBGD showed the largest effectiveness on the
      depression of cadmium contents in the liver and kidney. At 24 h after cadmium
      treatment, only HBGD among these chelating agents significantly reduced the
      cadmium contents in the liver and kidney. These results show that the injection
      of HBGD at both 30 min and 24 h after cadmium treatment can much more effectively
      mobilize cadmium from the body mainly through the bile without redistribution of
      cadmium to other tissues, such as brain, testes, and heart, than injection of BGD
      and CBGD.

PMID- 2218071
TI  - Teratogenic effects of nitrazepam in rats.
AB  - The teratogenicity of nitrazepam, a benzodiazepine-type drug, was investigated in
      Sprague-Dawley rats. Nitrazepam was administered to pregnant females at levels of
      100, 200 or 300 mg/kg in a single dose on one of gestation days 10-14. Fetuses
      were examined for external and skeletal malformations on day 20 of gestation.
      Nitrazepam was found to produce various types of malformations, i.e.,
      exencephaly, cleft palate, micrognathia, short or kinky tail and limb reduction
      defects. The predominant malformation was limb reduction defects, which were
      produced at high frequency by treatment on day 12 or 13 of gestation. Microscopic
      examination of limb buds revealed hemorrhage and mesenchymal cell necrosis at 24
      hours after nitrazepam treatment.

PMID- 2218072
TI  - Semicarbazide-sensitive amine oxidase activity in streptozotocin diabetic rats.
AB  - Semicarbazide-sensitive amine oxidase (SSAO) activity was investigated in serum
      and tissues of streptozotocin diabetic rats. Diabetes was induced by a single
      intraperitoneal injection of streptozotocin (STZ, 60 mg/kg) and rats were killed
      at 1, 3, 7, 9, 14, 28 and 56 days after treatment. STZ increased serum glucose
      and serum SSAO activity at all time points with a maximal increase (2 to 3 fold)
      at day 7. Kidney SSAO activity showed significant increases on days 9 and 14 (2.5
      and 4 fold, respectively). SSAO activity of aorta, lung and pancreas was not
      changed significantly. Kinetic analysis showed that the elevation in both serum
      and kidney SSAO activity was due to an increased Vmax with no change in Km. SSAO
      activity appears to be selectively increased in the serum and kidney of STZ
      diabetic rats which may be indicative of a relationship between serum SSAO and
      early renovascular damage in this animal model of diabetes mellitus.

PMID- 2218073
TI  - In vitro interaction of mercury, copper (II) and cadmium with human glutathione
      transferase pi.
AB  - The in vitro interaction of mercury, copper (II) and cadmium with human
      glutathione transferase (GST) pi was studied using reduced glutathione (GSH) and
      1-chloro-2,4-dinitrobenzene as substrate. Tumor specific human GST pi was
      isolated from the human hepatoma derived PLC/PRF/5 cell line. The inhibition of
      the GST pi activity was dose dependent. Kinetic studies never revealed
      competitive inhibition. A parabolic inhibition was found with GSH as the variable
      substrate. The heavy metals are spontaneously conjugated with GSH and cysteine,
      but interact with GST pi by direct binding to this protein. This binding could
      have a protective function against heavy metals.

PMID- 2218075
TI  - Transcatheter arterial embolization and chemoembolization induce the production
      of free radicals in the normal rat liver.
AB  - Superselective transcatheter arterial embolization (TAE) of the left and median
      lobes of the normal rat liver was performed using gelatin sponge (1.5 mg/ml).
      Superselective transcatheter arterial chemoembolization (TAC) of the same lobes
      was done adding mitomycin (MMC) at a dose of 1.6 mg/ml to the embolic solution.
      In another group of rats MMC alone was injected intraarterially into those lobes.
      It was found that both embolic procedures and the arterial injection of MMC
      decrease the hepatic total glutathione content. Glutathione peroxidase activity
      and alpha-tocopherol content remained unchanged. Lipoperoxides were detected 3
      and 6 h after TAC in chemoembolized and non-chemoembolized lobes. Similar
      findings in both injected and noninjected lobes were found after MMC injection.
      The TAE lobes only showed elevated lipoperoxide content 6 h after embolization,
      this parameter remained unchanged in the non-TAE lobes. These findings suggest
      that free radicals are formed after TAE, and that the addition of MMC to the
      embolic solution increases the oxidative attack and/or that the oxidative
      reactions after TAC are mainly mediated by lipid peroxidation due to the presence
      of MMC.

PMID- 2218074
TI  - Systemic anaphylaxis--separation of cardiac reactions from respiratory and
      peripheral vascular events.
AB  - An anaphylactic reaction in the isolated perfused heart is characterized by a
      drastic coronary constriction, arrhythmias, and an impairment of contractility.
      In vivo anaphylaxis is associated with respiratory distress and cardiovascular
      failure. The present investigation was designed to ascertain the
      electrocardiographic and cardiovascular changes during systemic hypersensitivity
      reactions. In addition, an attempt was made to differentiate cardiac from
      respiratory events. In guinea pigs, sensitization was produced by s.c.
      administration of ovalbumin together with Freund's adjuvant solution. Fourteen
      days after sensitization, the effects of an i.v. infusion of ovalbumin were
      tested in the anesthetized guinea pigs, which were ventilated with room air or
      100% oxygen. A second administration of the antigen induced the development of
      cardiovascular collapse, leading to death within 12 min. Within 3 min, cardiac
      output decreased by 90% and end-diastolic left ventricular pressure increased
      significantly, indicating left ventricular pump failure. In the same time range,
      ECG recordings uniformly showed signs of acute myocardial ischemia. In addition,
      arrhythmias occurred in the form of atrioventricular block. Left ventricular
      contractility declined continuously within the first 4 min. Finally, after 4 min,
      blood pressure steadily decreased. During ventilation with room air, severe
      hypoxia developed, with arterial PO2 decreasing from 94 mmHg to 14 mmHg after 3
      min. However, under ventilation with 100% oxygen, a dissociation between cardiac
      damage and respiratory distress occurred. Myocardial ischemia and signs of
      cardiac failure preceded the development of hypoxia by a significant time
      interval. It is to be concluded that cardiac damage is a primary event in
      anaphylactic shock. Furthermore, the electrocardiographic signs of ischemia are
      interpreted as a result of coronary artery spasm.

PMID- 2218076
TI  - Temperature-induced shape transformation of carrier erythrocytes.
AB  - Erythrocytes have been proposed as cellular carriers for enzymes and drugs for
      protected delivery, slow release, or targeting to specific organs. Several
      studies have established the heterogeneity of resealed carrier erythrocytes
      concerning various characteristics, including morphology. Carrier erythrocytes
      were prepared by hypo-osmotic dialysis and consecutive iso-osmotic resealing at
      different temperatures, and the morphology of these cells was studied by scanning
      electron microscopy. Different cell shapes could be prepared by temperature
      variations during resealing or incubation. All intermediate shapes of
      echinocytosis were observed at low temperatures or with depleted energy supply
      but could be reversed to biconcave discocytes. Resealing at 4 degrees C resulted
      in highest percentage of echinocytes III, spherocytes, and leaky cells.
      Spontaneous resealing of 20% of the cells was obtained at high lysis
      temperatures. Combining low temperatures for lysis and high temperatures for
      resealing and sufficient energy supply are advantageous for highest recovery of
      biconcave discocytes. Shape of the erythrocyte, is the result of divergent
      forces, and temperature during resealing was found to be an important factor.

PMID- 2218077
TI  - Beta-alanyl-L-histidinato zinc prevents skeletal unloading-induced disorder of
      bone metabolism in rats.
AB  - The effect of a new zinc compound beta-alanyl-L-histidinato zinc (AHZ) on the
      disorder of bone metabolism caused by skeletal unloading was investigated.
      Skeletal unloading was designed using the model of hind-limb hang in rats.
      Skeletal unloading for up to 4 days caused a remarkable decrease of zinc content,
      alkaline phosphatase activity, and DNA content in the femoral diaphysis of rats.
      Oral administration of AHZ (2.5, 5.0, and 10.0 mg/100 g) caused a significant
      increase in zinc, DNA, and calcium contents in the femoral diaphysis of rats with
      the skeletal unloading. Bone alkaline phosphatase activity was significantly
      increased by doses of 5.0 and 10.0 mg/100 g. These results clearly indicate that
      skeletal unloading-induced disorder of bone metabolism is prevented by the oral
      administration of AHZ. AHZ may be useful as a therapeutic tool in bone disorder.

PMID- 2218078
TI  - Aging affects cellular zinc and protein synthesis in the femoral diaphysis of
      rats.
AB  - To clarify the effect of aging on bone metabolism, alteration of the cellular
      zinc content and protein synthesis was examined in the femoral diaphysis of 3-
      and 30-week-old male rats. The cellular zinc content in bone tissue markedly
      decreased in 30-week-old compared to 3-week-old rats. When the bone tissue from
      older rats were cultured with [3H]leucine, incorporation of [3H]leucine into the
      acid-insoluble residues was less than for weanling rats. This decrease was partly
      restored by the oral administration of zinc sulfate (0.5, 1.0, and 2.0 mg Zn/100
      g body weight) to elderly rats for 3 days. An increase of in vitro [3H]leucine
      incorporation by bone tissues obtained from the rats that had received zinc (2.0
      mg/100 g) was blocked by cycloheximide (10(-6) M) or dipicolinate (10(-3) M), a
      chelator of zinc. These results suggest that bone protein synthesis declines with
      age, and that this decline may be based partly on the decrease in bone cellular
      zinc.

PMID- 2218079
TI  - Experimental analysis of gastric mucosal blood flow after transient forebrain
      ischemia.
AB  - Gastric mucosal blood flow (GMBF) was measured by a laser doppler flow meter
      continually during and after transient forebrain ischemia in rats. The value of
      GMBF obtained after at 15 min of ischemia did not change significantly compared
      to that of the preischemic period. However, a 26% decrease of GMBF was detected
      after 30 min of ischemia. When circulation of the brain was restored, the GMBF
      increased slightly after 15 min. After 30, 45, and 60 min of restored cerebral
      circulation, the GMBF decreased significantly and the values were 63%, 58% and
      51% of the control, respectively.

PMID- 2218080
TI  - [Recent advances in pulmonary surfactant research with special reference to
      surfactant apoproteins].

PMID- 2218082
TI  - [Recent elucidation of the genetic defects among disease of the chest: cystic
      fibrosis, chronic granulomatous disease, and alpha 1-antitrypsin deficiency].

PMID- 2218081
TI  - [Combination therapy of antiarrhythmic drugs].

PMID- 2218083
TI  - [Central nervous in cardiac disorder].

PMID- 2218084
TI  - [ACE inhibitors and cough].

PMID- 2218085
TI  - [Natural history of severe aortic regurgitation and timing of the aortic valve
      prosthesis].

PMID- 2218086
TI  - [A study on clinical and electrophysiologic characteristics of ventricular
      tachycardia: comparison of differences on its sustenance].
AB  - The purpose of this study was to clarify the difference of clinical and
      electrophysiologic characteristics between sustained ventricular tachycardia
      (SVT) and nonsustained ventricular tachycardia (NSVT). 40 patients consisting of
      24 males and 16 females with an average age of 50.0 years (range from 19 to 83),
      who had shown ventricular tachycardia (VT) on electrocardiogram, were studied
      consecutively. The patients were divided into SVT group (19 cases) and NSVT group
      (21 cases). Ventricular stimulation was performed up to triple extrastimuli, and
      ventricular burst pacing was used when required. After VT was induced, R-R
      interval during VT was measured and an antiarrhythmic agent was given by bolus
      injection. Echocardiography was used for measurement of left ventricular ejection
      fraction (EF) and for evaluation of mitral valve prolapse (MVP). Palpitation and
      oppressive sensation were dominant in SVT (84.2%), while dizziness and syncope
      were prominent in NSVT (57.1%). Organic heart disease (OHD) was observed in only
      42.1% of SVT, and in none of NSVT. MVP was observed in 6 patients of SVT and in 5
      patients of NSVT. EF was significantly higher in NSVT (67.1%) than in SVT (56.9%)
      (p less than 0.02), while it was not significantly different in cases of NSVT and
      SVT where OHD was not present (64.4%). VT was induced and sustained in 17 out of
      19 patients (89.5%) in SVT by ventricular stimulation. In NSVT, VT was induced in
      6 of 21 patients (38.6%), but it was not sustained in any of them. The induction
      of VT in NSVT appeared to require more extrastimuli than in SVT. The R-R interval
      in SVT was longer than in NSVT (345.9 +/- 84.6 msec and 245.0 +/- 40.7 msec, p
      less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218087
TI  - [Study on the respiratory failure with cardiac failure--focus on hypoventilation
      respiratory failure].
AB  - Respiratory failure accompanied by cardiac failure occurs mostly due to decreased
      PaO2. However, sometimes we encounter patients with cardiac failure having on
      increase of PaCO2, who develop CO2 narcosis in the ICU. In this study we
      evaluated hypoventilation respiratory failure in patients with cardiac failure.
      Seventy-six patients with both respiratory failure and cardiac failure caused by
      intrinsic heart disease, who required mechanical ventilation in the ICU were
      studied. The patients were divided into 2 groups; hypoxic respiratory failure
      group (n = 53) and hypoventilation respiratory failure group (n = 23). Blood gas
      analysis and cardiovascular hemodynamics including arterial blood pressure, heart
      rate and Swan-Ganz catheter findings were performed before, during and after
      mechanical ventilation in each patient. Mortality rate and its relation to
      hemodynamic variables were also evaluated in each group. In both groups even when
      it was possible to maintain oxygenation capacity by conducting mechanical
      ventilation against severe respiratory failure, what can be said about the
      prognosis is that it depended totally on the improvement of cardiac function. The
      mechanism by which hypoxemia is displayed due to cardiogenic pulmonary edema is
      already well known, but in regard to the mechanism of hypercapnia in cases with
      hypersensitivity of the airways it is thought that through induction of
      cardiogenic pulmonary edema bronchial spasms is induced, and this causes
      hypercapnia. However, it is also possible to consider cardiac asthma as the
      cause. Among respiratory failure cases due to cardiogenic pulmonary edema that
      occurs in association with heart failure, there is both hypoxic respiratory
      failure as well as hypoventilation respiratory failure.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2218088
TI  - [The effect of percutaneous transluminal coronary recanalization (PTCR) on late
      potentials detected by signal-averaged electrocardiogram in patients with
      previous myocardial infarction].
AB  - The purpose of this study was to assess the effect of percutaneous transluminal
      coronary recanalization (PTCR) on late potentials (LP) in patients with previous
      myocardial infarction (MI). The signal-averaged ECG was recorded by Fukuda VCM
      3000 in 54 patients with anterior MI (average of 32 months after onset of MI).
      Fifty four patients were divided into two groups: Group A was comprised of 29
      patients who underwent PTCR, and Group B was comprised of 25 patients who didn't
      receive PTCR. Ventricular arrhythmias detected by 24 hour Holter monitoring, and
      left ventriculographic findings were also evaluated. The presence of LP was
      defined as low amplitude signals (less than 15 microV) in the last 40 msec of the
      filtered QRS complex. The incidence of LP was significantly higher in Group B
      than in Group A (32% vs 7%, p less than 0.01). The presence of PVCs and ejection
      fraction (EF), LV end-diastolic volume (EDV), LV end-systolic volume (ESV) and %
      abnormally contracting segment (% ACS) were not significantly different in each
      respective groups. However, ESV and % ACS were significantly larger (p less than
      0.05), and EF was significantly smaller (p less than 0.01) in patients with LP
      (+) than in patients with LP (-). LP was present in two patients who had
      undergone PTCR (TIMI grade 2) unsuccessfully, whereas it was not present in the
      27 patients with successful PTCR (TIMI grade 3). It was concluded that successful
      recanalization of the infarct-related arteries may reduce the incidence of LP.

PMID- 2218089
TI  - [Continuous monitoring of mixed venous oxygen saturation during exercise using
      fiberoptic pulmonary artery catheter].
AB  - We measured the mixed venous oxygen saturation (SvO2) continuously using a
      fiberoptic thermodilution pulmonary artery catheter to analyze the time course of
      SvO2 during exercise, and evaluated the relationship between SvO2 and exercise
      load, SvO2 and cardiac output. Five patients with old myocardial infarction and
      one healthy man underwent pulmonary arterial catheterization and then performed
      an incremental steady state exercise test using a supine cycle ergometer. There
      was a rapid fall in SvO2 43.4 +/- 10.6 seconds after the start of exercise and
      new steady state were achieved 92.6 +/- 22.5 seconds after changing the exercise
      load. The value of SvO2 at exercise load 60 watts were 44.7 +/- 9.8% and this
      value was under the level of lactic acid accumulation. SvO2 correlates well with
      cardiac output by the thermodilution method in individual patients. We conclude
      that a fiberoptic thermodilution pulmonary artery catheter was useful to evaluate
      the dynamic changes of SvO2 during exercise.

PMID- 2218090
TI  - [Two cases of acute coronary occlusion after successful coronary angioplasty
      associated with a treadmill stress testing].
AB  - We presented two cases of acute coronary occlusion after successful percutaneous
      transluminal coronary angioplasty (PTCA) associated with a treadmill stress
      testing. Case 1: A 54-year-old man with effort angina was referred to our
      hospital for cardiac catheterization. At the time of cardiac catheterization, the
      proximal RCA had a 99% diameter narrowing, and the proximal LCX had a 90%
      diameter narrowing. PTCA was performed and both lesions were successfully
      dilated. Eight days after PTCA, he had a symptom-limited treadmill stress
      testing, using the Bruce protocol. The exercise was terminated at a peak heart
      rate of 173/min (103% of aged-predicted maximal heart rate), and at a maximal
      systolic blood pressure of 140 mmHg. A few minutes after the end of exercise, he
      developed a severe chest pain and ECG changes, which showed ST elevation in leads
      II, III, aVF and ST depression in leads V4-V6. Emergency coronary angiography
      disclosed an acute coronary occlusion of RCA at the site of PTCA. Emergency PTCA
      was performed and the lesion was successfully re-dilated. Case 2: A 68-year-old
      man was referred to our hospital for cardiac catheterization a month after
      subendocardial anterior myocardial infarction. At the time of cardiac
      catheterization, the proximal LAD have a 99% diameter narrowing. PTCA was
      performed and the lesion was successfully dilated. 18 days after PTCA, he had a
      symptom-limited treadmill stress testing, using the Bruce protocol. The exercise
      was terminated at a peak heart rate of 158/min (102% of aged-predicted maximal
      heart rate), and at a maximal systolic blood pressure of 218 mmHg. Ten minutes
      after the one of 218 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218091
TI  - [A case of intrapleural rupture of pulmonary arteriovenous malformation with
      shock].
AB  - We report a case of a 59-year-old male who suddenly developed massive right
      hemothorax and shock due to pulmonary arteriovenous malformation (AVM). He was
      admitted as an emergency case because of severe back pain, cyanosis and cold
      sweat. Although shock with massive right hemothorax was found, echocardiographic
      and X-ray computed tomographic examination showed no dilatation of the aorta, no
      intimal flap in the aorta and no pericardial effusion which suggested aneurysm.
      Pulmonary arteriography, performed subsequently, disclosed intrapleural rupture
      of the right pulmonary AVM. The patient recovered successfully from the state of
      shock. The pulmonary AVM was removed by segmentectomy of the right lung (S4). He
      was discharged following an uneventful postoperative course. Intrapleural rupture
      with shock is a very rare complication of pulmonary AVM. Pulmonary AVM should be
      considered as one possible cause in patients with massive hemothorax and shock.

PMID- 2218092
TI  - [Three operated cases of LMT-lesion with chief complaint of syncopal attack].
AB  - An urgent aorto-coronary bypass operation (AC-bypass) was made in three patients
      with unstable angina pectoris, suffering from stenosis of the left main trunk
      (LMT). All patients were admitted with chief complaints of chest discomfort and
      syncopal attack. Case 1 was a 71 year-old man who suffered with chest discomfort
      and syncopal attack. He was admitted to our emergency room by ambulance 40
      minutes after the syncopal attack, on January 11, 1989. His blood pressure was
      140/96; pulse 84 and regular. The electrocardiogram (ECG) showed right bundle
      branch block, ST elevation in aVR, aVL and ST depression in all other leads.
      Coronary arteriogram (CAG) was made urgently and showed 80% stenosis in LMT. The
      emergency AC-bypass operation was successfully carried out about 3 hours and 10
      minutes after the onset of symptoms. Case 2 was a 51 year-old man who suffered
      from precordial oppression and syncopal attack. He was admitted to our emergency
      room by ambulance about 1 hour after the attack, on January 17, 1989. His blood
      pressure was 94/74; pulse 120 and irregular. Chest radiography showed a
      cardiothoracic ratio of 58% and the ECG disclosed atrial fibrillation, ST
      elevation in aVR and ST depression in I, II, III, aVF, V1-6. The echocardiogram
      revealed hypokinetic motion in the antero-lateral wall of the left ventricle. CAG
      was carried out without delay, and showed 70% stenosis with slit in LMT. An
      emergency AC-bypass operation was successfully carried out about 3 hours and 50
      minutes after the onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218093
TI  - [Torsade de Pointes with T wave alternans in a patient receiving moderate dose of
      chlorpromazine: report of a case].
AB  - A case is presented of Torsade de Pointes (TDP) with T wave alternans in a 31
      year-old female receiving a moderate dose of chlorpromazine. She was treated in
      an another hospital for schizophrenia with chlorpromazine (100 mg daily) for
      several years and admitted to Fujisawa city hospital for numerous episodes of
      syncope. The electrocardiogram immediately after admission revealed a marked QTc
      prolongation to 0.81 seconds, T wave alternation without any obvious change in
      morphology of the QRS complex, and recurrent ventricular tachycardia called TDP.
      The T wave alternans and TDP were easily abolished by intravenous administration
      of a bolus of 50 mg lidocaine infusion. The QT interval however, remained
      prolonged. Physical examination, including cardiac examination, was normal. Serum
      potassium was 3.6/mEq. Chlorpromazine was discontinued immediately after
      admission and no further episodes of TDP were seen after the first day. After the
      QT interval returned to almost normal, chlorpromazine (50 mg daily) was re
      administered. Two days after the re-administration, the electrocardiogram
      revealed marked QT interval prolongation with prominent T waves. Psychotropic
      drugs, such as chlorpromazine, prolong the QT interval and cause TDP.
      Chlorpromazine appears to have been responsible for TDP and the T wave alternans
      in this case. TDP caused by a moderate dose of chlorpromazine has not been
      previously reported. Lone T wave alternans unaccompanied by changes in the QRS
      complex is a rare phenomenon and the mechanism underlying T wave alternans
      remains unknown.

PMID- 2218094
TI  - Factors limiting maximal oxygen consumption in humans.
AB  - The factors limiting VO2max in humans are analyzed according to a multifactorial
      model derived from the O2 conductance equation. In this context, alveolar
      ventilation (VA) and lung O2 transfer (GL) are not considered to be limiting, at
      least at sea level, because changes in VA and/or in GL are not accompanied by
      changes in VO2max due to the shape of the O2 dissociation curve. Thus, the limits
      to VO2max are shared between blood O2 transport (FQ') and a peripheral factor.
      This last includes tissue O2 transfer (Ft') and mitochondrial O2 utilization
      (Fm'). In untrained subjects at sea level, blood O2 transport is found to be
      responsible for approximately 70% of the overall limits to VO2max (FQ' = 0.7),
      the rest depending on the peripheral factors. FQ', as well as the sum of Ft' and
      Fm', are unchanged after training or upon return to sea level following exposure
      to chronic hypoxia (altitude higher than 5000 m). In the latter condition,
      however, since tissue O2 transfer, which sets Ft', is facilitated, and
      mitochondrial O2 utilization, which sets Fm', is impaired, Ft' is reduced and Fm'
      increased as compared to control condition and/or after training.

PMID- 2218095
TI  - The different relationship of VO2max to muscle mitochondria in humans and
      quadrupedal animals.
AB  - The relationship of VO2max to muscle oxidative capacity (estimated
      morphometrically as the volume of mitochondria of the entire musculature) was
      analyzed by compiling data on 8 species of mammals varying widely in VO2max. Over
      a five-fold range of weight-specific VO2max, a linear relationship between VO2max
      and muscle mitochondria was found. As an exception, humans seem to have 'excess'
      mitochondrial volume for their VO2max. However, the rate at which mitochondria
      operate in vivo at VO2max is found to be very similar for humans and quadrupedal
      animals. A larger total mitochondrial volume thus accounts for the well known
      finding that humans are capable of reaching VO2max with a subset of their body
      musculature. In quadrupedal animals the oxygen delivery system is geared to
      supply the entire musculature while in humans, possibly as a consequence of the
      upright posture, the cardiovascular system is designed to supply only a fraction
      of the total muscle oxidative capacity at VO2max.

PMID- 2218096
TI  - Operation Everest II: cardiac filling pressures during cycle exercise at sea
      level.
AB  - To examine the relationship between cardiac filling pressures during exercise in
      man and oxygen transport, we examined sea level data from Operation Everest II.
      The results showed that, (1) both right atrial and wedge pressures rose with
      heavy exercise in normal man, (2) the magnitude of the rise in these filling
      pressures related both to stroke volume and maximum exercise capacity, (3) wedge
      pressure was tightly coupled to right atrial pressure, with each mm Hg increase
      in right atrial pressure resulting in a 1.4 mm Hg increase in wedge pressure, and
      (4) very high wedge pressures occurred (in some subjects greater than 30 mm Hg),
      which contributed to an elevation of pulmonary arterial pressure. Thus direct
      measurements indicate right heart filling pressure increases with exertion in
      normal man, probably providing the necessary right heart output to fill the left
      heart. We speculated that the high cardiac filling pressures might be needed to
      maintain oxygen transport during heavy exercise, and that such pressures could
      contribute both to elevated pulmonary arterial pressure and to increased
      filtration of water into the lung.

PMID- 2218097
TI  - Comparative aspects of maximal oxygen consumption.
AB  - The respiratory system, that is the set of compartments interposed between the
      cells and the environment, is best studied among mammals. Across the compartments
      there exist net fluxes of O2 and CO2, the intensities of which depend on the
      animal's size. In steady state, at rest, the relation between O2 flux and body
      size has the form of an allometric equation in which the O2 consumption, MO2, is
      proportional to body mass with an exponent or scaling factor of about 0.75
      (Brody, 1945; Kleiber, 1961). The principal experimental methods to force animals
      to maximal MO2 are cold exposure and exercise. According to the concepts of
      physiological time, strenuous exercise to reach maximal MO2 should be shorter in
      small animals than in large ones. The scaling factor for maximal MO2 seems to be
      higher than standard conditions; in other terms, large exercising mammals may
      increase their maximal MO2 more than small animals. The comparative approach of
      maximal MO2 is a powerful tool for finding where in the respiratory system the
      strictures or bottlenecks are which may limit O2 consumption. According to the
      ambient or organismal conditions (pressure, temperature, posture, nutrition), the
      site of the stricture may vary. As far as is known, the O2 consumption of the
      whole human body, in standard conditions as well as in maximal activity, and for
      a given mass, is such that, compared to other mammals, the human exhibits no
      species-specific characteristics.

PMID- 2218098
TI  - Effects of normobaric and hypobaric hypoxia on ventilation and arterial blood
      gases in ducks.
AB  - We measured ventilation (V1) and arterial blood gases in awake Pekin ducks
      exposed to normoxia at sea level, normobaric hypoxia achieved by lowering FIO2 at
      normal barometric pressure (NORMO), and hypobaric hypoxia achieved with a low
      pressure chamber and 21% O2 (HYPO). Average normoxic values were: V1 = 0.46 L .
      (kg.min)-1, PaO2 = 99.7 Torr, PaCO2 = 30.1 Torr. At PIO2 = 90 Torr, NORMO and
      HYPO measurements were not significantly different (P greater than 0.05). At PO2
      = 46 Torr, NORMO V1 was less than HYPO V1 but blood gases were not significantly
      different: VI = 1.00 vs 1.45 L . (kg.min)-1; PaO2 = 31.3 vs 33.0 Torr; PaCO2 =
      11.5 vs 10.6 Torr. Although both tidal volume (VT) and respiratory frequency (fR)
      were greater in HYPO, similar blood gases with NORMO and HYPO suggest similar
      parabronchial ventilation. The results suggest increased physiologic dead space,
      caused by reduced efficacy of aerodynamic valving, with reduced gas density in
      hypobaria.

PMID- 2218099
TI  - The critical concentration of surfactant in fetal lung liquid at birth.
AB  - Various doses (0-4.8 mg) of porcine surfactant were administered into the airways
      of immature newborn rabbits delivered at a gestational age of 26 days and 17-23
      h. When the estimated concentration of exogenous surfactant in the lung liquid
      was less than or equal to 0.75 mg/ml (dose 0.6 mg), an average tidal volume of no
      more than a 3.0 ml/kg was obtained by mechanical ventilation with a peak
      insufflation pressure of 25 cm H2O, but when the estimated concentration was
      increased to 1.5 mg/ml (dose 1.2 mg), an average tidal volume of 17.7 ml/kg was
      attained, and the survival rate during a 30-min period of artificial ventilation
      improved significantly, from 14% to 53%. Even larger average tidal volumes, about
      25 ml/kg, were recorded in animals with estimated surfactant concentrations of 3
      and 6 mg/ml (doses 2.4 and 4.8 mg, respectively). In vitro observations revealed
      that the surface adsorption time of the surfactant suspension decreased non
      linearly from 20 to 1 sec when the concentration was increased from 1 to 3 mg/ml.
      The minimum surface tension during cyclic film compression also decreased non
      linearly from greater than 15 to less than 3 mN/m with the same increments in
      concentration. This led us to conclude that, under the present experimental
      conditions, the critical concentration of surfactant in fetal lung liquid at
      birth (about 3 mg/ml) is close to the concentration required in vitro for rapid
      adsorption and optimal dynamic surface properties.

PMID- 2218100
TI  - Influence of lung volume and rib cage configuration on transdiaphragmatic
      pressure during phrenic nerve stimulation in man.
AB  - Transdiaphragmatic pressure was recorded during bilateral supramaximal
      percutaneous phrenic nerve stimulation at 1 Hz (twitch Pdi) to investigate the
      effect of lung volume and rib cage configuration on diaphragm contractility in
      man. Stimulations were performed in 5 normal supine subjects at resting end
      expiration (FRC) and at lung volumes above and below FRC, during relaxation
      against a closed airway and during isovolume manoeuvres. Twitch Pdi at FRC was
      24.4 cm H2O. At lung volumes above FRC, twitch Pdi decreased by 7.04 +/- 3.2 cm
      H2O per litre of volume change. At lung volumes below FRC, twitch Pdi increased
      by 12.4 +/- 8.6 cm H2O per litre of volume change. When the diaphragm was
      lengthened during an isovolume manoeuvre at FRC, twitch Pdi increased. A similar
      relationship between lung volume and twitch Pdi was obtained during stimulations
      performed with abdominal binding. These results demonstrate that the pressure
      developed by the diaphragm during phrenic nerve stimulation is significantly
      affected both by increases and decreases in lung volume and by the rib cage
      configuration at which stimulation is performed.

PMID- 2218101
TI  - Cardiopulmonary responses to HCl infusion are mediated by thromboxane A2 but not
      by serotonin.
AB  - Intravenous infusion of HCl has been shown to elicit the release of thromboxane
      A2 (TxA2) which alters blood pressure and breathing independent of reductions in
      circulating blood pH. The present experiments were designed to determine if the
      release of serotonin (5-HT) in the anesthetized cat contributed to
      cardiorespiratory responses during acid infusion and, furthermore to define the
      source of TxA2, viz. blood or other tissues. To infuse HCl into the bloodstream
      without reducing circulating blood pH (= neutral acid-base infusion), an
      extracorporeal arteriovenous shunt (20 ml/min) between the femoral artery and
      femoral vein was installed. Into this loop, acid (0.25 M HCl), and approximately
      10 cm downstream, base (0.25 M NaOH) could be infused whereby blood pH could be
      locally reduced in the blood within the loop. This procedure was performed in
      three groups of cats: one group which received no drugs, a second group that was
      pretreated with indomethacin (2.5 mg/kg) and a third group that received the 5
      HT2 receptor antagonist, ketanserin (0.75 mg/kg), prior to the infusion. During
      neutral acid-base infusion in the nontreated animals, right ventricular blood
      pressure (PRV) increased and systemic arterial blood pressure (Pa) decreased.
      Respiratory frequency was increased, but total ventilation was not elevated
      because of a concomitant fall in tidal volume (VT). The response was transient
      and could not be evoked with repetitive infusions of HCl and NaOH. These
      responses were significantly attenuated in the indomethacin-treated animals, but
      persisted in the cats pretreated with ketanserin. In addition, TxB2, the stable
      degradation metabolite of TxA2, was elevated during the acid/base infusion, but
      there were no measurable changes in plasma 5-HT concentration. The source of TxA2
      was likely to be the blood since TxB2 was increased in plasma when acid and base
      were added to blood in vitro. We conclude from these experiments that transient
      cardiorespiratory responses to HCl infusion are mediated by the release of TxA2
      from the blood and do not involve serotonin.

PMID- 2218102
TI  - Effect of adenosine on chemosensory activity of the cat aortic body.
AB  - Adenosine, which is released during hypoxia, increases carotid chemoreceptor
      discharge. It is not known if adenosine also may stimulate the aortic
      chemoreceptors. The purpose of this study was to investigate if adenosine also
      can stimulate aortic chemoreceptors. The effect of adenosine (0.01, 0.1 and 1.0
      mumol/kg) on aortic chemoreceptor discharge was studied in seven anesthetized,
      paralyzed and artificially ventilated adult cats. Intra-aortic injections of
      adenosine produced an increase in chemoreceptor discharge, which reached its peak
      between 10 and 20 s. The chemoreceptor augmentation increased with higher doses
      of adenosine. Adenosine also caused a fall in blood pressure. The increase of
      chemoreceptor discharge was not related to fall in arterial blood pressure. Since
      adenosine is released during hypoxia, it is suggested that part of the
      cardiovascular changes induced by hypoxia is due to stimulation of aortic
      chemoreceptors by adenosine.

PMID- 2218103
TI  - Oxygenation properties of the two co-occurring hemoglobins of the tube worm
      Riftia pachyptila.
AB  - Riftia pachyptila vascular blood and coelomic fluid contain two hemoglobin
      molecules that differ in their distribution and physical properties. The present
      study of the two isolated hemoglobins shows that both have an extremely high
      affinity for oxygen, but differ in their oxygenation characteristics. FI, the
      larger molecular weight (Mr) fraction (1,700,000), has a lower oxygen affinity, a
      well defined pH Bohr effect, and high cooperativity of oxygen binding. FII, the
      lower Mr fraction (400,000) has a higher oxygen affinity, no pH Bohr effect, and
      reduced cooperativity of oxygen binding. Both hemoglobins show marked effects of
      temperature on oxygen binding, and no effect of heme concentration or the
      presence of sulfide on oxygen affinity. The differences in the oxygenation
      properties and distribution of the two hemoglobins in the body fluids of Riftia
      pachyptila may allow them to play different roles in oxygen transport and storage
      for the animal which lives in the variable environment of the hydrothermal vents.

PMID- 2218104
TI  - Solute-coupled liquid absorption from the pleural space.
AB  - The occurrence of a solute-coupled absorption of liquid from the pleural space
      was studied by measuring in anesthetized rabbits the volume of liquid of the
      right pleural space 1 h after injecting into it 2 ml of Ringer solution or of
      Ringer with an inhibitor of a Na(+)-Cl- coupled transport or of the Na+/K+ pump.
      Volume collected after Ringer was 1.56 +/- 0.08 ml. Initial volume being 2.2 ml,
      net absorption rate was 0.64 ml/h. Volume collected after disulfonic stilbene
      (0.1 mM) or bumetanide (0.1 mM) was 2.01 +/- 0.06 and 2.01 +/- 0.05 ml,
      respectively; net absorption rate was reduced to 0.19 ml/h. This suggests the
      occurrence of Na(+)-Cl- coupled transports. Volume collected after ouabain (0.5
      mM) was 2.08 +/- 0.08 ml; net absorption rate was reduced to 0.12 ml/h. This
      suggests the occurrence of the Na+/K+ pump. The marked reduction in the
      hydrothorax absorption produced by the inhibitors shows the occurrence of a
      solute-coupled liquid absorption from the pleural space. Liquid absorbed through
      the visceral pleura by the solute-coupled transport should be removed by the
      Starling forces of pulmonary capillaries. Solute-coupled absorption of liquid
      through the parietal pleura should oppose the filtration caused by the Starling
      forces.

PMID- 2218105
TI  - Active Na+ transport across Xenopus lung alveolar epithelium.
AB  - Bioelectric properties and unidirectional ion fluxes of alveolar epithelium were
      studied by utilizing excised Xenopus lungs mounted in the flux chamber under
      short-circuited conditions. Results show that the alveolar epithelium generates a
      potential difference (PD) of 8 mV (lumen negative) with a tissue resistance (Rt)
      of 1000 ohm.cm2. The short-circuit current (Isc) is inhibitable by 80% with
      alveolar amiloride. Alveolar or pleural exposure of ouabain slowly decreases Isc
      to zero. Rt is slightly increased by either agent. Control tissues exhibit a
      greater unidirectional 22Na+ flux in the alveolar to pleural (A----P) direction
      than in the opposite (P----A) direction, indicating a net removal of Na+ from the
      alveolar fluid. Amiloride and ouabain both decrease the A----P Na+ flux to the
      level of the P----A flux, thereby abolishing net Na+ absorption. In contrast,
      unidirectional 36Cl fluxes are not different in either direction. Neither
      amiloride nor ouabain affected these 36Cl fluxes and tissue resistance
      appreciably, indicating that Cl- passively permeates the alveolar epithelium.

PMID- 2218106
TI  - Effect of surfactant on bioelectric properties of canine tracheal epithelium.
AB  - The functional significance of pulmonary surfactant in the airways is not well
      known and the effects of surfactant on bioelectrical properties of airway
      epithelium have not been investigated. In the present study, we examined the
      effect of synthetic surfactant (TR-14) or calf lung surfactant extract
      (surfactant TA) on transepithelial potential difference (PD) and short circuit
      current (SCC) in canine trachea. The conductance (G) was calculated as the ratio
      of SCC per open-circuited PD. The posterior membrane without muscular layer from
      canine trachea was mounted in an Ussing-type chamber, bathed with Krebs-Ringer
      buffer solution at 37 degrees C and gassed with 95% O2-5% CO2, pH 7.4. Treatment
      with mucosal surfactant produced an increase in both PD and SCC in a dose
      dependent fashion. PD and SCC reached 132% and 124% of before control at 0.25
      mg/ml after the addition of each surfactant respectively, whereas G remained
      unchanged. Both ouabain and furosemide abolished surfactant-evoked increases in
      PD and SCC, whereas amiloride did not alter the surfactant-evoked increases. No
      significant differences in the effect on bioelectric parameters were observed
      between TR-14 and surfactant TA. These findings suggest that lung surfactant
      affects bioelectrical properties and changes ion transport (Cl- secretion) across
      airway epithelium, probably through the activity of ion pumps in the cellular
      membrane.

PMID- 2218107
TI  - Ischemia potentiates the reflex bronchodilation evoked by static muscular
      contraction in dogs.
AB  - In eleven anesthetized dogs, we found that static contraction of hindlimb muscles
      that were freely perfused decreased total lung resistance by 0.7 +/- 0.1 cm H2O.L
      1.sec, whereas static contraction of the same muscles rendered ischemic decreased
      total lung resistance by 1.5 +/- 0.4 cm H2O.L-1.sec (P less than 0.025). In ten
      other dogs, we found that static contraction of freely perfused hindlimb muscles
      decreased total lung resistance by 0.9 +/- 0.2 cm H2O.L-1.sec, whereas dynamic
      contraction of the same freely perfused muscles decreased total lung resistance
      by 1.1 +/- 0.3 cm H2O.L-1.sec. The difference in the magnitudes of the
      bronchodilator responses to the two modes of contraction was not significant (P
      greater than 0.05). We conclude that a mismatch between blood supply and demand
      in working skeletal muscle increases the reflex bronchodilator response to static
      contraction. We also conclude that dynamic contraction evokes a reflex
      bronchodilation equivalent to that evoked by static contraction provided that the
      tension produced by the two modes of contraction are equal.

PMID- 2218108
TI  - Vasodilators do not abolish pulmonary vascular critical closing pressure.
AB  - To examine whether the critical closing pressure (Pcrit) of the pulmonary
      vasculature is dependent upon vasomotor tone, we measured Pcrit in six dog lobes
      before and after the administration of vasodilators. We evaluated the pressure
      flow (P-Q) relationship in zone 2 flow conditions in situ perfused dog lobe
      (control period). We calculated Pcrit as the mean extrapolated zero-flow pressure
      intercepts for the P-Q relationship. We also used arterial and venous occlusions
      under zone 3 conditions to partition pulmonary vascular resistance into arterial,
      middle and venous segment resistances. We then repeated all measurements
      following administration of papaverine (150 micrograms/ml) and sodium
      nitroprusside (200 micrograms/min) into the venous reservoir (vasodilator
      period). Resistance in all three vascular segments was significantly reduced
      during vasodilator conditions. Pcrit decreased from 3.68 +/- 0.76 cm H2O to 2.53
      +/- 0.92 cm H2O during control and vasodilator periods respectively (P less than
      0.05). The slopes of the P-Q relationships were similar during both conditions.
      Our data support a model in which vasomotor tone normally sets Pcrit but in which
      the pulmonary vasculature can exhibit the phenomenon of critical closure even
      with vasomotor tone pharmacologically ablated.

PMID- 2218109
TI  - Effect on breathing of raising end-expiratory lung volume in sleeping
      laryngectomized man.
AB  - In animals, tonic vagal activity from lung receptors provides a means by which
      changes in end-expiratory lung volume can influence respiratory timing. We wished
      to examine whether increasing the end-expiratory lung volume within the tidal
      volume range had a similar effect in man. In order to minimize behavioral
      influences on breathing, the study was performed in subjects during deep non
      rapid eye movement sleep. Five laryngectomized subjects were chosen for the study
      since their permanent tracheal stomata allow simple, airtight connection to
      respiratory apparatus and avoided problems with glottic closure. During EEG
      documented sleep, end-expiratory volume was increased by up to 350 ml with the
      addition of expiratory threshold loads of 1 to 10 cm H2O. End-expiratory volume
      increased linearly with expiratory pressure. Inspiratory and expiratory times (TI
      and TE) were not affected by increases in end-expiratory volume. Tidal volume
      (VT) was decreased such that end-inspiratory volume remained unchanged. The
      decrease in VT may result from a reduction in inspiratory muscle efficiency at a
      higher lung volume. The results of the study provide no evidence that tonic vagal
      afferent information from the lungs is important in controlling respiratory
      rhythm within the tidal volume range in man when behavioral control of breathing
      is minimized.

PMID- 2218110
TI  - [Post-traumatic infections of the frontal sinus].
AB  - Post-traumatic infectious complications of the frontal sinus occur more
      frequently after multiple fractures than after isolated fractures. The greatest
      frequency is found with open traumas of the sinus, due to the presence of foreign
      bodies and to bone and mucosal destruction. Such infectious complications are
      curatively treated both medically and surgically, to eliminate the bony and
      mucosal infection and to restore the normal physiology of the frontal sinus.
      Stress is laid on the preventive treatment, especially on the quality of the
      initial surgical treatment, either by restoring the sinus with gauging of the
      nasal-frontal canals, or by eliminating the sinusal function by a canalization
      which appears preferable to exclusion by obliteration.

PMID- 2218111
TI  - Nasal mucociliary function during the menstrual cycle in healthy women.
AB  - Nasal mucociliary transport time was studied in nine healthy women over the
      menstrual cycle using the vegetable charcoal powder technique. Three measurements
      were made at different points of the cycle: during the early follicular phase,
      periovulatory phase and luteal phase. The mean transport times were 10.1 +/-
      3.50, 5.1 +/- 2.08 and 7.5 +/- 3.28 minutes, respectively. Transit was
      significantly accelerated during the periovulatory phase (p less than 0.01), when
      the seric estrogens are at their highest level.

PMID- 2218112
TI  - [The value of cellulo-adenectomy in the treatment of pharyngolaryngeal cancers
      without clinical adenopathy].
AB  - The term cellulo-adenectomy involves dissection of all the neck jugulo-carotid
      lymph nodes below the digastric muscle and above the omo-hyoid muscle. From the
      study of 133 cases treated by primary surgery, it can be said that this technique
      is essentially diagnosis to verify the actual integrity of the jugulo-carotid
      lymph trunk in patients who are clinically NO and who present a lymphophile ENT
      tumour. Such a technique necessitates a macroscopic lymph examination with an
      extemporaneous anatomical and pathological examination. Subsequent therapy
      depends on the result; for N+ patients, further surgery and/or irradiation,
      irrespective of the site; for a confirmed N- patient, additional therapy
      depending on the site of the tumour. Our experience has shown that this approach
      is safe and enables the treatment of the lymph glands to be better adapted to the
      reality of the neoplastic invasion.

PMID- 2218113
TI  - [Primary and recovery transmaxillar buccopharyngectomy in buccopharyngeal
      cancers].
AB  - From january 1976 to december 1986, 78 patients were treated surgically for
      squamous cell carcinoma of the lateral buccopharyngeal junction without
      chemotherapy at first. 36 patients were treated by primary surgery with post
      operative radiotherapy and 31 patients were treated by recovery surgery. Post
      operative course was uncomplicated in 41% of cases (39% in primary surgery, 43%
      in recovery surgery); in 14% of cases serious local complications were observed
      (11% in primary surgery, 17% in recovery surgery). Carcinological failures
      appeared in 46% of cases in primary surgery and in 70% of cases in recovery
      surgery. Three years and five years actuarial survival rate were 45% and 39%
      respectively in recovery surgery. Prognostic factors are studied: resection
      quality, histological metastasis in lymph nodes. The authors emphasize on the
      best control of the big tumors in primary surgery and on the best results with
      small ulcerated infiltrant carcinoma.

PMID- 2218114
TI  - [Analysis of prognostic factors in cervicofacial carcinology using the Cox model.
      An example of piriform sinus cancer].
AB  - Analysis of prognosis factors was performed on a surgical series of 34 of
      piriform sinus cancer, based on the use of a multivariate study according to the
      Cox model. The presentation is essentially didactic emphasizing the main points:
      how to collect data, what data to collect, and what judgment criterion to use.
      The authors detail the interpretation to be drawn from the analysis results using
      Cox model.

PMID- 2218115
TI  - Pupillary pharmacologic test in Meniere's disease: a useful method for routine
      diagnosis.
AB  - The role of the parasympathetic system in Meniere's disease was investigated by a
      pupillary pharmacologic test (methacholine test), using a computed infrared
      pupillograph. The test was performed in Meniere's disease (16 cases), other
      vertiginous disorders (23 cases) and normal subjects (10 cases). The results
      confirmed the presence, during the attack stage of Meniere's disease in 75% of
      cases, of an abnormal sensitivity of the iris musculature to methacholine,
      prevalent on the affected side, and an increasing pupillary asymmetry. These
      features were found in 17% of the patients with other vertiginous disorders and
      in none of the control subjects. The parasympathetic dysfunction is interpreted
      as a supersensitivity of central origin and seems directly related to the
      disease. It is proposed that the methacholine test acts as a complement to the
      glycerol test in the diagnosis of Meniere's disease.

PMID- 2218116
TI  - [Functional study of vestibular receptors by combined electric and rotatory
      stimulations].
AB  - After a brief review of the anatomical and functional characteristic of the inner
      ear, emphasizing audio-vestibular relationships, a direct method for recording
      peripheral vestibular potentials, the Electrovestibulogram (EGV) is described and
      compared with the techniques Electronystagmographic. Stimulating electrodes were
      implanted in the round window and vertex of a group of guinea-pigs, with
      recording electrodes near the internal acoustic meatus. A permanent electric
      stimulation was combined with an intermittent vestibular stimulation (horizontal
      angular acceleration) to derive afterfact-free vestibular specific responses. The
      characteristics of the EVG responses were analyzed and compared with the data in
      the literature concerning the responses of single fibres, to validate the
      technique. The diagnostic value of EGV is discussed.

PMID- 2218117
TI  - [Dynamic posturography in normal subjects].
AB  - The relative lack of data on the dynamic posturography led us to start a study in
      order to give our contributions to the standardization of M1, M2, M3, response
      parameters in normal subjects. Our research was carried out on 35 normal subjects
      aged 21 to 50. All of them were standing in Romberg's position on a Tonnies model
      board in a normally lit and ventilated room. We performed two tests: the first
      one open-eyed staring at no point, the second, 5 minutes later, closed-eyed. The
      EMG signals were obtained by surface electrodes on triceps sural and front tibial
      muscles. The EMG recording was determined by a "tilt" movement of the board at a
      steady speed of 50 per sec. and 4 wide. We use a XT 286 IBM computer with "T
      POST" software for checking and testing the data. Our results showed a
      significant variation in the value of the duration parameter in open-eyed and
      closed-eyed tests. Latency and area values were inferior to those obtained by
      other authors, except for Diener and Dichgans (3) whose results differ in latency
      value only.

PMID- 2218118
TI  - [Sinus infection and diving (a case of cerebral empyema)].
AB  - Intracranial complications following swimming or diving accidents are
      exceptional. A recent observation of a cerebral empyema in a 15-year old boy,
      with neurological sequellae was an opportunity the clarify the issue. Apart from
      the rapidity of the neurological signs, two points drew our attention:
      bacteriology, with a predominance of anaerobic germs; and the problem of therapy,
      both for the timing of neurosurgery and for the role of anticoagulants in venous
      thrombosis.

PMID- 2218119
TI  - [A case history of lateral cervical tumor].
AB  - The authors report on the observation of a voluminous aneurysm of the common
      carotid that had developed over 20 years in an 88-years old female patient. This
      was treated surgically by a Gore-Tex carotid graft with perfectly straightforward
      operative sequellae. With respect to this case, the author briefly review the
      semiology and diagnosis of aneurysms of the neck.

PMID- 2218120
TI  - [Tuberculosis of the cavum, report of two cases].
AB  - The authors report two cases of nasopharynx tuberculosis. This location is rare
      or misestimated. The sarcoidosis, the Wegener's granulomatis can be discussed.
      The diagnosis confirmation is based on the histologic features as a caseous
      necrosis in a langhans reaction cells or as the presence of mycobacterium
      tuberculosis at a Ziehl-Nielson coloration. The authors insist on the interest of
      a systematic biopsy of the nasopharynx at the presence of a nasopharynx lesion or
      a primitive cervical lymph-nodes. A bacteriologic investigation have to be done
      before the beginning of the specific treatment.

PMID- 2218121
TI  - Anatomy of the larynx, study of the anterior branch of the recurrent laryngeal
      nerve.
AB  - These studies are based upon 60 dissections of the recurrent laryngeal nerve. The
      authors describe the branches destined for the intrinsic musculature of the
      larynx. This study is a working approach for the operations of selective
      laryngeal reinnervation in man.

PMID- 2218122
TI  - Surgical anatomy of the superior laryngeal nerve.
AB  - The authors report on their anatomic findings in 42 surgical dissections of the
      superior laryngeal nerve. Better knowledge of this anatomy should enable a more
      conservative cervical surgery and help in attempts at nervous rehabilitation of
      laryngeal paralysis.

PMID- 2218123
TI  - [Systematization and histomorphometry of human laryngeal nerves].
AB  - Laryngeal nerves were dissected from 100 fresh subjects in order to compare right
      and left superior and inferior laryngeal nerves. The origin and the distribution
      of the vascularization was studied. The structure of these nerves was precised
      through an histomorphometric approach (distribution number of myelinated fibers
      per mm2, diameter of myelinated fibers). A cartographic study of the laryngeal
      nerves confirmed the structure of this innervation. The main conclusion of this
      study is the importance of the plexis structure of the laryngeal innervation and
      the variations of the nerve fibers diameter as a function of the length of the
      fiber.

PMID- 2218124
TI  - [Otospongiosis: different surgical technics, identical results. Why?].
AB  - Both platinectomy and platinotomy are currently used to treat otosclerosis
      surgically. Though the techniques are different from one another, especially by
      the new area ratio between tympanic membrane and stapes foot-plate, the results
      are similar. It should be clear that the simple "piston model" of the tympanic
      ossicular system cannot explain this results. If, for the seesaw mechanical view,
      a vibratory molecular system conducting acoustic energy is substituted, a
      pertinent explanation can be given for this result. Thus, understanding of the
      pattern motion of the tympanic ossicular system has to change drastically.

PMID- 2218125
TI  - [Pulse oximetry: an indicator for the closure of a tracheostome after lateral
      fixation of the vocal cords (cordopexy)].
AB  - The aim of the study was to establish an objective method to predict proper
      breathing after the closure of the tracheostomy in patients operated upon for
      laryngeal diplegia by lateral cordopexy. The method is non-invasive, quantitative
      and independent of the patient. The study covers 18 patients in whom the closure
      was performed after fixation of the vocal in whom it was performed prior to the
      operation. The arterial oxygen saturation was measured during closure using a
      beat-to-beat pulse oximeter and compared with the open tracheostomy, with the
      closed tracheostomy at rest and under stress, and finally with the closed
      tracheostomy in the recovery phase. The effort was continued for 5 minutes or
      until the patient complained of shortness of breath (3 patients). Initially the
      O2 saturation in these patients did not drop below 90%, but respiratory dependent
      saturation variations were noted. During the recovery phase, the saturation fell
      below 90%. The subjective declaration of "asphyxia" always preceded the
      variations in the O2 saturation. From this, and from the O2 saturation curves, we
      conclude that the cause for the reopening of the tracheostomy comes more from a
      circulatory problem that from hypoxemia.

PMID- 2218128
TI  - [Ophthalmological complications in ORL and maxillofacial surgery].
AB  - E.N.T. and maxillo-facial surgery may sometimes cause dramatic eye damage.
      Following a brief summary of the eye's anatomy and its surrounding parts, the
      most frequent surgical acts which may cause orbital complications are described.
      Perfect knowledge of the eye and its surrounding parts enable us to offset the
      dramatic changes due to the pathology.

PMID- 2218126
TI  - [Use of the Musco NT3 tympanic isopressor in tubal dysfunction. Apropos of 30
      cases].
AB  - We have studied the tolerance and efficacy of tubal insufflations with the MUSCO
      NT3 isopressor (Bexen) in a sample of 30 patients suffering from chronic tubal
      pathology. The apparatus was modified for use with an Itar Catheter. We recorded
      a favourable evolution of serous otitis (9 cases of normalization), with little
      modification of the retraction pockets. The paraclinical study revealed a major
      and significant overall, audiometric and tympanometric improvement.

PMID- 2218127
TI  - [Management of open and closed cavities in otology].
AB  - Surgery of chronic otitis follows a few basic principles, some of which are long
      standing but still topical. In the majority of cases, opening of the cavities of
      the middle ear uses one of the following two techniques: the open technique
      (radical mastoidectomy), or the closed technique (transmastoid approach or canal
      up technique). Whatever the technique used, a readjustment of the cavity is often
      indispensable to avoid any recurrence of the pathology (cholesteatoma) or the
      appearance of a new pathology (chronic otorrhea) and facilitates a functional
      step if required. Open techniques must therefore always follow the rule of the
      ratio V/S (where V = the volume of circulating air coming from outside, and S =
      the surface area of the skin of the cavity). This ratio is specific to each
      individual. The readjustment must enable either an increase of V
      (meatoconchaplasty) or a decrease of S (reconstruction of the posterior auditory
      canal, obliteration of the cavity), or a combination of the two. Closed
      techniques must also be adjusted to avoid any retraction towards the posterior or
      upper cavities. Depending on the clinical background and on the aggressivity of
      the pathology, the posterior tympanotomy can be closed, and the attic and aditus
      cavities of the middle ear separated by a bony fragment leaving the protympanum
      open upwards to enable normal ventilation towards the attic, the aditus and the
      antrum, or much more rarely, these cavities can be completely closed.

PMID- 2218129
TI  - [Focal infection? Did you say focal infection ... focal infection and uveitis].
AB  - A chronic seat of infection more often than not situated in the E.N.T. area is
      responsible for remote pathological symptoms commonly called focal infection. The
      eye may be a target organ, where focal infection appears in the form of a
      uveitis. Four clinical observations are reported as demonstration. The
      transmission mechanism operates through an immune phenomenon from bacterial
      antigens which engender reactions of hypersensitivity. The E.N.T. specialist must
      be aware of these symptoms and seek a pharyngeal, sinusal or latent buccodental
      infection.

PMID- 2218130
TI  - [Oculo-orbital injuries caused by firearms. Clinical and ballistic study of 3
      cases].
AB  - For 3 cases, the authors made a clinical and ballistic analysis of the
      penetration of war projectiles inside the eye and the orbit. They emphasize the
      seriousness of the injuries, the multiplicity of the operations, the need for
      participation of different specialists and lastly, the almost-inescapable loss of
      sight.

PMID- 2218131
TI  - [Total ethmoidectomy using the mixed rhinoneurosurgical approach for malignant
      tumors of the anterior skull base. 14 years' experience. 62 cases].
AB  - Based on 62 cases, the authors report on 14 years of experience of total
      ethmoidectomies through a mixed rhinological and neurosurgical approach.
      Following a survey of the main points of the surgical technique, they emphasize
      the major evolution undergone, on the one hand, by the preoperative topographic
      diagnostic possibilities thanks to progress in imaging, and, on the other hand,
      the operative technique itself. The optimization of the reconstruction time for
      the base of the skull seems to provide a substantial advantage by reducing
      morbidity and operative mortality. The use of the epicranial flaps and to a
      lesser degree, cryo-stored bone allografts are the major stages. Prognostically
      speaking, the mixed approach offers a clear improvement in the 5-year survival
      rate of adenocarcinomas (80%), and olfactory placode tumors. However, the
      prognosis for epidermoid carcinomas continues to be poor (35% at 5 years) due to
      the frequency of local recurrences and visceral metastases.

PMID- 2218132
TI  - Acoustic neuroma: anatomo-clinical correlations in the posterior wall of the
      temporal bone.
AB  - A morphometric study of relationships among cranial nerves V-VI-VII-VIII-IX-X-XI
      XII and the posterior wall of the temporal bone was done in 58 specimens. Large
      variations occurred in measurements. Results were correlated to a clinical study
      of 30 patients undergoing surgery for removal of acoustic neuromas. No
      correlations could be found between size and shape of external auditory meatus
      (E.A.M.) and internal auditory meatus (I.A.M.) in the same temporal bone. Mean
      distances from the point where cranial nerves enter the temporal bone to the
      I.A.M. were: trigeminium nerve, 7.8 mm; abducent n., 15.2 mm; hypoglossus n.,
      21.4 mm; and glossopharyngeal n., 5.3 mm. Although the jugular foramina is the
      closest structure to the I.A.M., cranial nerves IX-X-XI were never clinically
      impaired in all 30 patients studied here. Clinically diagnosed trigeminium nerve
      impairment occurred more often than facial paralysis (33.3% against 20% of
      patients). It seems that motor fibers are more resistant to tumoral compression
      and distension.

PMID- 2218133
TI  - [Irradiation of neurinoma. Why? How? First results].
AB  - The treatment of acoustic neurinomas is above all surgical. Five situations lead
      us to opt for radiotherapy: the patient's poor general condition, tumoral
      bilaterality with a single ear, tumoral remnants, evolutive recurrences or
      relapses and lastly, tumoral hypervascularization (pre-operative radiotherapy).
      Therefore, 19 patients were treated between 1986 and 1988 by linear accelerator
      photons or cobalt, at doses of 50 to 60 Gy (1.8 Gy per session). Indubitable
      effectiveness was observed on the tumoral volume in the form of stabilization or
      regression in 14 cases. The evolution of hearing after treatment is not as
      favorable: out of 8 patients with good hearing on the irradiated side, 3
      maintained identical thresholds, but 5 secondarily developed total deafness. The
      therapeutic protocol change will perhaps allow for improvement in hearing
      preservation.

PMID- 2218134
TI  - [Tuberculosis of the upper digestive and respiratory tract].
AB  - Based on seventeen cases of upper digestive and respiratory tract tuberculosis,
      the authors review the different localizations of the disease. The mean age of
      the patients is 34 years old. The diagnostic is based on bacteriological and
      especially histological examination. The prognostic of the affection is excellent
      if tuberculosis chemotherapy is used for a minimum of 9 months.

PMID- 2218135
TI  - [Naso-orbito-cerebral mucormycosis. A more & more common disease].
AB  - A typical case of naso-orbital-cerebral mucormycosis is described. This rare but
      serious disease mainly occurs in fragile patients, notably diabetics or those
      undergoing an immunosuppressant treatment. The cases recorded are therefore
      increasingly frequent. Mucorales, normally saprophytic, germinate in the nasal
      cavities due to an infection and then colonize the sinuses, the orbit, followed
      by the meninges. The diagnosis must be made before meningeal impairment when
      faced with a peri-orbital edema, the beginning of exophtalmy or oculomotor
      paralysis in high-risk patients with sinusal opacity. The diagnosis is based on
      the histology and the mucology which must be directed by the clinician: indeed,
      the histology of the naso-sinusal mucosa samples must be performed using special
      stains. The mycological samples must also be taken from special environments.
      Once the diagnosis is confirmed, the required treatment with high doses of
      intravenous Amphotericine B must be administered immediately, otherwise the
      evolution is fatal.

PMID- 2218136
TI  - [Isolated sphenoidal aspergillosis presenting as an optic neuropathy].
AB  - Aspergillosis fixation in the sphenoidal sinus is an exceptional occurrence when
      isolated. The clinical feature is misleading and the diagnosis often difficult;
      local and regional complications are dreadful. The authors report a case,
      presenting as an optic neuropathy, and the literature data.

PMID- 2218137
TI  - [Isolated fractures of the medial orbital wall, surgical indications in 5 cases].
AB  - Isolated fractures of the medial orbital wall are always blowout fractures. They
      are usually diagnosed when horizontal diplopia occurs (lateral movements of the
      globe and Lancaster test). If the medial rectus muscle is encapsulated (forced
      ductions and CT-scan), the area of restriction has to be explored surgically.

PMID- 2218138
TI  - [Pneumatocele caused by ballistic injury of the anterior stage of the skull base,
      a case report].
AB  - The authors present a case of intracerebral expansive pneumatocele following a
      ethmoido-sphenoidal fracture by a bullet. The case presented is exceptional, as
      the bullet went through the brain case without injuring the neurological
      structure. The patient is operated on through the low paralateronasal approach,
      by filling the ethmoid and the sphenoid with autologous bone material. This
      surgical treatment makes closure of the fistula and disappearance of the
      pneumatocele possible, however, not enough time has gone by for making other
      judgments. This approach, which has a much lower morbidity rate than the approach
      of the anterior stage through craniectomy, is effective for fractures of the
      sphenoid and the posterior ethmoid.

PMID- 2218139
TI  - [Radiation-induced sarcoma, apropos of a case with cervical and intrapetrous
      development].
AB  - The authors report on a case of fibrosarcoma of the secondary petrous part of the
      temporal bone following irradiation, eight years earlier, of a cerebellar
      astrocytoma. Based on a review of the literature, they recall the characteristic
      traits of these tumors: development in the field of irradiation, prolonged
      latency period, exact histology, rarity of cervico-cephalic locations. The
      treatment usually associates wide surgical exeresis and chemotherapy. The
      prognosis remains poor due to local recurrences and visceral metastases (20 to
      60% at five years).

PMID- 2218140
TI  - [Efficacy of Cefsulodin in pyocyanic otologic infections, apropos of 55 cases].
AB  - Our work consists of a comparative study of 4 therapeutic protocols for treatment
      of otological infection from the pyocyanic bacillus, and more specifically of 19
      patients with a necrotizing malignant otitis, 24 patients with perichondritis and
      12 patients suffering from a post-operative infection. The association of
      Cefsulodin (a 3rd generation Cephalosporin) and Gentamicin gave the best results.
      A major decrease of the time of treatment and a total absence of infectious
      complications were in fact recorded. The adjuvant therapies were duly observed
      for the 4 protocols, in particularly the surgical treatment and the treatment of
      the site (diabetes).

PMID- 2218141
TI  - [Role of the free forearm flap in reconstruction after total circular
      pharyngolaryngectomy. Review of the literature and a case report].
AB  - Methods of surgical repair after total pharyngo-laryngectomy have considerably
      improved since the introduction of micro-surgical techniques. The use of free
      autografts for reconstruction of the pharynx is now preferred in most centers to
      the use of musculo-cutaneous flaps. The free forearm flaps appears to be
      particularly suitable for this type of repair. The authors report on their
      experience in performing this procedure with one of their patients. The results
      of this technique in major published series are then compared with those achieved
      with similar procedures employing free jejunal interposition grafts.

PMID- 2218143
TI  - [Treatment of subglottic stenoses using the Pearson's operation: apropos of 3
      cases].
AB  - Surgery of stenoses of the laryngo-tracheal junction is governed by the necessity
      of maintaining the support of the cricoid-arytenoid articulations and of
      preserving the recurrent nerves. Sub-total cricoid resection with conservation of
      the recurrent nerves, known as Pearson's operation, enables the treatment of
      fixed sub-glottic stenoses with mobile larynx. On the basis of three recent
      observations, the authors define the indications and the performance of this
      surgery. The respiratory and vocal results are considered satisfactory in these
      three cases.

PMID- 2218142
TI  - [Treatment of laryngotracheal stenoses in children].
AB  - Over a period of 5 years, from 1984 to 1989, 35 children were treated surgically
      for a laryngo-tracheal stenosis, 27 by an external approach, 8 by endoscopy with
      the CO2 laser. Of the children, 25 (71%) were under 5 years old at the time of
      treatment and 77% of the stenoses (n = 27) corresponded to a post-intubation
      and/or tracheotomy acquired etiology. Based on the classification of stenoses
      according to the extent of the impairment of the aerial lumen, the authors stress
      the value of conservative treatment (endoscopy) in Stage I (less than 70%, n =
      8), and of treatment using the external approach in Stage II (between 70% and
      90%, n = 12), in Stage III (between 90% and 99%, n = 12) and Stage IV (complete
      obstruction, n = 3). The technique most widely used currently is laryngo
      tracheoplasty with the insertion of costal cartilage (n = 17). Analysis of the
      results shows that decannulation was successful in 85% of the cases. With respect
      to the management of stenoses in the new-born baby, the authors report on their
      recent experience with laryngo-trachoe-fissure in 6 cases as an alternative
      either to tracheotomy in difficult extubations, or to laryngo-tracheoplasty when
      the child's weight is particularly low.

PMID- 2218144
TI  - [Surgical anatomical study of the spinal nerve].
AB  - 100 dissections performed in the Anatomy Laboratory have made it possible to
      clarify certain details relating to the cervical trajectory of the accessory
      nerve (traditionally called the 11th or spinal nerve), its relationship with the
      jugular vein, with the S.C.M. muscle, its position on the anterior and posterior
      edges of the S.C.M. and on the anterior edge of the trapezius muscle, and the
      frequency of its branching in the sub-clavicular fossa.

PMID- 2218145
TI  - Pathology of the uterine cervix.

PMID- 2218146
TI  - Squamous cell carcinoma of the uterine cervix--a review with emphasis on
      prognostic factors and unusual variants.
AB  - Although the incidence of squamous cell carcinoma of the cervix has declined in
      recent years, it remains the most common type of cervical cancer in our society.
      In this review, the salient pathologic features of squamous cell carcinoma are
      discussed. Early invasive, International Federation of Gynecology and Obstetrics
      (FIGO) stage la carcinoma has been a source of controversy in diagnosis and
      therapy for many years. Specific requirements must be met in order to make this
      diagnosis. Most importantly, the cervical conization specimen must be handled
      properly, so that the features of tumor dimensions, vascular involvement, and
      completeness of excision can be correctly evaluated. Important diagnostic and
      prognostic pathologic findings of early invasive carcinoma are discussed. The
      risk of lymph node metastasis in lesions with depths of invasion up to 3 mm is
      less than 1%. This risk increases significantly with deeper levels of invasion.
      In the area of frankly invasive squamous cell carcinoma of the cervix, certain
      pathologic features have been shown to be clinically relevant. These include the
      extent of local disease, cell type, and the presence of vascular or lymphatic
      invasion. Regarding cell type, it is critical to distinguish between poorly
      differentiated small cell squamous carcinoma and small cell undifferentiated
      carcinoma, as the prognosis for these tumors may differ. Finally, several rare
      but pathologically distinct variants of squamous cell carcinoma of the cervix are
      reviewed, with emphasis on differential histologic features. As they often have
      different natural histories than typical squamous cell carcinoma, correct
      diagnosis of these lesions is vital.

PMID- 2218147
TI  - Invasive adenocarcinoma and related tumors of the uterine cervix.
AB  - Adenocarcinomas and related tumors now account for approximately 15% of
      carcinomas of the uterine cervix. In this review, the features of these neoplasms
      are reviewed with emphasis on their microscopic features, differential diagnosis,
      and subtypes about which there is new information such as adenoma malignum, and
      villoglandular, mesonephric, adenoid basal, and adenoid cystic carcinomas. These
      tumors may cause considerable diagnostic difficulty, sometimes being difficult to
      distinguish from nonneoplastic glandular proliferations. Their correct
      identification has major prognostic implications.

PMID- 2218148
TI  - Variability of symphysis-fundus height measurements: an experimental study among
      general practitioners.
AB  - With the aim of evaluating the impact of supervised training during a
      postgraduate course in obstetrics and gynaecology, the variability of symphysis
      fundus (SF) height measurements was studied by a group of general practitioners
      (GPs), all of whom provided primary antenatal care. A nested analysis of variance
      was used. The SF height measurements of the group differed significantly from
      those of a senior obstetrician and the course training had no impact on the
      variability. Similar studies should evaluate measurement variability in the light
      of pregnancy outcome.

PMID- 2218149
TI  - Failure to keep appointments at a community health centre. Analysis of causes.
AB  - The scheduled appointment system in primary care clinics became popular recently
      in Israel. Failed appointments created a problem for the doctors, patients and
      the clinic in Netivot. During 11 months, 2.317 appointments were surveyed. The
      survey showed 36% of failed appointments, with a decrease to 28% one year later.
      Rates of failed appointments were 38% for the paediatric population, 35% for
      adults, and 34% for pensioners. Market days and holidays predisposed to more
      failed appointments, representing community customs. The presence of a chronic
      disease that needed follow up ensured a higher rate of attendance (76%),
      especially among the paediatric population (92% attendance rate). By contrast, a
      geriatric patient with an acute disease had difficulty attending the clinic (only
      16% attending). 512 people (35% of the population) were responsible for the 827
      failed appointments, and among them only 12% of the population accounted for 59%
      of the failed appointments. These findings have important implications in the
      planning of an appointment system in an urban health centre, and they strengthen
      the assumption that a small number of patients cause a large number of failed
      appointments.

PMID- 2218151
TI  - A retrospective study of respiratory tract infections among children in different
      forms of day care.
AB  - This retrospective study investigated the records from July 1985 to June 1986 of
      all medical visits due to acute respiratory tract infections (RTIs) in infants
      aged 1-3 years. The study, in a municipal district, included all visits to the
      district health centre as well as visits to the paediatric and ear, nose and
      throat departments of the nearby hospital. The study population consisted on 489
      children, of whom 140 were cared for in day-care centres (DCC), 146 in family day
      care (FDC), while 203 did not receive any sort of municipally-supported day care
      (home care, HC). During the year studied, 223 children needed treatment by a
      doctor for acute RTI on altogether 499 occasions leading to the prescription of
      325 courses of antibiotics. As regards RTIs as a whole and regarding those
      treated with antibiotics, the incidence density was greatest among the DCC
      children and lowest among the HC children, while the FDC children formed an
      intermediate group.

PMID- 2218150
TI  - Intervention against long-term use of hypnotics/sedatives in general practice.
AB  - The aim of the study was to evaluate the efficiency of different strategies of
      intervention to reduce prescription of hypnotics/sedatives in general practice.
      All 356 general practitioners in the county of Aarhus, Denmark, were divided in
      three groups. One group received personal information at meetings, another
      received written material about proper use of hypnotics/sedatives and information
      about their own prescription rate, and the third group constituted a control
      group. The prescription rate was recorded before and after the intervention.
      There was a general decline in the prescription rate recordings, but there were
      no significant differences between the intervention groups and the control group.

PMID- 2218152
TI  - Lower mortality of demented nursing home residents. A two-year survival study.
AB  - The mortality of 318 patients residing permanently in a nursing home was analyzed
      over two years in a retrospective study. Survival analysis showed that age was
      significantly associated with increased mortality, and dementia with decreased
      mortality. The results may to some extent explain the large percentage of
      demented patients in nursing homes, and provide some support for the hypothesis
      that demented patients accumulate in the nursing homes, partly due to
      inappropriate community services for these patients, leading to a relatively
      early institutionalization.

PMID- 2218153
TI  - A three-year training programme for primary health care physicians in Poland.
AB  - A three-year training programme was developed and implemented by the Medical
      Centre of Postgraduate Education in Poland with the aim of improving the
      knowledge and skills of primary health care physicians working in the State
      Health Services' community centres. The programme creates several learning and
      self-assessment opportunities with the general principle of not distracting a
      doctor from his daily duties in a community health centre for more than one day a
      month. Preliminary assessment of the programme revealed its positive impact on
      both the health services system and primary health care physicians themselves. It
      increased health authorities' activity in creating new learning opportunities and
      doctors' motivation to learn. Self-assessment made by the first group of trainees
      who completed the three-year programme (results obtained by means of a
      questionnaire) revealed substantial increase in professional competence resulting
      from the participation in the programme.

PMID- 2218154
TI  - The general practitioner and the HIV epidemic.

PMID- 2218155
TI  - On promises and premises in qualitative general practice research.

PMID- 2218156
TI  - Factors of importance for the use of PAP-SMEAR in a Danish county without
      systematic screening.
AB  - Do various General Practice factors influence the participation rate (PR) in the
      cytological investigation for preventing cancer of the cervix uteri in counties
      without systematized screening? This was studied in the county of Aarhus,
      Denmark, where there are no systematic cytological examinations (CE). We studied
      a random sample of 2023 women aged 27.5 years to 47.5 years. Essential
      differences in PR depended on various practice characteristics. Practices with
      the highest average use of CE services, as counted by the Regional Health
      Authorities, also had the best PR. The relative chance of being sufficiently
      examined was almost twice as great among patients in active practices compared
      with other practices. Furthermore, practices with at least one female
      practitioner and practices that wanted the introduction of systematic screening
      had a significantly higher PR. There was a slightly higher PR for patients in
      large practices. Type of practice, i.e. whether single or partnership, and the
      individual practitioner's attitude to the efficiency of the present opportunistic
      screening were not related to the PR. Finally, a slightly lower PR was found
      among patients in the city of Aarhus, whereas the PR in the major cities of the
      county as a whole did not differ from the coverage rate in the county in general.
      It is concluded that the Health Authorities' average figure for CE-use/1000 women
      in the individual practice is the most significant factor that determines the CE
      rate for any given patient. Variation in the PR in different practices is
      unacceptably large if all the women are to receive a uniform CE screening offer.

PMID- 2218157
TI  - HIV infections and AIDS in Danish general practice--the role of the GP in AIDS
      prevention.
AB  - The occurrence and geographical distribution of HIV infections and AIDS
      (HIV/AIDS) in Danish general practice were examined in a questionnaire study sent
      to a 10% random sample of the GPs. Response rate was 92%. In 1988, a total of
      2969 patients were tested, median 10 patients per GP. GPs had 148 HIV-positive
      patients (66 in Greater Copenhagen) and 60 AIDS patients (27 in Greater
      Copenhagen). In Greater Copenhagen 37% of the GPs had neither HIV nor AIDS
      patients, vs. 71% in the rest of the country. Instruction in infection
      prophylaxis was usually initiated by the GPs, while HIV testing was mainly on the
      patient's initiative. 52% of GPs indicated a change in their routine,
      particularly with respect to sterilization of instruments and avoidance of direct
      contact with blood. An extrapolation of the results of this study indicates that
      about 1,500 of the estimated 2,000 HIV positive patients in Denmark are known by
      general practitioners.

PMID- 2218158
TI  - The diagnosis of bacteriuria during pregnancy.
AB  - Three diagnostic tests, Nitur, Urobact, and Uricult, were evaluated in the
      detection of bacteriuria in 865 pregnant women. As reference method agar culture
      was performed. Heavy growth (greater than 10(5) CFU/ml) of urinary tract bacteria
      was considered a true positive result and demonstrated in 58 (6.7%) of the women,
      14 of whom had gram-negative rods. The sensitivity of the nitrite test was
      extremely low (0.13). The test gave negative results in eight of 17 specimens
      yielding heavy growth of Escherichia coli or Proteus mirabilis. Although the
      Urobact test was highly sensitive as regards gram-negative infection, it had an
      unacceptably low (0.27) predictive value in positive tests. The sensitivity of
      the Uricult test was low (0.35) in this study. The predictive value (0.50) of a
      positive test result may be acceptable, since just over half of the false
      positive results were explainable by moderate growth of urinary tract pathogens
      (10(4)-10(5) CFU/ml). It is argued that semi-quantitative urine culture may be
      preferable to the rapid diagnostic methods studied for the screening of
      bacteriuria in pregnant women.

PMID- 2218160
TI  - Doctors in a white coat--what do patients think and what do doctors do?
AB  - Patients and general practitioners in northern Norway were asked their opinion on
      the doctors' use of a white coat in the consultation. 51.9% of the patients
      wanted their doctor not to wear a white coat, whereas 11.7% of the doctors never
      wore one. 5.7% of the doctors' staff members never wore a white coat. The
      patients' preferences were to some extent related to their own doctors' use of a
      white coat, and there was a significant increase in the demand for a white coat
      with increasing age of the patients.

PMID- 2218159
TI  - Intravenous urography versus ultrasonography in evaluation of women with
      recurrent urinary tract infection.
AB  - Intravenous urography and ultrasonography were compared prospectively in 120
      women with recurrent urinary tract infection. The median age was 44 years (range
      15-85). There was good correlation between the two methods in detecting
      hydronephrosis, calculi greater than or equal to 5 mm, and major post
      pyelonephritic scarring. Urography was superior in detecting small cortical
      scars, slight caliceal dilatation, and less than or equal to 4 mm calculi. Based
      on the good results, low cost, and absence of radiation hazards or contrast media
      reactions, we conclude that ultrasonography may replace urography when a
      radiological screening of the upper urinary tract is deemed necessary in women
      with recurrent urinary tract infection.

PMID- 2218162
TI  - In honour of Professor Peter Armitage.

PMID- 2218161
TI  - Health problems in Norwegians travelling to distant countries.
AB  - 373 travellers to countries outside Europe and North America were recruited
      before departure summer 1988 at the Vaccination Office, Trondheim, Norway, and
      participated in a follow-up study on health problems related to travel. 313 of
      the travellers (84%) responded by answering a postal questionnaire one month
      after return; it dealt with prophylactic measures, life-style, and health
      problems associated with travelling. An 18% failure in malaria prophylaxis and
      some risk-taking behaviour related to alcohol and sex were recorded. Diarrhoea
      (usually mild) was reported by 59%; other symptoms were also frequent. Medical
      advice was sought by 18% while abroad; 7% consulted a doctor. Ill health made
      travelling less enjoyable than expected for 8%. After return, 25% had health
      problems; 9% saw a doctor, three travellers were hospitalized, and 6% were absent
      from work. Total morbidity was high, but seldom serious. Targeted advice, which
      can well be given by primary health care personnel, could help to reduce
      morbidity and risk behaviour and improve travellers' handling of ill health.

PMID- 2218163
TI  - Sequential stopping rules in clinical trials.
AB  - This paper reviews aspects of the development of sequential analysis of clinical
      trial data in medicine and suggests simple strategies for progress. The emphasis
      is on the pragmatic and ethical requirements of aspects of the design of phase
      III trials and in circumstances of genuine uncertainty characterized by much
      clinical experimentation. In particular consideration is given to the
      consequences of determining sample sizes from incorrect estimates of treatment
      effects. Armitage's work on sequential trials is traced to simple group
      sequential procedures based on repeated significance tests to minimize expected
      sample sizes in a wide class of experimental situations.

PMID- 2218164
TI  - Must clinical trials be large? The interpretation of P-values and the combination
      of test results.
AB  - The notion that small, well planned clinical trials may not be worth undertaking
      is shown to arise from an overemphasis on just one way of interpreting P-values.
      Alternative forms of P and other interpretations are put forward. Attention is
      drawn to some aspects of the theory of hypothesis testing which seem less well
      known than they should be.

PMID- 2218165
TI  - How much further investigation?

PMID- 2218166
TI  - Measuring importance.

PMID- 2218167
TI  - Repeated measurements: what is measured and what repeats?
AB  - This paper expresses a personal view of experiments involving repeated
      measurements; it attempts to classify types of experiment and approaches to
      statistical analysis: no novel procedures are proposed, only a systematic outlook
      on objectives and methods.

PMID- 2218168
TI  - Randomized consent designs for clinical trials: an update.
AB  - Randomized consent designs were introduced to make it easier for physicians to
      enter patients in randomized clinical trials. Physician reluctance to participate
      in randomized clinical trials is often a reflection that the physician-patient
      relationship could be compromised if the physician makes known to the patient
      his/her inability to select a preferred therapy. Clinical trials having a no
      treatment control or placebo amplify this concern. This paper reviews the main
      ideas of randomized consent designs (single and double) and the statistical model
      underlying the analysis, and presents some recent experiences.

PMID- 2218169
TI  - Peter Armitage: a personal recollection.

PMID- 2218170
TI  - The Armitage-Doll multistage model of carcinogenesis.

PMID- 2218171
TI  - Time from infection with HIV to onset of AIDS in patients with haemophilia in the
      UK.
AB  - The two-stage parametric regression model of Brookmeyer and Goedert has been
      adapted and fitted to data on the development of AIDS in haemophiliacs in the UK
      who are seropositive for HIV. The risk of developing AIDS by a given time
      following seroconversion increases with increasing age at seroconversion. It is
      likely that the risk increases smoothly with age, although the data have been
      analysed in three age categories, and it is estimated that by seven years after
      seroconversion 6 per cent of patients aged under 25 at seroconversion, 20 per
      cent of those aged 25-44 and 34 per cent of those aged 45 or more have developed
      AIDS. For a given age at seroconversion the annual risk of developing AIDS
      increases with increasing time after seroconversion, and at seven years the
      annual risks of developing AIDS during the next year in the three age groups are
      estimated to be 2 per cent for those aged less than 25 at seroconversion, and 10
      and 11 per cent respectively for those aged 25-44 and 45 or more.

PMID- 2218172
TI  - An application of density estimation to geographical epidemiology.
AB  - A relative risk function over a geographical region is defined and it is shown
      that it can be estimated effectively using kernel density estimation separately
      for the spatial distribution of disease cases and for a sample of controls. This
      procedure is demonstrated using data on childhood leukaemia in the vicinity of
      the Sellafield nuclear reprocessing plant in Cumbria, U.K. Various modifications
      to the method are proposed, including the use of an adaptive kernel. The final
      plot demonstrates a sharp peak at Sellafield and a reasonably smooth surface over
      the rest of the region, despite the small number of cases in the series.

PMID- 2218173
TI  - The summarizing of clinical experiments by significance levels.
AB  - For a controlled clinical experiment in which two alternative treatments are
      compared, the statistical report often culminates in a significance test of the
      null hypothesis of no difference between the treatments, and significance at the
      5 per cent level is taken as positive evidence of difference. It is argued that
      such an experiment serves primarily an inferential purpose; it is not a simple
      decision procedure, although its effect on practice may be considered in relation
      to ethical issues. Statistical inference should not be identified with testing
      this null hypothesis, despite the emphasis on such tests by R. A. Fisher in his
      work on design of experiments. This null hypothesis often has no interest or
      credibility.

PMID- 2218174
TI  - Bibliography. Publications of Peter Armitage to December 1989.

PMID- 2218176
TI  - Further papers from the International Society for Clinical Biostatistics
      international meetings. Gothenburg, Sweden, September 1987 and Innsbruck,
      Austria, August-September 1988. Proceedings.

PMID- 2218175
TI  - HIV infection dynamics and intervention experiments in linked risk groups.
AB  - A multigroup transmission model is described to study the spread of the human
      immunodeficiency virus (HIV) in linked risk groups. The model permits
      simultaneous investigation of the increase in the number of persons infected with
      HIV in three main risk groups: promiscuous homo/bisexual men (two levels of
      promiscuity), intravenous drug users (men and women) and promiscuous heterosexual
      men and women. Three modes of transmission are considered: anal and vaginal
      intercourse and needle sharing. The high dimensional parameter space is connected
      with the HIV incidence through a transmission matrix. This matrix summarizes the
      annual effective contact rates due to the three transmission modes. The model
      helps to clarify which data are needed to disentangle the relative contribution
      of the within- and between-group transmission routes. The model can be used to
      perform theoretical experiments. Given a specification of a baseline, the
      potential use of the model is illustrated by a simulation describing the effect
      of blocking the transmission through needle sharing. Reference is made to the
      HIV/AIDS epidemic in The Netherlands. The results of the study show that the
      model can play a part in the classification of HIV prevalence patterns in linked
      risk groups, in the study of the interaction between the main risk groups and in
      the theoretical evaluation of intervention measures.

PMID- 2218177
TI  - Long term survival analysis: breast cancer and age at diagnosis.
AB  - The role of age at surgery of breast cancer patients as a determinant of relative
      survival after making allowance for clinical profile was investigated on a case
      series of 716 women followed for more than 20 years in one single institution.
      Multiplicative and additive models for grouped data were adopted to model the
      standardized mortality ratio and the excess death rate respectively. The models
      were fitted by the GLIM system assuming a Poisson error function. We conclude
      that operable breast cancer has a relatively lower impact on total mortality in
      older patients (65 years or more) than in younger ones and, moreover, the older
      patients have a more favourable course.

PMID- 2218178
TI  - Statistical analysis of quality of life data in cancer clinical trials.
AB  - In clinical trials endpoints other than total and/or disease-free survival are
      gaining more and more interest. In particular, quality of life (QOL) or the well
      being of patients has emerged as a synonym for variables describing the
      subjective reactions of patients towards their disease and its treatment. The
      statistical analysis of such QOL data is complicated firstly by the large number
      of variables measured and their obvious lack of objectivity. The construction of
      suitable aggregate measures allowing a reduction of the measurements into a
      (preferably) unidimensional index are discussed in the context of an analysis at
      a fixed time point during the course of treatment. A second problem arises from
      the consideration that a patient's well-being is subject to changes over time. We
      discuss the modelling of QOL by suitable stochastic processes which are
      extensions of a multistate disease process. This allows QOL events to be
      incorporated into methods of survival analysis by either estimating the relevant
      transition probabilities between states or calculating quality-adjusted survival
      times. Finally, some brief guidelines for the planning of clinical trials
      including QOL measurements will be proposed.

PMID- 2218179
TI  - The design of case-control studies: the effect of confounding on sample size
      requirements.
AB  - This paper considers the extent to which confounding effects of covariates, which
      are not controlled for by matching in the design, may influence the sample size
      necessary for case-control studies. The quantitative calculations are performed
      for an age-matched case-control study on lung cancer and air pollution, and are
      based on different evaluation methods. For illustrative purposes attention is
      confined to a dichotomous risk factor and a single dichotomous covariate. By
      using the numerical values of a pilot study investigating lung cancer and air
      pollution, it turns out that the sample size required for detecting a relative
      risk as close as 1.15 to 1 is only slightly influenced by the strength of the
      association between confounder and risk factor for reasonable variations around
      our empirical values. On the other hand, sample size considerably increases with
      increasing relative risk of a confounder even when the association remains small.
      The sample size required for an individually matched analysis practically equals
      that for an age-stratified analysis when the relative risk of the covariate is
      one. With a relative risk greater than one, however, the size for a matched
      analysis exceeds that for a stratified analysis and the ratio between them
      increases with increasing relative risk.

PMID- 2218181
TI  - CTS: a clinical trials simulator.
AB  - We describe an interactive clinical trial simulation program (CTS), which
      provides continuous graphical and numerical output as a simulation runs. CTS is
      capable of simulating trials with two treatment groups and a binary outcome with
      options for: (1) up to five prognostic subgroups; (2) one of three methods of
      randomization; (3) equal or unequal allocation of patients to treatment groups;
      (4) a null or alternative hypothesis; (5) common methodological problems
      including biased referrals, false positive and false negative outcome reports,
      non-compliance, dropouts, crossovers, and co-interventions; (6) six methods of
      dealing with each of these problems; (7) the type I error rate, and (8)
      stratified or unstratified analysis. In addition, the current results of a trial
      in progress may be used as the starting point of the simulation to estimate the
      power of the trial if carried to completion. A few thousand simulations of a user
      specified scenario is typically entered and executed in about 5 minutes,
      permitting a student or clinical investigator to explore a variety of scenarios.

PMID- 2218180
TI  - Efficient evaluation of treatment effects in the presence of missing covariate
      values.
AB  - In clinical trials, treatment comparisons are often performed by models that
      incorporate important prognostic factors. Since these models require complete
      covariate information on all patients, statisticians frequently resort to
      complete case analysis or to omission of an important covariate. A probability
      imputation technique (PIT) is proposed that involves substituting conditional
      probabilities for missing covariate values when the covariate is qualitative.
      Simulation results are presented which demonstrate that the method neither
      violates the size of the treatment test nor introduces additional bias for the
      estimation of the treatment effect. It allows use of standard software. A
      clinical trial of breast cancer treatment, in which an important covariate was
      partly missing, was analysed by Cox's model. The use of PIT resulted in smaller
      observed error probability compared with case deletion, and sensitivity analysis
      supported these results.

PMID- 2218182
TI  - A Markovian model for comparing incidences of side effects.
AB  - For clinical trials that entail observations at successive visits for the
      occurrence of a side effect, this paper considers a likelihood-based method to
      compare side effect incidence rates. The method, which employs the assumption of
      a Markov chain of order one for the vectors of binary responses, handles missing
      data due to premature withdrawals. An actual numerical example and a simulated
      example illustrate the technique.

PMID- 2218183
TI  - More powerful procedures for multiple significance testing.
AB  - The problem of multiple comparisons is discussed in the context of medical
      research. The need for more powerful procedures than classical multiple
      comparison procedures is indicated. To this end some new, general and simple
      procedures are discussed and demonstrated by two examples from the medical
      literature: the neuropsychologic effects of unidentified childhood exposure to
      lead, and the sleep patterns of sober chronic alcoholics.

PMID- 2218184
TI  - Applications of global statistics in analysing quality of life data.
AB  - Quality of life (QOL) instruments usually consist of a number of components, each
      of which deals specifically with a particular functionally related dysfunction.
      In a clinical trial whose primary aim is the evaluation of the treatment by means
      of QOL instruments, analysis of each of the components usually consists of either
      univariate analysis of variance (ANOVA) or some non-parametric methods. This
      multiple testing approach can produce an increase in false positive findings. One
      attempt to correct for this is the Bonferroni adjustment. Another approach is to
      apply global statistics (parametric or non-parametric) for the null hypothesis of
      no treatment difference versus the alternative hypothesis that one treatment is
      uniformly better than the other for QOL instruments as a whole. Data from a
      randomized double-blind trial of 111 congestive heart failure patients, which
      involved four QOL instruments, were analysed with univariate ANOVA, Bonferroni
      adjustment, parametric and non-parametric global statistics. The global
      statistics complemented the univariate methods and made the presentation of QOL
      data very effective. I recommend the general use of global statistics in analysis
      of QOL data.

PMID- 2218185
TI  - A stratified Wilcoxon-type test for trend.
AB  - We propose an extension of Cuzick's non-parametric Wilcoxon-like trend test for
      situations when the observations can be grouped into strata which are thought to
      be related to the outcome. We illustrate its use in two examples from cancer
      epidemiology.

PMID- 2218186
TI  - A two-step method for understanding and fitting growth curve models.
AB  - With data from a repeated measures design, analysts often overlook growth curve
      analysis based on the Potthoff-Roy model. The reluctance to perform a growth
      analysis may result partially from unfamiliarity with the technique, and
      partially from the lack of readily available computational programs to fit the
      models. Although growth curve analysis has traditionally appeared as a special
      technique in multivariate analysis, one can fit the models with the use of two
      simple ideas: transformation of variables, and weighted least squares (WLS). When
      presented in this manner, growth models are a natural extension of univariate
      repeated measures models. Growth curve analyses share with univariate analyses
      the common objective to limit estimation to a parsimonious set of parameters that
      characterize the response profiles. One can readily fit models with commonly
      available software. The two-step methodology also allows the fit of more general
      growth models that are appropriate when groups have different shape profiles. Two
      examples illustrate this approach to growth curve analysis.

PMID- 2218187
TI  - Poisson regression as an alternative to person-time logistic model.

PMID- 2218188
TI  - The impact that group sequential tests would have made on ECOG clinical trials.

PMID- 2218189
TI  - Remembrances of Max Halperin.

PMID- 2218190
TI  - Historical and methodological developments in clinical trials at the National
      Cancer Institute.
AB  - The first randomized clinical trial at the National Cancer Institute (NCI),
      planned in 1954, commenced in 1955 for the treatment of patients with acute
      leukaemia. The programme in clinical trials at NCI had strong influence from the
      clinician and administrator, C. Gordon Zubrod, who introduced the randomized
      clinical trial at NCI and organized the co-operative clinical trials programme of
      the Cancer Chemotherapy National Service Center (CCNSC) beginning about 1955. The
      biostatistician, Marvin Schneiderman, collaborated on the first randomized trials
      in acute leukaemia and solid tumours and recruited the biostatisticians and
      statistical centres in the early phase of the co-operative clinical trials
      programme of the CCNSC. From the beginning, there was acceptance of the
      principles of the randomization of patients and the statistical analysis of data.
      The sequence of clinical trials for a new agent included the non-randomized phase
      I (dosage finding) and phase II (preliminary efficacy) trials as well as the
      phase III (comparison of treatments) trials. New concepts for the treatment of
      patients developed from 1955 to the mid-1960s included the combination of
      therapies with independent activity to increase response rates and the
      administration of therapy to patients in a disease-free (remission) state to
      prolong the disease-free state. Methodological developments related to clinical
      trials up to the mid-1960s included: a plan for phase II trials (Gehan); a
      generalization of the Wilcoxon test for the comparison of survival distributions
      with right-censored data (Gehan); a test of proportional hazards for survival
      distributions, which later became known as the Mantel-Haenszel test (Mantel), and
      an exponential regression model with an explanatory variable (Feigl and Zelen).

PMID- 2218192
TI  - Some historical and methodological developments in early clinical trials at the
      National Institutes of Health.
AB  - This paper reviews five randomized clinical trials with unusual design or
      analysis features from institutes other than the National Cancer Institute or the
      National Heart, Lung and Blood Institute. These are: a Cooperative Study of
      Retrolental Fibroplasia sponsored by the National Institute of Neurological
      Diseases and Blindness; the Diabetic Retinopathy Study sponsored by the National
      Eye Institute; the University Group Diabetes Program sponsored by the National
      Institute of Arthritis and Metabolic Diseases; a Clinical Trial of the
      Extracranial to Intracranial Arterial Anastomosis (EC/IC bypass) by the National
      Institute of Neurological and Communicative Disorders and Stroke; and the
      Clinical Trial of Hereditary Angioedema by the National Institute of Allergy and
      Infectious Diseases.

PMID- 2218191
TI  - Early methodological developments for clinical trials at the National Heart, Lung
      and Blood Institute.
AB  - The National Heart Institute, now known as the National Heart, Lung and Blood
      Institute (NHLBI), initiated its first multicentre randomized clinical trials of
      rheumatic fever and rheumatic heart disease in 1951. The modern era of
      multicentre trials began, however, when the Coronary Drug Project was initiated
      in the 1960s. This trial and subsequent NHLBI trials stimulated a wide variety of
      research on clinical trial methodology. This paper reviews early methodologic
      developments in four areas. First, an organizational structure for multicentre
      clinical trials was developed and codified in the 'Greenberg Report' in 1967.
      Second, design considerations related to patient risk, non-compliance, a lag in
      treatment effect, and changing risk were explored. The 'intention-to-treat'
      principle was implicit in these investigations. Thirdly, the concept of periodic
      review of accumulating data, recommended in the Greenberg report, stimulated
      research on methods for sequential analysis. Three statistical approaches were
      developed and investigation of their statistical properties continues today.
      These approaches are usually described as group sequential, stochastic
      curtailment, and Bayesian methods. Finally, comparison of treatments in
      longitudinal studies has been an increasing part of NHLBI research and methods
      have been developed for design and analysis of longitudinal studies.

PMID- 2218193
TI  - Application of the triangular test to phase II cancer clinical trials.
AB  - Phase II cancer clinical trials are primarily designed to determine whether the
      response rate p to the treatment under study is greater than a specified value
      p0, that is to test the null hypothesis H0: p less than or equal to p0 against an
      alternative hypothesis H1 : p greater than p0 specified by p = p1. As an
      alternative to the single and multistage procedures and to Wald's continuous
      sequential probability ratio test (SPRT), we applied the group sequential methods
      proposed by Jones and Whitehead, namely the triangular test (TT) and the discrete
      SPRT, to the comparison of p with p0, and we expressed H0 and H1 in terms of the
      log odds-ratio statistic log [p(1 - p0)/p0(1 - p)]. A stimulation study showed
      that both the TT and the discrete SPRT had type I error and power close to the
      nominal values, and they compared favourably with multistage methods in terms of
      the average sample size.

PMID- 2218194
TI  - Hierarchical models for multicentre binary response studies.
AB  - A three-stage hierarchical model is proposed for two treatment, binary response
      studies conducted in a number of centres. The approach adopted is Bayesian.
      Marginal densities for second stage parameters are shown to provide useful
      summaries both of comparative efficacy and of the heterogeneity of treatment
      effects across centres. Sensitivity studies of model assumptions are illustrated.

PMID- 2218195
TI  - The measurement of change of quality of life in clinical trials.
AB  - A model is presented for the measurement of change of quality of life in clinical
      trials with time under the influence of one or more treatments. Quality of life
      is regarded as a multidimensional latent variable, and is measured through
      dichotomous item responses on a number of points in time. Change of quality of
      life is 'explained' with a latent logistic regression model which may include
      parameters for the time process, the effects of clinical treatments, and
      interaction parameters. By assuming the absence of patient/time interaction
      within treatment groups, the parameters of the time process and the treatment
      effects can be estimated independently of the latent quality of life parameters
      at the start of the treatment. Consequently, differential mortality, censoring
      mechanisms, and other mechanisms causing missing data can be ignored.

PMID- 2218196
TI  - Assessing the gain in efficiency due to matching in a community intervention
      study.
AB  - COMMIT (Community Intervention Trial for Smoking Cessation) is a randomized study
      employing a matched pairs design. Pairs of communities were selected on the basis
      of their geographical proximity and were chosen to be matched on variables
      strongly expected to relate to the outcome variable, the smoking quit rate.
      However, quantitative information was not available to evaluate the efficiency
      gain from matching. We have used baseline smoking quit rates in the communities
      as a surrogate for the outcome measure to evaluate the gain in efficiency from
      the matching. Our method takes account of the possible imperfection of the
      surrogate as a representative of the true outcome. The method estimates an
      efficiency gain of at least 50 per cent using the matched design. We also
      evaluate the further gains in efficiency which would be made by using the
      baseline quit rate to balance the randomization.

PMID- 2218198
TI  - Estimating benefits of screening from observational cohort studies.
AB  - Analysis and interpretation of observational studies of screening effectiveness
      is difficult because several biases threaten validity, including the structural
      healthy screenee bias, length bias, and effects of lead time. Although methods
      for the analysis of observational studies of screening effectiveness have been
      proposed, most have limitations such as incomplete control of length bias, or a
      heavy reliance on distributional assumptions. In this report we present a method
      for the analysis of observational cohort studies of screening effectiveness.
      Although developed independently and formulated specifically for estimating
      benefits of screening, our approach is implied by a more general approach
      developed previously by Robins. Our approach, in contrast to other available
      methods, avoids the healthy screenee bias, and length and lead time bias, and
      allows an empirical approach to analysis that need not depend highly on
      distributional assumptions. We illustrate application of the approach with
      analysis of published data from a study of breast cancer screening.

PMID- 2218197
TI  - Modelling forces of infection for measles, mumps and rubella.
AB  - Serological data from 8870 persons collected prior to the introduction of
      measles, mumps and rubella (MMR) vaccine in the UK are used to describe the rate
      at which individuals acquire infection by these diseases at different ages. A
      parsimonious model is developed and fitted under various interpretations of the
      data, particularly concerning the probability of lifelong susceptibility to
      infection. It is shown that, while the force of infection curves are relatively
      robust in their general features, they exhibit considerable sensitivity in
      matters of important detail. This is true in particular of the values taken by
      the force of infection in older age groups. As a result, estimates of the average
      age at infection are highly sensitive to these interpretations. This in turn may
      limit the accuracy of predictions from mathematical models based on these
      parameters, in particular regarding the level of immunization required for
      eradication of disease.

PMID- 2218199
TI  - The use of logit models to investigate social and biological factors in infant
      mortality. V: A multilogit analysis of stillbirths, neonatal and post-neonatal
      mortality.
AB  - Infant mortality data for England and Wales, cross classified by mother's age,
      parity and social class were published for 1949/50 and 1975. Previous analyses of
      these data have been based on graphical, tabular and logit models of stillbirths,
      neonatal and post-neonatal deaths separately. This paper summarizes the overall
      changes in infant mortality using a multilogit model. The model selected is
      illustrated by appropriate graphical presentations.

PMID- 2218200
TI  - Proportion cured and mean log survival time as functions of tumour size.
AB  - We obtained maximum likelihood estimates (MLEs) of the proportion cured pi c and
      mean log survival time mu t for a sample of 4355 patients with intraocular
      melanoma whose survival times subsequent to treatment were assumed to follow a
      log-normal distribution. Following stratification by tumour size, MLEs of pi c
      and mu t derived for each stratum correlate inversely with tumour size. We then
      expressed pi c and mu t as continuous functions of tumour size and calculated
      MLEs for the parameters of these functions from the entire sample. This
      investigation documents for ocular melanoma a significant relationship of tumour
      size to both cured fraction and mean log survival time.

PMID- 2218201
TI  - Homecare at the end of life. A study of fifteen patients.
AB  - The study is a part of a research project on death in a sector of a large city,
      involved cooperation with the Franciscan Aid "home care team". The purpose was to
      study death in the home setting. Fifteen deaths were registered. Participant
      observation in the care of 14 patients were made--a total of 83 visits to homes,
      2-15 visits per patient. In one case the author had contact with the relatives,
      after the death had occurred. Most of the patients had cancer. Their age varied
      from 28 to 80 years. The observations were recorded immediately after each visit.
      After the death of a patient a structured interview with the closest relatives
      and the nurse responsible were made. Their statements were used as a basis for
      formulating problems for the further study and the clarification of quantitative
      data. Results showed that the patients who chose to leave the hospital and remain
      at home often had negative experiences in hospital. All the patients in this
      study received good palliative treatment at home. All patients were also informed
      about their condition. One-third of the patients were readmitted to hospital
      during the final days.

PMID- 2218202
TI  - Uniform guidance for medical care. A description of the process for preparing
      guidelines accepted by different levels of care.
AB  - Advice by telephone is an important part of primary health care service.
      Telephone advice is given at different levels of care. In order to give people
      confidence in the health care system it is important that personnel at different
      levels give similar advice for the same symptom or complaint. In order to
      establish generally accepted guidelines, discussions were held between personnel
      at different levels of care. This procedure was laborious but successful.
      Generally accepted guidelines could be agreed upon for all the symptoms and
      complaints discussed, altogether more than 60. This paper describes the procedure
      used during the collaborative work to provide these guidelines. It must be
      emphasised, though, that the guidelines should be adapted to local circumstances
      before being used as a practical aid in the health care service at health centres
      and at other outpatient units.

PMID- 2218203
TI  - Prevalence and characteristics of persons with dependency on feeding at
      institutions for elderly.
AB  - The prevalence of dependency on feeding was estimated in 3,607 residents cared
      for in old people's homes, nursing homes, somatic long-stay clinics, psychiatric
      long-stay wards and psychogeriatric wards. Ten per cent of the residents were
      found to be dependent on the staff to eat. The highest proportion was found in
      nursing homes and somatic long-stay clinics. A considerably larger proportion of
      the residents with dependency on assisted feeding imposed the highest workload on
      the staff. Residents who were totally dependent on assisted feeding were more
      disabled with regard to other ADL functions and also they were demented more
      often. Loss of the ability to eat was related to an inability in other ADL
      functions. Support was gained for a hierarchical loss of ADL functions as
      suggested by Katz & Apkom. Feeding problems seem to be a terminal phenomenon in
      demented patients.

PMID- 2218204
TI  - Patient-nurse interactions: relationships between person characteristics,
      empathy, content of communication, and patients' emotional reactions.
AB  - Relationships between antecedent person variables (sex and age), empathic
      understanding, content of communication, and patients' emotional reactions were
      studied in 3200 patient-assistant nurse dyadic interactions. The sample consisted
      of 32 psychiatric patients (20 males and 12 females, mean age: 61 years) and
      eight female assistant nurses at a nursing-home in Sweden. Four assistant nurses
      were younger (25 years old or less) and four were older (45 years old or more).
      All interactions were regular morning meetings at which the patient's activity
      plans for the day were discussed. These meetings were held in each patient's
      private room, and lasted for about 15 min. High empathic understanding on part of
      the helper covaried with more communication of "everyday character" and
      communication dealing with "personal and emotional qualities", with less
      communication dealing with "facts and practical issues", and with a more cheerful
      emotional state among the patients during the encounters. Male patients were more
      cheerful during encounters with younger assistant nurses while female patients
      were more cheerful when interacting with older assistant nurses. Helpers with
      higher scores on empathic understanding seemed to have a higher awareness of
      relational history.

PMID- 2218205
TI  - [Emphysematous pyelitis and pyelonephritis: unrecognized clinical entities].
AB  - A case of emphysematous pyelitis occurring in an old diabetic woman is described.
      The data of the literature about the pathologic agents, the epidemiology and the
      physiopathology of the disease are reviewed. The approach for diagnosis and the
      therapy are discussed.

PMID- 2218206
TI  - [Peri-colostomy hemorrhage due to portal hypertension secondary to hepatic
      metastasis of a rectal adenocarcinoma. Apropos of a case report. Literature
      review].
AB  - The authors present a case report of recurrent peristomal variceal bleeding
      resulting from portal hypertension induced by hepatic metastases of a rectal
      cancer. They propose mucocutaneous disconnection as a simple and effective
      palliative surgery in order to prevent new bleeding. Discussion is based on a
      review of the literature and illustrates the different therapeutic options for
      this complication.

PMID- 2218207
TI  - [Differential diagnosis of giant-cell bone tumors].
AB  - Beyond the "myeloplax tumor", other tumoral bony lesions, essentially benign,
      present "osteoclast-like" giant multinuclear cells at the time of the anatomo
      pathologic examination. Generally, the differential diagnosis of these bony
      lesions with giant cells is due to the conjunction of several data such as the
      age of appearance of the lesion, bony location, radiological aspect,
      anatomopathological aspect, etc.

PMID- 2218208
TI  - [Sudden death in athletes].
AB  - In France, about one of ten thousand athletes die suddenly each year. Although
      this is a small proportion of the number of total deaths, it is a striking one
      because of the subjects it concern e.g: healthy and physically trained. Age is
      the major determinant cause of sudden death: coronary heart disease in victims
      over 35 years, hypertrophic cardiomyopathy, congenital disease and aortic rupture
      before. Positive predictive value of usual tests is given; high value of
      echocardiography is to be noted, in comparison with low value of the traditional
      stress test for detection of subjects at risk.

PMID- 2218209
TI  - [Current progress in antifungal therapy: the value of fluconazole].
AB  - Invasive fungal infections are major problems in immunocompromised patients and
      optimal therapeutical modalities are still far from optimal. Recently, progresses
      of antifungal therapy have been achieved with the development of new antifungal
      agents. In particular, fluconazole seems very promising due to the availability
      of oral and intravenous formulations. Tolerance and compliance of patients are
      excellent and side effects as well as interaction with other drugs are less
      commonly observed than with other antifungal agents available so far. The major
      indications of fluconazole are candidiasis and cryptococcosis.

PMID- 2218210
TI  - [Spastic colon: a multi-factorial pathology, a polyvalent therapy].
AB  - Irritable bowel syndrome represent the most common gastrointestinal disease. It
      is characterized by abdominal pain, distension and abnormalities of intestinal
      transit. It is a functional disorder determined by emotional stress and by diet.
      The treatment is polyvalent, dietary, medicinal and psychological. In the
      medicinal domain the anti-spasmodics (anti-nicotinic and musculotropic),
      represent the first choice weapons in association or not with an anxiolytic, an
      anti-depressor, even an antalgic in the acute phase.

PMID- 2218211
TI  - [Diuretics: mechanism of action and therapeutic indications].

PMID- 2218212
TI  - [Opioid peptides and obesity].

PMID- 2218213
TI  - [Hepatic fibrosis with cirrhogenous development in chronic vitamin A poisoning].

PMID- 2218214
TI  - [Collagenous colitis, achlorhydric gastritis and IgG deficiency].

PMID- 2218216
TI  - [Pharmacotherapy in the elderly].

PMID- 2218215
TI  - [Protothecosis and chlorellosis, 2 infections induced by algae].

PMID- 2218217
TI  - [Hyperthyroidism in the elderly].
AB  - Hyperthyroidism is a frequent disease in elderly people. Its diagnosis is often
      difficult, as its clinical presentation is atypical, with few symptoms. Results
      of laboratory tests can be difficult to interpret, because of physiological
      changes due to old age, and small abnormalities. Diagnostic and therapeutic
      procedures, as a function of aetiology, are discussed.

PMID- 2218218
TI  - [Diabetes in the elderly. Reflections by a practitioner in diabetology].
AB  - Above 70 years of age, it is no more necessary to be obsessed by the prevention
      of late complications in introducing an intensive treatment. A symptomatic one,
      particularly with insulin is more appropriate. Before treating diabetics it is
      necessary to search symptomatically for aggravating factors like the use of
      thiazide or intercurrent diseases.

PMID- 2218219
TI  - [What is your diagnosis? Pre-excitation syndrome with consecutive repolarization
      disorder].

PMID- 2218221
TI  - [The skin of the aged].
AB  - This is a review of physiological changes and photo-aging of the senescent skin
      and of their clinical aspects. It also contains a discussion of the origins
      pruritus in elderly people.

PMID- 2218220
TI  - [Treatment of arterial hypertension in the elderly person: unresolved problems].
AB  - There is not increasing evidence that, from an epidemiological stand-point,
      treatment of diastolic hypertension in the elderly leads to a significant
      cardiovascular risk reduction; however, for the individual patient, the magnitude
      of absolute risk reduction is relatively small. More widespread use of ambulatory
      blood pressure recording is suggested in order to improve patient selection -
      i.e. to avoid antihypertensive treatment in patients with white coat hypertension
      - and to prevent overtreatment in patients with established hypertension. This
      strategy should result in a selection of elderly, hypertensive patients who are
      more likely to benefit from pharmacological treatment and thus restrict the
      number of patients needing treatment for prevention of a cardiovascular
      complication. Furthermore, by decreasing the risk of overtreatment, this strategy
      is likely to result in a decrease in the number of medication-related side
      effects such as coronary morbidity and mortality.

PMID- 2218223
TI  - [Heart and heart-lung transplantation].

PMID- 2218222
TI  - [What is your diagnosis? Generalized hydroxyapatite disease].

PMID- 2218224
TI  - [Prevention of HIV infection in the methadone program. A study of a drop-in
      clinic in Zurich].
AB  - We were able to show for 21 patients who were all HIV-negative at the beginning
      of the methadone maintenance program of the Drop-in in Zurich that they remained
      HIV-negative over an average period of 34 months. At the beginning of the program
      48% of the patients had a good social integration with few contacts to the drug
      scene for buying or selling drugs. During the program this figure increased to
      90%. Before starting the program 43% of these HIV-negative patients were at high
      risk (needle sharing). During the maintenance program 57% of the patients became
      clean of heroin and 76% clean of cocaine. The remaining obviously abstained from
      needle sharing due to a continuous information concerning HIV-prevention. We
      conclude that a well structured methadone maintenance program with a close,
      consistent and enduring relationship between staff and patients can be of great
      importance in HIV-prevention among IV drug abusers.

PMID- 2218225
TI  - [Arthritis of the hip associated with infantile toxocariasis].
AB  - A parasitic origin of rheumatological manifestations is only suspected if the
      patient returns from an endemic area of the world. We report a young girl who
      developed without travelling, an isolated hip arthropathy simultaneously with a
      Toxocara infestation. Pathogenesis is discussed.

PMID- 2218226
TI  - [The current significance of spinal cord stimulation in the framework of
      functional neurosurgery].
AB  - Spinal cord stimulation (DCS) has proved effective in different types of
      Deafferentation Pain. Long-term results are good in 60-85% of cases. DCS improves
      microcirculation and ischemia in cases of inoperable peripheral vascular
      diseases. Advantages of this method are: Absence of severe complications and
      estimation of the effect during the test phase. - Nevertheless, other
      neurosurgical possibilities (destructive pain surgery, spinal/cerebral
      application of medicaments) continue to preserve their indications.

PMID- 2218227
TI  - [Severe vomiting, diarrhea].
AB  - Because of heavy vomiting and a watery diarrhoea after consumption of two Amanita
      phalloides mushroom taken in suicidal attempt this 31-year old female patient
      came to our emergency ward. The diagnosis being clear a therapy with stomach
      irrigation, substitution of fluid and electrolytes as well as application of
      penicillin and Silibinin was begun. The toxin concentration in the urine was not
      too high and the Quick value did not fall to low. The course was benign and the
      patient could leave the hospital only a few days later.

PMID- 2218228
TI  - [A case from practice (187). Lactose intolerance].

PMID- 2218229
TI  - [A case from practice (188). Temporal lobe epilepsy. Arterial hypertension.
      Obesity].

PMID- 2218231
TI  - [From curative to preventive medicine: integral prevention as exemplified by
      cardiology].

PMID- 2218230
TI  - [What is your diagnosis? Herpes zoster].

PMID- 2218232
TI  - [Primary prevention of coronary heart disease: possibilities and limitations].
AB  - Cardiovascular diseases are still the most important cause of death in
      industrialized countries. In spite of enormous progress regarding prevention,
      diagnostic and therapeutic procedures, coronary heart disease remains the most
      important cardiovascular cause for early invalidity, professional inactivity and
      premature death. The direct and indirect costs of cardiovascular diseases amount
      to 14.8% of total disease-related costs. The practicing physician has an
      important role to play in the prevention of cardiovascular diseases. In order for
      the physician to understand his critical role and to act accordingly, some
      fundamental epidemiological principles are introduced. Particularly, the notion
      of population attributable risk is important: As a consequence for the health of
      whole population groups, it is as important to advise the many at intermediate
      risk as the few at high risk of a cardiovascular accident. The future challenges
      are clear. This disease group is to a large extent preventable; efficient
      intervention models, both on an individual and on a community level, are
      available.

PMID- 2218233
TI  - [Nutrition and hypertension: what are the goals?].
AB  - The dependence of blood pressure on nutritional factors is reviewed in the light
      of possible therapeutic consequences. Salt restriction, increased administration
      of potassium, restriction of alcohol intake, weight loss and prescription of fish
      oil are discussed by review of own and published data. All these measures may
      contribute to a reduction of hypertension although to a variable extent. They
      should be envisaged as therapeutic alternatives to drugs in mild hypertension.

PMID- 2218234
TI  - [Smoking and smoking cessation in the context of preventive cardiology].
AB  - Knowledge about the effects of smoking on the development of cardiovascular
      disease is constantly growing. As an example, we know today that myocardial
      infarction is more frequent among smokers, also among monozygous twins, and that
      the relative risk of women who smoke is comparable to that of male smokers. The
      mechanisms of action are in atherogenesis, in the stimulation of the adrenergic
      system and in an increase of plasma fibrinogen. In order to best support his
      patients to give up smoking, the practicing physician has to be aware of the
      factors influencing the smoking habit. The parallel development of psychological
      dependence and physical addiction to nicotine is described, and it is shown how
      nicotine substitution therapy can help to stagger psychological and physical
      withdrawal. The introduction of transdermal nicotine substitution opens new
      possibilities in this context.

PMID- 2218235
TI  - [Physical activity and coronary heart disease].
AB  - Epidemiological data suggest that in middle aged men a regular physical activity,
      occupational or in leisure time, may protect against a first coronary event.
      Randomized clinical trial of cardiac rehabilitation after myocardial infarction,
      including physical training, has shown a positive trend for reduced rates of all
      cause death and coronary death in the intervention group. Although not
      statistically significant, physical training in coronary patients is recommended
      because the benefits of training include an improved exercise tolerance and risk
      factor profile. Furthermore, supervised cardiac exercise programmes appear to be
      safe for the average patient, with the possible exception of some patients with
      large anterior wall infarctions who might deteriorate and have, therefore, to be
      closely controlled during rehabilitation.

PMID- 2218236
TI  - [Re article: "The development in medicine in the Werdenberg-Sargan region" by Dr.
      M. Gassner, "Schweiz. Rundschau Med.(PRAXIS)" 79, No.8, pp. 193-201, 1990].

PMID- 2218237
TI  - [What is your diagnosis? Deficient excitation of the ventricular electrode].

PMID- 2218238
TI  - [Urological sexology].

PMID- 2218239
TI  - [Serum cholesterol of Swiss military personnel and assessment of nutrition in
      military service].
AB  - Two separate studies are reported. The first aimed at assessing the prevalence of
      hypercholesterolaemia in 453 military personnel who were in service in fall 1988
      in a military fort. According to the risk limits of the Swiss Working Group on
      Lipids, the serum cholesterol values were elevated in 30% (greater than 6.5
      mmol/l), in the borderline range in 31% (5.2. to 6.5 mmol/l), and only 39% had
      values in the ideal range (less than 5.2 mmol/l). There was a significant
      correlation of serum cholesterol (measured by Reflotron) with age, and the
      increase between age 20 and 40 was particularly remarkable (1.5 mmol/l increase).
      There was also a significant correlation of serum cholesterol with body weight.
      Only 9% of the soldiers knew their cholesterol levels before the study. One third
      were smokers, and 9% were hypertensive. The second aimed at analysing the
      consumption of food in the military service. This analysis was performed during a
      military service in an underground fort, where all food was controlled and known.
      The analysis indicated that per subject and day, 2051 kcal daily were consumed
      from the troup kitchen. Additional calories were consumed in the canteen (before
      and after the main meals) in the form of sweets, particularly as beverages. There
      were 1053 kcal per person and day consumed in the canteen, consisting of 39%
      carbohydrates, 36% fat, 15% proteins and 10% alcohol. The study demonstrates on
      one hand, that a significant number of military personnel demonstrates
      undesirably high serum cholesterol concentrations; on the other hand, the second
      study shows that too many calories are consumed during military service and that
      the foodstuff was too high in fat.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218240
TI  - [Erectile dysfunction of male spinal cord injury patients].
AB  - Different problems regarding erectile dysfunction in men with spinal cord-injury
      are outlined. Neuroanatomical and neurophysiological aspects of erection and
      ejaculation are outlined and brought into relation with the different clinical
      pictures of such lesions. Different therapeutical possibilities are presented,
      particularly the new treatments like intracavernous papaverine (autoinjection),
      prostaglandin E1 and transcutaneous nitroglycerin; action, advantages and
      indications are discussed. The experience in ten para- or tetraplegic patients
      are discussed. It seems that even in spite of the higher price of PGE1 this
      treatment of the erectile dysfunction in spinal cord-injured men should be
      preferred, since it shows more advantages and less complications than other
      treatments.

PMID- 2218241
TI  - [Aspects of Balint group activities].
AB  - The working with Balint groups is one of the best known instruments to teach
      doctors a 'psychosomatic' or a 'psychosocial' approach to their patients. Three
      case studies are reported. Apart from case-related knowledge, the particular
      attitude of this patient-oriented medicine is discussed. Characteristics of
      Balint groups and the changing of a therapist's opinion are listed.

PMID- 2218242
TI  - [Typical nosocomial infection with an unusual cause: Hafnia alvei. Report of 2
      cases and literature review].
AB  - The route of infection and the course of two typical nosocomial infections are
      described in two patients infected with a rare gram-negative bacterium. Both
      patients underwent cardiovascular surgery. They were placed close to each other
      in the intensive care unit for several days and suffered from pneumonia and from
      wound infection respectively. In both patients bacterial culture grew Hafnia
      alvei. Successful antibiotic treatment was achieved with Netilmicin and Imipenem.
      Urinary tract, respiratory tract and wound infections are the most frequent
      nosocomial infections according to the literature. Risk factors are duration of
      stay in the intensive care unit, shock, poor general condition and advanced age.

PMID- 2218243
TI  - [A case from practice (198). 1. Radiation-induced proctocolitis with anemia
      provoking hemorrhage following irradiation of a stage IIIb cervix carcinoma in
      1987. 2. Type II diabetes mellitus].

PMID- 2218244
TI  - [A case from practice (190). Cerebrospinal syphilis. Personality disorders.
      Alcohol and drug abuse].

PMID- 2218245
TI  - [What is your diagnosis? Acute bacterial endocarditis].

PMID- 2218246
TI  - [Stress: a treatable cardiovascular risk factor?].
AB  - The study of psychosomatic factors in the pathogenesis of ischemic heart disease
      has followed three directions, a clinical-phenomenologic, physiologic-behavioral
      and a curricular-psychodynamic one. From the sixties onward Type A behavior has
      been prevailing as concept for the investigation of prospective importance of
      psychic factors in ischemic heart disease. Such a behavior-oriented view alone
      proves however to be inadequate. For a comprehensive approach to psychic risk
      factors and their treatment and prevention anxiety, depression, important
      experiences in life and individual biographic constellations are equally
      important. They represent factors only approximated by the conventional term
      "stress".

PMID- 2218247
TI  - [Lipid-lowering therapy in the prevention of coronary heart disease].
AB  - Reasons for the current emphasis on cholesterol as coronary risk factor are
      multiple. On one hand current studies have shown that primary as well as
      secondary prevention of ischemic heart disease is a realistic possibility with
      lipid lowering measures. On the other hand new drugs are actually available which
      permit a potent and adapted therapy of hyperlipidemias. According to new
      guidelines of the Swiss "lipid task force" screening for hypercholesterolemia is
      recommended. A cholesterol value greater than 6.5 mmol/l should be investigated
      and treated. Because a great proportion of adult Swiss fall into this category
      (approximately 1/3) it is essential that all those are efficiently treated that
      have markedly abnormal cholesterol values or present with other risk factors such
      as smoking and hypertension or have a personal or familiar history of ischemic
      heart disease. Because progression is likely in patients with or after manifest
      ischemic heart disease even when hypercholesterolemia is mild (over 5.2 mmol/l)
      all patients presenting with an infarct should be investigated for dyslipidemia.
      Cholesterol, triglycerides and HDL should be determined. Dietary measures are the
      basis of every attempt to reduce hyperlipidemia. Most importantly intake of
      saturated fats prevailing in animal products should be restricted. The next
      important step is reduction of dietary cholesterol and in obese patients also
      caloric restriction. Lipid lowering agents are recommended in patients at risk
      who do not respond to or comply with dietary regimens. According to type of
      dyslipidemia bile-acid-binding resins, fibrates, nicotinic acid or HMG-CoA
      reductase inhibitors are available.

PMID- 2218248
TI  - [Antihypertensive therapy and prevention of hypertensive complications].
AB  - Arterial hypertension is one of the most important risk factors for the high
      cardiovascular morbidity and mortality. The efficacy of treatment is undisputed
      in patients with severe or accelerated hypertension. For the majority of patients
      suffering from mild to moderate hypertension the usefulness of treatment is not
      as well established although the potential benefit would be greatest. In this
      group the reduction of cerebrovascular complications has been demonstrated
      whereas reduction of morbidity and mortality for ischemic heart disease has
      remained controversial, indicating that reduction of blood pressure alone may not
      sufficiently reduce the risk for coronary complications. In contrast to
      cerebrovascular disease ischemic heart disease depends probably on several risk
      factors other than hypertension. For prevention of ischemic heart disease these
      other factors therefore need to be considered extensively.

PMID- 2218249
TI  - [Thrombocyte inhibitors in cardiovascular therapy].
AB  - An increased platelet-vessel wall interaction plays an important role in most
      forms of cardiovascular disease. In healthy arteries, the vascular endothelium
      prevents platelet adhesion and aggregation. As a mediator of this protective
      function, the endothelium produces prostacyclin, endothelium-derived nitric oxide
      and tissue plasminogen activator. Cardiovascular risk factors such as
      hypertension, hyperlipidemia and diabetes are associated with an increased
      platelet activation and with decreased antithrombotic properties of the blood
      vessel wall. The available inhibitors of platelet function interfere only with
      one of various mechanisms of platelet activation and of the platelet-vessel wall
      interaction. Prostaglandin inhibitors, such as aspirin and newer, more specific
      inhibitors, prevent the production and/or the effect of thromboxane A2 on
      platelets and the blood vessel wall. Other drugs interfere with the effect of
      adenosine diphosphate on platelets, or they increase intracellular concentration
      of cyclic GMP or AMP in platelets and vascular smooth muscle cells. The
      protective effects of platelet inhibitors in primary and particularly in
      secondary prevention of cardiovascular diseases have been documented in numerous
      studies. The successful clinical use of these substances, however, requires a
      selective prescription of the drugs in patients with cardiovascular disease.

PMID- 2218250
TI  - [A bayliff's kind of medicine].

PMID- 2218251
TI  - [Drugs and liver function].

PMID- 2218252
TI  - [Restaurant asthma].

PMID- 2218253
TI  - [Clinical aspects of hypothermia].

PMID- 2218254
TI  - [Significance of micro-albuminuria].

PMID- 2218255
TI  - [Sleep apnea syndrome: a new diagnostic entity?].

PMID- 2218256
TI  - [Jaundice. Clinical discussion].

PMID- 2218257
TI  - [Various carcinogenesis risk factors of radiotherapy].

PMID- 2218258
TI  - [The echocardiographic characteristics of cardiac lesions in beta-thalassemia].
AB  - The authors submit the results of clinicoechocardiographic investigations of 35
      patients with beta-thalassemia aged from 4 to 37 years of whom 23 patients were
      with acute beta-thalassemia, 6 with an intermediary form and 6 with a
      heterozygotic form of the disease. Various echocardiographic changes were
      observed in patients with acute and intermediary forms of beta-thalassemia, i.e.
      prolapse of the mitral valve (52 and 50 per cent), the presence of fluid in the
      pericardium (13 and 17 per cent), structural changes in the valvular apparatus
      (56 and 83 per cent), disorders of the inotropic and diastolic functions of the
      heart.

PMID- 2218259
TI  - [Roentgeno-morphological comparisons in rheumatoid arthritis based on data of a
      long-term prospective study].
AB  - During a prospective observation lasting 6 years 68 patients with rheumatic
      arthritis (RA) were repeatedly examined (up to 8 times) roentgenologically with
      parallel puncture biopsy of the synovial fluid of the knee joint made with an
      atraumatic needle, and numerical evaluation of markedness of 25 morphological
      signs of synovitis. A comparative analysis of the markedness of morphological
      signs of synovitis in relation to the degree and dynamics of destructive changes
      in the knee joint was made on the basis of the findings of 254 puncture biopsies
      and the same amount of roentgenograms. There is a close relationship between the
      activity of synovitis and the progress of destructive arthritis except for the
      morphological signs characterizing the reaction of hypersensitivity of an
      immediate type that may serve the purpose of prognostication of further articular
      destruction and of the choice of an early adequate therapy.

PMID- 2218260
TI  - [Dynamics of the basic statistical indices in rheumatic diseases].
AB  - The authors have analysed the State statistics data concerning the Soviet Union
      for 10 years with respect to the changes in the indices for morbidity,
      prevalence, invalidity, fatality and temporary incapacity for work in rheumatism
      and chronic diseases of the joints. It has been established that on the one hand
      the health of the population suffering from rheumatic fever improves but on the
      other hand the prevalence of chronic diseases of the joints according to the
      attendance to polyclinics and temporary incapacity for work due to diseases of
      the osteomuscular system steadily increase. The task of the rheumatological
      service of the country is to improve organization of effective prophylactic
      medical examination and therapy of patients with rheumatic diseases of the
      joints.

PMID- 2218261
TI  - [The clinical value of determining beta-glucuronidase activity in the cells and
      blood serum of patients with systemic scleroderma].
AB  - The spectrophotometric method was used to determine the activity of beta
      glucuronidase (BGU) in the cells (neutrophils, mononuclear cells, thrombocytes)
      in the blood serum of patients with systemic sclerodermia (SSD). The authors
      revealed a synchronous change in the activity of BGU in all the cells and in the
      blood serum, and also a decrease in the activity of the enzyme in the
      concentration of protein in neutrophils, it being very significant in patients
      with SSD accompanied by trophic changes. There was a direct relationship between
      the activity of BGU in the blood serum and the level of C-reactive protein and an
      inverse one between the activity of BGU and the content of circulating immune
      complexes in the blood. The level of BGU in the blood serum reflects not only the
      activity of the inflammatory process but also the markedness of trophic changes
      in patients with SSD.

PMID- 2218262
TI  - [Do non-steroidal anti-inflammatory agents possess antioxidant activity?].

PMID- 2218263
TI  - [Evaluation and prognosis of work capacity in rheumatoid arthritis].
AB  - Assessment of the functional state, social and psychological status of 82
      patients with RA was made with the aid of a modified health assessment
      questionnaire (HAQ) and individual arthritis impact measurement scales (AIMS). A
      group of disabled persons exhibited a greater markedness of articular
      destruction, high activity of the disease and a high functional index, all of
      them being old persons. Patients with working ability underwent prophylactic
      medical examination, more intensive therapy with basic drugs. The use of a
      computer for prognostication of capacity for work has been shown.

PMID- 2218264
TI  - [The microbiocenosis of the intestines and its influence on the course of
      postenterocolitic reactive arthritis].
AB  - The authors studied microbiocenosis of the intestine and its influence on the
      course of postenterocolitic reactive arthritis in 43 patients. The data obtained
      confirm the participation of intestinal dysbacteriosis in the development of a
      chronic form of reactive arthritis. The favourable effect of sour milk
      bifidumbacterin on articular manifestations in postenterocolitic reactive
      arthritis has been noted.

PMID- 2218265
TI  - [Exogenous and endogenous risk factors in rheumatoid arthritis (review of the
      literature and personal data)].

PMID- 2218266
TI  - [A case of an unusual lesion of the lungs in rheumatoid arthritis].

PMID- 2218268
TI  - [A study of Raynaud's syndrome using dynamic infrared thermography].
AB  - The method of infrared thermovision was used to study 22 patients with Raynaud's
      syndrome: 9 patients with sclerodermia, 8 with the primary Raynaud's syndrome and
      5 patients with various rheumatic diseases. Patients with recurrent Raynaud's
      syndrome exhibited adaptation disorders, anomalous distribution of temperature-
      warming up began not from the distal regions of the bones, as it happens in the
      norm and with the primary Raynaud's syndrome, but from the proximal regions.
      Functional tests for sympathetic activation showed the absence of excess reaction
      in all the groups under examination. Direct cooling of the hand in patients with
      recurrent Raynaud's syndrome was accompanied by a considerable delay in
      restoration of the initial temperature. Sublingual administration of nifedipine
      did not induce a rise in skin temperature in 6 out of 9 patients with
      sclerodermia. Marked disorders in microcirculation in patients with recurrent
      Raynaud's syndrome were observed. The role of injury inflicted to arteriovenous
      anastomoses in pathogenesis of the mentioned syndrome are discussed.

PMID- 2218267
TI  - [Remission of rheumatoid arthritis--myth or reality?].
AB  - Proceeding from a long-term observation of 956 patients with RA (rheumatoid
      arthritis) the authors discuss the problem of its remission. Spontaneous
      remissions of the disease are possible but in most of the cases remission comes
      as a result of therapy. Lengthy remission (from one to five years) was attained
      in 14 per cent of the patients, steady remission (not more than five years) in 8
      per cent of the patients. The following types of remission are distinguished:
      spontaneous remission, genuine remission changing the nature of RA course,
      therapy-induced remission, sham remission no modifying the nature of the process.
      Different types of remission have been analysed. Importance of correct evaluation
      of remission in prognosticating the course of RA and the choice of the most
      effective treatment plan has been analysed.

PMID- 2218270
TI  - [Gingival preparation].
AB  - For the general practitioner, the superficial periodontal structure is an
      obstacle when trying to gain access, control and visualization to juxta or infra
      gingival preparations. A temporary restoration will maintain and protect those
      limits and in many cases it is a very efficient procedure. Sometimes it is
      necessary to enhance the gingival preparation by sophisticated methods. There are
      many different technics available to the practitioner. In this article we will
      describe the technics with easy clinical use and those respecting the gingival
      tissue (mechanical, physico-chemical).

PMID- 2218271
TI  - [Reversible hydrocolloids].
AB  - Reversible Hydrocolloids impressions are the most simple, easy and reliable of
      all the available impression technics, when their indications are respected. The
      precision of this technic, although excellent, can not render this technic
      universal. The indications and limitations of this technic are directly related
      to the properties of the reversible hydrocolloids. Good clinical results will
      depend on: a very good gingival retraction technic (with enough space for the
      material) and the immediate casting of the impression; the knowledge of the
      intrinsic qualities and performances of the material during all the clinical
      steps, without trying to surpass or betray those qualities.

PMID- 2218269
TI  - [Fundamental properties of impression materials].

PMID- 2218273
TI  - [Full impressions with silicone elastomers. The wash technic].
AB  - The wash-technic is one of the most well known and most used impression technic
      when using elastomeric silicones. It is however one of the most criticized
      technic. The wash-technic depends on Biomaterials and on operative procedures.
      After reviewing the two types of elastomeric silicones available and the
      properties that are required for this technic, the author shows that additive
      materials are reliable and successful when used for the wash-technic.
      Nevertheless to eliminate all possible deformations due to internal tensions of
      the materials, it is very important to follow strict operative procedures
      (specially for the pre-impression preparation), and to respect the contra
      indications of this technic.

PMID- 2218272
TI  - [Hydro-alginates].
AB  - Hydro-alginates are a combination of reversible and irreversible hydrocolloids.
      These products are a material choice in fixed prosthodontics and removable
      partial denture due to their reliability and ease of use, depending on adequate
      utilization of the materials and on a perfect synchronization during the
      impression procedures.

PMID- 2218274
TI  - [A custom grooved impression tray].
AB  - Individual compartment trays can be used for dental impression in fixed
      prosthodontics and represent an original method which alleviates the pitfalls of
      standard technics. This method is based upon a strict adaptation of the tray to
      both the preparations and the dental arcade using the primary impression.
      Impression pastes can be used in their optimal conditions using the I.C.T.
      (Individual Compartment Trays) and a higher definition of cervical limits can be
      obtained. The use of I.C.T. reduces the risks of interposing free marginal
      gingival and eliminates the inconvenients of intrasulcular leakage.

PMID- 2218275
TI  - [Full band impressions].
AB  - Complete impression with rings achieves the same definition than complete
      impressions alone and gives a final quality similar to unitary guided
      impressions. The required steps are the following: 1st clinical: adjustment of
      the unitary rings, laboratory: elaboration of metallic resin boxing and
      individual tray, 2nd clinical: complete impression with rings. This method is of
      a particular interest because of its facility and its possible adaptations to
      various impression pastes or clinical situations. No gingival conditioning is
      required to the impression, and increased indications of the method can thus be
      seen when esthetics or periodontal conditions are a priority.

PMID- 2218276
TI  - [Modification and development of gingival tissue during eruption of permanent
      teeth].

PMID- 2218277
TI  - [Transposition of permanent canines and its prevention: a preventive approach].

PMID- 2218278
TI  - [Eruption failure of lower second premolars].

PMID- 2218279
TI  - [Role of surgery: early germectomy and rationale of the first premolar].

PMID- 2218280
TI  - [Early treatment of severe dento-maxillary dysharmony: eruption guidance of
      incisors and canines].

PMID- 2218281
TI  - [Intraosseous malposition of tooth germs: surgical treatment, results].

PMID- 2218282
TI  - ["Education" of shape memory wires: utilization (2)].

PMID- 2218283
TI  - ["Battery" in the face].

PMID- 2218284
TI  - [Lingual brackets without ligatures].

PMID- 2218285
TI  - [Detachable anchorage splint].

PMID- 2218287
TI  - [Intrathoracic Pott's abscesses, radiologic pitfalls for the pneumologist].
AB  - The authors have conducted a retrospective study of 200 cases of tuberculous
      spondylitis, and wish to draw attention to the clinical and, chiefly,
      radiological aspects of the disease. Intrathoracic Pott's abscesses are
      principally observed in developing countries but they are not exceptional in
      France, and their varied semeiology deserves to be described.

PMID- 2218286
TI  - [Intestinal perforation occurring at the beginning of treatment: a severe
      complication of bacillary tuberculosis].
AB  - We report 2 cases of intestinal perforation caused by tuberculosis and affecting
      the small intestine in one case and the colon in the other case. The patients
      were men aged 49 and 51 years respectively. Both were cachectic and presented
      with advanced open pulmonary tuberculosis. Perforation in free peritoneal cavity
      occurred 2 and 8 days respectively after an antituberculous treatment was
      initiated. The outcome was rapidly fatal in both cases. Tuberculous enteritis has
      become rare, but it can still be observed in patients with severe open pulmonary
      tuberculosis, where the gastro-intestinal tract is contaminated by the large
      number of virulent mycobacteria swallowed. In such patients clinicians must be
      alert to abdominal premonitory signs. Intestinal perforations in free peritoneal
      cavity are uncommon. Most perforation are small, single or multiple, and located
      on the antimesenteric side of the terminal ileum. They may occur at any time, and
      particularly just after an antituberculous therapy has been instituted. Clinical
      presentation is one of acute peritonitis requiring emergency laparotomy.
      Mortality has been reduced by technical improvements, notably temporary
      enterostomy, but perforation remains a serious and often fatal complication of
      tuberculosis in patients with severe malnutrition.

PMID- 2218288
TI  - [Respiratory diseases at hospitals in Brazzaville, Congo].
AB  - The authors has recorded all respiratory diseases encountered in the chest
      department of the University Hospital of Brazzaville, from January 1 to December
      31, 1988. The case-records of 912 patients were involved in this study.
      Respiratory disease were found to be more frequent in men than in women.
      Tuberculosis ranked first (52.08%), followed by acute lung infections (32.65%)
      and asthma (5.15%). Malignant tumours were rare (1.53%). The incidence of HIV
      infection was high (10.51%), and this disease was often associated with
      tuberculosis (10.30%). Subjects in the 20-29 years age group were those most
      affected. The overall mortality rate was 13.48%. Mortality increased with age,
      exceeding 30% in patients over 60. Mortality rates were 15% in acute lung
      infections and 10% in tuberculosis.

PMID- 2218289
TI  - [Pseudotumoral "pedicled" juxta-diaphragmatic opacities].

PMID- 2218290
TI  - [Isolated pleural actinomycosis. Apropos of 2 cases].
AB  - Two cases of isolated pleural actinomycosis are reported. This form is much less
      frequent than the pulmonary form, and it accounts for only 20% of thoracic
      actinomycoses. The bacteriological diagnosis is easily obtainable by pleural
      puncture, provided it has not been obscured by previous antibiotic therapy and
      provided the organism has systematically been cultured under anaerobic
      conditions. Pleural actinomycosis has a very favourable prognosis. Local
      treatment, sometimes surgical, is indispensable. If the condition is diagnosed at
      an early stage, systemic antibiotic therapy can be reduced to 6 to 12 weeks.

PMID- 2218291
TI  - [Plasma cell granuloma of the lung. Apropos of a case and review of the
      literature].
AB  - A case of plasma cell granuloma of the lung is presented, and the clinical,
      radiological, histological, diagnostic and therapeutic data obtained from 97
      published cases are reviewed. Since the disease is usually peripheral, the
      diagnosis rests on surgical biopsy and histological examination. In the case
      presented here, it was established on intrabronchial biopsy obtained by
      fibroscopy.

PMID- 2218292
TI  - [Environmental interstitial pneumonia caused by asbestos. Study of a Turkish
      family exposed to tremolite].
AB  - Environmental exposure to asbestos, as observed in Anatolia (Turkey), usually
      results in pleural pathology (plaques and mesothelioma). We report the case of a
      50-year old woman who, until the age of 50, had lived in Eregli, central
      Anatolia, a region where inhalation of environmental asbestos is responsible for
      a high prevalence of pleural diseases. Radiology showed diffuse interstitial
      pneumonia without pleural involvement. Bronchoalveolar lavage brought back
      asbestos bodies (AB) in concentrations of 4,250 per millilitre. All were made of
      tremolite, a non-commercial variety of asbestos. The patient's family was
      investigated by chest radiography and search for AB in sputum. The husband, who
      came from the same town as his wife and had been exposed until the age of 45, had
      the classical response with bilateral pleural thickening but no parenchymal
      abnormalities; 2 AB were found in his sputum. The 3 sons, exposed for 10, 13 and
      20 years respectively, had normal radiograms and no AB in their sputum, except
      for the older (3 AB) who had been exposed for 20 years. These cases illustrate
      the importance of environmental exposure to asbestos which may produce lesions
      similar to those observed in industrial exposure. Only mineralogical examinations
      can determine whether the asbestos is environmental or industrial.

PMID- 2218293
TI  - [Apropos of 2 cases of hemolytic anemia in mycoplasma pneumonia].
AB  - The authors present 2 cases of mycoplasmal pneumonia associated with severe
      haemolysis. Haemolytic anaemia is a well-known and habitually mild complication
      of the disease. It is related to a peak of cold agglutinins, which are antibodies
      that agglutinate red blood cells usually at low temperatures but sometimes at 37
      degrees C when they are present in high concentrations. The pathogenesis of cold
      agglutinins is thought to involve the secretion of peroxides by Mycoplasma
      pneumoniae with alteration of ed cell antigens which become immunogenic.

PMID- 2218294
TI  - [Broncholithiasis in a case of silicotuberculosis].
AB  - Broncholithiasis is usually a late complication of tuberculous lymphadenopathy.
      Clinical symptoms are not suggestive of the condition in most cases, except for
      lithoptysis which occurs in 5 to 34% of the patients. Owing to the currently low
      frequency of tuberculosis, broncholithiasis is a rare and sometimes surprising
      diagnosis, as in the case reported here. In this 65-year old silicotic man,
      broncholithiasis was manifested by blood-stained expectoration. Fibroscopy
      established the diagnosis by showing 2 broncholiths, about 1 cm wide, which were
      endoscopically extracted. The second peculiarity of this case is that
      broncholithiasis was associated with active tuberculosis.

PMID- 2218295
TI  - [Consensus development conference: diagnosis of nosocomial pneumonia in intensive
      care. 5th consensus conference in resuscitation and intensive care medicine
      (October 13, 1989)].

PMID- 2218296
TI  - [Natural history of systemic lupus erythematosus: the experience at the Arnaldo
      Vieira de Carvalho Cancer Institute].
AB  - The authors present an evaluation of sixty patients with SLE who were observed at
      the "Arnaldo Vieira de Carvalho" Cancer Institute from 1980 to 1988. Their
      findings were compared to findings of other international series. Some
      differences were observed in the frequency of clinical manifestations, laboratory
      findings, and mortality.

PMID- 2218297
TI  - [Immediate breast reconstruction and oncologic criteria: our current definition].
AB  - After a review of the literature, the authors attempt at a definition of the
      oncologically safe candidate to an immediate reconstruction after modified
      radical mastectomy for breast cancer. The analysis of the natural history of
      locally recurrent breast cancer indicates that the potential for its masking is
      negligible. Survival curves of patients submitted to immediate breast
      reconstruction are similar to those reported for historical controls. The ideal
      candidate for an immediate reconstruction is a stage I (negative axillary nodes)
      patient. As immediate breast reconstruction does not alter the prognosis of
      breast cancer patients nor does it harm the use of adjuvant therapies, the
      authors believe that even a well motivated stage II (positive axillary nodes)
      patient should be considered as a candidate for an immediate reconstructive
      procedure.

PMID- 2218299
TI  - [Professional training in health].

PMID- 2218298
TI  - [Lower limb repair. Bipedicled fasciocutaneous flap. A new technical approach].
AB  - The authors present an anatomical study of a fasciocutaneous flap of the lower
      limb and its clinical application. Sixteen patients with loss of cutaneous
      substance and exposure of the leg bone were operated on. The bipedicled
      fasciocutaneous flap presented by the authors allows the coverage of large areas
      of the lower limb in the initial stage of treatment. Preservation of the
      superficial venous system allows for a better vascularization of the flap and,
      thus, for the use of larger flaps.

PMID- 2218300
TI  - [Diagnosis of epilepsy].

PMID- 2218301
TI  - [Surgical treatment of inguinal hernias with local anesthesia].
AB  - Eighty-four cases of inguinal hernioplasty by Bassini's modified technique were
      performed using 1% lidocaine in regional infiltration block. The report analyzes
      the use of local anesthesia in the treatment of inguinal hernias. All patients
      had small reducible and non-recurrent inguinal hernia. Twenty-six compensated
      high risk patients were operated in the hospital and dismissed in the second post
      operative day, whereas the others were operated as outpatients and dismissed two
      hours after the surgical procedure. The rate of complication was low, but pain
      was a common complaint. In general, there was a good acceptance of this kind of
      anesthesia. The authors concluded that local anesthesia is a valuable method for
      the treatment of inguinal hernia.

PMID- 2218302
TI  - [Acute jejunogastric intussusception].
AB  - The authors present one case of type III jejunogastric intussusception that
      occurred on the 9th post-gastrectomy day. They compare this case to five others
      seen at the same hospital in the last nine years. They discuss the rarity of this
      complication that can only be resolved surgically, the importance of early
      diagnosis for the favorable clinical evolution, and the surgical technique used.
      They stress the need to include jejunogastric intussusception in the differential
      diagnosis of high intestinal obstruction in gastrectomized patients both in the
      early and in the late post-operative period.

PMID- 2218305
TI  - Another look at the new state Medicare law.

PMID- 2218303
TI  - [Late diagnosis of juvenile dermatomyositis with spontaneous pneumothorax,
      pneumomediastinum, and subcutaneous emphysema].
AB  - The authors describe a 11 year-old girl that presented eczematous scabies with
      acute oligoarthritis that subsided in one day. Fourteen months later, she
      developed a classical juvenile dermatomyositis with spontaneous pneumothorax,
      pneumomediastinum, subcutaneous emphysema; pulmonary infection due to
      Pneumocystis carinii had been diagnosed and was attributable to immunosuppressive
      therapy. Despite the late diagnosis, the rapid disease activity and the multiple
      complications, clinical and laboratory controls were achieved by the
      corticotherapy and by an early diagnosis and treatment of complications.

PMID- 2218304
TI  - [Familial Bloom's syndrome associated with neuroblastoma].
AB  - Bloom's syndrome (BS) is an autosomal recessive disease characterized by short
      stature, sensitivity to sunlight, and telangiectasic malar erythema. It is
      associated to chromosomal breakage, to primary combined immunodeficiency, and to
      a high incidence of neoplasias. The authors report the case of two siblings with
      BS and associated immunodeficiency. Both patients were male and 5 (A) and 4 (B)
      years old at the time of diagnosis. Chronic diarrhea, recurrent otitis media,
      purulent rhinitis, conjunctivitis and pyodermatitis were reported by patient A.
      Patient B was admitted with diagnosis of bilateral neuroblastoma and had the
      tumor resected. Later on, he presented with oral moniliasis, herpetic stomatitis,
      and skin abscesses. This patient did not have recurrent infections. Immunological
      evaluation showed normal serum levels of CH50, C3, and C4 for both patients.
      Serum IgG, IgA, IgM, and salivary IgA levels were: 455 mg/dl, 15mg/dl, 20mg/dl,
      0.6mg/dl for A, and 400mg/dl, 15mg/dl, 20mg/dl, and 0.2mg/dl for B, respectively.
      Serum antipolio antibodies (1, 2, and 3) were normal, and low levels of
      isohemagglutinins were observed in both patients. T cells subset determination
      showed: patient A--OKT3 = 66%, OKT4 = 33%, OKT8 = 32%, and 4/8 ratio = 1.0;
      patient B--OKT3 = 70%, OKT4 = 32%, OKT8 = 34%, and 4/8 ratio = 1.0. In vitro
      cellular immune response to PHA was depressed only in patient B. Patients
      karyotype showed chromosomal breaks with sister chromatid exchanges. Neither
      patient had abnormal alphafetoprotein and carcinoembryonic antigen serum levels.
      The rarity of such associations justifies the presentation of the cases.

PMID- 2218306
TI  - Reporting physicians' mistakes.

PMID- 2218307
TI  - Ethical issues in the practice of medicine.

PMID- 2218309
TI  - "Am I my brother's keeper?": a case study.

PMID- 2218308
TI  - "I do not want to be resuscitated": a case report.

PMID- 2218311
TI  - Cesarean section rates in Rhode Island, 1986-1988.

PMID- 2218310
TI  - Ethical issues at the end of life.

PMID- 2218312
TI  - The Brown University Program in medicine Class of 1990.

PMID- 2218313
TI  - Graduate medical education at the Brown University affiliated hospitals and
      institutions.

PMID- 2218314
TI  - Cheating in medical school: a problem or an annoyance?

PMID- 2218315
TI  - An outbreak of staphylococcal food poisoning among East Providence school
      children.

PMID- 2218316
TI  - A promising new treatment for hypercalcemia.

PMID- 2218318
TI  - AIDS claims more and more young women.

PMID- 2218317
TI  - Corticosteroids delay pneumonia in AIDS patients.

PMID- 2218319
TI  - Trading places--a seasonal exchange program.

PMID- 2218320
TI  - To appreciate nurses, try being the patient.

PMID- 2218321
TI  - How to spot child abuse.

PMID- 2218322
TI  - Incest: break the silence, break the cycle.

PMID- 2218323
TI  - Why the nursing shortage may not be all bad.

PMID- 2218324
TI  - Urokinase: restoring circulation without surgery.

PMID- 2218325
TI  - Nursing the mind. Understanding schizophrenia.

PMID- 2218326
TI  - When the patient is out of control.

PMID- 2218328
TI  - Legally speaking. Who's to blame for faulty equipment?

PMID- 2218327
TI  - What women can do to protect against osteoporosis.

PMID- 2218330
TI  - Yet another adverse effect of DES exposure.

PMID- 2218329
TI  - Home rehab for cardiopulmonary patients.

PMID- 2218331
TI  - [Detection and treatment of deafness in children].
AB  - Deafness must be systematically looked for in children during the first year of
      life, since the behaviour of a child with impaired hearing may closely resemble
      that of a child with normal hearing. Severe or deep deafness can be detected at
      birth by means of a babymeter. Between the ages of 6 and 18 months, sound
      emitting toy tests enable deafness to be detected. It is only at the age of 2-3
      years that testing can be performed separately on each ear to detect unilateral
      deafness. Treatment varies according to the degree and type of deafness.
      Conduction deafness is usually due to otitis media serosa and is treated with
      transtympanic aerators. Perceptive deafness requires acoustic prosthesis
      associated with orthophony and parental guidance.

PMID- 2218332
TI  - [The daily life of deaf children].
AB  - The loss of hearing modifies in every respect the relations between a child and
      his environment and results in serious communication problems. An early diagnosis
      and a coherent management using all the techniques that facilitate communication
      can thoroughly alter the consequences of deafness. The therapeutic and educative
      planning must be done by a competent, multidisciplinary team working in close
      cooperation with the child's parents. The plan must be adjusted to each
      individual child and constantly readjusted, the target being the social
      integration of deaf children when they reach adulthood.

PMID- 2218333
TI  - [Conduction deafness in adults. Diagnostic elements and therapeutic principles].
AB  - In the vast majority of cases, conduction deafness is due to a lesion of the
      eardrum-ossicles system located in the middle ear. The diagnosis, relatively
      easy, rests on the results of acoumetry (performed with a tuning-fork),
      audiometry and acoustic impedance measurement. The causes of conduction deafness
      are multiple and can be divided into 5 categories: major or minor malformations,
      injuries, tumours, otospongiosis and chronic otitis media. The last two named are
      the most frequent and must be considered first. Otospongiosis is the most common
      cause of conduction deafness with healthy typanic membrane. Kophosurgery usually
      triumphs in this field, even though occasional incidents or accidents must be
      deplored. Chronic otitis media has different forms and usually succeeds to an
      inflammatory disease of childhood: serous otitis which is the most obvious common
      factor in all forms. Despite its apparent complexity, otitis media can be
      diagnosed by the general practitioner. Although kophosurgery has made remarkable
      advances, surgical treatment is not always required.

PMID- 2218334
TI  - [Diagnosis of perceptive deafness in adults].
AB  - The finding of perception deafness in an adult patient should set off full
      clinical and paraclinical evaluation, as this symptom may hide two problems
      requiring urgent attention. The first problem concerns the diagnosis: any
      unilateral and progressive perceptive deafness suggests a possible acoustic
      neurinoma. The second problem is one of therapeutic decision, since in all
      patients with sudden onset deafness the prognosis depends on an early treatment.
      General practitioners can use simple tests that will give them some indications
      on the severity of the loss of hearing, but to establish the side and cause of
      the deficit, additional and highly specialized examinations are always needed.
      Medical and hearing aids are sufficient in most patients. Surgery should be
      reserved to very special cases and will be contemplated or not, depending on the
      cause of the deafness.

PMID- 2218335
TI  - [Occupational deafness].
AB  - Occupational deafness is usually caused by acoustic traumas and is particularly
      frequent in developed industrial countries. It proceeds very insidiously and
      characterized by bilateral perceptive hypoacusis of cochlear origin, centred on
      the 4000 Hz frequency. The social impairment is obvious and is often accompanied
      by tinnitus when the weighted mean hearing loss reaches 35/dB on conversation
      frequencies of 500 to 4000 Hz. The degree of deafness depends on multiple factors
      such as the physical characteristics of the traumatic noise (the critical level
      being 90 dBA), the highly variable individual susceptibility, the age of the
      subject and any previous or concomitant ear disease. In the absence of effective
      treatment one must rely entirely on prophylactic measures. Dysbaric occupational
      deafness if increasingly frequent in aeronautical and hyperbaric environments. It
      is usually of the mixed type, affecting both the middle and the inner ears.
      Deafness due to a hyperbaric environment figures on the list of occupational
      diseases. Occupational deafness of toxic origin is exceptional nowadays.

PMID- 2218337
TI  - [Is obesity hereditary].

PMID- 2218336
TI  - [Cochlear implants in 1990].
AB  - The various techniques of cochlear implantation are described. Implants may be
      divided into mono- and multi-electrode and into intra- and extra-cochlear.
      Cochlear implants are indicated only in patients with total or deep bilateral
      deafness with residual fibres still functioning in the acoustic nerves. Intra
      cochlear multi-electrode implants are the most sophisticated ones and usually
      provide better performances than those observed with mono-electrode implants.

PMID- 2218339
TI  - [Neurogenic, medullary, cerebellar, myogenic syndrome. Diagnostic orientation and
      management].

PMID- 2218338
TI  - [Oxygen: from transport to consumption. Symposium organized by Lilly-France
      Laboratory, Paris, September 22, 1989].

PMID- 2218340
TI  - [Tetanus. Epidemiology, etiology, physiopathology, diagnosis, development and
      prognosis, principles of curative, preventive and prophylactic treatment].

PMID- 2218341
TI  - [Manic-depressive psychosis. Diagnosis, development and prognosis, principles of
      treatment].

PMID- 2218342
TI  - [Pregnancy toxemia and eclampsia. Diagnosis, course and prognosis, treatment].

PMID- 2218343
TI  - [Cancer of the tongue. Etiology, diagnosis, course and prognosis, principles of
      treatment].

PMID- 2218344
TI  - [Pathology of the pleura].

PMID- 2218345
TI  - [The mesothelial cells].
AB  - Mesothelial cells are described in situ at the surface of the pleura. Their
      functions are discussed, in relation with the inflammatory response to different
      agents (infectious agents, mineral fibres...) and with the carcinogenic
      transformation, particularly in relation to asbestos exposure. The mechanisms of
      fibrogenesis, either symphysis or pleural plaques, are not clearly understood.
      The numerous studies now in progress on the different steps and mechanisms of
      mesothelial transformation and mesothelioma genesis are summarized focusing on
      the most recent cytogenetic and molecular biology findings.

PMID- 2218346
TI  - [Diagnosis of pleurisy].
AB  - Nowadays, the diagnosis of pleural effusion is greatly facilitated by
      thoracoscopy. Since most pleural effusions are due to neoplasias (notably in
      patients older than 40 years) and since the prognostic value of an early
      diagnosis is obvious in case of pleural carcinoma (notably mesothelioma), there
      is no justification in allowing the effusion to become chronic. If the diagnosis
      is confirmed by needle biopsy, thoracoscopy can rapidly be performed by skilled
      operators: in 95 p. 100 of the cases it provides the diagnosis. Five per cent of
      pleural effusions remain of unknown origin. In such cases the patients must be
      closely followed up for 12 to 18 months to make sure that no cancer has been
      missed and another thoracoscopy must be performed at the slightest clinical
      change. Test treatments (antibuberculous drugs, corticosteroids) are now
      obsolete.

PMID- 2218348
TI  - [Epidemiology and etiology of mesothelioma].
AB  - The early diagnosis of mesothelioma rests on very common clinical evidence,
      including pleuritis of recent onset, history of contact with asbestos chest pain,
      often moderate loss of weight and slight changes in old pleural images. The
      sensitivity of formal diagnostic examinations is 23 p. 100 for pleural fluid
      cytology, 24 p. 100 Adams' needle biopsy and 93 p. 100 for thoracoscopy, where
      the only negative results are obtained in patients with adhesive pleuritis.
      Prognosis depends on several factors, the most favourable ones being the
      histological type of the lesion (epithelial or mixed), the fact that it is
      limited to the parietal or diaphragmatic pleura and, on the patient's side and
      accessorily: female sex, lack of exposure to asbestos, age under 50, good general
      condition and absence of chest pain.

PMID- 2218347
TI  - [Tumoral markers and monoclonal antibodies].
AB  - The frequency of malignant pleuritis in general practice and its often difficult
      diagnosis have led to the ever increasing use of tumoral markers (TMs) which may
      overcome these difficulties and of immunocytochemical methods which may improve
      the results obtained by routine cytology. TMs are used in the diagnosis: a) to
      detect false-negative results and sometimes exclude false-positive results of
      cytology ("reactive" mesothelial cells); b) to distinguish reliably between
      malignant mesothelioma and metastatic pleuritis from an undetected
      adenocarcinoma, and c) to provide additional information, if needed, on the
      nature and origin of a malignant pleuritis. In pleural carcinology, TMs can be
      used as part of various methods which may be biochemical (assays of the marker in
      serum and, more important, in pleural fluid), cytochemical or immunocytochemical,
      histochemical or immunohistochemical, cytogenetic and cytofluorimetric. TMs can
      be defined and classified as follows: 1) intrinsic tumoral cell abnormalities; 2)
      substances associated with tumours which either induce them in the body without
      any specificity or secrete first generation TMs such as CEA, hyaluronic acid,
      NSE, ect.; 3) tumour-related antigens recognized by monoclonal antibodies or
      second generation markers. These markers, extremely varied, are directed against
      cell and often cell membrane antigens. They are not always very specific. When
      assayed separately their diagnostic sensitivity is low, but when used in
      batteries and combined with routine cytology they may fulfill the objectives
      listed above and fairly significantly improve the results of cytology. As last
      resort, they can be used in immunomorphology on cytology or biopsy specimens and
      provide a decisive answer.

PMID- 2218350
TI  - [Treatment of pleural tumors].
AB  - There is no such thing as a standard treatment for diffuse malignant mesothelioma
      of the pleura (DMM). Surgery, radiotherapy or chemotherapy do not appear to
      modify the course of the disease, and there seems to be little chance of DDM of
      the pleural being cured, except for those rare cases of stage I tumour detected
      early on and curable by surgery or by intrapleural interferon. Biological
      response modifiers, such as interferon or interleukin, might well be the future
      therapeutic approach of a tumour known for its resistance to chemotherapy.
      Surgery remains effective in localized benign (fibroma) or malignant
      (fibrosarcoma) tumours, although fibrosarcoma has a tendency to local recurrence.
      Metastatic pleuritis has no other treatment than that of the primary cancer.

PMID- 2218349
TI  - [Diagnosis and prognosis of malignant mesothelioma].
AB  - The early diagnosis of mesothelioma rests on very common clinical evidence,
      including pleuritis of recent onset, history of contact with asbestos, chest
      pain, often moderate loss of weight and slight changes in old pleural fluid
      cytology, 24% for Adams' needle biopsy and 93% for thoracoscopy, where the only
      negative results are obtained in patients with adhesive pleuritis. Prognosis
      depends on several factors, the most favourable ones being the histological type
      of the lesion (epithelial or mixed), the fact that it is limited to the parietal
      or diaphragmatic pleural and, on the patient's side and accessorily: female sex,
      lack of exposure to asbestos, age under 50, good general condition and absence of
      chest pain.

PMID- 2218351
TI  - [Pleurodesis technics].
AB  - In patients with recurrent malignant or benign pleural effusion practitioners use
      specific treatments, but they are then faced with the problem of pleural fluid
      recurrence. Several techniques of pleurodesis have been used, including drainage,
      surgery, intrapleural injections and poudrage. From an analysis of the results
      obtained and from our own experience, we have come to the conclusion that
      poudrage under thoracoscopy is the best type of pleurodesis.

PMID- 2218352
TI  - [Transgenic mice as models for human diseases].

PMID- 2218354
TI  - [Eosinophilia today].

PMID- 2218353
TI  - [Adrenoleukodystrophy: a new case of familial adrenal insufficiency].

PMID- 2218355
TI  - [Red eye. Diagnostic orientation and management].

PMID- 2218356
TI  - [Uncomplicated cholelithiasis. Etiology, physiopathology, diagnosis, medical
      treatment and principles of surgical treatment].

PMID- 2218357
TI  - [Virus infections: herpes simplex. Epidemiology, physiopathology, diagnosis,
      evolution and prognosis].

PMID- 2218358
TI  - [Louis Justin-Besancon. 3 June 1901 - 26 December 1989].

PMID- 2218359
TI  - [Evaluation of knee radiograms as criterion of femoro-tibial gonarthrosis
      development].
AB  - Within the context of the initiation of practising rheumatologists to the
      methodology and management of clinical trials, it seemed opportune to carry out a
      clinical research study whose aim would be pedagogical as well as scientific:
      pedagogical by making them aware of the problems linked with the management of a
      clinical trial and the problem of the variability of the measurements; scientific
      by trying to appreciate the clinical significance of the radiological examination
      data in the course of femoro-tibial gonarthrosis. The patients suffering from
      femoro-tibial gonarthrosis corresponding to the ARA criteria and having given
      their consent have been included in a multicentric prospective study where each
      investigator had to record--apart from the patient inclusion criteria--his
      personal characteristics, the characteristics of the arthrositic disease (site,
      aetiology, history, clinical condition). Moreover, the radiological analysis of a
      recent, frontal photograph of the knee on charge has been carried out by a
      practising rheumatologist and by a university-hospital rheumatologist. The number
      of observations collected (879), the low percentage of non exploitable data
      (3.4%) are in favour of having clinical research studies carried out by
      practising rheumatologists. The analysis of the study shows the following: 1) the
      inter-observer variability of the reading of the photograph of the gonarthrosis
      is high outside three parameters (osteophyte, degree of pinch and height of the
      spacing measured in millimetres) with an interclass correlation coefficient of
      0.69, 0.71 and 0.69 respectively; 2) the radiographical examination data
      correlate only very partially with the clinical elements of the disease.

PMID- 2218361
TI  - [Role and place of MRI in the diagnosis of aseptic osteonecrosis of the femoral
      head. Apropos of 58 pathologic hips].
AB  - The early diagnosis of aseptic osteonecrosis of the femoral head has always been
      difficult. By studying 58 cases, the authors have demonstrated the diagnostic
      superiority of magnetic resonance imaging. As in the literature, we found aseptic
      osteonecrosis of the femoral head with no clinical sign, neither radiographic nor
      scintigraphic, by positive magnetic, resonance imaging. Moreover, it enables the
      simultaneous study of both hips. It gives with precision the age and extent of
      the necrosed fragment and enables an absolute differential diagnosis with hip
      algodystrophy. Magnetic resonance imaging is therefore the second and only
      examination to be carried out after the standard radiography. The couple,
      radiography and magnetic resonance imaging, gives all the necessary information
      for the diagnosis and classification of the aseptic osteonecrosis of the femoral
      head and Te 99m bone scintigraphy and scanner, whose value was limited, can thus
      be avoided.

PMID- 2218360
TI  - [Cruralgia. Frequency of foraminal hernias not to be operated. Retrospective
      study of 19 cases].
AB  - The authors report the observation of 19 patients suffering from cruralgia, who
      have undergone a tomodensitometric examination. A foraminal hernia was revealed
      in 13 patients. Four other patients presented an arthrositic or hyperostositic
      foraminal stenosis. Only one patient was operated upon.

PMID- 2218362
TI  - [Hypertrophic osteoarthropathy and liver graft rejection. Apropos of 2 cases].

PMID- 2218363
TI  - [Synovial cysts of psoas bursa in men. 4 cases and literature review].
AB  - The authors report four observations of synovial cysts of the psoas bursa. They
      recall the following from a review of the literature: the relative rarity of
      these lesions, their physiopathology, their clinical expression, the diagnostic
      tests available, which at present consist mainly of modern imaging (echography
      and tomodensitometry), and finally the principles of treatment.

PMID- 2218364
TI  - [Pathologic fracture disclosing Letterer-Siwe disease in adults].

PMID- 2218365
TI  - [The value of nuclear magnetic resonance in tuberculosis of the posterior
      vertebral arch. A case report].

PMID- 2218367
TI  - [Rhizomelic pseudopolyarthritis disclosing cancer of the cavum. A case report].

PMID- 2218368
TI  - [Melitococcal pseudo-Pott with abscess of the psoas].

PMID- 2218366
TI  - [Horton's disease disclosed or caused by skull trauma].

PMID- 2218369
TI  - [Lupus erythematosus disseminatus and atrophic polychondritis].

PMID- 2218370
TI  - [Epidemiologies or epidemiology?].

PMID- 2218371
TI  - The relationships between selected anthropometric and socio-economic data in
      schoolchildren from different social strata in Rio de Janeiro, Brazil.
AB  - The nutritional status according to anthropometric data was assessed in 756
      schoolchildren from 5 low-income state schools and in one private school in the
      same part of Rio de Janeiro, Brazil. The prevalence of stunting and wasting (cut
      off point: less than 90% ht/age and less than 80% wt/ht) ranged in the public
      schools from 6.2 to 15.2% and 3.3 to 24.0%, respectively, whereas the figures for
      the private school were 2.3 and 3.5%, respectively. Much more obesity was found
      in the private school (18.0%) than in the state schools (0.8-6.2%). Nutritional
      problems seem to develop more severely in accordance with the increasing age of
      the children. Therefore it appears advisable to assess schoolchildren within the
      context of nutritional surveillance system.

PMID- 2218372
TI  - An investigation into support for restrictions on HIV carriers in the Chicago
      metropolitan area.
AB  - An investigation into support for restrictions on people testing seropositive for
      HIV is reported on. Data were collected during telephone interviews with two
      hundred adults aged eighteen to sixty-five in the Chicago metropolitan area.
      Using the analytic technique of LISREL, six models which attempt to explain
      support for restrictions were tested. It was found that the model best supported
      by the data indicates that two groups contribute to support for restrictions on
      HIV carriers--one due to intolerance of homosexuality and one to mistrust of
      public health officials regarding their control and management of the AIDS
      epidemic. The relevance of these findings for public health policy makers is
      discussed.

PMID- 2218373
TI  - [The School of Public Health at the University of Sao Paulo].

PMID- 2218374
TI  - [Acute poisoning by aldrin: relationship between serum levels and toxic effects
      in humans].
AB  - In the attempt to correlate clinical findings with serum levels of aldrin,
      sixteen patients were followed-up after acute intoxication by this agent. Eight
      of them, males and females, aged from 1 to 37 years, presented no or light
      symptoms (some discomfort and nausea). The serum of one of these patients was
      found to contain 16.6 ppb of aldrin and that of another, 1.41 ppb of dieldrin. A
      group of five patients, aged from two to 30 years, showed symptoms of moderate
      severity, reporting nausea, vomiting, drowsiness, dyspnea, sweating, mild
      jerking, rise in blood pressure and convulsions. Of these cases, two were
      accidental and three were attempted suicides, the majority achieving complete
      recovery within 24 hours. Serum levels of aldrin were between 6.98 ppb and 26.3
      ppb and of dieldrin between 82.00 and 314.18 ppb. We found three severe cases,
      aged from 21 to 35 years, two attempted suicides and one occupational case. Two
      of these patients died and one of them presented hypothermia, coma, absence of
      reflexes and generalized convulsions, and another presented abdominal pain,
      paleness, sweating, cold extremities, dyspnea, hyperthermia and generalized
      convulsions. In the first one that died the serum levels were: of aldrin 30.00
      ppb and of dieldrin 720 ppb. In the other levels of 747.3 ppb of aldrin and
      1,314.00 ppb of dieldrin were found. The third had less serious symptoms and
      presented serum levels of aldrin of 31.05 ppb and of dieldrin 147.11
      ppb.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218375
TI  - [Plasma zinc levels and the anthropometry of children in the outskirts of urban
      centers in Brazil].
AB  - The main objective of the present study was to estimate plasma zinc concentration
      in children belonging to low-income families residing in three different
      neighborhoods on the outskirts of Ribeirao Preto, SP, Brazil, and to determine a
      possible correlation of this parameter with several anthropometric measurements.
      Plasma zinc levels were lower than 70 micrograms% in 13% of the children studied.
      Weight for age, height for age and weight/height ratio were below 90% of the 50th
      percentile of National Center for Health Statistics (NCHS) in 42.9%, 6.3% and
      9.5% of children, respectively. Tricipital fold, arm circumference and muscle
      circumference were also below 90% of the 50th percentile in 65.8%, 11.0% and 7.3%
      of the children, respectively. No correlation was observed between plasma zinc
      levels and the anthropometric parameters studied.

PMID- 2218376
TI  - [Photosensitivity and stability of freeze-dried and/or reconstituted measles
      vaccines (Biken CAM-70 strain)].
AB  - Three different lots of measles vaccines produced with the Biken CAM-70 virus
      strain were requested from the central cold store of the Public Health Department
      of the State of S. Paulo, Brazil, and assays on photosensitivity at 2-8 degrees
      C, and on stability at 28, 36.5 and 45 degrees C were carried out to find out for
      how long these vaccines would maintain their minimum potency, established as
      being 3.70 log10 or 5000 TCID50 (50% tissue culture infective dose) per human
      dose. The analysis of the adjusted straight regression lines indicated that, with
      the passage of time, the potency of lyophilized or reconstituted vaccines, as
      well as of vaccines exposed to or protected from light decreased. Light-exposed
      vaccines, however, became less potent than vaccines protected from the light.
      None of the vaccine lots studied, reconstituted and stored at 2-8 degrees C,
      exhibited homogeneity as to sensitivity to light. When freeze-dried vaccines had
      their photosensitivity studied at 2-8 degrees C, lots 1 and 2 presented greater
      thermal degradation when exposed to light than when protected from it. However,
      in both instances, it was found that potency fell below that taken as minimum for
      the Biken CAM-70 virus strain. At all other temperatures considered, even when
      protected from light, lots 1 and 2 did not retain the minimum potency. Lot 3 kept
      the expected stability for 60 days at 2-8 degrees C when protected from light and
      for 40 days when unprotected, but its thermal degradation at other temperatures
      was more intense (28 degrees C: 5 days; 36.5 degrees C: 2 days; 45 degrees C: 0.5
      day).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218377
TI  - [Analysis of the use of an ambulatory unit of the Department of Health of the
      city of Sao Paulo, SP (Brazil)].
AB  - A working proposal for the integration of the activities of public health
      assistance is presented. Two health clinics in the city of S. Paulo, Brazil, were
      studied. Taking as a starting-point that all activity in the health sector
      depends on community participation, this study sought to discover how the
      population has received and used the geographically integrated health services.
      For this purpose, information was collected from the users of both of these
      services, by means of a questionnaire, as to the motive for the use of the
      service, the service's ability to meet the need, the degree of user-satisfaction,
      etc. The analysis of the above information as well as of the objective and the
      working method of these services, leads to the conclusion that they are used by
      the public in a selective way for the purpose of meeting immediate needs related
      to present illnesses.

PMID- 2218378
TI  - [An intra-community profile of nutritional deficiency: a study of children under
      5 years of age in a low-income community in Rio de Janeiro (Brazil)].
AB  - This study is part of a larger epidemiological study concerned with the health
      status of children under the age of five carried out in the squatter settlement
      of Rocinha, and focuses on the nutritional profile of a representative sample of
      591 children. According to the weight-for-age criteria (Gomez's classification),
      23.9% and 2.0% were, respectively, mildly and moderately malnourished. This
      finding is in agreement with the assessment using weight-for-height and height
      for-age as anthropometric indicators: (a) absence of acute malnutrition (wasting)
      indicated by a pattern overlapping that of an expected normal population, and (b)
      growth deficiency (stunting) indicated by 7% and 15% of children exceeding the
      proportion normally expected to be, respectively, below the -1 and -2 standard
      deviate limits. So far as growth failure was concerned, the following variables
      remained associated even when controlling for economic status (indicated by the
      environmental conditions of the household): low birth weight, number of siblings
      equal to or above three, male gender, a history of never having breastfed and a
      family history of previous sibling death. Each variable is discussed separately,
      as well as the overall nutritional profile and the marked social intra-community
      stratification related to growth deficit.

PMID- 2218379
TI  - [Birth weight and patterns of delivery care in a municipality of Sao Paulo State,
      Brazil, 1986].
AB  - A survey was made of the birthweight of live births and delivery care at
      hospitals in the city of Araraquara, S. Paulo State, Brazil, in 4,776 newborn
      infants during 1986. The incidence of cesarean delivery was 76.0%. It was
      discovered that the proportion of cesarean delivery was higher for deliveries
      with private medical care (92.4%) than for deliveries with free assistance
      (44.0%). The incidence of low birthweight was of 9.2%. The highest proportion was
      found in patients with free medical assistance and was of 10.8%, that of social
      security patients being at an intermediate level (9.8%) and of private patients
      at 5.6%.

PMID- 2218380
TI  - [The French College of Oral Medicine. History and peripety].

PMID- 2218381
TI  - [Labioglossopexy in Pierre Robin syndrome. Our experiences apropos of 70 cases].
AB  - Pierre Robin syndrome is typically characterized by glossoptosis and retrognathia
      associated with cleft palate, respiratory and deglutition disturbances. Two
      morphological tendencies arise out of this 70-patient series, 50 of whom were
      managed with the same therapeutical regimen, which included labioglossopexy and
      was associated with only one case of death: "deforming" type Pierre Robin
      syndrome most commonly follows a favorable course with respect to both function
      and facial deformations, provided labioglossopexy is carried out sufficiently
      early. Indeed, this surgical operation allows for prompt restoration of normal
      function, thereby limiting the dysfunction-deformation vicious circle. This form
      of Pierre Robin syndrome may find its origin in the embryo's abnormal amniotic
      environment. "Malformation"-associated Pierre Robin syndrome often presents with
      combined anomalies, respiratory disturbances that may evolve into severe airway
      problems, impaired deglutition and abnormal brain development; in most cases,
      labioglossopexy will dramatically improve the immediate state of the child,
      although long-term prognosis as regards malformation is rather guarded.

PMID- 2218382
TI  - [Control of the incisor axis in the vestibulo-lingual direction using an original
      titanium-molybdenum alloy arch].
AB  - In order to restore the vestibulo-lingual orientation of the incisor axis while
      controlling the position of the crowns, the author suggests using a simple
      original arch, compatible with any of the multi-clip technics used by
      orthodontists. This arch is made of Titanium-Molybdenum Alloy and presents the
      distinctive feature of being specially shaped, on the ribbon side, so as to be
      introduced edgewise. Practical ease, efficiency in obtaining large amplitude,
      precisely controlled movements, as well as accurate measurement of torque make of
      this instrument a practical tool for controlling the incisor axis in the
      vestibulo-lingual orientation, and for improving the I/i angle warranteeing the
      stability of the results. This arch can be used both in monodisciplinary and
      multidisciplinary orthodontics, more particularly in surgical-orthodontic
      management of retrognathia combined with traumatic supraclusion of incisors or
      with linguoversions of central upper teeth.

PMID- 2218383
TI  - [Cancellous mandibular autografts and titanium mesh].
AB  - Pure cancellous bone transplants constitute an alternative to the usual cortico
      cancellous grafts used in certain cases for restoring interrupting substance loss
      (ISL) in the mandible. The greater number of surviving transplant cells, the
      rapid revascularization and more complete osteogenesis that are achieved cause
      indications for this type of graft to be particularly well adapted for cases
      where local repair conditions are precarious, such as bullet wound related
      sequelae. Indications for their utilization also extend to patient who have had
      benign tumors excised. The titanium-made receiving splint designed by Pr. Dumbach
      is particularly well adapted to this type of restoration; it provides for
      necessary functional stresses to be translated to the implant, allowing for the
      latter's incorporation, while controlling the direction of osteogenesis, thereby
      yielding excellent morphological and functional results.

PMID- 2218384
TI  - [The importance of avoiding the use of rigid fixation in functional genioplasty].
AB  - This article presents a brief review of several principles which Delaire has
      shown to be important in both craniofacial growth and cranio-maxillofacial
      balance. In light of these events, we propose that the maxillofacial surgeon
      either avoids, if possible, the use of rigid fixation in functional genioplasty
      or that he removes the screws and plate at a later date. The specific patterns of
      bone apposition and resorption observed following functional genioplasty form the
      basis for this recommendation.

PMID- 2218385
TI  - [Skin carcinoma of the face: surgery or radiotherapy?].
AB  - Surgical exeresis and radiation therapy are effective means of treatment for
      facial carcinomas. In some areas that are difficult to manage (nose, ears,
      periorbital region), the respective importance of both approaches is discussed.
      We report on the retrospective study of 309 patients seen after a skin
      carcinology consultation in which a dermatologist, a surgeon and a radiotherapist
      were associated. These 309 patients, with a mean age of 73 years, presented with
      375 carcinomas, i.e. 246 basal-cell (BC) and 119 epidermoid (EC) carcinomas. The
      most frequent sites were the nose (33.8% of BC), the inner canthus (12.7% of BC),
      the lower lip (23.8% of EC) and the ear (15.6% of EC). Management mainly
      consisted of surgery (50.8%) then Curie therapy (37%). The rate of recurrence was
      the same (10.5%) after surgery and radiation therapy. The study of the results
      leads us to advocating surgery for carcinomas of the ear (due to the occurrence
      of radiation necrosis in every third case after radiation therapy) and Curie
      therapy for carcinomas of the lower lid (except the inner canthus) because of
      recurrence in every second case treated with surgery. We currently prefer surgery
      for carcinomas of the lower lip (radiodermatitis in 11.8% of cases) and Curie
      therapy for the nose (lower rate of recurrence than with surgery). However, in
      the last two cases, the proposals for treatment should be confirmed by randomized
      studies. Thus facial carcinomas of the skin surrounding the orifices of the face
      and/or those that affect patients who are difficult to treat must be seen during
      a skin carcinology consultation by a dermatologist, a surgeon and a
      radiotherapist working together.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218386
TI  - [Fibrous dysplasia of the jaw. Therapeutic approach apropos of 12 cases].
AB  - Twelve cases of maxillo-facial fibrous dysplasia are presented, with a brief
      review of the condition. Only the complete excision of the lesion allows full
      healing, but it is rarely feasible, even with immediate reconstruction. The
      surgical abstention and partial excision keep many indications, but require a
      regular follow-up.

PMID- 2218387
TI  - [Necrotizing fasciitis of the face. Clinical and therapeutic aspects].
AB  - Necrotizing fasciitis is a synergic infection, the chief causal agents of which
      are beta-hemolytic group A streptococci. The authors insistingly review the
      different aspects of this rare affection and stress the importance of emergent
      medical and surgical management, as the evolution of the disease is still often
      lethal.

PMID- 2218388
TI  - [Myxoma of the nerve sheath. Apropos of a case].
AB  - A case of oral nerve sheath myxoma is presented with the findings of light
      microscopy and immunochemistry. The tumor consists of well-defined lobules which
      are separated by septa composed of fibrous connective tissue that reassembled the
      perineurium. Each lobule is composed of elongated and stellate cells in a
      basophilic mucoid matrix. Immunohistochemically, S-100 protein is strongly
      positive in all tumor cells. The histogenesis and differential diagnosis are
      discussed.

PMID- 2218389
TI  - [Cystic cervicofacial lymphangioma].
AB  - A review of fifteen new cases of cystic cervicofacial lymphangiomas is presented.
      While discussing the different localizations of these malformations, the authors
      emphasize the relationships existing between this type of malformation and both
      the facial nerve and the vasculonervous axis of the neck. They recommend surgical
      management. 1-to-10 years' follow-up revealed one case of local recurrence
      associated with incomplete excision.

PMID- 2218390
TI  - [Occult tumors of the parotid gland and facial paralysis. A diagnostic problem].
AB  - The facial palsy produced by a parotid tumour, could be misdiagnosed due to the
      absence of a palpable mass or other any signs in the computerized axial
      tomography or nuclear magnetic resonance. However there are data derived from the
      facial anatomy, course and clinical characteristics from the palsy that could
      make us thinking on the presence of a parotid tumour. The objective of this
      article is to present this characteristics, together with a serial of clinic
      cases which coursed in the beginning with a facial palsy and had problems in
      their diagnostic. It's also remarked the significance of the presence or not of
      perineural infiltration to the parotid tumours that will condition not only the
      prognosis but also the clinic course.

PMID- 2218391
TI  - [The unforeseen aspects of expertise or the proper use of ones's nose and lips].
AB  - On the basis of two expert evaluations, the author first sets out a few general
      principles needed to guide the expert during his mission. He then describes the
      peculiar features of the two examples chosen, both of which, in his opinion,
      justify a valuation far exceeding the standard compensation for the damage
      sustained by the victims, due to their occupation: one is a customs officer in a
      major international airport, the other is a trumpeter in a famous philharmonic
      orchestra. As a conclusion, the author emphasizes the necessity to thoroughly
      examine any wounded or ill patient prior to deciding to operate them.

PMID- 2218392
TI  - Pepsinogen release and acid secretion from human and guinea pig gastric mucosa
      compromised by hypoxia, endotoxin, or critical illness.
AB  - Despite blockade and neutralization of gastric acid, acute gastric lesions cause
      substantial morbidity and mortality in critically ill patients. Pepsinogen
      release in response to noxious stimuli such as hypoxia and endotoxin might
      contribute to mucosal damage. Guinea pig fundic mucosa was mounted in Ussing
      chambers. Acid secretion, pepsinogen release, potential difference (PD), and
      resistance were monitored. Gassing with room air or nitrogen diminished acid
      secretion and PD but increased pepsinogen release 9.7- and 15.5-fold,
      respectively (both p less than 0.001). Similarly, endotoxin (0.01 and 0.1
      units/ml) dose-dependently inhibited acid secretion and PD but increased
      pepsinogen release 3.3- and 6.1-fold (both p less than 0.05). Endotoxic and air
      gassed tissues were edematous with scattered cellular damage by light and
      transmission electron microscopy; nitrogen-exposed membranes appeared necrotic.
      Pepsin release may therefore have resulted from cell damage rather than
      exocytosis. Intragastric peptic activity in critically ill H2-receptor-blocked
      patients (n = 20) was 5490 +/- 1701 U/ml. The gastric juice of H2-blocked
      convalescing surgical patients (n = 20) contained 315 +/- 101 U/ml (p less than
      0.0001). Occult blood correlated with intragastric peptic activity (r = 0.59, p
      less than 0.0001) but not with gastric pH (r = 0.04, p = 0.6). These data suggest
      that the complex of pathophysiologic abnormalities common in critical illness
      causes substantial pepsin release. Efflux of this potent mucolytic barrier
      breaker may damage gastric mucosa in severely stressed patients.

PMID- 2218393
TI  - Primary malignant non-epithelial tumours of the thoracic oesophagus and cardia in
      a 25-year surgical material.
AB  - During 25 years, 708 patients with primary malignant tumours of the thoracic
      oesophagus (n = 376) or cardia (n = 332) were referred to our department. Two
      hundred and forty-nine patients had squamous cell carcinoma and 425
      adenocarcinoma. The other 34 tumours, which were primarily classified as
      undifferentiated carcinoma, malignant carcinoid or non-epithelial, were re
      evaluated by means of a second microscopic histologic examination and
      immunohistologic investigation. This showed primary malignant non-epithelial
      tumours in seven patients (0.99%): two malignant melanomas, one leiomyosarcoma,
      one malignant fibrous histiocytoma in the oesophagus (1.06%), two malignant
      lymphomas, and one malignant melanoma in the cardia (0.90%). All but two of the
      patients with non-epithelial malignant tumours were 67 years of age or older, and
      oesophagogastrectomy was performed in all. All tumours were 5 cm or more in
      diameter (median, 8 cm). Distant metastases were found in three cases. Five died
      of postoperative complications, one of cancer recurrence 7 months after the
      operation, and one of an unrelated cause without cancer recurrence 16 months
      postoperatively. Except for two of the melanomas, the diagnosis was not
      established until histologic examination of the surgical specimen was performed
      and, for the third melanoma and the malignant fibrous histiocytoma, not until the
      present re-evaluation. The characteristics of these seven tumours are discussed,
      and the importance of obtaining a correct diagnosis from endoscopic biopsy
      specimens is emphasized.

PMID- 2218394
TI  - Regional differences in peripheral circulation between upper and lower extremity
      in patients with cirrhosis.
AB  - In 42 patients with compensated cirrhosis and 31 control subjects, blood flow
      (BF) and vascular resistance (VR) were measured at the forearm and calf, using a
      pneumoplethysmograph. In some of the subjects deep-body temperature (DBT) was
      also measured by the zero heat flow method. In cirrhosis, BF and DBT were
      significantly higher and VR was significantly lower in the forearm than in the
      calf. Corresponding differences were not observed in control subjects. When these
      indices of the forearm were compared between cirrhosis and controls, BF and DBT
      were significantly higher and VR was significantly lower in cirrhosis than in
      controls. In cirrhotics in whom the gradient between forearm BF and calf BF was 1
      ml.dl-1.min-1 or more (forearm greater than calf), the vascular response of the
      forearm to cold stimulation was reduced, whereas in the remaining patients and in
      controls the forearm BF and VR responded significantly. These results suggest
      that there is a regional difference in peripheral circulation in cirrhotics,
      partly with participation of impaired sympathetic nervous activity, which may
      account for the selective distribution observed in the clinical manifestations of
      vascular spider, palmar erythema, and warm hand, inclined toward the upper
      extremities or the upper part of the body.

PMID- 2218395
TI  - The incidence of ulcerative colitis in Northern Norway from 1983 to 1986. The
      Northern Norwegian Gastroenterology Society.
AB  - In a 3-year prospective epidemiologic multicentre study in Northern Norway the
      average annual incidence of ulcerative colitis was 12.8 per 100,000. Both
      inpatients and outpatients were included. There was a significant sex difference
      in annual incidence in the health region (15.1 per 100,000 in males versus 10.4
      per 100,000 in females), which was most pronounced Nordland county (16.6 per
      100,000 in males versus 10.4 per 100,000 in females). The highest incidence was
      seen in the age group 20-29 years, with an incidence of 30.3 in men and 20.3 in
      women per 100,000 per year. A family history of first-degree relatives with
      inflammatory bowel disease was obtained in 10.1%. The pathologic changes were
      equally distributed among the rectum and the distal and total colon. Ulcerative
      colitis located to the distal colon seemed more associated with extraintestinal
      manifestations.

PMID- 2218396
TI  - Calcium absorption and bone mineral content in patients subjected to ileal bypass
      because of familial hypercholesterolaemia.
AB  - Calcium absorption and bone mineral content were studied prospectively in 30
      patients with familial hypercholesterolaemia subjected to partial ileal bypass
      surgery. One-third of the patients were followed up for 10 years after the
      operation. Six months postoperatively calcium absorption decreased significantly,
      from a median of 16% to 13%. The effect persisted up to 5 years of follow-up
      study. Ten years after the operation the absorption of calcium (median, 14.5%)
      was not significantly different from the preoperative calcium absorption (median,
      16%). Bone mineral content, measured in 76% of the patients, was retained in all
      patients studied. A significant correlation was present between calcium
      absorption and urinary calcium. The reduction in calcium absorption did not
      correlate with increases in faecal fat. Other long-term side effects were
      persistent diarrhoea and moderate steatorrhoea. A significant weight loss was
      slowly regained in most patients. An increase of renal oxalate excretion was only
      small and transient in most patients. The study shows that bypass of the terminal
      200 cm of ileum for familial hypercholesterolaemia causes moderate diarrhoea and
      steatorrhoea in most patients but only a slight reduction of intestinal calcium
      absorption and apparently no risk of bone demineralization. A benefit of a
      postoperative calcium and vitamin D supply cannot be excluded.

PMID- 2218397
TI  - Fat inhibits pentagastrin-stimulated acid secretion from the duodenum but not
      from the proximal jejunum in chronic gastric fistula rats.
AB  - The effect of fat emulsion in the upper intestine on the maximal gastric acid
      response to pentagastrin was studied in chronic gastric fistula (GF) rats with a
      4-cm blind loop of the duodenum anastomosed to the jejunum (Roux-en-Y). Fat
      emulsion in the loop inhibited the acid response by 85%. To localize the site of
      the inhibitory mechanism, GF rats were provided with Thirty-Vella loops of the
      duodenum (bile and pancreatic ducts transplanted to the proximal jejunum) or with
      Thirty-Vella loops of the proximal jejunum and a Roux-en-Y loop of the duodenum
      to prevent gastric juice from entering the duodenum. Perfusion of the duodenal
      loop with fat emulsion mixed with bile and pancreatic juice reduced the acid
      response by 49%, but perfusion of the proximal jejunal loop did not alter the
      response. It is concluded that the intestinal mechanism for inhibition of acid
      secretion by fat is located in the duodenum in rats.

PMID- 2218398
TI  - Gastrin in non-neoplastic pancreatic tissue from patients with and without
      gastrinomas.
AB  - Processing-independent radioimmunoanalysis for progastrin showed that extracts of
      normal pancreatic tissue from normal subjects (n = 5) and from patients with
      adenocarcinoma of the papilla of Vater (n = 4) contain progastrin and its
      products. The concentrations varied from 0.1 to 5.8 pmol/g tissue, of which
      carboxyamidated bioactive gastrins constituted 0.03-1.9 pmol/g. In histologically
      normal and nonneoplastic pancreatic tissue from patients with duodenal (n = 3)
      and pancreatic (n = 2) gastrinomas the expression of gastrin was significantly
      higher-14.5 pmol/g (median), of which 28% was bioactive amidated gastrins.
      Gastrin-17 was the main bioactive product, but its immediate precursor, glycine
      extended gastrin-17, constituted the predominant part of the preprogastrin
      product in pancreatic tissue. Proper gastrinoma tissue contained several
      precursor forms, including intact unprocessed progastrin. Progastrins were also
      found in high concentrations in plasma from the gastrinoma patients. The results
      raise the possibility that increased expression of progastrin and its products in
      non-neoplastic pancreatic tissue is a primary defect predisposing to neoplasia.

PMID- 2218399
TI  - Phospholipase A2 activity and concentration in several body fluids in patients
      with acute pancreatitis.
AB  - According to recent studies, phospholipase A2 (PLA2) may be an important factor
      in the pathogenesis and pathophysiology of acute pancreatitis. Increased serum
      PLA2 activities and concentrations have been measured in patients with acute
      pancreatitis. Serum PLA2 activities have been shown to correlate with the
      severity and prognosis of the disease. To study the different methods of PLA2
      determination, we measured the PLA2 activity by means of an isotopic assay method
      and the concentration by a radioimmunologic method in several body fluids of 52
      consecutive patients with acute pancreatitis. PLA2 activity and concentration
      were detected in all of the patient body fluids. The serum PLA2 activities were
      2.5-fold higher (mean +/- SD, 7.6 +/- 6.0) than normal activities, and the
      concentrations were 9.6-fold higher (mean +/- SD, 41 +/- 88). The enzyme
      activities and concentrations correlated well in ascites, fluids from the pleural
      cavity, and peritoneal lavation and poorly in serum, urine, and fluid from
      pancreatic pseudocyst.

PMID- 2218400
TI  - Is gluten challenge necessary for the diagnosis of coeliac disease in young
      children?
AB  - Sixty-seven children under 2 years of age presenting with a classic clinical
      picture of coeliac disease with a severe small-intestinal mucosal lesion were
      investigated. All improved clinically and histologically on a gluten-free diet.
      During gluten challenge the mucosal damage recurred in 64 (95.5%) children, thus
      fulfilling the criteria for coeliac disease formulated by the European Society
      for Paediatric Gastroenterology and Nutrition. Three (4.5%) children had no
      mucosal relapse 2 years or more after return to a gluten-containing diet. These
      children were classified as having transient gluten intolerance. The low
      frequency of non-relapsers in the present study calls into question the practice
      of performing gluten challenge.

PMID- 2218402
TI  - Hepatitis delta virus superinfection among patients with chronic hepatitis B in
      southern Taiwan.
AB  - To study the prevalence of hepatitis delta virus (HDV) superinfection among
      patients with chronic hepatitis in southern Taiwan, total and IgM anti-delta
      antibody (anti-HD) and delta antigen (HDAg) were determined in 85 histology
      proven patients with chronic hepatitis. There were 12/85 (14.1%) cases with total
      anti-HD; 3 of them were also positive for IgM anti-HD. Another 9 (10.6%) cases
      were positive for HDAg. Thus, the prevalence of HDV superinfection was 21/85
      (24.7%), which was significantly higher than previous reports in southern Taiwan.
      The difference was not seen if anti-HD was used as the only detector. It is
      concluded that, when other methods are used than previously, HDV infection is
      more common than previously thought and there is no difference between different
      parts of Taiwan.

PMID- 2218401
TI  - A 10-year survey of clinically significant blood culture isolates and antibiotic
      susceptibilities from adult patients with hematological diseases at a major
      Swedish hospital.
AB  - In patients treated with cytotoxic drugs granulocytopenia and septicemia are
      commonly seen. In this 10-year survey 324 blood culture isolates from 184
      patients with hematological diseases and septicemia were studied. The
      distribution of microbiological diagnoses in patients with hematological diseases
      as well as acute leukemia 1980-1986 was significantly different (p less than
      0.01) from an unselected blood culture material from the same period. The
      differences are mainly seen between Enterobacteriaceae other than Escherichia
      coli, Pseudomonas aeruginosa and staphylococci. The microbiological spectrum for
      patients with hematological disease 1987-1989 was also significantly different (p
      less than 0.05) from the spectrum of the same group of patients 1980-1986 due to
      higher frequencies of coagulase-negative staphylococci and alpha-streptococci and
      lower frequency of E. coli in the latter period. 40% of the isolates were gram
      positive cocci during the first period and increased to 50% during the second
      period. The susceptibility testing indicates that trimethoprim/sulfonamide is not
      as good a choice as ciprofloxacin or norfloxacin for oral antibiotic prophylaxis.
      For intravenous therapy imipenem/cilastatin or the combinations of an
      aminoglycoside/piperacillin or aminoglycoside/third generation cephalosporin have
      advantages over aminoglycoside/trimethoprim/sulfa in combination. However,
      addition of isoxazolylpenicillin or vancomycin now seems necessary to cover the
      increasing part of gram-positive bacteria causing septicemia in patients with
      hematological disease.

PMID- 2218403
TI  - Incubation time of AIDS: progression of disease in a cohort of HIV-infected homo-
      and bisexual men with known dates of infection.
AB  - The time from infection with HIV to symptoms and AIDS is an important parameter
      in describing the natural course of HIV infection. We here describe disease
      progression in a group of 389 homo- and bisexual men. Of these 102 had known
      dates of infection, and during an average follow-up time of 31 months (range 2
      108), 28 of these progressed from being symptom-free (CDC group II and III) to
      having some symptom from CDC group IV; 7 progressed to AIDS. By life-table
      analysis, the estimated average time from seroconversion to first symptom is
      approximately 5 years and to AIDS approximately 8 years. Very few patients are
      diagnosed with AIDS the first 2 years after infection, but after that the risk
      seems to be 5-10% per year. Increasing use of anti-HIV medication will render
      studies of this kind difficult in the future.

PMID- 2218404
TI  - Streptococcal serogroup A epidemic in Norway 1987-1988.
AB  - A nationwide outbreak of Lancefield group A streptococcal (GAS) infections in
      Norway during the season 1987-88 is described. Data were collected from the
      Norwegian infectious disease notification system and supplemented by active
      search for cases of bacteraemia and other serious infections in addition to
      serotyping of selected clinical bacterial isolates. The number of reported cases
      of non-invasive GAS infections from week 29/1987 to week 28/1988 was 60% higher
      than expected. Between 1 Jan. and 30 June 1988, 84 cases of bacteraemia were
      notified, several with fulminant septicaemia and shock. The case fatality rate
      was 25%. Six cases of neonatal GAS septicaemia were seen. There was a nearly 3
      fold total increase in occurrence of GAS bacteraemia compared with previous
      years, and the increase was marked particularly in cases among older children and
      adults 30-50 years old. Additional culture-confirmed diagnoses included unusual
      cases compared to recent decades such as pneumonia with empyema, necrotising
      fasciitis and primary peritonitis. Serotyping of strains collected consecutively
      from localized infections revealed a marked predominance of T-type 1, opacity
      factor negative strains (T-1 OF-), ranging from 41% in North Norway to 87% in Mid
      Norway. M-typing confirmed that these strains were M-1, as were 87% of the
      preserved bacteraemia strains from the period described. Although most of the M-1
      strains were distinctly mucoid only one case of acute rheumatic fever was
      reported during the first half of 1988. We conclude that an epidemic of GAS
      infections caused by M-1 strains has occurred in Norway resulting in an increase
      in both incidence and seriousness of disease.

PMID- 2218405
TI  - Reappearance of group A streptococci in acute otitis media.
AB  - Specimens from acute otitis media (AOM) examined in the first quarter of the
      years 1986, 1987, 1988, and 1989 were reviewed in order to point out any changes
      in the bacteriological etiology. A total of 1,722 specimens were taken in the
      community and in the hospitals of a county of 500,000 inhabitants in the 4-year
      period: 447 (1986), 420 (1987), 388 (1988), 467 (1988). The majority of the
      specimens came from children less than 10 years of age. The specimen sampling
      technique differed between the various otologists, but their sampling techniques
      were constant through the years. Haemophilus influenzae was the most frequent
      isolate and held a constant incidence of 29.9% with little variation. In 1986-88
      Streptococcus pneumoniae was the second (19.8%) and group A streptococci (GAS)
      the third (9.8%) most common agent in frequency. In 1989 a change in the
      etiologic agents was seen as GAS increased in frequency to 18.8% (p less than
      0.001), while no significant changes occurred in the frequency of H. influenzae
      and S. pneumoniae. 33% of the specimens were negative in the whole period. It is
      too early to decide whether a transient epidemic has occurred or whether the
      findings announce a more constant change in etiology.

PMID- 2218406
TI  - Haemophilus isolated from unusual anatomical sites.
AB  - During a 15-year period Haemophilus species were isolated from unusual anatomical
      sites in 80 patients, mostly adults. The origin of specimens was pus and swabs
      from suppurative lesions, fluids from serosal cavities and gall bladder, gut
      content, and blood in cases with a supposed tissue focus. In 17 patients
      Haemophilus species were isolated in pure culture, in 63 patients in conjunction
      with other bacteria. 17 patients had gynaecological complaints: bartholinitis,
      salpingitis, and vaginal discharge. 22 patients had gastrointestinal complaints,
      comprising 17 with appendicitis, peritonitis following perforation of gastric
      ulcer, gall-duct infections, and an abscess in the stomach wall, and 5 patients
      with colonization of the gut. 41 patients had soft tissue and bone infections.

PMID- 2218407
TI  - Prevalence of IgM antibodies to nine Legionella species in Icelandic children.
AB  - In order to evaluate the prevalence of antibodies to Legionella species among
      children in Iceland, a prospective study was conducted in 424 children aged 1
      month to 12 years, 28 of whom had an acute respiratory tract infection. Antibody
      titers to L. pneumophila serogroup 1-6, L. bozemanii, L. dumoffii, and L.
      micdadei were measured by microagglutination technique. Seroreactivity to
      Legionella spp. was found in 30% of the children greater than 3 years of age and
      in 22% of all children. The majority of the children with legionella antibodies
      had no history of previous or present respiratory tract infection. The children
      with previous pneumonia or bronchial asthma did not show a higher seroreactivity
      to legionella than children without such a history. Our observations suggests
      that Icelandic children are frequently exposed to Legionella species or closely
      related bacteria.

PMID- 2218408
TI  - Estimation of symptomatic and asymptomatic Salmonella infections.
AB  - Since the surveillance of salmonellosis in Sweden is primarily passive, it can be
      assumed that most of the asymptomatic salmonella infections are never identified.
      We here report the proportion of asymptomatic and symptomatic salmonella
      infections in Swedish travellers to different geographic areas as well as in
      "contacts" to index cases with salmonellosis. In the 346 travellers studied
      Salmonellae were isolated equally often among those who remained healthy (10/216;
      4.6%) as in those with intestinal symptoms (7/130; 5.4%). Similarly, most of the
      salmonella-infected "contacts" to index cases (11/15; 73%) had an asymptomatic
      infection. No difference in the mean duration of excreting Salmonella in the
      stool was found between carriers with symptomatic and asymptomatic infection. The
      literature concerning transmission of nontyphi Salmonellae from carriers was
      reviewed. Since person to person transmission is rarely noted, screening for
      carriers may be limited to food handlers and hospital personnel taking care of
      patients susceptible to low infective doses of Salmonella. Similarly, follow-up
      faecal cultures in individuals with notified salmonella infection may be
      restricted to these groups.

PMID- 2218409
TI  - Toxigenic Escherichia coli associated with sudden infant death syndrome.
AB  - The role of Escherichia coli as a cause of sudden infant death syndrome was
      investigated prospectively. Strains of E. coli producing the heat labile
      enterotoxin (LT) or the Vero-cell cytotoxin (VT) were isolated from the
      intestinal contents of 21/46 infants who died from sudden infant death syndrome
      (SIDS). None were found in the contemporaneously sampled faeces of 24 normal live
      infants in the same area. Live infants were used as controls in the absence of
      dead infants who had not died of SIDS. This high incidence of toxigenic E. coli
      among the SIDS infants versus the low incidence in controls, together with the
      general rarity of finding such toxigenic E. coli in the community of a temperate
      developed country, made us conclude that there may be a causal relationship
      between toxigenic E. coli and SIDS. The O and H serotypes of the toxigenic E.
      coli associated with SIDS infants tended not to be those normally considered to
      be toxigenic. The toxigenicity appeared to be relatively labile. It is suggested
      that SIDS may be associated with the infant either acquiring these unusual types
      of E. coli or more likely that its normal resident E. coli acquire the plasmids
      to produce these toxins.

PMID- 2218410
TI  - Neonatal sepsis due to Streptococcus pneumoniae.
AB  - A 20-year-old primigravida in the 33rd week of gestation was delivered of a girl
      weighing 1,790 g 23 h after spontaneous rupture of the membranes. 13 h after
      birth, the child showed signs of shock. Cultures of blood, conjunctiva and
      nasopharyngeal aspirate grew Streptococcus pneumoniae of serotype 11. Cultures
      from the mother's cervix and from the placenta and membranes also grew S.
      pneumoniae of the same serotype. The infant responded well to ampicillin and
      netilmicin. The early-onset pneumococcal septicemic cases reported over the last
      20 years are reviewed.

PMID- 2218412
TI  - Ciprofloxacin treatment of murine typhus.
AB  - A 31-year-old woman developed fever, severe headache, myalgia and rash 3 weeks
      after a visit to Cyprus where she experienced insect bites in her bed. Treatment
      with ciprofloxacin resulted in a remarkable and rapid effect. Endemic typhus was
      proved by serology.

PMID- 2218411
TI  - Fatal mucormycosis presenting as an appendiceal mass with metastatic spread to
      the liver during chemotherapy-induced granulocytopenia.
AB  - Opportunistic fungal infections occur with increasing frequency during
      chemotherapy induced granulocytopenia. A 27-year-old woman developed mucormycosis
      in the ileocecal region with fatal dissemination to the liver while receiving
      consolidation therapy for acute T-lymphoblastic leukemia. The infection occurred
      during a period of decreased colonization resistance in the intestinal tract.
      Early symptoms were high fever unresponsive to broad spectrum antibiotics, severe
      pain in the right lower abdominal quadrant and diarrhoea. This was followed by an
      infiltrate in the right abdomen, ileus, and icterus. Diagnosis was established in
      the living patient by thin needle aspiration from affected liver tissue. Giemsa's
      stain and fungal cultures revealed Mucor indicus. The fatal outcome of
      disseminated mucormycosis justifies a high index of suspicion and a maximal
      (invasive) diagnostic effort as localised infections might be cured by resection
      and amphotericin B.

PMID- 2218413
TI  - Successful aztreonam treatment of acute typhoid fever after chloramphenicol
      failure.
AB  - Aztreonam treatment was successful in 4 cases of typhoid fever. The patients were
      seriously ill with growth of Salmonella typhi in blood cultures despite treatment
      with chloramphenicol. Aztreonam appears to be a useful alternative to standard
      therapy of typhoid fever.

PMID- 2218414
TI  - Are tumor necrosis factor (TNF) or cortisol of value for the diagnosis of acute
      septicemia?
AB  - Early diagnosis is of great importance to improve the prognosis of septicemia.
      Traditional laboratory tests are either delayed like blood cultures, or
      unspecific like WBC count or ESR. In this retrospective pilot study we have
      assayed plasma cortisol, blood sugar and serum tumor necrosis factor (TNF) from
      patients with verified septicemia. With the approach used in this study none of
      the tests were able to differentiate between septicemia and other infectious
      febrile illnesses, or to predict if the causing organism was gram-positive or
      gram-negative.

PMID- 2218415
TI  - Invasive Haemophilus influenzae infections in adults: a patient with prosthetic
      valve endocarditis.

PMID- 2218416
TI  - The influence of quinolones on the faecal flora.
AB  - Ingestion of antimicrobial agents may in several ways influence the indigenous
      flora of the human digestive tract. The influence can be evaluated by following
      qualitative and/or quantitative alterations in the composition of the flora and
      of its antibiotic resistance profile (ARP). Another approach is to follow
      alterations in physiological and/or biochemical intestinal characteristics which
      depend on the intestinal flora. In a Norwegian-Swedish collaborative study, the
      influence of 10 orally given antimicrobial drugs on seven to nine various
      biochemical microflora-associated characteristics in groups of healthy volunteers
      was followed. In contrast to most of the other drugs given, ofloxacin exerted
      almost no influence upon the characteristics investigated. The result of this
      study are reviewed, as well as the results of other studies dealing with the
      influence of the quinolones on the faecal flora.

PMID- 2218417
TI  - The pharmacokinetics of oral quinolones (norfloxacin, ciprofloxacin, ofloxacin).
AB  - The newer fluoro-quinolones including norfloxacin, ciprofloxacin and ofloxacin
      are all characterized by a good penetration into tissues and cells. In contrast
      to beta-lactam antibiotics, these quinolones often achieve tissue concentrations
      which are several times higher than concurrent serum levels. Therefore, MIC
      values should not be related to serum concentrations only, when possibilities for
      the use of quinolones in tissue infections are discussed. Following oral
      administration, norfloxacin and ciprofloxacin are well absorbed and the
      bioavailability of ofloxacin is almost 100%. Absorption is delayed but not
      reduced by food. Ofloxacin is mainly excreted unchanged; norfloxacin and
      ciprofloxacin are metabolized to some extent, but most metabolites are
      biologically active. Half-lives of the drugs are 3-6 hours and they may therefore
      be administrated twice daily. These quinolones are excreted by glomerular
      filtration and tubular secretion but also via faeces. Dose reduction is needed
      only in patients with severe reduction of kidney function. It has been suggested
      that when renal function is reduced an increased transintestinal passage of the
      quinolones may result. In the intestines the quinolones seem to be bound to
      faeces; anaerobes are mainly unaffected by these antibiotics.

PMID- 2218418
TI  - Treatment of chlamydial infections.
AB  - Antibiotic therapy of chlamydial infections means treatment of an intracellular
      parasite. That is, the antibiotic drug has to pass not only over the cell
      membrane of the organism but also over the cell membrane of the host cell and
      over the membrane lining the intracytoplasmatic vacuole, where the chlamydiae
      reproduce. To what extent antibiotic may induce "latent" chlamydial infections is
      badly defined. Beta-lactam antibiotics in certain concentrations may induce cell
      wall-deficient forms of chlamydiae. Still there is non-conformity in performing
      in vitro susceptibility tests and diversed opinions of how to interpret such
      tests. For several antibiotics there is a discrepancy between the result of in
      vitro susceptibility tests and therapeutic trials. There is a need for long term
      follow-up studies of the effect of antibiotic therapy of genital chlamydial
      infections. Just less than half of such infections in females are complicated,
      i.e., cases of endometritis/salpingitis. It is very difficult to differentiate
      uncomplicated from complicated genital chlamydial infections without invasive
      tests. Approximately 40% of chlamydial cervicitis cases has a concomitant PID.
      Thus all genital chlamydial infections in females should be treated as
      complicated.

PMID- 2218419
TI  - Occurrence of Ureaplasma urealyticus and Mycoplasma hominis in non-gonococcal
      urethritis before and after treatment in a double-blind trial of ofloxacin versus
      erythromycin.
AB  - The efficacy of ofloxacin, a new quinolone derivate, was tested against that of
      erythromycin in a prospective double-blind trial in patients with non-gonococcal
      urethritis (NGU) with special reference to the occurrence of Mycoplasma hominis
      and Ureaplasma urealyticum. 188 male NGU patients were randomized to treatment
      with either ofloxacin 200 mg b.i.d. or erythromycin 500 mg b.i.d. for seven days.
      Before treatment eight (4.3%) patients, five in the erythromycin group and three
      in the ofloxacin group, were M. hominis positive. At follow-up day 8 and 15 after
      start of treatment all five in the erythromycin group and two in the ofloxacin
      group were still positive. U. urealyticum was recovered in 16 patients (8.5%)
      before treatment. One patient was still positive in the erythromycin group when
      examined day 15, whereas all patients were negative in the ofloxacin group at
      both follow-up controls. Clinically, the efficacy of treatment day 15 was 77.4%
      in the erythromycin group and 84.3% in the ofloxacin group. The difference was
      not significant. Side-effects occurred in 38.5% in the erythromycin group and in
      21.3% in the ofloxacin group. This difference is significant. Ofloxacin is
      effective in the treatment of NGU in males and is an alternative to conventional
      antibiotic treatment.

PMID- 2218420
TI  - Ofloxacin in urinary tract infections.
AB  - Ofloxacin belongs to a new generation of fluorinated quinolones which are
      structurally related to nalidixic acid. It is an orally or parenterally
      administered antibacterial drug active against most Gram-negative aerobic
      bacteria, many Gram-positive bacteria and some anaerobes. The pharmacokinetic
      profile or ofloxacin shows a rapid gastrointestinal absorption and high
      concentrations are achieved in most tissues and body fluids. Clinical efficacy of
      ofloxacin has been demonstrated in a variety of systemic infections as well as in
      acute and chronic urinary tract infections and ofloxacin has generally appeared
      to be at least as effective as comparative orally administered antibiotics.
      Ofloxacin is well tolerated and bacterial resistance does not appear to develop
      readily, however, noncritical use of quinolones in simple infections where
      standard drugs may be equally effective and safe should be discouraged. In
      conclusion, ofloxacin is an orally active drug which offers a valuable
      alternative to other broad spectrum antibacterial drugs.

PMID- 2218421
TI  - Oral ofloxacin once daily and doxycycline in the treatment of acute exacerbations
      of chronic bronchitis.
AB  - 192 patients, most of them ambulatory, with acute exacerbation of chronic
      bronchitis were treated with 10- to 14-day courses of oral ofloxacin receiving
      400 mg once daily or doxycycline first 200 mg and then 100 mg once daily in this
      randomized observer-blinded multicentre study. 98 patients were included in the
      ofloxacin group and 94 in the doxycycline group. The clinical efficacy was 86/87
      (98.8%) in the ofloxacin group and 87/91 (91.2%) in the doxycycline group. The
      bacteriological efficacy was 31/34 (91.2%) in the ofloxacin group and 19/24
      (79.2%) in the doxycycline group. Some patients had more than one pathogen. There
      was no statistically significant difference in efficacy between the two treatment
      groups; both treatments were highly effective and well tolerated. The adverse
      events showed an expected pattern. Ofloxacin treatment was discontinued in three
      patients. In conclusion, both treatments were found to have similar safety and
      efficacy and were well tolerated when used for treatment of acute exacerbations
      of chronic bronchitis.

PMID- 2218422
TI  - A comparative study of ofloxacin and pivmecillinam in acute exacerbations of
      chronic bronchitis.
AB  - In a double-blind study in 84 patients with chronic bronchitis and purulent
      exacerbations, ofloxacin 200 mg b.i.d. and pivampicillin 700 mg t.i.d., were
      compared with respect to efficacy and safety. Both treatments resulted in a
      uniform and very high bacteriological elimination rate (94.1% to 97.2%) and
      clinical cure rate (97.4% to 97.6%). There were, however, signs of fewer adverse
      reactions and a better patient acceptance in the ofloxacin group.

PMID- 2218423
TI  - Prospective randomized clinical trials of new quinolones versus beta-lactam
      antibiotics in lower respiratory tract infections.
AB  - In four prospective randomized clinical trials between November 1983 and March
      1988, we studied 270 patients with severe bacterial infections, mainly lower
      respiratory tract ones. We compared ciprofloxacin and imipenem/cilastatin in the
      first study, ciprofloxacin and ofloxacin in the second study, ciprofloxacin and
      ticarcillin/clavulanic acid in the third study, and ofloxacin and cefpirome in
      the fourth study. A total of 90 pneumonias, 139 LRTIs, 22 septicaemias and 19
      other bacterial infections were treated; the dominant pathogens were Pseudomonas
      aeruginosa and enterobacteria. Clinical success rates were high; cure or
      improvement was registered in 89% of the patients on ciprofloxacin, 89% on
      ofloxacin and 85% on beta-lactams. Treatment failures occurred mainly in ICU
      patients with terminal underlying diseases. Bacteriologically, eradication rates
      were high for enterobacteria and Staphylococcus aureus, but a relatively high
      persistence rate was seen for P. aeruginosa due to increased resistance and/or
      specific type and location of the infections. The incidence of side-effects was
      relatively high (23%-29%) which was related to careful monitoring. Adverse
      effects were group-specific (CNS reactions with quinolones, diarrhoea with beta
      lactam antibiotics).

PMID- 2218424
TI  - Overview of experience with ofloxacin in respiratory tract infection.
AB  - Ofloxacin is highly active against common respiratory pathogens including
      Haemophilus influenzae and Branhamella catarrhalis and has clinically applicable
      activity against Streptococcus pneumoniae, Staphylococcus aureus and Pseudomonas
      aeruginosa. Sputum, lung tissue and bronchial mucosal concentrations of ofloxacin
      equal or, in most cases significantly exceed the MICs of such pathogens. These in
      vitro attributes are reflected in the results of the worldwide ofloxacin clinical
      trial program which achieved overall response rates of 98% in lower respiratory
      tract infections, 83% in pneumonias and 87% to 95%, in open and comparative
      studies respectively, in patients with acute exacerbations of chronic bronchitis
      (CB). Overall bacterial eradication rates ranged from 70% for pneumococci and
      84.5% for B. catarrhalis to 88.5% for H. influenzae. In lower respiratory
      infection ofloxacin gave equal or superior clinical results to amoxycillin or
      erythromycin therapy together with an overall bacterial eradication rate of 100%.
      Clinical results comparable with standard agents were also obtained in pneumonia,
      cure rates ranging from 77-89% at various dosages. Eradication rates proved
      greatest for H. influenzae (92%) and were satisfactory for Klebsiella spp. (80%),
      although less so for pneumococci (73%). Bacteriological eradication rates in
      acute exacerbations of chronic bronchitis ranged from 68% for pneumococcal
      infections, to 85% in B. catarrhalis and 94% in H. influenzae infections.
      Ofloxacin compared favourably with pivampicillin, co-trimoxazole and doxycycline
      clinically. A daily oral ofloxacin dose of 400 mg produced a good clinical
      response in 92% of patients or more. The available clinical data therefore
      substantially confirm the claim of ofloxacin to offer an effective alternative in
      many forms of acute bacterial respiratory infection, especially where H.
      influenzae and B. catarrhalis are involved.

PMID- 2218425
TI  - Clinical experience with parenteral and oral ofloxacin in severe infections.
AB  - This study included 107 patients who were given ofloxacin at daily doses of 400
      800 mg for 10 days to 12 months for treatment of a variety of infections. 77
      patients were given ofloxacin orally and 30 received it intravenously. Infections
      treated were bronchopneumonia (29), chronic bronchitis with acute exacerbation
      (15), chronic osteomyelitis with exacerbation (20), soft tissue infections (13),
      complicated urinary tract infections (7), chronic prostatis with exacerbation
      (7), malignant external otitis (4), or other infections (12). Pathogens included
      Pseudomonas aeruginosa (39), Acinetobacter spp. (9), various Enterobacteriaceae
      (30), Haemophilus influenzae (26), pneumococci (1) and Staphylococcus aureus (4).
      MICs of ofloxacin ranged from less than 0.06-2 mg/l. Clinically, 69% of the
      patients were cured, 18% improved and 13% failed to respond. Bacteriologically,
      pathogens were eradicated in 70%, persisted in 16% and relapsed in 14%.
      Resistance during therapy developed almost exclusively in P. aeruginosa strains
      (17.9%). The following adverse reactions were reported: gastrointestinal
      disturbances (6), rash plus facial oedema (1), abnormal liver function tests (5)
      and leukopenia (1). It is concluded that ofloxacin is suitable for treatment of a
      variety of infections, ranging from serious life threatening infections in ICU
      patients to chronic ones that require prolonged therapy.

PMID- 2218426
TI  - Resistance situation of oral antibiotics in the Scandinavian countries with
      special reference to the fluoro-quinolones.
AB  - In general, the Scandinavian countries have a rather conservative attitude
      towards new antimicrobial agents. Our antibiotic policies are based upon many
      years of clinical and laboratory experiences. It is generally believed, although
      not always satisfactorily proven, that our relatively restrictive attitude to the
      use of new as well as of older antimicrobial drugs by one mechanism or another,
      is a matter of some importance when explaining the relatively low antibiotic
      resistance profile (ARP) existing in most places in Scandinavia. When a new group
      of drugs, such as the quinolones, is going to be introduced in the therapeutic
      armamentarium, the existing ARPs of the microbes actually involved have to be
      taken into consideration.

PMID- 2218427
TI  - Swedish Association of Urology. Proceedings of the annual spring meeting 1990.
      Lund, May 3-4, 1990. Abstracts.

PMID- 2218428
TI  - Frozen shoulder: current concepts.
AB  - The literature on frozen shoulder (FS) is reviewed. The etiology of FS is still
      not known and our understanding of the pathogenesis is limited. Studies on
      treatment programs under controlled conditions are few and incomplete. Further
      research is urgently needed.

PMID- 2218429
TI  - Distribution of Gm allotypes in juvenile chronic arthritis.
AB  - The immunoglobulin allotypes G1m(a), G1m(x), G2m(n), G3m(b) and Km(1) were
      determined in 76 Swedish patients with juvenile chronic arthritis (JCA). Eight of
      the patients had the systemic form of the disease. 37 belonged to the
      polyarticular and 31 to the oligoarticular subset. The frequency of the G1ma(x),
      G3m-b haplotype was significantly increased in the polyarticular subset but not
      in the oligoarticular subset, compared with the normal population (p less than
      0.01). The polyarticular subset also differed from the oligoarticular subset with
      increased frequency (p less than 0.01) and higher levels (p less than 0.01) of
      IgM rheumatoid factor and a lower rate of remission (p less than 0.05). The few
      JCA patients in the systemic subset showed similar features as the polyarticular
      patients. The frequencies of G2m(n) and Km(1) did not deviate from the expected
      in any of the JCA subsets.

PMID- 2218430
TI  - IgG and IgA subclass distribution of total immunoglobulin and rheumatoid factors
      in rheumatoid tissue plasma cells.
AB  - The subclass distribution of IgG and IgA plasma cells, and in IgG and IgA
      rheumatoid factor (RF) producing cells was studied in sections of synovial tissue
      from seropositive RA and various types of seronegative arthritis, including
      ankylosing spondylitis, psoriatic arthritis, and Reiter's syndrome. The study was
      performed with immunofluorescence technique and monoclonal IgG and IgA subclass
      specific antibodies. IgG RF producing cells were identified by their ability to
      bind and activate factors both in the early (C3) and late (C5b-9) part of the
      complement cascade. IgA RF cells were identified by double staining experiments
      with heat-aggregated IgG and monoclonal antibodies to IgA subclasses. In 23
      tissues tested for total IgG, IgG1 cells were usually predominant, while the
      frequency of IgG3 cells was usually higher than that of IgG2. In 19 tissues also
      tested for IgA, both IgA subclasses were present in all tissues. IgA1 plasma
      cells were always predominant, with a mean ratio of IgA1 to IgA2 cells of
      approximately 10. In the 13 tissues tested for RF-producing cells, the highest
      frequency of IgG RF cells was found among the IgG3 cells, followed by IgG1 and
      IgG2. IgA RF cells were found in only one case, all cells being IgA1.

PMID- 2218431
TI  - Salmonella-reactive synovial fluid T-cell clones in a patient with post
      infectious Salmonella arthritis.
AB  - From a patient with reactive arthritis following Salmonella typhimurium
      enteritis, synovial fluid T-lymphocytes were cloned and expanded in vitro. Seven
      out of 74 clones showed a marked proliferative response to antigens of heat
      killed Salmonella typhimurium with autologous T-cell-depleted peripheral blood
      mononuclear cells as antigen-presenting cells. The Salmonella-reactive clones
      were of the CD4+ phenotype, antigen-induced proliferation could be inhibited by a
      monoclonal antibody to HLA class II. One clone recognized both Salmonella and
      Campylobacter jejuni antigens in the proliferation assay. The multiclonality of
      Salmonella-reactive synovial fluid T-cells indicates that the microorganisms have
      been present, at least transiently, within the affected joint and thus recruited
      specific T-lymphocytes that might initiate synovitis.

PMID- 2218433
TI  - Functional and psychosocial consequences of disease and experience of pain and
      exertion in a group of rheumatic patients considered for active training. Result
      of a survey in Bollnas Medical District. I.
AB  - The purpose of this study was to select and describe a group of RA patients
      within a defined area who had, on clinical grounds, been considered for active
      training. The material consisted of 69 patients with classical or definite RA. It
      comprised half of the RA patients known to the clinic. The patients were assessed
      by means of a questionnaire, functional tests with rating of activity-induced
      pain, a cycling-test with rating of perceived exertion, and an interview by a
      psychologist. Subjective disease consequences were pain and stiffness. 38% of the
      patients never or seldom exercised. 72% wished to increase their activity but
      were prevented by pain. The functional tests indicated slow performance and
      considerable pain in activities of daily life. The interview disclosed above all,
      a low degree of self-confidence. Generalized pain and functional impairment
      correlated slightly with psychosocial factors. The results of the study indicate
      the need for active training as one strategy to alleviate pain and to maintain
      functional capacity in RA patients.

PMID- 2218432
TI  - Signs and symptoms in the masticatory system in ten patients with mixed
      connective tissue disease.
AB  - Ten patients with mixed connective tissue disease (MCTD) were examined for signs
      and symptoms in the masticatory system. The study included clinical,
      radiological, histological and immunohistochemical examinations. The status of
      the teeth and periodontium did not seem to differ from that found in the general
      Finnish population. All 10 patients showed clinical dysfunction, and 7 had
      additional radiographic changes of the temporomandibular joints. Sialopenia was
      observed in 7 patients, and histological examination revealed sialoadenitis with
      a focus score exceeding 1 in the labial salivary glands in 9 patients. Only 1
      patient had clinically detectable mucosal lesions. However, in 5 of 6 patients
      with normal-appearing mucosa, histological examination revealed chronic
      inflammation. Three of the 10 patients had clinically atrophic and erythematous
      oral mucosa; histological examination again revealed chronic inflammation. The
      signs and symptoms appearing in the masticatory system of these 10 MCTD patients
      were many and varied and indicate the importance of closely examining all oral
      structures. As with other connective tissue diseases, MCTD should be treated on a
      multidisciplinary basis.

PMID- 2218434
TI  - Methimazole and arthritis.

PMID- 2218435
TI  - Type A behaviour in pre-school children: interrater reliability, stability over
      six months and subcomponents.
AB  - Type A behaviour was measured in 250 boys and 245 girls (ages 3-7) using a
      Swedish version of Matthews' Youth Test for Health (MYTH). In addition, speech
      and voice characteristics (speed, loudness, response latency) were measured. Each
      child was independently rated by two play group leaders and measurements were
      repeated after a six month interval. Interrater reliability (first session) was
      0.76 for both sexes and did not change with the age of the child. Boys obtained
      significantly (p less than 0.0001) higher scores than girls. Correlations over
      the six month period were 0.64 and 0.60 (p less than 0.001) for the two possible
      combinations of different raters and slightly higher (0.75 and 0.68, p less than
      0.001) when the same rater was used. Two components of Type A behaviour were
      identified from a factor analysis of the data: impatience and competitiveness,
      and they accounted for 57% of the total variance. As for the total scale, boys
      obtained significantly higher scores than girls on both subscales. Scores on the
      competitiveness scale increased systematically with age. Speech and voice
      characteristics correlated significantly with Type A scores (total Type A
      behaviour: r = 0.50, using different raters, and 0.71, using the same raters, p
      less than 0.001) and, once again, boys obtained significantly (p less than 0.001)
      higher scores than girls. The results are in close agreement with the American
      findings from the original scale. It was concluded that the scale provides a
      reliable and valid instrument for measuring Type A or Type A-like behaviours in
      pre-school children.

PMID- 2218436
TI  - Mice selectively bred for an open field activity increase after maze learning.
AB  - A unidirectional selective breeding experiment performed over six generations
      resulted in a line of mice (S6), which differed from the maintained unselected
      Swiss albino strain, called normal (N) strain, in the following respects: S6 mice
      increased their open field activity after maze learning significantly more than N
      mice. S6 mice ambulated more and exhibited more thigmotactic behaviour in a
      circular open field than N mice. S6 mice were superior than N mice in regard to
      maze learning capacity. Finally, S6 mice were interpreted as significantly less
      emotional according to their defecation, more responsive to novelty according to
      their urine pattern and more aggressive than N mice.

PMID- 2218437
TI  - Rod suppression of cone-mediated information about colour and form during dark
      adaptation.
AB  - Following substantial bleaches, the specific form and hue thresholds were
      measured during dark adaptation with a test stimulus of 1 x 2 degrees at 40
      degrees extrafoveally. The wavelength of the test field was varied between runs.
      The results show that both thresholds started to rise at about the cone-rod break
      of the dark-adaptation curve, irrespective of wavelength used in the test.
      Furthermore, the specific threshold for form was found to rise when a scotopic
      stimulus was superimposed on a photopic test flash. On the other hand, both
      thresholds remained at the cone-plateau level when the test flash was confined
      within the rod-free fovea. In order to explain the rise in the specific
      thresholds, it is suggested that signals from rods generated directly in response
      to the test stimulus may suppress both cone-mediated form and colour. It is also
      suggested that this type of rod-cone interaction represents a general
      characteristic involved in several kinds of visual information processing.

PMID- 2218438
TI  - Psychometric properties of the Danish MCMI-I translation.
AB  - A translation of the MCMI-I has been in use in Denmark for some years. An
      untested assumption in the interpretation of the pattern of test results is that
      the psychometric characteristics of the Danish and American versions are similar.
      The purpose of this study was to evaluate the psychometric properties of the
      questionnaire by using traditional psychometric analysis techniques on the
      results of a sample consisting of 423 patients and 179 normal controls.
      Coefficient alpha was calculated for the 20 clinical subscales of the test and
      the Danish results were strikingly similar to the original coefficients reported
      by Millon. Furthermore, factor analysis of the subscales showed a factor
      structure very similar to American findings, and it is concluded that the
      psychometric properties of the Danish MCMI are not significantly different from
      the original.

PMID- 2218439
TI  - On the distinction between perception and cognition.
AB  - To uphold the distinction between perception and cognition for certain classes of
      tasks or phenomena, it is proposed that three criteria must be met: (1) when
      perceptual and cognitive functions serve different biological purposes, (2) when
      stimulus information in dynamic events is necessary, but not sufficient for
      veridical perception, and (3) when the task emphasizes explicit retrieval, as
      opposed to implicit use of information. Conversely, when the three criteria have
      not been met, conditions for theoretical unification exist.

PMID- 2218440
TI  - Personality organization defined by DMT and the Structural Interview.
AB  - The psychoanalytic concept of Personality Organization (PO) may be
      operationalized by means of a Structural Interview as well as by means of
      psychological tests. The present study utilized the Structural Interview and a
      projective test called the Defence Mechanism Test (DMT) to operationalize the PO
      concept on a sample of 50 psychiatric inpatients. The reliability of the PO
      judgements were found to be acceptable for both the Structural Interview and the
      DMT. The validity, which was estimated as the correlation between the two
      methods, was also found to be substantial. The conclusion is that the concept of
      PO may be reliably operationalized for psychiatric patients and seems to have
      concurrent validity. Both the DMT and the Structural Interview may be used for
      differential diagnosis of PO.

PMID- 2218441
TI  - Tachistoscopic and questionnaire methods for the measurement of psychological
      defences.
AB  - Only few attempts have been made to compare different methods aiming at
      quantifying defensive strategies. In this study the tachistoscopic Defence
      Mechanism Test (Kragh, 1960b and 1985) is compared to paper-and-pencil tests of
      defence. There were virtually no correlations between the DMT and the other
      measures of defence. This may indicate that the concept of defence is a highly
      complex one. It is suggested that the Defence Mechanism Test may be measuring
      primary defence while defence questionnaires may be assessing more secondary
      forms of defence. The two questionnaires used for assessing defence correlated
      significantly, while a scale for social desirability showed no correlation with
      DMT or the two defence questionnaires.

PMID- 2218442
TI  - Rorschach-profile in panic disorder.
AB  - The Rorschach test was applied to four groups: 41 Panic Disorder (PD), 14 Major
      Depression (MD), 11 Generalized Anxiety Disorder (GAD) and 18 normal subjects.
      The aims were to describe the test profile of PD patients and to discuss
      implications for cognitive processing ability and personality structure. A
      hypothesis of a borderline personality structure in PD patients, based on
      psychodynamic literature, was tested, but was not unambiguously supported. A
      "loose", borderline-like personality structure and disturbances in processing
      abilities, however, characterized PD-patients. The normal subjects surprisingly
      provided many Fabulized Combinations, a response type, considered suspect of
      borderline pathology, but also showed more signs of integrative and synthesizing
      abilities than the other groups.

PMID- 2218443
TI  - [Airport malaria: mini-epidemic in Switzerland].
AB  - Five cases of airport malaria were observed in Geneva in the summer of 1989. All
      the patients lived within 2 km of Geneva-Cointrin International Airport. They
      were hospitalized between July 14 and August 2 for high fever. None had received
      a recent blood transfusion, an i.v. injection or traveled to a tropical country,
      except for one, a former pilot, whose last brief visit had been a year earlier.
      High minimum temperatures between July 6 and 10 in all likelihood allowed the
      survival of infected anopheles introduced by an aircraft. P. falciparum was
      identified in the blood smears of all the patients. Four had one or more symptoms
      of serious malaria and received intravenous treatment. In the fifth patient,
      treatment with cotrimoxazole for suspected acute pyelonephritis made diagnosis
      particularly difficult because the malaria infection was partially controlled by
      the antibiotic therapy. The time necessary for diagnosis of malaria varied from 5
      to 31 days in the 5 cases. Airport malaria has been observed over the past twenty
      years in Europe, particularly in the summer, and is often serious because of late
      diagnosis and the type of plasmodium most frequently involved, P. falciparum.
      This diagnosis should be considered in patients with high fever of unknown
      origin, even when they have not travelled to an endemic zone.

PMID- 2218444
TI  - [Isolated trochlear nerve paralysis following head trauma].
AB  - 39 cases with isolated trochlear nerve palsies of traumatic origin have been
      analyzed retrospectively. 18 patients (46%) had had cerebral contusion, 15 (39%)
      cerebral concussion, and 6 patients (15%) a minor head trauma. 33 patients had
      unilateral trochlear nerve palsies and 6 (all of them with cerebral contusion)
      bilateral. The degree of the palsies did not correlate with the severity of the
      head trauma. Essential pathogenetic mechanisms were frontal or occipital blows.
      We emphasize a fact hitherto underestimated in the literature, that even a
      relatively mild head trauma (cerebral concussion or minor head trauma) can cause
      isolated trochlear nerve palsies. This was the case in 21 of our 39 patients
      (54%). Simple clinical examination techniques are described (Bielschowsky
      phenomenon, pencil test), which allow detection of trochlear nerve palsies in
      most cases.

PMID- 2218445
TI  - [Chronic urticaria and acquired complement deficiency due to a nephritic factor
      (C3NeF)].
AB  - Several studies have suggested that complement activation processes are
      frequently involved in the pathogenesis of urticaria. We report clinical
      evolution and studies of complement-mediated functions in a 47-year-old
      previously described patient presenting with chronic urticaria, in whom we found
      persistent low complement hemolytic activity (65-75% of normal values), depressed
      levels of third complement component (C3, between 55% and 65%) and of factor B
      (between 60% and 75%), together with C1, C4, C2, C5, C5b neoantigen and fluid
      phase terminal complement (SC5b-9) complex within the normal range, pointing to
      activation of the alternative pathway. A circulating low affinity C3 nephritic
      factor (C3NeF), known to enhance cleavage of human serum C3, was detected. The
      urticarial lesions, which were initially pruritic and persisted for less than 24
      hours, became subsequently fixed and burning, and were accompanied by fever and
      arthralgia. Skin biopsy specimens showed moderate leukocytoclastic vasculitis.
      Response to varied treatment regimens, including antihistamines and colchicine,
      was poor. Therapy with oral corticosteroids produced some improvement. The
      association of chronic urticaria with C3NeF without clinical and biological signs
      of membranoproliferative glomerulonephritis and partial lipodystrophy has not to
      our knowledge been reported before. This observation raises the question of a
      possible role of C3NeF in the pathogenesis of urticaria.

PMID- 2218446
TI  - [X-chromosomal adrenoleukodystrophy. A peroxisomal disease important for
      differential diagnosis in the internal medicine-neurological field].
AB  - Clinically, X-chromosomal adrenoleukodystrophy is characterized by a variable
      neurological symptomatology and non-obligatory adrenocortical insufficiency. The
      underlying pathogenetic mechanism consists of a disturbance of the peroxisomal
      metabolism of fatty acids with consecutive accumulation of very long chain fatty
      acids (VLCFA) in the blood. The diagnosis of this rare condition is important in
      view of the possibility of special dietary treatment and genetic counseling of
      the family.

PMID- 2218447
TI  - [Etiology of diarrheal diseases in immunocompetent and HIV-positive patients].
AB  - In 1986 and 1987 the stool samples of 206 patients of the Medical Outpatient
      Clinic Basel were examined prospectively for bacteria, protozoa and worms.
      Clinical data of the patients were recorded by questionnaire. The patient group
      comprised 63 immunocompetent patients as well as 23 HIV-infected patients, all
      with symptoms of acute enteritis. The control group consisted of 120 healthy
      persons. Pathogenic organisms were found in the stools of 17.5% of the
      immunocompetent patients with enteritis. The most common germs were Campylobacter
      jejuni, Giardia lamblia and Salmonella enteritidis. Isospora belli, found in 2
      cases (8.7%), was the only pathogen found in HIV-infected patients. The most
      frequent pathogen found in 7.5% of the control group was Giardia lamblia. The
      facultative pathogenic protozoon Blastocystis hominis was found in 16.7-19.0% of
      the 3 groups. There was no correlation between clinical symptoms and the results
      of stool examinations. Stool examinations in the immunocompetent patients
      corresponded to the known distribution of pathogenic germs in Switzerland. The
      homogeneous distribution of Blastocystis hominis in the 3 groups examined proves
      the high rate of infection. There is no evidence of a significant correlation
      between clinical symptoms of enteritis and infection with Blastocystis hominis in
      immunocompetent patients.

PMID- 2218448
TI  - [Magnetic resonance in oncology].
AB  - The physical and biological background to magnetic resonance imaging (MRI) in
      patients with neoplasms is reviewed. The clinical indications for this method of
      diagnosis, staging, and follow-up of malignant neoplasms are discussed on the
      basis of the guidelines given by the MRI Consensus Conference on April 25-26,
      1989, in Berne. MRI is the modality of choice in patients with neoplasms of the
      central nervous system and the musculoskeletal system. Further emerging
      indications for MRI are neoplasma of the ENT region, liver, and pelvic organs.
      Finally, the foreseeable developments in MRI and in magnetic resonance
      spectroscopy (MRS) are mentioned.

PMID- 2218449
TI  - [Approach in metastasis with unknown primary tumor].
AB  - Metastases of an occult primary malignancy are quite common (5-10%), especially
      in lymph nodes, lung and bone. The search for the unknown primary is an
      intellectual challenge. Thorough history, meticulous physical examination, and
      economically and carefully directed additional investigations are the best
      methods of detecting a treatable malignancy. Even extensive standardized work-up,
      using all available laboratory and imaging techniques, may miss the primary tumor
      quite often and unnecessarily burden patients with poor prognosis. Prognostically
      and therapeutically distinct subgroups must be treated differently.

PMID- 2218450
TI  - [Vestibular disorders in Parkinson patients].
AB  - Patients suffering from Parkinson's disease frequently complain of dizziness,
      postural instability and falls. Vestibular tests have been performed in 30
      parkinsonian patients and in 28 controls. The results suggest a central
      vestibular disturbance in Parkinson's disease which correlates with the clinical
      disability. This vestibular disturbance is assumed to be due to dysfunction of
      the nigro-striato-collicular tracts.

PMID- 2218451
TI  - [Treatment of achalasia using balloon dilatation].
AB  - 40 patients with achalasia underwent pneumatic dilatation. 25 were followed up
      for a mean duration of 3.96 years. Digestive symptoms disappeared in 32% of
      cases, were diminished in 40% and remained unchanged in 28%. In 8 patients
      oesophageal manometry after dilatation showed a significant reduction in lower
      oesophageal sphincter pressure. The patients showing improvement had a more
      marked drop in lower oesophageal sphincter pressure, lower residual pressure in
      the lower oesophageal sphincter measured by wet swallows, and negative pressure
      in the oesophagus. As complications 3 patients developed oesophageal perforation
      with one subsequent death, and 3 symptomatic gastro-oesophageal reflux. In view
      of these results, we regard pneumatic dilatation as the treatment of choice in
      achalasia.

PMID- 2218453
TI  - [Reversible microangiopathies following massive weight loss].
AB  - A 17-year-old patient presented with loss of weight, acrocyanosis and trophic
      lesions of the tips of the toes. There were no clinical or immunological signs of
      connective tissue disease. Capillary microscopy revealed a severe organic
      microangiopathy and arteriolar spasm. A change in the patient's occupational
      conflict situation was followed by complete recovery and capillary findings
      normalized. The possible connection between anorexia-like affection and
      capillariopathy remains unclear.

PMID- 2218452
TI  - [Cardiac sources of cerebral embolism and infarction: results of the Lausanne
      register for cerebrovascular accidents].
AB  - We studied 305 patients with a first stroke and a potential cardiac source of
      embolism (PCSE), on the basis of the Lausanne Stroke Registry. We have compared
      these patients with 1006 patients with stroke but without PCSE, admitted into the
      Registry during the same period, in order to assess the potential role of PCSE
      and the coexistence of other causes of stroke. Analysis of the various types of
      PCSE suggests that some neurologic characteristics are more frequent in patients
      with than without PCSE (infarcts of the posterior division of middle cerebral
      artery with Wernicke's aphasia and lateral hemianopia; maximal neurologic deficit
      at onset; haemorrhagic infarcts).

PMID- 2218454
TI  - [Bilateral radial nerve paralysis. Diagnostic and differential diagnostic
      aspects].
AB  - Bilateral radial nerve palsies are rare, and hence in this situation an
      underlying generalized peripheral neuropathy must always be considered. Among 103
      patients with radial nerve palsies seen at our department during the last five
      years, there were three cases presenting with bilateral non-traumatic radial
      nerve palsies. These patients are presented in detail. One had a bilateral nerve
      entrapment in the supinator channel associated with a neuropathy of unclear
      origin, the second had bilateral sleep palsy, and the third had mononeuropathy
      multiplex associated with HIV infection. Following a summary of the cases
      reported in the literature, diagnostic considerations and additional
      investigations are discussed.

PMID- 2218455
TI  - [Analysis of the frequency of anti-HLA hyperimmunization in patients with kidney
      transplantation].
AB  - Highly sensitized patients tend to accumulate on renal transplant waiting lists.
      A long period of time is often needed for the identification of a compatible
      graft possessing the rare HLA antigens against which these patients are not
      immunized. The aim of this study was to identify factors which could explain the
      fact that the percentage of highly sensitized patients on the Swiss waiting list
      is one of the highest in Europe. Although no definite conclusion is possible, it
      seems that this phenomenon is not related to the fact that many of these patients
      have received mismatched grafts. It seems rather to result from the relatively
      high rate of transplantations for non-sensitized versus highly sensitized
      patients in comparison to what is encountered in other countries. The fact that
      this probably represents only a relative increase in hypersensitized patients is
      confirmed by the stability of the absolute number of these patients on the
      waiting list during recent years.

PMID- 2218456
TI  - [Isocyanate-induced respiratory tract diseases in Switzerland].
AB  - From 1980 to 1986 the Swiss National Accident Insurance Company (SUVA) recognized
      isocyanate-induced airway diseases as an occupational illness in 245 cases, which
      are presented retrospectively. Since isocyanates are widely used they are found
      at a large variety of workplaces. At present, isocyanates are the most frequent
      cause of occupational asthma in the Swiss industrial field. After complete
      avoidance of any further exposure respiratory symptoms persisted or airway
      obstruction could still be documented in one third of patients. An unfavourable
      prognosis is significantly associated with the following factors: (1) bronchial
      obstruction (FEVl/VC) at first pulmonary function test; (2) RAST positive for
      isocyanates; (3) long latency period between onset of symptoms and end of
      exposure. Therefore, individuals with isocyanate-induced airway diseases must be
      immediately removed from any further exposure to these substances.

PMID- 2218457
TI  - [East African sleeping sickness (Trypanosoma rhodesiense infection) in 2 Swiss
      travelers to the tropics].
AB  - We report on two Swiss travellers who acquired African sleeping sickness
      (Trypanosoma rhodesiense) the same day while visiting the Akagera park in Rwanda.
      The first patient developed clinical signs of sleeping sickness 8 days after
      being bitten by a tsetse fly. Trypanosomes were demonstrated in the blood and
      CSF. The other patient fell ill 13 days after the bite and trypanosomes were
      found only in blood samples. The first patient (cerebral trypanosomiasis), was
      treated with melarsoprol. He developed an allergic reaction under treatment but
      made a good recovery 4 months later. The second patient (hemo-lymphatic
      trypanosomiasis) was put on suramin, which was well tolerated. He recovered after
      2 months.

PMID- 2218458
TI  - [Preventive and therapeutic measures in cytostatic-associated toxicity].
AB  - Strategies (both prophylactic and therapeutic) to reduce side effects of
      chemotherapy are reviewed. In particular, issues concerning proper patient
      information are discussed which should help to increase patient compliance.
      Chemotherapy, especially regimens with a curative intent, must normally be
      administered under the guidance of an oncologist. However, close cooperation with
      the general practitioner is essential in order to ensure high quality counselling
      and treatment of the outpatient.

PMID- 2218459
TI  - [Chronic gastritis. Pathogenesis, clinical aspects and therapy].
AB  - Based on clinical and histopathological features, three different types of
      chronic gastritis can be distinguished: gastritis A is confined to the proximal
      stomach and is the result of an autoimmunological process with antibodies against
      parietal cells and intrinsic factor. It is a rare disorder and may lead to
      pernicious anaemia. Distal, antral gastritis B is caused by an infection of the
      gastric mucosa with Helicobacter pylori (HP). Its incidence increases with age
      (greater than 50% above age 50). Gastritis C may be caused by drugs and alcohol
      but is mainly found in gastric remnants after partial resection as a consequence
      of biliary reflux. Gastritis A rarely causes symptoms. A relationship between
      gastritis B and C and non-ulcer dyspepsia (NUD) is highly controversial.
      Gastritis B is very closely associated with peptic ulcer disease. HP-positive
      antral gastritis seems to be the prerequisite for ulcer formation. All 3 types of
      gastritis carry an increased risk of malignancy, which seems to be positively
      correlated with hypoacidity, the chronicity of the inflammation and the
      histopathological feature of intestinal metaplasia. Noninvasive diagnostic tests
      (serology, breath tests, scintigraphy) are available, but the diagnosis of
      gastritis is still mainly based on endoscopy and biopsy. Treatment of gastritis A
      is not possible. Gastritis B can be healed by eradication of HP using bismuth
      salts and antibiotics but only combinations of 2-3 compounds seem to afford long
      term positive results. Further clinical trials are needed to determine whether
      such treatment is justified in patients with gastritis and NUD. In patients with
      chronic recurrent peptic ulcers eradication of HP prevents relapses and heals
      ulcer disease. Gastritis C complicated by severe symptoms or ulcer can only be
      successfully treated by a biliary diversion, i.e. Roux-Y-gastrojejunostomy. The
      discovery that gastritis B is caused by HP improves our understanding of peptic
      ulcer disease and will change therapeutic concepts.

PMID- 2218460
TI  - [The histological diagnosis of chronic gastritis. A German proposal for an
      integrated nomenclature].
AB  - The Gastrointestinal Pathology Study Group of the German Pathological Society has
      drawn up a proposal for a unifying nomenclature for the graduation and
      classification of gastritis. The severity of chronic gastritis is divided into 4
      grades (minimal, light, moderate and severe) and the activity of the process is
      characterized by 3 grades (grade 1, 2 and 3 activity). In addition, the presence
      or absence of Helicobacter pylori (formerly Campylobacter pylori), the extent and
      type of intestinal metaplasia, and the degree of glandular atrophy are recorded.
      To the two already well established types of gastritis (type A and type B) a
      third type is added, type C gastritis due to biliary reflux or other chemical,
      mechanical or toxic influences.

PMID- 2218461
TI  - [HIV epidemic: a study among physicians in Vaud].
AB  - A two-phase survey was conducted in the Canton of Vaud among the 1006 registered
      private practitioners (response rate 98%). The first phase aimed at determining
      the proportion of these physicians involved in the care of HIV+ persons. The
      results showed that 43% of the practitioners had been consulted by HIV+ patients.
      In the second phase, all institutions (hospitals, prisons and IV-drug user
      rehabilitation and testing centers) and a representative sample of the physicians
      with HIV+ patients were asked about the transmission category of their HIV+
      patients. A mathematical method was used to estimate the true number of known
      HIV+ individuals by December 1988. Approximately 60% of the HIV+ persons had been
      seen exclusively by the private practitioners. IV-drug users represented 57% of
      all HIV+ persons compared to only 27% of the AIDS cases registered in 1988,
      suggesting that an important change in the transmission categories of AIDS cases
      is to be expected in the near future. These observations underscore the evolving
      nature of the HIV epidemic on the one hand, and the crucial role of the private
      practitioners in the prevention of the HIV infection on the other. This also
      points to the need for methods specifically designed to monitor HIV and AIDS
      epidemics respectively.

PMID- 2218462
TI  - [Posterior shoulder dislocation. An often overlooked injury].
AB  - Posterior dislocation of the shoulder is rare. Only 2% of dislocated shoulders
      are displaced posteriorly, and these are chiefly of the subacromial type. Over
      60% of the cases are not diagnosed initially because the arm is held in the
      normal position of adduction and internal rotation. The most consistent findings
      on physical examination are: the fixed internal rotation of the arm and the
      characteristic movement of the scapula with abduction of the upper extremity. It
      is essential that appropriate radiographs are obtained to correctly diagnose the
      dislocation. While the routine anteroposterior shoulder film is often enough to
      diagnose various anterior dislocations, it is not sufficient to diagnose the
      subacromial type of posterior dislocation. We recommend an anteroposterior view
      and an axillary lateral or tangential scapula view.

PMID- 2218463
TI  - [Atherosclerotic nephropathy. Clinical manifestations of chronic arterial
      circulatory insufficiency of the kidneys].
AB  - Atherosclerotic nephropathy is defined as renal insufficiency due to atheromatous
      disease of the main renal arteries and/or their branches. This disease
      essentially is characterized by atheromatous lesions in the renal arteries which
      compromise arterial renal blood flow. Clinically, patients with atherosclerotic
      nephropathy can present with refractory hypertension and renal insufficiency,
      acute renal failure after treatment with antihypertensive drugs and unexplained,
      slowly progressive renal failure with or without hypertension (elderly patients).
      Observations from uncontrolled studies indicate that both the progression of
      renal insufficiency and the control of hypertension can be influenced favorably
      in about 80% of the cases by a revascularization procedure (arterial anastomosis,
      percutaneous arterial dilatation). Patients with suspected atherosclerotic
      nephropathy should probably be evaluated invasively and considered candidates for
      a revascularization procedure. The benefits of these therapies compared to
      conservative management need, however, evaluation in a controlled, prospective
      clinical trial.

PMID- 2218464
TI  - [Dieulafoy's simple stomach ulcer: apropos of 5 cases].
AB  - Dieulafoy's ulcer is a probably congenital arterial malformation which may
      produce severe upper gastrointestinal haemorrhage. It represents about 1% of all
      cases of acute upper gastrointestinal haemorrhage (3/249 in our department during
      1989). We report 5 cases in whom haemostatic endoscopic treatment was successful
      and propose therefore that this therapy should be the initial treatment of
      choice. Surgical intervention should be considered only if endoscopic therapy
      fails.

PMID- 2218465
TI  - [Prognostic value of electroencephalography in non-traumatic comas].
AB  - We recorded an EEG within the first few days of coma in 100 patients without
      history of trauma or drug intoxication, in 50 after cardiac arrest, and in 50 in
      coma of other, chiefly metabolic etiologies. The EEG findings were classified in
      5 categories (I-V) in terms of increasing severity. We were especially interested
      in the question whether the degree of early EEG disturbances allows prognostic
      conclusions regarding the clinical fate of patients one month after the beginning
      of coma. It was found that very severe EEG changes (Grad IV-V) indicate a poor
      prognosis (death, persistent vegetative state or profound neurological deficits)
      in over 90% of coma both after cardiac arrest and of other etiologies. An EEG
      without very severe changes (grade I-III) does not allow definite prognostic
      conclusions. Depending on the etiology, recovery occurs in 10-33% of cases. The
      prognostic significance of certain EEG parameters can be summarized as follows:
      areactivity to external stimuli and the presence of an "alpha-coma" pattern are
      usually (but not necessarily) associated with a poor outcome. The same applies to
      coma patients with epileptiform patterns in the EEG and/or suffering from
      epileptic or myoclonic seizures. One-fourth of patients with triphasic EEG
      complexes recover completely.

PMID- 2218466
TI  - [Endoluminal sonography as a preoperative staging method in rectal carcinoma].
AB  - The selection of an appropriate surgical procedure for primary rectal cancer
      depends on the degree of local invasion of the tumor and its location. Computed
      tomography allows better preoperative staging than is possible by clinical
      staging. Endoluminal sonography demonstrates the different layers of the rectal
      wall as described by TNM-staging. Comparison of preoperative ultrasound staging
      and postoperative histopathological staging gave an overall accuracy of 83% in
      all of our consecutive 63 prospectively examined patients. In 11% the tumor was
      overstaged and in 6% understaged. Comparing clinical staging, computed tomography
      and endoluminal sonography in all patients with palpable but not stenotic tumors,
      endoluminal sonography gave an accuracy of 89% compared with 71% with clinical
      staging and 78% with computed tomography. The results demonstrate the reliability
      of the new staging method in selecting the surgical procedure (local excision -
      resection/amputation) in tumors of the lower rectum. Promising results with
      endoluminal sonography are also reported in the follow-up of patients operated on
      for rectal cancer.

PMID- 2218467
TI  - [Asymptomatic microhematuria: follow-up in 39 patients].
AB  - We have studied 39 patients with asymptomatic microhematuria (AM) over a mean
      period of 3.7 years (2.6 to 5.3). In 28 patients, the etiology of the AM had
      remained unknown despite extensive work-up at the time of AM diagnosis. During
      follow-up, the urine was examined by the dipstick method and a urine sediment was
      prepared by standard techniques. Erythrocyturia was judged as grade I or grade II
      (3-9 or less than 9 erythrocytes/hpf) and classified by phase-contrast microscopy
      as glomerular or non-glomerular (greater than 30% or less than 30% of
      erythrocytes with glomerular characteristics). The results were as follows. All
      patients were in good health during the whole follow-up. None developed
      significant proteinuria or gross hematuria. AM persisted in 28 of the 39 patients
      (72%) and in 22 of the 28 with AM of unknown etiology (79%). Persistence of AM
      was independent of grade and morphology of AM. Among the patients with AM of
      unknown cause, the fifteen who initially showed grade I AM had grade I AM in 92%
      and grade II AM in 8% of follow-up urinalyses, and the seven with grade II AM at
      the first examination had grade II AM in 65% and grade I AM in 35% of follow-up
      urinalyses (p = 0.007). The last morphologic classification of AM corresponded to
      the first in all patients with grade II AM, but only in 74% of patients with
      grade I AM. The following conclusions were drawn. (1) Most AM of unknown etiology
      persists over several years irrespective of grade and morphology of
      erythrocyturia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218468
TI  - [Ventilatory function and bronchial responsiveness in army recruits].
AB  - Lung function and determination of the bronchial responsiveness to methacholine
      were performed in two groups of Swiss army recruits aged 20 years (total 233),
      where 144 had respiratory complaints or a history of prior asthma and 89 were
      asymptomatic, among whom 26 had recently suffered from upper respiratory tract
      infection (URTI). A bronchial obstruction (ratio FEV1/FVC less than 73%) was
      observed among 6% of the subjects with symptoms, 6% of the asymptomatic control
      subjects and 4% in the group with recent URTI. The differences are not
      significant. A bronchial hyperresponsiveness (defined as PD20 less than 900 mcg)
      was observed in 45% of the symptomatic subjects (54% in 109 recruits complaining
      of dyspnea on exertion) against 3% in the control group (p less than 0.001) and
      12% in the group with recent URTI (NS, p = 0.14). Among subjects complaining of
      dyspnea on exertion, more than half have an obvious bronchial hyperresponsiveness
      at a level usually observed in asthmatics, most of them without any clinical
      finding or permanent bronchial obstruction. Although the sensitivity of the
      determination of bronchial responsiveness is low (47%) its specificity is high
      (97%). The test allows detection of some subjects with asthma among young
      subjects complaining of respiratory troubles in spite of normal clinical
      examination and lung function. A normal level of bronchial responsiveness
      practically excludes asthma.

PMID- 2218469
TI  - [SAF--an alternative fixation solution for parasitological stool specimens].
AB  - A comparative parasitological study in 3 collectives using 2 different fixatives
      for stool samples (SAF and MIF) was carried out. The SAF fixative consistently
      showed a significantly higher sensitivity for parasitic protozoa than the MIF
      fixative (Entamoeba histolytica 90.0% vs. 64.4%, Giardia lamblia 97.7% vs.
      64.4%), which was due to an increased detection of cysts of both species. No
      difference in sensitivity for helminths was found. The cheap, simple formula and,
      due to the absence of mercury, the low toxicity are further advantages of the SAF
      fixative. Moreover, contrary to the MIF fixative, the SAF fixative permits the
      use of a wide range of staining techniques starting from fixed specimens. These
      results led to the replacement of the MIF fixative by the SAF fixative at the
      Diagnostic Center of the Swiss Tropical Institute.

PMID- 2218470
TI  - [Changes in the endometrium of the cow after intrauterine administration of
      different drugs].
AB  - 32 young and healthy cows each received a single intrauterine treatment with one
      of the following solutions: Lugol's solution, Vetedine, Lorasol, Lotagen,
      Aureomycin, and normal saline solution as a control. Endometrial biopsies were
      taken immediately before application and at days 1, 3, 6, 10, 15, 20 and 30
      thereafter. On day 1, degenerative and inflammatory reactions could already be
      observed in all groups, with the exception of the control group. The intensity of
      the lesions varied, not only between treatment groups but also to a lesser extent
      between individuals within groups. Degeneration and inflammatory reaction found
      in the subepithelial stromal tissues were more distinct than those seen in the
      epithelia. Lorasol caused the most severe degenerative changes, regarding the
      depth of degeneration into the tissue, as well as the intensity of the
      inflammatory reaction. Lugol's solution also showed a high degree of change,
      followed by Lotagen and Vetedine showing moderate change, respectively. Reaction
      to the antibiotic treatment with Aureomycin was only slight. The regeneration
      time of these lesions was proportional to the intensity of the induced changes,
      amounting to 10-15 days for Lorasol and 3-6 days for Aureomycin, respectively.
      The clinical significance of these findings is discussed.

PMID- 2218471
TI  - [Capillaria hepatica in a dog and a hedgehog].
AB  - A liver infection with Capillaria hepatica is described, having been found for
      the first time in Switzerland in a dog and a hedgehog. After a literature review
      of cases known among man and animals, we present our own pathological findings.
      Furthermore, the parasite's life cycle is discussed.

PMID- 2218472
TI  - 10th autumn meeting of the European Society of Veterinary Pathology. Zurich,
      September 24-27, 1990. Abstracts.

PMID- 2218473
TI  - [The fight against doping: international and national efforts as exemplified by
      the Convention of the Council of Europe and the doping regulations of the Swiss
      National Association for Sports].
AB  - The international and national efforts to flight doping in sports are shown by
      the examples of the Anti-Doping Convention of the Council of Europe and the
      regulations of the Swiss Association of Sports. Major efforts are made in the
      fields of education and information, search for and application of optimal
      methods for training and care as well as dope-controls at and out of
      competitions. The harmonization of the anti-doping regulations and the
      disciplinary procedures that have to follow the principles of natural justice are
      considered to be important. The Swiss regulations allow, at variance with
      international customs, to treat injured athletes therapeutically with doping
      substances.

PMID- 2218474
TI  - [Sports correlate with positive living habits. Results from the population survey
      the Swiss MONICA project].
AB  - Exercise is associated with positive health habits: Findings from the populations
      survey of the Swiss MONICA-project. Relatively little is known on population-wide
      relations of habitual exercise to relevant health factors such as diet, cigarette
      smoking and overweight. Data from a population-based sample of approximately 800
      men and women each, aged 25-64, collected in western Switzerland as a part of an
      international WHO-project, were used to examine cross-sectionally the
      interrelationships between different lifestyle factors. Men and women training
      regularly (i.e. greater than or equal to 2 times/wk) exhibited consistently and
      highly significantly more favourable health habits, regarding diet (i.e. trimming
      visible fat, higher intake of fruits, salad and vegetables, yogurt and cottage
      cheese), nonsmoking, and weight control. Men and women with at least some regular
      physical activity during leisure-time had in turn more favourable health habits
      than their sedentary counterparts. In both sexes, educational level was directly
      related to exercise and a healthy diet, and inversely related to smoking and
      relative weight. Regularly training men and women also had a significantly
      improved lipid profile compared to inactive ones. It is concluded from this study
      that leisure-time physical activity and exercise are related to a positive health
      behaviour including diet, nonsmoking and efficient weight control. This may
      suggest that exercise should possibly be integrated into any population-wide
      attempts and efforts to promote health to enhance primary prevention.

PMID- 2218475
TI  - [The radiological functional testing in fibular ligament lesions--a critical
      analysis and clinical study].
AB  - Injuries to the lateral ligaments of the ankle require an accurate diagnosis,
      especially because most injuries to one ligament are not treated surgically any
      more. Different stress devices are in use for an objective and standardised
      assessment of the instability of the ankle joint. In a group of 76 patients with
      injuries to their lateral ligaments of the ankle we compared posttraumatic
      instability by radiological stress test as done by hand or by a Telos stress
      device. In 25 patients treated by surgery an additional intraoperative stress X
      ray (talar tilt) was performed. The results of the instability tests done by hand
      versus those obtained with a Telos stress device showed a poor correlation (r =
      0.786). An analogous result was obtained by comparing the Telos device stress
      views to the intraoperative stress controls done by hand (r = 0.771). Only the
      pre- and intraoperative measurements by hand showed a good correlation (r =
      0.958). The results are discussed with reference to a biomechanical model and
      recommendations for routine diagnosis are proposed.

PMID- 2218476
TI  - [The treatment of fibular ligament lesions using the Ortho-Rehab shoe].
AB  - In a prospective study we examined 46 patients (14-49 years of age) with fresh
      ruptures of the lateral ligaments of the ankle (talar tilt greater than or equal
      to 10 degrees). Treatment consisted in six weeks of taping combined with wearing
      of a special rehabilitation shoe (Ortho Rehab). 28 patients were treated
      conservatively and 18 had an operative repair of their ruptured ligaments. After
      8 weeks every patient was clinically controlled. Until now 35 patients were
      reevaluated more than one year after injury. Treatment was judged as very
      comfortable and positive. Working capacity was achieved after an average of 14.8
      days and all patients returned to their former sports activity 3 to 8 weeks after
      the event. Mechanical and functional stability after more than one year are
      excellent with the exception of 3 cases. The results are discussed and compared
      with other studies.

PMID- 2218477
TI  - Big-time orphan. Human growth hormone could be a blockbuster.

PMID- 2218478
TI  - Skin stand-ins. Dermal substitutes promise to reduce animal testing.

PMID- 2218479
TI  - Anatomical cartography. Computer maps reveal the topography of arthritis.

PMID- 2218480
TI  - Molecular engineers mimic mother nature.

PMID- 2218481
TI  - Energy for planet Earth.

PMID- 2218482
TI  - Fetal law. Experimental surgery may feed ethical debates.

PMID- 2218483
TI  - Overview: tolerating self. Experience teaches the immune system to recognize the
      self.

PMID- 2218484
TI  - The Dirty Air Act.

PMID- 2218485
TI  - Asbestos policy.

PMID- 2218486
TI  - Mad cow disease: uncertainty rules.

PMID- 2218487
TI  - Female primatologists confer--without men.

PMID- 2218488
TI  - Will AIDS conference migrate?

PMID- 2218489
TI  - NIH urged to be a smart shopper.

PMID- 2218490
TI  - Genome center grants chosen.

PMID- 2218491
TI  - Voice lessons for psychotics.

PMID- 2218492
TI  - Partner found for the myc protein.

PMID- 2218493
TI  - Drug policy: striking the right balance.
AB  - Drug policy should strike the right balance between reducing the harm done by
      psychoactive drugs and reducing the harm that results from strict legal
      prohibitions and their enforcement. It is concluded, from a cost-benefit analysis
      based on pharmacologic, toxicologic, sociologic, and historical facts, that
      radical steps to repeal the prohibitions on presently illicit drugs would be
      likely, on balance, to make matters worse rather than better. Specific
      recommendations are offered for ameliorating the dangers to users and to society
      that are posed by each addictive drug.

PMID- 2218494
TI  - New methods of drug delivery.
AB  - Conventional forms of drug administration generally rely on pills, eye drops,
      ointments, and intravenous solutions. Recently, a number of novel drug delivery
      approaches have been developed. These approaches include drug modification by
      chemical means, drug entrapment in small vesicles that are injected into the
      bloodstream, and drug entrapment within pumps or polymeric materials that are
      placed in desired bodily compartments (for example, the eye or beneath the skin).
      These techniques have already led to delivery systems that improve human health,
      and continued research may revolutionize the way many drugs are delivered.

PMID- 2218495
TI  - Structural characterization of a partly folded apomyoglobin intermediate.
AB  - To understand why proteins adopt particular three-dimensional structures, it is
      important to elucidate the hierarchy of interactions that stabilize the native
      state. Proteins in partly folded states can be used to dissect protein
      organizational hierarchies. A partly folded apomyoglobin intermediate has now
      been characterized structurally by trapping slowly exchanging peptide NH protons
      and analyzing them by two-dimensional 1H-NMR (nuclear magnetic resonance).
      Protons in the A, G, and H helix regions are protected from exchange, while
      protons in the B and E helix regions exchange freely. On the basis of these
      results and the three-dimensional structure of native myoglobin, a structural
      model is presented for the partly folded intermediate in which a compact
      subdomain retains structure while the remainder of the protein is essentially
      unfolded.

PMID- 2218497
TI  - "Pure" human hematopoietic progenitors: permissive action of basic fibroblast
      growth factor.
AB  - Methodology has been developed that enables virtually complete purification and
      abundant recovery of early hematopoietic progenitors from normal human adult
      peripheral blood. A fraction of the pure progenitors is multipotent (generates
      mixed colonies) and exhibits self-renewal capacity (gives rise to blast cell
      colonies). This methodology provides a fundamental tool for basic and clinical
      studies on hematopoiesis. Optimal in vitro cloning of virtually pure progenitors
      requires not only the stimulatory effect of interleukin-3, granulocyte-macrophage
      colony-stimulating factor, and erythropoietin, but also the permissive action of
      basic fibroblast growth factor. These findings suggest a regulatory role for this
      growth factor in early hematopoiesis.

PMID- 2218496
TI  - Direct interaction of a ligand for the erbB2 oncogene product with the EGF
      receptor and p185erbB2.
AB  - The erbB2 oncogene encodes a 185-kilodalton transmembrane protein whose sequence
      is similar to the epidermal growth factor receptor (EGFR). A 30-kilodalton factor
      (gp30) secreted from MDA-MB-231 human breast cancer cells was shown to be a
      ligand for p185erbB2. An antibody to EGFR abolished the tyrosine phosphorylation
      induced by EGF and transforming growth factor-alpha (TGF-alpha) but only
      partially blocked that produced by gp30 in SK-BR-3 breast cancer cells. In two
      cell lines that overexpress erbB2 but do not expresss EGFR (MDA-MB-453 breast
      cancer cells and a Chinese hamster ovary cell line that had been transfected with
      erbB2), phosphorylation of p185erbB2 was induced only by gp30. The gp30
      specifically inhibited the growth of cells that overexpressed p185erbB2. An
      antibody to EGFR had no effect on the inhibition of SK-BR-3 cell colony formation
      obtained with gp30. Thus, it appeared that gp30 interacted directly with the EGFR
      and erbB2. Direct binding of gp30 to p185erbB2 was confirmed by binding
      competition experiments, where gp30 was found to displace the p185erbB2 binding
      of a specific antibody to p185erbB2. The evidence described here suggests that
      gp30 is a ligand for p185erbB2.

PMID- 2218498
TI  - Protection from chemotherapy-induced alopecia in a rat model.
AB  - Alopecia (hair loss) is among the most distressing side effects of cancer
      chemotherapy. Little progress has been made, however, in its prevention or
      treatment, partly because of the lack of suitable experimental model. In recent
      work on the treatment of myelogenous leukemia in the rat, the following
      observations were made: (i) treatment of 8-day-old rats with cytosine arabinoside
      consistently produced alopecia, and (ii) ImuVert, a biologic response modifier
      derived from the bacterium Serratia marcescens, uniformly produced complete
      protection against the alopecia. In subsequent experiments, both cyclophosphamide
      and doxorubicin also produced alopecia in this model, and the doxorubicin-induced
      alopecia was prevented by treatment with ImuVert. The potential relevance of
      these observations to chemotherapy-induced alopecia in the clinical setting
      should be examined.

PMID- 2218499
TI  - Extension of the life-span of human endothelial cells by an interleukin-1 alpha
      antisense oligomer.
AB  - The proliferative potential of human diploid endothelial cells is finite, and
      cellular senescence in vitro is accompanied by the failure of the endothelial
      cell to respond to exogenous growth factors. Senescent human endothelial cells
      were shown to contain high amounts of the transcript for the cytokine interleukin
      1 alpha (IL-1 alpha), a potent inhibitor of endothelial cell proliferation in
      vitro. In contrast, transformed human endothelial cells did not contain
      detectable IL-1 alpha messenger RNA. Treatment of human endothelial cell
      populations with an antisense oligodeoxynucleotide to the human IL-1 alpha
      transcript prevented cell senescence and extended the proliferative life-span of
      the cells in vitro. Removal of the IL-1 alpha antisense oligomer resulted in the
      generation of the senescent phenotype and loss of proliferative potential. These
      data suggest that human endothelial cell senescence in vitro is a dynamic process
      regulated by the potential intracellular activity of IL-1 alpha.

PMID- 2218500
TI  - Molecular analysis of acute promyelocytic leukemia breakpoint cluster region on
      chromosome 17.
AB  - Acute promyelocytic leukemia (APL; FAB M3) is characterized by a predominance of
      malignant promyelocytes that carry a reciprocal translocation between the long
      arms of chromosomes 15 and 17, t(15;17) (q22;q11.2-q12). This translocation has
      become diagnostic for APL, as it is present in almost 100 percent of cases. A Not
      I linking clone was used to detect this translocation initially on pulsed-field
      gel electrophoresis and subsequently with conventional Southern (DNA) analysis.
      The breakpoints in ten APL cases examined were shown to cluster in a 12-kb region
      of chromosome 17, containing two CpG-rich islands. The region is the first intron
      of the retinoic acid receptor alpha gene (RARA).

PMID- 2218501
TI  - Different tumor-derived p53 mutants exhibit distinct biological activities.
AB  - In its wild-type form, the protein p53 can interfere with neoplastic processes.
      Tumor-derived cells often express mutant p53. Full-length mutant forms of p53
      isolated so far from transformed mouse cells exhibit three common properties in
      vitro: loss of transformation-suppressing activity, gain of pronounced
      transforming potential, and ability to bind the heat shock protein cognate hsc70.
      A tumor-derived mouse p53 variant is now described, whose site of mutation
      corresponds to a hot spot for p53 in human tumors. While absolutely
      nonsuppressing, it is only weakly transforming and exhibits no detectable hsc70
      binding. The data suggest that the ability of a p53 mutant to bind endogenous p53
      is not the sole determinant of its oncogenic potential. The data also support the
      existence of gain-of-function p53 mutants.

PMID- 2218502
TI  - Impact of mass treatment of onchocerciasis with ivermectin on the transmission of
      infection.
AB  - Onchocerciasis is a major blinding disease that, until recently, has been
      essentially untreatable. Ivermectin is a safe and effective drug for the mass
      treatment of onchocerciasis and when used on an individual basis, it reduces the
      ability of the treated person to transmit Onchocerca volvulus infection. In the
      present study, the effect of community-based ivermectin treatment on the degree
      of transmission within the community was assessed by determining the incidence of
      new infection in children. Ivermectin was distributed annually on three occasions
      to the eligible members of a population of approximately 14,000 people living on
      a rubber plantation in a forest area endemic for onchocerciasis. After 2 years,
      the prevalence of infection in 5-year-old children decreased by 21%. The annual
      incidence in an uninfected cohort of children decreased by 35% and, after age
      specific adjustment, the reduction in incidence in 7- to 12-year-old children was
      45%. Thus, community-based distribution of ivermectin led to a significant
      reduction in incidence of new infection. These findings suggest that ivermectin
      can be important in reducing the transmission of onchocerciasis.

PMID- 2218503
TI  - Extrageniculate vision in hemianopic humans: saccade inhibition by signals in the
      blind field.
AB  - The functional competence of extrageniculate visual pathways in hemianopic humans
      was demonstrated by showing that distractor signals in the blind half of the
      visual field could inhibit saccades toward targets in the intact visual field.
      This inhibitory effect of unseen distractors in patients occurred only when
      distractors were presented in the temporal half of the visual field, was specific
      to oculomotor responses, and did not occur in normal subjects. These results show
      that a peripheral visual signal activates retinotectal pathways to prime the
      oculomotor system and that these pathways can mediate orienting behavior in
      hemianopic humans.

PMID- 2218505
TI  - Inhibition of HIV-1 infectivity by phosphate-methylated DNA: retraction.

PMID- 2218504
TI  - Rhodopsin mutants that bind but fail to activate transducin.
AB  - Rhodopsin is a member of a family of receptors that contain seven transmembrane
      helices and are coupled to G proteins. The nature of the interactions between
      rhodopsin mutants and the G protein, transduction (Gt), was investigated by flash
      photolysis in order to monitor directly Gt binding and dissociation. Three mutant
      opsins with alterations in their cytoplasmic loops bound 11-cis-retinal to yield
      pigments with native rhodopsin absorption spectra, but they failed to stimulate
      the guanosine triphosphatase activity of Gt. The opsin mutations included
      reversal of a charged pair conserved in all G protein-coupled receptors at the
      cytoplasmic border of the third transmembrane helix (mutant CD1), replacement of
      13 amino acids in the second cytoplasmic loop (mutant CD2), and deletion of 13
      amino acids from the third cytoplasmic loop (mutant EF1). Whereas mutant CD1
      failed to bind Gt, mutants CD2 and EF1 showed normal Gt binding but failed to
      release Gt in the presence of guanosine triphosphate. Therefore, it appears that
      at least the second and third cytoplasmic loops of rhodopsin are required for
      activation of bound Gt.

PMID- 2218506
TI  - Human habitation of the Americas.

PMID- 2218507
TI  - Cetus's costly stumble on IL-2.

PMID- 2218508
TI  - Institute of Medicine backs training over research.

PMID- 2218509
TI  - Flying blind: the making of EMF policy.

PMID- 2218510
TI  - More mice on the way, thanks to NIH.

PMID- 2218511
TI  - Still flying blind in the war on drugs.

PMID- 2218512
TI  - Embryology gets down--to the molecular level.

PMID- 2218513
TI  - Zebrafish: swimming into the development mainstream.

PMID- 2218514
TI  - Functional magnetic resonance imaging in medicine and physiology.
AB  - Magnetic resonance imaging (MRI) is a well-established diagnostic tool that
      provides detailed information about macroscopic structure and anatomy. Recent
      advances in MRI allow the noninvasive spatial evaluation of various biophysical
      and biochemical processes in living systems. Specifically, the motion of water
      can be measured in processes such as vascular flow, capillary flow, diffusion,
      and exchange. In addition, the concentrations of various metabolites can be
      determined for the assessment of regional regulation of metabolism. Examples are
      given that demonstrate the use of functional MRI for clinical and research
      purposes. This development adds a new dimension to the application of magnetic
      resonance to medicine and physiology.

PMID- 2218515
TI  - Chromosomal region of the cystic fibrosis gene in yeast artificial chromosomes: a
      model for human genome mapping.
AB  - A general strategy for cloning and mapping large regions of human DNA with yeast
      artificial chromosomes (YAC's) is described. It relies on the use of the
      polymerase chain reaction to detect DNA landmarks called sequence-tagged sites
      (STS's) within YAC clones. The method was applied to the region of human
      chromosome 7 containing the cystic fibrosis (CF) gene. Thirty YAC clones from
      this region were analyzed, and a contig map that spans more than 1,500,000 base
      pairs was assembled. Individual YAC's as large as 790 kilobase pairs and
      containing the entire CF gene were constructed in vivo by meiotic recombination
      in yeast between pairs of overlapping YAC's.

PMID- 2218516
TI  - The human genome map 1990.

PMID- 2218518
TI  - African AIDS: whose research rules?

PMID- 2218517
TI  - Genetics of small populations.

PMID- 2218519
TI  - OTA quietly backs fetal tissue work.

PMID- 2218520
TI  - Gallo inquiry takes puzzling new turn.

PMID- 2218521
TI  - Tobacco industry does slow burn over EPA adviser.

PMID- 2218522
TI  - Celebrating the leech.

PMID- 2218523
TI  - NIH watch.

PMID- 2218524
TI  - The high culture of neuroscience.

PMID- 2218525
TI  - Mapping terra incognita (humani corporis)

PMID- 2218526
TI  - Sources of human psychological differences: the Minnesota Study of Twins Reared
      Apart.
AB  - Since 1979, a continuing study of monozygotic and dizygotic twins, separated in
      infancy and reared apart, has subjected more than 100 sets of reared-apart twins
      or triplets to a week of intensive psychological and physiological assessment.
      Like the prior, smaller studies of monozygotic twins reared apart, about 70% of
      the variance in IQ was found to be associated with genetic variation. On multiple
      measures of personality and temperament, occupational and leisure-time interests,
      and social attitudes, monozygotic twins reared apart are about as similar as are
      monozygotic twins reared together. These findings extend and support those from
      numerous other twin, family, and adoption studies. It is a plausible hypothesis
      that genetic differences affect psychological differences largely indirectly, by
      influencing the effective environment of the developing child. This evidence for
      the strong heritability of most psychological traits, sensibly construed, does
      not detract from the value or importance of parenting, education, and other
      propaedeutic interventions.

PMID- 2218527
TI  - Mapping the human genome: current status.
AB  - The human genome has already been the subject of extensive research activity even
      though the Human Genome Project is only just officially starting. This review and
      the accompanying wall chart attempt to provide an integrated, quantitative, and
      detailed summary of the status of knowledge on the human genome in mid-1990. The
      analysis has highlighted the rudimentary nature of many of the information links
      needed for the task. While this overview could not be fully comprehensive and
      required simplifying assumptions, the results have provided estimates of relative
      progress on a region-by-region basis throughout the genome.

PMID- 2218528
TI  - Radiation hybrid mapping: a somatic cell genetic method for constructing high
      resolution maps of mammalian chromosomes.
AB  - Radiation hybrid (RH) mapping, a somatic cell genetic technique, was developed as
      a general approach for constructing long-range maps of mammalian chromosomes.
      This statistical method depends on x-ray breakage of chromosomes to determine the
      distances between DNA markers, as well as their order on the chromosome. In
      addition, the method allows the relative likelihoods of alternative marker orders
      to be determined. The RH procedure was used to map 14 DNA probes from a region of
      human chromosome 21 spanning 20 megabase pairs. The map was confirmed by pulsed
      field gel electrophoretic analysis. The results demonstrate the effectiveness of
      RH mapping for constructing high-resolution, contiguous maps of mammalian
      chromosomes.

PMID- 2218529
TI  - Cleaving yeast and Escherichia coli genomes at a single site.
AB  - The 15-megabase pair Saccharomyces cerevisiae and the 4.7-megabase pair
      Escherichia coli genomes were completely cleaved at a single predetermined site
      by means of the Achilles' heel cleavage (AC) procedure. The symmetric lac
      operator (lacOs) was introduced into the circular Escherichia coli genome and
      into one of the 16 yeast chromosomes. Intact chromosomes from the resulting
      strains were prepared in agarose microbeads and methylated with Hha I (5'-GCGC)
      methyltransferase (M.Hha I) in the presence of lac repressor (LacI). All Hae II
      sites (5'-[sequence: see text]) with the exception of the one in lacOs, which was
      protected by LacI, were modified and thus no longer recognized by Hae II. After
      inactivation of M.Hha I and LacI, Hae II was used to completely cleave the
      chromosomes specifically at the inserted lacOs. These experiments demonstrate the
      feasibility of using the AC approach to efficiently extend the specificity of
      naturally occurring restriction enzymes and create new tools for the mapping and
      precise molecular dissection of multimegabase genomes.

PMID- 2218530
TI  - Mutations affecting TEA blockade and ion permeation in voltage-activated K+
      channels.
AB  - Voltage-dependent ion channels are responsible for electrical signaling in
      neurons and other cells. The main classes of voltage-dependent channels (sodium-,
      calcium-, and potassium-selective channels) have closely related molecular
      structures. For one member of this superfamily, the transiently voltage-activated
      Shaker H4 potassium channel, specific amino acid residues have now been
      identified that affect channel blockade by the small ion tetraethylammonium, as
      well as the conduction of ions through the pore. Furthermore, variation at one of
      these amino acid positions among naturally occurring potassium channels may
      account for most of their differences in sensitivity to tetraethylammonium.

PMID- 2218531
TI  - Neurotrophic and neurotoxic effects of amyloid beta protein: reversal by
      tachykinin neuropeptides.
AB  - The amyloid beta protein is deposited in the brains of patients with Alzheimer's
      disease but its pathogenic role is unknown. In culture, the amyloid beta protein
      was neurotrophic to undifferentiated hippocampal neurons at low concentrations
      and neurotoxic to mature neurons at higher concentrations. In differentiated
      neurons, amyloid beta protein caused dendritic and axonal retraction followed by
      neuronal death. A portion of the amyloid beta protein (amino acids 25 to 35)
      mediated both the trophic and toxic effects and was homologous to the tachykinin
      neuropeptide family. The effects of the amyloid beta protein were mimicked by
      tachykinin antagonists and completely reversed by specific tachykinin agonists.
      Thus, the amyloid beta protein could function as a neurotrophic factor for
      differentiating neurons, but at high concentrations in mature neurons, as in
      Alzheimer's disease, could cause neuronal degeneration.

PMID- 2218532
TI  - In vitro reconstruction of the respiratory central pattern generator of the
      mollusk Lymnaea.
AB  - Most rhythmic behaviors such as respiration, locomotion, and feeding are under
      the control of networks of neurons in the central nervous system known as central
      pattern generators (CPGs). The respiratory rhythm of the pond snail Lymnaea
      stagnalis is a relatively simple, CPG-based behavior for which the underlying
      neural elements have been identified. A three-neuron network capable of
      generating the respiratory rhythm of this air-breathing mollusk has been
      reconstructed in culture. The intrinsic and network properties of this neural
      ensemble have been studied, and the mechanism of postinhibitory rebound
      excitation was found to be important for the rhythm generation. This in vitro
      model system enables a better understanding of the neural basis of rhythm
      generation.

PMID- 2218533
TI  - A magnesium current in Paramecium.
AB  - Recent reappraisals of the role of ionized magnesium in cell function suggest
      that many cells maintain intracellular free Mg2+ at low concentrations (0.1 to
      0.7 mM) and that external agents can influence cell function via changes in
      intracellular Mg2+ concentration. Depolarization and hyperpolarization of voltage
      clamped Paramecium elicited a Mg2(+)-specific current, IMg. Both Co2+ and Mn2+
      were able to substitute for Mg2+ as charge carriers, but the resultant currents
      were reduced compared with Mg2+ currents. Intracellular free Mg2+ concentrations
      were estimated from the reversal potential of IMg to be about 0.39 mM. The IMg
      was inhibited when external Ca2+ was removed or a Ca2+ chelator was injected,
      suggesting that its activation was Ca2(+)-dependent.

PMID- 2218534
TI  - The primate hippocampal formation: evidence for a time-limited role in memory
      storage.
AB  - Clinical and experimental studies have shown that the hippocampal formation and
      related structures in the medial temporal lobe are important for learning and
      memory. Retrograde amnesia was studied prospectively in monkeys to understand the
      contribution of the hippocampal formation to memory function. Monkeys learned to
      discriminate 100 pairs of objects beginning 16, 12, 8, 4, and 2 weeks before the
      hippocampal formation was removed (20 different pairs at each time period). Two
      weeks after surgery, memory was assessed by presenting each of the 100 object
      pairs again for a single-choice trial. Normal monkeys exhibited forgetting; that
      is, they remembered recently learned objects better than objects learned many
      weeks earlier. Monkeys with hippocampal damage were severely impaired at
      remembering recently learned objects. In addition, they remembered objects
      learned long ago as well as normal monkeys did and significantly better than they
      remembered objects learned recently. These results show that the hippocampal
      formation is required for memory storage for only a limited period of time after
      learning. As time passes, its role in memory diminishes, and a more permanent
      memory gradually develops independently of the hippocampal formation, probably in
      neocortex.

PMID- 2218535
TI  - The meaning of hydrophobicity.

PMID- 2218536
TI  - Uncertainties about health effects of radon.

PMID- 2218537
TI  - Chloral hydrate warning.

PMID- 2218538
TI  - Biotechnology, human disease, and the FDA.

PMID- 2218539
TI  - Which patient did Gallo's virus come from?

PMID- 2218540
TI  - Judd leaves NIMH.

PMID- 2218541
TI  - The embryo takes its vitamins.

PMID- 2218542
TI  - Our chimp cousins get that much closer.

PMID- 2218543
TI  - Overcoming rejection to win a Nobel Prize.

PMID- 2218544
TI  - The drug dilemma: manipulating the demand.
AB  - Drug abuse in the United States has posed a dilemma during most of this century.
      Intemperate use of reinforcing drugs is hazardous to health and safety, but
      strict prohibition fosters an illicit market with criminal effects that may be
      equally harmful. The crux of the problem is the willingness of millions of people
      to risk toxicity and arrest to gain psychopharmacological rewards. Cocaine is the
      present source of most concern. Recommendations for reducing demand and abuse are
      given, including the implementation of preventive techniques, the investigation
      of various treatments, the use of modern chemical and electronic technology, and
      the development of new pharmacological alternatives.

PMID- 2218546
TI  - "Rock fever" on Majuro.

PMID- 2218545
TI  - Transport and storage of vitamin A.
AB  - The requirement of vitamin A (retinoids) for vision has been recognized for
      decades. In addition, vitamin A is involved in fetal development and in the
      regulation of proliferation and differentiation of cells throughout life. This
      fat-soluble organic compound cannot be synthesized endogenously by humans and
      thus is an essential nutrient; a well-regulated transport and storage system
      provides tissues with the correct amounts of retinoids in spite of normal
      fluctuations in daily vitamin A intake. An overview is presented here of current
      knowledge and hypotheses about the absorption, transport, storage, and metabolism
      of vitamin A. Some information is also presented about a group of ligand
      dependent transcription factors, the retinoic acid receptors, that apparently
      mediate many of the extravisual effects of retinoids.

PMID- 2218547
TI  - Assisting with developmental task achievement of the hospitalized adolescent.

PMID- 2218548
TI  - Rural health care in America: future directions. Testimony on the future of rural
      health care.

PMID- 2218549
TI  - Anatomy and physiology of the cervical spine.
AB  - Although the lumbar spine was extensively studied from 1934 to the present, the
      cervical spine has received far less attention. Anatomic, physiological,
      biochemical, and biomechanical characteristics of the lumbar spine are often
      presumed to apply to the cervical spine. The differences are far too extensive to
      warrant such an assumed correlation. Beginning in 1955, the authors have
      collected 171 whole human spines and studied them anatomically, physiologically,
      and histologically. Reported in this article are clinically important anatomic
      characteristics of the nucleus pulposus, the uncinate process, nerve root exit
      sites, position of the motor (anterior) nerve root, relation of spinal cord
      volume to size and shape of the spinal canal, anatomy of the anterior and
      posterior spinal canal, menisci of the zygapophyseal joints, and the anatomy and
      clinical significance of the autonomic nervous system in the cervical spine.

PMID- 2218550
TI  - Panoramic nailfold capillaroscopy: a new reading method and normal range.
AB  - Current interpretation of nailfold capillaroscopy is largely based on qualitative
      and subjective parameters. These parameters make the accurate assessment of the
      extent of the nailfold microangiopathy difficult. The authors present a
      comprehensive method in which several quantitative or semiquantitative parameters
      are used to assess the main microangiopathic features, such as microhemorrhage,
      plexus visibility, devascularization, and morphologic anomalies of the end row
      loops. The method is checked for reproducibility and applied to a sample of 800
      healthy people to establish the normal range. The influences of extrinsic
      variables, such as gender, ethnicity, age, and local nailfold conditions are also
      included.

PMID- 2218551
TI  - Therapeutic exercise for rheumatoid arthritis and osteoarthritis.
AB  - Therapeutic exercise in rheumatoid arthritis and osteoarthritis may be useful in
      improving aerobic capacity, strengthening muscles, improving endurance and
      increasing flexibility. This article reviews the major studies of exercise in
      these conditions and summarizes the authors recommendations regarding the use of
      therapeutic exercise in the treatment of rheumatoid arthritis osteoarthritis.

PMID- 2218552
TI  - Iliopsoas bursitis: clinical features, radiographic findings, and disease
      associations.
AB  - Inflammation of the iliopsoas bursa is a common manifestation of a wide array of
      inflammatory, degenerative, and traumatic musculoskeletal conditions. The
      clinical presentation of iliopsoas bursitis is variable, and includes pain, mass
      lesion, or compression syndromes of the inguinal compartment. Affected
      individuals frequently have underlying synovitis of the hip or a history of
      occupational or recreational injury. Early and accurate diagnosis is facilitated
      by appropriate radiographic studies.

PMID- 2218553
TI  - A long-term study of interstitial lung disease in systemic lupus erythematosus.
AB  - The clinical course of chronic diffuse interstitial lung disease (ILD) was
      studied in 14 patients with SLE. The mean duration of follow-up was 7.3 years.
      All patients had dyspnea on exertion, pleuritic chest pain, chronic cough, and
      basilar rales. Chest roentgenogram showed diffuse or basilar infiltrates, pleural
      disease, and elevation of both diaphragms. Systemic corticosteroids were given
      early in the course of the illness for lung involvement and multisystem disease.
      Diffusing capacity for carbon monoxide (DLCO) and inspiratory vital capacity
      (IVC) improved or remained unchanged in the majority of patients. Respiratory
      complaints improved in all patients; however, two patients died of pulmonary
      fibrosis and another died of bacterial pneumonia. Alveolar septal deposits of
      immunoglobulins and complement were found. This study showed that while
      variability existed among individual subjects, the clinical progression of ILD
      was slow and tended to improve or stabilize with time.

PMID- 2218554
TI  - Renal disorders in rheumatoid arthritis.
AB  - Renal disorders are a frequent cause of death in patients with rheumatoid
      arthritis (RA), but are less apparent in living RA patients. In part, this may be
      because of insensitive screening methods. In this review, some of the relations
      among renal pathology, renal function, and antirheumatic therapy are clarified. A
      classification of renal disorders according to etiology is proposed. Two
      categories of disorders are distinguished: those related to RA and its
      complications, and those related to drug therapy. The disorders belonging to
      these categories are reviewed. Finally, a case is made for the existence of a
      third category, "RA nephropathy." It is hypothesized that this mild and
      nonspecific nephropathy is the result of cumulative minor insults caused by the
      disease and its therapy. The presence of such a "subclinical" nephropathy would
      explain the greater sensitivity of RA patients to other renal insults, and the
      high prevalence of renal failure at death.

PMID- 2218555
TI  - [Dorsal plate osteosynthesis of the tibial shaft. Results of a collective study
      of the German section of the International AO (Study Group for Osteosynthesis
      Problems)].
AB  - This collective study was conducted by the German section of AO International to
      work out the indications for fixation of the tibial shaft by means of dorsal
      plating. Primary dorsal plating was done in 70 cases. Most of the patients had
      second- or third-degree open fractures with severe ventral soft tissue injuries
      or closed fractures that could not be reduced and fixed conservatively. In 72
      patients, secondary dorsal plate fixation was performed. The main reason for the
      dorsally positioned plate was persistent instability or axial malalignment after
      previous external or internal fixation, but failed conservative treatment
      constituted a further reason. Most of these patients had such severe damage
      following fractures that dorsal plating was the last chance of avoiding
      amputation. The high rate of complications (12 infections and 7 non-unions and
      breakages of implants after primary dorsal plating; 20 infections and 11 non
      unions and breakages of implants after secondary dorsal plating) has to be
      considered in the light of the extraordinary indications for the dorsal plating
      of the tibial shaft in especially severe fractures or disastrous sequelae. In
      cases with extremely severe conditions before fixation, dorsal plating of the
      tibial shaft for secondary operative treatment yields adequate results.

PMID- 2218557
TI  - [Biomechanical model calculations on the influence exerted by the sagittal
      sliding profile on patello-femoral load].
AB  - Patellofemoral loads are calculated by means of a mathematical model based upon
      an elliptical approximation of the articulating profile. Differences in the
      sagittal curvature of morphological and arthroplastic gliding surfaces can be
      approximated by a differing eccentricity of the ellipse. The joint is balanced in
      a static situation by two tension forces. The resultant is the vector sum of both
      forces and represents the entire load. Small loads in the initial flexion of the
      knee joint and high loads in the end of flexion are caused by a flat sagittal
      curve. A more eccentric shape of the articulating profile reduces the loads at
      the end of flexion, because the quadriceps tendon starts to turn around the femur
      earlier. The model also takes into account the patellar ligament turning around
      the proximal tibia at wide flexion angles. Besides the design of the prosthesis,
      patellofemoral loads depend on the height of implantation of the femoral
      component. It must be borne in mind that forces will vary in magnitude at
      different flexion angles; the patient's activities after the operation must also
      be considered.

PMID- 2218556
TI  - [Comparative studies on the ingrowth behavior and the bone adhesion of various
      implant materials. An animal experiment].
AB  - Each of 36 mongrel dogs received implants of the following six materials: methyl
      methacrylate, carbon fibre composite, aluminium oxide-ceramic, titanium alloy,
      pure titanium and hydroxylapatite (HA). Test rods 7 mm in diameter were used to
      perform a push-out test, and discs with a diameter of 25 mm and a thickness of 5
      mm were used for a plane traction test. The animals got a fluorochrome labelling
      and were harvested 8 weeks after operation. The results of the push-out test were
      a stability of 3.6 N/mm2 for HA and very low values for all the other materials,
      while the plane tension test showed a stability of 1.6 N/mm2 for the HA discs and
      values that were not even measurable for all the other materials. The interface
      of HA and the bone could not be separated by mechanical forces; usually the bone
      or the ceramic material fractured beneath the interface, so that the real
      stability of the interface must be rated very high. Light and fluorescence
      microscopy revealed a close bone connection for HA and only partial connections
      for the other materials. HA-coated materials may have a future in orthopaedics
      surgery.

PMID- 2218558
TI  - [Significance and mechanism of thoracic and lumbar spine injuries in traffic
      accidents].
AB  - An analysis of 96 persons who sustained injuries to dorsal and lumbar vertebrae
      during traffic accidents, established that spinal injuries (sustained by 3.8% of
      the 96 persons) are quite rare. Pedestrians, the elderly, and polytraumatized
      persons with extensive head injuries as accompanying trauma following
      particularly serious accidents are at especially high risk. The most frequent
      spinal injuries are compression fractures, which especially often give rise to
      the injury pattern found in the spine of motorcycle riders, pedestrians, and car
      passengers not wearing seat belts. In these cases a so-called "pushing-further"
      mechanism is quite often assumed as the biomechanical cause. In comparison,
      ruptures of the transverse process have often been established for car passengers
      wearing seat belts, which can be attributed causally to a psoas effect resulting
      from an overstretching movement of the body and muscular strain. Basically three
      different biomechanical movement patterns were established in this study: sliding
      mechanism, shearing effect and psoas effect; which of these is are involved
      depends on the capacity in which the person affected takes part in street
      traffic. All the spinal fractures examined can be classed as trauma sustained
      while travelling at high speed. They are not observed following collisions at low
      or moderate speed.

PMID- 2218559
TI  - [Quantitative immunohistological analysis of cell-mediated immunity in
      osteomyelitic bone tissue].
AB  - The present investigation allows an exact identification and quantification of
      cell populations involved in local cell-mediated immunity of osteomyelitic bone
      tissue. Determinations of systemic immunity carried out in osteomyelitis patients
      indicated the distribution of immunogenic cells in the osteomyelitic focus only
      indirectly. The method described combined with simultaneous determination of the
      systemic immunity and cell mediators can lead to a quantitative description of
      cell-mediated immunity and in turn to a better understanding of the interaction
      of cells and transmitters involved in osteomyelitis.

PMID- 2218560
TI  - [Dislocation-fracture of the cunei-navicular joint line. Clinical aspects,
      pathomechanism and therapeutic concept in a very rare foot injury].
AB  - Fracture dislocations of the cunei-navicular joints are a very rare type of
      intertarsal dislocation and most people are probably unfamiliar with this entity.
      Clinical, radiological and pathological aspects allow discrimination of such
      injuries from the dislocations in Lisfranc's and Chopart's articulation. We have
      seen one patient who was found to have a crush fracture of the cuneiforme mediale
      on one side and a fracture disruption with dorsal dislocation of the first and
      second metatarsals and of the medial and intermediate cuneiform bones on the
      other. According to the principles of treatment for other tarsal injuries, we
      carried out open reduction with joint debridement, reconstruction of ligaments
      and internal stabilization with transfixation screws.

PMID- 2218561
TI  - Chemotherapy for invasive bladder cancer: introduction.

PMID- 2218562
TI  - Neoadjuvant treatment of invasive bladder cancer.

PMID- 2218564
TI  - Pathology of bladder cancer: assessment of prognostic variables and response to
      therapy.

PMID- 2218563
TI  - Staging of bladder cancer: is the tumor, node, metastasis system adequate?

PMID- 2218565
TI  - Biological markers of prognosis in invasive bladder cancer.

PMID- 2218566
TI  - Imaging of invasive bladder cancer.

PMID- 2218567
TI  - Invasive bladder cancer: selection of primary treatment.

PMID- 2218568
TI  - Chemotherapy for invasive bladder cancer: neoadjuvant versus adjuvant.
AB  - The treatment of a patient with an invasive bladder tumor is based on the
      original urologic assessment. The global recommendation of a single treatment
      plan such as radical surgery, chemotherapy, radiation, or variations thereof, for
      all patients is clearly an antiquated approach. Case selection criteria for each
      single or multimodality approach need to be defined. Neoadjuvant therapy has the
      advantage of an in vivo response evaluation and the potential for bladder
      preservation. However, before treatment, the therapeutic goal--bladder
      preservation, treatment of micrometastases, or both--should be outlined. Patients
      with T2 or T3a tumors can be considered for bladder salvage by chemotherapy
      alone, chemotherapy plus radiation therapy or, chemotherapy followed by partial
      cystectomy. For those with higher stage tumors, therapy is directed more to the
      treatment of micrometastases, with bladder preservation as a secondary goal. In
      most cases additional therapy directed at the primary is required and clinical
      understaging remains significant. For some patients, initial surgery with the
      definition of the prognosis on firm pathologic grounds, may represent a better
      strategy. Those with positive nodes should be offered chemotherapy in the
      postoperative setting. Refinements in the techniques of ileo neo-bladders are of
      importance in improving quality of life, but when used alone will not alter the
      natural history of the disease. Drug resistance remains a major therapeutic
      obstacle. More effective agents, and the prospective identification of intrinsic
      or acquired resistance, invasion, and metastatic potential are required to
      optimize therapy for an individual patient. Ultimately, large scale randomized
      trials will be required to negate the heterogeneity of this patient population.
      Only then will individualization of treatment be possible.

PMID- 2218569
TI  - The role of radiation therapy alone or as an adjunct to surgery in bladder
      carcinoma.

PMID- 2218570
TI  - Radiotherapy combined with chemotherapy in treatment of muscle-invasive bladder
      carcinoma.

PMID- 2218571
TI  - Surgery of invasive bladder cancer: is pathologic staging necessary?

PMID- 2218573
TI  - Restaging procedures, criteria of response, and relationship between pathological
      response and survival.
AB  - The first priorities for upfront chemotherapy in TCCB are to prove in randomized
      phase III trials that the addition of toxic chemotherapy to toxic standard
      locoregional treatment can improve survival and/or permit bladder preservation.
      If such proof is obtained, we will need to distinguish patients who benefit from
      chemotherapy from those who do not. One way to make such a distinction is to
      separate responders from nonresponders. The prognostic value of downstaging to P0
      or noninvasive cancer is significantly different from the prognosis associated
      with the continued presence of invasive disease. The available data regarding
      clinical assessment of response still appear to indicate that only the
      demonstration of a lack of response (see Table 2: cIR, cSD, cPD, greater than or
      equal to cT2) is reliable, However, there may be some patients, who after two
      courses of chemotherapy, still show the presence of invasive bladder cancer
      together with signs of tumor cell kill and may be further downstaged to P0 during
      the next two courses of chemotherapy. The clinical assessment of cCR and cPR is
      too inaccurate to be used as a basis for decisions concerning continuation of
      chemotherapy or bladder preservation. The decision to leave the bladder untreated
      after a cCR carries the risk of jeopardizing cure. More studies on the evaluation
      of response of the primary tumor are needed, probably with a central role for the
      pathologist to evaluate not only the gross presence, minimal residual disease, or
      true absence of cancer but also the adequacy of site and deepness of the
      restaging TUR biopsy.

PMID- 2218572
TI  - Neobladders: clinical management and considerations for patients receiving
      chemotherapy.
AB  - Continent catheterizable urinary reservoirs and orthotopic bladder substitutes
      are complex surgical endeavors. The goal is preservation of renal function,
      reliable continence, and storage intervals acceptable to the patient. The
      construction requires familiarity with bowel segments and may increase operative
      time for radical cystoprostatectomy by 30% to 50%. Patients with continent
      reservoirs have improved body image, work habits, and sexual and interpersonal
      relationships. Experience with patients with dysfunctional neurogenic bladders
      previously converted to Bricker urostomies now undiverted to continent reservoirs
      indicates an overall increase in physical activity and self-satisfaction. These
      patients are tolerant of reoperations to maintain independence from wet
      urostomies. Undoubtedly, the expectations of bladder cancer patients will differ
      from those of young adults with neurogenic bladder, but we have found that when
      all options are presented patients will seek out therapy that least alters their
      body image. Therefore, patient selection becomes an important factor in
      determining the success of continent reservoirs. Patients must have the dexterity
      and motivation to catheterize the urinary reservoir, irrigate for mucus and, in
      cases of orthotopic bladder replacement to urethra, accept the need for
      artificial sphincter placement in 30% to 40% of cases. Management of the neo
      bladders requires additional consideration of several practical and theoretic
      points for both the surgeon and medical oncologist: 1. Patients with diffuse
      carcinoma in situ or transitional cell carcinoma at the bladder neck or prostatic
      urethra should undergo simultaneous urethrectomy excluding orthotopic bladder
      replacement. 2. Ten percent to 40% of patients undergoing radical
      cystoprostatectomy for transitional cell cancer will have concomitant
      underdiagnosed adenocarcinoma of the prostate; patient prognosis will remain
      defined by the stage and grade of the bladder cancer. 3. Patients may have a
      tendency toward dehydration because of increased loss of free water through bowel
      transit. 4. Absorption of chloride, ammonium, and hydrogen ions may cause
      hyperchloremic acidosis, especially in face of imparied renal function. 5.
      Because of the potential for drug absorption across reservoir mucosa, patients
      receiving chemotherapy may require Foley catheterization with irrigation in
      addition to intravenous hydration. 6. Creatinine clearance is unsuitable for
      studying the renal function of reservoir patients because urine passes through
      the intestinal segment where creatinine is absorbed; glomerular filtration is
      better estimated by nuclear scanning with the reservoir emptied. 7. Most
      reservoirs will remain colonized with bacteria. 8. Antibiotic prophylaxis for the
      patient with temporary impairment of immune function during chemotherapy may be
      necessary. 9. Mucus may entrap bacteria serving as a host defense; its production
      may diminish with time from construction. All patients should be capable of
      performing reservoir irrigations to manage mucus obstruction.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2218574
TI  - Preemptive (neoadjuvant) chemotherapy: can analysis of eligibility criteria,
      prognostic factors, and tumor staging from different trials provide valid or
      useful comparisons?

PMID- 2218575
TI  - Endpoints of clinical trials in invasive bladder cancer.

PMID- 2218576
TI  - Can we combine available data to evaluate the effects of neoadjuvant chemotherapy
      for invasive bladder cancer?

PMID- 2218578
TI  - Current management of gallstones.

PMID- 2218577
TI  - Neoadjuvant chemotherapy for invasive bladder cancer: future directions.

PMID- 2218579
TI  - Epidemiology and natural history of gallstone disease.

PMID- 2218580
TI  - Pathophysiology and pathogenesis of cholesterol gallstone formation.

PMID- 2218581
TI  - Pigment gallstone pathogenesis: from man to molecules.

PMID- 2218582
TI  - Oral dissolution treatment of gallstones with bile acids.

PMID- 2218583
TI  - Topical dissolution treatment of cholesterol gallstones with methyl tert-butyl
      ether.

PMID- 2218585
TI  - Role of surgery in the management of gallstones.

PMID- 2218584
TI  - Extracorporeal shock-wave lithotripsy of gallstones with the adjuvant use of
      cholelitholytic bile acids.

PMID- 2218586
TI  - Magnetic resonance imaging of knee trauma.
AB  - This article reviews the magnetic resonance (MR) appearance of normal knee
      anatomy and the role of MRI in the evaluation of knee trauma. Images acquired in
      the sagittal plane are the most useful. A combination of T1- and T2-weighted spin
      echo pulse sequences is most commonly employed. A meniscal tear is identified by
      an intrameniscal signal which extends to the joint surface. MR and arthroscopic
      findings agree in more than 90% of patients. It is important to be familiar with
      the MRI appearance of normal anatomic variants that may be confused with meniscal
      tears: the transverse geniculate ligament, the hiatus of the popliteal tendon
      sheath, and the meniscofemoral ligaments. Tears in the anterior cruciate,
      posterior cruciate, and collateral ligaments are also depicted.

PMID- 2218587
TI  - Paget's disease of the patella.
AB  - Five patients with Paget's disease involving the patella were evaluated for the
      following radiographic features: trabecular pattern, cortical integrity, density,
      and size of the affected patella. Radiographic appearances consisted of minimal
      trabecular coarsening in the patella of nearly normal size and progressed to
      considerable cortical thickening and osteoblastic remodeling in a dramatically
      enlarged patella. The radiologic features of Paget's disease of the patella are
      distinctive and should obviate biopsy.

PMID- 2218589
TI  - Osteochondrosis dissecans of the glenoid.
AB  - Osteochondrosis dissecans of the glenoid is a rare condition that has been
      mentioned only once in the literature, by Lavner in 1947. Trauma is generally
      accepted as a cause of this disorder. Injury produces an ischemic insult to the
      subchondral bone and possible loose body formation if fragmentation of the
      articular surface occurs. Endocrine abnormalities, genetic influences, and the
      presence of anomalous centers of ossification may also contribute to the
      development of this condition. We present two patients whose clinical histories
      indicate a traumatic etiology of osteochondrosis dissecans of the glenoid. We
      also discuss the radiological, clinical, and etiological features of this entity.

PMID- 2218588
TI  - The sclerotic pedicle--how many causes are there?
AB  - The sclerotic pedicle is a commonly encountered roentgen sign that may be
      associated with numerous conditions, both benign and malignant. The following
      paper discusses the common as well as the unusual causes of this interesting
      phenomenon and demonstrates the radiographic presentations of the various
      etiologies.

PMID- 2218590
TI  - Limb shortening secondary to complications of vascular cannulae in the neonatal
      period.
AB  - Four cases of limb shortening presenting in childhood are described. All four
      children had been managed in a neonatal intensive care unit and had developed
      complications following the insertion of intravascular cannulae. In two, lower
      limb shortening and deformity were secondary to direct epiphyseal damage
      following extravasation of calcium or dextrose from a peripheral venous line. In
      the other two, forearm shortening followed ischaemia, secondary to either radial
      artery thrombosis from a radial artery cannula or spasm of the brachial artery
      following extravasation from a venous cannula in a neonate who also had a radial
      artery cannula. These cases highlight an important complication of the use of
      vascular cannulae in neonates and the problems this may pose to the orthopaedic
      surgeon.

PMID- 2218592
TI  - Enchondroma protuberans. Report of a case and its distinction from chondrosarcoma
      and osteochondroma adjacent to an enchondroma.
AB  - Enchondroma protuberans has been defined as an exophytic enchondroma of a long
      bone. We contrast a case of enchondroma protuberans with two cases of coincident
      enchondroma and osteochondroma. Our cases and the previously published ones lead
      us to believe that enchondroma protuberans is probably an enchondroma variant and
      that its unusual growth pattern may be related to the oblique orientation of the
      proximal humeral epiphysis. Unlike osteochondroma, which may be treated
      surgically by removing the cartilage cap and, in some cases, the stalk,
      enchondroma protuberans requires intralesional curettage. Enchondroma protuberans
      must be distinguished radiographically from chondrosarcoma.

PMID- 2218591
TI  - Role of routine percutaneous hip aspirations prior to prosthesis revision.
AB  - We undertook a retrospective review of 78 percutaneous hip aspirations performed
      as a prerequisite to prosthetic revision or replacement. Although the majority of
      the patients were already scheduled for revision or replacement, many aspirations
      were requested as part of the "routine" algorithm in the evaluation of a painful
      hip. Cultures from the aspirated fluid were compared with those obtained
      intraoperatively (where possible) and to the clinical suspicion of infection.
      Many of the selected patients had clinical and/or radiographic indications of
      pain. Our results yielded no evidence of infection (0%) when there was no
      clinical suspicion of infection (60 patients). Clinical suspicion for infection
      was high in 7 patients; aspirates demonstrated infection in 5 of them. One
      aspiration was false negative for infection, but subsequent intraoperative
      cultures were positive. When the clinical suspicion was intermediate or equivocal
      (11 patients), results were negative in 9 and positive in 2, both at aspiration
      and intraoperatively. We contend that routine percutaneous hip aspirations do not
      need to be performed when a prosthetic revision or replacement is contemplated if
      the clinical suspicion for infection is low. Hip aspiration and arthrography
      should not be eliminated, however, when the clinical suspicion is equivocal or
      high or when there is no apparent cause for a painful prosthesis.

PMID- 2218593
TI  - Radiographic and computed tomographic findings in hydatid disease of bone.
AB  - Twenty-six patients with hydatid disease of bone were evaluated by means of
      radiography and conventional tomography. Fourteen patients underwent high
      resolution computed tomography (CT). In two patients with vertebral disease,
      magnetic resonance imaging (MRI) examination was also performed. Seventeen
      patients underwent surgery with histological examination in all. Based on the
      surgical data and gross examination of the specimen, the radiographic and CT
      findings have been reviewed to identify the most characteristic radiographic
      features and to assess the role of CT. Radiographic finding of hydatidosis are
      rarely typical in bone, and only in a few patients can CT contribute to the
      diagnosis. On the other hand, the local extension of the lesion both in bone and
      in soft tissues, which is essential in planning surgery, is always demonstrated
      well by CT.

PMID- 2218595
TI  - The radiologic assessment of post-traumatic vertebral stability.

PMID- 2218594
TI  - Ultrasound in degenerative cystic meniscal disease of the knee.
AB  - Ultrasonography of the knee joint using small-parts probes was performed on 27
      patients with clinical findings suggestive of meniscal cystic degeneration.
      Surgical or arthroscopic confirmation of sonographic findings was obtained in all
      cases. Sonography delineated the shape and structure of the meniscal profile and
      any degenerative changes. In the initial stage (6/27 patients, 22%), minor
      structural irregularities could be observed. Small, round, transonic cysts were
      found in 8 patients (30%); these lay mainly within the meniscus and were movable
      during stress flexion of the leg. In more advanced cases (8/27, 30%), larger
      cysts sometimes protruded on the skin surface. In 3 patients (12%), the soft
      tissue swelling was associated with a normal sonographic aspect of the menisci,
      but sonography could demonstrate an effusion of extra-articular origin.
      Ultrasound is a simple and effective method for the assessment of degenerative
      cysts of the menisci. It allows a reliable differential diagnosis between
      meniscal cysts and other causes of soft tissue swelling, and it is well suited
      for monitoring the course of the disease.

PMID- 2218596
TI  - Case report 610: Amyloid arthropathy of the left ankle.
AB  - In summary, a case of amyloid arthropathy of the left ankle in a 64-year-old
      patient with multiple myeloma is presented. The asymmetric presentation and site
      of deposition in the ankle were taken to be unusual. Involvement of both hips and
      the right shoulder was also suspected on subsequent evaluation. The patient's
      history and MR studies were essential in establishing the preoperative diagnosis.
      The extent of involvement, destruction of underlying cartilage, associated
      effusion and tenosynovitis were optimally defined by the MR images. The MR images
      also provided preoperative guidance in determining the approach and optimum site
      of biopsy.

PMID- 2218597
TI  - Case report 627: Septic arthritis of lumbar facet joint as initial manifestation
      of spondylodiscitis.
AB  - In summary, septic arthritis of a lumbar facet joint has been rarely discussed in
      the literature [1, 4]. In this case report the histological and bacteriological
      diagnosis was established by percutaneous needle biopsy guided by fluoroscopy and
      the response to treatment was confirmed by CT scans.

PMID- 2218598
TI  - Case report 628: Low-grade central osteosarcoma.
AB  - In summary, low-grade central osteosarcoma is a clinically recognizable rare
      subtype of osteosarcoma, representing 1.9% of all osteosarcomas found at the Mayo
      Clinic. The lesion is locally aggressive but also has the potential for
      metastasis, particularly after local recurrence. The tumor may be difficult to
      distinguish radiographically and histologically from benign conditions,
      particularly fibrous dysplasia. This difficulty has led to inadequate treatment.
      In most cases, a wide surgical margin achieved by either local resection or
      amputation should result in a cure. Because of the low metastatic potential of
      the initial lesion, there seems to be no need for adjuvant chemotherapy.

PMID- 2218599
TI  - Case report 629: Osseous hydatidosis.
AB  - In summary, hydatidosis is a common infection that infrequently involves the
      skeleton. When this happens the prognosis is uncertain because of the possible
      extension of the disease and serious complications, (e.g., pathological
      fractures, visceral involvement, neurologic damage from vertebral involvement).
      For this reason, simple curettage is not sufficient for cure and no medical
      treatment can surely eradicate the disease. Hydatidosis, in our opinion, should
      be staged and surgically treated like a malignant tumor (e.g., with wide surgical
      margins). Medical treatment is useful in association with surgery and remains the
      only therapy for inoperable lesions. A case of echinococcosis of the hip joint in
      a 37-year-old man has been reported. In this case the clinicoradiographical
      features suggested pigmented villonodular synovitis. Proof was obtained on the
      basis of a frozen section on biopsy. The clinical and laboratory characteristics
      of hydatidosis were discussed, with emphasis on the medical and surgical
      treatment of the disorder.

PMID- 2218600
TI  - Case report 631: Neo-osseous porosis (metaphyseal osteopenia) in polyglandular
      autoimmune (Schmidt) syndrome.
AB  - In summary, a case is reported of a patient with the radiographic findings of
      diffuse, symmetrical metaphyseal osteopenia of long bones. A constellation termed
      neo-osseous porosis, associated with polyendocrine failure (Schmidt syndrome)
      involving the thyroid gland, adrenal glands, and gonads has been described in
      this case. Neo-osseous porosis has been observed previously in idiopathic
      juvenile osteoporosis. This case represents the first instance in which this
      distinctive radiographic picture has been observed in the setting of specific
      (multiple) endocrine dysfunction disorders.

PMID- 2218601
TI  - Health inequities in Europe.

PMID- 2218602
TI  - Health inequities in Europe. Introduction.

PMID- 2218603
TI  - Health inequities in Europe. Comparative review of sources, methodology and
      knowledge.

PMID- 2218604
TI  - Health and social inequities in Belgium.
AB  - This paper presents two different yet complementary on-going studies related to
      the understanding of the mechanisms leading to social inequalities in health. The
      first part is devoted to a differential morbidity survey held in southern
      Belgium. It confirms that striking differences exist in the period around birth
      between social categories, and between the three districts under study. In a
      multivariate approach, differences remain between the social categories and
      between the district samples, which classically studied socio-demographical,
      behavioural and medical characteristics cannot fully explain. The role of
      cultural factors is analysed and discussed through the concept of 'health
      culture' and alternative hypotheses are reviewed in the light of the results. The
      second part reviews the studies conducted on the so-called avoidable mortality in
      the EEC and more specifically in Belgium. The concept of avoidable mortality is
      discussed, as well as its utility from the standpoint of the present concern on
      social inequalities. Differences between EEC countries are large, and even within
      Belgium there are important disparities between the districts. The role of health
      care supply has not been demonstrated yet in these two contexts. For Belgium, it
      appears that a major part of the unequally distributed mortality is constituted
      by causes of death considered as avoidable. Moreover, the most discriminating
      causes of death are overrepresented in socially deprived districts. The two
      perspectives are confronted in order to delineate perspectives for future
      research and operational outcomes for policy making and interventions.

PMID- 2218605
TI  - Health and social inequities in the Federal Republic of Germany.
AB  - The close relationship between social class and health status makes for the fact
      that indicators of health are supposed to tell something about the general
      conditions of life in the social structure of a particular country. This is one
      reason why trends in health and social inequities are to the foremost interest of
      the sociologist. Because the epidemiological literature in the Federal Republic
      does not allow one to consider trends over time, this paper tries to construct
      indicators from official statistics which have been regularly collected. The set
      of indicators discussed include data on mortality, age-at-death, morbidity as
      well as data related to health care and health risks. This discussion shows that,
      despite improving life expectancy and age-at-death figures, the major social
      class differential in health status has remained relatively stable over time,
      with a minor trend toward reduction in some figures. Since official statistics
      focus mainly on persons who are integrated in the labour market, only some groups
      with special risks may be detected. More information is certainly needed on
      disadvantaged groups with probably high health risks like the unemployed and
      those who subsist on welfare payments.

PMID- 2218606
TI  - Health and social inequities in Finland and elsewhere.
AB  - This review summarizes results of a number of studies on health and social
      inequities in Finland in comparison with other countries. Comparisons over time
      have been made when possible. Inequities in mortality in Finland can be compared
      with data from Denmark, Norway and Sweden as well as England and Wales plus
      Hungary. All countries show a similar relationship between mortality and level of
      education. No major changes in this relationship can be observed during the
      1970s. Data on morbidity and perceived health complete the picture obtained on
      the basis of mortality data. Inequities concern various dimensions of health.
      Taken as a whole, the data suggest that the pattern of health inequities is more
      accentuated in Finland than in other Nordic countries.

PMID- 2218607
TI  - Social inequalities in self-reported morbidity: interpretation and comparison of
      data from Britain and France.
AB  - This paper considers the results from national surveys of self-reported morbidity
      in Britain and France and discusses the implications for our understanding of
      social class differences in the propensity to report illness. The methods adopted
      in these surveys in the two countries are so different that any comparison of the
      results must be limited. However, evidence on the trends over time in illness
      reporting in both countries reinforces the impression that the survey methodology
      has a significant impact on the results in terms of social class inequalities.
      The discussion also considers some other possible explanations for apparent
      changes in the propensity to report illness. It is concluded that in both
      countries the national survey data on class differences in self-reported
      morbidity has limitations and might be improved in the light of developments in
      survey methodology and the cross-fertilisation of ideas through international
      comparative studies of the subject.

PMID- 2218608
TI  - Interpreting inequalities in the Hungarian health system.
AB  - In reviewing the Hungarian situation it is said that the ideals of a higher
      living standard and economic security have a much broader appeal in public
      opinion than equality. The impacts of state intervention to reduce inequalities
      are reduced by several factors such as the tipping system and centralization.
      Official statistics do not entirely shed light on prevailing inequities in
      health, in particular those related to phenomena outside the health system, i.e.
      there is a heavy biomedical bias. Some contradictory developments are identified.
      One of these is that successful factories have created independent industrial
      health care services for their workers which not infrequently provide a higher
      quality of care than the state system. Furthermore, sociology has not played that
      generalizing and integrating function in the uncovering of inequalities in health
      as it has in Western countries. One of the rare sociological studies in the field
      shows that the population considers health only fourth among other desired
      values. Due to the increase in mortality, the issue of health has recently become
      more focused in the public debate. In general, this paper considers that the
      health system conforms with other Hungarian social realities in the realm of
      economics and politics as well as in value-orientation. This has been reflected
      in the recently reorganized ministry that now also comprises social welfare.

PMID- 2218609
TI  - Health and social inequities in Ireland.
AB  - This paper attempts to discuss the shape of inequalities in health in the
      Republic of Ireland by focusing on social class, gender and regional inequalities
      in health outcomes as shown in annual publications of vital statistics and in
      various research studies. The Republic of Ireland has a demographic profile of
      rapid population increase, unique in Europe. While the birth rate is the highest
      in Europe, the infant mortality rate is relatively low, yet the perinatal
      mortality rate is relatively high. Attempts are made to analyse social class
      variations in mortality and morbidity rates but, except for psychiatric care,
      Irish data on health by social class are scarce. There exist more data on gender
      inequalities which pinpoint the particular vulnerability of Irish women to
      ischaemic heart disease and certain types of cancer. Regional analysis of vital
      statistics reveals the vulnerability of people in urban areas (compared to rural
      areas) to cancer of the trachea, bronchus and lung, cirrhosis of the liver,
      tuberculosis of the respiratory system, pneumonia, and bronchitis, emphysema and
      asthma. In comparison to several European countries, Irish standardized mortality
      rates were the worst for urban women dying from lung cancer, and for urban men
      and women, Irish standardized mortality rates were the worst for non-rheumatic
      heart disease and respiratory tuberculosis. Various studies of morbidity of the
      elderly clearly reveal the hidden clinical iceberg of symptoms which are not
      presented to the health care system. Unfortunately, there is relatively little
      evidence of the health situation of disabled people, the travelling community or
      the long term unemployed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218610
TI  - Health in Israel: patterns of equality and inequality.
AB  - While Israel does not have a nationalized health care system, 94.5% of its
      population is covered by comprehensive health insurance which includes curative
      and preventive ambulatory care as well as hospitalization. There is formal
      equality in access, distribution, and quality of the health services;
      nevertheless, there are pockets of deprivation that affect certain segments of
      the population. The paper focuses on three topics: (a) structure of the health
      care delivery system in terms of coverage, geographical and social distribution,
      and the public/private balance of the services; (b) processes of health care
      delivery in terms of utilization and quality; (c) health outcomes in terms of
      mortality, morbidity, health behavior, and disease vulnerability. Inequality in
      Israel appears to be structured in terms of six dimensions: coverage of health
      insurance, distribution of health services, the balance of public and private
      sectors of health services, utilization of existing services, quality of health
      services, and health outcomes as expressed by mortality, morbidity, health
      behavior and risk factors. Only two types of health care are not covered by the
      general health insurance: (a) dental care, and (b) long-term nursing care. Given
      the small area of Israel there are striking differences in the geographic
      distribution of health personnel of various types. There is evidence for gaps
      between needs and institutional services for many elderly who are on waiting
      lists for institutionalization. The ratio of primary care physicians to
      population is 1:2326 in development towns and 1:1852 in the older more
      established veteran communities. Kibbutzim, which are also located in large part
      in geographically remote areas, enjoy high quality health services and are not
      characterized by low ratios of health care personnel. In 1968-69, 6% of those
      insured by the sick funds purchased services at least once from a private
      physician, while in 1975-76 this figure rose to 32%. As in other countries,
      utilization of preventive services is generally correlated with socio-economic
      status and with education. While the network of primary care facilities in Israel
      is widespread and generally accessible, it is poorly integrated with the hospital
      system. Longevity has increased over the past years and is relatively high; 76.6
      for women and 73.1 for men in 1984. Nevertheless, differences between Jews and
      non-Jews may still be seen among both men and women. The same may be said
      concerning mortality and especially with regard to infant mortality. Differences
      with regard to certain risk factors among Jewish infants and adults are
      correlated with socio-economic class and country of origin.

PMID- 2218611
TI  - Social differences in health and utilization of health services in Italy.
AB  - This paper describes the present pattern of mortality, morbidity, invalidity, use
      of services, and life-style according to relevant social characteristics. On the
      whole, the empirical evidence shows that lower socioeconomic groups, identified
      either by level of education, profession, or region of residence, continue to
      score worse on different health measures despite a general improvement in their
      state of health. Two results are of particular importance. Some southern regions
      accumulated a higher concentration of ill-health conditions and became multi
      problem areas. Middle and, above all, upper social groups have increasingly used
      the private health sector despite that fact that they are covered under the
      National Health Service provisions. This last development may be counter
      productive for the strategy of equalization introduced in 1978 with the NHS.

PMID- 2218612
TI  - Health and social inequities in Malta.
AB  - This paper focuses on the sources that are thought to lead to the genesis of
      health and social inequity in a small island community. It is largely a
      descriptive exposition, the main aim of which is to introduce the topic in Malta.
      Small size is the key geographical factor. This fact is dwelt upon to stress that
      although there are differences, say, between the two inhabitable islands, such
      differences are very small. Social homogeneity and an almost indiscernible urban
      rural difference are strong factors that reduce any tendency for regional
      inequities. Socio-cultural factors in Malta are largely determined by family life
      and its relation with the established church. The traditional Catholic way of
      life is depicted as gradually giving way to a more secular lifestyle. Politics is
      represented as the prime factor for causing division within the this society.
      This is not without reason since this factor has taken over the other cause of
      division, namely parochialism. Political factors determine the distribution of
      resources including health resources. The important economic factors are that
      there are no great differences between the high income and the low income groups.
      However, due importance must always be given to the subterranean economy. The
      health profile is that of a developed country with low infant mortality and a
      long life expectancy. Infectious diseases have been on the decline and their
      persistence is usually linked to areas that have remained underdeveloped. The
      disadvantaged groups identified are the chronically unemployed, single mothers,
      possibly a section of the migrant population and the elderly.

PMID- 2218613
TI  - Health and social inequities in The Netherlands.
AB  - Although there is some knowledge of inequity in mortality due to socioeconomic
      differences in the late nineteenth and early twentieth century, we know very
      little about present mortality differentiated by socioeconomic status. However,
      at present there are signs that interest in this theme may be increasing,
      particularly among government authorities. An overview will be presented of the
      few, rather scattered, existing data on regional and socioeconomic differences,
      mortality and other indicators of ill-health. This includes results of a
      secondary analysis of mortality differences among middle-aged Dutch men in a
      rural town. In this analysis the central question was whether mortality
      differences related to socioeconomic status could be explained by different risk
      factors. Socioeconomic status and risk factors turned out to be independent
      predictors of mortality. Finally, a short description will be given of the
      awakening interest for such data among health policymakers.

PMID- 2218614
TI  - Health inequalities in Poland.
AB  - This text is a second paper on relations between social inequalities and health
      in Poland. Our first paper was included in a collective report from a conference
      on social inequalities in health and health services utilization in 24 European
      countries (The Health Burden of Social Inequalities: Poland, pp. 157-170. WHO
      EURO, Copenhagen, 1986). It contains a description of social inequalities in
      health occurring in Poland, based on existing statistical data and information
      from scientific research. This text is an expansion of the previous one; here we
      present more updated information; we also try to identify some reasons for
      existing inequalities in health.

PMID- 2218615
TI  - Health and social inequities in Spain.
AB  - This article examines the relationship between health and social differences in
      Spain. The dominant explanatory models (medical, health system oriented and
      economical) have focused on health care as the main source of health. They have
      disregarded the role of socioeconomic variables in the genesis, development and
      cure of illness. In relation to the distribution of health, the variables
      analysed here are those of poverty, social class, sex, age, living conditions,
      lifestyles and some existential indicators using both official aggregated data
      and survey data. We conclude that Spain is a country with major economic, social
      and regional differences and manifests important variations in the health of its
      population. The evidence taken from the data presented here seems to indicate
      that poverty, living conditions and income play a relevant explanatory role.

PMID- 2218616
TI  - Health and social inequities in Sweden.
AB  - Sweden is one of Europe's most egalitarian countries. The social inequities in
      living conditions have been gradually reduced to a level that is more equal than
      in most countries in Europe. Even if general health development has been positive
      during recent years, data reviewed here indicate that there may be adverse
      effects for some groups which may increase inequities. This article presents
      results on inequities in health from the Public Health Report of Sweden 1987 and
      discusses causal mechanisms and implications for health policy.

PMID- 2218617
TI  - Health and social inequities in Switzerland.
AB  - Despite standards of living and life expectancy amongst the highest in Europe,
      Switzerland exhibits fairly substantial social inequities in health. As regards
      male mortality by socio-economic group, these differentials are both marked and
      independent of cause of death. There is a wealth of information on morbidity and
      disability supporting the hypothesis that people in lower socio-economic groups
      tend to age faster and suffer more at younger ages. It is similarly evident that
      infants of low class mothers, particularly those unwed, underprivileged
      immigrant, are at excess risk. The Swiss results are of political and scientific
      interest in that they suggest that the average wealth of a community does not
      determine health differentials.

PMID- 2218618
TI  - Health and social inequities in Turkey.
AB  - Social and economic policies of governments directly influence the health of the
      people. These policies, in turn, are determined by the national and foreign
      controllers of power. Economic and social factors in Turkey during the late 1970s
      led to a new modelling of the economic system, from a Keynesian to a market
      oriented and monetarist model. The state mechanism was also altered to form a
      centralized, authoritarian regime in order to enforce the requirements of the
      economy. As a result, the middle class diminished in size, inequalities in income
      distribution increased, unemployment climbed, the purchasing power of wage
      earners decreased, government spending for education and health was cut and new
      oppressive laws were enacted. Health services were already urban-biased and
      hospital-oriented, but new free-market measures were instituted which promoted
      private health institutions and attempted to transform state-owned and financed
      hospitals into self-supporting, independent business enterprises. The only school
      of public health was closed down; preventive medicine expenditures were lowered
      while hospital rates and drug prices were increased. All these changes affected
      the health status of the population. Mortality and morbidity inequalities had
      already existed between the rich and the poor, men and women, urban and rural
      settlements, educated and illiterate, West and East, always in favour of the
      former. However, the new policies exacerbated the inequities. Infectious diseases
      including tuberculosis increased, nutrition worsened, occupational diseases and
      work accidents rose to be the highest in Europe. The power-holding minority is
      not interested in the health of populations and is committed to pursue its social
      and economic policies. Ad hoc research, especially cross-sectional mortality
      studies repeated at regular intervals can provide data on the most vulnerable
      groups as no other valid information exists. There is little hope of these data
      being used for intervention unless democratic changes take place.

PMID- 2218619
TI  - The measurement of inequities in health: lessons from the British experience.
AB  - There has been an acrimonious debate about trends in inequality in health in the
      U.K. over the last couple of years. Whilst the acrimony is highly specific to the
      U.K. context, the terms of the debate contain general lessons for others who
      would venture into the same territory. This paper has focused on problems with
      using occupational classifications, with using groups of different size, with
      assessing trends in inequalities in death, with the measurement tool employed,
      with comparing patterns of ill-health and with the framework of explanation. The
      U.K. debate provides a good example of the first problem. Much of the debate has
      had to rely on the classification of occupation at the time of death by the
      Registrar General's Department. The scheme used was devised in 1911 and has
      persisted despite the massive changes in occupational structure since then. The
      groups now contain different occupational titles, and it is not at all clear what
      is being referred to by the RG scheme. Moreover, the balance of the RG groups has
      shifted dramatically. Any scheme applied regularly and routinely to mortality
      statistics over time will have these problems--it is not surprising that it is
      very difficult to interpret patterns of class death rates. The argument over
      trends in the U.K. has sometimes focused exclusively on the measurement tool--the
      standardized mortality ratios. Various alternatives have been proposed, in
      particular the Gini coefficient which clearly answers a different, possibly
      rather uninteresting, question. The correct way of comparing 'top' and 'bottom'
      is to devise a method which produces a group of constant size in the different
      communities or at different times. The focus on death rather than survivorship is
      queried as is the usual restriction to comparing rates of early death.
      Possibilities of comparing patterns of ill-health are examined in the fifth
      section. Whilst routine health care data or survey morbidity data are invaluable,
      it seems highly unlikely that they can be compared between communities or over
      time. The alternative is to develop a series of 'risk' indicators and these are
      discussed in Section 5.3. The examination of patterns of inequalities in death
      and ill-health highlights the complexity of discussing aetiology. We consider the
      balance between long-term and short-term effects and the possible role of (ill)
      health on the social mobility process, and problems of directly relating low
      income to poor health.

PMID- 2218620
TI  - Health and social inequities in Yugoslavia.
AB  - In Yugoslavia the problem of social inequities comes on the political agenda
      every time when society is in a crisis. This paper describes the pattern of
      social inequities in health. Data are mostly used from statistics. The features
      of health inequalities are shown. The marked inequalities exist regionally, among
      republics and provinces, in spite of the reallocation of resources. Health
      inequalities exist also among social classes however they are measured.
      Individually based measurement shows inequalities in health between all
      individuals of the population. As Yugoslav society is passing through severe
      economic crisis when social structure polarizes and becomes rigid--inequalities
      in health tend to increase.

PMID- 2218621
TI  - The economics of inequality in health: a bibliography.
AB  - Economists have until recently taken a back-seat in the debate on inequality and
      health, despite various suggestions that economic science has much to contribute
      to the clarification of issues surrounding that polemic. This article presents a
      bibliography of English-language sources which explicitly consider the economics
      of inequality in the health domain or present methods which might suitably inform
      the debate. Initially, an introductory guide to the literature is presented,
      followed by the bibliography itself. This second section is divided into four
      distinct parts in order to facilitate use: works of a general economic nature,
      including those on the measurement and extent of inequality; discussions of
      normative aspects of equity in health; positive analyses drawing on models of the
      demand for health and medical care; and a final sub-section that groups works
      from other disciplines which are indispensable background for future work by
      economists.

PMID- 2218622
TI  - Questioning the status quo: sickness absence research so far claims more than it
      should!
AB  - This article is in the nature of a cautionary tale for those working alongside
      any group of medics who are required to collect epidemiological data, or plan
      based upon data collected by medical experts without having access to that data.
      The field of work is occupational health and the specialised area is the
      relationship between socio-economic variables and absence from work due to
      sickness. The over-riding criticism of the sickness absence literature to date is
      that the use of analytical statistics is poor or in most cases almost non
      existent and that there is very little understanding of the epidemiological
      concepts of 'confounding' and 'effect modification'. An example is given of one
      particular statistical procedure, multi-variate hierarchical log-linear
      modelling, which if used by future researchers could prevent the recurrence of
      some of the previous problems.

PMID- 2218623
TI  - Levels of health development: a new tool for comparative research and policy
      formulation.
AB  - Levels of health development are formed by mathematically clustering countries
      using six health status indicators: crude birth, crude death, infant mortality
      and child death rates, and male and female life expectancy. Stratifying two
      international samples of 128 and 163 countries into levels of health development-
      groups with similar health status profiles--improves the results of regression
      analyses used to identify economic, political, social, educational, health and
      other health determinants. For this reason, health development levels are a
      systematic framework for delineation of health determinants. Earlier large scale
      statistical studies have been limited in their success in part because they did
      not partition their data sets prior to analysis, or used inappropriate criteria
      that blurred rather than heightened developmental differences in underlying
      social systems. These developmental differences regulate the way in which health
      status inputs are converted into health status outputs, defining the relative
      importance of health determinants at various developmental levels. At lowest
      health development levels (countries with poorer health status), the under
      development of economic, health and educational infrastructures creates a vacuum
      which allows international intervention (aid, investment, export/import
      activities) to play a dominant role in health status determination. At middle
      health development levels, health and educational infrastructures are better
      developed, but still secondary in importance as health status determinants to
      basic economic infrastructure. Demographic problems are particularly apparent at
      these levels. At higher health development levels, education, women's status, and
      political structure are especially important health status determinants. This
      research has facilitated the identification of health status determinants for use
      in health policy analysis. Recommendations for future research include use of
      findings in health policymaking by individual countries and by comparative
      researchers, and development of appropriate health systems models for each level
      of health development.

PMID- 2218624
TI  - Characteristics of women having abortion in China.
AB  - A pre-coded, closed response questionnaire was administered to women at abortion
      clinic sites in August 1985. The convenience sample was comprised of 1200 women,
      200 samples in both Chengdu and the Lianshan Yi Autonomous Region in Sichuan
      Province, 400 in Nanjing and Jiangsu Province, and 400 in the municipality of
      Shanghai. The women were interviewed by physicians as part of the women's intake
      medical history. The sample yielded 574 respondents who were urban and 624 who
      were rural. The number of previous abortions reported ranged from 0 to 5. Nearly
      half of the abortion recipients had had at least one prior abortion and 18% had
      had two or more prior abortions. Education, age, marriage duration and residence
      have apparent effect on abortion order. The urban respondents reported an average
      of 1.08 children vs 1.60 children for the rural respondents. Approximately 72% of
      the respondents claimed to have been using a contraceptive method at the time
      they became pregnant. The most commonly used method was the IUD (41.6%), followed
      by the pill (21.3%) and the condom only (16.5%). Residence appeared to be the
      greatest factor determining the type of contraceptive methods. The data presented
      here are limited and cannot be generalized to the larger population. However,
      they do shed some light on the contraception characteristics of a group of women
      who undergo abortion procedures in China. Their response to questions to
      contracepting behavior prior to abortion suggests that the problem, in part, is
      behavioral. For example after the expulsion of the IUD, no other method was
      substituted to avert pregnancy. In order to alleviate the problem of
      contraceptive failure, and subsequent abortion, there are policy as well as
      training and education implications for the state.

PMID- 2218625
TI  - Reported versus recorded health service utilization in Grenada, West Indies.
AB  - Calls for household surveys to provide information on service utilization in less
      developed countries raise questions regarding the accuracy and reliability of
      reporting. This paper compares reported to recorded health service utilization
      for diarrhoea and any other morbidity over a 2-week and 3-month period for
      information obtained from a household survey in Grenada, West Indies. A
      sensitivity analysis is used to derive minimum and maximum estimates of the
      accuracy of reported utilization. Over-reporting utilization was found to be
      between 33 and 62% for diarrhoea and 49 and 81% for any other morbidity. Under
      reporting of all utilization was estimated to be between 47 and 65%. These
      results cast doubt on the utility of household surveys as a reliable source of
      information regarding service utilization.

PMID- 2218626
TI  - Length of unemployment and psychological distress: longitudinal and cross
      sectional data.
AB  - Data are presented from the second stage of a longitudinal study of unemployed
      young people, when their ages ranged from 19 to 24 yr. Data from the first stage,
      when their ages ranged from 16 to 20 yr, had provided support for a curvilinear
      hypothesis relating psychological distress or affective well-being, to
      unemployment duration. According to the curvilinear hypothesis, distress peaks at
      around 6 months and declines thereafter. In the present study three target groups
      were distinguished: those unemployed for 3 months or less, those unemployed from
      4 to 8 months, and those unemployed for 9 months or more. On most of the
      dependent measures the 3 month, and 4-8 month groups did not differ, but the 9
      month group was significantly worse off than either. It is concluded that the
      relations between length of unemployment and psychological distress, or well
      being, are different in teenagers and young adults. Possible explanations for the
      differences are discussed.

PMID- 2218627
TI  - Patterns of preference for information sources in the adoption of new drugs by
      specialists.
AB  - The present study investigated the adoption of new prescription drugs by
      specialists who treat serious disorders using relatively high risk drugs with
      potentially serious side effects. One-hundred and fifty-six specialists,
      primarily practicing in medical specialties, evaluated a number of drug
      information sources and reported their use of these sources both in their general
      drug adoption procedures and in the adoption of one of a number of target drugs.
      As predicted, the pattern of drug adoption among specialists is substantially
      different from that generally reported in earlier studies, which are usually
      based on samples of general practitioners or of general practitioners and
      specialists combined. Professional sources of information predominate throughout
      the process, both in adoption procedures generally used and in the adoption of
      target drugs. The majority of specialists reported contact with commercial
      sources at some stage in the adoption process for the target drugs, but these
      sources were not, as is often reported in the literature, the main sources of
      first news of a new drug, nor did they exert much influence at the prescribing
      stage. It is clear from these results that in future research on drug innovation,
      different classes of medical practitioners, such as specialists vs general
      practitioners, will need to be distinguished.

PMID- 2218628
TI  - The influence of social support on AIDS-related grief reaction among gay men.
AB  - This paper examines the relationships between instrumental and emotional social
      support and the experience of grief reaction in a sample of 180 gay men who had
      lost a lover or close friend to AIDS during the first 5 years of the epidemic.
      Structured, face-to-face interviews were conducted in mid-1985. Grief reaction
      was assessed through a newly developed 12-item scale (alpha = 0.85). Availability
      and adequacy of instrumental and emotional support were assessed with reference
      to the tasks of caretaking and emotional pain experienced during the lover's or
      close friend's illness with AIDS. The findings indicate that gay men who lost a
      lover or close friend to AIDS experienced symptoms of grief similar to those
      reported in studies of bereaved spouses and parents. The intensity of these grief
      reactions appears to be influenced by a number of factors. First, more intense
      grief reactions were observed among those who had taken care of their lover or
      close friend during his illness compared with those who did not act as
      caretakers. Second, while the simple availability of instrumental and emotional
      support was unrelated to grief reactions, the perceived adequacy of both types of
      support was strongly related to the level of grief. Respondents who had received
      inadequate help with caretaking responsibilities experienced more intense
      symptoms of grief subsequent to the death compared with those who reported
      receiving adequate caretaking support. Similarly, respondents who did not obtain
      adequate emotional support for the pain they experienced during the course of the
      illness reported more intense symptoms of grief compared with those who felt they
      had received adequate support.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218629
TI  - Falls and subjective health rating among the elderly: evidence from two Israeli
      samples.
AB  - Prevention and treatment of falls in the elderly is one of the challenges facing
      practitioners today. Falls are known to be associated with health status and
      demographic variables, however relatively little is known about how falls affect
      the health perceptions of elderly persons. Data from two Israeli samples were
      analyzed to examine the relationship between reported falls and self-rated
      health. The first sample was collected in 1978 in home interviews from 96% of
      residents aged 65 and over of the town of Kiryat Ono (N = 1276). The second
      sample was collected from a national probability sample of 3494 urban Israelis in
      1985, in home interviews. One-year incidence of falls was estimated from both
      samples at 23-24% for those over 65. Data from both samples showed that recent
      falls are negatively associated with subjective health rating. In Kiryat Ono,
      falls interacted with reported chronic conditions, so that the effect of a fall
      on subjective health status was only apparent in those with few chronic
      conditions. Among those who reported 4 or more chronic conditions, the occurrence
      of a fall had no independent effect on subjective health rating. In multivariate
      analyses of the national data, falls, and particularly those that happened in the
      home, or that required a visit to the emergency room had a negative effect on
      subjective health rating, after adjustment for age, sex, education, mobility and
      visual impairments and use of sleeping pills.

PMID- 2218630
TI  - An assessment of survey data on birthweight.
AB  - The objective of this analysis is to determine whether useful information on
      birthweight can be obtained from a retrospective survey. The 1986 Peru
      Demographic Health Survey collected both numerical weights (in grams) and
      subjective assessments of relative size at birth, for infants born during 1981
      86. Simple tabulations suggest that reports of both measures are of reasonably
      high quality. However, a more detailed analysis demonstrates that exclusion of
      the large proportion (almost one-third) of missing responses on numerical weights
      can lead to biases in the resulting estimates of the incidence and correlates of
      low birthweight, of the level of infant mortality, and probably of the relative
      risk of mortality for low birthweight infants. The results emphasize the
      necessity of collecting data on the relative size of infants, in addition to
      information on numerical weights, in populations in which a substantial fraction
      of infants are born outside the formal health system. The subjective assessments
      allow the analyst to examine the extent to which infants with missing numerical
      weights are select and to assess the degree of bias in estimates which are based
      on the subsample of births with reported weights.

PMID- 2218631
TI  - Psychology, mental health care and the future: is appropriate transformation in
      post-apartheid South Africa possible?
AB  - In accepting the principles that psychology and politics are intertwined and that
      major political transformation in South Africa is inevitable, the question that
      arises is to what extent appropriate transformation of the mental health care
      system is possible in a post-Apartheid state. A variety of factors need to be
      considered in exploring this question: the affordability of extending the mental
      health service; the expense of tertiary care; the increased demand for treatment;
      Apartheid mental health professionals' resistance to change; the inclusion of non
      professionals within the care system, and community involvement; and the problems
      posed by having residential areas still occupied by certain racial groups in a
      post-Apartheid society. All these factors are likely to make the transformation
      of psychology and the mental health care system more difficult to achieve.

PMID- 2218632
TI  - Urbanisation and health: methodological difficulties in undertaking
      epidemiological research in developing countries.
AB  - Rapid urbanisation has historically resulted in complex societal changes which
      have had both beneficial and adverse effects on the health of communities.
      Recently, it has been recognised that the urban poor in developing countries are
      at greatest risk for several adverse health effects. The epidemiologist has a key
      role to play in planning to meet current and future health needs of urban
      communities. Epidemiological research needs to focus on understanding the
      relationship between the changes that occur with urbanisation and their impact on
      health, in order to identify those at greatest risk, to identify the important
      risk factors that are amenable to intervention, and to evaluate the effectiveness
      of interventions aimed at improving the health of urban communities. This paper
      addresses several methodological difficulties in conducting epidemiological
      research on urbanisation and health in developing countries, with particular
      reference to Southern Africa. These relate to the definition of urban areas and
      residence thereof, the comparability across areas of exposure and outcome
      information, the identification of intra-urban variability, selection bias in
      cross-sectional studies, associating outcomes with specific urban exposures in
      analytic studies, and determining appropriate interventions and means of
      evaluation. Ways of overcoming these difficulties are suggested. Epidemiologists
      need to address these issues in order to make a valuable contribution to the
      improvement of health in urban communities.

PMID- 2218633
TI  - The blood transfusion taboo of Jehovah's Witnesses: origin, development and
      function of a controversial doctrine.
AB  - Jehovah's Witnesses are not allowed to accept a blood transfusion. According to
      the Watch Tower Bible and Tract Society this therapy is a transgression of divine
      precepts. Additionally, in the judgement of the believers, secular proof is
      abundant these days; to them AIDS is a powerful justification to abstain from
      blood. Founded on the work of the anthropologist Mary Douglas, it is argued that
      the rejection of this medical therapy is based on perceptions of pollution and
      purity inherent in the Watch Tower Society's ideological concept of anti
      worldliness. Rooted in the movement's pre-war opposition to vaccination the
      implementation of the taboo was triggered by the prevailing social-political
      climate surrounding the Society during the Second World War, resulting in this
      intriguing and controversial religious proscription. For the community of
      Jehovah's Witnesses the blood transfusion taboo still functions as a significant
      mechanism of sectarian boundary maintenance.

PMID- 2218634
TI  - Psychological distress and mortality: evidence from the Alameda County Study.
AB  - The relationship between psychological distress, in this case depression, and
      subsequent risk of mortality is examined using data from the Alameda County
      (California) Study, an 18-yr, three-wave prospective investigation of
      psychosocial risk factors and health. The results indicate no relationship
      between psychological morbidity and all-cause mortality or specific causes of
      death. While these results are discordant with those reported from a majority of
      studies of psychiatric patients, they are concordant with a majority of community
      based studies of the general adult population. Possible methodologic explanations
      are discussed which might account for disparate results reported to date, in
      particular failure to control for the effects of co-morbidity of somatic
      disorders and socioeconomic status.

PMID- 2218635
TI  - Sociodemographic and health factors in the well-being of homeless men in Sydney,
      Australia.
AB  - Throughout the world, homelessness is generally increasing. This paper examines
      some of the historical precedents and, in an Australian sample, some of the
      factors leading to ill-health in this group. All studies have shown the ill
      effects on health of being homeless and in this group drinking alcohol and length
      of time on skidrow appear to be the major factors. It is also suggested that the
      homeless are generally from comparatively disadvantaged backgrounds before
      becoming homeless, and more likely to be migrants. They were also less likely to
      have ever married and more likely to have been in jail or psychiatric
      institutions.

PMID- 2218636
TI  - Modeling heart disease mortality with census tract rates and social class
      mixtures.
AB  - The relationship between social class and 1980 heart disease (HD) mortality in
      eight urban U.S. counties was examined by regressing age and sex adjusted census
      tract specific HD rates (N = 1211) on tract social class characteristics. The
      regression model indicated that lower middle class residents experienced a HD
      mortality rate 1.9 (95% CI = 1.3, 2.8) times the rate in the upper middle/middle
      class, while the working poor experienced a HD rate 4.4 (95% CI = 3.5, 5.7) times
      the rate in the referent class. Similar class effects were seen for both black
      and nonblack residents. The crude race effect (1.3 with 95% CI = 1.2, 1.4) was
      explainable by the concentration of blacks in the lower classes. The methods
      illustrate the ecologic regression of mixtures of mortality rates on mixtures of
      exposure in the presence of random tract effects which eliminates some of the
      problems associated with small denominators or zero rates in some tracts.

PMID- 2218637
TI  - Sport participation and perceived health status: a study of adolescents.
AB  - Although it is a well-accepted notion that sport participation enhances health,
      the precise nature of the relationship has been unclear. Based on a national
      survey of Icelandic adolescents, this study evaluates the direct and indirect
      effects of sport participation on perceived health status. It is shown that sport
      participation has a substantial direct effect on perceived health, controlling
      for other health related behaviours, psychological distress and disease status.
      Sport participation also affects perceived health indirectly through distress and
      smoking, but does not seem to operate through alcohol consumption. The meaning of
      these results and their implications for future research are discussed.

PMID- 2218638
TI  - Emergency department utilization by two subcultures in the same geographical
      region.
AB  - An exploratory study of emergency department (ED) utilization, comparing Israeli
      adult Jews and Bedouin Arabs was conducted. The data interpretation derived from
      the premise that health services utilization reflects not only morbidity patterns
      but characteristics of both subcultures and the structure of health services. The
      Bedouins in the study are a Moslem traditional society going through a rapid
      process of urbanization and modernization, with a relative deficiency in primary
      health services. Data were collected from the general ED admissions registry.
      Patients (17+) who arrived at the ED during the first week of every even month of
      one calendar year were selected for this study (6815 Jews and 583 Bedouins). The
      findings indicate that, in general Bedouins use the ED significantly less than
      Jews. They adjust to the structure of the ED services and use them, more than
      Jews, as a primary service. Yet, the hospitalization rates of the two populations
      are similar. In both subcultures the pattern of gender differences changes after
      the age of 45. The change, however, is in the opposite direction. Differences in
      ED usage among Bedouin age-sex groups are discussed in terms of changes in social
      status during a period of socio-cultural transition.

PMID- 2218639
TI  - Primary care practitioners' likelihood to engage in a bio-psychosocial approach:
      an additional perspective on the doctor-patient relationship.
AB  - On the basis of a comprehensive study among Israeli primary care practitioners a
      multivariate framework aimed at furthering the understanding of salaried
      physicians' likelihood to engage in a bio-psychosocial approach has been
      developed and empirically verified. The framework augments earlier work on
      physicians' behavior by further specifying the concept of bio-psychosocial
      approach and the incentives and preconditions for such an approach. Multivariate
      analysis highlights the weight of the motivating, facilitating and impeding
      factors in shaping the primary care practitioners' likelihood to engage in a bio
      psychosocial approach. Conclusions are drawn regarding implications for the
      organization of care providing organizations.

PMID- 2218640
TI  - The mortality of first and second generation Irish immigrants in the U.K.
AB  - The Irish have generally been ignored in studies of the health needs of ethnic
      groups in the U.K. despite being the largest immigrant group and having the
      highest Standardised Mortality Ratio of all first generation immigrants. Using
      the OPCS Longitudinal Study, the present paper shows that this excess mortality
      persists into the second generation Irish in the U.K., regardless of the part of
      Ireland from which their parents originated or whether one or both parents were
      Irish. The effects of social class, age, sex, year of entry to the U.K. and
      period of death are explored, and variations with these factors are found to be
      complex.

PMID- 2218642
TI  - Community pharmacy: a method of assessing quality of care.
AB  - Generalisability theory is presented as a research method for assessing the
      quality of health advice. The theory is applied to make a comprehensive
      assessment of primary health care advice given by community pharmacists. A random
      sample of pharmacies from all London postal districts were selected and visited
      for set periods throughout one year. During these visits all consultations on
      health or the use of drugs between pharmacists and clients were tape-recorded.
      Nine characteristics were derived by an external criterion panel on which the
      quality of advice in a random sample of consultations (50) was assessed using
      rating scales. Following the application of generalisability theory, operational
      conditions for the assessment were selected to obtain a generalisability
      coefficient of around 0.8. Nearly half the consultations achieved satisfactory
      scores on at least three-quarters of the criteria on which they were assessed.
      However almost a third were considered satisfactory on less than a quarter of the
      criteria, most of these being satisfactory on none of them. Performance regarding
      disease prevention/health promotion activity was poorest. Thus the quality of
      most consultations was found to be either very good or very poor, relatively few
      occupying the middle ground.

PMID- 2218641
TI  - Application of the verbal autopsy during a clinical trial.
AB  - During a community-based treatment trial of onchocerciasis with ivermectin,
      verbal autopsies were employed as one method to assess the safety of the drug.
      The verbal autopsy questionnaire was designed to determine causes of death and
      mortality differentials in the treated population. During the 8 months of
      surveillance here reported, 25 individuals died, yet only 9 of these deaths were
      certified. Seven of the deaths occurred to individuals who had been treated with
      ivermectin and the majority of the deaths occurred to children under 5, who were
      excluded from treatment. The verbal autopsy method was evaluated and validated by
      comparing the verbal autopsy diagnosis of cause of death to death certificate
      diagnosis, when available. In addition, verbal autopsies were retrospectively
      performed for all deaths which had occurred at the hospital during the 6 months
      preceding the start of the study, if these deaths were traceable to households in
      the surveillance population. We found that in 80% of the adult deaths, the verbal
      autopsy and death certificate diagnoses of underlying cause of death agreed. The
      verbal autopsy was less accurate in diagnosing child deaths which we attribute to
      the design of the verbal autopsy (being to detect potential drug related deaths
      in adults) and to the delay between death and interview. We conclude that verbal
      autopsies are an important addition to surveillance systems in remote areas where
      the absence or inadequacy of health information systems does not allow a thorough
      follow-up of all subjects in drug studies.

PMID- 2218644
TI  - Tolerance for ambiguity among medical students: implications for their selection,
      training and practice.
AB  - The practice of medicine has always been characterized by uncertainty. Yet,
      attempts to study tolerance for uncertainty in medicine have been few, and
      limited to its influence on specialty preferences and test-ordering behavior. In
      particular, studies have not investigated how the process of socialization into
      the medical profession affects tolerance for uncertainty. Based on the assumption
      that uncertainty and ambiguity are related concepts, a modified version of a
      tolerance for ambiguity scale was used to study Johns Hopkins medical students'
      (N = 386) tolerance for ambiguity (TFA) through 4 yr of medical school. In
      addition, using alcoholism as an example of a clinically ambiguous condition, the
      association between students' tolerance for ambiguity and their perceived role in
      diagnosing and treating alcoholism was also investigated. Results indicate that
      tolerance for ambiguity (1) does not change throughout medical school, (2) is
      lower among men, whites and students who are younger when they begin medical
      school, (3) is higher among prospective psychiatrists than surgeons, and (4) is
      lower among students who do not feel responsible for diagnosing and treating
      alcoholism. These findings suggest that tolerance for ambiguity may, indeed,
      affect practitioners' career choices and performance and that selection of
      medical students may be more important than medical training per se in
      influencing students' tolerance for ambiguity. If medical schools admitted
      students who possess a high tolerance for ambiguity, quality of care for
      ambiguous conditions might improve, imbalances in physician supply and practice
      patterns might be reduced, and the increasing ambiguity in medical practice might
      be better acknowledge and accepted.

PMID- 2218643
TI  - A pilot study for an HIV prevention programme among commercial sex workers in
      Bulawayo, Zimbabwe.
AB  - In a health education pilot study for a programme to reduce HIV transmission
      among commercial sex workers (CSWs), 113 CSWs were interviewed and observed in
      Bulawayo, Zimbabwe during 1989. The educational level of the sample was low and
      less than a quarter had another job, either as a self-employed vendor/hawker or a
      domestic servant. Inability to earn income in other ways was the major reason
      cited for engaging in commercial sex. Nearly half the sample went for check-ups
      every 3 months or more often. All interviewees had heard about AIDS, but they
      were uniformed about several facets of AIDS. CSWs reported that they worked an
      average of 3.6 nights a week, averaged 1.3 clients a night and charged a mean of
      U.S. $2.8 a session and U.S. $6.5 a night. CSWs reportedly saw a total of 221
      clients in the past 7 days and used condoms with 87 (39.3%) clients. Nearly all
      CSWs said they had done something to reduce the risk of getting AIDS, but when
      asked what they had done, only 40% said they were using condoms more frequently
      and many cited ineffective precautions. CSWs who had a job, charged higher fees,
      experienced little client violence and believed that they were susceptible to
      AIDS were more likely to use condoms. Clients were a cross-section of Bulawayo
      society, with widely varying education, incomes and occupations and shared little
      except an interest in commercial sex. Ethnographic approaches demonstrated a lack
      of cohesion among CSWs and a consequent need to foster organized, motivated
      groups for health education, the importance of incorporating clients in health
      education and the feasibility of using bar security and sales personnel as health
      educators. It is concluded that health education is urgently needed among CSWs,
      but that it is equally important to direct health interventions at clients, many
      of whom are resistant to condom use.

PMID- 2218645
TI  - Belief in the efficacy of alternative medicine among general practitioners in The
      Netherlands.
AB  - A survey among 293 GPs in the Netherlands showed that many believe in the
      efficacy of common alternative procedures. High scores were especially found for
      manual therapy, yoga, acupuncture, hot bath therapy and homoeopathy. Other
      procedures, such as iridology, faith healing and many food supplements, were
      considered less useful.

PMID- 2218646
TI  - On lending a he'ping hand.

PMID- 2218647
TI  - On writing for reading.

PMID- 2218648
TI  - Assessing the risk of occupational acquisition of the human immunodeficiency
      virus: implications for hospital policy.
AB  - In determining infection control policy, it is essential to quantitatively assess
      the risk of transmission of human immunodeficiency virus (HIV) to health care
      workers and their families. The risk should be placed in perspective by comparing
      it with other occupational hazards. The risk of seroconversion from a needlestick
      injury can be calculated from the probability of a needlestick occurrence, the
      probability that the source patient is infected, and the probability of
      seroconversion, given an exposure. The risk of seroconversion due to drawing 1000
      blood specimens from seropositive patients is between 86 and 470 in 100,000. The
      risk to surgeons from performing 25 operations on infected patients is
      approximately 272 in 100,000. The risk of fatal injury in the course of one
      year's work on a Louisiana oil rig is between 188 and 283 per 100,000.

PMID- 2218649
TI  - Anxiety levels and cancer fear in patients admitted for elective operations.
AB  - Patients who are to have elective operations project varying degrees of anxiety,
      and many spontaneously express fear (without basis) that their operation involves
      a diagnosis of malignancy. To measure total, covert, and overt anxiety
      objectively, we gave the Institute for Personality and Ability Testing anxiety
      test to 125 consecutive patients admitted for elective general surgical
      procedures. A simple survey of cancer fear was also completed. Chi-square and
      Fisher's exact test were used to compare categoric data, and linear regression
      and analysis of variance were used where appropriate. Total anxiety scores were
      in the upper quartile compared to the general population. Scores indicating fear
      of cancer were elevated in 75% of patients who had no history of or reason to
      suspect malignancy. Covert anxiety scores correlated with cancer fear scores, and
      both significantly decreased as age increased (P less than .05). Also, as age
      increased, the cancer fear scores decreased (P less than .002). Obese patients
      had higher scores of cancer fear than all other patients (P less than .0001).

PMID- 2218650
TI  - Synergistic effects of psyllium in the dietary treatment of hypercholesterolemia.
AB  - We investigated psyllium fiber supplementation as a means of enhancing the
      cholesterol-lowering effect of the phase I American Heart Association diet. Fifty
      nine subjects with total serum cholesterol (TC) levels ranging from 5.56 to 10.24
      mmol/L (215 to 396 mg/dL) were given a 2-month dietary lead-in followed by 3
      months of diet only (29 subjects) or diet supplemented with 20.4 g of psyllium
      daily (30 subjects). Unlike women, men had a significant decrease in levels of
      both TC (-8.0%) and low-density lipoprotein cholesterol (LDL-C) (-10.1%) during
      the dietary lead-in. Psyllium supplementation resulted in an additional 5.5%
      reduction in the TC levels as compared to diet alone. Psyllium supplementation
      combined with dietary lead-in resulted in an overall 17.3% decrease in the TC and
      a 20.0% decrease in LDL-C for men, with decreases of 7.7% and 11.6%,
      respectively, for women. Psyllium effectively enhances the cholesterol-lowering
      effect of the phase I diet.

PMID- 2218651
TI  - Surgical management of palmar hyperhidrosis.
AB  - Hyperhidrosis is an idiopathic pathologic condition characterized by excessive
      sweating beyond that required to cool the body. Disturbance of the central
      nervous system, endocrine system, or obesity has been associated with this
      condition. Patients have a history of several years of occupational or social
      embarrassment. Individuals of Japanese ancestry and Jews of Northern African,
      Yemeni, or Balkan descent are predisposed to the condition. Nonoperative therapy
      is merely temporizing and unacceptable because of lack of efficacy or side
      effects. Surgical intervention provides effective and permanent control. The key
      to surgical correction appears to be the division of the sympathetic chain above
      the T-2 ganglion and below the T-3 ganglion of the involved side with removal of
      the entire T2-3 segment with its corresponding spinal nerves. This paper presents
      our experience with the dorsal thoracic approach for interruption of sympathetic
      innervation for severe palmar hyperhidrosis. We also review surgical efficacy of
      various approaches to the sympathetic chain, as well as possible side effects of
      operative intervention.

PMID- 2218652
TI  - Nephrotoxicity associated with concomitant ACE inhibitor and NSAID therapy.
AB  - Angiotensin-I converting enzyme (ACE) inhibitors and nonsteroidal anti
      inflammatory drugs (NSAIDs) can be nephrotoxic and may synergistically compromise
      renal function. A computer-assisted study was done to asses the prevalence of
      compromised renal function and the clinical importance of this drug interaction.
      A search of the records of all patients seen in the University of Nebraska
      Medical Center Internal Medicine Clinic was conducted to identify cases involving
      renal insufficiency, therapy with ACE inhibitors, or therapy with NSAIDs. Records
      of cases meeting these criteria were reviewed for clinical correlation and
      revealed 2278 patients treated with NSAIDs, 328 with ACE inhibitors, and 162 with
      both. No nephrotoxicity was found in conjunction with monotherapy, but three
      cases of reversible renal failure were found in conjunction with combination
      therapy. Significant nephrotoxicity during the concomitant use of ACE inhibitors
      and NSAIDs is not uncommon, and attention should be drawn to this potentially
      important interaction.

PMID- 2218653
TI  - The absence of nephrotoxicity and differential nephrotoxicity between tobramycin
      and gentamicin.
AB  - We conducted a prospective, double-blind, randomized trial of gentamicin and
      tobramycin to evaluate differences in nephrotoxicity. We evaluated levels of
      creatinine, creatinine clearance, beta 2-microglobulin, and N-acetyl-beta-D
      glucosaminidase (NAG) as indicators of nephrotoxicity, and attempted to correlate
      them. Forty patients met the criteria for evaluation; 14 were given tobramycin
      and the remaining 26 received gentamicin. Significant nephrotoxicity, as defined
      by an increase in creatinine of 0.5 mg/dL, did not occur in either group.
      Increases in beta 2-microglobulin values were seen in 67% of the patients in the
      tobramycin group, and 52% of those in the gentamicin group. Elevations in NAG
      levels occurred in 54% of those in the tobramycin group and 52% of those in the
      gentamicin group. Elevation of NAG and beta 2-microglobulin levels was congruent
      in only 40% of the cases. We conclude that there was no significant difference in
      nephrotoxicity between gentamicin and tobramycin. Elevations of NAG and beta 2
      microglobulin occurred at rates similar to those reported in the literature, but
      they did not correlate with significant nephrotoxicity.

PMID- 2218654
TI  - Comparative study of plasma epinephrine and norepinephrine concentrations during
      hemodialysis: measurement by high-performance liquid chromatography versus
      radioenzymatic assay.
AB  - We measured epinephrine and norepinephrine levels simultaneously using two
      methods of detection of catecholamines in plasma--radioenzymatic assay and high
      performance liquid chromatography with electrochemical detection. Measurements
      were made in 15 stable patients during hemodialysis. No statistical differences
      in intradialysis plasma concentrations were found for epinephrine or
      norepinephrine, and no statistical differences were found between the values of
      epinephrine and norepinephrine using the two different methods. No significant
      decrement in epinephrine or norepinephrine concentrations during the dialysis
      procedure was detected regardless of the method used. We conclude that the
      hemodialysis procedure does not affect the concentration of plasma catecholamines
      and that the two methods of detecting plasma catecholamines in patients with
      renal failure are equally accurate.

PMID- 2218656
TI  - Medicinal leeches: once again at the forefront of medicine.
AB  - Medical grade leeches have recently been used in the management of acute problems
      relative to venous congestion in patients with traumatic injuries and surgical
      problems. Specific cases, especially in the realm of reconstructive microsurgery,
      have demonstrated the effectiveness and application of leech therapy. Specific
      contraindications include arterial insufficiency from either anatomic or
      mechanical obstruction. We present five illustrative cases of successful
      therapeutic intervention.

PMID- 2218655
TI  - Acute promyelocytic leukemia: impact of hemorrhagic complications on response to
      induction chemotherapy and survival.
AB  - From 1976 to 1989, 21 adult patients with previously untreated acute
      promyelocytic leukemia were seen at the University of Virginia Hospital. We
      reviewed their cases retrospectively to determine the impact of hemorrhagic
      complications and other factors on treatment outcome. We observed a complete
      remission rate of 35%; the median survival in complete responders was 15 months.
      Evidence of disseminated intravascular coagulation was found in 13 (62%) of the
      21 cases at diagnosis. Fatal intracranial hemorrhage was the leading cause of
      death, occurring in eight (40%) of the 20 patients evaluated. Initial leukocyte
      count greater than 4.0 x 10(9)/L and platelet count less than 20 x 10(9)/L were
      significantly associated with an increased risk of intracranial hemorrhage. In
      patients with disseminated intravascular coagulation, the rate of intracranial
      hemorrhage was reduced by treatment with heparin. The high mortality of 40%
      (8/20) due to intracranial hemorrhage during induction was a major contributor to
      the low complete remission rate of 35% (7/20) in this series of consecutive
      unselected patients with newly diagnosed acute promyelocytic leukemia.

PMID- 2218658
TI  - A modification of the supraclavicular approach to the central circulation.
AB  - Traditional anterior or posterior triangle approaches to the central circulation
      may be at times unsuccessful in the patient whose anatomy makes cannulation
      difficult. We used a supraclavicular approach to cannulation of the central
      circulation in 100 patients for intraoperative monitoring or insertion of renal
      dialysis catheters. We have had only two failures, both in patients for dialysis
      catheter placement, and no complications. Review of the literature reveals a
      similar history of success with variations of this approach. The supraclavicular
      approach is an easy cannulation technique for the inexperienced physician and a
      useful alternative to traditional approaches for the experienced physician.

PMID- 2218657
TI  - Comparison of cefuroxime axetil, cefaclor, and amoxicillin-clavulanate potassium
      suspensions in acute otitis media in infants and children.
AB  - In this randomized, blinded, multicenter comparison study, 377 infants and
      children with acute otitis media (AOM) received a 10-day course of an oral
      suspension of one of the following: cefuroxime axetil (CAE), 30 mg/kg/day;
      cefaclor (CEC), 40 mg/kg/day; or amoxicillin-clavulanate potassium (AMX-CL), 40
      mg/kg/day. Clinical efficacy was determined by pneumatic otoscopy and
      tympanometric testing 3 to 5, 11 to 14, and 22 to 26 days after the initiation of
      therapy. There was a statistically significant difference among the three
      treatment groups with respect to clinical outcome; more patients in the CAE group
      (62%) than in the CEC group (46%) or the AMX-CL group (52%) had complete
      resolution of signs and symptoms of AOM (including effusion). Paired comparisons
      revealed a significant difference in efficacy between CAE and CEC and a nearly
      significant difference between AMX-CL and CEC. Taste acceptability was highest
      for CEC and lowest for this formulation of CAE. Significantly more patients in
      the AMX-CL group than in the CAE or CEC group had a side effect, primarily
      diarrhea, vomiting, or diaper rash. We conclude that CAE suspension has greater
      clinical efficacy than CEC and fewer side effects than AMX-CL.

PMID- 2218659
TI  - Dementia: what to do.
AB  - Dementia is a syndrome of acquired intellectual deterioration that interferes
      with personal or social functioning. Diagnosis requires historical information
      from the family and the mental status evaluation of orientation, recent memory,
      comprehension, calculation, and abstraction. Most dementias create permanent,
      even progressive cognitive deterioration, yet there are some presentations for
      which remission exists. Common reversible conditions include depression, drug
      toxicity, normal-pressure hydrocephalus, hypothyroidism, subdural hematoma, and
      neoplasm. Screening laboratory studies consist of urinalysis, chemistry profile,
      blood count, thyroid survey, vitamin B12 and folate measurements, serology, chest
      roentgenogram, computerized tomographic scan of the head, electroencephalogram,
      and electrocardiogram. Treatment focuses on potential reversibility, psychosocial
      issues, restoring deficits, and specific symptoms.

PMID- 2218660
TI  - Sarcoidosis ... or something like it.

PMID- 2218661
TI  - A personal history of the ectopic brain.

PMID- 2218662
TI  - The scope of scopes.

PMID- 2218663
TI  - Carl Moyer (1908-1970): surgical teacher of the mid-20th century.

PMID- 2218664
TI  - Duplex Doppler examination of a perinephric abscess in a renal transplant.
AB  - Perinephric abscess has no characteristic ultrasonic appearance or location.
      Differentiation from urinoma, lymphocele, or hematoma depends on clinical and
      laboratory findings. Therapy consists of percutaneous catheter drainage, surgical
      drainage, and antibiotic therapy. Acute rejection is the most common cause of
      decreased diastolic flow during the immediate postoperative period. Acute tubular
      necrosis does not usually alter blood flow unless it is severe. Duplex doppler
      ultrasonic assessment of the renal transplant during the immediate postoperative
      period may provide a valuable baseline for comparison if complications develop.
      Baseline and follow-up ultrasonography to evaluate diastolic flow can help
      determine whether a posttransplant patient should receive emergency or
      conservative therapy for complications.

PMID- 2218665
TI  - Simultaneous pneumococcal and Pneumocystis pneumonia in patients with the
      acquired immunodeficiency syndrome.

PMID- 2218666
TI  - Malignant melanoma and pigmented lesions: a diagnostic and management dilemma.
AB  - We document two cases of malignancy occurring at the site of partially removed
      benign nevi. Because of the difficulty in clinical diagnosis and the uncertainty
      in its behavior, we propose that any recurring melanocytic nevus expanding beyond
      the original surgical scar be re-excised and the specimen carefully analyzed to
      ensure complete removal.

PMID- 2218667
TI  - Intra-abdominal palpation of a nasogastric tube in the stomach does not assure
      appropriate placement.
AB  - Improperly placed nasogastric (NG) tubes have been associated with considerable
      morbidity. The only reliable indicator of correct NG tube placement appears to be
      the aspiration of gastric contents. We have reported a case of major morbidity
      from an improperly placed NG tube that perforated the cervical esophagus,
      dissected the mediastinum, and terminated in the omental bursa. No gastric
      aspirate was obtained by suctioning of the tube, but correct placement was
      presumed based upon the surgeon's direct intraoperative palpation of the tip of
      the tube. Failure to aspirate gastric contents should alert the practitioner to
      the possibility of improper NG tube placement.

PMID- 2218669
TI  - Hematoma of the optic nerve sheath after penetrating trauma.
AB  - We have presented a case involving the diagnosis and management of optic nerve
      sheath hematoma. Our patient's positive outcome demonstrates the usefulness of
      megadose steroid therapy for acute optic nerve injury.

PMID- 2218668
TI  - Disseminated strongyloidiasis in AIDS and non-AIDS immunocompromised hosts:
      diagnosis by sputum and bronchoalveolar lavage.
AB  - In conclusion, disseminated strongyloidiasis is a fatal disease that commonly
      affects the lungs. The disease should be suspected in an immunocompromised host
      who came from an area endemic for S stercoralis even years before the onset of
      symptoms or in patients with unexplained gram-negative bacteremia or meningitis.
      Treatment should be started promptly and should be maintained for a long time.

PMID- 2218670
TI  - Prevalence of HIV infection among intravenous drug users: a view from New
      Orleans.

PMID- 2218671
TI  - Thimerosal sensitivity.

PMID- 2218672
TI  - Allergic reaction to yellow dye no. 5.

PMID- 2218673
TI  - Lyme borreliosis and the heart.

PMID- 2218674
TI  - Fiberoptic bronchoscopy for investigating adenocarcinoma of unknown primary site.

PMID- 2218675
TI  - [Optimal management of the flux of patients during mass screening].
AB  - The article entitled "The optimization of technological flows of patients at the
      department of automated mass medical check-ups of workers (DAMMCHW)" sets forth
      the issues related to the activities of the department providing computer-based
      dispensarization of workers at industrial enterprises. The specific character of
      medical check-up organization under the conditions of DAMMCHW is described. A
      functional scheme of technological flows of patients is provided.

PMID- 2218676
TI  - [The automated system of management of the urban emergency medical services].
AB  - A description is given of the ways to improve the effectiveness of urban
      emergency medical care service without considerable increase of its material and
      manpower resources. These ways include the automation of the operative management
      process of the service and the use of optimum management procedures in the
      provision of emergency care. The main stages in the solution of this task are
      identified.

PMID- 2218677
TI  - [Rural medicine].
AB  - There is a need for radical restructuring of training of physicians with
      subsequent post-graduate training every three years and quarterly improvement of
      self-education of physicians. Head physicians of regional rural hospitals should
      be released from all administrative and economic functions. This is the
      responsibility of an administrator with higher technical or economic education.
      Regional and rural Soviets should provide physicians-graduates with dwelling
      space or flats at their arrival to the place of work; ensure patronage for all
      kinds of care at rural regional hospitals, their departments and wards; undertake
      daily supervision and provision of rural hospitals with food products and in
      autumn time with firing. Rural physicians should be granted an opportunity each
      month to order food products for themselves and their families from collective
      farms at State and collective-farm prices. The Ministry of Health of the USSR
      should solve the questions of centralization of supply and standardization of
      equipment and medical appliances for rural hospitals.

PMID- 2218678
TI  - [Problem of the adequacy of therapeutic and diagnostic services for the
      population].
AB  - The article defines the prevalence of paraclinical procedures and drug therapy
      among different groups of population. The data might be used for assessing the
      problems of health care delivery and also as a basis for dynamic evaluations in
      the light of multiaspect influence of medicine on the formation of population's
      health.

PMID- 2218679
TI  - [Various aspects of using the principles of insurance medicine in the USSR].

PMID- 2218680
TI  - [General risk factors of chronic non-infectious diseases among schoolchildren in
      Kaunas and Moscow].
AB  - Representative samples of 16-year-old school-children including 126 children from
      Kaunas and 124 children from Moscow were surveyed by one and the same team
      consisting of researchers from Kaunas and Moscow. The survey indicated a
      statistically valid higher level of systolic blood pressure among Kaunas
      schoolchildren as compared to Moscow schoolchildren of the same age group.
      Diastolic blood pressure was somewhat higher among Moscow schoolchildren. Moscow
      schoolchildren smoked statistically valid more often and more intensively. During
      leisure time boys from Kaunas and girls from Moscow were less physically active.
      A higher level of arterial blood pressure was found among schoolchildren with
      high rates of IMT and among non-smoking boys. There was no dependence between the
      duration of physical activity in leisure time and the level of arterial blood
      pressure. The established correlations between levels of general risk factors for
      chronic noninfectious diseases (CNID) among Kaunas and Moscow schoolchildren are
      important for the evaluation of the effectiveness of CNID integrated prevention
      programme.

PMID- 2218681
TI  - [Improving the organizational forms of early detection of arterial hypertension].
AB  - Within scientific and practical integral programme of chronic noninfectious
      diseases prevention and control scientifically substantiated prevention
      procedures are being developed and introduced into applied public health with the
      object of reducing morbidity and mortality in the republic from leading non
      infectious diseases. Proceeding from the assumption that each fifth or sixth
      adult inhabitant of the republic has elevated arterial blood pressure and during
      recent years the indices of effectively controlled arterial hypertension are not
      improving, the search for new forms of arterial hypertension control is quite
      timely. The results of work of the prevention unit established at the regional
      department store suggests great opportunities for increasing the volume of
      screening for arterial hypertension, increasing population's awareness of the
      necessity of arterial hypertension correction. Enlisting medical students and
      sometimes senior pupils from secondary school to work in the prevention units
      established at non-medical institutions serves as an example of using additional
      resources for the control of arterial hypertension at the community level.

PMID- 2218682
TI  - [Ways of improving medical services for schoolchildren].
AB  - The protection and promotion of schoolchildren's health might be ensured by means
      of differential approach to the use of different forms of organization of medical
      provision and its further improvement with due regard for regional conditions.
      The development of All-union programme "Schoolchildren" is needed which would
      provide for a scientific base for improving organizational and health-promoting
      activities at general education schools and boarding schools.

PMID- 2218683
TI  - [Improving health services for industrial workers].
AB  - The purpose of the present sociohygienic study is to improve a system approach to
      the problem of workers' health protection at industrial enterprises. The methods
      of sociological investigations, organisational experiment, system analysis,
      modelling, and health statistics were used. The improved system of workers'
      health protection was developed, tested in the course of organizational
      experiment and implemented at the industrial enterprises which resulted in the
      reduction of temporary disability, occupational accidents and diseases.

PMID- 2218684
TI  - [Altruism, humanism and medicine].

PMID- 2218685
TI  - [Traditional and folk medicine among the Ossetes].

PMID- 2218686
TI  - [Anti-alcoholism activities of Bolshevik physicians (1904-1917)].

PMID- 2218687
TI  - [New economic mechanism of public health administration: socio- economic
      aspects].

PMID- 2218688
TI  - [Relations between district outpatient service and emergency care service in the
      treatment of elderly patients].
AB  - On the basis of analysing the state of health care delivery for the elderly and
      aged population at prehospital stage (provided by emergency care service and
      district polyclinic) in big cities with a high level of aging of the population,
      a number of organizational activities for improving health care delivery for this
      group of population has been suggested. The data on peculiarities in the level,
      structure and nature of emergency care visits by elderly population are provided.
      The reasons for the irrational use of emergency care are discussed. The
      requirements of the populations under study for various kinds of specialized
      medical care are determined. Current tasks aimed at improving medical care for
      the elderly provided a foundation for the necessity to strengthen the succession
      and correlation between all links in the chain of prehospital care and to re
      calculate the workload in respect to applied public health institutions with due
      regard for age structure of the population in the region of health services.

PMID- 2218689
TI  - [Program-target method in hospital management].
AB  - The experience gained in developing the system of targets for a number of urban
      multi-profile hospitals suggests an opportunity for using a programme-target
      method in the management of an inpatient facility. The Samashko All-Union
      Research Institute of Social Hygiene, Public Health Economics and Management has
      developed a system of programme-target management, consisting of relatively
      autonomous blocks: the identification of actually existing hospital problems; the
      elaboration of the conception of hospital development; the building of a tree of
      targets; the projecting of structures for hospital management; the elaboration
      and implementation of programmes. The identification of problems is based on the
      analysis of factographic tree of hospital targets. The analysis of the problem
      situation and possible ways of solving the problems allow to elaborate the
      conception of hospital development. In order to simplify the procedure for the
      building of a tree of targets the subdivision of targets into the targets
      results, targets-processes and targets-objects is being introduced. On the basis
      of tree of targets the structure of management is being projected and programmes
      are being developed. The uniformity of methods used in this system makes it
      possible to presuppose the possibility of applying them at any institution and at
      any level of public health management.

PMID- 2218691
TI  - [Population health surveys and their role in the development of public health
      programs].

PMID- 2218690
TI  - [Improving coordination of scientific research on social hygiene and public
      health economics and management].
AB  - The article describes the system of research coordination established in the
      country on the problem of social hygiene, public health economics and management.
      Shortcomings are analysed and ways are outlined of improving the carrying out of
      these functions by the head institute.

PMID- 2218692
TI  - [Expectant mothers from other cities hospitalized for delivery in Moscow].
AB  - An analysis was made of geographical structure of women in childbirth from other
      towns who were admitted to maternity homes of Moscow during a year. Regions and
      districts were identified from which the flow of women was the greatest, a
      comparison was made with the number of deliveries in each region and also with
      educational level of women in these regions.

PMID- 2218693
TI  - [Computer technology and analysis of community health].

PMID- 2218694
TI  - [Morbidity and physical development of children's homes residents].
AB  - The data on morbidity and physical development of 647 children of preschool age
      from six children's homes of general type are provided. It was found that with
      age the number of children who come under I and II groups of health is decreasing
      and those who come under III and IV groups of health are increasing in number.
      The indices of physical development of these children are below the regional
      standards. On the average the physical development of these children is delayed
      approximately by one year. Health-promoting activities for children raised in
      children's preschool homes should include the follow-up by specialists, the
      optimization of general and motor regimen, proper nutrition.

PMID- 2218695
TI  - [Quantitative evaluation of the effects of environmental factors on health status
      indices].
AB  - The article is devoted to the problem of improving the methods of data collection
      and processing in solving the question of evaluating the health effect of
      environmental factors. Circumstances are pointed out which hamper the acquisition
      of reliable and operative data. The ways of improving the effectiveness of
      computer use are considered.

PMID- 2218696
TI  - [Physical development and dental caries in schoolchildren].
AB  - The study has been undertaken to examine physical development and stomatologic
      status of 1177 schoolchildren aged 7-14 involving 811 Russian and Nanai children.
      Proceeding from the obtained results the analysis of basic indicators of physical
      development and stomatologic diseases in children is presented.

PMID- 2218697
TI  - [Medical-genetic service and problems of prevention of hereditary diseases in the
      family].
AB  - The article provides the scientific substantiation of the economic effectiveness
      of early identification and treatment of patients with hereditary diseases
      proceeding from the example of patients suffering from mucoviscidosis. It was
      found that the degree of cost-effectiveness is closely related to the
      organization of early identification and timely treatment of such patients. The
      authors prove that identification and treatment of patients with mucoviscidosis
      is cost-effective.

PMID- 2218699
TI  - [Control of the quality of therapeutic process in hospital departments].
AB  - It is recommended to use the following indices for assessing the quality of
      hospital treatment: average hospital stay, the percent of repeated admissions
      with one and the same disease, the percent of discrepancy between clinical and
      postmortem diagnosis with subsequent expert evaluation of each case of death. The
      departments of surgery also find it necessary to take into account the frequency
      of postoperative complications, postoperative lethality and average hospital stay
      of operated patients. The well-founded complaints per 100 hospitalized patients
      can also be considered as indices.

PMID- 2218698
TI  - [Activities of women's consultation clinics in prevention of unplanned
      pregnancy].
AB  - The data on women of reproductive age residing in the area serviced by an
      obstetrician-gynaecologist were provided; the proportion of women requiring the
      prevention of unintended pregnancy was determined, their socio-hygienic
      characteristics were established. The peculiarities in the activities of an
      obstetrician-gynaecologist in the field of preventing abortions and regulating
      women's reproductive functions were identified. On the basis of these data
      measures to improve the performance of women's consultation clinic in preventing
      the unintended pregnancy were determined.

PMID- 2218700
TI  - [Formation of healthy and practically healthy person groups in ambulatory care of
      the population].
AB  - The out-patient department of an urban hospital conducted a comprehensive
      screening of all patients with acute diseases and all persons who applied for
      regular medical check-up. The continuity was established with other curative
      institutions and hospital departments. For convenience's sake all the patients
      were provided with "registration form". The positive effect of this work: the
      increase in the number of dispensary patients classified under I and II groups,
      identification of patients with early stages of different diseases.

PMID- 2218701
TI  - [Development of the concept of health and its promotion in programmed activities
      of WHO].

PMID- 2218702
TI  - [The Pavlov session (on the 40th anniversary of a joint session of the USSR
      Academy of Sciences and the Academy of Medical Sciences dedicated to I. P.
      Pavlov's physiology teachings)].

PMID- 2218703
TI  - [Traditional medicine of Vietnam: history and current trends].

PMID- 2218704
TI  - [Structure of regional complex programs: "Health"].
AB  - The development and realization of regional programme "Health" should be
      determined in accordance with problems in population's health and their
      hierarchy. This determines the formation of functional and target structures of
      the programme. The target structure of a regional programme includes programmes
      of different territorial level and nature aimed at health protection of different
      populations, prevention of diseases, realization of functions of the society and
      population at large.

PMID- 2218706
TI  - North American Spine Society fourth annual meeting. Quebec City, Quebec, Canada,
      June 29-July 2, 1989. Proceedings.

PMID- 2218705
TI  - Relationship between duration of spinal cord ischemia and postoperative
      neurologic deficits in animals.
AB  - Twenty hogs were administered the following procedures before, during, and after
      overdistraction of the spinal column at T5-T6: somatosensory (SEP) and neurogenic
      motor evoked potentials (NMEPs), hydrogen clearance procedures, Stagnara wake-up
      tests, and aortic-injection of silastic plastic. To ensure that overdistraction
      was possible, a nonosseous, circumferential osteotomy was made at T5-T6 and
      distraction applied in one-ratchet increments using Harrington instrumentation.
      Overdistraction was maintained for 3, 5, 6, 10, 15, 20, 25, or 30 minutes.
      Results indicated that the duration of overdistraction, as represented by lost
      NMEPs, was always correlated with the animal's clinical status on wake-up test.
      If overdistraction was maintained more than 6 minutes, 100% of the animals
      demonstrated positive wake-up results; if maintained between 5 and 6 minutes, 75%
      demonstrated positive wake-up results; and if maintained less than 5 minutes,
      only 25% demonstrated positive wake-up results. Time-to-loss of the NMEPs and
      SEPs, after onset of overdistraction, fell within two groups: slow and fast. In
      the slow group, it required slightly more than 20 minutes (mean = 20.6) for the
      potentials to be lost, while in the fast-loss group data were lost in slightly
      less than 4 minutes (mean = 3.6). Blood flow studies and inspection of the spinal
      cord revealed that the mechanism of action for the slow group appeared to be
      ischemia of the spinal cord that extended several centimeters above and below the
      site of maximum distraction. In the fast-loss group, it appeared that gross
      structural damage, with some very localized ischemia, were the mechanisms of
      actions influencing the integrity of the spinal cord.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2218707
TI  - Spinal sensory and motor tract activation after epidural electrical stimulation
      in the cat.
AB  - Somatosensory evoked potentials (SEPs) after peripheral nerve stimulation and
      motor evoked potentials (MEPs) after transcranial stimulation have been routinely
      used as monitors of the viability of pathways in the posterior and anterior
      spinal cord, respectively, in patients undergoing spinal cord surgery. To assess
      total spinal cord function, both of these procedures must be performed
      simultaneously, which is both cumbersome and technically difficult. The
      objectives of this study were to demonstrate both sensory and motor spinal tract
      activation after epidural electrical stimulation of the cat spinal cord. Thirty
      seven adult mongrel cats were anesthetized with ketamine, intubated, and
      maintained with Ethrane and nitrous oxide. Stimulating electrodes were placed
      over the right dorsolateral spinal cord epidurally at T7 after a laminectomy.
      Recording electrodes were placed over the right L3 spinal cord epidurally, on the
      right L7 dorsal and ventral nerve roots, on the right and left sciatic nerves in
      the popliteal fossa, and in the right gastrocnemius muscle. After epidural
      stimulation of the spinal cord at T11, distinct reproducible potentials were
      recorded at each site. Activity in the L7 dorsal root implicated activation of
      spinal sensory tracts. Activity in the L7 ventral root and in the gastrocnemius
      implicated activation of spinal motoneurons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218708
TI  - Histopathologic correlation of magnetic resonance imaging signal patterns in a
      spinal cord injury model.
AB  - Magnetic resonance imaging (MRI) provides a noninvasive method of monitoring the
      pathologic response to spinal cord injury. Specific MR signal intensity patterns
      appear to correlate with degrees of improvement in the neurologic status in
      spinal cord injury patients. Histologic correlation of two types of MR signal
      intensity patterns are confirmed in the current study using a rat animal model.
      Adult male Sprague-Dawley rats underwent spinal cord trauma at the midthoracic
      level using a weight-dropping technique. After laminectomy, 5- and 10-gm brass
      weights were dropped from designated heights onto a 0.1-gm impounder placed on
      the exposed dura. Animals allowed to regain consciousness demonstrated variable
      recovery of hind limb paraplegia. Magnetic resonance images were obtained from 2
      hours to 1 week after injury using a 2-tesla MRI/spectrometer. Sacrifice under
      anesthesia was performed by perfusive fixation; spinal columns were excised en
      bloc, embedded, sectioned, and observed with the compound light microscope.
      Magnetic resonance axial images obtained during the time sequence after injury
      demonstrate a distinct correlation between MR signal intensity patterns and the
      histologic appearance of the spinal cord. Magnetic resonance imaging delineates
      the pathologic processes resulting from acute spinal cord injury and can be used
      to differentiate the type of injury and prognosis.

PMID- 2218709
TI  - Sagittal plane analysis in idiopathic scoliosis patients treated with Cotrel
      Dubousset instrumentation.
AB  - One hundred sixty patients with idiopathic scoliosis treated with Cotrel
      Dubousset instrumentation (CDI) underwent preoperative and postoperative sagittal
      plane analysis of the thoracic spine, thoracolumbar junction, and lumbar spine.
      The data suggest that mild to moderate improvements in thoracic hypokyphosis are
      possible. When crossing the thoracolumbar junction, reversal of rod bend and
      reversal of hooks on the derotation rod appear to provide the most physiologic
      sagittal contour. Cotrel-Dubousset instrumentation to the mid and distal lumbar
      spine can preserve and, at times, enhance lumbar lordosis.

PMID- 2218710
TI  - Long scoliosis fusion to the sacrum in adults with nonparalytic scoliosis. An
      improved method.
AB  - The first 17 adults with nonparalytic scoliosis having long fusion to the sacrum
      treated with the Luque-Galveston technique were reviewed. There were 3 men and 14
      women. Their average age at the time of surgery was 47 years and the mean follow
      up period was 42 months. There were no neurologic complications and no patient
      developed significant loss of lumbar lordosis. Fusion occurred in 88% of
      patients. Two patients developed pseudarthrosis, neither of whom had anterior
      fusion at the level of pseudarthrosis. The best results occurred in patients who
      had two-stage procedures, with initial anterior lumbar fusion to the sacrum
      without instrumentation followed by posterior segmental instrumentation with the
      Galveston technique of fixation to the pelvis.

PMID- 2218711
TI  - Orthotic stabilization of thoracolumbar injuries. A biomechanical analysis of the
      Jewett hyperextension orthosis.
AB  - Spinal orthoses have been traditionally used in the management of thoracolumbar
      injuries treated with or without surgical stabilization. However, the orthotic
      treatment modality in the management of spinal fractures remains subjective since
      few objective data are available on the effectiveness of orthoses in stabilizing
      injured segments. This study used a finite element model of the spine to evaluate
      the effectiveness of a hyperextension orthosis in controlling the progression of
      deformities at the injury site under gravitational and flexion loads. Two types
      of injuries were simulated: a single-level injury at T12-L1 and a two-level
      injury at T11-T12-L1 segments. An injury of increasing severity was simulated by
      progressively reducing the bending stiffness of the affected segments relative to
      the normal values in flexion-extension mode. The interaction of a three-point
      hyperextension orthosis with the spine was simulated using experimentally
      measured stiffness properties of the orthosis. The authors' results suggest that
      in single-level injuries that cause up to 50% loss of segmental stiffness, the
      orthosis can restore normal resistance to deformity at the injured segments,
      under gravitational as well as large flexion loads. In loss of stiffness between
      50% and 85% of normal, such as severe two-column disruptions, the orthosis can
      restore resistance to deformity under restricted patient activity level in the
      brace (low-flexion moment). Beyond 85% loss of segmental stiffness, such as three
      column injuries, the orthosis alone appears to be ineffective in preventing
      progression of deformity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218712
TI  - Herniated intervertebral discs associated with unstable spinal injuries.
AB  - To examine the occurrence of traumatic herniated intervertebral discs associated
      with unstable spinal injuries, the authors reviewed the records of all patients
      with spinal cord level unstable spine injuries managed at their institution over
      a 26-month period. Ninety-three patients were identified. All patients had
      roentgenographic and computed tomographic (CT) evaluation. Magnetic resonance
      imaging was performed in 48 patients, and revealed the presence of a herniated
      intervertebral disc in 16, with the highest incidence being in the cervical
      spine. In the patients who had only plain film and CT scans, no disc pathology
      was identified. Magnetic resonance imaging provides a noninvasive means of
      examining intervertebral disc damage in unstable spinal injuries that might
      otherwise be unidentified and result in spinal cord injury at the time of
      surgery.

PMID- 2218713
TI  - Evaluation of surgical treatment for burst fractures.
AB  - The authors instituted a prospective, randomized study of patients presenting
      with acute burst fractures of the thoracolumbar and lumbar spine. Patients were
      alternately treated by posterior distraction using pedicle instrumentation (AO
      fixateur interne) or anterior decompression and instrumentation (Kostuik
      Harrington device). Forty patients are presented with a mean follow-up of 20
      months. Preoperatively, there was significant canal compromise in 39 patients.
      This measured 44.5% in those patients undergoing posterior surgery and 58% in
      those patients undergoing anterior surgery. Postoperatively, this was reduced to
      16.5% and 4%, respectively. There is a statistically significant difference
      between these two groups (P less than 0.0001). The mean preoperative kyphotic
      deformity was 18.7 degrees in those patients treated by anterior surgery and 18.2
      degrees in the group treated by posterior surgery. At last follow-up, the mean
      improvement in kyphotic deformity was 9.3 degrees in the anterior group and 11.3
      degrees in the posterior group. There is no statistically significant difference
      between these two groups. There were two implant failures of the anterior Kostuik
      Harrington construct and two implant failures of the AO fixateur interne. Blood
      loss was significantly higher in the patients undergoing anterior surgery, but
      there were no complications from thoracotomy and anterior decompression of the
      dural sac. This study supports the hypothesis that posterior distraction
      instrumentation can effectively decompress the canal and correct kyphosis in
      patients sustaining burst-type injuries. Anterior surgery, however, results in a
      more complete and reliable decompression of the canal.

PMID- 2218715
TI  - High lumbar disc degeneration. Incidence and etiology.
AB  - Three hundred seventy-nine consecutive magnetic resonance images (MRIs) with dual
      echo images of the entire lumbar spine were reviewed by the authors. All 379
      patients presented with back pain and/or leg pain; they were interviewed and
      examined. Pain drawings were completed by all. There were 42 patients (11.1%)
      with disc pathologies involving T12-L1, L1-2, and/or L2-3 levels. Six patients
      (1.6%) had isolated disc degeneration and/or herniations limited only to these
      high lumbar segments. The remaining 36 patients had degenerative changes of the
      higher discs with variable involvement of the lower lumbar discs. Out of 12
      spondylolistheses of L5 on S1, 7 had high disc pathologies at one or more levels
      presenting as skipped lesions; more severe high disc lesions were noted in Grade
      II slips. Isolated high disc degeneration is often associated with pre-existing
      abnormalities such as end-plate defects, Scheuermann's disease, limbus vertebra,
      and so forth, and stressful cumulative work activities such as in construction
      workers, airplane mechanics, and so forth. High disc degeneration was noted above
      or below previous fractures. High disc involvement with diffuse changes in lower
      lumbar spine was more commonly found in ascending fashion in older age groups,
      and in patients who have had previous lower lumbar spine surgeries, prior fusions
      in particular. Our findings suggest that altered mechanics are associated with
      the high lumbar disc pathologies.

PMID- 2218714
TI  - High levels of inflammatory phospholipase A2 activity in lumbar disc herniations.
AB  - Inflammation of neural elements is frequently mentioned clinically in association
      with lumbar radiculopathy. Mechanical embarrassment of neural elements by
      definable structural abnormalities is inadequate as a sole explanation of nerve
      injury in this condition. The purpose of this study was to demonstrate whether an
      enzymatic marker for inflammation (phospholipase A2) could be identified in human
      disc samples removed at surgery for radiculopathy due to lumbar disc disease.
      Samples were assayed for phospholipase A2 activity. The level of activity in the
      disc samples was compared with values obtained from other human tissues using the
      same assay. Specific activity (percent hydrolysis radiolabelled substrate) ranged
      from 238 to 1,014.5 nmol/min/mg. Mean activity for the human disc material was
      568.7 nmol/min/mg, compared with 0.006 nmol/min/mg for human PMN, and 12.1
      nmol/min/mg for inflammatory human synovial effusion. The pH and cation-related
      activity were identical to those demonstrated for phospholipase A2 inflammatory
      conditions. Human lumbar disc phospholipase A2 activity is from 20- to 100,000
      fold more active than any other phospholipase A2 that has been described. As the
      enzyme responsible for the liberation of arachidonic acid from cell membranes,
      phospholipase A2 is the rate-limiting step in the production of prostaglandins
      and leukotrienes. These data establish biochemical evidence of inflammation at
      the site of lumbar disc herniations.

PMID- 2218716
TI  - The natural history of lumbar intervertebral disc extrusions treated
      nonoperatively.
AB  - The purpose of this study was to evaluate the natural history of morphologic
      changes within the lumbar spine in patients who sustained lumbar disc extrusions.
      All patients in this study were treated nonoperatively for radicular pain and
      neurologic loss. The following questions were addressed: 1) Does perithecal or
      perineural fibrosis result when extrusions are not removed surgically, and 2) Do
      disc extrusions spontaneously resolve, and, if so, how rapidly? The study
      population consisted of 11 patients with extrusions and radiculopathy. All
      patients were successfully treated nonoperatively. All had a primary complaint of
      leg pain and all had positive straight leg raising reproducing their leg pain at
      less than or equal to 60 degrees. Additionally, 87% had muscle weakness on a
      neurologic basis in a root level distribution corresponding to the site of disc
      pathology. Computed tomographic (CT) examinations were obtained on all patients
      at the inception of treatment. These studies were compared with follow-up MRI
      studies. The initial CT scans were evaluated for the following criteria: disc
      size and position, thecal sac effacement, nerve root enlargement or displacement,
      and evidence of central or intervertebral canal stenosis. In addition to the
      pathomorphology evaluated on the CT scans, follow-up MRI studies also evaluated
      disc hydration at the herniated and contiguous levels, and the presence of
      perithecal or perineural fibrosis. The following grading system was used to
      evaluate change in fragment size on the follow-up studies: Grade 1-0 to 50%
      decrease in size; Grade 2-50 to 75% decrease in size; Grade 3-75 to 100% decrease
      in size.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218717
TI  - Metabolic bone disease in lumbar pseudarthrosis.
AB  - Pseudarthrosis occurs in many patients who undergo lumbar spine fusion and it has
      been suggested that abnormalities of bone metabolism contribute to it. The
      authors evaluated 47 patients with pseudarthrosis for metabolic bone disease.
      Symptomatic patients with pseudarthrosis underwent metabolic bone evaluation.
      Abnormal results of laboratory tests were found in 7 patients (14.9%): 3 low or
      borderline 1,25 dihydroxy vitamin D3, 2 elevated 24-hour urine calcium, and 2 low
      serum testosterone. None of these abnormalities correlated with other clinical
      findings. Bone density was low in 14 of 24 patients in whom it was measured. Low
      values did not correlate with smoking or abnormal laboratory values. Metabolic
      bone abnormalities do not appear to play a frequent or significant role in
      pseudarthrosis after attempted lumbar spine fusion.

PMID- 2218719
TI  - Selective enrichment for temperature-sensitive secretion mutants of mammalian
      cells using plant lectin, concanavalin A.
AB  - The use of conditional mutants as a genetic approach to study protein secretion
      in mammalian cells requires the isolation of a large number of mutants. Because a
      procedure for the direct selection of mutants with secretion defects is not
      available, their isolation depends upon the selective enrichment of mutant
      phenotypes in a cell population. We have devised an enrichment strategy in which
      rat hepatoma cells unable to replace surface membrane receptors of a plant
      lectin, concanavalin A, are resistant to the cytotoxic effects of this lectin
      when administered at a nonpermissive temperature. This treatment yields a
      population highly enriched in cells that demonstrate temperature-sensitive
      secretion. Therefore, this selection strategy has important application in
      isolating temperature-sensitive mutants for use in the study of the mammalian
      cell secretion pathway.

PMID- 2218718
TI  - A randomized double-blind prospective study of the efficacy of pulsed
      electromagnetic fields for interbody lumbar fusions.
AB  - A randomized double-blind prospective study of pulsed electromagnetic fields for
      lumbar interbody fusions was performed on 195 subjects. There were 98 subjects in
      the active group and 97 subjects in the placebo group. A brace containing
      equipment to induce an electromagnetic field was applied to patients undergoing
      interbody fusion in the active group, and a sham brace was used in the control
      group. In the active group there was a 92% success rate, while the control group
      had a 65% success rate (P greater than 0.005). The effectiveness of bone graft
      stimulation with the device is thus established.

PMID- 2218720
TI  - Energy dependence of DNA-mediated gene transfer and expression.
AB  - When cells are transfected with calcium phosphate-precipitated DNA, most of the
      DNA is internalized through active endocytosis but a small pool is postulated to
      be internalized by passive diffusion. The relative importance of these two DNA
      pools in gene transfer and expression has never been examined. We now show that
      mouse Ltk- fibroblasts internalize greater than 90% of radioactively labeled,
      calcium phosphate-precipitated DNA by a temperature- and energy-dependent process
      but a small pool of 2-3% of radioactively labeled DNA may be internalized even at
      4 degrees C or under energy depletion conditions. The contribution of these two
      pools of DNA to gene expression was examined by transfecting Ltk- cells with DNA
      from a plasmid encoding marker for both transient expression (human growth
      hormone) and stable integration (neomycin resistance). When cells were depleted
      of ATP during transfection, transient expression of human growth hormone was
      reduced to only 2% of control values at day 4 posttransfection. Under the same
      condition, stable expression of neomycin resistance also was reduced to less than
      1% of the control. Therefore, these data showed that only the pool of calcium
      phosphate-precipitated DNA internalized through an energy-dependent process is
      ultimately responsible for transient and stable expression of exogenous genes.

PMID- 2218721
TI  - Relative frequencies of homologous recombination between plasmids introduced into
      DNA repair-deficient and other mammalian somatic cell lines.
AB  - Twelve mammalian somatic cell lines, some of them DNA damage-sensitive mutants
      paired with their respective wild-type parental lines, were assayed for their
      ability to catalyze extrachromosomal, intermolecular homologous recombination
      between pSV2neo plasmid recombination substrates. All of the somatic cell lines
      analyzed are capable of catalyzing homologous recombination; however, there is a
      wide range of efficiencies with which they do so. Five human cell lines display a
      fourfold range of recombination frequencies, and six hamster cell lines vary
      almost 20-fold. Linearizing one of the recombination substrates stimulates
      recombination in all but one of the cell lines. Two of the three paired mutant
      cell lines display a threefold reduction in their ability to catalyze homologous
      recombination when compared to their respective parental cell lines, indicating
      that the mutations that render them sensitive to DNA damaging agents might also
      play a role in homologous recombination.

PMID- 2218723
TI  - A transcriptional terminator between enhancer and promoter does not affect remote
      transcriptional control.
AB  - Enhancers stimulate transcription of RNA polymerase II-transcribed genes in an
      orientation-independent manner and over long distances. This stimulation is known
      to be associated with an increased polymerase density over the linked gene.
      However, many aspects of the exact mechanism of remote gene control remain to be
      elucidated. Based on some reports on RNA polymerase I transcription, we wanted to
      test whether RNA polymerase II enters at the enhancer and from there proceeds
      towards the promoter while synthesizing unstable transcripts
      ("scanning/readthrough transcription" model). For this, we have inserted a
      complete terminator region from the mouse beta-globinmaj gene between the SV40
      enhancer and the rabbit beta-globin promoter. In contrast to what the model
      predicts, insertion of the terminator had no affect on remote enhancer action.
      Furthermore, we have determined the RNA polymerase density over the spacer DNA
      between enhancer and promoter, and over the reporter gene, by means of the so
      called run-on transcription assay. We find very low transcription of the spacer,
      but high transcription of the globin reporter gene. Thus, our data are not
      consistent with a scanning/readthrough transcription mechanism where RNA
      polymerase II would move from the enhancer to the promoter while transcribing the
      intervening spacer DNA. These and other findings are compatible with a model
      where enhancer and promoter are brought into close proximity, perhaps with
      concomitant looping out of the intervening DNA.

PMID- 2218722
TI  - Polyacrylamide gel analysis of polypeptides in gene transfer cell lines.
AB  - Differential polypeptide expression in gene transfer cell lines of limited
      genetic complexity was analyzed as a gene mapping strategy. Subcellular
      fractionation preceding two-dimensional gel electrophoretic analysis simplified
      protein patterns and revealed subcellular location of differentially expressed
      polypeptides. As a model system, human MET oncogene polypeptide was identified in
      gene transfer lines by this approach. Genes encoding five putative human proteins
      were identified and provisionally assigned to chromosomal region 7q21-31 or to
      chromosome 1.

PMID- 2218724
TI  - Antisense RNA inhibition of HPRT synthesis.
AB  - The abundant production of antisense hypoxanthine phosphoribosyltransferase
      (HPRT) RNA in NIH-3T3, COS, or HeLa cells leads to an inhibition of HPRT
      synthesis. HPRT enzyme levels in cells transfected with mouse HPRT antisense RNA
      expression vectors are reduced to less than 1% of parental cell activity,
      resulting in resistance to 6-thioguanine (6TG). The expression of antisense HPRT
      RNA leads to a marked reduction in the steady-state levels of endogenous HPRT
      mRNA. Furthermore, we demonstrate that intron-specific antisense RNA,
      complementary to sequences adjacent to splice donor or acceptor sites of the
      first intron of the mouse HPRT gene, are effective in depressing endogenous HPRT
      levels. These studies suggest that antisense RNA can inhibit gene expression in
      the nucleus, possibly by perturbing nuclear RNA processing.

PMID- 2218725
TI  - Antisense RNA production in transgenic mice.
AB  - There are many reports of antisense inhibition of gene expression in cultured
      cells. We have generated four strains of transgenic mice expressing antisense
      hypoxanthine guanine phosphoribosyltransferase (HPRT) RNA in brain, or heart and
      liver, or all three organs. In the brain of one strain, the level of antisense
      RNA in the different brain regions roughly correlates with the degree of
      inhibition of the native HPRT mRNA in those same regions. Despite this decrease
      of up to 60% of endogenous HPRT mRNA, no reproducible reduction in HPRT activity
      has been observed. Possible reasons for the differences between the effectiveness
      of antisense inhibition in cultured cells and transgenic animals are discussed.

PMID- 2218726
TI  - Gene complementing xeroderma pigmentosum group A cells maps to distal human
      chromosome 9q.
AB  - Phenotypic complementation of xeroderma pigmentosum group A (XP-A) cells by
      microcell-mediated transfer of a single rearranged neo-tagged human chromosome
      from a human-mouse somatic cell hybrid designated K3SUB1A9-3 was reported
      previously. Extended growth of this human-mouse hybrid in culture led to deletion
      of the small arm of the human chromosome, with concomitant loss of complementing
      ability when introduced into XP-A cells by microcell-mediated chromosome
      transfer. Cytogenetic analysis of both hybrids suggests that the complementing
      locus is on chromosome 9q22.2-q34.3, and Southern blot analysis confirms the
      presence of distal chromosome 9q sequences.

PMID- 2218727
TI  - [The status of the respiratory organs in students in Sabac exposed to increased
      air pollution].
AB  - The authors followed up the health of 322 elementary-school pupils at Sabac who
      were exposed to increased air pollution with chemical agents (ammonia, fluor
      hydrogen, chloracetic acid, sulfur dioxide, soot). The mean annual concentration
      of these gases were above or insignificantly under maximally permitted values.
      The results of the examination were as follows: recurrent cough in 12.4 per cent
      of cases and clinical signs of chronic or obstructive bronchitis in 8.4 per cent
      of children. Values of vital capacity were under normal in 27.6 per cent of cases
      and almost in the half of children vital capacity was at the lower normal limit.
      FEV1/FVC was under normal in 15 per cent of cases and at the lower normal limit
      in about 18.6 per cent of children. In spite of a great number of children with
      positive cutaneous tests to inhalation allergens with Prick's method IgE was
      within normal limits in these children. Thus, a significant noxious effect of
      allergic components on respiratory organs should be excluded. This was also
      confirmed by spirometric measurements of the two subsequent maximal expiriums
      when differences of +/- 3% were registered. However, in children with allergic
      bronchitis the value dispersion was by 2-3 times greater. Consequently, the
      authors concluded that damaged respiratory organs in children at Sabac appeared
      in a greater number of cases than in other places and that these damages were due
      to increased concentrations of different chemical air pollution agents.

PMID- 2218728
TI  - [Vascularization of the insular cortex and claustrum in human development].
AB  - The blood vessels of the insular cortex and the claustrum were studied in 26
      foetal brains of 16--25-week-old foetuses and one adult brain without noticeable
      pathological signs. The labelling of the vessels was wade according to Duvernoy
      et al. (1981). In 16-week-old foetuses arteries of types A6 as the A5 were found
      in the insular cortex as well as the veins of type V5. In 19-week-old foetuses
      the arteries of type A4 and the veins of type V4 appeared as only cortical
      vessels. In the following stages of the brain development the shorter and shorter
      arteries appeared so that in 24-week-old foetuses one could see all the types of
      arteries from A6 to A1. However, in the period from 19 to 25 weeks, no vein
      shorter than that of the type V4 was found in the insular cortex. In the adult
      brain it was possible to identify all the types of arteries and veins in the
      insular cortex, but distances between the individual vessels were larger in
      comparison with those in the insular cortex of the foetal brains. There claustrum
      was vascularized by the arterial branches from the insular arteries, whereas in
      the adult brain the claustrum received some of the branches from the striate
      arteries as well. This pattern of the vascular supply may indicate the common
      origin of the claustrum and the insular cortex.

PMID- 2218729
TI  - [Acute meningitis without cutaneous manifestations caused by varicella zoster
      virus--intrathecal synthesis of specific antibodies].
AB  - The results of virusologic and cytobiochemical evaluation of CSF and serum
      samples of four patients with acute viral meningitis (AVM), most probably induced
      by varicella zoster virus (VZV), are reported. In no case VZV infection was not
      cutaneously manifested. Aetiologic diagnosis was established according to the
      presence of specific anti VZV AVM, in spite of their presence in the sera. On
      samples detected by indirect enzyme immunoassay (EIA). Four different antibody
      indexes were used to prove that the antibodies were intrathecally synthesized.
      Other viral antibodies (HSV, mumps) were not evident in the CSF samples of the
      patients with VZV avm, in spite of their presence in the sera. On the other hand,
      anti VZV antibodies could not be identified in the CSF samples of the controls
      (AVM of other aetiology, meningism) in spite of their presence in the sera. A
      possible aetiologic link between anti VZV antibodies presence in the CSF samples
      and some neurologic syndromes is discussed.

PMID- 2218730
TI  - [Epidemiologic status of syphilis and gonorrhea in the area of Belgrade].
AB  - The authors present the epidemiological situation of venereal diseases (syphilis
      and gonorrhea) on the territory of Belgrade over the past twenty years with a
      detailed analysis of the past ten-year period. Constant decrease in morbidity
      rate was recorded in both diseases. The study showed that both diseases,
      expressed a high degree of parallelism in the dynamics of their appearance.
      Gonorrhoea was more frequent, with the rate of 1:4-41 in favour of gonorrhoea;
      the rate depended on the age. The incidence of gonorrhoea was 3.5 times higher in
      males than in females. However syphilis incidence was 2.5 times higher. The wafey
      endangered age groups for both diseases were 20-29 and 15-19 years for
      gonorrhoea, and 30-39 years for syphilis. In people working in catering services,
      tourism, public traffic, craftwork, as well as students and unemployed persons
      the highest frequency of these two diseases was observed. There was no seasonal
      difference in the incidence of syphilis, while gonorrhoea was frequent in the
      Summer months. There were differences in incidence (recent cases) and prevalence
      (number of recorded cases) of syphilis. Of the total number of annually recorded
      cases 30-60 per cent were recent cases. Repeated cases (especially of gonorrhoea)
      were frequent. The epidemiological research showed that approximately 37 per cent
      of primary source of infection were never recorded due to the lack of evidence
      and careless sexual contacts especially in the adolescent population.

PMID- 2218732
TI  - [Activity of delta-aminolevulinate dehydratase and glutathione levels in the
      erythrocytes of patients with endemic nephropathy and in healthymembers of their
      families].
AB  - In a previous paper a markedly decreased activity of delta-aminolevulinate
      dehydratase (ALA-D) in patients with endemic nephropathy and in 24.6% of their
      healthy family members, was found. In this study the possible mechanisms of the
      decreased enzyme activity and the level of erythrocyte glutathione in patients
      and in healthy members from nephropathic families, were studied. We established
      decreased ALA-D activity in endemic nephropathy patients and in some healthy
      persons from their families. The normal concentration of erythrocyte glutathione
      was found in all groups. However, it was possible to reactivate the ALA-D enzyme
      in vitro by addition of exogenous glutathione. The obtained results suggested a
      normal synthesis of ALA-D apoenzyme and the existence of some factors whose
      effect upon enzyme activity was mediated through a binding to the reactive groups
      in the active centre of his enzyme or by oxidation of he reactive groups.
      Therefore, increased concentrations of sulfhydryl compounds, mostly of reduced
      glutathione are necessary for an optimal ALA-D activity.

PMID- 2218731
TI  - [Lipids and total bile acids in the blood of patients with inflammatory bowel
      diseases].
AB  - We evaluated the total plasma bile acids, total lipids, total cholesterol, total
      triglicerides, LDL-cholesterol, HDL-cholesterol, phospholipids and lipoproteins
      (APOA-A and APO-B) in 25 patients with inflammatory bowel disease: 20 with
      ulcerative colitis (UC) and 5 with Crohn's disease. In comparison to 17 healthy
      volunteers, the total plasma bile acids were decreased in all patients. The serum
      level of total cholesterol, LDL-Ch, HDL-ch and APO-A was significantly lower in
      patients with Crohn's disease and ulcerative colitis (p less than 0.01) than in
      normal controls; total triglycerides and APO-B were decreased only in the group
      with Crohn's disease (p less than 0.05). Thus, decreased values of total plasma
      bile acids malabsorption, and they suggest a more important romalabsortion, and
      they suggest a more important role of the colon in the preservation of bile
      acids.

PMID- 2218733
TI  - [Cervical maturation using Prepidil gel in pregnancy termination in
      primigravidas].
AB  - The study investigated the possibility of pharmacological servical ripening
      induced by Dinoprostone (Prepidil Gel--Upjohn Co) prior to therapeutic abortion
      in primigravida. The study concerned patients-volunteers choosen by random. 73
      patients were divided into two groups with the same average age, term of
      gestation, cervix consistency and passage through the cervical canal before the
      application of gel. In the first group therapeutic abortion was carried out 6
      hours after the application of gle into cervical canal, and in the second group-
      4 hours after the gel application. Cervical maturation, testified by its
      consistency and spontaneous cervical ripening, was equal in both groups (average
      delta Hegar I was 7.32 and delta Hegar II--7.02), and it enabled medical
      procedure only with the local anaesthesia with 2% hylocein in 82% ob pregnant
      women. In a fifth of patients ob both groups it was necessary to do additional
      mechanical dilatation, which was easily performed due to the already soft cervix;
      these patients were also administered 1 ampulla ob Fortral I.V. In both groups
      during the action of Dinoprostone there were no significant changes either in
      blood pressure or in body temperature. More expressed uterine activity, followed
      by initial and incompleted abortions, were more frequent in patients of the first
      group (3529%) than in those from the second group (17.95%) in which only
      contractions occurred (33.33%). The rate of gastrointestinal side effects was
      29.41% in the first group and 41.03% in the second group. There was no uterine
      complication during the activity of Dinoprostone as well as during and after
      medical procedure.

PMID- 2218734
TI  - [Occupational injuries of the eye caused by optical irradiation].
AB  - On the basis of the increasing number of everyday exposures to numerous
      artificial sources of optical radiation (ultraviolet radiation, visible light,
      infrared radiation and laser), the probability of occupational and other ocular
      damages is increasing. The risk of vision damage due to sunlight radiation also
      exists during the staring at the sun with unprotected eyes especially in the time
      of eclipse, and the long stay in the bright light. In addition to ultraviolet
      radiation and short wavelengths of visible spectrum ("blue light") the
      photochemical (actinic) damage mechanism of the retina can occur. Numerous
      sources of ultraviolet radiation may cause acute photokerattoconjunctivitis; the
      long-term exposure to ultraviolet radiation possibly contributes to aging of the
      lens and to senile cataract, and also increases the risk of occurrence of
      conjunctival carcinoma and malignant melanoma of the eye. The infrared radiation
      of high intensity can produce corneal damage, probably cataract, and genuine
      thermal injury of the retina. Laser retinal injury, in its nature, is thermal,
      thermo-mechanical or with direct electric field effect.

PMID- 2218736
TI  - [Moschcowitz's disease--effect of therapeutic plasma exchange and splenectomy].
AB  - Moszkowicz's disease (thrombotic thrombocytopenic purpura), TTP, is an uncommon
      haematologic, neurologic syndrome which, almost regularly, terminates fatally.
      The disorder has a turbulent and fulminant course and is of short duration. The
      presented patient was treated with a combined therapeutic modality of intensive
      plasma exchange and subsequent splenectomy. This is the first case of successful
      treatment of TTP in Yugoslavia. The previous therapeutic approaches with
      infusions of fresh frozen plasma produced only transient or dubious responses.
      Clinical remissions were rare. In this patient, however, the plasma exchange with
      volume adjustment with the fresh frozen plasma or albumin produced restitution of
      the thrombocyte count to normal values and disappearance of all neurological
      signs and complaints. At that point surgical splenectomy was carried out with the
      concomitant extirpation of an accessory spleen circumstantially detected on
      exploration. Pathohistology of both spleens revealed typical tissue changes
      (disseminated hyaline and thrombocyte thrombi of small blood vessels)
      characteristic of Moszkowicz's disease. Following an uneventful splenectomy and
      discontinuation of all medicamentouse therapy the normal thrombocyte count was
      maintained without no sign of recurrence of neurological symptoms or
      manifestations.

PMID- 2218735
TI  - [Adrenocortical "incidentalomas" as a diagnostic and therapeutic problem].
AB  - P. Carpenter (1986) used the term "incidentalomas" in connection with all
      incidentally discovered adrenal masses. Previously these masses were frequent
      incidental discoveries at autopsies, but now, with the increasing use of
      abdominal computed tomography. In the last 10 years 5 patients with incidentally
      diseases, significant number of them have been detected. In the last 10 years 5
      patients with incidentally discovered adrenal masses (4 males and 1 female, aged
      from 37 to 66 years) were examined and treated in our Department. Long-lasting
      arterial hypertension was found in all of them, and in one patient here was
      impaired glucose tolerance with further evolution of diabetes. A possible
      excessive secretion of glucocorticoids, mineralocorticoids, androgenes and
      catecholamines was excluded. However, markedly elevated urinary excretion of
      pregnanediol, proved in all patients, indicated to a possible preservation of the
      first reaction in the biosynthesis of cortisol, at least synthesis of
      pregnenolone from cholesterol. One patient, submitted to a regular functional and
      morphological evaluation of previously discovered 'incidentaloma', showed no sign
      of expansion or pathological hormonal activity. Four patients were operated
      because of the suspected expansion and malignant alteration of the adrenal nodus.
      The histological proof of adrenocortical adenoma or hyperplasia, composed of the
      'fasciculata-like' cells, postoperatively maintained elevated values of steroid
      precursors in urine, and also a finding of adrenocortical noduses in remained
      adrenal noduses, confirmed the presumption that such masses could be the non
      essential finding in long-lasting arterial hypertension and degenerative changes
      during aging.

PMID- 2218737
TI  - [Biliary mucinous cystadenocarcinoma of the liver].
AB  - Biliary mucinous cystadenocarcinoma is an extremely rare tumour. Less than 50
      cases have been reported. It is usually a multilocular cystic tumour covered with
      mucous producing epithelium, with papillary excrescences containing mucinous mass
      arising from bile ducts. The size of the tumour varies from 3.5 to 25 cm in
      diameter. It is more frequent in women. The majority of patients belong to the
      middle age population. We present a 63-year-old man who had been suffering from
      an epigastric and right subcostal pain of unknown aetiology for over 35 years.
      During the last 10 years he suffered from multiple attacks of cholangitis with
      high temperature, rigor, chills, pain and obstructive jaundice. Five years ago he
      had the attack of pancreatitis with retroperitoneal fatty necrosis for which he
      was operated on in another institution and cholecystectomy and pancreatic
      necrectomy were carried out. The attacks of cholangitis continued they were more
      serious and more frequent until June 1987, when the "cyst" in the left lobe of
      the liver, dilated bile ducts and "polyps" in the common bile duct were diagnosed
      by ultrasonography. During the operation advanced biliary cirrhosis, portal
      hypertension, splenomegaly, very dilated common bile duct full of jelly and the
      "cyst" in the liver filled with jelly, were found. The removal of the jelly and
      choledochojejunostomy resulted in temporary relief. Two months later he was
      reoperated for recurrent obstructive jaundice during which left lobectomy,
      partial excision of the cyst and cystojejunostomy between the rest of the cyst
      and another Roux-en-Y jejunal limb, were carried out.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2218738
TI  - [Stability of complete dentures. 1].
AB  - The Author considers the necessary requisites for the complete denture's
      stability during masticatory function. This is due to the following anatomic and
      functional factors: a) Support tissues' morphology. b) Morpho-functional
      characteristics of the prosthetic tooth: unitary nupolivalent function in the
      different occlusal sectors. c) Linear arrangement of the teeth with unitary
      function along the "structural sagittal axis" or "central axis of dinamic and
      muscolar stabilization" of the mandible. d) Teeth's arrangement in the neutral or
      muscolar equilibration zone. e) Interalveolar axis' verticality of the teeth with
      unitary grinding function.

PMID- 2218739
TI  - [Stability of complete dentures. 2].
AB  - There is a necessary correlation between the Monson's curve, due to the
      mandibular kinematics, and the interalveolar axis' inclination in the different
      occlusal areas with unitary function. In the triturating area the verticality of
      the interalveolar axis is necessary for the stability of the cusp-fossa
      relationship in centric occlusion and for the stability of the prothesis during
      mastication. The Author shows the occlusal morphology and the arrangement of the
      prosthetic teeth in the different skeletal classes in relation to functional
      interalveolar strength's direction.

PMID- 2218740
TI  - [Stability of complete dentures. 3].
AB  - The author analyzes the fundamental parameters of the complete denture; stability
      occlusal in the eccentric mandibular movements. They are: a) Correlation between
      condylar and incisal guide and occlusal morphology of the dental-arches. b)
      Presence of interincisive and intercanine functional free space.

PMID- 2218741
TI  - [Epidemiological survey of the prevalence of dental caries in young thalassemia
      major patients].
AB  - 47 patients with thalassemia major treated with blood transfusions were studied
      by the authors. The aim was to carry out an investigation on caries incidence.
      From the data collected in this investigation it was found that 90% of males and
      66% of females showed caries, then there was a difference in percentage of caries
      between males and females. On the other hand the dmf and the DMF index showed
      quite the same values in males and in females.

PMID- 2218742
TI  - [Autoimmune pathogenesis of recurrent oral ulcers. 1].

PMID- 2218743
TI  - [Tenoxicam in treatment of oral inflammation and pain].
AB  - The efficacy of a new nonsteroidal anti-inflammatory agent, Tenoxicam, was valued
      in a study of 58 patients distinguished into 3 groups, group A consist of 29
      patients with inflammatory diseases of the mouth, group 1B and 2B (29 patients)
      with acute postoperative pain. Drug was given at doses of: 1) 20 mg/die in group
      A; 2) 40 mg/die for the first two days and 20 mg/die for successive days in group
      1B; 3) 20 mg/die in group 2B, for a period variable from 5 to 7 days. The
      outcomes showed that the administration of Tenoxicam resulted in a effective
      reduction of all inflammatory valued parameters (fever in 100%, inflammatory pain
      in 94% and edema in 90% of all cases) for the group A: acute postoperative pain
      was significantly reduced in group 1B where the patients have assumed drug at
      dose of 40 mg/die for the first two days and 20 mg/die for successive days. In
      group 2B (20 mg/die) drug's smaller dose showed reduced efficacy for control of
      postoperative pain. Although Tenoxicam was well tolerated and mild side effects
      were recorded only in 5% of cases.

PMID- 2218744
TI  - [Effect on periodontal tissue of a "cushioned" bristle brush. (S.E.M. analysis)].
AB  - The Authors have made in vivo verification by means of replica technique observed
      with SEM any possible traumatic effects and gingival modification which a bristle
      toothbrush (Sanogyl, Berna) has on the soft tissues. The toothbrush has
      particular features which make it possible to perform an almost perfect dental
      hygiene of the papillar area, it does not produce any secondary negative effects
      on the gingival soft tissues.

PMID- 2218745
TI  - [Strategy in radiologic diagnosis: CT of the neck].

PMID- 2218746
TI  - [Diagnosis of focal nodular hyperplasia].

PMID- 2218747
TI  - [Hepatic hemangioma: an improved diagnosis using rapid, dynamic sequential
      computed tomography].

PMID- 2218748
TI  - [Computed tomography of the skeletal system].

PMID- 2218749
TI  - [Computed tomography of the pelvis].

PMID- 2218750
TI  - Kimura's disease--a benign condition that may be confused with malignancy. A case
      report.
AB  - A case of Kimura's disease is reported. The importance of this rare benign
      condition lies in the fact that it is clinically similar to malignant disease.
      The important principle of confirming the diagnosis by histological examination
      before embarking on major surgery is highlighted. Similarity to and
      differentiation from angiolymphoid hyperplasia with eosinophilia is discussed.
      The patient underwent resection with functional clearance of the neck nodes, and
      is free from disease after a 2-year follow-up period. Improper management of this
      rare head and neck lesion may lead to unnecessary cosmetic deformity and
      significant loss of function.

PMID- 2218751
TI  - Acute airway obstruction in children with benign head and neck tumours. Case
      reports.
AB  - Infants presenting with acute airway obstruction secondary to cystic hygroma and
      neurofibroma are presented. Early surgical correction of large benign tumours of
      the head and neck is recommended to prevent life-threatening complications.

PMID- 2218752
TI  - Parotid haemangioma. A case report.
AB  - The presentation of a rare cavernous haemangioma of the parotid in a 17-year-old
      male is the twenty-first case in the English literature, and the first report in
      a black adult patient. The aetiology of this lesion is unknown and differs from
      that of the infantile capillary type. The pathognomonic signs of fluctuating
      size, discoloration and bruit are rare; the diagnostic hallmark in this case was
      spontaneous tumour regression. Doppler studies and arteriography may be valuable
      in diagnosis and management, in which surgical excision is the treatment of
      choice.

PMID- 2218753
TI  - Sarcoidosis with nasal obstruction and deformity. A case report.
AB  - Sarcoidosis is a relatively uncommon disease, seldom seen by ear, nose and throat
      departments. There are interesting head and neck and, more specifically, nasal
      manifestations. A patient with sarcoidosis presented at our department with nasal
      obstruction and deformity. Although these were the predominant features of the
      disease, the diagnosis was made together with other systemic signs. A case of
      sarcoidosis involving the nose is presented, with discussion emphasising the
      features more commonly seen by the ear, nose and throat surgeon.

PMID- 2218754
TI  - Ventriculosaccular carcinoma of the larynx.
AB  - The question of whether or not carcinoma arises in the ventricles and saccules of
      the larynx is a controversial one. These areas of the larynx have
      pseudostratified columnar ciliated epithelium. In the past several authors have
      not believed that carcinomas arise in these areas because of the absence of
      squamous metaplasia in their observations. However, other workers have been
      convinced that such tumours do arise and that they behave in certain specific
      ways. In order to clear up the controversy, these areas were studied in 154
      laryngeal specimens examined by a serial sectioning technique. In this study
      14.3% of the laryngeal specimens studied showed clear evidence of tumour
      emanating from these areas. Areas of squamous metaplasia with carcinoma in situ
      and frank invasion have been observed in many of these cases. These tumours
      spread by concentric enlargement within the paraglottic space and are often
      diagnosed late since they are difficult to observe from above. Patients who
      present with hoarseness and a mucosa-covered swelling in the false cord area
      should be carefully examined if a carcinoma arising in this area is not to be
      missed.

PMID- 2218755
TI  - Neonatal stridor. Five-year experience at King Edward VIII Hospital, Durban.
AB  - During the period January 1984-January 1989, 110 neonates were referred to the
      ENT clinic at King Edward VIII Hospital, Durban, with symptoms of upper airway
      obstruction. The medical records of these patients were reviewed in order to
      document the clinical presentation, diagnostic evaluation, pathological findings
      and therapeutic approach. All patients underwent a thorough clinical examination,
      postero-anterior and lateral chest radiography, soft-tissue lateral radiography
      of the neck and endoscopic evaluation. We outline our findings and briefly
      describe management. Of interest is the high incidence of vallecular cysts in
      this series (15%) compared with others.

PMID- 2218756
TI  - Nasopharyngeal carcinoma. An analysis of 100 Chinese patients.
AB  - Clinical manifestations in the first 100 patients with nasopharyngeal carcinoma
      to attend the ENT outpatient clinic at the Prince of Wales Hospital, Hong Kong,
      commencing in February 1986, are presented. All tumours were non-keratinising or
      anaplastic carcinomas, World Health Organisation types 2 and 3. Cervical
      lymphadenopathy was the commonest presenting complaint (43%), followed by nasal
      symptoms (32%) and aural symptoms (18%). On clinical examination 73% had cervical
      lymph node metastases, and 72% of patients were in stages III-V at presentation.
      Trivialisation of the symptoms by the patient and delay by the referring
      physician contributed to lateness of diagnosis.

PMID- 2218757
TI  - Hurthle cell medullary carcinomas of the thyroid gland.
AB  - Two medullary carcinomas of the thyroid (MCTs) composed entirely of Hurthle
      (oncocytic or oxyphilic) cells and containing follicular structures are
      described. Immunocytochemical analysis showed these tumours to be calcitonin-,
      carcino-embryonic antigen- and neuron-specific enolase-positive. The essence of
      this communication is twofold. Firstly, it highlights and draws attention to this
      unusual variant of MCT, which may be encountered at frozen section and
      misdiagnosed as a Hurthle cell tumour of follicular cell origin. Secondly, it
      undertakes a concise overview of the immunocytochemistry of Hurthle cell thyroid
      neoplasms and MCT.

PMID- 2218758
TI  - Are carotid body tumours malignant?
AB  - Carotid body tumours (CBTs) are slow-growing, malignant neoplasms by virtue of
      their local spread by continuity and contiguity and metastatic spread by lymph
      and blood. This article reports the findings of a pathological study of the
      growth characteristics of CBTs.

PMID- 2218759
TI  - The neglected disease of modern society and the Child Accident Prevention
      Foundation of Southern Africa.

PMID- 2218760
TI  - What are the prospects for improved health and increased longevity?

PMID- 2218761
TI  - Five years' experience of injured children.
AB  - This study was undertaken to analyse admission data on all patients seen in the
      Red Cross War Memorial Children's Hospital Trauma Unit during the period 24 April
      1984 - 31 March 1989. Data were retrieved from computerised records completed on
      admission and were reviewed descriptively. Variations in age, sex and population
      group pattern for different causes of injury were evaluated together with data on
      the nature and place of injury and time seen. Data for analysis of nature of
      injury by cause were also retrieved, but over a 2-year period only (1986-1987).
      Accuracy of recorded data was assessed from a random sample of hospital records.
      During the 5-year period 57,468 patients were seen in the Trauma Unit, of whom
      17.1% were admitted. In addition 6,377 cases of poisoning and 119 of near
      drowning were seen by the medical departments. Forty-three per cent of injuries
      were due to falls, which were the most important cause of injury in both admitted
      and non-admitted patients of all age, sex and population groups. Other main cause
      groups were bumps and blows (15%), transport (11%) and burns (11%). Transport and
      burn injuries had the highest admission rates. This is the first study of
      children's injuries in southern Africa and provides information essential to
      future design of paediatric trauma care systems and accident prevention
      programmes.

PMID- 2218762
TI  - Trends in childhood injury mortality in three South African population groups,
      1968-1985.
AB  - Trends in major causes of injury mortality and the proportion of total deaths
      attributable to injuries from 1968 to 1985 for white, coloured and Asian children
      less than 15 years in the RSA were examined. There were 937 injury deaths in 1968
      and 853 in 1985 but no clear trends in overall mortality rates were observed.
      There were, however, marked fluctuations in injury mortality rates from year to
      year with peaks in 1975 and 1981/1982. The impact of injury as a cause of death
      has increased relative to a decrease in other diseases, notably gastro-enteritis
      and malnutrition in children less than 5 years. Patterns varied considerably
      between age, sex and population groups. Overall, road and burn death rates
      decreased while drowning and assault rates increased. Reasons for observed trends
      are discussed and the need for the collection of reliable national data for the
      total population is highlighted.

PMID- 2218763
TI  - Injury-related mortality in South African children, 1981-1985.
AB  - Data on all registered deaths in children less than 15 years in the RSA
      (excluding Transkei, Bophuthatswana, Venda and Ciskei) were analysed for 1981
      1985. Variations in age, sex and population group pattern for different causes of
      injury were evaluated. Injury accounted for 8% of deaths in children less than 15
      years and was the leading cause of death between the ages of 5 years and 14 years
      (accounting for 43% of deaths). Motor vehicle accidents were the most important
      cause of injury deaths in all age groups except less than 1 year, when accidental
      choking and suffocation resulted in more deaths. Drowning accounted for 19% of
      injury deaths and burns for 11%. In 14% of injury deaths it was not determined if
      the injury was accidental or purposefully inflicted. In all age and population
      groups deaths among boys outnumbered girls. The impact and pattern of injury
      varied considerably between age and population groups and reasons for these
      findings are discussed.

PMID- 2218764
TI  - Patterns of referral to Red Cross War Memorial Children's Hospital, Cape Town.
AB  - Patterns of referral to Red Cross War Memorial Children's Hospital were studied
      to assess the appropriateness of referrals. From 1 July to 31 December 1987 all
      9,288 referral letters presented to the hospital were collected and a sample
      (4,662 letters) analysed. It emerged that the patients were similar to those
      attending the outpatient department without referral, except that relatively
      fewer referred patients were black. The private sector, i.e. general
      practitioners, was the largest referral agency, followed by day hospitals. Most
      patients were referred to the outpatient department without an appointment. Of
      the specialist clinics, the surgical clinics (i.e. ophthalmology and ear, nose
      and throat) had the highest number of referrals. The majority of patients (84.9%)
      were not admitted. Only in 30.3% of referred cases did the hospital make contact
      with referral agents. Referral rates were highest from the predominantly coloured
      areas of the Cape Peninsula. The hospital cannot isolate itself from the
      community it serves and needs to support and guide referral agents in order to
      improve the utilisation of the hospital. Training of health professionals in
      order to increase expertise is a priority. A study of the total patient
      population would facilitate the understanding of hospital utilisation. Similar
      studies could be beneficial at other hospitals.

PMID- 2218765
TI  - Utilisation of outpatient services at Red Cross War Memorial Children's Hospital,
      Cape Town.
AB  - The demand for outpatient services continues to grow at Red Cross War Memorial
      Children's Hospital (RCCH). To determine current utilisation patterns, we
      conducted a 2-week survey in the outpatient department (OPD). In addition, we
      reviewed the RCCH Annual Reports for the period 1961-1988. Annual outpatient
      attendances have increased from around 42,000 in 1957 to their highest level
      ever; nearly 350,000 in 1988. This steady rise in outpatient attendance was
      stemmed during the 1970s by the expansion of health services in the greater Cape
      Town area, in particular the introduction of day hospitals. In general, blacks
      are utilising the OPD as a primary community hospital for the treatment of
      infectious and environmentally induced diseases. In contrast, the white
      outpatient profile is more characteristic of a tertiary referral centre, with a
      higher proportion of specialist clinic attendances. The utilisation patterns for
      coloured children are intermediate. Analysis of the residential address of
      patients and their presenting diagnoses indicates an urgent demand for primary
      health care services in the most recently settled and poorest suburbs of Cape
      Town, many of which are remote from the hospital.

PMID- 2218766
TI  - Paediatric trauma care.
AB  - Paediatric trauma care varies in different countries. In South Africa injury is
      the leading cause of death in the 5-14-year-old age group--1.5-3.8 times higher
      than in the USA. In 1978 the Child Safety Centre was established and
      prospectively collected data on paediatric injuries. The various types of
      injuries are discussed. Trauma is responsible for the highest percentage of years
      of life lost but the least amount of money is being spent on research and
      prevention of injuries. The Child Accident Prevention Foundation of Southern
      Africa has been constituted to research, prevent and reduce the risk factors of
      the injuries and to improve facilities for the injured child.

PMID- 2218767
TI  - Childhood near-drowning--a 12-year retrospective review.
AB  - The epidemiological findings in 107 patients admitted to Red Cross War Memorial
      Children's Hospital, Cape Town, between 1976 and 1987 with a diagnosis of near
      drowning are reported. Of these patients, 77% were less than 5 years of age
      (ratio of boys to girls 2.1:1) and 46% of accidents occurred in swimming pools,
      18% in buckets and only 9% in the sea. The high percentage of bucket near
      drownings is unique in published medical reports; this appears prevalent in
      socially disadvantaged communities. Seventy-six per cent of the children were
      normal on discharge from hospital, 12% died and 6% had neurological damage. In 6%
      the final outcome was not known. These results are in keeping with other hospital
      based studies. Preventive strategies are discussed and the need for further
      research highlighted.

PMID- 2218768
TI  - Childhood near-drowning--factors associated with poor outcome.
AB  - Anoxic cerebral damage is the limiting factor in recovery from near-drowning
      accidents. This study reports factors associated with poor outcome in 100 near
      drowned patients admitted to the Red Cross War Memorial Children's Hospital from
      1976 to 1987. The study was designed as a retrospective folder search. Children
      with fixed dilated pupils, flaccidity, decerebrate or decorticate posturing, or
      clinical signs of cerebral oedema are more likely to have a poor outcome.
      Patients with metabolic acidaemia and those requiring cardiopulmonary
      resuscitation in the emergency room or subsequent mechanical ventilation also do
      poorly. Those requiring more aggressive management can be identified and a more
      accurate working prognosis may be possible in the hours after the accident.

PMID- 2218770
TI  - Treatment of erectile failure.

PMID- 2218769
TI  - The role of R. B. Thomson and E. P. Stibbe--brief heralds of the science of
      anatomy in South Africa. Part II. E. P. Stibbe.

PMID- 2218771
TI  - Arrhythmias in congestive cardiopathy.

PMID- 2218772
TI  - Spinal cord compression due to myeloma.

PMID- 2218773
TI  - Nasopalatine airflow resistance in awake subjects.

PMID- 2218774
TI  - White blood counts in radiation workers.

PMID- 2218775
TI  - Junk food and empty words.

PMID- 2218777
TI  - The future of medical education--locally relevant excellence.

PMID- 2218776
TI  - Spinal cord injury management in 1990.

PMID- 2218778
TI  - Risk factors for coronary heart disease in the Indians of Durban.
AB  - Coronary heart disease (CHD) is a major problem in migrant Indians throughout the
      world. In South Africa it has reached 'epidemic' proportions. A field survey was
      conducted among Indians in the metropolitan area of Durban to determine the
      prevalence and known risk factors for CHD. In a study of 778 subjects aged 15-69
      years (408 men), 15.3% (sex and age adjusted 13.4%) had a history of CHD. The
      important risk factors in men were hypercholesterolaemia, hypertriglyceridaemia,
      diabetes, and smoking, and in women diabetes, hypercholesterolaemia, and
      hypertriglyceridaemia. The minor risk factors were hyperuricaemia, sedentary
      occupation, obesity in women and a positive family history of CHD. A study of the
      major risk factors leading to CHD showed that 52% (sex and age adjusted 45.5%)
      had at least one major risk factor at the higher (level A) and 68% (sex and age
      adjusted 61.9%) at the lower (level B) risk levels. Diabetes mellitus was
      strongly associated with a positive history of CHD. In 47.6% (sex and age
      adjusted 48.2%) of the total group resting ECG abnormalities were found that
      could be coded. Because of the severe nature of CHD in the migrant Indian, an
      immediate and intensive programme of primary prevention of CHD risk factors
      should be instituted.

PMID- 2218779
TI  - Captopril in hypertensive black men in southern Africa.
AB  - A group of 55 black men with mild or moderate hypertension who were being treated
      with methyldopa, prazosin, and a thiazide diuretic in combination with sotalol,
      were studied before and after changing their treatment to captopril and a
      thiazide diuretic. The level of blood pressure control was similar in the 11 men
      with mild hypertension but the 44 men with moderate hypertension were less well
      controlled with captopril and a thiazide diuretic. In the men with moderate
      hypertension the mean increase in the systolic blood pressure after the change in
      treatment was 4.7 mmHg (not significant) and in the diastolic pressure 6.2 mmHg
      (P less than 0.02). The mean blood pressure was higher during treatment with
      captopril in 37 men and lower in 18 men (P = 0.01). Thirty-seven men found both
      regimens acceptable and 33 of these men preferred the captopril regimen; however,
      15 men said they did not like the captopril regimen while only 4 men did not like
      the methyldopa/prazosin regimen (P less than 0.01). Side-effects from the
      captopril regimen were reported by 18 of the men and from the methyldopa/prazosin
      regimen by 6 men (P less than 0.02). It was concluded that the captopril/thiazide
      regimen was less effective than the methyldopa/prazosin/sotalol/thiazide regimen
      for the control of moderate hypertension in this population of black men.
      Although the men who liked both regimens preferred the captopril regimen, that
      regimen was associated with significantly more side-effects and was disliked by
      more of the men than was the methyldopa/prazosin regimen.

PMID- 2218780
TI  - Long-term efficacy and safety of sustained-release diltiazem in the treatment of
      hypertension.
AB  - The long-term efficacy and safety of sustained-release diltiazem (Tilazem; Parke
      Davis) were evaluated. A total of 27 young, physically active patients with
      hypertension were followed up for 17 months. On a dosage of 90 mg twice daily,
      adequate blood pressure reduction was obtained in 23 patients (85%). No adverse
      effects were noted.

PMID- 2218781
TI  - Indoramin in the treatment of pregnancy hypertension. A placebo-controlled trial
      comparing the efficacy of indoramin with alpha-methyldopa.
AB  - A placebo-controlled trial was used to assess the antihypertensive efficacy of
      indoramin in the management of pregnancy hypertension. Sixty patients were
      recruited into the study and only 17 attained satisfactory blood pressure
      control. In the doses of drugs administered indoramin was not shown to be more
      effective than alpha-methyldopa.

PMID- 2218782
TI  - Can we predict and/or prevent type I diabetes?
AB  - The highest risk for the development of type I diabetes resides with first-degree
      relatives of the diabetic proband, this risk being in the order of 2.9%, 6.6% and
      4.9% for parents, siblings and children of the proband, respectively. The major
      genetic markers associated with the development of insulin-dependent diabetes
      mellitus (IDDM) is the possession of the HLA alleles DR3/DR4 and more recently
      the absence of aspartate in the 57th position on the beta-chain of the HLA DQ
      gene (HLA DQ beta Asp 57 negative). The most important auto-immune marker for
      predicting preclinical IDDM is the presence of high titres (greater than 40
      Juvenile Diabetes Foundation units) of islet cell antibodies (ICA), while the
      finding of insulin auto-antibodies (IAA) is a good predictive marker in children
      less than 5 years of age. The presence in a susceptible individual of ICA plus
      IAA is a better predictor of impending IDDM than the presence of either of these
      two markers alone. Antibodies which precipitate an islet membrane protein (MW
      64K) are highly sensitive and specific markers of preclinical IDDM. The presence
      of 64K antibodies may well be the most important predictive marker of impending
      IDDM in the future. The progressive decline of the first phase of insulin
      secretion in response to an intravenous glucose challenge is associated with the
      onset of IDDM within 18 months. Of the immunotherapeutic agents at present used
      in clinically manifest IDDM, azathioprine has been shown to be ineffective in
      increasing the remission phase, while the value of nicotinamide is
      controversial.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2218783
TI  - Malaria at Johannesburg Hospital. A retrospective study.
AB  - A total of 43 patients diagnosed as having malaria were admitted to Johannesburg
      Hospital during 1988; 40 (94%) were infected with Plasmodium falciparum. Only 26
      patients (60%) were recorded as having used prophylaxis of any kind; chloroquine
      alone and in combination was used as prophylaxis by 17. Patients were treated
      with quinine (alone or in combination) in 67% of cases. In 42% of patients
      chloroquine-resistant malaria was considered a possibility.

PMID- 2218784
TI  - Lactose maldigestion--age-specific prevalence in black and Indian children.
AB  - A study was performed to determine the prevalence and age of onset of primary
      lactose maldigestion in healthy black and Indian children, and to determine
      whether this was of clinical significance. More black (22 of 44-50%) than Indian
      children (10 of 45-22.2%) had lactose maldigestion (P less than 0.02), the
      development of which was age-related and occurred earlier in blacks than in
      Indians; 6 of 19 black children less than 5 years old (31.6%) were lactose
      maldigesters, compared with 8 of 10 (80%) over 10 years old, while only 1 of 16
      Indian children aged under 8 years (6.3%) were maldigesters, compared with 5 of
      13 (38.5%) aged over 10 years. Most children had a very low intake of milk and
      lactose maldigestion was of no clinical significance to them.

PMID- 2218785
TI  - The snacking habits of white preschool children.
AB  - Three-day estimated dietary records were kept for 194 white 3- and 4-year-old
      children to determine and evaluate the extent, nature and quality of their
      snacking. All but 1 child ate between meals, with morning and afternoon snacking
      being favoured in terms of frequency and quantity. Soft drinks were consumed most
      frequently, followed by fresh fruits and fruit juices, sweets and chocolates,
      milk and sugar. Between-meal eating contributed more than one-third of the
      average day's energy and approximately one-quarter of most vitamins and minerals
      to the children's diets. Foods eaten between meals were, however, significantly
      less nutrient-dense than mealtime foods. Non-basic foods supplied more energy to
      the diet than any of the five basic food groups, but minimal quantities of
      micronutrients. Sugar consumption, mostly in the form of sugary foods and drinks,
      was high, but was not consumed exclusively between meals. Such children should be
      encouraged to make more use of basic commodities, particularly when snacking.

PMID- 2218786
TI  - Toxic cannabis psychosis is a valid entity.
AB  - One hundred black men admitted to hospital with acute psychiatric symptoms were
      investigated for the presence of urinary cannabis metabolites in order to
      delineate the psychiatric role played by 'dagga', the potent South African
      cannabinol, in the study population and to determine the diagnostic value of the
      entity 'toxic psychosis (dagga)'. Cannabinoids were present in 29% of patients,
      and 31% were discharged with a diagnosis of toxic psychosis (dagga). Clinical and
      demographic material was gathered for all patients and no consistent differences
      were found between dagga-positive and dagga-negative patients or toxic dagga
      psychotic patients and 'functional' psychotics other than a history of recent
      dagga use and the dagga screening test result. The latter measure was found to be
      both more sensitive and more specific than the history of dagga use alone. The
      findings support the routine use of a simple screening test for dagga in the
      sample population studied. The study demonstrated the heterogeneous nature of the
      toxic dagga psychosis syndrome by documenting a variety of different clinical
      presentations, which included schizophrenia (42%), paranoia (26%), maniform
      psychosis (16%) and organic psychosis (16%).

PMID- 2218787
TI  - Prenatal ultrasonographic diagnosis and successful management of mediastinal
      teratoma. A case report.
AB  - A case of mediastinal teratoma, diagnosed in utero by realtime ultrasonography
      during a late 3rd trimester evaluation of polyhydramnios, is described. Prompt
      respiratory assistance to the infant at birth and early surgical intervention led
      to a successful outcome.

PMID- 2218788
TI  - Symptomatic rubella re-infection in early pregnancy and subsequent delivery of an
      infected but minimally involved infant. A case report.
AB  - A case of serologically proven symptomatic rubella re-infection in early
      pregnancy in a healthy multigravida who had been successfully vaccinated is
      reported to illustrate that the risk to the fetus is considerably less than with
      primary infection. The infant was infected, as evidenced by specific IgM in cord
      blood, but had no stigmata of congenital rubella at birth. Growth retardation was
      apparent at 6 months and hearing loss, not necessarily due to rubella, was
      detected at 8 months. Rubella re-infection, which may now be distinguished
      serologically by the urea degradation test from primary rubella, need not
      necessarily be an indication for termination of pregnancy.

PMID- 2218791
TI  - Weight information on the 'Road to Health' card inadequate for growth monitoring.

PMID- 2218790
TI  - Tetanus--a preventable disease.

PMID- 2218789
TI  - The healing bird.
AB  - The legend of the caladrius, a bird with prognostic and healing powers, first
      appeared in early Indian writings as the haridruva--a yellow bird that cured
      jaundice. In classical Greek mythology it was a nondescript bird but in the
      medieval bestiaries it became pure white. The caladrius is used in the coats of
      arms of the South African Medical and Dental Council and also the Medical
      University of Southern Africa. These appear to be the first use of this medically
      significant bird in modern heraldry.

PMID- 2218792
TI  - Medical surveillance in the workplace.

PMID- 2218793
TI  - Medical surveillance in the workplace: overview.
AB  - Medical surveillance in the workplace is the systematic collection and evaluation
      of employees' health data to identify specific instances of illness or health
      trends suggesting an adverse effect of workplace exposures on employees' health.
      This process is coupled with actions to reduce hazardous workplace exposures, as
      reviewed in this issue.

PMID- 2218794
TI  - Guidelines for medical screening in the workplace.
AB  - This chapter deals with general principles of conducting medical examinations to
      detect adverse health effects of workplace exposures and thereby prevent
      occupational disease or slow its progression. Much of the discussion is most
      relevant to screening for effects of chemical hazards, but many of the principles
      presented apply to physical and biological hazards as well. Procedural and
      administrative aspects of workplace medical examinations that are not "exposure
      specific" and are applicable to all medical programs are reviewed.

PMID- 2218796
TI  - Role of industrial hygiene in medical surveillance.
AB  - The industrial hygienist and the occupational physician comprise a team that can
      effectively recognize and evaluate employee exposures to workplace-generated
      contaminants. At the most basic level, the industrial hygienist performs the
      exposure assessment, and the occupational physician develops the medical
      surveillance program. The actual mechanisms for assessing employee exposures and
      ultimately implementing a medical surveillance program are complex and are
      detailed in this paper.

PMID- 2218795
TI  - Medical surveillance in the workplace--legal issues.
AB  - With increased medical surveillance comes increased concern about the legal and
      ethical issues that surround it. This chapter addresses five major issues
      surrounding medical surveillance in the workplace.

PMID- 2218797
TI  - Rhythmic variations in medical monitoring tests.
AB  - Medical surveillance must be done with an awareness that virtually all
      physiological functions exhibit regularly recurring rhythmic variations. These
      rhythms, often termed "biological rhythms," and their biological effects are
      reviewed in this paper.

PMID- 2218798
TI  - Biological monitoring.
AB  - It is important to distinguish biological from medical or health monitoring
      because the submission of a biological specimen often leads to the assumption of
      the part of workers and also health professionals that health effects are being
      measured, and that measurement exceeding a reference value indicates disease
      rather than exposure or health risk. This chapter briefly reviews the basic
      principles of biological monitoring, focusing primarily on its role within
      medical surveillance.

PMID- 2218799
TI  - Medical surveillance for pulmonary endpoints.
AB  - The institution of workplace medical surveillance for pulmonary endpoints assumes
      the following conditions: that occupational lung diseases can be detected in
      early or preclinical stages; that early detection with appropriate intervention
      can lead to reduced morbidity; and that early detection and appropriate
      intervention are both feasible. The author of this chapter points out that,
      unfortunately, very few occupational settings meet these conditions.

PMID- 2218800
TI  - Medical surveillance for workplace hepatotoxins.
AB  - In contrast to clinical practice, the objective of medical surveillance in a
      workplace population with potential exposure to hepatotoxins is to detect people
      with occupation-associated liver dysfunction who either have or are at risk for
      developing clinical disease. Ideally, medical surveillance tests for
      hepatotoxicity should have, either alone or in combination, a high positive
      predictive value.

PMID- 2218801
TI  - Medical surveillance for renal endpoints.
AB  - The ability to monitor exposed workers for early evidence of nephrotoxicity
      facilitates efforts at secondary prevention. When this monitoring identifies
      previously unrecognized or unappreciated risk factors and leads to their
      elimination from the environment of future workers, the more desirable goal-
      primary prevention--may be realized.

PMID- 2218802
TI  - Medical surveillance for neurologic endpoints.
AB  - Except for screening for noise-induced hearing loss, medical surveillance for
      neurologic disease in the workplace has not been done on a routine basis in the
      past. In the future, however, as occupational medicine focuses increasingly on
      the detection of preclinical effects of exposure and strategies to prevent such
      exposures, medical surveillance for neurologic disease will become a necessity.

PMID- 2218803
TI  - Medical surveillance and biomonitoring for occupational cancer endpoints.
AB  - Medical surveillance for carcinogens refers to the use of medical history,
      physical examinations, and laboratory examinations to detect medical effects of
      exposure to cancer-causing agents. Biomonitoring for carcinogens, in contrast,
      involves testing for changes in DNA or chromosomes, presence of mutagens in body
      fluids, or presence of markers of exposure in cells. This article evaluates the
      current medical surveillance and biomonitoring techniques to assess their utility
      as measures of potential exposure to and effects of carcinogens in the workplace.

PMID- 2218805
TI  - Drug testing in the workplace.
AB  - The author first discusses drug use in society at large versus the workplace,
      then focuses on the issue of drug testing in the workplace. Goals of and
      approaches to drug testing are discussed, legal issues highlighted, testing
      procedures detailed, testing programs introduced, and finally the role of
      employee assistance programs reviewed.

PMID- 2218804
TI  - Medical surveillance for melanoma at the Lawrence Livermore National Laboratory.
AB  - Following identification of an unusual cluster of cases of malignant melanoma
      among laboratory employees at this national facility, several studies were done
      to provide further understanding and solutions to the problem. This paper
      discusses the Laboratory's response, including the educational campaign and
      institution of self-examinations. Experience with the melanoma surveillance
      program to date reinforces its validity.

PMID- 2218806
TI  - Job-exposure matrices in epidemiologic research and medical surveillance.
AB  - In summary, job-exposure matrices consist of a number of related methods for the
      assessment of occupational exposures that have been adapted to a variety of
      research settings. The potential advantages of job-exposure matrices include the
      avoidance of some forms of bias and enhanced statistical power to detect
      associations. However, misclassification of exposures may be problematic, and the
      sensitivity of this approach has not been consistently shown to be greater than
      that of conventional methods of exposure assessment based upon interviews of
      subjects. The job-exposure matrix approach may be especially useful for studies
      involving the historical reconstruction of exposures at industrial sites. More
      attention needs to be given to improving the completeness and accuracy of
      employment history information and to the validity of exposure estimates over
      time. Future developments may include the increased availability and utilization
      of quantitative exposure estimates such as environmental air sampling and
      personal monitoring data. Although job-exposure matrices are generally associated
      with case-control study designs, they may also be useful in prospective studies.
      Thus, job-exposure matrices are a potentially valuable addition to epidemiologic
      research methods which, if applied judiciously, may contribute to etiologic
      research and to the identification and control of hazardous exposures in the
      workplace.

PMID- 2218807
TI  - [The economic and sociomedical efficiency of innovations in the practice of
      health protection].
AB  - The article discusses techniques for assessing the economic and medico-social
      efficiency of innovations introduced into health care practice starting from the
      example of a new procedure (prodigiosin inhalations) in prevention of ENT
      disorders and of influenza in preschool children. The analysis bears on the role
      and importance of evaluations of this type in the implementation of scientific
      findings, as well as in restructuring the health care sector and reorienting
      biomedical research. The authors contend that the expanding area of innovation
      use does not trigger more than insignificant rises in costs (costs allocated to
      scientific research, for instance), whereas cost containment is almost directly
      proportional to the expanding applications. It can, therefore, be concluded that
      imposing limitations and delays in the implementation of efficient innovations
      bars cost savings and diminishes the actual economic efficiency of biomedical
      research.

PMID- 2218808
TI  - Randomized clinical trials and public health: a review of current trends.

PMID- 2218809
TI  - [Trends in the improvement of the medical documentation system].
AB  - The paper reports on the general and specific functions of medical records, as
      well as on the need to improve medical recording and the circulation of medical
      records in health units. The economic medical and social advantages of keeping
      accurate records are highlighted. Recent breakthroughs in information science
      permit unifying and standardizing medical records, making them more problem
      oriented, developing technical equipment and extending its use in archives,
      expanding the role of the computer in clinical recording.

PMID- 2218810
TI  - [The social and hygienic aspects in the protection of the health of forest
      industry workers].
AB  - The study of social and hygiene aspects in the industry of forest exploitation
      permitted to point out the changes that occurred in the field of mechanization
      and automation of production processes, which radically influenced the working
      conditions and characteristics, as well as the health indices. The study
      approaches some economic, social and hygiene problems. Proposals are made
      regarding the improvement of medical care organization for workers, for example
      the drawing up of a complex programme of prophylaxis of diseases in the
      enterprises for wood industrialization and of utilization of the computation
      technique.

PMID- 2218811
TI  - Evaluation of risk factors for essential arterial hypertension in industrial and
      school environments.

PMID- 2218812
TI  - Domestic accidents: theoretical controversies.

PMID- 2218813
TI  - [A psychological profile of subjects from industrial sectors with cardiovascular
      diseases interviewed via the H. J. Eysenck questionnaire].
AB  - Authors in the literature are unanimous in considering type A personality as an
      individual characteristic susceptible to cardiovascular risk. The latter, in its
      turn, is regarded, after H. J. Eysenck [4], as an association of the scores of
      extroversion and neurosis. Starting from this assumption, we set out to outline a
      profile of the cardiovascular patient using the "Eysenck" questionnaire. The
      study population included 126 industrial workers compared to a matching control
      set. The resulting profile displayed neurotic components within an ego
      perpetually frustrated in its needs of well-being, emotional satisfaction and
      rewarding social relations (-1,dark blue, Luscher colour test in its shortened
      variant). Stress and introversion foster neuroticism and encourage the ego in its
      compulsive quest for autonomy, "eccentric" behaviour in actual situations and
      egocentric attitudes in reserve. Findings suggest that the "H. J. Eysenck" test
      for introversion-extroversion and neuroticism, as well as the Luscher colour test
      (the shortened variant) are likely to be useful predictive tools in
      cardiovascular disease.

PMID- 2218814
TI  - [The thermogenic function of the large intestine and diverticulosis].

PMID- 2218815
TI  - Alcohol--risk factor in prenatal pathology (alcohol embryo- and fetopathy).

PMID- 2218816
TI  - Results of conservative surgery and radiation therapy for breast cancer.
AB  - For stage I or II breast cancer, conservative surgery and radiation therapy are
      as effective as modified radical or radical mastectomy. In most cases, cosmetic
      considerations and the availability of therapy are the primary concerns. The
      extent of a surgical resection less than a mastectomy has not been a subject of a
      randomized trial and is controversial. It appears that removal of a quadrant of
      the breast for small lesions is safe but excessive. Using histologic findings in
      the biopsy as a guide, it may be possible to limit the breast resection to gross
      tumor removal for most patients while using wider resections for patients with an
      extensive intraductal component or for invasive lobular carcinoma. It also
      appears that excluding patients from breast conservation on the basis of positive
      margins on the first attempt at tumor excision may be unnecessarily restrictive.
      Although patients with an extensive intraductal component or invasive lobular
      carcinoma should have negative margins, it appears that a patient with
      predominantly invasive ductal carcinoma can be treated without re-excision if all
      gross tumor has been resected and there is no reason to suspect extensive
      microscopic disease. Patients with indeterminate margins should have a re
      excision. Axillary dissection provides prognostic information and prevents
      progression of the disease within the axilla. Axillary dissections limited to
      level I will accurately identify a substantial number of patients who have
      pathologically positive but clinically negative nodes. When combined with
      radiation therapy to the axilla, a level I dissection results in a limited number
      of patients with progressive axillary disease. Patients with pathologically
      positive axillas and patients at particularly high risk for systemic disease
      because of the extent of axillary node involvement can be identified by
      dissections of levels I and II. Radiation therapy can be avoided safely in
      patients who have pathologically negative axillas by level I and II dissection.
      There appears to be no advantage to routine dissection of level III lymph nodes.
      Lymphedema of the arm and breast increases with more extensive dissections and
      with radiation therapy.

PMID- 2218817
TI  - Role of mastectomy in breast cancer.
AB  - The surgical management of breast cancer continues to evolve in an attempt to
      define the ideal line between therapeutic efficacy and morbidity. It is clear
      that breast cancer is a biologically heterogeneous group of diseases, and no
      single hypothesis explains its behavior. The surgical options proposed to the
      individual patient must draw from the experience of retrospective clinical
      studies and prospective randomized trials in an attempt to optimize the treatment
      plan. Most patients without distant disease are eligible to consider mastectomy,
      which can accomplish excellent local control and significantly improve survival
      for earlier stages of disease. However, breast conservation remains an
      appropriate alternative for a carefully defined subset of patients. Today, with
      early-stage disease, no patient need leave the operating room without a breast.
      Recent advances in reconstructive surgery make mastectomy with immediate
      reconstruction or limited resection plus axillary dissection with postoperative
      radiation therapy the two principal treatment choices available. Future studies
      will focus on the integration of other treatment modalities. Clinical research
      into the use of preoperative chemotherapy to downstage the disease to permit less
      extensive surgery is of interest. Recent application of molecular biologic
      techniques such as oncogene analysis, cytogenetic studies, proliferative indices,
      and the highly sensitive detection of distant micrometastases using monoclonal
      antibodies may assist in the design of innovative approaches to surgery,
      radiation therapy, and systemic drug treatment. These advances show great promise
      for improving the quality of life and the cure rate for patients with breast
      cancer. Today, surgical treatment options have evolved that fulfill some of the
      objectives outlined by Dr. James Ewing of Memorial Hospital some 50 years ago.
      His concerns about breast cancer remain as relevant today as they were half a
      century ago: "I have drawn the impression that in dealing with mammary cancer,
      surgery meets with more peculiar difficulties and uncertainties than with almost
      any other form of the disease. The anatomical types are so numerous, the
      variations in clinical course so wide, the paths of dissemination so free and
      diverse, the difficulties of determining the actual conditions so complex, and
      the sacrifice of tissues so great, as to render impossible in the majority of
      cases a reasonably accurate adjustment of a means to an end."

PMID- 2218818
TI  - Selection of breast-preservation therapy for primary invasive breast carcinoma.
AB  - Breast-preservation treatment for primary breast cancer should not be used for
      all women. Women frequently excluded from consideration for such treatment or who
      choose not to have it may be elderly and not concerned about cosmetic appearance
      or live at a distance so that 6 weeks of daily trips to radiotherapy would be
      inconvenient or even impossible. Also, if radiotherapeutic expertise or
      facilities are not available, a breast-preservation program is difficult. In
      Massachusetts, a full course of just over 6000 cGy (4500 cGy to the whole breast
      and a 1600-cGy local boost) costs roughly $6000. Thus, breast preservation is
      more expensive than mastectomy even with reconstruction, as patients still
      frequently require a hospital admission with general anesthesia for an axillary
      dissection. Although insurance policies cover such expenses, patients who do not
      have insurance or have inadequate coverage may find the extra expense of the
      breast-preservation technique burdensome or impossible. Women with a small breast
      and a proportionately large cancer may have an unsatisfactory cosmetic outcome
      after appropriate lumpectomy. The cosmetic result in such patients frequently
      cannot be predicted beforehand; this fact adds emphasis to the need for a two
      step process of lumpectomy and then re-evaluation of the cosmetic outcome as well
      as pathologic features for decisions regarding breast preservation. Finally,
      women may have strikingly different attitudes toward breast preservation than
      expected by the surgeon. For some women, the urge to preserve the breast is so
      strong that they will accept virtually any risk to achieve this option, whereas
      for other women, the constant anxiety about a recurrence or undergoing radiation
      therapy is traumatic enough that they readily accept mastectomy. In our referral
      surgical oncology practice, roughly 60% of patients are currently treated with
      breast-preservation techniques; the remainder undergo mastectomy, with immediate
      reconstruction in approximately three fourths of the cases. The proportion of
      patients who elect to have breast preservation depends greatly on local medical
      customs and attitudes; the radiotherapeutic skills available; women's attitudes,
      which frequently are dependent on the local press and publicity; and the
      surgeon's interest and enthusiasm for such a program. There is no appropriate
      proportion of patients who should be treated by breast-preservation techniques,
      but clearly, the proportion of patients so treated increases with experience,
      acceptability, publicity, and availability. Thus, the selection of breast
      preserving therapy for individual patients is a result of an extraordinary array
      of factors that need to be considered in each patient.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2218819
TI  - Selection of therapy for stage III breast cancer.
AB  - Locally advanced breast cancer is a heterogenous group including both operable
      and inoperable lesions. Local surgery or radiation alone produces poor survival
      rates, indicating micrometastases at diagnosis. Systemic chemotherapy as part of
      multimodality regimens has increased the length and rate of disease-free
      survival.

PMID- 2218820
TI  - Adjuvant chemotherapy of breast cancer.
AB  - Many women will not be cured of breast cancer by even the best early detection
      and surgical techniques because of micrometastases present at diagnosis. Adjuvant
      therapy has extended the disease-free interval for most patients and lengthens
      overall survival for many. Combination chemotherapy has become the standard form
      of adjuvant treatment for premenopausal women with breast cancer and positive
      lymph nodes after primary therapy. With minimal toxicity, disease-free and
      overall survival are improved. Results are less impressive or less clear-cut for
      postmenopausal women or any woman with negative lymph nodes. Long-term toxicities
      of adjuvant chemotherapy may include second malignancies and cardiac dysfunction.
      Although these complications probably are rare, they must be considered seriously
      when weighing chemotherapy for patients in whom its benefits may be slight.
      Innovations likely to become standard in adjuvant therapy decision making include
      risk assessment with new prognostic indicators (growth fraction, oncogene
      expression) and investigation of dose intensification using bone marrow growth
      factors and autologous stem-cell support.

PMID- 2218821
TI  - Adjuvant antiestrogen therapy for breast cancer. Past, present, and future.
AB  - Laboratory investigations using animal models of breast cancer growth have
      indicated that the antiestrogenic compound tamoxifen is a tumoristatic agent. It
      is therefore effective in suppressing, rather than destroying, the breast tumor.
      Its use as an adjuvant in breast cancer management has been successful, with a
      proportion of women benefiting from long periods of tamoxifen treatment. All the
      initial studies recruited postmenopausal women, but tamoxifen is now proposed for
      the treatment of premenopausal women for an extended time. Naturally, there are
      many aspects of the toxicology of tamoxifen to consider; however, careful
      monitoring of clinical trials will determine the safety of the drug for the
      general patient population.

PMID- 2218823
TI  - Reconstruction after mastectomy.
AB  - Advances in materials and techniques, especially those involving transposition of
      muscle and skin flaps, have made breast reconstruction possible for most women
      who undergo mastectomy for breast cancer. The availability of this option can
      alleviate the breast and chest wall deformity that results from virtually all
      local treatment of breast cancer. It is essential that the reconstruction surgeon
      be part of the breast cancer management team from the beginning of treatment
      planning and that this surgeon work closely with the general surgeon, medical
      oncologist, and radiation therapist as well as the adjunctive treatment team
      members. The patient's clinical status and the type of local treatment will be
      significant determinants of the reconstructive options. For women with stage I
      breast cancer, these decisions may be based largely on the oncologist's local and
      adjunctive therapy procedures and the woman's desire to proceed or delay. For
      women with systemic disease, all members of the breast management team may need
      to agree on the advisability and timing of reconstruction. Central to all of the
      numerous decisions described in this paper regarding the timing, type, and extent
      of breast reconstruction is the primary goal of the entire team: the best
      possible management of the breast cancer itself. The promise of attractive,
      symmetric, and natural appearing breasts, complete with a symmetric nipple
      areolar complex, has eased somewhat the diminishment of self-esteem and the
      threat to femininity that can accompany the loss of a breast. By lowering fear,
      the widely recognized availability of breast reconstruction may encourage more
      women to monitor their breasts and seek diagnosis of changes and may influence
      selection of the type of local treatment if cancer is detected. Because of the
      psychological and cultural significance of the breast, the reconstructive surgeon
      must be particularly sensitive to the psychological and aesthetic expectations of
      the patient. Even in those patients with metastases and limited life expectancy,
      breast reconstruction can enhance the quality of life.

PMID- 2218822
TI  - Management of local and regional recurrence after mastectomy or breast-conserving
      treatment.
AB  - Locoregional failures after primary treatment for breast cancer include a diverse
      group of lesions that represent different categories of failures with various
      prognoses. Although patients with chest wall recurrences and regional nodal
      failures after traditional radical surgery have a poor prognosis, many patients
      can still achieve a significant degree of palliation and even long-term survival
      or cure with carefully orchestrated multimodal treatment. In patients who have
      breast failures after breast-conservation surgery and radiation, long-term
      salvage and cure can be achieved for the majority with prompt detection and
      appropriate treatment, which, like treatment for primary breast cancer, includes
      a consideration not only of local control but also of the risk of subsequent
      systemic failure and its need for treatment.

PMID- 2218824
TI  - Bilateral breast cancer.
AB  - A second primary breast cancer in the opposite breast can be either synchronous
      or metachronous. The majority are metachronous. A woman who has had breast cancer
      has a fivefold increase in risk for a second breast cancer. Additional risk
      factors include multifocal cancer, lobular carcinoma in situ, and an original
      cancer at an early age with long survival. Lobular carcinoma in situ is
      predominantly a marker for the subsequent development of a second primary breast
      cancer. The incidence of synchronous bilateral cancer is approximately 1% to 2%
      and that of metachronous cancer 5% to 6%. The cancer can be invasive or
      noninvasive. Mammography has increased the number of synchronous cancers found
      but not the overall incidence. The incidence of invasive cancer detected by
      random biopsy of the opposite breast is not high enough to justify routine
      adoption of this procedure. The remaining breast must be followed for the
      remainder of the patient's life by physical examination and annual mammography.
      The treatment of the secondary primary breast cancer should be that appropriate
      for the stage of the disease. The prognosis for the woman with a second primary
      breast cancer is quite favorable and is dependent on the stage of both the first
      and the second cancer.

PMID- 2218825
TI  - Breast cancer during pregnancy and lactation.
AB  - Breast cancer is the most frequently seen cancer in pregnancy and lactation, but
      the incidence is low, the disease being seen in approximately 0.03% of
      pregnancies. Only 1% to 2% of breast cancer overall is diagnosed during pregnancy
      or lactation. There is no evidence to implicate pregnancy or lactation in either
      the etiology or the progression of breast cancer. Careful breast examination
      early in the pregnancy is very important to find solid masses that require biopsy
      before breast engorgement hides them. Therapeutic options vary, depending on the
      stage of disease and the stage of the pregnancy. Operable disease in the first 6
      to 7 months of the pregnancy should be treated by mastectomy, as irradiation is
      contraindicated. Late in the pregnancy, a lumpectomy and axillary dissection can
      be done, with irradiation being delayed until after delivery. General anesthesia
      is safe if the usual precautions are taken to compensate for the physiologic
      changes induced by pregnancy. Unfortunately, delay in diagnosis is common, and
      70% to 89% of patients with operable primary lesions have positive axillary lymph
      nodes. Late stage appears to be the only reason for the generally worse prognosis
      in these patients, as stage for stage, they have a course similar to that of
      nonpregnant patients. Adjuvant chemotherapy can be considered late in the
      pregnancy but should usually be delayed until after delivery. In patients with
      locally advanced or metastatic cancer diagnosed early in the pregnancy, for whom
      both chemotherapy and radiation therapy would normally be recommended,
      consideration must be given to termination of the pregnancy. There is no evidence
      that termination of pregnancy improves the outlook for the patients, but it does
      permit standard aggressive therapy in advanced disease.

PMID- 2218826
TI  - Male breast cancer.
AB  - Male breast cancer is uncommon but important. The diagnosis is easily made by
      breast biopsy, and patients are presenting earlier in the course of the disease
      than in the past. Despite this, patients are often first seen with tumors that
      have metastasized to the axillary nodes, which markedly decreases the survival
      rate. Therapy of localized disease includes simple excision, modified radical
      mastectomy, and radical mastectomy, but there is no consensus for which operation
      is appropriate. Radiation therapy should be strongly considered in patients with
      metastases to the axillary nodes, but the role of adjuvant hormonal therapy or
      chemotherapy is unclear. For treatment of disseminated disease, tamoxifen seems
      to be replacing orchiectomy. The favorable response rate, especially in patients
      with estrogen-receptor-positive tumors, the lack of side effects, and the high
      level of patient acceptability make it an attractive therapeutic choice.

PMID- 2218827
TI  - Clinical problems in follow-up of patients after conservative surgery and
      radiotherapy.
AB  - Patients treated with conservative surgery and radiotherapy for early-stage
      breast carcinoma are at risk of developing an ipsilateral breast recurrence for a
      long period. Fortunately, few such patients present with an inoperable recurrence
      or simultaneous distant metastases. Salvage rates are high and may be improved by
      early detection. Although usually unambiguous, physical examination of the
      treated breast may reveal changes attributable to surgery and radiotherapy that
      can mimic a recurrent cancer. There also is substantial overlap in radiologic
      appearance between benign and malignant lesions. It may be necessary to perform a
      biopsy when there is a question of recurrence. Careful life-long follow-up of
      patients thus is a critical part of their care.

PMID- 2218828
TI  - Trends in primary breast cancer management. Where are we going?
AB  - The treatment of cancer during any period has been based not on the whim of a
      clinician but on the therapeutic consequences of the dominant biologic model of
      the disease. Until the 1960s, the dominant model of breast cancer was of a
      disease that spread centrifugally along anatomic pathways, with time being the
      only determinant of prognosis. An alternative model, that of biologic
      determinism, posits that the outcomes of treatment are determined by the extent
      of microscopic dissemination that occurred before the tumor became detectable.
      This model, too, has flaws, and the author suggests that it is time for a Kuhnian
      paradigm shift. Breast cancer exhibits a heterogeneity of phenotypes resulting
      from one or perhaps two mutations. The multiple prognostic variables may be
      epiphenomena, expressing different degrees of amplification of a limited domain
      of the genome.

PMID- 2218830
TI  - Breast cancer: strategies for the 1990s II.

PMID- 2218829
TI  - Prognostic indicators in invasive breast cancer.
AB  - Tumor size and axillary lymph node involvement are the primary determinants of
      clinical course for most patients. Receptors for estrogen and progesterone are
      important additional prognostic factors for disease-free survival, overall
      survival, survival time after initial disease recurrence, and the likelihood of
      response to hormonal therapy. Histologic grading has merit as a prognostic
      factor, although poor reproducibility limits its broad application. Promising
      data have been emerging from the use of flow cytometry to analyze DNA content and
      proliferative rate. Patients with aneuploid tumors are more likely to have a
      shorter survival time than patients with diploid tumors. A high S-phase fraction
      also identifies a subset of patients at increased risk for early relapse. A
      combined index of ploidy and S-phase may be a more useful guide; together,
      diploidy and low S-phase identify a subgroup of node-negative patients at very
      low risk for disease recurrence. A number of oncogenes have been identified in
      breast cancer; amplification of the HER-2/neu gene or overexpression of the gene
      product may be an important prognostic indicator for node-positive patients.

PMID- 2218832
TI  - Synchronous carcinoma of the colon and rectum.
AB  - Reports on the incidence of synchronous carcinoma of the colon and rectum have
      varied from 2 to 11 per cent. The variability is a result of a lack of uniformity
      in criteria of diagnosis, differences in the population studied and differences
      in time period used. In this study, we evaluated the incidence and distribution
      of synchronous lesions during a recent time period before the use of colonoscopy
      became widespread. We reviewed the records of all patients with newly diagnosed
      adenocarcinoma of the colon and rectum who were operated upon at our institution
      between 1976 and 1981. In a total group of 1,000 patients of which 52 per cent
      were men, there were 54 patients or 5.4 per cent who had synchronous carcinomas.
      The group of patients with synchronous carcinomas were older than the group with
      nonsynchronous carcinomas (72.4 versus 68.8 years). There was also a higher
      incidence of associated benign polyps in the group with synchronous carcinomas
      (70 versus 30 per cent for a nonsynchronous carcinomas). The anatomic
      distribution of carcinomas of the colon and rectum in the group with synchronous
      lesions (111 in total) revealed a higher percentage of carcinomas located on the
      right side (29.7 versus 22.5 per cent), although the difference did not reach
      statistical significance. Synchronous carcinomas were located in nonadjacent
      segments of the colon in 37 per cent. There was no difference in stage between
      the groups with and without synchronous carcinomas. The preoperative
      identification of synchronous lesions by either colonoscopy or barium enema is
      important for the proper treatment of patients with carcinoma of the colon and
      rectum. Failure to locate these tumors may lead to the demise of the patient.

PMID- 2218833
TI  - Total parathyroidectomy and autotransplantation in hyperplasia of the parathyroid
      gland.
AB  - Hyperparathyroidism caused by multiple-gland hyperplasia has traditionally been
      treated by subtotal parathyroidectomy. Excellent results have been reported by
      some, particularly in primary hyperparathyroidism, but other have reported a
      significant incidence of recurrent hyperparathyroidism. Since 1979, we have
      chosen to avoid the possibility of remedial exploration of the neck and its
      attendant risks by treating all patients with primary and secondary hyperplasia
      with total parathyroidectomy and heterotopic autotransplantation. A total of 20
      patients were studied. There were no failures of grafts and no operative
      complications. We conclude that this procedure is a reliable and safe alternative
      in the treatment of primary or secondary hyperplasia of the parathyroid gland.

PMID- 2218831
TI  - Broad spectrum penicillin as an adequate therapy for acute cholangitis.
AB  - In a previous study of patients with acute cholecystitis, we demonstrated equal
      efficacy with a broad spectrum penicillin (piperacillin) and a penicillin plus
      amino-glycoside combination. Whether a single agent broad spectrum penicillin is
      adequate treatment for more severe infections, such as acute cholangitis,
      however, is still unclear. We, therefore, conducted a three center, prospective,
      randomized trial to determine whether or not a broad spectrum penicillin alone is
      adequate therapy for patients with acute cholangitis. During a 36 month period,
      96 patients with sepsis and biliary obstruction were randomly assigned to receive
      either piperacillin (n = 49) or ampicillin plus tobramycin (n = 47). The two
      groups receiving antibiotics were similar with respect to all clinical and
      laboratory parameters. The incidence of blood cultures with positive results (20
      versus 21 per cent) and underlying malignant lesions (51 versus 62 per cent) was
      also similar between the two groups. The percentage of patients with a clinical
      cure or significant improvement was the same in the two groups (69 versus 70 per
      cent). However, there was a significant difference in the cure rate between
      patients with benign and malignant biliary obstructions (83 versus 59 per cent, p
      less than 0.01). No significant differences were noted between the two antibiotic
      groups with respect to drug toxicity, but patients with malignant conditions were
      more prone to antibiotic related toxicities (2 versus 19 per cent, p less than
      0.05). These data suggest that outcome of treatment in patients with acute
      cholangitis is similar with either a broad spectrum penicillin or a penicillin
      plus aminoglycoside combination and is dependent upon the nature of the biliary
      obstruction.

PMID- 2218834
TI  - A comparison of hospital costs and morbidity between octogenarians and other
      patients undergoing general surgical operations.
AB  - The hospital costs and clinical results of 304 patients who were more than 80
      years old and who underwent general surgical procedures were evaluated. The over
      all mortality rate was 14 per cent; 19.9 per cent occurred in patients admitted
      under emergency conditions as compared with 8.9 per cent that occurred in
      patients undergoing elective procedures (p less than 0.001). Seventy-nine per
      cent of the patients were discharged and 7 per cent required care in a skilled
      nursing facility. Survival rates were as good or better than standard life table
      survival rates for 80 year old patients. Costs were higher in those who were
      admitted under emergent conditions or who died in the hospital. Deaths were a
      result of complications of the primary disease rather than associated disease in
      most groups. Neither costs nor length of stay could accurately predict survival
      of individual patients. We concluded that health resources should be directed at
      treating problems, such as cholelithiasis, hernia or carcinoma, early before
      complications develop.

PMID- 2218835
TI  - Carcinoma of the thyroglossal duct.
AB  - A review of 39 instances of excision of a cyst of the thyroglossal duct performed
      at St. Paul Medical Center, Dallas, Texas, revealed two patients with carcinoma
      of the thyroglossal duct. A review of the English literature yielded 146
      instances of this uncommon tumor. Eighty-four per cent were papillary
      adenocarcinoma of thyroid type and 5 per cent were squamous cell carcinoma. The
      patients were from six to 81 years old with a 2:1 female to male ratio.
      Metastatic disease to lymph nodes was noted in 11 per cent and invasion of
      overlying strap muscles was found in 4 per cent. Carcinoma of the thyroid gland
      occurred in 14 per cent. Preoperative diagnosis was rare. The Sistrunk procedure
      is recommended for initial surgical therapy with further surgical or adjuvant
      therapy dependent on associated clinical findings. Prognosis for carcinoma of the
      thyroglossal duct of thyroid type parallels that of carcinoma of the thyroid
      gland.

PMID- 2218836
TI  - A multifactorial analysis of mortality and morbidity in perforated peptic ulcer
      disease.
AB  - Perforated peptic ulcer disease remains a source of considerable morbidity and
      mortality, and the suggested methods of surgical therapy are diverse. We reviewed
      the course of 113 patients who were treated surgically and identified 14 factors
      that influenced the morbidity or mortality rates, or both. Multiple regression
      analysis showed that the number of coexisting medical conditions, a lower mean
      blood pressure level and the duration of acute perforation were independent risk
      factors for death, while age, use of a bronchodilator, a lower mean blood
      pressure level and the number of coexisting medical conditions correlated
      positively with all complications. A duodenal site was independently favorable
      with respect to all complications. The type of operation performed either simple
      closure, vagotomy and drainage or resection, did not influence morbidity or
      mortality. The most severely ill patients also did not benefit from any
      particular type of operation in the short term. Long term results were improved
      with definitive operation, as measured by the Visick classification and the need
      for reoperations. Definitive operations are recommended for virtually all
      patients with perforated peptic ulcer.

PMID- 2218837
TI  - Surgical management of islet cell dysmaturation syndrome in young children.
AB  - Islet cell dysmaturation syndrome (ICDS) encompasses the causes of infantile
      hyperinsulinemic hypoglycemia histologically described as islet cell hyperplasia,
      pancreatic adenomatosis and nesidioblastosis. Eleven infants underwent 14
      pancreatic resections for ICDS from 1965 to 1990 at the University of California
      at Los Angeles Medical Center for severe hypoglycemia unresponsive to medical
      therapy. Seizures were the presenting symptoms of hypoglycemia in eight infants.
      Six patients had nesidioblastosis, four had islet cell hyperplasia and one
      patient had an adenoma with histologically normal pancreatic islet cells. Four
      neonates underwent 80 per cent pancreatic resection; three with nesidioblastosis
      required reoperation (90 to 95 per cent resection). Four older infants underwent
      80 per cent pancreatic resection but required diazoxide for less than six months
      postoperatively. Three infants underwent 90 to 95 per cent pancreatic resection.
      None have required reoperation or postoperative medications. All infants are
      normoglycemic without pancreatic exocrine insufficiency and none had
      postoperative complications. Five infants had preoperative neurologic impairment,
      with three having severe retardation; all showed some improvement
      postoperatively, but only one infant now has normal findings on neurologic
      examination. Early diagnosis and aggressive surgical resection should minimize
      neurologic complications of the ICDS.

PMID- 2218839
TI  - Results of vein graft reconstruction of the lower extremity in diabetic and
      nondiabetic patients.
AB  - The results of 171 vein grafts of the lower extremity were evaluated. These were
      placed between January 1981 and December 1987 in 150 patients, 75 diabetic and 75
      nondiabetic, to determine the influence of diabetes on the outcome of the
      procedure. One and four year patency rates were determined by a life table
      analysis. No statistical differences in primary patency were found between the
      patients with diabetes and those without diabetes for all indications of
      operations (one year, diabetic patients 95 +/- 3 per cent, nondiabetic patients
      85 +/- 3 per cent; four years, diabetic patients 89 +/- 11 per cent and
      nondiabetic patients 80 +/- 12 per cent; p = n.s.). For those operated upon for
      salvage of the limb because of rest pain, ulceration or gangrene, patency in
      diabetic patients at one year approached a statistically significant advantage
      (diabetic patients 94 +/- 4 per cent versus nondiabetic patients 79 +/- 8 per
      cent; p = 0.056). We believe that arterial reconstruction of the lower extremity
      can be performed upon patients with diabetes with the same high degree of success
      for revascularization and salvage of the limb as can be accomplished in
      nondiabetic patients. This is true even though those with diabetes present with
      necrosis of the tissue and more often require bypass to distal tibial arteries.

PMID- 2218838
TI  - Immediate preoperative phlebotomy with autologous blood donation for aortic
      replacement.
AB  - The preferential use of autologous blood provided by phlebotomy can reduce the
      need for homologous blood transfusion in patients undergoing extensive elective
      operations. This blood is usually provided either by intraoperative isovolemic
      hemodilution or phlebotomy one to two weeks preoperatively. To minimize the
      intraoperative time delay or preoperative period between phlebotomy and operation
      required in these patients, we performed preoperative isovolemic hemodilution in
      69 patients one to two days prior to elective aortic replacement for infrarenal
      aneurysmal disease. Patients underwent phlebotomy a mean of 0.57 +/- 0.01 liter
      of whole blood; volume was replaced with lactated Ringer's solution. Hematocrit
      levels decreased from a mean value of 42.9 +/- 0.4 per cent to 33.7 +/- 0.3 per
      cent. Mean intraoperative blood loss was 1.2 +/- 0.05 liters. Hemodynamic
      parameters (blood pressure, cardiac output, pulmonary capillary wedge pressure,
      central venous pressure, oxygen delivery and systemic vascular resistance)
      remained stable throughout the perioperative and intraoperative time periods. In
      addition, we evaluated the technical modification of exclusion aneurysmorrhaphy
      (n = 50) versus open aneurysmorraphy (n = 19) on reduction of intraoperative
      homologous blood transfusion in these patients. Seventy-two per cent (36 of 50)
      of patients whose aneurysms were excluded received no homologous blood
      intraoperatively. Blood loss was decreased in the excluded versus open
      aneurysmorraphy group, 920 +/- 90 milliliters versus 2,030 +/- 250 milliliters,
      as were homologous blood transfusion requirements, 175 +/- 35 milliliters versus
      570 +/- 119 milliliters. Two patients died (2.9 per cent mortality rate), and
      there was no increase in morbidity. Surgical treatment of large aortic aneurysms
      is frequently performed on an urgent basis; thus, provision of autologous blood
      for this operation in a short period of time may be beneficial. Isovolemic
      hemodilution performed during the immediate preoperative period can reduce
      homologous blood requirements and be safely performed without adverse effects on
      mortality, morbidity and myocardial performance. Exclusion aneurysmorrhaphy may
      further reduce dependence on homologous blood.

PMID- 2218840
TI  - Nonendoscopic percutaneous gastrostomy.
AB  - Tight peritoneal adherence of the stomach to the abdominal wall as a prerequisite
      of percutaneous gastrostomy can be achieved by a newly developed cannula. It
      serves for puncture and fixation of the gastric wall. Thus, percutaneous
      gastrostomy can be established safely even in instances of an endoscopically
      nonaccessible stomach. Further applications of the device for the purpose of
      intestinopexy and facilitation of endoscopic procedures are being evaluated.

PMID- 2218841
TI  - Patterns of small intestinal injury with the argon beam coagulator.

PMID- 2218842
TI  - Use of the internal mammary vein for central venous access.
AB  - We have reported two instances requiring long term central venous access in which
      the more traditional access sites were no longer available. The use of the
      internal mammary vein has made it possible to easily obtain central venous access
      in these patients without thoracotomy. Also, based on the anatomy, we believe
      this to be superior to the intercostal venous approach, since the passage of the
      catheter is more direct, thus, avoiding the acute azygous arch angle and
      cumbersome positioning.

PMID- 2218843
TI  - Simple technique for securing ureteral stents during urinary diversion
      [corrected].

PMID- 2218845
TI  - Evolution and future perspectives for reduced-size hepatic transplantation.
AB  - Reduced-size hepatic transplantation has evolved into a clinically useful
      procedure, particularly at institutions specializing in treating pediatric
      patients. It is being adopted by many of the hepatic transplantation institutions
      in the United States as a result of its effectiveness in providing a greater
      number of donors for small recipients and an outcome equal to full-size hepatic
      transplantation. It has led to the development of "split-liver" transplantation,
      which is at present not universally applicable because of its complexity, but
      could double the supply of donors available to small patients. It is also the
      precursor of orthotopic auxiliary transplantation, which could become the
      preferred method for treating children with metabolic diseases, but no structural
      changes, such as cirrhosis. Finally, the knowledge gained in reduced-size hepatic
      transplantation will inevitably lead to transplantation using living donors,
      which could completely alleviate the shortage of donors for small patients.

PMID- 2218844
TI  - Management of the pregnant patient with carcinoma of the breast.
AB  - The diagnosis of carcinoma of the breast during pregnancy poses a challenging
      dilemma. Although once regarded as incurable, recent reports reveal similar long
      term survival rates for pregnant and nonpregnant patients who have carcinoma of
      the breast. When referred to a surgeon, a pregnant woman with a suspicious
      mammary mass deserves an expedient histologic diagnosis; delay may jeopardize the
      chances of survival. Once the diagnosis is established, pregnant patients should
      be treated in a manner similar to nonpregnant patients because there is no
      evidence that carcinoma of the breast in pregnant women is biologically different
      than carcinoma of the breast in other premenopausal women. Fears of fetal
      exposure to radiation should not deter a physician from ordering appropriate
      preoperative diagnostic tests to stage the patients. Operation may be performed
      safely when general anesthesia is administered and postoperative adjuvant therapy
      should be administered when necessary. The involvement of multiple subspecialties
      in the management of these patients is highly recommended.

PMID- 2218846
TI  - Response of spinal cord blood flow and motor and sensory evoked potentials to
      aortic ligation.
AB  - To produce spinal cord ischemia in the lamb, ligation of the thoracic aorta was
      performed for 15, 30, and 45 minutes in three animals each. Spinal cord blood
      flow and motor and sensory evoked potentials were measured before, during, and
      after aortic ligation. Ischemia with a blood flow of zero during ligation was
      encountered in the thoracic and lumbar cords, followed by hyperemia upon release
      of the ligature. Both somatosensory and motor evoked potentials were obliterated
      during aortic ligation and gradually recovered following resumption of flow.
      Motor and sensory evoked potentials behaved similarly to high aortic ligation.

PMID- 2218847
TI  - Cerebral cysticercosis.
AB  - We studied 143 cases of cerebral cysticercosis over a 30-year period. In 46 there
      was hydrocephalus due to cysts obstructing the cerebrospinal fluid pathways, with
      signs of hydrocephalus and cerebellar dysfunction. In 97 there were cysts in the
      cerebral parenchyma, causing symptoms of intracranial hypertension alone in 22
      cases, with additional neurological deficits in the remainder. Before 1980
      diagnosis was made by pneumoencephalography and ventriculography, but since then
      it has mostly been done by computed tomography. In 28 cases scanned, typical
      abnormalities were present in 25. Complement fixation tests were positive in
      serum in 74% of cases and in cerebrospinal fluid in 73%, and the enzyme-linked
      immunosorbent assay test was positive in serum in 90% and in cerebrospinal fluid
      in 92%. Treatment of cases with hydrocephalus was by removal of the cysts at
      craniotomy, with placement of a shunt where necessary. Intracranial hypertension
      caused by parenchymal cysts was treated with steroids and osmotic agents, if
      possible. In resistant cases subtemporal decompression was needed, unilateral in
      55 cases and bilateral in eight. Mortality in the acute stage was 11%, with a
      further 20% at follow up.

PMID- 2218848
TI  - Experimental isobaric subarachnoid hemorrhage: regional mitochondrial function
      during the acute and late phase.
AB  - Patients treated for aneurysmal subarachnoid hemorrhage show, in the long-term
      follow up, an elevated rate of cognitive disturbances that are mainly related to
      the impact of the initial bleeding: the neurotoxic effects of blood deposition in
      subarachnoidal spaces may result in a diffuse encephalopathy, but the intrinsic
      mechanism and the biochemical correlates are not known. In the present study we
      have evaluated mitochondrial function after experimental induction of
      subarachnoid hemorrhage. Mitochondrial function was evaluated in four different
      rat brain areas (frontal cortex, occipital cortex, hippocampus, and brain stem)
      after experimental isobaric subarachnoid hemorrhage in rats. Subarachnoid
      hemorrhage was induced by injecting 0.07 mL of arterial autologous blood into the
      cisterna magna. Intracranial pressure did not significantly increase. The
      nonsynaptic mitochondrial fraction was isolated from different rat brain areas,
      and the maximal rate of enzymatic reactions of some key enzymatic activities
      related to the Krebs cycle [nicotinamide adenine dinucleotide (oxidized form)
      (NAD+)-isocitrate dehydrogenase, citrate synthase, and succinate dehydrogenase]
      and of the electron transfer chain (cytochrome oxidase) were evaluated. The
      nonsynaptic mitochondrial fraction was utilized also to check parameters related
      to the mitochondrial respiration: state 3, state 4, uncoupled state, respiratory
      control ratio, and adenosine 5'-diphosphate/oxygen ratio. The biochemical
      parameters were measured at 1 and 72 hours after the subarachnoidal injection of
      blood. Subarachnoid hemorrhage did not affect the mitochondrial enzymatic
      activities both at 1 and 72 hours, while the mitochondrial enzymatic activities
      parameters were significantly affected: in particular, a significant decrease of
      respiratory control ratio in all tested brain areas was demonstrated. The
      increased mitochondrial vulnerability in the delayed phases could be one of the
      biochemical correlates of post-hemorrhagic encephalopathy.

PMID- 2218849
TI  - Effects of medical and surgical treatment on cerebral perfusion and cognition in
      patients with chronic cerebral ischemia.
AB  - The effects of medical treatment with and without cerebral revascularization
      procedures on cognition and cerebral blood flow were compared among 36 patients
      with extracranial occlusive cerebrovascular disease and cognitive impairments.
      Three comparable groups were studied. The first group (N = 18) received only
      medical treatment by control of risk factors for stroke (including hypertension,
      diabetes, and hyperlipidemia) and antiplatelet aggregant medication. The second
      group (N = 10) had the same medical treatment plus superficial temporal-to-middle
      cerebral artery bypass, and the third group had the same medical treatment plus
      carotid endarterectomy. Regional cerebral blood flow and cognition were monitored
      in all three treatment groups over a 3-year interval. All groups showed
      stabilization without expected rates of decline for both cerebral blood flow and
      cognition, but no statistically significant differences emerged among the
      treatment groups.

PMID- 2218850
TI  - Effect of diltiazem and thromboxane A2 synthetase inhibitor (OKY-046) on vessels
      following experimental subarachnoid hemorrhage.
AB  - In order to examine the functional changes in the vascular smooth muscle, the
      effects of a thromboxane A2 synthetase inhibitor (OKY-046) and a calcium channel
      blocker (diltiazem) on vessels following subarachnoid hemorrhage, and the
      contractile activity of cerebral vessels with various vasoactive agents, were
      investigated by studying isometric tension recordings in rings of cat basilar
      artery. The maximum contractile activities of the vessels in response to
      noradrenalin and adrenaline during the course of subarachnoid hemorrhage were
      significantly less than those in the control group. On the other hand, the
      maximum contractile activity of the vessels in response to prostaglandin F2 alpha
      on the seventh day following subarachnoid hemorrhage was significantly augmented
      compared with that in the control group. A significant decline in the relaxation
      of responsiveness to diltiazem during the course of subarachnoid hemorrhage was
      observed compared with that of diltiazem in the control group. This
      responsiveness to vasoactive agents was not influenced by the application of OKY
      046. The present study reveals functional changes in vascular smooth muscle
      exposed to subarachnoid hemorrhage in response to vasoactive agents and a calcium
      entry blocker. Thromboxane A2 may not be a significantly influential factor in
      the present results. It is suggested that cerebral vasospasm may well be related
      to functional changes of the arterial wall, which appear to be associated with
      derangement of the mechanisms of smooth muscle constriction and dilatation based
      on organic changes.

PMID- 2218851
TI  - Intractable complex partial seizures associated with occult temporal lobe
      encephalocele and meningoangiomatosis: a case report.
AB  - Occult congenital temporal lobe encephalocele has rarely been reported in
      association with medically intractable complex partial seizures. The four
      previously reported cases were unsuspected preoperatively. We present the case of
      an 18-year-old woman with intractable complex partial seizures since age 13.
      Seizure onset was electrically localized to the right temporal lobe. Preoperative
      neuroimaging studies revealed a middle fossa defect and inferior herniation of
      the right temporal lobe. Pathologic examination of the resected encephalocele
      revealed prominent features of meningoangiomatosis. We believe this to be the
      first case of temporal lobe encephalocele and epilepsy to be diagnosed
      preoperatively, and the first case also to be associated with
      meningoangiomatosis. The relevant literature on meningoangiomatosis and on
      temporal lobe encephalocele as a cause of epilepsy is reviewed.

PMID- 2218852
TI  - An unusual epidural, vascular spinal lipoma in a 3-year-old child: a case report
      and review of the literature.
AB  - Epidural lipomas are usually benign tumors affecting the spinal cord. We report
      the unusual presentation of a cervicothoracic spinal lipoma associated with a
      cervical dysraphism in a young boy. Diagnostic options using magnetic resonance
      imaging and gadolinium-diethylenetriaminepentaacetic acid are discussed as a
      pathway to early diagnosis of these and other occult spinal lesions.

PMID- 2218853
TI  - Total removal of an arteriovenous malformation embedded in the brain stem.
AB  - The removal of brain stem arteriovenous malformations is one of the most
      challenging problems in neurosurgery. The authors report a successful total
      removal of an arteriovenous malformation situated in the middle cerebellar
      peduncle, which was embedded in the floor of the fourth ventricle. The importance
      of dissection "flush" with coils of an arteriovenous malformation is stressed.

PMID- 2218854
TI  - Cavernous-carotid thrombosis and ocular motor paresis.
AB  - A 64-year-old man presented with the acute onset of unilateral blindness and
      ipsilateral ocular motor paresis. Occlusion of the central retinal artery
      associated with thrombosis of the internal carotid artery in the cavernous sinus
      was demonstrated by angiography and magnetic resonance imaging. Cases of carotid
      thrombosis associated with ipsilateral ocular motor paresis are rare. The
      pathophysiology of intracavernous carotid thrombosis is discussed in connection
      with blood supply of the cranial nerves in the cavernous sinus.

PMID- 2218855
TI  - Neonatal intracranial teratomas.
AB  - Two neonates with intracranial teratomas presented with cranial enlargements a
      few weeks after birth. Both cases underwent surgery: one died intraoperatively;
      the other is the longest known survivor, alive 7 years and 9 months after
      subtotal excision of a mature teratoma of the left sylvian fissure. Previous
      operations have been relatively few and nearly all have been unsuccessful. Size
      and favorable location may be the most important prognostic features regardless
      of the histologic classification as mature or immature. One of our cases
      demonstrates that even subtotal excision of a mature teratoma can result in long
      term survival.

PMID- 2218856
TI  - Value of magnetic resonance imaging in spontaneous extradural spinal hematoma due
      to vascular malformation: case report.
AB  - A case of spinal cord compression due to spontaneous extradural spinal hematoma
      is reported. A spinal arteriovenous malformation was suspected on the basis of
      magnetic resonance imaging. Early surgical exploration allowed a complete
      neurological recovery. The vascular malformation was histopathologically
      confirmed. The role of magnetic resonance imaging in the evaluation of acute
      spinal cord compression syndromes is stressed.

PMID- 2218857
TI  - Spinal extradural cavernous hemangioma.
AB  - Three cases of isolated spinal extradural cavernous hemangiomas are reported, two
      in the thoracic and one in the lumbar region. One of them manifested as acute
      cord compression, the other two as chronic progressive myelopathy or
      radiculopathy. A total excision or subtotal excision with irradiation was
      performed. All of them had good functional recovery. The clinical picture,
      radiological diagnosis, and optimal method of treatment are discussed. The
      relevant literature is reviewed.

PMID- 2218858
TI  - International perspective: neurological surgery in Nicaragua.

PMID- 2218859
TI  - Two surgically cured cases of sub-ependymoma with emphasis on magnetic resonance
      imaging.

PMID- 2218860
TI  - [The results of simultaneous radio-chemotherapy in advanced head and neck
      tumors].
AB  - Patients suffering from locally advanced squamous cell carcinoma of the head and
      neck were treated with three courses of simultaneous radio-chemotherapy.
      Chemotherapy consisted of cis-platinum, 60 mg/m2 i.v. on day 2; 5-FU, 350 mg/m2
      i.v. bolus on day 2; leucovorin calcium, 50 mg/m2 i.v. on day 2; 5-FU, 350
      mg/m2/24 hrs continuously infused over 96 hrs from day 2 to day 5 and leucovorin
      calcium, 100 mg/m2/24 hrs continuously infused over 96 hours from day 2 to day 5
      each course. Radiotherapy was administered from day 3 to day 11. 23.4 Gy were
      given in 13 fractions, twice a day with a minimum interval of four hours. This
      schedule was repeated on days 22 and 44. The total radiation dose amounted to
      70.2 Gy/51 days. From 1984 to 1986, 62 patients were entered in this prospective
      trial. Three patients deceased due to massive hemorrhage during therapy, one
      patient was not eligible due to a second malignancy. 5/58 evaluable patients had
      a UICC-Stage III cancer, 53/58 had a UICC-Stage IV cancer. 48/58 (81%) showed a
      clinically complete response to therapy, 10/58 (17%) achieved partial response
      three months after the end of treatment. In 16/58 patients loco-regional cancer
      was not controlled (minimum follow-up 2 years), in 12/58 distant metastases
      occurred. Loco-regional control rate is estimated at 66% +/- 7% (Kaplan Maier).

PMID- 2218861
TI  - A simple experimental technique for interstitial iridium-192 high dose-rate
      afterloading.
AB  - A simple experimental technique for interstitial iridium-192 high dose-rate
      afterloading is described which allows to perform experimental brachytherapy on a
      rat tumor model. To illustrate the possibilities and limitations of the
      technique, rhabdomyosarcoma R1H of the rat were subjected to a combined brachy-
      and teletherapy treatment applying a total dose of 60 Gy in fractions of 2 Gy.
      The results show that the surgical procedure had no influence on tumor response.
      However, would healing was considerably disturbed in animals which received
      afterloading treatment.

PMID- 2218862
TI  - Optimized afterloading therapy of cervix carcinoma with the discontinuous
      movement of the iridium source.
AB  - Optimization of brachytherapy means first of all a physical adaptation of
      isodoses to shape and tolerances of radiosensitive tissues surrounding the target
      volume, and also to shape and dosage requirements of the tumor to be treated.
      Dose computation algorithms for optimizing afterloading therapy postulate the
      discontinuous movement of the iridium source. A new method for the application of
      the discontinuous movement to our afterloading equipment was worked out. It
      combines the abilities of the source movements and the demands of the clinical
      optimization of the isodoses used for the brachytherapy of cervix carcinoma.

PMID- 2218864
TI  - [Aspects of the computer-assisted irradiation planning for the HDR (high dose
      rate) afterloading technique].
AB  - A mathematical optimization method will be discussed concerning the three
      dimensional radiation treatment planning of the HDR-afterloading technique.
      Program libraries of the EDV Center of the University of Essen were used.

PMID- 2218863
TI  - [A low-cost localization technique for high-dose-rate afterloading applicators].
AB  - For radiation safety control radiotherapy today needs a method to check the
      correct position of a HDR-gynecological applicator before afterloading treatment.
      At the university clinic in Essen, West Germany, a surgical c-X-ray plant was
      used for the construction of an orthogonal X-ray-photograph plant, which combines
      illumination and photographs as localisation technique.

PMID- 2218866
TI  - An energy monitor for electron accelerators.
AB  - A monitor useful for checks of the energy selector scale of medical electron
      accelerators was developed and tested. It consists of a linear array of flat
      ionization chambers sandwiched between absorber plates of low-Z material. The
      first chamber at the electron beam entrance may be used to produce a reference
      signal Sr, if not another suitable reference signal is taken. The following
      chambers are electrically connected and deliver the measuring signal Sm. A
      clinical dosimeter can be used for recording current or charge. The energy
      dependent electron range parameters Rp, R50 and R80 in water vary as linear
      functions of the ratio Sm/Sr. The best linear fit was obtained for the half value
      layer R50. Three types of the energy monitor are described, and experimental
      results obtained with a linear accelerator and a betatron between 5 and 25 MeV
      are reported. Uncertainties for checks of R50 with a calibrated energy monitor
      were not larger than 1 to 2 mm. Theoretical considerations by a computer model
      support these results.

PMID- 2218865
TI  - [Dose calculation for very small irregular electron beam fields. 1. Dose
      calculation for the central beam using a simple field zone method].
AB  - Very small electron beams show considerable reduction of the dose output factor,
      the therapeutically relevant range, the practical range and the therapeutically
      relevant field size, compared to broad beams. The first three effects were
      measured on the central beam axis for different quadratic field sizes and are
      presented in the first part of this publication. A simple field zone method for
      calculation of irregular shaped electron beams was developed from the different
      depth dose curves. The method allows the determination of the maximum dose and
      the 80% range with sufficient accuracy for practical purposes. The examination of
      the reduction of the therapeutically relevant field size and the consequences
      following thereof with respect to the adequate electron therapy of a small
      irregular target volume will be published in a second part.

PMID- 2218867
TI  - Comparison of micronucleus frequencies and proliferation kinetics in three X
      irradiated cell lines.
AB  - The kinetics of the occurrence of micronuclei was correlated with the survival of
      three mammalian cell lines of human, monkey, and mouse origin after irradiation
      with 240 kV X-rays. Particular attention was paid to the evaluation of the
      individual proliferation kinetics of the cell lines as well as to the
      characterization of micronuclei subpopulation with respect to size and possible
      biological importance using DNA and BUdR labelling techniques, fluorescence
      microscopy, and image analysis. The results demonstrate very characteristic size
      distributions of micronuclei for the three cell lines independent of radiation
      dose and time after irradiation. A close correlation between cell death and the
      occurrence of micronuclei (expressed as a calculated "MN index") after
      irradiation could be established only when the kinetics of progression of cells
      through the cell cycle (e.g. the doubling time) and the biological
      characteristics of micronuclei (e.g. BUdR positivity, the micronucleus
      frequencies, and the number of micronuclei per main nucleus) were taken into
      account. Therefore, the micronucleus assay might not be useful as a quantitative
      predictive assay in vivo but may allow qualitative estimations of radiation
      damage only because the necessary proliferation parameters of the cells might not
      be possible to establish in vivo.

PMID- 2218868
TI  - [The effect of adriamycin derivatives in combination with x-rays on MeWo and Be11
      cells].
AB  - The survival rate of human melanoma cells after X-ray irradiation, treatment with
      adriamycin derivatives and combined treatment with X-rays and adriamycin
      derivatives was measured by means of the colony formation test. After X-ray
      irradiation the melanoma cells showed a high resistance for cell survival. In all
      tests the Be11-cells were more resistant than MeWo-cells. On combined exposure
      especially with higher doses of adriamycin derivatives, both cell lines showed
      the interesting effect, that with increasing concentration the survival rate
      decreased whereas the D(o) increased. Aclacinomycin-A (ACM-A) and Pirarubicin
      reduced recovery processes after X-ray irradiation. Therefore Be11-cells showed a
      four times higher DMF (dosis modifying factor) after ACM-A-treatment than MeWo
      cells. Low ACM-A-concentrations combined with low X-ray doses showed on both cell
      lines supraadditive effects. The effect of pirarubicin was in most of the tests
      only additive. Compared with ACM-A, pirarubicin was less cytotoxic, showed a
      larger therapeutic range, caused a smaller D(o) and Dq and had a supraadditive
      effect in low concentrations on both cell lines. For clinical combined therapy
      with patients ACM-A is probably better suited than pirarubicin.

PMID- 2218869
TI  - The challenge of a new decade--a surgeon's perspective of the 1990s.

PMID- 2218870
TI  - Prospective evaluation of clinical and pathologic detection of axillary
      metastases in patients with carcinoma of the breast.
AB  - Complete axillary dissection was performed in 287 patients undergoing modified
      radical mastectomy between 1984 and 1987 to identify patterns of axillary node
      metastases, as well as discontinuous axillary node ("skip") metastases. Positive
      pathologic findings were compared with preoperative clinical examinations in 266
      patients and showed only 60 cases (22.6%) clinically suspicious for tumor, in
      contrast to 131 (45.6%) with pathologically confirmed positive lymph nodes.
      Axillary contents were classified level I, II, or III based on their relationship
      to the pectoralis minor muscle. An average of 24.2 nodes was resected per patient
      (level I, 10; level II, 8.1; and level III, 5.3). Tumors ranged in size from 0.5
      to 12.0 cm (mean, 2.6 cm), and increasing tumor size was associated with an
      increased likelihood of positive nodes. The data on 204 patients with complete
      clinical and pathologic data show that of 119 patients with negative level I
      nodes a limited axillary dissection (level I only) would fail to identify 6 with
      positive level II and 2 with positive level III nodes, whereas of 85 patients
      with positive level I nodes limited axillary dissection would fail to identify 17
      with positive level II nodes, 7 with positive level III nodes, and 27 with
      positive levels II and III nodes. Complete axillary dissection (levels I, II, and
      III) should be performed to stage patients accurately, as well as to remove tumor
      involved nodes and diminish local axillary recurrences. Clinical examination of
      the axilla appears to be a poor means of identifying axillary metastatic cancer.

PMID- 2218871
TI  - Short-term tamoxifen plus chemotherapy: superior results in node-positive breast
      cancer.
AB  - Three hundred eleven patients with node-positive breast cancer were randomized to
      one of three adjuvant treatments: cyclophosphamide (Cytoxan), methotrexate, and 5
      fluorouracil; all of the above with tamoxifen citrate; or all of the above with
      tamoxifen and bacillus Calmette-Guerin vaccination. Local therapy for all
      patients was a modified radical mastectomy. Estrogen receptors were measured on
      all primary tumors. Patients were stratified by the number of positive nodes (one
      to three nodes and more than three nodes) and estrogen-receptor value (less than
      3 femtomole/mg and greater than or equal to 3 femtomole/mg). Follow-up is
      available, with a mean of 9.1 and maximum of 14.2 years. In this study the
      efficacy of short-term tamoxifen is apparent over that of chemoimmunotherapy
      alone and continues to be significant with prolonged follow-up. The addition of
      tamoxifen to chemoimmunotherapy significantly prolonged disease-free survival
      among patients with estrogen receptor-positive tumors who were postmenopausal,
      who had larger tumors (greater than 3 cm), or who had more extensive axillary
      node involvement (more than three nodes). Tamoxifen improved overall survival for
      patients with estrogen receptor-positive tumors larger than 3 cm. The addition of
      bacillus Calmette-Guerin Cytoxan, methotrexate, 5-fluorouracil, and tamoxifen did
      not significantly alter disease-free or overall survival.

PMID- 2218872
TI  - Ascending cholangitis: surgery versus endoscopic or percutaneous drainage.
AB  - A retrospective review of 61 patients with calculous cholangitis was carried out.
      There were 31 men and 30 women and their mean age was 75.8 years. All patients
      had abdominal pain, 87% had chills and fever, 65% had clinical jaundice, 23% were
      in shock, and 54% had positive blood cultures. Because intravenous hydration and
      antibiotics did not help, 33 patients underwent surgery, 25 patients underwent
      endoscopic papillotomy (EP), and three patients underwent percutaneous
      transhepatic drainage of the common bile duct (PTD). Morbidity in the surgery
      group included two wound infections, one respiratory failure, and one renal
      failure. Morbidity in the EP-PTD group was one case of arterial bleeding
      requiring surgery and one of pancreatitis treated conservatively. Two patients
      (6%) died in the surgery group, one of sepsis and the other of cardiorespiratory
      arrest. In the EP-PTD group nine patients (32%) died of sepsis and multisystem
      organ failure. These patients were considered too ill to undergo surgery and thus
      repeat EP-PTD was carried out. Cholangitis persisted, and retained common bile
      duct stones with sepsis was the cause of death. Thus when initial EP or PTD is
      unsuccessful, surgical exploration of the common bile duct should be carried out
      to control sepsis.

PMID- 2218873
TI  - Are cystgastrostomy and cystjejunostomy equivalent operations for pancreatic
      pseudocysts?
AB  - To compare the effectiveness of cystgastrostomy and cystjejunostomy for treatment
      of pancreatic pseudocysts, 39 patients with cystgastrostomy were compared to 59
      patients with cystjejunostomy. The groups were comparable in age, sex, cause of
      pancreatitis, pseudocyst location, symptoms, and preoperative serum amylase
      level. Cysts treated with cystgastrostomy were larger (mean diameter, 11.1 +/-
      0.9 cm) than cysts treated by cystjejunostomy (mean diameter, 6.7 +/- 0.7 cm) (p
      less than 0.05). Mean duration of surgery was 148 +/- 11 minutes for
      cystgastrostomy versus 265 +/- 15 minutes for cystjejunostomy (p less than 0.05).
      Mean blood loss was 397 +/- 82 ml for cystgastrostomy versus 703 +/- 80 ml for
      cystjejunostomy (p less than 0.05) Mean intraoperative fluid requirements were
      2640 +/- 313 ml for cystgastrostomy and 4403 +/- 362 ml for cystjejunostomy (p
      less than 0.05). Cyst recurrence was 10% for cystgastrostomy versus 7% for
      cystgastrostomy. Postoperative gastrointestinal bleeding occurred in 8% of
      patients with cystgastrostomy and in 2% of patients with cystjejunostomy.
      Infection problems with cystjejunostomy included two wound infections and one
      case of septicemia; infection problems with cystjejunostomy included five
      intraabdominal abscesses, two wound infections, and one case of pneumonia. Two
      patients died with cystgastrostomy (both from gastrointestinal bleeding); two
      patients died with cystjejunostomy (one from intraabdominal sepsis and one from
      pulmonary embolus). Cystgastrostomy was used for significantly larger pseudocysts
      and was associated with significantly less blood loss and operating time than
      cystjejunostomy (p less than 0.05). Morbidity and mortality from cystgastrostomy
      and cystjejunostomy were comparable, although gastrointestinal bleeding was more
      common with cystgastrostomy and intraabdominal abscess was more common with
      cystjejunostomy. Since cystgastrostomy can usually be performed more quickly and
      with less blood loss, it should be considered whenever anatomically feasible.

PMID- 2218874
TI  - Pancreatogastrostomy: a safe drainage procedure after pancreatoduodenectomy.
AB  - The purpose of this study was to evaluate the role of pancreaticogastrostomy as
      an alternative method of restoring pancreaticointestinal continuity after
      pancreaticoduodenectomy. Since 1975, 45 patients have undergone
      pancreaticogastrostomy after pancreaticoduodenectomy at our institution.
      Pancreaticoduodenectomy was performed for pancreatic carcinoma (24 patients),
      ampullary carcinoma (8 patients), duodenal carcinoma (4 patients), common bile
      duct carcinoma (4 patients), pancreatic islet cell carcinoma (1 patient), trauma
      (1 patient), extensive colon carcinoma (1 patient), chronic pancreatitis (1
      patient), and gastroduodenal artery aneurysm (1 patient). There was one operative
      death, for an overall operative mortality rate of 2%, and seven patients had
      major postoperative complications, for an overall morbidity rate of 15%. No
      pancreatic anastomotic leaks or other complications related to the
      pancreaticogastrostomy occurred. Twenty-four patients have died of recurrent
      carcinoma, with a mean survival of 25 months (range, 5 to 66 months), and 20
      patients are alive and well, with a mean follow-up of 27 months (range, 2 to 106
      months). Eight of these patients are alive 2 or more years after operation and
      four do not have exocrine pancreatic insufficiency. This experience confirms that
      pancreaticogastrostomy is a safe method of pancreatic drainage after
      pancreaticoduodenectomy and suggests that it may have technical advantages and
      therefore merits more widespread application.

PMID- 2218875
TI  - Early results of combined electrohydraulic shock-wave lithotripsy and oral
      litholytic therapy of gallbladder stones at the University of Iowa.
AB  - One hundred thirty-three patients were entered into a randomized, double-blind,
      placebo-controlled trial of extracorporeal shock-wave lithotripsy for symptomatic
      gallstones versus extracorporeal shock-wave lithotripsy plus adjuvant litholytic
      therapy with ursodeoxycholic acid (UDCA). Six months after lithotripsy, patients
      receiving placebo were crossed over to UDCA therapy without unblinding the study.
      One hundred sixteen patients have completed 6 months of follow-up. Five patients
      were dropped from the study. Nine percent have required cholecystectomy (11
      patients with biliary colic and 1 with acute cholecystitis). Ninety-one patients
      had a solitary stone (64 patients had stones less than or equal to 20 mm and 27
      patients had stones greater than 20 mm in diameter), and 25 patients had two to
      three stones. Fifty percent were retreated. Cumulative stone-free rates at 6, 12,
      and 18 months were 26%, 39%, and 41%, respectively. At 6 months there was a
      significant advantage for patients treated with UDCA versus placebo (36% vs 17%
      were stone free) that had disappeared by 12 months (placebo-treated patients had
      received 6 months of UDCA). Patients with solitary stones equal to or less than
      20 mm in diameter treated with UDCA had stone-free rates at 6, 12, and 18 months
      of 58%, 58%, and 62%, respectively, versus 27%, 56%, and 50%. The difference was
      significant only at the 6- month follow-up. Stone-free rates for patients with
      large solitary stones and multiple stones were very low. Extracorporeal shock
      wave lithotripsy is both safe and effective therapy for treatment of symptomatic
      gallstones in patients with a solitary stone equal to or less than 20 mm in
      diameter. UDCA markedly improves the efficiency of the procedure and results in a
      stone-free gallbladder sooner.

PMID- 2218876
TI  - Early tracheostomy for primary airway management in the surgical critical care
      setting.
AB  - During a 12-month period, 264 patients with multiple injuries who required
      mechanical ventilation were admitted to the surgical intensive care unit. One
      hundred twenty patients (46%) were disengaged from the ventilator, and 38
      patients (14%) died. Of the remaining 106 patients (40%) 51 patients (group I)
      were to receive tracheostomy within 1 to 7 days, and 55 patients (group II)
      underwent late (8 or more days after admission) tracheostomy. Multiple variables
      in four categories (admission, operative, ventilatory, and outcome) were analyzed
      prospectively to define the impact that early tracheostomy had on duration of
      mechanical ventilation, intensive care stay, and hospital stay. Morbidity and
      mortality rates of the procedures were assessed. Early tracheostomy, in a
      homogeneous group of critically ill patients, is associated with a significant
      decrease in duration of mechanical ventilation, as well as shorter intensive care
      unit and hospital stays, compared with translaryngeal endotracheal intubation.
      There were no deaths attributable to tracheostomy, and overall morbidity of the
      procedures was 4%. We conclude that early tracheostomy has an overall risk
      equivalent to that of endotracheal intubation. Furthermore, early tracheostomy
      shortens days on the ventilator and intensive care unit and hospital days and
      should be considered for patients in the intensive care unit at risk for more
      than 7 days of intubation.

PMID- 2218877
TI  - Combined orthopedic and vascular injury in the lower extremities: indications for
      amputation.
AB  - A retrospective review was undertaken to determine risk factors associated with
      amputation after open fractures of the lower extremity that were complicated by
      vascular injury. During an 11-year period ending in December 1987, we observed
      open fractures in 31 patients and injuries to the popliteal artery in 16
      patients, to the tibial arteries in eight patients, to the femoral artery in five
      patients, and to the dorsal artery of the foot in two patients. Vascular repair
      was accomplished in 25 patients; 12 patients had primary end-to-end anastomosis,
      12 patients had reverse saphenous vein grafts, and one patient had a bovine
      graft. Of these 25 patients, five patients required amputation because of
      infection and three patients required amputation because of continued ischemia.
      Three patients with irreparable damage had immediate amputation, and three
      patients without distal ischemia had vessel ligation only. The risk factors
      associated with amputation were shock on admission (10 of 19 patients [p less
      than 0.02]) and a crushed extremity (10 of 18 patients [p less than 0.01]). The
      overall amputation rate, which included three immediate amputations and eight
      late amputations, was 35.2%. The data suggest that limb salvage is possible in
      two thirds of patients with combined orthopedic and vascular injuries of the
      lower extremity, but a history of shock or crush injury with vascular compromise
      is an unfavorable prognostic sign.

PMID- 2218878
TI  - Inadequate granulopoiesis after major torso trauma: a hematopoietic regulatory
      paradox.
AB  - Late postinjury sepsis is largely the result of defective host defense including
      failure to maintain an adequate number of functioning phagocytic cells. In this
      study we used stem cell culture techniques to measure colony-stimulating activity
      and have quantitated the number of circulating myeloid stem cells to see if
      defects in granulopoiesis occur after major torso trauma. Forty-two acutely
      injured patients (13 blunt and 29 penetrating injuries; mean age, 29.7 years)
      undergoing laparotomy with an abdominal trauma index of 15 to 40 were studied
      prospectively. Blood samples were obtained on days 1, 5, and 10. Patients were
      segregated by injury severity: abdominal trauma index less than 25 (n = 25)
      versus abdominal trauma index greater than or equal to 25 (n = 17). The more
      severely injured (abdominal trauma index greater than or equal to 25) patients
      had fewer circulating granulocytes and monocytes. Colony-stimulating activity was
      below normal control levels in all patients and was decreased further with
      increased injury severity. The more severely injured patients had a blunted bone
      marrow response (significantly fewer circulating myeloid stem cells) and suffered
      more major septic complications (24% vs 8%). In conclusion, major trauma to the
      torso causes a paradoxic depression in granulopoiesis that worsens with increased
      injury severity and may contribute to late septic morbidity. This colony
      stimulating activity deficiency state is similar to that seen after major burns
      and may be amenable to future modulation.

PMID- 2218879
TI  - Subxiphoid pericardiotomy versus echocardiography: a prospective evaluation of
      the diagnosis of occult penetrating cardiac injury.
AB  - Diagnostic subxiphoid pericardiotomy (SP) is presently advocated for the
      diagnosis of occult cardiac injuries in patients with stable vital signs with
      juxta-cardiac-penetrating chest wounds. This approach, however, results in a
      reported 80% negative pericardial exploration rate. To investigate the
      reliability of bedside two-dimension echocardiography (2-D echo) in predicting
      cardiac injury as compared to SP, a prospective study was undertaken of patients
      with stable vital signs who were admitted with penetrating chest wounds that were
      located within the space bounded by the manubrium, nipples, and subcostal line.
      Initial evaluation of the patients with bedside 2-D echo was found to have a 96%
      accuracy, 97% specificity, and 90% sensitivity in predicting cardiac injury. The
      only false-negative findings were in a patient who consented to SP 18 hours after
      bedside 2-D echo was performed. The reliability of bedside 2-D echo compared to
      SP was not significantly different according to the kappa measure of reliability.
      These data suggest that bedside 2-D echo is an expeditious and reliable method to
      diagnose occult cardiac injuries during the initial assessment of a patient with
      stable vital signs who had penetrating chest trauma. This approach may allow for
      the selective use of SP on patients with positive bedside 2-D echo and could
      eliminate unnecessary surgical procedures.

PMID- 2218880
TI  - The use of the Jarvik-7 total artificial heart and the Symbion ventricular assist
      device as a bridge to transplantation.
AB  - The proliferation of transplantation programs has not been paralleled by a
      similar increase in the availability of organ donors. Between 1984 and 1987, 104
      orthotopic heart transplantations were performed at Loyola University Medical
      Center. During the same period, 25 patients died while awaiting a donor organ. To
      reduce the mortality, we began using the total artificial heart (TAH) and a
      ventricular assist device (VAD) as a bridge to transplantation in 1988. Of 29
      patients who underwent transplantation, 15 patients required a TAH and three
      patients required a VAD as a bridge. The underlying heart conditions were
      ischemic cardiomyopathy (11 patients), dilated cardiomyopathy (5 patients), giant
      cell myocarditis (1 patient), and allograft failure (1 patient). The average
      duration of mechanical support was 10 days (range, 1 to 35 days). Of the 17
      patients who successfully underwent transplantation, 1 patient died at 17 days
      because of acute rejection of the transplanted heart, and another patient died at
      14 days because of a cerebral vascular event. Fifteen patients (83%) were long
      term survivors. Nine patients required reoperation for bleeding. While the
      mechanical device was in place, the activated clotting time was maintained
      between 170 and 200 seconds with heparin. Dipyridamole was given. We conclude
      that the TAH and VAD are excellent mechanical bridges to transplantation.

PMID- 2218881
TI  - Heparin-induced thrombocytopenia in patients who undergo open heart surgery.
AB  - To determine whether heparin-dependent antiplatelet antibodies (HAAb) have an
      effect on morbidity and/or mortality rates, we reviewed the cases of 3438
      patients who underwent open heart surgery from 1981 to 1989. Forty-six patients
      (1.3%) had HAAb. The patients were divided into two groups: those patients who
      were known to have HAAb before surgery (group I) and those patients who were
      diagnosed with HAAb after surgery (group II). Group I patients (n = 5) were
      pretreated with platelet-inhibiting drugs before reexposure to heparin during
      cardiopulmonary bypass and were maintained with strict abstinence from heparin
      afterward. Their lowest observed platelet counts ranged from 42,000/mm3 to
      89,000/mm3 (median, 63,00/mm3). Thromboembolic complications did not occur, and
      all patients survived. Group II patients (n = 41) who were diagnosed to have HAAb
      after surgery had not been pretreated with platelet-inhibiting drugs before
      surgery. Lowest platelet counts ranged from 11,000/mm3 to 128,000/mm3 (median,
      42,000/mm3). Bleeding complications occurred in 21 patients (51%), and
      thromboembolic complications occurred in 13 patients (32%). Hospital mortality in
      group II patients was 37%. Late recognition of HAAb was associated with an
      increase in morbidity and mortality rates. Thromboembolic complications of HAAb,
      which had been diagnosed before surgery, were eliminated, and bleeding was
      reduced by pretreatment with platelet-inhibiting drugs and strict abstinence from
      heparin after surgery.

PMID- 2218882
TI  - Is DNA ploidy of prognostic significance in stage I cutaneous melanoma?
AB  - Recent studies have suggested that the presence of DNA aneuploidy in stage I
      cutaneous melanoma carries a poor prognosis. To see if our experience correlated
      with these reports, we used DNA analysis by flow cytometry of propidium iodide
      stained nuclei disaggregated from formalin-fixed paraffin-embedded tissue of
      biopsy specimens to retrospectively study 55 patients who had cutaneous stage I
      melanomas. The patients had been treated from 1977 to 1987 with a mean follow-up
      of 5.4 years. Thirty-nine (71%) of the 55 histograms were diploid, and 16 (29%)
      of the histograms were aneuploid. DNA content was significantly associated with
      other conventional prognostic factors, including growth pattern, ulceration,
      pathologic stage, tumor thickness, and Clark's level. DNA aneuploidy was
      significantly related to disease-free survival and predicted a poorer prognosis
      (p less than 0.05), but when stratified for tumor thickness it lost significance.
      A multivariate discriminant function analysis of 12 factors in melanoma showed
      six factors to be independently significant in determining prognosis. DNA content
      (p = 0.034) ranked fifth in importance behind growth pattern (p less than 0.001),
      ulceration (p less than 0.001), thickness (p = 0.001), and pathologic stage (p
      less than 0.005). DNA content, although significantly associated with
      conventional prognostic factors and disease-free survival, is not the best
      indicator of biologic behavior of melanomas in this study. Further investigation
      into its usefulness is necessary before DNA content can become a routine
      diagnostic modality in the work-up of stage I cutaneous melanomas.

PMID- 2218883
TI  - Anomalies of intestinal rotation in childhood: analysis of 447 cases.
AB  - This report concerns 447 infants and children with anomalies of rotation and
      fixation. Patients were placed in four groups based on initial symptoms. Group A
      involved 18 patients with acute midgut volvulus. At laparotomy, midgut volvulus
      was noted and reduction of midgut volvulus and a Ladd procedure were performed in
      10 cases and resection was required in 8. There were five deaths (28%). Group B
      included 54 children with chronic symptoms of intermittent volvulus or duodenal
      obstruction. Group C involved 44 cases of malrotation observed during exploration
      for other disorders. Patients in groups B and C underwent a Ladd procedure and
      appendectomy. There were five unrelated deaths. Group D included 331 neonates
      with malrotation caused by either diaphragmatic hernia (n = 111) or abdominal
      wall defects (n = 220). A Ladd procedure was performed on 48 patients with
      abdominal wall defects and 29 surviving children with diaphragmatic hernia. Only
      2 of 172 (1.2%) patients with abdominal wall defects and 1 of 34 (2.9%) patients
      with diaphragmatic hernia not treated for malrotation had midgut volvulus. Midgut
      volvulus is more common in infants and is associated with a high mortality rate
      (28%). Patients with malrotation and chronic obstructive symptoms or those
      observed during other elective procedures should undergo a Ladd procedure because
      of the risk of midgut volvulus. The risk of midgut volvulus is low in patients
      with abdominal wall defects and, probably as a result of adhesions from previous
      neonatal operations.

PMID- 2218884
TI  - Long-term follow-up of the ileoanal anastomosis in children and young adults.
AB  - The purpose of this study was to carry out a long-term study of the ileoanal
      anastomosis (IAA) in children and young adults, comparing the straight IAA to the
      J pouch. One hundred twenty-one young people who had undergone IAA were studied,
      with 114 available for long-term follow-up. One hundred one were 18 years and
      under. Forty-nine patients had a straight IAA and 72 had a J-pouch reservoir.
      There were no deaths. After surgery, three children had intraabdominal sepsis and
      one had pelvic sepsis, but it did not lead to excision of the IAA. The mean stool
      frequency in all 114 patients was 5.0 +/- 2.5 per day and 1.2 +/- 1.1 at night.
      The mean number of stools for the straight IAA was 6 per day and 2.1 at night.
      The mean number of stools for the straight IAA with balloon dilations was 5.8 per
      day and 1.2 at night, and for the J pouch it was 4 per day and 1 at night.
      Patients with both the J pouch and straight IAA had good to excellent sensation,
      with patients with the J pouch always able to distinguish flatus from stool in
      87% of patients and almost always in 13%. Daytime continence was very good in
      both groups. Moderate nighttime loss of stool occurred in 10 patients, 6 with a
      straight IAA and 4 with a J pouch. Ninety-five percent of the 114 patients were
      satisfied or very satisfied, with most children with a J pouch very satisfied.
      The J pouch remains the procedure of choice in young people.

PMID- 2218885
TI  - Kidney transplantation in patients aged sixty years and older.
AB  - Outcomes of renal transplantation were reviewed for 26 transplants performed in
      25 patients 60 years of age or older between 1985 and 1989. Three grafts were
      from family donors and 23 were from cadaver donors. Twenty-one were first
      transplants and five were retransplants. Cyclosporine was used as primary
      immunosuppression and azathioprine and prednisone were administered to most
      patients. Overall patient and graft actuarial survival rates were 79% and 71%,
      respectively, at both 1 and 3 years. Patients (n = 14) free of both diabetes and
      cardiac disease (low risk) had 1- and 3-year patient and graft survival rates of
      91% and 84%, respectively. Conversely, high-risk patients (n = 12) had patient
      and graft survival rates at 1 and 3 years of 67% and 58%, respectively. Early
      deaths (less than or equal to 6 months) were caused by sepsis (two patients) or
      cardiac events (three patients), and four of the five were in high-risk patients.
      Irreversible rejections and serious infectious complications were not as common
      as steroid-induced diabetes, which occurred in five patients. This experience
      suggests that kidney transplantation can be done safely and successfully in
      patients older than 60 years of age and should be the treatment of choice for low
      risk patients in this category.

PMID- 2218886
TI  - Beneficial effects of fetal liver tissue on fetal pancreatic transplantation.
AB  - Recently, composite grafts of hepatocytes and islets have been shown to improve
      the survival of hepatocytes. The possibility of a reciprocal effect of
      hepatocytes on islet function was investigated. Diabetic Lewis rats were
      isografted with (1) fetal pancreas and fetal liver (FP/FL), (2) fetal pancreas
      alone (FP), and (3) fetal pancreas and fetal spleen (FP/FS). Grafts were
      transplanted to the small bowel subserosa. All (6/6) FP/FL recipients were cured
      (glucose less than 250 mg/dl for greater than 30 days), whereas only 72% (13/18)
      of FP alone and 60% (3/5) of FP/FS recipients were cured. The amount of time to
      normoglycemia for FP/FS recipients was less (26 +/- 15 days) compared with FP (50
      +/- 29 days) or FP/FS recipients (71 +/- 40 days). Mean glucose levels at 6 weeks
      were 166 +/- 78 mg/dl, 237 +/- 97 mg/dl, and 355 +/- 81 mg/dl in cured FP/FL, FP,
      and FP/FS recipients, respectively. Glucose tolerance test results were not
      significantly different from those of nondiabetic control rats. In contrast to FP
      alone, FP/FL recipients had well-granulated hyperplastic islets and hepatocytes
      on histologic examination. When new isograft recipients were treated with
      cyclosporine, all FP recipients remained hyperglycemic; however, 75% (6/8) of
      FP/FL recipients were cured. In conclusion, FL in a composite graft with FP
      resulted in better engraftment, earlier isograft function, and protection from
      cyclosporine islet toxicity.

PMID- 2218887
TI  - Results of infrainguinal bypass for limb salvage in patients with end-stage renal
      disease.
AB  - Limb salvage in patients with end-stage renal disease (ESRD) is complicated by
      the diffuse, obstructive, calcific arteriopathy that makes anastomotic technique
      especially critical. Furthermore, decreased resistance to infection and impaired
      wound healing produced by host-factor deficiencies such as diabetes mellitus,
      hypoalbuminemia, uremia, and immunosuppression produce additional obstacles to
      successful limb salvage. This report summarizes our experience with distal
      arterial bypass procedures in these patients. A total of 32 bypass procedures
      were performed for limb salvage in 24 patients (17 diabetic) during a period of 5
      years. The operative mortality rate was 6%. During the same period, 635
      infrainguinal bypass procedures were performed by the in situ technique in
      patients without ESRD. Primary bypass patency was comparable in both groups at 24
      months (92% vs 90%). In the group with ESRD, overall limb salvage was 83% at 2
      years. Life-table analysis of bypass patency and limb salvage was thought not to
      be appropriate in the population with ESRD beyond 2 years because of the
      increased mortality rate (38%; 9/24) during this interval. It is important that
      limb salvage was achieved in diabetic patients with ESRD in the presence of
      extensive foot gangrene or ischemic ulceration. Revascularization should be
      considered strongly for limb salvage in all patients in this difficult
      population.

PMID- 2218888
TI  - Naloxone and spinal fluid drainage as adjuncts in the surgical treatment of
      thoracoabdominal and thoracic aneurysms.
AB  - Forty-seven patients who were treated for thoracoabdominal or thoracic aneurysms
      over a 5 1/2-year period were analyzed for neurologic deficit risk. Patients were
      divided into two groups for analysis. Twenty-four patients, who were treated from
      January 1984 to December 1986, did not undergo spinal fluid drainage or naloxone
      administration (group A). Twenty-three patients, who were treated from January
      1987 to August 1989, had spinal fluid drainage (group B); 12 patients in this
      group also received naloxone as an intravenous drip at 1 microgram/kg/hr for 48
      hours after surgery. Permanent neurologic deficits occurred in seven (29%) group
      A patients but in only one (4%) group B patient, who did not receive naloxone (p
      less than 0.03). The first two group B patients to receive naloxone showed
      complete reversal of neurologic deficits on waking from anesthesia. This
      significant reduction in neurologic deficit was associated with an increased 1
      year survival rate (72% in group A, 91% in group B). We conclude that the use of
      naloxone and spinal fluid drainage reduces the incidence of neurologic deficit
      that is associated with repair of thoracoabdominal and thoracic aortic aneurysms.
      This reduction in neurologic deficit is associated with improved survival in the
      long term. The observed reversal of postoperative neurologic deficits with
      naloxone implicates opiates as a major factor in the pathophysiology of spinal
      cord ischemia.

PMID- 2218889
TI  - Decreased parietal cell acid secretion after vagotomy is not associated with
      altered gastric prostaglandin levels.
AB  - In a previous investigation we demonstrated that after vagotomy there is a
      decreased ability of parietal cells to use intracellular cyclic adenosine
      monophosphate (cAMP). Prostaglandins are present in gastric mucosa and have been
      demonstrated to be inhibitors of in vivo and in vitro acid secretion through a
      cAMP-mediated mechanism. In the present study we have examined in vitro acid
      secretion and prostaglandin E2 levels in rabbits 8 weeks after vagotomy and
      pyloroplasty compared with control animals to investigate the possible role of
      prostaglandins in postvagotomy-impaired cAMP use. In vitro acid secretion was
      assessed in isolated gastric glands by 14C-labeled aminopyrine uptake and
      prostaglandin E2-generating capacity measured by high-pressure liquid
      chromatography. After vagotomy, there was a decrease in basal aminopyrine uptake
      (p less than 0.05), as well as that simulated by histamine and 8-bromo-cAMP (p
      less than 0.007). No differences were observed in prostaglandin E2 levels in
      either gastric glands or intact fundic mucosa (p greater than 0.5). These data
      suggest that impaired cAMP use observed in parietal cells after vagotomy is not
      the result of alterations in gastric prostaglandin levels.

PMID- 2218890
TI  - Circadian esophageal motor function in patients with gastroesophageal reflux
      disease.
AB  - Effective esophageal peristalsis is a major determinant of esophageal clearance
      function and may contribute to the development of complications in
      gastroesophageal reflux disease. Using 24-hour ambulatory esophageal manometry,
      we compared the circadian esophageal motor activity of normal volunteers to that
      of patients with increased esophageal exposure to gastric juice and various
      grades of mucosal injury (no mucosal injury, esophagitis, stricture, or Barrett's
      esophagus). The prevalence of a mechanically defective lower esophageal
      sphincter, esophageal acid exposure time, and the frequency of nonperistaltic
      esophageal contractions during the supine, upright, and meal periods increased
      with increasing severity of mucosal injury. The median amplitude of esophageal
      contractions was compromised only in patients with a mechanically defective
      sphincter. This was particularly so in patients with stricture or Barrett's
      esophagus and was associated with an increased frequency of ineffective
      contractions (less than 30 mm Hg). These data show that esophageal motor function
      deteriorates with increasing severity of mucosal injury. This appears to be
      caused by persistent reflux of gastric juice across a mechanically defective
      lower esophageal sphincter. The need for surgical correction of a mechanically
      defective sphincter before the loss of esophageal body function is implicated.

PMID- 2218891
TI  - Long-term results of surgical resection of locally advanced colorectal carcinoma.
AB  - This study was undertaken to review the long-term results of multivisceral
      resection of locally advanced colorectal carcinoma. Between 1964 and 1980, 1042
      patients underwent exploratory surgery for colorectal cancer. Of these, 58
      patients (5.5%) underwent curative multivisceral resection for suspected
      contiguous invasion by the primary tumor. Follow-up was complete for all
      patients. The primary tumors were located in the rectum (38 patients), sigmoid (9
      patients), left colon (6 patients), and right colon (5 patients). En bloc
      resection of other viscera included uterus, adnexa, bladder, vagina, small
      intestine, abdominal wall, liver, stomach, kidney, and ureter. The operative
      morbidity and mortality rates were 31% and 1.7%, respectively. Resection margins
      were free of tumor in 54 patients. In the four patients with tumor-positive
      resection margins, recurrence of disease was evident between 8 and 22 weeks after
      surgery (mean survival time, 8.2 months). Carcinomatous invasion of the resected
      contiguous organ was confirmed in 49 patients (84%). The mean survival time for
      patients without lymph node metastases was 100.7 months, but it was only 16.2
      months (p less than 0.01) for patients with lymph node metastases. Actuarial 5
      year disease-free survival rate for patients without lymph node metastases was
      76% (36 of 47 patients). None of the patients (0 of 11) with lymph node
      metastases survived for 5 years. Three of 36 of the 5-year survivors experienced
      recurrence of disease before the seventh postoperative year; no cancer-related
      deaths occurred between 7 and 25 years. These data suggest that survival in
      locally advanced colorectal carcinoma is more dependent on lymph node status than
      on the extent of local invasion. Effective disease control associated with
      survival in the long term can be achieved by multivisceral resection.

PMID- 2218892
TI  - Local recurrence after curative resection of colorectal adenocarcinoma.
AB  - A total of 853 patients with 861 colorectal adenocarcinomas were operated on at
      our institution between 1965 and 1981. Complete follow-up information was
      obtained in all but six patients (99.4%), and all available histologic slides
      were reviewed to determine pathologic stage and characteristics. Six hundred
      fifty-one patients (76.3%) underwent a potentially curative procedure, and their
      operative mortality rate was 2.8%. Of the 627 patients available for analysis, 50
      (8%) had a local recurrence. The median time to local recurrence was 18 months,
      and only 16% of local recurrences were diagnosed 5 years after the original
      resection. Median survival of patients with a local recurrence was 3 1/2 years
      from the original resection, and 16 patients (32%) survived 5 years or longer. A
      multivariate logistic regression analysis was conducted to examine the influence
      of several clinical and pathologic characteristics on local recurrence among
      Dukes' stages B and C adenocarcinomas (n = 539) after exclusion of patients with
      synchronous tumors (n = 8), postoperative deaths (n = 18), loss to follow-up (n =
      6), or incomplete data (n = 11). This analysis revealed that the local recurrence
      rate was significantly related to depth of invasion (B1 + C1 = 0%; B2 + C1 = 10%;
      p less than 0.01), site of origin (right plus transverse colon = 6%; left plus
      rectosigmoid colon = 10%; rectum = 12%; p less than 0.05), and lymphatic or
      capillary microinvasion (absent, 6%; present, 14%; p less than 0.05). This
      analysis attempts to identify patients at high risk for development of local
      recurrent disease to select candidates for postoperative adjuvant therapy.

PMID- 2218893
TI  - Follicular cell predominance in the cytologic examination of dominant thyroid
      nodules indicates a sixty percent incidence of neoplasia.
AB  - The interpretation of aspiration cytologic smears that contain a predominance of
      follicular components often presents a dilemma to the clinician who is treating a
      patient who has a dominant thyroid nodule, especially when thyroid-stimulating
      hormone suppression does not produce any significant involution of the dominant
      nodule. We reviewed a consecutive series of 555 fine-needle aspiration cytologic
      examinations of dominant thyroid nodules. All specimens that contained colloid or
      follicular cells mixed with lymphocytes or Hurthle cells were excluded from this
      review. Additionally, nine aspirates contained degenerated follicular cells with
      insufficient material for cytologic diagnosis. The remaining 76 specimens
      contained a predominance of follicular cells: 27 specimens were interpreted as
      containing "normal" follicular cells, and the remaining 49 specimens were read as
      "atypical" follicular cells. Histopathologic examination of the resected
      specimens indicated a 60% incidence of neoplasia (30% carcinoma, 30% adenoma) in
      which the aspiration cytologic study was interpreted as "normal" follicular
      cells. On the other hand, a 63% incidence of neoplasia (27% carcinoma, 36%
      adenoma) occurred in which the cytologic study was read as "atypical." In
      conclusion, aspirates showing a predominance of follicular cells, whether
      "normal" or "atypical" indicate a 60% incidence of neoplasia in dominant thyroid
      nodules that do not decrease significantly in size with thyroid-stimulating
      hormone suppression.

PMID- 2218894
TI  - Intraoperative parathormone level measurement in the management of
      hyperparathyroidism.
AB  - To investigate the potential use of intraoperative intact parathormone
      measurements to predict curative parathyroidectomy, we measured ionized calcium
      (Cai) levels and parathormone levels in 33 patients with hyperparathyroidism who
      underwent exploratory bilateral neck surgery. Nineteen patients each had a
      solitary adenoma, 13 patients had hyperplasia, and one patient had four normal
      parathyroid glands. These results were compared to the results for 37 patients
      who underwent either thyroid lobectomy (TL) (n = 10) or near-total thyroidectomy
      (NTT) (n = 27) and of 14 control patients who underwent miscellaneous operations.
      Parathormone decline after curative parathyroidectomy was 86.4 +/- 1.2% (mean +/-
      SE), which was significantly greater than a decline of 25.7% +/- 9.8% in three
      patients with persistent postoperative hyperparathyroidism (p less than 0.01).
      Declines were 38.5% +/- 8.7% after TL (p less than 0.01), 52.2% +/- 5.9% after
      NTT (p less than 0.01), and 8.3% +/- 4.3% (p less than 0.01), in the control
      patients. An intraoperative Cai decline of 4.0% +/- 0.6% after curative
      parathyroidectomy did not differ significantly from the results after TL, NTT, or
      miscellaneous operations in the control patients. Patients with persistent
      postoperative hyperparathyroidism had the greatest decline in Cai levels (7.1% +/
      2.3%; p less than 0.05). From these data we conclude that (1) a decline in
      parathormone level of 70% or more 20 minutes after parathyroidectomy is
      predictive of cure, (2) thyroidectomy, even unilaterally, produces a significant
      decline in parathormone level that affects interpretation of intraoperative
      parathormone level changes, (3) Cai level because of its slow decline is not
      useful in predicting effective parathyroidectomy, and (4) measurement of
      intraoperative parathormone level changes should not be used as a substitute for
      exploratory bilateral neck surgery.

PMID- 2218896
TI  - [Waiting time for abortion should be removed].

PMID- 2218897
TI  - [Danish Council of Nursing--the launching of a professional club].

PMID- 2218895
TI  - Assessment of cardiac function in patients who were morbidly obese.
AB  - Cardiac function of 30 patients who were morbidly obese was studied before
      bariatric surgery. Twelve patients were studied 13 +/- 4 months after surgery.
      These patients had a mean age of 37.1 +/- 2.9 years and a body mass index of 50.0
      +/- 1.4 kg/m2. Cardiac function was measured by echocardiography, radionuclide
      angiography scanning, and right heart catheterization. To determine the degree of
      cardiac dysfunction, the patients were studied with exercise and intravenous
      fluid challenges. Ultrasonography produced evidence of myocardial thickening with
      an increased interventricular septum in eight patients (32%) and increased left
      ventricular mass in 17 patients (53%). The radionuclide scan suggested that
      morbid obesity was associated with a significantly (p less than 0.05) increased
      end-diastolic volume and decreased left ventricular ejection fraction as compared
      with patients who were of normal weight. With exercise the patient who was of
      normal weight had an increase in the end-diastolic volume, stroke volume, and
      heart rate, but the patient who was morbidly obese only increased heart rate to
      produce the necessary increase in cardiac output. Right heart catheterization
      indicated that the relationship of the pulmonary wedge pressure and the left
      ventricular stroke work index was abnormal in 14 of 29 patients (48.3%) and
      depressed in six of 29 patients (20.7%) with exercise. One liter of fluid caused
      an abnormal relationship of the pulmonary wedge pressure and the left ventricular
      stroke work index in 12 of 30 patients (40%) and a depressed response in 10 of 30
      patients (33.3%). Cardiac studies were repeated in 12 patients after a 54.8 +/-
      1.9 kg weight loss. Echocardiography indicated a decrease in dilatation (27.3% to
      9.1%) and a significant (p less than 0.05) decrease in hypertrophy (45.5% to 0%).
      After the weight loss, radionuclide and right heart catheterization studies
      indicated improved cardiac function with reduced filling pressures and increased
      left ventricular work during fluid and exercise challenges. These results support
      the presence of obesity-related cardiomyopathy with ventricular dysfunction,
      which appears to be caused by a noncompliant ventricle. Significant weight loss
      achieved with gastroplasty results in increased ventricular compliance and
      improved cardiac function.

PMID- 2218898
TI  - [Unemployment insurance. Doubling of unemployed nurses].

PMID- 2218899
TI  - [Unemployment insurance. The first billion].

PMID- 2218900
TI  - [Denmark's best around-the-clock care automobile].

PMID- 2218901
TI  - [Cross-professional health care administration. Interview by Anne Brockenhuus
      Schack].

PMID- 2218902
TI  - [Melkersson-Rosenthal syndrome. Apropos of a clinical case].

PMID- 2218903
TI  - [Influence of occlusion on head posture, during periods of continuous
      intermaxillary pressure].
AB  - The influence of divergent splint-adjusted maximum intercuspation on head posture
      during prolonged phases of clenching was studied in five subjects. During
      clenching in maximum intercuspation profound changes of head posture were
      observed, if intercuspation was not harmonized with an upright posture of head
      and body. Since the interrelation between occlusion and head posture is
      established a comprehensive approach of orthopedic, physiotherapeutic, and dental
      measures, in particular for the therapy of myoarthropathy patients with cervical
      spine symptoms seems appropriate. Occlusal corrections and determination of
      occlusal relations must always be made or at least checked in the upright relaxed
      patient with the head straight.

PMID- 2218904
TI  - [Occlusal rehabilitation in cranio-mandibular dysfunction syndrome with
      ceramometal restorations].
AB  - We present a clinical case of a temporo-mandibular joint dysfunction pain
      syndrome treated with occlusal rehabilitation consisting on ceramometalic
      prosthodontic restorations. The result obtained after five years of evolution is
      excellent, due to the use of adequate technical and clinical procedures together
      with suitable hygienic habits and the post-treatment establishment of an occlusal
      splint used exclusively at night.

PMID- 2218906
TI  - [Kidney involvement in cryoglobulinemia].
AB  - The authors provide the reported data on renal impairment in mixed
      cryoglobulinemia (CGE) and 3 own CGE case reports. Renal impairment by the type
      of rapid-progressing nephritis with episodes of acute renal failure was the major
      sign in the clinical picture of those cases.

PMID- 2218905
TI  - [Kidney involvement in patients with rheumatoid arthritis].
AB  - Renal pathology was revealed in 284 out of 498 patients with rheumatoid arthritis
      (RA) subjected to the 15 years' prospective controlled follow-up and given
      individualized pharmacotherapy. Biopsy specimens of the kidney were examined in
      90 cases. Of these, in 14 patients, they were examined repeatedly. On morphology
      the following alterations were detected in renal tissue: minimum morphological
      alterations (18 cases), glomerulonephritis (32 cases), amyloidosis (53 cases),
      interstitial nephritis (4 cases), and arteriosclerotic nephrosclerosis (1 case).
      In patients with nephropathy, no pathology nas revealed on morphology (5 cases).
      Chronic pyelonephritis was diagnosed in 137, nephroptosis in 47, nephrolithiasis
      in 17, papillary necrosis in 3, and drug nephropathy in 33 patients. Many
      patients had concomitant renal pathology. Repeated morphological examinations of
      renal tissue point to dynamic morphological alterations occurring during
      treatment and disease. Chlorbutin was found to exert a beneficial effect not only
      on the manifestations of arthritis but also on renal tissue. It could be seen in
      patients with a primary morphological diagnosis of mesangioproliferative
      nephritis and minimum morphological alterations in renal tissue. In some cases
      the clinical and morphological data did not agree, which provides evidence in
      favour of making renal biopsy in RA patients with a purpose of early diagnosis
      and specification of renal pathology, choice of the treatment policy.

PMID- 2218908
TI  - [The combination of diffuse kidney lesions with different diseases of the other
      organs of the urinary system (the diagnosis, characteristics of the course and
      outcomes)].
AB  - The author characterizes in detail 4340 patients with diffuse renal lesions
      (chronic glomerulonephritis, renal amyloidosis, lupoid nephritis, diabetic
      glomerulosclerosis and nephrosclerosis) coupled with different diseases of the
      urinary organs including urolithiasis, cancerous and tuberculous processes,
      purulent diseases of the kidneys and prostatic lesions. Stage III chronic renal
      failure (CRF) was revealed in 2073 (57.1%) out of the 4340 patients. All of them
      died because of uremia. The mean lifespan of the patients was 1.6 +/- 0.1 yr.
      since manifestation of the concomitant process. The shortest times of CRF onset,
      the highest frequency of stage III CRF and the least lifespan were noted in
      patients with double association, particularly in those suffering from associated
      chronic glomerulonephritis with renal amyloidosis and urinary bladder cancer in
      the stage of compression with tumor of the intramural parts of the ureters,
      namely they were 0.6 +/- 0.1, 100% and 1.0 +/- 0.1 yr., respectively. The author
      holds that the main reason for such an abrupt CRF onset in patients with
      concomitant renal lesions of any type lies in simultaneous combined influence on
      the kidneys of absolutely different diseases bearing in mind their etiology and
      pathogenesis. Besides, according to the author's data, considerable influences on
      the times of CRF onset and rates of its progress are produced by both the course
      and stage (phase) of the development of each of the coexistent diseases.
      Attention is drawn to the necessity of early participation of urologists in the
      solution of the problems concerned with the policy of managing nephrological
      patients with diseases of other organs of the urinary system as well as with
      permanent dynamic follow-up of all the patients with concomitant processes,
      especially with double ones.

PMID- 2218907
TI  - [New markers of collagen and basal membrane metabolism and kidney involvement in
      systemic scleroderma].
AB  - The study was made within the framework of the Soviet-Finnish cooperation and
      represents a fragment of work pertaining to the clinical trials of new markers of
      metabolism of collagen and basal membranes in patients afflicted with systemic
      scleroderma (SSD). Sufficient clinical material (84 SSD patients) and
      radioimmunoassays were employed to study the clinical significance of
      aminoterminal propeptide of type III procollagen. In SSD patients with renal
      impairment (n = 34) and without it, PIIINP and PIIINP-Fab, serum galactosyl
      hydroxylysylglucosyltransferase and two antigens of basal membranes-7S-domene of
      type IV collagen and PI-fragment of laminine were determined. Renal impairment
      was established to correlate with serum concentration of PIIINP-Fab (p less than
      0.007). PI-fragment of laminine. The parameters under study correlated as well
      with the disease course, the presence of arthritis and the Raynaud's syndrome
      gravity and can be regarded as markers of the disease activity and high fibrous
      formation lying at the basis of SSD.

PMID- 2218909
TI  - [The malignant hypertension syndrome: incontrovertible and questionable truths].
AB  - A total of 42 patients with malignant arterial hypertension (MAH) were examined.
      Of these, 32 patients had essential hypertension (26 with normal renal function
      and 6 with renal failure treated by programmed hemodialysis) and 10 suffered from
      chronic glomerulonephritis. The patients were examined for central hemodynamics,
      hormonal background (plasma renin activity) (PRA), plasma aldosterone and
      cortisol concentration. 14 patients underwent closed puncture biopsy of the
      kidneys. All the patients manifested high PRA associated activation of gluco- and
      mineralocorticoid adrenal function along with the hyperkinetic syndrome. MAH was
      characterized by dramatic discrepancy between the stroke and cardiac indices and
      specific peripheral resistance. Nephrosclerosis whose extent varied, attaining
      maximum in patients with associated essential hypertension and renal failure and
      in autopsy material, in addition to severe lesions of the renal vessels appeared
      to be the common feature of all morphological alterations. Plasmic impregnation
      and fibrinoid necrosis of the arterioles were not detectable in all the patients,
      being of focal character. The same alterations were identified in the patients
      during exacerbation of glomerulonephritis and in the absence of MAH. The data
      obtained point to the nonuniformity of MAH. Four clinicomorphological variants of
      MAH are suggested.

PMID- 2218910
TI  - [Na-Li countertransport and the diagnosis of hypertension and combined
      hypertension and renal artery stenosis].
AB  - The rate of Na-Li countertransport was studied in inpatients with essential
      hypertension (n = 59), chronic diffuse glomerulonephritis (n = 30), chronic
      pyelonephritis (n = 26), renovascular hypertension (n = 15) and in those with
      associated renovascular hypertension and essential hypertension (n = 4). Multiple
      regression analysis has demonstrated that age, body weight and blood plasma
      lipids do not make any significant contribution to dispersion of the counter
      transport rate. The mean rate of countertransport in patients with essential
      hypertension turned out much higher than that in patients with secondary
      hypertensions. Repeated examinations have shown that in every man, the
      countertransport rate remains unchanged for 1.5 yr. It is not affected either by
      hypotensive therapy or surgical treatment. In inpatients with secondary
      hypertension and low rates of countertransport, high arterial pressure (AP) drops
      after surgical treatment of the kidneys, renal vessels or adrenals. Surgical
      treatment of patients with secondary hypertension and high rates of
      countertransport does not lead to any material decrease of AP. It is assumed that
      the rate of Na-Li countertransport can be used for diagnosing associated
      secondary hypertensions and essential hypertension and prediction of AP lowering
      after surgical treatment.

PMID- 2218911
TI  - [The determination of the separate intrarenal hemodynamics and its place in the
      diagnosis of nephrogenic arterial hypertension].
AB  - Differential diagnosis between essential hypertension and secondary arterial
      hypertension (AH) that developed in the presence of chronic pyelonephritis was
      made in 12 patients with AH and the urinary syndrome (leukocyturia and
      bacteriuria). With that purpose in view for revealing functional renal asymmetry,
      a study was made of the effective renal plasma flow (ERPF) and glomerular
      filtration rate (GFR) in each kidney separately based on computation of 99Tc-DTPA
      and 131I-hippuran clearances. Some patients in whom AH was later regarded as
      essential manifested practically equal values of the ERPF and GFR from both
      sides, with the real characteristics of the latter ones being little different
      from the respective populational values calculated by computer bearing in mind
      the body surface of those patients. The other patients' group showed, along with
      a decrease of the total ERPF and GFR, a dramatic asymmetry of the intrarenal
      hemodynamics of both ERPF and GFR, which is fairly characteristic of chronic
      pyelonephritis. This allows the syndrome of AH to be regarded in those patients
      as secondary.

PMID- 2218912
TI  - [Acute nephrological situations in the physician's practice].

PMID- 2218913
TI  - [The current procedures in the treatment of amyloidosis].

PMID- 2218915
TI  - [The development of rapidly progressing glomerulonephritis in a patient with
      systemic atherosclerosis and hyperlipidemia type IV].

PMID- 2218914
TI  - [A case of Meyer-Betz's syndrome complicated by acute kidney failure].

PMID- 2218916
TI  - [Eosinophilic vasculitis: the diagnostic difficulties].

PMID- 2218917
TI  - [Nephrotic hyperlipidemia and its clinical significance].

PMID- 2218918
TI  - [The nephrological aspects of infection with the human immunodeficiency virus].

PMID- 2218919
TI  - [The outcomes and prognosis of a course of acute glomerulonephritis].
AB  - Observation of 131 patients with acute glomerulonephritis (AGN) experiencing the
      first year of disease made it possible to distinguish, by the 4th month of
      disease, the lingering disease patterns encountered in 100% of cases with the
      nephrotic form and typical for pronounced and little symptomatic AGN (96.1
      78.8%). As compared to the catamnestic data, 83 patients manifested (after 5.8 +/
      0.7 yr.) an unfavourable influence of the lingering disease course on AGN
      outcomes (the probability of convalescence dropped to 30.8-33.3% in pronounced
      and little symptomatic forms and was completely excluded in the nephrotic one)
      and a high diagnostic significance of the dynamics of the urinary syndrome for
      prognosis determination. The constancy of proteinuria at a level of over 1 g/day
      and hematuria at a level over 50.0 x 10(3)/ml within 4 to 6 months significantly
      deteriorated the prognosis. Virus nature of pronounced AGN can be indicated among
      other prognostic criteria. The other characteristics of the debut produced no
      significant effect on the disease outcome. The morphological signs of the chronic
      disease corresponded to mesangiomembranous glomerulonephritis whereas
      fibroplastic alterations were only observed in special forms of AGN marked by
      rapid progress.

PMID- 2218920
TI  - [Clinico-morphological variants of mesangioproliferative glomerulonephritis].

PMID- 2218922
TI  - [The nephrological aspects of gerontology].

PMID- 2218921
TI  - [The prognostic significance of the morphological and clinical characteristics of
      chronic glomerulonephritis].
AB  - In 520 patients followed up for 4 to 20 years a study was made of the
      relationship between the actual survival time and the morphological and clinical
      characteristics of chronic glomerulonephritis. A well-defined parallelism was
      established between the rate of disease progress and the rate of exacerbations as
      was an unfavorable prognostic importance of marked tubulointerstitial lesions and
      glomerular sclerosis, which was more manifest in frequent relapses. Considerable
      differences in the survival of patients with hypertension or associated
      hypertension and the nephrotic syndrome with varying process activity do not
      provide evidence in favour of their direct influence on the rate of the disease
      progress. As far as certain morphological patterns of glomerulonephritis are
      concerned, the prognosis is different because of specific clinical manifestations
      and anatomic alterations common to each disease pattern.

PMID- 2218923
TI  - [The effect of pregnancy on the course of different clinical forms and
      morphological variants of primary chronic glomerulonephritis].
AB  - The author relates the data on the time-course of changes in diurnal proteinuria,
      diastolic arterial pressure and blood creatinine in 123 patients with primary
      chronic glomerulonephritis seen during 159 pregnancies. The dependence of the
      character of those changes on the respective parameters before conception was
      analyzed as was such a dependence, in part of the patients, on the morphological
      disease pattern. The rise of proteinuria and diastolic arterial pressure during
      gestation was seen more often in women with initial diurnal protein losses
      exceeding 1g and with arterial hypertension that occurred before pregnancy. The
      rise of blood creatinine before conception was a prognostically unfavourable
      sign. Mesangiocapillary glomerulonephritis occurring in the gestation period is
      viewed as less favourable as compared to mesangioproliferative
      glomerulonephritis.

PMID- 2218924
TI  - [A clinico-pathogenetic approach to choosing the therapeutic procedure in chronic
      glomerulonephritis].
AB  - The results have been compared of the use of two schedules (continuous and
      cyclic) of multimodality therapy of chronic glomerulonephritis (CGN) including
      cytostatics, corticosteroids, anticoagulants and deaggregation agents. Continuous
      therapy was carried out for 12.9 +/- 0.41 months on the average, with the drug
      dosage being corrected depending on the clinico-laboratory and immunological
      findings as well as on the parameters of the hemostatic system. Cyclic therapy
      was conducted for 6 months according to a strictly unified program. It has been
      shown that continuous individualized treatment compares very favourably with the
      cyclic schedule, which is particularly marked in mesangiocapillary CGN and CGN
      with a tubulointerstitial component. It is concluded that continuous
      multimodality treatment chosen with regard to the clinico-pathogenetic disease
      characteristics allows CGN prognosis to be improved.

PMID- 2218926
TI  - [Rapidly progressing lupus nephritis].

PMID- 2218925
TI  - [The catamnestic assessment of the efficacy of combined pathogenetic therapy in
      patients with different clinico-morphological variants of chronic
      glomerulonephritis].
AB  - In 70 patients with functionally compensated chronic glomerulonephritis (CGN),
      the disease outcomes were elucidated after the use of the 4-component therapy (a
      cytostatic, an anticoagulant, an antiaggregation agent and prednisone). The
      therapy appeared much more effective in the nephrotic types of CGN than in the
      active nephritic types. Remission was only attained in a subgroup of patients
      with the active types: with an early stage of the maximally active type of
      mesangiocapillary CGN. In the nephrotic type CGN, the therapy was effective in
      short-phase disease and ineffective in long persistence of that syndrome. In the
      nephrotic types, mesangioproliferative CGN as well as the short-phase nephrotic
      syndrome irrespective of the morphological type turned out predictors of a
      favourable outcome following the treatment. No effect can be predicted in focal
      segmental hyalinosis/sclerosis accompanied by arterial hypertension and the
      protracted nephrotic syndrome.

PMID- 2218927
TI  - [The use of ultrahigh doses of corticosteroids in treating the most severe
      variants of lupus nephritis].
AB  - The authors analyze the 10-year experience gained with the use of steroid pulse
      therapy for the gravest forms of lupus nephritis--rapid-progressing lupus
      nephritis and active lupus nephritis associated with the nephrotic syndrome.
      Ultrahigh doses of prednisolone and methylprednisolone (1000 mg i. v. for 3 days)
      was monotherapy or as a constituent part of multimodality treatment were given to
      30 patients including 27 women and 3 men aged 18 to 48 years. Of these, 12
      patients had rapid-progressing lupus nephritis and 18 active lupus nephritis. The
      short-term treatment results were estimated after 1 to 3 months, whereas the long
      term ones after 12 months to 9 years. Analysis of the treatment results allows
      the following conclusions to be drawn: the use of steroid pulse-therapy was
      monotherapy is only justified in patients suffering from active lupus nephritis
      with the nephrotic syndrome without renal failure and only at the disease debut.
      In rapid-progressing lupus nephritis and long active lupus nephritis with the
      phenomena of renal failure, the positive effect can only be attained after
      combination of steroid pulse therapy and high doses of prednisolone per os or
      long intake of cytostatics per os or in the form of cytostatic pulses.

PMID- 2218928
TI  - [The role of the kidney lymphatic capillaries in the pathogenesis of the
      nephrotic syndrome].
AB  - As many as 16 patients with nephrotic syndrome (NS) of varying etiology and 10
      patients without the NS were examined for ultrastructure of lymph capillaries of
      the kidney. Many-staged changes, from regenerative to destructive ones,
      associated with proteinuria growth and formation of the NS were revealed in lymph
      capillaries of the kidney. Patients with the NS of long standing manifested
      irreversible destructive processes--destruction of the capillary walls,
      karyopyknosis and cytoplasm coagulation. Microcirculatory disorders may be
      regarded as one of the mechanisms implicated in nephropathy progress.

PMID- 2218929
TI  - [The renal functional reserve in the nephrotic syndrome].
AB  - Functional reserves of the kidneys (FRK) were examined in 29 patients with the
      nephrotic syndrome and in 14 healthy subjects. FRK were determined as the degree
      of the increase of endogenous creatinine clearance after stimulation with beef
      protein (0.7 g per kg bw) or dopamine (3 micrograms/min per kg bw). It was
      revealed that in 2/3 of the patients, FRK were lowered or lacking. The lack of
      FRK was seen in all the morphological varieties of renal lesions, with the
      frequency being greater in the severe clinical forms of the nephrotic syndrome,
      in lasting nephropathy, in association with arterial hypertension or renal
      failure. It has been noted that FRK may recover after successful treatment of the
      nephrotic syndrome, attesting to a favourable regimen of organ functioning and
      suggesting deceleration of the tempo of renal disease progress.

PMID- 2218930
TI  - [The chemotactic characteristics of the leukocytes and fibroblasts in
      amyloidosis].
AB  - Altogether 44 patients with amyloidosis (7 with primary, 24 with secondary and 13
      with hereditary associated with periodic disease) and different stages of renal
      impairment and 32 patients with chronic glomerulonephritis (CGN) (14 with the
      latent and 18 with the nephrotic form) were examined for chemotactic properties
      of peripheral blood leukocytes and skin fibroblasts in Boyden's chambers.
      Chemotaxis of leukocytes from patients with different clinical forms of
      amyloidosis was found to be decreased. That decrease manifested itself even at
      the proteinuric stage of renal impairment. Addition of autologous serum brought
      about another decrease of the chemotactic response of leukocytes. There was a
      lowering of chemotaxis of cultivated skin fibroblasts from amyloidosis patients,
      which remained unchanged on repeated cell passages. Chemotactic activity of
      cultivated fibroblasts from CGN patients did not differ from that of healthy
      persons' fibroblasts and embryonal fibroblast strain. Possible causes of the
      alterations revealed are discussed.

PMID- 2218931
TI  - [Richard Bright and the problems of modern nephrology (on the 200th anniversary
      of the birth of R. Bright)].

PMID- 2218932
TI  - [The epidemiological aspect of chronic kidney lesions of drug origin].
AB  - In order to establish the prevalence of the intake of the most widely used
      nephrotropic drugs (non-steroidal anti-inflammatory agents and analgesic
      antipyretic drugs), the authors have carried out epidemiological studies among
      the urban population. 5996 persons living in Riga were examined according to the
      designed by the authors 4-staged system using computer at the final stage. All
      the examined underwent analysis of the morning portion of urine. The drugs
      indicated were discovered to be taken for a long time in 14% of cases (in 15.4
      among women and in 11.8% among men). The use of the drugs was motivated by
      degenerative dystrophic alterations in the bones and joints (56.27%), complicated
      virus infections (9.68%), headache (2.99%), and by combination of the three
      enumerated causes (30.34%). In 0.72% of cases, the causes of drug intake could
      not be established. Depending on the presence of a concrete urinary symptom, a
      high relative and a high absolute risk of the development of chronic
      tubulointerstitial renal lesions provoked by drugs have been defined in cases of
      the prolonged use of the drugs under study.

PMID- 2218934
TI  - [The use of enterosorption in the combined therapy of patients with urolithiasis
      complicated by chronic kidney failure].
AB  - The results of conservative treatment of 51 patients with urolithiasis
      complicated by chronic renal failure in the intermittent stage have been
      analyzed. There were two groups of patients. The first one included 36 patients
      receiving enterosorption in addition to routine multimodality treatment. The
      second group was made up of 15 patients who did not undergo enterosorption which
      consisted in oral application of SKH-1K coal in a dose of 10 to 15 g 3 times a
      day 1.5 h after meal for 10 days. The treatment efficacy was judged from the
      patients' general health status, central hemodynamics (cardiac index and
      peripheral vascular resistance), the level of azotemia, and the content of medium
      sized molecules. As shown by the data obtained, the multimodality treatment
      coupled with enterosorption produced an appreciable improvement of the patients'
      health status, reduction of the signs of intoxication, while the level of medium
      sized molecules and creatinine reached the control. The hypokinetic circulatory
      syndrome seen before the treatment disappeared. At the same time the second group
      patients retained the high level of azotemia, whereas the content of medium-sized
      molecules remained increased. Besides, they demonstrated the hypokinetic
      circulatory syndrome. It is thus recommended that enterosorption be applied to
      the treatment of patients with chronic renal failure.

PMID- 2218933
TI  - [Changes in the thrombocyte and plasma factors of hemostasis in amyloidosis].

PMID- 2218936
TI  - [The effect of acetate and bicarbonate hemodialysis on protein and lipid
      metabolism in patients with chronic kidney failure].
AB  - In 26 patients with chronic renal failure undergoing hemodialysis, use was made
      of an acetate solution (40 mmol/l) and in 7 patients, of a bicarbonate solution
      (35 mmol/l). The control group was made up of 20 healthy volunteers. In addition
      to better tolerance, the bicarbonate dialysis favoured adequate correction of
      acid-base balance, normalization of hypercholesterolemia, lowering of the rate of
      protein degradation. Among patients on the acetate dialysis, subgroups with
      normal (9 persons) and delayed (17 persons) acetate utilization were
      distinguished. A close relationship was discovered between blood acetate
      concentration before procedure and the rate of urea generation (r = +0.79, p less
      than 0.05). It is assumed that the acetate dialysis intolerance is determined by
      protein hypercatabolism under the conditions of delayed utilization of acetate by
      the peripheral tissues.

PMID- 2218935
TI  - [Disordered lipid metabolism and the morphofunctional instability of the
      erythrocyte membranes in patients with terminal kidney failure].
AB  - Fifty-two patients with terminal renal failure (TRF) placed on elective
      hemodialysis were examined for serum lipids and red blood cell membranes with the
      aid of chromatographic separation of lipids in thin-layer silica gel on Silufol
      plates followed by densitometry. Spectrocytophotometry was employed to study red
      blood cell distribution on the basis of the content of lipoproteins in TRF
      patients. Fluidity of the lipid bilayer of the red blood cell membrane was
      measured on Hitachi spectrofluorimeter according to the degree of eximerization
      of fluorescent pyrene. Dyslipidemia manifested itself as hyperlipidemia,
      hypertriglyceridemia, hypercholesterolemia and hyperphosphatidylcholinemia. The
      lipid profile of the red blood cell membranes was found to be deranged, which was
      evidenced by the reduced content of lipoproteins, total phospholipids,
      triglycerides, and cholesterol esters. In addition, there was a significant rise
      in the content of free cholesterol, lysolecithin and phosphatidyl ethanolamine.
      Impairment of lipid exchange between blood serum and the red blood cell membrane
      in TRF patients is under discussion. The changes in the lipid spectrum of the red
      blood cell membranes mirror their morphofunctional failure, supported by
      derangement of fluidity of the lipid bilayer of the red blood cell membrane. Both
      increase of viscosity of the lipid bilayer of the red blood cell membrane caused
      by a high level of cholesterol in the membrane and changes in the
      cholesterol/phospholipid ratio and reduction of the lipid bilayer viscosity
      related to the rise of the content of membrane lysolecithin in part of TRF
      patients were discovered. Hemodialysis influenced the lipid content of blood
      serum, producing no effect on the lipid spectrum of the red blood cells membrane.

PMID- 2218938
TI  - [The outpatient management of patients with a transplanted kidney].
AB  - Organization of the management of outpatients with a transplanted kidney is
      described. The basis of such organization is formed by documentation of the
      patients' status during the entire observation period in a special card
      containing the data on the donor; distant monitoring of cyclosporin A for
      patients living far from the clinic; training of patients. The main complications
      that occur in patients with a transplanted kidney in the long-term postoperative
      period are related. They are pyelonephritis of the transplant, essential
      hypertension and symptomatic hypererythrocytosis. The 2-year survival of the
      patients is 70.8%, that of the transplant 73.1%.

PMID- 2218937
TI  - [The diagnosis of cyclosporin nephrotoxicity in patients after kidney
      transplantation].
AB  - The authors review possibilities of thin needle aspiration biopsy of renal
      allotransplants in the diagnosis of cyclosporin nephrotoxicity. 151 thin needle
      aspiration biopsy specimens were explored in 55 patients following kidney
      transplantation. According to the authors, this method when applied in the early
      postoperative period may turn an informative one. However, if the time elapsed
      after operation exceeds 3 months, they recommend performing puncture biopsy of
      renal transplants.

PMID- 2218940
TI  - Expression of Veratrum alkaloid teratogenicity in the mouse.
AB  - Jervine, a steroidal alkaloid found as a minor constituent in the teratogenic
      range plant Veratrum californicum, has produced similar terata in sheep, rabbit,
      hamster, and chick, although the sensitivity to the alkaloid varies in the
      different species. Sprague Dawley rats and Swiss Webster mice are relatively
      insensitive. The aim of this study was to determine the teratogenic potential of
      jervine in three strains of mice and to ascertain if the response is strain
      dependent. One strain, Swiss N:GP(S), was retested since a Swiss Webster strain
      had been found previously to be jervine-resistant. In addition, we tested
      C57BL/6J and A/J, which are known to differ in their response to the teratogenic
      action of steroids and vitamin A. Mice were treated by gavage with single doses
      of jervine (70, 150, or 300 mg/kg body weight) on either day 8, 9, or 10 of
      gestation. Jervine was teratogenic to C57BL/6J and A/J mice but not to N:GP(S).
      The induced terata included cleft lip with or without cleft palate, isolated
      cleft palate, mandibular micrognathia or agnathia, and limb malformations. Fetal
      teratogenicity and maternal and fetal toxicity were highly correlated. The
      prevalence of each defect and fetal death was a function of strain, dose, and
      time of treatment. Maternal death was higher in C57BL/6J than in A/J mice.
      Although some of the terata were similar, the response pattern between strains
      was different from corticosteroids and vitamin A for both sensitive period and
      the strain dose response. An effect on differentiation of chondrocyte precursors
      may account for many of the defects, but an earlier lethal effect on
      differentiation of neural crest cells or precordal mesenchyme may also occur.

PMID- 2218939
TI  - [The clinico-morphological characteristics of psoriatic nephropathy].
AB  - Based on studying the data obtained during examination of patients with psoriasis
      combined with the urinary syndrome possible varieties of psoriatic nephropathy,
      namely chronic glomerulonephritis (CGN) and amyloidosis were distinguished. CGN
      combined with psoriasis was mainly represented by latent glomerulonephritis (GN)
      and morphologically, it was mostly represented by the mesangio-proliferative
      variant, with IgA and C3 being fixed on the basal membrane of the capillaries and
      in the mesangium. The clinicomorphological feature of that form of psoriatic GN
      is combination of the signs of both associated CGN and hyperuricemia and IgA
      nephritis. Special emphasis is laid on the diagnosis of rapid-progressing GN
      which is of paramount importance for institution of early etiopathogenetic
      therapy. Amyloidosis associated with psoriasis is characterized by the signs of
      acquired disease (AA-amyloidosis) and does not differ in its course from
      amyloidosis coupled with other diseases.

PMID- 2218941
TI  - Abnormal limb regeneration in adult newts exposed to a pulsed electromagnetic
      field.
AB  - This investigation examined two questions: 1) whether or not forelimb
      regeneration results in a faithful replacement of the distal skeletal pattern and
      2) what effect exposure to a pulsed electromagnetic field (PEMF), the type
      reported to facilitate healing of human non-united bone fractures, would have on
      the process of limb regeneration. Of the native forelimbs, 98% (132 out 134) had
      a skeletal pattern that showed little difference with the only variation being
      the range of carpal bones (5-8). Following a 4-5 month postamputation period, the
      skeletal pattern of the normal regenerates was examined. While 72% (135 out of
      188) of these forelimbs resembled the native group, 28% (53 out of 188) were
      abnormal. These abnormalities consisted of the loss of a digit, fused carpals,
      and long bone defects which occurred singly or in combination with one another.
      Exposure to a PEMF for the first 30 days postamputation, followed by a 3-4 month
      postamputation period, produced in addition to the normal (60%, 144 out of 240)
      and abnormal forelimbs (28%, 67 out of 240), a group of forelimbs with unique
      gross defects (12%, 28 out of 240). These defects, occurring singly or in
      combination, included the loss of two or more digits with associated loss of
      carpals, absence of the entire hand pattern, and abnormalities associated with
      the radius and ulna. We can offer no explanation for these observations.

PMID- 2218942
TI  - Protein alterations associated with N-methyl-N-nitrosourea exposure of
      preimplantation mouse embryos transferred to surrogate mothers.
AB  - Mouse preimplantation embryo functions have been shown to be disrupted by in
      vitro exposure to N-methyl-N-nitrosourea (MNU) with subsequent transfer to the
      uteri of pseudopregnant surrogate mothers. Increased gross malformations and
      decreased fetal body lengths in the midgestational period have been previously
      documented. Protein extracts were isolated from day 12 mouse fetuses developed
      from MNU- or solvent-exposed blastocysts and analyzed by two-dimensional
      electrophoresis. The electrophoretic patterns reveal six protein alterations in
      day 12 fetal tissue induced by MNU treatment at the blastocyst stage. Five of
      these alterations involve shifts in isoelectric point (pI) and the other
      alteration involves a quantitative increase in a protein. The possibility that
      two of the proteins which exhibit a shift in pI following MNU exposure represent
      the cell adhesion molecules, N-CAM and L-CAM (based on similar Mr values), was
      investigated by Western blot analysis. No pI alteration in L-CAM or N-CAM
      expression is seen after MNU exposure. These results demonstrate that in vitro
      MNU exposure of preimplantation embryos results in protein alterations in
      midgestational fetuses. Thus, the effects of MNU exposure on preimplantation
      embryos may be manifest long after exposure, and subtle, non-lethal mutations may
      play a role in poor fetal outcome after early chemical exposure.

PMID- 2218943
TI  - Effects of pulsing electromagnetic fields on the prenatal and postnatal
      development in mice and rats: in vivo and in vitro studies.
AB  - Electromagnetic fields (EMF) might have various biological effects on the
      developing embryo. We studied the effects of pulsing electromagnetic fields
      (PEMF) on the in vitro development of preimplantation mouse embryos and of early
      somite rat embryos as well as on the in vivo development of rat embryos. We used
      PEMF at frequencies of 1, 20, 50, 70, and 100 Hz with a tension of 0.6 V/m. The
      embryos were exposed to PEMF throughout the experimental period. PEMF at
      frequencies of 20 and 50 Hz were embryotoxic, inhibiting over 50% of blastocysts
      from hatching and further development, all within 72 h of culture. PEMF at
      frequencies of 50 and 70 Hz induced 22% and 30% incidence of malformations in
      10.5 day old rat embryos after 48 h in culture. The main malformations were
      absence of telencephalic, optic, and otic vesicles and of forelimb buds. In
      addition, retarded growth and development manifested by fewer somites, reduction
      in crown-rump length, and retarded closure of the neural tube were found in many
      embryos. No significant pathological changes were found by TEM in PEMF-exposed
      embryos. Disappearance of microvilli and collapse of apical parts of endodermal
      cells were observed by SEM in many yolk sacs of embryos exposed to 50 and 70 Hz
      PEMF. A slightly reduced litter average, a reduction or increase of weight, and a
      delay in eye opening was observed among offspring of pregnant rats exposed
      throughout pregnancy to PEMF at frequencies of 20, 50, and 100 Hz. No
      malformations were observed among these offspring. The mechanism of PEMF-induced
      embryotoxicity and teratogeneity is unknown, as is the mechanism of the
      "protective effects" of the mother on the rat embryos exposed to PEMF in vivo.

PMID- 2218944
TI  - Delayed neural crest cell emigration from Sp and Spd mouse neural tube explants.
AB  - Splotch (Sp) and splotch-delayed (Spd) are allelic mutations on chromosome 1 of
      the mouse. Embryos homozygous for either allele have neural tube defects (NTDs)
      and deficiencies in neural crest cell (NCC) derived structures. The fact that Spd
      mouse mutants sometimes have deficiencies in NCC derivatives in the absence of an
      NTD led to the hypothesis that neurulation and the release of NCCs may depend on
      a regulatory event that is common to both processes. Therefore, it may be
      possible to understand the cause of NTDs in these mutants by examining the basis
      of aberrant NCC derivatives. Caudal neural tubes were excised from day 9 Sp and
      Spd embryos and placed into gelatin-coated tissue culture dishes, or 3
      dimensional basement membrane matrigel, and cultured for 72 hours. A cytogenetic
      marker was used to genotype the embryos. In planar cultures, no morphological
      differences were observed between NCCs from neural tube explants of Spd mutants
      compared to those from heterozygous or wild-type embryos. However, there appeared
      to be a delay in the release of NCCs from the neural tube in both Sp and Spd
      mutants, which was particularly evident in Sp. After 24 hours in culture, the
      extent of NCC outgrowth, as well as the number of NCCs emigrating from explanted
      neural tubes, was significantly lower in Sp and Spd mutant cultures than in
      controls. No differences were observed in the mitotic indices among cells which
      had emigrated. By 72 hours, mutant cultures and their non-mutant counterparts
      were similar in terms of outgrowth, cell number, and migratory capability. After
      24 hours in 3-dimensional basement membrane matrigel, cell outgrowth from Sp
      explants was also significantly less than controls. The pattern of NCC outgrowth
      in both types of culture conditions indicates a 24 hour delay in mutant cultures
      compared to controls. This stems from a delay in the release of NCCs from the
      neural tube, suggesting that the defect lies within the neuroepithelium with
      respect to the release of NCCs.

PMID- 2218946
TI  - Stings and bites revisited.

PMID- 2218945
TI  - Expression of a new mutation (Axd) causing axial defects in mice correlates with
      maternal phenotype and age.
AB  - A new autosomal mutation, Axd (axial defects), is described. Axd segregates in a
      simple Mendelian fashion, and it is dominant with incomplete penetrance and
      variable expressivity. The phenotype of Axd heterozygotes ranges from a variety
      of tail anomalies to visibly normal tails. Approximately 12% of neonates from
      curly-tail (CT) F1 (Axd/+) x F1 (Axd/+) matings exhibit open neural tube defects
      (NTD) in the lumbosacral region and 16% have curly tails. Mean litter sizes and
      resorption rates comparable to wild type indicate that homozygosity for Axd is
      not obligately lethal. Genetic background plays a major role in Axd expression.
      Strains such as BALB/cByJ allow the highest penetrance of the mutation in single
      dose (46%), whereas, in CF-1 mice Axd is recessive. The tail phenotype of
      heterozygous Axd/+ dams, in part reflective of their genetic background,
      correlates with the incidence of NTD in F2 offspring: CT mothers produce
      significantly more neonates with frank NTD than normal tail mothers. At the one
      embryonic period examined for this study (D13/D14 post-coitus), an 85% higher
      incidence of total axial defects is observed than among the F2 at birth.
      Unchanging litter size and the relative increase in phenotypically normal
      offspring by birth suggest that Axd acts by delaying posterior neural tube
      closure. One of the most significant findings in this study is that maternal age
      influences the survival of Axd embryos in utero. Axd/+ dams older than 8 months
      yield fewer mean implants, higher resorption rates, and fewer viable embryos with
      axial defects than do Axd/+ dams younger than 8 months. Axd is not allelic to nor
      linked to the Sp (splotch) gene which also affects neurulation.

PMID- 2218947
TI  - Alprazolam withdrawal.

PMID- 2218948
TI  - TMA, AMA respond to blood banks' legal problems.

PMID- 2218949
TI  - Transfer law puts rural internist between a rock and a hard place.

PMID- 2218950
TI  - Disciplining doctors in Texas: the Texas State Board of Medical Examiners.

PMID- 2218951
TI  - The National Practitioner Data Bank, part II: Questions on problem areas.

PMID- 2218952
TI  - Where are tomorrow's scientists?

PMID- 2218953
TI  - Texas Tech MEDNET completes its first 'unplanned' video consult.

PMID- 2218954
TI  - Where is AIDS research taking us?

PMID- 2218955
TI  - TDH warns physicians: raw seafood may be dangerous menu item.

PMID- 2218956
TI  - AMA takes stand on pregnant woman's right to refuse treatment.

PMID- 2218958
TI  - Texas HMOs and PPOs: coming on strong in the '90s.

PMID- 2218957
TI  - Postoperative infections at Texas hospital prompt drug warning.

PMID- 2218959
TI  - West Texas teenagers and AIDS: a survey of their knowledge, attitudes, behavioral
      changes, and information sources.
AB  - We conducted this study to determine the knowledge, attitudes, behaviors, and
      sources of AIDS information among teenagers in West Texas. We also examined
      differences by gender, ethnicity, and rural/urban status. Results were divided
      into the following categories: general knowledge of AIDS, AIDS-related attitudes,
      behavior changes caused by AIDS, and AIDS information sources. The 289 ninth
      grade students revealed a greater knowledge of AIDS than had been shown in
      studies in other states. However, there were group differences with Anglo
      students exhibiting greater knowledge of AIDS. There were also some differences
      between rural and urban students, with urban students scoring higher on
      knowledge. Finally, doctors were regarded as the most reliable source of AIDS
      information. There were many implications related to AIDS education from these
      results and from the other findings in this study.

PMID- 2218960
TI  - Legal issues, AIDS, and the practicing physician.
AB  - This article highlights for the practicing physician some of the more important
      laws and regulations related to and arising from the AIDS epidemic. Medical-legal
      issues regarding the availability of health care as defined by federal and state
      law regarding employment and level of medical care given based on HIV status is
      discussed. Texas law regarding testing, disclosure of test results, and possible
      claims that could arise due to issues such as the invasion of privacy are
      examined along with criminal penalties for transmitting the virus to others,
      insurance, and insurability. Finally, the June 1989 Human Immunodeficiency Virus
      Services Act and Senate Omnibus Bill 959, which was passed into law, is briefly
      outlined.

PMID- 2218961
TI  - The "seed and soil" hypothesis and the decline of radical surgery: a surgeon's
      opinion.
AB  - Controlled, clinical trials have demonstrated that recurrent breast cancer
      following lumpectomy may pose little risk to patient survival. There is no
      generally accepted biologic explanation of this dilemma. One hundred years ago
      Paget proposed the "seed and soil" hypothesis to describe the variation among
      organs in their susceptibility to tumor metastasis. This paper defines his
      hypothesis in a manner which attempts to explain the dilemma of local recurrence.
      Since individuals vary widely in their levels of natural killer (NK)
      cytotoxicity, they may also vary widely in their susceptibility to disseminating
      tumor cells. Patients who survive their initial tumor without developing distant
      metastases can be expected to survive a recurrence arising from residual tumor
      cells of the primary lesion. The "seed and soil" hypothesis supports
      "preservation" surgery in the treatment of malignant disease. Patients who
      develop distant metastases early in the course of their disease are like fertile
      soil for circulating tumor cells. Patients who resist the development of distant
      metastases are like barren soil.

PMID- 2218962
TI  - [Does your patient take his medicine? Compliance problems in clinical practice].
AB  - There is convincing evidence from compliance research that deviations from the
      prescribed drug regimen is the rule rather than the exception. Demographic and
      psychosocial patient factors poorly correlate with non-compliance, whereas
      features of the disease, mechanisms of treatments, regimens and the patient
      physician interaction are particularly important determinants of patients'
      compliance behaviour. Non-compliance can not be predicted. There are problems in
      the assessment of non-compliance, more particularly of its clinical consequences.
      New microprocessor-based technology evaluated essential insight into patients'
      compliance behaviour and revealed different patterns of non-compliance. On one
      hand, the therapeutic outcome can be impaired by non-compliance, on the other
      hand, however, certain patterns of non-compliance appear to be appropriated from
      the patients' point of view. In medical practice it is important to consider non
      compliance as essential impact on drug therapy and to promote the discussion of
      this issue with patients.

PMID- 2218963
TI  - [Current problems in practical pharmacotherapy].

PMID- 2218965
TI  - [Pharmacogenetics for the practicing physician].
AB  - An important source of interindividual differences in drug action are inherited
      differences in the pharmacokinetics and pharmacodynamics of many drugs. Besides
      some well-known but rarely occurring examples of unusual drug action, the
      inherited variations of drug metabolism are of particular clinical importance, as
      a relationship between the defect of metabolism and the effects and toxicity of
      the drugs involved has been observed. Recent investigations were able to
      elucidate many of the molecular mechanisms responsible for these genetic defects.

PMID- 2218964
TI  - [Monitoring of therapy using drug concentration levels: Why? When? How?].
AB  - Serum concentration measurements represent a tool that can help the physician to
      choose the optimal dose in an individual patient. Its application has been
      recommended for several drugs that show a narrow therapeutic range and for which
      the dose cannot be individually adjusted directly on the basis of the therapeutic
      effect. For an effective use of his therapeutic tool, it is important to observe
      the following three points: 1. The dosage history must be known, including
      patient's compliance. 2. Whenever possible, the measurement should be obtained
      after steady-state has been reached on a constant dosing regimen (four half-lives
      of the drug). The dose adjustment in steady-state is very simple: The
      concentration changes are for most drugs proportional to the changes in dose
      rate. 3. The dose adjustment should never be performed on the basis of the
      concentration measurement alone, but always in the context of the clinical
      conditions and the patient's response.

PMID- 2218966
TI  - [Aspirin against aging? For whom and how much?].
AB  - Aspirin has been successfully used in the secondary prophylaxis of myocardial
      infarction, cerebral vascular events and peripheral arterial disease. Regular
      aspirin intake may further be beneficial in asymptomatic healthy male with
      cardiovascular risk factors over the age of 50. There is no good evidence that
      aspirin prevents the development of atherosclerosis and thromboembolic events in
      healthy individuals.

PMID- 2218967
TI  - [Antiviral substances: against what? For whom?].
AB  - Acyclovir and zidovudine are the two most widely used antiviral drugs. Acyclovir
      is efficacious against all infections caused by herpes simplex virus, but
      treatment must start early to be effective. Herpes zoster virus is less
      susceptible to acyclovir, but high doses shorten the duration of skin lesions,
      although the effect on post-herpetic neuralgia is uncertain. Zidovudine
      diminishes short-term mortality in patients with HIV infection and serious
      opportunistic infections. In those patients, the average increase in life
      expectancy is about one year. Because of myelotoxicity, frequent monitoring of
      blood counts is necessary. Recent results in patients who have few or no symptoms
      of HIV infection indicate that the drug decreases the chance of progressing to
      AIDS. Therefore, indications for treatment now include asymptomatic patients with
      unfavourable laboratory parameters.

PMID- 2218968
TI  - [Antimycotic therapy].
AB  - Because deep opportunistic mycoses are relatively rare, clinicians frequently
      lack routine in the application of antimycotics. It is the purpose of this review
      to summarize, from a practical point of view, rationale, indications,
      applications and toxicity of antimycotic therapy for the mycoses autochthonous to
      Europe. Amphotericin B remains the standard therapy for most deep opportunistic
      mycoses, while the newer azoles are the first line agents to be used for
      superficial forms of candidiasis.

PMID- 2218969
TI  - [Current perspectives in ulcer disease].
AB  - 1. Helicobacter pylori has been associated with chronic type-B gastritis, which
      in turn is always present in duodenal ulcer patients; therefore, it is likely
      that Helicobacter pylori is an important cofactor in the pathogenesis of peptic
      ulcer disease. An eradication of Helicobacter pylori is associated with the
      reduced ulcer relapse rate, but an effective therapy for eradication is not yet
      available and should be restricted to experimental protocols. 2. Omeprazole is an
      antagonist of the proton pump of the acid-producing cell of the human stomach.
      With once-daily omeprazole treatment it is possible to almost abolish 24-hour
      intragastric acidity in the majority of duodenal ulcer patients; therefore,
      omeprazole allows alternative treatment of different causes of peptic disease.

PMID- 2218971
TI  - Pericardial effusion after open heart surgery.

PMID- 2218970
TI  - Role of asbestos and other fibres in the development of diffuse malignant
      mesothelioma.

PMID- 2218972
TI  - Trends in lung cancer, chronic obstructive lung disease, and emphysema death
      rates for England and Wales 1941-85 and their relation to trends in cigarette
      smoking.
AB  - Trends in smoking associated respiratory diseases in England and Wales during
      1941-85 have been studied, with careful attention to problems caused by changes
      in classification of cause of death. Three diseases were selected for analysis:
      lung cancer, emphysema, and chronic obstructive lung disease. During 1971-85
      deaths that would previously have been certified under chronic bronchitis have
      increasingly tended to be classified under chronic airways obstruction. The
      definition of chronic obstructive lung disease that was used includes both terms
      to avoid the artificial decline caused by consideration of chronic bronchitis in
      isolation. Age specific rates for all three diseases show a pronounced cohort
      (period of birth) pattern, rates for men rising up to the rates for those born
      shortly after the turn of the century and then declining, and rates for women
      peaking in the cohort born 20-25 years later. For chronic obstructive lung
      disease, but not for lung cancer and emphysema, the cohort peak is superimposed
      on a sharply declining downward trend. In both sexes cohort patterns of
      cumulative cigarette consumption peak at a time broadly similar to those seen for
      the three diseases. Trends in cigarette consumption, however, cannot explain the
      underlying steeply declining rate of chronic obstructive lung disease. Nor can
      they fully explain the declining trends in lung cancer and emphysema rates in
      younger men and women.

PMID- 2218973
TI  - Use of biological glue to control pulmonary air leaks.
AB  - Biological glue is a natural adhesive generated by the interaction between
      fibrinogen (pre-glue) and thrombin to produce fibrin. The pre-glue is prepared
      from a single donor (to avoid the problems of pooled plasma) and stored as
      cryoprecipitate. Before being used it is thawed, dissolved in saline, and
      activated into an adhesive by the addition of topical thrombin. Biological glue
      was used prophylactically to prevent air leaks from bronchial suture lines and
      raw lung surfaces after pulmonary resections in six patients. In addition two new
      methods of using biological glue have been developed for the control of
      persisting air leaks. In selective intrabronchial tamponade the glue is instilled
      into the bronchial tree through a flexible bronchoscope, and in therapeutic
      pleurodesis it is instilled into the pleural cavity through a chest drainage
      tube. The air leaks were resolved in all cases. Seven procedures using selective
      intrabronchial tamponade were carried out in six patients. Four were immediately
      successful but three were not and required further interventions. Therapeutic
      pleurodesis alone was successfully carried out in one patient and as an adjunct
      to selective intrabronchial tamponade on two occasions. A thoracotomy was
      eventually needed in one of the seven patients.

PMID- 2218974
TI  - Effects of inflammation and fibrosis on pulmonary function in diffuse lung
      fibrosis.
AB  - To investigate the relation between lung function and inflammation and fibrosis
      in patients with diffuse lung fibrosis, a study was made of untreated patients
      without appreciable airway obstruction (14 patients with cryptogenic fibrosing
      alveolitis and seven with pneumoconiosis). Quantitative assessment of
      inflammatory infiltration and fibrosis was carried out on open lung biopsy
      specimens and compared with lung volumes, carbon monoxide transfer factor (TLCO),
      TLCO corrected for alveolar volume (TLCO/VA), and arterial blood gases at rest
      and during exercise. The degree of fibrosis and the degree of cellular
      infiltration were positively correlated. Lung volumes and TLCO were correlated
      with the grades of fibrosis and cellular infiltration of alveoli; arterial blood
      gases during exercise tended to correlate with both fibrosis and infiltration (p
      less than 0.06). In contrast, morphological data were not correlated with gas
      exchange at rest or with TLCO/VA. It is concluded that, in untreated patients
      with diffuse lung fibrosis, lung volumes, TLCO, and arterial blood gases during
      exercise reflect the lung lesions, and that the pulmonary function tests used
      cannot discriminate between fibrosis and infiltration of the lung by inflammatory
      cells.

PMID- 2218975
TI  - Plasma cross linked fibrin degradation products in pulmonary embolism.
AB  - Plasma concentrations of cross linked fibrin degradation products, a marker of
      intravascular thrombosis and fibrinolysis, were measured in 495 patients with
      suspected pulmonary embolism referred for ventilation-perfusion lung scanning to
      determine whether concentrations are increased in pulmonary embolism and their
      potential use in diagnosis. Lung scans were described as normal (n = 66) or as
      showing a low (n = 292), indeterminate (n = 58), or high probability (n = 79) of
      pulmonary embolism. There was a difference between the mean levels of cross
      linked fibrin degradation products in each scan category: normal scans, 142
      ng/ml; low probability scans, 295 ng/ml; indeterminate probability scans, 510
      ng/ml; high probability scans, 952 ng/ml (p less than 0.001). Of the patients
      with high probability scans, 96% had raised concentrations. Explanations for
      discrepant low results include incorrect scan diagnosis, delay in blood sampling,
      and anticoagulation. Of the patients with a low or indeterminate probability of
      pulmonary embolism, 43% had increased concentrations of cross linked fibrin
      degradation products that could be attributed in most cases to another illness.
      Owing to the wide range of values in each lung scan diagnostic category, raised
      concentrations of these fibrin degradation products cannot be used without
      reference to the patient's clinical state as a discriminatory test for pulmonary
      embolism. Further evaluation of the significance of normal concentrations in
      excluding a diagnosis of pulmonary embolism appears to be warranted.

PMID- 2218976
TI  - Use of a management plan for treating asthma in an emergency department.
AB  - A standardised management protocol has been developed for the assessment and
      treatment of adults with acute asthma attending an emergency department. The
      management protocol consists of an assessment sheet for recording essential
      features of the history and examination findings and a flow diagram with
      guidelines for initial management that were based on spirometric recordings. The
      protocol was introduced at Wellington Hospital in 1986. The effect of this
      intervention was assessed by analysing emergency department records during the
      three months before and one year after the introduction of the protocol. The use
      of the assessment sheet improved history taking and led to the increased use of
      serial measures of airflow obstruction and improved documentation of follow up
      arrangements. The provision of management guidelines influenced the emphasis of
      management, including an increased use of corticosteroids intravenously and more
      frequent use of an additional dose of nebulised bronchodilator. In the light of
      the initial experience the protocol has been modified and its use either in an
      emergency department or in general practice is recommended.

PMID- 2218977
TI  - The hyperimmunoglobulinaemia E and recurrent infections syndrome in an adult.
AB  - A 27 year old white woman with a history of chronic eczema and episodes of
      serious infection of the chest, skin, and bone presented with acute respiratory
      failure. She was found to have a spontaneous right pneumothorax and a
      pneumatocele in the left upper lobe. Despite a left upper lobectomy she was left
      with chronic respiratory failure, bullous lung disease, and bilateral
      bronchiectasis. The hyperimmunoglobulinaemia E and recurrent infections syndrome
      was diagnosed only in adult life.

PMID- 2218978
TI  - Pulmonary disease following intravesical BCG treatment.
AB  - Bacillus Calmette-Guerin (BCG) is an attenuated strain of Mycobacterium bovis
      that has been used in the treatment of malignant disease for over 20 years and
      for the treatment of bladder cancer since 1976. Major complications of this
      treatment are infrequent. We report two cases of systemic illness with pulmonary
      manifestations after treatment with intravesical BCG.

PMID- 2218979
TI  - Bronchoalveolar lavage findings in a patient with the organic dust toxic
      syndrome.
AB  - A previously healthy student developed the organic dust toxic syndrome after
      unloading a grain silo for one day. Bronchoalveolar lavage seven days later
      showed a total cell count six times normal with 70% lymphocytes. This suggests
      that the previously described acute neutrophil influx into the alveolar spaces in
      this syndrome is rapidly replaced by a lymphocyte dominated infiltration.

PMID- 2218981
TI  - Behavioural breathlessness.

PMID- 2218980
TI  - Effort rupture of the diaphragm.
AB  - Effort rupture of the diaphragm is rare and accounts for only 1% of all
      diaphragmatic injuries. A 23 year old patient with bilateral rupture that
      followed sudden movement is described.

PMID- 2218982
TI  - [Quality assessment in hospitals].

PMID- 2218983
TI  - [Funding for hip joint surgery].

PMID- 2218984
TI  - [Saving blood--what do we use instead?].

PMID- 2218985
TI  - [Fluid therapy changes in surgical treatment of abdominal aortic aneurysm].
AB  - The use of blood components and blood substitutes was studied in 25 patients
      undergoing surgical treatment for abdominal aortic aneurysm in 1983, and was
      compared with the use of such components in 44 patients operated in 1988. The use
      of blood components had decreased by 49% from 1983 to 1988. In 1988, erythrocytes
      were administered only when the hemoglobin concentration fell under 9 g/100 ml.
      The use of plasma postoperatively was reduced to a minimum. Normovolemia was
      maintained with polygeline, dextran, electrolytes and autotransfusion. The change
      in transfusion praxis did not lead to any reduction in postoperative hemoglobin
      values. The stay in hospital and the number of hours spent in a respirator were
      both reduced, and there was a general improvement in results.

PMID- 2218986
TI  - [The Bugoynes study. Population of Finnish ethnic background in Sor-Varanger. IV.
      A follow-up based on the cardiovascular study done in the county of Finnmark in
      1987].
AB  - An investigation conducted in 1972 among adult males in the fishing village of
      Bugoynes, where the majority of the population is of Finnish ethnic background,
      showed very high serum cholesterol values. This led to a recommendation that the
      population should modify its dietary habits. 1-1.5 years later the cholesterol
      values were reduced on average by 17.8%. Part of the adult population was
      reinvestigated in 1974 and 1977. At the last screening, in 1987, the whole adult
      population was invited to the investigation. In the age group 20-49 years the age
      adjusted serum cholesterol values in males were 16.8% lower in 1987 than in 1972.
      In females in the same age group the values had dropped by 5.4% from 1974 to
      1987. Compared with neighbouring villages, the population in Bugoynes has changed
      its dietary habits. The prevalence of atherosclerotic heart disease in males aged
      40-59 years, has declined from 18.9% in 1972 to 8.3% in 1987.

PMID- 2218987
TI  - [Accidental poisoning in children].
AB  - A retrospective study was carried out among children admitted to the Pediatric
      Clinic, Haukeland Hospital, from 1958 until 1986 for accidental poisoning. Drugs
      was the most frequent poisoning agent (49%), followed by household agents (22%),
      different agents (20%) and plants/mushrooms (9%). 89% of the children were under
      five years of age, 57% were boys. 20% stayed more than one day in the hospital.
      Very serious poisonings involving admission for more than 14 days were most
      frequently seen after intake of drugs. The number of admissions was doubled from
      1966-70 to 1981-85. Most of the increase referred to poisoning from plants,
      tobacco and hydrocarbon products. The greatest increase was found for admissions
      lasting less than two days. Most of the potentially serious poisonings in our
      study were caused by agents that, by American or British law, it would have been
      illegal to sell without special child-resistant packaging. It is strongly advised
      that a similar law be passed in Norway.

PMID- 2218989
TI  - [Ventricular tachyarrhythmias. Etiology, diagnosis and treatment, based upon a
      group of patients].
AB  - Sustained ventricular tachycardia and ventricular fibrillation are found to be
      the main causes of sudden cardiac death in out-of-hospital patients. Most of
      these patients do have serious organic heart disease, hence the arrhythmia must
      be regarded as a dangerous symptom. Of 44 consecutive patients referred for
      further investigation of either of these arrhythmias, organic heart disease was
      found in 43 (98%). Coronary heart disease and cardiomyopathy were the two most
      common illnesses found. Surgical treatment was efficient in cases of arrhythmias
      induced by myocardial ischaemia, and even patients with marked reduction in their
      left ventricular performance tolerated surgery well. As for the medically treated
      patients, the recurrence rate appeared to be lowest among those who received
      class-III-antiarrhythmic drugs.

PMID- 2218988
TI  - [Intracutaneous injections of sterile water as analgesia during labor].
AB  - The author points out that when midwives inject sterile water in the lumbar
      region as a form of analgesia during the first stage of labour, this may prolong
      delivery. The author has found no documentation to support this method. The
      labour lasts almost two hours longer in women receiving such injections. There is
      no adverse effect on Apgar score after one minute. More investigation is
      necessary in order to examine the effectiveness and/or adverse effects of method.

PMID- 2218990
TI  - [Percutaneous closure of ductus arteriosus using the umbrella technic].
AB  - In four patients between three and five years of age we performed closure of open
      ductus arteriosus with the Rashkind umbrella technique after percutaneous
      approach from the right groin. The smallest internal ductus diameter measured
      between 2 and 4 mm, and pulmonary blood flow was from 1.4 to 2.0 times systemic
      flow. In all four patients, pulmonary artery pressure was normal. In three
      patients the ductus arteriosus was completely closed, in the fourth a small
      residual shunt persisted. There were no complications. We describe the method in
      detail.

PMID- 2218991
TI  - [Crossed renal ectopia with nephrolithiasis].
AB  - Crossed unfused renal ectopia is an uncommon anomaly in which one of the uretes
      crosses the midline from the kidney to the vesical orifice on the opposite side.
      We report one case of crossed unfused renal ectopia, nephrolithiasis and pain on
      the side opposite to the renal mass.

PMID- 2218992
TI  - [Blood saving--what do we use instead? Fluid substitution during surgery of
      abdominal aortic aneurysm].
AB  - The use of blood components in major surgery has been reduced significantly. Full
      agreement exists that patients should be held normovolemic. However, the
      selection of blood substitutes is controversial. In the present study we analysed
      infusion and transfusion policy in seven major Norwegian hospitals during and
      following aortic surgery. The number of patients who underwent surgery for
      abdominal aortic aneurysm increased significantly from 1983 to 1988. The
      proportion of emergency operations remained unaltered. We found a significant
      reduction in the use of blood components. The amount of clear solutions remained
      unchanged. Two hospitals had chosen polygeline as the main blood substitute, six
      hospitals preferred dextran 70 as a combined volume substitute and prophylaxis
      against thrombosis. Two hospitals used albumin 4% as recommended by the blood
      banks, and four used autotransfusion. Both mortality and morbidity decreased
      during the five-year period.

PMID- 2218993
TI  - [Puncture of the joints].

PMID- 2218994
TI  - [Hyponatremia. A retrospective study of occurrence, etiology and mortality].
AB  - In patients admitted to a general medical ward, the incidence of hyponatremia on
      admission was 3.6%. Mortality was more than three times higher among patients
      with hyponatremia than among the patients as a whole. The triad hyponatremia,
      hypoalbuminemia and hypervolemia indicated a poor prognosis. A diversity of
      medical illnesses was associated with hyponatremia, and the use of diuretics was
      a major contributor to the electrolyte disturbance. Treatment of asymptomatic
      hyponatremia is discussed, with special emphasis on restriction of fluids.

PMID- 2218995
TI  - [Do antidepressive agents have analgesic effects?].
AB  - Patients with chronic pain are often depressed, and antidepressants have been
      widely used in the treatment of these patients. Well controlled clinical studies
      have shown that antidepressants have analgesic effects, apparently independent of
      changes in mood, and in lower doses than used in the treatment of depression.
      Good results have been reported for several types of chronic pain, especially
      headache and facial pain, arthritis, fibromyalgia and neuralgias. In addition,
      antidepressants have also an indirect analgesic action by relieving a depressive
      condition associated with chronic pain.

PMID- 2218996
TI  - [Use of economic incentives to promote hip replacement surgery at the regional
      hospital in Tromso].
AB  - Since 1 December 1988, the Norwegian Health Department has refunded NOK 12,000
      for each patient operated with a total hip replacement. The intention has been to
      encourage the hospitals to increase their capacity to operate such patients. The
      Regional Hospital of Tromso has paid the hospital staff extra to operate patients
      on Saturdays. In this way 58 extra patients received a total hip replacement in
      1989. The cost for each such extra patient was NOK 24,869. In comparison, the
      regular cost for such patients is NOK 35,125. In our opinion, the hospital has
      found a simple and economical way to increase its capacity for operating patients
      with total hip replacement.

PMID- 2218997
TI  - [Health care and social planning--priorities or wishes?].
AB  - The object of this research project was municipal planning of social services and
      health care. According to the regulations, the planning process shall result in a
      plan that gives guidelines for further development in the sector. Through data
      from a representative selection of Norwegian municipalities, it was found that
      the formulations of the goals in the plans were vague and unprecise. The plans
      generally include a long list of proposed new initiatives. There is hardly any
      evidence of choosing priorities or changing priorities. In their present form,
      the plans are more like lists of open wishes than tools for decision making. They
      therefore serve to raise problems rather than work as instruments for deciding
      priorities.

PMID- 2218999
TI  - [Alcohol abuse as the cause of hospital admissions].

PMID- 2218998
TI  - [Who is expert on justice--specialists or the local medical and social
      observers?].
AB  - A young Norwegian father was convicted of having battered his 5 month-old
      daughter to death. The trial relied heavily on a medicolegal autopsy report, the
      conclusions of which have been later questioned by clinical specialists. These
      specialists claim that the child died a natural death from hitherto undiagnosed
      osteogenesis imperfecta. The correspondence raises the question of why the
      opinions of local medical instances, and of people who had known the family and
      the circumstances for a long time, were neglected in favour of the opinions of
      experts during all phases of the trial. These people were convinced all the time
      that the child had been weak and sick from birth onwards, and that the innocent
      father was a victim of the tendency of the courts to accept expert advice only.

PMID- 2219000
TI  - [Drug induced damage of the nervous system].

PMID- 2219001
TI  - [Loss, depression and immunity].

PMID- 2219002
TI  - [Health services for immigrants].

PMID- 2219003
TI  - [Self-serving waste].

PMID- 2219004
TI  - [Is statistical analysis adequate for the evaluation of measuring methods? Lack
      of information and statistical data].

PMID- 2219005
TI  - [Smoking and health attitudes in Norway].

PMID- 2219006
TI  - [Electric stimulation of the pelvic floor].

PMID- 2219007
TI  - [Osteogenesis imperfecta].

PMID- 2219008
TI  - [Autologous bone marrow transplantation in children--experience with
      neuroblastoma].
AB  - Autologous bone marrow transplantation permits the use of greatly intensified
      cytoreductive therapy for cancer. Since 1983 seven children with disseminated
      neuroblastoma (stage IV) were treated by this method. Five were treated in first,
      and one in second complete remission; one child was in partial remission. Tumor
      cell purging of the marrow inoculum was performed in five cases. All children had
      engraftment and were discharged from hospital free of disease. Relapse was
      observed in three children within two years. Four children remain healthy at
      follow-up 5-77 months after autotransplantation. We describe and discuss
      indications, methods, side effects and results.

PMID- 2219009
TI  - [Testing of lung physiology in infants].
AB  - We evaluate the clinical value of pulmonary function testing in infants. 194
      infants were examined over a period of two years. Pulmonary function testing was
      found valuable in adjusting the ventilator to avoid overdistension of the lungs
      in the treatment of severe respiratory distress syndrome. In patients with
      bronchopulmonary dysplasi, forced expiratory flows were valuable in evaluating
      the degree of obstruction and for testing drug effects. Both systems used
      (Pulmonary Evaluation and Diagnostic System (PEDS) and Partial Forced Flow System
      (PUFFS)) were found to be user friendly.

PMID- 2219010
TI  - [Bronchopulmonary dysplasia--a general overview].
AB  - The article reviews the etiology, pathogenesis and symptoms of bronchopulmonary
      dysplasia, at present one of the most important complications to prematurity and
      neonatal lung disease. The different alternatives and aspects of treatment are
      discussed, with emphasis on the problems of adequate growth and nutrition.

PMID- 2219011
TI  - [Bronchopulmonary dysplasia--a one-year material].
AB  - We report the results of a prospective study on the incidence of bronchopulmonary
      dysplasia (BPD) in premature infants with gestational age less than or equal to
      32 weeks who were treated at Rikshospitalet in 1989. Of a study population of 119
      infants, 23 (19.3%) developed BPD. The incidence was 22.5% in the 112 infants who
      survived the neonatal period. BPD was found only in infants who had been treated
      with mechanical ventilation for respiratory distress syndrome (RDS). Pulmonary
      function studies at three days of age demonstrated no significant differences
      between infants who developed BPD and infants who had RDS only. However, at 12
      days of age, no change in compliance and resistance were found in infants who
      developed BPD, while in infants who only had RDS these lung parameters had
      markedly improved during this period.

PMID- 2219013
TI  - [Tricuspid valve endocarditis with pulmonary embolism].
AB  - We describe two patients suffering from bacterial endocarditis with tricuspid
      valve envolvement. Both had pulmonary embolism, revealed by scintigraphic lung
      perfusion examination. The diagnosis was made by transthoracic echocardiography
      in one patient and transoesophageal echocardiography in the other. Both received
      therapy with antibiotics and heparin given intravenously. In one patient the
      vegetation disappeared. We discuss the epidemiology, diagnosis and treatment of
      the condition, with special focus on the possible role of heparin.

PMID- 2219012
TI  - [Portal vein thrombosis. Etiology, complications and therapy].
AB  - In a retrospective study of 25 patients with portal vein thrombosis the etiology
      has been disclosed in 44%. The most common causes were infection, cirrhosis and a
      myeloproliferative syndrome. The most common mode of presentation was
      gastrointestinal bleeding (44%). 12 patients (48%) died, the majority after life
      threatening variceal bleeding. Today we restrict ourselves to treating the
      complications of portal hypertension. The aim for the future must be to diagnose
      and dissolve the thrombi shortly after formation.

PMID- 2219014
TI  - [Localized amyloidosis of the lower respiratory tract].
AB  - Primary amyloidosis localised to the lungs can simulate different types of lung
      diseases such as tuberculosis, carcinoma and repeated infections in the lower
      respiratory tract. The possibilities of treatment are limited. The prognosis is
      usually good, except when there is diffuse pulmonary involvement. Such patients
      can develop progressive respiratory failure The mechanism of amyloidogenesis is
      unclear. At the cellular level the macrophage may play a central role.

PMID- 2219015
TI  - [Combined lung and heart surgery].
AB  - Patients with concomitant pulmonary carcinoma and serious heart disease represent
      a therapeutic challenge. With the introduction of combined lung-heart surgery,
      both conditions may be treated adequately and safely. At Rikshospitalet, combined
      surgery was performed in four cases during the period 1984-88. In three patients
      heart surgery and lung resection were performed in one anesthetic session. In the
      fourth case the heart disease was corrected first and the tumor removed a few
      weeks later. After 1-4 years follow-up none of the patients has clinical
      manifestations of either condition. Combined surgery is only applicable if tumor
      removal is confined to wedge resection or lobectomy.

PMID- 2219016
TI  - [Sulindac-induced toxic epidermal necrolysis].
AB  - All nonsteroidal anti-inflammatory agents may have dermatological side effects,
      most of them harmless. However, serious adverse dermatological reactions have
      been described. The article presents a patient with probable sulindac-induced
      toxic epidermal necrolysis (TEN), and reviews the literature.

PMID- 2219017
TI  - [Routine control of type 2 diabetes. Are glycosylated hemoglobin and fructosamine
      measurements necessary?].
AB  - In 98 type 2-diabetics with stable fasting blood glucose who were treated by
      tablets and/or diet, fasting blood glucose, glycosylated hemoglobin A1c and serum
      fructosamine were measured simultaneously. Fasting blood glucose was defined as
      stable when all values were less than 7.1 mmol/l, or deviated by less than 20% in
      at least three months, and the treatment had not been changed during the last six
      months. There is satisfactory correlation between fasting blood glucose and
      glycosylated hemoglobin A1c (r = 0.64), and serum fructosamine (r = 0.63). It is
      concluded that glycosylated hemoglobin and fructosamine are superfluous in
      routine controls of such patients. When fasting blood glucose is unsuitable for
      practical reasons, fructosamine is a good and cheap alternative. In annual
      controls glycosylated hemoglobin is the best parameter, and reflects the longest
      period of metabolic control.

PMID- 2219018
TI  - [Testicular germ cell tumors--epidemiology and risk factors].
AB  - An increasing incidence of testicular germ cell tumours has been observed in many
      white populations in this century. Ethnic genetic implications and lifestyle seem
      to influence the development of testicular cancers, whereas the influence of
      intrauterine conditions is under debate. Epidemiologic studies cannot explain the
      increasing incidence among young men. The age variation of incidence and
      histologic type indicates at least two different aetiological mechanisms.
      Testicular cancers among young men are most probably due to gonadal dysgenesis,
      whereas in old men they reflect the general increased risk of cancer with old
      age. The increased risk of developing testicular germ cell tumours among
      cryptorchid young men supports the gonadal dysgenesy hypothesis.

PMID- 2219019
TI  - [The science of the art of medicine. Qualitative methods in medical research].
AB  - Qualitative research methods dominate in the humanities (history, literature),
      theology, law and some social sciences (ethnography). The authors claim that
      using such research traditions could expand the scientific field of medical
      research, and that qualitative methods can be tools for medical scientists to
      gain knowledge of matters that until now have been obscure. This article presents
      some characteristics of these research traditions: Qualitative researchers tend
      more often to formulate questions and hypotheses than provide answers. They
      produce arguments for a given result, and do not pretend to prove facts. The
      qualitative researcher works mainly with texts (documents, transcriptions of
      interviews etc.) not with numbers and statistics. The article presents a survey
      of qualitative research methods, and gives examples of the use of these methods
      in medical research in general practice. Finally the authors discuss the problems
      connected to using the concept of "science" in everyday medical practice.

PMID- 2219020
TI  - [Allergic reactions during streptokinase therapy].
AB  - The article reviews immunological reactions to streptokinase. The humoral immune
      response to streptokinase involves antibodies of different subclasses, including
      IgG, IgM, and IgE. A T cell response to streptokinase can also be demonstrated,
      involving both CD4 and CD8 positive cells. Streptokinase therapy involves
      increased risk of all kinds of allergic reactions, including urticaria, bronchial
      obstruction, shock and serum sickness.

PMID- 2219021
TI  - [Intravenous drug users and contact with the health care system].
AB  - Intravenous drug users in the Oslo area seem to have rather limited contact with
      treatment programmes (outpatient or inpatient). The data are taken from a survey
      of intravenous drug use among arrestees at Oslo Central Police Station. 1,394
      intravenous drug users were examined. Less than one third reported having had any
      contact with a treatment programme during the last six months, and less than 50%
      reported such contact during the last two years. More than 50% said that they had
      never been admitted to an inpatient treatment institution.

PMID- 2219022
TI  - [Accomplish more for less--a status report from Lovisenberg hospital].
AB  - In 1988 the local authorities increased the catchment area and reduced the budget
      for Lovisenberg hospital in Oslo. The hospital has met this challenge by
      improving its productivity. Despite a 20% cut in the acute bed capacity, the
      number of discharged patients was increased by 19 and 16%, and the length of stay
      for hospital care was shortened by 33 and 26%, at the medical and surgical
      departments respectively. The shorter period of hospitalization did not affect
      mortality or frequency of readmissions. We conclude that the present budget cuts
      have led to valuable changes at our hospital. The number of acute beds is now
      well balanced with the size of the catchment area (2.5 beds per 1000
      inhabitants). However, further reduction is not advisable.

PMID- 2219023
TI  - [Heredity and colorectal cancer].

PMID- 2219024
TI  - [Improved treatment of aortic aneurysms].

PMID- 2219025
TI  - [Are streptococcal infections on the rise?].

PMID- 2219026
TI  - [Diseases caused by Streptococcus pyogenes in Norway, 1975-1989. A microbiologic
      and epidemiologic survey].
AB  - The article briefly surveys the epidemiology of Streptococcus pyogenes caused
      disease in Norway during the last 15 years based on notification data, with
      emphasis on the nation-wide outbreak in 1987-88 caused by mucoid M-1 organisms.
      During the season S. pyogenes infections was 60% higher than expected. The number
      of bacteraemia cases, many with fulminant septicaemia, showed an almost threefold
      increase compared with earlier years. Unusual clinical manifestations such as
      necrotising fasciitis, pneumonia with empyema, primary peritonitis and meningitis
      also occurred. We briefly review the known virulence factors of S. pyogenes in an
      attempt to improve our understanding of the shift in clinical manifestations and
      occurrence of the disease.

PMID- 2219028
TI  - [The challenges of differential diagnosis of infections caused by beta-hemolytic
      streptococci].
AB  - Infections due to Streptococcus pyogenes are varied and often difficult to
      diagnose. During the last few years the clinical manifestations of these
      infections and the treatment rationale have changed. New diagnostic tests have
      been introduced. The present article reviews the diagnostic possibilities based
      upon clinical findings, the doctor's own laboratory and the microbiological
      laboratory. Rapid immunological tests, differential leukocyte count and C
      reactive protein are pointed out as potentially useful laboratory tools for the
      clinician.

PMID- 2219027
TI  - [Clinical manifestations caused by group A streptococci].
AB  - We describe the symptomatology of different disease entities caused by group A
      beta-hemolytic streptococci (Streptococcus pyogenes, GAS). The case histories of
      four patients, two of whom died, emphasize the severity of certain clinical
      manifestations of GAS-infections. A 34 year-old woman was admitted to hospital
      four days after start of the symptoms. She presented a clinical picture very
      similar to that observed in fulminant meningococcal septicaemia; i.e. extensive
      skin haemorrhages, circulatory collapse, and multiple organ failure. She died
      within 12 hours of admission. GAS were isolated in blood culture. A seven day-old
      girl died before admission to hospital. GAS were isolated in blood cultures,
      cerebrospinal fluid and from her nose and throat. An eight year-old,
      psychomotoric retarded girl developed a severe left-sided pneumonia, empyema and
      scarlatina. GAS were detected in throat culture. She responded poorly to high
      doses of benzylpenicillin given intravenously. She recovered rapidly after
      thoracotomy and decortication of her left lung. Finally, we describe the case of
      an 11 year-old boy with rheumatic fever without cardiac involvement. The reported
      cases underline the need for careful diagnosis and penicillin treatment in cases
      of GAS-infections.

PMID- 2219029
TI  - [Necrotizing fasciitis caused by group A streptococci].
AB  - The number of serious infections from group A streptococci has increased, and
      there have simultaneously been several cases of necrotizing fasciitis. This is an
      uncommon, but well-defined entity characterized by extensive necrosis of
      subcutaneous tissue and fascia, combined with signs of septicaemia. It is often
      accompanied by multi-organ failure. The mainstay of management is early diagnosis
      and prompt surgical intervention. It is mandatory that a surgeon, an infectious
      disease specialist and an anaesthesiologist collaborate on the therapy as a
      whole.

PMID- 2219030
TI  - [Improved treatment of abdominal aortic aneurysms. Progress over 17 years].
AB  - During the period 1970-86, 155 men and 24 women were operated on for abdominal
      aortic aneurysms at the University Hospital in Tromso. Elective operations were
      performed in 76 patients with an operative mortality of 5 (7%), impending rupture
      in 49, of whom 14 died (29%) and ruptured aneurysms in 54 patients, of whom 33
      (61%) died. There has been a substantial increase in the number of patients per
      year admitted with abdominal aneurysms, from an average of 4.5 during the years
      1970-76 inclusive, to over 20 during the years 1984-86. Operative and early
      postoperative mortality have been reduced and there has been no death following
      elective operations during the last three years of the reported period. Mortality
      was 8% for impending rupture and 45% for ruptured aneurysms. Electively abdominal
      aortic aneurysms can be operated safely even in patients over the age of 80.
      Ruptured aneurysms, however, still carry a high operative mortality in patients
      over the age of 70.

PMID- 2219031
TI  - [Outpatient angiography].
AB  - During the last few years it has been generally accepted that angiography can be
      performed on an outpatient basis. In 1988 and 1989, 130 angiographies were done
      in this manner at the Regional Hospital in Trondheim. All the examinations were
      carried out by conventional transfemoral technique. After the procedure the
      patients were observed for six hours in the surgical ward of the hospital before
      going home. 25 patients had to be hospitalized after examination. Only in two
      cases this was due to minor complications of the angiography. None of the
      patients experienced complications after discharge from hospital. The conclusion
      is that outpatient angiography must be considered a safe and cost-effective
      procedure.

PMID- 2219032
TI  - [Central nervous symptoms and findings in patients with systemic lupus
      erythematosus].
AB  - Systemic lupus erythematosus is a disease characterized by multiple autoimmune
      phenomena, and a broad clinical spectrum. Involvement of the central nervous
      system is common, and in the majority of patients occurs mainly as an organic
      brain syndrome or as migraineous headache. Cerebral atrophy as judged by CT scan
      is common. Cerebral infarction occurs in a minority of patients, mainly those
      with high disease activity and a high titer of anti-phospholipid antibodies.
      Systemic lupus erythematosus should be considered as a possible diagnosis in
      patients with certain central nervous system aberrations, especially young
      females.

PMID- 2219033
TI  - [Neuromuscular symptoms and findings in systemic lupus erythematosus].
AB  - Systemic lupus erythematosus (SLE) gives rise to a variety of autoimmune and
      clinical phenomena in a multisystem manner. Both the central and peripheral
      nervous systems are involved as well as skeletal muscle. Based on our work with
      SLE patients, we describe the different categories of peripheral neuropathy and
      myopathy. We suggest that the disease be considered as a possible diagnosis,
      especially when evaluating women with symptoms and signs of neuromuscular
      abnormalities.

PMID- 2219034
TI  - [Idiopathic long QT syndrome. An underdiagnosed disease].
AB  - Two eleven-year old boys were referred to the medical department, division of
      cardiology, Aust-Agder Central Hospital, because of reported attacks of syncope
      during physical exercise. Idiopathic prolongation of the QT-interval was
      diagnosed and their families were examined. A total of 25 patients with long QT
      syndrome were identified. Eight patients had attacks of syncope, six patients had
      dizzy spells and five persons were asymptomatic. Nine cases of sudden and
      unexpected death were assumed retrospectively to be due to QT-prolongation. All
      patients with syncopes of unknown cause should be examined for QT-prolongation,
      and the study confirms the importance of examining all family members of patients
      with idiopathic long QT-syndrome.

PMID- 2219035
TI  - [Rehabilitation after stroke].
AB  - Our hospital's stroke rehabilitation programme has been evaluated through a
      retrospective study of the record of 183 males (mean age 60 +/- 11 years) and 94
      females (mean age 59 +/- 14 years) admitted in 1982/83. 87% of the patients had
      motoric impairments on admission; 45% had apraxia, 17% neglect, 38% aphasia and
      57% other cognitive impairments. Most patients had both motoric and cognitive
      problems. 79% were able to ambulate freely at discharge as opposed to 55% on
      admission. 88% were independent in ADL when discharged; 67% on admission. The
      average length of stay (LOS) was shorter (p less than 0.005) for the males (57 +/
      32 days) than for the females (68 +/- 40 days). LOS was not significantly
      influenced by the patients' age. 81% of the patients were discharged to their
      homes. Significantly fewer patients with cognitive impairments were able to
      return to their homes after rehabilitation than in the case of those without such
      problems. The presence of aphasia did not significantly affect the rehabilitation
      outcome. It is concluded that the major obstacles for successful rehabilitation
      (i.e. back to the patient's home) are the cognitive impairments.

PMID- 2219036
TI  - [The risk of exposure to hepatitis B and human immunodeficiency virus among
      employees at Norwegian hospitals].
AB  - During the period from 1986 to 1989 a study was carried out to determine the risk
      of occupational exposure to hepatitis B virus and human immunodeficiency virus
      among approximately 5,500 employees at Aker hospital, Ulleval hospital and
      "Sentralsykehuset" in Akershus. Four hundred and fourteen injuries were reported
      during the study period of approximately 16,800 man-years, corresponding to an
      injury rate of 2.4/100 man-years. The majority of injuries occurred during direct
      patient contact in the wards. Of the known sources 8.2% were HBsAg positive and
      16.8% HIV-antibody positive. One attendant contracted hepatitis B during the
      observation period. No HIV-seroconversion has been observed as yet.

PMID- 2219037
TI  - [Ocular prosthesis production in Norway].
AB  - Individually adapted acrylic ocular prostheses are presented as an alternative to
      glass prostheses, which up to now have been the technique available to Norwegian
      patients who have lost an eye. The article describes the technique used to
      produce acrylic eyes and sums up the advantages of acrylic eyes compared with
      prostheses of glass.

PMID- 2219038
TI  - [Punch biopsy].

PMID- 2219039
TI  - [A neurologic day care clinic. Presentation of the concept, and the first 271
      patients].
AB  - Most of the patients remitted to this service are former inpatients who need more
      comprehensive examinations than usually performed in an ordinary outpatient
      setting. They attend for one or more days during office hours, spending the night
      at home or in a hotel. Investigative procedures are ordered in advance, and the
      patients receive written information about the various tests beforehand. Of the
      first 271 patients, 206 attended for one day, 63 for two days and two for three
      days. The examinations comprised 81 by lumbar myeloradiculography, 59 EMG, 56
      EEG, 46 cerebral CT scan, 33 SER (somatosensory evoked response), 32 BAER
      (brainstem auditory evoked response), and 16 VER (visual evoked response). A
      spinal fluid tap was performed in 49 patients, muscle biopsy in five patients,
      and 51 were examined by doppler of the precerebral arteries. The fact that the
      patients attend for one or more days instead of one hour is also of great benefit
      for teaching and research purposes.

PMID- 2219040
TI  - [Multidisciplinary assistance in a case of conduct disorder. A three-year
      project].
AB  - Conduct disorders are common. They concern many people inside and outside the
      health service. They are often a cause of despair in individuals, in the family
      and among professionals. This article describes the situation of a young boy. In
      1985 everybody was about to give up and said there was nothing more that could be
      done for him. In this situation a municipal multidisciplinary team, with a three
      year programme of treatment was organized. The purpose was to find out if it was
      possible to create new meanings in his surroundings, to give him a new start. The
      result is promising.

PMID- 2219041
TI  - [Use of public health statistics in the development of community diagnosis].
AB  - A community diagnosis which describes the health of the local population may be
      an important instrument in promoting health and preventing disease. Most general
      practitioners do not have time to carry out individual surveys in the local
      community. Therefore it seems relevant to look into the possibility of utilizing
      official health statistics as a basis for community diagnosis. We obtained and
      analysed demographic data, mortality data, statistics on cancer, data on causes
      of invalidity and risk factors for cardiovascular diseases for Askvoll
      municipality. This article demonstrates possibilities, obstacles and constraints
      in the use of such statistics. Suppliers of register data should make routine
      health statistics more available for use in the district health services. In this
      connection we recommend the development of a central health data information
      system.

PMID- 2219042
TI  - [Counselling in unplanned pregnancies].
AB  - The article describes experiences in a family guidance clinic when counselling
      women in early pregnancy. The women voluntarily sought help in deciding whether
      to have a legal abortion or to have the child. In this setting we have focussed
      mainly on the emotional relationship between the partners, and on the
      psychological reactions of the women confronted with this difficult choice.

PMID- 2219043
TI  - [Smoking and attitudes in Norway].

PMID- 2219044
TI  - [Latent and activated viral infections].

PMID- 2219045
TI  - [Should research be done at peripheral hospitals?].

PMID- 2219046
TI  - [Acute respiratory distress syndrome in adults].

PMID- 2219047
TI  - [Acute pulmonary dysfunction in adults. Adult respiratory distress syndrome-
      ARDS].
AB  - During a 3-year period 0.1% of all patients undergoing surgery and 0.3% of the
      patients submitted for trauma developed ARDS. The diagnosis was based on strict
      criteria. Mortality among the 42 patients was 45.2%. Abdominal sepsis was
      associated with high mortality, trauma with a much better prognosis. Swan-Ganz
      catheters were used in 81% of the patients. The measurements were characterized
      by high pulmonary vascular resistance and increased intrapulmonary shunting.
      However, the initial recordings showed only small differences between survivors
      and fatal cases as regards haemodynamics and blood gas parameters. Mortality was
      associated with low diuresis, heart failure, need of inotropic support and on age
      of over 50 years. The significance of invasive central monitoring is discussed.

PMID- 2219048
TI  - [Lung shock in connection with acute myocardial infarction. Adult respiratory
      distress syndrome, ARDS].
AB  - We describe the case of 42 year-old male patient who developed adult respiratory
      distress syndrome (ARDS) during an acute myocardial infarction. He was treated
      with positive pressure ventilation for 23 days. Chest X-ray showed multiple,
      bilateral infiltrates for several weeks. ARDS is accompanied by serious and
      progressive hypoxemia. Early diagnosis is important. The therapeutic consequences
      involve positive pressure ventilation with increased inspired oxygen
      concentration and positive end-expiratory pressure. ARDS in patients with
      impaired myocardial function can be difficult to recognize. It is an alternative
      diagnosis to pneumonia and ordinary heart failure when patients are seen to be
      suffering serious hypoxemia.

PMID- 2219050
TI  - [Xanthogranulomatous pyelonephritis. A benign, solid kidney tumor].
AB  - We report the case of a 68 year-old woman who underwent surgical treatment for
      xanthogranulomatous pyelonephritis. Xanthogranulomatous pyelonephritis is a rare,
      chronic, inflammatory lesion of the kidney. It is most frequently seen in middle
      aged women. Because of its clinical and radiological similarities to other renal
      lesions it can be difficult to establish a preoperative diagnosis. Nephrectomy is
      needed in most patients.

PMID- 2219049
TI  - [A phase II study of 5-fluorouracil/cisplatin in recurrent cervical cancer].
AB  - 50 patients with recurrent cervical carcinoma were included in a phase II study
      of cisplatinum and 5-fluorouracil. They were divided into patients with recurrent
      lesions outside the previously irradiated area (group 1) and those with at least
      one recurrent lesion inside this area (group 2). The treatment schedule consisted
      of 5-fluorouracil 1,000 mg/m2 intravenously during days 1 to 5, and cisplatinum
      100 mg/m2 intravenously in day 1. 45 patients could be evaluated for response and
      toxicity with a median survival of 14+ months, (range 4-38+). In group 1 (29
      patients) seven achieved complete response with a median duration of 14+ months,
      (range 3(+)-26+), median survival of 19+ months, (range 5(+)-28+), and 13
      achieved partial response with a median duration of 8+ months, (range 3(+)-25+),
      median survival of 16 months, (range 6(+)-31+). In group 2 (16 patients) one
      patient achieved complete response and two partial response. One patient in this
      group with stationary disease is still alive after 38+ months. All the patients
      suffered from nausea and vomiting. The dose-limiting factor was bone marrow
      suppression. The response rate in group 1 of 69%, with a median survival of 19+
      months, is higher than previously achieved with other cytostatic regimens. We
      found the regimen to be very toxic, however, for patients with central
      recurrences in previously irradiated areas, though some of these patients did
      achieve marked relief from pain.

PMID- 2219051
TI  - [Viral infections in immunocompromised patients].
AB  - An increasing number of patients are immunocompromised due to modern treatment of
      cancer, organ transplantations and HIV-infections. Opportunistic viral infections
      are common and may cause serious disease among these patients. New vaccines,
      immunomodulators and antiviral drugs make it possible to prevent and treat many
      of these infections. We review the host defence against viral infections and the
      most important viral infections. We also discuss prophylaxis, diagnosis and
      therapy.

PMID- 2219052
TI  - [Correlation of symptoms and clinical findings in polyneuropathy].
AB  - A scoring system for neuropathic symptoms (neuropathic symptom score) and signs
      (neurologic disability score) has been applied on 30 patients with
      polyneuropathy. Vibration sense thresholds were also measured by vibrametry. A
      statistically significant association between the neuropathic symptom score and
      the neurologic disability score was demonstrated. Disability scores expressing
      sensory items were significantly associated with vibration threshold on the index
      finger and even stronger with that on the big toe, which also correlated well
      with the sum of the patients' neuropathy deficits (total neurologic disability
      score). We recommend that registration of neurologic disability score in
      particular and if possible also vibrametry (and other quantitative sensory tests)
      are performed in the primary evaluation of patients with polyneuropathy, and
      especially in subsequent examinations to clinically monitor the patients.

PMID- 2219053
TI  - [The examination pattern at an x-ray department over a 25 year period].
AB  - The pattern of examinations at the x-ray department of Buskerud sentralsykehus
      has changed over the last 25 years. Heart- lung- and skeleton examinations remain
      unchanged, and represent 71 to 79% of the total number, but there has been a
      marked charge in other examinations. Through the years there has been a marked
      decline in the number of "classical" contrast medium examinations of
      gallbladder/gall-paths, gastroduodenal examinations and intravenous pyelography.
      Air-encephalography has disappeared, and arthrography is about to disappear as an
      x-ray examination. New methods, such as computer-tomography and ultrasonography
      and non-radiological examinations, such as gastroscopy and arthroscopy, seem to
      be the main reason for this change, but other factors, such as change in disease
      patterns and therapeutic procedures may also have contributed.

PMID- 2219056
TI  - [Clinical research--relations of central and peripheral hospitals].
AB  - Clinical research is of great importance for the patients, the medical industry,
      doctors, hospitals and society as a whole. More time should be set aside for
      clinical research during (daily) working hours. Arrangements should be made to
      stimulate and guide young colleagues who have new ideas, through scientific
      projects at whatever hospital they work. Depending on economy and the doctors'
      qualifications, central and peripheral hospitals should cooperate on clinical
      research. Although their hospitals are of different size, the doctors are equally
      capable and cooperation is characterized by colleagual interdependence.

PMID- 2219055
TI  - [The loose-leaf book of procedures. A regional model for diagnostic and referral
      routines--a basis for improved cooperation between primary and secondary
      services].
AB  - Initiated by the Telemark branch of the Norwegian Medical Association a loose
      leaf book of procedures has been prepared for use in the region of Telemark
      Central Hospital. The professional advice given in the book is based on an
      agreement between the chief physicians of the various hospital units, their
      discussions in the unit, and a group of four general physicians. The advice is
      only intended as a guide. The editors' idea is to have the book distributed to
      all G.P.s and hospital units in Telemark. The book is meant to be updated once a
      year.

PMID- 2219054
TI  - [Measurement of ankle blood pressure in peripheral atherosclerosis].

PMID- 2219057
TI  - [Should we perform long-term cohort studies on the use of antihypertensive
      agents?].
AB  - The 1-year PMS Carduran study included more than 4,500 hypertensive patients
      treated by more than 600 general practitioners. The objective was to study side
      effects and treatment efficiency. The Research Board of General Practitioners has
      criticised this and similar PMS studies because they tend to serve marketing
      purposes and are of low scientific value. It is argued in this paper that large
      independent prospective pharmaco-epidemiological studies, if well performed, may
      provide important information on the use (and possibly misuse) of new drugs in
      general practice, information which may not be known prior to registration. Also,
      the great potential in providing long term information on disease prognosis is
      underlined. An example of a 5-year study of Carduran-treated hypertensive
      patients is outlined.

PMID- 2219058
TI  - [Ergotamine induced ischemia].

PMID- 2219059
TI  - [Health problems and health care needs of HIV positive drug abusers].

PMID- 2219060
TI  - [Atopic dermatitis (eczema) and skin tests].

PMID- 2219061
TI  - [Therapeutic and health care needs of HIV positive drug abusers. A study from an
      emergency institution].
AB  - Drug taking behaviour(DTES), psychiatric condition(DSM-III-R) and physical health
      were evaluated in 44 HIV-positive inpatients at a detoxification unit for drug
      addicts during the period October 1987 to December 1988. The investigation
      revealed marked psychopathology, especially in terms of personality disorders.
      The patients were followed up at the end of April 1989. At this time ten patients
      were abstinent, though all of them remained under care. 26 patients had relapsed
      to heavy abuse. Four had died. An unfavourable outcome seems to correlate with
      heavy abuse and poor physical health. We discuss the consequences for existing
      provisions for treatment, as well as alternative solutions.

PMID- 2219062
TI  - [Skin-prick tests in atopic dermatitis].
AB  - The usefulness of skin prick tests in the management of atopic dermatitis is
      discussed on the basis of results from testing 100 patients, mean age 23 years.
      Skin prick tests may be useful when allergies to food are suspected, and also
      when it is suspected that the dermatitis is aggravated due to reactions to
      airborne allergens. Testing with a series of common inhalant allergens may
      provide information about the tendency to respond with IgE-synthesis. From a
      practical and economical point of view, a skin prick test may be a good
      alternative to other techniques for allergy testing.

PMID- 2219063
TI  - [Alternative medicine and chronic skin disease. Use of alternative treatments
      among patients with atopic eczema and psoriasis].
AB  - In a questionnaire study at a university hospital in Norway, 227 of 444 patients
      with atopic dermatitis (51.1%) and 215 of 506 patients with psoriasis (42.5%)
      reported previous or current use of one or more form of alternative medicine.
      Most used were homoeopathy, health food preparations and herbal remedies. The use
      was related to the disease duration and severity of the disease and, among the
      atopic dermatitis patients, lack of effective treatment by physicians, as judged
      by the patients. The patients also reported on their motivation for alternative
      medicine, their source of information on such, and its effect. The use of
      alternative medicine is commonplace and should be of concern to all physicians.
      The study emphasizes the need for documentation of the effects of alternative
      therapies.

PMID- 2219064
TI  - [Blood pressure elevation among industrial workers exposed to stress].
AB  - A standardized, annual medical examination of a group of heat workers exposed to,
      and another group not exposed to heat in a Norwegian ferro-alloy plant over a
      period of six years showed no statistically significant difference in blood
      pressure between the two groups. However, following three years of stable blood
      pressure and heart rates, both parameters increased markedly in both groups. The
      occurrence of this sudden increase in blood pressure coincided with the plant
      being threatened with the possibility of closure due to inability to operate at a
      profit. This threat persisted for more than two years, but even afterwards, when
      it was quite clear that jobs at the plant were no longer threatened, the blood
      pressure remained markedly elevated. These findings emphasize the importance of
      being aware of the possible relationship between prolonged mental stress and
      hypertension.

PMID- 2219065
TI  - [The use of copper and niobium filters in diagnostic x-ray equipment. A
      comparison of dose reduction, tube loading and picture quality].
AB  - A dose-reducing niobium filter for use in diagnostic radiology was introduced in
      Norway in 1989. The effect of this filter was compared with that of an ordinary
      copper filter. Either a 0.05 mm niobium filter or a 0.10 mm copper filter was
      placed into the beam from an X-ray tube. Parallel measurements were made of dose
      reduction to the patient, image quality and tube loading. The copper filter
      reduced skin doses more than the niobium filter did, and caused less increase in
      tube loading. The resulting image quality was considered to be the same. We
      conclude that a 0.10 mm copper filter is better than a niobium filter in
      achieving a considerable dose reduction to the patient, and is far less
      expensive.

PMID- 2219066
TI  - [Wegener's granulomatosis. New aspects of diagnosis, treatment and prognosis].
AB  - In its classical form, Wegener's granulomatosis (WG) is characterized by acute
      granulomatous vasculitis of the upper and lower respiratory tract together with
      glomerulonephritis, and when untreated, mortality is high. The use of
      cyclophosphamide and prednisolon has improved the prognosis dramatically, while
      azathioprine and trimetoprim-sulfamethoxazole are of limited therapeutic value in
      these patients. Only 1/3 of subacute and chronic cases show renal impairment, and
      the prognosis is better in limited Wegener's granulomatosis without renal disease
      than in the classical form. This case-report and review takes up various new
      aspects of diagnosis, treatment and prognosis.

PMID- 2219067
TI  - [Yellow nail syndrome. Lymphatic vessel hypoplasia as a cause of pleural
      effusion].
AB  - Yellow nail syndrome is a clinical entity characterized by lymphedema, nail
      dystrophy and exudative pleural effusion. The cause of the syndrome is thought to
      be hypoplasia of the lymphatic vessels, with local infection or inflammation as a
      common precipitating event. Treatment is symptomatic: chemical or surgical
      induced pleurodesis is the best way of controlling symptomatic pleural effusion.

PMID- 2219068
TI  - [Diagnosis of type 2 diabetes in general practice].
AB  - Among 285 patients seen in general practice, all over the age of 40, 11 (4%) new
      cases of non-insulin-dependent diabetes mellitus was diagnosed. 12 patients (4%)
      were found to have impaired glucose tolerance. Measurement of glucose levels in
      unstandardized blood samples is a suitable method of screening for non-insulin
      dependent diabetes in general practice. In order to reduce the number of oral
      glucose tolerance tests we suggest a modification of WHO guidelines.

PMID- 2219069
TI  - [Institutionalized treatment of agoraphobia with panic anxiety].
AB  - We describe an integrated behavioral-psychodynamic treatment programme for
      inpatients suffering from agoraphobia and panic anxiety. This programme
      emphasizes intensive drug-free exposure training followed by work with anxiety
      laden dynamic conflicts. We present promising results of evaluation studies, and
      discuss the important role of cognitive reconstruction of anxiety and of passive
      and active avoidant attitudes in exposure training. Lastly, we make certain
      recommendations concerning the approach to anxiety problems in general practice.

PMID- 2219070
TI  - [History of the Norwegian Military Medical Association].
AB  - The Norwegian Military Medical Association was founded in 1882 by a small group
      of army doctors. The principal aim of the Association was to establish a
      structured military medical corps with command functions. Furthermore, the newly
      founded group of active military doctors was intended to develop the medical
      knowledge and skills unique to this branch of medicine. In 1888 a military
      medical organization and command structure was finally accepted. The Association
      was very active for the first 25 years, printing articles and giving lectures on
      military medical subjects. After World War II the military medical service was
      organized in "HQ Defence Command Norway, Joint Medical Service". For many years
      to come this new organization took over some of the functions of the Military
      Medical Association. In 1952 the Association was accepted as a special branch of
      the Norwegian Medical Association. The Norwegian Military Medical Association is
      now active again, both as an organization and professionally. The number of
      members is increasing, and includes military doctors in active service as well as
      civilian doctors with an interest in military medicine.

PMID- 2219071
TI  - [Treatment of heart failure with angiotensin converting enzyme inhibitors].
AB  - Stimulation of the renin angiotensin system, catecholamines and antidiuretic
      hormone causes prominent vasoconstriction in severe heart failure. Angiotensin
      converting enzyme inhibitors reverse these effects, and thus ameliorate cardiac
      function and reduce mortality in severe heart failure. Angiotensin II is an
      important regulator of renal function in diseases with renal hypoperfusion, and
      treatment with angiotensin converting enzyme inhibitors may cause a serious
      decrease in glomerular filtration and hyperkalemia. Asymptomatic heart failure,
      acute heart failure and acute myocardial infarction are areas where angiotensin
      converting enzyme inhibitors may prove beneficial in the future.

PMID- 2219072
TI  - [Diagnostic prick tests].

PMID- 2219074
TI  - [Mad cow disease].

PMID- 2219073
TI  - [The physician, the drug abuser and drug abuse].
AB  - Drug abusers have a low tolerance for unpleasant and painful emotions and
      experience a need for chemical relief through use of narcotics, tranquilizers and
      analgesics. Physicians may show a tendency to comply with their request for such
      drugs, partly because they give way under pressure (threats, violence) and partly
      because of their own unconscious need for acceptance and appreciation from the
      patients. The use of prescribed drugs may inspire an illusion that drug therapy
      is a "solution" and withdraw attention from other therapies. The prescription of
      medicaments may represent an extension of already existing abuse. Physicians must
      be aware of these problems of prescription and of the problems connected to
      patients' use of threats and violence.

PMID- 2219075
TI  - [Intracutaneous injections with sterile water as obstetric analgesia].

PMID- 2219076
TI  - [Toxicological and pharmacological effects of the use of bovine somatotropin in
      dairy farming].
AB  - Some possible toxicological and pharmacological consequences of the use of bovine
      growth hormone (BST) synthesised using recombinant DNA techniques are discussed
      in the present paper. Three spheres of interest are reviewed. Target species:
      When BST is used correctly, negative effects on the target species are unlikely
      to occur. Obscurity may to some extent remain as regards the effect of BST on the
      immune system. Residues of BST and IGF: There is nothing to suggest that the BST
      levels in the milk will increase significantly following BST treatment. Slight
      elevations of the levels of IGF-1 (one of the so-called somatomedins) in the milk
      following treatment with BST have been reported. However, the concentration of
      IGF-1 that is reached after the correct use of BST is still lower than that in
      milk collected during early stages of lactation. As a result of the peptide
      character of BST and IGF-1, absorption by healthy human individuals is unlikely
      to occur. The relevance of the problem of BST and/or IGF-1, absorption from milk
      by some individuals such as young infants is also discussed in this paper.
      Interaction with the metabolism of drugs: A possible interaction between BST and
      drugs which are administered to the animal at the same time, as is observed in
      rats and occasionally also in human subjects could have consequences for the
      clinical effectiveness, side-effects and drug residues in food products of animal
      origin. So far, however, an interaction of this type could not be detected in
      ruminants. At the present time, this phenomenon is being studied in greater
      detail.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2219077
TI  - [Cobalt deficiency and photosensitivity in a flock of Texel lambs].
AB  - In a flock of thirty lambs ten animals showed symptoms of photosensitisation
      within a short period of time. Soon after treatment with vitamin B12 the symptoms
      disappeared. Clinical examination, differential diagnosis, treatment and course
      of the disease are discussed. It is assumed that the lambs suffered from 'white
      liver disease'.

PMID- 2219078
TI  - [Endoscopy in gastrointestinal problems in dogs--an indispensable diagnostic
      technique].

PMID- 2219079
TI  - [Malignant grass-tetanus and meat inspection].

PMID- 2219080
TI  - [Veterinary Chief Inspection of Public Health. Sequelae of open borders for the
      veterinary control of food of animal origin].

PMID- 2219082
TI  - [Current possibilities of improving health and welfare status of pigs through
      introduction of the specific 'Stress Free' (SSF) System].
AB  - Health and welfare problems of pigs in intensive husbandry systems are mainly
      caused by housing and management of the animals. The actual structure of these
      systems also gives rise to health and welfare problems. Solving these problems is
      very difficult to achieve in the existing systems. It will be necessary to create
      new structures and housing systems from a preventive veterinary point of view to
      avoid harm to health and welfare caused by specific stressors. Specific stressors
      which can be prevented are associated with the risk of infection, mixing and
      replacing animals, high density, inadequate house climate, handling of animals
      and the farmer's attitude towards his animals. The SSF-system specifies the
      method by which these specific stressors are prevented.

PMID- 2219081
TI  - [Oxytetracycline and oral herd treatment: a literature review].
AB  - Pharmacotherapeutic, pharmacodynamic and pharmacokinetic aspects of oral mass
      medication with oxytetracycline (OTC) in pigs, calves and poultry are discussed
      in this review. Clinical studies with successful therapeutic results are scarce
      in literature; however, OTC is still frequently used for mass medication. Some
      practical advice to improve the bioavailability of OTC is given. This mainly
      concerns the reduction of the interaction between calcium ions and OTC. OTC may
      be useful for oral mass medication when applied as a prophylactic drug.
      Pharmacological studies are required in order to provide more knowledge about the
      efficacy of OTC-mass medication. Additional information can be acquired from the
      field by improving and extending the reciprocal co-operation between field
      veterinarians and diagnostic laboratories. This may lead to a more justified
      choice from the various possibilities of antimicrobial use in livestock.

PMID- 2219083
TI  - [Euthanasia of bullfrogs (rana catesbeiana)].

PMID- 2219084
TI  - [Vaccination during corticosteroid therapy?].

PMID- 2219085
TI  - [Euthanasia of (bull)frogs].

PMID- 2219086
TI  - [Veterinary Chief Inspection of Public Health. Salmonella enteritidis in poultry:
      monitoring and control].

PMID- 2219088
TI  - [Lead poisoning in cattle in north Netherlands. October 1989-January 1990].
AB  - By the end of 1989 a serious lead intoxication of cattle occurred in the northern
      part of the Netherlands (provinces Groningen and Friesland). This intoxication
      appeared to be caused by contaminated feed. Over 300 farms were stricken, with
      about 15,500 animals (mostly dairy cattle). In a period of one to four weeks
      these animals consumed about 1,000 kg of lead. This resulted in lead levels in
      milk, livers, and kidneys above the regulatory safety limits. Thanks to the
      chelating therapy that was rapidly applied by the local veterinarians, only about
      30 animals died of an acute lead intoxication. The cooperating governmental and
      private authorities took action to prevent exposure of consumers to lead
      contaminated animal products. Based on careful estimations, predictions were made
      of the lead levels to be expected in animals products and the time needed for
      depletion of these levels. The appropriate animals were marked to ensure their
      identification, and the decline in time of the lead levels in milk and offals was
      conscientiously monitored. In the second week of 1990 the lead concentrations
      were decreased to levels well below the regulatory limits, and hence the marks
      were removed from the animals.

PMID- 2219087
TI  - [Triclabendazole (Fasinex) residue in milk: determination and excretion
      kinetics].
AB  - The determination of triclabendazole (Fasinex) in milk is described. The
      excretion of triclabendazole and its two main metabolites was measured under
      field conditions in twenty-five cows. Triclabendazole was administered to cows in
      a dosage of approximately 12 mg kg-1. The maximum concentration of the main
      metabolites of triclabendazole (triclabendzole sulphone) measured in milk was
      1.415 mg/l. Metabolites could be detected in milk during a ten-day-period. Only
      1.5% (maximum) of the triclabendazole administered was eliminated as
      triclabendazole sulphone by way of milk.

PMID- 2219089
TI  - [Epidemiology, chemotherapy, anthelmintics-resistance and prevention of
      Strongylidae infections in horses].
AB  - The epidemiology, chemotherapy and control of strongylus infections in the horse
      are discussed. The annual cycle of various species are stated. In addition the
      anthelmintics available for treatment and control and the occurrence of
      anthelmintic resistance are referred to. Finally the options for control under
      various management conditions (little if any grazing; extensive grazing;
      intensive grazing) are discussed.

PMID- 2219090
TI  - [Flatulence in connection with feed].

PMID- 2219091
TI  - [Sports during pregnancy].
AB  - The aim of this article is to investigate to what extent physical exercise and
      pregnancy affect each other. Despite an increase in metabolism at rest, the
      amount of oxygen available for exercise is virtually unaffected by pregnancy. The
      capability to perform exercise (in W) is equally unaffected, but body weight
      increases. As a result the maximal running speed and/or distance decreases during
      pregnancy. The fetus needs a constant supply of oxygen and nutrients. During
      exercise uterine blood flow decreases. This decrease is linearly correlated with
      the intensity and the duration of exercise and the maximal reduction averages
      approximately 25%. Nonetheless, uterine oxygen consumption is maintained. This is
      the result of compensation through hemoconcentration, redistribution of blood
      flow within the uterus, and increased oxygen extraction. A harmful effect of
      physical exercise on the child in utero, such as abortion, hypoxia, or growth
      retardation, has not been demonstrated so far. Although exercise does not seem to
      be harmful during normal gestation, one should be careful in case of pregnancy
      complications such as pregnancy-induced hypertension or premature contractions.

PMID- 2219092
TI  - [Healthy children and sports].
AB  - Sport can be considered as an excellent alternative for unhealthy consumption
      habits and can compensate far the outcome of a sedentary lifestyle. The youngster
      can improve technique, coordination and flexibility in an easy way by training
      programs. Specific weight training programs are not recommended for those under
      the age of fifteen years. Regular exercise programs at young ages have positive
      effects on the general education, and during life habitual exercise training
      reduce the severity of cardiovascular and other diseases. It promotes the fitness
      of the body and the mind. Sport, a lifetime, must be part of a healthy lifestyle
      and must be encouraged younger ages. Health effects in a long term depend on
      exercise programs lasting years.

PMID- 2219093
TI  - [Athletic injuries in children].
AB  - Sports participation can have both beneficial and negative effects. Specific
      effects are injuries. The change of incidence is dependent on a number of
      personal and environmental factors. Epidemiological research in the Netherlands
      in school aged children has shown that sports injuries occur primarily in club
      sport, even more during competition. The injuries are localised in the lower
      limbs: especially the knee and the ankle. The injuries are distortions and
      contusions and fewer fractures and muscle tears. The number of overuse injuries
      seems to be rising because children are doing increasingly more intensive sport
      at younger ages. A preventive sports medical examination has been discussed as
      well as the preventive effect of warming-up and cooling down, stretching
      exercises, rehabilitation, taping, rules of play and sports facilities. Finally,
      attention has been given to the general care of sports injuries in the way of
      active and functional guidance in the healing process.

PMID- 2219094
TI  - [When sports no longer is a game ... the clinical aspects of competitive sports
      in children].
AB  - Physical and psychic vulnerability in children performing competitive sports may
      turn an accidental injury into a starting-point for chronic pain. This pain may
      give rise to serious physical and social restraints. The case histories of two
      fourteen years old girls are presented. Both patients suffered from
      overburdening. This phenomenon had not been recognized, or was not explicitly
      stated at least. Probably, too high expectations from medical help by parents and
      child played a crucial role. Expectations were twofold: the chronic pain should
      fit a specific defect caused by the injury, or it should be due to a (serious)
      disease. Both types of expectations led to disappointments, repeated diagnostic
      procedures and ineffective therapies. A comprehensive assessment without delay by
      a multidisciplinary pediatric team is recommended.

PMID- 2219095
TI  - [sports by children with a bleeding tendency].
AB  - In children with bleeding tendency it is a dilemma to go in for sports. The risks
      and benefits are to be weighed against each other. Mostly there is no need to
      impede the child's activities. Several sports that safely can be played by
      children with hemorrhagic diathesis are summed up. Specific aspects of sports by
      children with thrombocytopenia, Von Willebrand's disease, hemophilia and
      thrombasthenia are discussed.

PMID- 2219096
TI  - [Points of departure in sports counseling of children with congenital heart
      defects].
AB  - When counseling children with congenital heart disease who want to participate in
      sports, it is, generally speaking, preferable to choose a dynamic sport rather
      than a static one. Also, the degree of intensity is of major importance. In this
      connection it is useful to differentiate between recreation-oriented and
      achievement-oriented participation in sports. The extra risks for a child with
      congenital heart disease are progression of the severely of the anomaly, rhythm
      disturbances, sudden death, and complications due to medication. For the majority
      of these children the recommendation will be a strictly individual one, based on
      the (exercise)electrocardiogram, the 24-hours-ECG monitoring, and the echo
      Doppler-cardiogram. Invasive techniques are usually unnecessary.

PMID- 2219097
TI  - [Diabetes mellitus in children and sports].
AB  - The short-term and longterm effects of physical exercise and sports on the
      regulation of diabetes mellitus in children are described. The precise tuning of
      insulin dosage, food and sports can be achieved with self-control and self
      regulation. Advisable sports activities and limitations like poor metabolic
      control are being discussed. Regular physical exercise for diabetic children is
      advised to prevent lack of movement, also for their health in older age.

PMID- 2219098
TI  - [Sports in children with COPD].
AB  - Doctors and the surroundings of children are often unacquainted with chronic
      illnesses in combination with physical activity. This leads to prudence. The
      latter causes restricted physical activity in a lot of children with obstructive
      lung diseases as a result of an advice not to participate in sports.
      Consequently, the child may get into psychosocial isolation. Pathogenesis,
      diagnosis and treatment of exercise-induced bronchoconstriction (EIB) are
      described. EIB is hardly ever a problem at participating in sports, if treated
      well. In general, it can be concluded that only a small group of children with
      diffusion disorder is at risk during some sports. Detection and sport advises for
      this group will be discussed.

PMID- 2219100
TI  - [Clinical case. Bull terrier, female, 5 years old].

PMID- 2219099
TI  - [Has the animal owner a right to radiographs taken of his animal?].
AB  - In the Federal Republic of Germany a veterinarian owns radiographs taken of
      animals in his practice. They have to be filed like any other results of
      diagnostic procedures. This is important, because evidence is required in the
      case of a law suit. On the other hand, it has to be stressed that taking
      radiographs is the subject of a free contract between owner and veterinarian. So
      it is possible to take the radiographs solely with the purpose of giving them to
      the owner, who may have them analysed by any other veterinarian of his choice.
      This is especially true in hip radiographs, which are evaluated and filed by an
      adjudicator of the breed association. In any case the radiologist has the
      obligation to lend the radiographs to another veterinarian on request for
      inspection. The second veterinarian has to give them back as soon as possible.

PMID- 2219101
TI  - [Diuretics].
AB  - The pharmacology of the commonly used diuretic agents is reviewed, with special
      reference to the "high ceiling" diuretics and the benzothiadiazines, which are
      widely used in veterinary medicine. The different clinical indications in
      veterinary medicine are discussed.

PMID- 2219102
TI  - [Disseminated candidiasis in a calf. Case report].
AB  - The pathological-anatomical and histological examinations of different organs
      from a calf that died at the age of 9 weeks indicated a disseminated candidiasis.
      Candida albicans was isolated from brain, lung, liver, spleen, kidney, intestinal
      lymph nodes and small intestinal contents. The antibiotics administered to the
      calf by the owner probably initiated the disseminated candidiasis.

PMID- 2219104
TI  - [Refusal of breeding bulls to eat hay contaminated with horsetail (Equisetum
      palustre)].
AB  - Bulls refused hay from a new batch (coming from a nonintensively fertilized area
      in Southern Germany). The intake of other components of the ration (silage,
      concentrates) was not influenced. The visual inspection of the hay revealed a
      massive contamination (about 12% by mass) by horsetail. According to the reported
      observations it seems that cattle recognize the plant by its odour, and refuse it
      if alternative roughage is available, thereby escaping an intoxication.

PMID- 2219103
TI  - [Recent information about the orf virus of small ruminants].
AB  - New scientific findings in the field of immunobiology and diagnosis of
      parapoxvirus ovis (Orf-virus) as the causal agent of a zoonosis are presented.
      The adaptation of Orf-virus to cell lines and its in vitro multiplication without
      difficulties offer the possibility for extensive studies into the biology of
      parapoxviruses. The development of monoclonal antibodies (MAB) against an
      attenuated Orf-virus strain (D-1701) led to the elaboration of a simplified,
      cheap and highly sensitive "antigen detection ELISA" as a diagnostic tool.
      Moreover the MAB's can be used to identify parapoxvirus in cells of infected
      tissues (indirect immuno-peroxidase technique) which is an important precondition
      for more detailed surveillance of the pathogenesis of parapoxvirus infections.
      The immunobiological behavior of the Orf-virus in its natural hosts (small
      ruminants) as well as in non-susceptible species (e.g. laboratory animals) is
      explained by the course of cellular and humoral immune reactions following
      infection or vaccination. The problems of combat measures against contagious
      ecthyma (scabby mouth) of sheep and the human Orf-virus infections are discussed.

PMID- 2219105
TI  - [Corynebacterium suis infection in swine. 1. Clinical diagnosis with special
      consideration of urine studies and cystoscopy].
AB  - Experimental and spontaneous infections with Corynebacterium suis in sows were
      investigated. In early stages animals show no clinical disorders or only for a
      short time. However, there are already marked changes in urinary samples
      (hematuria, proteinuria, leukocyturia, gross alterations). Using an endoscope
      mucosal irritations can be seen mainly on the floor of the bladders. In chronic
      cases alterations in urine are more pronounced. If a pyelonephritis is present in
      addition to the cystitis, general signs of illness are evident including
      anorexia, emaciation, anemia, subnormal body temperature and abortions. Bladders
      demonstrate an erosive and ulcerative, hemorrhagic cystitis on the whole mucosal
      surface. Uremia appears only in late stages of the disease.

PMID- 2219106
TI  - [Acidification of the stomach contents of weaned piglets--effect of feed quantity
      and composition].
AB  - The pH in the stomach chyme (5-8 hours past offering the diet) of reared piglets
      was strongly correlated to the ingested feed quantity, a complete acidification
      of the stomach contents occurred in restrictively fed piglets (15 g diet/kg BW)
      only. Feeding ad libitum resulted in comparable low pH values in the fundus and
      pylorus region only, whereas in the cardiac region high pH values (5-6.5) were
      observed. Formic acid as feed additive (5 ml/kg diet) did not influence the pH in
      stomach contents significantly, on the other hand the ingestion of a diet with
      high CaCO3 content (59 g Ca/kg DM) prevented the acidification of the stomach
      chyme totally. The variation of pH-values in the different areas within the
      stomach was caused mainly by the variation of hydrochloric acid concentrations,
      the influence of lactic acid concentration was negligible.

PMID- 2219107
TI  - [Epizootiology, clinical aspects and therapy of Pasteurella multocida infection
      in bird patients after cat bite].
AB  - Since early 1986, fatal cases of Pasteurella multocida infection following cat
      bites have been seen regularly among avian patients at our institute. The
      problems of the epizootiology of this infection are discussed on the basis of
      research during the last three and a half years. By evaluation of collected data
      from clinical examinations, autopsies, bacteriological and biochemical diagnosis
      of isolated strains from birds and cats the possibility of transmission via cat
      bite is discussed as well as the status of cats and birds in an epizootic chain.
      Even birds with trivial wounds caused by cats must be classified as emergency
      patients. The risk of an infection after a cat bite is about 56%. For treatment
      of a Pasteurella multocida infection Doxycycline should be used.

PMID- 2219108
TI  - [Radiographic diagnosis of abdominal diseases in foals and ponys. II. Pathologic
      findings in 60 cases].
AB  - A diagnostic approach based on clinical and radiographic examinations for
      evaluation of young foals and small ponies with acute abdominal discomfort is
      presented. Standing right to left lateral abdominal radiographs were taken of 54
      foals and 6 ponies using a previously described technique. Interpretation of the
      radiographs was in conjunction with all clinical and laboratory findings and
      patient management. Using this approach, the site and cause of acute abdominal
      discomfort could be diagnosed accurately in 55 of 60 (91%) patients as confirmed
      by clinical, surgical or necropsy findings. Typical radiographs and photographs
      taken at surgery or at necropsy are presented. Typical radiographic findings,
      their interpretation and possible underlying gastrointestinal diseases are
      listed. The incorporation of standing lateral abdominal radiography in the
      clinical evaluation of foals and ponies with acute abdominal diseases gives
      findings of high diagnostic significance and should contribute to clinical
      decision-making. Abdominal radiography can replace data from rectal palpation in
      foals and ponies.

PMID- 2219109
TI  - [The applicability of a detection method independent of a laboratory for
      progesterone in the blood plasma of mares (Hygia progesterone test)].
AB  - A rapid progesterone assay for cow's milk was checked as to whether it was
      applicable to mares' blood plasma. The "Hygia Progesterone-Test" is an on-farm
      test which serves for qualitative analysis. It is generally unusable for mares'
      plasma but sufficiently precise only in cases of larger or smaller progesterone
      levels. In cases of moderate amounts of progesterone the test is imprecise. The
      test can be carried out quickly and easily, but the preparation of blood samples
      takes more time than preparation of milk samples. The test can be recommended for
      usage in veterinary practice only, but not for animal owners.

PMID- 2219110
TI  - [The frequency of coccidial infection in dog families of different husbandry and
      breeds in south Germany].
AB  - Oocysts and/or sporocysts were detected in 50 litters and 37 bitches of 100
      coproscopically examined dog families in Southern Germany. Oocysts of Isospora
      spp. were excreted by 41 of the 50 positive litters, 36 and 16 litters shedding
      oocysts of Isospora ohioensis/burrowsi and I. canis, respectively. Sporocysts of
      Sarcocystis spp. and oocysts of Hammondia heydorni were detected in 12 and 7
      litters, respectively. The excretion rates of the dams were arranged analogous to
      the detection of oocysts of Isospora spp. in 25 animals. Sporocysts of
      Sarcocystis and oocysts of H. heydorni were excreted by 19 and 6 dams,
      respectively. With regard to husbandry conditions distinct differences were
      established only for Isospora spp., because dog families kept in kennels always
      revealed higher excretion levels than dog mothers and their litters kept indoors.
      Excretion intensities increased directly proportional to the number of additional
      adult dogs and the number of litters born per year/stock, reaching maximum values
      of 80-100%. Analysis revealed no breed-related differences.

PMID- 2219111
TI  - [Perinatal mortality in dogs. Clinical, bacteriological and pathological
      studies].
AB  - 1. In intensively operated dog breeding kennels bacterial infections are very
      significant in perinatal mortality. 2. Staph. aureus, Streptococci (type G) and
      also beta-haemolytic E. coli were transmitted intra-uterine or by the infected
      genital tract to the puppies. In many cases they are the cause of septicaemic
      death of the puppies. 3. A second important cause of infection is subclinical
      mastitis of the bitch, leading to septicaemic death of newborn puppies. 4.
      Prophylactic hygienic measures make possible a prognosis concerning the risk of
      perinatal death. This includes examinations of the dog and the bitch ante coitum,
      bacteriological examination of the genital tract of the bitch, and a
      bacteriological examination of the milk before the date of birth. 5. Prophylactic
      hygienic measures in combination with antibiotic treatment of the bitch or the
      puppies could reduce the losses of puppies to less than 10%.

PMID- 2219112
TI  - [Isopods as fish parasites].
AB  - In January '87 a parasitic isopod not previously described was discovered in the
      mouth of the fish species Cichla ocellatus from the South American river Demini,
      a tributary of the Rio Araca. The parasite was classified as Telotha sp. A short
      description is given.

PMID- 2219113
TI  - [The diagnostic significance of the protein-creatinine ratio in urine for the
      differentiation of feline nephropathies].
AB  - The normal U-P/C-range in cats was established with urine samples of 19 cats. The
      upper limiting value was fixed at 0.33 (mean +/- 2s). U-P/C is a reliable
      parameter for diagnosing proteinuria in the uremic cat. However, only very high U
      P/C-values allow a conclusion on the type of nephropathy, whereas with moderately
      increased U-P/C values, do not allow any distinction between feline
      nephropathies.

PMID- 2219114
TI  - Renal epithelial amino acid concentrations in mercury-induced and postischemic
      acute renal failure.
AB  - The concentration of 18 alpha-amino acids (AAs) in plasma and renal cortical cell
      water were measured 3 or 24 hr after 1 hr of unilateral renal artery clamping or
      24 or 48 hr after 15 mg/kg body weight HgCl2 injection sc as a test of epithelial
      integrity. Cellular glycine (Gly), hydroxyproline (Hpr), ornithine (Orn),
      phenylalanine (Phe), serine (Ser), and tryptophan (Trp) concentrations were
      depressed 24 hr after HgCl2 (p less than 0.05), but the remaining 12 AAs were not
      distinguishable from control despite the presence of severe renal failure.
      ARginine (Arg), glutamic acid (Glu), and valine (Val) also were decreased (P less
      than 0.05) 24 hr later, but concentrations of half of all measured AAs were still
      normal. Cellular alanine (Ala), Arg, Glu, Gly, Phe, and Ser concentrations were
      decreased 3 hr after ischemia, p less than 0.05, but 12 AAs were unchanged and
      only Arg, Phe, Ser, and threonine (Thr) were reduced 24 hr after ischemia was
      reversed. Concentrations of even the most affected AAs remained notably higher
      than in plasma in both forms of acute renal failure (ARF). Total loss of AAs from
      a small proportion of tubular cells would be hidden by essentially normal
      concentrations in the rest, and such losses may well have occurred. Unless
      cellular AAs in ARF are almost completely bound, however, the well-maintained
      cell:plasma AA concentration ratios indicate that cellular energetics were
      adequate for AA uptake and that epithelial permeability to AAs in the vast
      majority of cells was not greatly disturbed. Such findings suggest that most of
      the epithelium, although seriously damaged, had remained viable.

PMID- 2219115
TI  - Acetaminophen structure-toxicity studies: in vivo covalent binding of a
      nonhepatotoxic analog, 3-hydroxyacetanilide.
AB  - High doses of 3-hydroxyacetanilide (3HAA), a structural isomer of acetaminophen,
      do not produce hepatocellular necrosis in normal male hamsters or in those
      sensitized to acetaminophen-induced liver damage by pretreatment with a
      combination of 3-methylcholanthrene, borneol, and diethyl maleate. Although 3HAA
      was not hepatotoxic, the administration of acetyl-labeled [3H or 14C]3HAA (400
      mg/kg, ip) produced levels of covalently bound radiolabel that were similar to
      those observed after an equimolar, hepatotoxic dose of [G-3H]acetaminophen. The
      covalent nature of 3HAA binding was demonstrated by retention of the binding
      after repetitive organic solvent extraction following protease digestion. Hepatic
      and renal covalent binding after 3HAA was approximately linear with both dose and
      time. In addition, 3HAA produced only a modest depletion of hepatic glutathione,
      suggesting the lack of a glutathione threshold. 3-Methylcholanthrene pretreatment
      increased and pretreatment with cobalt chloride and piperonyl butoxide decreased
      the hepatic covalent binding of 3HAA, indicating the involvement of cytochrome
      P450 in the formation of the 3HAA reactive metabolite. The administration of
      multiple doses or a single dose of [ring-3H]3HAA to hamsters pretreated with a
      combination of 3-methylcholanthrene, borneol, and diethyl maleate produced
      hepatic levels of 3HAA covalent binding that were in excess of those observed
      after a single, hepatotoxic acetaminophen dose. These data suggest that the
      nature and/or the intracellular processing of the reactive metabolites of
      acetaminophen and 3HAA are different. These data also demonstrate that absolute
      levels of covalently bound xenobiotic metabolites cannot be utilized as absolute
      predictors of cytotoxic potential.

PMID- 2219116
TI  - Elevation of individual serum bile acids on exposure to trichloroethylene or
      alpha-naphthylisothiocyanate.
AB  - Rats were treated with trichloroethylene via intraperitoneal (ip) injection or
      inhalation, or with ip alpha-naphthylisothiocyanate (ANIT). Serum samples were
      assayed for indices of liver injury including alanine aminotransferase (ALT),
      sorbitol dehydrogenase (SDH), alkaline phosphatase (AP), and bilirubin. Liver
      from some rats was examined for histological appearance. These data were compared
      to levels of individual serum bile acids (SBA) determined by high-performance
      liquid chromatography. Trichloroethylene and ANIT, each at their highest dose
      only, caused elevations in ALT, but not SDH or AP. The highest dose of ANIT also
      caused elevated serum bilirubin and cholangitis in the liver. SBA were also
      elevated in response to both trichloroethylene and ANIT, but at doses below those
      at which other parameters of liver function were increased. For both chemicals,
      taurocholic acid was the most sensitive of the bile acids assayed, being elevated
      at the lowest doses tested of 10 mumols/kg for trichloroethylene and 5 mumols/kg
      for ANIT. As the doses were raised more of the individual bile acids showed
      increases. On exposure to trichloroethylene via inhalation taurocholic acid was
      one of two SBA to show elevation. Thus, both trichloroethylene and ANIT cause
      elevation in SBA at doses well below those which cause an increase in standard
      indicators of liver dysfunction. This suggests that SBA and perhaps taurocholic
      acid, in particular, may provide a sensitive tool for studying hepatobiliary
      effects of chemicals.

PMID- 2219117
TI  - Mesangial macromolecular uptake in captopril-treated uninephrectomized rats.
AB  - Captopril, an angiotensin II-converting enzyme inhibitor, ameliorates the renal
      mesangial lesions associated with subtotal nephrectomy, a process associated with
      increased mesangial macromolecular flux and injury. In the present study
      uninephrectomized rats with proteinuria and focal glomerular sclerosis had
      increased mesangial heat-aggregated human IgG (AHIgG) uptake. However,
      uninephrectomized rats treated daily with captopril, which failed to develop
      either glomerular lesions or proteinuria, also had significantly elevated
      mesangial AHIgG levels. Our results suggest that increased mesangial
      macromolecular flux may occur independent of altered glomerular permselectivity
      changes and proteinuria and appears to be related to glomerular hyperfiltration
      rather than glomerular hypertension. Further, glomerular mesangial sclerosis may
      not be the direct result of increased mesangial macromolecular flux.

PMID- 2219118
TI  - Structure-dependent induction of aryl hydrocarbon hydroxylase activity in C57BL/6
      mice by 2,3,7,8-tetrachlorodibenzo-p-dioxin and related congeners: mechanistic
      studies.
AB  - The time- and dose-dependent induction of murine hepatic microsomal aryl
      hydrocarbon hydroxylase (AHH) and ethoxyresorufin O-deethylase (EROD) activities
      by five polychlorinated dibenzo-p-dioxin and dibenzofuran congeners showed that
      the order of induction potency was 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)
      greater than 2,3,7,8-tetrachlorodibenzofuran (TCDF) greater than 1,2,3,7,8
      pentachlorodibenzo-p-dioxin (PCDD) greater than 1,2,3,7,8-pentachlorodibenzofuran
      (PCDF) greater than 2,3,7-trichlorodibenzo-p-dioxin (TrCDD). These structure
      induction relationships were comparable to the structure-toxicity and competitive
      structure-receptor binding relationships previously reported for these compounds.
      However, using the corresponding radiolabeled congeners, the direct binding Kd
      values for dissociation of the cytosolic receptor-ligand complexes were 9.52,
      7.96, 1.27, 3.10, and 8.31 nM for the 2,3,7,8-TCDD, 2,3,7,8-TCDF, 2,3,7-TrCDD,
      1,2,3,7,8-PCDD, and 1,2,3,7,8-PCDF congeners and these data were clearly not
      structure dependent (i.e., similar to the structure-activity relationships). Some
      of the molecular properties for several radioligand-receptor complexes were
      similar; for example, the sedimentation coefficients for the cytosolic and
      nuclear receptor complexes varied from 8.8-10.4 S and 5.98-7.0 S, respectively,
      and the nuclear receptor complexes for all the radioligands eluted from a DNA
      Sepharose column at salt concentrations of 0.27-0.29 M. Treatment of the mice
      with a maximum inducing dose of 2,3,7,8-[3H]TCDD resulted in a time-dependent
      formation of the nuclear receptor complex which was maximized between 16-24 hr
      and subsequently decreased up to 72 hr after initial exposure. In parallel
      studies, the nuclear receptor complex levels were determined 16 hr after
      treatment of the mice with different doses (2.25, 4.5, and 45 micrograms/kg) of
      all five radioligands. The results showed that at submaximal induction of the
      monooxygenase enzyme activities there was a linear correlation between the
      induced AHH or EROD activities (after 32 hr) and the corresponding nuclear
      receptor complex levels. It was also apparent from the data that the relative
      levels of nuclear receptor complex were structure dependent and this suggests
      that the transformation or activation of cytosolic receptor complexes may be a
      ligand structure-dependent process which correlates with the observed structure
      activity relationships for 2,3,7,8-TCDD and related compounds.

PMID- 2219119
TI  - Bioactivation of 3-methylindole by isolated rabbit lung cells.
AB  - 3-Methylindole (3MI) is a pneumotoxin that causes selective lung lesions
      indicative of Clara cell and alveolar epithelial cell damage in ruminants and
      rodents. The present study examined the cytotoxicity of 3MI to isolated rabbit
      Clara cells, type II alveolar epithelial cells, and alveolar macrophages. 3MI
      produced a dose-dependent cytotoxicity to Clara cells detectable within 1 hr of
      incubation at 37 degrees C which reached a maximum at 3 hr. Concentrations of
      0.25 and 0.5 mM 3MI were cytotoxic to Clara cells, while type II and alveolar
      macrophages required 1 mM 3MI before cytotoxicity was observed. The cytochrome
      P450 suicide substrate inhibitor, 1-aminobenzotriazole, inhibited 3MI-induced
      cytotoxicity in Clara cells, type II cells, and alveolar macrophages. These
      observations were consistent with a cytochrome P450-mediated bioactivation of 3MI
      to a toxic intermediate. Studies with a trideuteromethyl analog of 3MI
      demonstrated a much reduced cytotoxicity to Clara cells as well as to type II
      cells, and macrophages. The deuterium isotope effect suggested that C-H bond
      breakage at the 3-methyl group is a requisite oxidative transformation in the
      bioactivation of 3MI to a selective lung cell cytotoxin. The selectivity of
      cellular cytotoxicity is probably associated with higher rates of bioactivation
      by Clara cell cytochrome P450 monooxygenases compared to those of type II cells
      and macrophages. These studies demonstrate that 3MI is bioactivated in isolated
      pulmonary cells without the intervention of other organs and that bioactivation
      requires functional cytochrome P450 enzymes.

PMID- 2219120
TI  - High dietary protein regimens provide significant protection from mercury
      nephrotoxicity in rats.
AB  - The effects of high protein dietary regimens prior to the administration of
      inorganic mercury were investigated. Male Sprague-Dawley rats were pair-fed on
      purified test diets containing either normal (20%) or high (60%) concentrations
      of protein. Mercury was administered as a single intravenous injection of
      mercuric chloride (1 mg/kg). All rats maintained on normal dietary protein prior
      to and following mercury injection exhibited severe kidney dysfunction, extensive
      necrosis of both second (S2) and third (S3) segments of the kidney proximal
      tubules, and 100% mortality. In contrast, rats maintained on high dietary protein
      for 48 hr or longer just prior to mercury injection and returned to normal
      dietary protein immediately following mercury administration all survived and
      exhibited normal serum creatinine and BUN values within 4 days following mercury
      administration. The kidneys of this latter group took up significantly less
      radiolabeled mercury during the first 12 hr following mercury injection, and
      exhibited relatively little damage to the second segments (S2) of the proximal
      tubules. The third segments (S3) of the proximal tubules, however, exhibited the
      same degree of necrosis as that observed in the control group. Maintaining rats
      on high dietary protein regimens for shorter periods of time prior to mercury
      infusion (i.e., 12 or 24 hr) also dramatically reduced subsequent acute renal
      failure and improved survival, although not to the extent noted following 48 hr
      or longer on these diets. These observations suggested that high dietary protein
      regimens may protect from mercury nephrotoxicity by reducing mercury uptake to
      the second segments (S2) of the proximal tubules during the initial period of
      exposure to intravenously administered mercury.

PMID- 2219121
TI  - Formate metabolism in young swine.
AB  - Formate generated from methanol metabolism in vivo is the chemical entity
      responsible for the development of the methanol toxicity syndrome in the monkey.
      Compared to rats, monkeys are in a state of folate deficiency. This leads to a
      decreased ability to dispose of formate generated leading to its accumulation and
      the subsequent development of the classic symptoms of methanol toxicity. Rats
      possess a more efficient folate system; therefore, they metabolize formate very
      readily and do not exhibit methanol toxicity symptoms. In this report, the
      hepatic folate content and the ability to handle a formate "load" were evaluated
      in another animal species, the pig. The results obtained indicate that the pig,
      compared to all other species studied, has extremely low levels of folates and
      very low levels of a key enzyme in the folate pathway, namely 10-formyl H4folate
      dehydrogenase. Also the pig's ability to dispose of formate was extremely limited
      and slower than that observed in rats or monkeys. These results suggest that the
      pig may be a suitable animal model for studying formate metabolism and possibly
      methanol toxicity.

PMID- 2219122
TI  - Learning and memory deficits in rats following exposure to 3,3'
      iminodipropionitrile.
AB  - Rats were examined using a learning and memory test battery 4 weeks following
      exposure to 3,3'-iminodipropionitrile (IDPN). Initial testing revealed deficits
      in olfactory discrimination and passive avoidance (PA) conditioning. In order to
      dissociate learning and performance effects, additional tests were conducted.
      First, to rule out the possibility that IDPN reduced the aversiveness of foot
      shock, rats were tested in a simple shock sensitivity paradigm. The results
      indicated no change in shock sensitivity produced by IDPN. Second, to determine
      if the hyperactivity produced by IDPN was responsible for deficits in
      conditioning, several additional tests were conducted including (a) repeated
      trials active avoidance (AA) and PA conditioning, (b) a PA study which included
      both a 1- and 24-hr training-testing interval, and (c) long-delay flavor-aversion
      conditioning. Rats treated with IDPN required more conditioning trials to reach
      criterion on both AA and PA procedures suggesting that they were capable of
      performing the required response but acquired those responses at a much slower
      rate. The deficits in PA conditioning were similar at both the 1- and 24-hr
      training-testing interval. Finally, the effects of IDPN on flavor-aversion
      conditioning depended on the delay separating flavor intake and lithium
      administration during conditioning. Rats treated with IDPN demonstrated robust
      flavor aversions when trained with a 30-min but not with a 6-hr delay. In
      summary, the neurotoxic profile of effects produced by IDPN must be expanded to
      include a prominent cognitive component characterized by protracted deficits in
      learning and memory capacity. The present experiment illustrates how chemically
      induced disruption of learning and memory produced by IDPN can be experimentally
      dissociated from associate neurological symptoms using a simple, routine battery
      of neurobehavioral tests.

PMID- 2219124
TI  - Antagonism of carbon monoxide-mediated brain lipid peroxidation by hyperbaric
      oxygen.
AB  - The effects of oxygen at 1, 2, and 3, atmospheres absolute (ATA) were assessed on
      brain lipid peroxidation caused by carbon monoxide (CO) poisoning in a rat model.
      Oxygen at 3 ATA, but not 1 ATA, was found to prevent brain lipid peroxidation
      when administered to rats for 45 min, beginning 45 min subsequent to CO
      poisoning. Oxygen at 2 ATA had an intermediate effect. The action of hyperbaric
      oxygen could not be attributed to a more rapid diminution of carboxyhemoglobin,
      and appears to occur at the level of the brain tissue.

PMID- 2219123
TI  - Inhibition of rat liver monooxygenase activities by 2-methyl-1,4-naphthoquinone
      (menadione).
AB  - In rat liver microsomes, 2-methyl-1,4-naphthoquinone (menadione) inhibits
      cytochrome P450 (cyt P450)-mediated aniline-p-hydroxylation and aminopyrine-N
      demethylation with Ki values of 12 and 14.5 microM, respectively. The inhibitions
      of aniline-p-hydroxylation and aminopyrine-N-demethylation are mixed
      uncompetitive-noncompetitive and mixed competitive-noncompetitive, respectively.
      NADP antagonizes the inhibitory effect of menadione on aniline-p-hydroxylase
      activity but not that on aminopyrine-N-demethylase activity. Menadione does not
      give rise to any spectral change of cyt P450, but modifies the type I binding
      spectrum induced by aminopyrine. In contrast, menadione does not change the type
      II binding spectrum induced by aniline. These results indicate that menadione may
      inhibit aniline-p-hydroxylase activity by acting as a substrate for NADPH-cyt
      P450 reductase in the place of cyt P450 and inhibit aminopyrine-N-demethylase
      activity by impairing the binding of aminopyrine to cyt P450.

PMID- 2219125
TI  - Induction of DNA synthesis by sodium phenobarbital, uracil, and sodium saccharin
      in urinary bladder of the F344 rat.
AB  - DNA synthesis in urothelial cells was determined 2, 4, 6, 10, and 16 weeks
      following dietary administration of promoters of bladder tumors to weanling male
      F344 rats. The experimental groups were fed AIN-76A diet or this diet containing
      0.15% sodium phenobarbital, 3% uracil, 5% sodium saccharin, 2% sodium
      bicarbonate, or a combination of 5% sodium saccharin and 2% sodium bicarbonate.
      Two other groups were given Wayne rodent chow alone or in combination with 5%
      sodium saccharin. A group of rats given a drinking water containing 0.01% N-butyl
      N-(4-hydroxybutyl)nitrosamine served as a positive control. With the exception of
      phenobarbital which increased the labeling index but did not induce hyperplasia,
      all other compounds increased the labeling index and induced hyperplasia. The
      combination of sodium saccharin and sodium bicarbonate was more effective than
      either compound alone in increasing the labeling index. Sodium saccharin was
      equally active when incorporated in either the AIN diet or the Wayne rodent chow.
      The present results suggest that a fundamental mechanism of bladder tumor
      promotion may be due to an increased DNA synthesis which leads to an increased
      turnover rate of urothelial cells rather than hyperplasia. However, since sodium
      saccharin is a promoter when incorporated into the Wayne diet but not into the
      AIN diet, the ability to stimulate DNA synthesis may be an important but
      insufficient condition for promotion by saccharin.

PMID- 2219127
TI  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin enhances responsiveness to post-ingestive
      satiety signals.
AB  - The present study was designed to characterize the hypophagia that is a salient
      feature of the 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced wasting
      syndrome. When TCDD-treated Long-Evans (L-E; dose 50 micrograms/kg) and Han
      Wistar (H-W; 3000 micrograms/kg) rats were offered a simultaneous choice of three
      diets differing in their macronutrient composition, no selective aversion was
      seen to any of the varieties, although total energy intake decreased drastically
      and especially so in L-E rats. Further studies in H-W rats showed that TCDD
      treatment leads to a permanent retardation of weight gain accompanied by a
      decreased intake of chow and of a 10% sucrose solution, and to a reduced or
      unchanged consumption of water. In contrast, there was a progressive increase in
      saccharin drinking (when offered as the only choice) in TCDD-dosed rats with
      time. TCDD-treated animals also tended to consume a greater proportion of their
      daily feed intake during the daytime. These results imply that TCDD induces
      aversion to eating energy-providing food, irrespective of its type, and that TCDD
      exerts this at least in part by sensitizing the rats to post-ingestive satiety
      factors.

PMID- 2219126
TI  - Induction of metallothionein synthesis by zinc in cadmium pretreated rats.
AB  - The ability of zinc (Zn) salts to induce the synthesis of metallothionein (MT) in
      liver, kidney and pancreas of rats pretreated with cadmium (Cd) salts was
      investigated. Twenty-four hours after either CdCl2 (2.0 mg Cd/kg, s.c.) or saline
      pretreatment, rats were injected with saline, CdCl2 (2.0 mg Cd/kg, s.c.) or ZnSO4
      (20 mg Zn/kg, s.c.) and the concentrations of MT and MT-1 mRNA in tissues
      subsequently measured. After a single injection of Cd salts, concentrations of MT
      and MT-1 mRNA were significantly increased in liver as compared to control. With
      two injections of Cd, the accumulation of MT in liver was approximately twice the
      levels of MT following a single injection of Cd. In kidney, MT and MT-1 mRNA
      expression were significantly increased only after two injections of Cd and in
      the pancreas, Cd injections did not alter either MT content or MT-1 mRNA
      expression. Treatment with Zn salts increased MT concentrations in both liver and
      pancreas. However, the pancreas was the most responsive to injections of Zn salts
      as compared to the liver in terms of increases in both protein concentration and
      MT-1 mRNA expression. When Zn injection was preceded by a Cd injection, induction
      as measured by MT-1 mRNA and MT concentrations were approximately additive in
      liver. In kidney, although Cd or Zn treatment separately had no effect on MT or
      MT-1 mRNA content, injection of Cd followed by Zn resulted in significantly
      increased levels of renal MT and MT-1 mRNA. Fractionation of liver cytosols on a
      Sephadex G-75 column revealed that in animals receiving two injections of Cd,
      virtually all the Cd was associated with MT whereas Zn was distributed between
      both high molecular weight (HMW) proteins and MT. In animals receiving both Cd
      and Zn injections, cytosolic Cd was still bound predominantly to the MT fraction,
      while the proportion of cytosolic Zn associated with MT increased. The results of
      this study suggest that, treatment with Cd salts followed by Zn salt injection
      can induce further synthesis of MT in liver, kidney and pancreas with subsequent
      binding of both Zn and Cd to the intracellular MT.

PMID- 2219128
TI  - Ingestion of chlorinated water has no effect upon indicators of cardiovascular
      disease in pigeons.
AB  - Cardiovascular disease (CVD) accounts for nearly half the deaths, yearly, in the
      United States. The arterio(athero)sclerotic plaque is the principal lesion of
      CVD. The White Carneau (WC) pigeon is an animal model that has been employed
      extensively for studying CVD. Cholesterol (CHOL) feeding aggravates
      atherosclerosis in WC pigeons greater than 2 years old. In 1986, two reports
      appeared from a single laboratory claiming a direct effect of drinking
      chlorinated (Cl) water upon lipid levels and plaque development in young (less
      than 1 year) WC pigeons. These are the only reports of such direct effects, to
      date. Three months' exposure to 2 ppm or 15 ppm Cl in the drinking water,
      resulted in increased circulating CHOL levels in young male WC pigeons fed a
      normocholesterolemic (NC) diet in which Ca2+ levels were reduced. In addition, at
      both Cl concentrations there was a significant increase in plaque size, compared
      to controls. Pigeons in the 2 ppm group also exhibited elevated low density
      lipoprotein (LDL) levels after 3 months on the NC diet. These findings, if
      extrapolated to man, could have considerable public health consequences, since
      nearly 200 million people in the United States drink Cl water. We have carried
      out a similar set of studies but with strikingly different results. We used the
      same suppliers of pigeons and feed as did the authors of the 1986 reports and
      followed their approach where possible. Six month-old male WC pigeons drank water
      with 2 ppm or 15 ppm Cl (pH 8.5) and ate a NC diet with Ca2+ reduced to 80% of
      normal. At both 1 and 3 months, body weight, CHOL, triglyceride and LDL levels
      were unaffected by drinking Cl water. There was also no effect of Cl water on
      plaque size after 3 months. Thus, we found no evidence that drinking chlorinated
      water has any effect upon circulating lipid levels or upon the development of
      arteriosclerotic plaques, in this animal model.

PMID- 2219129
TI  - Interactions between paraquat, endogenous lung amines' antioxidants and isolated
      mouse Clara cells.
AB  - The ability of paraquat to damage mouse lung Clara cells in the presence and
      absence of herbicide inhibitors is investigated using a cell culture system.
      Clara cell damage is assessed on the loss of nitroblue tetrazolium reductase
      activity and the inability to attach and spread on an extracellular matrix.
      Endogenous amines such as putrescine and spermidine reduce paraquat-induced
      damage at low concentrations indicating that they compete for the same cell
      surface receptor as paraquat and thus potentially block the accumulation of the
      herbicide. The efficacy of 10 microM exogenous putrescine as a protectant is
      reduced the longer the time before it is added to the cultures. Clara cells
      contain high levels of NADPH-dependent P-450 reductase which is required to redox
      cycle the paraquat and generate reactive oxygen radicals. Compounds with
      antioxidant properties are examined for their ability to reduce the Clara cell
      damage. Cystamine, the disulphide form of the naturally occurring thiol,
      cysteamine, and taurine, a metabolite of cystamine, both of which are accumulated
      in the lung, do not reduce paraquat-induced Clara cell damage. Another
      antioxidant, alpha-tocopherol is also ineffective but reduced glutathione (GSH),
      present in high quantities (3.2 mM) in clara cells, could reduce damage to the
      cultured cells. Cysteine, a precursor of GSH, can also prevent Clara cell damage
      when the concentration of paraquat is low.

PMID- 2219130
TI  - Liver tumor induction in B6C3F1 mice by dichloroacetate and trichloroacetate.
AB  - Male and female B6C3F1 mice were administered dichloroacetate (DCA) and
      trichloroacetate (TCA) in their drinking water at concentrations of 1 or 2 g/l
      for up to 52 weeks. Both compounds induced hepatoproliferative lesions (HPL) in
      male mice, including hepatocellular nodules, adenomas and hepatocellular
      carcinomas within 12 months. The induction of HPL by TCA was linear with dose. In
      contrast, the response to DCA increased sharply with the increase in
      concentration from 1 to 2 g/l. Suspension of DCA treatment at 37 weeks resulted
      in the same number of HPL at 52 weeks that would have been predicted on the basis
      of the total dose administered. However, none of the lesions in this treatment
      group progressed to hepatocellular carcinomas. Conversely, the yield of HPL at 52
      weeks when TCA treatment was suspended at 37 weeks was significantly below that
      which would have been predicted by the total dose administered. In this case, 3
      of 5 remaining lesions were hepatocellular carcinomas. Throughout active
      treatment DCA-treated mice displayed greatly enlarged livers characterized by a
      marked cytomegaly and massive accumulations of glycogen in hepatocytes throughout
      the liver. Areas of focal necrosis were seen throughout the liver. TCA produced
      small increases in cell size and much a more modest accumulation of glycogen.
      Focal necrotic damage did not occur in TCA-treated animals. TCA produced marked
      accumulations of lipofuscin in the liver. Lipofuscin accumulation was less marked
      with DCA. These data confirm earlier observations that DCA and TCA are capable of
      inducing hepatic tumors in B6C3F1 mice and argue that the mechanisms involved in
      tumor induction differ substantially between these two similar compounds.
      Tumorigenesis by DCA may depend largely on stimulation of cell division secondary
      to hepatotoxic damage. On the other hand, TCA appears to increase lipid
      peroxidation, suggesting that production of radicals may be responsible for its
      effects.

PMID- 2219131
TI  - Early induction of reparative hyperplasia in the liver of B6C3F1 mice treated
      with dichloroacetate and trichloroacetate.
AB  - Trichloroacetate (TCA) and dichloroacetate (DCA) were administered at
      concentrations of 0, 300, 1000 or 2000 mg/l in the drinking water of male B6C3F1
      and male and female Swiss-Webster mice for up to 14 days. At 2, 5 or 14 days of
      treatment, mice were injected with [3H]thymidine 2 h prior to sacrifice. The
      livers were examined histologically and autoradiographically and DNA was isolated
      and counted. As observed in chronic studies dichloroacetate induced a marked
      increase in liver weights, but only after 14 days of treatment and local necrosis
      in both B6C3F1 and Swiss-Webster mice. A significant increase in the labeling
      index of hepatocytes was observed in animals treated with DCA, but only at 14
      days of treatment. No such increases were observed in animals treated with TCA.
      In contrast, significant increases in [3H]thymidine were observed in the livers
      of both DCA- and TCA-treated animals after 5 days of treatment. This effect
      remained apparent with TCA after 14 days of treatment. These data support the
      hypothesis that the tumorigenic effect of DCA is strongly influenced by necrosis
      and reparative hyperplasia. On the other hand, the carcinogenic effects of TCA
      appear to be more closely associated with [3H]thymidine incorporation that can be
      separated from cell division, suggesting an elevated rate of repair synthesis of
      DNA. Thus the carcinogenic effects of TCA (and perhaps lower doses of DCA) may
      involve damage to DNA.

PMID- 2219132
TI  - Increased expression of c-myc and c-Ha-ras in dichloroacetate and
      trichloroacetate-induced liver tumors in B6C3F1 mice.
AB  - The expression of c-myc and c-H-ras in hyperplastic nodules and hepatocellular
      carcinomas induced in male B6C3F1 mice after chronic administration of
      dichloroacetate (DCA) and trichloroacetate (TCA) was studied using in situ
      hybridization. Expression of c-myc and c-H-ras mRNA was increased in both nodules
      and carcinomas relative to surrounding tissue and tissues obtained from control
      animals. Myc expression was similar in hyperplastic nodules and carcinomas
      induced by DCA, but was significantly higher in TCA-induced carcinomas than in
      hyperplastic nodules and carcinomas produced by DCA. In carcinomas from animals
      whose TCA treatment was suspended at 37 weeks, c-myc expression remained high
      relative to control and surrounding liver tissue at 52 weeks. In contrast, the
      expression of c-H-ras was consistently elevated in carcinomas from both
      treatments relative to hyperplastic nodules and non-tumor tissue. Within
      carcinomas from both treatments, focal areas could be located which expressed
      even higher levels of c-myc. This heterogeneity was not observed in carcinomas
      hybridized to c-H-ras-probes. These data suggest that elevated expression of c-H
      ras and c-myc might play an important role in the development of hepatic tumors
      in B6C3F1 mice. Elevated expression of c-H-ras was closely associated with
      malignancy. Increased c-myc expression does not seem necessary for progression to
      the malignant state. On the other hand, the increased expression of c-myc appears
      related to the earlier progression of TCA-induced tumors to the malignant state.

PMID- 2219133
TI  - Prevalence of metallothioneinuria among the population living in the Kakehashi
      River basin in Japan--an epidemiological study.
AB  - An epidemiological study to evaluate cadmium-induced renal dysfunction by urinary
      metallothionein levels was carried out in an environmentally-exposed Japanese
      population. The study population consisted of 3168 men and women from a cadmium
      polluted area who were 50 years and older and 291 individuals from a non-polluted
      area. The mean metallothionein levels in urine of the control population were
      138.2 +/- 2.1 and 198.6 +/- 1.9 microgram/g creatinine for men and women,
      respectively. The corresponding values for the cadmium-exposed population were
      157.8 +/- 2.2 and 248.0 +/- 2.2. The 97.5% upper limits for men in the control
      population was determined to be 638 and for women 693 microgram MT/g creatinine.
      Based on these values as the cut-off levels, the prevalence of
      metallothioneinuria was calculated to be 4.6% in men and 8.4% in women from the
      cadmium-polluted area. Further selection of the population, based on life-time
      residence in the polluted area accompanied with the consumption of cadmium
      containing rice, showed an even greater prevalence of metallothioneinuria: 5.4%
      in men and 10.9% in women of all ages. The prevalence of metallothioneinuria
      increased with age and duration of residence in the polluted area. These results
      suggest that metallothioneinuria can be used as an indicator of renal dysfunction
      due to environmental cadmium exposure.

PMID- 2219134
TI  - Subchronic 90 day toxicity of dichloroacetic and trichloroacetic acid in rats.
AB  - Male Sprague-Dawley rats were treated with either dichloroacetic acid (DCA) or
      trichloroacetic acid (TCA) in the drinking water at levels of 0, 50, 500 and 5000
      ppm for a period of 90 days to determine the toxicities associated with
      subchronic exposure. All animals were sacrificed and examined for gross and
      histopathologic lesions, serochemical changes, immune dysfunction, hepatic
      peroxisomal and mixed function oxidase enzyme induction and organ-body weight
      changes. Animals treated with DCA had decreased body weight gains (500 and 5000
      ppm) and decreased total serum protein (all doses). Rats given either TCA (5000
      ppm) or DCA (500 or 5000 ppm) had increased liver and kidney organ to body weight
      ratios. Rats offered DCA had significantly elevated alkaline phosphatase (500 and
      5000 ppm) and alanine-amino transferase (5000 ppm). No consistent immunotoxicity
      was observed in animals exposed to either compound. Rats treated with 5000 ppm
      TCA or DCA had significantly increased hepatic peroxisomal beta-oxidation
      activity. These data, along with histopathologic changes, suggest that TCA and
      DCA produce substantial systemic organ toxicity to the liver and kidney during a
      90-day subchronic exposure, although only at doses greater than those expected to
      occur in the environment.

PMID- 2219135
TI  - Cadmium teratogenicity and its relationship with metallothionein gene expression
      in midgestation mouse embryos.
AB  - As an approach toward understanding the mechanisms by which cadmium (Cd) exerts
      its teratogenic effects, the expression and metal regulation of the
      metallothionein (MT) genes in midgestation mouse embryos were studied by Northern
      blot and in situ hybridization. Maternal injection of a teratogenic dosage of Cd
      (50 mumol Cd/kg body wt) did not induce MT mRNA in day 10 (D10) CD-1 mouse
      embryos, whereas zinc (Zn) (50 mumol/kg was an effective inducer. In contrast, Cd
      was about 10-fold more potent than Zn at rapidly inducing MT mRNA in D10 embryos
      incubated in vitro in medium containing micromolar concentrations of these
      metals. This suggests that following maternal injection, Cd but not Zn is
      prevented from reaching the D10 embryo and establishes that the embryonic MT
      genes are not refractory to metal induction, which might have explained the
      sensitivity of the embryo to Cd. MT mRNA was detected at high levels only in the
      extraembryonic membranes of D9 embryos exposed to Cd in vivo. On days 9 and 10,
      no embryonic cell types contained detectable levels of MT mRNA. This mRNA was
      detected first at low levels in hepatocytes on D11, soon after formation of liver
      and these levels increased dramatically by D12. Therefore, Cd teratogenicity was
      not associated with high levels of cell type-specific expression of the MT genes
      in Cd-sensitive regions of the embryo (neural tube, limb bud), that might have
      served to target Cd to these cells. Taken together, the results of this study
      suggest that Cd teratogenicity reflects damage to maternal or extraembryonic
      tissues. However, the results cannot exclude the possibility that certain cells
      in the embryo are exceptionally sensitive to low levels of Cd.

PMID- 2219136
TI  - Effect of acetone administration on renal, pulmonary and hepatic monooxygenase
      activities in hamster.
AB  - Administration of acetone in drinking water to Syrian Golden hamsters for 9-10
      days altered microsomal P-450 dependent monooxygenase activities in the liver and
      the kidney but not in the lung. While hepatic microsomal NADPH-cytochrome c
      reductase was unaffected, cytochrome b5 and P-450 content increased (about 100%)
      in liver but not in kidney. Furthermore acetone treatment resulted in an increase
      of microsomal reverse type I binding with DMSO and in an increase in the P
      450IIE1-linked renal and hepatic activities such as aniline hydroxylase (AnH) and
      p-nitrophenol hydroxylase (pNPH). The SDS-PAGE analysis confirmed the induction
      in acetone-treated microsomes of a hepatic protein with the M.W. of ethanol
      inducible P-450IIE1 of hamster. The acetone treatment however, unlike ethanol,
      induced other activities such as benzphetamine N-demethylase and ethoxycoumarin O
      deethylase in liver and aminopyrine N-demethylase in kidney. No change of
      ethoxyresorufin O-deethylase and pentoxyresorufin O-depentylase was observed in
      either renal or hepatic microsomes. Addition of acetone in vitro had an
      inhibitory effect on pNPH by hepatic microsomes from control or acetone induced
      hamsters, while AnH was not affected. Interruption of acetone administration for
      24 h resulted in a return of AnH and pNPH activities to essentially basal levels
      in the liver suggesting a rapid turnover of the hamster P-450IIE1 (ham P-450j).
      Our results indicate that, as found in rat, acetone is a good inducer of the P
      450IIE1 (ham P-450j) in hamster in both the liver and kidney. However other P-450
      forms, such as, probably, the renal and hepatic P-450IIB1, are also induced. Thus
      acetone-treated hamsters, which, in certain respects, show a qualitatively
      different induction pattern from that reported for ethanol, can be used as an
      useful animal model to study the toxicity of certain xenobiotics.

PMID- 2219137
TI  - Developmental toxicity of in utero exposure to toluene on malnourished and well
      nourished rats.
AB  - The aim of the present study was to investigate the effects of toluene on fetal
      development in well nourished and malnourished rats. Long-term behavioural
      consequences after in utero exposure were also studied. Toluene (1.2 g/kg s.c.)
      was administered daily to well nourished and to malnourished (food restricted to
      50% of ad libitum intake) pregnant rats, during the second (8-15 days) or the
      third week of pregnancy (14-20 days). Offspring were evaluated for malformations,
      development of the skeleton, prenatal growth of the brain and liver, postnatal
      growth and long lasting behavioural effects. In utero exposure to toluene during
      the third week of pregnancy resulted in low body weight at birth, which persisted
      in the male offspring into adulthood. Malnutrition increased fetal susceptibility
      to the effects of toluene as indicated by evaluation of the development of the
      skeleton. Behavioral tests performed when the pups were 30 and 90 days old showed
      effects of in utero malnutrition (increased ambulation and worse performance in a
      shuttle box), but no behavioural effects related to toluene exposure were
      detected. These data indicate that in utero exposure to toluene can have long
      lasting effects on body growth and that maternal malnutrition increases the risk
      for toluene fetotoxicity.

PMID- 2219138
TI  - Immune alterations in rats following subacute exposure to tributyltin oxide.
AB  - Adult male Fischer 344 rats were dosed by oral gavage with bis(tri-n
      butyltin)oxide (TBTO) in peanut oil for 10 consecutive days, at dosages ranging
      from 1.25 to 15 mg/kg/day. Other groups of rats were dosed daily for 10 days by
      oral gavage with cyclophosphamide (CY) at dosages ranging from 0.75 to 6
      mg/kg/day. These rats served as positive controls for the immune assays employed.
      The immune function parameters examined included the following: delayed-type
      hypersensitivity (DTH) and antibody responses to bovine serum albumin (BSA),
      primary antibody responses to sheep red blood cells (SRBC) and trinitrophenyl
      lipopolysaccharide (TNP-LPS) and enumeration of splenic lymphocyte populations.
      The DTH and antibody responses to BSA were not affected by TBTO exposure; however
      these responses were suppressed in rats dosed with CY at 6 mg/kg/day. The plaque
      forming cell (PFC) response to the T cell-dependent antigen SRBC was enhanced in
      rats dosed with TBTO at from 5 to 15 mg/kg/day. On the other hand, the PFC
      response to the T cell-independent antigen TNP-LPS was unaffected by TBTO
      exposure. Rats dosed with CY had suppressed PFC responses to SRBC and TNP-LPS at
      dosages of 3 and 6 mg/kg/day, respectively. Enumeration of splenic lymphocyte
      populations from TBTO-exposed rats revealed a reduction in OX8- but not W3/25- or
      IgG-positive cells. These results, as well as results from an earlier study from
      this lab, suggest that T lymphocytes are a primary target for TBTO-induced immune
      alterations and that the enhancement of the PFC response to SRBC in TBTO-exposed
      rats may be mediated by alterations in the suppressor (OX8-positive) T lymphocyte
      population.

PMID- 2219139
TI  - Excretion and blood radioactivity levels following [14C]senecionine
      administration in the rat.
AB  - Macrocyclic pyrrolizidine alkaloids (PAs) are a mixed group of phytotoxins with
      similar chemical structures and varying biological effects. A commonly studied
      member of this group is senecionine (SEN) which causes hepatotoxicity. We have
      undertaken metabolism and excretion studies of SEN in rats to provide data for
      comparison between PAs and to evaluate the potential role of metabolism and
      excretion in toxicity. Following intravenous administration of [14C]SEN (60
      mg/kg, 10 microCi/kg), bile, urine and blood were collected over a 7-h period. Of
      the total administered radioactivity, 44% and 43% were excreted in the bile and
      urine, respectively. Using mass spectroscopy, senecionine N-oxide (SENNOX) was
      identified as the major metabolite in bile (52% of 44%) and urine (30% of 43%).
      For the total 7 h, less than 5% in bile and 18% in urine was excreted as parent
      alkaloid. The plasma concentration of Senecionine-equivalents/g (SEN-EQ/g)
      decreased from 107 to 12 nmol, while red blood cell (RBC) concentrations declined
      from 109 to 26 nmol/g. Without bile collection, the plasma levels of SEN-EQ were
      similar, while the final RBC level was almost double (47 vs. 26 nmol/g) and total
      radioactivity excreted in the urine was increased (59% vs. 43%). Biliary pyrrolic
      metabolites were estimated to be 1.43 mg, using a dehydroretronectin standard.

PMID- 2219140
TI  - Arsenic-cadmium interaction in rats.
AB  - Simultaneous exposure to cadmium and arsenic is highly probable in the urban area
      of San Luis Potosi, Mexico due to common localization of copper and zinc
      smelters. Therefore, in this work, rats were intraperitoneally exposed either to
      cadmium or arsenic alone, or simultaneously to both metals. The effects of these
      treatments on three different toxicological parameters were studied. Cadmium
      modified the LD50 of arsenic and conversely arsenic modified the LD50 for
      cadmium. At the histopathological level, arsenic appeared to protect against the
      cadmium effects, especially on testes. This protective effect seemed to be
      related to the glutathione levels found in this tissue: rats exposed to both
      arsenic and cadmium, presented glutathione values intermediate to those observed
      after exposure to either metal alone; arsenic had the highest value and cadmium
      the lowest. In liver, rats exposed to arsenic, cadmium or arsenic and cadmium,
      presented glutathione values below those in the saline group, with the lowest
      value corresponding to the arsenic and cadmium treatment. The results appear to
      support the proposed interaction between arsenic and cadmium and coexposure to
      both metals seems to alter certain effects produced by either metal alone.

PMID- 2219141
TI  - Renal, hepatic, cardiac and thymic acute toxicity afforded by
      bis(helenalinyl)malonate in BDF1 mice.
AB  - Bis(helenalinyl)malonate [BHM], a pharmacologically active sesquiterpene lactone
      potentially useful as an antineoplastic agent, proved to be less toxic than its
      parent compound, helenalin. Its LD50 in BDF1 mice, i.p. was more than twice that
      of helenalin. Its lower toxicity allowed a higher therapeutic dose (15 mg/kg/day
      vs. 8 mg/kg/day for helenalin) which, in turn, afforded a greater T/C% (261 vs.
      161). When BHM was employed at its therapeutic dose of 15 mg/kg/day, no marked
      toxicity was evident after three daily doses. However, continuation of treatment
      at this level led to both kidney and liver toxicity as measured by clinical
      chemistry parameters. Histological lesions in the thymus and kidney were
      demonstrated within 48 h at 25 mg/kg as a single dose. Apparently the toxicity
      was delayed with BHM but accumulated over time. Transient cardiotoxicity occurred
      with the drug and the agent was suspected of causing intestinal blockage.

PMID- 2219142
TI  - Penetration of [3H]T-2 mycotoxin through abraded and intact skin and methods to
      decontaminate [3H]T-2 mycotoxin from abrasions.
AB  - Penetration of 50 muCi of [3H]T-2 mycotoxin through abraded and intact skin was
      studied in anesthetized rats sacrificed at 5, 15, 30, 45, 60 and 90 min post
      exposure. The greatest penetration was through abraded skin (49 +/- 7%) at 90 min
      post-exposure, whereas penetration through intact skin (2 +/- 3%) was
      substantially less (P less than 0.0015). Methods to decontaminate [3H]T-2
      mycotoxin from abraded skin over time were studied. Treatment of [3H]T-2
      contaminated abrasions by applying Trau + Medic dressing, applying Charcoal Cloth
      Anti-bacterial Field Dressing (Charcoal Dressing), or swabbing with povidone
      iodine 30 min post-exposure removed 17-32% of the applied [3H]T-2. Immediate
      blotting with immediate removal of the dressings absorbed 103 +/- 4% (Trau +
      Medic) and 87 +/- 4% (Charcoal Dressing) of the applied [3H]T-2, while immediate
      blotting and leaving the dressing in place for 30 min removed 91 +/- 5% (Trau +
      Medic) and 76 +/- 3% (Charcoal Dressing). It appears that immediate blotting with
      either dressing followed by immediate removal before application of a clean
      dressing is an effective method for decontaminating [3H]T-2 from abrasions.

PMID- 2219143
TI  - Phospholipase A2 in venom extracts from honey bees (Apis mellifera L.) of
      different ages.
AB  - We measured phospholipase A2 activity in the venom of worker honey bees (Apis
      mellifera L.) of known ages using chemical (titrimetric) and radioallergosorbent
      methods. The two techniques give similar results. Low levels of phospholipase A2
      are present in the venom system at the time of eclosion. Phospholipase A2
      activity in the venom increases steadily through the 10 days after eclosion.
      Maximal phospholipase A2 levels (about 40 micrograms phospholipase A2/venom sac)
      are maintained through the rest of the life of a worker bee in summer.

PMID- 2219144
TI  - Pathogenesis of hemorrhage induced by bilitoxin, a hemorrhagic toxin isolated
      from the venom of the common cantil (Agkistrodon bilineatus bilineatus).
AB  - The pathogenesis of hemorrhage induced by the i.m. injection of the hemorrhagic
      toxin, bilitoxin, was studied using light and electron microscopy. White mice
      were injected with sublethal doses of the toxin, and tissue samples were obtained
      at 5 and 30 min, and 1, 3 and 24 hr after the injection. There was a good
      correlation between amount of toxin injected and amount of hemorrhage observed.
      Microscopically, hemorrhage was visible in all parts of the connective tissue
      surrounding muscle cells just 5 min after injection and fibrin was present both
      intravascularly and extravascularly. At later time periods the hemorrhage was
      more extensive and there was more fibrin. Many vessels were plugged with
      platelets. At 30 min after the injection, muscle cells appeared to be damaged
      having either delta lesions or disrupted myofibrils. Electron microscopy revealed
      damaged capillaries with ruptured endothelial cells, disrupted basal lamina and
      intact intercellular junctions. Thus, this hemorrhagic toxin acts rapidly to
      disrupt the capillary endothelium without damaging the intercellular junctions,
      and it also appears to damage skeletal muscle cells.

PMID- 2219145
TI  - A toxin profile for shellfish involved in an outbreak of paralytic shellfish
      poisoning in India.
AB  - Toxin profiles of clams and oysters involved in the outbreak of paralytic
      shellfish poisoning in India in 1983 were studied by a liquid chromatographic
      technique. Gonyautoxins 1, 2, 3, 4 and 8, and 11-epigonyautoxin 8 appeared to be
      the major toxins along with small amounts of saxitoxin, neosaxitoxin,
      decarbamoylsaxitoxin, decarbamoylgonyautoxins 2 and 3, C3 and C4. Toxin profile
      suggests the involvement of Alexandrium spp. in this outbreak.

PMID- 2219146
TI  - Renal disposition and nephrotoxicity of xenobiotics. Proceedings of the joint
      symposium of the Universities of Wurzburg and Rochester. Wurzburg, 7-10 October,
      1990.

PMID- 2219147
TI  - Renal cell cultures: a tool for studying tubular function and nephrotoxicity.

PMID- 2219148
TI  - Nephrocarcinogenic xenobiotics.

PMID- 2219149
TI  - Nephrocarcinogenicity of estrogens.

PMID- 2219150
TI  - Perturbation of calcium homeostasis as a link between acute cell injury and
      carcinogenesis in the kidney.

PMID- 2219151
TI  - The role of damage and proliferation in renal carcinogenesis.

PMID- 2219152
TI  - Renal processing of glutathione conjugates by rat, chicken, pig and calf.

PMID- 2219153
TI  - Elimination of 14C by calves, pigs and rats renally perfused with radiolabelled
      dichlorovinyl or acetamide substrates.

PMID- 2219154
TI  - Cytotoxicity of 2-bromo-(N-acetylcystein-S-yl)-hydroquinone isomers in rat renal
      tubular epithelial cells.

PMID- 2219155
TI  - Effects of antioxidants and of different metabolic activation systems on
      dichlorovinylcysteine-induced genotoxicity.

PMID- 2219156
TI  - A 90-day study in rats with the monoglutathione conjugate of chlorothalonil.

PMID- 2219157
TI  - The activity of chromate reduction in renal tissue corresponds to chromate
      nephrotoxicity--developmental aspects.

PMID- 2219158
TI  - Primary cultures of rat and rabbit renal proximal epithelium as models for
      nephrotoxicity investigations.

PMID- 2219159
TI  - Transport and toxicity of CdCl2 in LLC-PK1 cells.

PMID- 2219160
TI  - Evidence of circadian variations in mercuric-chloride-induced proximal tubular
      necrosis by digital imaging microscopy.

PMID- 2219161
TI  - A 13C-NMR study on metabolic changes in proximal convoluted tubule cells induced
      by cadmium.

PMID- 2219162
TI  - Naproxen and indomethacin: disposition and effects in the isolated perfused rat
      kidney.

PMID- 2219163
TI  - A quantitative method for the measurement of urinary glycosaminoglycans-
      potential use in studies of xenobiotic nephrotoxicity.

PMID- 2219164
TI  - Peroxidative potential of suramin and effect on organic ion transport in rat
      kidney cortex.

PMID- 2219165
TI  - Renal tubular cell handling of digoxin and ouabain--in vitro study using LLC-PK1
      cell lines.

PMID- 2219166
TI  - Gentamicin nephrotoxicity in rat renal proximal tubular cells.

PMID- 2219167
TI  - Netilmicin affects Na(+)-dependent D-glucose transport and the membrane fluidity
      of rabbit renal brush-border membrane vesicles: a comparison with gentamicin.

PMID- 2219168
TI  - Comparison of the renal response of male Fischer 344, Sprague-Dawley and Wistar
      rats to administration of gentamicin.

PMID- 2219169
TI  - Autacoid modulation and N-(3,5-dichlorophenyl)succinimide nephrotoxicity.

PMID- 2219170
TI  - Role of metabolic activation in the renal toxicity of carbon disulfide (CS2).

PMID- 2219171
TI  - Biochemical mechanisms of cephaloridine nephrotoxicity in suspensions of isolated
      rabbit proximal tubules.

PMID- 2219172
TI  - The avian renal portal system: a model for studying nephrotoxicity of
      xenobiotics.

PMID- 2219173
TI  - Involvement of tubular transport processes in nephrotoxicity.

PMID- 2219174
TI  - Cell culture in nephrotoxicity testing.

PMID- 2219175
TI  - Maintenance of glucose uptake in suspensions and cultures of human renal proximal
      tubular cells.

PMID- 2219176
TI  - Use of human proximal tubule cell cultures to study folate transport and binding.

PMID- 2219177
TI  - Protective effect of verapamil in cyclosporin-incubated isolated rat glomeruli.

PMID- 2219178
TI  - Potential contribution of lysosomal proteases to cyclosporine-A-induced
      nephrotoxicity.

PMID- 2219179
TI  - Human renal C-S lyases: two cytosolic isoenzymes.

PMID- 2219180
TI  - Human renal C-S lyase: structure-activity relationships of cytosolic and
      mitochondrial enzymes.

PMID- 2219181
TI  - Mercapturic acid formation in cultured opossum kidney cells.

PMID- 2219182
TI  - Transport of heavy metals by the kidney.

PMID- 2219183
TI  - Energy metabolism of the kidney: segmental differences may determine xenobiotic
      actions.

PMID- 2219184
TI  - Biochemical markers to monitor nephrotoxic effects in patients.

PMID- 2219185
TI  - Morphology of renal tubular damage from nephrotoxins.
AB  - The proximal renal tubular cells' vulnerability to the direct toxic action of
      chemicals is largely due to the role played by this nephron portion in absorption
      and secretion. This is an energy-demanding function so that these cells must have
      a high rate of oxidative metabolism and thus contain many mitochondria supplying
      the Na+/K+ pumps at the basolateral plasma membrane domain, thereby driving the
      carrier systems for entry of water and solutes across the luminal membrane. Thus
      toxic mechanisms leading directly or indirectly to disturbances of the renal
      cells' energy metabolism will result in cell injury and acute renal
      insufficiency. Quantitative morphological-stereological-analysis of at least two,
      the mercuric chloride- and the maleate-induced experimental models of toxic acute
      renal failure, show a very early substantial loss of ATP-generating mitochondrial
      inner membrane surface as well as substantial decrease in those functions
      protecting cells against oxidative or auto-oxidative processes, i.e. glutathione
      content, activities of the free-radical-scavenging systems superoxide dismutase,
      glutathione peroxidase and glutathione reductase and catalase. The cellular
      dysfunction following these early events may be considered as causative of the
      subsequent development of most of the morphological alterations described, which
      are fairly similar in appearance regardless of the toxic principle acting upon
      the kidney.

PMID- 2219186
TI  - Renal transport and metabolism of mercapturic acids and their precursors.

PMID- 2219187
TI  - Biosynthesis, bioactivation, and mutagenicity of S-conjugates.

PMID- 2219188
TI  - Mechanisms underlying cyclosporin A nephrotoxicity.

PMID- 2219189
TI  - Chronic nephrotoxicity of 2,2,4-trimethylpentane and other branched-chain
      hydrocarbons.

PMID- 2219191
TI  - Nephrotoxicity of metals: effects on plasma membrane function.

PMID- 2219190
TI  - Mechanisms of beta-lactam antibiotic nephrotoxicity.

PMID- 2219192
TI  - NMR: a tool for studying renal function and nephrotoxicity.

PMID- 2219193
TI  - Renal toxicity of antineoplastic agents.

PMID- 2219194
TI  - Susceptibility to toxic injury in different nephron cell populations.

PMID- 2219195
TI  - Electron microscopic identification and morphologic preservation of enriched
      populations of lung cells isolated by laser flow cytometry and cell sorting: a
      new technique.
AB  - There is increasing need to verify the identities of cell subpopulations enriched
      by laser flow cytometry and fluorescence-activated cell sorting (FACS). When cell
      subpopulations isolated from whole organs or tissues have similar characteristics
      (e.g., size, granularity, staining), light, phase contrast or fluorescence
      microscopy may not provide sufficient resolution to identify isolated cells
      accurately and many flow cytometric parameters (e.g., viability, fluorescence)
      require the cells to be live at the point of analysis where the cell transects
      the laser beam. In some studies, cells identified by fluorescence microscopy as a
      highly enriched subpopulation were found by electron microscopy to contain
      significant populations of other cell types. A technique, fixation-in-flow (FIF),
      has been developed to increase ability to correlate morphological and laser
      analyses of cell subpopulations. Sheath fluid is replaced by fixative, permitting
      fixation to be initiated immediately after laser beam analysis of live cells.
      This new procedure yields improved cytoarchitectural preservation of recovered
      cell subpopulation(s) for evaluation by transmission or scanning electron
      microscopy. This report presents results from applying the methodology to
      identify more accurately cell subpopulations of the distal lung, specifically
      type II pneumocytes, Clara cells and pulmonary macrophages. A modification of
      this procedure was employed to isolate fibroblast subpopulations from murine lung
      fibroblasts grown in vitro and the procedure is being used to determine the
      responses of cultured fibroblasts to other permutations (e.g., X-irradiation,
      cytokines).

PMID- 2219196
TI  - Induction and inhibition of estradiol hydroxylase activities in MCF-7 human
      breast cancer cells in culture.
AB  - The effects of estradiol, progesterone, and tamoxifen on the activity of
      estradiol 2- and 16 alpha-hydroxylases were studied in human breast cancer cell
      cultures using a radiometric assay. After 5 days' exposure to these compounds,
      incubations in the presence of either [2-3H]estradiol or [16 alpha-3H]estradiol
      as substrate were carried out. In MCF-7 cells, estradiol (10(-8) M), progesterone
      (10(-6) M) and tamoxifen (10(-6) M) significantly increased 16 alpha-hydroxylase
      activity (estradiol; 21% progesterone 10% to 32%; tamoxifen 21% to 31%; P less
      than 0.01). Synergistic effects were observed when the cells were successively
      exposed to tamoxifen and progesterone. Simultaneous treatment with tamoxifen plus
      estradiol or estradiol plus progesterone showed no change from estradiol alone.
      On the other hand, although estradiol had no direct effects on 2-hydroxylase
      activity, tamoxifen decreased this enzymatic activity significantly at 10(-6) M
      (23% to 37%). Progesterone acted synergistically to further decrease this
      reaction. Treatment with only progesterone caused an increase in 2-hydroxylation.
      In contrast, a subline of MCF-7 cells with low estrogen receptor levels showed
      only minimal enzyme-hormone responses. Likewise, treatment of the estrogen
      receptor-negative MDA-MB-231 human breast cancer cell line with these compounds
      showed no effects on either 2- or 16 alpha-hydroxylase activity. In the
      progesterone receptor-rich T47D cell line, estradiol decreased both activities
      while progesterone increased both.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2219197
TI  - Synthesis of 7 alpha,12 alpha-dihydroxy-3 alpha- [2-(beta-D
      glucopyranosyl)acetyl]-5 beta-cholan-24-oic acid.
AB  - A C-glucoside of cholic acid was synthesized by the introduction of an acetyl
      group at position 3 alpha and direct one-pot C-glucosidation using 2,3,4,6-tetra
      O-benzyl-alpha-D-glucopyranosyl chloride.

PMID- 2219199
TI  - Monoclonal antibodies to pregnanediol-3-glucuronide: application to a direct
      enzyme-linked immunosorbent assay of urine.
AB  - Monoclonal antibodies to pregnanediol-3-glucuronide were produced and
      characterized. One of three clones investigated provided antibody suitable for a
      direct urinary enzyme-linked immunosorbent assay (ELISA). The ELISA uses a
      pregnanediol-thyroglobulin conjugate adsorbed onto the wells of a standard 96
      well microtiter plate. Pregnanediol-3-glucuronide in standards or diluted urine
      competes with the immobilized steroid for antibody-binding sites. After washing,
      mouse monoclonal antibody bound to the plate is probed with antimouse
      immunoglobulin peroxidase. After further washing, o-phenylenediamine substrate is
      added and, finally, the absorbance is read at 492 nm. The ELISA shows excellent
      performance and agreement with the previous gas chromatographic method. The ELISA
      is ideal for aiding the assessment of ovarian function in the routine laboratory.

PMID- 2219198
TI  - Rapid transformation of [3H]cholesteryl ester in rat high-density lipoprotein: in
      vivo and in vitro studies.
AB  - [24,25-3H]Cholesteryl ester-labeled rat high-density and low-density lipoproteins
      were administered to recipient rats. Following death of the rats, a major portion
      of the radioactivity in administered [3H]cholesteryl ester-high-density
      lipoprotein rapidly appeared in less dense [3H]cholesteryl ester-lipoproteins and
      was isolated with the low-density lipoprotein fraction. The specific activity of
      the esterified cholesterol in the product lipoproteins found with the low-density
      lipoproteins exceeded that of the precursor high-density lipoproteins. In vitro,
      the addition of [3H]cholesteryl ester-high-density lipoprotein to plasma resulted
      in a five- to six-fold increase in radioactivity recovered in the low-density
      lipoprotein. These results demonstrate that, under a variety of experimental
      conditions, isolated high-density lipoprotein particles (both in vitro and in
      vivo) tend to become larger and less dense. Rapid changes in the density of
      lipoproteins labeled with [3H]cholesteryl ester must be considered when
      interpreting physiologic studies using this label.

PMID- 2219201
TI  - Determination of the affinity of a steroid for its receptor is not sufficient to
      measure its intrinsic hormonal activity.

PMID- 2219200
TI  - Sex steroid changes in porcine cystic ovarian disease.
AB  - Ten sex steroids were measured in the peripheral serum and ovarian follicular
      fluid of female pigs with or without cystic ovarian disease. In general,
      progestin, especially progesterone, accumulated excessively in the fluid
      contained in cystic compared with normal follicles. Nonluteinized cystic
      follicles contained up to four times the progesterone concentration found in
      large normal preovulatory follicles. Levels of this steroid increased with
      luteinization of cystic follicles to as much as 10 times those found in large
      preovulatory follicles. In contrast, the concentration of follicular fluid
      androgens and estrogens in cystic follicles were, at best, barely detectable (5
      to 10 pg/ml). These results are indicative of a steroidogenic blockade in the
      conversion of C21 progestin to C19 androgens and C18 estrogens in the cystic
      follicles. In spite of an enormous accumulation of follicular progestin and
      subnormal concentration of androgens and estrogens, circulating levels of these
      hormones in pigs bearing cystic ovaries were in the normal range for cycling
      sows. Clearly, the hormonal abnormalities in the cystic follicles are not
      reflected in the serum profiles of these steroids.

PMID- 2219202
TI  - Stroke and its modification in Parkinson's disease.
AB  - Previous studies have not agreed on the incidence of ischemic stroke in persons
      with Parkinson's disease. There are epidemiologic and neurochemical facets of
      Parkinson's disease that might confer some benefit or protection against ischemic
      stroke. We used a case-control method to determine the lifetime history of
      ischemic stroke in 200 patients with Parkinson's disease and 200 controls of a
      similar age range. Analysis was also carried out for myocardial infarction as a
      marker of generalized atherosclerotic disease and for stroke risk factors. The
      cumulative incidence of ischemic stroke was significantly less in the patients
      with Parkinson's disease than in the controls, as was the cumulative incidence of
      myocardial infarction. Among risk factors, significantly fewer patients with
      Parkinson's disease used tobacco than controls. The decreased incidence of
      ischemic stroke in the patients with Parkinson's disease appears to be related to
      their less severe generalized atherosclerosis, possibly due to their lower
      incidence of tobacco use. In view of the known potential for dopamine to
      exacerbate experimental ischemic tissue damage, the possibility that the dopamine
      deficiency in the central nervous system of persons with Parkinson's disease
      confers an additional specific protective benefit against ischemic stroke cannot
      be excluded and requires further study.

PMID- 2219203
TI  - Hemodynamics in internal carotid artery occlusion examined by positron emission
      tomography.
AB  - Using positron emission tomography in nine patients with minor strokes,
      unilateral internal carotid artery occlusion, and good collateral circulation
      through the anterior portion of the circle of Willis, we analyzed regional
      cerebral blood flow, cerebral metabolic rate of oxygen, oxygen extraction
      fraction, and cerebral blood volume. These studies allowed quantification of the
      regional hemodynamic status, especially in relation to watershed areas. Compared
      with eight normal controls, the patients had significantly (p less than 0.01)
      decreased regional cerebral blood flow in the middle cerebral artery territory
      and the surrounding watershed areas of the occluded hemisphere. The oxygen
      extraction fraction rose with the distance from the anterior portion of the
      circle of Willis, attaining the highest value in the superior parietal and
      posterior temporo-occipital watershed area. A concomitant decrease in the
      cerebral blood flow/cerebral blood volume ratio suggested reduction in the mean
      blood flow velocity, whereby elevated blood viscosity would be more liable to
      reduce cerebral blood flow. These findings suggest hemodynamic vulnerability of
      the watershed areas after internal carotid artery occlusion in persons with good
      collateral circulation through the anterior portion of the circle of Willis. Our
      results also emphasize the importance of systemic hemodynamic factors such as
      blood pressure and circulating blood volume in the genesis of watershed
      infarction.

PMID- 2219204
TI  - Acute and long-term changes in serum lipids after acute stroke.
AB  - We studied serum lipid profiles in 171 patients less than or equal to 48 hours
      after the onset of acute stroke and 3 months later. The 83 patients suffering
      cerebral infarction had significantly higher serum concentrations of total
      cholesterol, low density lipoprotein-cholesterol, and apolipoprotein B and
      significantly lower serum concentrations of triglycerides and lipoprotein (a)
      less than or equal to 48 hours after ictus than 3 months later. The lipid
      profiles of the 53 patients suffering lacunar infarction were similar on both
      occasions, the only significant differences being higher total cholesterol and
      low density lipoprotein-cholesterol concentrations less than or equal to 48 hours
      after ictus. No significant changes were observed among the 35 patients suffering
      cerebral hemorrhage apart from a significantly higher concentration of high
      density lipoprotein3-cholesterol less than or equal to 48 hours after ictus. Our
      study, with many patients classified according to stroke subtype, gives results
      different from those of previous studies with much fewer patients. We conclude
      that in studies of serum lipid and lipoprotein concentrations as risk factors for
      cerebral infarction, comparing values obtained less than or equal to 48 hours
      after admission with control values may incorrectly identify certain lipid
      fractions as risk factors.

PMID- 2219205
TI  - Age-related spontaneous intracerebral hematoma in a German community.
AB  - We investigated incidence, age distribution in relation to etiology, and
      localization of spontaneous intracerebral hematoma in 100 consecutive cases.
      Incidence in the total population of the Giessen area was estimated to be greater
      than 11/100,000 inhabitants/yr and increased with age. There was a trend toward
      higher incidence in males. Overall mortality was 27%, 22% of 58 patients aged
      less than 70 years and 33% of 42 patients aged greater than or equal to 70 years.
      Hypertensive putaminal hematoma showed the highest mortality rate (42%, 10 of 24
      cases). Chronic alcoholism and anticoagulant medication influenced the mortality
      rate unfavourably. We found the following localizations and etiologies to have a
      specific relation with age: 1) lobar hematomas from vascular malformations, group
      aged less than 40 years; 2) hypertensive putaminal hematomas and hypertensive
      thalamic hematomas, group aged 40-69 years; and 3) lobar hematomas, group aged
      greater than or equal to 70 years. Alcoholism was an additional factor in 38% of
      the 13 middle-aged men with hypertensive putaminal hematomas. Fourteen cases of
      spontaneous intracerebral hematoma were possibly due to cerebral amyloid
      angiopathy. Six of these 14 patients had recurrent lobar hematomas, but only
      three of the six could be histologically investigated. In these three cases,
      cerebral amyloid angiopathy was proven.

PMID- 2219206
TI  - Leukoaraiosis, intracerebral hemorrhage, and arterial hypertension.
AB  - To investigate whether the observed association of leukoaraiosis with
      intracerebral hemorrhage is direct or mediated by risk factors, we compared 116
      patients with intracerebral hemorrhage confirmed by computed tomography and 155
      controls without intracerebral hemorrhage, evaluating the prevalence of
      leukoaraiosis and vascular risk factors. Leukoaraiosis was observed in 21 (18%)
      of the 116 patients and in 12 (8%) of the 155 controls (p less than 0.01). Only
      two (6%) of the 31 patients with lobar hemorrhage had leukoaraiosis on computed
      tomograms, compared with 17 (24%) of the 71 patients with basal ganglionic
      hemorrhage (p less than 0.05). Leukoaraiosis was significantly correlated with
      intracerebral hemorrhage after controlling for age and sex by using multiple
      logistic regression analysis, while the correlation disappeared after controlling
      for hypertension. Our results indicate that leukoaraiosis is not an independent
      risk factor for intracerebral hemorrhage.

PMID- 2219207
TI  - Risk factors for white matter changes detected by magnetic resonance imaging in
      the elderly.
AB  - We found increased age (p = 0.001) and history or evidence of stroke (p = 0.016)
      to be significant independent multivariate predictors of the presence and
      severity of leukoencephalopathy on magnetic resonance imaging brain scans in a
      mixed population of 35 elderly psychiatric patients and 25 neurologically healthy
      elderly volunteers. These results suggest that subcortical ischemia, as well as
      age-related changes that may not be vascular in origin, contribute to the
      emergence of periventricular and other deep white matter hyperintensities that
      are commonly seen on the magnetic resonance imaging brain scans of older adults.

PMID- 2219208
TI  - A 21-aminosteroid reduces hydrogen peroxide generation by and chemiluminescence
      of stimulated human leukocytes.
AB  - Leukocytes recruited to regions of focal cerebral ischemia may contribute to
      tissue injury by their ability to promote inflammation. A novel group of drugs,
      the 21-aminosteroids, have been observed to reduce neurologic damage and
      vasogenic cerebral edema in animal models of stroke by inhibiting lipid
      peroxidation. Production of hydrogen peroxide and free radicals by leukocytes
      during the inflammatory response may contribute to lipid peroxidation and other
      consequences of free radical-mediated tissue injury. We assessed the effect of
      U74500A, a 21-aminosteroid, on the generation of hydrogen peroxide by and on the
      chemiluminescence of stimulated polymorphonuclear leukocytes and monocytes from
      normal humans. U74500A significantly reduced the generation of hydrogen peroxide
      by polymorphonuclear leukocytes (p less than 0.001) and monocytes (p less than
      0.01) in a dose-dependent manner. Monocyte chemiluminescence was also
      significantly inhibited (p less than 0.05), but polymorphonuclear leukocyte
      associated chemiluminescence was unchanged. Our results indicate that U74500A can
      reduce the concentration of oxygen metabolites associated with stimulated human
      leukocytes, and this effect may explain in part how 21-aminosteroids reduce lipid
      peroxidation, ischemic injury, and vasogenic edema.

PMID- 2219209
TI  - Cerebral blood flow in experimental ischemia assessed by 19F magnetic resonance
      spectroscopy in cats.
AB  - We evaluated a 19F magnetic resonance spectroscopic technique that detects Freon
      23 washout as a means of measuring cerebral blood flow in halothane-anesthetized
      adult cats during and after transient cerebral ischemia produced by vascular
      occlusion. The experiments were performed to test the ability of this recently
      developed method to detect postischemic flow deficits. Results were consistent
      with postischemic hypoperfusion. The method also proved valuable for measuring
      small residual flow during vascular occlusion. Our experiments indicate that this
      method provides simple, rapid, and repeatable flow measurements that can augment
      magnetic resonance examinations of cerebral metabolic parameters in the study of
      ischemia.

PMID- 2219210
TI  - Evidence for platelet-activating factor as a novel mediator in experimental
      stroke in rabbits.
AB  - Platelet-activating factor is a potent mediator of inflammation, which has
      untoward effects on cerebrovascular and neural elements. While several
      investigators have reported attenuation of ischemic damage after treatment with
      antagonists of platelet-activating factor, no study has proved endogenous
      production of platelet-activating factor in ischemia of the central nervous
      system. We hypothesized that endogenous production of platelet-activating factor
      participates in the early pathologic manifestations of deteriorating stroke. In
      12 rabbits, we found tissue levels of platelet-activating factor measured by the
      release of serotonin from washed platelets to be elevated by approximately 20
      fold in spinal cord injured by 25 minutes of ischemia and 2 hours of reperfusion
      (2.80 +/- 0.98 ng/g) compared with that in normal spinal cord (0.15 +/- 0.06
      ng/g, p less than 0.01). Given during ischemia to seven rabbits, 10 mg/kg i.p. of
      a highly selective and potent antagonist of platelet-activating factor (BN 50739)
      accentuated the early postischemic hyperemia and prevented the delayed
      hypoperfusion measured by on-line laser-Doppler flowmetry (-35 +/- 7% of baseline
      [n = 7] without versus 33 +/- 14% with treatment, p less than 0.01) and the edema
      formation measured as the increase in tissue water content (4.4 +/- 0.7% without
      [n = 6] versus 2.1 +/- 0.6% with [n = 7]treatment, p less than 0.05) after 2
      hours of reperfusion. This neurochemical and pharmacologic evidence emphasizes a
      new perspective of ischemia-induced phospholipid degradation and suggests an
      important role for platelet-activating factor in the early manifestations of
      stroke.

PMID- 2219212
TI  - Diurnal variation of cerebral blood flow in rat hippocampus.
AB  - We measured local cerebral blood flow over 24 hours in 10 unanesthetized, freely
      moving rats to determine whether blood flow in the hippocampus fluctuated as a
      function of time of day. We measured hydrogen clearance at 1-hour intervals using
      a polyurethane-coated platinum electrode with a 1-mm bare tip implanted in the
      dorsal hippocampus. Individual rats displayed a wide range of local cerebral
      blood flow values (from 30 to 100 ml/min/100 g tissue) in a day. In seven of the
      10 rats, the overall mean hippocampal blood flow for the dark cycle (7 PM-5 AM)
      was significantly (p less than 0.001, 0.01, or 0.05) greater than that for the
      light cycle (6 AM-6 PM), showing an average increase of 20%. Further, the maximum
      mean hippocampal blood flow at 11 PM in all 10 rats was 42% greater than the
      minimum at noon. Our study demonstrates for the first time that local cerebral
      blood flow in the hippocampus shows diurnal variation.

PMID- 2219211
TI  - Beneficial effect of 1,3-butanediol on cerebral energy metabolism and edema
      following brain embolization in rats.
AB  - We assessed the effect of 1,3-butanediol on cerebral energy metabolism and edema
      after inducing multifocal brain infarcts in 108 rats by the intracarotid
      injection of 50-microns carbonized microspheres. An ethanol dimer that induces
      systemic ketosis, 25 mmol/kg i.p. butanediol was injected every 3 hours to
      produce a sustained increase in the plasma level of beta-hydroxybutyrate.
      Treatment significantly attenuated ischemia-induced metabolic changes by
      increasing the concentrations of phosphocreatine, adenosine triphosphate, and
      glycogen and by reducing the concentrations of pyruvate and lactate. Lactate
      concentration 2, 6, and 12 hours after embolization decreased by 13%, 44%, and
      46%, respectively. Brain water content increased from 78.63% in six unembolized
      rats to 80.93% in 12 saline-treated and 79.57% in seven butanediol-treated rats
      12 hours after embolization. (p less than 0.05). The decrease in water content
      was associated with significant decreases in the concentrations of sodium and
      chloride. The antiedema effect of butanediol could not be explained by an osmotic
      mechanism since equimolar doses of urea or ethanol were ineffective. Our results
      support the hypothesis that the beneficial effect of butanediol is mediated
      through cerebral utilization of ketone bodies arising from butanediol metabolism,
      reducing the rate of glycolysis and the deleterious accumulation of lactic acid
      during ischemia.

PMID- 2219213
TI  - Pharmacologic irreversible narrowing in chronic cerebrovasospasm in rabbits is
      associated with functional damage.
AB  - We studied isolated basilar artery segments from a rabbit model of chronic
      cerebrovasospasm. Autologous blood placed around the basilar artery of rabbits
      killed 1, 2, 3, 4, 5, 6, 7, or 9 days later caused narrowing of the segments with
      a biphasic time course. The first (immediate) phase was reversed by intra
      arterial papaverine; the second phase exhibited an increasing component of
      narrowing that was papaverine-insensitive. Based on the passive force/length
      curves, basilar artery segments became increasingly stiff over 9 days. By
      contrast, the segments' contractility decreased. Responses of the basilar artery
      segments were greater over the first few days, but then became less than that of
      saline-injected controls. Contractions in response to norepinephrine and
      potassium were reduced. Endothelium-based acetylcholine-induced vasodilation
      progressively diminished, as did the response to sympathetic nerve stimulation.
      There was a negative correlation between artery wall stiffness and contractility.
      The papaverine-insensitive component of angiographic narrowing correlated
      directly with loss of contractility and with artery wall stiffness. These results
      are consistent with the conclusion that increased artery wall stiffness is a
      primary determining factor in the arterial narrowing of chronic cerebrovasospasm.

PMID- 2219214
TI  - Progressive shrinkage of the thalamus following middle cerebral artery occlusion
      in rats.
AB  - Permanent middle cerebral artery occlusion in rats results in infarction in the
      ipsilateral cortex and caudate nucleus-putamen. In this ischemia model, severe
      shrinkage of the ipsilateral half of the thalamus was observed several months
      after surgery. We examined the serial profile of this phenomenon in 40 rats at
      intervals from 2 weeks to 6 months after the operation. The area of the
      ipsilateral half of the thalamus as a percentage of the area of the contralateral
      half was 87% at 2 weeks, 77% at 1 month, 54% at 3 months, and 54% at 6 months.
      Such severe morphologic change distant from the original ischemic focus has not
      been reported in models of experimental focal ischemia. Retrograde degeneration
      is thought to play an important role in this phenomenon.

PMID- 2219215
TI  - Therapeutic window of CA1 neuronal damage defined by an ultrashort-acting
      barbiturate after brain ischemia in gerbils.
AB  - Previous therapeutic studies on the prevention of selective vulnerability of
      neurons in the hippocampus have suggested that the critical period for induction
      of delayed neuronal injury occurs early during recirculation. To determine the
      onset and duration of this period, an ultrashort-acting barbiturate
      (methohexital) was infused into the left carotid artery of 47 gerbils after
      various times of recirculation following 10 minutes of bilateral forebrain
      ischemia. Neuronal density in the left CA1 sector was determined 7 days later by
      counting the number of surviving neurons per millimeter of pyramidal cell layer.
      In 16 saline-treated gerbils, less than 10% of the CA1 neurons survived the 10
      minutes of ischemia. Postischemic carotid infusion of methohexital improved
      neuronal survival, the degree of improvement depending on the timing and duration
      of the methohexital infusion. When carried out during the initial 40 minutes of
      recirculation, methohexital infusion for 10 minutes increased the number of
      surviving neurons to approximately 60% of that in five sham-operated control
      gerbils. This increase was significant for infusions carried out between the 10th
      and 20th minutes (n = 6, p less than 0.05) and between the 30th and 40th minutes
      (n = 6, p less than 0.05) of recirculation. Methohexital infusion for 20 minutes
      increased neuronal survival to 95% and 73% of that in the controls when carried
      out between the 0th and 20th minutes (n = 5, p less than 0.005) and between the
      20th and 40th minutes (n = 5, p less than 0.005) of recirculation, respectively.
      Protection was nonsignificant for 10- or 20-minute methohexital infusions carried
      out after the 40th minute of recirculation. Our results demonstrate that the
      pathologic processes leading to delayed neuronal injury in the CA1 sector are
      induced during the initial 40 minutes of recirculation and that barbiturates are
      able to reverse these processes only if given during this period.

PMID- 2219216
TI  - Retinal infarction during sleep and wakefulness.
AB  - Brain and retinal infarctions during sleep have been attributed to focal
      hypoperfusion caused by systemic hypotension combined with underlying arterial
      stenosis, rather than to embolism. Because some retinal emboli may be visualized
      on ophthalmoscopy, we studied 24 consecutive patients (18 men and six women) aged
      26-78 (mean 58) years with recent retinal infarction and determined whether the
      infarction had occurred during sleep or wakefulness. All patients underwent
      dilated ophthalmoscopy and a carotid artery study (arteriography in 20, duplex
      ultrasound in the remaining four), and 12 had echocardiography. Retinal
      infarction occurred during sleep at an unexpectedly rate (14 of 24 observed
      compared with eight of 24 expected, p = 0.02). Retinal cholesterol emboli were
      seen in one half of the patients regardless of whether the retinal infarction had
      occurred during sleep or wakefulness. Carotid artery disease was found in seven
      of the 14 patients in whom infarction had occurred during sleep and in eight of
      the 10 patients in whom infarction had occurred during wakefulness (p = 0.21).
      Cerebrovascular occlusive disease was not found in the five patients aged less
      than 50 years. Our findings suggest that embolism is a common mechanism of
      retinal infarction during sleep or wakefulness, that in patients aged greater
      than 50 years extracranial carotid artery disease is a common source of retinal
      emboli, and that the retina may be especially susceptible to infarction during
      sleep.

PMID- 2219217
TI  - Etiologic importance of the intimal flap of the external carotid artery in the
      development of postcarotid endarterectomy stroke.
AB  - A technically unsatisfactory end point (transition from the removed diseased
      plaque to normal distal intima) leading to an intimal flap of the external
      carotid artery has been identified as a source of perioperative stroke. The
      mechanism involves thrombus formation with retrograde propagation of the thrombus
      and subsequent embolization of the internal carotid artery. This report describes
      three cases illustrating this mechanism and methods of identification and
      correction. This mechanism of postoperative stroke adds further justification for
      the routine use of intraoperative surveillance studies to document the technical
      result of endarterectomy involving the internal and external carotid arteries.
      When an unsatisfactory end point is identified in the external carotid artery, it
      should be corrected with the same sense of concern as a similar finding in the
      internal carotid artery.

PMID- 2219218
TI  - Cerebral venous thrombosis due to heparin-induced thrombocytopenia.
AB  - A patient with polycythemia vera who was treated with heparin for superficial
      septic thrombophlebitis developed heparin-induced thrombocytopenia and cerebral
      venous thrombosis with superior sagittal sinus occlusion 11 days after the
      institution of heparin therapy. We suggest that the severe thrombotic response to
      the heparin-induced platelet disorder in this patient occurred because the
      polycythemia vera and the purulent infection enhanced the thrombophilia caused by
      heparin-induced thrombocytopenia. This condition can be avoided in most instances
      if heparin is used for no longer than 5 days.

PMID- 2219219
TI  - Two cases of spontaneous internal carotid artery occlusion due to giant
      intracranial carotid artery aneurysm.
AB  - Although spontaneous thrombosis of a giant intracranial aneurysm is relatively
      common, occlusion of its parent artery is rare. We describe two recent patients
      in whom the parent artery spontaneously occluded. One patient had severe stenosis
      of the left internal carotid artery, with delayed appearance of a faint shadow of
      vascular widening near the posterior clinoid process. One month later, complete
      occlusion of the left internal carotid artery was shown angiographically. The
      second patient had dysarthria and left hemiparesis, resulting in the diagnosis of
      a left internal carotid artery giant aneurysm. He had suffered an episode of
      visual disturbance of the right eye 5 years before. Angiography showed the right
      cervical internal carotid artery to be occluded. We believe the mechanism of
      parent artery occlusion in our two patients to be due first to stretching of the
      internal carotid artery by the enlarged aneurysm, followed by compression of the
      internal carotid artery by the aneurysm itself. Next, the anterior clinoid
      process and the optic nerve are involved, and, finally, thrombosis of the
      aneurysmal cavity extends into the internal carotid artery itself.

PMID- 2219221
TI  - Sneddon's syndrome with negative antiphospholipid antibodies.

PMID- 2219220
TI  - Coexistence of cystatin C and beta protein immunoreactivity.

PMID- 2219222
TI  - Detection of middle cerebral emboli during coronary artery bypass surgery using
      transcranial Doppler sonography.

PMID- 2219223
TI  - Effect of intra-aortic balloon pumps on cerebral circulation.

PMID- 2219224
TI  - Maternal-child health and family planning: user perspectives and service
      constraints in rural Bangladesh.
AB  - This article presents a microanalysis of interactions between female fieldworkers
      and women in rural Bangladesh, and a discussion of the broader organizational
      constraints that hamper service delivery. It is argued that the fieldworker,
      herself a rural woman, is faced with considerable demand for both maternal-child
      health (MCH) and reproductive health care services, but that operational
      constraints prevent her from realizing her potential in both of these areas.
      Qualitative data show that, in the eyes of rural women, contraceptive use and
      health care are intricately intertwined, and that this association often raises a
      range of questions that the worker cannot address competently. A number of
      specific operational barriers--worker densities, staff motivation, supervision,
      technical competence, supplies--are identified. These barriers reflect a general
      institutional weakness in the Ministry of Health bureaucracy that prevents it
      from organizing itself to deliver user-oriented health and family planning
      services while maintaining adequate and appropriate standards of care.

PMID- 2219225
TI  - Pregnancy termination and the law in Nigeria.
AB  - Abortion in Nigeria is illegal and carries a heavy jail sentence--up to 14 years
      imprisonment--unless it is performed to save the life of the pregnant woman.
      Nevertheless, a large number of clandestine abortions continue to be carried out
      regularly, often with dire consequences for the lives and health of the women
      involved. This article reviews abortion legislation in Nigeria, examines court
      decisions on the subject, and presents the results of a survey conducted on the
      incidence of abortion in the country. A case is made for revising existing
      abortion laws. A brief look is taken at the various indications for abortion that
      might be adopted and a proposal is made for a new abortion policy in Nigeria in
      the light of the country's recently adopted population policy.

PMID- 2219226
TI  - Fertility intentions and subsequent behavior: a longitudinal study in rural
      India.
AB  - This report compares fertility and family planning intentions of rural Indian
      women in 1975 with actual outcomes in 1987. Ninety-four of 103 respondents who
      had fewer children than they wanted in 1975 and had stated definite intentions
      with respect to future fertility and contraceptive use were reinterviewed in
      1987. Overall, women had fewer children than desired and stopped childbearing
      when they reached or closely approximated their ideal number of sons. Since sons
      were clearly the determinant of "reproductive success," it is argued that only a
      significant change in the status of rural women can bring about widespread
      compliance with the official family planning program's two-child norm.

PMID- 2219227
TI  - Toward consistency in breastfeeding definitions.
AB  - On 28 April 1988, the Interagency Group for Action on Breastfeeding met to
      develop and agree upon a set of definitions that could be used as standardized
      terminology for the collection and description of cross-sectional information on
      breastfeeding behavior. The schema and potential framework suggested at the
      meeting were reviewed extensively by breastfeeding researchers and program
      personnel, revised at subsequent meetings by a variety of organizations, and
      compared against published research on patterns of breastfeeding and their
      effects on infant nutrition, health, and fertility. This schema and framework:
      (1) acknowledge that the term "breastfeeding" alone is insufficient to describe
      the numerous types of breastfeeding behavior, (2) distinguish full from partial
      breastfeeding, (3) subdivide full breastfeeding into categories of exclusive and
      almost exclusive breastfeeding, (4) differentiate among levels of partial
      breastfeeding, and (5) recognize that there can be token breastfeeding with
      little to no nutritional impact. The schema and framework should assist
      researchers and agencies in their efforts to accurately describe and interpret
      breastfeeding practices.

PMID- 2219230
TI  - Xenophobia, T cells and a journey to a foreign land.

PMID- 2219228
TI  - Observations on abortion in Zambia.
AB  - This report describes the findings of a preliminary investigation of women who
      sought treatment for abortion from the Gynecological Emergency Ward at the
      University Teaching Hospital (UTH) in Lusaka, Zambia. Barriers to obtaining legal
      abortions are identified and the harsh experiences of women seeking treatment for
      complications of illegally induced abortion are discussed. The data contribute to
      an understanding of the intensity of abortion for Zambian women and draw
      attention to the value of small-scale, qualitative research on women's
      reproductive health care needs. It is suggested that a study be planned at UTH to
      determine how health care delivery can be improved for women who seek abortion.

PMID- 2219229
TI  - Ghana 1988: results from the Demographic and Health Survey.

PMID- 2219232
TI  - Serum concentrations of IgM, IgG1, IgG2b, IgG3 and IgA in C57BL/6 mice and their
      congenics at the nu(nude)locus.
AB  - The absolute concentrations of IgM, IgG1, IgG2b, IgG3 and IgA were determined in
      mice of C57BL/6 background, from weaning to one year of age, by quantitative
      isotype-specific, indirect double sandwich ELISAs. The comparison of 10-40 weeks
      old athymic nude C57BL/6 females with age matched females of the wild strain
      showed a general decrease of the whole serum Ig levels in the athymic mice, which
      was however contributed quite differently by the different Ig isotypes: a
      significant decrease (about 3.5 fold) was found for IgG2b only (0.34 mg/ml),
      whereas 1.5 fold more IgM (0.28 mg/ml) and about 2 fold more IgG3 (0.27 mg/ml)
      were detected, the IgG1 (0.19 mg/ml) and IgA (0.07 mg/ml) levels remaining within
      the normal range ! Limited data for IgG2a suggest that that this isotype may also
      be decreased in nude mice (0.36 mg/ml) in comparison with normal B6 + mice (0.54
      mg/ml). Thus, although homozygosity at the nu locus results in a lack of effector
      T cells, our data show, at the humoral level, a limited degree of thymus
      dependence of an Ig isotype. It is intriguing that, although thymus dependence of
      several Ig isotypes looked evident ten years ago in early studies on nude mice,
      more recent data are very variable and controversial in this respect.

PMID- 2219231
TI  - Characterization of lymphatic and venous emigrants from the thymus.
AB  - Lymphocytes leaving the thymus via two different pathways were examined as to
      their morphology and phenotype. Cells leaving the thymus via lymphatics were
      obtained by a direct cannulation of thymic lymphatics and those leaving via the
      thymic vein were labelled within the thymus using an extracorporeal perfusion
      system and identified subsequently as fluorescent cells in the draining vein. In
      both cases the cervical thymus in lambs was used, since it is located in the neck
      region and ensures easy access to both blood and lymphatic vessels of the thymus
      without subjecting the animal to a major trauma or stress. Cells obtained from
      the thymic lymphatics or lymphatic emigrants were found to have distinct features
      different from peripheral T cells in terms of their surface morphology and
      expression of the MHC antigens. Venous emigrants were also slightly different
      from peripheral T cells in MHC expression. Estimation on the rate of thymocyte
      emigration into the periphery suggested that neither venous nor lymphatic
      emigrants represent a major fraction of de novo synthesized cells in the thymus
      of this animal species, as has been suggested in the mouse.

PMID- 2219233
TI  - Enzyme-histochemical profile of macrophages in the rat thymus after the
      application of cyclophosphamide.

PMID- 2219234
TI  - Abnormal thymocyte subpopulations in split dose irradiated C57BL/Ka mice before
      the onset of lymphomas. Effects of bone marrow grafting.
AB  - Fractionated whole-body X irradiation (4 x 1.75 Gy at weekly intervals) induces a
      high percentage of thymic lymphomas in C57BL/Ka mice. The present work reports
      the phenotypic alterations of thymocyte subpopulations during the preleukemic
      period: there were a decrease of CD4+ CD8+ cells and an increase of CD4- CD8- and
      CD4- CD8+ cells. Marrow grafting early after irradiation that prevents lymphoma
      development restores the thymocyte subpopulations. In many instances,
      transplantation of 'preleukemic thymocyte inoculate' gives rise to an active and
      long lasting repopulation of recipient thymuses. However in all cases, donor
      lymphomas can develop after inoculation of 'preleukemic thymocyte inoculate'.

PMID- 2219235
TI  - [Detection of memory impairment using a recognition test for words and faces].
AB  - Fifty-two patients (mean age 78.3; sd: 5.5; range 70-94) who were admitted to
      psychogeriatric day care because of memory problems and other cognitive deficits
      were tested with the Dutch form of Warrington's Recognition Memory Test (RMT).
      Forty-five mentally normal elderly (mean age 79.5; sd: 5.7; range 69-92) were
      also tested in order to establish the sensitivity and specificity of the test for
      the detection of memory impairment. Mentally normal subjects were mainly
      recruited from homes for the aged and were rated by the staff as free from any
      symptoms of dementia or other psychiatric disease. Using cut-off scores at the
      98%-specificity level, the sensitivity of the RMT was 54% for the verbal part
      (Recognition Memory for Words, RMW) and 73% for the non-verbal part (Recognition
      Memory for Faces, RMF). Selection of cut-off scores with high sensitivity (96%)
      resulted in specificities of 62% and 71% for RMW and RMF, respectively. The RMF
      appears to be a more valid test for the detection of memory impairment than the
      RMW. Selection of cut-off scores is contingent on knowledge of the pretest or
      prior probability of memory impairment. A cut-off score with high sensitivity is
      recommended if impairment is strongly suspected, whereas high specificity is
      needed to verify the presence of impairments for which there is little clinical
      evidence.

PMID- 2219236
TI  - [Loneliness among the frail elderly and possibilities for intervention by primary
      care caregivers. Report of an inventory study in 2 Amsterdam neighborhoods].
AB  - In Amsterdam in 1987 an inventory was drawn up of factors that practitioners (n =
      39) and volunteers (n = 22) associated with loneliness among the elderly. Three
      groups of non-institutionalized old elderly (80 years and older) served as
      respondents (total n = 100). Some of the factors that the helpers mentioned, such
      as reported health problems, not having children and dissatisfaction with housing
      conditions are actually found to be related to loneliness. Other factors such as
      gender, marital status and the presence of children, relatives and friends in the
      neighbourhood had no association with loneliness. Although not all the factors
      mentioned were related to loneliness, when practitioners assumed an older person
      to be lonely, their assessment was rather correct. Practitioners and volunteers
      claimed to use a broad scale of interventions where loneliness was concerned.
      Their help varied from practical to psycho-geriatric care. Clients often did not
      recognize such help as being directed at their loneliness. We refer to this as
      'latent' help. The effectiveness of interventions for loneliness can be enhanced
      by more openness in the helping situation. Moreover the success of interventions
      seemed to be thwarted by reluctance on the part of helpers to be more critical
      about their own behaviour. Improvement of social contacts is not the only way to
      help the alleviation of feelings of loneliness among the oldest old. Emphasizing
      the merits of nonsocial activities can be an additional way to help.

PMID- 2219237
TI  - [Incidence, risk and operability of abdominal aortic aneurysm in the elderly
      patient].
AB  - The risks of operative treatment of abdominal aortic aneurysm are considerably
      smaller in elective circumstances than after rupture of the aneurysm. The risk of
      a ruptured aneurysm is higher than the indicated percentage in the literature,
      because this only reflects the operative mortality. Possibly almost 65% of the
      patients with a rupture of an abdominal aortic aneurysm die at home or during
      transport to the hospital. In the absence of valid contra-indications to surgery,
      elective operative treatment should be considered, also in the elderly patient.

PMID- 2219239
TI  - [Pneumonia in the elderly].
AB  - In the aged, pneumonia is associated with considerable morbidity and mortality.
      As a consequence of ageing, decreased mobility, underlying illnesses and
      medication, especially the host defense mechanisms in the respiratory tract may
      become deficient. The kind of micro-organism that causes the infection depends on
      whether the patient lives at home or whether he is institutionalised (nursing
      home, skilled nursing facility, hospital). Pneumonia in patients at home is
      mainly caused by pneumococci, whereas in institutionalised patients also other
      micro-organisms, especially Gram-negative bacteria are the cause. The diagnosis
      is often difficult due to the lack of symptoms and signs in the aged patient. An
      important sign is tachypnea. For the choice of anti-microbial therapy the
      question whether the patient acquired the infection at home or in an institution
      is crucial, as is the question, whether the patient has recently used anti
      microbial drugs. Finally, therapy differs in patients that produce sputum and in
      those who do not.

PMID- 2219238
TI  - [Drug treatment of cancer in elderly patients].
AB  - Cancer is a disease predominantly seen in the older age group. The most frequent
      forms are in males: lung, prostatic, stomach, colonic and bladder cancer. In
      females: breast, colonic, stomach cancer, lymphoma, leukaemia and rectal cancer.
      In view of the expected demographic figures a dramatic increase in the incidence
      of cancer is expected. The malignancies seen in the elderly respond generally
      poor to chemotherapy. Most cytotoxic drugs are excreted by the kidneys.
      Especially the renal clearance of anticancer drugs will therefore be compromised
      in the elderly, this should be considered when giving cytostatics. Mucositis,
      bone marrow toxicity, pulmonary and neurotoxicity are quite often enhanced in the
      older patient group. The indications for chemotherapy are limited. Chemotherapy
      should not be withheld from patients with advanced breast cancer and certain
      haematological malignancies. Further clinical research focussed on the elderly is
      warranted. Drugs with a mild spectrum of side effects deserve priority. Hormonal
      treatment is an important modality in breast, prostatic and endometrial
      carcinoma. The burden for the patients is limited and the advantages are well
      documented.

PMID- 2219240
TI  - Break it off. Identifying a destructive love relationship.
AB  - 1. Destructive love is an active process of destroying the affection and
      tenderness between two people. 2. If people are unable to distinguish the
      difference between an argument that was formulated to clear up a misunderstanding
      from an argument that is destructive, they will be unable to function properly.
      3. Five basic therapeutic elements needed for recovery are: a willingness to seek
      help; a move toward a more realistic form of thinking; spirituality in one's
      personal and professional life; a circle of friends who support emotional
      honesty; and a personal appreciation of one's own values instead of the values of
      a past partner.

PMID- 2219241
TI  - Face value: trends and advances in craniofacial surgery.
AB  - 1. The ability of a computerized tomography scan to project a three-dimensional
      reconstruction of the patient's skeleton allows surgeons to plan the
      reconstructive process preoperatively. 2. Because of the length of the procedure,
      patient positioning, cardiorespiratory status, and laboratory values are
      essential. 3. It is beneficial to perform craniofacial surgery at early ages
      while there is still growth potential and before the skin and muscles have
      tightened.

PMID- 2219243
TI  - Draping: how much and which one?

PMID- 2219242
TI  - Nip it in the bud. Controlling wound infection with preoperative shaving.
AB  - 1. Postoperative wound sepsis can double the normal patient hospital stay and
      significantly add to the cost of hospitalization. Close skin shaving prior to
      surgery (especially if done the night prior to surgery) is a contributing factor
      to postoperative wound sepsis rates. 2. This problem can be managed by selecting
      a preoperative shaving technique that rids the skin surface of hair, soils, and
      microorganisms, but still leaves the epidermal layer intact as a natural barrier
      against opportunistic microorganisms. 3. Hair removal at the surgical site is not
      the cause of postoperative wound sepsis. Preoperative techniques that remove hair
      shafts and not epidermal layers are important in managing this problem in the
      operating room.

PMID- 2219244
TI  - How to detect if the balloon bursts.

PMID- 2219246
TI  - Interferon: a cure for hepatitis B.

PMID- 2219245
TI  - Anxiety related to impending surgery.

PMID- 2219247
TI  - Winds of change.

PMID- 2219248
TI  - Pancreatoduodenectomy: a complicated solution.
AB  - 1. Pancreatoduodenectomy is an effective operative procedure for benign large
      tumors and cancers of the pancreas and periampullary sites and extensive trauma
      to these areas. 2. Pancreatoduodenectomy may be performed in two stages: total
      excision of pancreas, subtotal excision, and pyloric exclusion procedures. 3.
      Carcinoma of the proximal pancreas is a serious medicosurgical problem, and
      radical pancreatoduodenectomy is the most effective form of therapy. 4.
      Pancreatoduodenectomy is a major operative procedure with serious intraoperative
      and postoperative complications that are directly related to the experience of
      the surgeon.

PMID- 2219249
TI  - Severe and complicated malaria. World Health Organization, Division of Control of
      Tropical Diseases.

PMID- 2219250
TI  - Cloning the ABH genes.

PMID- 2219251
TI  - Control of red cell production: the roles of programmed cell death (apoptosis)
      and erythropoietin.

PMID- 2219252
TI  - Routinely washing irradiated red cells before transfusion seems unwarranted.

PMID- 2219253
TI  - Prenatal identification of potential donors for umbilical cord blood
      transplantation for Fanconi anemia.
AB  - Reported here are studies of Fanconi anemia fetal cells that led to the first use
      of umbilical cord blood for hematopoietic reconstitution in a clinical trial.
      Prenatal diagnosis and HLA typing were performed in fetuses at risk for Fanconi
      anemia (FA) to identify, prior to birth, those that were unaffected with the
      syndrome and were HLA-identical to affected siblings. Umbilical cord blood was
      harvested at the delivery of these infants; assays of progenitor cells indicated
      the presence of colony-forming units-granulocyte-macrophage (CFU-GM) in numbers
      similar to those of bone marrow CFU-GM that are associated with successful
      engraftment in HLA-matched allogeneic bone marrow transplantation. The
      possibility that umbilical cord blood from a single individual can be used as an
      alternative to bone marrow for hematopoietic reconstitution has now been
      demonstrated by the successful engraftment of two patients with FA. Progenitor
      cell assays of umbilical cord blood collected at the birth of a child affected
      with FA, who had been misdiagnosed on the basis of chorionic villus sampling
      (CVS) studies, indicated a profound deficiency in colony formation, consistent
      with previously reported abnormalities in the growth of FA cells in vitro. These
      results suggest that the hematopoietic disorder in FA is related to an underlying
      problem with cell proliferation.

PMID- 2219254
TI  - The differentiation of delayed serologic and delayed hemolytic transfusion
      reactions: incidence, long-term serologic findings, and clinical significance.
AB  - Delayed serologic transfusion reactions (DSTRs) and delayed hemolytic transfusion
      reactions (DHTRs) were studied in a large tertiary-care hospital. A DSTR was
      defined by the posttransfusion finding of a positive direct antiglobulin test
      (DAT) and a newly developed alloantibody specificity. A DHTR was defined as a
      DSTR case that showed clinical and/or laboratory evidence of hemolysis. Thirty
      four cases of DSTR, 70 percent of which were due to anti-E and/or -Jka, were
      documented prospectively over a 20-month period. Retrospective review of the
      medical records found clinical evidence of hemolysis in only 6 (18%) of the 34.
      Thus, the incidence of DSTR was 1 (0.66%) of 151 recipients with posttransfusion
      samples available for testing, whereas the incidence of DHTR was only 1 (0.12%)
      of 854 patients tested. Fifteen of the 34 patients were followed for up to 174
      days after reaction. Twelve of the 15 still demonstrated a positive DAT with anti
      IgG only. Eluate studies indicated that the persistence of a positive DAT after
      DSTR or DHTR may involve several immunologic mechanisms, including the
      development of posttransfusion autoantibodies. This study indicates 1) that DSTRs
      are a frequent finding in multiply transfused patients, although most cases are
      benign and fail to meet rigid criteria for DHTR, and 2) that the persistence of a
      positive DAT after DSTR or DHTR is common.

PMID- 2219255
TI  - Detection of drug-dependent, platelet-reactive antibodies by antigen-capture
      ELISA and flow cytometry.
AB  - The effectiveness of flow cytometry in the detection of drug-dependent, platelet
      reactive antibodies was investigated. In studies of seven sera known to contain
      quinine- or quinidine-dependent, platelet-reactive antibodies, flow cytometry was
      5 to 10 times more sensitive in detecting drug-dependent antibodies (DDAbs) than
      the 51Cr release assay, antigen-capture enzyme-linked immunosorbent assay
      (ELISA), and indirect immunofluorescence microscopic assay. With flow cytometry,
      DDAbs could be detected at drug concentrations as low as 0.1 microM, or less than
      one-tenth the level required with other methods. Antigen-capture ELISA was not as
      sensitive as flow cytometry in DDAb detection, but it did allow identification of
      the DDAbs' target molecules. With this assay, five of the seven DDAbs recognized
      both the glycoprotein Ib/IX (GPIb/IX) and glycoprotein IIb/IIIa (GPIIb/IIIa)
      complexes, while the remaining two sera reacted only with GPIb/IX. Of 44
      consecutive patients who developed thrombocytopenia while taking quinidine, DDAbs
      were detected by flow cytometry in 11 (25%), more than twice the number detected
      by other methods. In one patient who developed thrombocytopenia while taking
      trimethoprim/sulfamethoxazole, DDAbs could be detected only by flow cytometry. It
      can be concluded that flow cytometry is highly sensitive in detecting DDAbs and
      allows their detection at pharmacologic concentrations of the drug. Most
      quinidine-dependent antibodies recognize at least two different glycoprotein
      complexes in the platelet membrane.

PMID- 2219256
TI  - Incubation of platelet concentrates before transfusion does not improve
      posttransfusion recovery.
AB  - Incubation of stored platelet concentrates (PCs) at 37 degrees C for 1 hour has
      been reported to result in a better morphology score and improved platelet
      recovery. A study was conducted in adult patients with leukemia to determine
      whether incubation of stored PCs results in an improved platelet recovery as
      measured by 10-minute posttransfusion corrected count increments (CCI). Eligible
      patients had platelet counts of less than 30,000 per microL and were clinically
      stable. Patients were transfused with 6 to 10 units of PC stored for 3 days (15
      studies) or 4 days (5 studies). Platelets were pooled and then split in two equal
      volumes so that each patient received two sequential half-transfusions, one
      incubated at 37 degrees C for 1 hour and the other kept at 22 degrees C for 1
      hour. Patients were randomized as to which half-transfusion was received first.
      The mean CCI of the incubated half-transfusions was 13.6 x 10(3) when they were
      given first and 14.5 x 10(3) when given second; this was not significantly
      different from the mean CCI of the nonincubated half-transfusions: 13.8 x 10(3)
      when they were given first and 13.8 x 10(3) when given second. In contrast to
      earlier reports, it can be concluded that incubation of pooled PCs does not
      improve platelet recovery.

PMID- 2219257
TI  - A study of confidential unit exclusion.
AB  - The effectiveness of the confidential unit exclusion (CUE) procedure recommended
      by the Food and Drug Administration has been questioned by the blood banking
      community. The purpose of this study was to determine whether donors were
      informing the blood center correctly regarding the disposition (transfuse or do
      not transfuse) of their donated blood. A letter explaining the confidential study
      and requesting permission to send the participant a questionnaire noting his or
      her self-exclusion choice was mailed to 230 donors who had chosen transfuse and
      276 donors who had chosen do not transfuse. After consent was obtained,
      participants were sent a second packet and asked to indicate whether they had
      chosen correctly and, if not, to identify reasons for that incorrect choice. A
      seven-word terminology quiz made up of words from the CUE form was also enclosed.
      All participants who had chosen transfuse indicated that this was the correct
      choice. Approximately 50 percent of those who had chosen do not transfuse
      indicated that this was an incorrect choice; the most common reason was that "I
      was not paying attention." The most frequently misunderstood term was
      "confidential." Donors who chose do not transfuse had a significantly higher rate
      of error on the terminology quiz (p less than 0.01) than did those who chose
      transfuse.

PMID- 2219259
TI  - Red cell autoantibodies, multiple immunoglobulin classes, and autoimmune
      hemolysis.
AB  - The effects and interrelationships of multiple immunoglobulin coating (i.e.,
      increased red cell [RBC]-bound IgM and/or IgA in addition to IgG) were
      investigated in 404 patients with warm-reactive RBC autoantibodies on 590
      occasions. Multiple immunoglobulins were detected by enzyme-linked direct
      antiglobulin tests in 218 samples (37%), but in only 87 (15%) by agglutination
      methods. Differences in populations were examined by chi-square, with p less than
      0.005 being required for significance because of the multiple tests. Compared
      with IgG coating alone, multiple immunoglobulins were significantly associated
      with larger quantities (greater than 800 molecules/RBC) of IgG, multiple IgG
      subclasses, IgG3 and C3d bound to the cells, and with serum haptoglobin levels of
      less than 0.1 g per L. The latter association was still significant when higher
      levels of RBC-bound IgG and subclass pattern were taken into account. In samples
      with multiple immunoglobulin coating, there was no significant relationship (p
      greater than 0.05) between haptoglobins of less than 0.1 g per L and either C3d
      or multiple IgG subclasses. It was concluded that multiple immunoglobulin
      coating, even when undetected by agglutination methods, is a major cause of
      hemolysis: it is part of a more generalized autoimmune response and acts with
      other factors such as the quantity of bound IgG, the IgG subclass pattern, and
      complement; it also has an important hemolytic effect in its own right.

PMID- 2219260
TI  - In vivo viability and functional integrity of filtered platelets.
AB  - The in vivo viability and functional integrity of filtered platelets were
      compared with those of nonfiltered platelets in a controlled study. On two
      occasions, after template bleeding time, 14 healthy volunteers underwent
      plateletpheresis and received 600 mg of aspirin. Autologous 111In-labeled
      platelets were transfused without further manipulation (control) on one occasion
      and after filtration on a second occasion. The filter was primed and flushed with
      a buffered 12.6-percent solution of ACD-A in 0.9-percent normal saline (pH 6.5).
      After transfusion, the bleeding time was measured at 1, 4, and 24 hours and
      platelet survival at 10 minutes; 1, 4, and 24 hours; and daily for 6 days. The
      decrease in the bleeding time was not significantly different from that after
      transfusion of nonfiltered platelets (p greater than 0.2). Filtering of platelets
      did not affect 1-hour in vivo recovery (filtered, 69.5%; nonfiltered, 66%: p =
      0.56) or the platelet survival (filtered platelet t1/2 = 83.0 hours, nonfiltered
      platelet t1/2 = 82.9 hours: p = 0.96). It can be concluded that filtration does
      not adversely affect in vivo recovery, survival, or functional integrity of
      platelets.

PMID- 2219258
TI  - Effects of blood donation on cerebral blood flow velocity.
AB  - Eighteen healthy male blood donors, nine with hematocrit (Hct) of 0.40 to 0.45
      (normal Hct) and nine with Hct of 0.49 to 0.52 (upper-limit Hct), were monitored
      by continuous-wave internal carotid Doppler sonography and hematologic tests for
      28 days after blood donation, to ascertain whether and to what extent a single
      standard donation may modify the velocity of cerebral blood flow. The two groups
      had similar mean predonation values of internal carotid flow velocity (ICFV):
      blood donation was followed in both groups by a slight, transient decrease of
      ICFV at the end of phlebotomy, due to donation-induced hypovolemia, and then by
      an increase of ICFV lasting 7 to 10 days. Analysis of individual profiles
      revealed that only four of nine upper-limit and six of nine normal Hct donors
      displayed a positive trend (increase) in the ICFV within the first week after
      donation, and that it was due mainly to a rise in systolic flow velocity. Mean
      Hct and arterial oxygen content showed a negative trend (decrease) within the
      first week that was opposite to the ICFV trend. Other laboratory variables,
      including serum proteins and plasma fibrinogen concentration, and the iron status
      indicators did not change, except for serum ferritin, which also decreased within
      the first week after phlebotomy. It can be concluded that blood donation may
      result in a short-term increase of blood flow velocity that is independent of Hct
      predonation levels in approximately one-half of the donors.

PMID- 2219261
TI  - Abnormal membrane physical properties of red cells in McLeod syndrome.
AB  - McLeod red cells (RBCs) lack Kx antigens and have weak expression of the Kell
      antigens. Individuals who carry the McLeod phenotype have acanthocytic RBCs and a
      compensated hemolytic state. To elucidate the role of the protein on which the Kx
      antigens reside in maintaining membrane deformability, the rheologic properties
      of McLeod RBCs were determined by ektacytometry. RBCs were obtained from normal
      individuals and from four patients with McLeod syndrome. Osmotic gradient
      deformability profiles of McLeod RBCs showed decreased whole cell deformability.
      Resealed ghosts from McLeod RBCs also showed decreased deformability, partly
      because of the decreased cell surface area and partly because of an intrinsic
      membrane stiffness in this syndrome. For the measurement of membrane mechanical
      stability, resealed ghosts were subjected to constant high shear stress in the
      ektacytomer, and deformability was recorded continuously as the deformable ghosts
      fragmented into rigid spherical vesicles. Membranes from McLeod RBCs showed a
      noticeable increase in mechanical stability. Acquired causes of acanthocytosis,
      such as liver disease, did not cause the rheologic abnormalities observed in
      McLeod cells. Other abnormalities noted in McLeod RBCs were decreased RBC
      potassium content and an increased number of dense RBCs, as determined by
      centrifugation on a discontinuous density gradient. The data indicate that McLeod
      RBCs are rigid and have decreased surface area and that their membranes are
      intrinsically rigid with increased mechanical stability. These abnormalities may
      account for the reduced RBC survival observed in McLeod syndrome. The protein
      that carries the Kx surface antigen seems to be required for the maintenance of
      the normal physical function of RBC skeletal proteins.

PMID- 2219262
TI  - Clinical significance of white cell antibodies in febrile nonhemolytic
      transfusion reactions.
AB  - Febrile nonhemolytic transfusion reactions (FNHTRs) are associated with white
      cell (WBC) antibodies. The purposes of this study were to determine the frequency
      of WBC antibodies, to associate the severity of reactions with antibody
      specificity, and to distinguish FNHTRs from infection and postoperative fever. By
      using the granulocyte indirect immunofluorescence test in conjunction with
      lymphocytotoxicity testing, it was found that 70 percent of FNHTRs in 24 patients
      involved WBC antibodies. The remaining 30 percent of apparent FNHTRs were
      associated with infections and postoperative fever. Granulocyte-specific
      antibodies were as prevalent as HLA antibodies and were associated with the
      severest reactions. Because FNHTRs occur with granulocyte-specific antibodies,
      HLA antibodies, and possible monocyte-specific antibodies (untested in this and
      other studies), these reactions could be grouped together as WBC-associated
      reactions.

PMID- 2219263
TI  - Autoimmune hemolytic anemia in Kawasaki disease: a case report.
AB  - A 3-year-old boy presented with the fever, conjunctivitis, rash, and
      lymphadenopathy diagnostic of Kawasaki disease. Treatment with antibiotics,
      aspirin, and intravenous immunoglobulin was instituted. The hematocrit decreased
      from 35 percent on admission to 11 percent by hospital Day 10, and the white cell
      count had increased from 13.7 to 42 x 10(3) per microL, and the patient had a
      leukoerythroblastic blood smear. The direct antiglobulin test demonstrated IgG
      but not complement on the red cell (RBC) surface. An acid eluate reacted (titer
      of 4) with all panel cells in the antiglobulin phase. Intravenous immunoglobulin
      from the same lot used for treatment did not contain antibody that reacted with
      the patient's group O RBCs or a panel of group O RBCs, but did contain IgG anti-A
      and -B (titer of 4). The patient received a transfusion and was given
      methylprednisone. The direct antiglobulin test and acid eluate were negative 4
      days later. The patient had an uneventful recovery. The distinction between
      antibody-mediated hemolytic anemia and autoimmune hemolytic anemia is important
      in the treatment of this disease.

PMID- 2219264
TI  - Fibrin glue: the perfect operative sealant?

PMID- 2219265
TI  - Febrile reactions in platelet transfusion recipients.

PMID- 2219266
TI  - An unexpected effect of polyethylene glycol on the specificity of monoclonal anti
      B.

PMID- 2219267
TI  - Risks of plasticizers in blood bags.

PMID- 2219268
TI  - Use of polyethylene glycol in the blood bank.

PMID- 2219269
TI  - The role of endothelial cells in inflammation.

PMID- 2219270
TI  - The mechanism of synergistic interaction between anti-interleukin 2 receptor
      monoclonal antibody and cyclosporine therapy in rat recipients of organ
      allografts.
AB  - Untreated anephric LEW rats die ca. 9 days following transplantation of LBNF1
      kidney allografts. Although treatment with ART-18, a mouse antirat IL-2R mAb (300
      micrograms/kg/day x 10 days), prolonged graft survival to ca. 3 weeks, the
      severely impaired renal function was comparable to untreated controls (creatinine
      levels 3-5 mg/dl). In contrast, simultaneous infusion of ART-18 and a very low
      dose of CsA (0.75 mg/kg x 10 days), marginally effective on its own, resulted in
      survival of greater than 45 days; the grafts exhibited relatively good function
      comparable to that in rats treated with full-dose (15 mg/kg/day) CsA. This
      beneficial biological effect did not depend upon elevated CsA trough levels in
      animals conditioned with both modalities. The CD4:CD8 ratio at the graft site was
      lowest (0.3-0.4) in recipients treated with ART-18 + CsA. Synergy between the two
      agents has been demonstrated by adoptive transfer studies in which nonspecific
      suppression has been conferred selectively by cells infiltrating kidney grafts in
      rats given ART-18 and CsA in concert but not separately (LBNF1 and WF test
      cardiac allograft survival ca. 12 days). In contrast, suppression in the
      recipient spleens was donor-specific; both CD4 and CD8 cells prolonged test graft
      survival. Immunohistological evaluation of renal allografts revealed that therapy
      with ART-18 or low-dose CsA alone failed to deplete IL-2R+ cells and prevent
      production of IL-2, IFN-g, and TNF. In contrast, the frequency of infiltrating IL
      2R+ cells and elaboration of endogenous cytokines in non-uremic hosts receiving
      combination therapy was greatly depressed, stressing again synergistic
      interaction between ART-18 and CsA. Additionally, markedly reduced class II
      antigen induction, XL-fibrin deposition, and glomerulitis may also contribute to
      prolonged survival and satisfactory function of kidney allografts in this animal
      group.

PMID- 2219271
TI  - Short-term effects of cyclosporine on secretagogue-induced insulin release by
      isolated islets.
AB  - Brief exposure (30 min) of isolated islets to 0.5 microgram/ml cyclosporine leads
      to alterations in the insulin secretory response to selected stimuli. When
      glucose is used as the secretagogue, cyclosporine slightly stimulates insulin
      release at substimulatory concentrations of the hexose. The inhibitory effect
      predominates, however, at stimulatory concentrations of glucose with a threshold
      at 6 mmol/L glucose and maximal inhibition of 33.5 mmol/L glucose. By contrast,
      insulin release induced by 17 mmol/L arginine is not affected. Cyclosporine also
      inhibits by 66% the insulin secretory response to 100 nmol/L phorbol 12-myristate
      13-acetate, suggesting that either cyclosporine interferes with phorbol ester
      action on beta cells or the action site is located beyond the protein kinase C
      activation. On the other hand ionomycin-stimulated insulin response is also
      blocked by cyclosporine, indicating that insulin release induced by transient
      changes in cytosolic Ca++ is also affected. The evidence gathered here suggests
      that the inhibitory effect of cyclosporine on insulin release is apparent when
      glucose is used as a fuel stimulant and is reversed following removal of the
      stimulant. This effect is not reversed by using substances known to activate the
      protein kinase C or the Ca(++)-dependent branches of the stimulus-secretion
      coupling system in beta cells, indicating that the site of action of cyclosporine
      on pancreatic islets might be located in distal steps of the stimulus-secretion
      coupling of glucose-induced insulin release.

PMID- 2219272
TI  - Cardiac transplantation in the rat. II. Alteration of the severity of donor graft
      arteriosclerosis by modulation of the host immune response.
AB  - Cardiac transplantation between inbred rat strains that differ for weak
      histocompatibility antigens is associated with the development of
      arteriosclerosis in the arteries of the donor graft myocardium. The lesions are
      seen in donor/recipient pairs that differ for both MHC and non-MHC
      histocompatibility antigens that apparently stimulate a low-level, chronic
      rejection of the donor heart graft. The arteriosclerosis associated with this
      chronic rejection consists of a diffuse, concentric proliferation of the intima
      and pathologically resembles the lesions observed in the coronary arteries of
      long-term human cardiac graft recipients. We have recently examined the influence
      of positive and negative manipulation of the host immune response on the
      development of the graft arteriosclerosis. Our results demonstrate that delayed
      harvest of the cardiac grafts or immunization with donor skin grafts or splenic
      lymphocytes increases the sensitivity of the recipient to the donor heart grafts-
      and, under conditions that allow for the long-term survival of the graft-
      increases the severity of the arteriosclerotic lesions. Alternatively,
      suppression of the host immune responses with cyclosporine or FK506,
      substantially reduces the arteriosclerotic changes. These results suggest that
      control of accelerated graft arteriosclerosis in long-term human cardiac
      recipient may require more careful and effective immunosuppression of the
      allograft reaction.

PMID- 2219273
TI  - Modulation of experimental cyclosporine nephrotoxicity by inhibition of
      thromboxane synthesis.
AB  - The clinical usefulness of Cyclosporine is limited by its intrinsic
      nephrotoxicity. A potential mechanism of CsA-mediated renal injury may involve an
      alteration in the prostaglandin-thromboxane (PG-TX) cascade. In our studies,
      pharmacological manipulation of the PG-TX system in normal and nephrotoxic
      animals was conducted using a specific thromboxane synthetase inhibitor U63,557A,
      and the cyclooxygenase inhibitor indomethacin. Administration of CsA 50 mg/kg/day
      for 7 days to Sprague Dawley rats resulted in a 99% increase in urinary
      thromboxane B2 excretion compared with controls (48.2 +/- 3.1 vs. 24.2 +/- 2.6
      ng/24 hr, P less than 0.001), while plasma levels remained unchanged. Glomerular
      and tubular function was significantly reduced at this time, with a 48% decrease
      in creatinine clearance (CCr), and a 25% reduction in the fractional excretion of
      sodium (FeNa) (P less than 0.001). Histological injury included cortical tubular
      vacuolization and necrosis. Administration of indomethacin 8 mg/kg/day to both
      normal and CsA-treated rats resulted in a significant reduction in prostanoid
      excretion. Indomethacin alone had no adverse effect on glomerular function;
      however, when coadministered with CsA an exaggerated decrease in renal function
      was observed. CCr in this group fell by a further 27% compared with the CsA-50
      group, while FeNa decreased by 76% (P less than 0.001). Histologic injury
      intensified, with an increase in vacuolization and necrosis. In contrast,
      coadministration of U63,557A with CsA prevented the rise in urinary TXB2
      excretion, improved CCr by 20% (P less than 0.05), and restored FeNa to control
      levels. The severity of CsA-induced vacuolization was significantly diminished.
      Selective inhibition of thromboxane production may therefore be valuable in
      mitigating the clinical nephrotoxicity of CsA.

PMID- 2219274
TI  - Hemodynamic and biochemical changes during normothermic and hypothermic
      sanguinous perfusion of the porcine hepatic graft.
AB  - Using an ex vivo liver sanguinous perfusion system, hemodynamic and biochemical
      changes of the porcine livers were studied, which were preserved cold (4 degrees
      C) for 24 hr in University of Wisconsin solution and reperfused with normothermic
      (37 degrees C) (n = 8) or hypothermic (32 degrees C) (n = 8) blood for 3 hr. Six
      more livers were reperfused with normothermic blood (37 degrees C) immediately
      after procurement as controls. The total hepatic blood flow was adjusted to 1
      ml/min/g liver weight, in which hepatic artery and portal vein flows were
      administered at a 1:2 ratio. In livers stored cold for 24 hr in UW solution and
      perfused normothermically, a statistically higher hepatic artery resistance was
      exhibited at 30 and 60 min after reperfusion (P less than 0.05), and there was
      lower bile output (P less than 0.05) at 90 and 120 min as compared to the
      controls. In livers stored cold for 24 hr in UW solution and perfused
      hypothermically, as compared to ones perfused normothermically, statistically
      higher hepatic-artery and portal-vein resistances (P less than 0.05) were
      observed throughout the perfusion period and 60 min after reperfusion,
      respectively. In addition, bile output and oxygen consumption of these livers
      were statistically lower than those of ones perfused normothermically (P less
      than 0.05). In contrast, chemistries of the perfusate of livers perfused
      hypothermically were comparable to ones perfused normothermically. Histologic
      examination of the liver perfused hypothermically demonstrated hepatic arterial
      and/or portal venous congestion and mild-to-moderate hemorrhage in the portal
      triads. This study suggests that livers preserved for a prolonged period of time
      demonstrate a high hepatic arterial resistance shortly after revascularization,
      and that recipient hypothermia after revascularization may be a risk factor for
      the development of hepatic arterial thrombosis following liver transplantation.

PMID- 2219275
TI  - Cellular proliferation at the site of organ allografts and the influence of
      immunosuppressive therapy.
AB  - In this study we investigated cellular proliferation of T cells and macrophages
      at the site of rat cardiac allografts and determined the influence of
      immunosuppressive therapy on the proliferative characteristics of these cell
      types. A bromodeoxyuridine-labeling technique was used that allowed both the
      accurate detection of proliferative activity and the phenotypic characterization
      of cellular infiltrates within grafted tissues. In untreated recipients (BN---
      Lewis), T cytotoxic/suppressor cells as well as T helper cells showed
      proliferative activity at the site of the graft. The percentage of OX8-positive
      cells within the graft that showed proliferation ranged from 15% to 37%. The
      percentage of W3/25-positive cells within the graft that showed proliferation
      ranged from 25% to 30%. In contrast, macrophages hardly showed proliferative
      activity within the graft; only 1-4% of the macrophages stained positive for
      bromodeoxyuridine. From these observations it is concluded that the graft serves
      as a nonlymphoid tissue site, wherein lymphocytes can freely proliferate and
      expand. To study the influence of immunosuppressive therapy on cellular
      proliferation, the steroid budesonide, 120 micrograms/kg/day, was administered
      for 13 days (MST, 20 days). During effective immunosuppressive therapy, still a
      remarkable amount of infiltrating cells was present within the grafts. Moreover,
      immunosuppressive treatment did not primarily appear to affect the proliferative
      capacity of the individual cell types. OX8-positive cells as well as W3/25
      positive cells clearly showed proliferative activity within the treated grafts.
      However, despite the presence of these proliferative cells, signs of graft
      destruction were absent during immunosuppressive therapy. This finding may shed
      new light on the effect of steroids at the site of the graft and their role in
      the prevention of tissue destruction.

PMID- 2219276
TI  - Examination of the role of the impermeants lactobionate and raffinose in a
      modified UW solution.
AB  - Rat liver transplants were performed in order to assess the importance of the
      impermeant anion lactobionate and the trisaccharide raffinose on the
      effectiveness of a simplified variant of UW solution for liver preservation by
      simple cold storage. Rat livers were stored at 4 degrees C for 18, 24, 30, or 40
      hr in a modified UW solution or in one of three variants of UW in which one of
      these impermeants was replaced by another more permeable agent. Using modified UW
      solution (solution A), 50% (5/10) of rats receiving livers that had been
      preserved for 30 hr survived for more than 1 week; with solution B, which differs
      from A in the replacement of raffinose by glucose, the 1-week survival was 60%
      (6/10) after 30-hr preservation. Solution C, which is identical to A except for
      the replacement of lactobionate by gluconate, gave 20% (2/10) survival rate after
      30-hr preservation. However, using solution D, which is identical to A except for
      substitution of chloride for lactobionate, none (0/8) of the rats receiving liver
      preserved for 30 hr survived. These results suggest that the inclusion of
      lactobionate as a major anion plays a crucial role in the effectiveness of UW
      solution, whereas raffinose can be replaced by more permeant glucose without
      deleterious effect.

PMID- 2219277
TI  - Canine pancreas and kidney transplantation following total-lymphoid irradiation.
AB  - The effect of total-lymphoid irradiation on survival of canine pancreas and
      kidney allografts was studied. TLI had a marked immunosuppressive effect as
      measured by in vitro immune responses and reduced circulating leukocytes. Despite
      the changes, median graft survival times for animals treated with 800 cGy (9
      days) or 1800 cGy (9.5 days) were not significantly different from untreated
      control animals (7 days). The addition of low-dose antithymocyte globulin (10
      mg/kg/day) on post-transplant days 0, 2, 4, 6, 8, and 10 had no measurable
      synergistic effect. Similarly, median segmental pancreas allograft survival times
      after 1700-2200 cGy of TLI treatment (16.5 days) were only marginally longer than
      those of untreated controls (9 days). The only animal to maintain a graft for
      greater than 200 days was matched to the donor in mixed lymphocyte culture (MLC).
      This animal was able to reject a third-party skin graft after 8 days while a
      graft from the original donor was still surviving after 21 days when the pancreas
      graft failed from a chronic-type rejection. These results indicate that TLI alone
      or in combination with ATG will not be predictably effective as a method of
      prolonging allograft survival. The role of matching major histocompatibility
      complex antigens in TLI treatment requires clarification.

PMID- 2219278
TI  - Function of kidney grafts from brain-dead donor pigs. The influence of dopamine
      and triiodothyronine.
AB  - There are conflicting reports about the effects of administration of dopamine to
      brain-dead donors upon posttransplant organ function. This study compared the
      survival and serum creatinine levels in pigs that received renal grafts from
      untreated controls, from controls in which either the donor or donor and
      recipient received dopamine or from animals rendered brain dead for 16 hr by
      acute elevation of intracranial pressure, and given standard supportive
      treatment. In two additional groups, brain-dead donors were given dopamine or
      dopamine with triiodothyronine. Recipients of grafts from control animals or from
      brain-dead donors survived the 7-day period of study and showed minimal changes
      in serum creatinine. Recipients of grafts from brain-dead donors given dopamine
      however showed reduced survival and progressive increase in serum creatinine.
      This did not occur in the group given triiodothyronine concurrently with
      dopamine. It is suggested that if administration of dopamine is essential to
      treat donor hypotension, concurrent use of triiodothyronine may preserve
      posttransplant renal function.

PMID- 2219279
TI  - Correlation between class II antigen (DR) expression and interleukin-2-induced
      lymphocyte proliferation during acute cardiac allograft rejection.
AB  - We have previously reported a correlation between biopsy-proven rejection and the
      presence of IL-2-responsive lymphocytes for biopsy specimens from human cardiac
      allografts. We thus hypothesized a relationship between tissue expression of HLA
      class II antigen (DR) and the outgrowth of IL-2-responsive lymphocytes. Employing
      immunofluorescence DR staining with a propidium iodide counterstain in
      consecutive specimens from 41 patients, we found two patterns of DR expression:
      DR expressed on the vascular endothelial surface (donor antigens) and/or on
      myocardial infiltrating cells (presumably recipient antigens). Specimens were
      categorized by histologic diagnosis as "baseline nonrejecting controls" that were
      obtained 7.5 +/- 0.4 (mean +/- SE) days posttransplantation, "nonrejecting"
      (obtained 59.9 +/- 5.8 days posttransplantation), "prerejecting" (obtained 47.7
      +/- 6.3 days posttransplantation), and "rejecting" (obtained 101.3 +/- 10.1 days
      posttransplantation). Prerejecting specimens were histologically negative
      specimens obtained from patients a mean of 6.0 +/- 0.4 days before a biopsy
      proven rejection episode. The percentage of specimens positive for interstitial
      DR staining were: less than 1% for controls, 30% for nonrejecting specimens, 68%
      for prerejecting, and 46% for rejecting. For vascular DR staining, 25% of control
      specimens were positive, 56% of nonrejecting, 74% of prerejecting, and 73% of
      rejecting specimens. Culture positivity was seen for 38% of controls, 35% of
      nonrejecting specimens, 79% of prerejecting, and 70% of rejecting. Vascular DR
      staining was higher than interstitial staining for all specimen categories. For
      the vascular pattern, the mean score was significantly higher for culture
      positive specimens compared to culture negative (0.87 +/- 0.1 vs. 0.59 +/- 0.1; P
      less than 0.01). A similar relationship was not found for the interstitial
      pattern. Lymphocyte growth occurred in conjunction with vascular DR upregulation
      significantly more frequently than in conjunction with interstitial DR expression
      (65% vs. 35% of culture-positive specimens, P less than 0.0001). These findings
      suggest a relationship between DR expression, lymphocyte growth, and acute
      rejection. Vascular DR and interstitial DR patterns show several differences with
      respect to kinetics of expression and correlation with histology and culture, and
      thus may represent different processes.

PMID- 2219280
TI  - Cyclosporine nephrotoxicity in cardiac allograft patients--a seven-year follow
      up.
AB  - Renal function was observed retrospectively in a population of 228 adults who
      underwent a cardiac allograft at the University of Pittsburgh from June 1980
      through June 1987, survived a minimum of one year, and received cyclosporine.
      Renal function was determined by serial measurement of serum creatinine
      concentration. Serum creatinine rose from 1.2 +/- 0.0 mg/dl at time of hospital
      discharge to 2.0 +/- 0.0 mg/dl at two and four years and 3.3 +/- 0.1 mg/dl at
      seven years. The fall in renal function was biphasic, with a rapid decline
      (reciprocal creatinine slope -0.018 dl/mg-mo) through 24 months and a slower
      decline thereafter -0.0036 dl/mg/month). This occurred despite a progressive
      decrease in cyclosporine levels from 668 +/- 23 ng/ml (whole blood RIA) to 380 +/
      12 ng/ml at seven years. Three of 222 patients (1.6%) developed end-stage renal
      disease within 18 months of initiation of cyclosporine therapy. Only one
      additional patient of 26 followed through 54 months (3.8%) developed end-stage
      disease thereafter. The decline in renal function seen with cyclosporine is rapid
      in the first 18 months, with a slower but continuing decline seen with later
      follow up. At least in heart transplantation, the risk of end-stage renal disease
      is significant, but not prohibitive.

PMID- 2219281
TI  - The recurrence of focal segmental glomerulosclerosis in kidney transplant
      patients treated with cyclosporine.
AB  - To evaluate the rate of recurrence of focal segmental glomerulosclerosis (FSGS)
      in renal transplant patients treated with cyclosporine, we reviewed the outcome
      of 25 renal Tx performed in 24 patients who had FSGS as their original renal
      disease. After Tx, 6 patients were treated with steroids and azathioprine (follow
      up: 42 +/- 34 months) and 19 with CsA (follow-up: 30 +/- 31 months). Two of 6 Aza
      treated patients (33%) developed recurrence of FSGS and nephrotic syndrome (NS).
      Both patients lost their graft because of FSGS 24 and 25 months after Tx. Ten of
      19 patients (55%) given CsA showed recurrence of FSGS; one of them had had
      recurrence in the first graft treated with Aza. One patient lost his graft a few
      weeks after Tx because of acute rejection and 3 lost their graft because of FSGS
      4-28 months after NS developed. One patient with NS died from pneumonia 14 months
      after Tx when his plasma creatinine was 2.7 mg/dl. Three other patients now have
      NS and plasma creatinine between 1.9 and 2.4 mg/dl 15-37 months after Tx. The
      last two patients have NS and normal renal function 10 and 31 months after Tx. In
      both groups, most patients developed NS within the first week after Tx. The
      patients with recurrence, given Aza or CsA, tended to be younger at the onset of
      the disease and to have a shorter duration of the disease, when compared with
      those without recurrence, but the differences were not statistically significant.
      In our experience neither CsA nor Aza showed any effect on the outcome of FSGS
      recurring in the graft.

PMID- 2219282
TI  - Successful use of rifampicin in the treatment of tuberculosis in renal transplant
      patients immunosuppressed with cyclosporine.
AB  - Cyclosporine and rifampicin were used simultaneously in 6 renal transplant
      patients with tuberculosis. The total daily dose of cyclosporine had to be
      increased 3-5 fold, with the frequency of administration increased from twice to
      thrice daily. With this regimen, satisfactory cyclosporine levels were attained
      and there was no adverse affect on graft function.

PMID- 2219284
TI  - Multiple site estimates of erythropoietin and renin in polycythemic kidney
      transplant patients.
AB  - The development of polycythemia after renal transplantation is a well known
      phenomenon and its etiology remains controversial. In particular, it is unknown
      whether inappropriate erythropoietin (EPO) production could be a reason.
      Utilizing a sensitive radioimmunoassay for EPO we have measured EPO
      concentrations in venous blood from native and grafted kidneys in three
      normocythemic and seven polycythemic patients. We found that (1) in our
      posttransplantation polycythemic patients there are inappropriately high systemic
      EPO levels, hence that posttransplantation polycythemia is related to EPO
      overproduction. (2) This high EPO production comes from the native kidneys. (3)
      There is a correlation between EPO and renin levels in the peripheral as well as
      in native and transplanted kidneys' venous samples.

PMID- 2219283
TI  - The impact of HLA matching on graft survival and on sensitization after a failed
      transplant--evidence that failure of poorly matched renal transplants does not
      result in increased sensitization.
AB  - There are costs (both financial and ethical) to distributing kidneys by HLA-match
      (time, transportation, repeat crossmatch; possibly bypassing a more deserving
      recipient). Arguments favoring matching include better short- and long-term
      survival, and decreased panel-reactive antibody (PRA) if a well-matched vs.
      poorly matched transplant fails. We studied these phenomena in a single
      institution. Since 1970, 1329 patients received cadaver (CAD) transplants; for
      those with defined antigens (n = 1316) there was no difference in 10-year graft
      survival in those with a less than or equal to 1 AB match vs. those with greater
      than 1 AB match or those with less than or equal to 1 AB mismatch (mm) vs.
      greater than 1 AB mm. Similarly there was no difference in those with less than
      or equal to 2 BDR mm vs. greater than 2 BDR mm. In fact, those with less than
      ABDR mm had worse 10-year graft survival (55%) than those with greater than or
      equal to 3 ABDR mm (61%) (P = .001). For patients with function greater than 6
      months there was no difference in long-term outcome based on HLA match or mm.
      These findings were similar for patients both with and without CsA
      immunosuppression, and for primary and retransplants. A total of 382 patients
      transplanted since 1980 have lost their grafts (146 died with function). All had
      received pretransplant transfusions. Of 236 alive after graft loss, 64 had no
      postgraft failure PRAs (22 out of state, 23 chose to remain on dialysis, 19 died
      less than 3 months after graft loss); 172 had PRAs after failure; 106 (62%) have
      been retransplanted. Mean peak PRA in those retransplanted was 23 +/- 31 (range 0
      100) vs. 46 +/- 39 (range 0-100) in those not retransplanted (P less than .05).
      Patients were stratified by PRA prior to first transplant (0%, 1-20%, greater
      than 20%). For recipients with 0% PRA, failure of a CAD transplant (n = 58) was
      no more likely to result in an increase of PRA than failure of a living-related
      donor (LRD) transplant (n = 49) (NS). For those with an increase, mean increase
      was 45% +/- 34 after LRD transplant and 41% +/- 28 after CAD transplant (NS). The
      proportion developing PRA greater than or equal to 60% was not different after a
      failed LRD (7/49) or CAD (11/58) transplant (NS). Other subgroups had similar
      results. AZA or CsA immunosuppression did not affect development of increased PRA
      after a failed graft.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2219285
TI  - Bone marrow transplantation for the Wiskott-Aldrich syndrome. Long-term follow
      up.
AB  - Wiskott-Aldrich Syndrome (WAS) is a sex-linked disease characterized by
      immunodeficiency and thrombocytopenia. Supportive treatment of this disease is
      inadequate and bone marrow transplantation has been reported to result in
      excellent survival. The long-term follow-up of 8 male patients who received bone
      marrow transplantation for the WAS is reported here. All of these patients
      received ablative preparative treatment consisting of ATS (antithymocyte serum),
      cytoxan and either busulfan or TBI (total body irradiation). Bone marrow was
      transplanted from an HLA-matched donor. Seven of eight of these male patients
      have had excellent engraftment of their transplant and now have adequate
      lymphocyte and platelet function. In addition, they have had good growth and
      development. This suggests that ablative preparative treatment followed by early
      bone marrow transplantation from an HLA-matched donor is a highly successful
      therapy for this congenital disease.

PMID- 2219286
TI  - Subclinical hepatic encephalopathy. Comparison before and after orthotopic liver
      transplantation.
AB  - Sixty-two patients were evaluated before and after liver transplantation on a
      battery of neuropsychologic tests measuring hepatic encephalopathy. Compared to
      controls, deficits were found on tasks measuring memory and visuospatial capacity
      prior to transplantation. Most of these deficits were ameliorated following the
      surgery. It is concluded that functional psychological capacity is restored to a
      large extent, but not completely, following orthotopic liver transplantation.

PMID- 2219287
TI  - Effects of sex steroid hormones on sex-associated differences in the survival
      time of allogeneic skin grafts in rats. Evidence that testosterone enhances and
      estradiol reverses the immunosuppressive activity of cyclosporine.
AB  - Three-week-old DA (RT1a) male and female rats were pretreated with either
      orchiectomy or ovariectomy and administration of the opposite-sex steroid
      hormones, estradiol or testosterone. Skin from same-sex AO (RT1a) rats was then
      grafted when these pretreated rats reached 14 weeks of age, with a short course
      of immunosuppressive treatment of cyclosporine. The survival times of the grafts
      were reversed in that the male recipients pretreated to be like females acutely
      rejected the graft within 10 days as do normal adult female recipients. On the
      other hand, the female recipients pretreated to be like males accepted the graft
      as do normal adult male recipients. In addition, the synergistic effects of
      either testosterone or estradiol with CsA on the survival time of the graft were
      examined. Testosterone successfully prolonged graft survival on normal adult
      female and young male recipients, but negligible prolongation was observed on
      young females. In contrast, estradiol abrogated the immunosuppressive activity of
      CsA and accelerated graft rejection in both male and female recipients.

PMID- 2219288
TI  - Cyclosporine-induced tolerance to intratesticular islet xenografts.
AB  - Survival of highly immunogenic hamster islet xenografts can be achieved in rats
      if the graft is transplanted into the abdominal testis. Permanent survival
      requires the administration of cyclosporine during the first thirty days after
      grafting. The majority of grafts will survive indefinitely beyond this point if
      the grafted animals receive a once-weekly maintenance dose of CsA until day 100,
      when CsA is no longer necessary. Hamster islet xenografts transplanted under the
      kidney capsule or into the portal vein are rejected, regardless of CsA treatment.
      Animals maintaining long-term primary intratesticular xenografts accept secondary
      contralateral testicular xenografts. CsA is not required. Primary grafts are also
      resistant to the adoptive transfer of lymphocytes from rat donors primed to
      hamster xenoantigens. Secondary hepatic and renal islet xenograft survival is
      also extended--some hepatic grafts long-term. Therefore, the combination of CsA
      and the privileged status of the abdominal testis leads not only to the
      acceptance of primary intratesticular islet xenografts but also to partial
      immunological unresponsiveness of subsequent grafts in other sites.

PMID- 2219289
TI  - Dissociation of tissue destruction induced by cytolytic T cells in vivo and
      cytotoxicity as measured in vitro.
AB  - Two forms of local cutaneous graft-versus-host reactions were used to examine the
      in vivo activity of cytolytic T cells in a large number of antigen systems and
      mouse strain combinations. In immune lymphocyte transfer reactions (TrRs), CTL
      were injected intradermally into allogeneic hosts to which they were sensitized;
      in bystander reactions (ByRs), CTL were mixed with target cells and the mixture
      injected into hosts syngeneic to the CTL. Both reactions frequently culminate in
      full-thickness skin destruction. However, CTL highly active in cell-mediated
      lympholysis assays in vitro sometimes failed to induce significant reactions in
      vivo, and CTL with negligible CML activity often induced severe, necrotizing
      lesions. In addition, Clone 58, a non-MHC-specific CD8+ clone that originated
      from cells extracted from a sponge matrix allograft, lost its CML activity but
      continued to induce necrotizing TrRs and ByRs. Insofar as these reactions may
      exemplify the specific (TrR) and nonspecific (ByR) tissue injury that occurs in
      the rejection process, these findings question the reliability of CML for
      predicting the ability of CTL to induce the tissue destruction seen in allograft
      rejection.

PMID- 2219291
TI  - Specific suppression of allograft rejection by soluble class I antigen and
      complexes with monoclonal antibody.
AB  - In this experiment, we investigated the effect of daily injection or continuous
      slow infusion of either DA (MHC haplotype, RT1a) serum or soluble DA class 1 MHC
      antigen or its complexes with monoclonal antibody on rejection of heterotopic
      heart allograft in the combination of PVG.RT1a (RT1a) donor into PVG (RT1c)
      recipient. DA serum delayed significantly both the early and late rejection of
      PVG.RT1a heart grafts in PVG recipients. Removal of soluble class I MHC antigen
      from DA serum by affinity chromatography on a monoclonal anti-class I antibody
      column completely abolished the immunosuppressive effect. Continuous infusion of
      purified soluble class I antigen from DA rat liver, even from day 4 after heart
      grafting, induced a significant prolongation of graft survival. This
      effectiveness was donor-specific and amplified by the mixture of monoclonal anti
      class 1 (RT1a) antibody with DA serum--this being induced only by using
      continuous infusion but not by daily injection. The results indicate that soluble
      class I antigen can act as a specific immunosuppressive agent in allograft
      rejection and that its effect is amplified by monoclonal anti-class 1 antibody.

PMID- 2219290
TI  - Vascular thymus transplantation in rats. Technique, morphology, and function.
AB  - A new method of thymus transplantation is introduced, in which the graft is
      directly connected with the recipient's vascular system. This procedure was used
      both in euthymic rats and congenitally athymic nude rats. At all tested intervals
      after transplantation thymus grafts hardly differed from the recipient's own
      thymus in immunohistology and lymphocyte yield. In athymic nude rats, T cell
      dependent immunity, tested by mitogen- and alloantigen-induced T cell responses,
      as well as by antibody production and delayed-type hypersensitivity after
      ovalbumin administration, showed that vascular thymus grafts could generate T
      cell functions to euthymic control levels. We conclude that the technique of
      vascular thymus transplantation represents a valuable tool, either in fundamental
      research on thymus function, or for the purpose of immune (re)constitution.

PMID- 2219292
TI  - Expression and function of mutant Ia antigen in transgenic mice.
AB  - Cell surface expression of Ia antigens requires the assembly of alpha and beta
      heterodimers. We have produced a double transgenic mouse with a wild form Ak
      alpha gene and a mutant Ak beta (Ak beta MB) gene with d-allele substitution at
      positions 63 and 65-67. Initial studies indicated that the Ak alpha and Ak beta
      MB transgenes are not expressed on the surface of lymphoid cells of the
      transgenic mice. However, when spleen cells were stimulated with LPS prior to
      FACS analyses, Ak/Ak MB assembly and subsequent surface expression was induced.
      The tail skins from transgenic founder mice were rejected by the parental mice
      indicating a role for the mutant antigen on the allograft. In addition, the Ak
      transgenic mice on H-2q/q background can partially delete V beta 6+ T cells,
      suggesting the presence of the transgene product in the thymus.

PMID- 2219293
TI  - Resistant hepatic allograft rejection successfully treated with cyclophosphamide
      and plasmapheresis.

PMID- 2219294
TI  - Fine-needle aspiration biopsy of human liver allografts. Correlation with liver
      histology for the diagnosis of acute rejection.

PMID- 2219295
TI  - Erythropoietin therapy and the antibody levels of highly sensitized patients
      awaiting kidney transplantation.

PMID- 2219296
TI  - Fatal generalized acute graft-versus-host disease in a liver transplant
      recipient.

PMID- 2219297
TI  - Relevance of mesenteric lymph nodes to graft-versus-host disease following small
      bowel transplantation.

PMID- 2219298
TI  - Immunosuppressive action of low-dose heparin. Effect on skin allograft survival.

PMID- 2219299
TI  - Effect of a minimal number of donor rat islets on xenograft survival in mice.

PMID- 2219300
TI  - Posttransplant cecal volvulus.

PMID- 2219301
TI  - Bile cytology versus pancreatic juice cytology for diagnosis of allograft
      rejection.

PMID- 2219302
TI  - Our experience with bile cytology and pancreatic juice cytology.

PMID- 2219303
TI  - Antibody-induced rejection of long-term, functioning pig proislet xenografts in
      CD4+ T-cell-depleted diabetic mice.

PMID- 2219304
TI  - The effect of continuous anti-CD4 monoclonal antibody therapy on fetal pig
      pancreas xenografts in nonobese diabetic mice.

PMID- 2219305
TI  - An analysis of concordant xenograft rejection in the nude rat model.

PMID- 2219306
TI  - Enhancement of rabbit skin allograft survival by pretransplant and peroperative
      hepatic antigen treatments.

PMID- 2219307
TI  - Adhesion of lymphocytes to stimulated vascular endothelial cells occurs via ICAM1
      dependent and ICAM1-independent pathways.

PMID- 2219308
TI  - The importance of the ICAM-1/LFA-1-dependent pathway in in vitro cytotoxicity
      against cultured human kidney cells.

PMID- 2219309
TI  - A model of the corneal allograft reaction.

PMID- 2219310
TI  - Prolongation of heterotopic human corneal graft survival in mice treated with an
      anti-CD4 monoclonal antibody.

PMID- 2219311
TI  - The effect on researchers of handling human fetal tissue.

PMID- 2219312
TI  - Prolongation of fetal pancreas allograft survival in mice treated with anti-IL-2
      receptor monoclonal antibody (PC61) conjugated with idarubicin.

PMID- 2219313
TI  - Beneficial effects of monoclonal antibody targeting of CD4+ cells during the
      sensitisation but not effector phase of accelerated rejection of rat cardiac
      allografts.

PMID- 2219314
TI  - Castanospermine, an alpha glucosidase inhibitor, prolongs renal allograft
      survival in the rat.

PMID- 2219315
TI  - Urocanic acid in allotransplantation.

PMID- 2219316
TI  - The interaction of IL-2 and IL-4 with the effects of deoxyspergualin.

PMID- 2219317
TI  - The effect of 2-deoxyguanosine on graft immunogenicity.

PMID- 2219318
TI  - A prospective study of the effect of diltiazem in renal allograft recipients
      receiving cyclosporine A: preliminary results.

PMID- 2219319
TI  - Elimination of nonimmunological causes of cadaveric renal allograft loss--an
      attainable goal?

PMID- 2219320
TI  - Kidney preservation with UW solution: the nature of the impermeant.

PMID- 2219322
TI  - Heart/lung transplantation in Australia: early results of the St Vincent's
      program.

PMID- 2219323
TI  - Cells infiltrating heart allografts: specificity and function.

PMID- 2219321
TI  - Inhibition of PHA lymphocyte responses by cyclosporine and methylprednisolone.

PMID- 2219324
TI  - Determinants of successful liver transplantation.

PMID- 2219325
TI  - 31P-magnetic resonance spectroscopy in evaluating hepatic function: a possible
      application in donor assessment prior to liver transplantation.

PMID- 2219326
TI  - Complications of sclerotherapy for esophageal varices in liver transplant
      candidates.

PMID- 2219327
TI  - Glucose homeostasis in the rat after liver transplantation.

PMID- 2219328
TI  - Are kidney and pancreas rejection simultaneous events in combined transplants in
      dogs?

PMID- 2219330
TI  - Pretreatment of canine whole pancreas allografts with monoclonal antibodies does
      not prolong graft survival.

PMID- 2219329
TI  - 48-hour cold storage of the rat pancreas.

PMID- 2219331
TI  - The role of V beta 8 cells in disease recurrence in isografts in diabetic NOD
      mice.

PMID- 2219332
TI  - Bone marrow transplantation in children using closely matched related and
      unrelated donors.

PMID- 2219333
TI  - 99m-TC-DTPA aerosol lung clearance in the early detection of interstitial
      pneumonitis in pediatric bone marrow transplant patients.

PMID- 2219334
TI  - Sensitive detection of residual acute lymphoblastic leukemia cells for monitoring
      bone marrow purging.

PMID- 2219335
TI  - Comparison of magnetic particles for immunomagnetic bone marrow purging using an
      acute lymphoblastic leukaemia model.

PMID- 2219336
TI  - Organ donation in Singapore.

PMID- 2219337
TI  - Human hepatic preservation using Marshall's solution and University of Wisconsin
      solution in a controlled, prospective trial.

PMID- 2219338
TI  - Preliminary results of the European Multicenter Study on UW solution in liver
      transplantation. The Study Group.
AB  - The introduction of UW solution in clinical liver transplantation has had a
      tremendous impact on clinical practice. The preliminary evaluation of data in
      this interim report with UW solution in the European setting does confirm the
      clinical results as reported by the Belzer and Starzl groups. These data on the
      UW solution in its original composition concern in already 43% a population of
      liver transplant procedures performed with cold ischemia times of more than 12
      hours without clinical evidence of detrimental effects due to preservation times
      up to 26 hours. A comprehensive analysis of the results of this study will be
      performed upon completion of the 1 and 3 month follow-up. In this analysis all
      preservation related characteristics will be presented and statistically
      evaluated.

PMID- 2219339
TI  - Clinical use of UW solution or a simplified liver preservation solution prior to
      transplantation in 179 human livers, December 1987-July 1989.

PMID- 2219340
TI  - The functional effects of a colloid in liver cold storage preservation.

PMID- 2219341
TI  - Coenzyme Q. alpha tocopherol graft uptake and lipid peroxidation in human liver
      transplantation: evidence of energy metabolism protection in University of
      Wisconsin (UW) solution-preserved livers.

PMID- 2219342
TI  - Lactobionate as the most important component in UW solution for liver
      preservation.

PMID- 2219343
TI  - A pure class II MHC disparity does not induce rejection of cornea or heart grafts
      in the rat.

PMID- 2219344
TI  - Prevention of early graft failure by the calcium channel blocker nisoldipine:
      involvement of Kupffer cells.

PMID- 2219345
TI  - Preservation of isolated rat and human hepatocytes in UW solution.

PMID- 2219346
TI  - Effect of flush-perfusion with Euro-Collins solution on pulmonary arterial
      function.

PMID- 2219347
TI  - First results of the multicenter study of HTK protection for kidney transplants.

PMID- 2219348
TI  - Preliminary results of the European Multicenter Trial of UW and Euro-Collins
      solutions in kidney transplantation. The Study Group.

PMID- 2219349
TI  - Specific effect of University of Wisconsin solution on renal hemodynamics and
      microvasculature in canine kidney preservation.

PMID- 2219350
TI  - Rescue perfusion of the cold-stored kidney.

PMID- 2219351
TI  - Beneficial effect of superoxide dismutase (SOD) on erythrocyte trapping and 6
      keto-PGF1 alpha TxB2 ratio after ischemia-reperfusion in kidney transplantation.

PMID- 2219352
TI  - Prevention of acute renal failure after kidney transplantation by treatment with
      rh-SOD: interim analysis of a double-blind placebo-controlled trial.

PMID- 2219353
TI  - Heart-lung transplantation: graft function postoperatively.

PMID- 2219354
TI  - Comparison of Euro-Collins and UW-1 solutions for lung preservation using the
      parabiotic rat perfusion model.

PMID- 2219355
TI  - Effects of calcium channel blockage in postischemic lung reperfusion.

PMID- 2219356
TI  - Single flush perfusion with Euro-Collins solution in lung preservation: clinical
      assessment of early graft function.

PMID- 2219357
TI  - Free radical ablation prevents ischemic injury after long periods of cold storage
      in rat pancreas transplantation.

PMID- 2219358
TI  - A long-term study of Parkinson's patients subjected to autoimplants of perfused
      adrenal medulla into the caudate nucleus. CPH Neural Transplantation Group.

PMID- 2219359
TI  - Transplantation of allogeneic isolated hepatocytes induces a specific
      prolongation of allograft survival.

PMID- 2219360
TI  - Fetal liver cell transplantation: survival of grafted BALB/c lysosomal storage
      disease mice.

PMID- 2219361
TI  - Transplantation of bone marrow with vascularized bone.

PMID- 2219362
TI  - Effective radiation therapy for crescentic glomerulonephritis after renal
      transplantation.

PMID- 2219363
TI  - Problems of renal transplantation in Pakistan.

PMID- 2219364
TI  - Monotherapy with cyclosporine in kidney transplantation.

PMID- 2219365
TI  - Glomerular disease after kidney transplantation.

PMID- 2219366
TI  - Tubular markers in renal transplant patients under cyclosporine.

PMID- 2219367
TI  - Influence of cyclosporine on C-peptide levels in kidney allograft recipients.

PMID- 2219368
TI  - Cyclosporine: its time of impact on kidney graft survival.

PMID- 2219369
TI  - Quadruple drug induction treatment in patients with ATN-kidneys: expensive but
      effective.

PMID- 2219371
TI  - Differential crossmatch in renal transplantation: allopositive historical
      crossmatch (B and/or T) but current T-cell negative crossmatch.

PMID- 2219370
TI  - Monitoring of renal transplant patients with interleukin-2 and interleukin-2
      receptor enzyme immunoassay and interleukin-2 receptor immunocytology.

PMID- 2219372
TI  - Nonrandomized comparative study between University of Wisconsin cold storage and
      Euro-Collins solution in kidney transplantation.

PMID- 2219373
TI  - Efficacy of a modified University of Wisconsin solution in rat liver
      preservation: its prevailing role on vascular endothelium rather than hepatocyte
      protection.

PMID- 2219374
TI  - Evaluation of a prospective protocol for liver transplantation in the treatment
      of acute liver failure.

PMID- 2219375
TI  - Gallbladder conduit vs end-to-end anastomosis of the common bile duct in
      orthotopic liver transplantation.

PMID- 2219376
TI  - Transplantation aspiration cytology in the diagnosis of steroid resistant
      rejection in liver allograft patients.

PMID- 2219377
TI  - Rapid therapeutic decision-making using frozen sections of human liver allograft
      biopsies.

PMID- 2219378
TI  - Pathological and immunohistochemical features of graft liver antibody-mediated
      rejection.

PMID- 2219379
TI  - Hyaluronic acid in the assessment of liver graft function.

PMID- 2219381
TI  - Recruitment of lymphocytes to human liver allografts during rejection.

PMID- 2219380
TI  - Systemic fibrinogenolysis in liver transplantation.

PMID- 2219383
TI  - Serum tumor necrosis factor alpha in patients following liver transplantation.

PMID- 2219382
TI  - Induction of ICAM-1 on hepatocyte membranes during liver allograft rejection and
      infection.

PMID- 2219384
TI  - HLA class I matching is responsible for the hepatic lesions in recurrent viral
      hepatitis B after liver transplantation.

PMID- 2219385
TI  - Influence of long-term cyclosporine therapy on chronic liver disease after renal
      transplantation.

PMID- 2219386
TI  - Reliability of cytoimmunological monitoring after heart transplantation by
      consensus measurement: a multicenter study.

PMID- 2219387
TI  - Cardiotoxicity of cyclosporine A: light and electron microscopic findings in pigs
      and dogs.

PMID- 2219388
TI  - New immunosuppressive agents in experimental allogeneic heart transplantation.

PMID- 2219389
TI  - Prolongation of rat cardiac allograft survival by pretreatment of the donor to
      reduce class II antigen expression and dendritic cell content.

PMID- 2219390
TI  - Diagnosis and treatment of graft rejection in experimental and clinical small
      bowel transplantation.

PMID- 2219392
TI  - The effect of ketanserin on the immediate posttransplant function of canine
      kidneys.

PMID- 2219391
TI  - Cyclosporine and the ischemic rat liver.

PMID- 2219393
TI  - Contribution of nonendocrine tissue to the immunogenicity of endocrine pancreatic
      transplants.

PMID- 2219394
TI  - Transplantation of MHC incompatible vascularized mesenteric lymph nodes:
      identical pattern of lethal graft-vs-host disease as induced by small bowel
      grafts.

PMID- 2219395
TI  - Xenogeneic liver transplantation: its influence on secondary allogeneic graft
      rejection.

PMID- 2219396
TI  - A single exposure to ultraviolet radiation in vivo suppresses allogeneic
      responses in rat mixed lymphocyte cultures.

PMID- 2219397
TI  - Induction of tolerance after facilitation of engraftment with a monoclonal
      antibody anti-MHC class II in MHC fully allogeneic transplantation.

PMID- 2219398
TI  - Inhibition of leucocyte chemotaxis by immunosuppressive drugs: an important mode
      of action?

PMID- 2219399
TI  - Extrarenal pathology of cyclosporine: a lasting challenge.

PMID- 2219400
TI  - Mechanism of rejection of MHC class I-disparate murine skin grafts--histological
      and immunohistochemical studies of the rejection phenomenon.

PMID- 2219401
TI  - Examination of sex differences in tolerance induction by donor-heated lymphocyte
      pretreatment in a rat cardiac allograft model.

PMID- 2219402
TI  - Long-term (25-year) survival after renal homotransplantation--the world
      experience.
AB  - A follow-up is provided for 64 patients treated with renal transplantation at the
      University of Colorado before 31 March 1964. The 25-year survival was 15/64
      (23.4%) and 14 patients (22%) are still alive after 25 1/2 to 27 years. There are
      9 other survivors in the world from this era, distributed in 4 American and 2
      European centers. All of the 25-year survivors received their grafts from living
      related donors.

PMID- 2219403
TI  - Renal blood flow in the immediate posttransplant period as an index of the
      efficacy of organ procurement and preservation.

PMID- 2219404
TI  - Cyclosporin A-induced side effects in renal transplantation are related to the
      ratio of nonspecific/specific cyclosporin blood trough levels as analysed by
      radioimmunoassay.

PMID- 2219406
TI  - The use of the saphenous vein for arterial reconstruction in orthotopic liver
      transplant.

PMID- 2219405
TI  - Reactivity of peripheral blood lymphocytes to recombinant interleukin-2 in kidney
      transplant recipients.

PMID- 2219407
TI  - Graft-versus-host disease after orthotopic liver transplantation in a child.

PMID- 2219408
TI  - Prostaglandin E2 protects the isolated perfused rabbit liver from an oxygen free
      radical-induced injury.

PMID- 2219409
TI  - Cardiac transplantation in diabetic patients.

PMID- 2219410
TI  - Muscle flap closure for infected wounds after heart transplantation.

PMID- 2219411
TI  - Cyclosporin effect on ultrastructure of transplanted myocardium.

PMID- 2219412
TI  - Normal reproductive function in dogs with islet autografts.

PMID- 2219413
TI  - Prerequisites and initial experience for the noninvasive routine evaluation of
      viability of experimental and human organ transplants by magnetic resonance
      spectroscopy.

PMID- 2219414
TI  - The quality of life of donors, potential donors, and recipients of living-related
      donor renal transplantation.

PMID- 2219415
TI  - Barriers to organ donation among housestaff physicians.

PMID- 2219416
TI  - Rational drug use: an unsolved problem.

PMID- 2219417
TI  - Can education of the community help sleeping sickness control: a study from
      Cameroon.

PMID- 2219418
TI  - How to give priority to family planning in PHC programmes.

PMID- 2219419
TI  - Specialization and referral among the n'anga (traditional healers) of Zimbabwe.

PMID- 2219421
TI  - Experience with an active labour management protocol and reduction of caesarean
      section rate in Nicaragua.
AB  - Prospective data are presented on the outcome of labour in 67 women with
      uncomplicated pregnancy, who attended a rural Nicaraguan hospital and were
      managed actively in labour. No dystocia occurred and the caesarean section rate
      was 0%. Active management of labour is safe and feasible in a rural hospital
      setting. It results in a low caesarean section rate and reduced maternal
      mortality and morbidity, without compromising perinatal outcome.

PMID- 2219420
TI  - The village health worker project in Lesotho: an evaluation.

PMID- 2219422
TI  - Gastroscopy in a West African rural mission hospital.
AB  - The results of 1075 fibreoptic gastroscopies performed in the Northwest Province
      of Cameroon are presented. Three hundred and fifty-three examinations showed
      pyloroduodenal ulcer disease, 111 showed macroscopic gastritis, and 37 had
      gastric carcinoma. Sixteen other diagnosis were made, with a positive finding in
      620 cases. The benefits of the 'high-technology' gastroscope in a low technology
      setting are discussed. Included are examinations of a series of 46 patients with
      haematemesis and/or melaena, and 43 who had previous gastric surgery.

PMID- 2219423
TI  - Pancreatic calcification in diabetes mellitus at Ilorin, Nigeria.
AB  - Plain abdominal radiograph showed pancreatic calcification in four cases (5.2%)
      in a total of 77 cases of diabetes mellitus. All patients with calcified pancreas
      were insulin-dependent male diabetics. No direct relationship was observed
      between duration of illness and presence of calcification in the pancreas. Low
      incidence of pancreatic calcification among diabetics in recent reports from
      Nigeria probably suggests a changing pattern of the disease in the tropics.

PMID- 2219424
TI  - Electrocardiographic changes after recovery from measles.
AB  - Children with measles seen at our hospital had an initial electrocardiogram (ECG)
      and a repeat after 3 months. The patients were aged 5 months to 8 years (mean 19
      months). The ECG changes observed after clinical recovery included T-wave
      inversion in eight patients (16%), flattening in eight patients (16%), prolonged
      PR interval in six (12%), prolonged Q-Tc in three (6%) and low QRS amplitude in
      four (8%). At least one ECG change was present in 18 patients (36%) after
      recovery, 14 of these were due to persistence of the changes noted during
      measles. The implication of above findings and the need for a longer-term follow
      up study are discussed.

PMID- 2219425
TI  - Typhoid perforation: further experience with end-to-side ileotransverse
      colostomy.

PMID- 2219426
TI  - Stability of drugs in the tropics. A study in Sudan.

PMID- 2219427
TI  - Psychosocial counselling and HIV infection.

PMID- 2219428
TI  - Antibiotic sensitivity patterns of bacteria causing meningitis.

PMID- 2219429
TI  - Insulin needs of developing countries.

PMID- 2219430
TI  - International Network for the Rational Use of Drugs (INRUD)

PMID- 2219431
TI  - Study of site and nature of injury as prognostic factors in tetanus.

PMID- 2219432
TI  - Causes of infertility among 1000 patients in Ghana.

PMID- 2219434
TI  - A drug delivery system for small hospitals.

PMID- 2219435
TI  - Ileo ascending colon anastomosis after resection of terminal ileum and caecum for
      benign diseases.

PMID- 2219433
TI  - Risk factors of vesico-vaginal fistulae in Maiduguri, Nigeria: a case-control
      study.

PMID- 2219436
TI  - Penetrating injury of the thigh.

PMID- 2219437
TI  - Mammographic calcifications due to filarial disease.

PMID- 2219438
TI  - Prescribing.

PMID- 2219439
TI  - Infertility: an approach to management in a district hospital in Ghana.

PMID- 2219441
TI  - The VIIth biennial scientific meet of the Asian Pacific Association for the study
      of the liver 19th--21 February, 1190 Jakarta, Indonesia.

PMID- 2219440
TI  - Gastric mucormycosis.
AB  - A case of gastric mucormycosis proven on culture and histologic examination and
      successfully treated with resectional surgery and Amphotericin B is described.

PMID- 2219442
TI  - Liver transplantation in India.

PMID- 2219443
TI  - Pathophysiology and treatment of ascites in cirrhosis.
AB  - Ascites is the most frequent complication in patients with cirrhosis of the
      liver. In these patients, the onset of ascites indicates a profound impairment of
      hepatic and renal function and splanchnic and systemic hemodynamics and is
      therefore associated with a poor prognosis, the probability of survival at one
      and five years being of about 50 and 20 per cent, respectively. In patients with
      cirrhosis and ascites, parameters estimating splanchnic and systemic hemodynamics
      and renal function are better prognostic indicators than those currently used to
      evaluate liver function.

PMID- 2219444
TI  - Dissolution of pancreatic stones.
AB  - Chronic calcific pancreatitis (CCP) is the most clear-cut form of chronic
      pancreatitis. Till date, the common treatment of CCP has been directed toward
      discontinuation of alcohol consumption if the disease is associated closely with
      alcohol abuse, relief of pain, enzyme replacement, and the management of some
      complications like diabetes mellitus, cyst or abscess of the pancreas,
      malnutrition etc. In 1979, the research group for chronic pancreatitis in Japan
      proposed the therapeutic policy for this disease as illustrated in Fig. 1. A
      plausible new treatment is the dissolution of protein precipitates or calcified
      stones in pancreatic ducts by oral or intravenous administration of drugs.

PMID- 2219445
TI  - Endocrine diarrhoeas: current concepts.
AB  - Chronic diarrhoea occurs in several endocrine gland disorders, largely in gut
      neuro-endocrine tumours, due to the release of various agents into circulation,
      which affect gastrointestinal function (Table I). In the strict physiological
      sense, these agents may be hormones (such as gastrin), paracrine substance
      (somatostatin), neurotransmitters or neuro modulators (vasoactive intestinal
      polypeptide; VIP) or unknown agent(s) yet to be identified. For each of these
      syndromes or diseases (Table I), this review considers the characteristics of
      diarrhoea, its pathogenesis and the therapeutic aspects. The approach to the
      diagnosis of these syndromes, including localization of tumour tissue and the
      selection of appropriate anti-tumor treatment are also outlined.

PMID- 2219447
TI  - [The kinetic characteristics of the process of the contact stimulation of cell
      multiplication in a chick embryo cell culture].
AB  - As was reported elsewhere (Gasparian, Grigorian, 1989a, 1989b), the stimulation
      of cell proliferation takes place in established culture of chick embryo cells
      after adding a suspension of living or inactivated homologous cells. In the
      present paper the kinetic parameters of this process, termed as the contact
      stimulation of cell proliferation, were studied. The dose- and time-dependence of
      cell response to the stimulus is described. It was shown that the addition of
      cells activates cell growth both in exponential and stationary cultures. DNA
      synthesis in resting cells is seen initiated only if their continuous interaction
      with the added cells is provided. The nature of signals involved in the process
      of contact stimulation is described.

PMID- 2219446
TI  - [The stimulation of the transition of resting NIH 3T3 cells to proliferation
      under exposure to lysosomal inhibitors].
AB  - Lysosomal inhibitors (amino acid methyl esters) and the platelet-derived growth
      factor stimulate the resting NIH 3T3 cells to enter the S period. Incubation of
      cells in the medium containing lysosomal inhibitors enhances protein accumulation
      and seemingly does not disrupt lysosomes. These results indicate that
      proliferative homeostasis depends on the metabolic status of cells and that
      catabolic processes activated in resting cells negatively influence the
      prereplicative reactions.

PMID- 2219448
TI  - [The effect of oligomycin and cycloheximide on the ultrastructure of the
      segregation apparatus and on protein synthesis in the erythrocytes of the common
      frog].
AB  - The incubation of frog erythrocytes in the Ringer solution with novocaine (4.6 x
      10(-3) M) during 24 hours at 10 degrees C provoked vacuole formation (segregation
      zones). Changes of the novocaine solution for a fresh Ringer solution and the
      following 48 hour incubation was accompanied by a decrease in the number of
      vacuoles both electron-translucent and containing membranous material.
      Simultaneously, the number of vacuoles with amorphous material only and with
      amorphous and membranous substances was seen to increase. Under the action of
      cycloheximide (1.10(-2) M) or oligomycin (2.5 x 10(-6) M) on erythrocytes with
      preformed vacuoles for 48 hours the total number of vacuoles and their dimensions
      decreased, with numerous amorphous inclusions appearing. Vacuoles with amorphous
      and membranous material increased in size. Similar ultrastructural changes in the
      segregation zones under the influence of both the inhibitors were observed
      showing the appearance of thick threads and a decreased share of electron
      translucent vacuoles. A specific effect of cycloheximide, compared to that of
      oligomycin, involved the expansion of smooth endoplasmic reticulum cisternae.
      Under the influence of novocaine, 3H-leucin incorporation in proteins of frog
      erythrocytes was intensified. However, this incorporation was considerably
      inhibited by cycloheximide. Erythrocytes with segregation zones were more
      inhibitor susceptible than erythrocytes without vacuoles. The inhibitory effect
      was stronger early after their administration to the incubation medium, compared
      to the later periods.

PMID- 2219449
TI  - [The effect of cryopreservation on the cytogenetic characteristics of a cell
      subline of skin fibroblasts from the Indian muntjac].
AB  - After thawing cells, previously cryopreserved in the presence of dimethyl
      sulfoxide (DMSO), a decrease in their viability and increase in unscheduled DNA
      synthesis was observed. In 7 days, these parameters restored to the control
      level. Cryopreservation without DMSO resulted in the decrease in both cell
      viability and replicative and unscheduled DNA synthesis. In 14 days, these
      characteristics were seen to return to the normal level. Cryopreservation of
      cells without DMSO and their preservation in liquid nitrogen induced the
      frequency of chromosomal aberrations, mostly chromosomal breaks. The frequency of
      chromosomal aberrations increased with the duration of cell preservation in
      liquid nitrogen. The normal level was achieved following 7 days after cell
      thawing. Cells treated with DMSO only (without cryopreservation) display an
      increased number of chromosomal and chromatid breaks and translocations.
      Nonrandom distribution of chromosomal aberrations was observed, with particular
      chromosomes being involved in the appearance of dicentrics and translocations.
      The data obtained indicate that cryoprotective activity of DMSO is probably
      associated with the cell repair systems. The detected antimutagenic and mutagenic
      activity of DMSO may presumably reflect various conditions for its interaction
      with cells (with or without cryopreservation), as well as it may be specific for
      the muntjac cell line used in the present work.

PMID- 2219452
TI  - [The relationship between the spontaneous frequency of chromosome aberrations and
      the change in their frequency following mammography].
AB  - Changes in chromosomal aberration rates, analysed for women 35-60 years of age
      exposed to 0.5-2 cGy during the mammography, suggested a relationship between the
      initial rates of chromosomal aberrations and those caused by the procedure. The
      spontaneous level of cytogenetic changes is assumed to be indicative of the
      degree of body radiosensitivity.

PMID- 2219450
TI  - [The cytolytic function of mononuclear phagocytes. II. Factors that determine the
      binding and lysis of tumor cells by activated macrophages].
AB  - The effects of various modifiers upon the interaction of LPS- and BCG-activated
      macrophages with cells of mastocytoma P815 have been investigated. The efficiency
      of binding and lysis of the tumor cells is to a great extent determined by
      activation of the effector-cells, expression of the trypsin-sensitive receptors
      on the surface of macrophages, and by the type of target-cells. Introduction into
      the analytical system (effector-target) of unlabeled tumor cells or membrane
      preparations obtained from them inhibits substantially both binding and lytic
      activity of cytotoxic macrophages. If nontransformed cells or their membranes are
      applied, no significant changes in the investigated processes can be detected.
      Trypsinization of tumor cells as well as of activated but not resident
      macrophages modifies considerably the interaction of effectors with targets. The
      quantity of tumor cells bound with macrophages does not depend on the fact, which
      of the partners is subject to trypsinization, but it is much less than that of
      target-cells bound in the control. The incubation of activated macrophages with
      actinomycin D results in a substantial suppression of their lytic activity,
      whereas treatment of tumor cells with this inhibitor of protein synthesis leads
      to a considerable decrease in stability of the targets against lytic activity of
      the factor activated by effectors. The obtained data reveal the ways of selective
      binding and effective lysis of transformed targets by activated macrophages.

PMID- 2219453
TI  - [A device for immobilizing small biological objects under light optical study].
AB  - A device constructed on the base of a slide and a coverslip is proposed for
      immobilisation of small biological objects. The device permits performance of
      gradual and reversible squeezing of live micro-objects. Using the above device it
      is possible to watch one and the same living object, (for example, a ciliate)
      repeatedly within a prolonged period of time.

PMID- 2219451
TI  - [The effect of preparations of non-histone chromosomal proteins on the expression
      of hetero-organic membrane antigens of kidney origin in a primary rat hepatocyte
      culture].
AB  - The expression of membrane hetero-organic antigens of kidney origin, associated
      with the rat hepatomas in primary culture of intact adult rat hepatocytes, was
      investigated by means of the indirect immunofluorescence method using a specific
      immune serum. These antigens were observed on the membrane of some hepatocytes
      after their contact with nonhistone chromosomal proteins (NHCP), which were
      obtained from the kidney of intact rats from cells of hepatoma 27 and Zajdela
      hepatoma, or from the carcinogenic liver after a single diethylnitrosamine
      injection. Negative results were obtained after the incubation of hepatocytes in
      the medium lacking some of NHCP, or in that with NHCP obtained from the liver of
      intact rats.

PMID- 2219454
TI  - Bovine borreliosis: comparison of simple methods for detection of the spirochaete
      in the blood.
AB  - Natural Borrelia infection occurring in a calf was followed up using stained
      blood and buffy coat smears and direct observation of blood and buffy coat in
      order to compare these spirochaete detection methods. Direct examination of the
      platelet-plasma interface of the microhaematocrit capillary tubes after
      centrifugation allowed detection of two parasitaemias that were not seen in
      Giemsa stained blood smears. An ascending Babesia bigemina infection seemed to
      suppress the Borrelia parasitaemia. Spirochaetes were detected in five out of 37
      Boophilus decoloratus ticks recovered from the infected calf. The blood and the
      haemolymph stages of Borrelia were measured. After treatment with oxytetracycline
      the spirochaete could no longer be detected.

PMID- 2219455
TI  - Isolation of five species of Eimeria from chickens in Bangladesh.
AB  - Five species of Eimeria, namely E. acervulina, E. tenella, E. maxima, E. brunetti
      and E. necatrix were identified in chickens in Bangladesh on the basis of lesions
      seen at post-mortem examinations of naturally infected birds, and on the
      dimensions of oocysts and the lesions seen in chicks experimentally infected with
      single oocyst derived strains. The use of filter top, polycarbonate cages
      permitted the isolation of strains without sophisticated animal isolators and is
      appropriate for use in laboratories throughout the developing world. Responses to
      a questionnaire sent to all known intensive poultry farms suggested that
      coccidiosis is a major disease. For control, producers rely mostly on management
      procedures and the tactical use of sulphonamides; in-feed chemoprophylaxis is not
      widely used. These control measures are unsatisfactory and recent coccidiosis
      outbreaks were reported from seven of 16 farms. There was evidence of a seasonal
      incidence in clinical coccidiosis.

PMID- 2219456
TI  - Serological survey for leptospiral antibodies in goats in St Elizabeth Parish,
      Jamaica, 1985-1986.
AB  - A serological survey of goats in St Elizabeth Parish, Jamaica, comprising the
      breeding herd at the Agricultural Development Corporation (ADC) facility at
      Hounslow, five commercial herds and 21 family herds was carried out in 1985-1986.
      The Leptospira microscopic agglutination test indicated that one or more serovars
      in the Canicola serogroup were the most prevalent. Repeated samplings of goats at
      ADC, Hounslow demonstrated an increase in portlandvere and canicola seropositive
      animals following the onset of warmer weather and of icterohaemorrhagiae
      seropositive animals following the autumn rains and cooler weather. Apart from a
      cluster of family goats seropositive to pomona there was no geographical
      separation of reactors to the other serovars tested in the parish.

PMID- 2219457
TI  - Cattle poisoning and mortality associated with tortoise clostridial toxicity in
      the Beletu District of Ethiopia.

PMID- 2219458
TI  - Mineral deficiency in ruminants in subsaharan Africa: a review.

PMID- 2219459
TI  - Complement activation in pulmonary tuberculosis.
AB  - The alterations in serum/plasma levels of total haemolytic complement activity
      (CH50), complement components C3 and C3d, and circulating immune complexes (CICs)
      in patients with pulmonary tuberculosis were analysed in relation to the severity
      of disease and treatment status. The mean levels of CH50, C3, C3d and CICs were
      significantly higher in untreated than treated patients and in normal controls.
      In the untreated group, the level of each of these four parameters except C3d was
      significantly higher in patients with far advanced disease than in those with
      moderately advanced disease, whereas the difference between treated patients and
      normal controls was not statistically significant for any of the four parameters
      tested. There were statistically significant correlations between levels of CICs
      and both C3 and C3d in the untreated tuberculosis patients. However, the
      correlations for the same parameters were not significant when treated patients
      were considered. The CH50 levels in tuberculosis patients suggest a functional
      classical complement pathway, which is essential for immune complex
      solubilisation. High C3d level in untreated patients is indicative of increased
      complement activation, which in turn shows significant correlation with levels of
      CICs. It appears that the intact and elevated complement proteins and their
      proper activation by CICs prevents tuberculosis from becoming a typical immune
      complex disease.

PMID- 2219461
TI  - Adenosine deaminase (ADA) in peritoneal tuberculosis: diagnostic value in ascitic
      fluid and serum.
AB  - Simultaneous determination of ascitic fluid and serum adenosine deaminase (ADA)
      activity was evaluated as a diagnostic aid in peritoneal tuberculosis. The
      ascites was due to peritoneal tuberculosis (group 1), cirrhosis of the liver
      (group 2), cirrhosis of the liver with spontaneous bacterial peritonitis (group
      3), peritoneal malignancy (group 4), Budd-Chiari Syndrome (group 5) and
      miscellaneous conditions (group 6). Serum from patients of pulmonary tuberculosis
      and healthy volunteers was analysed for enzyme activity. In patients with
      peritoneal tuberculosis the ascitic fluid and serum ADA activity was
      significantly higher than for the other groups (P less than 0.001). Levels above
      36 u/l in ascitic fluid and above 54 u/l in the serum suggest tuberculosis. The
      ascitic fluid/serum ADA ratio was also higher in patients with peritoneal
      tuberculosis than with other causes of ascites (P less than 0.01). A ratio of
      more than 0.984 was suggestive of tuberculosis.

PMID- 2219460
TI  - A comparison of the relative sensitivity of two types of Heaf gun.
AB  - A total of 696 secondary school children were given a Heaf test in one forearm
      with a magnetic head Heaf gun and in the other forearm with a fixed head gun. One
      week later the results were read blind. In 333 (48%) children the fixed head gun
      gave a more strongly positive result than the magnetic head gun, while in only 27
      (4%) children did the magnetic head gun gives a more strongly positive result.
      These findings are statistically highly significant (p less than 0.001).

PMID- 2219462
TI  - The diagnostic value of an enzyme-linked immune sorbent assay using adsorbed
      mycobacterial sonicates in children.
AB  - We have evaluated the serodiagnosis of tuberculosis in children using
      mycobacterial sonicates in an enzyme-linked immunosorbent assay (TB ELISA), a
      method reported to have been used with success in adults. Attempts were also made
      to ascertain if prior BCG immunisation would influence the outcome of the test.
      Using clinically diagnosed and notified cases of tuberculosis as well as subjects
      in whom the condition had been excluded as controls, it was found that the TB
      ELISA showed very low degrees of specificity and sensitivity and consequently was
      not suitable as a diagnostic tool in identifying children aged 5 years or less
      with tuberculosis. In groups of older children the TB ELISA appeared to be much
      more promising and gave results more in keeping with those found in adults. In
      very young infants who were free from tuberculosis we showed that there was a
      cross reactivity with BCG. Thus it appears that, at present, serodiagnosis of
      tuberculosis in children is not practical.

PMID- 2219463
TI  - Ofloxacin and imipenem in the treatment of Mycobacterium fortuitum and
      Mycobacterium chelonae lung infections.
AB  - Two patients with Mycobacterium fortuitum and one patient with Mycobacterium
      chelonae lung infections were treated with ofloxacin and imipenem respectively.
      Of the former two, one had underlying inactive pulmonary tuberculosis and
      bronchiectasis and the other had silicosis. The latter had severe underlying
      bronchiectasis also. The treatments were well tolerated and the patients
      responded well.

PMID- 2219464
TI  - The significance of glucose intolerance in pulmonary tuberculosis.
AB  - We performed a sequential follow-up of oral glucose tolerance tests on 54
      Nigerian patients with active pulmonary tuberculosis in order to determine the
      significance of glucose intolerance in tuberculosis. Twenty-three patients
      (42.6%) were found to have abnormal results, including three (5.6%) with a
      diabetic pattern and 20 (37.0%) with impaired glucose tolerance; 15 (75%) of the
      latter group had normal results after 3 months treatment while one each of the
      former group was diabetic, intolerant of glucose and normal respectively. Two
      patients with normal results initially had impaired glucose tolerance at the
      second test. Three months after full anti-tuberculosis medication, only one of
      the eight patients with impaired glucose tolerance at the second oral glucose
      tolerance test remained intolerant of glucose. Only one patient was frankly
      diabetic. Our results suggest that glucose intolerance in pulmonary tuberculosis
      is secondary to infection and is reversible.

PMID- 2219465
TI  - Tuberculous pleurisy--a family outbreak.
AB  - Three female members of a family presented with tuberculous pleurisy over a 4
      month period. All three responded to chemotherapy but identification of the
      source of infection proved difficult.

PMID- 2219466
TI  - Eczema vaccinatum and postvaccinal BCG adenitis--case report.

PMID- 2219467
TI  - Renal allograft tuberculosis.
AB  - We present a case of miliary tuberculosis presenting as fever of unknown origin
      in an immunosuppressed patient following renal transplantation. Biopsy of the
      renal transplant revealed acid-fast bacilli histopathologically. Eye examination
      revealed bilateral choroidal tubercles. Recipients of kidney transplants with
      fever of undetermined aetiology should be investigated for tuberculosis and
      fundoscopy performed.

PMID- 2219468
TI  - Any questions? How should a patient be managed who is being treated for sputum
      positive pulmonary tuberculosis and becomes jaundiced in the third week of
      chemotherapy?

PMID- 2219469
TI  - Immunotherapy with Mycobacterium vaccae as an adjunct to chemotherapy in the
      treatment of pulmonary tuberculosis.
AB  - 47 patients with adult-type pulmonary tuberculosis attending the Chest Diseases
      Hospital in Kuwait were given a single injection of 10(9) irradiation-killed M.
      vaccae after 1 month of a 9-month course of chemotherapy. The patients were
      followed-up for 3 more months in double blind comparison with 65 patients given
      an injection of saline (placebo). The immunotherapeutic injection produced a
      small local lesion in 44/47 patients, 18 of which ulcerated and produced small
      scars. Immunotherapy made no measurable difference to the bacteriological,
      biochemical, haematological, or radiological parameters measured. However it was
      associated with significantly improved weight gain, reduced size of skin test
      response to Tuberculin, increased lymphocyte proliferation to common
      mycobacterial antigens, and increased antibody levels to mycobacterial antigens.
      The changes in skin test and LTT responses were related and occurred in 29% of
      patients whose recognition of common mycobacterial antigens returned to normal.
      The remaining patients did not differ in these respects from those receiving
      placebo. The proportion of patients whose responses were improved was very
      similar to that achieved using the same immunotherapeutic agent in a group of
      treated multibacillary leprosy patients.

PMID- 2219470
TI  - [Lithium treatment and kidney function].
AB  - Systematic cross-sectional and longitudinal examinations of the kidney function
      of patients in prophylactic lithium treatment have established that the therapy,
      even when given for many years, does not affect the glomerular filtration rate or
      lead to kidney failure. Lithium treatment may induce polyuria and lowered renal
      concentrating ability, but these side effects do not presage deterioration of the
      filtration rate, and they are not dangerous if dehydration is avoided. It is now
      possible to revise and simplify the guidelines for laboratory monitoring of
      maintenance treatment with lithium.

PMID- 2219471
TI  - [Forms of care and children's infections. 1. Occurrence and causal factors].
AB  - On an average, preschool children have 6-8 acute infections annually. This
      corresponds to approximately 80 sick-days including mild colds. If days in which
      the general health is affected only are included, approximately 25 days per child
      per annum are concerned. The amount of sickness in children attending day care
      centres is between 2-7 times as great as that of children cared for in their own
      homes. In particular, an increased risk has been demonstrated for children
      attending day care centres to develop conditions such as secretory otitis media,
      pneumonia, gastroenteritis, hepatitis A and meningitis. A close dose-response
      connection can be demonstrated between ill health and the number of children with
      whom the child is cared for. The increased possibilities of exposure to infection
      in day institutions must, therefore, be assumed to be the central factor for the
      excess morbidity demonstrated. The significances of a series of modifying factors
      in the pathogenesis, including age, genetically determined immunity, psychosocial
      stress, atmospheric contamination, quality of atmosphere and low temperatures,
      are reviewed. Despite the term "colds", there is no evidence that upper
      respiratory infections have any connection with cooling. With the object of
      establishing rational measures against spread of infection, the occurrence and
      routes of infection of the relevant microorganisms are reviewed. About 80% of the
      infections must be presumed to be viral. In children attending day care centres,
      viruses have been demonstrated in 10% of the children without symptoms. Air-borne
      infection appears to be responsible for a very limited proportion of infections.
      The routes of infection are mainly by direct or indirect contact infection e.g.
      via tables and toys.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2219472
TI  - [Forms of care and children's infections. 2. Consequences and possibilities for
      intervention].
AB  - t may be calculated that between one fourth and one third of all infectious
      illnesses in preschool children in Denmark can be attributed to care in day care
      centres. A series of socially stressing problems have been demonstrated for
      parents with work outside the home in connection with care of their sick
      children. There is no evidence that children with many recurrent infections early
      in the preschool age become more resistant to infection with increasing age. On
      the contrary there is evidence that recurring middle ear infections and
      respiratory infections in childhood may have chronic sequelae and may possibly
      predispose to allergic disease. From a community medical standpoint, there is no
      doubt that day care centres are of importance in the spread of infection e.g.
      influenza epidemics in the adult population. On this basis, indications are found
      to attempt to institute measures which can reduce sickness in day care centres.
      Apart from prohibition of smoking, it is not clear whether improved indoor
      atmospheric conditions will improve the resistance in children. More restrictive
      turning away of children with very slight symptoms of colds is probably of
      limited value, whereas more prolonged convalescence for the individual child
      would probably reduce the number of children with recurrent infections. This
      necessitates a considerable number of days of care at home for parents with sick
      children. Intensified microbiological hygiene should be the central measure in
      intervention. This necessitates improved microbiological training of the staffs
      of day care centres. Children should be out-of-doors to a greater extent and the
      space should be increased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2219473
TI  - [Study of the quality of measurement by the Sickness Impact Profile. Assessment
      of the reliability of a method to determine the functional level of psychiatric
      patients].
AB  - The Sickness Impact Profile (SIP) is a questionnaire method of assessing the
      functional level within 12 fields which together provide a generalized
      measurement of the level of health in agreement with the definition of health by
      WHO. In the present investigation, the method was employed for the first time
      occasion for 58 suitable psychiatric patients and the result of Rasch's item
      analysis of the replies to the individual questions showed altogether scales of
      good measurement quality. A single question, however, appeared to be unsuitable.
      The item-analysis is a demanding measurement for the internal validity and
      homogeneity and it supplements foreign investigations of the criteria-related
      validity of SIP.

PMID- 2219474
TI  - [Evaluation of the level of function before and after treatment at a psychiatric
      day-hospital. Are you better, or are you well].
AB  - A pilot project was carried out to assess the effect of group therapy. This
      demonstrates the employment of a method of measuring general health, the Sickness
      Impact Profile. Employment of this method before and after the period of therapy
      could demonstrate significant improvement in relevant functional fields and
      development towards normalization of health in the 12 categories which describe
      this.

PMID- 2219475
TI  - [Alcohol consumption and organic damage. Views and attitudes of Danish patients
      and their relatives].
AB  - A total of 201 patients and their relatives in a hospital in Copenhagen
      participated in a structured interview investigation about their knowledge of the
      long-term effects of alcohol and their attitudes to restrictions. The majority
      approved of an upper limit for alcohol consumption within the recommended limits
      but a total of approximately 1/3 preferred a higher limit. Only 28% realised that
      there was a difference in how much alcohol women and men can tolerate. The
      majority, but far from all of the participants knew that alcohol could damage the
      liver and brain but few knew of damage to other organs. A total of 64% had a
      positive attitude to prohibition of alcohol consumption in places of employment
      in Denmark. It is suggested that information about alcohol should be concentrated
      in the form of simple clear messages.

PMID- 2219476
TI  - [Acute alcohol poisoning in children in the Randers area 1978-1988].
AB  - The purpose is to examine retrospectively the circumstances, clinical course and
      sequelae in 37 children (32 boys, 5 girls) admitted with acute alcohol
      intoxication during the 11 years 1978-1988. It is concluded, that the number of
      admissions has increased. Two distinct populations are found: 0-3 and 8-15 years.
      Strong spirits were usually involved, excessive amounts ingested because of
      inexperience and not at home. Admission is within two hours from last ingestion
      and most often at week-ends. 24% had histories of chronic behaviour problems. 32%
      had minor injuries. The maximal alcohol concentration found was 2.9%. None of the
      patients were found to be hypoglycaemic or had long term sequelae.

PMID- 2219477
TI  - [Acute alcohol intoxication in children. Diagnosis, treatment and complications].
AB  - The purpose of this review is to describe the diagnosis, emergency treatment and
      further observation and complications. Alcohol poisoning and complications are
      underdiagnosed problems. Intoxication in young children is accidental and due to
      lack of experience in older children. Strong spirits are usually involved. The
      speed of elimination is greater than in adults and presumably 3-8 mmol/l/h. Fatal
      cases with alcohol concentrations less than 3.0% have been reported. The lethal
      dose is presumably 3 g/kg. Symptoms are as in adults but appear at lower
      concentrations. Infants do not reach a stage of exitation. Children are more
      prone to develop complications such as hypothermia, acidosis, electrolyte
      disturbance and trauma. Hypoglycaemia develops in 24-50% of cases, more
      frequently in infants and after starvation. The treatment is aspiration,
      admission to hospital, close observation, determination of core temperature,
      alcohol concentration, blood glucose-concentration and determination of serum
      electrolytes. Blood glucose should be monitored. Treatment is conservative but
      severely intoxicated children may require dialysis.

PMID- 2219478
TI  - [Hospital employees' knowledge about HIV disease. A study from 2 provincial
      hospitals].
AB  - The knowledge of and attitudes to HIV infection were investigated by means of
      questionnaires during the period 1.10.1988 to 30.4.1989 in two small Danish
      Hospitals. Two hundred and thirty two nurses, 147 nursing aids, 44 doctors, 25
      laboratory workers and 22 midwives took part in the investigation. The overall
      response was 99% of the staff contacted. The questionnaires were anonymous and
      were completed immediately and without use of any sources of information. Poor
      knowledge was revealed concerning symptoms, sources of infection, precautions to
      avoid infection, high-risk groups and patients duty to provide information. In
      fact, none of the groups exceeded 66% correct answers on these subjects. A total
      of 70% of the whole group had been in contact with patients, whom they suspected
      to be HIV-positive. Every third individual had felt insecure regarding HIV at
      work. Incidents at work had caused 18 employees to be tested for HIV. Only about
      half had been instructed about HIV. A total of 73% expressed needs for further
      instruction about the disease. The investigation shows difference between the
      staff opinion of possible claims on the patients about tests and to the policy of
      the Danish Department of Health concerning voluntary testing.

PMID- 2219479
TI  - [Complications of thrombolytic treatment of acute myocardial infarction].
AB  - In a retrospective study twenty-one Danish medical departments recorded the
      number of serious adverse events in patients who had acute myocardial infarction
      and according to local routine received thrombolytic therapy. Of 278 patients who
      were given streptokinase 1.5 million IU intravenously in 1 hour, 37 had falls in
      blood pressure less than 80 mm Hg; two had haemorrhage which required
      transfusion; one was temporarily disabled after paravenous infusion of
      streptokinase and one had a fatal intracerebral haemorrhage. Three patients
      developed stroke of unknown cause. The randomised prospective studies from recent
      years have shown similar complication rates. Nine patients who had thrombolytic
      therapy but were subsequently shown not to have acute ischaemic heart disease had
      no adverse events.

PMID- 2219480
TI  - [Carcinoma of the lip. Therapeutic results and cosmetic assessment].
AB  - The results of treatment of 283 patients with histologically verified
      infiltrating squamous cell carcinoma of the lip are presented. The cosmetic
      results after interstitial implantation of cesium needles, surgery or external
      irradiation are assessed. In tumours with the maximal surface diameter between 1
      and 2 cm, fewer visible scars were found after implantation (6.9%) than after
      surgical excision (23%). The recurrence rate after interstitial cesium
      implantation is 12% and after surgery 15%.

PMID- 2219481
TI  - [Routine roentgen examination of the skull].

PMID- 2219482
TI  - [Medical research in Greenland].

PMID- 2219483
TI  - [Confidence intervals instead of p-values].
AB  - International scientific journals expect authors of articles to an increasing
      extent to calculate confidence intervals for their statistical findings.
      Confidence intervals are more informative than p-values in hypothesis testing as
      the confidence interval expresses how great the value of an investigated effect
      may be anticipated to be in the population. Examples of calculation of confidence
      intervals are presented on the basis of data frequently occurring in medical
      investigations.

PMID- 2219484
TI  - [Treatment of interpleural pain].
AB  - Since then, a great deal of work on this topic has been published. The literature
      is reviewed and indications, contraindications, dosage, mechanism of action and
      side effects are discussed.

PMID- 2219485
TI  - [Rational hemotherapy. Indications, complications and practical performance].
AB  - Employment of allogenic blood products involves the risk of a series of
      complications in the recipient: transfusion-transmitted disease, immune
      suppression, immunological transfusion reactions and coagulopathy. Hepatitis C is
      the most common transfusion-transmitted infection with a post-transfusion
      incidence of 2-4%. Transfusion-transmitted AIDS plays a quantitatively lesser
      role but the course of the condition is frequently fatal. The duration of the
      period during which a HIV-sero-negative individual is potentially infectious is
      uncertain. After blood transfusion, the immune apparatus is suppressed, probably
      on account of the leukocyte content of the blood transfusion. These disturbances
      in immune function increase the risk of infection and possibly the frequency of
      recurrence of cancer after operative treatment of a series of neoplastic
      diseases. Coagulopathy after blood transfusion may be related primarily to the
      number of transfusions and can be counteracted by administration of the relevant
      coagulation factors. Rational hemotherapy aims at minimizing these transfusion
      related complications by restricting the indications for blood transfusion, blood
      component therapy, peroperative normovolaemic haemodilution, preoperative
      deposition of autologous blood and/or peroperative collection of blood and re
      infusion. Employing rational hemotherapy, it becomes possible to reduce the need
      for transfusion by 20-90% and hence the morbidity and the mortality connected
      with blood transfusion.

PMID- 2219486
TI  - [Iatrogenic biliary tract injuries].
AB  - From 1984 to 1986 The Medico-Legal Council was heard concerning four cases of
      iatrogenic lesions of the common bile duct during cholecystectomy. The Council's
      statements show that lesions of the common bile duct or the common hepatic duct
      during otherwise uncomplicated, elective cholecystectomy are considered surgical
      malpractice and not accidental mishaps.

PMID- 2219487
TI  - [Arteriosclerosis in Greenlanders].
AB  - X-ray examination of the lumbar spine of 268 Greenlanders and a corresponding
      number of Danes were reviewed in order to diagnose arteriosclerotic lesions of
      the abdominal aorta. In 10.4% of the Greenlanders and 11.6% of the Danes major
      calcifications were found. The two groups did not differ in distribution of age
      and sex of patients with arteriosclerotic lesions. It is known that
      arteriosclerotic complications occur less frequently in Greenlanders than in
      Danes. The study seems to indicate that this cannot be explained by a rarer
      occurrence of generalized arteriosclerosis.

PMID- 2219488
TI  - [Radiographic examination of the lumbar spine in Greenlanders].
AB  - X-ray examinations of the lumbar spine from a two-year period in 268 Greenlanders
      and an equivalent number of danes were reviewed in order to diagnose all
      radiological lesions. Twenty-five percent of the X-ray examinations of the
      Greenlanders and 28% of the Danes showed normal conditions. Eighteen percent of
      the Greenlanders and 3% of the Danes had evident sacroliitis. Four Greenlanders
      and one Dane had radiological ankylosing spondylitis. The high frequency of
      sacroiliitis can probably be explained by the genetic structure of the population
      and the pattern of infections. Spondylolisthesis was found in 24% of the
      Greenlanders, confirming previous findings. Degenerative lesions, fractures,
      developmental anomalies and Scheuermann's disease were equally frequent in the
      two populations, while scolioses were less frequent among the Greenlanders than
      among the Danes.

PMID- 2219489
TI  - [Radiographic examination of the stomach in Greenlanders].
AB  - X-ray examinations of the stomach and duodenum from a two year period of 135
      Greenlanders and an equivalent number of Danes were reviewed in order to diagnose
      all radiological lesions. The results are presented. In 37% of the Greenlanders
      and 51% of the Danes, x-rays showed normal findings. Peptic ulcerations were
      diagnosed for the first time in 2.4% of Greenlanders over the age of 15 years.
      The incidence of gastric ulcer was 1.5% and of duodenal ulcer 0.9%. The
      male/female ratio was 1.3 in Greenlanders. The esofagus and cardia region of the
      Greenlanders revealed many serious lesions, emphasizing the importance of further
      investigations in this area. The incidence of peptic ulcer disease and gastric
      ulcer is higher than the incidence in Denmark but approximately the same as in
      the Faroe Islands. The incidence of duodenal ulcer is found to be lower among
      Greenlanders than in the other two populations.

PMID- 2219490
TI  - [Double contrast arthrography as a screening method of suspected meniscal
      lesions].
AB  - On reevaluation after one year of experience with double-contrast-arthrography
      (DCA) we found in 83 consecutive patients with suspected meniscal lesion a true
      positive diagnostic frequency of 0.84, a true negative diagnostic frequency of
      0.75, a true positive nosografic frequency of 0.87 and a true negative nosografic
      frequency of 0.70. This gives an increased diagnostic accuracy compared to the
      initial evaluation of the arthrografies. No complications of the examination were
      registered. As DCA demands fewer resources than arthroscopy, this method is
      suggested as a screening procedure in patients with possible tears of the
      menisci.

PMID- 2219491
TI  - [Smoking habits among children aged 11-15 years in 1988. A study of smoking
      habits and their connection with social background factors, health, satisfaction
      and social networks].
AB  - A total of 1,671 schoolchildren aged 11, 13 and 15 years answered an anonymous
      questionnaire in 1988 on their social backgrounds, social networks, health, life
      satisfaction and health behaviour. The proportions who had tried to smoke were
      24%, 51%, and 66% in the three age groups; the proportions of smokers were 3%,
      8%, and 29%, and the proportions of daily smokers were 0%, 2% and 6%. More girls
      than boys were smokers but there was almost no difference if place of residence,
      social class, or family type were considered. Almost the entire variation could
      be explained by best friends' smoking habits and by the number of smokers at
      home. Smoking was associated with poor health, fatigue, school tiredness, school
      performance below the average, frequent contacts with friends outside school and
      at night, difficulties in discussion with parents, ease in discussions with
      friends, and with having close friends. The proportion of smokers, among children
      has been steadily declining since the first Danish nationwide survey was carried
      out in 1959.

PMID- 2219492
TI  - [Basic research and aimed research].

PMID- 2219493
TI  - [Insulin-like growth factors and growth hormone].

PMID- 2219494
TI  - [Polymyalgia rheumatica].

PMID- 2219495
TI  - [Standardized treatment].

PMID- 2219496
TI  - [Copper toxicity in animal cell cultures].

PMID- 2219497
TI  - [Diagnostic use of measurements of gastrointestinal hormones].

PMID- 2219498
TI  - [Disaster planning in Danish hospitals].
AB  - With the object of obtaining insight into establishing of disaster planning in
      Danish hospitals, an investigation was carried out in the departments
      responsible. The insight of the house officer on duty and his immediate
      description for disaster planning were employed as indications of the level of
      establishment of disaster planning. This investigation indicates a low level of
      establishment of disaster planning and reveals the need for further training and
      information on this subject.

PMID- 2219499
TI  - [First aid, prehospitalization treatment, performed by non-professionals].
AB  - In the Casualty Department of the Central Hospital in Slagelse, all acute
      referrals during a period of 48 hours (illness or accidents) were registered with
      the object of assessing the extent to which lay persons employ first-aid. First
      aid had been employed in half of the cases investigated but was considered
      relevant in 82% of the cases. The circumstances associated with performance of
      first-aid are discussed and proposals are made for improvement.

PMID- 2219500
TI  - [Mandibular fractures. 1. Etiology and fracture pattern in 348 patients].
AB  - We reviewed 348 consecutive patients with 536 mandibular fractures treated in the
      ENT department of Aalborg Hospital from 1982 to 1986 retrospectively. The most
      frequent causes of mandibular fractures were violence (37.3%) and traffic
      accidents (36.8%) in adults, and bicycle accidents in children. A total of 85
      patients (24.4%) had associated injuries. The anatomic distribution revealed a
      high percentage (41.4%) of condylar fractures, while the rest of the fractures
      were distributed in accordance with similar studies. In 32 edentulous patients,
      body and condylar fractures were most frequent.

PMID- 2219501
TI  - [Mandibular fractures. 2. Treatment, complications and late sequelae].
AB  - A total of 536 mandibular fractures were reviewed as regards treatment and
      complications. Among the 348 patients, 216 (62.1%) were hospitalized. Compared to
      other studies, many patients (31.2%), particularly with condylar fractures, were
      treated conservatively with soft diet only. Open reduction was used in 23.7% of
      the patients. Thirty five patients (10.1%) developed complications such as
      infection and/or delayed union. Postoperative infection was positively correlated
      to delayed union. Treatment-delay predisposed to primary, but not secondary
      infection. No correlation between fracture dislocation and development of
      complications was observed. A total of 209 patients came for follow-up after
      observation periods varying between one and six years. 48.8% had no symptoms. The
      most frequent late complications were occlusive change (22.2%) and sensory
      disturbances in the mental region. The mean ability to open the mouth was 48.5
      mm. In one third of the patients with condylar fractures, the jaw deviated to the
      side of the involved condyle, but this finding did not interfere with function.
      Radiographically, shortening and, in many young patients, remodelling of the
      fractured condyle could be demonstrated. Teeth in the line of fracture should in
      general be preserved.

PMID- 2219502
TI  - [Primary assessment of X-ray images in a casualty department].
AB  - During a period of three months, the primary diagnoses made by the duty officer
      in the casualty department on x-rays taken on patients with orthopaedic
      conditions were compared with the definitive diagnoses made after a conference
      with the radiological department. The consequences of possible erroneous
      diagnoses were also recorded. A total of 634 regions were examined in 555
      patients. Incorrect diagnoses were made in 55 regions (8.5%). In 21 of these,
      alterations in the primary treatment were required. All of the treatments could
      be corrected by telephone (7) or an additional visit by the patient (14). X-rays
      of the cranium and the spine are known to be difficult to evaluate by
      inexperienced doctors. This was also found to be the case in the present
      investigation.

PMID- 2219503
TI  - [Physical exercise among school children. A nation-wide sociomedical study of
      1,671 children 11-15 years of age].
AB  - A total of 1,671 children aged 11, 13 and 15 years from a nationwide random
      sample of schools completed an anonymous questionnaire on their social
      backgrounds, social networks, health, life satisfaction, and health behaviour.
      The proportion practising outdoor activities at least three times a week was 57%;
      37% did some physical exercise in their leisure time sufficient to make them
      breathless or sweat at least four times a week; 43% at least four hours a week.
      Two thirds were active members of a sports club. A minority of 8% did not carry
      out any physical exercise during their leisure time sufficient to make them
      breathless or sweat. Boys did more physical exercise than girls irrespective of
      the measurement of exercise. The most important motives for physical exercise
      were to improve health, to get in good shape, to have fun, and to make new
      friends. More than 90% of the children intended to do physical exercise at the
      age of 20. High intensity of physical activity was associated with high social
      class, strong social integration in the peer group, easy contact with parents and
      friends, physical exercise among parents and best friends, high degree of life
      satisfaction, and good health.

PMID- 2219504
TI  - [Sexual habits of women aged 20-39 years. A comparison of 3 population-based
      studies from Nykobing Falster, Copenhagen and Nuuk/Godthab].
AB  - The sexual habits in women aged 20-39 years chosen at random were investigated. A
      total of 513 women from Copenhagen participated while there were 586 women from
      Nykobing Falster and 661 women from Nuuk (Godthab) in Greenland. The women from
      Copenhagen replied to a questionnaire investigation while women from the other
      two regions were interviewed personally. The age of commencement of sexual
      activity was considerably lower in Godthab in women of all age groups than in
      Copenhagen and Nykobing Falster e.g. the prevalence of women with age on
      commencement of sexual activity less than or equal to 16 years was 70-80% in
      Godthab while the corresponding figures for Copenhagen were 50-60% and for
      Nykobing Falster 30-58%. Comparison with previous investigations revealed that
      the average age at the first coitus showed a tendency to decrease in all three
      regions during the past 20-30 years. The difference in the age at the first
      coitus between a provincial town (Nykobing Falster) and a city (Copenhagen) was
      present only in the case of women in the oldest age group (35-39 years) and a
      geographical levelling appears to have occurred in the younger age groups (20-24
      years) concerning the age at commencement of sexual activity. Women in Greenland
      had significantly more partners than women in the two South Danish regions. In
      Godthab, the prevalence of women with greater than or equal to 40 partners was
      thus 22.4% while the prevalences in Copenhagen and Nykobing Falster were 3.5% and
      0.3%, respectively. The prevalences of women with 0-1 partners were 1.7%, 10.7%
      and 20.4%, respectively in Godthab, Copenhagen and Nykobing Falster.

PMID- 2219505
TI  - [Rectoscopy and Hemoccult II in irritable colon. A prospective study].
AB  - It was investigated whether Hemoccult-II test (H-II) could reduce the number of
      colonic examinations in patients with the irritable bowel syndrome, with normal
      rigid proctoscopic findings. A negative H-II was obtained in 299 patients from
      general practice and a positive test in nine. Colonoscopy was done in 157 and
      double contrast barium enema in 142 after random allocation. The nine patients
      with positive H-II all had colonoscopy. Among the 299 with negative H-II, colonic
      adenomas were detected in ten and an early cancer in an adenoma in the sigmoid
      colon; overlooked rectal adenomas were found in three, rectal cancer in one,
      rectal carcinoid in another and a coecal cancer, which could be palpated, in a
      third patient. Two patients with colonic cancer and one with adenoma were
      detected among those with positive H-II. All patients were followed by clinical
      examination after one year. In conclusion, colonic examination should carry a low
      priority in patients with symptoms of irritable bowel, negative Hemoccult-II and
      normal rigid proctoscopic findings performed by an experienced examiner. The
      investigation confirmed the recommendation of total colonoscopy in patients with
      a positive H-II and added support for increasing number of endoscopy services in
      contrast to those of diagnostic radiology, which should be reduced.

PMID- 2219506
TI  - [Treatment of women with severe pre-eclampsia in an intensive care unit during a
      3-year period].
AB  - During the period 1.1.1986-31.12.1988, the number of patients with severe
      preeclampsia referred to the intensive care unit in Sonderborg Hospital
      increased. On the basis of a retrospective study of the hospital records,
      possible reasons and certain characteristics of this increase are pointed out.
      Failure of treatment of severe hypertension and oliguria were the most frequent
      reasons for referral. Respiratory complications predominated: four women had
      pulmonary oedema and eight required ventilatory support. Despite difficulties in
      assessing the haemodynamic status, these nineteen cases appear to illustrate the
      unpredictable variation in severe preeclampsia per se. Insufficient volume
      expansion may explain a few episodes of oliguria, but neither excessive volume
      expansion nor unacceptable delay in observation appear to offer plausible
      explanations for the increase observed. The authors conclude that the frequency
      of haemodynamic complications in this analysis illustrated the potentially
      disastrous effect of preeclampsia in itself. Early delivery should always be
      considered in patients with even minor symptoms of treatment failure, regardless
      of the age of gestation. Should haemodynamic complications occur despite this,
      referral to an intensive care unit should be considered.

PMID- 2219507
TI  - [Convulsions after flumazepil].
AB  - Two cases of convulsions following intake of the benzodiazepine antagonist,
      flumazepil, are presented. The etiology is discussed and special precautions are
      recommended for the diagnostic employment of the preparation.

PMID- 2219508
TI  - [Education in disaster medicine].

PMID- 2219510
TI  - [Inhaled steroids and growth inhibition].

PMID- 2219511
TI  - [Do two thirds of all small children have fluid in their middle ear?].

PMID- 2219509
TI  - [Alcohol tests, legal safety and equality].

PMID- 2219512
TI  - [Preventive effects of bicycle helmets].
AB  - The total number of persons injured following bicycle accidents in Denmark is
      estimated to be more than 50,000 annually. In half of the injured cyclists,
      lesions localized to the region of the head occur. Bicycle helmets provide
      considerable protection against brain injuries which constitute 13%. Several
      investigations from abroad and from Denmark have demonstrated that protection of
      the head can reduce the number of deaths and of acute brain injuries due to
      bicycle accidents. On the basis of the literature, it is concluded that bicycle
      helmets provide good protection of the head in connection with bicycle accidents.
      When a bicycle helmet is purchased, it is important to ensure that the helmet
      fits the head, that vision is not impeded and that the chinstrap secures the
      helmet correctly. Legislation is necessary to ensure that bicycle helmets sold in
      Denmark fulfill the minimum safety requirements.

PMID- 2219513
TI  - [Effects of antihypertensive agents on lipoproteins and thrombocyte function].
AB  - This article is a review of the literature concerning the effects of
      antihypertensive agents on the lipid status and thrombocyte function. Many
      investigations have revealed that thiazide diuretics, non-selective beta-blockers
      and beta-1 selective beta-blockers have resulted in alteration of lipids in a
      potentially atherogenic direction. Only thiazide diruetics have caused increase
      in low density lipoprotein, which is causally connected with increased tendency
      to atheroschlerosis. In some investigations, alpha-1 blockers have had a
      favourable effect on lipids in an atherogenic direction. Other antihypertensive
      agents appear, by and large, to be lipid neutral even although isolated
      investigations have demonstrated displacement of lipids both in positive and
      negative directions. Non-selective beta-blockers appear to alter thrombocyte
      function towards a greater tendency to aggregation while beta-1 selective beta
      blockers are neutral. Ca-antagonists, angiotensin converting enzyme inhibitors
      and ketanserin have, theoretically, anti-aggregatory effects on the thrombocytes
      but only few ex vivo and in vivo experiments have confirmed this effect.
      Monitoring of lipids is recommended before and after antihypertensive treatment.
      Finally, the effect on thrombocyte function should be considered in the choice of
      hypertensive agent.

PMID- 2219514
TI  - [Serotonin and cardiovascular control].
AB  - Serotonin is a monoamine and is widely distributed in the human organism.
      Serotonin is synthesized from the amino acid tryptophane and is broken down via
      mono-amino-oxydase enzymes to 5-hydroxy-indol-acetic acid and by acetylizing and
      methylizing to melantonin. In 1986, a consensus concerning the classification of
      the serotonergic receptors was established. Three main classes were determined,
      viz: 5-HT1, 5-HT2 and 5-HT3. 5-HT1 receptors were further subdivided into A, B, C
      and D-receptors and, of these, the 5-HT1A-receptor is involved in the centrally
      mediated blood pressure control via reduction in the pre- and postganglionic
      sympathetic activity. The 5-HT2 receptors are primarily involved in control of
      peripheral blood pressure where agonizing results in vascular contraction of the
      large arteries and veins and thrombocyte aggregation. The 5-HT1 receptors are
      also involved peripherally in connection with release of relaxing factors derived
      from endothelium. In vitro and in animal experiments, it has been demonstrated
      that serotonin is capable of inducing arrhythmia and myocardial dysfunction via 5
      HT3 receptors. Several preparations with effects on both the central and
      peripheral serotonergic receptors are already marketed for treatment of
      hypertension and other conditions.

PMID- 2219515
TI  - [Scheuermann's disease].
AB  - Scheuermann's disease is most frequently diagnosed in patients between 13 and 17
      years and is subdivided into high, long and low kyphoses. The symptoms consist of
      pain which may be aggravated by physical exertion. Pain is most frequent and most
      severe in the long and low kyphoses. The etiology and pathogenesis are not
      entirely elucidated but it is probable that there is a genetic component, that
      the condition is not unifactorial and that it may be due to weakness in the
      epiphyseal plates of the vertebrae. Radiography reveals irregularities of the end
      plates of the vertebrae, frequently with Schmorl's impressions, narrowing of the
      intervertebral spaces, one or more wedge-shaped vertebral bodies and increased
      kyphosing. No effective symptomatic treatment is known but the patients should be
      advised about choice of career and work. In order to avoid hyperkyphosis and
      chronic pain, back and abdominal musculature must be strengthened and mobility in
      the spine improved. Gymnastics, swimming and cycling on stationary bicycles may
      be recommended but sports associated with jumping and marked stress for the spine
      must be warned against. In few and severe cases, treatment with a corset or
      operation may be necessary.

PMID- 2219516
TI  - [Diarrhea acquired abroad--traveller's diarrhea. Admissions to Medical Department
      C, Odense Hospital, during the period 1977-1988].
AB  - A total of 106 out of 267 patients admitted with acute gastroenteritis to Medical
      Department C, Odense Hospital, during the period 1977-1988 had acquired the
      condition abroad. This group was investigated retrospectively. During the period
      of investigation, the number of patients with "traveller's diarrhoea" increased
      but compurized constantly approximately 40% of the patients admitted with acute
      gastroenteritis. The patients were investigated routinely for pathogenic
      intestinal bacteria and parasites and the etiology could be determined in 72%.
      Salmonella infections were found in 50% and 1/5 of these were caused by
      Salmonella typhi or Salmonella paratyphi. Double and triple infections occurred.
      51% of the infections were acquired in Asia and Africa although less than 7% of
      Danish package tours visit these regions. Five patients (5%) developed serious
      complications.

PMID- 2219517
TI  - [Recurrent abdominal pain in schoolchildren 9-12 years of age].
AB  - The frequency of recurrent abdominal pain (RAP) was investigated in a material of
      664 Danish schoolchildren. 15% of the children aged 9-12 years had RAP, defined
      as at least three episodes of abdominal pain during a period of three months with
      pain of an intensity which affected the behavior of the child. In general, there
      was no significant difference in the frequency of RAP in boys and girls in the
      material, however, a preponderance of girls with RAP after the age of ten years
      was found. The investigation showed that symptoms such as headache, limb pains
      and diarrhoea were experienced more frequently among children with RAP. In
      general, RAP occurred more frequently among children in families with high
      frequencies of psychosomatic symptoms. 40% of all the children questioned lived
      in broken homes. A tendency to increased frequency of RAP was found among these
      children. Children who lived in a garden city had essentially lower frequencies
      of RAP than children from other areas. There was an evident preponderance of
      children with RAP in families who lived in flats. There was no significant
      difference in the school and occupational education of the parents and the
      frequency of RAP.

PMID- 2219518
TI  - [Treatment of medial femoral neck fractures in Denmark].
AB  - Variations in the treatment of medial fractures of the neck of the femur were
      investigated by means of a questionnaire sent to all hospital departments which
      operated on these fractures. 91% replied. 86% of the departments used
      thromboembolic prophylaxis as a routine and 24% employed prophylactic
      antibiotics. Operation was only performed prophylactically on cases of impacted
      fractures in 24% of the departments. Orthopaedic departments operated earlier and
      more frequently preferred cancellous bone screws as the method of osteosynthesis
      rather than a sliding screw plate. The latter method was preferred by the non
      orthopaedic departments. Patients were mobilized earlier in the orthopaedic
      departments and fewer postoperative x-rays were taken than in the non-orthopaedic
      departments.

PMID- 2219519
TI  - [Percutaneous embolization of vascular abnormalities].
AB  - In six male patients, percutaneous embolisation of symptom-producing vascular
      anomalies was performed with spirals or small particles. After a total of ten
      treatments, symptom-free states were obtained in half of the patients and
      definite improvement in the remainder. The results are so promising that this
      method of treatment will be continued.

PMID- 2219520
TI  - [10-22 years follow-up after truncal vagotomy and drainage of chronic duodenal
      ulcer].
AB  - Long-term observation with a minimum 10 years on patients treated for duodenal
      ulcer is rare. This paper presents the long-term results of truncal vagotomy and
      drainage with a observation time of 16.8 years (range 10.1-22.4). A total of 146
      patients were investigated. The side effects of the operation were moderate and
      only four per cent had unsatisfactory results at observation time. The recurrence
      rate was 25.5 per cent. Only 50 per cent of the recurrences were seen after the
      first eight years. A long follow-up time is therefore recommended in follow-up
      study of treatment of duodenal ulcer.

PMID- 2219521
TI  - [Leukemoid reaction caused by hypernephroma primary diagnosed as chronic
      granulocytic leukemia].
AB  - A case of leukemoid reaction associated with renal carcinoma is presented. On
      account of the high leukocyte count and a palpable abdominal mass in the upper
      left quadrant, interpreted as an enlarged spleen, the primary tentative diagnosis
      was chronic granulocytic leukemia. Abdominal ultrasonographic scan revealed an
      enlarged left kidney and subsequent nephrectomy revealed a large hypernephroma.
      Leukemoid reactions associated with malignant disease are described in general
      with emphasis on the differential diagnosis.

PMID- 2219522
TI  - [Hyperhidrosis. Hypnotherapy of 2 patients with hyperhidrosis].
AB  - Two cases of hypnotherapeutic treatment of psychogenic hyperhidrosis are
      presented. In both cases, organic aetiology could be excluded and conventional
      medical treatment modalities had no effect. In both cases, it was possible to
      modulate sweating in the trance state within less than a minute, thus supporting
      other reported cases of the effect of hypnotically induced modulation of
      autonomic responses. In the first case the psychological dynamics behind the
      physiological symptoms seemed unrelated to fundamental emotional and personal
      problems and relaxation and conditioning techniques in hypnosis had a positive
      effect in reducing the sweating to both objectively and subjectively socially
      acceptable standards. In the second case the hyperhidrosis was related to more
      fundamental personality problems and short term hypnotherapy proved ineffective
      in treating the condition.

PMID- 2219523
TI  - [Changes in risk factor levels in Osterbro].

PMID- 2219524
TI  - [Analgesic-induced mortality].

PMID- 2219525
TI  - [Surgical complications--surgical education].

PMID- 2219526
TI  - [Hantaan virus infections].

PMID- 2219527
TI  - [Lung transplantation].
AB  - Isolated lung transplantation or combined heart and lung transplantation provides
      a new therapeutic possibility for patients with certain benign terminal pulmonary
      diseases. This method of treatment makes great demands on not only the donors but
      also the recipients. Following operation, which is undertaken in selected
      centres, life-long clinical control with immune suppressive treatment is
      essential. The method of treatment is associated with a series of complications
      and long-term survival does not appear to be optimal yet. A series of Danish
      patients have received lung transplantation abroad and are now followed in Danish
      special departments in cooperation with their own general practitioners.

PMID- 2219528
TI  - [High Dose Rate 192Ir-Microselectron].
AB  - The HDR 192Ir-Microselectron is a new high-dose-rate remote afterloading
      apparatus using a small 192Ir source with very high activity, 370 GBq (10 Ci).
      The size of the source permits treatment through catheters with diameters as
      small as 1.9 mm. This makes it possible to give endobronchial treatment to lung
      cancer patients through a fibrebronchoscope in local anaesthesia. Preliminary
      results of treating cancer of the oesophagus, -prostate, -head and neck and
      breast cancers are promising. In addition the HDR 192Ir-Microselectron seems to
      have a promising potential in the treatment of several other tumours, especially
      in treating nonresectable intraabdominal tumours intraoperatively.

PMID- 2219529
TI  - [Social inequalities in child health status].
AB  - The article describes the health situation in relation to demographic and social
      class variables in a sample of 1,671 schoolchildren aged 11, 13 and 15 years in
      Denmark. The proportions assessing their health as excellent, good, fair, or poor
      were 47%, 39%, 13%, and 1%, respectively. 22% reported daily symptoms and 74%
      weekly symptoms (20% one symptom a week, 54% two or more symptoms). During one
      week, 50% suffered from bad moods, 37% insomnia, 30% depression, 26% headaches,
      22% nervousness, 19% back pain, 14% abdominal pain, and 12% vertigo. 37% had used
      medical drugs during the last month, most frequently for headaches (25%), colds
      (11%), coughs (9%) and abdominal pain (8%). Girls showed poorer self-assessed
      health than boys, more symptoms and more use of medication. The youngest pupils
      had the most frequent symptoms and the oldest least. There were no health
      differences when place of residence or family composition were considered, but
      there were clear social class differences. Pupils from the lowest social class
      and pupils whose parents were not included in the social class classification
      (e.g. disability pensioners) had the poorest self-assessed health, the most
      frequent symptoms and the highest use of medication.

PMID- 2219530
TI  - [Commitment of the mentally ill].
AB  - This investigation consists of a cross-sectional study on 1 June 1989 of
      committed or compulsorily detained psychiatric patients in Denmark according to
      the legislation no. 118 of 13 April 1938. All of the departments which had
      received committed patients during the past five years participated. 87.2%
      replied. A total of 275 persons were found who were involuntarily admitted or
      compulsorily detained during their stay in hospital, or both. 59.9% of the
      patients were in closed departments and the remainder in open departments. The
      prevalence of committed or compulsorily detained patients was low compared with
      conditions in Norway and Sweden. Almost half of the patients were schizophrenic.
      The voluntarily admitted, but compulsorily detained patients comprised 28.8% of
      the reported patients. Notifications of compulsory detentions to the Ministry of
      Justice involved 34.4%. Half of the patients were admitted less than 2 1/2 months
      prior to the investigation but approximately 10% had been admitted for over ten
      years, which emphasizes the necessity of good physical and mental surroundings in
      psychiatric institutions.

PMID- 2219531
TI  - [Labor complications and interventions in immigrant and Danish women during the
      period 1983-1987].
AB  - Based on data retrieved from the Danish Medical Birth Register, deliveries among
      Danish and immigrant women were compared in the years 1983-1987. The women were
      divided into two groups, primiparous and multiparous, and then compared by
      frequency and type of complications and interventions during labour. Five
      hospitals in the Copenhagen area were selected and more than 40,000 women were
      included in the survey. About 3,500 were from Yugoslavia, Turkey, Pakistan and
      Morocco and the remainder were from Denmark. An increased frequency of
      complications and interventions during labour was recorded among primiparous in
      comparison to multiparous during the period. This observation was not related to
      nationality. Stimulation of labour by intravenous drugs was more frequent among
      immigrant women than Danish women and was particular frequent among Moroccan and
      Pakistani women. Among these nationalities higher frequencies of complications
      were not recorded and the use of intravenous drugs did not imply more
      instrumental deliveries. It is presumed that one of the reasons why the use of
      intravenous drugs is more frequent among immigrant women is due to a feeling of
      insecurity during labour. This might be caused by defective communication between
      the woman in labour and the midwife. The subject calls for closer investigations
      based on case records and the women's own experiences. The necessities for
      special training of immigrant women and staff members in maternity wards are
      pointed out.

PMID- 2219532
TI  - [Acute iliofemoral venous thrombosis. 26 cases treated with thrombectomy,
      temporary arteriovenous fistula and anticoagulants].
AB  - During a period of two years, 26 patients with acute iliofemoral venous
      thrombosis were treated with venous thrombectomy, establishing of a temporary
      arteriovenous fistula and anticoagulants as thrombolytic treatment was not
      possible. Twenty-five patients were followed-up after an average of 20 months
      with clinical examination, phlebography, venous strain-gauge pletysmography and
      vein-pump examination. At follow-up examination, 68% of the patients were free
      from symptoms, in 54% vein-pump function was normal and 79% had normal venous
      strain-gauge pletysmographic findings. One patient had venous claudication.
      Thrombectomy with temporary arteriovenous fistula formation offers a possibility
      of ensuring normal venous drainage from the lower limbs in patients with
      contraindications to thrombolysis.

PMID- 2219535
TI  - [Retrograde colo-colic invagination].
AB  - A case of retrograde colo-colic intussusception, diagnosed preoperatively by
      straight films of the abdomen and confirmed by barium enema X-ray, is presented.
      The mechanisms behind intussusception are discussed briefly.

PMID- 2219534
TI  - [Upper abdominal pain and pre-eclampsia--HELLP syndrome].
AB  - A 26 year old primiparous woman in the 30th gestational week presented with upper
      right abdominal pain. Clinical examination revealed direct tenderness under the
      right curverture, oedema, hypertension and proteinuria. Ultrasound scanning
      showed a normal gallbladder. Laboratory findings revealed Hemolysis, Elevated
      Liver enzymes and Low Platelet count. On account of suspected HELLP-syndrome
      cesarean section was performed. We suggest screening of all pregnant with upper
      abdominal symptoms suspected for preeclampsia by measuring platelet count and
      liver enzymes.

PMID- 2219533
TI  - [Giant cell arteritis. Can blindness be avoided?].
AB  - It is recognized that temporal arteritis may cause blindness as one of the
      numerous symptoms. Three case histories are presented to illustrate this. In the
      discussion, the effect of rapid treatment with high-dose corticosteroids is
      emphasized to avoid blindness.

PMID- 2219536
TI  - [NovLet. A new pen-like device for insulin administration].

PMID- 2219537
TI  - Electrochemical deposition of molecular adsorbates for in situ scanning probe
      microscopy.
AB  - We have studied gold and graphite electrodes in an electrochemistry cell under
      various solutions using the scanning tunneling microscope (STM). The gold (111)
      surface yields quite reproducible images and cyclic voltammograms. In situ
      voltammograms show that, under certain conditions, nanomolar quantities of DNA
      fragments can suppress the adsorption of a buffer salt of millimolar
      concentration. When the DNA concentration is reduced below that required for a
      monolayer coverage, the salt adsorption is restored. We show images of bare gold,
      gold covered with an adsorbate produced by the buffer salt, and gold prepared
      with a concentration of DNA fragments close to that required for monolayer
      coverage added to the buffer. Under these conditions, the surface is found to be
      uniformly covered with a characteristic structure.

PMID- 2219538
TI  - Scanning tunneling microscopy of planar biomembranes.
AB  - We combined planar membrane monolayer techniques with scanning tunneling
      microscopy (STM) to measure the thickness of metal-coated purple membrane (PM)
      isolated from Halobacterium halobium. Although the metal coating precluded
      obtaining high-resolution lateral information, it facilitated obtaining high
      resolution vertical information. For example, the apparent mean thickness of
      planar PM and variations in thickness of enzyme-treated PM could be detected and
      quantified at sub-nanometer resolution.

PMID- 2219539
TI  - [The density of cortical bone of the distal radius].
AB  - The rigid fixation of distal radius fractures by T plates needs a bone substance
      of sufficient strength to insert screws. In case of advanced osteoporosis only
      the cortical cone will provide a secure fixation. In this investigation the
      results of measurement concerning the thickness of palmar and dorsal cortical
      bone of the distal radius are reported relating to age and sex.

PMID- 2219540
TI  - [Experimental determination of sliding friction during insertion of femoral
      intramedullary nails].
AB  - No data have published concerning the procedure of driving in intramedullary
      nails. An extensive experimental device consisting of a contact-free distance
      measurement, a dynamograph connected to strain gages and an accelerometer now
      enabled this investigation. Among other things we determined the range of sliding
      friction for each stroke at different levels of nail-progression. Depending of
      the depth of nail-progression forces between 200 N und 400 N were measured. When
      the nail is stuck these values rise to over 1000 N. The sliding-process lasted
      between 10 ms and 20 ms. Knowledge of these data is of major importance for
      improvement of surgical technique and possible development of mechanical nail
      insertion aids.

PMID- 2219541
TI  - [The surgical treatment of thoracic wall instability].
AB  - Cardinal symptom of the instability of thorax with paradoxical respiration is the
      irreversible respiratory insufficiency. The lethality is over 50%. For the
      treatment often besides the longterm respiration with the well known
      complications the operative stabilisation of the chest wall by osteosynthesis of
      the ribs by small plates. Thereby the mortality of this severe injury can be
      reduced significantly, if there is a good indication for osteosynthesis.

PMID- 2219542
TI  - [The treatment of post-traumatic recurrent anterior shoulder dislocation using Du
      Toit's operation].
AB  - From 1.4. 1986 to 31.12. 1987 we operated 21 patients with a recurrent anterior
      dislocation of the shoulder with the Du Toit staple capsulorrhaphy. 20 patients
      we followed clinically and radiologically for an average period of one year and
      four months. By using a rating sheet 17 patients had an excellent and three
      patients a good result. There was, against other operation techniques, a
      minimally limiting of external rotation. We had no recurrents of dislocation. We
      concluded that the Du Toit staple capsulorrhaphy makes necessary only short
      postoperative immobilisation and renders an early return of motion and that a
      good function can be expected.

PMID- 2219544
TI  - [Meniscus replacement using Hoffa's infrapatellar fat bodies--initial clinical
      results].
AB  - Between December 1986 and July 1988 a replacement of the absent medial meniscus
      was taken by means of the infrapatellar adipose body in seven patients. A
      replacement of the anterior cruciate ligament by means of the middle one third of
      the patellofemoral ligament was taken too. This operation was done for
      reconstruction of the synergism between the anterior cruciate ligament and the
      posterior horn of the medial meniscus. All patients are controlled in our special
      knee outpatient service. There were no complication postoperatively and on all
      seven patients a control arthroscopy was performed twelve months postoperatively.
      The subjective results are very satisfying because of the restoration of knee
      stability. The arthroscopic controls of the meniscal replacements, however,
      showed a reduction in size of the transplants after one year, the tissue was weak
      and not identical to that of a normal meniscus. Autologous strong tissue, e.g.
      quadriceps tendon, may have better presuppositions for meniscal replacement.

PMID- 2219543
TI  - [Treatment and results following rupture of the quadriceps tendon].
AB  - Ruptures of the quadriceps tendon are rather uncommon and are usually due to
      minor trauma. From 1971 to 1986 we observed 13 spontaneous ruptures in contrast
      to a single case due to adequate trauma. The average age of the patients was 64.0
      years. There is no alternative to surgical reconstruction of the ruptured or torn
      out quadriceps tendon. Tendon-repair with supportive wire-looping produces a good
      functional result. After immobilisation of the knee for five to six weeks
      intensive physiotherapy is required. The outcome of patients treated in this
      manner shows persisting slightly muscular atrophy of minor degree and limited
      knee-mobility with only a little all-day handicap.

PMID- 2219545
TI  - [Management of anteromedial instability of the knee joint].
AB  - The management of patients with antero-medial rotatory instability of the knee is
      described. The therapy of the special patient depends on the age of the patient
      and the extent of instability. The therapy is also influenced by the degree of
      degenerative arthritis and differs between well trained and untrained persons.

PMID- 2219546
TI  - [Splenic rupture following arthroscopy].
AB  - Retroperitoneal bleeding from splenic rupture occurred after initially uneventful
      arthroscopy. The diagnosis was finally set up in CT-scan, whilst peritoneal
      lavage was negative. Since there was no incidence of previous abdominal trauma
      and no abnormal findings in histology, spontaneous perioperative splenic rupture
      has been discussed.

PMID- 2219548
TI  - Interaction of ethanol and the high pressure nervous syndrome in rats.
AB  - The aim of this study was to determine whether administration of ethanol protects
      rats against the preconvulsive symptoms of high pressure nervous syndrome (HPNS).
      Male Sprague-Dawley rats were given either saline or 0.5, 1.5 or 2.5 g/kg ethanol
      i.p. After injection, the animals were individually exposed to helium-oxygen at
      60 atmospheres absolute (atm abs) pressure. The chamber temperature was adjusted
      to counteract ethanol- and helium-induced hypothermia. Several behavioral
      parameters were scored continuously during the first 64 min after injection. The
      time spent in tremor at high pressure was significantly less in the 1.5 and 2.5
      g/kg ethanol-treated groups. The number of jerks was significantly lower in the
      2.5 g/kg ethanol-treated group. The two highest doses of ethanol induced a
      characteristic pattern of unsteady locomotion, which was returned to normal in
      the 1.5 g/kg group at 60 atm abs. Other behavioral effects of ethanol, such as
      depression of total motor activity, were also reduced. These results indicate
      that ethanol can significantly ameliorate some of the adverse symptoms of HPNS in
      freely moving rats.

PMID- 2219547
TI  - [The diagnosis of so-called whiplash injury of the cervical vertebrae. A case
      report].
AB  - The acceleration injury of the cervical spine (so-called whip-lash injury) is a
      common traumatic mechanism in traffic accident. Severe damages are possible.
      Scepticism is necessary, if several hours or days are symptom-free. Radiological
      results which seem to prove an injury should be controlled. Severe injuries are
      in consideration of the symptom-free course incredible. This is demonstrated with
      a description of a case.

PMID- 2219549
TI  - Cardiovascular changes in anesthetized rats during exposure to 30 bar.
AB  - The effect of exposure to 30 bar (PHe = 29.0 bar, PN2 = 0.8 bar, PO2 = 0.2 bar)
      on left ventricular pressure, cardiac contractility, heart rate (HR), and
      arterial pressure was studied in anesthetized rats. During compression there was
      a progressive increase in maximal left ventricular pressure (LVPmax), maximal
      velocity of LVP rise (+ dP/dtmax) and fall (- dP/dtmax), systolic pressure
      (APsys), and pulse pressure (delta AP). The greatest increase in contractility
      per bar was found between 1 and 5 bar. Immediately after 30 bar was reached,
      LVPmax (19%), + dP/dtmax (60%), and - dP/dtmax (22%). APsys (19%), and delta AP
      (43%) were significantly increased from predive values, with an additional
      increase detected for all these variables after 60 min at 30 bar. An increase in
      estimated oxygen consumption (work load) of the heart was also found during
      compression to and at 30 bar. No changes in HR, mean arterial pressure, and end
      diastolic pressure were observed during the high-pressure exposure, indicating
      that the inotropic changes were not due to changes in peripheral hemodynamics.

PMID- 2219550
TI  - Effects of breathing-gas pressure on pulmonary function and work capacity during
      immersion.
AB  - Upright immersion induces respiratory mechanical changes that may impair
      pulmonary function during hyperbaric exercise. To evaluate this, 10 divers
      performed an incremental cycling protocol while immersed upright at 1.02 and 6.05
      atmospheres absolute (atm abs). Air was supplied at each of two hydrostatic
      pressures: mouth pressure (Pm: to stimulate a mouth-held demand regulator) and
      lung centroid pressure (PLC). Subjects perceived air delivery at PLC to be more
      comfortable at each level of exercise at both absolute pressures (P less than
      0.05). At 6.05 atm abs subjects perceived narcosis to be greater for Pm than for
      PLC air delivery. Hypoventilation was encountered at 6.05 atm abs with PLC air
      delivery and was further exacerbated when air was delivered at Pm (P less than
      0.05). It was concluded that hypoventilation and narcosis are reduced whereas
      respiratory comfort is increased when air is delivered at PLC. This change is
      possibly due to improved pulmonary mechanics accompanying PLC air supply
      pressure.

PMID- 2219551
TI  - Combined arterial gas embolism and decompression sickness following no-stop
      dives.
AB  - Decompression sickness (DCS) has been clinically classified as Type I
      (predominantly joint pain) or Type II (predominantly spinal cord lesions). We
      present 3 cases that are all characterized by severe (Type II) DCS with signs and
      symptoms of spinal cord injury occurring in conjunction with arterial gas
      embolism (AGE). We consider the AGE "minor" because only 2 of the 3 subjects
      initially lost consciousness, and in all cases the signs and symptoms of the AGE
      had essentially resolved within 1 h or by the time recompression therapy began.
      DCS was resistant to recompression therapy, even though treatment began promptly
      after the accident in 2 of the 3 cases. None of the cases had a good neurologic
      outcome and there has been one death. None of the divers exceeded the U.S. Navy
      "no-stop" limits for the depths at which they were diving. We have observed a
      previously unreported clinical syndrome characterized by severe Type II DCS
      subsequent to AGE following pressure-time exposures that would normally not be
      expected to produce DCS. We postulate that AGE may have precipitated or
      predisposed to this form of DCS.

PMID- 2219552
TI  - Atmosphere contamination following repainting of a human hyperbaric chamber
      complex.
AB  - The Naval Medical Research Institute currently conducts hyperbaric research in a
      Man-Rated Chamber Complex (MRCC) originally installed in 1977. Significant
      engineering alterations to the MRCC and rusting of some of its interior sections
      necessitated repainting, which was completed in 1988. Great care was taken in
      selecting an appropriate paint (polyamide epoxy) and in ensuring correct
      application and curing procedures. Only very low levels of hydrocarbons were
      found in the MRCC atmosphere before initial pressurization after painting and
      curing. After pressurization, however, significant chemical contamination was
      found. The primary contaminants were aromatic hydrocarbons: xylenes (which were a
      major component of both the primer and topcoat paint) and ethyl benzene. The role
      that pressure played in stimulating off-gassing from the paint is not clear; the
      off-gassing rate was observed to be similar over a large range in chamber
      pressures from 1.6 to 31.0 atm abs. Scrubbing the chamber atmosphere with the
      chemical absorbent Purafil was effective in removing the contaminants.
      Contamination has been observed to slowly decline with chamber use and is
      expected to continue to improve with time. However, this contamination experience
      emphasizes the need for a high precision gas analysis program at any diving
      facility to ensure the safety of the breathing gas and chamber atmosphere.

PMID- 2219553
TI  - Measurement of static and dynamic pulmonary work during pressure breathing.
AB  - Various environments alter static and flow-resistive pulmonary mechanics. Of
      interest to diving physiologists is the negative pressure breathing induced
      during upright immersions without appropriate modification of air supply
      pressure. This paper outlines methodologic considerations for determining static
      and flow-resistive pulmonary work under such exposures. Ten males performed
      inspiratory pressure-volume relaxation maneuvers and spontaneous breathing in
      air, and during upright immersion with mouth pressure air supply. The immersed
      lung centroid pressure (PLC) was +1.19 kPa relative to the hydrostatic pressure
      at the sternal notch. Immersion elevated inspiratory static work from 0.36 to
      1.74 J.liter-1 (P less than 0.05). Pulmonary flow-resistive work was elevated
      from 0.20 to 0.75 J.liter-1 (P less than 0.05), whereas pulmonary resistance,
      determined at 0.5 liter.sec-1, increased from 0.18 to 0.44 kPa.liter-1.sec (P
      less than 0.05). No significant changes in the iso-volume compliance of the lung
      tissue, chest wall, or total respiratory system were observed (P greater than
      0.05). Results indicate that increases in the work of breathing are due to a
      combination of hydrostatic pressure imbalance, increased pulmonary resistance,
      and reduced end-expiratory total respiratory compliance.

PMID- 2219554
TI  - [Improvement of prostheses and orthotic aids for the handicapped using electric
      stimulation and the registration of bioelectric signals].
AB  - Electro-mechanical devices can help a variety of patients with motor
      disabilities. Surface EMG from remaining muscles in an amputated arm can be used
      to control powered electronic hands, wrists and elbows. Sensory signals such as
      knee angle and ankle torque can be used to control the visco-elastic properties
      of a knee joint for above-knee amputees. Finally, percutaneous electrodes can be
      used to stimulate paralyzed muscles to replace hand function in quadriplegics and
      leg function in paraplegics. This article summarizes recent progress in each of
      these areas.

PMID- 2219556
TI  - [Allergy: update. What is new in the treatment of hay fever?].

PMID- 2219555
TI  - [Interobserver agreement in the diagnosis and management of foot warts].
AB  - The interobserver agreement in diagnosing the presence or the disappearance of
      plantar wart was assessed among ten Family Physicians from the Family Medicine
      Unit (FMU) of the Centre hospitalier de l'Universite Laval (CHUL). Physicians
      were trained to recognize predetermined clinical criteria for the presence
      (microthrombi, interruption of skin folds and hyperkeratosis) and disappearance
      (return of skin folds) of plantar warts. Sixty (60) untreated plantar lesions in
      43 patients were examined independently by two to five available physicians.
      Twenty-two (22) patients who came for one to six follow-up visits generated 77
      post treatment assessments of plantar warts. The observed agreement was 82% for
      diagnosis (49/60) and for cure (63/77). The agreement corrected for chance as
      measured by the Kappa coefficient was 0.60 for diagnosis and 0.61 for cure. A
      good degree of agreement on diagnosis and disappearance of plantar wart was
      achieved among the FMU physicians.

PMID- 2219557
TI  - [Cholesterol. The complex relation of an indispensable enemy. Interview by Robert
      Henry].

PMID- 2219558
TI  - [Cholesterolemia, hypertension, diabetes: complex pharmacotherapeutic levels].

PMID- 2219559
TI  - [Women and cardiovascular disease. Interview by Robert Henry].

PMID- 2219560
TI  - Metabolism in vitro of cartilage proteoglycans in rat (pre)chondrocytes from
      different embryonic regions.
AB  - Diabetes in the mother may cause disturbances in the chondrocyte development in
      the embryo. A rat model was used to investigate whether this was reflected in the
      production of proteoglycans by cells from two embryonic regions. One of these
      regions is resistant (limb bud) and the other susceptible (mandibular arch) to
      malformation in diabetic pregnancy. Chondroitin sulphate proteoglycans from
      cultures of day-12 rat embryo limb bud and mandibular arch chondrocytes were
      extracted with guanidine-HCl and analyzed by gel chromatography after in vitro
      35S-sulphate-labeling. Two sizes of proteoglycans (Kav 0.26 and 0.66 on CL-2B
      Sepharose) were found in both types of chondrocytes and in all media. The
      polysaccharide chain length was the same (Kav 0.36 on CL-6B Sepharose) for both
      proteoglycans. Elevated levels of D-glucose or beta-hydroxybutyric acid had no
      effect on either proteoglycan size or proportion, nor on polysaccharide chain
      length. However, there were differences (in all culture conditions) between limb
      bud and mandibular arch cultures in that the larger proteoglycan accounted for
      80% of total radioactivity in the limb bud cultures, 53% in the mandibular arch
      cultures, and only 25-29% in the media from both types of cultures. Furthermore,
      different ratios between radioactive proteoglycans in medium and matrix suggested
      markedly different efficiencies for matrix formation in the two cell types. These
      findings indicate differences in the metabolism of the proteoglycans in these two
      cell types which may be related to the induction of mandibular malformation in
      diabetic pregnancy.

PMID- 2219561
TI  - Association between exposure to asbestos and pleural effusion. Results from a
      questionnaire study of 31,000 persons.
AB  - All visitors to a general health survey in 1979, 17,140 men and 14,371 women,
      completed a questionnaire on smoking habits, exposure to asbestos, silica and
      welding fumes, and diseases such as pleural effusion, pneumonia, cough, asthma
      and diabetes. Seven per cent of the men reported exposure to asbestos, 10% to
      welding fumes, and 6% to silica. Among those who reported work related dust
      exposure there was a higher proportion of smokers, and smokers exposed to dust
      smoked more tobacco per day than non exposed smokers. In the group of men 30-59
      years of age, who did not indicate exposure to occupational pollutants 2.7%
      reported previous pleural effusions. However, among asbestos exposed men of the
      same ages, the prevalence was more than doubled (5.7%, p less than 0.01). This
      finding was highly significant in a logistic regression model where age and
      smoking habits were included. The data indicate that 10% or more of diagnosed
      cases of pleurisy could be associated with previous asbestos exposure.

PMID- 2219562
TI  - The influence of body temperature on traumatic vasospasm.
AB  - The effect of hypothermia on traumatically induced vasospasm was studied in an in
      vivo model of the rabbit ear artery. Spasm was induced by standardized
      compression of a 3.2 mm segment of the artery for 3 s. The internal diameter was
      continuously measured with the aid of an operating microscope during
      transillumination of the artery. Measurements were begun before spasm induction
      and continued until the spasm was completely resolved. Spasm was first induced at
      normothermia and then after reduction of the body temperature by 1.0 degrees C
      and 1.75 degrees C. The spasm was evaluated in terms of its duration, intensity
      (% reduction of initial diameter) and severity (area under the curve where
      diameter was plotted against time). The results were compared with those in a
      control group which was kept normothermic. Reduction of the body temperature
      caused a significant increase in the duration of the spasm and increased its
      severity, but did not influence its intensity.

PMID- 2219563
TI  - EMLA for pain relief during arterial cannulation. A double-blind, placebo
      controlled study of a lidocaine-prilocaine cream.
AB  - The aim of the study was to evaluate the effect of a lidocaine-prilocaine cream
      (EMLA cream, Astra) in relieving pain during arterial cannulation. The study had
      a random, double-blind, placebo-controlled design and included altogether 90
      patients. All the patients were premedicated with an opioid before cannulation.
      An EMLA application time of 60 minutes was used in 60 patients (30 EMLA/30
      placebo) and there was no difference in the pain reaction measured on a visual
      analogue scale (VAS) or on an observer's verbal scale. The study was extended
      with a further 30 patients (15 EMLA/15 placebo) with an application time
      exceeding 90 minutes. Between these groups pain experience measured by VAS did
      not show any significant difference although the mean value was lower in the EMLA
      group. Observer ratings showed a significant (p less than 0.01) difference in
      distribution towards lower ratings in the EMLA group. In conclusion EMLA was
      found to have a weak, but measurable effect when the application time exceeded 90
      minutes but not after 60 minutes.

PMID- 2219564
TI  - Immune status and immune therapy of renal cell carcinoma.
AB  - At present, no sufficient therapy for metastatic renal cell carcinoma is
      available. Several immunotherapeutical protocols have been studied, success
      rates, however, were inconsistent. The purpose of this study was to assess the
      pretherapeutic immunological status of 13 patients with metastatic and 16
      patients with nonmetastatic renal cell carcinoma and of 15 healthy volunteers.
      Determined were differential blood counts, lymphocyte subpopulations, beta 2
      microglobulin, tumor necrosis factor (TNF), neopterin, immunoglobulin,
      fibronectin and ferritin. Additionally, these parameters were recorded for
      monitoring an immunotherapeutical approach with the xenogeneic biological
      response modifier Keyhole limpet hemocyanine (KLH) in 10 patients with metastatic
      and in 5 patients with nonmetastatic disease. The pretherapeutic immunological
      status of patients with metastatic disease was characterized by significantly
      reduced T4-, T8- and B-cell counts. Significantly increased were granulocyte
      counts, beta 2-microglobulin, neopterin and TNF. In patients who did not suffer
      from metastases, only beta 2-microglobulin and neopterin were increased
      significantly. During immunotherapy, in patients with metastases, there was a
      decline of lymphocyte subsets and of the T4/T8-ratio, which correlated with
      progress of the disease. Humoral immune parameters showed no changes compared to
      pretherapeutic values. In patients who did not suffer from metastases, cellular
      immune parameters showed stable values during immunotherapy; neopterin, beta 2
      microglobulin and TNF increased considerably. These findings indicate
      immunosuppression in patients with metastatic renal cell carcinoma, increasing
      with progression of the disease and possibly impairing the immunostimulating
      effects of biological response modifiers during immunotherapy. In conclusion, the
      clinical response of metastatic renal cell carcinoma to immunotherapy might be
      improved if the immunostimulant is combined with agents suitable to overcome
      immunosuppression, i.e. low doses of cyclophosphamide or inhibitors of
      prostaglandin synthesis. In addition, assessment of immune parameters for
      monitoring the actual immune status of a patient and the immunological effects of
      therapy was found to be a necessary part of immunotherapy.

PMID- 2219565
TI  - Effects of nifedipine on renal cortical and medullary blood flow in two-kidney,
      one-clip renovascular hypertension in rabbits.
AB  - The effects of nifedipine, a calcium antagonist, on blood pressure and renal
      regional blood flow were investigated in two-kidney, one-clip renovascular
      hypertensive rabbits. At 1 week after left renal artery constriction, in the
      constricted group, systemic blood pressure (BP) significantly rose with the
      elevation of plasma renin activity (PRA). In both kidneys, renal vascular
      resistance (RVR on the constricted group was significantly increased as compared
      to that in the control group. In the clipped kidney, total renal blood flow (RBF)
      and renal cortical blood flow (RCBF) of the constricted group were significantly
      decreased, while renal medullary blood flow (RMBF) remained at the control value.
      In the nonclipped kidney, RBF and RCBF of the constricted group did not
      significantly change, and RMBF was significantly increased as compared to that of
      the control group. After administration of nifedipine for 1 week (1.0 mg/kg/day),
      BP in the constricted group was decreased to the control level and PRA in both
      groups was increased. The percent change of BP in the constricted group was
      significantly decreased and the percent change of PRA in the constricted group
      was significantly increased as compared to those in the control group. Nifedipine
      increased RBF, RCBF and RMBF and decreased RVR of both kidneys in each group. In
      the nonclipped kidney, the percent change of RBF, RCBF and RMBF of the
      constricted group was significantly increased and the percent change of RVR was
      significantly decreased as compared to those of the control group. In the clipped
      kidney, only the percent change of RBF of the constricted group was significantly
      lower than that in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2219566
TI  - Cancer incidence in patients on chronic dialysis and in renal transplant
      recipients.
AB  - A markedly increased incidence of cancer in renal transplant recipients is now
      recognized; to determine if immunosuppression alone may be responsible for this
      increase in risk, cancer incidence was compared in 709 renal transplant
      recipients and 317 dialysis patients. Malignancy developed in 19 transplant
      recipients (2.7%) and in 33 patients on chronic dialysis (10.4%). In our report
      an excess of skin cancer was observed in the transplant series while tumors of
      the urinary tract were seen more frequently in patients on dialysis.
      Transplantation and consecutive immunosuppression does not appear to constitute
      an additional cancer risk for the uremic patient who is faced with the
      alternative to undergo chronic dialysis or renal transplantation.

PMID- 2219567
TI  - Effects of various acidic and alkaline solutions used to dissolve urinary calculi
      on the rabbit urothelium.
AB  - It is well known that infection-induced stones (apatite, struvite), uric acid and
      cystine calculi in the urinary tract can be managed by the use of certain
      chemical solutions. We investigated the effects of various acidic and alkaline
      solutions on the rabbit urothelium. Acidic solutions (pH: 4.2) caused more
      urothelial injury as compared to alkaline solutions (pH: 7.6). Ureteral injury
      was more severe than the bladder injury. Magnesium-containing solutions caused
      less injury to the urothelium.

PMID- 2219568
TI  - Precipitation of struvite in urine medium by urease-positive and urease-negative
      Yersinia strains.
AB  - Yersinia strains either urease-positive or urease-negative were examined for
      precipitation of struvite in human urine at 25 and 37 degrees C. All urease
      positive strains and 8 out of 10 urease-negative strains showed the ability to
      produce these crystals. Incubation time required for precipitation was longer for
      urease-negative strains and quantity of struvite formed was higher in urease
      positive ones. Regarding incubation temperature, no significant influence has
      been observed.

PMID- 2219569
TI  - Traumatic dislocation of the testes.
AB  - Traumatic dislocation of the testis is an unusual disorder. A case of bilateral
      traumatic dislocation of the testes is presented. Ultrasound examination is very
      useful for determination of the preoperative diagnosis and management of the
      dislocated testis.

PMID- 2219570
TI  - Carcinosarcoma of the spermatic cord.
AB  - The first case of carcinosarcoma in the spermatic cord is reported in a 40-year
      old man. The tumor was a 2.5 X 2 cm pseudoencapsulated formation located in the
      connective tissue of the spermatic cord among the blood vessels. Light microscopy
      examination of the neoplasm revealed two different histological patterns:
      epithelial and sarcomatous. Mitoses and atypias were infrequent in both types of
      areas. The epithelial cells formed papillary and gland-like structures stained
      with PAS, Hale and mucicarmine stains, and showed positive reaction for
      immunohistochemical demonstration of both keratin and epithelial membrane
      antigen. The lumen content of the gland-like structures reacted positively for
      the carcinoembryonic antigen. Electron microscopy revealed that the epithelial
      cells were joined by junctional complexes and displayed numerous short
      microvilli. The sarcomatous areas consisted of spindle cells embedded in a ground
      substance that occasionally presented myxoid changes. Mast cells and focal
      calcifications were seen. Sarcomatous cells showed positive reaction for vimentin
      but not for the other histochemical and immunohistochemical techniques mentioned
      above. The ultrastructure of sarcomatous cells was similar to that of epithelial
      cells except for the occurrence of small desmosomes instead of junctional
      complexes. The differential diagnosis with adenomatoid tumor and malignant mixed
      mesothelioma is discussed.

PMID- 2219571
TI  - Early detection and treatment of localized carcinoma of the prostate.

PMID- 2219572
TI  - Natural history of low-stage prostatic cancer and the impact of early detection.
AB  - An expanding and increasingly older population, a rising incidence of prostate
      cancer, and uncertainties regarding treatment effectiveness have made this
      disease a target of special concern. The natural history of the cancer must be a
      consequence of host-tumor interactions, but little is known for sure about this
      subject. The growth rate of the tumor is determined by many factors, including
      genetic instability. At present, tumor grade, volume, and ploidy are the most
      useful techniques for judging the growth rate and metastatic potential. Stage A1
      tumors generally are indolent, whereas stage A2 tumors are more aggressive. The
      natural history of stage B lesions is not well documented. The author asks two
      questions (Is cure necessary in those in whom it may be possible? Is cure
      possible in those in whom it may be necessary?) and reviews the problems inherent
      in screening for prostate cancer at this time.

PMID- 2219573
TI  - Epidemiology of prostate cancer.
AB  - Available epidemiologic data do not allow targeting of specific populations for
      prostate cancer screening or early detection programs. Although certain strong
      factors have been identified (age, race, location), none sufficiently defines
      high-risk groups in whom recommendations should differ from those of other age
      matched patients. Certainly, a strong familial tendency has been identified, but
      the relative contribution of genetic and environmental factors in these patients
      remains unclear. Some hypotheses on the pathogenesis of prostate cancer are
      possible based on the available data. Genetic factors appear to be permissive, as
      are hormonal influences, which are partially regulated by genetics. Environmental
      factors appear to be promotional in genetically susceptible men. Dietary fat may
      also be an important promotional factor in genetically susceptible men. Dietary
      factors appear to exert some influence by modulating sex hormone concentration.
      Several factors demand more investigation and understanding of the epidemiology
      of prostate cancer. The relative frequency of the disease and the increasing
      death rate from prostate cancer are of concern. The similarities in the incidence
      of latent prostate cancer among various groups with strong differences in the
      rate of clinically apparent disease raise significant issues regarding potential
      lifestyle or environmental promotional factors. Further understanding of the
      pathogenesis of prostate cancer may allow a refinement and definition of programs
      for prevention and early detection of the disease.

PMID- 2219574
TI  - Digital rectal examination in the early detection of prostate cancer.
AB  - Screening using digital rectal examination improves the clinical stage
      distribution of prostate cancer and prolongs survival. Unfortunately, digital
      rectal examination may not be sensitive enough to detect the small-volume tumors
      that are most amenable to cure. In several studies, approximately 50 per cent of
      cancers detected through screening had already spread beyond the prostate.
      Regardless, the key to demonstrating overall benefit from screening is a
      diminished disease-specific mortality rate. To date, this has not been shown.
      Lower mortality rates from prostate cancer can be demonstrated only through a
      randomized study comparing screened and unscreened populations. Such a study,
      which has recently been approved and funded by the National Institutes of Health,
      will require 10 to 15 years to complete. Until that time, the value of screening
      for prostate cancer by digital rectal examination or any other method will be
      unknown. Beyond a lack of proved benefit, screening for prostate cancer may be
      harmful because of the variable natural history of the disease and the morbidity
      and mortality rates associated with treatment. There exists a large population of
      patients with pathologically detectable prostate cancer who will never have
      clinical disease. The detection of some of these tumors may expose those patients
      to the risks of unnecessary treatment. Large-scale prostate cancer screening
      studies may ultimately be shown to be advantageous. The sooner this occurs, the
      earlier aggressive screening can be advocated, similar to screening for breast
      cancer. However, the temptation to embark on such screening programs without
      first demonstrating clear benefit should be resisted.

PMID- 2219576
TI  - Management of stage A prostate cancer.
AB  - Transrectal ultrasonography has defined a new category of stage A disease, namely
      nonpalpable lesions diagnosed by needle biopsy. How this type relates to classic
      stage A disease is unclear. Stage A1 carcinoma becomes clinically significant
      only in a distinct minority of patients, and even in this group, progression does
      not necessarily mean significant morbidity or death from prostate cancer. An
      aggressive approach is not justified. In contrast, stage A2 cancer is usually
      virulent, and aggressive therapy with curative intent is justified in patients of
      appropriate age and health. Both radical prostatectomy and external irradiation
      appear to provide long-term survival rates superior to those obtained with
      observation alone, but nearly 20% of these patients will die of cancer despite
      therapy. Unfortunately, forecasting the outcome in an individual case is still
      not possible, and efforts to identify prognostic features must continue. In the
      meantime, emotional arguments in favor of the treatment of all discovered cancers
      must be suppressed by an informed and objective understanding of the natural
      history of nonpalpable prostate cancer and the potential impact of treatment.

PMID- 2219575
TI  - Transrectal ultrasonography for the early detection and staging of prostate
      cancer.
AB  - Relatively recent changes and improvements in equipment have vastly increased
      image resolution for transrectal ultrasonography of the prostate. The expanded
      use of transrectal ultrasonography has greatly furthered knowledge of prostate
      zonal anatomy and permitted clinical evaluation of internal prostate
      architecture. The technique is operator dependent, as the quality of the results
      is related directly to that person's knowledge and experience. The significant
      majority of prostate cancers originate from the peripheral zone. Palpable stage B
      nodules characteristically have a hypoechoic appearance. There is disagreement
      about the tumor characteristics that cause hypoechogenicity, but large tumors may
      obscure the normal prostate anatomy and appear isoechoic because of the lack of
      contrast with surrounding prostate tissue. The transition zone of the prostate is
      the origin of benign prostatic hyperplasia and almost 20 per cent of prostate
      cancers. These tumors probably correspond to most stage A lesions. Transrectal
      ultrasonography is less accurate in identifying transition zone tumors because of
      the mixed echogenicity of the transition zone, interference from prostatic
      calculi or calcified corpora amylacea, and poorer image resolution in this area.
      Studies evaluating the use of transrectal ultrasonography for early detection of
      prostate cancer generally have shown a twofold increase in the detection rate
      compared with digital rectal examination. However, the decreased morbidity and
      expense of transrectal prostate biopsy using an automatic gun device have
      increased the frequency of biopsy in ultrasound-examined patients compared with
      those historically evaluated by digital rectal examination. The increased
      detection rate may in part be a function of the increased use of biopsies,
      independent of other factors. Transrectal ultrasonography rarely detects cancer
      in patient with normal digital rectal examination and a normal serum prostate
      specific antigen level. Transrectal ultrasonography may be capable of identifying
      early capsular penetration or seminal vesicle invasion in some patients with
      known prostate cancer. However, its superiority to digital rectal examination for
      this purpose has not been demonstrated unequivocally. Ultrasonography does allow
      directed biopsies of the seminal vesicles or other suspect areas, and this may be
      helpful in staging the disease. The use of transrectal ultrasonography in
      prostate cancer has evolved rapidly, and changes in technology antiquate reports
      within a few years.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2219577
TI  - Radiation therapy for localized prostate cancer. Justification by long-term
      follow-up.
AB  - In the series presented here, survival patterns at 15 years after radiotherapy
      for patients with clinical stage A carcinoma of the prostate did not deviate
      significantly from those of an age-matched peer group. For patients with clinical
      stage B disease (nodular disease that did not exceed involvement of one lateral
      lobe), survival was only 5% less at 15 years than for the age-matched group of
      California men. This was in spite of the fact that the lymph node status and the
      true incidence of capsular penetration were unknown. Moreover, the patients were
      not stratified by histopathologic grade or by either acid phosphatase or prostate
      specific antigen values. If one were to restrict the patients to those with
      intermediate and low Gleason scores, normal acid phosphatase, and low prostate
      specific antigen values, it is likely that there would have been no difference
      between the survival of those with prostatic cancer and their age-matched peers.
      As one deviates from these conservative selection criteria and includes patients
      with more advanced stages, the likelihood of achieving 15-year survival
      diminishes. With radiation treatment, however, patients whose disease, by
      clinical examination, extends beyond the prostate and who seem too advanced for
      radical prostatectomy still may have a 20 per cent to 30 per cent chance of 15
      year survival.

PMID- 2219579
TI  - Patient selection for, results of, and impact on tumor resection of potency
      sparing radical prostatectomy.
AB  - Our results show that by using the nerve-sparing radical retropubic
      prostatectomy, potency can be preserved in the majority of appropriately selected
      patients without compromising the adequacy of tumor excision. However, proper
      patient selection is important. Patients with focal, well-differentiated tumors,
      especially young patients with stage A or B1 tumors, are ideal candidates. In
      patients with more extensive and less well-differentiated tumors, there is a
      higher risk of incomplete tumor excision. Although we suspect that the adequacy
      of tumor excision is determined more by the extent of the tumor than by the
      technique of radical prostatectomy used, we believe that nerve-sparing surgery
      should be used with great caution, if at all, in patients with extensive or high
      grade tumors. In these patients, microscopic extracapsular tumor extension is
      extremely common, can be impossible to detect at the time of operation, and is
      less likely to be adequately encompassed by nerve-sparing techniques. On the
      other hand, our current data provide little evidence that excision of the
      neurovascular bundles is beneficial. It is possible that more extensive
      resections will not materially alter the incidence of positive margins or cure
      rates. Finally, it might be argued that all forms of radical prostatectomy are
      inappropriate for patients with poorly differentiated clinical stage B2 prostate
      cancer for whom there are no really effective treatment options. We continue to
      recommend radical prostatectomy for these patients based on the finding that
      patients with clinical stage B2 disease who have organ-confined tumors can be
      expected to have excellent long-term disease-free survival rates similar to those
      of clinical stage B1 patients. In the remaining patients who are clinically
      understaged, the prospects for the minimal microscopic tumor remaining being
      controlled with adjunctive radiation therapy may be better than those of
      controlling the bulky primary tumor with radiation therapy alone. This hypothesis
      will need to be tested in a randomized clinical trial.

PMID- 2219578
TI  - Significance and treatment of positive margins or seminal vesicle invasion after
      radical prostatectomy.
AB  - The periprostatic soft-tissue involvement described in the older urologic
      literature differs from that now recognized; a much "earlier" pathologic stage C
      is being identified. Apparent microscopic extension of the cancer to the margin
      of the specimen yields an approximately 25% risk of local recurrence.
      Postoperative radiation apparently is effective in reducing this risk, and if
      patients are properly selected, such treatment is well tolerated. Whether
      adjuvant radiation affects overall survival is not known. New observations on
      pathologic extension of the disease need to be refined.

PMID- 2219580
TI  - The case for no initial treatment of localized prostate cancer.
AB  - This contribution summarizes the evidence from the natural history and pathology
      of this disease that, given the high incidence of latent cancer, a policy of
      radical treatment at diagnosis will represent over-treatment in the majority of
      cases. As yet, neither radical prostatectomy nor radical radiotherapy has been
      shown to be effective in managing the poorly differentiated tumor in the patient
      with "localized" disease. For the patient with well-differentiated disease, there
      is little evidence that early treatment is mandatory, because the majority of
      these patients will not die of prostatic cancer. The adoption of a policy of
      diagnosis followed by active surveillance would spare many patients the hazard
      and discomfort of a major operation or of a course of radiotherapy, would
      minimize expenditure, and would ensure that treatment was given only to those
      patients in whom progression had been demonstrated. Such an approach is almost
      certain to be as effective as treatment at diagnosis. Confirmation of this view
      is likely to be obtained from the existing studies of immediate versus delayed
      orchiectomy or LHRH therapy currently being undertaken by the Urological Working
      Party of the Medical Research Council in the United Kingdom and the Urological
      Group of the EORTC within Europe.

PMID- 2219581
TI  - Local failure and related complications after definitive treatment of carcinoma
      of the prostate by irradiation or surgery.
AB  - The authors review their institution's experience with the failure of definitive
      treatment to achieve local tumor control and with the distant dissemination and
      local morbidity associated with such failure. The causes of local failure are
      various: incomplete resection, implantation of spilled cells, and, possibly,
      selective implantation of circulating tumor cells in traumatized tissues after
      surgery and totally or partially resistant cells, new tumors, or radiologic
      misses after radiation. Treatment of local failure may be prophylactic or
      therapeutic and differs depending on the stage of the disease. Failure to control
      the tumor locally in the presence of distant metastases does not alter the length
      of survival, but it can profoundly affect the quality of survival.

PMID- 2219583
TI  - New concepts in the treatment of stage D1 adenocarcinoma of the prostate.
AB  - Stage D1 disease will be encountered in 20 per cent of patients by those who
      treat prostate cancer. There is marked heterogeneity among cancers discovered at
      this stage, with 5-year disease-free survival rates ranging from 0 to 95 per
      cent. Generally, when prostate cancer has escaped the confines of the gland,
      metastasis occurs, and widespread systemic disease prevails. Any significant
      chance for long-term cure will then depend on systemic therapy. From maturing
      data in retrospective reviews, preliminary data from prospective trials, and
      recent well-conducted animal studies, chemotherapy and hormonal deprivation
      appear most effective when tumor volumes are the smallest. This evidence supports
      the removal of all cancer possible and the early institution of systemic
      treatment. Caution must be exercised in extrapolating the aforementioned evidence
      to include cases of more extensive prostate cancer (i.e., patients with bulky
      pelvic or retroperitoneal disease, distant metastasis, or significant elevation
      of serum markers). It is doubtful that "debulking" with removal of the prostate
      and lymph nodes will provide any justifiable advantages in these patients.
      Whether removal of the prostate affords any local palliative benefit is an issue
      for debate. Certainly, the primary tumor, if left untreated, will progress
      locally and cause symptoms necessitating further procedures in more than half
      these patients, whereas the incidence of local recurrence and the adverse effects
      of these recurrences in patients with D1 disease after radical prostatectomy and
      adjuvant therapy is less than 10 per cent. Surgical refinements coupled with
      acceptably low morbidity now associated with radical prostatectomy have led some
      authors to endorse the palliative benefits of removing the primary tumor in
      selected patients. The purpose of this article is not to endorse or disparage the
      aggressive treatment of patients with stage D1 prostate cancer. The evidence
      suggests that if long-term survival is the endpoint used to compare treatment
      groups, then to date no treatment option offers significant advantages. On the
      contrary, if progression rates or disease-free survival are compared, then
      cytoreductive surgery and early systemic adjuvant treatment (testosterone
      deprivation or chemotherapy) provides significant advantages for selected
      patients with stage D1 disease. Although ploidy analysis, receptor mapping, and
      oncogene assays are promising, today, there is no practical way to identify
      patients who will benefit most from multimodality treatment approaches.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2219582
TI  - Current options in the management of clinical stage C prostatic carcinoma.
AB  - The evaluation of clinical stage C prostatic cancer has been enhanced by advances
      in staging modalities over the past 15 years. Better staging of the local lesion
      is possible with transrectal ultrasound-guided multiple biopsies of the prostate
      and its vicinity. Biopsies of suspect pelvic lymph nodes guided by CT (or
      lymphangiography) may obviate pelvic lymphadenectomy, particularly in patients
      with high-grade stage C lesions. Advances in the understanding of serum markers
      have supplemented other staging information. No single therapeutic modality is
      appropriate for all cases of clinical stage C cancer. In C1 lesions, radical
      prostatectomy with adjunctive radiation or hormonal therapy seems to produce the
      best 5- and 10-year survival rates. External-beam radiation alone, or in
      combination with interstitial radiation, may have equivalent success. In clinical
      stage C2 disease, external-beam radiotherapy seems at present to be the best
      therapeutic modality. Interstitial radiation as a sole method of management in
      stage C disease carries a high local recurrence rate and a significant risk of
      metastatic progression. Transurethral prostatectomy and hormonal treatment
      continue to have a place in the management of selected poor-risk patients. The
      current results with surgery or radiation therapy alone are less than ideal. It
      is recommended that aggressive combination treatment be compared with monotherapy
      in randomized clinical trials monitored jointly by radiation and urologic
      oncologists.

PMID- 2219584
TI  - Flow cytometry in carcinoma of the prostate.
AB  - Flow cytometry is a quantitative cytologic technique with demonstrated utility in
      the assessment of prostate cancer as well as other tumors. The authors summarize
      current data on its use in disease detection and diagnosis, prognostic
      evaluation, and monitoring of response to therapy. They also project future
      developments.

PMID- 2219585
TI  - Current management of varicoceles.
AB  - In spite of all that has been written about the varicocele, it is still not clear
      who will benefit from occlusion of the spermatic vein or why improvement in semen
      takes place in some patients but not in others. Because fertility is usually
      assessed in the framework of a couple who are trying to establish a pregnancy, it
      is important to evaluate both partners before making any recommendations
      regarding therapy. If the man is found to have a varicocele and semen analyses
      that indicate deficits in either the quantity or quality of the sperm, surgical
      ligation or transvenous occlusion should be considered as one appropriate form of
      therapy. Varicocele ligation and embolotherapy both can be performed as an
      outpatient procedure with minimal morbidity and equal effectiveness regarding
      pregnancy outcome. The cost, if the procedures are done in an outpatient
      facility, should be approximately equal. The obvious benefits of the percutaneous
      technique are a slightly lower recurrence rate and a more rapid return to full
      physical activity. The surgical procedure described by Marmar and associates
      appears to have a similar rate of recurrence and short postoperative period of
      recovery. Greater experience by more urologists using this technique needs to be
      gained to compare it adequately with the other methods described. Varicocele
      ligation by the inguinal or retroperitoneal routes is familiar to most urologists
      and does not require the operating microscope or other special instruments. With
      greater understanding of the venous anatomy and with careful dissection, the
      persistence and recurrence rate can be acceptably low and the postoperative
      recovery relatively rapid and smooth.

PMID- 2219586
TI  - Enhanced in vivo cytotoxicity of recombinant human tumor necrosis factor with
      etoposide in human renal cell carcinoma. Evaluation in a pre-clinical model.
AB  - The combination of tumor necrosis factor (TNF) and etoposide (ETP) was evaluated
      for potential cytotoxic efficacy against a human renal cell carcinoma xenograft
      using an in vivo assay employing an athymic mouse host with tumor implanted a the
      subrenal capsule site. Both antitumor efficacy (relative survival or RTS) and
      toxicity (weight loss) of TNF and ETP alone and in combination were evaluated.
      While TNF and ETP alone were mildly inhibitory (RTS 90% and 71%, respectively),
      the combination caused marked tumor inhibition (45% of controls). Host toxicity
      encountered with the combination did not exceed the toxicity associated with ETP
      alone, suggesting that the therapeutic index may have been augmented. It is
      concluded that enhanced antitumor activity without substantial augmentation of
      toxicity is observed with this combination, providing a rationale for further
      evaluation of tumor necrosis factor-based regimens for the treatment of advanced
      renal carcinoma.

PMID- 2219587
TI  - Expression of ras gene family as result of compensatory renal growth in mice.
AB  - We have examined several gene expressions during the process of compensatory
      renal growth in mice following unilateral nephrectomy. On the 3rd, 5th and 7th
      days after operation in young mice (age: 5w), unilateral nephrectomy induced
      weight gain of the remaining kidney, but not in adults (age: 15w). It also
      induced maximum expression of c-H-ras and c-K-ras on the 3rd day in both young
      and adult mice, but there was no increase in N-ras in either. The expression
      levels of c-H-ras and c-K-ras were higher in young mice than in adults. However
      no expression of c-myc was detected at any point. Expression of metallothionein-I
      (MT-I) gene was detected during the first 12 h after unilateral nephrectomy both
      in the liver and the contralateral kidney. These data suggest that c-H-ras and c
      K-ras gene expressions are in some way related to compensatory renal growth in
      mice and may be strongly related to hyperplasia in the contralateral kidney.

PMID- 2219588
TI  - Damaging effects of high energy shock waves on cultured Madin Darby canine kidney
      (MDCK) cells.
AB  - Shock wave lithotripsy (ESWL) has become an almost non-invasive standard
      treatment modality for urolithiasis. Several investigations, however,
      demonstrated that ESWL is not completely free of side effects. Among others
      alteration of renal tubular function has been reported. To study the effect of
      shock waves on tubular cells directly an in-vitro model with cultured Madin Darby
      Canine Kidney (MDCK) cells was established. Suspensions of MDCK cells (7 groups
      of 6 containers each) were exposed to 0, 16, 32, 64, 128, 256 shock waves
      (Dornier HM4, 18 kV). Before and 0, 1, 3, 6, 9, 12, 24 h after ESWL the following
      parameters were measured in the nutrient medium: lactate dehydroxygenase (LDH),
      glutamate oxalacetate transaminase (GOT), electrolytes. LDH and GOT increased
      depending on the number of shock waves indicating a membrane damage of MDCK
      cells. The MDCK model seems suitable for further studies on the effect of shock
      waves on renal tubular cells.

PMID- 2219589
TI  - Ultrastructural visualization of human bladder mucous.
AB  - Mucous within the urinary bladder appears to play a protective role in shielding
      the uroepithelium against pathogens. This present study employs specific anti
      mucous, antisera stabilization techniques to visualize a thin, continuous layer
      of mucous closely adherent to the human bladder uroepithelium, in both scanning
      and transmission electron microscopic analyses.

PMID- 2219590
TI  - Anti-tumor effect of intravesical instillation of OK432 against rat bladder
      tumors induced by N-butyl-N-(4-hydroxybutyl) nitrosamine.
AB  - The anti-tumor effect of OK432 instilled into the bladder was evaluated in rat
      bladder tumors induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN). In
      experiment I, the rate of the natural killer (NK) activity was determined with
      cells from spleen and mesenteric lymph nodes. Intravesical OK432 instillation
      enhanced NK activity; however, this activity was not dose-dependent and was not
      augmented by OK432 inoculation into the foot pad. In experiment 2, the
      therapeutic effect of intravesical OK432 instillation was examined in rat bladder
      tumors induced by BBN. OK432 was instilled weekly for six weeks. Rats given BBN
      for 10 weeks were divided into six groups: 1) control; 2) saline; 3) OK432 0.05
      KE/ml; 4) OK432 0.05 KE/ml bladder instillation with 0.01 KE/ml foot pad
      inoculation; 5) OK432 0.05 KE/ml, every other week; and 6) OK432 0.5 KE/ml.
      Weekly OK432 instillation significantly reduced tumor weight and the incidence of
      tumor development; however, this inhibition was not dose-dependent and was not
      enhanced by OK432 inoculation into the foot pad. In rats given OK432 weekly, the
      augmentation of NK activity and increase in tissue infiltrating lymphocytes were
      significant. These results suggest that intravesical OK432 instillation is
      effective in the management of superficial bladder tumors. The study further
      emphasizes that the dose and method of administration are critical variables in
      determining the efficacy of immunotherapy.

PMID- 2219591
TI  - Effects of alpha-difluromethylornithine on the development of deeply invasive
      urinary bladder carcinomas in mice.
AB  - alpha-Difluoromethylornithine (DFMO), was examined for its ability to suppress
      the development of invasive urinary bladder carcinoma in C3H/He male mice.
      Continuous administration of 0.2% DFMO in water following carcinogen treatment
      (0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine, BHBN, in drinking water for 8
      weeks) was effective in suppressing urinary bladder carcinomas (P less than 0.05)
      as compared with the control group. However, when comparison was made based on
      tumors involving the entire urinary tract, protective effects could not be
      demonstrated. Coadministration of DFMO (0.2%) and BHBN (0.01%) did not alter
      tumor induction by the latter. These results were in sharp contrast to the
      protective effects in rats. Since bladder tumors in rats are of low grade and
      superficial whereas those in mice are of high grade and deeply invasive, our data
      indicate that DFMO has little to no effects against the development of aggressive
      forms of bladder carcinoma.

PMID- 2219593
TI  - In vivo effect of 5 French bipolar and monopolar electrosurgical probes on the
      porcine bladder.
AB  - Previous in vitro studies have indicated bipolar electrosurgical probes would
      electrodesiccate tissue in a normal saline solution. This study applies similar
      sized monopolar and bipolar electrosurgical probes to porcine bladder in order to
      compare each probe's effect in vivo. The power delivered by each probe was
      calculated; the width and depth of the porcine bladder damage was measured and
      the volume of the damage calculated. The animals were sacrificed at 24, 48 and 96
      h post-procedure so that the amount of tissue destruction could be quantitated
      relative to the bladder's natural tissue reaction. The data shows the power
      (watts) delivered by the monopolar probe to be approximately six times that of
      the bipolar probe. Likewise, the area of bladder wall damage was larger with
      monopolar at all time periods sampled and showed significant differences at 24
      and 48 h. These studies indicate that in viable bladder, tissue bipolar probes
      will electrodessicate at a lower power and with less shortterm tissue damage.

PMID- 2219592
TI  - Absence of structural alterations of the multidrug resistance genes in
      transitional cell carcinoma.
AB  - Tumor DNA from 27 patients with treated or untreated transitional cell carcinomas
      of the urinary tract was screened for genomic alterations of the multidrug
      resistance genes in order to determine whether structural changes of these genes
      are important in primary urothelial tumors. None of the tumors showed evidence of
      amplification or rearrangements of either mdr1 or mdr2. The lack of amplification
      or rearrangements observed in these tumors suggests that structural alterations
      of the mdr1 and mdr2 genes are not important mediators of drug resistance in TCC.

PMID- 2219596
TI  - [Traumatology in urology].

PMID- 2219595
TI  - [Tumors in childhood. II. Neuroblastoma].

PMID- 2219594
TI  - Transforming growth factor beta-like activity in human hydrocele fluid.
AB  - In this study transforming growth factor beta (TGF-beta)-like activity in human
      hydrocele fluid was investigated. Inhibition of DNA synthesis of adult rat
      hepatocytes in primary culture and stimulation of colony formation of normal rat
      kidney (NRK) fibroblasts, clone 49F in soft agar were observed in all acidified
      hydrocele fluids and these activities were neutralized by the specific antibody
      raised against human native TGF-beta. In samples obtained from recurrent cases of
      hydrocele, TGF beta-like activity was observed in its active form (without
      acidification). These results suggest that human hydrocele fluid contains TGF
      beta-like activity and that the active form of TGF-beta in recurrent hydrocele
      fluid may be responsible for the recurrence of the disease even after repeated
      aspiration.

PMID- 2219597
TI  - [Injuries of the urogenital system].
AB  - Ultrasonography is accepted as a valuable screening method for the detection of
      renal trauma, although it does not make any functional contribution. Computerized
      tomography has replaced excretory urography for the evaluation of blunt renal
      trauma, because it makes more precise diagnosis possible. Arteriography is
      mandatory when injuries of the renal branch are suspected. The management of
      renal trauma should restore normal circulation and renal function and should
      preserve as much functioning renal tissue as possible. For renal contusion and
      minor cortical lacerations, even when there is a small extravasation of urine,
      conservative management is sufficient, while major cortical lacerations and
      injuries of the renal vessels require prompt operative methods. The
      classification of urethral ruptures is based on rectal palpation of the prostate,
      distribution and size of hematomas and urethrography. A primary catheter for
      diagnostic purposes is strictly contraindicated. Urinary diversion proximal to
      the urethral lesion is the primary therapeutic procedure, while the definite
      management of the ruptured urethra can be postponed. Injuries to the organs of
      the urogenital system are rarely life threatening, and in the case of multiple
      trauma their management can be adapted to fit in with the treatment of injuries
      to other vital organs. Nevertheless, diagnosis and adequate treatment of injured
      urogenital organs must not be neglected as long-lasting or permanent damage could
      result.

PMID- 2219598
TI  - [Results of the West German multicenter study "Urological traumatology"].
AB  - The West German Multicenter Study on Urological Traumatology ran from April 1984
      to December 1986. During this time, 19 departments of urology evenly scattered
      over the Federal Republic of Germany including Berlin (West) recorded and
      evaluated the data pertaining to a total of 385 patients (83% male, 17% female)
      with urogenital trauma. The distribution of the different mechanisms of injury
      demonstrates that 41% were due to traffic accidents; 13% each to accidents during
      sports and work; 8% to sexual activities; and 6% to violence. The trauma was
      slight in 40% of the cases, moderate in 21%, and severe in 39%. Of a total of 427
      urogenital injuries, 27% were combined with intra-abdominal and 24% with pelvic
      injuries. Renal injuries were recorded in 51%, ruptures accounting for 49% of
      these and contusions for 48%. Hilar lesions were observed in 7%, with complete
      destruction of the organ occurred in 6% of these cases. In all, 76% of these
      traumas were treated conservatively, while 8% each required surgical
      reconstruction and nephrectomy. Traumatic lesions of the urinary bladder,
      urethra, penis, and scrotum including the testes and accessory organs were
      recorded in about 10% each. Macrohematuria was seen with 73% of renal, 83% of
      urinary bladder, and 73% or urethral injuries. Microhematuria occurred with 24%,
      9%, and 13% of all cases, while no hematuria was ascertained in 3%, 5%, and 13%
      of renal, bladder and urethral traumas, respectively. The injury-related
      sensitivity of the different imaging methods was calculated at 95% for
      cystograms, 91% for retrograde urethrograms, and 83% for angiograms.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2219599
TI  - [Late sequelae after urogenital trauma. Results of follow-up studies].
AB  - In the course of the Multicenter Study on Urological Traumatology ("UMCEST"), 61
      patients who had been treated at the Departments of Urology of the Ludwig
      Maximilian University in Munich and the Heinrich Heine University in Dusseldorf
      were followed up. These included 39 patients with multiple trauma and 22 patients
      who had suffered isolated urological injuries. There were 45 patients with renal
      injuries, 7 with injuries to the bladder, and 11 who had presented with urethral
      injuries. Late complications were detected in 38% of the 45 patients with renal
      injuries. Of the 11 patients with urethral injuries, 6 suffered from urethral
      strictures, 9 from sexual dysfunction and 3 from incontinence. The 7 patients
      with bladder injuries had no late complications related to the bladder trauma.

PMID- 2219600
TI  - [Spontaneous kidney rupture].
AB  - Two cases of spontaneous rupture of the kidney are reported and the literature is
      reviewed. The clinical and pathological features of this uncommon disease and its
      treatment are discussed. In the first case the cause of retroperitoneal bleeding
      was a renal carcinoma, while in the second it was the result of renal metastases
      from gestational trophoblastic disease. The most common symptoms are an acute
      onset of flank or abdominal pain, macroscopic hematuria and a drop in the
      hemoglobin level. Resistance or a mass can be palpated. Ultrasound and
      radiological examinations allow visualization of a tumor or hematoma and mostly
      reveal the etiology of hemorrhage. An exploratory operation is necessary for
      diagnosis, and primary nephrectomy should be seriously considered.

PMID- 2219601
TI  - [The value of surgical therapy in the treatment of urogenital tuberculosis].
AB  - A series of 94 patients treated over a period of 22 years for genitourinary
      tuberculosis is reviewed. The group was made up of 72 patients with isolated
      urinary tuberculosis, 12 with isolated tuberculosis of the genitalia and 12 with
      combined disease. In 70 patients surgery was performed in addition to the
      standardized chemotherapy. Of the 72 patients with urinary tuberculosis, 21
      received exclusively conservative treatment, while 16 underwent conservative
      surgery and the remaining 35, ablational surgery. The high nephrectomy and
      overall operation rate is explained by the high percentage of advanced state of
      disease and a large number of patients referred to us for nephrectomy following
      long-term conservative treatment. A retrospective justification for this
      procedure is found in the fact that 52% of the surgical specimens showed florid
      tuberculosis though the patients had been receiving standardized chemotherapy for
      an average of 9 months.

PMID- 2219602
TI  - [Urological aspects of non-urological tumor in the lesser pelvis].
AB  - The surgical outcome in 30 patients with advanced pelvic malignancies of
      nonurological origin infiltrating the urinary tract was analyzed. The pelvic mass
      was totally removed by multivisceral resection in 15 patients, and incompletely
      removed in 11 patients; 4 patients underwent only palliative treatment in the
      form of urinary diversion, because of unresectable tumors. Mortality, morbidity,
      survival rates and quality of life were evaluated and showed significant
      differences. The best results were achieved in the group with complete excision
      of pelvic viscera. Patients treated with incomplete resection or palliative
      urinary diversion because of unresectable mass had a poor outcome.

PMID- 2219603
TI  - [Ambulatory carboplatin monotherapy in advanced seminoma].
AB  - Six patients with advanced seminoma (stage IIc) received single-agent carboplatin
      therapy. The drug was administered to outpatients without prior hyperhydration.
      All five patients who completed the regimen of three to four cycles achieved
      complete remission, which was confirmed histologically in four patients by
      retroperitoneal lymph node dissection. No severe side-effects were observed.
      Single-agent carboplatin therapy is a highly efficient regimen with very little
      toxicity. This treatment seems to be the therapy of choice in patients with
      advanced seminoma.

PMID- 2219605
TI  - Low incidence of asymptomatic brain metastases in patients with renal cell
      carcinoma.
AB  - Brain metastases from renal cell carcinoma are uncommon. The present study was
      undertaken to determine the value of routine computerized tomographic (CT)
      scanning of the brain in patients with renal cell carcinoma. A review of 106
      patients with renal cell carcinoma who had undergone CT scan of the brain
      revealed brain metastases in only 13.2 percent. Brain metastases were accompanied
      by central nervous system (CNS) symptoms in 78.6 percent of patients, with
      headaches constituting the most common presenting symptom (64.3%). Brain
      metastases were detected in only 3.3 percent of patients who had no CNS symptoms
      at the time of evaluation. It is concluded that CT scanning of the brain should
      be performed routinely only for those patients who report CNS symptoms at the
      time of evaluation.

PMID- 2219604
TI  - [Asymptomatic paraganglioma of the bladder wall with unusual extensive submucous
      vascular proliferation].
AB  - Paraganglioma of the urinary bladder is a very rare tumor, which is usually
      diagnosed on the basis of its endocrine symptoms because of the excretion of
      vasoactive substances. One case of asymptomatic paraganglioma detected by chance
      is described, it was misdiagnosed as hemangioma because of its marked
      suburothelial vessel proliferation.

PMID- 2219606
TI  - Is urethral sparing at cystectomy a safe procedure?
AB  - Urethrectomy is performed with cystectomy when the neoplasm is multifocal, at the
      bladder neck, or associated with carcinoma in situ (CIS). The records of the most
      recent 20 patients treated by radical cystectomy at our institution were
      reviewed. In 50 percent of the cases, the extent of disease within the bladder
      was found to have been underestimated to the point that a urethral sparing
      operation (i.e., to maintain urinary continence with an intestinal segment and an
      intact urethra) might have been dangerous.

PMID- 2219607
TI  - Neodymium:YAG laser treatment of bladder hemangiomas.
AB  - We present 3 cases of bladder hemangiomas, one single and two multiple, with a
      long-term history of recurrent hematuria, treated with endoscopic neodymium:YAG
      (yttrium, aluminum, garnet) laser photocoagulation, and obtaining good results.

PMID- 2219608
TI  - Allopurinol and thiazide effects on new urinary stone formed after discontinued
      therapy in patients with urinary stones.
AB  - We treated 87 patients with calcium-containing urinary stones with either
      allopurinol alone (44 patients) or in combination with thiazide (43 patients) and
      studied new stone formation before, during, and after the discontinuation of the
      drug therapy. The number of stones formed were 1.18, 0.24, and 0.13 before,
      during, and after discontinuation of the drug therapy, respectively, in the
      patients treated with allopurinol alone and 1.32, 0.20, and 0.09 in those treated
      in combination with thiazide. No differences were observed in these values and
      the duration of each observation period between the two groups. Decreases in the
      incidence of stone formation even after interruption of drug therapy suggested
      that recurrence-preventive effects observed following administration of these
      drugs include the effects of medical guidance. However, allopurinol therapy was
      effective in preventing recurrence in patients with hyperuricosuria.

PMID- 2219609
TI  - Squamous cell carcinoma antigen (TA-4) in penile carcinoma.
AB  - TA-4 antigen, originally isolated from women with squamous cell carcinoma of the
      cervix, is elevated in the sera of patients with squamous cell carcinomas of
      several sites, including esophagus, lungs, and head and neck. In this study, we
      compared the serum levels of TA-4 in normal volunteers, patients with resected
      penile squamous cell carcinoma, and patients with metastatic penile squamous cell
      carcinoma. TA-4 values were elevated in 5 of 11 patients (45%) who had metastatic
      disease. In 2, TA-4 was normal the first time metastasis was clinically detected
      but rose as the disease progressed. Moreover, in 3 patients in whom serial
      determinations were made, serum TA-4 values correlated well with disease
      progression and response to treatment. We conclude that TA-4 values are elevated
      in some patients with metastatic squamous cell carcinoma of the penis and may
      become a useful marker for monitoring response to therapy.

PMID- 2219610
TI  - Management of penile gunshot wounds.
AB  - The management of 10 cases of penile gunshot wounds treated at Henry Ford
      Hospital from 1982 to 1986 is reviewed. All patients were assaulted by low
      velocity weapons (handguns). Eight patients had associated injuries,
      predominantly to the genital region (thigh, pubis, and scrotum). There were 5
      urethral injuries; 4 were treated with primary repair, the remaining patient
      underwent delayed repair, complicated by severe urethral strictures requiring
      reoperation. Blood at the urethral meatus was suggestive of urethral injury but
      microscopic hematuria was not. Five penile injuries did not involve the urethra
      and were treated by debridement and primary wound closure with no immediate or
      delayed complications. In dealing with these injuries we recommend a high index
      of suspicion for urethral and regional organ injury and primary urethral closure
      if at all possible.

PMID- 2219611
TI  - Sex reversal syndrome (XX male).
AB  - Men who appear normal and live a normal life, may have a 46,XX karyotype and
      present with the typical features of infertility and end organ (testicular)
      failure. They are azoospermic and their small testicles show specific patterns on
      light and electron microscopy. Recent advances in genetics (1) favor the "X-Y
      interchange" theory to explain this phenomenon; (2) hypothesize about the roles
      of the H-Y antigen and testis determining factor (TDF) in determining "maleness";
      and (3) allow mapping of the relative positions of H-Y and TDF loci on the Y
      chromosome.

PMID- 2219613
TI  - Triorchidism--a reconstructive approach.
AB  - Testicular duplication is a relatively rare condition. A case is described in
      which conservative surgery was performed with reconstruction to produce a single
      testis.

PMID- 2219612
TI  - Renal abscess in children.
AB  - Three cases of renal abscesses in children are described to illustrate the
      variable presenting features. An additional 23 pediatric cases, reported over the
      past ten years, were reviewed for clinical features and therapy. Fever, loin
      pain, and leukocytosis were common presenting features, but less than half of all
      abscesses were associated with either an abnormal urinalysis or a positive urine
      culture. The presenting features were sometimes confused with appendicitis,
      peritonitis, or a Wilms tumor. An organism was identified in 17 cases-
      Escherichia coli in 9 children and Staphylococcus aureus in 8 children. The
      majority of E. coli infections occurred in girls and the majority of S. aureus
      infections occurred in boys. Reflux was documented in 5 patients, and 2 children
      had a possible extrarenal source of infection. Antibiotics alone produced a cure
      in 10 children (38%), but 16 children (62%) required a surgical procedure.

PMID- 2219615
TI  - Inverted papilloma of renal pelvis: flexible ureteroscopic diagnosis and
      treatment.
AB  - A case is reported of inverted papilloma of the renal pelvis in a patient with
      previous transitional cell carcinoma of the bladder. The renal pelvic lesion was
      diagnosed and treated with a flexible ureteropyeloscope. Although
      nephroureterectomy was avoided, the patient must be carefully followed
      endoscopically and radiographically for recurrence of lesions throughout the
      urinary tract. This case represents the first report of the endoscopic diagnosis
      and treatment of an inverted papilloma of the renal pelvis. It demonstrates the
      vast potential for endoscopic diagnosis, treatment, and surveillance throughout
      the urinary tract.

PMID- 2219614
TI  - Treatment of primary nocturnal enuresis by oral androgen mesterolone. A clinical
      and cystometric study.
AB  - A double-blind clinical study of 30 boys, six to ten years of age, with primary
      nocturnal enuresis was undertaken to assess the role of androgens in treating
      enuresis. The oral synthetic androgen mesterolone was selected because of its
      minimal potential toxic effects. Twenty boys were treated with mesterolone and 10
      received placebo. Fourteen boys (70%) became dry during treatment (20 mg daily
      for 14 days), and 5 (25%) remained dry for a follow-up period of four months.
      Increased cystometric bladder capacity and disappearance of uninhibited detrusor
      contractions were noticed in a significant number of cases after treatment. No
      side effects were recorded. Mesterolone has probably modulated the autonomic
      innervation of the vesical musculature with correction of the defective neural
      mechanism which is believed to be implicated in the pathogenesis of nocturnal
      enuresis.

PMID- 2219616
TI  - Improved early detection of recurrence in prostatic carcinoma following hormonal
      therapy. Combined use of palpation and fine needle aspiration cytology.
AB  - Fifty-nine hormonally treated prostatic carcinoma patients were prospectively
      followed by rectal examination and fine needle aspiration cytology at six-month
      intervals for periods ranging from six to one hundred twenty months (median
      follow-up 48 mos). The cytologic findings and clinical impressions were divided
      into four or five categories, respectively, ranging from benign to clearly
      malignant. Cytologic material and clinical descriptions suitable for evaluation
      were available for 306 follow-up examinations. Of these, 209 were cytologically
      benign (including 191 without and 18 with clinical evidence of malignancy). The
      remaining 97 examinations showed cytologic evidence of malignancy of which 50
      were clinically apparent (51.5%). While the correlation of clinical and cytologic
      findings was good (91.4%) in cases with no evidence of disease activity, our
      findings indicate that many recurrences which are occult to clinical examination
      may be detected by cytologic examination.

PMID- 2219618
TI  - Urothelial grafts in mice.
AB  - Mouse bladder epithelium has been successfully transplanted to the bladders of
      syngeneic mice and has survived for at least twenty weeks. The fate of the
      transplanted tissue was followed using a fluorescein label. The recipient
      bladders were prepared by stripping the urothelium either by a surgical or a
      chemical method. The possibility of adopting a comparable technique for the
      treatment of early bladder cancer in man is discussed.

PMID- 2219619
TI  - Acute aluminum toxicity after continuous intravesical alum irrigation for
      hemorrhagic cystitis.
AB  - An encephalopathy and cardiomyopathy developed in a seventeen-year-old girl with
      chemotherapy-induced renal failure while receiving an intravesical aluminum
      infusion for hemorrhagic cystitis. Premortem serum and postmortem tissue aluminum
      levels were markedly elevated. It is likely that her inability to excrete
      absorbed aluminum contributed to her death. Aluminum infusions should be used
      with caution in patients with renal failure.

PMID- 2219617
TI  - Staging of ureteral transitional cell carcinoma by CT and MRI.
AB  - Intravenous urography and retrograde pyelography are the primary radiologic
      studies for detecting ureteral carcinoma but give limited information regarding
      stage of disease. Computed tomography (CT) and magnetic resonance imaging (MRI)
      delineate the extent of ureteral carcinomas with a high degree of accuracy by
      depicting the periureteral fat and presence or absence of lymphadenopathy. In
      selected cases, CT and MRI are valuable for assessing the presence or absence of
      tumor in a ureteral stump and for the differential diagnosis of ureteral
      obstruction. Five cases of ureteral carcinoma and 2 cases of stump carcinoma are
      presented with preoperative CT and/or MRI evaluation and staging.

PMID- 2219620
TI  - Mumps orchitis.

PMID- 2219621
TI  - Uneventful delivery following series of successive treatments for virilized
      Cushing syndrome due to adrenocortical carcinoma.
AB  - A twenty-one-year-old virilized woman with Cushing syndrome due to a huge
      adrenocortical carcinoma was successively treated with trilostane (3 beta
      hydroxysteroid dehydrogenase inhibitor), subsequent adrenalectomy, and
      postoperative cis-platinum. Clinical or biochemical abnormalities peculiar to
      Cushing syndrome gradually subsided, and three and one-half years after the
      adrenal surgery, the patient delivered a normal female infant. This study points
      out some of the clinical and biochemical responses of each treatment.

PMID- 2219622
TI  - Single polypoid cystitis cystica and glandularis presenting as benign bladder
      tumor.
AB  - A case report of a ten-year-old boy with a benign polypoid bladder tumor is
      presented. The rarity of benign or malignant bladder tumors in children is
      reviewed, as well as the possible etiology of this unique lesion.

PMID- 2219623
TI  - Controlled vacuum chamber for standardized photographic documentation of penile
      erectile deformity.

PMID- 2219625
TI  - [The genetic contribution of cows to the prevalence of mastitis in the following
      generation].
AB  - Investigations of mastitis prevalence were performed in 1227 dam-daughter pairs
      during 1985-1988. From the records of the last 10 years, the findings concerning
      mammary gland were obtained. Six herds of agricultural co-operatives in the Brno
      region were investigated. In the early period the Bohemian Pied breed, later the
      crosses of this breed with Red Holstein and a low genetic proportion of Ayrshire
      cattle, dominated in the set of cows. Udder health was assessed using the
      clinical and bacteriological findings in individual udder quarters and the
      results of the rapid mastitis test NK. Based on this data, the cows were divided
      into two groups--resistant and susceptible. The lactation order in which the
      disease appeared for the first time was of great importance. The occurrence of
      the disease in daughters and udder health in dams were in a significant relation
      (P less than or equal to 0.01). While nearly 50% of daughters of susceptible dams
      were affected, it was only 25% in daughters of the resistant group. The
      assessment of heritability of resistance to mastitis was carried out on the
      principle of dam-daughter regression. The index of heritability h2 = 0.52 +/-
      0.06 was calculated. The results show that the genetic contribution of dams to
      the susceptibility of daughters to mastitis is significant.

PMID- 2219624
TI  - Transitional cell carcinomatous meningitis after M-VAC (methotrexate,
      vinblastine, doxorubicin, and cisplatin) chemotherapy.
AB  - The M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) regimen has
      been utilized at our two institutions to treat 17 patients with advanced stage
      transitional cell carcinoma of the bladder. We report 2 cases of carcinomatous
      meningitis resulting from metastatic transitional cell carcinoma which occurred
      in patients treated with M-VAC. Review of the literature suggests that our
      experience with central nervous system metastases is not unique, and that
      treatment of advanced stage transitional cell carcinoma of the bladder with M-VAC
      may enhance the incidence of meningeal metastases. Carcinomatous meningitis,
      although rare, is a rapidly fatal manifestation of metastatic transitional cell
      carcinoma if left untreated. However, prompt diagnosis and early aggressive
      therapy may result in palliation and stabilization of neurologic status. We
      review the pathophysiology, diagnosis, and treatment of transitional cell
      carcinomatous meningitis.

PMID- 2219626
TI  - [Determination of beta-lactamase production in strains of Staphylococcus aureus
      isolated from the milk of cows].
AB  - Determination of sensitivity to penicillin G by a standard disk assay diffusion
      method was compared with a iodometric method of test papers to determine beta
      lactamase production after Jorgensen in Staphylococcus aureus strains isolated
      from cow's milk from different farms. Out of 179 test strains, 32 strains 17.8%)
      were found to be well sensitive in the diffusion test; eight of these strains
      (25.0%) were demonstrated to produce beta-lactamase. 54 strains (30.2%) were
      sensitive. 27 strains (50%) of this group produced beta-lactamase. 93 strains
      (51.9%) were resistant to penicillin G in the diffusion test. 86 strains (92.5%)
      were found to produce beta-lactamase and seven strains were negative in this
      test. Using the diffusion test of sensitivity in these cultures, 86 strains were
      sensitive (48.1%) and 93 strains were resistant (51.9%). Beta-lactamase was
      produced by 121 strains (67.6%) and no beta-lactamase production was recorded in
      58 strains (32.4%). Differences in the results of both tests were manifest mainly
      in the set of strains qualified as sensitive (inhibition zone diameter 24 to 16
      mm) and well sensitive (inhibition zone diameter larger than 25 mm). The results
      indicate that the currently performed diffusion test of sensitivity to penicillin
      G should be accompanied by an assay of beta-lactamase production. The iodometric
      method of test papers is simple, rapid and cheap and can be made in any
      bacteriological laboratory. The high resistance of Staphylococcus aureus strains
      to penicillin G documents that this antibiotic is little efficient in the
      treatment of mastitis of this etiology in the given region.

PMID- 2219627
TI  - [Alkaline phosphatase activity in goblet cells in the small intestine of piglets
      experimentally infected with the coccidium Isospora suis].
AB  - Alkaline phosphatase activity (EC. 3.1.3.1.) in goblet cells was investigated in
      the small intestine of 16 gnotobiotic piglets infected one day after delivery
      (DAD) by different rates of oocysts of Isospora suis coccidia. At a high
      infection rate of I. suis (750,000) the goblet cells were found to be highly
      positive to alkaline phosphatase on day 3 to day 4 after infection (DAI). In
      piglets infected by a low infection rate of I. suis oocysts (100,000) the
      activity of alkaline phosphatase activity in goblet cells was proved on days 4 to
      10 after infection. In the first group of piglets, the positive goblet cells
      prevailed in the middle region of jejunum, with the peak on 4th DAI. It the
      second group of piglets a marked increase in the alkaline phosphatase activity
      was recorded in the goblet cells in the posterior part of jejunum on days 4 to 5
      after infection and on 10th DAI. No alkaline phosphatase activity in the goblet
      cells was demonstrated in the control gnotobiotic piglets at the age of two to
      seven days.

PMID- 2219628
TI  - [Superovulation induction in sheep using PMSG].
AB  - The effects of application of differentiated PMSG rates (Antex Leo, Denmark) were
      investigated in 30 ewes of the Slovak Merino breed in the period of May--June in
      experimental conditions on the induction of superovulation and on the speed of
      egg transport through the sexual organs. After administration of PMSG at rates of
      750, 1000 and 1500 i. u. per head/day, increases were recorded in the average
      weight of ovaries, number of large follicles and ovulations. Flushing the eggs
      from different parts of the sexual organs indicated that the higher the PMSG
      rate, the faster was the egg transport.

PMID- 2219630
TI  - Veterinary research--an exciting muddle.

PMID- 2219629
TI  - [The ependymal lining of the median eminence in goats].
AB  - Ependymal epithelium of eminentia mediana in goats, examined under a light
      microscope, was found to be formed by beta 2 tanycytes, basal processes reaching
      the surface of zona externa and bifurcating in zona interna. The thickest is zona
      interna, consisting of dense fibres of different arrangement. A scanning
      electrone microscope revealed that the structure of the ependymal surface of
      eminentia mediana in goats depends on the phase of sexual activity of a given
      individual. In female and male animals the findings are almost identical
      (ependymoresorption is prevailing) in the period of quiescence (anoestrus, out of
      the season, April); an analogical situation was observed in females and males in
      the period of mating (hyperependymosecretion, October, November). The ependymal
      surface of eminentia mediana in female animals has also a typical structure in
      the preparatory pro-estrous stage of sexual cycle, when the results were almost
      identical with those in a hermaphrodite (secretion and resorption are almost
      equilibrated). The occurrence of supraependymal cells on the surface of eminentia
      mediana is scarce. These cells are very similar to nerve cells as to their
      external morphological structure. The presence of supraependymal fibres on the
      surface of the bottom of the IIIrd cerebral ventricle can be explained only
      partly by the finding of supraependymal cells. The investigations revealed that
      the structure of the surface of the ependymal epithelium of eminentia mediana in
      goats is markedly differentiated according to the sex; this confirms the
      participation of tanycytes in the control of the reproductive cycle.

PMID- 2219631
TI  - Ten cases of bladder paralysis associated with sabulous urolithiasis in horses.
AB  - Bladder paralysis and sabulous urolithiasis were diagnosed in 10 horses with
      urinary incontinence. Additional neurological deficits in the hindquarters were
      detected in five of them. Treatment by catheter drainage and bladder lavage was
      unsuccessful, and all the horses were destroyed within 14 months of presentation.
      Neuritis of the cauda equina was diagnosed post mortem in one horse, but the
      cause of the paralysis was not identified in the others, although radiography
      revealed abnormal lumbosacral vertebral angulation in one case.

PMID- 2219632
TI  - A question of judgement.

PMID- 2219633
TI  - Animal identification.

PMID- 2219634
TI  - Dystocia in Friesian heifers.

PMID- 2219635
TI  - Klebsiella pneumoniae infection in chinchillas.

PMID- 2219636
TI  - Terminal ileitis in lambs.

PMID- 2219638
TI  - RAVC director.

PMID- 2219637
TI  - Blood sampling bitches for pregnancy tests.

PMID- 2219639
TI  - Sale and supply of veterinary medicines.

PMID- 2219640
TI  - Use of a uterine pessary to prevent infection of the uterus of the cow after
      parturition.
AB  - A uterine pessary containing penicillin, streptomycin, formosulphathiazole and
      ethinyloestradiol, was assessed for its efficacy in reducing the frequency and
      severity of uterine infections in cows after parturition. Fifteen pluriparous
      Holstein Friesian cows had pessaries inserted into the uterus within 24 hours
      after calving. Compared with 14 similar untreated cows there were significant
      reductions in the number infected by Actinomyces pyogenes and in the number
      exhibiting abnormal uterine discharges.

PMID- 2219642
TI  - Antibiotic residue in milk.

PMID- 2219641
TI  - Delayed drainage of neomycin from the uterus of mares susceptible to
      endometritis.

PMID- 2219644
TI  - Tail docking.

PMID- 2219643
TI  - Professions under attack.

PMID- 2219645
TI  - Welfare of exported livestock.

PMID- 2219646
TI  - Drastic measures.

PMID- 2219648
TI  - Efficacy of a baiting system for vaccinating foxes against rabies with vaccinia
      rabies recombinant virus.
AB  - The efficacy of a vaccinia-rabies recombinant virus (10(8) TCID50) contained in a
      machine-made baiting system has been tested in 22 captive young foxes which were
      divided into three experimental groups of six and a control group of four foxes.
      Each fox in groups 1, 2 and 3 were fed one, two and three vaccine-baits,
      respectively, on successive days. The four unvaccinated foxes were housed
      separately. As shown by the incorporation of a tetracycline biomarker into their
      bones, all the baited foxes ingested at least one bait. Thirty days after baiting
      seroconversion to rabies was observed in 15 (83 per cent) of the foxes and
      seroconversion to vaccinia in 14 (78 per cent). Sixteen of the 18 (89 per cent)
      baited foxes resisted a rabies challenge 30 days after baiting. One cub was
      protected against rabies despite the absence of detectable anti-rabies antibody.
      The results demonstrate that the bait-sachet system permits a good release of the
      virus suspension into the mouth.

PMID- 2219647
TI  - Analysis of peritoneal fluid as a diagnostic aid in grass sickness (equine
      dysautonomia).
AB  - The analysis of peritoneal fluid is of value in the differential diagnosis of
      equine colic but its characteristics have not been evaluated in grass sickness.
      Peritoneal fluid was collected from 15 normal horses and from 11 cases of medical
      colic, 11 cases of surgical colic, 20 cases of acute grass sickness and 13 cases
      of subacute grass sickness. The fluid was analysed for its appearance, total and
      differential white cell count, specific gravity, total protein concentration and
      total and intestinal alkaline phosphatase activity. Fluid from cases of medical
      colic was normal in these respects. Surgical cases were unique in having
      bloodstained fluid with a high alkaline phosphatase activity. Grass sickness
      cases had a higher specific gravity and protein content than the cases of medical
      colic although the appearance of the fluid was similar. Grass sickness cases were
      distinguishable from cases of surgical colic on the basis of the appearance of
      the fluid and its lower alkaline phosphatase activity.

PMID- 2219649
TI  - Detection of antibody to Salmonella enteritidis by a gm flagellin-based ELISA.

PMID- 2219650
TI  - Comparison of a dot-ELISA and a plate-ELISA for bovine brucellosis diagnosis.

PMID- 2219651
TI  - Dystocia in Friesian heifers.

PMID- 2219652
TI  - Role of veterinary nurses.

PMID- 2219653
TI  - Summer mastitis caused by Pasteurella haemolytica biotype A.

PMID- 2219654
TI  - Treatment of obese dogs.

PMID- 2219655
TI  - A comparative study on irritation and residue aspects of five oxytetracycline
      formulations administered intramuscularly to calves, pigs and sheep.
AB  - After intramuscular (IM) administration (dose 20 mg/kg) of three 20%
      (Terramycin/LA (product A), Alamycin LA (product B) and Terralon 20% LA (product
      C) and two 10% oxytetracycline (OTC) formulations (Engemycin 10% (product D) and
      Oxyject 10% (product E)), to calves, pigs and sheep, the OTC residue
      concentrations were determined in organs, muscle, fat, plasma, urine and at the
      injection sites at 10 days post injection (p.i.). At that time the irritation at
      the injection site was studied, too. The three 20%-formulations (products A, B,
      C) and one 10%-formulation (product E) induced considerable local irritation in
      and between the muscles. This was most pronounced in calves and pigs; in sheep
      the extent of irritation was limited. Ten days after administration of
      formulations A, B, C and E, OTC residues were found in organs and the OTC
      recovery at the injection sites varied widely among the three species. Following
      IM injection of product D minimal tissue irritation and no OTC residues could be
      detected at the injection site at 10 days p.i. The differences in local tissue
      irritation and the residue state of the carcass (including injection site) are
      related to the various solvent systems used in the formulations.

PMID- 2219657
TI  - Three arterial ostia in the base of the pig's heart. Abnormal ductus arteriosus
      or an additional stem vessel?
AB  - A macroscopic description of four hearts showing three arterial ostia in the base
      of the pig's heart was carried out. Portions of the vascular walls were
      histologically examined in three hearts. All hearts belong to the Tetralogy of
      Fallot group. Spitzer's hypothesis concerning the phylogenetic development of the
      mammalian heart was tested against the observations. The hypothesis could not be
      verified. The study leads to the conclusion that the ductus arteriosus has its
      origin in the base of the heart in the four hearts studied.

PMID- 2219656
TI  - Haematology and blood-chemistry for predicting abscesses and other abnormalities
      in slaughtered pigs.
AB  - Blood values of slaughtered pigs were determined in an attempt to relate the
      blood profile with the prevalence of abscesses. To this end 319 pigs were
      selected and grouped into classes on the basis of pathological ante- and post
      mortem findings. The classes thus distinguished were (i) no pathology, (ii)
      pleurisy or pneumonia and (iii) abscesses occurring singly, metastasised or in
      combination with other abnormalities. By stepwise discriminant analysis it was
      established that the blood variables ln(fibrinogen) and albumin were particularly
      suitable for the detection of abscesses in slaughtered pigs. In this way a
      correct classification of 89.3% of affected pigs is possible. The numbers of
      false-positives and false-negatives were 19.3% and 10.7%, respectively. For meat
      inspection purposes application of blood analyses is promising. For application
      in meat-inspection practice rapid on-line methods need to be devised.

PMID- 2219658
TI  - Survival time in dogs with spontaneous atrial fibrillation related to
      scintigraphically measured cardiac performance.
AB  - In 40 canine patients with spontaneous atrial fibrillation (AF) cardiac
      performance was measured scintigraphically and correlated with the survival time
      (ST) following the diagnosis of AF. The parameters used for cardiac performance
      were heart rate (HR), end-diastolic left ventricular volume (EDV), ejection
      fraction of the left ventricle (EF), left ventricular regurgitation fraction (RF)
      and cardiac output (CO). ST varied from 3 days to 780 days. Two groups of animals
      were distinguished as previously described: group A (EF less than 0.3, n = 26)
      and group B (EF greater than or equal to 0.3, n = 14). The median ST (90 days) in
      group A was only weakly significant (p = 0.1) shorter than in group B (150 days).
      RF was significantly lower in group A than in group B (p less than 0.001). A weak
      correlation was found between ST and EF (r = 0.28; p = 0.04). It was concluded
      that the prognosis in the described AF patients is slightly favourable if EF is
      normal or only moderately reduced.

PMID- 2219659
TI  - Pharmacokinetics of chloramphenicol in sheep after intravenous, intramuscular and
      subcutaneous administration.
AB  - The pharmacokinetics of chloramphenicol were studied in sheep after 3 single
      intravenous (IV), intramuscular (IM) and subcutaneous (SC) administrations (30
      mg/kg). The two extravascular routes were studied during a crossover trial for a
      bioequivalence test. After IV and SC administrations, the plasma-concentration
      time graphs were characteristic of a two-compartment model, and after IM
      administration it was characteristic of a monocompartment model. The two routes
      of absorption were not bioequivalent. Using the kinetic values, multidose
      regimens to maintain the therapeutic chloramphenicol blood level (5
      micrograms/ml) were proposed: 60 mg/kg every 12 hours for 72 hours for the IM
      administration and 45 mg/kg administered subcutaneously according to the same
      regimen. A study of the chloramphenicol residues in tissues was carried out.
      Chloramphenicol residues remained at the injection site, and 400 hours would be
      necessary to obtain the level of 10 micrograms/kg. Determination of the
      creatinine phosphokinase serum values showed that the subcutaneous route induced
      less damage to muscle than the intramuscular route.

PMID- 2219660
TI  - Efficacy of toltrazuril in broilers and development of a laboratory model for
      sensitivity testing of Eimeria field isolates.
AB  - (1) The efficacy of toltrazuril (Baycox) against coccidiosis was established on a
      broiler farm in an intermittent application during five consecutive growing
      periods. Treated birds were fed a broiler ration without anticoccidials. The
      efficacy of Baycox was compared with the nicarbazin-salinomycin shuttle. It was
      concluded that Baycox retarded the onset of Eimeria infection for several weeks.
      During the fifth rearing period coccidiosis problems emerged on the farm in all
      birds during medication, suggesting development of resistance. (2) During a
      laboratory experiment the efficacy of Baycox was studied in birds after
      inoculation with different numbers of oocysts at 7, 10 or 15 days of age. Baycox
      was applied at 10 and 11 days of age. In all cases medication with Baycox
      protected birds from coccidiosis during a period of at least 7 days. This effect
      of Baycox could be due to the long-existing tissue levels of the product and its
      metabolites as well as its specific effect on the second generation of schizonts.
      (3) In another laboratory experiment coccidia obtained from field trials were
      tested for sensitivity to Baycox in conjunction with two strains obtained from
      farms were coccidiosis emerged during application. The inoculation model
      developed in this study was used for sensitivity testing. One of the Eimeria
      strains tested was resistant to the product, one strain was tolerant and the
      remaining two strains, including the control strain, were fully sensitive to
      Baycox.

PMID- 2219661
TI  - Characterisation of Chlamydia psittaci isolated from a horse.
AB  - This paper describes the isolation and characterisation of a strain of Chlamydia
      psittaci obtained from a nasal swab taken from a horse with serous nasal
      discharge. Initial isolation was achieved in cycloheximide-treated McCoy cell
      monolayers. Chlamydial inclusions stained by immunofluorescence either with a
      rabbit antiserum raised against C. psittaci or with a monoclonal antibody
      directed against the genus-specific lipopolysaccharide antigen were single and
      compact. They did not stain with iodine or with a monoclonal antibody reactive
      against Chlamydia trachomatis. The agent was re-isolated in the yolk sacs of
      embryonated hens eggs and designated N16. Identification of the agent was
      confirmed by electron microscopy. Unique plasmid DNA was prepared from a purified
      suspension of chlamydial elementary bodies (EBs), and analysed by electrophoresis
      through 1.0% agarose gels stained by ethidium bromide. This strain of C. psittaci
      grew relatively slowly in cycloheximide-treated McCoy cells, and the yield of
      elementary bodies during the course of one growth cycle was relatively low.

PMID- 2219662
TI  - Efficacy against ovine enzootic abortion of an experimental vaccine containing
      purified elementary bodies of Chlamydia psittaci.
AB  - A vaccine prepared from purified, inactivated elementary bodies of Chlamydia
      psittaci protected sheep against abortion after subcutaneous challenge with live
      chlamydiae. Immunoblot analysis of serum samples revealed a consistently dominant
      antibody response against the chlamydial major outer membrane protein in all
      vaccinated sheep. Reactions to other chlamydial antigens were also detected but
      were less pronounced or inconsistent. Serological responses detected by
      complement fixation were variable and did not correlate with immunity.

PMID- 2219663
TI  - Biochemical and immunochemical characterisation of strains of Treponema
      hyodysenteriae.
AB  - The protein composition of 18 clinical isolates of Treponema hyodysenteriae from
      pigs with swine dysentery in Australia were compared by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblot analysis. Coomassie
      Blue stained SDS-PAGE-profiles of whole cell and outer membrane (OM) proteins
      demonstrated the same gel pattern among the T. hyodysenteriae isolates,
      particularly the OM proteins in the molecular mass (Mr) range of 30 kDa to 40
      kDa. The T. hyodysenteriae isolates were categorised into two distinct groups (A
      and B) based on the strain-variability in the 37 kDa OM protein. Immunoblotting
      of whole cell proteins after SDS-PAGE using serum from rabbits and pigs immunised
      with known T. hyodysenteriae serotypes revealed a number of common immunoreactive
      bands in all isolates. LPS typing of the T. hyodysenteriae isolates by
      immunoblotting with the rabbit antiserum revealed one additional serotype
      emphasising the LPS heterogeneity among the strains isolated from geographic
      locations in Australia, Great Britain and the U.S.A. Immunoblotting of the OM
      preparations revealed several common immunoreactive polypeptides corresponding to
      Mr values of 34 kDa to 30 kDa among the T. hyodysenteriae and T. innocens
      isolates but a distinct 39 kDa found only in the T. hyodysenteriae isolates.
      Trypsin proteolysis of intact. T. hyodysenteriae cells caused selective loss of
      these and other major abundant proteins identifying the location of the 39 kDa,
      36 kDa, 34 kDa and 30 kDa proteins on the cell surface and suggesting a possible
      role of these proteins in the pathogenesis of swine dysentery.

PMID- 2219664
TI  - Factors influencing the degree of in vitro bacterial adhesion to ovine mammary
      gland epithelial cells.
AB  - Bacterial adhesion to mammary gland epithelial cells (EC) may play a role in the
      pathogenesis of mastitis. In vitro adherence systems have been developed to study
      mastitis in cattle but little has been done in sheep. In this work, a method is
      described for obtaining mammary gland cell preparations containing greater than
      or equal to 65% EC from live or dead ewes, using a Ficoll-Hypaque flotation
      method (cell viability = 70-90%). An in vitro adhesion assay procedure was also
      developed to study the interaction between EC and ovine mastitis bacterial
      strains. It was observed that, under the test conditions, adherence increased as
      the incubation time was prolonged from 30 to 120 min (P less than 0.05). Adhesion
      was greater at incubation temperature of 37 degrees C than at 22 degrees C (P
      less than 0.001). An acidic pH (5.9) was associated with an increase in adhesion,
      when compared with a higher pH (7.2; P less than 0.05). Tween 20, Tween 80 and
      bovine serum albumin helped to eliminate a background of unbound bacteria from
      the test slides, but they also inhibited adhesion to some strains. Strain
      differences in adhesion and in ability to form a background were also observed.
      Some of these findings may have in vivo implications.

PMID- 2219665
TI  - Bactericidal activity in the sera of mice vaccinated with Pasteurella multocida
      type A.
AB  - The susceptibility of Pasteurella multocida to killing by serum and the ability
      of protective vaccines to stimulate this mechanism of immunity in mice were
      investigated. P. multocida type of bovine origin was used to prepare a vaccine
      incorporating heat killed organisms and for homologous infection of mice.
      Bactericidal capacity and ELISA antibody titres were determined for individual
      mouse sera. Protection was clearly associated with bactericidal antibodies raised
      by vaccination. The bactericidal assay may be useful as a rapid, simple screening
      test of vaccinated mice for functional protective antibody levels.

PMID- 2219666
TI  - Susceptibility of Mongolian gerbils (Meriones unguiculatus) to leptospires and
      the protective effect of vaccination.
AB  - Mongolian gerbils, Meriones unguiculatus, were shown to be highly susceptible to
      Leptospira interrogans serovars such as icterohaemorrhagiae, copenhageni,
      canicola, autumnalis, javanica, pyrogenes and hebdomadis as compared to guinea
      pigs and hamsters. Mortality with signs of haemorrhage and jaundice was recorded
      in all experimental rodents after intraperitoneal inoculation with all strains of
      the serovars indicated. However, Mongolian gerbils were comparatively susceptible
      to strains which were of low virulence to guinea pigs and hamsters. Use of
      leptospiral vaccination proved effective in protecting the animals against
      inoculum challenges. The Mongolian gerbil is a species that may be selectively
      and preferentially useful for assays on the protective effects of leptospiral
      vaccination.

PMID- 2219667
TI  - Diagnosis of bovine brucellosis by enzyme immunoassay of milk.
AB  - Enzyme-immunoassays using lipopolysaccharide as antigen were developed for the
      detection of bovine IgG1, IgG2 or IgA Brucella antibodies (Ab) in milk. The
      results of these tests were compared with those of the milk ring test (MRT) by
      analyzing 3212 bulk milk samples from farms located in regions where brucellosis
      is prevalent. Among the 105 herds detected by ELISA and/or MRT, 29 infected herds
      were detected by ELISA only. The 40 MRT-positive herds were also ELISA positive.
      Five herds became infected during the study and were detected by ELISA 15 days to
      6 months prior to detection by MRT. The ELISA IgG1 titration (IgG1 ELISA)
      detected 92.8% of the herds found positive in the three ELISA assays. The
      concomitant use of IgA ELISA raised the sensitivity to 100% but slightly
      decreased the specificity. The IgG2 ELISA did not improve the diagnosis. The
      sensitivity of MRT and IgG1 ELISA was compared by testing successive dilutions in
      negative milk of 110 individual MRT positive milks samples. On average, IgG1
      ELISA was 22 times more sensitive than MRT.

PMID- 2219668
TI  - Characteristics of the Shiga-like toxin produced by Escherichia coli associated
      with porcine edema disease.
AB  - Shiga-like toxin (SLT-IIv) from Escherichia coli strains associated with edema
      disease of pigs was characterized and compared with SLT-I, SLT-II, and the SLT of
      E. coli strain HI8 (SLT-HI8). SLT-IIv from an E. coli K12 in which the genes for
      SLT-IIv had been cloned was indistinguishable from SLT-IIv of wild strains of E.
      coli from edema disease. There was cross-neutralization among all SLTs except SLT
      I. The different SLTs could be distinguished by heat lability, with the
      descending order of heat lability being SLT-IIv, SLT-II, SLT-I, and SLT-HI8. SLT
      IIv and SLT-HI8 had lower cytotoxic titers on HeLa cells compared with Vero cells
      and were more active on MDBK cells than were the other SLTs. All SLTs were
      enterotoxic in rabbit but not in pig intestine and SLT-IIv was less enterotoxic
      than SLT-I. SLT-IIv had a lower LD50 in mice than did the other SLTs.

PMID- 2219669
TI  - A symmetric axis-based method for measuring the projected femoral angle of
      inclination in dogs.
AB  - A new, simple and more consistent method for measuring the projected angle of
      inclination of the canine femoral neck was devised and tested. This method, based
      on the principles of symmetric axis (symax) shape analysis, was compared with
      three other techniques currently in use. Diplomates of the ACVR or ACVS and
      senior veterinary students were asked to perform measurements of the angle of
      inclination using the four methods, record their results, and answer several
      questions about the techniques. Although greater precision was not evident when
      performed by diplomates, descriptive statistics and a significant difference
      among the student-derived variances of the four methods demonstrated that the
      symax-based measurements were most consistent.

PMID- 2219670
TI  - Partial carpal arthrodesis for third degree carpal sprains. A review of 45 carpi.
AB  - The efficacy of partial carpal arthrodesis was evaluated retrospectively in 39
      dogs (45 carpi) with severe sprains of the middle carpal joints, the
      carpometacarpal joints, or both. The carpometacarpal joint was the most
      frequently injured joint. Jumping or falling from heights was the cause of injury
      in 49% of these animals. Of the 25 owners who responded to a mailed questionnaire
      (mean follow-up, 32 months), all stated their animal had improved or greatly
      improved after partial carpal arthrodesis and all were pleased or very pleased
      with the final surgical result. Hyperextension persisted in 11% of the cases and
      degenerative joint disease of the antebrachiocarpal joint was present in 15.5% of
      the cases. No dogs with partial carpal arthrodesis required panarthrodesis at a
      later date.

PMID- 2219671
TI  - The effects of aortic occlusion on transcranially induced evoked potentials in
      the dog.
AB  - Evoked potentials were produced by anodal stimulation over the motor cortex in
      six dogs. Potentials were recovered from the cranial thoracic and caudal lumbar
      portions of the spinal cord, and the radial and sciatic nerves. Evoked potential
      averages were recorded every 1.5 minutes during 40 minutes of aortic occlusion
      and during 40 minutes of reperfusion. Mean amplitudes of evoked potentials
      recovered from the caudal lumbar spinal cord decreased to 50% of original values
      at minute 12.2. Upon release of occlusion, the evoked potentials returned to
      baseline levels and remained there throughout the period of reperfusion. Sciatic
      nerve amplitudes decreased to 50% of original values at minute 4.5. In no subject
      could wave forms be recovered after minute 9.0. Upon release of occlusion, the
      evoked potentials returned to baseline levels and above, then deteriorated to 29
      +/- 12% after 40 minutes of reperfusion. We concluded that transcranially induced
      evoked potentials were highly sensitive to spinal cord ischemia. Evoked
      potentials recovered from the sciatic nerve were consistent with functional grey
      matter immediately upon reperfusion, but deteriorated during reperfusion.

PMID- 2219673
TI  - Transendoscopic Nd:YAG laser surgery for treatment of epiglottal entrapment and
      dorsal displacement of the soft palate in the horse.
AB  - Transendoscopic neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used to
      treat 12 standing horses with epiglottic entrapment (EE) or dorsal displacement
      of the soft palate (DDSP), or both. In four horses, transendoscopic laser
      staphylectomy was performed. The most common presenting complaints were
      respiratory stridor, cough, and exercise intolerance. Ten horses with EE healed
      without epiglottic complications; in one horse, partial adhesion of the
      aryepiglottic fold to one side of the epiglottis was corrected surgically through
      a laryngotomy incision. One horse with DDSP had no further signs, one continued
      to have continual DDSP, and two had induced DDSP. Transendoscopic Nd:YAG laser
      proved to be a feasible means of correcting EE and selected cases of DDSP.

PMID- 2219672
TI  - Subtotal canine prostatectomy with the neodymium: yttrium-aluminum-garnet laser.
AB  - A technique was developed for subtotal prostatectomy in dogs with the
      neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. In six normal dogs, full
      thickness necrosis of the prostate occurred if the central-lateral region within
      5 mm of the urethra was photoablated at 60 watts for 1 second. Moderate to
      superficial necrosis occurred when the prostate within 5 mm of the urethra was
      photoablated at 35 watts for 2 seconds or 60 watts for 0.5 second. At necropsy,
      leakage of the urethra occurred in two dogs at sites treated at 60 watts for 1
      second. In a clinical study, complications associated with subtotal prostatectomy
      with the Nd:YAG laser (n = 6) were compared with complications associated with
      prostatic drainage (n = 6) in dogs with prostatic disease. Intraoperative death
      (2/6 dogs) and nocturnal incontinence (4/4 surviving dogs) occurred with subtotal
      prostatectomy. Uncontrolled prostatic infection (2/6 dogs) occurred with
      prostatic drainage and resulted in the death of one dog on day 11. Four of five
      dogs surviving prostatic drainage developed recurrent urinary tract infection.

PMID- 2219674
TI  - Arytenoidectomy for advanced unilateral chondropathy with accompanying lesions.
AB  - A noncurrent prospective study of nonworking horses with arytenoid chondropathy
      was conducted to confirm a clinical impression that horses with unilateral
      chondropathy and accompanying lesions had a poorer prognosis after
      arytenoidectomy than horses with bilateral or uncomplicated unilateral
      chondropathy. Surgical failure was defined as death, euthanasia, permanent
      tracheostomy, or reoperation. Survival to surgical failure and clinical
      improvement data were compared between horses with and without accompanying
      lesions treated by arytenoidectomy. The probability of surgical failure was
      significantly higher and times to surgical failure were significantly shorter for
      horses with unilateral chondropathy and accompanying lesions than for horses with
      bilateral or uncomplicated unilateral chondropathy. Clinical improvement at the
      median follow-up time of 6 months was significantly less likely in horses with
      than without accompanying lesions. Horses with endoscopic evidence of
      inflammation and paralyzed opposite cartilage were significantly less likely to
      improve clinically than horses with pharyngeal cicatrix.

PMID- 2219676
TI  - Intra-articular replacement of bovine cranial cruciate ligaments with an
      autogenous fascial graft.
AB  - Transected cranial cruciate ligaments in nine Holstein heifers were replaced with
      an autograft harvested from fascia on the medial surface of the gluteobiceps
      muscle and a connected segment of the lateral patellar ligament. There was
      minimal lameness at month 1, and all animals were sound by month 2. There was no
      evidence of degenerative joint disease in any stifles examined at necropsy on
      days 90, 120, or 365. Augmented healing of the severed cranial cruciate ligaments
      occurred in several animals. The mean failure strength of the cranial cruciate
      ligament replacements was 29.7% of the failure strength of the contralateral
      normal cranial cruciate ligament in four heifers. The technique was successful in
      eight of 13 bulls and cows with ruptured cranial cruciate ligaments. Animals
      treated successfully had significantly lower body weights than those with
      unsuccessful outcomes.

PMID- 2219675
TI  - The etiology and surgical management of tracheal collapse in calves.
AB  - The mean ages of 10 calves with tracheal collapse were 2.7 weeks at onset of
      clinical signs and 9.4 weeks at presentation for treatment. Inspiratory and
      expiratory dyspnea and stunted growth were the most common clinical signs. There
      were abnormalities of the cranial ribs consistent with healing fractures with
      redundant callus in eight lateral thoracic radiographs. Tracheal collapse in
      calves may result from cranial thoracic trauma during or soon after birth. Short
      polypropylene ring prostheses made from 60 ml syringe barrels were placed on the
      tracheas of four calves with cervical tracheal collapse. There were cranial rib
      masses in all calves and resection of the right first and second ribs was
      necessary in one calf to allow placement of prostheses. Dyspnea was relieved in
      all calves. One calf died of unrelated causes in year 3, and one calf had
      recurrence of clinical signs at month 5 and was euthanatized. In both calves,
      tracheal stenosis resulted from continued growth and infolding of the trachea
      within the constraints of the prostheses. One calf was alive at month 11, and one
      calf died of acute bronchopneumonia on day 2. Removal of tracheal prostheses in
      calves is recommended after 2 to 3 months if clinical signs recur.

PMID- 2219677
TI  - Equine post-anesthetic lameness. A retrospective study.
AB  - The incidence of post-anesthetic lameness in 655 horses undergoing 733 anesthetic
      episodes over a 3 year period was 6.4%. Nineteen factors previously reported or
      proposed to play a role in the development of post-anesthetic lameness were
      evaluated statistically. Only hypotension and the duration of the anesthetic
      period were significant factors.

PMID- 2219678
TI  - Reversal of oxymorphone sedation by naloxone, nalmefene, and butorphanol.
AB  - The effects of naloxone (0.4 mg and 1.2 mg intravenously [IV]), nalmefene (0.03
      mg/kg IV) and butorphanol (0.2 mg/kg IV and 0.4 mg/kg IV) on oxymorphone-induced
      sedation were studied in six dogs over a 4-hour observation period. The same dogs
      were observed for 4 hours untreated (unsedated control) and with oxymorphone
      sedation followed by saline solution (sedated control). The reversal drug or
      saline placebo was administered IV 20 minutes after oxymorphone (4.5 mg IV).
      Blinded observers evaluated the dogs for positional and attitudinal responses,
      heart rate, and respiratory rate. Sedated dogs treated with nalmefene most
      closely resembled unsedated dogs in all observed variables. Naloxone was most
      effective when administered at the higher dose. Mild renarcotization occurred in
      two dogs at hour 2, even after the higher naloxone dose. Residual sedation was
      observed in all dogs treated with 0.4 mg naloxone. Butorphanol resulted in
      partial reversal of sedation at both dosage levels. However, the degree of
      sedation was significantly less than that observed in the saline-treated
      controls, and it appeared that 0.4 mg/kg butorphanol may be clinically useful for
      opiate reversal in some situations.

PMID- 2219679
TI  - [A complex x-ray study of patients with enterocutaneous fistulas].
AB  - The paper is concerned with analysis of the results of x-ray examination of 78
      patients with enterocutaneous fistulas of various etiology and site. The authors
      have shown the characteristic features of x-ray examination of patients in whom
      the fistulas were at the acute phase of their development. They have also defined
      the diagnostic value of the employed methods and their efficacy for the diagnosis
      not only of fistulas but also of related complications (inflammatory infiltrates
      and abscesses of the abdominal cavity, fatty phlegmon, purulent "fillings",
      complicated fistulas, etc.). During combined x-ray investigation accurate
      diagnosis of fistulas was established in 97.4% of the patients, purulent
      complications were revealed in 94.6%.

PMID- 2219680
TI  - [X-ray diagnosis of primary sclerosing cholangitis].
AB  - Primary sclerosing cholangitis (PSC) should be regarded as a disease of the bile
      tracts which is difficult to diagnose rather than a rare disease. Combined
      radiodiagnostic investigation in the preoperative period is of great importance.
      Direct methods of an induced contrast study of the biliferous system
      (transcutaneous transhepatic cholangiography, endoscopic retrograde
      pancreatocholangiography) play a major role in the diagnosis of PSC. The authors
      present 11 cases, describing in detail x-ray semiotics of various sites of PSC
      and its differential diagnosis with similar diseases.

PMID- 2219681
TI  - [The state of the veins of the esophagus and the stomach in chronic diffuse liver
      diseases (based on data from a combined roentgeno-endoscopic and echographic
      study)].
AB  - Combined roentgenological and endoscopic investigation was used to study the
      state of the esophageal submucous veins. Echography was used for investigation of
      the gastric subserous veins and esophageal abdominal veins. The results obtained
      indicate that in the presence of portal hypertension there are two types of
      shunting: via the esophageal submucous (82%) and subserous (18%) veins. In
      patients with the predominant affection of the esophageal subserous veins x-ray
      investigation and endoscopy do not allow correct estimation of the presence and a
      degree of the gastroesophageal shunt. Echography results enable one to arrive at
      a correct conclusion in all patients.

PMID- 2219683
TI  - [Differential ultrasonic diagnosis of jaundice].
AB  - Multiprojection ultrasound investigation was performed in 87 patients with
      jaundice. Echography was shown to be an effective method of differential
      diagnosis of parenchymatous and obstructive jaundice. The accuracy of ultrasound
      introscopy in the detection of parenchymatous jaundice was 84.3%, that in the
      detection of mechanical jaundice was 100% (the general accuracy being 85.7%). The
      authors proposed an algorithm for the use of ultrasound tomography, x-ray and
      clinico-instrumental methods in differential diagnosis of jaundice of different
      etiology.

PMID- 2219682
TI  - [Embolization of the hepatic artery in cases of atypical anatomical structural
      variants in patients with malignant liver tumors].
AB  - Therapeutic embolization of the hepatic artery was performed in 60 patients with
      nonresectable malignant liver tumors. Atypical topographical anatomical variants
      of the arterial system of the liver were revealed in 10 of them (16.7%). In 8
      patients two hepatic vessels, one coming out of the celiac artery, the other--out
      of the upper mesenterial or left gastric artery supplied a tumor with blood. In
      three of them one vessel was embolized, in five patients both arteries were
      embolized. The blocking of the entire blood flow of a tumor brought about a
      positive clinical effect in all the patients. Embolization of one blood-supplying
      artery alone led to no improvement. A conclusion was made of a necessity to
      achieve arterial devascularization of the entire tumor tissue area during
      intravascular therapy.

PMID- 2219684
TI  - [Ultrasonic diagnosis of liver hydatidosis].
AB  - The paper is concerned with a study of an ultrasound picture of verified
      hydatidosis in 62 patients. The symptoms of hydatid cysts are the presence of
      daughter cysts and "hydatid sand", cuticular membrane desquamation, local cyst
      wall thickening and parietal layers, a necrotic zone in a preparasitic space and
      cyst calcification. The detection of these symptoms helps to estimate not only
      the type of a hydatid cyst but also the state and character of parasite activity
      permitting a choice of therapeutic tactics.

PMID- 2219685
TI  - [Computed tomography in the diagnosis of diffuse diseases of the liver].
AB  - Methods of CT, echotomography and scintigraphy of the liver were used to
      investigate 95 patients with diffuse liver diseases (fatty dystrophy, hepatitis,
      cirrhosis, hemosiderosis and amyloidosis). CT changes in these diseases were
      described. A high efficacy of CT was established in the detection of diffuse
      liver lesions and portal hypertension permitting one to give up in some cases
      invasive puncture biopsy of the organ.

PMID- 2219686
TI  - [Magnetic resonance tomography, computed tomography and ultrasonic diagnosis of
      hemangiomas of the liver].
AB  - The paper is concerned with the potentialities of modern radiation methods in the
      diagnosis of liver hemangiomas. USI, CT, angiography and MR-tomography (MRT) were
      used for investigation of 64 patients with liver hemangiomas. The diagnostic
      potentialities and the role of each of the above methods in the diagnostic
      algorithm in liver hemangiomas were studied. The results of the investigation
      have shown that MRT possesses a higher informative value than USI and CT in the
      diagnosis of liver hemangiomas and can even replace angiography in the
      verification of diagnosis.

PMID- 2219687
TI  - [X-ray diagnosis of peptic ulcers of the jejunum].
AB  - The paper is devoted to a study of the results of clinicoroentgenological and
      endoscopic investigation of 188 patients aged 23 to 60 who developed jejunal
      peptic ulcer. It was done to specify the features of an x-ray picture of jejunal
      peptic ulcers with relation to the cause of ulcer development and optimum methods
      of x-ray investigation. The predominant localization of peptic ulcer in the
      jejunal efferent loop and its typical ulcero-cicatricial deformity were
      established. Jejunal peptic ulcers developing as a result of an insufficient area
      of resection, are characterized by a relatively benign course of the disease. In
      case ulcer development was determined by the residual antral stomach mucosa at
      the duodenal stump or by the Zollinger-Ellison syndrome, considerable
      pathological changes (gigantic ulcer sizes greater than 2.5 cm and a sharp
      deformity of the jejunal efferent loop) were noted.

PMID- 2219688
TI  - [The sequence of interventions in pancreatic cavities].
AB  - Schemes for the sequence of therapeutic interventions were worked out based on
      experience in the recognition of 56 pancreatic cavitations (cysts, abscesses), US
      assisted diagnostic punctures, 28 external drainages of the cavities (mainly
      prolonged catheterization), 4 diagnostic and therapeutic transcutaneous
      wirsungographies. The authors also worked out recommendations for a choice of
      instruments for prolonged external transcutaneous drainage of pancreatic cysts
      and abscesses, cleansing of the cavity and its sclerosing, inoperative
      cystogastrostomy between a cyst and a stomach stent.

PMID- 2219690
TI  - [Stage I cancer of the stomach (T1N0M0P1-2). Classification and x-ray diagnosis
      (review of the literature].

PMID- 2219689
TI  - [Magnetic resonance tomography in focal diseases of the liver (review)].
AB  - A review is devoted to the use of MR-tomography in the diagnosis of focal liver
      lesions. Various pulse sequences and a choice of an optimum variant are under
      discussion. A possibility of contrast intensification of MR-tomograms with
      paramagnetic substances is indicated, the problems of occurrence of motor
      artefacts are considered. A conclusion has been made that relaxation time can
      serve a tissue characteristic, permitting differential diagnosis on the basis of
      difference in relaxation time between different types of pathological changes.

PMID- 2219691
TI  - [X-ray diagnosis of the spread of cancer of the esophagus to the trachea and
      major bronchi].
AB  - X-ray and endoscopic investigations were compared in 80 operated on patients to
      estimate the role of the x-ray method for a choice of adequate therapeutic
      tactics for esophageal cancer patients. Operations were explorative or palliative
      resulting from the involvement of the tracheobronchial tree in a tumor process.
      The efficacy of the x-ray method in the detection of tracheal compression by an
      esophageal tumor is higher than that of tracheobronchoscopy which in its turn,
      has its advantages in the determination of tumor spreading to the left major
      bronchus.

PMID- 2219692
TI  - [Methodologic procedures in the study of the biliary system using
      cholecystography].
AB  - New methods of x-ray investigation of the biliary system (BS) were proposed. A
      method of hydrostatic load in per os cholecystography, a method of the combined
      use of per os and iv cholecysto-cholangiography with hydrostatic load, and the
      use of finely divided suspension are simple and reliable, permitting one to
      obtain objective information on the BS.

PMID- 2219693
TI  - [Indirect sialadenolymphography of the major salivary glands].

PMID- 2219694
TI  - [Duodenography in hypotension using sound waves].

PMID- 2219695
TI  - [Standard serial cholecystography in the diagnosis of digestive disorders
      following gastrectomy].

PMID- 2219696
TI  - [Stenosis of the pylorus in adults (x-ray endoscopic studies)].

PMID- 2219697
TI  - [A.S. Popov--one of the founders of Soviet roentgenology].

PMID- 2219698
TI  - Primary structure and post-translational processing of the Berne virus peplomer
      protein.
AB  - The nucleotide sequence of the peplomer (P) protein gene of Berne virus (BEV),
      the torovirus prototype, was determined. The gene encodes an apoprotein of 1581
      amino acids with an Mr of about 178K. The open reading frame was cloned behind
      the T7 RNA polymerase promoter and its translation product was identified as the
      BEV P protein precursor by in vivo expression and immunoprecipitation. The
      deduced amino acid sequence contains a number of domains which are typical for
      type I membrane glycoproteins: an N-terminal signal sequence, a putative C
      terminal transmembrane anchor, and a cytoplasmic tail. Eighteen potential N
      glycosylation sites, two heptad repeat domains, and a possible "trypsin-like"
      cleavage site were identified. The mature P protein consists of two subunits and
      their electrophoretic mobility upon endoglycosidase F treatment strongly suggests
      that the predicted cleavage site is functional in vivo. The heptad repeat domains
      are probably involved in the generation of an intra-chain coiled-coil secondary
      structure; similar inter-chain interactions can play a role in P protein
      oligomerization. Using a sucrose gradient assay the P protein was indeed shown to
      form dimers. The intra- and inter-chain coiled-coil interactions may stabilize
      the elongated BEV peplomers.

PMID- 2219699
TI  - Purified phi 6 nucleocapsids are capable of productive infection of host cells
      with partially disrupted outer membranes.
AB  - Purified nucleocapsids of bacteriophage phi 6, lacking the phage lipid envelope,
      are unable to infect intact Pseudomonas syringae host cells. A method for
      studying the process by which a naked virus particle, the phi 6 nucleocapsid,
      penetrates the host cytoplasmic membrane was developed. Host cells were rendered
      competent for nucleocapsid infection by treatment with repeated washings with
      salt and sucrose and the subsequent addition of lysozyme. This treatment disrupts
      the outer membrane, permitting the nucleocapsid to reach the cytoplasmic membrane
      and to infect the cell. The nucleocapsid infection is blocked by monoclonal
      antibodies raised against the nucleocapsid shell protein P8.

PMID- 2219700
TI  - Sequence conservation and divergence of hepatitis delta virus RNA.
AB  - The complete RNA sequence of the hepatitis delta virus (HDV) obtained from the
      Nauru Island in the Pacific was determined by cDNA cloning and amplification by
      polymerase chain reaction (PCR). The sequence showed 14-17% divergence from the
      two known HDV RNA sequences. There are three highly conserved domains: the region
      around the autocatalytic cleavage site of the genomic RNA (nucleotides 659 to
      772), the region around the autocatalytic cleavage site of the antigenomic-sense
      RNA (nucleotides 847 to 966), and the region around the middle one-third domain
      of the open reading frame (ORF) encoding the hepatitis delta antigen on the
      antigenomic RNA (nucleotides 1267 to 1347). The two autocatalytic activities are
      required for the cleavage and ligation of HDV RNA during RNA replication. The
      third conserved domain codes for the RNA-binding domain of HDAg, which
      specifically interacts with HDV RNA. Three nucleotide changes within the genomic
      catalytic sequence are present but did not alter the catalytic cleavage activity
      of the HDV RNA. Microheterogeneity of the RNA sequences was also detected. One of
      these occurred within the coding region of the delta antigen, creating an amber
      termination codon in some of the RNA species. Thus, this HDV strain contains two
      different RNA species, one of which encodes a delta antigen of 214 amino acids
      and the other 195 amino acids. These two protein species were detected by
      immunoblotting of the patient's plasma. In contrast to other HDV strains, only
      three ORFs capable of encoding more than 100 amino acids each are present in this
      HDV RNA. We recommend that oligonucleotides complementary to the highly conserved
      sequences should be used as primers for PCR in clinical detection assays of
      hepatitis delta virus infection.

PMID- 2219701
TI  - The vaccinia virus HindIII F fragment: nucleotide sequence of the left 6.2 kb.
AB  - The nucleotide sequence of the left 6.2 kb of the 13.2-kb HindIII F fragment of
      vaccinia virus was determined. Translation of the sequence revealed nine closely
      spaced, tandemly oriented open reading frames (ORFs), all reading leftward. The
      transcriptional organization of this region was determined by Northern blot and
      S1 nuclease mapping. The analysis suggested that ORFs 1, 2, 4, 5, 6, 7, and 8 are
      transcribed early in infection, whereas ORFs 3 and 9 are probably late genes. Two
      of these ORFs have been reported previously. ORF F4L encodes the small subunit of
      ribonucleotide reductase and ORF F2L is homologous to a retroviral protease-like
      gene.

PMID- 2219702
TI  - Both amino acid changes in nsP1 of Sindbis virusLM21 contribute to and are
      required for efficient expression of the mutant phenotype.
AB  - SVLM21 is a mutant of Sindbis virus which in contrast to the standard virus,
      SVSTD, is able to replicate in Aedes albopictus mosquito cells deprived of
      methionine. Previously, by making use of the infectious Toto plasmids, we had
      constructed recombinant viruses containing various SVLM21 sequences, and were
      thereby able to map the mutations associated with the SVLM21 phenotype to the
      gene for the nonstructural protein nsP1. Two mutations were found in the nsP1
      gene of SVLM21. These led to predicted amino acid changes at residue 87 from Arg
      to Leu, and at residue 88 from Ser to Cys. In the work presented here, we assess
      the relative contributions of these two mutations to the SVLM21 phenotype using
      site-directed mutagenesis to obtain virus encoding only the change to Leu at
      residue 87 of nsP1 (SVMS319), or only the change to Cys at residue 88 (SVMS321).
      In addition we show that SVLM10, which was isolated during the selection
      procedure for SVLM21, encodes only the change at residue 88. In addition to its
      ability to grow in methionine-deprived mosquito cells, SVLM21 differs from SVSTD
      in two other respects: (1) it shows an increased sensitivity to neplanocin A
      (NPA) and (2) it generates increased levels of methyltransferase in infected
      cells. Whether we looked at resistance to low methionine, sensitivity to NPA, or
      levels of methyltransferase generated, SVMS319, SVMS321, and SVLM10 all expressed
      only a partial SVLM21 phenotype. Furthermore we were not able in these
      experiments to distinguish between these three viruses. We conclude therefore
      that both amino acid changes, i.e., at residues 87 and 88, are required to
      produce the full SVLM21 phenotype, and that both changes contribute equally.

PMID- 2219703
TI  - The nucleotide sequence of abutilon mosaic virus reveals prokaryotic as well as
      eukaryotic features.
AB  - The complete nucleotide sequence of abutilon mosaic virus (West Indian isolate,
      AbMVa) is presented. The resulting genomic structure resembles that of other
      geminiviruses which are transmitted by the whitefly Bemisia tabaci: AbMV
      possesses a bipartite circular genome with bidirectional orientation of the open
      reading frames (ORF). Both components have a common region of 180 bases with 99%
      homology while the rest of their sequence is distinct. Eukaryotic regulatory
      transcription elements precede most ORFs and polyadenylation signals are present
      at the end of most ORFs. However, two ORFs show features of prokaryotic genes.
      This chimaeric genome organisation is discussed with reference to the finding
      that AbMV DNA is present in plastids as well as in the nucleus of infected cells.

PMID- 2219704
TI  - Expression, characterization, and purification of a phosphorylated rabies
      nucleoprotein synthesized in insect cells by baculovirus vectors.
AB  - A baculovirus expression vector (AcNPV3) derived from the nuclear polyhedrosis
      virus of Autographa californica (AcNPV) was prepared containing the complete
      coding region of the nucleoprotein (N) gene of rabies virus (Gif-sur-Yvette clone
      of the CVS strain). The gene was placed under the control of the AcNPV polyhedrin
      promoter and was expressed to high levels (66 mg N protein/liter of 2 x 10(9)
      cells) by the derived recombinant virus using a Spodoptera frugiperda cell line.
      Using available antisera, it was established that the antigenic characteristics
      of the N protein were similar by comparison with those of the native N protein of
      rabies virus. Characterization of the expressed protein established that, like
      the N protein of mammalian cell-grown CVS virus, the N protein was
      phosphorylated. The expressed rabies N protein induced antibodies in mice that
      reacted strongly with the rabies viral protein. The expressed nucleoprotein was
      recovered from the insect cells by differential centrifugation followed by ion
      exchange chromatography. The expressed rabies N protein represents a source of
      authentic protein suitable for virus diagnosis as well as structural studies.

PMID- 2219705
TI  - Folding and oligomerization properties of a soluble and secreted form of the
      paramyxovirus hemagglutinin-neuraminidase glycoprotein.
AB  - The paramyxovirus SV5 hemagglutinin-neuraminidase (HN) glycoprotein (a type II
      integral membrane protein) was converted into a soluble and secreted form (HN-F)
      by replacing the HN signal/anchor domain with a hydrophobic domain that can act
      as a cleavable signal sequence. Approximately 40% of the HN-F synthesized was
      secreted from cells (t1/2 approximately 2.5-3 hr). The extracellular HN-F
      molecules were identified as disulfide-linked dimers and the majority of the
      population of molecules were resistant to endoglycosidase H digestion.
      Examination of the oligomeric form of the secreted HN-F, by sucrose density
      gradient sedimentation, indicated that under conditions where HN was a tetramer,
      HN-F was found to be a dimer, and no extracellular HN-F monomeric species could
      be detected. Secreted HN-F was fully reactive with conformation-specific
      monoclonal antibodies and was enzymatically active as shown by HN-F having
      neuraminidase activity. Examination of the intracellular HN-F species indicated
      that HN-F monomers were slowly converted to the disulfide-linked form and that
      under the sucrose density gradient sedimentation conditions used the HN-F
      monomers aggregated. Some of the HN-F monomers were degraded intracellularly.
      These data are discussed in relationship to the seemingly different folding and
      oligomerization requirements for the intracellular transport of soluble and
      membrane bound forms of a glycoprotein. The soluble and biologically active form
      of HN may be suitable for further structural and enzymatic studies.

PMID- 2219706
TI  - Systemic movement and symptom production following agroinoculation with a single
      DNA of tomato yellow leaf curl geminivirus (Thailand).
AB  - Two different DNA species were cloned from purified tomato yellow leaf curl
      geminivirus particles after annealing a specific primer to virus DNA and
      generating a second strand; both were approximately 2.8 kbp in length. One clone
      contains sequences which hybridize to the coat protein gene of tomato golden
      mosaic virus and most likely represents the A DNA of tomato yellow leaf curl
      virus (Thailand). The other clone may represent the B DNA of this geminivirus.
      Both clones contain short sequences which share extensive homology. These
      sequences have some of the same features of common regions of other
      geminiviruses. Systemic viral infection of tomato and Nicotiana benthamiana was
      accomplished by agroinoculation with the proposed A DNA. The symptoms of
      systemically A-infected plants include stunting, lack of flower production, and
      mottled, yellowish leaves. At low frequency during agroinoculation of N.
      benthamiana with a mixture of both DNAs, replication of the second DNA is also
      detected. In these instances, symptoms are more pronounced than infections where
      only the A DNA is agroinoculated. This is the first report of a whitefly
      transmitted dicot-infecting geminivirus capable of infection (via
      agroinoculation), symptom induction, and systemic movement using a single DNA.

PMID- 2219708
TI  - Comparative sequence of the helper component (HC) region of potato virus Y and a
      HC-defective strain, potato virus C.
AB  - Potato virus C (PVC), a non-aphid transmissible strain of potato virus Y (PVY),
      was found to code for a protein (PVC-HC) which is similar in molecular weight and
      immunological reactivity to the helper component protein of PVY (PVY-HC). PVC-HC,
      however, was inactive with respect to its ability to effect aphid transmission of
      either PVC or PVY. The 5'-terminal 2.7-kb regions of PVC and PVY were sequenced.
      Within the HC region there was 92% nucleotide homology between the two strains;
      comparison of the derived amino acid sequences revealed 24 amino acid
      differences. Comparison of the PVC-HC sequence with that of five potyviruses
      revealed 2 amino acid changes which were specific to PVC-HC. These amino acids
      are prime targets for mutational analysis of HC activity.

PMID- 2219709
TI  - The hepatitis B virus X-C fusion protein is unlikely to be produced by the
      mechanism of ribosomal frameshifting.
AB  - A novel hepatitis B viral (HBV) protein of 35-40 kDa, characterized by antibodies
      and proposed as an X-C fusion protein, was previously described in core particles
      isolated from HBV-, WHV-, and GSHV-infected livers. The X and C genes are two
      adjacent genes in all mammalian hepadnaviruses but are not contiguous in WHV and
      GSHV. After examination of the X and preC/C junction sequences of 10 HBV, 4 WHV,
      and 1 GSHV, we found that the ORF of preC can be extended 7 more sense codons
      upstream so that X overlaps with the preC/C gene in all sequences. The number of
      overlapping base pairs (bp) is varied: 46 bp in HBV, 19 bp in WHV, and 10 bp in
      GSHV. In this region a conserved A-track was found to be followed by a pair of
      inverted repeats, suggesting that a ribosomal frameshift may occur for X-C fusion
      protein production. To assess this possibility, we have used an in vitro
      transcription and translation coupling system to identify X-C protein production.
      Two recombinant SP6 plasmids were used. One contained a full length of the X and
      preC/C gene of wild-type HBV-DNA and the other fused the X-preC/C gene by
      inserting a 10-bp HindIII linker at the junction of the X-preC/C region. No X-C
      fusion protein was detected from the wild-type plasmid. In contrast a large
      amount of X-C fusion protein was produced from the linker-inserted clone. It
      appears, therefore, that the X-C fusion protein is unlikely to be produced via
      the mechanism of ribosomal frameshifting.

PMID- 2219707
TI  - Does the human immunodeficiency virus Tat trans-activator contain a discrete
      activation domain?
AB  - Human immunodeficiency virus type 1 (HIV-1) encodes a transcriptional trans
      activator, termed Tat, that is absolutely required for viral replication in
      vitro. By analogy to other known transcription factors, it has been suggested
      that the HIV-1 Tat protein may contain discrete protein domains that determine
      sequence specificity and transcriptional activation potential. Here, we report
      the use of site-directed mutagenesis to examine the functional significance of
      two candidate activation domains within Tat. A 12 amino acid sequence adjacent to
      the N-terminus of the Tat protein, which includes a proposed acidic amphipathic
      alpha-helix activation motif, was found to contribute to, but be dispensable for,
      Tat function in vivo. In contrast, the integrity of a second potential Tat
      activation motif, centered on a lysine residue at position 41, was found to be
      essential for Tat function. However, Tat proteins mutated in this area displayed
      a fully recessive negative phenotype. Therefore, neither of these two regions of
      the Tat protein appear to be discrete activation domains. We conclude that
      previous attempts to categorize Tat as a modular transcription factor have not
      succeeded and suggest that the functional organization of this complex trans
      activator remains to be defined.

PMID- 2219710
TI  - Isolation of a Friend recombinant polytropic virus with a T-cell-restricted
      leukemogenicity.
AB  - Hematopoietic malignant cells of various types were isolated from ICFW mice
      inoculated as newborn or adult with F-MuLV and grafted into recipient mice. After
      repeated in vivo cell transplants, several recombinant polytropic viruses (also
      termed MCF or dualtropic viruses) were isolated from tumors by limiting dilution.
      Two virus isolates designated RA1-17 and EA1-17 were recovered from the spleen
      and the omentum, respectively, of the same grafted animal. When inoculated into
      newborn mice, RA1-17 induced erythroblastosis similar to that induced by other
      Friend recombinant polytropic viruses. Remarkably, EA1-17 induced T-cell leukemia
      after a short latency. To our knowledge, this is the first description of a
      polytropic recombinant virus with a T-cell tropism isolated after inoculation of
      F-MuLV.

PMID- 2219712
TI  - Vaccinia virus gene D7R encodes a 20,000-dalton subunit of the viral DNA
      dependent RNA polymerase.
AB  - The polypeptide encoded by the vaccinia virus open reading frame D7R was
      synthesized in bacteria. Immunization of rabbits with the polypeptide resulted in
      antibodies that specifically recognized a virion polypeptide of 20,000 daltons.
      The immunoreactivity with the 20,000-dalton polypeptide was found to coincide
      with the virion-associated DNA-dependent RNA polymerase through DEAE-cellulose
      chromatography and glycerol gradient sedimentation. These results argue that the
      product of the vaccinia open reading frame D7R is a subunit of the viral RNA
      polymerase.

PMID- 2219711
TI  - Systematic classification of HIV biological subtypes on lymphocytes and
      monocytes/macrophages.
AB  - The growth properties and cytopathic effects of several HIV-1 and HIV-2 strains
      were compared between cultures on human lymphocytes and monocytes/macrophages,
      respectively. For some isolates (among these three paired isolates from blood and
      cerebrospinal fluid) replication and cytopathogenicity were comparable between
      lymphocytes and monocytes/macrophages (dual tropic viruses), while others showed
      a very specific tropism for only one cell type. Yet another subtype grew neither
      well on lymphocytes nor on macrophages. Taking into account the growth properties
      in monocytes/macrophages we propose a classification system for HIV subtypes on
      these cells (alpha-delta), in analogy to the nomenclature for HIV-subtyping on
      lymphocytes (a-d). Using this system, some prototypic viruses (LAV/HTLV-IIIB, HIV
      2ROD, SIVBK28, HIV-2ALT) as well as several other HIV-1 and HIV-2 isolates were
      subtyped.

PMID- 2219713
TI  - The complete nucleotide sequence of an infectious clone of porcine parvovirus,
      strain NADL-2.
AB  - The complete nucleotide sequence of an infectious clone of porcine parvovirus,
      strain NADL-2, was determined. The nucleotide sequence organization of the viral
      genome was found to be similar to that of the other autonomous parvoviruses, such
      as canine parvovirus and minute virus of mice.

PMID- 2219714
TI  - Reverse guanine phosphoribosyltransferase selection of recombinant vaccinia
      viruses.
AB  - We have developed a procedure for the selection of recombinant vaccinia viruses
      with applicability to poxvirus mutagenesis studies and to the use of vaccinia
      virus as an expression vector. The method depends on the specific inability of a
      recombinant vaccinia virus expressing the Escherichia coli guanine
      phosphoriboxyltransferase gene (gpt) to form plaques on a hypoxanthine-guanine
      phosphoribosyltransferase-negative line of mouse fibroblasts in the presence of 6
      thioguanine. Recombinant viruses that have the gpt removed can form plaques under
      selection conditions, thus providing a simple and efficient selection protocol.
      We have demonstrated the method by isolating a pseudo-wild type revertant virus
      and a simple deletion mutant virus from a recombinant vaccinia virus with gpt
      inserted into the vaccinia virus gene encoding the major 35,000-Da secretory
      protein.

PMID- 2219715
TI  - Nucleotide sequence and characterization of the 39K gene region of Autographa
      californica nuclear polyhedrosis virus.
AB  - The complete nucleotide sequence of the Pstl-K fragment of the Autographa
      californica nuclear polyhedrosis virus (AcMNPV) genome was determined. This
      region of the genome contains the delayed early 39K gene and V-ubi, a viral
      protein with homology to ubiquitine. In addition, Pstl-K potentially encodes five
      other proteins. Hybrid-select translation mapped nine viral-specific proteins to
      this fragment. Three proteins were observed with both early and late RNA; two of
      them comigrated with proteins directed by transcripts made from the 39K open
      reading frame (ORF). One protein which was only seen with hybrid-selected late
      RNA comigrated with ubiquitin. A correction of previously published sequence data
      indicates that there is an additional AUG codon upstream of the 39K ORF. This AUG
      codon is located 8 nucleotides downstream of the early transcription initiation
      site. The methionine codon is followed by codons for three amino acids and a
      termination codon. The 39K ORF is located 102 nucleotides downstream of the
      minicistron. In vitro transcription-translation experiments confirmed that the
      downstream AUG serves as the initiation codon for the 39K ORF.
      Radioimmunoprecipitation experiments indicated that the Pstl-K-encoded 39K
      protein reacted with antiserum raised against a previously described nuclear
      matrix-associated 39K protein.

PMID- 2219716
TI  - Nucleotide sequence and genomic organization of apple chlorotic leaf spot
      closterovirus.
AB  - The nucleotide sequence of Apple chlorotic leaf spot closterovirus (ACLSV)
      genomic RNA has been determined from cDNA clones. It is 7555 nucleotides in
      length excluding the 3' terminal poly(A) tail and contains three putative open
      reading frames capable of encoding proteins of 216.5, 50, and 28 kDa. ACLSV RNA
      has untranslated regions of 151 and 190 nucleotides at its 5' and 3' termini,
      respectively. The 216.5-kDa ORF encodes a protein which contains the conserved
      "signature" sequences and has significant homology with the proteins suspected to
      be involved in viral RNA replication of members of the "Sindbis-like" supergroup
      of viruses. On the basis of distant homologies with viral movement proteins (M
      proteins), the 50-kDa ORF is suspected to encode a protein responsible for virus
      cell-to-cell spread. The 28-kDa ORF contains, in frame, a smaller 21.5-kDa ORF
      encoding the coat protein of ACLSV. These results show that ACLSV and probably at
      least the subgroup A of closteroviruses should be regarded as members of the
      "Sindbis-like" supergroup of RNA viruses.

PMID- 2219717
TI  - Fiber sequence heterogeneity in subgroup F adenoviruses.
AB  - The fiber gene of adenovirus type 41 was sequenced and compared to the fiber gene
      sequence of adenovirus type 40 (A. H. Kidd and M. J. Erasmus, 1989, Virology 172,
      134-144), the other known member of subgroup F. The open reading frame, from map
      units 87 through 92 with transcription from the r-strand, comprised 1686 bases
      and was 45 bases longer than its counterpart on the Ad40 genome. The 45-base
      difference appears to have resulted from a block deletion on the Ad40 sequence.
      Apart from this one region, the Ad40 and Ad41 fiber genes showed remarkably high
      homology (95.6%), indicating a relatively recent evolutionary divergence. The
      deduced amino acid sequence of the Ad41 fiber polypeptide was analyzed according
      to the model of N. M. Green et al. (1983, EMBO J. 2, 1357-1365) for the structure
      of the adenovirus fiber. Ad41 had one more 15-residue repeat in the shaft region
      than Ad40, there being 22 repeat motifs. A detailed study of various Ad40 and
      Ad41 strains with proven genome differences indicated that the 15-amino acid
      difference in polypeptide length at the 14th repeat motif is a type-specific
      difference among the subgroup F adenoviruses. However, two uncommon Ad41 strains
      belonging to 2 of the 16 Ad41 genome types tested had a 15-amino acid block
      deletion which was different to that of the Ad40 polypeptide. The implication
      from this work is that the Ad40 fiber gene probably arose from its Ad41
      counterpart, but the fiber gene sequences of both types of subgroup F adenovirus
      are so similar that genetic recombination between strains could occur with some
      frequency.

PMID- 2219719
TI  - Characterization of the cord-like structures emerging from the surface of
      influenza C virus-infected cells.
AB  - When HMV-II cells (a human malignant melanoma cell line) infected with a newly
      isolated influenza C strain (Yamagata/1/88) were examined by simple light
      microscopy, it was found that a large number of cord-like structures which had
      lengths up to about 500 microns or greater were emerging from the cell surface.
      The existence of viral glycoproteins (hemagglutinin-esterase, HE) on the surface
      of these huge structures was confirmed by hemadsorption experiments with
      erythrocytes from a variety of species as well as by immunofluorescent staining
      with anti-HE monoclonal antibody. Furthermore, electron microscopy revealed that
      numerous filamentous particles in the process of budding, each covered with a
      layer of surface projections approximately 13 nm in length, aggregated with their
      long axes parallel to form a cord-like structure visible under a light
      microscope. An electron-dense layer, which presumably consists of membrane
      protein (M), was seen in cross-sections of all filamentous virions whereas
      internal nucleocapsids were rarely seen. SDS-polyacrylamide gel electrophoresis
      of the purified cords also showed that they contained HE and M polypeptides but
      not nucleoprotein, confirming that long filamentous particles are mostly devoid
      of nucleocapsids. The emergence of cords on the cell surface was observed in
      various cell cultures infected with C/Yamagata/1/88 though their number and
      length varied markedly depending on cell type. The production of cord-like
      structures was also evident in HMV-II cells infected with any of several
      different influenza C strains, which suggests that the cord formation is a common
      feature of influenza C virus group.

PMID- 2219718
TI  - Expression in Escherichia coli of the large genomic segment of infectious
      pancreatic necrosis virus.
AB  - A complete cDNA clone of the larger A segment of the genome of infectious
      pancreatic necrosis virus (IPNV) was expressed in Escherichia coli in an effort
      to develop a vaccine for IPNV in fish. When the cDNA insert was positioned in the
      correct orientation to the pUC19 lacZ promoter, the viral proteins VP2, NS, and
      VP3 were synthesized and processed as observed in infected cells. When the insert
      was placed in the opposite orientation, VP3 and a 38-kDa virus-specific
      polypeptide were also synthesized. In addition, specific deletions made from the
      3' end into the NS gene of the cloned A segment led to inactivation of the NS
      proteolytic activity and subsequently, the synthesis of an unprocessed VP2-NS
      polyprotein precursor. Antiserum to this polyprotein distinguished NS (28.5 kDa)
      from VP3 (31 kDa) and led to the identification of a previously undescribed 38
      kDa virus-specific polypeptide in infected cells. Thus, both internal
      translational initiation and proteolytic cleavage could lead to the synthesis of
      VP2, NS, and VP3 from a single mRNA with a single open reading frame. A trpE
      expression vector, pATH2, was used to synthesize large quantities of the A
      segment-encoded proteins in bacteria. The resulting bacterial lysate was very
      effective in inducing protective immunity in rainbow trout fry.

PMID- 2219720
TI  - Structure of the gene encoding the M1 protein of sonchus yellow net virus.
AB  - The gene encoding the M1 protein of sonchus yellow net virus (SYNV), a plant
      rhabdovirus, has been sequenced and identified by Western blot analysis of SYNV
      proteins using antibodies directed against a fusion protein derived from a
      portion of the sequenced gene. The M1 gene is positioned between nucleotides 4039
      and 5109 relative to the 3' end of the viral RNA and is the fourth gene from the
      3' end of the genome. The 1071-nucleotide (nt) M1 gene lies between a putative
      nonstructural gene of unknown function and the gene encoding the glycoprotein and
      is bordered on either side by the same GG intergenic dinucleotide that separates
      other genes in the SYNV genome. The M1 mRNA (scRNA 6) consists of a 71-nt
      untranslated region at the 5' terminus followed by an 858-nt open reading frame
      (ORF) capable of encoding a protein with a calculated molecular weight of 31,779.
      The amino acid sequence deduced from this ORF is not highly homologous to those
      of other rhabdovirus matrix proteins, but has some localized regions of
      similarity. The UGA codon that terminates the M1 ORF is followed by a 3'
      untranslated region of 142 nt. The viral RNA (minus-sense) sequence corresponding
      to the extreme 3' end of the mRNA contains a 9-nt tract (3'-AUUGUUUUU-5') that is
      identical to the sequences at the termini of other SYNV genes.

PMID- 2219721
TI  - Genetic variation and multigene families in African swine fever virus.
AB  - The genome of a virulent strain (LIS57) of African swine fever virus differs from
      that of the Vero-cell-adapted strain (BA71V) in several deletions located in the
      variable regions. The region which contains the most differences is located 8-20
      kb from the left end. The DNA sequence of this region was obtained from LIS57
      virus DNA and compared with the overlapping sequences of BA71V virus. This
      comparison revealed that the changes in the variable regions result in
      differences in the number of genes which belong to the multigene families 360 and
      110. Virus isolate LIS57 contains at least 8 genes of the multigene family 360
      and 12 genes of the multigene family 110, instead of the 6 and 5 genes,
      respectively, found in BA71V virus strain. The position of the deletions
      indicates that new combinations of multigene family members in African swine
      fever virus DNA may arise by in-frame recombination between homologous genes.
      These data indicate that the evolution of the multigene families 360 and 110 in
      African swine fever virus DNA has involved different processes, including gene
      duplication, divergence of duplicated genes, and gene deletion.

PMID- 2219722
TI  - The complete DNA sequence of vaccinia virus.
AB  - The complete DNA sequence of the genome of vaccinia virus has been determined.
      The genome consisted of 191,636 bp with a base composition of 66.6% A + T. We
      have identified 198 "major" protein-coding regions and 65 overlapping "minor"
      regions, for a total of 263 potential genes. Genes encoded by the virus were
      located by examination of DNA sequence characteristics and compared with existing
      vaccinia virus mapping analyses, sequence data, and transcription data. These
      genes were found to be compactly organized along the genome with relatively few
      regions of noncoding sequences. Whereas several similarities to proteins of known
      function were discerned, the function of the majority of proteins encoded by
      these open reading frames is as yet undetermined.

PMID- 2219723
TI  - A DNA ligase gene in the Copenhagen strain of vaccinia virus is nonessential for
      viral replication and recombination.
AB  - Biochemical and genetic analyses have been conducted to determine whether a
      vaccinia virus open reading frame (orf) with extensive homology to the
      Saccharomyces cerevisiae DNA ligase gene encodes a functional ligase activity.
      This orf in HindIII A, designated A50R, is capable of encoding a 552-amino-acid,
      63.4-kDa polypeptide. Full-length A50R mRNA produced in vitro directed the
      synthesis of a polypeptide with an apparent molecular weight of 57 kDa.
      Significantly, translation reactions programmed with A50R mRNA were capable of
      ligating a 3-kb Notl restriction fragment into multimers. DNA ligase activity was
      not detectable when either truncated sense or full-length antisense mRNA was
      translated in vitro. In extracts prepared from cells infected with wt vaccinia
      virus, DNA ligase activity was detected as assayed by the formation of a 57 kDa
      ligase-AMP adduct which was expressed early in the viral replication cycle. In
      cells infected with a DNA ligase deletion mutant no equivalent AMP-labeled adduct
      was detected. Relative to wt virus, the DNA ligase deletion mutant exhibited no
      significant differences in homologous recombination. These results indicate that
      the vaccinia orf A50R encodes a functional DNA ligase expressed early in
      infection, but this DNA ligase is nonessential for either recombination or viral
      replication.

PMID- 2219724
TI  - Expression pattern of the hepatitis B virus genome in transfected mouse
      fibroblasts.
AB  - Permanent mouse fibroblast LTK- cells were transfected with dimeric hepatitis B
      virus (HBV) DNA linked to the simian virus 40 (SV40) early promoter/enhancer.
      Many clones stably expressed high levels of polyadenylated RNAs encoding
      hepatitis B surface (HBs) proteins (2.1 kb), HBe protein (3.6 kb), and HBx
      protein (0.6 kb). Although a chimeric RNA (4.0 kb) probably starting from the
      SV40 promoter was also synthesized, transcription of viral RNAs was predominantly
      directed by HBV promoters and its terminator. In contrast to HBV-transfected
      liver cells, the fibroblasts expressed only pregenomic 3.6-kb transcripts
      starting 5' to, but not within, the precore sequence. Thus, no normal core
      protein could be synthesized, but the cells expressed and secreted HBe protein of
      heterogeneous size. Small and middle HBs proteins were strongly expressed, while
      large HBs protein was almost absent. HBx mRNA expression was more efficient in
      mouse fibroblasts than in human hepatoma cells and 18-kDa HBx protein was
      exclusively detected in purified nuclei. Expression of HBe, small and middle HBs,
      and HBx proteins apparently does not require hepatic factors. Underexpression of
      HBc mRNA and large HBs mRNA suggests that activity of their promoters depends on
      cell-type-specific transcription factors.

PMID- 2219725
TI  - Replication of hepatitis B virus in transfected nonhepatic cells.
AB  - Permanent murine fibroblasts (LTK-) were transfected with a dimer of hepatitis B
      virus (HBV) DNA and a neomycin resistance gene which were both linked to the
      simian virus 40 (SV40) early promoter/enhancer. One of the stably transfected
      clones, LTK4/36, which secreted HBsAg, HBeAg, and HBV DNA was further analyzed.
      It contained eight to nine copies of integrated HBV DNA per haploid genome and
      low amounts of episomal HBV DNA. The secreted viral DNA was covalently linked to
      protein and was associated with particles which had the characteristic density of
      natural virions from serum of human viremic carriers. The particles contained an
      endogenous DNA polymerase, small and middle surface proteins, but in contrast to
      natural virions very little core protein and large surface protein. Instead of
      core protein, they contained incompletely processed HBe protein which is colinear
      to core protein. The fibroblast-derived virions were less stable than virions
      from human carriers or from transfected hepatoma cells. After several days of
      storage, their DNA was only partially protected against DNase. Obviously,
      nonhepatic cells can express HBV-like particles, even if liver-dependent gene
      products like large surface protein and core protein are missing.

PMID- 2219726
TI  - Expression of cauliflower mosaic virus gene I using a baculovirus vector based
      upon the p10 gene and a novel selection method.
AB  - A new baculovirus expression vector based upon the p10 gene of Autographa
      californica nuclear polyhedrosis virus (AcNPV) and a novel system for the
      screening of p10 recombinants have been developed. The insertion of a cassette
      containing the lacZ gene under the control of a heat-shock promoter of Drosophila
      melanogaster downstream from the cloning site in p10 transfer vectors allows the
      convenient identification of putative recombinants by virtue of their expression
      of beta-galactosidase. Using this p10 transfer vector an AcNPV recombinant was
      engineered with a cDNA copy of gene I of cauliflower mosaic virus (CaMV) in place
      of the p10 coding sequence. This p10 recombinant expressed CaMV gene I at levels
      equivalent to those of p10 and polyhedrin, and was shown to be as effective in
      producing this protein as recombinants exploiting the polyhedrin promoter. CaMV
      gene I protein formed large numbers of hollow fiber-like structures in the
      cytoplasm of infected cells. Because the polyhedrin gene remains intact, these
      p10 expression vectors may be exploited for the expression of heterologous
      proteins in insects infected per os and for the enhancement of baculovirus
      pathogenicity for insect control.

PMID- 2219727
TI  - Processing, assembly, and immunogenicity of human immunodeficiency virus core
      antigens expressed by recombinant vaccinia virus.
AB  - Recombinant vaccinia viruses that contained regions of the gag-pol open reading
      frames of human immunodeficiency virus type 1 (HIV-1) were constructed. Cells
      infected with recombinants containing both gag and protease genes expressed and
      processed HIV gag antigens efficiently. Processing was much reduced in cells
      infected with recombinants containing only gag, but not the protease gene.
      However, significant amounts of p41 were produced by protease-defective
      recombinants. This protein was immunoreactive with p24-specific monoclonal
      antibodies and was produced in a truncated form by a recombinant containing a 3'
      deletion in the p15 coding region of gag ORF. These results indicate that p41
      could represent an alternative gag precursor with N-terminal sequences derived
      from p24 and C-terminal from p15. Ultrastructural analysis of recombinant
      infected cells revealed that the gag antigens expressed were assembled into
      retrovirus-like particles and were secreted into culture medium. This assembly
      process was not dependent on HIV protease function, because immature core
      particles were produced by recombinants lacking HIV-1 protease functions.
      Immunization of mice and chimpanzees with vaccinia-HIVgag recombinant viruses
      generated both antibody and cell-mediated immune responses to HIV gag antigens.
      These recombinants are therefore useful not only for studying HIV virion
      processing and assembly, but also for designing immunogens for the prophylaxis
      and immunotherapy against AIDS.

PMID- 2219728
TI  - The hemagglutinin of influenza B virus present in clinical material is a single
      species identical to that of mammalian cell-grown virus.
AB  - When clinical specimens of influenza virus are adapted to grow in embryonated
      hens' eggs, variants are selected which have specific amino acid substitutions in
      the hemagglutinin (HA). In contrast, a single virus, distinct from any egg
      adapted variant, is selected when virus is isolated on MDCK mammalian cell
      culture. We have utilized the polymerase chain reaction to determine the nature
      of the hemagglutinin of influenza B viruses present in clinical material prior to
      cultivation in the laboratory. Sequence analysis of individual clones of
      amplified DNA reveals that the HA of clinical virus is essentially homogeneous
      and identical to the virus derived on MDCK cells. The HA of egg-adapted virus was
      heterogeneous and nonidentical to that of the clinical material and of the MDCK
      derived virus.

PMID- 2219729
TI  - Factors affecting efficient infection of tobacco with in vitro RNA transcripts
      from cloned cDNAs of satellite tobacco mosaic virus.
AB  - Recombinant cDNA clones of the complete satellite tobacco mosaic virus (STMV)
      genome (1059 ribonucleotides) were constructed with unique Xbal and HindIII or
      Pstl restriction sites engineered at the 5' and 3' termini, respectively. The
      genome-length cDNAs were positioned downstream of T7 or SP6 phage promoters.
      Genome-sense RNAs transcribed in vitro from the T7 promoter were biologically
      active, while negative-sense RNAs transcribed in vitro from the SP6 promoter were
      not. Constructs that were identical to STMV and two other constructs in which
      there were two or six specific nucleotide differences in the 3' noncoding region
      yielded RNAs that were infectious. Sequence analysis of the progeny RNA derived
      from infections with transcripts containing nucleotide differences between
      nucleotides 682 and 753 revealed that these changes in sequence were maintained.
      In contrast, differences in the nucleotide sequence between nucleotides 989 and
      1059 were not maintained in progeny RNA; one mutant reverted to the wild-type
      sequence, and the other generated a new sequence during infection.

PMID- 2219730
TI  - Cloning of the genome of a densovirus and rescue of infectious virions from
      recombinant plasmid in the insect host Spodoptera littoralis.
AB  - We have cloned an infectious genome of the Junonia coenia densonucleosis virus
      (JcDNV) into the bacterial plasmid pBR322. The viral genome could be rescued from
      the recombinant plasmid pBRJ by transfection of pBRJ DNA to sensitive Spodoptera
      littoralis larvae. pBRJ DNA produced a typical viral infection and a comparable
      percentage of larvae became infected following inoculation of equivalent amounts
      of purified virion DNA or cloned viral DNA. Virions extracted from transfected
      larvae were indistinguishable from wild-type (wt) virions with regard to their
      biophysical and biological properties. In particular, rescued virions were as
      infectious as wt virions and showed identical restriction profiles of their
      genome. In contrast, subcloning of JcDNV DNA deleted at both extremities of a
      sequence of ca 250 or ca 100 bp resulted in the inability of the recombinant
      plasmids to initiate a viral infection. These data suggest that, as for
      vertebrate parvoviruses, the inverted terminal repeats display essential
      functions in the rescue process and replicative cycle of densoviruses. This is
      the first report of the molecular cloning of the infectious genome from an insect
      parvovirus, and more generally from an invertebrate virus. pBRJ should provide an
      efficient tool to further define the organization of the JcDNV genome and compare
      it to other parvoviruses.

PMID- 2219731
TI  - Selective inhibition of hepatitis B virus and human immunodeficiency virus
      sequence-promoted gene expression by cotransfected poly(I):poly(C).
AB  - The transient expression of hepatitis B virus (HBV) surface and "eJ" antigens
      caused by transfection of human hepatoblastoma HepG2 cells with HBV DNA was
      markedly inhibited by cotransfection with poly(I):poly(C). Cotransfection with
      poly(I):poly(C) also inhibited the expression of bacterial chloramphenicol
      acetyltransferase (CAT) gene which was under the control of either the HBV core
      promoter or the human immunodeficiency virus (HIV-1) long terminal repeat. This
      inhibition was much more pronounced on the expression of HBV-promoted CAT than
      HIV-promoted CAT. The uptake of reporter plasmid was not affected by
      cotransfected poly(I):poly(C). The inhibition was found to be at the steady-state
      CAT mRNA level and appeared to be specific for HBV and HIV regulatory sequences
      since CAT expression directed by other viral and cellular regulatory sequences
      was not inhibited. Cotransfection with a mixture of equal amounts of poly(I) and
      poly(C) had similar inhibitory effects whereas cotransfection with poly(l) or
      poly(C) alone, or other double-stranded ribo- or deoxyribonucleotides, did not
      have such strong effects. The addition of poly(l):poly(C) to the culture medium
      of cells transfected with these reporter plasmids caused little inhibition.
      Transfection with poly(l):poly(C) induced a minimal amount of intracellular
      interferon-alpha in HepG2 cells which may be involved in selective inhibition of
      HBV-and HIV-1-directed gene expression. 2-Aminopurine, an inhibitor of double
      stranded RNA activated protein kinase known to block interferon gene induction by
      poly(l):poly(C), partially reversed the poly(l):poly(C)-induced inhibitory effect
      on HBV-CAT expression.

PMID- 2219732
TI  - Sequence analysis of rice dwarf phytoreovirus genome segments S4, S5, and S6:
      comparison with the equivalent wound tumor virus segments.
AB  - The complete nucleotide sequences of genome segments S4, S5, and S6 of rice dwarf
      phytoreovirus (RDV) were determined. S4 and S5 consist of 2468 and 2570 base
      pairs, respectively, S5 thus being larger in size than S4, contrary to the
      situation suggested by their relative migration in a polyacrylamide gel. S6 is
      1699 nucleotides long. The individual segments have segment-specific inverted
      repeats adjacent to the conserved terminal sequences (5'GGUAAA---UGAU3' for S4,
      5'GGCAAA---UGAU3' for S5 and S6). S4, S5, and S6 each have single long open
      reading frames encoding 727, 801, and 509 amino acids, respectively. A low level
      of amino acid sequence homology was observed between RDV S4 and wound tumor virus
      (WTV) S4 (22.4%), and between RDV S6 and WTV S6 (20.2%). On the other hand, RDV
      S5 and WTV S5 show 52.0% amino acid sequence similarity, indicating that S5 is
      much more conserved than any other segments of RDV and WTV reported so far.
      Further comparative analyses indicate that the RDV segment shows a greater
      frequency of usage of codons XYG and XYC, and much less frequent usage of codon
      XYA than the equivalent WTV segment, this codon preference bias being more
      conspicuous than expected from the base contents.

PMID- 2219733
TI  - Sequence analysis of the rice dwarf phytoreovirus segment S3 transcript encoding
      for the major structural core protein of 114 kDa.
AB  - The primary structure of rice dwarf phytoreovirus (RDV) genome segment S3 was
      determined. RDV S3 consists of 3195 nucleotides. A 14-bp segment-specific
      inverted repeat is located immediately adjacent to the conserved terminal
      sequence (5'GGCAAA---UGAU3'). A single long open reading frame encoding for 1019
      amino acids with an Mr of 114,289 is also identified. In order to investigate the
      localization of the predicted polypeptide, we determined the amino acid sequence
      of the 26-kDa peptide fragment obtained from the structural core protein digested
      by Staphylococcus aureus V8 protease. The sequence of the fragment was found in
      the translational product presumed from the nucleotide sequence of RDV S3,
      indicating that RDV S3 encodes the major structural core protein of 114 kDa.

PMID- 2219734
TI  - Reovirus protein sigma 1 translated in vitro, as well as truncated derivatives of
      it that lack up to two-thirds of its C-terminal portion, exists as two major
      tetrameric molecular species that differ in electrophoretic mobility.
AB  - Reovirus protein sigma 1 is the cell attachment protein that modulates tissue
      tropism and the nature of the antiviral immune response. This protein is present
      in reovirus particles in the form of 12 tetramers that are associated with the
      projections or spikes. We have analyzed a series of deletion mutants of protein
      sigma 1 in order to localize its oligomerization domain and found that
      progressive deletion from the C-terminus fails to affect ability to oligomerize,
      even when the deletion extends into the N-terminal heptapeptide repeat region. It
      was also found that native tetrameric protein sigma 1 synthesized in vitro, as
      well as its truncated derivatives, exists in two forms that differ in
      electrophoretic mobility. Possible reasons for this are discussed.

PMID- 2219735
TI  - Adenovirus type 2 precursor proteins are cleaved by proteinases of other
      adenoviruses.
AB  - A virus-encoded endoproteinase is responsible for the cleavage of adenovirus type
      2 (Ad2) precursor proteins. By analyzing the genetic maps of previously
      characterized interserotypic recombinants between Ad2 and Ad5 and by means of an
      in vitro proteinase assay using Ad1, 2, 3, 4, 5, 6, 7, 9 as the source of enzyme,
      it was demonstrated that (i) the enzyme was present in these serotypes and by
      extension it is likely to be present in all adenoviruses, and (ii) that
      proteolytic cleavage can take place efficiently even between widely different
      serotypes. These attributes suggest a high degree of sequence conservation of the
      enzyme and substrate cleavage sites, thus designating proteolytic processing as
      an excellent target for chemotherapy.

PMID- 2219736
TI  - Heterogeneity of Nef proteins in cells infected with human immunodeficiency virus
      type 1.
AB  - Human T-lymphocytic cell line H9 infected with the HTLV-IIIB isolate of human
      immunodeficiency virus type 1 (HIV-1) synthesizes two forms of the Nef protein
      (p25 and p27) that differ both in molecular weight and charge. Different
      subpopulations of viruses were isolated from the HTLV-IIIB stock which induce
      expression of only p25 or p27. Cells infected with HIV-1 derived from the HXB3
      clone of the HTLV-IIIB isolate made only the p25 species, whereas the 8E5/LAV
      cell line which harbors a single defective LAV provirus produces only the p27
      species. These findings are consistent with the notion that the HTLV-IIIB isolate
      consists of at least two distinct variants with different nef genes, one
      specifying p25 and the other encoding p27. After a considerable number of
      passages in culture, H9 cells chronically infected with the HTLV-IIIB isolate
      produced high levels of p25 and lower levels of p27. Passages in culture appear
      to select for a subpopulation of virus variants that specify high levels of p25
      Nef expression.

PMID- 2219737
TI  - Effect of two novel inhibitors of the human immunodeficiency virus protease on
      the maturation of the HIV gag and gag-pol polyproteins.
AB  - The ability of two novel synthetic compounds to inhibit the HIV protease-mediated
      processing of HIV-1 precursor polyproteins was investigated in an in vitro gag
      protease mixed lysate assay system and in an assay using recombinant
      baculoviruses engineered to express the HIV-1 gag and pol genes in cultured
      insect cells. With the in vitro mixed lysate assay we have shown that both
      compounds at 1 microM can completely inhibit the HIV-1 and HIV-2 protease
      mediated release of p24 from the HIV-1 gag precursor at pH 5.5 and pH 7.0. In the
      intracellular baculovirus system these compounds were shown to inhibit the
      protease-mediated maturation of gag and also the excision of the protease moiety
      from its precursor.

PMID- 2219738
TI  - Palmitoylation of the influenza A virus M2 protein.
AB  - The M2 proteins of a variety of influenza A viruses of different subtypes were
      shown to possess associated palmitate. Susceptibility to removal by reduction or
      treatment with hydroxylamine is consistent with attachment via a thioester
      linkage to cysteine. The absence of the acyl group from the M2 proteins of
      several equine viruses of the H3N8 subtype correlates with the replacement of
      cysteine 50 with phenylalanine and points to this as the site of palmitate
      attachment.

PMID- 2219739
TI  - Terminal structure of a Densovirus implies a hairpin transfer replication which
      is similar to the model for AAV.
AB  - We cloned the complete sequence of Bombyx DNV (Ina isolate; Bm DNV-1) genome in a
      bacterial plasmid pUC 119 and determined the nucleotide sequences of both
      termini, resulting in elucidation of the nucleotide sequence of the complete
      genomic DNA of DNV. The complete sequence of the DNV DNA (5048 nucleotides) has
      inverted repeats of 225 nucleotides and the terminal 153 nucleotides are
      palindromic. The palindromes can fold back on themselves to form a hairpin
      structure but, unlike AAV, the small internal palindrome which forms a T-shaped
      conformation was not observed. End-label analysis demonstrated that the
      palindromic sequences at both termini can exist in either of two orientations
      (flip or flop) in virion DNA with different frequencies. These data suggest that
      the hairpin transfer model for AAV replication must be modified to explain the
      DNV replication. Additionally, a comparison study on the terminal structures of
      insect, human, and rodent parvoviruses allowed a prediction on the ancestral
      terminal structure of parvovirus genome.

PMID- 2219740
TI  - A new hepatitis B virus variant in a chronic carrier with multiple episodes of
      viral reactivation and acute hepatitis.
AB  - To examine whether there are HBV variants not yet described which cannot express
      HBe due to a mutation in the pre-C region, and, if they exist, whether they cause
      a particular course of infection and disease, we analyzed the HBV genomes of a
      HBs/anti-HBe positive chronic carrier who had several episodes of acute
      reexacerbations of chronic hepatitis with at least two viremic phases. Direct
      sequencing of the precore/core and the pre-S regions of the HBV sequences of both
      viremic phases amplified by the polymerase chain reaction revealed that they were
      very similar to each other but substantially divergent from published HBV
      genomes. Both virus populations contained a mutation in the first nucleotide of
      the pre-C translation initiation codon (AUG/CUG) which prevents HBeAg expression.
      These data demonstrate the existence of a new HBV variant which can enter a
      latent phase from which it can be reactivated with acute reexacerbation of liver
      inflammation.

PMID- 2219741
TI  - Genetic analysis of tomato golden mosaic virus: ORF AL2 is required for coat
      protein accumulation while ORF AL3 is necessary for efficient DNA replication.
AB  - Tomato golden mosaic virus (TGMV) is a geminivirus whose genome is divided
      between two DNA components, designated A and B. The TGMV genome contains six open
      reading frames (ORFs) which can encode proteins of greater than 10 kDa. We have
      used a protoplast transfection system to determine the effects of viral proteins,
      as defined by these ORFs, on the accumulation of viral DNA in infected cells. The
      accumulation of cost protein was also examined in leaf discs. Our results
      indicate that mutations in ORFs AR1 and AL2 do not affect viral double-stranded
      DNA (dsDNA) levels, although AR1 and AL2 mutants accumulate only small amounts of
      single-stranded viral DNA (ssDNA). In contrast, a large reduction in both ss- and
      dsDNA levels is observed when a mutation is introduced into ORF AL3. Mutations
      within either of the two DNA B ORFs do not affect DNA replication. The AL3, BR1,
      and BL1 mutants are capable of synthesizing coat protein; however, coat protein
      is not detected in leaf discs inoculated with AR1 or AL2 mutants. Testable models
      are proposed to explain the influence of AL2 protein on coat protein accumulation
      and to account for the stimulation of viral DNA synthesis mediated by the AL3
      gene product.

PMID- 2219742
TI  - In vitro DNA replication by cytoplasmic extracts from cells infected with African
      swine fever virus.
AB  - A cell-free system that catalyzes DNA replication was prepared from cytoplasmic
      extracts of Vero cells infected with African swine fever virus (ASFV). The cells
      were permeabilized with lysolecithin and disrupted by mild mechanical action and
      the nuclei were removed by low-speed centrifugation. Extracts prepared from
      infected cells at the time of maximal DNA replication incorporated [alpha
      32P]dTTP into acid-insoluble material that was sensitive to DNase and resistant
      to RNase. The reaction was inhibited by phosphonoacetic acid, an inhibitor of
      ASFV-specific DNA polymerase. Extracts from mock-infected cells had a negligible
      activity. Micrococcal nuclease-treated extracts were able to replicate added
      virion DNA or viral replicative DNA. An increase in the mass of DNA detected by
      ethidium bromide staining and by dot blot hybridization with ASFV DNA showed that
      the incorporation was due to true replication. Plasmid DNA was also replicated,
      which indicates that ASFV-specific DNA polymerase does not require a virus
      specific origin of replication. The pattern of fragments generated by EcoRI
      digestion of the in vitro product was characteristic of viral replicative DNA.
      Hybridization with a recombinant plasmid containing a terminal fragment of ASFV
      DNA confirmed the presence of dimer terminal ASFV fragments presumably generated
      from concatemeric replicative intermediates.

PMID- 2219743
TI  - The N-terminal quarter of reovirus cell attachment protein sigma 1 possesses
      intrinsic virion-anchoring function.
AB  - Previously the receptor recognition domain of the reovirus serotype 3 (T3) cell
      attachment protein (sigma 1) was mapped to the C-terminal half of the protein
      using deletion mutagenesis of the reovirus S1 gene. A similar approach has been
      adopted in the present study to map the domain on T3 sigma 1 that is responsible
      for incorporation into the virion (i.e., the anchoring domain). Restriction
      enzymes which divide the T3 S1 cDNA into four segments (5'-I-II-III-IV-3') of
      similar size were used to generate four mutants, each with a particular segment
      deleted. The mutants were cloned into SV40 expression vectors and used to
      transfect COS-1 cells which were subsequently with reovirus serotype 1. Progeny
      viral particles with truncated T3 sigma 1 proteins incorporated were then
      identified by radioimmunoprecipitation with a serotype-specific anti-T3 sigma 1
      serum. It was found that the mutant lacking I (mutant dl) was totally incapable
      of being incorporated into the virion, whereas the mutant lacking domain II
      (mutant dII) was incorporated efficiently. Due to altered antigenicities of the
      mutants lacking domain III (mutant dIII) or domain IV (mutant dIV), incorporation
      of these two proteins into virions was less detectable using the above assay.
      Evidence that domain I (the N-terminal 121 amino acids) alone dictates the
      incorporation of sigma 1 into the virion came from the subsequent demonstration
      that a chimeric protein containing domain I fused to chloramphenicol
      acetyltransferase (CAT) was incorporated into the virion (detectable with an anti
      CAT serum) as efficiently as the full-length sigma 1 protein.

PMID- 2219745
TI  - Retinal ganglion cell distribution and behaviour in procellariiform seabirds.
AB  - Retinal ganglion cell distribution in nine species of procellariiform seabirds
      was studied by Nissl staining of retinal whole-mounts and the construction of
      density contour maps. Most species showed a horizontal linear area of high cell
      density, but concentric distributions with dorsal and central cell concentrations
      were found in two species. These results are discussed in relation to the birds'
      foraging behaviour.

PMID- 2219744
TI  - Spatial properties of horizontal cell responses in the cat retina.
AB  - The spatial properties of horizontal cells in the cat retina have been studied by
      means of intracellular recordings in the optically intact, in situ, eye. The
      spread of potentials in the horizontal cell layer and the spatial summation
      properties have been investigated using "white light" stimuli in several
      different configurations. Area-response curves were measured with flashing spots
      carefully centered on the receptive field. The lateral spread of potentials was
      studied using long, narrow slits of light and circular spots of different sizes
      at different positions in the receptive field. Two-dimensional receptive field
      profiles showed that the receptive field structure was, both on a large scale and
      at higher resolutions, relatively homogeneous and isotropic. The size and shape
      of the receptive fields have been characterized by applying a simplified version
      of the model proposed by Naka and Rushton (1967) of electrical coupling in the
      horizontal cells layer in fish. Results show that the model describes the
      variation of response amplitude reasonably well both as a function of spot size
      and spot or slit position. However, deviations were found for area-response
      curves measured at higher light intensities and for receptive field profiles
      measured with relatively small spots. Furthermore, the estimated length constants
      resulting from the different experiments were not in agreement. Different model
      parameters were needed in order to describe the spatial summation properties and
      the lateral spread of potentials respectively. It is concluded that passive
      electrical spread and linear summation of potentials cannot account for the
      observed spatial properties.

PMID- 2219746
TI  - Age-related changes in the morphology, absorption and fluorescence of melanosomes
      and lipofuscin granules of the retinal pigment epithelium.
AB  - The morphological and spectral characteristics of purified populations of
      melanosomes and lipofuscin granules from the human retinal pigment epithelium
      (RPE) were studied with respect to donor age. All melanosome and lipofuscin
      fractions exhibited the typical ultrastructural appearance associated with these
      granules. Absorption profiles of both melanin and lipofuscin granules
      demonstrated an increased optical density of the granules with increasing age.
      The former was associated with an overall increase of melanin within the
      granules. Melanosomes were weakly fluorescent; emission in the blue decreased
      with increasing age while emission in the red increased. The fluorescent
      intensity of lipofuscin granules increased with age. These results provide
      support for the concept that melanogenesis is occurring within the human RPE
      throughout life and that pigment granules within the RPE undergo age-related
      modifications during life.

PMID- 2219747
TI  - Salience of chromatic basic color terms confirmed by three measures.
AB  - Using single color terms of their choice, nine subjects named each of 424 colors
      twice under carefully-controlled conditions. Compared to any other color names,
      the chromatic basic color terms (red, green, yellow, blue, orange, purple, brown
      and pink) are all used more consistently within subjects, with greater consensus
      between subjects, and with shorter mean response times; there is no overlap
      between the two categories of color names by any of these criteria. The results
      are interpreted as supporting the conception that basic color terms refer to
      fundamental sensations for which there is a specific physiological basis.

PMID- 2219748
TI  - Motion coherence in infants.
AB  - Two perpendicular square-wave gratings (i.e. plaids) were used to investigate
      motion coherence in 1-, 2- and 3-month-old infants. The direction of motion of
      the stimulus was judged by an adult observer, on the basis of the induced
      optokinetic nystagmus (OKN) in an eight-alternative eye movement voting paradigm.
      Infants as young as 1 month of age demonstrated OKN in the direction consistent
      with motion coherence. There was no significant difference among the performances
      of 1-, 2- or 3-month-old infants. However, the percentage of trials on which
      infants demonstrated OKN in the coherence direction was less than that obtained
      from adults tested with the same paradigm. Movshon, Adelson, Gizzi and Newsome
      (1985) have suggested that the cohered motion of a complex pattern may be
      processed after the orientation of the components of the pattern, perhaps in the
      middle temporal area of the visual cortex (MT). The present results suggest that
      either young infants and adults process the motion of complex patterns similarly
      or that the OKN consistent with the direction of motion coherence observed in
      infants involves subcortical nonoriented visual centers rather than the higher
      level process which is presumed to occur in adults.

PMID- 2219749
TI  - Spatial-frequency discrimination of drifting gratings.
AB  - Spatial-frequency discrimination thresholds were measured for briefly (300 msec)
      presented sinewave gratings having a contrast one logarithmic unit above
      detection threshold. The gratings were drifted at rates varying from 1.1 to 40
      Hz. In a two-interval forced-choice paradigm thresholds were determined for
      vertically and obliquely oriented gratings. Three reference spatial frequencies
      (1, 4, 12 c/deg) were tested. For the 1 c/deg reference spatial frequency,
      spatial-frequency discrimination thresholds were constant over the wide range of
      drift rates used. For 4 and 12 c/deg reference gratings, discrimination
      thresholds were constant for drift frequencies up to 14 Hz. For drift frequencies
      beyond 14 Hz, spatial-frequency discrimination thresholds increased abruptly,
      rising from approx. 6% at 14 Hz to 25% at 40 Hz drift rate. Measurements with
      obliquely oriented gratings yielded comparable results. The increase in the
      spatial-frequency discrimination threshold for medium-high spatial frequencies
      and high temporal frequencies might reflect an increase in the spatial frequency
      bandwidth of the mechanisms sensitive to these stimulus frequencies.

PMID- 2219750
TI  - Perception of directional sampled motion in relation to displacement and spatial
      frequency: evidence for a unitary motion system.
AB  - Perception of directional motion was studied by displaying two images (F1 and F2)
      in rapid succession. The two images were identical except for a horizontal
      displacement of F2 with respect to F1. Observers reported the direction of
      horizontal motion over a wide range of displacements. The stimuli in Experiment 1
      were one-dimensional gratings with spatial frequency between 0.125 and 6 c/deg.
      Motion was seen at all displacements to almost 0.5 cycles (counterphase) and
      remained invariant across spatial frequencies. In Experiment 2 the stimuli were
      band-pass filtered random-dot patterns. The bandwidth of the filters was 1
      octave, and centre frequencies ranged from 0.75 to 12 c/deg. In every case, the
      response functions exhibited quasi-periodic oscillations related to structural
      properties of the images. One-dimensional analyses based on autocorrelation did
      not provide a satisfactory account of the data. By contrast, the data were fitted
      successfully by a two-dimensional analysis that integrated the responses of
      neighbouring motion detectors so as to yield a smooth motion flow field from
      which left-right directional motion could be derived. Practically and
      conceptually, the outcome supports a unitary motion system as distinct from
      separate systems subserving short-range and long-range motion.

PMID- 2219751
TI  - Foveating saccades.
AB  - A review of the literature revealed that foveating saccades were found to be
      faster than other fast eye movements (FEMs) except optokinetic nystagmus (OKN)
      quick phase. In the present experiment, foveating saccades were compared to OKN
      quick phase in humans and were found to have higher maximum speeds and shorter
      durations. Unlike previous experiments, foveating saccades were made to targets
      at unpredictable distances, and active pursuit during OKN was discouraged.
      Previously reported differences between the speeds of foveating saccades and
      saccades to remembered target positions were replicated. Foveating saccades,
      therefore, can be distinguished from other FEMs on the basis of speed. This
      behavioral difference suggests that a distinctive mechanism exists for foveating
      targets.

PMID- 2219752
TI  - Readily visible changes in color contrast are insufficient to stimulate
      accommodation.
AB  - In an earlier study (Wolfe & Owens, 1981) it was reported that humans could not
      accommodate to an insoluminant red-green border. However, recent masking studies
      (Switkes, Bradley & DeValois, 1988) have shown that, using an appropriately
      normalized contrast metric, contrast decrements similar to those produced by
      defocus are equally visible for color or luminance modulated grating patterns. We
      have compared accommodative responses to 1.75 c/deg gratings that consisted of
      either isochromatic luminance modulations or isoluminant red-green color
      modulations. All four observers could accommodate accurately to luminance
      modulated gratings over a wide range of contrasts. However, no appropriate
      accommodative responses were obtained even for the highest contrast color
      modulated gratings. These results show the changes in color contrast are
      ineffective as stimuli for the human accommodative response even when the changes
      in chromatic contrast accompanying defocus are readily perceived.

PMID- 2219753
TI  - Detection of an orientation singularity in Gabor textures: effect of signal
      density and spatial-frequency.
AB  - This work presents evidence for a second stage of spatial filtering in early
      vision. This second stage operates on the output of the well known linear spatial
      filters and integrates their thresholded responses with a center-surround
      weighting function. The evidence for the existence of this second stage comes
      from experiments where observers have to detect a Gabor signal with known
      parameters (target) among a varied number of other Gabor signals having
      orthogonal orientation (distractors). Detection performance on this task depends
      on the number of distractors and the distance between them: when the number of
      distractors is small performance deteriorates with an increasing number of
      distractors; however, when the number of distractors becomes larger performance
      improves with an increasing number of distractors. This improvement depends on
      the spatial-frequency of the signals and their spatial separation. Best
      performance is achieved when the spatial separation between signals is larger
      than three times their center wavelength but smaller than nine times their
      wavelength, implying a second stage filtering with a center size of six
      wavelengths and a total size of 18 wavelengths. This second stage of filtering
      may underlie our ability to detect certain texture boundaries preatentively.

PMID- 2219754
TI  - Optimal displacement in apparent motion and quadrature models of motion sensing.
AB  - A grating appears to move if it is displaced by some amount between two brief
      presentations, or between multiple successive presentations. A number of recent
      experiments have examined the influence of displacement size upon either the
      sensitivity to motion, or upon the induced motion aftereffect. Several recent
      motion models are based upon quadrature filters that respond in opposite
      quadrants in the spatiotemporal frequency plane. Predictions of the quadrature
      model are derived for both two-frame and multiframe displays. Quadrature models
      generally predict an optimal displacement of 1/4 cycle for two-frame displays,
      but in the multiframe case the prediction depends entirely on the frame rate.

PMID- 2219755
TI  - [Selected anthropometric findings in women with disorders of glucose tolerance
      with hypertension].
AB  - In a group of 26 women with an impaired glucose tolerance anthropometric
      measurements of basic somatometric characteristics were made with special
      attention to the subcutaneous fat distribution and compared the findings with the
      healthy Czech population. Changes in body build, BMI, subcutaneous body fat
      distribution were evaluated and the causality of the relationship between blood
      pressure and gluteofemoral and abdominal obesity was investigated. From the
      author's observations ensues that in the group of women with impaired glucose
      tolerance overweight was recorded, as compared with the normal population,
      disproportions in the circumferences of the trunk and extremities, an excessive
      percentage of body fat, well developed muscles. In abdominal obesity a
      significant increase of the blood pressure and BMI was found.

PMID- 2219756
TI  - [The effect of streptozotocin-induced diabetes treated with insulin on the
      metabolism of calcium, magnesium and phosphorus].
AB  - In a group of rats with streptozotocin induced diabetes the excretion of calcium,
      magnesium, phosphorus and creatinine in urine was investigated and the calcium,
      magnesium and phosphorus content of bone in relation to the duration of the
      disease. The authors observed that in diabetic rats the urinary losses of
      calcium, magnesium and phosphorus increase significantly. The creatinine
      excretion is also significant but lower in relation to calciuria and therefore
      the value of Nordin's index in diabetic rats rises markedly. Bone of diabetic
      rats in the early stage of diabetes (32 days) loses magnesium, while the calcium
      and phosphorus content does not change significantly. During longer persistence
      of severe diabetes (70 days) a significant drop of all three minerals in bone was
      observed. The bones of diabetic animals on the 70th experimental day were
      macroscopically smaller and were very fragile. The authors' findings suggest a
      marked influence of streptozotocin diabetes on calcium phosphate metabolism and
      bone metabolism, in particular on account of STZ diabetes, on an early drop of
      magnesium in bone. The possible impact of this finding for clinical practice will
      have to be tested further.

PMID- 2219757
TI  - [Changes in magnesium and ionized calcium serum levels in disorders of glucose
      tolerance].
AB  - In a group of 58 subjects with a strictly defined glucose tolerance (38 normal-
      nGT, 10 impaired glucose tolerance--pGT, 10 type II diabetics treated by diet)
      the authors investigated the mutual relationship between changes in the blood
      sugar level and insulin serum level in relation changes of calcium, ionized
      calcium, magnesium and total proteins. In addition to expected differences in the
      native blood sugar level and insulinaemia, the authors found in pGT group in
      reduction of ionized calcium and magnesium on fasting. In the course of the oGTT
      in pGT group there is a rise of ionized calcium and magnesium and thus the
      changes, as compared with the initial value, differ significantly from changes in
      subjects with a normal glucose tolerance and in type II diabetics. The
      differences in the pattern total calcium are less marked, the changes of total
      protein did not differ. Evaluation of correlations revealed a only significant
      relationship between the change of ionized calcium and blood sugar level after
      120 mins, in DM II. The findings suggest a different calcium and magnesium
      metabolism after a glucose load in subjects with an impaired glucose tolerance.
      It is not clear whether a cause of the disorder is involved or a possible
      compensatory mechanism. The clinical impact will have to be examined.

PMID- 2219758
TI  - [Anticoagulantion and antiaggregation therapy in patients with unstableangina
      pectoris].
AB  - Heparin, aspirin with dipyridamol or 5% dextrose were administered to 266
      patients admitted to the coronary unit with unstable angina. All patients were
      concurrently treated with isosorbide dinitrate, a beta-blocker and nifedipine.
      The number of patients who developed an acute myocardial infarction (IM) during
      the subsequent 72 hours was comparable in all three groups. However, in the
      heparin treated group only 3.2% patients developed Q IM, as compared with 20%
      patients treated with aspirin and dipyridamol (p = 0.005) and with 19% in the
      control group (p = 0.006). The magnitude of the IM was evaluated according to the
      highest serum value of creatine phosphokinase. In the heparin treated group its
      value was 810.5 +/- 538 i.u./l which was significantly less than in the aspirin +
      dipyridamol group where it was 1229 +/- 829 i.u./l (p = 0.048) and in the control
      group where it was 1417 +/- 919 i.u./l (p = 0.009). The authors defined the group
      of patients with a high risk of development of IM who had protracted anginous
      pain longer than 45 mins. with ST segment depression deeper than 1 mm on the ECG
      on admission. 55% of these patients developed an infarction in the course of the
      subsequent 72 hours.

PMID- 2219759
TI  - [Detection of atrial septal defects using esophageal echocardiography].
AB  - By means of transoesophageal (oesophageal) echocardiography (TEE) the authors
      examined a group of 20 subjects. In 10 there was clinical suspicion (physical
      finding, ECG, X-ray) of an atrial septal defect. Common precordial
      echocardiographic examination (TTE) and dilution of indocyan green by means of an
      acustic sensing unit were negative or only marginally positive and did not
      provide a final decision. By means of TEE the defect was confirmed in 8 subjects
      by the finding of anatomical discontinuity of the septum and the presence of
      coloured Doppler shunt flow. In two subjects the finding was negative, in 10
      controls no pathological findings were detected. The authors confirmed that TEE
      is a reliable method which proves even slight shunts in the area of the atrial
      septum. It is probably the most sensitive existing method.

PMID- 2219760
TI  - [Diagnosis of acute dissection of the aorta].
AB  - The authors present a group of 14 patients (9 men and 5 women) aged 38-76 years
      (mean age 59 years) who were hospitalized during the five-year period between
      1984 and 1988 at the medical department A of the Regional Institute of National
      Health in Banska Bystrica on account of acute dissection of the aorta. The
      authors describe clinical manifestations which can lead to suspicion of this
      serious disease. They make the readers familiar with their experience with
      ultrasonic and X-ray examination (in particular aortography and computed
      tomography). They analyze their contribution to the diagnosis of acute dissection
      of the aorta.

PMID- 2219761
TI  - [Cardiac function and adrenergic regulation in incipient hyperthyroidism].
AB  - The authors investigated in 14 euthyroid women the action of triiodothyronine
      administered for 7 days, 100 micrograms per day. It was revealed that after the
      administration of triiodothyronine the duration of the preejection period of the
      systole was reduced as well as the index of the preejection period and the index
      of the electromechanical systole, and the weight declined. At the same time the
      authors recorded a drop of the plasma noradrenaline and adrenaline level, of the
      serum cholesterol and thyroxine concentration. The serum triiodothyronine level
      increased and correlated inversely with the duration of the preejection period.
      Triiodothyronine administration had no effect on the heart rate, Q-Kd interval,
      blood pressure and plasma concentration of cyclic adenosine monophosphate. The
      authors conclude from the findings that in triiodothyronine-induced
      hyperthyroidism the first cardiac effect of the administered hormone is enhanced
      contractility of the heart, this change being due to the direct effect of
      triiodothyronine not mediated by catecholamines.

PMID- 2219762
TI  - [Comparison of 2 methods for determination of antibodies to thyroglobulin in
      clinical practice].
AB  - The authors compared the results of two methods for the estimation of antibodies
      against thyroglobulin: the principle of the Thymune-T test (Wellcome) is a
      haemagglutination method; parallel examinations were made by the author's
      modification of the radiochemical coprecipitation test (RCT). The laboratory
      results were evaluated in a large clinical group of patients with different types
      of thyroid disease. It was confirmed that the haemagglutination method gives more
      frequently positive results than the radiochemical test, in particular in the
      range of low titres. The chi square test provided, however, evidence that between
      methods a significant correlation exists. Although the results of the two tests
      are not necessarily identical in individual patients, it may be stated that RCT
      is an adequate method of choice, as it is simpler, more rapid and cheaper, and
      that it can be done in large series with objective automated evaluation of data.

PMID- 2219764
TI  - [Campylobacter pylori and treatment of duodenal ulcer].
AB  - The authors subjected to endoscopic examination 90 patients with duodenal ulcers.
      From each patient they collected a bioptic specimen of the gastric antrum and
      duodenal bulbus for microbiological and histological examination. They found that
      for detection of C. pylori the microscopic examination was most useful. The
      presence of C. pylori in the gastric antrum was detected in 87% of the subjects
      and in the duodenal bulb only in 48%. The difference is significant at the 0.01
      level. To 43 patients of the group Ranitidine was administered. The ulcer was
      cured within 4 weeks in 35 subjects. Ranitidine did not affect the presence of C.
      pylori and antral gastritis. After cure of the ulcer the authors administered
      Tarivid to 10 patients with persisting C. pylori positivity. The presence of C.
      pylori and antral gastritis were not affected by this treatment.

PMID- 2219763
TI  - [Subclinical hypothyroidism].
AB  - Subclinical hypothyroidism was detected in 5.7% of 853 patients referred for
      ambulatory examination to a department in Prague. In patients referred with a
      mild degree of subclinical hypothyroidism with an evaluated level of thyrotropic
      hormone in serum (TSH) no significant deviations of serum thyroxine and
      triiodothyronine (T4 and T3) were found nor different values of the Achilles
      tendon reflex time, as compared with patients with normal thyroid function. In
      case of a more marked grade of subclinical hypothyroidism with an elevated TSH
      level without stimulation the patients have on average significantly lower T4
      vales, significantly longer Achilles tendon reflex times and preejection stage of
      left ventricular contraction, and of Rodbard's Q-Kd interval (Q-Kd) than
      euthyroid patients. The values are, however, still within the reference range for
      normal function and in individual cases cannot be decisive for establishment of
      the diagnosis. The authors discuss the differential diagnosis and views on
      treatment of this disease.

PMID- 2219765
TI  - [Tenoxicam in the long-term treatment of active rheumatoid arthritis].
AB  - The authors present the results of six months treatment with Tenoxicam (Tilcotil)
      in 30 patients with active rheumatoid arthritis. In no instance was it necessary
      to discontinue treatment, only one female patient complained of transient
      vertigo. During the final evaluation of the therapeutic effect as regards
      painfulness, sensitivity on palpation, oedema, restriction of movements, the
      author did not observe a satisfactory effect only in 8.5-24%. As regards hand
      grip, 20 m walk and consumption of analgesics the effect was also very
      satisfactory. Only four patients used occasionally Paracetamol or Alnagon, 1-2
      tablets per day. The results achieved with this treatment indicate that it is a
      very good preparation suited for prolonged therapy of active rheumatoid
      arthritis, incl. patients of advanced age. Tenoxicam is particularly suited for a
      single dose per day (20 mg). It can be recommended also combined with gold
      therapy and treatment with antimalaric drugs.

PMID- 2219766
TI  - [An unusual case of prolonged hypoglycemia].
AB  - The author described a case of protracted hypoglycaemia in a young type I insulin
      treated diabetic, associated at first with neurological symptomatology imitating
      a cerebrovascular attack. After three days, when it was necessary to administer
      repeatedly glucose by the i.v. route on account of low blood sugar levels, the
      carbohydrate metabolism deteriorated and called for administration of similar
      insulin doses as before. In the discussion the author deals with pathogenetic
      possibilities of the described condition.

PMID- 2219767
TI  - [Pathogenic aspects of diabetic macroangiopathy].
AB  - Diabetics of both types suffer more frequently from atherosclerosis of the
      coronary, cerebral and peripheral arteries than the non-diabetic population of
      similar age groups. In the pathogenesis of atherosclerosis in diabetes an
      important part is played by the very frequent association of the diabetic
      syndrome with hyperlipoproteinaemia and hypertension, elevated levels of
      substances potentially toxic for the endothelium such as glucose, chylomicron
      remnants, sorbitol, immunocomplexes, CO and others. Changes of thrombocyte
      functions and of the equilibrium of the system prostacycline-thromboxane as well
      as disorders at different sites of the haemocoagulation an fibrinolytic cascade,
      no doubt, interfere in a negative way with the process of atherogenesis. Non
      enzymatic glycosylation of various proteins probably is also of a certain
      importance for the process of atherogenesis. The genetic background of the
      individual has obviously an impact on atherosclerotic complications in diabetics
      of type 2 (U-allele) where potential atherogenic hyperinsulinaemia is one of the
      constant manifestations of the disease. The second form of macroangiopathy
      (mediocalcinosis) affects practically only diabetic subjects and is probably due
      to the denervation of the blood vessels of the extremities in diabetic
      neuropathy. Identification and influencing of risk factors of macroangiopathy
      could have a favourable effect on the quality of life and prognosis of diabetic
      patients.

PMID- 2219768
TI  - [Treatment of hyperglycemic coma states in diabetics].
AB  - In the treatment of acute decompensation of diabetes, diabetic ketoacidosis and
      hyperosmolar non-acidotic syndrome the basic demand is insulin administration--in
      small doses by the i.v. route, preferably by means of an injectomat in a
      permanent infusion. An alternative method for departments which do not possess a
      suitable infusion pump, is fractionated administration of small insulin amounts
      into the vein after 30 minute intervals. Equally important is rehydration
      treatment with saline; only in case of hypernatriaemia above 150 mmol/l the
      author recommends 0.45% NaCl. Acidosis in DKA is corrected by sodium bicarbonate
      only at pH 7.1 or less. As to K cations, the replacement of potassium ions is
      most important; the value of substitution of other cations (Ca, Mg) is doubtful
      and is not currently done, the same applies to phosphate anion replacement. It
      has not been proved that prevention of thromboembolic complications by heparin is
      expedient in these conditions.

PMID- 2219769
TI  - [Treatment of acute pulmonary edema].
AB  - The authors give an account of treatment of acute pulmonary oedema. Their account
      is based on contemporary data in the literature and their own experience. Some
      aspects of the therapeutic procedures are described in detail. The review should
      serve as a practical guide for doctors not concerned in particular with the
      treatment of acute states.

PMID- 2219770
TI  - [The significance of rehabilitation in angiology].
AB  - The author draws attention to the important position of different types of
      rehabilitation in the treatment of arterial, venous and lymphatic diseases. He
      mentions also different methodical procedures in the listed diseases. He
      emphasizes that rehabilitation, in particular intensive interval training,
      remains the main therapy of ischaemic disease of the lower extremities.

PMID- 2219772
TI  - [Prof. Julius Markovic, an outstanding patriot and physician].

PMID- 2219771
TI  - [Use of nonparametric methods in medicine. I. Introduction].
AB  - This is the introductory article of a series of eight where the authors discuss
      non-parametric methods. They compare the advantages and disadvantages of non
      parametric methods with parametric ones. Non-parametric methods can be used in
      particular where the investigated variables do not have a normal distribution,
      where the small size of the investigation and the type of classification do not
      permit to test, when information on the investigated variables are presented by
      means of rank or normal scales etc. Their disadvantage is a smaller ability to
      refute the null hypothesis, when it is not correct, as compared with parametric
      tests.

PMID- 2219773
TI  - [The problems of medical support in extreme situations].

PMID- 2219774
TI  - [The organization of laboratory diagnosis in catastrophic medicine].

PMID- 2219775
TI  - [The organization of a hospital at home for the Central Consultative Diagnosis
      Polyclinic].

PMID- 2219776
TI  - [Experience with the integrated use of microcomputers in a military hospital].

PMID- 2219777
TI  - [The prevention and treatment of stomatological diseases in servicemen: the
      problems and the reserves].

PMID- 2219778
TI  - [Experience in treating patients with lesions of the periodontal tissues].

PMID- 2219779
TI  - [The diagnosis and treatment of the vascular injuries in gunshot fractures of the
      leg bones].

PMID- 2219780
TI  - [Military medical colleges on the pathways of perestroika].

PMID- 2219781
TI  - [The treatment of the acute stage of inflammation of epithelial fistulae and
      cysts of the coccyx by using the CO2 laser].

PMID- 2219782
TI  - [Surgical treatment in inflammation of epithelial fistulae and cysts of the
      sacrococcygeal region].

PMID- 2219783
TI  - [The Paget-Schroetter syndrome].

PMID- 2219784
TI  - [Current problems of rheumatic diseases (based on materials from an editorial
      round table)].

PMID- 2219785
TI  - [The iridodiagnosis of diseases of the internal organs in persons with
      conjunctivitis].

PMID- 2219786
TI  - [The epidemiology of AIDS (a review of the literature)].

PMID- 2219787
TI  - [Experience in treating cutaneous leishmaniasis by using low-energy laser
      radiation].

PMID- 2219788
TI  - [The psychophysiological characteristics of the occupational adaptation of
      servicemen].

PMID- 2219789
TI  - [Ways to improve health education].

PMID- 2219790
TI  - [The relationship of the arterial pressure level and blood lipids to body weight
      in flight personnel].

PMID- 2219791
TI  - [The assessment of the functional state of the cardiorespiratory system in
      sailors with a high level of physical work capacity].

PMID- 2219792
TI  - [The improved conservative treatment of pelvic bone fractures in multiple and
      combined injuries].

PMID- 2219793
TI  - [A method for treating severe forms of typhoid peritonitis].

PMID- 2219794
TI  - [The problems of building medical service personnel up to strength during World
      War II].

PMID- 2219795
TI  - [A quarter century for the military medical faculties in medical institutes].

PMID- 2219796
TI  - [The 50th anniversary of the Department of Military Naval and Hospital Therapy of
      the S. M. Kirov Military Medical Academy].

PMID- 2219797
TI  - [Metabolic turnover of catecholamines in the heart of rats after nonfatal burns].
AB  - The content and metabolic turnover of noradrenaline (NA) and adrenaline (A) have
      been studied in the hearts of rats subjected to nonlethal scalding. The results
      of the study have shown that in an early phase of the general reaction of the
      organism to thermal trauma it has come to the decreased NA content while in the
      later phase the NA content was in the limits of control values. The increased
      contents of Na and A in the murine hearts after monoamineoxidase inhibition and
      injection of L-DOPA indicated the preservation of the synthesis and overtaking of
      catecholamines by the heart muscle. The increase of the metabolic turnover and
      shortening of the time of the metabolic turnover of NA and A have pointed that
      the increased NA content in the hearts of the traumatized animals is the
      consequence of the increased requirements of these catecholamines by the heart
      muscle in the early posttraumatic phase.

PMID- 2219798
TI  - [Chlamydia trachomatis in women].
AB  - The results of the prospective study of chlamydia trachomatis infection in women
      are presented. The study comprised 288 women aged from 19 to 67 years with the
      completed clinical and anamnestic data and the following tests have been
      performed: indirect immunofluorescence test for detection of Chlamydia
      trachomatis antigens in endocervical smears (using monoclonal antibodies), ELISA
      test for detection of IgG antibodies against Chlamydia trachomatis in the sera
      and complement binding reaction for detection of antibodies against grouped
      Chlamydia antigen. Chlamydia trachomatis infection was found in 29.51% of cases
      equally distributed in all age groups. The incidence of Chlamydia positive
      findings was analysed according to clinical diagnosis, parity, relevant data from
      gynecologic anamnesis and the results of vaginal secretion and Papanicolau's
      stain test. In order to establish a reliable diagnosis of Chlamydia trachomatis
      infection two methods should be regularly used: one direct-for detection of a
      causative agent in patients' materials, and the other-indirect, for detection of
      specific antibodies in the serum.

PMID- 2219799
TI  - [Injuries during specialist training of recruits].
AB  - Traumatism of recruits has been studied during specialized infantry and artillery
      courses within the basic training of recruits. The prospective study refers to
      the application of the Plan and Program of Training and Education for 1985. It
      has been found that the observed activities did not present equally risky
      activities concerning traumatism of recruits of the studied branches of the army.
      Physical activity has shown to be the most risky one within the training program.

PMID- 2219800
TI  - [Verification of vital capacity and 1 second forced expiratory volume values in
      14,234 candidates for aviation school].
AB  - The values of vital capacity (VC), forced expiratory volume in the first second
      (FEV1) and Tiffeneau index (100xFEV1/VC) were determined in 14,234 examinees in
      the period 1977-1987. Examinations were performed using the Godart expirometer.
      After the statistical analysis of the results being performed, the unique table
      was made according to height and age of examinees. The examinees came from all
      regions of Yugoslavia. The results of the study can be used for establishment of
      standard values of pulmonary ventilation for candidates for aviation schools,
      i.e. for youngsters aging from 14 to 20 years.

PMID- 2219801
TI  - [Personal experience in the diagnosis and treatment of pulmonary embolism].
AB  - The 188 patients with pulmonary embolism were treated at the Clinic for Pulmonary
      Diseases of the M.M.A. in the period 1979-1989. Clinical symptoms and signs,
      diagnostic procedures and therapy of pulmonary embolism are analysed. The
      diagnosis is difficult and is suggested by the predisposing factors, symptoms and
      signs of the disease as well as indirect diagnostic procedures. The contribution
      of perfusion lung scintigraphy is precious. Deep venous thrombosis of the lower
      extremities, the source of pulmonary embolism, is commonly clinically absent. The
      complete cure without complications was achieved in 156 (83%) patients. The most
      common complications were: early and late recurrences, hematuria and peptic
      bleeding. The lethal outcome occurred in two cases of basic disseminated
      malignant disease.

PMID- 2219802
TI  - [Value of the stress test in the evaluation of the severity of ischemic heart
      disease].
AB  - Loading test was used in 156 patients with ischemic heart disease and the results
      of their selection are presented. In all patients occlusive coronary disease was
      detected by selective coronarography. They were divided in three groups. Two
      groups of patients had a high risk ischemic heart disease requiring surgical
      revascularization of the myocardium and selective coronarography. The first of
      these two groups comprised 48 patients with significant stenosis of the main tree
      of the coronary artery and the second comprised 35 patients with equivalent
      stenosis of this artery. The third group comprised 73 patients with ischemic
      heart disease of small risk in whom occlusive changes of the coronary arteries
      were of distal localization. The statistically significant difference was found
      between the two groups of patients with high risk and the third group with small
      risk according to early development of ST depression in the first minutes of
      loading, its degree, number of leads with ST depression, form and its maintenance
      after cessation of loading. The difference was also significant regarding the
      submaximal pulse rate and systolic blood pressure during loading test. It has
      been concluded that by using loading test as a functional diagnostic method
      patients with a high risk ischemic heart disease can be selected stressing the
      advantage of physiology over morphology.

PMID- 2219804
TI  - [Use of enamel-dentin adhesive in the restoration of defects in the cervico-root
      region of teeth].
AB  - The incidence of cervical defects was epidemilogically studied on a sample of 60
      teeth with periodonatl disease and cervical defects which were classified in
      three groups. Also, the control clinical prospective study comprised 44 esthetic
      external restorations made of monocomponent resin (Heliosit and Visio-Disperse)
      and bicomponent resin (Silar and Dentosit) in the cervico-radical region of the
      vestibular surface od teeth with periodontal disease. Enamel-dentin adhesive was
      used as a bonding agent. Two parameters were followed up: 1. restoration margin
      staining, and 2. retentional state of restoration. The studies have shown that:
      a) the cervico-radical defects affecting both the dentin-coronary third of the
      root and the dentin-cervical third of the crown were found in 64% of subjects
      with periodontal disease and cervical defects requiring application of
      monocomposite resin in the same percentage, b) enamel-dentin adhesive+ composite
      restorations made of monocomposite resin showed changes in both mentioned
      parameters in a significantly lower percentage being of markedly smaller
      intensity than those made of bicomposite resins, and c) bonding capacity of
      enamel-dentin adhesives is an important additional factor of retention of
      esthetic restorations made in the cervico-radial dental region.

PMID- 2219803
TI  - [Fibrin glue in tympanoplasty].
AB  - In order to achieve more favourable anatomic and functionally more permanent
      position of the transmission materials, fibrin glue was applied in 68 patients
      undergoing different microsurgical interventions for the cure of inflammatory
      processes in the middle ear or improvement of conductive deafness of inflammatory
      or traumatic origin. Fibrin glue has shown to be equally suitable both in
      fixation of the biological materials - homografts and autografts and in fixation
      of alloplastic prostheses. The efficacy of preservation of the best position was
      demonstrated in all forms of direct collumelas, ossicular graft interposition,
      closure of the labyrinthine fistulas and reconstruction of the external attic
      wall.

PMID- 2219805
TI  - [Young people in the Yugoslav Military and smoking].

PMID- 2219806
TI  - [Hypochondria--definition and clinical use of the concept].

PMID- 2219807
TI  - [Treatment of late-stage skin porphyria].

PMID- 2219808
TI  - [Advances in the surgical treatment of ostial stenosis of the left coronary
      artery].

PMID- 2219809
TI  - [The action of a decimeter-wave electromagnetic field on the indices of the blood
      kallikrein-kinin system in rabbits with an experimental myocardial infarct].
AB  - Continuous 10-day exposure of the heart and adrenal regions of rabbits with
      myocardial infarction to electromagnetic field produced by decimeter waves leads
      to activation of kallikrein-kinin system. With the heart exposure, this
      activation comes through marked changes in microcirculatory bed, whereas in the
      adrenal exposure it is trophic defects that are induced in the myocardium. The
      exposure of the thyroid regions brings about unnoticeable effect.

PMID- 2219810
TI  - [Physical factors in the treatment of patients with ankylosing spondylarthritis].
AB  - The effect of decimeter electromagnetic waves, ultrasound, induction therapy,
      crysanol phonophoresis was compared in relevant treatment of 180 AS patients. The
      response to the above factors was almost similar in AS activity of the I degree.
      Central AS of the II degree of activity was more sensitive to decimeter waves
      while for peripheral and rhizomelic forms the results of crysonal phonophoresis
      were more positive. Dominating immunocorrective effect of the waves and partial
      immunodepressive action were referred to decimeter waves and crysanol
      phonophoresis, respectively.

PMID- 2219811
TI  - [Aspirin-butadione electrophoresis in the treatment of patients with rheumatoid
      arthritis].

PMID- 2219812
TI  - [The balneological and traction therapy of osteoarthrosis patients].

PMID- 2219814
TI  - [The use of UV irradiation to correct the immune system and decrease morbidity in
      athletes].

PMID- 2219813
TI  - [A new heliotherapy unit for treating patients with osteoarthrosis deformans].
AB  - The effectiveness of osteoarthritis deformans treatment was compared for impulse
      concentrated solar light and heliotherapy under screen gills. Either therapy was
      combined with therapeutic exercises, massage and mineral baths.

PMID- 2219815
TI  - [The interference-current therapy of chronic salpingo-oophoritis (a trial of
      studying the regional hemodynamics)].
AB  - Blood redistribution in blood circulatory beds (the uterus, external genitalia
      and vagina) and as a whole have been established in exposure to interference
      currents. Ka index of rheoencephalography may be used as an additional objective
      criterion of individual sufficiency of physiotherapeutic exposure.

PMID- 2219816
TI  - [Experience with the combined treatment of chronic prostatitis].
AB  - Available are the results of combined treatment of chronic prostatitis in 86
      patients. The treatment schedule included ultraphonophoresis of highly dispersed
      drug mixtures, bitemporal UHF waves exposure, endourethral electrostimulation and
      laser radiation of prostatic tissue. The complex of interacting modalities has
      been substantiated pathogenetically. Clinical and laboratory assessment of the
      patients' response supports high effectiveness of the proposed combined schemes
      for management of chronic prostatitis.

PMID- 2219817
TI  - [The effect of electromagnetic oscillations in the decimeter range on the
      function of nerve and muscle tissues (experimental research)].

PMID- 2219818
TI  - [The experimental effect of centimeter-range microwaves on drug
      biotransformation].

PMID- 2219819
TI  - [A method for enhancing the therapeutic action of ultraviolet rays in psoriasis].

PMID- 2219821
TI  - [Tumnin--the first place for radon treatment in the Far East].

PMID- 2219820
TI  - [The differential use of methods of vibration therapy in the neurological
      manifestations of spinal osteochondrosis].

PMID- 2219823
TI  - [The ecological problems of the health resort and recreational use of bodies of
      water].

PMID- 2219824
TI  - [Physiotherapy during World War II].

PMID- 2219822
TI  - [The experimental and clinical aspects of the action of electromagnetic fields on
      the endocrine glands and brain].

PMID- 2219825
TI  - [Therapeutic physical exercise during World War II].

PMID- 2219826
TI  - [The treatment of 5 multiple primary neoplasms in one patient over a period of 17
      years].

PMID- 2219827
TI  - [The local application of metronidazole during the radiotherapy of endometrial
      cancer].

PMID- 2219828
TI  - [Morphologic criteria of the risk of cancer of the vulva].

PMID- 2219830
TI  - [X-ray studies of Kaposi's sarcoma].

PMID- 2219829
TI  - [Current approaches to the treatment of patients with lymphogranulomatosis].

PMID- 2219831
TI  - [Paraneoplastic psychopathologic syndromes].
AB  - The diagnosis of paraneoplastic neuro-psychic syndromes is very difficult and
      still remains an unresolved issue. A retrospective analysis included case
      histories of 79 patients with marked psychopathologic symptoms concomitant to
      cancer which had been verified at autopsy but had been difficult to diagnose
      during life. All these cases are regarded as having suffered paraneoplastic
      psychopathologic syndromes which are of great clinical and diagnostic interest.
      Certain theoretical observations concerning the pathogenetic mechanisms
      underlying paraneoplastic psychic disorders are made.

PMID- 2219832
TI  - [Melanoma of the skin: clinico-genetic studies].
AB  - As a result of clinico-genealogical analysis of data on 691 skin melanoma
      patients, a classification of skin melanoma was elaborated which reflected the
      etiologic heterogeneity of the disease. Inheritable and non-inheritable forms of
      skin melanoma were identified. The inheritable tumor group included familial
      disease (2%) and tumors developing against the background of hereditary diseases
      and syndromes (32.7%). The data obtained served as basis for the identification
      of families with high genetic predisposition to skin melanoma development and for
      the assessment of individual risk of the disease in patients' relatives.

PMID- 2219833
TI  - [The diagnosis and treatment of primary malignant tumors of the sternum].
AB  - Results of examination and treatment of 24 patients with primary neoplasms of the
      sternum including chondrosarcoma (18 cases), solitary plasmacytoma (5) and
      osteogenic sarcoma (1) were analysed. The diagnosis was based mainly on X-ray
      procedures and was further improved by computed tomography which allowed to
      precisely evaluate the extent of intrathoracic mass and its relation to adjacent
      mediastinal structures. Surgery was the main procedure used for the treatment of
      primary tumors of the sternum. Sixteen patients were operated on, and not a
      single case showed involvement of the mediastinum. Closure of defect was the
      major difficulty involved in the surgical treatment. Adequate resection of the
      sternum followed by autoplasty yielded good results.

PMID- 2219834
TI  - [Stimulation of the synthesis of C-reactive protein using pyrogenal in non
      neoplastic diseases and cancer of the lungs].
AB  - Method of immunodiffusion titration of rabbit monospecific antiserum (The I. M.
      Mechnikov Central Research Institute of Vaccines and Sera of the USSR Ministry of
      Health) in agar was used to measure blood C-reactive protein (C-RP) level in
      patients with acute pneumonia (32), protracted pneumonia or activation of chronic
      non-specific lung pathology (101) and lung cancer (153) after a 3-4-week course
      of complex antiinflammatory treatment and a 10-14-day course of immunostimulation
      with pyrogenal (The N. F. Gamaleya Research Institute of Epidemiology and
      Microbiology). A decrease in the incidence (from 81.2% to 14.2%) and level (from
      1.4 +/- 0.3 to 0.3 +/- 0.03 mg%) of C-RP was observed in cases of non-tumor
      pathology whereas in patients with lung cancer those values rose in step with
      tumor progression (from 72.2% and 0.4 +/- 0.07 mg% at stage I to 96.3% and 1.2 +/
      0.12 mg% at stage IV). Treatment with pyrogenal allowed to identify C-RP in
      patients with false-negative reaction in all subgroups. Two-week dynamic C-RP
      curves characterizing non-tumor and tumor pathology of the lung were plotted.

PMID- 2219835
TI  - [Melanomas of the anorectal region].
AB  - Melanoma of the anorectal region is a rare disease which makes up 1.8% of all
      rectal malignancies and 1.4% of all cases of melanoma. Surgery is the only
      radical procedure for the treatment of anorectal melanoma. Abdomino-perineal
      extirpation of the rectum proved most radical. Overall five-year survival rate
      was 17.0 +/- 5.3%.

PMID- 2219836
TI  - [Immunologic markers of erythrocytes in lymphogranulomatosis].
AB  - The paper summarizes results of a study on immunologic markers of eight
      erythrocytic systems (ABO, Rh-Hr, MNSs, Kell-Cellano, Daffy, Kidd, Levis and
      Diego) which include 21 antigens in healthy subjects and patients with Hodgkin's
      disease of the Armenian nationality. Peculiarities of distribution of some
      erythrocytic antigens in patients with Hodgkin's disease were identified.

PMID- 2219837
TI  - [Approaches to predicting the reaction of human tumors to radiotherapy].
AB  - Immunofluorescent method using anti-thymidine antibodies was employed to assess
      proliferative activity of 217 human tumors including oropharyngeal, esophageal,
      gastric, rectal and lung cancer. The activity was evaluated before and, in 38
      neoplasms, in the course of radiotherapy. It was shown that changes in the
      proliferative activity of oropharyngeal and gastric malignancies observed early
      in the course of radiation treatment may serve for predicting response.

PMID- 2219838
TI  - [The cytostatic action of the K+/H+ antiporter nigericin].
AB  - A decrease in pH in Ehrlich ascites carcinoma cells to 6.3 leads to intracellular
      DNA synthesis inhibition. The inhibitory effect was achieved in the course of
      incubation of cells at pH 6.2 as well as by the addition of low-dose K+/H+
      antiporter antibiotic nigericin. DNA synthesis inhibition by nigericin was not
      associated with significant decrease in ATP level or mitochondrial membrane
      potential. The effect was mediated by a decrease in intracellular pH rather than
      by a decrease in intracellular potassium level or elevation in that of
      intracellular sodium which accompanied nigericin treatment.

PMID- 2219839
TI  - [The antitumor effect of an extract of human umbilical cord].
AB  - The study was concerned with the evaluation of effect of the extract of a human
      fetal organ, the umbilical cord, on development and growth of such transplantable
      tumors as Ehrlich's ascites tumor, sarcoma 37, sarcoma 180 and Zajdela's hepatoma
      as well as of dimethylbenzanthracene- and benzo(a)pyrene-induced cancer. In a
      subgroup of animals who had been vaccinated once or twice prior to inoculation of
      cells, a significant inhibition of growth of tumors of all the histologies except
      sarcoma 180 was observed alongside with a decrease in tumor incidence and partial
      resorption of ascitic fluid. Preliminary vaccination of rats interfered with
      dimethylbenzanthracene- and benzo(a)pyrene-induced carcinogenesis reducing tumor
      incidence and assuring longer latent period and slower progression of cancer.

PMID- 2219840
TI  - [Organizational principles of the outpatient examination of patients suspected of
      malignant tumors].
AB  - Out-patient diagnosis of cancer is carried out in three stages which involve
      activities of different physicians. Cancer is first suspected by a general
      practitioner. Prophylactic measures other than examination by specialists and
      chest photo-roentgenography proved insufficient, and the authors give reasons for
      this. During the second stage, the patient undergoes further thorough examination
      which should be well organized to succeed. The third stage, viz. making the final
      diagnosis, should be performed in an oncologic establishment only.

PMID- 2219841
TI  - [The attitude of cancer patients to their own diagnosis].
AB  - The wide spectrum of viewpoints on how fully should a cancer patient be informed
      of his or her disease made it interesting to evaluate patients' own attitude to
      the issue. A questionnaire was offered to 280 cancer patients to assess the
      degree of awareness of their disease as well as psychologic preparedness to face
      the true diagnosis. As many as 93.6% of patients expressed a certain degree of
      desire to know diagnosis and details of their disease.

PMID- 2219843
TI  - [Echographic semiotics of cancer of the breast].
AB  - Analysis of ultrasonic tomograms of 228 cases of breast cancer identified three
      ultrasonographic patterns of tumor which included seven basic variants.
      Ultrasonographic features of tumor were compared to their histology. Methods of
      ultrasonic examination of the breast and processing data are described.

PMID- 2219842
TI  - [The combination treatment of malignant bone tumors using fast neutrons].
AB  - The study deals with results of a clinical trial evaluating treatment efficacy of
      a 6 MeV neutron beam produced by Y-120 cyclotron (Kiev). Procedures of
      preoperative radiotherapy and radical treatment are discussed. Radiotherapy was
      administered to 52 patients suffering chondrosarcoma (30 cases), osteogenic
      sarcoma (15) or chordoma (7). Combined treatment (radiation + surgery) was given
      to 22 patients whereas neutron beam therapy--to 30. All patients with osteogenic
      sarcoma received adjuvant combination chemotherapy. Three-year survival rate was
      compared to that observed in controls in whom combined treatment had included
      gamma-therapy. A significant increase in three-year survival rate was observed
      for osteogenic sarcoma and chordoma whereas for chondrosarcoma the improvement in
      survival proved insignificant. The use of fast neutrons in combined treatment of
      bone tumors was considered promising.

PMID- 2219844
TI  - [The ambulatory care of patients with precancerous diseases of the stomach].
AB  - Two hundred and ninety-four patients with precancerous lesions of the stomach
      were followed and treated. The group included cases of gastric ulcer (101),
      polyps (78), atrophic-hyperplastic gastritis (81) and 34 patients who had
      undergone gastric resection for duodenal ulcer. Pathologic foci were surrounded
      by areas of epithelial dysplasia of varying degree in almost all patients. In the
      course of follow-up and treatment, dysplasia regressed in several cases and
      progressed to early cancer of the stomach in three. Recommendations for
      periodicity of check-ups of patients with chronic cancer of the stomach depending
      on degree of mucosal epithelium dysplasia were developed.

PMID- 2219845
TI  - [The relation between dysplasia of the bronchial epithelium and endocrine shifts
      in patients with chronic nonspecific diseases of the lungs].

PMID- 2219846
TI  - [The human immunodeficiency virus type 2].

PMID- 2219847
TI  - [Experimental research on the ecology of the tick-borne encephalitis virus].

PMID- 2219848
TI  - [The prodigiozan and pyrogenal stimulation of the humoral response to influenza
      virus antigens in mice].
AB  - The adjuvant properties of prodigiosan and pyrogenal, lipopolysaccharides of
      medical importance, were studied. Prodigiosan inoculated to mice together with
      influenza virus was found, on the one hand, to increase 10-fold the titer of
      specific antibodies and, on the other, to allow to reduce the antigen dose 50
      fold or more. No adjuvant properties of pyrogenal were observed under the
      experimental conditions.

PMID- 2219850
TI  - [The importance of early and maternal antibodies to HBsAg in preventing hepatitis
      B in plasma recipients].
AB  - Among 182 prematurely born babies receiving transfusions of HBsAg-negative plasma
      (blood), 49 (26.9%) were found to have antibodies to HBsAg (anti-HBs) in the 1st
      week of life, of them 29 had maternal and 20 early antibodies. Early anti-HBs and
      maternal antibodies detectable in blood sera of premature newborns were found to
      be protective, capable of preventing both icteric forms of acute posttransfusion
      hepatitis B and anicteric variants of this infection after plasma transfusion.

PMID- 2219849
TI  - [The immunomodulating action of mytilan in an experimental influenza infection].
AB  - The materials characterizing the immunomodulating activity of mytilan, a
      bioglycane from an industrial object of Japanese sea, Crenomytilus grayanus, in
      experimental influenza infection are presented. The preparation protected up to
      60% of mice intranasally inoculated with influenza virus, and significantly
      inhibited influenza virus reproduction. It induced interferon (possibly gamma IF)
      synthesis in low titres. The immunomodulating effect of mytilan consisted in
      stimulation of specific antibody genesis, enhancement of chemotaxis, increasing
      oxidation-reduction activity, enhancement of expression of Fc gamma-receptors by
      splenocytes and macrophages, enhancement of antibody-dependent spleen cell
      cytotoxicity, increased activity of natural killer cells, as well as increased
      complementary activity of blood serum and enhanced expression of C3 receptors by
      mouse spleen cells.

PMID- 2219852
TI  - [The characteristics of the interaction of the proteins comprising the virions of
      the human immunodeficiency virus type 1].
AB  - Treatment of virions of human immunodeficiency virus type 1 (HIV-1) with ionic
      and nonionic detergents (NP-40, octylglucoside, sodium deoxycholate) exerted an
      effect on the virus uncommon for enveloped viruses: instead of solubilization,
      both glycoproteins (gp120 and gp41) were found in subviral particles, whereas the
      core protein p24 was found in the supernatant fluid after the removal of subviral
      particles by centrifugation. The matrix protein p17 and unprocessed molecules of
      the precursor protein p55 were associated with subviral particles. The above data
      confirm the proposed model of the HIV-I structural organization according to
      which glycoproteins are incorporated into the isometric matrix formed by protein
      p17. Our data indicate that the core protein p24 is not incorporated into the
      matrix and not associated with nucleocapsid proteins.

PMID- 2219851
TI  - [The localization of delta antigen in the hepatocytes in chronic delta
      hepatitis].
AB  - The results of immunohistochemical and electron microscopic examinations of liver
      biopsies from 47 patients with chronic delta hepatitis are presented. Delta
      antigen (HDAg) was detected by immunoperoxidase method in the liver of 35 (74.4%)
      patients. HDAg was demonstrated in hepatocyte nucleus alone in 22 (62.9%)
      patients, simultaneously in the nucleus and the cytoplasm in 9 (25.7%), in the
      cytoplasm alone in 4 (11.4%). In nuclear localization, delta antigen may fill the
      entire nucleoplasm or only the peripheral zone of the nucleus. When delta antigen
      fills the entire nucleus, hepatocytes undergo more marked pathological changes
      than those in which HDAg is localized in the nuclear periphery or those where no
      delta antigen was found.

PMID- 2219853
TI  - [The properties of HIV protease synthesized in E. coli cells].
AB  - A hybrid plasmid pPR6 was constructed containing BgII-EcoRI fragment of the pol
      region of HIV (strain IIIB) genome which determined the synthesis of virus
      specific protease. Extracts of E. coli DN5/pPR6 bacteria provided for specific
      hydrolysis of hybrid protein p165 (the N-terminus of which is presented by
      complete beta-galactosidase and the C-terminus by duplicated area of virus
      specific precursor p55 containing a site for virus-specific protease located at
      the border of proteins p17 and p24) with formation of products having molecular
      weights of 19, 42, 28, 23, and 19 kD. Polypeptides 119K, 23K, and 19K are
      products of complete hydrolysis, and 42K a result of partial cleavage. The
      kinetics of hydrolysis in relation to pH values of the reaction mixture was
      analysed. It is suggested that the reported system of HIV protease activity
      determination be used for screening of potential inhibitors of this enzyme.

PMID- 2219854
TI  - [A mixed infection of lymphoid cell lines by the human T-lymphotropic retrovirus
      type I (HTLV-I) and the measles vaccine virus].
AB  - Interaction of HTLV-1 and vaccine strain of measles virus (VM-L16) in different T
      and B cell lines was studied. VM-L16 replicated in T and B cells with a
      cytopathic effect. At a multiplicity of infection of 1 TCD50 per 10 cells, all
      the cells in cultures died within 4-13 days. No effect of HTLV-1 on cell
      sensitivity to VM-L16 was demonstrated. HTLV-1 produced in various T-cell lines
      had different syncytium-forming activity in XC cell cultures. Cocultivation of
      C91/pL cells with XC cells led to the formation of multiple syncytia. HUT-102
      cells had no such activity. Infection of these cell lines with VM-L16 did not
      change their properties. Another HTLV-1-infected cell line, MT-2, caused
      insignificant aggregation of XC cells. Infection of the latter with VM-L16
      increased the number of racemations 8-fold, and they consisted of numerous
      adhesive cells. The cell adhesion, however, which is the first stage of syncytium
      formation did nor terminate in cytoplasm confluence. MT-2 nad XC cell lines may
      be used as model systems for the study of various factors influencing HTLV-1
      activation.

PMID- 2219855
TI  - [The purification of tick-borne encephalitis virus preparations of cellular DNA].
AB  - According to the WHO requirements, the concentration of cellular DNA in vaccine
      preparations produced by pooling virus from continuous cell lines is limited to
      100 ng/dose. In this study, different methods were used for purification of tick
      borne encephalitis virus suspensions grown in continuous cultures of cell line
      4647 from cellular DNA. Two approaches are proposed based on treatment with DNAse
      and promamin sulfate which allow one to reduce cellular DNA concentration in the
      virus preparation to the acceptable level. Prospects of their use in vaccine
      production are discussed.

PMID- 2219856
TI  - [The immunogenic and hemagglutinating activities of tick-borne encephalitis viral
      strains isolated from patients in different parts of the geographic range of the
      disease].
AB  - Considerable variability of the immunogenic and antigenic (in HA test) activity
      of tick-borne encephalitis virus strains was shown. No correlation was observed
      between the hemagglutinating activity of strains and their capacity to stimulate
      humoral immunity in the infected animals. The results of the study did not allow
      one to place strains into groups according to the area of isolation in relation
      to their immunogenic and antigenic activity.

PMID- 2219857
TI  - [Cellular transformation in an MDCK culture caused by the agent of amyotrophic
      leukospongiosis].
AB  - The possibility of infecting epithelioid MDCK cell culture with the agent of
      amyotrophic leukospongiosis (AL) was shown. Various morphofunctional changes were
      observed in the infected cells. In the first subpassage, the saturation density
      and yields of cells increased, while their mitotic activity decreased and
      adhesive properties changed. In the second subpassage, the cell morphology and
      monolayer architectonics changed, the cells losing the ability to form a
      confluent monolayer. The infected cultures died in further subpassages. Clinical
      signs of the disease and morphological changes in the CNS typical of AL were
      observed in the animals infected with a homogenate of cells and culture fluid
      from the AL-agent-infected cultures.

PMID- 2219858
TI  - [The antiviral efficacy of ribamidil in an experimental infection of animals with
      the Venezuelan equine encephalomyelitis virus].
AB  - Considerable differences in antiviral efficacy of ribamydil were demonstrated in
      various animals experimentally infected with Venezuelan equine encephalomyelitis
      virus. The infection in baboons was quite similar to the manifestations of this
      disease in man as reported in the literature. With ribamydil used
      prophylactically, manifestations of the infection in monkeys were less marked.

PMID- 2219860
TI  - [The comparative characteristics of the genetic traits of the Lassa and Mopeia
      viruses].

PMID- 2219859
TI  - [The determination of viral antibodies in patients with disseminated sclerosis].

PMID- 2219861
TI  - [The preservation of human immunodeficiency viruses by lyophilization].

PMID- 2219863
TI  - [An evaluation of immunoenzyme test systems for detecting HIV antibodies in an
      international trial].

PMID- 2219862
TI  - [The detection of the HIV antigen and antibodies by using an agglutination test
      with Soviet latex].

PMID- 2219864
TI  - [A comparative evaluation of methods for detecting the Rift Valley fever virus].

PMID- 2219866
TI  - [A list of the scientific topics recommended by the Expert Council to the
      Presidium of the Academy of Medical Sciences of the USSR on the scientific
      problems of AIDS for study in 1989-1990].

PMID- 2219865
TI  - [The trans-activator genes of viral transcription].

PMID- 2219867
TI  - [A list of the scientific topics recommended by the Expert Council to the
      Presidium of the Academy of Medical Sciences of the USSR on the scientific
      problems of AIDS for study in 1989-90].

PMID- 2219869
TI  - The changing epidemiology of diabetes mellitus among Navajo Indians.
AB  - Although early descriptions of diabetes mellitus among Navajo Indians
      characterized the disease as an infrequent and "benign chemical abnormality," the
      prevalence of diabetes and its complications among Navajos appears to have
      increased substantially in this century. We reviewed recent Indian Health Service
      inpatient and ambulatory care data and compared these data with previous reports.
      Of the estimated Navajo population aged 45 years or older, 4,331 (16.9%) had an
      ambulatory care visit for diabetes between October 1, 1986, and September 30,
      1987. Diabetes was coded for 1,041 (7.0%) of hospital admissions of persons aged
      20 and older. Of 377 lower-extremity amputations done from 1978 to 1987, diabetes
      was involved in 245 (66%). The 1986 age-adjusted mortality rate from diabetes was
      30.3 per 100,000, approximately twice that for the general US population. The
      explanation for the increased prevalence of diabetes mellitus among Navajos
      probably relates to an increasing prevalence of obesity.

PMID- 2219868
TI  - Compliance and outcome in anorexia nervosa.
AB  - Anorexia nervosa is notoriously difficult to treat, but little is known regarding
      the relationship of compliance to treatment outcome. We investigated in 41
      adolescents who fulfilled DSM-III-R criteria for anorexia nervosa, the
      relationship between the completion of a standard psychosocial treatment program,
      subtypes of anorexia nervosa, and outcome as determined by standardized
      measurements. These adolescents were observed for an average of 32.4 months.
      Overall, 29 patients (70%) improved considerably, but 10 (24%) were symptomatic,
      and 2 (5%) remained in poor condition. There were no deaths. Of the 41 patients,
      14 (34%) completed our entire treatment program, 15 (37%) received major
      treatment and failed in the outpatient follow-up phase only, 7 (17%) dropped out
      of inpatient treatment before its completion, and 5 (12%) refused treatment in
      our system altogether. Of all the dropouts, 10 received no further treatment. One
      patient was admitted to hospital elsewhere but again dropped out in the
      outpatient phase of that program. Seven patients (17%) received further
      outpatient treatment only, and 9 (22%) received inpatient and outpatient care and
      seemingly completed their treatment. Treatment completion significantly affected
      the measures of global clinical functioning and specific psychopathologic
      features, but only for those patients who completed the initial program. Bulimic
      patients did considerably worse on follow-up and were less likely to complete
      treatment. Patients with restricted anorexia nervosa were more likely to complete
      treatment than those with a bulimic subtype (P = .03). Differential compliance
      rates in the two subtypes confound the effects of treatment completion and need
      to be controlled for in future studies. Depression was not associated with
      noncompliance but, if present, was associated with poor outcome on follow-up and
      abated in only a third of those in whom it was initially present.

PMID- 2219870
TI  - Neurologic complications of cardiac transplantation.
AB  - Between 1984 and 1989, orthotopic cardiac transplantations were done in 90
      patients from 10 to 65 years of age for end-stage, refractory congestive
      cardiomyopathy. Two patients had had ischemic strokes 5 months and 18 years,
      respectively, before transplantation. Six patients (7%) suffered acute neurologic
      events perioperatively. Three patients suffered cerebral infarctions. In 1 case
      this occurred 10 days before transplantation--probably as a result of systemic
      hypoperfusion--with the placement of ventricular assist devices. Two others
      suffered infarctions 5 and 21 days, respectively, after transplantation, each of
      probable embolic origin. Two patients had an acute intracerebral hemorrhage 21
      and 36 days, respectively, after transplantation; both were located within the
      basal ganglia and subcortical regions. Both patients had moderate to severe
      hypertension, and in 1, renal failure and a coagulopathy developed before
      hemorrhage. Tremor, seizures, and an altered level of consciousness developed in
      1 patient as an apparent toxic reaction to cyclosporine treatment. Only 1 patient
      died as a result of the neurologic complication--of an acute intracerebral
      hemorrhage. Three patients recovered fully, 2 partially. Only the case of drug
      toxicity could be directly attributed to the transplantation procedure itself. We
      conclude that the risk of an acute neurologic insult with orthotopic cardiac
      transplantation is low but may result from drug toxicity, cerebral ischemia, or
      hemorrhagic mechanisms.

PMID- 2219871
TI  - Alcohol and trauma. An endemic syndrome.
AB  - Injuries are a pervasive and costly problem, and alcohol use appears to be an
      important risk factor for injury. We examined the blood alcohol levels and
      selected demographic and epidemiologic variables recorded on trauma patients by 1
      trauma center for a 28-month period. A total of 2,262 trauma patients were
      admitted to the trauma center during this period, of whom 75% were male and 72%
      were injured in vehicle-related incidents. Blood alcohol levels of 2,095 patients
      (93%) were measured, and alcohol was present in the blood of 855 (41%). Of those
      patients with a blood alcohol level done, 32% had a level higher than 100 mg per
      dl. We conclude that the level of alcohol involvement in trauma is high and that
      this involvement must be addressed by the medical community and the health care
      system.

PMID- 2219873
TI  - Selenium. Nutritional, toxicologic, and clinical aspects.
AB  - Despite the recent findings of environmental contamination, selenium toxicosis in
      humans is exceedingly rare in the United States, with the few known cases
      resulting from industrial accidents and an episode involving the ingestion of
      superpotent selenium supplements. Chronic selenosis is essentially unheard of in
      this country because of the typical diversity of the American diet. Nonetheless,
      because of the growing public interest in selenium as a dietary supplement and
      the occurrence of environmental selenium contamination, medical practitioners
      should be familiar with the nutritional, toxicologic, and clinical aspects of
      this trace element.

PMID- 2219872
TI  - From Leningrad to the day-care center. The ubiquitous Giardia lamblia.
AB  - Giardiasis is recognized as a worldwide public health problem. Seroprevalence
      data from both the developing and developed world show high rates of carriage in
      populations at risk for fecal-oral transmission, such as children in day-care
      centers. Outbreak investigation has expanded our understanding of reservoirs for
      Giardia lamblia and of the routes of transmission. Various host factors have been
      associated with infection. The pathogenesis of giardial infections is being
      elucidated, in particular the role of lectin activation in producing disease.
      Three standard chemotherapeutic agents are available in the United States. The
      institution of community-wide prevention measures is equally important. Current
      areas of investigation including antigenic composition and enzymatic variants
      should result in effective forms of immunotherapy, while more effective forms of
      chemoprophylaxis could assist in eradicating the pathogen from institutional
      settings.

PMID- 2219876
TI  - Recent developments in radial keratotomy.
AB  - The Scientific Board of the California Medical Association presents the following
      inventory of items of progress in ophthalmology. 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, research workers, or scholars to stay abreast of these
      items of progress in ophthalmology 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 Ophthalmology of the California Medical
      Association, and the summaries were prepared under its direction.

PMID- 2219877
TI  - Current uses of collagen shields.

PMID- 2219874
TI  - Prostaglandins, the kidney, and hypertension.
AB  - Prostaglandins are part of the family of oxygenated metabolites of arachidonic
      acid known collectively as eicosanoids. While they are formed, act, and are
      inactivated locally and rarely circulate in plasma, they can affect blood flow in
      some tissues and so might contribute to the control of peripheral vascular
      resistance. Few studies have shown any derangement of total body prostaglandin
      synthesis or metabolism in hypertension, but increased renal synthesis of one
      prostanoid, thromboxane A2, has been noted in spontaneously hypertensive rats and
      some hypertensive humans. This potent vasoconstrictor may account for the
      increased renal vascular resistance and suppressed plasma renin activity seen in
      many patients with hypertension. Increased renal vascular resistance could
      increase the blood pressure directly as a component of total peripheral
      resistance or indirectly by increasing glomerular filtration fraction and tubular
      sodium reabsorption. Specific thromboxane synthesis inhibitors not only decrease
      renal thromboxane production but also increase renal vasodilator prostaglandin
      synthesis when prostaglandin synthesis is stimulated. This redirection of renal
      prostaglandin synthesis toward prostacyclin might be of benefit in correcting a
      fundamental renal defect in patients with hypertension.

PMID- 2219875
TI  - Stress and hypertension.
AB  - In susceptible persons emotional stress results in immediate sympathetic
      stimulation, with a vasomotor response that results in a high-output state and
      elevated blood pressure; the vasopressor response seems to be transient. There
      seems to be no longitudinal epidemiologic validation of the attractive hypothesis
      that transiently elevated blood pressures are the prelude to fixed hypertension,
      however. The acquisition of hypertension by populations abandoning their
      traditional mode of living has been attributed to the sociocultural stress
      inherent in westernization, but these studies usually have not taken into account
      concomitants of this type of acculturation, such as dietary changes and increased
      body weight. The inverse relationship of blood pressure levels to education could
      explain the development of hypertension when aspiration to upward mobility is
      thwarted. The severity of perceived occupational stress relates inversely to
      blood pressure, suggesting that familiarity with a job renders the demands made
      by the work environment more predictable and less threatening in terms of
      vasopressor response.

PMID- 2219879
TI  - Evaluating functional vision.

PMID- 2219878
TI  - Botulinum toxin for the treatment of blepharospasm and strabismus.

PMID- 2219880
TI  - Extended-wear soft contact lenses.

PMID- 2219881
TI  - Update on retinopathy of prematurity.

PMID- 2219882
TI  - Current recommendations for the treatment of diabetic eye disease.

PMID- 2219883
TI  - Using fluorouracil in surgical therapy for glaucoma.

PMID- 2219884
TI  - The dilemma of neonatal ophthalmic prophylaxis.

PMID- 2219885
TI  - Growing interest in selenium.

PMID- 2219886
TI  - Lung abscess causing Horner's syndrome.

PMID- 2219887
TI  - Transient infantile hypertension.

PMID- 2219888
TI  - Valproic acid-associated encephalopathy.

PMID- 2219889
TI  - Regulation of immunity by anti-T-cell antibodies.
AB  - Current pharmacologic approaches to immune suppression leave much to be desired.
      The prevention of allograft rejection and the suppression of autoimmunity
      generally require treatment with corticosteroids or cytotoxic drugs, or both,
      which may not be sufficiently effective and which frequently cause serious
      immediate and long-term complications. With the advent of monoclonal antibody
      technology, it has become possible to identify and selectively inhibit distinct
      elements in the immune system that contribute to pathologic immune responses.
      This achievement has led to new therapeutic strategies that may be safer and more
      effective than the immunosuppressive therapies currently available. Many of these
      strategies focus on subsets of T cells because of the critical importance of T
      cells in immune responses. Monoclonal antibodies directed against CD4 + T cells,
      T-cell activation antigens, and T-cell receptor families have all shown promise
      in animal models and, in some cases, in preliminary human trials. The challenge
      now is to translate this promise into practical new forms of immunosuppressive
      therapy.

PMID- 2219891
TI  - Pleuropulmonary manifestations of hepatic amebiasis.
AB  - Pleuropulmonary manifestations of hepatic amebiasis occurred in 30 patients; 18
      (60%) presented with at least 1 pulmonary complaint and 10 (33%) had multiple
      pulmonary symptoms. In 14 patients (47%), abnormalities were found on examination
      of the chest. In 16 chest roentgenograms (53%), there was at least 1 abnormality:
      right-sided pleural effusion (9 patients) and elevated right hemidiaphragm (8
      patients) were the most common. All patients were treated with metronidazole
      (Flagyl) and had resolution of the amebic liver abscess and pulmonary disease.
      Pleuropulmonary disease is a common complication of amebic liver abscess. The
      clinical presentation and chest roentgenograms are virtually diagnostic and
      obviate the need for invasive procedures to confirm the diagnosis.
      Pleuropulmonary disease resolves with amebicidal treatment of the hepatic
      abscess.

PMID- 2219890
TI  - Tryptophan-induced eosinophilia-myalgia syndrome.
AB  - Eight patients who became ill while taking tryptophan had myalgia, fatigue, rash,
      fever, edema, alopecia, arthralgias, diminished joint motion, skin tightening,
      muscle cramping, and distal paresthesias. Three had shortness of breath, and one
      had pulmonary hypertension. Laboratory abnormalities included peripheral
      eosinophilia, leukocytosis, thrombocytosis, raised erythrocyte sedimentation
      rate, and elevated serum levels of aldolase, lactate dehydrogenase, and liver
      enzymes. Of 4 chest radiographs, 3 were abnormal. Of 5 skin and muscle biopsies,
      4 showed sclerosis or mixed inflammatory cell infiltration of the dermis,
      subcutis, and fascia. Eosinophils were often present, but vasculitis was absent.
      Muscle inflammation was minimal. We conclude that the "eosinophilia-myalgia
      syndrome" is related to the ingestion of tryptophan and that abnormalities in the
      secretion of lymphokines may be important in its pathogenesis.

PMID- 2219893
TI  - Does paramedic-base hospital contact result in beneficial deviations from
      standard prehospital protocols?
AB  - We reviewed written and audio records of paramedic-base hospital radio contact to
      determine whether care differed from that suggested in standard prehospital care
      protocols. Records of all 659 contacts for seizure, syncope, abdominal pain, or
      altered mental state during 1987 (28.4% of all contacts) were scored for the use
      of standard therapies (such as intravenous access, oxygen, naloxone
      hydrochloride) and unanticipated therapies (intubation, nitroglycerin). Cases
      that involved unanticipated treatments were reviewed to determine whether they
      could have been prospectively identified by simple clinical findings. Standard
      therapies were used in the majority of patients. Unanticipated therapies were
      administered to 13 patients, all of whom had abnormal vital signs, diaphoresis,
      respiratory distress, or a second prominent symptom. Data suggest that protocols
      could replace radio contact for most patients and that the few who might benefit
      from radio contact can be easily identified. A 90% reduction in radio contacts in
      Los Angeles county could save $3 million each year.

PMID- 2219892
TI  - Barriers to prescribing the Copper T 380A intrauterine device by physicians.
AB  - From a questionnaire sent to all obstetricians and gynecologists and all family
      and general practitioners in San Diego County, California, regarding the Copper T
      380A intrauterine device, substantial barriers to prescribing it were identified.
      Of all physicians responding, 40% reported that they were not recommending the
      Copper T 380A to anyone, the single most common reason given being concern about
      medical liability. A lack of knowledge about the new device, a lack of
      intrauterine device insertion skills, and certain medical practice settings were
      also important barriers to prescribing it. The new intrauterine device is
      considered in the context of innovation-diffusion theory. Substantial amounts of
      education and training and improvement in the medical-legal climate are needed
      before current barriers to prescribing the new device are removed.

PMID- 2219896
TI  - Failure to recognize late postpneumonectomy empyema. Role of diagnostic
      thoracentesis.

PMID- 2219894
TI  - Therapeutic cardiac catheterization in children.
AB  - Cardiac catheterization, once the mainstay of diagnosis in children with
      congenital heart disease, has become a therapeutic modality for many conditions.
      Balloon dilatation can now open stenotic valves and vessels, coils and umbrellas
      can now close unwanted communications, and emboli can be withdrawn without
      surgical intervention.

PMID- 2219897
TI  - Pericarditis--an extraintestinal complication of inflammatory bowel disease.

PMID- 2219895
TI  - Overview of hemochromatosis.
AB  - Hemochromatosis is an autosomal recessive genetic disorder that occurs with high
      prevalence in populations of European origin. The gene that is abnormal in
      hemochromatosis is found on the short arm of chromosome 6 in close proximity
      (approximately 1 centimorgan) to HLA-A, but the product coded for by that gene is
      unknown. The pathogenetic mechanism in hemochromatosis is that of continued,
      excessive absorption of dietary iron with loss of normal control mechanisms,
      leading to a gradual but vast expansion of storage iron as ferritin and
      especially as hemosiderin. Through mechanisms that probably include peroxidation
      of lipid membranes, the excess iron injures hepatocytes, islet B cells,
      gonadotropes in the anterior pituitary, myocardium, synovial cells, and
      chondrocytes, and probably other cells and tissues as well. Most patients with
      hemochromatosis remain undiagnosed throughout life. Removal of the excess iron by
      phlebotomy will prevent all of the complications of hemochromatosis when begun
      early and will significantly improve survival in virtually all patients. It is
      important, therefore, that the diagnosis of hemochromatosis be considered much
      more frequently in clinical medicine in order that this effective therapy be
      utilized.

PMID- 2219898
TI  - Rattlesnake capsule-induced Salmonella arizonae bacteremia.

PMID- 2219899
TI  - Indolent Staphylococcus aureus pneumonia.

PMID- 2219900
TI  - Ride and tie. A hybrid sport with synergistic potential for injury.

PMID- 2219901
TI  - The eosinophilia-myalgia syndrome.

PMID- 2219902
TI  - Hemochromatosis--treatment is easy, diagnosis hard.

PMID- 2219903
TI  - Transcatheter treatment of congenital heart disease. Past, present, and future.

PMID- 2219904
TI  - Human growth hormone--orphan with a silver spoon.

PMID- 2219905
TI  - Family physicians and obstetrics.

PMID- 2219906
TI  - Just say no?

PMID- 2219907
TI  - Physician diversion programs and AA.

PMID- 2219908
TI  - There ought to be a law.

PMID- 2219909
TI  - Dying of a broken heart.

PMID- 2219910
TI  - [Arrhythmias during automobile driving in patients after acute myocardial
      infarction].
AB  - In 90 patients after acute whole-thickness myocardial infarction suffered 3-48
      months earlier 24-hour ECG recording was done for assessment of arrhythmias
      occurring while they were driving cars and for their comparison with the
      remaining recording hours. In most patients driving cars episodes of sinus
      tachycardia even up to 130/min were noted, in about half the patients some
      increase occurred in the frequency of ventricular ectopic beats, in two patients
      double and in one patient triple ectopic beats (salvoes) appeared, although they
      had not been recorded when the patients were not driving cars. The study was
      carried out (and is still continued) in autumn-winter, when the conditions of car
      driving were worse. None of the patients was in a collision-threatening situation
      which could increase dangerous arrhythmias.

PMID- 2219911
TI  - [Effect of nitrates on left ventricular function and exercise tolerance in
      patients with mild circulatory failure caused by ischemic heart disease].
AB  - In 26 patients with ischaemic heart disease with symptoms of mild chronic
      circulatory failure (NYHA grade II) aged 56.2 +/- 14.4 years the left ventricular
      function was tested by two-dimensional echocardiography, the exercise tolerance
      was determined on cycle ergometer at submaximal workloads, the cardiothoracic
      index (CTI) and cardiac volume index (CVI) were calculated from chest radiograms.
      The tests were done before and after 2 and 6 weeks of treatment with isosorbide
      dinitrate in doses of 49.6 +/- 15.2 mg/day. Isosorbide was found to increase
      somewhat the ejection fraction (EF), and to raise statistically significantly (p
      less than 0.05) the velocity of shortening of the circumferential fibres in left
      ventricular myocardium (mVCF), and to reduce the internal dimensions of the left
      ventricle (LVIDd and LVIDs), without changing the values of the ejection index
      (SVI) and cardiac index (CI). Decreased transverse dimensions of the left
      ventricle was correlated with a significant decrease of the CVI index. No
      statistically significant effect of isosorbide was noted on the parameters
      characterizing exercise tolerance but the quotient of the exercise-induced heart
      rate by the workload (HR/Wat) and the index of myocardial oxygen requirement (HRx
      Ps) were decreased in a demonstrable way.

PMID- 2219912
TI  - [Blood and plasma viscosity and the distance of intermittent claudication in
      patients with type II diabetes and thrombophlebitis].
AB  - In 49 patients with insulin-resistant diabetes, with ischaemia of the lower
      extremities blood viscosity was measured at low coagulation rates and plasma
      viscosity was determined also. Moreover plasma measurements were done of total
      lipids, alpha-, pre-beta-, and beta lipoproteins, triglycerides, total
      cholesterol, free fatty acids, and, besides that, the hematocrit was measured.
      Immediately after blood sampling for rheological and biochemical investigations
      the distance of intermittent claudication was measured. A rather considerable
      increase of blood and plasma viscosity was noted in the patients in comparison
      with controls, other findings included disturbances of lipid metabolism,
      increased fibrinogen level, and a negative correlation between the distance of
      intermittent claudication and blood and plasma viscosity.

PMID- 2219914
TI  - [Esophageal achalasia in children (analysis of five cases)].
AB  - Oesophageal achalasia is a disease of middle age and is only exceptionally
      observed in children. Five patients aged from 6.5 to 14 years were treated for
      this achalasia. Routine therapeutic method was repeated pneumatic dilatation of
      the cardia with a Rider-Moeller dilator. In all, 33 such procedures were carried
      out without complications. Very good results were obtained in 2 cases already
      after 3 dilatation procedures. The remaining 3 cases required surgical
      intervention: in 2 of them esophagomyotomy with antireflux operation was done
      with a very good result in one case and a good result in another case. The child
      not treated surgically (lack of parental consent) has still most signs of
      achalasia with body weight below the 3 centile and with recurrent respiratory
      infections. The follow-up is from 5 to 66 months.

PMID- 2219913
TI  - [Comparison of the quantitative determination of blood in stools with the
      Hemoccult test in various digestive tract diseases].
AB  - The reported investigations of haemoglobin (Hb) concentration in stools of
      healthy subjects and patients with digestive tract diseases were carried out for
      determining the physiological value of blood loss into the digestive tract, and
      for comparing the sensitivity of quantitative and qualitative tests for
      demonstration of occult blood in stools in cases of colonic neoplasms. The
      qualitative Haemoccult test was compared to the quantitative test based on heme
      conversion to porphyrins by iron decoupling, which makes possible determination
      of total Hb content in stools and measurement of the so called intestinal
      fraction which develops as a result of Hb conversion to porphyrins in the upper
      digestive tract.

PMID- 2219915
TI  - [Urapidil (Ebrantil) use in patients on chronic hemodialysis].
AB  - In 10 patients on chronic haemodialysis treatment for terminal renal failure with
      hypertension urapidil (Ebrantil) was given in one daily dose of 30 mg, usually
      continuing the previously used antihypertensive drugs. A significant decrease of
      the systolic and diastolic arterial blood pressure was achieved in most cases.
      Full therapeutic effect was manifested after several weeks of drug
      administration. During the treatment no tendency was noted for orthostatic
      hypotension, and no other side effects were observed. It seems that urapidil may
      be useful in the treatment of hypertension in dialysed patients. The usefulness
      of the drug in monotherapy requires further studies.

PMID- 2219917
TI  - [Markers of osteoporosis in clinical practice].
AB  - For the assessment of the degree of osteoporosis progression of use are, besides
      biochemical and histological investigations, also photodensitometry,
      microradiography and radiological examinations. The last of them are easily
      available and cheap and they are recommended for screening examinations. Using
      the cortico-diaphyseal index determined by an own method and the Singh index it
      was found that atrophy of the spongy bone is not parallel in conditions regarded
      as pathological. The simultaneous use of both indices makes possible an easy,
      simple and rapid assessment of the degree of bone atrophy providing a possibility
      of introducing prophylactic and therapeutic management.

PMID- 2219916
TI  - [Ultrasonographic assessment of changes in the location of the lower border
      (termed migration) of the placenta].
AB  - Ultrasonographic assessment of the so called placental migration was done in 136
      patients in whom the preliminary diagnosis was made between 18th and 34th week of
      pregnancy. It was found that placental migration was a commonly observed
      phenomenon in patients with preliminary diagnosis of low-located marginal
      placenta previa while in the case of central placenta previa it occurred
      sporadically only in the second trimester of pregnancy. The lower placental
      border migration rate was higher in the second than in the third trimester of
      pregnancy.

PMID- 2219918
TI  - [Is local antiproteolytic failure the cause of a prolonged course in various
      forms of glomerulonephritis?].
AB  - Just as in other inflammatory processes in glomerulonephritis also a great role
      has been ascribed recently to proteases released from phagocytes and mesangial
      cells. On the basis of original observation (clinical and experimental) of
      glomerulopathy inhibition by EACA, the authors present the concept of local
      antiproteolytic failure as the cause of protracted course of certain forms of
      glomerulonephritis.

PMID- 2219919
TI  - [Endogenous growth factors].

PMID- 2219920
TI  - [Advances in the diagnosis of Alzheimer's disease].
AB  - Alzheimer's disease is diagnosed ever more frequently and this requires more
      precise clinical and laboratory diagnostic methods. The authors discuss the
      diagnostic criteria and principles of diagnosis in this disease.
      Neuropathological lesions are described which are required for reliable diagnosis
      of the disease. Much attention is given to neuroradiological methods, including
      nuclear magnetic resonance and positron emission tomography.

PMID- 2219921
TI  - [Duodenal pressure ulcer as a cause of anemia].
AB  - A case is presented of anaemia which was caused by decubitus ulcer and fistula of
      the duodenum developed as a result of pressure exerted by aortofemoral vascular
      prosthesis.

PMID- 2219922
TI  - [Pleomorphic lipoma].

PMID- 2219923
TI  - [The frontonasal dysplasia syndrome (DeMyer's syndrome) in a newborn aged two
      weeks].
AB  - A description is presented of a rarely observed frontonasal dysplasia (DeMyer's
      syndrome) whose diagnosis confirmed by X-ray and ophthalmological examinations
      was based on demonstration of a wide midline cleft of the facial skeleton,
      hypertelorism of eyes, and coexisting severe and infrequently occurring in this
      syndrome deformity of lower extremities. The authors think that the cause of
      DeMyer's syndrome in this case should be sought in the action of many various
      harmful factors.

PMID- 2219924
TI  - [Level of amino acids in blood plasma as a test for exocrine pancreatic
      function].
AB  - A well known in physiology fact is that stimulation with enterohormones
      (secretin, cholecystokinin) causes a steep increase in the synthesis of
      pancreatic enzymes, and this might affect the plasma level of amino acids. In
      view of this, this level was studied in healthy subjects and patients with
      chronic pancreatitis. Hormonal stimulation was observed to cause in healthy
      subjects a significant rapid fall of the levels of all amino acids, which was
      greatest in the 20th minute. A less evident fall of the amino acid level was
      observed in chronic pancreatitis. A high correlation was noted (r = 0.9) between
      the value of amino acid fall in plasma and the degree of failure of the exocrine
      pancreatic function measured with the NBT-PABA test. All results are an
      encouraging indication that plasma amino acid level fall may be used for the
      assessment of the pancreatic exocrine potential. In the analysis of individual
      amino acids the most significant fall was noted of methionine, serine, valine,
      isoleucine, glutamine and tyrosine.

PMID- 2219926
TI  - [Two cases of sclerosing cholangitis in a group of 127 patients with nonspecific
      enteritis].

PMID- 2219925
TI  - [Functional hyperbilirubinemias. Clinical, biochemical and morphological
      findings].
AB  - Eighty-three cases of functional hyperbilirubinaemia (non-conjugated, non
      haemolytic hyperbilirubinaemia) were subjected to clinical, biochemical, and
      morphological analysis. Men accounted for almost 80% of patients, the mean age at
      time of first manifestations of the disease was 26 years. Persistent jaundice was
      present only in 31% of cases. The mean non-conjugated bilirubin level was 2.8
      mg%. The so-called hunger test is very spectacular, but its diagnostic value must
      be evaluated cautiously. It was found that alkaline phosphate activity and BSP
      retention test were not in all cases normal. Other biochemical tests gave normal
      results. Percutaneous liver biopsy was carried out in 71 patients without finding
      any changes in 42%, while in others slight, mainly degenerative changes in 42%,
      while in others slight, mainly degenerative changes were demonstrated. In most
      cases the diagnosis of non-conjugated, non-haemolytic hyperbilirubinaemia can be
      made on the basis of clinical and biochemical evaluation. Only few doubtful cases
      should be qualified for liver biopsy.

PMID- 2219927
TI  - [Two types of electromechanical coupling in myocardial myocytes].
AB  - Sarcoplasmic reticulum (SR) of isolated myocytes of guineapigs deprived of Ca2+
      by means of short exposure of the cell to caffeine does not re-uptake Ca in the
      quiescent cell. In rat Ca2+ SR content is promptly recovered under the same
      experimental conditions. The results of this study confirm the two types of
      excitation-contraction coupling in isolated myocyes of gineapig and rat hearts:
      without Ca uptake and with Ca uptake between excitations, respectively.

PMID- 2219928
TI  - [Caffeine blood concentration as an indicator of liver damage in patients with
      cirrhosis--correlation with Child's classification].
AB  - In 25 patients with cirrhosis fasting caffeine blood concentration was determined
      and the results were compared with Child's liver function sufficiency score. The
      caffeine blood concentrations in patients were higher than those in healthy
      controls (p less than 0.0001). Differences in comparison with controls were the
      more evident the greater was the degree of liver damage. Caffeine concentrations
      correlated well with the score indicating the sufficiency of the organ according
      to Child (R = 0.61; p = 0.002).

PMID- 2219929
TI  - [Studies of vitamin A metabolism in malignant neoplasms].
AB  - Retinol concentration in the serum was determined in 600 healthy subjects and 250
      cancer patients, including 116 patients with large bowel cancer, 90 with adenomas
      of the large bowel and 23 with cancer developing inn large bowel adenoma.
      Moreover, vitamin A concentration was determined in the liver obtained during
      autopsy from 23 patients dying from cancer and 34 dying from other chronic non
      cancer diseases. A significantly lower serum retinol concentration was confirmed
      in patients with cancer, but it depended on the degree of disease progression,
      since a significantly lower retinol concentration in relation to healthy subjects
      was found only in advanced neoplasms. In patients with adenoma or cancer in
      adenoma the serum retinol level was normal. Moreover, retinol concentration lower
      before the operation returned to normal after the operation. On the other hand,
      in patients dying from cancer previous operation was without effect on the low
      serum retinol level. Tissue examinations showed significantly decreased vitamin A
      concentration in the liver of patients dying from cancer. The results of this
      study indicate that reduced serum retinol concentration is rather a consequence
      of the malignant process and is due to impaired retinol release from the liver
      blood. Long-lasting malignant process may also lead to an actual vitamin A
      deficiency in the organism.

PMID- 2219930
TI  - [Primary biliary cirrhosis--analysis of clinical material].
AB  - The analysis is presented of 67 patients with primary biliary cirrhosis treated
      in the years 1971-1988. The group consisted of 60 women (89.5%) and seven men
      (10.5%). Presenting symptoms were mostly itching (66%) and jaundice (12%). The
      time between the onset of the first symptoms and the diagnosis was three years,
      on the average. Autoantibodies to mitochondria were present in 86% of patients.
      In 27% of cases markers of HB virus infection were found. Cholelithiasis was
      present in 19 patients (28%). Primary biliary cirrhosis was diagnosed with delay.
      Third degree of histological changes was observed in 38.8% of cases and in 18% of
      patients it was already fourth degree. Eighteen patients (27%) died after six
      years, on the average, from the onset of symptoms. The direct causes of death
      were, most frequently, liver failure and haemorrhage from oesophageal varices.

PMID- 2219931
TI  - [Regulation of triiodothyronine levels in fatty tissue in obese patients].
AB  - Specific activity of T4-5'-deiodinase, the enzyme which catalyze peripheral
      production of triiodothyronine (T3) from thyroxine (T4) has been evaluated in the
      subcutaneous adipose tissue of obese patients. In lean healthy women (BMI less
      than 21) mean activity of T4-5'-D was found to be 122 +/- 29.4 fmol T3/mg of
      protein/min and was higher then respective activity of the enzyme in adipocytes
      of patients with mild obesity (22 less than BMI less than 30) where the mean was
      92.14 +/- 18.05 fmol T3/mg/min. The activity of T4-5'-D was significantly
      decreased in patients with severe obesity (BMI less than 30) when compared with
      respective activity of the enzyme found in controls (47.36 +/- 18.4 fmol
      T3/mg/min vs 122.4 +/- 29.4 fmol T3/mg/min; p less than 0.01). As T4-5'-D in
      human adipose tissue has been previously characterized as type II of the enzyme,
      diminished activity found in obese subjects means that thyroid metabolic activity
      of adipocyte is decreased. Such a state would lead to antilipolytic action of
      catecholamines in obesity.

PMID- 2219932
TI  - [Obesity as a risk factor for ischemic heart disease].
AB  - The occurrence of risk factors for ischaemic heart disease in obesity is
      discussed. The presented view is based on the review of literature and own
      preliminary experiences. The importance of the distribution of the fatty tissue
      was shown for the medical practice. Android-type obesity increases the
      probability of the occurrence of metabolic disturbances leading to ischaemic
      heart disease.

PMID- 2219933
TI  - [The effect of omega 3 fatty acids on serum lipoproteins].

PMID- 2219934
TI  - [Oncological supervision of patients after colonoscopic polypectomy].
AB  - The high frequency of development of new adenomas in patients after colonoscopic
      polypectomy (30-50%) suggests the need for periodic control examinations of the
      whole large bowel. The diagnostic value of rectoscopy and routine diagnostic
      enema is limited and these methods are not suitable for periodic control of the
      bowel. An important method is fiberoptic sigmoidoscopy (FSS), but it is also
      insufficient because neoplasms are present frequently in proximal parts of the
      colon. The best method for evaluation of the whole colon is coloscopy, moreover,
      this method makes possible removal of the found polyps. In particular cases an
      alternative of coloscopy may be a combination of FSS and double contrast
      radiological examination of the colon. The frequency of control examinations of
      the large bowel depends primarily on the number of removed polyps. The patients
      after removal of a single polyp should undergo control examinations at intervals
      of 4-5 years. In cases with multiple adenomas removed during the first procedure
      or with one large adenoma (over 2 cm in diameter) should have control
      examinations repeated every 2-3 years.

PMID- 2219935
TI  - [Physical exertion and obesity].

PMID- 2219936
TI  - [Assessment of the practical skills of physicians by means of estimation scales].
AB  - The method is presented of objective assessment of practical skill in clinical
      medicine by means of so-called estimation scales. The scales are shown used for
      the assessment of know-how in management of vomiting and diarrhoea and
      examinations testing validity and reliability of this assessment are described.

PMID- 2219937
TI  - [Role of coloscopy in diagnosis and treatment of large bowel diseases].
AB  - Coloscopy is the most accurate method of evaluation of the whole large bowel. The
      main indications for this examination are doubtful radiological changes in the
      colon and unexplained intestinal symptoms, bleeding in the first place. Coloscopy
      plays also an important role in the differential diagnosis of colitis and in the
      oncological follow-up of patients after polypectomy or with long-standing
      ulcerative colitis. The therapeutic use of coloscopy includes removal of polyps
      and foreign bodies, control of bleeding, and laser photocoagulation of
      neoplasmatic lesions. Since 1973 in the Department of Gastroenterology of the
      Postgraduate Medical Center 2360 diagnostic coloscopies were carried out in 1838
      patients. The most frequent diagnoses were polyps (34%) and large bowel cancer
      (12%). Various forms of colitis were diagnosed in 7% of patients, and all other
      diseases jointly in 11% of cases. In 36% of patients the large bowel showed no
      changes, in spite of undoubtful indications for coloscopy. Many of these patients
      were spared explorative laparotomy. By means of diathermic loop 808 colorectal
      polyps were removed in 421 patients. Rare complications of this procedure were
      bleedings (1.5%) and peritoneal irritation symptoms without perforation (0.25%).
      Adeneomas prevailed among polyps. Seventeen patients with invasive cancer in
      adenoma were treated successfully only endoscopically.

PMID- 2219938
TI  - [Therapy and prognosis of children with prenatally diagnosed urinary tract
      abnormalities].
AB  - Urinary tract malformations are recognized already prenatally to an increasing
      extent, but the indications for, and the time of surgical intervention are still
      a matter of debate. The present study is an analysis of the data collected over
      an 80-month period of 76 patients whose urinary tract malformation was suspected
      prenatally and confirmed after birth. Patients with lethal malformations whose
      disease led to abortion or intrauterine death were excluded. Ureteropelvic
      junction obstruction was present in 47% of the patients and obstructive uropathy
      accounted for 67% of all malformations. In contrast, vesicoureteric reflux was
      found only in eight patients. Thirty seven infants (49%) required surgical
      intervention and 61% of all operations were performed during the first month of
      life. 57% of these early interventions were temporary diversions. The indication
      for surgical treatment was based on sonographic and radiological assessment of
      the malformation and on the results of functional assessment. In many instances
      surgery was delayed until indicated on the basis of the findings of the follow-up
      studies. All reconstruction operations were successful. Prenatal diagnosis
      benefitted most children, especially those with the most severe malformations. No
      patient died as a result of the renal condition and the prognosis is grave in
      only one child, who is likely to go into terminal renal failure in childhood.

PMID- 2219940
TI  - [Automated exchange transfusion in premature and newborn infants with
      hyperbilirubinemia using a peripheral arteriovenous vascular access device].
AB  - The technique of exchange transfusion using a plastic catheter in the umbilical
      vein developed by Diamond and modified by Allen was instrumental in decreasing
      the mortality and morbidity in newborn infants with jaundice. Allen et al.
      demonstrated that the development of kernicterus in infants with erythroblastosis
      with indirect hyperbilirubinemia could be prevented by this method. Since that
      time numerous modifications of this "single site, push pull technique" have been
      described to further reduce the risk of morbidity and mortality. On the basis of
      the successful use of percutaneous radial artery catheters for arterial blood gas
      monitoring, we developed a technique for exchange transfusion using a peripheral
      arterial catheter inserted in the radial artery for blood withdrawal and a
      peripheral venous catheter for replacement of heparinized compatible donor blood.
      For simultaneous withdrawal and replacement we used two volumetric infusion
      pumps, one aspirating patients' arterial blood, the other replacing equal volumes
      of donor blood at exactly the same time. We evaluated our new procedure in 19
      newborn infants (group 1) with hyperbilirubinemia who required exchange
      transfusion. Retrospectively we analysed the data in 18 newborn infants (group 2)
      treated over a previous period by means of the conventional "one site, push pull"
      technique using the umbilical vein, and compared the data. Mean birth weights,
      gestational ages and Apgar scores were similar in both groups, as were volumes of
      blood used for exchange transfusions. The results were superior in group 1
      infants, as reflected by the significantly greater percentage decreases in serum
      bilirubin concentration and fewer complications. No baby died.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2219939
TI  - [Harmful effects in early pregnancy--results of a teratological counseling
      center].
AB  - In the years 1986, 1987, and 1988 altogether 132 consultations were conducted
      during pregnancy at the Landesfrauenklinik Linz. These pregnant women had all
      been exposed to potentially harmful influences (drugs, maternal diseases and as
      infections or cancer, X-rays or pregnancy despite IUD). In most of the cases we
      recommended carrying the pregnancy to full term; only a few were interrupted,
      sometimes against on recommendation to proceed with the pregnancy. The rate of
      abortion and the frequency of ectopic pregnancies were within normal limits. Due
      to personal investigations after birth we registered postnatal findings in nearly
      all cases. No serious malformations were recorded. Detailed teratological
      knowledge is necessary for correct advice at consultation after exposure to
      harmful influences during early pregnancy. In most cases it is possible to avoid
      interruption without risking an increased rate of malformations.

PMID- 2219941
TI  - [Percutaneous cannulation of the radial artery in severely ill premature and
      newborn infants].
AB  - Cannulation of the radial artery is an easy and safe alternative to the usual
      procedure of catheterization of the umbilical artery to secure blood for gas
      sampling and for monitoring blood pressure in critically ill neonates. The use of
      a fiberoptic light source further improves the success of percutaneous radial
      artery cannulation. We performed this procedure in 264 critically ill babies and
      it was successful in 211 (80%). The average weight was 2.160 g (740-4,300),
      gestational age was 33 weeks (26-45). The radial artery catheter had an average
      useful life of 5 days (1-22). In 53 newborn infants the catheter had to be
      removed prematurely because obtaining blood samples was no longer possible. In 15
      babies the catheter had to be removed on account of arterial spasms. One patient
      developed skin necrosis of a small area on the tip of the thumb due to a thrombo
      embolic complication. No case of bacterial infection due to cannulation was
      observed. No neurological disturbance in hand or finger function was found on
      follow up after one year. In conclusion, this method is safe, easy to handle, has
      less complications and several advantages over previous methods.

PMID- 2219942
TI  - [20-year-old HIV-1-positive hemophiliac patient with conspicuous plantar warts-
      effects of zidovudine (Retrovir) treatment].

PMID- 2219944
TI  - [Hyperlipidemia and coronary heart disease].
AB  - The coronary heart disease (CHD) is of great importance, because it is the
      leading cause of death in the western world. There is general agreement in the
      scientific and medical community that high levels of cholesterol and low density
      lipoproteins (LDL) play a dominant role in atherosclerosis, whereas high lipid
      lowering agents are associated with a reduced risk for CHD.

PMID- 2219943
TI  - [Current findings on nocturnal catecholamine excretion in coronary patients].
AB  - In 10 patients after myocardial infarction (mean age 53 +/- 8 years) with a
      normal ejection fraction (EF) and in 10 healthy people (mean age 52 +/- 8 years)
      the night urinary excretion of noradrenaline and adrenaline was investigated.
      Additionally to that the vanillic acid vanilmandelic acid and serotonin were
      determined. Our results show that patients after myocardial infarction with
      normal EF have significant higher noradrenaline values at night than healthy
      people (1.95 +/- 1.26 micrograms/h vs. 0.96 +/- 0.37 microgram/h [p less than
      0.01]). The night urinary excretion of adrenaline was also increased in patients
      after MI, but there were no significant differences between the 2 groups (0.51 +/
      0.28 microgram/h vs. 0.27 +/- 0.14 microgram/h [p less than 0.1]). Serotonin was
      higher in patients with coronary heart disease (CHD), but there was also no
      significant difference (0.15 +/- 0.14 mg/h vs. 0.08 +/- 0.05 mg/h). Cholesterol
      values were significantly higher in patients with CHD (245 +/- 56 mg%) than in
      the group of healthy people (177 +/- 45 mg% [p less than 0.01]). Our own results
      are of great interest because we found out (to our knowledge for the first time)
      that patients with CHD show significant higher levels of urinary noradrenaline
      excretion during the night than healthy volunteers. The raised noradrenaline
      values may present a particular risk factor for coronary heart disease.

PMID- 2219946
TI  - [Vascular surgery in Austria--report on the 21st annual meeting in Eisenstadt].
AB  - The Austrian Society for Vascular Surgery exists since 21 years. At the beginning
      of October 1989 she held her Annual Meeting in Eisenstadt, Burgenland, Austria.
      The topics of this well-attended meeting were: Surgery of the vertebral artery,
      the external carotid artery, and the deep femoral artery. The last scientific
      experiences in diagnosis and therapy, especially in surgical therapy, were
      reported. In the session Angiochirurgicum interesting cases, new diagnostic
      procedures, new vascular surgical techniques, new instruments, and new bypass
      materials were introduced. Both the selected topics and the great number of
      attendees showed that the Austrian Society for Vascular Surgery is an up to date
      and active scientific association which follows this special field of surgery
      into its most subtle ramifications, and has proved a success compared to
      international standards. Active international exchange of views leads to an
      improvement and standardization of surgical results and is thus for the benefit
      of the patients.

PMID- 2219945
TI  - [Ophthalmological significance of stenosing carotid processes].
AB  - In a retrospective study we looked at the incidence of carotid artery stenosis in
      191 ophthalmological patients, which underwent duplex sonography. In all these
      patients the oculist had considered carotid artery stenosis to be a possible
      reason for the present eye disease or visual disturbance. The incidence of
      stenosis found in these patients was compared to a group of 186 persons of the
      same mean age, which underwent routine-sonography without suffering from any
      symptoms related to carotid artery disease. Patients with amaurosis fugax, with
      occluded retinal veins and patients with glaucoma associated changes of the
      retina (in spite of normal eye pressure) suffered more often from carotis
      stenosis than asymptomatic persons (statistically significant), patients with
      occluded retinal arteries showed also more often carotid artery stenosis than the
      asymptomatic collective but without statistical significance. We conclude, that
      patients presenting with the mentioned symptoms should undergo carotid artery
      sonography. Furthermore these results could be of importance in evaluation the
      indication for carotid thrombendarterectomy (stadium II of cerebrovascular
      insufficiency).

PMID- 2219947
TI  - [The relevance of diet for civilization diseases, especially atherosclerosis].
AB  - Atherosclerosis is a consequence of modern civilization and nutrition. It became
      a problem due to higher life-expectancy and changed nutritional habits. This is
      discussed in relation to myocardial infarction, gout and inborn errors of
      metabolism and modern nutrition.

PMID- 2219948
TI  - [Atherosclerosis and possibilities of dietary prevention or therapy].
AB  - Hypercholesterolemia, hypertension, smoking and diabetes mellitus are the main
      risk-factors for the development of early atherosclerosis. The association of
      hypercholesterolemia and atherosclerosis is well established: there is a strong
      correlation of the duration and severity of atherosclerosis to the extend of
      plaque-formation. Dietetic measures in large populations show reduction in
      cardiovascular events, drastic lipid-lowering therapy (i.e. drugs, plasma
      exchange, ileum-bypass operation) may induce regression of plaque-formation.

PMID- 2219949
TI  - [Atherosclerosis: sugar, weight reduction, trend towards thinness].
AB  - Sugar by itself is not a factor in the etiology of atherosclerosis. It is only in
      fostering overweight. The reasons for the public discussion of sugar in nutrition
      are tentatively analyzed.

PMID- 2219950
TI  - [Fats in the diet].
AB  - The importance of nutritional fats as a source of energy declined in the past in
      industrialized countries due to a decrease of physical activity. On the other
      hand the association between the intake of particular fats and the development of
      cardiovascular diseases is generally accepted. Thus, some scientific societies
      (American Heart Association, NIH Consensus Development Conference) recommend a
      maximal intake of 30% of total energy by fats. In regards to the quality of fats
      and their effect on blood levels of lipoproteins, it is accepted that large
      amounts of polyunsaturated fatty acids lower increased blood levels of low
      density lipoproteins; however, they lower in a small extent also the
      antiatherogenic high-density lipoprotein (HDL) particles. Monounsaturated fatty
      acids also tend to lower increased LDL, without any lowering effect on HDL, W-3
      fatty acids (mainly from fish oil) lower increased triglyceride levels and
      therefore are used a therapeutic dietary regimen. However, their long-term
      effects are not quite well known.

PMID- 2219951
TI  - Effect of pyridoxine on the disposition and lymphopenic effects of 2-acetyl-4(5)
      tetrahydroxybutyl imidazole in the rat.
AB  - 1. 2-Acetyl-4(5)-tetrahydroxybutyl imidazole (THI) administered orally to rats
      markedly decreased the peripheral blood lymphocyte count within 16-24 h. The
      lymphopenic effect of THI was prevented by co-administration of pyridoxine. 2.
      14C-THI, administered orally, was absorbed in a dose-dependent manner and
      excreted unmetabolized. These processes were not affected by co-administration of
      pyridoxine. 3. In contrast, the rate of excretion of 14C-THI administered i.v.
      was increased by both dietary and parenterally-administered pyridoxine, and
      pyridoxine decreased the amount of radiolabel associated with lymphoid tissues.
      4. The results show that the lymphopenic effect of THI is not sustained once it
      is excreted, and indicate that pyridoxine and THI may compete for the same
      binding site in lymphoid tissues.

PMID- 2219952
TI  - Metabolic studies on pentachlorophenol (PCP) in rats.
AB  - 1. The metabolism of pentachlorophenol in rats was studied. 2. Metabolites
      isolated from rat urine and identified were: 2,3,4,5-tetrachlorophenol, 2,3,4,6
      tetrachlorophenol, 2,3,5,6-tetrachlorophenol, tetrachlorocatechol,
      tetrachlororesorcinol, trichlorohydroquinone, tetrachlorohydroquinone, and traces
      of trichloro-1,4-benzoquinone, and tetrachloro-1,4-benzoquinone.

PMID- 2219953
TI  - Fungal metabolism of 4-substituted amphetamines.
AB  - 1. rac.-4-Ethoxyamphetamine was incubated with 14 different yeast and fungal
      microorganisms. 4-Hydroxyamphetamine was the major metabolite; traces of N-acetyl
      4-ethoxyamphetamine were also detected. 2. The major fungal (Cunninghamella)
      metabolite of 4-propoxyamphetamine and 4-benzyloxyamphetamine was 4
      hydroxyamphetamine. The major metabolites of 4-methoxyamphetamine were N-acetyl-4
      methoxyamphetamine and 4-hydroxyamphetamine. 3. Acetoin derivatives were formed
      when alkoxyamphetamine substrates were incubated in the presence of various fungi
      and yeasts. 4. The findings indicate that Cunninghamella echinulata may be a
      useful microbial model for drug disposition and interaction studies.

PMID- 2219954
TI  - Biliary excretion and intestinal metabolism in the intermediary metabolism of
      pentachlorothioanisole.
AB  - 1. Biliary metabolites from rats dosed with pentachlorothioanisole (PCTA) were
      characterized by fast atom bombardment mass spectrometry and electron impact mass
      spectrometry. 2. Most of the biliary metabolites from PCTA were mercapturic acid
      pathway metabolites of methylsulphinyltetrachlorobenzene (51% of the dose); the
      remaining characterized biliary metabolites (20%) were mainly
      methylsulphinyltetrachlorothiophenols excreted as unknown conjugates. 3. Pathways
      are proposed for the intermediary metabolism of PCTA to bis
      (methylthio)tetrachlorobenzene (bis-MTTCB) involving glutathione conjugation,
      biliary excretion, intestinal metabolism, and enterohepatic circulation.

PMID- 2219955
TI  - Dissimilation of 2,4-dichlorophenoxyacetic acid by Azotobacter chroococcum.
AB  - 1. A strain of Azotobacter chroococcum which could use 2,4-dichlorophenoxyacetic
      acid (2,4-D) as sole carbon source was isolated. 2. The strain metabolized 2,4-D
      via p-chlorophenoxyacetic acid, p-chlorophenol and 4-chlorocatechol; the last
      metabolite was cleaved by catechol 1,2-dioxygenase. 3. The enzyme exhibited broad
      substrate specificity.

PMID- 2219956
TI  - Formation of amphetamine from its nitro analogue by anaerobic intestinal
      bacteria.
AB  - 1. Microbial reduction of 1-phenyl-2-nitropropane 1 was carried out using 40
      strains of intestinal anaerobic bacteria. Among them, 12 strains (Mitsuokella
      multiacidus, Clostridium perfringens, C. innocuum, C. clostiriiforme, C.
      difficile, C. butyricum, C. sp., Eubacterium limosum, E. aerofaciens, E.
      multiforme, Peptostreptococcus anaerobius and P. productus) had the ability to
      reduce 1 to amphetamine 2 (0.1-1% yield). 2. Clostridium species were more active
      than another intestinal anaerobic bacteria. 3. When Clostridium perfringens was
      used in preparative fermentation, the yield of 2 was increased, and its absolute
      structure had an (S)-configuration with an optical purity of 68% in enantiomeric
      excess.

PMID- 2219957
TI  - Comparison of digoxin analysis by high-performance liquid chromatography/post
      column derivatization and fluorescence polarization immunoassay.
AB  - 1. This study compared the analysis of digoxin using a high-performance liquid
      chromatographic post-column derivatization (HPLC-PC) assay and the TDx
      fluorescence polarization immunoassay (FPIA). 2. Serum obtained from 15
      digitalized patients showed higher mean digoxin levels with the FPIA method as
      compared to the HPLC-PC procedure such that the mean HPLC-PC/FPIA ratio was 0.91
      +/- 0.14 (mean +/- SD). Demonstrated cross-reactivity of digoxin metabolites with
      the FPIA is probably responsible for this observation. 3. Cross-reactivity of the
      immunoassay towards endogenous material present in serum samples from certain
      patient groups was an even greater problem, with apparent 'digoxin' serum
      concentrations in untreated hepatic failure patients being within the therapeutic
      range for digoxin. 4. The HPLC-PC method did not suffer from such interference
      and would therefore provide more accurate values for patients where high levels
      of interference could contribute to false digoxin levels.

PMID- 2219958
TI  - Disposition of ampiroxicam, a prodrug of piroxicam, in man.
AB  - 1. Ampiroxicam, a prodrug of the effective anti-inflammatory agent piroxicam, was
      completely converted to piroxicam after oral administration to man. 2. At
      clinical doses there was no detectable portal or systemic exposure of man to
      ampiroxicam, indicating that conversion to piroxicam was complete during the
      absorption process. 3. The pharmacokinetics of piroxicam from ampiroxicam were
      essentially the same as those after piroxicam itself except that Cmax was
      slightly lower and tmax was slightly longer after administration of ampiroxicam.

PMID- 2219959
TI  - Conjugation of chemical carcinogens by primary cultures of human hepatocytes.
AB  - 1. The conjugation of benzo[a]pyrene (BP) and 2-acetylaminofluorene (AAF) was
      investigated in primary cultures of human hepatocytes. Human hepatocytes
      conjugated 12.5-63% of the BP and 1.7-52% of the AAF to sulphates and
      glucuronides over a thousand-fold concentration range. 2. BP is conjugated to
      glucuronides from non-detectable levels to 50%, and to sulphates from non
      detectable levels to 30%. The major conjugated metabolites are the highly polar
      metabolites. 3. AAF is conjugated to glucuronides from 1.5 to 51% and to
      sulphates from 0.2 to 12%. The C-hydroxylated AAF metabolites were conjugated to
      glucuronides more than N-hydroxy AAF and aminofluorene metabolites.

PMID- 2219960
TI  - Absorption, distribution and excretion of lacidipine, a dihydropyridine calcium
      antagonist, in rat and dog.
AB  - 1. The absorption, distribution and excretion of lacidipine have been studied in
      rat and dog after i.v. (0.05 mg/kg for rat; 0.5 mg/kg for dog) and oral dosage
      (2.5 mg/kg for rat; 2.0 mg/kg for dog). 2. Lacidipine was rapidly and extensively
      absorbed after oral dosing, in both species. Oral bioavailability was up to 26%
      in rat and up to 32% in dog, due to extensive first-pass metabolism. 3. After
      oral administration, peak levels of radioactivity were reached at 4-8 h in rat
      and 1-2 h in dog. Unchanged lacidipine peaked at 1-2 h in both species. Plasma
      levels of radioactivity were higher in female rats than in males but there was no
      difference in levels of unchanged drug. 4. After i.v. dosing the terminal half
      life of unchanged drug was 2.9 h in rat and 8.2 h in dog. The half-life of
      radioactivity in plasma was longer in both species. 5. After both routes of
      administration, radioactivity was rapidly distributed in rat tissues with the
      highest concentration in liver, fat and gastrointestinal tract. Only traces of
      radioactivity were detected in the CNS and in rat foetuses. 6. Extensive biliary
      elimination occurred, and most of the radioactivity (73-95%) was excreted in the
      faeces after i.v. or oral administration. 7. The compound was extensively
      metabolized, no significant amount of unchanged drug was excreted in bile or
      urine.

PMID- 2219961
TI  - In vitro metabolism of the antianxiety drug buspirone as a predictor of its
      metabolism in vivo.
AB  - 1. Metabolism of the antianxiety drug buspirone was studied by in vitro
      incubations with rat liver microsomes and hepatocytes. Metabolites were isolated
      and purified by h.p.l.c. The purified metabolites were identified by co-elution
      on h.p.l.c. with authentic standards and by g.l.c.-electron impact mass
      spectrometry of their trimethylsilyl (TMS) derivatives. 2. Five metabolites of
      buspirone were identified in the microsomal incubates and seven in the hepatocyte
      incubates. The major metabolites arose from aromatic hydroxylation at C-5, N
      dealkylation of the butyl chain, and hydroxylation at C-6' and C-3' on the
      azaspirodecanedione moiety. 3. Metabolism of buspirone by rat liver microsomes
      was NADPH-dependent and was completely inhibited by cytochrome P-450 inhibitors
      SKF-525A and metyrapone. 4. Metabolites of buspirone formed in vitro were good
      predictors of the primary metabolites formed in vivo. 5. Hepatocytes and
      phenobarbital-induced rat liver microsomes were better predictors of in vivo
      metabolism of buspirone than non-induced rat liver microsomes. These in vitro
      systems should provide excellent models for studying the metabolism of other
      azaspirodecanedione-containing drugs.

PMID- 2219962
TI  - Interspecies comparison of the metabolic pathways of perindopril, a new
      angiotensin-converting enzyme (ACE) inhibitor.
AB  - 1. The metabolism of perindopril (non-thiol angiotensin-converting enzyme
      inhibitor) was studied in rat, dog and monkey after single oral and i.v.
      administration of 14C-perindopril, and in man after a single oral dose. 2. Six
      biotransformation products of perindopril from urine, faecal and plasma samples
      (bile only for rats) were identified. 3. The main route of biotransformation in
      all species is the hydrolysis of the carboxylic ethyl ester side-chain, with the
      formation of perindoprilate, the active metabolite. 4. A minor route of
      biotransformation led to the acyl glucuronides of perindopril and perindoprilate.
      5. Internal dehydration of perindopril and perindoprilate into cyclic lactam
      structures occurs. This route of metabolism is of minor importance except in
      humans.

PMID- 2219963
TI  - Evidence for the absence of cysteine S-conjugate N-acetyltransferase activity in
      the metabolism of propachlor, naphthalene, and dichlobanil in calves.
AB  - 1. The glutathione conjugate of 2-chloro-N-isopropyl[1-14C]acetanilide (14C
      propachlor) was perfused through a calf kidney in situ; 23% of the dose was
      excreted in the perfused kidney urine as the cysteine conjugate, no mercapturic
      acid was detected. 2. A 5-day-old calf dosed orally with 14C-propachlor excreted
      70% dose in the urine as the cysteine conjugate; no mercapturic acid was
      detected. Rumen microflora were established in the calf (5 weeks older) and the
      experiment was repeated with the same results. 3. When the same calf was dosed 1
      week later with 14C-naphthalene, 99% dose was excreted in the urine, mostly as
      the dihydrodiol-glucuronide (34%) and the dihydrohydroxy-cysteine conjugate
      (47%); no mercapturate was detected. 4. A 9-day-old calf dosed orally with 2,6,
      dichlorobenzo[14C]nitrile (14C-dichlobanil) excreted 67% dose in the urine as
      cysteine conjugates (34%), and products of cysteine conjugate beta-lyase cleavage
      of cysteine conjugates (30%); no mercapturates were detected. 5. Cysteine S
      conjugate N-acetyltransferase activity in calf kidney and liver was about 10% of
      that in the corresponding rat tissues.

PMID- 2219964
TI  - Oxidative transformation of paxilline in sheep bile.
AB  - 1. 14C-Paxilline incubated in bile from pasture-fed sheep was efficiently
      transformed to a more polar dioxygenated derivative in which the indole 2,3
      double-bond had opened to give an 8-membered ring. The structure is proposed on
      the basis of mass spectrometry and 1H- and 13C-n.m.r. spectroscopy. The new
      compound is 2,18-dioxo-2,18-seco-paxilline. 2. The paxilline transformation also
      occurred in bile which had been boiled to inactive enzymes. 3. The dissolved
      oxygen concentration in freshly collected sheep bile was in the range 38-163
      nmol/ml. 4. Whereas paxilline causes pronounced tremor in the mouse given 4 mg/kg
      i.p., the dioxygenated paxilline was biologically inactive at ten times this
      dose. 5. The feasibility that analogous oxidative transformation of indole
      diterpenoid tremorgenic mycotoxins may occur, increasing polarity advantageously
      to xenobiotic elimination, during biliary elimination from agricultural ruminants
      in the field, is recognized. Concomitant loss of tremorgenicity is an additional
      benefit. 6. The biotransformation of paxilline in sheep bile was mimicked by
      ozonolysis but the ozone equivalent 4-t-butyl-iodoxybenzene was not similarly
      effective.

PMID- 2219966
TI  - Effects of blockage of urine and/or bile flow on diflunisal conjugation and
      disposition in rats.
AB  - 1. The effects of surgical blockage of either or both of the urinary and biliary
      excretion routes on the elimination of diflunisal (DF) and its conjugates were
      investigated in pentobarbitone-anaesthetized rats given DF at 10 mg/kg i.v. 2. In
      control animals the acyl glucuronide and phenolic glucuronide conjugates were
      excreted predominantly in bile, whereas the sulphate conjugate was eliminated
      almost exclusively in urine. 3. Bilateral ureter ligation had little effect on DF
      elimination, except for accumulation of the sulphate conjugate in plasma.
      Compensatory biliary excretion did not occur. 4. Total plasma clearance of DF
      decreased from 1.01 to 0.68 ml/min per kg following bile duct ligation. Plasma
      concentrations and urinary excretion of the glucuronides were elevated. 5. In
      rats with blockage of both urinary and biliary excretion routes, total plasma
      clearance of DF decreased to 0.59 ml/min per kg. Both the sulphate and phenolic
      glucuronide conjugates accumulated in plasma, whereas the acyl glucuronide peaked
      at 30 min and then declined in parallel with DF. The latter result indicates
      systemic instability of DF acyl glucuronide with hydrolytic regeneration of DF as
      the likely major consequence.

PMID- 2219965
TI  - Mechanism of formation of 6-amino-5-(N-methylformylamino)-1-methyluracil and 3,7
      dimethyluric acid from theobromine in the rat in vitro: involvement of cytochrome
      P-450 and a cellular thiol.
AB  - 1. The involvement of glutathione (GSH) and cytochrome P-450 in the conversion of
      theobromine to 6-amino-5-(N-methylformylamino)-1-methyluracil (3,7-DAU) and 3,7
      dimethyluric acid (3,7-DMU) has been investigated in rat liver microsomal
      incubations. 2. The ratio of formation of 3,7-DAU to 3,7-DMU increased with
      increasing GSH concentration, reaching a maximum (approximately 12:1) at 2 mM.
      For any given added GSH concentration the formation of 3,7-DAU plus 3,7-DMU
      remained constant. 3. 3,7-DAU and 3,7-DMU formation were increased approx. 12-
      and 1.6-fold in liver microsomes from rats treated with 3-methylcholanthrene and
      phenobarbitone, respectively. Cimetidine, metyrapone and SKF-525A each inhibited
      the conversion of theobromine to 3,7-DAU and 3,7-DMU. 4. Apparent Km and Vmax
      values for the combined formation of 3,7-DAU and 3,7-DMU were the same in the
      absence and presence of GSH, 2 mM. 5. L-Cysteine and N-acetyl-L-cysteine were as
      effective as GSH in causing a shift from 3,7-DMU to 3,7-DAU formation, but the
      non-thiol reducing agents ascorbic acid and alpha-tocopherol were ineffective. 6.
      Data are consistent with the hypothesis that 3,7-DAU and 3,7-DMU are derived from
      a common oxidized intermediate of theobromine, the formation of which is rate
      limiting. The putative intermediate normally serves as a precursor to 3,7-DMU but
      in the presence of GSH, or some other cellular thiol, it may be reduced to give
      3,7-DAU.

PMID- 2219967
TI  - Comparative metabolism of high doses of aspirin in man and rat.
AB  - 1. Metabolism of aspirin was studied in 10 human volunteers who took a
      therapeutic dose (600 mg) by mouth and in nine patients who took aspirin in
      overdose. 2. Salicyluric acid was the major urinary metabolite in volunteers
      (63.1 +/- 8.4% of dose in 0-8 h). In overdose patients, salicyluric acid in urine
      was decreased (30.0 +/- 8.2%, 0-24 h, P less than 0.001) and there was increased
      elimination of salicyclic acid (34.1%, P less than 0.005), salicyl acyl
      glucuronide (14.4%, P less than 0.05) and gentisuric acid (5.3%). 3. Metabolism
      of orally administered 14C-aspirin in rats over a 10-fold dose range (10-100
      mg/kg) resulted in excretion of 81-91% dose in urine in the first 24 h.
      Salicyclic acid was the major urinary metabolite (43-51% dose). Excretion of
      salicyluric acid decreased with increasing dose, whereas gentisic acid and
      salicyl phenolic and acyl glucuronides increased. 4. The profile of aspirin
      metabolites was qualitatively similar in man and rat but there were quantitative
      differences. Limited capacity to form salicyluric acid was observed in both
      species. Dependence on this pathway in rat was low and was compensated by
      increased utilization of other routes; dependence on salicyluric acid formation
      in man was high and in overdose, compensation by other routes was incomplete.

PMID- 2219969
TI  - Treatment of bone tumors around the shoulder joint by the Tikhoff-Linberg
      procedure.
AB  - The Tikhoff-Linberg procedure is a limb-sparing surgical option to be considered
      for bony and soft tissue tumors in and around the proximal humerus and shoulder
      girdle. The authors reported 6 cases of the Tikhoff-Linberg procedure for tumors
      around the shoulder joint at the Department of Orthopedic Surgery of Severance
      Hospital from March 1988 to May 1989. The results of the study are as follows:
      The 6 cases were composed of: osteogenic sarcoma 2 cases, chondrosarcoma 2 cases,
      chondroblastoma 1 case, and giant cell tumor 1 case. The tumors were completely
      removed by the Tikhoff-Linberg procedure without amputation or disarticulation of
      the upper extremity. The distal clavicle, upper humerus and part of all of the
      scapula were resected. The Tikhoff-Linberg procedure was performed for patients
      whose tumors did not involve the neurovascular bundle in the axilla. The function
      of the hand and forearm after the Tikhoff-Linberg procedure was nearly normal in
      all cases. The Tikhoff-Linberg procedure would be recommended as a limb-sparing
      operation for tumors around the shoulder joint that require wide resection
      without disarticulation or forequarter amputation of the upper extremities.

PMID- 2219968
TI  - The effect of experimental trypsin on the regeneration of hyaline articular
      cartilage.
AB  - There is evidence from other studies that some degree of cartilage healing may
      take place after the initiation of an inflammatory response. It is postulated
      that the induction of the platelet-cartilage interaction may eventuate in
      cartilage repair. The treatment of fresh articular cartilage with proteolytic
      enzymes rendered the tissue active as a platelet aggregant. During platelet
      aggregation a host of active substances are released which are known to play a
      role in the inflammatory response (Thompson 1975). This study was undertaken to
      evaluate the effects of trypsin on the surface injury of rabbit hyaline
      cartilage. The results were as follows: 1) Hyaline cell regeneration was observed
      only in the group treated with trypsin and blood; 2) Hyaline cartilage
      regeneration did not occur in the group treated with a single injection of
      trypsin or blood; 3) There was no significant damage to the healthy articular
      cartilage by the single injection of trypsin or blood, or both; and 4) Platelets
      do not adhere to cartilage and superficial damaged cartilage does not induce
      platelet aggregation.

PMID- 2219971
TI  - Congenital dislocation of the hip--a long-term follow-up in Korea.
AB  - The results of fifty-eight congenitally dislocated hips in fifty-four children,
      who were between two months and eleven years old when treatment was begun, have
      been reviewed. Thirteen hips were treated by closed reduction, seventeen hips by
      open reduction, seventeen hips by Salter's innominate osteotomy, five hips by
      Klisic operation, and six hips by other operations. At an average 5.1 year follow
      up (range, three to twelve years), a 91% satisfactory result was obtained when
      treatment was started under two years of age. With preoperative traction, in the
      cases when the femoral head was pulled down below to the zero station, the
      clinical result was satisfactory in 83%. We think that the treatment of
      congenital dislocation of the hip should be started before two years of age and
      that the femoral head should be pulled down below to the zero station to prevent
      avascular necrosis, and to obtain a satisfactory result.

PMID- 2219970
TI  - Non-Hodgkin's lymphoma: a histopathologic and immunohistochemical study of 79
      cases.
AB  - Recently immunophenotyping has become a valuable tool in the diagnostic workup of
      malignant lymphoma. We classified 79 consecutive cases of non-Hodgkin's lymphoma
      experienced at our hospital during the last two years according to the Working
      Formulation and immunologically using MT1, UCHL1 and MB2 monoclonal antibodies.
      The results of this study are as follows: 1) four cases (5.1%) were low grade, 54
      cases (68.4%) were intermediate grade, and 21 cases (23.3%) were high grade. The
      most common subtype was 'diffuse, mixed' type, 2) fifty cases (63.3%) showed T
      cell phenotype and 14 cases (17.7%) showed B-cell phenotype. Immunophenotyping
      was impossible in 15 cases due to either double staining or negative staining. 3)
      the incidence of extranodal presentation was high (65.8%) and the most common
      extranodal site was the upper aerodigestive tract (29.1%) followed by the
      gastrointestinal tract (16.4%), and 4) MT1, UCHL1 and MB2 monoclonal antibodies
      are valuable markers of T- and B-cells in paraffin embedded tissue, enabling
      retrospective study. However, because these antibodies are not lineage specific,
      the results of immunostaining should be interpreted with caution.

PMID- 2219972
TI  - Comparison of adjuvant radiotherapy and chemoradiotherapy following surgery in
      stage IE and IIE primary gastrointestinal tract non-Hodgkin's lymphoma.
AB  - Forty patients (median age 49.6 years) were treated for primary gastrointestinal
      lymphoma between 1979 and 1989. There were twenty-three cases of gastric lymphoma
      and seventeen cases of intestinal lymphoma. Following surgery, seventeen patients
      received postoperative chemoradiotherapy (ACOP) by the sandwich technique, seven
      patients received postoperative radiotherapy, and sixteen patients did not
      receive any other form of adjuvant treatment. Nineteen patients were stage IE and
      twenty-one were stage IIE. Stage IE disease was more prevalent in the gastric
      lymphoma group than the intestinal lymphoma group (p less than 0.01). At a median
      follow-up of 17 months (1-102 + months), 17 of 19 stage IE patients and 15 of 21
      stage IIE patients remained alive. The survival rate was 90% in the postoperative
      chemoradiotherapy group and 83.3% in the postoperative radiotherapy group at five
      years, and 42.7% in the surgery alone group at four years, which showed
      statistical significance (p less than 0.01, p less than 0.05, each).
      Statistically improved survival rates were achieved with a postoperative
      chemoradiotherapy modality in intestinal lymphoma (p less than 0.01), stage IIE
      (p less than 0.01), intermediate grade by NCI criteria (p less than 0.01), poorly
      differentiated lymphocytic lymphoma (p less than 0.05), and diffuse histiocytic
      lymphoma (p less than 0.01) according to Rappaport classification, compared to
      those of the surgically treated only group. Three local relapses occurred in the
      operation alone group, and one in the adjuvant radiotherapy group which occurred
      simultaneously with distant lymph node recurrence. The pathologic stage of all of
      these relapsed patients was stage IIE-2. These results suggest that adjuvant
      chemoradiotherapy in completely resected localized gastrointestinal non-Hodgkin's
      lymphoma can decrease local and systemic relapse resulting in long-term disease
      free survival and overall survival compared to operation alone.

PMID- 2219973
TI  - Effect of tolazoline on persistent hypoxemia in severe hyaline membrane disease.
AB  - Ten critically-ill preterm infants with severe hyaline membrane disease received
      tolazoline because of persistent hypoxemia refractory to the administration of
      100% oxygen and mechanical ventilation. Seven infants (70%) responded immediately
      with an increase in PaO2 greater than or equal to 20 mmHg in the umbilical
      arterial gas within 60 minutes after bolus infusion (1 to 2 mg/kg) of tolazoline.
      Twenty-four hours later after the tolazoline infusion, the FiO2 had been
      decreased from 1.0 to a mean of 0.82 +/- 0.16, and the MAP from 16.5 +/- 1.8 to
      15.6 +/- 4.5 cm H2O. Four of 7 infants (57%) who had an immediate response
      survived, whereas none survived out of 3 infants who failed to respond initially.
      Three infants experienced relatively severe complications possibly related to
      tolazoline. There appears to be a place for the use of tolazoline in a severely
      hypoxemic infant with hyaline membrane disease who is being ventilated, and in
      whom arterial oxygenation cannot be improved by a further increase in the
      inspired oxygen concentration or by an alteration of ventilator settings.

PMID- 2219974
TI  - Benign proliferative disorders of the breast.
AB  - Fibrocystic disease of the breast has been generally regarded as a disorder due
      to either excess hormonal stimulation or an exaggerated proliferative response by
      hypersensitive breast epithelium. The unique lobular lesion-adenosis- and its
      variants have been regarded as non-neoplastic and non-preneoplastic glandular
      hypertrophy and hyperplasia, and have different organoid patterns and origins. We
      have examined a total of 242 cases previously diagnosed as 'fibrocystic disease'
      at the Department of Pathology with the purpose of clarifying the variants of
      adenosis in detail and refining the infinitely large 'fibrocystic disease'
      classification as non-proliferative fibrocystic change and proliferative
      disorders, such as epitheliosis and atypical hyperplasia. In this study, 224
      cases (92.5%) were nonproliferative disease, mostly adenosis (40.1%), and 18
      cases (7.5%) were proliferative disease, which consisted of moderate to florid
      hyperplasia and epitheliosis.

PMID- 2219975
TI  - Effect of polyadenylic.polyuridylic acid on the proliferative responsiveness of
      mouse thymus and spleen cells.
AB  - The effects of polyadenylic.polyuridylic acid [poly(A).poly(U)] on in vitro
      proliferations of thymus and spleen cells from C57BL/6 mice were investigated.
      Mice were injected intravenously with 30 micrograms of poly(A).poly(U) or
      placebo. Two days later, thymus, spleen and peritoneal cells from these mice were
      prepared and cultured in pooled or non-pooled conditions. Cell proliferations
      were assessed by the technique of incorporation of tritiated thymidine. It has
      been revealed that the in vitro proliferations of thymus and spleen cells as well
      as the productions of interleukin-1 by peritoneal adhering cells and interleukin
      2 by spleen cells were significantly enhanced in the cultures of cells from
      poly(A).poly(U)-treated mice. These enhancing effects were observed only in the
      cultures of pooled cells from mice whose genetic homogeneity is suspected.
      Furthermore, thymus cells from poly(A).poly(U)-treated mice acted as strong
      responder cells but not as stimulators in one way mixed cultures. Thus, the
      enhanced cellular responsiveness may be mediated by the increased production of
      cytokines and antigen recognitions of thymus-derived cells following activations
      via the adjuvant effect of poly(A).poly(U).

PMID- 2219976
TI  - Aberrant breast tissue of the perineum--a report on two cases.
AB  - In this abstract we report on two cases of aberrant breast tissue of the perineum
      in a 41-year-old and a 42-year-old woman with the complaint of a slowly growing
      vulvar mass. The masses were not fixed, they were ovoid, rubbery firm and
      measured 3 x 2.5 and 4 x 3 cm in size. Microscopically, they revealed normal
      lobular architecture with focal papillomatosis in the former.

PMID- 2219977
TI  - Gracilis myocutaneous flap for the coverage of an extensive scrotoperineal defect
      and protection of the ruptured urethra and testes.
AB  - The use of a gracilis myocutaneous flap to overlay an extensively traumatized
      scrotoperineal soft tissue defect, through which both testes and the ruptured
      bulbous urethra were exposed, is discussed. The transplanted gracilis
      myocutaneous flap, which included vascularized and innervated tissue, was well
      taken and covered the perineal defect, exposed testes and urethral stricture both
      cosmetically and functionally.

PMID- 2219978
TI  - Current trends in human IVF and other assisted reproductive technologies.
AB  - The new reproductive technologies such as IVF, GIFT, ZIFT, and micromanipulation
      have had a profound influence on the therapeutic and diagnostic management of
      infertility, and in turn have resulted in better understanding of human
      fertilization and embryo development. While the clinical pregnancy rates in GIFT
      and ZIFT procedures are comparable to the natural fecundity in the population at
      large, pregnancy rates in IVF have been generally lower. Further investigations
      should be directed to improve the implantation rates, and to develop better
      controlled methods of multiple follicle development. Although more studies are
      needed, a recent report of potential utilization of nonstimulated oocytes for
      donor programs as well as IVF-cryopreservation was a promising new development
      (Cha et al. 1989). Other exciting prospects on the horizon are the possibilities
      of gene transfer for the treatment of certain genetic diseases and diagnostic
      applications of embryonal biopsy. These new technologies have also generated
      serious ethical and legal issues. Any ethical or legal guidelines affecting new
      reproductive technologies should be developed to protect all participants only
      when the need for regulation is clear. Ethical guidelines and appropriate
      legislations with contributions from the medical and scientific community are
      gradually being established worldwide.

PMID- 2219979
TI  - Reactive dye induced occupational asthma without nonspecific bronchial
      hyperreactivity.
AB  - Current asthma is often excluded by the presence of normal bronchial
      hyperresponsiveness. We report two asthmatic patients with normal bronchial
      hyperresponsiveness and one asthmatic patient with mild bronchial
      hyperresponsiveness (methacholine PC20; 24 mg/ml) which was presumed to be caused
      by sensitization and exposure to Black GR, the most frequent sensitizer among
      reactive dyes. They all complained of lower respiratory symptoms after work as
      well as at the workstation. The bronchoprovocation test with Black GR revealed
      isolated immediate bronchoconstrictions in all 3 patients and all had high
      specific IgE antibodies to Black GR-human serum albumin conjugate. After one
      worker continued at work for 3 days, he experienced a marked drop of methacholine
      PC20, and it returned to the pre-exposure level during 1 week. The other patient
      whose initial methacholine challenge was negative developed bronchial
      hyperresponsiveness on the first day after the dye bronchoprovocation, and
      returned to normal bronchial hyperresponsiveness on the third day. These findings
      suggested that patients with occupational asthma caused by reactive dye may not
      always have bronchial hyperresponsiveness to methacholine, and the screening
      program utilizing methacholine challenges may not always identify these patients.

PMID- 2219980
TI  - [Senile psychoses in family clinical practice].

PMID- 2219981
TI  - [Management of suicidal patients].

PMID- 2219982
TI  - [Dysphagia].

PMID- 2219983
TI  - [Chronic dyspepsia].

PMID- 2219984
TI  - [Liver cirrhosis--current aspects of diagnosis and therapy. 1: etiology,
      epidemiology, prognosis, diagnosis].

PMID- 2219985
TI  - [Helminthiases].

PMID- 2219986
TI  - [Sense and nonsense of vitamin C and E treatment].

PMID- 2219987
TI  - [Adverse effects of drugs and their legal consequences].

PMID- 2219988
TI  - [Current status of preventive drug therapy of thromboembolic arterial vascular
      diseases].

PMID- 2219989
TI  - [Maxim Zetkin--addendum to his biography on the occasion of his 25th anniversary
      of his death].

PMID- 2219990
TI  - Ultrastructural changes of air-blood-barrier and surfactant in chronic non
      specific lung diseases.
AB  - The study of changes of ultrastructure of air-blood-barrier components in
      comparison with indices of surfactant surface activity was carried out on
      fragments of lung tissue, cut from 36 patients with bronchiectasis, chronic
      abscess and fibrosis of post-pneumonic nature. Our data indicate, that in
      patients with chronic non-specific lung diseases the areas, more distant from the
      focus of affection, have changes, involving all the components of air-blood
      barrier. Dystrophic and destructive processes, taking place in some pneumocytes
      of the 2nd type, result in suppression of the surface active characteristics of
      surfactant. On the other hand, processes of compensatory nature, directed to
      making up a deficiency of surfactant, take place.

PMID- 2219991
TI  - [The lymphocyte transformation test in sarcoidosis].
AB  - A suppressive effect of the sarcoidosis serum on the mitogenic stimulation of
      lymphocytes could be confirmed statistically (p less than 1%). But there remained
      a lot of deviating results in distinct individual cases which could not be
      explained by subdividing the material in regard to different clinical points of
      view. The practical utility of the LTT as a diagnostic tool in sarcoidosis is
      therefore very limited. The partly missing suppression or even a stimulation
      compared to the culture with pooled AB-sera can be interpreted by the interesting
      phenomenon of a concentration dependent counter-current action of the sarcoidosis
      serum: On suboptimal PHA-dosage undiluted serum caused a significant reduction of
      the transformation rate of donor lymphocytes, 1:10 diluted serum was inefficient
      and in a 1:100 concentration it induced a stimulation (p less than 5%).

PMID- 2219992
TI  - [Malignant schwannoma of the lung].
AB  - A case of a histologically confirmed malignant schwannoma of the lung is
      reported. The pathological and clinical features, the immuno-histological
      diagnosis and the prognosis of the tumor are reviewed. Furthermore, the
      successful surgical treatment of the patient is described; he survived 7 years
      after the operation, and now there aren't any clinical and roentgenological signs
      of recurrences.

PMID- 2219994
TI  - [Correlations of quartz dust exposure, scleroderma and lung function].
AB  - There are closed relations between progressive systemic sclerosis (PSS) and
      exposure to quartz dust in the GDR. The recognition of PSS as an occupational
      disease is regulated by law. By analysis of the dust exposed working places a
      limit for silica concentrations were fixed. It is unlikely, that silica
      concentrations below 10% in the respirable dust induce a PSS. There are no
      significant differences in lung function of PSS-patients with and without quartz
      exposure.

PMID- 2219993
TI  - [Coincidence of silicosis and lupus erythematosis].
AB  - From 1975 to 1989 37 patients with Lupus erythematodes exposed to quartz dust
      over many years were observed. Thirty of them suffered from silicosis. The
      coincidence of silicosis and Lupus erythematodes can be an expression of a common
      pathogenesis.

PMID- 2219995
TI  - [Model and experimental animal studies of the use of hand-controlled catheter-jet
      ventilation (CJV) by plastic replacement of the tracheobronchial tree].
AB  - Pressure and volume flow measurements were performed on a simple model of the
      tracheobronchial tree using a catheter-jet-ventilation apparatus. This type of
      respiration is particularly favourable in tracheo-bronchial surgery, i.e.
      resections and anastomosing, due to the experience of model as well as animal
      experiments. Under consideration of the particularities of catheter-jet
      ventilation, this type of respiration provides excellent conditions for the
      surgeon. This is valid for the overview of the site of operation and possible
      manipulation within this region. This method of respiration is suggested as a
      reliable tool in the hands of less skilled anaesthetists, too, for its easy
      handling.

PMID- 2219996
TI  - [Fundamental research in ultrasonic surgery. IX. Splenic surgery using cavitation
      ultrasound--an experimental animal study of aspiration and sealing technics with
      ligament FIMOMED].
AB  - A farther alternative for the conservation of the spleen represents the
      ultrasonic aspiration and sealing technique by means of the monomeric tissue
      adhesive Ligament Fimomed. The effectiveness of the method was proved by
      histomorphologic investigations in animal experiment with the porcine spleen. The
      method was effective in nearly all injuries across to the longitudinal axle of
      the organ even with a larger parenchymal defect and also in case of splenic
      tumor. The control of hemorrhage succeeded promptly and surely. Not any
      postoperative complication appeared.

PMID- 2219997
TI  - [Electrophoretic studies of the composition of peripheral mononuclear cells
      during operations with extracorporeal circulation].
AB  - The increased incidence of infections after operations can be connected with
      changes of the immunocompetent cells. Mononuclear blood-cells were investigated
      by means of the cell electrophoresis during and after operations under the
      extracorporeal circulation, because electrophoretically different cells correlate
      with several immunological phenotypes. A heavy decrease of the electrophoretic
      quick mobility cell population was found out on the first postoperative day above
      all. This change allows itself the interpretation by decreasing the T-lymphocytes
      connected to a relative increase of monocytes, B-cells, and immature T-cells.
      Besides a lower quotient of the quick and low mobility T-cells refers to a lower
      immunoregulatory quotient CD4/CD8 after operation. Changes of the cell
      composition becomes evident also in dependence on the bypass length and the blood
      supply.

PMID- 2219998
TI  - [The question of the transmissibility of the results of subcutaneous tests of
      biomaterials from animals to humans].
AB  - The histologic estimation of the subcutaneous connective-tissue reaction at
      implants forms an important part of the biocompatibility test. The connective
      tissue capsulae around titanium implants in man, guinea-pig, and Wistar-rat were
      analysed by a special test system because of the question concerning the
      transmission of results of animal experiments on the man. The subsidence process
      of the thickness of the connective-tissue capsule and of the cell count per
      measuring fields were represented in dependence on the time. The findings showed
      the fundamental similar course of wound healing in man, guinea-pig, and Wistar
      rat by the influence of an implant.

PMID- 2219999
TI  - Pancreatic transplantation in the rat. An experimental model.
AB  - Following the induction of experimental diabetes in two groups of rats using an
      isograft model, a comparative study was made of two types of pancreas transplants
      in which several procedures were employed. The vascular anastomosis in one group
      were to the renal artery and vein, and in the other, to the iliac vessels. The
      pancreatic ducts in one subgroup were ligated, in another, they were diverted to
      the urinary system; in a third sub-group, they were diverted to the intestine.
      The results obtained for the sub-group with the transplant anastomosed to the
      renal vessels were the best. It is suggested that this was due to two factors:
      the simplicity of the technique and the short operating times. In this present
      work the two best methods of dealing with the exocrine secretion were diversion
      to the ureter and ligation of the common bile duct. The worst results were in the
      group with duodeno-cystostomy.

PMID- 2220000
TI  - [An immunomonitoring program for supervising transplant patients].
AB  - Lymphocytes and monocytes with differential and activation antigens were
      determined by means of the flow cytometry by using monoclonal antibodies in the
      peripheral blood of patients after organ transplantation. Examinations of the
      course showed that in this way the acute activity is seized by the cellular
      immunosystem. Acute reject crises, systemic virus infections, as well as septic
      states lead to characteristic changes and these verify the diagnostic assertion
      of this immunomonitoring programme.

PMID- 2220001
TI  - [Prolongation of transplantation survival time by a PUVA treatment. Experimental
      and clinical results].
AB  - The treatment of transplants by a combination of 8-methoxypsoralen and longwave
      ultraviolet radiation (PUVA) leads to prolongation of the transplants in
      allogeneic receivers without immunosuppression. The rejection of skin grafts in
      the mice could be delayed significantly. The rejection of kidney and heart
      allografts could be prevented completely. A significant diminution of the acute
      rejection crises and a raising of the one-year survival rate showed a first
      clinical study by means of PUVA treatment in human kidney grafts.

PMID- 2220002
TI  - [Behavior of pO2 on rabbit small intestine serosa, measured with the Clark
      electrode in different models of intestinal ischemia].
AB  - The pO2 on the surface of the small intestine serosa was measured on an isolated
      small intestine loop of the rabbit after synchronistic arterial and venous
      ligature of the mesenterium, after synchronistic arterial starvation and venous
      ligature, and after torsion of the mesenterium. The measurements of the pO2 were
      carried out by means of a Clark-electrode. Different periods for the decrease of
      the pO2 to zero Torr were shown in the different models of intestinal ischemia.
      Only the difference between the synchronistic arterial and venous ligature and
      torsion was statistically significant.

PMID- 2220003
TI  - [The effect of proximal selective vagotomy on experimental gastric mucosal
      lesions in the rat].
AB  - The influence of the proximal selective vagotomy (PSV) on the origin and the
      extent of experimental gastric ulcer were investigated in rats. The lesions of
      the gastric mucosa were caused in three groups: by stress through swimming-test,
      by application of phenylbutazone, and by ischemia (ligature of the left gastric
      and the right gastroepiploic vessels). The PSV practised a protective influence
      on the pharmacodynamic etiology, however, not on the stress ulcer. The areas of
      the ischemic gastric ulcers were larger on an average of 40% after PSV than in
      the control animals. The difference was not statistically significant. In case
      the PSV caused besides hyposecretion and hypo-acidity even passive hyperemia
      caused in the denervated part of the stomach then these did not produce any
      sufficient defence against the origin of stress ulcers and ischemic lesions.

PMID- 2220004
TI  - [Computer-assisted analysis of the pressure behavior of the esophagogastric
      junction during increase in intragastric pressure].
AB  - Two factors are to determine increasing lower esophageal sphincter pressure
      during intragastric pressure rising mainly: 1. the active intrinsic muscle tone
      and 2. the efficiency of the law by La Place. The purpose of the study was to
      estimate the part of both of them in this measurable phenomenon. We investigated
      15 healthy volunteers and 5 patients post Nissen fundoplication. A simultaneous
      manometric examination of gaster and LES was carried out during gradual
      compression of abdominal wall. Analysis of dependence of LES-pressure on
      intragastric pressure, based on computer usage, was established. A linear
      equation described this dependence with the best correlation coefficient (r =
      0.98) followed by potential and exponential equation. Fundoplication caused a
      steeper ascent without any changing of linear character of function. Considering
      linear equation is compatible with the law by La Place out not with a
      simultaneous pressure depending change of intrinsic muscle tone, these results
      indicate that the law by La Place has major importance in the measurable rising
      of high pressure zone during intragastric pressure increasing.

PMID- 2220005
TI  - [Electromyographic and manometric studies of the antrum and duodenal motility in
      rabbits under the influence of pentagastrin in a mechanical duodenal passage
      disorder].
AB  - The influence of a mechanical disturbance of the duodenum on the motility of the
      antrum and duodenum was investigated by means of the electromyography and the
      perfusion manometry. Thereby the effect of the pentagastrin stimulating the
      motility of the unstriated muscles of the gastro-intestinal tract was used for
      testing the function reserve of the antrum- and duodenal-muscles. After one and a
      half month of establishing the passage obstacle there occurs a complex
      disturbance of the electrical activity; the unstriated muscles does not react on
      a stimulating excitation.

PMID- 2220007
TI  - [A skin button to anchor and lead out catheters or cable links from the skin].
AB  - The manufacture of a skin button for use in chronic animal experiments is
      described, which is made of silicone rubber and intended to anchor the exit site
      of intravascular catheters. The button holds the catheter permanently in the skin
      and can also be used to anchor connections for occlusion cuffs and cables leading
      to implanted measuring elements.

PMID- 2220006
TI  - [Experimental animal studies of the stability of colon anastomoses after
      supplementary fibrin glue sealing].
AB  - Sutures of the colon can be insufficient or leaking. This leads in some cases to
      a peritonitis or sepsis sometimes with lethal outcome. Therefore experiments in
      animals were performed to investigate the effect of additional applied biogenic
      glue. Especially in the beginning of the wound healing, at the 4th postoperative
      day, the firmness could be improved by fibrin glue. The bursting pressure of
      fibrin glue sealed colon sutures was 94 mmHg, whereas only 66 mmHg was observed
      in the control group. This additional firmness remains over the whole observation
      time of 3 weeks. An intensified proliferation of the connective tissue is
      responsible for this observation which could be substantiated by histological
      investigations and by measuring the thickness of the scar. If biogenic glue is
      used in animals it can have the consequence that the recipient reacts with the
      production of antibodies, since the components of the glue are proteins from
      different species. Investigations of the serum of animals which had been treated
      with fibrin glue revealed in a part of them precipitating antibodies against
      fibrinogen. With regard to this observation a second application of biogenic glue
      must be done with the necessary precaution.

PMID- 2220008
TI  - [Distance holder for implanted carotid catheters].

PMID- 2220009
TI  - [Bipolar impulses or direct current as an adjuvant treatment of incisional
      hernia? Comparative experimental animal study].
AB  - The electrostimulation of the cicatricial healing in the abdominal wall were
      tested in 119 Wistar rats by means of bipolar rectangularly pulsed current (0.87
      Hz, +/- 25 mu A) and direct current (1 mu A). Doubling of the fascia of an
      abdominal wall hernia was carried out in three groups of rats. In the first group
      the operational region was stimulated by rectangularly pulsed current, strong
      proliferated cicatrices were formed with premature production of fibroblasts and
      collagenous fibres, fast maturation, and high strength. In the second group it
      was stimulated by direct current, a less exact longitudinal orientation of the
      collagenous fibres and a slower cicatricial maturation were shown. The third
      group applied as a control showed a cicatricial distension up to 5 mm. The
      electrostimulation of the proliferation of connective tissue and cicatricial
      healing could be pointed out between different tissues (peritoneum and fascia).

PMID- 2220010
TI  - [Strengthening of cryodestruction by ultrasonic energy].
AB  - The ultrasonic treatment of vital tissue with therapeutically qualified
      ultrasonic intensity immediate before the cryosurgery leads to a significant
      enlargement of the plane and the depth of the cryodestruction. This knowledge
      should be used in the cryosurgical treatment of inoperable carcinomas with
      extensive tumor mass.

PMID- 2220011
TI  - [Are double potentials an indication of reentry? Intra-atrial catheter mapping in
      atrial flutter].
AB  - A local doubling of atrial potentials was demonstrated in 40 out of 49
      electrophysiological investigations with intraatrial catheter-mapping during
      atrial flutter. Such doubled potentials can be localized in small areas of the
      right atrium. In these circumscribed areas the distances between the doubled
      potentials vary. A predilection area inside the right atrium was not detected.
      The doubled potentials were found in different sites varying from patient to
      patient: 15 times in the upper, 13 times in the middle, and 12 times in the lower
      areas of the atrium. In each patient there was a particular reproducible place,
      where the doubled potentials were found. Sequential activation time mapping seems
      to show atrial excitation spreading from the area where the doubled potentials
      were found. We interpreted these findings as evidence of a reentry-circuit.
      However, the reentry-circuit apparently does not use preexisting anatomical
      obstacles, but rather a circumscribed pathological alteration in the atrium.

PMID- 2220012
TI  - [Effect of cibenzoline on atrial vulnerability and value of electrophysiological
      methods in the treatment of paroxysmal atrial fibrillation].
AB  - The effects of intravenous cibenzoline (1,5 mg/kg) on atrial vulnerability and
      electrophysiology were assessed in 25 patients with documented paroxysmal atrial
      fibrillation, in whom sustained (greater than 30 s) atrial fibrillation/-flutter
      was induced by programmed atrial stimulation. In seven patients atrial
      fibrillation persisted despite the application of cibenzoline; in eight patients
      induction of atrial fibrillation was not prevented. In 10 patients the induction
      of sustained atrial fibrillation was prevented by cibenzoline. Intraatrial
      conduction time and shortest ventricular cycle length during atrial fibrillation
      were increased by cibenzoline (p less than or equal to 0.01). The effective
      refractory period of the right atrium was not significantly affected. Eight
      patients with frequent episodes of paroxysmal atrial fibrillation received oral
      cibenzoline (320 mg/day) for control of paroxysmal atrial fibrillation
      irrespective of the efficacy of intravenous cibenzoline. Prevention of
      stimulation-induced atrial fibrillation predicted successful treatment of
      paroxysmal AF. In conclusion, cibenzoline might be effective in the treatment of
      atrial tachyarrhythmias. Programmed atrial stimulation seems to be helpful in the
      prediction of the efficacy of an antiarrhythmic treatment of paroxysmal atrial
      fibrillation.

PMID- 2220013
TI  - [Reduction in left ventricular volume and improvement in hemodynamics following
      intravenous administration of pimobendan (UDGG 115 BS) in dilated
      cardiomyopathy].
AB  - Acute cardiovascular effects of 5 mg (group I, n = 6) and 10 mg (group II, n = 6)
      i.v. pimobendan (UDCG 115 BS) were studied by right and left heart
      catheterizations in patients suffering from idiopathic dilated cardiomyopathy
      (NYHA II and III). Before and 2.5 h after application of pimobendan left
      ventricular volumes and left ventricular dP/dtmax were evaluated by left heart
      catheterization. Right atrial pressure (RAP), pulmonary capillary wedge pressure
      (PCP), cardiac output (CO), heart rate, and systemic blood pressure were assessed
      before and 2.5, 4, and 6 h after administration of pimobendan. PCP was reduced
      from 12.2 +/- 7.5 to 8.3 +/- 7.1 mm Hg (p less than 0.05) by 5 mg of pimobendan,
      and from 18.3 +/- 6.2 to 6.2 +/- 3.4 mm Hg (p less than 0.005) by 10 mg of
      pimobendan. Reduction of RAP was significant only in group II (from 6.2 +/- 3.2
      to 1.2 +/- 0.9 mm Hg; p less than 0.05). In contrast to other hemodynamic
      parameters, the significant increase of CO exhibited no dose-dependency. Only 10
      mg of pimobendan induced a temporary reduction of mean arterial blood pressure.
      An increase in heart rate occurred only in group I and was merely transient. Left
      ventricular end diastolic and end systolic volume indices were clearly reduced by
      5 mg as well as by 10 mg of pimobendan. A significant rise of left ventricular
      ejection fraction occurred only in group II. However, left ventricular dP/dtmax
      was increased significantly in both groups. No adverse effects were noted during
      acute administration of pimobendan. Therefore, intravenous pimobendan may be a
      useful drug in the treatment of acute cardiac failure.

PMID- 2220014
TI  - [Three-dimensional analysis of the regional contractility of the normal and the
      cardiomyopathic left ventricle using cine-magnetic resonance imaging].
AB  - The left ventricular regional contractile pattern, global function and mass of
      normal subjects and patients with idiopathic dilated cardiomyopathy was compared
      using cine magnetic resonance imaging (MRI) in a short-axis imaging plane. Left
      ventricular ejection fraction and mass were 64.3 +/- 2.5% and 115 +/- 10 g in
      normal hearts and 23.5 +/- 3.1% and 194 +/- 20 g in dilated cardiomyopathic
      hearts (p less than 0.001 and p less than 0.002). Left ventricular end-diastolic
      wall thickness was homogeneous in normal hearts except for the posterior wall at
      the basal level, which was significantly thinner compared to the anterolateral
      wall and the septum (p less than 0.02). End-diastolic wall thickness in the
      cardiomyopathic group was significantly more heterogeneous and was thinner at the
      apical compared to the basal level (p less than 0.02) as well as in the segment
      of the posterior compared to the anterolateral and septal wall (p less than 0.005
      and p less than 0.03). In normal hearts, left ventricular end-systolic wall
      thickness was progressively greater from base to apex for the anterolateral (p
      less than 0.01) and posterior wall (p less than 0.02) and the septum (p less than
      0.02). Such a uniform gradient of end-systolic wall thickness was not present in
      hearts with dilated cardiomyopathy. It was even reversed for the anterolateral
      wall with decreasing thickness from base to apex (p less than 0.03). Left
      ventricular mean systolic wall thickening increased progressively from base to
      apex (p less than 0.005) in normal hearts, whereas there was no significant
      gradient from base to apex in hearts with dilated cardiomyopathy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2220015
TI  - [Thrombolysis therapy and coronary angiography in acute myocardial infarct in the
      Augsburg region: results of the Augsburger Heart infarct register 1985-1987].
AB  - In the years 1985-87, the Augsburg Coronary Event Register registered 1333
      hospitalized patients who had survived an acute myocardial infarction (AMI) for
      at least 24 h. In 953 patients, data on time intervals in the prehospital phase
      were documented in addition to the medical records data in a standardized nurse
      interview. The time from onset of AMI until the patient called for medical
      attention constituted most of the prehospital time delay. Of the interviewed male
      and female patients, 67% were hospitalized within 6 h (= time limit). The
      differences, both in the number of thrombolyses and the number of coronary
      angiographies performed in men and in women are statistically significant.
      Thrombolysis was performed in 27% of the male and 12% of the female AMI patients
      who were admitted to hospital within the time limit. The rate of thrombolytic
      therapy decreased with increasing age and was less in patients with recurrent AMI
      (men: 20%, women: 0%) than in patients with first AMI (men: 29%, women: 15%).
      There was some time-of-day variation in the percentage of thrombolytic therapy
      which may be attributable to hospital organization. From 1985 to 1987, the
      coronary angiography rates performed in the medical center doubled, independent
      of the thrombolytic therapy rates. In this time, angiography rates in
      thrombolyzed patients increased from 49% to 75%, and from 14% to 31% in patients
      without thrombolysis. The 28-day case fatality was 4.8% in patients with
      thrombolysis and 13% in patients without thrombolytic therapy. Controlling for
      age, sex, and recurrent AMI, this difference is not statistically
      significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220016
TI  - [Diagnosis of ventricular septum rupture following acute myocardial infarct using
      a fiber-optic indwelling catheter].
AB  - Rupture of the ventricular septum is a rare complication of acute myocardial
      infarction. Time of diagnosis, hemodynamic condition, as well as duration and
      effectiveness of the preoperative treatment determine the clinical outcome after
      surgical repair. Since its introduction the bedside-applied Swan-Ganz catheter
      has maintained an important role for the rapid confirmation and quantitation of
      the infarct-induced ventricular septal rupture. We report on the clinical courses
      of two patients whose diagnoses were established by means of a fiberoptic-armed
      Swan-Ganz catheter. Accuracy of the measured oxygen saturation was controlled by
      in vitro gas analyses with heparinized blood samples. As compared to conventional
      methods the continuous in vivo oximetry by a fiber-optic system is a simple
      procedure which facilitates repeated shunt calculations during hemodynamic
      monitoring in critically ill patients.

PMID- 2220018
TI  - [Abstracts of the autumn meeting of the German Society for Heart and Circulatory
      Research. 4-6 October 1990, Gottingen].

PMID- 2220017
TI  - [Dilated myocardial disease as sequela of chronic Lyme carditis].
AB  - A report is given on a 39-year-old man, who developed, after a tick bite,
      erythema, progressing symptoms and, after 3 years, showed the typical clinical
      and echocardiographic signs of a dilative cardiomyopathy. A serological test for
      Lyme Borreliosis was positive. Most of the symptoms disappeared after high-dose
      penicillin therapy.

PMID- 2220019
TI  - [Professor Dr. Zdenek Frankenberger, founder and first head of the Histological
      Embryological Institute of the Medical Faculty of Komensky University in
      Bratislava].

PMID- 2220020
TI  - Intermediate cell tumour of the pancreas in rat.
AB  - A malignant tumour of the rat pancreas with features of both acinar and endocrine
      cells is presented. This consisted of a continuous cytoplasmic mass with numerous
      dispersed nuclei and branches protruding from its borders invading the
      surrounding exocrine tissue. The most prominent characteristic of the tumour was
      the co-existence of zymogen and endocrine secretory granules and cytoplasmic
      organelles typical of both acinar and islet cells. Some hypotheses are put
      forward concerning the origin of the tumour and its vasculature.

PMID- 2220022
TI  - Ultrastructural studies on the placentae of streptozotocin induced maternal
      diabetes in the rat.
AB  - Following induction of diabetes by a single injection of (IP) streptozotocin
      (STZ) to pregnant Wistar rats on days 2, 4 and 6 to 12 of gestation, fetuses and
      placentae were collected on day 20. The controls were either untreated or vehicle
      treated; alternatively following STZ injection, 2-6 IU of insulin was
      administered (sc) daily until term. The placentae were fixed in a glutaraldehyde
      and paraformaldehyde mixture and ultrathin sections were examined under the
      electron microscope. The structure of the vehicle treated control resembled that
      of the untreated control. The insulin control group had pathological changes
      similar to those of the diabetic group but with considerably less frequency. The
      giant cells in the basal zone of STZ group were numerous; they had abundant
      dilated cisternae of rough endoplasmic reticulum, intracytoplasmic fibrinoid and
      nuclear inclusions. The trophospongial cells presented numerous clear vacuoles,
      lysosomes and myelin bodies. Enlarged vacuoles often impinged deeply on the
      nucleus. The glycogen cells disintegrated resulting in cyst formation. In the
      labyrinthine zone, layer I trophoblast revealed increased number of large pores
      through which layer II trophoblast projected into the maternal sinusoid. Layer II
      had abundant glycogen, lipid droplets and lysosomes. Layer III had imbibed much
      fluid and appeared foamy with swollen organelles. Fibrinoid substance was
      produced by the giant cells, basophils and the trophoblast bordering the maternal
      sinusoids. Cyst development was preceded by degeneration of glycogen cells in the
      basal zone and of the trophoblast in the labyrinthine zone. Pronounced
      development of gonadotropin/somatotropin granule-like 'secretory granules' and
      smooth endoplasmic reticulum associated lipid droplets also characterised the
      labyrinthine trophoblast. The observed placental pathology appears to correlate
      well with the intrauterine growth retardation and fetal malformations recorded in
      this animal model.

PMID- 2220021
TI  - The capsule structure of Pacinian corpuscles from the cat mesentery.
AB  - Using the electronograms of Pacinian corpuscle capsule of the cat mesentery the
      authors have studied in details the structure of its layers and lamellae. The
      thickness of the capsule lamellae ranged between 30 nm-320 nm, the mean width
      being 150 nm. On the surface they are overlaid by means of lamina basalis. The
      capsule is formed by circular layers composed, most often, by 1-2 lamellae, less
      frequently, by larger number of lamellae. The width of the space between the
      layers of lamellae is 150-820 nm. A number of lamellae is provided with longer or
      shorter processes. They are directed more often to the adjacent lamella with
      which they can be also connected by means of membrane specialization. However,
      they are also directed into the space between individual layers of the capsule.
      The importance of these processes has not been known. Furthermore, the authors
      have studied the reciprocal link-up of the lamellae within one layer. The
      lamellae are connected either side-to-side, by inserting the end of one lamella
      into the infolding of the other, end-to-side or end-to-end. Rich pinocytotic
      activity (rich occurrence of caveolae) was observed in the lamellae of the
      capsule. Therefore the authors are of the opinion that the capsule and its
      lamellae have not only mechanical significance or the function of the transfer
      system and filter, but they form an important component (subsystem) of the whole
      metabolic system in the sensory corpuscle.

PMID- 2220023
TI  - Ultrastructural aspects of and observations on the permeability of the rat
      mesentery to colloidal iron.
AB  - In works already published, it was made clear that many researches were
      interested in the absorption phenomena, permeability and structure of the
      visceral mesothelial tissue. Attention was concentrated on the mesentery and
      observations were made using the application of lanthanum nitrate and osmium
      amine. The penetration of lanthanum nitrate is impeded by the basement membrane
      situated between the connective and mesothelial tissues. The heavy salt moves
      through and not between the mesothelial cells by passive diffusion. No reaction
      was observed in general with osmium-amine, with the exception of a few cases. In
      those instances, the osmium-amine reacted not only in the outer surface of the
      mesentery, but also penetrated with no visible reaction all the way to the
      connective tissue where it was detected in the elastic layer. In this paper, the
      colloidal iron was employed using different techniques, and depositions were
      detected in the surface of the mesentery, in the mesothelial cells and also in
      the connective tissue. A final conclusion that the permeability of different
      layers of tissues is of great variety and has a definite capacity for selectivity
      is suggested.

PMID- 2220024
TI  - Use of prostaglandin inhibitor, 2-(6-methoxy-2-naphthyl) propionic acid,with
      regard to morphological and enzymatic changes of gastric mucosa.
AB  - 2-(6-methoxy-2-naphthyl) propionic acid is introduced to treatment as non-steroid
      antiinflammatory drug (NSAID) under the trade-mark of Naprosyn. Inhibition of
      prostaglandin synthesis is regarded as the most likely mechanism of its action.
      In some patients, its side-effects include gastritis, reactivation of ulcerous
      niche, and upper gastrointestinal haemorrhage. The absence of complex studies
      addressed to the question of morphological and histochemical changes in gastric
      mucosa after oral administration of Naprosyn prompted our undertaking. In
      experimental animals, with varying doses (10 mg/kg and 50 mg/kg) and variously
      long administrations (1 week and 3 weeks), a trial has been reported here upon.
      In the frozen-sectioned preparations, the histochemical reaction for acid
      phosphatase activity, according to Gomori, was made. The paraffin sections were
      subjected to the HE staining, PAS staining according to McManus and with the
      Masson's method. Our results of the morphological and histochemical studies in
      rats support the clinical observations of mucosal destruction in stomach in
      patients after oral administration of Naprosyn.

PMID- 2220025
TI  - The effect of progesterone and progesterone + estradiol on the morphology of the
      pineal gland in immature female pigs.
AB  - Pineal gland of the immature female pigs treated with progesterone and
      progesterone and estradiol simultaneously were investigated with light and
      electron microscopy. Both of the applied hormones influenced the structure of the
      pineal glands. Inhibitory effect of progesterone on the relative volume of
      mitochondria, granular vesicles and dense bodies of type one was observed.
      Administration of progesterone and estradiol simultaneously caused more
      complicated influence statistically significant increase of pinealocyte nuclei
      volume and at the same time significant decrease of mitochondria and granular
      vesicles.

PMID- 2220026
TI  - Electron microscopic observations on the effect of gossypol on rat cauda
      epididymis.
AB  - Gossypol administered orally to male rats at a daily dose of 20 mg/kg body weight
      for 63 days caused hypertrophy of the cauda epididymal epithelium, with more than
      fourfold increase in height of the cells. The principal cells lost most of their
      microvilli and formed apical blebs which appeared to produce the dense secretory
      material which was found in the lumen. Less dramatic but similar changes also
      occurred after 9 days on the same regimen, with the height of the epithelium
      doubling. However after 19 days on this regimen, with the height of the
      epithelium doubling. However after 19 days on this regimen, the epithelium looked
      fairly normal apart from a maintained hypertrophy. As reported in other studies,
      the cauda epididymal sperm were severely damaged and immotile; many were
      decapitated and the oxygen uptake was low. Ultrastructural defects were abnormal
      or absent mitochondria, absence of plasma membranes and axonemal components and
      accessory fibres.

PMID- 2220028
TI  - Superficial and deep blood vessel distribution in the frog telencephalon.
      Reference to morphological brain asymmetries.
AB  - Nine frogs of the species "Rana esculenta" were heart perfused with Microfile
      Silicone Rubber. The frogs were examined both after dissection (cut with a razor
      blade) to study the superficial blood vessel pattern, and histologically (the
      Nissl staining method) to study the distribution of the deep blood capillaries.
      While the superficial blood vary in pattern, the deep capillaries are distributed
      symmetrically. This finding does not support a correlation between blood vessel
      pattern and morphological brain asymmetry, at least in the frog, and thus other
      explanations must be sought to explain brain asymmetry.

PMID- 2220027
TI  - An ultrastructural study on gastric endocrine cells in the stomach gland patch of
      the koala Phascolarctos cinereus.
AB  - The endocrine cells in the stomach gland patch of the koala (Phascolarctos
      cinereus) were studied ultrastructurally. They were classified into 3 types based
      on the ultrastructural profiles of their endocrine granules and tentatively
      categorized as type I, II, and III endocrine cells. Type I cells contained round
      granules that were for the most part larger than those observed in the other 2
      cell types. The granules ranged from moderate to relatively high in electron
      density. Type II cells were angular in shape and characterized by the presence of
      granules that were polymorphous in profile. Contents of the endocrine granules in
      type II cells also showed a range of high to moderate electron density. Type III
      cells were oval or pyramidal in shape. They contained highly polymorphous
      granules that were round, oval, dumbbell-like or comma in shape and characterized
      by the presence of a clear space or halo separating the high to low electron
      dense core from the limiting membrane of granules. Type III cells were observed
      most often whereas type I and II cells were a less frequent observation.

PMID- 2220030
TI  - To change or not to change: is there a choice?

PMID- 2220029
TI  - AChE-positive innervation of the ureters, urinary bladder, and urethra in pigs.
AB  - Histochemical method of KARNOWSKY and ROOTS (1964) was used to discover the AChE
      positive nerves. These nerve fibres were found in all layers of all organs under
      study. The ureter was weakly innervated, while the urinary bladder and the
      urethra possessed strong AChE-positive innervation. AChE-positive fibres were
      most abundant in the bladder trigone. Muscular membrane was the best supplied
      layer, both in the urinary bladder and in the urethra. Part of AChE-positive
      nerves was connected with the blood vessels in all organs under discussion.

PMID- 2220031
TI  - Calcium and the kidney--from stones to molecules.
AB  - Shortly after the introduction of the thiazide diuretics it was noted that they
      lower the excretion of Ca2+ in the urine, enough so that they were introduced for
      the therapy of hypercalciuria in calcareous stone formers. This observation
      prompted us to begin a series of investigations designed to better understand the
      handling of Ca2+ by the kidney in general, and the effects of diuretics on Ca2+
      transport in particular. Since it was already known that the excretion of Ca2+
      followed closely the excretion of Na+ we postulated that the effects of diuretics
      are related to the shrinkage of extracellular (ECF) volume which signals the
      kidney to enhance filtrate absorption particularly in the proximal tubule. This
      we supported with studies showing that calcium excretion will return to the
      original elevated level, inspite of continued administration of the diuretic, if
      a high salt intake were allowed. We also showed the opposite, namely that
      hypercalciuria can be produced by mineralocorticoid administration if liberal
      salt intake were allowed, and is prevented by salt restriction. This latter
      observation antedated the clinical observation that primary aldosteronism is
      accompanied by hypercalciuria. These studies clearly showed the importance of ECF
      volume in determining urinary excretion of Ca2+. The site of action in the
      nephron of volume changes was thought to be the proximal convoluted tubule.
      Volume expansion had already been shown to depress proximal tubular absorption of
      Ca2+. We carried out studies using in situ micropuncture and demonstrated that
      ECF volume depletion caused by thiazide diuretics results in enhanced absorption
      in the proximal tubule confirming the suspicion that changes in ECF volume were
      translated into reciprocal changes in proximal tubular absorption. Meanwhile we
      showed that a different group of diuretics, the high-ceiling diuretics, unlike
      the thiazides produce a major increase in Ca2+ excretion suggesting that they
      exert their effects at a different site in the nephron, namely the loop of Henle.
      These and many other studies dictated that we examine more directly the handling
      of Ca2+ by the kidney, and for that purpose we employed the technic of in vitro
      microperfusion of isolated renal tubule segments. In the S2 segment of the
      proximal convoluted tubule we were able to show that Ca2+ absorption was entirely
      passive, following the electrochemical gradient for calcium present in this
      segment (luminal PD positive, tubular fluid [Ca2+] greater than plasma
      [Ca2+]).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2220032
TI  - [Metabolic diseases: a challenge for pediatrics].
AB  - During the past ten years we have identified in five girls a previously
      unreported hereditary metabolic disease with severe neurologic involvement. A
      common defect in the carbohydrate structure of serum glycoproteins could be
      demonstrated. This disease illustrates the great challenge that metabolic
      diseases are for pediatrics. Their number is very large and increases steadily;
      most of them can not yet be treated efficiently, and nearly all these disorders
      are hereditary. These and other features make a national and international
      approach necessary.

PMID- 2220033
TI  - [Problems of the preparation and control of properties of sterile drug-containing
      liposomes].
AB  - The techniques employed to produce drug-containing liposomes and to control the
      disperse composition of the included preparation are discussed. The method of
      cryoradiation sterilization of liposomes containing different types of drugs is
      detailed. The applications of the described methodologies for obtaining the
      optimal technological parameters of liposome production are exemplified.

PMID- 2220036
TI  - [All-Union program "Liposomes and their use in biology and medicine" (the
      research and research-practice parts of the program)].

PMID- 2220035
TI  - [Effect of the liposomal preparation aminophosphatide on erythrocyte lysis].

PMID- 2220034
TI  - [Effect of subcutaneous administration of liposomes on the functional state of
      the organs and systems in experimental animals].
AB  - Based on the study of subcutaneous injection of lecithin-cholesterol liposomes,
      its possible toxic effect is discussed and the effect threshold is determined. It
      is shown, that long-term subcutaneous liposome administration is attended with
      hepatic cell damage. One or two injections of the preparation does not cause a
      toxic lesion of the viscera and may be used for therapeutic purposes. A
      considerable threshold-subthreshold dosage range allows for vast variability of
      administered liposome amounts.

PMID- 2220037
TI  - [Ectericide as a dispersion medium for the preparation of prospective clinical
      liposomal drug forms].
AB  - The possibility of using ectericide, having antibacterial, detergent,
      antioxidative, and reparative effects, as a dispersion medium for liposome
      production has been studied. Its application allows for elaboration of a
      simplified liposome production technique simultaneously imparting them stability
      against oxidation, heating, and pH changes. A technology to produce
      multivesicular liposomes with ectericide++, containing rifampicin in the
      membranous envelope and gentamicin in the inner volume, has been developed.
      Liposomal antibiotics proved to be effective in clinical trials.

PMID- 2220038
TI  - [Anti-inflammatory effects of liposomes].
AB  - Studies of antiexudative, antialterative, and antibacterial effects of lecithin
      cholesterol liposomes suggest their possible use as antiinflammatory agents. It
      is shown that incubation of liposomes with opportunistic microorganisms is
      attended with a pronounced antibacterial effect, while subcutaneous injection of
      liposomes significantly reduces the soft tissue edema caused by administration of
      formalin, and prevents pronounced alteration in response to acetic acid solution.
      A conclusion is derived on the possibility to use the membranotropic properties
      of liposomal membranes to alleviate manifestations of inflammation.

PMID- 2220039
TI  - [Biological effect of liposomes in hypoxic conditions of various etiologies].
AB  - The antihypoxic and antioxidative effects of phosphatidyl choline liposomes have
      been studied in hypoxic hypoxia, pneumonia, and acute blood loss. It was
      demonstrated that the body tolerance of persisting hypoxia increased on liposome
      administration due to elimination of lactate-acidosis, inhibition of lipid
      peroxidation and higher rate of oxygen diffusion through the biological barriers.
      The antihypoxic properties of the vesicles are determined by their remedial
      effect on the key mechanisms responsible for the development of hypoxic organ
      damage.

PMID- 2220040
TI  - [The first results and objectives of the study of Lyme disease in the USSR].
AB  - Results of research on the prevalence, etiology, laboratory diagnosis,
      epidemiology, epizootology, and other aspects of Lyme's disease, which was
      initiated in this country in 1984, are summed up. This Borrelia-caused condition
      is now suggested to be a lead in morbidity rate among human diseases of natural
      nidus. The most topical, priority directions of further research are discussed.

PMID- 2220041
TI  - [Molecular mechanisms of the effect of estradiol (the latest concept)].

PMID- 2220042
TI  - [Methodology of the branch program in traumatology and orthopedics in present-day
      conditions].
AB  - The method of targeted programming is just entering the practice of science
      planning in traumatology and orthopedics as specific branch-oriented scientific
      and technological programmes. The essence of the methodological maintenance of
      Programme C.18 is presented; the Programme is aimed at elaborating the
      therapeutic system to manage patients with fractures of bones of the locomotor
      apparatus. Its result will present as the data on the structure of the general
      population of such patients, on the optimal methods of treatment, as well as on
      the issues of the emergency aid organization. Methods to estimate the future and
      current need in the traumatological-orthopaedic equipment will be elaborated. The
      programme is carried out according to the coordinated schedule, involving
      research institutes and departments of traumatology and orthopedics, the total
      number of the establishments amounting to 70. The programme implementation covers
      the period from 1986 to 1999.

PMID- 2220043
TI  - [Trends in the development of research in the field of liposomes (review of
      patent literature)].
AB  - The review embraces major trends and tendencies in liposome studies and is based
      on the statistical and qualitative analysis of patent information issued in the
      period 1970-1988. Special attention is devoted to the analysis of patents in
      liposome production techniques, their lipid composition, and application in
      pharmaceutical and cosmetic industries and also for the diagnostic and
      therapeutic purposes. Liposomal preparations are shown to be superior to common
      drugs as concerns, in particular, liposomes containing medicinal agents for
      prolonged use (including hormones, antibiotics, cytostatics, and
      immunostimulants) and liposomes used in dermatological practice. Liposome-based
      assessment of application prospects is given.

PMID- 2220044
TI  - [Abortion as a high risk factor in perinatal pathology].
AB  - Analysis of the pregnancy course and neonatal outcomes in 896 women with a
      history of recurrent spontaneous abortion showed a high rate of perinatal disease
      and neonatal problems. This is underlain by hormonal, immunological, and some
      other disorders, and also by a high infection level both during pregnancy and
      without it. To reduce the perinatal morbidity rate, a system of the reproductive
      function check-up and rehabilitation for the non-pregnant and a stage-by-stage
      control over the pregnancy course and the status of the fetoplacental unit was
      suggested.

PMID- 2220045
TI  - [Rational tactics in the management of pregnancy and labor to prevent perinatal
      morbidity and mortality].
AB  - Results of a cooperative multicenter research have shown that extended studies
      into scientifically based and regionalized diagnostic screening programmes aimed
      at sequential follow-up of the gestational phases and early detection of
      complications is a means to reduce perinatal morbidity and mortality. These
      programmes should be based on the population characteristics of the fetal and
      neonatal growth as well as on the incidence and pattern of perinatal disease with
      consideration of the region-specific birth rates. An adequate range of diagnostic
      tests provides comprehensive information on intrauterine growth disturbances and
      allows for finding the criteria for pregnancy prolongation, a complex of
      intensive therapy steps, and modes of elective delivery together with indications
      for it.

PMID- 2220046
TI  - [Effect of ecological factors on the course of pregnancy].
AB  - Results of the studies dealing with the peculiarities and mechanisms of abnormal
      pregnancy in women working under unfavourable environmental factors are
      overviewed, including the diseases most commonly complicating the gestational
      course in female workers of chemical and electronic industries, patterns of
      pregnancy complications, and immunological mechanisms of placental damage under
      chemical aggression. Data are given on the fetal functional status derangement
      under the environmental stress. The concept of a three-stage adaptation of the
      female organism to the environmental hazards is introduced, and priorities are
      formulated relating to the control of environmental impacts on gestation, female
      fertility, and fetal and neonatal health.

PMID- 2220047
TI  - [Occupational hazards as risk factors of perinatal pathology].
AB  - Occupational hazards play the leading role among the factors responsible for
      perinatal disease, increased morbidity and mortality of neonates and infants of
      the first year of life. These factors are deleterious to the female organism both
      prior to and during pregnancy, they may exert an unfavourable effect on the
      fetus, and impair the general health status of future mothers by affecting the
      functioning of separate organs and body systems, triggering metabolic disorders,
      and reducing body defence. Studies conducted by experts in labour hygiene,
      obstetricians-gynecologists, and pediatricians yielded results that formed the
      basis for prevention planning aimed at health promotion effect.

PMID- 2220048
TI  - [Group B streptococci in neonatal pathology: pathogenetic mechanism, diagnosis
      and prevention].
AB  - Group B streptococci have recently attracted the attention of researchers as the
      causative agents of human neonatal disease. They are currently encountered much
      more frequently than it was believed previously. Various types of adult pathogen
      carriers have been described; this accounts for the numerous sources and pathways
      of infection transmission, both vertical and horizontal. The transmission risk
      depends on many factors, vaginal colonization in the parturient being of special
      import. The level of the pathogen adhesion to the barrier epithelium is
      reflective of the tissue sensitivity to infection. Increased sensitivity of the
      vaginal epithelium to B streptococci adhesion in association with the intake of
      some contraceptives has been found. The adhesive activity of avirulent
      streptococci B strains is shown to be higher than in the virulent strains, which
      is especially important in mixed virus bacterial infections. The streptococcal
      infection of high mortality is underlain by activation of persisting avirulent
      streptococci B that manifest their pathogenicity as a result of the virus
      specific modifications in the host cell membrane. During 1985-1987, in Leningrad
      Institute of Gynecology and Obstetrics over 80 strains of streptococci B were
      isolated, the leading serotypes being Ia/C, Ib/C, II/C, III/R. Only 54% of the
      studied pregnancies attended with the streptococcus carriage had a favourable
      neonatal outcome. The strain serotypes from maternal isolates and abortuses fully
      correlated. Further improvement of the laboratory diagnosis and means of the
      pathogen and its carriers identification is a current priority.

PMID- 2220049
TI  - [Medical aspects of reducing perinatal mortality and perinatal morbidity].

PMID- 2220050
TI  - [Diagnosis of chronic fetal anoxia].
AB  - The intrauterine fetal status was assessed in women at 34-42 week gestation; the
      pregnancies were complicated by obstetric and extragenital disease (nephropathy,
      prolonged gestation, hypertension, diabetes mellitus, renal disease). Computer
      assisted analysis of the diagnostic value of fetal cardiotocography, uterine
      placental hemodynamics, and acid-base status of maternal capillary blood showed
      that the following parameters are most informative for the diagnosis of chronic
      fetal hypoxia: stable rhythm duration; oscillation amplitude;
      acceleration/deceleration number, amplitude, and duration; volume flow rate of
      the uterine-placental unit; and pH and base deficiency in the blood taken from
      the cervix uteri.

PMID- 2220051
TI  - [Protection of the developing brain--the most important task of perinatal
      medicine].

PMID- 2220052
TI  - [Autonomic and visceral disorders in perinatal encephalopathy].
AB  - The prevalence of perinatal encephalopathy is shown to be significantly
      increased. This pathology is associated with involvement of the brain and spinal
      cord and the whole organism with subsequent development of cerebral dysfunction
      and somatic disease. Medicamentous therapy is aimed at improving the trophics of
      the damaged tissues and elimination of edema. The role played by the district
      pediatrician in the follow-up of children with the discussed disease is
      considered to be of special significance.

PMID- 2220053
TI  - [Respiratory distress syndrome in newborn infants].

PMID- 2220055
TI  - [Can medical research institutes take advantage of a new economic system?].

PMID- 2220054
TI  - [Use of human immunoglobulin in infectious and inflammatory diseases of premature
      infants].

PMID- 2220056
TI  - [The ultrastructure of epithelioid cells in sarcoidosis and sarcoid reactions].
AB  - Electron microscopic examination of epithelioid-cell granulomas of two patients
      with total sarcoidosis and of three ones with isolated sarcoidosis of the skin
      (sarcoid reactions) has revealed a morphologic polarization of epithelioid cells,
      manifesting as 4 zones: (1) crimped [correction of chimp] edge zone, (2) zone of
      vesicles and vacuoles, (3) basal zone, (4) osmiophilic granules zone. The
      structure of epithelioid cells in sarcoidosis and in sarcoid reactions was found
      similar, evidencing a high biosynthetic function of the cells.

PMID- 2220057
TI  - [The clinical and serological characteristics of early congenital syphilis today.
      1].
AB  - The results of examinations of 210 infants with early congenital syphilis with
      emphasis on skin involvement are analyzed. An increased incidence of syphilitic
      pemphigus was recorded along with decreased incidence of diffuse infiltration and
      papular elements.

PMID- 2220058
TI  - [Devergie's lichen ruber pilaris].

PMID- 2220059
TI  - [Systemic antimycotics in the therapy of patients with foot mycoses].

PMID- 2220060
TI  - [Mixed bacterial and viral infections of the urogenital tract].

PMID- 2220061
TI  - [Metabolism, vascular tonus and the bone-joint system of psoriasis patients].
AB  - A total of 113 patients with disseminated psoriasis were examined. Roentgenograms
      of the joints have shown signs of osteoarthrosis deformans in 85.7 percent of
      them. Involvement of the joints of the soles was recorded in 80.5 percent, of the
      hands in 58.3 percent, of iliosacral articulation in 33.3 percent of patients.
      These shifts were in line with clinico-laboratory changes characteristic of
      psoriatic arthropathy in less than one third of the examinees. Rheovasography of
      the upper and lower limbs has revealed the spastic asthenic syndrome in all the
      examinees; this syndrome most frequently manifested by increased tone and
      decreased pulse blood content of the vessels. A direct correlation between x-ray
      changes in the joints and disordered vascular tone of the limbs has been
      revealed. The detected elevation of blood lipid level in psoriasis patients as a
      rule did not correlate with impaired blood supply to the upper and lower limbs.
      These findings bring the authors to a conclusion that in psoriasis not only the
      skin, but the bone-and-joint and vascular systems are involved in the process, as
      are the metabolic processes.

PMID- 2220062
TI  - [The morphofunctional characteristics of the peripheral lymph nodes in patients
      with chronic pyoderma].
AB  - Pathohistologic examinations of the peripheral lymph nodes in 14 patients with
      abscessed acne, chronic infiltrative ulcerous and infiltrative fistulous pyoderma
      coursing for 1 to 11 years have revealed that chronic pyococcal infection induces
      manifest atrophic and sclerotic changes in the cortical and medullary layers of
      the regional lymph nodes and of those distant from foci of involvement; these
      changes are accompanied by essential impairments of the immunologic,
      lymphopoietic, and other functions.

PMID- 2220063
TI  - [The immunological indices of the blood serum and saliva in children with
      psoriasis].
AB  - Blood serum and salivary characteristics of immunobiologic reactivity were
      examined in children suffering from psoriasis. Increased blood serum levels of
      IgG and lowered IgM were detected. Lysozyme and complement levels were increased
      both in the blood serum and saliva.

PMID- 2220064
TI  - [The rate of detecting Chlamydia in male homosexuals with syphilis].
AB  - A total of 159 homosexuals suffering from various forms of syphilis, aged 17 to
      71, were screened for chlamydial antigen with the use of fluorescent monoclonal
      antibodies. Asymptomatic urogenital chlamydiosis was detected in 33 of 107 (30.8
      percent) homosexual syphilitics. In 52 patients the material was collected
      simultaneously from the throat, urethra, and rectum; Chlamydia were detected in
      71.2 percent of these.

PMID- 2220065
TI  - [Experience in treating chronic urethritis in men by iontophoresis and
      inductothermy].
AB  - A method for therapy of chronic urethritis by exposure to ionized solutions of
      drugs has been developed (Authors' Certificate of the USSR No. 876138). Active
      electrode is placed in the flask with the drug, passive one on the external
      surface of the body as close to the focus of involvement as possible. Ionized
      solution of the drug (2.5-3.1) is introduced into the urethra via a double-lumen
      catheter, washes its walls and saturates the mucosa; the solution is aspirated
      from the urethra through the other lumen of the catheter, thus removing the
      inflammation products from the urethra. Current density has made up 0.01-0.03
      mA/cm2, length of session 12-15 min, 6-8 sessions per course. A device for local
      therapy of chronic urethritis by a combination of ionophoresis and inductothermy
      has been suggested (Authors' Certificate of the USSR No. 1084031). This device
      permits a simultaneous administration of 2 drugs: one from the tube via urethral
      mucosa, the other from the cuvette outwardly. Current density has made up 0.01
      0.03 mA/cm2, with the current of 200 mA in the inductor. Length of inductometry
      and ionophoresis session is 10-15 min.

PMID- 2220067
TI  - [Monilethrix in 3 generations].
AB  - Monilethrix, a kind of hair aplasia, is described in patients belonging to three
      generations. An original treatment scheme used is described.

PMID- 2220066
TI  - [Early congenital lymphedema of the lower extremities combined with
      pachyonychia].
AB  - A four-year-old girl with early congenital lymphedema of the lower limbs in
      combination with the nail plate involvement (pachyonychia) is described. Such a
      combination is not characteristic of early lymphedema, it is usually described in
      late edema of the lower limbs. The described case was a sporadic one in the
      family. It cannot be excluded that lymphedema development was induced by impaired
      embryogenesis of the lymph vessels resultant from sulphanilamides intake for
      severe bronchitis that proband's mother had suffered during pregnancy.

PMID- 2220069
TI  - [The clinico-morphological diagnosis of cancer of the sweat glands].
AB  - Comprehensive clinical, morphologic, and ultrastructural studies of 12 cases with
      various forms of carcinoma of the sweat glands permitted distinguishing the
      clinical nodular and papular-cystic forms. Histologically malignant analogs of
      benign tumors, primary adenocarcinomas, and unclassified tumors are
      distinguished. The histogenetic appurtenance of the tumors of the latter group
      may be identified only by ultrastructural studies that help detect a number of
      organ specificity signs. Electron microscopy used in the diagnosis of poorly
      differentiated tumors of the skin helps carry out adequate therapeutic strategy
      and permitted a better validated prediction.

PMID- 2220068
TI  - [The metronidazole treatment of vaginitis patients].

PMID- 2220070
TI  - The polypeptide composition of vaccinia-infected cell membranes and rifampicin
      bodies.
AB  - The protein and glycoprotein composition of a sucrose gradient fraction from
      vaccinia infected cells treated with rifampicin was studied. This particulate
      fraction contained cytoplasmic membranes and pleomorphic membranous structures.
      The glycoproteins (89, 42 and 20-23 kDa, respectively) were identified as the
      same glycoproteins that are found in plasma membranes of infected cells and the
      envelope of extracellular enveloped vaccinia (EEV). These glycoproteins could be
      solubilized by 0.1% NP-40. The Golgi membrane associated 41K acylated vaccinia
      protein was also NP-40 soluble. In contrast, most particulate fraction proteins
      (125, 100, 86, 65, 41, 39, 31, 27, 25, 14 and 12.5 kDa) with the exception of the
      33 and 29 kDa proteins remained essentially insoluble after NP-40 treatment. The
      86 and 65 kDa proteins are the rifampicin inhibited precursors to INV core
      proteins while the 33 and 29 kDa proteins are INV surface proteins. Twelve
      proteins behaved like their respective comigrating INV proteins when extracted
      with NP-40 and 2ME. Electron microscopy showed that a centrifuged sediment from
      NP-40 treated cells contained pleomorphic protein containing membranous
      structures that we have called rifampicin bodies. We conclude that (1) the major
      glycoproteins found in the particulate fraction from sucrose gradients are
      vaccinia glycoproteins residing in cytoplasmic membranes while (2) the major non
      glycosylated proteins are components of the rifampicin bodies and that (3) the
      rifampicin bodies represent an intermediate in the morphogenetic process leading
      to mature INV.

PMID- 2220071
TI  - Serological analysis of duck hepatitis B virus infection.
AB  - A radioimmunoassay was developed to detect duck hepatitis B virus surface antigen
      and antibody; viraemia (DHBV DNA or DHBsAg) was detected in all ducks inoculated
      within 3 weeks post-hatch, and persistent infection developed in 93% of birds in
      this group. In contrast, only 80% and 60% of ducks inoculated 4- and 6-weeks post
      hatch respectively developed viraemia, and approximately 70% of the viraemic
      ducks became carriers. Markers of viraemia were undetected in ducks inoculated 8
      weeks post-hatch and in uninfected controls. A typical anti-DHBs seroconversion
      developed subsequently in 2 of 4 birds that showed transient viraemia, and
      antibody also developed in 3 of 7 ducks inoculated 4-8 weeks post-hatch that
      showed no viraemia. However, gene amplification by the polymerase chain reaction
      demonstrated DHBV DNA in ducks from the latter group suggesting that the antibody
      did not result from passive vaccination. Thus, increased resistance to infection
      develops with increasing age that may be related to several factors including
      host immunity. This model may help elucidate similar age-related features of
      human hepatitis B virus infections.

PMID- 2220072
TI  - Yeast Saccharomyces cerevisiae selectable markers in pUC18 polylinkers.

PMID- 2220073
TI  - The chromosomal constitution of wine strains of Saccharomyces cerevisiae.
AB  - A general procedure is described for determining the chromosomal constitution of
      industrial strains of Saccharomyces cerevisiae based on analysis of segregation
      frequencies for input markers among random spore progeny of industrial-laboratory
      strain hybrids. The multiply auxotrophic haploid testers used carried a dominant
      erythromycin-resistance marker, allowing hybrids to be selected in mass matings
      with spores produced by the wild-type industrial strains. Analysis of a number of
      independent crosses between the haploid testers and an unselected population of
      spores of each wine strain distinguished between disomic, trisomic and tetrasomic
      chromosomal complements in the parents. Possible explanations for a significant
      class of aberrant segregation frequencies are discussed. Results of the analysis
      indicate that UCD Enology 522 (Montrachet) is diploid and possibly trisomic for
      chromosome VII; 522X is diploid; UCD Enology 505 (California Champagne) is
      disomic for chromosome XVI, trisomic for chromosomes I, II, III, VI, VIII, IX, X,
      XII, XV, tetrasomic for chromosomes IV, XI, XIII, XIV and either trisomic or
      tetrasomic for chromosomes V and VII; and that UCD Enology 595 (Pasteur
      Champagne) is disomic for chromosomes I, II, III, IX, XVI, trisomic for
      chromosomes IV, VI, X, XII, XIV, XV, tetrasomic for chromosomes V, VIII, XI, XIII
      and either disomic or tetrasomic for chromosome VII.

PMID- 2220074
TI  - Chromosome III of Saccharomyces cerevisiae: an ordered clone bank, a detailed
      restriction map and analysis of transcripts suggest the presence of 160 genes.
AB  - Using lambda phage vector EMBL4, we isolated 344 clones containing segments of
      chromosome III of Saccharomyces cerevisiae, analysed their physical structure
      with eight restriction enzymes and sorted the data in contiguous groups with
      computer programmes. Furthermore, we performed Southern hybridizations between
      the sorted contiguous clone groups and interrelated them into larger groups. In
      this way, we constructed an ordered clone bank that covers almost the whole of
      chromosome III with a single gap of several kilobases in length. The consensus
      physical map thus obtained totals 334.6 kb, which is in good agreement with the
      size of this chromosome estimated by pulsed-field gel electrophoresis. Southern
      hybridization analysis with the DNA probes containing telomere-specific sequences
      showed that the bank contained a telomere at a position corresponding to the
      right arm terminus of chromosome III. Also, five Ty elements were found to be
      present. To estimate the number of genes on this chromosome and to analyse their
      levels of expression, we performed a series of Northern hybridization experiments
      using total poly(A)+ RNA from vegetatively growing cells and appropriate
      restriction enzyme fragments from the bank. Thus, we identified a total of 156
      transcripts on chromosome III, indicating, on an average, one gene in every 2 kb
      on this chromosome. The transcripts were visually categorized into five groups
      according to their apparent levels of expression. It was found that the genes
      located near both termini are expressed only at low levels and that highly
      expressed genes are rather scattered over the chromosome.

PMID- 2220075
TI  - Mapping of the trifunctional fatty acid synthetase gene FAS2 on chromosome XVI of
      Saccharomyces cerevisiae.
AB  - The trifunctional FAS2 gene encoding subunit alpha of the Saccharomyces
      cerevisiae fatty acid synthetase complex was mapped on the left arm of chromosome
      XVI 24 centimorgans proximal to GAL4 and 39 centimorgans distal to PEP4 relative
      to the centromere. Mapping was achieved by three independent methods: meiotic co
      segregation of FAS2 and ARO7 in recombination-deficient spo11-mutants: tetrad
      analysis of crosses between FAS2, GAL4 and PEP4; and Southern hybridization of
      purified FAS2 DNA with individual yeast chromosomes separated by pulsed-field gel
      electrophoresis.

PMID- 2220076
TI  - Mating type locus-dependent stability of the Kluyveromyces linear pGKL plasmids
      in Saccharomyces cerevisiae.
AB  - The linear killer plasmids, pGKL1 and pGKL2, from Kluyveromyces lactis stably
      replicated in mitochondrial DNA-deficient (rho 0) MATa or MAT alpha haploids of
      Saccharomyces cerevisiae, but were unstable and frequently lost in rho 0 MATa/MAT
      alpha diploids, suggesting that the replication of pGKL plasmids was under the
      control of the MAT locus. In MATa/MAT alpha cells of S. cerevisiae, the MAT alpha
      gene product (alpha 2) is combined with the MATa gene product (a1) and the
      resultant protein, a1-alpha 2, acts to repress the expression of haploid specific
      genes. Experiments showed that the K. lactis linear plasmids were stably
      maintained in rho 0 mata1/MAT alpha diploids, indicating that the a1-alpha 2
      repressor interfered with the stability of pGKL2. It was revealed by computer
      analysis that the consensus sequence homologous to the a1-alpha 2 repressor
      binding site occurred within the coding regions of pGKL2 genes which were
      presumed to be essential for the plasmid replication. Since the plasmids were
      stably maintained in diploids of K. lactis, the mating type control must not be
      working there.

PMID- 2220077
TI  - The omnipotent suppressor SUP45 affects nucleic acid metabolism and mitochondrial
      structure.
AB  - Yeast (Saccharomyces cerevisiae) strains sensitive to a variety of drugs were
      used to select for novobiocin-resistant mutants that were simultaneously
      temperature-sensitive. The mutants remained as sensitive as the parent strains to
      a wide range of drugs other than novobiocin, and did not exhibit any suppression
      of suppressible auxotrophic markers. At the non-permissive temperature, the
      mutant cells arrested mainly as unbudded cells, and were instantly defective in
      DNA and RNA synthesis, but not protein synthesis. The cloned wild-type gene was
      identified as SUP45, which has been previously implicated in the translation
      process. Our results suggest that SUP45 may have a function in addition to, or
      different from, the one that has been assigned to it previously.

PMID- 2220078
TI  - The yeast regulatory gene PHO4 encodes a helix-loop-helix motif.
AB  - Evidence is presented, based on sequence comparisons and secondary structure
      prediction, of the presence of a DNA-binding and dimerization helix-loop-helix
      motif in the yeast transcription activator PHO4. Interest in the existence of
      this first known motif in yeast is discussed.

PMID- 2220079
TI  - Development of rancidity in salmonoid steaks during retail display. A comparison
      of practical storage life of wild salmon and farmed rainbow trout.
AB  - The quality of wild salmon and farmed rainbow trout from aquaculture, both packed
      in transparent vacuum-skin packaging, was followed during storage for 6 months in
      an illuminated freezer cabinet (product temperature -17 degrees C, half of the
      packs protected against light, and half of the packs fully exposed to light),
      combining (a) colour determination of the carotenoid-pigment flesh by tristimulus
      colorimetry, (b) determination of thiobarbituric-acid-reactive substances (TBA
      value), (c) carotenoid analysis and, at the end of the storage experiment, (d)
      sensory evaluation. Rancidity developed faster in steaks of wild salmon (TBA
      increased during 6 months of storage from 2.8 mumols malonaldehyde/kg flesh to
      12.5 mumols/kg for light-protected packages, and to 17.6 mumols/kg for packages
      exposed to fluorescent light) as compared to steaks of farmed rainbow trout (TBA
      increased from 1.2 to 5.8 mumols/kg, independent of light exposure), a finding
      also confirmed by sensory evaluation. In both products, the carotenoid pigment
      was identified as astaxanthin; salmon steaks, the product more susceptible to
      developing rancidity, had the lower astaxanthin content (rainbow trout 9.1 mg/kg
      flesh, salmon 4.9 mg/kg, prior to storage). While the astaxanthin content
      remained virtually constant in salmon steaks during storage, the content
      decreased significantly in steaks of rainbow trout, an observation which suggests
      the role of astaxanthin as a sacrificial protector against radical processes.

PMID- 2220080
TI  - [Investigation of accuracy of fit of partial crowns with different shaped
      margins].
AB  - The marginal adaptation of partial crowns with different types of finish line
      preparations was determined by means of dye penetration tests. The best marginal
      sealing was found for the featheredge-like preparation, followed by the shoulder
      preparation and the chamfer preparation with or without bevel. The scanning
      electron microscopic evaluation revealed that a finishing of the restoration
      margins during the setting of the luting material resulted in a better marginal
      sealing than a finishing after the cementation.

PMID- 2220081
TI  - [Evaluation and classification of dysfunction patients].
AB  - The "Stomatognathic-Dysfunction-Index" (SDI) comprises anamnestic and clinical
      information regarding occlusion, TMJ, head- and neck muscles. The different SDI
      parameters were chosen in a way that enables them to lead to a firm statement
      regarding the individual dysfunction. The examination results are easily
      reproduceable in the sense of a "intra- and inter-examiner reliability" and the
      scores can be reattributed to individual combinations of symptoms. The patients
      can be sorted into classes of dysfunction according to their total SDI-Score.
      This makes the SDI especially suitable for epidemiologic studies, but the easy
      handling of the SDI allows its use in private practice as well. Here it enables
      the dentist to classify patients with stomatognathic dysfunctions according to
      the necessity of treatment and sometimes to determine such necessity as well. The
      SDI is not meant to replace the extensive standard methods of clinical and
      instrumental analysis. It is meant to provide a maximum of diagnostic and
      therapeutic economic value from an affordable input of time in the everyday
      routine. It fulfills all requirements of an index for epidemiological studies.

PMID- 2220083
TI  - [Lithiasis in small salivary ducts. Report of 3 cases].
AB  - Three cases with sialolithiasis of minor salivary gland are presented. The
      sialoliths were found on the left side of the upper lip (two patients) with local
      infection and on the right side of buccal mucosa (one patient) without any
      symptom. The histologic findings resulted from our own cases and the etiology are
      discussed extensively and a literature review is made as well.

PMID- 2220084
TI  - [Advances in tooth root resection].

PMID- 2220082
TI  - [Comparison investigation of non-precious metal-synthetic resin bond on basis of
      new adhesives and the non-precious metal-ceramic bond].
AB  - The adhesive force was tested between the Silicoater and Sebond-MKV bonding
      systems and two Co Cr alloys. The tests were: The flexural strength-test, the
      tensile stress-test, the fracture test and the shear strength test. The ceramic
      veneering had worse results only in the flexural strength test compared with the
      two bonding systems. The bonding system Silicoater was in the tensile stress test
      and in the fracture test better than the Sebond MKV system. The bonding system
      Sebond-MKV showed better results in the flexural strength test and in the shear
      strength test than the Silicoater system. Differences in the results you could
      find between the test after dry air storing and saliva storing.

PMID- 2220085
TI  - [Functional value of hyperbalance for function course in temporomandibular
      joint].
AB  - The resulting effects of excursive attrition contacts on balanced side are
      pointed out. In a case report new ultrasonic recordings of TMJ movements with MT
      1602 system are described to demonstrate the influence of overbalanced contacts
      on the axiographic track of TMJ condyle. Characteristic changes of the
      axiographic path results and are discussed as distraction effects of TMJ condyle.

PMID- 2220086
TI  - [Theoretical and clinical aspects of guide plane in crown and bridge
      prosthetics].

PMID- 2220087
TI  - [Musculature in dentistry].

PMID- 2220088
TI  - [Is the telescope system still reasonable?].
AB  - Parallel milled abutments in partial dentures are the anchors of the so called
      telescoping system. Excellent function, easy cleaning and the possibility of
      modification on the case at a later date - if further losses of teeth should
      occur - are the great advantages of this design. The application of this suitable
      attachment seems to be limited by economic considerations and patients' desire
      for fixed brigdework. The state of the art is presented and proved by pretentious
      case-reports.

PMID- 2220089
TI  - [Follow-up study of accuracy of fit of crowns, prepared for phantom head under
      practice conditions].
AB  - Mesial, distal, oral and vestibular measurement of fissure spaces in 39 crowns
      and 51 bridges (divided with interlock-connection) made in the context of
      propedeutic instruction showed a mean marginal discrepancy of 62-90 microns in a
      range of 30-160 microns. A simple method to evaluate the fissure space was
      described. In actually discussion the results would be helpful to determine
      criterions for quality on fixed restorations.

PMID- 2220090
TI  - [Perspectives of a function study of the TMJ with magnetic resonance imaging].
AB  - Magnetic resonance imaging of the temporomandibular joint is usefull in the
      examination of the stomatognathic system. In order to visualize the components of
      the temporomandibular joint during dynamic jaw movement and to improve the
      diagnostic accuracy of temporomandibular joint disorders we present remedies for
      magnetic resonance imaging and discuss their possibilities and limits how you can
      stabilize the jaw in an interesting functional position during examination
      period.

PMID- 2220091
TI  - [Function damage of masticatory organ. Retrospective study of 1,778 patients in a
      West German clinic].
AB  - The etiology of the TMJ dysfunction-pain syndrome is multicausal and composed of
      several factors which are just partly known. To get more information about
      etiology, diagnostic and therapeutic means, data from 1778 patients with
      subjective complaints of mandibular dysfunction have been analyzed. The most
      frequent dental findings in clinical functional analysis and psychological and
      social aspects are evaluated and discussed. Concepts for initial therapy are
      pointed out and reviewed in experience of the numerous cases. The data show that
      filling therapy could initiate functional disturbances which should be considered
      in daily practice.

PMID- 2220092
TI  - [Patient with high risk of caries. Definition, epidemiology and clinical
      aspects].
AB  - Epidemiological studies have shown that there is a small group of patients with
      high caries prevalence. This survey illustrates the clinical picture of caries
      active patients on the basis of exemplary cases and defines a number of terms
      which are important in this context. In addition to this, possible causes of an
      increased caries risk are discussed.

PMID- 2220093
TI  - [Identification of children with high risk of caries related to caries occurrence
      in the past].
AB  - In several studies high correlations were found when the prevalence of caries in
      the past was correlated with future caries risk in children and adolescents. The
      practical value of this method for the identification of children with high risk
      for caries can be assessed by measurement of the ability of the method to
      recognize subjects who will develop caries (sensitivity) and to exclude those who
      will not (specificity). Taking into consideration worldwide studies from recent
      years the problems of this method were pointed out and discussed.

PMID- 2220094
TI  - [Possibilities of assessing the individual caries risk using microbiological
      parameters].
AB  - The most commonly used microbiological tests for identifying patients with high
      caries activity are based on quantitative or semi-quantitative counts of
      Streptococcus mutans and Lactobacilli. In a review the prognostic value of such
      tests is discussed and shown, that in spite of partially high prediction rates,
      the prognostic value of either S. mutans or Lactobacillus tests can be confirmed
      only in combination with additional relevant clinical parameters (e.g. anamnesis,
      DMF-increment, secretation rate and bufferin capacity of saliva...).

PMID- 2220095
TI  - [Selective intensive prophylaxis in area of group prophylaxis].
AB  - An increasing polarisation of caries prevalence in children was found in recent
      years. A needs-related prevention programme was thus developed which provides for
      selective intensive treatment of pupils with increased caries risk. A
      corresponding prevention programme was tested at elementary schools in Gottingen
      in 1985-1989: whereas in 1985, 31% of the 4th-class pupils had caries-free
      permanent teeth, this percentage had increased to 45% in 1989. The average DMF-S
      was 1.9 in 1989 (1985: 3.9).

PMID- 2220096
TI  - [Concept for the care of caries active patients in dental practice].
AB  - By help of a practical procedure the individual caries risk can be estimated.
      Regarding the individual caries risque and the age of the patient, therapeutical
      steps can be taken to reduce this risk. This concept of reducing the number of
      bakteries causing caries can be divided in therapeutical procedures, that can be
      made in the dental office and procedures, that can be made by home care.
      Therapeutical effects can be controlled by microbiological procedures.

PMID- 2220097
TI  - [Caries risk in youth from sociopsychological viewpoint].
AB  - Attitudes and behavioural patterns to dental health were recorded by standardized
      questionings of 900 juveniles aged between 12 and 16 years. Health-related
      behaviour corresponds with demographic and sociopsychological factors. Education
      within the family is very important for the development of a healthy way of life.
      Experiences of juveniles with dental care essentially determine their curative
      and preventive compliance. Juveniles with a negative attitude towards dental
      health require as a potential caries risk group special attention in health
      advising and dental care.

PMID- 2220098
TI  - [Electric toothbrushes--manual toothbrushes, a comparison].
AB  - This study covering a period of almost 16 weeks shows that manual tooth cleaning
      must be regarded as somewhat superior to electric tooth-brushes in terms of the
      plaque index. Concerning the more important sulcus bleeding index, the electric
      tooth-brush leads to better results. This, however, only after at least two weeks
      of "familiarisation" of the patients with the electric tooth-brush, and after a
      minimum follow-up time of three to five weeks! This is why another quite
      important conclusion should be drawn from this study: studies of this type should
      not be planned for too short a period, i.e. for at least 12 weeks.

PMID- 2220100
TI  - [Plaque reduction in patients with removable partial dentures and abutment teeth
      with greatly reduced periodontium].
AB  - The presented investigation was carried out on 19 individuals who were referred
      for prothetic and periodontal treatment. All patients suffered from advanced
      periodontal disease and had no more than 3 teeth left in the jaw going to be
      treated. Following a baseline examination comprising assessment of oral hygiene
      and tooth mobility the patients were subjected to prothetic and periodontal
      treatment. Removable partial dentures were constructed using the conical crown
      system. The patients were distributed into 2 different maintenance groups. 10
      patients (group 1) were instructed to use the Bass Technique for cleaning the
      remaining abutment teeth. Group 2 applied proximal brushes for cleaning the
      interdental spaces prior to removing the partial dentures for cleaning as
      prescribed for group 1. Three months after treatment a reexamination was
      performed. In both groups a significant reduction of plaque was observed. The
      plaque scores of the second group were below those of the first group but the
      difference was statistically not significant.

PMID- 2220099
TI  - [Local treatment of inflammatory changes in oral cavity with the new Dontisolon
      M].

PMID- 2220101
TI  - [Innovative system for overlay denture therapy].
AB  - The short blade-implant ist adapted to the more reduced alveolarappendage in
      profile too. Generally this implant means more safety for the operating dentist.
      A lately developed intramobile element connected with this implant provides a
      greater relief of the implanted. A long vertical way of replacement produces more
      extra safetyreserves for the effective compendation of the appearing chewing
      forces. The attachment can be combined with nearly all prothetical solutions.
      This intramobile element can be changed without any problems by the patient
      himself.

PMID- 2220102
TI  - [Endocarditis risk in use of dental irrigators].
AB  - The incidence of bacteremia after application of a dental irrigator was
      investigated in 100 healthy volunteers. Venous blood was inoculated in routine
      blood culture bottles one, three and five minutes after dental irrigation. In 39
      volunteers a transient bacteremia was detected, mainly Strep. Viridans was
      cultured. Incidence correlated with the grade of oral hygiene und periodontal
      disease.

PMID- 2220103
TI  - [Replantation].

PMID- 2220104
TI  - [Determination of transverse resilience of human temporomandibular joint].
AB  - Transversal TMJ-resiliency is defined as a possible movement of the condyles
      exclusively in the lateromedial direction. The extent of this individual and
      variable shifting of the condyles can be recorded and reproduced using high
      resolution electronic axiography and a special manipulating technique by the
      dentist. A study on 52 patients showed an average value of 0.3 mm for the
      transversal resiliency, which can be considered as physiological range. The
      results were discussed along with the question for the relevance of transversal
      TMJ-resiliency measuring regarding TMJ-disorders.

PMID- 2220105
TI  - [Gerontoprosthesis. Concept of rebuilding old complete dentures].
AB  - If aged patients who have been wearing their full dentures without complications
      so far, need further prothetic treatment, the dentist must not replace the old
      denture by a completely new one. It is better to rebuild it step by step. This
      demand is based on the following theses: --Nobody but the patient himself is able
      to perform functional movements. --Unless bite and occlusion are correct,
      patients are not able to perform accurate functional movements. --When bite and
      occlusion have been checked and, if necessary, improved, bases and alveolar
      ridges must be congruent.

PMID- 2220106
TI  - [Injury-free removal of cemented crowns and bridges].
AB  - Seven methods for removing crowns and bridges were studied in in vitro tests.
      Systems gripping the crowns on both sides led to the best results. Cemented
      crowns were loosened by ultrasound. All restorations could be removed after an
      average time of 6 1/2 min ultrasound influence. The increase of temperature in
      the pulp chamber requires sufficient waterspraying.

PMID- 2220107
TI  - [Polymerization shrinkage of denture resins in different preparation procedures].
AB  - The Intention of this study was to examine and compare the effect of three
      different polymerization systems on the dimensional changes of denture-resin. The
      development of the fissure has been measured at five fixed points at the
      posterior border of upper complete dentures after a 4-weeks'-storage in water and
      saliva respectively. The perform-Inkovac-System showed the best, the SR-Ivocap
      System the most unfavorable results; the conventional "stuff-press-system" gave
      only medium satisfaction.

PMID- 2220108
TI  - [Is the German dental industry ready for the future?].
AB  - The future perspectives of the German dental industry will depend on the
      individual productivity of the different manufacturers and especially on the
      political and economic development of Europe as a whole. National, European and
      international standarization will play an important role with work safety and
      environment protection as center points. Not innovations but the consolidation of
      product fabrication selection and use - with quality assurance as a common
      objective of the dental world - will be one of the major challenges in the near
      future.

PMID- 2220109
TI  - [Efficacy of different therapeutic procedures in treatment of inflamed primary
      tooth pulps. Results after 6 years].
AB  - The efficiency of 3 different methods of primary pulp therapy (pulpotomy with
      formocresol in one and two appointments, pulpotomy with Triopaste) was studied
      over a period of 6 years in more than 300 teeth. The clinical results show a 98%
      success rate in the formocresol-treated teeth compared to only 55% of the
      Triopaste-group.

PMID- 2220110
TI  - [Comparative investigations of new dental electrosurgical instruments].
AB  - 11 electrosurgical units of several manufactures were analysed by physical
      measurements. Conventional units and those with constant output voltage
      demonstrate nearly identical behavior in their voltage- and power-characteristics
      at load-impedance occurring during dental electrosurgery. So far there are no
      advantages of simple voltage control. We did not find technical deficiencies
      concerning security in the modern units examined.

PMID- 2220111
TI  - [Possibilities of crowning damaged primary teeth].
AB  - Supply of extensively destroyed primary molars with preformed stainless steel
      crowns has been a method approved for decades and can be carried out in practice
      without taking a lot of time and financial costs. Maintenance and reconstruction
      of primary anterior teeth by ready made or individually manufactured crowns is
      necessary also for phonetic reasons. Depending on the grade of destruction of the
      clinical crown different possibilities for restoration are available: that is for
      the group of preformed types pedoformstripcrowns, polycarbonate crowns and
      stainless steel crowns with a composite facing, and for the group of individual
      manufactured crowns as resin crowns and short-pin crowns.

PMID- 2220112
TI  - [Considerations of precision and consistance of mandibular transverse hinge
      axis].
AB  - This paper deals with the nature of mandibular hinge axis and the consequences
      for its application in diagnostics and treatment. The transversal hinge axis of
      the mandible can be characterized as an exact and true axis of pure mandibular
      rotation or a more or less exactly located axis as a result of a combined
      rotation and translation of the condyles. During opening movements of about 8 mm
      already an insignificant gliding of the condyles of 0.5 mm displaces the
      individual located hinge axis of more than 6 mm in its relation to the lower jaw.
      The true hinge axis as it is needed for achsiographic or pantographic
      registration techniques has inevitably not to be identical with the transferred
      axis for mounting casts in an adjustable articulator.

PMID- 2220113
TI  - [Nutritional care and guidance in caries active patients].
AB  - Nutritional care and nutritional guidance are an important column of prophylaxis
      against dental caries and illness of the paradentium. Since these diseases, not
      neglibly resulting from influences of civilization, occur more and more
      frequently and on younger patients, suitable strategics for nutrition-anamnesis
      and nutrition-advice are required. Tooth-healthy nutrition must have the
      particular priority on already caries-active persons. The author tried to design
      a conception for the registration of caries-favourable influences, for
      recognizing special types of caries caused by nutrition and of individual
      instructions of nutrition.

PMID- 2220114
TI  - [Root fractures and tooth luxations. 1].
AB  - Root fractures and subluxation of teeth often play only a minor role in the
      discussion of the therapy of traumatic tooth defects. This contribution discusses
      possible therapeutic approaches as well as prognosis and long-term results in
      cases of tooth root fractures and partially dislocated teeth. The primary aim of
      the therapy is to avoid further damage to the developing teeth of the first set,
      and to keep the permanent teeth in a proper condition for the maximum time
      possible.

PMID- 2220115
TI  - [Results of incorrectly positioned hinge axis on axiographic tracings of
      mandibular movement].
AB  - This article deals with the different influences of an incorrectly located or
      arbitrary hinge axis upon axiographic tracings of mandibular movements. Unless
      the recorded curvatures of the three-dimensional pathways of the condyles start
      from true hinge axis points, paraxial distortions of the tracings will be the
      result. These recording errors can be so outstanding, that essential advantages
      of the modern electronical registration systems like the possibility of high
      resolution measurement will become uncertain. Within the scope of instrumental
      analysis of stomatognathic disturbances distorted tracings can lead to false
      diagnosis easily.

PMID- 2220116
TI  - [Possibilities of prosthetic rehabilitation of edentulous patients using
      cephalometric analysis].
AB  - Cephalometric research showed an obvious and definite trend. Skeletal proportions
      and relations influence and determine the individual structure of the masticatory
      system. Transferring the relations to the edentulous patient the position and the
      inclination of the teeth and the occlusal plane can be determined. The evaluation
      of cephalometric analysis in edentulous is shown. The proceedings are
      demonstrated in two clinical cases.

PMID- 2220118
TI  - [Preparation and insertion of computer-designed ceramic inlays].
AB  - The CEREC-system allows the production and insertion of ceramic inlays chairside
      in one visit. For this purpose an optical impression of the cavity is made, the
      inlay is designed on the computer screen and ground from a ceramic bloc. The
      inlay is bonded to the tooth using acid etch technique and a luting composite.
      Finally occlusal adjustment is performed. The technical prerequisites and the
      clinical procedure are presented and discussed in comparison to other tooth
      coloured inlay systems.

PMID- 2220117
TI  - [Intraligamentary anesthesia. Procedures using high pressure injection system
      (Ultraject)].
AB  - The intraligamental anaesthesia via the periodontic sulcus is to be applied with
      high pressure. Therefore special syringes are needed. However the forced
      application may produce in some cases unwelcome effects as e.g. the breaking of
      the cartridge. This paper presents an intraligamental syringe with a device
      limiting maximum pressure. Working with this syringe proved comfortable in
      practice.

PMID- 2220119
TI  - [Influence of registration plate placement on axiographic tracings of mandibular
      movement in transverse plane mandible].
AB  - In all achsiographic techniques a non perpendicular alignment and adjustment of
      the sagittal-vertical registration plates to the centric positioned hinge axis
      leads to an incorrect recording of mandibular movements. Among other things the
      dimension of the registration error decisively depends on the quality and
      quantity of the angle of hinge axis inclination. The achsiographies of 234
      patients were analysed. In most cases incorrect measurements of the individual
      Bennett angle of only 1-2 degrees were found. These deviations are not relevant
      and have therefore not to be taken into account. On the other hand differences of
      the correct and incorrect recorded Bennett angle between 3 degrees and 8 degrees
      could be registrated in more than 25%. These errors have to be considered in
      diagnostics and treatment procedures. Correcting methods and techniques are
      described and discussed.

PMID- 2220120
TI  - [Accuracy of fit and margins of laboratory-finished SR-Isosit composite inlays].
AB  - 30 inlays were produced exactly by manufactures instruction using the SR-Isosit
      composite. Before cementation the marginal gaps of the inlays extended to 280
      microns occlusal resp. to 350 microns gingivoproximal. After insertion the
      thickness of the luting composite ranged from 40 to 400 microns occlusal resp.
      from 40 to 470 microns gingivoproximal. Dye penetration test indicated that only
      43.7% of the inlays had a good marginal behaviour after storage in water over a
      six month period. Particularly remarkable was the insufficient junction between
      the luting composite and the highly polymerized inlay.

PMID- 2220121
TI  - [Thermal dimensional stability of dental registration wax].
AB  - Three bite registration waxes were tested for their thermic dimensional behavior
      under several heating and cooling conditions. Aluwax showed the smallest changes
      in length. Difficulties of application are expected because of its low softening
      temperature. There were greater dimensional changes with Beauty Pink Hard-Wax,
      but Kerr No. 8-Wax showed the greatest changes. The cooling method had a small,
      the heating temperature, however, a strong influence on the thermic dimensional
      behavior. These are the recommendations for the clinical application of the
      tested waxes: The bite registration material should not be heated more than
      necessary for achieving a sufficiently plastic quality for the registration. It
      should be stored in ice water to be resistant enough to deformation during the
      model mounting.

PMID- 2220122
TI  - [Corrosion resistance and bond strength of dental alloys].
AB  - Investigated Ni-alloys, which showed extensive solubility of Ni particles in
      corrosion bathes due to DIN 13927, also revealed pronounced lost of bond strength
      to ceramic veneers when immersed into corrosion bathes of equal constitution.
      Noble metal alloys with a gold concentration more than 50 percent, however,
      showed no such large lost of bond strength. Pd alloys showed a lost of bond
      strength which increased with their Ga concentration. Co alloys revealed a
      behavior similar to the Ni alloys but with no obvious correlation between
      solubility and lost of bond strength.

PMID- 2220123
TI  - [Experimental investigation of ceramic materials for bonded metal ceramic
      systems].
AB  - Opaque porcelain materials used for the bonding layer in metal-ceramic
      restorations were analysed. The type of bond failure, produced by a bond/shear
      test was determined and the differences between metal/ceramic systems with
      conventional opaquers and metal/ceramic systems with special bonding agents are
      discussed.

PMID- 2220124
TI  - [Non-precious metal dental alloys in laboratory tests--critical judgement of
      results].
AB  - An in vitro corrosion investigation of 15 dental NEM alloys respecting the
      solubility of Ni and Co and the surface destruction shows that results can be
      interpreted only in combination of visual and SEM investigations. With these
      results it is possible to make a selection for clinical application. The inverse
      voltammetry is a sensitive quantitative method for very small amounts of ions in
      solutions.

PMID- 2220125
TI  - [Cyclosporin A-induced gingival hyperplasias: cross-sectional study of young
      organ transplantation patients].
AB  - In this study 137 patients (30 adolescence, 2-21 years, 107 adults, 22-68 years),
      which had been treated with Cyclosporine-A, between 17 to 2461 days after organ
      transplantation, were examinated by gingival status. The severity of gingival
      hyperplasia increases in both groups with mean transplantations period,
      independent of mean daily doses of CsA and Azathioprin and independent of mean
      plasma concentration. Adolescence and adults differ significantly, in relation of
      each severity group frequency. The adolescence group includes 66.7% of the cases
      with gingival enlargement of severity degree 3. In both groups increases the mean
      value of PGI-Index with the severity degree.

PMID- 2220126
TI  - [19th annual meeting of the Japanese Society of Neuropsychopharmacology. Fukuoka,
      24-25 October 1990 1989. Abstracts].

PMID- 2220127
TI  - Role of neostriatal and mesostriatal or mesolimbic dopaminergic fibres in
      Parkinson's disease with and without dementia: prospects, concepts and facts.

PMID- 2220128
TI  - [Digital autopsy archive using the personal computer].
AB  - The development of a dissection register for Legal medicine well differentiated
      and considering special requirement of the subject was not achieved in history
      because of complexity of post mortem findings in many cases. Realizing that an
      all satisfying concept failed we looked for the possibility of using electronic
      data processing for rapid and flourish collection of autopsy results not
      requiring much time for the coroner. Based on personal computer software "dBase"
      a database program was developed easy to handle using different forms asking for
      characteristic circumstances of the case and essential post mortem findings.
      Short codes for locations and ascertainments were chosen to enable rapid
      selection of interesting statements as far as handling for statistical
      evaluations later on. Less then 10 minutes are needed for recording post mortem
      results in this way short time after autopsy.

PMID- 2220129
TI  - [Age-dependent morphologic findings of the thyroid in sudden infant death].
AB  - Age (eight days to 12 months) and degree of colloid depletion or colloid content
      of the follicles (normal, partially depleted, depleted) were correlated on the
      basis of 176 thyroid investigations in cases of sudden infant death syndrome
      (SIDS). In the 176 SIDS cases, a resting thyroid gland with normal colloid
      content could only be found in 14%, whereas partially depleted follicles were
      found in 35% and depleted follicles in 51%. 60% of all cases showed a large
      degree of epithelial desquamation up to collapse of all follicles. A marked
      capillary hyperemia was found in 48%. 80% of the cases showed a normal colloid
      content in the first month of life, and colloidfree follicles should not be
      detected in any case. An increased incidence of thyroid activation was obtained
      in the total number of cases only from the second month of life. The
      histomorphological appearance of the thyroid gland thus corresponds to that of
      healthy infants only in the first month of life. The question as to why there is
      an evidently raised thyroid activity in the subsequent months of life in SIDS
      cases is discussed.

PMID- 2220131
TI  - [Injuries of the occipital condyles in fatal traffic accidents].
AB  - Among 600 deaths of traffic accidents we found injuries of the occipital condyles
      in 10 cyclists, 12 car drivers and 3 pedestrians. In most cases the collision
      speed ranged from 70 to 100 km/h. In 18 cases of direct head impact the more
      severe injury was on the opposite side, in 4 cases of indirect side impact
      (whiplash injury) on the same side. Most types of fractures were 12 horizontal
      disconnections and 4 fractures of the inner edges. In 9 cases the condyle
      fractures were on one side, in 16 cases on both sides.

PMID- 2220132
TI  - Chronic cadmium intoxication caused by a dental prosthesis.
AB  - We present a case of chronic cadmium intoxication caused by a gold dental
      prosthesis. The first symptoms of the disease appeared 2 years after insertion
      and gradually intensified over the next 3 years. Analysis of blood and urine
      samples, as well as parts of the prosthesis, revealed an excessive concentration
      of cadmium. The prosthesis was removed and the concentration of cadmium gradually
      returned to normal, with an amelioration of symptoms. This case illustrates the
      importance of investigating the possibility of intoxication with a heavy metal
      when symptoms of chronic illness accompany the presence of a prosthesis.

PMID- 2220130
TI  - [Detection of morphine and codeine in blood samples with gas chromatography/mass
      spectrometry (NCI and PCI) for differentiating codeine use from use of heroin and
      morphine].
AB  - Morphine and codeine were isolated from blood with C18 Bond Elut columns and
      derivatised with pentafluoropropionic anhydride (PFPA). The PFPA-derivatives were
      examined by means of gas chromatography/mass spectrometry using electron impact
      and chemical ionisation (positive and negative mode). The negative chemical
      ionisation, as most sensitive, was applied for the quantitation of both examined
      substances in forensic blood samples.

PMID- 2220133
TI  - [Sudden death in urticaria pigmentosa].
AB  - A case of sudden death of a 25-year-old man, with a six years history of
      Urticaria pigmentosa, is reported. On a cold morning in November he was found
      lying dead on the lawn. Histology revealed no signs of systemic mastocytosis. The
      biochemical investigations (high free histamine level in urine) in addition to a
      BAC of 0,72 mg/g and the scene conditions (cold irritation) explained the
      mechanism of death, a systemic anaphylactoid reaction.

PMID- 2220135
TI  - [The 24th meeting of the German Rheumatology Society together with the 15th
      meeting of the German, Austrian and Swiss Societies for Pain Study. September 25
      29, 1990, Hanover. Abstracts].

PMID- 2220134
TI  - Fatal complications of intramuscular and intra-articular injections.
AB  - Four fatalities related to intramuscular and intra-articular injections are
      reported. In two of these cases a Staphylococcus aureus sepsis developed, as a
      consequence of injections into the left hip joint in one and in the lateral upper
      quadrant of the gluteal region in the other. The intra-articular injection of
      triamcinolone produced severe pain, but no marked signs of purulent arthritis
      were seen at autopsy, probably because of the anti-inflammatory effect of the
      corticosteroid. A cutaneous infection was seen in the gluteal region of the other
      patient, but no apparent abscess formation. In another case of intra-articular
      injection, purulent knee joint arthritis developed after an injection of
      glucosaminoglycan. The patient died of renal insufficiency, which was probably
      connected with the treatment of the arthritis with tobramycin and cefuroxim. The
      fourth case was that of a mentally ill patient who suffered sudden cardiac arrest
      after an intramuscular injection of chlorpromazine, but with no apparent signs of
      an anaphylactic reaction. It is suggested that vasodilatation and drop in blood
      pressure caused by the chlorpromazine could have had some effect, while
      cardiotoxicity of other psychotropic drugs with which he had been treated cannot
      be ruled out.

PMID- 2220136
TI  - [Pathophysiology and clinical significance of obstructive nephropathy].
AB  - It is reported on the classification, pathophysiology and clinical relevance of
      obstructive nephropathy in the case of obstructive urinary transport disorders of
      the upper urinary tract. Despite successful experimental models a clinical
      indicator of reversibility of obstructive lesions may fail.

PMID- 2220137
TI  - [The value of diagnostic computerized tomography in tumor nephrectomy patients].
AB  - In 84 patients after nephrectomy due to renal cell carcinoma a computerized
      tomography was performed to evaluate local tumor recurrence. The findings are
      classified stage-dependent. Other metastatic lesions were found by conventional
      radiologic methods. Based on stage-dependent different occurrence of metastases
      or local recurrences recommendations are made to the use of computerized
      tomography in the follow-up of patients suffering from renal cell carcinoma after
      nephrectomy.

PMID- 2220138
TI  - [Incidence of hemorrhage following suprapubic Cystofix puncture using a new
      trocar-cannula combination--a randomized, prospective comparative study].
AB  - In this study a new trocar-cannula-unit(10 French) is introduced, which was used
      in a prospective randomised comparative study in 74 patients for suprapubic
      bladder punction. Another 75 patients served as controls receiving a suprapubic
      punction with the standard Cystofix (French 10)-system. In the control-group 9
      cases (12%) of macrohematuria occurred. On the other hand we found that the
      incidence of macrohematuria was reduced to 5 cases (6.8%), when using the new
      trocar-cannula-unit, which had been developed in our hospitals.

PMID- 2220139
TI  - [Female hypospadias: a rare cloacal abnormality].
AB  - The term "hypospadia feminis" means a congenital false urethral opening in the
      anterior vaginal wall proximal to the hymenal ring. In comparison to the male
      hypospadia it is a rare event. Obligatory an obstructive uropathy is found, but
      the pathophysiology remain obscure.

PMID- 2220141
TI  - [Evaluation of spermiogram findings using the revised WHO nomenclature].

PMID- 2220140
TI  - [Urosepsis and uroseptic shock].
AB  - The currently high letality rate of uroseptic shock may be reduced by early
      recognition of symptoms and adequate therapy with elimination of causes. Decisive
      for the septic shock are initial disturbances of the microcirculation in the
      presence of hyperdynamic circulatory regulation with following disorders of the
      coagulation system, tissue metabolism, acid-base-balance and heart contractility.
      In the therapeutic armament the important role of vasoactive substances is
      stressed. In an analysis of 59 patients suffering from urosepsis the intrinsic
      and iatrogenic causes, the bacterial spectrum and the emergency operative
      interventions are evaluated, whereas a letality rate of nearly 12% and an injury
      grade of 34% are estimated.

PMID- 2220142
TI  - [Status of office-EDP].

PMID- 2220144
TI  - [Rotational dental instruments].

PMID- 2220143
TI  - [Test of three unit adhesive bridges].

PMID- 2220145
TI  - [Natural bone closure in complete lip, jaw and gum clefts].

PMID- 2220146
TI  - [Handling problem patients in orthodontics].

PMID- 2220147
TI  - [Prevention in Europe: Danes are in the forefront].

PMID- 2220148
TI  - [Income projection for dentists is already decreased].

PMID- 2220149
TI  - [EDP--documentation of dental examination in practice].

PMID- 2220150
TI  - [Documentation of patient data in EDP forms].

PMID- 2220151
TI  - [Amalgam concerns with removal].

PMID- 2220152
TI  - [Electric sensitivity test with protective gloves].

PMID- 2220153
TI  - [Artificial intelligence in dentistry].

PMID- 2220154
TI  - [EDP--procedure data in a dental office].

PMID- 2220155
TI  - [Market for dental computers. 10,000 computers in dental offices].

PMID- 2220156
TI  - [Dental library seeks old dental catalogs].

PMID- 2220157
TI  - [Alfred Kantorowicz and his student, Lem'i Belger].

PMID- 2220158
TI  - [Caries prevention by the dentist--essential, efficient and rational].

PMID- 2220160
TI  - [Prevention by fissure sealing: principles and practice procedures].

PMID- 2220159
TI  - [Caries prevention by use of sugar substitutes].

PMID- 2220161
TI  - [Basic principles and new concepts in prevention of marginal periodontopathies].

PMID- 2220162
TI  - [Motivation for dental care].

PMID- 2220163
TI  - [Active time management with help of two computers].

PMID- 2220165
TI  - [The occurrence of Yersinia enterocolitica in sewage].
AB  - Using a modified cold enrichment procedure Yersinia spp. were detected in 90.6%
      out of 32 raw waste water samples obtained within one year from two municipal
      sewage treatment plants. Moreover Yersinia were isolated from 50% of 6 effluent
      samples. Altogether 118 Yersinia strains were isolated and typed biochemically
      and serologically. 69 out of these isolates belonged to Yersinia enterocolitica,
      60 strains to biotype 1, and 9 to biotype 4, serotype 0:3, 8 strains Yersinia
      enterocolitica serotype 0:3, biotype 4, considered to be a causative agent in
      human enteritis, harboured an 48 MD plasmid. The remaining isolates were
      identified as Yersinia frederiksenii (24 strains), Yersinia intermedia (22
      strains) and Yersinia kristensenii (3 strains). The frequency of the isolation of
      Y. enterocolitica serotype 0:3, biotype 4 from sewage showed the same seasonal
      dependence as known from strains of human origin. In contrast to this, such
      dependence could not be found among other serovars of Y. enterocolitica and
      related species.

PMID- 2220164
TI  - [Pathohistology of inflammatory reaction on badly maintained periodontium].

PMID- 2220166
TI  - Distribution, ecology, and immunosuppressive properties of Tricholoma populinum
      (Basidiomycetes).
AB  - Tricholoma populinum is widely distributed in Europe and North America. In the
      GDR 110 localities have been recorded, ranging from sea level to 470 m s.m. It is
      associated with many Populus spp. on acidic and neutral ground; its frequency has
      locally increased by recultivation of slap-dumps and waste land with poplars.
      Maximum of fructification is in the first decade of October. Investigations,
      stimulated by empiric observations on immunosuppressive effects of the mushroom
      in allergic diseases of man, lead to isolation of ergosterol peroxide as one
      substance responsible for these effects.

PMID- 2220167
TI  - [Minimal diagnostic program in urinary incontinence in the female].

PMID- 2220168
TI  - [Effect of a new gestagen--dienogest--and its combination with ethinyl estradiol
      on the activity of biotransformation reactions].
AB  - Caffeine is mainly metabolized by 3-methyl-cholanthrene-inducible cytochrome P
      450, whereas metamizol (Analgin) is probably mainly metabolized by phenobarbital
      inducible cytochromes P-450. Therefore the elimination of caffeine from serum and
      the amount of the main metabolites of metamizol excreted into urine reflect the
      activity of these two cytochrome P-450 families. Sex hormones can influence the
      activity of cytochrome P-450. Dienogest is a new gestagen, used for temporary
      contraception. We investigated the effect of this new sexual hormone alone and in
      combination with ethynylestradiol on the elimination of both testdrugs. In 10
      healthy volunteers dienogest 2 mg daily for 14 days have no effect on the
      metabolism of model drugs whereas the combination with 0.05 mg ethynylestradiol
      has an influence on the elimination of caffeine and metamizol.

PMID- 2220169
TI  - [Long-term analysis of causes, sites and results of treatment of urogenital
      fistulas at the Charite Gynecologic Clinic].
AB  - Analyses of aetiology, localisation, and curing of urogenital fistulae permit
      conclusions as to efficiency of public health services. Recorded are 810 fistulae
      in 45 years which were analysed by 15-year periods. The ratio of obstetric to
      gynaecological fistula causes has remained unchanged through the entire period
      under review (10:90). However, substantial shifting was observed within either
      main group. In obstetrics, vesicocervical and vesicovaginal fistulae following
      caesarean section, have been predominant and on rising trend for 30 years. In
      gynaecology, vesicovaginal fistulae in the wake of vaginal and abdominal
      hysterectomy have considerably increased in the last 15 years. The present of
      benign to malignant primary diseases is 70 to 20%, as compared to 40:50% in the
      past. Vesicovaginal fistulae have continued to account for 60% of the general
      incidence. Urethral fistulae have gone up from 6 to 13%, while ureteral and
      trilocal fistulae have dropped from 20 to 16 and 11 to 7%. Fistula incidence
      figures at present are 0.01% obstetric as well as 0.2-0.5% benign and 0.7-1.4%
      malignant gynaecological causes. Rates of healing improved from 90 to 96% in
      obstetrics and stayed constant in gynaecology (94% benign and 80% malignant). The
      worst prognosis has continued to be recordable from trilocal fistulae. Current
      principles of therapy are, finally, put to discussion, together with
      modifications to the therapeutic regime. The conclusion is drawn that operations
      on women for urogenital fistulae should be performed only in urogynaecological
      centres and that fistula prophylaxis should be further intensified, especially in
      the context of gynaecological standard operations.

PMID- 2220170
TI  - [Local treatment of malignant pleural effusion in gynecologic tumors].
AB  - Pleural effusions are a frequent complication of malignant gynecologic diseases,
      especially in breast cancer with an incidence of about 50%. Pleural effusions
      usually occur at a stage of the disease where no further curative therapeutic
      options exist. Therefore, the treatment should be effective and have a low side
      effect profile. The intrapleural administration of mitoxantrone in comparison
      with other pleurodesis techniques has been demonstrated to meet these
      requirements.

PMID- 2220171
TI  - [Pregnancy in diabetes insipidus--a case report with review of the literature].
AB  - A 32 year old I P II G with preexisting diabetes insipidus was treated with 1-(3
      mercaptopropionic acid)-8-d-arginine vasopressin (DDAVP) during pregnancy. An
      otherwise normal pregnancy was marked only with an excessive weight increase. A
      healthy girl was delivered by secondary cesarean section at term. Postoperative
      the mother developed a water intoxication accompanying oxytocin-infusion. During
      nursing the diabetes insipidus improved significantly whereby DDAVP doses could
      be reduced to 20-10 percent. We suppose an overreaction to endogene oxytocin with
      an antidiuretic effect.

PMID- 2220173
TI  - [When is cerclage indicated?].

PMID- 2220172
TI  - [Endometriosis of the ureter].
AB  - In this report two cases of hydronephrosis caused by an isolated ureter
      endometriosis are shown. The symptoms were few and not typical. The function of
      one kidney was severely diminished.

PMID- 2220174
TI  - [Echocardiography during pregnancy--longitudinal studies in primigravidae].
AB  - As a result of hormonal changes processes of adaptation of the cardio-vascular
      system occur during pregnancy. These regulative changes are the basis for the
      present echo-cardiographic study which was made under standardized conditions
      with healthy primigravidae (n = 20) compared to nulligravidae (n = 24). Besides
      blood pressure and heart frequency dimension and volume sizes of the left
      ventricle (LV) as well as the LV-weight of muscle and the peripheral vascular
      resistance were analysed. As result significant increases from the 15th to the
      35th week of pregnancy (SSW) could be found for the following parameters: heart
      frequency, arterial blood pressure, endosystolic volume of the left ventricle,
      cardiac output, left ventricular weight of muscle (p less than 0.01) endosystolic
      diameter of the left ventricle, enddiastolic volume of the left ventricle and
      heart index (p less than 0.05). The peripheral resistance was continuously
      decreased in the course of pregnancy (p less than 0.01). Compared to non-pregnant
      women the following parameters showed significantly higher values: heart
      frequency, cardiac output and heart index (p less than 0.01). The peripheral
      resistance was significantly lower in pregnant women compared to non-pregnant
      women (p less than 0.01). From the results the conclusion can be drawn that with
      statistic certainty echocardiography records adaptive processes of the
      circulation regulation relative to pregnancy and enables a separation in the
      groups of pregnant and non-pregnant women.

PMID- 2220175
TI  - [Contribution to cervical pregnancy].
AB  - It is reported on a rare case of cervical pregnancy as a dangerous form of
      ectopic pregnancy. Etiology of this case is described only hypothetically like in
      literature. Clinical diagnosis always is difficult and was made seldom prior to
      operation. By ultrasonics cervical pregnancy diagnosis is possible if it is
      considered. On the other hand even that can mislead as cases from literature and
      our case show. For prognosis the same principles are applicable as with any other
      ectopic pregnancy--it must be finished definitely a certain number of pregnancies
      carried to term can be found in literature. Mortality has been reduced by the
      generally improved operation conditions. Primary hysterectomy has proven therapy
      of choice. Conserving uterus after ligature or embolisation of the internal iliac
      artery seems to be justified only in exceptional cases. In early pregnancy up to
      the 8th gestational week vacuum extraction or curettage can be tried.

PMID- 2220176
TI  - [Efficacy of an adjuvant norethisterone acetate therapy (NEA) of endometrial
      carcinoma treated with primary surgery or irradiation].
AB  - The efficiency of NEA (norethisteronacetate) as an adjuvant hormone therapy in
      196 pat. suffering from endometrial cancer has been evaluated in a prospective
      randomized trial. Primarily 93 patients had been operated on and 103 ones
      irradiated. From these 45 patients following surgery and 51 ones following
      radiation therapy had been treated with NEA. Schedule of adjuvant NEA therapy was
      for a time 6 ms 50 mg/d followed by 6 ms pause and so on till 5 years post op. 5
      years survival in the operation group was 91.7 per cent without and 81.6 per cent
      with NEA, in the irradiated group 43.1 per cent and 44.8 per cent respectively.
      Side effect (47.9%) were caused by NEA at least twice higher than in control
      groups. IN CONCLUSION: the adjuvant hormone treatment without hormone receptor
      analysis is not recommendable.

PMID- 2220180
TI  - [Is radioisotope placental perfusion determination still acceptable today in the
      diagnosis of fetal retardation or placental insufficiency?].

PMID- 2220177
TI  - [Hormone receptor status in adenomatous hyperplasia of the endometrium and
      endometrial carcinoma].
AB  - 1. In glandular hyperplasia and endometrial carcinoma a correlation exists
      between the increased proliferation rate and the rise of the ER/PR-quotient. 2.
      The decline of both receptor concentrations and the increase of ER/PR-Quotient in
      the tumor and neighbouring, non-diseased tissue was demonstrated with increasing
      dedifferentiation, comparing endometrial carcinoma of different stages (G1 and
      G2, respectively). 3. In adenomatous hyperplasia the two receptors are
      significantly increased compared to normal cycling and glandular-hyperplastic
      endometrium, respectively; there the ER/PR-quotient is smaller than 1. After
      gestagen therapy decrease of both receptor concentrations demonstrates the
      success of therapy on one hand. On the other hand the higher decrease of PR
      shows, that duration and success of therapy could be limited temporally. 4. In
      endometrial carcinoma, especially in case of progression, recurrence and/or
      metastases, the determination of receptor status could be useful for therapy
      conception in the individual patient.

PMID- 2220178
TI  - [Image analysis study of squamous epithelial cells in cytological smears of the
      uterine cervix].
AB  - The automated image analysis is a method, which may model essential effects of
      the cytologist's perception, combined with an increase of objectivity. We studied
      9136 epithelial cells from 105 suspension smears of the cervix by means of image
      analysis. The results show that the process of maturation of squamous cells can
      be represented by image analysis parameters. Such a model enables an opposition
      of processes of differentiation and dedifferentiation. Furthermore subvisual
      changes in visual inconspicuous intermediate cells can be proved, too which
      appear in different degree correlated with the grade of dedifferentiation. At
      present a study is designed to investigate cases without any atypical cells, but
      having been classified as "positive cases" by the evaluation of intermediate
      cells in a long term follow-up.

PMID- 2220179
TI  - [Prenatal diagnosis of fetal small bowel stenosis. A case report].
AB  - The authors describe an own case of fetal jejunal atresia with its antenatal
      ultrasound findings. With regard to the reported case the diagnostic and
      differential-diagnostic considerations of this rare fetal malformation are
      discussed.

PMID- 2220181
TI  - Phagocytosis of opsonized fluorescent microspheres by equine polymorphonuclear
      leukocytes.
AB  - Equine blood polymorphonuclear leukocytes (PMN) were isolated by buffy coat and
      hypotonic lysis of residual erythrocytes. A highly reproducible method is
      described for measuring the uptake of opsonized latex microspheres by equine PMN
      using flowcytometry. The use of cytochalasin D allowed for differentiation of
      ingested from attached particles. The kinetics of phagocytosis in vitro is shown
      for different experimental conditions. We developed an assay for evaluation of
      phagocytic capacity of PMN which allows the assessment of drugs for their
      influence on phagocytosis in vivo as well as in vitro.

PMID- 2220182
TI  - [Comparative studies of the paraspecific immunostimulation (paramunization) by
      bacterial lysates in bacterial infection models and in the cytotoxicity test].
AB  - Bacterial lysates of different bacterial strains (E. coli, B. bronchiseptica, P.
      haemolytica) were prepared by heating, acid- and alkaline-hydrolysis. Lysates
      were tested for their immunostimulating effect in bacterial infection models and
      with chromium 51 test demonstrating spontaneous (natural) cytotoxicity. Lysate
      production was standardized by protein- and Lps-determination. The alkaline
      hydrolysis reduced toxicity of Lps and increased the content of soluble bacterial
      protein. Heating and acid-hydrolysis did not alter bacterial suspensions with
      respect to Lps-toxicity and protein-content. Mice infected with P. aeruginosa, P.
      multocida, E. coli and L. monocytogenes (5-10 LD50) had a significantly longer
      survival time after prophylactic immunostimulation with bacterial lysates than
      control animals. No protection was observed in immunostimulated mice infected
      with Erysipelothrix rhusiopathiae. In the Pseudomonas infection model, bacterial
      lysates prepared by alkaline-hydrolysis had a 10 times higher immunostimulating
      effect than lysates prepared by acid-hydrolysis or heating. Bacterial lysates
      stimulated spontaneous cytotoxicity of natural mouse peritoneal killer cells
      after intraperitoneal application. Whole bacterial lysates had a higher NK
      activity as their corresponding purified lipopolysaccharide portion.

PMID- 2220183
TI  - Scanning electron microscopic characterization of bovine coronavirus plaques in
      HRT cells.
AB  - The ecology of cytopathic expression of bovine coronavirus (BCV) in HRT-18 cells
      was analyzed within virus-induced plaques by scanning electron microscopy. Virus
      replication was cytocidal for many HRT-18 cells, a function enhanced in the
      presence of trypsin. A monolayer of cells remained that imparted a characteristic
      turbidity to the plaque. These structurally normal, lysis-resistant cells did not
      stain with fluorescent antibodies specific for BCV antigens, failed to adsorb
      virus particles or mouse erythrocytes in contrast to the susceptible cells. The
      survival of cells in the plaque interior reflects a non-productively infected
      population with evidence of viral persistence.

PMID- 2220184
TI  - [Experimental studies of in vitro cultivation of the cells of Kartner honeybees
      (Apis mellifera carnica Pollmann, 1879)].
AB  - A synopsis about published methods and results on experiments to cultivate bee
      cells in vitro is given. Experimental investigations were performed with
      haemocytes of larvae of the L-5 stage using many different media and methods for
      the preparation of primary tissue culture. Monolayers could be prepared and a
      high rate of reproduction has been achieved, although subpassages could not be
      obtained. Haemocytes could be kept alive up to 27 days by using BML-TC/7A medium
      according to Gardiner and Stockdale, modified by Skatulla (pers. communic.,
      1987). Further experiments are necessary in order to study the suitability of bee
      cells to detect specific pathogens and toxic substances.

PMID- 2220185
TI  - [Electron microscopic studies of mucosal extirpates of rabbits after after in
      vitro contact with Pasteurella multocida subsp. multocida strains].
AB  - In vitro experiments of adhesion and colonisation of mucosal surface fragments
      (nose, trachea) from freshly killed rabbits with four strains of Pasteurella
      multocida subsp. multocida with different types of capsule antigen (A, D, without
      capsule) showed the following results: Above all the capsule serovar A strain,
      producing a capsule of hyaluronic acid and fimbria, were able to adhere and to
      form microcolonies on the mucosal surface. Microvilli of epithelial cells and
      mucus producing cells were recognized as the place of adhesion. The formation of
      microcolonies occurred with a destruction of the kinocilia, which was caused by a
      bacteria free culture filtrate as well.

PMID- 2220186
TI  - Aujeszky's disease in a horse.
AB  - A horse with neurological signs and severe meningoencephalitis caused by
      Aujeszky's disease is described. The diagnosis was established by
      immunohistochemistry, DNA-in situ hybridization and serological tests. Aujeszky's
      disease virus antigen and Aujeszky's disease viral DNA were detected in neurons
      of the cerebrum. In the serum of the horse antibodies against Aujeszky's disease
      virus were detected in a virus neutralization test, in a blocking ELISA which
      specifically detects antibodies against the glycoprotein I (Ig) of the virus, in
      an indirect double sandwich ELISA and with colloidal gold immunoelectron
      microscopy which detects antibodies directed against the envelope and
      nucleocapsid of the virus. Intranasal infection of two points with a high dose of
      Aujeszky's disease virus caused very wild and transient signs. Although the
      experimental infection induced virus neutralizing antibodies, it failed to induce
      gI specific antibodies.

PMID- 2220187
TI  - [The detection of antibodies to the agent of malignant catarrhal fever in sheep
      and goat sera].
AB  - An epidemiologic study was undertaken by means of the SNT on three sets of sheep
      sera and one set of goat sera to evaluate for the occurrence of antibodies
      against strain WC11. Out of 791 sera of a sheep breeding organisation 57 samples
      (7.2%) showed positive titers. The positive samples originated from 24 farms
      (36.4%) out of 66 farms under test. Out of 118 sheep sera sent in from different
      parts of Austria 35 (29.7%) showed positive titers. 73 sheep sera out of a farm
      where MCF had clinically occurred were also tested. 20 samples (27.4%) scored
      positive. Also 40 goat sera (20.3%) out of 197 samples showed positive titers.
      The results are in accordance with publications from other countries. Special
      reference is made to goats as possible carriers and transmitters of MCF.

PMID- 2220188
TI  - [The genesis of permanent growth of the beak wattle of a wattle-type pigeon].
AB  - Variation in size of warts located on the beak of wattle-pigeons represents a
      dominant trait of this breed. Excessive growth to extraordinary size in two
      breeds (barbs and carriers), in addition to a large beak, can cause losses due to
      the inability of the parents to feed the offspring properly. In older birds,
      respiration is impeded and the field of vision is limited. This permanent growth
      in barbs and carriers could not be attributed neither to an infection with
      papovaviruses, nor to the overexpression of the retroviral c-src-protooncogen.
      This finding, in conjunction with the genetic analysis, underlines that this
      prominent trait is genetically determined.

PMID- 2220189
TI  - Trials with an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of
      subclinical genital infections in rams caused by Histophilus ovis and
      Actinobacillus seminis.
AB  - The performance of an enzyme-linked immunosorbent assay (ELISA) was evaluated in
      the serological diagnosis of subclinical genital infection in 6 naturally
      infected ram flocks and 2 experimentally infected ram hoggets. The test employs
      lipopolysaccharide (LPS) antigen prepared by autoclaving from Actinobacillus
      seminis and Histophilus ovis. A total of 193 sheep (118 unmated virgin rams and
      75 mature breeding rams) were examined clinically, serologically (by ELISA) and
      bacteriologically (semen bacteriology) at the same time. Serum samples from all
      animals were also tested by an ELISA employing LPS antigen prepared from Brucella
      ovis in the same way. Shedding of A. seminis and H. ovis did not show close
      correlation with serological positivity (Table 1), as only 9 (15.0%) out of the
      60 A. seminis shedders were ELISA seropositive at the same time. As regards H.
      ovis only 10 (19.2%) out of the 52 H. ovis shedders were ELISA seropositive at
      the same time. The results indicate that, when used alone, the ELISA employing
      LPS antigen is unsuitable for diagnosing subclinical genital infection caused by
      H. ovis and A. seminis in rams. The authors discussed shortly the employing
      fields of this ELISA test in the diagnostic work.

PMID- 2220190
TI  - Milk whey induction of agglutination in ovine and bovine mastitis Staphylococcus
      aureus.
AB  - A total of 59 mastitis staphylococcic strains were tested for growth
      agglutination upon supplementation of growth media with ovine and bovine milk
      whey and mammary secretions from dry cows. Differences were observed when
      comparing bacterial species or origins (ovine vs. bovine) of bacteria and whey.
      All of the ovine and bovine S. aureus strains tested, but only 4 among 22 other
      ovine mastitis staphylococcic strains, showed growth agglutination in Todd Hewitt
      broth (THB) supplemented with greater than or equal to 30% (v/v) ovine milk whey.
      None of the strains agglutinated during growth in regular THB medium. Ovine whey
      had an agglutination induction capacity higher than bovine whey (P less than
      0.005), concerning the number of responsive ovine and bovine S. aureus strains.
      There were no differences between whey samples from different ewes with regard to
      their capacity to induce agglutination. Ovine S. aureus strains were more
      responsive than bovine strains of this bacterial species, concerning the number
      of responsive strains (P less than 0.001) to bovine whey (greater than or equal
      to 30% in THB), the proportion of responsive strains at low (10%) ovine whey
      concentration (P less than 0.001), and the strength of reaction (precipitation
      timing and clump size). Secretions from dry cows systematically induced
      agglutination in all of the bovine and ovine S. aureus strains tested.

PMID- 2220191
TI  - Complement-dependence of polymorphonuclear yeast cell phagocytosis: a comparison
      between man and various domestic animals.
AB  - The complement-dependence of polymorphonuclear yeast cell phagocytosis of sheep,
      goat, cattle, horse, dog, pig and man is determined by comparing the opsonizing
      abilities of untreated sera with complement-inactivated autologous sera at a
      serum concentration of 2.5% and at different phagocytosis periods. The performed
      phagocytosis assays only detects incorporated particles and allows for the
      differentiation of granulocytes with different quantities of phagocytosed
      particles. In sheep, horse and man the addition of heat-inactivated serum reduces
      the phagocytosis index to less than -80% of the value obtained at untreated serum
      addition at a phagocytosis period of 60 min. The other species show a smaller
      reduction ranging from -66.9% (dog) to 41.4% (cattle). The evaluation of the
      distribution pattern of granulocytes incorporating a certain number of yeasts
      offers significant differences in the investigated species.

PMID- 2220192
TI  - The role of intestinal volatile fatty acids in the Salmonella shedding of pigs.
AB  - Factors affecting colonization of the intestinal tract by salmonellas were
      studied in two pig herds. In herd H 18% of the faecal samples taken from live
      pigs and 30% of the colon content samples collected at slaughter contained
      salmonellas. In contrast, the 50 faecal samples taken from pigs of herd L were
      negative and only 2% of the colon contents collected at the yielded salmonellas.
      An antibacterial effect inhibiting salmonella multiplication was demonstrable in
      vitro in colon contents from pigs of herd L. No such effect was found to exist in
      samples taken from pigs of herd H. The antibacterial effect is due to the non
      dissociated volatile fatty acid (VFA) molecules present in the colon content. As
      the degree of VFA dissociation depends on the pH of the environment, at lower pH
      values (pH 6.1 +/- 0.2) of the colon contents from herd L the ratio of non
      dissociated VFA molecules is higher and the resulting antibacterial effect is
      stronger than in samples from herd H (pH 7.1 +/- 0.3).

PMID- 2220193
TI  - Serological reactions of leptospirosis-positive (MAR and CFT) bovine sera in
      ELISA.
AB  - The collection of test sera for measuring ELISA results was composed of bovine
      sera with MAT titres of greater than or equal to 1:200 in the leptospirosis MAT
      and of greater than or equal to 1:5 in the CFT together with sera from a
      serologically negative and clinically non-suspicious cattle herd. To establish
      cut-off ODs, the geometric mean net-extinction of the negative serum collection
      plus 1, 2, and 3 standard deviations were calculated. By comparison of 3
      different conjugates from rabbits, it was demonstrated that results from anti
      total bovine Ig were superior to anti-IgG and anti-IgM conjugates. Considerations
      regarding sensitivity and specificity led to the recommendation to use a test
      serum dilution of 1:160, to apply anti-total bovine Ig conjugates, and to
      establish the cut-off OD at the geometric mean net-extinction of negative sera
      plus 3 standard deviations. Under such conditions, agreement between
      leptospirosis MAT/CFT positivity on the one side and ELISA positivity on the
      other was reached in 74%. This recommendation is made for cross-sectional studies
      but not for examinations of clinically suspicious cattle herds.

PMID- 2220194
TI  - In vitro and in vivo glucose consumption in swine eperythrozoonosis.
AB  - One complication of swine eperythrozoonosis is the hypoglycemia that occurs
      during parasitemia. To determine the cause of the hypoglycemia, we studied
      glucose consumption in splenectomized pigs infected with Eperythrozoon suis. With
      the rapid rise of erythroparasites, the in vitro glucose consumption of parasited
      whole blood increased dramatically, and hypoglycemia developed. Because mature
      porcine erythrocytes are impermeable to glucose, the increased glucose
      consumption is most logically the result of E. suis metabolism. Iodoacetamide and
      sodium fluoride (which inhibit glycolysis), but not sodium cyanide (which
      prevents cellular respiration), and tetracycline (which is used to treat
      eperythrozoonosis) inhibited glucose consumption. In vivo glucose turnover
      studies before infection and during peak parasitemia indicated an increased
      glucose production by infected pigs during parasitemia. The results suggest that
      hypoglycemia occurs during swine eperythrozoonosis because the parasite uses
      glucose faster than the gluconeogenic pathways can provide it.

PMID- 2220195
TI  - Comparison of six different regimens for the control of atrophic rhinitis in
      swine.
AB  - Effectiveness of six different programs of atrophic rhinitis (AR) control was
      evaluated under field conditions. Efficacy of treatments was recognized on the
      basis of--comparative evaluation of the average daily gain (ADG), morphometric
      examination of turbinate bones and computer conchal morphometry (TPR). Usefulness
      of the evaluated regimes differed significantly. TPR appeared to be the most
      objective method for AR evaluation. Correlation between severity of turbinate
      atrophy and ADG was only partial.

PMID- 2220196
TI  - Isolation of Mycoplasma arthritidis from the joint fluid of boars.
AB  - During an outbreak of a disease in a swine insemination centre in Bavaria, Fed.
      Rep. of Germany, characterized by conjunctivitis, severe polyarthritis and
      infertility mycoplasmas have been isolated from the joint fluids of the three
      boars investigated. Two of the isolate could be typed as Mycoplasma (M.)
      arthritidis which causes arthritis in rats, mice and rabbits, the third as M.
      collis, a probably apathogenic rodent mycoplasma species. One of the two isolated
      M. arthritidis strains (strain D 263) was injected intravenously in rats and
      mice, which developed mild to severe polyarthritis or even died, depending on the
      numbers of organisms inoculated. Since the bacteriological and virological
      investigations of the joints of boars did not yield a causative agent, it is to
      suppose that M. arthritidis played the substantial role in the production of the
      disease of the boars. It is very likely that the boars caught the mycoplasmas
      from rodents infected with the isolated species.

PMID- 2220197
TI  - On the importance of bacterial L-forms in pigeons.
AB  - Following a definition of bacterial L-forms and a literature review on
      introduction and reversion of bacteria to and from L-forms, respectively, the
      results of a study comprising 587 samples (316 pigeons and 271 pigeon eggs) are
      reported. As a control 25 free living pigeons and 25 eggs of those pigeons were
      used, because antibiotic treatment of these could be excluded. From 79 samples
      (75 pigeons and 4 eggs) Salmonella typhimurium var. copenhagen (STMC) was
      isolated (none from the urban pigeons), of them 11 in the L-form from joints and
      organs and 3 from eggs. 325 of other bacterial isolates were found as L-forms (=
      approx. 40%). Out of 168 serum samples investigated, 33.9% showed antibodies
      against STMC. Corresponding antibodies could only be demonstrated in 73.4% of the
      pigeons with a STMC isolate. The occurrence of L-forms explains resistance to
      therapy and the failure of vaccines. The high frequency of L-forms is probably an
      indication of an inconsequential use of antibiotics in managing pigeon diseases.

PMID- 2220198
TI  - Influence of estradiol administration to lactating cows on bacterial growth in
      milk whey.
AB  - Bacterial growth (E. coli) in whey was studied by turbidometric technique during
      estradiol benzoate administration (0.02 mg/kg of body weight/day for 12-19 days)
      to 13 ovariectomized cows at three stages (early, mid and late) of the 1st- and
      3rd-lactations. Whey samples from cows at early stage (60-90 days) of 1st
      lactation promote the growth of E. coli during the estradiol treatment. This
      included a significant increase in the maximum turbidity and a decrease in the
      generation time. Bacterial growth was inhibited in whey from cows at other stages
      of lactation during the hormone treatment. The degree of inhibition varied at
      different stages of lactation. No significant alterations in the ability of whey
      to support bacterial growth were observed in 3 ovariectomized cows treated with
      the drug vehicle (arachis oil) alone. Majority of the quarters included in the
      present study were bacteriologically negative throughout the study.

PMID- 2220199
TI  - Production of interleukin 2 and expression of interleukin 2 receptors by pony
      peripheral blood lymphocytes after stimulation with a soluble fraction of
      Trypanosoma evansi.
AB  - Pony peripheral blood lymphocytes (PBL) were stimulated with a soluble fraction
      of Trypanosoma (T.) evansi (SF). As determined by 3H-thymidine incorporation, the
      cells underwent a proliferative response and were able to: a) produce a factor
      having the biological activities of interleukin 2 (IL-2) since their supernatants
      could support the in vitro growth of pony PBL stimulated with concanavalin A (Con
      A-blasts); b) undergo a further proliferative response when incubated in short
      term cultures with SF, human recombinant IL-2 (hrIL-2), or both c) bind
      specifically radiolabelled hrIL-2 (125I-hrIL-2). The date described here indicate
      that a soluble fraction of T. evansi stimulated pony PBL which subsequently
      produced IL-2 and expressed IL-2 receptors (IL-2R).

PMID- 2220200
TI  - Measurement of endotoxic activity in feces of normal horses.
AB  - Two chromogenic Limulus amebocyte lysate systems were evaluated for the
      measurement of endotoxic activity in feces of normal horses. Fecal extracts had
      neither non-specific nor inhibitory effect on the test reaction, and the two
      systems with different specificity showed equivalent results. Endotoxic
      activities in feces of healthy horses averaged 5.7 +/- 2.8 microns/g wet weight.
      Correlation between the endotoxin levels and the fecal microbial flora could not
      be determined.

PMID- 2220202
TI  - [An analysis of the peripheral blood picture in the suslik and the white rat at
      different seasons of the year].
AB  - New data are presented concerning seasonal changes in the peripheral blood of
      hibernating and non-hibernating rodents. In non-hibernating rats, seasonal
      changes in the blood are mainly phenotypical. Hibernating mammals are capable
      periodically to renew cellular composition of the blood during winter and summer
      hibernation.

PMID- 2220203
TI  - [The direct stimulating effect of arginine vasotocin on the functional activity
      of the interrenal gland in the frog Rana temporaria].
AB  - Using radioimmunoassay it has been detected that both nonoperated and
      hypophysectomized, lacking endogenous ACTH, frogs injected one or three times
      with arginine vasotocin (5.10(-9) M/kg b. w.) show a statistically significant
      increase of plasma corticosterone level as compared with that in control animals
      and frogs injected with Ringer solution. The level of 11-hydroxycorticosteroids
      (fluorometric determination) in the interrenal gland decreases significantly only
      in animals three times injected with arginine vasotocin. It is assumed that
      arginine vasotocin produces a direct stimulatory effect on corticosteroid
      producing cells of the frog interrenal gland.

PMID- 2220205
TI  - [The late prolonged motor discharges during stimulation of the segmentary
      afferents in rat pups: the age-related characteristics].
AB  - In experiments on intact 5-30-day rat puppies under slight urethane narcosis,
      stimulation of contralateral afferents evoked late prolonged discharges in
      extensor muscles. Apart from these discharges, studies were also made on the
      outbursts of autogenic periodic motor activity. The specific feature of late
      discharges within the first 10 days is their extreme duration and the presence of
      rhythmic components. With respect to the pattern and temporal parameters, there
      is a strong similarity between late discharges and autogenic periodic motor
      activity which is typical of newborn rats. The decrease in the intensity of late
      discharges in ontogenesis is paralleled by inhibition of autogenic activity. The
      data obtained indicate that late discharges are genetically related to the
      ancient property of the central nervous system, i.e. the capacity to self
      excitation and maintenance of active state.

PMID- 2220204
TI  - [The effect of dehydration on the functional activity of the interrenal gland in
      adenohypophysectomized Rana catesbeiana frogs. A preliminary report].
AB  - A significant increase of the content of corticosterone in the blood collected
      from intravenous cannula or by intracardiac punction has been detected using
      radioimmunoassay in non-operated and adenohypophysectomized frogs Rana
      catesbeiana subjected to dehydration in 6.2% mannitol solution during 24 hours.
      The osmolality of the blood plasma of these animals also increases although less
      significantly than the growth of plasma corticosterone content. There is a
      tendency to substantial increase of plasma arginine-vasotocin level prior to the
      growth of corticosterone level, already after 6 hours of dehydration. Based on
      the present results and literature data, it is suggested that in
      adenohypophysectomized frogs lacking endogenous ACTH just the increase of blood
      arginine-vasotocin level results in a substantial activation of corticosteroid
      producing cells of the interrenal gland and in the growth of plasma content of
      corticosterone.

PMID- 2220206
TI  - [The late prolonged motor discharges during stimulation of the segmentary
      afferents in rat pups: the effect of L-DOPA].
AB  - In experiments on 5-30-day rat puppies, under slight urethane narcosis, studies
      have been made on the late prolonged discharges in extensor muscles evoked by
      stimulation of contralateral tibial nerve before and after injection of DOPA.
      Within the first 16 days, the drug completely abolished or significantly reduced
      late discharges, increasing the spontaneous motor activity. Beginning from the
      16th day, periods of potentiation of late discharges were observed. The data
      obtained are discussed in relation to the development of mechanisms of control of
      the activity of spinal generators which are responsible for late discharges and
      spontaneous motor activity.

PMID- 2220207
TI  - [The wakefulness-sleep cycle in rats with a genetic predisposition to catalepsy].
AB  - Neurophysiological studies on wakefulness-sleep cycle have been made in rats
      selected for hereditary inclination to catalepsy. It was shown that in these
      animals, the stage of delta-sleep is significantly reduced, whereas the duration
      of a superficial slow-wave sleep is increased. In a sleeping phase of the cycle,
      large amount of spindles in the range of alpha- and beta 1-oscillations was
      observed, especially significant in electrograms of n. caudatum and sensorimotor
      cortex. This activity is considered as a pathological manifestation of a
      transient hypnotic phase which includes the increase in immobilization of a
      cataleptic type.

PMID- 2220208
TI  - [Differences in the corticofugal facilitating effect on evoked potentials in the
      neostriatum of rats and monkeys].
AB  - Identical facilitation of the primary response to peripheral stimuli in rats and
      monkeys has been induced by local superficial cooling of the cortex in the
      somatosensory area S1. Higher facilitation of the evoked potentials was observed
      in the neostriatum of rats. Correlation of the evoked potentials with primary
      responses was more significant with respect to temporal than amplitude
      parameters. In monkeys, "cool" facilitation of the cortical primary response did
      not result in facilitation of the evoked potential in the neostriatum. Temporal
      correlation between the primary response and the evoked potential was less
      significant, whereas correlation in the amplitude was absent. The data obtained
      indicate the existence of differences in functional organization of corticofugal
      influences upon the neostriatum in rodents and primates.

PMID- 2220209
TI  - [The ontogenetic characteristics of the effect of stimulating the "reward zones"
      on the evoked potential in the parafascicular complex of the rabbit].
AB  - In experiments on 24 anaesthetized 30-40-days rabbits, studies have been made of
      the effect of stimulation of the "reward zones" on the evoked potentials in the
      parafascicular complex in response to nociceptive stimulation of the hindlimb. It
      was shown that the effect of depression depends on the strength and duration of
      stimulation, being more evident in animals with a strong reaction to self
      stimulation. A comparison was made of analgetic effects produced by stimulation
      of the reward zones in various brain structures (the anterior, median and
      posterior lateral hypothalamus, the capsula interna, subthalamic region, etc.).
      Original description is presented of ontogenetic peculiarities of the recovery
      period for the evoked potentials after cessation of stimulation. The data
      obtained are discussed in relation to functional properties of nonspecific
      thalamic system of rabbits at the given stage of their development.

PMID- 2220201
TI  - [The presence of a correlation between erythrocyte acetylcholinesterase activity
      and body mass in small rodents].
AB  - Studies have been made on the activity of erythrocyte acetylcholinesterase in 18
      species of wild and laboratory rodents. Significant differences in the enzymic
      activity unrelated to taxonomic position of rodents were revealed. Negative
      correlation was found between the enzymic activity and body mass in rodents. The
      relationship between these parameters for wild rodents is approximated by an
      allometric equation Y = 1.1 . X-0.73, for laboratory species--Y = 1.5 . X-0.41.
      It is suggested that the revealed relationship indicates the existence of a
      connection between the activity of erythrocyte acetylcholinesterase and the
      intensity of metabolism in small rodents.

PMID- 2220213
TI  - [The status and outlook for mathematical modelling in epidemiology].

PMID- 2220212
TI  - [The validation of the use of acarid antigens in developing vaccinal-serum
      preparations for the prevention of tick-borne encephalitis].

PMID- 2220211
TI  - [Free amino acids in the blood plasma of lampreys, frogs and rats].
AB  - Free amino acids in the blood plasma of lampreys, frogs and rats were determined
      by HPLC. In spite of quantitative differences in the total pool of free amino
      acids, the specific content of physiologically important amino acids is quite
      similar in representatives of different classes of vertebrates, from cyclostomes
      to mammals.

PMID- 2220214
TI  - [The article by Iu. P. Solodovnikov The etiological structure of bacterial
      dysentery in the USSR].

PMID- 2220210
TI  - [The transventricular pathway of hypothalamic neurohormone distribution--the most
      ancient mechanism of neurohormonal regulation].

PMID- 2220215
TI  - [The infection of monkeys with Ureaplasma urealyticum serovar VIII].
AB  - The possibility of modeling chronic infection on monkeys by the injection of the
      culture of U. urealyticum, serotype VIII, was shown. The infection of monkeys
      with these microorganisms introduced in a single intraperitoneal injection
      resulted in the generalization of the process, which was manifested by the
      persistence and reproduction of the infective agent in the organs and blood of
      the animals for as long as 6 months (the term of observation). Lymphoid
      hyperplasia in the organs of immunogenesis and transitory immunomorphological
      reaction in the tissues of some organs of the urogenital system were noted. The
      localization of infective agents in some endocrine glands was not accompanied by
      disturbances in their function.

PMID- 2220216
TI  - [The use of a molecular hybridization method for studying the enterotoxigenic
      properties of Salmonella].
AB  - The occurrence of the tox gene among 320 Salmonella strains of 23 serovars,
      differing in their origin, sensitivity to antibiotics, the presence of R-plasmids
      and a number of biochemical properties, has been studied by the method of DNA-DNA
      hybridization in situ. Essential differences in the occurrence of the tox gene
      have been detected both among S. typhimurium hospital strains and strains
      isolated in sporadic diseases, from the environment, from animals and among
      salmonellae belonging to different serovars. The direct correlation between the
      presence of the enterotoxigenicity gene and plasmids controlling resistance to
      antibiotics in Salmonella strains has been established. The expediency of using
      the method of gene probing for the study of the enterotoxigenic properties of
      salmonellae has been substantiated.

PMID- 2220217
TI  - [A radioimmunoprecipitation method in the serodiagnosis of HIV infection: the
      development of the optimal conditions for its performance and the evaluation of
      the possibilities for its use].
AB  - The optimum conditions for using the method of radioimmunoprecipitation (RIP) for
      the detection of human immunodeficiency virus (HIV) in serum samples have been
      established. Out of several available cell lines persistently infected with HIV,
      specially selected line 17 has been chosen. The characteristic feature of this is
      the high and stable (under the conditions of prolonged cultivation) accumulation
      of virus-specific proteins in infected cells. The optimum conditions for making
      the test and its evaluation have also been established. The data of literature on
      the advantages of the method of RIP over such traditional methods as the enzyme
      immunoassay and immunoblotting have been confirmed. Thus, the presence of
      specific antibodies in several serum samples registered as false negative has
      been established. The intertypical reactivity of two serotypes of the virus, HIV
      1 and HIV-2, has been studied. Cross reactivity of antibodies with respect to the
      HIV gene gag, but not with respect to viral glycoproteids, has been established.
      Ideas on the expediency and prospects of using RIP for the serological control of
      HIV infection are presented.

PMID- 2220218
TI  - [An analysis of the dysentery epidemic process in Blagoveshchensk].
AB  - The retrospective analysis of dysentery morbidity in Blagoveshchensk for the
      period of 1960-1987 was made. The regularities linking general natural and
      biological factors triggering the epidemic process with dysentery morbidity among
      the population are emphasized. The study revealed that under the conditions of
      Blagoveshchensk dairy products were of major epidemic importance among factors
      contributing to the transmission of dysentery. Such a factor as flies also had a
      definite influence on the epidemic process of dysentery. Another risk factor was
      drinking water which influenced the epidemic process both directly and indirectly
      through dairy products and, probably, other foodstuffs. Reliable correlation
      between dysentery morbidity among the population and the quality of dairy
      products, tap water and the number of flies was established.

PMID- 2220219
TI  - [An outbreak of ornithosis at a textile factory].
AB  - For the first time an outbreak of ornithosis at a textile factory is described.
      The data on the specific epidemiological features of the outbreak, the specific
      clinical features of the disease, the results of catamnestic observations and the
      study of the titers of specific antibodies in the complement fixation test are
      presented.

PMID- 2220220
TI  - [The use of pharmacological screening for characterizing the toxicity of
      pertussis vaccines].
AB  - The influence of pertussis preparations, introduced by oral and parenteral
      routes, on the detoxifying function of the liver and the state of the nervous
      system of the animals was studied by methods used in pharmacology and toxicology.
      The use of these methods made it possible to find out side effects produced by
      corpuscular pertussis vaccine, introduced parenterally, on the detoxifying
      function of the liver and the state of the nervous system of the animals. The
      negative influence on the nervous system was more pronounced after the injection
      of the commercial adsorbed diphtheria-pertussis-tetanus vaccine used in this
      investigation than after the injection of pertussis monovaccine. The oral
      administration of corpuscular pertussis vaccine exerted no negative influence on
      the above-mentioned body functions of the animals.

PMID- 2220221
TI  - [The efficacy of a cultured rabies vaccine studied on guinea pigs previously
      infected with the rabies street virus].
AB  - In this work materials on the development of an experimental model for the study
      of rabies vaccines are presented. The comparative study of different immunization
      schedules for vaccines with different protective potency has been carried out.
      Guinea pigs infected with street rabies virus, strain k, were used as an
      experimental model. As shown in this investigation the optimum method of
      infecting the animals with strain k was intramuscular injection causing 50%
      mortality among the animals, the incubation period lasting 10-24 days. Only those
      tissue-culture rabies vaccines which had activity equal to 1.0-1.3 I. U. and,
      when injected into the animals, ensured survival rate ranging from 57% to 76%,
      depending on the immunization schedule, were shown to possess protective potency.
      It should be pointed out that survival rate among the animals receiving the
      preparation according to the reduced schedules recommended by WHO was higher than
      among those immunized daily for 14 days. In all groups immune response was
      observed. Still in the animals receiving the preparation according to the reduced
      schedules a higher level of virus-neutralizing antibodies was registered. Thus,
      an experimental model capable of being used for the evaluation of the quality of
      existing and newly developed antirabies preparations was obtained. Besides, we
      believe it to be expedient to carry out the field trial of rabies vaccines with
      activity equal to 1.0-1.3 I. U., using the reduced immunization schedules.

PMID- 2220225
TI  - [A method for the experimental determination of the intensity of immunity from a
      series of different antigen doses].
AB  - A new immunological regularity has been discovered mathematically; proceeding
      from this regularity, a simple index characterizing the immune responsiveness of
      animals has been proposed and a new (universal) method for the determination of
      the intensity of immunity has been developed and checked according to
      experimental data.

PMID- 2220222
TI  - [The functional characteristics of the peripheral blood granulocytes in
      erysipelatous inflammation].
AB  - The receptors (FcR, C3R) and functional activity, determined by the nitroblue
      tetrazolium (NRT) test, of polymorphonuclear leukocytes (PML) of low and normal
      density were studied in erysipelas patients. The leukocytes were obtained by
      sedimentation on the 2-stage gradient of Ficoll-Verographin (1.077 and 1.119 g/cu
      cm). No statistically significant difference in the average group indices between
      "light" and "normal" PNL of erysipelas patients were detected. In comparison with
      donor PNL, higher expression of C3R, a high spontaneous NBT(+)-PNL level and poor
      response to stimulation with IgG in the NBT test were observed on granulocytes of
      the patients. The short-term treatment of the whole blood obtained from the
      patients with Streptococcus haemolyticus allergen led to a significant increase
      in the output of "light" PNL. As negative control, brucellin treatment was used,
      which produced no essential effect. The treatment of donor blood with the above
      mentioned antigens did not significantly affect the density of PNL. These facts
      suggest that in erysipelas the presence of "light" PNL is linked not with the
      release of granulocytes from the marrow, but with the activation of leukocytes by
      the products of infective inflammation.

PMID- 2220224
TI  - [Changes in the membrane lipids and lymphocyte function in staphylococcal
      infection and the development of delayed hypersensitivity].
AB  - Experimental staphylococcal infection was reproduced in rats by the
      intraperitoneal injection of S. aureus strain 75. The degree of the development
      of delayed hypersensitivity (DH) to staphylococci, microviscosity, the levels of
      free radical oxidation and antioxidation resistance were evaluated in the
      dynamics of the infectious process by the methods of chemiluminometry and
      fluorescent probing with pyrene. The functional activity of lymphocytes was
      determined by the inclusion of 3H-thymidine into DNA as the consequence of
      stimulation with phytohemagglutinin. The development of DH was found to depend on
      the microviscosity and antioxidation resistance of membrane lipids. The increase
      of microviscosity and the simultaneous decrease of the induction time of
      chemifluorescent rapid flash inhibit the development of DH, leading to the
      aggravation of the infectious process. The increase of fluidity and the
      accumulation of antioxidants facilitate the development of DH and lead to a
      milder course of the infectious process.

PMID- 2220223
TI  - [Candidal carriage and the development of invasive candidiasis of the organs of
      the digestive tract during experimental immunodepression].
AB  - After infecting healthy mice with Candida by their oral administration the fungi
      are rapidly eliminated from the digestive tract. In the animals, immunosuppressed
      by the injection of cyclophosphamide, the prolonged persistence of Candida in the
      digestive tract occurs, and the administration of Candida in considerable doses
      over prolonged periods in combination with the injections of high doses of
      immunosuppressing agents results in the development of profound invasive lesions,
      in some cases leading to the dissemination of the process.

PMID- 2220226
TI  - [The preparation of an IgG diagnostic agent based on stained polyacrolein latexes
      for use in the latex agglutination reaction].
AB  - IgG diagnosticum for measuring the concentration of 131I-labeled IgG antibodies
      to enteric antigen beta 1MA by the latex agglutination inhibition (LAI) test has
      been prepared on the basis of polyacrolein latexes. A method for the titration of
      anti-IgG antibodies with the use of the above diagnosticum has been developed,
      based on the late, agglutination (LA) test. The optimum conditions for the
      microtitration variant of the LA and LAI tests have been defined. High
      sensitivity, specificity and simplicity of analysis with the use of latex IgG
      diagnosticum have been demonstrated. The newly developed methods have been
      successfully used in laboratory trials of a new diagnostic radiopharmaceuticals
      for the assay of 131I-labeled antibodies in this preparation and for the
      detection of side effects of immunization on the recipients.

PMID- 2220228
TI  - [The results of preclinical trials of the Soviet recombinant preparation of human
      interferon alpha-2 (reaferon)].

PMID- 2220227
TI  - [The immunological properties of the main outer membrane protein of Legionella].
AB  - The immunogenic properties of Legionella outer membrane main protein (OMMP) were
      studied by its effect on the proliferative activity of lymphocytes in guinea
      pigs. Preliminary immunization with OMMP activated only the specific and
      nonspecific proliferation of spleen cells. After infection with Legionella,
      secondary immune response developed in the spleen and lungs of previously
      immunized animals, in contrast to intact ones, and the nonspecific proliferative
      activity of lymphocytes in the spleen and lungs of previously immunized animals
      considerably increased. These results are indicative of the fact that Legionella
      OMMP, similarly to other Legionella antigens and immunomodulators, may be used
      for the formation of protective immunity.

PMID- 2220230
TI  - [Pathophysiology of open fractures and principles of their treatment. Review].
AB  - Authors have worked out in detail the problems of fractures associated with the
      injury of soft tissues. They use their own classification dividing these
      fractures into two major groups, and namely open and closed fractures. In each
      group they distinguish 4 degrees of severity of the injury of soft tissues. Of
      decisive importance for both the final result and the course of the treatment is
      the method of treatment which starts already on the scene of the injury. The
      whole therapeutical management up to the actual operation has several successive
      phases. The way of osteosynthesis can be decided upon only after the primary
      treatment of the wound which makes it possible to evaluate properly the condition
      of soft tissues and the contamination of the wound. Of vital importance is the
      radicalism of the primary treatment and the removal of all necrotic tissues.
      Potential defects can be temporarily covered with artificial skin and permanently
      with skin grafts or muscular, myocutaneous or fasciocutaneous flaps.

PMID- 2220231
TI  - [Long-term results of Ludloff's repositioning method].
AB  - Authors have evaluated results of the surgical treatment of congenital dysplasia
      of the hip joint performed at I Orthopaedic Clinic in Prague in the years 1970
      1985. In the course of this period open reduction according to Ludloff was
      performed in seventy children out of which eight times bilaterally. Fifty-six out
      of the total number of seventy children same for the follow-up check. The age of
      the children operated on ranged between five and 23 months; in six cases the
      operation was performed on both hip joints. The follow-up ranged from three to
      eighteen years with an average of eleven years. In all children the postoperative
      treatment consisted in the application of the Hanausek biomechanical apparatus.
      On the basis of clinical and roentgenological criteria the results were divided
      into fair and poor results. For fair result were considered the hips with a good
      range of motion (none of the motions was reduced more than by 50 percent of the
      normal range), patients did not feel any pain, the limb shortening did not exceed
      1 cm and the Trendellenburg test was negative. From the roentegonological
      viewpoint for fair were considered the findings without persisting subluxation
      and dislocation with the spheric head (the asphercity on the Moose template did
      not exceed 2 mm) and without evident shape deformities of the proximal end of the
      femur (coxa vara, overgrowth of the greater trochanter). Only such hips which
      meeted both the clinical and roentgenological criteria were evaluated in general
      as fair, the other were assessed as poor. On the basis of these criteria the
      result of the treatment was evaluated as fair in 76 percent and poor in 24
      percent of cases. The authors also observed the incidence of aseptic necrosis of
      the femoral head from the viewpoint of the types defined by Bucholz and Ogden.
      Necrosis of Type I was not found in the group, necrosis of Type II occurred 12
      times, necrosis of Type III and Type IV three times each. No evident connection
      was found out between the incidence of the necrosis of head and the ligation of
      both branches of a. circumflexa femoris medialis. The main cause of the
      impossibility to perform reduction was the isthmus of the joint capsula in its
      inferomedial portion in the area of iliofemoral ligament. Of decisive importance
      for the development of the joint after open reduction was a perfect reduction of
      the head into acetabulum.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2220229
TI  - [The status of infectious and parasitic morbidity and the priority tasks in its
      decrease].

PMID- 2220233
TI  - [Resection of the subtalar joint--long-term results].
AB  - In the years 1965-1985 212 patients were treated at the I. Orthopaedic Clinic in
      Brno by means of the resection sub talo. 100 patients with 105 operations were
      checked up on average 13 years after operation. The average age in the time of
      operation was 27. Indicated for operation were in 54 cases patients with
      neurologic deformity of the foot, in 51 cases patients with a local deformity.
      Reported were 65 good, 25 fair and 15 poor results. Residual deformity occurred
      in 12 patients and severe instability of the leg also in 12 cases. Eight patients
      suffered from moderate arthrosis of the joint ankle, three patients had severe
      arthrosis. Pseudoarthrosis in the area of resection was found in 5 cases. Prior
      to operation it is inevitable to examine the stability of the talus and anterior
      subluxation of the ankle joint. In cases of the instability of the talus ankle
      arthrodesis is indicated. The authors put emphasis on the release of soft tissues
      prior to or during the operation. The work proves longterm usefulness of the
      resection sub talo.

PMID- 2220232
TI  - [Results of surgical treatment of dislocation fractures of the ankle joint].
AB  - The authors have made evaluation of the surgical treatment of luxation fractures
      of the ankle in the period 1979-1987 in 105 patients (60 female, 45 male
      patients) in the age range from seventeen to eighty-one years, with the most
      frequent representation of the age group ranging from thirty-five to forty-five
      years. The group comprised 2,70 percent of fractures of type Weber A, 31.53
      percent of fractures of type Weber B and 65.77 percent of fractures of type Weber
      C. 53 percent of patients were operated on the day of injury, 24.8 percent of
      patients were transferred with a delay from other clinics and in the rest of the
      patients the timely operation was contraindicated because of the poor local or
      general condition. The results were processed according to a uniform worksheet by
      the computer. On the basis of the evaluation there were found out 87.62 percent
      of successful and 12.38 percent of poor results. 93.3 percent of patients resumed
      their original jobs and there was no patient eligible for a full disability
      pension. The main cause of failure was the osteoarthritis of the ankle joint
      found out in connection with the inaffestable factors (such as defects of
      cartilage, nature of the bone lesion, luxation of talus, age and sex of the
      patient) and affectable factors (infection, failure of osteosynthesis,
      pseudoarthrosis of medial malleolus, non-anatomical position in the area of
      tibiofibular syndesmosis). The incidence of these negative factors may be reduced
      by a timely operation, precise surgical strategy and technique and proper post
      operative treatment.

PMID- 2220234
TI  - [Osteomalacia. I. Review].
AB  - The authors present the survey of the history, diagnostics and treatment of
      osteomalacia with special treatment to Looser zone and Milkman syndrome. For the
      application in the clinical practice we recommend the bone index after McKenn.
      The authors point out favourable results of longterm vitamin D therapy.

PMID- 2220238
TI  - [Medical study in North America].

PMID- 2220237
TI  - [The formal aspect of scientific research].

PMID- 2220235
TI  - [Osteomalacia. II. The Milkman-Looser syndrome. Case report].
AB  - The authors present the case study of Milkman-Looser syndrome in a 83 years old
      female patient. The diagnosis was made on the basis of typical laboratory and X
      ray findings. The authors point out excellent curative effect of vitamin D.

PMID- 2220236
TI  - [Chondrodysplasia punctata].
AB  - Authors deal with the classification of chondrodysplasia punctata, in detail they
      analyze the clinical and radiomorphological symptoms. From the diagnostic
      viewpoint it is important to evaluate typical X-ray epiphyseal changes in the
      first year of age of the affected child. Clinical symptoms vary and they are not
      typical only for this disease. They are often combined with various congenital
      developmental anomalies. The case study presents the correlation between X-ray
      epiphyseal changes in the knee and the arthroscopic findings.

PMID- 2220239
TI  - Leopold G. Koss, M.D., F.I.A.C., 70th birthday.

PMID- 2220243
TI  - Peritoneal washing cytology in cervical carcinoma. Analysis of 109 patients.
AB  - The peritoneal washing cytologies of 109 patients (112 procedures) undergoing
      laparotomy for cervical carcinoma were evaluated retrospectively and compared
      with the clinical and pathologic findings. Nine patients (8.3%) had malignant
      peritoneal washings (including three of four with washings initially termed
      "inconclusive"). Four (4.9%) of the 82 patients with squamous carcinoma and 3
      (16.7%) of 18 with adenocarcinoma had positive washings. Five (5.6%) of 90
      washings obtained at initial explorations were positive, as compared with 4
      (18.2%) of 22 washings obtained as follow-up operations in recurrent cases. The
      111 peritoneal washing cytologies with a corresponding histologic evaluation of
      the peritoneal cavity showed a good correlation; peritoneal washing cytology had
      an efficiency of 91.0%, a sensitivity of 52.9% and a specificity of 100%. Two
      cases in which the cytologies were considered positive only after review had
      negative peritoneal histologies; both patients died of progressive disease within
      11 months. Peritoneal washing cytology was positive in 5 (5.9%) of 84 cases with
      FIGO stage 1 cancers, 2 (18.2%) of 11 cases with stage 2 cancers, 1 (33.3%) of 3
      cases with stage 3 cancers, and 1 (10%) of 10 cases with recurrent tumors. Eight
      (88.9%) of nine patients with malignant peritoneal washings died of disease from
      3 to 15 months following surgery; one showed no evidence of disease at 9 months.
      These results suggest that: (1) cervical carcinomas are infrequently associated
      with a positive peritoneal washing; (2) peritoneal washing cytology is more
      likely to be positive in cases of adenocarcinoma than in cases of squamous
      carcinoma; (3) peritoneal washings obtained at the time of surgery for recurrence
      are more likely to contain malignant cells than are washings obtained during
      initial exploration; (4) nonkeratinizing malignant squamous cells may be confused
      with reactive mesothelial cells; and (5) peritoneal washing cytology is a
      relatively insensitive technique for detecting advanced cervical disease, but
      correlates with a poor prognosis when positive.

PMID- 2220240
TI  - Colonic cytology. A retrospective study with histopathologic correlation.
AB  - Three hundred sixty cytologic specimens obtained by colonoscopic brushing from
      336 patients were compared with biopsy specimens simultaneously obtained for
      histologic examination. Of the cytologic specimens, 160 (44%) were positive for
      malignant cells, 37 (10%) contained suspicious cells, 54 (15%) had atypical
      glandular cells, 107 were cytologically negative, and 2 were considered
      unsatisfactory. Eight-four percent of the patients with cytologically positive
      smears and 54% of those with suspicious smears had malignant neoplasms in the
      simultaneously obtained tissue biopsies. Of the patients with follow-up, all with
      cytologically positive findings and nine with suspicious findings on the initial
      cytologic examination and simultaneous negative tissue biopsies, were
      subsequently found to have carcinoma of the colon. Cytology proved to have a
      sensitivity of 0.73 and a specificity of 1.00 while tissue biopsy showed a
      sensitivity of 0.81 and a specificity of 1.00. By combining the two methods, the
      sensitivity increased to 0.92. It is concluded that cytologic examination of
      colonic brushings is a highly accurate and reliable technique for the detection
      of malignant neoplasms of the colon and can preempt the use of biopsy forceps.

PMID- 2220241
TI  - Exfoliative colonic cytology. A simplified method of collection and initial
      results.
AB  - Exfoliative colonic cytology for the diagnosis of colorectal cancer has been
      largely abandoned due to (1) the widespread use of colonoscopy, (2) the
      cumbersome methods of cell collection and (3) the occasional difficulty of
      interpreting the cytologic findings in the presence of inflammatory bowel disease
      or adenomas. This paper describes a newly formulated bowel preparation for
      routine colonoscopy, based on imbibing 2 L to 4 L of a balanced electrolyte
      solution, in which the recovered precolonoscopic effluent (using a convenient
      disposable collecting kit) yielded cells for cytologic evaluation from 70% of a
      group of 80 patients at high risk for large bowel neoplasia. Cytology
      demonstrated neoplastic cells in most cases of endoscopically proven cancer.
      These results suggest that colonic exfoliative cytology may be useful as a
      supplemental test to routine colonoscopy. This could be enhanced by further
      methodologic modifications to the collecting and cytologic methods; large long
      term studies are needed to evaluate the potential usefulness of colonic
      exfoliative cytology.

PMID- 2220245
TI  - Fine needle aspiration cytology of squamous cell carcinoma of the breast.
AB  - A rare case of pure squamous cell carcinoma of the breast is reported in which
      the diagnosis was initially suggested by fine needle aspiration cytology. Smears
      and cell blocks of the aspirate showed atypical keratinized cells admixed with
      inflammatory cells. The diagnosis was confirmed by open biopsy. The excised tumor
      tissue was positive for both estrogen and progesterone receptors; flow cytometry
      showed a diploid DNA content and a high S-phase fraction.

PMID- 2220242
TI  - Fine needle aspiration cytology of pancreatoblastoma with immunocytochemical and
      ultrastructural studies.
AB  - The cytologic features of a pancreatoblastoma (infantile adenocarcinoma), a rare
      pancreatic neoplasm of childhood, are described. Fine needle aspiration (FNA)
      under ultrasound guidance produced a hypercellular specimen consisting of
      numerous oval-to-cuboidal cells that had a moderate amount of granular cytoplasm.
      Spindle-shaped, elongated and triangular-shaped epithelial cells were also seen,
      along with smaller cells that had a higher nuclear/cytoplasmic ratio and a denser
      cytoplasm. In addition, there were abundant fragments of stroma present,
      including some surrounded by epithelial cells. Immunoperoxidase studies performed
      on the aspirated material revealed positive staining of the epithelial cells for
      cytokeratin (AE1/3), including high and low molecular weight cytokeratin,
      carcinoembryonic antigen, neuron-specific enolase and alpha-1-antitrypsin.
      Ultrastructural examination demonstrated epithelial cells containing either large
      electron-dense zymogen granules in the range of 400 nm to 600 nm or small dense
      neuroendocrine granules measuring from 100 nm to 200 nm. This finding, in concert
      with the immunocytochemical studies, supported a "blastemal" cell origin with
      bidirectional differentiation for this unusual pancreatic neoplasm and enabled a
      specific preoperative diagnosis of pancreatoblastoma to be made. The differential
      diagnosis of pancreatoblastoma from other pediatric neoplasms involving the
      pancreas, including neuroendocrine tumors and neoplasms of acinar cell
      derivation, is presented. We believe that the FNA cytologic findings can lead to
      a correct diagnosis of pancreatoblastoma, especially when coupled with
      immunocytochemical and ultrastructural studies performed on the aspirated
      material.

PMID- 2220244
TI  - Density distribution, cytomorphologic features and immunologic characteristics of
      ovarian and endometrial clear cell carcinomas.
AB  - Three subpopulations of cancer cells with different morphologic features were
      separated by density gradient centrifugation of two ascitic fluids and one cystic
      fluid from one patient with ovarian clear cell carcinoma and one with endometrial
      clear cell carcinoma. Immunophenotypic analyses of isolated fractions using
      polyclonal and monoclonal antibodies against ovarian carcinoma-associated
      antigens revealed significant immunologic heterogeneity among the tumor cells.
      The identical histopathologic structures of the ovarian and endometrial clear
      cell carcinomas and the similar distribution and immunologic reactivity of the
      cell types isolated from the ascitic and cystic fluids confirmed the common
      histogenesis of both cancers. These findings suggest that the conventional
      cytologic diagnosis of clear cell carcinomas could be supplemented by
      immunofluorescent staining. Density gradient centrifugation appeared to be a
      useful method for the separation of mesothelial cells.

PMID- 2220246
TI  - Recurrent Hodgkin's disease in the breast. Diagnosis of a case by fine needle
      aspiration and immunocytochemistry.
AB  - Recurrent Hodgkin's disease involving the breast in a 17-year-old girl was
      diagnosed by fine needle aspiration (FNA) biopsy of a solitary mass that
      developed one year after "curative" radiation. Benign breast disease and breast
      carcinoma were ruled out upon cytologic examination of the FNA smears, which
      contained diagnostic Reed-Sternberg cells and the characteristic polymorphic
      background elements. Follow-up immunoperoxidase staining for Leu-M1 on destained
      smears confirmed the diagnosis. Definitive therapeutic measures were initiated
      after the FNA diagnosis.

PMID- 2220247
TI  - Fine needle aspiration biopsy of the breast. Influence of the number of passes
      and the sample size on the diagnostic yield.
AB  - The sensitivity of fine needle aspiration (FNA) biopsy of the breast as a
      function of the number of aspirations performed on any given lesion was
      investigated. Four separate aspirations each were performed on over 400 lesions
      of the breast, 93 of which yielded a cytologic diagnosis. The incremental
      diagnostic yields of each subsequent aspiration were tabulated. The first
      aspirate of the sequence gave the greatest yield, with smaller incremental yields
      on the second through the fourth aspirates. Benign and malignant lesions gave
      similar results, as did palpable and nonpalpable lesions (the latter being
      usually smaller in size). A mathematical extrapolation of the data indicates that
      three or four aspirations of any given lesion provide the optimal yield within
      the limits of practicality. This performance of multiple FNA biopsies is
      particularly important when the pathologist does not perform the biopsy, or is
      unable to assist in the immediate interpretation of the specimen to assess its
      adequacy.

PMID- 2220250
TI  - Suction sampling technique for obtaining standardized cytologic specimens from
      the oral mucosa.
AB  - To enhance the value of exfoliative cytology for the study of the oral mucosa, a
      simple apparatus was developed to permit adequate sampling of a specific site so
      that samples collected on different occasions could be compared. The device
      essentially consists of a collecting cup connected to a blood collection
      evacuation system. The collecting cup is a modified female half of a stainless
      steel filter holder supporting a 13-mm-diameter cellulose filter of 0.05-microns
      pore size. Suction pressure is applied by means of a 10-mL glass tube of
      premeasured vacuum. After positioning the collecting cup on the selected site on
      the buccal mucosa, the vacuum (440 mm Hg) is applied for five seconds. The mucosa
      is drawn in against the filter, producing a monolayered imprint of cells. This
      sample may be disengaged from the filter by agitation into a solution; this
      allows quantitative cytologic studies, such as the measurement of cell numbers by
      an electronic counter or the estimation of the areas of cells and nuclei by
      computer-aided image analysis of Cytospin preparations. Five separate samplings
      from each of three test subjects produced a harvest of 3,000 to 7,000 epithelial
      cells per sample; the cellular areas ranged from 784 to 1,052 sq microns while
      the nuclear areas ranged from 18.4 to 21.8 sq microns.

PMID- 2220248
TI  - Fine needle aspiration cytology of bone lesions. Analysis of a three-year
      experience in rural Africa.
AB  - FNA biopsies were performed on 24 patients with bone lesions. Cytology diagnosed
      ten of the cases as classic Burkitt's lymphomas. The cytodiagnoses in the
      remaining 14 cases were primary bone tumors (5 cases), bone cysts (2 cases),
      inflammatory lesions (4 cases) and inadequate material (3 cases). Smears of the
      Burkitt's lymphomas of the jaw contained starry sky macrophages and neoplastic
      lymphoid cells with deep basophilic cytoplasms and fine vacuolizations. Taking
      into consideration the load of Burkitt's lymphoma cases in Africa, FNA cytology
      appears to be a very simple method for getting a quick tissue diagnosis (results
      were available within 24 hours). For doctors working in tropical hospitals with
      limited facilities, FNA cytopathology is very useful for distinguishing between
      tumors and inflammations and for differentiating between benign and malignant
      tumors.

PMID- 2220249
TI  - Inflammatory pseudotumor of the lung diagnosed as granulomatous lesion by
      preoperative brushing cytology. A case report.
AB  - The clinical and cytologic features of a case of inflammatory pseudotumor of the
      lung are presented. Chest roentgenograms revealed a solitary circumscribed round
      mass in a nine-year-old boy. The mass was diagnosed as a granulomatous lesion by
      bronchoscopic brushing cytology. Although smears and cultures of sputum and
      brushing specimens were negative for tuberculosis, a tuberculin reaction was
      positive and antitubercular therapy was instituted. Since the mass had grown
      further after six months of therapy, an open lung biopsy was performed to resect
      the lesion and establish the diagnosis. Imprint smears of the cut surface of the
      lesion showed cytologic features similar to those of the brushings: short,
      spindle-shaped cells with a tendency to be arranged in stori-form patterns
      against a background of minimal necrotic debris. Histopathology established the
      final diagnosis of inflammatory pseudotumor, a rare granulomatous lesion
      radiologically resembling a true tumor. Since this lesion usually occurs in
      younger patients, inflammatory pseudotumor should be considered in pediatric
      cases with an intrapulmonary lesion that shows histiocytic spindle-shaped cells
      in stori-form patterns, but whose smears and cultures test negative for
      tuberculosis.

PMID- 2220251
TI  - 38th annual scientific meeting of the American Society of Cytology. Washington,
      D.C., November 7-11, 1990. Abstracts.

PMID- 2220253
TI  - Cytologic findings in spermatic granuloma.

PMID- 2220254
TI  - Megakaryocytes in a fine needle aspirate of the thyroid gland.

PMID- 2220252
TI  - Detached ciliary tufts in the aspirates of spermatoceles.

PMID- 2220256
TI  - The molecular and cellular biology of platelet-derived growth factor.

PMID- 2220255
TI  - Fine needle aspiration biopsy in the diagnosis of liver echinococcosis.

PMID- 2220260
TI  - Renal tubular reabsorption of calcium and sodium in primary hyperparathyroidism.
AB  - Nine patients with primary hyperparathyroidism were studied to investigate the
      renal tubular reabsorption of calcium and sodium. Fasting serum and urine samples
      were analysed, and the glomerular filtration rate and the renal plasma clearance
      of lithium were determined simultaneously. Comparison was made with 9 age- and
      sex-matched normocalcemic controls. In the proximal tubule, there was a
      significantly higher absolute reabsorption of calcium in patients than in
      controls, whereas the fractional reabsorption rate of calcium did not differ
      between the two groups. In the distal tubule, the absolute calcium reabsorption
      rate was significantly higher in the patients, whereas the fractional
      reabsorption rate of calcium was significantly lower than in controls. In the
      patient group there was a significantly positive linear correlation between the
      increased tubular capacity for calcium reabsorption and the absolute proximal
      calcium reabsorption rate, but not between the increased capacity and the
      absolute distal calcium reabsorption rate. No significant differences were found
      in the renal tubular handling of sodium between patients and controls. Our
      results suggest that the increased capacity for tubular calcium reabsorption in
      primary hyperparathyroidism mainly is localized in the proximal tubule, and that
      the renal tubular handling of calcium and sodium in this disease differs from
      that in familial hypocalciuric hypercalcemia.

PMID- 2220258
TI  - Pyridostigmine partially restores the GH responsiveness to GHRH in normal aging.
AB  - In 11 elderly normal subjects and in 17 young healthy subjects we studied the
      response of plasma growth hormone to GH-releasing hormone (GHRH(29), 1
      microgram/kg iv) alone and preceded by pyridostigmine (120 mg orally 60 min
      before GHRH), a cholinesterase inhibitor likely able to suppress somatostatin
      release. The GH response to pyridostigmine alone was also examined. Basal plasma
      GH levels were similar in elderly and young subjects. In the elderly, GHRH
      induced a GH rise (AUC, median and range: 207.5, 43.5-444.0 micrograms.l-1.h-1)
      which was lower (p = 0.006) than that observed in young subjects (548.0, 112.5
      2313.5 micrograms.l-1.h-1). The pyridostigmine-induced GH rise in the elderly was
      similar to that in young subjects (300.5, 163.0-470.0 vs 265.0, 33.0-514.5
      micrograms.l-1.h-1). Pyridostigmine potentiated the GH responsiveness to GHRH in
      both elderly (437.5, 152.0-1815.5 micrograms.l-1.h-1; p = 0.01 vs GHRH alone) and
      young subjects (2140.0, 681.5-4429.5 micrograms.l-1.h-1; p = 0.0001 vs GHRH
      alone). However, the GH response to pyridostigmine + GHRH was significantly lower
      (p = 0.0001) in elderly than in young subjects. In conclusion, the cholinergic
      enhancement by pyridostigmine is able to potentiate the blunted GH response to
      GHRH in elderly subjects, inducing a GH increase similar to that observed after
      GHRH alone in young adults. This finding suggests that an alteration of
      somatostatinergic tone could be involved in the reduced GH secretion in normal
      aging. However, a decreased GH response to combined administration of
      pyridostigmine and GHRH in elderly subjects suggests that other abnormalities may
      coexist, leading to the secretory hypoactivity of somatotropes.

PMID- 2220257
TI  - Thyroid hormones and thermogenesis: a microcalorimetric study of overall cell
      metabolism in lymphocytes from patients with different degrees of thyroid
      dysfunction.
AB  - We used microcalorimetry to measure lymphocyte heat production rate in patients
      with clinical and laboratory hyperthyroidism (serum TSH decreases, serum FT4
      increases, serum FT3 increases), subclinical hyperthyroidism (serum TSH
      decreases, serum FT1 increases, serum FT3 =), and subclinical hypothyroidism
      (serum TSH increases, serum FT4 decreases, serum FT3 =) compared with healthy
      controls (N = 13). The lymphocyte heat production rate was significantly
      correlated to the free thyroxine level (r = 0.53, p less than 0.01) and to the
      free triiodothyronine level (r = 0.51, p less than 0.01) when calculated from
      pooled data for the three patients groups. The hyperthyroid patients (N = 8) had
      a significantly increased lymphocyte heat production rate, 3.43 +/- 0.25 pW/cell,
      as compared with 2.31 +/- 0.12 pW/cell in the control group (p less than 0.001).
      The groups with subclinical hyperthyroidism (N = 7) and subclinical
      hypothyroidism (N = 9) had lymphocyte heat production rates of 2.14 +/- 0.11 and
      2.56 +/- 0.15 pW/cell, respectively, not significantly different from that in the
      controls. Consistently, there was no significant difference between patients with
      subclinical hyperthyroidism (N = 5) and controls (N = 5) with regard to
      lymphocyte energy production as calculated from separately measured oxygen
      consumption rates in vitro, 1.36 +/- 0.20 and 1.56 +/- 0.12 pW/cell,
      respectively. Thus microcalorimetry seems to be suitable for studying the
      influence of thyroid hormones on cellular metabolism. Subclinical thyroid
      dysfunction does not seem to alter the overall rate of lymphocyte metabolism.

PMID- 2220261
TI  - Epidermal growth factor in mice: effects of estradiol, testosterone and
      dexamethasone.
AB  - To clarify the influence of steroids on the metabolism of epidermal growth
      factor, we studied the effects on its concentrations in adult male and female
      mice of 1. gonadectomy, 2. postgonadectomy treatments with estradiol and
      testosterone, and 3. treatment with dexamethasone. We also measured its mRNA
      levels in submandibular salivary glands and kidneys after ovariectomy. After
      gonadectomy, the male mice had 1.4-fold higher mean epidermal growth factor
      concentration in the urine than the female, in contrast to a 1.5-fold reverse
      difference in intact mice; the female mice had 2.5-fold higher concentration in
      the submandibular glands than the male animals, in contrast to a 4.5-fold reverse
      difference in intact mice. The kidney sex difference of intact mice (male greater
      than female) was abolished. In both gonadectomized sexes, treatment with
      testosterone increased the concentration of epidermal growth factor in plasma and
      the submandibular gland; treatment with estradiol increased the concentration in
      urine and decreased it in the submandibular gland. Treatment with dexamethasone
      decreased the concentration of epidermal growth factor in plasma of the male
      mice, and in urine of the female mice, thus decreasing the sex differences. In
      the submandibular gland and the kidneys, dexamethasone increased the
      concentration. The mRNA levels were higher in the submandibular gland and lower
      in the kidneys in the ovariectomized than in the intact female mice. The effects
      of sex steroids on epidermal growth factor concentrations are mediated through
      modulation of its gene activity. Testosterone has an increasing and estradiol a
      decreasing effect in the submandibular gland. Estradiol has also an increasing
      effect in the kidneys.

PMID- 2220259
TI  - Physical and psychological capabilities during substitution therapy with
      recombinant growth hormone in adults with growth hormone deficiency.
AB  - In a double-blind cross-over study with recombinant methionyl growth hormone (GH)
      and placebo during 12 weeks, the effect of GH substitution therapy (0.5-06 IU.kg
      1.week-1) on physical performance, muscle strength, bone mineral density, and
      mood and cognitive functions was investigated in 6 GH-deficient adults. During GH
      substitution serum concentrations of insulin-like growth factor-I and procollagen
      III peptide increased in all 6 patients, whereas concentrations of serum urea
      decreased. Five of the patients identified the GH period and reported improved
      well-being with increased mental alertness and vitality and improved physical
      capacity and muscle strength. There was, however, no change of the isokinetic
      muscle strength during GH substitution therapy, and the working capacity on the
      bicycle ergometer was just slightly improved in some patients. The bone mineral
      density was low and unchanged in all patients. Mood and cognitive functions did
      not change during GH therapy. A reversible fluid retention was observed in one
      patient during the GH period. In conclusion, short-term GH substitution therapy
      to GH-deficient adults induced a subjective improvement of general well-being.
      Longer treatment periods will be necessary to establish the effect on physical
      capacity, muscle strength, bone mineral density, and mood and cognitive
      functions.

PMID- 2220262
TI  - Characterization of cytosolic female rat liver receptors of the lactogenic type.
AB  - Some properties of cytosolic receptors of the lactogenic type from female rat
      liver were studied and compared with those of membrane-bound (microsomal)
      receptors. The association constant between the cytosolic receptors and human
      growth hormone was 2.2 l/nmol, which was not significantly different from the
      value obtained for the microsomal receptors (3.6 l/nmol). Since unlabeled hGH and
      human prolactin, but not bovine growth hormone, displaced [125I]hGH bound to
      receptors from both sources, the cytosolic receptors, like the microsomal
      receptors, must be lactogenic. Furthermore, the cytosolic receptors were
      recognized by a monoclonal antibody raised against microsomal receptors from
      female rat liver. However, covalent cross-linking of cytosolic receptors to
      [125I]hGH and subsequent sodium dodecyl sulphate electrophoresis gave a single
      band corresponding to a molecular weight of 42,200 (after subtraction of the
      molecular weight of hGH), which differs significantly (p less than 0.01) from the
      values determined for the two distinct bands given by the microsomal fraction.
      Moreover, upon molecular sieve chromatography the receptor activity in the two
      fractions appeared at significantly (p less than 0.05) different elution volumes.
      These results show that the cytosolic and microsomal receptors have some
      structural features in common but are definitely not identical.

PMID- 2220268
TI  - [Plasma membrane separation. A therapeutic possibility in thyrotoxic crisis].
AB  - A case of thyroid storm is presented, successfully treated with a combination of
      antithyroidal drugs and plasma exchange. A 280% separation removed 447 micrograms
      T4 and 12 micrograms T3. During separation, the elevated T4 and T3 values
      returned to normal. Basic concepts of plasma membrane separation investigated by
      plasma and whole body counting after administration of 131I-T4, as well as
      radioimmunoassay measurement of thyroid hormones in plasma and separate are
      discussed.

PMID- 2220265
TI  - [Bier's occlusion. An unjustly neglected therapeutic possibility in resistant
      tissue defects of the extremities].
AB  - The retrograde intravenous pressure infusion into an arterially occluded segment
      of an extremity (Bier's technique) is the most effective method to achieve
      maximal tissue concentrations of a drug. This was proven by nuclear medical
      examinations. By application of contrast-medium it was shown that the injected
      fluid penetrates in a retrograde direction into the foot inspite of primarily
      intact valves. A second important mechanism of action is the haemodynamic
      consequence of an arterial occlusion which is characterized not only by an
      immediate reactive hyperaemic response but also by a delayed increase of blood
      flow after several days. Favourable clinical results were obtained with
      antibiotics in infected gangrene of the feet or in necrotizing erysipelas and
      with urokinase in resistant leg ulcers.

PMID- 2220264
TI  - [Assessment of different clearance mechanisms of the lung using factor analysis].
AB  - Measurement of epithelial clearance over the lungs is always influenced by
      mucociliary transport since the lung is a 3-dimensional organ where ciliated and
      respiratory epithelia overlap. Factor analysis provides factor images and time
      activity curves of extracted physiological factors corresponding to specific
      structures, even if these structures overlap. In 16 inhalation studies of 99m Tc
      DTPA aerosol, factor analysis always extracted 2 factors with opposite temporal
      behavior, one corresponding to epithelial and one to mucociliary transport.
      Clearance rates measured over the lungs were significantly lower than epithelial
      transport-related factor curve values (1.35%/min vs 2.2%/min), but were identical
      with the clearance rates of the sum of both factors plus factor background.
      Factor analysis allows quantitative assessment of epithelial transport without
      interference of other clearance mechanisms and should be evaluated further in
      different pulmonary disorders.

PMID- 2220263
TI  - Calcitonin causes a sustained inhibition of protein kinase c-stimulated bone
      resorption in contrast to the transient inhibition of parathyroid hormone-induced
      bone resorption.
AB  - Calcitonin is a well known inhibitor of osteoclastic bone resorption, both in
      vivo and in vitro. However, it is also known that calcitonin has only a transient
      inhibitory effect on bone resorption. The mechanism for this so-called "escape
      from inhibition" phenomenon is not clear. In the present study, the inhibitory
      effect of calcitonin on phorbol ester-induced bone resorption was examined in
      cultured neonatal mouse calvaria. Bone resorption was assessed as the release of
      radioactivity from bones prelabelled in vivo with 45Ca. Two protein kinase C
      activating phorbol esters, phorbol-12-myristate-13-acetate and phorbol-12,13
      dibutyrate, both stimulated 45Ca release in 120-h cultures at a concentration of
      10 nmol/l. Calcitonin (30 nmol/l) inhibited phorbol ester-stimulated bone
      resorption without any "escape from inhibition". This was in contrast to the
      transient inhibitory effect of calcitonin on bone resorption stimulated by
      parathyroid hormone (10 nmol/l), prostaglandin E2 (2 mumol/l), and bradykinin (1
      mumol/l). Our results suggest that activation of protein kinase C produces a
      sustained inhibitory effect of calcitonin on bone resorption.

PMID- 2220267
TI  - [Immunoscintigraphic follow-up studies with the 99m-Tc marked monoclonal anti-CEA
      antibody BW 431/26].
AB  - Repeated immunoscintigraphy with murine monoclonal antibodies was performed in
      only few patients because of developing HAMA (Human Anti Mouse Antibodies) and
      therefore high risk of allergic reactions. Patients with HAMA, which could be
      observed in about 26% after immunoscintigraphy, show high liver-spleen uptake of
      labeled monoclonal antibodies in further examinations in some cases.

PMID- 2220266
TI  - [Blood-pool-SPECT for imaging portosystemic collaterals in portal hypertension].
AB  - In 46 patients, 26 male and 20 female, age from 32 to 71 years (mean 47.4 +/- 11
      years) a bloodpool-scintigraphy (BPS) with SPECT (single photon emission computed
      tomography) was performed. The in-vivo labelling of the erythrocytes with
      pyrophosphate and Tc-99m was performed in the usual way. The SPECT investigations
      were performed with a digital Anger-Camera (Elscint; Apex 401). In 14 patients
      without collaterals BPS was performed to compare the method with patients with
      liver diseases and collaterals. 29 patients with liver cirrhosis and portal
      hypertension were investigated with the BPS and additionally a
      scintisplenoportography (SSP) was performed. In patients with only cephalad
      collaterals all the results were concordant. In just 1 patient with cephalad and
      caudad collaterals we found a discordant result. In 8 patients we performed BPS,
      SSP and a katheterangiography (KA). Taking the KA as the "golden standard" we
      found a concordant result with the 3 methods in all patients with cephalad
      collaterals. In patients with cephalad and caudad collaterals we once found a
      discordant result with the SSP and twice with the BSP. In 2 patients the patency
      of surgical shunts were proved. 2 patients after sclerosis of the oesophageal
      varices have been proved by BPS and SSP and both patients showed good
      therapeutical results.

PMID- 2220271
TI  - [The 21st annual meeting of the Austrian Society for Internal Medicine.
      Abstracts].

PMID- 2220272
TI  - A service to members: the QA consultant.

PMID- 2220270
TI  - [Nuclear medicine measurement of the contractile activity of the stomach antrum
      using factor analysis].
AB  - The motor activity of the gastric antrum is difficult to record by manometric
      means and scintigraphic methods have proved unsatisfactory so far as no
      consistent relationship between antral contractile activity and gastric emptying
      rate could be detected. We investigated, using data recorded in 16 healthy human
      subjects after the ingestion of a semisolid standard meal, whether a newly
      developed method employing factor analysis would yield more meaningful and
      reproducible results. Factor analysis was applied to sequential scintigraphic
      images (3-s frame time) of the gastric antrum. The computed factor images and the
      respective factor curves are representative of distinct dynamic structures of the
      antrum. From the more or less sinusoidal excursions of the factor curves, which
      exhibited the 3 cycles per minute frequency characteristic for the stomach,
      amplitude, frequency and propagation velocity of antral contractions can be
      calculated. The amplitudes of the factor curves were used to calculate a
      contraction index. This contraction index was found to be correlated
      significantly negatively with the gastric half-emptying time of the ingested
      meal. The employed factor analytical approach thus seems a promising tool to
      further investigate the role of antral contractility in the process of gastric
      emptying.

PMID- 2220273
TI  - The standards review project.

PMID- 2220275
TI  - Law and the abused woman.

PMID- 2220274
TI  - Caring for the disoriented older person: the family caregiver's perspective.

PMID- 2220276
TI  - Oncology nurses: affecting the journey.

PMID- 2220278
TI  - Is quality assurance dead?

PMID- 2220281
TI  - Law and the abused woman. Part two.

PMID- 2220277
TI  - 1991 75th anniversary AARN: our history--a proud heritage. The 1930's--dirty and
      depressing.

PMID- 2220280
TI  - Pain corner: chronic pain? Have you considered the stepwise approach?

PMID- 2220279
TI  - An ethnography of the spinal cord injury unit. Part one.

PMID- 2220269
TI  - [Clinical significance of Tl-201/Tc-99m subtraction scintigraphy as a parameter
      for surgical indication of cold struma nodules].
AB  - In a retrospective study Tl-201/Tc-99m subtraction scintigraphy (method acco. to
      Ferlin et al.) was performed in addition to Tc-99m scintigraphy, sonography and
      fine needle puncture in 400 patients. Postoperative histological evidence was
      available of all patients (carcinomas [n = 31], follicular and oncocytic adenomas
      [n = 235], nodular hyperplasia, Hashimoto's thyroiditis, Riedel's struma and de
      Quervain's thyroiditis [n = 134]). With regard to possible malignancy the
      sensitivity, in case of positive Tl-201 uptake was 85%. As however, adenomas also
      have a high tendency towards isolated Tl-201 uptake, the specificity for
      malignant growth was 62%. Thus Tl-201/Tc-99m subtraction scintigraphy is well
      suited as a criterion to exclude thyroid carcinomas; on the other hand, a
      positive Tl-201 uptake is not a fail-safe indication of malignant processes. At
      best it suggests the occurrence of autonomous growth and can thus, in addition to
      sonography and fine needle biopsy, serve as an aid in the decision as to whether
      surgical intervention is indicated.

PMID- 2220282
TI  - Medication administration.

PMID- 2220283
TI  - Background paper regarding abuse of nurses in the workplace.

PMID- 2220286
TI  - Early changes in the rat pancreatic B cell size induced by glucose.
AB  - The perimeter, cell area and volume density (Vvi) of B cells and exocytotic
      images present in these cells were measured in rat pancreas perfused with 3.3 or
      16.6 mM glucose. Four minutes after the beginning of 16.6-mM glucose perfusion
      and coincident with the appearance at the apex of the first phase of insulin
      secretion, all these parameters underwent a significant increase. The changes
      observed in the perimeter, the cell area and the Vvi of B cells suggest an
      increase in their surface area. An imbalance in the rate of
      endocytosis:exocytosis processes with a relative predominance of the latter would
      increase the length of the plasma membrane and could be responsible, at least
      partly, for the changes in the B cell size.

PMID- 2220284
TI  - Comparing the somal size and nuclear positions of the monkey stellate and coeliac
      ganglion cells.
AB  - The stellate and coeliac ganglia of 2 Macaque monkeys were cut serially at 1
      micron thickness and analysed. Results from the analysis of 82 stellate and 60
      coeliac ganglion cells in 1 monkey show that in cross-sections, the neuronal
      nuclei may be eccentric, centric or nearly centric and remain so throughout the
      longitudinal extent of the neuron. In both ganglia, the majority of neurons
      possess eccentric nuclei, but in the coeliac ganglion, the percentage of neurons
      with centric and/or nearly centric nuclei is higher (41.7%) than that in the
      stellate ganglion (26.3%). While 5% of neurons in the coeliac ganglion are
      binucleated, no binucleated neurons were found in the stellate ganglion. The
      somal size ranges of the stellate (10-39 microns) and the coeliac (14.5-45
      microns) ganglion neurons as obtained from both monkeys are quite close. The
      percentage frequency distribution of the stellate ganglion neurons in monkey 1
      was also quite similar to that of the coeliac ganglion neurons. It is concluded
      that different neuronal size is not likely to be associated with different target
      organs.

PMID- 2220287
TI  - [Ultrastructure of the substantia spongiosa of the femur head and talus].
AB  - The results of the SEM examination of the zone between the cartilage and the
      spongeous substances are described precisely. For the first time, W. Lierse
      examined the 'tensulae' of calcium-collagen lamellae by light microscopy. The
      examination of this zone was initiated by the fact that the hydrodynamic flow can
      take place in the calcified zone of the cartilage which is filled with synovial
      fluid and that the calcified zone adheres to the subchondral substantia
      corticalis. The subchondral corticalis is characterized by funnel-like
      indentations with a high number of calcium-collagen and chondrocyte 'tensulae'
      which are up to now uncounted. The special aim was to locate the separation of
      the space of adipose and arterial supplies.

PMID- 2220288
TI  - Comparative electron microscopy of chorio-allantoic placental barrier in some
      Indian Chiroptera.
AB  - In the present study the comparative ultrastructure of the definitive chorio
      allantoic placental barrier has been studied in considerable detail in six
      species of bats, representing six different families and both suborders of
      Chiroptera, by electron microscopy, and these species illustrate different kinds
      of interhaemal membranes met with among bats. The definitive chorio-allantoic
      placenta of Rousettus leschenaulti is haemodichorial, since the
      syncytiotrophoblast and cytotrophoblast layers are present to term. The fine
      structure of the placental barrier in the labyrinth of the definitive placenta of
      Rhinopoma hardwickei hardwickei is essentially endotheliomonochorial due to the
      presence of a single layer of cytotrophoblast and maternal endothelial cells. The
      placenta of Taphozous melanopogon, examined electron-microscopically in the
      present study, shows a thick maternal endothelium, a continuous interstitial
      membrane and the presence of a single layer of syncytiotrophoblast. The placenta
      of Megaderma comprises a typical endotheliochorial labyrinth and the presence of
      two layers of trophoblast. In Rhinolophus rouxi, the mature placenta during
      advanced pregnancy resembles that of Megaderma, its labyrinth containing large
      maternal capillaries with maternal endothelial cells and the two layers of
      trophoblast. Finally, the placental barrier of Hipposideros fulvus fulvus is
      haemodichorial due to the presence of two layers of trophoblast and the absence
      of maternal endothelial cells.

PMID- 2220289
TI  - Ultrastructure of interstitial cells of Cajal at the gastro-oesophageal junction
      of the monkey (Macaca fascicularis).
AB  - The ultrastructure of the interstitial cells of Cajal (ICC) in the oesophagus of
      the monkey resembled that described in the oesophagus of other mammalian species
      but differed in their paucity and almost lack of smooth endoplasmic reticulum,
      caveolae and filaments. The plasmalemma of the ICC was in close contact (20- to
      30-nm gaps) with that of smooth muscle cells. This may occasionally take the form
      of a desmosome, but gap junctions have not been observed. Vesiculated axon
      profiles, containing large granular or agranular vesicles were in close contact
      (20- to 30-nm gaps) with the plasmalemma of ICC. In a few vesiculated profiles a
      presynaptic density could be recognized. The intercalation of the ICC between the
      vesiculated axon profiles and the smooth muscle cells suggest a role in
      oesophageal motility. Between 3 and 21 days following bilateral vagotomy some ICC
      showed regressive changes such as increased electron density and shrinkage of the
      cytoplasm, crowding of the organelles and dissolution of the nuclear chromatin
      material. Axon profiles in the vicinity of the affected ICC contained glycogen
      granules suggesting injury. In late stages, the number of ICC and smooth muscle
      contacts was reduced. The results suggest that the vagus nerves exert a trophic
      influence on the ICC and that the intercellular relationships between ICC and
      smooth muscle cells possess a degree of plasticity. It is tentatively suggested
      that these vagal effects may be mediated via the oesophageal myenteric ganglia.

PMID- 2220290
TI  - Acetylcholinesterase activity of developing muscles in the lower limb of the rat.
AB  - A cytochemical study of acetylcholinesterase was done in the lower limb of the
      prenatal rat and in the gastrocnemius muscle of the postnatal rat. Between 15 and
      17 days of gestation, mesenchymal cells constituting the muscle primordia are
      characterized by the presence of enzyme activity in their rough endoplasmic
      cisterns and nuclear envelopes, while those involved in the formation of the
      neocapillary and cartilage do not show enzyme activity. This suggests that
      mesenchymal cells destined to myogenic cells actively produce
      acetylcholinesterase in a limited period, which may play a role in cellular
      aggregation and fusion during the muscular morphogenesis. Cytochemical findings
      as to extensive networks of secondary synaptic folds of the neuromuscular
      junctions and invaginations of the sarcolemma in the extrasynaptic regions are
      also illustrated in the differentiating gastrocnemius muscles.

PMID- 2220293
TI  - Myocardial fiber architecture in the human heart. Anatomical demonstration of
      modifications in the normal pattern of ventricular fiber architecture in a
      malformed adult specimen.
AB  - Ventricular myocardial fiber architecture has been considered an important factor
      in heart dynamics. Most anatomical studies however have focussed on the analysis
      of normal hearts. The present study compares ventricular myocardial fiber
      architecture patterns in dissections of 5 normal hearts and a malformed human
      heart with membranous ventricular septal defect, overriding right aorta, pulmonic
      stenosis, with absent pulmonary valve and hypertrophied right ventricle.
      Qualitative and quantitative changes in ventricular myocardial fiber architecture
      were noted in the malformed heart.

PMID- 2220291
TI  - The milky spots on the chest wall in newborns.
AB  - The histologic properties of pleural adipose organs were studied in 14 newborns.
      These organs contain milky spots, in which lymphocytes, macrophages and
      plurivacuolated fat cells are present. The milky spots have a mesothelial
      covering, persist to the age of 9 months and seem to act as defence devices and a
      site of fluid exchange.

PMID- 2220294
TI  - Early evaluation of postmenopausal hormonal steroid therapy by scanning electron
      microscopy of the uterine epithelium.
AB  - Scanning electron microscopy has been used in a preliminary study to evaluate the
      value of steroid replacement therapies in restoring uterine epithelium in
      postmenopausal patients. All therapies resulted in increased epithelium over
      controls, but one regime was markedly better than others.

PMID- 2220296
TI  - Lymphocyte blastogenesis and lepromin reactivity in leprosy patients and their
      parents.
AB  - To determine whether there is an inherited familiar trait linked to the
      lymphocyte blastogenesis test (LTT), under stimulation with PHA, lepromin and
      Mycobacterium leprae in culture medium containing autologous plasma, this test
      was carried out in patients with the polar forms of leprosy and their parents.
      The lepromin reaction was also studied in the patients and their parents because,
      since the test is negative in lepromatous (L) patients and a greater proportion
      of negativity is detected among their relatives, it might be assumed that the
      lymphocytes of these individuals could have a lower tendency towards
      blastogenesis than lymphocytes of tuberculoid (T) patients and their relatives.
      Thirty individuals were studied, ten of them being leprosy patients (4 L and 6 T)
      and the remaining their parents; 115 LTT, including control and stimulated
      cultures, were performed. In the limited number of patients and parents studied,
      the results showed that mothers of either L or T patients displayed a similarly
      low response to the stimulants M. leprae and lepromin. The lepromin reaction was
      negative in all L patients and positive in 3 out of 8 parents, as well in all the
      T cases and their fathers. Fathers and their T descendants were lepromin positive
      and there was a certain relationship between this reactivity and blastogenesis.
      This might suggest a possible inherited familiar trait related to a relative
      degree of resistance. However, further evidences from studies with larger number
      of subjects are required to support this hypothesis.

PMID- 2220295
TI  - [Late reversal reactions in leprosy].
AB  - Since the application of short duration multidrug therapy (MDT) in leprosy, it
      has been reported that reversal reactions (RR) may occur after withdrawal of
      treatment. Surprisingly, such "late reversal reactions" have quite never been
      described after monosulphonotherapy. Such RR, especially in endemic areas, may
      represent diagnostic and therapeutic difficult problems. We report 5 cases of
      late RR. In 4 cases (1 BT patient and 3 BL-LLs patients), the RR occurred 1 month
      1/2 to 3 years after cessation of MDT. In the last case (form LLs), the RR
      happened 6 months after that a 14 years monosulphonotherapy has been stopped.
      These observations strengthen the need of a complete clinical, bacteriological
      and immunological evaluation at the time of the diagnostic, more useful than a
      single bacteriological study, to differentiate late RR from relapses. Moreover,
      the last case confirms that late RR may occur after monosulphonotherapy.

PMID- 2220292
TI  - Size of the fibrillar centres of the nucleoli in the supraoptic nucleus of the
      rat taking the Swiss cheese effect into account.
AB  - The size of the fibrillar centres (FC) in nucleoli was investigated taking the
      Swiss cheese effect into account. Electron microscopy was performed on the
      neurons of the rat supraoptic nucleus after the secretion of vasopressin had been
      fully suppressed by water load, after the secretion had been stimulated by water
      deprival and in normal rats with water ad libitum. When the secretory activity
      was suppressed from a normal level to approximately no activity, the size of the
      individual FC was doubled. Moreover, with increasing secretory activity the
      number of FC per cell increased.

PMID- 2220297
TI  - [Evaluation of 7 years of systematic surveys of leprosy in Morocco].
AB  - Between 1980 and 1987, 12 systematic surveys were made on a population of 254,979
      people, of whom 236,868 were actually examined (92.61%). 422 suspected cases were
      identified i.e. a global detection rate of 1.66% of which only 241 reported to
      Ain-Chock Hospital for further tests (55%). Out of these 241 suspected cases, 217
      proved as having leprosy, i.e. a 90% correlation between the clinical suspicion
      and the biological identification. The 181 suspected cases who never reported to
      the hospital and the 16 leprosy patients whom we lost sight of constitute as a
      whole 46.68% of the suspected cases first identified. This shows an obvious lack
      of coordination between the local Authority and the medical service. The 185
      confirmed cases of leprosy are shown in the table below and compared with those
      of the Central Statistical Office.

PMID- 2220285
TI  - Chronic hyperglycemia in experimental diabetes mellitus of short duration does
      not contribute to muscle capillary basement membrane thickening.
AB  - The effect of chronic hyperglycemia on the relationship of nonenzymatic glycation
      and capillary basement membrane thickness in muscle was studied in streptozotocin
      induced diabetic rats early in the course of diabetes mellitus. Diabetic animals
      were placed on either standard (24%) or restricted (8%) protein diet. The animals
      on 8% protein diet had elevated glycated hemoglobin levels (p less than 0.01) and
      increased levels of nonenzymatic glycation of basement membrane (p less than
      0.01) as compared to insulin-treated diabetic (euglycemic), age-matched control,
      and streptozotocin-injected nondiabetic animals also on 8% protein diet. In
      contrast, diabetic animals on restricted (8%) protein diet and those on standard
      (24%) protein diet showed no statistical differences between them with regards to
      the above parameters. Moreover, there were no statistical differences among
      diabetic and control animals on either 8 or 24% protein diet with respect to
      muscle capillary membrane thickness. Even though the peripheral muscle biopsy
      study of capillary basement membrane is less invasive than kidney biopsy, the
      results of this study suggest that neither nonenzymatic glycation nor basement
      membrane thickness can be utilized as predictors of renal dysfunction during
      early onset of diabetes mellitus.

PMID- 2220299
TI  - A case of isolated tuberculoid leprosy of brachial cutaneous nerve.
AB  - The author relates a rare case of cutaneous-brachial nerve mononeuritis in a
      Hansen's disease patient, presenting a pure neural tuberculoid form, with
      spontaneous drainage of abscess.

PMID- 2220302
TI  - [Necessary methodologies for research advancements in leprous neuritis].

PMID- 2220301
TI  - Histological changes in tuberculoid leprosy after fixed duration multidrug
      therapy for six months.
AB  - The length of treatment advocated for leprosy has been very long and arbitrary.
      During the past few years, attempts have been made to reduce the length of
      treatment required. World Health Organization (WHO) has recommended six months
      therapy for paucibacillary leprosy. The present study was undertaken to see the
      extent of histological changes that occur with this therapy. Thirty four
      untreated tuberculoid (TT/BT) leprosy patients were biopsied initially and after
      completion of fixed course of this treatment. Clinically, 50 percent of the
      patients showed regression of disease activity at the end of six months.
      Morphology of the lesions was studied, in clinically active and inactive cases on
      completion of therapy. It was found that after six month's therapy, histology of
      the lesions was similar, whether the case was active or not. After the prescribed
      treatment, biopsy showed marked reduction in the extent of granuloma, along with
      significant increase in lymphocytes and a increase in epithelioid cells in these
      granulomas.

PMID- 2220300
TI  - Isolation and characterization of infiltrates in the nerves of patients with
      neuritic leprosy.
AB  - A study was done on the characteristics of infiltrating cells in the nerves of 9
      patients with pure neuritic leprosy, by preparing a single cell suspension. The
      patients had no skin lesion. Histopathological examination revealed that 2 of the
      9 nerves showed granulomas characteristics of tuberculoid leprosy, while the
      remaining 7 had features of lepromatous granulomas. In the nerves showing
      tuberculoid granulomas, a high proportion of lymphocytes were T cells as they
      formed rosettes with sheep erythrocytes and only a few percent were EAC rosette
      forming cells. On the other hand, the nerves showing lepromatous granulomas
      contained only occasional lymphocytes which formed E and EAC rosettes.
      Macrophages from the granulomas of all the nerves were esterase positive,
      peroxidase negative, contained M. leprae and did not exhibit C3 surface
      receptors.

PMID- 2220303
TI  - The demystification of leprosy: a multifactorial problem.
AB  - Abolishment of misbeliefs and misconceptions, unfounded fear and prejudice are
      factors as important in leprosy control as prevention, early detection and
      therapy. Concrete measures of demystification are proposed. Identify and divulge
      the absolute truth about leprosy. Calling leprosy "Hansen's disease" did not
      result in demystification. Patients know that the two terms are identical.
      Treating them as human beings attracts more patients to the healers than the
      Hansenologian ritual. Contrary to statements, no major advances are being made in
      the field of bacteriology, immunology, molecular biology, mode of transmission
      and epidemiology of leprosy. Not a single new drug has been discovered in 26
      years. Vaccination is a dubious venture. The question arises as to whether the
      right priorities are promoted in leprosy research. Cultivation of the leprosy
      bacillus is the sine qua non of any further progress. This field of research is a
      lost and totally neglected priority. Consequently we have no pharmacological
      model for badly needed of ultrapotent antileprosy drugs. Syphilis is now cured
      with a single dose of penicillin. A drug as potent against leprosy should not be
      a mission impossible if an appropriate pharmacological model--the in vitro
      culture--is available. The multifactorial problem of demystification is a
      difficult but not an impossible task. Less sensationalism, more real progress in
      research, selecting the right priorities, achieving the "ultimate drug", shelter,
      food, shoes, soap and broom for every human on this planet constitute the road to
      demystification.

PMID- 2220298
TI  - [The evaluation of an anti-leprosy program in Ueles (1975-1989)].
AB  - Foperda, who took over and continued the work initiated in 1924 by the Congo Red
      Cross, is responsible for the programme of fight against leprosy in the Ueles
      region (Zaire). Important results have been obtained since 1975 in the framework
      of a specialised medical service. These results are exposed and discussed
      herebelow. The evolution of the endemic leprosy in the region under survey allows
      to contemplate new trends for the pursuit of the programme in the coming years
      (controlled integration within polyvalent health services).

PMID- 2220306
TI  - Improved energy kinetics following high protein diet in McArdle's syndrome. A 31P
      magnetic resonance spectroscopy study.
AB  - A patient with McArdle's syndrome was examined using bicycle ergometry and 31P
      NMR spectroscopy during exercise. The patients working capacity was approximately
      half the expected capacity of controls. Muscle energy kinetics improved
      significantly during intravenous glucose infusion and after 6 weeks of high
      protein diet. During intravenous infusion of amino acids, no changes in working
      capacity could be detected. No decrease was seen in intracellular muscle pH
      during aerobic exercise. A significant decrease in muscle pH during aerobic
      exercise was detected in all controls.

PMID- 2220310
TI  - Forceps delivery as a risk factor in epilepsy: a comparative prospective cohort
      survey.
AB  - Three-hundred and eighty-one children born with forceps delivery and 372 with
      normal delivery were followed up for 4-7 years. More children in the forceps
      group developed seizures than in normal group, i.e. 22:10. This was statistically
      significant (P less than 0.05). A prolonged follow-up is necessary for further
      observations.

PMID- 2220304
TI  - Multiple sclerosis in Spain: an epidemiological study of the Alcoy health region,
      Valencia.
AB  - Alcoy is a defined health region in eastern Spain, at 3 degrees E-38 degrees N,
      with a single neurology department and includes 33 towns with a total population
      of 133,915 inhabitants. We have evaluated the prevalence and incidence of
      multiple sclerosis (MS) by analysing this region. Six new cases have been
      detected (2.24/100,000/year) and the prevalence rate was 17.17/100,000, the
      highest in Spain at the moment. However, we found an irregular distribution in
      the different towns in so far that 15 of our 23 patients lived in a particular
      subregion, which means a prevalence of 44.59/100,000. Our study shows that the
      area of Alcoy is a medium MS risk region according to the thesis of Kurzke,
      although high MS areas may be found, thus confirming that MS distribution in
      southern Europe is not uniform.

PMID- 2220309
TI  - Ventricle brain ratio in the clinical course of HIV infection.
AB  - As part of the computerized tomographic assessment of an unselected group of 47
      patients in different stages of HIV infection we determined the ventricle brain
      ratio (VBR) and the width of several cortical sulci. We compared the findings for
      subgroups of patients defined by their stage in the Walter Reed Staging
      Classification. There was a significant increase in VBR only in the subgroup of
      patients with manifest acquired immune deficiency syndrome (AIDS) (WR 6). The
      findings are discussed in connection with the question of the likelihood that
      dementia will develop even in stages of HIV-infection preceding AIDS.

PMID- 2220308
TI  - Auditory ear extinction in lacunar syndromes.
AB  - A dichotic listening test was administered to 28 patients with lacunar syndromes
      in order to contribute to the investigation of the subcortical route of
      interhemispheric auditory pathways. Topographic study showed that lesions in the
      external capsule or in the anterior limb of the internal capsule in both
      hemispheres produced left ear extinction. The possibility that some of the
      auditory fibres travel through the external capsule, as well as the anterior limb
      of the internal capsule, before crossing the contralateral cerebral lobe is
      suggested.

PMID- 2220312
TI  - Thermal discrimination thresholds: a comparison of different methods.
AB  - Thermal testing was carried out on 55 healthy subjects in order to establish
      normal results and reproducibility of warm and cold thresholds. Diurnal
      variations of thresholds were investigated in a further 30 normal subjects. Then
      the sensitivity of different testing procedures was investigated in 33 patients
      with diabetes mellitus, but without severe polyneuropathy. Forced choice testing
      takes 6 times longer than the method of limits, and the results are not
      considerably different. It is thought that the forced choice algorithm does not
      provide a method for clinical routine. Another new approach, the double random
      staircase method, may help to exclude bias without taking too much time.

PMID- 2220313
TI  - Therapy and survival of adult patients with intracranial glioma in a defined
      population.
AB  - During the 3 years 1978-1980 146 adult patients with intracranial glioma were
      diagnosed in the Province of Uusimaa in southern Finland. The median survival of
      all patients was 15 months, of glioblastoma (n = 41) 5.1 months, of anaplastic
      astrocytoma (n = 29) 12.4 months, of benign grade I-II astrocytoma (n = 30) 93.5
      months, of other glioma 82.9 months (n = 27), and of probable glioma 9.8 months
      (n = 19); 22 patients are still alive 8.9-11.9 years after diagnosis. The
      patients who were 15-44 years of age at the time of diagnosis survived 75.4
      months in the median (n = 58), 45-64 years 10.5 months (n = 61) and 65 years or
      older 4.8 months (n = 27); 96 patients were operated, 89 received radiotherapy
      and 34 chemotherapy. According to the proportional hazards' model, follow-up
      time, age and histological type of tumor were statistically highly significant in
      explaining differences in survival.

PMID- 2220307
TI  - Cognitive effects of long-term treatment with phenobarbital and valproic acid in
      school children.
AB  - The Wechsler Intelligence Scales for Children was applied to 64 epileptic
      children and 60 healthy subjects; patients followed chronic treatment with
      valproic acid (n = 32) or phenobarbital (n = 32). None of the children suffered
      mental retardation or neurological abnormalities. The test was repeated after a 9
      12 month interval: 26 of the valproate treated children and 23 of the
      phenobarbital-treated children performed the second evaluation. At baseline,
      total, verbal and performance IQ scores of children receiving phenobarbital were
      lower than those of controls. When the results of the first and the second tests
      were compared, a significant increase in IQ scores was detected among controls
      and patients treated with valproic acid, but not among phenobarbital-treated
      patients. It is concluded that long-term phenobarbital therapy induces a
      significant impairment in learning ability whereas long-term valproate therapy
      does not exert a noticeable noxious effect at this respect.

PMID- 2220316
TI  - Novel therapeutic strategies for dementia diseases. Proceedings of the Nobel
      Medicare Research Forum. Sweden, August 21-23, 1989.

PMID- 2220317
TI  - Role of catechol autooxidation in the degeneration of dopamine neurons.

PMID- 2220314
TI  - Transient global amnesia and Raynaud's phenomenon in scleroderma.
AB  - Transient global amnesia (TGA) is a well-recognized clinical entity, but its
      pathophysiology and prognosis have remained arguable. We reported that a 63-year
      old woman with scleroderma developed two TGA episodes. The patient sometimes
      suffered from headaches when Raynaud's phenomenon appeared in her fingers, but
      she did not experience further cerebrovascular events. This case suggests that
      the unique clinical presentation of this syndrome may result from an ischemic
      event, possibly triggered by a vasospastic mechanism like Raynaud's phenomenon.

PMID- 2220318
TI  - The cholinergic system and the excitatory amino acids in Alzheimer's disease.

PMID- 2220305
TI  - Relation between thyroid and cardiac functions and the geriatric rating scale.
AB  - To assess the effects of thyroid hormone and cardiac function on senile dementia,
      relations between serum thyroid hormone concentrations, hemodynamic parameters
      and dementia rating scale scores were studied in 83 subjects aged 70 and over.
      Age and serum-free T3 concentrations had a significantly negative correlation in
      all subjects and in subjects without dementia, but not when analysed only in
      dementia subjects. Regarding the genesis of dementia, serum free T3
      concentrations and cardiac index were both significantly lower in cerebrovascular
      dementia than in those without dementia. Moreover, subjects with cerebrovascular
      dementia showed significantly lower serum free T3 concentrations and cardiac
      index than those with senile dementia of Alzheimer's type in all age groups.
      These findings suggest that cognitive function is closely related to serum free
      T3 and cardiac function in subjects with cerebrovascular dementia and that serum
      free T3 concentrations may be a good indicator, reflecting health and cognitive
      status.

PMID- 2220315
TI  - Increased endothelin concentration in CSF from patients with subarachnoid
      hemorrhage.
AB  - A considerable quantity of endothelin-like immunoreactivity was demonstrated as
      present in the CSF of patients with subarachnoid hemorrhage. The endothelin
      levels in the CSF raised from 0.4 +/- 0.2 (Mean +/- SD) pmol/L at Day 0-1 to 2.2
      +/- 0.6 pmol/L at Day 6 and the levels decreased gradually. The result suggest
      that endothelin may contribute the generation of vasospasm often observed in
      subarachnoid hemorrhage.

PMID- 2220319
TI  - Alzheimer disease: the clinical syndrome; diagnostic and etiologic importance.

PMID- 2220321
TI  - THA, a putative drug in the treatment of Alzheimer's disease?

PMID- 2220320
TI  - Gangliosides and nerve growth factors in Alzheimer's disease.

PMID- 2220323
TI  - Plasticity of memory functioning in normal aging and Alzheimer's disease.

PMID- 2220324
TI  - Is good care the best treatment for the Alzheimer patient?

PMID- 2220328
TI  - Progression of posterior approximal carious lesions in Norwegian teenagers from
      1982 to 1986.
AB  - The purpose of the present study was to assess the progression rate of approximal
      carious lesions in Norwegians aged 14-18 years. Sixty-five subjects whose average
      age at base line was 14.9 years had one pair of posterior bitewing radiographs
      taken annually from 1982 to 1986. One examiner assessed all radiographs in
      chronologic order, recording degree of approximal caries. When a surface changed
      from one state to another, it was assumed to have changed at the midpoint between
      the two examinations. A total of 590 lesions were observed. Uncensored lesions
      took on average nearly 3 years to penetrate the enamel. Inclusion of right
      censored lesions by the Kaplan-Meier approach increased the uncensored estimate
      by approximately 20%. The average for doubly censored lesions was about 6.5
      years. Low average rate of caries progression coupled with wide variations
      between lesions and among subjects suggests a need for individually prescribed
      recall routines.

PMID- 2220322
TI  - Molecular genetics of Alzheimer's disease.

PMID- 2220325
TI  - Recent progress in the characterization of the pathological hallmarks for
      Alzheimer's disease.

PMID- 2220329
TI  - Weekly variation in the acidogenic response of plaque.
AB  - The fall in plaque pH after sucrose rinsing was monitored once a week for 9 (8)
      weeks in succession, to measure the weekly variation in the magnitude of pH drop
      in the same subject. The plaque pH was measured with a touch electrode placed
      interdentally between the first and second premolar. The subject rinsed his mouth
      with 10% (w/v) sucrose solution, and the plaque pH was thereafter monitored for
      40 min. The minimum plaque pH (pHmin), the change between starting and minimum pH
      (delta pH), and the resting pH value were determined. The pH values of the
      maxilla and mandible differed. No difference was seen between the right and left
      sides. As a rule, intraindividual variation was lower in terms of pHmin values
      than in terms of delta pH values. It was concluded that pH assessment with the
      touch electrode appeared to show a small weekly variation intraindividually and
      to be sensitive enough to test the acidogenic potential of foods, but only in the
      maxilla.

PMID- 2220326
TI  - The empty sella. A reappraisal of etiology and pathogenesis.
AB  - The empty sella turcica is defined as a sella which, regardless of its size, is
      completely or partly filled with cerebrospinal fluid. An empty sella of normal
      size is a frequent and probably normal finding in unselected autopsy series. In
      clinical series an empty sella usually appears enlarged and is often associated
      with a variety of clinical disorders, constituting the so-called empty sella
      syndrome. Several causes of an enlarged empty sella have been suggested: a
      congenitally missing (deficient) sellar diaphragm with or without altered
      cerebrospinal fluid dynamics, previous pituitary gland hypertrophy or the outcome
      of a pituitary tumor necrosis. Increased intracranial pressure will induce a
      sellar enlargement in some patients and, consequently, also the emptiness. This
      pathogenesis is, however, applicable only in a minority of patients with an empty
      enlarged sella. Data from the literature and from own studies suggest that the
      enlarged empty sellae and the associated findings in the majority of cases are
      caused by spontaneous necrosis of a previous pituitary adenoma. This theory
      explains the frequent presence of pituitary insufficiency, pituitary
      hypersecretion, and visual field defects in patients with an empty sella.
      Furthermore, it offers an explanation of the finding of an empty enlarged sella
      in some patients with non-traumatic cerebrospinal fluid rhinorrhea and probably
      also benign intracranial hypertension. Thus, an empty enlarged sella is a stage
      in the spontaneous course of some pituitary adenomas and the associated findings
      constituting the empty sella syndrome are an occasional part of the clinical
      presentation of pituitary adenomas.

PMID- 2220327
TI  - Effect of culture medium on acid production from sorbitol by oral bacteria.
AB  - The fermentation of sorbitol or glucose and the acid production by strains
      belonging to the genera Actinomyces, Lactobacillus, and Streptococcus isolated
      from the predominant sorbitol-fermenting human dental plaque flora were studied
      in cultures in complex or defined bacteriologic broths and in saliva-based broth.
      The growth yields of Lactobacillus and Streptococcus in the saliva-based media
      and of Actinomyces in the defined broth were poor. Addition of fermentable
      carbohydrate to the saliva-based broth favored the growth of Streptococcus and
      Lactobacillus but not that of Actinomyces. The results showed obvious differences
      in the capacity of oral bacteria to ferment sorbitol between cultures in saliva
      based and bacteriologic broths. Lactobacillus failed to utilize sorbitol when
      saliva was the only source of nutrients. Lower proportions of lactic and formic
      acids were formed from sorbitol by Actinomyces and Lactobacillus in the saliva
      based than in the bacteriologic media. The findings illustrate some mechanisms
      possibly involved in the interactions between sorbitol and dental plaque flora.

PMID- 2220311
TI  - Abnormal hemorheological parameters in vertebrobasilar-insufficiency.
AB  - Thirty-seven patients, aged 47 +/- 22 years, diagnosed suffering from
      vertebrobasilar insufficiency (VBI), underwent a hemorheological examination; 20%
      of these patients had no vascular risk-factor but none showed complete normal
      hemorheological findings. The distribution of hemorheological parameters was
      comparable to those in patients suffering from stroke or TIA. Abnormal were
      platelet-reactivity in 78%, plasma-viscosity in 57%, fibrinogen in 23%, red-blood
      cell-aggregation in 13% and hematocrit in 11% of all cases. To obtain more
      information on how to classify common clinical symptoms i.e. headache in
      combination with vertigo it may be useful to introduce hemorheological parameters
      as platelet-reactivity, plasma-viscosity, fibrinogen, in the further laboratory
      examination of those patients.

PMID- 2220330
TI  - Fixed restorations produced for recipients of dental prosthodontic treatment. A
      comparison between general dental practice and a dental school.
AB  - Fixed prosthodontic work ordered by general dental practitioners was examined
      through registrations made in commercial dental laboratories. A comparison was
      made with similar data from student files on fixed prosthodontic treatment at the
      University Clinic in Bergen, Norway, which is located in the same geographic
      area. The results indicated that the distributional pattern of fixed restorations
      within the dentition was much the same in the individuals attending the general
      dental practitioners as in those treated at the dental school. While the
      practicing dentists preferred metal-ceramics in most cases, most of the
      restorations inserted at the dental school were based on the metal-resin
      technique.

PMID- 2220331
TI  - Storage stability of solutions of pyruvic acid/glycine used in adhesive bonding.
AB  - The rate of deterioration of pyruvic acid/glycine solutions used as common
      pretreatment of enamel and dentin in the Gluma bonding technique was
      investigated. Bond strengths between composite resin and enamel/dentin were
      measured. The bonds were mediated by pyruvic acid/glycine solutions, applied from
      0 to 6 months after the time of manufacture. Bond strengths to enamel varied
      between 8.6 and 13.5 MPa and to dentin between 6.2 and 18.0 MPa. The pH of the
      solutions rose slightly during the experimental period, but no statistically
      significant change in bond strengths was observed.

PMID- 2220332
TI  - A simple system for generating low-dosage mercury vapor for animal experiments.
AB  - A system using unlabeled, metallic mercury for generating low-dosage vapor for
      animal experiments is described. The system consists of four acrylic plastic
      chambers: one chamber containing the mercury source, one for mixing the mercury
      vapor with air, one exposure chamber, and one containing activated coal filters
      and mechanisms for regulating the airflow. The chambers are connected to each
      other by means of 80-mm-diameter polyvinyl chloride tubes reinforced with wire.
      Additional control and supporting equipment is also used. The system is easy to
      set up and requires minimal attendance during use. A standard deviation of 3-4%
      in the mercury vapor level during 6 h of exposure is typical. The conditions for
      the animals during exposure and the safety for the personnel during use are
      optimal.

PMID- 2220334
TI  - Validity of the radiographic assessment of ankylosis. Evaluation of long-term
      reactions in 10 monkey incisors.
AB  - The accuracy and sensitivity of radiographic assessments of reactive processes in
      dental tissues were evaluated by comparison of radiographs and histologic
      sections. Experimental lesions inflicted on the roots of 10 monkey incisors had
      been observed by means of serially obtained radiographs over a period of 315 to
      370 days. The material was used for evaluation of radiographic assessment of
      ankylosis. For comparative purposes, assessment of the experimental lesion
      penetrating to the pulp and periapical radiolucency was added. True and falsely
      positive or negative recordings formed the basis for calculation of the accuracy
      and sensitivity of the radiographic assessment. The sensitivity, or the
      observers' ability to detect the actual changes, was high for pulp penetration,
      intermediate for inflammation, and low for ankylosis.

PMID- 2220333
TI  - An 11-year follow-up study of dental caries after discontinuation of school-based
      fluoride programs.
AB  - The purpose of the present study was to determine whether the caries-preventive
      effect of school-based programs with fluoride (F) mouthrinsing or toothbrushing
      was evident at the end of a post-treatment follow-up period of 11 years. Two
      groups of subjects examined at 14 years of age (born in 1960), who had
      participated in fortnightly F rinsing (n = 52) or in F brushing 4-5 times a year
      at school (n = 50), were re-examined radiographically and completed a
      questionnaire at age 25 years. A comparison group of 25-year-olds (n = 51) was
      also included. Analyses of variance showed that the benefits of participation in
      school-based F programs seem to have been lost. It appears that these caries
      preventive programs have delayed rather than prevented caries and that F
      toothpaste and other caries-preventive efforts have been insufficient to avert a
      substantial caries activity during the follow-up period.

PMID- 2220336
TI  - Prevalence and severity of occlusal tooth wear in a young Saudi population.
AB  - An epidemiologic investigation of the prevalence and severity of occlusal wear
      was carried out in a young Saudi population. Occlusal wear was evaluated on a
      tooth-by-tooth basis on study casts made for 206 dental students, using an
      ordinal scale. The reliability of the scale was assessed by percentage inter- and
      intra-observer concordance. The mean occlusal wear was high for the population
      studied. The sample presented the highest wear scores in the incisor region,
      maxillary canines, and mandibular molars. Comparison with other studies of
      similarly aged Western populations showed a more extensive pattern of wear in the
      present sample, pointing to the possible role of environmental influences.

PMID- 2220335
TI  - Comparison of three radiographic methods in screening of temporomandibular joint
      involvement in patients with psoriatic arthritis.
AB  - Fifty-three randomly selected subjects with psoriatic arthritis (PA) were
      examined radiographically by means of orthopantomography, transcranial
      radiography, and transmaxillary radiography. Two examiners graded the
      radiographic signs of flattening, osteophytes, erosion, and sclerosis. The
      findings obtained were then compared, to determine the best technique for
      screening of temporomandibular joint (TMJ) bone changes. Together the techniques
      showed definite (24%) and possible (6%) changes suggesting TMJ involvement in 31
      (30%) of 106 joints. In all projections radiographic signs suggesting TMJ
      involvement were most frequent in the condyle. Erosion in the condyle was the
      most frequent finding. Agreement with regard to definite changes in the condyle
      was found in only one-third to half of the cases. It is concluded that in
      radiography of the TMJ in subjects with PA a combination of radiographic
      techniques should be used to obtain maximum information. However,
      orthopantomography is well suited for screening of TMJ involvement in subjects
      with PA.

PMID- 2220338
TI  - Introducing a new section, and a note on geography.

PMID- 2220339
TI  - Acta sixty years ago. A theory on the dominant follicle and uniovulation.

PMID- 2220337
TI  - The influence of dental amalgam placement on mercury, selenium, and glutathione
      peroxidase in man.
AB  - Amalgam restorations were inserted in eight healthy persons, previously
      unprovided with dental restorations, who had several severe carious lesions. The
      mean number of surfaces restored were 16.1 (range, 11 to 22). The total mean
      calculated amount of mercury inserted was 2.9 g (range, 1.5 to 4.3 g). Blood and
      urinary levels were measured on seven occasions during a 4-month period before
      and a 3-month period after amalgam placement. One and 3 months after placement,
      the P-mercury mean values were almost equal to the preplacement values (3.3
      nmol/l). After placement U-mercury increased continuously; 3 months after
      placement a statistically significantly higher (p less than 0.05) mean U-mercury
      value (0.58 nmol/mmol creatinine) was found compared with the mean preplacement
      value (0.34 nmol/mmol creatinine). No statistically significant correlation was
      found between the P- and U-mercury concentrations and the total number of amalgam
      surfaces. Selenium levels in plasma and urine and erythrocyte glutathione
      peroxidase showed no systematic change of pattern. The results show that the
      insertion of amalgam fillings contributed to the U-mercury concentration, but
      apparently even more extensive amalgam therapy and/or longer exposure periods are
      needed to affect the P-mercury concentration. No negative effects on the P- and U
      selenium or the erythrocyte glutathione peroxidase levels could be found during
      the 3 months immediately after an extensive amalgam placement. The supplementary
      blood and urine analyses were not influenced by the insertion of amalgam
      fillings.

PMID- 2220341
TI  - Venous muscle pump function during pregnancy. Assessment by ambulatory strain
      gauge plethysmography.
AB  - The venous muscle pump function was quantitatively assessed through pregnancy
      weeks 16, 30, 38 and 3 months (week 53) following delivery, in 24 pregnant women
      who completed a normal pregnancy. A statistically significant increase was found
      in the mean venous reflux (P less than 0.01), which was restored to initial
      values postpartum. Expelled calf volume remained stable throughout pregnancy but
      increased following delivery. Venous outflow from the legs was significantly
      reduced in the third trimester. Subjective symptoms of venous insufficiency
      increased through pregnancy, but, these symptoms had virtually disappeared post
      partum, corresponding to the muscle pump normalization. No statistical
      correlation was found between venous muscle pump values and changes in hormone
      concentrations of estradiol, estriol and progesterone. It is suggested that
      venous insufficiency development in pregnancy is caused primarily by mechanical
      obstruction, or hormonal influence other than that of estradiol, estriol or
      progesterone. 17% (4.7-37%) of the women with a normal pregnancy developed a
      pathological venous muscle pump function.

PMID- 2220342
TI  - Epidermal growth factor (EGF) concentrations in amniotic fluid and maternal urine
      during pregnancy.
AB  - Epidermal growth factor (EGF) was measured in amniotic fluid and maternal urine
      from women undergoing amniocentesis for genetic studies (15-22 weeks' gestation,
      n = 36) and lung maturational studies (35-39 weeks' gestation, n = 20). Amniotic
      fluid EGF concentrations (mean +/- SD) were higher near term (87 +/- 71 pM) than
      mid-gestation (35 +/- 8 pM) (p less than 0.0001). Urinary EGF concentrations were
      higher near mid-gestation (53.9 +/- 30.8 micrograms EGF/g creatinine) than near
      term (33.4 +/- 14.1 micrograms EGF/g creatinine) (p less than 0.006). There was
      no correlation between individual amniotic fluid and urinary EGF concentrations.
      The amniotic fluid EGF concentrations correlated with gestational age. However,
      there was no relationship between EGF concentrations and pulmonary maturity
      studies or placental weight from the pregnancies studied near term. We conclude
      that the concentration of EGF in amniotic fluid increases towards term. The lack
      of correlation between amniotic fluid and maternal urinary EGF concentrations
      suggests that there probably is a different source of EGF in the two compartments
      and that EGF does not cross the placenta to any great extent.

PMID- 2220340
TI  - Duration of human singleton pregnancy. A population-based study.
AB  - We have analysed the duration of pregnancy for singleton births in Sweden during
      1976-80 by means of data from the Swedish Birth Registry. Information, which was
      obtained from special forms with standard questions, include date of first day of
      last menstrual period (LMP) and whether that date was considered reliable or not.
      Recording was done prospectively, starting at the first antenatal visit. In 10%
      of cases the dates were labelled uncertain. Information on LMP and birth dates,
      parity, age of mother, sex of child, and/or mode of delivery was missing in 5.5%
      of the singleton cases, leaving 427,581 singleton births for analysis. In cases
      of reliable menstrual dates, the average duration from LMP to vaginal birth was
      282 days (median), 281 days (mean) and 283 days (mode), remaining constant over
      the years of study. One standard deviation of the mean was approximately 13 days,
      varying slightly with age and parity. Ten per cent of these women gave birth post
      term (past 294 days). The duration of cesarean section births became shorter over
      the years, in spite of little change in cesarean section frequency (9.5% in 1976
      7 and 10.9% in 1979-80). Mothers aged 35 and over tended to give birth 2 days
      earlier than those below 35. Second and subsequent children of mothers below 35
      had slightly shorter gestations than first-borns. Boys were born earlier than
      girls, on average. When LMP was unreliable, the distribution of gestational
      lengths was wide. We also noted a seasonal rhythmicity in average duration of
      pregnancy, with consistent shortening in the month of December.

PMID- 2220343
TI  - Effects of intravenous terbutaline on maternal circulation and fetal heart
      activity.
AB  - The effects of terbutaline on maternal circulation and fetal heart activity were
      studied in 15 healthy pregnant women admitted for external cephalic version. The
      two-step infusion of terbutaline (5-10 micrograms/min) resulted in increases in
      maternal heart rate (p less than 0.001), cardiac output (p less than 0.001),
      systolic arterial pressure (p less than 0.001) and pulse pressure (p less than
      0.001), while diastolic arterial pressure (p less than 0.001) and total
      peripheral vascular resistance (p less than 0.001) were reduced. Mean arterial
      pressure was unchanged after the infusion. Fetal heart activity assessed by
      cardiotocography showed a gradual increase in baseline fetal heart rate (p less
      than 0.01) and an increased percentage acceleration time (p less than 0.05).
      Fetal movements also increased during the infusion (p less than 0.05). The
      terbutaline infusion had a positive inotropic effect and produced decreased
      systemic vascular resistance in the pregnant woman, and placental transfer of the
      drug resulted in increased fetal heart activity. The potential influence of the
      drug-induced changes in maternal hemodynamics on utero-placental perfusion
      require further investigation.

PMID- 2220344
TI  - Acceleration of fetal maturation with intra-amniotic thyroxine in the presence of
      maternal malignancy.
AB  - Acceleration of fetal maturation with intra-amniotic administration of thyroxine
      was employed in eight patients in whom preterm delivery was necessary because of
      malignant disease of the mother. Thyroxine (200 mcg to 500 mcg) was given at
      weekly intervals starting at the 27th to 32nd week of gestation until the L-S
      ratio exceeded 2.0. The fetuses were delivered between the 29.4 and 34.0 week.
      None of the newborns suffered from respiratory distress syndrome, and three
      newborns were cared for in the regular nursery. Thyroxine-induced acceleration of
      fetal maturation and pre-term delivery permits earlier initiation of
      antineoplastic and radiation therapy without exposing the fetus to the hazards of
      maternal therapy and those of prematurity.

PMID- 2220346
TI  - Radical surgery compared with intracavitary cesium followed by radical surgery in
      cervical carcinoma stage IB. Analysis of patients less than or equal to 45 years
      of age with small tumors with regard to treatment results and ovarian
      preservation in the primary surgery group.
AB  - Forty-nine patients aged less than or equal to 45 years, with cervical carcinoma
      stage IB (less than or equal to 3 cm) were treated with either primary radical
      surgery (n = 26), or intracavitary irradiation followed by radical surgery (n =
      23). With primary surgery, ovarian function had been preserved in 15 of the 25
      patients, who were alive and well. Seven of the primary surgery patients were
      irradiated postoperatively and 2 others with a central recurrence were cured by
      irradiation. One other patient, who was not irradiated postoperatively, had an
      intestinal metastasis and died of the disease. If any of the adverse prognostic
      factors (as reported in the literature) had been considered as an indication for
      postoperative irradiation, 17 patients instead of 7 would have been irradiated
      after primary radical surgery. In the comparable group of 23 patients treated by
      intracavitary irradiation and radical surgery (and in 4 cases postoperative
      irradiation as well) there was no recurrence. There was no significant
      statistical difference between the treatment results in the cesium + surgery
      group and those who underwent primary radical surgery. Young patients with early
      cervical carcinoma without prognostic indicators for postoperative irradiation
      can benefit from primary radical surgery, because their ovarian function can be
      preserved.

PMID- 2220348
TI  - Familial cancer aggregation in cases of adenocarcinoma corporis uteri.
AB  - In a detailed prospective interview study, all newly diagnosed cases of
      adenocarcinoma corporis uteri at Malmo during a 2-year period (n = 51) were
      analysed with regard to the occurrence of tumors in first-degree relatives. The
      families of the proband's male consorts were used as controls. Sisters and
      mothers of probands had tumors (particularly of the corpus uteri or breast) more
      often than had controls. Colon and prostate cancer also figured in family
      histories of proband relatives, more often and with earlier age at onset than in
      controls. Nine patients (18%) either had additional concomitant malignancies, or
      had had such malignancies previously. Familial cancer predisposition was
      associated with poorly differentiated anaplastic cancer of the corpus uteri with
      poor prognosis. Three cases of familial cancer (CFS) observed at Malmo are also
      described, in which the probands presented with adenocarcinoma corporis uteri.
      The findings suggest that a hereditary, cancer predisposing factor (gene) is
      involved in a significant proportion of cancer corporis uteri, and that it is
      expressed in a heterogeneous tumor pattern, predominantly at sites sensitive to
      hormonal influences.

PMID- 2220345
TI  - Prevention of breast pain and milk secretion with bromocriptine after second
      trimester abortion.
AB  - Within 24 hours after abortion, 62 patients with a mean gestational age of 19
      weeks, who had either induced (n = 50) or spontaneous (n = 12) abortions were
      randomly allocated to three groups: Group 1, bromocriptine 2.5 mg twice daily for
      2 weeks; Group 2, placebo tablets 1 tablet twice daily for 2 weeks; Group 3, no
      treatment. Fifty-two patients completed the study (bromocriptine n = 18, placebo
      n = 18 and no treatment n = 16). Placebo had no apparent influence on breast
      symptoms. In both the placebo group and the untreated group, breast pain and milk
      secretion peaked on days 3 to 7, and milk secretion often continued for 3 weeks.
      Only 3/34 (9%) of untreated and placebo treated patients were free of breast
      symptoms. Compared with placebo, bromocriptine caused a significant reduction in
      the objective assessment score of breast tenderness (p less than 0.05) and milk
      secretion (p less than 0.01), in serum prolactin (PRL) (p less than 0.001) and in
      the subjective assessment score of breast pain (p less than 0.01) and milk
      secretion (p less than 0.01). Alleviation of breast pain and prevention of milk
      secretion appears to be indicated after second-trimester abortion, and treatment
      with bromocriptine is efficacious.

PMID- 2220349
TI  - Primary melanoma of the cervix uteri, an avis rara? A review of the literature.
AB  - A primary melanoma of the uterine cervix is presented. Diagnostic approaches and
      therapeutic procedures are discussed following a review of the literature.

PMID- 2220351
TI  - Fibroepithelial polyp of the ureter. A case history and discussion.
AB  - A 46-year-old woman had a 13 cm long benign fibroepithelial polyp arising in the
      right lower ureter and prolapsing through the urethral meatus. She also had
      uterine fibromyomata. She made an uneventful recovery after laparotomy with
      supravaginal amputation of the uterus and resection of a 1-cm segment of the
      ureter. Benign fibroepithelial polyps very rarely recur and may be treated with
      local resection.

PMID- 2220350
TI  - Ovarian metastatic carcinoma presenting as a primary cervical carcinoma.
AB  - A case of an ovarian carcinoma presenting as a primary cervical carcinoma is
      described. Although a rare event, this must be considered whenever the clinical
      or histological findings are unusual. The importance of careful histological
      review of all specimens in cases such as this is emphasized.

PMID- 2220352
TI  - Keratoprosthesis. I. Results obtained after implantation of 12 one-piece
      prostheses. A retrospective, follow-up study.
AB  - A total of 12 one-piece keratoprostheses were implanted in 6 eyes of 6 different
      patients with bilateral blinding, severe corneal disease with no possibility for
      a successful corneal transplantation. The prosthesis and the surgical procedure
      used are described. The short-term results were good, with 4 of the 6 patients
      obtaining a substantial visual improvement. In the remaining 2 patients
      preexisting pathology in the posterior segment of the eye was strongly suspected.
      However, the long-term complication rate was high, the chief problems being
      tissue necrosis around the prosthesis with eventual prosthesis loss and the
      development of retroprosthetic membranes. Repeated replacements of
      keratoprostheses extruded or removed because of complications were possible with
      restoration of the vision obtained after the first implantation.

PMID- 2220354
TI  - Granular corneal dystrophy Groenouw type I. Clinical aspects and treatment.
AB  - The paper describes the comparatively benign nature of granular corneal dystrophy
      Groenouw type I and the results of treatment of the disease. 71 patients with a
      classic clinical appearance comprised the largest pedigree in medical literature.
      The disorder was confined to the eyes only. Visual acuity was close to normal in
      children; the children had small, superficial, corneal opacities, often arranged
      in lines, and for the most part with a smooth exterior surface when examined with
      Javal keratometry. In adult patients visual acuity was around 0.5, the exterior
      surface uneven, the corneal opacities larger, and distributed superficially as
      well as deeper in the corneal stroma. In elderly patients visual acuity was
      between 0.5 and 0.1 and they all had additional cataract. Fourteen patients were
      treated with corneal grafting during the past 15 years and all grafts remained
      clear.

PMID- 2220347
TI  - Peripheral and ovarian venous concentrations of estradiol and progesterone in
      postmenopausal women with "non-endocrine" ovarian tumors.
AB  - Estradiol (E2) and progesterone (P4) levels in peripheral venous blood were
      measured in 45 postmenopausal (more than 5 years after menopause) women with
      ovarian neoplasms. The E2 and P4 concentrations in ovarian venous blood were also
      measured in 26 of these 45 patients. The steroid levels were compared with the
      values in 10 postmenopausal women without ovarian tumors. In peripheral venous
      blood, relatively high E2 concentrations were found in 24 of the 45 (53%)
      postmenopausal patients with ovarian tumors, and relatively high P4
      concentrations were noted 15 of 45 (33%) of the patients. In ovarian venous
      blood, relatively high values of E2 were found in 18 of 26 (69%) of the
      postmenopausal patients, and relatively high values of P4 were noted in 11 of
      these 26 (42%). No differences in the E2 and P4 levels in peripheral and ovarian
      venous blood were noted between the patients with benign tumors and those with
      malignant tumors. These results suggest that some of the epithelial ovarian
      tumors in postmenopausal women have steroid-producing activity.

PMID- 2220355
TI  - The postnatal development of the oscillatory potentials of the electroretinogram.
      I. Basic characteristics.
AB  - The postnatal development of the oscillatory potentials (OPs) of the rat
      electroretinogram (ERG) was studied. The appearance and/or completion of the
      development of the individual oscillatory peaks differed from that of the a- and
      b-waves as well as from each other. The OPs appeared postnatally one to two days
      later than the a- and b-waves, respectively. The first oscillatory peak, O1, was
      present before the second, O2, which appeared before the later wavelets, O3, O4
      and O5. The pattern of maturation of the oscillatory peaks in relatively more
      scotopic conditions differed from that in relatively more photopic ones. The
      summed amplitudes of the OPs attained adult size earlier (about two weeks) during
      relatively more scotopic conditions. The peak time of each oscillation gradually
      decreased with age. These findings show that the origin of the OPs is different
      from that of the a- and b-waves of the ERG and strongly indicate different
      origins of the earlier OPs from the later ones. Thirdly, the scotopic mechanism
      underlying the OPs seems to mature faster than the photopic system involved in
      the generation of the OPs.

PMID- 2220353
TI  - Keratoprosthesis. II. Results obtained after implantation of 27 dismountable two
      piece prostheses. A retrospective, follow-up study.
AB  - During the years 1974-1987 a total of 27 two-piece keratoprostheses were
      implanted in 25 eyes of 22 different patients with bilateral blinding anterior
      segment disease with no possibility for a successful corneal transplantation. The
      prosthesis design and the surgical procedures used are described. The healing in
      and fixation of the prostheses were initially good in all cases, but 9 prostheses
      were lost or removed because of complications during the postoperative period of
      observation. The prosthesis retention time was significantly longer than that
      earlier achieved by the use of a one-piece prosthesis. In 18 of 27 cases a visual
      acuity of 6/60 or better was obtained. Postoperative complications included
      necrosis of the tissues covering and supporting the prosthesis, infection around
      the prosthesis, overgrowth of the surrounding tissues and the development of
      dense retroprosthetic membranes. Despite the obvious risks, keratoprosthesis
      surgery in a small number of patients with severe corneal disease represents the
      only potential hope for a visual rehabilitation, and should therefore be
      considered.

PMID- 2220356
TI  - Occurrence of drusen, pigmentary changes and exudative changes in the macula with
      reference to age-related macular degeneration. An epidemiological study of 1000
      aged individuals.
AB  - Macular changes in 60 to 80-year-old people i.e. drusen (DR), pigmentary changes
      (PC) and exudative changes (EXC) are assessed by fundoscopy in a random and age
      stratified population with 924 of the participants examined in both maculae (1848
      eyes). DR, PC and EXC were found in 18.4%, 12.9% and 2.1% of all eyes with a
      rising frequency associated with increasing age. A separation was made between
      changes implying a visual acuity of 6/9 or less as criteria of age-related
      macular degeneration (AMD) and age related macular changes without visual
      impairment (AMCW). The occurrence of DR, PC and EXC from eyes with AMD showed an
      age related rise which was also found for DR, contrary to PC and EXC deriving
      from eyes with AMCW. The basic forms of AMD, atrophic and exudative, were
      represented in 78.6% and 21.4% of individuals or 80.9% and 19.1% of eyes with
      AMD. The predominant findings in AMD eyes were DR + PC in combination represented
      in 60.7% of atrophic and 66.8% of exudative AMD eyes, while in atrophic AMCW eyes
      DR as only finding was leading with 59.2%. It is concluded that in eyes with
      atrophic macular changes, DR, respectively PC as only finding involves no visual
      deterioration in 80.6%, respectively 72.6%, while DR + PC in combination, as well
      as the appearance of EXC, are found to be the most likely expression of AMD as
      long as a visual impairment of 6/9 or worse is included in the definition of AMD.

PMID- 2220357
TI  - Vitreous fluorophotometry in juvenile diabetics with and without retinopathy in
      relation to metabolic control: insulin antibodies and c-peptide levels.
AB  - Vitreous fluorophotometry was performed in 56 juvenile insulin-dependent diabetic
      patients aged 9-23 years (median: 16 years), diabetes duration 1-20 years
      (median: 8 years). Fundus photography showed mild background retinopathy in 5
      patients, while 51 patients had no signs of retinopathy. Abnormal leakage into
      the posterior vitreous body was found in 4/5 patients with background retinopathy
      and in 24/51 with normal fundi. We found a significantly positive correlation
      between abnormal leakage and duration of diabetes and HbA1 with Kendall rank
      order correlation coefficients T = 0.21 (P = 0.01) and 0.19 (P = 0.02) resp. No
      significant correlation was found between leakage and age, actual blood glucose
      level or insulin antibodies expressed as insulin binding capacity of IgG, but a
      significantly negative correlation between abnormal leakage and low levels of
      fasting c-peptide/s T = 0.437 P less than 0.001. Kendall partial rank-order
      correlation analysis showed that c-peptide/s significantly explained the leakage
      when HbA1 or duration was kept constant. Duration could only explain leakage when
      HbA1 was fixed but not when c-peptide/s was kept constant. HbA1 could also
      explain leakage when duration or c-peptide was fixed.

PMID- 2220358
TI  - Coexistence of localized scotomata and neovascularizations in proliferative
      diabetic retinopathy.
AB  - Fifteen eyes of 15 patients with proliferative diabetic retinopathy within the
      central 60 degrees of the eye fundus were examined with computerized perimetry,
      and the visual field data were accurately correlated with the corresponding
      morphology as seen on fundus photographs and fluorescein angiograms. In 12 out of
      13 eyes with neovascularizations outside the optic disc area an absolute scotoma
      could be correlated with a retinal area distal from the neocascularization, and
      in one case no scotoma was found in this area. The localized scotomata
      corresponded in 8 cases to non-perfusion areas as seen on fluorescein angiograms,
      whereas in 5 cases no pathological morphology was detected in these areas. Seven
      eyes which had neovascularizations at the optic disc showed the same pattern, but
      with visual field loss of more pronounced degree. Furthermore, other scotomata
      which not corresponded to any pathological fundus morphology occurred at approx.
      30 degrees eccentricity in the visual field. The findings are discussed in
      relation to the current hypothesis about the initiation and development of
      neovascularizations in proliferative diabetic retinopathy.

PMID- 2220360
TI  - A longitudinal study of a population based sample of astigmatic children. II. The
      changeability of anisometropia.
AB  - The variability of anisometropi in a sample of 310 children with astigmatism at
      the age of 1 year was longitudinally studied during a 3-year period between 1 and
      4 years of age. The prevalence of anisometropia of 1 D or more at each year level
      was rather stable. When individual cases were examined we found that between the
      first and the last test session 19 of the 33 children with anisometropia at the
      first test session had become non-anisometropic and were substituted with 14 new
      cases which were non-anisometropic at the age of 1 year. In general, less than
      half of the cases, at all levels of anisometropia, remained anisometropic
      throughout the whole test period. We also found that children with anisometropia
      persisting through the whole test period were at considerable risk, about one out
      of four, of developing amblyopia. There was no simple relationship, however,
      between anisometropia at a certain age level between 1 and 4 years and amblyopia
      and/or strabismus. Non-persisting anisometropia in an emmetropizing eye is in
      most cases a benign sign and not connected with an increased risk for developing
      amblyopia.

PMID- 2220359
TI  - A longitudinal study of a population based sample of astigmatic children. I.
      Refraction and amblyopia.
AB  - The refraction changes in 310 children with astigmatism greater than or equal to
      1.0 D in at least one eye at one year of age were followed during a period of 3
      years. At the age 4 years amblyopia was found in 23 children (7%). The refraction
      data of these children were compared to the rest of the sample. We found that an
      increasing astigmatism during the test period was associated with an increased
      risk to develop amblyopia. The majority of children (n = 280) showed a decrease
      of their astigmatism, whereas all cases with a marked amblyopia (V.A. less than
      0.5) or binocular amblyopia, except one, had an increasing or unchanged
      astigmatism during the age period 1 to 4 years. Strabismus and oblique
      astigmatism at any time during the test period was also strongly related to
      amblyopia. The incidence of strabismus (1%) was unexpectedly low. The study also
      showed that independent of age there was no simple relationship between amblyopia
      and refraction errors measured at a single test session. The main conclusion of
      this study is that failure of emmetropization may play an important role in
      visual development.

PMID- 2220361
TI  - Retinal nerve fibre layer photography in glaucomatous and normal eyes.
AB  - The technique of retinal nerve fibre photography has been developed and tested in
      specialized centres and glaucoma clinics. The usefulness of a modified technique
      in clinical practice is the subject of this prospective study. Retinal nerve
      fibre photos from 41 patients with open-angle glaucoma and 40 normal patients
      were examined in a blind study, a total of 161 eyes. Photos from 5 eyes were of
      insufficient quality to allow evaluation. Nerve fibre loss was found in 36% of
      the normal eyes, 42% of glaucomatous eyes without visual field defects, and 87%
      of eyes with glaucomatous visual field defects. Sensitivity was 86% and
      specificity was 62% totally. In the younger patients aged less than 65 years both
      values were 82%. Photographic nerve fibre loss was found in 69% of normal eyes
      from patients aged more than 65 years, leading to a low specificity of 31% in
      this age group. Age related nerve fibre loss and clinically insignificant
      cataracts were the most obvious causes of non-glaucomatous nerve fibre loss.

PMID- 2220362
TI  - Screening for glaucoma with a non-mydriatic fundus camera.
AB  - 183 first-degree relatives of glaucoma patients were photographed by a technician
      with non-mydriatic fundus camera in order to study the suitability of wide angle
      black-and-white fundus photographs in screening for glaucoma. The success rate of
      photography was 92%. The optic disc and retinal nerve fiber layer abnormalities
      were evaluated from the photographs by an ophthalmologist. 31 subjects (17%) were
      referred to further ophthalmological examinations. We found 6 (3%) new glaucomas.
      In addition, in 6 patients (3%) retinal nerve fiber layer defect was the only
      abnormality, 5 subjects (3%) showed a hemorrhage and 2 eyes had collateral
      vessels as a sign of asymptomatic venous stasis change at the optic disc. Only 1
      of the 6 (17%) patients with glaucoma would have been found with tonometry alone.
      The results of this study indicate that non-mydriatic retinal camera is a useful
      tool in screening for glaucoma.

PMID- 2220365
TI  - Role of aqueous and vitreous cultures in diagnosing infectious endophthalmitis in
      rabbits.
AB  - Staph.aureus endophthalmitis was induced in both eyes of 32 rabbits.
      Endophthalmitis developed in all the 64 eyes within 24-36 h. All vitreous
      cultures were positive while only 21 simultaneous aqueous cultures were positive.
      Thus, the importance of vitreous cultures in diagnosing bacterial endophthalmitis
      is emphasised.

PMID- 2220363
TI  - Optic disc haemorrhages preceding manifest glaucoma.
AB  - The Dalby population has been subjected to repeated glaucoma surveys in a
      deliberate effort to describe the early stages of glaucoma. A total of 28
      haemorrhagic episodes were observed at 3819 examinations of persons not having
      manifest glaucoma. The prevalence of optic disc haemorrhages was dependent on age
      and residence. The mean IOP in eyes with optic disc haemorrhages was 17.0 mmHg.
      Only four out of 24 haemorrhages in eyes without pseudoexfoliations were
      associated with intraocular pressures over 20.5 mmHg. Of twelve cases followed
      more than six years two died and five developed manifest glaucoma. The period of
      latency between the detection of a haemorrhage and the development of a
      glaucomatous visual field defect was 2, 3, 5, 6, and 7 years, respectively.

PMID- 2220366
TI  - Immunohistochemical demonstration of epidermal growth factor in the lacrimal and
      submandibular glands of rats.
AB  - The extraorbital and intraorbital lacrimal glands, the Harderian glands, and the
      submandibular glands of five rats were excised after ethanol perfusion under
      general anesthesia. Indirect immunohistochemistry with antibodies specific to
      epidermal growth factor (EGF) was performed. EGF-like immunofluorescence (EGF-LI)
      was shown to be present both in the lacrimal glands (extra- and intraorbital) and
      in the submaxillary gland. In the lacrimal glands the specific immunoreaction
      appeared within the lumen of the acini and the cells of the tubular ducts close
      to the acini. Only faint EGF-LI was observed within the acinar cells. The
      submandibular glands showed intense EGF-LI only in the cells of the granular
      convoluted tubules. The Harderian gland did not show any EGF-LI. The results
      strongly support the idea that the lacrimal gland is a source of EGF in tear
      fluid (TF). Diseases of the lacrimal gland therefore may lead to decreased
      concentrations of EGF in tears. This may account in part for the pathophysiology
      of tear deficiency syndromes and may serve as the basis of a new rationale for
      the external application of EGF.

PMID- 2220370
TI  - Scleral dellen in strabismus surgery.
AB  - This communication highlights scleral dellen as an unusual complication of
      strabismus surgery in a 55-year-old hypertensive male. The clinical significance,
      differential diagnosis and management of this condition has been discussed.

PMID- 2220371
TI  - Workshop on current trends in growth related research. Proceedings of a meeting
      held in Haifa, Israel 24-27 October, 1989.

PMID- 2220367
TI  - Retinal nerve fiber layer in multiple sclerosis.
AB  - To evaluate the usefulness of the retinal nerve fiber layer (RNFL) appearance in
      estimation of optic nerve damage in MS, we examined 20 patients with definite MS
      and 20 normal control patients. Photographs of the RNFL in 80 eyes were
      classified as normal or abnormal by two examiners working independently. The
      results were very similar, even though the clinical data of which they were
      informed and their experience with RNFL-evaluation differed. We found RNFL
      defects in 80% of MS patients and in 73% of MS eyes. In the control group the
      values were 5% and 2.5%. Subclinical optic neuropathy in eyes without any history
      of optic neuritis was demonstrated by RNFL defects in 68%. We conclude, that in
      detecting clinical and subclinical optic neuropathy, RNFL-evaluation is to be
      recommended as the method of choice.

PMID- 2220368
TI  - The correction of ptosis with adjustable suture technique.
AB  - We discuss here the results of a simple technique for the correction of ptosis,
      performed by us as an alternative to other techniques. The basic principal of
      this technique is to suspend the ptotic upper eyelid to the frontalis muscle by
      3/0 silk sutures passed above the tarsus using a peritoneal needle and to adjust
      the rima palpebrarum in the post-operative period. This method is simple and easy
      to perform with few complications.

PMID- 2220374
TI  - Endocrine basis for growth-promoting therapy.

PMID- 2220372
TI  - Growth hormone therapy: the ethical angle.

PMID- 2220376
TI  - The endocrinology of the pubertal growth spurt.

PMID- 2220375
TI  - The infancy-childhood growth spurt.
AB  - Early normal human linear growth is unstable and oscillates owing to an increase
      in growth rate between 6 and 12 months of age. This defines the onset of the
      infancy-childhood growth spurt (IC spurt). The onset is identical with the onset
      of the childhood component of the infancy-childhood-puberty growth model. The IC
      spurt is completed when the infancy component of this model has virtually ceased,
      at around 3 years of age. Additional observations suggest that its onset
      represents the age at which growth hormone (GH) begins to regulate growth
      significantly. The negative impact of late onset of the IC spurt on attained
      height is illustrated and discussed. A delayed spurt is observed in 30-50% of
      children with growth-related disorders and of infants living in a poor area of a
      developing country. The IC spurt is absent in children with GH deficiency who
      receive no hormonal therapy.

PMID- 2220378
TI  - Actions of growth hormone on adipose tissue: possible involvement of autocrine or
      paracrine factors.

PMID- 2220379
TI  - Cartilage as a target tissue for growth hormone and insulin-like growth factor I.

PMID- 2220377
TI  - The determinants of catch-up growth.

PMID- 2220380
TI  - Effects of growth hormone on body composition and metabolism.

PMID- 2220381
TI  - Growth hormone binding proteins in plasma--an update.

PMID- 2220364
TI  - Intraocular levels of cefuroxime in uninflamed rabbit eyes.
AB  - Intraocular levels of cefuroxime following subconjunctival, intravitreal and
      combined intravitreal and intravenous administration were determined in
      uninflamed rabbit eyes. Intraocular levels of the antibiotic were assayed by a
      biological method. Penetration of cefuroxime into the vitreous following
      subconjunctival administration was poor. Subconjunctival administration produced
      higher levels of cefuroxime in the aqueous when compared to parenteral
      administration alone. Higher levels of cefuroxime were achieved both in the
      aqueous and in the vitreous after an intravitreal injection. Intravitreal
      injection of 100 and 1000 micrograms cefuroxime produced intravitreal levels
      close to the minimum inhibitory concentration (MIC) for most ocular pathogens up
      to 24 h after drug administration. Intravenous supplementation did neither
      enhance the intraocular levels nor did it delay the clearance of the
      intravitreally injected antibiotic. Mild histopathological changes were seen with
      equal frequency both in the control and the test eyes and are attributed to the
      sampling techniques. Electroretinography (ERG) showed no definite changes
      suggestive of retinal toxicity up to 55 days after intravitreal administration.

PMID- 2220373
TI  - Fetal growth in late gestation--a constrained pattern of growth.

PMID- 2220382
TI  - Regulation of growth hormone receptor turnover by growth hormone.

PMID- 2220384
TI  - Treatment with human growth hormone: who, how, when and why?

PMID- 2220387
TI  - Is there an auxological basis for growth-promoting treatment with human growth
      hormone in short children?

PMID- 2220386
TI  - Gonadotrophin-releasing hormone agonist treatment of central precocious puberty:
      an analysis of growth data in a developmental context.
AB  - Growth and skeletal maturation was assessed in 83 girls with central precocious
      puberty (CPP) during pituitary-gonadal suppression induced by treatment with a
      gonadotrophin-releasing hormone agonist (GnRHa). The mean pretreatment
      chronological age (CA) was 6.3 years and the mean bone age (BA) was 10.6 years.
      During the suppression of gonadal sex steroid secretion, mean height velocity
      (HV) decreased from a pretreatment value of 10.8 cm/year to 5.9 (year 1, n = 83),
      4.9 (year 2, n = 72), 4.2 (year 3, n = 45), and 4.4 (year 4, n = 23) cm/year.
      During each interval, there was a negative correlation between HV and the
      pretreatment BA. In addition, the rate of skeletal maturation was reduced during
      GnRHa treatment (delta BA/delta CA = 0.6 +/- 0.1 over 3 years, n = 45). The rate
      of skeletal maturation during therapy was also negatively correlated with
      pretreatment BA. Predicted adult stature, based upon zeta-scores of height for
      BA, increased significantly and progressively during therapy but the changes in
      height SDS for BA varied significantly. Since HV, delta BA/delta CA, and the
      change in height SDS for BA (delta HT SDS for BA) during pituitary-gonadal
      suppression all correlated with the initial degree of skeletal maturation, the
      effect of GnRHa therapy on final adult height in children with CPP will be best
      understood if growth data are assessed within a developmental framework.

PMID- 2220388
TI  - Biosynthetic human growth hormone in the treatment of growth hormone deficiency.
AB  - A total of 309 previously untreated children with growth hormone deficiency (GHD)
      (219 boys, 90 girls; mean age 8.4 +/- 3.9 years, range 1.5-19 years) were treated
      for up to 3 years in an ongoing trial designed to examine the long-term efficacy
      and safety of biosynthetic somatropin (rhGH). The children were treated with
      rhGH, 0.06 mg/kg (0.16 IU/kg) three times weekly. In the prepubertal children,
      the mean height velocity increased during the first year from 3.8 +/- 1.8 cm/year
      to 8.9 +/- 2.2 cm/year (n = 188). During the second and third years, their height
      velocities were 7.1 +/- 1.1 (n = 147) and 6.3 +/- 1.2 cm/year (n = 64),
      respectively. The height velocity SDS increased from -2.5 +/- 1.9 before
      treatment to 3.1 +/- 2.6 during the first year of treatment in the prepubertal
      children. The mean pretreatment height velocity in those with idiopathic GHD (3.8
      +/- 1.6 cm/year) did not differ from that in children with organic GHD (3.8 +/-
      2.3 cm/year). In addition, the height velocities during the first year of therapy
      did not differ significantly with respect to the aetiology of GHD. For the
      children who entered puberty during the study, the mean height velocity increased
      from 3.0 +/- 1.7 cm/year before treatment to 8.4 +/- 2.3 cm/year during the first
      year of rhGH therapy. In the first year, the height velocity of children with a
      bone age of less than 5 years (9.4 +/- 2.3 cm/year) was significantly greater
      than that in children with a bone age of 5-10 years (8.4 +/- 1.8 cm/year) or
      greater than 10 years (7.8 +/- 2.2 cm/year: p = 0.001).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2220383
TI  - Conclusions: a consensus statement on growth hormone therapy.

PMID- 2220369
TI  - Central vein thrombosis and topical dipivalyl epinephrine.
AB  - A report is given on an 83-year-old female who acquired central vein thrombosis
      in her seeing eye one day after having started topical medication with dipivalyl
      epinephrine for advanced glaucoma discovered in the other eye. From present
      knowledge about the effects of adrenergic eye drops on ocular blood circulation,
      it is difficult to suggest an association between the two events, which may be
      coincidental only.

PMID- 2220385
TI  - Neuroactive drugs in growth disorders.

PMID- 2220389
TI  - Effects of insulin-like growth factor I in man.
AB  - A 6-day period of subcutaneous infusion with recombinant human insulin-like
      growth factor I in three healthy male volunteers resulted in an increase in the
      ratio of insulin to C-peptide levels and significant decreases in triglyceride
      levels and the ratio of total to high density lipoprotein-cholesterol in serum.
      Increased renal plasma flow and glomerular filtration rates were also observed.

PMID- 2220391
TI  - Insulin-like growth factor II effects mediated through insulin-like growth factor
      II receptors.
AB  - Insulin-like growth factor II (IGF-II) resembles the homologous peptide insulin
      like growth factor I (IGF-I) in that it stimulates cellular growth in vitro. This
      effect is generally believed to be mediated through IGF type 1 receptors; the
      role of the IGF type 2 receptor remains, as yet, unknown. IGF-II has been shown
      to stimulate clonal expansion in cells from the human erythroleukaemia cell line
      K562, which displays binding of IGF-II and insulin but not IGF-I. This IGF-II
      effect was dose-dependent and correlated to the amount of specific binding; IGF-I
      did not stimulate growth. A similar effect on clonal growth was observed in the
      human T-cell line Jurkat. Furthermore, IGF-II was found to stimulate the
      cytotoxic activity of natural killer cells (as does interleukin 2). This effect
      was not inhibited by addition of IGF binding protein 1. Thus, it can be concluded
      that IGF-II, besides demonstrating standard IGF properties, exhibits unique
      biological effects in certain cells.

PMID- 2220393
TI  - Growth factors and the developmental neurobiology of the hypothalamus.

PMID- 2220392
TI  - Growth hormone-releasing hormone: structure, gene expression and molecular
      heterogeneity.

PMID- 2220390
TI  - Anabolic and tissue repair functions of recombinant insulin-like growth factor I.
AB  - Recombinant human insulin-like growth factor I (rhIGF-I) has been produced in
      yeast and purified using conventional biochemical techniques. It has been shown
      to have receptor-binding properties and in vitro growth-promoting activities
      comparable to those of plasma-derived IGF-I. The anabolic actions of IGF-I can be
      studied using both systemic and local administration in vivo. The growth
      promoting activity and systemic anabolic actions of recombinant IGF-I were
      studied in mutant dwarf rats. IGF-I was infused intravenously for 9 days and
      resulted in a significant gain in body weight and significant bone growth, though
      the effects were not as great as those observed with human growth hormone (hGH).
      IGF-I also had selective effects on specific organs which were not observed in
      hGH-treated animals. The results indicate that the growth-promoting effects of
      IGF-I show a different pattern compared to hGH. The effects of local
      administration of recombinant IGF-I on tissue regeneration and maintenance were
      also studied in hypophysectomized and normal rats. After hypophysectomy, the
      regeneration processes were impaired when both peripheral nerve regeneration and
      incision wound healing were considered. The results indicate that local
      administration could have significant effects on regeneration of, for example,
      peripheral nerves.

PMID- 2220394
TI  - Hashimoto's thyroiditis as a risk factor of thyroid lymphoma.
AB  - Hashimoto's thyroiditis (struma lymphomatosa), first described by Hashimoto in
      1912, is an autoimmune inflammation of the thyroid commonly affecting middle-aged
      women. Histologic features of Hashimoto's thyroiditis (HT) include diffuse
      infiltration of lymphoid cells usually with formation of lymphoid follicles,
      varying degrees of fibrosis, oxyphilic change or squamous metaplasia in the
      epithelial cells. When the presence of focal lymphocytic infiltration is assumed
      to be an adequate criterion for diagnosis of autoimmune thyroiditis, the
      incidence appears to be as high as 16-23% in elderly females. An etiologically
      important role of HT in the development of thyroid lymphoma had been postulated,
      and recently, this was confirmed by epidemiological studies. In this article, a
      brief review of HT is given, together with results of our studies on thyroid
      lymphoma, and a discussion in the light of the pertinent literature. Immunologic
      and immunohistologic studies revealed that all of the thyroid lymphomas were of
      the B-cell type. Malignant lymphomas developing in patients with other autoimmune
      diseases such as Sjogren syndrome and rheumatoid arthritis have also been
      reported to be B-cell derived. Therefore it is suggested that immune deficiency
      is a causal factor for B-cell lymphoma.

PMID- 2220396
TI  - Gastric and intestinal phenotypic expression of human stomach cancers as revealed
      by pepsinogen immunohistochemistry and mucin histochemistry.
AB  - Gastric and intestinal phenotypic expression in 223 surgically obtained primary
      gastric cancers and their histogenetic relationship to intestinal metaplasia in
      the surrounding gastric mucosa were studied by mucin histochemistry and
      pepsinogen (Pg) immunohistochemistry. Histochemical differentiation of mucins
      (paradoxical concanavalin A, the galactose oxidase-Schiff sequence and sialidase
      galactose oxidase-Schiff) and immunohistochemical staining of Pgs I and II,
      allowed differentiation of gastric cancer cells from different histological
      categories into gastric elements including mucous neck cells, pyloric gland cells
      and surface mucous cells or intestinal elements including goblet cell and
      intestinal absorptive cell types. Of 122 papillary and tubular adenocarcinomas,
      33 (27.1%) consisted mainly of gastric-type cells and 42 (34.4%) predominantly of
      intestinal-type cells. The remainder (38.5%) consisted of mixtures of gastric-
      and intestinal-type cells. Of 101 poorly differentiated adenocarcinomas, signet
      ring cell carcinomas and mucinous adenocarcinomas, 59 (58.4%) consisted mainly of
      gastric-type cells and 20 (19.8%) mainly of intestinal-type cells. Seven out of
      35 papillary and tubular adenocarcinomas consisting mainly of gastric-type cancer
      cells were surrounded by mucosa with intestinal metaplasia. Conversely, 10 out of
      40 papillary and tubular adenocarcinomas consisting mainly of intestinal-type
      cancer cells were observed in nonmetaplastic gastric mucosa. Thus no relationship
      as regards intestinal phenotypic expression was found between gastric cancers and
      surrounding gastric mucosa.

PMID- 2220395
TI  - Immune complex-induced disseminated intravascular coagulation (DIC). An
      experimental study.
AB  - Disseminated intravascular coagulation (DIC) was induced in rabbits by
      administration of antibody and antigen. The rabbits were sensitized passively by
      i.v. injection of antiferritin antiserum and challenged simultaneously by an i.p.
      inoculation of ferritin. After the challenge, circulating white blood cells,
      platelets and plasma fibrinogen levels showed an early fall, reaching minimum
      values at 3, 10 and 6 h, respectively. Fibrin thrombi appeared first at 2 h,
      reached a maximum at 5-7 h, and had mostly disappeared by 24 h. Formation of
      fibrin thrombi was frequent in the lung, liver, kidney and spleen. Early
      morphological changes included neutrophilic infiltration and accumulation of
      platelets in capillaries. Ferritin-antiferritin complexes were noted among fibrin
      thrombi or phagocytized by reticuloendothelial cells and neutrophils. The
      capacity of Kupffer cells to remove circulating immune complexes was saturated
      transiently; at this time fibrin thrombosis in various organs was most widespread
      and severe. It seems likely that formation of antigen-antibody complexes in the
      microcirculation initiates activation of platelets and neutrophils with
      subsequent release of mediators responsible for triggering DIC. Activation of
      complement was another possible factor inducing the reaction. In addition,
      blockade of the reticuloendothelial system promotes the progression of DIC. It is
      considered that the methods described constitute a useful model for further
      elucidation of immune complex-induced DIC.

PMID- 2220397
TI  - Immunohistochemical and gross dissection studies of annular pancreas.
AB  - Three cases of annular pancreas were studied immunohistochemically on an
      embryological basis in relation to the duct system. Annular pancreatic tissue was
      characterized by abundant, irregularly shaped islets with a very high proportion
      of pancreatic polypeptide (PP) cells, similar to those in the postero-inferior
      part of the pancreatic head of controls. This PP-rich area fused with PP-poor
      areas in both the anterior and posterior portions, resulting in encirclement of
      the duodenum except for a few PP-poor areas. The pancreatic duct of the annular
      tissue passed from the anterior portion to the lateral and posterior portions,
      finally joining with the main pancreatic duct. No connection was present between
      the duct of the anterior portion and the main pancreatic duct. Therefore, the
      annular pancreatic tissue was revealed to arise from the ventral primordium,
      supporting Lecco's theory that the free end of the ventral anlage is fixed.

PMID- 2220398
TI  - Expression of blood group antigens and lectin binding in adenocarcinomas of the
      endometrium.
AB  - To investigate cytoplasmic alterations in cancers of the endometrium, monoclonal
      antibodies against H, A and B blood group substances and related lectins such as
      Ulex europaeus agglutinin 1 (UEA-1), Lotus tetragonolobus agglutinin (LTA), and
      Griffonia simplicifolia 1 (GS1-A4, -B4) were applied to 42 cases of endometrial
      adenocarcinoma (EAC) and 11 adenomyoses. The control specimens consisted of
      normal endometria with leiomyoma or adenomyosis from patients of known blood
      group type. The brightest and most consistent staining was obtained with GS1-A4,
      showing 98% positivity in EAC in contrast to 18% in normal endometria. In
      contrast, expression of A antigen was seen in only 24% of EAC and in 13% of
      normal endometria, UEA-1 binding was seen in 81% of EAC and in 10% of normal
      endometria, whereas H antigen was seen in 60% of EAC and 0% of normal endometria.
      In adenocarcinomas, staining was seen not only along the luminal border of glands
      but also in the cytoplasm and the lateral or basal cell membranes, whereas in the
      normal endometrium staining was mostly along the luminal border. Thus, a
      difference in the positivity and localization of glycoconjugates was observed in
      neoplastic and non-neoplastic endometrium.

PMID- 2220399
TI  - Biclonality of composite B- and T-cell lymphomas. A case report.
AB  - Most composite lymphomas which are composed morphologically of two different
      tumor cell types are considered to represent different morphological expressions
      of a single clone. However, in recent years, composite B- and T-cell lymphomas
      and biclonality of B-cell lymphoma have been reported. We experienced a case of
      composite lymphoma which initially developed as cutaneous lymphoma composed of
      lymphoplasmacytes associated with large clear cells. It was confirmed that the
      tumor cells of these two systems were biclonal on the basis of surface markers
      and DNA rearrangements, i.e. B cells of the IgG kappa type, showing IgH and kappa
      chain DNA rearrangement, and T-cells with CD4 surface marker, showing
      rearrangement of the T-cell receptor beta chain gene. This case showed a
      predominant B-cell pattern at the initial stage, and terminated in T-cell
      lymphoma, as revealed at autopsy. Therefore we considered this case to be a
      unique composite lymphoma showing biclonality of both B- and T-cell systems,
      providing a number of suggestions for future study of malignant lymphoma.

PMID- 2220400
TI  - Characterization of myxoid substance of human aortic sarcoma.
AB  - An autopsy case of aortic sarcoma which was located in the intima of the
      abdominal aorta and characterized by abundant extracellular myxoid substances was
      examined. Histological, immunohistochemical and ultrastructural studies revealed
      no characteristics suggestive of endothelial, leiomyogenic or histiocytic
      differentiation. Histochemical and biochemical analyses revealed that the myxoid
      substances were glycosaminoglycans (GAGs) consisting of hyaluronic acid (85% of
      the total GAG) and chondroitin sulfate proteoglycan (15% of the total GAG).
      Neither heparan sulfate proteoglycan nor dermatan sulfate proteoglycan was
      detected. In the aorta, GAGs are synthesized mainly by arterial smooth muscle
      cells and endothelial cells. Among these cells, the arterial smooth muscle cell
      is the principal cell type that synthesizes aortic GAGs, predominantly
      chondroitin sulfate proteoglycan, whereas the endothelial cell synthesizes small
      amounts of GAGs, predominantly heparan sulfate proteoglycan. Therefore, the
      results of this study suggest that the tumor cells of the present case have a
      property similar to arterial smooth muscle cells in terms of GAG synthesis, and
      that the tumor originated most probably from arterial smooth muscle cells.

PMID- 2220401
TI  - Giant cell fibroblastoma. A case report.
AB  - A case of giant cell fibroblastoma occurring in the knee of a 16-month-old girl
      is reported. The ill-defined subcutaneous tumor measuring 2 x 2 cm was composed
      of diffusely proliferating spindle-shaped tumor cells with scattered, atypical
      multinucleated giant cells in a myxoid or collagenous background and irregularly
      branching sinusoid-like tissue spaces. In addition to floret-type giant cells, a
      few osteoclast-like giant cells were present in a cellular area where tumor cells
      were focally arranged in a storiform pattern. Immunohistochemically, the tumor
      cells gave positive reactions for only vimentin and actin. In spite of the high
      recurrence rate of this type of tumor, the course of the patient after excision
      of the tumor has been uneventful. It is important to distinguish this rare,
      peculiar fibrous tumor from other soft tissue tumors including some sarcomas.

PMID- 2220402
TI  - Role of fluid volume retention in angiotensin II salt-dependent hypertension.

PMID- 2220404
TI  - Role of renal nerves in volume homeostasis.

PMID- 2220403
TI  - Renal function curves and control of body fluids and arterial pressure.
AB  - The purpose of this paper has been to emphasize the extreme importance of the
      renal function curve in determining the long-term level of arterial pressure. The
      reason for this importance is that the renal-body fluid-pressure control system
      exhibits the phenomenon of "infinite feedback gain". This is, the arterial
      pressure will stabilize only when the intake and output of water and salt becomes
      exactly equal, and this occurs at only one very exact pressure level for any
      given renal function curve and given salt intake level. This renal mechanism for
      controlling the body fluids and simultaneously controlling the arterial pressure,
      because of its infinite feedback gain capability for controlling arterial
      pressure, requires that other pressure control mechanisms must interact with this
      mechanism either to alter the renal function curve or to make the animal change
      its intake of salt and water if the other pressure mechanisms are to have any
      effect on the long-term arterial pressure level. Therefore, in virtually any
      analysis of long-term arterial pressure regulation, the renal function curve or
      its mathematical equivalent plays a central role.

PMID- 2220407
TI  - The natriuretic effects of AVP and dDAVP: a lithium clearance study in conscious
      rats.

PMID- 2220406
TI  - Different effects of short and longer-term arginine vasopressin (AVP)
      administration on sodium excretion in Brattleboro rats.

PMID- 2220405
TI  - Quantitative aspects of renal actions of vasopressin.

PMID- 2220408
TI  - Role of blood pressure in the control of renin release.

PMID- 2220409
TI  - Role of the renin-angiotensin system in control of sodium excretion and arterial
      pressure.
AB  - The RAS is part of an extremely powerful feedback system for long-term control of
      arterial pressure and volume homeostasis as illustrated in Figure 4. Disturbances
      that tend to lower blood pressure such as heart failure, cirrhosis, and
      peripheral vasodilation, cause sodium and water retention until blood pressure
      returns to normal due in large part to the combined actions of ANGII and reduced
      renal perfusion pressure. In response to disturbances such as high sodium intake,
      suppression of ANGII greatly amplifies the effectiveness of the basic pressure
      natriuresis and diuresis mechanism, thereby preventing large increases in body
      fluid volumes and blood pressure. In circumstances in which the RAS is
      inappropriately activated, the sodium-water retaining effects of ANGII
      necessitate increased blood pressure to maintain sodium and water balance via
      pressure natriuresis. The sodium retaining actions of the RAS are mediated by
      intrarenal as well as extrarenal mechanisms. The intrarenal actions of ANGII
      include a direct effect on tubular sodium transport as well as a potent
      constrictor action on efferent arterioles which increases tubular reabsorption by
      altering peritubular capillary physical forces. The constrictor action of ANGII
      on efferent arterioles also plays an important role in stabilizing GFR and
      therefore in preventing fluctuations in excretion of metabolic waste products
      that depend upon a high GFR for excretion. ANGII is known to stimulate proximal
      reabsorption, but the effects on more distal tubular segments have not been
      completely elucidated. The primary extra-known to stimulate proximal
      reabsorption, but the effects on more distal tubular segments have not been
      completely elucidated. The primary extra-renal effect of ANGII which influences
      sodium excretion is stimulation of aldosterone secretion. Current evidence,
      however, suggests that the various intrarenal actions of ANGII are quantitatively
      more important in causing sodium retention than those mediated by changes in
      aldosterone secretion. However, the combined intrarenal and extrarenal actions of
      ANGII on sodium reabsorption provide the body with one of its most potent
      feedback systems for long-term regulation of body fluid volumes and arterial
      pressure.

PMID- 2220410
TI  - Contribution of the tubuloglomerular feedback mechanism to sodium homeostasis and
      interaction with the renin-angiotensin system.

PMID- 2220411
TI  - Intrarenal control of GFR, with special reference to proximal reabsorption.

PMID- 2220412
TI  - Psychosocial function before and after gastric banding surgery for morbid
      obesity. A prospective psychiatric study.
AB  - The objective of this study was to measure psychosocial functioning in morbid
      obese patients before and after horizontal gastric banding surgery, and to
      analyse the relations between the changes in psychosocial functioning and
      preoperative variables and degree of weight loss. METHODS: One hundred and three
      patients undergoing horizontal gastric banding surgery from 1982-85 were
      personally interviewed and rated by the author on DSM-III axis 1, 2 and 5, the
      CPRS, demographic data and precoded clinical scales. The interviews and ratings
      were completed in the last week before the operation. In addition the patients
      completed questionnaires concerning psychic symptoms (SCL-90) and quality of
      life. Twenty-five patients also completed the questionnaires six months before
      the operation. The patients were followed up after one and three years. RESULTS:
      There were 66 women and 24 men with a mean age of 35.4 years. Their mean
      preoperative weight was 121.8 kg corresponding to a Broca Index of 1.72 and a
      Body Mass Index of 41.5. They had a mean SCL-90/GSI score of 0.99. Fourty-one
      percent got a diagnosis on DSM-III axis 1 and 22% a diagnosis on axis 2. Thirty
      seven percent had made at least one contact with health services before the
      operation due to psychiatric problems. There were no strong relations between the
      relative preoperative weight and any other preoperative variable. The follow-up
      rate was 93%. The patients had a mean weight loss of 34.9 kg after one year and
      31.5 kg three years after the operation. On group level the course and outcome of
      psychosocial functioning was a beneficial one. These changes were highly
      statistically significant and evident after one year, with only slight
      differences to the three years follow-up. The degree of weight loss explained a
      modest but statistically significant part of the variance in most of the
      psychosocial outcome variables when the preoperative level of the variable and
      the preoperative weight were controlled for. The degree of psychiatric contact in
      the follow-up period seemed to reflect another dimension. It was not related to
      the changes in the other psychosocial outcome variables, nor to the degree of
      weight loss, but was highly correlated to the degree of preoperative psychiatric
      contact. A group of patients with negative psychosocial outcome was identified.
      This group was characterized by a higher frequency of preoperative psychiatric
      help-seeking, than the rest of the patients. This pattern was most evident in a
      subgroup of 19% of the patients, who had a negative psychosocial reaction in
      spite of a sufficient weight loss.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2220413
TI  - Whole blood luminol-enhanced chemiluminescence: statistical analysis of the
      responses of different subjects.
AB  - Whole blood luminol-enhanced chemiluminescence (CL) was studied using N-formyl
      methionyl-leucyl-phenylalanine (FMLP) or opsonized zymosan particles as stimuli.
      The peak and the integral responses of CL were recorded. In the FMLP-induced CL
      the initial activation (1-minute values) was also studied, because it coincides
      with the extracellular production of oxy radicals. Correction factors based on
      neutrophil count and on haemoglobin concentration were found to decrease
      dispersion and shape the distributions of the CL responses close to normal in a
      study of 50 healthy adults. One-minute values were significantly lower in women
      than in men but there were no significant differences for peak or integral values
      between sexes. Depressed reaction is in accordance with the previous findings
      that phagocytic oxy radical production is depressed in female plasma. Thus, our
      results suggest that 1-minute value is a variable more sensitive than peak or
      integral value of the CL response.

PMID- 2220414
TI  - Influence of gluten-derived fractions on chemiluminescence production by human
      neutrophils.
AB  - The effects of gliadin and glyc-gli on leukocyte chemiluminescence response were
      assessed in vitro. A dose-dependent increase in chemiluminescence response of
      neutrophils stimulated by zymosan was observed by using gliadin at concentrations
      ranging between 1 and 20 micrograms. By increasing glyc-gli concentration, a
      bimodal response was observed with an enhancement up to 50 micrograms/ml,
      followed by suppressive effects, which were again dose-dependent. The possible
      implications of these findings in human pathology are discussed.

PMID- 2220415
TI  - Chemiluminescence properties of human, canine and rat polymorphonuclear cells.
AB  - Human as well as canine and rat polymorphonuclear cells (PMN) were separated from
      whole blood by centrifugation. Two-step discontinuous Percoll gradients with
      distinct different densities were used. The chemiluminescence properties of the
      isolated PMN and of phagocytes in small quantities of whole blood were compared
      in luminol-enhanced assays after stimulation with various agents: non-opsonized
      zymosan (3.5 g/l), phorbol myristate acetate (PMA, 2.8 x 10(-6) mol/l), calcium
      ionophore A 23187 (10(-5) mol/l) and N-formyl-methionyl-leucyl-phenylalanine
      (FMLP, 3.5 x 10(-6) mol/l). The isolated cells of the three species responded to
      all of the various stimuli. Species-related sensitivity could be ordered: human
      greater than canine greater than rat. Response to the various agents in the human
      cells can be ranked: PMA greater than or equal to A 23187 greater than zymosan
      greater than FMLP; for the dog: A 23187 greater than PMA greater than zymosan
      greater than FMLP; and for the rat: zymosan greater than or equal to PMA greater
      than FMLP greater than or equal to A 23187. Time course and peak maximum response
      were different upon stimulation in the absence and presence of autologous plasma.
      Distinct soluble stimuli resulted in maximum responses below the baseline in the
      whole blood assays with canine (FMLP) and rat (FMLP, A 23187) phagocytes.

PMID- 2220416
TI  - Affinity purification of bacterial luciferase and NAD(P)H:FMN oxidoreductases by
      FMN-sepharose for analytical applications.
AB  - A modified purification method for bacterial luciferases and NAD(P)H:FMN
      oxidoreductases is described which uses FMN-Sepharose alone or coupled to DEAE
      ion exchange chromatography for the simultaneous purification of luciferase and
      the various oxidoreductases from Vibrio harveyi, a bright mutant of Vibrio
      harveyi, Vibrio fischeri, and Photobacterium phosphoreum. This purification
      method is compared with DEAE-Sepharose Cl 6B fractionations from these organisms.
      Both methods allow the separation of oxidoreductases specific for either NADH or
      NADPH. The use of FMN-Sepharose coupled to DEAE-Sepharose fractionation allows
      the isolation of highly purified enzymes. Lacking interfering factors, these are
      very suitable for various analytical applications based on bacterial
      bioluminescence enzymes. The partially purified enzymes from the affinity column
      have higher specific activities than those obtained using DEAE-Sepharose.

PMID- 2220417
TI  - Enhanced chemiluminescence in the measurement of proteins and haptens: evaluation
      of choriogonadotropin (hCG) and free thyroxin.
AB  - We evaluated the Amerlite system (Amersham, Bucks, UK) for hCG and FT4. The
      within-run imprecision (CV%) for hCG was 4.05 at 19.6 U/l (n = 10), 6.28 at 43.45
      U/l (n = 10) and 4.62 at 298.57 U/l (n = 10). The between-run imprecision (five
      replicates for ten days) was 4.8%, 15% and 11%, respectively. The system was
      linear up to 200 U/l. A good correlation between Amerlite hCG and an IRMA assay
      (Becton Dickinson, r = 0.91), Delfia (Pharmacia, r = 0.91) and an automated ELISA
      assay on ES 600 (Boehringer, r = 0.92) was observed on 70 samples. Within-run
      imprecision for FT4 was 3.8% at 0.7 ng/dl (n = 10), 3.3% at 1 ng/dl (n = 10) and
      4.32% at 5.15 ng/dl (n = 10), and between-run was 5.95%, 4.4% and 8.2%,
      respectively. The comparison with a commercial direct RIA (Becton Dickinson)
      showed good correlation (r = 0.90, n = 100 samples). The diagnostic value of the
      association of thyrotropin and FT4, in comparison with the traditional thyroid
      tests (T3, T4, thyrotropin, FT4, FT3) has been assessed in various thyroid
      diseases.

PMID- 2220418
TI  - Chemiluminescence (CL) in blood samples reflects leukocyte activation (LA) during
      anaphylactoid reactions in dogs.
AB  - Inflammation is accompanied by leukocyte activation (LA). We describe a simple ex
      vivo technique for studying LA that might help to find new LA inhibitors for the
      treatment of pathologic events related to LA. Arterial and venous blood samples
      obtained from six permanently catheterized beagle dogs -60, 0, +15 min and +23 h
      after i.v. challenge with C 48/80, and also blood samples from six normal
      beagles, were minimally diluted 1:2.5 with buffer. Total leukocyte counts (LC),
      and luminol amplified CL, induced by opsonized zymosan (C3-Z), were estimated.
      Blood samples from dogs elicited CL responses of almost 1/10 the magnitude of
      erythrocyte-free human leukocytes, whereas blood samples from rats reacted three
      orders of magnitude less. Obviously quenching of CL by accompanying erythrocytes
      in blood samples from dogs is not important, for CL correlated almost linearly
      with the CL in differently diluted samples. In arterial, but not in venous
      samples from catheterized dogs, absolute CL and LC, both were significantly
      depressed (p less than or equal to 0.05) 15 min after C 48/80 challenge. CL/10(6)
      leukocytes was augmented twofold. All leukocyte deviations returned to pre-values
      23 h post-challenge.

PMID- 2220419
TI  - Chemiluminescence of irradiated animal blood plasma.
AB  - Spontaneous and induced chemiluminescence of rat blood plasma following
      irradiation of the animals with fast neurons was studied. Dynamics of the
      luminescence reflected the degree of radiation injury and an oscillatory response
      of blood chemiluminescent effect was observed.

PMID- 2220420
TI  - A new fluorescence enhancement solution for europium-based time-resolved
      fluoroimmunoassays.
AB  - A cationic detergent is proposed as suitable insulating agent for the preparation
      of a fluorescence enhancement solution useful for europium-based time-resolved
      fluoroimmunoassays. Luminescence from europium ions at concentration as low as
      0.5 pmol/l can be detected in solution containing 1.6 mmol/l
      thenoyltrifluoroacetone, 110.5 mumol/l Adogen 464 and 0.1% Tween 20, in the
      presence of 0.5 mol/l NaCl. A competitive TR-FIA for rabbit IgG is described,
      showing that the new enhancement solution allows a sensitivity comparable to that
      of the high performance LKB Wallac DELFIA.

PMID- 2220421
TI  - Bioluminescence decay kinetics in the reaction of bacterial luciferase with
      different aldehydes.
AB  - At 22 degrees C the bioluminescence decay kinetics in the in vitro reaction
      catalysed by Vibrio harveyi luciferase in the presence of different aldehydes-
      nonanal, decanal, tridecanal and tetradecanal did not follow the simple
      exponential pattern and could be fitted to a two-exponential process. One more
      principal distinction from the first-order kinetics is the dependence of the
      parameters on aldehyde concentration. The complex bioluminescence decay kinetics
      are interpreted in terms of a scheme, where bacterial luciferase is able to
      perform multiple turnovers using different flavin species to produce light. The
      initial phase of the bioluminescent reaction appears to proceed mainly with fully
      reduced flavin as the substrate while the final one results from the involvement
      of flavin semiquinone in the catalytic cycle.

PMID- 2220422
TI  - [Endoscopic sphincterotomy in choledocholithiasis: analysis of an experience of
      530 interventions].
AB  - We report the experience of 530 consecutive cases of choledocolithiasis treated
      through Endoscopic Sphincterotomy (ES) between January 1980 and January 1988 (74%
      of total patients submitted to ES in the same period). 73% had more than 60 years
      and 47% more than 70 years. A slight majority (52%) had previous cholecystectomy
      (1/3 still with T-tube drainage) and the remaining had gallbladders insitu
      (lithiasic in 82%). Therapeutic goals (achieved drainage and complete stone
      removal) have been achieved in 95% of patients with a low immediate morbidity
      (9%) and mortality (1%). Delayed mortality, until 30th day (3%) includes 6 cases
      of obstructive cholangitis with sepsis, unaltered by emergent ES. Follow-up
      showed a 3% incidence of reintervention from restenosed ES. Patients with
      lithiasic gallbladder had a 33% cholecistectomy rate, mostly elective during
      first month post-ES. Our experience confirms ES as an efficient and safe routine
      treatment for choledocolithiasis. It should be the first choice in patients with
      previous cholecystectomy or alithiasic gallbladder and a largely applicable tool
      in those with associated gallbladder stones. Decision about post-ES
      cholecystectomy in these patients must be weighed on clinical grounds and
      according to surgical risk groups.

PMID- 2220424
TI  - [Treatment of anemia in patients with chronic kidney insufficiency in
      hemodialysis with erythropoietin].
AB  - A group of 50 patients (26 men and 24 women, mean age 50 +/- 19 years and range
      21 to 67) on chronic hemodialysis (HD) and with basal levels of hemoglobin (Hb)
      less than or equal to 8 g/dl was treated with recombinant human erythropoietin (r
      HuEpo) during 3 months. r-HuEpo was started at 50 U/kg I.V. 3 times a week,
      immediately after each session of HD, for 4 weeks, and this dose was increased in
      steps of 25 U/kg until a Hb level of 12 g/dl or a maximum dose of 100 U/kg were
      reached. Complete blood counts and biochemical profile were performed before the
      first dose of r-HuEpo and once weekly and monthly respectively during the period
      of treatment. In 8 patients the red-cell life span was studied with cromium 51
      labelled erythrocytes just before and after treatment. One patient had a grand
      mal seizure and the r-HuEpo was discontinued. In 44 patients the mean hematocrit
      increased from 21.8% to 32.1% and in the other 5 there were no response because
      of iron deficiency. There were no changes in leucocytes and platelets counts and
      consistent decreases in iron and ferritin serum concentrations were observed
      despite oral supplementation of iron. In the 8 patients studied the shortened
      erythrocyte survival did not suffer any significant variation with r-HuEpo.
      Predialysis creatinine, urea and phosphorus blood levels increased significantly
      at 3th month of treatment but there was no increase in potassium. In 32.6% of
      previously normotensive and hypertensive patients an increase in blood pressure
      was founded. Thrombosis of arteriovenous fistulas and other severe clinical side
      effects were not observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220423
TI  - [Preservation of the liver using a new solution of phosphate-buffered
      saccharose].
AB  - The efficacy of the new phosphate-buffered sucrose solution (PBS), was compared
      with the conventional Euro-Collins (EC) and the lactated Ringer solution (LR), in
      its capacity to preserve the canine liver in cold storage. Three groups of 6
      canine livers, each group in one of those solutions, were put in cold storage for
      24 h at 4 degrees centigrade. At the end of this period the effect of warm
      hepatic reperfusion was studied in relationship with the following parameters:
      weight of the liver, bile excretion, hepatic biopsy, Na, K, Ca, P and some tests
      used to evaluate the hepatic function. The results obtained confirm, that PBS has
      an important impermeant effect over the hepatocyte, simulating that described
      recently by Lam et al to the kidney. Contrary to the EC and LR, the PBS inhibits
      hypothermic cell swelling, is more effective in the preservation of the liver
      histology, and has an opposed effect to the weight gain tendency induced by cold
      storage. During the period of warm reperfusion, high volumes of bile excretion
      and lesser levels of K depletion were observed in the PBS model. PBS is easy to
      prepare, and it is not expensive. For these reasons PBS could be an advantageous
      substitute of the EC in liver preservation.

PMID- 2220425
TI  - [Cryptococcosis. A study of 9 strains of Cryptococcus neoformans isolated from
      immunodeficient patients].
AB  - Five strains of Cryptococcus neoformans isolated from the cerebro-spinal fluid
      and 4 from the blood of AIDS patients, were studied. Although morphologically
      identical, they differed in the auxanographic pattern. All strains were
      pathogenic for mice by intracerebral route. Six isolates were sensitive and the
      other three resistant to 5-fluorocytosine. All strains were sensitive to the
      other antifungal tested: nystatin, amphotericin B, clotrimazole, miconazole,
      econazole and ketoconazole.

PMID- 2220427
TI  - [Affinity constant in radioimmunoassay].
AB  - Values for the affinity constant were determined, in three kits, for seric
      gastrin, following the Scatchard plot and Michaelis-Menten representation. The
      determination of the affinity constant, K, is of great value for it defines the
      antigen-antibody complex stability and it gives information about some aspects of
      the analysis system: sensitivity and antibody saturation.

PMID- 2220426
TI  - [Idiopathic proctocolitis. Follow-up (1-13 years) of 71 patients].
AB  - Follow-up was possible in 71 of 74 patients with idiopathic proctocolitis
      diagnosed and/or assisted at the Department of Gastroenterology of the Centro
      Policinico de Almada, between 1973 and 1985. The aim of the present study was to
      verify the natural history of the disease and if there were statistically
      significant differences depending on the extension of the disease (proctitis
      versus colitis). Complications were present in 22 patients (31%): peri-anal
      (10%), local or intestinal (24%) and extra-intestinal (28%). Fifteen patients
      (21% of the cases) had hospital admission at least once, and 2 of them (3%) were
      submitted to surgery. No cases of cancer of the colon and rectum were detected
      and mortality was nil. Forty-one patients (58%) were assymptomatic at the last
      observation (45% with colitis and 75% with proctitis). There were statistically
      significant differences between the group of patients with ulcerative colitis and
      that of proctitis concerning the total number of complications (p less than
      0.001), local complications (p less than 0.01), extra-intestinal complications (p
      less than 0.05), need for hospital admission (p less than 0.001) and absence of
      symptoms at the time of last observation (p less than 0.05), thus confirming a
      better prognosis of the disease when only the rectum is involved.

PMID- 2220428
TI  - [Evolution of clinical teaching at the Medical School of Lisbon (2)].
AB  - Clinical teaching at Lisbon's Faculty of Medicine is analyzed in its two phases:
      1. A period of stability and continuity of the institution (from 1911 to 1947)
      characterized by good rules in the selection of teachers: an impressive group of
      personalities (F. Gentil, Pulido Valente, Reynaldo dos Santos, Egas Moniz, A.
      Flores, Sobral Cid, Lopo de Carvalho, Gama Pinto, etc). At the same period a true
      University Hospital (of Santa Marta) provided clinical investigation (cerebral
      angiography and leucotomy, aortography and arteriography of the limbs,
      angiopneumography, endarterectomy) and the creation of new specialities
      (neurosurgery, vascular surgery, pneumology) (Act. Med. Port. 1990; 2: 109-114).
      2. A period of instability due to a deleterious political intervention (from 1947
      to the present day) responsible for the destruction of the structure and concept
      of a new teaching hospital (Hospital de Santa Maria). As a result of the socio
      political situation conflicting laws and vicious rules lead to an excess of non
      selected teachers and an alarming increase of students, patients and medical
      doctors A change from the present situation and a new concept of clinical
      teaching must be imagined.

PMID- 2220429
TI  - [Neoplastic hypercoagulability. Apropos of 2 cases with Trousseau syndrome].
AB  - The authors describe two cases with venous thromboembolism and neoplasia (ovary
      and stomach), which also showed evidence of arterial thromboembolic phenomena-
      cerebrovascular disease in the 1st case and acute myocardial infarction in the
      2nd case--favouring the existence of nonbacterial thrombotic endocarditis. This
      presentation of neoplastic hypercoagulability is frequently underrated in
      clinical practice. Pathogenesis, clinical manifestations, etiology, and
      therapeutics of these syndromes are discussed in relation to the presented cases.

PMID- 2220431
TI  - Placental haemangioma associated with acute fetal anemia in labour.
AB  - A case of pregnancy complicated by a placental hemangioma is presented. This was
      unassociated with any of the complications commonly coexistant with this tumor,
      and presented with fetal anemia due to a fetomaternal transfusion.

PMID- 2220430
TI  - [Intra-arterial occlusion of renal arteriovenous fistula using a detachable
      balloon].
AB  - Several intra-arterial embolization techniques with polimerization substances,
      particles, thrombogenic coils and silicone and latex balloons have been used in
      the endovascular therapy of arteriovenous fistulas in different vascular
      territories. Using the Seldinger technique by femural route and with a coaxial
      system including a microcatheter with a latex Debrun type balloon, the authors
      describe the selective occlusion of an iatrogenic arteriovenous fistula of the
      left kidney.

PMID- 2220432
TI  - [Radiotherapy of malignant melanoma].

PMID- 2220433
TI  - Function of dog's auditory cortex in tests involving auditory location cues and
      directional instrumental response.
AB  - Twenty one dogs, distributed into four groups, were trained pre-operatively in
      differentiation of auditory location or frequency cues. In each group
      instrumental responses, reinforced by food consisted in placing by the animal its
      right paw on the side levers. The first differentiation, go-left, go-right task
      with two location cues, required the animal to place its paw on the lever
      opposite to the source of the cue. The second differentiation task with the same
      location cues required placing the paw on the lever located close to the cue. The
      third task, involving 700 Hz vs. 1,000 Hz tone, required responding to one lever
      to the presentation of one tone and responding to the opposite lever to the
      presentation of the other. The last task was a symmetrically reinforced go, no-go
      differentiation with, again, auditory location cues: the animals were trained to
      place the paw on a lever to one location cue and to withhold this response to the
      other location cue. Bilateral ablation of the primary auditory cortex produced a
      considerable impairment of the performance of the two go-left, go-right tasks
      involving location cues. The go-left, go-right task employing frequency cues, and
      the symmetrically reinforced go, no-go task with location cues, were only
      slightly disturbed by this lesion.

PMID- 2220435
TI  - Electrical activity and feeding correlates of intracranial hypothalamic injection
      of GABA, muscimol and picrotoxin in the rats.
AB  - Assemblies of electrodes and a cannula were stereotaxically implanted in the
      ventromedial (VMH), lateral (LHA) and paraventricular (PVH) hypothalamic areas in
      male albino rats. Electrical activity of these regions was recorded
      electrographically before and following intracranial injection (ICI) of GABA,
      muscimol and picrotoxin. In another set of animals, food intake and water intake
      were also measured. The activity of the ventromedial hypothalamus changed from
      slow to fast after ICI of GABA and picrotoxin and fast to slow after muscimol.
      The activity of the lateral hypothalamus changed from slow to fast with ICI of
      muscimol and picrotoxin and from fast to slow with GABA, while that of the
      paraventricular hypothalamic nucleus changed from slow to fast with ICI GABA and
      fast to slow with muscimol and picrotoxin. ICI of GABA into VMH and LHA and
      muscimol in VMH, LHA and PVH caused a decrease in food intake. Water intake was
      also decreased after ICI of GABA in PVH and muscimol in LHA and PVH. On the
      opposite picrotoxin increased food intake in VMA and LHA and water intake in PVH.
      The possible interaction of GABAergic drugs with the areas of the brain
      controlling feeding and drinking is being discussed.

PMID- 2220434
TI  - Post-stress analgesia after lesions to the central nucleus of the amygdala in
      rats.
AB  - In two experiments the role of the central nucleus of the amygdala under two
      modes of foot-shock analgesia was studied in 39 male Moll-Wistar rats. In
      Experiment I a 4 min continuous foot-shock, dependent on neural mechanism was
      used as a stressor. Analgesia was produced by regularly intermitted 20 min of
      foot-shock action in Experiment II which evoke an opioid, humorally mediated
      mechanism. The results suggested that the central nucleus is involved only in the
      humoral regulation of the opioid form of analgesia. This finding fits well with
      the concept of limbic control of the anterior pituitary and the pituitary
      adrenocortical axis, and points to the role of the amygdaloid complex in
      processing of stressful stimuli.

PMID- 2220436
TI  - The perception of figure reversal as a function of contrast reversal exemplified
      with the Schroder staircase.
AB  - During spontaneous reversal of a reversible figure (Schroder staircase), subjects
      spent less time in perceiving line drawings white on black then black on white.
      Possibly the first stimulus makes a stronger three-dimensional impression.

PMID- 2220437
TI  - Structure of spinal cord locomotor strip in the cat.
AB  - The origin of spinal locomotor strip fibers was studied in the cat by means of
      electrical stimulation combined with horse-radish peroxidase transport technique.
      It was revealed that a corticospinal tract presumably formed the locomotor strip.
      Some reticulospinal and trigeminal tract fibers were also found. Descending
      catecholaminergic fibers do not pass through the investigated regions of
      dorsolateral funiculus; probably they are not a part of the spinal locomotor
      strip.

PMID- 2220438
TI  - [Minor neurological signs in obsessive-compulsive disorders].
AB  - Present and classic observations allow us to relate the obsessive-compulsive
      disorder (OCD) with different structural and functional anomalies, disorders and
      neurological findings which let us elaborate etiopathogenic and therapeutic
      hypothesis. From this and from our experience in the study about soft neurologic
      signs (SNS) in psychiatry, we explored 20 patients with OCD (DSM-III), compared
      with 28 phobic disorders and 20 healthy controls, following a SNS protocol and
      picking up demographic and clinical variables. We besides administered
      intellectual efficiency exams (WAIS) and neuropsychological tests
      (Benton/Bender), blind to the SNS exploration. The OCD group showed a higher
      global incidence of SNS, and especially more alterations in movement's
      coordination in upper extremities and balance with a trend to show more anomalies
      in dominance-laterality. This higher incidence of SNS didn't correlate with age,
      familiar or personal psychiatric history, indicators of neuropsychological
      impairment and pharmacotherapy. Men with OCD showed more SNS than women did, and
      as men have higher schooling rates, we found a relationship between SNS and
      schooling. OCD group showed a trend to be more intelligent than healthy controls,
      reaching significant higher scores in verbal than in manipulative scales. This
      lower manipulative score could relate with SNS, suggesting a possible concordance
      or significant relation with neurobiologic hypothesis, but not supporting
      neuroevolutionary and organic impairment theories as OCD etiopathogenesis.

PMID- 2220439
TI  - [The distinctive quality of depressed mood. V: Its prevalence in depressive
      disorders].
AB  - A prevalence of the 90% of "distinct quality" in depressed is detected using the
      Pathological Sadness Index. Its presence is non dependent of the presence or
      absence of life event and it is more frequent in melancholic subjects. The
      Pathological Sadness Index show a presence of "distinct quality" in 83% of cases
      without subjective experience of it.

PMID- 2220441
TI  - Asymptomatic ischemia: resolved and unresolved issues.

PMID- 2220440
TI  - [Description of patients diagnosed with "alcohol dependence syndrome" and
      "alcohol abuse" according to the C.I.E.-9a criteria of the W.H.O. at a
      psychiatric hospitalization service].
AB  - The authors make an introduction where they describe several problems found in
      the alcoholic diseases researches. The most important of them are related to the
      "alcoholic case" concept. After this the authors report several epidemiological
      facts about the alcoholic diseases and disorders in Castilla-Leon and Madrid.
      Then a retrospective analysis of inpatients psychiatric records from the
      Psychiatry Department of Valladolid's University Hospital between 1980 to 1984 (N
      = 1.259) is made. 252 (20.01%) of them suffered an alcoholic disorders, following
      the I.C.D.-9th criteria psychoses alcoholic were 102 (8.10%) and they were
      excluded. However "Alcohol dependence" with 128 cases (10.17%) and "Alcohol Abuse
      Syndromes" with 22 cases (1.75%) were studied deeply, being 150 cases--120 males
      (80%) and 30 females (20%)--evaluated. Every diagnostic group was analysed in a
      distinct way through 41 epidemiological, clinical, diagnostic and medical care
      variables. These two groups and their differences and similarities between them
      are reported. The main profile is a male patient, 43 years old, married, urban
      life, blue collar worker, unskilled work, primary studies, bad economic level,
      marriage and working maladapted, clinical admitted through the Emergency Service,
      with an alcoholism 24 years old and intake of 234 grs. alcohol/day, with former
      treatment of minor tranquilizers (B.D.Z.) and at last is readmitted by alcoholic
      disease of disorder or a different psychiatric disease or disorders (I.C.D.-9.a
      or D.S.M.-III) in a 37.5% and 16.41% respectively.

PMID- 2220442
TI  - Ambulatory monitoring of left ventricular function: a new modality for assessing
      silent myocardial ischemia.

PMID- 2220443
TI  - The hidden entity of right ventricular ischemia.

PMID- 2220444
TI  - Significance of experimental models in assessing the link between myocardial
      ischemia and pain.

PMID- 2220445
TI  - Pain perception and endogenous pain modulation in angina pectoris.

PMID- 2220447
TI  - Variability of myocardial ischemia: implications for monitoring strategies.

PMID- 2220446
TI  - Silent ischemia during PTCA: its relationship with exercise-induced silent
      ischemia and the possible role for beta-endorphins.

PMID- 2220448
TI  - The prognosis of individuals with silent myocardial ischemia.

PMID- 2220449
TI  - Incidence, precursors and prognosis of unrecognized myocardial infarction.

PMID- 2220450
TI  - Risk stratification in unstable angina: screening for silent myocardial ischemia.

PMID- 2220451
TI  - Ischemia detected on ambulatory monitoring: has it prognostic implications?

PMID- 2220452
TI  - Scintigraphic evidence of silent myocardial ischemia in post-infarction patients:
      prognosis implications.

PMID- 2220453
TI  - Silent myocardial ischemia after coronary artery bypass graft surgery.

PMID- 2220454
TI  - Prognostic significance of silent myocardial ischemia by exercise testing.

PMID- 2220455
TI  - Coronary angioplasty in silent and painful myocardial ischemia.

PMID- 2220456
TI  - Silent myocardial ischemia after bypass surgery and percutaneous transluminal
      coronary angioplasty.

PMID- 2220457
TI  - Diabetes mellitus and silent myocardial ischemia.

PMID- 2220458
TI  - Silent myocardial ischemia in asymptomatic patients: should we screen? Should we
      treat?

PMID- 2220460
TI  - Ischemic preconditioning and myocardial stunning: related consequences of brief
      coronary occlusion and reperfusion?

PMID- 2220459
TI  - Significance and management of silent myocardial ischemia.

PMID- 2220461
TI  - Management strategies for high-risk patients with silent myocardial ischemia.

PMID- 2220462
TI  - Mechanisms of silent myocardial ischemia: implications for selection of optimal
      therapy.

PMID- 2220463
TI  - Silent myocardial ischemia: potential for clinical trial.

PMID- 2220464
TI  - Myocardial ischemia: pathogenic role of disturbed vasomotion and endothelial
      dysfunction in coronary atherosclerosis.

PMID- 2220465
TI  - Silent ischemia during mental stress: scintigraphic evidence and
      electrocardiographic patterns.

PMID- 2220466
TI  - Ambulatory monitoring and silent myocardial ischemia: have the basics been done?

PMID- 2220467
TI  - Myocardial effects of brief periods of ischemia followed by reperfusion.

PMID- 2220468
TI  - Methodological aspects of detecting patients with symptomatic and silent
      myocardial ischemia.

PMID- 2220469
TI  - Real-time digital monitoring: current capabilities and future role.

PMID- 2220470
TI  - Expression of a plant virus-coded transport function by different viral genomes.

PMID- 2220471
TI  - Structural and functional properties of plant reovirus genomes.

PMID- 2220472
TI  - Regulation of tobamovirus gene expression.

PMID- 2220473
TI  - Adverse drug reactions in neonatal intensive care units.

PMID- 2220474
TI  - Are pesticides immunotoxic?
AB  - So far there is little evidence that occupational or environmental exposure to
      pesticides has led to clinically significant immunosuppression, and hence to an
      increased risk of developing infection or cancer. In addition, the incidence of
      hypersensitivity reactions to pesticides is generally low. Experiments have been
      conducted in experimental models that indicate that certain pesticides are
      immunosuppressive to animals. The majority of these experiments, however, have
      used high (frankly toxic) doses of pesticides and immunosuppression has been
      monitored using in vivo or in vitro immune function tests, the results of which
      are difficult to interpret in terms of effects on health. One exception is
      tributyltin oxide which, in the rat, causes immune dysfunction at doses below
      those that cause general toxicity, and which compromises the ability of the
      animals to resist bacterial and parasitic infection. Predictive assessment of
      possible immunotoxicity induced by exposure to a pesticide should be structured
      within the current framework of acute, subacute and chronic testing procedures
      used for regulatory purposes. With the exception of predicting some
      hypersensitivity reactions (respiratory allergy and autoimmunity), which would
      require the development of novel specialized methods, indications of potential
      immunotoxicity can be obtained from standard haematological investigations and by
      evaluation of lymphoid organs and tissues such as the spleen, thymus, lymph
      nodes, and bone marrow. Pathological and histopathological examination of the
      lymphoid system is a mandatory requirement of nearly all subchronic testing
      guidelines for pesticides worldwide. The incorporation of specialized, and in
      particular in vitro, immune function tests into the routine toxicological
      assessment of a pesticide is not only time-consuming and potentially wasteful of
      animals, but is also scientifically unacceptable; the significance of changes in
      such tests must await further research on the reserve capacity of the immune
      system.

PMID- 2220476
TI  - The relation between immunology, nutrition and disease in elderly people.

PMID- 2220475
TI  - Amino acids and proteins in relation to the nutrition of elderly people.
AB  - In this short review some aspects of body protein and amino acid metabolism
      during ageing in human subjects have been explored. The picture that emerges is a
      progressive diminution of total body protein with ageing, due largely to a
      decline in the size of the skeletal muscle mass. These changes are accompanied by
      a shift in the overall pattern of whole body protein synthesis and breakdown,
      with muscle mass estimated to account for about 30% of whole body protein
      turnover in the young adult, as compared with a lower value of 20% or less in the
      elderly subject. The metabolic significance and possible functional implications
      of this alteration in the quantitative contribution by muscle to whole body amino
      acid and protein dynamics have been considered. The determination of requirements
      for individual essential amino acids and for total protein has been discussed,
      and it is evident that the data are limited and often contradictory. However,
      elderly individuals are more likely to be influenced by various biological,
      environmental and social factors, the effects of which would be generally to
      increase protein needs above those for younger adults. Thus, in practice, the
      protein needs of elderly people are probably higher than for the young. The
      decline in energy intake, together with its possible consequences for reduced
      dietary protein utilization, will also tend to increase the protein need of
      elderly subjects, compared with that for physically more active young adults.
      Until more data become available, it is recommended for food planning purposes
      that an appropriate protein allowance could be 12-14% of the total energy intake,
      for mixed protein sources characteristic of the diets of industrialized countries
      or the more affluent sectors of populations in developing countries. Energy
      intake should be at a level that meets the estimates proposed by FAO/WHO/UNU for
      older persons. Tentative recommendations are made herein that intakes of specific
      indispensable (essential) amino acids, per unit of protein need, should be
      similar to those for the young school-age child and they should be higher than
      those currently judged by international authorities (i.e. FAO/WHO/UNU) to be
      sufficient for maintenance of protein nutritional status in the adult. In view of
      (i) the increasing proportion of older individuals within technically advanced
      populations together with the need of this group for health care and (ii) the
      important role played by diet and food habits in health maintenance, and in the
      aetiology or progression of degenerative disease, it is vitally necessary to
      improve upon the current state of knowledge concerning protein and amino acid
      metabolism and nutrition during the later phases of our lives.

PMID- 2220477
TI  - Nutritional aspects of dementia, especially Alzheimer's disease.

PMID- 2220478
TI  - Trans-cultural aspects of nutrition in old age.

PMID- 2220479
TI  - Physiology of ageing: nutritional aspects.

PMID- 2220480
TI  - Postprandial hypotension in elderly people.

PMID- 2220481
TI  - Elderly patients' understanding of their drug therapy: the effect of cognitive
      function.
AB  - The relationship between cognitive function and knowledge about drug therapy and
      its risks was examined in 207 elderly patients attending a geriatric outpatient
      clinic. The patients' reports of their therapy were compared with those of their
      clinic doctor. Patient-doctor agreement on the number of drugs taken per patient
      fell with increasing age independently of change in cognitive function. However,
      knowledge about drugs was related to cognitive function. Many patients taking
      some of the potentially more dangerous drugs were ignorant of possible side
      effects of their treatment. Doctors need to be trained more effectively in
      communicating with elderly patients about their treatment and its risks.

PMID- 2220482
TI  - Changes in carotid artery compliance with age.
AB  - Doppler-shifted ultrasound was used to measure arterial compliance non-invasively
      in the internal and external carotid pathways of 270 male and 388 female
      asymptomatic volunteers aged 5 to 90 years. There was a significant decrease in
      the compliance of both arteries from 5 to 50 years of age (p less than 0.001),
      when it then levelled out. Arteries of women were more compliant than those of
      men at ages 35 to 60 years.

PMID- 2220483
TI  - Dementia and abnormal breathing during sleep.
AB  - We have examined a group of cognitively impaired elderly people who already
      showed some increase in indices of sleep-disordered breathing and applied
      standard criteria for dementia to them. This resulted in a subgroup of truly
      demented subjects who showed significantly more abnormal breathing during sleep
      than either normal subjects or those whose cognitive impairment may not have been
      due to a dementing illness.

PMID- 2220484
TI  - Affective flattening in elderly patients.
AB  - Forty-eight consecutive patients not taking dopamine antagonists and without
      Parkinson's disease referred to a psychogeriatric service with a diagnosis of
      psychiatric disorder were assessed for affective flattening using an objective
      rating scale. Nearly half (44%) exhibited significant affective flattening, which
      proved open to reliable assessment. Affective flattening is a useful sign of
      pathology.

PMID- 2220485
TI  - Predicting urodynamic dysfunction from clinical features in incontinent elderly
      women.
AB  - In a retrospective survey of 296 elderly women referred with urinary incontinence
      and in whom urodynamic studies were completed, multiple logistic regression was
      used to determine the optimal set of clinical features to predict the urodynamic
      dysfunction. Three formulae were obtained expressing the predicted probabilities
      (p) of the urodynamic dysfunctions as functions of the clinical variables. By
      choosing the cut-off values of p which gave equal weighting to sensitivity and
      specificity, we found that clinical features (symptoms, signs, residual volume)
      are helpful in diagnosing the presence of unstable detrusor and voiding
      dysfunction, but not incompetent urethra.

PMID- 2220486
TI  - Hypothesis: temperature recommendations for elderly people: are we wrong?
AB  - By concentrating housing recommendations purely on temperature, particularly of
      the living room, the medical profession may be doing a disservice to the elderly
      and may be causing increased numbers of cold-related deaths through attempting to
      reduce the far fewer cases of hypothermia. The best advice may be to avoid having
      one room significantly warmer than the rest of the house, to prewarm the bed and
      bedroom at night, to wear adequate clothing, eat adequate food, and take some
      exercise.

PMID- 2220487
TI  - Fallers, non-fallers and Poisson.

PMID- 2220488
TI  - [Interaction between corneal invasion of polymorphonuclear leukocytes and corneal
      epithelium].
AB  - The interaction between corneal invasion of polymorphonuclear leukocytes (PMNs)
      and corneal epithelium was investigated following different types of corneal
      injury. Histological examination of centrally denuded corneas demonstrated that
      it took 18-24 hours for PMNs to infiltrate into the center of the denuded stroma,
      approximately synchronous with the reepithelialization. On the other hand, in the
      centrally denuded corneas immediately covered by glue to prevent the
      reepithelialization, the time required for the appearance of PMNs at the central
      portion of the corneas was more than 96 hours. Chemotactic activities of PMNs in
      the conditioned media of normal cornea, completely denuded cornea and
      reepithelializing cornea were examined using a Boyden chamber. The highest
      chemotactic activity was defected in the conditioned medium of the cornea with
      reepithelialization. These data suggest the possibility that the corneal
      epithelium, especially the re-covering epithelium, stimulates infiltration of the
      stroma by PMNs.

PMID- 2220489
TI  - [Effects of T cell subsets on mouse herpetic keratitis].
AB  - Immune splenocytes were obtained from C3H/He mice, which had been inoculated with
      herpes simplex virus (HSV) type 1 by the corneal route 6 or 12 days previously,
      and restimulated by lipopolysaccharide-induced lymphoblasts infected with HSV.
      These cells were either not treated or treated with anti-L3T4 antibody plus
      complement/anti-Lyt-2 antibody plus complement, and were transferred to
      subconjunctiva of mice with HSV corneal infection. Adoptive transfer of non
      treated cells diminished corneal ulcers, when the splenocytes were transferred
      from mice inoculated 12 days previously. This effect was reduced by depletion of
      Lyt-2 bearing cells, but not reduced by depletion of L3T4 bearing cells. Adoptive
      transfer of splenocytes from mice inoculated 6 days previously did not diminish
      corneal++ ulcers. These findings demonstrate that HSV specific cytotoxic T
      lymphocytes (CTL) play an important role in the late phase of recovery from HSV
      corneal infection.

PMID- 2220490
TI  - [The ultrastructural changes in the corneal lens stroma of wound healing process
      following epikeratophakia in rabbits].
AB  - We investigated the ultrastructural change of corneal lens+ stroma histologically
      following epikeratophakia in rabbits. Epikeratophakia was performed on rabbit
      corneas using cryolathed corneal lens+. At days 10, 16, 45, 63 and 90 after the
      operation, pachymetry was performed, and corneas were excised and analyzed
      histologically using an electron microscope. At days 16 to 63, collagen fibril
      density (CFD) in corneal lens+ stroma decreased 57 to 63% of that in the control
      cornea, but returned to 78% at day 90. The results of pachymetry revealed that
      postoperative increase of corneal thickness was greater than the expected value
      at days 10 and 16. However, after that the corneal thickness decreased gradually
      and became thinner than the expected value after 45 days postoperatively. At days
      45 to 90, many activated keratocytes with dilated and well developed rough
      endoplasmic reticulum, suggestive of active collagen production, were observed in
      corneal lens+ stroma. Furthermore, at day 90, keratocytes with extended
      pseudopoidia that suggested phagocytic activity were also observed, especially in
      the subepithelial zone. These findings indicated that collagen fibrils in the
      corneal lens+ stroma were damaged under the influence of the cryolathing process
      and partially exfoliated postoperatively, however, collagen-producing activity
      increased gradually and the reconstruction of corneal lens+ stroma continued
      through day 90 after the operation.

PMID- 2220491
TI  - [A polyvinyl alcohol (PVA) hydrogel as a soft contact lens material].
AB  - A transparent polyvinyl alcohol (PVA) hydrogel was prepared from a PVA solution
      in a mixed solvent consisting of water and a water miscible organic solvent by
      cooling. The physical properties were evaluated in comparison with commercially
      available soft contact lens materials, such as polyhydroxyethyl methacrylate
      (PHEMA) and copolymers of methyl methacrylate (MMA) and N-vinyl pyrrolidone (VP).
      The PVA hydrogel showed higher tensile strength and elongation at break than the
      other materials, while it had high water content and oxygen permeability the
      latter being comparable to those of PMMA/VP copolymers. The protein adsorption of
      the PVA hydrogel was much less than those of the other materials. The PVA
      hydrogel soft contact lenses were applied on rabbit eyes for 12 weeks. The
      influence on the cornea was studied by biomicroscopy, ultrasonic corneal
      pachymetry and histopathological examination. These examinations revealed no
      abnormal findings in the cornea. These results suggest that the PVA hydrogel may
      be promising as a new soft contact lens material.

PMID- 2220492
TI  - [Ocular symptoms in mitochondrial myopathy].
AB  - The corneal endothelial cells in 6 cases of mitochondrial myopathies were
      examined by specular microscope, and electron microscopic studies of the cornea
      were made in one autopsy case. The cornea was clear and the thickness was within
      the normal range. The endothelial cell mean size was larger in 3 out of 10 eyes
      than among controls and the variance of endothelial cell size was larger in all
      of 10 eyes than among controls. The difference was found to be statistically
      significant. Electron microscopical findings of the cornea revealed mitochondrial
      abnormalities. Inclusions were observed in the stromal keratocyte.

PMID- 2220493
TI  - [Intravitreal drug delivery by microspheres of biodegradable polymers].
AB  - We evaluated the efficacy of microspheres of biodegradable polymers as a slow
      releasing drug delivery system in the vitreous body. Microspheres containing 5-FU
      were prepared with polymers of poly-(lactic acid) or copolymers of glycolic acid
      and lactic acid. The release of the drug was studied in vitro. Poly-(lactic acid)
      microspheres released 5-FU for 7 days. The intravitreal kinetics of the
      microspheres was studied in rabbits in vivo. The microspheres disappeared from
      the vitreous cavity of normal eyes by 48 +/- 5 days after injection.
      Disappearance was accelerated from the vitreous cavity of vitrectomized rabbits
      (14 +/- 2 days, p less than 10(-6)). No abnormality was found on
      electroretinographic or histological examinations after microspheres injection.
      These results suggested that microspheres of biodegradable polymers could be
      useful as a potential drug delivery system for sustained drug release in the
      vitreous body.

PMID- 2220494
TI  - [The influence of the intraocular pressure on the visual field of low tension
      glaucoma].
AB  - To study the effect of the intraocular pressure (IOP) on the visual field (VF)
      damage in low tension glaucoma (LTG), we compared the IOP and the VF damage in
      both eyes of 46 LTG patients. As an index of the VF damage, we used the mean
      deviation (MD) value calculated by the Humphry (30-2) STATPAC program, and for
      the IOP data, the mean of 24 hour IOP measurements (diurnal IOP) and the mean of
      the IOPs measured at each visit to our outpatient clinics (follow-up IOP). In 13
      cases, the diurnal and the follow-up IOPs were 0.3 mmHg higher or more in the
      more damaged eye than those in the less damaged eye, and in 7 cases they were 0.3
      mmHg higher or more in the less damaged eye than those in the more damaged eye.
      Between these two groups, no significant difference was seen in the value of MD,
      but the diurnal IOP and the follow-up IOP was significantly higher in the former
      than in the latter group. By discrimination analysis, the two groups were
      distinguished at the diurnal IOP of 14.1 mmHg (hit rate 77.6%) and the follow-up
      IOP of 15.0 mmHg (74.2%). An analysis using the whole 46 LTG cases yielded the
      following results: when the diurnal or follow-up IOP of the more damaged eye was
      higher than the above determined level, the IOP in the more damaged eye was
      significantly higher than that in the contralateral less damaged eye.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2220495
TI  - [Autoregulation of macular capillary blood flow evaluated by the blue field
      entoptic phenomenon].
AB  - Autoregulation of the macular capillary blood flow was investigated using a blue
      field entoptoscope and OCVM suction cup system. The perfusion pressure was
      reduced by elevation of the intraocular pressure with a Langham's suction cup
      placed on the temporal sclera. The results showed that the autoregulatory
      response maintains the macular capillary blood flow velocity until the perfusion
      pressure is reduced to approximately 25 mmHg. The Closed-loop gain of the
      autoregulatory response functions at a perfusion pressure as low as approximately
      10 mmHg, below which it did not work well.

PMID- 2220496
TI  - [Aging effects on upper and lower half visual fields by VECPs and automated
      static perimetry].
AB  - We studied the aging effects on upper and lower half visual fields using pattern
      VECPs with half fields stimuli and automated static perimetry. The subjects,
      consisting of 56 normal volunteers ranging in age from 10 to 69 years old, were
      divided into three groups (10-29, 30-49, 50-69 years old). Their visual acuities
      were better than 1.0 and refractive errors were within +/- 2.0 diopters.
      Perimetry was performed with an automated perimeter (Octopus, program 61). An
      artificial pupil of 3 mm was used after cycloplegia with 1% tropicamide to
      eliminate senile miosis effects in recording of VECPs. Subjective light
      sensitivity decreased with age and there was a noticeable hiatus between the
      third and fourth decades. However the age-related decrease in sensitivity showed
      no difference between the upper and lower half fields. However VECPs results
      showed that with aging the P100 peak latency did not increase for lower half
      field stimuli, but increased for the upper half field stimuli, especially for
      smaller check sizes. These results suggested that there were different aging
      processes a in the upper and lower half fields and higher neural factors
      participated in the effects.

PMID- 2220497
TI  - [A case of orbital hemangiopericytoma].
AB  - A 38-year old woman presented with severe proptosis in the left eye which had
      been developing for more than ten years. CT scan revealed a large mass in the
      left orbit, therefore lateral orbitotomy was performed. The histopathology of
      this tumor consisted of ovoid to spindle-shaped cells tumor around a sinusoidal
      vascular component forming staghorn channels. This tumor was diagnosed as a
      hemangiopericytoma. The prognosis of orbital hemangiopericytoma including
      clinicopathological aspects are discussed with reference to recent reports.

PMID- 2220498
TI  - [Cavum vergae, cyst of cavum septi pellucidi, mega cisterna magna, and general
      fibrosis syndrome].
AB  - One family of 17 cases of general fibrosis syndrome was reported. Four out of
      five patients examined with CT and/or MRI revealed cavum vergae or cyst of the
      cavum septi pellucidi or mega cisterna magna, which were characterized by
      existing on the midline of the brain. The patient with cavum vergae had also
      platybasia. In one patient, surgical correction of vertical deviation and
      blepharoptosis of both eyes was performed. There was abnormal insertion of the
      superior and inferior rectus muscles in posterior and nasal direction, and
      adhesion of the superior oblique muscle to the superior rectus muscle at the
      point of it's insertion was found in both eyes. Histopathological findings of the
      extraocular muscles of two patients showed mixture of relatively normal muscle
      tissues and vast amounts of collagen fibers. Electron microscopically many
      glycogen granules were found in muscle fibers. From these findings, this syndrome
      may be based on failure in development and differentiation.

PMID- 2220499
TI  - [Mammalian pupil constriction to light in the presence of atropine in hamster.
      Part I. Hamster and visual rays].
AB  - Mammalian pupils constrict in reaction to lights. Miosis occurs via afferent and
      efferent nerves. Therefore, once the pupil is pretreated with atropine, miosis no
      longer occurs, even when the retina is intact. We found that hamster pupil
      constricts in reaction to light in the presence of atropine. We examined the
      relationship with pupillary size, light intensity, wavelength and intervals of
      darkness. Pupillary constriction was found when the retina was withdrawn, and the
      miosis was not affected by autonomic blocking agents, capsaicin pretreatment and
      tetrodotoxin, a nerve blocking agent. Hamster pupil reacts to lights (visible
      rays-ultraviolet) in the presence of atropine and in the absence of retinal
      function.

PMID- 2220500
TI  - [Effect of ultraviolet light on the hamster pupil].
AB  - This is the first study on the effects of ultraviolet light (UV) on the hamster
      pupil in vivo and in vitro. UV caused constriction of the pupil even after the
      death of the hamster. Both visible light and UV induced myosis of the enucleated
      hamster eyes. UV-induced miosis occurred very late and continued after the
      cessation of UV stimuli. The UV-induced miosis was not significantly affected by
      ascorbic acid, catalase, allopurinol, but it was gradually inhibited by procaine
      or quinacrine, phospholipase A2 inhibitors. Withdrawal of Ca2+ and Mg2+ with EGTA
      and/or EDTA strongly inhibited the UV-induced miosis. This study suggests that
      the UV-induced miosis was not related to oxidative stress, but related to a
      second messenger via the muscle cell membrane.

PMID- 2220501
TI  - [Fundus video fluorescein angiography with low steady light].
AB  - To decrease both the intensity of the exciting light and the amount of sodium
      fluorescein, we attached a compact image intensifier incorporating a microchannel
      plate with a fundus photoscope and tried to record video-fluorescein angiography
      with low steady light. We preliminarily examined the relationships of exciting
      and emitted light intensity with various concentrations of sodium fluorescein.
      The strongest fluorescence was obtained with a concentration of 0.01 mg/ml
      solution of sodium fluorescein. When the compact image intensifier was attached
      to the equipment, the exciting light intensity could be decreased to 1/300 with
      an exciting filter of lambda max of 486 nm. When sodium fluorescein of 0.01 mg/ml
      solution was injected directly into the heart of Rana catesbeiana, complete video
      fluorescein angiography with sufficient brightness and resolution was possible.
      With the same machine, we recorded video-fluorescein angiography in a normal
      human subject with injection of 5 ml of 10% sodium fluorescein. The ordinary
      observing light of the machine was strong enough for video-recording. This
      exciting light intensity caused no trouble and elicited no complaint from the
      examinee. These results showed that the use of a compact image intensifier
      incorporated microchannel plate with a fundus photoscope made it possible to
      record video-fluorescein angiography and to decrease exciting light intensity and
      the amount of fluorescein dye. This means that light damage to photoreceptors by
      exciting light and problems induced by allergic reaction with fluorescein dye
      might be decreased. These aspects might be very important to obtain information
      about both retinal circulation and disruption of the blood-retinal barrier and
      also to perform safe fluorescein angiography examination.

PMID- 2220502
TI  - [Destruction of anionic sites in blood-retinal barrier after retinal
      photocoagulation].
AB  - The retinal pigment epithelial cells (RPE) have "tight junctions" at the apical
      side of the lateral wall between neighbouring cells and form physiological blood
      retinal barriers. Recently, in addition to physiological barriers, charged
      barriers, consisting of anionic sites of cell membrane and its basement membrane,
      have been discussed. We performed weak retinal photocoagulation in rabbit eyes in
      order to break their charged barriers, and examined the repair process using a
      cationic probe, polyethyleneimine (PEI). Two days after photocoagulation, RPE
      cells were broken down and choriocapillaries were occluded with thrombi, and
      their anionic sites were lost. At one week after photocoagulation, structural
      reconstruction started from the edge of the photocoagulation area. In this area,
      proliferated RPE cells covered Bruch's membrane, but their charged barrier did
      not recover. Two weeks after photocoagulation, proliferated RPE cells covered
      Bruch's membrane over the entire photocoagulated area, and they obtained anionic
      charge. The present study revealed that retinal damage induced by weak laser
      photocoagulation was repaired within two weeks after photocoagulation with
      respect to the charged barrier.

PMID- 2220503
TI  - [Effect of intravitreal gas on the destruction of anionic sites in the outer
      blood-retinal barrier].
AB  - The present work was undertaken to evaluate the effect of sulfur hexafluoride
      (SF6) injected intravitreously in rabbit eyes. The alterations of the outer blood
      retinal barrier that was composed of anionic sites, using a cationic probe,
      polyethyleneimine (PEI). We injected 0.5 ml of 100% SF6 or 0.5 ml of air into the
      vitreous cavity of rabbit eyes, and the 0.5% PEI-saline solution was given
      intravenously at 2, 4, 7, or 14 days after the injection. Control eyes
      demonstrated numerous PEI-positive sites at the basement membrane of the RPE,
      collagen fiber of Bruch's membrane, and basement membrane of choriocapillaries.
      Until seven days after SF6 injection, PEI-positive sites decreased, but had
      increased at 14 days to control levels, while in air-injected eyes, they had
      recovered at seven days. SF6 in the vitreous was absorbed in seven days and air
      in three days. While gas was present in the vitreous, the charge barrier of the
      outer retina and choroid decreased, but when the gas was absorbed, the charge
      barrier recovered. The result showed that the decrease of charge barrier was a
      reversible change.

PMID- 2220504
TI  - [MRI lesions of the optic nerves in optic neuritis].
AB  - Magnetic resonance imaging (MRI) was performed in 14 patients with optic
      neuritis. Three patients suffered from multiple sclerosis but the etiologies of
      the remaining 11 cases could not be identified. They were bilateral in 6, and
      unilateral in 8. The MR images were compared with the symptomatic lesions of
      optic neuritis and pattern reversal VECP. The STIR mode (short time inversion
      recovery), was employed for the MRI in the orbit and T2-weighted mode in the
      brain. In 11 eyes with hyperemia of the optic disc, 7 eyes showed a high signal
      in the optic nerve with the MRI, and 9 eyes showed an abnormal pattern VECP.
      Seven eyes with normal disc and two eyes with a pale disc showed a high signal in
      the optic nerve with MRI, those 9 eyes had abnormal pattern VECP. The high signal
      in the optic nerve was not related to visual acuity or visual field abnormalities
      of patients. However, the degree of the high signal of the optic nerve lesion in
      MRI was associated with the clinical course and prognosis of the optic neuritis.
      The degree of the high signal of the optic nerve lesion decreased with the
      recovery of visual acuity in optic neuritis.

PMID- 2220505
TI  - [Spatial frequency characteristics of upper and lower hemiretina with pattern
      reversal VECPs].
AB  - We studied the spatial frequency characteristics in the upper and lower
      hemiretina using pattern reversal VECPs. The subjects were 56 normal volunteers
      ranging in age from 14 to 69 years old. The latency of the first major positive
      component (P100) of VECPs was measured using checker board pattern stimuli under
      varying conditions of spatial frequency (112', 56', 28', 14', 7'). For the upper
      hemiretinal stimuli, the P100 peak latency vs spatial frequencies curve reached
      minimum at 56' approximately 28' and increased at both lower and higher
      frequencies. For the lower hemiretinal stimuli, this curve shifted towards lower
      frequencies. The results suggested that the spatial frequency characteristics
      between the upper and lower hemiretina were different.

PMID- 2220506
TI  - [DNA diagnosis of Leber's hereditary optic neuropathy].
AB  - The point mutation at nt11778 in mitochondrial DNA is highly associated with
      Leber's hereditary optic neuropathy and eliminates a restriction enzyme SfaNI
      site in American blacks and Caucasians. DNA diagnosis was applied to a male
      Japanese patient with this disorder and his mother as a carrier. The
      mitochondrial DNA fragments (255bp) including this mutation were amplified by
      polymerase chain reaction. SfaNI digested the DNA fragments of normal Japanese
      subjects, but did not digest those of the patient or the carrier, The mutation
      within the SfaNI site is also associated with Japanese suffering from this
      disorder.

PMID- 2220507
TI  - [Serum immunosuppressive acidic protein (IAP) in inflammatory ocular disease].
AB  - The titer of serum immunosuppressive acidic protein (IAP) was determined by the
      method of single radial immunodiffusion (Matsuda et al) in Behcet's disease,
      sarcoidosis, tuberculosis, toxoplasmosis, etiology-unknown anterior uveitis
      (granulomatous, non-granulomatous), allergic conjunctivitis and scleritis. The
      titer of IAP in these diseases except allergic conjunctivitis was significantly
      higher than in normal controls. In all the diseases studied, the titer during the
      active stage was significantly higher than that during the inactive stage. The
      titer in Behcet's disease was significantly higher than that in sarcoidosis,
      particularly during the active stage. In three cases of Behcet's disease, the
      titer was increased markedly a few days before the ocular attacks. There was no
      difference in the titer between etiology-unknown granulomatous and non
      granulomatous anterior uveitis. IAP may be useful as a clinical index in
      inflammatory ocular diseases.

PMID- 2220508
TI  - [A case of Rubinstein-Taybi syndrome suspected with goniodysgenetic glaucoma].
AB  - We reported a case of Rubinstein-Taybi syndrome suspected in association with
      goniodysgenetic glaucoma, and studied using light and electron microscopy the
      anterior chamber angle tissues obtained surgically by trabeculectomy. The patient
      was 31-year old male, who had a systemic appearance of Rubinstein-Taybi syndrome
      with dwarfism, mental retardation, antimongoloid slant, flat-broad based thumbs,
      low set ears, high arched plate except for whorl of dermatographism. In addition
      to these malformations, goniodysgenetic glaucoma was also present which is
      characterized by underdevelopment of the angle recess and invisible ciliary body
      band in gonioscopic examination. The histopathological studies of the specimens
      revealed the presence of a compact tissue filled with a large amount of collagen
      fibers with few cells in the juxta-canalicular tissue of Schlemm's canal. There
      were 3 to 4 layers of trabecular sheets of corneoscleral meshwork at the anterior
      chamber side of the compact tissue. We conclude that the presence of the compact
      tissue under Schlemm's canal represents goniodysgenesis, underdevelopment of the
      trabecular meshwork, which is the primary cause of the glaucoma in this case.

PMID- 2220510
TI  - How to help your patients stop smoking.
AB  - Family physicians can effectively help their patients stop smoking by using brief
      intervention and simple office organizational procedures. Intervention involves
      asking all patients about smoking, advising smokers to stop, assisting with self
      help materials, establishing a date for quitting, possibly prescribing nicotine
      gum and, finally, arranging for follow-up visits. Office procedures include
      selecting an office coordinator, ensuring a smoke-free office, establishing a
      mechanism to identify and monitor patients who smoke, and involving the office
      staff in intervention and follow-up. With this protocol, intervention is possible
      at every office visit.

PMID- 2220509
TI  - Inhaler and spacer use in obstructive airway diseases.
AB  - The role of inhaled aerosols in the treatment of obstructive airway diseases is
      increasing for both immediate bronchodilation and prophylactic anti-inflammatory
      effects. Inhaled aerosol agents are available in metered-dose inhaler and
      nebulizer forms. Maximum therapeutic benefit from metered-dose inhalers is
      assured when the correct inhaler technique is used. Spacer devices may be helpful
      in some patients.

PMID- 2220511
TI  - Puffer fish poisoning.
AB  - Regarded by many as a delicacy, puffer fish can be the source of lethal food
      poisoning in humans. The syndrome is caused by tetrodotoxin, one of the most
      potent poisons known. Intoxication produces a constellation of symptoms, with
      paresthesias and generalized muscle weakness being common complaints. Treatment
      is symptomatic and often needs to be aggressive. Life support may be required. In
      some series, the mortality rate has approached 60 percent.

PMID- 2220513
TI  - Desmopressin for diabetes insipidus, hemostatic disorders and enuresis.
AB  - Arginine vasopressin preparations have been used in the treatment of diabetes
      insipidus for many years. Compared with older antidiuretic agents, the synthetic
      analog desmopressin is more potent, longer acting and easier to use. It is
      available for intravenous, subcutaneous and intranasal administration.
      Desmopressin may be useful in the treatment of hemostatic disorders such as von
      Willebrand's disease and hemophilia A. It has also been used for nocturnal
      enuresis. The vasopressor effects of arginine vasopressin preparations have been
      exploited for use as a temporizing measure in controlling acute gastrointestinal
      bleeding. Side effects such as hyponatremia and water intoxication are uncommon
      when these drugs are used with proper precautions.

PMID- 2220512
TI  - Update on combination oral contraceptives.
AB  - Oral contraceptives in current use appear to be safe and effective. Studies found
      that early contraceptive pills, which had a high estrogen content, were
      associated with a number of serious side effects and long-term sequelae. Studies
      of the newer low-dose preparations demonstrate a much lower incidence of adverse
      effects. The beneficial effects of oral contraceptives in disease prevention are
      now widely recognized. The diversity of available formulations allows the
      physician to tailor therapy to the individual patient, maintaining contraceptive
      efficacy while minimizing adverse effects and long-term risks.

PMID- 2220514
TI  - Abnormal eye movements may be first sign of HIV disease.

PMID- 2220516
TI  - Recent ACOG bulletin covers management of postpartum hemorrhage.

PMID- 2220515
TI  - AAFP position statement: ethical 'need to know' considerations in HIV infection.
      The Committee on Medical Ethics.

PMID- 2220518
TI  - Series of family doctor CHATS begins with AIDS education.

PMID- 2220517
TI  - Facing the challenge of laboratory regulation.

PMID- 2220519
TI  - Value of serum chemistry testing.

PMID- 2220520
TI  - MRI and claustrophobia.

PMID- 2220521
TI  - HIV infection: the dilemma of patient confidentiality.

PMID- 2220522
TI  - The family physician's role in helping older smokers quit.

PMID- 2220523
TI  - Changing attitudes toward tobacco and its promotion.

PMID- 2220524
TI  - HIV disease: a review for the family physician. Part I. Evaluation and
      conventional therapy.
AB  - Family physicians will be challenged with caring for increasing numbers of
      patients infected with human immunodeficiency virus. After confirming the
      presence of the infection, the physician must follow a logical sequence of
      evaluation, counseling and treatment. The current Centers for Disease Control
      classification and a series of evaluation and treatment protocols form the basis
      for prescribing zidovudine to delay or mitigate involvement of T lymphocytes and
      neuronal cells.

PMID- 2220525
TI  - Screening for prostate cancer. The U.S. Preventive Services Task Force.

PMID- 2220526
TI  - Ascariasis.
AB  - Ascaris lumbricoides is the most common helminth to infect humans. Infection
      occurs when contaminated soil containing mature eggs is swallowed. Clinically,
      infection ranges from the asymptomatic carrier state to life-threatening
      pulmonary disease or intestinal obstruction. Diagnosis is most frequently
      established by identification of the eggs in stool specimens. Treatment with
      antiparasitic drugs is effective in preventing serious complications and
      eradicating the parasite from all members of the household.

PMID- 2220527
TI  - Pseudoaneurysm of a Shiley composite aortic valve and graft prosthesis.

PMID- 2220528
TI  - Echocardiographic diagnosis of rheumatic cardiopathy affecting all four cardiac
      valves.

PMID- 2220529
TI  - Acute combined aortic and mitral regurgitation during balloon catheter
      valvuloplasty for a third recurrence of critical aortic stenosis.

PMID- 2220530
TI  - Assessment of myocardial viability.

PMID- 2220531
TI  - Time delays in the diagnosis and treatment of acute myocardial infarction: a tale
      of eight cities. Report from the Pre-hospital Study Group and the Cincinnati
      Heart Project.
AB  - To establish the magnitude of prehospital and hospital delays in initiating
      thrombolytic therapy for acute myocardial infarction, the time from telephone 911
      emergency medical system (EMS) activation to treatment and its components were
      analyzed from eight separate ongoing trials. This included estimates of ambulance
      response time, prehospital evaluation and treatment time, and time from admission
      to the hospital to initiation of thrombolytic therapy. The average time from EMS
      activation to patient arrival at the hospital was prospectively determined to be
      46.1 +/- 8.2 minutes in 3715 patients from eight centers. The time from admission
      to the hospital to initiation of thrombolytic therapy was retrospectively
      determined to be 83.8 +/- 55.0 minutes in a separate group of 730 patients from
      six centers. Both the prehospital and hospital time delays were much longer than
      those perceived by paramedics and emergency department directors. Shorter
      hospital time delays were observed in patients in whom a prehospital ECG was
      obtained as part of a protocol-driven prehospital diagnostic strategy and a
      diagnosis of acute infarction made before arrival at the hospital (36.3 +/- 11.3
      minutes in 13 patients). These results show that the magnitude of time required
      to evaluate, transport, and initiate thrombolytic therapy will preclude
      initiation of treatment to most patients within the first hour of symptoms.
      Implementation of a protocol-driven prehospital diagnostic strategy may be
      associated with a reduction in time to thrombolytic therapy.

PMID- 2220532
TI  - Assay of serum cardiac myosin heavy chain fragments in patients with acute
      myocardial infarction: determination of infarct size and long-term follow-up.
AB  - To evaluate the correlation between myosin heavy chain release and the necrosis
      mass, serum levels of myosin heavy chain fragments were determined serially in 55
      patients with acute myocardial infarction. Eight of these patients were
      successfully treated with thrombolytic agents: the others were not treated. The
      same myosin titration was applied to the sera of 25 dogs with an experimental
      myocardial infarction. Six of the dogs were successfully treated with
      thrombolytic agents. The time courses of the myosin concentrations are typical
      and monophasic for all patients with a noncomplex myocardial infarction. The
      values for the kinetic parameters of myosin release are comparable to those
      previously reported. We have now determined that cumulative myosin release
      significantly correlates with cumulative creatine kinase (CK), CK-MB, and lactate
      dehydrogenase release, as well as with thallium-201 distribution, as determined
      for different patient groups. Thrombolytic treatment does not seem to
      qualitatively upset myosin kinetics. The results obtained in dogs with or without
      thrombolysis conclusively indicate that myosin release is a quantitative index of
      the necrosis mass. From a practical point of view, a few serial determinations of
      serum levels of myosin heavy chains are enough to estimate the necrosed mass in
      patients with acute myocardial infarction. More generally, serum myosin titration
      could be useful in detecting any cardiac disturbance involving myocardial injury
      resulting in membrane leakage of cardiac cells.

PMID- 2220533
TI  - Reduction in infarct size by the phospholipase inhibitor quinacrine in dogs with
      coronary artery occlusion.
AB  - It has been suggested that activation of tissue phospholipases may contribute to
      the development of ischemic cell injury. In the present study we sought to assess
      whether administration of the phospholipase inhibitor quinacrine would reduce the
      extent of myocardial necrosis after coronary artery occlusion. In open-chest,
      anesthetized dogs the left anterior descending coronary artery was ligated, and
      technetium-99-labeled albumin microspheres were injected into the left atrium to
      measure the area at risk. The animals were then randomly divided into a control
      group (n = 8) and a group receiving quinacrine (5 mg/kg intravenous bolus
      followed by a 40 micrograms/kg/min infusion for 6 hours; n = 9). The animals were
      killed 6 hours after occlusion, and the infarcted area was delineated by
      triphenyltetrazolium chloride staining. The extent of the risk region was similar
      in the two groups (32.3 +/- 2.1% of the left ventricle in control dogs and 34.2
      +/- 3.4% in quinacrine-treated dogs). Infarct size was 86.4 +/- 8.8% of the risk
      region in control animals, whereas in treated dogs it averaged 62.3 +/- 6.4% of
      the risk region (p = 0.05). No differences were found in heart rate, arterial
      pressure, and rate-pressure product between the two groups. Thus administration
      of the phospholipase inhibitor quinacrine reduced the extent of myocardial
      necrosis in a model of fixed coronary artery occlusion. Preservation of membrane
      phospholipids, reduced formation of lipoxygenase metabolites, or both may mediate
      this phenomenon.

PMID- 2220534
TI  - Intracoronary adenosine administration during reperfusion following 3 hours of
      ischemia: effects on infarct size, ventricular function, and regional myocardial
      blood flow.
AB  - Previous studies have demonstrated that adenosine significantly enhances
      myocardial salvage after 90 minutes of regional ischemia. To determine its effect
      after prolonged ischemia, closed-chest dogs underwent 3 hours of left anterior
      descending artery occlusion followed by 72 hours of reperfusion. Intracoronary
      adenosine (3.75 mg/min; at 1.5 ml/min:total volume = 90 ml; n = 10) or an
      equivalent volume of saline (1.5 ml/min: total volume = 90 ml; n = 9) was infused
      into the left main coronary artery during the first 60 minutes of reperfusion.
      Regional myocardial blood flow was assessed serially with microspheres and
      regional ventricular function was assessed by contrast ventriculography. Infarct
      size was determined histologically. Light and electron microscopy were utilized
      to assess neutrophil infiltration and microvascular injury. Adenosine failed to
      reduce infarct size expressed as a percentage of the area at risk (38.0 +/- 4.9%
      versus 34.8 +/- 4.6%; p = NS) or to improve regional ventricular function as
      measured by the radial shortening method (3.2 +/- 1.8% versus 2.2 +/- 3.1%; p =
      NS) at 72 hours after reperfusion. Vasodilatory effects were not observed in the
      endo- and midmyocardial regions of the ischemic zone during adenosine
      administration. This was associated with a similar extent of capillary
      endothelial changes and neutrophil infiltration in both adenosine-treated and
      saline control groups. These results suggest that severe functional abnormalities
      are present in the vasculature after 3 hours of ischemia and that adenosine
      therapy is ineffective in enhancing myocardial salvage.

PMID- 2220535
TI  - Clinical significance of plasminogen activator inhibitor activity in patients
      with exercise-induced ischemia.
AB  - To assess the fibrinolytic system in patients with exercise-induced ischemia and
      its relation to ischemia and severity of coronary artery disease (CAD), 47
      patients with CAD confirmed by results of coronary angiography underwent symptom
      limited multistage exercise thallium-201 emission computed tomography. All
      patients with CAD had exercise-induced ischemia as assessed from thallium-201
      images. Pre- and peak exercise blood samples from each patient and preexercise
      blood samples from control subjects were assayed for several fibrinolytic
      components and were also assayed for plasma adrenaline. The extent of ischemia
      was defined as delta visual uptake score (total visual uptake score in delayed
      images minus total visual uptake score in initial images) and the severity of CAD
      as the number of diseased vessels. In the basal condition, plasminogen activator
      inhibitor (PAI) activity was significantly higher in patients with exercise
      induced ischemia as compared to control subjects (p less than 0.01), although
      there were no significant differences in other fibrinolytic variables between the
      two groups. Moreover, PAI activity in the basal condition displayed a
      significantly positive correlation with the extent of ischemia (r = 0.47, p less
      than 0.01). Patients with exercise-induced ischemia were divided into two groups
      (24 with single-vessel disease and 23 with multivessel disease). There were no
      significant differences in coronary risk factors, hemodynamics, or plasma
      adrenaline levels during exercise between single-vessel and multivessel disease
      except that delta visual uptake score was significantly higher in multivessel
      disease (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220536
TI  - Comparison of coronary angiography and early oral dipyridamole thallium-201
      scintigraphy in patients receiving thrombolytic therapy for acute myocardial
      infarction.
AB  - We evaluated 50 consecutive patients who received thrombolytic therapy for acute
      myocardial infarction using thallium-201 single photon emission computed
      tomography in combination with oral dipyridamole (300 mg) to assess the frequency
      of residual myocardial ischemia. Thallium studies were performed early after
      myocardial infarction at a mean of 4.6 days (range 3 to 11) in 50 patients. The
      time from the onset of chest pain to the administration of thrombolytic therapy
      was 2.6 hours (range 0.5 to 5.5). Q wave myocardial infarction was evident in 46
      patients; four patients had a non-Q wave infarction (anterior infarction in 31
      patients and inferior infarction in 19 patients). The serum mean peak creatinine
      kinase was 1503 IU/L (range 127 to 6500). Coronary angiography was performed in
      all patients at a mean of 3.1 days (range 2 to 10) and revealed the infarct
      related vessel to be patent in 36 patients (72%). The ejection fraction was 48%
      (range 26% to 67%). After dipyridamole administration, 13 patients (26%)
      developed angina that was easily reversed with the administration of intravenous
      aminophylline. Systolic blood pressure decreased from 122 to 115 mm Hg (p less
      than 0.05) and the heart rate increased from 76 to 85 beats/min (p less than
      0.05). None of the patients had significant hypotension, arrhythmias, or evidence
      of infarct extension. Perfusion abnormalities were present on the initial
      thallium images in 48 patients. Redistribution suggestive of ischemia was present
      in 36 patients (72%). Ischemia confined to the vascular distribution of the
      infarct vessel was evident in 22 patients. Seven patients had ischemia in the
      infarct zone as well as in a remote myocardial segment. Thus 29 patients (58%)
      had ischemia in the distribution of the infarct vessel. Ischemia in the infarct
      zone was evident in 19 of 36 patients (53%) with open infarct vessels and in 10
      of 14 patients (71%) with occluded infarct vessels. In conclusion, thallium-201
      single photon emission computed tomography using oral dipyridamole was safely
      performed in patients with recent myocardial infarctions who receive thrombolytic
      therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220537
TI  - Similar time course of ST depression during and after exercise in patients with
      coronary artery disease and syndrome X.
AB  - To assess whether the time course of ST segment depression differs in patients
      with coronary artery disease and patients with angina and normal coronary
      arteries, the exercise tests of 54 patients with documented coronary artery
      disease and 25 patients with syndrome X (angina, positive exercise test, no
      evidence of coronary artery spasm, and normal coronary arteries) were compared.
      All tests were performed with therapy withheld, using the modified Bruce
      protocol. In each test, time, heart rate and blood pressure were measured at the
      onset and at 1 mm of ST segment depression, and at peak exercise. Recovery
      (return of the ST segment to baseline +/- 0.2 mm) time was also assessed. Peak ST
      segment depression was similar in coronary artery disease and syndrome X patients
      (1.5 +/- 0.3 versus 1.6 +/- 0.4 mm). In 42 coronary artery disease patients, ST
      segment depression developed early (less than or equal to 6 minutes) during
      exercise; this was associated with a short recovery (less than or equal to 3
      minutes) in 17 (40%) and with a long recovery (greater than 3 minutes) in 25
      (60%) patients. In 17 patients with syndrome X, ST segment depression developed
      early; it was associated with a short recovery in six (35%) and with a long
      recovery in 11 (65%) patients. Late (greater than 6 minutes) onset of ST segment
      depression was observed in 12 coronary artery disease patients; of these, eight
      (67%) had a short recovery and 4 (33%) had a long recovery. Late onset of ST
      segment depression occurred in eight patients with syndrome X; six (75%) had a
      short recovery and two (25%) had a long recovery.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2220538
TI  - Prolongation of ventricular refractoriness by class Ia antiarrhythmic drugs in
      the prevention of ventricular tachycardia induction.
AB  - The effects of class la antiarrhythmic drugs (procainamide, quinidine) on the
      right ventricular effective refractory period (VERP) and intraventricular
      conduction time were assessed during serial invasive electrophysiologic studies
      for sustained monomorphic ventricular tachycardia (VT). In 47 patients with
      remote myocardial infarction, sustained VT was inducible by up to two
      extrastimuli after the basic drive at one of two basic cycle lengths at the right
      ventricular apex. With oral drug administration, sustained VT was no longer
      inducible (group I) in 27 patients but remained inducible (group II) in 20 with
      the same protocol. Class la drugs prolonged the VERP in both groups, but there
      was greater lengthening when drugs were effective (e.g., +32 +/- 14 msec in group
      I vs +12 +/- 19 msec in group II; p less than 0.005, basic cycle length 600 to
      700 msec). Prolongation of the VERP by greater than 30 msec had an 88% positive
      predictive value for prevention of sustained VT induction. In all except one
      patient in group I, drugs prolonged the VERP such that the coupling intervals
      that had resulted in sustained VT induction under control conditions were no
      longer attainable. In contrast, conduction time through the ventricle (surface
      QRS duration) in sinus rhythm and during right ventricular pacing was prolonged
      similarly regardless of efficacy (e.g., +33 +/- 21 msec vs +27 +/- 27 msec at a
      cycle length of 400 msec). The presence of similar plasma levels of drug did not
      imply equivalent prolongation of the VERP in the two groups. These results
      suggest that greater prolongation of the VERP by oral procainamide or quinidine
      correlates with drug efficacy against VT induction and is a better predictor of
      drug effect than achievement of a "therapeutic plasma level."

PMID- 2220539
TI  - Lesions in side branches of arteries having undergone percutaneous transluminal
      coronary angioplasty: a histopathologic study.
AB  - Percutaneous transluminal coronary angioplasty (PTCA) may cause occlusion in side
      branches. No histologic studies, however, have been made on side branches of the
      arteries in which PTCA has been performed. A histologic study was therefore made
      to explain the effect of PTCA on side branches. Histologic specimens were
      prepared by serial step sectioning from 15 side branches of 10 autopsied cases
      that had undergone PTCA. The results of examination by light microscope were as
      follows: (1) Stenoses due to PTCA were seen in seven branches (46.7%). (2) The
      stenoses were classified into three types: (a) stenosis due to blocking of the
      orifice of a side branch by the disrupted portion of the intima of the main
      artery (one branch); (b) stenosis due to medial dissection of the main artery or
      further dissection occurring even in the side branches (three branches); and (c)
      stenosis due to fragmentation of the internal elastic lamina of the main artery
      accompanied by proliferation of smooth muscle cells even in the side branch
      (three branches). It is now clear that stenosis is caused in side branches long
      after PTCA. Extra care is required when major side branches exist in the portion
      where this procedure is to be performed.

PMID- 2220540
TI  - Residual atrial septal perforation after percutaneous transvenous mitral
      commissurotomy with Inoue balloon catheter.
AB  - To estimate the incidence of residual atrial septal perforation (ASP) following
      percutaneous transvenous mitral commissurotomy (PTMC) with the Inoue balloon
      catheter and to examine the factors contributing to ASP, we studied 46 patients
      with mitral stenosis undergoing PTMC. Residual ASP was evaluated by Doppler color
      flow imaging 1 day after PTMC, and was detected in 7 out of 46 patients (15.2%).
      We examined the relationship between the development of ASP (ASP+) and the age of
      the patient, the left atrial dimension before PTMC, the mean pressure difference
      between left and right atrium after PTMC, and the duration of the procedure from
      atrial septal puncture by the Brockenbrough method to balloon inflation. There
      was a good correlation between the development of residual ASP and the duration
      of the procedure (ASP+, 51.0 +/- 34.0 minutes; without ASP, 24.6 +/- 16.2
      minutes; p less than 0.01). However, there was no significant correlation between
      the development of ASP and other factors. In the follow-up study, ASP disappeared
      in four patients within 3 months. ASP persisted in two patients for 1 year after
      PTMC. However, the shunt in these two patients was clinically insignificant.
      These data suggest that residual ASP may depend on the duration of the procedure,
      and that most cases of ASP disappear within 1 year after PTMC.

PMID- 2220541
TI  - Results of repeat percutaneous balloon valvuloplasty for pulmonary valvar
      restenosis.
AB  - Follow-up cardiac catheterization studies were used to evaluate 105 patients who
      had undergone percutaneous balloon pulmonary valvuloplasty. Fifteen of those
      patients who had peak systolic pulmonary valve gradients greater than = 40 mm Hg
      at follow-up underwent repeat balloon valvuloplasty. For the initial balloon
      pulmonary valvuloplasty, the mean ratio of the balloon diameter to pulmonary
      valve annulus diameter was 0.98 +/- 0.2; at repeat valvuloplasty the mean was
      1.19 +/- 0.12. The immediate post-repeat balloon valvuloplasty results showed a
      reduction in the peak systolic gradient from a mean of 70.2 +/- 17.8 to 29.1 +/-
      19.0 mm Hg (p less than 0.001). This reduction in the gradient was maintained at
      a mean of 14.3 +/- 5.0 mm Hg in 8 of the 10 patients who underwent further follow
      up studies. We conclude that successful repeat balloon pulmonary valvuloplasty
      with the use of larger sized balloons is feasible in patients who have restenosis
      after the initial percutaneous balloon valvuloplasty--including partial but not
      complete dysplasia of the pulmonary valve.

PMID- 2220542
TI  - Noninvasive discrimination of right atrial ectopic tachycardia from sinus
      tachycardia in "dilated cardiomyopathy".
AB  - Right atrial ectopic tachycardia (RAET) with secondary cardiac dysfunction can be
      difficult to differentiate from primary dilated cardiomyopathy (CMP) with sinus
      tachycardia. In an attempt to separate RAET from CMP by noninvasive testing,
      routine surface electrocardiograms (EGGs), 24-hour ambulatory ECGs (Holter
      monitors), and echocardiograms of patients with RAET (n = 34) and CMP (n = 33)
      were reviewed. RAET atrial rates were significantly faster than CMP rates on the
      resting ECG and on Holter monitoring; 12 of 33 patients with RAET had resting ECG
      rates greater than 150% of predicted normal values for age but none of 32
      patients with CMPs had resting ECG rates in this range. Mean P wave axis in the
      horizontal plane was more posterior in patients with RAET and was less than 0
      degrees (negative in lead V2) in 8 of 29 patients with RAET but in 1 of 33
      patients with CMP. Second-degree atrioventricular (AV) block was observed in 12
      of 33 patients with RAET but in none of 33 with CMP. Shortening fraction less
      than 10% was found in 13 of 33 individuals with CMP but in only 1 of 27 with
      RAET. We conclude that noninvasive studies can help identify RAET among patients
      with poor functioning hearts and right atrial tachycardia.

PMID- 2220543
TI  - Left ventricular end-systolic stress-volume index ratio in aortic and mitral
      regurgitation with normal ejection fraction.
AB  - To evaluate the left ventricular contractile state in regurgitant valvular
      disease with normal ejection fraction, we analyzed the end-systolic stress-volume
      index relationship (ESSVR) by means of cineangiography in 15 normal subjects, 11
      patients with aortic regurgitation (AR), and 10 patients with mitral
      regurgitation (MR) whose ejection fraction (EF) was 60% or more. The end-systolic
      stress-volume index ratio in normal subjects was 5.57 +/- 0.60 kdyne/cm5/m2 (mean
      +/- standard deviation), and we defined the range including +/- 2 standard
      deviations of the ratio as the normal ESSVR range. Six patients with AR and five
      patients with MR placed inside the normal ESSVR range, termed AR IN and MR IN,
      but the remaining five patients with AR and MR placed to the right of the normal
      range, termed AR OUT and MR OUT. EF did not differ between patients with AR IN
      and AR OUT (69.4 +/- 5.4 verus 70.7 +/- 6.1%) and between MR IN and MR OUT (71.6
      +/- 3.6 versus 71.1 +/- 7.9%). The EF of the subdivided groups with AR and MR
      also did not differ from that of normal subjects (70.7 +/- 7.3%). This finding
      showed that the left ventricular contractile state was depressed in patients with
      AR OUT and MR OUT despite a normal EF. In AR and MR the end-systolic stress and
      end-systolic volume index of OUT did not differ from those of IN, but the end
      diastolic volume index of OUT was larger than that of IN (AR OUT 156.8 +/- 27.9
      versus AR IN 110.8 +/- 24.1 ml/m2, MR OUT 160.5 +/- 44.7 versus MR IN 101.0 +/
      16.6 ml/m2; both p less than 0.05), and the regurgitant fraction of OUT was
      higher than that of IN (AR OUT 52.6 +/- 13.6 versus AR IN 29.7 +/- 13.3%, MR OUT
      52.9 +/- 10.2 versus MR IN 30.2 +/- 11.4%; both p less than 0.05). In addition,
      there was a linear inverse correlation between the end-systolic stress-volume
      index ratio and the end-diastolic volume index in all subjects (r = -0.82, n =
      36). In normal subjects there was a linear inverse correlation between end
      systolic stress and the EF (r = -0.91, n = 15), but this relationship failed to
      separate patients with OUT from those with IN. Results of the present study
      suggest that some patients with AR and MR whose EF was normal had a depressed
      contractile state, and these patients had a large end-diastolic volume index and
      a high regurgitant fraction.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2220544
TI  - Maximal oxygen uptake in severe aortic regurgitation: a different view of left
      ventricular function.
AB  - Respiratory gas exchange was used to assess left ventricular (LV) function in 22
      patients with severe aortic regurgitation (19 men and three women, aged 18 and 70
      years, mean 49 years). Anaerobic threshold and symptom-limited maximal oxygen
      consumption (VO2 max) were measured during treadmill exercise, and the results
      were compared with conventional echocardiographic and radionuclide indices of LV
      systolic function. The results were considered with respect to the patients' New
      York Heart Association functional class. Both rest and exercise LV ejection
      fractions were variable, but the mean results were similar in all classes. The
      echocardiographic indices of LV cavity dimensions, fractional shortening,
      radius/thickness ratio, and systolic wall stress also showed a wide range but
      with similar mean results in each class. In contrast, VO2 max and anaerobic
      threshold showed a relationship to functional class. VO2 max was 32.4 +/- 3.4
      ml/kg/min in age-matched control subjects; in the patients it was 27.9 +/- 4.7 in
      class I, 24.7 +/- 5.7 in class II, and 14.2 +/- 2 in the combined class III/IV.
      Results in patients in classes I and II were similar, but both groups were
      significantly different from control subjects (p less than 0.05) and from
      patients in class III/IV (p less than 0.01). About half of the patients with
      moderate LV dysfunction (judged by reduced VO2 max) were asymptomatic, and LV
      function was impaired in 4 of 10 patients in class I. Thus, unlike conventional
      indices of LV function, VO2 max appeared capable of distinguishing patients with
      moderate-to-severe LV dysfunction from those with little or no LV dysfunction.
      Measurement of respiratory gas exchange appears to be a valid and useful
      supplementary means of assessing LV function in severe aortic regurgitation.
      Further long-term evaluation is required.

PMID- 2220545
TI  - Contribution of transesophageal echocardiography to patient diagnosis and
      treatment: a prospective analysis.
AB  - The capability of transesophageal (TEE) versus transthoracic (TTE)
      echocardiography as a diagnostic tool in clinical practice was prospectively
      examined in 86 consecutive cases. A conclusive diagnosis was possible in 95% with
      TEE, whereas the same result was achieved in 48% by TTE. Specifically, TEE
      provided a conclusive diagnosis in 14 of 16 cases of infective endocarditis,
      while TTE gave this result in 4 of the 16 cases (p less than 0.001). Similarly,
      TEE allowed a conclusive diagnosis in 11 of 11 instances of aortic dissection,
      while TTE gave this indication in two cases (p less than 0.001). TEE was
      similarly effective in eight of eight cases of atrial thrombi, whereas TTE gave
      the diagnosis in three of eight cases (p less than 0.01). In five subjects with
      intracardiac masses, TEE gave a conclusive diagnosis in all five, whereas TTE was
      able to diagnose conclusively in one subject (p less than 0.02). In seven
      patients with mitral regurgitation, TEE gave the conclusive diagnosis in all
      seven and TTE was able to provide this information in four (p = NS). TEE was able
      to provide a conclusive diagnosis in four patients with aortic insufficiency, and
      TTE gave the same information in two of the four (p = NS). In 14 patients with
      prosthetic valve dysfunction, TEE gave the diagnosis in 12 and TTE gave it in
      eight patients (p = NS). Both methods gave a conclusive diagnosis in 13 out of 13
      cases of mitral stenosis (p = NS). Also, TEE provided a conclusive diagnosis in
      eight of eight patients with adult congenital heart disease and TTE gave this
      information in four (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220546
TI  - Spontaneous echocardiographic contrast in the descending aorta.
AB  - The visualization of echocardiographic spontaneous contrast is a common
      phenomenon in patients undergoing transesophageal echocardiographic studies. Its
      pathophysiology is not well understood, but it has been related to the presence
      of a low flow state in the cardiac chambers. We report the presence of
      spontaneous contrast in the descending aorta of four patients, a location not
      previously described in the absence of aortic dissection. In two patients,
      spontaneous contrast was noted in both the left atrium and the descending aorta.
      In one patient with moderate left ventricular dysfunction, spontaneous contrast
      was noted in the descending aorta and in the left ventricle. In the remaining
      case, no cardiac or aortic abnormalities were observed and this represents the
      first time that spontaneous contrast has been identified in a patient with an
      echocardiographically normal heart. The occurrence of spontaneous contrast has
      been considered an abnormal echocardiographic finding, since it has always been
      described in patients with clinical symptoms and cardiac abnormalities. The fact
      that spontaneous contrast can be visualized in patients with very mild structural
      cardiac abnormalities or none at all, warrants further investigation, especially
      when therapeutic or prognostic implications are considered.

PMID- 2220547
TI  - Marfan syndrome in China: a collective review of 564 cases among 98 families.
AB  - This is a collective review of 564 patients with Marfan syndrome among 98
      pedigrees reported from 18 provinces and cities in China over a 37-year period
      from 1951 to 1987. A positive family history of Marfan syndrome was found in
      74.3% of the patients: the mode of inheritance was dominant in 73.8% and
      recessive in 0.5%. Sporadic cases occurred in 25.7%. A screening of 29,067
      children found five children with Marfan syndrome, giving a prevalence of 17.2
      per 100,000 of the population, a gene frequency of 8.61 per 100,000 genes, and a
      penetrance of 71.69%. Pleiotropy was clear in these cases: arachnodactyly in 77%,
      ectopia lentis in 86.8%, and dilated aortic root in 80.1%. Chromosome examination
      showed no regular aberrations except in a family of five in whom a giant
      satellited chromosome 14 was found in three afflicted members but not in the two
      unaffected relatives. The high prevalence of aortic root dilation in Marfan
      syndrome makes echocardiography the most useful and practical means of diagnosis.
      Close follow-up and regular echocardiographic evaluation are indicated not only
      in patients with Marfan syndrome but also in their families, for both diagnostic
      and therapeutic purposes.

PMID- 2220548
TI  - Atrial septal aneurysm: recognition and clinical relevance.

PMID- 2220549
TI  - Parental history is an independent risk factor for coronary artery disease: the
      Framingham Study.
AB  - Family history of CAD, defined as parental death by CAD, was found to be a
      significant independent predictor of CAD in a logistic regression model
      controlling for standard risk factors and length of follow-up among the 5209
      participants in the Framingham Study. Persons with a positive parental history
      have a 29% increased risk of CAD, and the strength of the association between
      parental history and CAD is similar to that found for other standard risk factors
      such as systolic blood pressure, cholesterol level, and cigarette smoking. No
      evidence was found that persons with a family history of CAD have a decreased
      capacity to cope with the deleterious effects of known risk factors; that is, no
      significant interaction was found between any of the risk factors and parental
      history of CAD. Among men with low risk for CAD by risk-factor profile (i.e.,
      nonsmoking, thin, nonhypertensive persons), more than two thirds of those who
      experience CAD have a positive parental history. This study suggests that CAD
      among persons who are predicted to be at low risk by standard risk factors may
      have a substantial genetic component and that the risk associated with parental
      history may not be reduced by modification of these factors. Nevertheless, among
      persons with a positive family history, those with a favorable risk profile are
      at substantially less risk for CAD than those with an unfavorable risk profile.

PMID- 2220550
TI  - Successful coronary angioplasty in two patients with cardiogenic shock using the
      Nimbus Hemopump support device.

PMID- 2220551
TI  - Delayed complete heart block complicating percutaneous transluminal coronary
      angioplasty.

PMID- 2220552
TI  - Cocaine-induced torsades de pointes in a patient with the idiopathic long QT
      syndrome.

PMID- 2220553
TI  - Conduction system disease in a child with long QT syndrome.

PMID- 2220554
TI  - AV blockade via selective AV nodal artery injection in a patient.

PMID- 2220555
TI  - Spontaneous echo contrast in the left atrium during paroxysmal atrial
      fibrillation.

PMID- 2220556
TI  - Left ventricular pseudoaneurysm: detection and postoperative follow-up by color
      Doppler echocardiography.

PMID- 2220557
TI  - Congenital left atrial appendage aneurysm with intact pericardium: diagnosis by
      transesophageal echocardiography.

PMID- 2220559
TI  - Persistent left superior vena cava: unusual wave contour of left jugular vein as
      the presenting feature.

PMID- 2220558
TI  - Cardiac manifestations of Churg-Strauss syndrome: report of a case and review of
      the literature.

PMID- 2220560
TI  - APhA announces national DUR program.

PMID- 2220561
TI  - Update on quinolone drug interactions.
AB  - Concurrent administration of both ciprofloxacin and norfloxacin with sucralfate
      leads to a decrease in quinolone bioavailability. It is unknown whether this
      decrease is clinically significant because studies have focused primarily on
      pharmacokinetics and not therapeutic outcomes. A reasonable recommendation may be
      to avoid using sucralfate and norfloxacin concurrently, or avoid administration
      of norfloxacin and ciprofloxacin within two hours of sucralfate administration.
      Magnesium- and aluminum-containing antacids may also interfere with quinolone
      absorption. Calcium carbonate and H2 receptor antagonists do not appear to
      interact with quinolones and may be considered as an alternative to sucralfate or
      magnesium- and aluminum-containing antacids when quinolones are administered.
      Concurrent administration of ciprofloxacin and theophylline may precipitate
      theophylline toxicity if not monitored carefully. Some clinicians recommend a 30%
      empiric reduction in theophylline dosage when ciprofloxacin therapy is initiated.
      Because the drug interaction is not completely predictable, the patient's
      theophylline levels should be monitored and signs and symptoms of toxicity noted,
      adjusting the dose as needed. Decreased theophylline clearance may persist for as
      long as five days following discontinuation of ciprofloxacin. Some potential for
      slight increases in serum theophylline concentrations secondary to norfloxacin
      administration may exist. However, it is unlikely to be clinically significant,
      based on currently available information.

PMID- 2220562
TI  - Path through the job jungle: Part 2. The hunt is on.

PMID- 2220563
TI  - 'Drug' is not a four-letter word.

PMID- 2220564
TI  - Noise exposure reduction aboard an oceangoing hopper dredge.
AB  - Reported industrial hygiene surveys aboard seagoing vessels are few, despite the
      presence of many potentially hazardous chemical and physical agents aboard ships.
      This investigation focused on crew noise exposure aboard an oceangoing hopper
      dredge. Noise exposure criteria were adopted based on the 24-hr equivalent
      continuous sound level (Leq(24)) because of the absence of standards for U.S.
      shipboard noise exposure. Personal noise dosimeters were used to measure the
      noise exposure of watchstanders, whose duties were predictable and repetitive.
      Watchstanders with high noise doses were asked to estimate their duration of
      exposure in specific areas of the vessel to enable calculation of noise dose per
      space. Noise sources within spaces associated with high noise dose were
      identified by sound pressure and surface vibration analysis in octave bands.
      Almost all accommodation spaces (cabins, recreation rooms, dining rooms, and
      hospital) were sufficiently quiet (sound pressure levels [SPLs] less than 65 dBA)
      to permit hearing threshold recovery. Machinery space SPLs ranged from 85 to 108
      dBA, and engineering personnel noise exposure exceeded the selected criterion of
      Leq(24) = 80 dBA. Selective noise abatement and use of an enclosed operating
      station in the engine room were recommended to control engineering personnel
      noise exposure. This approach to noise exposure assessment and reduction should
      be applicable to other oceangoing ships where personnel may be exposed to noise
      24 hr per day for weeks at a time.

PMID- 2220565
TI  - PPG's Safety and Health Index System: a 10-year update of an in-plant Hazardous
      Materials Identification System and its relationship to finished product
      labeling, industrial hygiene, and medical programs.
AB  - The Safety and Health Index System (SHIS) has developed beyond its initial role
      as an in-plant labeling system. It has evolved into a classification scheme to
      rank the hazards found in the workplace and is useful in prioritizing industrial
      hygiene monitoring programs, installation of engineering controls, and
      implementation of medical monitoring for chronic hazards. In addition to
      providing objective criteria on which to evaluate physical and acute health
      hazards, this system addresses chronic health hazards such as carcinogens,
      mutagens, teratogens, and reproductive toxins.

PMID- 2220566
TI  - Using noise exposure histories to quantify duration of vibration exposure in tree
      fallers.
AB  - A study of tree fallers in the British Columbia forest industry was done to
      determine if noise histories could be used to monitor the daily duration of
      exposure to hand-arm vibration from chain saws. Field observations and noise
      dosimetry showed that chain saw noise was distinguishable from other sound
      sources in fallers' work environments. Using data from noise dosimetry
      synchronized with observations of fallers' chain saw use, a model of sound
      pressure levels predictive of chain saw operating mode was developed. Subsequent
      workday noise histories of 13 fallers showed that the chain saw was off for an
      average of 331 +/- 27 min, idling for 91 +/- 11 min, and cutting wood for 96 +/-
      7 min. This method could be used to collect data to refine dose-response
      estimates for vibration syndrome or to monitor administrative controls of
      vibration exposure time.

PMID- 2220567
TI  - A predictive model for vapor concentration in a nose-only inhalation chamber.
AB  - A unique nose-only inhalation chamber was designed and constructed to deliver
      uniform concentrations of gas, vapor, and aerosol contaminants to mice. This
      research investigated the fluid dynamics of a vaporous contaminant in the
      vertical flow chamber. The vapor was introduced by allowing the liquid phase of
      the contaminant to evaporate freely into the chamber interior. A contaminant mass
      transfer model was developed to predict concentrations generated by the system.
      The mathematical model of the system used clean airflow, liquid surface area,
      thickness of the stagnant air layer covering the liquid, system pressure,
      contaminant diffusion coefficient, and contaminant vapor pressure to compute the
      vapor concentration delivered to exposure ports. The equation was verified by
      placing various containers of methyl isobutyl ketone in the chamber and
      determining with a photospectrometer the resulting equilibrium concentrations.
      Vapor pressure, diffusion coefficient, and system pressure were held constant
      while airflow, surface area, and stagnant air layer thickness were varied
      systematically within the chamber. The resulting empirical data points were
      compared to the curves predicted by the theoretical model. Empirical
      concentrations fell within 0 to 48% of the theoretical values, showing that the
      equation can be used to choose values for airflow, surface area, and stagnant air
      layer thickness that will result in chamber concentrations in close proximity to
      the target concentration. If an exact concentration is essential, parameters may
      be individually adjusted to converge on the target concentration.

PMID- 2220568
TI  - Evaluation of methods for destruction of some alkylating agents.
AB  - Destruction procedures for dimethylsulfate (DMS), diethylsulfate (DES), methyl
      methanesulfonate (MMS), and ethyl methanesulfonate (EMS) have been investigated
      using treatment by 1 N NaOH, 1 N NH4OH, 1 M Na2CO3, and 1 M Na2S2O3. During the
      kinetic study of the destruction process, the determination of remaining
      concentrations of the alkylating agents was performed by the derivatization of p
      nitrophenoxide to p-nitroanisole and p-nitrophenetole, which were separated by
      high performance liquid chromatography. The mutagenic activity of the destruction
      products was evaluated by the Ames test using Salmonella tester strains TA97,
      TA98, TA100, and TA102. The kinetics of destruction in every case followed a time
      dependent exponential relationship. Solutions of 1 M Na2S2O3 showed the highest
      capacity for destruction of the four alkylating agents, half-lives of DMS, DES,
      MMS, and EMS being 0.14 min, 1.26 min, 0.60 min, and 5.26 min, respectively. No
      mutagenic activity was detected following complete destruction in 1 M Na2S2O3.

PMID- 2220569
TI  - Vibration exposure for selected power hand tools used in automobile assembly.
AB  - A practical method for assessing vibration exposure for workers operating
      vibrating hand tools on an automobile assembly line is presented. Vibration
      exposure is difficult to assess directly using many fast Fourier transform (FFT)
      spectral analyzers because of long task cycle times. Exposure time cannot be
      accurately estimated using time standards because of the high variability between
      operators and work methods. Furthermore, because workers frequently move about
      and get into inaccessible spaces, it is difficult to record vibration without
      interfering with the operation. A work sampling method was used for determining
      vibration exposure time by attaching accelerometers to the tools and suspending a
      battery-operated digital data logger from the air hose. Vibration acceleration
      and frequency spectra for each tool were obtained off-line replicating actual
      working conditions and analyzed together with exposure time data for determining
      individual worker vibration exposure. Eight pneumatic vibrating power hand tools,
      representing tools commonly used in an automobile assembly plant, were studied.
      Spectra for the rotary and reciprocating power tools and had large distinct
      dominant fundamental frequencies occurring in a narrow frequency range between 35
      Hz and 150 Hz. These frequencies corresponded closely to tool free-running
      speeds, suggesting that major spectral component frequencies may be predicted on
      the basis of speed for some tools.

PMID- 2220570
TI  - Occupational intake by dermal exposure to polychlorinated dibenzo-p-dioxins and
      polychlorinated dibenzofurans in pulp mill industry.
AB  - The extent of probable intake of polychlorinated dibenzo-p-dioxins (dioxins) and
      polychlorinated dibenzofurans (furans) from exposure to process liquor, effluent,
      sludge, and pulp contaminated with dioxins/furans in pulp mills was examined. It
      is expected that intake of dioxins/furans by skin exposure may exceed their
      intake by inhalation. Limiting skin exposure to these chemicals should receive
      similar emphasis as inhalation exposure to volatile chemicals. Because of an
      inadequate scientific data base, assumptions erring toward safety had to be made
      in estimating the intake from potential exposures. Therefore, the calculated
      intakes are likely to be overestimates.

PMID- 2220571
TI  - Frequency of low-grade residual coronary stenosis after thrombolysis during acute
      myocardial infarction.
AB  - The clinical, angiographic and demographic characteristics of 42 patients with
      low-grade (less than 50%) residual stenosis at the infarct lesion after
      thrombolysis for acute myocardial infarction (MI) were assessed. The study group
      (group I) represented 21% of 198 consecutive patients receiving thrombolytic
      therapy over a 59-month period. Data on the 156 remaining patients were pooled
      for comparison (group II). Group I patients were predominantly men (86%) who were
      cigarette smokers (81%). Group II patients were predominantly men (75%, p greater
      than 0.10) but were significantly older (52 +/- 12 vs 56 +/- 10 years, p = 0.02).
      Prior acute MI or angina was unusual in group I. Sixty percent had no significant
      (greater than 50%) residual coronary artery disease while 25% had residual single
      artery disease. Average significant (greater than 50% diameter stenosis) residual
      vessel disease was 0.6 +/- 1.0 for group I and 1.9 +/- 0.9 for group II (p less
      than 0.001). In group I, average residual infarct lesion diameter stenosis was 36
      +/- 7% in the right anterior oblique and 34 +/- 8% in the left anterior oblique
      views. Thirty-nine group I patients were discharged with medical therapy and 100%
      follow-up was obtained over a mean interval of 18 +/- 17 months. Fifteen patients
      experienced chest pain after acute MI accounting for 17 discrete events. Fifty
      nine percent of group I had a benign course on follow-up. Eight events were
      classified as unstable angina, 4 as acute MI and 5 as atypical angina. Documented
      coronary vasospasm occurred in 3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220572
TI  - Effect of verapamil on mortality and major events after acute myocardial
      infarction (the Danish Verapamil Infarction Trial II--DAVIT II)
AB  - The effect of verapamil on death and major events (i.e., death or reinfarction)
      after an acute myocardial infarction was studied in a double-blind, randomized,
      placebo-controlled multicenter trial. Eight hundred seventy-eight patients
      started treatment with verapamil, 360 mg/day, and 897 patients with placebo.
      Treatment started in the second week after admission and continued for up to 18
      months (mean 16 months). Ninety-five deaths and 146 major events occurred in the
      verapamil group and 119 deaths and 180 major events in the placebo group. The 18
      month mortality rates were 11.1 and 13.8% (p = 0.11, hazard ratio, 0.80; 95%
      confidence limits, 0.61 to 1.05), and major event rates 18.0 and 21.6% (p = 0.03,
      hazard ratio, 0.80; 95% confidence limits, 0.64 to 0.99) in the verapamil and
      placebo groups, respectively. In patients without heart failure in the coronary
      care unit the mortality rates were 7.7% in the verapamil group and 11.8% in the
      placebo group (p = 0.02, hazard ratio, 0.64; 95% confidence limits, 0.44 to
      0.94), and major event rates 14.6 and 19.7% (p = 0.01, hazard ratio 0.70; 95%
      confidence limits (0.52 to 0.93). In patients with heart failure the mortality
      rates were 17.9 and 17.5% (p = 0.79, hazard ratio, 1.05; 95% confidence limits,
      0.72 to 1.54), and major event rates 24.9 and 24.9% (p = 1.0, hazard ratio 0.98;
      95% confidence limits 0.72 to 1.39). Long-term treatment with verapamil after an
      acute myocardial infarction caused a significant reduction in major events, and
      the positive effect was found in patients without heart failure.

PMID- 2220573
TI  - Impact of field-transmitted electrocardiography on time to in-hospital
      thrombolytic therapy in acute myocardial infarction.
AB  - To assess the impact of a field-transmitted electrocardiogram (ECG) on patients
      with possible acute myocardial infarction, randomized and open trials were
      performed with a portable electrocardiographic system coupled with a cellular
      phone programmed to automatically transmit ECGs to the base hospital. Consecutive
      patients served by the 6 units of the Salt Lake City Emergency Rescue System were
      studied; 71 patients were randomized to in-field ECG (n = 34) versus no ECG (n =
      37). Time on scene was 16.4 +/- 9.7 minutes for the ECG group versus 16.1 +/- 7.0
      minutes for the non ECG group (difference not significant). Time of transport
      averaged 18.2 +/- 9.9 and 17.6 +/- 13.1 minutes, respectively (difference not
      significant). Six of 34 patients with in-field ECG showed acute myocardial
      infarction, qualified for and received thrombolytic therapy at 48 +/- 12 minutes
      after hospital arrival (range 30 to 60) compared with 103 +/- 44 minutes (p less
      than 0.01) for 51 historical control patients and 68 +/- 29 minutes for 6
      concurrent control patients without in-field ECG. Thus, in-field ECG causes
      negligible delays in paramedic time, leads to significant decreases in time to in
      hospital thrombolysis and may make in-field therapy feasible. In-field ECG may be
      an important addition to reperfusion strategies.

PMID- 2220574
TI  - Sensitivity of a set of myocardial infarction screening criteria in patients with
      anatomically documented single and multiple infarcts.
AB  - A subset of 3 screening criteria (Q wave greater than or equal to 30 ms in lead
      aVF, any Q or R wave less than or equal to 10 ms and less than or equal to 0.1 mV
      in lead V2, and R wave greater than or equal to 40 ms in V1) has been proposed to
      identify single nonacute myocardial infarcts. Cumulatively, these 3 criteria
      achieved 95% specificity, and 84 and 77% sensitivities for inferior and anterior
      myocardial infarcts, respectively, among patients identified by coronary
      angiography and left ventriculography. This study establishes the true
      sensitivities of the set of screening criteria in 71 patients with anatomically
      proven single myocardial infarcts and 32 patients with multiple myocardial
      infarcts. In the single inferior infarct group, the aVF criterion was 90%
      sensitive. The V2 criterion (any Q or R wave less than or equal to 10 ms and less
      than or equal to 0.1 mV) was 67% sensitive in the single anterior infarct group.
      No single criterion proved sensitive in identifying a posterolateral infarct. The
      set of screening criteria performed just as well for multiple infarcts as it did
      for single infarcts, with a cumulative sensitivity of 72%. The overall
      sensitivity of the screening set in the 103 patients in all groups was 71%.

PMID- 2220575
TI  - Two-year outcome after angiographically documented myocardial reperfusion for
      acute coronary occlusion. Thrombolysis and Angioplasty Study Group.
AB  - Reperfusion therapy has been clearly shown to decrease the early mortality after
      acute myocardial infarction, but the impact of this therapy on long-term survival
      has been less extensively evaluated. This study reports the extended follow-up of
      a large cohort of 810 patients treated with intravenous thrombolytic therapy
      combined, when considered necessary to maintain or augment infarct vessel
      patency, with mechanical reperfusion therapies. Each patient underwent coronary
      angiography within 2 hours of the initiation of the thrombolytic infusion.
      Coronary angioplasty was performed in 62% of the patients before hospital
      discharge and 21% underwent coronary artery bypass graft surgery. Follow-up was
      obtained in 96% to a mean of 18.8 months (range, 1.5 to 48 months). All-cause
      mortality over this period was 3.3%; 2.1% died from cardiac causes. Nonfatal
      reinfarction occurred in 5.1%. Although the low event rate limits the validity of
      statistical comparisons, the patients who survived the follow-up period tended to
      be younger (56 +/- 10 vs 65 +/- 7 years), to have better predischarge left
      ventricular function (left ventricular ejection fraction, 52 +/- 11 vs 46 +/-
      13%) and to have a lower prevalence of multivessel coronary artery disease (45 vs
      67%). This excellent long-term survival may, in part, reflect the exclusion of
      high-risk patients from enrollment in the Thrombolysis and Angioplasty in
      Myocardial Infarction (TAMI) studies. It may also be attributable, however, to
      the frequent use of combined thrombolysis and mechanical revascularization in
      this population.

PMID- 2220576
TI  - Functional significance of myocardial perfusion defects induced by dipyridamole
      using thallium-201 single-photon emission computed tomography and two-dimensional
      echocardiography.
AB  - The mechanisms responsible for inhomogeneous myocardial blood flow after oral
      administration of a large dose (300 mg) of dipyridamole were assessed in 27
      patients with serial thallium-201 single-photon emission computed tomography
      (SPECT) and simultaneous 2-dimensional echocardiograms. Myocardial tomographic
      images were obtained 50 minutes and 3 to 4 hours after administration of
      dipyridamole. Two-dimensional echocardiograms were recorded at baseline and then
      every 15 minutes for 60 minutes. Dipyridamole caused only a mild reduction in
      blood pressure (from 129 +/- 18 to 126 +/- 16 mm Hg) and a mild increase in heart
      rate (from 69 +/- 15 to 73 +/- 4 beats/min). Sixteen patients had perfusion
      defects after dipyridamole by SPECT, which underwent partial or total filling-in.
      Fourteen of these patients (87.5%) had either a new abnormality or further
      deterioration of a preexisting wall motion abnormality by 2-dimensional
      echocardiography, and thus were considered to have developed transient ischemia
      during dipyridamole administration. Ten of 11 patients (91%) with normal
      perfusion or fixed defects by SPECT had no further deterioration in wall motion
      after oral dipyridamole, and were thus considered to have no evidence of
      myocardial ischemia. In conclusion, most patients with transient thallium-201
      defects after dipyridamole develop transient worsening of resting wall motion by
      2-dimensional echocardiography, suggestive of true myocardial ischemia. Because
      myocardial oxygen demand, as indicated by the heart rate-blood pressure product,
      did not change significantly, the mechanism of myocardial ischemia in these
      patients is likely to be diminished regional blood flow related to a
      "subendocardial steal" induced by dipyridamole.

PMID- 2220577
TI  - Left ventricular dilatation and pulmonary thallium uptake after single-photon
      emission computer tomography using thallium-201 during adenosine-induced coronary
      hyperemia.
AB  - This study examined the implications of left ventricular (LV) dilatation and
      increased pulmonary thallium uptake during adenosine-induced coronary hyperemia.
      The lung-to-heart thallium ratio in the initial images was significantly higher
      in patients with coronary artery disease (CAD) than normal subjects; 0.48 +/-
      0.16 in 3-vessel disease (n = 16), 0.43 +/- 0.10 in 2-vessel disease (n = 20),
      0.43 +/- 0.08 in 1-vessel disease (n = 16) and 0.36 +/- 0.05 in normal subjects
      (n = 7) (p less than 0.001, 0.09 and 0.06, respectively). There was a significant
      correlation between the severity and the extent of the perfusion abnormality
      (determined from the polar maps) and the lung-to-heart thallium ratio (r = 0.51
      and 0.52, respectively, p less than 0.0002). There was also a significant
      correlation between lung thallium washout and lung-to-heart thallium ratio (r =
      0.42, p = 0.0009) and peak heart rate (r = -0.49, p less than 0.0001). The LV
      dilatation was mostly due to an increase in cavity dimension (30% increase) and
      to a lesser extent (6% increase) due to increase in LV size. (The cavity
      dimensions were measured from the short-axis slices at the midventricular level
      in the initial and delayed images). The dilation was seen in patients with CAD
      but not in the normal subjects. These changes correlated with the extent and
      severity of the thallium perfusion abnormality. Thus, adenosine-induced coronary
      hyperemia may cause LV dilation and increased lung thallium uptake on the basis
      of subendocardial ischemia.

PMID- 2220578
TI  - Effects of bepridil and diltiazem on ventricular repolarization in angina
      pectoris.
AB  - To examine the time-course and potential predictors of prolongation of
      ventricular repolarization with the calcium antagonist bepridil, the effects of
      bepridil (300 to 500 mg/day; n = 45) and diltiazem (180 to 300 mg/day; n = 42) on
      QT and QTc interval duration were analyzed in a randomized double-blind study in
      patients with angina pectoris. Electrocardiograms were recorded before and 14,
      28, 70 and 112 days after treatment was begun. After 14 days, bepridil prolonged
      QT interval by 26 +/- 35 ms (range, -60 to 120 ms) and QTc (Bazett's formula) by
      17 +/- 33 ms (range, -73 to 107 ms) compared to baseline (both p less than 0.05).
      QT or QTc did not significantly increase thereafter. However, among the 30
      patients who had less than 40 ms QTc prolongation at day 14 compared with
      baseline, 13 (43%) exceeded this limit on at least 1 of the following visits.
      Diltiazem did not significantly alter QT or QTc intervals. The absolute change in
      QTc interval from baseline observed after 14 days of bepridil therapy was
      inversely proportional to the baseline QTc interval (r = -0.68; n = 42; p less
      than 0.001). The degree of bepridil-induced QTc prolongation on day 14 correlated
      with pretreatment RR interval (r = 0.36; n = 42; p less than 0.02). In
      conclusion, chronic administration of bepridil but not of diltiazem prolongs
      ventricular repolarization in patients with angina pectoris. The overall effects
      of bepridil therapy on QT and QTc intervals can be assessed by an
      electrocardiogram recorded after 14 days of treatment but subsequent measurements
      may be required in individual patients. A short baseline QTc interval and a slow
      initial heart rate may be potentially useful predictors of a greater QTc
      prolongation with bepridil.

PMID- 2220579
TI  - Effects of intravenous verapamil on left ventricular relaxation and filling in
      stable angina pectoris.
AB  - Left ventricular (LV) diastolic function is often impaired in coronary artery
      disease (CAD). To assess whether verapamil could improve LV diastolic properties,
      12 patients with CAD undergoing right- and left-sided cardiac catheterization, as
      well as simultaneous radionuclide angiography, were studied before and during
      intravenous administration of verapamil (0.1 mg/kg as a bolus followed by 0.007
      mg/kg/min). The heart rate was kept constant by atrial pacing in both studies. LV
      pressure-volume relations were obtained. Verapamil decreased LV systolic pressure
      (130 +/- 22 to 117 +/- 16 mm Hg, p less than 0.01) and the end-systolic
      pressure/volume ratio (2.4 +/- 1.3 to 1.6 +/- 0.5 mm Hg/ml, p less than 0.05),
      and increased LV end-diastolic (13 +/- 4 to 16 +/- 4 mm Hg, p less than 0.02) and
      pulmonary capillary pressures (10 +/- 5 to 12 +/- 5 mm Hg, p less than 0.005).
      Despite such negative inotropic effects, cardiac index increased (3.4 +/- 0.7 to
      3.9 +/- 0.6 liters/min/m2, p less than 0.02). The time constant of isovolumic
      relaxation shortened (63 +/- 14 to 47 +/- 9 ms, p less than 0.02); peak filling
      rate increased (370 +/- 155 to 519 +/- 184 ml/s, p less than 0.001; 2.6 +/- 1.1
      to 3.3 +/- 0.9 end-diastolic counts/s, p less than 0.02; and 4.1 +/- 1.6 to 5.5
      +/- 1.5 stroke counts/s, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220581
TI  - Long-term follow-up in patients with incessant ventricular tachycardia.
AB  - Seventeen patients with coronary artery disease, idiopathic dilated
      cardiomyopathy or no organic heart disease who presented with incessant
      ventricular tachycardia (VT) were studied and followed for a mean period of 51 +/
      35 months. In these patients the incessant VT included greater than or equal to
      3 episodes of sustained VT at a rate of greater than or equal to 120 beats/min
      and frequent episodes of nonsustained VT over a 24-hour period. No patient had
      electrolyte disorder, prolonged QT interval, drug-induced arrhythmia or
      myocardial infarction less than 2 weeks old. Six patients died within 27 months
      of follow-up; 4 from sudden death and 2 from acute myocardial infarction. Three
      of the 11 surviving patients had remission of their VT within 1 week after the
      diagnosis of incessant VT. In 3 other patients in whom antiarrhythmic drugs were
      discontinued during follow-up because of adverse effects of the drugs or other
      medical reasons, 2 were found in remission. In the remaining 5 alive patients,
      deliberate attempts were made to discontinue the antiarrhythmic drugs; 4 of these
      patients were found in remission when the drugs were discontinued. Thus, 9 of
      these patients (53%) with incessant VT had remission over a mean follow-up of 55
      +/- 34 months after discontinuation of the antiarrhythmic drugs. The probability
      of remission in patients surviving incessant VT warrants trials of
      discontinuation of antiarrhythmic drugs in these patients.

PMID- 2220580
TI  - Analysis of programmed stimulation methods in the evaluation of ventricular
      arrhythmias in patients 20 years old and younger.
AB  - The purpose of this study was to systematically evaluate programmed ventricular
      stimulation in patients less than 21 years of age undergoing electrophysiologic
      testing. A standardized protocol was applied in 55 consecutive patients (mean age
      14 years) with the following clinical presentations: sustained ventricular
      tachycardia (VT) (n = 17); ventricular fibrillation (VF) (n = 7); syncope with
      heart disease (n = 10); nonsustained VT (n = 6); and syncope with an ostensibly
      normal heart (n = 15). The stimulation protocol consisted of 1 and 2 ventricular
      extrastimuli during sinus rhythm, followed by 1 to 4 (S2, S3, S4, S5)
      extrastimuli during pacing at 2 ventricular sites. Of the 17 patients with
      sustained VT, 12 had induction of the arrhythmia (sensitivity = 71%). Overall, 18
      of 55 patients had inducible sustained VT, with this response significantly
      enhanced by use of S4 or S5 protocols (p = 0.02). Although no syncope patients
      with an ostensibly normal heart had inducible sustained VT, 7 had polymorphic
      nonsustained VT in response to ventricular stimulation. The mean number of extra
      stimuli preceding the induction of nonsustained or sustained VT or VF did not
      differ. The induction of VF in 5 cases during this study was preceded in each
      case by extrastimuli intervals less than or equal to 190 ms. Thus, data indicate
      that aggressive stimulation protocols appear to be required for induction of
      sustained VT in most young patients, nonsustained polymorphic VT as a response to
      aggressive programmed stimulation is of uncertain significance, and that coupling
      intervals less than or equal to 190 ms may correlate with the induction of VF.

PMID- 2220582
TI  - The nuclear pacemaker: is renewed interest warranted?
AB  - From 1973 through 1987, 155 radioisotope-powered "nuclear" pacemakers were
      implanted in 132 patients at the Newark Beth Israel Medical Center. The longevity
      of the first 15 devices, all of which were fixed-rate (VOO) pacemakers, was
      significantly better than that of 15 lithium-chemistry demand (VVI) pacemakers
      used as control devices (p = 0.0002). Of the entire cohort of 155 nuclear
      pacemakers, 136 were VVI devices and 19 were VOO units. The patients with VOO
      pacemakers needed reoperations more often than did those with VVI pacemakers,
      chiefly for mode change (p less than 0.001). Power-source failure was observed in
      only 1 case, but 47 nuclear pacemakers were removed for other reasons, including
      component malfunction (15 units), mode change (12 units), high pacing thresholds
      (8 units) and lead or connector problems (5 units). The actuarial survival at 15
      years was 99% for power sources and 82% for the entire pacing systems (pulse
      generators plus leads). The frequency of malignancy was similar to that of the
      population at large and primary tumor sites were randomly distributed. Deaths
      most commonly were due to cardiac causes (68%). Thus, nuclear pacemakers are safe
      and reliable and their greater initial cost appears to be offset by their
      longevity and the resulting decrease in the frequency of reoperations. It is
      reasonable to suggest that further use be made of long-lasting nuclear power
      sources for modern pacemakers and other implantable rhythm-management devices.

PMID- 2220583
TI  - Effects of metoprolol on rest and exercise cardiac function and plasma
      catecholamines in chronic congestive heart failure secondary to ischemic or
      idiopathic cardiomyopathy.
AB  - To define the effects of 2 months of metoprolol therapy on cardiac function,
      aerobic performance and sympathetic nervous system activity, metoprolol (75 to
      100 mg/day) was administered to 10 patients with chronic congestive heart failure
      (CHF). Metoprolol was discontinued in 2 patients because of worsening CHF. In the
      remaining 8 patients, peak oxygen uptake increased significantly (14.8 +/- 3.0 to
      16.1 +/- 2.5 ml/kg/min, p less than 0.05) as did the oxygen pulse (9.0 +/- 2.2 to
      12.6 +/- 1.8 ml/beat, p less than 0.02). Resting heart rate (87 +/- 18 to 62 +/-
      9 beats/min, p less than 0.05) and peak exercise heart rate (133 +/- 13 to 105 +/
      30 beats/min, p less than 0.02) were both reduced. Mean resting ejection
      fraction increased from 0.15 +/- 0.06 to 0.25 +/- 0.11 and peak exercise ejection
      fraction also tended to increase (0.19 +/- 0.11 to 0.28 +/- 0.15, difference not
      significant). Both resting plasma norepinephrine (613 +/- 706 to 303 +/- 142
      pg/ml, p less than 0.05) and epinephrine (71 +/- 50 to 40 +/- 21 pg/ml, p less
      than 0.05) were reduced. Circulating lymphocyte beta-adrenergic receptor number
      was unchanged (1,334 +/- 292 to 1,344 +/- 456 receptors/cell, difference not
      significant). It is concluded that metoprolol therapy is associated with
      improvements in rest and exercise ventricular performance and maximal aerobic
      capacity. These improvements are associated with a decline in resting sympathetic
      nervous system activity.

PMID- 2220584
TI  - Digital acoustical analysis of normal and bimodal Bjork-Shiley 60 degrees convexo
      concave heart valves.
AB  - Fracture of the outlet strut of the Bjork-Shiley 60 degrees convexo-concave
      (BS60CC) valve has been attributed to a bimodal closing pattern in certain valves
      in which the closing disk rotates about the inlet strut, causing upward
      displacement of the outlet strut and its eventual fracture. This article reports
      the in vivo studies of the normal BS60CC valve and the in vitro studies of the
      normal and bimodal BS60CC valves, using a digital acoustical signal processing
      technique, in which the individual collisions (impact history) of the occluder
      disk with the components of the valve body are revealed during each closing
      cycle. In vitro analysis of the closing acoustical signals of normal BS60CC
      valves showed impact history cluster width (IHCW) means of 2.07 +/- 0.85 ms
      (standard error), not significantly different from those of 1.86 +/- 0.58 ms
      (standard error) observed in 38 clinically normal patients with BS60CC valves (p
      greater than 0.1). The bimodal valves showed IHCW of 6.14 +/- 0.98 ms (standard
      error), in vitro, which was significantly greater than those observed in the
      normal in vitro valve group and in the normal patient population (p less than
      0.0001).

PMID- 2220585
TI  - "Cardioprotection"--not all calcium antagonists are created equal.

PMID- 2220586
TI  - Percutaneous transluminal coronary angioplasty in octogenarians with unstable
      coronary syndromes.

PMID- 2220587
TI  - Frequency and causes of failure with contemporary balloon coronary angioplasty
      and implications for new technologies.

PMID- 2220588
TI  - Creatine kinase-MB activity after implantation of a cardiac pacemaker.

PMID- 2220589
TI  - From various kinds of heart rate variability to chronocardiology.

PMID- 2220590
TI  - Prognosis and predisposing factors for essential malignant hypertension in
      predominantly black patients.

PMID- 2220591
TI  - Transesophageal color flow Doppler and echocardiographic features of normal and
      regurgitant St. Jude Medical prostheses in the mitral valve position.

PMID- 2220592
TI  - Transesophageal color flow Doppler and echocardiographic features of normal and
      regurgitant St. Jude Medical prostheses in the aortic valve position.

PMID- 2220593
TI  - Comparison of clinical features in patients greater than or equal to 60 years of
      age to those less than or equal to 40 years of age with hypertrophic
      cardiomyopathy.

PMID- 2220594
TI  - Obstruction of systemic pulmonary arterial shunts by diagnostic cardiac
      catheters.

PMID- 2220595
TI  - Nongeometric Doppler stroke volume determination is limited by aortic size.

PMID- 2220596
TI  - Quantification of tricuspid regurgitation by Doppler color flow mapping after
      cardiac transplantation.

PMID- 2220597
TI  - Ventricular tachycardia and torsades de pointes complicating pentamidine therapy
      of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome.

PMID- 2220598
TI  - Primary sarcoma of the heart causing mitral stenosis.

PMID- 2220599
TI  - We think we are one, we act as if we are one, but we are not one.

PMID- 2220601
TI  - Mechanisms in heart failure and the role of angiotensin-converting enzyme
      inhibition.
AB  - The four major diagnostic criteria for the syndrome of congestive heart failure
      are left ventricular dysfunction, exercise intolerance, pulmonary congestion or
      edema and ventricular arrhythmias. Activation of norepinephrine, angiotensin II,
      vasopressin and atrial natriuretic peptide may be a key factor in the
      vasoconstriction and increased impedance to left ventricular ejection in heart
      failure. Interventions that interfere with these vasoconstrictor mechanisms
      should have a salutary effect on left ventricular performance. Treatment with
      angiotensin-converting enzyme (ACE) inhibitors, alpha-adrenoceptor blockers and
      vasopressin antagonists has resulted in hemodynamic benefits, but it has been
      more difficult to demonstrate long-term clinical effectiveness. Reductions in
      mortality have been demonstrated in patients with heart failure treated with
      vasodilators and ACE inhibitors. Improvement in the quality of life and
      prolongation of life are the only two appropriate goals in the management of
      heart failure. Further understanding of the role of angiotensin II and its
      interference by ACE inhibition in the tissue processes of heart failure is
      needed.

PMID- 2220600
TI  - Renal effects of angiotensin-converting enzyme inhibition in congestive heart
      failure.
AB  - Some studies report that inhibition of angiotensin-converting enzyme (ACE)
      improves renal function in patients with congestive heart failure, whereas others
      report that renal deterioration is a frequent complication of treatment with ACE
      inhibitors. This article explores the mechanisms by which antagonism of the renin
      angiotensin system improves kidney function in some patients while causing harm
      in others. ACE inhibition may alter renal blood flow, glomerular perfusion
      pressure, basement membrane activity and renal tubular function both directly and
      indirectly. In most patients, renal function is maintained as other neurohormonal
      mechanisms compensate for the negative effects and permit the positive effects
      (such as improved renal flow) to predominate. However, when physiologic
      characteristics or iatrogenic interventions (such as volume reduction or
      prostaglandin inhibition) limit the effectiveness of neurohormonal compensation
      to maintain renal autoregulation, clinically important deterioration in renal
      function may occur. An understanding of the renal effects of ACE inhibitors
      permits their safe and effective use in most patients with congestive heart
      failure.

PMID- 2220602
TI  - Potential role of the tissue renin-angiotensin system in the pathophysiology of
      congestive heart failure.
AB  - The circulating renin-angiotensin system (RAS) plays an important role in the
      maintenance of cardiovascular homeostasis. It has recently been demonstrated that
      endogenous RAS exist in target tissues that are important in cardiovascular
      regulation. This article reviews the multiple effects of angiotensin II in target
      tissues, the evidence for the presence of functional tissue RAS and the data that
      suggest a role for these tissue RAS in the pathophysiology of heart failure.
      Activation of circulating neurohormones is predictive of worsened survival in
      heart failure; however, cardiac and renal tissue RAS activities are also
      increased in the compensated stage of heart failure, when plasma renin
      angiotensin activity is normal. It is hypothesized that the plasma RAS maintains
      circulatory homeostasis during acute cardiac decompensation, while changes in
      tissue RAS contribute to homeostatic responses during chronic sustained cardiac
      impairment. This concept of different functions of circulating and tissue RAS in
      the pathophysiology of heart failure may have important pharmacologic
      implications.

PMID- 2220603
TI  - Neuroendocrine activity in congestive heart failure.
AB  - The increased neuroendocrine activity in patients with congestive heart failure
      appears to be a generalized attempt to maintain blood pressure at the expense of
      reduced cardiac performance and salt and water retention. It is likely that
      baroreceptor dysfunction contributes to increased sympathetic nervous system
      activity in patients with congestive heart failure. The usual tonic inhibitory
      messages emanating from baro- and mechanoreceptors in the great vessels and heart
      fail to adjust sympathetic traffic from the brain to the periphery, leading to
      uninhibited sympathetic tone. Arginine vasopressin and plasma renin activity may
      be increased secondarily; however, plasma renin activity activation could also be
      induced by a low-salt diet and diuretic use. Preliminary baseline data indicate
      that patients with left ventricular dysfunction (ejection fraction less than or
      equal to 35%) but no or very mild symptoms of heart failure have increased plasma
      levels of norepinephrine, atrial natriuretic factor and arginine vasopressin,
      while plasma renin activity is normal, suggesting that neuroendocrine activity
      contributes to the pathogenesis of congestive heart failure. Neurohormones such
      as angiotensin II may alter gene expression, leading to changes in the shape and
      size of the cell. Remodeling of the heart and blood vessels is associated with
      both heart failure and hypertension. Angiotensin-converting enzyme inhibitors
      have been demonstrated to retard or reverse the remodeling process under certain
      experimental conditions. Studies are currently under way to test this possibility
      in patients.

PMID- 2220604
TI  - Effects of enalapril and neuroendocrine activation on prognosis in severe
      congestive heart failure (follow-up of the CONSENSUS trial). CONSENSUS Trial
      Study Group.
AB  - This study enrolled 253 patients with severe heart failure (New York Heart
      Association functional class IV) from 35 centers in Scandinavia, randomly
      assigned to treatment with placebo or enalapril, in addition to their usual
      treatment for heart failure. After an initial titration period, the daily doses
      of enalapril ranged from 2.5 to 40 mg. At the end of the trial, 46% of the
      placebo-treated patients and 61% of the enalapril-treated patients were alive (p
      = 0.003); the survival figures at 8 months after completion of the trial were 32
      and 48%, respectively (p = 0.001); and 21 and 30%, respectively (p = 0.006) at
      the 2-year follow-up. In the placebo group, there was a significant positive
      association between mortality and baseline levels of norepinephrine, epinephrine,
      angiotensin II, aldosterone and atrial natriuretic peptide; no such association
      was found in the enalapril-treated patients. The results suggest that the effects
      of enalapril on mortality are related to a counteraction of the neuroendocrine
      activation in general and to the renin-angiotensin system in particular.

PMID- 2220605
TI  - Pharmacology of angiotensin-converting enzyme inhibitors as a guide to their use
      in congestive heart failure.
AB  - The pharmacokinetics of the angiotensin-converting enzyme (ACE) inhibitors are
      difficult to assess for several reasons. First, these compounds exert their
      influence by inhibiting an intermediary enzyme of a cascade of enzymatic events,
      whose rate-limiting enzyme (renin) is not directly affected by ACE inhibition.
      Second, renin and angiotensin I accumulate during ACE inhibition and a change in
      the dose of an ACE inhibitor could produce sudden shifts of angiotensin I to
      angiotensin II. Third, components of the circulating renin system require the
      interaction of several organ systems and effector sites. Fourth, the kinetics of
      ACE inhibitors can be influenced by the organ systems responsible for drug
      absorption, metabolism and excretion, and the functional status of these systems
      can be affected by the heart failure process. Fifth, at least some portion of the
      cardiovascular effects of ACE inhibitors is influenced by the contributions of
      other systems whose physiologic effects may be of importance in some patients
      with congestive heart failure. Sixth, the potential impact of tissue-bound ACE is
      not yet fully understood. Finally, for appropriate drug dosing, the effects of
      aging on the heart failure process, the extent of renin system activity, and the
      disposition of ACE inhibitors need to be considered. Because of their complex
      pharmacokinetics, treatment with ACE inhibitors has been guided by their
      pharmacodynamic and clinical characteristics.

PMID- 2220606
TI  - Clinical and hemodynamic assessment of the hepatojugular reflux.
AB  - The hepatojugular reflux (HJR) test was studied to assess the ability to
      clinically predict response during cardiac catheterization and to determine its
      significance in patients without heart failure and correlate it to their baseline
      hemodynamic parameters. Sixty-five patients considered to be free of heart
      failure undergoing routine cardiac catheterization were enrolled. The HJR test,
      defined as the venous pressure response to sustained abdominal compression, was
      performed in a standardized manner at the bedside assessing change in internal
      jugular venous pressure and during right-sided cardiac catheterization measuring
      change in right atrial pressure. For comparison a sustained increase greater than
      or equal to 1 cm was considered positive. In 62 of 65 patients the HJR test
      stabilized by 15 seconds. The results during examination at the bedside agreed
      with those at catheterization (K = 0.74, p less than 0.001). The HJR test result
      correlated best with baseline mean right atrial pressure (r = 0.59) and right
      ventricular end-diastolic pressure (r = 0.51), and in bivariate regression
      analysis predicted right atrial (F(1,63) = 32.8, R2 = 0.34, p less than 0.0001)
      and right ventricular end-diastolic (F(1,63) = 22, R2 = 0.26, p less than 0.0001)
      pressures. A positive test had high sensitivity and specificity for predicting
      right atrial pressure greater than 9 mm Hg (1.0, 0.85) and right ventricular end
      diastolic pressure greater than 12 mm Hg (0.90, 0.89). It is concluded that 15
      seconds is adequate for interpretation, and bedside observation predicts the
      response during right-sided cardiac catheterization.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2220607
TI  - Anatomic correlations of the long-axis views in biplane transesophageal
      echocardiography.
AB  - The number of views obtainable during transesophageal echocardiography (TE) has
      been limited by the fixed position of the transducer at the end of the probe.
      This has confined standard TE studies to short-axis tomography of the heart and
      aorta. Recently, a biplane TE probe has become available that is capable of both
      long- and short-axis imaging. This study prospectively assessed the application
      of the long-axis plane of the biplane probe in providing complementary long-axis
      views in ambulatory patients. Six standard long-axis views could be obtained and
      were compared with corresponding anatomic sections to illustrate anatomic
      relations and facilitate structure identification. The long-axis views provide a
      better appreciation of the 3-dimensional nature of cardiac anatomy and function,
      especially in demonstrating the relation of vertically aligned structures.

PMID- 2220608
TI  - Circadian fluctuations in ventricular response to atrial fibrillation.

PMID- 2220609
TI  - Comparison of indications for aortic valve replacement in 1978 and in 1988.

PMID- 2220611
TI  - Assessing left ventricular ejection force.

PMID- 2220610
TI  - Noninvasive evaluation of left ventricular performance with a new systolic time
      interval, the Q-V peak, and comparison with established systolic time intervals.

PMID- 2220613
TI  - Functional status after coronary artery bypass grafting and percutaneous
      transluminal coronary angioplasty.
AB  - Two cohorts of consecutive patients of comparable age with similar preprocedure
      cardiac function who underwent either coronary artery bypass grafting (CABG; n =
      106) or percutaneous transluminal coronary angioplasty (PTCA; n = 64) were
      entered into a prospective comparison study examining functional status and
      return to work during the first year of recovery. Patients were evaluated using
      standardized functional status instruments for activities of daily living, work
      performance, social activity, mental health and quality of social interaction at
      1, 6 and 12 months after the procedure. Within the CABG group, statistically
      significant improvements of functional status on every subscale were noted over
      the 1-year follow-up. Patients undergoing PTCA demonstrated significant
      improvement in all dimensions except for the quality of interaction at 1 year as
      compared with baseline. When the 2 groups were compared, the PTCA group
      demonstrated greater participation than the CABG group in routine daily physical
      and social activities at 1 and 6 months, but this apparent advantage disappeared
      by 1 year. Measures of psychological functioning were better after CABG than
      after PTCA. A reduction in the number of those with employment occurred in both
      the CABG and PTCA groups, independent of physical functional status measures,
      which improved in both groups after the procedures. For those with employment,
      the CABG group reported the greatest improvement in work performance.

PMID- 2220612
TI  - Transient left ventricular filling abnormalities (diastolic stunning) after acute
      myocardial infarction.
AB  - A variety of experimental studies suggest that diastolic left ventricular (LV)
      function changes after acute myocardial infarction (AMI), but limited data exist
      on these changes in humans. To assess diastolic filling after AMI, 60 patients
      underwent Doppler echocardiographic examination within 24 hours of AMI. Of 54
      patients who also underwent catheterization, 45 (83%) were successfully
      reperfused. A subgroup of 17 patients underwent a follow-up Doppler examination
      at 7 days after infarction, whereas 15 patients with stable exertional angina
      served as control subjects. There was no significant difference in age, gender,
      incidence of systemic hypertension or diabetes mellitus, heart rate, mean
      arterial pressure or severity of coronary artery disease between the infarct and
      control groups. The infarct group had a lower velocity time integral total (9.9
      +/- 0.4 cm vs 12.0 +/- 0.9 cm, p less than 0.001), a lower velocity time integral
      E (5.8 +/- 0.3 cm vs 6.8 +/- 0.5 cm, p less than 0.01) and a lower velocity time
      integral 0.333 (3.5 +/- 0.4 cm vs 6.1 +/- 0.5 cm, p less than 0.01) than the
      control group. In addition, velocity time integral A/total was significantly
      greater in the infarction group (0.44 +/- 0.03 vs 0.35 +/- 0.04, p less than
      0.01) compared to the control group. The follow-up subgroup showed an increase in
      velocity time integral total (p less than 0.01), velocity time integral E (p less
      than 0.05) and velocity time integral 0.333/total (p less than 0.05) over the
      first 7 days after infarction. The final recovery values at 7 days were not
      significantly different from those of the coronary artery disease group.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2220615
TI  - Results of percutaneous transluminal coronary angioplasty of high-risk angulated
      stenoses.
AB  - Percutaneous transluminal coronary angioplasty (PTCA) of angulated stenoses has
      been found in studies using older PTCA equipment to be associated with a
      heightened risk of procedure-related major ischemic events. To better understand
      the factors associated with procedural risk and to identify means of lessening
      that risk, 100 patients, treated sequentially from 1986 to 1989, who underwent
      PTCA of stenoses located at greater than or equal to 45 degrees bends, were
      characterized for 27 clinical, anatomic and procedural variables. Clinical
      outcome of angioplasty was related to these variables. In addition, results from
      344 consecutive contemporary patients undergoing PTCA of nonangulated lesions
      were compared to those of the study group. Procedural success was achieved in
      only 70% of patients with angulated stenoses, compared with 306 of 344 (89%)
      nonangulated stenoses, and major ischemic complications (death, bypass surgery or
      myocardial infarction) occurred in 13% of patients with angulated stenoses
      compared with 12 of 344 (3.5%) with nonangulated stenoses (both p less than
      0.001). The presence of associated thrombus, stenosis length greater than 10 mm
      or age greater than or equal to 65 years led to an even higher risk of major
      complications (9 of 44 = 20.5%), whereas highly experienced angioplasty operators
      and the use of polyethylene terephthalate balloons appeared to decrease risk and
      increase the likelihood of success. PTCA of such stenoses should be undertaken
      only cautiously and in carefully selected patients.

PMID- 2220614
TI  - Patient-related variables and restenosis after percutaneous transluminal coronary
      angioplasty--a report from the M-HEART Group.
AB  - As part of a randomized prospective study designed to investigate the restenosis
      process after percutaneous transluminal coronary angioplasty (PTCA), the relation
      between patient-related variables and restenosis rate was examined. A total of
      722 patients had successful PTCA. Angiographic follow-up was scheduled for 6 +/-
      2 months after the procedure and achieved in 510 patients (71%), yielding 598
      lesions for analysis. The overall restenosis rate was 40%. The rate was higher in
      patients undergoing early restudy for a clinical event than in those undergoing
      routinely scheduled follow-up restudy (71 vs 22%, p less than 0.0001). Age, sex,
      cigarette smoking history, diabetes mellitus and history of previous myocardial
      infarction were not associated with restenosis rate. Angina duration and severity
      before PTCA were also unrelated to restenosis rate. In summary, these variables,
      many of which have been previously implicated in restenosis, were not found to be
      predictors of restenosis. The decision to perform PTCA in individual patients
      should not be negatively influenced by the presence of these factors.

PMID- 2220616
TI  - Quantitative angiographic comparison of the immediate success of coronary
      angioplasty, coronary atherectomy and endoluminal stenting.
AB  - Coronary atherectomy and coronary stenting effectively reduce the severity of
      coronary artery stenoses, but direct comparisons of these interventions with
      conventional balloon angioplasty have not been performed. To compare the
      immediate efficacy of these 3 interventions, the angiographic morphology and the
      severity of the residual coronary stenosis were quantitatively evaluated in 18
      patients undergoing coronary atherectomy and in 21 patients treated by
      endoluminal coronary stenting. Each of these groups of patients was compared with
      a matched group of coronary angioplasty patients selected from a large,
      computerized data-base. The variables matched included patient age and sex,
      lesions site and severity, and lesion complexity. Both coronary atherectomy and
      coronary stenting more effectively reduced the severity of the coronary stenosis
      when compared with balloon angioplasty. The luminal diameter stenosis was reduced
      from 69 +/- 10 to 22 +/- 20% in the atherectomy group compared with a reduction
      from 74 +/- 11 to 44 +/- 14% in the matched coronary angioplasty population (p =
      0.008). Similarly, the luminal diameter stenosis was reduced from 77 +/- 11 to 26
      +/- 12% in the stented group compared with a reduction from 81 +/- 10 to 42 +/-
      14% in the matched coronary angioplasty group (p = 0.014). In addition, moderate
      or severe coronary dissections were noted more frequently in the coronary
      angioplasty groups than in their respective atherectomy and stent groups (0 vs
      33%, p = 0.008, and 5 vs 19%, p = 0.15, respectively).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2220617
TI  - Early postoperative balloon coronary angioplasty for failed coronary artery
      bypass grafting.
AB  - In a small number of patients, coronary artery bypass grafting (CABG) fails to
      relieve anginal symptoms. The usefulness of coronary angioplasty for the
      treatment of early (less than or equal to 90 days) recurrent ischemia after CABG
      was examined. Forty-five patients were treated from 2 to 90 days after CABG,
      including 8 patients studied emergently for prolonged ischemic symptoms. One-, 2-
      and 3-vessel native disease was found in 4, 10 and 31 patients, respectively. At
      the time of postoperative angiography, the major anatomic mechanism of recurrent
      ischemia was complete vein graft occlusion in 12 patients (27%), internal mammary
      artery occlusion in 3 (7%), vein graft stenoses in 13 (29%), internal mammary
      artery stenoses in 10 (22%), unbypassed disease in 4 (8%) and disease distal to
      the graft insertion site in 3 (7%). Angioplasty was successful at 91 of 98 sites
      (93%), including 95% of 41 lesions in native arteries, 89% of 46 lesions in vein
      grafts and 100% of 11 internal mammary artery lesions attempted. Complete
      revascularization was achieved in 84% of patients. There were 2 in-hospital
      deaths and 2 myocardial infarctions. Two additional patients underwent repeat
      CABG before discharge after uncomplicated but unsuccessful angioplasty. At late
      follow-up of the 43 survivors (mean 44 months), there were 4 deaths, 2 of which
      were noncardiac. Repeat CABG was required in only 3 patients and repeat
      angioplasty was performed in 10. Angina was absent or minimal in 35 patients; 17
      patients were employed full time. Thus, percutaneous transluminal coronary
      angioplasty can relieve myocardial ischemia after unsuccessful CABG in the
      majority of patients.

PMID- 2220619
TI  - Circadian rhythmicity of rate-normalized QT interval in hypothyroidism and its
      significance for development of class III antiarrhythmic agents.
AB  - Lengthening of repolarization and refractoriness occurs in hypothyroidism; it is
      associated with a reduced probability of arrhythmias, with the converse occurring
      in hyperthyroidism. Because the QT interval and its circadian rhythmicity
      relative to heart rate is poorly defined in man, we used our new computer
      assisted technique to measure QT interval in our analysis of 24-hour Holter tapes
      before and after (8 to 12 weeks) thyroxine (T4) replacement in 10 patients with
      hypothyroidism; the findings were compared to those in 6 normal control subjects.
      QTc interval was prolonged (p less than 0.02) and heart rate decreased (p less
      than 0.005) during the hypothyroid state. Data were analyzed for circadian
      rhythmicity by repeated-measures analysis. Circadian variation in QTc and heart
      rate was statistically significant during hypothyroid and euthyroid states (p
      less than 0.001) as well as in control subjects, but the circadian rhythmicity of
      QTc interval and heart rate were out of phase; the maximum prolongation of QTc
      occurred between midnight and 6 A.M., at a time when heart was at its lowest. QTc
      interval remained significantly prolonged after 8 to 12 weeks of T4 replacement,
      when biochemical indexes of hypothyroidism had returned to normal values. The
      computer-assisted QTc interval determination technique that we used, and our data
      on the circadian rhythmicity of QTc and heart rate, have significant implications
      for the development of new class III antiarrhythmic agents.

PMID- 2220618
TI  - Role of alcohol in recurrences of atrial fibrillation in persons less than 65
      years of age.
AB  - The role of alcohol in recurrences of atrial fibrillation (AF) was assessed in a
      consecutive series of 98 patients (75 men) aged less than 65 years. In addition
      to etiologic assessment using clinical and laboratory methods and
      echocardiography, the patients' drinking habits were evaluated by recording the
      amount of alcohol used during the week preceding AF, by responses to the CAGE
      (Cut, Annoying, Guilt, Eye; see below) questionnaire (a screening test for
      alcohol abuse) and by selected laboratory tests. Two groups of control subjects
      were studied: 98 sex- and age-matched patients admitted to the emergency ward for
      acute illnesses, and 50 subjects selected randomly from the local out-of-hospital
      population. The mean alcohol consumption among men during the study week was 186
      g (median 45 g; range 0 to 2,100 g) among patients, whereas among male hospital
      and population control subjects it was 86 g (30 g; 0 to 1,050 g) and 94 g (35 g;
      0 to 630 g), respectively. When the weekly alcohol consumption was analyzed in 3
      categories (0; 1 to 210 g; greater than 210 g), there was a significant
      difference between AF cases and hospital control patients (p = 0.03), but not
      between AF cases and population control subjects. Multivariate analysis of data
      of AF cases and population control subjects showed that alcohol intake and a
      positive response to 1 or more of the CAGE questions were independently related
      to AF in men. Other independent risk factors were the presence of heart disease,
      low serum potassium and lack of sleep or experience of excess psychologic stress,
      or both.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220620
TI  - Chronic transvenous pacemaker lead removal using a unique, sequential transvenous
      system.
AB  - Transvenous removal of 43 consecutive chronic pacemaker leads was successful in
      28 patients. For leads not removed by traction at the pacemaker connection
      terminal, a unique locking stylet was advanced through the inner coil lumen and
      engaged at the tip to allow traction without lead elongation. Leads not extracted
      with the locking stylet alone had traction maintained on the stylet as sheaths
      were advanced over the lead to dilate and detach any fibrous tissue adherent to
      the lead. By applying traction at the pacemaker connection terminal, 2 leads were
      removed. The locking stylet alone extracted 9 leads. Both the locking stylet and
      sheaths were necessary to explant 32 leads. There were 15 right atrial and 22
      right ventricular leads completely removed. Additionally, 6 right ventricular
      leads were subtotally removed leaving only the tip in the right ventricular apex.
      Avulsed myocardium was removed with the lead in 1 patient without sequelae. A
      subacute hemothorax developed in 1 patient 18 days after discharge requiring
      drainage, and subclavian vein thrombosis developed in another, which was
      successfully treated with anticoagulation. Hypotension occurred in 1 patient
      during final positioning of new leads, which responded to conservative treatment.
      Chronic pacemaker leads can be reliably removed without thoracotomy. Both a
      unique locking stylet to allow traction without lead elongation and a sheath to
      dilate and detach adherent fibrous tissue are needed for consistent success.
      Recognized complications included myocardial avulsion without sequelae, subacute
      hemothorax, subclavian vein thrombosis and transient hypotension.

PMID- 2220621
TI  - Comparison of the antihypertensive efficiency of nitrendipine, metoprolol,
      mepindolol and enalapril using ambulatory 24-hour blood pressure monitoring.
AB  - In a randomized 6-month study of 201 patients, the antihypertensive efficiency of
      the calcium antagonist nitrendipine, the beta 1-selective blocker metoprolol,
      mepindolol, the beta blocker with intrinsic activity and the angiotensin
      converting enzyme inhibitor enalapril were compared as monitored by 24-hour
      ambulatory blood pressure (BP) measurements. The study was designed so that a
      comparable decrease in casual BP values was obtained with all 4 drugs. If
      normotension was not achieved with monotherapy, a diuretic also was administered.
      Pretreatment casual BP and mean 24-hour ambulatory BP values did not differ
      between the 4 groups. Normotension as assessed by casual BP measurements was
      observed in all 4 groups after 6 months of therapy, there being no significant
      differences between the groups. However, significantly more diuretics were
      required in the mepindolol (n = 14) and in the enalapril (n = 20) groups compared
      to the nitrendipine (n = 5) and metoprolol (n = 7) groups. Despite comparable
      casual BP control, the 4 groups differed significantly in their mean 24-hour
      measurements. The greatest systolic and diastolic BP decreases were seen in the
      metoprolol group. Metoprolol was also the most effective drug in decreasing the
      frequency of systolic pressure peaks greater than 180 mm Hg. Both beta blockers
      and enalapril significantly decreased the morning BP increase compared to the
      values before treatment, while nitrendipine did not. These data show that casual
      BP measurement is not a good predictor of 24-hour BP in patients taking
      hypertensive therapy. Despite an equal degree of "office" BP control, different
      antihypertensive regimens do not confer the same degree of "nonoffice" BP
      control.

PMID- 2220622
TI  - Usefulness of verapamil for congestive heart failure associated with abnormal
      left ventricular diastolic filling and normal left ventricular systolic
      performance.
AB  - Normal left ventricular systolic performance with impaired left ventricular
      diastolic filling may be present in a substantial number of patients with
      congestive heart failure (CHF). To evaluate the effect of oral verapamil in this
      subset, 20 men (mean age 68 +/- 5 years) with CHF, intact left ventricular
      function (ejection fraction greater than 45%) and abnormal diastolic filling
      (peak filling rate less than 2.5 end-diastolic volumes per second [edv/s]) were
      studied in a placebo-controlled, double-blind 5-week crossover trial. All
      patients underwent echocardiography to rule out significant valvular disease, and
      thallium-201 stress scintigraphy to exclude major active ischemia. Compared to
      baseline values, verapamil significantly improved exercise capacity by 33% (13.9
      +/- 4.3 vs 10.7 +/- 3.4 minutes at baseline) and peak filling rate by 30% (2.29
      +/- 0.54 vs 1.85 +/- 0.45 edv/s at baseline) (all p less than 0.05). Placebo
      values were 12.3 +/- 4.0 minutes and 2.16 +/- 0.48 edv/s, respectively
      (difference not significant for both). Improvement from baseline in an objective
      clinico-radiographic heart failure score (scale 0 to 13) was significantly
      greater with verapamil compared to placebo (median improvement in score: 3 vs 1,
      p less than 0.01). Mean ejection fraction and systolic blood pressure were
      unchanged from baseline; diastolic blood pressure and heart rate decreased to a
      small degree. Verapamil may have therapeutic efficacy in patients with CHF,
      preserved systolic function and impaired diastolic filling.

PMID- 2220624
TI  - Effects of preload reduction on mitral flow velocity pattern in normal subjects.
AB  - In the last few years, alterations in transmitral diastolic flow pattern have
      been used to assess changes in left ventricular diastolic properties. However,
      since diastolic flow primarily reflects the atrioventricular pressure gradient,
      loading conditions, as well as intrinsic left ventricular properties, should be
      able to affect this pattern. This study was selectively designed to decrease
      preload (a major determinant of the atrioventricular pressure gradient) in normal
      subjects to observe the effects on the Doppler transmitral flow pattern without
      pharmacologic interventions that may also affect left ventricular diastolic
      properties. In 12 normal subjects, preload was reduced by inflation of blood
      pressure cuffs placed at the level of the root of the 4 limbs. The peak velocity
      of early mitral flow (E wave) decreased from 62 +/- 8 to 51 +/- 7 cm/s (p less
      than 0.001), while no changes were found in the maximal velocity after atrial
      contraction; this caused a significant decrease in the ratio of these 2
      velocities (the E to A ratio) from 1.5 +/- 0.3 to 1.1 +/- 0.1 (p less than
      0.001). The time-velocity integral of early diastolic inflow decreased from 7.8
      +/- 1.3 to 6.1 +/- 1.3 cm (p less than 0.001) with no significant changes of the
      time-velocity integral of inflow after atrial contraction. Therefore, preload
      reduction in normal subjects significantly reduces transmitral flow in early
      diastole with preserved late ventricular filling, producing a pattern that can
      mimic the changes previously described in left ventricular diastolic dysfunction.

PMID- 2220623
TI  - Changes in circulating norepinephrine with hemofiltration in advanced congestive
      heart failure.
AB  - In congestive heart failure (CHF), hemofiltration is associated with an obvious
      decrease in circulating norepinephrine. This method was used for investigating
      the mechanisms whereby plasma norepinephrine is increased in chronic CHF. In 23
      cases of advanced CHF, hemofiltration (2,983 +/- 1,228 ml) lowered plasma
      norepinephrine by 515 +/- 444 pg/ml. This effect was prompt, persisted or became
      greater in the next 24 hours. It was not associated with significant changes in
      cardiac output, aortic pressure or systemic vascular resistance. It did not
      appear to depend on variations in parameters related to the sympathetic activity,
      such as plasma renin, right atrial, wedge pulmonary artery and renal perfusion
      pressures, and was independent of duration and amount of hemofiltration. These
      observations did not support the concept that the norepinephrine decrease was the
      main consequence of a neural sympathetic inhibition. Hemofiltration increased
      diuresis by 606 +/- 415 ml; changes were prompt and correlated inversely (r = 
      0.7; p less than 0.01) with those in plasma norepinephrine. The same unknown
      mechanism of the increased urinary output might potentiate the norepinephrine
      removal from the blood by the kidney, or hemofiltration and the augmented
      diuresis might result in a regression of congestion of lungs and kidneys, leading
      to an improved extraction of norepinephrine. In CHF, a relation may exist between
      fluid retention and norepinephrine and in advanced stages, circulating
      norepinephrine, although strikingly increased, is devoid of important
      cardiovascular effects. At these stages, plasma norepinephrine is probably
      unreliable as an index of the sympathetic neural activity.

PMID- 2220625
TI  - Clinical experience with technetium-99m teboroxime, a neutral, lipophilic
      myocardial perfusion imaging agent.
AB  - Technetium-99m (Tc-99m) teboroxime is a new technetium-based myocardial perfusion
      imaging agent (investigational code = SQ30217 [Cardiotec, Squibb Diagnostics]). A
      member of a class of neutral, lipophilic, technetium-containing complexes known
      as boronic acid adducts of technetium dioxime (BATO) complexes, this agent is
      chemically very different from the cationic tracer thallium-201 (Tl-201) and from
      the cationic technetium complex Tc-99m sestamibi (Cardiolite, Du Pont Imaging
      Agents). Tc-99m teboroxime has high myocardial extraction, rapid blood clearance,
      little lung uptake and rapid myocardial washout. A biexponential pattern of
      myocardial washout is demonstrated in animals and in man. Effective half-lives of
      the 2 washout components in man are 5.2 minutes and 3.8 hours and represent
      approximately 66 and 33% of the myocardial activity, respectively. The first half
      life for the myocardium is approximately 11 minutes. As the agent washes out of
      the heart, hepatic uptake occurs, peaking at about 5 minutes after injection. The
      liver is the major organ of excretion and receives, along with the large bowel,
      the largest radiation dose. Rapid imaging protocols using standard cameras have
      achieved good myocardial counts from 3 planar views acquired over a 4- to 5
      minute period or for single photon emission computed tomography (SPECT) images
      acquired over a 10-minute period. An entire stress/rest procedure can be
      completed in 1 hour. Analysis of data from 155 patients from 4 centers using
      planar or SPECT imaging showed a sensitivity and specificity for blinded readings
      of 82 and 91%, respectively, when compared against overall clinical
      impression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220626
TI  - Percutaneous excimer laser coronary angioplasty.
AB  - To determine the efficacy of percutaneous excimer laser coronary angioplasty as
      an adjunct or alternative to conventional balloon angioplasty, 55 patients were
      studied in a multicenter trial. These patients underwent the procedure using a
      modification of conventional balloon angioplasty technique. A first-generation,
      1.6-mm diameter catheter constructed of 12 individual silica fibers
      concentrically arranged around a guidewire lumen was used. Catheter tip energy
      density varied from 35 to 50 mJ/mm2. The mean number of pulses delivered at 20 Hz
      was 1,272 +/- 1,345. Acute success was defined as a greater than or equal to 20%
      increase in stenotic diameter and a lumen of greater than or equal to 1 mm in
      diameter after laser treatment. Acute success was achieved in 46 of 55 (84%)
      patients. Adjunctive balloon angioplasty was performed on 41 patients (75%). The
      percent diameter stenosis as determined by quantitative angiography decreased
      from a baseline of 83 +/- 14 to 49 +/- 11% after laser treatment and to 38 +/-
      12% in patients undergoing adjunctive balloon angioplasty. The mean minimal
      stenotic diameter increased from a baseline of 0.5 +/- 0.4 to 1.6 +/- 0.5 mm
      after laser treatment and to 2.1 +/- 0.5 mm after balloon angioplasty. There were
      no deaths and no vascular perforations. One patient (1.8%) required emergency
      coronary bypass surgery. These data suggest that excimer laser energy delivered
      percutaneously by specially constructed catheters can safely ablate atheroma and
      reduce coronary stenoses.

PMID- 2220627
TI  - Results of percutaneous transluminal coronary angioplasty in patients greater
      than or equal to 65 years of age (from the 1985 to 1986 National Heart, Lung, and
      Blood Institute's Coronary Angioplasty Registry).
AB  - The 1985 to 1986 National Heart, Lung, and Blood Institute Percutaneous
      Transluminal Coronary Angioplasty (PTCA) Registry series of 1,801 initial
      procedures included 486 patients age greater than or equal to 65 years (elderly).
      In comparison to younger patients, a greater proportion of elderly patients were
      women and had unstable angina. Elderly patients had more history of hypertension
      and more history of congestive heart failure. Although the elderly had more
      extensive vessel disease, the numbers of lesions and vessels attempted with PTCA
      were similar in the older and younger cohorts. Angiographic success rates were
      similar for all age groups. Although complication rates in the catheterization
      laboratory did not differ, patients greater than or equal to 65 years were much
      more likely to require emergency coronary artery bypass graft surgery (CABG) (5.4
      vs 2.8%, p less than 0.05) or elective CABG (3.9 vs 1.6%, p less than 0.01). The
      in-hospital death rate was considerably higher among the elderly (3.1 vs 0.2%, p
      less than 0.01). At 2-year follow-up, symptomatic status and cumulative rates of
      myocardial infarction, CABG and repeat PTCA were similar for elderly and younger
      patients. The death rate after 2 years was higher among elderly patients (8.8% of
      patients greater than or equal to 65 years vs 2.9% of patients less than 65
      years, p less than 0.01). When the relative risk of death for the elderly was
      adjusted for factors more prevalent among those greater than or equal to 65 years
      (history of congestive heart failure, multivessel disease, unstable angina,
      history of hypertension and female gender), the relative risk remained
      significant but was substantially reduced (from 3.3 to 2.4).

PMID- 2220628
TI  - Quantitative angiographic assessment of elastic recoil after percutaneous
      transluminal coronary angioplasty.
AB  - Little is known about the elastic behavior of the coronary vessel wall directly
      after percutaneous transluminal coronary angioplasty (PTCA). Minimal luminal
      cross-sectional areas of 151 successfully dilated lesions were studied in 136
      patients during balloon inflation and directly after withdrawal of the balloon.
      The circumvent geometric assumptions about the shape of the stenosis after PTCA,
      a videodensitometric analysis technique was used for the assessment of vascular
      cross-sectional areas. Elastic recoil was defined as the difference between
      balloon cross-sectional area of the largest balloon used at the highest pressure
      and minimal luminal cross-sectional area after PTCA. Mean balloon cross-sectional
      area was 5.2 +/- 1.6 mm2 with a mean minimal cross-sectional area of 2.8 +/- 1.4
      mm2 immediately after inflation. Oversizing of the balloon (balloon artery ratio
      greater than 1) led to more recoil (0.8 +/- 0.3 vs 0.6 +/- 0.3 mm, p less than
      0.001), suggestive of an elastic phenomenon. A difference in recoil of the 3 main
      coronary branches was observed: left anterior descending artery 2.7 +/- 1.3 mm2,
      circumflex artery 2.3 +/- 1.2 mm2 and right coronary artery 1.9 +/- 1.5 mm2 (p
      less than 0.025). The difference was still statistically significant if adjusted
      for reference area. Thus, nearly 50% of the theoretically achievable cross
      sectional area (i.e., balloon cross-sectional area) is lost shortly after balloon
      deflation.

PMID- 2220629
TI  - Timing and mechanism of in-hospital and late death after primary coronary
      angioplasty during acute myocardial infarction.
AB  - The effect of early myocardial reperfusion on patterns of death after acute
      myocardial infarction (AMI) is unknown. Thus, the mechanism and timing of in
      hospital and late deaths among a group of 614 patients treated with coronary
      angioplasty without antecedent thrombolytic therapy for AMI were determined.
      Death occurred in 49 patients (8%) before hospital discharge. Four patients died
      in the catheterization laboratory. Death was due to cardiogenic shock in 22
      patients, acute vessel reclosure in 5 patients, was sudden in 8 patients and
      followed elective coronary artery bypass surgery in 8 patients. Cardiac rupture
      was observed in only 2 patients after failed infarct angioplasty, and did not
      occur among the 574 patients with successful infarct reperfusion. Intracranial
      hemorrhage did not occur. Multivariate predictors of in-hospital death included
      failed infarct angioplasty, cardiogenic shock, 3-vessel coronary artery disease
      and age greater than or equal to 70 years. During a follow-up period of 32 +/- 21
      months (range 1 to 87), 55 patients died. The cause of death was cardiac in 36
      patients, including an arrhythmic death in 23 patients and was due to circulatory
      failure in 13 others. One patient died of reinfarction due to late reclosure of
      the infarct artery. Actuarial survival curves demonstrated overall survival after
      hospital discharge of 95 and 87% at 1 and 4 years, respectively. Freedom from
      cardiac death at 1 and 4 years was 96 and 92%. Multivariate predictors of late
      death included 3-vessel disease, a baseline ejection fraction of less than or
      equal to 40%, age greater than 70 years and female gender.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2220630
TI  - Circadian rhythm of heart rate variability after acute myocardial infarction and
      its influence on the prognostic value of heart rate variability.
AB  - This study examined heart rate (HR) variability in patients surviving acute
      myocardial infarction (AMI) to find the optimum time and duration of recording of
      the ambulatory electrocardiogram for the prediction of the risk of sudden cardiac
      death, or serious arrhythmic events, or both. Twenty patients (group I) who
      initially survived an AMI but later experienced serious events (death or
      symptomatic sustained ventricular tachycardia) during a 6-month follow-up were
      compared with 20 patients (group II) who remained free of complications for
      greater than 6 months after discharge. Groups I and II were matched with regard
      to age, gender, infarct site, ejection fraction, and beta-blocker treatment. HR
      variability was assessed in the 24-hour electrocardiograms recorded during the
      first 2 weeks after an AMI and in various portions of the complete 24-hour
      recording, with both the beginning and the length of the analyzed portion varied
      by 20 minutes (a total of 5,113 possibilities). The maximum reduction of HR
      variability in group I patients was systematically found when assessing HR
      variability in recordings starting approximately at 6 A.M. and lasting for
      approximately 8 hours. In the low-risk patient, the diurnal rhythm of HR
      variability is more marked than in the high-risk patient and the long-term
      components of HR variability due to the diurnal variation must be included in the
      measurement of HR variability when using it as a long-term predictor of risk from
      arrhythmic events after an AMI.

PMID- 2220631
TI  - Doppler assessment of left ventricular filling pattern in silent ischemia in
      patients with Prinzmetal's angina.
AB  - Spontaneous angina is an ideal condition in which to study left ventricular (LV)
      dysfunction induced by acute myocardial ischemia. In 6 patients with Prinzmetal's
      angina, LV diastolic function during 16 episodes of spontaneous angina was
      studied by simultaneous recordings of electrocardiographic (ECG),
      echocardiographic and hemodynamic parameters. In particular, pulsed Doppler
      echocardiography measured peak velocity of early (E) and late (A) transmitral
      flow and E/A ratio, as indexes of relative early versus late LV filling. During
      the ischemic attacks, the time sequence of pulsed Doppler echocardiographic and
      ECG changes showed 3 distinct phases: (1) "waxing phase: transmitral flow changes
      with minimal ECG modifications (E/A = 0.85 +/- 0.1); (2) "steady" phase: maximal
      ECG changes (E/A = 0.9 +/- 0.1); and (3) "waning" phase: regression of the ECG
      changes (E/A = 1.26 +/- 0.15). In each phase, E/A ratio showed a significant
      difference from the baseline value (E/A = 1.17 +/- 0.2) as a result of changes in
      E, suggesting that myocardial ischemia affects mainly the early phase of
      diastole. In the waxing phase, LV diastolic dysfunction preceded systolic
      abnormalities, as documented by a significant reduction of E/A ratio in the
      absence of alterations in LV ejection fraction, as well as in systemic arterial
      and pulmonary wedge pressures. Finally, all the recorded parameters were
      consistent with LV "contractile rebound" occurring in the waning phase and
      affecting both diastole and systole.

PMID- 2220633
TI  - Comparison of direct and indirect measures of systemic arterial pressure during
      weightlifting in coronary artery disease.
AB  - Based on auscultation measurements after exercise, circuit weight training in
      cardiac patients has been reported to provoke minimal increases in systolic
      pressure. Direct (brachial artery catheter) and indirect (sphygmomanometry)
      measures of blood pressure were compared at rest, during lifting with the legs
      (approximately the fourth, ninth and fourteenth repetition) and during 2 minutes
      of recovery after lifting with the arms and legs. Subjects performed 15
      repetitions of single-arm curl, single-arm military press and single- and double
      leg press exercises at 40 and 60% of the maximum load that could be lifted once
      on a multistation weightlifting apparatus. Indirect measures of systolic pressure
      at rest were 13% less than those recorded directly (130 +/- 7 vs 149 +/- 8 torr;
      p less than 0.01); diastolic pressures were similar using either method. This
      pattern was maintained during lifting with the legs at both intensities, and
      after exercise with both the legs and the arms. The mean systolic pressure
      recorded indirectly immediately after exercise was 63 torr (31%) and 76 torr
      (34%) less than the average peak intraarterial value recorded during leg and arm
      exercises, respectively. The highest intraarterial pressures were generated
      during the final repetitions of the set; immediately after the last repetition,
      both systolic and diastolic pressures rapidly decreased. It is concluded that
      indirect estimates of systolic pressure are significantly less than true arterial
      values at rest, and during and after lifting. Moreover, indirect measurements
      after lifting do not allow accurate conclusions to be drawn about the arterial
      pressures generated during lifting because of the rapid decrease in pressure that
      occurs after exercise.

PMID- 2220632
TI  - Aortic calcified plaques and cardiovascular disease (the Framingham Study).
AB  - The relation between the presence of calcified plaques in the thoracic aorta, as
      detected on chest x-rays, and the development of cardiovascular disease is
      examined during 12 years of follow-up of the Framingham cohort (n = 5,209). The
      prevalence of aortic calcified plaques approximately doubled with each decade of
      age, with only a trivial male predominance. Its presence was associated with a
      twofold increase in risk of cardiovascular death in men and women younger than
      age 65, even after other risk factors were taken into account. Similar increases
      in risk were found for coronary artery disease, stroke and intermittent
      claudication among middle-aged women. In middle-aged men these risks were less
      marked. The predictive value of aortic calcified plaques generally diminished
      with age. Risk of sudden coronary death in men with calcified plaques in the
      thoracic aorta ranged from a sevenfold increase at age 35 to no excess risk at
      age 70 years. These results support the view that atherosclerosis is a
      generalized process. The finding of aortic calcified plaques in a relatively
      young subject on a routine chest x-ray should be regarded as a sign for potential
      development of clinically manifest atherosclerotic disease in the cardiac,
      cerebral and peripheral arterial circulation.

PMID- 2220634
TI  - Response of angiographically normal and atherosclerotic left anterior descending
      coronary arteries to acetylcholine.
AB  - Acetylcholine-induced constriction of human coronary arteries in vivo is commonly
      attributed to endothelial dysfunction. To examine the effects of 2 other
      important determinants of vascular responses--namely, agonist concentration and
      the segment of circulation under study--the diameters of proximal, middle and
      distal segments of the left anterior descending artery (LAD) and coronary sinus
      oxygen saturation were measured in 10 patients with angiographically normal
      coronary arteries (group 1) and in 7 patients with coronary atherosclerosis
      (group 2) after intracoronary acetylcholine was infused at concentrations from
      10(-7)M to between 10(-4)M and 10(-2)M. In group 1, acetylcholine caused minor
      (less than or equal to 6%) but progressive dilatation of the LAD up to 10(-4)M,
      but constriction, particularly of the distal segments and tertiary branches,
      occurred at higher concentrations. Over the same concentration range, coronary
      sinus oxygen saturation rose progressively from a basal level of 36 +/- 3% to a
      maximum of 72 +/- 3% in the absence of changes in heart rate and blood pressure,
      suggesting marked progressive dilatation of resistance vessels. Concentrations
      greater than or equal to 10(-3)M caused intense constriction of distal epicardial
      vessels and, in some cases, anginal pain and objective signs of ischemia.
      Conversely, in group 2, acetylcholine (infused only up to 10(-4)M for ethical
      reasons) failed to cause significant changes in LAD diameter. These data suggest
      that the local acetylcholine concentration and coronary vascular segment under
      study may determine the observed response to at least an equivalent extent as
      does the presence or absence of coronary atherosclerosis, raising the question of
      whether a constrictor response to intracoronary acetylcholine reliably indicates
      the presence of coronary atherosclerosis.

PMID- 2220635
TI  - Clinical and electrophysiologic characteristics of patients with antidromic
      circus movement tachycardia in the Wolff-Parkinson-White syndrome.
AB  - Antidromic circus movement tachycardia was documented in 36 of 345 consecutive
      patients with Wolff-Parkinson-White syndrome undergoing detailed
      electrophysiologic evaluation. Twenty-six patients were men and 10 were women
      (mean age +/- standard deviation 26 +/- 12 years [range 12 to 45]). Multiple
      accessory pathways were identified in 12 of these 36 patients (33%). Ten of the
      patients (67%) with clinically documented antidromic tachycardia had multiple
      accessory pathways. Dizziness and syncope occurred in 61 and 50% of patients with
      antidromic circus movement tachycardia. Six patients had clinical documentation
      of atrial fibrillation, and 4 patients (11%) were resuscitated from ventricular
      fibrillation. In the 36 patients, 56 distinct antidromic tachycardias were
      recorded and several different pathways were observed. Orthodromic tachycardia
      was the most frequently associated arrhythmia (72%). Dual atrioventricular nodal
      pathways were present in 12 patients (33%); however, atrioventricular nodal
      tachycardia could be initiated in only 2 of them. Interruption of the accessory
      pathway was successfully performed in all 20 patients undergoing surgery.

PMID- 2220636
TI  - Persistence of arrhythmia exercise response in healthy young men.
AB  - This study assesses the persistence of arrhythmia at rest or during exercise
      tests, or both, after a mean follow-up period of 6.7 years in 76 young men (mean
      age 21.5 years) without evidence of organic heart disease. The exercise test was
      performed using a near-maximal protocol based on progressively increasing
      intermittent work loads, each of 5 minutes' duration. The initial work load was
      50 W. The electrocardiogram was continuously registered throughout all stages of
      the examination. Arrhythmia was defined as the occurrence of greater than or
      equal to 1 supraventricular or 1 ventricular premature beat at any stage of the
      examination. At the follow-up examination, the rate of persistence of arrhythmia
      did not differ significantly among the subgroups, irrespective of follow-up
      interval, type of arrhythmia, or arrhythmia patterns of response to exercise. Two
      dimensional echocardiography did not show any structural abnormalities and
      Doppler examination did not demonstrate significant abnormal flow patterns. Our
      data show that almost all patients continued to present arrhythmia after the
      follow-up period, without any evidence of development of organic heart disease.
      Moreover, the arrhythmia pattern of response to exercise remained constant
      throughout the years. At this time, arrhythmia without underlying heart disease
      seems to be of a benign natural course in these young men.

PMID- 2220637
TI  - Electrocardiographic signal-averaging during atrial pacing and effect of cycle
      length on the terminal QRS in patients with and without inducible ventricular
      tachycardia.
AB  - Electrocardiographic signal-averaging during sinus rhythm (61 to 99 beats/min)
      and atrial pacing (100 to 171 beats/min) were performed to determine the effect
      of heart rate on late potentials in 15 patients without (group 1) and 7 patients
      with (group 2) inducible sustained ventricular tachycardia (VT). In sinus rhythm
      (79 +/- 12 vs 77 +/- 12 beats/min, difference not significant), the duration of
      the low-amplitude signal less than 40 microV was longer in group 2 than group 1
      (43 +/- 21 vs 26 +/- 8 ms, p = 0.034) and more patients had late potentials (57
      vs 7%, p = 0.021), but QRS duration (121 +/- 32 vs 98 +/- 19 ms) and terminal
      voltage (33 +/- 33 vs 50 +/- 26 ms) were not significantly different. With atrial
      pacing in group 1 (128 +/- 16 beats/min), 3 patients developed a simultaneous
      decrease in terminal voltage and an increase in terminal QRS duration consistent
      with a late potential, but mean total and terminal durations were unchanged.
      Terminal voltage increased (50 +/- 26 to 59 +/- 40) but not significantly. With
      atrial pacing in group 2 (119 +/- 12 beats/min) all patients either had a late
      potential or developed a simultaneous decrease in terminal voltage and an
      increase in terminal QRS duration (p = 0.001 vs group 1). Root mean square (p =
      0.001 vs group 1). Root mean square voltage decreased (33 +/- 23 to 22 +/- 23)
      and became significantly different from group 1 (p = 0.017). Mean QRS duration,
      root mean square terminal voltage and low-amplitude terminal QRS duration,
      however, were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220638
TI  - Comparison of intravenous amrinone and dobutamine in congestive heart failure due
      to idiopathic dilated cardiomyopathy.
AB  - A prospective randomized study was performed in 46 consecutive patients with
      refractory congestive heart failure (CHF) due to idiopathic dilated
      cardiomyopathy to compare the hemodynamic responses to 48-hour infusions of
      amrinone and dobutamine. Both drugs substantially reduced pulmonary arterial
      wedge pressure, right atrial pressure and systemic vascular resistance and
      increased cardiac index. Amrinone caused a greater decrease in right atrial
      pressure than dobutamine (p less than 0.02) and had a positive chronotropic
      effect not observed with dobutamine (p less than 0.01). The increase in heart
      rate produced by amrinone correlated inversely with the changes in right atrial
      and pulmonary arterial wedge pressures, suggesting a baroreceptor response to
      reduced preload. Dobutamine produced a larger increase in stroke volume index
      than amrinone (p less than 0.01). Ninety-one percent of patients receiving
      amrinone and only 65% receiving dobutamine had reduction of greater than or equal
      to 30% in pulmonary arterial wedge pressure (p less than 0.05). Cardiac index
      increased greater than or equal to 30% in similar numbers of patients given
      amrinone (74%) and dobutamine (65%). Negative fluid balance was recorded in all
      patients receiving amrinone and in 78% of patients receiving dobutamine (p less
      than 0.05). Target hemodynamic criteria were achieved in 83% of patients
      receiving 10 micrograms/kg/min of amrinone. The effective maintenance dose of
      dobutamine was extremely variable. No clinically important adverse effects were
      observed with either drug regimen. Both amrinone and dobutamine are effective and
      safe agents for short-term parenteral therapy of patients with dilated
      cardiomyopathy in severe CHF that is unresponsive to oral medication.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2220639
TI  - Comparison of frequency of late potentials in idiopathic dilated cardiomyopathy
      and ischemic cardiomyopathy with advanced congestive heart failure and their
      usefulness in predicting sudden death.
AB  - Signal-averaged electrocardiograms were obtained in 62 consecutive patients with
      advanced congestive heart failure (CHF) undergoing evaluation for possible heart
      transplantation to determine if late potentials: (1) provide unique information
      compared to assessment of ventricular ectopic activity on ambulatory
      electrocardiogram, and (2) identify a subgroup of CHF patients with higher sudden
      death risk. Patients with a history of cardiac arrest or sustained ventricular
      tachycardia were excluded. CHF was due to old myocardial infarction in 40
      patients and idiopathic dilated cardiomyopathy in 22 patients. Late potentials
      were present in 16 of 40 (40%) patients with old infarction but in only 3 of 22
      (14%) patients with nonischemic CHF (p = 0.03). Twenty-four-hour ambulatory
      electrocardiograms were obtained in 34 patients (55%). Total ventricular ectopic
      activity and repetitive forms of ectopy were similar in patients with and without
      late potentials. Nine patients died suddenly, 9 had nonsudden death, 15 underwent
      heart transplantation and 29 were alive and well after a mean follow-up of 218 +/
      154 days. At 1 year, the actuarial risk of death was 37% and of sudden death was
      20%. Sudden death risk was 12% in patients with late potentials versus 21% in
      those without (p = 0.73). Thus, the incidence of the arrhythmia substrate
      producing late potentials depends on the CHF etiology. The signal-averaged
      electrocardiogram and ambulatory electrocardiogram provide independent
      information for possible risk assessment in CHF. However, late potentials are
      poor predictors of sudden death risk when CHF is advanced, possibly due to the
      heterogeneity of causes of sudden death--ventricular tachycardia being only 1 of
      many possible mechanisms.

PMID- 2220640
TI  - Improvement in early diastolic filling dynamics after aortic valve replacement.
AB  - With use of ultrafast computed tomography, 13 patients undergoing aortic valve
      replacement for aortic stenosis were prospectively followed to evaluate the
      relation between left ventricular mass and diastolic function. Studies were done
      before intervention, and then at 4 and 8 months later. Mass decreased from 161 +/
      11 g/m2 (+/- standard error of the mean) at baseline to 106 +/- 5 g/m2, and then
      to 97 +/- 7 g/m2 at 4 and 8 months, respectively, in 12 patients who demonstrated
      significant (greater than 20%) mass regression after operation. One patient
      failed to show significant changes in mass. Diastolic function, as defined by the
      peak filling rate of early diastole, improved (p less than 0.02) in the group
      with mass regression, from 2.11 +/- 0.17 s-1 at baseline to 2.12 +/- 0.23 s-1,
      and then to 2.62 +/- 0.26 s-1 at 4 and 8 months, respectively. Improvement in the
      time to peak filling rate was also noted. Heart rates were unchanged, whereas end
      diastolic volumes decreased and ejection fractions increased slightly.
      Postoperative increase in peak filling rate correlated with regression of
      ventricular mass to within normal range (+/- 2 standard deviations) and
      attainment of New York Heart Association class I status by 8 months (p less than
      0.02). Thus, improvement in diastolic function can be seen after aortic valve
      surgery and is associated with improved functional class. Diastolic function
      improves later than the regression in wall mass and may imply a delayed
      remodeling of the ventricle.

PMID- 2220641
TI  - Lipoprotein and hepatic lipase activity and high-density lipoprotein subclasses
      after cardiac transplantation.
AB  - Atherosclerosis is the leading obstacle to long-term survival in cardiac
      transplant patients. Increases in plasma triglycerides and lipoprotein
      cholesterol levels occur after transplantation that may contribute to transplant
      atherosclerosis. The etiology of this increase is unclear. We investigated the
      interaction of immunosuppressive medications with plasma triglycerides, low
      density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL)
      cholesterol, the HDL subclasses HDL2 and HDL3 cholesterol, and hepatic and
      lipoprotein lipase activity in 72 consecutive cardiac transplant patients
      compared to 51 healthy control subjects. In the transplantation group, greater
      concentrations of plasma triglyceride (80%, p less than 0.001), LDL cholesterol
      (16%, p less than 0.005) and hepatic lipase activity (100%, p less than 0.001)
      were noted, whereas lipoprotein lipase activity was noted to be significantly
      lower (124%, p less than 0.001). No difference was detected in HDL, HDL2, or HDL3
      cholesterol. Cyclosporine dose was significantly associated with hepatic lipase
      activity (r = 0.33, p less than 0.02) and inversely associated with lipoprotein
      lipase activity (r = -0.28, p less than 0.05). Lipoprotein lipase activity after
      transplantation correlated inversely with triglycerides (r = -0.36, p less than
      0.002) and positively with HDL cholesterol (r = 0.23, p less than 0.05) and HDL2
      cholesterol (r = 0.29, p less than 0.05). Hepatic lipase activity correlated
      inversely with LDL cholesterol (r = -0.21, p less than 0.08). In multiple
      regression analysis, cyclosporine dose was the major source of variation in
      hepatic lipase activity.

PMID- 2220642
TI  - Serial evaluation of lipid profiles and risk factors for development of
      hyperlipidemia after cardiac transplantation.
AB  - To determine the prevalence, time course and factors responsible for
      hyperlipidemia after heart transplantation, 83 consecutive 1-year survivors were
      studied. By 1 year, 83% of patients had serum total cholesterol levels greater
      than 5.2 mmol/liter (200 mg/dl) and 28% of the patients had serum total
      cholesterol higher than the age- and sex-matched ninety-fifth percentile. At the
      end of 1-year follow-up, serum total cholesterol correlated with the recipient
      age (p less than 0.0001), the preoperative cholesterol level (p less than 0.001),
      the actual dose of maintenance prednisone at 1 year (p less than 0.02) and the
      cumulative 1-year steroid dose (p less than 0.03). Similarly, the serum
      triglyceride level at 1 year correlated with the pretransplant level of serum
      triglycerides (p less than 0.0001), recipient age (p less than 0.03) and
      cumulative 1-year steroid dose (p less than 0.03). Patients with a pretransplant
      diagnosis of coronary artery disease had a significantly higher level of serum
      total cholesterol and triglyceride levels at 1 year (p less than 0.02 and p less
      than 0.03, respectively). Heart transplant recipients with body mass index
      greater than or equal to 25 kg/m2 also presented with significantly elevated
      serum total cholesterol and triglyceride levels at 1 year compared with nonobese
      patients (p less than 0.01 and p less than 0.002, respectively). Hyperlipidemia
      occurs frequently and is detected within the first month after heart
      transplantation. Optimal management of this problem requires further study.

PMID- 2220643
TI  - Electrocardiographic Q-wave inconstancy in inferior wall myocardial infarction.

PMID- 2220644
TI  - ST elevation in the right chest leads in anterior wall left ventricular acute
      myocardial infarction.

PMID- 2220645
TI  - Emergency stenting for refractory acute coronary artery occlusion during coronary
      angioplasty.

PMID- 2220646
TI  - Efficacy of acebutolol after acute myocardial infarction (the APSI trial). The
      APSI Investigators.
AB  - A randomized, placebo-controlled trial was carried out to determine the
      effectiveness of acebutolol in preventing late death in high-risk patients
      surviving an acute myocardial infarction (MI). The average 1-year mortality rate
      in placebo groups of 9 trials of beta blockers in post-MI patients was 7.2%
      compared with 17% in a nonselected cohort of patients who had survived at least 7
      days after an MI. The mandate for this trial was based on the fact that high-risk
      patients whose mortality rate exceeds 20% have not been enrolled in significant
      numbers in previous trials. It remains to be proved whether beta-blocking therapy
      in this patient population is beneficial. Selection of high-risk patients for
      inclusion in the trial was based on an algorithm set up from the Essai de
      Prevention Secondaire de l'Infarctus du Myocarde Registry. At the time of the
      second interim analysis, the mortality rate in the placebo group was 12%, lower
      than expected (greater than or equal to 20%). The trial was stopped; at that
      time, 309 patients had been allocated to placebo and 298 patients to acebutolol
      therapy. After 318 days, there were 17 deaths in the acebutolol-treated group and
      34 in the placebo group, a reduction in total mortality of 48% (p = 0.019). There
      were 30 vascular deaths in the placebo group and 12 in the acebutolol group.
      Thus, cardiovascular mortality with acebutolol was reduced by 58% (p = 0.006).
      The incidence of all cardiovascular-related deaths was lower in the acebutolol
      treated group. The total reduction in mortality did not appear to be correlated
      with secondary risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220647
TI  - Characteristics of participants at baseline in the Treatment of Mild Hypertension
      Study (TOMHS).
AB  - The Treatment of Mild Hypertension Study (TOMHS) is a randomized, double-blind
      clinical trial currently being conducted to compare the effects of
      nonpharmacologic therapy alone with those of 1 of 5 active drug regimens combined
      with nonpharmacologic therapy, for long-term management of patients with mild
      hypertension. Six classes of drugs were studied: (1) acebutolol (beta blocker),
      (2) amlodipine (calcium antagonist), (3) chlorthalidone (diuretic), (4) doxazosin
      (alpha 1 antagonist), (5) enalapril (angiotensin-converting enzyme inhibitor) and
      (6) placebo. All participants received nutritional-hygienic advice to reduce
      weight and sodium and alcohol intakes and to increase physical activity. End
      points include blood pressure change, side effects and quality-of-life indices;
      incidence of electrocardiographic and echocardiographic abnormalities; and
      incidence of cardiovascular clinical events, including death, among participants
      receiving drugs as first-step treatment as well as nonpharmacologic treatment
      compared with incidence among those participants randomized to nonpharmacologic
      treatment only as the initial step.

PMID- 2220648
TI  - Arterial protection: a neglected but crucial therapeutic goal.
AB  - Hypertension is accompanied by 2 major types of arterial pathologic conditions:
      smooth muscle hypertrophy of arteriolar resistance vessels and atherosclerosis,
      primarily involving the larger arteries. Smooth muscle hypertrophy may develop
      either as a secondary defense against elevated intravascular pressure or as a
      primary defect responsible for the increased pressure. Insulin and a number of
      other trophic stimuli may play a pathogenetic role in vascular hypertrophy.
      Reducing blood pressure and trophic stimuli may cause hypertrophy to be reversed.
      Because atherosclerosis may be markedly accelerated by hypertension, especially
      in the presence of concomitant risk factors, such as hypercholesterolemia,
      cigarette smoking and diabetes mellitus, antihypertensive treatment may attenuate
      or even reverse the extent of atherosclerosis, but only when the causative
      factors are also corrected. Some commonly used antihypertensive agents, e.g.,
      diuretics and beta blockers without intrinsic sympathomimetic activity, often
      aggravate hypercholesterolemia and glucose intolerance, thereby diminishing their
      potential protective value. Other types of drug therapy, such as alpha blockers,
      beta blockers with intrinsic sympathomimetic activity or other vasodilator
      activity, angiotensin-converting enzyme inhibitors and calcium entry blockers
      that may not induce biochemical changes, should provide better control of
      multiple risks and thereby better protection against atherosclerosis. With a
      better understanding of how hypertension induces arterial damage, clinicians will
      be able to provide more appropriate treatment and, it is hoped, alleviate such
      damage.

PMID- 2220649
TI  - Mechanical factors in large artery disease and antihypertensive drugs.
AB  - Hypertension may induce early alterations in large arteries by 2 mechanical
      stresses: one related to intravascular pressure, the other to blood flow
      dynamics. Distending pressure force acts in a circumferential direction, inducing
      decreased arterial distensibility. Arterial distensibility can be evaluated in
      humans by measurement of arterial compliance and pulse-wave velocity. It is well
      established that in chronic hypertension age and elevated pressure act together
      to increase arterial rigidity. Blood flow dynamics induce frictional forces in
      the endothelial surfaces of arteries. These forces, expressed by shear stress,
      are proportional to the viscosity of the blood and to the velocity gradient at
      the arterial wall. Measurement of blood viscosity and evaluation of velocity
      profile in the brachial arteries of hypertensive subjects have shown a reduction
      in wall shear rate and stress despite the elevation in blood viscosity. Several
      studies have shown that drug therapy that successfully reduces blood pressure
      does not necessarily improve arterial compliance. In contrast, few data are
      available on the effects of antihypertensive medication on arterial wall shear in
      humans. Arterial compliance and wall shear stress are 2 main therapeutic targets
      of potential importance in the physiopharmacologic approach to the effects of
      hypertension on atherogenesis.

PMID- 2220650
TI  - Documentation of the effective length of action of antihypertensive treatment.
AB  - The technique of automated ambulatory blood pressure (BP) monitoring offers an
      innovative means for measuring BP throughout the 24-hour period. Recently
      available compact monitoring instruments have been shown to be accurate and to
      provide reproducible measurements of the circadian BP pattern. The monitoring
      procedure is advantageous in that it minimizes or avoids placebo effects during
      therapeutic trials. Moreover, its power makes it possible to draw statistically
      valid conclusions regarding efficacy in fewer patients than would be required if
      conventional methods were used. This procedure also enhances the diagnosis of
      hypertension by identifying patients with "office" or "white coat" hypertension,
      and thereby facilitates assessment of treatment effects in those patients who are
      truly hypertensive. Automated monitoring measures BP at critical times of the
      day, including the preawakening and early morning hours, and it enables peak and
      trough antihypertensive drug effects to be carefully quantified. Since patient
      compliance appears to be enhanced with once- or twice-daily dosing,
      antihypertensive agents with long durations of action (24 hours) are of
      considerable interest. This report reviews some recent studies in which the
      monitoring technique has been used to measure the efficacy and duration of action
      of differing antihypertensive drugs.

PMID- 2220651
TI  - Acebutolol effects on lipid profile.
AB  - The relation between lipid profile and the incidence of coronary artery disease
      has been confirmed by the results of epidemiologic and intervention studies.
      Among antihypertensive agents, beta blockers, particularly those without
      intrinsic sympathomimetic activity (ISA), are generally reported to have negative
      effects on lipids, which may increase the risk of coronary artery disease. The
      ongoing Treatment of Mild Hypertension Study, now in its third year, has
      evaluated 847 patients to date with regard to lipid profile. Additional end
      points measured in this multicenter, randomized, controlled, double-blind study
      include blood pressure reduction and target organ deterioration. During the
      trial, all patients received nutritional and behavioral counselling to modify
      their diet, exercise habits and alcohol and sodium consumption to control their
      hypertension by nonpharmacologic means. In addition, some patients were
      randomized to receive low doses of 1 of the 5 classes of antihypertensive
      medication: acebutolol, a beta blocker with ISA (n = 124); amlodipine, a calcium
      channel blocker (n = 122); chlorthalidone, a diuretic (n = 125); doxazosin, an
      alpha blocker (n = 128); enalapril, an angiotensin-converting enzyme inhibitor (n
      = 127) or placebo (n = 221). At 1 year, acebutolol showed a statistically
      significant (p less than 0.001) decrease in total cholesterol (-12.7 mg/dl)
      compared with placebo (-5.2 mg/dl) and with chlorthalidone (1.0 mg/dl); a
      significant (p less than 0.001) decrease in low-density lipoprotein cholesterol (
      6.0 mg/dl) compared with placebo (+0.7 mg/dl) and with chlorthalidone (+8.0
      mg/dl) and no change in high-density lipoprotein cholesterol (-0.4 mg/dl).

PMID- 2220652
TI  - Dissociation and displacement: where goes the "ouch?".
AB  - Hypnosis is widely used to relieve pain. Current theory emphasizes its
      dissociative features. Multiple personality patients can eliminate pain in the
      primary personality by displacing it into underlying alters. The Hilgards
      demonstrated that normal hypnotized subjects can similarly dissociate pain into a
      covert cognitive structural system which they called the "hidden observer." The
      Watkins discovered that "hidden observers" appeared to be the same phenomenon as
      "ego states." "Ego-state theory" assumes that human personality develops through
      integration and differentiation. At one end of the continuum, "differentiation"
      is adaptive. Ego states possess relatively permeable boundaries as in normal
      moods. At the other end ego-state boundaries become less permeable. Normal
      "differentiation" becomes maladaptive "dissociation" and multiple personalities
      may be created. In the intermediate range of the differentiation/dissociation
      continuum, "covert" ego states can be found in many normal subjects who volunteer
      for hypnotic laboratory experiments. Normal individuals, like multiple
      personalities and "hidden observer" subjects, can displace (dissociate) pain into
      "covert" ego states. The pain is not eliminated. This suggests that when we
      remove pain by hypnosis we may not be getting away "scot-free."

PMID- 2220653
TI  - Etiology and treatment of dental anxiety and phobia.
AB  - Dental anxiety and phobia afflict millions of people. Dental patients who are
      anxious anticipate pain and feel vulnerable and out of control. Hypnotherapy to
      alleviate dental anxiety and phobias has received clinical and empirical support.
      Our purpose in this paper is to provide a body of objective data from American
      Society of Clinical Hypnosis members regarding incidence rates and the relative
      importance of various etiological and conceptual issues in the development and
      maintenance of dental anxiety and treatment interventions. From these data, we
      constructed a model of etiology, maintenance, and treatment of dental anxiety.

PMID- 2220654
TI  - Characteristics of change in Ericksonian hypnotherapy: a cognitive-psychological
      perspective.
AB  - Milton H. Erickson's approach to hypnosis and psychotherapy has established
      itself as a therapeutic paradigm in recent years. As its popularity grows,
      however, myths and misconceptions about his approach have also emerged. Some of
      them claim falsely that Erickson's therapy consists of nothing more than a set of
      quick, symptom-management formulae. To understand Erickson's hypnotic
      psychotherapy in a proper context, a systematic review is warranted. In this
      article I have examined, from a cognitive-psychological perspective, four of the
      major characteristics of therapeutic change underlying Erickson's work: (a) self
      efficacy, (b) spontaneous compliance, (c) cognitive/experiential reorganization,
      and (d) global distribution of information. Drawing on Erickson's original
      writing, this paper integrates his published cases into an existing theoretical
      and empirical framework. Clinical implications are also discussed.

PMID- 2220655
TI  - Hypnotic susceptibility and experimental pain reduction.
AB  - We exposed 24 subjects high in hypnotic susceptibility and 24 subjects low in
      hypnotic susceptibility to a cold-pressor pain stimulus under either hypnotic or
      waking conditions, using each of two pain-reduction strategies (analgesia and
      distraction) separately. Trance depth level was held constant for hypnotized
      subjects. We used pain-tolerance levels as measures of pain, and we analyzed them
      by survival analysis. High susceptibles reported significantly lower pain ratings
      and kept their hands immersed longer in the cold water than low-susceptible
      subjects. There were no significant differences between hypnotic and waking
      condition subjects or between the different strategies. We have discussed the
      results in terms of a relationship in the literature between choice of
      experimental design (between-subjects or within-subjects) and the effectiveness
      of a hypnotic induction for suggested pain reduction.

PMID- 2220656
TI  - Hypnotic age regression and the autokinetic effect.
AB  - Based on research with children, we hypothesized that hypnotically age-regressed
      adult subjects would respond differentially across stimuli conditions on the
      autokinetic illusion. We assigned 18 highly susceptible subjects, assessed on the
      Harvard Group Susceptibility Scale, to one of three treatment groups: waking
      control, standard hypnotic induction, and age regression. Three target shapes, a
      control stimulus (circle), a representational stimulus (profile of a man), and a
      symbolic stimulus (cross) were presented. Results failed to show reinstatement of
      childlike performance on this perceptual illusion. The conceptual and empirical
      implications for future age-regression studies on memory, perception, and emotion
      are discussed.

PMID- 2220658
TI  - Matched group study of preenucleation radiotherapy versus enucleation alone for
      primary malignant melanoma of the choroid and ciliary body.
AB  - We report the results of a nonrandomized, matched group survival study comparing
      29 patients with a choroidal or ciliary body melanoma managed by enucleation
      alone to 29 patients managed by enucleation following external beam ocular
      irradiation (20 Gy in five fractions over 5-7 days just prior to enucleation).
      Variables on which the patients in the two groups were matched included age at
      time of enucleation, largest linear tumor dimension, location of the anterior
      tumor margin relative to the equator and ora serrata, melanoma cell type, and
      extrascleral tumor extension. The cumulative 5-year survival in the enucleation
      alone group was 57.9% (SE = 9.9%), whereas that in the preenucleation radiation
      therapy group was 63.9% (SE = 12.2%). This difference is not statistically
      significant (p greater than 0.5, Mantel-Haenszel test). The authors discuss the
      strengths and limitations of their study and the implications of their results.

PMID- 2220657
TI  - Phase II trial of etoposide, doxorubicin (Adriamycin), and cisplatin (EAP
      regimen) in advanced gastric cancer.
AB  - Ten previously untreated patients with gastric cancer were treated with
      etoposide, 120 mg/m2 intravenously (i.v.) on days 4, 5, and 6, Adriamycin, 20
      mg/m2 i.v. on days 1 and 7, and cisplatin, 40 mg/m2 i.v. on days 2 and 8 (EAP).
      Etoposide, 240 mg/m2 on days 4, 5, and 6, was administered orally instead of
      intravenously in alternating cycles, and pharmacokinetic studies were performed
      in those who had previously undergone gastrectomy or who had tumor infiltrating
      the stomach to determine oral bioavailability. Nine patients had advanced
      measurable gastric cancer, and one patient had an elevated carcinoembryonic
      antigen after surgery for synchronous gastric and colon cancer. The median age
      was 54 years (range 38-69), and the median Eastern Cooperative Oncology Group
      (ECOG) performance status was 2 (range 0-3). Nine of 10 patients had poorly
      differentiated adenocarcinoma. Twenty-four cycles were administered to 10
      patients, and hematologic data were available for 23 courses. ECOG grade 4
      neutropenia and thrombocytopenia developed in 19 (83%) and 8 (53%) courses,
      respectively. Thirteen courses (54%) were complicated by fever requiring
      parenteral antibiotics. Two patients (20%) died due to neutropenic sepsis. The
      profound myelotoxicity observed in our study prompted us to terminate the
      investigation prior to completing accrual. The oral bioavailability of etoposide
      was 21% and 36% in the two patients who had had prior gastrectomy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2220659
TI  - Hypercalcemia in head and neck squamous-cell carcinoma.
AB  - Hypercalcemia was previously considered a terminal phenomenon in advanced head
      and neck squamous-cell carcinoma. We report on six patients with head and neck
      carcinoma and hypercalcemia refractory to conventional measures. Three patients
      had stage IV tumor not amenable to surgery or radiation therapy and three others
      had carcinoma recurrent after surgery and/or radiation therapy. Five of the six
      patients had paraneoplastic hypercalcemia and one had extensive bone metastases.
      One refused chemotherapy and died in 2 months. Five treated with cisplatin 100
      mg/m2 i.v. and 5-fluorouracil (5-FU) 960 mg/m2/day x 5, on days 2-7 as a
      continuous infusion, had prolonged control of hypercalcemia and required no other
      therapy to maintain eucalcemia. All three patients with no prior therapy, and one
      of the two patients with recurrent cancer, had a partial response after
      chemotherapy. The survivals of the patients with recurrent cancer were 1 and 3
      months. The survivals in the patients with no prior antitumor therapy were 10,
      11+, and 23 months, respectively. In conclusion, hypercalcemia in head and neck
      carcinoma can be well controlled by cisplatin and 5-FU chemotherapy for a
      prolonged period. The impact of chemotherapy on survival was minimal in patients
      with recurrent cancer. In contrast, patients with hypercalcemia at initial
      presentation of an advanced head and neck cancer have a high likelihood of tumor
      control and prolongation of survival by chemotherapy.

PMID- 2220660
TI  - Phase II study of interferon alpha-2a and dacarbazine in advanced melanoma.
AB  - Based on the report of some activity of combination therapy with dacarbazine
      (DTIC) and interferon alpha-2a (rIFN alpha-2a) in disseminated melanoma, we
      conducted a phase II study to determine the feasibility and efficacy in a large
      series of patients. DTIC was administered in 79 patients at the dose of 800 mg/m2
      every 3 weeks and rIFN alpha-2a was given daily at the dose of 9 X 10(6) IU for
      the first 10 weeks and three times a week thereafter. Among the 75 evaluable
      patients, 25% achieved an objective response, with 8% complete and 17% partial
      remissions. The regression occurred within a mean time of 1.9 +/- 1.03 months
      from starting therapy and the mean duration of response was 8.2 +/- 4.2 months.
      The major side effects were vomiting, anorexia, fever, fatigue, and myalgia.
      There was one death related to sepsis after myelosuppression. In the other
      patients bone marrow and liver toxicities were not remarkable. Our data reveal
      that a combination regimen of rIFN alpha-2a with a cytotoxic agent has some
      therapeutic activity in the management of advanced malignant melanoma.

PMID- 2220661
TI  - A phase II trial of mitomycin in patients with epithelial ovarian carcinoma
      resistant to cisplatin or carboplatin.
AB  - Intravenous bolus mitomycin was given at a dose of 10-12 mg/m2 to patients with
      epithelial ovarian cancer resistant to cisplatin or carboplatin. There were three
      (12%) partial responses and no complete responses in the 25 patients so treated.

PMID- 2220662
TI  - Phase II trial of carboplatin in soft-tissue sarcoma.
AB  - As part of the Eastern Cooperative Oncology Group program for the assessment of
      new drugs in sarcomas, a Phase II trial of carboplatin was performed in patients
      who had received no more than one prior chemotherapy regimen. A total of 50
      patients received either 400 mg/m2 or 320 mg/m2 depending on whether they had
      received prior radiotherapy. A response rate of 16% (95% confidence interval 6
      32%) occurred in the 37 patients who had received doxorubicin as their only prior
      systemic therapy. Three of the six responses were complete and persisted for 7 to
      34 months. In contrast none of the 13 patients who received carboplatin after
      initial progression on doxorubicin and subsequent progression on interferon alpha
      responded. The overall response rate was therefore 12% (95% confidence interval 5
      24%). Toxicity was primarily hematologic, with 14 patients having Eastern
      Cooperative Oncology Group (ECOG) grade 3 toxicity and no grade 4 or 5
      toxicities. In view of the number of complete responses, carboplatin should be
      studied further in untreated patients with advanced soft tissue sarcoma.

PMID- 2220663
TI  - Solitary brain metastasis: results of an RTOG/SWOG protocol evaluation surgery +
      RT versus RT alone.
AB  - From 1983 through 1986, the Southwest Oncology Group and Radiation Therapy
      Oncology Group conducted an intergroup study designed to evaluate the
      effectiveness of surgical resection in those patients with solitary central
      nervous system (CNS) metastases. The study was initially designed as a
      prospective randomized trial. Because of difficulty accruing patients, the
      registration format was altered and the patients were placed on study according
      to physician preference. Ninety-seven patients were registered on study and 80
      patients were eventually analyzed. Fifty-five patients underwent radiation
      therapy alone and 25 patients received surgery and radiation. Fifty-nine percent
      of those patients undergoing radiation therapy alone improved or stabilized while
      79% of those patients undergoing surgery and radiation therapy improved or
      stabilized. Eventually, 22% of the surgically treated patients failed in the
      brain while 45% of the patients undergoing radiation therapy exhibited a CNS
      relapse. Survival was improved when corrected for other prognostic factors in
      those patients undergoing surgical resection. Although not a prospective
      randomized trial, this study does suggest an improvement in the survival of a
      select group of patients able to tolerate neurosurgical resection.

PMID- 2220664
TI  - Phase II study of oral idarubicin in elderly patients with advanced breast
      cancer.
AB  - Thirty-one elderly patients with measurable advanced breast cancer entered this
      phase II study. A dose of 15 mg/m2/day of Idarubicin (IDA) for 3 consecutive days
      every 3 weeks was given orally. Mean total cumulative dose of IDA received was
      175 mg/m2 (range: 45-475 mg/m2). Mean number of cycles given was four (range: 1
      15). Out of 27 evaluable patients, three achieved a complete response (CR), four
      had a partial response (PR) (CR + PR = 26 +/- 17%), nine showed no change, and 11
      had a progressive disease. Median time to progression was 83 days (range: 19-728
      days). Out of 26 patients evaluable for toxicity, hematologic toxicity at day 21
      was moderate: neutropenia grades 3 and 4 = 16% of cycles: two patients had grade
      1 thrombopenia; and three patients, grade 3. No cumulative hematologic toxicity
      was detected. Nonhematologic toxicities consisted of nausea and vomiting in 72%
      of patients [World Health Organization (WHO) grades 3 and 4 = 8%)] and alopecia
      in 76% (WHO grades 2-3 = 38%). Grade 1 stomatitis occurred in 4% of cycles.
      Chemotherapy was discontinued in one patient because of drop of left ventricular
      ejection fraction (LVEF) from 0.62 to 0.44 at a cumulative IDA dosage of 322
      mg/m2. The results of this study show that IDA is an active drug in elderly
      patients with advanced breast cancer. Due to its simplicity of administration IDA
      deserves further investigations in combination with other drugs.

PMID- 2220665
TI  - Long-term results after chemoradiotherapy for locally confined squamous-cell head
      and neck cancer.
AB  - The long-term results after simultaneous chemoradiotherapy in 54 patients with
      previously untreated or minimally treated, locally confined (M0) squamous-cell
      carcinoma of the head and neck are presented. Multiple concurrent courses of
      radiation therapy and chemotherapy with cisplatin and a four-day 5-fluorouracil
      infusion were given. Twenty-eight patients underwent definitive surgery and 26
      were treated without surgical resection. Treatment-associated toxicity was
      significant, including mucositis, myelosuppression, and a mean 12% loss of
      initial body weight. Of the 54 patients, 51 were ultimately rendered disease free
      by this combined modality protocol. With a follow-up ranging from 42-68 months,
      the projected Kaplan-Meier relapse-free survival for the entire patient cohort is
      70%, with all relapses occurring within 17 months of patient entry. The projected
      Kaplan-Meier relapse-free survival for patients with Stage IV disease is 62%. The
      durability of these remissions suggests that there is a significant likelihood of
      cure in all patients with locally confined disease, and justifies comparative
      trials with standard treatment.

PMID- 2220666
TI  - A phase I-II trial of continuous-infusion cisplatin, continuous-infusion 5
      fluorouracil, and VP-16 in colorectal carcinoma.
AB  - Twenty-nine evaluable patients with colorectal adenocarcinoma were treated in a
      phase I-II trial of combination chemotherapy with a 72-h continuous infusion of
      cisplatin (CDDP) and 5-fluorouracil (5-FU) with an infusion of VP-16 given at 24
      and 48 h after the start of therapy. There were five (17 +/- 14%) partial
      responses lasting 2-6 months (median, 3). Three of these responses occurred among
      the 10 previously untreated patients. The toxicity of this regimen was
      pronounced. Four of eight patients with severe neutropenia required
      hospitalization for infections, two of which were life-threatening; one of six
      patients with severe thrombocytopenia had a life-threatening hemorrhagic
      complication; and four patients experienced severe, dose-limiting fatigue. These
      complications occurred principally with CDDP and VP-16 at doses above 27.5
      mg/m2/day and 110 mg/m2/dose, respectively. Mucositis occurred in six patients
      and limited the dose of 5-FU to 1,300 mg/m2/day. Although the response rate
      appeared to be high in previously untreated patients, the minimal palliative
      benefit of treatment and the brief duration of the responses do not compensate
      for the toxicity observed.

PMID- 2220668
TI  - Isolation of human immunodeficiency virus (HIV) at autopsy one to six days
      postmortem.
AB  - Blood and tissue were studied for potential infectivity at autopsy of ten
      patients with human immunodeficiency virus (HIV) infection. Special attention was
      paid to the possibility of detecting HIV in bone at craniotomy. Postmortem
      intervals were one to six days. Specimens for HIV isolation included skull bone,
      brain, blood, bone marrow, spleen, and lymph node, and cerebrospinal fluid in one
      case. HIV grew in culture from at least one specimen from eight autopsies, one of
      which was performed six days postmortem. HIV was recovered from the blood of five
      patients and the tissue of five patients, including three with negative blood
      cultures. Skull bone contained HIV in two cases. HIV also grew from native spleen
      specimens stored for up to 14 days postmortem at 20 degrees C. Recommended
      precautions, including those for bone, are indicated at autopsy of HIV-infected
      patients even after long postmortem intervals.

PMID- 2220667
TI  - Global and molecular hemostatic markers in acute myeloid leukemia.
AB  - Patients with acute myeloid leukemia have multiple hemostatic and thrombotic
      complications, which may or may not result from disseminated intravascular
      coagulation. Previous studies incorporating routine coagulation analyses failed
      to detect any clinically useful information in most of these patients. In this
      study, the first comprehensive evaluation of the various aspects of the
      hemostatic system in a population of patients with acute myeloid leukemia was
      performed. Eighteen patients (23-71 years of age) were studied at either
      diagnosis or relapse. Hemostatic studies were performed at onset and on days 3,
      7, and 30 after initiation of therapy. The bone marrow blast counts ranged from
      8% to 98%; prothrombin time and activated partial thromboplastin time showed only
      minor prolongations in a few of these patients. However, in all patients
      measurement of platelet-associated markers revealed elevated platelet factor 4
      and thromboxane B2 and normal 6-keto-prostaglandin F1 alpha levels. Fibrinolytic
      markers showed an increase in D-dimer and tissue plasminogen activator and a
      decrease in alpha 2-antiplasmin levels. Plasminogen, plasminogen activator
      inhibitor, and fibrinogen levels were normal. Coagulation markers demonstrated a
      decrease in protein C and antithrombin III levels and an elevation of the
      thrombin-antithrombin complex. The pretreatment values for all hemostatic markers
      studied were similar to the values obtained on days 3, 7, and 30 during
      treatment. This investigation demonstrated a subclinical activation of the
      components of the hemostatic system possibly leading to a hypercoagulable state.
      Although only six patients (33%) experienced hemorrhagic complications, the risk
      of bleeding and/or thrombosis was strongly evident in all patients. The
      significance of finding abnormal levels of specific molecular markers of
      hemostasis will be established in the future application of such markers in
      clinical evaluations of leukemic patients known to be at risk for coagulation
      disorders.

PMID- 2220669
TI  - Cerebrospinal fluid changes after 48 hours of effective therapy for Hemophilus
      influenzae type B meningitis.
AB  - Interval cerebrospinal fluid (CSF) analysis is often performed to assess efficacy
      of treatment for bacterial meningitis. The authors reviewed 101 cases of
      pediatric bacterial meningitis resulting from Hemophilus influenzae type b in
      which analysis of CSF occurred on admission and between 48 and 72 hours after
      initiation of parenteral antibiotic therapy; of these, only one patient had a
      positive repeat CSF culture. Of the 100 cases with sterile CSF on repeat culture,
      there was no instance of recrudescence of infection during hospitalization. The
      following characterized the interval changes in CSF profile of this group: 100
      (100%) with persistence of pleocytosis; 14 (14%) with differential cell count
      conversion from polymorphonuclear neutrophil leukocyte (PMN) predominance to
      relative lymphocytosis; 96 of 98 (98%) with initial positive Gram-stained smear
      with negative results for organisms; 53 of 75 (71%) with normalization of initial
      hypoglycorrhachia; and 10 of 94 (11%) with normalization of initial abnormally
      elevated protein levels. The differences in mean values of CSF total white blood
      cell counts, percentage PMNs, and glucose and protein concentrations on
      presentation and between 48-72 hours of therapy were highly significant (P less
      than 0.0001). After 48 hours of effective antibiotic therapy for H. influenzae
      type b meningitis, CSF pleocytosis and abnormally elevated protein concentration
      are usually preserved, whereas hypoglycorrhachia usually resolves; it is not
      uncommon for the differential cell count to convert from a PMN predominance to a
      relative lymphocytosis. Significant alteration in all CSF parameters associated
      with H. influenzae type b meningitis can occur after 48 hours of effective
      parenteral antibiotic therapy.

PMID- 2220670
TI  - Safety and cost-containment data that advocate abbreviated pretransfusion
      testing.
AB  - Abbreviated pretransfusion testing, although permitted by American Association of
      Blood Banks Standards for unimmunized patients, is not widely practiced. Concerns
      remain about optimal antibody screening methods, antibodies missed by deleting
      the antiglobulin crossmatch, and cost-effectiveness. The authors prospectively
      tested 3,380 serum samples for blood type, antibody screen, and antiglobulin
      crossmatch. Antibody screens for 2,000 samples, performed with the use of a two
      cell screen, were compared with 1,380 samples studied with a three-cell screen.
      Also, all 3,380 sera had major crossmatches performed carried through the
      antiglobulin phase. Two and three screening cells gave comparable results, with
      5.45% of patients tested by two-cell and 5.22% by three-cell screens having a
      positive antibody screen. Of those with negative screens, 0.5% screened by two
      cell screens and 0.8% by three-cell screens had a positive major crossmatch.
      Among these (negative antibody screen, positive crossmatch), only 0.03% (1 of
      3.380) had a clinically significant alloantibody (anti-Kpa); 0.27% (9 of 3,380)
      had antiglobulin crossmatch positive with polyspecific antisera but negative with
      anti-IgG; and 0.12% (4 of 3,380) had positive crossmatch because of passive anti
      A. By cost accounting of labor and reagents, 84 per unit would be saved using
      abbreviated versus complete pretransfusion testing. Blood banks now performing
      complete pretransfusion testing should reconsider abbreviated crossmatching for
      unimmunized patients as a safe, efficacious means of cost-containment.

PMID- 2220671
TI  - The frequency of uterine leiomyomas.
AB  - As a leading cause of hysterectomy in premenopausal women. uterine leiomyomas are
      a major public health problem. However, very little work has been done on their
      epidemiology. Indeed, their true frequency has never been established using
      systematic and meticulous methods. In this study, gross serial sectioning at 2-mm
      intervals was applied as an adjunct to routine pathology processing in 100
      consecutive total hysterectomy specimens. This tripled the number of leiomyomas
      noted in routine pathology reports. There were 649 leiomyomas in 77 of 100 uteri,
      with multiplicity of leiomyomas in 84%. Although leiomyomas were more numerous
      and larger in women with a clinical diagnosis of myomatous uterus, the incidence
      was no higher than in uteri removed for other reasons. The postmenopausal
      incidence of leiomyomas was no lower than the premenopausal incidence, although
      postmenopausal leiomyomas were smaller and fewer. These findings suggest that
      epidemiologic studies of leiomyomas may not be valid if they are based only on
      clinical diagnoses or routine pathology reports.

PMID- 2220672
TI  - Anaplastic large cell (Ki-1) lymphoma with histiocytic phenotype simulating
      carcinoma.
AB  - Histiocytic and epithelial cell types share many cytomorphologic and functional
      characteristics; it is predictable, therefore, that corresponding malignancies
      might be difficult to distinguish. Described is the case of a 52-year-old woman
      in whom disseminated anaplastic large-cell lymphoma simulated carcinomatosis by
      conventional morphologic criteria. Evidence of histiocytic differentiation was
      derived from immunocytochemical, fine structural, and genetic probe analyses. The
      diagnosis of histiocytic neoplasia is discussed in relation to categories
      previously termed malignant histiocytosis, "Ki-1" lymphoma, and regressing
      atypical histiocytosis, and comparisons are made with animal tumor models.

PMID- 2220673
TI  - Primary splenic lymphocyte-depletion Hodgkin's disease.
AB  - A case of lymphocyte-depletion Hodgkin's disease is described for the purpose of
      reviewing the criteria currently used to distinguish this disease from other
      pleomorphic large-cell malignancies. A 76-year-old man with a 3-month history of
      daily fevers underwent extensive evaluation and exploratory laparotomy, which
      revealed only two large, separate splenic tumor nodules. Postoperatively, the
      patient remained asymptomatic. Histologically, the tumor was composed of giant
      cells, including both typical Reed-Sternberg forms and mononuclear variants with
      inflammatory stromal response along its borders. Immunoperoxidase showed tumor
      cells to be strongly reactive for Leu-M1 (CD15), BER-H2 (CD30), Leu-3 (CD4), and
      T11 (CD2) and weakly reactive for Leu-4 (CD3) but nonreactive for EMA, LCA,
      lysozyme, Leu-9, Leu-M3, Leu-M5, and immunoglobulin light chains. Southern blot
      analysis revealed an isolated clonal band for kappa light chain only. Included in
      the discussion of this case of primary splenic lymphocyte-depletion Hodgkin's
      disease is a review of clinical, histologic, immunohistochemical, and gene
      rearrangement characteristics of what can be defined as lymphocyte-depletion
      Hodgkin's disease.

PMID- 2220674
TI  - Isolation of measles virus in primary rhesus monkey cells from a child with acute
      interstitial pneumonia who cytologically had giant-cell pneumonia without a rash.
AB  - The isolation of measles virus in primary Rhesus monkey kidney cells (PRMK) in
      patients with documented giant-cell pneumonia who have presented without a rash
      is limited. The diagnosis usually is made by cytologic examination of nasal or
      bronchial secretions in which characteristic multinucleated giant cells with
      intranuclear and intracytoplasmic inclusion bodies are observed. The diagnosis of
      giant-cell pneumonia has been associated with measles virus but not exclusively.
      Canine distemper, herpes group viruses, and parainfluenza infections have been
      associated with these cells. In addition, vitamin A deficiency also has been
      cytologically associated with multinucleated giant cells. The authors describe
      the isolation of measles virus from bronchial washing and sputum in PRMK cells at
      4 days from an 11-year-old child with acute interstitial pneumonia who was in
      remission for acute lymphocytic leukemia. Classic cytopathologic effect (CPE)
      consisting of syncytial and hole formation on the PRMK monolayer was apparent. In
      addition, a foamy appearance of the monolayer was noted in an otherwise clean lot
      of monkey cells. Confirmatory testing with measles antibody of the infected areas
      of the monolayer by indirect immunofluorescence (IFA) was positive for measles
      antigen and negative for mumps, parainfluenza (types I, II, and III) and
      influenza A and B virus. Serologic studies for measles antibody revealed an IFA
      IgG titer of greater than 1:10,240, and an IgM titer of 1:128. Cytologic
      examination of the same bronchial fluid revealed the typical giant cells with
      characteristic inclusions associated with measles virus. Because this disease
      usually is severe, and often fatal, prompt recognition of this virus is
      essential, not only to the patient, who can be treated with immunoglobulin and/or
      antiviral therapy, but also to prevent the spread of the virus to other patients
      and medical personnel. These findings also support direct evidence for the
      etiologic role of measles virus in giant-cell pneumonia that has been detected
      either histologically or cytologically and in tissue culture at autopsy.

PMID- 2220675
TI  - Special report. Immunocytochemistry in diagnostic cytology: a 12-year
      perspective.
AB  - In recent years immunocytochemistry has become an important addition to
      diagnostic cytology. Its routine application in cytology, however, has not yet
      reached the practical levels it has achieved in diagnostic histopathology. This
      review examines the values and limitations of immunocytochemistry in diagnostic
      cytology and addresses some of the most common technical and analytical factors
      that can affect the outcome of the procedure.

PMID- 2220676
TI  - Special report. The Second International Anti-cardiolipin Standardization
      Workshop/the Kingston Anti-Phospholipid Antibody Study (KAPS) group.
AB  - Forty-three laboratories in 13 countries participated in a workshop to determine
      the degree of agreement between laboratories performing anticardiolipin tests.
      Each laboratory received freeze-dried aliquots of three samples labeled G1 (107
      GPL units), G2 (20 GPL units), and G3 (6 GPL units) to be used as reference
      standards in the IgG assay, and three samples labeled M1 (106 MPL units), M2 (21
      MPL units), and M3 (5 MPL units) as references for the IgM assay. Participating
      laboratories were divided into 8 groups and serum samples were exchanged between
      laboratories in each group. For IgG anticardiolipin, results were reported as:
      high, IgG positive for samples with optical absorbance readings exceeding G1;
      medium, IgG positive for samples with readings between G1 and G2; low, IgG
      positive between G2 and G3, and negative, if less than G3. In like manner,
      samples were defined as high-, medium-, or low-IgM positive, with reference to
      standards M1, M2, and M3. An index of agreement was computed to determine the
      degree of agreement between laboratories in each group. Interlaboratory agreement
      was excellent in each category assessed. For high positive and negative IgG and
      IgM results, the index of agreement exceeded 90%, and for medium and low positive
      results, agreement exceeded 75%. The overall index of agreement between
      laboratories exceeded 90%. The researchers conclude that the use of these six
      standards to obtain a semiquantitative measure of anticardiolipin positivity will
      enable good interlaboratory agreement in reporting anticardiolipin results.

PMID- 2220677
TI  - HIV and the autopsy.

PMID- 2220678
TI  - Serum tests for diagnosis of iron deficiency.

PMID- 2220679
TI  - Ability of whole blood aggregometer to detect platelet hyperaggregability.

PMID- 2220680
TI  - A diagnostic expert system for colonic lesions.
AB  - The diagnostic expert system for colonic lesions (DESCL) was designed to
      discriminate colonic adenoma and adenocarcinoma from normal colonic tissue.
      Although it was originally developed for use in conjunction with a machine vision
      analytic system, the DESCL has evolved into a teaching tool and a model for
      conceptual machine learning. The expert system is table driven and consists of a
      shell and a knowledge base. The latter comprises a series of architectural and
      cytologic observations and a quantitative estimate of diagnostic importance
      relating these observations to diagnostic outcome. In a validation study of 100
      colonic lesions, the expert system achieved a success rate of 98%. It has the
      flexibility to allow individual pathologists to "customize" the knowledge base to
      suit their diagnostic criteria.

PMID- 2220681
TI  - ESPRE--expert system for platelet request evaluation.
AB  - The expert system for platelet request evaluation (ESPRE) is being developed to
      support independent learning and decision making regarding the use of platelet
      transfusions while physicians are actively engaged in clinical practice. The
      knowledge of transfusion medicine incorporated in ESPRE has been largely gathered
      from blood bank physicians responsible for determining the appropriateness of
      blood product administration. Knowledge acquisition methods have included
      structured and unstructured interviews with protocol analysis using real and
      fabricated transfusion cases and critiques of an expert system prototype's
      conclusions. For knowledge representation, ESPRE uses frames with embedded
      production rules to provide processing efficiency and facilitate knowledge base
      development. ESPRE automatically acquires key laboratory findings from a
      laboratory information system. Systems such as ESPRE require careful evaluation
      and, if proven effective and accurate, present to laboratorians a new tool for
      delivering high-quality and individually adapted health care.

PMID- 2220682
TI  - Informatics as a separate section within a department of pathology.
AB  - Departments of pathology should be reorganized to include a separate section of
      pathology informatics (PI) in addition to the traditional sections of clinical
      pathology and anatomic pathology. PI is the discipline of medical informatics as
      practiced within pathology and encompasses a rich mix of activities. The primary
      role of specialists working in clinical pathology and anatomic pathology would be
      to create information, whereas that of informaticians in a section of PI would be
      to add value to the created information by processing it and communicating it to
      users. The four major benefits associated with a PI section would be as follows:
      (1) enhanced productivity and efficiency in the development of alignment and
      impact applications; (2) better management of the information product of
      pathology and the informaticians themselves; (3) increased political power and
      influence for pathology; and (4) increased awareness and sophistication on the
      part of departmental leaders about information processing. Departmental benefits
      from the proposed organizational change would thus be calibrated in terms of the
      ability of the revamped department to harness and exploit new information
      technology.

PMID- 2220683
TI  - A knowledge-based system for transfusion advice.
AB  - A knowledge-based system has been designed for evaluating the appropriateness of
      transfusion of non-red blood cell blood components. The goal of the system is to
      assist the blood bank physician in quality assurance efforts by automatically
      identifying cases of inappropriate transfusion before the blood is issued.
      Evaluation of a working prototype system shows that it is indeed capable of
      serving this function. The system identifies and summarizes cases, but it leaves
      consultation, education, and decision making to the blood bank physician. Small
      "expert systems" such as this may find use in quality assurance activities
      throughout the laboratory.

PMID- 2220685
TI  - An interview with Bill Meissner. Interview by Merle A. Legg.

PMID- 2220684
TI  - Overview of digital imaging in pathology. The fifth wave.
AB  - During the last decade, pathologists have witnessed dramatic advances in computer
      hardware and software technology. The major impact of these technologies has been
      in the management of text information. Significant benefits, however, lie in the
      manipulation and use of digital images of pathology specimens. Digital images may
      be analyzed to extract feature information, processed to enhance the visual
      image, archived to aid diagnostic efforts and education, or transmitted to
      facilitate communication between pathologists. These components can be integrated
      with information management systems to form the basis for a work-station for
      diagnostic pathology. Such technology will likely improve the productivity and
      diagnostic ability of pathologists in the coming years.

PMID- 2220686
TI  - Embedding expert systems in laboratory information systems.
AB  - Expert systems (ESs) may enhance decision making throughout most steps in the
      clinical laboratory testing process. By embedding ES capabilities in a laboratory
      information system (LIS), the LIS gains the capability of symbolic reasoning
      whereas the ES gains use of the LIS database and communications resources. Design
      considerations include modular integration, performing timely inferences, sparing
      LIS resources, and providing a syntax that facilitates knowledge base development
      and verification by laboratorians. The LIS notifies the ES of specimen status
      changes through an event log. An event scanner finds events that are relevant to
      prestored knowledge frames and passes this information to an inference processor
      through instance records. If conditions specified in the knowledge frames are
      satisfied, an alert processor sends a message to a CRT, printer, file, or report.
      Examples of applications during order entry, specimen distribution, processing,
      and results reporting are presented.

PMID- 2220688
TI  - Has evolution resulted in linear reduction of the jaw?

PMID- 2220687
TI  - A concern about facial esthetics.

PMID- 2220689
TI  - An American Board of Orthodontics case report.

PMID- 2220690
TI  - Trends in sterilization and disinfection procedures in orthodontic offices.
AB  - The present survey is a repetition of a 1987 survey examining the
      sterilization/disinfection procedures of Georgia's orthodontists. The purpose of
      this study is to examine the trends in orthodontic sterilization/disinfection
      procedures. Orthodontists in Georgia have dramatically changed their
      sterilization and disinfection procedures. The major changes represented are
      greater use of protective barrier wear by doctor and staff members; increased
      heat sterilization methods for instruments, pliers, and handpieces; and increased
      disinfection of alginate impressions.

PMID- 2220691
TI  - Coefficients of friction for arch wires in stainless steel and polycrystalline
      alumina bracket slots. I. The dry state.
AB  - The surface roughness and the coefficients of friction were measured for sixteen
      arch wire-bracket combinations. The sample included one rectangular arch wire
      product from each of the four principal alloy groups and one bracket product from
      among the stainless steel and polycrystalline alumina inventory. Although
      subsamples representing both the 0.018-inch and the 0.022-inch slot sizes were
      evaluated, no differences were observed in their rankings. When tested over a
      series of eight incident angles, the optical surface roughness of representative
      stainless steel and alumina brackets averaged 0.148 and 0.193 microns,
      respectively. After testing at a single angle (82 degree) and referencing a
      nomogram, the roughness of the stainless steel, cobalt-chromium, beta-titanium,
      and nickel-titanium arch wire surfaces averaged 0.053, 0.129, 0.137, and 0.247
      microns, respectively. When the various arch wire-bracket couples were pressed
      against an 0.010-inch stainless steel ligature wire at 34 degrees C and otherwise
      prevailing atmospheric conditions, the coefficients of friction ranged from
      stainless steel (lowest) to cobalt-chromium, nickel-titanium, and beta-titanium
      (highest)--regardless of bracket product or slot size. These results corroborated
      earlier observations in which the same arch wire products were drawn between
      stainless steel or alumina contact flats. In the current research, the average
      coefficient of kinetic friction for the stainless steel couple (0.139) was less
      than that for the stainless steel arch wire against a polycrystalline alumina
      bracket (0.174).

PMID- 2220692
TI  - Impact of orthognathic surgery on normal and abnormal personality dimensions: a 2
      year follow-up study of 61 patients.
AB  - The psychological adjustments and self-concepts of 61 orthognathic surgery
      patients were evaluated before surgery and at 1 month, 6 months, 1 year, and 2
      years after surgery. The impact of orthognathic surgery on self-concept and
      personality adjustment was assessed. Significant improvements in group scores
      were found with the use of a repeated measures ANOVA in the following subscales
      of personality disturbances: general maladjustment, psychosis, neurosis,
      personality disorder, and personality integration. A significantly positive
      effect was also observed in the following subscales of self-concept: self-esteem,
      self-satisfaction, self-identity, physical self, family self, social self, and
      total self-conflict. The improved changes in psychological profile two years
      after orthognathic surgery are encouraging.

PMID- 2220693
TI  - Use of cephalometry in diagnosing resonance disorders.
AB  - A comparative cephalometric study of the oronasopharyngeal dimensions was carried
      out on 20 patients with normal speech, 20 patients with nasality and 22 patients
      with cleft palate speech, with the help of cephalometric landmarks given by
      Proffit and McGlove, Proffit et al., and Ricketts. The data obtained were
      subjected to statistical analysis, to determine whether there were any
      significant changes in oronasopharyngeal dimension between the various groups. It
      was concluded from the obtained data that there was an increase in the width and
      depth of the nasopharynx, with a consequential increase in the pharyngeal cavity
      volume in patients with cleft palate speech when compared with patients who had
      normal speech and those who had nasality.

PMID- 2220694
TI  - Equilibrium situations in bend force systems.
AB  - This article provides a simple theoretical approach to the equilibrium situations
      encountered in biomechanics. Basic differences between the moment of a force and
      the moment of a couple are described. The concept of the center of resistance is
      defined and applied to the case of a force system (Rs). Three equilibrium
      situations are schematically described: the off-center V bend, the centered V
      bend, and the step bend. Two clinical examples are detailed (one from the Begg
      technique and one from the Ricketts technique) to demonstrate clinical
      applications of force in these three situations.

PMID- 2220695
TI  - Methods used to evaluate growth modification in Class II malocclusion.
AB  - The methods used to study growth modification in orthodontic patients can have
      considerable impact on the conclusions that may be drawn. Because of the large
      "between-patient" variation and small mean changes usually observed, apparent
      differences in response may sometimes be more attributable to study design than
      to treatment effectiveness. A systematic review of four major orthodontic
      journals (1980 to 1987) identified 50 studies reporting treatment of young
      patients with Class II malocclusion. Variables defined to classify the studies
      included appliance systems, patient selection, comparison groups, research
      design, data collection, analysis, and reporting. The appliance systems most
      frequently investigated were the function regulator and the activator, used with
      and without headgear. Only 11 (22%) studies were prospective, and random
      assignment to alternative treatments was never used in this sample. Comparison
      groups used in 76% of the studies were untreated Class II patients (n = 18)
      and/or patients with alternate appliance systems (n = 17). In only 24% of the
      reports were groups tested for pretreatment equivalence. Few studies reported
      fully how patients had been selected, how decisions had been made to discontinue
      or change treatment, or whether patients had been lost to study. While most
      studies reported "p values," in only four were alpha levels adjusted for the
      number of tests (type I error), and no study included a post beta estimate (type
      II error). Age, sex, maturation, and duration of treatment were usually reported
      but seldom adjusted for in the analyses. Given the multiple indices of treatment
      effect, the generally small sample sizes, weak research designs, and incomplete
      reporting of important data, we cannot yet conclude whether orthodontic treatment
      influences the growth of Class II patients.

PMID- 2220696
TI  - So, how much do orthodontists earn?
AB  - A review is carried out on available data from the American Dental Association,
      the Journal of Clinical Orthodontics, and various proprietary publications in an
      effort to obtain reliable information on orthodontists' income. The results of
      this study indicate that no definite determination can be made.

PMID- 2220697
TI  - Appointment in Mostaganem.

PMID- 2220698
TI  - The American Board of Orthodontics: milestones of progress.

PMID- 2220699
TI  - Legal aspects of orthodontic practice: risk management concepts. Excellent
      diagnostic informed consent practice and record keeping make a difference.
AB  - In this and succeeding issues of the American Journal of Orthodontics and
      Dentofacial Orthopedics, factual risk management scenarios will be presented.
      These scenarios are based on composites of actual court cases that have been
      tried to verdict or decision. Valuable risk management lessons may be learned
      from careful analysis of the course of the events described. Please be advised
      that the standard of care determined in any case is specific for that
      jurisdiction and that set of facts as established by expert testimony for the
      prevailing party. Readers' comments may be addressed to Dr. Donald E. Machen,
      5801 Beacon St., Pittsburgh, PA 15217.

PMID- 2220700
TI  - Wounding effects of the AK-47 rifle used by Patrick Purdy in the Stockton,
      California, schoolyard shooting of January 17, 1989.
AB  - The limited disruption produced in tissue simulant by the rifle and bullets used
      in the Stockton, California, schoolyard shooting is entirely consistent with the
      autopsy reports on the five children who died of their wounds. It is also
      entirely consistent with well-documented battlefield studies and with previous
      tissue-simulant studies from many laboratories. It is inconsistent with many
      exaggerated accounts of assault-rifle wounding effects described by the media in
      the aftermath of this incident. This information should be documented for the
      historical record. However, the critical reason for correcting the misconceptions
      produced by media reaction to this incident is to prevent inappropriate gunshot
      wound treatment.

PMID- 2220701
TI  - Identification of the driver in two-rider motorcycle accidents. Inguinal
      contusion-laceration as an indication of the driver.
AB  - In motorcycle accidents involving two riders, medicolegal identification of the
      driver is necessary when one or both riders die. It is particularly important in
      the latter case, because the survivor almost always insists that he or she was
      not driving. One characteristic injury that distinguishes the driver from the
      passenger is inguinal contusion-laceration (accompanied internally by pelvic
      fracture). This injury, caused by collision of the pelvis with the fuel tank,
      identifies the driver.

PMID- 2220702
TI  - Atlanto-occipital disarticulation. Accident characteristics.
AB  - A retrospective study of cases of atlanto-occipital disarticulation was conducted
      to describe incident characteristics: 24 cases were identified, including nine
      motor vehicle drivers, two passengers, seven pedestrians, and five motorcyclists;
      one other person had fallen four stories. The highest rates were found among
      motorcyclists and pedestrians. Atlanto-occipital disarticulations occur in high
      energy impacts and collisions and are associated with aortic laceration in 25%
      and basilar skull fracture in 21% of such cases. Current restraint systems and
      motorcycle helmets do not appear to prevent this generally rapidly fatal injury.

PMID- 2220703
TI  - Atherosclerotic cardiovascular disease and sudden deaths among young adults in
      Wayne County.
AB  - Based on postmortem records at the Wayne County Medical Examiners' Office from
      1982 to 1986, autopsy results indicated that the deaths of 129 persons aged 20-34
      resulted from heart disease: 51 of these deaths were attributed to
      atherosclerotic cardiovascular disease (ASCVD), 29 to hypertensive cardiovascular
      disease, 28 to cardiomyopathy, and 21 to other cardiac causes. The majority of
      the deaths due to ASCVD occurred among men, both black and white, followed by
      black women, and the incidence increased with age. All of these deaths due to
      ASCVD were sudden and accounted for all deaths due to ischemic heart disease in
      this age group among Wayne County residents. Diabetes mellitus, left ventricular
      hypertrophy, a history of seizures, and the recent ingestion of alcohol were all
      found to be associated with sudden death from ASCVD in this group. Obesity did
      not seem to be a significant factor. These data suggest that ASCVD is not rare as
      a cause of death in young adults and some of the risk factors identified in older
      subjects also operate in this age group.

PMID- 2220704
TI  - Heart weights of white men 20 to 39 years of age. An analysis of 218 autopsy
      cases.
AB  - Review of autopsy data for 218 white men between 20 and 39 years of age who died
      of injuries or suddenly and unexpectedly indicated a mean heart weight of 371 g.
      The mean for those dying of external causes was 364 g whereas the mean for those
      dying of natural causes was 446 g. A coefficient for heart weight expressed as a
      percentage of body weight was lower in heavy individuals than lightweight
      individuals; it ranged between 0.38% and 0.55%, with a mean of 0.48%. Heart
      weight, including epicardial fat, increased with age and body weight. These data
      may be useful to those who are called upon to investigate sudden and unexpected
      deaths.

PMID- 2220705
TI  - Sudden unexpected nocturnal death syndrome in the Mariana Islands.
AB  - Sudden unexpected nocturnal death syndrome (SUNDS) is a distinct clinical entity
      in previously healthy, young, Southeast Asian males. It is well known in the
      Philippines and more recently recognized in the U.S. by nonspecific autopsy
      findings, with no evidence of underlying disease and absence of toxic drug or
      alcohol levels. In 1973-89, 14 cases of apparent SUNDS came to coroner's autopsy
      in the Commonwealth of the Northern Marianas (CNMI) and Guam. All 14 cases, with
      the exception of one Yapese, were previously healthy, male Filipinos, aged 23 to
      55, who were either found dead in bed, or described by their colleagues as having
      nocturnal seizure activity consisting of gurgling, frothing, and tongue biting
      immediately prior to death. Autopsy findings showed no anatomic findings to
      account for death. Comprehensive serum and urine drug analyses were negative. All
      decedents showed absence of significant atherosclerosis or grossly detectable
      structural cardiac anomaly, while four showed cardiomegaly. Migrants from
      Southeast Asia carry with them a pre-disposition to this syndrome, which appears
      to decline with longer residence in the new country. The mechanism of death in
      SUNDS is believed to be ventricular fibrillation, possibly precipitated by sudden
      sympathetic discharge. Studies suggest at least some deaths may be associated
      with an abnormal cardiac conduction system. Acute pancreatitis has been a finding
      in some series, but not our cases. Why the condition is virtually limited to
      males and seemingly sleep-triggered, has not been adequately explained. Stress
      and depression are believed to be predisposing factors.

PMID- 2220706
TI  - Fatal big cat attacks.
AB  - Two cases of fatal attacks by large cats are presented. In the first case, a 30
      year-old female zoo worker was attacked by a jaguar that had escaped its cage. In
      the second case, a 2-year-old girl was fatally injured by her father's pet
      leopard. The pattern of injuries in these cases is nearly identical to those of
      these cats' prey in the wild.

PMID- 2220707
TI  - Cardiac conducting tissue. A simplified technique for examination of the SA and
      AV nodes.
AB  - We describe a modified method for examination of the atrioventricular and
      sinoatrial nodes that displays the major elements of the cardiac conducting
      system, yet is not time-consuming for the technician. We examined 31 cases in
      three categories: cases with previous cardiac history, sudden deaths from no
      known cause, and cases where death was sudden and accidental. All cases showed
      histologic abnormalities in the cardiac tissue. We contend that our method would
      permit such examination to be routinely used in the pathology laboratory.

PMID- 2220708
TI  - Arsenic poisoning: acute or chronic? Suicide or murder?
AB  - The case of the death by arsenic poisoning of a 62-year-old white man is
      presented. One year prior to death, he developed intermittent bouts of severe
      gastroenteritis with vomiting and diarrhea, hyperpigmentation and keratosis of
      the skin, neutropenia, and Guillain-Barre-like neuropathy for which he was
      hospitalized several times. Urine test results 6 months prior to death indicating
      36 mg/L arsenic were believed to be in error. At the patient's last admission, he
      appeared in the emergency room with severe gastroenteritis, hypotension, and
      dehydration. He died 3 days later. Antemortem as well as autopsy specimens
      revealed elevated arsenic concentrations. Arsenic micrograms/g analysis by
      neutron activation of hair pulled from the man's head revealed by centimeter
      segmental analysis proximal to distal: 226, 104, 28, 56, 41, 40, and 74. The wife
      of the decedent was charged with murder by arsenic poisoning of this, her fifth,
      husband. The defense alleged that the decedent had committed suicide. The judge
      awarded a directed verdict of "not guilty." Particulars of the medical,
      toxicological, and investigative findings are presented.

PMID- 2220709
TI  - Can dentists recognize their own work? The forensic implications.
AB  - After 10 months, 71.4% of a group of dental students were able to recognize
      amalgam restorations that they had placed in the mouths of manikins. After 24
      months, 57.1% of the group were able to recognize their work again. In contrast,
      only 5.5% of a second group of students, who did not have the interim viewing at
      10 months, could recognize their work at 24 months. These results suggest that,
      with time, dental operators lose the ability to recognize their work but that
      this ability is prolonged by interim observations of the work. This study
      underscores the need for dentists to chart and record accurately any artifacts
      introduced into the patient's mouth, as well as any features that would make the
      patient unique upon forensic examination.

PMID- 2220710
TI  - Accidental death from a black-powder rifle breech plug.
AB  - Authentic black-powder muzzle-loader weapons and replicas are used today
      primarily for hunting game such as deer and hogs. The following is a case
      presentation of accidental death from cerebral trauma caused by a .45-caliber
      black-powder-rifle breech plug implanting in the victim's brain.

PMID- 2220711
TI  - Path of bullet and injuries determined by radiography.
AB  - Radiography is commonly used to find bullet pathways in forensic pathology. In
      the case presented here, a man had sustained multiple gunshot wounds and one
      bullet could not be traced. A radiograph was used to find the bullet and showed
      an interesting bullet pathway. By observing the bullet pathway on a radiograph,
      sometimes we can surmise the victim's body posture at the time of an incident.

PMID- 2220712
TI  - Identification of the driver in an automobile collision.
AB  - We report on a three-occupant automobile collision in which one of the two
      survivors claimed that the deceased had operated the vehicle. We attempted to
      identify the driver. The left face and neck of the deceased appeared to have
      struck the vehicle's interior. The survivors were slightly injured on the right
      side of their faces. In Japan, the passenger side is on the left, and in this
      case, the right side of the vehicle had been damaged. By comparing the injuries
      of the deceased and the survivors in relation to the vehicle damages, we
      concluded that the deceased occupant had probably been a passenger, not the
      driver.

PMID- 2220713
TI  - Fatal high cervical spinal cord injury in an automobile accident complicating os
      odontoideum.
AB  - We report a case where spinal instability from incomplete fusion of the dens of
      C2 (os odontoideum) allowed anterior displacement of the skull and first cervical
      vertebra following right frontal impact against the A pillar in an automobile
      accident. Resultant crushing and laceration of the spinal cord occurred at the
      level of C1 and C2. Without either radiographic investigation or detailed
      examination of the spine, the fatal injury might have been overlooked and death
      attributed to acute alcoholic poisoning because the blood alcohol level was
      .613%.

PMID- 2220714
TI  - Thymic hyperplasia. A clue to the diagnosis of hyperthyroidism.
AB  - The association of simultaneous abnormalities of the thyroid and thymus is well
      documented, particularly in the case of Graves' disease. We present a case of a
      natural death following thyroid storm in which marked thymic hyperplasia was
      present. This finding can be helpful in determining the cause of death.

PMID- 2220715
TI  - Sudden death due to right ventricular cardiomyopathy.
AB  - A 21-year-old man died suddenly at a small party. He had had no clinical signs of
      cardiac disease except for a slightly abnormal electrocardiogram (occasional
      premature ventricular contractions) since he was 15 years of age. Autopsy
      examination revealed cardiomegaly (469 g), with right atrial and ventricular
      dilatation. The right ventricular myocardium was massively replaced with adipose
      tissue, and there was one isolated fatty lesion in the right side of the
      ventricular septum. There were no congenital malformations such as a septal
      defect or valvular deformity. Histologically, muscular fibers remaining in the
      right ventricular wall showed neither degenerative nor inflammatory changes. An
      isolated lesion of the ventricular septum consisted of almost complete
      replacement of the muscle bundles with adipose tissue. Such a pathologic
      condition has recently been termed right ventricular cardiomyopathy. Postmortem
      examination is necessary to make a definite diagnosis of the disease, because in
      most adult cases of the disease, sudden death occurs before there have been any
      critical signs.

PMID- 2220716
TI  - Forensic medicine in Hong Kong. A personal view.

PMID- 2220717
TI  - Medical examiner office management using the personal computer. The Fulton County
      experience.

PMID- 2220718
TI  - Sudden death due to delayed rupture of hepatic subcapsular hematoma following
      blunt abdominal trauma.
AB  - Blunt abdominal trauma can cause sudden, unexpected death due to injuries to
      internal organs. Rupture of a hepatic subcapsular hematoma is a relatively rare
      cause of sudden death following minor blunt abdominal trauma. Death may be
      delayed several days to weeks. The autopsy is an invaluable diagnostic tool that
      can be utilized to uncover sudden deaths due to abdominal trauma. The case of an
      alcoholic who died of a ruptured hepatic subcapsular hematoma is presented. The
      death investigation revealed that the victim had sustained blunt abdominal trauma
      during a fall a few days prior to death.

PMID- 2220719
TI  - Clinical significance of colonic fermentation.
AB  - Recent evidence of the potential benefits of short chain fatty acids has prompted
      renewed interest in the area of human colonic fermentation. This paper reviews
      the clinical and metabolic consequences of colonic fermentation.

PMID- 2220720
TI  - Is brief arterial oxygen desaturation during endoscopy dangerous?

PMID- 2220721
TI  - Arterial oxygen desaturation during gastrointestinal endoscopy.
AB  - This prospective study evaluated the incidence and severity of arterial oxygen
      desaturation during gastrointestinal endoscopy. Following pulmonary function
      testing, 115 male patients underwent esophagogastroduodenoscopy (EGD),
      colonoscopy, or colonoscopy followed by EGD, with continuous recording of
      arterial oxygen saturation (SaO2). Most patients (80/115, 70%) showed arterial
      oxygen desaturation (greater than 4% decrease from baseline SaO2); severe
      arterial oxygen desaturation (SaO2 less than or equal to 85%) reflecting
      hypoxemia (PaO2 less than or equal to 50 mm Hg) was noted in one-third of
      patients overall (37/115, 32%). Severe arterial oxygen desaturation occurred in
      9/62 EGD patients (15%), 23/46 colonoscopy patients (50%), and 4/7 patients
      having colonoscopy followed by EGD (57%). Arterial oxygen desaturation occurs
      frequently during gastrointestinal endoscopy and is often severe. These data
      support the concept that continuous monitoring of SaO2 should be standard
      procedure during all gastrointestinal endoscopic procedures.

PMID- 2220722
TI  - Prospective randomized comparison of Brown-McHardy and microvasive balloon
      dilators in treatment of achalasia.
AB  - We report the results of a randomized prospective study comparing a standard
      bougie rubber balloon dilator [Brown-McHardy (BMH)] and a newer polyethylene
      dilator passed over a guide wire [Microvasive Rigiflex (MVR)]. Twenty achalasia
      patients (15M, 5F, mean age 45.4 yr) considered candidates for either dilator
      were randomized. Symptom assessment, body weight, and upright radionuclide solid
      esophageal emptying study were measured before and 6 months after pneumatic
      dilatation. All dilatations were performed by one of three experienced
      gastroenterologists under fluoroscopic guidance. Overall success occurred with
      10/10 BMH and 7/10 MVR. One patient not improved with MVR had myotomy; the other
      two were successfully treated by BMH. No complications occurred with either
      dilator.

PMID- 2220723
TI  - Features distinguishing secondary achalasia from primary achalasia.
AB  - Eighteen patients with cancer-induced or secondary achalasia (SA) were compared
      to 421 patients with idiopathic or primary achalasia (PA). The aim of the study
      was to detect any differences in clinical presentation between the two groups.
      Mean age of patients with SA was 57.1 (range 15-78) and 47.1 (range 1-90) in
      patients with PA (p = 0.02). Three patients with SA were 15, 24, and 36 yr old,
      respectively. Symptom frequency was comparable in SA versus PA. Mean duration of
      symptoms in SA was 4.5 months, with 15 of the 18 patients experiencing symptoms
      for six months or less. Weight loss occurred in 88.2% of patients with SA and
      57.3% of patients with PA (p less than 0.05). Cancer was at the gastroesophageal
      junction in 16 patients, duodenum in one, and breast in one. Endoscopy showed
      tumor in 12 (67%). The esophagram was suspicious for tumor in only 25%. We
      conclude that patients with SA are older, more likely to lose weight, and have a
      short duration of symptoms. However, SA may occur in younger patients, and
      endoscopy with biopsy is necessary in any newly diagnosed case of achalasia.

PMID- 2220724
TI  - Healing or amelioration of esophagitis does not result in increased lower
      esophageal sphincter or esophageal contractile pressure.
AB  - There is conflicting evidence regarding whether lower esophageal sphincter and
      esophageal contractile pressures are affected by changes in the severity of
      gastroesophageal reflux disease. We compared the manometric and endoscopic
      findings from 30 patients before and after treatment for esophagitis. Before
      treatment, the grade of esophagitis (I-III) was significantly correlated (r = 
      0.37; p less than 0.05) with lower esophageal sphincter pressure, but not with
      esophageal contractile pressure. After treatment, the grade of esophagitis did
      not change or became worse in 15 patients, and became better in 15 patients. Of
      these, seven healed. The group that showed no endoscopic improvement demonstrated
      no change in lower esophageal sphincter or esophageal contractile pressures. The
      group that did show endoscopic improvement also demonstrated no increase in lower
      esophageal sphincter or esophageal contractile pressures, and this was
      particularly evident in those whose esophagitis healed. These data suggest that
      healing of esophagitis does not result in improvement of esophageal motor
      function.

PMID- 2220725
TI  - Sucralfate used as adjunctive therapy in patients with severe erosive peptic
      esophagitis resulting from gastroesophageal reflux.
AB  - A total of 36 patients with grade 2 or greater erosive esophagitis and an
      abnormal 24-h pH monitor study, were treated in a randomized, double-blind
      fashion to assess the efficacy of sucralfate suspension as adjunctive therapy to
      cimetidine for severe esophagitis secondary to gastroesophageal reflux. Treatment
      consisted of cimetidine, 300 mg qid and either sucralfate suspension (1 g/10 ml)
      or an identical placebo suspension, 10 ml after meals and 20 ml hs. Patients were
      treated for 12 wk unless endoscopic healing occurred earlier. Initial evaluation
      and monthly follow-up consisted of symptom monitoring, endoscopic evaluation and
      pre- and post-therapy esophageal manometry, Bernstein test, and 24-h pH
      monitoring. The combination of cimetidine and sucralfate suspension was superior
      to cimetidine alone in improving daytime heartburn symptoms (p less than 0.05)
      but not nighttime heartburn, dysphagia, or regurgitation. Sucralfate plus
      cimetidine improved the overall endoscopic outcome of esophagitis more than
      cimetidine alone (p less than 0.05). More patients exhibited endoscopic healing
      in the adjunctive sucralfate group than in the cimetidine-only group. Endoscopic
      healing, however, was not statistically different between groups. We conclude
      that sucralfate used as adjunctive therapy to cimetidine resulted in improvement
      of some of the symptoms of reflux, and probably increases the likelihood of
      complete healing of esophagitis, compared with cimetidine alone.

PMID- 2220726
TI  - Comparison of coffee intake and coffee-induced symptoms in patients with duodenal
      ulcer, nonulcer dyspepsia, and normal controls.
AB  - Coffee and decaffeinated coffee stimulate acid secretion. In addition, many
      patients experience dyspepsia after coffee ingestion. Therefore, coffee is often
      prohibited by physicians in patients with peptic diseases. However, the
      association between peptic disease and symptoms remains unclear. This study
      compares coffee intake and the induction of symptoms by coffee in patients with
      duodenal ulcer disease, nonulcer dyspepsia, and normal controls. We have studied
      the coffee drinking habits of 58 duodenal ulcer patients, 55 nonulcer dyspepsia
      patients, and 55 normal controls. The use of coffee on a daily basis was not
      significantly different between duodenal ulcer patients (64%) and controls (56%),
      or between nonulcer dyspepsia patients (55%) and controls. There was also no
      difference between the three groups in the use of decaffeinated coffee, the
      number of cups per day, the method of preparation, the length of time of coffee
      use, or any change in coffee intake in the previous year. The intake of tea,
      caffeinated carbonated beverages, and aspirin or nonsteroidal anti-inflammatory
      drugs was also similar in the three groups. The duodenal ulcer patients were more
      likely to be cigarette smokers (45%) than either the controls (16%) or the
      nonulcer dyspepsia patients (24%). Daily alcohol intake was not significantly
      different in the three groups. The prevalence of coffee induction of dyspeptic
      symptoms was similar in duodenal ulcer patients (29%) and controls (22%), but was
      much more common in nonulcer dyspepsia patients (53%) than in controls (22%), p =
      0.0036. In conclusion, there was no difference in coffee intake between patients
      with duodenal ulcer, nonulcer dyspepsia, or normal controls. However, patients
      with nonulcer dyspepsia, but not duodenal ulcer, were more likely to experience
      dyspeptic symptoms after coffee ingestion.

PMID- 2220727
TI  - Duodenal ulcer hemorrhage with and without dyspepsia.
AB  - To clarify the clinical significance of dyspepsia in patients with bleeding
      duodenal ulcer, we studied 298 patients prospectively. Ages of patients ranged
      from 16 to 81 yr (mean 45.9). There were 244 (82%) dyspeptic and 54 (18%)
      nondyspeptic patients. In the dyspeptic group, significantly more patients were
      taking nonsteroidal anti-inflammatory drugs. In the nondyspeptic group, there was
      a higher percentage of patients with duodenal bulb deformity (p less than 0.005),
      which deformity was related to previous peptic ulcer disease. The age, sex, past
      history of dyspepsia or bleeding, consumption of alcohol and cigarettes, and the
      hospital course of the two groups of patients did not differ significantly. Our
      results show that the clinical course of duodenal ulcer hemorrhage is not
      significantly different in patients with or without dyspepsia, and indicate that
      bleeding and dyspepsia probably are two independent presentations in the natural
      course of the disease. The significance of the correlation between dyspepsia and
      duodenal bulb deformity is discussed.

PMID- 2220728
TI  - Liver pathology in morbidly obese patients with and without diabetes.
AB  - The contribution of obesity and/or diabetes to liver pathology in the morbidly
      obese patient is controversial. We studied the liver biopsies of 100 consecutive
      patients undergoing gastric bypass surgery for morbid obesity. Multiple
      morphologic parameters were analyzed and graded independently, without knowledge
      of the clinical history, liver function tests, and oral glucose tolerance results
      of the patients. Six percent of the entire group demonstrated no fat, 42% mild
      fat, 20% moderate fat, and 24% severe fatty metamorphosis of the liver. Twenty
      three percent of the patients had central vein fibrosis, 23% sinusoidal fibrosis,
      19% bridging fibrosis, and 4% cirrhosis. Thirty-six percent of the patients had
      some degree of steatohepatitis, 66% possessed so-called glycogen nuclei of
      hepatocytes, 6% had PAS-positive thickening of blood vessels in the portal
      tracts, and 1% had lipogranulomas. The degree of fatty metamorphosis and fibrosis
      was analyzed in three separate groups, categorized by the glycemic status of the
      patient: 46 patients with normal glucose tolerance (NGT), 23 patients with
      impaired glucose tolerance (IGT), and 31 patients with non-insulin-dependent
      diabetes mellitus (NIDDM). Increasing severity of fatty metamorphosis from the
      normoglycemic obese to the diabetic obese patients was found, which was
      statistically significant by chi 2 analysis. Four of the six patients showing no
      fatty metamorphosis were normoglycemic. Glycogen nuclei and PAS-positive blood
      vessels were significantly more prevalent in the diabetic obese than in the
      normal obese. In conclusion, the distribution of significant liver histopathology
      in the morbidly obese patient correlates in severity with the degree of impaired
      glycemic status.

PMID- 2220730
TI  - Percutaneous transhepatic cholecystostomy for acute complicated cholecystitis in
      elderly patients.
AB  - We report our experience with percutaneous transhepatic cholecystostomy in 10
      elderly patients with acute cholecystitis, complicated by empyema formation. Most
      of these patients has severe underlying disease, rendering them at high risk for
      surgical intervention. In all patients, the percutaneous procedure was followed
      by a rapid regression of clinical symptoms and of radiologic abnormalities. Six
      were considered inoperable. Three of these remain free of biliary symptoms,
      respectively 22, 10, and 7 months after percutaneous cholecystostomy. Three
      others died of nonbiliary disease 1-4 months after cholecystostomy. Three
      patients underwent successful elective cholecystostomy 1-5 wk after percutaneous
      cholecystostomy. In one patient, cholecystectomy had to be performed because of
      recurrence of hydrops, 1 wk after catheter removal. In our opinion, percutaneous
      transhepatic cholecystostomy is a safe and effective procedure in the treatment
      of elderly patients with acute complicated cholecystitis. It can be followed by
      elective cholecystectomy in good surgical candidates, or by an expectant
      conservative management in high surgical risk patients.

PMID- 2220729
TI  - Factors influencing the development of metabolic bone disease in primary biliary
      cirrhosis.
AB  - The prevalence, type, and factors that may influence the development of bone
      disease in primary biliary cirrhosis, have been investigated in 20 consecutive
      patients, who, in addition to liver function tests and mineral and vitamin D
      metabolism studies, were submitted to a transiliac bone biopsy after tetracycline
      double-labeling for quantitative histomorphometric examination. Intestinal
      calcium absorption was also assessed in 16 patients. Seven patients (35%) had
      reduced bone volume and were considered osteoporotic. Three also had bone
      mineralization impairment, but did not have criteria for osteomalacia. Bone
      formation was depressed in 15 patients, and bone resorption was low or normal in
      19 cases. Eroded surfaces were reduced in all osteoporotic patients. Duration of
      primary biliary cirrhosis was significantly longer in patients with osteoporosis
      (6.3 +/- 0.6 yr) than in those without osteoporosis (2.6 +/- 0.6, p = 0.004).
      Moreover, osteoporosis was more prevalent in postmenopausal women, and in those
      who had intestinal calcium malabsorption, which was present in 80% of
      osteoporotic patients but in only 18% of nonosteoporotic patients (p = 0.03).
      Osteoporosis and mineralization bone impairment were unrelated to the severity of
      cholestasis. 25-Hydroxyvitamin D was significantly lower in those patients with
      intestinal calcium malabsorption. The results of this study indicate that
      osteodystrophy in primary biliary cirrhosis is characterized mainly by "low
      turnover" osteoporosis, which is related to the duration of the liver disease,
      postmenopausal condition, and calcium malabsorption.

PMID- 2220732
TI  - Comparison of a new immunoassay for determining serum pancreatic isoamylase with
      two standard techniques.
AB  - A method has recently been developed for measuring serum pancreatic (P)
      isoamylase, using two monoclonal antibodies specific for salivary isoamylase. We
      performed this test on 67 healthy controls and 133 patients: 15 with acute
      pancreatitis, 53 with chronic pancreatitis (20 during painful relapse and 33 in
      clinical remission), 18 with pancreatic cancer, 41 with nonpancreatic disease
      with abdominal pain, five with macroamylasemia, and one with total
      pancreatectomy. Results were compared with those of a wheat germ inhibition
      method and with electrophoresis on cellulose acetate. A close correlation was
      found between the results of immunoinhibition assay and those of the other two
      tests. All patients with acute pancreatitis had abnormally high values in all
      three tests. In the group with chronic pancreatitis studied during painful
      relapse, 16 had an increase in P-isoamylase, as determined with the
      immunoinhibition assay, 13 with the wheat germ inhibition test, and 15 with
      electrophoresis. In the group with chronic pancreatitis in clinical remission, we
      found low values in one patient, by immunoinhibition assay, but found low values
      in 17 and 19 patients by wheat germ inhibition and electrophoresis, respectively.
      Low P-isoamylase values corresponded to a severe exocrine pancreatic
      insufficiency. In the group with pancreatic cancer, the three tests showed
      similar results, and the majority of the patients had normal values. In the
      patients with nonpancreatic diseases, abnormally high levels were found in five,
      by immunoassay, in four by electrophoresis, and in three by the wheat germ
      inhibition method. In the five cases with macroamylasemia, both inhibition assays
      erroneously demonstrated an abnormal P-isoamylase elevation. The results show
      that the three tests are equally useful for the diagnosis of acute pancreatitis,
      or chronic pancreatitis during an acute relapse. In these diseases, the
      immunoinhibition test would be the preferred assay because it is simple and
      rapidly performed.

PMID- 2220731
TI  - Comparative studies of DU-PAN-2, carcinoembryonic antigen, and CA19-9 in the
      serum and bile of patients with pancreatic and biliary tract diseases: evaluation
      of the influence of obstructive jaundice.
AB  - The levels of DU-PAN-2 antigen, carcinoembryonic antigen, and CA19-9 in serum and
      bile of patients with pancreatic and biliary tract diseases were measured. The
      sensitivities (true positive) of DU-PAN-2 in serum to pancreatic carcinoma (64%)
      and to biliary tract carcinoma (62%) were similar to those of CA19-9 in serum
      (69% and 72%, respectively). Nine of 18 (50%) patients with CA19-9-negative
      pancreatic carcinoma tested positive for DU-PAN-2. The sensitivities of CEA to
      pancreatic carcinoma (56%) and to biliary tract carcinoma (52%) were lowest. The
      measurement of these antigens in bile seemed to be of little diagnostic value in
      differentiating between malignant and benign diseases. False positives of these
      three assays occurred frequently in patients with benign pancreatic or biliary
      tract disease coupled with obstructive jaundice. After percutaneous transhepatic
      biliary drainage, serum DU-PAN-2 and CA19-9 levels returned to normal ranges in
      patients with benign diseases, but not in patients with carcinoma of the pancreas
      or of the biliary tract. Serum CA19-9 and DU-PAN-2 antigens are useful tumor
      markers for pancreatic and biliary tract carcinomas. Longitudinal assays of these
      antigens may be useful for the differential diagnosis of patients with
      obstructive jaundice.

PMID- 2220733
TI  - In vivo evaluation of monopolar versus bipolar electrosurgical polypectomy
      snares.
AB  - The energy required and tissue damage in bipolar and monopolar polypectomy snares
      were compared in a canine model. The bipolar snare required an average of 34
      joules of energy, whereas the monopolar snare required 228 joules to cut the same
      diameter of gastric mucosa tended into a polypoid structure (p = 0.0005). The
      reduced energy delivered to the tissue from the bipolar procedure resulted in
      only 32% average depth of damage to the underlying gastric wall, whereas the
      monopolar procedure caused an average 69% (p = 0.001). Surgically created polyps
      required 247 joules and 69 joules for corresponding monopolar and bipolar
      polypectomy (p = 0.001). The decreased energy required and the correspondingly
      reduced damage caused to the underlying bowel wall by the bipolar snare should
      reduce the incidence of perforation and post-polypectomy syndrome. The bipolar
      snare completes a local circuit about the snare, eliminating the return electrode
      and, consequently, the possibility of any return electrode burns. The bipolar
      snare thus provides an added safety margin during polypectomy.

PMID- 2220734
TI  - Endoscopic ultrasonography in staging rectal cancer.
AB  - Endoscopic ultrasonography (EUS) was used to stage rectal cancer by assessing
      depth of invasion through bowel wall layers and/or involvement of lymph nodes.
      EUS findings were correlated with histopathologic findings to discern the
      usefulness of this modality in predicting which patients could be candidates for
      sphinctersaving procedures and the avoidance of abdominoperineal resection. The
      Olympus EU-M3 endoscopic ultrasound system was used to assess depth of
      penetration through rectal wall layers and to identify lymph nodes. Comparison of
      EUS findings to histopathologic findings was possible in 13 patients. EUS agreed
      with histopathology in 9 of 13 cases (69.3%) ( p = 0.07, kappa statistic). EUS
      agreed with histopathology as the presence or absence of lymph nodes in 9 of 13
      cases (69.3%) (p = 0.07). However, the presence of lymph nodes could not
      necessarily predict metastatic involvement of these nodes. In one patient,
      invasion of vaginal cuff was correctly predicted. In nine cases, computed
      tomographic analysis (CT) was available for comparison to EUS in detection of
      penetration beyond the bowel wall. CT agreed with histopathology in 3 of 9 (33%),
      whereas EUS agreed with histopathology in 7 of 9 (78%).

PMID- 2220736
TI  - Protein-losing enteropathy in systemic lupus erythematosus associated with
      intestinal lymphangiectasia.
AB  - This case report concerns a young woman with systemic lupus erythematosus who
      presented with a protein-losing enteropathy. Intestinal biopsy revealed
      lymphangiectasia. Mesenteric lymph nodes showed paracortical lymphoid depletion
      and multiple small sinusoids. Elevated cholesterol levels and normal lymphocyte
      counts characterized the peripheral blood samples. Lymph nodes, though enlarged,
      showed no evidence of obstructive pathology. No secondary cause of
      lymphangiectasia could be identified. The patient exhibited antinuclear
      antibodies and antibodies to dsDNA at the onset, and then, 5 yr later, the
      classic features of systemic lupus erythematosus (SLE). The lymphocytopenia and
      hypolipidemia that characterizes lymphangiectasia is not a feature of the SLE
      cases reported to date. Furthermore, the mechanism for the dilated lymphatics and
      villous edema is more likely immunological than mechanical disruption of
      lymphatics.

PMID- 2220735
TI  - Hyperplastic gastric polyps associated with persistent Helicobacter pylori
      infection and active gastritis.
AB  - We report two cases of patients with 3-yr histories of upper gastrointestinal
      symptoms, hyperplastic gastric polyps, and active chronic gastritis. Biopsies
      retrospectively stained with Giemsa revealed the persistent presence of
      Helicobacter pylori (HP) in gastric biopsies of both patients throughout the 3
      yr. After treatment with amoxicillin and bismuth subsalicylate, both became
      asymptomatic, one demonstrating disappearance and recurrence of the gastric
      polyps in conjunction with the HP. These cases demonstrate 3 yr of hyperplastic
      gastric polyps associated with HP and active gastritis.

PMID- 2220737
TI  - Gallbladder carcinoma producing human chorionic gonadotropin.
AB  - A primary carcinoma of the gallbladder producing human chorionic gonadotropin
      (HCG) was encountered in an 83-yr-old Japanese woman, with elevation of HCG/beta
      HCG in urine and serum. Remarkable elevation of serum estradiol was an associated
      finding, with increased HCG. At autopsy, we found that the primary carcinoma of
      the gallbladder extensively involved the liver. Histologically, the tumor
      revealed adenosquamous cell carcinoma in the primary site, and moderately to
      poorly differentiated adenocarcinoma in metastatic foci. Immunohistochemical
      staining for beta-HCG showed a positive reaction in adenocarcinoma components.
      This is an extremely rare case of an HCG-producing gallbladder carcinoma, which
      leads us to speculate that HCG-positive tumor cells may occur due to
      dedifferentiation.

PMID- 2220738
TI  - Isolated ventral pancreatitis in a patient with pancreas divisum.
AB  - A previously healthy 22-yr-old woman was found to have chronic pancreatitis
      restricted to the ventral pancreas in association with pancreas divisum. When
      conservative treatment failed, sphincteroplasty of both papillae was performed
      with good results. This well-documented case represents a clear exception to the
      commonly held concept that obstruction of the dorsal duct is the essential
      pathogenic factor in the development of pancreatitis associated with pancreas
      divisum. The importance of visualizing both the dorsal and ventral pancreatic
      ducts to direct therapy for patients with idiopathic pancreatitis is discussed.
      Theories of the pathogenesis of concomitant pancreatitis and pancreas divisum are
      reviewed.

PMID- 2220739
TI  - Hepatic giant cavernous hemangioma with microangiopathic hemolytic anemia and
      consumption coagulopathy.
AB  - We describe a case of hepatic giant cavernous hemangioma with both
      microangiopathic hemolytic anemia (MAHA) and consumption coagulopathy, but
      without thrombocytopenia, which was completely cured by surgical resection of the
      tumor. The patient was a 54-yr-old Japanese woman whose chief complaint was right
      upper abdominal discomfort. Angiography and dynamic computed tomography revealed
      typical findings of hepatic cavernous hemangioma. The patient also had
      hematological disorders. At surgery, we performed an atypical right lobectomy to
      preserve as much normal liver tissue as possible. The patient has been well, with
      no related complaints or abnormal laboratory findings, 5 yr since her operation.
      This case indicates that giant cavernous hemangioma of the liver should be
      considered in the differential diagnosis of MAHA, and if surgical treatment is
      adequate, hematological abnormalities may be eliminated.

PMID- 2220740
TI  - Exacerbation of chronic active hepatitis type B after short-term corticosteroid
      therapy resulting in fatal liver failure.
AB  - The case of a 36-yr-old male with chronic active type B hepatitis in whom 4-wk
      prednisone therapy resulted in prolonged and fatal exacerbation of liver disease
      is described. Thus, short-term corticosteroid therapy may in some patients have
      disastrous effects on the course of chronic active hepatitis B.

PMID- 2220741
TI  - Toxoplasmic chorioretinitis and hepatic granulomas.
AB  - A 71-yr-old male presented with a 2-month history of fever, malaise, and weight
      loss. Physical exam revealed chorioretinitis. Laboratory studies were notable for
      elevated levels of alkaline phosphatase, gamma-glutamyl transpeptidase, aspartate
      transaminase, and alanine transaminase. Immunoglobulin G antibody to Toxoplasma
      gondii was positive to a dilution of 1:4096, whereas serologic studies for
      hepatitis A virus, hepatitis B virus, cytomegalovirus, Epstein-Barr virus, human
      immunodeficiency virus, Brucella, and Tularemia were negative. A percutaneous
      biopsy of the liver revealed hepatic granulomas. Culture of the biopsy specimen
      was negative for growth of mycobacteria or fungi. Spontaneous improvement in
      clinical and laboratory parameters occurred over a 4-month period.

PMID- 2220742
TI  - Disseminated, nonmeningeal gastrointestinal cryptococcal infection in an HIV
      negative patient.
AB  - Gastrointestinal cryptococcosis is extremely rare, especially in patients with no
      involvement of the central nervous system. We describe a 63-yr-old man undergoing
      prednisone therapy for chronic hepatitis and cirrhosis who presented with
      peritonitis, colitis, and skin lesions. Pathological studies revealed necrosis
      and numerous cryptococcal organisms in the colon, omentum, and skin, and cultures
      yielded Cryptococcus neoformans. The patient died of multisystem organ failure
      following emergency exploratory surgery performed when he had onset of symptoms
      of a bowel perforation after an endoscopic biopsy. Clinicians should be aware
      that gastrointestinal cryptococcosis can occur in the absence of infection of the
      central nervous system or lungs, and that it may affect relatively healthy
      patients who are immunocompromised because of splenectomy, chronic liver disease,
      or steroid therapy.

PMID- 2220743
TI  - Prognosis in acute pancreatitis: an alternative to Ranson's criteria.

PMID- 2220744
TI  - Predictors of variceal bleeding: solving the puzzle.

PMID- 2220745
TI  - Chronic pancreatic pain: cut for cure?

PMID- 2220746
TI  - Onions and dyspepsia.

PMID- 2220747
TI  - Pneumatosis cystoides intestinalis after cardiac transplantation: report of three
      cases.

PMID- 2220748
TI  - Gastric carcinoma presented as cardiac tamponade.

PMID- 2220749
TI  - Endoscopic diagnosis of esophageal tuberculosis.

PMID- 2220750
TI  - Nocardia brasiliensis peritonitis in a patient with AIDS.

PMID- 2220751
TI  - Colonoscopic identification of "Crohn's carcinoma" of the ileum.

PMID- 2220752
TI  - Intravascular hemolysis following endoscopic variceal sclerotherapy.

PMID- 2220753
TI  - Disaccharidases in duodenal biopsies in Helicobacter pylori-positive patients.

PMID- 2220754
TI  - Incipient papillary cystic tumor of the pancreas.

PMID- 2220755
TI  - Acute abdomen in drug addicts: think of blunt trauma.

PMID- 2220756
TI  - Platelet derived growth factor messenger RNA is increased in bone marrow
      megakaryocytes in patients with myeloproliferative disorders.
AB  - Platelet derived growth factor (PDGF) has been suggested to play an important
      role in the pathogenesis of myelofibrosis, which often occurs in patients with
      myeloproliferative disorders (MPD). We examined the expression level of PDGF mRNA
      in bone marrow megakaryocytes from 13 MPD patients by in situ hybridization,
      using cDNA probes for both human PDGF A chain and B chain (c-sis). The mRNA level
      for both chains in the patients was significantly higher than that in control
      patients, and was markedly higher for one patient with essential thrombocythemia
      and one with polycythemia vera. Transcripts for A chain and B chain were
      expressed with a positive correlation in the MPD patients. Using the marrow
      fibroblast proliferation assay, we found PDGF activity in purified megakaryocytes
      from one of the MPD patients with high mRNA level to be similar to that from one
      control patient. In addition, PDGF was previously shown to be decreased in
      circulating platelets from MPD patients. These results may suggest that, in some
      patients, PDGF is synthesized in megakaryocytes at a high rate, but some fraction
      is released into the bone marrow environment, if the level of PDGF mRNA is
      assumed to be linearly related to the protein synthesized. This might be one
      possible mechanism causing marrow fibrosis in MPD patients.

PMID- 2220757
TI  - Proliferation and differentiation of erythroid progenitors in liquid culture:
      analysis of progenitors derived from patients with polycythemia vera.
AB  - We have recently described a new two-phase liquid culture that supports the
      development of human erythroid progenitors (Fibach et al., Blood 73:100, 1989).
      The procedure separates the erythroid burst-forming units (BFUe) from the
      erythroid colony-forming units (CFUe) stage and enables quantitation of the
      proliferation and differentiation of BFUe into CFUe. In the present study we have
      utilized this system to study erythroid progenitors in polycythemia vera (PV).
      The abnormality of the erythroid series in PV has been shown to be associated
      with an increased responsiveness of the progenitors to the hormone erythropoietin
      (Epo). A basic question in this clonal stem cell disorder is at what
      developmental stage this abnormality of the PV clone is phenotypically expressed.
      We have studied this question by comparing the development of Epo-dependent and
      Epo-independent CFUe from peripheral blood BFUe of the PV patient during the BFUe
      to CFUe transition in the liquid culture. The results indicated that both types
      of CFUe are generated and that in all cases tested the ratio of Epo-independent
      progenitors at both the BFUe and CFUe stage was similar indicating no
      preferential development of Epo-independent CFUe. These results suggest that the
      abnormality of the PV erythroid progenitors is expressed only at the CFUe level.
      Moreover, since the liquid culture did not contain Epo, the results also support
      the conclusion that BFUe do not require Epo for proliferation or differentiation
      into CFUe.

PMID- 2220758
TI  - Identification of p70 and p80 associations with class II MHC molecules and Ii.
AB  - Two proteins, p70 and p80, were found in chemically crosslinked complexes with
      class II MHC molecules and Ii after 3-12 hr labelings with [35S]methionine. Two
      dimensional, nonreduced/reduced SDS gel electrophoresis of immunoprecipitated
      complexes revealed 1) endogenous disulfide linkages between Ii-Ii and Ii-p70 and
      2) chemically crosslinked, nearest neighbors of alpha-beta, alpha-Ii, Ii-p70, and
      alpha-p80. Although such nearest neighbors within multimeric complexes were
      identified as dimers in nonreduced/reduced 2D gels, stoichiometries could not be
      determined in the high molecular weight complex(es), which included alpha, beta,
      Ii, p70, and p80, and were not separated in the first dimension. p80 was not the
      chondroitin-sulfate form of Ii (Ii-CS) because it was not electrophoretically
      heterogeneous and was not sensitive to chondroitinase ABC. p70 was not hsp72/74
      detected with C92 or N27 mAbs, and p80 was not BiP detected with its respective
      mAb. While only these two proteins associated prominently with class II MHC
      antigens and Ii late after synthesis, their functions are unknown.

PMID- 2220760
TI  - Efficacy of the high molecular weight fraction of plasma for the maintenance of
      pregnancy associated with thrombotic thrombocytopenic purpura.
AB  - We have investigated the methods for the maintenance of a pregnancy in a patient
      with thrombotic thrombocytopenic purpura (TTP), said condition, since 1984,
      having been controlled by a plasma infusion every 3 to 4 weeks. In a preliminary
      trial it was confirmed that an infusion of the high molecular weight fraction
      (HMW-F) of plasma, separated by an Evaflux 2A fractionator, improved the
      patient's thrombocytopenia as the plasma infusion, and maintained its beneficial
      effect for about 2 weeks during early pregnancy. Though an occurrence of a
      toxemia-like syndrome responded to repeated plasma infusion, the dose of plasma
      required to improve the thrombocytopenia gradually increased and reached 5,040 ml
      by the 20th week of pregnancy. Thus, instead of periodic infusions of whole
      plasma, periodic infusions of the HMW-F of plasma were used. Under this regimen
      the platelet count remained above 10.0 x 10(4)/microliters during late pregnancy,
      and the total dose (2,600 ml) of HMW-F of plasma that was administered until
      delivery at full term was less than the dosage of whole plasma that was used
      during early pregnancy. In this manner we were able to obtain a healthy baby by
      controlling the patient's TTP during pregnancy. This method of preventing
      thrombocytopenia appears to be safer with respect to volume loading during
      pregnancy in the TTP patient.

PMID- 2220759
TI  - Selective reduction of serotonin storage and ATP release in chronic renal failure
      patients platelets.
AB  - Hemorrhagic complications, as monitored by skin bleeding times, occur in a
      significant number of chronic renal failure (CRF) patients. The etiology of
      hemostatic defects in these patients is complex and ill defined. Our studies
      demonstrate, for the first time, that activated platelets, derived from CRF
      patients, release significantly (P less than .001) less ATP than controls while
      the percent of releasable serotonin (5HT), assumed to be co-stored with ATP, is
      unaltered. Analysis of the CRF-derived platelets reflects a selective acquired
      storage pool defect with significantly (P less than .001) reduced 5HT levels
      while their dense granule contents of ATP and ADP are normal. The comparison of
      ATP release from platelets derived from CRF patients whose bleeding times were
      less than 9 min to those with bleeding times of 9 min or greater was
      significantly different (P less than .02). This report demonstrates for the first
      time that there is a statistically significant correlation of ATP release and 5HT
      content to bleeding times (P less than .001). The perturbation of platelet 5HT
      uptake, 5HT dense granule content, and ATP release appears to result from newly
      described altered plasma factors, detected by our in vitro mixing studies. It is
      proposed that the reduced level of releasable platelet 5HT and ATP contributes to
      bleeding disorders commonly encountered in CRF patients.

PMID- 2220761
TI  - Leukocyte depletion filters: a comparison of efficiency.
AB  - Four commercially available leukocyte depletion filters were evaluated using a
      flow cytometric technique to determine the efficiency of each type of filter. The
      Sepacell R-500A and the PALL RC50 were the most efficient in leukocyte depletion
      having a mean depletion percentage of 99.3% and 99.5%, respectively. The PALL
      RC100 which is used for two units also had a 99.3% depletion with the first unit
      but with the second unit the depletion dropped to 94.2%. The imugard IG-500 had a
      97.3% depletion. Red cell recovery ranged from 87.4% for the PALL RC50 to 92.2%
      for the Sepacell R-500A.

PMID- 2220762
TI  - Diagnosis of pyruvate kinase deficiency in a transfusion-dependent patient with
      severe hemolytic anemia.
AB  - In a 2-yr old girl a hemolytic anemia was present since birth requiring multiple
      blood transfusions. Pyruvate kinase deficiency was suspected on the basis of a
      marginal enzyme activity, but could not be established due to the presence of
      massive numbers of donor cells in her peripheral blood. However, by density
      fractionation we succeeded in the isolation of a small fraction of the patient's
      own cells, in which a severe pyruvate kinase deficiency could be detected. In
      contrast hexokinase and glucose-6-phosphate dehydrogenase activities were
      extremely high, which is indicative that a very immature cell population is
      present in this fraction. In immunofluorescence studies a clear crossreaction was
      apparent with anti M2-type pyruvate kinase antibodies, whereas only a faint
      reaction with anti L-type could be detected. Despite the presence of a slight
      amount of L-type immunoreactive material, the residual activity in the patient's
      cell fraction could only be attributed to M2-type pyruvate kinase as was shown by
      cellulose acetate electrophoresis.

PMID- 2220763
TI  - New treatment strategies for multiple myeloma.
AB  - During the past 5 years, several new treatments and strategies have been
      developed for patients with multiple myeloma. For patients with disease resistant
      to standard therapies, these include the VAD regimen, dexamethasone alone, high
      dose melphalan, and intensive chemoradiotherapy with bone marrow transplantation.
      Alpha interferon appears to have its greatest potential as part of early
      induction therapy or during remission maintenance. The role of hemopoietic growth
      factors or blood stem cells in support of high-dose therapy and drugs that may
      overcome multiple drug resistance continues under study. A sequence of non-cross
      resistant therapies early in the disease course seems worthy of investigation,
      especially in patients at high risk for early relapse.

PMID- 2220764
TI  - Neonatal alloimmune thrombocytopenic purpura associated with sensitization
      against the platelet-specific antigen Yuk(a).
AB  - We report a Japanese newborn who developed alloimmune thrombocytopenia by the
      antibodies to the newly discovered platelet antigen Yuk(a). The infant recovered
      uneventfully in 10 days without specific treatment. Antiplatelet alloantibodies
      in the patient were IgG class detected by mixed passive hemagglutination (MPHA).
      Family study showed that Yuk(a) antigen was inherited as an autosomal dominant
      trait. Cases with Yuk(a)-associated alloimmune thrombocytopenia are reviewed.

PMID- 2220765
TI  - Disseminated intravascular coagulation and hemorrhage in hemophilia B following
      elective surgery.
AB  - Two patients with hemophilia B are described in whom disseminated intravascular
      coagulation (DIC) developed following infusion of repeated doses of Factor IX
      concentrate in the perioperative period. In both cases the surgery was elective,
      Factor IX survival studies had been done to assure proper dosing, and Factor IX
      levels were monitored daily. Neither patient had clinically significant liver
      disease. The DIC manifested itself as excessive blood loss from surgical drains
      without documented thrombosis and was accompanied by prolonged coagulation times,
      increased fibrin split products and decreased fibrinogen and platelets. In both
      patients the process was quickly reversed with administration of fresh frozen
      plasma, cryoprecipitate, and the addition of heparin to the Factor IX
      concentrate. These cases highlight the difficulty in managing patients with
      hemophilia B undergoing surgical procedures due to the potential thrombogenicity
      of the currently available concentrates, and the importance of differentiating
      the bleeding associated with DIC from underdosing with Factor IX. Furthermore,
      the potential complications associated with the presently available Factor IX
      concentrates stress the need for the development of purer, safer Factor IX
      concentrates.

PMID- 2220766
TI  - Congenital factor XIII deficiency associated with von Willebrand disease.
AB  - A boy with umbilical bleeding and severe hemorrhages after minor trauma, without
      family bleeding history, was studied. Coagulation tests showed abnormalities in
      FXIII subunits and FVIII/vWF complex. Both parents presented results compatible
      with a heterozygote state for FXIII deficiency and the father had abnormalities
      of FVIII/vWF. The propositus was diagnosed as congenital FXIII deficiency
      associated with vWD. No severe hemorrhagic complication was observed after a
      prophylactic regimen with cryoprecipitates.

PMID- 2220767
TI  - Acute myocardial infarction, non-bacterial thrombotic endocarditis, and
      disseminated intravascular coagulation in a severe hemophiliac.
AB  - Thrombosis in hemophilia is very rare and is usually associated with the
      administration of prothrombin complex concentrates. We describe a severe
      hemophiliac with P. carinii pneumonia who had clinical and laboratory evidence of
      acute myocardial infarction and disseminated intravascular coagulation, and at
      autopsy, nonbacterial thrombotic endocarditis as well. We suggest that
      prothrombin complex concentrates should be used cautiously in the setting of
      acute infection, and perhaps be given with appropriate doses of anticoagulants
      such as heparin.

PMID- 2220768
TI  - Ph chromosome in a patient with non-leukemic non-Hodgkin B-cell lymphoma.
AB  - A standard Philadelphia translocation, t(9;22) (q34;q11), was found in lymph node
      cells from a patient with non-leukemic non-Hodgkin lymphoma at the time of
      diagnosis. The rearrangement of the breakpoint cluster region (bcr) was not
      detected with a bcr-3' probe. The neoplastic clone was of monoclonal B-cell
      character with E-, CD5-, CD10-, CD13-, CD19+, CD20+, CD21+, CD25-, HLA DR+, and
      positive surface Ig(kappa). The patient showed no evidence of chronic myelogenous
      leukemia.

PMID- 2220769
TI  - FAB L3 type of B-cell acute lymphoblastic leukemia (B-ALL) without chromosome
      abnormalities.
AB  - Acute lymphocytic leukemias (ALLs) are morphologically classified into L1, L2,
      and L3. The former two types are phenotypically constituted of quite
      heterogeneous ALLs. In the present study, phenotypes of cells from five L3 type
      ALL were analysed in FACS-IV using a panel of monoclonal antibodies (MAbs). The
      leukemic cells of all these patients coexpressed la (HLA-DR), CD19, CD20, CD21,
      CD24, CD38, and surface immunoglobulins, whereas a negative reaction with MAbs
      CD1, CD2, CD3, CD4, CD7, CD8, and Ti (WT31), Ti gamma A, delta TCS 1, and anti
      TCR-gamma/delta was observed. Neither myeloid-monocyte-erythroid nor
      megakaryocyte related cell surface antigens were detected in these cases with L3
      type ALL. Chromosomal analysis of the ALL cells from two cases revealed a
      normoploid karyotype with specific translocation t(8;14)(q24;q32), whereas it was
      normal (46XY or 46XX) for the remaining three cases. Expression of myc oncogene
      was high in the former group, but low in the later one. Basing from our findings,
      we conclude that L3 type ALL is heterogeneous with respect to immunophenotypes,
      cytogenetics and oncogene analysis.

PMID- 2220770
TI  - Overview: renal physiology and pathophysiology of aging.
AB  - Cross-sectional studies in humans have suggested that there is a progressive
      decline of renal function with age after 40 years. The decline in various
      functions (eg, tubular maximums, concentrating and diluting abilities, and
      acidification) tend to parallel the decreases in glomerular filtration rate (GFR)
      and renal blood (plasma) flow (RPF). Recent observations from the Baltimore
      Longitudinal Study of Aging suggest that not all individuals follow this pattern,
      and that, indeed, many show no decline and some even an increase in their renal
      function over time. Whether the observed decreases in renal function with aging
      are the results of intervening pathologic processes, eg, immunologic, infectious,
      and toxic injury and ischemia, or can be related to hyperperfusion and
      hyperfiltration with resultant glomerulosclerosis, or to some other relentless
      involutional process, remains unclear. The purpose of this report is to review
      the descriptive studies documenting the changes in renal morphology and
      physiology with age and to discuss what is known about mechanisms involved in
      these losses of renal substance and function.

PMID- 2220771
TI  - Geriatric pharmacokinetics and the kidney.
AB  - The general population is aging and, as a result, drugs are increasingly
      prescribed for a variety of medical conditions in a group of patients with
      multiple physiologic and pharmacokinetic abnormalities. The present report
      summarizes principles of prescribing for the elderly, especially those related to
      the decline in renal function that frequently occurs.

PMID- 2220772
TI  - Nutritional causes of renal impairment in old age.
AB  - The occurrence of renal insufficiency tends to increase in late adulthood. This
      common complication of old age is associated with increased physical dependency,
      morbidity, and mortality, and a lowered quality of life. In this review, the
      authors will develop the thesis that dietary practices during early and middle
      adulthood importantly influence the risk of renal insufficiency in the elderly.

PMID- 2220773
TI  - Hyperkalemia in the elderly.
AB  - Physiologic and pathologic events that occur in patients as they grow older may
      result in distal renal tubular dysfunction, as well as decreased levels of plasma
      renin activity and plasma aldosterone. Such alterations result in a tendency
      toward hyperkalemia. A syndrome termed hyporeninemic hypoaldosteronism,
      associated with hyperkalemia, has been frequently described in elderly patients.
      The common occurrence of hyperkalemia in the elderly may be aggravated by the use
      of drugs that either further suppress renin and/or aldosterone or interfere with
      distal tubular potassium excretion. Some patients with hyporeninemic
      hypoaldosteronism respond to diuretic therapy. The recognition of the possible
      development of severe hyperkalemia in the elderly patient may avoid serious and
      even fatal complications of this electrolyte disorder.

PMID- 2220774
TI  - Renal disease in the elderly: the role of the renal biopsy.
AB  - The causes of renal disease in the young and the elderly vary in their frequency.
      There are many indications for renal biopsy in older patients, with the nephrotic
      syndrome (NS) being the most common, followed by acute renal failure. Biopsy does
      not carry a greater risk for older patients, but there is a greater risk of
      complications when there is coexistent renal insufficiency. Interpretation of the
      renal biopsy in elderly patients may be more complex because of changes
      associated with aging or intercurrent disease--arteriolar sclerosis and global
      sclerosis. A prospective study is needed to determine the exact prevalence of
      renal insufficiency, NS, and other renal diseases in noninstitutionalized elderly
      individuals and to determine the role of renal biopsy in making these
      determinations.

PMID- 2220775
TI  - Treatment of glomerulonephritis in the elderly.
AB  - Glomerular disease was assessed in persons who had renal biopsies and who were
      age 60 years and older in retrospective reviews of referral-based cohorts in
      Europe, the United States, and Japan. From a cumulative total of 514 patients
      reported from five centers, 337 (66%) patients had primary glomerular diseases
      and 177 (34%) had various secondary renal diseases. Amyloidosis was the largest
      histopathologic group among the secondary disorders. Idiopathic membranous
      nephropathy was the most common primary glomerulopathy (107/337 [32%] patients)
      and also comprised 46% of nephrotic patients. In our experience covering two
      consecutive 13-year periods from 1959 to 1984, there was an increase both in
      total number of patients, and in percentage more than 60 years old, with
      membranous nephropathy in the more recent study period compared with the earlier
      period reflecting a trend to more biopsy procedures that included older patients.
      Non-immune-mediated rapidly progressive glomerulonephritis (RPGN), thought by
      some to be more common in older adults, has been shown to represent a crescentic
      glomerulonephritis associated with systemic necrotizing vasculitis. Treatment
      with corticosteroids had a short-term favorable effect on renal function in this
      disorder over that achieved in antiglomerular basement membrane-associated or
      idiopathic RPGN. However, the 5-year patient survival was remarkably lower in
      older patients irrespective of the disease entity. On the other hand, age was not
      associated with progressive renal failure in patients with membranous
      nephropathy. Finally, minimal change glomerulopathy accounted for 35 of 204 (17%)
      nephrotic subjects, and complete remissions occurred after corticosteroid
      treatment at the same frequency (80% to 90%) observed in younger patients.

PMID- 2220777
TI  - Basic evaluation of female urinary incontinence.
AB  - Urinary incontinence is a common disorder that is frequently underreported
      because of its social implications. Although several types of urinary
      incontinence are recognized, they can be generally classified as failure of the
      bladder to store or failure of the urethral mechanism. A systematic approach for
      the evaluation of incontinence that includes history, physical examination, basic
      laboratory tests, and often urodynamic evaluation, offers the most comprehensive
      assessment of the etiology of incontinence.

PMID- 2220776
TI  - Geriatric diabetic nephropathy: an analysis of renal referral in patients age 60
      or older.
AB  - We report a series of 33 consecutive hospitalized geriatric diabetic patients who
      were referred for evaluation of diabetic nephropathy, defined as proteinuria
      greater than or equal to 1 g/d (1,000 mg/24 h) or a serum creatinine
      concentration greater than or equal to 177 mumol/d (greater than or equal to 2
      mg/dL). The study population was 60 years old or older (mean age, 68 +/- 6
      years), was comprised mainly of women (24 of 33, 72.7%), and was predominantly
      black (25 of 33, 75.8%). All patients had type II diabetes. A family history of
      diabetes in parent or sibling was elicited in 24 (72.7%) patients. There were
      eight patients undergoing maintenance hemodialysis and 25 with less severe
      nephropathy (mean proteinuria, 2.7 g/d [2,700 mg/24 h]; mean creatinine
      clearance, 0.57 mL-s [34 mL/min]). Cardiac disorders were noted in the majority
      of patients: congestive failure in 20 (60.6%), myocardial infarction in eight
      (24.2%), and active angina in five (15.2%). Other comorbid diseases were present
      in both hemodialysis patients and the subset of nondialyzed azotemic-proteinuric
      patients, and consisted of peripheral neuropathy in 31 (93.9%), gastroparesis in
      16 (48.5%), retinopathy in 28 (84.8%), and legal blindness in 11 (33%). We
      conclude that geriatric diabetic nephropathy in type II diabetes is similar in
      presentation and severity of comorbid extrarenal complications to the syndrome
      described in younger adults. This inference must be tempered by both the small
      size and the limitation imposed by the demographics of the study population,
      which is predominantly composed of black patients receiving treatment at inner
      city hospitals.

PMID- 2220778
TI  - Bladder dysfunction in the elderly.
AB  - Bladder dysfunction in the elderly is an enormous public health problem.
      Laboratory research using animal models has to date not yielded clinically useful
      new information. Demographic and urodynamic studies in selected elderly patients
      indicate that neurological disease and bladder outlet obstruction are the primary
      causes for voiding dysfunction. The effect of aging per se on the urinary bladder
      is not known. Elderly patients who have bladder dysfunction should be evaluated
      with a careful history and physical examination combined with a practical
      urodynamic evaluation rather than simply being labeled as having "bladder
      dysfunction in the elderly."

PMID- 2220779
TI  - Genitourinary cancer in the elderly.
AB  - The subject of genitourinary cancer in the elderly becomes increasingly more
      important as our population of patients older than 50 years expands. Carcinoma of
      the kidney, bladder, and prostate all have an increasing incidence over the age
      of 50 and have a predilection for afflicting men more commonly than women.
      Etiologic factors, especially with bladder and kidney carcinomas, are well
      documented and in some cases preventable. Screening the urine for hematuria and
      careful digital rectal examinations may uncover a higher percentage of these
      malignancies in earlier, more curable stages. Recent advances in the treatment of
      all of these malignancies have improved survival and quality of life for these
      patients.

PMID- 2220780
TI  - Treatment of renal calculi in the elderly.
AB  - The management of renal calculi in the geriatric patient population poses some
      unique problems that include anesthetic risks, underlying medical disease, and
      general risk/benefit concerns. A variety of relatively noninvasive procedures are
      available, including extracorporeal shock wave lithotripsy (ESWL) and
      percutaneous nephrostolithotomy (PCNL). A practical management plan is presented
      that is based primarily on stone size and takes into consideration problems
      unique to the elderly patient.

PMID- 2220781
TI  - Systolic hypertension in the elderly: reasons not to treat.
AB  - Isolated systolic hypertension in the elderly is associated with increased
      morbidity and mortality. Accurate measurement of blood pressure in older patients
      is difficult. Therapy can be associated with various complications, and the
      special problems of the elderly, such as orthostatic hypotension and
      hyperkalemia, should be carefully considered. Drugs should be used in low doses
      and changes in dosage should be made infrequently. Patients should be monitored
      frequently for untoward effects of therapy. The benefits of blood pressure
      reduction and the optimal degree of blood pressure reduction remain unknown.

PMID- 2220782
TI  - Peritoneal dialysis in the geriatric patient.
AB  - Elderly patients on chronic peritoneal dialysis (CPD) from two large chronic
      peritoneal dialysis programs were compared with younger patients in regard to
      peritonitis rates, catheter problems, hospital days, transfers to other forms of
      therapy, and mortality. Peritonitis rates and organisms were similar in younger
      and older patients. Catheter replacements were less common in the elderly.
      Differences in hospital days were attributable to hospitalization for vascular
      disease. The elderly were more likely to have the first episode of peritonitis,
      to die and to change dialysis modalities at all times after the first year of
      continuous ambulatory peritoneal dialysis (CAPD) treatment, although other than
      increased mortality, differences between the two groups were small. CPD appears
      to be an acceptable form of renal replacement therapy in the elderly.

PMID- 2220783
TI  - Hemodialysis and the elderly patient: potential advantages as to quality of life,
      urea generation, serum creatinine, and less interdialytic weight gain.
AB  - A total of 204 patients treated by maintenance hemodialysis or continuous
      ambulatory peritoneal dialysis (CAPD) were studied to ascertain how advancing age
      influences adaptation to uremia therapy. No difference in Karnofsky score was
      noted among patients over 70 years of age and two groups of patients, 16 to 59,
      and 60 to 69 years of age, respectively. In a subset of 33 hemodialysis patients
      studied midweek, it was noted that increasing age is associated with a lower
      serum creatinine concentration, lower interdialytic weight gain, and a lower urea
      generation rate. These three findings contribute to a relative ease in treating
      older uremia patients with hemodialysis or CAPD, as they tend to be stable and
      compliant relative to younger patients.

PMID- 2220784
TI  - The elderly on dialysis: some considerations in compliance.
AB  - Compliance with scheduled treatments, dietary and fluid restrictions, and
      multiple medications is an important component in the care and well-being of end
      stage renal disease (ESRD) patients. Given the rigorus and complex demands of
      dialysis, it is important to examine the issue of compliance, focusing on a large
      and ever-increasing segment of our patient population, the elderly. The ESRD
      literature reflects efforts to define and measure levels of compliance, identify
      factors that influence and predict compliance, and develop intervention
      strategies to improve adherence to treatment regimens. While limited attention
      has been focused specifically on the elderly, there are studies suggesting that
      age may be a factor associated with improved adherence and that social support
      may be a significant contributor to compliance in this patient group. In an
      effort to examine the current status and needs of the dialysis elderly, research
      is in progress at Chromalloy American Kidney Center, Washington University, which
      replicates a study of 5 years ago. Eighty-four patients age 60 and over, on
      dialysis for a minimum of 6 months, were identified. Sociodemographic, treatment,
      compliance, and functional capacity data were collected; additional mental and
      psychological testing was completed on patients willing and able to participate.
      Preliminary data suggest the current elderly population is larger and
      significantly older than that of 5 years ago. Other sociodemographic data
      indicate the population is increasingly female, black, and more socioeconomically
      disadvantaged. In regard to compliance, the vast majority of elderly demonstrate
      good compliance as measured by serum potassium, fair to good compliance with
      phosphorus, and fair to poor compliance with fluid restrictions.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2220785
TI  - Strategies for enhancing compliance in the dialysis elderly.
AB  - Noncompliance must be viewed as a symptom of another problem or problems.
      Treatment plans should be developed based on an individualized assessment of the
      patient's physiologic functioning and psychosocial situation. It must be
      determined whether the patient is intentionally or unintentionally not complying.
      Staff must also be aware of how they impact compliance. While staff have a
      responsibility to maximize the individual's efforts to comply, it must be
      realized that the ultimate decision and responsibility rests with the patient.

PMID- 2220786
TI  - Principles of geriatric care.
AB  - The increase in the numbers of elderly in the United States, and their projected
      continued increase to 21% or more of the population by 2030, has provided impetus
      for the growth of geriatrics. Recognition of change that is age-related rather
      than disease-related, and the ways in which the elderly differ from their young
      counterparts is vital in the care of the elderly. A functional approach and
      appropriate geriatric assessment have been shown to be beneficial to the
      individual.

PMID- 2220787
TI  - Prevention of renal disease and conservation of renal function.
AB  - In summary, we have reviewed some of the most frequently encountered areas of
      prevention of renal failure in the elderly. They include obstruction,
      hypertension, drug interaction, and inappropriate use of drugs and the silent
      killer of the elderly, renal carcinoma. Only by a thorough understanding of the
      altered physiology of the aging kidney can the physician avoid making the same
      mistakes when new drugs are developed or new types of diseases are encountered.
      Proper early diagnosis and understanding the guidelines to therapy in these
      conditions, can save huge human costs in terms of mortality, morbidity, and
      money.

PMID- 2220788
TI  - Ethical issues in geriatric nephrology: overview.
AB  - Developments in medical care over the past five to six decades have provided
      remarkable life-sustaining technologies (LST) that have contributed to
      prolongation of the life span of patients, as well as to a general increase in
      health and well-being. End-stage renal disease (ESRD) treatment is a prototype of
      these LST treatments and of the issues surrounding provision of
      chronic/catastrophic care. This remarkable progress has been accompanied by
      ethical dilemmas that include allocation of scarce resources, and initiation and
      termination of care with LST. Consideration of these ethical dilemmas are
      especially poignant for the elderly, because they raise "hard choices" and there
      are no easy answers to these ethical dilemmas.

PMID- 2220789
TI  - Ethical principles in geriatric nephrology.
AB  - Seven principles are suggested to resolve ethical issues raised by medical
      developments affecting an aging society. First, there must be clear
      identification of the goals of medical treatment. Second, treatments must
      consider the whole person. Third, physiological concerns are more important than
      chronological age. Fourth, a patient's choice must be respected when choice is
      the result of an informed decision-making process. Fifth, access has to be
      equitable while respecting the sixth principle which requires allocation of
      resources. Finally, society must more clearly identify the appropriate principles
      to guide the care of the dying person.

PMID- 2220790
TI  - Ethical and legal issues in geriatric nephrology.
AB  - Ethical and legal issues affecting geriatric nephrology are conditioned more by
      individuals' status as elderly, sick people than by the distinctive
      characteristics of kidney disease or failure. Key ethical issues are the
      obligation to respect persons, in particular by recognizing competent persons'
      autonomy of medical choice and affording due protection to dependent or
      vulnerable individuals, by beneficence or doing good, and by acting with justice,
      treating like cases alike and avoiding unjust discrimination. The law reinforces
      ethical obligations through such legal concepts as informed consent and the duty
      to maintain appropriate confidentiality, which have special applications
      concerning medication and management of the elderly. Additional legal issues
      concern advanced care directives and terminal care decisions.

PMID- 2220791
TI  - High technology health care.
AB  - High technology medicine often harms more people than it saves. The resources
      that are spent in too many of our high technology procedures could be far more
      effectively used to save far more lives in other parts of the system. High
      technology health care is thus a blessing and a curse. It is a blessing if it is
      used correctly, but tragically it is too often a curse, stealing resources
      desperately needed elsewhere.

PMID- 2220792
TI  - Rationing of health care and the end-stage renal disease program.
AB  - The potential impact of rationing health care on the end-stage renal disease
      (ESRD) program is considered. The possible implications of the recommendations
      emanating from the study being conducted by the Institute of Medicine of the
      National Academy of Sciences are also mentioned. Particular emphasis is given to
      the potential consequences of rationing health care on the elderly and on certain
      socioeconomic groups with ESRD.

PMID- 2220793
TI  - Looking upon the water: taking in the students.

PMID- 2220794
TI  - The renal cardiac connection: pieces of the puzzle. A symposium held in
      conjunction with the annual meeting of the American Society of Nephrology.
      December 1989, Washington, D.C. Proceedings.

PMID- 2220795
TI  - Effects of calcium antagonists on renal hemodynamics.
AB  - Recent attention has been focused on the effects of calcium antagonists on renal
      function. When administered in vitro to the isolated perfused kidney, calcium
      antagonists exhibit consistent actions permitting characterization of actions
      permitting characterization of their renal effects. Calcium antagonists do not
      affect the vasodilated isolated perfused kidney, but they do markedly alter the
      response of the kidney to vasoconstrictor agents. In the presence of
      norepinephrine, calcium antagonists markedly augment the glomerular filtration
      rate but produce only a modest improvement in renal perfusion. Studies using the
      isolated perfused hydronephrotic rat kidney model, which permits direct
      visualization of afferent and efferent arterioles, have demonstrated that the
      augmentation of the glomerular filtration rate is attributable to a preferential
      vasodilation of preglomerular vessels. Although the clinical implications of such
      observations are not fully delineated, preliminary studies in experimental animal
      models indicate that calcium antagonists might exert salutary effects on renal
      function in clinical settings characterized by an acute impairment of renal
      hemodynamics. It is apparent, however, that the renal hemodynamic effects of
      calcium antagonists commend their use in the management of essential
      hypertension.

PMID- 2220796
TI  - Calcium channel blockers versus angiotensin-converting enzyme inhibitors: renal
      effects.
AB  - Angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers are
      two classes of antihypertensive agents with novel effects on renal function. In
      both experimental and clinical studies, calcium channel blockers tend to increase
      renal blood flow, glomerular filtration rate, and urinary sodium excretion in
      essential hypertension. ACE inhibitors have similar effects on renal blood flow
      and glomerular filtration rate in essential hypertension, but they tend to cause
      sodium retention. ACE inhibitors can cause marked reductions in glomerular
      filtration rate in renovascular hypertension, making them a problematic choice
      for the treatment of this form of hypertension. In chronic, progressive renal
      diseases, ACE inhibitors have been shown to decrease protein excretion and
      morphologic evidence of glomerulosclerosis. The relationship of the decrease in
      protein excretion to the progression of renal disease has not yet been
      established.

PMID- 2220797
TI  - Diabetes mellitus and hypertension.
AB  - Hypertension and diabetes mellitus are chronic medical conditions that frequently
      coexist. In the United States, it is estimated that 10 million persons suffer
      from diabetes mellitus, 60 million from hypertension, and 3 million from the
      combination of the two. There may be a causal relationship between hypertension
      and diabetes. Obesity may be a precipitating factor for both hypertension and non
      insulin-dependent diabetes mellitus. Those with insulin-dependent diabetes
      mellitus generally become hypertensive only with the onset of nephropathy.
      Glucose tolerance, insulin resistance, and hyperinsulinemia frequently occur with
      essential hypertension and may be aggravated by hypertension therapy, especially
      with diuretics and beta-blockers. Hyperinsulinemia may be an important common
      factor promoting sodium retention, sympathetic nervous system stimulation, and
      inhibition of the sodium pump. The Working Group on Hypertension in Diabetes has
      outlined a flexible modified version of the stepped-care approach to the
      treatment of hypertension in diabetes. Management is complex because diabetes is
      associated with autonomic neuropathy, sexual dysfunction, hyperlipidemia, and
      fluid and electrolyte disorders. All these problems can be exacerbated by
      antihypertensive treatment. Nonpharmacologic measures, which address weight
      reduction and sodium restriction, are logical, but aggressive antihypertensive
      medication is invariably necessary. Diuretics and/or beta-blockers were the
      mainstay of treatment until the introduction of angiotensin-converting enzyme
      (ACE) inhibitors and calcium channel blockers. These newer agents have no
      deleterious effects on carbohydrate metabolism and are generally better
      tolerated. Antihypertensive therapy may slow the rate of deterioration in
      diabetic nephropathy. This was first shown with diuretics, beta-blockers, and
      hydralazine and more recently with ACE inhibitors, which provide effective blood
      pressure control and a significant drop in albuminuria without affecting the
      glomerular filtration rate adversely. ACE inhibition may also lead to increased
      insulin sensitivity and glucose disposal rate. Long-term trials are needed to
      assess the effects of these new agents on the treatment of hypertension in the
      diabetic population.

PMID- 2220798
TI  - Calcium channel blockers and atherosclerosis.
AB  - Several chemical classes of calcium channel blockers (CCBs) inhibit
      atherosclerotic lesion formation in rabbit models by reduction of calcium, lipid,
      and matrix accumulation in the arterial wall. The mechanisms of these
      antiatherogenic effects are under investigation. Smooth muscle cells and
      macrophages, which synthesize matrix products and accumulate intracellular
      lipids, play a central role in lesion formation. Smooth muscle cell hyperplasia,
      with intracellular and functional changes, is common to both atherosclerosis and
      hypertension. The antiatherogenic properties of CCBs may be related in part to
      the protection of arterial cells from calcium overload through inhibition of
      calcium flux across voltage-regulated ion channels. CCBs may also inhibit cell
      migration, influence the uptake and catabolism of lipoproteins, alter smooth
      muscle matrix synthesis, and promote the depletion of intracellular cholesteryl
      ester stores. It appears that CCBs may inhibit the development of atherosclerotic
      lesions by two sets of mechanisms: alteration of lipid metabolism in smooth
      muscle cells and regulation of calcium-initiated or -accelerated intracellular
      processes.

PMID- 2220799
TI  - Hypertension: racial differences.
AB  - Racial differences in the prevalence, course, and pathophysiologic
      characteristics of hypertension in black and white populations are reviewed.
      Accumulated epidemiologic data indicate that the prevalence of hypertension among
      blacks is greater than that among whites in almost all age- and sex-matched
      groups. Hypertensive blacks have a higher incidence of left ventricular
      dysfunction, stroke, and renal damage, but a lower incidence of ischemic heart
      disease, than do hypertensive whites. A significant pathophysiologic difference
      between blacks and whites is salt sensitivity; normotensive, as well as
      hypertensive, blacks tend to be salt sensitive. Blacks also tend to have lower
      renin levels than do whites, while dopamine response to a salt load is diminished
      among blacks as compared with whites. These differences and others lead to the
      recommendation that hypertension among blacks should be managed initially with
      salt restriction; if dietary control is insufficient, administration of an
      antihypertensive agent with 24-hour efficacy, which lowers vascular peripheral
      resistance, promotes sodium excretion, and potentially improves renal
      hemodynamics, is recommended. A calcium channel blocker may satisfy these
      requirements.

PMID- 2220801
TI  - Making history.

PMID- 2220800
TI  - Diet, smoking, and alcohol: influence on coronary heart disease risk.
AB  - The Framingham study on coronary heart disease (CHD) has shown that life-style,
      particularly diet, smoking, and alcohol consumption, has a great impact on the
      incidence of CHD. Blood lipoproteins, rather than total blood cholesterol, have
      been found to be more accurate predictors of CHD risk. Blood triglyceride,
      previously considered to have little bearing on CHD risk, was found to have a
      negative impact in many cases. A population subgroup with high triglyceride
      greater than or equal to 1.7 mmol/L (greater than or equal to 150 mg/dL), low
      high-density lipoprotein less than or equal to 1.04 mmol/L (less than or equal to
      40 mg/dL), increased insulin resistance, and a higher incidence of diabetes
      mellitus has been found to be at increased risk for CHD. Diet intervention trials
      have shown that a reduction in total cholesterol and saturated fat consumption
      produced reduction in CHD incidence proportionate to the fall in cholesterol.
      Cigarette smoking increased CHD risk moderately; those who smoked one pack per
      day had twice the risk of nonsmokers. Alcohol consumption actually lowered CHD
      incidence in the Framingham study; however, when alcohol consumption was greater
      than two drinks per day, a rise in mortality from cancer and stroke was observed.

PMID- 2220802
TI  - Carrier screening for cystic fibrosis.

PMID- 2220803
TI  - Cystic fibrosis mutations in North American populations of French ancestry:
      analysis of Quebec French-Canadian and Louisiana Acadian families.
AB  - A 3-bp deletion (delta F508) in the cystic fibrosis (CF) gene is the mutation on
      the majority of CF chromosomes. We studied 112 CF families from North American
      populations of French ancestry: French-Canadian families referred from hospitals
      in three cities in Quebec and from the Saguenay-Lac St. Jean region of
      northeastern Quebec and Acadian families living in Louisiana. delta F508 was
      present on 71%, 55%, and 70% of the CF chromosomes from the major-urban Quebec,
      Saguenay-Lac St. Jean, and Louisiana Acadian families, respectively. A weighted
      estimate of the proportion of delta F508 in the French-Canadian patient
      population of Quebec was 70%. We found that 95% of the CF chromosomes with delta
      F508 had D7S23 haplotype B, the most frequent haplotype on CF chromosomes. In the
      Saguenay-Lac St. Jean families, 86% of the CF chromosomes without delta F508 had
      the B haplotype, compared with 31% for the major-urban Quebec and Louisiana
      Acadian families. The incidence of CF in the Saguenay-Lac St. Jean population was
      1/895 live-born infants.

PMID- 2220805
TI  - Genetics and biology of human ovarian teratomas. I. Cytogenetic analysis and
      mechanism of origin.
AB  - One hundred and two benign, mature ovarian teratomas and two immature, malignant
      teratomas were karyotyped and scored for centromeric heteromorphisms as part of
      an ongoing project to determine the chromosomal karyotype and the genetic origin
      of ovarian teratomas and to assess their utility for gene-centromere mapping.
      Karyotypic analysis of the benign cases revealed 95 46,XX teratomas and 7
      chromosomally abnormal teratomas (47,XXX, 47,XX,+8 [two cases], 47,XX,+15,
      48,XX,+7,+12 91,XXXX,-13 [mosaic], 47,XX,-15,+21,+mar). Our study reports on the
      first cases of tetraploidy and structural rearrangement in benign ovarian
      teratomas. The two immature cases had modal chromosome numbers of 78 and 49.
      Centromeric heteromorphisms that were heterozygous in the host were homozygous in
      65.2% (n = 58) of the benign teratomas and heterozygous in the remaining 34.8% (n
      = 31). Chromosome 13 heteromorphisms were the most informative, with 72.7%
      heterozygosity in hosts. The cytogenetic data indicate that 65% of teratomas are
      derived from a single germ cell after meiosis I and failure of meiosis II (type
      II) or endoreduplication of a mature ovum (type III); 35% arise by failure of
      meiosis I (type I) or mitotic division of premeiotic germ cells (type IV).

PMID- 2220804
TI  - Deletions in patients with classical choroideremia vary in size from 45 kb to
      several megabases.
AB  - Making use of the p1bD5 probe (DXS165), we have isolated several markers from the
      choroideremia locus by chromosomal jumping, preparative field-inversion gel
      electrophoresis, and cloning of a deletion junction fragment. With these clones
      we were able to identify and characterize eight deletions in 69 choroideremia
      patients investigated. The deletions are heterogeneous, in both size and
      location. The smallest deletion (patient LGL1134) comprises approximately 45 kb
      of DNA, whereas the largest ones (patients 25.6 and LGL2905) span a DNA segment
      of at least 5 megabases, which is comparable in size to the smallest deletion
      detected in a TCD patient (patient XL45) showing a complex phenotype. The TCD
      deletions encompass variable parts of 150-200-kb DNA segment that is flanked by
      p1bD5 (DXS165) at the centromeric side and by pZ 11 at the telomeric side. The
      deletions in patients 33.1, LGL1101, and LGl1134 do not span a translocation
      breakpoint which was previously mapped on the X chromosome of a female with TCD.
      The clones isolated from the TCD locus are valuable diagnostic markers for
      deletion analysis of patients or carrier females. In addition, they should be
      useful for the isolation of expressed sequences that are part of the TCD gene.

PMID- 2220807
TI  - Phenotypic heterogeneity in osteogenesis imperfecta: the mildly affected mother
      of a proband with a lethal variant has the same mutation substituting cysteine
      for alpha 1-glycine 904 in a type I procollagen gene (COL1A1).
AB  - A proband with a lethal variant of osteogenesis imperfecta (OI) has been shown to
      have, in one allele in a gene for type I procollagen (COL1A1), a single base
      mutation that converted the codon for alpha 1-glycine 904 to a codon for
      cysteine. The mutation caused the synthesis of type I procollagen that was
      posttranslationally overmodified, secreted at a decreased rate, and had a
      decreased thermal stability. The results here demonstrate that the proband's
      mother had the same single base mutation as the proband. The mother had no
      fractures and no signs of OI except for short stature, slightly blue sclerae, and
      mild frontal bossing. As a child, however, she had the triangular facies
      frequently seen in many patients with OI. On repeated subculturing, the proband's
      fibroblasts grew more slowly than the mother's, but they continued to synthesize
      large amounts of the mutated procollagen in passages 7-14. In contrast, the
      mother's fibroblasts synthesized decreasing amounts of the mutated procollagen
      after passage 11. Also, the relative amount of the mutated allele in the mother's
      fibroblasts decreased with passage number. In addition, the ratio of the mutated
      allele to the normal allele in leukocyte DNA from the mother was half the value
      in fibroblast DNA from the proband. The simplest interpretation of the data is
      that the mother was mildly affected because she was a mosaic for the mutation
      that produced a lethal phenotype in one of her three children.

PMID- 2220806
TI  - Cytogenetic analysis of 750 spontaneous abortions with the direct-preparation
      method of chorionic villi and its implications for studying genetic causes of
      pregnancy wastage.
AB  - Altogether, 750 cases of spontaneous abortion between the fifth and 25th week of
      gestation were analyzed cytogenetically by the direct-preparation method using
      chorionic villi. The majority of cases (68%) were derived from early abortions
      before the 12th week of gestation. The frequency of abnormal karyotypes was
      50.1%; trisomy was predominant (62.1%), followed by triploidy (12.4%), monosomy X
      (10.5%), tetraploidy (9.2%), and structural chromosome anomalies (4.7%). Among
      trisomies, chromosomes 16 (21.8%), 22 (17.9%), and 21 (10.0%) were prevalent. The
      frequency of chromosomally abnormal abortions increased with maternal age but
      only because of an increase of trisomy. Polyploidy and monosomy X, however,
      decreased. Mean maternal age was significantly increased for trisomies 16, 21,
      and 22 and was highest for trisomies 18 and 20. The results obtained are within
      the range of variability reported earlier from tissue culture-type studies. A
      consistent feature during our study is the excess of females in chromosomally
      normal abortions (male:female sex ratio 0.71). According to the methodology
      applied, maternal cell contamination and undetected 46,XX molar samples cannot
      have influenced the sex ratio. However, a bias introduced by social status or
      maternal age cannot be excluded. With the more rapid and convenient direct
      preparation of chorionic villi, reliable cytogenetic data on causes of
      spontaneous abortions can be obtained.

PMID- 2220808
TI  - Assignment of the Charcot-Marie-Tooth neuropathy type 1 (CMT 1a) gene to 17p11.2
      p12.
AB  - Charcot-Marie-Tooth disease type 1a (CMT 1a) is an autosomal dominant peripheral
      neuropathy linked to the DNA markers D17S58 and D17S71, located in the
      pericentromeric region of the chromosome 17p arm. We analyzed an extended 5
      generation Belgian family, multiply affected with CMT 1a, for linkage with eight
      chromosome 17 markers. The results indicated that the CMT 1a mutation is
      localized in the chromosomal region 17p11.2-p12 between the marker D17S71 and the
      gene for myosin heavy polypeptide 2 of adult skeletal muscle.

PMID- 2220809
TI  - Frequency of three Hex A mutant alleles among Jewish and non-Jewish carriers
      identified in a Tay-Sachs screening program.
AB  - Mutations in the HEX A gene, encoding the alpha-subunit of beta-hexosaminidase A
      (Hex A), are the cause of Tay-Sachs disease as well as of juvenile, chronic, and
      adult GM2 gangliosidoses. We have examined the distribution of three mutations--a
      4-nucleotide insertion in exon 11, a G----C transversion at a 5' splice site in
      intron 12, and a 269Gly----Ser amino acid substitution in exon 7--among
      individuals enzymatically diagnosed as carriers of Hex A deficiency. Mutation
      analysis included polymerase chain reaction (PCR) amplification of the relevant
      regions of genomic DNA, followed by allele-specific oligonucleotide
      hybridization; another test for heterozygosity of the exon 11 insertion was based
      on the formation of heteroduplex PCR fragments of low electrophoretic mobility.
      The percentage distribution of the exon 11, intron 12, exon 7, and unidentified
      mutant alleles was 73:15:4:8 among 156 Jewish carriers of Hex A deficiency and
      16:0:3:81 among 51 non-Jewish carriers. Regardless of the mutation, the ancestral
      origin of the Jewish carriers was primarily eastern and (somewhat less often)
      central Europe, whereas for the non-Jewish carriers it was western Europe.
      Because a twelfth of the Jewish carriers and four-fifths of the non-Jewish
      carriers of Hex A deficiency had mutant alleles other than the three common ones
      tested, enzyme-based tests cannot be replaced by DNA-based tests at the present
      time. However, DNA-based tests for two-carrier couples could identify those at
      risk for the chronic/adult GM2 gangliosidoses rather than for infantile Tay-Sachs
      disease.

PMID- 2220812
TI  - Screening for cystic fibrosis carriers.

PMID- 2220813
TI  - Some issues in the study of birth defects and recurrence risks in live births and
      "stillbirths".

PMID- 2220811
TI  - Definitive prenatal diagnosis for type III glycogen storage disease.
AB  - Prenatal diagnosis for type III glycogen storage disease was performed by using
      (1) immunoblot analysis with a polyclonal antibody prepared against purified
      porcine-muscle debranching enzyme and (2) a qualitative assay for debranching
      enzyme activity. Cultured amniotic fluid cells from three pregnancies (three
      families in which the proband had absence of debrancher protein) were subjected
      to immunoblot analysis. Two unaffected and one affected fetus were predicted. In
      addition, cultured amniotic fluid cells from nine pregnancies (eight families)
      were screened with a qualitative assay based on the persistence of a
      polysaccharide that has a structure approaching that of a phosphorylase limit
      dextrin when the cells were exposed to a glucose-free medium. This qualitative
      assay predicted six unaffected and three affected fetuses. All predictions by
      either method were confirmed postnatally except for one spontaneously aborted
      fetus. Our data indicate that a definitive diagnosis of type III glycogen storage
      disease can be made prenatally by these methods.

PMID- 2220810
TI  - DNA haplotype analyses of patients with hyperphenylalaninemia.
AB  - Linkage analysis of phenylketonurics has shown a strong association between the
      DNA haplotype at the phenylalanine hydroxylase (PAH) locus and phenylketonuria
      (PKU). Similarly, a genetic linkage between less severe forms of
      hyperphenylalaninemia (HPA) and the PAH locus has been suggested. In the present
      study we analyzed this linkage in more detail. Haplotypes at the PAH locus were
      determined for 19 individuals with moderately elevated plasma phenylalanine and
      normal urinary neopterin/biopterin ratios. Fourteen of these individuals had
      plasma phenylalanine levels of 4-10 mg/dl (mild HPA), and the other five had
      plasma phenylalanine levels of 10-19 mg/dl (atypical PKU). Thirteen of the 15 HPA
      families consisted of an affected child and at least one other sibling. Elevated
      plasma phenylalanine was seen to genetically segregate with specific PAH alleles
      in each family. Summation of the LOD scores for both categories of moderate
      plasma phenylalanine elevation gave a maximum value of 3.556 at theta = 0. At
      theta = 0 this gives a probability of linkage between the PAH locus and the locus
      for moderate phenylalanine elevations that is approximately 3,600:1. None of the
      alleles segregating with either mild HPA or atypical PKU were of haplotype 2 or
      3, and 13/20 were of types 1 or 4. This is in agreement with the most deleterious
      mutations being on haplotypes 2 and 3 and with the less severe mutations being on
      haplotypes 1 and 4. chi 2 Analyses indicated no statistically significant
      correlation between HPA and a particular haplotype or restriction-enzyme site.

PMID- 2220814
TI  - Integrating genetics into the medical school curriculum.

PMID- 2220815
TI  - Physicians and other nongeneticists strongly favor teaching genetics to medical
      students in the United Kingdom.

PMID- 2220816
TI  - Innovations in human genetics education. Incorporation of genetics into a problem
      based medical school curriculum.
AB  - There has been recent interest in the development of problem-based human genetics
      curricula in U.S. medical schools. The College of Human Medicine at Michigan
      State University has had a problem-based curriculum since 1974. The vertical
      integration of genetics within the problem-based curriculum, called "Track II,"
      has recently been revised. On first inspection, the curriculum appeared to lack a
      significant genetics component; however, on further analysis it was found that
      many genetics concepts were covered in the biochemistry, microbiology, pathology,
      and clinical science components. Both basic science concepts and clinical
      applications of genetics are covered in the curriculum by providing appropriate
      references for basic concepts and including inherited conditions within the
      differential diagnosis in the cases studied. Evaluations consist of a multiple
      choice content exam and a modified essay exam based on a clinical case, allowing
      evaluation of both basic concepts and problem-solving ability. This curriculum
      prepares students to use genetics in a clinical context in their future careers.

PMID- 2220817
TI  - Alkaline phosphatase (tissue-nonspecific isoenzyme) is a phosphoethanolamine and
      pyridoxal-5'-phosphate ectophosphatase: normal and hypophosphatasia fibroblast
      study.
AB  - To clarify its physiologic role, alkaline phosphatase (ALP) was examined in
      normal skin fibroblasts and was shown to be the tissue-nonspecific (TNS)
      isoenzyme type (as evidenced by heat and inhibition profiles) and to be active
      toward millimolar concentrations of the putative natural substrates
      phosphoethanolamine (PEA) and pyridoxal-5'-phosphate (PLP). Fibroblast ALP has a
      low-affinity activity, with a distinctly alkaline pH optimum (9.3), toward 4
      methylumbelliferyl phosphate (4-MUP), PEA, and PLP but a more physiologic pH
      optimum (8.3) toward physiologic concentrations (micromolar) of PEA and PLP.
      Normal fibroblast ALP is linked to the outside of the plasma membrane, since in
      intact cell monolayers (1) dephosphorylation rates of the membrane-impermeable
      substrates PEA and PLP in the medium at physiologic pH were similar to those
      observed with disrupted cell monolayers, (2) brief exposure to acidic medium
      resulted in greater than 90% inactivation of the total ALP activity, and (3)
      digestion with phosphatidylinositol-specific phospholipase C (PI-PLC) released
      about 80% of the ALP activity. Hypophosphatasia fibroblasts were markedly
      deficient (2%-5% control values) in alkaline and physiologic ALP activity when 4
      MUP, PLP, and PEA were used as substrate. The majority of the detectable ALP
      activity, however, appeared to be properly lipid anchored in ecto-orientation.
      Thus, our findings of genetic deficiency of PEA- and PLP-phosphatase activity in
      hypophosphatasia fibroblasts, as well as our biochemical findings, indicate that
      TNS-ALP acts physiologically as a lipid-anchored PEA and PLP ectophosphatase.

PMID- 2220818
TI  - Splicing defect at the ornithine aminotransferase (OAT) locus in gyrate atrophy.
AB  - Gyrate atrophy (GA), a recessive eye disease involving progressive vision loss
      due to chorioretinal degeneration, is associated with the deficiency of the
      mitochondrial enzyme ornithine aminotransferase (OAT), with consequent
      hyperornithinemia. We and others have reported a number of missense mutations at
      the OAT locus which result in GA. Here we report a GA patient of Danish/Swedish
      ancestry in whom one OAT allele produces an mRNA that is missing a single 96-bp
      exon relative to the normal mRNA. Polymerase-chain-reaction amplification and
      sequencing revealed a 9-bp deletion covering the splice acceptor region of exon
      5, resulting in the absence of exon 5 sequences from the mRNA with no disruption
      to the reading frame. This mutation, which was not present in 15 other
      independent GA patients, adds to the array of allelic heterogeneity observed in
      GA and represents the first example of a splicing mutation associated with this
      disorder.

PMID- 2220819
TI  - Deletion mapping of Aland Island eye disease to Xp21 between DXS67 (B24) and
      Duchenne muscular dystrophy.
AB  - Aland Island Eye Disease (AIED) is an X-linked form of ocular hypopigmentation-
      also known as Forsius-Eriksson, or type 2, ocular albinism--in which affected
      males demonstrate subnormal visual acuity, protanomalous red-green
      colorblindness, axial myopia, astigmatism, hypoplasia of the fovea, and
      hypopigmentation of the fundus. A patient has previously been described who, in
      addition to AIED, manifested a contiguous gene syndrome which included congenital
      adrenal hypoplasia (AHC), glycerol kinase deficiency (GKD), and Duchenne muscular
      dystrophy (DMD). In the present paper report we report the molecular genetic
      analysis of his deletion. Initially, multiplex polymerase-chain-reaction
      amplification was used to screen for a DMD-locus deletion which was then further
      characterized, using DMD cDNA and genomic probes, via Southern blot analysis. The
      deletion includes the region encompassed by probes C7 (DXS28) and DMD cDNA 8.
      Probes B24 (DXS67) and DMD cDNA 5b-7 show normal hybridization patterns and
      appear to flank the deletion, while the DMD cDNA 8 detects a junction fragment.
      Molecular genetic techniques have mapped the deletion in this patient to the
      subbands Xp21.3-21.2, between DXS67 and DMD.

PMID- 2220820
TI  - Chromosomal localization of the human alpha-L-iduronidase gene (IDUA) to 4p16.3.
AB  - The lysosomal hydrolase alpha-L-iduronidase (IDUA) is one of the enzymes in the
      metabolic pathway responsible for the degradation of the glycosaminoglycans
      heparan sulfate and dermatan sulfate. In humans a deficiency of IDUA leads to the
      accumulation of glycosaminoglycans, resulting in the lysosomal storage disorder
      mucopolysaccharidosis type I. A genomic subclone and a cDNA clone encoding human
      IDUA were used to localize IDUA to chromosome 4p16.3 by in situ hybridization and
      this was confirmed by Southern blot analysis. This localization is different from
      that of a previous report mapping IDUA to chromosome 22 and places the gene for
      IDUA in the same region of chromosome 4 as the Huntington disease gene.
      Measurement of expressed human IDUA activity in human-mouse hybrid cell lines
      confirmed that IDUA is on chromosome 4.

PMID- 2220821
TI  - More than one mutant allele causes infantile Tay-Sachs disease in French
      Canadians.
AB  - Two Tay-Sachs disease (TSD) patients of French-Canadian origin were shown by
      Myerowitz and Hogikyan to be homozygous for a 7.6-kb deletion mutation at the 5'
      end of the hexosaminidase A alpha-subunit gene. In order to determine whether all
      French-Canadian TSD patients were homozygotes for the deletion allele and to
      assess the geographic origins of TSD in this population, we ascertained 12 TSD
      families of French-Canadian origin and screened for occurrence of mutations
      associated with infantile TSD. DNA samples were obtained from 12 French-Canadian
      TSD families. Samples were analyzed using polymerase-chain-reaction (PCR)
      amplification followed by hybridization to allele-specific oligonucleotides (ASO)
      or by restriction analysis of PCR products. In some cases Southern analysis of
      genomic DNA was performed. Eighteen of the 22 independently segregating mutant
      chromosomes in this sample carried the 7.6-kb deletion mutation at the 5' end of
      the gene. One chromosome carried the 4-nucleotide insertion in exon 11 (a
      "Jewish" mutation). In this population no individuals were detected who had the
      substitution at the splice junction of exon 12 previously identified in Ashkenazi
      Jews. One chromosome carried an undescribed B1 mutation; this allele came from a
      parent of non-French-Canadian origin. Patients in three families carried TSD
      alleles different from any of the above mutations. The 5' deletion mutation
      clusters in persons originating in southeastern Quebec (Gaspe) and adjacent
      counties of northern New Brunswick.

PMID- 2220823
TI  - The pattern of factor IX germ-line mutation in Asians is similar to that of
      Caucasians.
AB  - To begin documenting the pattern of germ-line mutations in different human races,
      we have delineated the mutation in nine Korean families with hemophilia B by
      direct genomic sequencing of the regions of likely functional significance in the
      factor IX gene. An evaluation of these mutations in combination with previously
      described point mutations in the factor IX gene of Asians indicates that
      transitions predominate followed by transversions and microdeletions/insertions.
      Transitions at the dinucleotide CpG are a dramatic hot spot of mutation. This
      pattern of mutation is very similar to that observed in Caucasians with
      hemophilia B, despite the many differences between Asians (mostly Koreans) and
      Caucasians in diet, environment and cultural life-styles. The similarity may
      reflect the predominance of endogenous processes or ubiquitous mutagens rather
      than specific mutagens in the environment. The following additional conclusions
      emerge: (1) The missense mutations in Asians occur at evolutionarily conserved
      amino acids. When combined with the previous data this makes it likely that more
      than two-thirds of the missense mutations which could possibly occur at
      nonconserved amino acids do not cause hemophilia B. (2) Surprisingly, a change in
      the sixth base of the intron 2 donor splice-junction sequence is associated with
      severe disease in HB 74/77. (3) Direct carrier testing of nine Korean families
      demonstrates that the stability of DNA at ambient temperature in blood with the
      anticoagulant ACD solution B makes it feasible for a diagnostic laboratory to
      perform such testing at a distance of 7,000 miles. Carrier testing revealed that
      the mutation in HB78 arose in his mother's germ-line.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2220824
TI  - The probabilistic determination of identity-by-descent sharing for pairs of
      relatives from pedigrees.
AB  - Methods for detecting genetic linkage are more powerful when they fully use all
      of the data collected from pedigrees. We first discuss a method for obtaining the
      probability that a pedigree member has a given genotype, conditional on the
      phenotypes of his relatives. We then develop a rapid method to obtain the
      conditional probabilities of identity-by-descent sharing of marker alleles for
      all related pairs of individuals from extended pedigrees. The method assumes that
      the individuals are noninbred and that the relationship between genotype and
      phenotype is known for the marker locus studied. The probabilities of identity-by
      descent sharing among relative pairs, conditional on marker phenotype
      information, can then be used in any of the model free tests for linkage between
      a trait locus and a marker locus.

PMID- 2220822
TI  - Equal parental origin of chromosome 22 losses in human sporadic meningioma: no
      evidence for genomic imprinting.
AB  - Inactivation of tumor suppressor genes can occur either by mutation at the gene
      locus or by loss of part or all of the chromosome region containing the gene. The
      latter is most frequently detected by DNA markers as loss of heterozygosity in
      the tumor tissue. In several reports, the paternal homologue was preferentially
      retained in embryonal tumors associated with loss of particular chromosomal
      regions, suggesting genomic imprinting of the corresponding tumor suppressor
      loci. To explore the generality of these findings and the possible role of
      genomic imprinting in adult tumors of the nervous system, we have determined the
      parental origin of chromosome 22 loss in sporadic meningioma. Of nine cases
      studied, five tumors retained the maternally derived chromosome 22 homologue
      while four retained the paternally derived chromosome 22. Thus, in contrast to
      the embryonal tumors, the meningioma locus on chromosome 22 is inactivated by
      random mutation in sporadic adult meningiomas.

PMID- 2220825
TI  - Minisatellite allele diversification: the origin of rare alleles at the HRAS1
      locus.
AB  - Three genetic markers within the promoter-exon 1 region of the HRAS1 locus have
      been employed to investigate lineage relationships among alleles of the highly
      polymorphic variable tandem repeat (VTR) immediately downstream of the HRAS1
      gene. These markers were in absolute linkage disequilibrium with the HRAS1 VTR,
      allowing the assignment of unique upstream haplotypes to each of the four common
      VTR alleles. Analysis of 17 rare alleles revealed a stratification of allele
      fragment size and upstream haplotype in which each rare VTR allele possessed the
      markers characteristic of the common allele nearest in size. Therefore,
      hyperallelism emanated from the four common alleles in a defined fashion, the
      size of a rare allele specifying its origin. As discussed below, this result
      implies that unequal crossing-over between homologues is unlikely to be the
      predominant mechanism for generating new VTR alleles at this minisatellite locus.

PMID- 2220826
TI  - Further mapping of an ataxia-telangiectasia locus to the chromosome 11q23 region.
AB  - We recently mapped the gene for ataxia-telangiectasia group A (ATA) to chromosome
      11q22-23 by linkage analysis, using the genetic markers THY1 and pYNB3.12
      (D11S144). The most likely order was cent-AT-S144-THY1. The present paper
      describes further mapping of the AT locus by means of a panel of 10 markers that
      span approximately 60 cM in the 11q22-23 region centered around S144 and THY1.
      Location scores indicate that three contiguous subsegments within the [S144-THY1]
      segment, as well as three contiguous segments telomeric to THY1, are each
      unlikely to contain the AT locus, while the more centromeric [STMY-S144] segment
      is most likely to contain the AT locus. These data, together with recent
      refinements in the linkage and physical maps of 11q22-23, place the AT locus at
      11q23.

PMID- 2220828
TI  - Preventing respiratory disease in swine confinement workers: intervention through
      applied epidemiology, education, and consultation.
AB  - A combined epidemiological and intervention study was conducted on 207 swine
      confinement farmers with matched comparison subjects. The objectives of the study
      were to define, in detail, the nature and disease determinants in this exposed
      group and to explore methods of disease prevention. This 5 year prospective study
      included three annual medical assessments of workers and complementary work
      environment assessments. Between the first and second assessment periods, an in
      depth educational intervention was conducted. An industrial hygiene consultation
      intervention was conducted between the second and third measurement periods.
      Outcome measurements included changes in knowledge, attitudes, and behavior
      following educational intervention. Additionally, the outcomes measured included
      changes in medical and environmental assessment over the 3 year assessment
      periods. Results of the baseline respiratory symptoms assessment are reported
      here. Nearly 20% of swine confinement workers reported chronic cough, and 25%
      reported phlegm (American Thoracic Society questionnaire). Both symptoms were
      significantly more prevalent in the confinement workers compared to a blue collar
      comparison group, but only phlegm production was more prevalent compared to
      nonconfinement farmers. Work-related symptoms were reported much more frequently
      than chronic symptoms (e.g., 87% of confinement workers reported work-related
      cough). Bronchitis as well as airways reactivity were all significantly more
      prevalent in confinement workers compared to nonconfinement workers. Smoking
      seemed to have an additive effect with confinement exposure. Bronchitis and chest
      tightness symptoms were reported to be more severe upon return to work after an
      absence of 7 days or more. Finally, 34% of workers reported episodes of organic
      dust toxic syndrome.

PMID- 2220827
TI  - Diversity of some gene frequencies in European and Asian populations. V. Steep
      multilocus clines.
AB  - Regions of abrupt genetic change, which result from either rapid spatial change
      of selective pressures or limited admixture, were investigated in Europe and Asia
      on the basis of eight red cell markers typed in 960 samples. Two methods were
      employed, one based on genetic distances and one on evaluation of the first
      derivative of the surfaces representing allele-frequency variation. Genetic
      divergence tends to be maximal between populations that are separated by physical
      factors (mountain ranges and seas) but also separated by cultural barriers
      (different language affiliation). This suggests that mating isolation, rather
      than adaptive response to environmental change, accounts for spatially abrupt
      genetic change at the loci studied and that cultural differences associated with
      language contribute to isolating populations. Although selection may have
      determined two wide allele-frequency gradients, the genetic structure of European
      and Asian populations seems primarily to reflect isolation by distance when
      investigated on a small scale and migration patterns (or absence of migration)
      when investigated on a larger scale.

PMID- 2220829
TI  - Cohort studies of immunologic lung disease among Wisconsin dairy farmers.
AB  - Traditionally, hypersensitivity pneumonitis (HP) or farmer's lung disease (FLD)
      was thought to be the major occupational respiratory problem of farmers. In
      recent years, other acute conditions, particularly organic dust toxic syndrome
      (ODTS), have been recognized as significant features of the agricultural
      respiratory disease picture. The differences between HP and ODTS are discussed in
      this article. A cohort of workers on 90 dairy farms has been under study since
      1975. Prevalence of FLD was calculated at 4.2/1,000. Extensive immunologic
      testing of this group was conducted. Serum antibody reactivity to farmer's lung
      antigens was related to chronic symptoms of bronchitis and occupational asthma,
      but not FLD. Serology may be thought of as a measure of exposure, but not FLD.

PMID- 2220830
TI  - Work-related respiratory disorders among Finnish farmers.
AB  - Several research projects on work-related respiratory diseases have been
      conducted in Finland. One of the largest, "Farmers' Occupational Health
      Programme," was conducted by the Social Insurance Institution of Finland during
      1973-1983 in cooperation with Kuopio Regional Institute of Occupational Health
      and the National Board of Health. The main objective of the program was to
      develop a model for occupational health services for farmers. As a part of the
      program, postal surveys were conducted in 1979 and 1982. The surveys allowed an
      analysis of both the prevalence and the mean annual incidence of asthma, farmer's
      lung, and chronic bronchitis as well as of background variables related to the
      diseases. More than every tenth farmer suffered from these respiratory diseases.
      The occurrence of chronic bronchitis (the most common disease) was, in general,
      related to farming types in which grain crops (including animal feeds) were
      handled. Chronic bronchitis was most prevalent among farmers who worked in
      piggeries, implying a combined effect of grain dusts, dusts of animal origin, and
      development of the disease. Atopy predisposed to and had an additive effect with
      smoking on chronic bronchitis.

PMID- 2220831
TI  - Practical aspects of sampling for organic dusts and microorganisms.
AB  - Air sampling for organic dusts and microorganisms was carried out in silos when
      moldy silage was discarded through the discharge chute. Concentrations of
      respirable dust and airborne viable microorganisms exceeded 20 mg/m3 and 1 x
      10(9)/m3, respectively, when dry silage was removed from silos. Much lower
      concentrations of dust and microorganisms were present when wet silage was
      discarded. Impinger and filter cassette samplers were equally effective in
      collecting the hardy spores present in silage dusts.

PMID- 2220832
TI  - Presence of endotoxins in different agricultural environments.
AB  - Gram-negative bacterial endotoxins are contaminants of dusts from agricultural
      products. They represent a potential health hazard for farmers working in many
      different processes. However, the occurrence of endotoxins has not been well
      characterized in the various farming operations. Therefore, two farming
      activities with potential for generating airborne endotoxins were studied: 1)
      chopping of baled corn stalks or straw for bedding in New York State, and 2) oat
      bin unloading in Alabama. Actual airborne endotoxin levels in dusts obtained
      during bedding chopper operations far exceeded [90 endotoxin units (EU)/m3] the
      level at which acute pulmonary function decrements occur in cotton dust-exposed
      individuals. Endotoxin contamination of laboratory-generated dust from an oat
      sample likewise exceeded these levels. This study documents the presence of
      potentially hazardous exposures to endotoxins in two common farm processes, which
      expands the knowledge of airborne endotoxin exposures on the farm.

PMID- 2220833
TI  - Methodologic issues in exposure assessment for case-control studies of cancer and
      herbicides.
AB  - Epidemiologic studies of cancer and exposure to herbicides have shown puzzling
      inconsistencies. Exposure-response gradients have been reported for non-Hodgkin's
      lymphoma in Sweden and Kansas, but no significant associations were seen in New
      Zealand or Washington State. Subjects in these studies were categorized by
      exposure using information obtained primarily by interview. A number of questions
      can be raised regarding the reliability and validity of such an exposure
      assessment. We examined procedures used to assess pesticide exposures in case
      control studies of cancer to evaluate their limitations and their probable
      effects on risk estimates. Except for case recall bias, problems of
      misclassification in these studies would tend to bias risk estimates toward the
      null and dilute exposure-response gradients. These problems are, therefore,
      unlikely explanations for the positive associations between cancer and herbicide
      use noted in some investigations. A tendency for false-negative findings,
      however, is not reassuring, and improvements in exposure assessment are needed if
      epidemiologic investigations are to continue to provide reliable information on
      the relationships of cancer and pesticide exposure.

PMID- 2220834
TI  - Cancer in Iowa farmers: recent results.
AB  - Previous analysis of Iowa death certificates from 1971 through 1978 identified
      several cancers with significantly elevated mortality in farmers. Subsequent
      ecological studies identified farm practices, including pesticide usage, that
      might be associated with these mortalities. These results led to several case
      control studies and a similar analysis of more recent death certificates. 'Usual
      occupation' has been added to the death certificate tapes for the years 1979
      1986. Cancer mortality in Iowa farmers for this period is very similar to that
      for 1971-1978. Case-control studies for acute lymphocytic leukemia and multiple
      myeloma indicated that farming in general is not a risk factor for either cancer
      type. However, exposure to general classes of insecticides and herbicides is
      associated with an elevated odds ratio in farmers for incidence of multiple
      myeloma. The odds ratios are not statistically significant at the 5% level,
      probably due to relatively small numbers of cases and controls exposed to any one
      class of pesticides.

PMID- 2220836
TI  - Pesticide illness surveillance: review of the National Pesticide Hazard
      Assessment Program.
AB  - Regarding consultations on pesticide exposures by Oregon State University, the
      following information is summarized: 1) source of queries; 2) locations of
      exposure; 3) types of chemicals; and 4) nature of the illnesses. The majority of
      queries involve nonagricultural exposures in the home and workplace. Principal
      sources of referral are from the National Pesticide Telecommunications Network
      (toll-free number), state departments of agriculture, and state extension
      services. In addition to illnesses, the system also responds to press releases
      such as those that occurred after the withdrawal of chlordane. Previously
      unsuspected clinical problems have been reported (suggesting new areas of
      research need), including cases associated with long-acting organophosphates,
      such as chlorpyrifos, and with the pyrethroids.

PMID- 2220835
TI  - Environmental epidemiology of non-Hodgkin's lymphoma in eastern Nebraska.
AB  - The incidence of non-Hodgkin's lymphoma (NHL) is increased in many counties in
      eastern Nebraska. Histologic analysis has revealed a twofold increase in the
      clinically aggressive, diffuse large cell subtype of NHL. To investigate the
      possible association between NHL and agricultural exposures, a population-based
      case-control study was conducted in eastern Nebraska in 1985. Telephone
      interviews were conducted with 201 men having histologically confirmed NHL and
      725 controls. Among men, the use of the herbicide 2,4-D was associated with a 50%
      increased risk of NHL (OR 1.5, 95% CI 0.9, 2.4). Personal exposure to 2,4-D more
      than 20 days per year increased the risk threefold (OR 3.3, 95% CI 0.5, 22.1).
      Several classes of insecticides were also associated with increased risk:
      organophosphates (OR 1.9, 95% CI 1.1, 3.1), carbamates (OR 1.8, 95% CI 1.0, 3.2),
      and chlorinated hydrocarbons (OR 1.4, 95% CI 0.8, 2.3). As a result of intense
      agrichemical use, extensive contamination of shallow groundwater by nitrate and
      atrazine has also occurred in eastern Nebraska. A twofold increased incidence of
      NHL is present in counties with greater than 20% of the wells contaminated by
      nitrate (greater than 10 ppm) and in counties with intense fertilizer use. These
      findings suggest that NHL in eastern Nebraska may be related to the use of
      pesticides and nitrogen fertilizers.

PMID- 2220837
TI  - Effects of organophosphate insecticide residue variability on reentry intervals.
AB  - A stochastic simulation program was written to study the importance of residue
      variability in predicting excessive chronic (seasonal) cholinesterase (AChE)
      inhibition and acute illness among a cohort of agricultural harvesters grouped
      into crews exposed to AChE-inhibiting insecticides. It was concluded that residue
      variability can substantially affect the cohort's AChE level only for daily mean
      AChE inhibitions below 4% per day, increasing end-of-season mean AChE inhibition
      but actually decreasing the cohort's end-of-season variability. The incidence of
      acute individual and group (crew) AChE inhibitions in excess of that potentially
      producing clinical symptoms (assumed herein to be greater than 50% in a day),
      exhibits a fairly clear boundary as a function of a combination of the residue's
      mean and deviation. The predicted acute response accurately parallelled reported
      rates, thus validating the simulation model.

PMID- 2220838
TI  - Chronic neuropsychological sequelae of occupational exposure to organophosphate
      insecticides.
AB  - The early (immediate and delayed) neurotoxic effects of acute organophosphate
      intoxication are well documented in the scientific literature; lack of
      recognition and inappropriate treatment of occupational poisonings continue. Less
      well understood is the potential development of chronic neuropsychological
      sequelae from exposures to insecticides. We undertook two cohort studies to
      assess chronic neuropsychologic effects of insecticide poisoning. Based, in part,
      on our clinical evaluation of several patients, these studies included: 1) a
      retrospective cohort study assessing function at least 1 year following moderate
      to severe poisonings among farm workers; and 2) a prospective cohort study
      assessing neuropsychological function before and after a season of
      organophosphate exposures among pesticide applicators. A typical case
      description, the study design, methodologic problems, and preliminary findings of
      these ongoing studies are presented.

PMID- 2220839
TI  - Neurotoxic concerns of human pesticide exposures.
AB  - While the human effects of acute pesticide poisoning are well known, significant
      data gaps exist with regard to what is known about some of the chronic effects,
      particularly neurotoxic and behavioral aspects of organophosphate exposures. The
      extent of this concern is particularly high in Europe where these issues are
      being addressed by the World Health Organization and the United Nations
      Development Programme. These agencies are sponsoring a ten-nation, international
      study of chronic neurologic and neurotoxic sequelae. In the United States,
      evidence for chronic neurologic effects have come from case studies, clusters of
      neurologic disease, or from specific epidemiologic studies. For both toxicologic
      and epidemiologic reasons, it is essential that the neurobehavioral potential of
      low-level, prolonged exposure to pesticides and pesticide mixtures be more
      thoroughly investigated. Workers exposed to pesticides are one of the largest
      occupational populations at risk in the world. The effects of these occupational
      exposures on the worker's nervous system and behavior are just beginning to be
      investigated.

PMID- 2220840
TI  - Noise-induced hearing loss in randomly selected New York dairy farmers.
AB  - To understand better the effects of noise levels associated with dairy farming,
      we randomly selected 49 full-time dairy farmers from an established cohort.
      Medical and occupational histories were taken and standard audiometric testing
      was done. Forty-six males (94%) and three females (6%) with a mean age of 43.5
      (+/- 13) years and an average of 29.4 (+/- 14) years in farming were tested. Pure
      Tone Average thresholds (PTA4) at 0.5, 1.0, 2.0, and 3.0 kHz plus High Frequency
      Average thresholds (HFA3) at 3.0, 4.0, and 6.0 kHz were calculated. Subjects with
      a loss of greater than or equal to 20 db in either ear were considered abnormal.
      Eighteen subjects (37%) had abnormal PTA4S and 32 (65%) abnormal HFA3S. The left
      ear was more severely affected in both groups (p less than or equal to .05, t
      test). Significant associations were found between hearing loss and years worked
      (odds ratio 4.1, r = .53) and age (odds ratio 4.1, r = .59). No association could
      be found between hearing loss and measles; mumps; previous ear infections; or use
      of power tools, guns, motorcycles, snowmobiles, or stereo headphones. Our data
      suggest that among farmers, substantial hearing loss occurs especially in the
      high-frequency ranges. Presbycusis is an important confounding variable.

PMID- 2220841
TI  - Hip joint arthrosis: an occupational disorder among farmers.
AB  - Observations among Swedish farmers indicate that coxarthrosis is a common
      disorder in farming populations. In this case-referent study, we describe
      relationships between farming and hip joint arthrosis. The case-group consisted
      of 105 persons who have had surgery because of coxarthrosis and the referents
      consisted of 222 randomly selected persons. Non-responders totaled 9%. Farming
      was significantly more common in the case group. The ratio varied between 2.1 and
      3.2, varying with the length of time in farming. Longer exposure did not seem to
      result in greater risk. There was no risk elevation related to forestry or
      transportation work. Nor was there any over-representation of accidents with
      injuries to the lower extremities in the case group. Heavy work load did not seem
      to be related to the genesis of coxarthrosis. Farming is an amalgamation of
      different types of work. However, we develop the hypothesis from this study that
      tractor driving may be related to hip arthrosis. Unfavorable angles in the hip
      joints may occur during tractor driving. Other studies support this hypothesis,
      as it has been found that unsuitable conditions for the hip joints may be related
      to arthrosis.

PMID- 2220843
TI  - Doxorubicin multiple-dose vials.

PMID- 2220842
TI  - Aztreonam--vancomycin incompatibility.

PMID- 2220845
TI  - Managed-care pharmacy.

PMID- 2220844
TI  - Methylprednisolone for acute spinal cord injury.

PMID- 2220846
TI  - Revisiting "The strengths of pharmacy": the 1953 Remington Medal address.
AB  - Five reasons for the continued strength of the pharmacy profession, each of which
      was originally proposed in 1953 by Hugh Muldoon, are explored in this address by
      1990 Remington Medalist Joseph A. Oddis. The strengths of pharmacy in the 1990s
      are based on the same factors that served the profession well in the 1950s. As
      outlined in Muldoon's 1953 Remington Medal address, these factors are (1)
      pharmacists' character and motivation, (2) the profession's public trust, (3) the
      profession's respect for education, (4) pharmacy's willingness to confront its
      problems, and (5) pharmacy's concern for the future. Today's pharmacists are
      strongly motivated; they continue to strive to raise the level of services
      provided in all practice settings and to maximize their value to patients.
      Pharmacists retain a high degree of public trust; they should take advantage of
      this position to expand their scope of services in areas such as managed care.
      During the 1990s pharmacy's concern for education is focused on pharmacy work
      force needs as a whole, including issues related to technical personnel and
      specialization as well as the role of the Pharm.D. degree in the overall
      education program. Pharmacy's willingness to resolve its problems is evident in
      the growth of such organizations as the Joint Commission of Pharmacy
      Practitioners, which has allowed the profession to achieve strength through
      unity. Pharmacy's concern for the future is reflected in the deliberations at
      recent conferences on Pharmacy in the 21st Century, where participants concurred
      that pharmacy's highest priority is to demonstrate and communicate to others its
      value in health care.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220847
TI  - Understanding the resources and organization of an industry-based drug
      information service.

PMID- 2220848
TI  - Drug information services at Burroughs Wellcome Co.

PMID- 2220849
TI  - Drug information services at Genentech.

PMID- 2220850
TI  - Drug information services at Eli Lilly and Company.

PMID- 2220851
TI  - Drug information services at Pfizer labs.

PMID- 2220852
TI  - Drug information services at the Upjohn Company.

PMID- 2220853
TI  - Implementation of product-line management in a hospital pharmacy department.
AB  - The development and implementation of product-line management (PLM) in a pharmacy
      department is reviewed. The PLM system of hospital organization shifts the
      emphasis from function to product. The pharmacy department at a 737-bed nonprofit
      hospital adopted PLM in an effort to reach more directly the physician and
      patient markets, enhance the image of pharmacy, and help meet requirements of the
      Joint Commission on Accreditation of Healthcare Organizations. The department
      surveyed physicians and administrators to identify their product and service
      needs and surveyed pharmacy staff members to identify the perceived benefits and
      risks of a PLM system. A strategic-planning session was held to decide how best
      to match the pharmacy department's product lines with market needs. The team
      leaders were renamed clinical supervisors and were no longer responsible for
      defined physical areas but rather for clinical matters relating to patients in
      the product line assigned. Pharmacy's chosen product lines were oncology
      services, neuropsychiatry, maternal and child care, cardiovascular, operating
      room-anesthesia-pain clinic, and general medical. The transition is being
      accomplished one product line at a time; interested team leaders transfer into
      clinical supervisor positions by achieving clinical expertise within the relevant
      product lines. Despite some initial confusion, PLM contributed to job
      satisfaction and morale and allowed the pharmacy department to provide increased
      clinical consultation and intervention services. PLM enhanced the clinical
      pharmacy program and focused clinical services on the physician and ultimately
      the patient.

PMID- 2220854
TI  - Outcome-focused counseling program for quality assurance in ambulatory care.
AB  - An outcome-focused patient-counseling program designed to enhance quality
      assurance in ambulatory pharmaceutical care is described. Drugs for which
      counseling was mandatory because of their potential for association with an
      adverse outcome were listed. A checklist was created for each drug class to
      assist pharmacists in providing uniform information and to serve as a follow-up
      document for quality assurance. The completed forms are used to indicate which
      patients' charts should be pulled for review against quality assurance criteria
      for the monitored drug classes; the criteria function as indicators of an adverse
      outcome. Findings are summarized and presented at the monthly meeting of the
      departmental quality assurance committee. The program was phased in one drug
      class at a time. Between October 1988 and January 1989, 18 charts were reviewed
      for the two drug classes being monitored during that period. There were no
      patients to whom the indicators of an adverse outcome applied. The outpatient
      counseling program helped pharmacists to provide consistent information and to
      focus on those drugs with the highest potential for adverse outcomes.
      Incorporating the program into quality assurance activities made it easier to
      measure patient outcomes.

PMID- 2220855
TI  - Use of time clocks for employees in health-care institutions.
AB  - The reasons for time clock use in health-care institutions, the categories of
      workers required to use a time clock and other timekeeping methods, and the
      incidence of time-clock-related conflicts were studied. A questionnaire was
      mailed to a random sample of 565 hospitals in October 1989. Usable responses were
      received from 340 (60.0%) of the institutions. Reasons given for time clock use
      included payroll tabulation, overtime calculation, and ensuring fair payment.
      Thirty-four institutions (10.0%) required all employees to clock in, and 179
      (52.6%) required some employees to do so. A written time card completed by the
      employee was the method used most frequently if a time clock was not used.
      Clinical pharmacists were required to clock in at 51 institutions (15.0%), staff
      pharmacists at 62 (18.2%), and pharmacy technicians at 144 (42.9%). Clinical
      nurse specialists and registered nurses clocked in at 88 (25.9%) and 169 (49.7%)
      hospitals, respectively, and licensed practical nurses and nurse's aides each
      clocked in at 176 hospitals (51.8%). Less than 6% of the hospitals required
      salaried pharmacists or nurses to use a time clock. Of the respondents, 152
      (44.7%) reported that they were not aware of any conflicts or that no conflicts
      had been experienced. Inconvenience and inaccurate clocking were the most common
      sources of conflict cited. Most hospitals use time clocks for nonsalaried
      employees for bookkeeping purposes; dissatisfaction with this method of tracking
      hours worked does not appear to be widespread.

PMID- 2220856
TI  - Using pharmacists' perceptions in planning changes in pharmacy practice.
AB  - Pharmacists' perceptions of and goals for clinical pharmacy services, as well as
      the proportion of time devoted to clinical services, were studied at one hospital
      as part of the process for establishing departmental goals. Three methods were
      used in evaluating pharmacists' perceptions of clinical pharmacy services. The
      first was a departmental survey. Second, staff members were asked to generate and
      prioritize a list of goals for clinical pharmacy services; this was done by means
      of an interactive, small-group process. Finally, a work-sampling study was
      performed that indirectly measured use of staff pharmacist and technician time.
      Staff pharmacists perceived that clinical pharmacy services were being provided
      to individual patients; however, support for these services from upper management
      was perceived as inadequate. Staff development had the highest priority for the
      further development of clinical pharmacy services. Only 19.7% of pharmacists'
      time was devoted to clinical services. Data from all three studies were
      incorporated into the development of a strategic plan that set forth long-term
      departmental goals and objectives. The plan includes a statement of commitment to
      develop management systems to eliminate deficiencies identified in the study.
      Among the changes in pharmacy operations introduced as a result of the survey
      were (1) a career-ladder system, (2) new opportunities for staff development, and
      (3) improved documentation systems. Surveying staff perceptions of existing
      services, joint goal setting and prioritization, and work-sampling studies formed
      the basis for the development and implementation of a new model of integrated
      pharmacy services at this institution.

PMID- 2220857
TI  - Promotion of extended-release niacin tablets at a Veterans Affairs medical
      center.
AB  - A program to modify the prescribing of antilipemic agents by promoting the use of
      extended-release niacin tablets is described. Between December 1987 and August
      1988, pharmacists at a 1188-bed Veterans Affairs medical center observed a large
      increase in the number of outpatient prescriptions for antilipemic agents. In an
      attempt to control costs, a program to promote the use of extended-release niacin
      tablets for treating hyperlipemia was conducted during August and September 1988.
      Various educational materials on niacin were distributed to physicians. A display
      on therapy of hyperlipemia was featured at the monthly drug fair, and articles on
      niacin were presented during a journal club meeting of ambulatory-care
      clinicians. Pharmacists succeeded in having extended-release niacin tablets
      placed on the formulary in September. Data on the number of prescriptions filled
      for antilipemic agents were collected before and after the niacin promotional
      program. The number of prescriptions filled for extended-release niacin 500-mg
      tablets increased steadily during a six-month study period after the program
      ended; the number of prescriptions filled for regular niacin decreased by 50%. As
      prescribing of extended-release niacin increased, prescribing of colestipol,
      gemfibrozil, and probucol declined. The promotional program was well received by
      most of the medical staff. A program of education and formulary management
      successfully changed physician prescribing habits for antilipemic agents.

PMID- 2220858
TI  - Stability of fentanyl citrate and bupivacaine hydrochloride in portable pump
      reservoirs.
AB  - The stability of fentanyl citrate and bupivacaine hydrochloride in an admixture
      with 0.9% sodium chloride injection in portable pump reservoirs with or without
      overwraps was investigated. Twelve 100-mL samples containing fentanyl 20
      micrograms/mL and bupivacaine hydrochloride 1250 micrograms/mL were placed in the
      plastic drug reservoirs, and 1-mL quantities were withdrawn immediately after
      preparation and at intervals during 30 days of storage. Six reservoirs were
      refrigerated (3 degrees C) and six stored at room temperature (23 degrees C);
      three at each temperature were placed in overwraps. All samples were observed for
      precipitation and for change in color or pH and were analyzed for drug
      concentration by high-performance liquid chromatography. No precipitation or
      change in color or pH was observed during the 30-day storage period. No loss of
      fentanyl or bupivacaine was detected in either the wrapped or the unwrapped
      samples. Fentanyl citrate and bupivacaine hydrochloride in 0.9% sodium chloride
      injection appear to be compatible, and admixtures containing the two drugs at the
      concentrations studied can be stored without overwraps for up to 30 days at
      refrigerated or room temperature without any significant loss of potency.

PMID- 2220859
TI  - Stability of morphine sulfate in Cormed III (Kalex) intravenous bags.
AB  - The stability of various concentrations of morphine sulfate solution stored in
      Cormed III (Kalex) i.v. bags at two temperatures was investigated. Solutions of
      morphine sulfate 0.5, 15, 30, and 60 mg/mL were prepared under a horizontal
      laminar-airflow hood with 0.9% sodium chloride solution and placed into 100-mL
      Kalex bags. Two bags were prepared for each concentration; one was stored at 5
      degrees C and the other at 37 degrees C. Samples were analyzed in triplicate by
      high-performance liquid chromatography on days 0, 2, 5, 9, and 14. All morphine
      sulfate solutions were stable for 14 days at 37 degrees C, and the 0.5-, 15-, and
      30-mg/mL solutions were stable for 14 days at 5 degrees C. However, the 60-mg/mL
      solution stored at 5 degrees C was found to contain 57% of the actual initial
      concentration on day 9 and 51% on day 14; the decrease coincided with the
      appearance of a white precipitate. Beginning on day 5, all the solutions
      displayed a light brown color that darkened as the study proceeded. This
      qualitative change was not associated with any change in morphine concentration.
      Solutions of morphine sulfate 0.5 to 60 mg/mL stored at 5 or 37 degrees C were
      stable for 14 days in Kalex bags, except for 60-mg/mL solutions stored at 5
      degrees C for nine days or longer.

PMID- 2220860
TI  - Stability of ranitidine in intravenous admixtures stored frozen, refrigerated,
      and at room temperature.
AB  - The stability of ranitidine in concentrations of 0.5, 1.0, and 2.0 mg/mL in
      admixtures with commonly used i.v. fluids was studied. The admixture vehicles
      were 0.9% sodium chloride, 5% dextrose, 10% dextrose, 5% dextrose and 0.45%
      sodium chloride, and 5% dextrose with lactated Ringer's (DLR) injections in
      polyvinyl chloride bags. Three bags were prepared for each test solution and
      stored under each of the following conditions: seven days at room temperature (23
      +/- 1 degrees C) in normal laboratory lighting, 30 days at 4 degrees C, and 60
      days at -20 degrees C followed by either seven days at room temperature (in
      light) or 14 days at 4 degrees C. Ranitidine content was determined by high
      performance liquid chromatography at several intervals. Color, clarity, and pH
      were also examined. Ranitidine concentrations remained greater than or equal to
      90% of initial concentrations under all storage conditions except in the frozen
      DLR admixtures. Drug loss in the DLR admixtures was greatest at the lower
      ranitidine concentrations. The only visual changes were yellow color in the
      thawed DLR admixtures and those containing ranitidine 2.0 mg/mL in 5% dextrose
      and 0.45% sodium chloride. Slight increases in the pH of some admixtures were
      noted. Ranitidine is stable for seven days at room temperature and 30 days at 4
      degrees C at all concentrations and in all vehicles studied. At the studied
      concentrations, the drug is stable in admixtures frozen for 60 days and stored
      for seven days at room temperature or 14 days refrigerated, except in DLR
      admixtures; these admixtures should not be stored frozen.

PMID- 2220861
TI  - Managed care: the second generation.
AB  - The current status of managed health care is described and its impact on hospital
      and pharmacy operations is summarized. In the 1980s, managed care evolved into a
      three-segment industry, comprising health maintenance organizations (HMOs),
      preferred-provider organizations, and fee-for-service plans. Five new trends are
      emerging as managed care, now an established part of the country's health-care
      delivery system, enters its second generation: dual- and triple-option plans with
      financial risk sharing between employers and insurers/HMOs, point-of-service
      determination of benefits and coverage, consolidation of the number of options
      offered by employee health plans, creation of exclusive provider organizations,
      and direct provider contracting. Persons charged with negotiating managed-care
      contracts will make use of three primary cost-management methods: benefit design,
      provider reimbursement, and prospective pricing. Employees will take an
      increasingly active part in purchase decisions. Enrollees will face tradeoffs
      between their desire for maximum freedom of choice of provider and higher
      premiums, deductibles, and out-of-pocket expenses. Managed-care plans will
      continue to have a strong impact on hospitals, especially in the areas of
      reimbursement and use review. The effect of managed care on pharmacy operations
      will vary from institution to institution; among the positive results may be
      increased appreciation of the role of clinical pharmacy services in reducing the
      incidence of readmissions and the length of hospital stays. The result of these
      changes in the structure of health-care benefits will be greater price
      sensitivity, marked by a suppression of unnecessary use of health-care services
      and an increased tendency to compare and evaluate health-plan costs.

PMID- 2220862
TI  - Employer management of employee health plans.
AB  - Current trends in employer management of health-care plans are summarized, and
      the role of managed care is emphasized. Employers realize that employees perceive
      health-care plans as an important benefit and that attractive benefit plans will
      help in recruiting and retaining employees. At the same time, companies are faced
      with the need to find new ways in which to curtail the rising cost of health
      benefit plans, which often constitute their largest and most uncontrollable
      budget item. Such techniques as more effective claims administration, plan design
      changes, plan financing arrangements, education of employees, and increased
      employee cost sharing are among the cost-containment actions that employers are
      implementing. Managed-care networks including health maintenance organizations
      are often viewed as the ultimate cost-containment model; however, the
      effectiveness of these evolving arrangements must be rigorously evaluated on the
      basis of appropriate performance criteria and documentation of achievement. Faced
      with cost-containment pressures, employers are taking a more assertive and
      informed role in health-plan purchasing decisions. The future course of health
      care delivery will depend in large part on the response of corporate management
      to the challenge of ensuring that their employees receive quality health care at
      controllable costs.

PMID- 2220863
TI  - Shared-risk arrangement between employers and insurers.
AB  - Development of and initial experience with a shared-risk arrangement between an
      employer, Allied-Signal, Incorporated, and a health insurer, CIGNA Corporation,
      are discussed. Rapidly rising health-plan costs and projections for even greater
      increases in the next three years, coupled with other related considerations,
      spurred Allied-Signal to undertake a major re-evaluation of its employee health
      plan in 1987. After extensive discussions and consultation, Allied-Signal
      negotiated a shared-risk contract with CIGNA, a dual-option insurer, under which
      premium price increases are capped for a period of three years. CIGNA is at risk
      for any costs that exceed premium revenue; if costs are less than premium
      revenue, CIGNA will retain the surplus. Price and geographic accessibility to
      Allied-Signal beneficiaries were the two key factors in the choice of CIGNA
      Corporation. The company selected a point-of-service delivery model, which grants
      employees greater freedom of choice in the use of health-care providers; those
      who use network providers pay a fixed copayment while those who use nonnetwork
      providers pay a fixed copayment providers pay an annual deductible plus 20% of
      medical expenses incurred above the deductible. During the first year of the
      program, 75% of beneficiaries used network providers from 95% to 100% of the
      time. The actual costs for the first 18 months were less than projected and much
      less than increases experienced by fee-for-service plans during that same period.
      The shared-risk contract between Allied-Signal and CIGNA Corporation has been
      successful thus far.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2220864
TI  - Screening discharge prescriptions on a pediatric ward.

PMID- 2220865
TI  - Trends in advertisements as an indicator of pharmacy work-force demand.

PMID- 2220866
TI  - Survey of technician use in hospital and community pharmacies in South Carolina.

PMID- 2220867
TI  - Reducing costs by adjusting dosage intervals for intravenous ranitidine.

PMID- 2220868
TI  - Impact of computerization on New England hospital pharmacy personnel.

PMID- 2220869
TI  - Use of premixed frozen small-volume injections in a small community hospital.

PMID- 2220870
TI  - Stability of famotidine frozen in polypropylene syringes.

PMID- 2220872
TI  - The pharmacist as an expert witness.

PMID- 2220871
TI  - Pharmacist's qualifications as an expert witness on a physician's standard of
      care.

PMID- 2220873
TI  - Cyclophosphamide: to pulse or not to pulse?

PMID- 2220874
TI  - Treatment of Wegener's granulomatosis with intermittent high-dose intravenous
      cyclophosphamide.
AB  - PURPOSE: Concerns regarding the long-term toxicity of daily cyclophosphamide (CP)
      therapy for the systemic vasculitides have led us to evaluate alternative
      approaches to treatment in an attempt to achieve comparable efficacy with less
      toxicity. This study sought to determine the efficacy, toxicity, and immunologic
      effects of glucocorticoids (GC) and intermittent high-dose intravenous CP
      ("pulse" CP) in the treatment of 14 patients with Wegener's granulomatosis (WG).
      PATIENTS AND METHODS: The diagnosis of active WG was supported by a typical
      clinical presentation and histopathologic findings of vasculitis, granulomatous
      inflammation, and tissue necrosis. GC treatment was initially provided on a daily
      basis and later tapered to an alternate-day schedule if vasculitis remained
      inactive. Pulse CP treatment was initially administered once a month for 6
      months. If after 6 months remission had been attained and GC therapy had been
      discontinued, then pulse CP treatment was given at less frequent intervals
      thereafter. Treatment and evaluation were provided for participants as inpatients
      in a clinical research center (National Institutes of Health). RESULTS: Thirteen
      of 14 patients (93%) initially experienced unequivocal improvement with pulse CP
      therapy, and seven of 14 (50%) achieved remission within 4 months. However,
      treatment was associated with significant toxicity in two patients and later
      relapses in nine patients, so that a total of 79% either failed to achieve
      sustained remission or were unable to continue therapy. Three of 14 (21%)
      patients have achieved sustained remissions with the pulse CP protocol and one
      additional patient (who had a limited exacerbation of WG) continues to receive
      that therapy after 14 to 22 months (mean 17 months). CONCLUSIONS: The use of
      pulse CP and GC therapy in 14 patients with WG was associated with a high initial
      response rate. However, failure to respond initially to treatment, to sustain
      improvement, or to tolerate continued treatment was noted in 79% of patients
      within a period of 1 to 22 months. These observations indicate that this
      particular pulse CP protocol does not achieve a high degree of lasting efficacy.

PMID- 2220875
TI  - Digitalis-like activity in human plasma: relation to blood pressure and sodium
      balance.
AB  - PURPOSE: On the assumption that renal tubular cells are more important as the
      target cells for a natriuretic factor than blood cells, we used a well
      characterized cultured renal tubular cell line, Madin-Darby canine kidney (MDCK),
      cells to monitor the circulating digitalis-like factor in human plasma and
      examine its role in the regulation of blood pressure and sodium balance. SUBJECTS
      AND METHODS: We investigated the effects of plasma on binding of radioactive
      ouabain to monolayered MDCK cells in order to determine the level of a
      circulating digitalis-like factor. First, we measured specific 3H-ouabain binding
      to MDCK cells in the presence of plasma from 71 outpatients (34 normotensive
      subjects and 37 hypertensive patients) after incubation for 4 hours. Second, we
      measured specific 3H-ouabain binding after incubation of cells with plasma from
      16 hospitalized subjects (eight normotensive subjects and eight hypertensive
      patients) receiving low and high sodium diets. RESULTS: In Study 1, ouabain
      binding was lower by 30% with plasma from hypertensive patients than with plasma
      from normotensive subjects (p less than 0.01). There was a significant negative
      correlation between individual subject's systolic or mean blood pressure and
      ouabain binding (r = -0.34, p less than 0.01 or r = -0.29, p less than 0.01). In
      Study 2, ouabain binding was also significantly reduced by 25% in the presence of
      plasma from hypertensive subjects as compared with plasma from normotensive
      subjects irrespective of sodium intake (p less than 0.01). A significant negative
      correlation was also found for all subjects between either systolic, diastolic,
      or mean blood pressure and ouabain binding (r = -0.58, p less than 0.01, r = 
      0.51, p less than 0.01, or r = -0.55, p less than 0.01, respectively). With the
      changes from low to high sodium intake, there was a corresponding decrease in
      ouabain binding (p less than 0.01) and an increase in sodium excretion (p less
      than 0.01). A significant negative correlation was observed between these two
      parameters (r = -0.47, p less than 0.05). CONCLUSIONS: These findings suggest
      that a circulating digitalis-like factor, which may act on renal tubular cells as
      the ouabain-displacing compound, is increased in patients with essential
      hypertension and also demonstrate that plasma levels may be influenced by changes
      in dietary sodium intake.

PMID- 2220876
TI  - Effect of dietary protein restriction on functional renal reserve in diabetic
      nephropathy.
AB  - PURPOSE, PATIENTS, AND METHODS: Functional renal reserve in patients with insulin
      dependent diabetes mellitus, as determined by the glomerular filtration rate
      (GFR) response test, is a measure of the capacity of the kidney to increase
      glomerular filtration in response to the stimulus of a protein meal or amino acid
      infusion. This 12-month study evaluated the changes in functional renal reserve
      in eight patients with insulin-dependent diabetes mellitus with nephropathy
      (micro-albuminuria [greater than or equal to 30 micrograms/minute]) who
      chronically decreased their dietary protein intake to a mean of 0.6 g/kg/day
      (Group 1) compared with a group of similar patients (n = 7) who maintained their
      unusual dietary protein intake (1.0 g/kg/day, Group 2). Patients were evaluated
      and measurements taken at 3-, 6-, and 12-month intervals. Absolute and percent
      increases in GFR were calculated from three averaged 1-hour measurements after an
      80-g protein test meal. RESULTS: Although the initial absolute mean rise (14 +/-
      12 versus 18 +/- 13 mL/minute/1.73 m2) in GFR and maximal percent rise (16% +/-
      16% versus 32% +/- 27%) after the meal did not differ significantly between the
      two groups, at 12 months, values in the lower protein group increased (27.8 +/-
      9.5 mL/minute/1.73 m2 and 54.7% +/- 48.8%), whereas those in the normal protein
      intake group declined significantly (3.7 +/- 3.6 mL/min-ute/1.73 m2 and 6.5% +/-
      6.5%) (p less than 0.05). Both urine urea and microalbuminuria decreased
      significantly (p less than 0.05) in the low protein group. Unstimulated GFR at
      the end of 12 months was significantly less (p less than 0.05) in Group 2 (47 +/-
      2 mL/minute/1.73 m2) than in Group 1 (71 +/- 21 mL/minute/1.73 m2). The rate of
      decline in GFR was significantly greater (p less than 0.05) in the normal protein
      intake group than in the low protein intake group (0.68 +/- 0.4 versus 0.28 +/-
      0.15 mL/minute/1.73 m2/month). CONCLUSIONS: This study indicates that sustained
      dietary protein restriction can help to preserve renal function, decrease
      albuminuria, and lower the baseline GFR while maintaining functional renal
      reserve in patients with insulin-dependent diabetes mellitus.

PMID- 2220877
TI  - Treatment of the anemia of chronic renal failure with subcutaneous recombinant
      human erythropoietin.
AB  - PURPOSE: The purpose of this study was to determine the efficacy of recombinant
      human erythropoietin (rHuEPO) given subcutaneously three times/week in patients
      with chronic renal failure and anemia (predialysis). PATIENTS AND METHODS: Eleven
      patients with predialysis chronic renal failure participated in a double-blind,
      placebo-controlled study of subcutaneously administered erythropoietin. For 12
      weeks, patients received either rHuEPO 100 mu/kg body weight three times/week
      subcutananeously or a placebo. After 12 weeks of placebo, patients now also
      received rHuEPO in a dose up to 150 mu/kg three times/week until target
      hematocrit was achieved. Throughout the study, blood pressure was monitored
      closely and blood work was obtained regularly for hemoglobin, hematocrit,
      reticulocyte count, and iron profile determinations. RESULTS: At 12 weeks, the
      hematocrit of the treated group had risen from 29% +/- 2% to 35% +/- 2% (p less
      than 0.001). The placebo group baseline hematocrit was 28% +/- 2% and at 12 weeks
      26% +/- 2% After 12 weeks of rHuEPO therapy, the hematocrit of the prior placebo
      group was 32% +/- 2% (p less than 0.001 versus baseline). No significant change
      in biochemical parameters was noted. Mean blood pressure values were comparable
      before and after treatment. All protein ultimately required iron supplementation.
      In two patients, the rate of progression of renal failure appeared to increase as
      their hematocrit rose and rHuEPO was discontinued. CONCLUSIONS: It is concluded
      that rHuEPO given subcutaneously is an effective and safe therapy for patients
      with chronic renal failure who are anemic and who are not receiving dialysis.

PMID- 2220878
TI  - Pleuritis as a manifestation of reactivation tuberculosis.
AB  - PURPOSE: The purpose of this study was to determine the frequency with which
      tuberculous pleuritis is a manifestation of reactivation tuberculosis and to
      compare the clinical manifestations of reactivation tuberculous pleuritis with
      "classic" tuberculous pleuritis, in which chest roentgenograms reveal no
      parenchymal infiltrates. PATIENTS AND METHODS: We evaluated the medical records
      of 59 patients in whom tuberculous pleuritis was confirmed by histologic findings
      or mycobacterial culture. Twenty-seven patients (46%) had typical chest
      roentgenographic findings of reactivation tuberculosis, whereas 32 (54%) had
      classic tuberculous pleuritis. The clinical and laboratory features of these two
      groups were compared. RESULTS: Symptoms were more prolonged and pleural fluid
      glucose and lactate dehydrogenase concentrations were more markedly abnormal in
      patients with reactivation pleuritis than in those with classic pleuritis,
      suggesting a more chronic inflammatory process in the former group. Compared with
      patients with classic tuberculous pleuritis, those with reactivation pleuritis
      had a lower frequency of reactive tuberculin skin tests (61% versus 88%) and
      granulomatous pleural inflammation (25% versus 72%), but a higher bacillary
      burden, manifest by a higher frequency of positive sputum smears for acid-fast
      bacilli (50% versus 0%) and positive mycobacterial cultures from sputum (60%
      versus 23%) and pleural fluid (91% versus 66%). CONCLUSIONS: In contrast to
      previous reports, tuberculous pleuritis was a manifestation of reactivation
      tuberculosis in 46% (27 of 59) of patients. Tuberculous pleuritis is a more
      chronic process in patients with reactivation disease than in those with classic
      pleuritis. The lower frequency of reactive tuberculin skin tests and granuloma
      formation, combined with the higher bacillary burden in patients with
      reactivation pleuritis, suggest that these patients mount a less effective immune
      response to Mycobacterium tuberculosis infection than do patients with the
      classic form of tuberculous pleuritis.

PMID- 2220879
TI  - Association of Helicobacter pylori infection with dyspeptic symptoms in patients
      undergoing gastroduodenoscopy.
AB  - PURPOSE: To determine the prevalence of Helicobacter pylori in patients with non
      ulcer dyspepsia and ulcer disease as well as in a control population undergoing
      endoscopic retrograde cholangiopancreatography (ERCP) for suspected pancreatic or
      biliary disease. PATIENTS AND METHODS: Forty-six eligible patients undergoing
      upper endoscopy at Massachusetts General Hospital were studied over a period of
      18 months, as well as 24 patients undergoing ERCP for presumed pancreatic or
      biliary disease. Two biopsy specimens from the fundus and two from the antrum
      were taken for microbiologic and histopathologic analysis. Sera were examined by
      enzyme-linked immunoabsorbent assay. All specimens were processed in a blind
      fashion. Chi-square test with Yates' correction was used for statistical
      analysis. RESULTS: H. pylori was found in 31 of 46 (67%) study patients and in
      six of 24 (25%) control patients (by microbiologic or histologic techniques) (p
      less than 0.01). H. pylori was found in all patients with peptic ulcer disease
      and in 60% of patients without ulcers. No association between H. pylori and any
      specific gastrointestinal symptom was observed. H. pylori was identified in the
      fundus as often as in the antrum, although in the antrum the organism was more
      often associated with histologic gastritis. Compared with histology, serologic
      assays for IgG and IgA antibodies to H. pylori had sensitivities of 100% and 94%,
      and specificities of 86% and 76%, respectively. Reexamination of selected
      specimens without knowledge of their identity revealed that the specificity of
      serology exceeded 94% while the sensitivity of histologic and microbiologic
      studies may have been closer to 80%. CONCLUSIONS: H. pylori was more common in
      dyspeptic patients than in our control subjects undergoing ERCP. Multiple biopsy
      sites from fundus and antrum are required to exclude infection. Serologies of IgG
      and IgA were sensitive and specific for H. pylori, suggesting a possible role for
      non-endoscopic diagnosis of this infection. The frequent association of H. pylori
      with active inflammation rather than with quiescent gastritis is consistent with
      a pathologic role of this organism.

PMID- 2220880
TI  - Evidence of subclinical blastomycosis in forestry workers in northern Minnesota
      and northern Wisconsin.
AB  - PURPOSE: To investigate the incidence of remote subclinical blastomycosis in a
      high-risk population of forestry workers. PATIENTS AND METHODS: The study
      consisted of 39 male forestry workers from northern Minnesota and northern
      Wisconsin, areas endemic for blastomycosis but not for histoplasmosis. All
      subjects were histoplasmin skin test-negative, and none had ever been diagnosed
      with blastomycosis or pneumonia. An antigen-specific lymphocyte stimulation assay
      was performed to determine the presence of blastomycosis. RESULTS: Peripheral
      blood lymphocytes from 12 of 39 subjects demonstrated specific antigen-induced
      proliferation when stimulated with a purified alkali- and water-soluble antigen
      derived from the cell wall of Blastomyces dermatitidis. CONCLUSION: The finding
      that 30% of these men had evidence of previous blastomycosis suggests that
      subclinical cases do occur sporadically, and are probably more common than
      diagnosed symptomatic cases. This is similar to histoplasmosis, in which the
      majority of infections are subclinical. However, the reservoir of persons with
      previous undiagnosed blastomycosis is probably small compared to the huge number
      of persons (perhaps 30 million) with prior histoplasmosis.

PMID- 2220881
TI  - Cardiorespiratory effects of endoscopic esophageal variceal sclerotherapy.
AB  - Endoscopic variceal sclerotherapy (EVS) is an effective means of controlling
      variceal hemorrhage, which develops as a consequence of portal hypertension.
      While esophageal perforation, ulceration, strictures, and mediastinitis are
      potential complications associated with this procedure, it is not clear whether
      isolated pleuropulmonary events such as pleuritis, pneumonitis, and adult
      respiratory distress syndrome are causally related to the EVS. Endoscopy and
      sedation with the attendant risk of aspiration, particularly in the background of
      hepatic encephalopathy, may account for some of these events. Recent controlled
      studies of respiratory function demonstrate that EVS as such results in minor
      changes in gas exchange, lung volumes, and pulmonary and systemic hemodynamics.
      Most pulmonary complications have been reported with the use of sodium morrhuate
      sclerosant. Comparative studies among different sclerosants are necessary to
      evaluate relative safety. Finally, there have been rare reports of myocardial
      ischemia and pericarditis reported in association with EVS, but these are of a
      transient nature. Chest symptoms, roentgenographic pleuropulmonary changes,
      pulmonary hemodynamics, and cardiac perturbations are transient and should not
      preclude offering EVS to patients with variceal hemorrhage.

PMID- 2220882
TI  - Refractory ventricular arrhythmias and death in a 43-year-old man.

PMID- 2220883
TI  - Supersensitivity of isolated coronary artery to ergonovine in a patient with
      variant angina.

PMID- 2220884
TI  - Congenital methemoglobinemia due to methemoglobin reductase deficiency in two
      unrelated American black families.

PMID- 2220885
TI  - Disappearance of muscular calcium deposits during resolution of prolonged
      rhabdomyolysis-induced hypercalcemia.

PMID- 2220886
TI  - Acute eosinophilic colitis and hypersensitivity reaction associated with naproxen
      therapy.

PMID- 2220888
TI  - Extraneural manifestations of chronic inflammatory demyelinating
      polyradiculoneuropathy.

PMID- 2220887
TI  - Successful treatment of gastroparesis with erythromycin in a patient with
      progressive systemic sclerosis.

PMID- 2220891
TI  - Primary intracranial meningeal lymphoma.

PMID- 2220890
TI  - Massive rhabdomyolysis: a rare presentation of primary Vibrio vulnificus
      septicemia.

PMID- 2220889
TI  - Lepromatous leprosy and seropositivity for HTLV-I.

PMID- 2220892
TI  - Stroke in protein C deficiency.

PMID- 2220893
TI  - Resolution of prosthetic valve stenosis (presumed thrombosis) without
      thrombolytic therapy or surgical intervention.

PMID- 2220894
TI  - Trends in the scientific literature on cocaine.

PMID- 2220895
TI  - Asymptomatic carrier state for cryptosporidium.

PMID- 2220896
TI  - Pancreatitis and typhoid fever.

PMID- 2220897
TI  - Pyrrolizidine poisoning.

PMID- 2220899
TI  - A CPT code for "caring".

PMID- 2220898
TI  - Autoantibodies to vascular endothelial cell antigens in systemic vasculitis.

PMID- 2220900
TI  - Midwest jobfocus. The best of all worlds.

PMID- 2220902
TI  - Chicago jobfocus. Magnetic milieu.

PMID- 2220901
TI  - Self-confidence: a feeling you can create.

PMID- 2220903
TI  - Ninety years through nursing's lens.

PMID- 2220904
TI  - National study on nurses' and physicians' attitudes on AIDS.

PMID- 2220905
TI  - Resurrection drug.

PMID- 2220906
TI  - Helping patients recover faster.

PMID- 2220907
TI  - Critical care. From sentinels to specialists.

PMID- 2220908
TI  - Pain management. Nurses lead the way to new priorities.

PMID- 2220910
TI  - Military nurses rally for Operation Desert Shield.

PMID- 2220909
TI  - Wound care. Trial & error yields to knowledge.

PMID- 2220911
TI  - Professional status. The struggle for just compensation.

PMID- 2220912
TI  - Drug therapy. The history of a life affair.

PMID- 2220913
TI  - The first seventy years.

PMID- 2220914
TI  - Contraception and ectopic pregnancy risk.
AB  - Studies of the association of ectopic pregnancy with contraception have generated
      a conflicting array of results because of methodologic differences between
      studies. We estimated the absolute incidence rates of ectopic pregnancy for
      various contraceptives by multiplying the pregnancy rate by the proportion of
      pregnancies with ectopic implantation for each method. Our results indicated a
      more than 500-fold difference in ectopic pregnancy incidence, from a low of 0.005
      ectopic pregnancies per 1000 women years of oral contraception or vasectomy to a
      high of 2.6 per 1000 women years of no contraception. These estimated incidence
      rates should be useful for clinicians and patients seeking to better understand
      the risks and benefits of contraceptives.

PMID- 2220915
TI  - Calcium supplementation during pregnancy may reduce preterm delivery in high-risk
      populations.
AB  - Results are presented of a randomized, double-blinded controlled clinical trial
      of calcium supplementation (2.0 gm of elemental calcium as calcium carbonate) and
      a placebo. All participants were 17 years of age or less and clinically healthy.
      Patients were enrolled by the twenty third week of gestation. The mean duration
      of calcium supplementation or placebo was approximately 14 weeks. Treatment
      consisted of 2.8 (+/- 1.5) tablets per day in the placebo group (N = 95) and 3.0
      (+/- 1.4) tablets per day in the calcium group (N = 94). Dietary calcium intake
      was similar in both groups at about 1200 mg/day. The calcium group had a lower
      incidence of preterm delivery (less than 37 weeks; 7.4% vs 21.1%; p = 0.007);
      spontaneous labor and preterm delivery (6.4% vs 17.9%; p = 0.01); and low birth
      weight (9.6% vs 21.1%; p = 0.03). This effect was also present after stratified
      analysis by level of treatment compliance, urinary tract infection, and
      chlamydial infection. Life-table analysis demonstrated an overall shift to a
      higher gestational age in the calcium group compared with the placebo group (log
      rank test, p = 0.02). As suggested previously, the observed effect could be
      mediated by a reduction in uterine smooth muscle contractibility. If confirmed by
      future research, these results could represent an important preventive
      intervention for prematurity in high-risk populations.

PMID- 2220916
TI  - The association of intrapartum asphyxia in the mature fetus with newborn
      behavior.
AB  - A matched cohort study of mature newborns with biochemically determined
      intrapartum fetal asphyxia and mature newborns with normal blood gas and acid
      base assessments at delivery were studied to demonstrate the effect of fetal
      asphyxia on newborn behavior as expressed by the Brazelton newborn behavioral
      assessment scale. The newborn behavioral assessment scale was administered 3 days
      after delivery and again 2 weeks after delivery. The Lester newborn behavioral
      assessment scale summary scores for the group with asphyxia were of the same
      order as those in the control group. This was also true of the group of newborns
      with asphyxia with the more severe metabolic acidosis and those with low Apgar
      scores. These findings support the contention that many newborns who have
      undergone an intrapartum asphyxial insult will not have evidence of central
      nervous system injury and that the threshold of central nervous system injury is
      at the severe end of the spectrum of asphyxia as expressed by a metabolic
      acidosis.

PMID- 2220917
TI  - Sexually transmitted diseases and human immunodeficiency virus infection among
      women with pelvic inflammatory disease.
AB  - Both human immunodeficiency virus infections and pelvic inflammatory diseases are
      sexually acquired illnesses of great consequence to women. This study was
      undertaken to determine if women hospitalized with pelvic inflammatory disease,
      in a community endemic for human immunodeficiency virus, were at high risk to be
      infected with human immunodeficiency virus and if human immunodeficiency virus
      infections altered their hospital course. One hundred ten women hospitalized with
      pelvic inflammatory disease in Brooklyn (in a hospital in which 2% of parturients
      are human immunodeficiency virus seropositive) agreed to human immunodeficiency
      virus testing; 15 (13.6%) were found to be seropositive. Seropositive women were
      significantly more likely to have an admission white blood cell count less than
      10,000/mm3 (p = 0.001). Human immunodeficiency virus seropositivity was not
      associated with a higher frequency of other sexually transmitted diseases
      although there was a trend toward more cases of syphilis among human
      immunodeficiency virus-infected women. Similarly, although there was no
      significant difference in rates of operative intervention (26.6% among
      seropositive and 8.4% among seronegative; p = 0.058), there was a trend toward
      more surgery among those who were human immunodeficiency virus infected. Women
      hospitalized with pelvic inflammatory disease, in a community endemic for human
      immunodeficiency virus, are at high risk for human immunodeficiency virus
      infection. More research is needed to verify a trend toward more refractory
      infections among human immunodeficiency virus-infected women.

PMID- 2220918
TI  - The natural history of thrombocytopenia associated with preeclampsia.
AB  - Sixty-one of 375 women with hypertension and preeclampsia in a 48-month period
      had thrombocytopenia. By postpartum day 3, 90% of these women had rising platelet
      counts, and by day 4, 59 of 61 women had counts greater than 100,000/mm3. The two
      exceptions had other pathologic conditions in addition to preeclampsia.
      Thrombocytopenia associated with preeclampsia should resolve by postpartum day 4.

PMID- 2220920
TI  - Pregnancy-induced hypertension and acute fatty liver of pregnancy: atypical
      presentations.
AB  - Severe pregnancy-induced hypertension and markedly elevated levels of serum
      alkaline phosphatase developed in a 29-year-old-woman in whom one pregnancy
      resulted in intrauterine death. Acute fatty liver of pregnancy developed with
      good fetal outcome in the next pregnancy. This case suggests that pregnancy
      induced hypertension and acute fatty liver of pregnancy are part of a clinical
      spectrum. Moreover, classic abnormalities of liver function tests need not be
      present in acute fatty liver of pregnancy.

PMID- 2220919
TI  - Continuing controversy in alloimmune thrombocytopenia: fetal
      hyperimmunoglobulinemia fails to prevent thrombocytopenia.
AB  - Two patients with severe alloimmune thrombocytopenia were managed by weekly
      intrauterine platelet transfusions at 25 to 36 weeks. In one patient high-dose
      immunoglobulin was also administered weekly to the mother, and high maternal and
      fetal immunoglobulin levels were achieved. Fetal platelet counts were similar in
      both patients. The only variable that affected fetal platelet concentration was
      the posttransfusion platelet count from the previous transfusion.

PMID- 2220921
TI  - Vibroacoustic stimulation and fetal behavioral state in normal term human
      pregnancy.
AB  - Vibroacoustic stimulation may affect human fetal behavior. Continuous graphic
      records of simultaneous ultrasonographic observations of fetal activities and
      electronic fetal heart rate tracings of 30 normal term fetuses were examined
      visually for the occurrence of behavioral state 30 minutes before and after 3
      seconds of vibroacoustic stimulation. After vibroacoustic stimulation, the total
      time spent in state 1 decreased significantly, that spent in state 4 increased
      significantly, and times spent in state 2 and indeterminate state (no state
      established for at least 3 minutes) were unchanged. No fetus exhibited state 3
      before or after vibroacoustic stimulation. State 4 occurred in 22 fetuses after
      vibroacoustic stimulation with a duration of at least 30 minutes in four fetuses,
      and was noted in all fetuses in pre-vibroacoustic stimulation state 1 and 11 of
      16 fetuses in pre-vibroacoustic stimulation state 2. Fetal heart rate
      accelerations occurred within 10 seconds after vibroacoustic stimulation in 94%
      of the fetuses studied regardless of their prior behavioral state. The variation
      in the onset and duration of behavioral state responses in most fetuses after
      vibroacoustic stimulation may depend on previous behavioral state and could be
      important for interpretation of antenatal assessment that uses this stimulus.

PMID- 2220922
TI  - Successful conservative management of primary nonmetastatic cervical
      choriocarcinoma.
AB  - Primary cervical choriocarcinoma is a rare disease; since 1915 only about 60
      cases have been published. The case presented here can be defined as primary
      cervical choriocarcinoma since it fulfills all the criteria delineated
      previously.

PMID- 2220924
TI  - Spontaneous infarction of placental chorioangioma and associated regression of
      hydrops fetalis.
AB  - We report a case of a large chorioangioma diagnosed prenatally with concomitant
      meconium peritonitis and hydrops fetalis in the second trimester. Spontaneous
      regression of the tumor occurred, associated with some resolution of the fetal
      hydrops and delivery near term with good neonatal outcome.

PMID- 2220925
TI  - Ovarian pregnancy: a report of twenty cases in one institution.
AB  - A series of 20 cases of primary ovarian pregnancy that were diagnosed and treated
      in one institution is reported. The prevalence rate of 1:3600 deliveries seems to
      be increasing in past years and comprises 3.3% of all extrauterine pregnancies.
      Clinical presentation, possible pathogenesis, diagnostic steps, preferred
      management, and future fertility are detailed. Inasmuch as all our 18 fertile
      patients used an intrauterine contraceptive device before the operation, special
      emphasis is made on the controversial relationship between use of intrauterine
      contraceptive devices and ovarian pregnancy.

PMID- 2220923
TI  - Effects of hypertension on pregnancy monitoring and results.
AB  - The effect of severity of hypertension on fetal heart rate tracing changes and
      neonatal outcomes was evaluated on all patients with hypertension seen in 1980
      and 1981 (666 cases, 10% of the pregnant population) in the Chicago-Lying In
      Hospital. The patients were grouped according to severity of hypertension, and
      the fetal heart rate monitoring, drugs administered, mode of delivery, and
      neonatal outcome were analyzed. Half of the patients (326) had mild hypertension
      and 13% (87) had severe hypertension; the remainder (253) had moderate
      hypertension. There were 49% primiparous and 51% multiparous women. The diagnosis
      of preeclampsia was made in 76% of cases, and chronic hypertension in 19%. Only
      12% of the total were premature by dates, but 47% of this group were among the
      severe group. Oxytocin was given to 50%, whereas delivery was spontaneous in 56%
      of cases, and by cesarean section in 22%. This was higher among the severe
      hypertension group (37%), and the prematurity rate was 47%. Nonstress testing was
      done in one third of cases and only nonreactivity was associated with neonatal
      death. Neonatal depression (Apgar score less than 6 at 5 minutes) was
      significantly associated with intrapartum fixed baseline and late decelerations;
      these were the best predictors of fetal outcome. The administration of magnesium
      sulfate, hydralazine, meperidine, or morphine did not predictably affect the
      fetal heart rate pattern. The perinatal mortality was 21% in the mild group and
      36% and 138%, respectively, among moderate and severe cases of hypertension.
      Close antepartum and intrapartum surveillance, including proper fetal monitoring,
      should help to reduce risks for mother and fetus through timely intervention.

PMID- 2220926
TI  - Second-trimester ultrasonography: determinants of visualization of fetal anatomic
      structures.
AB  - Little information has been published regarding rates of visualization of fetal
      anatomic structures or factors affecting visualization in unselected patients. We
      prospectively studied these points by scoring visualization of intracranial,
      spinal, cardiac, ventral wall, umbilical cord, stomach, bladder, and genital
      anatomy in 573 consecutive midtrimester scans in which no fetal anomalies were
      seen. Each feature was scored 0, 1, or 2, corresponding to poor, adequate, or
      optimal visualization, and these eight numbers were summed for an overall
      visualization score. Overall visualization fell abruptly beyond maternal weight
      165 pounds (p less than 0.001) and rose with advancing gestational age (p less
      than 0.001). Placental location did not significantly influence visualization.
      Overall, an adequate screening scan, defined as adequate visualization of central
      nervous system, heart, stomach, ventral wall, bladder, and cord was obtained in
      51% of scans, and optimal visualization of each of these in only 9% of cases.
      Factors that might improve anatomic visualization and the implications of these
      results for the use of ultrasonography in screening for congenital anomalies are
      discussed.

PMID- 2220928
TI  - Postpartum osteomyelitis caused by group B streptococcus.
AB  - Postpartum infections caused by group B streptococci are generally limited in
      scope. We report a case of vaginal colonization with group B streptococcus that
      progressed in the postpartum period to osteomyelitis that necessitated total hip
      replacement. The patient had no risk factors predisposing to streptococcal
      osteomyelitis. An altered immune status in pregnancy and intrapartum bacteremia
      may be involved in the pathogenesis of this infection.

PMID- 2220927
TI  - Infertility and eating disorders.
AB  - Sixty-six consecutive infertility clinic patients were prospectively screened
      with the 26-item Eating Attitudes Test and a study questionnaire. Women
      identified as being at high risk for an eating disorder were then interviewed to
      confirm or refute the diagnosis. A total of 7.6% of infertility clinic women were
      found to suffer from anorexia nervosa or bulimia nervosa. If eating disorders not
      otherwise specified were included, a total of 16.7% of infertility patients were
      found to suffer from an eating disorder. Among infertile women with amenorrhea or
      oligomenorrhea 58% had eating disorders. Because women often fail to disclose
      eating disorders to their gynecologists and may appear to be of normal weight, it
      is recommended that a nutritional and eating disorder history be taken in
      infertility patients, particularly those with menstrual abnormalities. It has
      previously been shown that disorder eating and nutrition can affect menstruation,
      fertility, maternal weight gain, and fetal well-being.

PMID- 2220929
TI  - Antenatal spontaneous perforation of the extrahepatic biliary tree.
AB  - Spontaneous perforation of the biliary system is an unusual neonatal phenomenon
      that is rarely recognized at birth. To date, it has not been reported
      antenatally. A 16-year-old pregnant adolescent had an ultrasonogram at 25 weeks
      of pregnancy that revealed ascites in the fetus. After the infant was delivered
      at 32 weeks, a hepato-iminodiacetic acid scan showed a spontaneous rupture of the
      common bile duct. The infant was treated with external drainage of the biliary
      tree and recovered well. This case demonstrates that spontaneous perforations of
      the bile ducts can occur much earlier than the usually described 2 to 12 weeks
      after birth, can be diagnosed antenatally, and should be added to the list of
      causes of fetal ascites.

PMID- 2220930
TI  - Antenatal diagnosis of molybdenum cofactor deficiency.
AB  - Analysis of uncultured chorionic villus material from a woman at risk of fetus
      with sulfite oxidase deficiency revealed a deficiency of sulfite oxidase. This
      was confirmed on termination of the pregnancy.

PMID- 2220931
TI  - Preoperative evaluation of serum CA 125, TAG 72, and CA 15-3 in patients with
      endometrial carcinoma.
AB  - We evaluated 109 women with endometrial carcinoma to determine the accuracy of
      preoperative tumor-associated antigen levels (CA 125, CA 72, CA 15-3) for
      prediction of extrauterine disease and whether TAG 72, CA 15-3, or both would
      improve the predictive value of CA 125 alone. Eleven (12%) of 80 patients with
      disease confined to the uterus or positive cytologic findings had CA 125 values
      greater than 35 U/ml versus 12 (65%) of 20 patients with extrauterine metastasis.
      Therefore CA 125 values had sensitivity of 65% and specificity of 88%. The TAG 72
      level was elevated (greater than 6 U/ml) in 4% of patients with localized disease
      and 30% with metastasis. CA 15-3 was elevated (greater than 30 U/ml) in 17% and
      65% in these categories, respectively. TAG 72 or CA 15-3 levels did not improve
      the combination of sensitivity and specificity of CA 125 alone. In addition, only
      one of 10 patients with microscopic metastasis (three cases) or positive
      peritoneal cytology (seven) had elevation of any of these tumor-associated
      antigen levels. Failure to detect occult metastasis and a high false-positive
      rate limit the role of these tumor-associated antigen assays in the preoperative
      evaluation of patients with endometrial carcinoma.

PMID- 2220933
TI  - The effect of race on the relationship between fetal death and altered fetal
      growth.
AB  - This population study examines racial differences in the relationship between
      birth weight and fetal death. An earlier report showed that a birth weight that
      results in a fourfold increased risk of stillbirth is not a constant birth weight
      percentile (2nd percentile at 25 weeks, 17th percentile at 42 weeks). This
      analysis was applied to 782,430 white and black births in Illinois from 1980 to
      1984. Mean and 10th percentile growth for white and black infants is identical
      before 34 weeks' gestation and growth diverges by 250 gm at term, with white
      infants being larger. Race-specific birth weights resulting in quadrupling of the
      stillbirth rate were determined with an exponential regression analysis of the
      relationship between birth weight and fetal death rate for each gestational age.
      The data indicate (1) that the birth weights resulting in quadrupling the
      stillbirth rate are substantially above the Denver 10th percentile and the
      previously unpublished race-specific Illinois 10th percentiles and (2) that at
      term white infants demonstrate this constant risk at the 12th percentile, whereas
      black infants exhibit the risk at the 18th percentile. From these data we
      conclude that black fetuses are more sensitive than white fetuses to factors that
      adversely affect growth and that continued use of "race-neutral" data for
      clinical management in racially heterogenous populations will not accurately
      predict the risk of stillbirth.

PMID- 2220934
TI  - Effects of intravascular fetal blood transfusion on fetal intracardiac Doppler
      velocity waveforms.
AB  - In 12 fetuses from pregnancies with red blood cell isoimmunization Doppler
      velocity waveforms were recorded at the level of atrioventricular valves
      immediately before and at 15-minute intervals for 2 hours after the intravascular
      transfusion. The left and right cardiac outputs, the ratio between the peak
      velocities during early passive ventricular filling and active atrial filling at
      the level of both ventricles as well as the heart rate were calculated. Before
      transfusion, the left and right cardiac outputs were significantly higher than
      reference ranges for gestation that were constructed from the cross-sectional
      study of 187 normal pregnancies. After transfusion there was a significant
      temporary fall in right and left outputs associated with increased ratios between
      the peak velocities during early passive ventricular filling and active atrial
      filling. Within 2 hours after transfusion both parameters returned toward the
      normal range. In addition, no significant changes were found for fetal heart rate
      values before and after transfusion. The fall of cardiac output was significantly
      related to the amount of expansion of the feto-placental volume.

PMID- 2220932
TI  - High infectious morbidity in pregnant women with insulin-dependent diabetes: an
      understated complication.
AB  - Patients with insulin-dependent diabetes are prone to infection, possibly related
      to poor metabolic control. Relative immune deficiency exists in pregnancy. We
      hypothesized that pregnant patients with insulin-dependent diabetes are at an
      increased risk for infection and that infection is related to poor glycemic
      control. We matched 65 pregnant women with insulin-dependent diabetes to 65
      nondiabetic pregnant controls. At least one episode of infection before delivery
      occurred in 83% of the women with insulin-dependent diabetes (26% in control
      group). The rate of postpartum infection was five times higher in the group with
      insulin-dependent diabetes and they were susceptible to more kinds of infections.
      Although there was no overall difference among the indices of glycemic control,
      hemoglobin A1 obtained before the infection was higher than during infection. We
      conclude that a high rate of infection exists in pregnant women with diabetes;
      infection and poor glycemic control may be associated, but it is unclear whether
      improvement in metabolic control will reduce this high infection rate.

PMID- 2220935
TI  - Human fetal foramen ovale flow velocity waveforms relative to behavioral states
      in normal term pregnancy.
AB  - In 16 normal pregnancies the relationship between foramen ovale flow velocity
      waveforms and fetal behavioral states at 37 to 38 weeks' gestation was studies
      with Doppler techniques. Foramen ovale flow velocity waveforms are characterized
      by a typical systolic/diastolic component. Average flow velocity was
      statistically significantly increased in behavioral state 2F (active sleep) as
      compared with state 1F (quiet sleep), which was mainly determined by an increase
      in flow velocity during the end-systolic and passive atrial filling phase. The
      increase in the average flow velocity at the foramen ovale level during active
      sleep suggests a redistribution of blood flow at the cardiac level, resulting in
      an increased right-to-left shunt.

PMID- 2220936
TI  - Suppression of serum insulin level by diazoxide does not alter serum testosterone
      or sex hormone-binding globulin levels in healthy, nonobese women.
AB  - Suppression of serum insulin levels with diazoxide is associated with a decrease
      in serum testosterone and an increase in serum sex hormone-binding globulin in
      obese women with the polycystic ovary syndrome. To determine whether physiologic
      insulin levels play a regulatory role in the androgen status of nonobese women
      with normal menses, the androgen status of five nonobese normal women was
      assessed on two occasions: during a control study and after 10 days of oral
      diazoxide (100 mg, three times daily) administration. Insulin release in response
      to 100 gm oral glucose administration decreased from 108.0 +/- 28.2 to 49.3 +/-
      5.2 nmol.min/L (p = 0.05) after diazoxide administration. However, despite
      suppression of insulin release, diazoxide administration did not affect serum
      total testosterone (diazoxide, 0.73 +/- 0.10; control, 0.69 +/- 0.11 nmol/L; p =
      NS) or sex hormone-binding globulin (diazoxide, 79.7 +/- 16.6; control, 70.2 +/-
      12.6 nmol/L; p = NS) concentrations. These observations suggest that physiologic
      insulin levels in nonobese healthy women do not regulate testosterone metabolism
      and that diazoxide does not exert a direct or independent effect on serum
      testosterone or sex hormone-binding globulin levels.

PMID- 2220937
TI  - Intrapartum uterine rupture and inflammatory bowel disease.
AB  - The incidence of uterine rupture in pregnant women ranges from 0% to 1.1% in
      large series. This case report describes a woman with a history of obstetric
      complications, uterine rupture, and active inflammatory bowel disease that was
      treated with high-dose prednisone.

PMID- 2220938
TI  - Pelvimetry by magnetic resonance imaging in breech presentation.
AB  - Evaluation of the pelvis by pelvimetry plays an important role in selecting
      patients with term breech presentation for possible vaginal delivery. X-ray
      pelvimetry involves the disadvantage of fetal exposure to ionizing radiation.
      Computed tomography reduces the amount of radiation markedly, but there is still
      a risk. Ten patients with breech presentation at term underwent antepartum
      pelvimetry with magnetic resonance imaging, following by postpartum magnetic
      resonance pelvimetry and x-ray pelvimetry. Measurements with magnetic resonance
      imaging are as reliable as those obtained with x-ray pelvimetry and the contrast
      of the magnetic resonance images is even better. The advantages of magnetic
      resonance pelvimetry are clear: no ionizing radiation and reliable pelvimetry
      results in cases of term breech presentation in which a normal pelvis is a
      prerequisite for safe vaginal delivery.

PMID- 2220939
TI  - Intraamniotic infection in the very early phase of the second trimester.
AB  - A total of 157 consecutive patients were studied in an effort to examine
      prospectively the incidence of asymptomatic intraamniotic infection in the early
      phase of the second trimester. All patients were referred for amniotic fluid
      karyotyping. In addition, the amniotic fluids were examined for Gram stain and
      were directly cultured on blood agar and MacConkey agar as well as in
      thioglycollate broth. We found positive amniotic fluid cultures in eight cases
      (5.09%); however, results of Gram stain examinations were negative in all
      amniotic fluid samples. The data indicate that there is no correlation between
      white blood cells in the amniotic fluid and positive amniotic fluid culture
      results. Only one pregnancy with positive amniotic fluid culture resulted in a
      septic abortion. Therefore we can suggest that intraamniotic infection can exist
      early in pregnancy, even with intact membranes, and in most cases without any
      clinical symptoms.

PMID- 2220940
TI  - Placental histology in fetuses between 18 and 23 weeks' gestation with abnormal
      karyotype.
AB  - Placentas from karyotypically abnormal fetuses (18 to 23 weeks' gestation) were
      analyzed prospectively at the light microscopic level. Group I consisted of 14
      control placentas. Group II consisted of 14 placentas from fetuses with an
      abnormal karyotype. Secondary and tertiary stem villi counts, small muscular
      artery counts, and total vessel counts were determined per 100 x field. There
      were no differences in secondary and tertiary stem villi counts between groups. A
      significant decrease in small muscular artery counts (p less than 0.01) and total
      vessel counts (p less than 0.01) was noted in group II. Placental and fetal
      weights were comparable between groups. This undervascularization may represent
      placental immaturity as a result of arrested or delayed angiopoiesis. It appears
      that this abnormality is established before the third trimester and may be
      enhanced by late vascular obliteration as reported by others. These data
      substantiate the concept that the structure and function of the placenta is
      determined to a great degree by fetal karyotype and may help explain the
      morbidity and mortality seen in these fetuses.

PMID- 2220942
TI  - Autologous antibodies eluted from membrane fragments in human ovarian epithelial
      neoplastic effusions. III. Cytotoxic potential in vitro and characterization of
      antigen(s).
AB  - Cyst and ascites fluids from patients with ovarian epithelial neoplasms contain
      immunoglobulins with antitumor activity. Autologous antibodies bound to the
      cellular membrane fragments obtained from human ovarian neoplastic effusions
      react with cell-surface antigens on different human ovarian cell lines, surgical
      specimens of human ovarian adenocarcinoma, and human ovarian tumors grown in
      athymic Balb/c mice. The antibodies do not react with tissue preparations from
      normal human ovaries, other nonovarian normal or neoplastic tissues, and
      nonovarian human cell lines. These studies indicate that these antibodies are
      capable of complement-mediated lysis of human ovarian tumor cell lines in vitro.
      Preliminary characterization of the autologous ovarian tumor-associated
      antigen(s) indicates that it may be composed of three large-molecular-weight
      proteins of 182,000, 164,000, and 122,000 d.

PMID- 2220941
TI  - Collagen metabolism in gynecologic patients: changes in the concentration of the
      aminoterminal propeptide of type III procollagen in serum.
AB  - We have previously found the serum concentration of the aminoterminal propeptide
      of type III procollagen, an indicator of collagen metabolism, to be increased in
      advanced ovarian cancer. In this study we measured the serum aminoterminal
      propeptide of type III procollagen concentration in healthy women during the
      menstrual cycle and in patients with salpingo-oophoritis, leiomyomas,
      endometriosis, and benign ovarian tumors. The concentration was higher in the
      luteal phase than that in the follicular phase, suggesting an association of
      collagen metabolism with ovarian steroid hormones. Severe salpingo-oophoritis
      increased the serum level of the aminoterminal propeptide of type III procollagen
      with a decrease to normal during recovery. Elevated values were occasionally seen
      in endometriosis and leiomyomas. These findings indicate that the aminoterminal
      propeptide of type III procollagen is a relatively unspecific indicator of
      ovarian carcinoma.

PMID- 2220944
TI  - A progesterone-induced blocking factor corrects high resorption rates in mice
      treated with antiprogesterone.
AB  - Earlier we showed that because of the presence of functional progesterone
      receptors, lymphocytes of healthy pregnant women produced an immunomodulatory
      protein in the presence of progesterone, whereas those of nonpregnant persons did
      not. Progesterone-treated murine pregnancy lymphocytes release a similar factor.
      The present study reveals the biologic significance of this finding. Treatment of
      BALB/c mice that were 8 days pregnant with a progesterone receptor blocker (RU
      486) resulted in 100% resorption of the fetuses. Simultaneous administration of
      the supernatant from progesterone-treated murine pregnancy spleen cells restored
      the resorption rate to the original 6% observed in untreated control animals.
      These data suggest that functional lymphocytic progesterone binding sites are
      needed for the maintenance of normal pregnancy. Because of the blockage of
      progesterone receptors and the consequent inability of the lymphocytes to produce
      the progesterone-induced blocking factor, abortion is initiated by immune
      factors. The fact that administration of the preformed blocking factor
      counteracted the effect of antiprogesterone treatment suggests that progesterone
      mediated immunosuppression is needed for the maintenance of normal gestation.

PMID- 2220943
TI  - Hypoxic acidemia, hyperviscosity, and maternal hypertension do not affect the
      umbilical arterial velocity waveform in fetal sheep.
AB  - The effect of hypoxic acidemia, hyperviscosity, and maternal hypertension on the
      umbilical arterial velocity waveform was studied in 23 chronically catheterized
      fetal sheep. Fetal hypoxic acidemia induced by lowering the maternal inspired
      oxygen concentration (n = 7) caused no change in the ratio of systolic/diastolic
      blood velocity even when fetal arterial pH was as low as 6.8. Fetal blood
      hyperviscosity (n = 7) induced by exchange transfusion with packed maternal blood
      cells increased placental vascular resistance by greater than or equal to 50% but
      had no significant effect on the systolic/diastolic ratio. Similarly, maternal
      hypertension induced by intravenous infusion of angiotensin II to the ewe (n = 9)
      did not affect the systolic/diastolic ratio despite a 50% increase in maternal
      arterial blood pressure. We conclude that umbilical arterial velocity waveform
      abnormalities observed in growth-restricted human fetuses are probably not a
      direct result of fetal hypoxemia or hyperviscosity or maternal hypertension.

PMID- 2220945
TI  - Vasodilatory effects of nifedipine, methoxyverapamil, and sodium nitroprusside on
      contractile responses of the ewe uterine artery at term pregnancy.
AB  - The differential inhibitory effect of the vasodilators on contractile responses
      to norepinephrine, serotonin, and potassium on isolated uterine artery ring
      segments from pregnant ewes within 2 weeks of term was quantified and correlated
      with the source of Ca++ for the vasoconstrictors producing the smooth muscle
      contraction. The contraction evoked by the vasoconstrictors was dependent on
      extracellular Ca++ and in agonist-induced contractions also on an intracellular
      pool of Ca++. Nifedipine effectively inhibited K(+)-induced (90 mmol/L)
      contractions (antagonist concentration to reduce the maximum contractile effect
      to the agonist to 50%, 1.95 +/- 0.9 x 10(-8) mol/L), whereas it was relatively
      ineffective in blocking norepinephrine-induced (10(-5) mol/L) or serotonin
      induced (10(-5) mol/L) vasoconstriction (antagonist concentration to reduce the
      maximum contractile effect to the agonist to 50%, 1.38 +/- 0.4 x 10(-4) mol/L and
      2.04 +/- 0.4 x 10(-5) mol/L, respectively). Methoxyverapamil (D-600) strongly
      inhibited serotonin-induced contractions (antagonist concentration to reduce the
      maximum contractile effect to the agonist to 50%, 3.3 +/- 0.3 x 10(-7) mol/L).
      The phasic rather than the tonic components of the serotonin- and norepinephrine
      induced contractions were more effectively inhibited by D-600 (p less than 0.05).
      Sodium nitroprusside preferentially blocked (p less than 0.05) the sustained
      tonic components of norepinephrine- and serotonin-induced vasoconstrictions
      (antagonist concentration to reduce the maximum contractile effect to the agonist
      to 50%, 7.1 +/- 0.4 x 10(-7) mol/L and 8.2 +/- 0.6 x 10(-7) mol/L, respectively).
      On the basis of these findings it is concluded that D-600 and sodium
      nitroprusside are more effective than nifedipine in blocking contractile
      responses due to receptor stimulation, and therefore might be more effective in
      the treatment of hypertensive emergencies in which these amines might be
      implicated.

PMID- 2220947
TI  - Long-term maternal-fetal exposure to high-low insulin concentrations alter liver
      but not brain insulin receptors.
AB  - We investigated the effects of long-term (5 to 6 days) in vivo exposure to
      hyperinsulinemia and hypoinsulinemia on maternal and fetal rat (18 to 20 days'
      gestation; term approximately 21 days) brain and liver insulin receptors. Further
      we studied the in vitro effects of long-term insulin exposure on cultured rabbit
      neuronal cell insulin receptors. Long-term glucose infusions to maternal rats
      resulted in maternal and fetal hyperglycemia and mild hyperinsulinemia, which
      decreases the liver insulin receptor abundance of the mother but increased that
      of the fetus. Streptozotocin-induced maternal diabetes resulted in maternal and
      fetal hyperglycemia with hypoinsulinemia (or near-normal insulin levels) and
      increased maternal and fetal liver insulin receptors. The maternal and fetal
      brain insulin receptor abundance failed to change at high or low insulin
      concentrations. Similarly long-term insulin (5 micrograms/ml) exposure failed to
      alter cultured neuronal cell insulin receptors as well. We conclude that
      perturbations in maternal and fetal circulating insulin concentrations fail to
      affect the brain insulin receptors. This protective phenomenon may be critical in
      maintaining the normal neuronal energy balance and functioning during certain
      disease states such as diabetes mellitus and hyperinsulinism.

PMID- 2220946
TI  - Fetal and maternal response to intravenous infusion of a thromboxane synthetase
      inhibitor.
AB  - Pharmacologic inhibition of thromboxane synthetase activity has reversed the
      clinical manifestations of toxemia in the ovine model. To investigate placental
      transfer and fetal effects of a selective thromboxane synthetase inhibitor,
      CGS13080 (Ciba-Geigy, Summit, N.J.) was intravenously infused into eight
      singleton- or twin-bearing ewes near term. During CGS 13080 infusion (0.1
      mg/kg/hr), maternal steady-state CGS 13080 levels of 102 +/- 18 ng/ml were
      achieved within 30 minutes and maternal serum thromboxane generation decreased
      significantly (13 +/- 3 to 4 +/- 1 ng/ml). However, fetal serum levels of CGS
      13080 were only 4% of peak maternal concentrations and fetal serum thromboxane
      generation did not change. There was no evidence of change in uterine blood flow,
      maternal or fetal blood pressure, heart rate, blood gas values, or fetal or
      maternal metabolites of prostacyclin or prostaglandin E2 during the study. We
      speculate that CGS 13080 may be efficacious in the treatment of human pregnancy
      induced hypertension.

PMID- 2220949
TI  - Definition of fetal asphyxia.

PMID- 2220948
TI  - Venous and hepatic vascular responses to indomethacin and prostaglandin E1 in the
      fetal lamb.
AB  - Evidence is accumulating that prostaglandins affect the tone of the ductus
      venosus. Therefore prostaglandins might alter the distribution of umbilical
      venous return between the ductus venosus and liver. We have examined the effect
      of indomethacin and prostaglandin E1 on the vascular resistance of the umbilical
      placental circulation, ductus venosus, and liver in 14 chronically instrumented
      fetal lambs. We found that indomethacin caused a nearly twofold increase in the
      vascular resistance of both the ductus venosus and liver. Prostaglandin E1,
      administered 70 minutes after indomethacin at a dose of 0.41 +/- 0.09 (SEM)
      micrograms/min per kilogram of fetal weight, decreased umbilical-placental blood
      flow, increased the vascular resistance of the umbilical arteries and placenta,
      and reversed the elevation of the vascular resistances of the ductus venosus and
      liver. Because both indomethacin and prostaglandin E1 affected the resistances of
      the ductus venosus and liver to the same extent, it is unlikely that
      prostaglandins of the E series mediate the change in distribution of umbilical
      venous return between the ductus venosus and liver during fetal stress.

PMID- 2220950
TI  - Cocaine effects on fetal behavioral state.

PMID- 2220951
TI  - Possible therapeutic applications of cordocentesis.

PMID- 2220952
TI  - Serum levels of interleukin-2 and tumor necrosis factor-alpha in women with
      recurrent abortion.

PMID- 2220953
TI  - What is birth asphyxia?

PMID- 2220954
TI  - Embryo migration responsible for ectopic pregnancies.

PMID- 2220955
TI  - Responsibility expands to extended family members.

PMID- 2220956
TI  - Does prophylactic amnioinfusion make a difference.

PMID- 2220957
TI  - Cordocentesis and immune thrombocytopenia--continued.

PMID- 2220958
TI  - Measures of test performance and predictive values.

PMID- 2220959
TI  - Toxicity of vancomycin given during pregnancy.

PMID- 2220960
TI  - Ethics of new reproductive technologies.

PMID- 2220961
TI  - Twin transfusion syndrome.

PMID- 2220962
TI  - Oral contraceptives and breast cancer.
AB  - Among women in general the risk of breast cancer through 59 years of age does not
      appear to be affected appreciably by the use of oral contraceptives. Nonetheless,
      concern continues to be expressed about the effects of early age at first use,
      long-term duration of use, formulation, and a variety of other factors thought to
      influence breast cancer risk in the presence of oral contraception. A number of
      recent studies restricted to young women suggest that long-term use may increase
      the risk of disease occurring very early, but the present lack of consistent
      findings in well-conducted epidemiologic studies prevents any certain conclusion
      with regard to cause-and-effect. However, if an increased risk were indeed
      present, the most plausible interpretation is that long-term oral contraception
      promotes earlier clinical manifestation of breast cancer in some women while
      having no net impact on their lifetime risk of the disease.

PMID- 2220964
TI  - Oral contraceptives and myocardial infarction.
AB  - The risk of myocardial infarction in contraceptive users is limited to women over
      35 years of age who smoke. The cause of myocardial infarction in oral
      contraceptive users is thrombotic and not atherosclerotic. Minor lipid changes
      have no clinical relevance to myocardial infarction in contraceptive pill users
      and do not appear to increase coronary plaques.

PMID- 2220965
TI  - Clinical acceptability of monophasic gestodene.
AB  - The monophasic low-dose contraceptive containing 30 micrograms of ethinyl
      estradiol and 75 micrograms of gestodene has been tested in numerous clinical
      studies to determine contraceptive reliability, cycle control, and influence on
      metabolism and to uncover concomitant symptoms. Clinical data have been derived
      from continuous phase III studies. Now that the preparation has been introduced
      in several countries, the opportunity to assemble comprehensive experience has
      been taken by initiating phase IV studies. Documentation on 600,000 therapy
      cycles with monophasic gestodene among 100,000 women is already available. The
      drop-out rate was low. A large number of women participated in the clinical
      studies for a long time--some up to 3 years. Study results showed that
      contraceptive reliability was high and cycle control was excellent. The gestodene
      combination was well tolerated. The frequency of concomitant symptoms was low.
      The monophasic gestodene meets the basic criteria essential for an oral
      contraceptive.

PMID- 2220963
TI  - Oral contraceptives, lipoproteins, and atherosclerosis.
AB  - A nonhuman primate model was developed to study the effects of oral
      contraceptives on lipoproteins and atherosclerosis. Cynomolgus macaques were
      selected because of their susceptibility to diet-induced atherosclerosis and
      because their reproductive physiology, menstrual cycle, and circulating sex
      hormone patterns are similar to those of human females. The first study compared
      a vaginal ring containing levonorgestrel and estradiol with an oral contraceptive
      containing norgestrel and ethinyl estradiol. A second study compared two oral
      combinations: norgestrel-ethinyl estradiol and ethynodiol diacetate-ethinyl
      estradiol. As predicted, use of all the contraceptives led to lowering of high
      density lipoprotein cholesterol levels. However, contrary to what might be
      expected, use of the ethinyl estradiol-containing oral contraceptives did not
      lead to an increase in the prevalence or extent of atherosclerosis. We concluded
      that ethinyl estradiol neutralized the atherogenic influence of the progestin
      component of oral contraceptives.

PMID- 2220966
TI  - Pharmacokinetics of gestodene and ethinyl estradiol after oral administration of
      a monophasic contraceptive.
AB  - The pharmacokinetic and protein-binding properties of gestodene and ethinyl
      estradiol have been investigated after single and multiple dosing in several
      studies in 83 healthy, young women. After oral administration, gestodene is
      completely absorbed and bioavailable and exhibits dose-linear pharmacokinetics.
      During long-term pill use, serum levels of gestodene were four to five times
      higher than after single administration, showing a periodic increase from day 1
      to day 10 during each cycle. Ultrafiltration studies revealed that 75.3% of total
      serum gestodene is bound to sex hormone-binding globulin, 24.1% is bound to
      albumin, and only 0.6% is not protein bound. Thus gestodene levels during steady
      state are explained by an increase in sex hormone binding-globulin as a result of
      concomitant administered ethinyl estradiol and a specific binding of gestodene to
      this protein. Serum levels of ethinyl estradiol during single and multiple
      administration were identical and were not different from those observed with
      another preparation containing 30 micrograms of ethinyl estradiol.

PMID- 2220968
TI  - Crohn's disease and retinal vascular disease.
AB  - Patients with Crohn's disease may manifest extraintestinal findings including
      ocular involvement. We treated two patients with Crohn's disease who manifested
      retinal vascular disease that may have been related to the immune nature of the
      underlying disease or possibly to changes in the vasculature or coagulation
      system. One patient had a central retinal vein occlusion and the other had
      retinal vasculitis involving retinal arteries and veins with an apparent branch
      retinal artery occlusion. Both patients were in excellent health except for
      Crohn's disease, which was confirmed by a biopsy specimen. In one patient, the
      diagnosis of retinal vasculitis preceded the clinical diagnosis of Crohn's
      disease, whereas for the second patient the symptomatology of the intestinal
      disease preceded the ocular manifestations. We suggest that inflammatory bowel
      disease should be considered in the differential diagnosis of retinal vascular
      occlusive disease, especially in a young patient.

PMID- 2220967
TI  - Rapidly progressive outer retinal necrosis in the acquired immunodeficiency
      syndrome.
AB  - Two patients, both seropositive for the human immunodeficiency virus, developed
      rapidly progressive retinal necrosis associated with a systemic herpes zoster
      infection. The retinitis in these patients was characterized by primary
      involvement of the outer retina, with sparing of the inner retina and retinal
      vasculature until late in the disease process; a rapidly progressive course; poor
      response to intravenous acyclovir; and development of rhegmatogenous retinal
      detachment. In one of the patients, the retinitis was initially multifocal.
      Electron microscopy of a retinal biopsy specimen from one of the patients
      demonstrated virus particles consistent with a herpesvirus, and polymerase chain
      reaction disclosed herpesvirus in a retinal biopsy specimen of the other patient.
      This entity may represent a distinct form of acute retinal necrosis that is seen
      in immunocompromised individuals.

PMID- 2220969
TI  - Vitrectomy retinotomy aspiration biopsy of choroidal tumors.
AB  - We used an investigational technique for the biopsy of intraocular tumors to aid
      in the diagnosis of three choroidal tumors. A three-port trans-pars plana
      vitrectomy was performed in conjunction with retinotomy, tumor biopsy,
      endophotocoagulation, and air-fluid exchange. Vitrectomy was used to decrease the
      amount of traction secondary to retained vitreous after intraocular surgery.
      Retinotomy sites were chosen under microscopic control to avoid large caliber
      retinal vessels. Then a modified tumor-aspiration technique, together with
      endophotocoagulation and aspiration of intraoperative vitreous hemorrhages,
      provided an opportunity to sample tumor tissue continually at varied depths. We
      have added standard vitreous surgery concepts, techniques, and instrumentation to
      produce vitrectomy retinotomy aspiration biopsy of choroidal tumors.

PMID- 2220970
TI  - Magnetic resonance imaging in the evaluation of vitreoretinal disease in eyes
      with intraocular silicone oil.
AB  - Media opacification in eyes filled with silicone oil makes the evaluation of
      recurrent retinal detachment difficult. Ultrasonography through silicone oil is
      subject to significant imaging artifacts. We performed magnetic resonance imaging
      on six patients with unilateral intravitreal silicone oil to determine if the
      technique would detect detached retina and subretinal oil. All patients had
      undergone pars plana vitrectomy with silicone oil injection for proliferative
      vitreoretinopathy; five patients had encircling solid silicone scleral buckles.
      In five patients the media were clear, and ophthalmoscopic findings were
      correlated with magnetic resonance findings. Four patients had recurrence of
      inferior retinal detachment; magnetic resonance imaging demonstrated subretinal
      oil in three of these patients. One patient had a concentric, shallow, anterior
      retinal detachment; magnetic resonance scanning demonstrated a globular
      hyperintensity suggestive of subretinal oil. In the sixth patient, who had an
      opaque cornea, magnetic resonance imaging suggested that the retina was attached
      preoperatively; this was confirmed at subsequent surgery. A chemical shift
      artifact was helpful in defining the contour of retinal detachments and the
      presence of subretinal oil by outlining the silicone oil within the eye.

PMID- 2220971
TI  - Histopathologic study of the Molteno glaucoma implant in three patients.
AB  - Three eyes with the Molteno glaucoma implant (one eye with epithelial downgrowth,
      one eye with iridocorneal endothelial syndrome, and one eye with aphakia and
      glaucoma) were enucleated two to six years after implantation. Histopathologic
      examinations disclosed no evidence of erosion of sclera or conjunctiva of the eye
      by the glaucoma implant device. In the outer layers of the bleb wall, few and
      mostly degenerated inflammatory cells were present, which represented a minimal
      inflammatory reaction. Scanning electron microscopy of the tubes in these three
      patients showed that the tube was intact, patent, and without signs of
      degradation. The tube entering into the anterior chamber caused no appreciable
      inflammation and maintained its patency even when downgrowth epithelial cells
      lined the anterior chamber. The Molteno plate induced little or no inflammatory
      reaction. Therefore, the Molteno glaucoma implant is a useful device for patients
      with high risk for failure after surgery for glaucoma.

PMID- 2220972
TI  - Correlations of acoustic tissue typing of malignant melanoma and histopathologic
      features as a predictor of death.
AB  - Forty-six eyes with uveal melanoma were scanned with a computerized diagnostic
      ultrasound system before enucleation, and light microscope sections were
      obtained. Tumors were characterized by ultrasonically measured dimensions and
      power spectrum analysis, which provided information not available in conventional
      A- or B-scan ultrasonography. Histopathologic features, including cell clustering
      pattern, cell type, pigmentation, vascularity, and necrosis, were quantified.
      Statistically significant correlations were found between parameters derived from
      the power spectrum and histologic characteristics. Patients were followed up for
      up to ten years with 14 deaths occurring because of metastases. Using a Cox
      relative risk model with histopathologic data, a risk model comprising
      pigmentation and cell type (P less than .0001) was obtained. Using ultrasonic
      characteristics, a model comprising tumor volume and scatterer concentration (P =
      .0062) was obtained. The results suggest that ultrasonic tissue characterization
      and three-dimensional biometry may provide improved in vivo prognostic indicators
      for uveal melanoma.

PMID- 2220973
TI  - Magnetic resonance imaging of radiation optic neuropathy.
AB  - Three patients with delayed radiation optic neuropathy after radiation therapy
      for parasellar neoplasms underwent magnetic resonance imaging. The affected optic
      nerves and chiasms showed enlargement and focal gadopentetate dimeglumine
      enhancement. The magnetic resonance imaging technique effectively detected and
      defined anterior visual pathway changes of radionecrosis and excluded the
      clinical possibility of visual loss because of tumor recurrence.

PMID- 2220975
TI  - Successful treatment of recurrent corneal erosion with Nd:YAG anterior stromal
      puncture.
AB  - I used a new technique to create anterior corneal stromal punctures for the
      treatment of traumatic recurrent corneal erosions that had not responded to
      conventional therapy. Three patients with such erosions within the visual axis
      were successfully treated by using multiple applications of the Nd: YAG laser set
      at energy levels between 1.8 and 2.2 mJ. One of these patients had previous
      stromal puncture with a bent 25-gauge needle. The erosions of all patients healed
      without complications and have remained symptom-free for four to six months.
      Compared with needle puncture, the laser punctures were more reproducible,
      shallow, and translucent.

PMID- 2220974
TI  - Successful medical management of Acanthamoeba keratitis.
AB  - Seven patients with documented Acanthamoeba keratitis were treated with prolonged
      and intensive triple antiamoebic therapy consisting of topical neomycin-polymyxin
      B-gramicidin, propamidine isethionate 0.1%, and miconazole nitrate 1%.
      Additionally, five patients were treated with topical corticosteroids. Six of
      seven patients were cured of Acanthamoeba keratitis with medical therapy alone,
      one patient required therapeutic penetrating keratoplasty to eradicate the
      infection. Two patients underwent penetrating keratoplasty to improve their
      vision after medical therapy. Our series differs from previous reports in that
      triple antiamoebic therapy was used in all seven patients and was successful in
      both early and advanced cases of Acanthamoeba keratitis. Prolonged and intensive
      topical therapy with these three antiamoebic drugs may be an effective mode of
      therapy for Acanthamoeba keratitis.

PMID- 2220976
TI  - Penetrating keratoplasty after ocular trauma.
AB  - We reviewed the records of 41 patients who underwent penetrating keratoplasty for
      a corneal opacity caused by trauma between Jan. 1, 1983, and Dec. 31, 1988. Most
      of the patients were young males whose average age was 35 years. Common tools
      accounted for many injuries (14 of 41, 34%). Sixteen injuries (39%) were work
      related. Thirty-six patients (88%) had corneal scars from a perforating injury,
      four patients (10%) had corneal edema, and one patient (2%) required emergency
      penetrating keratoplasty for extensive tissue loss. Of the 39 patients with one
      year of follow-up, 31 (82%) maintained clear corneal grafts. Rejection occurred
      in nine of 39 patients (23%) and only three (33%) of the rejections resolved.
      Visual outcome was favorable with 20 patients (51%) attaining best-corrected
      postoperative visual acuity of 20/20 to 20/40, nine patients (23%) attaining
      visual acuity of 20/50 to 20/100, and ten patients (26%) attaining visual acuity
      of 20/200 or worse. Preoperative retinal disease (six of 39, 15%), astigmatic
      errors (five of 39, 13%), graft failures (four of 39, 10%), and postoperative
      glaucoma (12 of 39, 31%) adversely influenced the outcome. Although the
      prevalence of postoperative complications is relatively high, good visual results
      can be obtained in patients who undergo penetrating keratoplasty after ocular
      trauma.

PMID- 2220977
TI  - Limbal autograft reconstruction after conjunctival squamous cell carcinoma.
AB  - Two patients who had squamous cell carcinoma with extensive limbal and corneal
      involvement were treated with surgery and cryotherapy. Rarely large areas of the
      cornea are involved by this tumor. Visual prognosis in such patients is poor. In
      these two patients, autologous limbal transplants were effective in restoring an
      excellent corneal surface and good visual function. This technique may be useful
      in the reconstruction of eyes with extensive neoplastic involvement of the
      corneoscleral limbus and cornea.

PMID- 2220978
TI  - Response of Bitot's spots in preschool children to vitamin A treatment.
AB  - In a double-masked, placebo-controlled, clinical trial in Indonesia, 88 preschool
      children between the ages of 36 and 72 months with Bitot's spots were randomly
      assigned to 200,000 IU of oral vitamin A or placebo and followed up for five
      weeks. Baseline and follow-up serum vitamin A levels were obtained. Of the 45
      children receiving vitamin A, 33 (73.3%) showed complete cure and disappearance
      of Bitot's spots, six (13.3%) had disappearance of some but not all Bitot's
      spots, and six (13.3%) were unresponsive to treatment. The nonresponsive children
      were older, all male, and had higher initial mean serum vitamin A levels, 23.0
      micrograms/dl, compared to 15.9 micrograms/dl in the cured group (P = .017).
      These data suggest that normal vitamin A status may be found in approximately 13%
      of children with Bitot's spots before vitamin A intervention and that one fourth
      of those who had Bitot's spots originally will not be cured of all Bitot's spots
      after intervention. These are important factors to consider when using Bitot's
      spots in prevalence surveys as a clinical sign of vitamin A deficiency.

PMID- 2220979
TI  - Facial nerve injury and hemifacial spasm.
AB  - We studied evidence of facial nerve damage in patients with hemifacial spasm.
      Three types of evidence of nerve damage were analyzed: objectively measured
      weakness in eyelid protractor strength, clinically evident weakness of muscles
      innervated by the seventh nerve, and clinically evident aberrant seventh nerve
      regeneration. Of the 60 patients in the study, 54 (90%) had at least one of these
      features of seventh nerve damage. Objectively measured eyelid protractor weakness
      was noted in 27 of 58 patients (47%) who were tested. Clinically apparent
      weakness of at least one of four facial muscle groups was noted in 42 of 60
      patients (70%). Aberrant seventh nerve regeneration was documented in 25 of 60
      patients (42%). These findings indicate that facial nerve damage is common in
      patients with hemifacial spasm.

PMID- 2220980
TI  - Multifocal intraocular lenses--better or worse?

PMID- 2220981
TI  - National Registry of Drug-Induced Ocular Side Effects.

PMID- 2220982
TI  - Nd:YAG treatment of a posterior vitreous cyst.

PMID- 2220983
TI  - Argon laser photocoagulation for advanced retinopathy of prematurity.

PMID- 2220984
TI  - Retinoscopy with a bent filament.

PMID- 2220985
TI  - A simple method for detection of hemianopsia or quadrantanopsia.

PMID- 2220986
TI  - Demographic patterns and academic choices of graduates of one ophthalmology
      training program.

PMID- 2220987
TI  - Congenital myopia in Stickler's hereditary arthro-ophthalmopathy.

PMID- 2220988
TI  - Systemic neurocristopathy associated with Rieger's syndrome.

PMID- 2220989
TI  - Sixth nerve palsy as the initial manifestation of sarcoidosis.

PMID- 2220990
TI  - Unsuspected renal cell carcinoma metastatic to the choroid nine years after
      nephrectomy.

PMID- 2220991
TI  - Progressive optic atrophy and the primary antiphospholipid antibody syndrome.

PMID- 2220992
TI  - Acute dacryocystitis caused by Pasteurella multocida.

PMID- 2220993
TI  - Keratitis associated with Pseudomonas mesophilica in a patient taking topical
      corticosteroids.

PMID- 2220994
TI  - Nocardia scleritis.

PMID- 2220995
TI  - The effects of education on hand use with industrial workers in repetitive jobs.
AB  - Eighteen subjects participated in a preliminary study to determine the effects of
      two types of educational programs on the hand-use patterns of industrial workers
      at risk for developing cumulative trauma disorder (CTD). The subjects were
      divided into three groups: Two groups received different educational programs and
      the third group served as the control. One program used a handout as the only
      educational tool; the other used the handout as well as a hands-on demonstration
      of the concepts in the handout. Pretests and posttests of the frequency of
      movements identified with CTD of the hand and wrist during work were administered
      to all subjects. Both educational programs were significantly effective in
      reducing the number of at-risk movements performed by workers tested 1 week after
      receiving the education. No significant difference was found between the two
      educational programs. The results of this study show that education can affect
      hand-use patterns, and a similar study on a larger sample is recommended.

PMID- 2220996
TI  - The Test of Orientation for Rehabilitation Patients: interrater reliability.
AB  - The Test of Orientation for Rehabilitation Patients (TORP) (Deitz, Beeman, &
      Thorn, in press) was developed for use with patients with brain injuries in
      inpatient rehabilitation settings. It was designed to assess orientation to
      person and personal situation, place, time, schedule, and temporal continuity.
      Interrater reliability for the TORP was examined with the use of 34 brain-injured
      and 35 non-brain-injured patients. Two occupational therapists trained in
      administering the TORP, as specified in the test manual (Dietz et al., in press),
      served as the examiners. One therapist administered and scored the test while the
      second therapist observed and scored the test for the same subject. Intraclass
      correlation coefficients, used as indexes of reliability for the scoring of the
      total test and subtests, ranged from .89 to 1.00 for the non-brain-injured group
      and from .94 to .99 for the brain-injured group. These findings suggest that an
      occupational therapist can reliably score the TORP for patients both with and
      without brain injuries.

PMID- 2220997
TI  - The value of psychosocial Level II fieldwork.
AB  - The shortage of occupational therapists choosing to practice in mental health and
      the increase of therapists electing to specialize in other areas led to a pilot
      study designed to gather information regarding the value of psychosocial Level II
      fieldwork. A survey was mailed to 152 practicing occupational therapists who had
      graduated from Colorado State University in Fort Collins between 1983 and 1988;
      of the surveys returned, 116 were used in this study. The results indicate that
      the psychosocial Level II fieldwork experience provides therapists with valuable
      training and experience regardless of their current area of practice or
      specialization. The results also suggest that to preserve the holistic approach
      that occupational therapists offer their clients, psychosocial Level II fieldwork
      must remain a requirement of occupational therapy programs.

PMID- 2220998
TI  - The use of relaxation training to enhance functional outcomes in adults with
      traumatic head injuries.
AB  - Impaired anxiety management and poor emotional control have a negative effect on
      the adaptive functioning of persons with head injuries who are in the postacute
      stages of recovery. This paper outlines a relaxation training program
      administered individually to 4 adults with severe head injuries. Each subject was
      in the postacute phase of recovery and had reported stress to be a persistent
      problem in daily living. The relaxation training protocol combined biofeedback,
      imagery, autogenic training, and deep breathing. Significant improvement in
      function, measured by scores on a scale of illness-related dysfunction, support
      the potential benefits of stress management training as part of functional
      training programs for persons with traumatic head injuries.

PMID- 2221000
TI  - Occupational therapy in acute inpatient psychiatry: an activities health
      approach.
AB  - This article discusses some of the challenges that occupational therapists
      working in acute psychiatric inpatient settings commonly face. There is often a
      lack of sufficient time available for treatment as well as limitations inherent
      in addressing functional problems in the artificiality of a hospital environment.
      A theoretical framework is introduced from which the role of occupational therapy
      and realistic objectives for acute short-term care can be identified. This
      framework for inpatient occupational therapy practice is based on the concept of
      activities health, which provides a definition of health in functional rather
      than medical terms. The importance of emphasizing the patient's competence in
      roles assumed in community living is emphasized. A step-by-step approach to
      program development with specific examples is also provided.

PMID- 2220999
TI  - Developing a variable budget for occupational therapy contract work.
AB  - Contract occupational therapists need to develop a financial plan for improved
      control of their business. The variable budget allows financial planning
      according to actual performance volume. This paper describes a step-by-step
      method for the development of a variable budget through the illustration of a
      case example.

PMID- 2221002
TI  - Program evaluation for accreditation.
AB  - Program evaluation in preparation for accreditation provides opportunities for
      the identification of program strengths, weaknesses, and improvement potential.
      In the present study, naturalistic inquiry, an evaluation methodology responsive
      to the concerns of persons with a stake in the program, was successfully used in
      preparation for the accreditation of an occupational therapy program. The
      experiences of undergraduate students who implemented the program evaluation as
      part of an honors elective course describe the process, outcomes, benefits, and
      problems associated with the use of naturalistic inquiry as a responsive program
      evaluation.

PMID- 2221001
TI  - Creating excellence in patient care.
AB  - Occupational therapists are working in health care organizations that operate
      from an efficiency perspective. There is growing criticism that this approach can
      put quality patient care at risk. This article proposes the excellence
      perspective as a way to address quality as well as productivity. The excellence
      perspective is one that occupational therapists can use as a guide to program
      innovation. It is a perspective that fits with the occupational therapist's
      concern for quality patient care and the administration's concern for
      productivity. This article examines the excellence perspective and describes its
      use in business and its potential for health care. A case study that exemplifies
      excellence in patient care is presented.

PMID- 2221003
TI  - Clinical teaching: fieldwork supervisors' attitudes and values.
AB  - The purpose of this study was to initiate the identification of fieldwork
      supervisors' educational needs by ascertaining their values and attitudes toward
      exemplary principles of teaching advocated by adult educators. Each principle was
      rephrased as an attitude or value associated with Level II fieldwork, matched
      with a Likert-type 5-point interval scale, and distributed to a convenience
      sample of 81 fieldwork supervisors. Ninety-two percent of the questionnaires were
      returned. The statement responses were tallied by frequency and were then summed
      and ranked. The range of scores indicated that the fieldwork supervisors' values
      and attitudes were congruent with the identified principles of teaching. The
      rankings revealed that the supervisors placed the highest value on providing a
      thorough orientation and the lowest values on individualization of the fieldwork
      experience and supervisor-student collaboration. The findings indicate a need for
      further education about ways to individualize learning and involve students in
      planning, implementing, and evaluating the learning experience.

PMID- 2221004
TI  - Upper extremity casting: adjunct treatment for a child with cerebral palsy
      hemiplegia.
AB  - A common upper extremity deformity with hemiplegia is pronation contracture of
      the forearm in association with flexion contracture of the elbow. Early
      management of the child with hemiplegic cerebral palsy is critical in optimizing
      overall function. The use of inhibitory upper extremity casting can enhance
      function and improve arm-hand position. The present paper describes the
      evaluation process before casting, the goals of each phase of the casting
      program, and the follow-up.

PMID- 2221005
TI  - Progressive student expectations based on AOTA's fieldwork evaluation.
AB  - Behavioral statements for each item of the FWE were developed according to a
      developmental learning hierarchy and then organized into specific categories and
      time frames. The performance expectations are presented to occupational therapy
      students in Level II fieldwork in the areas of psychiatry and physical
      disabilities; a similar process was used to develop performance expectations for
      the Level II fieldwork of those studying to be occupational therapy assistants.
      The advantages of this system over the system we had used previously were readily
      apparent: Supervisor preparation time was considerably reduced, and the content
      and format of the supervisory meetings changed. Meetings are now spent
      productively discussing strengths and patterns of behaviors, rather than
      reviewing endless lists of behavioral statements.

PMID- 2221006
TI  - Referral for profit (white paper). American Occupational Therapy Association
      (AOTA).

PMID- 2221007
TI  - More on the Barthel Index.

PMID- 2221008
TI  - Protease nexin-1. Localization in the human brain suggests a protective role
      against extravasated serine proteases.
AB  - Protease nexin-1 (PN-1) is a potent thrombin inhibitor that is identical to the
      glia-derived neurite-promoting factor or glia-derived nexin. Here we report
      immunocytochemical studies of adult human cerebral cortex that revealed the
      presence of strong immunoreactivity for PN-1 in capillaries and in the smooth
      muscle cells of arteries and arterioles. Expression of PN-1 was also abundant in
      astroglial processes in the parenchyma and in perivascular astroglial endfeet of
      human cerebral cortex. In situ hybridization with an 35S-labeled RNA antisense
      probe for PN-1 resulted in significant labeling of astrocytes and blood vessels.
      Because thrombin is known to cause retraction of neurites and modification of
      astrocytic morphology at low concentrations, PN-1 around blood vessels may play a
      major protective role against extravasation of thrombin and possibly other serine
      protease into the human brain.

PMID- 2221009
TI  - Megakaryocyte synthesis is the source of epidermal growth factor in human
      platelets.
AB  - Epidermal growth factor (EGF) is known to be present in the alpha granules of
      human platelets; however the source of this EGF, ie, whether it is taken up by
      the platelets from the circulation, or whether it is packaged into the platelets
      from the megakaryocyte during thrombopoiesis, is unknown. To determine whether
      EGF is taken up by platelets, platelets for EGF receptors were assayed and it was
      attempted to detect uptake of EGF by the platelets from culture medium. Platelets
      were found to lack EGF receptors, and no uptake of EGF from the culture medium
      was detected. To assess whether EGF is packaged into platelets from the
      megakaryocyte, megakaryocytes in frozen section bone marrow cores were stained
      for EGF protein by immunohistochemistry, and it was demonstrated that EGF is
      present in megakaryocytes. In addition, staining of megakaryocytes by in situ
      hybridization for EGF mRNA demonstrated its presence in these cells. Therefore it
      is concluded that the source of EGF in human platelets is the megakaryocyte and
      that this EGF is synthesized in the megakaryocyte rather than being taken up from
      its environment.

PMID- 2221010
TI  - Early proto-oncogene expression in rat aortic smooth muscle cells following
      endothelial removal.
AB  - To study the mechanism(s) of vascular smooth muscle cell proliferation in vivo,
      mRNA levels of c-fos, c-jun, and c-myc were determined by Northern blot analysis
      following vascular balloon de-endothelialization (BDE). Medial smooth muscle
      cells (SMC) were separated and studied by enzymatic digestion of the vessel wall.
      mRNA levels of c-fos and c-jun from aortic smooth muscle cells (SMC) were
      simultaneously induced within 30 minutes of BDE and declined to baseline by 1.5
      hours, c-myc mRNA did not begin to increase until 1 hour after vascular injury.
      Levels of c-myc peaked at 2 hours and were sustained for an additional 4 hours
      before gradually declining. Smooth muscle cells derived from enzyme-treated
      control aortae that did not undergo BDE expressed c-fos and c-jun, but showed no
      evidence of c-myc message. In contrast, nonenzymatically treated, non-BDE whole
      aortae (containing both media and adventitia) demonstrated a prominent c-myc
      signal, but failed to express c-fos and c-jun. Corresponding examination of
      adventitia derived from enzyme-treated aortae showed this tissue to be a source
      of all three proto-oncogenes. The results of this study demonstrate the earliest
      in vivo molecular markers of vascular injury reported to date and implicate SMC
      proto-oncogene expression in the initiation of SMC proliferation. Furthermore
      these findings suggest two avenues for proto-oncogene induction, that are due to
      (1) vessel wall manipulation and (2) humoral stimulation.

PMID- 2221011
TI  - Immunopathology of diabetes in the RT6-depleted diabetes-resistant BB/Wor rat.
AB  - Insulin-dependent diabetes mellitus appears to be an autoimmune disease that is
      characterized morphologically by insulitis, an inflammation of the pancreatic
      islets of Langerhans that results in the destruction of the insulin-producing
      beta cells. The RT6-depleted DR rat provides a good model for the in situ study
      of insulitis. The authors used the anti-RT6.1 monoclonal antibody to selectively
      deplete RT6 T cells in DR rats and produce a synchronous and rapid development of
      insulitis that commences 10 days after treatment. The phenotype of cells that
      infiltrated the islets at different stages of insulitis in the RT6-depleted DR
      rat was determined by immunocytochemical techniques. A prodromal period of 10
      days was present in which the authors could not detect morphologic alterations
      within the pancreas. This is followed by a second phase of early insulitis in
      which a few islets are infiltrated by macrophages and T cells. This rapidly
      progresses by 18 days to the final phase of generalized insulitis in which the
      islets are massively infiltrated by macrophages and T cells.

PMID- 2221012
TI  - Reversal of colchicine-induced mitotic arrest in Chinese hamster cells with a
      colchicine-specific monoclonal antibody.
AB  - The ability of a high-affinity colchicine-binding monoclonal antibody to reverse
      the effects of colchicine on Chinese hamster ovary cells was investigated. Using
      flow cytometry, a complete mitotic blockade was demonstrated after 16 hours with
      2.5 x 10(-7) mol/l (molar) colchicine. Colchicine-induced changes were reversible
      when equimolar antibody was added simultaneously with or up to 6 hours after
      colchicine. With further delay in addition of antibody, a progressive
      irreversible increase in mitotic blockade and increase in mean cell size was
      observed. Prolonged colchicine exposure, without antibody reversal, led to
      polyploidy and structural chromosome breakage. Early antibody reversal restored
      cells to the diploid state, whereas delayed reversal resulted in a time-dependent
      increase in polyploidy. Colchicine-induced polyploidy and chromosomal aberrations
      may be the basis for both colchicine toxicity and the time-dependent increase in
      irreversibility of colchicine effects.

PMID- 2221013
TI  - Immunohistochemical study of fibronectin in experimental myocardial infarction.
AB  - Light microscopic immunohistochemical studies were performed to evaluate the
      distribution of fibronectin in paraffin sections of p-formaldehyde-fixed normal
      rat hearts and the hearts of rats that had undergone ligation of the left
      coronary artery. A peroxidase-labeled antibody technique was used, together with
      appropriate immunohistochemical control procedures, for the localization of
      fibronectin in normal hearts and in the hearts of sham-operated animals.
      Fibronectin was localized in the interstitial space between myocytes, and beneath
      arterial, venous, and capillary endothelium. At 4 hours after coronary ligation,
      fibronectin was localized in a patchy fashion in the cytoplasm and interstitial
      space of some of the myocytes in the area supplied by the ligated vessel. At 24
      hours, there was more intense, homogeneous staining in necrotic myocytes in the
      infarcted area and in the capillary endothelium in the border zone. At 48 hours,
      the intensity of staining for fibronectin was maximal in and between the necrotic
      myocytes in the center of the infarct and in proliferating and migrating
      capillaries and fibroblasts in the border zone. Similar patterns of localization
      were observed at 3 and 7 days after coronary ligation, but with progressive
      decreases in the intensity of staining. Two sources of fibronectin appeared to
      have contributed to these changes: plasma fibronectin diffusing through damaged
      blood vessels would account for the early staining observed in necrotic myocytes
      in the center of the infarct, whereas de novo synthesis of fibronectin by
      connective tissue cells and endothelial cells in sprouting capillaries would be
      responsible for the subsequent staining observed in viable capillaries in the
      border zone of the infarct. Known properties of fibronectin in vitro, combined
      with these in vivo observations, indicate that fibronectin may influence the
      thrombotic, inflammatory, angiogenic, and fibrotic processes involved in infarct
      healing.

PMID- 2221014
TI  - Lyme borreliosis in the severe combined immunodeficiency (scid) mouse manifests
      predominantly in the joints, heart, and liver.
AB  - The authors describe the histopathologic evolution of Lyme disease in severe
      combined immunodeficiency (scid) and normal C.B-17 and C57BL/6 mice inoculated
      with Borrelia burgdorferi. Starting on day 7 after inoculation, all scid mice
      infected subcutaneously in the tail with a low-passage European tick isolate of
      B. burgdorferi had clinical evidence of arthritis characterized by reddening and
      swelling of tibiotarsal joints. Later on, other joints, ie, metatarsal and
      ulnacarpal joints were also affected. The infection of scid mice resulted in a
      persistent spirochetemia and the development of a multisystem disease with
      chronic progressive inflammation of joints, heart, and liver. Major
      histopathologic alterations included 1) severe joint lesions, characterized by
      the presence of hyperplastic inflamed synovial lining cells associated with the
      erosion and destruction of cartilage and/or bone; 2) pancarditis with
      infiltrations of mononuclear cells in the endocardium, myocardium, and
      pericardium; and 3) hepatitis with mononuclear cell infiltrations confined to the
      portal field and central vein, granulomatous reactions, and eventually the
      development of liver fibrosis. In addition, smaller more confined lesions were
      found in kidneys, lung, brain, and striated muscle. The inflammatory infiltrates
      in the various organs were associated mostly with Mac-1+ cells, largely monocytes
      and macrophages, as well as some polymorphonuclear leukocytes, but not B and T
      lymphocytes. Infective spirochetes could be readily isolated from blood and
      joints and were found at the site of inoculum and the myocardium. In contrast,
      subcutaneous inoculation of normal C.B-17 or C57BL/6 mice with spirochetes in
      general did not result in clinical signs of arthritis. Only 10% to 20% of the
      C57BL/6 mice, but none of the C.B-17 mice, showed clinical evidence of
      oligoarthritis, which appeared not before day 36 after inoculation. In general,
      the infection of normal mice resulted in minimal lesions in various organs, and
      no spirochetes could be visualized or reisolated from their tissues. The data
      demonstrate that Lyme borreliosis may develop in mice in the absence of
      detectable specific B and T cells and thus suggest an immunologic control of the
      disease in this species. The scid mouse model therefore can be used to define the
      components of the immune system responsible for the suppression and/or the
      progression of the disease.

PMID- 2221015
TI  - Cell density governs the ability of human bronchial epithelial cells to recognize
      serum and transforming growth factor beta-1 as squamous differentiation-inducing
      agents.
AB  - Sparse (75 to 2000 cells/cm2) density cultures of normal human bronchial
      epithelial cells uniformly undergo terminal squamous differentiation when
      incubated in medium containing serum (fetal bovine serum [FBS]) or transforming
      growth factor beta-1 (TGF-beta 1). It was found that the cell density of the
      culture affects the probability that a cell will respond to these differentiation
      inducing agents. Thus whereas irreversible inhibition of DNA synthesis occurs in
      sparse cell-density cultures within 24 hours after exposure, only a transient
      (less than 36 hours) depression in DNA synthesis was seen in high (more than
      10,000 cells/cm2) density cultures. In addition, although phase microscopic image
      analysis revealed that virtually all of the cells displayed a squamous morphology
      within 1 hour after exposure to FBS or TGF-beta 1, observations made 48 to 72
      hours later showed the presence of clusters of small prolate spheroid-shaped
      cells surrounded by many involucrin-positive squamous-appearing cells. Only the
      small cells were capable of DNA synthesis and cell division as determined by
      autoradiography and time-lapse photomicrographic images. These replicating cells
      immediately undergo squamous differentiation if they are subcultured and
      reinoculated at low cell density and incubated in medium supplemented with FBS or
      TGF-beta 1. Therefore the probability that a human bronchial epithelial cell will
      be refractive to FBS- or TGF-beta 1 induced terminal squamous differentiation is
      solely a function of the cell density of the culture.

PMID- 2221016
TI  - Decreased expression of integrin adhesive protein receptors in adenocarcinoma of
      the breast.
AB  - The integrin superfamily represents a major class of receptors mediating cell
      substrate adhesion. Our recent study of the tissue distribution of the alpha 2
      beta 1 integrin, a cell-surface collagen receptor, revealed that high levels of
      receptor expression were associated with orderly, regulated epithelial cell
      proliferation. Those observations prompted the present investigation of alpha 2
      beta 1 and other integrins in adenocarcinoma of the breast. The alpha 2 beta 1
      integrin was highly expressed on the epithelium of the ducts and ductules of
      normal breast tissue. Normal or nearly normal levels of the receptor were
      expressed in fibroadenomas. In contrast, markedly decreased or undetectable alpha
      2 beta 1 expression was typical of poorly differentiated adenocarcinomas. Well
      differentiated lesions exhibited intermediate levels of expression. Similar, but
      less extensive, decreases in expression were observed for the alpha 5 beta 1
      (fibronectin receptor) and alpha v beta 3 (vitronectin receptor). Significant
      expression of the beta 1 subunit on even poorly differentiated tumors suggests
      that the expression of other undefined members of the beta 1 family is not
      reduced to the same low level as alpha 2 beta 1 and alpha 5 beta 1. Expression of
      the alpha 2 beta 1 integrin was highly correlated with estrogen-receptor
      expression. Decreased expression of alpha 2 beta 1 and other integrin adhesive
      protein receptors probably contributes to the altered adhesive properties of
      tumor cells characteristic of the malignant phenotype.

PMID- 2221017
TI  - Intraluminal fibrosis induced unilaterally by lobar instillation of CdCl2 into
      the rat lung.
AB  - Lung injury induced by intratracheal instillation of cadmium chloride (CdCl2)
      into the rat lung may serve as a model of human interstitial lung disease. In
      this study, CdCl2 solutions were instilled through a lobar bronchus into the left
      lung of the rat. Two doses (400 micrograms or 50 micrograms of CdCl2, each in 400
      microliters of neutral saline) were used and the morphologic changes occurring
      during the first 7 days after a single exposure were documented by light and
      electron microscopy. With the higher dose, inflammatory cells appeared in the
      alveolar interstitium 1 day after CdCl2 administration. Edema and thickening of
      the alveolar walls were evident, as were damaged type I epithelial cells and
      denuded basement membranes. Fibrin was found in the air spaces. Within 2 days,
      inflammatory cells were seen in large numbers and fibroblasts were observed
      passing through gaps in the alveolar basement membranes into the air spaces. By 4
      and 7 days after CdCl2, various forms of intraluminal fibrosis, including
      intrabronchiolar budding, mural incorporation, and obliterative changes, were
      observed. The contralateral lungs had normal-appearing architecture for all the
      time points investigated. In the lower dose exposure, gradients of alveolar
      damage were observed in which normal lung, interstitial fibrosis, and/or
      intraluminal fibrosis were seen within treated lungs. In the mildly damaged
      regions, interstitial fibrosis predominated, while in the more severely damaged
      regions, mural incorporation of the convoluted basement membranes was observed.
      The pulmonary fibrosis that developed appeared to be similar to some human
      interstitial lung diseases and may offer a system in which to study the
      regulation of collagen deposition and fibrosis development in these pathologic
      conditions.

PMID- 2221019
TI  - Morphometric analysis of follicular center cell lymphomas.
AB  - The Lukes/Collins classification of non-Hodgkin's lymphomas subdivides follicular
      center cell (FCC) lymphomas into four categories based on nuclear size, shape,
      and state of transformation. Because of the well-recognized difficulty in making
      these subdivisions in routine histologic sections, a morphometric analysis of
      typical small cleaved (SC), large cleaved (LC), small noncleaved (SNC), and large
      noncleaved (LNC) FCCs was performed to describe and compare these four categories
      using objective parameters. The following features, which had been previously
      tested on normal follicles, were measured and calculated: nuclear area (NA),
      nuclear contour index of ellipticity (NCIe), nuclear contour index of nuclear
      irregularity (NCIni), and a relative chromatin dispersal index (CDI). The
      presence of nucleoli also was recorded. Mean values for the NA, NCIe, NCIni, and
      CDI were significantly different among all four FCC lymphoma subtypes, except
      that the CDI, which reflects transformation, was similar for the SC and LC cell
      groups. Comparison using the proportion of cells with nucleoli in each case
      revealed significant differences between all but the SNC and LNC groups. The LC
      group had the highest mean nuclear ellipticity and nuclear irregularity values.
      Mean nuclear area was smallest for the SC group followed by the LC, SNC, and LNC
      groups. Despite these many differences, all parameters showed a broad spectrum of
      values when either mean values for individual cases of each FCC subtype or
      distribution curves for all cells within a certain subtype were compared. This
      morphometric data demonstrates that the four histologically recognized types of
      FCC lymphomas are distinctive using a more analytic technique. This study also
      provides further insight into the differences among them. Evidence of nuclear
      transformation (nuclear size, chromatin dispersal, and frequent nucleoli) is a
      more important criterion than nuclear contours in distinguishing LNC from LC
      lymphomas. Although LC lymphomas have some features intermediate between SC and
      the noncleaved FCC lymphomas, they more closely resemble SC lymphomas. Finally
      morphometric analyses such as these provide an objective morphologic foundation
      for future prospective investigations of transformation-related phenomena; these
      studies may facilitate comparison of morphologic data with immunophenotype and
      genotype in non-Hodgkin's lymphomas and comparison of various other B-cell
      neoplasms with follicular center cell neoplasms.

PMID- 2221018
TI  - MaxEPA fish oil enhances cholesterol-induced intimal foam cell formation in
      rabbits.
AB  - In this study, the cholesterol-fed rabbit model was used to test the hypothesis
      that fish oil supplementation can influence the initiation and development of
      atherosclerotic lesions. Rabbits were fed one of two diets for a period of 30
      days: a nonatherogenic diet with corn oil as the sole fat source, or an
      atherogenic diet containing beef tallow and cholesterol. In addition, animals
      received a daily supplement of either MaxEPA fish oil or corn oil (0.5 ml/kg body
      weight). Terminal blood samples were drawn and the cholesterol and triglyceride
      levels determined for both plasma and very low-density (VLDL), intermediate
      density (IDL), low-density (LDL), and high-density (HDL) lipoproteins.
      Thiobarbituric acid-reacting substance (TBARS), an indicator of lipid
      peroxidation, was measured in the plasma samples. Besides these biochemical
      parameters of atherogenesis, the number of intimal foam cells in the descending
      thoracic aorta of each animal was determined by microscopic examination of the
      vessels en face. In rabbits fed the nonatherogenic diet, fish oil supplementation
      did not significantly affect any of the biochemical parameters that were
      measured. In contrast, fish oil supplementation of the atherogenic diet led to a
      significant increase in the LDL- and HDL-cholesterol as well as the HDL
      triglyceride levels. Plasma TBARS also increased more than four times.
      Morphologic analysis of the vessels from rabbits fed the atherogenic diet
      indicated that fish oil supplementation led to a threefold increase in the number
      of intimal foam cells, a result that may be linked to increases in both LDL
      cholesterol and plasma TBARS. The results of these experiments do not support the
      hypothesis that dietary fish oil will inhibit the initiation or progression of
      lesion formation in the cholesterol-fed rabbit.

PMID- 2221020
TI  - Perturbation of differentiated functions during viral infection in vivo. In vivo
      relationship of host genes and lymphocytic choriomeningitis virus to growth
      hormone deficiency.
AB  - Retarded growth and disordered glucose metabolism secondary to growth hormone
      (GH) deficiency are associated with persistent lymphocytic choriomeningitis virus
      (LCMV) infection of GH-producing cells in the anterior lobe of the pituitary
      gland. Infected C3H/ST mice, which are H-2k haplotype, become GH deficient, and
      LCMV replicates in most (more than 90%) of their GH-producing cells. In contrast,
      BALB/WEHI and SWR/J mice, which are H-2d and H-2q, respectively, do not develop
      this GH deficiency, and less than 20% of their GH-producing cells are infected by
      virus. Yet all three strains infected at birth with LCMV strain Armstrong (ARM)
      carry equivalent amounts of virus in their blood, brain, heart, kidney, liver,
      spleen, and thymus throughout life. Of five additional H-2k murine strains
      tested, C3H/HEJ and CBA/N mice develop this GH-like disorder, whereas neither
      AKR/J, B10/BR, nor BALB/KAE mice do, indicating that the H-2K haplotype does not
      control the GH susceptibility. Furthermore C3H/SW mice, which have the H-2b
      haplotype on the C3H background, develop the disease, again negating any
      correlation with H-2k but inferring that the C3H background is responsible. One
      half of the hybrid offspring produced by crossing the C3H/ST GH-deficient strain
      with BALB/WEHI-resistant mice develop the disease, but the trait is not sex
      linked. F1 hybrid backcrosses with the susceptible C3H/ST parental strain or
      resistant BALB/WEHI strain indicate the involvement of more than two genes. Hence
      the development of a GH deficiency by LCMV-infected C3H/ST mice is not linked to
      the MHC haplotype, is not sex linked, and is not due to a dominant gene. Multiple
      genes are involved and these are related to C3H background.

PMID- 2221021
TI  - Bacterial lipopolysaccharide transforms mesangial into proliferative lupus
      nephritis without interfering with processing of pathogenic immune complexes in
      NZB/W mice.
AB  - Systemic lupus erythematosus is a multifactorial systemic disease in which
      genetic, immunologic, hormonal, and environmental factors may contribute to
      disease pathogenesis. Bacterial products (eg, bacterial lipopolysaccharide [LPS])
      induce a lupuslike disease in normal mice and trigger an early and accelerated
      form of lupus nephritis in NZB/W mice. To investigate whether the mechanism by
      which LPS accelerates nephritis in the NZB/W mice involves interference with
      processing of immune complexes (IC), we administered LPS to NZB/W mice for 5
      weeks and probed the kinetics of removal, liver uptake, and organ localization of
      a subsaturating dose of radiolabeled IC (2.5 mg of bovine serum albumin
      antibovine serum albumin). Control NZB/W mice received vehicle (saline) alone. In
      NZB/W exposed to LPS, features of polyclonal B-cell activation (PBA) were
      enhanced, anti-DNA antibodies were raised, and a proliferative glomerulonephritis
      developed that was associated with renal insufficiency and substantial
      proteinuria. This LPS-accelerated nephritis could not be attributed to altered
      complement concentration, to altered blood cell carrier function, to delayed
      removal of pathogenic (large-sized) ICs from the circulation, to impaired liver
      uptake of ICs, or to enhanced localization of ICs in kidney. The findings
      indicate that transformation of nephritis is probably the result of LPS-induced
      PBA, that defective processing of pathogenic IC is not a contributory factor to
      nephritis, and that mechanisms other than passive renal localization of
      circulating ICs must be operative.

PMID- 2221022
TI  - Separate and combined interactions of fibrinogen-gold and latex with surface
      activated platelets.
AB  - Glycoprotein (GP)IIb-IIIa receptors on human platelets in suspension and after
      surface activation bind a variety of specific antibodies and ligands and
      transport them across the outside of the plasma membrane by processes of
      clustering, patching and capping, and endocytosis to the platelet interior. The
      present study evaluated the separate and combined interaction of fibrinogen
      coupled to colloidal gold (Fgn/Au) and small latex particles with fixed and
      unfixed, surface-activated platelets. Results demonstrate that populations of
      GPIIb-IIIa and other mobile receptors on fully spread platelets are not exhausted
      by binding and transporting a single ligand. Addition of a first ligand followed
      by a second one results in concentration of the initial wave in the platelet
      center, surrounded by a halo of second ligand. The margin of the double-labeled
      cell is cleared of both ligands. However, if the double-labeled platelet is fixed
      briefly and exposed to a third wave of ligand, that also will bind to the cell
      and cover the peripheral margin. How many waves of ligand can couple to spread
      platelets and translocate before the ability of the plasma membrane receptors to
      bind and clear has been depleted remains to be determined. Yet evidence of the
      interaction with three waves indicates that the surface-activated platelet has a
      nearly inexhaustible population of mobile receptors to participate in hemostatic
      events.

PMID- 2221023
TI  - Cladistics and the hominid fossil record.
AB  - Cladistic methodology has become common in phylogenetic analyses of the hominid
      fossil record. Even though it has correctly placed emphasis on morphology for the
      primary determination of affinities between groups and on explicit statements
      regarding traits and methods employed in making phylogenetic assessments,
      cladistics nonetheless has limitations when applied to the hominid fossil record.
      These include 1) the uncritical assumption of parsimony, 2) uncertainties in the
      identification of homoplasies, 3) difficulties in the appropriate delimitation of
      samples for analysis, 4) failure to account for normal patterns of variation, 5)
      methodological problems with the appropriate identification of morphological
      traits involving issues of biological relevance, intercorrelation, primary versus
      secondary characters, and the use of continuous variables, 6) issues of polarity
      identification, and 7) problems in hypothesis testing. While cladistics has
      focused attention on alternative phylogenetic reconstructions in hominid
      paleontology and on explicit statements regarding their morphological and
      methodological underpinnings, its biological limitations are too abundant for it
      to be more than a heuristic device for the preliminary ordering of complex human
      paleontological and neonatological data.

PMID- 2221024
TI  - Dermatoglyphic and anthropometric relationships within the Inupiat (Eskimo) hand.
AB  - On the basis of earlier findings with Easter Islanders suggesting a positive
      correlation between dermatoglyphic variables and hand anthropometric
      measurements, the present study was designed to determine if such a relationship
      could be generalized to another population, namely, Inupiat (Eskimo). Since some
      dermatoglyphic and anthropometric variables were available for both sides of the
      body, the extension of this study to explore the question of asymmetry was also
      possible. The Inupiat sample numbered 142 male and 176 female adult inhabitants
      of five Alaskan North Slope communities. The major findings of this study
      included, for males, significant negative correlations between left arm length
      and digital ridge counts and positive relationships between the palmar variable
      of axial index and hand length on both hands. For females, the hand
      breadth/length index was negatively related to most of the digital variables.
      Very little definitive information regarding the relationship of the asymmetry
      variables between the two types of measures was ascertained.

PMID- 2221025
TI  - Size of the sella turcica and its relation to iron deficiency anemia: a
      prehistoric example.
AB  - This paper examines the usefulness of volume and area assessments of the sella
      turcica from radiographs in order to aid in the differential diagnosis of iron
      deficiency anemia in past populations. Lateral and posterior-anterior radiographs
      were taken of each cranium in the sample. The length, depth, and width of the
      sella turcica were then measured directly from the appropriate view, and
      subsequently the volume and area were calculated for each. The 20-25 year-old
      cohort was found to yield the most promising results; however, a statistical
      difference was not found to exist using the volume or area. The width dimension
      was found to be of far more use than any other in this study. In no instance was
      any feature of typical porotic hyperostosis, visually or radiographically, found
      to be statistically correlated with any difference in the dimensions of the sella
      turcica. A discussion of how the various dimensions of the sella turcica react to
      changes in size of the hypophysis cerebri is presented.

PMID- 2221026
TI  - An epidemiologic study of sacroiliac fusion in some human skeletal remains.
AB  - A case-control study was undertaken to generate some hypotheses concerning the
      etiology of sacroiliac fusion in a group of skeletons dating from the 18th and
      19th centuries. Forty-one skeletons with fusion of the sacroiliac joint were
      compared with eighty-two adult skeletons without the condition. The sacroiliac
      joints were most frequently fused with bridging osteophytes and no preference for
      site or side of fusion could be detected. Except where there were other features
      in the skeleton suggestive of a sero-negative arthropathy, radiography
      demonstrated that there was no intra-articular ankylosis. We were able to confirm
      earlier observations that the condition is more prevalent in males and in older
      age-groups. The study also showed a significant association between sacroiliac
      fusion and the presence of diffuse idiopathic skeletal hyperostosis (DISH) and
      osteoarthritis of the spine but not for osteoarthritis at any other site. There
      was a highly significant association between sacroiliac fusion and the phenomenon
      that we refer to as "bone forming." We devised a series of bone-former scores and
      were able to show a significant excess of cases with high scores compared with
      the controls. This association persisted when allowance had been made for
      potential confounding factors such as DISH, osteoarthritis of the spine, and age.

PMID- 2221027
TI  - Metatarsophalangeal joints of Australopithecus afarensis.
AB  - Metatarsophalangeal joints from African pongids, modern humans, and
      Australopithecus afarensis are compared to investigate the anatomical and
      mechanical changes that accompanied the transition to terrestrial bipedality.
      Features analyzed include the shape and orientation of the metatarsal heads,
      excursion of the metatarsophalangeal joints, and orientation of the basal
      articular surface of the proximal phalanges. These features unequivocally
      segregate quadrupedal pongids and bipedal hominids and demonstrate a clear
      adaptation to terrestrial bipedality in the Hadar pedal skeleton.

PMID- 2221028
TI  - Deconstructing reconstruction: the OH 62 humerofemoral index.
AB  - The humerus and femur of the fossil hominid OH 62 are badly damaged and their
      lengths are not directly measurable (Johanson et al., 1987). Nevertheless, using
      relatively intact reference materials from another early hominid, AL 288-1,
      Johanson et al. (1987) reconstructed the bones to estimate the humerofemoral
      index, which falls well above the range for modern Homo, above the estimate for
      AL 288-1, and within the range for Pan paniscus. The reconstruction of missing
      bone by the method originally employed for OH 62 is broadly reproducible in a
      representative modern sample of Homo, making possible the estimation of an
      associated error term intrinsic to this method. Using the approximate variance of
      the ratio mean (Kish, 1965), shown here to be a good estimator of the sample
      variance of the humerofemoral index, the analysis of this modern sample
      extrapolated to other living hominoids gives quite acceptable results. Applied to
      OH 62, it suggests an error term associated with the estimated humerofemoral
      index so substantial that it is only possible to situate the index somewhere
      between the distributions for Homo and Gorilla, and quite possibly not above the
      index for AL 288-1. On the other hand, the predicted distribution for the
      humerofemoral index of AL 288-1 is more securely placed between the distributions
      for Homo and Pan paniscus.

PMID- 2221029
TI  - Studies of ancient crania from northern Africa.
AB  - Historical sources and archaeological data predict significant population
      variability in mid-Holocene northern Africa. Multivariate analyses of crania
      demonstrate wide variation but also suggest an indigenous craniometric pattern
      common to both late dynastic northern Egypt and the coastal Maghreb region. Both
      tropical African and European metric phenotypes, as well intermediate patterns,
      are found in mid-Holocene Maghreb sites. Early southern predynastic Egyptian
      crania show tropical African affinities, displaying craniometric trends that
      differ notably from the coastal northern African pattern. The various
      craniofacial patterns discernible in northern Africa are attributable to the
      agents of microevolution and migration.

PMID- 2221030
TI  - Three-dimensional computed tomography of the mummy Wenuhotep.
AB  - Computed tomography allows cross-sectional imaging of anthropological as well as
      clinical subjects. Recently, technical innovations have made three-dimensional
      reconstruction of these images feasible. We performed two-dimensional and three
      dimensional computed tomography of a Late Period Egyptian mummy to reexamine
      findings seen on previous radiographic studies and to evaluate the usefulness of
      these techniques in paleopathology. Two-dimensional images provided excellent
      anatomic detail. There was graphic depiction of the mummification process that
      corroborated information previously obtained from Egyptological studies. Three
      dimensional reconstruction provided images of facial features as if the mummy had
      been unwrapped. Three-dimensional computed tomography is a useful method of
      nondestructively evaluating paleopathological remains, and it may yield
      information not obtainable by any other means.

PMID- 2221031
TI  - Uralic genes in Europe.
AB  - We have analysed data of three European populations speaking non-Indoeuropean
      languages: Hungarians, Lapps, and Finns. Principal coordinate analysis shows that
      Lapps are almost exactly intermediate between people located geographically near
      the Ural mountains and speaking Uralic languages, and central and northern
      Europeans. Hungarians and Finns are definitely closer to Europeans. An analysis
      of genetic admixture between Uralic and European ancestors shows that Lapps are
      slightly more than 50% European, Hungarians are 87% European, and Finns are 90%
      European. There is basic agreement between these conclusions and historical data
      on Hungary. Less is known about Finns and very little about Lapps.

PMID- 2221033
TI  - Atresia of the external acoustic meatus in prehistoric populations.
AB  - A case of atresia of the external acoustic meatus is presented from a prehistoric
      Late Woodland site in Iowa. The affected individual was a female aged 30 to 40
      years. The left temporal bone displayed a thin bony plate occluding the external
      acoustic canal. No evidence of middle ear or inner ear malformation was observed
      on the axial tomographs, although the external canal was shortened. The
      individual is diagnosed as having a mild case of congenital atresia. The report
      extends the geographical and temporal distributions of this archaeologically rare
      condition.

PMID- 2221032
TI  - Caries experience in Mediaeval Scots.
AB  - Dental caries prevalence, distribution, and site of attack was investigated in a
      Scottish Mediaeval population. The findings supported previous reports, which
      suggested that caries prevalence in Scotland was lower than in contemporaneous
      English populations. Attrition of the occlusal surface of the teeth with
      accompanying alteration of the anatomy of the interproximal space is suggested as
      the principal reason for the differences in the pattern of distribution of caries
      between this and modern populations.

PMID- 2221034
TI  - Paleoepidemiology of a central California prehistoric population from Ca-Ala-329:
      II. Degenerative disease.
AB  - Degenerative lesions are scored and frequencies of involvement are computed for a
      skeletal collection from Ca-Ala-329, a prehistoric site on the southeastern side
      of San Francisco Bay, dating from 500 A.D. up to European contact. A large
      earthmound site, excavations conducted there by San Jose State University
      retrieved close to 300 burials. For this epidemiological analysis, reasonably
      complete and aged skeletons representing 77 adult females and 90 adult males are
      available. Degenerative changes are scored macroscopically in an ordinal fashion
      for the large fibro-cartilagenous joints between adjacent vertebral bodies
      (vertebral osteophytosis) as well as the small apophyseal articulations of the
      spine. In addition, in the peripheral skeleton degenerative changes are scored in
      the temporo-mandibular, shoulder, elbow, hip, and knee joints as well as the
      small articulations of the hands and feet. The most common degenerative changes
      in the spine are seen between the vertebral bodies of the lower lumbar region. In
      the peripheral skeleton the highest involvement of degenerative disease is seen
      in the hands and feet. Compared to other relevant osteological samples, this
      group of hunting-gathering California Indians shows more degenerative changes
      than settled agriculturists (from Pecos Pueblo, New Mexico) but substantially
      less frequent involvement than in arctic hunters (Alaskan Eskimos).

PMID- 2221035
TI  - Differences between the hand-wrist and the knee in assigned skeletal ages.
AB  - Skeletal ages were assessed for 4,902 pairs of hand-wrist and knee radiographs of
      children aged 2-17 years. The FELS method was used to assess the hand-wrist, and
      the RWT method was used to assess the knee. These methods have the same
      conceptual and statistical basis. The mean absolute differences, within age- and
      sex-specific groups, ranged from 0.34 to 0.87 years. The SD of the differences
      ranged from 0.31 to 0.68 years and, like the means, tended to increase with age
      until about 8-11 years. The means and SD were generally larger for the boys than
      for the girls, except after 14 years. Within age- and sex-specific groups, the
      maximum absolute differences were from 1.45 to 2.99 years. These maximum
      differences changed irregularly with age but tended to increase until 11 years in
      the boys and 9 years in the girls. These large absolute differences between the
      skeletal ages of the hand-wrist and the knee cannot be explained completely by
      the effects of observer errors. The means of the relative (signed) differences
      between the skeletal ages of the hand-wrist and the knee were all close to zero,
      but there was a wide range within age- and sex-specific groups. These skeletal
      ages of the hand-wrist and the knee are not interchangeable. The 95th percentiles
      of the absolute differences show that, in at least 5% of children, the choice of
      the area for skeletal age assessment will markedly influence the evaluation of
      individuals. They also demonstrate that descriptions of populations based on
      distributions of skeletal ages from one part of the skeleton may be misleading.

PMID- 2221036
TI  - Extracellular magnesium-dependent sodium efflux in squid giant axons.
AB  - Experiments were designed to determine whether the putative Na(+)-Mg2+ exchanger
      previously demonstrated to mediate Mg2+ efflux (R. DiPolo and L. Beague. Biochim.
      Biophys. Acta 946: 424-428, 1988) could also mediate the efflux of Na+
      (presumably a Na+ efflux-Mg2+ influx exchange) in squid giant axons. The effects
      of external Mg2+ (Mg(o)) on 22Na efflux were measured in internally dialyzed, ATP
      fueled axons in which the contribution to Na+ efflux by other pathways was
      inhibited. To facilitate measurement of Mg(o)-dependent Na+ efflux, the
      intracellular concentration of Na+ was increased. To prevent Na(+)-Na+ exchange,
      external Na+ was replaced by tris(hydroxymethyl)aminomethane. To assess the
      effect of Mg(o) on Na+ efflux without altering the total divalent cation
      concentrations, Mg(o) was replaced mole-for-mole by external Ba2+ (Ba(o)). This
      manipulation produced reversible reductions in Na+ efflux. These reductions were
      neither due to membrane hyperpolarization nor to a direct effect of Bao but were
      due instead to the reduction in Mg(o). The Mg(o)-dependent Na+ efflux was
      inhibited by external amiloride but was spared by bumetanide. In the absence of
      external Na+, the Mgo-dependent Na+ efflux increased as a function of external
      Mg2+ with Michaelis-Menten kinetics. These results indicate that the Na(+)-Mg2+
      exchange can mediate the efflux of Na+ (operate in Na+ efflux-Mg2+ influx mode of
      exchange).

PMID- 2221037
TI  - Regulation of Na-K-Cl cotransport in cultured canine airway epithelia: a
      [3H]bumetanide binding study.
AB  - We examined [3H]bumetanide binding to membranes isolated from canine tracheal and
      bronchial epithelia and to confluent primary cultures of these cells. Crude
      plasma membranes from trachea and bronchus bind [3H]bumetanide in a saturable
      manner; tracheal membranes have a higher affinity but lower maximal binding (K1/2
      approximately equal to 0.7 microM; Bmax approximately equal to 2.5 pmol/mg
      protein) than do bronchial membranes (K1/2 approximately equal to 3.5 microM;
      B(max) approximately equal to 7.5 pmol/mg). In both cases, saturable binding is
      reduced by greater than 65% when either Na, K, or Cl is removed from the medium.
      In primary cultures, saturable [3H]bumetanide binding (inhibited by a 30-fold
      excess of unlabeled bumetanide) occurs when [3H]bumetanide (1.0 microM) is added
      to the solution bathing the basolateral side of tracheal (1.20 +/- 0.10 pmol
      bound/mg total cell protein) and bronchial (1.79 +/- 0.52 pmol/mg) cultures;
      minimal binding is seen with apical [3H]bumetanide. Isoproterenol (10(-5) M;
      basolateral exposure) produces approximately 100% increase in saturable
      basolateral [3H]bumetanide binding to tracheal cultures and approximately 30%
      increase in bronchial cultures. Similar augmentation of binding is seen when
      apical Cl is reduced from 134 to 4 mM and when both apical and basolateral media
      are made hypertonic by addition of 100 mM sucrose. Under these latter two
      conditions, isoproterenol produces little or no additional increase in binding.
      Our results indicate that the increase in basolateral Cl influx via Na-K-Cl
      cotransport that must occur during beta-adrenergic stimulation of net salt
      secretion in canine airway epithelia is related to an actual increase in the
      number of functioning cotransporters in the basolateral membrane and is not
      simply due to a change in ion gradients. The increase in cotransport sites,
      however, may be secondary to initial stimulation of apical Cl channels, with
      resultant cell shrinkage.

PMID- 2221038
TI  - Chloride (or bicarbonate)-dependent copper uptake through the anion exchanger in
      human red blood cells.
AB  - The initial rate of Cu2+ uptake in human red blood cells was measured by atomic
      absorption. About 80% of Cu2+ uptake was inhibited by 4,4'-diisothiocyanostilbene
      2,2'-disulfonic acid (DIDS) concentrations greater than 5-10 microM. DIDS
      sensitive Cu2+ uptake required the presence of external HCO3- or external Cl-. Cl
      strongly stimulated Cu2+ uptake following a Michaelis-like function, with
      apparent dissociation constant (KCl) of 72 +/- 9.4 (SD) mM (n = 6 experiments).
      HCO3- stimulated DIDS-sensitive Cu2+ uptake following a Michaelis-like function,
      with apparent dissociation constant (Kbic) of 10 +/- 1.9 (SD) mM (n = 4
      experiments). Maximal rates (of Cl(-)- or HCO3(-)-stimulated Cu2+ uptake) were
      nonadditive. DIDS-sensitive Cu2+ uptake was not modified by physiological
      concentrations of phosphate or sulfate. Conversely, it was strongly inhibited by
      physiological concentrations of L-histidine and cysteine (at a Cu2+ concentration
      of 100 microM, these physiological ligands exhibited KHis and KCys of 50 and 80
      microM, respectively). By using a copper-selective electrode, we found that at pH
      7-7.4 copper is associated with OH-, particularly in the form of Cu(OH)2
      complexes. In conclusion, the anion exchanger is the major transport mechanism
      for red blood cell Cu2+ uptake. The translocating species can be the monovalent
      anion complexes of copper with OH-, Cl-, and/or HCO3-.

PMID- 2221039
TI  - A factor in serum lowers resistance and opens tight junctions of MDCK cells.
AB  - During an inflammatory reaction, factors in blood affect the permeability of
      endothelium and possibly organ epithelium. In this study we partially
      characterized a factor in human and canine blood that lowered the transepithelial
      electrical resistance (TER) of canine kidney epithelial cells (MDCK) and examined
      whether vascular permeability factors [complement component C3a and C5a and
      platelet-activating factor (PAF)] were responsible for this reaction. C3a and C5a
      caused a small (10-13%) dose-related decrease in the TER (alpha = 0.05), whereas
      PAF had no effect. In contrast, the factor found in both serum and plasma caused
      a large (60-83%) dose-dependent decrease (saturated at 30%) in the TER that was
      reversible within 60 min. The blood factor, which does not appear to be albumin,
      was heat stable and has an apparent molecular mass of 67 kDa. It preferentially
      decreased the TER of the epithelium when it came in contact with its basolateral
      surface and significantly lowered the resistance within 60 min by opening the
      zonula occludentes. These findings suggest that C3a, C5a, and a factor in blood
      can directly modulate the permeability of renal epithelium.

PMID- 2221040
TI  - Sequence homologies among intestinal and renal Na+/glucose cotransporters.
AB  - Sodium-dependent glucose transport occurs in the intestine and kidney of most
      animal species. The cDNA encoding the Na+/glucose cotransporter from rabbit
      jejunum was used to examine the distribution of homologous mRNA in other rabbit
      tissues and in the intestines of other species. Northern blots of mRNA extracted
      from various tissues were probed with radiolabeled cDNA of the cloned rabbit
      transporter. The probe hybridized with mRNA of approximately 2.2 kb from rabbit
      jejunum, renal cortex, and renal medulla, indicating that related mRNA of the
      same size is found in these tissues. With the use of the same cDNA probe, a 1.6
      kb partial-length clone encoding 484 amino acids was isolated from a rabbit renal
      cortex cDNA library. There was greater than 99% identity between the cDNA
      sequences, and 100% identity between the amino acid sequences, of the renal clone
      and the rabbit intestinal Na+/glucose cotransporter. The 2.2-kb transcript was
      seen in mRNA from duodenum, jejunum, and ileum, with a distribution that matched
      the Na+/glucose transport capacity in these tissues. A faint signal at 2.2 kb was
      also seen in colon mRNA. There was no detectable hybridization to blots of
      stomach and heart mRNA. The rabbit probe also hybridized to intestinal mRNA from
      a number of species from trout to humans. We conclude that a Na+/glucose
      cotransporter of rabbit renal cortex is very similar to that of the intestine and
      that the intestinal transporter has been conserved during evolution.

PMID- 2221041
TI  - Protein kinase C activation and myosin light chain phosphorylation in 32P-labeled
      arterial smooth muscle.
AB  - Experiments using 32P-labeled strips of swine carotid artery medial smooth muscle
      were performed to define the relative contribution of myosin light chain (MLC)
      phosphorylation as an activation mechanism mediating contractile responses
      stimulated by phorbol dibutyrate (PDB). Tryptic phosphopeptide mapping of
      phosphorylated MLC indicated that near-maximal force responses were associated
      with increases in functional MLC phosphorylation of less than 10% of the total
      MLC content following tonic (45 min) stimulation by PDB. Significant
      phosphorylation of MLC residues, consistent with the specificity of protein
      kinase C, occurred in response to high concentrations of PDB (greater than 0.1
      microM). Histamine (10 microM)-induced MLC phosphorylation after 2 min (72.5% of
      total MLC) or 45 min (61.7%) was restricted to serine residues on peptides
      thought to contain serine19. Although agonist (histamine)-induced responses were
      eliminated under conditions of Ca2+ depletion, near-maximal force in response to
      10 microM PDB (89.4% of a standard KCl response) was associated with
      monophosphorylation of less than 9% of the total MLC on peptides interpreted as
      containing serine19. A substantial fraction of this was localized to threonine
      residues. The quantitative analysis of the relation between PDB-stimulated force
      and the residues in MLC phosphorylated supports the concept that PDB stimulation
      results in activation of arterial smooth muscle cross bridges by MLC
      phosphorylation-independent mechanisms.

PMID- 2221042
TI  - Nonmetabolizable glucose analogues and ornithine decarboxylase expression in LLC
      PK1 cells.
AB  - This report examines the effect of nonmetabolizable glucose analogues on
      ornithine decarboxylase (ODC) activity in LLC-PK1 cells. The addition of Na(+)
      dependent cotransported glucose analogues, 1-O-methyl-alpha-D-glucopyranoside
      (alpha-MDG) and 1-O-methyl-beta-D-glucopyranoside, to Earle's balanced salt
      solution minus glucose (EBSS-G) increased ODC activity five- to sevenfold above
      basal levels. The passive carrier-mediated transported glucose analogue 3-O
      methyl-D-glucopyranose had very little effect on enzyme activity. alpha-MDG
      increased ODC activity in quiescent but not growing cells. ODC activity increased
      as a function of both the incubation time in EBSS-G + alpha-MDG and the
      concentration of alpha-MDG in EBSS-G. Phlorizin significantly reduced the level
      of enzyme activity induced by alpha-MDG. ODC expression by alpha-MDG was reduced
      in cells incubated in hypertonic EBSS-G + alpha-MDG. Enzyme activity, in the
      absence of extracellular organic substrates, was markedly elevated in cells
      incubated in hypotonic media. It is suggested that an influx of Na+ and/or an
      increase in cell volume elevates one or more signal transducers that regulate ODC
      expression.

PMID- 2221043
TI  - Hepatic cytochrome P-450 in rats submitted to chronic hypobaric hypoxia.
AB  - Hepatic cytochrome P-450 content in adaptation to hypobaric hypoxia was studied
      in three groups of rats and in their respective controls at sea level atmospheric
      pressure. The experimental groups were as follows: 1) young male and female rats
      submitted to 4,400 m (simulated altitude) for 6-8 mo, 2) the same animal model of
      group 1 submitted to 5,500 m (simulated altitude) for a subsequent period of 2-3
      mo, and 3) adult males exposed to 5,500 m for 35 days. Hypoxia caused a marked
      polycythemia in all three groups, body weight loss in males of the three groups
      and at 5,500 m also in females, whereas liver weight was normal in groups 1 and 2
      and slightly decreased in group 3. Cytochrome P-450 content measured in
      microsomal suspensions of groups 1 and 2 was unchanged. In liver homogenates,
      cytochrome P-450 content was normal at 4,400 m (group 1) and decreased at 5,500 m
      (groups 2 and 3). Therefore, endoplasmic reticulum mass, calculated as the ratio
      of cytochrome P-450 in the homogenates and in the isolated microsomes, was
      unchanged in group 1 (4,400 m) and decreased in group 2 (5,500 m). The content of
      antioxidant enzymes superoxide dismutase, catalase, and glutathione peroxidase,
      measured in liver homogenates of group 3, were markedly decreased (by 40, 30, and
      35%, respectively). Results do not support the hypothesis that an increase in
      cytochrome P-450 content plays a role in adaptation to hypoxia.

PMID- 2221044
TI  - Spatial dynamics of intracellular calcium in agonist-stimulated vascular smooth
      muscle cells.
AB  - Vasoconstrictor agonists stimulate smooth muscle contraction by inducing a rise
      in intracellular free Ca2+. Digital-imaging microscopy of fura-2 fluorescence
      from single vascular smooth muscle cells cultured from the human internal mammary
      artery has allowed us to record the subcellular alterations in Ca2+ that occur
      immediately after stimulation by receptor agonists. The thrombin-induced rise in
      cytoplasmic free Ca2+ begins in a discrete region typically located close to the
      end of the cell. Subsequently, this region of elevated Ca2+ expands until Ca2+ is
      elevated throughout the cell cytoplasm. The rate of spreading in the region of
      elevated Ca2+ in a linear direction averaged 10.1 microns/s, enabling it to
      traverse the length of most cells within approximately 5 s, and involved rises in
      Ca2+ of between 200 and 500 nM. In some cells, the Ca2+ rise began at both ends
      and collided midway. Similar dynamic changes in the spatial distribution of Ca2+
      were recorded in cells stimulated by acetylcholine. The novel observation that
      vasoconstrictor agonists induce an elevation of Ca2+ in a localized region which
      subsequently expands throughout the cytoplasm of single smooth muscle cells may
      provide new insight into the nature of Ca2+ signaling in vascular tissue.

PMID- 2221045
TI  - Time-varying magnetic fields increase cytosolic free Ca2+ in HL-60 cells.
AB  - Electromagnetic fields have been reported to cause a variety of biological
      effects. It has been hypothesized that many of these phenomena are mediated by a
      primary effect on the concentration of cytosolic free calcium ([Ca2+]i). We
      investigated the effects of exposure to electromagnetic fields on [Ca2+]i in HL
      60 cells using the Ca2(+)-sensitive fluorescent indicator indo-1. Indo-1-loaded
      cell samples were exposed to a radiofrequency electromagnetic field, a static
      magnetic field, and a time-varying magnetic field, which were generated by a
      magnetic resonance imaging (MRI) unit. We found that a 23-min exposure to all
      three fields, in combination, induced a significant increase in [Ca2+]i of 31 +/-
      8 (SE) nM (P less than 0.01, n = 13) from a basal level of 121 +/- 8 nM. Also,
      cells exposed to only the time-varying magnetic field had a mean [Ca2+]i that was
      34 +/- 10 nM (P less than 0.01, n = 11) higher than parallel control samples.
      Separate exposure to the radio-frequency (6.25 MHz) or static field (0.15 T) had
      no detectable effects. These results demonstrate that time-varying magnetic
      fields alter [Ca2+]i and suggest that at least some of the reported biological
      effects of time-varying magnetic fields may arise from elevation of [Ca2+]i.

PMID- 2221046
TI  - AVP stimulates adenylyl cyclase and phospholipase C in reciprocal fashion in
      cultured RIMCT cells.
AB  - In cultured rat inner medullary collecting tubule (RIMCT) cells, arginine
      vasopressin (AVP) stimulates adenylyl cyclase (AC) activity in dose-dependent
      fashion, with no response at concentrations of 10(-10) M or below and with peak
      activity at 10(-7) M AVP. In contrast, AVP-stimulated phospholipase (PLC)
      activity is greatest at concentrations at which there is no effect on AC and
      decreases at higher concentrations of AVP, becoming undetectable at 10(-7) M.
      Increasing cellular adenosine 3',5'-cyclic monophosphate (cAMP) content with
      either exogenous ClPheScAMP or forskolin eliminates inositol trisphosphate
      production in response to 10(-13) M AVP. Conversely, inhibition of AC by 2',5'
      dideoxyadenosine (DDA) unmasks PLC activity in response to 10(-7) M AVP that is
      not observed in the absence of DDA. Similarly, DDA prevents inhibition of
      epidermal growth factor-stimulated PLC by AVP. These findings demonstrate the
      reciprocal relationship between AVP-stimulated AC and PLC activities in cultured
      RIMCT cells, which may explain previous divergent results regarding the ability
      of AVP to stimulate PLC in this tissue.

PMID- 2221047
TI  - Mechanism of clearance of dipeptides by perfused hindquarters: sarcolemmal
      hydrolysis of peptides.
AB  - The objective of the present experiment was to investigate the mechanism of
      clearance of a load of dipeptides (10 mumols) by perfused hindquarters of rats.
      The clearance was progressive over 60 min and was significantly (P less than
      0.01) greater for glycylleucine than for glycylglycine (99 vs. 58% disappearance
      from the medium). Insulin had no significant effect on clearance of these
      dipeptides but stimulated the net uptake of their constituent amino acids.
      Investigation of the fate of peptides considered resistant to membrane hydrolysis
      showed a modest (24%) clearance for glycylsarcosine but a substantial one (89%)
      for glycylproline. Investigation of hydrolysis by sarcolemmal vesicles of
      skeletal muscle showed hydrolase activity against glycylglycine and glycylleucine
      but none against glycylsarcosine and glycylproline. Investigation of hydrolysis
      in the medium previously used to perfuse hindquarters for 60 min showed
      considerable activity against glycylleucine and glycylproline but none against
      glycylglycine and glycylsarcosine. These activities were entirely abolished by p
      hydroxymercuribenzoate, an inhibitor of cytoplasmic peptide hydrolases. In
      conclusion, our data show that the mechanism of clearance of dipeptides by the
      perfused hindquarters is largely by hydrolysis, and the site of this hydrolysis
      differs for different dipeptides; hydrolysis is mediated either by plasma
      membrane enzymes, cytoplasmic enzymes released into the medium, or a combination
      of both.

PMID- 2221048
TI  - Effect of exercise and recovery on muscle protein synthesis in human subjects.
AB  - Previous studies using indirect means to assess the response of protein
      metabolism to exercise have led to conflicting conclusions. Therefore, in this
      study we have measured the rate of muscle protein synthesis in normal volunteers
      at rest, at the end of 4 h of aerobic exercise (40% maximal O2 consumption), and
      after 4 h of recovery by determining directly the rate of incorporation of 1,2
      [13C]leucine into muscle. The rate of muscle protein breakdown was assessed by 3
      methylhistidine (3-MH) excretion, and total urinary nitrogen excretion was also
      measured. There was an insignificant increase in 3-MH excretion in exercise of
      37% and a significant increase (P less than 0.05) of 85% during 4 h of recovery
      from exercise (0.079 +/- 0.008 vs. 0.147 +/- 0.0338 mumol.kg-1.min-1 for rest and
      recovery from exercise, respectively). Nonetheless, there was no effect of
      exercise on total nitrogen excretion. Muscle fractional synthetic rate was not
      different in the exercise vs. the control group at the end of exercise (0.0417 +/
      0.004 vs. 0.0477 +/- 0.010%/h for exercise vs. control), but there was a
      significant increase in fractional synthetic rate in the exercise group during
      the recovery period (0.0821 +/- 0.006 vs. 0.0654 +/- 0.012%/h for exercise vs.
      control, P less than 0.05). Thus we conclude that although aerobic exercise may
      stimulate muscle protein breakdown, this does not result in a significant
      depletion of muscle mass because muscle protein synthesis is stimulated in
      recovery.

PMID- 2221049
TI  - Effect of starvation on human muscle protein metabolism and its response to
      insulin.
AB  - Although starvation is known to impair insulin-stimulated glucose disposal,
      whether it also induces resistance to insulin's antiproteolytic action on muscle
      is unknown. To assess the effect of fasting on muscle protein turnover in the
      basal state and in response to insulin, we measured forearm amino acid kinetics,
      using [3H]phenylalanine (Phe) and [14C]leucine (Leu) infused systemically, in
      eight healthy subjects after 12 (postabsorptive) and 60 h of fasting. After a 150
      min basal period, forearm local insulin concentration was selectively raised by
      approximately 25 muU/ml for 150 min by intra-arterial insulin infusion (0.02
      mU.kg-1. min-1). The 60-h fast increased urine nitrogen loss and whole body Leu
      flux and oxidation (by 50-75%, all P less than 0.02). Post-absorptively, forearm
      muscle exhibited a net release of Phe and Leu, which increased two- to threefold
      after the 60-h fast (P less than 0.05); this effect was mediated exclusively by
      accelerated local rates of amino acid appearance (Ra), with no reduction in rates
      of disposal (Rd). Local hyperinsulinemia in the postabsorptive condition caused a
      twofold increase in forearm glucose uptake (P less than 0.01) and completely
      suppressed the net forearm output of Phe and Leu (P less than 0.02). After the 60
      h fast, forearm glucose disposal was depressed basally and showed no response to
      insulin; in contrast, insulin totally abolished the accelerated net forearm
      release of Phe and Leu. The action of insulin to reverse the augmented net
      release of Phe and Leu was mediated exclusively by approximately 40% suppression
      of Ra (P less than 0.02) rather than a stimulation of Rd. We conclude that in
      short-term fasted humans 1) muscle amino acid output accelerates due to increased
      proteolysis rather than reduced protein synthesis, and 2) despite its catabolic
      state and a marked impairment in insulin-mediated glucose disposal, muscle
      remains sensitive to insulin's antiproteolytic action.

PMID- 2221050
TI  - Fetoplacental deamination and decarboxylation of leucine.
AB  - Fetal and placental metabolism of leucine (Leu) and ketoisocaproic acid (KIC)
      were studied in seven fetal lambs at 132 +/- 1.3-days gestation. Fetal infusions
      of [1-13C]Leu, [1-14C]Leu, and antipyrine were carried out for 4 h. Uterine and
      umbilical blood flows were measured using the antipyrine steady-state diffusion
      technique. Leu and KIC concentrations, [14C]Leu-specific activities, 14CO2,
      [13C]Leu, and [13C]KIC enrichment (mole percent enrichment) were measured in the
      maternal artery, uterine vein, and umbilical artery and vein to calculate net
      fluxes of tracee and tracer molecules between fetus and placenta and between the
      uteroplacenta and the maternal circulation. There were net Leu and KIC fluxes
      into the fetus from the placenta with the KIC flux equal to approximately 19% of
      the combined Leu plus KIC flux. In addition, there was a net KIC flux into the
      uterine circulation. The fraction of infused tracer Leu escaping the placenta
      into the mother was small (approximately 6%). By contrast, there was a rapid
      exchange of tracer Leu carbon between placenta and fetus resulting in a
      significant flux of labeled KIC from placenta to fetus. Approximately 20% of the
      infused tracer carbon was converted to CO2 within the fetus. This rate of
      conversion was greater than 80% of the total fetoplacental conversion rate and
      significantly higher than the flux of KIC tracer carbon from placenta to fetus.
      Fetal KIC decarboxylation rate, calculated from the fetal KIC enrichment data,
      was 2.83 +/- 0.40 mumol.min-1.kg fetus-1 and approximately 60% of the combined
      net Leu and KIC flux into the fetus from the placenta.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2221052
TI  - Formation of gluconeogenic precursors in rat skeletal muscle during fasted-refed
      transition.
AB  - During the fasted-refed transition, hepatic glycogen repletion from glucose can
      occur by the direct and indirect pathway. In the indirect pathway, glucose is
      first metabolized to 3-carbon intermediates that then are converted in the liver
      to glucose 6-phosphate via the gluconeogenic pathway before conversion to
      glycogen. The present study evaluated whether skeletal muscle is a major source
      of 3-carbon intermediates (i.e., lactate, pyruvate, and alanine) during refeeding
      of 1-day fasted rats. Arteriovenous differences for lactate, pyruvate, and
      alanine across the anesthetized rat hindlimbs were used to evaluate muscle
      metabolism in the fed, fasted, and refed state. In the fasted state, liver
      glycogen was depleted, and muscle released 3-carbon intermediates. One hour after
      refeeding, hepatic glycogen was 30% repleted, and blood lactate, pyruvate, and
      alanine increased. Despite this, the release of alanine by muscle diminished at
      this time and lactate was removed. At 4 h after refeeding, 3-carbon intermediates
      were all released by hindlimb tissue but in an amount not greater than in the
      fasted state. Overall, these results suggest that skeletal muscle in the rat is
      not a major source of 3-carbon precursors for early postprandial hepatic glycogen
      repletion via the indirect pathway, nor is the rise in 3-carbon intermediates in
      blood during refeeding caused by their increased output by muscle.

PMID- 2221051
TI  - Altered hepatic mitochondrial fatty acid oxidation and ketogenesis in endotoxic
      rats.
AB  - Rat hepatic mitochondrial function, including oxidative phosphorylation, fatty
      acid oxidative capacity, kinetic parameters of carnitine palmitoyltransferase I
      (CPT I), and sensitivity of CPT I to malonyl-CoA inhibition were studied in vitro
      in isolated mitochondria following Escherichia coli lipopolysaccharide (LPS). The
      hepatic mitochondrial CPT I in LPS-treated rats showed a lower apparent maximum
      velocity (Vmax) for palmitoyl-CoA and Ki for malonyl-CoA without changes in
      apparent Km for palmitoyl-CoA. The rate of oxygen consumption or end-product
      formation of palmitoyl-L-carnitine and octanoate was not altered, but the rate of
      CPT I-dependent palmitoyl-CoA (plus L-carnitine) oxidation was reduced by LPS,
      when acetyl-CoA produced via beta-oxidation was directed toward citrate. When
      acetyl-CoA was directed to acetoacetate, the oxygen consumption rates of
      palmitoyl-L-carnitine and palmitoyl-CoA (plus L-carnitine) were decreased by LPS,
      although mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase activity was not
      altered. These results indicate that hepatic mitochondria isolated from LPS
      treated rats show lower ketogenic and long-chain acyl-CoA oxidative capacity than
      those of fasted controls, and inhibition of ketogenesis is elicited at a site
      distal to CPT I in addition to reduction in CPT I activity.

PMID- 2221053
TI  - Insulin binding to individual rat skeletal muscles.
AB  - Studies of insulin binding to skeletal muscle, performed using sarcolemmal
      membrane preparations or whole muscle incubations of mixed muscle or typical red
      (soleus, psoas) or white [extensor digitorum longus (EDL), gastrocnemius] muscle,
      have suggested that red muscle binds more insulin than white muscle. We have
      evaluated this hypothesis using cryostat sections of unfixed tissue to measure
      insulin binding in a broad range of skeletal muscles; many were of similar fiber
      type profiles. Insulin binding per square millimeter of skeletal muscle slice was
      measured by autoradiography and computer-assisted densitometry. We found a 4.5
      fold range in specific insulin tracer binding, with heart and predominantly slow
      twitch oxidative muscles (SO) at the high end and the predominantly fast-twitch
      glycolytic (FG) muscles at the low end of the range. This pattern reflects
      insulin sensitivity. Evaluation of displacement curves for insulin binding
      yielded linear Scatchard plots. The dissociation constants varied over a ninefold
      range (0.26-2.06 nM). Binding capacity varied from 12.2 to 82.7 fmol/mm2. Neither
      binding parameter was correlated with fiber type or insulin sensitivity; e.g.,
      among three muscles of similar fiber-type profile, the EDL had high numbers of
      low-affinity binding sites, whereas the quadriceps had low numbers of high
      affinity sites. In summary, considerable heterogeneity in insulin binding was
      found among hindlimb muscles of the rat, which can be attributed to heterogeneity
      in binding affinities and the numbers of binding sites. It can be concluded that
      a given fiber type is not uniquely associated with a set of insulin binding
      parameters that result in high or low binding.

PMID- 2221054
TI  - Inhibition of intermediary metabolism by amiodarone in dog thyroid slices.
AB  - Amiodarone, an iodine-containing antiarrhythmic drug, has been reported to
      interfere with thyroid function and thyroid hormone metabolism. We studied the
      effects of amiodarone on basal and agonist [thyroid-stimulating hormone (TSH),
      phorbol ester, or carbachol]-stimulated glucose oxidation, 32PO4 incorporation
      into phospholipids, and adenosine 3',5'-cyclic monophosphate (cAMP) concentration
      in dog thyroid slices. Slices were preincubated with amiodarone at 37 degrees C
      for 1 h before the addition of agonist and the appropriate radioisotope. cAMP
      stimulation was measured after 20 min, glucose oxidation for 45 min, and 32PO4
      incorporation into phospholipids for 2 h. Amiodarone (0.5 mM) had no effect on
      basal 14CO2 formation or 32PO4 incorporation into phospholipids but significantly
      inhibited TSH, phorbol ester, and carbachol stimulation of these parameters. It
      also inhibited cAMP stimulation by TSH. Inhibition of TSH-stimulated [14C]glucose
      oxidation was also obtained with another iodide-containing compound, iopanoic
      acid (0.5 mM), but not with iothalamate (up to 10 mM). Inhibition by amiodarone
      was still present, but to a lesser extent, when it was added at the same time as
      the agonist. Inhibition of stimulated [14C]glucose oxidation persisted even after
      the slices were incubated without amiodarone for 6 h. Inhibition by amiodarone,
      in contrast to that by inorganic iodide, was not prevented by 1 mM methimazole
      added at the same time as amiodarone. These results indicate that the inhibitory
      effects of amiodarone on thyroid function are not due to dissociation of iodide
      from the molecule.

PMID- 2221055
TI  - Thermogenesis following meal feeding, isoproterenol, and cold in rats with LH
      lesions.
AB  - Responses to several thermogenic stimuli were measured in rats maintaining stable
      but reduced body weights following lateral hypothalamic (LH) lesions. Oxygen
      consumption was monitored in open-circuit respirometers before and after exposure
      to cold (16.5 degrees C), intubation of a meal, and isoproterenol injection (40
      micrograms/kg 0.75). Observations were made in both warm- (28 degrees C) and cold
      acclimated (9 degrees C) LH-lesioned rats. Cold exposure, intubation, and drug
      injection each caused marked increases in heat production in sham- and LH
      lesioned rats. This thermogenic response was similar in magnitude and form for
      both groups. Acclimation to 9 degrees C caused increased baseline levels of heat
      production when measured at 28 degrees C. Subsequent exposure to thermogenic
      stimuli revealed an exaggerated response to isoproterenol but not intubation in
      cold-acclimated groups. The LH-lesioned cold-acclimated rats responded in the
      same manner as sham-lesioned cold-acclimated rats. These findings are in contrast
      to the immediate postlesion period when rats show enhanced thermogenic activity.
      At reduced body weights LH-lesioned rats show normal rates of heat production and
      make normal responses to thermogenic stimuli. Enhanced thermogenesis does not
      appear to play a role in the maintenance of chronically reduced body mass in LH
      lesioned rats.

PMID- 2221056
TI  - Novel effects of insulin secretagogues on capacitation of insulin release and
      survival of cultured pancreatic islets.
AB  - Agents that stimulate insulin release from fresh pancreatic islets were tested
      for their ability to capacitate pancreatic islets to secrete insulin and to
      support beta-cell survival in tissue culture. Capacitation was defined as the
      ability to release insulin after 24 h in culture in the presence of an
      insulinotropic concentration of a secretagogue. Viable islets that lose glucose
      induced insulin release gradually regain it during culture for 24 h in 20 mM
      glucose. Survival was defined as the ability to regain glucose-induced insulin
      release. To measure insulin release after culture, islets were incubated with
      various secretagogues in Krebs-Ringer buffer for 1 h. Examples of the diverse
      patterns of responses included the following. Glucose was the only secretagogue
      that capacitated glucose-induced release. Leucine-, leucine plus glutamine-, and
      glyceraldehyde-induced release remained capacitated after culture with no
      secretagogue. Culture at high glucose completely inhibited leucine-induced
      release. Culture at low glucose (1 mM) or at both high leucine and glutamine
      abolished glucose-induced release. Only leucine and glutamine capacitated
      monomethyl succinate-induced release. All agents including subinsulinotropic
      glucose (1 mM), except D-glyceraldehyde, permitted islet survival. Thus the
      metabolic pathways for initiation, capacitation, and survival are not identical
      between and within secretagogues. There is a reciprocal relationship between
      leucine and glucose with respect to capacitation. Capacitation follows a time
      course, which suggests that it is regulated by enzyme induction.

PMID- 2221058
TI  - Acute effects of insulin-like growth factor I and insulin on glucose metabolism
      in vivo.
AB  - We have compared the actions of insulin-like growth factor (IGF-I) and insulin on
      glucose metabolism in vivo, using the glucose clamp technique in rats. Both
      hormones caused dose-dependent inhibition of hepatic glucose production,
      stimulation of whole body glucose disposal, and an increase in the glucose
      metabolic rate of specific muscles. Infusion of IGF-I also decreased the plasma
      concentration of insulin. An an infusion rate of 0.57 nmol.kg-1.min-1, IGF-I led
      to stimulation of whole body glucose uptake that was similar to the glucose
      uptake produced by infusion of 0.01 nmol.kg-1.min-1 insulin. The glucose
      metabolic rate, as measured by 2-deoxy-D-glucose uptake, was comparable in
      quadriceps femoris, soleus, and diaphragm muscles during the infusion of 0.57
      nmol.kg-1.min-1 IGF-I and 0.01 nmol.kg-1.min-1 insulin. However, at these rates
      of infusion, IGF-I caused only a 38 +/- 6% inhibition of hepatic glucose output
      compared with 66 +/- 12% inhibition by insulin (P less than 0.05). Thus, under
      these conditions, muscle is more responsive than liver to IGF-I, which agrees
      with the complement of IGF-I receptors in the two tissues.

PMID- 2221057
TI  - Effects of testosterone on muscle insulin sensitivity and morphology in female
      rats.
AB  - Intact or oophorectomized (OVX) female rats were given moderate doses of
      testosterone for 12 wk. Insulin-stimulated glucose transport with submaximal
      insulin concentrations was studied with the euglycemic clamp technique. Glycogen
      synthesis and 2-deoxy-D-glucose uptake were measured during the clamp in the
      extensor digitorum longus, white and red portions of the gastrocnemius, and in
      the soleus muscles by tracer technique. Testosterone treatment resulted in
      elevations of circulating testosterone, increased plasma insulin concentrations,
      and a marked decrease in insulin-stimulated glucose transport. In control
      animals, glycogen synthesis and 2-deoxy-D-glucose transport increased with
      increasing concentrations of type 1 fibers. Testosterone inhibited glycogen
      synthesis and 2-deoxy-D-glucose transport to approximately 50% in all muscles
      except 2-deoxy-D-glucose transport in intact rats. Glycogen synthesis in the
      liver was not affected. Testosterone administration also resulted in changes in
      muscle morphology. The relative number of type 1 fibers decreased, whereas type 2
      fibers increased. This was most pronounced in red muscles. There was also a
      decrease in capillary density after testosterone treatment. It was concluded that
      testosterone administered to female rats is followed by marked insulin
      resistance. This is correlated to alterations in muscle morphology with fewer
      type 1 fibers and a lower degree of capillarization, which are both known to be
      characteristics of insulin-insensitive muscles.

PMID- 2221060
TI  - Oxygen consumption of human adipose tissue.

PMID- 2221059
TI  - Comparison of in vitro and in vivo 44Ca labeling of bone by scanning ion
      microprobe.
AB  - To determine whether Ca incorporation from medium into cultured bone represents
      normal mineralization, we labeled some neonatal mouse calvariae in vitro and
      others in vivo with the stable isotope 44Ca and compared surface label
      localization with a scanning ion microprobe utilizing secondary ion mass
      spectrometry. To label in vitro, we incubated live calvariae in medium containing
      40Ca or 44Ca for 3 h. Compared with a 44Ca/40Ca ratio of 0.020 with 1 mM 40Ca,
      the ratio with 1 mM 44Ca was 0.135 and with 2 mM 44Ca was 0.556. Erosion revealed
      a marked decrease in 44Ca/40Ca with depth. To label in vivo, we subcutaneously
      injected 40Ca or 44Ca into mice equal to a percentage of their total body weight
      and dissected the calvariae 24 h later. Compared with a 44Ca/40Ca ratio of 0.021
      with 2% 40Ca, the ratio with 2% 44Ca was 0.120 and with 6% 44Ca was 0.205.
      Erosion revealed only a slight decrease in 44Ca/40Ca with depth. Elemental
      distribution maps of in vivo labeled samples show broad deposition of 44Ca,
      whereas maps of in vitro labeled bones show 44Ca preferentially localized at the
      surface in contact with the medium. Thus calvariae can be labeled with 44Ca both
      in vitro and in vivo. However, the differing patterns of isotope localization
      under the conditions of this study indicate that in vitro Ca deposition differs
      from normal in vivo bone mineralization.

PMID- 2221061
TI  - Validation of tonometric measurement of gut intramural pH during endotoxemia and
      mesenteric occlusion in pigs.
AB  - Tonometry is a minimally invasive method for estimating gastrointestinal
      intramural pH (pHi). Tissue pH is calculated by using the Henderson-Hasselbalch
      equation and measurements of arterial [HCO-3] and CO2 tension (PCO3) of saline
      contained in a Silastic balloon within the lumen of the gut. The validity of the
      method rests on two key assumptions: 1) PCO2 in saline in the tonometer balloon
      is similar to tissue PCO2 and 2) tissue and arterial [HCO-3] are similar. To
      validate this method, ileal pHi measured directly with a microelectrode was
      compared with pHi estimated tonometrically in four groups of anesthetized pigs.
      Group I (n = 4) were controls. In group II (n = 4), intestinal tissue acidosis
      was induced by total occlusion of the superior mesenteric artery (SMA). In group
      III (n = 5), acidosis was induced by partial occlusion of the SMA. In group IV (n
      = 4), tissue acidosis was induced by endotoxemia. Agreement was excellent between
      direct and tonometric measurements in groups I and IV and less good in groups II
      and III. Weighted mean correlation coefficients (rw) for the two measurement
      methods were 0.743 and 0.9447 in groups II and IV, respectively. Correlation
      coefficients for the individual animals in group III were more variable than the
      other groups and ranged from 0.547 to 0.990. The tonometric method for measuring
      GI pHi is invalid under conditions of zero flow and leads to error under
      conditions of low flow. However, the method is reliable in the setting of tissue
      acidosis induced by endotoxemia.

PMID- 2221062
TI  - Bioavailability of dietary glutathione: effect on plasma concentration.
AB  - Plasma glutathione (GSH) concentration in rats increased from approximately 15 to
      30 microM after administration of GSH either as a liquid bolus (30 mumol) or
      mixed (2.5-50 mg/g) in AIN-76 semisynthetic diet. GSH concentration was maximal
      at 90-120 min after GSH administration and remained high for over 3 h.
      Administration of the amino acid precursors of GSH had little or no effect on
      plasma GSH values, indicating that GSH catabolism and resynthesis do not account
      for the increased GSH concentration seen. Inhibition of GSH synthesis and
      degradation by L-buthionine-[S,R]-sulfoximine and acivicin showed that the
      increased plasma GSH came mostly from absorption of intact GSH instead of from
      its metabolism. Plasma protein-bound GSH also increased after GSH administration,
      with a time course similar to that observed for free plasma GSH. Thus dietary GSH
      can be absorbed intact and results in a substantial increase in blood plasma GSH.
      This indicates that oral supplementation may be useful to enhance tissue
      availability of GSH.

PMID- 2221063
TI  - Fate of dietary glutathione: disposition in the gastrointestinal tract.
AB  - Studies were performed in rats that had been fasted 24 h, fed a glutathione (GSH)
      free semisynthetic diet (AIN-76), and fed the same diet supplemented with GSH.
      The results from the fasted rats and those fed GSH-free diet showed that the
      duodenum and jejunum contained 0.2-0.5 mumol of GSH/gram wet wt of luminal
      contents. The GSH contents of biliary juice was sufficient to maintain this
      amount of GSH in the intestinal lumen. Other analyses showed that cell sloughing,
      bacterial GSH content, and GSH secretion by epithelial cells of the jejunum were
      not sufficient to account for this content. GSH concentrations following
      consumption of a GSH-supplemented diet (5-50 mg/g AIN-76) showed a rapid increase
      in all regions of the small intestine and indicated that removal occurred
      primarily in the jejunum. However, the combined activities of brush-border gamma
      glutamyltransferase and GSH uptake systems were not sufficient to remove all of
      the ingested GSH. Results from in situ vascular perfusions of small intestine
      showed that the upper jejunum is a principal site of GSH absorption. Measurements
      of the GSH-to-glutathione disulfide (GSSG) ratio in the lumen after ingestion of
      GSSG (5 mg/g diet) indicated that the upper small intestine also has a mechanism
      for reducing GSSG to GSH. The results therefore indicate that GSH is present in
      the lumen of the small intestine of rat under most if not all conditions.
      Although the physiological importance of luminal GSH remains unclear, it could
      potentially be used to detoxify reactive electrophiles in the diet or be absorbed
      for intracellular detoxication reactions.

PMID- 2221064
TI  - Ontogenetic development of monosaccharide and amino acid transporters in rabbit
      intestine.
AB  - We measured brush-border uptakes of seven sugars and amino acids by rabbit
      intestine as a function of age from the day of birth to adulthood. Gut
      dimensions, especially those of the colon and cecum, increase more rapidly with
      body weight than would be true if rabbits maintained identical proportions as
      they grew. However, nominal small intestinal area increases in approximately
      direct proportion to the animal's basal metabolic rate. For all solutes except
      fructose, uptake per milligram of intestinal tissue is maximal at or near birth
      and declines to a level 2.5-5 times lower in the adult. Because of small
      intestinal growth, though, the total uptake capacity of the whole length of the
      small intestine increases in approximately direct proportion to metabolic rate.
      Fructose uptake per milligram is unique in increasing steeply at the time of
      weaning, correlated with the post-weaning first appearance of fructose in the
      natural diet. Age-related changes in uptake ratios among aldohexoses or amino
      acids suggest developmental sequences of related transporters. Correlated with
      the very high protein content of rabbit milk, the proline-to-glucose uptake ratio
      is higher in suckling rabbits than in other sucking mammals. Remarkably, the
      ratio for adult rabbits is higher than in other monogastric herbivores and is
      instead similar to values for carnivores. In explanation, although the transport
      capacity of the small intestine appears to account for proline absorption in
      rabbits of all ages and for sugar absorption in suckling rabbits, the hindgut may
      be a major site of carbohydrate digestion in adult rabbits.

PMID- 2221065
TI  - Dual modulation by adenosine of gastrin release from canine G-cells in primary
      culture.
AB  - The effects of adenosine on gastrin release were studied in enzymatically
      dispersed canine antral cells after 24-36 h in primary culture. We found two
      contrasting actions for adenosine: inhibition of forskolin-stimulated gastrin
      release and potentiation of bombesin-stimulated gastrin release. These actions
      appeared to be mediated by A1 and A2 receptors, respectively. Forskolin
      stimulated gastrin release was reduced by adenosine and the A1-selective agonist
      N6-(L-2-phenylisopropyl)adenosine (L-PIA) but not by the A2-selective agonist 2
      phenylaminoadenosine (CV 1808). This inhibition by adenosine was reversed by the
      preferential A1-receptor antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) as
      well as by the nonselective adenosine receptor antagonist 8-phenyltheophylline (8
      PT). Incubation of the cells with pertussis toxin (200 ng, 8 h) reversed the
      inhibition by adenosine. In contrast, bombesin stimulation of gastrin release was
      potentiated by adenosine and CV 1808 but not altered by L-PIA. This effect was
      enhanced by DPCPX and was not altered by treatment of cells with pertussis toxin.
      In the absence of exogenous adenosine, 8-PT and DPCPX produced a small increase
      in basal and stimulated gastrin release. These data suggest dual modulation by
      adenosine of G-cell function. A1 receptors inhibit adenosine 3,5'-cyclic
      monophosphate (cAMP)-mediated gastrin release via a pertussis toxin-sensitive
      mechanism, whereas A2 receptors potentiated the response to cAMP-independent
      stimuli of gastrin release. Enhancement of gastrin release by adenosine
      antagonists suggests functional restraint by endogenous adenosine.

PMID- 2221066
TI  - Effect of basolateral acidification on the frog oxynticopeptic cell.
AB  - The effects of intracellular acidosis induced by acidification of the basolateral
      (nutrient) perfusate on the structure and function of the oxynticopeptic cell
      were studied in in vitro frog gastric mucosa. Changing the pH of the unbuffered
      nutrient perfusate (UNB) from 7.2 to 3.5 acidified the oxynticopeptic cell with
      no change in potential difference (PD) or resistance (R). Intracellular pH (pHi),
      PD, and R were 7.05 +/- 0.01, 16 +/- 1 mV, 165 +/- 7 omega.cm2 before and 6.44 +/
      0.01, 16 +/- 2 mV, 170 +/- 9 omega.cm2 after nutrient acidification. Acid
      secretion (H+) increased from 0.86 +/- 0.07 to 1.88 +/- 0.18 mu eq.cm-2.h-1.
      Addition of forskolin to tissues perfused with nutrient pH (pHn) 3.5 decreased PD
      to 2 +/- 2 mV and further increased H+ to 3.07 +/- 0.19 mu eq.cm-2.h-1. By light
      and electron microscopy oxynticopeptic cells perfused with UNB, pHn 3.5, appeared
      normal. Oxynticopeptic cells in tissues pretreated with omeprazole and then
      exposed to UNB, pHn 3.5, had extensive morphological damage. On increasing the pH
      of the nutrient perfusate from 3.5 to 7.2 there was prompt recovery of pHi in
      untreated and forskolin-stimulated mucosae (pHi 6.87 +/- 0.06 and 6.85 +/- 0.04)
      but no recovery of pHi in tissues pretreated with omeprazole or cimetidine (pHi
      6.26 +/- 0.04 and 6.44 +/- 0.06, n = 6, 30 min after reexposure to UNB, pHn 7.2).
      We conclude that in a secreting mucosa intracellular acidification of the
      oxynticopeptic cell to pHi 6.4 is associated with normal morphology, PD, R, and
      increased H+, and that intracellular acidosis is not de facto deleterious.

PMID- 2221067
TI  - Intestinal D-glucose transport and membrane fluidity along crypt-villus axis of
      streptozocin-induced diabetic rats.
AB  - Diabetes was induced in male Lewis rats by a single injection of streptozocin (50
      mg/kg body wt ip). After 10-14 days, diabetic and age- and sex-matched control
      animals were killed, and their proximal small intestines were removed. Villus
      tip, mid-villus, and lower-villus enterocytes were harvested from each group with
      a method that combined divalent cation chelation with mild mechanical
      dissociation. These fractions were used as starting material to prepare brush
      border membrane vesicles. Preparations from each of these fractions were then
      analyzed and compared with respect to their Na(+)-gradient-dependent and Na(+)
      independent D-glucose transport, lipid fluidity, and lipid composition. The
      results of these experiments demonstrated that 1) maximum rates of Na(+)-gradient
      dependent D-glucose transport (Vmax) were greatest in membrane vesicles prepared
      from mature cells (villus tip and mid villus) of control rats; 2) the glucose
      concentration producing half-maximal rates of transport (Km), however, was
      significantly lower in lower-villus membrane vesicles of control rats, suggesting
      that a distinct glucose transporter existed in the membranes of these relatively
      immature enterocytes; 3) Na(+)-gradient-dependent, but not Na(+)-independent, D
      glucose uptake was greater in diabetic membrane vesicles prepared from mid-villus
      and lower-villus fractions but not in vesicles prepared from villus-tip cells;
      and 4) no obvious relationship between alterations in membrane lipid fluidity and
      enhanced uptake of Na(+)-gradient-dependent D-glucose by these transporter(s)
      could be established in this experimental model of acute diabetes mellitus.

PMID- 2221069
TI  - Submucosal plexus alone integrates motor activity and epithelial transport in rat
      jejunum.
AB  - It has been well established in several mammalian species, including humans, that
      contractions of jejunal smooth muscle correlate temporally with increases in
      mucosal ion transport. Furthermore, this correlation is abolished through local
      application of neurotoxins, suggesting interaction of enteric neurons. The
      purpose of this study was to determine whether the myenteric plexus is involved
      in this correlation. In the rat jejunum in vivo, we simultaneously measured
      phasic changes in intraluminal pressure and transmural potential difference (PD)
      as indicators of smooth muscle motor activity and epithelial ion transport,
      respectively. We compared the temporal association of these parameters in control
      animals with animals in which either the extrinsic nerves only or the extrinsic
      nerves and the myenteric plexus of a 5-cm jejunal segment had been ablated 30
      days previously. A one-to-one coupling between muscle contractions and transmural
      PD fluctuations was observed in all animals; ablation of the extrinsic and/or
      myenteric neurons did not eliminate this correlation. We conclude that, in the
      rat jejunum, the submucosal plexus alone can integrate the reflex that couples
      ion secretion to muscle contraction.

PMID- 2221068
TI  - Ethanol enhances leukocyte-endothelial cell interactions in mesenteric venules.
AB  - In vivo studies have implicated neutrophils in the gastric mucosal injury
      produced by intraluminal administration of ethanol. However, in vitro studies
      indicate that ethanol inhibits various neutrophil functions such as adherence,
      chemotaxis, and degranulation. The aim of the present study was to assess whether
      ethanol, at clinically relevant concentrations, is proinflammatory in vivo.
      Ethanol (0.2, 1.0, 2.0, and 4.0%) was applied to the surface of the cat
      mesentery, and neutrophil adherence to venules (30 microns diam) and
      extravasation into the interstitium were quantitated using intravital microscopy.
      Hemodynamic parameters were also measured (venular diameter, red blood cell
      velocity, and leukocyte rolling velocity) or calculated (venular blood flow and
      wall shear stress). In this model ethanol produced a dose-dependent increase in
      neutrophil adherence and extravasation. The increase in leukocyte-endothelial
      cell interactions could not be attributed to alterations in hemodynamic factors.
      Pretreatment of animals with a monoclonal antibody (MoAb IB4) directed to the
      neutrophil CD11/CD18 adherence complex completely prevented the ethanol-induced
      neutrophil adherence and extravasation. Pretreatment with a leukotriene B4 (LTB4)
      receptor antagonist (SC 41930) or a platelet-activating factor (PAF)-receptor
      antagonist (WEB 2170) did not alter the ethanol-induced neutrophil-endothelial
      interactions. We conclude that ethanol is proinflammatory at concentrations which
      may be achieved in the mucosal interstitium during acute alcohol intoxication.
      The ethanol-induced leukocyte adherence and extravasation is dependent on the
      expression of adhesive glycoproteins. The inflammatory mediators, PAF and LTB4,
      do not appear to play an important role in the leukocyte-endothelial cell
      interactions initiated by ethanol.

PMID- 2221070
TI  - Hypoxia-induced vasodilation of the feline superior mesenteric artery is not
      adenosine mediated.
AB  - The role of adenosine in hypoxia-induced vasodilation was examined in the
      intestine of pentobarbital sodium-anesthetized cats. A hollow-fiber fetal
      oxygenator was used to selectively reduce the PO2 of the blood supplying the
      superior mesenteric artery, thereby inducing hypoxia in the intestines.
      Decreasing the PO2 from 109 to 38 Torr caused vascular resistance to decrease
      from 10.2 to 7.5 Torr.kg.min.ml-1, a decrease of 2.7 Torr.kg.min.ml-1 or 24%.
      During selective adenosine receptor blockade with 8-phenyltheophylline, the same
      decrease in PO2 (from 109 to 40 Torr) produced a similar decrease in resistance
      from 5.7 to 3.4 Torr.kg.min.ml-1 or a difference of 2.3 Torr.kg.min.ml-1 (-36%).
      Thus adenosine is not the mediator of hypoxia-induced vasodilation in the feline
      intestine because blockade of the vasodilating effects of exogenous and
      presumably endogenous adenosine did not affect the observed decrease in
      resistance.

PMID- 2221071
TI  - Effect of cellular iron concentration on iron uptake by hepatocytes.
AB  - The effect of intracellular iron content on transferrin and iron uptake by
      cultured hepatocytes isolated from fetal rat liver was examined with ferric
      ammonium citrate and the iron chelator desferrioxamine (DFO). Incubation of the
      cells with ferric ammonium citrate for 24 h significantly increased the cellular
      nonheme iron level, whereas the number of transferrin binding sites and the
      uptake of transferrin and iron were reduced. In contrast, when iron-treated cells
      were incubated with DFO for 24 h, the cellular nonheme iron level was not
      altered, but the number of transferrin binding sites was increased. Treatment of
      the cells with exogenous iron and/or DFO did not affect the uptake of transferrin
      and iron by the nonsaturable processes. These results indicated that, in cultured
      hepatocytes, transferrin receptor expression and the subsequent uptake of
      transferrin and iron are regulated by the size of an intracellular, chelatable
      iron pool, whereas the uptake of iron by the nonsaturable processes is dependent
      on the extracellular transferrin concentration.

PMID- 2221072
TI  - Both tissue and serum phospholipases release rat intestinal alkaline phosphatase.
AB  - Rat intestinal alkaline phosphatase (IAP) is unique among the brush-border
      membrane enzymes in that it is released bidirectionally (lumen and blood) and
      exists in either soluble (serum) or particulate (cellular) form. To elucidate the
      mechanism of membrane release, we examined the effects of phosphatidylinositol
      specific phospholipase C (PtdIns-PLC) and serum anchor-specific phospholipase D
      (PLD) on the solubility of the various tissue forms of IAP. The "solubility" of
      cytosol IAP could be explained in part by intracellular PtdIns-PLC activity,
      detected by production of acidic IAP isomers, and by ethylene glycol-bis(beta
      aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA)-sensitive PtdIns hydrolysis.
      Contamination with serum (abundant with anchor-specific PLD) was responsible for
      the complete or partial solubilization of IAP that was found during processing of
      light mucosal scrapings. Anchor-specific PLD activity was increased after fat
      feeding, and the IAP released did not react with antiserum that recognizes the
      PtdIns-PLC-released phospholipid portion of trypanosomal variable surface
      glycoprotein. These data are consistent with the hypothesis that, after secretion
      from the enterocyte bound to a phospholipid-rich membranous particle, IAP release
      into serum is mediated by serum anchor-specific PLD. The soluble forms of IAP in
      the lumen and the cytosol fraction appear to be due to a combination of
      endogenous PtdIns-PLC activity and anchor-specific PLD contamination that occurs
      during cell fractionation.

PMID- 2221073
TI  - Role of tyrosine kinases in gastrin induction of ornithine decarboxylase in
      colonic mucosa.
AB  - An organ culture system was utilized to evaluate the role of tyrosine kinases
      (Tyr-k) and tyrosine-specific phosphorylation of proteins in gastrin regulation
      of ornithine decarboxylase (ODC) activity in colonic mucosa. Exposure of colonic
      mucosal explants to gastrin (50-100 ng G-17 I/ml) resulted in a profound
      stimulation of both Tyr-k and ODC activities compared with the corresponding
      basal levels. Whereas the maximal stimulation (ranging between 70 and 150%) of
      Tyr-k occurred within 10-15 min of exposure to gastrin, ODC activity was
      significantly stimulated (180%) 2 h after exposure to the hormone, and at 4 h it
      was found to be 750% above the corresponding basal level. Difluoromethylornithine
      (DFMO; 2 mM), an irreversible inhibitor of ODC, completely abolished the gastrin
      mediated stimulation of ODC but not Tyr-k activity. On the other hand, genistein
      (100 micrograms/ml), a specific inhibitor of Tyr-k, caused a total suppression of
      the gastrin-induced stimulation of both Tyr-k and ODC. Gastrin also stimulated
      tyrosyl phosphorylation of a colonic mucosal membrane protein with molecular mass
      of 57 kDa, and genistein greatly attenuated this effect. We conclude that gastrin
      stimulates colonic mucosal ODC in vitro, and Tyr-k may be required for the
      regulation of this process.

PMID- 2221074
TI  - Vitamin D-independent intestinal calcium and phosphorus absorption during
      reproduction.
AB  - A special metabolic cage system was employed to measure the intestinal, renal,
      and mammary gland fluxes of Ca, P, and Mg in vitamin D-deficient rats during late
      pregnancy and lactation. Dietary Ca, P, and Mg levels were 0.78, 0.34, and
      0.083%, respectively; this diet minimizes the reduction in milk production
      observed during vitamin D deficiency. Compared with identically treated virgin
      rats, lactating rats were slightly hypocalcemic and severely hypophosphatemic.
      Hypertrophy of the small intestine, as indicated by increased intestinal length
      and villus height, occurred during lactation. Net fractional intestinal
      absorption of Ca and P, but not Mg, was elevated twofold during late pregnancy
      and throughout lactation. Despite this elevated intestinal absorption, lactating
      rats were in negative Ca and P balance and lost bone mass. The transfer rates of
      Ca, P, and Mg into milk were approximately 77% of values previously observed in
      vitamin D-replete rats. Lactating rats conserved P by dramatically reducing renal
      P excretion. Pup retention of ingested Ca was virtually complete. These results,
      together with previous observations using everted duodenal gut sacs, indicate
      that there is a vitamin D-independent stimulation of intestinal Ca and P
      absorption during pregnancy and lactation. Because fractional Mg absorption was
      not similarly enhanced, this stimulation shows some specificity.

PMID- 2221075
TI  - Role of microfilaments in asialoglycoprotein processing in adult and developing
      liver.
AB  - To assess the role of microfilaments in receptor-mediated endocytosis of
      asialoglycoproteins, hepatocytes isolated from adult and 6-day-old rats were
      treated with the antimicrofilamentous agent cytochalasin D and then incubated
      with 125I-asialoorosomucoid (ASOR). Cytochalasin D (50 microM) reduced
      degradation of continuously endocytosed ASOR (7.5 micrograms/ml) equally in adult
      and neonate to approximately 20% of control. Internalization of surface-bound
      ASOR suggested at least two discrete sites at which ligand translocation was
      inhibited by drug at both ages: 1) initial movement of receptor-ligand complex
      from cell surface to interior and 2) postinternalization ligand transit to
      lysosomes. Inhibition of plasma membrane translocation was confirmed by
      calculation of endocytotic rate constant (Ke) values, which were decreased to
      approximately 20-30% of control after cytochalasin D treatment. In contrast, the
      antimicrotubular drug colchicine did not reduce Ke values significantly nor did
      colchicine in combination with cytochalasin D impede lysosome-directed transport
      more than cytochalasin D alone. These results indicate that internalization of
      occupied asialoglycoprotein surface receptor is microfilament dependent
      irrespective of postnatal age and that subsequent participation of microfilaments
      in asialoglycoprotein trafficking is closely related to that of microtubules.

PMID- 2221076
TI  - Acidic mucin layer facilitates micelle dissociation and fatty acid diffusion.
AB  - The presence of a mucin layer on the surface of the intestinal epithelium has
      been suggested as an important factor in maintaining an acidic microclimate. The
      presence of such a low-pH compartment has been shown to facilitate fatty acid
      uptake. The mechanisms leading to the enhancement of fatty acid uptake were
      investigated in a purified acidic mucin layer. Our results indicate that the
      presence of a low-pH compartment indeed facilitates the dissociation of mixed
      micelles made of taurocholate and oleic acid. The released fatty acid formed an
      emulsion at the mucin layer, and this event could be visualized by the naked eye.
      When the size of the particles in the micelle solution was examined by photon
      correlation spectroscopy, it was found that acidification alone can lead to the
      formation of particles with size substantially greater than that of micelles.
      With the use of labeled fatty acid, the change in optical density can be
      correlated to the amount of fatty acid appearing in the mucin layer in an
      asymptotic fashion, suggesting that using the turbidity as an indicator might
      underestimate fatty acid diffusion. Despite this limitation, the rate of fatty
      acid diffusion in the mucin layer was estimated to be 400% of that in the buffer
      solution.

PMID- 2221077
TI  - Effect of duodenal amino acid infusion on solid gastric emptying in pigs.
AB  - The emptying of a 400-g test meal of cubed liver was studied in eight pigs
      equipped with duodenal cannulas. Gastric effluent was diverted to measure both
      the rate of emptying and the distribution of particle sizes. The effect of
      emptying and particle size of infusing normal saline or an isosmolar amino acid
      solution into the small bowel was studied. Normal saline infusion did not alter
      the proportion of particles emptied, which were less than 1 mm in diameter.
      Infusion of the amino acid solution at the same rate significantly decreased the
      mass of liver emptied from 69.9 to 38.4 g compared with normal saline, and the
      percentage of particles less than 1 mm in diameter in the gastric effluent
      increased from 66 to 82%. We conclude that the amino acid solution produced both
      a reduction in the rate of gastric emptying and an increase in the proportion of
      small particles in the gastric effluent. We postulate that this may have been due
      to changes in gastric motility, together with alterations in gastric secretion
      and digestion, produced by the infusion of the amino acid solution into the small
      bowel.

PMID- 2221078
TI  - Lipid binding to gastric mucin: protective effect against oxygen radicals.
AB  - Gastric mucus forms a viscous gel overlying the gastric mucosa and is thought to
      protect the underlying mucosa from noxious agents such as acid, proteases, and
      bile salts. A common property of mucin, the principal glycoprotein in mucous
      secretions, is its ability to bind lipids. The purpose of this study was to
      determine if lipids bound to gastric mucin protect the mucin from oxygen radical
      attack. Pig gastric mucin, partially purified by Sepharose 4B gel chromatography,
      was found to contain large amounts of free fatty acids and cholesterol as well as
      lesser amounts of sphingomyelin and phospholipids. Purified mucin obtained by
      density-gradient ultracentrifugation in a CsCl gradient contained only trace
      amounts of fatty acids but no other lipids. Exposure to the oxygen radical
      generating system iron/ascorbate caused a marked reduction in viscosity of
      purified mucin but did not affect partially purified mucin, suggesting that bound
      lipids shielded the mucin from attack by oxygen radicals. Using discontinuous
      sucrose-gradient ultracentrifugation in the presence of liposomes containing
      [3H]palmitic acid, we demonstrated that mucin is capable of binding fatty acids.
      We also observed a striking increase in solution viscosity of gastric mucin at
      low pH, a feature that might contribute to the ability of mucin to form a
      protective diffusion barrier for the underlying epithelium.

PMID- 2221079
TI  - Characterization of saturable binding sites for circulating pancreatic
      polypeptide in rat brain.
AB  - Pancreatic polypeptide (PP) inhibits pancreatic exocrine secretion by indirect
      mechanisms that may be centrally mediated. The central site of action of PP that
      results in inhibition of pancreatic secretion has not been identified. Using
      autoradiography to identify 125I-PP binding to frozen sections of rat brain, we
      have identified saturable, high-affinity PP receptors in high concentrations in
      the interpenduncular nucleus, area postrema (AP), nucleus tractus solitarius, and
      dorsal motor nucleus of the vagus. The PP receptor differs from neuropeptide Y
      and peptide YY receptors in its binding specificity and location. Because PP is
      not produced in the brain, and the blood-brain barrier (BBB) excludes circulating
      peptides from most areas in the brain, we employed an in vivo radioreceptor assay
      to determine whether circulating PP binds to areas such as the AP that has both
      an incomplete BBB and a high concentration of PP receptors. 125I-PP and 131I
      bovine serum albumin were infused simultaneously into rats through a peripheral
      vein with or without excess unlabeled PP. After 10 min, rats were killed and the
      brains were removed and cut into eight regions based on the autoradiographic
      localization of PP receptors. There was a significant (P less than 0.02) increase
      in saturable radiolabeled PP accumulation in the region that included the AP,
      demonstrating that circulating PP can bind to this area of the brain in vivo. PP
      is released into the circulation after a meal via mechanisms that exhibit vagal
      and cholinergic dependence. We speculate that PP completes a feedback loop by
      binding to receptors in the AP and interacting with the adjacent vagal nuclei to
      inhibit vagal activity.

PMID- 2221080
TI  - Pathobiology of pulmonary fibrosis.
AB  - Pulmonary fibrosis is characterized by an increase in lung matrix and alterations
      in the numbers and spatial relationships of lung parenchymal cells. The increase
      in matrix results from a proliferation and "activation" of fibroblasts (FB) with
      increased production and deposition of matrix macromolecules at sites of lung
      injury. Connective tissue cell activation is associated with increased gene
      expression of collagens, fibronectin, proteoglycans and other matrix components;
      cytoskeletal alterations; and probably also with changes in the expression of
      matrix receptors and matrix-degrading enzymes and inhibitors. The
      fibroproliferative reaction involves the participation of a variety of cytokines
      and inflammatory mediators by resident and inflammatory cells at sites of lung
      injury. Thickening of the alveolar wall can result secondary to matrix deposition
      within the interstitium and as a result of "mural incorporation" of organized
      airspace exudate. However, marked structural remodeling of the gas-exchange
      tissues, with the development of honeycomb lung, involves airspace fibrosis and
      alveolar collapse. The latter processes lead to areas of airspace obliteration
      secondary to airspace filling, and to fibrous adhesion of collapsed septa. The
      extent of airspace obliteration is determined largely by the severity or extent
      of epithelial injury. Although lung fibrosis is usually irreversible, the
      activated state is reversible after clearance of exudate and reepithelialization.
      A continuing and seemingly autonomous fibroproliferative reaction can result in
      the face of ongoing injury and delayed repair.

PMID- 2221081
TI  - Strategies for analysis of gene expression: pulmonary surfactant proteins.
AB  - Gene transcription is regulated by the formation of protein-DNA complexes that
      influence the rate of specific initiation of transcription by RNA polymerase.
      Recent experimental advances allowing the identification of cis regulatory
      sequences that specify the binding of trans acting protein factors have made
      significant contributions to our understanding of the mechanistic complexities of
      transcriptional regulation. These methodologies have prompted the use of similar
      strategies to elucidate transcriptional control mechanisms involved in the tissue
      specific and developmental regulation of pulmonary surfactant protein gene
      expression. The purpose of this review is to describe various methodologies by
      which molecular biologists identify and subsequently assay regions of nucleic
      acids presumed to be integral in gene regulation at the level of transcription.
      It is well established that genes encoding surfactant proteins are subject to
      regulation by hormones, cytokines, and a variety of biologically active reagents.
      Perhaps future studies utilizing molecular tools outlined in this review will be
      valuable in identification of DNA sequences and protein factors required for the
      regulation of lung surfactant genes.

PMID- 2221082
TI  - Uptake of palmitic acid by rabbit alveolar type II cells.
AB  - Alveolar type II cells require a source of palmitic acid for synthesis of
      dipalmitoyl phosphatidylcholine (DPPC), a major constituent of pulmonary
      surfactant. Previous studies indicated that maximal rates of DPPC synthesis are
      achieved only if exogenous palmitate is available to the type II cell. Little is
      known of the mechanisms by which fatty acids enter type II cells. To determine if
      uptake is mediated by a membrane carrier system, as described in other cell
      types, we examined the kinetics of palmitate uptake. Using freshly isolated
      rabbit type II cells, we demonstrated that radiolabeled palmitate uptake was
      maximal and linear for 45 s; after 1 min the apparent rate of uptake declined.
      The initial uptake phase was taken as a measure of cellular fatty acid influx
      because intracellular radiolabeled palmitate remained 80% nonesterified at this
      time but was 55% esterified by 2 min. Cellular influx of palmitate showed
      saturation kinetics with increasing concentration of nonalbumin bound palmitate.
      Michaelis constant was 52.6 nM, and maximum velocity was 152 pmol.10(6) cells
      1.min-1. The hypothesis that saturable cellular influx of palmitate is likely
      linked to the previously identified membrane fatty acid binding protein (MFABP)
      was supported by Western-blot analysis of rat lung tissue with an antibody to
      MFABP that demonstrated the presence of this carrier protein in lung tissue.
      These data suggest that palmitate uptake by type II cells is saturable and may be
      mediated by a membrane-associated carrier as described in other cell types.

PMID- 2221083
TI  - Acrolein stimulates eicosanoid release from bovine airway epithelial cells.
AB  - Injury to the airway mucosa after exposure to environmental irritants is
      associated with pulmonary inflammation and bronchial hyperresponsiveness. To
      better understand the relationships between mediator release and airway
      epithelial cell injury during irritant exposures, we studied the effects of
      acrolein, a low-molecular-weight aldehyde found in cigarette smoke, on
      arachidonic acid metabolism in cultured bovine tracheal epithelial cells.
      Confluent airway epithelial cell monolayers, prelabeled with [3H]arachidonic
      acid, released significant levels of 3H activity when exposed (20 min) to 100
      microM acrolein. [3H]arachidonic acid products were resolved using reverse-phase
      high-performance liquid chromatography. Under control conditions the released 3H
      activity coeluted predominantly with the cyclooxygenase product, prostaglandin
      (PG) E2. After exposure to acrolein, significant "peaks" in 3H activity coeluted
      with the lipoxygenase products 12-hydroxyeicosatetraenoic acid (HETE) and 15
      HETE, as well as with PGE2, PGF2 alpha, and 6-keto-PGF1 alpha. Dose-response
      relationships for acrolein-induced release of immunoreactive PGF2 alpha and PGE2
      from unlabeled epithelial monolayers demonstrated 30 microM acrolein as the
      threshold dose, with 100 microM acrolein inducing nearly a fivefold increase in
      both PGF2 alpha and PGE2. Cellular viability after exposure to 100 microM
      acrolein, determined by released lactate dehydrogenase activity, was not affected
      until exposure periods were greater than or equal to 2 h. These results implicate
      the airway epithelial cell as a possible source of eicosanoids after exposure to
      acrolein.

PMID- 2221084
TI  - Aldosterone regulation of basolateral potassium channels in alveolar epithelium.
AB  - To reveal the regulatory mechanism of the mineralocorticoid aldosterone on
      basolateral K+ channels, the aldosterone-sensitive lung epithelium of Xenopus
      laevis was investigated in Ussing chambers under voltage-clamp conditions.
      Transepithelial measurements were supplemented by current fluctuation analysis of
      short-circuit current noise in nonstimulated and aldosterone-stimulated lung
      tissues. The addition of 10(-6) M aldosterone stimulated short-circuit current
      from 11.3 +/- 2.0 to 27.8 +/- 4.8 microA/cm2 (n = 11) within 4-5 h. In the
      presence of an alveolar-to-pleural K+ gradient, transepithelial K+ currents were
      induced by permeabilizing the apical membrane with the pore-forming antibiotic
      amphotericin B. When the local anesthetic lidocaine (25-1,000 microM) was added
      to the pleural solution, macroscopic K+ current was dose dependently depressed.
      Lidocaine induced a Lorentzian component in the power density spectra, and the
      corner frequency increased linearly with blocker concentration. Aldosterone
      treatment did not affect mean single K+ channel current, which was 1.5 +/- 0.12
      pA corresponding to a 15-pS channel conductance, whereas the number of
      basolateral K+ channels doubled. We conclude that the basolateral K+ channels in
      alveolar epithelia are a target site of aldosterone action.

PMID- 2221085
TI  - Uptake of instilled radiolabeled lamellar bodies from alveolar compartment of the
      rat.
AB  - Following the instillation of lamellar bodies containing dipalmitoyl phosphatidyl
      [3H]choline (DPPC) down the trachea of adult rats, we found that the half-life of
      alveolar [3H]-DPPC was 85 min and the time constant was 120 min. As much as 85%
      was recycled. When we labeled the DPPC with both [3H]choline and [14C]acetate,
      the ratio 3H/14C increased in the alveolar compartment and then increased further
      in the lamellar body fraction of the recipient lungs, suggesting that some
      deacylation-reacylation was occurring. Further evidence of degradation was an
      increase in free [3H]choline in the microsomal fraction. Whereas hyperpnea
      induced by breathing 5% CO2-13% O2-82% N2 increased the reuptake of DPPC,
      reuptake did not appear to be enhanced in the rest period immediately after
      hyperpnea induced by swimming, when alveolar DPPC was still markedly elevated.
      Propranolol did not affect reuptake, suggesting that beta-adrenoreceptors were
      not essential. We suggest that reuptake is coupled more to release than to the
      amount of surfactant in the alveolar compartment.

PMID- 2221086
TI  - Lung fibroblasts from animals breathing 100% oxygen produce growth factors for
      alveolar type II cells.
AB  - Type II cells were isolated from rats with a purity of 80-95% with less than 4%
      macrophages. These cells, after plating for approximately 16 h, were cultured
      with 50% RPMI 1640 and 50% (vol/vol) conditioned medium obtained from confluent
      hamster lung fibroblasts, together with 0.1% fetal calf serum (FCS). Conditioned
      media were obtained from either fibroblasts derived from normal hamsters
      breathing room air [normoxic-conditioned medium (NCM)] or from hamsters exposed
      for 4 days to 100% O2 [hyperoxic-conditioned medium (HCM)]. Controls consisted of
      100% minimal essential medium (MEM) containing 0.1% FCS. Over a 96-h culture
      period, NCM stabilized cell populations but was unable to induce proliferation.
      In contrast, at low cell densities, HCM could cause a two- to threefold increase
      in type II cell number within 24-48 h after introduction. This effect could not
      be demonstrated at high cell densities. When tested with FCS concentrations
      ranging from 0 to 10%, maximum effects were obtained using 0.1-0.2% FCS. We
      conclude that lung fibroblasts from oxidant-injured hamsters produce growth
      factors that can stimulate at least one mitotic division in cultured type II
      cells, which are plated at low density. These factors are absent, or present in
      much lower concentration, in lung fibroblasts from normal animals.

PMID- 2221087
TI  - TGF-beta 1 modulation of urokinase and PAI-1 expression in human bronchial
      epithelial cells.
AB  - Normal human bronchial epithelial (NHBE) cells respond to signals initiated by
      the binding of transforming growth factor-beta type 1 (TGF-beta 1) to its surface
      receptors by activating pathways that result in terminal squamous
      differentiation. By use of both normal and SV40 T-antigen-immortalized cells, it
      was found that treatment with TGF-beta 1 transiently increases mRNA levels for
      urokinase (uPA) and plasminogen activator inhibitor type 1 (PAI-1) approximately
      5- and 50-fold, respectively, within 4 h. In NHBE cells, PAI-1 protein is
      increased by TGF-beta 1 in both extracellular matrix and medium. The net effect
      of TGF-beta 1 on plasminogen activator activity in the medium was a 50% reduction
      as measured by a caseinolytic assay. A T-antigen-immortalized bronchial
      epithelial cell line that does not undergo squamous differentiation in response
      to TGF-beta 1 but binds this growth factor did not respond to TGF-beta 1 by
      modulation of either uPA or PAI-1 expression. Comparison of human bronchial
      epithelial, pleural mesothelial, and lung fibroblastic cell strains indicated
      that the epithelial cells have a constitutively higher ratio of uPA to PAI-1 mRNA
      expression. These data suggest that modulation of pericellular proteolysis in
      bronchial epithelial cells in response to TGF-beta 1 represents a significant
      biological change in their pericellular environment. The induction of uPA and PAI
      1 expression in human bronchial epithelial cells may be related to the ability of
      the cell to undergo squamous differentiation in response to TGF-beta 1. These
      observations identify specific changes in gene expression that may serve as
      markers for the differentiation process.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221088
TI  - Enzymatic activity is necessary for thrombin-mediated increase in endothelial
      permeability.
AB  - alpha-Thrombin causes a dose-dependent increase in endothelial permeability as
      measured by the clearance rate of 125I-albumin across a monolayer of bovine
      pulmonary artery endothelial cells. We determined if an active catalytic site is
      necessary for the thrombin-mediated increase in endothelial permeability. alpha
      Thrombin was reacted with 10-fold excess D-phenylalanyl-prolyl-arginine
      chloromethyl ketone (PPACK), an irreversible inhibitor that forms a covalent bond
      with thrombin's active site, producing an enzymatically inactive thrombin. PPACK
      completely inhibited the alpha-thrombin-mediated increase in 125I-albumin
      permeability. Similar results were obtained with gamma-thrombin, an enzymatically
      active alpha-thrombin form with an altered fibrinogen recognition domain. PPACK
      alone and the active site-inhibited PPACK-alpha-thrombin had no effect on
      permeability. Diisopropylphospho (DIP)-alpha-thrombin was effective only in very
      high concentrations (10(-6)M), and this effect was abolished by the addition of
      PPACK. These studies demonstrate that binding alone is insufficient for the
      thrombin-mediated increase in endothelial monolayer permeability. Thrombin's
      active catalytic site is a requirement for the increase in transendothelial
      albumin permeability.

PMID- 2221089
TI  - Epithelium-dependent contraction of airway smooth muscle caused by eosinophil
      MBP.
AB  - We have identified two distinct functions of the epithelium of guinea pig airways
      that modulate airway smooth muscle contractility in the presence of the major
      basic protein (MBP) of human eosinophilic granules: 1) active force generation
      resulting less than 1 min after epithelial contact with MBP; and 2) sustained,
      augmented force generation that does not depend on cytotoxic interference with
      the synthesis of an epithelial-derived inhibitory factor. To evaluate these
      influences, an in situ preparation of guinea pig trachea was developed that
      permitted direct, on-line measurement of isometric force generation in the
      underlying muscle. Direct application of 10(-8) mol/cm2 MBP to the surface of the
      epithelium elicited force generation that did not require the presence of a
      contractile agonist. Force generation began less than 1 min after MBP application
      and reached maximum active tension (AT) of 0.97 +/- 0.38 g/cm at 30 min (P less
      than 0.05 vs. baseline). Denatured MBP did not elicit active tension. MBP also
      caused augmented contraction to intravenous acetylcholine (ACh); 30 min after
      topical application of MBP, AT generated by 3 x 10(-7) mol/kg iv ACh was 0.85 +/-
      0.14 vs. 0.55 +/- 0.08 g/cm in control animals (P less than 0.05). Threshold
      response to ACh (-8.1 +/- 0.3 log mol/kg) also decreased significantly after MBP
      (-9.1 +/- 0.4 log mol/kg) vs. baseline (P less than 0.01). Removal of the
      epithelium (confirmed histologically) abolished both direct contraction and
      augmented force generation to ACh caused by topical application of MBP to the
      airway muscle. These data suggest actions of MBP that have not been demonstrated
      previously: 1) activation of epithelial function that causes direct contraction
      of airway smooth muscle; and 2) independence of the MBP-induced effects from
      active tone elicited by other agonists. We also demonstrate that augmented
      contraction that does not depend on MBP blockade of tonic inhibitory secretion
      from the epithelium.

PMID- 2221091
TI  - Glomerular response to hyperglycemia in human diabetic nephropathy.
AB  - We have studied the effect of acute hyperglycemia on glomerular function in seven
      insulin-dependent diabetics with overt nephropathy during hyperglycemic or
      euglycemic clamp. In all patients glomerular filtration rate (GFR) was higher
      during hyperglycemia than during euglycemia (35.0 +/- 15.5 vs. 21.4 +/- 10.3
      ml.min-1.1.73 m-2, P less than 0.01), whereas renal plasma flow did not change
      significantly. To establish which determinant of GFR is altered by hyperglycemia,
      fractional clearances of neutral dextrans of graded molecular size were
      determined in both glycemic states, and data were analyzed by a theoretical model
      of hindered transport of macromolecules through a porous membrane. Hyperglycemia
      significantly increased sieving coefficients of small dextran molecules (28-40 A
      in radius), whereas fractional clearances of large macromolecules (greater than
      44 A) did not change. Theoretical analysis suggested that the ultrafiltration
      coefficient (Kf) and membrane permeability to small dextrans (less than 40 A)
      increased in hyperglycemia in respect to euglycemia. Because these results have
      been obtained in patients with severe renal failure and hypertension, our
      conclusions do not necessarily apply to the early phase of diabetic nephropathy.

PMID- 2221090
TI  - Endogenous xanthine oxidase-derived O2 metabolites inhibit surfactant metabolism.
AB  - The ability of xanthine oxidase (XO)-derived, partially reduced O2 species (PROS)
      to inhibit surfactant production was examined in freshly isolated alveolar type
      II (ATII) pneumocytes from New Zealand White rabbits. [Methyl-3H]choline chloride
      and [1-14C]palmitate incorporation into phosphatidylcholine (PC) decreased in a
      dose-dependent manner, whereas peak media hydrogen peroxide (H2O2) concentration
      increased, when 1, 5, or 10 mU/ml XO were added to cell suspensions containing
      500 microM xanthine. Addition of 100 microM allopurinol inhibited H2O2 production
      and abolished the decrease in choline and palmitate incorporation into PC. ATII
      cells incubated with 500 microM xanthine alone incorporated choline and palmitate
      at 90 and 80% of control levels, respectively. However, 100 microM allopurinol
      restored precursor incorporation to control values. To identify a possible
      intracellular source of PROS, ATII cell xanthine dehydrogenase (XDH) and XO
      activities were measured. Both total activity (XDH + XO; 45 +/- 7 microU/mg
      protein) and the percentage activity in the oxidase form (%XO; 30 +/- 4%)
      remained unchanged in ATII cells incubated in media only (control) for 2 h. In
      contrast, incubation of ATII cells with 500 microM xanthine resulted in a 50%
      loss of XDH + XO activity and a 21% increase in %XO within 10 min. After 2 h
      there was no measurable XDH + XO activity in xanthine-treated cells. Total XDH +
      XO activity in cells incubated with 500 microM xanthine and 100 microM
      allopurinol was less than 6% of control values throughout the
      incubation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221092
TI  - Segmental distribution of epidermal growth factor binding sites in rabbit
      nephron.
AB  - The kidney possesses epidermal growth factor (EGF) receptors and is a major site
      of synthesis for the EGF precursor, prepro-EGF. To examine the segmental
      localization of EGF receptors in the rabbit kidney, we characterized 125I-labeled
      EGF binding to micro-dissected rabbit nephron segments. Specific binding
      constituted 70-80% of total binding and was saturable with an apparent Kd of 8
      nM. Kinetic studies (0 degrees C) revealed an association t1/2 of 20.7 min and a
      dissociation t1/2 of 27 min. Competition studies revealed that 125I-EGF binding
      was inhibited by unlabeled EGF or its homologue transforming growth factor-alpha,
      but not by parathyroid hormone or insulin. Mapping studies showed specific 125I
      EGF binding (attomoles per centimeter) was highest in proximal straight tubules,
      followed by proximal convoluted tubules, cortical collecting ducts, inner
      medullary collecting ducts, outer medullary collecting ducts, and distal
      convoluted tubules. Specific binding to glomeruli was also observed.
      Interestingly, no specific binding of 125I-EGF to thick ascending limbs, a site
      of EGF precursor synthesis, was observed. These studies suggest potential sites
      of action for EGF in the rabbit kidney.

PMID- 2221093
TI  - Bilitranslocase localization and function in basolateral plasma membrane of renal
      proximal tubule in rat.
AB  - Bilirubin and phthalein dyes are taken up by the liver via a carrier-mediated
      mechanism operated at least in part by bilitranslocase (BTL). Because they also
      undergo renal transport, the presence and function of BTL was investigated in rat
      renal tubular plasma membrane vesicles. Transport of sulfobromophthalein (BSP)
      was enriched in basolateral domain of plasma membrane and followed the
      distribution pattern of Na(+)-K(+)-ATPase but not of gamma-glutamyltransferase.
      BSP uptake was inhibited by addition of monospecific antibodies raised against
      hepatic BTL. As in liver vesicles, BSP transport was electrogenic, being greatly
      accelerated by addition of valinomycin in presence of an inwardly directed K+
      gradient. Apparent Km of BSP transport was 17 +/- 2 microM (n = 3 expts), one
      order of magnitude higher than that measured in liver; however, Vmax was similar
      to that described in liver vesicles (429 +/- 18 nmol BSP.mg protein-1.min-1, n =
      3 expts). Competitive inhibition was observed with both unconjugated bilirubin
      (Ki, 2.9 +/- 0.2 microM) and rifamycin SV (Ki, 76 +/- 10 microM), known
      competitors for hepatic BTL-mediated transport of BSP. Immunoblotting studies
      with anti-BTL monospecific antibodies revealed presence of a single positive band
      only in basolateral-enriched membrane fraction; its apparent molecular mass was
      37 kDa, virtually identical to that of hepatic protein. Immunohistochemistry
      confined presence of BTL to renal proximal tubules (RPT) We conclude that BTL is
      present in basolateral plasma membrane of RPT cells. Lower affinity of renal,
      compared with hepatic protein, for substrates might explain the marginal role of
      kidney in plasma clearance of bilirubin and cholephilic dyes.

PMID- 2221094
TI  - Restoration of tubuloglomerular feedback in volume-expanded rats by angiotensin
      II.
AB  - Experiments were performed in anesthetized rats to examine whether angiotensin II
      corrects the attenuation of tubuloglomerular feedback (TGF) responses produced by
      acute extracellular volume expansion. Volume expansion was achieved by an
      infusion of isotonic saline at a rate of 9 ml/h. When urine flow had stabilized,
      an increase in loop of Henle flow from 0 to 45 nl/min caused a fall in stop-flow
      pressure (PSF) by 3.7 +/- 0.3 mmHg and in single-nephron glomerular filtration
      rate (SNGFR) by 5.1 +/- 1.7 nl/min. During continued saline administration
      angiotensin II was infused at 16, 48, or 96 ng.kg-1.min-1 while renal arterial
      pressure was held constant by suprarenal aortic clamping. The mean responses of
      PSF increased to 5.9 +/- 0.6, 9.8 +/- 0.7, and 14.9 +/- 1.7 mmHg. Angiotensin II
      infused at 54 ng.kg-1.min-1 increased the SNGFR response to 15.1 +/- 2.1 nl/min,
      whereas kidney GFR and distal SNGFR fell. Subcapsular pressure was not
      significantly altered by angiotensin II infusion (16 ng.kg-1.min-1). Plasma
      angiotensin (y, pg/ml) as a function of angiotensin II infusion rate (x, ng.kg
      1.min-1 for approximately 20 min) was found to fit the function y = 2.89 + 3.53x.
      An infusion of approximately 15 ng.kg-1.min-1 restored plasma angiotensin levels
      in the volume-expanded rats to hydropenic values. These data confirm that
      angiotensin II may play a role as a physiological regulator of TGF sensitivity.

PMID- 2221095
TI  - Renal responses to lower body negative pressure in humans.
AB  - Renal blood flow, renal sympathetic nerve activity, assessed by the renal
      overflows of norepinephrine (NE), dopamine (DA), and neuropeptide Y-like
      immunoreactivity (NPY-LI), as well as plasma renin activity and angiotensin II
      (ANG II) were evaluated during stepwise increases in lower body negative pressure
      (LBNP) in 10 healthy volunteers. The fractional extraction of epinephrine (Epi)
      was used to assess renal catecholamine removal (approximately 50%) from arterial
      plasma. Renal NE, DA, and NPY-LI overflows at rest were 235 +/- 31, 30 +/- 5, and
      0.6 +/- 0.2 pmol/min, respectively. LBNP increased renal vascular resistance
      (RVR) by 52% and renal NE overflow by 31%. Renin release increased by 330% (from
      64 +/- 12 units/min) and arterial ANG II levels by 119%, without altering the
      renal ANG II extraction (which was approximately 50%). Renal DA and NPY-LI
      overflows were unaffected. A "vaso-vagal" reaction in one subject was associated
      with cessation of renal NE overflow and marked elevations of arterial Epi, renal
      renin release, and arterial ANG II. Selective unloading of cardiopulmonary
      baroreceptors by low-level LBNP did not affect RVR, whereas higher levels of LBNP
      caused renal vasoconstriction probably mediated in part by increased renal
      sympathetic nerve activity and in part by ANG II.

PMID- 2221096
TI  - Glucose absorption by isolated perfused rat proximal straight tubules.
AB  - Glucose absorption was investigated in isolated perfused proximal straight
      tubules from rats by use of a newly developed ultramicrofluorometric assay. This
      assay takes advantage of the increase in fluorescence associated with the
      reduction of NAD to NADH while glucose is degraded to 6-phosphogluconate. When
      tubules were perfused at 6.70 +/- 0.42 nl.mm-1.min-1, the mean rate of glucose
      absorption was 11.0 +/- 1.0 pmol.mm-1.min-1, and the mean rate of fluid
      absorption was 0.61 +/- 0.06 nl.mm-1.min-1. Glucose transport is generally due to
      Na-glucose cotransport in the proximal nephron. In the rat proximal straight
      tubule, glucose absorption also appeared to be primarily due to Na-glucose
      cotransport, since 10(-4) M phlorizin inhibited absorption by 100%, as did
      inhibition of Na(+)-K(+)-ATPase by K removal. To determine the maximum rate of
      transport, tubules were perfused at rates greater than 20 nl.mm-1.min-1 with a
      solution containing 5.5 mM glucose. The maximum rate of glucose absorption was
      approximately 20 pmol.mm-1.min-1 under these conditions. The concentration of
      glucose that supports 50% of the maximum rate of absorption, Km, was 0.6 mM. When
      tubules were perfused at flow rates of less than or equal to 2 nl.mm-1.min-1, the
      luminal glucose concentration reached a limiting value of 0.47 mM with 5.5 mM
      glucose in the bath. The glucose permeability was 3.1 X 10(-6) cm/s.

PMID- 2221097
TI  - Pathways for apical and basolateral membrane NH3 and NH4+ movement in rat
      proximal tubule.
AB  - To examine the mechanism of preferential luminal ammonia secretion in the
      proximal tubule the apical and basolateral membrane pathways for NH3 and NH4+
      movement were studied in the in vivo microperfused rat proximal tubule. Na and Cl
      were absent from all perfusates. Changes in pHi in response to rapid addition of
      NH3-NH4+ to either the luminal or peritubular perfusates were measured
      microfluorimetrically and expressed as the H(+)-equivalent flux (JeqH in pmol.mm
      1.min-1). After ammonia addition ([NH3] 0.3 mM; [NH4+] 14.7 mM) to the luminal or
      peritubular fluids, pHi increased, and JeqH = 1,713 +/- 181 and 1,040 +/- 132
      pmol.mm-1.min-1, respectively. To determine whether the above difference was due
      to NH3- or NH4(+)-driven fluxes, the effect of a fivefold greater [NH4+] ([NH3]
      0.3 mM; [NH4+] 74.5 mM) on JeqH was examined. With luminal addition of a fivefold
      greater [NH4+], JeqH increased to 3,299 +/- 292 pmol.mm-1.min-1, demonstrating a
      pathway for NH4(+)-driven H+ efflux. One millimolar luminal amiloride inhibited
      JeqH in response to luminal NH3-NH4+ addition, suggesting that the amiloride
      sensitive Na(+)-H+ antiporter mediates the NH4(+)-driven H+ efflux. JeqH was
      unaffected by addition of a fivefold greater [NH4+] to the peritubular perfusate,
      demonstrating the absence of an NH4(+)-driven H+ flux on the basolateral
      membrane. From these data, the calculated NH3 permeabilities were 6.2 +/- 1.3 and
      7.0 +/- 0.9 X 10(-2) cm/s for the apical and basolateral membranes, respectively
      (NS). We conclude that apical and basolateral membrane NH3 permeabilities are
      similar and large. The apical membrane can also transport NH4+ on the amiloride
      sensitive Na(+)-H+ antiporter.

PMID- 2221098
TI  - Relative osmotic effects of raffinose, KCl, and NaCl across basolateral cell
      membrane.
AB  - Lumen-collapsed segments of rabbit S2 proximal tubule were bathed in isotonic
      medium and then exposed acutely to a medium made hypertonic by the addition of
      raffinose, NaCl, KCl, Na gluconate, K gluconate, or choline Cl. The result was a
      rapid efflux of water and a shrinking of the tubule, which could be measured by
      video techniques within the first 0.1 s. After reequilibration in isotonic
      medium, each tubule was then exposed to a second hypertonic medium to provide a
      direct comparison between two different solutes, either NaCl vs. KCl or raffinose
      vs. any one of the other solutes. Because raffinose is impermeant across the
      basolateral cell membrane, the ratio of its effect to that of another solute is a
      measure of the reflection coefficient (sigma) of that other solute. The following
      results were obtained: sigma KCl = 0.70 +/- 0.02, sigma K gluconate = 0.97 +/-
      0.07, sigma Na gluconate = 0.84 +/- 0.06, and sigma choline Cl = 0.75 +/- 0.06.
      We previously have reported sigma NaCl = 0.56 +/- 0.07. If sigma of each salt is
      considered to be the arithmetic average of its component parts, and if gluconate
      and choline are considered to be impermeant, we also obtain sigma Na+ = 0.68,
      sigma K+ = 0.94, and sigma Cl- = 0.50.

PMID- 2221099
TI  - Effects of nifedipine and enalapril on glomerular injury in rats with
      deoxycorticosterone-salt hypertension.
AB  - Male Munich-Wistar rats underwent right nephrectomy and were given weekly
      injections of deoxycorticosterone acetate (DOCA) and 1% saline (salt) to drink.
      Two studies were performed. In the first, rats given enalapril (ENP) were
      compared with controls. In the second, rats ingested either standard chow or chow
      to which the calcium-entry blocker nifedipine (NIF) had been added. Six to eight
      weeks after nephrectomy, both control DOCA-salt rats and those given ENP had
      severe hypertension and significant proteinuria. Rats given NIF excreted less
      protein, and glomerular lesions were not observed in this group. The effects of
      NIF on several parameters that have been associated with glomerular injury were
      examined. Micropuncture studies revealed that glomerular capillary pressure was
      increased in DOCA-salt rats and was not reduced by NIF. Platelet aggregation was
      also similar in NIF-treated and control rats. Morphometric studies revealed a
      tendency toward lower glomerular volume of NIF-treated rats; however, kidney
      weight and glomerular capillary radius were unaffected by therapy. Thus NIF, but
      not ENP, prevents DOCA-salt rats from developing hypertension and glomerular
      injury. This effect does not depend on reduction in glomerular pressure or
      inhibition of platelet aggregation.

PMID- 2221100
TI  - Salicylic acid permeability properties of the rabbit cortical collecting duct.
AB  - To assess the role of nonionic diffusion of salicylic acid (pKa = 3) in the
      terminal nephron, we measured the passive permeability of [14C]salicylic acid in
      rabbit cortical collecting ducts isolated and perfused in vitro. This segment can
      produce and maintain a maximal pH gradient between blood and tubular fluid. When
      peritubular pH was kept constant at pH 7.4 the apparent permeability of salicylic
      acid (P', 10(-6) cm/s) was 6.2 +/- 1.1 at a luminal pH of 6.0, 17.2 +/- 5.3 at a
      luminal pH of 5.5, and 39.0 +/- 4.7 at a luminal pH of 5.0. These permeabilities
      were in close correlation with the percentage of nonionized salicylic acid
      present at each pH, indicating that only the nonionized molecule can diffuse
      across the collecting duct epithelium. By recalculating the permeability, taking
      into account only the concentration of the nonionized salicylic acid molecules,
      we obtained the apparent permeability of nonionized salicylic acid, which was no
      longer pH dependent and averaged 4,345 +/- 460 x 10(-6) cm/s. The apparent
      activation energy of this diffusion process was 9.3 +/- 1.2 kcal/mol as
      calculated from an Arrhenius plot.

PMID- 2221101
TI  - Depressed distal tubule acidification corrects chloride-deplete alkalosis in
      rats.
AB  - We investigated the relative contributions made by the proximal and distal tubule
      to the correction of Cl-deplete metabolic alkalosis induced by systemic
      administration of NaCl. Free-flow micropuncture was used to examine net
      bicarbonate reabsorption in superficial proximal and distal tubules of
      anesthetized Munich-Wistar rats during maintenance and correction of chronic
      furosemide-induced Cl-deplete metabolic alkalosis. The distal tubule of animals
      with correcting vs. maintained alkalosis had a lower fractional reabsorption of
      bicarbonate (38 vs. 75%, P less than 0.001) and a lower slope of the linear
      regression comparing absorption to delivered load (0.48 vs. 0.99, P less than
      0.02). By contrast, proximal tubule of animals with correcting vs. maintained
      alkalosis had fractional reabsorption (85 vs. 90%, P = 0.07) and slopes of the
      regression comparing reabsorption to filtered load (1.09 vs. 0.98, P = 0.48) that
      were not different. The data indicate that correction of Cl-deplete metabolic
      alkalosis induced by NaCl administration involves a qualitative decreased in
      bicarbonate reabsorption in distal tubule with maintenance of the same load
      dependent relationship for bicarbonate reabsorption in proximal tubule.

PMID- 2221102
TI  - Renal actions of endothelin: interaction with prostacyclin.
AB  - The renal actions of endothelin were examined by infusing it intrarenally in
      anesthetized dogs at 4 ng.min-1.kg-1 without affecting arterial blood pressure or
      cardiac output. Endothelin infusion caused a transient and significant increase
      in renal blood flow (RBF) by 13 +/- 2%, followed by large decreases in RBF and
      glomerular filtration rate (GFR; by 26 +/- 2 and 23 +/- 7%, respectively) but did
      not alter urine flow rate or absolute sodium excretion. After endothelin
      infusion, renal venous and arterial plasma 6-ketoprostaglandin F1 alpha increased
      from 250 +/- 58 and 117 +/- 31 to 1,044 +/- 249 and 617 +/- 211 pg/ml,
      respectively, and its renal output increased from 339 +/- 99 to 963 +/- 202
      pg.min-1.g-1 (P less than 0.01 for all). The renal prostacyclin synthesis was
      augmented by endothelin without stimulating the renal renin release or
      norepinephrine output. Inhibition of prostaglandin synthesis with indomethacin
      partially prevented the early renal vasodilation induced by endothelin, which
      then caused a more pronounced decline in RBF and GFR (by 65 +/- 7 and 54 +/- 8%,
      respectively). With suppression of prostacyclin synthesis, inhibition of renin
      release by endothelin was observed. Thus the vasoconstrictive effects of
      endothelin on renal hemodynamics are significantly modified by its ability to
      enhance production of vasodilators, including prostacyclin.

PMID- 2221104
TI  - Recruitment of renin gene-expressing cells in adult rat kidneys.
AB  - To define whether angiotensin I-converting enzyme (ACE) inhibition affects the
      distribution of renin gene-expressing cells within the kidney, a control group of
      adult male Wistar-Kyoto rats (C, n = 7) was compared with a group of rats treated
      with enalapril (E, n = 6) for 5 days. Renin mRNA distribution was assessed using
      in situ hybridization to a 35S-labeled 28 mer oligonucleotide complementary to
      rat renin mRNA. Whereas in control rats renin mRNA was confined to a
      juxtaglomerular location, in enalapril-treated rats, renin mRNA extended
      proximally along the length of the afferent arteriole. The percent of visible
      afferent arteriolar length containing renin mRNA was higher in enalapril-treated
      (71.7 +/- 2.8%) than in control (49.6 +/- 2.1%) rats (P less than 0.0001). These
      findings were accompanied by an increase in the percent of juxtaglomerular
      apparatuses (JGAs) containing renin mRNA (71 +/- 2.2 vs. 49 +/- 2.9%; E vs. C, P
      less than 0.0001). Also, the intensity of the JGA hybridization signals was
      higher in enalapril-treated (757 +/- 59 grains/JGA) than in control (167 +/- 11
      grains/JGA) rats (P less than 0.00001). We conclude that the increased kidney
      renin gene expression elicited by ACE inhibition is the result of an increase in
      renin mRNA content per JGA, an increase in the number of JGAs expressing the
      renin gene, and a recruitment of renin gene-expressing cells along the afferent
      arteriole.

PMID- 2221103
TI  - Modulation of osmolytes in MDCK cells by solutes, inhibitors, and vasopressin.
AB  - MDCK cells accumulate organic osmolytes in response to hyperosmotic NaCl
      supplemented medium. We examined time course and inhibitor sensitivity of myo
      inositol, sorbitol, and glycerophosphorylcholine (GPC) accumulation in MDCK cells
      exposed to hyperosmotic NaCl-, D-glucose-, or mannitol-supplemented media. In
      NaCl medium, cells preferentially accumulated inositol and GPC. In comparison, in
      glucose medium cells preferentially accumulated sorbitol and GPC. Inositol
      demonstrated a late (72-96 h) accumulation in glucose medium, although less than
      in NaCl medium. Mannitol medium did not significantly stimulate accumulation of
      any of these three osmolytes at 24 h, suggesting that hyperosmolality alone is
      not sufficient stimulus for their accumulation in this time frame. GPC
      accumulation was very rapid in glucose medium, and fell to the level induced by
      NaCl medium at 96 h (approximately 50 nmol/mg protein). Inositol and sorbitol
      accumulated more gradually, each reaching greater than 400 nmol/mg protein after
      96 h. Sorbitol was still accumulating at 96 h, whereas inositol plateaued at 72
      96 h. Phlorizin or sorbinil blocked accumulation of inositol or sorbitol,
      respectively. Sorbitol and GPC accumulation in glucose medium were partially
      inhibited in absence of serum or in presence of 1 microM vasopressin. Thus NaCl
      and glucose appear to stimulate specific cellular mechanisms responsible for
      accumulation of inositol, sorbitol, and GPC in MDCK cells. This accumulation is
      also modulated by constituents of serum.

PMID- 2221105
TI  - Glucocorticoid receptors mediate mineralocorticoid-like effects in cultured
      collecting duct cells.
AB  - To investigate the direct epithelial effects of corticosteroids on renal ion
      transport, we studied the influence of the pure glucocorticoid agonist RU 28362
      and aldosterone on Na+ and K+ transport in primary cultures of immunodissected
      rabbit cortical collecting duct (CCD) cells. When grown on permeable supports in
      a steroid-free medium, CCD monolayers exhibited a lumen-negative transepithelial
      potential difference (PD) of 5.2 +/- 1.07 mV and a short-circuit current (SCC) of
      8.54 +/- 2.2 microA/cm2. Transepithelial resistance averaged 660 +/- 49
      omega/cm2. The cultures actively reabsorbed Na+ and secreted K+. Both aldosterone
      and RU 28362 significantly increased PD and SCC; the effects were time and dose
      dependent. The effect of RU 28362 was completely prevented by the glucocorticoid
      receptor antagonist RU 486, whereas ZK 91587, a specific mineralocorticoid
      receptor antagonist, did not block its effect. Both aldosterone and RU 28362
      increased the bath-to-lumen concentration ratio of Na+ while lowering that of K+,
      indicating an increased Na+ reabsorption and K+ secretion. The number of Na(+)
      K(+)-ATPase units was significantly enhanced (approximately 2-fold) by both RU
      28362 and aldosterone. These results demonstrate that, in cultured CCD cells, not
      only aldosterone but also a pure glucocorticoid is able to exert
      mineralocorticoid-like effects, and this latter effect is mediated by
      glucocorticoid receptors. Because all parameters studied responded similarly to
      aldosterone and RU 28362, we speculate that in CCD cells glucocorticoids and
      mineralocorticoids might act by regulating the same gene(s).

PMID- 2221106
TI  - High glucose induces cell hypertrophy and stimulates collagen gene transcription
      in proximal tubule.
AB  - Tubulointerstitial changes in the diabetic kidney correlate closely with the
      decline in glomerular filtration. In this study, we used a cell culture system of
      mouse proximal tubule epithelial cells to test the effects of glucose on cell
      growth, size, and matrix biosynthesis. [3H]thymidine incorporation was
      significantly inhibited in cells grown in 450 mg/dl glucose, compared with cells
      grown in 100 mg/dl glucose. The cells grown in the higher glucose concentration
      were slightly larger, their protein content and the total protein synthetic rate
      were significantly increased, and they secreted approximately twice as much
      procollagens type IV and type I. Concordantly, steady-state procollagen mRNA
      levels were also increased: 2.6-fold for the alpha 1(IV) and 2.2-fold for the
      alpha 2(I) procollagens. Additionally, nuclear run-off studies demonstrated that
      procollagen gene transcription rate was stimulated approximately 50%; beta-actin
      transcription rate was not altered. We used chloramphenicol acetyltransferase
      (CAT) reporter gene constructs to determine whether the increased transcription
      rate of alpha 2(I) gene was associated with activation of its enhancer sequence.
      Cells transfected with the enhancer demonstrated more than fivefold increase in
      CAT activity when cultured in the high-glucose medium. These studies demonstrate
      a multitude of effects of high ambient glucose concentrations on proximal tubule
      cell growth and collagen biosynthesis; cell proliferation is decreased although
      cell hypertrophy occurs. Procollagen gene transcription rate is stimulated and
      this response contributes to the observed increase in procollagen mRNA content.
      Activation of an enhancer sequence may be one possible mode through which high
      glucose levels increase the transcription of procollagen type I, presumably
      involving trans-acting factor(s).

PMID- 2221107
TI  - Model of TGF-proximal tubule interactions in renal autoregulation.
AB  - Previous models, assuming constant reabsorption in the proximal tubule, have
      shown that tubuloglomerular feedback (TGF) can explain only a fraction of
      glomerular filtration rate (GFR) and renal blood flow autoregulation. Increased
      arterial pressure inhibits proximal tubule fluid reabsorption, an effect that
      should increase the efficacy of TGF because of the resulting increased flow rate
      in the loop of Henle. Models describing pressure and flow in a glomerulus and a
      nephron were derived to test this prediction. The models were coupled by a TGF
      function with tubular flow rate at the end of the proximal tubule (superficial
      nephron) or at the macula densa (juxtamedullary nephron) as input and with
      afferent arteriolar resistance as output. In agreement with others, the model
      predicted that TGF alone could account for about one-half of autoregulation.
      Pressure-dependent inhibition of proximal reabsorption increased the ability of
      TGF to account for autoregulation, providing compensation for increases in
      arterial pressure comparable to published whole kidney values. The inclusion of
      an approximation of an effect of arterial pressure on TGF marginally improved
      predicted autoregulation. Although the results suggest that the proximal tubule
      TGF interaction can provide a quantitatively adequate explanation for
      autoregulation, they also indicate that the effect of the interaction is spent at
      arterial pressures greater than 130 mmHg. Additional mechanisms are required to
      extend this range.

PMID- 2221108
TI  - Thapsigargin demonstrates calcium-dependent regulation of phosphate uptake in
      HeLa cells.
AB  - We used thapsigargin, a sesquiterpene lactone that mobilizes intracellular Ca
      without increases in inositol phosphates or major activation of protein kinase C
      (PKC), to test the specific effects of increasing cytosolic Ca on Na-dependent
      phosphate uptake in HeLa cells. Thapsigargin increased the Vmax for phosphate
      uptake from 5.40 +/- 0.26 to 7.86 +/- 0.43 nmol.mg protein-1.3 min-1 (n = 7, P
      less than 0.001) without change in the apparent Km for phosphate, which averaged
      0.15 +/- 0.02 mM. The effect of thapsigargin was dependent on concentration and
      time. Inactivation of PKC by overnight exposure to 16 microM phorbol 12,13
      dibutyrate did not eliminate the effect of thapsigargin, although it completely
      abolished the effects of phorbol ester on phosphate uptake. Thus thapsigargin are
      not dependent on PKC. As in other cell systems, thapsigargin increased cytosolic
      Ca concentration. Removal of extracellular Ca diminished the increase in
      cytosolic Ca and eliminated the effect of thapsigargin on phosphate uptake.
      Collectively, our data indicate that Na-dependent phosphate uptake in HeLa cells
      can be regulated by at least three specific signaling pathways: protein kinase A,
      PKC, and increased cytosolic Ca.

PMID- 2221109
TI  - Compliance of left atrium with and without left atrium appendage.
AB  - Compliance of the left atrial chamber was estimated with and without the
      appendage intact in six isolated canine left atria. Pressure-volume
      determinations were measured over a range of 5-30 mmHg for the whole left atrium
      and were repeated with the appendage excluded. The slope of the pressure vs.
      normalized volume data for the left atrium without the appendage (10.45 +/- 0.87)
      was significantly greater (P less than 0.01) than with the appendage intact (4.10
      +/- 0.72). These data suggest that the left atrial appendage is more compliant
      than the remaining left atrium. Assuming that this relationship remains in vivo,
      the left atrial appendage may play an augmented role in maintaining hemodynamic
      function when filling pressures are elevated.

PMID- 2221110
TI  - Temporal analysis of myocardial glucose metabolism by 2-[18F]fluoro-2-deoxy-D
      glucose.
AB  - To assess kinetic changes of myocardial glucose metabolism after physiological
      interventions, we perfused isolated working rat hearts with glucose and 2
      [18F]fluoro-2-deoxy-D-glucose (2-FDG). Tissue uptake of 2-FDG and the input
      function were measured on-line by external detection. The fractional rate of 2
      FDG phosphorylation was determined by graphical analysis of time-activity curves.
      The steady-state uptake of 2-FDG was linear with time, and the tracer was
      retained predominantly in its phosphorylated form. Tissue accumulation of 2-FDG
      decreased with a reduction in work load and with the addition of competing
      substrates. Insulin caused a significant increase in 2-FDG accumulation in hearts
      from fasted but not from fed animals. We conclude that in the isolated working
      rat heart there is rapid adjustment of exogenous substrate utilization and that
      most interventions known to alter glucose metabolism induce parallel changes in 2
      FDG uptake. Qualitative differences in the in vitro response to insulin may be
      affected by the presence of either endogenous insulin or glycogen.

PMID- 2221111
TI  - Loss of vascular responsiveness induced by endotoxin involves L-arginine pathway.
AB  - The involvement of L-arginine-dependent nitric oxide (NO) production in the
      vascular failure observed in endotoxemia was investigated in male Wistar rats
      treated with Escherichia coli lipopolysaccharide (LPS). Contractile responses to
      norepinephrine (NE) were measured ex vivo in aortas isolated from rats treated
      with LPS (20 mg/kg ip, 4 h before experiments) and pressor responses to NE were
      recorded in vivo in rats infused with LPS (5 mg.kg-1.h-1 iv). LPS pretreatment
      induced a rightward shift of the concentration-response curve to NE and a
      reduction of the maximal contraction by approximately 43% and 54% (P less than
      0.05) in aortic rings with and without functional endothelium, respectively. This
      was not modified by the presence of indomethacin (10 microM) during the
      contractile experiments. In contrast, in the presence of NG-monomethyl-L-arginine
      (L-NMMA, 300 microM) or methylene blue (10 microM), maximal contractions to NE
      were restored to control values whether functional endothelium was present or
      not. The effects of L-NMMA were reversed by L- but not by D-arginine.
      Additionally, the effects of LPS pretreatment on vascular contractility were
      potentiated by L-arginine. In vivo, LPS infusion produced a reduction in pressor
      responsiveness to NE (0.1-10 mg/kg), which was also abolished by L-NMMA (30 mg/kg
      iv). This effect of L-NMMA was reversed by L- but not by D-arginine (100 mg/kg
      iv). These results demonstrate that activation of the L-arginine pathway has a
      major role in the production of vascular hyporeactivity in endotoxemia, ex vivo
      as well as in vivo. Additionally, they suggest that endothelium-independent
      vascular production of NO may be involved.

PMID- 2221112
TI  - Identification of major slow blood pressure oscillations in conscious dogs.
AB  - All physiological feedback systems (e.g., in arterial pressure control) tend to
      oscillate in a characteristic manner. Mechanoreceptors can effectively buffer
      resulting fluctuations in arterial blood pressure. In this study arterial and
      cardiopulmonary receptors were interrupted in eight conscious foxhounds by
      sectioning the afferent pathways to the central nervous system. In response,
      three major peaks were detected in the blood pressure power spectrum: in addition
      to the well-known rhythms reflecting heart rate and respiration, very slow
      oscillating waves with a cycle length of 20 +/- 4 min and a 10(5)-fold higher
      power than the other two waves were detected. The amplitude of these oscillations
      could exceed 100 mmHg. This peak was also identified under control conditions (at
      a cycle length of 21 +/- 4 min, n = 6); however, the relative power was greater
      than 10(3)-fold less with mechanoreceptors intact (P less than 0.001). Thus a
      major slow oscillating component of arterial pressure control has been
      identified. Normally, mechanoreceptors buffer the resulting waves of this
      oscillator. These very strong fluctuations may characterize an important feature
      of blood pressure regulation.

PMID- 2221113
TI  - Endothelium-dependent, flow-induced dilation of isolated coronary arterioles.
AB  - Flow-mediated dilation has been documented in large conduit coronary arteries but
      not in coronary arterioles. The goal of this study was to determine whether this
      response occurs in coronary arterioles and whether it competes with myogenic
      constriction. Subepicardial arterioles (40-80 microns) were isolated and
      cannulated with two glass micropipettes connected to independent reservoir
      systems. During zero flow, myogenic responses were studied over the range of
      intraluminal pressure (IP) between 20 and 140 cmH2O. Myogenic constrictions and
      dilations was observed when IP was increased (greater than 60 cmH2O) and
      decreased (less than 60 cmH2O), respectively. Flow was initiated by
      simultaneously moving the reservoirs in equal and opposite directions, thus
      generating a pressure gradient (delta P) without changing the mean luminal
      pressure (range delta P = 4-60 cmH2O). Flow-induced responses were studied at
      low, intermediate, and high myogenic tones by setting IP at 20, 60, and 100
      cmH2O, respectively. The threshold for flow-induced dilation was delta P = 4
      cmH2O, and maximum dilation was observed at delta P = 20 cmH2O. Red cell
      velocities in isolated arterioles at delta P of 4 and 60 cmH2O were 1.2 +/- 0.2
      and 15.9 +/- 1.3 mm/s, respectively, which are within the range of those reported
      for coronary microvessels in vivo. The magnitude of the flow-induced dilation was
      greatest at the intermediate tone (60 cmH2O IP) but was attenuated at lower and
      higher IP. After mechanical removal of the endothelium, spontaneous tone and
      myogenic responses were preserved, but flow-induced dilation and bradykinin
      induced dilation were abolished.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221114
TI  - Deformation response of red blood cells in oscillatory shear flow.
AB  - The characteristics of red cell deformation were studied, focusing on deformation
      response of the cells subjected to oscillatory shear stress. Red blood cells were
      fractionated into subpopulations of different densities, i.e., low-density and
      high-density cells. The deformation response of the fractionated cells was
      evaluated with a rheoscope varying their intracellular viscosity and oscillation
      frequency of the applied shear stress, and determinants of the deformation
      response were compared with those of whole cell deformation under stationary
      shear stress. When the fractionated cells were exposed to sinusoidally oscillated
      shear stress, the cells underwent oscillatory deformation. The degree of
      deformation of the low-density cells correspond to the magnitude of the applied
      shear stress up to an oscillation frequency of 2.7 Hz. Meanwhile, such an
      oscillatory deformation as to correspond to the applied shear stress was observed
      up to 1.7 Hz for the high-density cells. It was suggested that intracellular
      viscosity was an important factor to determine the deformation response of red
      cells to oscillatory shear stress.

PMID- 2221115
TI  - Dichloroacetate stimulation of glucose oxidation improves recovery of ischemic
      rat hearts.
AB  - We have previously shown that high concentrations of fatty acids depress
      reperfusion recovery of ischemic rat hearts as a result of a fatty acid
      inhibition of glucose oxidation. In this study, we determined whether
      dichloroacetate, an activator of pyruvate dehydrogenase, could overcome fatty
      acid inhibition of glucose oxidation and thereby improve mechanical recovery of
      hearts reperfused after a period of transient global ischemia. Isolated working
      rat hearts, perfused with 11 mM glucose, 1.2 mM palmitate, and 500 microU/ml
      insulin, were subjected to a 30-min period of no flow ischemia, followed by a 30
      min period of reperfusion. Under these conditions, control hearts recovered 37%
      of preischemic function. The addition of 1 mM dichloroacetate to the perfusate at
      reperfusion resulted in a significant improvement in recovery of mechanical
      function (to 73% of preischemic function). When dichloroacetate was added before
      the onset of ischemia, however, this protective effect was lost, and a
      significant increase in myocardial lactate accumulation during ischemia was
      observed. The effects of dichloroacetate on glucose oxidation rates in both
      nonischemic and reperfused ischemic hearts was determined by perfusing hearts
      with 11 mM [U-14C]glucose and 1.2 mM palmitate and quantitatively collecting
      14CO2 produced by the heart. In nonischemic hearts, 1 mM dichloroacetate
      increased steady-state glucose oxidation rates from 298 +/- 69 to 1,223 +/- 135
      nmol.g dry wt-1.min-1. The addition of dichloroacetate to hearts reperfused after
      a 25-min period of ischemia also increased glucose oxidation rates from (112 +/-
      25 to 561 +/- 83 nmol.g dry wt-1.min-1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221117
TI  - Hyaluronan in prenodal lymph from skin: changes with lymph flow.
AB  - Hyaluronan, an important structural component of the interstitial matrix in skin,
      is found in lymph to be subsequently degraded in lymph nodes and liver.
      Hyaluronan concentration and flux were measured in prenodal lymph from the
      hindpaw in six pentobarbital-anesthetized mongrel dogs at normal and increased
      transvascular fluid flux. Lymph flow and hyaluronan concentration in control
      averaged 16.3 +/- 15.0 (SD) microliters/min (range 6.3-46.5) and 6.16 +/- 3.78
      micrograms/ml, respectively. Lymph flow was increased stepwise by raising venous
      pressure, and measurements were performed at each step after three consecutive
      and identical measurements of lymph flow and protein concentration taken 15 min
      apart. Hyaluronan concentration was unchanged until venous pressure was raised
      above 20 mmHg and then gradually fell to an average of 4.8 +/- 2.67 micrograms/ml
      at venous pressures around 40 mmHg. The lymphatic hyaluronan flux averaged 0.085
      +/- 0.034 micrograms/min in control and 0.28 +/- 0.14 micrograms/min at the
      highest flows (4.3 times control), draining 2% and 10% of the total interstitial
      hyaluronan in the tissue in 24 h, respectively. The results suggest that at least
      part of the hyaluronan in skin is loosely bound and easily removed via lymph.

PMID- 2221116
TI  - Severe myocardial dysfunction induced by ventricular remodeling in aging rat
      hearts.
AB  - To determine if aging engenders alterations in the functional properties of the
      myocardium and ventricular remodeling, the hemodynamic performance and structural
      characteristics of the left ventricle of male Fischer 344 rats at 4, 12, 20, and
      29 mo of age were studied by quantitative physiology and morphology. In vivo
      assessment of cardiac pump function showed no change up to 20 mo, whereas left
      ventricular end-diastolic pressure was increased at 29 mo. Moreover, peak rates
      of pressure rise and decay, stroke volume, ejection fraction, and cardiac output
      were depressed at the later age interval, demonstrating the presence of
      ventricular failure at this time. The measurements of chamber size and wall
      thickness showed that ventricular end-diastolic and end-systolic volumes
      progressively increased with age with the greatest change occurring at 20-29 mo.
      Aging was also accompanied by a marked augmentation in the volume fraction of
      fibrotic areas in the ventricular myocardium that was due to an increase in their
      number and cross-sectional area with time. These architectural rearrangements, in
      combination with the abnormalities in ventricular function, resulted in an
      elevation in the volume of wall stress throughout the cardiac cycle. Wall stress
      increased by 64, 44, and 50% from 4 to 12, 12 to 20, and 20 to 29 mo of age. In
      conclusion, aging leads to a continuous rise in wall stress that is not
      normalized by ventricular remodeling. These two independent processes appear to
      be responsible for the onset of heart failure in the senescent rat.

PMID- 2221118
TI  - Role of iron on membrane phospholipid breakdown in ischemic-reperfused rat heart.
AB  - Oxygen-derived free radicals have been implicated in causing degradation of
      myocardial membrane phospholipids associated with ischemia and reperfusion. Since
      iron is known to catalyze the hydroxyl radical formation responsible for cellular
      injury, this study was designed to relate the role of iron with phospholipid
      breakdown in ischemic-reperfused heart. Isolated rat heart perfused by the
      Langendorff technique was subjected to 30 min of normothermic ischemia followed
      by 30 min of reperfusion. The experimental group received 0.6 mM deferoxamine, an
      iron chelator, before reperfusion of ischemic myocardium. Deacylation and
      reacylation of membrane phospholipids were monitored by using [14C]arachidonic
      acid (AA), whereas the de novo phospholipid synthesis was evaluated by using
      [3H]glycerol in the perfusate. In the deferoxamine group, the loss of
      [14C]phosphatidylcholine (PC) and the corresponding accumulation of isotopic
      lysophosphoglycerides as well as AA was significantly lower compared with the
      control. The incorporation of radioactivity for [14C]AA and [3H]glycerol into
      phospholipids was significantly increased in the treated group compared with the
      untreated group. In addition, decreased malonaldehyde formation and lactate
      dehydrogenase release, a higher recovery of high-energy phosphate compounds, and
      myocardial contractility were noticed in the deferoxamine-treated hearts. These
      results indicated that postischemic administration of an iron chelator such as
      deferoxamine can preserve membrane phospholipids and reduce myocardial
      dysfunction associated with reperfusion of ischemic heart.

PMID- 2221119
TI  - Cardiac effects induced by chemically activated neurons in canine intrathoracic
      ganglia.
AB  - Regional or global cardiac responses were elicited when various chemicals were
      injected into discrete loci within acutely decentralized stellate and middle
      cervical ganglia. Nicotine (100 micrograms), acetylcholine (100 micrograms), or
      isoproterenol (1, 2, or 5 micrograms) in 1 microliters of normal saline was
      administered individually into 30 discrete loci within each stellate ganglion and
      25 within each middle cervical ganglion. Cardiac augmentation was elicited when
      approximately 1 site per ganglion was injected with nicotine or acetylcholine.
      Similar injections into sites approximately 1-2 mm away from an active site
      usually failed to elicit cardiac responses. Isoproterenol elicited cardiac
      augmentations when injected into, on average, 3 different loci per ganglion. The
      responses elicited by isoproterenol injections were eliminated when the efferent
      sympathetic nerves arising from an injected ganglion were divided or when timolol
      maleate (0.1 mg/microliters normal saline) was previously injected into the same
      locus. These data indicate that the effects elicited by injecting isoproterenol
      into an intrathoracic ganglion locus were not due to leakage of this agent into
      the blood in sufficient quantities to directly activate cardiac myocytes. When L
      glutamic acid (100 microliters of 1 M solution in normal saline) or L-aspartic
      acid (100 microliters of 1 M solution in normal saline) was injected into a
      stellate ganglion or middle cervical ganglion, positive chronotropic and/or
      inotropic responses were elicited. When DL-homocysteic acid (100 microliters of 1
      M solution in normal saline) was administered no augmentation occurred. It is
      concluded that intrathoracic ganglion cardiac neurons can be activated by
      nicotinic or beta-adrenergic agonists, as well as by specific amino acids. These
      neurons are located throughout the stellate and middle cervical ganglia, cardiac
      neurons in one ganglionic locus being capable of activation by more than one of
      these chemicals.

PMID- 2221120
TI  - Unloaded shortening velocity of skinned rat myocardium: effects of volatile
      anesthetics.
AB  - The slack test method has been adapted for measurement of unloaded velocity of
      shortening in rat ventricular trabeculae that were skinned with saponin (50
      micrograms/ml for 30 min). The method was sensitive enough to detect a 17%
      reversible change in the unloaded velocity of shortening produced by a 3 degrees
      C change in temperature. At pCa 5.30 (80-90% activation), halothane, enflurane,
      and isoflurane each slowed the shortening velocity by 25-30% at dose levels of 8
      mM or greater but not at 4 mM or less. At pCa 5.48 (50-60% activation), halothane
      slowed the shortening velocity by 20-45% at dose levels of 4 mM or greater but
      not at 2 mM. The slowing effect of anesthetics on shortening velocity showed
      saturation at 8 mM for halothane, enflurane, and isoflurane when activation was
      at pCa 5.30. Saturation occurred at 4 mM for halothane when the pCa was 5.48.
      This result indicates that the dose-response relationship may be narrow, such
      that it can be demonstrated between 2 and 4 mM halothane for pCa 5.48 and between
      4 and 8 mM halothane for pCa 5.30. The anesthetic dose dependence of isometric
      force and length axis intercept did not generally follow the same relationship as
      for the shortening velocity. Thus in several instances force did not
      significantly decrease when the velocity of shortening did. This may be
      interpreted as lack of simple inhibition by anesthetics on the number of
      interacting cross-bridges and as direct influence by anesthetics on the cross
      bridge cycle.

PMID- 2221121
TI  - Differential effects of hemorrhage on adrenal and renal nerve activity in
      anesthetized rats.
AB  - Evidence that sympathetic outflow to organs with different functions reacts
      nonuniformly to various stimuli has accumulated. To clarify the difference in
      outflow characteristics of adrenal and renal nerves, the neural and neurochemical
      mechanisms involved in the response to hemorrhage were examined in anesthetized
      rats. Hemorrhage (2, 5, and 10 ml/kg) increased adrenal nerve activity (ANA) and
      decreased renal nerve activity (RNA) in a bleeding volume-dependent manner,
      accompanied with a decrease in mean arterial blood pressure and heart rate.
      Bilateral vagotomy attenuated the response in ANA and completely abolished the
      response in RNA. Sinoaortic denervation (SAD) and vagotomy combined with SAD
      inversely decreased ANA during hemorrhage. However, SAD appears to have no effect
      on the response in RNA, which was completely abolished by combined denervation.
      Our results suggest that the differential effects of hemorrhage on ANA and RNA
      may be due to different contributions via the afferent neural pathways from the
      baro- and cardiopulmonary receptors. Because naloxone attenuated the dissociated
      response to hemorrhage, the endogenous opioid system may be involved.

PMID- 2221122
TI  - Oxygen consumption is less in rat hearts arrested by low calcium than by high
      potassium at fixed flow.
AB  - The purpose of the present study was to determine whether myocardial oxygen
      consumption (MVO2) differs when the heart is arrested by hyperkalemic arresting
      solution (ASK) or by hypocalcemic arresting solution (ASCa) when coronary flow is
      maintained constant. MVO2 was measured in 12 isolated, Langendorff-perfused rat
      hearts alternately perfused with ASK (20 mM K+ and 1.5 mM Ca2+) and ASCa (5 mM K+
      and 0.08 mM Ca2+). Six of the hearts were perfused with ASK for 10 min, ASCa for
      5 min, ASK for a second 5 min, and finally ASCa for 5 min; ASCa and ASK were
      opposite in this sequence for the other six hearts. Measurements of MVO2 during
      ASK and ASCa arrest, taken at the end of each perfusion period, were analyzed to
      distinguish the independent influences of time and perfusate composition on MVO2
      in the arrested hearts (analysis of covariance). Consistent with previous
      findings, MVO2 decreased with time after the onset of cardiac arrest with both
      solutions. The average per minute fall was 0.0003 ml O2.min-1.g-1 (P less than
      0.01). However, at any given time after arrest, MVO2 averaged 0.004 ml.min-1.g-1
      less during ASCa arrest than during ASK arrest (P less than 0.01), which amounted
      to a 15% reduction in MVO2. To test whether the increased MVO2 during
      hyperkalemic arrest was dependent on calcium in the perfusion medium, a third
      series of six hearts was studied in which MVO2 values measured during ASCa and
      ASK arrest were compared with those measured during arrest by hyperkalemic
      hypocalcemic solution (ASK,Ca: 20 mM K+, 0.08 mM Ca2+).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2221123
TI  - Role of endocardial endothelium in positive inotropic action of vasopressin.
AB  - We have studied the effects of vasopressin on isolated cat papillary muscle both
      before and after damaging the endocardium. The experiments were performed in
      physiological conditions of temperature (35 degrees C) and calcium concentration
      (1.25 mM Ca2+). Isometric and isotonic twitches as well as maximal unloaded
      velocity of shortening (Vmax) were measured. In muscles with an intact
      endocardium (n = 13), vasopressin (10(-12) to 10(-6) M) induced early twitch
      relaxation with a significant reduction of time to half isometric tension decline
      and with concomitant significant decrease in peak twitch performance. In a second
      group of muscles (n = 13) the endocardial endothelial surface was damaged by
      briefly (1 s) exposing the muscles to a 0.5% Triton X-100 followed by abundant
      wash with Krebs-Ringer solution, thereby irreversibly decreasing time to half
      twitch relaxation and peak twitch tension without significantly affecting Vmax.
      After this intervention, vasopressin had a positive inotropic effect with a
      significant increase in peak twitch tension and Vmax with no significant changes
      in twitch duration. Accordingly, in the presence of a functional endocardium, the
      direct myocardial positive inotropic effect of vasopressin was reversed, with
      early twitch relaxation and diminished peak twitch performance. At the highest
      concentrations of vasopressin, vasopressin-induced functional and morphological
      damage of the endocardium was observed.

PMID- 2221124
TI  - Diaphragm does not produce ammonia or lactate during high-intensity short-term
      exercise.
AB  - To ascertain whether costal diaphragm engages in ammonia and lactate production
      (like limb muscles) during high-intensity short-term exercise, experiments were
      carried out on six healthy trained ponies in which phrenic venous catheters had
      been implanted 5-9 days earlier. Simultaneous anaerobically obtained blood
      samples from abdominal aorta and the phrenic vein at rest and during 4 min of
      exertion at 32 km/h and at a 7% grade were analyzed for blood-gas variables as
      well as lactate and ammonia concentrations using standard procedures. At rest,
      heart rate was 47 +/- 4 beats/min and the diaphragmatic O2 extraction was 26.5%.
      With exercise, heart rate rose to 218 +/- 6 beats/min, marked acidosis and
      hyperventilation occurred, and the diaphragmatic O2 extraction increased
      threefold (80.9%). Such exercise is known to dramatically increase the work of
      breathing as respiratory frequency and change in pleural pressure approach 138 +/
      4 breaths/min and 30 +/- 3 cmH2O, respectively. Despite the fact that phrenic
      venous O2 tension of exercised ponies decreased to 15.5 +/- 0.6 Torr, the phrenic
      venous lactate and ammonia concentrations did not exceed corresponding arterial
      values. These data thus revealed that the diaphragm is uniquely unlike limb
      muscles, which at high workloads readily engage in net ammonia and lactate
      production, and that the diaphragmatic energy needs during high-intensity short
      term exercise are primarily met by aerobic metabolism.

PMID- 2221125
TI  - Myocardial high-energy phosphates in reactive hyperemia.
AB  - This study used 31P nuclear magnetic resonance (NMR) spectroscopy to determine
      whether the magnitude and duration of myocardial reactive hyperemia (RH) reflect
      a commensurate derangement of myocardial high-energy phosphate (HEP) metabolism,
      or if coronary blood flow (CBF) and HEP metabolism are dissociated during RH.
      Twelve open-chest anesthetized pigs were studied during and after 24 s occlusion
      of the anterior descending coronary artery. CBF velocity was measured with a
      Doppler probe. NMR time resolution (4.8 s) was obtained by summing corresponding
      short blocks of data from multiple occlusions. During occlusion, phosphocreatine
      (PCr) declined to 65 +/- 5% (mean +/- SE) of control accompanied by increased
      spectral intensity of the Pi + phosphomonester region. By 20 s of reflow, HEPs
      had returned to control levels, but CBF was still elevated at 282 +/- 18% of
      control and remained elevated for an additional 53 +/- 7 s, during which 44 +/-
      6% of total RH flow occurred. Therefore, the control of CBF is not closely
      coupled to the levels of myocardial HEPs during RH and the duration of RH does
      not reflect prolonged depletion of myocardial HEPs.

PMID- 2221127
TI  - Activity of canine in situ left atrial ganglion neurons.
AB  - The responses of 135 spontaneously active neurons were recorded from ganglionated
      plexi located in the three epicardial fat pads on the ventral surface of the left
      atrium of ten dogs. Ganglia, some of which were adjacent to the recording sites,
      containing varying numbers of neurons were identified throughout these fat pads.
      Spontaneous activity in 50% of the identified neurons was correlated with
      specific phases of the cardiac cycle when arterial systolic pressure was between
      approximately 70 and 180 mmHg and in 28% it was correlated with the respiratory
      cycle. More neurons displaying cardiovascular-related activity were recorded when
      systolic pressure was increased after administration of positive inotropic agents
      or aortic occlusion. However, when systolic pressure increased above
      approximately 150 mmHg the number of active neurons decreased, and when pressure
      reached approximately 180 mmHg no activity was recorded. The activity of 36% of
      identified neurons was altered when discrete regions of the heart, great thoracic
      vessels, lungs, neck, upper limb, chest wall, or abdominal wall were mechanically
      distorted by gentle touch. After acute decentralization of the intrathoracic
      nervous system some neurons still displayed spontaneous cardiovascular- or
      respiratory-related activity. Single stimuli or trains of stimuli delivered to
      the vagosympathetic complexes, stellate ganglia, or cardiopulmonary nerves
      activated neurons in intact or acutely decentralized preparations. It is
      concluded that ventral left atrial ganglionated plexi neurons display activity
      related to cardiovascular or respiratory dynamics, and that these neurons are
      influenced by sympathetic and parasympathetic efferent axons, as well as by
      cardiac and other mechanoreceptors.

PMID- 2221126
TI  - Sympathetic activity during graded central hypovolemia in hypoxemic humans.
AB  - To determine how hypoxemia (Hx) might alter muscle sympathetic nerve activity
      (MSNA) (microneurography, peroneal nerve), norepinephrine (NE) levels, and
      vasoconstriction during mild central hypovolemia, we exposed eight men to
      continuous graded lower body negative pressure (LBNP) (-5, -10, -15, -20, and -25
      mmHg, 5 min per level) during both Hx (10 or 12% O2) and normoxia (Nx). Hx
      significantly augmented MSNA during LBNP. Total MSNA (average amplitude X burst
      frequency) rose at each level of LBNP by 2, 28, 93, 61, and 123% (Nx) and 32,
      110, 127, 179, and 216% (Hx). Only at LBNP -20 and -25 mmHg did Hx significantly
      augment the increase in forearm venous NE concentration. Arterial pressure was
      unaffected by LBNP in Nx and Hx. Forearm blood flow (venous occlusion
      plethysmography) fell, and forearm vascular resistance (FVR) rose 23, 53, 65, 67,
      and 86% (Nx) vs. 22, 23, 60, 69, and 87% (Hx), but increments in FVR (absolute
      units) were significantly less in Hx. Correlations among MSNA and other variables
      were insignificant for pooled data owing to large inter-individual variations in
      slopes, but correlations were significant for total MSNA (and burst frequency)
      vs. FVR (Nx) and NE (Hx). Three men released epinephrine during LBNP; this was
      accompanied by forearm vasodilation and falling pressure, and in two men,
      decreased MSNA and bradycardia occurred (i.e., vasovagal reaction). Overall, we
      found no major defect in sympathetic control during graded hypovolemia and Hx as
      long as epinephrine levels did not rise.

PMID- 2221128
TI  - Contraction and sarcoplasmic reticulum Ca2+ content in single myocytes of guinea
      pig heart: effect of ryanodine.
AB  - The relationship between the ability of sarcoplasmic reticulum (SR) to accumulate
      and retain Ca2+ and the electrically stimulated contractions (ESCs) of isolated
      cells from guinea pig ventricular myocardium was investigated. Caffeine
      contractures or rapid cooling contractures were used as a relative measure of the
      SR Ca2+ content. Depletion of SR Ca2+ by short exposure to caffeine (15 mM) or by
      prolonged rest resulted in a reduction of the amplitude of the ESCs by 83 +/- 14
      and 65 +/- 11% (means +/- SD), respectively. This result points to SR as a major
      source of the Ca2+ that activates contraction. However, depriving the SR of the
      ability to retain Ca2+ by means of prolonged (up to 75 min) exposure to 0.1
      microM ryanodine (as shown by the absence of contractile response to caffeine or
      cooling) did not prevent an ESC of nearly normal amplitude (81 +/- 24% control),
      albeit with a reduced contraction velocity and a time to peak contraction
      prolonged by 51 +/- 11%. Additionally, while rest decay of ESCs was present after
      ryanodine treatment, the time for the ESCs to recover their steady-state
      amplitude was prolonged at least twofold. Thus, in contrast with the normal
      guinea pig cells, ESCs of the myocytes exposed to ryanodine are controlled by
      sarcolemmal processes. This change in the state of excitation-contraction
      coupling results mainly in modification of the time course of the ESCs and of the
      time course of the response of the cells to the change in the rate of
      stimulation.

PMID- 2221129
TI  - Perinatal aortic growth in lambs: relation to blood flow changes at birth.
AB  - We have examined aortic growth and aortic hemodynamics in lambs in the perinatal
      period. Morphometry of histological cross sections indicated that abdominal
      aortic circumference decreased by 31% between 131 days of gestation and 2-3 wk
      postpartum. In contrast, the internal circumference of the thoracic aorta
      increased by 34% over the same time interval; thus size reduction of the
      abdominal aorta was not part of a generalized arterial response to ex utero life.
      We also determined medial cross-sectional area as an index of medial tissue mass.
      In the perinatal period (120 days gestation to 21 days postpartum), this index
      increased by 144% for the thoracic aorta but only by 69% in the abdominal aorta.
      Differences in rate of medial tissue accumulation were much greater postpartum
      than in utero. The relationship between abdominal aortic growth and hemodynamic
      changes was examined by instrumenting fetal lambs with blood pressure catheters,
      abdominal aortic blood velocity transducers, and sonomicrometer diameter crystals
      mounted on the abdominal aorta. Parturition, and the consequent loss of the
      placental circulation, caused a 73% reduction in abdominal aortic blood velocity.
      Abdominal aortic external diameter in the period between 4 and 14 days postpartum
      was reduced significantly compared with in utero values. These data are
      consistent with the hypothesis that blood flow changes at birth significantly
      influence arterial growth postpartum.

PMID- 2221130
TI  - Regional autoregulatory responses during infusion of vasoconstrictor agents in
      conscious dogs.
AB  - We investigated pressure-dependent autoregulatory responses in mesenteric, iliac,
      and renal vascular beds of conscious dogs during intravenous infusion of
      angiotensin II, phenylephrine, or arginine vasopressin at rates which increased
      arterial pressure by 20-40 mmHg. The arteries supplying these beds were
      instrumented with an electromagnetic flow probe, a nonoccluding catheter, and an
      electromagnetic flow probe, a nonoccluding catheter, and an occluder cuff
      connected with a servo-amplifier, which enabled us to return perfusion pressure
      to control levels during infusion of the vasoconstrictor agents. We attempted to
      differentiate between the increase in vascular resistance due to the direct
      effect of the vasoconstrictor agent and the increase induced by an autoregulatory
      response induced by elevations of aortic perfusion pressure. We measured a strong
      degree of autoregulation in the renal vascular bed with a fractional compensation
      value close to 1. Moderate autoregulation occurred in the mesenteric vascular
      bed, where the compensation was 0.4-0.5 with angiotensin II and phenylephrine and
      between 0.74 and 0.94 with vasopressin. No autoregulatory capacity could be
      demonstrated in the hindlimb. The findings indicate that, under conditions of
      increased systemic blood pressure, both the renal and the mesenteric vascular
      beds contribute to the increase in total peripheral resistance by pressure
      dependent vasoconstrictor responses.

PMID- 2221132
TI  - Neutrophil-mediated vascular leakage is not suppressed by leukocyte elastase
      inhibitors.
AB  - Application of leukotriene B4 (LTB4) to hamster cheek pouches induces neutrophil
      dependent vascular leakage of macromolecules as well as leukocyte intravascular
      adherence and emigration. The effect of inhibitors of neutrophil elastase on
      these reactions was studied with intravital microscopy. Anesthetized hamsters
      were pretreated with the elastase inhibitors L 658,758, Eglin C, or dextran
      sulfate, and LTB4 (10 nM) was superfused over the cheek pouches. Neither Eglin C
      nor L 658,758 had any effect on the resulting vascular leakage of a
      macromolecular marker; in contrast, dextran sulfate suppressed this leakage by
      85%. None of the compounds affected LTB4-induced leukocyte adherence or
      neutrophil diapedesis. The inhibitors were able to inhibit both hamster and human
      neutrophil elastase as estimated in crude neutrophil extracts. These results
      suggest that neutrophils extravasate and generate vascular leakage without the
      use of their elastase activity. The inhibitory effect of dextran sulfate on
      macromolecular leakage may be due to interaction with cationic proteins released
      from the neutrophils.

PMID- 2221131
TI  - BBB transport and rapid tissue binding of cyclofoxy: comparison of active and
      inactive enantiomers.
AB  - The "rapid-phase" brain distribution of 3H-labeled enantiomers of the opiate
      receptor antagonist cyclofoxy (CF), receptor active (-) and inert (+) forms, was
      measured during 20- to 180-s intravenous infusion in rats. [14C]iodoantipyrine
      was coinfused during these experiments to obtain a simultaneous measure of blood
      flow. The influx clearance (K1) across the blood-brain barrier (BBB) and the
      rapid binding equilibrium constant (Keq) were estimated in different brain
      regions for both enantiomers (2-compartmental model); a possible receptor binding
      process (k3) was also examined for (-)-CF (3-compartment model). K1 (0.46-0.91
      ml.min-1.g-1), the capillary permeability-surface area product (PS; 0.75
      approximately 1.4 ml.min-1.g-1) and the tissue extraction fraction (E; 0.6-0.7)
      were found to be identical for both enantiomers in the nonreceptor binding model;
      Keq was identical in cerebellum but larger for (-)-CF in other brain structures.
      The difference in Keq between the enantiomers (2-compartment model) correlated
      with the rank order of opiate receptor density observed in vitro and in vivo.
      These results suggest that concomitant use of (-)-CF and (+)-CF will be useful
      for in vivo receptor binding analyses.

PMID- 2221134
TI  - A method to estimate the point at which two lines intersect from noisy data.

PMID- 2221133
TI  - Adenosine and active hyperemia in soleus and gracilis muscle of cats.
AB  - Exercise-induced increases in tissue adenosine level vary in muscles having
      different oxidative capacities. These studies were designed to further evaluate
      the role of this potent vasodilator as a modulator of active hyperemia in muscles
      having different intrinsic metabolic profiles. Soleus (slow-twitch oxidative) and
      gracilis (fast-twitch glycolytic) muscles of anesthetized cats were stimulated to
      contract isometrically in the presence of adenosine deaminase (ADA) or ADA that
      had been deactivated by boiling (BADA). Stimulation parameters were chosen to
      provide similar high and low blood flow responses in the two muscle types. ADA
      did not affect resting blood flow or vascular resistance. In the soleus muscle,
      ADA attenuated both the increase in blood flow and oxygen consumption and the
      decrease in vascular resistance at the high level of muscle stimulation. In
      addition, muscle performance decreased to 60% of its initial level in the
      presence of ADA, although the same initial performance level was maintained over
      the stimulation period during BADA infusion. Temporal studies in the soleus
      muscle demonstrated an ADA-induced decrease in oxygen consumption, which was the
      product of an attenuated blood flow, followed by reductions in muscle
      performance. ADA had no effect on active hyperemia in either muscle at the low
      stimulation level. Additionally, ADA did not attenuate active hyperemia in the
      gracilis when stimulated at a level that normally produced muscle fatigue.
      Therefore these data support a role for adenosine in mediating vasodilation in
      skeletal muscle composed of high-oxidative fibers at high levels of muscle
      performance but do not support a role for adenosine in skeletal muscle having low
      oxidative fibers, even at levels of exercise which produce fatigue.

PMID- 2221135
TI  - A method for continual monitoring of bone resorption in rats: evidence for a
      diurnal rhythm.
AB  - A method has been developed to monitor bone resorption (BR) based on the urinary
      excretion of [3H]tetracycline ([3H]TC) from chronically prelabeled rats. This is
      possible because the [3H]TC released from bone has been found to be in a form
      that is not or only poorly bound to apatite and thus not reincorporated into
      newly formed bone. When BR was increased by means of dietary calcium restriction,
      parathyroid hormone (PTH) infusion, or retinoid injections, urinary [3H]TC
      doubled. When BR was inhibited by feeding calcium supplements or administration
      of dichloromethylenebisphosphonate, [3H]TC excretion dropped by two-thirds.
      Thyroparathyroidectomy inhibited [3H]TC excretion by one-third. The results
      obtained with this technique are therefore similar to those obtained with other
      methods such as 45Ca kinetics. The effect of dietary manipulations on BR was
      detected within 6 h of changing diet. Furthermore, a strong diet-dependent but
      PTH- and calcitonin-independent diurnal rhythm in BR was found. By use of this
      technique, bone resorption can be assessed continuously over long periods, and
      the acute regulation of bone resorption can be studied for the first time.

PMID- 2221136
TI  - Fetal endocrine responses to prolonged hypoxemia in sheep.
AB  - Our aim was to characterize the pattern of release of epinephrine,
      norepinephrine, arginine vasopressin (AVP), cortisol (hydrocortisone), and
      prostaglandin E2 (PGE2) into the fetal circulation during prolonged reductions in
      uterine blood flow (RUBF). In five sheep RUBF was induced for 24 h, whereas in
      another five sheep (controls) uterine blood flow was not reduced. Fetal arterial
      oxygen saturation was decreased from 60.5 +/- 3.6 to 20.3 +/- 1.6% after 2 h of
      RUBF and remained significantly reduced for the entire RUBF period. The incidence
      of fetal breathing movements (FBM) and fetal arterial pH were reduced from 36.7
      +/- 4.5 min/h and 7.36 +/- 0.01 to 4.3 +/- 1.8 min/h and 7.13 +/- 0.02,
      respectively, after 2 h of RUBF, but both had returned to control levels after 14
      h. Fetal plasma AVP and epinephrine concentrations were increased from 4.4 +/-
      0.5 pg/ml and 0.19 +/- 0.05 ng/ml to 333.8 +/- 41.5 pg/ml and 1.5 +/- 0.6 ng/ml,
      respectively, after 2 h and then declined to near control levels after 12 h of
      RUBF. Fetal plasma norepinephrine and cortisol concentrations were increased from
      1.3 +/- 0.4 and 4.0 +/- 2.2 ng/ml to 6.1 +/- 1.8 and 13.5 +/- 4.1 ng/ml,
      respectively, after 2 h of RUBF, and both remained significantly elevated
      throughout the remainder of the RUBF period. Fetal plasma PGE2 concentrations
      progressively increased (from 1.9 +/- 0.4 to 8.8 +/- 1.7 nmol/l at 12 h) as the
      duration of RUBF increased and were still significantly elevated after 24 h. The
      time course for the increase in PGE2 during RUBF was very similar to the
      increases in arterial pH and in the incidence of FBM.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2221137
TI  - Roles of interleukin 1 beta and tumor necrosis factor in lipopolysaccharide fever
      in rats.
AB  - The roles of interleukin 1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF)
      in lipopolysaccharide (LPS)-induced fever were investigated in the rat. We used
      antisera against IL-1 beta and TNF to determine whether we could alter the fever
      by blocking the action of these cytokines. The intravenous injection of antiserum
      IL-1 beta 3.5 days before the intraperitoneal injection of LPS resulted in a mean
      fever that was significantly lower than that seen in rats that had been injected
      with control serum (0.36 +/- 0.11 vs. 0.82 +/- 0.16 degrees C, P = 0.016). The
      intravenous injection of antiserum against TNF 3.5 days before the
      intraperitoneal injection of LPS did not block the fever but significantly
      enhanced it (1.31 +/- 0.16 vs. 0.82 +/- 0.16 degrees C, P = 0.027). These data
      support the hypotheses that IL-1 beta is responsible for a significant part of
      LPS fever and that TNF acts as an endogenous antipyretic to limit the magnitude
      of LPS fever in the rat.

PMID- 2221138
TI  - Angiotensin and salt appetite of BALB/c mice.
AB  - The influence of systemic or intracerebroventricular (icv) administration of
      angiotensin II on the intakes of NaCl solution, water, and food was investigated
      in BALB/c mice. Systemic administration of angiotensin II had little, if any,
      influence on these ingestive behaviors. On the other hand, icv infusion of
      angiotensin II at 70 ng/day increased (P less than 0.05) intakes of NaCl solution
      and water by the third day of infusion. The amount of NaCl ingested daily during
      the infusion was two to three times body sodium content. The mean daily water
      intake increased to 40-60% of body weight. The vast increase in NaCl intake was
      not secondary to a natriuresis caused by the icv infusion of angiotensin II. The
      results suggest that angiotensin II has a direct effect on neural systems
      involved in sodium appetite in this species.

PMID- 2221139
TI  - Effect of angiotensin-converting enzyme inhibitor on salt appetite and thirst of
      BALB/c mice.
AB  - The role of angiotensin II (ANG II) in Na-depletion-induced Na appetite of mice
      was investigated. Intraperitoneal injection of the angiotensin-converting enzyme
      inhibitor captopril at 1.7 mg/mouse (high dose) decreased the Na intake of the Na
      depleted (furosemide-treated) mice by 80-85%. The decrease in Na intake was
      restored to the initial level by concurrent subcutaneous infusion of ANG II. High
      dose of captopril also decreased the Na intake of fluid-deprived, Na-depleted
      mice. High dose of captopril did not alter water intake in any of the four
      conditions examined, i.e., in fluid-replete, Na-depleted, water-deprived, or
      fluid-deprived, Na-depleted mice. Low dose of captopril (1.7 microgram/mouse)
      tended to or significantly enhanced Na intake of Na-depleted mice. Low dose of
      captopril, however, did not enhance water intake in any of the conditions
      examined. Both high- and low-dose captopril treatment decreased food intake in
      water-deprived mice, whether or not the mice were Na depleted as well. The
      addition of captopril (0.1 or 1.0 mg/ml) to the drinking water did not influence
      Na or food intake. Water intake was enhanced during treatment with the low but
      not with the high dose of captopril. The results are consistent with the
      proposition that ANG II is involved in the Na appetite of Na-depleted mice. ANG
      II does not appear to have a role in water intake of Na-depleted or water
      deprived mice, but neural mechanisms in which angiotensin has a role may
      influence food intake of water-deprived mice.

PMID- 2221140
TI  - Decreased cerebral sodium concentration and sodium appetite in BALB/c mice.
AB  - BALB/c mice were allowed free access to water, food, and 0.3 M NaCl.
      Intracerebroventricular infusion of 0.7 M mannitol in artificial cerebrospinal
      fluid (CSF) was used to reduce CSF sodium concentration. The infusion was made at
      24 microliters/day, which was similar on a body weight basis to the rate that
      evoked a large increase in sodium appetite in sheep. Reduction of CSF sodium
      concentration did not increase the voluntary sodium intake of sodium-replete mice
      or furosemide-treated, sodium-depleted mice. Thus, in contrast to findings in
      sheep and cattle and similar to the findings in the laboratory rat and wild
      rabbits, changes in cerebral sodium concentration are apparently not involved in
      the sodium appetite of mice.

PMID- 2221141
TI  - Endocrine and fluid-balance responses to amniotic and allantoic fluid loss in
      sheep.
AB  - Our aim was to determine fetal and maternal endocrine and fluid-balance responses
      to prolonged loss of amniotic and allantoic fluids in sheep. In seven sheep,
      amniotic and allantoic fluids were drained [379.1 +/- 20.1 (SE) ml/day] from 107
      to 135.3 +/- 0.6 days of gestation (term: 145 days). The results from these sheep
      were compared with those from seven control sheep. Maternal water intake, urine
      production, and urine osmolality were not altered by fluid drainage, nor were
      fetal and maternal arterial blood gases, pH, or plasma osmolalities. Fluid
      drainage increased amniotic, but not allantoic, fluid osmolality. Maternal plasma
      cortisol concentration increased with fluid drainage, but maternal plasma
      concentrations of prolactin and arginine vasopressin were unchanged. Fluid
      drainage increased prolactin concentrations in fetal plasma and amniotic fluid,
      but fetal plasma concentrations of cortisol (hydrocortisone), arginine
      vasopressin, norepinephrine, and epinephrine were unchanged. Our results show
      that the fetus is capable of maintaining its plasma osmolality despite prolonged
      loss of fluid from its amniotic and allantoic sacs and that this is associated
      with alterations in the production rate and the composition of amniotic fluid.

PMID- 2221142
TI  - Norepinephrine sensitivity of mesenteric veins in pregnant rats.
AB  - This study was designed to test the hypothesis that during the course of
      pregnancy there is a decrease in the venous response to adrenergic stimulation
      that is characterized by a decrease in venoconstriction to both exogenous
      norepinephrine (NE) and to transmural electric stimulation of endogenous
      sympathetic nerves. Capacitance-size mesenteric veins were removed from
      nonpregnant and early- (7/8 day) and late-pregnant (18/19 and 20/21 day) Sprague
      Dawley rats and studied in vitro under pressurized conditions. Lumen diameter was
      measured continuously by a video-electronic method. There was a marked increase
      in the sensitivity of the veins to exogenous NE stimulation at the end of
      pregnancy, which was most dramatic at a transmural pressure of 6 compared with 2
      mmHg. The increase in exogenous NE sensitivity was associated with a progressive
      decline in the response to transmural nerve stimulation during pregnancy.
      Cocaine, an inhibitor of neuronal uptake, resulted in a greater potentiation of
      the response to transmural nerve stimulation in the pregnant rats compared to
      controls, suggesting an increased reuptake mechanism during pregnancy. Additional
      studies in the pseudopregnant, lactating, and nonlactating rat suggested that the
      conceptus was necessary for the alterations in neural response but not for the
      increase in exogenous NE sensitivity. In conclusion there is a dramatic change in
      venous function during pregnancy in the rat that is characterized by a difference
      between endogenous and exogenous NE sensitivity. The fact that transmural
      pressure can profoundly affect exogenous NE sensitivity suggests that pregnancy
      induced changes in venous volume could contribute to changes in venous
      reactivity.

PMID- 2221143
TI  - Testosterone influences hibernation in golden-mantled ground squirrels.
AB  - At different phases of the hibernation season, castrated male golden-mantled
      ground squirrels were implanted with capsules that either were filled with
      testosterone (T) or left empty (blank). Blank-treated animals hibernated normally
      when housed at 5 degrees C. Entry into hibernation was prevented in the majority
      of squirrels treated with T several days before the initial cold challenge. T
      concentrations that inhibited torpor (greater than 1.2 ng/ml) were comparable
      with those of intact males at the end of the hibernation season. In some
      squirrels, moderate T concentrations were compatible with hibernation, but torpor
      bout duration was shorter than normal. The inhibitory effect of T on hibernation
      did not appear to require aromatization of T to estradiol. We suggest that a
      steroid-independent mechanism triggers arousal from hibernation and that T
      dependent processes determine whether hibernation is resumed at the end of an
      arousal period.

PMID- 2221144
TI  - Effect of outflow pressure on liver lymph flow in unanesthetized sheep.
AB  - We used lymph flow rate (QL) to lymphatic vessel outflow pressure (Po)
      relationships to analyze lymphatic flow in five unanesthetized sheep with liver
      lymphatic cannulas. The olecranon was the zero reference level for pressures.
      Increases in Po did not change QL until Po exceeded 19 +/- 4 (SD) cmH2O. However,
      for Po greater than 19 +/- 4 cmH2O, QL decreased linearly with increases in Po.
      We fit regression lines to the QL vs. Po data for Po greater than 19 cmH2O and
      estimated the effective lymphatic resistance (RL) as -delta Po/delta QL. The
      effective pressure driving lymph (PL) was the Po at which QL = 0. At baseline, RL
      = 0.18 +/- 0.10 cmH2O.min.microliter-1 and PL = 29.6 +/- 3.4 cmH2O. When we
      increased hepatic vein pressure by 5.7 +/- 1.7 cmH2O, QL increased to 6.2 +/- 3.2
      times baseline, RL decreased to 0.050 +/- 0.015 cmH2O.min.microliter-1, and PL
      increased to 37.1 +/- 3.5 cmH2O (P less than 0.05). Thus 1) liver lymph flow is
      very sensitive to increases in hepatic vein pressure, 2) there is a substantial
      QL vs. Po plateau for liver lymphatics, and 3) after hepatic venous pressure
      elevations, liver lymph flow increases as if it were driven by a higher pressure
      through a lower resistance.

PMID- 2221145
TI  - Functional recovery of the gustatory system after sodium deprivation during
      development: how much sodium and where.
AB  - Restriction of maternal dietary sodium beginning on or before embryonic day 8 and
      continued thereafter results in reduced taste responses of the chorda tympani
      nerve to NaCl in the offspring. The effects of deprivation, however, are
      reversible. A single ingestive bout of 30 ml isotonic NaCl was sufficient to
      restore normal sodium taste, and the restorative effects of the single exposure
      apparently persisted throughout multiple generations of taste receptor cells.
      Furthermore, the recovery apparently did not depend on direct receptor cell
      stimulus interactions. Rats permitted to drink 30 ml of isotonic NaCl, but not
      allowed to retain it, did not recover normal sodium taste responses, suggesting
      that factors other than taste stimulation are important in the restorative
      effects of sodium.

PMID- 2221146
TI  - Baroreflex responses to acute changes in blood volume in humans.
AB  - To test the hypothesis that acute changes in plasma volume affect the stimulus
      response relations of high- and low-pressure baroreflexes, eight men (27-44 yr
      old) underwent measurements for carotid-cardiac and cardiopulmonary baroreflex
      responses under the following three volemic conditions: hypovolemic,
      normovolemic, and hypervolemic. The stimulus-response relation of the carotid
      cardiac response curve was generated using a neck cuff device, which delivered
      pressure changes between +40 and -65 mmHg in continuous steps of 15 mmHg. The
      stimulus-response relationships of the cardiopulmonary baroreflex were studied by
      measurements of forearm vascular resistance (FVR) and peripheral venous pressure
      (PVP) during low levels of lower body negative pressure (0 to -20 mmHg). Altered
      vascular volume had no effect on response relations of the carotid-cardiac
      baroreflex but did alter the gain of the cardiopulmonary baroreflex (-7.93 +/-
      1.73, -4.36 +/- 1.38, and -2.56 +/- 1.59 peripheral resistance units/mmHg for
      hypovolemic, normovolemic, and hypervolemic, respectively) independent of shifts
      in baseline FVR and PVP. These results indicate greater demand for
      vasoconstriction for equal reductions in venous pressure during progressive
      hypovolemia; this condition may compromise the capacity to provide adequate
      peripheral resistance during severe orthostatic stress. Fluid loading before
      reentry after spaceflight may act to restore vasoconstrictive capacity of the
      cardiopulmonary baroreflex but may not be an effective countermeasure against
      potential post-flight impairment of the carotid-cardiac baroreflex.

PMID- 2221147
TI  - Preoptic area injection of corticotropin-releasing hormone stimulates sympathetic
      activity.
AB  - To investigate the sites of action of corticotropin-releasing hormone (CRH) on
      sympathetic nerve activity to interscapular brown adipose tissue (IBAT), we
      injected CRH into the third cerebroventricle, medial preoptic area (MPOA), and
      other hypothalamic areas in anesthetized rats. The multiunit discharges of
      sympathetic nerves to IBAT were recorded electrophysiologically. The
      intracerebroventricular injection of CRH increased sympathetic nerve activity in
      a dose-dependent manner over the range 250-1,000 pmol. The microinjection of CRH
      (200 pmol) into the unilateral MPOA increased the sympathetic nerve activity to
      IBAT by +150.6 +/- 25.9% at 30 min after injection. However, the injection of
      saline (0.15 M NaCl) and glucagon (200 pmol) into the MPOA did not increase
      sympathetic nerve activity. The microinjection of CRH (200 pmol) into the
      anterior hypothalamic area, paraventricular hypothalamic nucleus, ventromedial
      hypothalamic nucleus, and lateral hypothalamic area had no significant effect on
      nerve activity. We conclude that central administration of CRH increases the
      sympathetic nerve activity to IBAT and that the MPOA is one of the sites for this
      action. The result is consistent with the hypothesis that CRH is a neurochemical
      stimulator of the sympathetic nervous system, which may be involved in control of
      energy expenditure in rodents.

PMID- 2221148
TI  - Calorimetric study of the energetics of pregnancy in golden hamsters.
AB  - The energetics of pregnancy have been assessed in the golden hamster, using
      continuous whole body indirect calorimetry to determine energy expenditure
      throughout gestation. Energy intake was unchanged during pregnancy, either on a
      daily or cumulative basis. The total energy expenditure per animal was, however,
      significantly higher (14%) in pregnant hamsters than in virgin control animals.
      The increase in total expenditure was the result of increases in daily energy
      expenditure over the last one-third of gestation (mean increase 21%), the period
      during which the energy costs associated with fetal growth are highest. The
      respiratory quotient (RQ) of the control hamsters was approximately 0.95, but in
      the pregnant group there was a progressive reduction over the second half of
      gestation, and by parturition the RQ had fallen to 0.80. The changes in RQ
      indicate that there is a switch toward the oxidation of fat, away from the
      oxidation of carbohydrate, in the later stages of pregnancy. Measurements of body
      lipid suggest that the fall in RQ in the second half of pregnancy is the result
      of a net utilization of maternal fat reserves; 42% of maternal body lipid was
      lost during pregnancy, with most of the loss occurring over the final one-third
      of gestation. Because energy expenditure is increased (relative to virgin
      controls) without any change in energy intake, it is evident that the efficiency
      of energy utilization (energy gain per unit of energy intake) is not increased
      during pregnancy in the golden hamster.

PMID- 2221150
TI  - Dissociative analysis of ventromedial hypothalamic obesity syndrome.
AB  - Electrolytic lesions of the ventromedial hypothalamus (VMH) produce an obesity
      syndrome characterized by hyperphagia, adiposity, and heightened parasympathetic
      tone. Experiments were conducted to evaluate the possibility that these symptoms
      arise from damage to distinct and separated loci within the hypothalamus. Rats
      received either VMH lesions, perifornical hypothalamic (PFH) knife cuts,
      ventromedial hypothalamic nucleus (VMN) lesions, or sham surgery (Sham). When
      maintained ad libitum, VMH and PFH rats were hyperphagic, overweight, and became
      obese. VMN rats were not hyperphagic, nor did they gain excessive weight, but
      they did develop an obesity reflected as a significantly elevated level of
      carcass fat. Under restricted feeding conditions, both VMH and VMN rats became
      obese; PFH rats did not. Also, only VMH lesions and PFH knife cuts increased
      basal gastric acid secretion. These data demonstrate dissociations between
      hyperphagia and obesity, as well as between stomach secretion and obesity, in the
      VMH syndrome. The implications of these findings for a dissociative model of the
      VMH obesity syndrome are discussed.

PMID- 2221149
TI  - Insulin modifies flavor aversions and preferences in real- and sham-feeding rats.
AB  - In separate, parallel experiments, rats were allowed to sham or real feed a
      flavored sweetened condensed-milk solution after a 17.5-h fast. Coinciding with
      administration of the milk were injections of insulin or vehicle (saline).
      Insulin had no effect on intake in the real feeding situation, and flavors paired
      with insulin (0.8, 2.5, or 5.0 U/rat) were avoided, relative to saline-paired
      flavors. In sham-feeding rats, insulin (0.8 U/rat) significantly reduced the
      amount of milk consumed, and flavors paired with insulin injection were
      preferred, relative to saline-paired ones. Insulin produced a relatively larger
      hypoglycemia during sham feeding than during real feeding. Thus it appears that
      insulin-paired flavors of milk may be preferred by animals when they are ingested
      in sham feeding but not in animals real feeding. Perhaps rapid gastric emptying,
      as would occur with a liquid diet, accompanied by increased insulin levels, leads
      to malaise and flavor aversion.

PMID- 2221151
TI  - Control of ventilation in adult rats hypoxic in the neonatal period.
AB  - Three groups of 50-day-old (i.e., postpuberty) rats have been studied: controls,
      rats exposed to 6 days of hypoxia [inspired fraction of O2 (FIo2) = 10% O2] when
      newborn (Nb-Hypox), and rats exposed to the same level and duration of hypoxia
      after weaning (Ad-Hypox). Ventilation during normoxic breathing was higher in Nb
      Hypox than in controls or Ad-Hypox. The ventilatory response to acute hypoxia (10
      min of 10% O2) was about one-half in Nb-Hypox than in the other two groups.
      Additional measurements performed on Nb-Hypox and controls showed minimal or no
      differences between the two groups in the ventilatory responses to hyperoxia and
      hypercapnia, heart rate and blood pressure at various FIO2, and blood
      biochemistry. Analysis of the Hering-Breuer reflexes, during barbiturate
      anesthesia, suggested a decreased central inhibition on inspiratory activity in
      Nb-Hypox, which with a lower sensitivity to inputs from the peripheral
      chemoreceptors may contribute to the normoxic hyperventilation and the blunted
      response to acute hypoxia. The ventilatory patterns of Nb-Hypox rats bear
      numerous similarities with those of high-altitude natives and could suggest that
      the highlander's ventilatory responses are not genetic characteristics but relate
      to chronic hypoxia early in life.

PMID- 2221152
TI  - Diminished cardiovascular responsiveness to vagal stimulation in obese rats.
AB  - Obese rats maintained on a high-fat diet since weaning were studied to determine
      whether parasympathetic deficiencies contribute to the cardiovascular malfunction
      in obesity. Elevations in tail-cuff systolic pressures and plasma insulin
      indicated that obese rats had borderline hypertension and hyperinsulinemia.
      Reflex bradycardia produced by angiotensin or phenylephrine in conscious obese
      rats was less than that in age-matched controls. However, reflex responses
      elicited by phenylephrine or sodium nitroprusside when the same rats were later
      anesthetized did not differ between groups. Impairment of afferent or central
      components of the baroreflex arc was considered unlikely, because depressor,
      bradycardic, and sympathoinhibitory responses to electrical stimulation of aortic
      depressor afferents were similar in both rat groups. By contrast, efferent
      parasympathetic mediation was probably reduced, since depressor and bradycardic
      responses to electrical stimulation of vagal nerve efferents were significantly
      smaller in obese than in control rats. Collectively our findings suggest that
      cardiovascular and baroreflex malfunction in obese rats may result from an
      autonomic imbalance involving diminished parasympathetic activity.

PMID- 2221153
TI  - Responses of harbor seal and pig heart to progressive and acute hypoxia.
AB  - Myocardial oxidative and glycolytic reserves were evaluated in four harbor seals,
      Phoca vitulina richardsi, and six domestic pigs, Sus scrofa (hematocrits: 58 +/-
      5 and 34 +/- 1%., respectively). Progressive hypoxia was induced by lowering
      arterial hemoglobin-oxygen saturation in 10% decrements, each maintained for 10
      min periods, until the onset of heart failure. Myocardial oxygen consumption rate
      (VO2), lactate release/uptake rate (L), and triple product, an index of
      myocardial energetic demand, were determined at each saturation level. Onset of L
      began in pigs at Sao2 = 57 +/- 5% and in seals at Sao2 = 35 +/- 4%. Cumulative
      oxygen consumption (VO2) during hypoxia, determined from the onset of cardiac
      lactate release, was 435 ml O2/100 g in seals and 172 ml O2/100 g in pigs.
      Cumulative lactate release during the same period was 14 mM/100 g in seals and
      4.6 mM/100 g in pigs. The pigs' left ventricular contractile response (dP/dtmax)
      was greater than that of seals throughout the time of lactate release. Total
      myocardial energetic sources were higher in seals than in pigs, and seals were
      better able to tolerate myocardial hypoxia than were pigs. In a separate
      experiment, two seals and six pigs were made acutely hypoxic until cessation of
      cardiac output (seals, 17.5 min; pigs, 7.4 min) and were then reoxygenated. Both
      seals recovered promptly to control levels of cardiac mechanical function,
      whereas none of the pigs recovered. Additionally, five pigs were beta-blocked
      with 0.10 mg/kg of propranolol and were subjected to acute hypoxia. Tolerance to
      cardiac hypoxia in beta-blocked pigs was significantly increased compared with
      that of control animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221154
TI  - DSM-IV: work in progress.
AB  - The authors present an overview of the work in progress on DSM-IV. After a brief
      historical review, they discuss the principles and multiple purposes of the DSM
      IV effort and outline the three stages of its empirical documentation: systematic
      literature reviews, analysis of unpublished data, and field trials. Next, they
      discuss several of the basic conceptual issues that are implicit in revising a
      nomenclature. These include the definition of mental disorder, the balance
      between multiple diagnosis and differential diagnosis, the use of categorical and
      dimensional models of classification, and issues involved in the construction of
      criteria. Finally, they summarize the most important specific questions being
      reviewed by each of the DSM-IV work groups.

PMID- 2221155
TI  - A critical review of epidemiological studies of Puerto Rican mental health.
AB  - Through a review of the epidemiological literature on the mental health of Puerto
      Ricans and other Hispanics, the authors argue that lack of attention to cultural
      issues in epidemiological studies leaves many questions unanswered and raises
      concerns about the validity of studies in this area. The authors point out that
      the mental health status of Puerto Ricans in New York City is still poorly
      understood after 30 years of research. The roles of cultural response styles and
      of culturally meaningful expressions of distress in shaping responses to research
      interviews should be central concerns in developing research in cross-cultural
      psychiatry.

PMID- 2221156
TI  - Auditory hallucinations and smaller superior temporal gyral volume in
      schizophrenia.
AB  - Recent neuropathologic investigations in schizophrenia report smaller volume of
      medial temporal lobe structures. These findings are confirmed by preliminary
      magnetic resonance imaging (MRI) studies. Direct stimulation of lateral temporal
      lobe structures in the region of the superior temporal gyrus provokes
      hallucinations. The authors' MRI study of young schizophrenic patients
      demonstrates smaller volume of the superior temporal gyrus (an auditory
      association area) and of the left amygdala. Smaller size of the left superior
      temporal gyrus and left amygdala is not accounted for by smaller size of the
      overall brain or temporal lobe. Shrinkage of the left superior temporal gyrus is
      strongly and selectively correlated with severity of auditory hallucinations.

PMID- 2221157
TI  - Plasma norepinephrine in chronic schizophrenia.
AB  - Several lines of evidence indicate altered noradrenergic function in
      schizophrenia. The authors examined resting, standing, and change (standing minus
      resting) in plasma norepinephrine levels in 14 drug-free patients with chronic
      schizophrenia or schizoaffective disorder and in 33 age- and sex-matched healthy
      volunteers. Schizophrenic patients had significantly higher resting and standing
      plasma norepinephrine levels and significantly greater change. Resting and
      standing levels were significantly related to positive and negative symptoms.
      There was a significant positive correlation between resting plasma and CSF
      norepinephrine levels and a significant negative correlation between CSF
      homovanillic acid and resting, standing, and change in plasma norepinephrine
      levels.

PMID- 2221158
TI  - Influence of patient-related variables on clozapine plasma levels.
AB  - The authors investigated the clozapine plasma levels of 148 psychiatric
      inpatients. Multiple regression analysis revealed a linear relationship between
      dose of clozapine and plasma concentrations. The analysis showed a significant
      influence of dose, sex, smoking, weight, and age on the plasma concentrations of
      clozapine under clinical conditions. These results remained significant when
      clozapine doses below 150 mg/day and above 500 mg/day were excluded from the
      analysis.

PMID- 2221159
TI  - Personality differences between patients with remitted melancholic and
      nonmelancholic depression.
AB  - Seventy-five patients with remitted depression were categorized as having
      melancholic-endogenous or non-melancholic-nonendogenous depression according to
      DSM-III criteria, Research Diagnostic Criteria, and the Newcastle endogeneity
      scale. The patients' scores on four personality scales--the Eysenck Personality
      Inventory, the Interpersonal Dependency Inventory, locus of control, and the
      Interpersonal Sensitivity Measure--were then compared. Patients with
      nonmelancholic-nonendogenous depression were generally rated as having more
      vulnerable personality styles, but the differences were dependent on the
      particular diagnostic system used. A principal components analysis isolated three
      underlying personality constructs--dependency, introversion, and timidity.
      Patients with nonmelancholic-nonendogenous depression scored as significantly
      more dependent.

PMID- 2221160
TI  - Depression in dementia of the Alzheimer type and in multi-infarct dementia.
AB  - The authors used the Hamilton Rating Scale for Depression and a rating of
      depressed mood to investigate the prevalence of depression in 55 patients with
      Alzheimer's disease, 37 patients with multi-infarct dementia, and 30 nondemented
      comparison subjects. The prevalence of depressed mood depended on the severity of
      dementia as measured by the Mini-Mental State examination and was significantly
      lower among patients in more severe stages of Alzheimer's disease but not among
      patients with severe multi-infarct dementia.

PMID- 2221161
TI  - Value of the DST for predicting response of patients with major depression to
      hospitalization and desipramine.
AB  - The authors examined the value of the dexamethasone suppression test (DST) for
      predicting response of patients with unipolar, nonpsychotic major depression to 1
      week of hospitalization without antidepressant drugs and to a 4-week trial of
      desipramine at a fixed plasma level. The rates of response to hospitalization
      without drug treatment (defined as a score of 12 or less on the Hamilton Rating
      Scale for Depression) were not significantly different for the patients with a
      positive DST and those with a negative DST. This finding differs from those of
      prior studies of the DST and response to placebo. The responses of the DST
      positive and DST-negative patients to desipramine also did not differ, a finding
      that replicates those in some prior reports.

PMID- 2221162
TI  - Antidepressant pharmacotherapy of depression associated with multiple sclerosis.
AB  - In a double-blind clinical trial involving 28 patients with multiple sclerosis
      and major depressive disorder, 14 patients were randomly assigned to a 5-week
      trial of desipramine and individual psychotherapy and 14 to placebo plus
      psychotherapy. Clinical judgments indicated that patients treated with
      desipramine improved significantly more than the placebo group. This was
      confirmed by scores on the Hamilton Rating Scale for Depression but not by Beck
      Depression Inventory scores. Side effects limited desipramine dosage in half of
      the treated patients. The authors conclude that desipramine has a modest
      beneficial effect in serious depression associated with multiple sclerosis but
      that side effects may be more of a limiting factor than in patients without
      medical or neurologic disease.

PMID- 2221163
TI  - Panic disorder and cardiovascular/cerebrovascular problems: results from a
      community survey.
AB  - Follow-up studies of psychiatric patients with panic disorder have shown an
      abnormally high mortality rate in men due to cardiovascular and cerebrovascular
      events. The authors report that in the New Haven portion of the Epidemiologic
      Catchment Area program the risk for stroke in persons with lifetime diagnoses of
      panic disorder was over twice that in persons with other psychiatric disorders or
      no psychiatric disorder. After adjustments for demographic differences between
      groups, the risk was even higher. While the results should be interpreted
      cautiously because of the small sample and absence of medical examinations, these
      findings are consistent with clinical studies showing an association between
      panic disorder and cardiovascular/cerebrovascular events.

PMID- 2221164
TI  - Successful treatment of nonpurging bulimia nervosa with desipramine: a double
      blind, placebo-controlled study.
AB  - Twenty-three women with nonpurging bulimia underwent a 12-week, double-blind,
      placebo-controlled trial of desipramine hydrochloride. Repeated standardized
      rating scales, mood assessments, and self-reports of dietary habits were used to
      measure changes in binge frequency and cognitive processes associated with food
      intake. The women who received desipramine reduced their frequency of binge
      eating by 63%, but women receiving placebo increased their frequency of binge
      eating by 16%. Twelve weeks after initiating treatment, 60% of the treatment
      group but only 15% of the placebo group abstained from binge eating. The women
      who received desipramine showed significantly more dietary restraint and reported
      significantly less hunger, suggesting that desipramine acts to suppress appetite.
      These preliminary findings suggest that the therapeutic effects of desipramine
      established in the treatment of purging bulimia nervosa extend to patients with
      nonpurging bulimia.

PMID- 2221165
TI  - Update on the epidemiology of anorexia nervosa in a defined region of
      Switzerland.
AB  - In this follow-up investigation, the authors studied all Swiss women in the
      canton of Zurich who developed anorexia nervosa between ages 12 and 25 years and
      who were hospitalized for the first time with this diagnosis between 1983 and
      1985. Data were compared with those from an earlier study, which focused on the
      periods 1956-1958, 1963-1965, and 1973-1975. The incidence of anorexia nervosa
      did not increase significantly during 1983-1985 compared to 1973-1975, in
      contrast to the constant increase found between 1956 and 1975. However, the more
      frequent use of vomiting and abuse of laxatives in 1983-1985 may indicate an
      increase in cases with mixed features of anorexia nervosa and bulimia.

PMID- 2221167
TI  - Structured interviews for borderline personality disorder.
AB  - The authors compared three instruments used to diagnose borderline personality
      disorder--the Diagnostic Interview for Borderline Patients (DIB), the Schedule
      for Interviewing Borderlines, and the Structured Interview for DSM-III
      Personality Disorders--in 56 patients with personality disorders. A borderline
      diagnosis was made according to the DIB in 30%, the Structured Interview for DSM
      III Personality Disorders in 48%, and the Schedule for Interviewing Borderlines
      in 55% of the patients. Diagnostic agreement was only 52%, which has implications
      for the generalizability of results of validation studies of the borderline
      diagnosis. Improvement in diagnostic agreement requires modification of current
      criteria sets and/or the use of dimensional models.

PMID- 2221166
TI  - Thyroid function and ultrasonically determined thyroid size in patients receiving
      long-term lithium treatment.
AB  - Thyroid function was investigated in 100 manic-depressive patients. Goiter was
      more common in patients treated with lithium for 1-5 years (44%) or more than 10
      years (50%) than in patients who never received lithium (16%). Smoking
      contributed significantly to thyroid size and goiter. In nonsmoking patients,
      ultrasonically determined thyroid volume was significantly related to treatment
      duration. The mechanism behind this increased thyroid volume is unclear, as most
      patients had normal serum thyrotropin levels and no thyroid autoimmunity.
      Subclinical or overt hypothyroidism was found in 4% and 21% of patients treated
      for 1-5 and more than 10 years, respectively. Since few hypothyroid patients had
      autoimmunity or goiter, lithium may affect the thyroid gland directly.

PMID- 2221168
TI  - Children's PTSD reactions one year after a sniper attack at their school.
AB  - Fourteen months after a sniper attack at an elementary school, level of exposure
      to that event remained the primary predictor of ongoing posttraumatic stress
      reactions in 100 schoolchildren who were followed up. Guilt feelings and knowing
      the child who was killed were associated with a greater number of symptoms. Grief
      reactions occurred independent of degree of exposure to the event. The authors
      discuss the public health implications of these longitudinal findings.

PMID- 2221169
TI  - Psychiatric status of adolescents who had extreme temperaments at age 7.
AB  - Two temperamentally extreme (extremely easy and extremely difficult) subgroups of
      children were selected at the age of 7 years from a large random sample of the
      general population of Quebec City. The clinical status, family functioning, IQ,
      and academic performance of these children were reassessed at 12 and 16 years of
      age. Findings suggest that extreme temperament at age 7 predicts psychiatric
      status in preadolescence and adolescence only when family functioning is also
      taken into account. The adolescents who had been temperamentally difficult
      children and who were living in families with dysfunctional behavior control
      displayed more clinical disorders.

PMID- 2221171
TI  - Cocaine/"crack" dependence among psychiatric inpatients.
AB  - The authors studied 40 cocaine-dependent subjects admitted to psychiatric
      inpatient wards of a metropolitan hospital because of general psychiatric
      symptoms. The results indicate that the predominant form of cocaine
      administration (88%) was freebasing "crack." DSM-III-R cluster B personality
      disorders (N = 17) and schizophrenia (N = 13) constituted the diagnoses for 75%
      of the sample. Compared to the schizophrenic patients in this cohort, the
      patients with cluster B personality disorders used cocaine in greater quantities
      and more frequently and began abuse of the drug at an earlier age. The escalation
      in urban areas of psychiatric hospitalizations attributed to use of crack may be
      largely related to psychiatric symptoms in cocaine-dependent patients with
      personality disorders as well as cocaine-induced psychopathology in schizophrenic
      patients.

PMID- 2221170
TI  - The natural history of alcohol abuse: implications for definitions of alcohol use
      disorders.
AB  - Is the DSM-III-R category of alcohol abuse validly differentiated from the DSM
      III-R category of alcohol dependence, or is abuse primarily a mild, prodromal
      condition that typically deteriorates into dependence? A 4-year longitudinal
      epidemiologic study of male drinkers provided data to answer this question. The
      study used identical questions at baseline and follow-up. At follow-up, 70% of
      the subjects who were initially classified as alcohol abusers were still abusers
      or were classified as remitted. This contrasted significantly with outcome in the
      subjects who initially reported alcohol dependence. Although additional research
      is needed, these results indicate that alcohol abuse often has a course distinct
      from that of alcohol dependence.

PMID- 2221172
TI  - Dissociative experiences in the general population.
AB  - The Dissociative Experiences Scale was administered to a random sample of 1,055
      adults in the city of Winnipeg. Results showed that scale scores did not differ
      between men and women and were not influenced by income, employment status,
      education, place of birth, religious affiliation, or number of persons in the
      respondent's household. Dissociative experiences are common in the general
      population and decline with age. The findings suggest that dissociative disorders
      may also be common in the general population.

PMID- 2221173
TI  - Psychiatry takes to the streets: the New York City initiative for the homeless
      mentally ill.
AB  - The authors describe New York City's program to remove seriously mentally ill
      homeless people from the streets to a public hospital. They report on the 298
      patients hospitalized during the first year of this program. Most of the patients
      were male (66%), single (77%), and from outside of New York City (79%) and
      claimed a history of previous psychiatric hospitalization (92%) and that they had
      been homeless for more than 1 year (66%). Most of the patients suffered from
      schizophrenia (80%) and had additional medical diagnoses (73%). Follow-up contact
      with the patients 2 years after initiation of the program revealed that 55% of
      the patients either were living in a community setting or were under
      institutional care.

PMID- 2221174
TI  - Antidepressant-induced mania.

PMID- 2221175
TI  - Transient SIADH associated with fluoxetine.

PMID- 2221176
TI  - Discussion of fluoxetine and suicidal tendencies.

PMID- 2221177
TI  - Another case of self-cutting after combat stress.

PMID- 2221178
TI  - Obsession or worry?

PMID- 2221179
TI  - Comment on DSM-III-R panic disorder with agoraphobia.

PMID- 2221180
TI  - Seasonal independence of decreased intraocular pressure dynamics in seasonally
      depressed women.

PMID- 2221181
TI  - Initial reaction and subsequent response to antidepressants in panic patients.

PMID- 2221182
TI  - Manic illness presenting with physical symptoms.

PMID- 2221183
TI  - Use of unproven and unapproved drugs to treat cocaine addiction.

PMID- 2221184
TI  - Decisions in psychopharmacologic treatment.

PMID- 2221185
TI  - Hopelessness as a predictor of suicide.

PMID- 2221186
TI  - Personality traits and ethnic background.

PMID- 2221187
TI  - Seasonal variation in bulimic symptoms.

PMID- 2221189
TI  - More on psychotherapy training during residency.

PMID- 2221188
TI  - Further discussion of article on prodromal symptoms in panic disorder.

PMID- 2221191
TI  - The psychiatrist and the juvenile justice system.

PMID- 2221190
TI  - Comments on review of Male homosexuality.

PMID- 2221192
TI  - Identification of letters in the predesignated target paradigm: a word
      superiority effect for the common word the.
AB  - The size of the perceptual unit used in reading was addressed using the
      predesignated target paradigm. Sixteen subjects viewed the following stimuli in
      random order: the words tee, the, tie, and toe; the nonwords eet, eht, eit, and
      eot; and the letters e, h, i, and o. Subjects fixated on the location of the
      center letter and identified the letter as e, h, i, or o, alternatives which were
      known to them at the onset. A word superiority effect was obtained for the common
      word the but not for the less common words tee, tie, and toe. The word
      superiority effect was attributable to bias rather than discriminability:
      Subjects exhibited a bias to perceive the words in this experiment as the (i.e.,
      there was a bias to perceive h in the t e stimulus presentations). These results
      suggest that the common word the is processed in reading units that are larger
      than the letter, and that the system is biased to perceive common rather than
      uncommon words in data-limited conditions.

PMID- 2221193
TI  - Memory for names and faces: a fair comparison.
AB  - Comparison between recognition memory for materials drawn from different stimulus
      classes has been hazardous because of unavoidable variation in the similarity of
      director sets involved. The present study attempts to make a more equitable
      comparison between memory for names and faces by employing both distractor-free
      and conventional recognition tests. University undergraduates viewed slides of
      names or faces and subsequently attempted to identify those they had seen
      earlier. The interaction between stimulus class and type of recognition test was
      significant. It is suggested that the frequently reported superiority of memory
      for faces as compared with names may be an artifact of the distractors used in
      these tests.

PMID- 2221194
TI  - Effect of instructions on elementary cognitive tasks sensitive to individual
      differences.
AB  - The effect of instructions on basic cognitive tasks was investigated. In the
      first study, 60 college students completed both a choice reaction time and a
      modified match-to-sample task. Students were given either written, non-verbal, or
      no instructions. Mean level of performance changed across type of instruction for
      each task. The correlations between the task parameters and a measure of general
      intelligence also appeared to change across instructional conditions. A second
      study was conducted with 464 Air Force and National Guard recruits who completed
      choice reaction time, match-to-sample, tachistoscopic threshold, and probed
      recall tasks. Approximately half of these subjects received standard written
      instructions while the others received no instructions. Mean group differences
      were substantial but decreased with practice. Patterns of individual differences
      between the instruction and no-instruction conditions varied more with increased
      task complexity, with greater change occurring in more complex tasks such as
      probed recall. In sum, instructions have a significant impact on mean performance
      on basic cognitive tasks and a lesser effect on individual differences.

PMID- 2221195
TI  - Cultivating openness in the therapeutic relationship.

PMID- 2221196
TI  - The bipolar causality of regression.

PMID- 2221197
TI  - Culture and symptomatology--the role of personal meaning in diagnosis and
      treatment: a case study.

PMID- 2221198
TI  - The collective past, group psychology and personal narrative: shaping Jewish
      identity by memoirs of the Holocaust.
AB  - Through honing its collective memory, especially after the Holocaust, the Jewish
      community has attempted to sustain its culture, bolster the Jewish identity of
      its members, and regain a resolute sense that its narrative is again proceeding.
      To some degree, all these aims are realized by instilling in its members the
      Jewish modal character structure: a psychological configuration with two
      contrastable entities. One chronically discomposed self-structure, defining
      itself as polluted and helpless, trembles with the appalling imagery of
      historical and imminent community disasters. The other entity believes in its
      unmatched capacity for reparative, socially beneficial actions. The paradigm of
      this psychological organization is found in many children of survivors. The
      memory of a tragic history abides alongside the community's hopes in the Jewish
      modal personality. The need to set forth and accommodate these two motifs
      imprints upon the Jewish "national" character many of its distinctive qualities.
      The designs of the Jewish community for this particularly Jewish twofold
      personality formation are augmented by the personal revelations of survivors.
      Therefore, Holocaustic testimonies are invested with a sacred aura. In measure,
      these recitals of the disaster with their stark images, plus the clashing affects
      aroused in the reader toward main characters of the narrative, dictate the way
      Jews define themselves in the world and the way they live. A confluence of being
      covertly commissioned by the Jewish community joins with the narrators' more
      idiosyncratic longings. Together they generate a steady stream of Holocaustic
      accounts. Complementary vectors drive the reader to peruse these records. The
      results therefrom, intimate knowledge of the disaster, plus the twofold
      personality motifs stamp many Jews as scions of the Holocaust.

PMID- 2221199
TI  - Love and fellowship in the doctor-patient relationship in psychiatry.

PMID- 2221200
TI  - Abusive families and character formation.
AB  - Family research studies confirm that abusive parents tend to be undifferentiated
      partners who compete with each other and with their children for attention and
      nurturance. More or less healthy parents make demands on children to counteract
      their own injured narcissism, but they do so largely without devaluation and the
      sadistic use of projective identification. Under sufficient stress abusive
      parents attack the child who fails to gratify their needs, thereby giving vent to
      longstanding frustrations and feelings of being threatened by the child's
      individuation and competency. The emotional atmosphere in such families
      facilitates ego deficits like those of the borderline personality as it molds the
      child's efforts to avoid anxiety. Devaluation, loss, and defenses against
      mourning partially account for depression and paranoid traits in abused
      youngsters. Early neglect and abuse exposes them to influential models who act
      out rage and primitive defenses. Some abused individuals project their rage and
      later become paranoid or antisocial, whereas others fragment or retain infantile
      defenses. The destructiveness of severe psychological abuse lies in the
      constriction of the experiencing self and healthy character development, together
      with the conditioning to repeat abusive relationships and to avoid intimacy.
      Achieving individuation under these circumstances entails overcoming the
      internalized abusive relationships and relinquishing the unconscious wish to be
      transformed from the abused into the abuser.

PMID- 2221201
TI  - The single parent: power and the integrity of parenting.
AB  - I have explored some issues of power and the balance of power in the situation of
      the single parent and the family. The single parent may need the support of a
      holding environment to achieve psychological integration as exemplified by my
      treatment with Ms. B. Without a cooperative mate and with societal prejudice, the
      psychotherapeutic situation may be the only nurturing environment. The therapist
      empowers the single parent by providing a supportive, nurturing environment.
      Parenting is receiving bad press in this decade. More examples of child abuse and
      the extreme of homicide come to public attention. Children do have power and
      society needs to support a constructive use of child as well as parental power.
      At this stage in societal/cultural development the legal system is unfortunately
      more available to punish than provide lines of protection or guidance to parent
      or child. The psychoanalytic literature hasn't been kind or supportive to the
      parent. We must keep in mind that the psychotherapist's lot is simpler, less
      stressful, and more protected from real life stresses than that of the single
      parent. I suggest a model of parenting with the establishment of ongoing dialogue
      between parent and child in which each is receptive to the other. While it is the
      parental task to set limits and teach about the real world, the goal is to
      establish an exchange in which parent and child are both teacher and student.
      This creative relationship produces growth and builds esteem for parent and child
      alike.

PMID- 2221202
TI  - Was Freud really tone deaf? A brief commentary.

PMID- 2221203
TI  - Out of despair.

PMID- 2221204
TI  - The relationship between socioeconomic and sociopolitical forces and individual
      psychologic behavior in Central and Eastern Europe: a proposed international
      study.

PMID- 2221205
TI  - The psychotherapies in the context of new developments in the neurosciences and
      biological psychiatry.
AB  - We are in an era when the common denominators accounting for the major favorable
      effects of the different psychotherapies merit further clarification. At the same
      time, definite progress has been made in determining those specific
      psychotherapeutic techniques and methods that produce the desired results most
      efficiently with particular types of patients with specific types of problems.
      Continuing psychotherapy research will be required, and such research will need
      to be linked and co-ordinated with the new scientific progress being made in
      biological psychiatry and the neurosciences.

PMID- 2221206
TI  - Relationship between hypochondriasis and obsessive-compulsive personality
      disorder: close relatives separated by nosological schemes?
AB  - It has been proposed that the relationship between obsessive-compulsive
      personality disorder and hypochondriasis can basically be conceptualized along
      the severity continuum, so that hypochondriasis would be conceived of as a more
      pervasive and more incapacitating form of the same or closely related underlying
      psychopathology. Clinically, this relationship is manifested through emergence of
      hypochondriasis as a complication of the obsessive-compulsive personality
      disorder. The principal components of the psychopathology common to both
      disorders, are perception of excessive threat to oneself with the consequent
      experience of vulnerability and insecurity, mistrust in oneself and others,
      greatly increased need for control, inordinate search for security, poor
      tolerance and fear of uncertainty and ambiguity, and specific cognitive style,
      mainly developed to support a struggle for control. In view of the most striking
      phenomenological characteristic of both disorders being an excessive need for
      control, displayed in a repetitious manner, the essence of hypochondriasis and
      obsessive-compulsive personality disorder could be captured by the term "chronic
      disorders of the measure of control." The main phenomenological differences
      between hypochondriasis and obsessive-compulsive personality disorder have been
      interpreted as expressive of the lower and higher levels of intrapsychic
      integration respectively. In this regard, the manner in which the bodily self has
      been formed and the degree to which it has been incorporated into the self as a
      whole have been considered particularly important.

PMID- 2221207
TI  - Twelve cognitive errors about multiple personality disorder.
AB  - Multiple personality disorder (MPD) is often responded to with extreme skepticism
      by mental health professionals. This skepticism is based in part on twelve
      cognitive errors about the disorder that can be corrected by argument and
      research evidence. The errors include the mistaken ideas that MPD patients have
      more than one personality; that the diagnosis means such patients are not
      responsible for their actions; that MPD patients are really just borderlines;
      that MPD is an iatrogenic artifact; that MPD can be created experimentally; that
      MPD must be rare; that MPD is a therapeutic metaphor; that everyone has different
      personalities; that MPD will go away if you ignore it; that patients pretend to
      have MPD in order to please the therapist; that the abuse histories of MPD
      patients are confabulated; and that one must be a hypnotist to treat MPD. It is
      important to correct these cognitive errors because MPD is not rare. It can be
      diagnosed with good reliability and its features are stable and consistent in a
      number of large published series. Although definitive treatment-outcome studies
      have not been conducted, clinical experience to date suggests that the disorder
      can often be cured with psychotherapy. After successful integration, MPD patients
      function much better than before, and can be released from the mental health
      system.

PMID- 2221208
TI  - Covert multiple personality underlying eating disorders.
AB  - Frequently, MPD patients present themselves to the clinician with a variety of
      psychophysiological symptoms. Eating-disorder symptoms may be one of these, and
      may include the following: binge eating, self-induced vomiting, laxative abuse,
      excessive exercising, body image distortion, self-starvation, fluctuations in
      body weight, and nausea. Following are five cases in whom the pathological eating
      behavior was a manifestation of an underlying multiple personality disorder. The
      pathological eating behavior was so severe that some patients matched DSM-III-R
      diagnostic criteria for an eating disorder. Clinicians dealing with eating
      disorders should be aware that some patients may represent a subgroup in whom the
      underlying cause for the eating disorder may be MPD. These patients seldom
      respond to conventional treatment modalities used in eating-disorders programs,
      and only when the underlying multiplicity is identified and treated by a trained
      clinician, will the patient's eating-disorder symptoms improve.

PMID- 2221209
TI  - Supervising the therapy of patients with eating disorders.
AB  - Supervising residents, fellows, and interns conducting psychoanalytic
      psychotherapy with eating-disorder patients presents special problems and
      opportunities. The authors explore specific countertransference issues in the
      long-term therapy of patients with anorexia and bulimia, and describe how these
      issues in the therapy are often mirrored in the supervisory process.
      Countertransference phenomena include being secretive, intrusive, shaming,
      overcontrolling, overindulgent, or overidentified. Experiences associated with
      countertransference impasses include power struggles, despair, helplessness, and
      boredom. The wide range of transference and countertransference manifestations
      represents the difficult domain of long-term therapy with anorexic and bulimic
      patients, whose relationship with their eating symptom is so complex and
      ambivalent. Therapists in training benefit from a supervisory attitude of respect
      and empathy, with specific attention to countertransference difficulties as they
      arise. While unaddressed countertransference poses the risk of disrupting the
      supervision and/or the therapy, appropriate recognition and exploration of its
      meaning in the supervision is an especially valuable training tool in the
      teaching of psychodynamic psychotherapy, and a source of learning for the
      therapist in training, the supervisor, and ultimately the patient.

PMID- 2221210
TI  - Combat-related, chronic posttraumatic stress disorder: implications for group
      therapy intervention.
AB  - The patient with combat-related chronic Posttraumatic Stress Disorder suffers
      from a wide spectrum of maladaptive behaviors. This paper delineates the work
      that has been done with such a population in group therapy. The plan that is
      proposed takes into account three interrelated sets of factors: factors important
      for creating an effective working relation; curative factors; and particular
      themes. Each of these factors is analyzed in the light of the particularities of
      group work with such a population. Each of the points discussed is based upon the
      relevant literature, upon the experience of the therapist, and illustrated with
      examples.

PMID- 2221212
TI  - Relaxation and merging in the treatment of personality disorders.
AB  - A behavioral intervention specifically designed to merge split self
      representations was found helpful as an adjunct to the psychotherapy of
      personality-disordered patients. The method, which is introduced only after signs
      of split self-representation have been identified through exploratory
      psychotherapy, consists of a series of steps. Patients are first taught a
      relaxation technique and are asked to practice at home. Once they are able to
      relax in the session, they are asked for visual images of first one and then
      another of the conflicting self-representations. After clear images have been
      elicited and discussed, they are encouraged to merge them. Finally, they are
      asked "Who's watching" or some similar question designed to elicit a statement
      about a unified self. Twenty-four of 27 patients meeting criteria for personality
      disorders in Clusters B and C of DSM-III-R responded with greater compliance,
      reduced resistance, and improved relationships at work and elsewhere. Comparison
      is made to the merging intervention commonly used in the treatment of Multiple
      Personality Disorder.

PMID- 2221211
TI  - Hypnosis: placebo or nonplacebo?
AB  - According to Grunbaum's definition of placebo, a therapeutic procedure can be
      considered a nonplacebo if it can be demonstrated that its effects are produced
      according to the theory upon which the therapy is based. If the theory is adopted
      that hypnotic effects depend upon mobilization of the patient's hypnotizability,
      which is a measurable characteristic, a testable theory is provided. Experimental
      literature is reviewed that shows that placebo effects are not related to
      hypnotizability. Clinical outcome studies make it clear that results of
      hypnotherapy are related to hypnotizability in some disorders such as pain and
      anxiety, but not in the treatment of addiction or habit disorders. An example of
      a procedure is given in which hypnosis is nonetheless usefully applied for its
      placebo value as a method to generate positive expectancies.

PMID- 2221213
TI  - Splitting and projective identification among healthier individuals.
AB  - This paper illustrates splitting and projective identification among people with
      normal and neurotic personality organizations. Adding these concepts to the
      repertoire of analytically oriented psychotherapists does not replace previous
      theories but adds to them. This approach can be integrated with drive theory and
      ego psychology in practice, or can be used to supplement the approaches of
      cognitive or interpersonal therapists. Not only borderline patients, but all of
      us, continually need to define and re-define ourselves in relation to others as
      we grow and change. The concepts of splitting and projective identification can
      help when that growth process becomes stymied.

PMID- 2221214
TI  - Treating those who fail to take themselves seriously: pathological aspects of
      humor.
AB  - A method of analyzing humor was presented. Patients are first made aware of their
      "being amused" by bringing their smiling and laughing to their attention. They
      can be then be led to see that their external life situation has predisposed them
      to experience an intrapsychic event--the spontaneous emergence of antithetical
      ideation into consciousness which has, in turn, given rise to three beliefs: (1)
      the ir-responsibility, (2) the incongruity, and (3) the inconsequentiality of the
      production and nature of this ideation. Two patients were presented to illustrate
      how foreknowledge of the three beliefs could aid the therapist in working through
      what might otherwise have been intractable pathology. The author is, generally,
      in favor of a more relaxed attitude about the use of humor and nonverbal
      expressive behavior in general, but urges that this material be integrated within
      the framework of a structured cognitive approach.

PMID- 2221215
TI  - Adult agoraphobia and childhood separation anxiety: using children's literature
      to understand the link.
AB  - Separation-anxiety stories are frequent in children's literature and have eight
      characteristic elements. Peter Rabbit is used as an early and very simple
      example. A case study follows which illustrates the fear of separating from the
      family in an adult agoraphobic. The Wizard of Oz is presented as a more expanded
      version of a separation-anxiety story. A case study follows which illustrates a
      woman's difficulty with maturity and separation. A review of the literature is
      made in which studies are cited which indicate a history of childhood-separation
      problems in adult agoraphobics. Studies also show that panic disorder in these
      patients is often precipitated by losses and separations. Studies also show that
      agoraphobics may have poor problem-solving skills. Children's stories may serve
      as a guide to children toward mastery of separation fear. A case study follows of
      a man who developed a panic disorder while watching E.T. E.T. is presented as a
      separation-anxiety story for the late 1900s. The paper concludes with a brief
      review of children's separation-anxiety stories and how they reflect broad
      cultural changes.

PMID- 2221216
TI  - Mortality and infertility in adult mosquitoes after the ingestion of blood
      containing ivermectin.
AB  - Mosquitoes of 3 species (Aedes aegypti, Ae. albopictus, and Culex
      quinquefasciatus) were fed on human blood containing various concentrations of
      ivermectin. Three effects (death, decreased egg production, and reduced egg
      hatching) were observed in the insects, depending upon the concentration of
      ivermectin ingested. The LD50 of ivermectin in human blood for the 3 mosquito
      species was estimated to be 126, 208, and 698 ng/ml, respectively. Mosquitoes
      dying after ingestion of ivermectin developed signs of acute toxicity including
      paralysis, lethargy, incoordination, and difficulty in movement. Death usually
      occurred within 48-72 hr. With sublethal blood concentrations of the chemical,
      mosquitoes survived, but there was a marked reduction in both the number and
      viability of their eggs. This infertility was only temporary, however, as
      subsequent refeeding of the insects on uncontaminated blood resulted in the
      production of normal numbers of fertile eggs. Blood levels of ivermectin which
      made 50% of the eggs infertile in Ae. aegypti and Ae. albopictus were calculated
      3.4 and 4.3 ng/ml, respectively. These latter concentrations of the chemical are
      within the range found in blood of humans and domestic animals receiving
      ivermectin for treatment of parasitic infections. This finding suggests that the
      widespread use of ivermectin in veterinary and human medicine may have an
      unrecognized effect on mosquito populations.

PMID- 2221217
TI  - Humoral and cell-mediated immune responses to the Plasmodium falciparum antigens
      PF155/RESA and CS protein: seasonal variations in a population recently reexposed
      to endemic malaria.
AB  - Resurgence of falciparum malaria occurred in the Central Highlands of Madagascar
      in the 1980s and the disease is currently hyperendemic. We determined the humoral
      and cellular responses to synthetic peptides reproducing the repeat sequences of
      2 major Plasmodium falciparum antigens: the Pf155/RESA and the circumsporozoite
      (CS) protein. Blood samples from 83 subjects living in a rural community near
      Antananarivo were obtained at the beginning and the end of the transmission
      season. At enrollment, 40 subjects presenting with and 43 without blood parasites
      had similar T cell proliferative response and antibody level to all antigens
      tested. However, P. falciparum-infected individuals exhibited a decrease in the
      absolute number of T lymphocytes, due to a diminished number of CD8+ and natural
      killer lymphocytes. The number of CD4+ cells was similar in both groups. In the
      overall population, 45% of subjects had a T cell response to at least 1 RESA
      peptide (29-35% responding to a given peptide) and 35% to the CS protein peptide.
      Thirty-two percent of the donors presented with RESA antibodies and 23% had CS
      protein antibodies. After 20 weeks, at the end of the transmission season,
      cellular proliferative responses to all antigens markedly decreased as evidenced
      by a decrease of both the number of responders and mean stimulation indexes.
      Humoral response to RESA, as detected by erythrocyte membrane immunofluorescence
      (number of responders and mean antibody titers) markedly increased. Humoral
      responses to the CS protein and RESA peptides were similar.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2221218
TI  - In vitro growth inhibition of Plasmodium falciparum by sera from different
      regions of the Philippines.
AB  - Sera from different malaria endemic regions of the Republic of the Philippines
      were compared for their ability to inhibit growth of Plasmodium falciparum in
      vitro. Dialyzed serum was added to synchronous cultures containing schizonts for
      either the total 48 hr test period or only the last 24 hr in order to analyze the
      effects on erythrocytic invasion and intraerythrocytic growth, respectively.
      Reduction in 3H-hypoxanthine uptake was used to determine the percent of
      inhibition compared to nonimmune serum. One hundred seventy sera from Mindanao
      and Palawan in the South, the centrally located island of Mindoro, and Luzon in
      the North, were tested against 4 P. falciparum strains from the Philippines and 1
      from Africa. Indirect fluorescent antibody titers were not predictive of
      inhibition. Inhibition of merozoite invasion rather than intraerythrocytic
      parasite growth is suggested by this study. Generally, sera were more inhibitory
      to parasite strains from the same geographical area than to those from more
      remote areas.

PMID- 2221219
TI  - Endemic Cryptosporidium and Giardia lamblia infections in a Thai orphanage.
AB  - We conducted a point prevalence survey for enteric protozoa in 205
      institutionalized orphans 1-61 months of age in Bangkok, Thailand.
      Cryptosporidium was identified in 17 children (8%), Giardia lamblia in 42 (20%),
      and 3 children (1%) had both parasites. At the time of diagnosis, diarrheal
      symptoms were present in a minority of subjects: 36% of children with
      Cryptosporidium alone, 10% with G. lamblia alone, and in 20% of those with
      neither parasite. Although chronic nutritional status (height/age) was similar in
      all groups, acute nutritional status (weight/height) was lower only in children
      with Cryptosporidium (Z score = -1.39 +/- 0.13) compared with children with G.
      lamblia (mean Z score +/- SEM = -0.56 +/- 0.26) or neither parasite (Z score = 
      0.78 +/- 0.13; P = 0.05). Detectable levels of Cryptosporidium-specific IgG
      antibodies by ELISA were identified in 15 of 16 Thai children with
      Cryptosporidium and in 17 of 19 Thai children without Cryptosporidium (mean OD +/
      SEM = 1.27 +/- 0.18 vs. 1.06 +/- 0.13, respectively), but in only 1 of 18 sera
      from toddlers in day-care centers in Denver, CO (OD = 0.128 +/- 0.03). Although
      neither infection with Cryptosporidium nor G. lamblia was consistently associated
      with acute diarrheal symptoms, Cryptosporidium was more often associated with
      depressed acute nutritional status than G. lamblia. The high prevalence of
      specific antibodies to Cryptosporidium in Thai orphans suggests an association
      between high rates of exposure with asymptomatic excretion of the parasites.

PMID- 2221220
TI  - Comparison of active and passive case detection of cutaneous leishmaniasis in
      Guatemala.
AB  - To estimate the degree to which passive case detection underestimates the true
      incidence of cutaneous leishmaniasis in Guatemala, we compared data from the
      passive surveillance system of the Guatemalan Ministry of Health with a cross
      sectional population-based survey of cutaneous leishmaniasis in Guatemala. Of the
      2,938 persons interviewed, 143 (5%) reported having had cutaneous leishmaniasis
      at some time in the past, 37 (1.3%) reported the onset of infection in the 12
      months before the survey, 31 (1.1%) had active infections, and 16 (0.5%) had
      parasitologically confirmed infections. Calculated on the basis of these reports
      and the estimated population of the endemic area, the total number of new cases
      in the leishmaniasis-endemic area in the 12 months before the survey was
      approximately 2,574; during the same 12 month period, Ministry of Health data
      based on passive surveillance listed 64 cases of cutaneous leishmaniasis. In
      Guatemala, incidence estimates based on passive surveillance may underestimate
      the occurrence of cutaneous leishmaniasis by as much as a factor of 40.

PMID- 2221221
TI  - Diffuse cutaneous leishmaniasis acquired in Peru.
AB  - A case of diffuse cutaneous leishmaniasis (DCL) acquired in Peru is described.
      The causative agent was Leishmania mexicana amazonensis as determined by
      isoenzyme analysis and species-specific monoclonal antibody binding
      characteristics. Histological examination of biopsy material showed a large
      number of intracellular and extracellular amastigotes and few lymphocytes.
      Treatment with meglumine antimoniate (Glucantime) administered iv at a dosage of
      20 mg antimony/kg body weight/day for 60 days resulted in visible improvement of
      the lesions, but not in clinical or parasitological cure.

PMID- 2221222
TI  - Host immunoglobulin on spleen-derived Leishmania donovani amastigotes.
AB  - Leishmania donovani, an intracellular pathogen in vertebrates, is found as an
      amastigote within cells of reticuloendothelial origin. The spleens of
      experimentally infected Syrian hamsters are frequently used as a source of
      amastigotes for studies of host-parasite interactions, but amastigotes isolated
      from hamster spleens have been found to have surface-bound host immunoglobulins,
      which may confound interpretation of such studies.

PMID- 2221223
TI  - A comparison of host responses of the Mongolian jird to infections of Brugia
      malayi and B. pahangi.
AB  - Host responses of jirds receiving a single subcutaneous inoculation of
      subperiodic Brugia malayi were compared with those of jirds similarly infected
      with B. pahangi. Parasite burdens, lymphatic lesion severity, granulomatous
      reactivity, antibody responses to parasite antigens, and complete blood cell
      counts were assessed at 60 and 150 days post-inoculation. At 60 days post
      inoculation, percentages of adults recovered at necropsy and lymphatic lesion
      severity were greater in B. pahangi-infected jirds. At 150 days post-inoculation,
      lesion severity and percentages of worms recovered were similar in both
      infections. No significant differences were noted in either infection in
      reactivity to homologous or heterologous parasite antigens in any parameter
      measured. Similarities in the kinetics of the inflammatory reactivities of the 2
      infections suggest that previous observations made in the jird-B. pahangi model
      could be utilized in designing studies using B. malayi. Further, the more marked
      lesion severity observed in B. pahangi-infected jirds and the relative ease of
      maintaining B. pahangi in the laboratory support the continued use of this system
      as a conceptual model for the study of lymphatic lesion pathogenesis.

PMID- 2221224
TI  - Transmission indices of Loa loa in the Chaillu Mountains, Congo.
AB  - A longitudinal entomological survey of the vectors of loiasis was conducted in
      the Missama area (Lekoumou region) in the Congo from September 1987 to August
      1989. The principal catching site was a palm grove surrounded by forest 3 km from
      the village. Landing/biting densities of Chrysops were measured by standardized
      fly catches lasting 11 hr carried out twice a month. Vector landing densities
      were also assessed in the Bantu and Pygmy villages and in the fields. Populations
      of Chrysops from the palm grove were examined 6 times a month for infection with
      the infective stage of Loa loa. Chrysops silacea was the predominate vector
      except at the beginning of the rainy season, when C. dimidiata was the prevailing
      species. Chrysops were caught throughout rainy season, from October to June. The
      host-seeking activity of C. silacea was greatest in the middle of this season
      (February), but occurred sooner (October) for C. dimidiata. The following
      variables associated with transmission were calculated from our observations in
      the palm grove (the first figure corresponds to the first year of the study and
      the figure in parentheses corresponds to the second year). It was calculated that
      2.658 (2.185) C. silacea and 1.412 (1.182) C. dimidiata could bite a person in
      the palm grove per year, including an average of 14.4 (12.7) infective C. silacea
      and 9.8 (7.2) infective C. dimidiata. The percentage of all dissected flies with
      third stage larvae in the head and the mean number of larvae in the
      head/infective fly were 0.57% and 10.1 +/- 6.8 for C. silacea and 0.66% and 11.2
      +/- 6.5 for C. dimidiata, respectively. The estimated annual transmission
      potentials were 171.1 (102.9) for C. silacea and 116.1 (73.8) for C. dimidiata.
      In the palm grove, transmission was ensured by 2 effective vectors during the
      rainy season (October to May). Although the annual biting rate for both species
      was twice as low in the village as in the forest, our data suggest that effective
      transmission occurs there also.

PMID- 2221225
TI  - Variation among strains of Aedes aegypti in susceptibility to oral infection with
      dengue virus type 2.
AB  - We compared 18 Aedes aegypti strains for oral susceptibility to dengue virus type
      2 (DEN-2) using a feeding protocol in which all parameters remained constant,
      including the titer of the infectious bloodmeal. For most strains, no significant
      variation between replicates was observed. Comparisons between pairs of strains
      showed variation of different degrees, and allowed us to characterize the strains
      with respect to their oral susceptibility to DEN-2.

PMID- 2221227
TI  - Head and neck surgery: ruminations.

PMID- 2221226
TI  - Isolation of Tete serogroup bunyaviruses from Ceratopogonidae collected in
      Colorado.
AB  - Two viruses were isolated from ceratopogonid midges collected in northern
      Colorado. Electron microscopy indicated that both isolates were bunyavirus-like.
      Indirect fluorescent antibody and serum dilution-plaque reduction neutralization
      tests showed that these isolates were members of the Tete serogroup, most closely
      related antigenically to Tete and Batama viruses but distinguishable from both
      and from each other. We suggest the name Weldona virus for these isolates.
      Antibody in both waterfowl and passerine birds in northern Colorado indicates the
      enzootic presence of these viruses in northern Colorado and raises unanswered
      questions about the introduction and establishment of Tete serogroup viruses in
      the Americas.

PMID- 2221228
TI  - Hayes Martin lecture. Reflections of a cancer observer.

PMID- 2221229
TI  - Initial failure of surgical exploration in patients with primary
      hyperparathyroidism.
AB  - To determine the causes of failures of cervical exploration for primary
      hyperparathyroidism, we reviewed 892 patients operated on by one surgeon from
      1953 to 1990. Twenty-seven patients (3%) remained hypercalcemic or developed
      hypercalcemia within 6 months of surgery. Of these, five patients had one adenoma
      removed initially; at reoperation, three patients had a second adenoma that was
      successfully removed, whereas the other two patients had hyperplasia and required
      subtotal parathyroidectomies. No enlarged parathyroid glands were identified in
      22 patients. Eventually, six patients became normocalcemic spontaneously, seven
      patients underwent re-exploration with a successful outcome in all but one case,
      two patients had ectopic hyperparathyroidism associated with carcinoma elsewhere,
      and seven patients refused reoperation and remain hypercalcemic. The failure rate
      of surgical exploration for primary hyperparathyroidism can be reduced by
      systematically exploring all four parathyroid glands. All abnormal parathyroids
      should be removed with histologic verification. When no abnormal glands are
      found, localization studies should be performed before re-exploration.

PMID- 2221230
TI  - Results of surgical treatment for hyperparathyroidism associated with renal
      disease.
AB  - Recently, the role and timing of surgery for treating secondary and tertiary
      hyperparathyroidism (HPT) have been questioned. In order to delineate the
      indications for surgery in these patients, a retrospective analysis of 53
      consecutive patients treated with parathyroidectomy was conducted. Subtotal
      thyroidectomy was done in 37 of 45 patients undergoing their initial operations
      for HPT. Eight additional patients were referred after failed operations. Of 33
      patients with preoperative bone pain, 70% improved. Joint pain improved in 87% of
      30 patients, pruritus improved in 81% of 27 patients, and preoperative malaise
      improved in 73% of 33 patients after parathyroidectomy. Abdominal pain and
      irritated eyes were unlikely to improve. The best predictors of a successful
      outcome were a markedly elevated preoperative immunoreactive parathyroid hormone
      (mid-region) level and an elevated alkaline phosphatase level. There were no
      perioperative deaths. One patient (1.6%) had a recurrent laryngeal nerve injury,
      and one patient required reoperation for a neck hematoma. No patient had
      permanent hypoparathyroidism, but transient hypocalcemia (less than 7 mg/dL)
      occurred in 22%. Postoperative hypocalcemia correlated with elevated preoperative
      alkaline phosphatase levels (r2 = 0.247).

PMID- 2221231
TI  - Lymph node metastasis from papillary-follicular thyroid carcinoma in young
      patients.
AB  - A total of 117 patients under 20 years of age with papillary and/or follicular
      thyroid cancer presented to the M. D. Anderson Cancer Center between 1949 and
      1987. The most common presenting symptom was a cervical mass. Twenty percent of
      the patients had a history of prior irradiation. Sixty percent initially had
      palpable lymph nodes, while 26% who had clinically negative examinations had
      pathologically positive lymph nodes. Recurrence was highest in regional lymph
      nodes at 24%, with only a 4% recurrence rate at the primary site and a 3%
      recurrence rate at distant sites. There were no deaths due to the thyroid cancer.
      To maintain a low rate of recurrence, near-total thyroidectomy with neck
      dissection followed by iodine 131 treatment should be considered in these young
      patients.

PMID- 2221232
TI  - Survival discriminants for differentiated thyroid cancer.
AB  - Since 1975, the American Cancer Society, Illinois Division, has published end
      results of major cancer sites drawn from patient data contributed voluntarily by
      hospital cancer registries throughout the state. The current study was
      undertaken, in part, to apprehend information regarding contested areas in the
      management of patients having differentiated (papillary/follicular) thyroid
      cancer. A total of 2,282 patients with either papillary or follicular carcinoma
      of the thyroid from 76 different Illinois hospitals and providing 10 years of
      follow-up information (life-table analysis) were retrospectively analyzed for
      demographic, disease, and treatment-related predictors of survival. Multivariate
      analysis using the Cox proportional hazards method was made for stage, age, race,
      sex, morphology, history of radiation exposure, presence of positive lymph nodes,
      initial surgical treatment, postoperative iodine 131 therapy, and
      replacement/suppressive thyroid hormone treatment. Statistically significant (p
      less than or equal to 0.05) predictors of favorable survival after thyroid cancer
      were low stage (I and II), young age (less than 50 years), white race, female
      sex, and the administration, postoperatively, of either thyroid hormone or
      radioactive iodine. Factors that had no influence on survival were lymph node
      status, choice of initial surgical treatment, and a history of prior irradiation.
      We suggest that where a prospective clinical trial is impracticable, a
      retrospective analysis of a large and detailed database, such as that available
      from cooperating hospital-based tumor registries, may yet provide useful insights
      to solutions of cancer management problems.

PMID- 2221233
TI  - Long-term effects of radiotherapy in childhood and adolescence.
AB  - The records of 50 selected pediatric patients who were treated and followed at M.
      D. Anderson Cancer Center were reviewed to study the late effects of nonsurgical
      treatment of cancer in children. There were 26 girls and 24 boys ranging in age
      between 2 months and 16 years. Patients with head and neck cancer received
      chemotherapy and radiotherapy for rhabdomyosarcoma (n = 27), retinoblastoma (n =
      8), or nasopharynx cancer (n = 2). Median follow-up was 13 years. The most severe
      side effects were noted in the fields of radiation and included hypoplasia of the
      jaw, orbit, or hemi-face with varying degrees of atrophy of the overlying soft
      tissues. A wide range of endocrine, dental, and psychologic abnormalities was
      also documented. Since 1 in every 1,000 adults older than 20 years today is
      likely to be a survivor of childhood cancer, recommendations are made for this
      "new" class of patients whom the head and neck surgeon will be seeing in the
      future.

PMID- 2221234
TI  - Complications of the pectoralis major myocutaneous flap in head and neck
      reconstruction.
AB  - A retrospective review of the complications in 211 patients undergoing pectoralis
      major myocutaneous flap reconstruction is presented. The flap was used for
      mucosal lining of the oral cavity or oropharynx in 109 patients, for
      pharyngoesophageal reconstruction in 44, for skin coverage in 47, and for other
      locations in 14 patients. Flap-related complications developed in 63% of the
      patients. These included flap necrosis, suture line dehiscence, fistula
      formation, infection, and hematoma. Analysis of risk factors for the development
      of flap complications showed the following factors to be significant: age over
      70; female gender; nomographic overweight; albumin less than 4 g/dL; use of the
      flap in reconstruction of the oral cavity after major glossectomy; and presence
      of other systemic diseases. The median length of hospitalization for those
      developing complications was 33 days compared with 16 days for those who did not
      develop any complications. Thirty-five (26%) of the 135 patients developing
      complications required reoperation and only 2 among these required a second flap.
      Similarly, only 13 of the 61 patients who developed fistulas required surgical
      closure.

PMID- 2221235
TI  - Soft tissue sarcomas of the head and neck in adults.
AB  - We reviewed the clinical records and pathologic material of 176 adults with
      primary soft tissue sarcomas treated at Memorial Sloan-Kettering Cancer Center
      between 1950 and 1985. Seventy-two patients (41%) had low-grade sarcomas and 104
      (59%) had high-grade sarcomas. All but 18 patients underwent some form of
      excision as initial therapy. Adjuvant radiotherapy and chemotherapy combined with
      surgical excision showed no significant effect. A significantly increased risk of
      treatment failure was associated with large tumor size, positive surgical
      margins, bone involvement, local recurrence, metastatic spread, and high
      histologic grade. Except for recurrence, the p value by univariate analysis in
      the log-rank test for comparison of survival according to these clinical and
      pathologic characteristics was p less than 0.0001. Although the overall survival
      was 75% at 2 years, 55% at 5 years, and 46% at 10 years, only 20% of the patients
      with high-grade sarcomas were alive 10 years after treatment. Most patients with
      rhabdomyosarcoma, high-grade peripheral nerve tumor, and high-grade fibrous
      histiocytoma and all patients with high-grade angiosarcoma died of disease less
      than 5 years after diagnosis. New therapeutic strategies are needed to improve
      the survival of adult patients with high-grade soft tissue sarcomas of the head
      and neck.

PMID- 2221236
TI  - Multimodality preoperative treatment for advanced stage IV (MO) cancer of the
      head and neck.
AB  - Sixty-three patients with advanced unresectable squamous cell carcinoma of the
      head and neck were treated with a combination of chemotherapy, radiation, and
      surgery. We observed a 75% response to neoadjuvant chemotherapy. The 5-year
      survival rate for all 63 patients was 20%, and only 3 patients were alive at 8
      years. The 5-year survival rate for patients who completed the treatment plan and
      received chemotherapy, radiation, and surgery was 43% compared with 20% for those
      who had chemotherapy and radiation but refused surgery. Development of a second
      primary cancer was the cause of death in 62% of the patients who survived more
      than 24 months.

PMID- 2221237
TI  - Needle aspiration biopsy in salivary gland lesions.
AB  - The value of needle aspiration biopsy in the evaluation and management of
      salivary gland pathology is controversial. The major reasons for this controversy
      are the difficulty in cytologic evaluation and the fact that the extent of
      surgery can be easily defined based on clinical judgement. However, a
      preoperative diagnosis is helpful in discussions with patients regarding the
      extent and type of surgery. Apart from the fact that needle biopsy can
      distinguish benign from malignant conditions, it is also very useful in
      distinguishing between salivary and other nonsalivary pathology. Over the past 7
      1/2 years, we have performed 160 needle aspirations of parotid, submandibular,
      and submucosal lesions. Adequate specimens for cytologic evaluation were obtained
      in 155 patients (97%). A total of 84 parotid lesions, 70 submandibular lumps, and
      6 submucosal abnormalities were detected. A cytologic diagnosis of benign
      pathology was made in 120 patients. Twelve patients had lymphoma and the
      diagnosis was suspected based on needle aspiration. There were 10 patients with
      tuberculosis and 30 patients with hyperplastic lymph nodes or benign
      lymphoepithelial disease of the parotid. There were three false-positive and two
      false-negative reports. No complications such as hematoma, nerve injury, or
      infection developed. The major difficulty was in distinguishing between
      malignancy and obstructive sialadenitis in the submandibular region. Needle
      aspiration was helpful in evaluating lesions in the tail of the parotid and
      submandibular area. The cytologic distinction between salivary and nonsalivary
      pathology was useful in planning the appropriate surgery and the extent of
      surgical resection. From a clinical standpoint, the distinction between benign
      and malignant salivary and nonsalivary pathology was very helpful. Preoperative
      diagnosis of Warthin's tumor, lymphoma, or benign lymphoepithelial disease was
      essential to the correct management of these patients.

PMID- 2221238
TI  - Early facial reanimation following radical parotid and temporal bone tumor
      resections.
AB  - A retrospective study of 35 patients who underwent early facial reanimation
      following extirpative parotid and temporal bone surgery requiring facial nerve
      sacrifice was performed. Regional facial reanimation performed immediately or
      within several days included 16 patients who underwent temporalis muscle
      transposition and 27 who underwent gold weight or eyespring lid reanimation with
      lower lid tightening. Simultaneous nerve grafts or nerve crossover procedures
      were performed in 22 patients. The authors' favored approaches to facial
      reanimation are discussed, with an emphasis on the value of early reanimation
      using properly selected techniques.

PMID- 2221239
TI  - Definitive mandibular replacement using reconstruction plates.
AB  - Mandibular defects following radical cancer surgery continue to provide
      challenges to head and neck surgeons. Twenty-seven patients with advanced oral
      cancer underwent primary mandibular replacement with metal reconstruction plates
      without the use of bone. Twenty-one patients (78%) had successful reconstruction
      with primary soft tissue healing. Six patients required removal of the plate in
      the postoperative period. Two of these patients had their reconstruction plates
      replaced as a secondary procedure following soft tissue healing. Thus, 23 of 27
      patients (85%) had final mandibular reconstruction and were followed for an
      average of 19 months. Functional and cosmetic results were satisfactory. For
      patients with advanced disease, this technique compares favorably with
      microvascular transfer in terms of operating time and donor defect. Despite
      problems with plate exposure, the initial and overall success rates of 78% and
      85%, respectively, make the use of these plates a reasonable choice for immediate
      reconstructive needs in patients with difficult tumors.

PMID- 2221240
TI  - Mandibular reconstruction with composite microvascular tissue transfer.
AB  - Microvascular free tissue transfer has provided a variety of methods of restoring
      vascularized bone and soft tissue to difficult defects created by tumor resection
      and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular
      reconstruction, 15 for primary squamous cell carcinoma of the floor of the mouth
      or tongue, 7 for recurrent tumor, and 6 for other reasons [lymphangioma (1),
      infection (1), gunshot wound (1), and osteoradionecrosis (3)]. Primary
      reconstruction was performed in 19 cases and secondary in 9. All repairs were
      composite flaps including 12 scapula, 5 radial forearm, 3 fibula, 2 serratus, and
      6 deep circumflex iliac artery. Mandibular defects included the symphysis alone
      (7), symphysis and body (5), symphysis-body-ramus condyle (2), body or ramus
      (13), and bilateral body (1). Fourteen patients had received prior radiotherapy
      to adjuvant or curative doses. Eight received postoperative radiotherapy. All
      patients had initially successful vascularized reconstruction by clinical
      examination (28) and positive radionuclide scan (22 of 22). Bony stability was
      achieved in 25 of 26 patients and oral continence in 24 of 26. One complete flap
      loss occurred at 14 days. Complications of some degree developed in 22 patients
      including partial skin necrosis (3), orocutaneous fistula (3), plate exposure
      (1), donor site infection (3), fracture of reconstruction (1), and fracture of
      the radius (1). Microvascular transfer of bone and soft tissue allows a reliable
      reconstruction--despite previous radiotherapy, infection, foreign body, or
      surgery--in almost every situation in which mandible and soft tissue are absent.
      Bony union, a healed wound, and reasonable function and appearance are likely
      despite early fistula, skin loss, or metal plate or bone exposure.

PMID- 2221241
TI  - Reconstruction of mandibular defects in irradiated patients.
AB  - In this prospective study, mandibular reconstruction using titanium plates was
      evaluated in 31 patients treated between July 1988 and January 1990. Sixteen
      patients had prior surgery; 13 had prior radiotherapy. In 11 patients, prior
      radiation and surgery had failed. Sixteen patients received postoperative
      radiotherapy either in standard or accelerated fractions. Twelve patients had
      complications of either intraoral (8), extraoral (5), or combined (1) plate
      exposure or fistula formation (2). Factors significantly related to complications
      were poor nutrition, accelerated radiation, and recurrence. Sixty-one percent of
      all patients healed uneventfully. When patients with complications secondary to
      recurrence who subsequently died were excluded, the success rate was 73%. Only
      one patient had an unacceptable result that produced a cosmetic and functional
      deformity despite secondary repair.

PMID- 2221242
TI  - Long-term fate of the vascularized iliac crest bone graft for mandibular
      reconstruction.
AB  - Vascularized bone grafts, such as the iliac crest, have become a major tool for
      mandibular reconstruction. Due to the growing trend toward immediate bone
      replacement followed by implant osseointegration and dental rehabilitation,
      further understanding of the long-term characteristics of these grafts is
      essential. Early postoperative bone scans demonstrate increased activity within
      the vascularized graft relative to surrounding bone. This study addressed the use
      of bone SPECT (single photon emission computed tomography) scintigraphy as a long
      term method of evaluating the integrity of vascularized bone grafts.

PMID- 2221243
TI  - Sequential connection of flaps: a logical approach to customized mandibular
      reconstruction.
AB  - Microsurgery has improved the success rate for reconstruction of composite
      defects in the head and neck. Restoration of mandibular continuity alone is not
      adequate for reconstruction. Replacement of the oral lining with thin tissue is
      necessary to improve tongue mobility and to set the stage for later dental
      restoration. There is currently no ideal osteocutaneous free flap that provides
      unlimited length of bone, can undergo multiple osteotomies to produce the proper
      curve to the reconstructed mandible, and provides thin skin for oral lining.
      Combining free flaps can take advantage of the strengths of the individual donor
      sites and eliminate some of the problems with current osteocutaneous flaps. In
      six patients, a fibular osseous free flap was combined with either a radial
      forearm flap or a lateral arm flap to provide bone and oral lining in
      reconstruction of mandibular composite defects. In these selected patients, the
      fibula provided the blood supply for the second free flap, which was placed
      sequentially. The distal peroneal vessels were used to anastomose to the radial
      forearm vessels or the lateral arm pedicle. This approach allows the surgeon to
      customize the defect by improving both the functional and aesthetic aspects of
      reconstruction and is of use in cases where vascular access is limited, such as
      following head and neck surgery and radiation.

PMID- 2221244
TI  - Patterns of cervical lymph node metastasis from squamous carcinomas of the upper
      aerodigestive tract.
AB  - A consecutive series of 1,081 previously untreated patients undergoing 1,119
      radical neck dissections (RNDs) for squamous carcinoma of the head and neck was
      reviewed to study the patterns of nodal metastases. Primary tumors were located
      in the oral cavity in 501 patients, in the oropharynx in 207 patients, in the
      hypopharynx in 126 patients, and in the larynx in 247 patients. Lymph node
      metastases were confirmed histologically in 82% of 776 therapeutic neck
      dissections, and micrometastases were discovered in 33% of 343 elective RNDs.
      Lymph node groups in the neck were described by levels (I to V). Predominance of
      certain levels was seen for each primary site. Levels I, II, and III were at
      highest risk for metastasis from cancer of the oral cavity, and levels II, III,
      and IV were at highest risk for metastasis from carcinomas of the oropharynx,
      hypopharynx, and larynx. Supramohyoid neck dissection (clearing levels I, II, and
      III) for NO patients with primary squamous cell carcinomas of the oral cavity and
      anterolateral neck dissection (clearing levels II, III, and IV) for NO patients
      with primary squamous cell carcinomas of the oropharynx, hypopharynx, and larynx
      are recommended.

PMID- 2221245
TI  - Significance of positive margins in oral cavity squamous carcinoma.
AB  - Three hundred ninety-eight consecutive, previously untreated patients undergoing
      surgery for epidermoid carcinoma of the oral cavity from 1979 to 1983 were
      reviewed. One hundred twenty-nine patients were classified as having positive
      surgical margins. Of these, 83 patients had tumor within 0.5 mm of the surgical
      margin, 9 had premalignant changes at the margin, 9 had in situ carcinoma at the
      margin, and 28 had invasive cancer at the margin. The remaining 269 patients had
      uninvolved margins. The significance of positive margins relating to survival,
      subsequent clinical course, local recurrence, and patterns of treatment failure
      was examined, along with the impact of adjuvant postoperative radiotherapy on
      positive margins. The percentage of patients having positive margins
      progressively increased with increasing T stage: 21% in T1 versus 55% in T4
      primary cancer. The overall 5-year survival for patients with negative margins
      was 60%. For patients with positive margins, 5-year survival was 52%. This
      difference was statistically significant. The incidence of local recurrence in
      patients having positive surgical margins was twice as much as in those with
      negative margins (36% versus 18%). Metastasis rates in the neck and at distant
      sites were not significantly influenced by the status of the surgical margin. Of
      the 129 patients with positive margins, 49 received postoperative radiotherapy.
      In those patients so treated, a trend toward lower recurrence rates was noted.
      Differences were not statistically significant. This retrospective review
      confirms the importance of adequate resection of the primary tumor as well as the
      relative ineffectiveness of adjuvant postoperative radiotherapy in the
      improvement of local control in patients with positive surgical margins.

PMID- 2221246
TI  - Treatment selection for carcinoma of the base of the tongue.
AB  - Between 1974 and 1984, 173 patients were treated for squamous cell carcinoma of
      the tongue base. Fifty-four patients had T1 or T2 primaries, while 115 patients
      had T3 or T4 tumors (4 were not staged). Lymph node metastasis was present in 120
      patients. Early primary tumors treated with surgery or radiotherapy had a control
      rate of 83% (5 of 6 tumors) and 89% (40 of 45 tumors), respectively. For advanced
      primary tumors, definitive radiotherapy produced a local control rate of 55% (42
      of 76 tumors), compared with 79% (23 of 29 tumors) for surgery and postoperative
      radiotherapy. If primary control was obtained, the regional failure rate was less
      than 10%. Tumor growth patterns were predictive of the response to radiotherapy.
      The primary control rate at 2 years for 21 patients with exophytic tumors was 84%
      as opposed to 58% for 62 patients with ulcerative-infiltrative tumors (p = 0.04).
      Radiotherapy is effective for early stage or exophytic tumors, whereas for
      advanced or deeply invasive tumors combined therapy enhances local control.

PMID- 2221248
TI  - Flow cytometric evaluation of chemosensitive and chemoresistant head and neck
      tumors.
AB  - For patients with head and neck squamous carcinoma, a clinical response to
      induction chemotherapy has correlated with a survival advantage. Similarly,
      patients with diploid tumors have displayed a survival advantage when compared
      with patients with aneuploid tumors. This study examined DNA content in 33
      patients who had undergone induction chemotherapy as part of two clinical
      protocols to determine if there was a correlation between the patients with
      diploid tumors and the patients with a clinical response to chemotherapy.
      Although patients with stage III tumors had a longer disease-free survival than
      stage IV patients (p less than 0.0002), the addition of DNA content information
      did not improve the ability to predict response. Specifically, there was no
      correlation between DNA content and the response to chemotherapy. In addition,
      for this group of patients, a diploid DNA content was not correlated with a
      survival advantage. We conclude that DNA content information did not add
      significantly to the prediction of clinical outcome in these patients who
      received induction chemotherapy.

PMID- 2221247
TI  - Squamous carcinoma of the posterior pharyngeal wall.
AB  - We have reviewed a 12-year experience with 295 patients treated for squamous
      carcinoma of the pharynx in order to focus on 78 patients whose lesions arose in
      the posterior wall. Surgery was the definitive therapy for the primary tumor in
      57 (73%), including 3 treatment groups. Thirty-two patients had limited
      resections that preserved the larynx, involving local excision (7 patients),
      anterior pharyngotomy (7 patients), lateral pharyngotomy (6 patients), median
      labiomandibular glossotomy (6 patients), or median mandibulotomy with paralingual
      extension (6 patients). The second group consisted of 21 patients with more
      extensive tumors who required a laryngectomy and complex reconstruction, often
      with postoperative radiotherapy. Finally, there were four patients who developed
      metachronous second primaries in the pharynx subsequent to a laryngectomy. All
      required flap reconstruction. Of the 21 patients whose primary treatment was
      radiotherapy, 5 had lesions that were implanted after access was provided by a
      mandibulotomy. Cumulative 5-year survival was 32% and ranged from 44% in those
      with favorable lesions to 15% in those with extensive tumors. Our experience
      highlights the variety of treatment approaches available in patients with
      pharyngeal carcinomas confined to the posterior wall. Surgery in this setting
      carries acceptable morbidity and yields survival rates that compare favorably
      with those achieved by external radiation therapy alone. Results in patients with
      extensive lesions still leave much to be desired, despite radical surgery and
      aggressive radiotherapy. Innovative brachytherapy techniques using surgery for
      access deserve further investigation.

PMID- 2221249
TI  - Lateral temporal bone resections.
AB  - Eighteen consecutive patients underwent a lateral temporal bone resection for the
      treatment of tumors originating in the auricle, the external auditory canal, the
      periauricular skin, or the parotid and were retrospectively analyzed. The
      different lateral temporal bone resections performed have been categorized into
      four types. The type I resection consists of the removal of the tympanic bone and
      the external auditory canal lateral to the tympanic membrane. The type II
      resection consists of the removal of the entire tympanic bone, the tympanic
      membrane, the incus, and the malleus, preserving the facial nerve and the inner
      ear. Type III resections remove, in addition to the those structures removed in
      type II resections, the distal facial nerve and fallopian canal, the mastoid tip,
      the styloid process, and the stylomastoid foramen. The type IV resection consists
      of the removal of only the mastoid tip and the inferior portion of the tympanic
      bone. When the techniques of lateral temporal bone resection are used
      appropriately, adequate surgical treatment of patients with selected advanced and
      recurrent malignant tumors of the external ear, the periauricular skin, and the
      parotid is possible with low morbidity and a high probability of local regional
      control.

PMID- 2221250
TI  - Serologic determinants of survival in patients with squamous cell carcinoma of
      the head and neck.
AB  - Specific circulating serum proteins may reflect unique properties governing the
      growth and progression of head and neck cancers. One hundred three previously
      untreated patients with squamous cell carcinoma of the head and neck were
      prospectively evaluated for serum IgA, IgG, and IgM and C1q-binding
      macromolecules. Immunoglobulins were assessed by the immunoturbidimetric
      technique. C1q-binding macromolecules (C1qBM) were measured utilizing the iodine
      125 assay of Zubler et al (J Immunol 1976; 116: 232-5). Neither the level of
      serum immunoglobulins nor C1qBM values were correlated with the primary site, AJC
      (American Joint Committee on Cancer) stage of disease, or size of primary lesion.
      Likewise, comparison of serum IgA with C1qBM values demonstrated that these
      laboratory parameters were independent variables (r = 0.15 by Pearson linear
      regression). Univariate statistical analysis, utilizing the Cox proportional
      hazard model, showed serum IgA and C1qBM values to each contribute significantly
      to the ability to predict survival in patients with advanced squamous cell
      carcinoma of the head and neck (p = 0.01 and 0.003, respectively). Furthermore,
      multivariate analysis reveals that both C1qBM and serum IgA levels contribute
      significantly to the hazards model beyond staging in predicting survival (p less
      than 0.001). Predictive results were most apparent in patients with stage IV
      disease and related to the probability of both regional and distant metastatic
      recurrences. Conversely, serologic analysis provided no information in patients
      who were staged early. These results support pretreatment multiparametric
      serologic analysis of patients with squamous cell carcinoma of the head and neck.

PMID- 2221251
TI  - Efficacy of radical neck dissection for the control of cervical metastasis after
      radiotherapy for nasopharyngeal carcinoma.
AB  - Fifty-one patients who had persistent or recurrent neck disease from
      nasopharyngeal carcinoma after radiotherapy underwent radical neck dissection.
      The follow-up period ranged from 0.5 to 9 years (median: 2 years). Multiple
      cervical lymph node involvement was present in 51% of the patients (26 of 51).
      Malignant cells were detected in 88% of the resected specimens (45 of 51). The
      clinical sign of fixation of lymph node is the only factor that affects the
      successful control of neck disease (p = 0.04). Extracapsular extension of the
      nodal disease was present, and 35% of the lymph nodes were adherent to
      surrounding structures at operation (18 of 51). There was one hospital mortality
      and the overall morbidity was minimal. The actuarial survival at 5 years was 38%,
      and the probability of control of neck disease was 66%. Radical neck dissection
      is effective in controlling post-irradiation cervical metastasis from
      nasopharyngeal carcinoma.

PMID- 2221252
TI  - Cervical lymph nodes from an unknown primary tumor in 190 patients.
AB  - Over 10 years, 475 patients with isolated lateral neck masses were evaluated: 190
      with lymph nodes from an unknown primary tumor (LNUP), 188 with neck lymphomas,
      78 with benign tumors, 10 with sarcomas, and 9 with chemodectomas. This study
      focused on the patients with LNUP. Only 86 patients were treated with surgery
      (plus radiotherapy). Other patients were treated with radiotherapy (84) or
      chemotherapy (13) or had no treatment (7). For the overall population, failures
      in the neck occurred in 51% of the patients and distant metastases in 27%, while
      primary tumors appeared in 16%. Survival rates at 3, 5, and 10 years were 27%,
      19%, and 7%, respectively, for the overall population and 45%, 35%, and 19%,
      respectively, for the surgical group. The diagnosis and therapeutic approach had
      a direct effect on neck control; failure in the neck occurred in 7 of 47 patients
      (15%) when fine needle aspiration and radical neck dissection with radiotherapy
      were performed, in 5 of 12 patients (42%) when fine needle aspiration and
      modified neck dissection with radiotherapy were used, in 5 of 12 patients (42%)
      when adenectomy diagnosis and radiotherapy treatment were performed, and in 6 of
      11 patients (54%) when diagnosis by incisional biopsy was performed prior to
      admission, despite subsequent radical neck dissection and radiotherapy treatment.
      In our opinion, panendoscopy and fine needle aspiration should be the first-line
      diagnostic approach. When cytologic diagnosis proves impossible, the second-line
      approach must consist of cervical exploration with frozen section examination and
      excisional biopsy, followed by immediate appropriate treatment. In cases of LNUP,
      radical neck dissection seems to be preferable.

PMID- 2221253
TI  - Delayed reconstruction following Mohs' chemosurgery for skin cancers of the head
      and neck.
AB  - The case records of 52 patients with 55 cutaneous neoplasms treated by Mohs'
      chemosurgery and subsequently reconstructed by plastic surgeons were reviewed to
      determine if delay between resection and reconstruction adversely affected the
      outcome of reconstruction. Reconstruction was performed from 5 to 61 days after
      Mohs' chemosurgery for 45 basal cell carcinomas and 10 other cutaneous neoplasms.
      There were no complications during the interval between resection and
      reconstruction. Following reconstruction, minor wound complications occurred in
      6% of patients; there were no major complications. Microscopic examination of the
      re-excised wound revealed residual disease in 2 of 45 cases of basal cell
      carcinoma and 0 of 10 other cutaneous malignancies. Both patients with residual
      basal cell carcinomas (i.e., false-negative margins after Mohs' surgery) had
      presented to the Mohs' surgeon with recurrent tumors. During a follow-up period
      of 3 months to 3 years after complete resection, recurrent tumor developed in 2
      of 45 cases of basal cell carcinoma and 3 of 8 cases of squamous cell carcinoma.
      Delayed reconstruction, usually 5 to 20 days after Mohs' chemosurgery, can be
      performed without significant morbidity. Re-excision of the Mohs' chemosurgical
      wound for pathologic examination can detect residual disease and may be
      especially indicated for large recurrent wounds.

PMID- 2221254
TI  - Parascapular free flaps for head and neck reconstruction.
AB  - We report our experience with single-stage, primary reconstruction of the head
      and neck in 29 consecutive patients using parascapular free flaps. The commonest
      indications were for craniofacial defects (9), oropharyngeal soft tissue defects
      (10), and combined mandibular and soft tissue losses (4). Ablative surgery was
      performed for squamous carcinoma (22), melanoma (2), and malignant fibrous
      histiocytoma (2). Seven patients died of recurrent disease during a 3 1/2 year
      follow-up. Seven patients are alive with recurrence. Flap complications included
      total loss (2) due to unsalvageable microvascular thrombosis, wound breakdown
      with oropharyngeal fistula (2), mandibular osteomyelitis (1), trismus (2), neck
      contracture (1), and donor site wound dehiscence (1). The overall success of this
      reconstruction was 93%. Primary wound healing was the general rule with lower
      morbidity than with other reconstructive techniques. The flap is thin, pliable,
      and conforms well to three-dimensional defects. The lateral border of the scapula
      can be incorporated on the same vascular pedicle for single-stage mandibular
      reconstruction. No muscle is sacrificed, and the posterior donor defect is an
      added advantage. The parascapular flap is our first choice for reconstruction of
      major defects in the head and neck.

PMID- 2221255
TI  - [Pathogenesis and the principles of prevention and therapy of various types of
      coagulopathy in obstetrical practice (clinical lecture)].

PMID- 2221256
TI  - [Maturation of the pituitary-gonadal system in girls born at term with low birth
      weight].
AB  - Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH),
      estradiol and progesterone have been assayed in 92 girls of 10 to 17 years of age
      who were term low birthweights and in 114 girls of matched ages who had normal
      birthweights. The girls with perinatal complications were found to have an
      aberrant pituitary-gonadal status: an increased FSH and estradiol level in the
      pubertal phase, relatively early age of menarche, delayed maturation of steroid
      and ovulatory ovarian function, significant incidence of menstrual disorders.
      These abnormalities of reproductive maturation are likely to be associated with
      adverse factors of the antenatal period of ontogenesis.

PMID- 2221257
TI  - [Tall stature and its correction in girls].
AB  - The paper presents a classification of tall stature and clinical and hormonal
      findings in 35 girls in the age range of 11 to 18 years with constitutional tall
      stature. They showed a normal decline in growth hormone (GH) concentrations in
      the second phase of pubertal maturation. Concentrations of GH clearly correlated
      with the menstrual status. They were low in regularly menstruating girls, higher
      in non-menstruating girls and highest in tall girls with irregular menstrual
      cycles. Estrogen therapy in 7 girls decelerated growth rates and promoted
      epiphyseal ossification. Regular menstrual cycles established after withdrawal of
      therapy in all patients.

PMID- 2221258
TI  - [Comparative analysis of the data of acupuncture electrodiagnosis and hormonal
      status of women with oligomenorrhea].
AB  - This study has compared acupuncture electrodiagnostic and hormonal data of
      oligomenorrheic women before and after an acupuncture regimen. According to the
      pretreatment hormonal status the patients were assigned to 3 groups: (1) ovarian
      hypofunction; (2) ovarian hypofunction with hyperandrogenism; (3) ovarian
      hypofunction with functional hyperprolactinemia. The treatment normalized the
      hormonal status in all 3 groups. The hormonal status of oligomenorrheic patients
      was found to correlate with conductivity of the skin at biologically active
      sites.

PMID- 2221259
TI  - [Anatomic and functional characteristics of resistant ovaries].
AB  - Resistant ovary syndrome has been confirmed in 42 women using clinical,
      roentgenologic (craniography, hysterosalpingography, pneumogynecography,
      electroencephalography), genetic, sonographic, endoscopic and histologic studies.
      Fibrocystic breast disease was identified in 64% and normal ovarian size in 74%
      of the patients with resistant ovary syndrome. Progesterone test was positive in
      84% of the patients. Resistant ovary syndrome was associated with higher serum
      estradiol levels as compared with ovarian dystrophy and pure gonadal dysgenesis.
      Diagnosis confirmation requires ovarian biopsy with a histological examination of
      ovarian specimen, but its outcome is not always significant.

PMID- 2221260
TI  - [Precursor diseases of the cervix uteri: pathogenesis, diagnosis and treatment].

PMID- 2221261
TI  - [Follicular development during menstrual cycle and the levels of steroid hormones
      in the follicular fluid of women with infertility of inflammatory origin].
AB  - Gonadal hormone levels have been evaluated in the follicular fluid of 67 women
      with tubal and peritoneal infertility. Follicular fluid concentrations of
      estradiol, progesterone and testosterone were compared with sonographically
      ascertained follicle sizes and growth rates. The results indicate a high
      incidence of peripheral damage of the hypothalamic-pituitary-ovarian axis in
      women with inflammatory diseases of the internal genitalia.

PMID- 2221262
TI  - [Mycoplasma infections in marital infertility].
AB  - Evaluation of 302 infertile married couples has identified Mycoplasma infection
      in 106 (35.5%) of women and 96 (31.8%) of men. The infection was associated
      primarily with cervical and endometrial abnormalities in the women and sperm
      abnormalities in the men. Tetracycline treatment resulted in clinical improvement
      both in the women and men. This study suggests Mycoplasma infection to be an
      etiological factor in infertile marriage.

PMID- 2221263
TI  - [Clinico-morphological characteristics of internal endometriosis of the uterine
      body after menopause].
AB  - A study in 100 women with postmenopausal bleedings has identified internal
      endometriosis of the uterine corpus in 50 of them. The diagnosis was made on the
      basis of past history, hysteroscopy, ultrasound scanning, roentgenotelevision
      hysterosalpingography, histological examination of resected uterine and adnexal
      tissues. Thirty patients were operated on and found to have internal
      endometriosis of different locations and extent as well as nodular adenomyosis.
      Endometriosis was functionally progressive in 29 patients and regressive in 1
      patient, as was confirmed with luminescence histological examination. Ovarian
      hyperplasia and/or luteinization of the theca interna, stromal hyperplasia, focal
      thecomatosis and granulosa cell tumour which were present in 56.7% of the
      patients accounted for active endometriosis. Duration of postmenopause did not
      influence the functional activity of internal endometriosis.

PMID- 2221264
TI  - [Ovarian metastatic antigen in the blood serum of patients with ovarian tumors].
AB  - Enzyme immunoassays of ovarian metastatic antigen 8 (OMA-8) in sera of patients
      with ovarian cancer have shown its elevation in 74.5% of samples. OMA-8 levels
      did not correlate with histology, differentiation, clinical stage of the tumour
      or the presence of ascites. Increased OMA-8 levels in sera of 70% of patients
      with stage I-II ovarian cancer suggest that it may be a marker of this disease.

PMID- 2221265
TI  - [Clinico-hysteroscopic characteristics of chronic endometritis].
AB  - Clinical presentations of chronic endometritis have been compared with
      hysteroscopic findings in 60 women of reproductive age. Clinical and
      hysteroscopic data were indicative of a close correlation of gross endometrial
      abnormalities with certain symptoms of chronic endometritis and of severity and
      pattern of mucosal lesions of the corpus mucosa. Elucidation of clinical and
      hysteroscopic features of chronic endometritis permits a differential approach to
      the management of these patients.

PMID- 2221266
TI  - [Comparative evaluation of various methods of treatment of threatened abortion in
      patients with uterine myoma].

PMID- 2221267
TI  - [The role of middle-weight molecules in the pathogenesis of late pregnancy
      toxemia].
AB  - Serum levels of plasma-derived toxic protein components, the median weight
      molecules (MWM), have been assayed in 206 women with third-trimester pregnancy
      and in their newborns. Toxemia of various severity was present in 194 women and
      had developed in the presence of an extragenital disease in 84.2%
      (pyelonephritis, glomerulonephritis, essential hypertension, etc.).
      Concentrations of MWM were found to increase with deterioration of renal function
      and to correlate with severity of nephropathy. In every second pregnancy with
      toxemia, interventions included extracorporeal detoxication: ultraviolet
      irradiated blood autotransfusion (UIBA) and hemosorption. The rates of intra- and
      postpartum complications or requirement for surgery were 1.5-2-fold lower in
      these patients, and their newborns has better neonatal progress. Perinatal
      mortality of these patients was two times as low as that in the rest of the
      population (31.9:1000 versus 62.6:1000). The use of UIBA is recommended for mild
      and moderate toxemia and in combination with hemosorption for severe nephropathy.

PMID- 2221268
TI  - [Effect of preventive use of dexamethasone on various indicators of humoral
      immunity in mothers and newborn infants].
AB  - In order to explore the immunosuppressive effect of glucocorticoids as
      accelerators of fetal lung maturity, 98 women with imminent premature labor were
      examined in respect to the effect of dexamethasone on IgG, IgA and IgM levels in
      mothers and infants. No convincing immunosuppressive effect was found on the
      production of the above mentioned markers of humoral immunity in the treated
      groups of pregnant women and their newborns.

PMID- 2221269
TI  - [Secretory immunity of the vagina in acute nonspecific salpingitis].

PMID- 2221270
TI  - [Electroroentgenography in the diagnosis of the causes of female infertility].

PMID- 2221271
TI  - [Treatment of excretory male infertility by ultraviolet irradiation of autologous
      blood].

PMID- 2221272
TI  - [Selection of a surgical method in rectovaginal fistula].

PMID- 2221273
TI  - [Morphological aspects of acute adnexitis in women of reproductive age].

PMID- 2221274
TI  - [Chlamydia infections in gynecology].

PMID- 2221275
TI  - Application of the Tridimensional Personality Questionnaire to a population of
      alcoholics and other substance abusers.
AB  - To assess its construct validity and application, Cloninger's Tridimensional
      Personality Questionnaire (TPQ) was administered to 267 inpatient substance
      abusers. One hundred seventy-two of the patients were alcoholic, 47 abused
      stimulants, and 48 abused other drugs, primarily benzodiazepines, marijuana, or
      were polysubstance abusers. Of the sample 33.8% were female. Analyses were
      conducted to (1) determine whether TPQ scores could be used to classify
      alcoholics as either Cloninger Type I or Type II; (2) examine the
      intercorrelations of TPQ scales and identify differences in these patterns due to
      drug of choice; (3) replicate previously obtained gender differences on the TPQ.
      The results indicate that (1) TPQ scores did not classify the alcoholics into the
      expected frequencies for Type I and Type II; (2) the scales were not independent
      and did not give rise to any differences among drug user groups, but (3) did
      confirm previously reported gender differences. These results indicate that
      Cloninger's model and the TPQ must be subjected to careful empirical study prior
      to their widespread acceptance.

PMID- 2221276
TI  - Learned tolerance to alcohol: mental rehearsal with imagined consequences.
AB  - Two experiments tested the hypothesis that the acquisition of a new response is
      enhanced by mental rehearsal which includes the imagined consequence of mental
      performance. A total of 48 males participated in the research. Experiment 1
      tested drug-free learning of a motor skill task. Experiment 2 used the same task
      to test the acquisition of a drug-compensatory response (i.e., tolerance) under
      alcohol. Subjects in each experiment were randomly assigned to one of three
      treatments: mental rehearsal with imagined consequences (C), mental rehearsal
      with no imagined consequences (N), and rest (R). Both experiments confirmed the
      hypothesis. C treatment yielded superior drug-free performance, and a greater
      tolerance. The effect of N treatment was intermediate, and R treatment was least
      effective. It was concluded that incorporating an imagined consequence of mental
      performance enhances the learning of alcohol tolerance and the acquisition of a
      motor skill. Factors that may have contributed to the marginal efficacy of N
      treatment were discussed, and research implications were considered.

PMID- 2221277
TI  - Brain and liver dolichol in chronic alcoholism: a necropsy study.
AB  - Cerebral gray and white matter and liver dolichol levels were measured in
      postmortem samples from chronic alcoholics and nonalcoholic controls following
      recent suggestions that dolichol levels may be used as a marker for alcoholism.
      No significant differences in brain dolichol were found between the control and
      alcoholic groups. A significant reduction in the liver dolichol was observed in
      the alcoholic group. This was most marked in those alcoholics with liver disease.

PMID- 2221278
TI  - Genotyping of mitochondrial aldehyde dehydrogenase locus of Native American
      Indians.
AB  - Using the polymerase chain reaction to amplify genomic DNA from hair roots, we
      have examined the mitochondrial aldehyde dehydrogenase (ALDH2) genotypes of 28
      individuals from the South American Mapuche Indians. We have determined that
      individuals from this population previously reported to lack (ALDH2) activity do
      not show the presence of the inactive (ALDH2(2] allele frequently found in
      Orientals.

PMID- 2221279
TI  - Isoenzymes of aldehyde dehydrogenase in human lymphocytes.
AB  - The types of isozymes of aldehyde dehydrogenase (ALDH) present in human
      lymphocytes has been investigated using isoelectric focusing of polyacrylamide
      gels followed by substrate-specific staining. Lymphocytes obtained from most
      individuals were found to contain both types I and II ALDH. This group of
      'typical' individuals reported that they did not develop marked facial flushing
      or rapid heart rate after drinking alcohol nor did they develop an erythema to
      cutaneously applied ethanol. Lymphocytes obtained from 'atypical' individuals who
      do suffer from alcohol-induced flushing and rapid heart rate and who developed
      erythema to cutaneous ethanol displayed type II, but not type I, ALDH.
      Lymphocytes thus appear to be an easily accessible and suitable tissue for
      determining type I ALDH phenotype.

PMID- 2221280
TI  - Maternal genetic effects on ethanol teratogenesis and dominance of relative
      embryonic resistance to malformations.
AB  - Maternal genetic factors and/or fetal genetic factors contribute to variations in
      response to prenatal alcohol exposure. To assess the contribution of maternal
      genotype to ethanol teratogenesis, a reciprocal cross study was conducted in an
      animal model using C57BL/6J (B6) and long-sleep (LS) mice. B6 mice are more
      susceptible than LS mice to prenatal ethanol-induced malformations but both mouse
      stocks are susceptible to fetal weight deficits following in utero alcohol
      exposure. B6 and LS dams were reciprocally mated to B6 or LS males producing four
      embryonic genotype groups: the true-bred B6B6 and LSLS genotypes, and the
      genetically similar B6LS and LSB6 genotypes (the F1 genotype). Dams were
      intubated with either 5.8 g/kg ethanol (E) or an isocaloric amount of sucrose (S)
      on day 9 of pregnancy. Fetuses were removed on gestation day 18, weighed, and
      assessed for soft tissue or skeletal malformations. Results showed a greater
      litter weight deficit and increased total malformation rate in ethanol-exposed F1
      litters carried by B6 mothers compared to ethanol-exposed F1 litters carried by
      LS mothers. This result would be expected only if maternal genetic factors
      contribute significantly towards susceptibility to ethanol teratogenesis. The
      influence of the LS mother was to decrease susceptibility to ethanol
      teratogenesis compared to the B6 mother while the influence of the B6 mother was
      to increase susceptibility to ethanol teratogenesis compared to the LS mother.
      The average malformation rate for F1 litters was significantly less than the
      predicted midparental value. This shows that the F1 genotype exhibited dominance
      towards resistance to prenatal alcohol effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221281
TI  - Murine model of ethanol-induced immunosuppression.
AB  - Alcohol abuse has been associated with an increased susceptibility to infectious
      diseases and certain tumors. On the basis of these observations, an effect of
      ethanol on the immune system has been suggested. We have used a mouse model
      system in which male C57Bl/6 mice were fed either Lieber-DeCarli liquid diet
      containing ethanol sufficient to supply 37% of the total calories or isocaloric
      control diet in a pair-feeding design to examine the effect of ethanol on the
      immune system. The group consuming the ethanol-containing diet maintained
      relatively stable levels of blood ethanol for the 8 days of feeding. Consumption
      of ethanol for 8 days resulted in a profound loss of thymus and spleen cells, and
      the recovery of thymus cellularity was delayed relative to the recovery of spleen
      cell numbers after ethanol feeding was discontinued. Proliferation of spleen
      lymphocytes to T-cell stimuli (concanavalin A and alloantigens) was diminished;
      however, B-cell proliferation to lipopolysaccharide was relatively unchanged in
      mice fed ethanol-containing diet. Also in ethanol-fed mice a significant decrease
      in the primary antibody response to sheep red blood cells but not to the T
      independent antigen trinitrophenol-ficoll occurred. These data establish the
      murine model system as a means to define further the effect of ethanol on the
      immune system and host defense mechanisms.

PMID- 2221283
TI  - The detection of alcoholism in hospitalized schizophrenics: a comparison of the
      MAST and the MAC.
AB  - The Michigan Alcoholism Screening Test (MAST) and the MacAndrew Alcoholism Scale
      (MAC) were administered to forty-one schizophrenic inpatients also meeting DSM
      III criteria for either alcohol abuse or alcohol dependence and 29 schizophrenic
      inpatients who did not qualify for an additional substance abuse diagnosis other
      than marijuana abuse/dependence. The MAC failed to differentiate between the
      alcoholic and nonalcoholic groups and both groups scored above the recommended
      cutting score. The MAST significantly differentiated the alcoholic and
      nonalcoholic schizophrenic patients and was as sensitive to a history of alcohol
      abuse as to alcohol dependence. Neither the MAST nor MAC was sensitive to recent
      versus more remote drinking. The overall classificatory accuracy of the MAST was
      found to be 80% and that of the MAC was 56%. A logistic regression analysis
      revealed that the use of just four MAST items can yield a group classificatory
      rate of 83%. It was concluded that the MAST exhibited sufficient sensitivity and
      specificity to be used as an initial screening instrument for alcoholism in
      schizophrenic patients.

PMID- 2221282
TI  - Deranged vitamin D metabolism but normal bone mineral density in Finnish
      noncirrhotic male alcoholics.
AB  - To study the effect of prolonged ethanol consumption on calcium metabolism and on
      the prevalence of osteoporosis we examined 38 Finnish noncirrhotic male
      alcoholics (30-55 years of age) with dietary interviews and biochemical
      measurements and by measuring the bone mineral content of the forearm using
      single photon absorptiometry (SPA) and the bone mineral density of the spine,
      humerus and proximal femur using nonquantified computer tomography (CT) and dual
      energy x-ray absorptiometry (DEXA). In comparison two groups of healthy controls
      were studied. The mean daily dietary intake of calcium was 1.3 g in the patients
      and 1.2 g in the controls. The dietary intake of vitamin D was equal in the study
      groups, too. The serum levels of calcium, phosphate and parathyroid hormone did
      not show any difference between the patients and controls but in the alcoholics
      the urinary excretion of calcium was reduced by 42% (p less than 0.0001) as
      compared to the controls. The serum levels of 25-hydroxyvitamin D3, 1,25
      dihydroxyvitamin D3, and 24,25-dihydroxyvitamin D3 were reduced in the alcoholics
      by 40% (p less than 0.0001), 23% (p less than 0.01), and 48% (p less than
      0.0001), respectively, as compared to the controls. The alcoholic men had normal
      levels of serum testosterone and they did not have hypercortisolism. The bone
      mineral content of the dominant forearm measured by SPA was similar in the study
      groups as were the bone mineral densities (BMD) of the lumbar and humeral areas
      measured by CT. The BMD at the lumbar, femoral neck, Ward's triangle and
      trochanter sites measured by DEXA did not differ, either.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2221284
TI  - Esophageal motor disorder in alcoholics: result of alcoholism or withdrawal?
AB  - Both acute and chronic ethanol consumption may cause esophageal dysmotility. In
      order to systematically evaluate the effect of ethanol on esophageal motility, we
      studied esophageal motility in 13 healthy subjects before and following acute
      intravenous administration of 0.8 g/kg ethanol and in chronic alcoholics within 6
      hr of their last drink (n = 6) and following 24 to 48 hr of abstinence when signs
      of withdrawal were present (n = 13). Withdrawing alcoholics were also restudied
      after intravenous administration of 0.8 g/kg ethanol. Ethanol transiently
      decreased lower esophageal sphincter pressure (LESP) and inhibited LES relaxation
      in all control subjects; this inhibitory effect of ethanol on LESP in alcoholics
      was significantly less, indicating the development of tolerance. Ethanol
      moderately decreased esophageal contraction amplitude (ECA) in 10 of 13 controls
      and prolonged duration of contractions in all but had no effect on velocity of
      esophageal contractions. In contrast, ECA was significantly elevated in both
      groups of alcoholics, but this was significantly more marked in withdrawing
      alcoholics. Ethanol infusion returned ECA toward normal values in withdrawing
      alcoholics. Abnormal motility was noted in three intoxicated alcoholics and 10
      (77%) withdrawing alcoholics. This included nutcracker esophagus in five and
      hypertensive LES in two. These data indicated that (1) esophageal motor
      dysfunction is common in alcoholics; (2) acute ethanol administration decreases
      LESP and esophageal contraction amplitude, whereas chronic ethanol consumption
      and withdrawal from ethanol increases ECA. This suggests development of a
      compensatory mechanism in chronic alcoholics leading to high pressure esophageal
      contractions during withdrawal.

PMID- 2221285
TI  - Alcohol protects the diaphragm during dietary restriction.
AB  - We recently reported that alcoholic rat diaphragm develops greater contractile
      force than diaphragm of pair-fed control animals. The present experiment examines
      whether alcohol or dietary restriction is the more likely cause of this
      surprising finding. We conditioned 10 rats using a liquid diet containing ethanol
      as 36% of calories. Ten pair-fed control animals received an equal amount of
      isocaloric, ethanol-free liquid diet. Ten ad libitum control animals had
      unrestricted access to lab chow and water. Rats were killed after 30 weeks. Left
      costal diaphragm strips were studied in vitro at optimal length using direct
      stimulation at supramaximal voltage. Isometric force was measured and divided by
      muscle cross-section to compute stress. Maximal tetanic stresses developed by
      muscle from pair-fed controls were systematically less than alcoholic and ad
      libitum control values (p less than 0.0001); this did not depend on temperature
      (25 degrees vs. 37 degrees; p greater than 0.50). Pair-feeding increased twitch
      half-relaxation times (p less than 0.03) and shifted the tetanic stress
      stimulation frequency relationship leftward by 10 Hz (p less than 0.01).
      Diaphragm of pair-fed rats continued to generate lower stresses during the
      fatigue caused by repeated contractions (p less than 0.01). We conclude that
      dietary restriction associated with pair-feeding compromises diaphragm
      performance in rats. Chronic alcohol consumption prevents or reverses these
      changes, since diaphragm function of alcoholic and ad libitum control animals was
      not different.

PMID- 2221286
TI  - Late versus early onset problem drinking in older men.
AB  - Age at onset of problem drinking was studied in 132 older men (age 60 years and
      older) admitted to a VA geriatric alcoholism outpatient treatment program.
      Demographics, alcohol history, self reported psychological status, special
      treatment, and treatment compliance variables were tested for association with
      onset age. Late onset (defined as onset of the first alcohol problem at or after
      age 60) was not uncommon, occurring in 15% of the sample (29% of patients age 65
      or older). Compared to earlier onset cases, late onset alcohol problems were
      milder and more circumscribed, and were associated with less family alcoholism
      and greater psychological stability. Late onset patients were also more compliant
      with outpatient treatment requirements; however, treatment program variables were
      better predictors of compliance than onset age.

PMID- 2221287
TI  - Inpatient treatment of employed alcoholics: a randomized clinical trial on
      Hazelden-type and traditional treatment.
AB  - The first randomized clinical trial on the Hazelden-type of treatment showed that
      this AA-oriented treatment for alcoholism can result in significant improvement
      in drinking behavior as compared to a more traditional form of treatment. One
      hundred forty-one employed alcoholics were randomized to either Hazelden-type
      treatment (N = 74) or to traditional-type treatment (N = 67). The treatment
      groups were highly comparable. The bimonthly follow-up lasted one year. According
      to the COPES-questionnaire (short form), the treatment at the Hazelden-type
      institute was significantly more involving, supportive, encouraging to
      spontaneity and oriented to personal problems than at the traditional-type
      institute. In accordance the treatment drop-out rate was 7.9% at Hazelden-type
      institute and 25.9% at traditional-type institute (p less than 0.02). The
      participation in outpatient treatment was significantly better after the Hazelden
      type treatment. The proportion of those abstinent (admitted ethanol consumption,
      0 g/day; gammaglutamyl transferase, and mean cell volume were normal) was higher
      at Hazelden-type institute during the last (8-12 months) follow-up period (26.3%
      vs. 9.8%, p = 0.05). Fourteen percent of the Hazeldon-type institute patients and
      1.9% of the traditional-type institute patients stayed abstinent during the whole
      1-year follow-up period (p less than 0.05). The differences for the corresponding
      rates for controlled drinking (admitted ethanol consumption less than 40 g/day,
      GGT, and MCV normal) were in the same direction but did not reach statistical
      significance. Thus the Hazelden-type treatment obtained better results in 1-year
      abstinence rate than a more traditional-type treatment.

PMID- 2221288
TI  - Ethanol-inducible cytochrome P-450: assessment of substrates' specific chemical
      probes in rat liver microsomes.
AB  - The capacity of liver microsomes to oxidize various substrates known to be
      specific of alcohol-inducible cytochrome P-450 was studied in rats treated with
      different xenobiotics such as 3-methylcholanthrene, phenobarbital, acetone, and
      ethanol. Analysis of results showed a significantly marked increase following
      ethanol and acetone treatments of the p-nitrophenol hydroxylation (283 +/- 19%
      and 304 +/- 21%), N-nitrosodimethylamine (NDMA) demethylation (280 +/- 105% and
      228 +/- 95%), benzene hydroxylation (258 +/- 60% and 236 +/- 61%), butanol
      oxidation (173 +/- 34% and 154 +/- 32%), aniline hydroxylation (147 +/- 22% and
      95 +/- 8%), and ether de-ethylation (95 +/- 17% and 83 +/- 17%) and a not
      significant increase of N-nitrosodiethylamine (NDEA) de-ethylation (34 +/- 11%
      and 9 +/- 8%) in rat microsomes, respectively, versus control animals (mean +/-
      SD, values expressed as nmol/min/nmole P-450). All of these activities
      significantly decreased after 3-MC treatment, except for the p-nitrophenol
      hydroxylation. PB treatment markedly enhanced NDEA de-ethylation, p-nitrophenol,
      and benzene hydroxylations (106 +/- 38%, 109 +/- 14%, and 153 +/- 62%,
      respectively) versus controls. These results suggest that NDMA and especially 1
      butanol are the most specific and useful probes of alcohol-inducible cytochrome P
      450 in crude liver microsomes.

PMID- 2221289
TI  - Effects of alcohol on the import of aldehyde dehydrogenase precursor into rat
      liver mitochondria.
AB  - We previously showed that incubation of rat liver mitochondria with alcohols
      resulted in the inhibition of the import of aldehyde dehydrogenase precursor but
      not that of ornithine transcarbamylase precursor (Wang TTY, Farres J, and Weiner
      H: Arch Biochem Biophys 272:440-449, 1989). The time required for inhibition of
      import to occur was now measured with ethanol (200 mM) and butanol (100 mM) at 0
      degree and 30 degrees C. It required approximately 30 min to achieve 50%
      inhibition with butanol and 50 min with ethanol. To further substantiate the
      membrane perturbing effects of alcohols, we also examined the effect of oleic
      acid on import. We found that incubation of mitochondria with oleic acid (0-100
      microM) resulted in inhibition of aldehyde dehydrogenase precursor import in a
      dose response fashion. In addition to in vitro effects of alcohols on import, we
      conducted a preliminary study on import of protein into liver mitochondria
      isolated from rats fed ethanol. We found that the rate of aldehyde dehydrogenase
      precursor import into liver mitochondria isolated from ethanol fed rats was
      identical to that from control. The results are consistent with finding that the
      activity and amount of aldehyde dehydrogenase was the same in mitochondria
      isolated from the alcohol-fed or control animals.

PMID- 2221290
TI  - A comparison of sensitivity to oxotremorine and muscarinic receptors in LS and SS
      mice.
AB  - Several studies have suggested that ethanol interacts with muscarinic cholinergic
      systems in the brain. In order to assess whether muscarinic systems regulate
      sensitivity to ethanol, the effects of oxotremorine pretreatment on sensitivity
      to ethanol were determined in the long-sleep (LS) and short-sleep (SS) mice,
      which were selectively bred for differential sensitivity to ethanol. In addition,
      the relative sensitivity of these two lines to intraperitoneally (ip) injected
      oxotremorine and total muscarinic receptors, as measured by quinuclidinyl
      benzilate (QNB) binding, M1 receptor subtypes, as measured by pirenzepine (PZ)
      binding, and ratios of high and low agonist affinity were measured in seven brain
      regions. SS mice were more sensitive to oxotremorine-induced increases in
      sensitivity to ethanol but the LS mice were more sensitive to the effects
      elicited by ip oxotremorine injection. Because the effects of oxotremorine were
      blocked by scopolamine but not by methylscopolamine, it is likely that the
      effects of oxotremorine that were measured are centrally mediated. QNB binding
      did not differ between the LS and SS mice except for cortex where the SS mice
      exhibited slightly larger numbers. The mouse lines did not differ in the number
      of M1 receptors or in ratio of high to low affinity agonist sites. Therefore, it
      does not seem likely that differences in receptor numbers are important in
      regulating the differential sensitivities of the LS and SS mice to oxotremorine
      or ethanol. Differences in receptor coupling processes may be critically
      involved.

PMID- 2221291
TI  - Alterations in splanchnic blood flow following chronic ethanol exposure.
AB  - The purpose of these experiments was to determine whether or not tolerance
      develops to the effect of 3.0 g/kg ethanol on total and regional splanchnic blood
      flow in male Wistar rats. The animals were given the Lieber-DeCarli liquid diet
      containing ethanol for 10 days; ethanol-fed animals were withdrawn 24 hr prior to
      experiments. Regional blood flow and cardiac output (CO) were measured by the
      reference microsphere technique after an intraperitoneal injection of 3.0 g/kg of
      ethanol. Acute ethanol administration produced early nonsustained increases in
      portal vein blood flow in animals fed ethanol for 10 days and withdrawn for 24 hr
      and in control animals. However, after chronic exposure to ethanol, the pattern
      of increase in blood flow in response to ethanol in the splanchnic organs was
      different between the ethanol-fed and control groups. Increases in portal vein
      flow in control groups were due to concomitant increases in small intestinal,
      colonic, and cecal blood flow while the increase in the ethanol-fed group was due
      to a rise in small intestinal and stomach blood flow. The increase in stomach
      blood flow that occurred in the animals treated chronically with ethanol may be
      viewed as a conditioned response to ethanol, since this was not found in the
      control group. These results, demonstrate that the pattern of increase in blood
      flow in the splanchnic organs produced by an acute dose of ethanol depends on the
      animal's previous exposure to ethanol.

PMID- 2221292
TI  - Examination of Cloninger's type I and type II alcoholism with a sample of men
      alcoholics in treatment.
AB  - Cloninger's clinical method of classifying alcoholics into two groups (Types I
      and II) was examined with data obtained from 360 VA hospitalized male alcoholic
      patients. For operational criteria, the Cloninger clinical method of subtyping
      alcoholics employs age-of-onset of problem drinking and symptom-clusters
      supposedly associated with each subtype. Marked overlap was found between the
      symptom-clusters used to define the two subtypes. Ninety-one percent of the
      entire sample satisfied criteria for both symptom-clusters. Dividing the sample
      by early-onset (Type II, less than or equal to 25 years) and late-onset (Type I,
      greater than 26 years) alcoholism did not substantially reduce the overlap
      between symptom-clusters; i.e., 96% of the early-onset and 83% of the late-onset
      subgroups were positive for both symptom-clusters. Only 21 men (6%) could be
      classified when both age-of-onset and the type-appropriate symptom-cluster were
      used to separate patients. In hospital settings, at least, these findings suggest
      that the two-group clinical alcoholism typology proposed by Cloninger basically
      reflects the age-of-onset of problem drinking.

PMID- 2221293
TI  - Problems in alcoholism treatment: labeling and negative stereotyping.

PMID- 2221294
TI  - The type 2 primary alcoholic?

PMID- 2221295
TI  - Beef fat prevents alcoholic liver disease in the rat.

PMID- 2221296
TI  - Methanol as a marker of alcohol abuse.

PMID- 2221297
TI  - [Therapy of chronic pain--a task of the anesthetist?].

PMID- 2221298
TI  - [Anesthesiologic complications in risk patients during and following upper and
      lower abdominal interventions].
AB  - It was the aim of this study to determine intraoperative and postoperative
      complications following lower abdominal or upper abdominal surgical interventions
      both quantitatively and qualitatively using the risk classification of the
      Mannheim risk check list. The types of surgical interventions in the upper and
      lower abdomen can be considered as comparable in respect of influence exercised
      on the homeostasis. The case records of 386 patients were evaluated
      retrospectively who had been operated on at the biliary tract, stomach (upper
      abdomen) or sigma, rectum or ileocaecum (lower abdomen). Preceding diseases were
      noted and recorded, and so were intraoperative and postoperative complications up
      to the 4th postoperative week. Statistical testing was effected by means of the
      chi-square test with alpha = 0.05. In accordance with the determined risk
      classifications, the incidence of preceding diseases increased for both the types
      of surgery (cardiovascular diseases and pulmonary diseases being the preliminary
      diseases recorded in this context). If intraoperative and postoperative
      complications are broken down, there is a dominance of bronchopulmonary
      complications after upper abdominal surgery postoperatively, and an equal
      distribution of overall intraoperative complications. The data prove that in
      assessing the risk according to the Mannheim risk check list, laparotomies of the
      upper abdomen are underestimated, so that this type of surgery should rank higher
      in risk check list than large-scale laparotomies at the sigma and rectum. Over
      and above this, the enhanced pulmonary risk of upper abdominal surgery continuous
      to be a proven fact.

PMID- 2221299
TI  - [Unstable blood pressure during anesthesia in diabetic patients with autonomic
      neuropathy].
AB  - Diabetic autonomic neuropathy (AN) as a risk factor of surgical procedures has so
      far been described in case reports, but no controlled clinical studies are known.
      Therefore, we intended to study systematically the perioperative relevance of the
      autonomic dysfunction. 32 ophthalmosurgical patients (20 diabetics, 12 non
      diabetics) were investigated. Cardiovascular autonomic function was examined
      preoperatively by a combination of tests (heart rate variations during deep
      breathing, Valsalva ratio, 30:15 ratio, postural hypotension, sustained hand
      grip). A scoring system based on these tests provided the staging of the
      autonomic involvement of the patients (AN score). The anaesthesiological
      management (thiopentone, N2O, halothane) and the operative procedure (vitrectomy)
      were uniform. A significant correlation was found between the AN score and the
      coefficient of variation of the systolic (r = 0.70, p less than 0.001) resp. the
      diastolic (r = 0.52, p less than 0.01) blood pressure during anaesthesia. No
      correlation was found between the intraoperative variability of the arterial
      blood pressure (coefficient of variation) and the age of the patients resp. the
      preoperative value of the blood pressure. In diabetics with severe autonomic
      neuropathy (AN score greater than 5) hypotensive reactions were seen very often
      during the operation. The results demonstrate that the haemodynamic stability in
      the perioperative period depends on the severity of the autonomic dysfunction.
      Diabetics with severe autonomic neuropathy have a high risk of blood pressure
      instability. Non-invasive diagnostic methods allow to identify these patients
      preoperatively.

PMID- 2221301
TI  - [Clonidine supplemented analgesia and sedation in prevention of postoperative
      delirium].
AB  - In an open prospective study we investigated the efficacy of the supplementation
      of analgosedation by clonidine. 40 patients with oesophagus malignancy and
      definite alcohol abuse were on respiration therapy postoperatively after having
      been treated with oesophago-gastro anastomoses. With regard to manifestation
      intensity and development of withdrawal symptoms we found that during basic
      medication with piritramid-diazepam continuously i.v. administered clonidine can
      eliminate haemodynamic and psychovegetative symptoms related to alcohol
      withdrawal. The clonidine group required less analgosedation. The measurement of
      the urinary catecholamine output showed a normalised endogenous output. As a
      finding of importance the gastrovolume was reduced, and the haemodynamically
      firm, stable and less sedated patients of the clonidine group required fewer days
      of respiration therapy. Hence, the hazard of aspiration pneumonia and
      insufficienty anastomosis was lower. Risk of bradycardia of high potential danger
      did not occur with a median daily dosage of 1.09 mg/d clonidine. We consider
      clonidine to be a potent supplement to analgosedation for the surgical patient
      who is at high risk of alcohol withdrawal.

PMID- 2221300
TI  - [Anaphylactoid reaction to a non-ionic roentgen contrast medium in general
      anesthesia].
AB  - The occurrence of adverse reactions is decreasing since the introduction of non
      ionic contrast media. Anaphylactoid reactions during general anaesthesia are rare
      and hitherto only documented with the administration of ionic compounds. We
      report an episode of hypotension, tachycardia, bronchospasm and urticaria
      following application of a non-ionic contrast medium (Iopamidol) during
      isoflurane anaesthesia. We conclude that a combinent use of anaesthesia and non
      ionic contrast media does not guaranty protection from anaphylactoid reactions to
      iodinated radiopaque compounds.

PMID- 2221302
TI  - [Analgesia and sedation in neurosurgical intensive care patients].
AB  - Different concepts for analgosedation of neurosurgical patients are recommended
      during postoperative ventilation. In 30 neurosurgical patients (2 groups of 15
      patients), we studied a continuous i.v. application of alfentanil (Rapifen) and
      midazolam (Dormicum) compared to an application of continuously given alfentanil
      with discontinuously given midazolam. A good analgosedation (i.e. sufficient
      sedation with good neurological judgement) was more frequently achieved (8/15
      patients) by continuous application of both substances (alfentanil 0.023 mg/kg
      b.w./h, midazolam 0.10 mg/kg b.w./h), compared to discontinuous application of
      midazolam (4.5/15 patients; alfentanil 0.028 mg/kg b.w./h, midazolam 0.13 mg/kg
      b.w./h). No differences in extubation times were observed. We conclude from our
      results that a continuous application of both substances is superior to a
      discontinuous application of midazolam with continuously given alfentanil. A
      lower dosage of each substance is necessary to maintain a better state of
      analgosedation.

PMID- 2221303
TI  - [Case report: lumen obstruction with a Magill tube].
AB  - A case is reported where a reusable red rubber tube was obstructed by a plastic
      capsule. This capsule was part of a washing machine for cleaning of reusable
      anaesthetic equipment. As a consequence we recommend the examination for free
      passage of each endotracheal tube before use.

PMID- 2221304
TI  - [Lung edema following intestinal irrigation with golytely solution].
AB  - A case of pulmonary edema following whole gut lavage with Golytely's solution is
      reported. The patient did not suffer from gastrointestinal obstruction, renal
      dysfunction or cardiac congestion.

PMID- 2221305
TI  - [Comments on the contribution by W. Tolksdorf, H. Bremer and B. Tokic (Anasth.
      Intensivther. Notfallmed. 24 (1989) 94-99): "Postoperative, opiate-induced
      respiratory depression is not dependent on arousal"].

PMID- 2221306
TI  - [Uvulo-palato-pharyngoplasty, 1-yr follow-up].
AB  - Seven patients suffering from obstructive sleeping sickness syndrome and operated
      on U-P-P-P-., were controlled, one year later, through the polysomnographic test.
      The tracings showed a clear improvement compared with the preoperative records.
      Best results are gained in those cases with lesser apneic degree.

PMID- 2221307
TI  - [Sudden hearing loss and the cranio-cervical junction].
AB  - Morphological alterations of the craniocervical junction as basilar impressions,
      a ponticulus posterior, an atlas assimilation, an intervertebral narrowing and
      spondylosis deformans, were found radiologically in patients with sudden hearing
      loss. There were no radiological differences to a healthy population. No
      relationship could be established between static morphological changes of the
      craniocervical junction of the upper cervical spine and the sudden hearing loss.
      However, there was a statistically significant reduction of the mobility in the
      upper cervical spine in patients suffering from sudden hearing loss. Very high
      standard deviations in the atlanto-occipital and the atlanto-odontoid joints are
      interpreted as hyper- as well as hypomobile joints. These results indicate a
      possible correlation between sudden hearing loss and a functional pathology of
      the craniocervical junction.

PMID- 2221308
TI  - [Use of local infiltration for tonsillectomy in adults under general anesthesia].
AB  - The paper deals with 60 adults (aged between 13-30) tonsillectomies done under
      general anesthesia. The collective was alternatively divided in 2 groups, only
      one of them receiving local infiltration. In the infiltrated group the tonsil
      dissection was easier, the bleeding sparse and the follow-up less unpleasant.

PMID- 2221309
TI  - [Dysphonia caused by idiopathic skeletal hyperostosis. Apropos of a case].
AB  - The Forestier's disease is an skeletal idiopathy described by this A. and Rotes
      Querol, in 1950, characterized by the systemic ossification in variable degree of
      the vertebral column. The neck localization can produce pharyngeal or laryngeal
      symptoms, due to the compression of the structures of the neighbourhood. So was
      the case recorded which being symptomless remain untreated. Survey of today's
      literature on the subject so as diagnosis, pathophysiology and its management.

PMID- 2221310
TI  - [Otitis externa maligna. Our experience].
AB  - The AA. expose the experience gained through a group of 9 cases of malignant
      external otitis. They review the previous circumstances, assess the results of
      medical and/or surgical treatment and the evolution of the processes, emphasizing
      the importance of prognostic factors. Twenty-two per cent was the rate mortality.

PMID- 2221311
TI  - [The presentation of cleft palate in isolation or as part of a syndrome].
AB  - Clefting of the palate may be complete or incomplete (bifid uvula, submucous
      cleft palate). Cleft palate with or without cleft lip is part of many different
      syndromes, which are briefly reviewed with highly selected references.

PMID- 2221312
TI  - [Characteristics of cardiopulmonary resuscitation in pregnant women].
AB  - Cardiopulmonary resuscitation (CPR) during pregnancy is a rare event, but due to
      the increasing number of pregnant women with significant medical disorders it
      will gain more importance in the near future. Effective CPR with respect to
      survival of mother and infant can only be accomplished under optimal conditions.
      We discuss important pathophysiological alterations during pregnancy and,
      including recommendations in the available literature, we present a standardized
      protocol for life support for mother and infant. The protocol depends on the
      progress of the pregnancy. Compared to non-pregnant patients, pregnant women must
      be placed in a left lateral position immediately. If possible, the decision to
      perform open-chest CPR has to be made within 15 min of unsuccessful closed-chest
      CPR. In addition, during late pregnancy there should be no delay in performing an
      emergency cesarean section, even during CPR.

PMID- 2221313
TI  - [Anesthesia induction in children: propofol in comparison with thiopental
      following premedication with midazolam].
AB  - Propofol provides smooth and rapid induction of anesthesia in adults and
      guarantees rapid recovery. The use of propofol in adults is frequently associated
      with pain on injection, but this can be reduced by: (1) injection into the
      relatively large veins in the forearm or the antecubital fossa: (2) addition of
      lignocaine to the propofol; or (3) injection of an opioid (alfentanil) before
      propofol. Compared with experience in adults, there is very little experience
      with propofol in pediatric anesthesia. The aim of this random prospective study
      was to compare the induction characteristics of propofol and thiopentone in
      pediatric anesthesia. Vigilance and behavior in the postoperative period were
      also compared. METHOD. A total of 75 healthy children aged 3-12 years who were
      undergoing elective operations were studied. All the children received
      premedication with 0.5 mg/kg midazolam with 0.02 mg/kg atropine by the rectal
      route. The children were divided randomly into 3 groups and received: group A,
      thiopentone 3-6 mg/kg; group B, propofol 1-3 mg/kg mixed with lignocaine (10/200
      mg); group C, propofol 1-3 mg/kg, followed 1 min later by alfentanil 0.01 mg/kg.
      The induction agent was injected over 30 s, if possible into the vein in the
      forearm or the antecubital fossa. The immediate reaction on vein puncture and any
      discomfort during the injection were noted. After intubation the anesthesia was
      maintained with 1 vol% halothane, nitrous oxide and oxygen (2:1). Arterial
      pressure was measured on arrival in the induction room, immediately after the
      induction of anesthesia, immediately after intubation and thereafter at 5-min
      intervals throughout the anesthesia. Heart rate (ECG) and arterial oxygen
      saturation (saO2) were measured continuously. The existence of any anterograde
      amnesia was tested (age over 4 years) by means of one of 6 pictures shown to each
      before operation. The ability to recall the picture shown was recorded 2-5 h
      postoperatively. The completeness of recovery was assessed at 10-min intervals up
      to 1 h, and thereafter at 1-h intervals. In the postoperative period a recovery
      test (postbox test) was performed. The incidence of side effects during the
      induction of anesthesia and also during recovery and the postoperative period
      (for 5 h) was recorded. RESULTS. There was no significant difference between the
      children in the 3 different groups with regard to age, body weight, type of
      operation, or duration of anesthesia. Among the total of 75 children, 66.7%
      accepted the vein puncture very well, and 24% well. In some children in each
      group we observed obstruction of the respiratory tract (group A, 36%; group B,
      48%; group C, 64%). Apnea for 20 s was observed only in groups B and C (2 and 3
      children respectively). During spontaneous respiration with room air there was a
      significant decrease of the arterial oxygen saturation about 1 min after
      induction in all groups. In children ventilated with oxygen by mask, the SaO2
      remained nearly constant...

PMID- 2221314
TI  - [Hemodynamics and myocardial energy balance in coronary surgery patients during
      high-dose fentanyl-pancuronium anesthesia and modified neurolept-pancuronium
      anesthesia].
AB  - In 8 patients with coronary artery disease (CAD) classed as NYHA II or III,
      anesthesia was induced with high-dose fentanyl (0.05 mg/kg) and pancuronium (0.1
      mg/kg). The patients were ventilated normally with the aid of a mask (O2: air
      1:1, tidal volume 10 ml/kg with a rate of 10/min) for 5 min and then intubated.
      In 8 further patients with CAD NYHA class II or III, anesthesia was induced with
      0.02 mg/kg flunitrazepam, N2O/O2 1:1 and isoflurane 0.5 vol%; they were relaxed
      with pancuronium (0.1 mg/kg) in combination with a bolus of 0.005 mg/kg fentanyl.
      These patients were also ventilated normally for 5 min and then intubated.
      Measurements of cardiovascular dynamics included cardiac output (CO), heart rate
      (HR), arterial pressure (AP), pulmonary artery pressure (PAP), pulmonary
      capillary wedge pressure (PCWP), right atrial pressure (RAP), myocardial blood
      flow (MBF), and arterial and coronary sinus oxygen and lactate contents. Cardiac
      index (CI), stroke volume index (SVI), total peripheral resistance (TPR),
      myocardial oxygen consumption (MVO2), coronary vascular resistance (CVR),
      coronary perfusion pressure (CPP), myocardial oxygen content difference
      (AVDO2cor) and myocardial lactate extraction rate (LE) were calculated from
      standard formulas. Measurements and an electrocardiogram were taken before
      anesthesia, after induction of anesthesia and after intubation. The hemodynamic
      parameters HR, AP, CI, CPP were relatively stable in patients anesthetized with
      high-dose fentanyl and pancuronium, whereas we found greater decreases in these
      parameters with the balanced anesthesia technique. Determinants of myocardial
      oxygen demand were higher in the high-dose fentanyl group; therefore, myocardial
      blood flow and oxygen consumption did not decrease to the same extent as in the
      balanced anesthesia group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221315
TI  - [Problems of intubation using the flexible LF-1 fiberoptic bronchoscope.
      Development of an intubation aid].
AB  - Fiberoptic endotracheal intubation with an endoscope (external diameter 4 mm)
      especially designed for anesthesiologists proved to be safe providing small
      diameter tubes were used. The use of large-diameter tubes (I.D. 7.5-8.5 (mm))
      involves a risk of the tip of the tube clinging to the arytenoid cartilages
      preventing any further advancement. To avoid this complication another special
      tube has been constructed, which fills the space between the endotracheal tube
      and the bronchoscope and centers the bronchoscope within the endotracheal tube.
      When this new tube was used there were no problems either in passing the
      bronchoscope through this "inner" tube or in withdrawing the inner tube after
      successful intubation. With the new device it was even possible to pass tubes
      with wider lumen into the trachea over the fiberscope with minimal difficulty and
      trauma.

PMID- 2221316
TI  - [Intraoral dental fixation of an endotracheal tube using a cofferdam clamp].
AB  - Extraoral tape fixation of the orotracheal tube for general anesthesia is a major
      problem in maxillofacial surgery. First of all, surgical access to the perioral
      and nasal region is handicapped by the tape covering and distracting the skin,
      especially in those cases where no nasotracheal intubation is possible;
      furthermore, blood, saliva, and disinfectant fluid interfere with reliable
      adhesion of the tape. A method of intraoral dental fixation of the orotracheal
      tube by a rubber dam fixation clamp is presented. The rubber dam isolates teeth
      against the oral cavity, providing a dry operative field to the dentist. The set
      of clamps, each designed according to the individual anatomy of the different
      teeth, is usual in the dental trade. After intubation the selected clamp is
      placed on the tooth by means of the forceps. The tube is laid on the clamp and
      tied on by a silk thread (2 x 0), which is inserted through the clamp's holes. We
      recommend fixation to the teeth in the mandible to avoid tension load, which
      could strain teeth in the maxilla; as far as possible only teeth without any
      impairment (e.g. loosening) should be selected. CONCLUSION: The method of
      intraoral dental fixation of the orotracheal tube by a rubber dam clamp offers
      the following advantages: (1) the surgeon, especially the maxillofacial surgeon,
      has a good view of the perioral region and free access for surgery; there is (2)
      no skin distraction or irritation by tape; there is (3) reliable tube fixation
      even for patients with allergy to adhesive materials; there is (4) no solution of
      tape fixation by blood, saliva, or disinfectant fluid; and (5) silk sutures
      cannot be subjected to strain when solving tape fixation.

PMID- 2221317
TI  - [Comments on the paper by J. Schou et al. The double mask].

PMID- 2221319
TI  - Symposium issue: obstetric anesthesia. Proceedings.

PMID- 2221318
TI  - The Minnitt Gas/Air Apparatus (Queen Charlotte model).

PMID- 2221320
TI  - Epidural opioids in obstetrics--a review.
AB  - Epidural opioids have been used in obstetrics since 1980. Various opioids are
      reviewed in relation to their pharmacology, their efficacy in labour, during
      caesarean section and for postoperative analgesia, their side-effects and safety.
      In this patient population it appears safe to administer epidural opioids on the
      general ward provided that strict monitoring standards are maintained. Practical
      considerations of nursing management are discussed.

PMID- 2221321
TI  - Epidural medication after the initial dose: reflections on current methods of
      administration during labour.
AB  - Most women who receive epidural pain relief during labour require additional
      epidural analgesia following the initial dose. This review examines the relative
      merits associated with current methods of epidural drug delivery when further
      analgesia is required. Apart from considerations of patient safety and
      convenience the review compares the relative flexibility in pain management which
      can be provided by these different regimens. It is postulated that patient
      satisfaction is enhanced when the mother has some personal control over the
      density of neural blockade provided by epidural analgesia.

PMID- 2221322
TI  - Monitoring epidural analgesia in the parturient.
AB  - Appropriate monitoring during obstetric epidural analgesia consists of: 1.
      Indirect BP and pulse monitoring before epidural insertion, frequently after
      every dose, and intermittently thereafter. 2. The aspiration test before all
      injections. 3. Frequent clinical monitoring for signs of intravascular injection
      during administration of small intermittent doses (not more than 3-5 ml at a
      time). 4. Frequent clinical monitoring for sympathetic, sensory and motor signs
      indicating upward extension of the block. 5. Frequent monitoring of the fetal
      heart rate (FHR) and other signs of fetal welfare. In many instances continuous
      tocogram with fetal heart rate (CTG) monitoring is useful. We do not believe CTG
      use is mandatory for epidural analgesia in the uncomplicated pregnancy, but we do
      advocate that it (and other appropriate fetal monitoring techniques) be used when
      risk factors or complications, either fetal or maternal, are present or
      suspected. The anaesthetist should be familiar with fetal monitoring techniques,
      their use and interpretation. He or she should be prepared to recommend their use
      when it is considered appropriate to do so.

PMID- 2221323
TI  - The place of caudal anaesthesia in obstetrics.
AB  - Present day trainee anaesthetists could be forgiven if they finished their
      anaesthetic training believing that caudal anaesthesia in obstetrics is not only
      unnecessary, but dangerous and a relic of the past. Many anaesthetic texts teach
      applications and techniques which are little or no advance on the teachings of
      Hingson and Edwards in 1942 and reflect nothing of the true value and application
      of this valuable block. This paper presents a critical review of these texts and
      of the results of the use of the block in a busy obstetric unit.

PMID- 2221324
TI  - Epidurals, spinals and bleeding disorders in pregnancy: a review.
AB  - Paraplegia caused by spinal haemorrhage is a very rare but disastrous
      complication of spinal or epidural insertion. The risk in uncomplicated surgical
      and obstetric patients is outlined. Bleeding disorders in pregnant patients may
      prevent the use of major regional anaesthesia. Factors which influence the choice
      of anaesthetic technique for patients with pregnancy-induced hypertension, von
      Willebrand's disease, and anticoagulation therapy, are discussed.

PMID- 2221325
TI  - Anaesthesia and the sick foetus.
AB  - The primary cause of foetal illness is placental pathology. The use of diagnostic
      ultrasound allows for a better understanding of how the foetus may be compromised
      by inadequate placental function. Anaesthesia affects placental function by
      changing uteroplacental and umbilical placental perfusion. Regional anaesthesia
      may have a beneficial effect on these circulations although general anaesthesia
      may be adapted to produce minimal disturbance of placental circulatory dynamics.
      The advantages and disadvantages of particular anaesthetic techniques in the
      delivery of the sick foetus are discussed.

PMID- 2221326
TI  - Management of failed endotracheal intubation at caesarean section.
AB  - A review of the history of endotracheal intubation and endotracheal tubes is
      presented and a plan of management of failed endotracheal intubation at caesarean
      section is described. The importance of preparation for such an event by
      incorporation of certain features into anaesthesia training programs is
      emphasised.

PMID- 2221327
TI  - Haematological disorders responsible for maternal bleeding in late pregnancy.

PMID- 2221328
TI  - The Melbourne Chart--a logical guide to neonatal resuscitation.
AB  - Resuscitation of the asphyxiated infant is one of the great emergencies in
      medical practice. Properly done, it can save many lives and greatly reduce the
      morbidity resulting from hypoxic-ischaemic encephalopathy, but if it is ineptly
      performed, the effects of hypoxic-ischaemic encephalopathy may be accentuated,
      with resultant increased morbidity and even mortality. Other than paediatricians,
      few practitioners have regular experience in neonatal resuscitation: indeed many,
      including obstetricians, anaesthetists, general practitioners and midwives may
      only rarely face the problem of severe asphyxia. It is therefore essential for
      the occasional practitioner to have ready reference to a logical guide to
      resuscitation. We have designed such a guide which is widely distributed in
      delivery suites and operating theatres in Victoria. Its basic form has been in
      use for over a decade and it has recently been revised. Use of the chart assists
      the resuscitator to judge the level of resuscitation required. It is our
      experience that much unnecessary intervention occurs at resuscitation, and we
      believe the methods outlined in this schematic chart represent a more
      conservative but logical approach to neonatal resuscitation. The chart is based
      on the pathophysiological changes that occur in perinatal asphyxia, directing the
      user to the appropriate manoeuvres required to correct those changes, depending
      on the degree of asphyxia which is determined by clinical signs and by use of the
      Apgar score.

PMID- 2221329
TI  - Drug dependence and pregnancy: antenatal and intrapartum problems.
AB  - The last decade has seen an increase in the use of illicit drugs and alcohol in
      the community including an increase in the use of these agents by women in the
      reproductive age group. With this in mind, health-care workers need to avoid
      being complacent in caring for these women--they are a high-risk obstetric
      population with a significant incidence of medical, obstetric and paediatric
      complications. This paper concentrates on the antenatal and intrapartum problems,
      and outlines their management. An overview of the problem is presented as well as
      an illustrative case report.

PMID- 2221330
TI  - Management of severe pregnancy-induced hypertension, or gestosis, with sodium
      nitroprusside.

PMID- 2221331
TI  - Pulmonary hypertension and pregnancy--a lethal combination.
AB  - Pulmonary hypertension may be either primary of unknown aetiology or secondary to
      existing cardio-respiratory disease. As a single entity the prognosis is poor but
      superimposition of the physiological changes of pregnancy and labour produces a
      lethal condition. This paper sets out two clinical cases of primary pulmonary
      hypertension as background for discussion to highlight the issues involved.
      Whatever this discussion does, let it be clearly spelled out that prevention is
      better than any proposed cure.

PMID- 2221333
TI  - Predictors of mortality in children with respiratory failure: possible
      indications for ECMO.
AB  - There are many unproven methods of ventilation and oxygenation that have been
      used in children dying from respiratory failure, including extracorporeal devices
      and high frequency ventilation. However, no objective predictors of death have
      been developed that enable clinicians to decide when it is reasonable to use
      these therapies in children over one month of age with acute respiratory failure.
      To determine predictors of death, we evaluated the charts of all 42 children aged
      one month to eighteen years admitted to the intensive care unit who were
      ventilated for more than twelve hours, received greater than 90% oxygen, received
      a peak inspiratory pressure greater than 25 cmH2O and had no pre-existing
      neurodevelopmental handicap. A combination of a variable reflecting ventilation
      and a variable reflecting oxygenation reliably predicted death: a combination of
      ventilation index greater than 40 and oxygenation index greater than 0.4 was
      associated with a 77% chance of mortality (sensitivity 65% and specificity 74%);
      a combination of peak inspiratory pressure greater than 40 cmH2O and A-aDO2
      greater than 580 was associated with an 81% chance of mortality (sensitivity 74%
      and specificity 79%). These criteria may be useful in predicting death from
      respiratory failure in children.

PMID- 2221332
TI  - Role of repeated doses of oral activated charcoal in the treatment of acute
      intoxications.
AB  - While single dose activated charcoal is effective in preventing drug absorption,
      repeated doses not only prevent absorption but also can increase systemic drug
      clearance. The mechanism for the latter effect may involve interruption of
      enterohepatic recycling and/or promotion of drug exsorption from the systemic
      circulation into the gut lumen. A comprehensive review of reported studies in
      volunteer subjects and overdose patients showed that repeated dose activated
      charcoal markedly decreased the half-life and/or increased the clearance of a
      wide range of drugs. Side-effects of the treatment were infrequent, but included
      aspiration pneumonia, diarrhoea and constipation. The addition of laxatives to
      repeated dose charcoal treatment did not offer any significant increase in drug
      clearance and is not recommended. It is suggested that the optimal regimen for
      the use of repeat dose activated charcoal in acute drug intoxications is an
      initial dose of 75-100 g, followed by 50 g every 4 hours until the risks of
      systemic drug toxicity are reduced to an acceptable level.

PMID- 2221335
TI  - Inadvertent spinal anaesthesia with 0.125% bupivacaine and fentanyl during
      labour.

PMID- 2221334
TI  - Halothane reductive metabolism in an adult surgical population.
AB  - The reductive metabolism of halothane was studied in 34 adult patients undergoing
      routine surgery. Reductive biotransformation of halothane was more extensive in
      females than males and was also enhanced in two patients treated preoperatively
      with phenytoin, an enzyme-inducing drug. Tobacco, ethanol and the patient's age,
      body weight and previous exposure to halothane did not influence reductive
      metabolism of halothane.

PMID- 2221336
TI  - Hyperbaric oxygen for cerebral arterial air embolism occurring during caesarean
      section.

PMID- 2221337
TI  - Three cases of anaphylactoid reaction to Haemaccel.

PMID- 2221338
TI  - Obituary: a man of history-- Douglas Joseph.

PMID- 2221339
TI  - Malignant hyperpyrexia and oxygen consumption.

PMID- 2221340
TI  - Respiratory arrest with epidural fentanyl.

PMID- 2221341
TI  - Avoiding needle-stick injury.

PMID- 2221343
TI  - Failure of endotracheal tube cuff deflation.

PMID- 2221342
TI  - Peritoneal dialysis in ICU.

PMID- 2221344
TI  - Trilene afficionados.

PMID- 2221345
TI  - Percutaneous dilational tracheostomy--a caution.

PMID- 2221346
TI  - The use of a multichannel scaling method to detect radioactive species in spread
      monolayers.
AB  - This study describes a simple and inexpensive method for monitoring radioactive
      species spread as monolayers at the air/water interface. The combination of a
      discriminator and multichannel scalar counter with a personal computer functions
      to unify all measurements, to simplify the operational process and data
      acquisition, and to provide a real-time display of the data. Its use is
      demonstrated by following the hydrolysis of L-alpha-[1-14C]dioleoyl
      phosphatidylcholine by the enzyme, phospholipase A2, isolated from the porcine
      pancreas.

PMID- 2221347
TI  - Electrophoretic detection of ascorbate oxidase activity by photoreduction of
      nitroblue tetrazolium.
AB  - A method for the detection of ascorbate oxidase in electrophoretic gels is
      described. This method relies on the ability of the enzyme to prevent the
      photoreduction of nitroblue tetrazolium (NBT). The method is based on that
      described by C. Beauchamp and I. Fridovich (1971, Anal. Biochem. 44, 276-287) for
      the superoxide dismutase and was made specific for ascorbate oxidase detection by
      treating the gel with 0.1 M hydrogen peroxide. Ascorbate (25 microM) or
      riboflavin (500 microM) was used as the electron donor. The possible reaction
      mechanism in the presence of ascorbate has been investigated. Western and
      Northern blot analyses confirmed the results obtained from the NBT staining
      procedure.

PMID- 2221348
TI  - A radioisotopic assay for polyamine oxidase.
AB  - A new radioisotopic assay for polyamine oxidase with N1-acetylspermine as
      substrate is presented. A modified method for the chemical synthesis of
      radioactive N1-acetylspermine, which gave a good yield, is also described. The
      reaction mixture, containing N1-[14C]acetylspermine and tissue homogenate, was
      incubated for the enzyme reaction and applied to a minicolumn of Amberlite CG-50.
      The reaction product 3-[14C]-acetamidopropanal did not adsorb to the column, but
      passed through it; thus the eluate could be directly subjected to liquid
      scintillation counting. The blank levels were low and relatively constant even
      with crude tissue homogenates. The detection limit obtained was 0.05 nmol per
      tube. This method is simple, highly sensitive, and highly specific.

PMID- 2221349
TI  - 2,4-Dinitrophenyl [14C]cysteinyl disulfide allows selective radioactive labeling
      of protein thiols under spectrophotometric control.
AB  - 2,4-Dinitrophenyl [1-14C]cysteinyl disulfide readily introduces by disulfide
      exchange [14C]cysteine as a label into proteins with exposed thiols. The release
      of an equivalent amount of colored 2,4-dinitrothiophenolate allows the labeling
      reaction to be followed spectrophotometrically. In reaction with two cysteine
      residues of rabbit skeletal muscle actin, the thiol selectivity of the reagent
      corresponded to that of 5,5'-dithiobis(2-nitrobenzoic acid) (Ellman's reagent)
      and was superior to that of N-[14C]ethylmaleimide. Labeling of single SH groups
      of actin and papain proceeded faster than titration with Ellman's reagent under
      the same conditions. The [14C]cysteine label could be removed under mild
      conditions, e.g., with dithiothreitol, but proved to be stable during cyanogen
      bromide degradation of the protein and peptide purification. 2,4-Dinitrophenyl
      cysteinyl disulfide can be easily prepared within a few hours.

PMID- 2221350
TI  - Application of sodium dodecyl sulfate-gel electrophoresis to low molecular weight
      polypeptides.
AB  - Experiments with nine polypeptides with molecular weights between 2000 and 10,760
      confirm the value of sodium dodecy sulfate (SDS)-gel electrophoresis for
      separating polypeptides in this molecular weight range. In one case,
      electrophoretic blotting and microsequencing were successfully carried out.
      However, molecular weight determination in the low molecular weight range (less
      than 10,000) is much less reliable than that in the conventional molecular weight
      range (greater than 10,000) for SDS gels. Information provided by suppliers of
      horse heart myoglobin fragment kits is potentially misleading.

PMID- 2221351
TI  - High-performance liquid chromatographic analysis of radiolabeled inositol
      phosphates.
AB  - Separation of inositol phosphates by low-pressure anion-exchange chromatography
      yields unsatisfactory results, while previously described anion-exchange HPLC
      methods require such extensive processing times that they preclude efficient
      sample analysis. Using a low-capacity Vydac nucleotide anion-exchange column, we
      have developed a method which allows complete separation of myo-inositol,
      inositol 1-phosphate, inositol 1,4-bisphosphate, inositol 1,4,5-trisphosphate,
      and inositol 1,3,4,5-tetrakisphosphate in approximately 10 min followed by a 5
      min column regeneration time. This method provided exceptional reproducibility
      and quantitative recovery of each inositol phosphate. One column was used for
      over 300 separations with no loss in performance or alteration in elution
      pattern. A modified procedure with a 14-min gradient was developed to separate
      the 1,3,4- and 1,4,5-isomers of inositol trisphosphate. These separation
      procedures were used to characterize the kinetics of degradation of inositol
      phosphates by lysates of erythrocytes and neutrophils. We conclude that these
      procedures are applicable for rapid and quantitative analysis of radiolabeled
      inositol phosphates in cellular extracts.

PMID- 2221352
TI  - Difference between histidine and histamine in the mechanistic pathway of the
      fluorescence reaction with ortho-phthalaldehyde.
AB  - Histamine reacts with ortho-phthalaldehyde (OPA) in an alkaline medium to form an
      unstable fluorescent adduct (Fbase-Hm). Acidification of the solution to pH 2-4
      gives a stable and highly fluorescent adduct (Facid-Hm). In contrast, histidine
      develops a relatively stable fluorescent adduct (Fbase-Hd) with OPA in an
      alkaline medium. Upon acidification of the solution, however, only trace amounts
      of the alternative fluorescent adduct (Facid-Hd) are produced although Fbase-Hd
      disappears similarly to Fbase-Hm. In this paper, the reaction pathway of
      histidine with OPA was clarified by the kinetic analysis of formation and
      degradation of Fbase-Hd. In comparing the results of this study with the previous
      ones for histamine (T. Yoshimura et al., 1987, Anal. Biochem., 164, 132-137), we
      elucidate the difference between histamine and histidine in the mechanism of
      fluorescence reaction with OPA. The presence of the carboxyl group in histidine
      not only stabilizes Fbase-Hd in an alkaline medium but also prevents the
      formation of a 1:2 adduct of histidine and OPA, the precursor of Facid-Hd.

PMID- 2221353
TI  - Preparative high-performance liquid chromatography purification of
      polyunsaturated phospholipids and characterization using ultraviolet derivative
      spectroscopy.
AB  - A preparative reversed-phase HPLC system utilizing an isocratic mobile phase to
      purify up to 10-mg quantities of phospholipids is described. The method was
      developed to separate oxidation products of polyunsaturated phospholipids from
      intact, parent lipids. The method is useful for phosphatidylcholine and
      phosphatidylethanolamine on a preparative scale and for phosphatidylserine and
      phosphatidic acid on an analytical scale. Both intact phospholipids and oxidized
      phospholipids were monitored by absorbance at 206 nm. The oxidation products were
      simultaneously monitored at 234 nm where the intact phospholipids have only a
      very slight end absorption. Second-derivative uv spectroscopy proved to be
      extremely useful to identify the presence or to verify the absence of oxidation
      products in phospholipid samples. For autoxidized docosahexaenoic acid containing
      phospholipids, the absorbance maximum of diene oxidation products is 237 nm for
      the trans,trans (t,t) isomer and 246 nm for the cis,trans (c,t) isomers.
      Similarly, five classes of triene oxidation product stereoisomers have distinct
      absorbance maxima detected by second-derivative spectroscopy ranging from 269 to
      292 nm.

PMID- 2221354
TI  - Colorimetric determination of N-acetylhexosamine-terminating O-glycosidically
      linked saccharides in mucins and glycoproteins.
AB  - A sensitive colorimetric assay for detecting mucins and glycoproteins rich in O
      glycosidically linked saccharides is reported. The method combines the
      susceptibility of N-acetylgalactosamine terminating O-glycosidically linked
      saccharides to beta-elimination with the Morgan-Elson reaction for N
      acetylhexosamines with free reducing ends. All mucin and mucin-type glycoproteins
      but none of the serum-type glycoproteins tested resulted in characteristic color
      production. All mucins tested gave linear responses in the range 5 to 200
      micrograms and the assay was also adapted to the microscale involving the use of
      96-well microtiter plates. The microassay in which the volumes of samples and
      reagents are scaled down 2.5-fold was particularly useful in monitoring of
      mucins, in the presence of other glycoconjugates, in large numbers of samples
      obtained during fractionation procedures. Cesium chloride, cesium bromide,
      potassium thiocyanate, and various detergents do not interfere with the
      colorimetric determination. Guanidine hydrochloride, cesium trifluoroacetate, and
      beta-mercaptoethanol decreased color by 30 to 45%; however, the interference was
      not serious to prevent the use of the method for detection of mucins in their
      presence. The use of the method for the specific detection of mucin during
      fractionation by gel filtration and density gradient centrifugation of cystic
      fibrosis sputum samples is demonstrated.

PMID- 2221355
TI  - Preparation and characterization of monoclonal antibodies to an N-linked
      oligosaccharide.
AB  - Two monoclonal antibodies to an N-linked oligosaccharide, MT-5 and MT-9, have
      been prepared by immunization with a pyridylaminated, asialylated,
      galactosylated, fucosylated, bisected biantennary sugar. The reactivity of these
      antibodies was monitored by their reaction with human asialoglycophorin in a
      solid-phase enzyme-linked immunosorbent assay. Both antibodies reacted with the
      sugar chains of various human glycoproteins such as immunoglobulin G,
      transferrin, gamma-glutamyl transpeptidase, alpha 1-acid glycoprotein, and alpha
      fetoprotein. Treatment of asialoglycophorin with beta-N-acetylhexosaminidase or
      alpha-mannosidase resulted in reduction of the binding to these antibodies. The
      reactivity of MT-5 to asialoglycophorin was slightly inhibited by D-mannose and N
      acetylglucosamine, whereas that of MT-9 was inhibited by D-mannose, N-acetyl-D
      glucosamine, chitobiose, and L-fucose. The epitope specificity of MT-5 appears to
      be a sugar chain containing biantennary N-acetyl-D-glucosamine residues, the
      bisected N-acetyl-D-glucosamine residue, and a trimannosyl core. The epitope to
      which MT-9 is directed may be a complex made up of beta-mannose, chitobiose, and
      L-fucose. These studies indicate that immunization with pyridylaminated sugars
      can produce antibodies that recognize N-linked oligosaccharides.
      Monoclonal/polyclonal antibodies to the N-linked sugar chains of glycopeptides
      would be useful in such studies of proteins.

PMID- 2221356
TI  - Conditions influencing yield and analysis of 8-hydroxy-2'-deoxyguanosine in
      oxidatively damaged DNA.
AB  - We have conducted studies to obtain practical knowledge regarding the stability,
      digestion, and analytical determination of the content of 8-hydroxy-2-deoxy
      guanosine (8-OHdG) in oxidatively damaged DNA. Utilizing H2O2 plus uv light to
      form oxidatively damaged DNA, we found that storage of the DNA at -20 degrees C
      at alkaline pH caused a significant loss of 8-OHdG, whereas storage at -20
      degrees C at neutral or acidic pH prevented loss of 8-OHdG. The 8-OHdG within DNA
      is stable at 100 degrees C for at least 15 min. Formation of 8-OHdG within DNA
      using uv light and H2O2 as a hydroxyl free radical-generating system yields the
      highest amounts when low levels of phosphate buffer are used; but the use of Tris
      or citrate buffers causes a lower yield of 8-OHdG because these buffers act as
      scavengers for the hydroxyl free radicals. Independent assessment of hydroxyl
      free radical flux by the use of salicylate trapping allows assessment of
      competitive radical reactions. Ethanol washing of plastic microfuge tubes prior
      to DNA enzymatic digestion improved the yield of 8-OHdG and reduced the
      variability between samples. Digestion of the oxidatively damaged DNA by the use
      of a method involving DNase I, endonuclease, phosphodiesterase, and alkaline
      phosphatase produced the highest yield of 8-OHdG.

PMID- 2221357
TI  - Identification of FAD, FMN, and riboflavin in the retina by microextraction and
      high-performance liquid chromatography.
AB  - The presence of flavins in the retina has been known for some time. However, the
      small size of the tissue has made it difficult to quantify the levels of the
      individual flavins, riboflavin (RB), FMN, and FAD without pooling large numbers
      of retinas. A procedure to extract and quantitate RB, FMN, and FAD in retinal
      tissue from as few as four rat retinas has been developed. The procedure resolves
      these three classes of flavins and provides a recovery near 100%. For the
      analysis, HPLC using a reverse-phase column with cyclohexyl functional groups was
      coupled to a fluorescence detector. The microextraction-HPLC procedure was
      reproducible for the quantitative analysis of flavins in the retina and equally
      applicable for analysis of flavins in liver and plasma.

PMID- 2221358
TI  - Analysis of beta-hydroxy-beta-methyl butyrate in plasma by gas chromatography and
      mass spectrometry.
AB  - A method for measuring the branched chain hydroxy acid beta-hydroxy-beta-methyl
      butyrate (HMB, a product of leucine catabolism) has been described. A [2H6]HMB
      internal standard was added to plasma and standards, and samples were extracted
      with diethyl ether, backextracted into neutral phosphate, dried, and derivatized
      for gas chromatography and mass spectrometry. The natural HMB was monitored at
      175 amu and the deuterated HMB was monitored at 181 amu. Standard curves were
      linear to at least 25 microns and were quantitatively recovered from plasma.
      Basal concentrations of plasma HMB were from 1 to 2 microM in sheep and increased
      three- to fourfold when leucine's alpha-ketoacid (alpha-ketoisocaproate, KIC) was
      fed to lambs. This method can also be adapted to quantitate KIC and other
      branched chain ketoacids in plasma during the same run.

PMID- 2221359
TI  - A rapid, high resolution DNA sequencing gel system.
AB  - We have developed a simple method which significantly increases the efficiency of
      manual DNA sequencing. This method increases both the ease of gel preparation and
      the quality of fragment resolution. Our system involves (i) casting of gels
      horizontally, without sealing around the plates; (ii) the use of a self-forming
      buffer gradient to stack bands in the lower part of the gel; (iii) separation of
      the samples on two 0.2-mm-thick acrylamide gels (4.5 and 4%) with overlapping
      readings; (iv) "nonsmiling" electrophoresis with very simple, self-made
      electrophoresis stands; and (v) prior to exposure in situ dry fixation of the gel
      matrix to the glass support without previous covalent binding of the gel. On
      average, we are able to read from nucleotide position 50 to position 600 without
      ambiguity.

PMID- 2221360
TI  - Analysis of mucin-derived oligosaccharides by medium-pressure gel-permeation and
      amino-plate thin-layer chromatography conducted in conjunction.
AB  - Oligosaccharides present in mucin were labeled by reduction with NaB3H4 and
      separated by gel-permeation chromatography with a Toyopearl HW-40S column using
      0.1 M pyridine acetate, pH 5.0, as the solvent. Each fraction was further
      analyzed by thin-layer chromatography (TLC) on a Funagel AMP plate, a glass plate
      precoated with 3-aminopropyl-bonded silica. Acetonitrile/10 mM triethylamine
      acetate (3/2, by volume) served as the solvent. The sites of oligosaccharides on
      the TLC plate could be determined according to size, anionic charge, and sugar
      composition. They could thus be "mapped" on the plate. In this manner, the
      distribution of oligosaccharides on bovine submaxillary mucin and rat gastric
      mucin was determined. Each radiolabeled oligosaccharide in newly synthesized rat
      gastric mucin, metabolically labeled with [14C]glucosamine or [35S]sulfate, was
      also identified by this method.

PMID- 2221362
TI  - Extraction method for preparing pyridylamino sugar derivatives and application to
      porcine gastric mucus glycoprotein analysis.
AB  - For the sensitive detection of free sugars and oligosaccharides, the use of their
      pyridylamino derivatives has now found general acceptance. To remove excess 2
      aminopyridine from this derivative in a reaction mixture, gel filtration and ion
      exchange chromatography were conducted. It was found in the present study that
      contaminated 2-aminopyridine could be selectively removed from the reaction
      mixture by adjusting the pH with saturated sodium bicarbonate at above 8.5
      followed by extraction with benzene. By using this method, fewer purification
      steps and less time are required, with minimum loss of pyridylamino sugar
      derivatives.

PMID- 2221361
TI  - High-pressure liquid chromatography of sialic acids on a pellicular resin anion
      exchange column with pulsed amperometric detection: a comparison with six other
      systems.
AB  - A wide variety of different sialic acids have been reported in nature. Following
      their release and purification, detection and quantitation of these molecules is
      now possible by a number of techniques. We and others have previously reported
      high-pressure liquid chromatography separation of sialic acids with several
      different columns, elution methods, and detection techniques. We report here a
      new method for the separation of sialic acids at neutral pH on a Carbopac PA-1
      anion-exchange column of pellicular resin, with pulsed amperometric detection
      following postcolumn addition of alkali. The major advantages of this system are
      the separation of a variety of sialic acids, sensitive detection (into the
      picomole range), and the relative ease of use for preparative purposes. Using a
      set of defined sialic acid standards, this method is compared and contrasted with
      six other HPLC methods previously described by us and by others. The advantages
      and disadvantages of each system are also addressed. In the final analysis, no
      single method is adequate to completely separate and quantitate all of the known
      sialic acids. However, used in appropriate combinations, these methods allow
      exploration of the biology of sialic acids in a manner heretofore not possible.

PMID- 2221363
TI  - Isolation of proteoglycans using phenol extraction and isopycnic centrifugation
      in cesium trifluoroacetate.
AB  - A procedure for the rapid isolation of heparan sulfate proteoglycans from
      Zwittergent lysates of cultured cells and cetylpyridinium precipitates of culture
      medium is described. After removal of most nonglycosylated proteins by phenol
      extraction, the proteoglycans are fractionated and isolated by isopycnic
      sedimentation in cesium trifluoroacetate gradients. The density-isolated
      proteoglycans, which are largely free of high molecular weight DNA, RNA, and
      nonglycosylated proteins, are readily amenable to chemical and enzymatic
      characterization. These procedures, which are designed for efficient and rapid
      isolation of lipophilic proteoglycans, also appear applicable to the isolation of
      other high density proteoglycans.

PMID- 2221364
TI  - Affinity chromatography of DNA fragments and P-modified oligonucleotides.
AB  - The wide possibilities for use of affinity chromatography are demonstrated by two
      examples: (i) isolation of a single-stranded fragment of the tick-borne
      encephalitis virus DNA (302-mer) and an oligonucleotide (34 bases) from reaction
      mixtures and (ii) fractionation of mixtures of diastereoisomers of
      octathymidylates with modified internucleotide phosphates. All affinity sorbents
      are constructed by the covalent attachment of the oligonucleotides to solid
      supports and can be used repeatedly.

PMID- 2221365
TI  - A spectrophotometric method for simultaneous determination of protein-bound
      hexoses and fucose with a mixture of L-cysteine and phenol.
AB  - A very suitable spectrophotometric method for simultaneous determination of
      protein-bound hexoses and fucose is presented. A mixture of L-cysteine and phenol
      in sulfuric acid was used as reagent, whereas absorption measurements were
      carried out at two wavelengths, namely at 398 nm for fucose and 490 nm for
      hexoses determination. Optimum conditions for the application of the method were
      established, special attention being paid to the possible interference of fucose
      determination with that of hexoses, and vice versa. The proposed method was
      applied to the determination of hexoses and fucose in serum glycoproteins and
      seromucoids. The method was found to be very practical enabling a simultaneous
      determination of both kinds of carbohydrates; moreover, it was proved to be more
      sensitive and specific in comparison with methods commonly used for individual
      determination of fucose with L-cysteine and hexoses with phenol.

PMID- 2221366
TI  - A modified tetramethylbenzidine method for measuring lipid hydroperoxides.
AB  - A simple and sensitive spectrophotometric method for measuring lipid peroxides
      and peroxides in general is described. The method was developed by modifying an
      existing method based on the peroxidase activity of hemoglobin with
      tetramethylbenzidine as the electron donor. The modifications resulted in much
      improved sensitivity and reproducibility. With the modified method lipid
      peroxides as low as 2 nmol can be measured, a high sensitivity compared with
      other spectrophotometric methods. The absorbance is linear over a wide range of
      concentrations. It is suggested that this modified method in combination with the
      commonly used thiobarbituric acid method will give a better quantitation of lipid
      peroxidation.

PMID- 2221368
TI  - Gangliosides noncovalently bound to DEAE-Sephadex: application to purification of
      anti-ganglioside antibodies.
AB  - A simple, rapid, effective, and inexpensive method for the purification of
      ligands having high affinity for gangliosides has been developed. DEAE-Sephadex
      has a high capacity for binding gangliosides (approx 1/1.6, w/w). The
      gangliosides, bound to the support by electrostatic and hydrophobic interactions,
      showed a high resistance, in an aqueous environment, to being detached by eluants
      commonly employed to desorb ligands (i.e., low or high pH or chaotropic agent
      solutions) or by nonionic detergent solutions as well as by organic solvents. The
      DEAE-Sephadex-ganglioside complex was assayed as an immunoadsorbent for purifying
      anti-GM1 ganglioside antibodies from serum of an immunized rabbit. The specific
      activity of the purified antibodies was 200- to 400-fold higher, and the recovery
      of the anti-ganglioside activity was above 50%, with respect to the untreated
      antiserum. The preparation of the complex and the purification of the antibodies
      can be done in less than 5 h. The glycolipids from the complex can be recovered
      by elution with organic solvents containing salt or volatile base solutions, and
      reused. In principle, this method can be adapted for other anionic amphipathic
      receptor molecules to purify ligands which bind to them.

PMID- 2221367
TI  - A methodology for determination of phospholipids.
AB  - A simple method for the determination of phospholipids in an aqueous dispersion
      and in amniotic fluid was developed. The procedure is based on the observation
      that dispersed phospholipids promoted the solubilization of an insoluble dye-
      detergent complex. The solubilization of the complex between the negatively
      charged dye, Coomassie brilliant blue (CBB), and a positively charged detergent,
      cetyltrimethylammonium bromide (CTAB), produced a blue solution having a visible
      absorbance maximum above 600 nm. A linear increase in absorbance intensity occurs
      with an increase in phospholipid concentration. An assay using the CBB-CTAB
      reagent adsorbed on 3-mm glass beads is used to estimate total dispersed
      phospholipids between 2 and 25 micrograms/ml. Thereby, a two-phase water-methanol
      chloroform system is formed. The products of zwitterionic phospholipids (such as
      phosphatidylcholine and phosphatidylethanolamine) partition to the organic phase
      while the dye complex solubilized in anionic phospholipids (such as
      phosphatidylglycerol and phosphatidylinositol) partitions to the aqueous phase.
      This procedure results in a convenient, sensitive, and rapid method for the
      simultaneous determination of the total phospholipid, zwitterionic phospholipid,
      and anionic phospholipid concentrations. Application of the new assay for
      determination of phospholipids in amniotic fluid is described.

PMID- 2221369
TI  - A kinetic method for determination of free vanadium(IV) and (V) at trace level
      concentrations.
AB  - A kinetic method based on alkaline phosphatase has been developed to measure free
      trace levels of vanadium(IV) and (V). The method involves measuring the rate of
      the alkaline phosphatase-catalyzed hydrolysis of p-nitrophenyl phosphate with
      (Vi) and without (Vo) a competitive inhibitor in the assay. Michaelis-Menten
      kinetics for a competitive inhibitor was used to express the relationship between
      Vo/Vi and the inhibitor concentration. Measuring both Vo and Vi thus yields a
      Vo/Vi ratio that allows calculation of the competitive inhibitor concentration.
      Determination of free vanadium in complex fluids can be accomplished by comparing
      the ratio of rates of p-nitrophenyl phosphate hydrolysis with and without a
      sequestering agent to the ratios of rates measured on addition of a known
      vanadium concentration. Free vanadium(V) can conveniently be measured from 10(-7)
      to 10(-5) M and free vanadium(IV) can be measured at 10(-8) M and above. The
      error limits on the vanadium determinations range from +/- 3 to +/- 12% of the
      concentration under investigation depending on the conditions under which the
      assay was conducted.

PMID- 2221370
TI  - Method for rapid separation of liposome-associated doxorubicin from free
      doxorubicin in plasma.
AB  - To understand and predict the efficacy and/or toxicity of liposomal drugs in
      vivo, it is essential to have rapid, reliable methods of separating and
      quantitating both the free and the liposomal forms of the drug. A method using
      solid-phase extraction chromatography columns was developed to separate and
      quantitate unencapsulated doxorubicin and liposome-associated doxorubicin in
      plasma following the intravenous injection of liposomal doxorubicin. The method
      facilitated the recovery and quantitation of free and liposomal drug. The
      separation and recovery of doxorubicin were linear across the entire range of
      possible mixtures (0 to 100%) of the two forms of the drug in plasma. Free drug
      and liposomal drug were readily separated for liposomal doxorubicin systems
      varying in size (0.1-1.0 microns) and lipid composition (egg yolk
      phosphatidylcholine/cholesterol and distearylphosphatidylcholine/cholesterol).
      The method is rapid and allows for multiple samples to be processed
      simultaneously.

PMID- 2221371
TI  - Optimization of immobilized enzyme hydrolysis combined with high-performance
      liquid chromatography/thermospray mass spectrometry for the determination of
      neuropeptides.
AB  - Peptidases, including chymotrypsin, thermolysin, trypsin, V8 protease, and
      carboxypeptidases A, B, and Y, were immobilized for use in conjunction with
      HPLC/thermospray MS for the analysis of neuropeptides. The optimal operating
      conditions for each immobilized enzyme bioreactor were determined. Optimal
      hydrolysis usually occurred at the highest percentage of aqueous solution in the
      mobile phase at pH 7-8 and 40-50 degrees C. Often post-HPLC column addition of
      aqueous solutions before the bioreactor could improve activity and thermospray
      sensitivity without changing the HPLC separation. Enzymatic hydrolysis
      requirements were compatible under conditions for HPLC separation and thermospray
      MS detection of the selected neuropeptides. Synthetic alpha-, beta-, and gamma
      endorphins were the primary neuropeptides used to evaluate on-line immobilized
      enzyme bioreactor/MS. HPLC followed by peptidase hydrolysis produced
      characteristic hydrolysis products for confirming the peptides' identity using
      thermospray MS detection. Furthermore, the peptide formed from enzymatic
      hydrolysis resulted in a MS ion current 10-40 times higher than that of the [M +
      2H]2+ ion for unhydrolyzed beta-endorphin. The increased sensitivity achieved for
      detecting the hydrolysis products permits detection and quantitation of synthetic
      peptides down to 800 fmol.

PMID- 2221372
TI  - A solid phase assay for the protease of human immunodeficiency virus.
AB  - A solid phase assay for human immunodeficiency virus (HIV) protease using an
      immobilized substrate, Affi Gel 10-Gly-Gly-Gly-Gly-Val-Ser-Gln-Asn-Tyr-Pro-Ile
      Val-Gln-[3H]Gly-OH has been devised. The Tyr-Pro bond of the substrate was
      hydrolyzed by the protease, releasing the radiolabeled cleavage product, Pro-Ile
      Val-Gln-[3H]Gly-OH, into the supernatant. The pH optimum was found to be 6.0, and
      a high ionic strength was required for maximal activity. The solid phase assay is
      usable for convenient monitoring of purification procedures, and rapid screening
      of inhibitors of HIV protease.

PMID- 2221373
TI  - pH and buffering in the bicinchoninic acid (4,4'-dicarboxy-2,2'-biquinoline)
      protein assay.
AB  - The HCO3/CO3(2-) buffer used in the bicinchoninic acid (BCA) protein assay has
      only weak buffering capacity at the recommended pH (11.25). Consequently the
      assay is rather sensitive to interference from effectively acid or alkaline
      samples, particularly in the micro method. Adjustment of pH in these alkaline
      solutions of high [Na+] is complicated by Na+ errors on the pH electrode. Hence
      it is recommended to prepare the buffers from known amounts of NaHCO3 and Na2CO3,
      and to reduce the pH to around 10.7; this offers much better buffering capacity
      with only a limited reduction in color development.

PMID- 2221374
TI  - Nonradioactive ligand binding assay for epidermal growth factor receptor.
AB  - A rapid and sensitive nonradioactive ligand binding assay for identifying the
      agonists and antagonists of epidermal growth factor receptor is described. The
      assay is easy to perform, has a within-assay error of less than 15%, and does not
      use radioactive substances. Nonspecific binding is less than 10% and the assay is
      sensitive enough to detect epidermal growth factor (EGF) antagonists at as little
      as 10 nM, if the antagonist has the same affinity as EGF. The assay is carried
      out in 96-well plates and is particularly suitable for large-scale screening.
      This report includes description of the methods that we used to assess the
      validity of the assay system, and the results of that assessment.

PMID- 2221375
TI  - Deletion mutagenesis in M13 by polymerase chain reaction using universal
      sequencing primers.
AB  - A simple procedure is described for the efficient deletion of large DNA
      sequences. The method involves a combination of oligonucleotide-directed
      mutagenesis in bacteriophage M13 and amplification of the mutagenized product by
      polymerase chain reaction. In contrast to other protocols employing polymerase
      chain reaction, synthesis of only one specific primer is required. The efficiency
      of heteroduplex formation between mutagenic primers directing large deletions and
      single-stranded template is discussed.

PMID- 2221376
TI  - Parameterization of contribution of sugar units to elution volumes in reverse
      phase HPLC of 2-pyridylaminated oligosaccharides.
AB  - The reverse-phase high-performance liquid chromatography elution data, expressed
      in glucose units, of 2-pyridylaminated oligosaccharides (PA-oligosaccharides)
      originated from N-glycosides of glycoproteins have been analyzed with multiple
      regression to obtain parameters of contribution ascribable to each monosaccharide
      unit. For the best results, the known PA-oligosaccharides were classified into M
      series (the "high mannose" type), X-series (those containing xylose), F-series
      (those containing L-Fuc alpha (1,6)GlcNAc-PA), and Z-series (all others). Within
      each series, a variable ("unit contribution") is assigned to every sugar
      component in the oligosaccharide, and the elution value of a given
      oligosaccharide was assumed to be the sum total of the unit contributions. The
      unit contribution obtained from such multiple regression calculations led to a
      set of elution values for oligosaccharides in each series, which showed very good
      agreement with the observed elution values. These unit contribution values are
      useful in predicting the elution value when the exact structure is known, and
      they also aid in predicting the structure from the known elution value.

PMID- 2221377
TI  - Detection of lipopolysaccharides blotted to polyvinylidene difluoride membranes.
AB  - Bacterial lipopolysaccharide (LPS) blotted to polyvinylidene difluoride (PVDF)
      membranes was detected by a technique adapted from current methodologies used to
      detect glycoproteins. PVDF-bound LPS was coupled to a hapten and localized on the
      membrane by Western blotting with an antibody-alkaline phosphatase conjugate
      specific for the hapten. Immobilon blots could be made reversibly transparent for
      photography and densitometry.

PMID- 2221378
TI  - Separation of phycobiliprotein subunits by reverse-phase high-pressure liquid
      chromatography.
AB  - Baseline separation of subunits of diverse phycobiliproteins was achieved by a
      reverse-phase HPLC gradient method with a C4 large-pore column and a solvent
      system consisting of 0.1% trifluoroacetic acid (TFA) in water and 0.1% TFA in 2:1
      (v/v) acetonitrile:isopropanol. The procedure was successfully applied to
      cyanobacterial allophycocyanin and C-phycocyanins, an unusual phycocyanin from a
      marine cyanobacterium, red algal B- and R-phycoerythrins, and a cryptomonad
      phycoerythrin. The subunit sizes in these proteins range from about 7.5 to 30
      kDa. Sample recovery was in excess of 85% in all cases. On-line spectroscopic
      analysis with a multiple diode array detector allowed determination of the type
      and number of bilins carried by each subunit.

PMID- 2221379
TI  - Automation of a chloramphenicol acetyltransferase assay.
AB  - Accurate quantification of chloramphenicol acetyltransferase (CAT) enzyme
      activity in a large number of samples has been achieved through robotization of a
      CAT assay on a laboratory workstation (Biomek 1000). The basic principle of this
      CAT assay relies on the selective diffusion of [3H]acetylchloramphenicol into a
      water-immiscible liquid scintillation cocktail. This methodology gives unique
      characteristics to this robotized protocol by allowing complete control over the
      kinetics of the CAT enzymatic reaction which is a critical parameter in the CAT
      assay. Thus it has been possible to optimize the CAT assay for every processed
      sample, through real time monitoring of the enzymatic reaction, and to achieve
      maximum accuracy in CAT quantification. Moreover the sensitivity of this
      automated assay is high (detection threshold; 10(-4) CAT unit), and the sample
      processing is fast (approximately 125 samples per hour). Compared to other CAT
      assay protocols currently used, our robotized technique offers major advantages
      in terms of CAT quantification, and sets new standards for CAT assay
      productivity.

PMID- 2221380
TI  - Fluorescence assay for per-cell estimation of cytochrome P-450-dependent
      monooxygenase activities in keratinocyte suspensions and cultures.
AB  - An assay was characterized that facilitated per-cell estimation of cytochrome P
      450-dependent monooxygenase activities in whole-cell suspensions and cultures of
      murine epidermal keratinocytes (MEKs). 7-Ethoxycoumarin O-deethylase (7-ECD), 7
      ethoxyresorufin O-deethylase (7-ERD), and 7-pentoxyresorufin O-deethylase (7-PRD)
      activities were monitored by fluorescent detection of their products. MEKs were
      made permeable by a freeze-thaw cycle, and xenobiotic metabolism occurred in
      situ. Analyses of cultured MEKs were made with the cells attached to the culture
      dishes. Product formation was proportional with MEK cell number and assay time
      and was dependent upon a NADPH-generating system. The three monooxygenase
      activities were inhibited to various degrees, in a dose-dependent manner, by the
      P-450 inhibitors alpha-naphthoflavone and metyrapone. The number of MEKs obtained
      from a single mouse was sufficient for multiple analyses. The assay was also used
      to determine monooxygenase activities in whole-cell suspensions of rat
      hepatocytes. Constitutive per hepatocyte 7-ECD, 7-PRD, and 7-ERD activities were
      357-, 96-, and 1926-fold greater, respectively, than the activities measured in
      suspensions of dorsal MEKs.

PMID- 2221381
TI  - Flow injection analysis of serum urea using urease covalently immobilized on 2
      fluoro-1-methylpyridinium salt-activated fractogel and fluorescence detection.
AB  - Serum samples were analyzed for their urea content using fluorescence flow
      injection analysis incorporating an immobilized urease bioreactor and a gas
      permeable separator. The urease was immobilized under mild and facile conditions
      to a hydrophilic 2-fluoro-1-methylpyridinium-activated support. The ammonia
      released as a result of urease-catalyzed urea hydrolysis diffused through a gas
      permeable membrane into a constant stream of o-phthaldehyde solution to form a
      highly fluorescent product with lambda ex at 340 nm and lambda em at 455 nm. Up
      to 25 serum samples can be analyzed per hour. The within-day coefficient of
      variation (CV) was 1.12% and the day-to-day CV was 1.25% for serum containing
      10.50 mg urea nitrogen dl-1. The bioreactor shows excellent storage (at 4 degrees
      C) and operational stabilities (at 37 degrees C).

PMID- 2221382
TI  - Comparison of specific radioactivities of human alpha-lactalbumin iodinated by
      three different methods.
AB  - Radioiodination provides an extremely sensitive method for the detection of low
      levels of proteins. In the development of a sensitive radioimmunoassay for human
      alpha-lactalbumin (alpha-LA), the protein was labeled to high specific activity
      (approaching 2000 Ci/mmol) with lactoperoxidase, chloramine-T, and Iodogen.
      Despite high specific activities of the labeled protein by each method, there was
      a considerable difference in their binding affinity with monoclonal anti-human
      alpha-LA antibodies due to varying degrees of protein damage. Iodination of human
      alpha-LA with Iodogen resulted in labels of the highest specific activity and
      immunoreactivity with the monoclonal antibodies used.

PMID- 2221383
TI  - Nonradioactive labeling of probe with digoxigenin by polymerase chain reaction.
AB  - Probes nonradioactively labeled with the steroid hapten digoxigenin have several
      intriguing properties, including a high sensitivity equivalent to that of
      radioactive probes, speed in detection, low hazard potential in handling, and
      possibility of long-term storage. The use of polymerase chain reaction for
      labeling probe has been demonstrated to offer various advantages including
      efficient labeling of fragments as small as 100 bp, direct labeling of genomic
      DNA, and labeling with subnanogram amounts of input DNA. We therefore
      investigated whether this technique could be adapted for labeling with a
      relatively large molecule such as digoxigenin. In this report, we show that the
      polymerase chain reaction is a very efficient technique for synthesis of
      digoxigenin-labeled DNA and we present an extremely simple procedure for
      purification of the non-isotopically labeled fragments.

PMID- 2221385
TI  - Microscale, filtration-type binding assay for studying myosin-erythrocyte protein
      4.1 interactions.
AB  - In vitro binding of skeletal muscle myosin and the erythrocyte cytoskeleton
      linker protein, band 4.1, was evaluated in a novel small-volume, filtration-based
      binding assay. The assay equipment consisted of a plastic grid containing several
      buffer-filled wells into which were placed small nylon screens. Myosin was
      covalently tethered to an agarose (Sepharose) support and aliquots of this resin
      were pipetted onto the surface of the submerged nylon screen. Following addition
      of radiolabeled protein 4.1, and an appropriate incubation period, the myosin
      Sepharose beads and bound protein 4.1 were separated by wicking the buffer from
      beneath the nylon screen with a piece of filter paper. Nylon screens, with
      adherent resin beads, and the filter paper wicks were then counted to give the
      amounts of bound and free protein 4.1, respectively. This system proved to be a
      rapid, simple, and quantitative method for evaluating the behavior of a myosin
      binding protein under conditions in which free myosin would be prone to assemble
      into filaments. Moreover, since the assay separates bound and free components
      within a few seconds, it is well suited for the analysis of low-affinity
      interactions.

PMID- 2221384
TI  - Simultaneous isolation of DNA, RNA, and antigenic protein exhibiting kinase
      activity from small tumor samples using guanidine isothiocyanate.
AB  - Correlative studies of genes and their expression in human tumors are often
      hampered by the small sample size and the need to use differing and incompatible
      techniques to obtain DNA, RNA, and protein. We describe an extension of the
      established guanidine isothiocyanate method for isolation of DNA and RNA which
      allows the simultaneous isolation of total cellular protein. The protein obtained
      by this method (from solid tumors and cell lines) was comparable to protein
      extracted by a standard detergent solubilization method. Antigenicity was
      retained as demonstrated by Western blotting for epidermal growth factor receptor
      and actin and by immunoprecipitation of p53. Kinase activity was similar in
      proteins extracted by the two methods. It seems probable that most monomeric
      proteins can be obtained in a form suitable for Western analysis and
      immunoprecipitation and that these may also retain some functional activity.

PMID- 2221386
TI  - A procedure for making simultaneous determinations of the relative levels of gene
      transcripts in tissues or cells.
AB  - In this paper, we describe a method for making simultaneous determinations of the
      relative levels of selected resident gene transcripts in biological samples. The
      procedure consists of immobilizing a battery of cloned genes on a nitrocellulose
      or nylon filter and hybridizing the filter with radiolabeled cDNA synthesized
      from mRNA extracted from tissue or cell lines. The intensity of the
      autoradiographic signals obtained from the various genes on the filter is
      interpreted to be roughly proportional to the relative numbers of transcripts of
      the genes present in the original mRNA population. The reliability of the method
      was established by detecting the expression of c-N-ras and c-myc in human
      promyelocytic HL-60 cells, which are known to express these two oncogenes. The
      accuracy of the technique was further established by using a conventional method
      to hybridize filter-bound, cytoplasmic RNA with labeled probes synthesized from
      plasmid inserts of genes identified by the screening procedure. The utility of
      the procedure was demonstrated by our ability to simultaneously examine the
      relative levels of expression of 21 oncogenes in a radiation-induced canine lung
      carcinoma.

PMID- 2221387
TI  - Assay of N-myristoyl transferase by selective adsorption of myristoyl-coenzyme A
      on acidic alumina.
AB  - We have developed a simple and rapid method for detecting the enzyme myristoyl
      CoA:protein N-myristoyl transferase. The enzyme catalyzes the transfer of the
      myristoyl moiety of myristoyl-CoA to the amino-terminal glycine residue of a
      peptide (protein). Incorporation of the [14C]myristate into the peptide is
      quantified after separation of the [14C]myristoyl-peptide from unreacted
      [14C]myristoyl-CoA by selective adsorption of [14C]myristoyl-CoA on acidic
      alumina. Optimal assay concentrations were 200 microM synthetic peptide, 1 microM
      [14C]myristoyl-CoA, 10 mM Tris-HCl/1 mM dithiothreitol/0.1 mM ethylene glycol
      bis(beta-aminoethyl ether) N,N,N',N'-tetraacetic acid/aprotinin (10
      micrograms/ml) buffer, pH 7.4, and 1-10 micrograms protein.

PMID- 2221388
TI  - Determination of sulfhydryl groups and disulfide bonds in a protein by
      polyacrylamide gel electrophoresis.
AB  - A general method by polyacrylamide gel electrophoresis for the determination of
      sulfhydryls and disulfides in a protein was developed. The method included a two
      step alkylation procedure: the first step consisted of alkylation of the
      sulfhydryl groups with iodoacetic acid in the presence and absence of 8 M urea;
      the second step consisted of alkylation of the disulfide groups with
      iodoacetamide after reduction with a thiol. By high-pH urea gel electrophoresis,
      all the half-cystine residues in a protein could be categorized into three
      states: reactive sulfhydryls, nonreactive sulfhydryls, and disulfide bonded. The
      particular advantage of the method is that the states of half-cystines in
      different protein species can be analyzed independently both in isolated protein
      and in biological translation systems.

PMID- 2221389
TI  - Quantitative analysis of N-sulfated, N-acetylated, and unsubstituted glucosamine
      amino groups in heparin and related polysaccharides.
AB  - A colorimetric procedure for quantitative determination of free and substituted
      glucosamine amino groups in heparin and related polysaccharides has been
      developed. The total content of hexosamine amino groups is determined by a
      modification of the method of Tsuji et al. (1969, Chem. Pharm. Bull. 17, 1505
      1510); this method involves acid hydrolysis under conditions effecting complete
      removal of N-acetyl and N-sulfate groups, deaminative cleavage with nitrous acid,
      and colorimetric analysis of the resultant anhydromannose residues by reaction
      with 3-methyl-2-benzothiazolinone hydrazone (MBTH). N-sulfated glucosamine
      residues are cleaved selectively by treatment with nitrous acid at pH
      approximately 1.5 (J. E. Shively, and H.E. Conrad, 1976, Biochemistry 15, 3932
      3942) and quantitated by the MBTH reaction. Under carefully controlled
      conditions, deamination at pH approximately 1.5 is highly specific for N-sulfated
      glucosamine residues, but an excess of reagent causes some cleavage of residues
      with unsubstituted amino groups as well. Deaminative cleavage at pH approximately
      4.5 results in preferential degradation of unsubstituted glucosamine residues,
      but some cleavage (5-8%) of N-sulfated residues also occurs. However, analysis of
      the content of N-sulfated residues by the specific pH 1.5 procedure allows
      appropriate corrections to be made. From the value for total hexosamine content
      and the sum of N-sulfated and unsubstituted residues, the content of N-acetylated
      residues is calculated by difference. The modified deamination procedures, in
      combination with product analysis by the MBTH reaction, have been applied to
      several problems commonly encountered in the analysis and characterization of
      heparin.

PMID- 2221390
TI  - Reversed-phase liquid chromatographic separation of juvenile hormone and its
      metabolites, and its application for an in vivo juvenile hormone catabolism study
      in Manduca sexta.
AB  - A convenient reversed-phase liquid chromatographic method was developed to
      separate juvenile hormone (JH) and its metabolites. The known metabolites
      including JH acid, JH diol, and JH acid-diol, as well as an unknown metabolite,
      were efficiently separated within 25 min on a 50 X 4.6 mm polymer column using a
      linear gradient of acetonitrile:5 mM Hepes (pH 7.4) buffer. Use of the polymer
      column diminished tailing observed for the diol metabolite on a C18 silica
      column, and allowed use of slightly basic buffers without concern of column
      instability. Use of buffer was essential to give good peak shape and reproducible
      retention behavior for the acidic metabolites. Using this method, an in vivo JH
      catabolism study was performed in fifth stadium larvae of Manduca sexta. Injected
      (10R)-[3H]JH III was rapidly converted to JH acid-diol and to an unknown
      compound(s) indicating that, in addition to JH esterase, epoxide hydrolase and
      other reactions play an important role in the catabolism of JH.

PMID- 2221391
TI  - High-performance liquid chromatographic separation of hyaluronan and four
      proteoglycans produced by human bone cell cultures.
AB  - Four proteoglycans and hyaluronan synthesized by cultured human bone cells were
      isolated using a two-step high-performance liquid chromatography system involving
      desalting and buffer exchange with a TSK-GEL HW 40(S) column followed by ion
      exchange separation on a Nucleogen 4000-10 DEAE column. The desalting of 4 M
      guanidinium HCl extracts by a TSK-GEL HW 40(S) column equilibrated in a
      formamide:KH2PO4 buffer produces greater than 95% recoveries, enables
      quantitation of label incorporation and requires only 40 min to complete. The
      Nucleogen 4000-10 DEAE column utilizes the same buffer system and requires only
      100 min for the resolution of four distinct types of proteoglycans. The
      formamide:KH2PO4 buffer system is compatible with a previously developed
      polyacrylamide gel system for the electrophoretic profiling of proteoglycans.
      After separation by charge density, proteoglycans were further resolved by size
      distribution using a calibrated TSK-GEL HW 75(F) column which also enabled the
      estimation of the apparent Mr of hyaluronan produced by the bone cells. The same
      TSK-GEL HW 40(S) resin is used to exchange pooled proteoglycans into buffers for
      analyzing enzyme digests of glycosaminoglycan chains and core proteins. The
      technique has been applied to the analysis of biosynthetically labeled
      proteoglycans produced in culture by fetal and adult human bone cells. A distinct
      pattern of proteoglycan size and secretion for both cell types could be shown
      using this method. The method of analysis is useful for high yield and rapid
      screening of various cell types for both biosynthetic rate studies and analysis
      of patterns of proteoglycan synthesis.

PMID- 2221392
TI  - A radiometric assay for HIV-1 protease.
AB  - A rapid, high-throughput radiometric assay for HIV-1 protease has been developed
      using ion-exchange chromatography performed in 96-well filtration plates. The
      assay monitors the activity of the HIV-1 protease on the radiolabeled form of a
      heptapeptide substrate, [tyrosyl-3,5-3H]Ac-Ser-Gln-Asn-Tyr-Pro-Val-Val-NH2, which
      is based on the p17-p24 cleavage site found in the viral polyprotein substrate
      Pr55gag. Specific cleavage of this uncharged heptapeptide substrate by HIV-1
      protease releases the anionic product [tyrosyl-3,5-3H]Ac-Ser-Gln-Asn-Tyr, which
      is retained upon minicolumns of the anion-exchange resin AG1-X8. Protease
      activity is determined from the recovery of this radiolabeled product following
      elution with formic acid. This facile and highly sensitive assay may be utilized
      for steady-state kinetic analysis of the protease, for measurements of enzyme
      activity during its purification, and as a routine assay for the evaluation of
      protease inhibitors from natural product or synthetic sources.

PMID- 2221393
TI  - A gas chromatographic-mass spectrometric technique for studying simultaneous
      hydrogen-deuteron exchange and para-orthohydrogen conversion in hydrogenases of
      Desulfovibrio vulgaris Hildenborough.
AB  - An original gas chromatographic-mass spectrometric technique is described for
      studying simultaneous dihydrogen-deuteron exchange and para-ortho H2 conversion
      catalyzed by different Desulfovibrio hydrogenases. Para and orthohydrogens are
      separated on an alumina column at the temperature of liquid nitrogen, but if both
      HD and ortho H2 are present, their retention times are too close to each other
      for total separation and only one peak is observed with a thermal conductivity
      detector. In order to resolve the peaks from one another, a fraction of the gas
      released from the gas chromatograph column is admitted to the ion source of a
      mass spectrometer, where the gases are separated according to their respective
      masses. Because of a peak-jumping system, the different components involved in
      the exchange and in the conversion reactions can be scanned so that the spectra
      corresponding to mass m/e 2 (para and ortho H2), m/e 3 (HD), and m/e 4 (D2) can
      be obtained simultaneously. This technique has been employed to resolve a
      controversial problem concerning the occurrence or lack of any para-orthohydrogen
      conversion in heavy water. Actually both exchange and conversion were
      demonstrated to occur with a (NiFe) hydrogenase, whereas with a (NiFeSe)
      hydrogenase, which had an exchange activity equivalent to that of the former,
      practically no para-ortho conversion could be observed in D2O. These findings are
      related to the constitutional and catalytic properties of the hydrogenases
      belonging to the different classes.

PMID- 2221394
TI  - Analysis of inositol by high-performance liquid chromatography.
AB  - A high-performance liquid chromatographic (HPLC) method has been developed for
      identification and quantification of inositol isomers and monosaccharides in
      inositol-containing glycans. The method, which can determine 10 pmol of inositol,
      utilizes an Aminex HPX-87C column packed with an 8% crosslinked cation-exchange
      resin in the calcium form eluted with deionized water at 50 degrees C. NaOH
      solution is added to the column effluent through a postcolumn tee to increase the
      pH (pH greater than 11.6) before entering a pulsed amperometric detector which is
      highly sensitive for polyhydroxylated compounds. Samples in which inositol is
      linked to sugar through a glycosidic bond are hydrolyzed with 5.5 N
      trifluoroacetic acid, 100 degrees C, 4 h, and then reduced with NaBH4. Samples in
      which inositol is linked via a phosphate ester are hydrolyzed with 6 N HCl, 110
      degrees C, 24 h. This method has been applied to the analysis of inositol in the
      hamster prion proteins (PrP) PrP27-30, and PrPSc.

PMID- 2221395
TI  - Enhanced spectrofluorimetric determination of the pesticide warfarin by means of
      the inclusion complex with beta-cyclodextrin.
AB  - The warfarin-beta-cyclodextrin inclusion complex alters the luminescent
      properties of warfarin. This feature allows the use of a spectrofluorimetric
      method for its determination that gives improved analytical performance. The
      spectral changes associated with the inclusion process allowed a value of 160 l
      mol-1 to be obtained for the complexation constant. Fluorescence intensity is
      linearly related to warfarin concentration for a quantification limit of from 0.2
      to 4 micrograms ml-1. The relative standard deviation at the 1.5 microgram ml-1
      level is 3.5%. The method was applied satisfactorily to the determination of
      warfarin in irrigation water.

PMID- 2221396
TI  - Determination of salicylic acid and its metabolites in urine by derivative
      synchronous spectrofluorimetry.
AB  - The simultaneous determination of salicylic acid in binary and/or ternary
      mixtures and its two main urinary metabolites is proposed. Mixtures of salicylic,
      salicyluric and gentisic acids are resolved by synchronous spectrofluorimetry, in
      combination with first-derivative measurements. The urine is extracted with
      diethyl ether in acid medium. Salicylic and salicyluric acids are re-extracted
      into glycine-sodium hydroxide buffer solution of pH 11.6 and determined at that
      pH, and salicylic and gentisic acids are re-extracted into boric acid-sodium
      hydroxide buffer solution of pH 8.5 and determined at pH 6.

PMID- 2221397
TI  - Bioluminescent flow sensor for the determination of L-(+)-lactate.
AB  - The amount of L-lactate in biological fluids (serum, plasma and cerebrospinal
      fluid) was determined by monitoring the reduced form of nicotinamide adenine
      dinucleotide (NADH) produced by immobilised lactate dehydrogenase (LDH), with
      bacterial bioluminescent enzymes immobilised on a separate nylon coil. The LDH
      catalysed the reaction of L-lactate with NAD; this reaction took place in a nylon
      coil that preceded the coil for the bioluminescent detection. The co
      immobilisation of alanine aminotransferase (ALT) with LDH improved the lactate
      transformation by 117-183%. The response was linear from 0.1 to 50 micron mol l(
      1) at 25 degrees C for the LDH - ALT reactor. The intra- and inter-assay
      coefficients of variation were less than 5% and the recoveries ranged from 93 to
      106%. The results agreed well with those obtained with a spectrophotometric
      method and with the normal reference values.

PMID- 2221398
TI  - Influence of bovine immunoglobulin G on faradaic reactions at electrodes.
AB  - The effect of bovine immunoglobulin G (IgG), adsorbed on different electrode
      materials, on faradaic reactions of hexacyanoferrate(III)-hexacyanoferrate(II),
      hydroquinone-benzoquinone, nicotinamide adenine dinucleotide, reduced from
      (NADH), and phenol is described and discussed. The reactions are partially
      inhibited by IgG, but the current and peak potentials reach protein-independent
      values for higher concentrations of IgG. The hydroquinone-benzoquinone couple can
      be used for detection purposes at IgG-covered electrodes in electrochemical
      immunoassays.

PMID- 2221399
TI  - Determination of 2-methylaziridine in workplace atmospheres.
AB  - A sampling and analytical procedure was developed for the monitoring of airborne
      2-methylaziridine (MA). The analyte is collected by drawing air through a
      solution of 2,4,6-trinitrobenzenesulphonic acid (TNBS). In situ derivatisation of
      MA with TNBS during sample collection provides stability to the highly reactive
      analyte and makes it amenable to a sensitive high-performance liquid
      chromatographic determination with ultraviolet detection. The purified synthetic
      derivative of MA with TNBS is more suitable as a calibration standard than
      commercially available MA.

PMID- 2221400
TI  - Determination of 1,4-dioxane in cosmetic products by high-performance liquid
      chromatography.
AB  - A rapid high-performance liquid chromatographic procedure has been developed for
      the assay of 1,4-dioxane in cosmetic products. After solid-phase extraction,
      using Bond Elut CN and Bond Elut C18 cartridges, samples were analysed directly
      on a LiChrospher CH-8 reversed-phase column with spectrophotometric detection at
      200 nm and acetonitrile - water as eluent. Recovery of 1,4-dioxane from different
      cosmetic matrices was between 81.5 and 90.1% in the 30-90 microgram g(-1) range.
      The minimum quantifiable amount was 6.5 microgram g(-1). The method is simple,
      reproducible and specific and is suitable for routine analyses of commercial
      cosmetics.

PMID- 2221401
TI  - Determination of non-metallic elements by capacitively coupled helium microwave
      plasma atomic emission spectrometry with capillary gas chromatography.
AB  - A capacitively coupled microwave helium plasma with a tubular tantalum electrode
      was evaluated as an element selective detector for gas chromatography (GC). The
      end of a 10-m bonded fused capillary column was directly inserted into the
      tubular electrode without any switching system. A heated copper tube was used to
      house the part of the GC column that protruded from the oven. The optimisation of
      operating parameters, line selection, background emission and horizontal and
      vertical observation position is described. Analytical figures of merit including
      sensitivity, reproducibility, signal to background ratio, selectivity, dynamic
      range and limit of detection (LOD), were evaluated for carbon, hydrogen, chlorine
      and bromine emission. Limits of detection in the low ng range (20 pmol) were
      obtained for halogenated compounds using carbon emission, whereas LODs in the 0.1
      micrograms range (2 nmol) were obtained using chlorine or bromine emission lines.

PMID- 2221402
TI  - Single-sweep polarography of the copper(II)-3-hydroxy-1-p-sulphonatophenyl-3
      phenyltriazene complex and its analytical applications.
AB  - A polarographic investigation of the copper-3-hydroxy-1-p-sulphonatophenyl-3
      phenyltriazene (HSPT) complex in 0.05 M sodium tetraborate medium is described
      and a simple and sensitive single-sweep polarographic method for the
      determination of trace amounts of copper in biological samples is proposed. The
      complex was shown to be Cu(HSPT)2 with log beta' = 11.38. The polarographic wave
      is caused by the reduction of copper(II) in the adsorbed complex to copper
      amalgam on the surface of a mercury electrode. The current peak is directly
      proportional to the concentration of copper in the range 8.0 x 10(-9)-4.0 x 10(
      6) M and the detection limit is 5.0 x 10(-9) M.

PMID- 2221403
TI  - Nitriles and isonitriles as interferents in cyanide determination in polluted
      waters.
AB  - The interference of nitriles and isonitriles in cyanide determination was studied
      using the pyridine-barbituric acid direct spectrophotometric method or the same
      method after distillation of the sample, a microdiffusion-potentiometric (ion
      selective electrode) also being used. Phenylacetonitrile, benzonitrile,
      acrylonitrile, iminodiacetonitrile and acetonitrile were tested as nitriles.
      Benzyl isocyanide butyl isocyanide and 1-[(isocyanomethyl)sulphonyl]-4
      methylbenzene were assayed as isonitriles. It can be concluded that both nitriles
      and isonitriles should be considered as interferents in all the methods of
      cyanide determination studied. The level of interference generally increases with
      the ratio of interfering compound to cyanide and is greatest for low cyanide
      concentrations.

PMID- 2221404
TI  - Second-derivative spectrofluorometric determination of sulphoxide impurity in
      phenothiazine drug substances and formulation.
AB  - A direct second-derivative spectrofluorimetric procedure for determining
      sulphoxide impurity in phenothiazines and their formulations has been developed.
      The method, which has been applied to the analysis of chlorpromazine
      hydrochloride and prochlorperazine mesylate, as examples of typical phenothiazine
      substances, and to their formulations, is based on the measurement of the
      amplitude taken from the minimum at ca. 270 nm to the longer wavelength maximum
      in the second-derivative excitation spectrum of the sulphoxide in pH 8 buffer
      solution. The method is rapid, accurate and precise, and can be used to measure
      the concentration of sulphoxide in phenothiazines and their formulations at
      concentrations down to 0.1% m/m of that of the parent phenothiazine.

PMID- 2221405
TI  - Human auditory steady-state response during general anesthesia.
AB  - The 40-Hz auditory steady-state evoked response (ASSR) is a sinusoidal electrical
      response of the brain to periodically presented auditory stimuli. It was recorded
      during anesthesia in 10 elective surgical patients to evaluate its usefulness as
      a measure of the level of consciousness. The anesthetic agents used were
      thiopental, fentanyl, and isoflurane with or without nitrous oxide. Recordings
      were carried out during the period before induction and during induction,
      surgical anesthesia, emergence, and recovery from anesthesia. The level of
      consciousness was measured with an auditory stimulus detection task. The
      electroencephalogram (EEG) was also recorded for comparison with the ASSR. The
      following indices were analyzed: total EEG power, relative power in the beta,
      alpha, theta, and delta frequency bands, and the median and spectral edge
      frequency. The amplitude of the ASSR was reduced significantly at the end of the
      induction period and decreased below noise levels during surgical anesthesia. It
      increased significantly during emergence and recovery. The amplitude during
      recovery remained significantly smaller than the preinduction values. The changes
      of the ASSR paralleled those of the level of consciousness. The EEG measurements
      were distorted by the presence of muscle artifacts that were prominent during
      emergence and recovery. The amplitude of the ASSR appears to provide a more
      reliable indicator of the level of consciousness than the EEG.

PMID- 2221406
TI  - Does isoflurane lead to a higher incidence of myocardial infarction and
      perioperative death than enflurane in coronary artery surgery? A clinical study
      of 1178 patients.
AB  - To examine if the choice of volatile agents influences cardiac outcome in
      coronary artery surgery, 1178 patients undergoing elective coronary artery bypass
      grafting without additional operations received enflurane (608) or isoflurane
      (570) as their primary anesthetics. The inspired concentration of volatile agent
      (administered with 50% nitrous oxide) was adjusted depending on the level of
      blood pressure at the discretion of the anesthesiologist. In addition to the
      volatile agent assigned, each patient received small doses of fentanyl at
      induction and before sternotomy (total 0.006-0.008 mg/kg). The groups did not
      differ in preoperative and surgical characteristics except for a more frequent
      history of renal dysfunction in patients given isoflurane. The rates of
      postoperative myocardial infarction, administration of positive inotropic agents
      at the time of weaning from cardiopulmonary bypass, and in-hospital deaths in the
      enflurane and isoflurane groups were 1.8% and 4.0% (P less than 0.05), 4.9% and
      8.1% (P less than 0.05%), and 0.3% and 2.1% (P less than 0.01), respectively.
      Although the mechanism of the adverse effects of isoflurane could not be
      clarified in this study, these results demonstrate that the use of isoflurane
      could be inappropriate in patients undergoing coronary artery bypass grafting.

PMID- 2221408
TI  - Contributions of liver perfusion flow rate and enzyme inhibition to altered
      verapamil clearance with halothane: a study in the isolated perfused rat liver.
AB  - Verapamil clearance is reduced during halothane administration. This study
      evaluated relative contributions of reduced hepatic flow rate and hepatic
      metabolizing enzyme inhibition by halothane as a cause of reduced verapamil
      clearance. An isolated perfused rat liver model was utilized in which flow rate
      could be fixed during halothane administration. Perfusions were performed on five
      to six livers under each of the following conditions: (a) control--40 mL/min flow
      rate with no anesthetic exposure; (b) 1.5% halothane--40 mL/min; (c) 2.25%
      halothane--40 mL/min; (d) reduced flow--20 mL/min with no anesthetic exposure;
      and (e) reduced flow with 1.5% halothane--20 mL/min. Halothane caused dose
      dependent decreases in both total hepatic and intrinsic clearance rates (P less
      than 0.05). With no anesthetic exposure, a flow reduction of 50% (20 mL/min) also
      gave a large reduction (P less than 0.05) in hepatic clearance of verapamil
      compared with the control condition (40 mL/min). The addition of 1.5% halothane
      to the reduced flow condition was not associated with further reduction in
      hepatic clearance rate. Results of this study suggest that although both reduced
      hepatic perfusion and hepatic enzymatic inhibition by halothane administration
      are associated with decreased verapamil clearance, a greater proportion of this
      decrease appears to be due to reductions in hepatic flow. The present results may
      apply to other drugs used in anesthesia that have high hepatic extraction ratios;
      thus, clearance of these drugs may be more dependent on hepatic blood flow than
      on hepatic enzyme activity.

PMID- 2221407
TI  - Low-dose almitrine bismesylate enhances hypoxic pulmonary vasoconstriction in
      closed-chest dogs.
AB  - The effect of almitrine bismesylate on the hypoxic pulmonary vasoconstrictor
      response was studied in six closed-chest dogs anesthetized with pentobarbital and
      paralyzed with pancuronium. The right lung was ventilated continuously with 100%
      O2; the left lung was ventilated either with 100% O2 ("hyperoxia") or with an
      hypoxic gas mixture ("hypoxia": end-tidal oxygen tension = 60.3 +/- 0.6 mm Hg).
      On two consecutive days, each dog received either almitrine (Vectarion, Servier
      Lab) or malic acid. Consecutive almitrine doses of 0.003, 0.03, 0.3, and 3.0
      micrograms.kg-1.min-1, or the equivalent volumes of malic acid without almitrine,
      were administered intravenously as a constant peripheral infusion for 15 min.
      Percent blood flow to each lung was calculated based on a variation of the
      traditional shunt equation. The change in percent left lung blood flow (delta %QL
      VA) increased significantly between the hypoxia-no drug and the hypoxia-almitrine
      (3.0 micrograms.kg-1.min-1) phase. No significant changes occurred during the
      other almitrine doses or the respective malic acid control phases. The change in
      arterial oxygen tension (delta PaO2) also increased significantly between the
      hypoxia-no drug and the hypoxia-almitrine (3.0 micrograms.kg-1.min-1) phase. No
      significant changes occurred during the other almitrine doses or the respective
      malic acid control phases. It is concluded that in dogs low-dose almitrine
      enhances hypoxic pulmonary vasoconstriction and that this enhancement is dose
      related.

PMID- 2221409
TI  - Hemodynamic effects of diltiazem during vasoconstrictor pulmonary hypertension in
      sheep.
AB  - Calcium channel blockers have been effective as pulmonary vasodilators in
      patients with pulmonary hypertension. The current study therefore compared the
      effects of prostaglandin E1, an effective pulmonary vasodilator, with the effects
      of the water-soluble calcium channel blocker diltiazem during pulmonary
      hypertension in sheep. Pulmonary hypertension was produced by continuous
      intravenous administration of U46619 to halothane-anesthetized sheep.
      Prostaglandin E1 decreased pulmonary artery pressure 29%, decreased pulmonary
      vascular resistance (Rp) 57%, and did not affect the ratio of pulmonary to
      systemic vascular resistance (Rp/Rs). Diltiazem decreased pulmonary artery
      pressure 15%, decreased Rp 50%, and did not affect Rp/Rs. When 0.33 mL/kg
      polyethylene glycol-ethanol vehicle (the vehicle used for nifedipine
      administration in a prior study) was administered during diltiazem infusion,
      pulmonary artery pressure increased 19%, Rp increased 72%, and Rp/Rs increased
      29%. These results indicate that diltiazem is an effective pulmonary vasodilator
      and suggest that the previously reported unfavorable results of nifedipine may
      have been due to the vehicle used for nifedipine administration.

PMID- 2221410
TI  - Changes in cerebral blood flow velocity after release of intraoperative
      tourniquets in humans: a transcranial Doppler study.
AB  - The effect of release of intraoperative thigh tourniquets on velocity of blood
      flow in the middle cerebral artery was examined in five patients given general
      anesthesia with controlled ventilation for lower extremity orthopedic procedures
      using transcranial Doppler sonography. Middle cerebral artery blood flow velocity
      increased significantly from 52 +/- 6 (SEM) to 82 +/- 24 cm/s (an increase of 58%
      +/- 13%) within 4 +/- 1 min after tourniquet release and remained significantly
      elevated for 7 min. A positive linear correlation was found between middle
      cerebral artery blood flow velocity and PETCO2 on each occasion (0.97 greater
      than or equal to r greater than or equal to 0.84, 0.001 greater than P greater
      than 0.0001) after tourniquet deflation. Assuming a linear relationship between
      flow velocity and flow, these findings suggest that significant increase in
      cerebral blood flow can occur after intraoperative tourniquet release and that
      this increase appears to be mostly CO2-dependent.

PMID- 2221411
TI  - Comparison of propofol and thiopental/halothane for short-duration ENT surgical
      procedures in children.
AB  - Experiences with propofol in pediatric anesthesia are limited. We undertook a
      study to evaluate the quality of induction and recovery from anesthesia with
      propofol compared to thiopental/halothane. Twenty children received 3 mg.kg-1.min
      1 of propofol as a loading dose followed by a maintenance dose of 0.1 mg.kg-1.min
      1 (+/- 10%). Twenty children received 5-7 mg/kg of thiopental, and maintenance
      was provided with halothane (0.5%-1.5%). The interval between the end of the
      administration of propofol or thiopental/halothane and extubation, as well to
      discharge to the ward, was significantly shorter with propofol (4.4 versus 13.5
      min and 7.22 versus 30.4 min, respectively). Spontaneous movements and pain on
      injection were seen significantly more frequently with propofol, whereas
      laryngospasm and hiccup were only observed with thiopental. During the first 6 h
      after the surgical procedure, analgesics were needed significantly more often in
      the thiopental group. Nausea and vomiting also were observed more frequently in
      the thiopental group. In conclusion, propofol used as a single anesthetic is a
      satisfactory technique for ENT surgery of short duration in children.

PMID- 2221412
TI  - Preoxygenation in the elderly: a comparison of the four-maximal-breath and three
      minute techniques.
AB  - To compare the effectiveness of two routinely used methods of preoxygenation in
      protecting against hypoxia in the elderly, the arterial O2 saturation was
      measured using an oximeter. Twenty-four elderly patients (greater than or equal
      to 65 yr) presenting for elective orthopedic surgery were randomly allocated to
      receive either 3-min or four-maximal-breaths of 100% O2 via a Bain circuit. After
      preoxygenation, anesthesia was induced, tracheal intubation performed with
      patients kept apneic, and the endotracheal tube left open to air. The arterial O2
      saturation was measured before preoxygenation and continually recorded during
      desaturation. Although attaining similar arterial O2 saturation values after
      preoxygenation, patients in the four-maximal-breath group had significantly
      shorter times (P less than 0.0001) to all levels of desaturation. We suggest that
      preoxygenation with 3-min breathing of 100% O2 offers more protection against
      hypoxia due to prolonged apnea after induction of anesthesia in the elderly than
      does four maximal breaths of 100% O2.

PMID- 2221413
TI  - Cardioprotective effects of carnitine in extensive aortocoronary bypass grafting:
      a double-blind, randomized, placebo-controlled clinical trial.
AB  - The cardioprotective effects of carnitine were tested in patients undergoing
      multiple aortocoronary bypass grafting. Intermittent aortic cross-clamping at 28
      degrees C was used. Mean total cross-clamping time was 30 +/- 11 min. Patients
      were randomized into three groups: a control group receiving placebo (group 1), a
      group pretreated with 3 g carnitine intravenously before cardiopulmonary bypass
      (CPB) (group 2), and a group pretreated with 6 g carnitine intravenously (group
      3). The markers of myocardial ischemia included levels of adenosine triphosphate,
      its catabolites, and creatine phosphate in transmural left ventricular biopsy
      specimens taken at the beginning and end of CPB, as well as hemodynamic recovery
      during weaning from CPB and for the next 24 h. The intravenous infusion of
      carnitine (3 or 6 g) had no hemodynamic effect. At the end of CPB myocardial
      tissue levels of adenosine triphosphate and creatine phosphate did not differ
      significantly among the groups (P greater than 0.05). Recovery of cardiac
      function during weaning from CPB and for the following 24 h was similar in all
      three groups (P greater than 0.05). It is concluded that pretreatment with
      carnitine neither facilitates weaning from cardiopulmonary bypass in patients
      undergoing aortocoronary bypass surgery nor favorably affects hemodynamic
      function during the next 24 h.

PMID- 2221414
TI  - A rabbit model for evaluation of spinal anesthesia: chronic cannulation of the
      subarachnoid space.
AB  - A rabbit model for evaluation of spinal anesthesia is presented. Chronic
      cannulation of the subarachnoid space was performed in 44 rabbits using the
      translumbar approach. An autopsy was performed 24 h after the operation on four
      of the animals. Intrathecal injections of methylene blue did not reveal any
      leakage from the spinal space. X-ray examination performed on the second and 30th
      days after the implantation indicated free spread of the injected solution in the
      subarachnoid space without any obstruction. Repeated injections of four identical
      doses of bupivacaine at 3-day intervals showed reproducible pharmacologic
      effects. Administration of different doses of the anesthetic produced a clear
      dose-response relationship. The relative activity of the anesthetic agents was
      found to be identical to that previously obtained in humans. No significant
      complications after the implantation have been recorded. We suggest the current
      model as an additional appropriate tool for the investigation of spinal
      anesthesia.

PMID- 2221415
TI  - Is the antiemetic effect of the emulsion formulation of propofol due to the lipid
      emulsion?
AB  - The hypothesis that the lipid emulsion of the emulsion formulation of propofol is
      responsible for the low frequency of nausea, retching, and vomiting after
      propofol anesthesia was tested. A randomized, prospective, and comparative study
      was performed to evaluate the antiemetic effect of 10% lipid solution in 60
      women, ASA physical status I and II, scheduled for ambulatory laparoscopic
      procedures. Two groups of patients were studied. Induction of anesthesia
      (thiopental) and maintenance of anesthesia (enflurane, nitrous oxide) were
      similar in both groups. At induction the study group received 10% Intralipid (3
      mL/min for 20 min). The control group received 5% dextrose in lactated Ringer's
      solution at the same rate. Other drugs administered during or after anesthesia
      were similar among the groups. The groups were similar with respect to duration
      of anesthesia, characteristics of early and intermediate recovery, as well as
      pain scores in the postanesthesia care unit. There were no differences in the
      amount of antiemetic medications administered or postoperative nausea, retching,
      or vomiting when the patients were evaluated objectively by a blinded observer or
      subjectively by patient self-evaluation. It is concluded that 10% Intralipid, the
      lipid in the emulsion formulation of propofol, does not possess significant
      antiemetic effects.

PMID- 2221416
TI  - A comparison of conductivity-based hematocrit determinations with conventional
      laboratory methods in autologous blood transfusions.
AB  - An investigation was made of the accuracy of a portable hematocrit measurement
      device (Stat-Crit) on the infusate of an autologous blood transfusion system.
      Baseline hematocrit values were determined by three methods on in vivo blood
      samples of surgical patients immediately after the start of surgery, and again on
      the first product of the autologous blood retrieval system. At baseline, there
      were no significant differences in the values determined by the Stat-Crit (33.4%
      +/- 6.2%, mean +/- SD) and those determined by the microcentrifuge technique
      (33.8% +/- 4.7%) or by the Coulter method (33.5% +/- 4.5%) (P = 0.9). In
      contrast, hematocrit values determined on infusate samples by the Stat-Crit
      (36.6% +/- 4.8%) were significantly lower than those determined by the
      microcentrifuge technique (51.2% +/- 5.9%) or by the Coulter method (51.6% +/-
      5.8%) (P = 0.0001). This study confirms close agreement of hematocrit values
      derived by the conductivity of whole blood in normal samples with those
      determined by conventional laboratory techniques, but indicates that this method
      will report falsely low readings in situations where plasma has been replaced by
      crystalloid, as in patients who have received large transfusions of processed
      autologous blood.

PMID- 2221417
TI  - Acute progesterone treatment has no effect on bupivacaine-induced conduction
      blockade in the isolated rabbit vagus nerve.
AB  - Pregnancy decreases anesthetic requirements during regional anesthesia. Using an
      in vitro animal model, this study attempts to elucidate the mechanism of hormonal
      effects on nerve conduction in desheathed rabbit vagus nerve. The acute effects
      of progesterone administration on neural blockade induced by bupivacaine were
      investigated in terms of changes in compound action potentials of A, B, and C
      fibers. No change in baseline compound action potential was found after 30 min of
      perfusion of the nerve with progesterone. Exposure of the nerve to progesterone
      before exposure to bupivacaine did not significantly increase the degree of
      conduction blockade produced by bupivacaine, and a radioactive assay demonstrated
      that progesterone was taken up acutely by neural tissue over a 45-min measurement
      period. These results indicate that although progesterone was taken up in
      significant amounts by neural tissue, an acute exposure does not increase the
      sensitivity of the nerves to bupivacaine. Hence, the increased sensitivity of
      nerves to local anesthetics seen with pregnancy or with chronic progesterone
      treatment requires some period of time to occur. The mechanism is therefore
      unlikely to be a direct effect of progesterone on the cell membrane but may
      involve hormonal effects on protein synthesis.

PMID- 2221418
TI  - Baseline activated coagulation time should be measured after surgical incision.
AB  - The activated coagulation time (ACT) is widely used to guide heparin and
      protamine dosing during cardiac surgery. A common protocol involves establishing
      a baseline ACT before administering heparin, then using this ACT as a target
      value for assessing the adequacy of heparin neutralization after cardiopulmonary
      bypass. Results vary in previous comparisons of baseline ACT to postprotamine
      ACT, with some showing postprotamine ACT significantly below baseline values. The
      present study examined ACTs at three possible baseline intervals in 68 patients
      at two institutions: (a) before anesthetic induction; (b) after anesthetic
      induction; and (c) after sternotomy. Baseline ACT decreased significantly with
      anesthesia and surgery. The poststernotomy baseline ACT best matched the
      postprotamine ACT. It appears likely that surgery induces a thromboplastic
      response that decreases ACT. Establishing baseline ACT before anesthetic
      induction would predispose to false diagnoses of adequate protamine
      neutralization after cardiopulmonary bypass, because ACT is relatively
      insensitive to low concentrations of unneutralized heparin. Baseline ACTs should
      therefore be measured after surgical incision.

PMID- 2221419
TI  - Treatment of refractory seizures in massive isoniazid overdose.

PMID- 2221420
TI  - Anesthetic management of cerebral aneurysm resection in a patient with idiopathic
      hypertrophic subaortic stenosis.

PMID- 2221421
TI  - Hearing loss after spinal anesthesia.

PMID- 2221422
TI  - Bupivacaine-induced cardiac arrest.

PMID- 2221423
TI  - Missed diagnosis of cuff herniation in a modern nasal endotracheal tube.

PMID- 2221424
TI  - Mixed venous oximetry may detect critical oxygen delivery.

PMID- 2221425
TI  - A simple method for reducing backup of blood into intravenous lines caused by
      inflation of a blood pressure cuff.

PMID- 2221426
TI  - ASA Award: John D. Michenfelder.

PMID- 2221427
TI  - Cardiorespiratory interactions in patients with an artificial heart.
AB  - A retrospective analysis of the influence of respiration was carried out in three
      patients with artificial hearts. During spontaneous ventilation, large swings in
      intrathoracic pressure can produce a pattern reminiscent of pulsus paradoxus in
      the systemic arterial pressure. A decrease in intrathoracic pressure decreased
      biventricular filling and enhanced biventricular emptying. An increase in
      intrathoracic pressure increased biventricular filling, but acting as an
      increased afterload, impeded biventricular emptying. The influence of respiration
      on the artificial heart can be considered the result of the artificial
      ventricles' functioning effectively as extrathoracic pumps, such that changes in
      intrathoracic pressure produce gradients for biventricular filling and ejection
      relative to atmospheric pressure (which serves as the reference pressure for the
      artificial ventricles). Respiratory-induced variation in ventricular performance
      is clearly present with the artificial heart, but the mechanisms producing these
      changes appear to be markedly different from normal conditions, in which the
      ventricles are functionally within the thorax and have a compliant common septum
      allowing ventricular interaction.

PMID- 2221428
TI  - The air test as a clinically useful indicator of intravenously placed epidural
      catheters.
AB  - The authors performed a clinical trial in 313 patients in labor to determine the
      safety and efficacy of an air test for unintentional intravenous placement of
      epidural catheters. Following routine aspiration for blood and cerebrospinal
      fluid, 1 ml of air was injected through each epidural catheter while heart tones
      were continually monitored with a Doppler ultrasound probe placed over the
      maternal precordium. In 281 patients, Doppler heart tones did not change
      following air injection (negative air test). All but eight of these patients
      developed an adequate level of analgesia following anesthetic administration, and
      no patients with negative air tests developed signs or symptoms of local
      anesthetic toxicity (false-negative rate, 0%; 95% confidence limits, 0.0-1.1%).
      Doppler heart tone changes followed air injection in 22 cases (positive air
      test). In 16 of these, intravenous catheter position was subsequently shown by
      aspiration of blood from the catheter or by the use of test doses consisting of
      local anesthetics with or without epinephrine. In six cases, adequate levels of
      analgesia developed despite a positive air test (false-positive rate, 2%; 95%
      confidence limit, 0.7-4.3%). None of the 303 patients receiving the air test
      developed any complications attributable to the injection of air (95% confidence
      limits, 0.0-1.0%). The authors conclude that air, with precordial Doppler
      detection, is a safe and effective test for identifying intravenously located
      epidural catheters.

PMID- 2221429
TI  - Quantitation of the interaction between atracurium and succinylcholine using
      closed-loop feedback control of infusion of atracurium.
AB  - The authors used closed-loop feedback control of infusion of atracurium to study
      the effect of prior administration of succinylcholine on neuromuscular blockade
      induced by atracurium in patients undergoing otolaryngologic surgery. Anesthesia
      was maintained with nitrous oxide in oxygen, flunitrazepam, and fentanyl. Of 14
      patients given atracurium, seven were given prior administration of
      succinylcholine and seven were not. Interaction between the two drugs was
      quantified by determining the asymptotic steady-state rate of infusion necessary
      to produce a constant 90% neuromuscular blockade. This was accomplished by
      applying nonlinear curve-fitting to data on the cumulative dose requirement
      during anesthesia. The neuromuscular blocking effect of atracurium was found to
      be greater after prior administration of succinylcholine. The asymptotic steady
      state rate of infusion (+/- SD) for atracurium was 0.27 +/- 0.06 mg.kg-1.h-1 for
      patients given succinylcholine and 0.38 +/- 0.10 mg.kg-1.h-1 for those not given
      succinylcholine. The clinical implication of this study is that the clinician
      should be aware of the fact that an induction dose of 1 mg/kg of succinylcholine
      does reduce atracurium requirement for 90% neuromuscular blockade by
      approximately 30%.

PMID- 2221430
TI  - Relationship between anesthetic procedure and contact of anesthesia personnel
      with patient body fluids.
AB  - We recorded the frequency with which anesthesia personnel came in contact with
      patient body fluids in order to provide an empirical basis for the recommendation
      of relevant precautions. Anesthesia personnel completed a questionnaire when
      performing a range of standardized procedures. The rate of contact with blood was
      as follows: catheterization of peripheral vein, 18%; insertion of central venous
      catheter, 87%; arterial puncture, 38%; lumbar puncture, 23%; catheterization of
      the extradural space, 34%; tracheal intubation, 4%; tracheal extubation, 9%;
      suction of oral cavity, pharynx, or trachea, 13%; intramuscular injection of
      drug, 8%; and establishment or discontinuation of drip for blood transfusion,
      43%. By using protective gloves, 98% of contacts with patient blood would have
      been prevented. Blood contact was more frequent in the emergency ward than in the
      operating room (P less than 0.05). Health care workers were not able to predict
      when a specific procedure would imply that contact with patient blood would
      occur. We recommend that specific precautions be adopted for the various
      procedures and discuss precautions that could have prevented contact with body
      fluid.

PMID- 2221431
TI  - Anterior fontanel pressure and visual evoked potentials in neonates and infants
      undergoing profound hypothermic circulatory arrest.
AB  - To determine the effects of cardiopulmonary bypass with profound hypothermic
      circulatory arrest (PHCA) on anterior fontanel pressure (AFP) and visual evoked
      potentials (VEPs), 21 neonates and infants undergoing cardiopulmonary bypass
      (CPB) with PHCA for surgical correction of congenital heart defects were studied.
      Mean (+/- SD) minimum nasopharyngeal, esophageal, and rectal temperatures of 16.4
      +/- 2.2, 11.2 +/- 2.7, and 17.7 +/- 1.9 degrees C, respectively, were achieved
      for a mean duration of PHCA of 51.6 +/- 18.7 min. AFP increased significantly
      above pre-CPB values for the first 21.7 +/- 8.1 min of rewarming. The duration of
      this increase in AFP was related logarithmically and directly to the product of
      the nasopharyngeal temperature (NPT) at the end of PHCA and the duration of PHCA
      (r2 = 0.82, P less than 0.0001). Nineteen of these patients had simultaneous
      monitoring of VEPs. The latency of both the N70 and P100 components of the VEPs
      increased as temperature decreased. The cerebral perfusion pressure was linearly
      and inversely related to the AFP (r2 = 0.72, P less than 0.01). The VEPs
      disappeared as a nasopharyngeal temperature (NPT) of 18.9 +/- 2.8 degrees C and
      reappeared after 21.9 +/- 8.8 min post-PHCA at an NPT of 32.8 +/- 1.4 degrees C.
      There was no significant difference between duration of increased AFP (20.9 +/-
      8.1 min) and the duration of absence of VEPs during the post-PHCA period. The
      duration of increased AFP correlated linearly and directly with the duration of
      absence of VEPs (r2 = 0.84, P less than 0.005). These data demonstrate that
      transient neurophysiologic dysfunction occurs after PHCA. This dysfunction is
      related to the duration of elevation of the AFP and cannot be explained solely by
      a temperature effect.

PMID- 2221432
TI  - Intraoperative 133Xe cerebral blood flow measurements by intravenous versus
      intracarotid methods.
AB  - To document the comparability of cerebral blood flow (CBF) values determined by
      quantification of 133Xe washout after either intravenous or intracarotid
      administration, 12 patients undergoing elective carotid endarterectomy
      anesthetized with N2O/O2 and either isoflurane or halothane were studied.
      Scintillation counters were placed over the middle cerebral artery territory
      ipsilateral to the operated carotid artery. CBF was measured by the intravenous
      method during dissection of the carotid sheath and was calculated as the initial
      slope index from head washout curves collected for 11 min after injection of 10
      20 mCi 133Xe in saline into a large vein. Immediately prior to carotid occlusion,
      CBF was determined by direct injection of 1 mCi 133Xe in saline into either the
      internal carotid artery or the common carotid artery with the external carotid
      artery occluded. For the intracarotid injections, the initial slope was
      calculated from the 1st min of washout. Data were analyzed by linear regression
      and analysis of variance. Values are expressed as mean +/- SD. The mean CBF for
      intravenous and intracarotid methods were both 29 +/- 10 ml.100 g-1.min-1. The
      correlation between CBF measured by intravenous and intracarotid methods was
      excellent and was described by the line y = x + 0.6, r = 0.92. We conclude that
      in the flow range studied, the intravenous technique may be applied to measure
      CBF in physiologically stable situations in which direct intracarotid injection
      is not feasible.

PMID- 2221433
TI  - The "natural history" of segmental wall motion abnormalities in patients
      undergoing noncardiac surgery. S.P.I. Research Group.
AB  - Intraoperative segmental wall motion abnormalities (SWMA) detected by
      transesophageal echocardiography (TEE) are sensitive, but not always specific,
      markers of myocardial ischemia. To determine their incidence, characteristics,
      and relation to postoperative cardiac morbidity, we continuously recorded the
      left ventricular short-axis view and 12-lead ECG in 156 high-risk patients
      undergoing non-cardiac surgery. Monitoring was clinically blinded. Wall motion
      was scored at predefined clinical, hemodynamic, and ECG events and at periodic
      intervals (26 +/- 11 samples per patient). We detected 44 episodes of new or
      worsened SWMA in 32 patients (20%). The severity of most episodes was limited to
      severe hypokinesis (24/44, 55%) followed by akinesis (16/44, 36%) and dyskinesis
      (4/44, 9%). The remaining 124 patients had normal wall motion or only mild
      hypokinesis (56/156, 36%) or chronic SWMA (68/156, 44%). The incidence of new
      SWMA did not differ for patients with known coronary artery disease (CAD) and
      those with cardiac risk factors only (22% vs. 19%, P = not significant), although
      CAD patients had a significantly greater incidence of chronic SWMA (62% vs. 41%,
      P = 0.02). The incidence of new or worsened SWMA was significantly greater during
      aortic vascular surgery (38% vs. 17%, P = 0.05). Approximately 40% of all new TEE
      changes occurred in the absence of either an apparent clinical event or a
      significant change in systolic blood pressure or heart rate. Ten patients had new
      or worsened SWMA persisting until the end of surgery, 8 with new akinesis, only 1
      developing myocardial infarction. The distribution of new or worsened SWMA and
      significant intraoperative ST-T changes (n = 19) in this cohort was discordant:
      temporal overlap between modalities was present in only 5 patients. Major cardiac
      complications occurred in 5 patients (3.2%), all of whom underwent peripheral
      vascularization. All patients with cardiac complications and new or worsened SWMA
      also had intraoperative or early postoperative ST-T changes. We conclude that: 1)
      continuous TEE recording with offline analysis in this high-risk group of
      patients revealed a relatively low incidence of new or worsened SWMA (20%), most
      episodes of which were characterized by severe hypokinesis (55%); 2) episodes
      were more common in patients undergoing aortic vascular surgery; 3) approximately
      40% of episodes were unaccompanied by clinical events or significant hemodynamic
      changes; 4) episodes were poorly correlated with postoperative cardiac
      complications; and 5) the discordant relation between TEE and ECG changes
      observed here necessitates careful monitoring of the ECG when TEE is used
      clinically.

PMID- 2221434
TI  - Thermoregulatory vasoconstriction decreases cutaneous heat loss.
AB  - To determine the extent to which thermoregulatory vasoconstriction decreases heat
      loss to the environment, we measured regional heat flux, average skin
      temperature, and tympanic membrane temperature before and after thermoregulatory
      vasoconstriction in five minimally clothed volunteers maintained in a 30.8 +/-
      0.1 degrees C environment. Thermoregulatory vasoconstriction was induced by
      central venous infusion of cooled fluid. Peripheral cutaneous blood flow was
      evaluated with venous-occlusion volume plethysmography and skin-surface
      temperature gradients. Laser Doppler flowmetry was used to measure
      vasoconstriction in centrally located skin. This model mimics the common clinical
      situation in which patients in a warm environment are centrally cooled by
      administration of cold intravenous fluids or by lavage of internal cavities with
      cold fluids. Tympanic membrane temperature decreased 1.5 +/- 0.3 degrees C in the
      first 15 min after the cold fluid infusion was started and remained approximately
      1 degrees C below control values during the rest of the study. Average skin
      surface temperature decreased slowly to approximately 0.7 degrees C below
      control. Flow in capillaries of centrally distributed skin, determined with laser
      Doppler flowmetry, decreased only approximately 40%. Total heat flux, and flux
      from the arms and legs decreased approximately 25% (15.5 +/- 0.3 W). Heat loss
      from the trunk and head decreased only 17%, whereas, loss from the hands and feet
      (10.5% of the body surface area) decreased approximately 50%. All measured values
      decreased significantly following vasoconstriction (P less than 0.01). Therefore,
      thermoregulatory vasoconstriction in a thermoneutral environment appears to
      decrease cutaneous loss of metabolic heat approximately 25%.

PMID- 2221435
TI  - Hormonal-metabolic stress responses in neonates undergoing cardiac surgery.
AB  - Hormonal and metabolic responses were measured in 15 neonates who underwent
      repair of complex congenital heart defects during a standardized anesthetic
      protocol. Four of the 15 neonates died postoperatively in the intensive care
      unit. Analysis of arterial plasma samples obtained before, during, and 24 h after
      surgery showed that plasma epinephrine, norepinephrine, cortisol, glucagon, and
      beta endorphin increased in all patients (P less than 0.05). Insulin levels
      increased only at the end of surgery but remained elevated for 24 h
      postoperatively (P less than 0.02). Intraoperative metabolic changes were
      characterized by hyperglycemia and lactic acidemia that persisted
      postoperatively. This pattern of neonatal stress responses is distinct from and
      more extreme than that seen in adult cardiac surgical patients. The four neonates
      who died postoperatively tended to have higher stress responses intra- and
      postoperatively despite having been indistinguishable from survivors by the usual
      clinical and hemodynamic criteria. These preliminary results suggest that
      neonatal hormonal and metabolic responses to cardiac surgical operations in
      neonates are extreme and are associated with a high hospital mortality rate.

PMID- 2221436
TI  - hemofiltration reverses left ventricular dysfunction during sepsis in dogs.
AB  - Depressed left ventricular (LV) contractility in sepsis has been ascribed to the
      presence of circulating cardiodepressant substance (filterable cardiodepressant
      factor in sepsis [FCS]); however, this finding is controversial. The authors
      hypothesized that if a decrease in LV contractility indeed occurred due to a
      circulating depressant substance, then removal of this substance by
      hemofiltration would reverse by dysfunction. In this study, LV mechanics were
      examined before and after hemofiltration in anesthetized dogs during continuous
      intravenous infusion of live Escherichia coli. Left ventricular anterior
      posterior and apex-base dimensions were measured by subendocardial ultrasonic
      crystal transducers implanted 4 weeks before the experiments. Left ventricular
      contractility was determined from the end-systolic pressure-dimension
      relationship. The slope of this relationship (Emax) is an index of contractility.
      After 4 h of sepsis, Emax was reduced by one half. Hemofiltration resulted in a
      return of Emax to control values. The FCS activity in the plasma was also
      assessed by the percent reduction in isometric contraction of electrically
      stimulated, isolated right ventricular trabeculae obtained from nonseptic dogs.
      The FCS activity reached a peak 4 h after sepsis and was reduced after 2 h of
      hemofiltration. The results show that during experimental sepsis, a circulating
      substance of less than 30,000 d produces a decrease in LV contractility and that
      this LV dysfunction may be improved by hemofiltration.

PMID- 2221437
TI  - Nitrous oxide does not alter infarct volume in rats undergoing reversible middle
      cerebral artery occlusion.
AB  - This experiment was designed to determine if nitrous oxide alters neurologic and
      pathologic outcome from temporary focal cerebral ischemia in spontaneously
      hypertensive rats deeply anesthetized with a barbiturate. Two groups of rats were
      given intravenous methohexital such that a stable EEG pattern of burst
      suppression was achieved. In one group of rats (n = 11), the lungs were
      mechanically ventilated with 70% N2O/30% O2, and in the other group (n = 10),
      ventilation was done with 70% nitrogen/30% O2. The middle cerebral artery was
      then occluded for 2 h, during which time mean arterial pressure, blood gases,
      hematocrit, plasma glucose, and head temperature were held constant between
      groups. The total doses of methohexital administered were similar in both groups
      as were the plasma methohexital concentrations immediately prior to onset of
      ischemia. After reperfusion of the middle cerebral artery, the animals were
      allowed to awaken. Neurologic evaluations were performed prior to ischemia and at
      24 and 96 h postischemia. Cerebral infarct volume was measured at 96 h
      postischemia using triphenyl tetrazolium chloride staining and computer imaging
      techniques. There were no neurologic differences between the N2O and nitrogen
      groups at any experimental interval although both groups exhibited deficits at
      both 24 and 96 h postischemia relative to preischemic values. The two groups also
      had nearly identical cerebral infarct volumes (N2O = 231 +/- 97 mm3; nitrogen =
      226 +/- 75 mm3; mean +/- SD).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221438
TI  - Endogenous vasopressin supports blood pressure and prevents severe hypotension
      during epidural anesthesia in conscious dogs.
AB  - To evaluate whether, and to what extent, release of endogenous vasopressin
      supports blood pressure when efferent sympathetic drive is blocked by epidural
      anesthesia, the authors studied the effects of high epidural anesthesia alone and
      when vasopressin was prevented from acting at its vascular (V1)-receptor in six
      awake, trained, unsedated dogs. On different days, the same dose of 0.5%
      bupivacaine (8-13 ml) was injected epidurally in a randomized fashion either in
      the presence or absence of (V1)-vasopressin receptor blockade, and the effects
      were evaluated on cardiovascular (arterial blood pressure, heart rate) and
      respiratory (blood gases, oxygen consumption) variables, and on plasma
      concentrations of vasopressin and renin. Results were also contrasted to those
      obtained after epidural injection of saline alone (placebo) in the same dogs.
      When endogenous vasopressin was prevented from acting by intravenous pretreatment
      with a specific V1-receptor antagonist (beta-mercapto-beta, beta-cyclopenta
      methylene-propionyl-O-Me-Tyr-Arg-Vasopressin), epidural anesthesia resulted in a
      rapid and sustained 35% decrease in mean arterial blood pressure from 92 mmHg +/-
      5 SE to 60 mmHg +/- 4. In contrast, only a 14% decrease in mean blood pressure
      from 92 mmHg +/- 5 to 79 mm Hg +/- 6 was noted after epidural anesthesia alone.
      This difference between groups was statistically significant (P = 0.0001). The V1
      receptor blockade alone had no detectable effect. Vasopressin plasma
      concentrations significantly increased from 3.4 +/- 0.3 pg.ml-1 to 16.2 +/- 3.2
      pg.ml-1 after epidural anesthesia but did not change after epidural
      saline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221439
TI  - Resistance to d-tubocurarine in lower motor neuron injury is related to increased
      acetylcholine receptors at the neuromuscular junction.
AB  - The hypothesis that lower motor neuron injury, with its associated proliferation
      of acetylcholine receptors (AChR), induces resistance to the neuromuscular
      effects of d-tubocurarine (dTC) was tested in the rat. The left gastrocnemius was
      denervated by a 75-80% lesion of the sciatic nerve. The effective dose for 95%
      twitch depression (ED95) was studied in the denervated gastrocnemius and compared
      to the contralateral undenervated and sham-injured (control) gastrocnemius
      muscles approximately 2 weeks after injury. The AChR number was quantitated by
      the specific ligand 125I-alpha-bungarotoxin (125I-alpha-BT). Plasma dTC
      concentrations, measured by high-performance liquid chromatography (HPLC), were
      correlated to twitch tension during spontaneous recovery from neuromuscular
      blockade in the denervated animal. The ED95 (mean +/- SE) of dTC for the
      denervated leg was significantly (P less than 0.05) higher (0.26 +/- 0.06 mg.kg
      1) than contralateral (0.16 +/- 0.03) and sham-operated left (0.13 +/- 0.03)
      legs. The twitch tension recovered to 50% of control twitch height at
      significantly (P less than 0.05) higher plasma dTC concentrations in the
      denervated (0.78 micrograms.ml-1) compared to contralateral (0.24 micrograms.ml
      1) limb. The AChR number was significantly increased in the denervated limb (1041
      +/- 96 fmol.mg protein-1) compared to contralateral right (109 +/- 4) and control
      left limb (113 +/- 11). There was a significant (P less than 0.05) positive
      correlation (R2 = 0.73) between ED95 and AChR number; that is, 73% of the
      variability in ED95 could be explained by changes in AChR. This study, therefore,
      confirms the hypothesis that proliferation of AChR after nerve denervation
      results in resistance to the neuromuscular effects of dTC.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2221440
TI  - The minimum alveolar concentration (MAC) and hemodynamic effects of halothane,
      isoflurane, and sevoflurane in newborn swine.
AB  - To determine the minimum alveolar concentration (MAC) and hemodynamic responses
      to halothane, isoflurane, and sevoflurane in newborn swine, 36 fasting swine 4-10
      days of age were anesthetized with one of the three volatile anesthetics in 100%
      oxygen. MAC was determined for each swine. Carotid artery and internal jugular
      catheters were inserted and each swine was allowed to recover for 48 h. After
      recovery, heart rate (HR), systemic systolic arterial pressure (SAP), and cardiac
      index (CI) were measured awake and then at 0.5, 1.0, and 1.5 MAC of the
      designated anesthetic in random sequence. The (mean +/- SD) MAC for halothane was
      0.90 +/- 0.12%; the MAC for isoflurane was 1.48 +/- 0.21%; and the MAC for
      sevoflurane was 2.12 +/- 0.39%. Awake (mean +/- SD) measurements of HR, SAP, and
      CI did not differ significantly among the three groups. Compared to the awake HR,
      the mean HR decreased 35% at 1.5 MAC halothane (P less than 0.001), 19% at 1.5
      MAC isoflurane (P less than 0.005), and 31% at 1.5 MAC sevoflurane (P less than
      0.005). Compared to awake SAP, mean SAP measurements decreased 46% at 1.5 MAC
      halothane (P less than 0.001), 43% at 1.5 MAC isoflurane (P less than 0.001), and
      36% at 1.5 MAC sevoflurane (P less than 0.005). Mean SAP at 1.0 and 1.5 MAC
      halothane and isoflurane were significantly less than those measured at
      equipotent concentrations of sevoflurane (P less than 0.005). Compared to awake
      CI, mean CI measurements decreased 53% at 1.5 MAC halothane (P less than 0.001)
      and 43% at 1.5 MAC isoflurane (P less than 0.005).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2221441
TI  - Halothane decreases the release of neuropeptide Y and 3,4-dihydroxyphenylglycol
      from superfused segments of dog pulmonary artery.
AB  - Neuropeptide Y (NPY), norepinephrine (NE), and 3,4-dihydroxyphenylglycol (DOPEG),
      the metabolite of NE that arises intraneuronally, were measured in superfusates
      before, during, and after nerve stimulation and in extracts of dog pulmonary
      artery after superfusion and electrical stimulation (ES) at 12, 6, and 1 Hz. NE
      and DOPEG were quantified by high-pressure liquid chromatography with
      electrochemical detection; peptides were quantified by radioimmunoassay. The rate
      of overflow of NPY, NE, and DOPEG into superfusate was measured over time. The
      overflow of DOPEG into superfusate during basal conditions was 3.0 times that of
      NE. Efflux of DOPEG and NPY increased during ES; peak effluxes were not reached,
      however, until after cessation of stimulation. NE efflux peaked during ES.
      Effluxes of NE, NPY, and DOPEG were frequency-dependent at 12 and 6 Hz; at 1 Hz
      efflux of only NE was greater than basal. Halothane decreased significantly the
      rates of NPY and DOPEG efflux during and after 12 Hz ES; DOPEG efflux evoked by 6
      Hz stimulation was also decreased by halothane. The percentage of the total
      tissue content of NPY that overflowed was decreased by halothane. Halothane did
      not affect the molar ratios of NE:DOPEG or NE:NPY during basal conditions or ES.
      These studies provide evidence that halothane slows efflux of NPY that is
      released along with NE from dog pulmonary artery during high frequencies of
      stimulation. Halothane also reduces the metabolism of NE to DOPEG.

PMID- 2221442
TI  - Volatile anesthetic effects on left ventricular relaxation in swine.
AB  - The effects of halothane (0.5, 1.0, and 1.5%; n = 10), enflurane (1.0, 2.0, and
      3.0%; n = 8), and isoflurane (0.75, 1.5, and 2.25%; n = 8) on isovolumic
      relaxation were studied in open-chest swine. The time constant for isovolumic
      left ventricular pressure decline, T, was determined at each anesthetic
      concentration at the intrinsic heart rate and during atrial pacing to 150 beats
      per min. The effect of increased left ventricular afterload on T was investigated
      by partial occlusion of the thoracic aorta to raise the left ventricular systolic
      pressure to baseline in the presence of volatile anesthetics, and 20% above
      baseline in the absence of volatile anesthetics. Heart rate and left ventricular
      systolic pressure decreased substantially with all three anesthetics, whereas
      left ventricular end-diastolic pressure increased (by 3-4 mmHg). Relaxation time
      constants increased with all three anesthetics at the intrinsic heart rate; when
      the heart rate was controlled by pacing, T increased in the halothane and
      enflurane, but not in the isoflurane, experiments. T was significantly prolonged
      (by 30-100%) by partial aortic occlusion in the presence of anesthetic, but not
      in the control measurements. T did not change significantly in the isoflurane
      experiments when atrial pacing was employed with partial aortic occlusion. The
      volatile anesthetics, particularly halothane, seem to impair the relaxation
      process of the left ventricle; further investigation of the mechanisms of this
      interference, such as anesthetic effects on intracellular calcium movement and
      total left ventricular load, is warranted.

PMID- 2221443
TI  - Dwarfs: pathophysiology and anesthetic implications.

PMID- 2221444
TI  - Continued demonstration of qualifications for board-certified anesthesiologists.

PMID- 2221445
TI  - Guide wire as a cause of complete heart block in patients with preexisting left
      bundle branch block.

PMID- 2221446
TI  - Airway compromise from prevertebral soft tissue swelling during placement of halo
      traction for cervical spine injury.

PMID- 2221447
TI  - Mallory-Weiss tear complicating intraoperative transesophageal echocardiography
      in a patient undergoing aortic valve replacement.

PMID- 2221448
TI  - An unusual presentation of intercostal neuralgia.

PMID- 2221449
TI  - Acute upper airway obstruction due to arterial puncture during percutaneous
      central venous cannulation of the subclavian vein.

PMID- 2221451
TI  - Epidural opioids as a cause of vertical nystagmus.

PMID- 2221450
TI  - Perioperative diagnosis of subclavian artery stenosis: a contraindication for
      internal mammary artery-coronary artery bypass graft.

PMID- 2221452
TI  - Emergency transtracheal jet ventilation system.

PMID- 2221453
TI  - Transtracheal jet oxygenator from capnographic monitoring components.

PMID- 2221454
TI  - Propofol during cesarean section.

PMID- 2221455
TI  - Patient-controlled epidural anesthesia during labor may be hazardous.

PMID- 2221457
TI  - Effects of epidural saline and epidural fentanyl.

PMID- 2221456
TI  - Inappropriate use of the t-test.

PMID- 2221458
TI  - Early reports of pulmonary aspiration during general anesthesia.

PMID- 2221459
TI  - Linear regression is a poor descriptor of accuracy.

PMID- 2221460
TI  - Timing of data acquisition determines image quality in femoropopliteal phase
      sensitive MR angiography.
AB  - To study the effects of timing of data acquisition on quality of femoropopliteal
      magnetic resonance (MR) angiograms, the authors studied 16 healthy men, mean age
      34.3 +/- 6 years, by color Doppler imaging and by phase-sensitive (PS) MR
      angiography. PS MR imaging was performed at 1.5T using a flow adjustable gradient
      (FLAG) pulse sequence. The images were graded in a blinded fashion by two
      independent observers. Of 16 MR angiograms consisting of 141 angiographic images
      (AI), 45 (31.9%) were diagnostic. At least 1 diagnostic AI was obtained in each
      subject, and 38 (84.4%) of the diagnostic images were acquired within the first
      120 milli-seconds (ms) of the systolic flow pulse. The highest yield of
      diagnostic images (90.9%) was obtained in the interval of thirty to sixty ms
      before the peak flow velocity. In healthy man diagnostic PS MR angiography
      requires triggering to the femoropopliteal systolic flow pulse. The highest yield
      of diagnostic images is acquired during the flow pulse acceleration.

PMID- 2221461
TI  - Optimizing heparin utilization in angiographic flush solutions.
AB  - Various concentrations of heparin in angiographic flush solutions are employed
      during angiography. In an effort to determine whether differences in outcome are
      seen when either high or low concentrations of heparin in angiographic flush
      solutions are utilized, two groups of patients were evaluated. There was no
      difference in outcome and a small systemic effect from heparin was seen in both
      groups. Use of a low concentration of heparin is suggested for routine
      angiography.

PMID- 2221462
TI  - Hindbrain ischemia produced by bilateral vertebral artery occlusion and moderate
      hypotension in spontaneously hypertensive rats.
AB  - Hindbrain ischemia was induced by bilateral vertebral artery occlusion and
      moderate hypotension in spontaneously hypertensive rats (SHRs). Mean arterial
      blood pressure was lowered to 80 mmHg in SHRs and to 50 mmHg in Wistar-Kyoto rats
      (WKYs) by a controlled hemorrhage, and then the vertebral artery was bilaterally
      occluded through alar foramina of the first cervical vertebra. Following
      vertebral occlusion, blood flow of the cerebellum was significantly decreased to
      9.4 +/- 2.0 mL/100g/min (+/- SEM) while flow of the cerebrum remained at 32.1 +/-
      5.4 in SHRs. In contrast, cerebellar blood flow in WKYs was preserved at 24.2 +/-
      2.9 mL/100g/min. Brain lactate, pyruvate, and adenosine triphosphate (ATP) were
      determined in SHRs after sixty minutes of hypotension with or without vertebral
      occlusion. Although infratentorial metabolites were actually unaltered in rats
      with hypotension alone, infratentorial lactate and lactate/pyruvate ratio
      significantly increased to 14.38 +/- 3.61 mmol/kg and 67.7 +/- 12.1,
      respectively, with a concomitant decrease in ATP in SHRs with hypotension and
      vertebral occlusion. Bilateral vertebral artery occlusion, together with moderate
      hypotension, was shown to produce a marked reduction of cerebellar blood flow and
      to induce ischemic metabolic changes in the infratentorial brain in SHRs.

PMID- 2221463
TI  - Clinical evaluation of a novel ambulatory automatic blood pressure monitoring
      system.
AB  - Reliability and reproducibility of a new automatic ambulatory blood pressure
      recorder were tested on 31 subjects (18 normotensives and 13 hypertensives). Of
      3688 recordings, 1424 measurements were cross-checked with a sphygmomanometer in
      standing or sitting position at the beginning and at the end of a twenty-four
      hour monitoring period. In the normotensive subjects cross-checkings were
      performed also during a treadmill exercise stress test. Analysis of variance did
      not indicate statistical differences between the two types of measurement (p
      greater than 0.09 for systolic and p greater than 0.62 for diastolic), and a
      significant linear correlation was found at rest (r = 0.99, p less than 0.001 for
      systolic and r = 0.98, p less than 0.001 for diastolic pressure). During the
      effort test the device was unable to correctly measure blood pressure values
      after the first step. During the twenty-four hour monitoring period only 1.1% of
      the preprogrammed measurements were lost for each subject. The recorder seems to
      be a suitable and reliable tool for automatic blood pressure monitoring.

PMID- 2221464
TI  - Effect of high-dose furosemide in refractory congestive heart failure.
AB  - High-dose firosemide is considered effective in primary renal sodium retention
      but is not generally recommended in congestive heart failure. In order to
      evaluate efficacy and safety of high-dose furosemide (greater than 500 mg/day),
      the authors studied 20 patients (pts) resistant to therapy (including furosemide
      less than 500 mg/day) selected from 161 pts admitted for chronic heart failure.
      All refractory pts (15 men and 5 women, mean age sixty +/- 12 years) were in NYHA
      class IV and showed hyponatremia (130 +/- 5 mEq/L) and impaired renal function
      (BUN 31 +/- 14 mg/dL, serum creatinine 1.3 +/- 0.3 mg/dL and BUN/creatinine ratio
      23 +/- 7). In addition to digitalis, dopamine, angiotensin-converting enzyme
      inhibitors, or vasodilators, IV high-dose furosemide (775 +/- 419 mg/day, 500
      2000) was given for ten +/- five days under daily clinical and laboratory
      monitoring. Three pts died of low-output syndrome while 16 pts were upgraded to
      NYHA class III and 1 pt to class II; a mean weight reduction of 7.3 +/- 2.9 kg in
      ten + five days (0.80 +/- 0.4 kg/day) and a mean diuresis increase of 88 +/- 57%
      occurred. The maximal dose of furosemide did not correlate with serum creatinine
      but did correlate with BUN/creatinine ratio (r = 0.78, p less than .001). Pts
      were discharged on with chronic heart failure, and 43% in the subgroup in NYHA
      class IV with hyponatremia. High dose furosemide was effective for rapid removal
      of excess water and salt in "furosemide-resistant" congestive heart failure. The
      relationship between renal impairment and maximal furosemide doses seems to
      confirm the role of renal pharmacokinetics in the appearance of furosemide
      resistance.

PMID- 2221465
TI  - Comparison of standard one-minute treadmill exercise and strandness test
      (absolute walking distance) in relation to site of lesion, walking distance, and
      diastolic blood flow velocity (Doppler curves).
AB  - In 215 outpatients suffering from occlusive arterial disease of the lower limbs
      the authors compared the decrease in the ratio of ankle systolic pressure to
      brachial systolic pressure according to whether the treadmill exercise was
      limited to one minute or extended until pain forced the patient to stop. After a
      one-minute walk the pressure index always decreased significantly, especially
      when walking was restricted. The decrease in the pressure index was generally
      greater when the exercise was continued until the absolute walking distance, and
      the recovery time was usually twice as long. The fall in the pressure index was
      significantly greater for patients with single and multiple iliac stenoses than
      for those with stenoses at lower levels. In patients having a diastolic blood
      flow velocity on Doppler curves at rest, not modified by walking, a maximum drop
      in peripheral pressure was recorded after walking for one minute. In this
      instance there was no intensification of the decrease in peripheral pressure,
      unlike in patients without a diastolic blood flow velocity at rest. This one
      minute test is not a maximal hemodynamic response, but it is sufficient for the
      appreciation of ischemia during exercise, according to the different parameters
      measured.

PMID- 2221466
TI  - Use of Doppler flow velocity waveform analysis in detection of initial diabetic
      microangiopathy.
AB  - Doppler flow velocity waveform analysis (FVWFA), recorded from the dorsalis pedis
      artery (DPA) and the radial artery (RA), was performed on 36 women in attempting
      to detect an initial diabetic microangiopathy (DM). The study comprised two
      groups of women affected by non-insulin-dependent diabetes mellitus, 6 patients
      (pts) of reproductive age (1), 12 pts in menopause (II), and two groups of age
      matched healthy controls (C) (III and IV). Clinical signs of initial DM were
      present in group I. All the examined pts were nonsmokers and normotensive and
      without cardiopathy, signs of diabetic macroangiopathy, collagen vascular disease
      and/or Raynaud's phenomenon, and renal failure. Four waveform dimensions capable
      of separating different degrees of peripheral obstructive arteriolar disease were
      determined on velocity tracing and the results used in a single best discriminant
      equation. The resultant discriminant score (DS), derived by FVWFA on DPA, showed
      a highly accurate rate of separating the young pts with DM from both C and the
      pts in menopause without DM. Furthermore, the resultant DS was statistically not
      different in groups II, III, and IV. In conclusion, FVWFA on DPA, in this
      experience, has proved to be an accurate and sensitive method in the detection of
      initial DM.

PMID- 2221467
TI  - Coronary artery dissection--a case report.
AB  - Coronary artery dissection, both spontaneous and catheter-induced, is associated
      with a significant morbidity and mortality. The authors present a case of a
      middle-aged woman with spontaneous right coronary artery dissection causing
      inferior wall myocardial infarction and left coronary artery dissection at the
      time of coronary arteriography. It is suggested that emergency aortocoronary
      bypass surgery be performed preceded by insertion of an intra-aortic balloon in
      acute evolving cases where coronary anatomy is favorable to limit infarction and
      avert loss of life.

PMID- 2221468
TI  - A forme fruste of Marfan's syndrome: case history.
AB  - A thirty nine year old woman presented with multiple aneurysms and dissections of
      the arterial system secondary to cystic medial necrosis is presented. After
      assessment of the family history a diagnosis of a forme fruste of Marfan's
      syndrome was made. Preoperative consideration of this rare diagnosis is important
      for treatment and surgical management.

PMID- 2221469
TI  - Underestimation of treatment effect in crossover trials.
AB  - In crossover trials each subject serves as his own control. For the study of
      cardiovascular diseases such as hypertension and angina pectoria, properly
      designed crossover studies are preferred to parallel studies. There is a
      considerable between-subject variability of symptoms in some of these conditions.
      Bias due to this is eliminated by the use of a crossover design. However, a
      problem is the so-called treatment-by-period interaction. The present study
      analyzes the potential influences of this on the outcome of the trial. Physical
      carryover effect, defined as a physical effect of the first treatment period
      carrying on into the second, tends to minimize differences between two
      consecutive treatment periods. So does the frustrating experience of an inactive
      agent in the first treatment period. Outside influences such as the change of the
      seasons may affect lengthy crossover trials in a similar way. The author
      concludes that the treatment effect in a crossover trial tends to be
      underestimated. The current concept that reports of clinical trials are generally
      biased toward an exaggeration of treatment effects does not seem to apply to
      crossover trials.

PMID- 2221470
TI  - Electrocardiographic abnormalities in cerebrovascular accidents.
AB  - The electrocardiographic abnormalities found in 100 patients with acute
      cerebrovascular disease and previously normal hearts are described. The
      abnormalities were more often seen in patients with intracerebral and
      subarachnoid hemorrhages. The most common changes were Q-Tc Prolongation and ST
      segment and T wave abnormalities. The mechanisms of these electrocardiographic
      abnormalities appear to be multiple.

PMID- 2221472
TI  - The effect of local temperature versus sympathetic tone on digital perfusion in
      Raynaud's phenomenon.
AB  - Matched groups of 7 to 8 patients with primary Raynaud's phenomenon, systemic
      sclerosis, and undifferentiated connective tissue disease and cold-tolerant
      normal control subjects were studied by simultaneous digital strain gauge
      plethysmography and laser Doppler capillary velocimetry during two controlled
      cycles of hand warming and cooling with and without addition of central cooling
      and during clinical maneuvers to evoke sympathetic tone. Transient
      vasoconstrictor responses of comparable degree could be evoked in all patient
      groups and in both the arterial and microvascular beds. While the addition of
      central cooling had little influence on arterial flow, patients with systemic
      sclerosis manifested a failure to maintain nutritive perfusion at finger
      temperatures associated with Raynaud's phenomenon. Linear regression and
      multivariate analysis suggested that finger temperature was the principal
      determinant of arterial flow in systemic sclerosis and that arterial flow was the
      principal determinant of microvascular perfusion. The inability of patients with
      systemic sclerosis to maintain nutritive flow in the face of either reflex or
      cold-induced proximal arterial constriction is consistent with their clinical
      propensity to ischemic tissue injury and separates these patients physiologically
      from other forms of Raynaud's phenomenon.

PMID- 2221474
TI  - Transient reversal of inverted U waves during Valsalva's test--a case report.

PMID- 2221473
TI  - Successful direct PTCA on LAD after first episode of acute myocardial infarction:
      does it improve cardiac function?
AB  - Patients who received direct percutaneous transluminal coronary angioplasty
      (PTCA) after acute mycardial infarction and maintained potency but with
      unimproved cardiac function were studied. In 15 patients, the first episode of
      acute myocardial infarction was caused by a left anterior descending branch
      lesion; 11 had an ejection fraction of 50% or more in the left ventriculogram in
      the follow-up period (improved group), and 4 patients had ejection fraction of
      less than 50% (unimproved group). There was so significant difference between the
      groups in the mean time between the onset of infarction and revascularization
      (improved group, 259.3 +/- 76.9 min; unimproved group, 168.0 +/- 101.6 min) or in
      the sigma Q. which was the sum of the Q wave depth of V2, V3, and V4 at the time
      of admission (improved group, 12.1 +/- 15.6 mm; unimproved group 29.8 +/- 13.4
      mm). The maximum creatine kinase concentration was significantly higher in the
      unimproved group (improved group 2670 +/- 893 IU/L; unimproved group, 7243 +/-
      1928 IU/L, p less than 0.05), and the time taken from the onset to reach its peak
      was significantly shorter in the unimproved group (improved group, 13.0 +/- 5.1
      hr; unimproved group, 6.8 +/- 1.3 hr, p less than 0.05.) These results suggest
      the probability of sudden deterioration of myocardium, and factors other than
      microcirculatory thromboembolism should be considered as the cause of unimproved
      cardiac function after successful direct PTCA.

PMID- 2221471
TI  - Does the decrease in heart rate prevent a detrimental decrease of the end
      systolic volume during central hypovolemia in man?
AB  - Central hypovolemia occurring with epidural anesthesia was investigated by
      measurement of hemodynamic and endocrine variables in 10 patients. Responses fell
      into two categories. Four patients experienced a hypotensive bradycardic episode
      after seventeen +/- four minutes. In this group epidural anesthesia initially
      induced a tendency toward an increase in heart rate from 65 +/- 4 to 73 +/- 5
      beats/min concomitantly with decreases in end-diastolic (172 +/- 22 to 138 +/- 16
      mL), end-systolic (67 +/- 12 to 51 +/- 9 mL), and stroke (105 +/- 10 to 85 +/- 7
      mL) volumes (radionuclide cardiography). A subsequent decrease in mean arterial
      pressure from 76 +/- 3 to 67 +/- 4 mmHg was associated with a decrease in venous
      return as reflected by the decrease in cardiac output from 6.1 +/- 0.4 to 4.7 +/-
      0.7 L/min. In this situation when the venous return was critically reduced, the
      heart rate was 49 +/- 4 beats/min and no further reduction in end-diastolic and
      end-systolic volumes was observed. The observed endocrine changes were compatible
      with a response to central hypovolemia. In the other 6 patients the reaction to
      epidural anesthesia did not induce statistically significant changes in
      hemodynamic and endocrine variables. It is concluded (1) that the decrease in
      heart rate associated with central hypovolemia during epidural anesthesia seems
      to be elicited when the left ventricular end-systolic volume is decreased by
      about 25% and (2) that a further decrease in end-systolic volume during
      progressive central hypovolemia is avoided possibly as a direct consequence of
      the slowing of the heart.

PMID- 2221475
TI  - Laser angioplasty: a critical review based on 1849 clinical procedures.

PMID- 2221476
TI  - Arterial revascularization by laser angioplasty: first Italian experiences.
AB  - Eighty-seven laser angioplasty procedures were performed on 85 patients (73 men
      and 12 women). In the first phase (54 patients) a broad selection process
      included long occlusions (23.9 cm avg) and vessels with heavy calcification; in
      the second phase (31 patients) the authors treated vessels with shorter
      occlusions (10 cm avg) and less calcific. The primary success rate, based on
      number of procedures (73.5% overall) was 69% in the first phase but reached 81.3%
      in the second phase. There were 14 perforations (16%), 8 dissections (9.4%), and
      4 peripheral emboli (4.7%). Six-month follow-up shows that the Winsor index
      maintained its initial improvement in 76.5% of all patients, or 62% in just the
      long occlusions. These data and a review of the cases suggest that no more of 10
      20% of patients with claudication in lower extremities can be treated by laser
      angioplasty; the authors consider ideal candidates those patients who noncalcific
      lesions in the common iliac or superficial femoral arteries at the III medium
      level with obstructions shorter than 8 cm and good runoff.

PMID- 2221477
TI  - Effects of a 2.15-micron laser on human atherosclerotic xenografts in vivo.
AB  - The thulium-holmium-chromium:yttrium-aluminum-garnet (THC:YAG) laser has a tissue
      effect similar to that of the CO2 laser, with the advantage of transmissibility
      through flexible fibers. The authors used a human-rabbit xenograft model to
      evaluate the thrombotic and healing responses of atherosclerotic vessels
      subjected to laser energy. Occluded atherosclerotic human coronary artery
      segments were recanalized in vitro by use of the THC:YAG laser. Destruction of
      plaque by the laser was achieved with minimal collateral thermal damage. These
      vascular segments were then transplanted into the rabbit abdominal aorta. The
      authors observed that the luminal surface of the lased vessels was more
      thrombogenic than that of the nonlased control vessels. However, occlusion of the
      lased vessels did not occur. Repair of laser-treated tissue progressed until a
      mature, nonthrombogenic fibrin-platelet aggregate was adherent to the luminal
      wall. Overall, the lased vessels behaved in a fashion similar to the nonlased
      control vessels. On the basis of these results, the authors believe that the
      THC:YAG laser may have use in human angioplasty.

PMID- 2221478
TI  - Intraoperative coronary excimer laser angioplasty: preliminary clinical
      experience.
AB  - Diffuse coronary artery atherosclerosis is generally recognized as a deterrent to
      successful revascularization if it cannot be adequately treated. Mechanical
      endarterectomy can be useful, but it is not the optimal solution owing to the
      associated higher incidences of perioperative infarction and mortality. The use
      of laser energy as an endarterectomy tool appears promising. To investigate the
      application of excimer laser radiation to intraoperative coronary artery
      endarterectomy, 15 stenotic lesions in 13 patients were treated with excimer
      irradiation during coronary artery bypass grafting. Eleven (73%) of the lesions
      were enlarged by the excimer probe (6 of the successes were in calcified
      lesions). The 4 arteries not enlarged by the excimer laser all demonstrated
      calcified lesions. There were 3 perforations and 2 dissections, all but 1 in
      heavily calcified arteries. The results of this phase 1 safety and efficacy study
      indicate that excimer irradiation can recanalize most arteries, including total
      and subtotal occlusions and some calcified lesions. Further evaluation with
      better delivery systems is needed to determine whether the perforation rate can
      be reduced.

PMID- 2221479
TI  - Intraoperative coronary angioscopy: development of practical techniques.
AB  - Techniques and equipment for intraoperative coronary angioscopy were studied in
      the coronary arteries and cardiac veins of excised and in vivo animal hearts.
      These studies then allowed development of safe, practical techniques for human
      clinical use. In coronary artery bypass operations, multichannel angioscopes of
      2.3 to 2.8 mm diameter gave the best results for examinations of the bypass vein
      and anastomosis, whereas smaller optical fibers of 1 mm diameter were required
      for inspection of the native coronary artery. Abnormalities were detected in 11
      of 48 (23%) coronary bypass anastomoses, and significant discrepancy in the
      degree of coronary artery stenosis as compared with the preoperative angiogram
      was revealed in 2 patients. The authors concluded that a new design of ultrafine,
      multichannel angioscope would be more suitable to the different requirements for
      inspection of both the anastomosis and the recipient artery.

PMID- 2221480
TI  - Intravascular laser therapy of acute myocardial infarction.
AB  - The efficacy of a new method of treatment, endovascular blood irradiation with He
      Ne laser, developed by the authors, was studied in 295 patients with primary
      acute transmural myocardial infarction (MI). Twenty-four-hour Holter monitoring
      findings before and after laser irradiation suggested the possibility of
      preventing sudden death in the acute period of MI owing to the high anti
      arrhythmic efficacy of the method with respect to high-grade ventricular
      arrhythmias. Precodial ECG mapping and serial determination of blood enzyme
      activities (CPK and MB-CPK) showed that irradiation performed within the first
      hours of MI development contributed to effective limitation of the infarction
      area and restricted the spread of the area of myocardial ischemic damage.

PMID- 2221481
TI  - Blinding reviewers improves peer review.

PMID- 2221482
TI  - The hidden tonsils of Waldeyer's ring.
AB  - The visible and the hidden tonsils of Waldeyer's ring merit attention from
      specialists in allergy and clinical immunology not only because they are sites of
      antigen recognition and synthesis of antibody, including IgE, but also because
      they may produce a wide range of symptoms in the upper airway. Ordinarily, such
      symptoms may be differentiated from those of classic allergic rhinitis, but
      allergists commonly see patients with a variety of upper airway complaints that
      on investigation prove not to have an allergic basis. Use of flexible fiberoptic
      upper airway endoscopy, a simple office procedure that permits direct inspection
      of the recessed areas of the upper airway, will result in timely evaluation and
      treatment of pathology of these upper airway lymphatic structures, and
      identification of patients requiring referral to another specialist.

PMID- 2221483
TI  - Adverse reactions to heparin.
AB  - Heparin is a medication that has gained widespread use in clinical medicine as
      the therapy of choice for acute anticoagulation in the prevention and treatment
      of thromboembolic disease. Therapy with heparin is associated with many potential
      adverse side effects. Heparin-induced skin necrosis is an uncommon complication
      of heparin therapy that is now believed to be a thrombotic complication of
      heparin-induced thrombocytopenia. The pathogenesis of this disorder is unknown,
      but it is presumed to be immunologically mediated. The diagnosis is frequently
      one of exclusion. Significant morbidity and mortality may arise from failure to
      recognize this adverse reaction.

PMID- 2221484
TI  - Bakers' asthma: prevalence and evaluation of immunotherapy with a wheat flour
      extract.
AB  - One hundred thirty-nine bakers and pastry cooks were included in a prevalence
      study of IgE-mediated hypersensitivity to wheat flour demonstrated by skin tests,
      specific IgE to wheat flour (RAST), and inhalation challenge. From the sensitized
      workers, we selected 30 asthmatic patients. Twenty patients were treated with a
      standardized wheat flour extract, and ten with a placebo in a double-blind
      clinical trial. Before and after immunotherapy we performed tests in vivo (skin
      tests with wheat flour and methacholine tests), and in vitro (total IgE and
      specific IgE to wheat flour). We found substantial prevalence of wheat flour
      allergy (25.17% of workers), and a significant decrease (P less than .001) in
      hyperresponsiveness to methacholine, skin sensitivity (P = .002), and specific
      IgE (P less than .005) to wheat flour after 20 months of immunotherapy. There was
      also significant subjective improvement (P less than .001). The placebo group
      showed no changes in these variables.

PMID- 2221485
TI  - Exercise-induced biphasic responses and methacholine reactivity in asthma.
AB  - Biphasic (early and late) asthmatic responses to exercise occurred in seven of 43
      children with reproducible exercise-induced asthma. As biphasic allergen-induced
      asthma is associated with a prolonged increase in nonspecific bronchial
      hyperreactivity, this effect was not sought in the 43 asthmatic children. There
      was no significant change in methacholine PD20 FEV1 before and after exercise
      challenge, either in children who had early, or early and late, exercise
      responses. Late reactions after allergen exposure are likely to be of
      considerable clinical significance in relation to the enhancement of bronchial
      responsiveness. It is reassuring that this is not the case for exercise
      challenge, as it would have major implications in relation to the recommendations
      that asthmatics should participate in normal activities and even in training
      programs. Furthermore, it suggests that there are differences between the
      pathophysiology of asthma induced by exercise and that produced by allergens.

PMID- 2221486
TI  - Oral gold therapy in steroid-dependent asthma, nasal polyposis, and aspirin
      hypersensitivity.
AB  - Eight patients are described who fulfill the criteria for the triad of asthma,
      nasal polyposis, and aspirin hypersensitivity who have been treated with oral
      chrysotherapy from 7 to 17 months. Patient diary and symptom scores reflect an
      overall improvement in global symptoms. Monthly pulmonary assessment (spirometry)
      does not indicate a significant change (improvement or deterioration) but average
      daily oral prednisone requirements have decreased. One of eight patients
      experienced a minor side effect of treatment but did not require discontinuation
      of therapy. Oral gold therapy may prove to be an alternative therapy in a select
      population of patients and permit a reduction or discontinuation of oral
      corticosteroid therapy.

PMID- 2221487
TI  - Dust mite assays in clinical allergy practice: mite antigen exposures among skin
      test positive patients in Kansas.
AB  - We have attempted to determine whether sensitive monoclonal antibody assays for
      Dermatophagoides mite antigens Der p I and Der f I can be carried out in a
      private clinical allergy practice laboratory, to ascertain incidence of
      significant home mite exposure in dust samples from patient homes in Kansas, and
      to consider whether such information impacts on patient management. We analyzed
      152 dust samples from 62 patient homes. All patients were skin prick test
      positive for one or both common mite species available for skin testing, and had
      potentially relevant histories. Der p I and Der f I antigen levels were added
      together, and levels above 2 micrograms/g of dust were considered "positive." By
      this definition, elevated levels were found in at least one sample from 48 of 62
      homes tested (77%); however, 61% of mattress samples tested, 41% of carpet
      samples, and 54.5% of furniture samples had levels below those considered likely
      to cause symptoms. Only 13 of 152 samples yielded Der p I levels above 2
      micrograms/g. We conclude that monoclonal antibody assays for Der p I and Der f I
      antigens can be performed in a well-equipped office laboratory staffed by trained
      medical technologists, that Der f I is the predominant mite species in Kansas,
      and that data derived from mite assays may be important in treatment planning for
      patients suspected of having mite-related allergy symptoms.

PMID- 2221488
TI  - A controlled, double-blind study of the effect of quazolast on nasal challenge
      with ragweed antigen.
AB  - Quazolast is a potent mediator release inhibitor as determined by in vitro and in
      vivo testing. A placebo-controlled, double-blind, two-way crossover study
      compared the safety and efficacy of Quazolast, 400 mg bid orally, with placebo in
      23 subjects with ragweed (RW) allergy, out of season. Subjects were assigned to
      two 7-day treatments in a random sequence with an 8-day washout. Subjects were
      challenged on days 1 and 7 of each trial with serial dilutions (10, 100, 1000,
      1350, and 2700 PNU/0.135 mL) of RW, using metered pump spray bottles, (two sprays
      delivered 0.135 mL), preceded by saline control. Efficacy evaluation consisted of
      nasal flow rates measured by rhinomanometry, sneeze counts, nasal itchiness
      scores, and weight of nasal secretions during challenges. During Quazolast
      treatment, subjects had significantly lower (P less than .05) mean percent
      decreases in nasal flow rate at 1350 and 2700 PNU. Nasal itchiness scores were
      significantly lower (P less than .05) during Quazolast treatment than at placebo
      at 1000, 1350, and 2700 PNU. Although sneeze counts were lower during treatment
      with Quazolast than with placebo, the results did not reach statistical
      significance. No significant improvement was seen in the weight of nasal
      secretions. Adverse experiences, clinical laboratory results, and physical
      examinations were unremarkable, posttreatment. Quazolast was superior to placebo
      in protecting against nasal congestion and nasal itchiness after ragweed nasal
      challenge.

PMID- 2221489
TI  - Effect of exercise on complement activity.
AB  - Complement measurements of C1, C1q, C2, C3, C4, C5; the anaphylatoxins, C3a, C4a,
      and C5a; and total hemolytic activity of the classical and alternative pathways
      were made in 26 experienced adult runners before and after shortterm aerobic
      exercise. The baseline results were compared with those of nonexercising age
      matched controls. In most subjects tested, running resulted in nanogram increases
      in C3a and C4a with corresponding decreases in the hemolytic activity of C4
      (C4H). Baseline values of C3 and C4H were decreased significantly in runners when
      compared with nonexercising controls. Preliminary studies measuring the effect of
      exercise on C3a levels were also done in three asthmatic runners. Mean resting
      and postexercise levels, and exercise-induced increases in C3a anaphylatoxin in
      the asthmatic subjects were significantly higher than in the nonasthmatic
      subjects. The findings indicate that short-term exercise results in the
      activation of C3 and C4 and subsequent generation of C3a and C4a anaphylatoxins,
      and suggest that both activation of the classical pathway of complement and a
      selective downregulation of C3 production may occur in persons regularly engaged
      in aerobic exercise. The exaggerated generation of C3a by asthmatic subjects
      during exercise raises the possibility that anaphylatoxins play an etiologic role
      in exercise-induced asthma.

PMID- 2221490
TI  - Effect of vitamin C on histamine bronchial responsiveness of patients with
      allergic rhinitis.
AB  - The effect of acute oral administration of 2 g vitamin C on bronchial
      responsiveness to inhaled histamine in 16 patients with allergic rhinitis was
      compared with placebo on two consecutive days in a double-blind, crossover
      design. The PC15FEV1 was significantly increased one hour after treatment with
      vitamin C but not after placebo.

PMID- 2221491
TI  - Topical capsaicin induces cough in patient receiving ACE inhibitor.

PMID- 2221492
TI  - Spacers for childhood asthma.

PMID- 2221493
TI  - [Study of the complement system. General principles and perspectives].
AB  - Measurement of complement in clinical medicine is traditionally based on the
      determination of CH50 and immunochemical and/or functional measurement of
      complement proteins C1q, factor B, C3 and C4. The interpretation of these
      measurements, as far as complement activation is concerned, can however be
      difficult as these tests do not allow to discriminate between consumption due to
      activation, hereditary deficiency, increased rate of synthesis or even
      hyposynthesis. This explains why their use as markers of evolutivity in diseases
      where complement activation is occurring has given variable results. New tests
      for complement activation have been more recently introduced. These are mainly
      the measurements of the anaphytotoxins, the degradation products of C3 and the
      membrane attack complex. As these tests reflect more directly complement
      activation, they may be more reliable markers. The immunochemical and functional
      measurements of C1-inhibitor are of special interest as they are the tests which
      allow definitive diagnosis of the hereditary angio-oedema. General principles for
      the interpretation of the different tests used to evaluate the complement system
      are presented and discussed.

PMID- 2221494
TI  - [Antibody interference in immunoassays with markers].
AB  - Antibody interferences in competitive and non-competitive immunoassays are
      discussed for analyte specific and reagent specific (anti-antibodies) antibodies.
      The effect on apparent measured concentrations is described and the methods to
      detect and, when possible, to eliminate these interferences are reported.

PMID- 2221495
TI  - [Application of the immunoenzyme technic in double determination of antibodies
      for the study of hyperlipoproteinemia].
AB  - Antibodies directed against designed apolipoprotein, were absorbed on microtiter
      plates, the other apolipoprotein present on the retained particles was evaluated
      by using corresponding peroxidase labeled antibodies. This differential antibody
      immunosorbent assay was applied to evaluate lipoprotein particles concentration
      in familial type IIa, IIb, III, IV, and in the type IV secondary to chronic renal
      failure. Type IIa and IIb, were characterized by the increasing plasma
      concentration of lipoprotein particles containing both apo B and apo E (LpE-B).
      Although type IIa have high level of apo CIII, the plasma concentration of
      lipoprotein containing both apo B and apo CIII was within the normal range. The
      high concentration of apo E in type III hyperlipoproteinemia, revealed the
      accumulation of LpB-CIII-E but mainly lipoproteins containing both apo B and apo
      E (LpE-B). The latter represents 0.94 +/- 0.51 g/l when compared to
      normolipidemic subjects: 0.29 +/- 0.06 g/l. The decrease concentration of apo AI
      affects essentially lipoprotein containing apo AI without apo AII (LpAI) in
      primary type IV hyperlipoproteinemic patients, while in chronic renal failure,
      both populations of apo AI (with and without apo AII) were affected. The
      differential antibody immunosorbent assay may be used in the future as a new
      approach to classify lipid transport disorders.

PMID- 2221496
TI  - [Evaluation of ELISA using A60 antigen from Mycobacterium bovis BCG: specific IGG
      and IGM in mycobacterial infections].
AB  - The authors have evaluated an ELISA (A60-Tb, Anda biologicals) allowing the
      detection of specific IgG and IgM against A60 antigen from Mycobacterium bovis
      BCG during mycobacterial infections. This study included sera from 110 african
      subjects and from 71 French subjects distributed in 4 clinical groups: 55
      tuberculous patients (I), 41 leprous patients (II), 33 pneumopathies (III) and 52
      healthy subjects (IV). Serological results were compared taking as reference for
      the diagnosis of tuberculosis the positivity of culture and/or that of a direct
      examination, and for leprosy the positivity of a direct examination associated
      either with a Mitsuda's reaction or with an histopathological examination. IgG
      were found to be more discriminative than IgM. Considering together the results
      of groups I and II, the authors found a sensitivity of 95.8 p. cent and a
      specificity of 75.3 p. cent with threshold of 200 U/ml for specific IgG. Anti-A60
      antigen antibodies obtained for groups I and II were significantly higher (IgG: p
      less than 0.0001; IgM: p less than 0.001) than those observed in other groups.
      African subjects presented IgG titers higher than those obtained by French
      subjects (p less than 0.0001). IgM response was more frequent among group II
      (97.6 p. cent) than group I (21.8 p. cent). However, IgG (26.9 p. cent) and IgM
      titers (30.8 p. cent) were detected among group IV. This test would allow a
      control of therapeutic efficacy with an additional interest for classifying
      borderline forms of leprosy.

PMID- 2221497
TI  - [Accuracy in thyroid hormonology: evaluation of free T4 by five immunometric
      methods using cold markers].
AB  - During a comparative multicentric evaluation, five commercially available non
      isotopic methods for FT4 measurement were tested. As with the radioactive methods
      the problem with accuracy is again evident. This is true both for setting
      reference values and standards as well as for the specificity of the methods. The
      authors demonstrated highly significant correlations as described in recent
      papers: many of the values may, however, be up to double value in one center
      compared to another despite the correlation of 0.90.

PMID- 2221498
TI  - [Study of lymphocytes T chromosome aberrations in painters exposed to genotoxic
      risk].
AB  - Chromosomal aberrations test was applied to 12 chemically exposed painters and 13
      occupationally non exposed subjects. The results showed a significant increase of
      heritable chromosomal aberrations level (chromatid breaks and chromatid gaps) in
      painters. The authors discussed the applicability of this test of the
      occupational health.

PMID- 2221499
TI  - Dry chemistry thin film immunoassay.
AB  - The authors report the development of a novel thin film multilayer immunoassay
      technology. The technology is applied to therapeutic drug monitoring and thyroid
      hormone testing in serum or plasma and can be extended to assays of other low
      molecular weight analytes. The assay detection range spans five orders of
      magnitude, from 1 x 10(-3) to 1 x 10(-8) M. The assay element comprises of
      multilayer coated chip, containing the active reagents in an agarose matrix and a
      plastic module serving both as a holder and a spreader. The assays are in the
      fluorescent competitive immunoassay format of the ligand displacement mode and
      are performed on an automated instrument with random access capability. The
      assays are fast and reliable and gave very good agreement when compared to
      reference methods.

PMID- 2221500
TI  - The "soluble sandwich" approach for immunoassays: methodological and instrumental
      implications.
AB  - The simultaneous presence of homogeneous and heterogeneous reactions at different
      binding sites of a multiepitope antigen makes the description of the kinetic
      parameters of the so called "one step" solid phase immunometric assays complex.
      The authors extended the "one step" approach to the concept of the "soluble
      sandwich" methodology which differs from the former by the delayed solid phase
      capture of the biotinylated immunocomplex to a streptavidin coated solid support.
      Using prolactin monoclonal IEMAs as a model, the equilibria involved in the
      reactions have been studied on a thermodynamic basis through a description of the
      kinetics of the interactions between biotinylated Mabs and solid phase
      streptavidin both in presence and/or in absence of the antigen and HRP-conjugated
      antibody. A comparative evaluation of models in which the biotinylated antibody
      was previously insolubilized on the streptavidin solid phase has been performed
      as well. The experimental work was carried out by using 125I labelled McBiot and
      Prolactin to trace individual interactions and peroxidase/H2O2/TMB systems to
      develop the enzymatic analytical signals. A new instrument/data reducing system
      was also optimized to expand the OD reading range provided by conventional,
      single wavelength colorimeters. The greater flexibility theoretically expected
      for the "soluble sandwich" approach and the possibility to extend the analyte
      working range without detrimental effects on the readability of low doses
      responses have been experimentally confirmed.

PMID- 2221501
TI  - Amplifiable hybridization probes.
AB  - Amplifiable hybridization probes enable the development of extremely sensitive
      clinical assays. These novel molecules consist of a probe sequence embedded
      within the sequences of a replicatable RNA. The molecules are first hybridized to
      target sequences in a conventional manner. The probe-target complexes are then
      isolated and the probes are released from their targets. The released probes are
      then amplified by incubation with the RNA-directed RNA polymerase, Q-beta
      replicase. The replicase copies the probes in a geometrically increasing manner:
      after each round of copying, the number of RNA molecules is twice the previous
      number. The doubling process is very rapid, resulting in as many as one billion
      copies of each molecule in 30 minutes. The amount of RNA that is made is large
      enough to be measured without using radioisotopes. Theoretically, these assays
      should be extraordinarily sensitive, since only one probe molecule is required to
      start the amplification process. In practice the sensitivity of the assays is
      limited by the presence of non hybridized probes that persist, despite extensive
      washing of the probe-target hybrids. Currently, the limit of detection is about
      10,000 molecules of target. However, replicatable probes are now being prepared
      that include a "molecular switch", which is a region of the RNA that undergoes a
      conformational change when the probe sequence hybridizes to its target. Protocols
      are being developed that link signal generation to the state of this switch. The
      simplicity and speed of the enzymatic steps that are required facilitate
      automation of the assays.

PMID- 2221502
TI  - The polymerase chain reaction in the human immunodeficiency virus diagnosis.
AB  - The PCR technique detects HIV1 and HIV2 DNA and RNA sequences in mononuclear
      cells with high sensitivity. It allows therefore to analyse the mother to child
      HIV1 transmission. Moreover, in the near future, the quantification of the PCR
      products could allow the follow-up of the patients treated for HIV infection.

PMID- 2221503
TI  - Experience of gas-liquid chromatography in clinical microbiology.
AB  - In clinical microbiology, gas-liquid chromatography (GLC) is used mainly for the
      following applications: (1) demonstration of microbial metabolites in cultures:
      studies of short-chain fatty acids (chain length 2 to 6 carbon atoms) and of the
      non-volatile lactic and succinic acids are the basis of taxonomy of obligate
      anaerobes on the genus level. Demonstration of these compounds in spent culture
      media is also used for identification of anaerobic bacteria in the clinical
      laboratory. (2) Investigation of long-chain fatty acids of cell membranes and the
      cell wall: analysis of fatty acids with chain lengths of 9 to 20 carbon atoms are
      used primarily for taxonomic purposes. A practical application for use in
      clinical bacteriology is the Microbial Identification System (MIS) based on
      equipment built by Hewlett-Packard. Although this system is excellently suited
      for quantitative analysis of long chain fatty acids and gives valuable
      preliminary or confirmative information, it often requires additional testing for
      identification of bacteria to species level. (3) Direct rapid diagnosis of
      infection: demonstration of metabolic products in body fluids can be of value in
      infections with anaerobes (demonstration of fatty acids) and yeasts (sugars). GLC
      combined with mass spectrometry or frequency-pulsed electron capture GLC
      techniques have been applied to studies of sera, fecal specimens, and
      cerebrospinal fluids. These latter applications are still in an experimental
      stage. However, the rapid diagnosis of tuberculosis directly from cerebrospinal
      fluid and sputum is well advanced. The potential of direct diagnosis without the
      resort to cultures warrants continued research with these techniques.

PMID- 2221504
TI  - Implants, transplants, and other parts of the medicine of the future.
AB  - Today, therapies that rely on adding something "more than natural" to the patient
      are a commonplace of medical practice. Although we may view such therapies as
      recent developments of biomedical science and engineering, they are actually the
      culmination of efforts to replicate, replace, and enhance parts of the human
      anatomy that date from the early days of recorded history. A review of some of
      those early efforts is an instructive way to begin. It helps us to appreciate
      that current developments at the forefront of biomedical science and engineering
      will soon transform the implants and transplants of today into the relatively
      primitive implants and transplants of the past. A discussion of the present state
      of implants and transplants follows. It is necessary to allow us to appreciate
      the great potential offered by current biomedical science and engineering for
      future developments in the therapies of the "more than natural." And then,
      finally, we can offer a present view of the implants, transplants, and other
      parts of the medicine of the future.

PMID- 2221505
TI  - Parametric analysis of flow in the intramyocardial circulation.
AB  - A simple mathematical model of the intramyocardial circulation has been utilized
      to provide a better understanding of coronary blood flow. The model includes
      three myocardial layers, each characterized by a three-parameter windkessel with
      one capacitance and two resistances. The effects of the beating heart are taken
      into account by means of an intramyocardial pump and the possible collapse of the
      vessels by an elevated backpressure. The three basic parameters that govern the
      flow are a normalized time constant, tau, the total resistance, Rt, and a
      parameter, alpha, which specifies the resistance distribution in the
      intramyocardial circulation. Both the normal beating heart and prolonged diastole
      have been investigated analytically as well as numerically. It is shown that each
      of these parameters has its own special significance. Calculated pressure-flow
      relationships and zero-flow pressures for the case of prolonged diastole show a
      high sensitivity to tau and alpha.

PMID- 2221506
TI  - A planar slab bidomain model for cardiac tissue.
AB  - A fully three-dimensional model of the ventricular or atrial free wall will
      involve a planar geometry of finite thickness. The governing equations for the
      interstitial and extracellular potential of a planar slab of cardiac tissue
      comprised of parallel fibers undergoing uniform plane-wave activation are
      presented. A comparison with a bidomain of cylindrical geometry with the same
      half-thickness shows that the potentials in the planar bidomain (as a function of
      depth) approach core-conductor behavior more quickly.

PMID- 2221507
TI  - Blood pressure levels and variance assessed by ambulatory monitoring: optimal
      parameters.
AB  - We obtained multiple ambulatory blood pressure monitoring (ABPM) records over
      five years from two trained, normotensive subjects experienced in wearing the
      apparatus. The resulting time series data on systolic blood pressure (SBP),
      diastolic blood pressure (DBP), and heart rate (HR) were used to suggest optimal
      parameters for monitoring by two instruments (Colin Medical Instruments ABPM-630
      and Del Mar Avionics Pressurometer) and to compare two indirect methods
      (auscultatory and oscillometric). A 10-min sampling interval day and night
      provided sufficient density of data to support spectral analysis for ultradian
      rhythms in the frequency range of one cycle per hour to one cycle per 9 h on a 24
      h record. Rhythms with major periods of approximately 3, 6, and 9 h were
      variously found in 94 normotensive subjects, aged 20 to 95 years, including the
      two trained subjects. When the monitoring period was extended to 72 h, the
      circadian (approximately 24 h) rhythm could be more sharply defined, as well as a
      12-h harmonic. In some studies the two trained subjects wore two monitors, one on
      each arm, set to read simultaneously. From the simultaneous measurements on both
      arms, it was shown that averaging across three points (30 min of record) reduced
      the coefficient of variation between the two simultaneous records to 6% or less.
      Auscultatory and oscillometric methods were equally reliable. Echocardiographic
      data were obtained in five normotensive subjects and compared to their ABPM data.
      The ABPM records provided additional information about cardiovascular function
      not merely duplicating that obtained by acute stress tests, such as exercise or
      cold pressor responses, or echocardiography. Standards for ABPM are suggested.

PMID- 2221508
TI  - Imbalanced biphasic electrical stimulation: muscle tissue damage.
AB  - The effects of imbalanced biphasic stimulation were studied on cat skeletal
      muscle to determine if greater charge densities can be safely used than with
      balanced or monophasic stimulation. The results of the study indicate that
      imbalanced biphasic stimulation can be tolerated safely by tissue at or below a
      net dc current density of 35 microA/mm2 and not safely tolerated at or above a
      net dc current of 50 microA/mm2. Monophasic stimulation has been shown to be safe
      at or below net dc current levels of 10 microA/mm2 and in these studies we found
      it was not safe at or above net dc current levels of 20 microA/mm2. Stimuli were
      applied to muscles via coiled wire intramuscular electrodes using a regulated
      current source. Since the safe average current density was higher for imbalanced
      biphasic stimulation than for monophasic stimulation, this suggests that: (a) pH
      change is not the primary reaction causing tissue damage and (b) the damaging
      electrochemical process that takes place during a cathodic stimulation pulse can
      be reversed by an anodic pulse having substantially less charge than its
      companion cathodic pulse. We conclude that greater cathodic charge densities can
      be safely employed with imbalanced biphasic stimulation than with either
      monophasic stimulation or balanced charge biphasic stimulation.

PMID- 2221509
TI  - Temporal aggregate size distributions from simulation of platelet aggregation and
      disaggregation.
AB  - A modification of the Smoluchowski collision theory for platelet aggregation is
      proposed with additional kinetic terms to accommodate observed disaggregation
      behavior. This model, consisting of a set of coupled, nonlinear, first-order
      differential equations, approximates size distributions with time for normal
      human platelets in plasma after the addition of a stimulus. Parameters
      controlling the kinetics of the formation and breakup of aggregates are
      numerically investigated. The aggregation coefficient, predominant during the
      aggregation phase, is strongly dependent on both time and aggregating agent
      doses. For the disaggregation phase, the disaggregation rate constants are a
      function of aggregate size, with a time-dependent disaggregation coefficient.
      Numerical results generated by the model are compared with experimental volume
      size distribution curves from the literature.

PMID- 2221510
TI  - Analysis and prediction of left ventricular performance under load changes during
      cardiac catheterization.
AB  - The applicability of a computer model, which relates the transmural mechanical
      distribution in the left ventricle (LV) to its global function at different
      loading conditions, was evaluated in patients with normal to near normal LV
      function undergoing cardiac catheterization. Left ventriculography and
      measurements of aortic and LV pressures were performed at baseline conditions and
      repeated following rapid volume expansion with intravenous infusion of 250 to 300
      ml of physiologic saline and also after sublingual isosorbide-dinitrate (ISDN)
      administration. Twenty patients (18 men and 2 women, average age = 53 years)
      underwent coronary angiography and left ventriculography. Sixteen patients had
      coronary artery disease with one- to three-vessel involvement and 4 had normal
      coronary arteries. The measured input data into the model included the end
      diastolic LV volume and wall thickness, aortic pressure, heart rate, and the
      peripheral resistance. The model parameters of myocardial contractility and
      arterial system capacitance for the control baseline conditions were estimated so
      that an accurate match was obtained between the predicted and the measured end
      systolic (ES) volume and pressure. Using these parameters, model predictions for
      the two load perturbations were compared to the measurements. An excellent
      correlation was found between the predicted and measured LV ES volumes and peak
      systolic pressures (PSP) (R2 greater than 0.994). In four patients, who developed
      ischemic symptoms during saline injection, the prediction of end-systole volumes
      were lower than the measured values, suggesting an actual reduction in
      contractility during acute ischemia. Therefore, the model is sensitive to
      contractility changes. The model predicts global LV performance, under different
      loading conditions, including stroke work, peak developed wall stress, velocity
      of fiber shortening, and myocardial oxygen consumption.

PMID- 2221511
TI  - A comparative trial of three agents in the treatment of acute migraine headache.
AB  - STUDY OBJECTIVES: A study was conducted to evaluate the relative efficacy of
      three non-narcotic agents, chloropromazine, lidocaine, and dihydroergotamine, in
      the treatment of migraine headache in an emergency department setting. DESIGN:
      The trial was randomized and single blinded. SETTING: The study was conducted in
      two university-affiliated EDs. TYPE OF PARTICIPANTS: All patients had an isolated
      diagnosis of common or classic migraine. INTERVENTIONS: Patients were pretreated
      with 500 mL (IV) normal saline before randomization. Study drugs as administered
      were dihydroergotamine 1 mg IV repeated after 30 minutes if the initial response
      was inadequate; lidocaine 50 mg IV at 20-minute intervals to a maximum total dose
      of 150 mg as required; or chloropromazine 12.5 mg IV repeated at 20-minute
      intervals to a total maximum dose of 37.5 mg as required. Patients were asked to
      grade headache severity on a ten-point scale before and one hour after the
      initiation of therapy. Follow-up by phone was sought the following day.
      MEASUREMENTS AND MAIN RESULTS: Of 76 patients completing the trial, 24 were
      randomized to receive chloropromazine, 26 to receive dihydroergotamine, and 26 to
      receive lidocaine. Reduction in mean headache intensity was significantly better
      among those treated with chloropromazine (P less than .005). Persistent headache
      relief was experienced by 16 of the chloropromazine-treated patients (88.9%)
      contacted at 12 to 24 hours follow-up compared with ten of the dihydroergotamine
      treated patients (52.6%) and five of the lidocaine-treated group (29.4%).
      CONCLUSION: The relative effectiveness of these three antimigraine therapies
      appears to favor chloropromazine in measures of headache relief, incidence of
      headache rebound, and patient satisfaction with therapy.

PMID- 2221512
TI  - A prospective, double-blind study of metoclopramide hydrochloride for the control
      of migraine in the emergency department.
AB  - STUDY OBJECTIVE: To determine the effectiveness of IV metoclopramide as sole
      therapy for relieving the pain of acute migraine in the emergency department.
      DESIGN: Prospective study. Fifty patients were divided randomly into subjects and
      placebo controls with blinding of the treating physician and the patient.
      PARTICIPANTS: Patients presenting to the ED with migraine requiring parenteral
      treatment. INTERVENTIONS: Subjects received 10 mg IV metoclopramide and controls
      received IV normal saline; patient assessment of relief was followed by means of
      a numerical scale. MEASUREMENTS AND MAIN RESULTS: Sixty-seven percent of subjects
      compared with 19% of controls had effective pain relief within one hour (P less
      than .001). Subjects achieved mean relief scores of 2.46 compared with 1.69 for
      controls (P less than .02). No significant side effects were observed.
      CONCLUSION: IV metoclopramide as a single agent is effective and safe therapy for
      migraine in the ED.

PMID- 2221513
TI  - An evaluation of cocaine-induced chest pain.
AB  - STUDY OBJECTIVE: To determine if enzymatic evidence of acute myocardial injury is
      present in patients complaining of chest pain after cocaine use when the ECG is
      normal or nondiagnostic. DESIGN: Serial ECG and creatinine kinase (CK) and CK
      isoenzymes (CK-ISO) determinations were performed at time of emergency department
      presentation and every six hours over 12 hours on individuals complaining of
      chest pain within six hours of last cocaine use. SETTING: ED of an urban tertiary
      care center. TYPE OF PARTICIPANTS: Forty-two individuals with a mean age of 28.5
      years. INTERVENTIONS: Patients with positive CK-ISOs were admitted immediately to
      formally rule out myocardial infarction. Patients developing ECG changes during
      observation period also were admitted even if CK-ISOs were normal. Patients with
      unchanged ECGs and normal CK-ISOs were discharged after 12 hours of observation.
      RESULTS: Eight patients (19%) had elevated CK and CK-ISO values at presentation.
      Two of these patients had elevated values on three sequential determinations and
      were believed to have sustained acute myocardial infarction. Six patients had
      elevated CK and CK-ISOs at presentation only. ECGs remained normal or
      nondiagnostic in all patients. CONCLUSIONS: Enzymatic evidence of acute
      myocardial injury may occur in patients who develop chest pain after cocaine use
      and have normal or nondiagnostic ECGs. This injury may reflect acute infarction
      or transient ischemia. Single or serial normal or nondiagnostic ECGs do not rule
      out ischemia or injury in this group of patients.

PMID- 2221514
TI  - Treatment of moderate-to-severe hypothermia in an urban setting.
AB  - STUDY OBJECTIVES: To study the treatment of moderate-to-severe hypothermia using
      a combination of core rewarming techniques. DESIGN: A prospective study. SETTING:
      The emergency department of an urban, community hospital. TYPE OF PATIENTS:
      Sixteen patients who presented with accidental hypothermia with a core
      temperature of less than 32 C. INTERVENTIONS: All patients were treated with
      warmed IV fluids either through central or peripheral IV lines and heated aerosol
      masks. MEASUREMENTS AND MAIN RESULTS: The patients had a mean rewarming rate of
      1.16 C/hr; all survived. The majority were chronic alcoholic patients who
      presented with multiple medical conditions that required hospitalization.
      CONCLUSION: All patients recovered with this method of core rewarming.

PMID- 2221515
TI  - Emergency department diagnosis of ectopic pregnancy.
AB  - STUDY OBJECTIVES: To assess the accuracy of the history and physical examination
      as compared to the addition of serum progesterone screening for ectopic pregnancy
      in women presenting to the emergency department. DESIGN: Prospective, consecutive
      case series, N = 2,157. SETTING: ED of the Regional Medical Center at Memphis, a
      publicly subsidized, 450-bed acute care hospital staffed by residents and faculty
      of the University of Tennessee, Memphis. TYPE OF PARTICIPANTS: All ED patients
      with a positive urine pregnancy test treated between January 1 and December 31,
      1988. INTERVENTIONS: Screening history, physical examination, and serum
      progesterone (P) and quantitative human chorionic gonadotropin (hCG) titer.
      MEASUREMENTS: All discharged patients were given follow-up appointments within
      two weeks; those found to have a P less than 25 ng/mL were called to return for
      repeat hCG and transvaginal ultrasound. MAIN RESULTS: One hundred sixty-one of
      2,157 patients (7.5%) with a positive urine pregnancy test were found to have an
      ectopic pregnancy. All but five had a P of less than 25 ng/mL (sensitivity, 97%);
      four of these were admitted for immediate surgery because of symptoms. Overall,
      the ED physician detected 89 of 161 ectopics (55.3%) on initial presentation, 53
      (60%) of which were ruptured at the time of surgery. Seventy-two patients (44.7%)
      who were discharged but later found to have an ectopic pregnancy had benign
      clinical presentations, including 41 with vaginal bleeding. There were no
      statistically significant differences in the presenting symptoms of patients with
      unruptured ectopics compared with normal intrauterine pregnancies. All but one of
      the 72 discharged patients were noted the following day to have a progesterone of
      less than 25 ng/mL and contacted to return. Eight of these were found to have a
      ruptured ectopic at the time of surgery. Only 91 of 161 patients (56.5%) with
      ectopic pregnancy acknowledged one or more clinical risk factors on follow-up
      questioning. CONCLUSION: The standard history and physical examination, including
      those performed by gynecologic specialists, are insufficiently sensitive for
      early detection of unruptured ectopic pregnancy. EDs with a high incidence of
      ectopic pregnancy should strongly consider implementation of a universal
      progesterone screening program to decrease unnecessary patient morbidity and the
      risk of mortality from undiagnosed ectopic pregnancy.

PMID- 2221516
TI  - Brain water content, brain blood volume, blood chemistry, and pathology in a
      model of cerebral edema.
AB  - STUDY OBJECTIVES: The objective was to correlate regional changes during brain
      water content with alterations in blood chemistry and cerebral pathology during
      hypo-osmotic edema. PARTICIPANTS: Sprague-Dawley male adult rats were used in
      these studies. DESIGN: Animals were block-randomized to receive either an
      intraperitoneal distilled water injection equivalent to 5% or 15% of their body
      weight or no injection (controls). Rats were sacrificed 15 or 60 minutes after
      water injection or at an equivalent time for controls. INTERVENTIONS: No
      interventions were performed. MEASUREMENTS AND MAIN RESULTS: Water content of
      cerebral cortical gray and white matter was calculated from measurements of
      tissue specific gravity. Blood plasma osmolality and sodium and potassium
      concentrations were determined at various times after water injection. An index
      of blood-brain barrier permeability was obtained by measuring brain red blood
      cell and plasma volumes. A qualitative assessment of edema was made from light
      and electron micrographs of the cerebral cortex. We found that water injection
      produced a dose-dependent decrease in plasma osmolality and sodium concentration
      within 15 minutes. Cortical water content was unchanged after this period. An
      influx of water into cerebral gray, and, less readily, into cerebral white matter
      occurred during the next 15 minutes. Whole blood specific gravity and brain blood
      content were unchanged and thus did not confound the measurement of cerebral
      water content. Hematocrit was increased 60 minutes after a 15% water injection.
      The blood-brain barrier remained intact throughout this period. Microscopy
      revealed astrocytic swelling with slight extracellular fluid accumulation 60
      minutes after the water injection. CONCLUSIONS: Homeostatic mechanisms in the
      cerebral cortex can maintain constant water content for at least 15 minutes
      during maintained intravascular hypo-osmolality. Fluid that subsequently moves
      into the tissue primarily enters an intracellular compartment. This model will be
      useful in investigating physiological mechanisms of brain water regulation and
      the pathogenesis of brain edema, a common clinical entity in emergency
      conditions.

PMID- 2221517
TI  - Improved survival and reduced myocardial necrosis with cardiopulmonary bypass
      reperfusion in a canine model of coronary occlusion and cardiac arrest.
AB  - STUDY QUESTION: Does cardiopulmonary bypass (CPB) improve resuscitation rates and
      limit infarct size after cardiac arrest and acute myocardial infarction? DESIGN:
      Controlled randomized trial with all animals undergoing left anterior descending
      coronary artery occlusion and subsequent ventricular fibrillation and
      resuscitation. All animals were supported for four hours after resuscitation in
      an intensive care setting. INTERVENTION: Group 1 (eight) was resuscitated with
      standard external CPR and advanced life support. Group 2 (eight) was resuscitated
      with CPB. MEASUREMENTS AND MAIN RESULTS: Group hemodynamic, resuscitation
      variables, number resuscitated, and number of four-hour survivors were compared.
      Ischemic and necrotic myocardial weights were determined with histochemical
      staining techniques in four-hour survivors. Infarct size was measured as the
      ratio of necrotic weight to ischemic weight. Significantly fewer dogs were
      resuscitated in group 1 (four of eight) than in group 2 (eight of eight) (P less
      than .05). Group 2 survivors required significantly less epinephrine and
      lidocaine than group 1 survivors (P less than .05) and higher aortic diastolic
      and coronary perfusion pressures after CPB (P less than .001). The ratio of
      myocardial necrotic weight to ischemic weight at four hours was 0.82 +/- 0.25 in
      group 1 and 0.22 +/- 0.25 in group 2 (P less than .05). However, collateral blood
      flow was not measured in this study. CONCLUSION: This pilot study further
      substantiates the improvement in resuscitation rates obtainable with CPB. CPB may
      also limit infarct size during the postresuscitation period and requires further
      study.

PMID- 2221518
TI  - Interaction between whole-bowel irrigation solution and activated charcoal:
      implications for the treatment of toxic ingestions.
AB  - STUDY OBJECTIVES: The purpose of this study was to address the issues of safety
      and efficacy of combining whole-bowel irrigation and activated charcoal
      administration for the treatment of toxic ingestions. STUDY DESIGN: Two in-vitro
      studies were performed. In the first, serial ratios of polyethylene glycol (PEG)
      and activated charcoal (AC) powders were added to water and the solutions were
      analyzed for PEG concentration and osmolality. In the second, serial ratios of a
      pharmaceutical bowel irrigation solution and an AC preparation were combined with
      a constant amount of salicylic acid. Solution osmolalities, PEG, and salicylic
      acid concentrations were then quantified. RESULTS: Adsorption of PEG powder by AC
      was demonstrated; however, changes in solution osmolality were negligible. Thus,
      concurrent administration of these therapies appears safe. However, combining
      bowel irrigation solution with AC resulted in decreased salicylic acid
      adsorption. This was especially so with smaller amounts of AC that would pertain
      more to the smaller doses of AC used for multiple-dose charcoal therapy.
      CONCLUSION: If these in-vitro data are applicable to overdose patients, the
      administration of a routine initial charcoal dose to those who will be treated
      with whole-bowel irrigation would be appropriate. However, it is unlikely that
      the addition of multiple-dose charcoal therapy to whole-bowel irrigation would
      provide additional benefit for the patient.

PMID- 2221519
TI  - Clinical evaluation of an acetaminophen meter for the rapid diagnosis of
      acetaminophen intoxication.
AB  - STUDY OBJECTIVES: To test the accuracy of a newly developed meter that determines
      serum acetaminophen concentration after a 30-second analysis of one drop of whole
      blood. DESIGN: Sixty-six blood samples from patients with known or suspected drug
      overdose were analyzed for the presence of acetaminophen. In all cases
      determination of serum acetaminophen concentration was performed simultaneously
      with the meter and by a reference laboratory. SETTING: Eligible patients were
      those who presented during a nine-month period to the emergency departments of
      two tertiary care hospitals (including a pediatric hospital). RESULTS: Thirty-one
      specimens had a laboratory-confirmed detectable acetaminophen concentration. The
      meter identified these toxic specimens in all cases; there were no false
      negatives (sensitivity, 100%). Among the 35 specimens not containing
      acetaminophen, the meter invariably confirmed a nondetectable serum acetaminophen
      concentration (specificity, 100%). Acetaminophen measurements by the meter
      correlated strongly with laboratory determinations (r = .985, P less than .001).
      Repeated testing of one specimen documented the precision and reproducibility of
      the meter's analysis; mean coefficient of variation was .08 in measuring toxic
      acetaminophen concentrations. Drug coingestion had no significant effect on the
      accuracy of the meter. Instrument accuracy was maintained after more than 100
      uses without recalibration. CONCLUSIONS: This meter identifies the possibility of
      rapid and accurate determinations of serum acetaminophen concentration. The
      instrument is ideally suited for patients with acetaminophen poisoning in whom
      expeditious and appropriate administration of antidotal therapy is desired.

PMID- 2221520
TI  - Predicting the severity of cocaine-associated rhabdomyolysis.
AB  - STUDY OBJECTIVES: The syndrome of rhabdomyolysis associated with cocaine use has
      been recently described, but the incidence, severity, risk factors, and
      complications are unknown. This study sought to describe the spectrum of the
      syndrome and identify clinical features of patients at risk. DESIGN:
      Retrospective case series with analysis of common clinical features. SETTING:
      Medical emergency department of an urban teaching hospital serving an indigent
      population. TYPES OF PARTICIPANTS: ED patients with acute cocaine intoxication
      and a serum creatine kinase (all MM) of more than 500 U/L (8.3 ukat/L) who were
      admitted for in-hospital management. MEASUREMENTS AND MAIN RESULTS: Twenty-nine
      patients, representing 5% of cocaine-related patient visits, were identified over
      20 months. Patients were divided into three groups: mild, characterized by
      anxiety, tachycardia, diaphoresis, dyspnea, or chest pain; moderate,
      characterized by delirium, agitation, fever, leukocytosis, or an elevated serum
      creatinine; and severe, characterized by seizure, coma, hypotension, arrhythmia,
      or cardiac arrest. There was a significant association between the rating system
      for level of intoxication and the severity of rhabdomyolysis and its
      complications (P less than .01). Patients at highest risk for complications of
      rhabdomyolysis were those in the moderate or severe groups. CONCLUSION: This
      classification system may be useful for the management of patients with acute
      cocaine intoxication, predicting those patients in whom aggressive therapy should
      be initiated in the ED to minimize the complications of rhabdomyolysis.

PMID- 2221521
TI  - The effect of activated charcoal on phenytoin pharmacokinetics.
AB  - STUDY OBJECTIVES: To examine the effect of administration of oral activated
      charcoal with or without sorbitol on the elimination of phenytoin. SETTING:
      Emergency department of a rural teaching institution. TYPE OF PARTICIPANTS: Eight
      normal volunteers. INTERVENTIONS: Subjects received 15 mg/kg phenytoin as an IV
      infusion. During the first phase of the study, oral activated charcoal was
      administered to a total dose of 140 g over a ten-hour period. During the second
      phase of the study, phenytoin alone was administered. MEASUREMENTS AND MAIN
      RESULTS: Administration of activated charcoal resulted in a significant decrease
      in the area under the curve 0-inf (p = .008) and in total body clearance (P =
      .008). No difference in the effect on phenytoin pharmacokinetic parameters was
      noted when the charcoal was administered with or without sorbitol, but fewer
      gastrointestinal adverse effects were noted without sorbitol treatment.
      CONCLUSION: Oral activated charcoal was shown to affect phenytoin pharmacokinetic
      parameters. Further pharmacokinetic/pharmacodynamic studies are warranted to
      determine if activated charcoal results in a faster recovery from phenytoin
      toxicity.

PMID- 2221522
TI  - Transcranial Doppler determination of cerebral perfusion in patients undergoing
      CPR: methodology and preliminary findings.
AB  - STUDY OBJECTIVES: To correlate cerebral arterial blood velocity measurements as
      determined by transcranial Doppler ultrasound with various resuscitation
      maneuvers performed in an uncontrolled manner in a series of cardiac arrest
      patients undergoing standard resuscitation. TYPE OF PARTICIPANTS: Any patient
      undergoing resuscitation for a nontraumatic cardiac arrest was eligible for the
      study. INTERVENTIONS: Resuscitation was carried out while flow velocities were
      monitored in various intracranial arteries by transcranial Doppler ultrasound.
      Vessel identification was based on the angle and depth of insonation.
      MEASUREMENTS AND MAIN RESULTS: The internal carotid artery was located more
      consistently than either middle cerebral or ophthalmic arteries and provided
      superior waveforms for analysis. Alterations in flow velocity were noted and
      correlated to various therapeutic interventions. Flow velocities were 70% of
      normal during the early phase of resuscitation but deteriorated over time until
      there was no evidence of net forward flow. Even early in CPR, flow was
      demonstrated only during systole. CONCLUSION: Transcranial Doppler ultrasound
      appears to be a potentially promising means of determining cerebral flow in
      patients undergoing CPR.

PMID- 2221523
TI  - A model preclinical, clinical, and graduate educational curriculum in emergency
      medicine for medical students and rotating residents.
AB  - The Society for Academic Emergency Medicine model curriculum for medical students
      and rotating residents was developed over a two-year period. The document was
      created as a complementary work to the undergraduate Core Content to provide
      appropriate emphasis, structure, and suggestions on the teaching of emergency
      medicine core curriculum topics at all levels. Consensus on the curriculum
      contents was reached from a national sample of emergency medicine educators. An
      educational matrix format was used to enhance flexibility based on the
      educational level of the learner and the instructional strengths of the teacher,
      and allowing for incorporation of a problem-based learning format. An outline of
      document contents and representative samples from each section are included; the
      entire document is available from SAEM.

PMID- 2221524
TI  - Methylene iodide poisoning.
AB  - A 20-month-old girl ingested a maximum of 25 mL of pure methylene iodide. Within
      two hours, the patient exhibited lethargy and incoordination and vomited. An
      abdominal radiograph demonstrated the radiopaque material in the gut. In vivo
      conversion to carbon monoxide was documented with a peak carboxyhemoglobin level
      of 14.2% reached at 11 hours after ingestion. Two days after ingestion, evidence
      of hepatotoxicity was apparent, and fulminant hepatic failure quickly ensued.
      Despite aggressive supportive care and transfer to a liver transplant center, the
      patient died nine days after ingestion. Methylene iodide ingestion has not been
      previously reported in human beings. This case verifies that this substance is a
      potent hepatotoxin, is metabolized to carbon monoxide in vivo, is radiopaque, and
      may cause bone marrow suppression.

PMID- 2221525
TI  - Castor bean intoxication.
AB  - We report the cases of a child who ingested two or more castor beans and two
      adults who each ingested four beans. All three patients developed severe
      gastroenteritis and recovered without sequelae after receiving IV fluids. The
      literature contains reports of 424 cases of castor bean intoxication. Symptoms of
      intoxication include acute gastroenteritis, fluid and electrolyte depletion,
      gastrointestinal bleeding, hemolysis, and hypoglycemia. Delayed cytotoxicity has
      not been reported. Of the 424 patients, 14 died (mortality rates: 8.1% of
      untreated and 0.4% of treated). Deaths were due to hypovolemic shock. Recommended
      treatment for asymptomatic patients who have chewed one or more raw beans is
      emergency department evaluation, gastric decontamination, administration of
      activated charcoal, observation until four to six hours after ingestion, and
      discharge instructions to return if symptoms develop. After decontamination and
      activated charcoal, symptomatic patients require hospitalization for treatment
      with IV fluids, supportive care, and monitoring for hypoglycemia, hemolysis, and
      complications of hypovolemia. Monitoring for delayed cytotoxicity is unnecessary.
      Castor beans and their dust are highly allergenic and may cause anaphylaxis.

PMID- 2221527
TI  - The strengths & weaknesses of undergraduate education.

PMID- 2221526
TI  - The role of undergraduate education in emergency medicine.

PMID- 2221528
TI  - Strong foundations for undergraduate education.

PMID- 2221529
TI  - Refusal of care: the ethical dilemma.

PMID- 2221530
TI  - Nurses drive public health: serving the public good is their goal and their
      focus.

PMID- 2221531
TI  - Public health nurses at work.

PMID- 2221533
TI  - Challenges confront public health.

PMID- 2221534
TI  - Public health nurses speak out.

PMID- 2221532
TI  - Physician advises RNs to leverage their power. Interview by Patricia McCarty.

PMID- 2221535
TI  - VA nursing has much to offer RNs. Interview by Patricia McCarty.

PMID- 2221537
TI  - Regulations address H-1 Visa nurses.

PMID- 2221536
TI  - ANA's greatest moments remembered.

PMID- 2221538
TI  - ANA-PAC carries collective clout.

PMID- 2221539
TI  - HIV counseling--know the risks.

PMID- 2221540
TI  - D.C. nurses fight for public health.

PMID- 2221541
TI  - Public health nurses face challenges.

PMID- 2221542
TI  - In defense of the public health.

PMID- 2221543
TI  - As I see it. Convention brings profession together.

PMID- 2221545
TI  - Future of public health brightens.

PMID- 2221544
TI  - Public health nurses put caring to work.

PMID- 2221548
TI  - Take charge of your career.

PMID- 2221547
TI  - Directions.

PMID- 2221546
TI  - Indian Health Center fills community gap.

PMID- 2221549
TI  - Nursing students face liability risk, too.

PMID- 2221550
TI  - Programs help minority nurses earn doctorates.

PMID- 2221552
TI  - Be proud, caring and involved. Nurses give advice to nursing students.

PMID- 2221551
TI  - Back to school--what it's like.

PMID- 2221553
TI  - Collective bargaining benefits staff RNs. Interview by Patricia McCarty.

PMID- 2221554
TI  - How I became a certified nurse.

PMID- 2221555
TI  - Career information--get it here: organizations offer lots of information on
      nursing careers.

PMID- 2221556
TI  - ANA wins major victories on Hill for nurses, clients.

PMID- 2221557
TI  - Nursing career campaign attracts 49,000 callers.

PMID- 2221558
TI  - Board acts on health policy, AIDS statement and more.

PMID- 2221559
TI  - Brochure alerts RNs to liability risks.

PMID- 2221560
TI  - You can help shape national health policy.

PMID- 2221561
TI  - Self care for professionalism.

PMID- 2221562
TI  - As I see it. How to campaign for an ANA office.

PMID- 2221563
TI  - Asian-American educational achievements. A phenomenon in search of an
      explanation.
AB  - Considerable attention has been paid to the academic achievements of Asian
      Americans because there is convergent evidence that this population has attained
      high educational mobility. In trying to explain the achievement patterns,
      researchers have largely limited their investigations to one of two contrasting
      hypotheses involving (a) hereditary differences in intelligence between Asians
      and Whites and (b) Asian cultural values that promote educational endeavors.
      Research findings have cast serious doubt over the validity of the genetic
      hypothesis. Yet, there has been a failure to find strong empirical support for
      alternative hypothesis concerning cultural values. It is proposed, under the
      concept of relative functionalism, that Asian Americans perceive, and have
      experienced, restrictions in upward mobility in careers or jobs that are
      unrelated to education. Consequently, education assumes importance, above and
      beyond what can be predicted from cultural values. Research and policy
      implications of this view are noted.

PMID- 2221564
TI  - Alcohol myopia. Its prized and dangerous effects.
AB  - This article explains how alcohol makes social responses more extreme, enhances
      important self-evaluations, and relieves anxiety and depression, effects that
      underlie both the social destructiveness of alcohol and the reinforcing effects
      that make it an addictive substance. The theories are based on alcohol's
      impairment of perception and thought--the myopia it causes--rather than on the
      ability of alcohol's pharmacology to directly cause specific reactions or on
      expectations associated with alcohol's use. Three conclusions are offered (a)
      Alcohol makes social behaviors more extreme by blocking a form of response
      conflict. (b) The same process can inflate self-evaluations. (c) Alcohol myopia,
      in combination with distracting activity, can reliably reduce anxiety and
      depression in all drinkers by making it difficult to allocate attention to the
      thoughts that provoke these states. These theories are discussed in terms of
      their significance for the prevention and treatment of alcohol abuse.

PMID- 2221565
TI  - Coordination.
AB  - The Russian physiologist Bernstein (1967) defined coordination as a problem of
      mastering the very many degrees of freedom involved in a particular movement--of
      reducing the number of independent variables to be controlled. The initial
      theorizing and experimentation on "Bernstein's problem" was conducted largely in
      terms of how a device of very many independent variables might be regulated
      without ascribing excessive responsibility to an executive subsystem. A second
      round of theory and research on Bernstein's problem is now under way. This second
      round is motivated by similarities between coordination and physical processes in
      which multiple components become collectively self-organized; it is directed at
      an explanation of coordination in terms of very general laws and principles. The
      major achievements of the first round of efforts to address Bernstein's problem
      are summarized, and six examples of the theory and research typifying the second
      round are presented.

PMID- 2221566
TI  - The old homeless and the new homelessness in historical perspective.
AB  - In the 1950s and 1960s homelessness declined to the point that researchers were
      predicting its virtual disappearance in the 1970s. Instead, in the 1980s,
      homelessness increased rapidly and drastically changed in composition. The "old
      homeless" of the 1950s were mainly old men living in cheap hotels on skid rows.
      The new homeless were much younger, more likely to be minority group members,
      suffering from greater poverty, and with access to poorer sleeping quarters. In
      addition, homeless women and families appeared in significant numbers. However,
      there were also points of similarity, especially high levels of mental illness
      and substance abuse.

PMID- 2221567
TI  - Mental health services for homeless mentally ill persons. Federal initiatives and
      current service trends.
AB  - Recent research suggests that approximately one third of the population of
      homeless single adults suffer from severe mental illnesses. Despite multiple
      health, mental health, and social welfare needs, this population is often unable
      to obtain necessary housing and community-based services. For this reason, since
      1982, the National Institute of Mental Health (NIMH) has undertaken a number of
      federal initiatives to encourage research and assist states and localities in
      improving services focused on this vulnerable subgroup of the homeless
      population. This article describes the target population, NIMH research findings,
      and current mental health service trends--with particular emphasis on two mental
      health programs established under the Stewart B. McKinney Homeless Assistance
      Act. Proposed future directions for federal research and evaluation efforts in
      this area are also discussed.

PMID- 2221568
TI  - Major mental illness, housing, and supports. The promise of community
      integration.
AB  - Providing housing and supports for people with psychiatric disabilities,
      particularly those who are homeless, is a major public policy challenge. This
      article summarizes the ways in which the concept of these needs is rapidly
      shifting in the mental health field. The article is based on research on the
      effectiveness of non-facility-based community support and rehabilitation
      approaches, the findings of other disability fields, and the emergence of mental
      health consumers' own preferences for expanded choices, normal housing, and more
      responsive services, including consumer-operated services. These new sources of
      knowledge are facilitating a paradigm shift in which people with psychiatric
      disabilities are no longer seen as hopeless, or merely as service recipients, but
      rather as citizens with a capacity for full community participation and
      integration.

PMID- 2221569
TI  - Women's health. Review and research agenda as we approach the 21st century.
AB  - This article reviews past research and projects future research directions
      regarding women's health. Sex differences in mortality and morbidity, along with
      evidence that the quality and quantity of these differences are changing, are
      examined. Over the past decade, concurrent with dramatic changes in lifestyle and
      social roles for women, mortality rates have shifted, resulting in a decreasing
      advantage for women. Explaining the consequences of these dynamic changes
      requires understanding the health effects of such variables as perceived control,
      the experience of life roles, perceived and actual social support, and
      redefinition of gender roles. The future portends additional changes that will
      significantly affect women's health. In establishing an explicit psychological
      research agenda on women's health, (a) general recommendations for research are
      provided and (b) important issues that have not yet received a great deal of
      research attention (e.g., women and AIDS, psychopharmacology, reproductive
      technologies) are highlighted. This article expands the current discourse in
      health psychology and raises a number of issues for serious consideration.

PMID- 2221570
TI  - Gay people and government security clearances. A social science perspective.
AB  - Lesbian and gay male applicants routinely are denied government security
      clearances or are subjected to unusually lengthy and intensive investigation.
      This article reviews social science data relevant to the principal justifications
      that have been offered for this policy and presents the following conclusions:
      (a) Lesbians and gay men are no more likely than heterosexuals to suffer from a
      personality disorder or emotional stress, or to be psychologically unstable; (b)
      lesbians and gay men are no more likely than heterosexuals to be unduly sensitive
      to coercion, blackmail, or duress; (c) lesbians and gay men are no more likely
      than heterosexuals to be unwilling to respect or uphold laws or regulations, or
      to be unreliable or untrustworthy. Three major flaws are discussed that underlie
      current government policies toward gay applicants for security clearances: (a)
      Groups rather than individuals are screened for undesirable characteristics; (b)
      applicants are rejected on the basis of problems created by government policies
      themselves; and (c) homosexual applicants are scrutinized according to criteria
      that are not applied similarly to heterosexual applicants. An alternative
      hypothesis, that experience with stigma actually may increase a gay applicant's
      ability to maintain secrecy, is discussed. Finally, some consequences of current
      policies are noted.

PMID- 2221571
TI  - Implicit memory. Retention without remembering.
AB  - Explicit measures of human memory, such as recall or recognition, reflect
      conscious recollection of the past. Implicit tests of retention measure transfer
      (or priming) from past experience on tasks that do not require conscious
      recollection of recent experiences for their performance. The article reviews
      research on the relation between explicit and implicit memory. The evidence
      points to substantial differences between standard explicit and implicit tests,
      because many variables create dissociations between these tests. For example,
      although pictures are remembered better than words on explicit tests, words
      produce more priming than do pictures on several implicit tests. These
      dissociations may implicate different memory systems that subserve distinct
      memorial functions, but the present argument is that many dissociations can be
      understood by appealing to general principles that apply to both explicit and
      implicit tests. Phenomena studied under the rubric of implicit memory may have
      important implications in many other fields, including social cognition, problem
      solving, and cognitive development.

PMID- 2221572
TI  - The hospital. Psychology's challenge in the 1990's.

PMID- 2221573
TI  - The practice of psychology in hospital settings.

PMID- 2221574
TI  - Ethical and malpractice issues in hospital practice.
AB  - Ethical and malpractice issues arising in hospital practice are reviewed. Topics
      include (a) preparation and authorization to carry out clinical responsibilities,
      (b) personnel procedures, (c) financial and political forces influencing hospital
      policies, (d) billing procedures, (e) clinical procedures for responding to
      patients' needs, (f) confidentiality, (g) discrimination, (h) internship and
      training issues, (i) sexual abuse of patients, and (j) staff conflicts
      influencing patient care.

PMID- 2221575
TI  - The psychologist as admitting clinician. A single case example.
AB  - An experiential view of significant issues associated with independent hospital
      practice for psychologists is offered through a case presentation. The example is
      a model of practice in effect at a 90-bed, free-standing, inpatient facility
      opened in 1985, that gives psychologists full professional staff privileges.

PMID- 2221577
TI  - The role of surfactant-associated proteins.

PMID- 2221576
TI  - Psychological assessment versus psychological testing. Validation from Binet to
      the school, clinic, and courtroom.
AB  - Increasingly, psychological assessment is conducted with clients and patients
      involved in child custody and personal injury litigation. Clinical
      neuropsychologists are being asked sophisticated questions by attorneys regarding
      the validity of practitioners' most highly respected tests. Research reviewed
      here bears on the validity of test-buttressed clinical opinions, including
      research related to the following psychometric properties of individual test
      scores: standard errors of measurement, test-retest stability and subtest-to
      subtest intercorrelations. The highest and the lowest subtest scores used as
      indices, respectively, of an individual's premorbid level of cognitive
      functioning and the degree of current impairment from that presumed earlier level
      is not justified when used in isolation from the life history and current medical
      findings. Although many practitioners use information from the wider research,
      courtroom experience suggests that a number do not; contrariwise, the attempt of
      Faust and Ziskin (1988a) to undermine the courtroom testimony of every
      psychologist who serves as an expert witness is also criticized.

PMID- 2221578
TI  - Effects of surfactant protein-A on surfactant function in preterm ventilated
      rabbits.
AB  - Surfactant protein-A (SP-A) isolated from cow surfactant was added to organic
      solvent extracts of natural bovine surfactant or of Survanta (Abbott
      Laboratories), and dynamic compliances and pressure-volume curves were measured
      in rabbits with a gestational age of 27 days. Organic solvent extracts of natural
      surfactant and Survanta significantly improved dynamic compliances and lung
      volumes compared with those in control rabbits, but the effects were less than
      for natural surfactant. Adding 1 to 10% by weight SP-A to organic solvent
      extracts of natural surfactant increased dynamic compliances and maximal lung
      volumes on pressure-volume curves to values comparable with natural surfactant.
      Lung volumes at 10 cm H2O on deflation curves increased in a dose-dependent
      fashion at concentrations of SP-A between 0.5 and 5% by weight with no further
      improvement at 10% SP-A, although the volumes were significantly lower than for
      natural surfactant. Five percent by weight SP-A did not improve any measurements
      for Survanta. These results indicated that SP-A favorably improved organic
      solvent extracted natural surfactant function in vivo. However, the responses
      could not be generalized to another surfactant.

PMID- 2221579
TI  - Inhalation of nitrogen dioxide fails to reduce the activity of human lung alpha-1
      proteinase inhibitor.
AB  - Healthy, nonsmoking human volunteers were exposed to environmentally relevant
      concentrations of NO2 followed by bronchoalveolar lavage (BAL) to study whether
      NO2 exposure decreases the functional activity of alpha-1-proteinase inhibitor
      (alpha 1-PI) in the lung. Two 3-h exposure protocols with intermittent exercise
      were employed and BAL was performed 3.5 h after exposure. The first exposure
      protocol with nine subjects involved three 2-ppm "peaks" with a 0.05 ppm
      background, whereas the second protocol with 15 subjects was a continuous
      exposure to 1.5 ppm NO2. All subjects were randomly exposed to either air or NO2,
      with at least a 2-wk interval between treatments, and the BAL fluids obtained
      after air exposure served as the controls. The BAL fluids were analyzed for alpha
      1-PI elastase inhibitory activity, the immunologic concentration of alpha 1-PI,
      total protein, and albumin. The ratio of alpha 1-PI activity to its immunologic
      concentration was taken as the functional activity of alpha 1-PI, and possible
      changes in the amount of alpha 1-PI in the lung were assessed by examining the
      ratio of the immunologic concentration of alpha 1-PI to total protein. Neither of
      the NO2 exposure protocols resulted in a decrease in the functional activity of
      alpha 1-PI, nor were there alterations in the immunologic levels of alpha 1-PI.
      These data suggest that short-term exposures to low levels of NO2 do not result
      in a lung-localized deficiency of active alpha 1-PI, which has been hypothesized
      to be a contributing factor in the pathogenesis of emphysema.

PMID- 2221580
TI  - Inactivation of chemotactic factor inactivator by cigarette smoke. A potential
      mechanism of modulating neutrophil recruitment to the lung.
AB  - Activation of the complement system with generation of the potent neutrophil
      chemotactic factor C5a has been proposed to play a significant role in the
      neutrophil accumulation in the lungs of cigarette smokers. Chemotactic factor
      inactivator (CFI) can inhibit C5a-directed neutrophil chemotaxis by binding to
      the C5a cochemotaxin GcGlobulin (GcG), a vitamin-D-binding protein, and
      inhibiting the capacity of GcG to enhance the chemotactic activity of C5a.
      Because cigarette smoke can inhibit the function of some proteins, a loss of CFI
      functional activity induced by cigarette smoke would allow an increased capacity
      of GcG to augment C5a-directed neutrophil chemotaxis. In order to test this
      hypothesis, cigarette smoke was bubbled through a CFI solution, and the solution
      was evaluated for its ability to inhibit the chemotactic activity of C5a and GcG.
      Smoke-treated CFI inhibited only 36% of the C5a-GcG chemotactic activity. In
      contrast, a CFI solution treated with air inhibited 62% of the chemotactic
      activity (p less than 0.001). Consistent with these observations, smoke-treated
      CFI exhibited a decreased capacity to bind to GcG and a decreased capacity to
      inhibit the binding of C5a des Arg to GcG. CFI contained in the bronchial lavage
      fluids obtained from patients with chronic obstructive pulmonary disease
      secondary to cigarette smoking and asymptomatic smokers exhibited a decreased
      capacity to inhibit C5a-GcG neutrophil chemotaxis and to bind to GcG (p less than
      0.05, both comparisons). Furthermore, smoke bubbled through normal bronchial
      lavage fluid decreased the capacity of CFI to bind to GcG.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2221581
TI  - Functional character and augmentation of lymphocytes in regional lymph nodes of
      patients with lung cancer.
AB  - It appears that lymph node metastases are more frequent in lung cancer than in
      other cancers because of impaired defensive mechanisms in the regional lymph
      nodes. However, little is known about the immunologic function of regional lymph
      node lymphocytes (RLNL) in patients with lung cancer. We have studied the
      immunologic properties of RLNL in comparison with peripheral blood lymphocytes
      (PBL). We measured the natural killer (NK) cell activity of RLNL and PBL in
      patients with lung cancer and found that the NK activity was significantly more
      depressed in the RLNL than in the PBL. In contrast, interleukin-2 (IL-2)
      production was markedly higher in the RLNL than in the PBL. The cytotoxic effect
      of RLNL in nonmetastatic lymph nodes on target cells (such as K562 cells) or PC-3
      and PC-10 cells (NK-resistant, human lung cancer of adenocarcinoma and epidermoid
      carcinoma, respectively) was significantly enhanced by in vitro incubation with
      recombinant IL-2 (rIL-2). Furthermore, we clarified that both rIL-2 and OK-432,
      which is a biologic response modifier and IL-2 inducer as well, augmented the
      cytotoxicity of RLNL and that these effector cells were lymphokine-activated
      killer (LAK) cells. The depletion of lymphocyte subsets by pretreatment with
      specific monoclonal antibody showed that the LAK activity in RLNL was mediated by
      CD3+ and CD8+ cells, whereas the lymphocyte subsets contributing the LAK activity
      in PBL were CD3+ and CD16+ cells. It was concluded that a majority of the
      effector cells in RLNL were LAK cells of the cytotoxic T cell population.

PMID- 2221582
TI  - Studies of an antiendotoxin antibody in preventing the physiologic changes of
      endotoxemia in awake sheep.
AB  - In sheep, endotoxin (LPS) causes pulmonary hypertension, hypoxemia, leukopenia,
      exudation of protein-rich lung lymph, reduced dynamic compliance (Cdyn), and
      increased resistance to airflow (RL), changes similar to those seen in human
      sepsis and sepsis-induced ARDS. We used well-described methods in the awake sheep
      endotoxin model to evaluate the effectiveness of a commercially manufactured
      antibody to prevent the physiologic changes of endotoxemia. In awake sheep with
      chronic lung lymph fistulas, we used a whole-body plethysmograph to measure Cdyn,
      RL, and FRC. Pulmonary artery, left atrial, and systemic arterial pressures were
      recorded continuously. Arterial blood gases (for calculating AaPO2), leukocyte
      counts, and lymph samples were collected every 30 min. Animals received a 30-min
      (2 mg/kg) infusion of antiendotoxin antibody 4 h before LPS (0.75 micrograms/kg)
      challenge (n = 4), or were given a mixture of LPS (0.75 micrograms/kg) and
      antibody (2 mg/kg) that had been incubated in vitro at 37 degrees C for 30 min
      before infusion (n = 6). A control group given only 2 mg/kg of antibody (n = 4)
      showed no change in any measured parameter, whereas control animals receiving LPS
      alone (n = 6) exhibited a typical endotoxin response. In all animals receiving
      endotoxin, Cdyn declined by approximately 50% within 30 to 60 min, and RL
      increased approximately sixfold over a similar time course. Accompanying the
      abnormalities in lung mechanics were pulmonary hypertension, leukopenia, and
      widening of the AaPO2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221583
TI  - Effect of recombinant hirudin, a specific inhibitor of thrombin, on endotoxin
      induced intravascular coagulation and acute lung injury in pigs.
AB  - We hypothesized that thrombin activation may play a prominent role in endotoxin
      induced secondary organ failure, such as acute lung injury. To test this
      hypothesis, we administered a thrombin-specific inhibitor, recombinant hirudin,
      in endotoxemic pigs. The pigs were anesthetized, mechanically ventilated, and
      prepared with Swan-Ganz and extravascular lung water (EVLW) catheters. A total of
      18 randomly selected animals received a pretreatment of 1,000 U/kg of hirudin,
      followed by a continuous infusion over 6 h of 500 U/kg/h given simultaneously
      with the infusion of 10 micrograms/kg/h of Salmonella abortus equi endotoxin.
      Another 18 animals received a continuous infusion over 6 h of endotoxin but did
      not receive hirudin. All animals were fluid resuscitated with 17 ml/kg/h of
      saline for the duration of the experiment. Data are expressed as the mean (95%
      confidence interval). Hirudin reduced the endotoxin-induced consumption of plasma
      fibrinogen from -110 (-138 to -82) mg/100 ml to -39 (-67 to -12) mg/100 ml (p =
      0.0001) and endotoxin-induced increases in the soluble fibrin in plasma from 434
      (369 to 499) ng/ml to 236 (171 to 300) ng/ml (p = 0.0002). These data suggest an
      effective inhibition of the endotoxin-generated thrombin by hirudin. Furthermore,
      hirudin significantly reduced endotoxin-induced increases in pulmonary vascular
      resistance from 32 (27 to 37) kdyn x s x cm-5 x kg to 20 (15 to 25) kdyn x s x cm
      5 x kg (p = 0.0015) and increases in EVLW from 15.4 (13.2 to 17.6) ml/kg to 12.2
      (10.0 to 14.4) ml/kg (p = 0.0299).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221584
TI  - Doppler assessment of pulmonary hypertension induced by hypoxic breathing in
      subjects susceptible to high altitude pulmonary edema.
AB  - To verify the abnormal pulmonary vascular response implicated in the pathogenesis
      of high altitude pulmonary edema (HAPE), we examined the hemodynamic responses to
      hypoxia in HAPE-susceptible subjects (HAPE-S) by means of both right heart
      catheterization and pulsed Doppler echocardiography. The HAPE-S were seven men
      and one woman with a history of HAPE. Six healthy volunteers who had repeated
      experiences of mountain climbing without any history of altitude-related problems
      served as control subjects. The HAPE-S showed much greater increase in pulmonary
      vascular resistance (PVR) than did the control subjects, resulting in a much
      higher level of pulmonary arterial pressure (Ppa) under acute hypoxia both of 15%
      O2 and 10% O2. We then evaluated the usefulness of pulsed Doppler
      echocardiography in the prediction of pulmonary hypertension. Acceleration time
      (AcT) and right ventricular ejection time (RVET) were measured from the flow
      velocity pattern in the right ventricular outflow tract. The ratio of AcT to RVET
      was correlated to invasively determined mean Ppa (Ppa) and PVR. The results were
      as follows: (1) AcT/RVET = 0.52 to 0.0047 (Ppa), r = -0.93, SEE = 0.017, p less
      than 0.001 (HAPE-S); (2) AcT/RVET = 0.55 to 0.0055 (Ppa), r = -0.70, SEE = 0.030,
      p less than 0.001 (HAPE-S); (4) AcT/RVET = 0.52 to 0.00077 (PVR), r = -0.91, SEE
      = 0.016, p less than 0.001 (control subjects). We conclude that HAPE-S have a
      constitutional abnormality in the pulmonary vascular response to hypoxia, which
      is a possible causative factor of HAPE, and that pulsed Doppler echocardiography
      may be supportive to assess the pulmonary vascular pressor response in the HAPE
      S.

PMID- 2221585
TI  - Role of molecular diffusion in conventional and high frequency ventilation.
AB  - The influence of molecular diffusion on gas-mixing during conventional mechanical
      ventilation (CMV) and high frequency ventilation (HFV) was studied by observing
      the wash-in of six poorly soluble, inert gases in arterial blood. Anesthetized
      dogs were ventilated either with CMV or HFV. Following a step change in inspired
      gas composition, the increase in arterial concentrations of hydrogen, helium,
      methane, ethane, isobutane, and sulfur hexafluoride was determined by gas
      chromatography. The relative gas diffusivities encompassed a range of almost one
      order of magnitude. Propane, present in inspired gas during both the control and
      wash-in phases, served as an internal reference for calculation of blood tracer
      concentrations. The wash-in of all six inert gases followed a single exponential
      time course during both CMV and HFV. The rate of wash-in of each gas decreased
      with increasing molecular weight (MW). The relationship of rate constants to a
      measure of relative diffusivity (MW-0.5) was significantly different than zero
      for both types of ventilation. The slope of this relationship was three times
      larger for CMV than HFV, indicating that molecular diffusion has a greater role
      in gas mixing during ventilation with large tidal volumes. Diffusion has a minor
      role in gas mixing during high frequency ventilation with small tidal volumes.
      Demonstration of the presence of gas separation secondary to molecular diffusion
      during HFV is enhanced by measuring wash-in, rather than wash-out, of inert gases
      because gas separation is likely to be obscured as exhaled gases pass through the
      well-mixed central airways during gas wash-out.

PMID- 2221586
TI  - Endogenous opioids modulate the increase in ventilatory output and dyspnea during
      severe acute bronchoconstriction.
AB  - The aim of this study was to evaluate whether endogenous opioids are involved in
      the regulation of breathing pattern and respiratory drive during
      bronchoconstriction induced by methacholine (MCh). We studied six male
      asymptomatic asthmatics 18 to 35 yr of age. In a preliminary study we determined
      the concentration of MCh causing a 60% fall in FEV1 (PC60 FEV1). On two
      subsequent days, we measured breathing pattern, dyspnea sensation (Borg scale),
      mouth occlusion pressure (P0.1), and FEV1 before and 10 min after an intravenous
      injection of either naloxone (0.1 mg/kg) or saline according to a randomized
      double-blind crossover design. A MCh concentration equal to the PC60 FEV1 was
      then inhaled, and measurements were repeated 5 min later. Neither placebo nor
      naloxone affected baseline breathing pattern, P0.1, and FEV1. Naloxone
      pretreatment did not influence airway response to MCh; the mean percent fall in
      FEV1 was 65.9 +/- 1.3 and 64.7 +/- 1.2% (mean +/- 1 SE) on the placebo day and
      the naloxone day, respectively. After MCh inhalation no significant changes in
      VE, VT, and breathing frequency occurred when patients received placebo. However,
      P0.1 increased from 1.48 +/- 0.17 to 3.43 +/- 0.70 cm H2O (p less than 0.05), and
      VT/TI fell from 0.66 +/- 0.08 to 0.52 +/- 0.04 L/s (p less than 0.05). Naloxone
      pretreatment resulted in an increase in breathing frequency (from 18.2 +/- 1.7 to
      22.8 +/- 2.6 breaths/min; p less than 0.05) and VT/TI (from 0.58 +/- 0.06 to 0.74
      +/- 0.05 L/s; p less than 0.05) after MCh.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221588
TI  - Effects of deep inhalation during early and late asthmatic reactions to allergen.
AB  - Eighteen asthmatic patients with a biphasic asthmatic reaction to house dust mite
      were studied. The effect of deep inhalation (DI) was quantitated by comparing the
      maximal expiratory flow at 40% (MEF40) of vital capacity from partial (P) and
      maximal (M) flow-volume curves, and specific airway conductance (SGaw) before and
      after DI (SGawDI). At baseline, the ratio MEF40M/P was significantly larger than
      unity (1.45 +/- 0.26 SD), whereas the ratio SGawDI/SGaw was not significantly
      different from unity (0.92 +/- 0.24). During early phase reaction, both MEF40M/P
      and SGawDI/SGaw were significantly increased to 2.66 +/- 0.97 and 1.96 +/- 0.47,
      respectively. During late phase reaction, when the FEV1 values were similar to
      those observed during early phase reaction, MEF40M/P and SGawDI/SGaw were 1.86 +/
      0.46 and 1.43 +/- 0.29, respectively, significantly higher than the values at
      baseline but significantly lower than those during early phase reaction. Similar
      results were obtained in a subgroup of nine patients when SGaw values during the
      late phase reaction were similar to those during the early phase reaction. We
      conclude that DI has a different effect during early and late asthmatic
      reactions, suggesting a different ratio of airway to parenchymal hysteresis. This
      may result from an increased parenchymal hysteresis (more peripherally located
      bronchial obstruction) or a decreased airway hysteresis (prominent airway
      inflammation) during the late phase reaction.

PMID- 2221587
TI  - Indomethacin does not inhibit the ozone-induced increase in bronchial
      responsiveness in human subjects.
AB  - Exposure of human subjects to sufficiently high levels of ozone can result in
      reversible changes in lung function (restrictive in nature) and increases in
      nonspecific airway responsiveness. Several studies have implicated products of
      cyclooxygenase metabolism in the mediation of these changes. The purpose of this
      study was to determine if indomethacin (a cyclooxygenase inhibitor) would alter
      the changes in the ozone-induced increase in responsiveness to methacholine or
      the ozone-induced decrease in lung function. Thirteen male subjects underwent
      three randomly assigned 2-h exposure to 0.4 ppm ozone with alternating 15-min
      periods of rest and exercise on a cycle ergometer (30 L/min/m2, body surface
      area). For the 4 days before each of the exposures, the subjects received either
      indomethacin (150 mg/day) or placebo, or no modification. Of the 13 subjects,
      only seven had both detectable indomethacin serum levels on the indomethacin
      Study Day and a significant increase in bronchial responsiveness to methacholine
      on the No Medication Day. For this group of seven subjects, we found that
      indomethacin did not alter the ozone-induced increase in bronchial responsiveness
      to methacholine (decrease in PC100SRaw for the different study days: no
      medication, -78.4 +/- 5.3% [mean +/- SEM]; placebo, -48.9 +/- 12.2%;
      indomethacin, -64.5 +/- 6.3%; p greater than 0.2), although indomethacin did
      attenuate the ozone-induced decrease in lung function. The decrease in the FEV1
      for the different study days was as follows: no medication, -20.7 +/- 5.0% (mean
      +/- SEM); placebo, -19.2 +/- 6.3%; indomethacin, -4.8 +/- 3.7% (p less than
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221589
TI  - The effect of repetitive exercise on airway temperatures.
AB  - To determine if a relationship exists between intra-airway thermal events and the
      reduction in pulmonary mechanics that occur in asthmatics when they perform
      repetitive exercise, we recorded intrathoracic airstream temperatures in seven
      subjects during and after two identical bouts of cycle ergometry performed 30 min
      apart. From these data, global and regional thermal energy exchanges were
      calculated. Inspired air conditions, work loads, and minute ventilations were
      held constant for both trials. Pulmonary mechanics were measured prior to and
      serially after each challenge. As expected, the second provocation produced a
      smaller response than did the first. In association with these mechanical
      changes, the second challenge also produced less airway cooling and slower
      rewarming in the central airways. Hence, repetitive exercise trials performed
      over short intervals attenuate the essential thermal gradients necessary to
      produce obstruction. To the extent that these differences in intra-airway
      temperature reflect changes in perfusion, our data raise the possibility that the
      responsivity of the bronchial microcirculation of asthmatics may be altered by
      repetitive exercise.

PMID- 2221590
TI  - Effect of long-term treatment with an inhaled corticosteroid (budesonide) on
      airway hyperresponsiveness and clinical asthma in nonsteroid-dependent
      asthmatics.
AB  - Several short-term studies have shown that inhaled steroids can reduce airway
      hyper-responsiveness in asthma. To evaluate whether prolonged treatment can bring
      about full recovery, this double-blind, randomized, controlled trial examined the
      effect of budesonide, 400 micrograms daily for 1 yr, on airway
      hyperresponsiveness. The time course and characteristics of improvements and
      associated changes in clinical asthma severity were also evaluated. Thirty-two
      stable adult asthmatics, requiring bronchodilators alone, were selected. Before
      and monthly throughout the study, airway responsiveness to methacholine was
      measured and clinical asthma severity assessed by questionnaire, daily
      bronchodilator use, and number of asthma exacerbations. Patients receiving
      budesonide showed a fourfold mean improvement in airway responsiveness compared
      with those receiving placebo (p less than 0.0005), whose responsiveness remained
      very stable. Fifteen of the 16 budesonide subjects improved and 5 returned to the
      normal range. Largest improvements occurred during the first 3 months but, in
      some, were still progressing slowly at 1 yr. Improvements in responsiveness were
      accompanied by significant improvements in asthma symptoms, bronchodilator use,
      and number of asthma exacerbations. The results show that regular, prolonged use
      of inhaled steroid can produce marked improvements in airway hyperresponsiveness,
      sometimes with full resolution, and these improvements are accompanied by
      clinically significant improvements in clinical asthma.

PMID- 2221592
TI  - Selective IgG subclass deficiencies and antibody responses to pneumococcal
      capsular polysaccharide antigen in adult community-acquired pneumonia.
AB  - We measured the serum concentrations of IgG subclasses in healthy subjects (n =
      26) and in patients with community-acquired pneumonia (CAP) on admission (n =
      38), at recovery (n = 21), and 9 months after admission (n = 19). Then, in 8 of
      the control subjects and 15 of the patients, we measured IgG subclasses and mean
      serum antibody concentrations of pneumococcal capsular polysaccharides before and
      3 wk after immunization with a pneumococcal vaccine. Compared to the control
      subjects, the serum concentration of the IgG2 subclass was lower at admission in
      patients with CAP of bacterial or unknown cause (p less than 0.005).
      Concentrations of IgG subclasses in patients did not differ between admission and
      recovery, or between admission and 9 months later. After vaccination, in both
      control subjects and patients, there was an increase in the concentrations of
      IgG2 subclasses (p = 0.01) and antipneumococcal antibodies (p less than 10(-4)).
      We show that serum IgG2 concentration in patients with CAP of bacterial or
      unknown cause is lower than in healthy subjects and remains lower for several
      months. After immunization with a pneumococcal vaccine, the increase in serum
      concentrations of IgG subclasses and antipneumococcal antibodies in patients does
      not differ from those in control subjects.

PMID- 2221591
TI  - The relationship between respiratory impairment and asbestos-related pleural
      abnormality in an active work force.
AB  - With the general improvement in environmental controls in workplaces where
      asbestos is used, an increasing number of workers are seen who exhibit isolated
      pleural plaques. The question as to whether these are associated with respiratory
      impairment independently of parenchymal disease remains unresolved. The question
      was reinvestigated using quantitative gallium-67 lung scanning to take into
      account early parenchymal change not evident on the chest radiograph. We carried
      out a cross-sectional study of 110 construction insulators all currently at work.
      Overall, 58.2% had pleural abnormality, 52.5% pleural plaques only, and 5.5%
      diffuse pleural thickening as assessed from the PA chest radiograph. Compared
      with those without, those with any pleural abnormality had a decrease in FEV1 and
      FVC on average of 222 and 402 ml (p less than 0.05), and those with isolated
      pleural plaques, a decrease on average of 200 and 350 ml (p less than 0.05),
      after taking into account age, height, smoking status, and the presence of
      parenchymal abnormality as assessed by chest radiography and gallium uptake. The
      complaint of dyspnea with strenuous activities was also significantly related to
      the width and extent of chest wall pleural thickening (p less than 0.05),
      independently of parenchymal disease. This study suggests that the most common
      radiographic findings in asbestos-exposed, isolated pleural plaques are
      associated with a significant reduction in FEV1 and FVC, which cannot be
      attributed to the presence of radiographic and subradiographic pulmonary
      fibrosis.

PMID- 2221593
TI  - Epidemiology of infection by nontuberculous mycobacteria IX. Evidence for two DNA
      homology groups among small plasmids in Mycobacterium avium, Mycobacterium
      intracellulare, and Mycobacterium scrofulaceum.
AB  - A 12.9 kb plasmid, pVT2, from a clinical Mycobacterium avium isolate, MD1, was
      cloned and radiolabeled for use as a DNA probe to examine the relatedness of
      plasmids in M. avium complex. That probe hybridized with plasmids isolated from
      M. avium complex strains from the environment (7 of 16) and from non-acquired
      immunodeficiency syndrome (AIDS) (10 of 17) and AIDS (5 of 6) clinical isolates.
      The similarity of plasmids from the environment with those from patients supports
      the hypothesis that the environment is a source of human M. avium complex
      infection. More striking was the observation that pVT2 hybridized with every
      plasmid (13 of 13 clinical and 5 of 5 environmental isolates) of 13.5 kb or
      smaller. A second probe, consisting of a 15.3 kb plasmid (pLR7) from another
      clinical isolate of the M. avium complex, hybridized with plasmids of 15.3 to 25
      kb from environmental and clinical (AIDS and non-AIDS) isolates. There was no
      hybridization between pVT2 and pLR7. Thus, these two probes define two different
      groups of small mycobacterial plasmids.

PMID- 2221594
TI  - Quantitation of mast cells and eosinophils in the bronchial mucosa of symptomatic
      atopic asthmatics and healthy control subjects using immunohistochemistry.
AB  - We have used fiberoptic bronchoscopy to obtain endobronchial biopsies in which
      mast cells and eosinophils were enumerated using monoclonal antibodies directed
      against mast cell tryptase (AA1) and the eosinophil cationic protein (EG2).
      Eleven symptomatic atopic asthmatics treated with beta 2-agonists alone and six
      normal subjects were studied. Over a period of 2 wk prior to bronchoscopy,
      patients recorded asthma symptom scores, bronchodilator usage, and twice-daily
      peak expiratory flow. Five days before bronchoscopy, methacholine responsiveness
      was assessed. Two biopsies were taken from the subcarinae, one of which was
      processed into araldite for immunostaining by the streptavidin biotin
      immunoperoxidase method and the other into Spurr resin for electron microscopy.
      The number of AA1 staining mast cells present in the bronchial mucosa was not
      significantly different in the epithelium or submucosa between the asthmatic and
      the normal subjects. However, in the biopsies from asthmatics, there were
      significantly greater numbers of EG2-staining eosinophils in the epithelium
      (median, 1.2/mm versus zero; p less than 0.005) and in the submucosa (median,
      50/mm2 versus 1/mm2; p less than 0.001). Electron microscopy showed morphologic
      features of mast cell and eosinophil degranulation in the asthmatics. No
      correlation could be established between mast cell or eosinophil numbers and
      indices of disease activity of PC20 methacholine, which points to the complexity
      of mechanisms responsible for the symptoms and the airway hyperresponsiveness of
      asthma.

PMID- 2221595
TI  - Timing of corticosteroid treatment. Effect of lung lymph dynamics in air injury
      in awake sheep.
AB  - In paired experiments, we studied the effects of high-dose methylprednisolone on
      the acute pulmonary injury caused by 4 h of venous air embolization in 19
      chronically instrumented, unanesthetized sheep with lung lymph fistulas. We
      compared the effect of methylprednisolone (30 mg/kg intravenous bolus) given
      before embolization, early (1 H) in the course of embolization, late (3 h) in the
      course of embolization, or after embolization (at the beginning of the recovery
      period). We measured pulmonary hemodynamics and lymph dynamics. In six sheep we
      also fixed lung tissue for semiquantitative histology, and in some we measured
      leukocyte concentrations in blood and in pulmonary lymph. Methylprednisolone did
      not significantly affect pulmonary hemodynamics but it largely prevented lung
      injury when it was given before embolization. It also lessened the degree of lung
      injury when it was given during embolization, although this effect became less
      marked as treatment was delayed. Methylprednisolone had no effect on lung injury
      when given after embolization was completed (4 h). We found fewer leukocytes
      attached to air emboli and fewer endothelial cell gaps in the lungs of sheep
      given methylprednisolone as prophylaxis. Leukocyte counts were lower in lung
      lymph and higher in the circulating blood of methylprednisolone-treated sheep. We
      conclude that methylprednisolone has a preventive effect on air embolism lung
      injury, such that its effect is greater when given earlier during the development
      of injury.

PMID- 2221596
TI  - Sarcoidosis complicated by HIV infection: three case reports and a review of the
      literature.
AB  - We report three cases of sarcoidosis complicated by human immunodeficiency virus
      (HIV) infection and review four other isolated case reports in the literature.
      There is clinical overlap of both diseases, including symptoms, pulmonary
      function abnormalities, and lymphocyte function. Bronchoalveolar lavage (BAL) in
      these patients showed a lymphocytic alveolitis without pathogens. BAL lymphocyte
      subset analysis showed markedly depressed CD4+/CD8+ ratios in three patients.
      These data were clinically useful for distinguishing the CD8+ alveolitis
      associated with HIV infection from the CD4+ alveolitis associated with
      sarcoidosis. Three patients improved with corticosteroid therapy. Two patients
      with BAL-documented CD8+ alveolitis tolerated discontinuation of steroids. One
      patient's sarcoidosis improved without therapy concurrent with the diagnosis of
      Kaposi's sarcoma. Another patient developed sarcoidosis 1 yr after manifesting
      HIV positive serology. BAL can be used to distinguish the lymphocytic alveolitis
      of sarcoidosis from that associated with HIV infection. Patients with active
      sarcoidosis complicated by HIV infection can be effectively treated with
      corticosteroid therapy.

PMID- 2221597
TI  - Ciliary motility in two patients with yellow nail syndrome and recurrent
      sinopulmonary infections.
AB  - The yellow nail syndrome (YNS) is described as a combination of yellow nails,
      chronic lymphedema, pleural effusions, and recurrent sinopulmonary infections,
      but all these features need not be present for the diagnosis. The mechanism that
      renders patients with this syndrome susceptible to respiratory infections is not
      known. To determine whether abnormal ciliary motility is a predisposing factor,
      in vitro ciliary beat frequency (CBF) was measured in two patients with YNS and
      recurrent respiratory infections. In each case, the CBF was within normal limits
      (12 Hz). These data suggest that abnormal ciliary motility is not a
      pathophysiologic mechanism of recurrent sinopulmonary infections in YNS.

PMID- 2221598
TI  - Manual ventilation bags as a source for bacterial colonization of intubated
      patients.
AB  - A group of 14 intensive care unit (ICU) patients were studied to determine if
      manual ventilation bags (MVB) could serve as a source of bacterial or fungal
      pathogens that could colonize the respiratory tract of intubated patients. A
      total of 51 cultures were simultaneously obtained of patient's sputum, the
      exterior MVB surface, MVB port, and MVB interior (postexhalation valve).
      Pathogens colonizing or infecting the respiratory tract of intubated ICU patients
      were frequently simultaneously present on the exterior surface of the MVB and
      inside the MVB port used to connect the MVB with the endotracheal tube. In
      addition, coagulase-negative staphylococci and yeast were frequently present on
      the exterior surface of the MVB. The interior of the MVB was usually sterile. In
      three instances pathogens were isolated from the MVB before isolation from the
      patient's sputum. MVB may serve as a source for colonizing the respiratory tract
      of intubated ICU patients and/or the hands of medical personnel. The exterior
      surface and port of MVB should be cleaned of visible debris and disinfected at
      least once a day.

PMID- 2221599
TI  - NHLBI Workshop Summary. Effect of physical forces on lung structure, function,
      and metabolism.

PMID- 2221601
TI  - Training programs in adult respiratory disease and training programs in pediatric
      respiratory disease.

PMID- 2221600
TI  - Environmental Controls and Lung Disease.

PMID- 2221602
TI  - Relation between tumor necrosis factor-alpha and granulocyte elastase-alpha 1
      proteinase inhibitor complexes in the plasma of patients with cystic fibrosis.

PMID- 2221604
TI  - Management of the acute abdomen complicating oral anticoagulation therapy.
AB  - Acute abdominal pain in the patient receiving oral anticoagulants poses a
      difficult diagnostic and therapeutic challenge. We describe two cases of
      peritonitis requiring laparotomy in anticoagulated patients, and review 49
      similar case reports from the world literature. These patients were usually
      explored for signs of bowel obstruction. At operation, the intestine often
      appeared infarcted, but pathologic examination commonly revealed intramural
      hematomata. In contrast, we present microscopic evidence of hemorrhagic cecal
      infarction complicating oral anticoagulation therapy in one patient. Intramural
      intestinal hemorrhage is the most common cause of acute abdominal pain in the
      anticoagulated patient who undergoes laparotomy. In addition to intramural
      hemorrhage, 14 per cent of patients had coexistent volvulus, appendicitis,
      intestinal wall disruption or intestinal infarction. We conclude that
      anticoagulated patients with suspected intramural intestinal hemorrhage may have
      severe intraabdominal pathology requiring operation. Therefore, operation is
      mandatory for patients who fail to improve after a short course of expectant
      management.

PMID- 2221603
TI  - A prospective assessment of the Garren-Edwards Gastric Bubble and bariatric
      surgery in the treatment of morbid obesity.
AB  - Morbid obesity is a serious medical hazard, and effective alternatives to surgery
      have been unsuccessful. In 1985, the Garren-Edwards Gastric Bubble (GEGB) was
      offered as an adjunct to dietary and behavioral therapy for weight loss
      treatment. The safety and efficacy of the GEGB were compared with bariatric
      surgery, the current standard for the treatment of morbid obesity. Fifty-seven
      patients received GEGB and 77 underwent bariatric surgery. GEGB patients were
      divided into two groups: those who attended group therapy and those who did not.
      This study showed that bariatric surgery was far more effective in reducing
      excess body weight during a 12-month period compared with the GEGB plus group
      therapy and the GEGB alone. The morbidity from bariatric surgery was greater than
      in the GEGB-treated groups, while the cost for uncomplicated cases for a year's
      treatment was comparable. It is concluded that the GEGB does not offer an
      effective alternative to bariatric surgery in the treatment of morbid obesity.

PMID- 2221605
TI  - Nonoperative management of small-bowel obstruction with endoscopic long
      intestinal tube placement.
AB  - Intestinal obstruction remains a major cause of morbidity and mortality in
      surgical patients. We reviewed the records of 77 patients with mechanical small
      bowel obstruction who were treated with endoscopically and fluoroscopically
      placed Leonard long intestinal tube decompression. Most patients (59%) had failed
      a trial of nasogastric tube or Miller-Abbott tube decompression. Overall, 29 per
      cent of patients were able to resolve their obstruction with Leonard tube
      decompression alone. Subdivision of patients on the basis of the etiology of
      their obstruction demonstrated a much higher rate of success for tube
      decompression in adhesive obstruction (37%) versus malignant obstruction (12%) or
      inflammatory obstruction (no successes). Patients with radiographic and clinical
      evidence of complete intestinal obstruction were significantly less likely to
      respond to long intestinal tube treatment (13%). The long intestinal tube was
      easily passed in all patients. There were no complications of the intubation
      procedure in our series, and the incidence of tube-related complications was four
      per cent. We conclude that an initial period of long intestinal tube
      decompression allows a significant percentage of patients with mechanical small
      bowel obstruction to be treated nonoperatively, particularly if a partial
      obstruction from postoperative adhesions is present. Patients who have failed a
      trial of nasogastric tube decompression and are poor operative risks should also
      be considered for long intestinal tube placement.

PMID- 2221606
TI  - The influence of sclerotherapy on gastric mucosal blood flow distribution.
AB  - Hemodynamic events and structural vascular changes of the gastric mucosa in
      cirrhotics have caught the attention of investigators in the recent past, but as
      yet it is not known whether therapeutic interruption of variceal blood flow at
      gastroesophageal level alters such portal hypertensive mucosal features. The
      newly developed endoscopic laser-Doppler technique was used to assess whether
      variceal eradication by means of endoscopic sclerotherapy influences the gastric
      mucosal congestion in portal hypertension patients. Gastric mucosal blood flow
      was determined at ten defined sites of the stomach, before the first session of
      sclerotherapy and after complete variceal eradication had been achieved in 15
      patients. A statistically significant decrease (P less than 0.01 to 0.05) in
      microcirculation was found at the gastric antrum and corpus, an increase at the
      pylorus (P less than 0.05), but no change in the fundic area. An important
      question following these findings is: What are the consequences of such
      aggravation of gastric congestion on the integrity of the gastric mucosa?

PMID- 2221607
TI  - A five-year U.S. Army experience with 36,250 abdominal hernia repairs.
AB  - Thirty-six thousand two hundred fifty abdominal hernia repairs were performed in
      U.S. Army medical treatment facilities during a five-year period. This study
      presents data about the type of hernia, incidence of complications by obstruction
      or strangulation, age, sex, and mortality. Hernias occurring with intestinal
      obstruction or gangrene (strangulation) are referred to as complicated hernias.
      Inguinal hernias in children less than two years of age, femoral hernias, and
      unusual (such as internal or obturator) hernias were found to have an increased
      incidence of complications. Surgical repair of ventral, umbilical, and femoral
      hernias was done with a low surgical risk and the presence of complications did
      not significantly increase this risk. An increased risk of mortality is
      associated with the repair of complicated unusual hernias and complicated
      inguinal hernias in patients more than 60 years of age.

PMID- 2221608
TI  - Spontaneous splenic rupture following infectious mononucleosis.
AB  - Four cases of spontaneous splenic rupture after infectious mononucleosis (IM)
      have been treated at this institution since 1978. The condition is rare,
      occurring in 0.1-0.5 per cent of patients with proven infectious mononucleosis.
      Splenectomy is considered the treatment of choice for these patients. However,
      because recent trends in the management of traumatic splenic rupture are moving
      towards nonoperative treatment with selected patients, a similar approach has
      been considered for the patient with spontaneous splenic rupture following IM.
      The major reason for avoiding splenectomy is the increased incidence of sepsis in
      splenectomized patients. Yet, splenic rupture is accompanied by hemorrhage and
      the risks associated with blood transfusion for ongoing hemorrhage are of similar
      magnitude as those of sepsis following splenectomy. In addition, the grossly
      abnormal spleens seen at operation tend to include large, contained hematomas
      that may also be prone to rupture. Therefore, operative management still appears
      to be the preferred treatment for spontaneous splenic rupture following IM.
      Splenectomy is curative, safe, and obviates the need for transfusion, extended
      hospitalization, and activity restriction.

PMID- 2221609
TI  - Comparison of ulcer surgery at a Veterans Administration and University Hospital.
AB  - We compared the patient populations and outcome of surgery for peptic ulcer
      disease in 81 patients at a Veterans Administration Hospital (OVAH) and 97
      patients at an affiliated University Hospital (UNH). The surgeons and choice of
      operation were comparable at both facilities. Patients were similar with respect
      to severity of ulcer disease, percentage of elderly patients and distribution of
      comorbid conditions. There were significantly more female patients (45% vs 2%, P
      less than 0.05), patients less than 40 years old (22% vs 6%, P less than 0.05),
      and patients with gastric ulcers (27% vs 12%, P less than 0.05) at UNH.
      Alcoholism was more prevalent at OVAH (57% vs 22%, P less than 0.05).
      Postoperative morbidity and mortality rates were 27 per cent and 14 per cent at
      OVAH and 25 per cent and 16 per cent at UNH. These data suggest that quality of
      care for surgical therapy of ulcer disease at a VA Hospital is comparable to its
      tertiary care affiliate with a similar patient population.

PMID- 2221610
TI  - Toxic shock syndrome after inguinal hernia repair. Report of a case with patient
      survival.
AB  - A 40-year-old man developed fulminant multisystem failure several days after
      elective repair of an inguinal hernia. Toxic shock syndrome (TSS) was diagnosed.
      There was, however, no evidence of wound infection at the time of multisystem
      failure. Only later in his hospital course did the wound drain. Staphylococcus
      aureus was cultured from the wound and was the presumed etiologic agent in the
      patient's life-threatening illness. The patient recovered fully with supportive
      care, antibiotics, and surgical debridement of the inguinal hernia site. This
      case is discussed in the context of existing literature on the toxic shock
      syndrome. The site of infection is typically nonsuppurative, but the systemic
      manifestations are typically life threatening. The responsible organism is
      commonly believed to be a strain of S. aureus that expresses a toxin (TSS toxin
      1) that effects multisystem failure, but which also diminishes the local
      inflammatory response and explains the benign appearance of the wound. Although
      this is a rare clinical entity, elective surgical procedures complicated by fatal
      TSS have been reported. Surgeons should understand this disease and the
      management necessary to avert mortality.

PMID- 2221611
TI  - Ceftazidime/clindamycin versus tobramycin/clindamycin in the treatment of intra
      abdominal infections.
AB  - In order to assess the efficacy and toxicity of ceftazidime as a substitute for
      aminoglycosides in the treatment of intra-abdominal sepsis, a prospective
      randomized trial was conducted. Ninety-four patients (49% trauma) were randomized
      to receive ceftazidime/clindamycin (CAZ/C) (n = 47) or tobramycin/clindamycin
      (T/C) (n = 47). CAZ (2.0 gm) and C (0.9 gm) were administered intravenously every
      8 hours while T dosage was adjusted to maintain peak (5-8 mg/L) and trough (less
      than 2 mg/L) concentrations. Age, sex, baseline serum creatinine, and etiology of
      infection were comparable in the two groups. Clinical cure was similar in culture
      positive and culture-negative patients who received CAZ/C (94% vs 88%). The
      clinical cure rate however was significantly lower in the T/C culture positive
      (73%) than in the culture negative patients (100%) (P = 0.016). Pathogenic
      organisms were eradicated in 100% (30/30) and 76% (13/17) of CAZ/C and T/C
      patients, respectively (P = 0.0006). Nephrotoxicity Nephrotoxicity or ototoxicity
      was observed in none of the CAZ/C patients and in one and two T/C patients,
      respectively. CAZ/C more effectively eradicated the bacteria isolated from these
      patients and no significant difference in clinical response was observed in
      culture-positive patients. These findings plus the lack of toxicity suggest that
      CAZ/C is an effective alternative for treatment of IAI.

PMID- 2221612
TI  - A comparison of parallel versus perpendicular placement of retention sutures in
      abdominal wound closure.
AB  - A new technique for placement of retention sutures is described. Twenty-five rats
      underwent midline laparotomy incision. The control group was closed with
      traditional placement of through-and-through retention sutures placed in a
      perpendicular direction to the wound. The experimental group was closed with
      retention sutures placed in a parallel direction to the wound as described below.
      Wound bursting strength was significantly (P less than 0.001) greater at one to
      five days in the experimental group compared with the control animals. In
      addition, inflammatory reaction and pressure necrosis were greater in the control
      group. It appears that parallel placement of sutures has less of a tendency to
      cut through tissue when subjected to the distracting forces on a midline wound.

PMID- 2221613
TI  - Urgent management of a giant scrotal hernia.
AB  - An unusual case of giant scrotal hernia is presented. Hernias of this magnitude
      are extremely rare, even in underdeveloped countries, and their repair is
      challenging to the surgeon and stressful to the patient. Only a few case reports
      on the use of pneumoperitoneum prior to herniorrhaphy have been published;
      however, our patient's accompanying complications of diabetes mellitus and
      gastrointestinal symptoms precluded the use of pneumoperitoneum. The emergency
      management, including the expansion of the abdominal cavity with prosthesis, the
      ensuing postoperative complications, and the patient outcome, are discussed.

PMID- 2221614
TI  - CT diagnosis of acquired small bowel volvulus.
AB  - Small-bowel volvulus is an uncommon but important cause of small-bowel
      obstruction and often results in ischemia or infarction. Clinical examination and
      plain film radiography may be nondiagnostic, leading to delay in surgical
      intervention with subsequent increase in morbidity and mortality. We present two
      patients in whom the diagnosis of strangulating small-bowel volvulus was made by
      computed tomography (CT), allowing rapid surgical correction of this potentially
      life-threatening condition.

PMID- 2221615
TI  - Biomechanical performance of cardiovascular needles.
AB  - Standardized reproducible tests have been developed to determine the
      biomechanical performance of cardiovascular needles. The parameters used to
      assess performance were sharpness, resistance to bending, and ductility. Three
      comparable groups of taper point cardiovascular needles were selected from
      different manufacturers for these biomechanical studies. The results of this
      testing demonstrated that needle geometry, needle composition, and the
      manufacturer were important determinants of needle performance. When needles of
      comparable size were evaluated, the biomechanical performance of cardiovascular
      needles manufactured by Ethicon, Inc., were superior to needles produced by other
      manufacturers. The superior performance characteristics of the cardiovascular
      needles produced by Ethicon, Inc., were related to their unique stainless steel
      alloy, American Society for Testing Materials 45500, which has greater yield and
      tensile strengths than the alloy used by the other manufacturers. Scanning
      electron microscopic photographs of the Ethicon, Inc., needle revealed a uniform
      taper point geometry without irregularities. The deformations of the points of
      cardiovascular needles produced by the other manufacturers could alter their
      performance.

PMID- 2221616
TI  - Lung lobe torsion following lobectomy.
AB  - Three cases of postoperative pulmonary lobe torsion were reported. Two of three
      showed hemorrhagic infarctions, and as a result underwent rethoracotomies and
      removal of the affected lobes. From these experiences, we consider that computed
      tomography (CT) and bronchofiberscopic examinations are useful for the diagnosis
      of advanced torsion.

PMID- 2221617
TI  - Metallurgically bonded needle holder jaws. A technique to enhance needle holding
      security without sutural damage.
AB  - A new needle holder jaw face has been specifically designed and developed to
      increase needle holding security without sutural damage. Tungsten carbide
      particles have been metallurgically bonded into the stainless steel jaw to create
      a fine granular surface. This bonded jaw enhances needle holding security by
      limiting either twisting or rotation of the clamped needle. In addition,
      compression of the monofilament synthetic sutures by the bonded jaws does not
      reduce suture breaking strength.

PMID- 2221618
TI  - Effects of method of hemostasis on wound-infection rate.
AB  - Adequate hemostasis is important in preventing postoperative wound infection.
      This study compared four methods of hemostasis: specific pinpoint vessel
      electrocautery (SPC), specific vessel ligation with 4-0 vicryl (SVL), nonspecific
      electrocautery of vessel plus excessive surrounding tissue (NSC), and nonspecific
      ligation of vessel and excessive surrounding tissue with 4-0 vicryl (NSL), on the
      rate of wound infection in rabbits that were contaminated with 10(6)
      Staphylococcus aureus. There was no statistical significant increase in the rate
      of wound sepsis when electrocautery was used in a fashion producing minimal
      nonviable tissue compared to specific vessel ligation. Electrocautery use for
      specific vessel hemostasis does not result in a higher wound infection rate in
      contaminated wounds.

PMID- 2221619
TI  - Penetrating injuries of the abdominal aorta.
AB  - The charts of 56 consecutive patients with penetrating injuries to the abdominal
      aorta were reviewed in an attempt to identify prognostic factors. Mechanism of
      injury was gunshot wound (GSW), 82 per cent (.22 cal: 15.2%; greater than .38
      cal: 84.8%); shotgun wound (SGW), 5 per cent; and stab wound (SW), 13 per cent.
      Overall mortality was 73 per cent, with GSW 78 per cent (.22 cal: 0%; greater
      than .38 cal: 92%), 67 per cent with SGW, and 43 per cent with SW. Average
      initial systolic blood pressure (ISBP) was 53 (0-130); 87 (0-120) in survivors;
      and 40 (0-130) in nonsurvivors (NS). Eighteen patients (32%) had no ISBP, with
      one survivor. Thirty (54%) patients had ISBP less than 70, with three survivors.
      Six Emergency Department (ED) thoracotomies were performed, with five patients
      surviving to reach the operating room (OR), and none surviving long-term. Ten
      patients died in the ED, 18 during surgical intervention, six within 24 hr, and
      seven greater than 24 hr postop. Average time from injury to OR was 75 minutes,
      with 122 minutes in survivors, and 53 minutes in nonsurvivors (P less than 0.05);
      49 minutes in those dying in the OR; and 58 minutes in those surviving the OR but
      dying postop (NS). At surgery, six patients had thoracotomy before celiotomy for
      control of the thoracic aorta, with three surviving the OR and two surviving long
      term. Survivors had 2.53 associated injuries; nonsurvivors had 2.89 (NS). No
      significant difference was noted in number or location of associated injuries
      between survivors and nonsurvivors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221620
TI  - [Antiviral drugs in pediatrics].

PMID- 2221621
TI  - [Exercise test in exercise-induced asthma in children: study of delayed
      response].
AB  - In this study we perform the exercise broncho-provocation test according to a
      protocol and involving 27 children with allergic asthma to study the prevalence
      and distinctive traits of the late response in exercise-induced asthma (EIA). At
      the conclusion of the study, 20 patients (74%) were diagnosed of EIA through some
      of the tests employed (ergometric bicycle, free run). In the cases where both
      tests were negative, we reproduced in a controlled manner the exercise reported
      as asthmogenic on the basis of anamnesis; no positivity was observed for the test
      in any case. Prevalence of late asthmatic response was 40% (8/20); mean beginning
      time to this response was 4-6 hours, lasting less than 1 hour and with a mean
      intensity rate of 26.8% (measured as the percentage of PEFR drop according to the
      preexercise basal value). The results are discussed, comparing them with those of
      other authors and with the allergen provocation response pattern; in addition the
      methods used and therapeutic implications in view of the results are dealt with.

PMID- 2221623
TI  - [The form of crystallization of perspiration in pancreatic cystic fibrosis].
AB  - The present study is based on the typical dendritic forms of the sweat
      crystallization from patients with cystic fibrosis (CF). The phenomenon was
      analyzed in sweat collected by pilocarpine iontophoresis in 26 affected subjects
      (Homozygotes), 42 heterozygotes and 100 healthy-control subjects. The positive
      crystallization pattern (dendritic form), became useful in identifying the
      affected patients in 100% of cases and in differentiating them from the healthy
      control subjects (100%, negative crystallization). The positive crystallization
      pattern was not altered by decreasing the electrolytes concentration in the
      sweat. This test could be a help to evaluate the diagnosis of cystic fibrosis.

PMID- 2221622
TI  - [Results of the treatment of gastroesophageal reflux and peptic esophagitis using
      cisapride].
AB  - Cisapride is a new prokinetic agent that acts at gastric emptying, esophagic
      peristalsis and the pressure of the low esophagic sphincter. In the present study
      we grave Cisapride for 12 weeks to 34 patients with severe pathologic
      gastroesophageal reflux and/or peptic esophagitis. The results show an important
      improvement of the clinic, pH monitoring, endoscopic and histologic alterations.

PMID- 2221624
TI  - [Importance of childhood accidents. Results of a regional study].
AB  - In order to know the importance and epidemiology of childhood accidents, a
      prospective study was made in a Spanish region, this study was founded in death
      certificates and 3,344 questionnaires from children under 7 years old, accidented
      in 1986 and attended in emergency departments in our region. The information was
      coded and analysed by computer of the Murcia University. Accidents are the main
      cause of death in children aged over 1 year, as a common cause of assistance in
      emergency departments. Its characteristic are common to most countries, but the
      authors find some differences in our region. It is necessary to dedicate bigger
      effort to study and prevention of childhood accidents.

PMID- 2221625
TI  - [Standardization of forced spirometry. Analysis of the basal pulmonary function
      (PEF, FEF2575, FEF50) in a selected group of children].
AB  - This is a study of the ventilatory function (FEF2575, FEF50, PEF) by dry
      spirometer Vitalograph in 1,566 children of both sexes with ages ranging from 7
      to 14 years; 1,156 children (73.6%) were selected as reference population. Height
      was the biometric parameter with the greatest correlation to the functional
      variables studied in both sexes, except to PEF in females. Significant
      differences were observed in functional variables between male and female
      subjects. Multiple and simple linear regression equations and percentiles tables
      for each sex are presented.

PMID- 2221626
TI  - [Basal pulmonary function studies (FVC, FEV) in a selected child population].
AB  - This is a study of the ventilatory function (FVC, FEV1) by dry spirometer
      Vitalograph in 1566 children of both sexes with ages ranging from 7 to 14; 1156
      children (73.6 per 100) were selected as reference population. Height was the
      biometric parameter with the greatest correlation to the functional variables
      studied in both sexes. Significant differences were observed in functional
      variables between male and female subjects. Multiple and simple linear prediction
      equations and percentiles tables for each sex are presented. The results of the
      present study are compared with those of previously published of children.

PMID- 2221628
TI  - [Staphylococcus coagulase negative infection in neonates caused by intravascular
      catheters. Prospective study].
AB  - We present a prospective study about 100 intravascular catheters inserted into 88
      newborns. 35 positive blood cultures were obtained; 19 with clinical signs of
      sepsis and 16 in asymptomatic newborns. Coagulase-negative Staphylococci were the
      most common isolated organisms -84.2% in the symptomatic cases, 100% in the
      asymptomatic ones. A comparative study was realized between cases of catheter
      related sepsis with positive blood culture of coagulase-negative Staphylococcus
      (n = 14) versus asymptomatic cases with positive blood culture (n = 16). Risk
      factors in the appearance of symptoms are: prematurity, newborns old age when
      catheters are inserted and days of catheter placement.

PMID- 2221627
TI  - [Anorexia nervosa in adolescents].
AB  - We have made a revision of our casuistics, according DSM-III-R, between 1968 and
      1988, of 53 cases. The ages go between 10 and 21 years, being the more frequent
      those from 13 to 15 years old. In the sample 5 males stand out. The most common
      symptomatology in the course of the disease was in its first phase: "prudent
      child", irritability or obsessions. In the second phase dominated phobias,
      obsessions, irritability, agitation and anxiety. And in the third phase we found
      more often: passiveness, inhibition, phobias and obsessions. As regards the
      treatment, individual psychotherapy was practised in 42 out of the 53 cases, with
      an evident improvement of personality. The environmental separation, circumstance
      we considered essential though not sufficient to cure the disease, was put in
      practice in 39 of the cases. And the biological treatment, generally through
      antidepressives, was administered to 44 patients, some of whom took more than one
      medication during the course of the treatment. The evolution was positive in 35
      out of the 53 cases. Fifteen abandoned the treatment; and one suffered from a
      psychotic depression and the other two did not follow the recommended
      environmental separation.

PMID- 2221629
TI  - [Wolff-Parkinson-White syndrome: long-term follow up study in a pediatric
      population (86 cases)].
AB  - Eighty six patients (48 males and 38 females) with W-P-W diagnosed before the age
      of 15 years had a maximum follow-up of 20 years. The mean age at diagnosis was 3
      y and 5 m., most cases being concentrated in the first 6 months of life (37%).
      Twenty seven (31.4%) had associated heart disease, the more common being:
      ventricular septal defect (6 cases), Ebstein malformation (5 cases) and
      transposition of the great arteries (4 cases). Supraventricular tachycardia (SVT)
      was the commonest form of clinical presentation, followed by examination because
      heart murmur or heart disease. Fifty patients (58%) had SVT along the follow-up.
      SVT was more frequent in W-P-W type A than in type B (p less than 0.05). There
      was a statistically significant correlation (p less than 0.001) between the
      association of SVT and the absence of heart disease, but the finding must be
      questioned because the true incidence of W-P-W in normal population is unknown.
      There also were a significant correlation (p less than 0.05) between the
      association of W-P-W type B and the presence of heart disease. An
      electrophysiologic study was performed in 11 patients, 6 of them being concealed
      W-P-W. Four patients were operated upon because of SVT. We have studied a total
      of 154 SVT episodes in the 50 patients with SVT. The treatment more frequently
      used to finish the SVT included: verapamil, DC-Countershock and Digoxin.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2221630
TI  - [Neonatal cardiac insufficiency caused by a cerebral arteriovenous fistula.
      Review of the authors' cases].
AB  - Four cases of newborn infants presenting congestive heart failure in the first
      two weeks of life with the clinical suspicion of cerebral arteriovenous fistula
      which was subsequently confirmed by cerebral echography or TAC and, after death,
      by necropsy, are described. Only one patient survived, the one treated
      surgically. CONCLUSION: It is necessary to carry out urgent diagnosis with an
      early surgical operation, the only possibility of survival for these children.

PMID- 2221631
TI  - [Primary pancreatic hydatid cyst and primordial familial dwarfism].
AB  - A 10 years and 7 months old male, was studied for a pathologic, primordial
      hipogrowing disease, probably due to a recessive and autosomic transmission,
      because he has got a sister with the same illness, and he was diagnostified of a
      pancreatic cyst, whind was found in an echographical exploration and established
      by scanner as intraglandular cyst. There are no others cysts found detected in a
      complete body-check. The chirurgic findings was a solitary hydatidic
      intrapancreatic cyst whid was extirpated. The patient's and sister's facial
      characteristics (big nose, long and thin neck, large forehead), the normal
      hormonal study in this case, the observation of small bone defects (first finger
      of the foot thicker than usual, cone epifisis in hands), a normal intelligence
      and the not accordance between them and the usual in literature described kind,
      suggest to be a different form the congenital autosomic, recessive dwarfism, not
      according to the usual one.

PMID- 2221632
TI  - [Are we well informed about the health status of adolescents?].

PMID- 2221633
TI  - [Splenic torsion in a patient with prune belly].

PMID- 2221634
TI  - [Trans-sphenoidal encephalocele associated with hypopituitarism and arteriovenous
      malformations].

PMID- 2221635
TI  - [Intervertebral calcification syndrome: clinical manifestation nine years after
      radiologic diagnosis].

PMID- 2221636
TI  - [A case of childhood choreoathetosis induced by diphenylhydantoin].

PMID- 2221637
TI  - [Ring chromosome 13 (type I) 45,XY,-13/46, XY,r(13)(p11:q34)].

PMID- 2221638
TI  - [Population studies on childhood accidents].

PMID- 2221639
TI  - [Benign acute myositis associated with respiratory syncytial virus infection].

PMID- 2221640
TI  - [Robinia pseudoacacia poisoning].

PMID- 2221641
TI  - [Chronic sulmetin papaverin poisoning].

PMID- 2221643
TI  - Clinical practice guidelines.

PMID- 2221642
TI  - [Serological markers in active celiac disease].

PMID- 2221644
TI  - Cassandra and the clinician: are clinical prediction rules changing the practice
      of medicine?

PMID- 2221645
TI  - Treatment of postmenopausal osteoporosis with high doses of synthetic calcitriol.
      A randomized controlled study.
AB  - OBJECTIVE: To study the efficacy of synthetic 1,25 dihydroxyvitamin D3
      (calcitriol) in the treatment of osteoporosis. DESIGN: Two-year, double-blind,
      randomized clinical trial. SETTING: University medical center. PATIENTS: Fifty
      postmenopausal women with vertebral fractures recruited by referral.
      INTERVENTION: Calcium intake was adjusted to 25 mmol/d (1000 mg/d) at baseline.
      Patients were then randomized to treatment with either calcitriol or placebo.
      During the study, calcium intake was reduced to 15 mmol/d (600 mg/d) and the dose
      of calcitriol was adjusted to maintain serum calcium less than 2.74 mmol/L (less
      than 11.0 mg/dL) or urine calcium less than 9.96 mmol/d (less than 400 mg/d).
      MEASUREMENTS AND MAIN RESULTS: After 2 years, the mean dose of calcitriol in the
      treated group was 0.62 micrograms/d. Bone mineral density of the spine increased
      1.94% with calcitriol therapy and decreased 3.92% with placebo (P = 0.001). Total
      body calcium increased 0.21% with calcitriol therapy and decreased 1.85% with
      placebo (P = 0.004). Patients receiving placebo had significant decreases in
      spine density (P = 0.0007) and total body calcium (P = 0.0004). There were no
      differences in vertebral fracture rates between the groups. Renal function
      studies were not statistically different between the groups after 2 years.
      CONCLUSION: The treatment of postmenopausal osteoporotic women with synthetic
      calcitriol for 2 years was associated with increases in spine density and total
      body calcium. No adverse effects on renal function were seen after long-term
      calcitriol therapy.

PMID- 2221646
TI  - Clinical course of anti-neutrophil cytoplasmic autoantibody-associated
      glomerulonephritis and systemic vasculitis. The Glomerular Disease Collaborative
      Network.
AB  - OBJECTIVES: To determine the spectrum of clinical manifestations in patients with
      anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis; to
      determine renal and patient survival in these patients; to compare survival among
      patients treated with corticosteroids alone, corticosteroids plus intravenous
      cyclophosphamide or corticosteroids plus oral cyclophosphamide; and to assess the
      correlation of disease manifestations and treatment response with ANCA subtypes
      and serial autoantibody titers. DESIGN: Inception cohort study; mean follow-up of
      24 months. SETTING: Collaborative network of 120 university and private practice
      nephrologists (The Glomerular Disease Collaborative Network). PARTICIPANTS:
      Seventy patients with ANCA and pauci-immune necrotizing and crescentic
      glomerulonephritis, of whom 59 were treated with either corticosteroids alone (14
      patients), corticosteroids plus oral cyclophosphamide (30 patients), or
      corticosteroids plus intravenous cyclophosphamide (15 patients). MAIN RESULTS: Of
      the 70 patients, 18 had renal-limited disease (idiopathic crescentic
      glomerulonephritis); 15, nonpulmonary extrarenal disease consistent with
      polyarteritis nodosa; and 37, pulmonary disease consistent with Wegener
      granulomatosis or alveolar capillaritis. There were overlapping manifestations of
      disease between patients with autoantibodies producing a cytoplasmic pattern and
      patients with autoantibodies producing a perinuclear pattern; however, the
      perinuclear pattern occurred more frequently in patients with renal-limited
      disease. Renal and patient survival was 75% at 24 months, and no difference in
      survival was seen between patients with renal-limited disease and those with
      systemic disease. No differences in survival were seen between patients treated
      with oral cyclophosphamide and those treated with intravenous cyclophosphamide;
      however, the comparative data from patients treated with corticosteroids alone
      were inconclusive. In general, autoantibody titers correlated with response to
      treatment and disease activity, but there were exceptions. CONCLUSIONS: Patients
      with ANCA have various forms of necrotizing vascular inflammation, ranging from
      renal-limited disease to widespread systemic vasculitis, including polyarteritis
      nodosa and Wegener granulomatosis. Oral corticosteroids with either oral or
      intravenous cyclophosphamide appear to be equally effective therapy for ANCA
      associated glomerulonephritis.

PMID- 2221647
TI  - Clinical prediction rule for pulmonary infiltrates.
AB  - OBJECTIVE: To derive and validate a clinical rule for predicting pneumonic
      infiltrates in adult patients with acute respiratory illness. DESIGN: Prevalence
      studies in three settings. SETTING: Emergency departments of the University of
      Illinois Hospital at Chicago, the University of Nebraska Medical Center at Omaha,
      and the Medical College of Virginia at Richmond. PATIENTS: Symptoms, signs,
      comorbidity data, and chest roentgenogram results were recorded for 1134 patients
      from Illinois (the derivation set), 150 patients from Nebraska, and 152 patients
      from Virginia (the validation sets). All patients presented to the emergency
      department and had a chest roentgenogram to evaluate fever or respiratory
      complaints. MEASUREMENTS AND MAIN RESULTS: Within the training set, temperature
      greater than 37.8 degrees C, pulse greater than 100 beats/min, rales, decreased
      breath sounds, and the absence of asthma were identified as significant
      predictors of radiographically proved pneumonia in a stepwise logistic regression
      model (P = 0.001). The logistic rule discriminated patients with and without
      pneumonia in the training set with a receiver operating characteristic (ROC) area
      of 0.82. In the validation sets, the rule discriminated pneumonia and
      nonpneumonia with ROC areas of 0.82 and 0.76 after adjusting for differences in
      disease prevalence (P greater than 0.2 compared with the training set). The
      predicted probability of having pneumonia for patients with different clinical
      findings corresponded closely with the incidence of pneumonia among patients with
      such findings in the three settings. CONCLUSIONS: Among adults presenting with
      acute respiratory illness, a prediction rule based on clinical findings
      accurately discriminated patients with and without radiographic pneumonia, and
      was used in two other samples of patients without significant decrement in
      discriminatory ability. This rule can be used by physicians to develop more
      effective strategies for detecting pneumonia and for helping to determine the
      need for radiologic study among patients with acute respiratory disease.

PMID- 2221648
TI  - Regional deposition of aerosolized pentamidine. Effects of body position and
      breathing pattern.
AB  - OBJECTIVE: To evaluate the effects of varying body position and breathing pattern
      on overall lung distribution of aerosolized pentamidine. DESIGN: Nonrandomized
      control trial with four weekly inhalational treatments. SETTING: The nuclear
      medicine department of a voluntary hospital. PATIENTS: Sixteen men with the
      acquired immunodeficiency syndrome (AIDS) or positive serology for the human
      immunodeficiency virus (HIV). Thirteen patients (81%) completed the study.
      INTERVENTIONS: Patients inhaled a solution of either saline and technetium-99m
      bound to diethylenetriamine penta-acetic acid or sterile water, pentamidine (60
      mg), and technetium-99m bound to human serum albumin. On weekly visits, the
      patients inhaled the aerosol solution using four methods: sitting, supine,
      sitting with an abdominal binder, and sitting and breathing from residual volume
      with a shallow inspiration. MEASUREMENTS AND MAIN RESULTS: Deposition scans,
      obtained after each aerosol inhalation, were superimposed on each patient's
      equilibrium xenon scan, and a frequency distribution histogram was constructed.
      An asymmetry index was determined from this histogram. The lower the asymmetry
      index, the more homogeneous the aerosol distribution. Only use of the supine
      position showed a significant decrease in the asymmetry index (mean, 0.34 +/-
      0.02 in the supine position, 0.48 +/- 0.03 in the sitting position; P less than
      0.001). CONCLUSIONS: Aerosol distribution in the lungs was more uniform when
      administered to patients in the supine position. Patients receiving aerosolized
      pentamidine may benefit from inhalation in the supine position; these results
      should be verified by clinical study.

PMID- 2221650
TI  - Efficacy of exercise thallium-201 scintigraphy in the diagnosis and prognosis of
      coronary artery disease. American College of Physicians.

PMID- 2221649
TI  - Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary
      artery disease.
AB  - OBJECTIVE: To determine the discriminant accuracy of exercise thallium-201
      myocardial perfusion scintigraphy for the diagnosis and prognosis of patients
      with known or suspected coronary artery disease. DATA IDENTIFICATION: A survey of
      the National Library of Medicine MEDLINE database. STUDY SELECTION: The key
      medical subject headings used were coronary disease, myocardial infarction,
      radionuclide imaging, and thallium. A total of 122 retrieved studies were
      considered relevant and were reviewed in depth. DATA EXTRACTION: Only studies
      reporting both the sensitivity and specificity of thallium scintigraphy were
      analyzed. RESULTS: Discriminant accuracy for diagnosis and prognosis was
      summarized in terms of pooled sensitivity and specificity. CONCLUSIONS: Exercise
      thallium scintigraphy is useful in the noninvasive diagnosis of coronary artery
      disease, especially in patients with abnormal resting electrocardiograms,
      restricted exercise tolerance, and intermediate probability of having disease at
      the time of testing as well as of defining the prognosis of patients with known
      or suspected coronary artery disease, especially in those with previous
      myocardial infarction. Because of various shortcomings in the published record,
      however, the marginal discriminant accuracy and cost effectiveness of thallium
      scintigraphy compared with conventional clinical assessment and exercise
      electrocardiography remain controversial.

PMID- 2221651
TI  - A long run for a short jump: understanding clinical guidelines.
AB  - Clinical guidelines for application of medical technologies are being advanced as
      consensus recommendations by consumer groups, professional societies, and health
      care managers. Although different groups' guidelines for use of a given
      technology may vary--or even conflict--depending on the methods by which they
      were formulated, their proponents' interests, and the subjective values attached
      to potential outcomes, they make it possible to quantify somewhat and predict, on
      a population basis, clinical gains relative to costs. Clinical guidelines can
      introduce into patient-physician decision making systematic consideration of a
      given technology's demonstrated efficacy and its likely advantages compared with
      its personal and its societal costs. Provided there is flexibility to allow for
      individual departures from consensus recommendations and for development of new
      technologies, applying clinical guidelines in health care can serve both
      individual patients and society and help to balance their respective needs for
      informed decision making and for resource allocation.

PMID- 2221652
TI  - Medical practice guidelines: current activities and future directions.
AB  - OBJECTIVE: To examine the state of the art in the field of medical practice
      guidelines, to identify limitations, and to suggest future directions. DESIGN:
      Informal descriptive survey using a questionnaire administered by telephone,
      supplemented by comments, by opinions, and by examples solicited from the
      participating organizations. PARTICIPANTS: Eight prominent organizations
      representing prototypic approaches to guideline development; these organizations
      included three medical societies, two health care organizations, two insurers,
      and one private health benefits management company. RESULTS: Improving the
      quality of medical care was a stated goal of all eight surveyed organizations.
      However, their objectives have not been stated in operational terms, reflecting
      the lesser emphasis placed on methods and means for both implementing guidelines
      and evaluating their impact on health practices and outcomes. In contrast,
      several systematic methods for developing guidelines exist. They differ in the
      stress placed on formal literature reviews, reliance on local as opposed to
      national experts, and formal methods of group judgment, but no evidence exists on
      which approaches produce sounder and more usable guidelines. CONCLUSIONS:
      Guidelines are being vigorously promoted as a means to improve the effectiveness
      of the health care system. Current initiatives show both strengths and
      weaknesses. In particular, the attention now paid to the development of
      guidelines needs to be matched by attention to implementation strategies and to
      the scientific evaluation of their effectiveness in real clinical settings. Also,
      more agreement is needed on acceptable methods for developing guidelines,
      assessing their content, and evaluating their impact on professional behavior,
      patient outcomes, and health care costs. Fortunately, several initiatives to
      bring greater order and quality to this field are under way.

PMID- 2221653
TI  - Intestinal infarction after intravenous cocaine administration.

PMID- 2221654
TI  - Corticosteroids for asthma.

PMID- 2221655
TI  - Prostatic cryptococcal infection.

PMID- 2221657
TI  - Clarification of contaminants in L-tryptophan.

PMID- 2221656
TI  - Erythropoietin for anemia in Jehovah's Witnesses.

PMID- 2221658
TI  - Loose connections between peer-reviewed clinical journals and clinical practice.
AB  - Many important advances in medical care are first reported in the biomedical
      literature, but physicians find the literature overwhelming and, therefore, are
      often unaware of advances. This article examines the ways in which peer-reviewed
      clinical journals contribute to this problem and proposes some solutions for both
      their editors and clinical readers. Peer-reviewed clinical journals impede the
      dissemination of validated advances to practitioners by mixing a few rigorous
      studies (communications from scientists to practitioners) with many preliminary
      investigations (communications from scientists to scientists). Journals wishing
      to improve communication with practitioners should feature rigorous studies of
      the nature, cause, prognosis, diagnosis, prevention, and treatment of disease and
      should feature sound clinical review articles (communications from practitioners
      to practitioners). Additional strategies for improving communication between
      medical scientists and practitioners include improving publication standards for
      clinical journals, proving more informative abstracts for clinical articles,
      fostering the development of derivative literature services, and enhancing
      practitioners' skills in critically appraising the medical literature.

PMID- 2221659
TI  - [The Oedipus complex and organization of the normal personality].
AB  - The parents' task is to get the child to move from his absolute and original
      narcissism to the awareness of and submissiveness to the principle of Reality,
      without prejudice to his affective life. This entails a tragic triangular
      situation that we shall qualify as being Oedipean, although differing from
      Freud's interpretation. It has a structuring psychodynamic effect requiring
      complex yet precise mechanisms which entirely proceed from this situation and
      that we have tried to study thoroughly. The child can thus reach the adult status
      through access to Reality, and the development of his latent faculties. The
      Oedipean situation is therefore unique in allowing the progressive making of a
      normal personality.

PMID- 2221660
TI  - [Denial and coronary disease. A reconsideration of the denial mechanism in
      psychosomatic diseases and particularly in coronary disease].
AB  - Recent research has shown that patients with life-threatening illnesses have
      improved chances of survival and enhanced abilities to manage situational anxiety
      and depression if, instead of recognizing the seriousness of their illness, they
      employ the psychological defense mechanism of denial. Denial as a coping style
      provides indeed marked benefits for the patient, at least during acute hospital
      recovery, but seems to be possibly maladaptative in the long run after hospital
      discharge. The present study is an attempts to review the different findings
      related to the use of denial by the coronary patient. The concept and its use are
      re-examined from the very different standpoints of the patient, the cardiologist
      and the psychologist, in a psychodynamic, a systemic and a psychosomatic
      perspective. Even if clinically meaningful, denial is also revisited through both
      the ethical and the epistemological approaches.

PMID- 2221661
TI  - [Tutelage and management: better knowledge for a better use].
AB  - At present, almost half of tutelages pronounced, are management's tutelages.
      However, legislation and rules of provision's patronage are complex and appear
      misunderstood with themselves who regularly use them in their practice. A
      reminder of legal feasibilities but also of their eventual disadvantages is
      appeared necessary to the authors. Who can do what and how? The roles of each
      protagonist are related in detail, with pragmatism.

PMID- 2221662
TI  - [The pre-revolutionary Penal Code. A tribute to the bicentennial of the 1789
      French Revolution].

PMID- 2221663
TI  - [Pierre Janet. Disintegrating psychological analysis].

PMID- 2221664
TI  - [Synthetic activity in Janet's psychology].

PMID- 2221665
TI  - [Manic-depression and reversed genetics].

PMID- 2221666
TI  - [Shared delusion: results of a survey of psychiatrists in Western France].

PMID- 2221668
TI  - Myoblast diversity and the formation of the early limb musculature.

PMID- 2221667
TI  - Caldesmon: fragments, sequence, and domain mapping.
AB  - A summary of the available binding site data is shown in Figure 6 and should be
      compared with the predicted structures in Figure 5. The blocks of amino acid
      sequence were those known at the time the cDNA sequencing was being done; they
      now include the entire head region. The phosphorylation site, indicated here, is
      a potential site, a consensus sequence, -AXYS(T)-, for the multifunctional
      calmodulin-dependent kinase. It has not been established that this site is
      utilized, and it is not clearly related to any of the established binding
      domains. Exactly how caldesmon regulates the actomyosin interaction and whether
      it contributes to the latch state is unclear. The organization of the molecule
      suggests, however, that it could function as a bridge between thick and thin
      filaments. In support of this idea, our recent efforts to map the smaller non
      muscle form of caldesmon indicate that it retains the myosin and the calmodulin
      approximately actin binding domains, but is missing the central repeated region,
      arguing this region may serve to space the N and C terminal-binding domains in
      smooth muscle. Work from several laboratories has demonstrated that smooth muscle
      caldesmon is an elongated molecule with a calmodulin, tropomyosin, and actin
      binding region at the C-terminus and a myosin-binding domain at the N-terminus.
      Sequence determination has shown that smooth muscle caldesmon is smaller than
      previously believed, has demonstrated similarities between caldesmon and troponin
      T, and has suggested possible calmodulin-binding peptides. The available sequence
      and domain mapping studies on smooth muscle caldesmon are reviewed.

PMID- 2221669
TI  - Molecular analysis of the c-myc transcription elongation block. Implications for
      the generation of Burkitt's lymphoma.

PMID- 2221670
TI  - The arithmetic of skeletal myogenesis in the chick embryo.

PMID- 2221671
TI  - Cell lineage segregation during neural crest ontogeny.

PMID- 2221672
TI  - Analysis of frequency of intermingling between labeled clones in Xenopus embryos.
AB  - These experiments were designed to provide data that would test alternative
      hypotheses of the basis of clonal intermingling during early development of
      Xenopus. Clones were initiated by injection of different fluorescent cell lineage
      tracers into two blastomeres in the same 512-cell embryo. In order to find out
      how frequently clonal intermingling or clonal separation developed between the
      progeny of two ancestral cells at different distances apart, the pair of injected
      cells was either adjacent, separated by one uninjected cell, or separated by two
      uninjected cells, chosen at random in the animal dorsal region of the embryo. The
      final positions of the labeled clones were analyzed at tailbud stages. The
      results closely match the probability of interclonal mingling predicted by a
      compartment model, in which two clones intermingle or remain separate as a
      function of the probability of a clonal restriction boundary developing between
      them, rather than as a continuous function of the distance between the two cells
      at the time of labeling.

PMID- 2221673
TI  - Autonomous expression of the differentiation programs of cells in the cardiac and
      skeletal myogenic lineages.

PMID- 2221674
TI  - Macromolecular organization of the extracellular matrix of cartilage.

PMID- 2221675
TI  - Collagen types and chondrogenesis.

PMID- 2221677
TI  - Covalent cross-bridge regulation in smooth muscle.

PMID- 2221676
TI  - Hypertrophic chondrocytes. The terminal stage of differentiation in the
      chondrogenic cell lineage?
AB  - Chondrocytes emerging in the limb or other locations during embryogenesis are
      currently considered terminally differentiated cells and thus represent the last
      stage of differentiation in the chondrogenic cell lineage. Most chondrocytes,
      however, undergo further major phenotypic changes during late embryogenesis and
      early postnatal life as they take part in the endochondral ossification process.
      During this process, "resting" chondrocytes first enter an active, proliferative
      phase and then develop into large, round hypertrophic chondrocytes with unique
      phenotypic traits. The question thus arises as to whether hypertrophic
      chondrocytes actually represent the terminal stage of differentiation in the
      chondrogenic lineage. To assess the developmental position of these cells along
      the lineage, we examined the expression of four genes encoding extracellular
      matrix components in chondrocytes undergoing endochondral ossification in chicken
      tibial growth cartilage. We found that the steady-state levels of mRNAs coding
      for proteoglycan core protein increased in regions of cartilage destined for
      endochondral ossification. Similarly, type II collagen gene expression increased
      markedly in proliferating chondrocytes and then returned to basal levels in
      hypertrophic chondrocytes. As revealed by in situ hybridization, type X collagen
      gene expression was undetectable in resting and early proliferating chondrocytes
      and was detectable in hypertrophic chondrocytes. Osteonectin synthesis appeared
      to characterize chondrocytes in the resting, proliferating, and hypertrophic
      zones of growth cartilage. The protein was scarce, however, and cell-associated
      in the former zones, although it was very abundant and matrix-associated in the
      hypertrophic zone. Clearly, the emergence of hypertrophic chondrocytes during
      endochondral ossification is accompanied by marked quantitative and qualitative
      changes in gene expression. Interestingly, these changes occur during or
      immediately after the period of active chondrocyte proliferation. On the premises
      of the cell lineage definition proposed by Holtzer, the above data suggest that
      the hypertrophic chondrocytes represent the terminal stage of differentiation in
      the chondrogenic cell lineage.

PMID- 2221678
TI  - Caldesmon and the structure of vertebrate smooth muscle thin filaments. A
      minireview.

PMID- 2221679
TI  - Regulation of ATP hydrolysis by caldesmon. A novel change in the interaction of
      myosin with actin.

PMID- 2221680
TI  - P wave morphology.

PMID- 2221681
TI  - Electrocardiography--past and future. A conference. September 8-9, 1989, Nice,
      France. Proceedings.

PMID- 2221682
TI  - Myocardial perfusion scintigraphy as an aid in understanding electrocardiographic
      changes of ischemia and infarction.
AB  - In summary, myocardial perfusion scintigraphy with either thallium or the
      isonitriles has added substantially to electrocardiographic definition of both
      myocardial infarction and acute and chronic myocardial ischemia. Using perfusion
      scintigraphy, one can define infarct zones, risk zones, and the presence of
      reperfusion following thrombolytic therapy. When perfusion scintigraphy is
      combined with physiologic or pharmacologic stress, myocardial ischemia can be
      documented, irrespective of electrocardiographic documentation of the phenomenon.
      Delayed imaging may be important for defining viability even in the presence of
      significant Q waves. Myocardial perfusion scintigraphy provides prognostic
      evaluation of patients with both acute and chronic coronary syndromes. When the
      current cumulative experience is looked at critically, it is clear that
      myocardial perfusion scintigraphy has helped in the development of an
      understanding of the limitations of electrocardiography in the diagnostic and
      functional categorization of patients with acute and chronic coronary disease.

PMID- 2221683
TI  - Endocardial monophasic action potentials. Correlations with intracellular
      electrical activity.

PMID- 2221684
TI  - Endocardial and epicardial recordings. Correlation of twelve-lead
      electrocardiograms at the site of origin of ventricular tachycardia.

PMID- 2221685
TI  - Signal averaging.

PMID- 2221686
TI  - Spectral estimation of the electrocardiogram.

PMID- 2221687
TI  - Autonomic interactions in cardiac control.

PMID- 2221688
TI  - Circadian variations of electrical properties of the heart.
AB  - Cardiac refractoriness and electrical inducibility of supraventricular
      tachycardia (SVT) were assessed at intervals of 1 to 2 hours over a period of 22
      hours in 38 patients (25 with paroxysmal SVT). Daily variability of effective
      refractory period (ERP) had a mean range of 35 +/- 14 mseconds for the atria, 79
      +/- 65 mseconds for the AV node, 24 +/- 10 m seconds for the ventricles, 51 +/-
      27 mseconds for the retrograde Kent bundle, and 35 +/- 17 mseconds for the
      antegrade Kent bundle. Between 11 PM and 8 AM there was a significant
      prolongation of the ERP of the atria (ANOVA, p less than 0.001), AV node (p =
      0.002), right ventricle (p less than 0.001), and retrograde Kent bundle (p =
      0.005), and a reduction in electrical induction of SVT from 75% to 42% (p less
      than 0.05) with respect to the first electrophysiologic study. This nocturnal
      prolongation was preceded by ERP shortening of all explored cardiac sites and by
      increased tachycardia inducibility between 8 and 10 PM. Six patients with dual AV
      nodal pathways showed a prolongation of the fast pathway ERP at midnight, whereas
      conduction through the slow pathway followed an unpredictable daily variability.
      These data indicate a circadian influence on refractoriness of normal cardiac
      tissues and accessory pathways that exerted a midnight protection against
      electrical inducibility of reciprocating tachycardia but a transient arrhythmia
      facilitation at the evening.

PMID- 2221689
TI  - Clinical exploration of the autonomic nervous system by means of
      electrocardiography.

PMID- 2221690
TI  - Autonomic nervous system and arrhythmias.

PMID- 2221692
TI  - Irregular dynamics of excitation in biologic and mathematical models of cardiac
      cells.
AB  - Excitation and impulse propagation in cardiac tissues are dependent on the heart
      rate and can occur in extremely complex patterns. In this chapter we present the
      results of Purkinje fiber experiments and of computer simulations using an ionic
      (Beeler & Reuter) model for the ventricular cell. We have studied the global rate
      dependent behavior of cardiac cells through a systematic analysis of their
      response to single as well as repetitive depolarizing stimuli, and determined the
      role of nonlinearity in the mechanism(s) of their behaviors. To this end, we
      devised an analytical difference equation model of cardiac cell excitation which
      could be used to predict simple as well as chaotic behavior of both the Purkinje
      fiber and the Beeler & Reuter cell, depending on the stimulation rate. Both
      experimental and modeling results suggest that the presence of supernormal
      recovery in cell excitability establishes sufficient nonlinearity so that, during
      repetitive stimulation, the dynamics of cell response may be regular and
      predictable when the stimulus magnitude is either very small or very large, or
      they may be chaotic and very unpredictable when the stimulus magnitude is
      intermediate. The overall results suggest that the application of nonlinear
      systems theory to electrophysiology may have importance in the understanding of
      cardiac rhythm and conduction disturbances, and may have clinical implications as
      well.

PMID- 2221691
TI  - The cellular basis of cardiac arrhythmias. A matrical perspective.

PMID- 2221693
TI  - Electrocardiography. Past, present, and future.

PMID- 2221694
TI  - Multidimensional quantitation of ventricular repolarization. Static and dynamic
      characteristics.

PMID- 2221695
TI  - Quantitative electrocardiography. Standardization and performance evaluation.

PMID- 2221697
TI  - Computer-assisted analysis of Holter recordings.

PMID- 2221696
TI  - Computerized electrocardiography. A historical perspective.

PMID- 2221698
TI  - Electrocardiographic characteristics and main causes of pseudoprimary T wave
      changes. Significance of concordant and discordant T waves in the human and other
      animal species.

PMID- 2221699
TI  - The promise of electrocardiography in the 21st century.

PMID- 2221700
TI  - The reflex effects of tachycardias on autonomic tone.

PMID- 2221702
TI  - The predictive accuracy of the electrocardiogram in identifying the presence and
      location of myocardial infarction and coronary artery disease.
AB  - In summary, the electrocardiogram is limited in its ability to detect a
      myocardial infarction. Its sensitivity is compromised seriously by a substantial
      number of patients (table; see text) with non-Q wave infarction or regression of
      Q waves. Once a Q wave occurs, the predictive accuracy of those changes, in
      delineating the location of the infarction, is quite high. The ability of Q waves
      or ST segment elevation to predict or identify the "culprit artery" is less
      strong, primarily due to the variation in coronary anatomy commonly found. The
      relationship between anterior or inferior lead changes and anterior or inferior
      myocardial damage is close. However, lateral lead changes may more accurately
      represent anterolateral (I, AVL) or apical (V5-V6) infarction. Tall R waves in
      anterior precordial leads is most often associated with posterolateral
      infarction.

PMID- 2221701
TI  - Electrocardiographic diagnosis of transient myocardial ischemia. Sensitivity,
      specificity, and practical significance.

PMID- 2221703
TI  - Positron emission tomography as an aid in understanding electrocardiographic
      changes of ischemia, infarction, and cardiomyopathy.

PMID- 2221704
TI  - Presynaptic purine receptors.

PMID- 2221705
TI  - Eye banking: the Minnesota experience.
AB  - We present a brief report on the activities of the Minnesota Lions Eye Bank. This
      eye bank receives and supplies tissue to several midwestern states. In addition,
      it plays a vital role in providing tissue for research and training at the
      University of Minnesota. In association with the Department of Ophthalmology, the
      eye bank is also actively involved in the research and development of various
      corneal preservation systems. Included below is information relative to
      procedures used in the eye bank for the selection and collection of donor
      material; the decontamination, preparation, and storage of corneas; cost of eye
      bank services; and staff coverage. Also included is some data on the number of
      eyes received and processed and the eventual uses of the tissues, during the last
      ten years.

PMID- 2221706
TI  - Spectral electroretinography in thioridazine toxicity.
AB  - In three patients with thioridazine toxicity, the electroretinogram (ERG) to red
      light was found to be below the average normal range. A significant increase in
      its amplitude appeared with cessation of therapy in two cases. A further
      deterioration of the ERG amplitude to all stimulus conditions (white, blue, and
      red lights) occurred when the dose of the medication was increased in the third
      patient.

PMID- 2221707
TI  - A case of unilateral posterior ischemic optic neuropathy after radical neck
      dissection.
AB  - We present a case of unilateral posterior ischemic optic neuropathy after
      bilateral radical neck dissection. Etiologic factors are discussed.

PMID- 2221708
TI  - Fluorescein angiography using ultra-high speed film.
AB  - We used a new ultra-high speed black-and-white film, Kodak T-MAX P3200 (ASA
      3200), in routine fluorescein angiography on 51 patients and one normal
      volunteer. The increased film speed permitted a lower flash intensity than with
      other available films. Photophobia was improved subjectively in 25% of patients
      who had undergone prior angiography at a higher flash setting. In addition,
      patient cooperation was improved as evidenced by a decrease in the frequency of
      photographic artifacts and uninterpretable photographs compared with prior
      angiograms done using Kodak TRI-X Pan film (ASA 400). T-MAX yielded excellent
      resolution, but its grain size was slightly greater than that of TRI-X Pan. The
      use of ultra-high speed film and reduced light intensity may benefit the patient
      and improve photographic quality in some individuals with photophobia.

PMID- 2221709
TI  - Visual disturbances associated with over-the-counter ibuprofen in three patients.

PMID- 2221711
TI  - [Provoked oto-emissions. Parameters obtained in normal subjects using Kemp's
      equipment].
AB  - Response parameters relating to the stimulus (click or filtrated bursts), the
      patient's age and audition curve (physiological presbyacusis) were derived from
      3158 provoked otoemission (POE) recordings obtained in normal subjects. Current
      limits imposed by the device used constitute a factor restricting indications for
      such devices to the screening of loss hearing in the young child, obviously, but
      also to the investigation of certain paucisymptomatic hearing disorders
      presenting with normal or subnormal pure tome audiograms.

PMID- 2221710
TI  - Branch retinal vein occlusion: the pathogenetic role of blood viscosity.
AB  - The pathogenesis of branch retinal vein occlusion has not been completely
      clarified. The role of abnormal blood viscosity in the appearance and evolution
      of the disease has recently been advocated. We studied 54 patients with long
      standing branch retinal vein occlusion from a hemorrheologic point of view.
      Depending on the extension of retinal ischemia, two subgroups were identified.
      Hematocrit, blood and plasma viscosity, whole blood filterability, cell
      deformability, and fibrinogen levels were investigated. Thirty-five subjects of
      similar age, sex, and risk factors of diabetes and hypertension served as
      controls. Our results showed that blood viscosity is higher in patients with
      occlusion and particularly in those with severe retinal ischemia. Statistical
      analysis showed a direct correlation between blood viscosity and hematocrit.

PMID- 2221712
TI  - [Acoustic distorsion products: technic, reproducibility and audiometric value. A
      new technic for the clinical evaluation of hearing].
AB  - Acoustic distorsion products are sounds emitted by the cochlea, in relation with
      the outer hair cell properties and the micromechanical properties of the Organ of
      Corti, in response to an acoustic stimulation by two primairies F1 and F2.
      Acoustic distorsion product 2F1-F2 have been recorded in two populations: 10
      normally-hearing subjects and 10 subjects with pure sensorineural hearing losses.
      Three points are discussed: (i) the test-retest reliability, (ii) the clinical
      tolerance and (iii) the clinical applications of this test.

PMID- 2221713
TI  - [Amyloidosis disclosed by ORL manifestations].
AB  - Amylosis is characterized by an infiltration of acellular substance into the
      tissues. This substance is mainly made of protein molecules. This disease is
      primary or secondary to general disorders. Its anatomical polymorphism can well
      involve the ENT system. Its clinical pictures are well known by the ENT
      specialist. About tow amyloid tumors diagnosed because of oropharyngeous signs,
      the authors remind the main symptoms at the upper airway and ENT tracts; the
      local, regional and general treatment will be discussed.

PMID- 2221714
TI  - [Immunohistology of polyps of the nose and paranasal sinuses. Physiopathologic
      value].
AB  - The pathophysiology of nasal polyposis is yet unclear, but chronic disturbances
      of the inflammatory pathways may be suspected. Immunological investigations were
      performed in 3 series of patients: 37 with nasal polyps, 22 with chronic
      sinusitis, and 15 controls with healthy nasal and sinusal mucosa. Patients with
      nasal polyps had up to ten times more eosinophil density than patients with
      sinusitis or healthy mucosa. The average of mast cells and IgE or IgA, M, G
      plasma cells were not different in the various group. Deposited immune complexes
      were always absent. These results gave us the opportunity to discuss recent
      pathogenic theories.

PMID- 2221715
TI  - [Anatomic and endoscopic studies of the anterior ethmoid].
AB  - Introduction of present-day sinonasal endoscopy and progress in endonasal surgery
      under endoscopic guidance of endoscopy provide for anatomical exploration of the
      anterior part of the ethmoid bone, which is the crosspoint of the facial sinus
      draining paths. We propose to present here a simple and logical scheme of the
      topographical anatomy of the ethmoid bone. Classification of the ethmoidal cells
      allows to define the structures, whereby appropriate nomenclature may be adopted
      and certain confusions avoided. Thus, each cell within particular cell groups
      acquires a specific designation based on its draining paths and location in
      relation to basal lamellae. Endoscopic analysis also deserves being described in
      some length, since the panoramic view afforded by currently used optics modifies
      the image ans requires that the observer develop an "endoscopic eye". We draw
      attention to the endoscopic anatomical fine points in the crucial area of the
      bullar "circus". These landmarks come in as necessary guides in surgical
      practice.

PMID- 2221716
TI  - [The value of endoscopy in recurrent acute laryngotracheitis in children. Apropos
      of 406 cases].
AB  - Acute laryngo-tracheitis in infants represents a common cause of respiratory
      distress with stridor accompanied with hospital admission. The prognosis is
      usually favorable in light of the available medical and environmental management.
      We performed a retrospective analysis of 1739 case reports from 1974 to 1989 with
      special attention being paid to infants admitted three times or more for
      recurrent acute laryngo-tracheitis. An ENT consultation was requested in 406
      infants which resulted with an endoscopy being performed. Narrowing of the airway
      was noted in 75% of cases. Dynamics of fluids explains why a silent lesion
      becomes symptomatic as soon as an inflammatory process is also present. As there
      are pathologies which are life-threatening, we advocate routine endoscopy as a
      precautionary method of investigation, followed by close reassessments, in all
      cases of recurrent acute laryngo-tracheitis with dyspnea. Preferably, this
      procedure should be performed between dyspneic episodes.

PMID- 2221717
TI  - [Choice of methods for reconstruction of the cheek after carcinologic excision
      based on a retrospective study of 32 cases in 8 years from 1980 to 1987 at the
      Gustave Roussy Institute].
AB  - In this article, after reviewing the different possibilities for cheek
      reconstruction consecutive to carcinologic excision, we specify the choice method
      for closure, according to the anatomical type of substance loss incurred. In all
      cases, endobuccal skin covering is needed. --As regards small lesions, there is
      no such thing as "the" ideal flap. --As far as tegumental cheeks are concerned,
      the deltopectoral flap is the choice one. --In case of mucous reconstruction,
      submental flaps afford elegant solutions. --With large lesions, musculocutaneous
      flaps are best used. Lastly, it seems that the first surgical treatment
      (excision, curage and plasty) followed or not by radiotherapy, depending on
      anatomopathological findings, brings acceptable and prompt restoration of
      function and morphology.

PMID- 2221718
TI  - [How many peripheral facial paralyses are manifestations of Lyme disease? A
      French multicenter study].
AB  - The diagnosis of Lyme disease is easy on the basis of clinical features only when
      it combines migrans chronic erythema, severe root pain affecting the limbs and
      facial paralysis, above all when bilateral. When pain is transient and slight and
      when erythema and the tick bite are absent facial paralysis may be mistaken for
      Bell's palsy. The risk is that of failing to recognise Lyme disease which may
      subsequently manifest itself as severe neurologic complications minimally
      sensitive to antibiotics. The multicenter study envisaged is designed to
      determine the incidence of Borrelia burgdorferi seroconversion in all individuals
      with a non-traumatic peripheral facial paralysis seen between 1.1.90 and
      12.31.90. Serology is difficult to interpret on an individual basis. A large
      series will be necessary in order to be able to draw reliable conclusions. Two
      control series will be used: one consisting of a sub-group of facial paralyses
      with herpes zoster vesicles and the other based upon pairing of two control sera
      for each Borrelia burgdorferi positive serum. This should show whether Lyme
      disease need really be feared in presence of an apparently isolated FP.

PMID- 2221719
TI  - [Extensive fibromatosis of the neck muscles].
AB  - Extensive fibromatosis, also called desmoid tumor, is a histologically benign
      tumor, which is nonetheless serious due to its recurrent character and to its
      potential for infiltration of neighboring tissues. Extensive surgery is the only
      effective means of treatment, radiation therapy being used only as a complement.
      The authors describe an elective location of the lesion in the sheaths of the
      scalenus muscles. This development is usually observed in young women, as is the
      case in the observation reported here.

PMID- 2221720
TI  - [Comparative study of the efficacy and tolerance of prednisolone versus niflumic
      acid in the treatment of acute sinusitis in adults].

PMID- 2221722
TI  - [Post-traumatic decompression of the optic nerve. Ophthalmologic and x-ray
      computed tomographic evaluation. Results in a series of 23 cases].
AB  - Post traumatic optic nerve compression gives a Clinic picture of physiological
      section. CT Scan is consistent with optic canal lesion when considering direct
      signs (bony fragments compressing the nerve) or indirect (fractures and hematoma
      of posterior orbital wall, of posterior ethmoid, and sphenoid). 23 patients had a
      surgical decompression through transethmoidosphenoidal approach. A lesion of
      optic canal was found in 22 out of 23 cases. Improvement of vision was noted in
      12 cases.

PMID- 2221721
TI  - [Vestibular compensation. Review of the literature and clinical applications].
AB  - Vestibular compensation is an excellent model for the study of plasticity of the
      adult central nervous system. Therefore it has been the subject of several
      studies in humans and animals, which will be briefly summed up by the authors.
      Lesions of the labyrinth or vestibular neurectomy are immediately followed of
      postural and oculomotor disorders, as well as by dynamic deficits of the various
      vestibular reflexes (vestibulo-ocular and vestibulonucal reflexes). While the
      former problems always recede in all species, the restoration of the dynamic
      properties of vestibular reflexes largely depends upon the species considered, in
      particular for the vestibulo-ocular reflex. However, this function seems to
      recover the gain and phase it had prior to the lesion in both humans and monkeys.
      What is the neuronal substrate of these various deficits? Electrophysiological
      studies have demonstrated at the acute stage a symmetrical activity between the
      two vestibular nuclei: on the side of the lesion, the nucleus becomes inactive,
      while the resting discharge of the contralateral vestibular neurons is increased.
      Following compensation, symmetric activity is restored between both nuclei due to
      the regeneration of a new basic discharge in the deafferented neurons. The matter
      of vestibular compensation can therefore be formulated as follows: which
      mechanisms enable a central neuron inactivated du to the suppression of most of
      its excitatory afferences to recover a normal spontaneous activity? Several
      hypotheses, either pre- or postsynaptic, are currently put forward. Presynaptic
      hypotheses consider the role of the various afferences of the vestibular nuclei,
      ie. visual, proprioceptive, commissural, cerebellar and other afferences. In
      fact, the vestibular nuclei are not merely relays between the labyrinthine
      receptors and the nuclei of the oculomotor nerves, but actually form real
      sensorimotor integration centers. Besides the afferences from the vestibular
      nerve, they receive several other sorts of information, including visual and
      spinal proprioceptive inputs. An increase in the activity of these afferences, a
      sprouting of their axon collaterals, may favor the return to a normal basic
      discharge of the central vestibular neurons. The postsynaptic hypotheses involve
      either a change in the intrinsic membrane properties of the central vestibular
      neurons following the lesion, or an increase in the number of receptors located
      on their surface. More specifically, denervation supersensitivity of the
      glutamatergic receptors has been put forward as the possible origin of vestibular
      compensation.

PMID- 2221723
TI  - [The value of pharyngo-esophageal manometry in the study of deglutition
      disorders].
AB  - Pharyngoesophageal manometry is an excellent tool for the study of pharyngeal
      swallowing disorders, and allows quantifying the various anomalies. The
      comparison of pre- and postoperative results allows better differentiation of the
      indications for myotomy or myectomy of the cricopharyngeal muscle. On the basis
      of a series of 10 cases with sufficient distance in time, the operation can be
      regarded as even more beneficial as the manometric anomalies are confined to the
      sole upper esophageal sphincter.

PMID- 2221724
TI  - [Mouth and pharyngeal hyperalgesic syndromes in AIDS].
AB  - In a series of 12 patients suffering from an HIV infection, including 9 with
      confirmed AIDS, who complained about pharyngeal pain in a fixed site, having a
      progressive intensity and not relieved by antalgics and the specific treatments
      that were prescribed empirically, and for whom etiological investigation yielded
      negative results, Thalidomide proved to be the only effective means of healing
      the exulcerated, nail-mark lesions or the ulcerated, budding, neoplastic-like
      lesions, and of completely suppressing pain.

PMID- 2221725
TI  - [Contribution of immunologic technics to the characterization of lethal midline
      granuloma of unknown origin].
AB  - The lethal midline granuloma is a clinical entity characterized by a relentless
      ulceration of the upper airway involving the nose, the palate and the face,
      without any demonstrable etiology. We have applied the cell membrane
      immunostaining techniques to twelve cases. According to the results, it seems
      that most of the cases are in fact T-cell lymphomas with membrane staining
      consistent with either precursor or mature lymphoid T-cells. Some cases, however,
      exhibit an immunostaining pattern compatible with other origins, the
      proliferating cells belonging either to the B lymphoid or to the histio-monocytic
      lineages. We conclude that the lethal midline granuloma is an heterogeneous group
      of neoplastic diseases, in the most part close to a T cell lymphoma, but with a
      remarkable clinical unity.

PMID- 2221726
TI  - [Frontal and ethmoidal mucoceles. Apropos of 17 cases].
AB  - We have been studying 17 cases for operated mucoceles over a period of 4 years.
      Usual predisposing factors are often present, however we found no underlying
      malignant tumor revealed by a mucocele. Surgical treatment always included
      exclusion and filling with bone grafts in case of frontal involvement. Small
      ethmoidal lesions without symptom found on the CT scan are worrying because of
      their potential deterioration; in such cases, our attitude has been surgical.

PMID- 2221727
TI  - [Sinusitis during intensive care. Prospective studies].
AB  - Two series of ICU patients, the first one with nasal endotracheal intubation, the
      other one with a tracheostomy, were included in a prospective and comparative
      study with repeated CT scans of the sinuses. Radiological sinus involvement is
      seen in both groups almost constantly; purulent sinusitis are often seen in both
      series. Unexplained fever should make us look for a sinusitis, even in patients
      with early tracheostomy. Moreover, our results ask for more study about
      associated causes, apart from nasal endotracheal intubation.

PMID- 2221728
TI  - [Endocranial complications of chronic otitis in adults].
AB  - 47 patients with intracranial abscess were admitted in the neurosurgical
      department of Professor Fohanno Pitie-Salpetriere Hospital, between 1973 and
      1989. Most often central abscesses were found. In 9 cases, the ear was the
      primary septic focus: 3 chronic otitis with cholesteatoma, 6 chronic otitis
      without cholesteatoma. In most cases, treatment included: Immediate drainage,
      Delayed surgery for the primary focus.

PMID- 2221729
TI  - [Value of the administration of trimetazidine associated with hemodilution in the
      treatment of sudden deafness. Report of a multicenter study].
AB  - Sudden deafness is a medical emergency, for which etiopathology is ill-known and
      no therapeutic consensus exists. This study is aimed at demonstrating that a
      greater audiometric gain can be achieved if trimetazidine, a major cellular anti
      ischemia agent, is associated with hemodilution, than when the treatment is based
      on hemodilution only. 42 patients suffering from sudden deafness were all treated
      with hemodilution before their 7th day of deafness, half of them being given 3
      tablets of trimetazidine daily in addition and the other half placebo, during one
      month. The results of this double-blind trial demonstrate an additional
      audiometric gain of 10% in the trimetazidine group for all frequencies, as well
      as a higher percentage of total recovery, ie. 63% vs. 47% in the placebo group.
      No particular sensitivity to treatment was noted according to the shape of the
      audiometric curve or in the case of initial cophosis, known to be of poor
      prognosis. The statistic significance was not established due to the small number
      of cases. The association of trimetazidine and hemodilution therefore seems to be
      an interesting therapeutic approach for sudden deafness, owing to the clinically
      appreciable audiometric improvement we have noted.

PMID- 2221730
TI  - Teflon versus thyroplasty versus nerve transfer: a comparison.
AB  - Surgical rehabilitation of the paralyzed larynx is currently performed by Teflon
      injection, thyroplasty, and reinnervation techniques. Proponents of the two newer
      techniques maintain that they are preferred to Teflon injection because superior
      phonatory quality is achievable. This paper was written in an attempt to dissect
      the issues regarding this question. Teflon remains the quickest and least
      expensive procedure, but further experience with stroboscopic and other voice
      analyses reveals that the other procedures demonstrate some superiority in
      phonatory quality over Teflon. In this author's hands, the nerve transfer offers
      the best opportunity to achieve a normal phonatory voice. In addition, it is the
      only one of the three procedures that leaves the vocal cord entirely undisturbed-
      important in the event one of the other two procedures becomes necessary.

PMID- 2221731
TI  - Endoscopic laser arytenoidectomy revisited.
AB  - Arytenoidectomy is currently the most reliable method of treating patients with
      bilateral vocal cord paralysis. Although both endoscopic and external approaches
      have been described, the endoscopic laser technique is more desirable because it
      requires no incision and allows for the immediate assessment of airway size.
      Eleven patients with bilateral vocal cord paralysis treated by endoscopic laser
      arytenoidectomy were presented in 1984. At that time, 10 of the 11 patients had
      been successfully decannulated. Follow-up on that group of patients revealed that
      7 of the 10 successfully treated patients remain decannulated with a good airway,
      although 2 of these patients required a revision procedure to excise a granuloma.
      One patient failed at 15 months and has failed two subsequent revision
      operations, and 2 patients have been lost to follow-up. Since 1984, 17 additional
      patients with bilateral vocal cord paralysis have been treated by the authors
      using the same endoscopic laser arytenoidectomy technique; all have been
      successfully managed, with a minimum follow-up of 3 years. The technique of this
      operation will be reviewed. This study demonstrates the clinical usefulness of
      endoscopic laser arytenoidectomy in the treatment of bilateral vocal cord
      paralysis.

PMID- 2221732
TI  - Laryngeal framework reconstruction with miniplates.
AB  - Defects of the laryngeal framework after trauma, cancer, and thyroplasty have
      been reconstructed with mini-reconstruction plates. Six patients had miniplates
      used to repair the thyroid cartilage defect after type I thyroplasty to prevent
      lateralization of the Silastic implant; three patients had miniplates used after
      hemilaryngectomy to bridge the thyroid cartilage remnants, resulting in better
      deglutition after hemilaryngectomy; and three patients had miniplates used to
      repair laryngeal fractures. The plates were tolerated well by the patients; there
      were no major complications. Rigid fixation using miniplates for laryngeal
      reconstruction has unique advantages over the use of wires. It offers the
      advantages of rigid and immediate stabilization with the ability to bridge large
      defects. It can be an alternative to existing techniques of laryngeal
      reconstruction.

PMID- 2221733
TI  - Combined laryngeal framework medialization and reinnervation for unilateral vocal
      fold paralysis.
AB  - The laryngeal framework-Silastic implant technique has become an increasingly
      attractive alternative to Teflon injection, particularly when there is fixation
      of the cricoarytenoid joint or the defect to be corrected is larger than usual;
      but it does not restore ability to change tension in the vocal fold. Unilateral
      vocal fold reinnervation can overcome this drawback and, when used in conjunction
      with surgical medialization, may offer return of function very close to normal.
      Twenty-nine patients with unrecovered unilateral vocal fold paralysis and/or
      fixation of the cricoarytenoid joint have been managed by use of a Silastic
      implant combined with unilateral vocal fold reinnervation with no complications.
      Voice improvement has been assessed on preoperative and postoperative voice
      recordings. The combined surgical techniques for reinnervation and a modification
      of Silastic implantation via the laryngeal framework approach are reported.

PMID- 2221734
TI  - Auditory brain stem implant: effect of tumor size and preoperative hearing level
      on function.
AB  - The auditory brain stem implant is an investigational device designed to provide
      hearing sensations to patients without functioning auditory nerves. We analyzed
      results from 17 implants in 15 patients to determine if tumor size or
      preoperative hearing level might be related to proper device function. We found
      no significant correlation between preoperative hearing level or tumor size and
      device function. We also found no significant correlation between preoperative
      hearing level and tumor size in these 15 patients.

PMID- 2221735
TI  - Cochlear implant flap complications.
AB  - In a series of 52 patients who received cochlear implants, 4 patients suffered
      flap complications (7.7%). The problems encountered involved the postauricular
      flap and were usually minor in nature. None required explantation as a direct
      result of these complications. Flap ischemia in a patient with Cogan's syndrome
      and vasculitis, two cases of suture extrusion with one having exposure of the
      implant, and a case of receiver unit magnet extrusion repaired with a
      vascularized pericranial flap based upon temporalis muscle are presented. Flap
      design in patients who have had postauricular incisions demands special
      consideration. Principles useful for avoiding complications as well as their
      management are discussed.

PMID- 2221736
TI  - Percutaneous pedestal in cochlear implantation.
AB  - Direct electrical connection between an external sound-processing device and
      intracochlear electrodes is accomplished via a percutaneous pedestal. Patient
      pedestal complaints and experience have been recorded. Pedestal problems have
      been classified into six classes, with class 0 indicating no problems and the
      severity of problem increasing in classes 1 through 4. Class 5 indicates pedestal
      trauma. No class 5 problems were encountered. At 48 months of experience, 53% of
      patients were class 0 and 26% were class 1. The pedestal experience is detailed
      in the paper. The percutaneous pedestal has been found to be a well-tolerated,
      efficient system for information transfer in cochlear implant patients.

PMID- 2221737
TI  - Further studies on the effects of magnetic resonance imaging fields on middle ear
      implants.
AB  - We investigated the effects of magnetic resonance imaging (MRI) fields on 21
      stapedectomy prostheses and other middle ear implants and two different receiver
      stimulator modules from 22-channel cochlear implants. None of the middle ear
      implants was displaced by the magnetic field, except for one platinum-stainless
      steel stapedectomy piston. Magnetism was not induced in any of the middle ear
      implants subjected to prolonged exposure in the MRI scanner. We conclude that MRI
      could pose a hazard to patients who have had stapedectomy using certain platinum
      stainless steel piston prostheses and to patients with cochlear implants.
      Magnetic resonance imaging should pose no hazard to patients who have had the
      other middle ear implants reported on in this and our previous investigation.

PMID- 2221738
TI  - Vestibular recruitment in Meniere's disease.
AB  - The aim of this study was to search for vestibular recruitment in a sample of
      patients with Meniere's disease. Recruitment was defined as an abnormal growth of
      response with increasing stimulus intensity. Twenty-nine patients were tested
      with sinusoidal rotation of three different magnitudes at four different
      frequencies. We also searched for auditory recruitment in each patient via tests
      of auditory brain stem responses, acoustic reflexes, and loudness balance and
      discomfort level. Analysis of vestibular responses indicated, on average, a
      linear relationship between stimulus magnitude and response magnitude, ie,
      doubling the stimulus magnitude resulted in twice the response magnitude.
      Meniere's patients did not yield results significantly different (although they
      were more variable) from those of the normal subjects. The vestibular responses
      of patients with auditory recruitment did not differ systematically from those of
      patients without auditory recruitment. We conclude that vestibular recruitment,
      if it exists in patients with Meniere's disease, is not demonstrated by
      sinusoidal rotational testing.

PMID- 2221739
TI  - Histopathologic study of otitis media in individuals with head and neck tumors.
AB  - Five temporal bones, each including the eustachian tube, were obtained from five
      adults with advanced malignant tumors of the head and neck. The specimens were
      from the side on which the tumor had occurred. Otitis media had been detected
      clinically in two cases, and was detected histopathologically in the other three.
      We discuss the possibility that otitis media might have been caused by tumor
      invasion of the paratubal area, by postoperative inflammation in the nasopharynx,
      or by an inflammatory reaction of tubal structures to radiotherapy, or that these
      conditions may have coexisted.

PMID- 2221740
TI  - Internal auditory canal enlargement in Paget's disease appearing as bilateral
      acoustic neuromas.

PMID- 2221741
TI  - Histopathologic grading of salivary gland neoplasms: I. Mucoepidermoid
      carcinomas.
AB  - Histopathologic grading of salivary gland neoplasms has been done with various
      degrees of success and hence various degrees of acceptance among pathologists and
      otolaryngologists-head and neck surgeons. Given their histopathologic diversity,
      three carcinomas--mucoepidermoid, adenoid cystic, and acinic cell--would seem to
      be suitable candidates for grading. In this, the first of a three-part series,
      the authors present a three-level grading scheme for mucoepidermoid carcinomas.
      It combines histocytologic and growth features of the carcinomas that
      independently or together, in other grading proposals, have shown prognostic
      value.

PMID- 2221742
TI  - Laryngotracheal reconstruction with composite nasal septal cartilage grafts.

PMID- 2221743
TI  - Excessive nasality or hypernasality as twang quality that is made in the nose.

PMID- 2221744
TI  - [Evaluation of cutaneous risks of the Pill].
AB  - Despite the fact that about 150 millions women must have taken hormonal
      contraceptives all over the world since the 1960s, the risk/benefit ratio of this
      birth control method has yet not been reliably assessed. The side effects of the
      pill on the skin do not pertain, in general, to those (like thrombo-embolism or,
      perhaps, breast cancer) which might be life-threatening, but they are probably
      more frequent and may have a potential to alter the quality of life of women who
      use it. The aim of this paper is to review the dermatological effects of hormonal
      contraceptives from the point of view of everyday prescribing, with the emphasis
      on the quality of life of patients. The reported side effects of the pill are
      therefore classified according to their real or probable frequency, not to their
      severity or the theoretical importance of their mechanisms. As it would be unwise
      to speak of the risks without consideration for the benefits, an attempt is made
      to compare the dermatological safety profile of oral contraceptives to that of
      other birth control methods (barrier contraceptive methods, intrauterine devices,
      etc.) on the one hand; on the other hand, one insists upon the fact that the pill
      in itself may have health benefits, general (reduction in the incidence of some
      cancers) or dermatological (e. g. an effect on acne).

PMID- 2221745
TI  - [Epithelio-lymphohistiocytic tumor. Apropos of 3 cases].
AB  - We report three cases of epithelio-lympho-histiocytic tumour with very original
      histological features. The patients were young adults presenting with a nodular
      lesion on the face which had been present for several years. No recurrence was
      observed after surgical excision. Histologically, the dermal lesion consisted of
      epithelial pouches edged with a few layers of basal-like cells and filled with
      lymphocytes and large clear cells. Relations were found between these lobules and
      hair follicles, and rudiments of piliary differentiation were noted. The stroma
      was dense and infiltrated by small lymphocytes and large clear cells. An
      immunohistochemical study showed marking of the large clear cells by the S 100
      protein, which suggested that they were Langerhans cells. The lymphocytes were
      recognized by the common panleucocyte antibody. The KL 1 antibody marked a few
      isolated cells within the lobules, but not the basal-like cells. These cases
      seemed to be similar to the 7 cases reported in the literature by Santa-Cruz and
      Barr who used the term lymphoepithelial tumour of the skin. We felt justified in
      putting the stress on the histiocytic component of this tumour and calling it
      epithelio-lympho-histiocytic tumour. We agree with these authors that this is a
      tumour of the appendages of the skin and in particular the hair.

PMID- 2221746
TI  - [Unusual complication of liposuction (atypical cutaneous mycobacteriosis?)].

PMID- 2221747
TI  - [Cowden's disease. Adenomatous polyps. Periorifichal lentiginosis].

PMID- 2221748
TI  - [Bullous pemphigoid-multiple sclerosis association. A case report].

PMID- 2221749
TI  - [Propionibacterium acnes septicemia in T lymphoblastic lymphoma].

PMID- 2221750
TI  - [What is your diagnosis? Naevus vascularis mixtus].

PMID- 2221751
TI  - [Influence of ultraviolet rays on the immune system].

PMID- 2221752
TI  - [Cheilitis and lip lesions artificially induced].

PMID- 2221753
TI  - [Cutaneous manifestations of infections in newborn infants].

PMID- 2221754
TI  - [Proceedings of the 48th yearly meeting of the American Academy of Dermatology in
      San Francisco, 2-7 December 1989].

PMID- 2221755
TI  - Biology of Plasmodium merozoites with special reference to the chemoresistance of
      Plasmodium falciparum.

PMID- 2221756
TI  - [Effects of Saccharomyces boulardii yeast on trophozoites of Entamoeba
      histolytica in vitro and in cecal amebiasis in young rats].
AB  - Lyophilized and rehydrated Saccharomyces boulardii yeasts were administered to
      young rats previously inoculated into the cecum with Entamoeba histolytica. The
      numbers of diseased young rats and the severity of the infection, assessed from
      the appearance of the cecum and its content of mucus and amebae, were
      significantly reduced by the treatment. The lesions observed resembled those seen
      in the untreated controls, although healing was faster in the treated animals.
      Saccharomyces boulardii had no intrinsic amebicidal action in vitro.

PMID- 2221757
TI  - A technique for identification of cercariae of Schistosoma haematobium, S.
      curassoni, S. bovis and S. intercalatum.
AB  - The chaetotaxy of 84 samples or isolates of Schistosoma spp. from western or
      central Africa has been studied. Three indices were calculated for cercariae of
      each sample; their average value, the skewness and kurtosis of each indice was
      established. Each species (S. haematobium, S. curassoni, S. bovis and S.
      intercalatum) was discriminated with nine variables. The present work gives
      information to assess, specific diagnosis with simple calculations easily
      achieved on a small computer.

PMID- 2221758
TI  - Broncho-pulmonary helminths of chamois (Rupicapra rupicapra parva) captured in
      North-West Spain: assessment from first stage larvae in faeces and lungs.
AB  - The bronchopulmonary helminths of 66 chamois (49 males and 17 females), captured
      in various parts of the Cantabrian mountain range (N. W. Spain) in the autumn of
      1983, and in the summer and the autumn of 1984, were studied. The animals were
      adult and aged between 2 and 16 years. The lungs, trachea and faeces from the
      last section of the intestine were taken from each animal individually. The
      trachea and pulmonary larval nodules were dissected. First stage larvae (L-I)
      were obtained from finely cut up pulmonary tissue and from faeces by migration.
      The number of larvae I per gram varied between 0.08 and 2,662 (mean = 151.5 +/-
      59.5 s. e.) in the faecal samples, and between 0.03 and 1,733 (mean = 65.2 +/-
      32.4 s. e.) in the pulmonary ones. There was a low correlation between the two
      sets of data. When taking into account age and sex, no statistically significant
      differences were observed in relation to the number of larvae/gram found either
      in faeces or in pulmonary tissue, while there were statistically significant
      differences when considering the periods of sampling and reserve of origin, in
      relation to the larvae found in faeces and lungs, respectively. Infections by
      three nematodes (Neostrongylus, Muellerius and Protostrongylus) were more common
      than those produced by two or one, in the lungs as well as in the faeces. The
      most common genus was Neostrongylus, followed by Muellerius, and no Cystocaulus
      or Dictyocaulus larvae were found.

PMID- 2221759
TI  - The fate of the filaria Monanema martini in two rodent hosts: recovery rate,
      migration, and localization.
AB  - In Meriones unguiculatus, the recovery rate of 80 inoculated larvae was low
      (about 20%) and irregular. In the natural host Lemniscomys striatus, the recovery
      rate was about 50% with inoculated doses of 30, 80 or 400 L3, but slightly higher
      for 400 L3. This rate was constant from day 2 to month 8 post infection (p.i.).
      When 7-9 reinoculations were performed in one year, the recovery rate of the late
      inoculation was of only 14%. After subcutaneous inoculations, larvae penetrated
      into the peripheric lymphatic vessels from hour 6 p.i. and migrated to the lumbar
      and mesenteric lymph nodes; this first migratory phase was achieved 5 days p.i.
      Later, the larvae migrated into the digestive tract lymphatic system. Filarial
      localization did not depend upon the L3 dose: half were found in the caecum and
      anterior colon (3 cm) wall, and half were distributed in the posterior colon,
      mesentery and small intestine. A small number (3-5%) of the filariae were found
      in the pulmonary blood vessels, as a result of accidental migration by the
      thoracic canal. A similar phenomenon is known in the lymphatic filariae Brugia
      spp. in rodents and Conispiculum flavescens in a lizard. Several arguments
      suggest that the genus Monanema is fundamentally lymphatic. Migrations and life
      of filariae in the lymphatic system seems to be more usual than it is generally
      admitted. In onchocerciasis, this may at least partially explain the
      lymphopathology of the inguinal region.

PMID- 2221760
TI  - The response of general surgeons to HIV in England and Wales.
AB  - The prevalence of HIV in the UK has been estimated to be 1 in 1000 of the
      population. Surgeons are at particular risk of occupational transmission from
      infected blood. To determine the effect of HIV on surgical practice we sent a
      questionnaire to 681 general surgeons in England and Wales; 450 replied (66%). Of
      those who replied, 42% were aware of having operated on an HIV-infected patient
      at least once, and 28 had recognised self-injury in such circumstances; 79%
      attempted to identify HIV-infected patients preoperatively, though many depended
      on clinical suspicion alone, which is known to be unreliable. Of those who had
      operated on a seropositive patient, 90% reported taking special precautions to
      avoid blood contact and minimise sharps injuries for such cases. The majority
      wore double gloves, eye protection and fluid-resistant gowns, but only a minority
      reported changes in surgical technique. Half had made no changes in procedures or
      technique when operating on patients not identified as being at risk of HIV
      infection. Among a wide variety of comments made by the surgeons, the commonest
      was a call for facilitation of HIV testing prior to surgery. This survey
      indicates that surgery on HIV-infected patients is not restricted to specialist
      centres. We review the means of identifying HIV-infected patients, the
      precautions that can be taken to minimise HIV transmission during surgery, and
      the possible influences of HIV status on surgical decisions. We conclude that the
      prevalence of HIV among surgical patients is being underestimated at present,
      that several simple changes in surgical technique should be adopted generally,
      and that there is limited value in preoperative HIV testing, though this may
      become more useful in the foreseeable future.

PMID- 2221761
TI  - Local audit in vascular surgery.
AB  - A 2-year audit of the Southampton Vascular Unit showed marked discrepancies in
      workload from nationally accepted figures. All forms of reconstructive surgery
      except emergency aortic aneurysm grafting were performed more frequently than
      expected. The vascular population is elderly and at high risk from major surgery.
      Mortality was appreciable in all major vascular procedures and usually cardiac or
      renal related. The elderly population and resulting workload is likely to
      increase in the near future. The role of local audit in vascular surgery is
      emphasised.

PMID- 2221762
TI  - Postoperative muscle strength.
AB  - This study investigates the role of motivation in voluntary strength measurements
      during the postoperative period. Thirty patients underwent surgery which was
      deemed minor, intermediate or major in severity. Before operation and on the 4th
      postoperative day measurement of grip strength, maximal voluntary and maximal
      tetanic (stimulated) contraction of adductor pollicis and assessment of mood were
      recorded. These investigations were also repeated on the 7th postoperative day in
      those who had major surgery. No patient had postoperative complications. Minor
      surgery had no influence on any of the values. Those who underwent major surgery
      showed significant reductions in grip strength, maximal voluntary contraction and
      mood; however, maximal tetanic contraction was unaffected. The results in the
      intermediate group were similar to the major group, although mood depression was
      less marked. Real strength of a hand muscle appears to be unaltered even by major
      surgery, but voluntary muscle force is decreased by intermediate and major
      surgery, and correlates with the patient's subjective state of well-being.

PMID- 2221763
TI  - A comparison of danazol and placebo in the treatment of adult idiopathic
      gynaecomastia: results of a prospective study in 55 patients.
AB  - In an attempt to define the efficacy of danazol in the treatment of idiopathic
      gynaecomastia, 55 patients were enrolled into a randomised double-blind
      comparison of danazol 200 mg twice daily for 3 months against placebo. The
      results of 52 patients were evaluated, three patients being excluded because of
      protocol violations. Danazol improved breast tenderness to a significantly
      greater degree than did placebo (P = 0.022, danazol vs placebo) and was
      associated with statistically significant improvement in the degree of
      gynaecomastia and in its measured size (P less than 0.05). The intended
      management of patients who had received danazol was less likely to be surgery
      compared to the placebo group when assessed at the end of treatment (27% vs 50%).
      Minor side effects were common in both groups, but significant weight gain was
      noted in the danazol group alone. If there is no urgent need for rapid resolution
      of gynaecomastia, danazol 200 mg twice daily can provide effective control of
      symptoms and may obviate the need for surgery.

PMID- 2221764
TI  - A prospective study of bilateral inguinal hernia repair.
AB  - A prospective study of outcome after inguinal hernia repair in patients
      undergoing simultaneous repair of bilateral hernias (n = 31), sequential repair
      of bilateral hernias (n = 5), and unilateral hernia repair (n = 75) is reported.
      There were no differences in wound complications, post-operative respiratory
      complications, or other adverse effects in the three groups. Operating time was
      similar in the unilateral and bilateral simultaneous repairs (median 55 min), but
      was longer (100 min) for the combination of two sequential repairs. Hospital stay
      was shortest for patients undergoing unilateral repair (2 days) but was less with
      bilateral simultaneous repair (4 days) than after two sequential repairs (total
      of 6 days). There were 12 (11%) wound complications of which five (5%) were
      infections. There was no difference in complication rate between unilateral and
      bilateral hernia repair. Postoperative recovery was assessed prospectively and
      was recorded at 1 month. There was no difference between unilateral and bilateral
      simultaneous repairs in the number of days before the patient was able to climb
      stairs easily, drive a car or return to work. The duration of the requirement for
      analgesia was similar in each group. We conclude that bilateral simultaneous
      hernia repair can be carried out with no greater morbidity than a unilateral
      repair, and the return to normal activity is as rapid. Bilateral hernias should
      be repaired simultaneously rather than sequentially.

PMID- 2221765
TI  - McBurney's point--fact or fiction?
AB  - Anthropometric measurements were performed on 51 normal, supine, barium enema
      examinations to determine the position of the lower pole of the caecum and the
      base of the appendix relative to palpable bony landmarks (the anterior superior
      iliac spine and the symphysis pubis). Four quadrants were defined (iliac,
      umbilical, inguinal and pelvic) by the intersection of the right lateral line and
      the interspinous line (the line joining the left and right anterior superior
      iliac spines). The position of the lower pole of the caecum was iliac in 12%,
      inguinal in 37%, and pelvic in 51%. The appendix or appendix stump was visualised
      on 53% of the barium examinations. The position of the appendix was iliac in 15%,
      umbilical in 15%, inguinal in 11%, and pelvic in 59%. The positions of the lower
      pole of the caecum and base of the appendix are lower and more medial than
      previously described. 70% of appendices were found to lie inferior to the
      interspinous line, contrary to established surgical teaching, which assumes
      McBurney's point to be the surface landmark for the appendix.

PMID- 2221766
TI  - The role of the high dependency unit in postoperative care: an update.
AB  - The current experience of a high dependency unit established 5 years ago for the
      postoperative care of high-risk patients undergoing surgery is reported. The
      resource implications and contributions to the safety and quality of post
      operative care, particularly pain relief, are described.

PMID- 2221767
TI  - A simple technique for successful primary closure after excision of pilonidal
      sinus disease.
AB  - Primary closure after excision of postanal pilonidal sinus disease frequently has
      been complicated by wound break-downs. Healing by second intention takes many
      weeks and requires supervised wound care. A simple technique has been developed
      which has resulted in primary healing in 28 of 31 patients treated in a 5-year
      period. Sepsis and haematoma formation, the causes of wound breakdown after
      pilonidal sinus excision, have been prevented by preoperative preparation,
      prophylactic antibiotic administration, wound irrigation with povidone-iodine and
      simple skin closure over a Redivac suction drain for at least 4 days. This series
      suggests that primary closure can be successful using the technique described.

PMID- 2221768
TI  - Smooth muscle tumours of the alimentary tract.
AB  - Neoplasms arising from smooth muscle of the gastrointestinal (GI) tract are
      uncommon, comprising only 1% of gastrointestinal tumours. A total of 51 cases of
      smooth muscle tumour of the GI tract were analysed; 44 leiomyomas and 7
      leiomyosarcomas. Lesions occurred in all areas from the oesophagus to the rectum,
      the stomach being the commonest site. Thirty-six patients had clinical features
      referable to the tumour. The tumour was detected during investigation or
      management of an unrelated disease process in 15 patients. The clinical
      presentation varied depending on tumour location, but abdominal pain and GI
      bleeding were the commonest presenting symptoms. The lesion was demonstrated
      preoperatively, mainly by endoscopy and barium studies, in 27 patients. Surgical
      excision was the treatment of choice, where possible. There was no recurrence in
      the leiomyoma group but four patients died in the leiomyosarcoma group. Although
      rare, smooth muscle tumours should be considered in situations where clinical
      presentation and investigations are not suggestive of any common GI disorder. The
      preoperative assessment and diagnosis is difficult because of the variability in
      clinical features and their inaccessibility to routine GI investigation. It is
      recommended that, where possible, the lesion, whether symptomatic or discovered
      incidentally, should be excised completely to achieve a cure and prevent future
      complications.

PMID- 2221769
TI  - A technique for monitoring evoked potentials during scoliosis and brachial plexus
      surgery.
AB  - A total of 40 patients undergoing scoliosis or brachial plexus surgery had
      bipolar electrodes inserted preoperatively in the cervical epidural space located
      by the 'hanging drop technique'. The angle of approach to the space was different
      for each spinal interspace used. Good quality recordings were obtained of SSEPs
      with no long-term complications and we recommend this as a safe technique.

PMID- 2221770
TI  - Local analgesia for infant pyloromyotomy. Does wound infiltration with
      bupivacaine affect postoperative behaviour?
AB  - A series of 20 infants undergoing general anaesthesia for pyloromyotomy were
      studied in a randomised, blind and controlled trial to determine the
      postoperative behavioural and cardiorespiratory effects of wound infiltration of
      bupivacaine. Ten infants received bupivacaine (0.6 ml/kg, 0.25% = 1.5 mg/kg)
      injected intradermally into the wound during general anaesthesia and 10 infants
      received general anaesthesia only. Postoperatively, an independent observer
      assessed conscious level, crying, posture and facial expression using a simple
      numerical scoring system, and also recorded heart and respiratory rates over a 2
      h period. Infants who had received bupivacaine were observed to have higher
      respiratory rates and behaviour scores, although these differences were not
      statistically significant. These results indicate that wound infiltration with
      bupivacaine offers no obvious advantage to infants following pyloromyotomy.

PMID- 2221772
TI  - Aortocaval fistulas and the use of transvenous balloon tamponade.
AB  - Six cases of acute aortocaval fistula are reported, which illustrate the
      difficulties of diagnosis and management in a rare life-threatening condition.
      Five cases arose from spontaneous rupture of aortic aneurysms and one from
      trauma. In four cases the diagnosis was made before surgery. Useful diagnostic
      features included inappropriate jugular venous distension in five patients, lower
      abdominal and trunk cyanosis in three patients and a palpable thrill in three
      patients. Preoperative diagnosis permitted attempts to control venous haemorrhage
      in three cases, one by balloons through the aortic sac and two by transvenous
      positioning of balloon catheters in the vena cava before aortic opening. The use
      of transvenous balloon catheters was found to be helpful in reducing haemorrhage.
      Four patients left hospital alive. Preoperative recognition of the signs of an
      acute aortocaval rupture and preliminary balloon tamponade appear to be valuable
      in the management of acute aortocaval fistulas.

PMID- 2221771
TI  - Thoracoabdominal total gastrectomy in the management of adenocarcinoma of the
      cardia. Is it worth it?
AB  - A series of 47 consecutive patients with adenocarcinoma of the gastric cardia
      presenting between 1982 and 1987 have been reviewed. Of these, 38 patients were
      eligible for surgery (operability rate of 80.85%) but only 25 patients underwent
      potentially curative resection (resection rate of 65.7%). The disease was
      extensive at the time of operation, with only two patients (8%) having node
      negative tumours. The mean hospital stay for patients undergoing resection was 21
      days. There were 15 major complications in 10 patients undergoing resection, but
      a zero 30-day mortality rate. The prognosis of those patients undergoing radical
      resection remains dismal. No patient survived longer than 30 months, 80% were
      dead within 1 year. Tumour recurrence and metastases were documented in 13
      patients (52%). In the unresectable group there were two deaths from intubation
      (9%). The mean hospital stay for this group of patients was 12 days. The mean
      duration of survival in the group was 5.4 months, 70% of patients dying within 6
      months and 95% dead within 1 year. The value of radical surgery in patients with
      adenocarcinoma of the gastric cardia is questioned.

PMID- 2221773
TI  - Clinical and pathological effects on the rabbit's eye of some plant-derived
      ophthalmic swabs.
AB  - The stems of corn, millet, sugar cane and the banana leaf frond excite some
      clinical and pathological effects in the rabbit's eye when implanted either into
      the anterior chamber (AC) or subconjunctivally. These effects have not been sight
      threatening. The materials can either be left to be cleared by the body's
      phagocytes when they produce mild inflammatory reaction or removed surgically if
      the inflammatory response is moderate when fragments have been left
      intraocularly.

PMID- 2221774
TI  - Blood transfusion and surgery: the effect of growth of a syngeneic sarcoma.

PMID- 2221775
TI  - Optimal operative treatment in acute septic complications of diverticular
      disease.

PMID- 2221776
TI  - The incidence of congenitally absent foot pulses.

PMID- 2221777
TI  - Educating adults: principles for postgraduate education in surgery.

PMID- 2221778
TI  - [Boerhaave's syndrome].
AB  - Spontaneous esophageal perforation (Boerhaave syndrome) is a life-threatening
      emergency. It usually has misleading clinical manifestations and causes severe
      complications. In the presence of the clinical manifestations: vomiting, pain,
      emphysema, this diagnosis must be considered and confirmed by radiological
      evaluation of the chest and the esophagus. We report two cases and we describe
      the severity of this syndrome, its cause, its pathogenesis, and its
      characteristic clinical features and radiological signs.

PMID- 2221779
TI  - [Agenesis of the right lobe of the liver. Apropos of a case].
AB  - The authors describe a recent case of agenesis of the right lobe of the liver.
      Such cases are rare and can be diagnosed with state of the art imaging
      modalities, ultrasound and computed tomography, which permit early diagnosis and
      help avoid liver complications of cirrhosis, cholangiocarcinoma and hepatoma.
      This type of congenital anomaly can be associated with biliary tract disease,
      portal hypertension or other congenital anomalies.

PMID- 2221781
TI  - [Fracture of the base of the first metacarpus].
AB  - The authors report a group of 73 cases of fractures of the base of the first
      metacarpal treated between 1974 and 1989. Fifty-three articular fractures (73%)
      and 20 non-articular fractures are described. Sixty-eight patients were treated
      surgically: 49 diverging pin insertions were used, 15 Lars Thoren technique, 5
      rigid osteosyntheses with AO miniaturized material. Forty-two patients were seen
      again after one year or more. We classify the results as follows: very good: 29
      (69%), good: 10 (24%), bad: 3 (7%). The relative simplicity, the reliability and
      the good results of the double diverging pin insertion lead the authors to apply
      this method in most fractures of the base of the first metacarpal, either
      articular or extra-articular.

PMID- 2221780
TI  - [Hemangiopericytoma. Apropos of a case].
AB  - Haemangiopericytomas are ubiquitous tumours with an equivocal clinical and
      radiological expression. They generally have a slow course and the lesions are
      usually revealed by a non-specific mass effect on adjacent structures. The
      authors report a case of subcutaneous haemangiopericytoma of the elbow which
      presented clinically as a vascular malformation. Amongst the various imaging
      techniques performed, only arteriography defined the vascular nature of the
      lesion and should have suggested the diagnosis of haemangiopericytoma on the
      basis of classically described specific signs. Instead of preserving the muscular
      environment, the surgical resection had to be extensive because of the poorly
      determined malignant potential of the tumour.

PMID- 2221782
TI  - [Three-dimensional imaging of the carpus].
AB  - Since 1987, the authors have developed three-dimensional (3D) imaging of the
      carpus. This reconstruction based on 30 CT scans of the carpus is a new approach
      to imaging and allows spatial visualisation of the complex shapes of the carpal
      skeleton from all angles. The development of this technique should lead to a
      better understanding of the intimate physiology of the carpus and should allow
      the development of a real simulator of the wrist for precise planning of surgical
      procedures (osteotomy, intracarpal arthrodeses, etc.). It also helps to elucidate
      complex pathological images which are not always easy to interpret on CT scans.

PMID- 2221783
TI  - [Radiographic views in hand surgery].
AB  - Numerous radiographic views are available for visualisation of the squeleton of
      the hand. After an analysis of the literature, the authors selected those
      approaches which are simple and yield the best results.

PMID- 2221785
TI  - [Current data on iron overload].

PMID- 2221784
TI  - [MRI of acute myocardial infarction with injection of Gd-DOTA (15 patients)].
AB  - We studied 15 patients 4 to 8 days after myocardial infarction by using ECG gated
      MR before and after administration of 0.2 mmol/kg Gd-DOTA. The diagnosis in each
      patient was confirmed by electrocardiographic criteria, elevated levels of
      fractionated creatine kinase (CK) isoenzyme, thallium scintigraphy,
      ventriculography and coronarography. T1-weighted, spin-echo images, were obtained
      before and immediately after injection of Gd-DOTA and were repeated 15 min later.
      The site of infarction was visualised in 10 patients as an area of high signal
      intensity after the injection of Gd-DOTA. Contrast between normal and infarcted
      myocardium was greatest 15 min after injection. Three patients were excluded
      because of failure to acquire adequate MR studies. In 2 other patients, the
      infarct were not detected. Before injection of Gd-DOTA, only 2 infarcts were
      detected. These results suggest that Gd-DOTA can improve MR visualisation and
      detection of acute myocardial infarction.

PMID- 2221787
TI  - [Synchronous and resectable hepatic metastases of colorectal cancer: should there
      be a minimum delay before hepatic resection?].

PMID- 2221786
TI  - [Peroperative isotope detection].

PMID- 2221789
TI  - [Hepatectomy with total vascular exclusion. Anatomical principles based on 64
      dissections].
AB  - Intra-operative hemorrhage is the main surgical risk during liver resections.
      Nowadays hepatectomies for large or posterior liver tumors close to the
      hepatocaval junction can benefit from total hepatic vascular exclusion (HVE)
      involving portal triad exclusion and clamping of the inferior vena cava (IVC)
      below and above the liver. Anatomical aspects of HVE have been studied in 64
      subjects by segmental occlusive phlebographies of the IVC, injection of corrosive
      substances into the hepatocaval network, biometry of the retrohepatic IVC and
      serial sections of injected livers. A total HVE should exclude the right
      suprarenal and phrenic veins. Clamping of the suprahepatic IVC depends on the
      termination of the left inferior phrenic vein. Clamping of the subhepatic IVC
      must be retrohepatic: the right lobe of the liver has to be mobilized to free the
      right border of the retrohepatic IVC into which flows the right suprarenal vein
      40 +/- 20 mm above the right renal vein and under the superior right hepatic
      vein. Both suprahepatic and retrohepatic clamps excluding the retrohepatic
      portion of the IVC (46.6 +/- 13 mm) and the hepatocaval junction should come in
      contact behind the IVC without overlapping.

PMID- 2221788
TI  - [Conservative surgery of splenic injuries in adults: trend or progress?].

PMID- 2221790
TI  - [Obstruction of the common bile duct by a cystic duct cyst in the recipient after
      liver transplantation].
AB  - Four cases of tension mucocele of the cystic duct of the graft after orthotopic
      liver transplantation have been described in the English literature. We report
      the case of a mucocele of the recipient's cystic duct occurring in a patient who
      underwent liver transplantation for sclerosing cholangitis secondary to
      histiocytosis X. At variance with the 4 previously reported cases, this
      complication could be related to progression of the initial disease in the
      recipient's cystic duct. To avoid such a biliary complication in patients
      undergoing a liver transplantation for sclerosing cholangitis, resection of the
      extra-hepatic duct must be as large as possible and choledochojejunostomy seems
      to be the best procedure for biliary reconstruction.

PMID- 2221791
TI  - [Early stomach cancer. Do not miss it!].
AB  - It may be better to use the term of "superficial carcinoma" than "early gastric
      carcinoma". Out of 194 patients operated on for gastric carcinoma, 37 had a
      superficial carcinoma (19%). Seventeen had previously been treated for duodenal
      (n = 10) or gastric (n = 7) ulcer. Out of 23 barium meal examinations, 3 were
      normal. The macroscopic appearance at endoscopic examination was normal in 4
      patients. In these cases the carcinoma was identified in biopsies. At laparotomy
      the gastric wall was normal in 16 patients. Gastric resection was subtotal (n =
      28), total (n = 6), or partial (n = 1). The tumor was multifocal in 8 cases, and
      associated with intestinal metaplasia in 24 cases. The five-year actuarial
      survival rate was 77%. It is important to do not miss superficial carcinoma even
      in patient treated for peptic ulcer, and to perform biopsies even if endoscopic
      examination is normal. A subtotal gastrectomy may be performed with excellent
      results.

PMID- 2221792
TI  - [Factors influencing survival after resection of cancer of the cardia. Comparison
      of total esophagogastrectomy and upper pole esophagogastrectomy].
AB  - Total oesophagogastrectomy (TOG) is the best surgical technique for carcinoma of
      the cardia. However, oesophagogastric anastomosis is easier in upper pole
      oesophagogastrectomy (UPOG). This is a retrospective study excluding post
      operative deaths and palliative surgery. We studied the factors affecting the
      survival and then compared TOG (n = 15) and UPOG (n = 26) in carcinomas of the
      cardia. Bad prognosis was related to several factors: poorly differentiated
      adenocarcinomas, tumor size, lymph node involvement and residual tumor at the
      resection margins. The survival rate of resected carcinomas of the cardia was 22
      +/- 13%. No difference was noted between extended and limited resections. 5-year
      survival after UPOG was 20 + 18% and after TOG 11% (0-30) (p = 0.21). In stage
      1B, 5-year survival after UPOG 11% and TOG was 50% (19-81) and 33% (0-82) (p =
      0.54). In stages II and III A, 3-year survival after UPOG and TOG was 7% (0-20)
      and 0% (p = 0.16). For a given tumor size, 5-year survival is the same whatever
      the technique.

PMID- 2221793
TI  - [Perforation and rupture of the esophagus. Apropos of 35 cases].
AB  - A series of 35 oesophageal perforations from the period 1980-1987 is reported.
      Sixteen perforations followed oesophageal endoscopy, 10 were spontaneous, 8 were
      due to foreign bodies and one was post-operative. The delay in reaching the right
      diagnosis was less than 24 hours in 18 cases and more than 24 hours in 17 cases.
      Oesophageal leak was demonstrated in 86% of our cases by contrast study; in the
      others by rigid oesophagoscopy. Perforation occurred in the cervical oesophagus
      in 6 patients, thoracic oesophagus in 28 and abdominal oesophagus in 2 (one had a
      double perforation). Three patients were managed non operatively and survived.
      Cervical oesophagostomy and oesophageal diversion were used in 4 patients as
      primary treatment because of perforation occurring in caustic burn cases (2
      cases, both survived) or late severe sepsis (2 cases, both died). Two patients
      with neoplastic stricture were treated by oesophago-jejunal bypass without
      resection and partial oesophago-gastrectomy respectively: both survived. Direct
      suture and closure of the perforation were performed in 26 patients. Two died,
      one because of oesophageal leak. Post-operative localized leaks developed in 5
      other patients without any mortality and 4 healed with conservative management.
      The overall mortality rate was 11% (4 patients). All had a delayed diagnosis
      (more than 48 hours). We suggest that even in patients with delayed diagnosis of
      a non-malignant oesophageal perforation, direct suture and closure should be
      attempted under protection of functional oesophageal diversion and "contact
      drainage" to canalize a possible post-operative localized leak. Good oesophageal
      diversion can be achieved by naso-oesophageal suction and gastric suction through
      gastrostomy or with oesogastric antireflux procedure.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2221794
TI  - [What is the value of tracheobronchial fibroscopy in the assessment of esophageal
      cancer?].
AB  - The aim of this study is to evaluate the role of bronchoscopy in the assessment
      of resectability of esophageal carcinomas. From 1981 to 1986, 125 patients were
      referred for a carcinoma of the esophagus. Bronchoscopy was performed in 105
      cases. Patients were classified into 3 groups: group I: normal bronchoscopy (58
      cases: 55.2%); group II: compression, localized inflammation (35 cases: 33.3%);
      Group III: invasion (12 cases: 11.5%). Tracheo-bronchial abnormalities were found
      whatever the site of the esophageal carcinoma: 60% of cases for the upper third,
      40% for the middle third and 36% for the lower third. They were significantly
      more frequent when the esophageal tumor was larger than 5 centimeters.
      Correlation with CT scan was good in 75% of cases. Sensitivity and specificity of
      these two exams were similar and they appeared to be complementary. In group I,
      resection was impossible or palliative for bronchial reasons in 10% of cases,
      while resection was impossible or palliative in 35% of cases in group II. Lastly,
      resection was curative in 73.5% of cases in group I and in only 39% of cases in
      group II. Bronchoscopy must be systematically performed in carcinoma of
      esophagus. It may predict the palliative nature of resection if abnormalities are
      present, and may contraindicate the resection when invasion of the bronchial tree
      is discovered.

PMID- 2221796
TI  - [Pancreatic pseudotumor caused by isolated tuberculous retro-duodenopancreatic
      adenopathy. Apropos of a case].
AB  - The authors report the case of 32 year old woman with tuberculous lymph nodes of
      the common bile duct which simulated a tumor of the head of the pancreas. Despite
      modern radiological investigation (US, CT scan, IRM, US with aspiration biopsy),
      laparotomy was necessary to establish the diagnosis and to perform simple
      drainage.

PMID- 2221795
TI  - [Gastric esophagoplasty in the treatment of cancer of the esophagus].
AB  - Between March 1982 and December 1987, 112 patients with oesophageal cancer were
      treated by gastroplasty following oesophagectomy to restore gastrointestinal
      continuity. This technique was used in all oesophageal cancers regardless of
      their site, with the exception of paryngo-oesophageal and oesophago-cardio-fundal
      cancers. The overall mortality of 12.5% fell to below 6% during the last two
      years. The postoperative course was straightforward in 54.5% of cases. The most
      frequent complications were respiratory tract complications (19 cases of ARDS out
      of 112 patients, i.e. 17%) and fistulae at the oesophago-gastric anastomosis (9
      cases out of 112, i.e. 8%). The secondary complications were dominated by
      anastomotic stenoses (19/98, i.e. 19.3%).

PMID- 2221797
TI  - Differentiated thyroid cancer: outcome of treatment in 80 cases.
AB  - The author carried out a retrospective analysis, with 6-13 years follow up, of 80
      patients with differentiated thyroid cancer. The patients were treated with
      surgery, radioactive iodine, radiation therapy and suppression hormone therapy.
      The results, 5 year and 12 year survivals of 97% and 85%, are comparable with the
      results of much larger series with longer periods of follow up. The most
      significant prognostic factor was age at presentation. No patient below the age
      of 45 died from the cancer even if, at presentation, there was very advanced
      local disease or multiple distant metastases. In addition, sex, extent of local
      disease and presence of multiple metastases were also important in predicting
      survival. Cervical node involvement, by itself, did not worsen the prognosis and
      long survival with lung secondaries is possible.

PMID- 2221798
TI  - A study of non-toxic goitre.
AB  - A population study showed a prevalence of 2.8% for nontoxic goitres. The clinical
      significance of non-toxic goitres were not previously defined. This study
      examined 64 patients with non-toxic goitres which were classified clinically as
      diffuse (gp1), lobular (gp2) and nodular (gp3). They were studied in terms of
      thyroid antibodies, radioisotope scanning, ultrasonography and fine-needle
      aspiration cytology. The goitres were mainly nodular (69%), the rest were diffuse
      and lobular in equal numbers. Seventy percent of the nodular goitres had 1
      nodule. One case of diffuse goitre and half the lobular goitres had
      multinodularity demonstrated on imaging. Antithyroid antibodies were detected in
      20% of gp2, 7% of gp3 and none in gp1. Malignancy was found in 2% of gp2, 11% of
      gp3 and nil in gp1. A management strategy for non-toxic goitre was discussed.

PMID- 2221799
TI  - Humoral immune abnormalities in diabetes mellitus.
AB  - We previously showed that for Singapore diabetics, a low prevalence of islet cell
      antibodies (ICA) and insulin autoantibodies (IAA) were observed, unlike the high
      prevalence rates in Caucasian populations. In this report, we have measured other
      autoimmune markers (thyroid autoantibodies, thyrotrophin [TSH] receptor
      antibodies, rheumatoid factor and anti-dsDNA antibodies) to assess the extent of
      autoimmunity in our newly diagnosed diabetes patients and those with long
      standing diabetes. Results indicate that there is a raised prevalence of thyroid
      autoantibodies in diabetics compared to the general population. Thyroid
      autoantibodies occurred in 24.3% (28/115) of the patients; thyroid microsomal
      antibodies (16.5%, 19/115) was much higher than for thyroglobulin antibodies
      (1.7%, 2/115). Prevalence rates of thyroid autoantibodies were lower in diabetics
      who were newly diagnosed (21.6%, 11/51), compared to those with long-standing
      disease (25.5%, 14/55). Three patients (3/9) with gestational diabetes were also
      positive for thyroid autoantibodies. TSH receptor antibodies associated with
      Graves' disease, were found in two patients. However, they also had
      thyrotoxicosis. Five patients (4.3%, 5/115) were detected with rheumatoid factor,
      but were clinically asymptomatic. Anti-dsDNA antibodies were not detected in any
      of the subjects. The presentation of thyroid autoantibodies or rheumatoid factor
      with age did not coincide with diabetes-associated ICA and IAA. It may mean that
      inspite of prevalence of subclinical autoimmunity in diabetes, autoimmunity
      against beta-cell lesions is not associated with the overall autoimmune tendency
      in our diabetes.

PMID- 2221800
TI  - The pattern of diabetes in a primary health care setting in Singapore.
AB  - This is a study of Diabetes mellitus and its treatment in a single doctor
      government primary health care clinic in Singapore. Data was collected on the
      entire 349 patients with diabetes attending this clinic over a three month period
      in 1987. We found there was an increasing number of diabetics with age and a
      substantial proportion was above 70 years of age. Only 7% had their diabetes
      treated with diet alone and 9.6% were treated with insulin. Most (61%) patients
      were on tolbutamide, with 17.6% on glibenclamide and 5.9% on chlorpropamide.
      Hypertension was found in 38% of the diabetic patients but was not associated
      with increase in age of the patient. The duration of diabetes, but not the age of
      the patient, was positively associated with the number of drugs taken by the
      patient (chi-squared, p less than 0.05).

PMID- 2221801
TI  - Oral glucose tolerance test--can the reflectance meter replace laboratory-based
      methods?
AB  - Sixteen national servicemen detected to have glycosuria on routine medical
      examination were subjected to 3 successive oral glucose tolerance tests.
      Capillary blood glucose was measured by reflectance meter in the first test
      (oGTT1), venous whole blood glucose by Beckman Synchron CX3 Analyser in the
      second (oGTT2) and by both methods in the third (oGTT3). In oGTT1, 1 subject was
      classified as diabetic and 15 as Impaired Glucose Tolerance (IGT). In oGTT3,
      using capillary blood glucose, 1 was diabetic, 8 IGT and 7 normal. Using venous
      whole blood, in oGTT2, 1 was diabetic, 3 IGT and 12 normal as compared to 1
      diabetic, 4 IGT and 11 normal in oGTT3. There is considerable variation in
      classification as a result of using capillary blood glucose measured by
      reflectance meter as compared to the laboratory-based method. Capillary blood
      glucose measurement for oral glucose tolerance test cannot be recommended.

PMID- 2221803
TI  - Management and outcome of gestational diabetes in Alexandra Hospital, Singapore.
AB  - We analysed 216 patients with gestational diabetes over a 3 year period. These
      patients were managed by a diabetic team under a standardised protocol. Forty
      percent of these patients required insulin therapy. The incidence of pregnancy
      hypertension was 14.4%, macrosomia 8.8% and major congenital malformation 3.7%.
      The Caesarean Section rate was 34% and the overall Perinatal Mortality Rate was
      1.9%. However, neonatal morbidity rate remained high--44% of infants have had one
      neonatal complication and 17.6% had 2 or more complications. Pregnancy outcome
      was further analysed among patients with different degrees of glucose intolerance
      at diagnosis. We noted that both macrosomic rate, neonatal morbidity rate, as
      well as proportion of patients requiring insulin were higher in the group with a
      higher degree of glucose intolerance. There was, however, no difference in
      incidence of hypertension or hydramnios in the different subgroups.

PMID- 2221802
TI  - Effects of low dose guar in non-insulin dependent diabetic patients.
AB  - Thirteen non-obese, non-insulin-dependent diabetic patients were given guar
      granulate in an average dose of 7.1 grams daily for 8 weeks. The mean
      fructosamine fell from 3.3 +/- 0.69 mmol/L (p less than 0.01). Mean glycosylated
      haemoglobin (HbA1c) fell from 8.17 +/- 2.2% preguar to 7.67 +/- 1.81% (1 = ns)
      and to 7.39 +/- 1.23% (p = ns) at 8 weeks and 12 weeks postguar respectively.
      Eight weeks after the discontinuation of guar fructosamine rose to 3.61 +/- 0.95
      mmol/L (p less than 0.05) while HbA1c rose to 8.23 +/- 2.08% (p = 0.05). There
      were no significant changes in fasting blood glucose, lipids, and body weight.
      Mild gastrointestinal side-effects occurred in 11 patients during the treatment
      with guar. It is concluded that daily ingestion of low dose guar modestly
      improves glycaemic control, such improvement dissipating by 8 weeks following
      cessation of its use.

PMID- 2221804
TI  - The value of C-peptide level measurements in diabetes mellitus.
AB  - A prospective study of 27 patients with diabetes mellitus was done to assess
      their basal and glucagon stimulated C-peptide levels. Based on recommended cut
      off values for both basal and stimulated C-peptide levels, these patients were
      subsequently classified as insulin or non-insulin requiring diabetics. As in most
      other studies, we demonstrated a good correlation between the basal and glucagon
      stimulated C-peptide levels. Of the 8 patients on insulin therapy prior to this
      test, we found that only 2 actually required insulin i.e. had poor pancreatic
      reserve. Of the remaining 19 patients who were on diet and/or oral hypoglycaemic
      agents, we found that only one newly diagnosed diabetic had a definitive
      indication for insulin therapy. Among the other diabetics with poor control
      despite being on oral hypoglycaemic therapy, we found they had good islet cell
      secretory capacity for insulin.

PMID- 2221806
TI  - An amperometric measurement--the ExacTech pen meter.
AB  - A new device based on amperometric measurement is currently available for
      diabetic patients to perform blood glucose tests for self-monitoring. The meter
      (Exac TechR) which comes configured as a pen, is extremely simple to use. It
      takes only 30 seconds for a blood glucose reading to be determined and virtually
      eliminates user errors commonly associated with colour reagent test-strips. An
      assessment of the technical aspects--precision and accuracy, was carried out in
      comparison with a reference analyser. Analysis of 174 venous blood samples (range
      26-412mg/dl) indicated that ExacTechR gave acceptable accuracy for values greater
      than 151mg/dl but less accurate at less than 150mg/dl. Precision, assessed with
      seven glucose concentrations (52-300mg/dl), gave an average CV of 4.3% (2.6
      5.2%). Data obtained from two other ExacTechR meters demonstrated similar
      precisions. Anticoagulants affected ExacTechR measurements. Compared to plain
      blood, blood glucose measurements with the ExacTechR using fluoride-oxalate, EDTA
      and heparinised blood, showed a mean deviation of +22%, -4% and -1.9%
      respectively.

PMID- 2221807
TI  - Serum fructosamine concentrations in Singapore pregnant women.
AB  - Serum fructosamine levels in women at pregnancy (28 weeks' gestation) were
      determined. The women (n = 99) also participated in an oral glucose tolerance
      test (OGTT) with a 75g liquid glucose load, to determine their glucose tolerance.
      At 32 weeks' gestation, seventy-nine of them repeated the oral glucose tolerance
      test and fructosamine measurement. Results showed that fructosamine levels in
      pregnant women with normal glucose tolerance (2.20 +/- 0.19 mmol/l, n = 76), were
      not statistically different from those with glucose intolerance (gestational
      diabetes: 2.19 +/- 0.22 mmol/l, n = 23) at 28 weeks' and also 32 weeks'
      gestation. However, serum fructosamine levels in pregnant women were lower than
      those in non-pregnant subjects. Serum fructosamine measurement is not a
      sufficiently sensitive test for diagnosis of gestational diabetes.

PMID- 2221805
TI  - Home glucose monitoring in management of diabetes in pregnancy in Singapore.
AB  - The incidence for diabetes in pregnancy for 10,941 deliveries in the department
      over a 3 1/2 year period is 5.04% (551 patients). Of these, 33.2% (183 patients),
      were recruited for home glucose monitoring programme. The gestational diabetics
      form 76.3%, while pregestational diabetics form 23.7% of the patients. The total
      period of hospitalisation was less than 4 weeks in 89.4% of patients. The
      corrected (excluding those with birthweight of less than 1000 G) perinatal
      mortality rate was 5.78 per 1000.

PMID- 2221808
TI  - Diabetic retinopathy--results of a two year screening programme in two medical
      units in Singapore.
AB  - Three hundred patients with Diabetes Mellitus from 2 medical units in Singapore
      were screened for retinopathy over a 24 month period. Prevalence of retinopathy
      in this population was 38% with sight-threatening retinopathy in 17%. Risk
      factors associated with retinopathy included a longer duration of disease, the
      presence of hypertension, nephropathy and poor glycaemic control. Prevalence of
      retinopathy was higher in females. Malays and Indians had higher prevalence of
      retinopathy than Chinese.

PMID- 2221809
TI  - Epidemiology of diabetes mellitus in the Asia-Pacific region.
AB  - The complex interaction between genetic and environmental factors in the
      causation of diabetes mellitus is well illustrated by the epidemiology of
      diabetes in the Asia-Pacific region. Among the Chinese, the prevalence of
      diabetes is uniformly higher among Chinese living outside China than in the
      Chinese in The People's Republic of China. Similarly among the Indians, the
      prevalence of diabetes is universally higher in those who have settled outside
      India than in Indians in India. In the Pacific populations, diabetes is much
      commoner among the Nauruans and Fiji Indians. Throughout the Asia-Pacific
      countries, economic progress and urbanisation have a uniformly deleterious effect
      on diabetes. A better understanding of the hereditary and environmental factors
      in the causation of diabetes is required to halt and reverse the rising
      prevalence of diabetes in the Asia-Pacific region.

PMID- 2221810
TI  - Pathogenesis of type 1 and type 2 diabetes mellitus.
AB  - The majority of patients with diabetes mellitus can be classified as suffering
      from either Type 1 or Type 2 diabetes. The pathogenetic pathways for these two
      categories of diabetes appear to be distinct and separate. Both forms of diabetes
      have a genetic as well as environmental component in their pathogenesis. Type 1
      diabetes has a weaker genetic link; its association with HLA antigens is well
      established. Type 2 diabetes has a stronger genetic association but the exact
      gene or genes responsible is unknown. The environmental trigger in Type 1
      diabetes may be a viral infection while urbanisation, obesity, physical
      inactivity and stress may trigger the development of Type 2 diabetes. Type 1
      diabetes is a chronic autoimmune disease where beta cell destruction may occur
      over a number of years before clinical diabetes is diagnosed. Type 2 diabetes is
      the result of an interplay of relative insulin deficiency or a defect in insulin
      release together with insulin resistance. Hyperglycaemia perpetuates the problem
      of beta cell defect and insulin resistance. The understanding of pathogenesis of
      diabetes is the key to prevention and treatment of diabetes mellitus.

PMID- 2221811
TI  - Diabetes education: the Singapore experience.
AB  - Diabetes Mellitus is one of the world's major health problems in the developed
      and developing countries. With increasing industrialization and urbanisation,
      there is an increasing frequency of diabetes in every decade.

PMID- 2221812
TI  - Diabetes mellitus and its chronic complications in Singapore: an increasing
      healthcare problem.
AB  - We studied the prevalence of diabetes mellitus in Singapore and compared it to
      the study conducted ten years previously. A rise in prevalence rates from 2.0% to
      4.7% was demonstrated. Impaired glucose tolerance (IGT) was studied for the first
      time, and a prevalence rate of 0.9% was found. Findings on chronic complications
      of diabetes were also reported. A high frequency of coronary heart disease and
      hypertension were detected in both diabetic and IGT subjects. Obesity and
      hyperlipidaemia were identified as important risk factors. This study
      demonstrates the scope and impact of diabetes mellitus as a major healthcare
      problem in Singapore. Strategies directed at prevention and control of this
      disease needs to be implemented so as to check its rising trend.

PMID- 2221814
TI  - The use of luteinising hormone releasing hormone and its analogues for induction
      of ovulation and ovarian stimulation for in-vitro fertilisation.
AB  - The use of subcutaneous pulsatile luteinising hormone releasing hormone (LHRH)
      for induction of ovulation in patients with hypogonadotrophic hypogonadism is
      efficacious and safer compared to human menopausal gonadotrophin (hMG) because of
      the lower risk of ovarian hyperstimulation and multiple pregnancy. In clomiphene
      citrate (CC) nonresponsive cases of polycystic ovarian disease (PCOD), the major
      advantage of pulsatile LHRH is that when ovulation occurs, it is usually uni
      follicular. In cases of PCOD, we have found that if pulsatile LHRH alone fails to
      induce ovulation, addition of clomiphene citrate or a small dose of follicle
      stimulating hormone (FSH) will augment its action and allow, in the majority of
      cases, the threshold of stimulation to be reached that would be sufficient to
      induce ovulation but not produce clinical hyperstimulation or multiple pregnancy.
      LHRH analogues to desensitise the pituitary prior to ovarian stimulation with hMG
      have been recently used in in-vitro fertilisation (IVF). We have compared the use
      of the LHRH analogue, buserelin (Hoechst, UK) + hMG with clomiphene + hMG for
      ovarian stimulation in IVF in a number of prospective studies. In this review,
      the role of pituitary desensitisation in IVF is discussed in the light of our
      results. We have found that although the mean number of oocytes, the implantation
      rate and pregnancy rate per embryo transfer are higher in patients who receive
      buserelin + hMG, the differences are not statistically significant. The length of
      time taken to achieve pituitary desensitisation is increased in patients who have
      PCOD or who form ovarian cysts in response to the administration of
      buserelin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221813
TI  - The gonadotrophin surge in humans: its mechanism and role in ovulatory function-
      a review.
AB  - The presence of the positive feedback by oestrogen resulting in the mid-cycle
      gonadotrophin surge in women distinguishes the female's feedback control of
      gonadotrophin secretion from that in males. The gonadotrophin surge is an event
      crucial for final oocyte maturation, ovulation and subsequently for corpus luteum
      function. In this article, the roles of oestrogen, progesterone and testosterone
      in the regulation of the gonadotrophin surge are reviewed. Evidences appear to
      support the suggestion that an oestradiol pulse of sufficient potency and lasting
      for an adequately long duration alone is sufficient to trigger off the LH surge.
      Progesterone has a biphasic effect on LH secretion, and although not required for
      the initiation of the LH surge, may play a role in maintaining the LH peak.
      Testosterone, on the other hand, does not modulate the LH surge mechanism in man.
      Dysfunction of the gonadotrophin surge mechanism may account for some forms of
      ovulatory disorders: amenorrhoea and in some cases of delayed or precocious
      puberty. In patients with polycystic ovary syndrome (PCOS), different degrees of
      dysfunction of the gonadotrophin surge mechanism have been shown.

PMID- 2221815
TI  - Persistent hypomagnesaemia following parathyroid surgery, hypermagnesuria as a
      possible cause.
AB  - A patient who had prolonged hyperparathyroidism with extensive bone involvement
      developed delayed post-surgical complications of pseudogout and the hungry bone
      syndrome with persistent hypocalcaemia and hypomagnesaemia. Although urinary
      calcium excretion was appropriate for the hypocalcaemia, there was severe
      excessive renal loss of magnesium despite the hypomagnesaemia. Renal magnesium
      excretion returned to normal only after correction of the hypocalcaemia.
      Hypermagnesuria may be an important cause of resistant hypomagnesaemia after
      parathyroid surgery.

PMID- 2221816
TI  - Non-functioning cyst of the adrenal gland--a case report.
AB  - Adrenal cysts are a rare entity. Only about 300 cases have been reported
      throughout the world. A case of an asymptomatic, benign, non-functioning adrenal
      cyst of the left adrenal gland is presented. Pre-operative diagnosis is usually
      by incidental imaging findings as the majority of adrenal cysts are asymptomatic.
      The adrenal cyst in this case was detected on an abdominal ultrasound for the
      investigation of jaundice, and confirmed by a CT scan examination. Selective
      biochemical studies are needed to assess adrenal function, and here they were
      normal. Simple surgical enucleation of the cyst, with preservation of remaining
      adrenal tissue is the treatment of choice.

PMID- 2221817
TI  - A Chinese family with Wolfram syndrome presenting with rapidly progressing
      diabetic retinopathy and renal failure.
AB  - We describe a Chinese family with three siblings, all females, presenting with
      the Wolfram Syndrome. All three cases had almost similar clinical presentation of
      insulin-dependent diabetes mellitus, with rapid development of severe renal and
      retinal complications. Two siblings died at age thirty and thirty-one years of
      end-stage renal failure. All three cases had visual symptoms since early
      childhood progressing rapidly to loss of vision. Two of the three siblings had
      severe diabetic retinopathy requiring laser photocoagulation. These presentations
      are in contrast to most reported cases of the Wolfram syndrome where advanced
      diabetic eye complication is a rare feature. We also present several features
      present in one of the siblings, viz., microcephaly, microstomia, clinodactylyl,
      brachydactylyl, empty sella syndrome and severe hypoplasia of the right internal
      carotid vessels associated with mild narrowing of the left internal carotid
      artery which have not been previously described.

PMID- 2221818
TI  - [18-Hydroxycorticosterone, 18-hydroxydesoxycorticosterone. Why, when, how to
      determine plasma levels in some adrenal pathologies].
AB  - The authors review some current ideas concerning the role of 18-hydroxylated
      corticosteroids as mineralocorticoids themselves and as possible precursors of
      the principal mineralocorticoid, aldosterone. In particular, the physiological
      and pharmacological agents affecting their secretion are discussed together with
      a description of the methods used for their analysis in plasma in the department
      of Clinical Biochemistry Pitie-Salpetriere. Finally, the value of these assays in
      the differential diagnosis of mineralocorticoid hypertension and inborn errors of
      corticosteroid biosynthesis is assessed and the constraints on sampling technique
      listed.

PMID- 2221819
TI  - [Stress and immunity. The role of stress in auto-immunity of Basedow's disease].
AB  - The possible influence of stress on the immune system, long since suspected by
      the clinicians in their daily practice, was confirmed by human and animal
      studies, some of which being recent. Stress generally exert an immunosuppressive
      effect, but some of its characteristics (nature, duration, intensity,
      controllability of the stressing situation) can modulate this response,
      amplifying or reversing it. The concerned mechanisms are complex, involving the
      autonomic nervous system, the hypothalamo-pituitary complex and its target-glands
      through hormonal receptors born on immunocompetent cells. The immune system,
      conversely, is able to inform the brain about the interference of non cognitive
      stimuli (viruses, bacteria, tumors) through immunologic cell-derived
      immunohormones active in the central nervous system. Thus, close immune
      neuroendocrine interactions exist, in order to cope with stress of all kinds. The
      stress can act in Graves' disease by depressing the T suppressive function via
      the hypothalamo-pituitary-adrenal axis, by eliciting the secretion of
      catecholamines capable of initiating an hyperthyroidism, by facilitating through
      its immunosuppressive action a viral infection that can have a part in initiating
      the auto-immune process.

PMID- 2221820
TI  - [Induction of ovulation, with pulsatile GnRH by subcutaneous route in amenorrhea
      of hypothalamic origin].
AB  - Twelve patients affected by secondary amenorrhea of hypothalamic origin,
      resistant to Clomiphene Citrate treatment, were treated for 2 consecutive cycles
      with subcutaneous pulsatile administration (s.c.) of Gn-RH by computerized
      portable pump (Ziklomat-Ferring) at a dose of 20 mcg every 60-90 minutes for a
      total of 20 cycles. On the average 85% of ovulatory cycles and 30% of pregnancies
      per cycle were obtained with this therapy. The number of ovulatory cycles and
      pregnancies obtained in the second cycle of treatment were in percentage higher,
      with respect to the first cycle of treatment. Only one subject, not responsive to
      both cycles of s.c. administration, underwent an intravenous therapy with
      positive results.

PMID- 2221821
TI  - [Familial primary empty sella turcica. Apropos of a family with 3 cases].
AB  - Three members of a family, the father and two children, present a primary empty
      sella. The only clinical symptom is headache. The ophthalmologic examen, and the
      pituitary function are quite normal. No other anomaly is associated. This type of
      cases has never been published.

PMID- 2221822
TI  - [Dysthyroidism and Parkinson's disease].
AB  - Associations between hyperthyroidism and Parkinson disease have been reported.
      The treatment of the hyperthyroid state seems to improve the extrapyramidal
      symptomatology. We report a case of a woman suffering from Parkinson disease and
      hypothyroidism. The treatment with thyroxine increased parkinsonian tremor.
      Dopamine regulation of TSH circadian and pulsatile release is not clear. These
      observations stress the possible role of thyroid hormones in regulating
      dopaminergic metabolism.

PMID- 2221823
TI  - Use of DNA amplification (PCR) and direct DNA sequencing in the characterization
      of C4 alleles.
AB  - A procedure for detailed characterization of individual C4 alleles has been
      developed. DNA containing the two polymorphic clusters of C4 was amplified in the
      polymerase chain reaction (PCR). Direct DNA sequencing of amplified DNA was then
      performed by a modification of previously described techniques. The results were
      confirmed by M13 sequencing. Single C4A3 and C4B1 allele sequences were in
      accordance with previous reports. An individual typed C4A3B1 revealed double
      bands in the autoradiogram in the positions corresponding to the polymorphic
      nucleotides. We did not find the reported thymine in position 3641 specific for
      the C4A4 allele in an individual typed C4A4B2.

PMID- 2221824
TI  - Assignment of the human nicotinic acetylcholine receptor genes: the alpha and
      delta subunit genes to chromosome 2 and the beta subunit gene to chromosome 17.
AB  - The chromosomal assignments of the genes coding for the alpha, beta and delta
      subunits of the human nicotinic acetylcholine receptor have been determined from
      a panel of somatic cell hybrids and by direct in situ hybridization. The results
      localize CHRNA to 2q24-2q32. CHRNB to 17p11-17p12, and CHRND to chromosome 2q33
      2qter.

PMID- 2221825
TI  - A cytogenetic and molecular reappraisal of a series of patients with Turner's
      syndrome.
AB  - The results of a cytogenetic and molecular reinvestigation of a series of 52
      patients with Turner's syndrome are reported. No evidence of Y chromosome
      material was found among the patients with a 45,X constitution but two patients
      were found to have a cell line with a r(Y) chromosome which was previously
      thought to be a r(X). The parental origin of the single X in the 45,X patients
      was maternal in 69% and paternal in 31%, a similar ratio to that seen among
      spontaneously aborted 45,X conceptuses. This suggests that X-chromosome
      imprinting is not responsible for the two grossly different phenotypes associated
      with a 45,X chromosome constitution. Approximately half of the structurally
      abnormal X chromosomes were maternal in origin and half paternal. This
      observation is consistent with either a meiotic or post-zygotic mitotic origin
      and at variance with the predominantly paternal origin reported for autosome
      structural abnormalities.

PMID- 2221826
TI  - Standard maps of chromosome 10.
AB  - To achieve consensus more exact definitions of genetical maps are required, of
      which standard, comprehensive and skeletal might be some. A standard genetic map
      gives distance from pter in centimorgans (cM), uses the international
      nomenclature for assigned loci, is sex-specific, and allows as well as possible
      for interference and typing errors. A standard physical map gives distance from
      pter in megabases (Mb). A standard map is called comprehensive if it aims to
      include all syntenic loci, and skeletal if it is limited to loci whose order is
      well supported. Loci with established order are called skeletal, and are used to
      define regional assignments of other loci. These principles are illustrated using
      the CEPH data for chromosome 10. Map lengths by multiple 2-point analysis under
      supported interference are in good agreement with other evidence, but multipoint
      mapping gives a substantial overestimate. There are currently 21 loci in the
      skeletal genetic map and 40 loci in the comprehensive genetic map. From these
      data, cytogenetic assignments, and partial genetic maps the physical location has
      been estimated for 85 loci. MEN2A is in a region close to the centromere in which
      male recombination per megabase is much reduced. Order of DNA markers in this
      densely mapped region has not been determined, and therefore the exact location
      of MEN2A is uncertain, although it is likely to lie between D10S34 and D10S30 and
      close to D10S11.

PMID- 2221827
TI  - The linkage detection problem.
AB  - Linkage data in man are usually analysed on families lacking a full set of
      grandparents on the assumption that there is one locus relating to an abnormal
      phenotype, the test locus. The basic problems of establishing linkage of this
      locus to another locus, the marker locus, with a defined likelihood and of
      estimating the recombination fraction were resolved by Morton (1955). However,
      the likelihood ratio derived after estimating the most likely recombination
      fraction is widely misunderstood to be a direct measure of the likelihood of
      linkage while the bias of estimates conditional on some likelihood criterion
      derived from the same data is usually ignored. Since data are limited this
      tolerance of excessive confidence in detecting linkages and a consistent tendency
      to underestimate recombination fractions is justified but the expected errors are
      not small and they are readily magnified when multiple loci are involved.
      Multiple markers provide further opportunities for detecting false linkages
      although the corrections required are known. The problems imposed by multiple
      loci at which mutations lead to a common phenotype have so far had little
      consideration. As most proteins are multimers whose units are not necessarily
      coded for by neighbouring loci, and as disturbances to any of several enzymes
      acting in series may lead to similar consequences, the assumption of a one-to-one
      relationship between a locus and a phenotype will usually be wrong.

PMID- 2221829
TI  - [Autosomal dominant polycystic kidney in adults and transplantation].
AB  - Seventy-six patients with polycystic kidneys were followed in the Bicetre renal
      transplantation unit. Fifty four were transplanted. Fifty two nephrectomies were
      performed in these patients essentially because of the size of the kidney and for
      renal infections. Fifty four patients were transplanted at a mean of 44 years.
      The actuarial survival of the patients at one year and at three years was 92% and
      88% and the actuarial survival of the grafts at one year and at five years was
      87% and 71%. These results are comparable to those obtained in other patients
      transplanted in the unit. Pre-transplantation nephrectomy and the patient's age
      do not aggravate the prognosis. Nephrectomy may be justified in these patients
      when they must be transplanted as transplantation currently gives very good
      results.

PMID- 2221828
TI  - [Autosomal dominant polycystic kidney in adults].
AB  - The authors present a general review of autosomal dominant transmission of
      polycystic kidneys. It represents 10% of all causes for haemodialysis. Its
      penetrance is close to 100%. The dominant aetiology at the present time is
      obstruction due to hyperplasia of the tubular epithelium which induces cystic
      dilatation which extends to involve all of the nephron. The cysts are cortical
      and medullary. The diagnosis is based on an association of enlarged kidney and a
      family history. The commonest associated abnormalities are hepatic cysts in 60%
      of cases, cerebral aneurysms in 10 to 20% of cases and colonic diverticulosis in
      80% of cases. At the stage of renal failure, patients must be treated for
      hypertension and deterioration in nephron function must be prevented by a low
      protein diet. When the patient reaches the stage of renal failure and must be
      dialysed, he must be rapidly enrolled in a transplantation programme as the
      actuarial graft survival is more than 80% at 1 year and more than 70% at 5 years.

PMID- 2221830
TI  - [Percutaneous nephrostomy in the treatment of pyonephrosis. A comparative study
      apropos of 36 cases].
AB  - This study is a comparison of the treatments used in 36 patients suffering from
      pyonephrosis. The patients were subdivided in two groups: cases having undergone
      previous percutaneous drainage; and cases having undergone primary nephrectomy.
      These latter cases presented a high complication rate. We believe that
      preliminary drainage by percutaneous nephrostomy, constitutes the procedure of
      choice, when ever possible, to drain the kidney and prepare the patient for
      nephrectomy.

PMID- 2221831
TI  - [Endo-urology in diseases of the upper urinary tract other than tumors and
      calculi].
AB  - Thirty-three patients underwent percutaneous treatment for upper urinary
      obstructive disease in our Institute. Cold-knife incision of 16 cases of uretero
      pelvic junction obstruction and 4 cases of infundibular stenosis was performed.
      Balloon dilatation of the caliceal neck was performed in 1 patient with caliceal
      diverticulum. In 4 of the patients treatment failed requiring open surgical
      correction. Thirteen patients presented iatrogenic ureteral obstruction: balloon
      dilatations or cold-knife incisions were performed. Four of the 9 patients
      evaluable obtained significant benefit from the endourological treatment.
      Endopyelotomies for UPJ obstruction seem effective and reduce morbidity and
      operating times. Ureteral obstructions appear less responsive to the endo
      urological approach. Definitive conclusions concerning the effectiveness of these
      procedures requires larger series of patients and longer follow-up.

PMID- 2221832
TI  - [Current status of urethral stenosis in tropical Africa/ Apropos of 71 cases].
AB  - In this study of seventy-one cases, the authors report the characteristics of the
      clinical course and treatment of urethral stricture in tropical Africa. In this
      special context, only 38% cases could benefit from a curative procedure on the
      urethra, whereas in 43.6% of patients, local complications only allowed
      palliative treatment (periodic dilatation of urethra, perineal uretherostomy or
      definitive cystostomy).

PMID- 2221833
TI  - [Obstructive anuria in children. Apropos of 22 cases].
AB  - The authors report twenty two cases of obstructive anuria observed in children.
      Causes are diverse: 6 cases were observed during the course of tumors, 4 cases
      were secondary to bilateral renal stones (or unilateral in a single kidney), 3
      cases were observed before surgical correction of latent or well tolerated
      congenital uropathy, and 9 cases in the immediate postoperative period (including
      8 after antireflux surgery). In the emergency situation, treatment of obstructive
      anuria is based on urinary diversion ideally by percutaneous nephrostomy under
      ultrasonic control. But prevention is the best treatment of anuria: treatment of
      urinary tract infections resulting in renal stones, in case of tumor,
      ultrasonographic survey of chronic upper tract dilatation: rigorous atraumatic
      operative technique avoiding any oedema.

PMID- 2221835
TI  - [Results of the surgical treatment of impotence due to venous leakage by
      insertion of a prosthetic venous tourniquet. 26 patients reviewed with a 1-year
      follow-up].
AB  - Twenty-six patients have been operated by pericavernoplasty with a band of
      synthetic material. After 1 year, 61.6% had a good result. Venous leaking is
      certainly a disease of the corpora cavernosa.

PMID- 2221834
TI  - [Varicocele in childhood and adolescence. Evaluation apropos of a series of 58
      cases].
AB  - 5 to 25% of the male adolescents present with a varicocele; only those cases
      inducing serious discomfort or affecting the development of the testis require
      surgical treatment. Nevertheless the results of surgery are disappointing with a
      high recurrence rate. Based on a better knowledge of the testicular venous
      drainage, it appears that the conventional high ligation of the spermatic vein(s)
      might not be sufficient to cure the varicocele, fifty-eight patients were
      operated upon using four different procedures. Only a complete and proximal
      ligation of all of the visibly dilated veins seems to prevent recurrences with a
      follow-up of at least one year. However, out of eleven cases treated with this
      original procedure, one patient, already operated upon twice without success,
      developed secondary atrophy.

PMID- 2221836
TI  - [Fracture of the corpus cavernosa. Apropos of 67 cases].
AB  - The authors report a series of sixty-seven cases of fracture of the corpus
      cavernosa, 2 of which were associated with partial rupture of the urethra. Most
      of the fractures (61 cases) were due to a deliberate manipulation of the erect
      penis. A coital "faux pas" was only reported in 6 cases. Early surgical
      treatment, drainage of the haematoma and suture of the corpus cavernosa prevented
      cicatricial fibrosis, curvature of the penis and distal flaccidity interfering
      with erection.

PMID- 2221837
TI  - [Exclusive piezoelectric lithotripsy in the treatment of calculi larger than 30
      mm (partial or complete coralliform, pyelic calculi)].
AB  - Thirty patients with partial or total staghorn stones or calculi larger than 30
      mm were treated by piezoelectric lithotripsy (PEL) monotherapy using an EDAP LT
      01 lithotripter with ultrasound guidance. Nineteen of these patients had pelvic
      stones; the other 11 had partial (9) or total (2) staghorn stones. All patients
      first underwent an initial lithotripsy session. No anesthesia or IV sedation was
      required in any case. If stone fragmentation was achieved during this first
      session, a double-J stent was inserted before the second lithotripsy session.
      Prior to the first session, 18 of 30 patients had sterile urine cultures; 12 of
      30 presented major distension of the excretory tract. Results were analyzed to
      determine the factors influencing the outcome of this therapy. Three months after
      the first session, patients were considered cured if their stones had completely
      disappeared according to plain abdominal films (14 of 30, 46%). In seven patients
      (23.3%) fragmentation had occurred but residual fragments remained (1 to 3
      fragments less than or equal to 4 mm). No fragmentation was obtained after the
      first session in nine patients (30.7%) (1 total staghorn stone, 8 pelvic stones).
      The mean number of treatment sessions was five (range, 1 to 15). Complications
      occurred in only 10% of patients (3 of 30): two steinstrassen and one acute
      pyelonephritis. Eighty-three percent of patients without major excretory tract
      distension and 55% of patients whose initial urine culture was sterile achieved a
      stone-free state. Therefore the best indications for PEL monotherapy for calculi
      larger than 30 mm are pelvic stones and partial staghorn stones and no major
      excretory tract dilatation in patients with sterile initial urine
      cultures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221838
TI  - [Emphysematous pyelonephritis. Apropos of a case].
AB  - Emphysematous pyelonephritis is a rare form of pyelonephritis that carries a very
      poor prognosis. This article reports a review of the literature on this condition
      and describes the clinical and roentgenographic criteria for diagnosis. Diagnosis
      rests on the presence of clinical manifestations of pyelonephritis with
      intrarenal air-filled images on the roentgenograms. Both the author's personal
      experience and the data from the literature confirm the need for urgent treatment
      combining antimicrobial agents effective against Escherichia coli, the most
      common causative agent, and surgery, which usually consists in a nephrectomy.

PMID- 2221839
TI  - [Treatment using an endo-urologic approach of stenoses following uretero
      intestinal anastomosis].
AB  - Twenty-one strictures following uretero-digestive anastomoses were treated by
      percutaneous transrenal dilatation. In 20 cases, an Olbert type angioplasty
      balloon on a guidewire was used. Rigid coaxial dilators were used in one patient
      after failure of the preceding technique and an electroincision was performed
      prior to dilatation in the remaining case. Overall, percutaneous transrenal
      dilatation was successful in nine patients, whereas ten dilatations failed and
      two patients are undergoing continued modeling with a mean follow-up of 16 months
      (range 1-42 months). Success rates by type of anastomosis were as follows:
      Bricker 5/12; Coffey 1/4; enterocystoplasty 2/4 and ureteroileovesical
      anastomosis 1/1. The date of development of the stricture, duration of modeling,
      and caliber of the indwelling catheter were apparently without influence on
      results. Because morbidity is low with percutaneous transrenal dilatation, this
      technique is advocated as first-line treatment, with surgery being reserved to
      failures.

PMID- 2221840
TI  - [Can CT scanner and MRI predict capsular invasion of local cancer of the
      prostate? A study of 20 radical prostatectomies].
AB  - Spread beyond the capsule is a poor prognosis factor in clinically localized
      carcinomas of the prostate; preoperative diagnosis is difficult and clinical
      evaluation usually underestimates tumor spread. This prospective study was
      undertaken to confront results of the conventional workup (rectal examination,
      transrectal ultrasonography and PSA) and of CT scan and MRI findings with
      findings upon the pathologic study of operative specimens following radical
      prostatectomy. Results show that the conventional workup remains the diagnostic
      gold standard and that CT scan yields no additional information. Technically
      faultless MRI with sections in the three planes is a good means for analyzing the
      capsule of the prostate.

PMID- 2221841
TI  - Cholinergic deficiency and frontal dysfunction in Parkinson's disease.
AB  - To investigate the influence of central cholinergic deficit on cognitive function
      in Parkinson's disease (PD), we compared the neuropsychological performance of a
      group of 20 patients who were treated with anticholinergic drugs (mean daily
      dose, 10.2 mg) with that of a group of 20 patients who received no
      anticholinergics. The two groups were matched for all the variables of
      parkinsonism and levodopa therapy. At the dose used, there was no significant
      difference between the two groups of patients for intellectual, visuospatial,
      instrumental, and memory function. In contrast, in the group that received
      anticholinergics severe impairment was observed on tests believed to assess
      frontal lobe function. These results suggest that the lesion of the ascending
      cholinergic neurons, which has been demonstrated post mortem in PD, may play a
      role in the subcorticofrontal behavioral impairment of this disease.

PMID- 2221842
TI  - Posthypoxic glucose supplement reduces hypoxic-ischemic brain damage in the
      neonatal rat.
AB  - We evaluated the effect of posthypoxic glucose supplement in a neonatal hypoxic
      ischemic animal model. Seven-day-old rats underwent bilateral ligation of the
      carotid arteries, followed by exposure to an 8% oxygen atmosphere for 1 hour. The
      extent of hypoxic-ischemic brain damage was assessed histologically 72 hours
      later. Glucose load immediately after the end of the hypoxic exposure reduced the
      volume of neocortical infarction to 37% of the unsupplemented value, and
      attenuated ischemic damage in the striatum and the dentate gyrus. At the end of
      the hypoxic exposure, the brain level of glucose was 0.3 mmol/kg and the level of
      lactate 9 mmol/kg. Glucose supplement produced a rapid rise in brain glucose
      level to 3 to 5 mmol/kg over the next 2 hours. Lactate in both brain and plasma
      gradually fell toward the baseline level during the first hour of recovery.
      Posthypoxic glucose supplement slightly retarded lactate restitution. At any
      period of this neonatal model, brain lactate levels did not exceed the toxic
      level, which is postulated to be responsible for cerebral infarction in adult
      ischemic models. These results illustrate the important role of glucose in the
      development of neonatal hypoxic-ischemic encephalopathy and the fact that full
      cortical infarction can develop even if brain lactate levels are low.

PMID- 2221844
TI  - A computer simulation of conduction block: effects produced by actual block
      versus interphase cancellation.
AB  - A reduction in compound muscle action potential (CMAP) amplitude and area
      following proximal versus distal stimulation is the accepted clinical hallmark of
      conduction block; however, quantitative criteria for determining conduction block
      remain ambiguous. In this study, digitized records of individual motor unit
      action potentials (MUAPs) elicited by incremental stimulation in vivo were
      arithmetically combined in a computer simulation of CMAP generation. Through
      simulation of possible phase interaction patterns of individual MUAPs, we have
      shown that abnormal temporal dispersion alone can produce reductions in CMAP area
      of up to 50%, values that are commonly thought to represent conduction block.
      Furthermore, by simulating conduction block without excessive temporal dispersion
      in defined subpopulations of axons, we have demonstrated the importance of the
      fastest conducting (largest MUAP) axons in determining CMAP amplitude and area.
      In conclusion, measurements of CMAP amplitude and area in determining conduction
      block may be misleading if there is significant abnormal temporal dispersion, and
      quantitation of the degree of conduction block is difficult without knowledge of
      which subpopulations of axons are affected.

PMID- 2221843
TI  - Relation of hyperglycemia early in ischemic brain infarction to cerebral anatomy,
      metabolism, and clinical outcome.
AB  - We studied the relation of serum glucose level measured in the first 12 hours of
      symptoms to the clinical findings, results of computed tomography (CT), and
      patterns of cerebral metabolism in 39 patients who had acute ischemic cerebral
      infarction. Structural damage was assessed by CT. Metabolic disruption was
      assessed using 18F-fluorodeoxyglucose and positron emission tomography (PET).
      Median initial serum glucose concentration was 155 mg/dl (6.7 mM). Clinical
      recovery was significantly poorer in patients with initial serum glucose levels
      higher than the median (p less than 0.05, chi square). PET tended to show normal
      results or minor abnormalities in patients with initial glucose levels less than
      the median, as opposed to lobar or multilobe abnormalities in patients with
      levels that were higher than the median (p less than 0.05, Kendall's Tau b). The
      severity of hypometabolism in the ischemic region, expressed as the percent
      asymmetry of local cerebral glucose metabolism between homologous brain regions,
      was greater in patients with initial glycemia concentrations higher than the
      median (p less than 0.001, t test). Relationships of serum glucose level with
      metabolic derangement and structural damage, but not outcome, held true in
      patients without a history of diabetes mellitus.

PMID- 2221845
TI  - Soluble interleukin-2 receptors in cerebrospinal fluid from individuals with
      various neurological disorders.
AB  - Soluble interleukin-2 (IL-2R) levels in the cerebrospinal fluid (CSF) were
      studied in infectious, inflammatory, degenerative, and neoplastic disorders to
      evaluate their usefulness as a marker for the presence of activated T cells, thus
      indicating an inflammatory process. CSF from control subjects and patients with
      stationary, progressive, and treated multiple sclerosis (MS); aseptic meningitis;
      lymphoid and nonlymphoid central nervous system (CNS) tumors; Alzheimer's
      disease, as well as serum from MS patients and control subjects were studied for
      levels of soluble IL-2R. A significant increase in CSF IL-2R levels was observed
      in patients with MS, meningitis, and lymphoid CNS tumors; the MS group showed the
      highest values. CSF from individuals with Alzheimer's disease and from patients
      with nonlymphoid tumors did not show significantly elevated values. Serum IL-2R
      levels were significantly higher in MS patients than in control subjects, but
      there was no significant correlation between individual serum and CSF IL-2R
      levels. This study suggests the presence of activated T-lymphocytes in the CNS of
      patients with MS.

PMID- 2221846
TI  - Multiple sclerosis is prevalent in the Zoroastrians (Parsis) of India.
AB  - Using Schumacher's classification, we determined the prevalence rate of
      clinically definite multiple sclerosis (MS) in the distinct but tiny Zoroastrian
      (largely Parsi) community in the adjacent cities of Bombay (latitude, 18.55
      degrees) and Poona (Pune). On prevalence day, 16 clinically definite cases of MS
      were counted, 14 in Bombay and 2 in Poona, from a total Zoroastrian population of
      50,053 and 3,399, respectively. The crude prevalence ratio was 26 per 100,000 for
      Bombay and 58 per 100,000 for Poona. The age-adjusted prevalence ratio for Bombay
      was 24 per 100,000, with 95% confidence limits of 13.1 to 40.3. These are much
      higher than the low rates believed to be prevalent in India, and are comparable
      with those found in parts of Europe and the United States.

PMID- 2221848
TI  - Relapse of infant botulism.
AB  - We report on 3 infants who had relapse of infant botulism after apparent
      resolution of clinical symptoms. This group represented 5% of the infants with
      confirmed infant botulism who were treated at our institution since 1976. The
      exact cause for these relapses was unclear, but three potential mechanisms are
      examined. There were no historical, clinical, or electrophysiological predictors
      of relapse. Although at the time of writing recovery from relapse appeared
      complete, close follow-up of patients recovering from a bout of infant botulism
      is necessary.

PMID- 2221847
TI  - Middle cerebral artery strokes causing homonymous hemianopia: positron emission
      tomography.
AB  - Eight patients were evaluated with 18F-fluorodeoxyglucose positron emission
      tomography between 3 and 30 days after isolated stroke involving the middle
      cerebral artery territory that caused homonymous hemianopia. Diffuse
      hypometabolism was present throughout the damaged cerebral hemisphere, even in
      cortical areas not obviously ischemic by clinical examination or neuro-imaging.
      Glucose metabolism in primary and association visual cortex of the damaged
      hemisphere was decreased by more than 47% (p less than 0.01). Metabolism in the
      undamaged hemisphere was less profoundly affected, but significant decrements
      were found in calcarine (40%; p less than 0.01) and lateral occipital cortex
      (35%; p less than 0.05).

PMID- 2221849
TI  - HLA-DR antigens in Kleine-Levin syndrome.

PMID- 2221850
TI  - Nicotine and tobacco-induced nystagmus.

PMID- 2221851
TI  - Capsaicin for the treatment of pain in Guillain-Barre syndrome.

PMID- 2221852
TI  - 115th annual meeting of the American Neurological Association. October 14-17,
      1990, Atlanta, GA. Abstracts.

PMID- 2221853
TI  - Newer uses of intravenous immunoglobulins as anti-infective agents.

PMID- 2221854
TI  - In vivo assessment of antimicrobial agents against Toxoplasma gondii by
      quantification of parasites in the blood, lungs, and brain of infected mice.
AB  - The in vivo effects of antimicrobial agents against Toxoplasma gondii were
      evaluated in mice that were infected intraperitoneally with 10(4) tachyzoites of
      the RH strain by determination of survival rates and study of the kinetics of
      growth of T. gondii in infected mice. At various intervals after infection,
      subcultures of serial dilutions of blood, lung, and brain homogenates were
      performed in fibroblast tissue cultures for determination of parasitic loads.
      Pyrimethamine (18.5 mg/kg per day), sulfadiazine (375 mg/kg per day), and
      clindamycin (300 mg/kg per day) were administered for 10 days from day 1 or day 4
      after infection. Untreated control mice died within 9 days and showed early and
      predominant lung involvement. All mice treated with sulfadiazine administered
      from day 1 survived and were apparently healthy; parasitic loads decreased early
      after treatment, but a relapse was observed 5 days after the cessation of
      therapy. When pyrimethamine was administered from day 1, 7 of 11 mice died within
      25 days; by determination of parasitic loads, the effect of pyrimethamine was
      only demonstrable from day 6, and a relapse was constantly observed after the
      cessation of therapy. When pyrimethamine and sulfadiazine were administered in
      combination, 100% of mice survived; when therapy was started at day 1, parasites
      remained undetectable; in mice treated from day 4, parasites were eradicated by
      day 8 but infection relapsed 8 days after the cessation of therapy. All mice
      treated with clindamycin from day 1 or day 4 died within 10 days, but parasitemia
      was always undetectable. These results indicate that study of the kinetics of
      parasitic loads in blood and organs may provide additional information on the
      effect of antimicrobial agents against T. gondii in regard to the evolution of
      the infection and may represent a reliable basis for the determination of
      therapeutic regimens in humans.

PMID- 2221855
TI  - Problems with current recommendations for susceptibility testing of Haemophilus
      influenzae.
AB  - We compared results of MIC and disk susceptibility tests on Haemophilus test
      medium (HTM) and those on comparative media. Ampicillin MICs were determined with
      seven ampicillin-resistant, non-beta-lactamase-producing (AmprNBLP) isolates by
      using HTM and supplemented brain heart infusion (sBHI) agar. Ampicillin and
      amoxicillin-clavulanate disk tests with 16 AmprNBLP strains, 18 ampicillin
      susceptible (Amps) isolates, and 17 ampicillin-resistant, beta-lactamase
      producing (AmprBLP) strains were performed by using five media: laboratory
      prepared HTM (PHTM), commercial HTM (CHTM), sBHI, enriched chocolate agar, and
      Mueller-Hinton chocolate agar. We observed that five of seven and three of seven
      AmprNBLP strains were misclassified as susceptible with PHTM (MIC, less than 2
      micrograms/ml) with inocula of 10(3) and 10(5) CFU, respectively, but were
      resistant with sBHI (MIC, greater than or equal to 2 micrograms/ml). Whereas
      Mueller-Hinton chocolate agar and enriched chocolate agar plates supported the
      growth of all 51 strains by the disk tests, 37% (19 of 51) and 8% (4 of 51) of
      strains did not grow on PHTM and CHTM, respectively. Lack of growth on PHTM was
      observed for all three phenotypes; 7 of 18 Amps, 4 of 17 AmprBLP, and 8 of 16
      AmprNBLP strains did not grow. The four strains that did not grow on CHTM were
      all AmprNBLP isolates. Zone sizes were significantly larger on PHTM than on the
      other media. Of the strains that were evaluable by the new National Committee for
      Clinical Laboratory Standards guidelines with either PHTM or CHTM, all Amps
      strains were classified as susceptible. Among the AmprBLP strains, CHTM correctly
      identified all as resistant, whereas PHTM detected two isolates to be
      intermediate. Among the AmprNBLP strains, CHTM and PHTM misclassified four (33%)
      and five (62%) isolates, respectively, as susceptible; an additional isolate was
      identified as intermediate on both media. We conclude that there is strain
      dependent growth on HTM, that adoption of this medium for routine Haemophilus
      susceptibility testing is problematic due to this growth variability, and that
      detection of AmprNBLP isolates would be unreliable.

PMID- 2221856
TI  - Pharmacokinetics of enoxacin and its oxometabolite following intravenous
      administration to patients with different degrees of renal impairment.
AB  - Enoxacin is a fluorinated quinolone with potential clinical use in the treatment
      of serious infections. Twenty-three patients (age, 19 to 87 years) with different
      degrees of renal function, including a group undergoing chronic hemodialysis,
      received enoxacin (400 mg) by intravenous infusion (1 h). Blood samples were
      collected before infusion; at the end of infusion; and at 5, 10, 20, 30, 45, 60,
      90, and 120 min and 3, 4, 6, 12, 18, 24, 48, and 72 h after infusion. Enoxacin
      and oxoenoxacin concentrations were measured by high-pressure liquid
      chromatography. Pharmacokinetic parameters (mean +/- standard deviation) were
      calculated by using a noncompartmental PK model according to creatinine
      clearances (in milliliters per minute). Total clearance of enoxacin decreased
      from 4.95 +/- 1.16 ml/min per kg in the group with normal creatinine clearance to
      0.76 +/- 0.21 ml/min per kg in the patients with severe renal failure (creatinine
      clearance, less than 15 ml/min), whereas the elimination half-life increased from
      4.5 +/- 1.0 to 20 +/- 5 h, respectively. The elimination of oxoenoxacin (the main
      metabolite of enoxacin) in urine was markedly decreased when creatinine clearance
      was less than 15 ml/min. Hemodialysis removed an insignificant amount of enoxacin
      and oxoenoxacin. These data indicate that as creatinine clearance falls below 30
      ml/min, the daily enoxacin dose should be reduced by half. During prolonged
      administration of enoxacin to patients with creatinine clearances of less than 30
      ml/min, the accumulation of oxoenoxacin might lead to unexpected side effects.

PMID- 2221857
TI  - In vitro cultivation of Cryptosporidium parvum and screening for
      anticryptosporidial drugs.
AB  - Sporozoites of Cryptosporidium parvum which were excysted in vitro from oocysts
      isolated from calves or patients with acquired immune deficiency syndrome
      underwent development in monolayers of the mouse fibroblast cell line L929.
      Asexual multiplication occurred, with the maximum numbers of parasites usually
      being observed between 24 and 48 h after infection. Gametocytes were also found,
      but their numbers were relatively small compared with those of the asexual
      stages. A study was made of the effect on parasite development of 20
      antimicrobial agents, most of which were anticoccidial or antimalarial agents.
      The majority of the drugs had a limited inhibitory effect on parasite
      development, but usually only at high concentrations. The two most active drugs
      were monensin and halofuginone, which reduced parasite multiplication by more
      than 90% at high concentrations. In the case of monensin, however, inhibition of
      parasite development at higher concentrations was due, at least in part, to a
      toxic effect of the drug on the host cells.

PMID- 2221858
TI  - Novel beta-lactamase from Capnocytophaga sp.
AB  - A novel beta-lactamase activity which confers resistance to expanded-spectrum
      cephalosporins and penicillins has been found in strain IC 5/21 of Capnocytophaga
      spp. Enzyme activity migrated at a molecular size of 38,000 daltons and at an
      isoelectric point of 3.6, with a minor band at 4.1. Kinetic studies suggested
      that it belonged to Richmond and Sykes beta-lactamase class 1c. Isoelectric
      focusing could be achieved only if a nonionic detergent was added to the gel,
      suggesting the presence of a hydrophobic enzyme akin to a membrane-bound beta
      lactamase of gram-positive bacteria. The location of the gene coding for this
      beta-lactamase is not yet known.

PMID- 2221859
TI  - Bactericidal effect of doxycycline associated with lysosomotropic agents on
      Coxiella burnetii in P388D1 cells.
AB  - There is no consistently reliable treatment for endocarditis resulting from
      chronic Coxiella burnetii infection, the causative agent of Q fever. Although
      certain antibiotics are recommended on the basis of their in vitro bactericidal
      activities, results of therapy with these antibiotics are often disappointing. To
      evaluate whether the currently recommended antibiotic susceptibility tests for C.
      burnetii give misleading results because of continued division of uninfected
      cells, thereby resulting in the dilution of infected cells and, hence, a false
      picture of antibiotic efficacy, we blocked cell division during antibiotic
      susceptibility testing with cycloheximide. Using this new method, we found that
      the currently recommended antibiotics for the treatment of Q fever, doxycycline,
      pefloxacin, and rifampin, did not reduce the ratio of infected to noninfected
      cells (either L929 or P388D1) by 9 days postinfection. To test the hypothesis
      that this lack of antibacterial activity is due to antibiotic inactivation by the
      low pH of the phagolysosomes in which C. burnetii is found, we used alkalinizing
      lysosomotropic agents (chloroquine or amantadine) concurrently with doxycycline.
      This resulted in the sterilization of C. burnetii infection in P388D1 cells. This
      finding seems to confirm our suspicion that the acidic conditions of the
      phagolysosomes in which C. burnetii is located inhibit antibiotic activity. This
      inhibition can be reversed in vitro when lysosomotropic alkalinizing agents are
      used.

PMID- 2221860
TI  - Meropenem pharmacokinetics and penetration into an inflammatory exudate.
AB  - The pharmacokinetics and penetration into a cantharidine-induced inflammatory
      exudate of meropenem was studied in six volunteers following a single 1-g
      intravenous dose. Concentrations in plasma, urine, and the inflammatory exudate
      were determined by a microbiological assay. The mean elimination half-life of
      meropenem in plasma was 1.1 h, with the concentration in plasma declining from a
      mean of 23.6 micrograms/ml at 1 h to 0.7 micrograms/ml at 6 h. The inflammatory
      fluid penetration was rapid (time to maximum concentration of drug in serum, 0.75
      h), and the penetration was 111%. The recovery of meropenem in urine at 24 h was
      65.4% of the administered dose.

PMID- 2221861
TI  - Mode of action of tubulozoles against Plasmodium falciparum in vitro.
AB  - The mode of action of the tubulozole isomers, recently recognized as a new class
      of potential antimalarial agents, was investigated. Whereas neither glycolysis,
      protease activity, or nucleic acid biosynthesis was primarily affected, protein
      biosynthesis decreased soon after addition of the drug. Inhibitors of protein
      biosynthesis, however, did not show synergistic activity with tubulozole.
      Colcemid, on the other hand, had an effect on protein synthesis similar to that
      seen with the tubulozoles. Furthermore, combinations of the tubulozole isomers
      with compounds known to interact with tubulin inhibited malaria in a synergistic
      or antagonistic fashion. Therefore, the inhibition might be elicited by
      interaction with tubulin or some other component of the microtubules. This is
      remarkable insofar as only one of the tubulozole isomers affects mammalian cells
      by binding to tubulin.

PMID- 2221862
TI  - Branched-chain fatty acids produced by mutants of Streptomyces fradiae, putative
      precursors of the lactone ring of tylosin.
AB  - Three branched-chain fatty acids (7-hydroxy-4,6-dimethylnona-2,4-dienoic acid
      [compound 1], its 7-epimer [compound 2], and 7-keto-4,6-dimethylnona-2,4-dienoic
      acid [compound 3]) and a ketone (9-hydroxy-6,8-dimethylundeca-4,6-dien-3-one
      [compound 4]) were isolated from the culture broth of mutants of Streptomyces
      fradiae which were blocked in the biosynthesis of the macrolide antibiotic
      tylosin. Two phenotypic classes of mutants of this organism which were blocked in
      the addition of mycaminose to tylactone (compound 6) accumulated these compounds.
      These compounds were not produced by mutants which were blocked in lactone
      synthesis, in steps beyond mycaminose addition, or by the wild-type strain.
      Synthesis of these compounds, like synthesis of tylosin, was inhibited by the
      addition of cerulenin. Compounds 1, 2, and 3 were partially interconvertible by
      these mutants; but they were not produced from the degradation of tylactone and
      they were not directly incorporated into tylosin by intact cells. The structures
      of compounds 1 and 2 were equivalent to that of a predicted intermediate (S. Yue,
      J. S. Duncan, Y. Yamamoto, and C. R. Hutchinson, J. Am. Chem. Soc. 109:1253-1255,
      1987) in the biosynthesis of tylactone. The ketone (compound 4) reported
      previously (N. D. Jones, M. O. Chaney, H. A. Kirst, G. M. Wild, R. H. Baltz, R.
      L. Hamill, and J. W. Paschal, J. Antibiot. 35:420-425, 1982) appears to be the
      decarboxylation product of the intermediate following that represented by
      compound 1. This represents the first report of the isolation of putative
      precursors of tylactone from tylosin-producing organisms.

PMID- 2221863
TI  - Effects of incubation temperature, inoculum size, and medium on agreement of
      macro- and microdilution broth susceptibility test results for yeasts.
AB  - We examined the effects of temperature and inoculum on the agreement of macro-
      and microdilution broth MICs of five antifungal agents against six isolates of
      Candida species or Torulopsis glabrata. Incubation temperature affected results
      with amphotericin B, flucytosine, fluconazole, and SCH 39304, producing better
      agreement at 35 degrees C than at 37 degrees C. Agreement between methods was
      better with an inoculum size of 10(2) than with one of 10(4) yeast cells per ml
      in testing fluconazole or SCH 39304, and the discrepancies seen with a higher
      incubation temperature and a larger inoculum appeared to be additive. However,
      inoculum size did not seem to affect agreement between methods in testing
      amphotericin B, flucytosine, or ketoconazole. Regardless of test conditions,
      macrodilution broth MICs of amphotericin B for different isolates were strikingly
      higher than microdilution test MICs, with mean differences being greater than
      ninefold under some test conditions. We conclude that for most currently
      available antifungal agents, an incubation temperature of 35 degrees C and a
      starting yeast inoculum of less than 10(4) cells per ml improve the agreement
      between macro- and microdilution broth tests.

PMID- 2221864
TI  - Beta-lactamase production and susceptibilities to amoxicillin, amoxicillin
      clavulanate, ticarcillin, ticarcillin-clavulanate, cefoxitin, imipenem, and
      metronidazole of 320 non-Bacteroides fragilis Bacteroides isolates and 129
      fusobacteria from 28 U.S. centers.
AB  - beta-Lactamase production (nitrocefin disk method) and agar dilution
      susceptibility of amoxicillin, amoxicillin-clavulanate, ticarcillin, ticarcillin
      clavulanate, cefoxitin, imipenem, and metronidazole were determined for 320
      Bacteroides species (not Bacteroides fragilis group) and 129 fusobacteria from 28
      U.S. centers. Overall, 64.7% of Bacteroides species and 41.1% of fusobacteria
      were beta-lactamase positive. Among the Bacteroides species, positivity rates
      were highest for B. bivius (85.0%), followed by B. splanchnicus (83.3%), B.
      eggerthii (77.8%), and B. oralis (77.1%); 54.5% of black-pigmented Bacteroides
      species were beta-lactamase positive. Among the fusobacteria, Fusobacterium
      mortiferum showed the highest rate of beta-lactamase positivity (76.9%). MICs of
      amoxicillin (128 micrograms/ml) and ticarcillin (64 micrograms/ml) for 90% of all
      beta-lactamase-positive strains were reduced to 4 and 2 micrograms/ml,
      respectively, with the addition of clavulanate. MICs of amoxicillin and
      ticarcillin for 90% of all beta-lactamase-negative strains were 1 and 4
      micrograms/ml, respectively, and greater than or equal to 98.4% of the strains
      were susceptible to the beta-lactams tested. Of the beta-lactamase-producing
      strains, 45.9% were susceptible to amoxicillin at less than or equal to 4
      micrograms/ml and 93.4% were susceptible to ticarcillin at less than or equal to
      64 micrograms/ml; the addition of clavulanate raised the rates to 90.4 and 100%,
      respectively. All strains were susceptible to cefoxitin, imipenem, and
      metronidazole. The activity of amoxicillin against 29 beta-lactamase-producing
      strains (10 Bacteroides species and 19 fusobacteria) was not enhanced by the
      addition of clavulanate; however, 82.7% of these strains were susceptible to
      amoxicillin, and all were susceptible to ticarcillin. Although beta-lactamase
      positivity is on the increase in non-B. fragilis group Bacteroides species and
      fusobacteria, amoxicillin-clavulanate, ticarcillin, cefoxitin, imipenem, and
      metronidazole should be suitable for the treatment of infections with these
      strains. The addition of clavulanate does not appreciably improve the efficacy of
      ticarcillin against these organisms.

PMID- 2221865
TI  - Effects of timing of food and fluid volume on cefetamet pivoxil absorption in
      healthy normal volunteers.
AB  - Cefetamet pivoxil (1,000 mg orally) absorption was evaluated in 16 male subjects
      (age, 23.4 +/- 1.7 years; weight, 73.9 +/- 7.0 kg) 1 h before (BE), with (WI),
      and 1 h after (AF) a standard breakfast. The time to peak concentration of
      cefetamet in plasma (Tmax) was increased from 3.25 +/- 1.44 h in the BE group to
      4.31 +/- 1.54 and 4.13 +/- 1.54 h in the WI and AF groups, respectively (P less
      than 0.05). The maximum cefetamet concentration in plasma (Cmax) and the area
      under the plasma cefetamet concentration-time profiles (AUC) in the BE, WI, and
      AF groups were 5.50 +/- 1.06, 5.47 +/- 1.4, and 6.57 +/- 0.93 micrograms/ml and
      38.2 +/- 10.1, 35.7 +/- 11.9, and 42.8 +/- 6.8 micrograms.h/ml, respectively. The
      Cmax and AUC values were not different between the BE and WI groups (P greater
      than 0.05). However, differences in these values were found between the WI and AF
      groups (P less than 0.05). The effect of fluid volume intake on cefetamet pivoxil
      (1,000 mg orally) absorption was evaluated in 12 male subjects (age, 23.8 +/- 2.3
      years; weight, 74.9 +/- 9.0 kg) under fasted and WI conditions. Increasing fluid
      volume intake from 250 to 450 ml under the fasted condition had no effect on the
      absorption of the prodrug (Tmax, 2.50 +/- 0.52 versus 2.83 +/- 0.94 h; Cmax, 4.89
      +/- 1.04 versus 4.84 +/- 0.89 micrograms/ml; AUC, 29.6 +/- 5.1 versus 30.7 +/-
      7.1 micrograms.h/ml; P greater than 0.05. Thus, independent of fluid volume
      intake, cefetamet pivoxil absorption is enhanced when it is given within 1 h of a
      meal, and it is recommended that the prodrug should be taken during this period
      of increased bioavailability.

PMID- 2221866
TI  - SCH-39304 in prevention and treatment of disseminated candidiasis in persistently
      granulocytopenic rabbits.
AB  - To investigate the potential use of SCH-39304 for the prevention and treatment of
      disseminated candidiasis in granulocytopenic patients, we studied its in vivo
      antifungal activity as preventive, early, and late treatments in three models
      (acute, subacute, and chronic) of disseminated candidiasis in persistently
      granulocytopenic rabbits. SCH-39304 was an effective as amphotericin B alone and
      fluconazole alone for the prevention of disseminated candidiasis. SCH-39304 alone
      and fluconazole alone were as effective as amphotericin B plus flucytosine for
      early treatment of subacute disseminated candidiasis. When treatment was delayed
      for 5 days to establish chronic disseminated candidiasis, SCH-39304 was less
      effective than amphotericin B plus flucytosine. In comparison with different
      treatment regimens, SCH-39304 was more effective in early and preventive
      treatment. Thus, SCH-39304 was comparable to treatment control regimens in
      prevention and early treatment of subacute disseminated candidiasis. SCH-39304
      also was most effective in granulocytopenic rabbits with disseminated candidiasis
      when used for prevention or early treatment.

PMID- 2221867
TI  - Cloning of SHV-2, OHIO-1, and OXA-6 beta-lactamases and cloning and sequencing of
      SHV-1 beta-lactamase.
AB  - Molecular cloning of DNA fragments permitted the isolation of structural genes
      coding for SHV-1, SHV-2, OHIO-1, and OXA-6 beta-lactamases. DNA probes were
      constructed for SHV-1, and under conditions of high stringency, hybridization was
      observed only between SHV-1 and SHV-2. Oligonucleotide typing with a 15-mer SHV-1
      probe was capable of discriminating between SHV-1 and SHV-2 but not OHIO-1. The
      nucleotide sequence of the SHV-1 beta-lactamase gene from plasmid R974 has been
      determined. The structural gene encodes a polypeptide product which differs by 9
      residues from the p453 (SHV-1) PIT-2 enzyme determined by peptide sequencing. The
      significance of each mutation was assessed by alignment of amino acid sequences
      and comparisons with the Staphylococcus aureus PC1 penicillinase crystal
      structure. Structural similarities between SHV-1 and class A beta-lactamases are
      extensive, with amino acid identities of 88.9% between SHV-1 and LEN-1, 91.8%
      between SHV-1 and OHIO-1, and 63.7% between SHV-1 and TEM-1.

PMID- 2221868
TI  - Enhanced action of amphotericin B on Leishmania mexicana resulting from heat
      transformation.
AB  - A comparative study of the effect of the polyene antibiotic amphotericin B (AmB)
      on the viability of Leishmania mexicana promastigotes before and after their
      transformation by heat into amastigotelike forms was carried out. The kinetics of
      cell death were followed by spectrofluorometry with the nucleic acid-binding
      compound ethidium bromide. It was found that the rapid killing effect that is
      exerted by AmB on Leishmania promastigotes was even faster after their
      transformation into amastigotelike forms. Binding studies of AmB to Leishmania
      membranes by circular dichroism indicated that heat transformation modified it
      from noncooperative to cooperative binding, decreasing the amount of antibiotic
      that bound to the membranes. Thus, the increased rate of ethidium bromide
      incorporation into transformed cells was not related either to the amount of AmB
      bound or to an increased amount of ergosterol in the membrane (the
      ergosterol/phospholipid ratio was four times smaller after heat shock). An
      increase in the Mg2+ content of the external aqueous solution was able to prevent
      the AmB-induced incorporation of ethidium bromide into Leishmania promastigotes
      to a greater extent (Ki = 13.8 mM) than it was into heat-transformed cells (Ki =
      64 mM), suggesting that there were significant changes at the Leishmania cell
      surface on heat transformation. The significance of these results for
      understanding the mechanism of action of AmB on sensitive organisms is discussed.

PMID- 2221869
TI  - In vitro susceptibility of Ehrlichia sennetsu to antibiotics.
AB  - Antibiotic efficacies were evaluated by Diff-Quik (Dade, Dudingen, Federal
      Republic of Germany) staining of Ehrlichia sennetsu in P388D1 murine macrophages
      grown in 96-well microtiter plates. Sennetsu disease is generally cured with
      tetracyclines. In vivo, E. sennetsu is susceptible to doxycycline and is
      resistant to erythromycin, penicillin, and chloramphenicol. Our study confirmed,
      in vitro, the efficacy of doxycycline, which had an MIC of 0.125 micrograms/ml.
      E. sennetsu was found to be resistant to erythromycin, chloramphenicol,
      penicillin, gentamicin, and co-trimoxazole, while it was very susceptible to
      ciprofloxacin (MIC, 0.125 micrograms/ml) and rifampin (MIC, 0.5 micrograms/ml).

PMID- 2221870
TI  - Activity of compound G2 isolated from alfalfa roots in experimental dermatophyte
      infection.
AB  - Compound G2 isolated from alfalfa roots was applied topically to skin lesions of
      guinea pigs experimentally infected with the dermatophyte Trichophyton
      mentagrophytes var. granulare. After 12 to 15 applications, 80% of the infected
      lesions were cured, as judged by clinical and microbial criteria, compared with
      20% of the untreated lesions which healed spontaneously (P less than 0.01).

PMID- 2221871
TI  - Comparison of ofloxacin, gentamicin, and tobramycin concentrations in tears and
      in vitro MICs for 90% of test organisms.
AB  - Concentrations of three anti-infective agents in tear film were monitored after
      one topical application in rabbits. Ofloxacin concentrations exceeded the MIC for
      90% of the organisms tested (MIC90) (gram-negative and gram-positive organisms)
      for 240 min. Tobramycin concentrations exceeded the MIC90 for 10 min. Gentamicin
      concentrations exceeded the MIC90 for 20 min for gram-positive organisms and 120
      min for gram-negative organisms.

PMID- 2221872
TI  - In vitro susceptibility of Xanthomonas (Pseudomonas) maltophilia to newer
      antimicrobial agents.
AB  - The susceptibilities of 45 clinical and 3 environmental isolates of Xanthomonas
      maltophilia to 14 antimicrobial agents was determined by broth microdilution. The
      newer quinolones PD117596, PD117558, PD127391, A-56620, amifloxacin, and
      fleroxacin were the most active agents tested, with 70 to 99% of isolates being
      susceptible to these agents. All isolates were resistant to trospectomycin. The
      new aminoglycosides SCH24120 and SCH22591 were active against 12 and 1% of
      isolates, respectively.

PMID- 2221873
TI  - Gene heterogeneity for tetracycline resistance in Staphylococcus spp.
AB  - Nucleotide sequences related to four tet genes were studied by hybridization in
      183 clinical Staphylococcus isolates. tet(K) predominated in strains resistant
      only to tetracycline, while tet(M) was responsible for combined tetracycline and
      minocycline resistance. In strains harboring both genes, they contributed
      additively. tet(L) was detected in only five strains, and no hybridization was
      observed with tet(O).

PMID- 2221874
TI  - Blockage of cell wall receptors for yeast killer toxin KT28 with antimannoprotein
      antibodies.
AB  - Binding of yeast killer toxin KT28 to its primary cell wall receptor was
      specifically blocked with polyclonal antimannoprotein antibodies which masked all
      toxin-binding sites on the surface of sensitive yeast cells. By indirect
      immunofluorescence, it was shown that KT28 binds to the cell wall mannoprotein
      and that the toxin resistance of mannoprotein mutants (mnn) of Saccharomyces
      cerevisiae was due to a lack of killer toxin-binding sites within the yeast cell
      wall. Structural analysis of acetylated mannoprotein from KT28-resistant mutant
      strains identified the outer mannotriose side chains as the actual killer toxin
      binding domains.

PMID- 2221877
TI  - Assessing ECG rhythms is part of perioperative nursing.

PMID- 2221876
TI  - The search for common standards and guidelines is a collaborative effort.

PMID- 2221875
TI  - Comparison of cilofungin and amphotericin B for therapy of murine candidiasis.
AB  - We compared the efficacies of cilofungin and amphotericin B treatment in a murine
      model of disseminated candidiasis. Three different dosages of each drug plus
      controls were evaluated. Statistically improved survival was noted only among
      mice treated with 1 mg of amphotericin B per kg of body weight (P less than
      0.05). While all amphotericin B regimens and the two lower-dosage cilofungin
      regimens significantly reduced yeast cell counts in kidneys compared with the
      controls, the amphotericin B-treated mice had a significantly higher percentage
      of sterile kidneys following therapy compared with those treated with cilofungin
      (P = 0.0001).

PMID- 2221878
TI  - Many hospitals ignore AIDS testing guidelines.

PMID- 2221879
TI  - Hepatic resection. Indications, procedures, patient care.

PMID- 2221880
TI  - Reduced-size liver transplantation. Hope for pediatric patient with end-stage
      liver disease.

PMID- 2221881
TI  - Electrocardiogram monitoring. Interpreting normal cardiac rhythms.

PMID- 2221882
TI  - Electrocardiogram monitoring. Interpreting abnormal cardiac rhythms.

PMID- 2221883
TI  - Inguinal hernia repairs. Types, patient care.

PMID- 2221884
TI  - Thyroid storm. Potential perioperative crisis.

PMID- 2221885
TI  - OR nurse turnover. Collecting pertinent data to analyze the problem.

PMID- 2221886
TI  - BSNs for RNs. An off-campus program may be the answer.

PMID- 2221887
TI  - Preparing for the CNOR exam. An independent study plan that worked.

PMID- 2221888
TI  - Surgical positions. Their effects on cardiovascular, respiratory systems.

PMID- 2221889
TI  - AORN recommended practices. A valuable resource, not policy.

PMID- 2221890
TI  - Proposed recommended practices: electrosurgery. Association of Operating Room
      Nurses.

PMID- 2221891
TI  - Agency for the blind receives grant for AIDS project.

PMID- 2221892
TI  - Proposed recommended practices: surgical tissue banking. Association of Operating
      Room Nurses. AORN Recommended Practices Coordinating Committee.

PMID- 2221893
TI  - Issues involving stockless inventory systems.

PMID- 2221894
TI  - The risk of carpal tunnel syndrome with computer use.

PMID- 2221895
TI  - Projecting a positive image is important when dealing with patients and other
      health care professionals.

PMID- 2221896
TI  - Making choices: the crux of ethical problems in nursing.

PMID- 2221897
TI  - Beating the heat during pediatric surgery.

PMID- 2221898
TI  - The challenges of conducting clinical nursing research with elderly populations.

PMID- 2221899
TI  - Using wall suction for evacuating laser plumes.

PMID- 2221900
TI  - Signing operative permits in the holding room.

PMID- 2221901
TI  - An obituary for the nursing care plan.

PMID- 2221902
TI  - Computerized preference lists. Using computers to integrate and improve patient
      care.

PMID- 2221903
TI  - Chemical dependency in nursing. Identifying and helping the troubled nurse.

PMID- 2221904
TI  - Peripheral vascular angioscopy. Performance, equipment, technique.

PMID- 2221905
TI  - Patient assessment. Conducting an effective interview.
AB  - The patient interview is a complex process that requires the interviewer to have
      a high degree of skill. By improving interviewing skills, nurses can become more
      adept at obtaining valid information from patients. With the knowledge they
      obtain from successful interviews, nurses can continue to plan and implement the
      care each patient requires.

PMID- 2221906
TI  - Hernia repair with polypropylene mesh. An improved method.

PMID- 2221907
TI  - Preoperative teaching videotape. The effect on children's behavior.

PMID- 2221908
TI  - Malignant hyperthermia crisis. Planning a mock demonstration.

PMID- 2221909
TI  - Pharmacologic actions of commonly used preoperative medications.

PMID- 2221910
TI  - Ethical issues involved with in vitro fertilization.
AB  - There are three elements to consider with in vitro fertilization. First, the
      paramount concern needs to be the well-being and best interests of the child,
      even though he or she may be an embryo at the time. Second, some people think a
      child will solve their marital problems. Although couples seeking in vitro
      fertilization should not be subjected to more scrutiny than couples conceiving in
      the traditional way, the stresses and uncertainties of in vitro fertilization can
      further strain a marriage. Clinic staff members should be sensitive to this issue
      as a way of helping to avoid complications later. Third, how we resolve the
      status and fate of the frozen embryo and who has disposition over it surely will
      reflect how we consider abortion rights. For example, if the standards of Roe vs
      Wade were applied, one could argue that the woman should have total disposition
      over the frozen embryo. On the other hand, if the father receives a say in the
      matter, what impact would this have? Given the nature of our society and the
      tenuous state of marriage, the problem of disposing frozen embryos is a critical
      one that has no satisfactory solution. Finally, there is the stress factor.
      Although this is not an issue of direct ethical concern, it is related to the
      necessity of the couple receiving accurate information. If the couple receives an
      incorrect impression of a clinic's success rates, they may be exposed
      unnecessarily to further stress and frustration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221911
TI  - Rat renal proximal tubular gluconeogenesis: possible involvement of
      nonmitochondrial carbonic anhydrase isozymes.
AB  - The carbonic anhydrase (CA) inhibitor ethoxzolamide decreases the rate of glucose
      synthesis from 10 mM pyruvate by tubules incubating in 25 mM HCO3- but not in 50
      mM HCO3-: this is evidence that rat renal cortical mitochondrial CA (CA V)
      provides HCO3- for pyruvate carboxylation in renal tubular gluconeogenesis at
      physiological total CO2 (CO2 + HCO3-). In renal proximal tubules prepared from 48
      h-starved rats and incubating in 10 mM pyruvate in 25 mM HCO3- buffered saline
      (Krebs-Henseleit buffer) the CA inhibitors acetazolamide (AZ) and benzolamide
      (BZ) decreased the rate of glucose synthesis. Maximal inhibition was reached with
      125 microM AZ or with 450 microM BZ. The rate of glucose synthesis increased with
      increasing pyruvate concentration from 3.33 to 20 mM; including 600 microM BZ or
      188 microM AZ results in glucose synthesis becoming independent of increasing
      pyruvate concentration. Doubling the physiological concentration of bicarbonate
      restored the dependence of glucose synthesis on pyruvate concentration and
      partly, but not completely, alleviated the inhibitory effect of AZ and BZ,
      leading to the conclusion that AZ and BZ influence gluconeogenesis by affecting
      enzymes in addition to CA V. Tubules were incubated with substrates which do not
      require pyruvate carboxylation for synthesis of oxaloacetate. When tubules were
      incubated in 10 mM malate the rate of glucose synthesis was unaffected by less
      than 100 microM AZ or 400 microM BZ and was decreased maximally by 40 and 20%,
      respectively, by 125 microM AZ, 450 microM BZ, and higher concentrations of these
      drugs. Increasing the malate concentration from 3.33 to 20 mM increased the rate
      of glucose synthesis; 600 microM BZ inhibited the rate of glucose synthesis only
      when the malate concentration was greater than 10 mM but 188 microM AZ decreased
      the rate of glucose synthesis at each concentration of malate. Results were
      similar when tubules were incubated in glutamine with CA inhibitors. The rate of
      glucose synthesis differed with the substrate metabolized and the substrate
      concentration except when 600 microM BZ was included.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2221913
TI  - Yeast thioltransferase--the active site cysteines display differential
      reactivity.
AB  - Thioltransferase, catalyzing thiol-disulfide interchange between reduced
      glutathione and disulfides, was purified to homogeneity from Saccharomyces
      cerevisiae. The purification procedure included ammonium sulfate precipitation,
      Sephadex G-50 gel filtration, CM-Sepharose ion exchange chromatography, and C18
      reverse phase high pressure liquid chromatography. Two thioltransferase activity
      peaks were resolved by CM-Sepharose chromatography. The protein from the major
      peak had a molecular weight of 12 kDa on sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis while the minor peak protein migrated slightly faster in this
      gel system. Both proteins showed similar amino acid compositions and identical N
      termini. The major peak of thioltransferase was extensively characterized. Plots
      of thioltransferase activity as a function of S-sulfocysteine or hydroxyethyl
      disulfide concentration did not show normal Michaelis-Menten kinetics. The enzyme
      activity had a pH optimum of 9.1. The protein has 106 amino acid residues with
      two cysteines and no arginine. The active site amino acid sequence of the enzyme
      was identified as Cys26-Pro-Tyr-Cys29, which is similar to that of mammalian
      thioltransferase and Escherichia coli glutaredoxin. The two cysteines at the
      active site displayed different reactivities to iodoacetamide. Cys26 was
      alkylated by iodoacetamide at pH 3.5 while Cys29 was alkylated at pH 8.0. The
      enzyme was completely inactivated when the Cys26 was carboxymethylated. A plot of
      incorporation of iodoacetamide into Cys29 at different pHs was similar to the pH
      dependence of the enzyme activity. The result suggested that Cys26 could readily
      initiate nucleophilic attack on disulfide substrates at physiological pH.

PMID- 2221912
TI  - beta-Glucuronidase is transported slowly to lysosomes in BW5147 mouse lymphoma
      cells: evidence that the prelysosomal enzyme is not restricted to the endoplasmic
      reticulum.
AB  - The post-translational processing of beta-glucuronidase in BW5147 mouse lymphoma
      cells is slow relative to other newly synthesized lysosomal enzymes. To
      characterize this slow maturation the acid hydrolase was immunoprecipitated from
      cells pulse-labeled with [2-3H]mannose. Radiolabeled beta-glucuronidase migrated
      as the precursor form of the enzyme for up to 4 h of chase, whereas another acid
      hydrolase, beta-galactosidase, was processed completely to its mature form within
      this same time period. Both beta-glucuronidase and beta-galactosidase obtained
      high levels of mannose 6-phosphate (Man 6-P) within 60 min of their biosynthesis.
      The Man 6-P content of beta-galactosidase declined rapidly during a subsequent
      chase while that of beta-glucuronidase remained high during the first 4 h of
      chase and then slowly declined. 3H-Labeled phosphorylated high mannose-type
      oligosaccharides isolated from beta-glucuronidase after 1 h of chase were
      composed primarily of species with one or two phosphodiester groups, but
      oligosaccharides with one and two phosphomonoesters became the predominant
      phosphorylated species with longer chase times. The phosphorylated
      oligosaccharides attached to other newly synthesized acid hydrolases, on the
      other hand, contained primarily phosphodiester species at all chase times. When
      BW5147 cells were pulsed with [3H]mannose and chased in the presence of monensin
      to disrupt transport, the number of phosphorylated oligosaccharides recovered
      from beta-glucuronidase was comparable to the quantity recovered from the enzyme
      produced by non-drug-treated cells. The number of phosphorylated units recovered
      from all other newly synthesized acid hydrolases, however, was greater in the
      presence of the ionophore than in its absence. Nondenaturing gel electrophoresis
      studies indicated that beta-glucuronidase existed in two forms at steady state
      within BW5147 cells and, as such, was similar to liver beta-glucuronidase in
      which a large percentage of the enzyme was present as a complex bound to egasyn.
      These data suggest that newly synthesized beta-glucuronidase produced by BW5147
      cells complexes with an egasyn-like protein within the endoplasmic reticulum.
      This interaction retards the enzyme's migration through the secretory apparatus
      but does not prevent its access to Golgi-associated processing enzymes.

PMID- 2221914
TI  - Structural and functional studies of the rat mitochondrial single strand DNA
      binding protein P16.
AB  - The rat mitochondrial single strand DNA binding protein (SSB) P16 was purified to
      apparent homogeneity by elution from single strand DNA agarose with ethidium
      bromide. Each monomer of P16 contains two tryptophan residues, and the intrinsic
      fluorescence from these residues is quenched upon binding to single strand
      polynucleotides. From fluorescence quench titrations of ligand to fixed amounts
      of DNA lattice, a binding site size of 8 or 9 nucleotides per P16 monomer was
      found. Measurement of the affinity of P16 for isolated sites by titration with
      either oligo(dT)8 or 5'-dephosphorylated oligo(dT)8 indicated values on the order
      of 10(7) M-1. P16 exhibited a binding preference for single strand DNA, poly(dT),
      and poly(dC) in comparison to double strand DNA, poly(U), or poly[d(A-T)].
      Although it was not possible to show that P16 destabilizes double helical DNA or
      even poly[d(A-T)], binding of P16 does inhibit the process of renaturation as
      shown by inhibition of duplex formation between poly(dA) and poly(dT). The
      binding of saturating amounts of P16 to single strand poly(dT).oligo(dA)50
      template-primers enhanced approximately 10-fold the activity of both the
      homologous mitochondrial DNA polymerase and the Escherichia coli DNA polymerase I
      Klenow fragment. However, the mitochondrial DNA primase was nearly completely
      inhibited by the saturation of the poly(dT) template with P16. Amino-terminal
      sequence analysis of P16 and a protease-insensitive, DNA binding domain (Mr
      approximately 6000) revealed that the DNA binding domain residues, at least in
      part, in the amino-terminal third of the P16 molecule. Furthermore, the amino
      terminal sequence was found to be strikingly similar to that of the Xenopus
      laevis mtSSB-1 and to a lesser extent similar to E. coli SSB and E. coli F sex
      factor SSB.

PMID- 2221915
TI  - Transient expression of type 2 chain in A-active hexaglycosylceramide of rat
      small intestine at weaning time. Demonstration by affinity chromatography and
      ceramide glycanase hydrolysis of A-active glycosphingolipids followed by gas
      chromatography and mass spectrometry of permethylated hexasaccharides.
AB  - The small intestine of 15- to 23-day-old rats was cut into four segments from the
      duodenum to the ileum. Neutral glycosphingolipids were purified from each segment
      and submitted to thin-layer chromatography and immunostaining with the A005
      monoclonal anti-A antibody. This antibody detected an hexaglycosylceramide
      located mainly in the duodenum during the postnatal development. In order to
      characterize hexaglycosylceramides, blood group A-active glycolipids were
      purified by affinity chromatography on immobilized Helix pomatia lectin in
      organic solvent. Hexaglycosylceramides (A-6) were subsequently isolated by
      preparative thin-layer chromatography and hydrolyzed with ceramide glycanase. The
      free hexasaccharides were permethylated and analyzed by gas chromatography. Two
      peaks were detected in varying ratios during development, corresponding to type 1
      and type 2 chain A hexasaccharides. Gas chromatography clearly demonstrated that
      type 2 A-6 occurred in the duodenum of developing rats, and that a shift from
      type 2 to type 1 A-6 occurred with growing age. The change from type 2 to type 1
      chain was also assessed by methylation analysis, and by the variation of the
      characteristic fragmentations of type 1 and type 2 chain hexasaccharides upon
      mass spectometry of the permethylated A-6 oligosaccharides from the duodenum of
      19-day-old and adult rats.

PMID- 2221916
TI  - Regional differences in the appearance of adult-type glycosphingolipids in the
      small intestine of inbred rats at weaning time.
AB  - The small intestine of 15- to 33-day-old rats was cut into four segments:
      duodenum, proximal jejunum, distal jejunum, and ileum. Neutral glycosphingolipids
      and gangliosides were purified from each segment and analyzed by thin-layer
      chromatography in order to study the developmental appearance of adult-type
      glycolipids at each level of the small intestine. Type 1 A-6 glycolipid was first
      detected in the ileum at 15 days and subsequently in the jejunum and duodenum at
      19 days of age. N-Glycolylneuraminic acid was expressed first in the ileum at 17
      days, then in the proximal jejunum at 21 days, but only after 29 days in the
      duodenum. In each region, 6-8 days were required between first detection and full
      expression of N-glycolylneuraminic acid. The presence of 2-hydroxylated fatty
      acids in glucosylceramide was found first in the ileum at 19 days, 2-3 days
      before appearing in the duodenum and proximal jejunum. A period of 2-3 days was
      necessary to reach full adult-type level of 2-hydroxylated fatty acids in
      glucosylceramide. These results show that adult-type glycolipids appear earlier
      in the distal than in the proximal region of the rat small intestine, and that
      different glycolipids appear at different times and at different rates. The
      finding that the biochemical differentiation of the whole small intestine expands
      over a period of 3 days to 2 weeks, depending on the region and the glycolipid,
      before being fully completed indicates that, in addition to the time lag observed
      between the distal and the proximal region, the new cells arising from the crypt
      of Lieberkhun after 15 days of age are not at once fully differentiated.

PMID- 2221917
TI  - Purification and characterization of flavone synthase I, a 2-oxoglutarate
      dependent desaturase.
AB  - Soluble flavone synthase I from illuminated parsley cells was purified to near
      homogeneity by a six-step procedure. A molecular mass of 48 +/- 2 kDa was
      determined by gel permeation chromatography and denaturing polyacrylamide gel
      electrophoresis. A single protein with an isoelectric point at pH 4.8 +/- 0.1 was
      detected on isoelectric focusing gels, which catalyzed the overall conversion of
      2S-flavanones into the corresponding flavones in the presence of molecular
      oxygen, 2-oxoglutarate, ferrous ion, and ascorbate. Apparent Michaelis constants
      for 2S-naringenin, 2S-eriodictyol, and 2-oxoglutarate were determined as 5, 8,
      and 16 microM, respectively. (+)-Dihydrokaempferol and 2R-naringenin were not
      accepted as substrates. The enzyme was strongly inhibited by Cu2+ and Zn2+.
      Potent competitive inhibition with respect to 2-oxoglutarate was observed with
      2,4-pyridinedicarboxylate (Ki = 1.8 microM). With crude extracts as well as with
      the purified enzyme neither the hypothetical intermediate 2-hydroxyflavanone nor
      a dehydratase activity capable of converting the chemically synthesized compound
      to flavone could be observed. Moreover, the introduction of the double bond into
      the substrate naringenin was not altered by addition of chemically synthesized 2
      hydroxynaringenin into the reaction mixture. Therefore, 2-hydroxyflavanones are
      apparently not freely dissociable intermediates in the biosynthesis of flavones
      in parsley and are not capable of entering the active site of the enzyme to
      compete with the flavanone. It is postulated that flavone synthase I catalyzes
      double-bond formation by direct abstraction of vicinal hydrogen atoms at C-2 and
      C-3 of the substrate. Thus, flavone synthase I is a member of a novel subgroup
      within the 2-oxoglutarate-dependent dioxygenases that can be referred to as 2
      oxoglutarate-dependent desaturases.

PMID- 2221918
TI  - Reactivity of ebselen and related selenoorganic compounds with 1,2-dichloroethane
      radical cations and halogenated peroxyl radicals.
AB  - The reactivity of ebselen, 2-phenyl-1,2-benzisoselenazol-3(2H)one, and
      structurally related analogues was studied by pulse radiolysis. The rate constant
      for the reaction of ebselen with trichloromethylperoxyl radicals was determined
      to be 2.9 X 10(8) M-1 s-1, while its sulfur analogue, 2-phenyl-1,2-benzisothiazol
      3(2H)one, was oxidized at much lower rates, k less than or equal to 10(7) M-1 s
      1. Among several derivatives studied, the only other compound that exhibited a
      high rate constant was 2-(methylseleno)-benzoic acid-N-phenylamide. Oxidation of
      ebselen by other halogenated peroxyl radicals was also carried out and revealed a
      direct relationship between rate constant and the degree of halogenation of the
      oxidant. The transient radicals generated during oxidation of ebselen and the
      analogues were characterized by optical absorption and conductivity measurements
      and were attributed to one-electron-oxidized radical cations. The oxidation
      potentials were determined by cyclic voltammetry. Comparative evaluation of the
      in vitro behavior during microsomal lipid peroxidation revealed ebselen to be the
      most potent antioxidant of the compounds investigated, 2-(Methylseleno)-benzoic
      acid-N-phenylamide, despite its high rate constant for oxidation by halogenated
      peroxyl radicals, was found to be a poor antioxidant. The rate constant of
      oxidation of ebselen by trichloromethylperoxyl radicals is comparable to that of
      alpha-tocopherol under similar conditions, underscoring the potential
      pharmacological interest of ebselen as an antioxidant.

PMID- 2221919
TI  - Base modifications in plasmid DNA caused by potassium permanganate.
AB  - KMnO4 is a powerful oxidizing agent which has been used to modify DNA bases. In
      previous studies, mild KMnO4 treatment has been shown to preferentially modify
      Thy; Cyt and Gua are modified only under harsher conditions to as yet
      unidentified products. In the present study, denatured plasmid pCMV beta gal DNA
      was exposed to 0.015-1.5 mM KMnO4, pH 8.6, at 4 degrees C for 5 min, after which
      the DNA was hydrolyzed in formic acid, trimethylsilylated, and analyzed for
      modified base content by gas chromatography-mass spectrometry/selected ion
      monitoring. KMnO4 treatment, even at concentrations as low as 0.015 mM, caused a
      concentration-dependent increase in the Thy products Thy glycol and 5-hydroxy-5
      methylhydantoin, the Cyt products Cyt glycol, 5,6-dihydroxycytosine, and 5
      hydroxyhydantoin, the Ade product 8-hydroxyadenine, and the Gua product 8
      hydroxyguanine. The Ade product 4,6-diamino-5-formamidopyrimidine and the Gua
      product 2,6-diamino-4-hydroxy-5-formamidopyrimidine were minimally (less than or
      equal to 2-fold) increased by treatment with greater than or equal to 0.8 mM
      KMnO4. These data demonstrate that, in addition to Thy, Cyt, Gua, and Ade bases
      in plasmid DNA may be modified by treatment with KMnO4, even under mild
      conditions. They represent the first identification of Cyt, Gua, and Ade products
      caused by KMnO4 treatment. Furthermore, these data suggest that previous studies
      which have used treatment with KMnO4 to study the mutagenicity of Thy glycol
      specifically or as a Thy-specific probe in DNA structure should be interpreted
      with caution.

PMID- 2221921
TI  - Inhibition of phosphoenolpyruvate carboxykinase from Trypanosoma (Schizotrypanum)
      cruzi epimastigotes by 3-mercaptopicolinic acid: in vitro and in vivo studies.
AB  - 3-mercaptopicolinic acid (3MP) was shown to be a powerful and specific inhibitor
      of the phosphoenolpyruvate carboxykinase (PEP-carboxykinase; ATP:oxyloacetate
      carboxylyase (transphosphorylating), EC 4.1.1.49) isolated and purified to
      homogeneity from Trypanosoma (Schizotrypanum) cruzi epimastigotes (Urbina, J. A.,
      1987, Arch. Biochem. Biophys. 258, 186-195). In the presence of saturating
      concentrations of the cosubstrates the inhibition was purely noncompetitive
      toward all substrates in the carboxylation reaction. The inhibition was specific
      to this enzyme, being nonexistent or moderate toward eight other enzymes tested
      that are involved in glycolysis, hexose monophosphate shunt, Krebs' cycle, and
      amino acid metabolism. These facts, together with the kinetic constants of the
      enzyme and the intracellular concentrations of its substrates, predicted a very
      potent inhibition of the reaction catalyzed by this enzyme in vivo. In accordance
      of this prediction 200 microM 3MP inhibited 2.2-fold the production of [2,2'
      13C]succinate from D-[1-13C]glucose by intact epimastigotes under anaerobic
      conditions, as shown by 13C NMR and 1H NMR spectroscopy; correspondingly the
      overall glucose consumption rate decreased by the same factor, while the relative
      rate of production (per mole of glucose consumed) of the other main product of
      glucose catabolism, [3-13C]alanine, was increased 3-fold by the drug. Under
      aerobic conditions the glucose catabolism was faster (negative Pasteur effect)
      and the drug at the same concentration again blocked succinate production but had
      negligible effects on glucose consumption. On the other hand, 200 microM 3MP
      blocked completely the epimastigotes' catabolism of L-[U-14C]proline through the
      Kreb's cycle via PEP-carboxykinase, as indicated by the disappearance of 14C
      label present in alanine, pyruvate, citrate, and isocitrate after 1 h of
      incubation in the presence of the labeled amino acid, while the amount of
      radioactivity present in alpha-ketoglutarate and malate doubled. The results
      support the proposition that PEP-carboxykinase has a central role in the energy
      metabolism of this organism as it is essential for the catabolism of amino acids.

PMID- 2221920
TI  - Blood antioxidant status and erythrocyte lipid peroxidation following distance
      running.
AB  - The relationship between prolonged exercise, oxidative stress, and the protective
      capacity of the antioxidant defense system has been determined. Venous blood
      samples were removed from seven trained athletes before and up to 120 h after
      completion of a half-marathon for measurements of blood antioxidants, antioxidant
      enzymes, and indices of lipid peroxidation. Plasma creatine kinase (CK) activity,
      an index of muscle damage, increased (P less than 0.05) to a maximum 24 h after
      the race but this was not accompanied by changes in conjugated dienes and
      thiobarbituric acid reactive substances (TBARS), which are indices of lipid
      peroxidation. An increase (P less than 0.05) in plasma cholesterol concentration
      (4%) immediately after the race was similar to the change in plasma volume (6%).
      However, transient increases (P less than 0.05) immediately postrace in the
      plasma concentrations of uric acid (24%), vitamin A (18%), and vitamin C (34%)
      were only partly accounted for by the fluid shifts. The immediate postrace
      increases in alpha- and gamma-tocopherol did not attain statistical significance.
      Erythrocyte antioxidant enzyme activities were unaffected by the exercise but the
      alpha- and gamma-tocopherol concentrations progressively increased (P less than
      0.001 and P less than 0.05, respectively) up to 48 h postrace. Paradoxically, 24
      h after the race erythrocyte susceptibility to in vitro peroxidation was markedly
      elevated (P less than 0.01). This enhanced susceptibility to peroxidation was
      maintained even at 120 h postrace and did not correspond to changes in the age of
      the red cell population. A decrease (P less than 0.001) in total erythrocyte
      glutathione immediately after the half-marathon was mainly due to a reduction in
      the reduced form (GSH). The results show that when trained athletes run a
      comparatively short distance sufficient to result in some degree of muscle damage
      but which is insufficient to cause elevations in plasma indices of lipid
      peroxidation, significant alterations in erythrocyte antioxidant status do occur.

PMID- 2221922
TI  - [Regulation of the multidrug resistance (MDR)1 gene expression].
AB  - MDR1 gene encodes a gp-170 membrane protein which acts as a energy-dependent pump
      to transport anticancer agents out of the cells. In this article, we briefly
      summarize the MDR gene family, gene amplification, gene expression by
      differentiation and gene expression in clinical tumors. We also describe the
      characterization of the promotor and tissue specific enhancer of the MDR1 gene
      and our recent study of the regulatory mechanism of this gene expression.

PMID- 2221923
TI  - [Alternating non-cross resistant multi-drug chemotherapy against malignant
      lymphoma (CAMBO-VIP)--consideration of the dose intensity].
AB  - Dose intensity defined as the amount of drug used per unit time, expressed as
      mg/m2/week, was reported to be a significant determinant of antitumor activity of
      single or combined drugs in cancer chemotherapy. We formulated a 12 week high
      dose intensity chemotherapy (CAMBO-VIP) for the treatment of advanced non
      Hodgkin's lymphoma with aggressive histology. The treatment consists of weekly
      alternate administration of myelosuppressive and non-myelosuppressive agents.
      Doxorubicin was administered every other week in combination with either
      cyclophosphamide, etoposide or ifosfamide. On the weeks in between, non
      myelosuppressive vincristine was given with either methotrexate with leucovorin
      rescue or bleomycin. Prednisolone was given for the first and the last 4 weeks.
      Dose reduction and treatment delay were kept minimal for the purpose not lowering
      dose intensity. As of February 1990, 32 patients (pts), median age 52, entered
      the study, 29 of whom completed the treatment. There were 3 incomplete cases, in
      which 2 were due to interruption of the treatment at 5 and 6 weeks, respectively
      and 1 due to a half dose given because of the old age. CR was obtained in 29 pts
      (90.6%). Relapse occurred in 3 (10.4%) with the median follow-up of 12 months.
      Two year disease-free survival (DFS) was estimated to be 76.0% for all the
      patients and 83.9% for CR patients. Toxicity of CAMBO-VIP was moderate with no
      chemotherapeutic death. Myelosuppression was severe but of short duration,
      requiring virtually no dose reduction. Treatment delay was 3 days, median, and
      maximally 28 days. The average actual dose intensity calculated from given amount
      of drugs and treatment duration was as high as 90% of the protocol dose
      intensity. Dose intensity of CAMBO-VIP protocol is highest, equaling to that of
      MACOP-B, among representative series of reported lymphoma protocols. A highly
      significant correlation was observed between 9 drug relative dose intensity and
      DFS of the patients treated with each protocol. Significance of dose intensity as
      an independent prognostic factor, however, should be determined, by a prospective
      carefully designed stratified randomized studies.

PMID- 2221924
TI  - [Chemotherapy of thymoma].
AB  - Thymoma is a low malignant, slow growing tumor and rarely metastasizes
      hematogenously or lymphogenously. Therefore, the local treatment by surgery or
      irradiation has been the main therapy for this tumor. In this paper, we reviewed
      the chemotherapy for thymoma in literature. Cis-platinum, doxorubicin,
      vincristine, cyclophosphamide and corticosteroid are mainly used by various
      dosages and various combinations. Papers concerning the chemotherapy for thymoma
      were reports of a single or a few cases. The chemotherapy is now effective for
      some kinds of malignant tumor. The chemotherapy for thymoma should be
      systematically studied.

PMID- 2221925
TI  - [MTT assay using fresh surgical specimens with reference to the transfer system
      and reproducibility in "test center" method].
AB  - A chemosensitivity test (MTT assay) was conducted using 59 fresh surgical
      specimens collected from Keio University, Kitasato Institute Hospital and 14
      affiliated hospitals, in order to assess the specimen transfer system and the
      reproducibility of the assay results obtained at Keio University and Kitasato
      Institute Hospital. Although the optical density yielded by the tumor cells in a
      number of 5 x 10(4)/well and the number of evaluable cases were significantly
      reduced through the transfer, the chemosensitivity pattern of the specimen was
      identical before and after the transfer. Fifty seven of 59 cases were evaluable
      and the concordant rate of the assay results between the two institutes was 80.6%
      (108/134) among each case-drug combination. Since the transfer system of the
      specimen was established and the reproducibility of the assay results in two
      institutes was confirmed, the "test center" method of the MTT assay appears to be
      possible by collecting the surgical specimens from the affiliated hospitals.

PMID- 2221926
TI  - [Antitumor activity of UFT against murine renal cell carcinoma: a study on the
      suppression tumor metastases].
AB  - Experimental chemotherapy with UFT was performed against murine renal cell
      carcinoma (Renca) of spontaneous origin in BALB/c mice and the antitumor activity
      of UFT was compared with that of 5-FU. By oral administration started from the
      day after inoculation of Renca cells under the capsule of a kidney, the growth of
      tumor and formation of the spontaneous metastases to the lymph nodes, lung,
      spleen, and abdominal wall were inhibited significantly. The UFT or 5-FU
      treatment started on the 8th day after tumor inoculation also extended the
      survival time of the tumor-bearing mice and the anti-tumor effect of UFT was more
      marked than 5-FU. However, UFT treatment started on the 15th day did not prolong
      the survival time of Renca-bearing mice. From these results, UFT therapy seems to
      be beneficial for prevention of metastases after nephrectomy in the patients with
      renal cell carcinoma.

PMID- 2221927
TI  - [Investigation of UFT and radiation combination therapy of head and neck cancer-
      mainly in laryngeal cancer].
AB  - We studied the effects of simultaneous combination therapy with UFT and radiation
      for 69 head and neck cases with the same protocol in 6 universities in Kanagawa.
      Completed cases (cases in which therapeutic effects could be evaluated) totaled
      67 patients who could receive more than 40 Gy as a given radiation dose and more
      than 8.4 g as a total UFT dose. Responder rate at 90th day after completion of
      radiation in 67 completed cases (CR 57 cases + PR 6 cases/67 cases) was as
      favorable as 94%. A comparison between 52 cases of the most frequent laryngeal
      cancer and historical control 113 cases received single radiation therapy by
      means of Kaplan-Meier method resulted significantly (P less than 0.05) favorable
      in UFT combination group as for disease free rate in all cases, disease free rate
      in Stage IV cases, disease free rate in glottic cancer, and survival rate and
      disease free rate in supraglottic cancer. No severe adverse reactions were
      observed in all cases. This combination therapy with radiation and UFT was judged
      effective for head and neck cancer, especially laryngeal cancer.

PMID- 2221928
TI  - [Clinical results of UFT enteric-coated granule therapy under cooperative study
      (phase II study). Tokyo Cancer Chemotherapy Cooperative Study Group].
AB  - We have carried out the Phase II study by oral administration of UFT enteric
      coated granules (UE) against various malignant tumors. Out of 45 patients entered
      in the study, 40 patients were evaluable: 36 patients among them had measurable
      lesions. PR (partial response) were obtained in two (11.1%) out of 18 patients
      with gastric cancer and one (50.0 %) out of 2 patients with lung cancer. Total
      response rate was 8.3%. Side effects by UE were slight; that is, anorexia
      (13.3%), nausea and vomiting (8.9%), generalized malaise (8.9%) and so forth. UE,
      as a long-term therapy, can be considered a useful drug against cancers with less
      side effects.

PMID- 2221929
TI  - [A comparative clinical trial of UFT medication and intravesical BCG in the
      recurrence of superficial bladder cancer. Study Group of UFT and BCG adjuvant
      therapy for bladder cancer].
AB  - In sixty-four patients who had TUR-bt for superficial bladder cancer, the effect
      of intravesical BCG and UFT medication were compared. Group A (n = 20) were
      treated with BCG, group B (n = 22) were treated with UFT and group C (n = 22)
      were treated with both agents. The patients were followed up for more than 12
      months by cystoscopy at a interval of 3 months, urinary cytology and bladder cold
      cup biopsy, if necessary. Thirteen of the 20 patients in group A and 13 of the 22
      patients in group B were free of tumors, compared to 5 of the 22 patients in
      group C. Although the recurrence-free-rate in each group does not differ
      significantly, the combination therapy of intravesical BCG and UFT medication
      seems to decrease the rate of tumor recurrence for superficial bladder cancer.
      Side effects of BCG and UFT were tolerated well.

PMID- 2221930
TI  - [Septicemia in children with malignant disease].
AB  - Severe infection is a major cause of morbidity and mortality in patients with
      malignancy. In this study, 34 episodes of septicemia occurred in 1,468 childhood
      patients with malignancy who admitted and were treated at National Sapporo
      Hospital between 1979 and 1988. The occurrence of septicemia and its mortality
      rate were higher in malignant hematologic disease than in malignant solid tumor.
      Most cases of septicemia occurred in relapse. The most frequent organism causing
      septicemia were Klebsiella pneumoniae (16.3%) and Staphylococcus epidermidis
      (16.3%). Septicemia due to Gram-negative organism was more frequent than that of
      Gram-positive organism or fungus. Polymicrobic septicemia occurred 3 times and
      multiple episodes 6 times. They had a high mortality rate. Neutropenia was
      strongly associated with episode of septicemia. In our series, absolute
      neutrophil count under 500 per microliter developed septicemia. Especially,
      children with less than 100 granulocytes per microliter had a major risk factor
      for the development of infection and death. No children with granulocyte count
      greater than 1000 per microliter died in connection with septicemia.

PMID- 2221931
TI  - [Studies on the mechanism of protective effect of selenium on nephrotoxicity of
      cis-diamminedichloroplatinum (CDDP) in mice].
AB  - The mechanism of protective effect of sodium selenite (Se) on the nephrotoxicity
      of cis-diamminedichloroplatinum (CDDP) was studied with mice. CDDP and Se
      concentrations in the plasma, blood cell, kidney and liver were measured in mice
      given CDDP alone and those given both CDDP and Se. The nephrotoxicity of CDDP was
      observed in mice fed Se deficient diet (SDD). The activities of glutathione
      peroxidase (G-Px) in the plasma, blood cells, kidney and liver were measured in
      mice mentioned above. Co-administration of Se did not influence on the
      concentration of CDDP in the blood, kidney and liver. In mice fed SDD, the
      nephrotoxicity of CDDP increased and G-Px activities of the blood and kidney
      decreased. In mice given Se, G-Px activities was not increased. These results
      suggest that interaction between CDDP and Se differs from that between mercury
      and Se, or between cadmium and Se (formation of compound). Intake of Se is
      related to the appearance of the nephrotoxicity of CDDP. G-Px may be related
      partially to the protective effect of Se on the nephrotoxicity of CDDP.

PMID- 2221932
TI  - [A case of effective chemotherapy with CDDP and VDS for metastatic lesions of the
      lung and spleen and simultaneous resection].
AB  - A case of 51-year-old woman, she was suffered from primary parotic cancer and the
      right parotic gland was resected in 1980, and pulmonary metastatic nodule was
      also operated in 1982. She was admitted in our institute with complaint of bloody
      sputum and cough in 1989, and diagnosed as pulmonary and splenic metastasis of
      parotic cancer. Two courses of combined chemotherapy, with CDDP by administration
      through bronchial artery, with CDDP and VDS by a systematic intravenous
      injection, was done. With these therapies, partial responses were obtained in the
      metastatic lesions, so spleen and left lower lobe of lung were resected. In the
      histological examination of the resected tumors, tumor cells were nearly
      disappeared, and we obtained Ef-2 effect according to the general rule for
      clinical and pathological record of lung cancer. She was discharged after one
      more chemotherapy and with no sign of recurrence now. We reported this case
      because of the possibility of the effective adjuvant therapy of the case with
      multiple lesions of cancer metastasis, and the rare case of splenic metastasis.

PMID- 2221933
TI  - [Single drug chemotherapy with 5-FU oral administration of bladder cancer].
AB  - 58-year-old male with bladder cancer complicated acute myocardial infarction
      (aMI) were treated by 5-FU 300 mg/day orally for approximately one and a half
      months as single drug chemotherapy preoperatively. CT studies showed PR in
      bladder lesion and an improvement of bilateral hydronephrosis also. Biochemical
      evaluations as Thymidylate synthase inhibition and FdUMP were made on biopsy and
      operative specimens of urinary bladder. Clinical trials with 5-FU oral
      administration in bladder cancer were not held widely. Although its effectiveness
      and safety has been accepted in several fields. It was useful for a conservative
      operation case as single drug chemotherapy.

PMID- 2221935
TI  - Histopathologic spectrum of clinically atypical melanocytic nevi. II. Studies of
      nonfamilial melanoma.
AB  - We studied the clinically most atypical pigmented lesion removed from each of 142
      patients with newly diagnosed sporadic melanoma. The specimens were categorized
      as to the type of nevus, ie, junctional or compound, presence of congenital
      features, and degree of nuclear atypicality--presence of nuclear enlargement,
      nuclear pleomorphism, hyperchromatism, and prominent nucleoli--of intraepidermal
      nevomelanocytes. The frequency of nuclear abnormality was graded as 1 (rare
      cells), 2 (10% to 50% of cells), or 3 (greater than 50% of cells) for each
      nuclear parameter. Among all lesions, 42 (29.6%) were junctional nevi, 74 (52.1%)
      were compound nevi, and 14 (9.9%) were dermal nevi. Eighteen percent of the total
      were either dysplastic nevi (23 cases) or malignant melanoma in situ (three
      cases). Fourteen nevi (9.9%) had congenital features. There were 12 junctional
      and 39 compound nevi and one dermal nevus that exhibited nuclear abnormality, but
      only four junctional nevi compared with 19 compound nevi had sufficient atypia
      for a designation of dysplastic nevus. Only two nevi with congenital features
      demonstrated any nuclear abnormality, and these were clearly nondysplastic. Thus,
      among nevi surgically removed as the clinically most atypical lesion in this
      study, compound nevi were much more likely to demonstrate nuclear atypia (and
      dysplasia) than were other nevi, ie, junctional or dermal nevi, or nevi with
      congenital features.

PMID- 2221934
TI  - Management of chronic photosensitive eczema.

PMID- 2221936
TI  - Ionizing radiation-induced pemphigus. Case presentations and literature review.
AB  - Reports of pemphigus following ionizing radiation exposure are rare. We report
      two cases and review the literature regarding this association. Characteristics
      common to these cases include a prodromal persistent nonspecific dermatitic
      eruption that is often interpreted as radiation dermatitis, and latency of
      variable duration before the onset of a vesiculobullous eruption that begins at
      the portal of irradiation. Direct immunofluorescence is positive for
      intercellular IgG, while indirect immunofluorescence is commonly positive only at
      low titers; HLA correlations have not been studied. Documentation of clinical
      course and laboratory confirmation of the diagnosis, including hematoxylin-eosin,
      direct and indirect immunofluorescence, and HLA determinations (if available),
      should be recorded to enable further clarification of this entity.

PMID- 2221937
TI  - Transfusion-associated graft-vs-host disease in patients with malignancies.
      Report of two cases and review of the literature.
AB  - Graft-vs-host disease can develop in immunosuppressed individuals who receive
      blood-product transfusions that contain immunocompetent lymphocytes. We report
      two cases of fatal transfusion-associated graft-vs-host disease that developed in
      patients with Hodgkin's disease who were undergoing therapy. We review all cases
      of this entity in patients with malignancies, represented predominantly by
      patients with hematologic malignancies. The groups at risk for development of
      transfusion-associated graft-vs-host disease, the clinical presentation and
      course, and methods of diagnosis are summarized. Prevention of this highly fatal
      condition is possible by irradiation of blood products given to patients at risk,
      but problems remain in determining the groups that warrant such measures.
      Dermatologists need to have heightened awareness of this entity to facilitate
      more complete diagnosis and allow establishment of effective standards of care.

PMID- 2221938
TI  - Compound blue nevus: a variant of blue nevus with an additional junctional
      dendritic component. A clinical, histopathologic, and immunohistochemical study
      of six cases.
AB  - We studied six cases of heavily pigmented melanocytic lesions with features of
      blue nevi within the dermis, but with an additional junctional dendritic
      component. This compound variant of blue nevus is an uncommon lesion that has not
      been previously identified as a distinct histologic entity. Immunoperoxidase
      staining for S100 protein and counterstaining with azure B distinguished the
      presence of melanocytes among numerous melanophages within the dermis. The
      compound variant of blue nevus can be distinguished histologically from combined
      blue nevus, pigmented spindle cell nevus, malignant melanoma, and melanosis due
      to a regressed malignant melanoma. The six lesions were from three men and three
      women whose ages ranged from 11 to 51 years (mean, 31 years). Three lesions were
      located on the trunk, two on the extremities, and one on the head. After a mean
      follow-up period of 47 months (range, 38 to 58 months), there was no evidence of
      recurrence.

PMID- 2221939
TI  - Severe phototoxic burn following celery ingestion.
AB  - A 65-year-old woman developed a severe, generalized phototoxic reaction following
      a visit to a suntan parlor. History taking revealed that she had consumed a large
      quantity of celery root (Apium graveolens) 1 hour earlier. With the use of thin
      layer chromatography, methoxsalen (8-methoxypsoralen) and 5-methoxypsoralen were
      identified in the extract from a similar celery root. The biologic activity of
      this extract, as evaluated with the semiquantitative Candida albicans inhibition
      technique, indicated a total psoralen dose of approximately 45 mg. Substantial
      amounts of psoralen may be absorbed from vegetables, such as celery, and under
      unusual circumstances, this may constitute a health hazard.

PMID- 2221940
TI  - Autoantibodies from patients with localized and generalized bullous pemphigoid
      immunoprecipitate the same 230-kd keratinocyte antigen.
AB  - Two patients demonstrating the typical clinical, histologic, and immunopathologic
      features of nonscarring localized bullous pemphigoid are described. These
      patients possess circulating IgG autoantibodies that bind the epidermal side of
      1.0-mol/L sodium chloride-split human skin in indirect immunofluorescence
      microscopy. Immunnoprecipitation studies demonstrate that these patients have
      circulating autoantibodies that immunoprecipitate the same 230-kd bullous
      pemphigoid antigen that is precipitated by autoantibodies from patients with
      generalized bullous pemphigoid. These findings indicate that localized bullous
      pemphigoid is a true clinical variant of generalized pemphigoid rather than a
      separate nosologic entity.

PMID- 2221942
TI  - Vulvar erythema and induration. Extraintestinal Crohn's disease of the vulva.

PMID- 2221941
TI  - Blood transfusions and graft-vs-host disease.

PMID- 2221943
TI  - Vulvar erythema. Vulvitis chronica plasmacellularis (Zoon's vulvitis).

PMID- 2221944
TI  - A gray-brown discoloration of the penis. Malignant melanoma of the penis (MMP).

PMID- 2221945
TI  - Repeat direct immunofluorescence to discriminate pemphigoid from epidermolysis
      bullosa acquisita.

PMID- 2221946
TI  - Hello tricone; good-bye "dog-ear".

PMID- 2221947
TI  - Anti-single-stranded DNA antibody and muscle involvement in localized
      scleroderma.

PMID- 2221948
TI  - Dosage guidelines: extracorporeal photochemotherapy (photopheresis)

PMID- 2221949
TI  - Fibrous papule and intradermal nevus.

PMID- 2221951
TI  - Androgenetic alopecia.

PMID- 2221950
TI  - Granuloma annulare and gold therapy.

PMID- 2221952
TI  - Acral persistent papular mucinosis: a peculiar variant of the discrete papular
      form of lichen myxedematosus.

PMID- 2221953
TI  - The nail fold in pemphigus vulgaris.

PMID- 2221954
TI  - Urticaria pigmentosa in monozygotic twins.

PMID- 2221955
TI  - Fournier's gangrene: the human counterpart of the local Shwartzman phenomenon?

PMID- 2221956
TI  - Examinations in paediatric training.

PMID- 2221957
TI  - Senior house officer posts in community paediatrics--an introduction to child
      health.

PMID- 2221958
TI  - Growth failure secondary to moyamoya syndrome.

PMID- 2221959
TI  - Management of infantile gastroenteritis.

PMID- 2221960
TI  - Use of hearing aids in infancy.

PMID- 2221961
TI  - Phenobarbitone and febrile convulsions.

PMID- 2221962
TI  - Magnetic resonance imaging in neurological disorders.
AB  - To investigate the role of magnetic resonance imaging (MRI) in neurological
      disorders, 115 children were studied in two groups. Group A (78 patients) was
      studied by paired computed tomography and MRI cranial scans. Group B (37
      patients) was studied by paired computed tomography assisted myelography (CTM)
      and MRI spinal scans. In group A, the scans were generally equivalent for
      supratentorial tumours and for investigating fits, hydrocephalus, benign
      intracranial hypertension, and cerebral atrophies, but MRI scanning was superior
      for posterior fossa tumours and cysts. In group B, MRI scans were superior for
      intramedullary spinal tumours, spinal dysraphic problems with tethering or
      syrinx, and were complementary to CTM in diastematomyelia.

PMID- 2221963
TI  - Slow release carbamazepine in treatment of poorly controlled seizures.
AB  - Thirty three children with poorly controlled epilepsy, and six new patients, were
      treated with slow release carbamazepine. Twelve of the former had a reduction in
      the number of seizures of more than half, and 10 had fewer side effects. Three of
      the new patients stopped having seizures. Variations in plasma concentrations
      between doses was significantly less when patients took the slow release
      preparation (22%) compared with the standard preparation (41%). Slow release
      carbamazepine may improve the conditions of children whose seizures are poorly
      controlled.

PMID- 2221964
TI  - Acute gastroenteritis in infants under 6 months old.
AB  - Sixty two babies under the age of 6 months who were admitted with gastroenteritis
      completed a study of gradual refeeding compared with abrupt refeeding after a
      period of rehydration. There was no difference in the incidence of recurrence of
      diarrhoea due to lactose intolerance, effect on weight, or duration of hospital
      stay. Twenty six babies (42%) had recurrence of diarrhoea after refeeding, all of
      whom settled with the introduction of a lactose free soya based formula. Well
      nourished babies under 6 months of age with mild to moderately severe
      gastroenteritis can be fed immediately with full strength milk feeds after
      rehydration. The introduction of a lactose free soya based preparation may
      provide an alternative to repeated attempts at regrading with cows' milk feeds in
      those patients with lactose intolerance.

PMID- 2221965
TI  - Management of gastroenteritis.
AB  - Childhood gastroenteritis remains a common reason for admission to British
      paediatric units, although the severity of the disease appears to be diminishing
      in recent years. We studied 215 infants and children with gastroenteritis
      admitted consecutively to four paediatric units in South Wales in order to
      determine the severity of the disease, the organisms isolated, the frequency of
      complications, and the adequacy of management before admission. Stool pathogens
      were isolated in 125 (58%) patients (viruses in 65, bacteria in 30, and protozoa
      in 19, with multiple infection found in 11). There was a low incidence of
      morbidity and complications, but prolonged diarrhoea (postenteritis syndrome) was
      present in 24 (11%) cases and 77 (36%) had received inappropriate treatment
      before admission. Contemporary gastroenteritis is thus a relatively mild disease
      in the acute phase, but management before admission to hospital is often
      inadequate, and prolonged diarrhoea may be a feature in a considerable number of
      cases.

PMID- 2221966
TI  - Prognosis of chronic granulomatous disease.
AB  - The records of 28 patients with chronic granulomatous disease born over a 32 year
      period were reviewed. The characteristics of the group, and the frequency with
      which various clinical and laboratory features had been recorded, was assessed.
      Nine patients were known to have died, in most cases of progressive suppurative
      infection. Actuarial analysis showed 50% survival through the third decade of
      life. The long term survival of patients developing symptoms after the end of the
      first year of life was significantly better than that of patients whose illness
      started in infancy. Our data confirm that the severity of chronic granulomatous
      disease is not uniform, and that the prognosis for long term survival is better
      than that suggested in earlier reports. Early onset may be a poor prognostic sign
      and invasive aspergillosis is a life threatening complication. In the absence of
      curative treatment, trials to assess the effectiveness of interferon gamma are
      necessary and early antenatal diagnosis should be offered to as many affected
      families as possible.

PMID- 2221967
TI  - Latent sensitisation to respiratory syncytial virus during acute bronchiolitis
      and lung function after recovery.
AB  - To determine whether latent sensitivity to respiratory syncytial virus antigen(s)
      occurs after infection, 27 infants with acute bronchiolitis were studied and
      compared with 15 hospital controls. Blood was collected for whole blood
      challenge, and histamine release was measured by a high performance liquid
      chromatography technique with fluorometric detection. There was a significantly
      greater histamine release to respiratory syncytial virus antigen(s) in those with
      bronchiolitis than in controls, expressed either in amount (median 154 nmol/l
      compared with 104 nmol/l) or percentage release (median 20% compared with 3%).
      There was a significant difference between index and control groups in terms of
      individual histamine responses. These findings strongly suggest that infants
      develop latent sensitivity to respiratory syncytial virus antigen(s) during the
      course of acute bronchiolitis. Serial lung function tests were performed in 15
      infants. All infants had abnormalities of lung function at some stage, but the
      small numbers of subjects precluded comparison between 'sensitised' and 'non
      sensitised' infants. Further study is indicated to define the relation of latent
      sensitisation and subsequent bronchial hyper-responsiveness after respiratory
      syncytial virus infection in infants.

PMID- 2221968
TI  - Recurrent cyanotic episodes with severe arterial hypoxaemia and intrapulmonary
      shunting: a mechanism for sudden death.
AB  - The pathophysiology of recurrent cyanotic episodes has been investigated in 51
      infants and children. Episodes began at a median age of 7 weeks (range 1 day to
      22 months, 39 at less than 4 months). They were characterised by the rapidity of
      onset and progression of severe hypoxaemia with early loss of consciousness from
      cerebral hypoxia. The most common precipitating factor was a sudden naturally
      occurring stimulus from pain, fear, or anger. In uncontrolled trials, cyanotic
      episodes were reduced in frequency and severity by tetrabenazine (n = 15) and
      additional inspired oxygen (n = 10). Eight patients died suddenly and
      unexpectedly (four during cyanotic episodes). Twenty eight patients underwent
      physiological studies during cyanotic episodes. There was no evidence of seizure
      activity at the onset and although prolonged absence of inspiratory effort with
      continued expiratory efforts was common, breathing sometimes continued. Episodes
      were not caused by upper airway obstruction and sometimes occurred during
      positive airway pressure ventilation. The rapidity of fall in arterial oxygen
      pressure and continued breathing suggested a right to left shunt of sudden onset.
      The results of contrast echocardiography and lung imaging studies confirmed that
      this was occurring within the lungs. These cyanotic episodes included both
      intrapulmonary shunting and prolonged expiratory apnoea. They are best explained
      by interactions between central sympathetic activity, brainstem control of
      respiration and vasomotor activity, reflexes arising from around and within the
      respiratory tract, and the matching of ventilation to perfusion in the lungs.
      They are a cause of sudden unexpected death in infancy and early childhood.

PMID- 2221969
TI  - Natural and modified history of complete atrioventricular septal defect--a 17
      year study.
AB  - We reviewed 103 cases of isolated complete atrioventricular septal defect. These
      cases represented 4.4% of the cases of congenital heart disease diagnosed in our
      hospital by catheterisation and angiography during 1971-88. Most children (n =
      76) had Down's syndrome. Banding of the pulmonary artery was performed in seven
      cases and complete repair in 67 cases. In the period 1971-82 the complete
      correction was performed at a mean age of 23 months with a surgical mortality of
      88.8%. In the period 1983-8 the mean age at complete correction was 13 months,
      the mortality 43.2%, and the five year actuarial survival was 46.8%. The 22
      patients that survived after complete correction were in functional classes I and
      II of the New York Heart Association classification. After a mean follow up of 10
      years only eight (36%) of the 22 who were followed up and treated medically
      survived; all had developed pulmonary vascular obstructive disease and were in
      functional classes III or IV. Our findings stress the importance of early
      complete surgical repair.

PMID- 2221970
TI  - Pharmacokinetics of paracetamol after cardiac surgery.
AB  - Plasma concentration was measured after rectal and nasogastric administration of
      paracetamol 15 mg/kg to 28 febrile children aged between 9 days to 7 years who
      had undergone cardiac surgery. After equivalent doses, rectal administration in
      neonates and children on the first postoperative day was found to produce plasma
      concentrations below the therapeutic range with higher concentrations after
      nasogastric paracetamol on the second postoperative day. There was less variance
      in plasma paracetamol concentrations in neonates. Both plasma elimination half
      life and area under the plasma concentration time curve were significantly
      increased in neonates after suppository dosing compared with older children.
      There was no difference in antipyretic effect between the two routes of
      administration, but this was much lower than that previously reported in febrile
      children.

PMID- 2221972
TI  - Social integration of the older thalassaemic patient.
AB  - Because social policy favours the fullest possible social integration of
      chronically ill patients, we have evaluated the facilities that are needed to
      achieve this for patients with beta thalassaemia major in the light of the
      therapeutic advances that now permit them to survive into adulthood. We have
      investigated the social integration of adolescent and young adult thalassaemic
      patients, 171 from Greece and 112 from Ferrara in Italy. Patients in both areas
      show a good level of social integration and favourable self image, indicating
      what may be achieved by providing psychosocial support as part of a comprehensive
      approach to treatment.

PMID- 2221971
TI  - Plasma prolactin and clinical outcome in preterm infants.
AB  - Plasma prolactin was measured weekly in 280 preterm infants. The complex
      gestational age dependent pattern of postnatal prolactin release has been defined
      and reference standards provided. Plasma prolactin was higher in girls, with
      increasing divergence between the sexes from the third week onwards, and higher
      after two weeks, in infants of mothers with pregnancy related hypertension. Diet,
      assigned randomly, exerted a major effect on plasma prolactin, with significantly
      higher values in infants fed donor breast milk or standard formula than in those
      fed a protein, energy, and mineral enriched preterm formula. After adjusting for
      confounding factors, infants with the lowest plasma prolactin concentrations
      (less than 1000 mU/l, 32.9 micrograms/l) occurring usually at a nadir between
      days 5 and 12, showed a 120% increase in the duration of ventilatory assistance
      required, a 20% increase in the number of days to attain full enteral feeds, and
      a 30% decrease in length gain. We suggest preterm birth disrupts the normal
      perinatal pattern of prolactin release and that those infants who develop
      relatively low plasma concentration have an adverse outcome. Our data add to the
      broader debate on whether preterm infants require multiple endocrine replacement
      treatment.

PMID- 2221973
TI  - The iris in Williams syndrome.
AB  - Forty three children with Williams syndrome and 124 control subjects had their
      eyes photographed. The photographs were examined by three ophthalmologists and
      four geneticists of varying experience. A stellate pattern was noted more often
      in the irides of patients with Williams syndrome (51%) than in those of the
      control subjects (12%), and was more difficult to detect, or was absent, in
      heavily pigmented irides. We conclude that the stellate pattern is of diagnostic
      importance, particularly if the pattern is carefully defined and the clinician is
      experienced.

PMID- 2221974
TI  - Perforated duodenal ulcer: an unusual complication of gastroenteritis.
AB  - A 7 year old boy was admitted to hospital with gastroenteritis, which was
      complicated by an acute perforated duodenal ulcer. After oversewing of the
      perforation he made an uncomplicated recovery. Peptic ulceration is under
      diagnosed in childhood and this leads to delay in diagnosis and appropriate
      management. Ulceration is associated with severe illness and viral infections,
      but perforation is rare.

PMID- 2221975
TI  - An unusual cause of thoracic mass.
AB  - A previously well 10 year old boy presented with scoliosis, a mass in the chest
      wall, and a pleural effusion. Chest radiography showed the triad of chronic
      consolidation, pleural effusion, and rib periostitis. Investigations confirmed
      thoracic actinomycosis. Tissue spread was evaluated by computed tomography. It
      was successfully treated with benzylpenicillin, which was later replaced by
      clindamycin.

PMID- 2221976
TI  - Spontaneous resolution of congenital nephrotic syndrome in a neonate.
AB  - An infant with congenital nephrotic syndrome recovered spontaneously and
      completely by the age of 11 days and had remained well at the age of 1 year. This
      reinforces the view that reversible congenital nephrotic syndrome does occur and
      that it is not a single disease with a universally dismal prognosis.

PMID- 2221977
TI  - Congenital diaphragmatic hernia: impact of prostanoids in the perioperative
      period.
AB  - A prospective study of 10 neonates with congenital diaphragmatic hernia and five
      controls to determine the importance of prostanoid concentrations perioperatively
      and the relation with persistent pulmonary hypertension (PPH) is reported. In
      neonates with congenital diaphragmatic hernia postoperative concentrations of the
      vasoconstrictor thromboxane B2 rose significantly and were higher during episodes
      of PPH; this rise may provoke PPH and subsequent right to left shunting.

PMID- 2221978
TI  - Reflux vomiting.

PMID- 2221979
TI  - Elastic properties of human skin: relation to age, sex, and anatomical region.
AB  - Using a recently developed noninvasive, in vivo suction device for measuring skin
      elasticity, we evaluated age, sex, and regional differences in the viscoelastic
      properties of skin. A total of 33 volunteers participated in the study consisting
      of (a) 8 young females, (b) 9 old females, (c) 8 young males and (d) 8 old males.
      Measurements were performed on 11 anatomical regions; three different loads were
      applied: 100, 200, and 500 mbar. The parameters used were: immediate distension
      (Ue); delayed distension (Uv); immediate retraction (Ur); and, final deformation
      (Uf). To compare between subjects and anatomical regions, relative parameters
      independent of skin thickness were calculated: Uv/Ue, the ratio between the
      viscoelastic properties of skin and immediate distension, and Ur/Uf, which
      measures the ability of the skin to regain its initial position after
      deformation. Generally, Uv/Ue increased while Ur/Uf decreased with aging.
      Responses were variable with respect to load applied. Variability within
      anatomical regions was also noted. However, differences between the sexes were
      not statistically significant for most regions. These findings are in congruence
      with earlier studies suggesting the differences are mainly attributable to
      alterations in the elastic fiber network. This procedure provides a simple,
      quantitative assessment of elastic properties of the skin. Its application may
      help in future investigations of other connective tissue disorders.

PMID- 2221980
TI  - UVA-induced tumours in pigmented hairless mice and the carcinogenic risks of
      tanning with UVA.
AB  - An animal experiment is presented in which two groups of pigmented hairless mice
      were exposed daily to suberythemal doses of UVA to study tumourigenesis. The aim
      of the study was to estimate the carcinogenic risks of tanning by UVA. The
      pigmented hairless mice, Skh-hr2, were separated by selective breeding into two
      groups, the "browns" and the "blacks". Both groups were exposed daily to UVA from
      fluorescent UVA lamps (Philips TL40W/09) purified by rigorously filtering out the
      shorter wavelengths. No acute actinic damage was observed after any exposure.
      However, in most UVA exposed animals, especially in the blacks, a marked
      scratching preceded the development of tumours. Hyperkeratosis was also observed.
      All animals developed tumours. Histopathologically at least 60% of the tumours
      were squamous cell carcinomas. Depositions of melanophages were observed, but no
      melanomas. It is beyond any doubt that UVA is carcinogenic in laboratory animals.
      The present state of knowledge justifies no preference for tanning with UVA over
      tanning with UVB.

PMID- 2221981
TI  - IgE-positive epidermal Langerhans cells in allergic contact dermatitis lesions
      provoked in patients with atopic dermatitis.
AB  - To see whether or not IgE-bearing epidermal Langerhans cells are specific to skin
      lesions of atopic dermatitis (AD), we performed immunohistochemical and
      immunoelectron microscopic examinations of dinitro-chlorobenzene (DNCB) contact
      dermatitis lesions provoked in uninvolved skin of eight patients with AD. In all
      of the eight examined, IgE-positive epidermal Langerhans cells were observed in
      the DNCB dermatitis lesions. Typical staining of anti-IgE was absent in the
      epidermis of normal-appearing skin of five patients with AD. Thus, it is likely
      that IgE positive epidermal Langerhans cells non-specifically occur in different
      eczematous diseases provoked in patients with AD.

PMID- 2221982
TI  - Desmosomes, corneosomes and desquamation. An ultrastructural study of adult pig
      epidermis.
AB  - We recently developed a pig skin model to determine the role of corneosomes
      (modified desmosomes in the stratum corneum) and extracellular lipids in
      desquamation. The present study provides control morphometric data on the
      morphological changes in desmosomes and corneosomes leading to desquamation in
      adult pig epidermis in vivo. The extracellular space within desmosomes gradually
      widened from the basal to the granular layer, and decreased slightly in the
      stratum corneum. Mid-dense line broadening, and increased electron density of the
      distal light layers, coincided with membrane-coating granule extrusion in the
      outer granular layer. Corneocyte attachment correlated with corneosome
      distribution. Compactum packing was relatively tight and corneosomes were
      numerous. Cohesion was mainly peripheral in the disjunctum, and corneosomes were
      restricted to corneocyte edges. Adhesion had a tongue-and-groove appearance with
      corneosomes riveting corneocyte peripheries into a lipped groove on adjoining
      cells. Cells shed by peeling radially towards the lipped groove, and corneosomes
      decreased from lower to upper disjunctum. Corneosome breakdown commenced with an
      electron lucent band forming between the plug and lipid envelope. The plug was
      then unzipped from the lipid envelope and degraded. Corneosomes did not form
      squamosomes.

PMID- 2221984
TI  - Lactate dehydrogenase release as an indicator of dithranol-induced membrane
      injury in cultured human keratinocytes. A time profile study.
AB  - HaCaT cells, a rapidly multiplying human keratinocyte line, were tested for their
      sensitivity to antipsoriatic dithranol with regard to classical proliferation
      parameters and for the drug's action on the plasma membrane integrity by the dose
      and time-dependent release of cytosolic lactate dehydrogenase (LDH). In the case
      of 3H thymidine as well as 14C amino acid incorporation the 50% inhibition
      concentration (IC50) was 0.2 microM dithranol 24 h after initial exposure to the
      drug. For protein content of attached cells the IC50 proved to be greater than
      3.0 microM. Using 0.3, 1.0 and 3.0 microM dithranol, significant (p less than
      0.05) dose dependent LDH release of 0.866 +/- 0.387, 1.842 +/- 1.127 and 2.938 +/
      1.635 mU per hour and cm2 confluent culture area was measured between the 5th
      and the 24th hour, compared to an acetone control of 0.504 +/- 0.299 mU/h x cm2.
      Between the 2nd and the 4th hour as well as from the 25th to the 48th hour and
      the 49th to the 72nd hour the LDH release after dithranol treatment did not
      exceed the control value. In accordance with these findings dose-dependent
      morphological signs of cell injury were detected by phase contrast microscopy
      beyond the 4th hour. The data reveal that: HaCaT cells are a very sensitive
      target for the antiproliferative action of dithranol; the drug causes
      considerable plasma membrane damage even at concentrations as low as 0.3 microM;
      and this membrane damage becomes evident after a latency of at least 4 h and for
      a limited period of up to 24 h.

PMID- 2221983
TI  - Immunohistological evaluation of basal cell carcinoma immunoinfiltrate during
      intralesional treatment with alpha 2-interferon.
AB  - We investigated the peritumoral and intratumoral immune infiltrate in 6 basal
      cell carcinomas (BCCs) treated with recombinant alpha 2b-interferon. Each BCC was
      injected intralesionally three times a week for 3 weeks with 1.5 x 10(6) IU of
      interferon per injection (total dose 13.5 x 10(6) IU). The immunohistological
      study was done before the start of interferon therapy and 15 days afterwards,
      using a series of monoclonal antibodies and an immunocytochemical technique.
      Before therapy the infiltrate consisted mainly of CD3+ (T) cells, with prevalence
      of CD4+ (helper/inducer) T cells. The percentage of T cells expressing
      interleukin-2 receptor (CD25+ cells) was higher in the tumor nests than in the
      peritumoral infiltrate (20% and 11% respectively). CD1+ (Langerhans) cells and
      CD14b+ cells (monocytes/macrophages) were present in the peritumoral infiltrate
      in all cases (9% +/- 5% and 14% +/- 7% respectively). Very few CD56+ (natural
      killer), CD15+ (granulocytes) and CD20+ (B) cells were observed in the
      peritumoral infiltrate and none at all in tumor nests. After 15 days of
      interferon therapy, we observed an increase in peritumoral and intratumoral CD4+
      cells. There was a decrease in the number of CD25+ cells and of CD1+ cells in the
      peritumoral infiltrate. The number of intratumoral CD25+ increased. No variations
      were seen in CD14b, CD15, CD20, and CD56 positive cells. Eight weeks after
      completion of therapy, two BCCs were cleared and the remaining four showed
      clinical and histological improvement. These results may indicate a direct effect
      of interferon against BCC; in addition the immunohistological findings suggest
      that intralesional interferon enhances T cell mediated immune response,
      especially in tumor nests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2221985
TI  - Growth advantage by overexpression of normal Harvey ras proto-oncogene in
      cultured rat epidermal keratinocytes.
AB  - The ras proto-oncogene is frequently amplified and overexpressed in the
      hyperproliferative conditions of epidermal keratinocytes. To investigate the
      effects of its overexpression on the growth of keratinocytes in a model system,
      we constructed expression vectors for normal human Ha-ras and introduced them
      into FRSK cells, a fetal rat epidermal keratinocyte cell line. Several clones
      containing the transfected Ha-ras were isolated, and two of them overexpressed
      this gene. In these clones DNA synthesis and cell growth were greater than in
      other clones expressing this gene at low levels. Thus we suggest that
      overexpression of normal ras gene may provide growth advantage to epidermal
      keratinocytes.

PMID- 2221986
TI  - Sphingoglycolipids in human cultured keratinocytes.

PMID- 2221987
TI  - Inflammatory mediators are involved in the Candida albicans killing activity of
      human epidermal cells.

PMID- 2221988
TI  - Effects of Sandimmun on T lymphocyte and dendritic cell subpopulations in
      psoriasis.

PMID- 2221989
TI  - The effect of fibrin glue and peritoneal grafts in the prevention of
      intraperitoneal adhesions.
AB  - We studied the effect of fibrin sealant and peritoneal grafts applied by fibrin
      glue on adhesion formation in the rat. Sealing and patching of ischaemic lesions
      of the uterus resulted in a significant increase in adhesion formation. We
      conclude, that fibrin sealant and peritoneal grafts can not be given general
      approval for prophylaxis of intraperitoneal adhesions.

PMID- 2221990
TI  - Plasma and erythrocyte zinc and birth weight in pre-eclamptic pregnancies.
AB  - Plasma and erythrocyte zinc concentrations in 45 proteinuric pre-eclamptic
      Chinese women were measured. There was no difference in either the plasma or
      erythrocyte zinc concentration between pre-eclamptic patients with and without
      intrauterine growth retardation. There was no correlation between either plasma
      or erythrocyte zinc concentration with the gestation at delivery, birth weight,
      mean arterial pressure and plasma albumin concentration. On the other hand, both
      plasma albumin concentration and mean arterial pressure were significantly
      correlated to birth weight, and the mean arterial pressure was also significantly
      higher in patients with intrauterine growth retardation. Plasma and erythrocyte
      zinc are not useful as indices of severity in pre-eclampsia.

PMID- 2221991
TI  - Fructosamine in relation to maternofetal glucose and insulin homeostasis in
      gestational diabetes.
AB  - The problem in screening for gestational diabetes is recognizing fetuses
      endangered by hyperinsulinism. 21.8% of patients with gestational diabetes
      (defined as a glucose peak exceeding 160 mg/dl after an oral glucose load of 1 g
      per kg body weight) develop fetal hyperinsulinism. Thus, is indicated by an
      elevated amniotic fluid insulin (AFI) concentration and requires insulin
      treatment. Since fetal hyperinsulinism can be neither predicted nor ruled out by
      single parameters of maternal metabolism, every patient with gestational diabetes
      had to undergo amniocentesis for amniotic fluid analysis. In 110 gestational
      diabetics and 822 controls, fetal hyperinsulinism was predicted by the
      combination of the oGTT (greater than or equal to 160 mg/dl) and maternal serum
      fructosamine (greater than or equal to 2.6 mmol/l) with a sensitivity of 95.8%
      and a specificity of 91.8%. Thus, 73% of gestational diabetics need not undergo
      amniocentesis. With a sensitivity of 20.8%, the combination of the oGTT and HbA1c
      is not useful in identifying hyperinsulinemic fetuses.

PMID- 2221992
TI  - The grand multipara--still an obstetrical challenge?
AB  - To study whether grand multiparity (parity of 6 or more) still carries risk, we
      studied two birth cohorts in northern Finland: the first comprised 12,231 births
      to 12,068 mothers in 1966 and the second comprised 9478 births to 9362 mothers in
      1985/86. The percentage of grand multipara decreased from 7.7 to 4.0. The grand
      multipara made fewer antenatal visits than the others. The proportion of grand
      multipara referred to maternity outpatient clinics of hospitals was smaller, but
      the mean number of visits was higher than of lower parity women. The mean number
      of admissions to hospital was similar in both groups but grand multipara stayed
      longer in hospital, smoked less (4.3% vs. 22.7%) and had a higher incidence of
      essential hypertension than women of lower parity. The grand multipara had fewer
      caesarean sections (7.5% vs. 14.1%) and vacuum extractions (0.5% vs. 5.1%) but
      more inductions of labour (33.1% vs. 23.5%) than mothers of lower parity. The
      number of low birth weight (LBW) infants (less than 2500 grams), stillbirths and
      neonatal deaths (before 28 days) was significantly lower in 1985/86 than in 1966
      in women of lower parity but there was no such change in grand multipara.
      However, the percentage of LBW infants was smaller among grand multipara than
      among women of lower parity in both cohorts (2.7% vs. 4.1%, NS). The stillbirth
      plus neonatal death rate in grand multipara was higher than in women of lower
      parity (1.9% vs. 0.9%, P less than 0.05) partly because of a higher incidence of
      major congenital anomalies.

PMID- 2221993
TI  - Screening for gestational diabetes among women who have previously had a large
      baby or a stillborn infant.
AB  - In Baranya county, Hungary oral glucose tolerance tests were done according to
      WHO recommendations in pregnant women with a history of a previous baby weighing
      greater than or equal to 4000 g and/or a previous unexplained intrauterine fetal
      death. The first oral glucose tolerance test was done at 16-20 weeks gestation,
      and it was repeated monthly if it was normal. Patients with impaired glucose
      tolerance or gestational diabetes were treated by diet and/or insulin. 152
      patients were involved in the screening program. Twenty-six of 81 patients had a
      "lag" curve blood glucose still above 5.5 mmol/ at 180 min.

PMID- 2221994
TI  - Androgen receptors, serum androgen levels and survival of breast cancer patients.
AB  - Steroid receptor levels and serum androgen levels were determined in 61 breast
      cancer patients and 34 patients with non-malignant breast lesions. Testosterone
      and dehydroepiandrosterone-sulfate did not and androstenedione did show a
      difference between the two groups. Androgen levels had no influence on survival
      rates. Androgen receptor (AR) levels correlated with progesterone receptor
      levels, but not with estrogen receptor levels or with tumor stage. Patients with
      positive AR findings had a better survival rate; this was independent of tumor
      stage. AR findings may therefore be a prognostic index in breast cancer patients.

PMID- 2221995
TI  - Acute urinary retention caused by a unilateral hematometra.
AB  - We describe a unilateral hematometra with an associated hematosalpinx causing
      acute retention of urine in a female adolescent. Normal menstruation had occurred
      from the uterine cavity on the unaffected side. Treatment was by abdominal
      metroplasty with complete excision of the uterine septum and a terminal cuff
      salpingostomy. Urological investigation revealed ipsilateral renal agenesis.

PMID- 2221996
TI  - Pancytopenia in a patient given pyrimethamine and sulphamethoxidiazine during
      pregnancy.
AB  - This is a report of a pregnant woman who became pancytopenic in the second
      trimester following pyrimethamine administration. The patient recovered on
      steroid, antibiotics, transfusion, folic acid and folinic acid therapy, and the
      pregnancy was uneventful afterwards. The patient was delivered of a healthy term
      infant.

PMID- 2221997
TI  - [In situ hybridization: principles, methods and applications].
AB  - In situ hybridization is used to localize DNA or RNA sequences in tissue
      sections, single cells or chromosome preparations. The preparation and labeling
      of probes and the main steps of the technique are described and discussed
      together with its main applications.

PMID- 2221998
TI  - [Mucocutaneous leishmaniasis. Histologic classification and anatomoclinical
      correlations. Apropos of 102 cases].
AB  - Two hundred and three skin and mucosal biopsies performed in 162 patients
      suffering from leishmaniasis, were studied retrospectively. They were classified
      according to Ridley into 5 histological groups of increasing severity. In
      cutaneous leishmaniasis, a high proportion of the biopsies belonged to groups III
      and IV. In mucocutaneous leishmaniasis, the percentage of groups III and VI was
      lower and group V was present in 20% of cases. In 16 patients, followed by
      repeated biopsies, we detected some variations of the histological group during
      the course of the disease. However, there were no positive correlations between
      clinicopathological features and prognosis.

PMID- 2221999
TI  - [Thyroid microcarcinoma with a fatal outcome and 34 other unusually aggressive
      cases reported in the literature].
AB  - A follicular thyroid microcarcinoma was revealed by scapular metastases. Despite
      treatment, other metastases were the cause of death after a course of 14 years.
      In the medical literature there are at least thirty-four other examples of
      follicular or papillary carcinoma of less than 15 mm (previously called occult)
      that have either given rise to blood-born metastases or have been the cause of
      death. Present data from light and electron microscopy, immunohistochemistry and
      microspectrophotometry cannot differentiate between small and large carcinomas.
      Microcarcinomas (particularly papillary ones) are frequent in the general
      population and are found in 5% of thyroids. They are usually not aggressive.
      Those which show vascular or capsular invasion, a lack of lymphoid infiltrate and
      large cervical lymph node metastases are more likely to have an unfavorable
      course. The discovery of a microcarcinoma in a thyroid cells for an extended
      follow-up.

PMID- 2222000
TI  - [Adult type rhabdomyoma of the soft palate: pathology of 2 cases with review of
      the medical literature].
AB  - In this paper, the authors report two cases of adult type rhabdomyomas of the
      soft palate. This tumor is composed of striated muscle cells containing
      striations and intracytoplasmic rod-shaped inclusions. In specimens already fixed
      in aqueous fixators (formalin...), some tumor cells presented a fixation artefact
      and displayed the morphology of so-called "spiderweb cells". Adult type
      rhabdomyoma is a real tumor. Total surgical removal is sufficient to cure the
      patient of this tumor in most cases.

PMID- 2222001
TI  - Primary vascular bone sarcomas. A clinicopathological and immunohistochemical
      study of two cases.
AB  - Two cases of primary vascular bone sarcomas are reported. The first case
      presented a rather slow clinical course and a non-aggressive histological picture
      and was classified as hemangioendothelioma. The second was a frankly malignant
      tumor, already metastatic at the time of diagnosis, which was classified as
      angiosarcoma. Views concerning the nomenclature and the behavior of primary
      vascular bone sarcomas are also discussed.

PMID- 2222002
TI  - Malignant melanoma of the gallbladder. Case report and review of the literature.
AB  - The authors are presenting a new case of malignant melanoma of the gallbladder to
      be added to those described in the literature. The tumour appeared as a polypoid
      mass of the gallbladder and had metastasized to the jejunum and the brain. Review
      of the literature and analysis of this case require a thorough discussion of the
      real existence of tumours in this unusual primary site.

PMID- 2222003
TI  - [Cardiac pathology in human immunodeficiency virus infection].
AB  - Clinical cardiac manifestations are rare in the course of acquired
      immunodeficiency syndrome (AIDS), but cardiac lesions can be found at autopsy in
      60% of cases. Myocardium and pericardium are the most frequently involved.
      Cardiac involvement in opportunistic infections, Kaposi's sarcoma, and non
      Hodgkin's malignant lymphomas usually reflects systemic dissemination of the
      disease. Idiopathic myocarditis and hypertrophic cardiomyopathy may also occur
      and may be related to human immunodeficiency virus. Dysautonomia and drug-induced
      cardiac lesions have also been reported. Cardiac involvement of acquired
      immunodeficiency syndrome in children is characterized by possible lesions of
      conduction tissue.

PMID- 2222004
TI  - Hydatidosis in Belgium: analysis of larval Echinococcus granulosus by SDS-PAGE
      and western blotting.
AB  - Echinococcosis/hydatidosis is characterized by the existence of various strains
      of the parasite Echinococcus granulosus. In order to study the degree of
      variability in Belgium, protoscoleces (PS) were isolated from infected
      intermediate hosts (horse, cattle, pig, goat and man). Homogenate supernatants of
      these PS were compared by SDS-polyacrylamide gel electrophoresis and western
      blotting: 15 to 26 predominantly silver staining bands (depending on the source
      of the parasites), were selected to study existing homologies among these
      possible strains. Antisera raised against PS homogenates of horse, cattle, pig
      and goat origin, were used to compare antigenicity by western blotting. The
      results indicate a closer similarity between E. granulosus of horse, goat and pig
      origin whereas E. granulosus derived from cattle showed less homology with any of
      the former. Results are discussed against the background of the occurrence of E.
      granulosus in Belgium.

PMID- 2222005
TI  - Characterization of a Trichinella isolate from polar bear.
AB  - An isolate of Trichinella of polar bear origin was studied by isoenzymatic
      typing. It was found referable to Trichinella nativa. While the Wistar rats
      proved nearly refractory to this isolate, the Swiss albino mice were highly
      susceptible. Ninety-one per cent of the cystic lesions in the diaphragm of the
      polar bear contained viable larvae after over 20 years of acquisition of the
      infection by the host which is a case of extreme adaptability of the parasite to
      its host. The anatomo-pathological aspects of these lesions are studied and the
      zoonotic significance of this isolate examined.

PMID- 2222006
TI  - [Evaluation of practice and costs of vector control on a family level in Central
      Africa. II. Douala City (Cameroon), July 1988].
AB  - A Knowledge, Attitude, Practice survey was carried out in July 1988 in Douala
      city, by cluster sampling and household visits. 98% of these households declared
      being disturbed by mosquitoes (bites, diseases, noise); 91% of families are using
      a vector control method; the main methods are: bed-nets (48%), insecticide sprays
      (39.5%) and mosquito coils (36.7%). The average cumulated expense by households
      for vector control (116.6 ECU/year) and care for diseases attributed to
      mosquitoes (147.4 ECU/year) was evaluated at the equivalent of about 3 months of
      "minimum monthly wages". More than 90% of people interviewed would accept buying
      and using an insecticide impregnated bed-net provided that the price of such a
      product be lower than the current habitual price for ordinary bed-nets. The
      distribution of the impregnation technique must be made at the level of
      impregnation centres, which should start impregnating the existing bed-nets and
      take care of informing the public.

PMID- 2222007
TI  - The effect of intersubspecific hybridization and gamma radiation on the
      reproductive biology of Glossina palpalis palpalis (Robineau-Desvoidy) and
      Glossina palpalis gambiensis Vanderplank.
AB  - The closely related tsetse fly subspecies Glossina palpalis palpalis (Nigeria
      origin) and Glossina palpalis gambiensis (Burkina Faso origin) hybridize readily
      in the laboratory. Hybridized G.p.palpalis females produced less offspring than
      the parental intrasubspecific crosses. Adult emergence was below 70% with at
      least 78% being females. Most female hybrids were fertile whereas most of the
      male hybrids were sterile when backcrossed to the G.p.palpalis parental line. All
      F1 males were capable of transferring a spermatophore but their mates rarely had
      sperm-impregnated spermathecae. Their testes rarely contained mature sperm;
      moreover, sperm, when present had low or no motility. During laboratory cage
      tests with virgin females of both subspecies and either sexually mature male
      G.p.palpalis or G.p.gambiensis, there was no indication for selective mating. The
      same was true when gamma irradiated males (120 Gy treatment in air) were used. In
      the latter case complete sterility was induced causing embryonic arrest in all
      inseminated female mates. Consequently, in ratio tests with untreated virgin
      G.p.palpalis females, untreated G.p.palpalis males and an increasing number of
      irradiated G.p.gambiensis males, there was a gradual decrease in production of
      viable offspring. The results of the present study are discussed with a view of
      using a combined hybridization and induced sterility in distinct geographical
      zones where the two subspecies are present.

PMID- 2222008
TI  - Bulinus africanus from Ituri (north-east Zaire) as a host for Schistosoma bovis.

PMID- 2222009
TI  - [Study of cellular immunity in patients with Mediterranean visceral
      leishmaniasis].
AB  - Cellular immunity against Leishmania infantum antigens was studied in visceral
      leishmaniasis patients and healthy subjects living in a endemic area. Only the
      healthy subjects were TTL positive with production of gamma interferon, whereas
      the visceral leishmaniasis patients presented a transitory inhibition of their
      specific cellular response mechanisms.

PMID- 2222010
TI  - Impaired myocardial function and oxygen utilization due to protamine sulfate in
      an isolated rabbit heart preparation.
AB  - The myocardial effects of protamine, with and without heparin, were documented in
      this investigation. Isolated rabbit hearts (n = 30) were retrograde perfused with
      Krebs-Ringers bicarbonate solution aerated with 95% O2/5% CO2 through the aortic
      root (37 C, 80 mmHg). Developed left ventricular blood pressure, heart rate,
      coronary artery flow, contractility as reflected by peak +dp/dt, oxygen
      extraction (a-vO2), and oxygen consumption (VO2) were measured at baseline and
      continuously throughout the experiment. Protamine (25 micrograms, 50 micrograms,
      and 250 micrograms per mL of perfusate) was circulated in the Krebs-Ringers
      buffer to hearts perfused without heparin (groups I, II, and III) or hearts
      perfused with heparin added to the buffer solution, 0.1 IU/1.0 microgram
      protamine (groups IV, V, and VI). Blood pressure 4 minutes after protamine was
      less in groups III (-23 mmHg) and VI (-28 mmHg) than in groups I (-6 mmHg), II (
      18 mmHg), IV (-1 mmHg), and V (-7 mmHg). Heart rate changes (beats/minute) at 4
      minutes revealed similar dose-dependent reductions (III and VI: -51, -55; II and
      V: -36, -36; and I and IV: -20, -16, respectively). Coronary artery flow at 4
      minutes was slightly increased in groups III (9 mL/minute) and VI (15 mL/minute),
      but was relatively unchanged in the other groups. Decreases in contractility were
      apparent in all groups 4 minutes after protamine was started: group I, -14%; II, 
      16%; III, -30%; IV, -7%; V, -15%; and VI, -34%. Similarly declines in oxygen
      extraction and consumption were noted in all groups at the same time period and
      were greater in groups III (-53%, -44%) and VI (-55%, -49%) than in groups I (
      25%, -26%), II (-15%, -12%), IV (-48%, -49%) and V (-15%, -18%), with p less than
      or equal to 0.05 or p less than or equal to 0.01 compared to baseline. Three of
      ten hearts exposed to high-dose protamine stopped beating after 5 minutes. This
      investigation establishes, for the first time, that protamine has dose- and time
      specific adverse effects on cardiac contractility. In addition protamine
      decreases myocardial a-vO2 and VO2. These changes may contribute to certain
      adverse events accompanying the clinical administration of protamine.

PMID- 2222011
TI  - Long-term course of patients with persistent hypercalcitoninemia after apparent
      curative primary surgery for medullary thyroid carcinoma.
AB  - Thirty-one patients with persistent hypercalcitoninemia after seemingly adequate
      primary operation for medullary thyroid carcinoma (MTC) were followed for a mean
      period of 11.9 years after operation. Ten patients had sporadic MTC and the
      remaining patients were members of families with multiple endocrine neoplasia
      (MEN)--either MEN 2A (15 patients) or MEN 2B (six patients). Overall 5- and 10
      year survival rates were 90% and 86%, respectively. Only four patients died at
      the completion of the study: two of MTC and two of unrelated causes. Eleven
      patients (35.5%) underwent surgical re-exploration after demonstration of
      recurrent disease clinically or radiologically. In no patient did the calcitonin
      level return to normal after re-exploration. The presence of more than three
      metastatic nodes at the time of initial operation was a statistically significant
      (p = 0.003) predictor for disease recurrence. Factors approaching statistical
      significance were patients younger than age 35 (p = 0.06) and the percentage of
      cells in the S phase of cell division (0.07). This data supports a conservative
      surgical philosophy in the management of the patient with persistent
      hypercalcitoninemia after resection of MTC.

PMID- 2222012
TI  - Selective evaluation and management of coronary artery disease in patients
      undergoing repair of abdominal aortic aneurysms. A 16-year experience.
AB  - Reduction of cardiac mortality associated with abdominal aortic aneurysm (AAA)
      repair remains an important goal. Five hundred consecutive urgent or elective
      operations for infrarenal nonruptured AAA were reviewed. Patients were divided
      into three groups based on preoperative cardiac status: group I (n = 260, 52%),
      no clinical or electrocardiographic (ECG) evidence of coronary artery disease
      (CAD); group II (n = 212, 42.2%), clinical or ECG evidence of CAD considered
      stable after further evaluation with studies such as dipyridamole-thallium
      scanning, echocardiography, or coronary arteriography; group III (n = 28, 5.6%),
      clinical or ECG evidence of CAD considered unstable after further evaluation.
      Group I had no further cardiac evaluation and groups I and II underwent AAA
      repair without invasive treatment of CAD. Group III underwent repair of cardiac
      disease before (n = 21) or coincident with (n = 7) AAA repair. In all instances,
      perioperative fluid volume management was based on left ventricular performance
      curves constructed before operation. The 30-day operative mortality rate for AAA
      repair in all 500 patients was 1.6% (n = 8). There was one (0.4%) cardiac-related
      operative death in group I, which was significantly less than the five (2.4%) in
      group II (p less than 0.02). Total mortality for the two groups were also
      significantly different, with one group I death (0.4%) and seven group II deaths
      (3.3%), (p less than 0.02). These data support the conclusions that (1) the
      leading cause of perioperative mortality in AAA repair is myocardial infarction,
      (2) correction of severe or unstable CAD before or coincident with AAA repair is
      effective in preventing operative mortality, (3) patients with known CAD should
      be investigated more thoroughly to identify those likely to develop perioperative
      myocardial ischemia so that their CAD can be corrected before AAA repair, and (4)
      patients with no clinical or ECG evidence of CAD rarely die of perioperative
      myocardial infarction, and thus selective evaluation of CAD based on clinical
      grounds in AAA patients is justified.

PMID- 2222013
TI  - Experience with cardiopulmonary bypass and deep hypothermic circulatory arrest in
      the management of retroperitoneal tumors with large vena caval thrombi.
AB  - From June 1984 to September 1989, 43 patients with large vena caval tumor thrombi
      from retroperitoneal malignancies underwent surgical treatment with
      cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). The
      primary malignancies were renal cell carcinoma (RCC) (n = 39), renal pelvic
      transitional cell carcinoma (n = 1), adrenal pheochromocytoma (n = 1), and renal
      (n = 1) or retroperitoneal (n = 1) sarcoma. The level of the caval thrombus was
      either suprahepatic (n = 27), intrahepatic (n = 14), or subhepatic (n = 2). In
      all cases the primary tumor and caval thrombus were completely removed.
      Concomitant procedures included coronary artery bypass grafting (n = 5),
      pulmonary resection (n = 2), and hepatic lobectomy (n = 1). The time of
      circulatory arrest ranged from 10 to 44 minutes (mean, 23.5 minutes). There were
      two operative deaths (4.7%), neither of them due to to the use of DHCA. Major
      postoperative complications occurred in 13 patients (30.2%). There were no
      ischemic or neurologic complications and no cases of perioperative tumor
      embolization. The median postoperative hospital stay was 9 days. Twenty-two
      patients (51%) are alive and enjoying a good quality of life. The 3-year patient
      survival rates in patients with localized (n = 24) versus metastatic (n = 15) RCC
      are 63.9% and 10.9%, respectively (p = 0.02). We conclude that CPB with DHCA
      facilities excision of retroperitoneal malignancies with large caval thrombi and
      provides the potential for cure with low morbidity and mortality rates.

PMID- 2222014
TI  - Urinary tract re-functionalization after long-term diversion. A 20-year
      experience with 177 patients.
AB  - From 1969 to 1990, previously diverted urinary tracts were 'undiverted' in 177
      patients whose ages ranged from 1 to 31 years. Fifty-six of the patients (32%)
      had been diverted for 10 years or longer. There were 67 female and 110 male
      patients. Forty-four patients had only one kidney and in two of those patients it
      was a previous renal transplant. One patient was anephric at the time of
      reconstruction, having had two unsuccessful transplants. Most of the diversions
      had been considered permanent. Types of diversions that were reversed include
      ileal loop, colon conduit, loop ureterostomy or pyelostomy, end ureterostomy,
      cystostomy or vesicostomy, long-term nephrostomy, and ureterosigmoidostomy.

PMID- 2222016
TI  - Tumor necrosis factor-alpha mediates acid aspiration-induced systemic organ
      injury.
AB  - Acid aspiration-induced systemic organ injury is mediated by the sequestration of
      activated neutrophils (PMN). In other settings cytokines have been shown to
      increase neutrophil-endothelial adhesion, a requisite for injury. This study
      tests whether the systemic leukosequestration and permeability following
      localized aspiration is mediated by tumor necrosis factor (TNF)-alpha-induced
      synthesis of an adhesion protein. Anesthetized rats underwent tracheostomy and
      insertion of a fine-bore cannula into the anterior segment of the left lung. This
      was followed by the instillation of either 0.1 mL 0.1 N HCI (n = 18) or 0.1 mL
      saline in control rats (n = 18). Localized aspiration induced generalized
      pulmonary leukosequestration with 95 PMN/10 high-power fields (HPF) in the
      aspirated lung and 46 PMN/10 HPF in the nonaspirated lung, higher than control
      values of 7 PMN/10 HPF and 5 PMN/10 HPF in saline- and nonsaline-aspirated sides,
      respectively (p less than 0.05). The leukosequestration was associated with
      permeability edema shown by increased protein concentrations in bronchoalveolar
      lavage (BAL) of 3900 micrograms/mL in the aspirated and 2680 micrograms/mL in the
      nonaspirated side, higher than saline with 482 micrograms/mL and 411
      micrograms/mL, respectively (p less than 0.05). There was generalized pulmonary
      edema following aspiration measured by increase in wet-to-dry weight ratios (w/d)
      of 6.6 in the aspirated and 5.1 in the nonaspirated lung, higher than control
      values of 3.5 and 3.4, respectively (p less than 0.05). Localized aspiration led
      to systemic leukosequestration documented by increases in myeloperoxidase
      activity (units/g tissue) of 2.2 and 1.7 in heart and kidney, higher than control
      values of 0.3 and 0.4, respectively (p less than 0.05). This event was associated
      with edema of these organs with w/d ratios of 4.6 and 4.3, relative to control
      values of 3.0 and 3.4 (p less than 0.05). Treatment of animals (n = 18) 20
      minutes after aspiration with anti-TNF-alpha antiserum (rabbit anti-murine) but
      not normal rabbit serum (n = 18) reduced lung leukosequestration in the aspirated
      and nonaspirated segments (61 and 32 PMN/10HPF), BAL protein concentration (1490
      and 840 micrograms/mL), and w/d ratio (4.3 and 3.7) (all p less than 0.05). In
      the heart and kidney there were reductions in myeloperoxidase activity (0.7 and
      0.6) and w/d ratio (3.5 and 3.6) (both p less than 0.05). Treatment of rabbits (n
      = 18) with the protein synthesis inhibitor cycloheximide, 0.2 mg/kg/hr was as
      effective as TNF-alpha antiserum in modifying aspiration injury.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2222015
TI  - The process of microbial translocation.
AB  - The process of microbial translocation was studied using Candida albicans,
      Escherichia coli, or endotoxin instilled into Thiry-Vella loops of thermally
      injured guinea pigs and rats. Translocation of C. albicans occurred by direct
      penetration of enterocytes by a unique process different from classical
      phagocytosis. Translocation between enterocytes was not observed. Internalization
      was associated with a disturbance of the plasma membrane and brush border, but
      most internalized organisms were not surrounded by a plasma membrane. Passage of
      the candida into the lamina propria appeared to be associated with disruption of
      the basal membrane with extrusion of cytoplasm of the cell and candida. Organisms
      in the lamina propria were commonly phagocytized by macrophages but also were
      found free in lymphatics and blood vessels. Translocation of E. coli and
      endotoxin also occurred directly through enterocytes rather than between them,
      but translocated endotoxin diffused through the lamina propria and muscular wall
      of the bowel wall by passing between rather than through the myocytes. These
      descriptive phenomena provide new insight into the role of the enterocyte and
      intestinal immune cells in the translocation process.

PMID- 2222017
TI  - Upper GI bleeding in an urban hospital. Etiology, recurrence, and prognosis.
AB  - Acute upper gastrointestinal bleeding (UGIB) continues to be a common cause of
      hospital admission and morbidity and mortality. This study reviews 469 patients
      admitted to a surgical service of an urban hospital. There were 562 total
      admissions because 53 patients were readmitted 93 times (recurrence rate, 20%).
      The most common causes of bleeding, all endoscopically diagnosed, included acute
      gastric mucosal lesion (AGML) (135 patients, 24%), esophageal varices (EV) (121
      patients, 22%), gastric ulcer (108 patients, 19%), duodenal ulcer (78 patients,
      14%), Mallory-Weiss tear (61 patients, 11%), and esophagitis (15 patients, 3%).
      Nonoperative therapy was sufficient in 504 cases (89.5%). Endoscopic treatment
      was used in 144 cases. Operations were performed in 58 cases (10.5%), including
      29% of ulcers. Emergency operations to control hemorrhage were required in only
      2.5% of all cases. The rate of major surgical complications was 11% and the
      mortality rate was 5.2%. There were 58 deaths (12.6%), with 36 deaths directly
      attributable to UGIB. Factors correlating with death include shock at admission
      (systolic blood pressure less than 80), transfusion requirement of more than five
      units, and presence of EV (all p less than 0.001). Most cases of UGIB can be
      treated without operation, including endoscopic treatment, when diagnostic
      endoscopy establishes the source. Subsequent operation in selected patients can
      be done with low morbidity and mortality rates.

PMID- 2222019
TI  - Ionized calcium, parathormone, and mortality in critically ill surgical patients.
AB  - A prospective study measured ionized calcium and parathormone sequentially at 48-
      to 72-hour intervals in 25 surgical intensive care unit patients. Twelve patients
      (48%) died at mean day 40 and median day 26. Levels of ionized calcium,
      parathormone, blood urea nitrogen, creatinine, albumin, magnesium, and phosphate
      for patients who lived were compared with levels for patients who died. The
      incidence of hypotension, renal failure (creatinine greater than or equal to
      3.0), and bacteremia, as well as the amount of red cell, crystalloid, and colloid
      administration for the two groups was compared. Hypotension, bacteremia, red
      cells, crystalloid, and colloid were no different. On days 1 and 2 ionized
      calcium levels were significantly lower and parathormone levels significantly
      higher in nonsurviving patients; this difference persisted through days 3 and 4.
      Blood urea nitrogen and creatinine levels increased early in nonsurviving
      patients but renal failure, which occurred in nine nonsurviving patients, did not
      develop until mean day 14, median day 18. The phosphate level was slightly higher
      but still within normal range in nonsurviving patients. By days 5 and 6 ionized
      calcium and parathormone levels were no different in nonsurviving patients,
      despite there being no improvement in renal function. Magnesium and albumin
      levels were no different between groups. Ionized calcium levels are lower and
      parathormone levels higher early in nonsurviving patients. This difference is not
      readily explained by associated clinical conditions, including renal dysfunction.
      Although etiology remains unclear, low ionized calcium and elevated parathormone
      are early predictors of mortality in critically ill surgical patients.

PMID- 2222018
TI  - Surgical therapy in Barrett's esophagus.
AB  - Seventy-six patients with Barrett's esophagus were cared for during a 10-year
      period. Fifty-six patients (74%) presented with complications of the disease.
      There were 20 strictures, 7 giant ulcers, 11 cases of dysplasia, and 29 patients
      with carcinoma. In patients with benign disease, 93% had mechanically defective
      sphincters and 83% had peristaltic failure of the lower esophageal body.
      Esophageal pH monitoring showed excessive esophageal exposure to pH less than 4
      in 93% and excessive exposure to pH more than 7 in 34% of the patients tested.
      Ninety-three per cent of patients with excessive alkaline exposure had
      complications, compared to only 44% with normal alkaline exposure (p less than
      0.01). Gastric pH monitoring, serum gastrin levels, and gastric acid analysis
      supported a duodenal source for the alkaline exposure. Antireflux surgery was
      performed using Nissen fundoplication in 30, Belsey partial fundoplication in 3,
      and Collis-Belsey gastroplasty in 2. Six required resection with colon
      interposition. Good symptomatic control was achieved in 77% after antireflux
      surgery. Four patients had symptoms and signs of duodenogastric reflux; three
      required a bile diversion procedure. Fifteen patients had an en bloc curative
      resection with colon interposition. One patient with high-grade dysplasia on
      biopsy was found to have intramucosal carcinoma after simple esophagectomy. Five
      tumors were intramucosal, seven were intramural, and four were transmural. Lymph
      node involvement occurred only in the latter two. Actuarial survival 5 years
      after curative resection was 53%. Median survival time for patients after
      palliative resection or no resection was 12 months. Study of en bloc specimens
      indicated that extent of resection should be adapted to extent of disease:
      esophagectomy for intramucosal disease, en bloc esophagectomy with splenic
      preservation for intramural and transmural disease. Serum CEA was useful in
      detecting recurrent disease after surgery when the primary tumor stained
      positively for CEA.

PMID- 2222020
TI  - Surgical aspects of sclerosing cholangitis. Results in 178 patients.
AB  - Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had
      associated inflammatory bowel disease, 72 had no such history, and 18 had
      iatrogenic injury or stone disease. A total of 233 biliary operations were
      performed, with a 75% rate of temporary improvement after initial operation.
      Subsequent operations resulted in a lower success rate and a higher mortality
      rate. Radiologic findings included predominant extrahepatic, intrahepatic, and
      diffuse disease in 29%, 28%, and 43% of patients, respectively; no survival
      differences were noted. Seventy-five of one hundred three deaths (73%) were
      related to liver failure, bleeding, or sepsis. Of 14 patients undergoing
      portosystemic shunt, 13 died of surgical complications or related disease.
      Orthotopic liver transplantation was performed in 16 patients and resulted in
      eight deaths, mainly in patients who had previously undergone extensive surgical
      treatment. No survival differences were seen between the patients with
      inflammatory bowel disease, those without the condition, or those who had
      colectomy. Surgical treatment in patients with sclerosing cholangitis should be
      minimized. Orthotopic liver transplantation should be offered as the treatment of
      choice for patients with portal hypertension, refractory cholangitis, advanced
      cirrhosis, or progressive liver failure.

PMID- 2222021
TI  - Depressive effect of a Taenia solium cysticercus factor on cultured human
      lymphocytes stimulated with phytohaemagglutinin.
AB  - Cysticercosis caused by Taenia solium is associated with immunodepression of T
      and B lymphocytes. In order to ascertain if this parasite affects lymphocyte
      activity, a factor isolated from the parasite was tested on (3H) thymidine uptake
      by cultured human lymphocytes stimulated by phytohaemagglutinin. This dialysable
      factor had a molecular weight of less than 3500 Da, and was isolated from an
      extract of Cysticercus cellulosae. It decreased phytohaemagglutinin-stimulated
      uptake of (3H) thymidine. After the material was treated with RNase 'A', the
      suppressive activity was destroyed. It thus appears that the factor could
      correspond to an RNA fraction.

PMID- 2222022
TI  - Seroepidemiological studies on human pulmonary dirofilariasis in Spain.
AB  - Preliminary data are presented on a serological survey of the human population of
      an area with a high prevalence of Dirofilaria immitis infection in dogs. Five per
      cent of the sera were positive for IgG. Simultaneous radiological study revealed
      a pulmonary nodule in one of the positive patients, and in this case the
      evolution of IgG and IgM levels was followed over a period of three months. None
      of the positive sera reacted with Toxocara canis antigens.

PMID- 2222023
TI  - Malaria in refugee camps in eastern Sudan: a sero-epidemiological approach.
AB  - A study of the endemicity of malaria was carried out in two refugee camps in
      Sudan, and the advantages and disadvantages of treating either all febrile cases
      or only confirmed cases of malaria were considered. Based on the information
      obtained during the survey, guidelines for the treatment of malaria in such
      refugee camps are proposed.

PMID- 2222024
TI  - In vivo efficacy of quinine treatment for Plasmodium falciparum malaria in
      Malawian children.
AB  - Twenty-five Malwaian children with Plasmodium falciparum infection were studied
      for response to quinine in an eight-hourly dosage of 10 mg salt kg-1 body weight.
      The mean parasite clearance time, defined as the time after initiation of
      treatment when the first of two consecutive 12-hourly smears was negative for P.
      falciparum parasites, was 67 hours. The mean fever clearance time, defined as the
      time after initiation of treatment when the axillary temperature first fell below
      37.5 degrees C and remained below this level for 48 hours, was 36 hours. Twenty
      four hours after the first dose of quinine, the geometric mean parasite density
      among the children studied had decreased by 84%, from 41 357-6586 parasites mm-3,
      and all children cleared their parasitaemia within 108 hours. Results of this
      study confirm that quinine remains effective in rapidly controlling P. falciparum
      parasitaemias in Malawi, where resistance to the 4-aminoquinolines is highly
      prevalent.

PMID- 2222026
TI  - A programme to reduce the risk of infection by Echinococcus multilocularis: the
      use of praziquantel to control the cestode in a village in the hyperendemic
      region of Alaska.
AB  - This paper reports the results of a 10-year field trial designed to reduce the
      risk of infection by Echinococcus multilocularis to residents of a village in a
      hyperendemic area (Savoonga, St. Lawrence Island). The objective was to prevent
      dispersal of infective eggs of the cestode within the village by means of monthly
      treatments of dogs with praziquantel. Northern voles, Microtus oeconomus, present
      in the village as commensals, served as an index of risk, as the incidence of
      infection in the voles provides information about the availability of eggs within
      the confines of the inhabited area. Voles were examined annually during early
      June before the population of overwintering voles was diluted by the first annual
      litters. The pretreatment infection-rate within the village was 29% (range 22
      35%), and in control areas at some distance from the village for the entire study
      period it averaged 53% (284 infected voles from a sample of 533). Some
      fluctuation in incidence of infection in village voles occurred, apparently
      depending on the extent to which the residents kept their dogs chained and thus
      available for treatment. The success of the programme was demonstrated by the
      reduction in prevalence of infection to about 1% of voles in 1985, and an average
      infection rate during the last five years of the study of 5% (29 infected voles
      in a sample of 582). This 83% average reduction in the prevalence of the larval
      cestode within the village reflects a corresponding reduction in the risk of
      acquiring by the residents of the village. The method would be applicable for the
      control of E. multilocularis in most hyperendemic regions. Success depends,
      however, on elimination of unrestrained dogs and a precise schedule of treatment.

PMID- 2222025
TI  - Treatment of chloroquine-resistant malaria with esters of cephalotaxine:
      homoharringtonine.
AB  - The esters of cephalotaxine-harringtonine, homoharringtonine and
      deoxyharringtonine--have been reported by both Chinese and American oncologists
      as useful in the treatment of human nonlymphoblastic leukaemias and selected
      solid tumours of the head and neck. We report our results with homoharringtonine,
      currently a Phase II clinical trial drug with the National Cancer Institute, in
      the treatment of malaria. Homoharringtonine, 2.7-3.4 nM, was effective in causing
      50% growth inhibition of two strains of chloroquine-resistant Plasmodium
      falciparum malaria in vitro. In vivo tests in mice infected with P. yoelii showed
      that this drug was effective in inhibiting parasite growth in this system as
      well. Histologically, the drug was associated with karyorrhexis. Drug-exposed
      cells showed decreased levels of putrescine and spermidine and increased spermine
      levels. Our findings not only demonstrate the potential usefulness of
      homoharringtonine in the treatment of chloroquine-resistant malaria, but also
      demonstrate the advantage of applying comparative biochemistry and an
      understanding of biological mechanisms in a rational approach to the development
      and treatment of diseases including malaria.

PMID- 2222027
TI  - Epidemiology of Mansonella perstans filariasis in the forest region of south
      Congo.
AB  - A study of Mansonella perstans filariasis conducted in the Chaillu mountains,
      Southern Congo, showed that 108 of 134 Pygmies (80.6%) and 79 of 302 Bantus
      (26.2%) presented with microfilaraemia. The mean microfilarial densities were
      also significantly higher in the Pygmies (1213 ml-1 of blood) than in the Bantus
      (136 ml-1). Ninety eight per cent of the Culicoides taken which had bitten man in
      the daytime were C. grahamii, and 0.8% of these were infected with filarial
      larvae. Two other species of Culicoides (C. kumbaensis and C. rutshuruensis)
      might also play a role in the transmission of M. perstans.

PMID- 2222029
TI  - Distribution of metacercariae in freshwater crabs in relation to Paragonimus
      infection of children in Liberia, West Africa.
AB  - An explanation was sought for the high prevalence of paragonimiasis in children
      in Liberia by examining possible modes of human infection from freshwater crabs.
      The occurrence, frequency of infection, and distribution of metacercariae of
      Paragonimus uterobilateralis in the freshwater crab Liberonautes latidactylus
      were studied. The muscles of the cephalothorax and of the legs were found to be
      the most frequently and most heavily infected parts of the crab. A likely risk of
      infection of children was considered to be the habit of chewing on, or ingesting
      in a raw state, the walking legs of infected crabs. Possible contamination of the
      hands of cooks with metacercariae from the internal organs or haemolymph of
      infected crabs was thought to be a minor route of infection.

PMID- 2222028
TI  - Leptospiral infection: a household serosurvey in urban and rural communities in
      Barbados and Trinidad.
AB  - A longitudinal study of leptospiral agglutinins in subjects five years of age and
      over was undertaken in Trinidad and Barbados between 1980 and 1982. Households
      were sampled randomly from one urban and two rural communities on each island,
      giving a total of 576 eligible individuals in Barbados and 524 in Trinidad.
      Participants were examined three times at approximately annual intervals. The
      prevalence of seropositivity at a titre of 1:50 using the microscopic
      agglutination test was 18.5% in Barbados and 21.9% in Trinidad. Prevalence
      increased steeply with age in both sexes and was higher in males than females on
      both islands. There was a marked difference in predominating serogroups on the
      two islands--Autumnalis (42% of positive cases) predominated in Barbados while
      Bataviae (29% of positive cases) predominated in Trinidad. Estimates of incidence
      rates for seroconversion were 2.9% per annum for Barbados and 3.5% per annum for
      Trinidad. Occupational risk varied between the islands, but in both cases highest
      seropositivity rates (greater than 50%) were found in outdoor labourers and
      lowest were found in indoor non-manual workers and urban homeworkers. In Barbados
      seroprevalence was higher among persons who cleared drains or who had contact
      with livestock. Lack of an inside toilet was associated with an increase in
      seropositivity on both islands. There was little evidence of household clustering
      of seropositive cases.

PMID- 2222030
TI  - Amoebic liver abscess: the effect of aspiration on the resolution or healing
      time.
AB  - Recent sonographic monitoring of patients treated for amoebic liver abscess has
      shown the healing or resolution time varying between 10 and 300 days. The effect
      of percutaneous needle aspiration under or resolution time was studied in 36
      patients. Nineteen patients had drugs and needle aspiration under ultrasound
      guide whilst the 17 patients had drugs--metronidazole, diloxanide, and
      chloroquine--alone. Both groups were monitored clinically and sonographically.
      Results showed that the abscess cavities of 18 out of 19 patients (94.7%) of the
      aspirated group and 10 of 17 patients (58.8%) of the non-aspirated group had
      resolved at the end of three weeks. The difference in response to treatment was
      significant (P less than 0.02) more so for lesion size more than 6 cm (P less
      than 0.01). There was also a more rapid clinical response in the aspirated group
      than in the non-aspirated group, particularly for patients whose lesion size was
      more than 6 cm (P less than 0.01). In conclusion, percutaneous needle aspiration
      is safe, enhances clinical recovery, and accelerates resolution particularly in
      patients with large abscess cavities.

PMID- 2222032
TI  - Survival rates of Bulinus globosus during aestivation.

PMID- 2222033
TI  - How many species are in the Anopheles punctulatus group?

PMID- 2222031
TI  - Hydatidosis among Iraqi children.
AB  - Thirty girls and 28 boys (aged from 3.6-18 years old) with hydatid disease were
      treated surgically. Data were statistically analysed according to age, sex and
      organs affected. The greater number of cases was in the age group 10-14 years.
      Liver involvement was more frequent (72.2%) than lung involvement (27.8%).
      Clinical manifestations of hepatic hydatidosis included fever, hepatomegaly and
      abdominal pain, while those of pulmonary hydatidosis included cough, haemoptysis
      and fever. The Casoni, indirect haemagglutination and ultrasound tests were
      positive in 55, 76 and 100% of cases respectively.

PMID- 2222034
TI  - Using ICD-9-CM and CPT in the nineties.

PMID- 2222035
TI  - Assessing the prognosis of thymomas.

PMID- 2222036
TI  - Traumatic bronchial rupture and other major thoracic injuries.

PMID- 2222037
TI  - Relief of tracheal compression by aortopexy.
AB  - We have performed aortopexy in 12 children with tracheal compression. Six infants
      had compression secondary to a vascular anomaly (group 1), and the other 6 had
      previous repair of esophageal atresia (group 2). Eleven of the 12 children are
      alive after a mean follow-up of 36 months. In group 1, 1 patient died and 3
      patients (50%) experienced recurrent respiratory distress. Five infants sustained
      a major postoperative complication, and the average postoperative hospital stay
      was 25 days. In group 2, however, aortopexy was uniformly successful. There were
      no deaths, no postoperative complications, and no cases of postoperative
      respiratory distress, and the mean postoperative hospital stay was only 10 days.
      For children with reflex apnea after repair of esophageal atresia, aortopexy is
      lifesaving and can be performed with minimal morbidity and mortality. Great
      caution is indicated in children with tracheal compression from other causes.

PMID- 2222038
TI  - Selective monitoring of patients with suspected blunt cardiac injury.
AB  - Blunt chest trauma can result in cardiac injury with consequent dysrhythmias,
      valve malfunction, or frank rupture. Typically, patients with blunt chest trauma
      and suspected cardiac injury have required cardiac monitoring for 48 to 72 hours.
      Predicting which patients with blunt chest trauma are not at risk for cardiac
      complications would obviate many patient-hours of monitoring in the intensive
      care unit. This series examines the sensitivity of two-dimensional surface
      echocardiography in predicting cardiac complications. Over a 24-month period, 115
      patients were admitted with blunt chest trauma and prospectively evaluated for
      cardiac injury with admission electrocardiograms, serial creatine kinase
      isoenzyme studies, and two-dimensional echocardiography. Thirty-one patients
      (27%) had abnormal two-dimensional echocardiograms. In 8 (25.8%) of these
      patients, cardiac complications requiring treatment developed. Eighty-four
      patients (73%) had normal two-dimensional echocardiograms, and a cardiac
      complication requiring treatment developed in only 1 (1.2%) of them. Of the 9
      patients who required treatment of cardiac complications, 3 had normal admission
      electrocardiograms and only 1 had elevated levels of the myocardial-specific
      isoenzymes of creatine kinase. We believe two-dimensional echocardiography is a
      sensitive test for evaluating cardiac injury resulting from blunt chest trauma
      and is helpful in selecting those patients who require monitoring in the
      intensive care unit.

PMID- 2222039
TI  - Analysis of prognostic factors and clinicopathological staging of thymoma.
AB  - The prognostic value of four clinical variables (age and sex of patients,
      association with myasthenia gravis, and clinical stage) and histological type was
      analyzed in 83 consecutive patients with thymoma, histologically classified as
      cortical, medullary, and mixed. Age, sex, and association with myasthenia gravis
      did not prove to represent significant prognostic factors; clinical stage and
      histological type, on the contrary, had a highly significant prognostic value (p
      less than 0.001). A model of clinicopathological staging, based on both clinical
      stage and histological type, in which three major prognostic groups are
      considered is proposed. The degree of significance of this model is higher (p
      less than 0.0001) than that of clinical stage and histological type considered
      individually; its validity is further supported by the results of multivariate
      analysis according to the Cox regression model (p = 0.0001). We think it
      represents a prognostically valuable approach to the problem of management of
      thymoma.

PMID- 2222040
TI  - Intraoperative ultrasonic imaging of the ascending aorta in ischemic heart
      disease.
AB  - In an attempt to locate any atherosclerotic lesion in the ascending aorta and to
      prevent embolization, intraoperative B-mode ultrasonography was performed in 100
      patients with ischemic heart disease (31 women and 69 men). Ultrasonography was
      carried out with a 10-MHz probe placed directly on the ascending aorta.
      Ultrasonic imaging demonstrated an atherosclerotic lesion in the lower half of
      the aorta in 76 patients (76%), a lesion in the upper half of the aorta in 89
      patients (89%), and a lesion at the orifice of the innominate artery in 99
      patients (99%). Prospective palpation identified an atherosclerotic lesion in 12
      (25%) of 48 patients. Thoracic computed tomography in 79 patients showed
      calcification in the lower half of the aorta in 6 patients (7.6%) and in the
      upper half of the aorta in 11 (13.9%). Palpation and thoracic computed tomography
      underestimated the frequency of atherosclerotic lesions. Intraoperative
      ultrasonography accurately identified atherosclerotic disease. This technique
      allows the surgeon to modify cannulation, aortic clamping, and operative
      technique to reduce the risk of perioperative stroke due to embolization of
      atherosclerotic debris from the ascending aorta.

PMID- 2222041
TI  - Prevention of paraplegia during aortic operations.
AB  - Ischemic spinal cord injury after aortic cross-clamping may be produced by a
      steal phenomenon. The present study investigates this possibility by directly
      measuring the oxygen tension on the spinal cord surface in pigs. After simple
      clamping of the aorta, oxygen tension decreased significantly distal to the
      clamping site both after occlusion of the thoracic aorta at T3-4 (group 1) and
      after occlusion of the abdominal aorta at L-1 (group 2). Exclusion of the
      thoracic aorta by a second clamp at T-13 restored oxygen tension almost to the
      original level, whereas segmentation of the abdominal aorta up to S-1 hardly
      affected oxygen tension in the area of the artery of Adamkiewicz in most of the
      animals. We conclude that after aortic cross-clamping, blood tends to drain away
      from the spinal cord rather than supplying it longitudinally. Without knowledge
      of the position of the Adamkiewicz artery in humans as well as of the competence
      of the collateral circulation in the excluded segment, it is necessary to develop
      a new strategy for repair of the aorta. We describe and discuss two surgical
      techniques for the prevention of paraplegia after aortic cross-clamping: the
      counterocclusion technique and the bypass fractionated technique.

PMID- 2222042
TI  - Combined internal mammary artery graft for coronary artery revascularization.
AB  - Five patients with multiple-vessel coronary artery disease underwent isolated
      coronary artery bypass grafting with a technique involving both internal mammary
      arteries and a small piece of interposed saphenous vein. The combined internal
      mammary artery grafts were used for sequential grafting. A total of 20
      anastomoses were performed (average number, 4 anastomoses per patient). There
      were no operative deaths. Postoperative complications included reoperation for
      bleeding in 1 patient and diaphragmatic dysfunction in another. Postoperative
      coronary angiography 2 days before discharge (mean time, 10 days postoperatively)
      revealed that all the sequential anastomoses with the combined IMA graft were
      patent. Exercise tolerance tests performed 3 and 11 months postoperatively
      indicated excellent results and no ischemia. Based on this experience, we
      conclude that this method appears promising for multivessel coronary artery
      bypass grafting.

PMID- 2222043
TI  - Surgical treatment of cardiac myxomas: long-term results.
AB  - Between 1965 and 1988, 22 patients underwent 24 operations for cardiac myxomas.
      Two patients had the complex myxoma syndrome. Mitral valve replacement was
      required at initial operation in 2 patients. One patient died perioperatively,
      and 5 others died subsequently. The 16 surviving patients recently underwent
      evaluation at a mean duration of 9 years after operation. Ten are asymptomatic
      and 6 have New York Heart Association class II symptoms. Nine patients continue
      to be employed. Eleven are in sinus rhythm, 3 have permanent pacemakers, and 2
      have chronic atrial arrhythmias. Echocardiography showed atrioventricular valve
      insufficiency in 3 patients and reduced contractility in 4, but no new tumor
      recurrences. The long-term prognosis of this relatively large group of patients
      with cardiac myxomas has been good. Patients without the complex myxoma syndrome
      had no recurrence, whereas 2 patients did require reoperation for mitral valve
      replacement. Long-term disability and chronic arrhythmias have been infrequent,
      and functional status and employability of these patients have been very good.

PMID- 2222044
TI  - Cor triatriatum: clinical presentation and surgical results in 12 patients.
AB  - Twelve patients with cor triatriatum have been seen at our institution since
      1979. The clinical presentation, diagnostic evaluation, and surgical results are
      outlined in this retrospective review. Operation is the treatment of choice for
      this rare congenital cardiac defect. One patient died 1 day before scheduled
      operation, and 2 patients died postoperatively, yielding a surgical mortality
      rate of 17% and an overall mortality rate of 25%. Resection of the obstructing
      atrial membrane was performed using hypothermic cardiopulmonary bypass in all
      cases. Left atriotomy was performed in 6 patients, and right atriotomy was
      performed in 7. The two postoperative deaths occurred in patients who had serious
      associated cardiac defects. Associated anomalies include atrial septal defect,
      persistent left superior vena cava, and partial anomalous pulmonary venous
      return. The postoperative course has been excellent in all 9 surviving patients;
      all remain asymptomatic. Cor triatriatum is amenable to surgical repair with
      excellent results when diagnosed early and when not complicated by other severe
      cardiac anomalies.

PMID- 2222045
TI  - Tracheal and main bronchial disruptions after blunt chest trauma: presentation
      and management.
AB  - Tracheobronchial disruption is one of the less common injuries associated with
      blunt thoracic trauma. This injury can be life threatening, however, and failure
      to diagnose it early can lead to disastrous acute or delayed complications. Nine
      cases of tracheobronchial disruption in the setting of nonpenetrating thoracic
      trauma were seen at four Los Angeles trauma centers between 1980 and 1987.
      Mechanism of injury, presentation, diagnosis, and management of these patients
      were reviewed. Disruptions involved the trachea in 3 patients, the right bronchus
      in 5 patients, and the left bronchus in 2 patients. Tracheobronchial disruptions
      occurred in settings of high-energy impact-type injuries and were more likely to
      have associated injuries than they were to occur alone. Common presenting signs
      included subcutaneous emphysema, dyspnea, sternal tenderness, and hemoptysis.
      Radiographic findings were most commonly pneumothorax, pneumomediastinum, and
      clavicle or rib fractures. Rigid bronchoscopy and fiberoptic bronchoscopy were
      both highly accurate methods for diagnosis but only in the hands of trained
      cardiothoracic surgeons. Delay in diagnosis increased the likelihood of
      postoperative complications.

PMID- 2222046
TI  - Subaortic obstruction: intraoperative echocardiography as an adjunct to
      operation.
AB  - Fourteen patients undergoing operation for subaortic obstruction (membranous
      obstruction in 11 patients, tunnel obstruction in 2 patients, obstruction due to
      reduplicated mitral valve tissue in 1 patient) were evaluated by intraoperative
      epicardial echocardiography. In all 9 patients with "discrete" obstruction who
      underwent prebypass epicardial echocardiography, the septal and lateral
      attachments of the lesion were correctly demonstrated. The precise extent of
      tunnel stenosis was seen in both patients. The lateral attachment of the membrane
      in 4 patients and multiple extensions in another 2 were identified by the
      epicardial study (having been missed on precordial echocardiography). The
      discrete membrane was enucleated in 10 of the 11 patients and was partially
      resected in 1. One tunnel obstruction was completely relieved; the other was
      partially relieved. Reduplicated mitral valve tissue in the remaining patient was
      completely resected. Epicardial imaging after bypass showed remnants of the
      membrane in 2 patients. Intraoperative Doppler echocardiography and color flow
      imaging confirmed the absence of clinically significant residual gradients (less
      than 20 mm Hg) in all but 1 patient with tunnel obstruction. Epicardial imaging
      provided excellent morphological information about obstructive lesions of the
      left ventricular outflow tract and enabled immediate assessment of surgical
      repair.

PMID- 2222047
TI  - Diagnostic imaging and surgical treatment of dumbbell tumors of the mediastinum.
AB  - We describe the diagnostic procedures and surgical approaches employed in 5
      patients with dumbbell tumors of the mediastinum. Magnetic resonance imaging
      accurately described the existence and longitudinal extension of the intraspinal
      component of the tumor and assisted in choosing the appropriate surgical
      approach. Both the intrathoracic and intraspinal components of the tumor were
      resected at one time by a thoracic and neurosurgical team. We employed the Grillo
      technique three times and a separate laminectomy and thoracotomy approach.
      Magnetic resonance imaging proved the most useful diagnostic technique for
      suspected dumbbell mediastinal tumors. In our experience, the extended
      thoracotomy proposed by Grillo and co-workers worked well for small tumors
      involving only one foramen in which the intraspinal extension was limited to 2 to
      3 cm, and when no more than two laminectomies were required. On the other hand,
      thoracotomy and a longitudinal paravertebral incision are preferable for larger
      tumors (more than 4 cm) involving more than one foramen in which the intraspinal
      extension exceeds 2 to 3 cm, for tumors requiring multiple laminectomy, and when
      bony infiltration is present.

PMID- 2222048
TI  - Reoperations on heart valve prostheses: an analysis of operative risks and late
      results.
AB  - To evaluate risks and complications of reoperations on heart valve prostheses, we
      reviewed data on 183 patients who underwent reoperation because of prosthetic
      valve malfunction. The incremental effect of the redo procedure on hospital
      mortality and morbidity was studied by comparing primary and reoperative
      procedures and analyzing a series of possible predisposing factors. Late survival
      after first and second reoperations was computed, and possible determinants of
      late mortality were examined. Overall operative mortality was 8.7%; emergency
      operation (p = 0.0001), previous thromboembolism (p = 0.05), and advanced New
      York Heart Association functional class (p = 0.031) were the independent
      determinants. In a series of 1,355 patients having primary or secondary isolated
      valve replacement, the redo procedure was a significant risk factor in the
      univariate analysis (p = 0.025) but not in the multivariate analysis except for
      the subset of patients having mitral valve replacement (p = 0.052). The
      postoperative course was quite complicated, as evidenced by the long mean stay in
      the intensive care unit (mean stay, 3.8 days; longer than 2 days for 26% of the
      survivors). Nevertheless, postoperative complications were not significantly
      greater after a redo procedure than after a primary operation. Actuarial survival
      at 7 years was 57.3% +/- 8%. A comparison with a nonhomogeneous series from our
      institution did not demonstrate significant differences. In the subset of 16
      patients having a second reoperation, late survival was 37.8% +/- 16% at 2 years.
      Advanced New York Heart Association class (p = 0.0001), double prosthetic valve
      dysfunction (p = 0.003), and any indication other than primary tissue failure (p
      = 0.06) were determinants of late mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222049
TI  - Complement activation and lung permeability during cardiopulmonary bypass.
AB  - Pulmonary dysfunction after cardiopulmonary bypass has been attributed to the
      damaging effects of complement activation on the lung. To further explore this
      phenomenon, we measured plasma levels of activated complement components
      (radioimmunoassay), assessed neutrophil n-formyl-methionyl-leucyl-phenylalanine
      (FMLP) receptor status (radioligand saturation binding assay), and quantified
      pulmonary epithelial permeability as radioaerosol lung clearance of technetium
      99m-labeled diethylenetriamine pentaacetic acid in a series of 8 patients
      undergoing cardiopulmonary bypass. Significant elevations of plasma C3adesArg,
      C4adesArg, and C5adesArg levels were seen just after CPB, indicating activation
      of both the classic and alternate complement pathways. Neutrophil activation was
      evident as increased expression of neutrophil FMLP surface receptors after
      bypass. Despite the presence of complement and neutrophil activation, increased
      pulmonary epithelial permeability was not seen. These data support the hypothesis
      that complement and neutrophil activation during cardiopulmonary bypass is not
      associated with acute lung injury, at least not pulmonary epithelial injury. One
      can therefore infer that increased pulmonary epithelial permeability in patients
      at high risk for and experiencing sepsis-induced and trauma-induced adult
      respiratory distress syndrome may be due to factors other than complement and
      neutrophil activation.

PMID- 2222050
TI  - Complications after cardiac operations in patients with severe pulmonary
      impairment.
AB  - The postoperative courses of 39 patients with severe lung disease (31 with
      obstructive disease and 8 restrictive) who underwent a cardiac operation were
      retrospectively reviewed. The stay in the intensive care unit of the study group
      was 7.9 +/- 10.3 days (mean +/- standard deviation) compared with 2.4 +/- 3.9
      days for the control group (100 patients with less impaired pulmonary function)
      (p less than 0.001). The study group also had a greater number of valve
      replacements than did the control group (p less than 0.01). Patients with
      obstructive disease had more respiratory complications than did patients with
      restrictive disease (p less than 0.05). There were 21 cases of atelectasis.
      Effusions were noted in 11 patients. Ten patients had bronchospasm. Bronchial
      secretions were a major problem in 6 patients. Pneumonia developed in 4 patients,
      and pneumothorax occurred in 3 others. The two in-hospital deaths were not
      directly related to pulmonary complications. Our findings indicate that (1)
      patients with severe lung impairment generally do well after a cardiac operation
      but have more postoperative pulmonary complications than patients with less
      impairment; (2) patients with restrictive pulmonary disease appear to fare better
      than those with obstructive disease; (3) pulmonary function tests can alert the
      clinician to the possible risk of postoperative complications, but they cannot,
      by themselves, be used to exclude patients from operation; and (4) patients with
      severe pulmonary impairment facing valve replacement are at greater risk of
      pulmonary complications than patients having other types of cardiac surgical
      intervention.

PMID- 2222052
TI  - Pharyngoesophageal perforation after blunt neck trauma.
AB  - Pharyngoesophageal perforation secondary to blunt neck trauma is an uncommon
      injury that can cause serious morbidity and mortality if not recognized and
      treated. Pharyngeal perforation secondary to blunt trauma sustained while boxing
      is reported. Review of the world literature found 10 cases of pharyngoesophageal
      perforation secondary to blunt neck trauma. Analysis of these cases indicates
      that perforations less than 2 cm and limited to the pharynx may be treated
      medically with close observation. Large perforations and those perforations that
      extend to the esophageal inlet or involve the esophagus exclusively are best
      treated surgically.

PMID- 2222051
TI  - Results in 104 patients undergoing bronchoplastic procedures for bronchial
      lesions.
AB  - Bronchoplastic procedures were used in 104 patients with various bronchial
      disorders. Ten had benign lesions and 94, malignant tumors. The principal
      operative procedures were sleeve lobectomy and sleeve pneumonectomy for
      bronchogenic carcinoma, but 11 limited bronchial resections were performed in
      patients with benign lesions, minute bronchogenic carcinomas, and low-grade
      malignant tumors. Of the 94 patients with malignant tumors, 79 underwent a
      bronchoplastic procedure without carinal resection (sleeve lobectomy in 75 and
      limited bronchial resection in 4), and there was one operative death (1.3%). The
      overall 5-year survival rate for the patients with bronchogenic carcinoma in this
      group was 45% and that for patients undergoing curative resection, 57% (survival
      of patients in stages I, II, and IIIA was 79%, 55%, and 30%, respectively). A
      bronchoplastic procedure with carinal resection was performed in 15 patients.
      Twelve in this group underwent sleeve pneumonectomy. There were two operative
      deaths, and 1 patient has survived for longer than 4 years. Two patients with low
      grade malignant tumors underwent carinal resection without lung resection and are
      still alive. We believe that bronchoplasty is a safe and valuable procedure and
      that limited bronchial resection appears to be the procedure of choice for
      localized bronchial lesions.

PMID- 2222053
TI  - Use of the variable-length intraluminal sutureless graft.
AB  - From August 1987 to May 1988 we treated 4 patients with acute ascending aortic
      dissections with a variable-length intraluminal aortic prosthesis. This operation
      uses profound hypothermic circulatory arrest and represents a refinement of
      existing techniques. There was no mortality, and morbidity was minimal.
      Modifications of this technique can be used in performing proximal aortic root
      reconstruction with a composite valved conduit. The use of a variable-length
      intraluminal prosthesis and hypothermic circulatory arrest is illustrated. This
      is a safe and useful technique in select cases of acute ascending aortic
      dissection.

PMID- 2222054
TI  - Intraoperative bronchial aspiration of ruptured pulmonary hydatid cysts.
AB  - Ruptured pulmonary hydatid cysts are seen clinically and radiologically as
      persistent cavitary lesions of the lung. Bronchi opening into the pericyst cavity
      allow for discharge of fluid matter but not the escape of solid remnants of the
      collapsed parasite. Operative manipulation of the involved lung in the course of
      surgical management of chronic ruptured pulmonary hydatids can force fragments of
      the laminated membrane or small daughter cysts into the bronchial tree. Such
      extruded solid fragments lodge in bronchi of the same or opposite lung with
      resulting acute obstruction of airways. Intraoperative bronchial aspiration of
      hydatid material was seen in 7 patients with ruptured hydatid cysts of the lung,
      either primary or secondary to transdiaphragmatic extension of liver hydatids.
      The first clinical sign can be unexplained difficulty in ventilation. Effective
      management consists of prompt exposure of the stem bronchus on the operative
      side, with bronchotomy for suction retrieval of escaped solid fragments of the
      parasite.

PMID- 2222055
TI  - Value of transesophageal echocardiography during repair of congenital heart
      defects.
AB  - Two-dimensional transesophageal color Doppler echocardiography was employed
      intraoperatively in 30 children undergoing repair of a variety of simple and
      complex cardiac malformations. There were 16 female and 14 male patients, with a
      mean age of 9 +/- 3 years (range, 4 to 13 years) and a mean weight of 31 +/- 9 kg
      (range, 16 to 50 kg), 16 children weighing less than 30 kg. A standard,
      commercially available transesophageal echocardiography probe (5 MHz, 64
      elements) was used in all patients without complications. Transesophageal
      echocardiography proved helpful in selecting the surgical approach, in assessing
      the adequacy of surgical repair, in detecting residual intracardiac shunts, and
      in allowing uninterrupted monitoring of ventricular performance throughout the
      procedure. Our initial experience suggests that transesophageal echocardiography
      is a valuable tool to be used in children with congenital cardiac malformations,
      particularly in those requiring complex intracardiac procedures. The amount of
      information obtained by the surgeon should favor the routine use of
      transesophageal echocardiography during open heart procedures and stimulate the
      development of probes to be safely used even in infants and newborns.

PMID- 2222056
TI  - Swan-Ganz catheter-induced massive hemoptysis and pulmonary artery false
      aneurysm.
AB  - Swan-Ganz catheter-induced massive hemoptysis and later pulmonary artery false
      aneurysm occurred in a patient with prosthetic mitral regurgitation. This patient
      was successfully managed by double-lumen endotracheal intubation, control of
      pulmonary hypertension, reversal of anticoagulation, mitral valve re-replacement,
      and transcatheter embolization. The pertinent literature is reviewed.

PMID- 2222057
TI  - Coexisting thymic carcinoid tumor and thymoma.
AB  - Thymic carcinoid tumors are unusual neoplasms that are different from thymomas.
      We report a case of coexisting thymic carcinoid tumor and thymoma associated with
      myasthenia gravis. The clinicopathological findings are discussed with a review
      of the literature.

PMID- 2222058
TI  - Cystic medionecrosis of the coronary arteries and fatal coronary vasospasm.
AB  - The histopathological basis of coronary vasospasm is not well defined. We report
      a patient with directly observed coronary artery spasm in whom cystic
      medionecrosis of the coronary arteries and great vessels and myxomatous
      degeneration of the mitral valve were evident. We suggest that myxoid connective
      tissue lesions of the heart may be linked to coronary vasospasm.

PMID- 2222059
TI  - Left superior vena cava: a pitfall in computed tomographic diagnosis with
      surgical implications.
AB  - We report 2 cases in which computed tomography of the mediastinum demonstrated an
      abnormality originally misinterpreted as lymphadenopathy but subsequently shown
      to represent a left superior vena cava. Misinterpretation may result in errors in
      optimum treatment and may complicate surgical exploration of the mediastinum.
      These 2 cases are presented to remind radiologists and surgeons of the
      possibility of this unusual anatomy.

PMID- 2222060
TI  - Liver transplantation with atrioatrial anastomosis for Budd-Chiari syndrome.
AB  - We report the case of a young woman with Budd-Chiari syndrome in whom
      mesentericoval shunt was first performed, followed by transcaval liver resection
      and hepatoatrial anatomosis 3 years later. Liver transplantation became necessary
      5 years later because of deterioarating liver function with portal hypertension
      and bleeding. Successful transplantation was performed with atrioatrial
      anastomosis with help of cardiopulmonary bypass, simplifying considerably the
      technical procedure and reducing dramatically blood loss.

PMID- 2222061
TI  - Resection of the superior vena cava for primary lung cancer: 5 years' survival.
AB  - We describe a patient with squamous cell carcinoma of the right lung that
      required a resection of the superior vena cava combined with a tracheal sleeve
      pneumonectomy. The superior vena cava was totally replaced with a
      polytetrafluoroethylene graft with 115 minutes cross-clamping of the superior
      vena cava. The patient remains healthy and the polytetrafluoroethylene graft
      remains patent 5 years 4 months after operation.

PMID- 2222062
TI  - Polytetrafluoroethylene graft for spontaneous coronary dissection: 7-year follow
      up.
AB  - Spontaneous coronary artery dissection remains an exceedingly rare cause of
      myocardial ischemia. The patients are usually young and female, and the
      dissection is frequently fatal. The use of polytetrafluoroethylene as an
      aortocoronary conduit is generally followed by early occlusion. We report a case
      of spontaneous right coronary dissection in which a polytetrafluoroethylene graft
      was placed that was observed to remain patent by angiography at least 72 months
      after operation.

PMID- 2222063
TI  - Modified pericardial closure to protect cardiovascular structures during sternal
      reentry.
AB  - A technique is described for covering the anterior surface of the heart and
      bypass grafts with autologous pericardium after myocardial revascularization. A
      trapezoidal flap is created that incorporates bilateral relaxing incisions to
      avoid distortion of grafts or increased risk of pericardial tamponade.

PMID- 2222064
TI  - Rapid placement of the Hemopump and hemofiltration cannula.
AB  - Hypervolemia, a potential complication in patients on ventricular assist device
      support, can be managed by use of continuous arteriovenous hemofiltration. The
      Hemopump, a new catheter-mounted, transaortic axial-flow ventricular assist
      device, and the vascular access catheter for the Diafilter-30 Hemofilter system,
      used in continuous arteriovenous hemofiltration, are both usually inserted by way
      of the femoral artery. Because placing two large catheters in the femoral artery
      of a patient with peripheral vascular disease can compromise circulation, a
      technique for placing them in the abdominal aorta was developed. Two patients
      have undergone combined Hemopump and hemofiltration treatment, and neither
      experienced complications. Such techniques may benefit more patients in the
      future, as the usefulness of the Hemopump is proved.

PMID- 2222065
TI  - Improved cannulation method for extracorporeal membrane oxygenation.
AB  - Extracorporeal membrane oxygenation has been shown to be useful for patients in
      reversible cardiogenic shock. Effective arterial cannulation techniques for
      infants have been developed that are simple to use and require minimal subsequent
      vascular repair or reconstruction after removal. Groin cannulation in adults
      frequently requires bidirectional arterial cannulation to ensure adequate distal
      perfusion as well as frequent complex arterial repairs after discontinuation. We
      describe a simple arterial cannulation technique using a single right-angle, high
      flow arterial cannula. With this technique adequate bidirectional arterial
      perfusion is maintained with a single arterial cannula while the need for
      vascular repairs or reconstruction is minimized.

PMID- 2222066
TI  - Origins of intraaortic balloon pumping.
AB  - In 1968, the Journal of the American Medical Association published a paper on the
      "Initial clinical experience with intraaortic balloon pumping in cardiogenic
      shock," which gave the results of the first clinical use of the procedure
      developed in our laboratory. For more than 2 years, our group was the only one
      using intraaortic balloon pumping clinically. Later, intraaortic balloon pumping
      was used by others, and despite poor clinical salvage, the hemodynamic benefit
      was demonstrated convincingly. At the present time, approximately 70,000 balloon
      pump procedures are performed annually.

PMID- 2222067
TI  - Guidelines for transfusion support in patients undergoing coronary artery bypass
      grafting. Transfusion Practices Committee of the American Association of Blood
      Banks.
AB  - We have reviewed the impact of evolving issues in coronary artery bypass grafting
      (CABG) on transfusion support for these patients. Issues include increased
      awareness of transfusion risks, reappraisal of traditional indicators triggering
      transfusion, and evolving alternatives to homologous blood transfusion such as
      autologous blood and pharmacologic therapy. These issues have been prompted by
      programs, such as the National Institutes of Health Consensus Conferences, to
      provide physicians with guidelines for appropriate use of blood components.
      However, evidence suggests that transfusion practice in coronary artery bypass
      grafting procedures remains variable and does not take into account the results
      of recently published clinical studies. We have therefore developed guidelines
      and recommendations for transfusion support in patients undergoing coronary
      artery bypass grafting. In summary, they are the following. 1. Institutions with
      coronary artery bypass grafting programs should establish a multidisciplinary
      approach to use a combination of interventions designed to minimize homologous
      blood exposure. 2. Prophylactic transfusion of plasma and platelets are of no
      benefit and therefore carry an unnecessary risk to the patient. 3. Special
      request products such as designated blood donation from first-degree relatives
      should not be used because of the risk of transfusion-associated graft versus
      host disease. 4. For support of intravascular volume, crystalloids or colloids
      should be used because they do not have the potential to transmit infection.

PMID- 2222068
TI  - Retrotracheal mediastinal goiter with contralateral extension.

PMID- 2222069
TI  - Postirradiation pericardiectomy.

PMID- 2222070
TI  - Efficacy of pulmonary artery versus left ventricular venting.

PMID- 2222071
TI  - Thymectomy for myasthenia gravis.

PMID- 2222072
TI  - Intraoperative photodynamic therapy for malignant mesothelioma.

PMID- 2222073
TI  - Respiratory function after thoracic operations.

PMID- 2222074
TI  - Seminal vesicles: development, secretory products, and fertility.
AB  - The development of the seminal vesicle from the mesonephric duct is described.
      Particular attention is given to the recent biochemistry of seminal vesicle
      proteins. Proteins in the seminal vesicle fluid are few in number, may be
      insoluble at certain pH, and frequently form large macromolecular aggregates.
      Although not an absolute requirement for fertility, seminal vesicle fluid assists
      in a number of ways to insure fertility. A biochemical model is presented that
      demonstrates that cAMP dependent phosphorylation may be an important interaction
      between sperm and certain seminal vesicle proteins.

PMID- 2222075
TI  - Immature spermatogenic cells and leucocytes in normal and abnormal semen.
AB  - The frequency and ranges of the immature germinal cells (IGC) were established in
      286 semen analyses from normozoospermic (group I), oligozoospermic (group II),
      and azoospermic (group III) subjects. The mean total count of IGC was greater
      between men from group I than between participants from groups II and III. Scd
      spermatids were the cells most frequently observed and the spermatogonia the most
      unfrequently seen. Sab and Scd spermatids were the most common cells observed in
      group I, whereas Scd and primary spermatocytes were the most common in group II,
      and Scd and secondary spermatocytes were the most common in group III.
      Correlation was found between sperm concentration and the IGC total count.
      Significant differences were not found when epithelial cell and leucocyte
      concentrations were compared between groups.

PMID- 2222077
TI  - Effect of pineal indoles on testicular histology of mice.
AB  - The effect of late afternoon injections of melatonin, 5-methoxytryptamine, 5
      methoxytryptophol, and 5-methoxyindole-3-acetic acid on testicular histology in
      mice were examined. Melatonin and 5-methoxytryptophol injections caused a
      reduction in the diameters of seminiferous tubules. The tests of melatonin
      treated animals underwent some detectable regressive changes in the seminiferous
      tubules, whereas administration of 5-methoxytryptamine or 5-methoxytryptophol
      appeared to cause atrophy in some tubules. The percentage of aspermic tubules in
      melatonin-treated and methoxytryptamine-treated mice was significantly higher
      than that of the control. In involuted testes, some seminiferous tubules
      contained only Sertoli cells together with spermatogonia and spermatocytes, but
      no discernible spermatids and spermatozoa. Regressing spermatids and cell debris
      were frequently observed in the tubules. The tested of mice that received daily
      injections of 5-hydroxytryptophol and 5-methoxyindole-3-acetic acid were
      indistinguishable from those of the controls.

PMID- 2222076
TI  - Antisticking protein factors in buffalo blood serum.
AB  - Buffalo blood serum is a potent source of antisticking factor (ASF) that inhibits
      with high affinity adhesion of goat epididymal spermatozoa to the glass surface
      of hemocytometer counting chamber. The serum is also capable of inhibiting glass
      sticking of spermatozoa of the buffalo, ram, and bull. The serum ASF activity is
      nondialyzable and stable to heat treatment at 100 degrees C for two minutes. The
      activity of the serum ASF was lost completely when treated with trypsin (50
      micrograms/ml) at 37 degrees C for thirty minutes indicating the polypeptide
      nature of the ASF. Serum ASF activity consists of at least two factors (A and B)
      as shown by concanavalin A-agarose affinity chromatography. ASF-A and -B
      represent nearly 75% and 25% of the total serum ASF activity. ASF-B is a
      glycoprotein as it binds with high affinity to concanavalin A. The sera of
      species such as man, goat, and rat possess ASF activity.

PMID- 2222078
TI  - Therapeutic intrauterine insemination (TII)--controversial treatment for
      infertility.
AB  - The literature on therapeutic intrauterine insemination (TII) is confused because
      of lack of homogeneity in case selection, differences in executing the procedural
      steps, and the manner of evaluating and reporting results. This review compares
      results from Norfolk with those in the English literature. Special emphasis has
      been placed on separately analyzing each step of the procedure and presenting
      results of different authors in a comparable fashion. Including all etiologic
      factors and types of cycles, the term pregnancy rate per cycle was 3% for
      Norfolk, 2.6% to 6.2% elsewhere. Patients receiving TII in stimulated cycles did
      significantly better than those receiving TII in natural cycles, in terms of
      total pregnancy rate per cycle (p = 0.002). In male factor infertility, term
      pregnancy rate per cycle was 1.1% in Norfolk, 4.7% to 6.2% elsewhere (perhaps
      because of stricter criteria in Norfolk). In cervical factor infertility, term
      pregnancy rate per cycle was 4.5% in Norfolk, 2.7% to 11% for others. For
      unexplained infertility, Norfolk had 5.8% term pregnancy rate per cycle for
      natural cycles, 8.3% for stimulated cycles. Best published prospective results
      were 23% for stimulated cycles. TII seems to have a very low efficiency rate
      judging from term pregnancy rates per cycle. There are clear data indicating the
      need for redefining the indications.

PMID- 2222079
TI  - Therapeutic insemination by donor (TDI) achieves high pregnancy rates in
      infertile couples regardless of male motile sperm density.
AB  - Therapeutic insemination by donor (TDI) was just as successful in achieving
      pregnancies in couples in whom the male counterparts had subnormal motile
      densities as in those with normal levels. All wives in this study had an
      infertility factor that was corrected and remained so for at least 8 months.
      Thus, motile density may not be a particularly good predictor of male fertility
      potential.

PMID- 2222080
TI  - Artificial insemination with fresh donor semen.
AB  - A review is given of the use of fresh donor semen for therapeutic artificial
      insemination. This includes a section on the legal, ethical, and psychological
      aspects as seen from the point of view of various cultures. Topics covered are
      the indications for donor insemination, the selection of donors, and the
      techniques in common use. The success rate is described together with the sex
      ratio of the neonates. Short mention is made of short-term office semen
      preservation and the obsolete technique of mixed husband-donor insemination.

PMID- 2222081
TI  - Cryopreservation of human semen.
AB  - A review is given of the techniques for the cryopreservation of human semen,
      including the preparation of cryoprotective media, the use of ampoules, straws,
      and pellets, and freezing and thawing techniques. The use of cryopreserved semen
      for therapeutic artificial insemination by donor is described. The advantages of
      cryopreserved semen over fresh donor semen mostly lie in the ability to exclude
      infections before use and the extra convenience, in spite of the lower success
      rate and increased cost. The recovery of sperm motility on thawing is described,
      as are other methods for assessing the degree of damage to the spermatozoa by the
      freezing procedure. The success rates reported by large semen banks are
      summarized.

PMID- 2222082
TI  - Is electroencephalography necessary in the evaluation of syncope?

PMID- 2222083
TI  - Medical education in ambulatory settings.

PMID- 2222084
TI  - Is long-term levothyroxine therapy safe?

PMID- 2222085
TI  - The present medical database needs reorganization. It's time for a change!

PMID- 2222086
TI  - The impact of medical therapy on hemorrhagic complications following coronary
      artery bypass grafting.

PMID- 2222088
TI  - Electroencephalography should not be routine in the evaluation of syncope in
      adults.
AB  - We reviewed the reports of all electroencephalograms obtained at the Nashville
      (Tenn) Veterans Administration Hospital from September 1987 to August 1989.
      Seventy-three patients were referred for evaluation of syncope or near syncope.
      Of these 73 patients, 10 (13.7%) had abnormal findings. Twenty-six patients were
      referred for other complaints similar to syncope (ie, blackouts, loss of
      consciousness, falling out, passing out, and fainting). Of these 26 patients,
      five (19.2%) had abnormal findings. We reviewed the medical records of the
      patients with abnormal findings and found that the final diagnosis or treatment
      of the syncope was affected by electroencephalogram in only one patient. These
      findings suggest that routine electroencephalography is not of significant value
      in the evaluation of syncope in adults.

PMID- 2222087
TI  - Risk of gastric cancer after gastric surgery for benign disorders.
AB  - The objective of this review was to evaluate published evidence for the
      association between gastric resection for benign disorders and subsequent cancer
      of the gastric remnant. We searched the literature through Medline (1970 to 1988)
      and through the references of relevant articles. Fifty-eight studies consisting
      of case series, uncontrolled surveys, and case control or cohort analyses were
      identified and critically assessed using defined methodological criteria. There
      were no consistent differences between the expected and observed number of
      cancers occurring within 15 years after gastric resection. However, all case
      control studies and seven of the eight cohort analyses, in which the prevalence
      of cancer was stratified by time since gastric resection, indicated a twofold to
      fourfold increase in the risk of gastric cancer in patients who survived 15 or
      more years after gastric surgery. We conclude that most studies of the
      association of gastric surgery with subsequent gastric cancer have relatively
      weak designs. Still, the repetitive demonstration of this association by
      different investigators using different research designs supports the hypothesis
      that gastric resection increases the risk of cancer in the gastric remnant.

PMID- 2222089
TI  - The influence of age vs peak serum concentration on life-threatening events after
      chronic theophylline intoxication.
AB  - To identify risk factors for the development of seizures and cardiac arrhythmias
      after chronic, unintentional theophylline intoxication we monitored the clinical
      course of 72 consecutive patients referred to a regional poison center with
      chronic theophylline intoxication (serum theophylline concentration, greater than
      or equal to 167 mumol/L after protracted use). The median age of the sample was
      47.5 years (range, 4 days to 91 years). Median peak theophylline concentration
      was 239 mumol/L, with a range of 167 to 722 mumol/L. A life-threatening event
      (LTE) occurred in 28 patients (39%) that included seizures in eight and a major
      cardiac arrhythmia in 22. The median peak (theophylline) of patients who had an
      LTE vs those who did not was 235.8 vs 238.7 mumol/L. However, the median age of
      patients with an LTE compared with those without an LTE was significantly greater
      (70.5 vs 18.0 years). Stratification of data by chronologic age revealed a
      stepwise increase in the frequency of LTE with advancing years: patients more
      than 75 years old had a 16.7-fold greater risk of LTE than patients less than 25
      years old (95% confidence interval, 3.56, 77.5) despite comparable intergroup
      median serum (theophylline). These data suggest the primary determinant of LTEs
      after chronic theophylline intoxication is chronologic age. Elderly patients have
      an inordinately greater risk of LTE than younger patients. Peak serum
      theophylline concentration cannot predict which patients with chronic
      theophylline intoxication will have an LTE. Finally, these data indicate that
      theophylline should be used cautiously and with frequent monitoring of serum
      theophylline concentrations in elderly patients.

PMID- 2222090
TI  - The prevalence of Helicobacter pylori in nonulcer dyspepsia. Importance of
      stratification according to age.
AB  - Helicobacter pylori (formerly Campylobacter pylori) is causally related to active
      antral gastritis and is highly associated with duodenal and gastric ulcers.
      However, the relationship of H pylori to nonulcer dyspepsia is less clear. We
      determined the presence of H pylori in unselected patients who were undergoing
      upper gastrointestinal tract endoscopy, and we found a prevalence of 37% in 110
      patients with nonulcer dyspepsia that was similar to previous data. Patients with
      nonulcer dyspepsia who had H pylori were found to be significantly older than
      patients with nonulcer dyspepsia who did not have H pylori. In addition, when
      stratified according to age, we detected an increased prevalence of H pylori in
      patients with nonulcer dyspepsia with increasing age, similar to that reported
      for asymptomatic control populations. This finding casts doubt as to the causal
      role of H pylori for most patients with nonulcer dyspepsia and stresses the
      importance of considering epidemiologic factors, such as age, when evaluating the
      role of H pylori in specific disease states.

PMID- 2222091
TI  - Treatment of adult chickenpox with oral acyclovir.
AB  - Thirty-one late adolescents and adults with varicella were studied. Patients
      identified within 72 hours of varicella exanthem were offered open treatment with
      acyclovir (4 g/d), and those patients identified after 72 hours of exanthem were
      followed up but not treated. Twenty-two patients were treated with acyclovir.
      Nine patients were not treated. No severe complications occurred in any of the 31
      patients. Minor complications, including prolonged fever, localized secondary
      infections, persistent cough, and prolonged fatigue were more frequent in the
      untreated group. If the acyclovir therapy was begun within the first 24 hours of
      varicella exanthem, then the rash and clinical illness were dramatically
      lessened. Treatment with oral acyclovir should be considered for varicella in
      adults who are identified within the first 24 hours of exanthem.

PMID- 2222092
TI  - The association of blood pressure levels and change in renal function in
      hypertensive and nonhypertensive subjects.
AB  - We compared the changes in serum creatinine levels over time after a mean follow
      up of 9.8 years in essential hypertensive (EH, n = 56) and control (n = 59) male
      veteran subjects. All subjects had normal serum creatinine levels (62 to 124
      mumol/L) and "normal" urinalysis results on entry into the study. Subjects with
      comorbid renal diagnoses and diabetes mellitus were eliminated from the analysis.
      Although not statistically significant, the rate of change in the serum
      creatinine concentration over time was greater in the EH cohort compared with the
      control cohort (1.08 +/- 4.8 vs 0.027 +/- 3.5 mumol/L per year). The difference
      was especially marked in black EH subjects vs black control subjects (1.60 +/-
      6.2 mumol/L per year vs -0.21 +/- 3.3 mumol/L per year). When age, race, body
      mass index, and a diagnosis of EH were entered into a logistic regression
      analysis, EH subjects had a statistically significantly greater rate of decline
      in renal function than did control subjects (1.5 +/- 8.3 mumol/L per year). When
      mean time-averaged systolic blood pressure for each subject was also included in
      the logistic regression analysis, only systolic time-averaged blood pressure was
      statistically significant (0.063 +/- 0.029 mumol/L per year). We conclude that in
      the absence of clinically detected parenchymal renal disease, EH subjects have a
      greater rate of decline in renal function than do nonhypertensive subjects. Time
      averaged blood pressure is predictive of the change in serum creatinine
      concentration not only in EH subjects but also in nonhypertensive subjects. Thus,
      preservation of renal function may require a blood pressure lower than the
      currently accepted normotensive range.

PMID- 2222093
TI  - Morbidity, mortality, and quality of life for patients treated with
      levothyroxine.
AB  - In a population study of 1462 middle-aged women initiated in 1968 and 1969 we
      identified 29 women treated with levothyroxine from 1 to 28 years. In a 12-year
      follow-up in 1980 and 1981 we investigated the subjects for end-point myocardial
      infarction, diabetes mellitus, stroke, cancer, and death (the status of 99.7% of
      the initial participants was established). The women treated with levothyroxine
      showed no increase in morbidity or mortality. Of the 24 women still receiving
      levothyroxine in 1980 and 1981, 22 had serum thyrotropin and triiodothyronine
      concentrations with-in reference limits. These individuals were compared with the
      968 women from the population study having no history of thyroid disease, and
      appeared identical as to laboratory and clinical data, with the exception of a
      slightly higher body mass, taller stature, and lower serum cholesterol
      concentration. The treated group did not differ in a life quality estimate based
      on 19 questions regarding life satisfaction and sensory function. We conclude
      that the levothyroxine-treated woman suffers no side effects from her life-long
      therapy.

PMID- 2222094
TI  - Acute lead poisoning in nursing home and psychiatric patients from the ingestion
      of lead-based ceramic glazes.
AB  - To our knowledge, acute inorganic lead poisoning from single ingestions of lead
      compounds has been only rarely reported. During a 14-month period, we were
      contacted regarding eight instances of acute ingestions of liquid lead-based
      ceramic glazes by mentally impaired residents of nursing homes or psychiatric
      facilities participating in ceramic arts programs. While some ingestions did not
      cause toxic effects, some patients developed acute lead poisoning characterized
      by abdominal pain, anemia, and basophilic stippling of red blood cells. In the
      blood of several patients, lead concentrations were far above normal (4 to 9.5
      mumol/L). Urinary lead excretions were tremendously elevated during chelation
      therapy, with one patient excreting 535.9 mumol/L of lead during a 6-day period,
      the largest lead excretion ever reported in a patient suffering from acute lead
      poisoning, to our knowledge. All patients recovered following supportive care and
      appropriate use of chelating agents. Lead-based glazes are commonly found in
      nursing homes and psychiatric facilities. We suspect that acute or chronic lead
      poisoning from the ingestion(s) of lead-based ceramic glazes may be an
      unrecognized but not uncommon problem among such residents. We urge physicians to
      take ingestions of lead-based glazes seriously and to consider the diagnosis of
      lead poisoning in nursing home and psychiatric patients who have participated in
      ceramic crafts programs.

PMID- 2222095
TI  - Lipoprotein and apolipoprotein levels in subclinical hypothyroidism. Effect of
      levothyroxine therapy.
AB  - To assess whether subclinical hypothyroidism is associated with changes in
      lipoprotein fractions, 13 patients maintained in a stable state of subclinical
      hypothyroidism for at least 3 months were studied prior to and 2 and 4 months
      following restoration of a euthyroid state with incremental levothyroxine sodium
      therapy. Thyrotropin levels ( +/- SEM) had decreased from 16.6 +/- 3.2 mU/L to
      3.1 +/- 0.7 mU/L and 3.2 +/- 0.7 mU/L at 2 months and 4 months. At 2 months,
      levothyroxine treatment led to a decrease in levels of total cholesterol from 5.5
      +/- 0.3 mmol/L (213 +/- 12 mg/dL) to 4.8 +/- 0.3 mmol/L (186 +/- 12 mg/dL), in
      low-density lipoprotein cholesterol (LDL-C) from 3.7 +/- 0.3 mmol/L (143 +/- 12
      mg/dL) to 2.9 +/- 0.3 mmol/L (112 +/- 12 mg/dL), and in apolipoprotein B from 91
      +/- 8 mg/dL to 74 +/- 7 mg/dL. At 4 months, levels of LDL-C and apolipoprotein B
      remained significantly lower than pretreatment values (2.9 +/- 0.2 mmol/L [112 +/
      8 mg/dL] and 75 +/- 6 mg/dL, respectively). While high-density lipoprotein
      cholesterol (HDL-C), HDL3-C, and apolipoprotein A-I were not significantly
      affected by levothyroxine therapy, there was a slight trend of increase in HDL2-C
      during levothyroxine substitution. There was also a tendency for a decrease in
      triglyceride levels from 1.3 +/- 0.2 mmol/L (115 +/- 18 mg/dL) to 0.9 +/- 0.1
      mmol/L (80 +/- 9 mg/dL) at 4 months of levothyroxine therapy. Levels of HDL-C
      tended to decrease from 4.8 +/- 0.4 mmol/L (186 +/- 15 mg/dL) to 4.5 +/- 0.5
      mmol/L (174 +/- 19 mg/dL) at 2 months and to 3.9 +/- 0.4 mmol/L (151 +/- 15
      mg/dL) at 4 months. The LDL-C/HDL-C ratio also decreased from 3.3 +/- 0.3 mmol/L
      (128 +/- 12 mg/dL) to 2.9 +/- 0.5 mmol/L (112 +/- 19 mg/dL) and 2.5 +/- 0.3
      mmol/L (97 +/- 12 mg/dL) at 2 months and 4 months, respectively. These results
      suggest that long-term levothyroxine therapy in patients with subclinical
      hypothyroidism is associated with a decrease in LDL-C and apolipoprotein B levels
      that are reflected in a trend of decreases in cholesterol/HDL-C and LDL-C/HDL-C
      ratios known to have a relationship with coronary artery disease.

PMID- 2222096
TI  - Mortality following hip fracture before and after implementation of the
      prospective payment system.
AB  - Recent studies of patients with hip fractures from two hospitals have suggested
      that the marked reduction in length of stay that occurred following
      implementation of the Medicare prospective payment system (PPS) resulted in
      decreased quality of care for these patients. To assess whether this change
      influenced mortality, we studied patients with hip fractures aged 65 years or
      older from a 20% sample of Michigan Medicare enrollees. There were 2130 such
      patients in the 2 years preceding (October 1981 through September 1983) and 2238
      in the 2 years following (October 1984 through September 1986) implementation of
      PPS. Although the demographic characteristics of patients with hip fractures did
      not change after PPS, the mean length of stay (95% confidence interval) decreased
      by 4.4 (4.1 to 4.7) days. However, mortality in the year following the fracture
      did not change: 23.2% before PPS, 23.7% after PPS; rate difference of 0.5% (-2.0
      to 3.0). This finding was consistently present within subgroups defined by
      patient demographic characteristics. Furthermore, when the analysis was
      restricted to patients treated in those hospitals with the greatest reduction in
      average length of stay following PPS (7.5 days, or 35%), there was no significant
      change in 1-year mortality. For those patients who were enrolled in Medicaid and
      not in a nursing home at the time of the fracture, there was no increase in the
      rate of nursing home residence 1 year after the fracture. Thus, the findings of
      this population-based study suggest that the key outcomes of postfracture
      mortality and nursing home residence were not affected by the implementation of
      PPS.

PMID- 2222097
TI  - Fast and effective treatment of malignant hypercalcemia. Combination of
      suppositories of calcitonin and a single infusion of 3-amino 1-hydroxypropylidene
      1-bisphosphonate.
AB  - Seventeen patients with malignant hypercalcemia were treated with a combination
      of a single dose of 3-amino 1-hydroxypropylidene-1-bisphosphonate (APD [also
      known as AHPrBP or palmidronate disodium]) and salmon calcitonin given as
      suppositories for 3 days. To assess whether such a combined short treatment has a
      significant benefit leading to earlier normalization of the plasma calcium level
      than does APD alone, 17 additional patients matched for the type of tumor,
      initial plasma calcium level, urinary hydroxyproline level, and the dose of APD
      served as controls. All patients receiving the combination of calcitonin and APD
      achieved normalization of the plasma calcium level within 9 days, with a decrease
      from 3.22 +/- 0.90 mmol/L (mean +/- SEM) to 2.29 +/- 0.03 mmol/L. In the group
      receiving APD alone, the plasma calcium level normalized in only 14 of 17
      patients by day 9. In the group receiving calcitonin and APD, the drop in the
      plasma calcium level occurred more rapidly, and the plasma calcium values were
      lower from days 2 to 4. This advantage was explained by the calciuric effect of
      calcitonin, as reflected by a significant decrease in the notional setting of
      renal reabsorption of calcium, reaching 2.16 +/- 0.06 mmol/L compared with 2.34
      +/- 0.06 mmol/L in the group receiving APD alone. There were no side effects of
      both treatments, in particular neither flushing nor nausea induced by the
      suppositories of calcitonin. Clinical Improvement occurred after 2 days in the
      group receiving the combined treatment. In conclusion, the combined treatment is
      rapidly effective and safe in the treatment of patients with hypercalcemia,
      particularly when the notional setting of renal tubular reabsorption of calcium
      is increased and a rapid correction of the plasma calcium level is needed.

PMID- 2222098
TI  - Strategies to improve teaching in the ambulatory medicine setting.
AB  - Expansion of resident training in ambulatory medicine has created new challenges
      for faculty preceptors. Outpatient teaching is hampered by inadequate time and a
      reliance on methods of instruction that are more useful for the inpatient
      setting. Effective outpatient teaching requires an understanding of the
      objectives of ambulatory medical training and improved facility with teaching
      methods that accommodate the brief, impromptu nature of ambulatory teaching. In a
      hypothetical outpatient teaching encounter, the interactions between the patient,
      resident, and attending physician are dissected to reveal missed opportunities to
      teach and to explore alternative approaches to the educational process. These
      approaches include promoting the resident's role as the primary provider,
      developing a limited teaching agenda for each teaching encounter, focusing on the
      learner rather than on the diagnostic dilemma posed by the patient, and using
      questions, role modeling and observation with feedback to promote learning.

PMID- 2222099
TI  - Pregnancy in women with immune thrombocytopenic purpura.
AB  - Thirty-six women with immune thrombocytopenic purpura were studied during 37
      pregnancies, and maternal characteristics with predictive value for the fetal
      platelet count were determined. Nine neonates were thrombocytopenic, with a
      platelet count of less than 50 x 10(9)/L in eight. Four of these nine neonates
      delivered to a subgroup of 31 mothers were studied prospectively; the frequency
      of thrombocytopenia in neonates of women with immune thrombocytopenic purpura was
      thus 13%. Only two of these nine neonates presented with hemorrhagic syndromes
      (two, petechial purpura; one, intracranial bleeding). The frequency of neonatal
      thrombocytopenia was higher in mothers with deep thrombocytopenia and in those
      who had not responded to corticosteroid treatment following diagnosis. No
      prognostic value could be assigned to the other maternal characteristics studied,
      such as a history of splenectomy, maternal treatment at the time of delivery, or
      the presence of platelet autoantibodies evaluated either with the platelet
      immunofluorescence test or the platelet Western blot immunoassay.

PMID- 2222100
TI  - Emergence of ciprofloxacin resistance in nosocomial methicillin-resistant
      Staphylococcus aureus isolates. Resistance during ciprofloxacin plus rifampin
      therapy for methicillin-resistant S aureus colonization.
AB  - We initiated a randomized, single-blinded trial of ciprofloxacin plus rifampin vs
      sulfamethoxazole and trimethoprim plus rifampin in the therapy for patients who
      underwent colonization with methicillin-resistant Staphylococcus aureus (MRSA).
      Patients who were colonized with MRSA received 2 weeks of either regimen. The
      study was terminated after the enrollment of 21 subjects due to the recognition
      of ciprofloxacin resistance in 10 of 21 new MRSA isolates during the last 2
      months of the study. Five of the 10 patients with ciprofloxacin-resistant MRSA
      isolates had never received ciprofloxacin. Long-term (6-month) eradication had
      been achieved in only three of 11 ciprofloxacin plus rifampin and four of 10
      sulfamethoxazole and trimethoprim plus rifampin recipients. The use of this new
      fluoroquinolone for the eradication of MRSA colonization is usually not effective
      and may risk the development of ciprofloxacin resistance in MRSA within the
      hospital environment.

PMID- 2222101
TI  - Vision screening in a primary care setting. A missed opportunity?
AB  - To determine the effectiveness of vision screening in a primary care setting, we
      administered a questionnaire and a vision test to 458 patients from a general
      medical clinic. Subjects were referred for complete ophthalmologic evaluation if
      they failed the vision test or met other "high-risk" criteria based on
      information contained in the questionnaire. Patient-initiated requests for eye
      examinations were also honored. A total of 169 patients were scheduled for eye
      examinations, and 148 actually underwent ophthalmologic evaluation. One hundred
      one of those examined were referred on the basis of the study criteria. "Serious
      eye disease" (cataract, glaucoma, diabetic retinopathy, or age-related macular
      degeneration) was diagnosed in 96 (95%) of these patients. Prompt surgical
      intervention was recommended in 27 (27%), and medical treatment was begun in 21
      (21%). Of those with serious eye disease, 59% met the criteria by failing the
      vision test, while 69% met the high-risk criteria determined by the
      questionnaire. Of the 148 subjects who received ophthalmologic evaluations, 47
      requested them. Serious eye disease was diagnosed in 23 (50%) of the 47 patients.
      None of these individuals required immediate surgery, and medical treatment for
      glaucoma was begun in eight (17%). These data suggest that screening for serious
      eye disease in a primary care setting is an efficient mechanism to use for the
      identification of patients with undetected ocular disorders that require follow
      up or treatment.

PMID- 2222102
TI  - Spontaneous pneumothorax in patients with acquired immunodeficiency syndrome
      treated with prophylactic aerosolized pentamidine.
AB  - Spontaneous pneumothorax is a known complication of Pneumocystis carinii
      pneumonia in patients with the acquired immunodeficiency syndrome. To evaluate
      the possible pathogenesis and natural history of pneumothorax in patients
      receiving aerosolized pentamidine prophylaxis, we retrospectively reviewed 327
      outpatients positive for human immunodeficiency virus receiving aerosolized
      pentamidine. There were 12 spontaneous pneumothoraces in this group of patients.
      Seventy-five percent of patients with pneumothorax had roentgenographic evidence
      of fibrocystic lung parenchyma and clinical evidence of active Pneumocystis
      pneumonia. The majority (83%) required chest tube evacuation. There was a 50%
      mortality rate associated with this complication. These findings suggest that
      spontaneous pneumothorax in patients treated with aerosolized pentamidine most
      commonly represents a prophylaxis failure associated with a high mortality rate.

PMID- 2222103
TI  - Deaths due to accidents and violence in two recent trials of cholesterol-lowering
      drugs.
AB  - The Helsinki Heart Study and the Lipid Research Clinics Coronary Primary
      Prevention Trial both reported higher rates of deaths due to homicides, suicides,
      and accidents in the groups receiving cholesterol-lowering agents compared with
      the groups receiving placebos. We examined these deaths in the active treatment
      arms of the two trials to determine if there were some readily explainable causes
      or if the cholesterol-lowering agents might be a factor. Our examination showed
      that the two homicides were victims, not offenders, and one had stopped treatment
      because of myocardial infarction 1 year before his death. Five of the eight
      suicides had dropped out of the trials and had not taken the cholesterol-lowering
      drugs for periods of months to years prior to committing suicide. Of the 10
      deaths due to accidents, two were dropouts from the trials, three others had high
      blood alcohol concentrations detectable at autopsy, and another three reported a
      history of psychiatric symptoms and/or treatment prior to entry. When dropouts
      and known risk factors for these deaths such as alcohol intoxication and
      psychiatric histories are considered, little evidence remains to support the
      hypothesis that cholesterol-lowering drugs are causally associated with deaths
      due to homicides, suicides, and accidents in these trials.

PMID- 2222104
TI  - Eosinophilia-myalgia syndrome. Recognition of a distinct clinicopathologic
      entity.
AB  - The eosinophilia-myalgia syndrome is a newly described disorder related to the
      ingestion of L-tryptophan-containing products. Its presentation may mimic other
      disorders characterized by eosinophilia and muscle pain and/or weakness, but can
      be differentiated by certain characteristic laboratory and pathologic findings.
      We report two such cases, describe their features, and review similar syndromes.

PMID- 2222106
TI  - Acute renal failure due to ciprofloxacin.
AB  - Acute renal failure developed in three patients within a few days of starting
      ciprofloxacin hydrochloride therapy. An allergic interstitial nephritis was
      suggested by fever and eosinophiluria in one patient and by erythema multiforme
      in another. A kidney biopsy specimen confirmed this diagnosis in one patient.
      Renal function improved shortly after withdrawal of the drug in all three
      patients. Literature survey revealed an additional three patients with a similar
      complication. Allergic manifestations, such as fever or rash, were a feature in
      most reported cases. In view of this potential complication, renal function
      should be closely monitored in patients receiving ciprofloxacin therapy,
      especially if other potentially nephrotoxic drugs are prescribed concomitantly.

PMID- 2222105
TI  - Eosinophilia-myalgia syndrome associated with L-tryptophan ingestion. Analysis of
      four patients and implications for differential diagnosis and pathogenesis.
AB  - Four patients fulfilling the case definition for eosinophilia-myalgia syndrome
      are described, including one whose disease began in 1986. Each displayed a
      variety of symptoms: one suffered principally from myalgia and recovered
      spontaneously on discontinuation of L-tryptophan therapy; one exhibited
      progressive sclerodermiform skin changes, neuropathy, and myopathy; a third had
      prominent neuromuscular disease and sclerodermiform skin changes; and the fourth
      experienced profound weight loss, an axonal polyneuropathy, and perivascular
      lymphoid infiltrates simulating a lymphoma. Evidence of T-cell activation was
      present in peripheral blood and affected tissues during the clinically active
      progressive phase of disease. Among other manifestations pleural effusion,
      cutaneous vasculitis, joint contractures, and bloody diarrhea were observed. A
      history of L-tryptophan ingestion should be sought in patients with myalgia,
      fatigue, or the above outlined symptoms.

PMID- 2222107
TI  - Desensitization in the management of vancomycin hypersensitivity.
AB  - Vancomycin is the preferred antimicrobial agent in the treatment of methicillin
      resistant staphylococcal infections. One of the well-known hypersensitivity
      reactions to this agent is the "red-man syndrome," which is believed to involve
      drug-induced histamine release in certain individuals. Although rate and/or dose
      reductions may be effective in some cases, some hypersensitivity reactions
      necessitate the discontinuation of vancomycin. In this article one patient is
      described who developed vancomycin-associated reactions consistent with the red
      man syndrome despite having tolerated vancomycin administration previously. This
      case was managed by sequential increments in vancomycin administration over
      several days that allowed for therapeutic doses of the drug to be administered.
      Prior to desensitization, vancomycin administration at a lowered rate and dose
      was unsuccessfully attempted, despite the presence of combination antihistamine
      therapy. A loss of skin prick test reactivity to vancomycin was demonstrated
      after successful desensitization. This desensitization method may be useful in
      managing certain refractory cases of vancomycin hypersensitivity.

PMID- 2222108
TI  - Comparative yield of blood culture for fungi and mycobacteria.

PMID- 2222109
TI  - Liver alterations in acute pneumonia.

PMID- 2222110
TI  - Seroprevalence of human immunodeficiency virus in a state psychiatric
      institution.

PMID- 2222111
TI  - Doppler echocardiography diagnosis of right ventricular outflow tract
      obstruction.

PMID- 2222112
TI  - A smoke-free hospital in China.

PMID- 2222113
TI  - [Sodium diphenylhydantoin changes the concentrations of DNA and proteins in the
      cerebrum, cerebellum and liver].
AB  - Sodium diphenylhydantoin (DFH-Na) is the drug of choice to control convulsive
      seizure disorders. Beneficial as well as adverse effects of DFH-Na have been
      reported to occur since 1938. Thus, the present article deals with the effect
      that 2.5, 5, 10, 15, 20 and 100 mg/kg/day (2.5, 5, 10, 15, 20 and 100) might
      cause on Cerebrum (C), Cerebellum (Cb) and liver (L) DNA [DNA] and Protein [Pr]
      concentration. Our results showed that: 1) DNA-C-14 (15, 20 and 100) were found
      decreased when compared to control (p less than 0.001) and [DNA]-C-30 (15, 20 and
      100) as well (p less than 0.001). [Pr]-C-7, 14, 30 (2.5, 5, 10, 15, 20 and 100)
      showed no statistically important differences. 2) [DNA]-Cb-14 (15 and 20) were
      found lower than control (p less than 0.05) and [DNA]-Cb-30 (15 and 20) as well
      (p less than 0.05). [Pr]-Cb-14,30 (100) was found decreased (p less than 0.05).
      3) [DNA]-L-14 (10, 15, 20 and 100) was found decreased when compared to control
      (p less than 0.001) and [DNA]-L-30 (10, 15, 20 and 100) as well (p less than
      0.001). [Pr]-L-7, 14 and 30 (2.5, 5, 10, 15, 20 and 100) were found lower than
      control (p less than 0.05). A bimodal pattern of [DNA] of C. Cb and L was
      demonstrated to occur with i.p. injected DFH-Na.

PMID- 2222114
TI  - The distribution of thallous ion between blood cells and plasma at equilibrium.
AB  - We have investigated the distribution of thallous ions between plasma and blood
      cells in whole blood both in vitro and in vivo (rabbit whole blood) and in vitro
      (human whole blood). The means of the percentual distribution are within the
      range of 61.4 to 64.2 percent for cell packet and 35.8 to 38.6 percent for plasma
      (n = 50), which is in agreement with previous reports. No significant differences
      between the two species were found when the direct percentages were compared;
      however, significant differences appeared (p less than 0.01; dose range 1 to 40
      micrograms ml-1) when the comparison was made in terms of the ratio:(formula:see
      text). As for the effect of dose, there is an an apparent disminution in the
      thallium retained by the cells as the dose increases. However, when the
      comparison is made in terms of the normalized values, the dose effect is null
      within the range 1 to 40 micrograms ml(-1). Finally, the observed ratio cell
      packet/plasma (between 2 and 3) suggests that in whole blood, at equilibrium,
      thallous ion is mainly distributed passively between cells and plasma. The
      biological significance of it is discussed.

PMID- 2222115
TI  - Mast cells and idiopathic lung fibrosis.
AB  - Mast cells are usually related with allergic reactions in the lung. This cells
      has a biochemical repertoire capable of modulate inflammatory reactions in this
      organ. The relation of this cell with idiopathic pulmonary fibrosis (IPF), has
      not been studied in depth. There is no agreement in which is the best technique
      for counting mast cells and what are the normal counts of these cells in the
      lung. We analyse some of the reported "normal values" and the differences within
      IPF and patients with nonfibrotic lung diseases. The results of the present study
      demonstrate that the largest population of mast cells in IPF patients were the
      interstitium (342 +/- 83 cells) compared with the nonfibrotic patients (31 +/- 8
      cells), and almost equal in both groups of patients in the subpleural,
      peribronchiolar and perivascular areas. However, it is necessary to unify
      criteria, in order to define what the normal values for mast cells in the lung
      are.

PMID- 2222116
TI  - [The biology of the volcano mouse (N. a. alstoni). XXI. Reproductive capacity of
      wild females in 15 successive matings].
AB  - This study comprises an investigation on the reproductive capacity of wild
      females of the volcano mouse (Neotomodon alstoni alstoni), in 15 successive
      matings. The neotomodon were captured in the Sierra del Volcan Ajusco (Cerro
      Pelado, Parres, D.F.). The animals were kept under environmental laboratory
      conditions, being fed ALBI-LAB pellets and tap water. The matings were performed
      from may 1985 to August 1988 by pairs and at random, during 12 days. The females
      were weighed on the day 1 of the mating; the young were sexed on the 7th day of
      life, and weaned at the 30th day of age. The results were: the mean of the
      percentages of pregnancy in the 15 matings was 39.6 +/- 3.0, being the highest
      percentages in Spring-Summer. The size of the litter varied from 1 to 6 young,
      with a mode of 3 and a global average of 2.7. The means of the percentages of
      survival at the first week of life and at weaning were 72.9 +/- 3.6 and 70.3 +/-
      3.3, respectively. The proportion males-females was 1.2:1. There was not found a
      significant positive correlation between the weight of the mothers at day 1 of
      the mating and the size of the litter (r = 0.65, p less than 0.05). These results
      allow to conclude that in the laboratory the wild volcano mouse exhibits a high
      reproductive capacity, which demonstrates that this rodent posseses very positive
      qualities in order to make out of him a new experimental animal.

PMID- 2222117
TI  - [Modified procedure for screening anticonvulsants. Re-evaluation of sodium
      diphenylhydantoin and phenobarbital].
AB  - A modified antiepileptic screening procedure to test anticonvulsant drugs is
      shown. Diphenylhydantoin sodium salt (DFH-Na) and phenobarbital (Phb) were tested
      throughout 8 h, at hourly intervals after a single oral drug intake in rats.
      Another group was tested at steady stage of DFH-Na during 7 days period. A single
      dose of DFH-Na was orally administrated to male and female rats (30 mg/kg) and
      after testing throughout 8 h: 0, 5, 28, 38, 52, 70 and 75% and 10, 18, 50, 35,
      62, 50 and 70% protection against MES, was found. Only 20% protection was found
      in females to METsc test on the 6th and 7th h. However, 80, 60, 60 and 20% males
      were found protected against METsc test from the 4th to the 8th hour. Maximum
      blood serum levels were 2 micrograms/ml. Phenobarbital at doses 12 mg/kg in males
      and females as well showed: 30, 64, 66, 74, 84, 90, 40, 34% and 14, 36, 53, 41,
      55, 70, 82 and 82% protection against MES, respectively. On the other hand, 60,
      60, 46, 47, 94, 100, 80 and 20% and 80, 80, 46, 70, 60, 40, 80 and 20% of males
      and females were protected against METsc test, respectively. An average of 8
      micrograms/ml and 12 micrograms/ml of Phb serum levels were found since the 1 to
      the 8th and 5th hours, correspondingly. A 28% protection of both male and female
      rats to MES test was found following 7 days of treatment with DFH-Na (30 mg/kg)
      treatment. Also an average of 10% female and males were found protected against
      METsc test.

PMID- 2222118
TI  - Influence of previous housing history on the toxicity of amphetamine in aggregate
      mice.
AB  - The lethality of d-amphetamine was studied in isolated and aggregated mice with
      and without previous habituation to the physical or to the physical and social
      environment of chronically aggregated social condition under which the toxic
      effects of d-amphetamine were tested. In animals without previous habituation to
      such environments, d-amphetamine's toxicity was greatly enhanced by social
      aggregation, as reported by several authors in the literature. It was found that
      mortality in the dose range from 5 to 90 mg/kg is mainly determined by the
      stimulation due to aggregation. Above 90 mg/kg, the mortalities in single and
      aggregated mice vary in parallel. Up from this dose, lethality is independent of
      the external stimulation. Previous experience with house sharing in aggregated
      conditions reduces aggregation mortality in proportion to the duration of the
      previous house sharing period.

PMID- 2222119
TI  - The sensitivity of rat uterus to serotonin in vitro is a late estrogenic
      response.
AB  - This study was designed to further characterize the sensitivity to serotonin of
      the isolated rat uterus. The contractile response to serotonin induced by the
      administration of estradiol was increased depending on the duration of estradiol
      treatment, reaching the maximal contractility when ovariectomized rats were
      treated for 48 hours. Pretreatment with actinomycin D 1 hour before estrogen
      administration completely blocked estrogen-induced uterine sensitivity to
      serotonin. These results indicate that the sensitivity of rat uterus to serotonin
      in vitro induced by estradiol is a response occurring in the late phase and
      mediated by genomic activation. Following estradiol-administration uterine
      sensitivity to serotonin was similar in ovariectomized and ovariectomized
      hypophysectomized rats, suggesting that in this response a pituitary factor is
      not required. The contractile responses to acetylcholine and oxytocin were not
      modified by estradiol; thus, estrogens induced specifically uterine sensitivity
      to serotonin. The present in vitro studies using pelanserin, a potent S2
      antagonist, show that serotonin induced contractions in the rat uterus are
      mediated by interaction with S2-receptors, since pelanserin inhibited not
      competitively the contractile response to serotonin.

PMID- 2222120
TI  - Hemolysin as a marker for Serratia.
AB  - All Serratia marcescens strains (total of 33) of different sources were hemolytic
      including clinical strains previously classified as being nonhemolytic. DNA
      fragments of the two hemolysin genes hybridized with the chromosomal DNA of S.
      marcescens, S. liquefaciens, S. kiliensis, S. grimesii, S. proteamaculans, S.
      plymutica, S. rubridaea which were also hemolytic. The restriction pattern of the
      hemolysin locus differed in each strain. S. ficaria and S. marinorubra expressed
      a different hemolysin which was much smaller than the S. marcescens hemolysin
      since it diffused through dialysis membranes. The DNA of the latter strains did
      not hybridize with the S. marcescens hemolysin DNA probes. Some S. marcescens
      strains, S. kiliensis and S. liquefaciens also expressed in addition the small
      hemolysin. No hybridization was found with DNA of Escherichia coli, Salmonella
      typhimurium, Proteus mirabilis, Proteus vulgaris, Citrobacter freundii,
      Enterobacter cloacae, Klebsiella arerogenes, Klebsiella pneumoniae, Shigella
      dysenteriae, Yersinia enterocolitica, Yersinia pseudotuberculosus, Listeria sp.,
      Aeromonas sp., Legionella sp. and a Meninococcus sp., indicating that the
      hemolysin DNA probes are specific for Serratia, or that the hemolysin genes occur
      rarely in genera other than Serratia.

PMID- 2222121
TI  - Stereoselective formation of a K-region dihydrodiol from phenanthrene by
      Streptomyces flavovirens.
AB  - The metabolism of phenanthrene, a polycyclic aromatic hydrocarbon (PAH), by
      Streptomyces flavovirens was investigated. When grown for 72 h in tryptone yeast
      extract broth saturated with phenanthrene, the actinomycete oxidized 21.3% of the
      hydrocarbon at the K-region to form trans-9,10-dihydroxy-9,10-dihydrophenanthrene
      (phenanthrene trans-9,10-dihydrodiol). A trace of 9-phenanthrol was also
      detected. Metabolites isolated by thin-layer and high performance liquid
      chromatography were identified by comparing chromatographic, mass spectral, and
      nuclear magnetic resonance properties with those of authentic compounds.
      Experiments using [9-14C]phenanthrene showed that the trans-9,10-dihydrodiol had
      62.8% of the radioactivity found in the metabolites. Circular dichroism spectra
      of the phenanthrene trans-9,10-dihydrodiol indicated that the absolute
      configuration of the predominant enantiomer was (-)-9S,10S, the same as that of
      the principal enantiomer produced by mammalian enzymes. Incubation of S.
      flavovirens with phenanthrene is an atmosphere of 18O2, followed by gas
      chromatographic/mass spectral analysis of the metabolites, indicated that one
      atom from molecular oxygen was incorporated into each molecule of the
      phenanthrene trans-9,10-dihydrodiol. Cytochrome P-450 was detected in 105,000 x g
      supernatants prepared from cell extracts of S. flavovirens. The results show that
      the oxidation of phenanthrene by S. flavovirens was both regio- and
      stereospecific.

PMID- 2222122
TI  - Purification and characterization of a (R)-2,3-butanediol dehydrogenase from
      Saccharomyces cerevisiae.
AB  - A NAD-dependent (R)-2,3-butanediol dehydrogenase (EC 1.1.1.4), selectively
      catalyzing the oxidation at the (R)-center of 2,3-butanediol irrespective of the
      absolute configuration of the other carbinol center, was isolated from cell
      extracts of the yeast Saccharomyces cerevisiae. Purification was achieved by
      means of streptomycin sulfate treatment, Sephadex G-25 filtration, DEAE-Sepharose
      CL-6B chromatography, affinity chromatography on Matrex Gel Blue A and Superose 6
      prep grade chromatography leading to a 70-fold enrichment of the specific
      activity with 44% yield. Analysis of chiral products was carried out by gas
      chromatographic methods via pre-chromatographic derivatization and resolution of
      corresponding diastereomeric derivatives. The enzyme was capable to reduce
      irreversibly diacetyl (2,3-butanediol) to (R)-acetoin (3-hydroxy-2-butanone) and
      in a subsequent reaction reversibly to (R,R)-2,3-butanediol using NADH as
      coenzyme. 1-Hydroxy-2-ketones and C5-acyloins were also accepted as substrates,
      whereas the enzyme was inactive towards the reduction of acetone and
      dihydroxyacetone. The relative molecular mass (Mr) of the enzyme was estimated as
      140,000 by means of gel filtration. On SDS-polyacrylamide gel the protein
      decomposed into 4 (identical) subunits of Mr 35,000. Optimum pH was 6.7 for the
      reduction of acetoin to 2,3-butanediol and 7.2 for the reverse reaction.

PMID- 2222123
TI  - Characterization of Aeromonas salmonicida variants with altered cell surfaces and
      their use in studying surface protein assembly.
AB  - Aeromonas salmonicida variants were characterized for alterations in their cell
      surface structure and used to examine reconstitution of the surface protein layer
      (A-layer). Variants lacking outer membrane O-polysaccharide were devoid of A
      layer and excreted stainable floret-like material of the surface protein (A
      protein). One variant, showing partial loss of O-polysaccharide, was associated
      with a disrupted A-layer and excretion of some A-protein. Variants lacking A
      protein but possessing O-polysaccharide rapidly absorbed and concentrated
      sufficient excreted A-protein at the cell surface to coat the cells with a single
      confluent layer. Although differences in electrophoretic mobilities of A-proteins
      and O-polysaccharides from "typical" and "atypical" strains were evident, the
      different A-proteins and A-protein-deficient variants were interchangeable for
      reconstitution of a surface protein layer. No association of A-protein with cell
      surfaces of unrelated gram-negative bacteria was observed.

PMID- 2222124
TI  - [Update on the morbidity of psychiatric disorders in patients with AIDS: results
      of a clinical follow-up].
AB  - A follow-up study after one or two years of treatment was carried out on 107 AIDS
      patients who were seen by the Consultation-Liaison Psychiatry Unit of the Ramon y
      Cajal Hospital. The sample was reduced to 52 patients (49%) mainly due to the
      lack of check-ups in 43% and to the death of 8% of the cases. 36% of patients
      suffered from Delirium or Dementia and these had the greater mortality rate.
      Grade IV patients and those with a diagnosis of Adjustment Disorders came to the
      check-ups most frequently.

PMID- 2222125
TI  - [Psychiatric complications related to AIDS infection: apropos of a case of
      hypomania].
AB  - The psychiatric disorders related with HIV infection can take various and complex
      forms. One case of Hypomania in a drug abuser patient with HIV + is reported, and
      it is suggested that this virus may produce symptomatology indistinguishable from
      the functional disorders.

PMID- 2222127
TI  - [Effect of cephalic perimeter and temperature on the latency and amplitude of the
      P100 component of the visual evoked potential].
AB  - Pattern reversal evoked potentials were recorded from 40 people (20 males and 20
      females) in good health. Latency and amplitude of P100 as well as cephalic
      perimeter and temperature were measured. Both samples did not differ in age.
      Males had a greater cephalic perimeter (p less than 0.00001) and females had a
      greater temperature (p less than 0.05). Amplitude of P100 decreased with age. We
      did not obtain any relation among cephalic perimeter or temperature with P100
      latency or amplitude. We conclude that the consideration of these measurements
      does not increase the sensibility of VEP.

PMID- 2222126
TI  - [Rehabilitation in old age: a neuropsychological perspective].
AB  - We are revising some programs of cerebral activation in elderly people. The
      application criteria from a neuropsychological perspective are proposed. A change
      about the rehabilitation of all types of brain injuries and its prevention is
      needed in the professional's attitude.

PMID- 2222128
TI  - [Hemangioblastoma associated with syringomyelia and syringobulbia in a patient
      with rheumatoid arthritis].
AB  - A 80-year-old woman with a 25-year history of seropositive, erosive rheumatoid
      arthritis (RA) presented with a neurological clinical picture consistent with
      cervical cord compression, secondary to a hemangioblastoma with medulla,
      cerebellum and spinal cord involvement, with associated syringomyelia and
      syringobulbia. We present a review of the literature remarking the low frequency
      of this tumor (1%-2% of all intracranial tumors) and its exceptional presentation
      over the age of 70. We have not been able to find no cases of hemangioblastoma
      associated with rheumatoid arthritis, thus, we think, this association may be
      casual. Nevertheless, it emphasizes the need for careful evaluation of patients
      with rheumatoid arthritis and neurological symptoms before ascribing them to
      complications due to the rheumatoid disease itself.

PMID- 2222129
TI  - Long-term therapeutic use of benzodiazepines. I. Effects of abrupt
      discontinuation.
AB  - We compared the effect of abrupt discontinuation of therapeutic doses of short
      half-life and long half-life benzodiazepines in 57 benzodiazepine-dependent
      patients (daily use, greater than 1 year). Despite the use of a mean daily dose
      of 14.1 mg of diazepam equivalents, there were notable residual symptoms of
      anxiety and depression present at intake (Hamilton Rating Scale for Anxiety
      score, 17.0; Hamilton Rating Scale for Depression score, 14.0). Benzodiazepine
      intake was stabilized for 3 weeks before double-blind assignment to placebo (n =
      47), or continued benzodiazepine use (n = 10). Clinical assessments were
      performed daily, including benzodiazepine plasma levels. Depending on the outcome
      criteria used, anywhere from 58% to 100% of patients were judged to have
      experienced a withdrawal reaction, with a peak severity at 2 days for short half
      life and 4 to 7 days for long half-life benzodiazepines. Relapse onto
      benzodiazepines occurred in 27% of patients who were receiving long half-life
      benzodiazepines and in 57% of patients who were receiving short half-life
      benzodiazepines. Baseline predictors of relapse were nonpanic diagnoses, a higher
      benzodiazepine dose, and a higher Eysenck neuroticism score. A short half-life
      and higher daily doses were associated with greater withdrawal severity, as were
      personality traits, such as dependency and neuroticism, less education and higher
      baseline levels of anxious and depressive symptoms. Patients who were able to
      remain free of benzodiazepines for at least 5 weeks obtained lower levels of
      anxiety than before benzodiazepine discontinuation. These results provide a
      detailed picture of the symptoms, time course, and multidimensional determinants
      of the benzodiazepine withdrawal syndrome.

PMID- 2222130
TI  - Long-term therapeutic use of benzodiazepines. II. Effects of gradual taper.
AB  - We compared the effect on withdrawal severity and acute outcome of a 25% per week
      taper of short half-life vs long half-life benzodiazepines in 63 benzodiazepine
      dependent patients. Patients unable to tolerate taper were permitted to slow the
      taper rate. Ninety percent of patients experienced a withdrawal reaction, but it
      was rarely more than mild to moderate. Nonetheless, 32% of long half-life and 42%
      of short half-life benzodiazepine-treated patients were unable to achieve a drug
      free state. The most difficulty was experienced in the last half of taper.
      Baseline personality, high Eysenck neuroticism, female sex, and mild-to-moderate
      alcohol use were found to be more significant predictors of withdrawal severity
      than the daily benzodiazepine dose or benzodiazepine half-life. These findings
      suggest that personality factors contribute significantly to the patient's
      difficulties with gradual benzodiazepine discontinuation of therapeutic doses of
      benzodiazepines.

PMID- 2222131
TI  - Controlled comparisons of clomipramine and fluoxetine in the treatment of
      obsessive-compulsive disorder. Behavioral and biological results.
AB  - Treatment with fluoxetine hydrochloride was compared with treatment with
      clomipramine hydrochloride in two groups of patients with obsessive-compulsive
      disorder using two different experimental designs. In the first group of 11
      patients with obsessive-compulsive disorder studied using a randomized, double
      blind, crossover design, treatment with fluoxetine for 10 weeks was found to
      produce therapeutic effects similar to treatment with clomipramine for 10 weeks.
      There were significantly fewer total side effects reported during fluoxetine than
      clomipramine treatment. Drug tapering and placebo substitution in the 4-week
      crossover interval phase led to substantial relapses in obsessive-compulsive
      disorder symptoms and depression. Furthermore, responses to the second drug took
      as long to occur as responses to the first drug, although both drugs are thought
      to act by a common mechanism, serotonin uptake inhibition. A second group of 21
      patients with obsessive-compulsive disorder that had been previously stabilized
      on clomipramine treatment with at least partial benefit were crossed over to
      fluoxetine treatment in a double-blind fashion. After 10 weeks of fluoxetine
      administration, most patients manifested behavioral rating scores of obsessive
      compulsive disorder and depressive symptoms that were comparable with
      precrossover ratings completed during clomipramine treatment. A significant
      exacerbation in obsessive-compulsive disorder and depression ratings as well as a
      similar lag in therapeutic efficacy were also noted in this second cohort of
      patients with obsessive-compulsive disorder. Platelet 5-HT concentrations were
      reduced 95% during both clomipramine and fluoxetine treatment periods. These
      results suggest that fluoxetine may represent a viable alternative to
      clomipramine in the treatment of obsessive-compulsive disorder, although further
      studies with larger sample sizes are needed.

PMID- 2222132
TI  - Atypical depression, panic attacks, and response to imipramine and phenelzine. A
      replication.
AB  - In an initial study with 120 patients with reactive mood and associated atypical
      symptoms, phenelzine sulfate was superior to imipramine hydrochloride and
      placebo. Since their response to phenelzine appears to be unique, this suggests
      that atypical depression may be a distinct subgroup of unipolar depressive
      illness. Unexpectedly, the benefit of antidepressants was limited to patients who
      also had spontaneous panic attacks. To help establish the validity of this
      syndrome, a new sample of 90 atypical depressives was studied. The clinical and
      demographic characteristics of the original and replication sample were virtually
      identical at baseline. In addition, the treatment response with either placebo,
      imipramine, or phenelzine was also indistinguishable in the two patient groups.
      The outcome in the replication study supports the hypothesis that this may be a
      distinct unipolar depressive subgroup. In the replication sample, a history of
      panic attacks did not appear to be a relevant predictor. We discuss the
      explanations for this discrepancy in the two patient samples.

PMID- 2222133
TI  - HLA-B38, DR4, DQw3 and clozapine-induced agranulocytosis in Jewish patients with
      schizophrenia.
AB  - Agranulocytosis develops in approximately 1% of patients with chronic
      schizophrenia treated with the atypical neuroleptic drug clozapine. Previous
      studies have not identified the mechanism or risk factors for this adverse
      reaction. Because of an observed association between Jewish ethnic background and
      the development of agranulocytosis in our patient sample treated with clozapine
      for refractory symptoms, HLA typing was performed in 31 patients (19.4% of whom
      had developed agranulocytosis). The HLA-B38 phenotype was found in 83% of
      patients who developed agranulocytosis and in 20% of clozapine-treated patients
      who did not develop agranulocytosis. Because B38 is part of a haplotype known to
      occur frequently in the Ashkenazi Jewish population, the frequencies of the
      combined alleles HLA-B38, DR4, and DQw3 were examined. The incidence of HLA-B38,
      DR4, DQw3 was significantly increased in patients with agranulocytosis (five of
      five patients) compared with control patients of Ashkenazi Jewish ancestry (two
      of 17 patients). These findings indicate that genetic factors marked by major
      histocompatibility complex haplotypes may be associated with the susceptibility
      of Jewish schizophrenic patients treated with clozapine to develop
      agranulocytosis. We postulate that gene products contained in the haplotype may
      be involved in mediating drug toxicity.

PMID- 2222134
TI  - Toward a scientific psychiatric nosology. Strengths and limitations.
AB  - A consensus is emerging that psychiatric nosology should become more
      "scientific." The application of the scientific method to psychiatric nosology
      has a number of important advantages, including (1) providing a clear criterion
      by which to evaluate nosologic proposals, (2) preventing rapid changes due to
      nosologic "fashions" not supported by research findings, (3) increasing the
      prestige and acceptability of our nosologic system to individuals outside of
      psychiatry, and (4) optimizing the reliability and validity of our diagnostic
      constructs. However, many critical issues confronting nosologists are
      fundamentally nonempirical and cannot be addressed by the scientific method.
      Examples of such issues include (1) disagreements about the proper construct for
      a psychiatric disorder; (2) the interpretation of results when different
      validators provide opposing answers; (3) defining how different syndromes must be
      to be considered subtypes of the same disorder, distinct disorders within the
      same overall category, or entirely independent disorders; and (4) the proper
      balance of reliability and validity. The optimal use of the scientific method in
      our nosologic process requires a recognition of both its strengths and its
      limitations.

PMID- 2222135
TI  - Is DSM-IV needed at all?

PMID- 2222136
TI  - Offspring of twins with schizophrenia.

PMID- 2222137
TI  - Use of antidepressants in schizophrenia: diagnostic problems.

PMID- 2222138
TI  - Psychiatric morbidity in research volunteers.

PMID- 2222139
TI  - National pathology manpower survey.

PMID- 2222140
TI  - Cutaneous vascular calcification with ulceration in hyperparathyroidism.

PMID- 2222141
TI  - Financial impact of a rapid CK-MB-specific immunoassay on the diagnosis of
      myocardial infarction.
AB  - The purpose of this study was twofold. First, we evaluated the financial impact
      of a rapid, monoclonal antibody-based CK-MB mass assay (Stratus, Dade Division,
      Baxter Laboratories, Miami, Fla) for the direct measurement of CK-MB in serum
      samples from 65 patients admitted to the coronary care unit with the possible
      diagnosis of acute myocardial infarction. Second, we evaluated retrospectively
      the Stratus assay and an activity assay (electrophoresis) for CK-MB in the
      following patient categories: acute myocardial infarction treated with and
      without thrombolytic therapy, angina, congestive heart failure, skeletal muscle
      trauma, and the acutely ill without acute myocardial infarction. The advantageous
      features of the Stratus mass assay were as follows. First, the laboratory was
      able to perform the assay more frequently because of the short assay time per
      specimen (less than 10 minutes) without additional personnel. This had a
      substantial impact on the clinician's ability to diagnose acute myocardial
      infarction and to move patients out of an intensive care unit at substantial
      financial savings to the patient, the hospital, or the third-party payer. Second,
      the Stratus assay was able to detect low levels of CK-MB (1 to 2 micrograms/L) in
      the presence of low total creatine kinase activity (less than 100 U/L). Third,
      the Stratus assay showed no interference due to very-high-total creatine kinase
      activities (greater than 100,000 U/L), CK-BB, macro-creatine kinase, and
      mitochondrial creatine kinase.

PMID- 2222142
TI  - The technicon H6000 analyzer discriminates chronic lymphocytic leukemia from
      other B-cell leukemias through automatic assessment of large unstained cells.
AB  - The separation of chronic lymphocytic leukemia of B-cell origin from other
      chronic B-cell leukemias is subjective, being largely based on the morphologic
      features of the lymphoid cells in the peripheral blood. The percentage of large
      unstained cells determined with a Technicon H6000 analyzer (an automated blood
      cell differential analyzer, Technicon Instruments Corp, Tarrytown, NY) was used
      as a cell volume variable in an investigation of 70 cases of chronic lymphocytic
      leukemia of B-cell origin and of other chronic B-cell leukemias. The significant
      degree of correlation between the percentage of large unstained cells and
      morphoimmunophenotypic diagnosis, although obtained for a relatively small number
      of cases, suggests that this method of cell volume analysis can be used to
      improve diagnostic reproducibility in chronic B-cell leukemia.

PMID- 2222143
TI  - An immunofluorescence study of cerebral malaria. A correlation with
      histopathology.
AB  - Histopathologic and immunopathologic features of cerebral malaria have been
      defined in a study of six autopsy cases with severe Plasmodium falciparum
      infection. In five cases, immunofluorescent studies demonstrated intense
      deposition of P falciparum antigen, IgG, and fibrin in cerebral vessels
      associated with the histopathologic finding of hemorrhage in the white matter of
      cerebrum and cerebellum regardless of the presence of parasitized erythrocytes in
      the cerebral vessels. Immunofluorescent study also demonstrated the extravascular
      deposits of P falciparum granular antigen associated with acute inflammatory
      lesion in cerebral tissue in one case. These findings suggested that the
      immunopathogenic mechanism may in some way play a role in the pathogenesis of
      cerebral malaria.

PMID- 2222144
TI  - A prospective necropsy study of arthritis in acquired immunodeficiency syndrome.
AB  - Thirty-two knee and 23 sternoclavicular joints from 35 subjects with acquired
      immunodeficiency syndrome were examined prospectively at necropsy. There were two
      instances of opportunistic infectious arthritis: one caused by Staphylococcus
      aureus, the other by Sporothrix schenckii. In five other subjects, para-articular
      bone was infiltrated by granulomatous or neoplastic sequelae of the human
      immunodeficiency virus infection. There was no immunohistochemical (p24 antigen)
      or other evidence for existence of a specific acquired immunodeficiency syndrome
      arthritis.

PMID- 2222145
TI  - Study of preneoplastic changes of liver cells by immunohistochemical and
      molecular hybridization techniques.
AB  - The status of hepatitis B virus DNA was investigated by in situ hybridization in
      multifocal areas of a noncancerous hepatitis B virus-associated cirrhosis. This
      liver exhibited a marked degree of dysplasia and adenomatous hyperplasia. The
      results of these studies were correlated with the histopathology and
      immunohistochemical stains for hepatitis B core and surface antigens. There was
      clear evidence of a marked reduction to absence of hepatitis B viral DNA by in
      situ hybridization and absence of HBc and HBsAg in the foci of liver cell
      dysplasia and adenomatous hyperplasia. These results support the hypothesis that
      liver cell dysplasia and adenomatous hyperplasia are preneoplastic in nature.

PMID- 2222146
TI  - Persistence of mucosal gastric carcinomas for 8 and 6 years in two patients.
AB  - A small gastric carcinoma was detected in a man, but he refused surgery. Eight
      years later, he was readmitted for a check-up, and a partial gastrectomy was
      performed. Pathologic examination revealed a well-differentiated adenocarcinoma
      restricted within the mucosa. In another man, an irregularly shaped, grossly
      depressed lesion indicating a malignancy was present at the gastric angle, and 6
      years later he agreed to a partial gastrectomy. The lesion proved to be a well
      differentiated adenocarcinoma confined to the mucosa. Retrospective examination
      of the original biopsy specimen revealed a small area of adenocarcinoma,
      presumably overlooked at the initial examination. Thus, some gastric carcinomas
      of the well-differentiated type can grow at an extremely slow rate, without
      extensive spread or invasion. Findings in these cases contribute to knowledge of
      the biological behavior of gastric carcinomas.

PMID- 2222147
TI  - Solid and cystic ultimobranchial body remnants in the thyroid.
AB  - In this study we determined the incidence rate (89%) and characterized the
      morphology of ultimobranchial body (UBB) remnants found in 18 serially sectioned
      neonatal thyroid glands. Although UBB remnants are often referred to as solid
      cell nests, we found cystic features in 55%. Ciliated columnar cells were seen in
      23%. One contained a large pseudo-papilla. The UBB cells had nuclei with features
      reminiscent of papillary carcinoma nuclei in that they were enlarged, oval, and
      contained finely dispersed chromatin when compared with follicular cell nuclei.
      Both papillary carcinomas and UBB remnants are common, occur as tiny, solid, or
      cystic thyroid entities in patients of all ages, may contain papillary
      structures, and share some common nuclear features. Therefore, it is important to
      include UBB remnants in the differential diagnosis of minute thyroid entities and
      to recognize their morphologic features.

PMID- 2222148
TI  - Tumor of the atrioventricular nodal region. A clinical and immunohistochemical
      study.
AB  - Autopsy specimens of 17 tumors of the atrioventricular nodal region were studied.
      Sudden death occurred in 14 children and adults; seven of these patients had a
      history of atrioventricular block or syncope. Three tumors were incidental
      findings in infants with other congenital anomalies; diaphragmatic agenesis,
      pulmonary hypoplasia, and Meckel's diverticulum in one patient; mitral atresia in
      one; and congenital hydrocephalus, ventricular septal defect, patent ductus
      arteriosus, coarctation of the aorta, and patent omphalovitelline duct in the
      third. Immunohistochemical stains demonstrated strong positivity for
      carcinoembryonic antigen in 13 of 13 cases, B72.3 antigen in 5 of 7 cases, and
      cytokeratin in 11 of 11 cases. Twenty control cases of mesothelioma and
      mesothelial hyperplasia were all negative for B72.3; one showed focal
      carcinoembryonic antigen staining. Ultrastructural analysis of one case
      demonstrated short rudimentary microvilli not characteristic of mesothelial
      cells. We conclude that so-called mesotheliomas of the atrioventricular nodal
      region are not of mesothelial origin, because of strong carcinoembryonic antigen
      positivity and occasional positivity with B72.3, as these antibodies react with
      glycoproteins found in endodermally derived tissue and generally not with
      mesothelial tissue. Conduction system tumors are most likely congenital rests of
      endodermal origin, can be associated with other congenital anomalies, and often
      cause symptoms of heart block and sudden death.

PMID- 2222149
TI  - Acalculus lymphoeosinophilic cholecystitis associated with interleukin-2 and
      lymphokine-activated killer cell therapy.
AB  - A case of unusual cholecystitis that developed on completion of interleukin-2 and
      lymphokine-activated killer cell therapy is described. A 62-year-old man was
      treated with interleukin-2 and lymphokine-activated killer cells for disseminated
      renal cell carcinoma. During the course of the immunotherapy, his serum alkaline
      phosphatase level increased, as did the peripheral eosinophil count (0.31).
      Subsequently, clinical and radiologic evidence of acute cholecystitis was noted.
      The removed gallbladder showed acalculus cholecystitis with extensive diffuse
      infiltrates of numerous eosinophils and T lymphocytes, but sparse
      polymorphonuclear leukocytes. The authors name this unusual cholecystitis
      acalculus lymphoeosinophilic cholecystitis and believe it to be associated with
      interleukin-2 and lymphokine-activated killer cell therapy. The pathogenic
      relationship is discussed.

PMID- 2222150
TI  - Pulmonary blastoma with malignant melanoma component.
AB  - Pulmonary blastomas are rare primary tumors that consist of tubular or glandular
      structures embedded in an undifferentiated mesenchymal stroma. Focal cartilage,
      bone, and skeletal muscle as well as squamous differentiation have been described
      in these tumors. We report a unique case of a pulmonary blastoma showing a
      malignant melanoma component. Immunohistochemical stains for S100 protein and HMB
      45 were positive in the areas of melanocytic differentiation.

PMID- 2222152
TI  - Human genome project.

PMID- 2222151
TI  - Neonatal intracranial choriocarcinoma.
AB  - A 1-month-old infant died from extensive intracerebral hemorrhage due to a
      metastatic choriocarcinoma to the brain that presumably originated in the
      placenta. The clinical course was characterized by hyperbilirubinemia, repeated
      episodes of seizures, and intracranial hemorrhage. A computed tomographic scan
      revealed a large vascular mass in the left parieto-occipital region and a small
      lesion in the left frontal lobe. The placenta was expelled during the delivery
      and was not examined. In view of the high level of maternal human chorionic
      gonadotropic hormone and the autopsy finding of metastasis, we presumed that the
      mass was a metastatic choriocarcinoma that had originated in the maternal
      placenta. To our knowledge, only one previous instance of this phenomenon has
      been reported.

PMID- 2222154
TI  - Functional assessment scales: a study of persons with multiple sclerosis.
AB  - The purpose of this study was to investigate disability in persons with multiple
      sclerosis (MS) by using combinations of functional assessment scales and
      subscales to predict (1) the burden of care measured in minutes of assistance
      provided per day by another person in the home, and (2) the subject's level of
      satisfaction with life in general. The Functional Independence Measure (FIM),
      Incapacity Status Scale, Environmental Status Scale, and the Barthel Index had
      high intercorrelations with each other. Although each was predictive of the MS
      subject's physical care needs, the FIM was the most useful. A change in total FIM
      score of one point was equivalent to an average of 3.38 minutes of help from
      another person per day. With the Brief Symptom Inventory and the Environmental
      Status Scale, the FIM contributed to predicting the patient's general
      satisfaction as well. We propose that burden of care and subjective satisfaction
      with life be the standards by which functional assessment instruments are
      compared to reflect, in pragmatic terms, the impact of disability on the lives of
      individuals and on the human and economic resources of the community.

PMID- 2222153
TI  - Physiologic responses to prolonged electrically stimulated leg-cycle exercise in
      the spinal cord injured.
AB  - This study determined the physiologic responses to prolonged functional
      neuromuscular stimulation (FNS) leg-cycle exercise in seven quadriplegic and
      seven paraplegic subjects. Each subject completed 30 minutes of continuous FNS
      leg cycling during which open-circuit spirometry, impedance cardiography,
      auscultation, and fingertip capillary blood sampling were used to assess
      metabolic and hemodynamic responses. Compared with resting values, oxygen uptake,
      carbon dioxide production, respiratory exchange ratio (RER), pulmonary
      ventilation, heart rate (HR), left ventricular stroke volume (SV), cardiac output
      (Qt), and blood lactate (La) concentration were significantly (p less than .05)
      elevated, whereas plasma volume, bicarbonate concentration, and pH were
      significantly decreased in both groups during prolonged FNS leg-cycle exercise.
      Mean arterial pressure remained unchanged in quadriplegic and paraplegic subjects
      during the prolonged FNS leg-cycle exercise bout. Persons with quadriplegia
      elicited significantly lower MAP and tended to have lower SV and Qt responses
      than persons with paraplegia, probably due to a higher degree of sympathetic
      dysfunction and circulatory hypokinesis during FNS leg-cycle exercise. All other
      physiologic variables responded similarly between groups. We speculate that the
      relative increases observed for HR (33% to 60%), SV (45% to 69%), and Qt (113% to
      142%) during prolonged FNS leg-cycle exercise create a sufficient cardiac-volume
      load to promote central cardiovascular conditioning in persons with both
      quadriplegia and paraplegia. The La accumulation (4.7 to 5.2 mmol.L-1) in the
      spinal cord injured during prolonged FNS leg cycling is unusually high for the
      power output attained (5.2W and 6.1W for quadriplegia and paraplegia,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222155
TI  - Rehabilitation of chronic stroke patients: changes in functional performance.
AB  - Forty stroke patients who were at least one year post-onset completed a one-month
      intensive rehabilitation program. The month before the program served as a
      control period. During the program, patients received individual sessions in
      occupational and physical therapy four days a week, and they participated in
      group activities on the fifth day. Therapy emphasized instruction in motor
      planning, balance and weight shift, and the use of adaptive equipment; these
      motor abilities were then practiced within real life situations. The patients
      demonstrated significant improvement in the outcome measures of weight shift,
      balance, and ADL scores after the one-month rehabilitation program (weight shift:
      F = 16.1, p = .0001; balance: F = 6.26, p = .0007; ADL: F = 13.8, p = .0001).
      They retained these new skills during a three-month follow-up period.

PMID- 2222156
TI  - Predicting inpatient rehabilitation length of stay.
AB  - Using standardized forms and predefined criteria, information was collected on
      all 1,238 patients admitted to the inpatient rehabilitation facility at our
      university hospital between August 1, 1980 and December 30, 1986. Data from 96%
      of these patients were used retrospectively to create a mathematic model, based
      on multiple linear regression, that predicts the patient's total rehabilitation
      length of stay (LOS). The model requires only information about the patient's
      admitting diagnosis, referral source, admission functional status, and date of
      admission. The model compared favorably with prospective estimates of LOS made
      independently by attending physicians at admission to rehabilitation. We conclude
      that such models could be used to facilitate management of rehabilitation units,
      forecast patient census, schedule unit personnel, set interim goals for LOS, and
      facilitate discharge planning. The delivery of rehabilitation services, like the
      delivery of other medical services, can be defined in part by objective,
      measurable patient characteristics.

PMID- 2222157
TI  - Manual stretch: effect on finger movement control and force control in stroke
      subjects with spastic extrinsic finger flexor muscles.
AB  - This study evaluated the effects of manual stretch of extrinsic finger flexor
      muscles on finger extension movement control and force control in 16 spastic
      hemiparetic subjects. These subjects were randomly divided into a control group
      and an experimental group. A group of able-bodied subjects also participated. A
      joint-movement tracking test (JMTT) quantified control of active finger extension
      movement at the metacarpophalangeal joint of the index finger within the
      available range of active movement, and a force tracking test (FTT) quantified
      control of isometric finger extension force at the same joint within the
      subject's available force range. Electromyographic activity was monitored in the
      extensor digitorum and flexor digitorum superficialis muscles during both
      tracking tests. Manual stretch was applied to the extrinsic finger flexor muscles
      of the experimental group between the pretest and posttest tracking tests. The
      JMTT performances of both control (p less than .025) and experimental (p less
      than .05) groups were significantly subnormal on the pretest as were FTT
      performances of controls (p less than .01) and study subjects (p less than .03).
      The JMTT improvement on posttest was significantly greater (p less than .05) in
      subjects than in controls. However, the change in FTT performance was not
      significantly different between the two groups. Manual stretch treatment,
      properly applied to extrinsic finger flexor muscles, is an effective method of
      temporarily improving the control of finger extension movement in spastic
      hemiparetic subjects.

PMID- 2222158
TI  - Long-term function of persons with atherosclerotic bilateral below-knee
      amputation living in the inner city.
AB  - Long-term function of 24 elderly persons with atherosclerotic bilateral below
      knee amputation living in an inner city for at least six months after the second
      amputation, was determined. Twenty-one (87.6%) subjects were living at home;
      three were living in nursing homes. Fourteen (70%) of 20 subjects who received
      bilateral prostheses were ambulators. At interview, the mean age was 75.2 years;
      4.87 years was the mean time since the second amputation. Ten (50%) subjects
      remained ambulatory. Among the other ten who received prosthesis, loss of
      ambulation occurred mostly due to medical factors, at an average of 3.47 years
      after the second amputation. Those no longer ambulatory were older and "sicker,"
      and the interval between amputations was shorter. Fifteen (62.5%) subjects were
      independent in dressing, 14 (58.4%) in toileting, and only nine (33.3%) in
      bathing. All but one subject required housekeeping assistance. The anticipated
      effect on function of environmental and socioeconomic factors could not be
      demonstrated in this sample. Survival time and retention of ambulatory skills for
      an average of nine years after the second amputation in eight (33.3%) subjects
      who died before the end of the study was longer than previously described. The
      high rate of success in rehabilitation and in maintenance of ambulatory skills
      fully justifies intensive restorative efforts for this group of amputees.

PMID- 2222159
TI  - A technique for quantifying and determining the site of isometric muscle fatigue
      in the clinical setting.
AB  - We investigated a clinically applicable technique for quantifying and determining
      the site of fatigue during isometric contraction. We measured torque in the right
      knee extensors of 17 able-bodied subjects during an isometric contraction for
      60sec at 100%, 75%, 50%, and 25% of maximal effort. During contractions, a 0.5
      sec train of 50-Hz stimulation was applied at 15, 30, and 45sec. We measured the
      percent decline in force over 60 sec (fatigue index) and average augmentation in
      torque during stimulation (AVAUGTORQ). The mean fatigue index at full effort was
      25.1%. The mean AVAUGTORQ at 100%, 75%, 50%, and 25% of maximal effort was 12.1%,
      26.3%, 40.5%, and 69.7% of values at complete relaxation, respectively. These
      methods should be clinically useful for quantifying the level of isometric
      fatigue, determining the site of fatigue, and measuring the level of effort in
      subjects without neuromuscular disease. The results agree with previous studies
      reporting a peripheral site of fatigue in healthy, well-motivated subjects.

PMID- 2222160
TI  - Kinematics of high-heeled gait with consideration for age and experience of
      wearers.
AB  - The purpose of this study was to determine whether the biomechanical
      accommodations to high-heeled shoes varied with age and experience in wearing
      high-heeled shoes. A t-test analysis was undertaken of the differences between
      low- and high-heeled gait in angles of rotation of the knee, hip, pelvis, upper
      trunk, and trunk. Biomechanical accommodations in gait caused by high-heeled
      shoes varied between younger and older individuals and between experienced and
      inexperienced wearers of high-heeled shoes. Younger subjects tended to increase
      lordosis of the trunk at heelstrike during high-heeled gait (1.7 degrees, SD =
      0.8 degrees), whereas older subjects tended to flatten the trunk (-3.7 degrees,
      SD = 4.7 degrees, p less than .05). Experienced wearers had much greater
      increases in knee flexion during stance phase of high-heeled gait (5.3 degrees,
      SD = 3.3 degrees) than inexperienced wearers (1.9 degrees, SD = 1.9 degrees, p
      less than .05). Exaggerated upper trunk rotations were found in older and
      inexperienced subject groups rather than younger, and experienced groups (p less
      than .05).

PMID- 2222161
TI  - Strapless oral-nasal interface for positive-pressure ventilation.
AB  - A custom-fabricated strapless oral-nasal interface (SONI) is described. It was
      used in the long-term administration of intermittent positive-pressure
      ventilation (IPPV) by 18 patients with paralytic or restrictive pulmonary
      insufficiency. This interface is an acrylic shell which is firmly fixed to an
      orthodontic bite plate; it is designed to form a seal over the nose and mouth for
      the entry of IPPV. Eight patients were ventilator dependent 24 hours a day. The
      ten patients who required only nocturnal aid had improvement in daytime arterial
      blood gases. Although nine of these patients could manage less than 15 minutes of
      unassisted breathing (free time) supine, all slept supine on SONI IPPV. The 13
      patients who underwent sleep monitoring maintained a mean oxygen saturation of
      95.3% +/- 1.7% and acceptable end-tidal pCO2 (30 to 45 mmHg). These 13 patients
      have used SONI IPPV for an average of 22 months (range = 3 to 63 months).
      Impediments to successful long-term use of a SONI include the presence of a
      hyperactive gag reflex or stimulation of excessive oral secretions. When combined
      with mouth IPPV, glossopharyngeal breathing, the intermittent abdominal pressure
      ventilator, or the cuirass ventilator for daytime use, SONI IPPV is an option for
      the patient who prefers total ventilatory support by noninvasive means.

PMID- 2222162
TI  - Stroke rehabilitation: a geropsychological perspective.
AB  - Rehabilitation medicine and geriatric medicine are similar in their concern for
      functional improvement in the face of chronic medical conditions. Although many
      patients served by rehabilitation medicine fall within the geriatric age range, a
      knowledge of normal aging does not necessarily inform clinical decision making or
      research practices in rehabilitation. Using stroke as an example of a disorder
      affecting primarily geriatric patients and requiring the technology of
      rehabilitation, ways in which age might affect assessment of outcome are
      examined. Three areas dealing with conceptual and methodologic issues-
      depression, neurochemical interventions, and family--are highlighted. The final
      section outlines recommendations for research on rehabilitation outcome of
      geriatric stroke patients.

PMID- 2222163
TI  - Childhood stroke after minor neck trauma: case report.
AB  - Cerebral infarction after minor trauma to the neck has rarely been reported. A
      case is presented of a child with trauma to the vertebrobasilar artery resulting
      in stroke. Computerized tomography scan and angiography results are presented.
      Despite two subsequent, separate transient episodes of vertigo, the child had
      good functional recovery with complete restoration of language and cognitive
      function. After 28 months, residual impairments identified were a mild right
      sided ataxia and hemiparesis.

PMID- 2222164
TI  - Accreditation. Procedures and staff support for the Surgery Residency Review
      Committee.
AB  - The purpose of this article is to give an overview of the accreditation
      procedures of the Residency Review Committee for Surgery and provide insight into
      the nature and functions of staff support for the committee. In the process, a
      better understanding of how the Residency Review Committee itself carries out its
      tasks should also emerge. What is described here is specific to the Residency
      Review Committee for Surgery and should not be generalized to other residency
      review committees.

PMID- 2222165
TI  - Forty years of the RRC in Surgery.

PMID- 2222166
TI  - Humanism and the profession of surgery in the era of medical perestroika.

PMID- 2222167
TI  - Is arterial proximity a valid indication for arteriography in penetrating
      extremity trauma? A prospective analysis.
AB  - Three hundred seventy-three patients with a penetrating extremity injury were
      studied to assess the yield of arteriography. Patients underwent arteriography if
      any of the following was present: bruit, history of hemorrhage or hypotension,
      fracture, hematoma, decreased capillary refill, major soft-tissue injury, or
      nerve or pulse deficit. In the absence of these findings, arteriography was
      performed if the injury was in "proximity" to a major neurovascular bundle. In
      216 patients, arteriography was performed when an abnormal finding was noted.
      Sixty-five injuries were identified, 19 requiring intervention. Proximity was the
      indication for arteriography in 157 patients. Seventeen injuries were identified,
      of which one required repair. In penetrating extremity trauma, the need for
      arteriography is based on clinical findings. The use of arteriography to screen
      for an arterial injury when proximity alone is the indication rarely identifies a
      significant injury and should be abandoned.

PMID- 2222168
TI  - Comprehensive management of acute necrotizing pancreatitis and pancreatic
      abscess.
AB  - Achieving reduced mortality rates in patients with necrotizing pancreatitis and
      pancreatic abscess is possible by employing a comprehensive management plan.
      Components of the plan include (1) rapid evaluation and assessment of the degree
      of physiologic and anatomic derangement, the latter by the prompt use of vascular
      enhanced computed tomographic scan; (2) adequate fluid resuscitation determined
      by early institution of advanced hemodynamic monitoring; (3) attempts to identify
      and document septic foci via computed tomography-guided percutaneous aspiration;
      and (4) aggressive surgical debridement. Close adherence to these policies
      allowed us to keep mortality in this seriously ill group of patients to 14%. Most
      deaths occurred in patients who were referred to this service late in the course
      of their disease. The Acute Physiology and Chronic Health Enquiry (APACHE) II
      severity of illness index applied at the time of admission proved an accurate
      predictor of mortality. A score of 25 or greater was highly predictive of death,
      and a lesser score, of survival.

PMID- 2222169
TI  - Immediate breast reconstruction following mastectomy is as safe as mastectomy
      alone.
AB  - We evaluated wound complications and potential risk factors after mastectomy with
      immediate breast reconstruction and compared them with similar data after
      modified radical mastectomy. The incidences of infection, seroma, hematoma, and
      epidermolysis were compared among 395 patients (305 with modified radical
      mastectomies and 90 with mastectomy with immediate breast reconstruction) from
      Virginia Mason Medical Center, Seattle, Wash, between 1983 and 1989. Obesity, age
      (60 years or older), smoking, antibiotics, and wound drainage were examined as
      possible risk factors. There were more wound complications in the modified
      radical mastectomy group (48% vs 31%), and specifically, more seromas (30% vs
      13%). In the modified radical mastectomy group, age of 60 years or older was
      associated with seroma and infection, drainage greater than 30 mL per day (at
      time of drain removal) with seroma, and smoking with epidermolysis. In the
      mastectomy with immediate breast reconstruction group, obesity was associated
      with seroma and epidermolysis. We conclude that mastectomy with immediate breast
      reconstruction appears to be as safe as modified radical mastectomy alone with
      respect to wound complications.

PMID- 2222170
TI  - Blunt intestinal injury. Keys to diagnosis and management.
AB  - Fifty-six patients with blunt intestinal injury seen during 39 months were
      reviewed for keys to diagnosis and treatment. Motor vehicle accidents were
      involved in 80% of the cases and seat/lap belts were in use 69% of the time.
      Blunt intestinal injury was the only abdominal injury in 70% of the cases. There
      were 42 perforations and 20 devascularizations; multiple injuries were common
      (27%). Abdominal tenderness was present on admission in 43 of 44 patients in whom
      a reliable examination was possible. Peritoneal lavage was positive in 13 (93%)
      of 14 patients. Computed tomography was falsely negative in three of four
      instances in which it was used. Perforations were most common in the upper and
      lower ends of the small bowel and in the sigmoid colon; devascularizations were
      most common in the distal ileum and sigmoid colon. Resection/anastomosis was
      performed in 38% of small-bowel perforations and in all small-bowel
      devascularizations. Resection/diversion was required in most colonic perforations
      (five of six patients) and devascularizations (four of six patients). There were
      five deaths (9%), none due to intestinal injury. There were seven complications
      related to intestinal injury. Diagnostic delay occurred in two patients; both had
      resultant morbidity. Blunt intestinal injury is associated with physical findings
      in conscious patients. Peritoneal lavage should be used when tenderness cannot be
      evaluated. Timely operative intervention minimizes morbidity and hospital stay.

PMID- 2222171
TI  - The operative management of coexisting thyroid and parathyroid disease.
AB  - Three hundred eight patients who underwent operation for hyperparathyroidism were
      studied. Fifty-two (17%) were identified who had a concomitant thyroid nodule.
      All 52 underwent parathyroidectomy and thyroid resection in a single operation.
      Eleven of these patients (21% of those with a thyroid nodule) had differentiated
      thyroid cancer. One patient with parathyroid hyperplasia developed permanent
      hypocalcemia. None had permanent vocal cord paralysis and none required
      tracheostomy. Thorough visual inspection and palpation of the entire thyroid
      gland should be performed during operations for hyperparathyroidism. Incidentally
      discovered thyroid nodules should prompt formal lobectomy with frozen section
      diagnosis; unanticipated thyroid malignancies should then be treated as
      independent entities. Treating simultaneous hyperparathyroidism and nodular
      thyroid disease with a single operation can be done safely; it avoids the expense
      and risk associated with neck reexploration and can detect unsuspected cancers.

PMID- 2222172
TI  - The efficacy of central venous and pulmonary artery catheters and therapy based
      upon them in reducing mortality and morbidity.
AB  - The purpose of this study was to (1) evaluate the relative cost effectiveness of
      the central venous pressure and flow-directed pulmonary artery catheters used to
      maintain normal hemodynamic values as therapeutic goals in the control groups vs
      supranormal values empirically observed in critically ill postoperative survivors
      in the protocol groups, and (2) to evaluate tissue perfusion and oxygenation in
      relationship to organ failure and mortality. In two prospective clinical trials
      there were no significant differences in outcome between the central venous
      pressure and pulmonary artery control groups that used normal values as
      therapeutic goals. However, there were marked and significant reductions in
      morbidity and mortality of the protocol groups using the supranormal cardiac
      index, oxygen delivery, and oxygen consumption values as goals. The cumulative
      oxygen debt was less and organ failures were fewer and less severe in the
      protocol groups than in the control groups.

PMID- 2222173
TI  - Popliteal vascular trauma. A community experience.
AB  - Preventing amputation continues to be a significant challenge when popliteal
      vascular injuries occur. A retrospective review of cases from the San Diego
      County (California) Trauma System identified 108 patients with 76 blunt and 32
      penetrating arterial injuries. The limb preservation rate was 88%; there were 13
      amputations. The fracture-dislocated knee injury and close-range shotgun blasts
      were particularly limb threatening. In general, the trauma system achieved rapid
      evaluation of injuries and early operative intervention. All 13 patients who
      underwent amputations presented with signs of severe ischemia. Concomitant
      injuries to the popliteal vein, tibial nerves, and soft tissue were significantly
      more frequent in patients who underwent amputations. The importance of complete
      fasciotomy for compartment hypertension, early reconstructive management of soft
      tissue injuries, and expeditious arterial repair, frequently without preoperative
      roentgenographic suite arteriography, is emphasized. An aggressive,
      multidisciplinary approach is required to achieve a functional extremity when
      popliteal vascular trauma occurs.

PMID- 2222174
TI  - Utility of computed tomography for surveillance of small abdominal aortic
      aneurysms. Preliminary report.
AB  - To assess the ability of computed tomography to predict the potential for
      expansion of small abdominal aortic aneurysms, we analyzed the computed
      tomographic scans of 30 patients who had two or more abdominal computed
      tomographic scans at least 6 months apart between 1979 and 1989. Clinical
      variables and 10 defined objective characteristics of computed tomography were
      evaluated. Twenty-five men and five women with abdominal aortic aneurysms ranging
      from 30 to 64 mm (mean, 45 mm) were followed up with serial computed tomographic
      scans for a mean (+/- SE) of 26 +/- 3 months. In 19 patients, enlargement of
      aneurysm diameter of 3 mm or more on serial computed tomographic scans was noted,
      whereas in 11, there was little or no expansion. Of the clinical variables
      studied, only serum cholesterol correlated with an increased risk of expansion.
      Thrombus area, measured by computed tomography, was 7.3 +/- 0.9 cm2 in enlarging
      aneurysms vs 4.3 +/- 0.9 cm2 in stable aneurysms. Based on these preliminary
      data, we conclude that computed tomography may provide valuable information about
      the likelihood of future expansion of small abdominal aortic aneurysms.

PMID- 2222175
TI  - Treatment of traumatic rupture of the thoracic aorta. A 15-year experience.
AB  - Traumatic rupture of the thoracic aorta is increasing in incidence and remains a
      highly lethal injury. The morbidity associated with this injury also remains
      high. We retrospectively reviewed the records of all patients admitted to our
      emergency department with ruptured thoracic aortas during a 15-year period to
      determine the reason for this persistently high morbidity and mortality and to
      identify any factors that might improve the outcome. We found that patients who
      are in unstable condition on arrival in the emergency department or who become
      unstable before reaching the operating room are not likely to survive. Patients
      who are injured in automobile accidents have a greater chance of survival than do
      those injured in motorcycle accidents or car-pedestrian accidents. Patients who
      are in hemodynamically stable condition after aortic injury survive only if
      diagnosis and treatment are prompt. Major complications of repair following
      thoracic aortic injury relate primarily to the length of cross-clamp time, and
      every effort should be devoted to keeping the cross-clamp time less than 30
      minutes.

PMID- 2222176
TI  - Angioscopy for intraoperative management of thromboembolectomy.
AB  - Our experience with angioscopy suggests that direct visualization of the arterial
      lumen during thromboembolectomy procedures would provide a more reliable method
      of assessing luminal morphologic characteristics than angiography alone. We
      inspected 32 grafts (seven aortobifemoral, 18 infrainguinal bypass, and seven
      dialysis access fistula grafts) in 32 patients. Thirty-one patients had
      thrombotic events and one patient had an acute embolus. Angioscopy following
      standard catheter thrombectomy revealed significant amounts of retained thrombus
      or neointima in all thrombectomies. Angioscopic information from 18 patients with
      an infrainguinal bypass graft led to graft revision in six cases and placement of
      a new graft in 10 cases. One graft limb was replaced in seven aortobifemoral
      grafts, and multiple repeated thrombectomies were employed to extract debris in
      the remaining six cases. Repeated graft thrombectomy was also beneficial in
      dialysis access fistulas. Angioscopy allowed us to omit the completion angiogram
      and led to an improved technical result. We conclude that angioscopy is useful
      during thromboembolectomy procedures.

PMID- 2222177
TI  - Massive splenomegaly. Superior results with a combined endovascular and operative
      approach.
AB  - Splenectomy for massive splenomegaly (drained splenic weight, greater than 1000
      g) has an uncommonly high morbidity and mortality because of technical challenges
      and problems of hemostasis. In a group of 10 patients with massive splenomegaly
      due to myeloproliferative disorders (average splenic weight, 4193 g), we
      developed a management algorithm based on preoperative angiographic embolization
      of the splenic artery. Average operating time was 1.7 hours (range, 1 to 2.5
      hours). Average blood loss was 528 mL; six of the 10 patients had blood loss less
      than 250 mL. There were four minor complications and one major complication
      (gastric ulcer requiring reoperation). There were no deaths in the perioperative
      period, and no patients required reoperation for hemorrhage.

PMID- 2222178
TI  - The recalcitrant perineal wound after rectal extirpation. Applications of muscle
      flap closure.
AB  - Perineal wounds developing after abdominoperineal resection result in chronic
      purulent drainage and intermittent episodes of sepsis and are generally
      unresponsive to conservative medical and surgical treatment. Thirteen consecutive
      patients (aged 27 to 74 years; mean, 48 years) who underwent debridement and
      immediate muscle flap closure of these wounds were analyzed to identify risk
      factors for delayed healing and to evaluate the effectiveness of muscle flap
      coverage. Three risk factors were identified: preoperative or postoperative
      radiation therapy, resection for recurrent carcinoma, and inflammatory bowel
      disease. A total of 19 muscle flaps (11 gracilis, five gluteal thigh, two gluteus
      maximus, and one rectus abdominis) were used to close these wounds. During an
      average 3.5-year follow-up, four (31%) minor complications and one (8%)
      recurrence were noted to occur. Muscle flaps provide safe, effective, single
      stage procedures for the closure of chronic perineal wounds.

PMID- 2222179
TI  - Selection factors resulting in improved survival after surgical resection of
      tumors metastatic to the lungs.
AB  - From 1973 through 1987, a total of 140 patients underwent 184 operations for
      removal of metastatic tumors to the lungs. The number of lesions removed ranged
      form one to 30. Of the patients, 44% had solitary lesions. Overall 3-year
      survival was 62.6%, and 5-year survival was 48.2%. In all primary tumors except
      melanoma and breast cancer, 3-year survival was greater than 50% and 5-year
      survival was greater than 40%. With rare exceptions, the operation of choice for
      unilateral lesions was ipsilateral thoracotomy, and for bilateral lesions it was
      median sternotomy. Adequate conservative resection was the rule. There were three
      pneumonectomies, 25 lobectomies, 71 single wedge resections, 38 multiple
      unilateral wedge resections, and 47 bilateral wedge resections. There were no
      postoperative hospital deaths. Cox covariate analysis demonstrated improved
      survival in patients whose largest lesion was less than 1.5 cm in diameter and
      with disease-free interval longer than 1 year, but survival was not related to
      number of lesions or age of patient. An aggressive surgical approach is justified
      in patients with most primary tumors and a limited number of lung metastases less
      than 1.5 cm in diameter. Resection of metastases from melanoma and breast cancer
      should be accomplished after other sites of metastatic disease have been ruled
      out by the most stringent criteria.

PMID- 2222180
TI  - Heterotopic tissue in lymph nodes. An unrecognized problem.
AB  - Heterotopic tissue in lymph nodes is both unknown to clinicians and a potential
      source of confusion with metastatic disease. We reviewed the English literature
      and found 289 cases of heterotopic tissue in lymph nodes. The majority (84%) of
      these patients were operated on for malignant neoplasms. The most frequent sites
      of occurrence was the pelvis (67%), followed by the axilla (14%), neck (14%),
      groin (3%), abdomen (2%), and mediastinum (less than 1%). The tissue seen is site
      specific and frequently resembles a neighboring organ. Three cases have been
      reported in which heterotopic tissue was mistaken for metastatic disease. These
      cases illustrate the importance of being familiar with heterotopic tissue in
      lymph nodes and identifying it when it does occur, to avoid inappropriate
      therapy.

PMID- 2222181
TI  - Reoperative surgery for the morbidly obese. A university experience.
AB  - Patients who undergo surgery for morbid obesity are often subjected to
      reoperation for a wide array of indications. To evaluate outcome following
      revisional procedures, we reviewed the records of 32 such patients treated at
      UCLA between April 1986 and May 1989. Twenty-five women (78%) and 7 men (22%)
      with a mean age of 44 years underwent 76 reoperations (2.4 per patient) for
      complications of prior obesity surgery. Indications for initial surgical revision
      consisted primarily of metabolic derangements (12 patients) and weight-related
      problems (11 patients). In contrast, indications for the patients' final surgical
      procedure were commonly for bowel obstruction (41%), intra-abdominal sepsis
      (12%), and gastrointestinal bleeding (6%). Following initial revision, 23
      patients (71.8%) required further surgery for major complications and four
      patients died (12.5%). While initial revisions are frequently indicated for
      metabolic problems, final reoperations are more frequently undertaken for urgent,
      life-threatening complications. Revisional procedures for morbid obesity should
      be carefully considered, and the potential for major complications and/or death
      should be weighted heavily against proposed benefits.

PMID- 2222182
TI  - Electron microscopy of mouse thymic virus.
AB  - Thymuses of mice infected with mouse thymic virus (MTV), a herpesvirus, were
      examined with the electron microscope. Damage was manifested by distortions of
      cells, nuclei, and other organelles, with cellular aggregation apparent at
      advanced stages of necrosis. Infected cells also contained MTV particles and
      filaments. Negative staining showed that naked MTV capsids were icosahedral in
      shape with diameters ranging from 95 to 110 nm. Enveloped capsids appeared
      spherical and ranged in diameter from 125 to 165 nm. Immunogold labeling revealed
      the presence of antigenic sites around both naked and enveloped capsids, and also
      on the 10 nm filaments. The use of electron microscopy and immunohistochemical
      techniques as diagnostic tools to demonstrate MTV infection could prove valuable
      for the detection of the infection and the study of its pathogenesis.

PMID- 2222183
TI  - Implication of mitochondria in the replication of Nodamura virus in larvae of the
      Lepidoptera, Galleria mellonella (L.) and in suckling mice.
AB  - The replication of Nodamura virus, type species of the family Nodaviridae, takes
      place principally into the interfibrillar spaces of the sarcoplasm in close
      association with mitochondria in the infected muscles of both G. mellonella and
      suckling mice. The most striking event in infection of G. mellonella muscle cells
      was the aggregation and shape modification of numerous mitochondria (elongation,
      interdigitation, and vesiculation) at an early stage of infection. These clusters
      of mitochondria were cemented by a thick electron-dense material at the periphery
      of which viral particles undergo maturation process. In a later stage,
      degenerated and dilated mitochondria showed a clear assembling of virus particles
      on their outer membrane and occasionally on some inner membranes. These facts and
      the localization of RNA by RNase-gold technique in the assembling sites of
      viruses around and inside the mitochondria allowed us to postulate a role for the
      mitochondria as supports and/or energy suppliers for viral RNA synthesis and
      translation.

PMID- 2222184
TI  - Replication of two porcine parvovirus isolates at non-permissive temperatures.
AB  - Previous studies have shown that replication in vitro of the porcine parvovirus
      (PPV) isolate, KBSH, was restricted at 39 degrees C but not at 37 degrees C. In
      contrast, replication of the Kresse isolate was restricted at 37 degrees C but
      not at 39 degrees C. In this study, Kresse and KBSH isolates were passaged up to
      ten times in swine testicle (ST) cells at non-permissive temperatures, and at
      subsequent passage viral protein synthesis, viral DNA synthesis, and progeny
      virus were evaluated. KBSH became adapted for replication at 39 degrees C upon
      serial passages, displaying an appreciable increase in viral progeny, viral
      polypeptides, and viral DNA concentration. This finding was also observed with
      Kresse virus isolate continuously passaged at 37 degrees C. Neither isolate
      became adapted for replication at 32 degrees C. In an attempt to examine the
      effect of in vitro passage at non-permissive temperatures on pathogenicity in
      swine, KBSH passaged 10 times either at 37 degrees C or 39 degrees C was
      inoculated into swine fetuses. Two of four fetuses inoculated with 39 degrees C
      passaged KBSH were dead and hemorrhagic or mummified. All four fetuses inoculated
      with 39 degrees C-KBSH contained viral antigen and viral DNA. In contrast,
      fetuses inoculated with 37 degrees C-passaged KBSH, or with cell culture fluid
      were normal in appearance. Viral antigen and viral DNA were not demonstrated in
      fetuses inoculated with 37 degrees C-KBSH or cell culture fluids. These findings
      suggest the possibility that the ability to replicate at 39 degrees C is
      associated with virulence in swine fetuses.

PMID- 2222185
TI  - Characterisation of an avian influenza virus nucleoprotein expressed in E. coli
      and in insect cells.
AB  - The nucleoprotein (NP) gene from influenza virus A/Shearwater/Australia/72 has
      been expressed intracellularly in both E. coli and insect cells. E. coli-derived
      NP was identified by Western blot analysis as a 56 kDa protein which co-migrates
      with virion-derived NP. This protein was purified by immunoaffinity
      chromatography and a nitrocellulose binding assay showed that NP formed complexes
      with positive- and negative-sense influenza neuraminidase RNA transcribed in
      vitro. ELISA and Western blot analysis revealed that recombinant NP of 56 kDa was
      produced in high yields in insect cells using a baculovirus vector.
      Immunofluorescence microscopy revealed that NP was localised to the nucleus of
      infected insect cells.

PMID- 2222186
TI  - Priming effect of recombinant vaccinia virus coding for the middle hepatitis B
      surface antigen.
AB  - Recombinant vaccinia virus expressing the middle hepatitis B virus surface
      antigen was incapable of inducing marked antibody response against the S and pre
      S2 antigenic specifities in mice. However, mice immunized with this virus
      produced antibodies to both these antigens after the following administration of
      subtreshold doses of plasmatic hepatitis B surface antigen.

PMID- 2222188
TI  - Antigenic stability of H3 influenza viruses in the domestic duck population of
      southern China.
AB  - An antigenic analysis was carried out on 145 duck influenza virus isolates of the
      H3 haemagglutinin subtype obtained over five years continuous surveillance from
      the region of southern China, a hypothetical influenza epicentre. This was done
      using a panel of twelve monoclonal antibodies raised to an early human strain of
      the H3 subtype. We demonstrate the existence of an extensive range of antigenic
      profiles, broadly similar but not identical to the human H3 strain, which
      persisted over the five year period. This variability was as great during
      discrete twelve month periods as over the whole five years. Hierarchic
      progression (observed with human strains) was not evident and no correlation of
      antigenic drift, in either positive or negative direction, was observed with the
      domestic duck isolates over time. Changing dominant antigenic profiles were,
      however, observed in faecal isolates with time within a single farm. The much
      broader range of profiles detected in pond water samples from the same farm
      suggested the existence of a heterogeneous antigenic reservoir. Local switching
      of dominant profiles may occur due to changes of cohorts as birds are taken to
      market. In vitro and in vivo passage experiments revealed a high degree of
      heterogeneity in antigenic profiles in progeny of uncloned isolates, whereas the
      profiles of cloned isolates were largely conserved. These results suggested that
      particular antigenic profiles in primary isolates may result from mixtures of
      subpopulations of the wild type virus in natural duck infections. Switching
      between reactivity profiles of different progeny is likely to be largely a result
      of regrouping of these subpopulations with lesser effects due to mutation.
      Hypervariability in some of the cloned isolates was observed with a few
      monoclonal antibodies recognising a region of HA reported to be hypervariable in
      swine influenza virus. Reactivity with one particular antibody was correlated
      with passage in chicken eggs. The ability of this enormously varied pool of duck
      influenza H3 strains to cross the species barrier to man and give rise to viruses
      with hierarchic capabilities was considered.

PMID- 2222187
TI  - Immunogenic properties of ISCOM prepared with influenza virus nucleoprotein.
AB  - After covalent attachment of bacterial lipopolysaccharide to the nucleoprotein of
      influenza A virus, this water-soluble antigen could be incorporated firmly into
      ISCOM. This potent "immunostimulating complex" induced the production of high
      antibody titers in mice and could partially protect the animals from a lethal
      challenge infection. After immunization with ISCOM preparations NP-specific
      cytotoxic T cell activity could not be demonstrated.

PMID- 2222189
TI  - HTLV-I antibody studies in villagers in East Sepik Province, Papua New Guinea.
AB  - Serum samples collected in 1984 during a malariometric survey of two villages in
      the East Sepik Province of Papua New Guinea were tested for antibodies to HTLV-I.
      None of the villagers showed any symptoms suggestive of retrovirus infection.
      Eighteen of the 186 (9.5%) sera tested at that time were found to be positive.
      Blood samples were subsequently obtained from fifteen of the eighteen positives
      and subjected to analysis by enzyme-linked immunosorbent assay (ELISA),
      radioimmuno assay (RIA), radioimmunoprecipitation assay (RIPA), and Western blot
      (WB). Fourteen of the fifteen gave a positive ELISA response, but none were
      unequivocally positive by p 24 RIA. All sera tested were reactive to gag antigens
      by WB, but gave "indeterminate" results currently accepted criteria. Notably
      absent from the WB profiles of all of the study subjects was an antibody response
      to HTLV-I envelope protein gp 46. It is possible that these antibody responses
      are directed against a variant of HTLV-I or to a novel retrovirus which possesses
      core antigens similar to those of HTLV-I but has different envelope antigens.
      Until a virus is isolated, or the viral genome is identified in infected
      lymphocytes, the possibility remains that the response may be due to factors
      unrelated to retrovirus infection.

PMID- 2222192
TI  - Anti IgE-induced asthma in guinea pigs; a new model for asthma. Physiological and
      pathological studies.
AB  - We established an experimental animal model for IgE-mediated asthma by the use of
      intravenous injection of rabbit anti guinea pig IgE in normal guinea pigs. The
      degree of asthmatic airway obstruction was quantitatively estimated by Mead's
      apparatus which enabled us to use unanesthetized guinea pigs. With the injection
      of anti IgE, only an early asthmatic response was observed. Inhalation of anti
      IgE did not trigger asthma. Histo-pathological changes in the lung obtained
      immediately after the injection of anti IgE resembled those reported in human
      asthma. This system may be used for pathological and pharmacological studies of
      the IgE-dependent early asthmatic response.

PMID- 2222190
TI  - Localization of nucleocapsid associated polypeptides in measles virus-infected
      cells by immunogold labelling after resin embedding.
AB  - The nucleo-, phospho- and matrix protein of measles virus were localized at high
      resolution within infected cells by use of post-embedding immunogold labelling
      techniques. In general, labelling with monospecific antibodies as well as with a
      polyvalent rabbit anti-measles hyperimmune antiserum revealed measles virus
      polypeptides to be distributed non-randomly within infected cells with the label
      largely confined to specific sites, namely inclusions of nucleocapsids and
      assembled virus structures at the plasma membrane. Immunogold double labelling
      indicated that the phosphoprotein strictly co-localized with the nucleoprotein in
      cytoplasmic inclusions of nucleocapsids and in budding virions, whereas
      intranuclear inclusions of nucleocapsids were devoid of phosphoprotein labelling.
      Antibodies to the matrix protein clearly labelled assembled virus structures at
      the plasma membrane but exhibited no significant cytoplasmic or intranuclear
      reaction. The data indicate that the composition of nucleocapsids varies with the
      cellular compartment with which they are associated, supporting the view of a
      rapid assembly of paramyxovirus nucleocapsid polypeptides, and emphasize the
      proposed selective role of the matrix protein in virus assembly and budding at
      the plasma membrane.

PMID- 2222193
TI  - [Allergic individuals to Japanese cedar or orchard grass consist of two subgroups
      based on the sensitization to Dermatophagoides pteronyssinus].
AB  - One hundred and twenty-six allergic subjects were divided into three groups based
      on the RAST results for Dermatophagoides pteronyssinus (D.p) and Japanese cedar
      (J.C.). We compared sex, age of examination for RAST, serum IgE, family history
      of allergic diseases, prevalence rate of bronchial asthma (BA) and allergic
      rhinitis (AR), and onset of AR among three groups. No significant difference in
      the other variables except serum IgE and prevalence rate of BA was found between
      the group with D.p-positive and J.C.-positive RAST and the group with D.p
      positive and J.C.-negative RAST. The group with positive RAST for D.p and J.C.
      showed lower age of the examination, higher serum IgE, higher incidence of
      allergic family history, higher prevalence rate of BA, and lower onset age of AR
      than the group with negative RAST for D.p and positive RAST for J.C. We suggested
      that in J.C. RAST-positive group there might be two different subgroups
      distinguished by RAST result for D.p Similar results were obtained from the
      assessment of RAST for Orchard grass instead of J.C.

PMID- 2222191
TI  - Characterization of a temperature-sensitive mutant in the RNA polymerase PB2
      subunit gene of influenza A/WSN/33 virus.
AB  - The temperature-sensitive mutant ts-1 of influenza virus A/WSN/33 carries
      mutations in the gene encoding RNA polymerase PB2 subunit. Effect of temperature
      on various steps of viral RNA synthesis was examined using disrupted virions of
      ts-1 mutant. The initiation of RNA synthesis with dinucleotide ApG primer was not
      affected by elevated temperature, whereas that with primer RNA containing 5'
      terminal cap-1 structure was temperature-sensitive. The result supports the
      previous notion deduced from the UV-crosslinking experiments, that PB2 is
      involved in the cap-1 dependent initiation of RNA synthesis. In addition, the ts
      1 mutant showed a defect in RNA chain elongation. Nucleotide sequence analysis of
      RNA segment 1 of ts-1 mutant revealed that the amino acid number 417 is essential
      for the recognition of cap-1 structures and/or the interaction with catalytic
      unit of the RNA polymerase.

PMID- 2222194
TI  - [The relationship between respiratory threshold to acetylcholine and prognosis
      for asthma].
AB  - Forty nine asthmatic children were studied to clarify the relationship between
      the respiratory threshold of acetylcholine (RT-Ach) and the prognosis for asthma.
      In those patients who had asthmatic attacks fewer than 60 days in the last year,
      there was a statistically significant relationship between RT-Ach and the number
      of the days of asthmatic attacks over the 6 and 12 month periods following the
      inhalation test. In the younger group (5-11 years old), there was a statistically
      significant relationship between RT-Ach and the number of the days of asthmatic
      attacks over the 6 and 12 month periods following the inhalation test. However,
      in the elder group (12-15 years old), no such relationship was recognized. In the
      elder group, the obstructive index, one of the indices of flow-volume curve, had
      a statistically significant correlation with the number of asthmatic attacks over
      the 6 and 12 month periods following the inhalation test. However in the younger
      group, no such relationship was recognized.

PMID- 2222195
TI  - [The effects of various drugs and immune complexes on the function of alveolar
      macrophages from patients with collagen-vascular diseases with interstitial
      pneumonia].
AB  - Alveolar macrophages (AM) taken from sixteen patients with collagen-vascular
      diseases with interstitial pneumonia (CVD-IP+) were cultured with prednisolone
      (PSL), prostaglandin E2 (PGE2), colchicine (Colch), D-penicillamine or aggregated
      IgG (agg-IgG). The culture supernatants were tested on the fibroblast
      proliferation function and the amounts of fibronectin (Fn) and interleukin 1 (IL
      1). The fibroblast proliferation was suppressed significantly by the supernatants
      of AM cultured with PGE2. The Fn production by AM was significantly suppressed by
      PGE2 and Colch. The IL-1 production by AM was not suppressed by these drugs, but
      was enhanced by Colch. In five patients with CVD-IP+, the fibroblast
      proliferation of AM supernatant was enhanced by agg-IgG. In these five patients,
      Fn and IL-1 production had a tendency to be increased by agg-IgG. The ratio of
      immune complexes (IC) in broncho alveolar lavage fluids to those in sera was
      significantly higher in patients with CVD-IP+ than in patients with CVD without
      IP suggesting a local production of IC in the lung in the patients with CVD-IP+.

PMID- 2222196
TI  - [A case of mixed connective tissue disease developed into overlap syndrome of
      progressive systemic sclerosis, systemic lupus erythematosus, polymyositis and
      Sjogren's syndrome].
AB  - We encountered a patient who developed an overlap syndrome of progressive
      systemic sclerosis (PSS), systemic lupus erythematosus (SLE), polymyositis (PM)
      and Sjogren's syndrome (SjS) while we were treating her for mixed connective
      tissue disease (MCTD). This 42-year-old woman had been photosensitive since 18
      years of age. In 1986, Raynaud's phenomenon, swollen hands and arthralgia
      appeared; therefore, we started to treat this patient based on a diagnosis of
      MCTD. At that time, her anti-RNP antibody titer was 82,920, but she was negative
      to anti-Sm antibody. In 1988, she was admitted to our hospital with chief
      complaints of aggravation of polyarthralgia and myalgia. On physical examination,
      she showed difficulty in opening her mouth, systemic dermal sclerosis, a decrease
      in muscular strength and rales. In laboratory tests, her myogenic enzyme level
      was increased, and she was found to be positive to LE cells, antinuclear
      antibody, anti-DNA antibody, anti-ENA antibody and anti-SSA antibody.
      Furthermore, histological features clearly corresponding to those of PSS were
      found by skin biopsy, myogenic changes by electromyography, evidence of chronic
      inflammation of the salivary glands by lip biopsy, and proliferative changes in
      the mesangium were detected by renal biopsy. The concept of MCTD, especially the
      differences from overlap syndrome, is vague. Therefore we need further study
      about many cases. Since there have been no reports on cases having sufficient
      evidence of the development of the overlap syndrome of PSS, SLE, PM and SjS
      during a course of MCTD, our patient would provide very useful data contributing
      to the study of MCTD.

PMID- 2222197
TI  - [Antigen-induced biphasic eosinophil infiltration in the airways of actively
      sensitized guinea pigs and its inhibition by PAF antagonist and cyclosporin A].
AB  - Bronchial eosinophilia is a characteristic of asthma. To elucidate the mechanisms
      of eosinophil accumulation in the airways, the time course of eosinophil
      infiltration in the airway mucosa after antigen inhalation was examined in
      actively sensitized and passively sensitized guinea pig models of asthma. The
      lungs and tracheae were removed at intervals after antigen challenge, fixed and
      stained. The eosinophil infiltration was quantitated in the tracheal walls by
      counting the number of cells per square millimeter. Guinea pigs sensitized by
      intraperitoneal injection of ovalbumin (OA) responded to a single exposure to
      aerosolized OA with biphasic infiltration of eosinophils in the tracheal walls; a
      striking early-phase which peaked at 6 hr and a delayed-phase which peaked at 24
      hr and persisted for as long as 5 days. These kinetics were different from those
      observed with passively sensitized animals which showed only early-phase
      infiltration. Administration of CV-6209, a specific PAF antagonist, before and 12
      hrs after antigen challenge significantly (p less than 0.01) inhibited the early
      phase but not the delayed-phase eosinophil infiltration in actively sensitized
      animals. In contrast, when guinea pigs were treated with Cyclosporin A, a T
      lymphocyte-selective immunosuppressive agent, throughout the immunization period,
      the delayed-phase but not the early-phase infiltration was significantly (p less
      than 0.01) inhibited. These results suggest that PAF may contribute to early
      phase and T cell factor(s) may contribute to delayed-phase eosinophil
      infiltration of the airways.

PMID- 2222198
TI  - [Platelet-activating factor in Japanese cedar pollinosis].
AB  - Japanese cedar pollinosis is a typical allergic disease and has recently become a
      big social problem. Many population are suffering from this disease every year
      from the end of February to the beginning of April. In this study, we planned to
      examine the role of platelet-activating factor (PAF) in this disease, because PAF
      has been known to be one of the potent chemical mediators in allergic and
      inflammatory reactions and many evidences indicate that PAF is deeply involved in
      the pathogenesis of bronchial asthma, a typical allergic disease. We measured the
      concentrations of the PAF derivative (lyso-PAF) in serum from patients with cedar
      pollinosis during the pollen season. The level of lyso-PAF in serum from
      untreated patients with cedar pollinosis (87.8 +/- 8.7 unit.) was significantly
      higher than that in healthy control (54.9 +/- 7.7 unit.). We also tested the
      effect of an anti-allergic drug on the level of serum lyso-PAF of cedar
      pollinosis. Eighteen pairs of serum samples from patients with cedar pollinosis
      were employed in this study. Lyso-PAF levels after two weeks' therapy with
      ketotifen (2 mg/day), an anti-allergic drug, decreased the levels significantly
      (from 82.6 unit to 41.3 unit). These results suggest that PAF could play some
      important role in cedar pollinosis and that the clinical effect of anti-allergic
      drug could be partially due to the anti-PAF action.

PMID- 2222199
TI  - Cloning and sequencing of cDNAs corresponding to mite major allergen Der f II.
AB  - A cDNA library corresponding to mite protein was screened employing anti-Der f II
      antibody. Two possible clones were obtained, which contained plasmids, pFL1 and
      pFL11, respectively. Both plasmids had insertions of about 500 base pairs. The
      DNA sequences of the two insertions were determined, from which the amino acid
      sequences were deduced. The amino acid sequence of the purified native Der f II
      protein could be determined to 45 residues from the N-terminus. As a result of
      comparison, we concluded that the cDNAs prepared from live mite Dermatophagoides
      farinae corresponded to the mite allergen, Der f II.

PMID- 2222200
TI  - [Morphofunctional changes in the hemo- and lymphomicrocirculatory bed of the
      uterus and its regional lymph nodes in venous congestion during pregnancy].
AB  - Interrelations of the blood and lymphatic systems of the uterus have been
      examined in rats at pregnancy complicated with the ++phlebo-occlusive syndrome.
      Blood stream impediment in the caudal vena cava results in increasing diameter of
      the arterioles, capillaries and venules of the endo- and myometrium. Certain
      disturbances of blood circulation in the uterus at the ++phlebo-cclusive syndrome
      in the pregnancy animals, as a rule, reflect in the uterine lymph outflow; this
      is demonstrated as dilatation and deformity of the lymphatic vessels and
      capillaries, appearance of protrusions of the lymphatic vessels wall. There is a
      definite co-ordination in the reaction to the caudal vena cava occlusion in the
      intra-, ++extra-organic uterine lymphatic bed and in its regional lymph nodes,
      manifested as the following morphological signs: decreasing relative volume, that
      the lymphoid tissue occupies and increasing relative volume of the cortical and
      medullary intermediate sinuses.

PMID- 2222201
TI  - [Structure of lymphatic vessels in the rat thyroid gland].
AB  - The lymphatic bed of the thyroid gland has been studied in 24 intact rats. Three
      techniques facilitating to reveal lymphatic vessels in the organ have been used:
      preparation of semithin sections, injection of the blood bed with methyl
      methacrylate with a successive chemical extraction of the preparations, injection
      of the blood bed with liquid solution of methyl methacrylate with a consecutive
      study of the preparations in the scanning electron microscope. Methods of
      electron histochemistry (revealing horseradish peroxidase) and kryofractography
      have been applied. Construction of the thyroid lymphatic bed, structure of the
      wall are described, fibroblastic membrane (F-membrane) is revealed and the signs
      are presented, that allow to differentiate F-membrane from endothelium of the
      lymphatic capillaries. The pathways of lymph outflow in the rat thyroid gland
      consist of the following links: interstitial space in the interlobular spaces of
      the gland, into them the tissue liquor (lymph) is filtered ; plates of the F
      membrane regulating direction of excessive albumin-containing liquor in the
      lymphatic capillaries, surrounding groups of 5-11 follicles, embracing the
      microlobule of the gland and situating in the interlobular spaces, deferent
      lymphatic vessels.

PMID- 2222202
TI  - [Transplantation of human embryonal nervous tissue to the spinal cord of mature
      rats].
AB  - Pieces of the wall obtained from the anterior cerebral bladder of human embryos
      at the age of 8-10 weeks can survive in the spinal cord of mature animals. In the
      transplant, unlike the normal embryonal histogenesis, neuroepithelial cells make
      groups of rosellas. The differentiation process of cells of the human nervous
      tissue transplant can be followed in the rat spinal cord without any immune
      suppression up to the end of the 2d month of development. During the 3d month the
      transplant neuroblasts perish as a result of the immune reaction.

PMID- 2222203
TI  - [Aldehyde dehydrogenase activity in the rat brain during ontogenesis].
AB  - By means of the quantitative histochemical method aldehyde dehydrogenase
      (1.2.1.3; AlDH) activity has been studied in the rat brain and spinal cord
      structures. AlDH activity (acetaldehyde is used as a substrate) in the barrier
      structures of the brain (vascular and villous ependymocytes of the cerebral
      ventricles, endothelium of blood capillaries) makes only 10-30% during the
      antenatal period and then increases gradually, reaching the activity specific for
      mature animals by the 20th-40th day after birth. Up to the 10th day of the
      postnatal development AlDH activity of neurocytes of various types makes 45-70%,
      and then increases sharply, and by the 20th day is approaches the definitive one.
      AlDH activity of the spinal cord motoneurons in old rats (2-year-old) essentially
      surpasses the control. In the white cerebral substance and its gliocytes from the
      10th up to the 40th day after birth AlDH activity sharply increases; this
      coincides with myelinization of the CNS. Dynamics of aldehyde-oxidating ability
      is probably connected with natural changes in the CNS metabolism during
      ontogenesis. At the same time, it reflects a low level in stability of the
      developing brain to the damaging effect of exogenic ethanol and especially to its
      toxic metabolite--acetaldehyde.

PMID- 2222204
TI  - [Morphological characteristics of the thymus gland of albino rats after prenatal
      administration of indomethacin].
AB  - By means of histological, histochemical and electron microscopical methods the
      thymus of white rat fetuses and offspring has been investigated during various
      age periods after indomethacin++ influence (2.5 mg/kg). In the fetuses
      retardation in separation of the gland parenchyma into lobules has been revealed.
      During the first two weeks of life the section area of the medulla decreases.
      Amount of lymphoid cells decreases; small and degenerating lymphocytes decrease
      in their number, while the part of lymphoblasts, middle lymphocytes and figures
      of mitosis increases. Enzymatic activity in the nervous structures of the organ
      is inhibited. Some essential disturbances of the intracellular structures are
      revealed; they demonstrate certain destructive changes. The data obtained show a
      decreasing function of the thymus after the prenatal influence of indomethacin++
      during the first month of life, which is especially manifested during the first
      two weeks.

PMID- 2222205
TI  - [Classification of erythroblastic islets of the bone marrow and the study of
      their cellular composition].
AB  - Cell composition of erythroblastic islands (EI), normal and at the phase of
      stimulation and inhibition of erythropoiesis at modelling of heat adaptation has
      been studied on hemopoietic tissue of 108 rats. In the hemopoietic tissue,
      together with EI of the 1st, 2nd and 3d classes of maturity, that have in their
      composition correspondingly up to 8, from 9 up to 16 and above 16 nuclei
      containing erythroid cells, there are involutive and reconstructing EI. The
      involutive EI are presented as nuclei-containing erythroid cells, that are not
      able to divide and are at late stages of differentiation: polychromatophilic and
      oxyphilic normoblasts, as well as reticulocytes. The reconstructing EI have in
      their composition both erythroid cells, that are not able to divide, and
      erythroid cells (pro-, erythroblasts and basophilic normoblasts), that are at
      early stages of differentiation. Application of the EI classification suggested,
      takes into account the rate, with which the erythroid cell-predecessors are drawn
      into erythropoiesis and intensity of erythroid differentiation. Therefore, it is
      possible to obtain earlier and more exact data on the state of hemopoiesis in
      comparison with traditional hematological methods.

PMID- 2222206
TI  - [Cytological structure of splenic white pulp in persons of different age].
AB  - Spleens (27) obtained from human corpses (from 1 year up to 85 years) have been
      investigated. By means of morphometrical grid amount of cells in the periarterial
      lymphoid muffs (PLM) and in marginal zones (MZ) of the spleen have been counted.
      In both structures of the white pulp small lymphocytes make the greatest number.
      Middle lymphocytes in comparison to the small ones are 1.5-4 times less in most
      of the age groups investigated. Amount of plasma cells is small. The part of
      reticular cells is 21-46% in MZ and 20-36% in PLM from the total amount of cells.
      In PLM immediately around the artery tightly packed to each other small
      lymphocytes are situated. Among small lymphocytes reticular cells are situated. A
      similar arrangement of cells is kept along the whole thickness of PLM. In MZ
      distance between cells of the lymphoid line is a little greater than in PLM. To
      singularly situating reticular cells small and middle lymphocytes are immediate
      neighbours. Plasma cells, as a rule, occur seldom; either middle lymphocytes, or
      reticular cells adjoin them. Sometimes, in PLM and MZ macrophages occur; they are
      situated in the areas free from other cells.

PMID- 2222207
TI  - [Analysis of the ultrastructure of atrial cardiomyocytes in rats after alimentary
      dehydration].
AB  - By means of water deprivation primary- and secondary-compensated and
      decompensated degrees of dehydration have been caused in 24 rats. Electron
      microscopical investigation has demonstrated a more pronounced granularity of
      cardiomyocytes in the left than in the right cardiac auricles. During the
      alimentary dehydration granularity of the atrial cardiomyocytes in the right
      auricles increases at the primary- and secondary-compensated degrees of
      dehydration, in the stage of decompensated dehydration it decreases, the
      character of distribution of the secretory granules, however, shows certain
      processes of exhaustion. Granularity of the atrial cardiomyocytes in the left
      auricles during alimentary dehydration of the organism does not change. Changes
      of the endocrine apparatus in the atrial cardiomyocytes occur against the
      background of microcirculatory disturbances in both auricles of the heart and are
      combined with dystrophic changes in cardiomyocytes.

PMID- 2222208
TI  - [Structure and cytophysiology of gastric endocrine gland cells after repeated
      administration of testosterone propionate].
AB  - By means of light, electron microscopy and morphometry methods contents and
      structural organization of endocrinocytes have been investigated in gastric
      glands of rats, to whom testosterone propionate has been injected for 5, 10, 15,
      20 days. The hormone produces certain stimulating effect on the endocrine
      apparatus function. During the first stages of the experiment most of the
      endocrinocytes are at the state of active secretion; this is testified as a
      decreasing composition of histochemically revealed cells in epithelium and their
      degranulation. During the following stages the process of synthesis is activated
      in the cells and their amount increases. Appearance of numerous agranular, poorly
      differentiated endocrinocytes and exo-endocrine cells demonstrates certain
      intensification of cytogenesis of endocrinocytes in the gastric epithelium. The
      changes observed are considered as adaptive, directed to stabilize homeostasis,
      when the hormonal balance is disturbed.

PMID- 2222209
TI  - [Reaction of the duodenum, renal parenchyma and their blood microvessels to
      external bile discharge in turtles].
AB  - Morphological characteristics in rearrangement of the structural components of
      the duodenum, renal parenchyma and their hemomicrocirculatory beds are presented
      at a chronic experimental external bile discharge in the tortoise. Common
      reactions of microvessels in response to this experimental action, manifesting as
      their constriction and dilatation, depend, possibly, on general changes in the
      organism specific for the acholia state. Specific rearrangements, such as
      reduction of blood capillaries of the duodenal mucous membrane and appearance of
      polypous outgrowths in this place with successive ulceration should be considered
      as a reaction to a decreased level of the functional loading to these parts of
      the duodenum.

PMID- 2222210
TI  - [Kinetics of cell population of the jejunal mucosal epithelium in mice after
      administration of syngeneic lymphocytes].
AB  - By means of the radioautographic method the state of cellular restoration of the
      gastric epithelium has been estimated after administration of syngenic
      lymphocytes to mice. Under conditions of physiological regeneration T-lymphocytes
      are able to inhibit proliferation of the epithelial cells and to limit the size
      of the proliferation zone in crypts. The inhibition degree of the proliferative
      activity depends on the doze of the T-cells administered. In order to demonstrate
      their activity, T-cells do not need DNA and RNA synthesis de novo. At the same
      time, protein synthesis is necessary; it occurs on long-living mRNA lymphocytes.
      The T-lymphocyte action is reversible at the tissue, but not at the cellular
      level. The mechanism of decreasing cell reproduction under effect of T
      lymphocytes is described. In the process of lymphoid regulation of the cellular
      restoration in the intestinal epithelium changes in the size of the proliferative
      pool play the main role.

PMID- 2222211
TI  - [Spermatogenic cycle in seals (Callorhinus ursinus L.)].
AB  - In the fur-seal germ cells at various stages of development are situated in the
      spermatic canaliculi as concentric layers in accordance with the stages of the
      spermatogenic cycle. By means of PAS-reaction 18 stages have been revealed in
      spermatogenesis of the fur-seal and basing on the first 15 of them, 15 stages of
      the spermatogenic cycles have been presented. Transformations of the nucleus
      during the process of spermatids development proceed similar to other animals
      studied, formation of acrosomes is accompanied with a specific for the given
      species development of temporal formation--tubulo-bulbar complexes, reduced at
      terminal stages of spermiogenesis.

PMID- 2222212
TI  - [Tasks of the departments of operative surgery and topographic anatomy of medical
      schools in the light of the reorganization of higher education].

PMID- 2222213
TI  - [Department of Histology and Embryology of the Kiev Medical Institute (on the
      120th anniversary of its founding)].

PMID- 2222214
TI  - [Chronic interstitial lung diseases. The status of the problem].
AB  - Literature and original data on etiology, pathogenesis and morphogenesis of
      chronic nonspecific lung diseases provided the authors with evidence leading to
      conclusions on common pathogenesis of the above wide spectrum of the diseases
      characterized by affected intercellular relations in the lungs. Immunologic
      homeostasis is suggested as an essential factor resultant in the disease
      progression along the vicious circle in case of its defective functioning.

PMID- 2222216
TI  - [The pathological anatomy of secondary immunodeficiency].
AB  - Secondary immunodeficiency is a polyetiological syndrome resulting mainly from
      the influence of exogenic factors and manifesting in the lack of immune response
      and nonspecific defence. Adequate documentation of secondary immunodeficiency
      revealing its role in the cause-result relationship when analysing the course of
      disease will improve not only evaluation of events but will create the conditions
      for the correction of secondary immunodeficiency the feasibility of which is
      proven experimentally.

PMID- 2222215
TI  - [Chronic inflammatory processes in the lungs: their intravital
      pathologicoanatomic diagnosis and prognosis].
AB  - Combined morphological study of 714 bronchial biopsies and 363 samples of
      bronchoalveolar lavage (BAL) from 560 patients with chronic inflammatory diseases
      of nonspecific and tuberculous etiology was carried out. By light microscopic,
      electron microscopic and radioautographic investigation it was shown, that more
      important criteria of the dynamics of pathologic process, the stages of
      compensatory-adaptive reorganization of the lungs and the prognosis of disease
      were the structural-metabolic transformation of surface epithelium (metaplasia to
      stratified squamous epithelium or its atrophy) and the quantitative-qualitative
      characteristics of alveolar macrophages. A correlation was revealed between
      metabolic activity of BAL cells and those of bronchial epithelial cells, which
      determined the structural-functional interaction between the airways and
      respiratory part of the lungs under chronic inflammatory processes and promoted
      the right interpretation of clinical and morphological data. Morphological
      changes mainly of degenerative, but noninflammatory genesis often observed in the
      last years during chronic inflammatory processes in the lungs, are considered in
      terms of regenerative-plastic insufficiency of cells and intracellular
      structures.

PMID- 2222217
TI  - [Tumor growth and immunodeficiency states].
AB  - The paper concerns problems of relations between tumor growth and immune system,
      complications of the tumor process due to immunodeficiencies and anticancer
      treatment, risk of metachronous tumors onset. Paraneoplastic phenomena and
      development of second tumors in patients treated in AUCRC are described. The
      pathologist should be active in carrying out a detailed clinical and anatomical
      analysis of malignant diseases.

PMID- 2222218
TI  - [Congenital immunodeficiency syndromes].
AB  - The definition of the congenital immunodeficiency syndrome (CIDS) is given.
      Structural alterations of the thymus in combination with zonal disturbances and
      cell composition of the peripheral lymph organs are main morphological
      manifestations of CIDS. The most reasonable classification of CIDS is that based
      on etiology and thus making necessary to reconsider the existing terminology with
      an exclusion of such terms as "primary" and "secondary" immunodeficiency. The
      crucial point in the CIDS pathogenesis is a time of structural disturbances
      resulting from the action of an altering factor on the immune system in
      ontogenesis. A list of diseases of the histiomonocytic system is given which can
      be used as a basis for developing the classification of CIDS of the above system
      as the most ancient element in the immune response in the phylo- and ontogenesis.

PMID- 2222219
TI  - [The pathological anatomy of acute inflammatory lung diseases in adults].
AB  - The paper relates the author's concern for diminishing interest of the
      pathologists to investigations of adult acute pneumonia, though chronic lung
      diseases and acute childhood pneumonia draw much attention. It is believed
      invalid to neglect classic methods of histobacterioscopy which are to be
      advanced. The researchers should insist on introduction of improved techniques of
      enzyme immunoassays in identification of pulmonary infection of viral and
      bacterial origin, study new kinds of pneumonias such as legionnaires' disease,
      Mycoplasma pneumonias, opportunistic infections in primary and secondary
      immunodeficiencies, e.g. AIDS, etc., presenting a wide field for the prosector's
      activity.

PMID- 2222220
TI  - [New data on thymomegaly as a syndrome of congenital (primary) immunodeficiency].
AB  - Basing on a combined clinicomorphological investigation of the thymicolymphatic
      and neuroendocrine systems including measurements of blood thymic hormones and
      their levels in thymic tissue it is shown that congenital thymomegaly can be
      considered a dysfunction of the hypothalamo-hypophysial system. The dysfunction
      manifests with polyglandular endocrinopathy and congenital immunodeficiency
      related to the group of thymus-dependent immunodeficiencies. Thymomegaly is often
      coupled with congenital malformations.

PMID- 2222222
TI  - [The modelling of chronic infection (experimental leprosy) against a background
      of macrophagal immunodeficiency].
AB  - The dynamics of mycobacterial multiplication was followed in mice with
      intraplantar leprosy infection and preinduced macrophage insufficiency. The
      characteristics of Shepard's model appeared to be similar to those of the method
      proposed by the authors including the susceptibility to the main antileprosy
      drugs. Peritoneal macrophages were cytochemically studied in the process of
      development of mononuclear phagocyte deficiency and experimental leprosy. It was
      concluded that the method proposed preserving all the merits of Shepard's model
      should allow one to shorten significantly the duration of testing potential drugs
      for their antileprosy activity.

PMID- 2222221
TI  - [Principles of the morphofunctional classification of granulocyte deficiencies].
AB  - On the basis of qualitative and quantitative indexes of the plasmatic-cellular
      system of neutrophilic leukocyte /NL/ a classification of granulocytic
      deficiencies /GD/ is developed, 4 forms of GD are distinguished: agranulocytosis,
      granulocytasthenia, myeloproliferative conditions and inflammatory leukocytosis.
      As a clinicomorphological criterium of GD a triad is suggested that includes a
      tissue necrosis, microbism and inflammatory infiltration. Functional failure
      typical for every form of GD has it sown features.

PMID- 2222223
TI  - [The tasks of pathological anatomy (pathology) in the medical college and the
      possible means for their resolution].
AB  - The course of pathologic anatomy in medical students' training is unsatisfactory
      as it doesn't cover many aspects of present-day human pathology. The graduates
      lack necessary knowledge in general and special pathology. The existing system of
      pathologist training is deficient, it should last for at least 4 years
      (subinternship, internship, clinical internship). Coordinated plans of advanced
      training of both the teachers and the pathologists are necessary. The
      relationships between chairs and bureaus of pathology should be systematized and
      creation of educational-scientific-practical complexes validated.

PMID- 2222224
TI  - [The most important prospects and tasks in improving the postgraduate instruction
      of pathologists under perestroika].
AB  - It is suggested to reorganize the postgraduate training of pathologists by
      improving the technical basis of pathology chairs in accordance with modern
      achievements of medicine and state examinations requirements. The postgraduate
      training should be continuous and be realized by a self-education and pathologist
      participation in special courses and teaching cycles with subsequent
      qualification examination for the 2nd, 1st and highest category (after 5, 7 and
      10 years, respectively).

PMID- 2222225
TI  - [Postgraduate instruction and certification in the system of the continuing
      education of pathologists].
AB  - The experience in changing pathology service, postgraduate training and
      attestation in the system of continuous education of pathologists is presented.
      The authors analysed different ways of pathologist training: specialization in
      subinternship, internship and clinical internship, short-term courses, at places
      of work and outpatient problem seminars, etc. The four-year program of
      pathologist training is suggested.

PMID- 2222226
TI  - [The organization of the training of scientific and teaching personnel with high
      qualifications in connection with the approval by the Council of Ministers of the
      USSR of the Regulations on the procedure for awarding academic degrees and
      conferring academic titles of 30 December 1989].

PMID- 2222227
TI  - [A case of malignant hemangiopericytoma of the pulmonary trunk valve of the
      heart].
AB  - A description of one case: 62-year-old woman died during an operation for a
      tumour of the right lung. Malignant haemangiopericytoma of the pulmonary trunk
      valve was found at the necropsy with an occlusion of pulmonary trunk and
      metastasis to the right lung.

PMID- 2222228
TI  - [Apropos the article by G. G. Avtandilov et al. The professional qualification
      requirements for the clinical pathologist in a general hospital].

PMID- 2222229
TI  - Australian midwives--politically active? What implications does this have for
      more effective policy making in health care?

PMID- 2222230
TI  - The Australian College of Midwives: a decade in review.

PMID- 2222231
TI  - The psychosocial-cultural aspects of pregnancy and holistic nursing care.
AB  - This paper discusses various psychosocial/cultural aspects of pregnancy that may
      alter the behaviour of the expectant couple. Holistic care plans are more likely
      to be effective if nurses are cognizant of these influences on the health of the
      child bearing couple. The quality of life from the moment of conception depends
      on a vast number of factors not the least being the physical and mental health of
      the expectant parents. Australian midwives contribute to the quality of maternal
      and fetal life by providing care throughout the pregnancy. In holistic care the
      health of the father is also considered therefore the quality of care provided to
      the growing family in the 1980's is a product of the nurses' knowledge.

PMID- 2222232
TI  - Women to have more say in births?

PMID- 2222233
TI  - "The alternative or the norm for the future?".

PMID- 2222234
TI  - Antihelminthic therapy for neurocysticercosis.

PMID- 2222235
TI  - No evidence for human T-cell leukemia virus type I or human T-cell leukemia virus
      type II infection in patients with multiple sclerosis.
AB  - The involvement of human T-cell leukemia viruses (HTLVs) in the pathogenesis of
      18 Hungarian patients with multiple sclerosis was investigated. No antibody to
      HTLVs could be detected in any of the patients. Furthermore, using polymerase
      chain reaction under highly sensitive conditions, neither HTLV-I DNA nor HTLV-II
      DNA could be noted in peripheral blood lymphocytes of the patients. Our data do
      not support a causal association of HTLV-I or HTLV-II with multiple sclerosis.

PMID- 2222236
TI  - Failure to detect human T-cell leukemia virus-related sequences in multiple
      sclerosis blood.
AB  - We tested 11 patients with multiple sclerosis for the presence of human T-cell
      leukemia virus type I (HTLV-I)- or type II (HTLV-II)-related sequences. DNA from
      blood mononuclear cells was analyzed by the polymerase chain reaction utilizing
      three different oligonucleotide primer pairs. Two of these primer pairs detect
      sequences shared between HTLV-I and HTLV-II in either p24, gag protein, or in
      p21, env transmembrane protein. The third primer pair was synthesized based on
      regions in the pol gene where amino acid sequences are conserved between HTLV-I,
      HTLV-II, and the related bovine leukemia virus. The multiple sclerosis samples
      were consistently negative while appropriate control samples were positive. We
      conclude that viruses related to HTLV-I, HTLV-II, or bovine leukemia virus are
      not present in the blood of patients with multiple sclerosis and, therefore, that
      HTLV-bovine leukemia virus-related viruses are not likely to be involved in the
      pathogenesis of multiple sclerosis.

PMID- 2222237
TI  - Apneic oxygenation in apnea tests for brain death. A controlled trial.
AB  - We performed a prospective controlled study of apneic oxygenation on 15 patients
      undergoing apnea tests for brain death. All patients were preoxygenated with 100%
      oxygen at existing respirator settings. During the 10-minute apnea tests, nine
      patients were given continuous apneic oxygenation by tracheal cannula. The other
      six patients had tracheal tubes open to room air. The patients given apneic
      oxygenation had little or no hypoxia by the end of the test. The patients given
      room air during the test became hypoxic. Many neurologists perform apnea tests
      with no oxygenation or with preoxygenation alone. This is the first prospective
      controlled study (to our knowledge) of apneic oxygenation; it shows that
      preoxygenation alone does not prevent hypoxia during apnea tests for brain death.
      We recommend that all apnea tests be performed with apneic oxygenation.

PMID- 2222238
TI  - Geographic patterns of parkinsonism-dementia complex on Guam. 1956 through 1985.
AB  - Average annual age-adjusted incidence rates of parkinsonism-dementia complex were
      obtained for the 19 election districts of Guam from 1956 through 1985. The
      highest rates were found in the southern and central districts, and the lowest
      rates were found in the northern and western districts. Geographic and temporal
      patterns of incidence were associated with socioeconomic status but not with
      geochemical factors. The risk of parkinsonism-dementia complex in susceptible
      sibships was much higher than that in the general population--even in districts
      with the highest incidence rates, but especially in districts with the lowest
      incidence rates. Our evidence tends to support the hypothesis that multiple
      factors linked to cycad use play an important role in the cause of PDC.
      Hypotheses related to metal exposure and simple genetic factors were
      unsatisfactory explanations for the epidemiologic patterns observed.

PMID- 2222239
TI  - Racial differences in the anterior circulation in cerebrovascular disease. How
      much can be explained by risk factors?
AB  - The entry characteristics of 1367 patients enrolled into the
      Extracranial/Intracranial Bypass Study were examined to determine if site
      differences in intracranial and extracranial arterial lesions among racial groups
      could be explained by differences in risk factors. Blacks were more often
      hypertensive, diabetic, or cigarette smokers, while whites had higher systolic
      blood pressure and hemoglobin values. Orientals had the lowest prevalence of
      vascular risk factors. Despite these differences in risk factors, multivariate
      analysis showed race to be an independent and strong predictor of the location of
      cerebrovascular lesions. To our knowledge, this study is unique in documenting
      risk factors prospectively and systematically in three racial groups
      simultaneously. Although generalization is limited by possible biases related to
      patient selection, the results affirm previous tentative conclusions about the
      role of race in determining the location of cerebrovascular disease.

PMID- 2222240
TI  - The large striatocapsular infarct. A clinical and pathophysiological entity.
AB  - We examined 29 patients with strictly subcortical large striatocapsular
      infarctions. Eight of them had aphasia or neglect. All patients underwent
      transcranial Doppler ultrasonography or selective carotid angiography, magnetic
      resonance imaging, and single photon emission tomography for assessment of
      cerebral blood flow, blood volume, and cerebral perfusion reserve. The signs were
      compatible with cortical territorial infarctions rather than lacunes. On both
      magnetic resonance imaging and computed tomographic scans, the lesions
      corresponded to the territories of the medial and lateral group of the
      lenticulostriate arteries, Heubner's artery, or the anterior choroidal artery.
      The infarctions were either due to cerebral embolization into the M1 segment of
      the middle cerebral artery or due to stenosis at the same site, ie, lesions that
      acutely and simultaneously occluded the orifices of the lenticulostriate or
      neighboring arteries. Persistent occlusion of the middle cerebral arteries and a
      decrease of cortical regional cerebral blood flow were only found in patients
      with aphasia or neglect. All patients without aphasia or neglect showed a rapid
      recanalization of the middle cerebral artery occlusion or a stenosis of the M1
      segment and no cortical regional cerebral blood flow decrease. Large
      striatocapsular infarctions occur due to occlusive disease of the middle cerebral
      artery (large-vessel disease) and not due to a disseminated in situ occlusion of
      the long penetrating arteries (small-vessel disease), as in lacunes.
      Neuropsychological deficits can be explained by decreased cortical blood flow due
      to a persistent occlusive lesion of the middle cerebral artery.

PMID- 2222241
TI  - Deep perforators from the carotid system. Template of the vascular territories.
AB  - Most reports on small infarcts in the territory of the deep perforators that
      arise from the internal carotid artery and its branches have focused on the
      anatomical structures. Recently, it has become possible to map the territories of
      the deep perforators from the carotid system, based on matching previous
      anatomical studies with recent data from computed tomographic and magnetic
      resonance imaging studies. The middle cerebral artery gives origin to two main
      groups of perforators: the medial and lateral lenticulostriate arteries. Rarely,
      the thalamotuberal artery may take origin from the middle cerebral artery but
      much more commonly it originates from the posterior communicating artery. The
      anterior cerebral artery gives origin to the anterior lenticulostriate arteries
      and the recurrent artery of Heubner. The anterior choroidal artery takes its
      origin from the internal carotid artery and exceptionally from the middle
      cerebral artery. In addition, a small group of perforators comes directly from
      the internal carotid artery. The anatomical structures supplied by these
      perforators are described, and a map of the territories is proposed.

PMID- 2222242
TI  - Failure of surgery to improve outcome in hypertensive putaminal hemorrhage. A
      prospective randomized trial.
AB  - Hypertensive putaminal hemorrhage remains a major cause of hemorrhagic stroke
      carrying extremely high morbidity. Considerable controversy remains regarding the
      optimal form of therapy. Between 1983 and 1989 we conducted a prospective
      randomized trial with three treatment strategies: best medical management, best
      medical management plus intracranial pressure monitoring, and surgical
      evacuation. Only patients with significant deficit harboring a putaminal hematoma
      at least 3.0 cm in diameter were entered. The study was interrupted after 21
      patients had been studied (9, best medical management; 4, intracranial pressure
      monitoring; and 8, surgical evacuation). No differences were found among groups
      for age, admission blood pressure, and time interval between onset of symptoms
      and arrival at hospital. None of the subjects were capable of returning to
      prestroke activity. Fifteen (71%) died or remained vegetative at 6 months, and
      only 4 (19%) were capable of independent life at home. Of the 9 patients in the
      best medical management arm, 7 were dead or vegetative. In the surgical group, 4
      patients died and only 2 were capable of independent life. These results suggest
      that current medical and neurosurgical therapies remain ineffective in preventing
      the devastating neurologic consequences of hypertensive putaminal hemorrhage.

PMID- 2222243
TI  - Brain imaging abnormalities in mental disorders of late life.
AB  - Psychiatric inpatients with dementia (N = 61) or depression (N = 67) in late life
      were 2.6 times more likely to manifest magnetic resonance imaging abnormalities
      of the brain than were elderly controls (N = 44). Controlling for the effects of
      age and gender, demented patients were distinguishable from controls by an
      increased prevalence of cortical atrophy and infarction, while depressed patients
      exhibited an increased prevalence of cortical infarctions and
      leukoencephalopathy. Patients with dementia were distinguishable from those with
      major depression by an increased prevalence of cortical atrophy. These results
      indicate that major depression in late life, like dementia, is associated with a
      remarkable increase in overt pathologic changes in the brain.

PMID- 2222245
TI  - X-linked spinal muscular atrophy (Kennedy's syndrome). A kindred with
      hypobetalipoproteinemia.
AB  - Kennedy's syndrome, X-linked adult-onset bulbospinal muscular atrophy, has been
      described in over 30 families. The characteristic distribution of weakness
      creates a recognizable syndrome, augmented by frequent findings of testicular
      atrophy and gynecomastia. Type IV or type II hyperlipoproteinemia has been found
      in some families. We have studied another family with Kennedy's syndrome, this
      one with hypobetalipoproteinemia. The diversity of serum patterns suggests that
      lipoprotein abnormalities are not causally related to either the endocrinopathy
      or the spinal muscular atrophy. However, gene linkage studies indicate proximity
      of the gene for Kennedy's syndrome and the gene encoding the androgen receptor,
      which could explain the combination of a motor neuron disorder and the endocrine
      abnormalities.

PMID- 2222244
TI  - Adjuvant chemotherapy for primary lymphoma of the central nervous system.
AB  - Ten immunocompetent patients with primary non-Hodgkin's lymphoma of the central
      nervous system were treated by the neuro-oncology service at the University of
      California at San Francisco (UCSF). After undergoing surgery for biopsy or
      removal of their tumors, these patients (group 1) received irradiation with
      hydroxyurea followed by adjuvant chemotherapy with the combination of
      procarbazine, lomustine (CCNU), and vincristine. The outcome of treatment in this
      group was compared with that in three other groups of patients with primary CNS
      lymphoma: patients treated at the UCSF Cancer Research Institute who underwent
      surgery and radiation therapy (RT) (group 2); patients described in the
      literature who had surgery and RT (group 3); or patients described in the
      literature who had surgery, RT, and chemotherapy (group 4). Median and quartile
      survival times were greater in patients who received adjuvant chemotherapy (group
      1, 30 and 50 months; group 4, 20 and 25 months) than in patients who did not
      receive chemotherapy after RT (group 2, 13 and 20 months; group 3, 15 and 24
      months). These results suggest that adjuvant chemotherapy is useful in the
      treatment of primary CNS lymphoma.

PMID- 2222246
TI  - GM-1 treatment of Alzheimer's disease. A pilot study of safety and efficacy.
AB  - A double-blind, placebo-controlled pilot study was conducted to evaluate the
      safety and efficacy of treatment of patients with Alzheimer's disease using
      monosialoganglioside GM-1, a neurotrophic factor. Of 46 patients enrolled, 42
      completed all study requirements. Nineteen patients received 100 mg of GM-1 by
      daily intramuscular injection for 12 weeks. Twenty-three patients received
      placebo. Case evaluations were done at baseline, week 12, and week 24 and
      included both cognitive and psychosocial scales. Study results suggested that the
      treatment was safe, yet offered no overall symptomatic benefit to patients with
      mild-to-moderate Alzheimer's disease. Whether or not GM-1 therapy may offer
      protective benefit by slowing or arresting the progression of the disease remains
      unclear, since the results of the cognitive evaluations suggested that neither
      the GM-1 group nor the placebo group declined significantly during the 24-week
      study.

PMID- 2222248
TI  - Low-grade gliomas: to treat or not to treat? A radiation oncologist's viewpoint.

PMID- 2222247
TI  - Episodic hyperammonemia in adult siblings with hyperornithinemia, hyperammonemia,
      and homocitrullinuria syndrome.
AB  - A 39-year-old man and his 42-year-old sister, both vegetarians, had episodic
      confusion for many years, but their mental function was normal between those
      episodes. They were recently diagnosed with hyperornithinemia, hyperammonemia,
      and homocitrullinuria syndrome. Hyperammonemia was documented during an episode
      of confusion in the male sibling but not in his sister. Both had elevated plasma
      ornithine, glutamine, and alanine levels and persistently low plasma lysine
      levels. Homocitrulline was present in their urine, and orotic aciduria and
      orotidinuria developed in the male sibling following ingestion of allopurinol.
      Studies on their cultured skin fibroblasts showed deficient metabolism of
      ornithine, indicating a defect in ornithine transport across the mitochondrial
      membrane. During therapy with citrulline and phenylbutyrate sodium, plasma
      ornithine levels increased in both patients, while plasma levels of glutamine and
      alanine decreased to normal. Since therapy started, their clinical conditions
      have also improved, and no recurrent neurologic dysfunction has occurred during a
      follow-up period of 20 months.

PMID- 2222249
TI  - Congenital myopathy and cardiomyopathy with identical ultrastructural changes.
AB  - A 7-day-old girl with congenital hypotonia and unexplained episodes of
      bradycardia had a broad spectrum of similar skeletal muscle and myocardial
      degenerative ultrastructural abnormalities. Ultrastructural studies showed
      obliteration of cross striations, myofilament disorganization, streaming,
      smearing, clumping, and zigzag Z-band deformities. A decrease in glycogen,
      mitochondria, and T-tubular system occurred in the regions showing Z-band
      abnormalities of both skeletal muscle and myocardium. Concurrent structural
      cardiomyopathy should be considered in patients with congenital myopathies,
      particularly with unexplained cardiac conduction abnormalities or contractile
      insufficiency. Ultrastructural evaluation of skeletal and cardiac muscle may be
      necessary to define such disorders.

PMID- 2222250
TI  - Unusual cause of 'piriformis muscle syndrome'.
AB  - The piriformis muscle syndrome is a controversial "clinical" syndrome primarily
      characterized by signs and symptoms of sciatic nerve compression at the region of
      the piriformis muscle as it passes through the greater sciatic notch. The
      syndrome is often referred to; however, cases are rarely reported, and it is
      generally an uncommon diagnosis. Of those cases reported, the incidence is six
      times more frequent in females than in males, and is typically temporally related
      to minor pelvic or buttock trauma. We describe a case of a 40-year-old woman
      presenting with signs and symptoms suggestive of piriformis muscle syndrome
      following a gynecologic procedure performed in the dorsal lithotomy position.
      Electromyographic findings were consistent with this clinical entity. Operative
      exploration, however, revealed the source of neural compression to be a
      pseudoaneurysm of the inferior gluteal artery adjacent to the piriformis muscle.
      The diagnostic features of this clinical syndrome are discussed.

PMID- 2222252
TI  - The induction of reparative dentine in the amputated dental pulp of the dog by
      bone morphogenetic protein.
AB  - Reparative dentine was formed in the cavity of the amputated pulp when capped
      with crude allogeneic BMP. This began with a slight cell-mediated immune response
      and was followed by resorption of BMP and proliferation of migratory spindle
      shaped mesenchymal cells, together with vascular invasion. Four weeks
      postoperatively, there were osteodentinoblasts embedded in forming matrix and/or
      osteodentinocytes trapped within osteodentine in some parts of the cavity. Other
      parts were filled with pulpal tissue. Eight weeks postoperatively, odontoblasts
      were forming tubular dentine next to the osteodentine. In albumin-implanted
      controls, a little osteodentine and no tubular dentine were seen. These findings
      suggest that dissolved BMP stimulates mitosis of mesenchymal cells and may induce
      differentiation of osteodentinocytes. The resultant osteodentine may play some
      role in the differentiation of odontoblasts.

PMID- 2222251
TI  - A new assessment in vitro of human salivary lubrication using a compliant
      substrate.
AB  - The lubrication effect of salivary secretions was assessed in terms of separating
      a rigid object from a compliant substrate. There was little difference among the
      various secretions of a single donor. The viscosity of salivas increased as a
      function of time. Neither the friction testing nor viscometry provided an
      adequate model of the tissue-coating function ascribed to saliva.

PMID- 2222253
TI  - A morphometric, electron microscopic analysis of tissue channels shown by ionic
      tracer in normal and tensioned rat molar apical periodontal ligament.
AB  - A 1.0 newton continuous, extrusive load was applied to the right maxillary molar
      for 30 min to determine the presence of channels as shown by the distribution of
      tracer across the interstitial compartment of normal and tensioned PDL. Sodium
      ferrocyanide (1% w/v), perfused via the common carotid arteries, was the tracer
      probe and tris(ethylenediamine) cobalt III chloride (1% w/v) the precipitating
      ion. Left molar control PDL had an overall mean of 0.43 +/- 0.05/microns2 tissue
      channels at 0.2 microns from the vascular endothelium, and 0.15 +/- 0.04/microns2
      at 7-8 microns. On the experimental side, the overall mean number of tissue
      channels was 0.65 +/- 0.13/microns2 at 0-2 microns and 0.19 +/- 0.07/microns2 at
      7-8 microns. A significant depth effect (P less than 0.01) was present in the
      control and experimental interstitial tissues for tissue channels adjacent to the
      endothelium of different categories of vessel. Extrusion increased the tissue
      channel density adjacent to arterial capillaries (P less than 0.01), venous
      capillaries (P less than 0.01) and postcapillary-sized venules (P less than
      0.01). These findings implicate these three types of vessel as being functionally
      important in fluid exchange across endothelial boundaries in the PDL.

PMID- 2222254
TI  - The effects of a liquid diet on initial and sustained, stimulated parotid
      salivary secretion and on parotid structure in the rat.
AB  - Adult male rats were maintained on a nutritionally adequate liquid diet, or
      laboratory chow and water (controls), for 7 days. They were then anaesthetized
      and parotid flow was recorded after isoprenaline or pilocarpine stimulation, each
      collected over two, timed sampling periods--an initial 5 min and a subsequent 15
      min. The isoprenaline-induced flow rates in liquid diet rats were reduced to 45
      and 30% of those in control rats for the first and subsequent samples
      respectively (p less than 0.02). After pilocarpine stimulation there were no
      significant differences in the first samples, but in the subsequent samples the
      flow rate in liquid diet rats was reduced to 54% of that in controls (p less than
      0.001). The parotid gland weights were reduced by 35% in liquid diet rats
      compared to controls (p less than 0.05). On computerized planimetric analysis,
      parotids (from rats that had not been given secretagogues) had significantly
      smaller mean acinar areas, mean acinar profile perimeters and mean acinar
      transection diameters after liquid feeding (p less than 0.001). The findings
      support the notion that there is a functional reserve capacity available in
      atrophied glands to support the relatively fast flow that occurs on initial
      stimulation but which becomes exhausted during sustained stimulation. This
      exhaustion occurs more severely and more rapidly in the low-volume, protein-rich
      saliva elicited by sympathomimetic stimulation than in the high-volume, low
      protein saliva formed in response to parasympathomimetic stimulation.

PMID- 2222255
TI  - Evaporative water loss from human dentine in vitro.
AB  - The rate of spontaneous evaporation of water from dentine was measured in
      extracted human teeth in vitro. Spontaneous water loss was the same with or
      without a smear layer. When air was blown on the dentine, the rate of evaporation
      increased significantly. After removal of the smear layer, the air blast-induced
      evaporative loss was twice as great as before its removal. Thus, with a smear
      layer present, evaporation is the major route by which fluid is lost from dentine
      rather than by filtration of dentinal fluid. After smear layer removal, fluid
      filtration sometimes may exceed the spontaneous rate of fluid evaporation.

PMID- 2222256
TI  - Gingival crevicular fluid prostaglandins and gingival phospholipids in
      experimentally-induced periodontitis in the dog.
AB  - Prostaglandins are known to be mediators of inflammation in many tissues. Their
      fluctuations in gingival crevicular fluid during experimentally induced
      periodontitis were investigated, together with the possible role of
      phospholipids, which were measured in normal gingiva and gingiva associated with
      the chronic periodontitis. Periodontitis was induced in 5 dogs in the lower
      premolar quadrant; the opposite quadrant was used as a control. A small amount of
      inter-radicular bone was removed and then a cotton-wrapped stainless steel
      ligature was placed around each of 3 premolar teeth below the gingival margin to
      provide an inflammatory irritant. Pocket depth was measured by periodontal probe;
      crevicular fluid was collected on absorbent paper points. PGs were analysed by
      HPLC and the results expressed as ng PG/microliter crevicular fluid. Measurements
      were taken in both quadrants at 1, 3 and 6 weeks after placement of the
      ligatures; PGI2, 6 keto-F1 alpha, F2 alpha, E2, E1 and D2 were detected in the
      crevicular fluid. At 1 week, there was no difference in PG levels between
      experimental and control sides. During week 3, PGI2 and PGE2 increased in the
      experimental crevicular fluid [214.1 +/- 49.3 (SEM) vs control 87.0 +/- 39.7; p
      less than 0.05 and 350.0 +/- 115 vs 162.0 +/- 14.7; p less than 0.05,
      respectively]. At week 6, only PGE2 was elevated in crevicular fluid (207.7 +/-
      68.1 vs 99.2 +/- 45; p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222257
TI  - Computer-assisted estimation of lines of action of human masticatory muscles
      reconstructed in vivo by means of magnetic resonance imaging of parallel
      sections.
AB  - The orientation of these lines of action was estimated in 9 healthy subjects, by
      reconstructing the muscle shape from a series of parallel sections obtained by
      MRI. In order to gain insight into sources of error, the lines of action of the
      masseter and medial pterygoid were estimated from two mutually perpendicular
      series of sectional images. Average results were compared with anatomical data
      from the literature. The results indicated that the accuracy of the estimate was
      principally dependent on the reliability of the reconstructions; the average
      accuracy of the estimated orientations was about 5 degrees.

PMID- 2222258
TI  - A quantitative method for assessing changes in rat palatal histology under
      denture-like appliances.

PMID- 2222259
TI  - Langerhans cells in human chronic gingivitis and phenytoin-induced gingival
      hyperplasia.
AB  - Langerhans cell numbers in oral epithelium increase as dental plaque accumulates.
      The anti-convulsant drug phenytoin predisposes to gingival hyperplasia in certain
      patients who take this medication for epilepsy and who also have poor oral
      hygiene. In this study 7 patients with phenytoin-induced gingival hyperplasia
      were compared with 5 subjects with chronic marginal gingivitis. On initial
      examination and on completion of the hygiene phase of periodontal therapy (a
      period ranging from 3.0 to 4.25 months), clinical indices of plaque and
      gingivitis were recorded and biopsies were taken from the lower anterior labial
      gingiva. Frozen sections were stained by an immunoperoxidase technique using the
      monoclonal antibody OKT6, and the number of Langerhans cells in a defined cross
      sectional area was counted. In phenytoin-induced gingival hyperplasia there was a
      marked increase in Langerhans cells (13.8 +/- 0.45) when compared with chronic
      gingivitis (7.7 +/- 0.31; p less than 0.05). Both groups showed marked reductions
      in their plaque and gingival indices and numbers of Langerhans cells once
      treatment had been completed. However, levels of Langerhans cells in the drug
      induced hyperplasia remained significantly higher (3.5 +/- 0.26) than in chronic
      gingivitis (1.5 +/- 0.22; p less than 0.05).

PMID- 2222260
TI  - Expression of fibronectin and type I collagen by human dental pulp cells and
      gingiva fibroblasts grown on fibronectin substrate.
AB  - Specific antibodies and indirect immunoperoxidase labelling were used to study
      the intracellular production of collagen and fibronectin by cells grown on
      fibronectin-coated glass; the same cell populations seeded on uncoated glass were
      used as controls. Strong intracellular staining for type I collagen was seen in
      all cases, but immunostaining for fibronectin was very faint or negative in both
      gingival and pulp cells grown on the fibronectin substrate, in contrast to
      control cells. Thus, fibronectin substrate inhibited fibronectin synthesis by the
      cultured cells, but did not seem to influence type I collagen synthesis.

PMID- 2222261
TI  - Binding of salivary or serum proteins to Candida albicans in vitro.
AB  - This binding was investigated with a simplified method: whole saliva and mucin
      bound to C. albicans in significantly greater quantities than other proteins such
      as whole serum, albumin, lysozyme or fibrinogen; and the enzymatic treatment of
      C. albicans with chymotrypsin, papain or mannosidase decreased the amounts of
      these proteins bound. These results, taken together, suggest that salivary
      proteins or mucin may bind to the mannoprotein of C. albicans.

PMID- 2222262
TI  - Cryotherapy for retinopathy of prematurity: none, one, or both eyes.

PMID- 2222263
TI  - The choice of posterior chamber intraocular lens style in patients with diabetic
      retinopathy.

PMID- 2222264
TI  - Blindness and visual impairment in an American urban population.

PMID- 2222265
TI  - Blacks at greater risk for blindness.

PMID- 2222266
TI  - Teaching ophthalmology in medical schools.

PMID- 2222267
TI  - Too much eye surgery?

PMID- 2222268
TI  - A yellow-green posterior limbal ring in a patient who does not have Wilson's
      disease.

PMID- 2222269
TI  - Generalized giant-cell arteritis with coronary artery involvement and myocardial
      infarction.

PMID- 2222270
TI  - Band keratopathy from emulsified silicone oil.

PMID- 2222271
TI  - Federal agency to develop cataract management guidelines by January 1991.

PMID- 2222272
TI  - Do we have a nutritional treatment for age-related cataract or macular
      degeneration?

PMID- 2222273
TI  - The molecular genetics of Leber's hereditary optic neuropathy.

PMID- 2222274
TI  - Multicenter trial of cryotherapy for retinopathy of prematurity. One-year outcome
      -structure and function. Cryotherapy for Retinopathy of Prematurity Cooperative
      Group.
AB  - This study of the safety and efficacy of cryotherapy in treating severe
      retinopathy of prematurity registered 9751 infants with birth weights less than
      1251 g at 23 study centers. Two hundred ninety-one infants developed a defined
      threshold retinopathy of prematurity, and cryotherapy was performed in
      approximately half of the eyes through a randomization protocol. Twelve months
      after randomization, results of masked grading of fundus photographs of the
      posterior pole were similar to results obtained 3 months after randomization, and
      indicated an unfavorable outcome in 25.7% of the eyes that received cryotherapy
      compared with 47.4% of the control eyes (P less than .0001). For the first time,
      masked Teller Acuity Card assessment of grating acuity was performed in this
      study group and indicated an unfavorable functional outcome in 35.0% of the
      treated eyes compared with 56.3% of the control eyes (P less than .0001). These
      results indicate that cryotherapy reduces the risk of unfavorable retinal and
      functional outcome from threshold retinopathy of prematurity.

PMID- 2222275
TI  - Echographic features of the Vogt-Koyanagi-Harada syndrome.
AB  - Vogt-Koyanagi-Harada (VKH) syndrome represents a spectrum of bilateral panuveitis
      with associated central nervous system and dermatologic manifestations. The
      diagnosis is based on clinical and angiographic findings, but some of the
      characteristic features may be either absent or difficult to visualize in the
      presence of opaque media. With the use of standardized echography (standardized A
      scan and contact B-scan echography), we examined nine patients with clear media
      and clinical evidence of VKH syndrome. Consistent echographic findings included
      (1) diffuse, low to medium reflective thickening of the choroid posteriorly; (2)
      serous retinal detachment, located inferiorly or in the posterior pole; (3) mild
      vitreous opacities with no posterior vitreous detachment; and (4) thickening of
      the sclera and/or episclera posteriorly. Resolution of these findings occurred
      with systemic corticosteroid therapy. Standardized echography should be
      considered an important diagnostic tool in VKH syndrome, especially when
      visualization of the fundus is poor or when clinical presentation is atypical.

PMID- 2222276
TI  - Clinical and morphometric results of penetrating keratoplasty with one-piece
      anterior-chamber or suture-fixated posterior-chamber lenses in the absence of
      lens capsule.
AB  - The clinical records and serial corneal endothelial images of 25 acapsular,
      pseudophakic eyes with Kelman-style, one-piece, anterior-chamber intraocular
      lenses and 24 acapsular, pseudophakic eyes with suture-fixated, posterior-chamber
      intraocular lenses following penetrating keratoplasty were reviewed to determine
      clinical success and endothelial survival after 1 year. Twenty-two (88%) of 25
      grafts in the anterior-chamber intraocular lens group and 23 (96%) of 24 grafts
      in the sutured posterior-chamber intraocular lens group were clear after 1 year;
      best corrected visual acuity of 20/40 or better was noted in 25% of the eyes in
      the anterior-chamber intraocular lens group and 29% of the eyes in the sutured
      posterior-chamber intraocular lens group. The mean intraocular pressure for the
      anterior-chamber intraocular lens group was significantly lower than for the
      sutured posterior-chamber intraocular lens group at 3 months (17 +/- 4 vs 21 +/-
      7 mm Hg) and at 6 months (17 +/- 3 vs 20 +/- 5 mm Hg); but did not differ at 1
      year. The mean percent of endothelial cell loss after 1 year did not differ
      between the anterior-chamber intraocular lens group (32% +/- 26%) and the sutured
      posterior-chamber intraocular lens group (27% +/- 26%). No clinical or
      endothelial morphometric advantages were noted after 1 year for the suture
      fixated, posterior-chamber intraocular lens over the Kelman-style, one-piece
      anterior chamber, intraocular lens following pseudophakic penetrating
      keratoplasty; however, a long-term, prospective, randomized study of these two
      intraocular lens types is recommended.

PMID- 2222277
TI  - Botulinum vs adjustable suture surgery in the treatment of horizontal
      misalignment in adult patients lacking fusion.
AB  - Thirty patients were treated with either botulinum toxin or adjustable suture
      surgery in a prospective, randomized clinical trial. All patients had horizontal
      deviations greater than 10 prism diopters and absent fusion. Seventeen patients
      were assigned to toxin treatment, and 13 were assigned to surgical treatment.
      Follow-up at 6 months after either procedure indicated that surgery was superior,
      with patient alignment showing a 92.7% average net change, compared with a 50.50%
      net change in the botulinum-treated group. There was no difference in response
      between those patients with a starting deviation of 20 PD or less and greater
      than 20 PD in the surgery group. However, in the botulinum-treated group, those
      patients with a starting deviation of 20 PD or less seemed to show better
      responses than those patients with greater than 20 PD. Patients with esotropia
      showed an 88.89% change with surgery and a 51.55% change with toxin treatment.
      Patients with exotropia had a 95.83% change with surgery but a 50.3% change with
      toxin treatment. Since we had 20 patients with exotropia and 10 patients with
      esotropia, a more formal comparison would require larger numbers.

PMID- 2222278
TI  - Assessment of vitamin A status by a disk applicator for conjunctival impression
      cytology.
AB  - Conjunctival impression cytology was performed on 236 Indonesian preschool
      children, half of whom had mild xerophthalmia and half of whom were age-matched
      controls. We devised an applicator that applies a paper disk of fixed area to the
      conjunctiva with even pressure. The disk applicator was used to collect
      impression cytology specimens from the temporal bulbar conjunctiva of one eye
      while the original strip technique was used on the other eye. Mean (+/- SD) serum
      retinol values for children with normal and abnormal discs were 22.0 +/- 8.6
      micrograms/dL and 18.0 +/- 7.2 micrograms/dL P less than .0001). Mean serum
      values for normal and abnormal strips were 21.7 +/- 8.6 micrograms/dL and 19.0 +/
      7.7 micrograms/dL (P less than .03). Specimens obtained with the new disk
      applicator corresponded more closely with serum vitamin A levels and therefore
      vitamin A status than those obtained with the traditional strip technique.

PMID- 2222279
TI  - A comparison of wound healing in sutured and unsutured corneal wounds.
AB  - We compared corneal wound healing in 25 clear transplants with 26 keratotomy
      specimens and sutured and unsutured corneal wounds in a monkey model. Monkey
      wounds healed faster than human wounds, but healing time within the same species
      varied. Sutured wounds were characterized by subepithelial fibroplasia, recovery
      of collagen fiber continuity and absence of epithelial plugs. Unsutured wounds
      had no subepithelial fibroplasia but had fibroblasts and collagen fiber
      orientation parallel to wounds. Unsutured wounds in corneas containing sutures
      had subepithelial fibroplasia, and fibroblast orientation and fiber deposition
      parallel to the wound. Epithelial ingrowth and incarceration of Bowman's layer
      and/or Descemet's membrane in unsutured wounds appeared to disrupt wound healing.
      Abnormalities in wound healing in sutured or unsutured wounds are associated with
      lamellar distortion, a modified inflammatory response, and individual wound
      healing responses.

PMID- 2222280
TI  - S-antigen. Identification of human T-cell lymphocyte proliferation sites.
AB  - Immune responses to normal retinal proteins, including S-antigen, have been
      demonstrated in patients with a variety of retinal disorders, as well as in those
      who have received panretinal laser photocoagulation. T-cell lymphocytes (T cells)
      have been implicated in the pathogenesis of several ocular inflammatory diseases
      of possible autoimmune etiology. We used synthetic peptides that correspond to
      the amino acid sequence of S-antigen in lymphocyte proliferation assays to
      identify specific sites in the molecule recognized by human T cells. Ten patients
      with type II diabetes were studied before and after initial panretinal laser
      photocoagulation for proliferative diabetic retinopathy. T-cell responses,
      expressed as a stimulation index, to S-antigen and peptides were negative in all
      patients before treatment. Three weeks after panretinal laser photocoagulation,
      eight of 10 assays were positive (stimulation index greater than 2; P less than
      .01) when lymphocytes were stimulated with peptide BSA(273-292); six of nine were
      positive (P less than .01) with peptide BSA(303-332); and six of six were
      positive (P less than .001) with peptide BSA(343-362). Our study identifies
      several specific sites in S-antigen that elicit human immune responses. The
      implications of these findings with regard to the pathogenesis and treatment of
      autoimmune uveitis are discussed.

PMID- 2222281
TI  - Recurrent Acanthamoeba keratitis following penetrating keratoplasty.

PMID- 2222282
TI  - A two-stage technique for intraoperative fluid-gas exchange following pars plana
      vitrectomy.
AB  - We describe herein a two-stage technique of intraoperative fluid-gas exchange
      following pars plana vitrectomy. The first stage is a complete fluid-air exchange
      using an air pump and intraocular linear suction. The air pump then maintains the
      intraocular pressure at the desired level during adjunctive procedures, such as
      laser endophotocoagulation. The second stage is an air-gas mixture exchange in
      which the desired gas, premixed in air to the desired final intraocular
      concentration, is manually flushed through the eye. This technique allows the
      attainment of an accurate concentration of intraocular gas if the air-gas mixture
      exchange is complete. In vitro and in vivo experiments in aphakic human eyes
      demonstrated that an effectively complete air-gas mixture exchange occurs with a
      25-mL flush volume. This result compares favorably with the theoretical
      prediction derived from a "pharmacokinetic approximation" equation.

PMID- 2222283
TI  - [Relationship between years of methamphetamine use and symptoms of
      methamphetamine psychosis].
AB  - The authors researched the demographic characteristics of 233 patients with
      methamphetamine-associated disorders, and the relation between years of
      methamphetamine use and symptoms of methamphetamine psychosis. The results were
      as follows: There were more male users than females. However there were signs
      that the female users were gradually increasing. Users tended to be older, but
      users in their 20's and 30's continued to be predominant. Their school careers
      were usually limited and most of them had left school at a young age. Relations
      with a particular social group (e.g. organized gangs) has given most of them a
      chance to use methamphetamine. The symptoms that were seen with high frequency at
      the first examination were anxiety, fretfulness, auditory hallucination,
      insomnia, irritability, psychomotor excitement, delusion of persecution,
      suspicion, delusion of reference, mistake of circumstance, loss of appetite,
      affective disorder, hypobulia and personality change. With these symptoms, there
      is a possibility that five years of methamphetamine use is the turning point in
      terms of the frequency of symptoms occurrence. It was suggested that affective
      and perceptual disorders depend on the dose of methamphetamine, but abnormalities
      in thought subject may be deeply influenced by the patient's "feeling of social
      wrong". Emotional exhilaration and euphoria decreased as the number of years of
      methamphetamine use increased. These phenomena may be an indication of tolerance.
      The symptoms that were seen with high frequency at the last examination were
      hypobulia, affective disorder, personality change, insomnia, anxiety and
      fretfulness. The symptoms that were highly resistant to treatment were hypobulia,
      affective disorder, personality change, general malaise, hypochondriasis,
      insomnia, anxiety and fretfulness. It was suggested that five years of
      methamphetamine use may be a turning point in the residual rate of symptoms at
      the last examination after treatment, and also the resistance rate to treatment.
      Hypobulia and personality change became more evident during treatment.

PMID- 2222284
TI  - [Study of the antibody to alcohol altered hepatocyte plasma membrane in alcoholic
      patients].
AB  - Significance of the antibody to alcohol altered hepatocyte plasma membrane (AAHM)
      was studied in various types of alcoholic liver diseases (ALD). AAHM was detected
      in the sera that were collected within 3 months of alcohol abstinence from
      patients with various types of ALD, with higher frequency in alcoholic hepatitis
      and cirrhosis. Serum acetaldehyde, gamma-globulin fraction, immunoglobulin A and
      G were higher in patients positive for AAHM, though the levels of GOT, GPT, mGOT
      were indifferent of the existence of AAHM. Histologically, hepatocyte ballooning
      and pericellular fibrosis were frequently seen in patients positive for AAHM, but
      close relationship between the extent of necrosis and existence of AAHM was not
      observed. These findings suggest that the occurrence of AAHM is closely related
      with the functional and morphological changes of the hepatocyte induced by
      acetaldehyde but not with hepatocyte necrosis.

PMID- 2222286
TI  - [The use of Pugh score to evaluate the prognostic and therapeutic influence of
      drinking in patients with decompensated liver cirrhosis].
AB  - The aim of this study is to evaluate the clinical usefulness of Pugh score in the
      prognosis of the patients (pts.) with decompensated liver cirrhosis (DLC). To
      determine the influence of heavy drinking with respect to the prognosis of DLC
      patients, 128 cases of DLC were divided into two groups including the 31 heavy
      drinker group (Group A) and 97 non-alcoholic group (Group B). At the time of
      admission, the both groups showed similar Pugh score. However, after initial two
      hospitalized weeks, Group A started to show significantly lower points of Pugh
      score than that of in Group B. Fifteen pts. (48%) in Group A and 55 pts. (57%) in
      Group B had greater than 9 in Pugh score at the time of admission. In Group A, 10
      of 15 pts. declined the scores after initial two weeks and 9 of them lived more
      than one year after admission. In contrast, none of those 55 pts. in Group B
      declined their Pugh score after admission and 45 of them died within one year. It
      was concluded that Pugh score was extremely useful to evaluate the prognosis of
      DLC pts., and DLC pts. who had greater than 9 Pugh score were seemed to be
      critical. It was suggested that DLC pts. due to heavy drinking tend to improve
      Pugh score comparing to no alcoholic DLC pts.

PMID- 2222285
TI  - [Influence of alcohol ingestion on plasma gastrin and CCK levels in human
      beings].
AB  - We investigated the time courses of the plasma ethanol, acetaldehyde, gastrin and
      cholecystokinin (CCK) levels after the ingestion of ethanol (1g/kg, 21.5%,
      whisky) in healthy male adult volunteers. The ethanol level reached a peak at 15
      to 45 minutes after the ingestion and then decreased almost linearly. The
      acetaldehyde level of the group who became flushed after drinking (the F group)
      peaked earlier than that of the other group whose faces became only slightly
      flushed (the N group). The gastrin level increased significantly and remained
      elevated for about 3 hours. In three of the nine subjects, the CCK level
      increased 75 minutes after drinking. As a result, the absorption of the ingested
      ethanol is more rapid than 15 minutes, followed by a quick catabolism of the
      absorbed ethanol to acetaldehyde, but the catabolic action of acetaldehyde in the
      F group is later than that in the N group. The plasma gastrin level is certified
      to increase after the ingestion of ethanol and this is not mediated by
      acetaldehyde because the intra-venous infusion of acetaldehyde was not increased
      the plasma gastrin level in dogs. CCK which stimulate the pancreatic enzymes may
      be considered to have a possibility relating to the development of alcoholic
      acute pancreatitis but the ingestion of ethanol showed no increase of the plasma
      CCK level. But we cannot deny the possibility of the individual differences in
      the hormonal reaction in these experiments.

PMID- 2222287
TI  - Frequency specificity of the auditory brainstem response elicited by 1,000-Hz
      filtered clicks.
AB  - In normal-hearing subjects and in subjects with a flat cochlear hearing loss,
      auditory brainstem responses (ABR) were recorded at various levels of a 1,000-Hz
      filtered click stimulus with and without high-pass filtered masking noise. The
      difference in latency of the major peak in the ABR for the masked and unmasked
      condition was zero at the ABR threshold. We regard this as proof of the frequency
      specificity of the 1,000-Hz filtered click-stimulated ABR threshold. The
      difference between ABR threshold and the subjective puretone threshold at 1,000
      Hz amounted to 19 dB in normal-hearing subjects and to 10 dB in subjects with a
      flat cochlear hearing loss. This is probably related to loss of temporal
      integration and an abnormal loudness growth (recruitment).

PMID- 2222288
TI  - Influence of menopause on the auditory brainstem response.
AB  - Auditory brainstem response (ABR) wave latency, interpeak interval and amplitude
      as a function of intensity were measured in 40 subjects divided into equal groups
      of postmenopausal females, age-matched males and young adults of both sexes. The
      results illustrate that age and gender play a significant role in ABR wave
      latency and amplitude. A larger age effect occurred for the female subjects.
      While this does not dispute an anatomical explanation for the gender effect in
      ABR, hormonal changes accompanying menopause may also account for some of the
      gender differences noted in ABR.

PMID- 2222289
TI  - Evoked-response tone-on-tone masking in the chinchilla: effect of masker
      frequency.
AB  - Tone-on-tone masking patterns were measured at 0.5, 1, and 4 kHz using the
      auditory-evoked response from the inferior colliculus of the chinchilla. Masking
      profiles obtained with a masking level of 30 dB SPL were relatively symmetrical;
      however, as masker level increased, masking spread toward the high frequencies,
      particularly with the 0.5-kHz masker. For masker frequencies of 1 and 4 kHz, a
      low-threshold notch was observed in the masking profile 2/3 of an octave above
      the frequency of the masker. The low-threshold notch may represent a response to
      the distortion tone 2F1-F2. The notch was absent in the 0.5-kHz masking profile.
      The masking profiles obtained with the evoked response are somewhat wider, but
      otherwise qualitatively similar to those measured psychophysically in humans.
      Thus, the evoked-response procedure may provide a convenient way of evaluating
      the spread of masking and the presence of distortion tones in difficult-to-test
      subjects.

PMID- 2222290
TI  - Auditory steady-state responses in the rabbit.
AB  - The authors have studied auditory brainstem (ABRs), middle latency (MLRs) and
      steady-state potentials (SSRs) in 15 adult male rabbits weighing between 2.5 and
      3 kg in order to verify if SSRs are due to a mere superimposition of ABRs and
      MLRs or to a resonance phenomenon. Ten of them were awake while 5 were studied
      under urethane anesthesia. Acoustic stimuli consisted in 0.1-ms square-wave
      pulses delivered at presentation rates ranging between 1 and 80/s at a stimulus
      intensity of 80 dB p.e. SPL. Our data show that reliable auditory SSRs can be
      obtained in the rabbit at a presentation rate of 30 stimuli/s, probably due to
      the superimposition of ABRs and MLR Pb waves which show an interwave interval of
      about 35 ms. The nonlinear aspects which can be detected are probably due to the
      effect of decreasing interstimulus intervals on the duration and amplitude of the
      Pb wave. It can then be concluded that SSRs in the rabbit are due more to a
      superimposition of ABR and MLR waves than to a resonance phenomenon.

PMID- 2222291
TI  - Effect of sound-absorbing treatment on speech discrimination in rooms.
AB  - Noise and reverberation in a room affect speech discrimination. Sound-absorbing
      materials are used to shorten reverberation times. To find out the effect of
      acoustic treatment on speech discrimination, an acoustic refitting was carried
      out in a classroom and in a multipurpose hall. The normal-hearing test subjects
      perceived the word material (sentences, words and nonsense words) binaurally from
      the loudspeaker. The tests were repeated after the acoustic refitting of the
      rooms. The sound-absorbing treatment improved speech discrimination. In quiet,
      the improvement in discrimination was minimal or absent, but was well documented
      in a noisy environment. In rooms where speech communication takes place,
      attention should be paid to acoustic conditions: acoustic treatment can improve
      the quality of communication.

PMID- 2222292
TI  - Procedure learning effects in speech perception tests.
AB  - The effects of procedure learning were studied using data obtained from normal
      hearing subjects by presenting words under noise either in isolation or in the
      context of sentences. The data establish firmly an effect of procedure learning
      on the performance of subjects during a 1-hour testing session when the subjects
      have participated in a previous 1-hour testing session during which about 250
      test words were presented. The magnitude of the effect is equivalent to a shift
      in signal-to-noise ratio of the order of 1 dB.

PMID- 2222294
TI  - Unstable angina pectoris.
AB  - In recent years, there have been considerable advances in our understanding of
      the complex pathophysiology of unstable angina. A number of therapeutic options
      are now available. This article reviews current concepts of pathophysiology and
      summarises clinical features, natural history and available treatments.

PMID- 2222293
TI  - Aspirin and thrombolytic therapy in the management of acute myocardial
      infarction.
AB  - The use of aspirin and thrombolytic agents in the management of acute myocardial
      infarction is now accepted as standard clinical practice, but not all patients
      with heart attack are suitable for such therapy. This article provides practical
      guidelines for patient management and the background information on which these
      recommendations are based.

PMID- 2222295
TI  - Update on percutaneous transluminal coronary angioplasty and CABG.
AB  - Over the past decade percutaneous transluminal coronary angioplasty (PTCA) and
      coronary artery bypass grafting (CABG) have undergone substantial changes. The
      growth of PTCA has been phenomenal and it now accounts for about 50 per cent of
      revascularisation procedures at Royal Perth Hospital. Coronary surgery has
      undergone less growth, but it is now being successfully used in a much more
      elderly and high risk group of patients without an increase in mortality.

PMID- 2222296
TI  - Cardiac rehabilitation. The human face of heart disease.
AB  - Cardiac patients have a number of physical, psychological and social problems.
      With adequate rehabilitation, most patients can return to all their normal
      activities and lead enjoyable, productive lives.

PMID- 2222297
TI  - Cardiac failure. Current therapeutic concepts.
AB  - Reflection on basic mechanisms in cardiac failure gives an insight into the modes
      of therapy available in management. Therapeutic options have in the past two
      decades expanded markedly with enhanced quality and quantity of life. With end
      stage disease the option of a heart transplant is providing quality of life to
      increasing numbers of selected patients.

PMID- 2222298
TI  - Permanent cardiac pacemakers. Indications and current trends.
AB  - In Australia, most patients requiring permanent cardiac pacing have either high
      grade atrioventricular block or sick sinus syndrome. Many receive simple
      ventricular demand pacemakers, but more 'physiological' systems are now available
      that allow changes in pacing rate depending on metabolic needs. The indications
      for pacemakers and the types available are discussed in this article.

PMID- 2222300
TI  - Simple tests for carpal tunnel syndrome.

PMID- 2222299
TI  - Valvular heart disease. Part I: Diagnosis.
AB  - Cardiac murmurs are common. The general practitioner is often the first person to
      detect a murmur. These are often asymptomatic, yet may be a consequence of
      haemodynamically significant valve disease. Accurate assessment is important to
      allow intervention and to improve prognosis. The clinical features of each valve
      lesion and relevant cardiac investigations are discussed.

PMID- 2222301
TI  - Perceptions of the FRACGP examination. A study of Victorian candidates.
AB  - It is proposed that by 1995 Fellowship of the Royal Australian College of General
      Practitioners will be the only recognised endpoint of vocational training in
      general practice in Australia. Currently however only one in six eligible general
      practitioners and one in three college members holds the FRACGP in Victoria. This
      case-controlled study carried out by survey questionnaire was designed to compare
      and contrast perceptions of the FRACGP examination of a group of candidates with
      a group of demographically matched non candidates. The study suggested that those
      who sat the examination did so to improve their self esteem, and wished their
      knowledge, competence and skills to be 'peer reviewed'.

PMID- 2222302
TI  - Acute sore throat.
AB  - The second common problem to be presented in this series is the acute sore
      throat. The common causes are viral pharyngitis and tonsillitis due to
      streptococcus pyogenes. Another important cause that warrants attention is
      Epstein Barr virus (infectious mononucleosis) so that prescribing of penicillins
      is carefully considered. The sore throat may be the presentation of serious and
      hidden systemic diseases, such as blood dyscrasias, AIDS and diabetes (due to
      moniliasis).

PMID- 2222304
TI  - Penetrating gun injuries.

PMID- 2222303
TI  - James Montague Bonwick, OBE. Fifty six years a country doctor.

PMID- 2222305
TI  - Chest pain of unusual cause.

PMID- 2222306
TI  - Patient education. Your stuffy, running nose.

PMID- 2222307
TI  - Do you believe in miracles?

PMID- 2222309
TI  - Solving the problems of country practice.

PMID- 2222308
TI  - Cardiovascular risk factors.

PMID- 2222311
TI  - Panic and phobic disorders. Current cognitive behavioural strategies.
AB  - The past 5 years have seen the development of a number of treatment strategies
      suitable for panic and phobic disorders. At this stage, a combined drug and
      psychological approach is appropriate. Not all patients will accept medication. A
      number of cognitive-behavioural techniques can be used with hope of success.
      Sessions must include positive statements such as 'you can do it', 'be
      persistent', 'look forward to this activity' and 'I am achieving'.

PMID- 2222310
TI  - Current treatment concepts in depression.
AB  - Depression is a common disorder. While depressive symptoms are often transient
      and may be regarded as normal, 10 per cent of the population suffers depressive
      symptoms of sufficient severity and duration to be diagnosed as suffering a
      depressive illness.

PMID- 2222312
TI  - Depression in the elderly.
AB  - Depression in the elderly is an eminently treatable disease. It may masquerade as
      a pseudo dementia--a reversible condition with proper treatment. The need for an
      eclectic approach to management is emphasised and the special needs of the
      elderly outlined.

PMID- 2222313
TI  - Depression in children.
AB  - Unhappiness and transient feelings of depression are common normal experiences
      for many children. Persistent depressive illness occurs in about 2 per cent of
      children and seriously affects social, educational and emotional development.
      Treatment usually requires family therapy and behavioural and psychotherapeutic
      measures. Antidepressant medication has an occasional role in cases with a
      biological basis.

PMID- 2222314
TI  - Hospital and general practice co-operative initiatives in education.
AB  - All these developments demonstrate what can be achieved by the presence, within
      the teaching hospital system, of a person who is recognised as being responsible
      for general practice training. Considerable progress has been made, but it is
      emphasised that this has been an evolutionary process. Further, almost all the
      programmes and activities that have evolved have been built on ideas initiated by
      the Director of Ambulatory Paediatrics or were already in the minds of a number
      of people but not implemented because of other commitments. The co-ordinator has
      been in a position to adopt these ideas and put them into practice.

PMID- 2222315
TI  - The management of ingrown toenails.
AB  - Ingrown toenail is an unpleasant condition often affecting young people. Surgery
      is often necessary for its treatment. A simple office procedure is described,
      with details and special precautions, which results in few complications and
      generally a good outcome.

PMID- 2222316
TI  - The painful arm.
AB  - The painful arm often presents a diagnostic challenge. The cause is often
      obvious, especially with regional pain syndromes including the carpal tunnel and
      the tennis elbows. However, pain reference syndromes can be confusing and it is
      advisable to first examine the cervical spine because it is a common and often
      overlooked cause of arm pain or paraesthesia. It is common for arm pain to cause
      sleep disturbances and in such cases it is worth considering cervical causes,
      carpal tunnel syndrome and the thoracic outlet syndromes. The working rule is:
      patients with thoracic outlet syndrome cannot fall asleep; a carpal tunnel lesion
      wakes the patient in the middle of the night; and cervical spondylosis wakes the
      patient with pain and stiffness that persists well into the day.

PMID- 2222317
TI  - Diagnosis of patellofemoral pain syndrome.
AB  - This syndrome, also known as chondromalacia patellae, is characterised by pain
      and crepitus around the patella during activities that require flexion of the
      knee under loading, for example, climbing stairs.

PMID- 2222318
TI  - Patient education. Contraception while breastfeeding.
AB  - Practising an effective form of contraception while breastfeeding can do much to
      ease your mind and allow you to enjoy life more. There are many 'old wives'
      tales' about breastfeeding and contraception.

PMID- 2222319
TI  - Notable Australian doctors. Dr Cyril Checchi, country doctor.

PMID- 2222320
TI  - Infectious diseases. Report from ASID, 1990.

PMID- 2222322
TI  - Spatula sketches for kids.

PMID- 2222321
TI  - A Yankee bug in Oz.

PMID- 2222323
TI  - 'Sacked'.

PMID- 2222324
TI  - Storing polio vaccine.

PMID- 2222325
TI  - Twin registry.

PMID- 2222327
TI  - A query on rebates.

PMID- 2222326
TI  - Any tips for dealing with consulting room flashers?

PMID- 2222328
TI  - Patients and empowerment.

PMID- 2222329
TI  - The role of the RACGP.

PMID- 2222331
TI  - Long-term effects of intense sound on hair cells of Corti's organ and
      endocochlear DC potential.
AB  - Cochleograms of guinea pig ears were made 30-40 days after exposure to intense
      pure tones of 300 Hz, 500 Hz, 2 kHz, or 4 kHz at 130-150 dB SPL for 4-24 h. At 4
      kHz, hair cells in the basal turn disappeared totally, in the second turn
      moderately, and were relatively undamaged in the third and apical turns. At 500
      Hz, hair cells in the second and third turns were almost completely injured and
      at 300 Hz moderately damaged in the third and apical turns although the basal
      turn remained undamaged. At 2 kHz for 9 h, hair cells were almost completely
      injured in all turns. Negative endocochlear DC potential (negative EP) induced by
      furosemide was observed in the basal turn but not in the third turn of animals
      exposed to 300 Hz. Contrarily, negative EP was observed in the third turn but not
      in the basal turn of animals exposed to 4 kHz. We conclude that the hair cells of
      Corti's organ play an essential role in the production of negative EP.

PMID- 2222330
TI  - Laryngeal epithelial changes on effects of smoking and drinking.
AB  - The human larynx is essential not only for speech, but also for swallowing and
      respiration. Its tissues are affected by the presence of alcohol and cigarette
      smoke. In this report we present our findings on the effects of smoking and
      drinking on histological changes in laryngeal tissue. The larynges studied were
      those of autopsy patients: cases with damaged tissue were excluded. We studied
      the larynges of 84 men (non-smoker and non-drinker, 22 cases; smoker and drinker,
      62 cases) and 48 women (non-smoker and non-drinker, 40 cases; smoker and drinker,
      8 cases) between the ages of 12 and 88. The squamous metaplasia of laryngeal
      epithelium was examined using the gross staining method (Pyronin Y) of STELL et
      al. (J. Laryngeal. Otol. 86: 589-594, 1972). The squamous epithelium is
      unstained, whereas the respiratory epithelium is a brilliant red. The area of
      metaplasia in the supraglottic region increased with aging, tobacco and alcohol
      consumption. Microscopic changes of the laryngeal epithelium were investigated
      using the hematoxylin-eosin staining method. The thickness of epithelium of the
      supraglottic region and vocal cord increased with age. There is a significant
      difference in the thickness of the epithelium of the supraglottic region and
      vocal cords of smoking and drinking patients, when compared with the same tissues
      of non-smokers and non-drinkers. Furthermore, there is a significant difference
      in those tissues of the supraglottic region of heavy smokers, when compared with
      light smokers, but no significant difference when compared with drinkers.
      However, there is no significant difference in the thickness of vocal cord
      tissues when comparing light smokers and drinkers on the one hand, and heavy
      smokers and drinkers on the other.

PMID- 2222332
TI  - Autonomic indexes during the vestibular-visual conflict exposure: a squirrel
      monkey study.
AB  - To assess the dynamic changes of the autonomic neural responses evoked by
      vestibular-visual conflict (VVC) in the squirrel monkey, we analyzed the changes
      of salivary amount and sodium concentration, and the coefficient of variance (CV)
      of R-R intervals (RRI) along the time course of VVC exposure given in pitch
      plane. The sodium concentration and the amount of saliva showed clear increases
      at the first and second 15 min stimulation periods. The CV of RRI was found to
      increase over the entire periods of stimulation, and there was a significant
      difference between the rest value and those in stimulated periods. The
      correlation between the CV of RRI, and amount of salivation was highly positive.
      These results indicate the existence of a common pattern of autonomic neural
      response during VVC, and suggest usefulness of these indexes for objectively
      monitoring the severity of motion sickness.

PMID- 2222334
TI  - Sinus histiocytosis with massive lymphadenopathy in a Japanese male with symptoms
      of dyspnea and visual disturbance.
AB  - A case study of sinus histiocytosis with massive lymphadenopathy is reported. A
      Japanese male developed lymphadenopathy in the nasal cavity 10 years ago. Biopsy
      specimens demonstrated massive histiocytosis with phagocytosis of lymphocytes,
      plasmacytes, and erythrocytes. During the course of his illness, the patient
      experienced an episode of massive nasal bleeding, and a tracheotomy was performed
      because of dyspnea. He had also an operation by Killian's approach to relieve a
      visual disturbance. The patient has been treated with cyclophosphamide and
      prednisolone for 6 months.

PMID- 2222333
TI  - Cryosurgery of the inferior nasal turbinates.
AB  - Forty-seven patients with irreversible nasal obstruction due to inferior
      turbinate hypertrophy were treated by cryosurgery, the short and medium term
      results having been clinically evaluated. Permanent good results in nasal
      breathing were achieved in 83% of the patients. Failures are mostly related to
      turbinates hypertrophy due to nasal allergy. The combination of cryosurgery and
      nasal septoplasty, in cases of hypertrophy associated with deformities of nasal
      septum, gives an excellent result. Cryosurgery of hypertrophic nasal turbinates
      is a simple, safe, and reliable procedure to improve nasal breathing in cases of
      nasal turbinate hypertrophy.

PMID- 2222335
TI  - Maybe the patient has PTA?

PMID- 2222336
TI  - Dust, flies and my PC.

PMID- 2222337
TI  - Breast self-examination. A teaching role for nurses.

PMID- 2222338
TI  - Monitoring life.

PMID- 2222339
TI  - Member services under review.

PMID- 2222340
TI  - Towards a national nurse registering authority.

PMID- 2222341
TI  - Cardiac scare.

PMID- 2222342
TI  - Healthy alliances.

PMID- 2222343
TI  - The third age. Sexuality and sensuality.

PMID- 2222345
TI  - Are the safety limits safe?

PMID- 2222344
TI  - Drug delivery systems--oral and buccal.

PMID- 2222346
TI  - Fixing anomalies.

PMID- 2222347
TI  - Effect of eicosapentaenoic acid on restenosis rate, clinical course and blood
      lipids in patients after percutaneous transluminal coronary angioplasty.
AB  - In order to study the effects of eicosapentaenoic acid (Maxepa), Maxepa placebo
      and aspirin/dipyridamole combination on the clinical course and restenosis rate
      of atherosclerotic lesions after percutaneous transluminal coronary angioplasty
      79 men and 29 women were randomly divided into three treatment groups and
      restudied angiographically within one year of the procedure. Angina recurred less
      in the Maxepa group than in the other groups, although not statistically so.
      Restenosis rate was significantly reduced in the Maxepa group (11%) compared to
      the placebo group (30%) but, while less, was not significantly lower than in the
      aspirin/dipyridamole group (17%). Maxepa treatment appears to reduce restenosis
      rate of coronary artery lesions after percutaneous transluminal coronary
      angioplasty and may be an acceptable and equally effective alternative therapy to
      aspirin/dipyridamole.

PMID- 2222348
TI  - Length of hospital stay after acute myocardial infarction.
AB  - A number of trials show that long stay in hospital after an acute myocardial
      infarction (AMI) is not necessary for many patients and that stays of three-ten
      days may be adequate. All patients aged under 70 years with a diagnosis of AMI
      admitted to the seven public hospitals in the Lower Hunter Region of New South
      Wales are monitored as part of the WHO MONICA Study. Between August 1984 and
      December 1985 of 438 hospitalised patients with a 'definite' AMI according to
      MONICA criteria and a clinical discharge diagnosis of AMI, 386 (88%) patients
      were discharged alive from hospital. Four patients had lengths of stay between 46
      and 77 days and have been omitted from further analysis. The mean length of
      hospital stay was 13.6 days (95% confidence intervals 12.9 to 14.3 days); 74% of
      all patients stayed in hospital for more than ten days. The mean length of stay
      in the Coronary Care Unit (CCU) was 4.5 days (95% confidence intervals 4.2 to 4.8
      days) with 60% staying longer than three days. Mean hospital stay varied from
      10.5 to 17.4 days among the seven hospitals, although most of this variation was
      accounted for by three hospitals with few patients. Restricting analysis to the
      four hospitals with 90% of all the patients, multiple regression analysis showed
      that the CK enzyme levels, the evolution of Q waves on ECG, the presence of an
      anterior AMI and the use of nitrates and digoxin during hospitalisation were all
      associated with increased length of stay in hospital.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2222349
TI  - Does the emergency room electrocardiogram identify patients with suspected
      myocardial infarction who are at low risk of acute complications?
AB  - To determine the early morbidity of patients admitted to the coronary care unit
      (CCU) with inconclusive evidence of acute myocardial infarction, the prognostic
      value of the emergency room electrocardiogram (ECG) was examined prospectively in
      a blinded fashion in 410 patients presenting with acute chest pain. One hundred
      and forty one patients (34.4%) had an ECG that was normal, showed ST segment
      changes less than 1 mm, or was unchanged from a previous recording (group 1). The
      remaining patients (65.6%, group 2) had ECGs considered abnormal. Thirty-nine
      patients in group 1 and 226 in group 2 had confirmed infarction. There was one
      CCU death in group 1 (0.7%) versus 27 (10.0%) in group 2 (p less than 0.001) and
      the overall hospital mortality for group 1 was 2.1% versus 13.0% in group 2 (p
      less than 0.001). Twenty-eight patients (19.9%) from group 1 suffered
      complications in the CCU versus 155 (57.6%) from group 2 (p less than 0.001). No
      life-threatening arrhythmias occurred in group 1 versus occurrence in 47 patients
      (17.5%) in group 2 (p less than 0.001). The need for acute intervention was also
      less for group 1 versus group 2 patients, 14 (9.9%) and 85 (31.6%) respectively
      (p less than 0.001) with no patient requiring electrical cardioversion in group
      1. It is concluded that the emergency room ECG can reliably identify a group of
      low risk patients presenting with suspected myocardial infarction and so help in
      establishing priority for admission to the CCU. Furthermore, the risk-benefit of
      thrombolytic therapy in these low risk patients appears unacceptable.

PMID- 2222350
TI  - The effect of ageing on autonomic nervous system function.
AB  - We studied 76 healthy subjects (five-85 years) with a number of invasive and non
      invasive tests of autonomic function. Age related effects were found with the
      tests of predominantly vagal cardiovascular function. However, there were no age
      related effects found with the tests of predominantly sympathetic cardiovascular
      function. The age of the subject should be taken into consideration when
      evaluating tests of autonomic function and each laboratory should establish its
      own control values.

PMID- 2222351
TI  - Lack of airway response to nasal irritation in normal and asthmatic subjects.
AB  - Twenty two subjects (10 normals, nine asthmatics and three who had suggestive
      histories for asthma but normal bronchial histamine challenges) underwent nasal
      challenges with logarithmic incremental doses of histamine or saline on alternate
      days. Nasal resistance (measured by posterior rhinometry), and forced expiratory
      volume in one second (FEV1) were assessed after each dose of nasal histamine or
      placebo. After each nasal challenge (maximum nasal dose of 250 micrograms of
      histamine or doubling of nasal resistance) bronchial responsiveness was measured
      with a bronchial histamine challenge. Despite significant changes in nasal
      resistance with nasal histamine (p less than 0.01) there was no significant
      change in the forced expiratory volume in one second, or in bronchial
      responsiveness. We were unable to demonstrate nasobronchial reflexes initiated by
      acute irritation of the nasal mucosa with histamine in either normal subjects or
      in those with mild to moderate asthma.

PMID- 2222352
TI  - The influence of dialect group on peptic ulcer frequency amongst the Chinese in
      Singapore.
AB  - In Singapore, peptic ulcer is more common amongst Chinese than amongst Malays or
      Indians. Earlier work has suggested that, amongst female Chinese, Cantonese women
      are more susceptible to ulcer disease when compared to females of other dialect
      groups. The aim of the present study was to confirm or refute this possibility.
      The dialect group distribution of 897 Chinese patients with peptic ulcer
      (duodenal ulcer 601, gastric ulcer 296) was compared with that of non-ulcer
      dyspepsia patients and 1602 general medical patients attending the same medical
      units. The proportion of various dialect groups (including Cantonese) was similar
      in all patient groups. The proportion of ulcer patients presenting with
      haemorrhage was also similar in the different dialect groups. We conclude that no
      major dialect differences exist in peptic ulcer frequency amongst the Chinese in
      Singapore.

PMID- 2222353
TI  - An unusual case of variegate porphyria with possible homozygous inheritance.
AB  - We report an unusual case of variegate porphyria in a young girl with epilepsy,
      mental retardation and premature adrenarche. Symptoms of porphyria commenced
      about the age of 12 years and death occurred about 18 months later. The patient
      had very low protoporphyrinogen oxidase activity in her cultured fibroblasts.
      Both parents had half the normal activity of this enzyme in lymphocytes and are
      heterozygous for the abnormal gene for variegate porphyria. Therefore, it is
      possible that the patient was a homozygous variant. Anticonvulsant therapy and
      low hepatic 5 alpha reductase activity were probably other contributing factors
      to the severity of the condition in this patient.

PMID- 2222354
TI  - Pituitary apoplexy presenting as aseptic meningitis without visual loss or
      ophthalmoplegia.
AB  - Clinical and spinal fluid evidence of aseptic meningitis were the sole features
      at presentation in a patient with pituitary apoplexy. Visual impairment and
      bitemporal field defects developed later. Necrosis within a chromophobe adenoma
      was found at surgical decompression of the sella.

PMID- 2222355
TI  - Creutzfeldt-Jakob disease in a recipient of human pituitary-derived
      gonadotrophin.
AB  - A forty-year-old female presented with an unsteady gait 13 years after receiving
      an eight-month course of human pituitary-derived gonadotrophin injections as
      treatment for infertility. Over the next ten months the patient subsequently
      developed generalised myoclonic jerks and dementia and finally died.
      Neuropathological examination revealed changes in the brain consistent with
      Creutzfeldt-Jakob disease. This is the first reported case of Creutzfeldt-Jakob
      disease in a recipient of human derived gonadotrophin.

PMID- 2222356
TI  - Cardiovascular reflexes from cardiac sensory receptors.
AB  - The mammalian heart, especially its left ventricle, is densely innervated by
      sensory nerves. One set of these travels to the brainstem in the vagus nerves;
      the other to the spinal cord in sympathetic nerves. Excitation of vagal cardiac
      afferents, especially unmyelinated afferents from the left ventricle, cause a
      reflex bradycardia and fall in blood pressure and, under some conditions, a
      massive release of AVP. The sympathetic afferents convey the sensation of cardiac
      pain, but innocuous stimuli may cause a reflex tachycardia and rise in blood
      pressure. Both sympathetic and vagal cardiac afferents can be excited by
      mechanical distension of the heart (mechanoreceptors), and by a variety of
      foreign and endogenous chemical substances (chemosensitive receptors). It is not
      yet clear whether the effective natural stimulus to these receptors is
      mechanical, or through the chemical products of myocardial metabolism. Neither is
      it clear whether information from the heart exerts a minute-to-minute regulatory
      effect on the circulation, or whether it has a purely defensive role in the face
      of extreme disturbances of cardiac function. Cardiogenic reflexes are also
      thought to be the cause of haemodynamic and humoral disturbances that occur in
      clinical conditions such as myocardial ischaemia or infarction, left ventricular
      outflow obstruction, and acute reduction in central blood volume as well as
      during coronary angiography.

PMID- 2222357
TI  - Electrocardiographic identification of late potentials: a new noninvasive
      technique for identifying patients with ventricular tachycardia.

PMID- 2222358
TI  - Disseminated histoplasmosis in an AIDS patient.

PMID- 2222359
TI  - Neurological features of early and latent HIV.

PMID- 2222360
TI  - Cardiogenic brain embolism: role of anticoagulants.

PMID- 2222361
TI  - Permanent infertility in ewes exposed to plant oestrogens.
AB  - In Australia, more than 1 million ewes have permanently damaged reproductive
      tracts because they have been grazed on oestrogenic pasture. These effects occur
      in the absence of classical clinical "clover disease". The lesions result from an
      "organisational" action of oestrogen, causing a mild sexual transdifferentiation
      to occur in ewes during adult life, with the main lesion being found in the
      cervix. Diagnosis of the problem depends primarily on detection of the
      pathological changes, rather than history or clinical signs. On average, affected
      flocks have around a 10% increase in non-pregnant ewes, but most farmers can
      achieve an acceptable lambing rate by increasing their management and feed inputs
      to produce more twin lambs. Agronomic approaches have been used in the past to
      combat "clover disease", but further progress with the present problem may depend
      on the development of animal-based solutions.

PMID- 2222362
TI  - Streptococcus suis serotypes associated with disease in weaned pigs.
AB  - Streptococcus suis was recovered from 9 outbreaks of septicaemia and meningitis
      in weaned pigs between 1979 and 1983. Fifteen isolates from 7 outbreaks were
      identified as S. suis type 9, and 3 isolates from 2 outbreaks as S. suis type 2.
      Three further isolates of S. suis type 2 and an isolate of S. suis type 3 were
      recovered from cases of bronchopneumonia in weaned pigs from 4 other piggeries.

PMID- 2222363
TI  - Effects of zeranol implants on post-castration response in calves.
AB  - Suckling and yearling calves were surgically castrated and one half of each group
      implanted with 36 mg zeranol at time of castration. Both treated and control
      cattle of each class were maintained as a group and evaluated for swelling of the
      scrotum, inflammation and healing, plasma prostaglandin levels and weight gain.
      Swelling and inflammation of the scrotum were less in treated suckling calves
      than in controls at both 7 and 14 d after castration, though this difference was
      not statistically significant. In yearlings at 7 d after castration, treated
      cattle had more swelling than controls; however at 14 d, treated cattle had less
      swelling and inflammation with only one treated yearling having an open scrotal
      wound versus 6 (P less than .03) in the control group. Plasma prostaglandin
      levels as indicated by plasma malondialdehyde increased from d 0 to 14; however
      no significant treatment differences were observed for either age group. Suckling
      calves treated with zeranol gained 9.79 kg more (P less than .03) than non
      treated calves during the 97 d of trial while the yearlings treated with zeranol
      gained 16.78 kg more (P less than .01) than controls during 102 d. It is
      concluded from the increased growth and reduced scrotal swelling and inflammation
      in treated cattle that zeranol implantation could possibly have a beneficial
      effect in improving the healing process after castration.

PMID- 2222364
TI  - Yersiniosis in farmed deer.
AB  - Samples from 77 chital (Axis axis), 42 fallow (Dama dama), 26 red (Cervus
      elaphus), 7 rusa (Cervus timorensis) and 1 sambar deer (Cervus unicolor) were
      examined. Yersinia pseudotuberculosis infection was diagnosed as the cause of
      death in 6 (23%) of the red and 23 (30%) of the chital deer. Yersiniosis was the
      most common infectious cause of death diagnosed. Affected deer were usually found
      moribund or dead, often with faecal staining of the perineum. Gross pathology in
      chital included a fibrinous enterocolitis, enlarged congested mesenteric lymph
      nodes and multiple pale foci through the liver. Gross changes in red deer were
      limited to intense congestion of the intestinal mucosa and enlargement and
      congestion of mesenteric lymph nodes. Microscopic intestinal changes in both
      species consisted of microabscessation or diffuse suppurative inflammation of the
      intestinal mucosa with numerous bacterial colonies in the lamina propria.
      Multifocal suppurative mesenteric lymphadenitis was a common finding. Multifocal
      suppurative or non-suppurative hepatitis was frequently present in the liver of
      chital but was uncommon in the red deer. Yersiniosis occurred during the cooler
      months from June to November, with younger age classes most commonly affected. Y.
      pseudotuberculosis serotypes I, II and III were isolated in the ratio 17:3:0 in
      the chital deer and 1:1:2 in red deer. The clinical, epidemiological and
      bacteriological features are similar to those documented previously by New
      Zealand workers. The increased susceptibility to disease of red deer and chital
      compared to fallow deer and perhaps other species has not previously been
      documented.

PMID- 2222365
TI  - Thiamine deficiency in sheep exported live by sea.
AB  - Three shipments of sheep being exported live by sea were examined to determine
      their thiamine status. Measurements were made of thiamine concentration in liver
      and ruminal contents, transketolase activity in erythrocytes and thiaminase
      activity in ruminal liquor. Sheep that died or were clinically ill and euthanased
      had significantly lower hepatic and ruminal thiamine concentrations than
      clinically healthy control sheep. A high proportion had thiamine concentrations
      comparable to those found in sheep that die with polioencephalomalacia. Thiamine
      concentrations decreased with increasing time that sheep were in pre-embarkation
      feedlots and on board ship. Destruction of thiamine in the rumen by thiaminase
      was not a significant factor. Erythrocyte transketolase activities indicated that
      many of the sheep that arrived in the Middle East without signs of clinical
      disease were also in a state of thiamine insufficiency.

PMID- 2222366
TI  - Premature farrowings caused by feeding cottonseed meal.
AB  - Increasing the level of cottonseed meal (CSM) in sow diets from less than 5% to
      10% increased the incidence of premature farrowings (gestation length less than
      111 days) from 1.1% to 2.7% (p less than 0.001) and reduced the mean gestation
      length from 114.07 +/- 1.53 to 113.70 +/- 1.59 days (p less than 0.0001).
      Survival of piglets born prematurely was poor. After removal of CSM from the diet
      there was a residual effect lasting several weeks before the gestation length
      returned to normal. Experimental feeding of diets containing 20% and 40% CSM to
      small groups of sows caused significant shortening of gestation length and 3 of
      26 sows fed 40% CSM farrowed prematurely. The mechanism by which CSM causes this
      effect has yet to be determined.

PMID- 2222368
TI  - Kikuyu poisoning in goats and sheep.

PMID- 2222367
TI  - Cysticercus bovis in cattle in New South Wales.

PMID- 2222369
TI  - Treating lupin stubbles with alkali is unlikely to prevent lupinosis.

PMID- 2222370
TI  - Serum agglutinating antibodies to Leptospira interrogans serovar canicola
      presumed due to serovar robinsoni infection in an Australian dog.

PMID- 2222371
TI  - Resistance to Toxoplasma abortion in female goats previously exposed to
      Toxoplasma infection.

PMID- 2222372
TI  - Triclabendazole in the treatment of Fasciola gigantica infection in swamp buffalo
      (Bubalus bubalis).

PMID- 2222373
TI  - The sterility and productivity of young, short scrotum, merino rams.

PMID- 2222375
TI  - Genital pathology of feral male goats.
AB  - Genitalia from 1000 feral male goats derived from western Queensland and New
      South Wales were examined after slaughter at an abattoir and the prevalence of
      abnormalities determined. Ulcerative balanoposthitis, considered due to caprine
      herpesvirus infection, was observed in 11 animals (1.1%); acidophilic
      intranuclear inclusions were found in 7 of these. Other conditions included focal
      hypoplasia of seminiferous tubules in 2 bucks (0.2%), segmental aplasia of the
      epididymis (one buck, 0.1%), bulbourethral gland cysts with contained
      aggregations (33 bucks, 3.3%) and haemangiosarcoma of the bulbourethral gland in
      one animal. The low prevalence of several conditions such as spermatic granuloma,
      cryptorchidism, and testicular hypoplasia, was attributed largely to the fact
      that the bucks examined were horned so that the recognised association between
      genital abnormalities and polledness did not apply.

PMID- 2222374
TI  - The reproductive performance of farmed fallow deer (Dama dama) in New South
      Wales.
AB  - Observations on the reproductive performance of fallow deer on 47 farms in New
      South Wales were made over 6 consecutive years. The minimum fawning rate for does
      varied significantly (p less than 0.001) between years, the corresponding fawning
      percentages varying from 75.0% to 96.4%, with an overall mean of 88.8%. The
      weaning rate also varied significantly (p less than 0.001) between years, the
      corresponding percentages varying from 65.0% to 89.1% with a mean over 6 years of
      81.4%. Weaning rates were low given the known high fertility of fallow deer. The
      ratio of male to female fawns at weaning varied significantly (p less than 0.05)
      between years, although the ratio was exactly 1:1 for all births recorded over
      the 6-year period. The mean birthweights for female and male fawns were 4.01 kg
      +/- 0.61 (n = 330) and 4.23 kg +/- 0.72 (n = 348) respectively. Mean birthweights
      varied significantly (p less than 0.001) between the sexes and between years.
      There was a greater difference between birthweights of male and female fawns in
      years with higher mean fawn birthweight. Fawn birthweights generally approximated
      10% of the pre-rut weight of their mother. Handling of newborn fawns for tagging
      and weighting did not increase the chance of mismothering and rejection. The mean
      weaning weight for doe fawns and buck fawns over 6 years was 18.7 kg (n = 227)
      and 21.2 kg (n = 231) respectively, with a mean birth to weaning interval of
      108.4 +/- 4.89 (n = 458). Growth rates of male fawns from birth to weaning were
      significantly higher (p less than 0.01) than for female fawns, and the growth
      rates of fawns were significantly different (p less than 0.01) between
      years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222376
TI  - Vitamin A concentrations in commercial foods for dogs and cats.
AB  - The vitamin A concentration was determined in 89 Australian brands of commercial
      foods for dogs and cats. It was found that 8% of the dog foods and 14% of the cat
      foods had concentrations of vitamin A below the minimum recommended 1.1 mg/kg dry
      matter (dm) for dogs and 1.8 mg/kg dm for pregnant or lactating cats. Canned and
      fish-labelled cat foods were the only varieties with less than the minimum
      recommended concentration of Vitamin A, of which 71% were the same brand. The
      minimum recommended concentration of vitamin A was exceeded in all canned dog
      food tested. Concentrations of vitamin A in dry (ca. 6% moisture) dog and cat
      foods and semi-moist dog foods (ca. 23% moisture) never exceeded 10 mg vitamin
      A/kg dm. In contrast, canned pet foods stated to contain liver or kidney showed
      vitamin A concentrations from 13 to 284 mg/kg dm.

PMID- 2222378
TI  - Melioidosis in a koala.

PMID- 2222377
TI  - Evaluation of protection against experimental salmonellosis in sheep immunised
      with 1 or 2 doses of live aromatic-dependent Salmonella typhimurium.
AB  - The minimum number of doses of a live aromatic dependent (aro-) Salmonella
      typhimurium vaccine strain (SL1479), given by the intramuscular, oral or
      subcutaneous route required to protect sheep from experimentally-induced clinical
      salmonellosis, was determined. A significant reduction in mortalities and
      diarrhoea occurred in those sheep immunised with one or 2 intramuscular doses or
      2 subcutaneous doses. On the other hand, sheep immunised with one subcutaneous
      dose were not protected. Immunisation with one or 2 oral doses also resulted in a
      significant reduction in mortality, although reduction in the prevalence of
      severe diarrhoea was less consistent. Sheep immunised with a single intramuscular
      dose of aro- S. typhimurium developed high levels of serum antibodies and
      significant delayed-type cutaneous hypersensitivity response to homologous
      Salmonella lipopolysaccharide and flagellin, whereas those with a single oral
      dose did not. It was concluded that immunisation of sheep with a single oral or
      intramuscular dose of live aro- S. typhimurium reduced mortalities and the
      prevalence of diarrhoea in sheep due to infection with virulent S. typhimurium.

PMID- 2222379
TI  - Use of a dietary supplement in koalas during systemic antibiotic treatment of
      chlamydial infection.

PMID- 2222380
TI  - Electrocardiographic values of German shepherd dogs.

PMID- 2222381
TI  - Mortality in calves associated with the feeding of milk containing bronopol.

PMID- 2222383
TI  - Parvovirus B19. A workshop organized by the German Association against Virus
      Diseases. April 1989.

PMID- 2222382
TI  - Trapping sheep blowflies using bait-bins.

PMID- 2222384
TI  - Molecular approaches for production of B19 antigen.
AB  - Owing to the lack of a practical means of production of large quantities of virus
      in cell culture, present tests to screen for parvovirus antibody rely on the use
      of virus obtained from the sera of blood donors during the brief, intensely
      viraemic phase of acute infection (Cohen et al, 1983). Accordingly, antigen is
      scarce and testing for parvovirus antibody is confined to a few centres.
      Availability of recombinant antigen would make the test more widely available,
      and by circumventing the requirement for use of whole virus render the test safer
      (Cohen et al, 1988). Therefore, constructs of parvovirus DNA encompassing the
      region of the genome coding for the structural proteins in expression vectors
      with T7 or trc or tac promoters were made, and proteins produced by the resulting
      clones tested for their ability to react with B19 antibodies from human sera.
      Additionally, recombinant B19 DNA was used as a hybridization probe for virus in
      clinical specimens, and a sensitive polymerase chain reaction assay was
      investigated as a tool for parvovirus diagnosis.

PMID- 2222385
TI  - The influence of family support on chronic pain.
AB  - This study examined the role family support plays in insulating chronic pain
      patients from maladaptive behaviors associated with their pain. Two hundred and
      thirty-three patients who described their family as always being supportive and
      never having any conflicts were compared with 275 chronic pain patients who
      endorsed having family disharmony and limited support. One year after completing
      an out-patient pain program a random sample of 181 of these patients were
      followed to determine the extent to which family support influenced treatment
      outcome. The patients who reported having non-supportive families tended to have
      liability and work-related injuries, relied on medication, reported having more
      pain sites and used more pain descriptors in describing their pain. These
      patients also tended to show more pain behaviors and more emotional distress
      compared with pain patients coming from supportive families. On follow-up,
      patients who described their families as being supportive reported significantly
      less pain intensity, less reliance on medication and greater activity levels.
      They tended to be working and not to have gone elsewhere for treatment of their
      pain compared with patients who described their family as non-supportive. The
      results of this study demonstrate that perceived support is an important factor
      in the rehabilitation of chronic pain patients.

PMID- 2222386
TI  - Types and correlates of blood/injury-related vasovagal syncope.
AB  - This study investigated by interview, the initial syncopal episode of 103
      blood/injury-related vasovagal fainters in order to examine two competing
      hypotheses concerning their origins. Graham (Circulation, 23, 901-906, 1961)
      postulated that the faint resulted when sympathetic nervous system (SNS) activity
      ceased on termination of a threat, leaving parasympathetic nervous system (PNS)
      activation unopposed. Engel [Fainting (2nd edn), 1962; Annals of Internal
      Medicine, 89, 901-906, 1978] proposed that when in the face of threat with SNS
      activation, escape is blocked, the PNS becomes activated as the conservation
      withdrawal response, leading to syncope. We found cases clearly conforming to
      each of these formulations as well as some with characteristics of both, and some
      who fainted in response to blood or injury but with no perception of threat. The
      Graham and Engel types did not differ in terms of fear or avoidance of blood,
      injury, or medically-related situations nor did they differ in the frequency with
      which their parents reported blood/injury-related syncopal episodes. It is
      proposed that both may be activated by a common psychological mechanism involving
      cessation of a defensive posture. In contrast, the non-threat fainters showed
      significantly less medically-related avoidance and had a greater percentage (94%)
      of parents with positive faint histories.

PMID- 2222387
TI  - The relationship of appraisal and coping to chronic illness adjustment.
AB  - There is evidence that adaptation to chronic illness may be affected by
      psychological factors, especially how patients appraise and cope with the stress
      of their illness. The purpose of the present study was to examine the
      relationship of stress appraisal and coping responses to multiple behavioral
      indices of illness adjustment among patients with diverse chronic medical
      conditions. One hundred and one patients admitted to a multidisciplinary
      medicine/psychiatry unit completed measures of functional impairment, depression,
      symptom severity, and the Ways of Coping Checklist--Revised. Hierarchical
      regression analyses indicated that emotion-focused coping was positively related
      to poor psychosocial adjustment and depression after controlling for physician
      rated disease severity. Appraising chronic illness as holding one back predicted
      greater emotion-focused coping responses and poorer adjustment to illness. The
      use of problem-focused coping strategies was generally unrelated to illness
      adjustment. These findings suggest the presence of an emotion-focused coping
      triad consisting of wishful thinking, self blame, and avoidance, all of which
      appear to be maladaptive strategies when coping with chronic medical conditions.
      Implications for coping skills training and the need for longitudinal research is
      discussed.

PMID- 2222389
TI  - The Agoraphobia Scale: an evaluation of its reliability and validity.
AB  - This article presents the Agoraphobia Scale (AS), and evidence for its
      reliability, validity, and sensitivity to change after treatment. The scale
      consists of 20 items depicting various typical agoraphobic situations, which are
      rated for anxiety/discomfort (0-4) and avoidance (0-2). The results show that AS
      has high internal consistency. Regarding concurrent validity it correlated
      significantly with other self-reported measures of agoraphobia (Mobility
      Inventory and Fear Questionnaire). The scale's predictive validity was shown as
      it correlated with avoidance behavior and self-rated anxiety during both an
      individualized and a standardized behavioral test of agoraphobia. The AS also
      discriminated between an agoraphobic sample and a normal sample, and a sample of
      simple phobia patients. Finally, it was sensitive to changes after behavioral
      treatment. The AS is useful both as a state, and as an outcome self-report
      measure of agoraphobia.

PMID- 2222388
TI  - Long-term follow-up of migraine treatment: do the effects remain up to six years?
AB  - Fifty migraine subjects (constituting 79% of the originally treated sample)
      participated in a follow-up study to 6 yr after the end of treatment. Subjects
      had been treated with different forms of biofeedback methods (skin temperature,
      BVP of the temporal artery) and applied relaxation training. The assessment
      included 4 weeks of continuous self-monitoring of headache activity and
      medication usage, as well as a retrospective self-rating scale. The main results
      indicated that, on a group basis, headache reductions achieved at the end of
      treatment persisted for up to 6 yr, and were indeed enhanced during the follow-up
      period.

PMID- 2222391
TI  - Maudsley Obsessional-Compulsive Inventory: obsessions and compulsions in a
      nonclinical sample.
AB  - Obsessive-compulsive disorder is increasingly being studied in nonclinical
      samples. The self-report instruments used to select these samples, however, have
      not been validated with a diagnostic interview. This study thus investigated the
      predictive validity of the Maudsley Obsessional-Compulsive Inventory (MOCI) using
      the Anxiety Disorders Interview Schedule (ADIS), a semi-structured interview
      created according to DSM-III guidelines. Four sections of the ADIS--generalized
      anxiety disorder, simple phobia, social phobia and obsessive-compulsive disorder-
      were administered to 11 individuals who scored in the top 2% and 11 individuals
      who scored in the normal range of the MOCI 6-7 months prior to the interview.
      High nonclinical MOCI scorers reported more frequent and severe obsessions and
      compulsions as well as greater disturbance by these symptoms. In addition, the
      high MOCI group experienced more general worry and interference from worry, and
      more frequent and severe physiological symptoms when they worry. However, the two
      groups did not differ in terms of simple and social phobia symptoms. High MOCI
      scorers thus did not report a broad range of anxiety symptoms or fears, but
      specific obsessions and compulsions. These results provide further support for
      the validity of the MOCI in nonclinical samples over a 6-7 month interval.

PMID- 2222390
TI  - Behaviorally treated irritable bowel syndrome patients: a four-year follow-up.
AB  - Nineteen of 27 patients suffering from Irritable Bowel Syndrome (IBS) who had
      completed a multicomponent treatment involving progressive muscle relaxation,
      thermal biofeedback, cognitive therapy and IBS education were located and
      evaluated 4 yr posttreatment. Seventeen of 19 (89.5, or 63% of the total original
      sample) rated themselves as more than 50% improved. Six of the 12 patients (50%)
      who submitted symptom monitoring diaries met our criteria for clinical
      improvement, i.e. achieving at least a 50% reduction in primary IBS symptom
      scores. The means on all measures at long-term follow-up were lower than those
      obtained prior to treatment. When follow-up symptom means were compared with
      pretreatment means, significant (P less than 0.05) reductions were obtained on
      abdominal pain/tenderness, diarrhea, nausea, and flatulence.

PMID- 2222392
TI  - Obsessions and compulsions: psychometric properties of the Padua Inventory with
      an American college population.
AB  - The psychometric properties of the Padua inventory, a self-report measure of
      obsessive-compulsive behaviors, were examined in a sample of 678 American college
      students. Results showed good internal consistency as well as convergent and
      divergent validity with the subscales of the Symptom Checklist-90 Revised and the
      Maudsley Obsessional-Compulsive Inventory. A principal components analysis
      suggested a four factor solution (i.e. 'impaired control of mental activities',
      'checking', 'urges and worries of losing control of motor behaviors', and 'being
      contaminated'). The factor structure was very similar to that found in the
      original Italian study of the inventory. Suggestions are made for the use of the
      Padua Inventory in the study of obsessions and compulsions in nonclinical
      samples.

PMID- 2222393
TI  - The effectiveness of Dry Bed Training for nocturnal enuresis in adults.
AB  - Nine enuretic adults were successfully treated by the Dry Bed Training in a
      fairly short time (means = 15 weeks) including the retraining period for 3 Ss who
      relapsed after the therapy. There were no differences between primary and
      secondary (nocturnal) enuretics. The few relapses were neutralized by a short
      retraining. The study shows that this minimal intervention treatment is effective
      and efficient.

PMID- 2222394
TI  - Alcohol and correspondence between self-report and physiological measures of
      anxiety.
AB  - The present study was designed to determine the main effects of alcohol
      intoxication on self-report and physiological measures of anxiety. Second, we
      aimed to assess the role of the Marlowe-Crowne Social Desirability (MCSD) scale
      in predicting the relationship between self-report and physiological indices of
      anxiety irrespective of drink content. A final purpose of the study was to
      determine whether the MCSD could account for discrepancies in the effects of
      alcohol on the two anxiety response systems. Subjects were male social drinkers
      who received an 0.70 g/kg dose of alcohol or placebo. Results indicated that
      irrespective of drink content, subjects with high MCSD scores reported lower
      levels of anxiety than did subjects with low MCSD scores. This relationship was
      not evident for heart rate. These results for measures of anxiety were not
      influenced by drink content.

PMID- 2222395
TI  - Relationships between catastrophic cognitions and body sensations in anxiety
      disordered, mixed diagnosis, and normal subjects.
AB  - Clark's (Behaviour Research and Therapy, 24, 461-470, 1986) cognitive model
      proposes that panic attacks result from the catastrophic misinterpretation of
      certain body sensations. The present study examined correlations between feared
      body sensations and catastrophic cognitions. It was hypothesized that regardless
      of diagnostic status meaningful correlations between sensations and cognitions
      would be obtained. Three groups--anxiety disordered patients (n = 33), nonanxiety
      disordered patients (n = 57), and normals (n = 60)--completed the Agoraphobic
      Cognitions Questionnaire and the Body Sensations Questionnaire. Results generally
      supported the hypothesis and the cognitive model of panic and anxiety.
      Limitations of the correlational methodology are discussed, and treatment
      implications are noted.

PMID- 2222396
TI  - Heterogeneity of biofeedback training effects in spasmodic torticollis: a single
      case approach.
AB  - Data from 184 biofeedback sessions are presented, in which 10 subjects with
      spasmodic torticollis had been trained to reduce pathologic activity in the
      hypertrophied sternocleidomastoid muscle. Each session was conducted as a single
      case experiment with nine successive trials. Attempts were made to distinguish
      motor learning processes which can be elicited independently from the biofeedback
      condition from the effects of specific biofeedback information. Results showed
      dramatic decreases of muscle activity under biofeedback. Contrary to expectation,
      action potentials did not decrease across a course of 14 training sessions.
      Instead, effects were exhibited in an all-or-none fashion early in the training.
      Single-case ARIMA intervention analysis has shown that in 59% of the sessions EMG
      decreases demonstrated under biofeedback could be elicited prior to biofeedback
      in a condition of instructed control. Case studies revealed complex interactions
      of instructed control, specific biofeedback effects, unspecific effects of the
      biofeedback setting, and cognitive processes. Effects obtained within
      experimental sessions varied highly between subjects. Results are discussed in
      terms of newer concepts of basal ganglia dysfunction, and conclusions for the use
      of biofeedback paradigms in torticollis subjects are outlined.

PMID- 2222397
TI  - Analysis of GFA-protein mRNA expression in developing bovine brain by in situ
      hybridization and northern blot hybridization.
AB  - Using bovine brains of adult and developmental stages, the time and place of the
      appearance of mRNA for glial fibrillary acidic protein (GFA-protein) were studied
      by in situ- and Northern blot-hybridization. Double-stranded cDNA labeled with
      [3H]dCTP or [32P]dCTP was used as the probe for this mRNA. To compare the
      location of GFA-protein mRNA and GFA-protein itself on serial sections. GFA
      protein immunohistochemistry was used. By in situ hybridization with adult bovine
      brain. GFA-protein mRNA was detected in astroglia, most of which were in the
      white matter. The distribution of these astroglia by in situ hybridization was
      consistent with the findings by GFA-protein immunohistochemistry and Northern
      blot hybridization, indicating that each techniques were specific. Concerning
      fetal stages, GFA-protein mRNA could be detected in the brain of a fetal calf
      with a body length of 28 cm by in situ hybridization using the 32P-labeled probe,
      and the mRNA was localized in the subpial area and the fornix. These results
      indicated that glial maturation first became recognizable at least in the subpial
      area and the fornix in the brain of a fetal calf measuring 28 cm. In this fetal
      brain, GFA-protein mRNA was almost undetectable by Northern blot hybridization.
      This suggested that in situ hybridization was more sensitive and useful for the
      analysis of gene expression than Northern blot hybridization, when the target
      mRNA is present in only a limited area, such as in the brain.

PMID- 2222398
TI  - Hinf I restriction endonuclease digestion on human fixed metaphase chromosomes.
AB  - The authors report on the activity of Hinf I restriction endonuclease on human
      fixed metaphase chromosomes. Experiments performed by digesting chromosomes just
      after harvesting or after ageing in methanol-acetic acid displayed a different
      pattern of digestion on metaphases, since only aged preparations showed gaps on
      heterochromatic regions of chromosomes 1, 9 and 16 and C-like bands on other
      chromosomes. In this view, the authors suggest that structural modifications of
      the DNA, induced by acid fixation, can influence Hinf I activity on fixed
      metaphase chromosomes.

PMID- 2222399
TI  - Lectin binding to the egg envelopes in Eyprepocnemis plorans (Charp.)
      (Orthoptera, Acrididae).
AB  - The distribution of glycoconjugates in the egg envelopes of Eyprepocnemis plorans
      was investigated using various FITC-conjugated lectins. In the epichorion, the
      lectins ConA, SBA and WGA each have particular binding patterns, while TPA
      binding is confined to its deepest regions only. The glycoconjugates of the
      micropylar wall present different characteristics from those of the surrounding
      chorion. The vitelline coat shows a marked binding for WGA and TPA only; below
      the inner micropylar openings, this binding pattern is uniform over the whole
      extent of the coat and therefore it is not possible to identify specific binding
      sites for these two lectins. Contrary to what has been observed in some other
      insect species, the vitelline coat does not seem to be involved in the structural
      organization of the mycropyles.

PMID- 2222400
TI  - Langerhans cells in odontogenic tumours and cysts as detected by S-100 protein
      immunohistochemistry.
AB  - Immunohistochemical demonstration of S-100 protein in Langerhans cells (LCs) was
      made in odontogenic epithelial tumours (71 cases), radicular cysts (40 cases),
      follicular cysts (28 cases), odontogenic keratocysts (11 cases), primordial cysts
      (7 cases) and fissual cysts (6 cases). With the use of polyclonal antiserum
      against S-100 protein, positive LCs, dendrical or irregular in shape were found
      in tumour or cystic epithelia, and sometimes in stromal connective tissue.
      Incidence of positive S-100 staining LCs was 11 cases out of 61 ameloblastomas,
      22 cases out of 40 radicular cysts, 3 cases of 28 follicular cysts, and other
      lesions in both odontogenic tumours and cystic diseases lacked LCs. The cases
      with S-100 protein positive LCs were usually accompanied with a high degree of
      inflammatory infiltration in their lesions; on the contrary, the negative cases
      also generally lacked inflammatory responses.

PMID- 2222401
TI  - Chromogranin A as a marker of neuroendocrine histogenesis of tumours: an
      immunoelectron microscopic study with considerations about the influence of
      fixation and embedding media on immunolabelling.
AB  - The ultrastructural localization of chromogranin A (Chr A) was studied in eleven
      neoplasias of the diffuse neuroendocrine system (3 pancreatic islet-cell tumours,
      1 medullary carcinoma of the thyroid, 1 large bowel and 1 small bowel carcinoid
      tumours, 2 carcinoid tumours of the lung, 1 adenoma of the parathyroid gland, 2
      pheochromocytomas of the adrenal gland). On account of the great influence of the
      technical treatment of the samples on the immunolocalization of Chr A, the effect
      of the following variables was studied in a case of pheochromocytoma: fixation in
      glutaraldehyde versus paraformaldehyde, postfixation in osmium tetroxide versus
      omission, embedding in epoxy resin versus acrylic resin. The method of choice for
      the better preservation of the antigenic character of the tissue was found to be
      fixation in 4% paraformaldehyde, omission of osmium postfixation and embedding in
      LRWhite acrylic resin; by this procedure we were able to find Chr A in the
      neurosecretory granules of all the studied cases, using three commercially
      available antibodies directed against Chr A. These findings further confirm that
      Chr A is a reliable marker for the study of neuroendocrine neoplasias by electron
      microscopy.

PMID- 2222402
TI  - A geometrical construction to assess scanning technique in microphotometry.

PMID- 2222404
TI  - Synthesis and secretion of active lipoprotein lipase in Chinese-hamster ovary
      (CHO) cells.
AB  - Cultured Chinese-hamster ovary cells (CHO cells) were found to produce and
      secrete a lipase, which was identified as a lipoprotein lipase by the following
      criteria. Its activity was stimulated by serum and apolipoprotein CII, and was
      inhibited by high salt concentration. The lipase bound to heparin-agarose and co
      eluted with 125I-labelled bovine lipoprotein lipase in a salt gradient. A chicken
      antiserum to bovine lipoprotein lipase inhibited the activity and precipitated a
      labelled protein of the same apparent size as bovine lipoprotein lipase from
      media of CHO cells labelled with [35S]methionine. The lipase activity and
      secretion were similar in growing cells and in cells that had reached confluency.
      Hence, lipoprotein lipase appears to be expressed constitutively in CHO cells and
      is not linked to certain growth conditions, as in pre-adipocyte and macrophage
      cell lines. At 37 degrees C, but not at 4 degrees C, heparin increased the
      release of lipase to the medium 2-4-fold. This increased release occurred without
      depletion of cell-associated lipase activity, suggesting that heparin enhanced
      release of newly synthesized lipase.

PMID- 2222403
TI  - The role of transferrin in the mechanism of cellular iron uptake.

PMID- 2222406
TI  - Reversible effects of sphingomyelin degradation on cholesterol distribution and
      metabolism in fibroblasts and transformed neuroblastoma cells.
AB  - Plasma-membrane sphingomyelin appears to be one of the major determinants of the
      preferential allocation of cell cholesterol into the plasma-membrane compartment,
      since removal of sphingomyelin leads to a dramatic redistribution of cholesterol
      within the cell [Slotte & Bierman (1988) Biochem. J. 250, 653-658]. In the
      present study we examined the long-term effects of sphingomyelin degradation on
      cholesterol redistribution in cells and determined the reversibility of the
      process. In a human lung fibroblast-cell line, removal of 80% of the
      sphingomyelin led to a rapid and transient up-regulation (3-fold) of acyl
      CoA:cholesterol acyltransferase (ACAT) activity, and also, within 30 h, to the
      translocation of about 50% of the cell non-esterified cholesterol from a
      cholesterol oxidase-susceptible compartment (i.e. the cell surface) to oxidase
      resistant compartments. At 49 h after the initial sphingomyelin degradation, the
      cell sphingomyelin level was back to 45% of the control level, and the direction
      of cell cholesterol flow was toward the cell surface, although the original
      distribution was not achieved. In a transformed neuroblastoma cell line (SH
      SY5Y), the depletion of sphingomyelin led to a similarly rapid and transient up
      regulation of ACAT activity, and to the translocation of about 25% of cell
      surface cholesterol into internal membranes (within 3 h). The flow of cholesterol
      back to the cholesterol oxidase-susceptible pool was rapid, and a pretreatment
      cholesterol distribution was reached within 20-49 h. Also, the resynthesis of
      sphingomyelin was faster in SH-SY5Y neuroblastoma cells and reached control
      levels within 24 h. The findings of the present study show that the cellular
      redistribution of cholesterol, as induced by sphingomyelin degradation, is
      reversible and suggest that the normalization of cellular cholesterol
      distribution is linked to the re-synthesis of sphingomyelin.

PMID- 2222405
TI  - Phenobarbital induction of cytochromes P-450. High-level long-term responsiveness
      of primary rat hepatocyte cultures to drug induction, and glucocorticoid
      dependence of the phenobarbital response.
AB  - The induction of hepatic cytochromes P-450 by phenobarbital (PB) was studied in
      rat hepatocytes cultured for up to 5 weeks on Vitrogen-coated plates in serum
      free modified Chee's medium then exposed to PB (0.75 mM) for an additional 4
      days. Immunoblotting analysis indicated that P-450 forms PB4 (IIB1) and PB5
      (IIB2) were induced dramatically (greater than 50-fold increase), up to levels
      nearly as high as those achieved in PB-induced rat liver in vivo. The newly
      synthesized cytochrome P-450 was enzymically active, as shown by the major
      induction of the P-450 PB4-dependent steroid 16 beta-hydroxylase and
      pentoxyresorufin O-dealkylase activities in the PB-induced hepatocyte microsomes
      (up to 90-fold increase). PB induction of these P-450s was markedly enhanced by
      the presence of dexamethasone (50 nM-1 microM), which alone was not an affective
      inducing agent, and was inhibited by greater than 90% by 10% fetal bovine serum.
      The PB response was also inhibited (greater than 85%) by growth hormone (250
      ng/ml), indicating that this hormone probably acts directly on the hepatocyte
      when it antagonizes the induction of P-450 PB4 in intact rats. In untreated
      hepatocytes, P-450 RLM2 (IIA2), P-450 3 (IIA1) and NADPH P-450 reductase levels
      were substantially maintained in the cultures for 10-20 days. The latter two
      enzymes were also inducible by PB to an extent (3-4 fold elevation) that is
      comparable with that observed in the liver in vivo. Moreover, P-450c (IA1) and P
      450 3 (IIA1) were highly inducible by 3-methylcholanthrene (5 microM; 48 h
      exposure) even after 3 weeks in culture. In contrast, the male-specific pituitary
      regulated P-450 form 2c (IIC11) was rapidly lost upon culturing the hepatocytes,
      suggesting that supplementation of appropriate hormonal factors may be necessary
      for its expression. The present hepatocyte culture system exhibits a
      responsiveness to drug inducers that is qualitatively and quantitatively
      comparable with that observed in vivo, and should prove valuable for more
      detailed investigations of the molecular and mechanistic basis of the response to
      PB and its modulation by endogenous hormones.

PMID- 2222407
TI  - Uptake and metabolism of dipeptides by human red blood cells.
AB  - A function of the abundant cytoplasmic peptidases in red blood cells could be
      hydrolysis of oligopeptides circulating in plasma. To investigate whether human
      red blood cells actively transport dipeptides for this purpose, these cells were
      incubated with 14C-labelled glycylproline, glycylsarcosine, glycine, proline and
      alanine. There was uptake of each dipeptide, as indicated by their recovery as
      dipeptides in the cell cytoplasm. However, after a brief time (1-2 min) uptake of
      dipeptides abruptly ceased, while that of amino acids continued. As a result,
      after 30 min red blood cell uptake of amino acids was 5-13-fold greater than that
      of any dipeptide. Investigation of intracellular contents after 1 min of
      incubation revealed different metabolism for different dipeptides. The
      composition of intracellular radioactivity was 19-71% as intact dipeptides, 0-20%
      as free amino acids and 8-77% as neither dipeptides nor constituent amino acids.
      Investigation of the mechanism of dipeptide uptake by red blood cells showed: (1)
      a lack of hydrolysis by the plasma membrane, (2) no non-specific binding to the
      plasma membrane, and (3) a lack of saturation over a wide range of concentrations
      (0.05-50 mM). The data suggest that the mechanism of uptake of trace amounts of
      dipeptides by human red blood cells is either by simple diffusion or by a carrier
      system which has a very weak affinity for dipeptides. Upon entry, depending on
      the molecular structure, dipeptides are either hydrolysed or transformed into new
      compounds. The red blood cell uptake, however, does not appear to play any
      appreciable role in clearance of dipeptides from the plasma in the human.

PMID- 2222408
TI  - Identification of a single base change in a new human mutant glucose-6-phosphate
      dehydrogenase gene by polymerase-chain-reaction amplification of the entire
      coding region from genomic DNA.
AB  - We report the characterization at the molecular level of a mutant glucose-6
      phosphate dehydrogenase (G6PD) gene in a Greek boy who presented with a chronic
      non-spherocytic haemolytic anaemia. In order to identify the mutation from a
      small amount of patient material, we adopted an approach which by-passes the need
      to construct a library by using the polymerase chain reaction. The entire coding
      region was amplified in eight sections, with genomic DNA as template. The DNA
      fragments were then cloned in an M13 vector and sequenced. The only difference
      from the sequence of normal G6PD was a T----G substitution at nucleotide position
      648 in exon 7, which predicts a substitution of leucine for phenylalanine at
      amino acid position 216. This mutation creates a new recognition site for the
      restriction nuclease BalI. We confirmed the presence of the mutation in the DNA
      of the patient's mother, who was found to be heterozygous for the new BalI site.
      This is the first transversion among the point mutations thus far reported in the
      human G6PD gene.

PMID- 2222409
TI  - Inhibition and recognition studies on the glutathione-binding site of equine
      liver glutathione S-transferase.
AB  - Equine liver glutathione S-transferase has been shown to consist of two identical
      subunits of apparent Mr 25,500 and a pl of 8.9. Kinetic data at pH 6.5 with 1
      chloro-2,4-dinitrobenzene as a substrate suggests a random rapid-equilibrium
      mechanism, which is supported by inhibition studies using glutathione analogues.
      S-(p-Bromobenzyl)glutathione and the corresponding N alpha-, CGlu- and CGly
      substituted derivatives have been found, at pH 6.5, to be linear competitive
      inhibitors, with respect to GSH, of glutathione transferase. N-Acetylation of S
      (p-bromobenzyl)glutathione decreases binding by 100-fold, whereas N-benzoylation
      and N-benzyloxycarbonylation abolish binding of the derivative to the enzyme. The
      latter effect has been attributed to a steric constraint in this region of the
      enzyme. Amidation of the glycine carboxy group of S-(p-bromobenzyl)glutathione
      decreases binding by 13-fold, whereas methylation decreases binding by 70-fold,
      indicating a steric constraint and a possible electrostatic interaction in this
      region of the enzyme. Amidation of both carboxy groups decreases binding
      significantly by 802-fold, which agrees with electrostatic interaction of the
      glutamic acid carboxy group with a group located on the enzyme.

PMID- 2222410
TI  - Synthesis of carboxy-residue-modified coenzyme derivatives as probes to the
      mechanism of glutathione enzymes.
AB  - a general procedure for the preparation of the monoglycyl and dimethyl ester and
      amide derivatives of s-(4-bromobenzyl)glutathione are reported, in addition to
      purification procedures.

PMID- 2222411
TI  - Effects of variation in glutathione peroxidase activity on DNA damage and cell
      survival in human cells exposed to hydrogen peroxide and t-butyl hydroperoxide.
AB  - The selenium-dependent glutathione peroxidase activities of two human cell lines,
      the colon carcinoma HT29 and the mesothelioma P31, cultured in medium containing
      2% serum, increased from 195 to 541 and from 94 to 361 units/mg of protein
      respectively after supplementation with 100 nM-selenite. The catalase activity
      remained unchanged by this treatment. The effects of the obtained variation in
      glutathione peroxidase activities were investigated by exposing cells to H2O2 and
      t-butyl hydroperoxide. Selenite supplementation resulted in a decrease in H2O2
      induced DNA single-strand breaks in both HT29 and P31 cells. A small, but
      significant, decrease in the number of DNA single-strand breaks for low doses (10
      50 microM) of t-butyl hydroperoxide was found only in P31 cells and not in HT29
      cells. We could detect neither induction of double-strand breaks (detection limit
      approx. 1000 breaks per cell) nor DNA-protein cross-links after exposing the
      cells to the two peroxides. In spite of the apparent protective effect of
      increased glutathione peroxidase activity on DNA single-strand break formation,
      there were no differences between selenite-supplemented and non-supplemented
      cells in cell survival after exposure to peroxide.

PMID- 2222412
TI  - Highly purified bile-canalicular vesicles and lateral plasma membranes isolated
      from rat liver on Nycodenz gradients. Biochemical and immunolocalization studies.
AB  - 1. A liver canalicular plasma-membrane fraction enriched 115-155-fold in five
      marker enzymes relative to the tissue homogenate was obtained by sonication of
      liver plasma membranes followed by fractionation in iso-osmotic Nycodenz
      gradients. 2. Two lateral-plasma membrane fractions were also collected by this
      procedure; the lighter-density fraction was still associated with canalicular
      membranes, as assessed by enzymic and polypeptide analysis. 3. The polypeptide
      composition of the domain-defined plasma-membrane fractions was evaluated. It was
      demonstrated by immunoblotting that the 41 kDa alpha-subunit of the inhibitory G
      protein, associated in high relative amounts with canalicular plasma-membrane
      fractions, was partially lost in the last stage of purification; however, this
      subunit was retained by lateral plasma membranes. 4. Antibodies to the proteins
      of bile-canalicular vesicles were shown to localize to the hepatocyte surface in
      thin liver sections examined by immunofluorescent and immuno-gold electron
      microscopy. Two subsets of antigens were identified, one present on both
      sinusoidal and canalicular plasma-membrane domains and another, by using antisera
      pre-absorbed with sinusoidal plasma membranes, that was confined to the bile
      canalicular domain.

PMID- 2222413
TI  - Differential regulation of the HepG2 and adipocyte/muscle glucose transporters in
      3T3L1 adipocytes. Effect of chronic glucose deprivation.
AB  - Glucose transport in 3T3L1 adipocytes is mediated by two facilitated diffusion
      transport systems. We examined the effect of chronic glucose deprivation on
      transport activity and on the expression of the HepG2 (GLUT 1) and
      adipocyte/muscle (GLUT 4) glucose transporter gene products in this insulin
      sensitive cell line. Glucose deprivation resulted in a maximal increase in 2
      deoxyglucose uptake of 3.6-fold by 24 h. Transport activity declined thereafter
      but was still 2.4-fold greater than the control by 72 h. GLUT 1 mRNA and protein
      increased progressively during starvation to values respectively 2.4- and 7.0
      fold greater than the control by 72 h. Much of the increase in total
      immunoreactive GLUT 1 protein observed later in starvation was the result of the
      accumulation of a non-functional or mistargeted 38 kDa polypeptide.
      Immunofluorescence microscopy indicated that increases in GLUT 1 protein occurred
      in presumptive plasma membrane (PM) and Golgi-like compartments during prolonged
      starvation. The steady-state level of GLUT 4 protein did not change during 72 h
      of glucose deprivation despite a greater than 10-fold decrease in the mRNA.
      Subcellular fractionation experiments indicated that the increased transport
      activity observed after 24 h of starvation was principally the result of an
      increase in the 45-50 kDa GLUT 1 transporter protein in the PM. The level of the
      GLUT 1 transporter in the PM and low-density microsomes (LDM) was increased by
      3.9- and 1.4-fold respectively, and the GLUT 4 transporter content of the PM and
      LDM was 1.7- and 0.6-fold respectively greater than that of the control after 24
      h of glucose deprivation. These data indicate that newly synthesized GLUT 1
      transporters are selectively shuttled to the PM and that GLUT 4 transporters
      undergo translocation from an intracellular compartment to the PM during 24 h of
      glucose starvation. Thus glucose starvation results in an increase in glucose
      transport in 3T3L1 adipocytes via a complex series of events involving increased
      biosynthesis, decreased turnover and subcellular redistribution of transporter
      proteins.

PMID- 2222414
TI  - Determination by photoaffinity labelling of the hydrophobic part of the binding
      site for acyl-CoA esters on acyl-CoA-binding protein from bovine liver.
AB  - Acyl-CoA esters containing the photoreactive acids 12-(4'-azido-2'
      nitrophenoxy)[1-14C]dodecanoic acid ([14C]AND-acid) or N-(4'-azido-2'-nitro-[3'
      5'-3H]phenyl)-12-aminododecanoic acid ([3H]NANPA-acid) were synthesized. The
      photoreactive acyl-CoA esters could be bound to bovine acyl-CoA-binding protein
      (ACBP) and photocrosslinked to the protein. The photocrosslinked acyl-CoA-ACBP
      complex was separated from unlabelled ACBP on reverse-phase h.p.l.c. and the
      purified complex was digested with trypsin, Staphylococcus aureus V8 proteinase
      or endoproteinase Asp-N. By four independent peptide maps it was shown that the
      amino acids taking part in forming the hydrophobic binding site for acyl-CoA
      esters in bovine ACBP are located on the peptide segment from Asp21 to Asp38.
      Both photoreactive acyl-CoA esters used in this study labelled strongly in the
      segment from Tyr28 to Ala34. 12-(4'-Azido-2'-nitrophenoxy)[1-14C]-dodecanoyl-CoA
      ([14C]AND-CoA) also introduced a label at position Asp38, but o labelling was
      found before Ser29. In contrast, N-(4'-azido-2'-nitro[3',5'-3H]phenyl)-12
      aminododecanoyl-CoA [3H]NANPA-CoA) also labelled the segment from Asp21 to Tyr28.
      The difference in labelling by the two photoreactive ligands is most likely
      caused by different mobility of the arylazido group when linked to the fatty acid
      either through a phenolic O- or an anilinic N- bond.

PMID- 2222415
TI  - There are two major types of skeletal keratan sulphates.
AB  - High-field 1H-n.m.r.-spectroscopic studies supported by chemical carbohydrate
      analyses show that skeletal keratan sulphates (KS-II) of bovine origin may be sub
      classified into two groups. Keratan sulphate chains from articular and
      intervertebral-disc cartilage (KS-II-A) contain two structural features, namely
      alpha(1----3)-fucose and alpha(2----6)-linked N-acetyl-neuraminic acid residues,
      that are absent from keratan sulphates from tracheal or nasal-septum cartilage
      (KS-II-B).

PMID- 2222416
TI  - Liberation of tryptic fragments from caseinomacropeptide of bovine kappa-casein
      involved in platelet function. Kinetic study.
AB  - Carbohydrate-free caseinomacropeptide (CMP) was purified from rennet-hydrolysed
      caseinate by trichloroacetic acid precipitation and DEAE-TSK Fractogel-650 ion
      exchange chromatography. To study the liberation of 106-112, 106-116 and 113-116
      fragments from carbohydrate-free CMP involved in platelet function, a
      quantitative study was made on the rate of hydrolysis of the three peptidic bonds
      that are susceptible to the action of trypsin. Data were obtained from reverse
      phase (Ultrabase column) and cationic-exchange (Mono S column) h.p.l.c. On the
      basis of the disappearance of substrate, kcat. and Km were respectively 3.95 s-1
      and 0.2 mM. The two 111-112 and 112-113 bonds were split according to similar
      kinetic parameters (kcat. = 1.97 s-1, Km = 0.2 mM) and much faster than the 116
      117 bond. The difference in susceptibility of the bonds can probably be
      attributed to the nature of residues flanking the primary proteolytic sites
      rather than to their accessibility to the proteinase. On the basis of our results
      the 106-116 fragment cannot be formed.

PMID- 2222417
TI  - Use of ATP, dATP and their alpha-thio derivatives to study DNA ligase
      adenylation.
AB  - Bacteriophage-T4 and human type I DNA ligases were found capable of self
      adenylating upon exposure to both ribo- and deoxyribo-[alpha-35S]thio-ATP.
      However, the joining reaction does not take place in the presence of the
      deoxyribotriphosphates. Enzyme adenylation is reversed in all cases by an excess
      of PPi, but the rate of reversion is lower with thio derivatives. Therefore thio
      derivatives can be used to study the adenylation of DNA ligases and to search for
      specific inhibitors of the first step of the ligation reaction. In addition we
      show that thio derivatives can be used to detect DNA ligase adenylation activity
      covalently bound to a solid matrix.

PMID- 2222418
TI  - Effect of local anaesthetics on mitochondrial membrane potential in living cells.
AB  - Using the laser dye rhodamine 123, we demonstrated that local anaesthetics can
      reach mitochondria in cell culture and reversibly decrease, or even collapse,
      their transmembrane potential. This effect is highly dependent on the lipid
      solubility of the local anaesthetic and can be facilitated by the presence of a
      lipophilic anion.

PMID- 2222419
TI  - Evidence by chemical modification that tryptophan-104 of the cysteine-proteinase
      inhibitor chicken cystatin is located in or near the proteinase-binding site.
AB  - The single tryptophan residue Trp-104 of chicken cystatin was modified with a 2
      hydroxy-5-nitrobenzyl group. The change of the absorption spectrum of this group
      on binding of the modified cystatin to papain indicated a decreased environmental
      polarity of the probe. The modified inhibitor had about a 10(5)-fold lower
      affinity for papain than had intact cystatin, this being due to a higher
      dissociation rate constant. These results show that Trp-104 of cystatin is
      located in or near the proteinase-binding site of the inhibitor, in agreement
      with a model proposed from computer docking Experiments.

PMID- 2222420
TI  - Expression and processing of procholecystokinin in a rat medullary thyroid
      carcinoma cell line.
AB  - A rat medullary thyroid carcinoma cell line, CA-77, was shown to express the
      cholecystokinin (CCK) gene. Measurements using a library of sequence-specific
      radioimmunoassays before and after enzymic treatment of extracts and
      chromatographic fractions showed that the cells contained 1.0 pmol of alpha
      carboxyamidated cholecystokinins/10(6) cells, 0.4 pmol of glycine-extended
      intermediates/10(6) cells and 1.0 pmol of further C-terminal-extended pro
      CCK/10(6) cells. Gel chromatography and reverse-phase h.p.l.c. revealed both
      sulphated and nonsulphated CCK-8 in the cells. The growth medium contained in
      addition alpha-amidated CCK-33, glycine-extended CCK-8 and pro-CCK. Exposure to
      0.1 microM-dexamethasone for 6 days increased the cellular content and secretion
      of all of the described CCK peptides by 2-3-fold. The increase was first noted
      after 3 days of treatment. Monensin inhibited the synthesis of alpha
      carboxyamidated CCK and the secretion of all of the CCK forms measured.
      Colchicine at a low concentration (0.2 mumol/l) apparently increased the
      synthesis and secretion of alpha-carboxyamidated CCK, whereas higher
      concentrations inhibited CCK synthesis. Finally, chloroquine inhibited the alpha
      carboxyamidation of CCK. We conclude that the CA-77 cell line is a useful tool
      for studies of the expression and post-translational processing of pro-CCK.

PMID- 2222421
TI  - Lipoamidase is a multiple hydrolase.
AB  - The substrate specificity of lipoamidase, purified from the pig brain membrane
      with lipoyl 4-aminobenzoate (LPAB) as a substrate, was extensively studied. This
      single polypeptide was found to hydrolyse the bonding between amide, ester and
      peptide compounds. However, stringent structural requirements were found in the
      substrates, e.g. LPAB was hydrolysed, whereas biotinyl 4-aminobenzoate was not,
      as stated in our previous paper [Oizmui & Hayakawa (1990) Biochem. J. 266, 427
      434]. The enzyme specifically recognized the whole molecular structure of the
      substrate, whereas it loosely recognized the bond structure of the substrate;
      e.g. the dipeptide Asp-Phe was not hydrolysed, whereas the methyl ester of Asp
      Phe (aspartame) was. The exopeptidase activity was demonstrated by lipoamidase;
      however, longer peptides than the hexamer seemed not to be substrates. Lipoyl
      esters, which were electrically neutral, exhibited higher specificity with longer
      acyl groups. Molecular mass and molecular hydrophobicity (hydropathy) seemed to
      determine the substrate specificity. Lipoyl-lysine, acetylcholine and
      oligopeptides were hydrolysed at similar Km values; however, acetylcholine was
      hydrolysed at a velocity 100 times higher. Although many similar specificities
      were found between electric eel acetylcholinesterase and lipoamidase, distinctly
      different specificity was demonstrated with lipoyl compounds. The role of
      lipoamidase, which resides on the brain membrane and possesses higher specificity
      for hydrophobic molecules, remains to be elucidated.

PMID- 2222424
TI  - Formation of the lignan, (-) secoisolariciresinol, by cell free extracts of
      Forsythia intermedia.
AB  - A crude cell-free extract from Forsythia intermedia catalyses the formation of (
      )secoisolariciresinol, and not its (+) enantiomer, when incubated with coniferyl
      alcohol in the presence of NAD(P)H and H2O2. This is the first report of an
      enzyme reaction specifically involved in the coupling reaction between two
      phenylpropanoid monomers to afford an optically pure lignan.

PMID- 2222422
TI  - Human liver iduronate-2-sulphatase. Purification, characterization and catalytic
      properties.
AB  - Human iduronate-2-sulphatase (EC 3.1.6.13), which is involved in the lysosomal
      degradation of the glycosaminoglycans heparan sulphate and dermatan sulphate, was
      purified more than 500,000-fold in 5% yield from liver with a six-step column
      procedure, which consisted of a concanavalin A-Sepharose-Blue A-agarose coupled
      step, chromatofocusing, gel filtration on TSK HW 50S-Fractogel, hydrophobic
      separation on phenyl-Sepharose CL-4B and size separation on TSK G3000SW Ultrapac.
      Two major forms were identified. Form A and form B, with pI values of 4.5 and
      less than 4.0 respectively, separated at the chromatofocusing step in
      approximately equal amounts of recovered enzyme activity. By gel-filtration
      methods form A had a native molecular mass in the range 42-65 kDa. When analysed
      by SDS/PAGE, dithioerythritol-reduced and non-reduced form A and form B
      consistently contained polypeptides of molecular masses 42 kDa and 14 kDa.
      Iduronate-2-sulphatase was purified from human kidney, placenta and lung, and
      form A was shown to have similar native molecular mass and subunit components to
      those observed for liver enzyme. Both forms of liver iduronate-2-sulphatase were
      active towards a variety of substrates derived from heparin and dermatan
      sulphate. Kinetic parameters (Km and Kcat) of form A were determined with a
      variety of substrates matching structural aspects of the physiological substrates
      in vivo, namely heparan sulphate, heparin and dermatan sulphate. Substrate with 6
      sulphate esters on the aglycone residue adjacent to the iduronic acid 2-sulphate
      residue being attack were hydrolysed with catalytic efficiencies up to 200 times
      above that observed for the simplest disaccharide substrate without a 6-sulphated
      aglycone residue. The effect of incubation pH on enzyme activity towards the
      variety of substrates evaluated was complex and dependent on substrate aglycone
      structure, substrate concentration, buffer type and the presence of other
      proteins. Sulphate and phosphate ions and a number of substrate and product
      analogues were potent inhibitor of form A and form B enzyme activities.

PMID- 2222423
TI  - The endogenous functional turkey erythrocyte and rat liver insulin receptor is an
      alpha 2 beta 2 heterotetrameric complex.
AB  - Previous studies have indicated that turkey erythrocyte and rat liver membranes
      contain endogenous alpha beta heterodimeric insulin receptors in addition to the
      disulphide-linked alpha 2 beta 2 heterotetrameric complexes characteristic of
      most cell types. We utilized 125I-insulin affinity cross-linking to examine the
      structural properties of insulin receptors from rat liver and turkey erythrocyte
      membranes prepared in the absence and presence of sulphydryl alkylating agents.
      Rat liver membranes prepared in the absence of sulphydryl alkylating agents
      displayed specific labelling of Mr 400,000 and 200,000 bands, corresponding to
      the alpha 2 beta 2 heterotetrameric and alpha beta heterodimeric insulin receptor
      complexes respectively. In contrast, affinity cross-linking of membranes prepared
      with iodoacetamide (IAN) or N-ethylmaleimide identified predominantly the alpha 2
      beta 2 heterotetrameric insulin receptor complex. Similarly, affinity cross
      linking and solubilization of intact turkey erythrocytes in the presence of IAN
      resulted in exclusive labelling of the alpha 2 beta 2 heterotetrameric insulin
      receptor complex, whereas in the absence of IAN both alpha 2 beta 2 and alpha
      beta species were observed. Turkey erythrocyte alpha 2 beta 2 heterotetrameric
      insulin receptors from IAN-protected membranes displayed a 3-4-fold stimulation
      of beta subunit autophosphorylation and substrate phosphorylation by insulin,
      equivalent to that observed in intact human placenta insulin receptors. Turkey
      erythrocyte alpha beta heterodimeric insulin receptors, prepared by defined
      pH/dithiothreitol treatment of IAN-protected membranes, were also fully competent
      in insulin-stimulated protein kinase activity compared with alpha beta
      heterodimeric human placenta receptors. In contrast, endogenous turkey
      erythrocyte alpha beta heterodimeric insulin receptors displayed basal protein
      kinase activity which was insulin-insensitive. These data indicate that native
      turkey erythrocyte and rat liver insulin receptors are structurally and
      functionally similar to alpha 2 beta 2 heterotetrameric human placenta insulin
      receptors. The alpha beta heterodimeric insulin receptors previously identified
      in these tissues most likely resulted from disulphide bond reduction and
      denaturation of the alpha 2 beta 2 holoreceptor complexes during membrane
      preparation.

PMID- 2222425
TI  - Electroporation of rat pituitary (GH) cell lines: optimal parameters and effects
      on endogenous hormone production.
AB  - An efficient electroporation procedure was established for the genetic
      transformation of two clonal strains of hormone producing rat pituitary cells
      (GH12C1 and GH3). We used the bacterial chloramphenicol acetyltransferase (CAT)
      gene as reporter gene to determine optimal conditions for electroporation. The
      conditions found to be optimal, measured as expression of the highest CAT
      activity, were 240-300 V and a DNA concentration of 30-60 micrograms/ml in
      sucrose buffer. Cell viability was then about 50 per cent. Maximum CAT activity
      was seen 24 hours after electroporation. The electroporation procedure, in the
      presence or absence of DNA, caused a transient decrease in endogenous growth
      hormone (GH) and prolactin (PRL) production.

PMID- 2222427
TI  - 1,25(OH)2D3 and calcipotriol (MC903) have similar effects on the induction of
      osteoclast-like cell formation in human bone marrow cultures.
AB  - MC903 is a novel analogue of 1,25(OH)2D3 which exhibits similar inhibitory
      effects on cell proliferation and like, 1,25(OH)2D3, stimulates synthesis of
      osteoblast specific proteins by osteoblast-like cells in vitro. It is less active
      than 1,25(OH)2D3 in causing hypercalcemia in vivo. Since 1,25(OH)2D3 is known to
      stimulate bone resorption and increase the number of osteoclasts in several
      systems (in vivo and in vitro) we examined the effects of MC903 on the formation
      of osteoclast-like cells in vitro. As reported previously 1,25(OH)2D3 promoted
      the formation of multinucleated cells with phenotypic and functional
      characteristics of osteoclasts from adult human bone-marrow cultures at
      concentrations between 10(-8)M to 10(-12)M. Higher doses consistently suppressed
      multinucleated cell formation to values seen in the absence of 1,25(OH)2D3. Cells
      cultured in the presence of MC903 or for three weeks consistently induced the
      formation of multinucleated cells at concentrations 10(-8)M to 10(-12)M. As seen
      with 1,25(OH)2D3, MC903 also inhibited multinucleated cell formation at very high
      concentrations (10(-6)M). In two separate experiments MC903 appeared to be more
      potent than 1,25(OH)2D3 at lower concentrations (10(-10)M - 10(-12)M). From this
      study we conclude that MC903 is at least as potent as 1,25(OH)2D3 in inducing the
      formation human osteoclast-like cells in vitro. The decreased ability of MC903 to
      induce hypercalcemia in vivo is not therefore a result of a less marked effect
      than 1,25(OH)2D3 on the regulation of osteoclast formation.

PMID- 2222426
TI  - The Ca-MOv18 molecule, a cell-surface marker of human ovarian carcinomas, is
      anchored to the cell membrane by phosphatidylinositol.
AB  - The structure of the 38 kD cell surface glycoprotein identified by the monoclonal
      antibody MOv18 and specifically expressed by human ovarian carcinomas has been
      investigated at a molecular level. The ovarian carcinoma cell line IGROV-1, which
      expresses high levels of Ca-MOv18, was treated with the phosphatidylinositol
      specific phospholipase C from B. thuringiensis. The phospholipase C specifically
      released most of the Ca-MOv18 molecules as shown by flow cytometric analysis of
      the treated cells and by radioimmunometric assays of the corresponding
      supernatants. Consistent with the known structure of other phosphatidylinositol
      linked molecules, Ca-MOv18 was biosynthetically labeled by [3H]ethanolamine and
      the labeled molecules were immunoprecipitated from the supernatant fo the
      phospholipase C treated cells. Evidence that Ca-MOv18 is anchored to the cell
      membrane via phosphatidylinositol may prove to be relevant in current
      investigations regarding the biological and clinical significance of this tumor
      marker.

PMID- 2222428
TI  - Protein kinase C subspecies in estrogen receptor-positive and -negative human
      breast cancer cell lines.
AB  - Estrogen receptor-positive (MCF7) and -negative (BT20) human breast cancer cell
      lines, which are frequently used for studies on cancer chemotherapy with
      triphenylethylene (TPE) anti-estrogens, express at least three protein kinase C
      subspecies. Two of them are identified as type II PKC having the beta-sequence
      and type III PKC having the alpha-sequence. The other one shows typical
      characteristics of PKC which responds to Ca2+, phosphatidylserine and
      diacylglycerol, but shows kinetic properties subtly different from the previously
      known PKC subspecies. Immunoblot analysis has shown that this enzyme does not
      correspond to any of the well defined subspecies with known sequence structures.
      All of these PKC subspecies are similarly susceptible to the TPE antiestrogens.

PMID- 2222429
TI  - Possible contribution of protein kinase C activation to priming for DNA synthesis
      induced by epidermal growth factor with insulin and its inhibition by plasma
      membrane in primary cultured rat hepatocytes.
AB  - In primary cultured rat hepatocytes, DNA synthesis was markedly induced 48 h
      after plating by epidermal growth factor (EGF) and insulin added at 24 h, but not
      by 12-O-tetradecanoyl-phorbol-13-acetate (TPA). When EGF and insulin were added
      at 6 h, DNA synthesis at 30 h was 7% of DNA synthesis seen at 48 h, but became
      27% by pretreatment with TPA. The similar pretreatment effect was also seen with
      vasopressin. Such induction at 30 h was inhibited by rat liver plasma membrane
      added at 2 h even in the presence of TPA or vasopressin, and also by 1-(5
      isoquinolinyl-sulfonyl)-2-methylpiperazine more extensively than N-(2
      guanidinoethyl)-5-isoquinolinesulfonamide. These results suggest that DNA
      synthesis induction by EGF and insulin may require a priming period related to
      protein kinase C activation in primary cultured rat hepatocytes, which is
      inhibited by plasma membrane.

PMID- 2222430
TI  - Effects of metoclopramide on rat spleen lymphocyte proliferation.
AB  - The effect of metoclopramide on proliferation of spleen lymphocytes in rats was
      examined. The rate of [3H]thymidine incorporation into DNA was used as an index
      of lymphocytes proliferation. It was shown that the incorporation of
      [3H]thymidine into DNA of spleen lymphocytes in the rats treated with
      metoclopramide was significantly higher than that in the control group. The
      effects of various concentrations of prolactin and metoclopramide on
      [3H]thymidine uptake by DNA of spleen lymphocytes was also studied in vitro. It
      was shown that: 1, Prolactin, at the concentration of 1 and 0.1 ng/ml
      significantly increased [3H]thymidine incorporation into DNA of spleen
      lymphocytes. Metoclopramide in all the examined concentrations also caused a
      significant proliferogenic effect on lymphocytes.

PMID- 2222431
TI  - Tauroursodeoxycholic acid inhibits the cytosolic Ca++ increase in human
      neutrophils stimulated by formyl-methionyl-leucyl-phenylalanine.
AB  - The effect of the cytoprotective bile acid tauroursodeoxycholic acid (TUDCA) on
      basal cytosolic free Ca++ (Ca++)i and receptor-mediated (Ca++)i increase was
      studied in human polymorphonuclear neutrophils using the fluorescent dye quin2.
      Basal levels of (Ca++)i were 96 +/- 6 nmol/l (mean +/- SEM, n = 48). TUDCA and
      its cytotoxic epimer taurochenodeoxycholic acid (TCDCA) at 500 mumols/l increased
      (Ca++)i by 31 +/- 12 and 27 +/- 7 nmol/l, respectively (n = 6, p less than 0.05).
      Stimulation of neutrophils with the chemotactic tripeptide N-formyl-methionyl
      leucyl-phenylalanine (FMLP; 10(-7) mol/l) induced a (Ca++)i increase of 200 +/-
      32 nmol/l which was inhibited after preincubation with TUDCA (500 mumols/l) or
      TUDCA + TCDCA (500 mumols/l, each) by 60.1% and 59.5%, respectively, but not with
      TCDCA (500 mumols/l) alone. The inhibitory effect of TUDCA on FMLP-induced
      (Ca++)i increase was strongly concentration-dependent and was nearly complete at
      1000 mumols/l. Since (Ca++)i is discussed as a mediator of cellular injury we
      hypothesize that TUDCA may exert its protective effects at least partly via
      inhibition of (Ca++)i-mediated cytotoxic processes.

PMID- 2222432
TI  - Translation of hepatitis B virus DNA polymerase from the internal AUG codon, not
      from the upstream AUG codon for the core protein.
AB  - Hepatitis B virus DNA replicates via its own polymerase that also acts as reverse
      transcriptase (Summers and Mason, 1982). This enzyme is encoded by a 3.5 Kb mRNA
      transcript covering the whole genome. Since the same transcript also codes for
      the core protein, and since the core open reading frame (ORF) is located upstream
      of the pol ORF, it has been suggested that the polymerase is first produced as a
      core-pol fusion protein that subsequently undergoes cleavage. This is already
      known to be the case with retrovirus reverse transcriptase, for which a gag-pol
      fusion protein is made first and the latter protein is liberated by proteolytic
      cleavage. We investigated this problem using mutants that were modified at the
      translation initiation codon for the core and precore ORF. Our findings suggested
      that polymerase translation occurred from the internal AUG codon independently of
      core protein synthesis, and that obligatory production of the core-pol fusion
      protein is accordingly unlikely.

PMID- 2222433
TI  - Regulation of ion uptake in membrane vesicles from rat brain by thiamine
      compounds.
AB  - We examined the effects of thiamine derivatives on ion uptake in rat brain
      membrane vesicles. Thiamine triphosphate (1 mM) and pyrithiamine (0.1 mM)
      increase chloride uptake. Preincubation of crude homogenate with thiamine or
      pyrithiamine increases chloride uptake while oxythiamine has the reverse effect.
      Thiamine and oxythiamine also affect 22Na+ and 86Rb+ uptake in the same way as
      for 36Cl- but to a lesser extent. Thiamine-dependent 36Cl- uptake is activated by
      sodium bicarbonate (10 mM) and partially inhibited by bumetanide (0.1 mM) and 2,4
      dinitrophenol (0.1 mM). Preincubation with thiamine increases the thiamine
      triphosphate content of the vesicles. The hypothesis that TTP is the activator of
      a particular chloride uptake mechanism is discussed.

PMID- 2222434
TI  - Sequence analysis of the promoter region of the glioblastoma derived T cell
      suppressor factor/transforming growth factor (TGF)-beta 2 gene reveals striking
      differences to the TGF-beta 1 and -beta 3 genes.
AB  - Human glioblastoma cells secrete a factor termed glioblastoma derived T cell
      suppressor factor (G-TsF) or transforming growth factor beta 2 (TGF-beta 2) which
      inhibits the response of T cells to mitogenic or antigenic stimulation. In the
      present study we isolated the promoter region of the G-TsF/TGF-beta 2 gene. The
      promoter region shares no homology to the promoter of the TGF-beta 1 or the 5'
      region of the TGF-beta 3 gene and harbours several familiar DNA motifs, including
      the cytokine-1 region, an octamer-like sequence, Sp1- and AP-2-like elements and
      a putative NF-kappa B site. In contrast to the TGF-beta 1 gene, the G-TsF/TGF
      beta 2 gene contains three TATA-like sequences but lacks an AP-1 site. To
      understand the cell type specificity of expression of G-TsF/TGF-beta 2, the
      individual contribution of the DNA elements detected in the promoter has to be
      analysed in further studies.

PMID- 2222435
TI  - A molecular model for the enzyme cytochrome P450(17 alpha), a major target for
      the chemotherapy of prostatic cancer.
AB  - The enzyme cytochrome P450(17 alpha) catalyses two key steps in the biosynthesis
      of the androgens from pregnanes: the 17 alpha hydroxylation step and the
      subsequent 17-20 lyase reaction. Using a variety of techniques, including
      sequence alignment, secondary structure prediction, molecular mechanics and
      molecular dynamics, we have constructed a model for the three-dimensional
      structure of P450(17 alpha) based on that of P450cam, the only cytochrome P450
      enzyme for which the crystal structure is known. The model suggests the
      possibility of two modes of binding of steroid substrates at the active site,
      perhaps reflecting the dual functionality of the enzyme.

PMID- 2222436
TI  - Penicillin binding proteins of Vibrio cholerae.
AB  - Eleven penicillin binding proteins (PBPs) of Vibrio cholerae have been identified
      using [125I] labelled p-hydroxybenzyl penicillin (PenX). These proteins are
      localised in the inner membrane and have molecular weights ranging from 97,000 to
      22,000. Neutral hydroxylamine released the labelled PenX from the PBPs and
      pretreatment with cold benzyl penicillin inhibited labelling completely. The PBP
      4 is the most sensitive target for cephaloridine and aztreonam. Cephaloridine
      also binds to three other high molecular weight PBPs, 1, 2 and 3. Aztreonam, in
      addition to PBP 4, has affinity for another low molecular weight PBP, PBP 7.
      Mecillinam has affinity for PBPs 1, 4 and 11.

PMID- 2222437
TI  - Inhibition of myosin light chain phosphorylation in cultured smooth muscle cells
      by HA1077, a new type of vasodilator.
AB  - When cultured smooth muscle cells were stimulated sequentially by concanavalin A
      and fetal calf serum, the cells rounded up, and there was an accompanying mono-
      and diphosphorylation of the 20 kDa myosin light chain. HA1077, a new type of
      vasodilator, inhibited both the cell rounding and the light chain phosphorylation
      in a concentration dependent manner. Since HA1077 inhibits myosin light chain
      kinase, in vitro, we propose that this vasodilator presumably inhibits cell
      rounding by limiting myosin light chain phosphorylation.

PMID- 2222438
TI  - Activation of GD3 synthase by sex steroid hormones in cultured rat hepatocytes.
AB  - The influence of sex steroid hormones on the activities of GM3 and GD3 synthases
      in isolated hepatocytes was studied. Progesterone (0.1 - 2.0 microM), beta
      estradiol (0.1 - 1 microM), and testosterone (0.1 - 1 microM) activate GD3 but
      not GM3 synthase when added directly to hepatocytes cultured in modified
      William's E medium.

PMID- 2222439
TI  - Conversion of big endothelin-1 by membrane-bound metalloendopeptidase in cultured
      bovine endothelial cells.
AB  - We propose a candidate for the "putative" endothelin (ET) converting enzyme in
      the cultured endothelial cells (ECs) of bovine carotid artery. The enzyme is
      membrane-bound, soluble in 0.5% Triton X-100, and capable of converting human big
      ET-1 to ET-1 by a specific cleavage between Trp21 and Val22. The conversion
      reached 90% after a 5-hr incubation in the presence of DFP, PCMS and pepstatin A,
      but it was inhibited by EDTA, omicron-phenanthroline or phosphoramidon. The
      enzyme is very sensitive to pH, and active only between pH 6.6 and pH 7.6.
      Conversion of big ET-3 by this enzyme was only 1/9 that of big ET-1. From these
      results, ET-1 converting enzyme in the bovine EC is most likely to be a membrane
      bound, neutral metalloendopeptidase, which is much less susceptible to big ET-3.

PMID- 2222440
TI  - Theoretical variation of the H alpha chemical shift in acetyl-glycyl-N
      methylamide and oligoglycines with molecular conformation and environment.
AB  - The sum of the magnetic anisotropy and polarization contributions to the magnetic
      shielding constants of the alpha protons is calculated as a function of the
      torsion angles about the NC alpha (phi) and C alpha C' (psi) bonds of the
      dipeptide. The results show that the polarization or electric field effect is
      several fold larger than the magnetic anisotropy contribution. The calculated
      variations are large enough to account for the spread of the values measured for
      these protons in peptides and proteins. The results obtained for polyglycine
      alpha helices and antiparallel beta sheets are discussed in relation with
      molecular conformation and environmental effects on the one hand and experimental
      data on the other.

PMID- 2222441
TI  - Catalase HPI influences membrane permeability in Escherichia coli following near
      UV stress.
AB  - The katG gene in Escherichia coli encodes catalase HPI, which is involved in
      membrane transport and protects the cell during oxidative stress. Hydrogen
      peroxide (H2O2) induces synthesis of HPI. We examined the role of HPI in membrane
      permeability (proline uptake) following exposure to near-ultraviolet radiation
      (NUV). We found that NUV resulted in the same type of induction as H2O2.
      KatG::Tn10 cells experienced a large drop in uptake after NUV exposure, and
      levels remained low following incubation. A strain carrying a katG+ plasmid,
      however, showed considerably less decrease in uptake after NUV, and uptake
      quickly resumed upon incubation. Further, in an srd mutant which lacks 4
      thiouracil, NUV resulted in only a small drop in proline uptake, which was
      immediately resumed.

PMID- 2222442
TI  - The mast cell as an effector of connective tissue degradation: a study of matrix
      susceptibility to human mast cells.
AB  - The susceptibility of connective tissue elements to degradation by human mast
      cells was explored using purified mast cell tryptase and sonicated mast cell
      preparations. The R-22 strain of smooth muscle cells from rat heart was used for
      preparation in vitro of a labelled anchored matrix. Digestion of 11.9 +/- 1.2% (n
      = 5) of this matrix was observed after overnight incubation with the mast cell
      sonicates. Pretreatment of the sonicate with a tryptase inhibitor TLCK reduced
      the digestion by 42%. Digestion of 12 +/- 1% (n = 4) of the matrix was observed
      with purified tryptase. The susceptible substrate within this anchored insoluble
      matrix resided in the glycoprotein compartment as defined by enzymatic
      characterization of the residual matrix. Mast cells may play a role in mediating
      connective tissue degradation through the release of proteases specifically
      synthesized by this cell.

PMID- 2222443
TI  - Binding of human sex hormone-binding globulin-androgen complexes to the placental
      syncytiotrophoblast membrane.
AB  - We have found that human SHBG complexed with androgens binds specifically to the
      plasma membrane of human placental syncytiotrophoblast. Apparent equilibrium
      association constants were 5.3.10(11) M-1 for SHBG-testosterone complex and
      1.1.10(11) M-1 for SHBG-5 alpha-dihydrotestosterone. Devoid of steroid, SHBG did
      not bind to the membrane. This suggests that the specific membrane binding of
      SHBG-androgen complexes is a step of the mechanism of androgen action on
      syncytiotrophoblast.

PMID- 2222444
TI  - Characterization of endothelin converting enzyme in rat lung.
AB  - An enzyme activity which converts human big endothelin (1-38) to endothelin (1
      21) and a C-terminal fragment (CTF, 22-38) was identified in a plasma membrane
      fraction prepared from rat lung. The conversion activity was optimal at pH 4.0,
      was inhibited by Pepstatin-A (IC50 = 20 nM), but was not affected by TLCK,
      Aprotinin, PMSF, E-64, Bestatin, Phosphoramidon or Thiorphan at 40 microM. Metal
      ions activated the activity by 1.5 - 2.5 fold in the order of Mn+2 greater than
      Zn+2 = Ca+2 greater than Ba+2. These data suggest that a Pepstatin-A inhibitable,
      metal ion related aspartic protease may be involved in the conversion of big
      endothelin to endothelin in rat lung.

PMID- 2222445
TI  - The complete nucleotide sequence of the gene coding for botulinum type C1 toxin
      in the C-ST phage genome.
AB  - Two DNA fragments, 3 kbp and 7.8kbp, which encode the type C1 botulinum
      neurotoxin gene, were obtained from toxigenic bacteriophage DNA by treatment with
      a restriction enzyme. They were cloned into the plasmid vectors for nucleotide
      sequence determination. The nucleotide sequence contained a single open reading
      frame coding for 1,291 amino acids corresponding to a polypeptide with a
      molecular weight of 149,000. The amino acid sequence of the C1 toxin has a few
      regions highly homologous with tetanus toxin.

PMID- 2222447
TI  - Sequence similarities between tryptophan synthase beta subunit and other
      pyridoxal-phosphate-dependent enzymes.
AB  - On the basis of 8 tryptophan synthase beta subunits (EC 4.2.1.20) consensus
      patterns were constructed comprising two conserved motifs. Screening of the
      SWISSPROT protein sequence database with these patterns indicates similarities
      with O-acetylserine sulfhydrolases (EC 4.2.99.8), threonine synthases (EC
      4.2.99.2), L- and D-serine dehydratases (EC 4.2.1.13/EC 4.2.1.14) and threonine
      dehydratases (EC 4.2.1.16). Using multiple alignment procedures the similar
      regions could be extended. In connection with their pyridoxal-phosphate-binding
      capacity and their positions in biochemical pathways evolutionary relationships
      among these enzymes are discussed.

PMID- 2222446
TI  - Allosteric control of quaternary states in E. coli aspartate transcarbamylase.
AB  - Changes in the molecular dimensions of ATCase in the unligated T-state are an
      increase of 0.4 A in the separation of catalytic trimers when ATP binds. When the
      R-state is produced by binding of phosphonoacetamide and malonate, addition of
      CTP or CTP + UTP decreases the separation of catalytic trimers by 0.5 A. In the
      unliganded Glu239----Gln mutant, in which the T-state is destabilized so that the
      enzyme exists in an intermediate quaternary state, ligation of ATP transforms the
      mutant enzyme to the R-state, whereas CTP converts this enzyme to the T-state.
      Thus, this mutant is much more sensitive to heterotropic allosteric control than
      is the native enzyme. In this communication we propose a preliminary model based
      on new crystallographic results that heterotropic regulation occurs partly
      through control of the quaternary structure by these effectors, thus regulating
      catalysis.

PMID- 2222448
TI  - Enhanced leukotriene C4 synthase activity in thioglycollate-elicited peritoneal
      macrophages.
AB  - The utilization of LTA4 by peritoneal macrophages (MO) obtained from untreated
      rats (control) as well as by those elicited from rats was investigated at
      designated intervals (on days 3, 7, and 14) following the intraperitoneal
      injection of thioglycollate (TG). On day 7 following the injection the elicited
      MO converted LTA4 to LTC4 at the highest rate while the resident MO showed the
      lowest rate. The conversion of LTA4 to LTC4 and LTB4 was next examined by using
      each MO lysate. The apparent LTC4 synthase activity was significantly higher in
      the MO lysate both on day 3 and day 7, with the latter being the highest value
      obtained. The GSH S-transferase activity in each lysate using as the substrate,
      DNCB was significantly lower on day 3 but significantly higher on day 7 as
      compared to control values. However, this elevated activity was less variable
      than that observed with LTC4 synthase. The possible implication for these
      observations is discussed.

PMID- 2222449
TI  - Inactivation of hepatocyte protein kinase C by carbon tetrachloride: involvement
      of drug's metabolic activation and prooxidant effect.
AB  - The involvement of CCl4 biotransformation mechanism in decreasing the Protein
      Kinase C activity has been analyzed in hepatocytes isolated from phenobarbital
      pretreated rats. A significant inhibition (55%) and an almost total disappearance
      (87%) of the enzyme activity were observed at 15 min and at 30 min incubation
      with CCl4, respectively. Cell preincubation with Trolox or desferrioxamine
      allowed a marked whilst not complete protection of both cytosolic and particulate
      Protein Kinase C activity. These results show that the CCl4 reactive metabolites
      play a primary role in hepatocyte Protein Kinase C impairment and suggest that
      besides lipid peroxidation other mechanisms -possibly a derangement of Ca2+
      homeostasis- may be involved in this process.

PMID- 2222450
TI  - Stimulation of Mn-superoxide dismutase expression by tumor necrosis factor-alpha:
      quantitative determination of Mn-SOD protein levels in TNF-resistant and
      sensitive cells by ELISA.
AB  - Marked increase in protein levels of Mn-superoxide dismutase (Mn-SOD) was found
      in TNF-resistant cell lines after treatment with Tumor Necrosis Factor (TNF). No
      such increase was observed in Cu,Zn-superoxide dismutase (Cu, Zn-SOD) protein in
      either TNF-resistant or sensitive cells. These results support the data that the
      Mn-SOD is one of the rescue proteins required for resistance to TNF cytotoxicity
      in these cell lines (Wong et al., Cell 58, 923-931, 1990). Mn-SOD was also
      responsive to TNF stimulation in KURAMOCHI, a human ovarian adenocarcinoma cell
      line. This may explain our previous result that Mn-SOD protein is highly
      expressed in epithelial ovarian cancer (Ishikawa et al. Cancer Res. 50, 2538
      2542, 1990).

PMID- 2222451
TI  - Polyethylene glycol modification of the monoclonal antibody A7 enhances its tumor
      localization.
AB  - The F(ab')2 fragment of murine monoclonal antibody A7 was covalently bonded to
      polyethylene glycol (PEG, molecular weight: 5000) and the conjugate was compared
      to the parent F(ab')2 fragment by in vitro and in vivo studies. PEG-conjugated
      antibody fragment retained its antigen-binding activity in a competitive
      radioimmunoassay. The conjugate had a longer half-life and showed increased
      accumulation in tumors. Although the tumor: blood ratio for parent F(ab')2
      fragment was higher than that for the conjugate, it showed higher value than
      whole MAb A7. The tissue: blood ratios were kept low with the conjugate,
      indicating that the conjugate was uptaken to normal organ with lesser extent, as
      compared with parent F(ab')2 fragment. Our findings indicate that this PEG
      conjugated F(ab')2 fragment could be a promising carrier for use in targeting
      cancer chemotherapy.

PMID- 2222452
TI  - Altered methylation of versican proteoglycan gene in human colon carcinoma.
AB  - We show for the first time that DNA isolated from human colon carcinoma tissue
      exhibits a selective hypomethylation of versican gene, which encodes a large
      chondroitin sulfate proteoglycan. The degree of methylation of CpG sequences of
      versican gene locus, as determined by isoschizomeric endonucleases and Southern
      hybridization, is about three times lower than that found in either normal colon
      or ulcerative colitis tissues. Hypomethylation can be observed in both benign and
      malignant colonic neoplasms; however, there is no correlation with increased
      expression since versican mRNA levels do not significantly vary between normal
      and neoplastic tissues. We further show that versican gene locus from malignant
      tissue, but not from normal or ulcerative colitis tissues, contains Hind III
      hypersensitive sites which also comprise hypomethylated CpG sequences. Analysis
      of versican methylation status in colon carcinoma cells and benign mesenchymal
      cells derived from human colon suggests that the changes observed in vivo derive
      from demethylating events involving host stromal cells rather than tumor cells
      themselves. These findings demonstrate that changes in versican gene methylation
      are specific for colonic neoplasms, that these changes may precede malignant
      transformation, and that inflammation and tissue remodelling alone are not enough
      to generate these changes in proteoglycan gene methylation and nuclease
      hypersensitivity.

PMID- 2222453
TI  - The 108-kDA peptidylglycine alpha-amidating monooxygenase precursor contains two
      separable enzymatic activities involved in peptide amidation.
AB  - A 43-kDa protein factor that increases the ability of purified bovine
      peptidylglycine alpha-amidating monooxygenase (PAM)-A and -B to produce alpha
      amidated peptides at physiological pH was purified to homogeneity from bovine
      neurointermediate pituitary. At each step of the purification, the amount of
      activity correlated with the amount of protein detected on Western blots by
      antibody to bovine PAM(561-579). In the bovine neurointermediate pituitary the
      108-kDa PAM precursor protein is cleaved to form a peptidylglycine alpha
      hydroxylating monooxygenase and a peptidyl-alpha-hydroxyglycine alpha-amidating
      lyase, which function sequentially in the 2-step formation of alpha-amidated
      peptides.

PMID- 2222454
TI  - Modulation of smooth muscle calponin by protein kinase C and calmodulin.
AB  - When smooth muscle calponin was incubated with protein kinase C, 1 mole of
      phosphate was incorporated per mole of calponin. The apparent Km value for
      calponin of the protein kinase was about 0.4 microM. The phosphorylation of
      calponin by protein kinase C was inhibited markedly by calmodulin in a calcium
      dependent manner. Kinetic analysis of calmodulin-induced inhibition of calponin
      phosphorylation by protein kinase C revealed that calmodulin inhibited the
      phosphorylation in a noncompetitive fashion with calponin and the determined Ki
      value was 0.4 microM. These results suggest that interaction of calmodulin with
      calponin may play a regulatory role in the phosphorylation by protein kinase C
      and smooth muscle contraction.

PMID- 2222455
TI  - Antagonistic effect of human alpha-CGRP [8-37] on the in vivo regional
      haemodynamic actions of human alpha-CGRP.
AB  - In conscious rats, infusion of human alpha-CGRP [8-37] (30 nmol/kg/min) caused
      small, reversible reductions in hindquarters flow and vascular conductance only,
      whereas at a dose of 300 nmol/kg/min there was a tachycardia and an increase in
      mean arterial blood pressure, together with renal, mesenteric and hindquarters
      vasoconstrictions. Human alpha-CGRP (0.03 nmol/kg/min) caused tachycardia,
      hypotension, and transient renal, but sustained hindquarters, vasodilatation;
      these changes were accompanied by mesenteric vasoconstriction. Infusion of human
      alpha-CGRP [8-37] (30 nmol/kg/min) during administration of human alpha-CGRP
      (0.03 nmol/kg/min) abolished the effects of the latter but these re-appeared when
      the human alpha-CGRP [8-37] infusion was stopped. This dose of human alpha-CGRP
      [8-37] did not affect cardiovascular responses to isoprenaline. These results
      indicate that human alpha-CGRP [8-37] is an effective antagonist of the
      cardiovascular actions of human alpha-CGRP in vivo.

PMID- 2222456
TI  - Evidence for protein kinase C independent activation of phospholipase D by
      phorbol esters in lymphocytes.
AB  - Recently it was reported that tumor-promoting phorbol esters stimulate the
      production of phosphatidylethanol (PEt) in lymphocytes through the activation of
      phospholipase D (PLD). However, it remains unclear whether this activation is
      mediated through protein kinase (PKC). The study reported here shows that tumor
      promoters 12-0-tetradecanoylphorbol-13-acetate (TPA), phorbol dibutyrate (PDBU),
      12-deoxyphorbol-13-phenylacetate (DOPP), 12-deoxyphorbol-13-phenylacetate-20
      acetate (DOPPA) and mezerin activated PLD, as measured by the formation of PEt,
      whereas Concanavalin A (ConA) had no effect. Inhibitors of PKC, sphingosine (2 x
      10(-6) M - 5 x 10(-6) M), H-7, HA1004 (5 x 10(-7) - 5 x 10(-6) M) and K252a (1 x
      10(-7) - 1 x 10(-6) M) failed to block the PEt synthesis induced by TPA. In fact,
      sphingosine increased it. Other PKC activators, 1-oleoyl-2-acetylglycerol (OAG)
      and dioctanoylglycerol (DiC8) had no effect on lymphocyte PLD activity. Analysis
      of the phospholipid contents after stimulation by TPA showed that only
      phosphatidylcholine (PC) was significantly decreased. Interestingly, TPA
      activated PLD in intact cells but not in lysates or subcellular fractions. These
      observations suggest that stimulation of PLD-catalyzed PEt synthesis by TPA is
      not solely mediated through PKC activation.

PMID- 2222457
TI  - Estradiol increases the secretion by MCF7 cells of several lysosomal pro-enzymes.
AB  - The synthesis and secretion of pro-cathepsin D is increased by estrogens in MCF7
      cells. We quantified the effect of estradiol on other lysosomal enzymes in order
      to investigate the mechanism of this hypersecretion. Precursors of beta
      hexosaminidase, cathepsin B and beta-galactosidase, which are routed to lysosomes
      via the mannose-6-phosphate (Man-6-P) receptor, were secreted in much lower
      amounts than pro-cathepsin D, but their secretion was also increased by
      estradiol. The activity of acid phosphatase, which is routed to lysosomes via a
      different transmembrane mechanism, was not altered by estradiol. While estradiol
      stimulated gene expression of pro-cathepsin D, it had no effect on that of pro
      cathepsin B. We conclude that estradiol stimulates the secretion of several
      lysosomal pro-enzymes in MCF7 cells, suggesting that a general mechanism is
      responsible for this derouting rather than a specific alteration of cathepsin D
      structure.

PMID- 2222458
TI  - Isolation and sequencing of mouse angiogenin DNA.
AB  - The mouse genomic DNA for angiogenin, a potent blood vessel inducing protein, has
      been isolated from a bacteriophage library using the human angiogenin gene as a
      probe. The 1129 bp fragment contains 499 bp in the 5' flanking region, 192 bp in
      the 3' flanking region, and 438 bp coding for the mature protein (121 amino
      acids) and signal peptide (24 amino acids). Potential TATA box and AATAAA
      polyadenylation sequences are present, and a consensus sequence for an intron 3'
      boundary occurs 16 bp upstream of the Met-(24) codon, suggesting the presence of
      an intron in the 5' region. The protein sequence inferred from the DNA is 76%
      identical to that of human angiogenin, and matches the sequences obtained
      previously from tryptic peptides of a serum-derived mouse angiogenin. The
      critical catalytic residues of human angiogenin are conserved in the mouse
      protein, as are the six cysteines necessary for disulfide bond formation.

PMID- 2222459
TI  - Decreased heat shock response upon adipose differentiation of 3T3-L1 cells.
AB  - In order to gain a better understanding of the regulation of heat shock gene
      (hsp) expression in terminal cell differentiation, we evaluated the effects of
      heat shock on the synthesis of HSPs, the abundance of mRNAhsp, and the heat shock
      transcription factor (HSTF) DNA-binding activity in the 3T3-L1 fibroblasts and
      adipocytes. We showed that the heat shock (42 degrees C) induction of synthesis
      of HSPs was significantly greater in the undifferentiated fibroblast than the
      differentiated adipocyte cultures. In particular, the heat shock induced
      synthesis of HSP 72 was at least 10 times greater in the fibroblasts than in the
      adipocytes. Analysis of mRNA of hsp 89 alpha, hsp 89 beta, hsp 70, and hsp 25 by
      Northern blot hybridization showed that the expression of these mRNAs was very,
      if not strictly, dependent on heat shock of the cells; the abundance of these
      heat inducible mRNAs was significantly higher in fibroblasts than in adipocytes.
      Quantitation of the HSTF DNA-binding activity by gel retardation assay
      demonstrated a specific decrease in this activity in the differentiated cells.
      These results provide evidence of a decreased transcriptional activation of heat
      shock genes upon adipose cell differentiation.

PMID- 2222460
TI  - Plasma lipoproteins mediate platelet adhesion.
AB  - Platelet adhesion to VLDL, LDL, HDL, and to a mixture of purified apolipoproteins
      was examined. Platelets adhered to all the classes of lipoproteins tested. VLDL
      and the apolipoprotein mixture promoted the greatest degree of adhesion. Platelet
      adhesion was inhibited by addition of EDTA, RGD-containing peptides and anti
      GPIIb-IIIa, monoclonal antibodies. Platelets from patients with Glanzmann's
      Thrombasthenia which lack the GPIIb-IIIa receptor adhered to VLDL less than half
      as well as did normal platelets. These results demonstrate that the major
      circulating lipoproteins can mediate in vitro platelet adhesion and that this
      adhesion occurs via platelet integrin receptors. We postulate that lipoprotein
      mediated platelet adhesion may play an important role in the progression of
      atherosclerosis.

PMID- 2222461
TI  - Heat-induced preferential synthesis and redistribution of HSP 70 and 28 families
      in Chinese hamster ovary cells.
AB  - We observed that members of two HSP families (70 and 28 kDa) preferentially
      redistributed into the nucleus after heating at 45.5 degrees C for 10 min. The
      rates of synthesis and redistribution of these proteins were different for each
      member of HSP families during incubation period at 37 degrees C after heat shock.
      The maximum rates of synthesis of HSP 70 and HSP 28 families, except HSP 28c,
      were 6-9 hr after heat shock, whereas the maximum rates of redistribution were 3
      6 hr after heat shock. These results suggest that the rates of redistribution of
      these proteins may be dependent on the amount of intracellular proteins as well
      as the alteration of binding affinity of nucleoproteins following heat shock.

PMID- 2222462
TI  - Expression of constitutive and inducible HSP70 and HSP47 is enhanced in cells
      persistently spread on OPN1 or collagen.
AB  - Cells persistently spread on OPN or collagen survive heat shock better than cells
      transiently spread on fibronectin or tissue culture plates. Thus, a central
      question is whether constitutively or inducible stress proteins are enhanced in
      cells grown on adhesive proteins that maintain a persistent spread cell shape.
      Levels of Hsp 72,73, and colligin/Hsp47 were determined by Western blot analyses.
      The inducible Hsp 72 was prominently expressed following heat shock in cells
      grown on OPN or collagen, but not in cells plated on fibronectin coated
      substratum or on tissue culture plates. Colligin/Hsp 47 and Hsp 73 manifested a
      similar pattern of expression indicating that these adhesive attachment proteins
      accommodate cell function through organization of cell architecture.

PMID- 2222463
TI  - L-glutamine inhibits the release of endothelium-derived relaxing factor from the
      rabbit aorta.
AB  - The present study investigates the effect of the amino acid L-glutamine (L-Gln)
      on the release of endothelium-derived relaxing factor (EDRF) from the luminally
      perfused rabbit aorta and on endothelium-dependent relaxations of rabbit aortic
      strips. L-Gln (200 microM) had no effect on the acetylcholine (Ach)-induced
      release of EDRF from freshly prepared aortic tissues. The concentration of L
      arginine (L-Arg) in endothelial cells isolated from these aortae was
      approximately 4 mM, as determined by HPLC analysis. After an initial
      equilibration period of 2 h and two consecutive infusions of Ach (55 microM for
      15 min) at 2 and 3 h, L-Arg levels fell by 62 +/- 14% (n = 4). Under these
      conditions, L-Gln (200 microM) but not D-Gln (200 microM) inhibited the release
      of EDRF by 50 +/- 4% (n = 7). This effect of L-Gln was partially reversed by
      infusions of L-Arg (500 microM) but not D-Arg (500 microM). L-Gln (200 microM)
      but not D-Gln (200 microM) potentiated the inhibitory effect of N omega-nitro-L
      arginine (30 microM), an inhibitor of EDRF biosynthesis, on Ach-induced
      relaxations of rabbit aortic strips, whereas L-Gln alone had no effect. Thus, L
      Gln inhibits the release of EDRF from intact blood vessels presumably by
      interfering with the generation of L-Arg by the endothelium.

PMID- 2222464
TI  - Human colony stimulating factor-1 receptor activates the C-raf-1 proto-oncogene
      kinase.
AB  - The proto-oncogene c-raf-1 encodes a 74 kD serine/threonine kinase. Recently, it
      has been shown that Raf kinase activity is stimulated by platelet derived growth
      factor (PDGF) treatment of receptor bearing cells, and that p74 is a direct
      substrate for PDGF receptor. CSF-1 treatment of BeWo cells, a human
      choriocarcinoma cell line, and mouse NIH 3T3 cells expressing a transfected human
      CSF-1 receptor cDNA, was associated with a 3-4 fold increase in phosphorylation
      of a 74 kD protein immunoprecipitated with affinity purified Raf-1 antibody. The
      kinase activity of p74 was increased 2-3 fold against two exogenous substrates
      following CSF-1 treatment of the transfected cells. These observations suggest
      that Raf-1 protein is a downstream second messenger molecule in CSF-1 mediated
      signal transduction.

PMID- 2222465
TI  - N-glycosylated and unglycosylated forms of caprine trophoblast protein-1 are
      secreted by preimplantation goat conceptuses.
AB  - Goat conceptuses secrete caprine trophoblast protein-1 (cTP-1) which is related
      antigenically to the abundant embryonic interferon-alpha II of sheep and cattle.
      Antiserum to ovine and bovine TP-1s immunoprecipitated three molecular weight
      classes (23,000, 21,000 and 17,000, each with two isotypes) of cTP-1 from goat
      conceptus culture medium. Cultures which contained tunicamycin resulted in a
      shift in the Mr = 23,000 and Mr = 21,000 forms to a Mr of 17,000. The Mr = 23,000
      and 21,000 forms, but not the Mr = 17,000 form, bound to Concanaval in A
      Sepharose and were eluted under conditions selective for glycoproteins bearing
      complex-type oligosaccharide(s). Thus cTP-1 is a mixture of glycosylated and
      unglycosylated polypeptides.

PMID- 2222466
TI  - Chromosomal assignment of the human homologue encoding SGP-2.
AB  - Although originally characterized as a constitutively expressed gene product in
      mammalian Sertoli cells, sulfated glycoprotein-2 (SGP-2) has gained widespread
      attention due to its remarkably rapid and sizable induction in numerous types of
      mammalian cells undergoing apoptosis, or programmed death. In order to identify
      the chromosomal assignment for the human homologue of SGP-2, we performed
      Southern blot analysis of Bgl II restricted genomic DNA extracted from a panel of
      cloned hamster-human hybrid cell lines and screened for the presence of
      restriction fragments homologous to SGP-2. The results of this analysis indicate
      that the human homologue of SGP-2 resides on chromosome 8.

PMID- 2222467
TI  - Special considerations in the purification of the GM3 ganglioside forming enzyme,
      CMP-sialic acid:lactosylceramide alpha 2-3 sialyltransferase (SAT-1):
      solubilization of SAT-1 with lauryldimethylamine oxide.
AB  - Lauryldimethylamine oxide (LDAO) was employed in the purification of the GM3
      ganglioside forming enzyme, CMP-sialic acid:lactosylceramide alpha 2-3
      sialyltransferase (SAT-1) (4). This detergent has advantages over the typically
      employed Triton detergents in the solubilization and stabilization of this
      sialyltransferase. Crude protein fractions solubilized from rat liver Golgi by
      several such detergents are very similar in composition as determined by two
      dimensional gel electrophoresis. However, LDAO appears to activate and stabilize
      SAT-1 activity. It is possible that SAT-1 activation involves the structurally
      similar hydrophobic moieties and quaternary amino groups of LDAO and
      phosphatidylcholine.

PMID- 2222468
TI  - Interaction between corticosteroid binding globulin and activated leukocytes in
      vitro.
AB  - The interaction between human corticosteroid binding globulin and activated
      leukocytes is restricted to the granulocyte population, and is characterized by
      specific proteolytic cleavage of corticosteroid binding globulin which markedly
      reduces its steroid binding activity. A direct interaction between corticosteroid
      binding globulin and the activated cells appears to enhance this event, and does
      not involve cellular internalization of corticosteroid binding globulin or its
      proteolytic degradation products, which resemble those obtained after incubation
      of corticosteroid binding globulin with neutrophil elastase. These data suggest
      that corticosteroid binding globulin interacts with elastase on the surface of
      activated neutrophils, and may promote glucocorticoid delivery to these cells
      during inflammation.

PMID- 2222469
TI  - Endogenous digitalis-like factor as a stimulator of endothelin secretion from
      endothelial cells.
AB  - Effects of human urine-derived endogenous digitalis-like factor (EDLF) and
      ouabain on endothelin (ET) secretion were examined in cultured endothelial cells.
      ET was secreted in a linear fashion over 5 hours from bovine pulmonary artery
      endothelium into serum-free medium. EDLF stimulated ET secretion in a dose
      dependent manner. In contrast, ouabain did not affect ET secretion at the
      concentration of 10(-9)-10(-5) M. These results indicate that human urine-derived
      EDLF is distinct from plant-derived ouabain and act as a stimulator of ET
      secretion by endothelial cells.

PMID- 2222470
TI  - Thylakoid-bound chloroplast DNA from spinach is enriched for replication forks.
AB  - Chloroplast DNA is bound to the thylakoids of spinach chloroplasts. To examine a
      possible role for thylakoid-bound DNA in chloroplast DNA replication, vesicles
      formed by treating chloroplasts in 3.5 mM MgCl2 were used. Chloroplast DNA
      fragments are bound to the surface of these vesicles. Chloroplast DNA isolated
      from vesicles that had been first treated with Eco R1 contained 10% of branched
      fragments whereas chloroplast DNA isolated from intact chloroplasts and treated
      with Eco R1 contained 2% of branched fragments. This result is consistent with
      the growing replication fork of chloroplast DNA being associated with the
      chloroplast internal membrane system. Branched fragments from the chloroplast DNA
      digested with Eco R1 prior to the isolation from the vesicle contained fragments
      of unequal length. Membrane binding in chloroplasts may have a similar role in
      DNA replication as it does in bacteria.

PMID- 2222471
TI  - Direct visualization of affected collagen molecules synthesized by cultured
      fibroblasts from an osteogenesis imperfecta patient.
AB  - Human skin fibroblasts obtained from normal controls and a patient with
      osteogenesis imperfecta were cultured in the presence of ascorbic acid 2
      phosphate, a long-acting vitamin C derivative. Crude collagen samples extracted
      from the cell layer were made to form lateral aggregates of collagen molecules,
      segment-long-spacing crystallites. Under the electron microscope, normal and
      abnormal crystallites of type I collagen were identified with the patient's
      collagen. While the carboxyl-terminal half of the abnormal crystallite was
      tightly packed, the amino-terminal half was loose and spreading, indicating the
      site of abnormality in the amino-terminal half of one of type I collagen alpha
      chains. The method is simple and useful to detect abnormal collagen and to
      predict the site of mutation.

PMID- 2222472
TI  - Message amplification phenotyping of an inherited delta-aminolevulinate
      dehydratase deficiency in a family with acute hepatic porphyria.
AB  - The molecular basis of the enzymatic defect responsible for acute hepatic
      porphyria due to delta-aminolevulinate dehydratase (ALAD) deficiency was
      investigated in a family including a proband with the acute disease. In order to
      delineate the mutation in the proband, cDNA for deficient ALAD was synthesized
      from the proband's cells. The ALAD phenotype was studied by message amplification
      phenotyping with total RNA extracted from lymphoblastoid cells of the proband and
      his family members. Two independent mutant alleles of ALAD were identified in the
      proband's cells. One mutant allele was shown to result in an amino acid
      substitution at residue 274 (Ala274----Thr). Message amplification phenotyping
      studies have also permitted us to define the ALAD phenotype of each subject in
      the family. This is the first mutation to be recognized in the human ALAD gene.

PMID- 2222474
TI  - Estrous cycle dependent regulation of peptidylarginine deiminase transcripts in
      female rat pituitary.
AB  - Northern blot hybridization demonstrated 4.5-5.0 kilobase peptidylarginine
      deiminase mRNA in poly (A)+ RNA-enriched fractions of both male and female
      pituitaries. Dot blot analysis of total RNA fractions showed more than 50-fold
      sex difference in the mRNA content. The female pituitary mRNA content showed at
      least a 50-fold variation during the estrous cycle characterized by elevation at
      diestrus and proestrus followed by a rapid decline at estrus. The data were
      discussed in comparison with the sex difference and estrous cycle dependence of
      the pituitary enzyme content reported previously.

PMID- 2222473
TI  - Efflux of bis-carboxyethyl-carboxyfluorescein (BCECF) by a novel ATP-dependent
      transport mechanism in epithelial cells.
AB  - The efflux of the intracellular pH fluorochrome 2',7'-bis(2-carboxyethyl)-5(6)
      carboxyfluorescein (BCECF) was quantified in four cultured epithelial cell lines;
      HCT-8, T84, HGT-1 and MDCK. BCECF efflux was time-dependent, and after 5 h 45-91%
      of the initial BCECF loaded was extracellular, efflux being greatest in MDCK
      cells. Depletion of cellular ATP approximately halved BCECF efflux. BCECF efflux
      was inhibited by indomethacin, vinblastine and verapamil, but not by nifedipine
      or reserpine. Certain features of BCECF efflux resemble drug efflux in multidrug
      resistant cells, but inhibition of efflux displays a distinct pharmacological
      profile suggesting BCECF is a substrate for a novel ATP-dependent transport
      system.

PMID- 2222475
TI  - Electro-permeabilization of cell membranes: effect of the resting membrane
      potential.
AB  - Electric field induced permeabilization of cell membranes is an important
      technique for gene transfection and cell hybridization. Mechanistic studies of
      this process revealed that the uptake of fluorescent indicator by plant
      protoplasts occurs predominantly on the hemisphere facing the positive electrode,
      while in erythrocyte ghosts the probes exit through the hemisphere facing the
      negative electrode. To reconcile these observations symmetrical pore formation
      and a mechanism of molecular exchange by electroosmosis has been proposed. In
      light of these controversial observations, we conducted a systematic study of
      electroporation of NIH3T3 cells with varying electric field strength, waveform
      and frequency. Our data revealed that (i) symmetrical permeabilization of the
      cell membrane occurs only with bipolar a.c. fields. (ii) When a critical membrane
      breakdown potential, Vc, is applied using either an unipolar a.c. fields or a
      single d.c. square pulse, the cell membrane becomes permeabilized only at the
      hemisphere facing the positive electrode. (iii) When the pulse-induced membrane
      potential, Vm, is approximately equal to or larger than the intrinsic membrane
      potential (i.e. using d.c. or unipolar a.c. field), asymmetric permeabilization
      was observed with the hemisphere facing the positive electrode being most
      permeable. (iv) The rate of fluorescent indicator uptake is dependent on the
      concentration of the indicator. These results indicate that electro
      permeabilization of cell membranes is affected by its resting potential and that
      electroosmosis is not the dominant mechanism for the cellular uptake of foreign
      molecules in electroporation.

PMID- 2222476
TI  - Inhibition of human immunodeficiency virus type 1 replication by phosphonoformate
      esters of 3'-azido-3'-deoxythymidine.
AB  - The water-soluble ammonium salt of 3'-azido-5'-(O-ethoxycarbonylphosphinyl)-3'
      deoxythymidine (ECP-AZT), the prototype of a novel class of compounds
      incorporating two active antiretroviral agents, in this case 3'-azido-3'
      deoxythymidine (AZT) and phosphonoformic acid (PFA), within the same structure,
      was synthesized and tested as an inhibitor of the replication of human
      immunodeficiency virus type 1 (HIV-1) in Jurkat cells, a CD4+ human T-lymphocyte
      cell line. The corresponding 5'-(O-methoxycarbonylphosphinyl) derivative (MCP
      AZT) was also prepared. The rationale for the synthesis of ECP-AZT and MCP-AZT
      was that they may be cleaved intracellularly to AZT and PFA via hydrolysis of the
      phosphate ester bond or to AZT 5'-monophosphate by oxidative cleavage of the
      carbon-phosphorus bond. ECP-AZT was found to block viral replication at a 50%
      inhibitory concentration (IC50) of ca. 10(-6) M as measured by reverse
      transcriptase (RT) activity in supernatants from cultures of infected cells.
      Little or no inhibition of cell growth was observed at this concentration, and
      there was less than 20% inhibition of cell growth at 10(-4) M. AZT itself was a
      more potent inhibitor of HIV-1 replication than ECP-AZT, but was also more
      cytotoxic. The antiviral selectivity of ECP-AZT, defined as the ratio IC50 (virus
      inhibition)/IC50(cell growth inhibition), was in the range considered to be
      therapeutic for anti-AIDS nucleosides.

PMID- 2222477
TI  - Metabolic correction of fucosidosis lymphoid cells by galaptin-alpha-L-fucosidase
      conjugates.
AB  - To determine if isolated galaptin, an endogenous galactoside-binding lectin,
      could serve as a transport vehicle of therapeutic agents to cells, galaptin and
      alpha-L-fucosidase were coupled using glutaraldehyde. The conjugates were
      incubated with alpha-L-fucosidase-deficient, EBV-immortalized lymphoid cells from
      a fucosidosis patient. Conjugates were effectively bound and internalized by the
      cells in a lactose inhibitable manner. Internalization of conjugate resulted in
      the reduced accumulation of alpha-L-fucosyl-N-acetylglucosaminylasparagine, a
      glycopeptide that accumulates in cells of fucosidosis patients, to levels found
      in lymphoid cells from a healthy individual. Thus, galaptin-alpha-L-fucosidase
      conjugates may be useful for enzyme replacement therapy of fucosidosis. The
      concept of using galaptin as a transport vehicle may be applied to the delivery
      of other compounds to cells bearing galaptin receptors.

PMID- 2222478
TI  - Release of T-antigen, a carcinoma marker from native human cells, by endo-alpha-N
      acetylgalactosaminidase of Alcaligenes sp.
AB  - The endo-alpha-N-acetylgalactosaminidase from Alcaligenes sp. could release T
      antigen (Ga1 beta 1----3GalNAc), a carcinoma-associated marker from asialo
      glycophorin and human cells. The released T-antigen from human asialo
      erythrocytes was determined by thin layer chromatography and gas liquid
      chromatography. The released T-antigen from human gastric carcinoma cell Kato III
      was identified by high performance liquid chromatographies with a reverse-phase
      column and a size fractionation column. Released T-antigen could be analyzed
      quantitatively by a sensitive method including pyridylamino derivatization and
      following high performance liquid chromatography. This suggests that the enzyme
      is useful for detection and determination of T-antigen from cells.

PMID- 2222479
TI  - An active site of growth hormone for eliciting the differentiation of preadipose
      3T3-F442A cells to adipose cells.
AB  - In order to elucidate the active sites of growth hormone for eliciting the
      differentiation of preadipose 3T3-F442A cells to adipocytes, four artificial
      mutant variants of human growth hormone (hGH) modified in the loop region of
      amino acid residues 54-74 were prepared in Escherichia coli by site-directed
      mutagenesis. Although the P59A (replacement of Pro59 with Ala) variant retained
      almost the same biological- and receptor binding-activity as hGH, the P61A
      (replacement of Pro61 with Ala) and the P59A-P61A (replacement of both Pro59 and
      Pro61 with Ala) both exhibited about half the activity, and the delta (62-67)
      variant (deletion of the residues 62-67) exhibited only about 0.1% the activity
      of those of intact hGH. The results suggest that Pro61 may be involved in
      formation of the active conformation of hGH, but Pro59 may not, and that the
      amino acid residues around 62-67 may be critical for the specific biological
      features of hGH.

PMID- 2222480
TI  - Peroxisomal disorders: complementation analysis using beta-oxidation of very long
      chain fatty acids.
AB  - Complementation studies, using fused cell lines from patients with peroxisomal
      disorders, have shown correction of defective plasmalogen synthesis and phytanic
      acid oxidation as well as an increase in the number of peroxisomes. At least six
      complementation groups have been reported. We demonstrate here that complementing
      cell lines also acquire the ability to oxidize very long chain fatty acids
      (VLCFA), and that complementation groups defined with this technique are
      identical to those reported previously when plasmalogen synthesis was used as the
      criterion for complementation. This VLCFA complementation technique is of
      particular value in the study of patients in whom defective VLCFA is the only or
      major enzymatic defect, and we show complementation between cell lines from two
      patients each with an isolated defect in one of the peroxisomal fatty acid beta
      oxidation enzymes.

PMID- 2222481
TI  - Changes in intracellular calcium of porcine sperm during in vitro incubation with
      seminal plasma and a capacitating medium.
AB  - The intracellular free Ca2+ concentration in ejaculated, porcine sperm was
      determined with a fluorescent, Ca2(+)-specific probe, Fura 2. Following
      suspension of sperm in a medium capable of sustaining capacitation and the
      acrosome reaction, the intracellular [Ca2+] increased from an initial value of
      about 75 nM to a peak value of 130 nM, after about 4 to 5 h of incubation. Within
      this period of time, a peak value of 246 nM was attained when sperm was incubated
      in seminal plasma. Ca2+ uptake is presumably not associated with membrane
      potential-dependent channels. The results indicate that a pronounced increase in
      intracellular free Ca2+ occurs towards the end of the incubation period when
      rather synchronous acrosome reactions take place in the sperm population, either
      in capacitating medium or in seminal plasma.

PMID- 2222482
TI  - Insulin-like growth factor 1 supports embryonic nerve cell survival.
AB  - Insulin-like growth factor 1 (IGF-1) is shown to support the long term survival
      of embryonic chicken central nervous system neurons cultured in a defined medium.
      This trophic activity for IGF-1 was discovered as the result of its presence as a
      contaminant in bovine serum albumin, a reagent frequently used in primary
      cultures of neuronal tissue. The observation that IGF-1 has cell survival
      activity may explain the high level of IGF-1 receptors found in embryonic brain.

PMID- 2222483
TI  - Extracellular depolymerization of hyaluronic acid in cultured human skin
      fibroblasts.
AB  - The chain length of [3H]hyaluronic acid synthesized by cultivating human skin
      fibroblasts in the presence of [3H]glucosamine was investigated. [3H]Hyaluronic
      acid obtained from the matrix fraction was excluded from a Sepharose CL-2B column
      irrespective of the incubation period, whereas that from the medium was
      depolymerized into a constant chain length (Mr = 40,000). The reducing and non
      reducing terminals of the depolymerized hyaluronic acid were N-acetylglucosamine
      and glucuronic acid, respectively. Prolonged incubation produced no
      oligosaccharides as shown by examination of hyaluronidase digests, suggesting the
      presence of a novel endo-beta-N-acetylglucosaminidase in cultured human skin
      fibroblasts.

PMID- 2222485
TI  - Protein oxidation and myelinolysis occur in brain following rapid correction of
      hyponatremia.
AB  - Myelinolysis occurs following rapid correction of hyponatremia in both humans and
      experimental animals. Although the mechanism of this effect at present is
      unknown, we have examined the possibility that a rapid rise in serum sodium
      following hyponatremia potentiates an oxidative stress and results in the
      oxidation of cellular proteins. In these studies, rats treated with 1 M NaCl
      following 3 days of vasopressin-induced hyponatremia exhibited myelinolysis in
      the corpus striatum and thalamus as well as significant increases in soluble
      oxidized proteins in the brain. These changes did not occur in rats treated with
      0.155 M (0.9%) NaCl following 3 days of hyponatremia.

PMID- 2222484
TI  - The strong hepatocarcinogenicity of the electrophilic and mutagenic metabolite 6
      sulfooxymethylbenzo[a]pyrene and its formation of benzylic DNA adducts in the
      livers of infant male B6C3F1 mice.
AB  - 6-Hydroxymethylbenzo[a]pyrene was activated to an electrophilic and mutagenic
      sulfuric acid ester metabolite by rat and mouse liver sulfotransferase activity.
      The intrinsic mutagenicity of this reactive ester, 6
      sulfooxymethylbenzo[a]pyrene, was inhibited by glutathione and glutathione S
      transferase. A single i.p. dose of 2.5 nmol/g body wt of 6
      sulfooxymethylbenzo[a]pyrene in infant male B6C3F1 mice induced liver tumors in
      35 of 36 mice at 10 months with an average multiplicity of 4.4. A comparable dose
      of the parent hydrocarbon, 6-hydroxymethylbenzo[a]pyrene, was only a tenth as
      active. The electrophilic sulfuric acid ester produced high levels of benzylic
      DNA adducts in the livers of these mice that accounted for about 80% of the total
      DNA adducts. These results strongly suggest that this sulfuric acid ester is an
      important ultimate electrophilic and carcinogenic metabolite in carcinogenesis by
      6-hydroxymethylbenzo[a]pyrene and possibly even by 6-methylbenzo[a]pyrene and
      benzo[a]pyrene in mouse liver.

PMID- 2222486
TI  - Oxidative C4-demethylation of 24-methylene cycloartanol by a cyanide-sensitive
      enzymatic system from higher plant microsomes.
AB  - Microsomes isolated from corn embryos (Zea mays) were shown to catalyse the C-4
      monodemethylation of 28-[3H],24-methylene cycloartanol 1, leading to the
      corresponding 4 alpha-methyl sterol, cycloeucalenol 5. An enzymatic assay has
      been developed for the 4,4-dimethyl sterol 4-demethylase in higher plants. The
      demethylation process was shown to involve a 4-methyl, 4-hydroxymethyl derivative
      2 which can be considered as the immediate metabolite of 1 by the 4-methyl
      oxidase. Compound 2 is further metabolized into 5 through a 4-methyl-4-carboxylic
      acid 3 and a 3-keto-4 alpha-methyl intermediate 4 which were identified. The
      conversion of 1 into 5 requires NADPH and molecular oxygen. The initial oxidative
      step was strictly dependent upon molecular oxygen, NADPH or NADH, and strongly
      inhibited by cyanide, whereas the overall process was completely insensitive to
      CO and to specific inhibitors of cytochrome P-450. It is concluded that in Zea
      mays microsomes, the C-4 demethylation of 1 results from a multistep process
      involving a terminal oxygenation system sensitive to cyanide which is distinct
      from cytochrome P-450 and in particular from that involved in the 14 alpha
      demethylation of obtusifoliol.

PMID- 2222487
TI  - Presence of a plant-like glyoxalase II in Candida albicans.
AB  - Glyoxalase II from Candida albicans was purified by affinity chromatography on S
      carbobenzoxyglutathione-Affi Gel 10. The enzyme was characterized and compared
      with the glyoxalases II from animal and plant sources. The relative molecular
      mass is 29 kDa, and the isoelectric point (pI) is 6.0. The acidic pI value
      appears to be typical for plant glyoxalase II, in contrast to the uniformly basic
      glyoxalase II pI values from animals. S-D-Lactoylglutathione and S
      acetoacetylglutathione are the best substrates, and S-carbobenzoxyglutathione is
      the best inhibitor of the yeast enzyme. Glutathione derivatives with a thioether
      bond are not inhibitory. Glyoxalase II from Candida albicans is compared either
      with animal and plant enzymes.

PMID- 2222488
TI  - Relative contribution of glycogenolysis and gluconeogenesis to basal, glucagon-
      and nerve stimulation-dependent glucose output in the perfused liver from fed and
      fasted rats.
AB  - The relative contribution to basal, glucagon- and nerve stimulation-enhanced
      glucose output of glycogenolysis (glucose output in the presence of the
      gluconeogenic inhibitor mercaptopicolinate) and gluconeogenesis (difference in
      glucose output in the absence and presence of the inhibitor) was investigated in
      perfused livers from fed rats with high and from fasted animals with low levels
      of glycogen. 1) Basal glucose output in both states was due only to
      gluconeogenesis. 2) Glucagon-enhanced glucose output was due about equally to
      glycogenolysis and gluconeogenesis in the fed state, but predominantly to
      gluconeogenesis (80%) in the fasted state. 3) Nerve stimulation-increased glucose
      output was due mainly to glycogenolysis (65%) in the fed state and about equally
      to both processes in the fasted state. The results suggest that under basal
      conditions of normal demands the liver supplies glucose only via gluconeogenesis
      and thus spares its glycogen stores, and that in situations of enhanced demands
      signalled by an increase in glucagon or sympathetic tone the liver liberates
      glucose mainly via glycogenolysis.

PMID- 2222489
TI  - Conversion of rat urinary prokallikrein to its active form.
AB  - A peptide derived from rat urinary prokallikrein by trypsin treatment comprised 7
      amino acids, the sequence (Ala-Pro-Pro-Val-Gln-Ser-Arg) of which was identical
      with that of the N-terminal region in prokallikrein. Thus, with trypsin
      treatment, rat urinary prokallikrein is converted to the active form with the
      release of the N-terminal propeptide consisting of 7 amino acids. An Arg-1-Val+1
      bond in the prokallikrein was found to be the site of proteolytic cleavage of the
      propeptide.

PMID- 2222491
TI  - Kinetic and molecular parameters of human hepatic porphobilinogen deaminase.
AB  - A basal level of human liver porphobilinogen deaminase of 3.66 units/g wet weight
      was found in adult tissue. Activity in neonatal liver was at least three fold
      higher. Physico-chemical studies revealed that the enzyme has the approximate
      form of a symmetrical molecule and exhibits hyperbolic kinetics with a Km value
      of 3.6 microM at pH 7.6. Two ionizable groups with pK values of 7.35 and 8.90 are
      prominent for catalysis. A set of pI (5.8-4.9) were observed under different
      conditions. Results demonstrate the existence of a single protein differentially
      charged with multiple molecular forms in adult liver.

PMID- 2222490
TI  - Isolation of cyclo(His-Pro)-like immunoreactivity from human urine and
      demonstration of its immunologic, pharmacologic, and physico-chemical identity
      with the synthetic peptide.
AB  - Measurements of cyclo(His-Pro) levels in human urine were carried out by specific
      radioimmunoassay. Cyclo(His-Pro)-like immunoreactivity in Human urine was found
      to be immunologically, pharmacologically, and physico-chemically identical to
      that of synthetic cyclo(His-Pro). The concentration of urinary cyclo(His-Pro) in
      24-h collection was 1133.8 +/- 122.5 nmol/L, with a range of 606 to 1865 nmol/L.
      The daily excretion rate of cyclo(His-Pro) was 1812 +/- 248 nmol cyclo(His-Pro)/g
      creatinine, or 1814 +/- 199 nmol cyclo(His-Pro/day.

PMID- 2222492
TI  - Transcriptional regulation of messenger RNA for ferritin heavy chain by
      thyrotropin.
AB  - Thyrotropin increased the steady state levels of ferritin heavy chain messenger
      RNA in cultured Fisher rat thyroid (FRTL5) cells by about 2.5-fold. Thyrotropin
      also stimulated the transcription rate of ferritin H gene determined by "nuclear
      run-on" assay by roughly the same extent as mRNA levels. Thyrotropin showed no
      effect on the stability of the ferritin heavy chain mRNA, which was suggested
      using actinomycin D. The results suggest that thyrotropin increases ferritin
      heavy chain mRNA expression in FRTL5 cells by affecting the step of
      transcription.

PMID- 2222493
TI  - Trypanosoma cruzi histones. Further characterization and comparison with higher
      eukaryotes.
AB  - Histones extracted from T. cruzi chromatin were analyzed in three electrophoretic
      systems. Our results show that a basic protein with some properties similar to
      those of histone H1 from higher eukaryotes is present in T. cruzi. However this
      protein presents different electrophoretic mobilities than H1 histone from higher
      eukaryotes in all three electrophoretic systems tested. Considering the marked
      differences observed in the electrophoretic mobilities of T. cruzi histones as
      compared with those from higher eukaryotes, it is proposed that histones are
      conservative proteins primarily with regard to their function.

PMID- 2222494
TI  - Partial amino acid sequence of osteocalcin from an extinct species of ratite
      bird.
AB  - Osteocalcin the major gamma carboxyglutamic acid containing protein of vertebrate
      bone has been purified from the bones of a specimen of Pachyornis elephantopus, a
      species of the extinct class of New Zealand ratite birds, the moas. The sequence
      of the N-terminal region of moa osteocalcin was determined using gas phase N
      terminal sequencing. The N-terminal sequences of the ostrich and rhea
      osteocalcins were also determined. Alignment of the N-terminal sequence of
      osteocalcin from the extinct moa against the osteocalcins of the extant ostrich,
      rhea and emu reveals the homology amongst the ratite species is greater than the
      homology with the chicken osteocalcin.

PMID- 2222497
TI  - Circadian changes in glycogen content in rat interscapular brown adipose tissue:
      effect of cold exposure and food deprivation.
AB  - The effects of food deprivation and cold exposure on brown adipose tissue (BAT)
      glycogen and lipid levels during the circadian cycle were studied. BAT glycogen
      levels in control animals followed a definite circadian cycle, showing an
      increase during the light period. In cold-exposed animals the pattern was
      different, with minimal values at the beginning of the dark period. Food
      deprivation caused a decrease in BAT glycogen concentration only after 48-hours.
      In contrast to the control animals, where BAT and liver showed a different
      glycogen pattern, in the cold exposed group the observed changes were similar.
      During cold exposure, lipid stores in BAT were decreased. The results obtained in
      this work highlight with the important role of glycogen and lipid stores in BAT
      thermogenesis.

PMID- 2222495
TI  - Glycogen biogenesis in the adipocyte and mammary adenocarcinoma and the influence
      of insulin.
AB  - 3T3 LI P-3 adipocytes and a rat mammary carcinoma each contain a protein (or
      proteins) of Mr 400 kDa approx. that undergoes glucosylation when incubated with
      UDPglucose and Mn2+. In each case, the product of glucosylation is a protein
      bound maltosaccharide containing up to 14 glucose residues, and therefore capable
      of priming glycogen synthesis. The proteins bear a formal similarity to the self
      glucosylating protein of Mr 37 kDa that primes muscle glycogen synthesis, but do
      not cross-react with an antibody that cross-reacts with the muscle protein. The
      extent of protein glucosylation in the adipocyte is rapidly and markedly
      stimulated when the cells are bathed in insulin, suggesting that this initial
      step in glycogen biogenesis, protein glucosylation, is under the influence of the
      hormone.

PMID- 2222496
TI  - Stimulation of protein synthesis by a 34 KD DNA-binding protein from human
      placenta.
AB  - A 34 KD DNA-binding protein fraction from human placenta stimulated endogenous
      protein synthesis in rabbit reticulocyte and wheat-germ cell-free systems. Though
      the synthesis of several proteins were stimulated by the 34 KD protein, a dose
      dependent increase of two polypeptides of molecular weights 42,000 and 51,000
      were distinctly observed in reticulocyte lysates. The synthesis of the major
      protein (beta-globin) was not affected by the 34 KD protein. In both hemin
      supplemented and unsupplemented lysates, the ability of 34 KD protein to
      stimulate the synthesis of high molecular weight (HMW) proteins was drastically
      reduced by Mg++ and not by dsRNA.

PMID- 2222498
TI  - Sucralfate protection of gastric mucosa against alcohol-induced injury: a
      phosphoinositide mediated process.
AB  - The mechanism of protection by sucralfate against gastric mucosal injury induced
      by ethanol was investigated. The experiments in vivo were conducted with groups
      of rats with and without indomethacin pretreatment, and the animals received
      sucralfate followed by ethanol. In the in vitro experiments, gastric mucosa was
      cultured in the presence of sucralfate, ethanol, or both. The in vivo experiments
      revealed that ethanol caused extensive gastric hemorrhagic lesions which were
      significantly reduced following sucralfate pretreatment and that this effect of
      sucralfate was not prevented by indomethacin. The data with gastric mucosal
      culture demonstrated that ethanol caused a 24% decrease in mucin synthesis, while
      mucin synthesis in the presence of sucralfate increased by 32%. This increase was
      accompanied by the enhanced metabolism of mucosal phosphoinositides, as reflected
      by a 22% decrease in PI, 1,2-fold increase in IP1 and 3.4-fold increase in IP3.
      In contrast, ethanol, caused 1.5-fold increase in IP1 and PIP2, and 35% decrease
      in PIP, 47% decrease in IP2 and 38% decrease in IP3. However, when the mucosal
      culture was carried out in the presence of both sucralfate and ethanol, the
      detrimental changes evoked by ethanol in mucin synthesis were prevented. The
      results suggest that the mucosal protective action of sucralfate involves the
      metabolism of phosphoinositide-derived messenger molecules.

PMID- 2222499
TI  - Proposal of leukotoxin, 9,10-epoxy-12-octadecenoate, as a burn toxin.
AB  - It is postulated that toxic substances (burn toxin) synthesized in burned skin
      are transferred into general circulation and cause multiple organ failure. We
      found a highly cytotoxic substance, leukotoxin, a linoleate epoxide, exists in
      burned skin. Leukotoxin, as the name indicates, was synthesized by leukocytes
      from linoleate as a substrate. The aim of this study is to evaluate the
      possibility of leukotoxin as a burn toxin. We studied plasma leukotoxin level of
      four patients with extensive burns (over 50% of body surface area) and examined
      coagulation studies in these patients. We detected considerable amounts of
      leukotoxin (11.4 nmol/ml-37.0 nmol/ml) in all patients. Leukotoxin was not
      detected in the control subjects. Pulmonary edema, cardiac failure, and
      coagulation abnormalities were found in these patients. Exogeneously administered
      leukotoxin induced similar pathological conditions in experimental animals to
      those observed in patients with extensive burns. Hence, it is concluded that
      leukotoxin is a responsible substance as a burn toxin.

PMID- 2222500
TI  - Actinomycin D suppresses hydrocortisone-induced changes in distribution and
      sialylation of brush-border enzymes in jejunal villi and crypts.
AB  - To investigate the regulatory role of hydrocortisone in the postnatal decline of
      sialylation of intestinal brush-border hydrolases, we applied actinomycin D, the
      well-known inhibitor of transcription, simultaneously with the hormone to 9-day
      old rats. On day 12 actinomycin D inhibited hydrocortisone-induced changes in the
      profile of enzyme activities along the villus-crypt axis and suppressed the
      appearance of asialylated forms of enzymes manifested precociously in the
      differentiating crypt cells under the effect of the hormone. These findings were
      correlative with sialyltransferase activity along the villus-crypt axis.

PMID- 2222501
TI  - Dopaminergic mechanisms in the locomotor stimulant effects of nicotine.

PMID- 2222502
TI  - Inhibition of mitochondrial carnitine palmitoyltransferases by adriamycin and
      adriamycin analogues.
AB  - Adriamycin (ADR; doxorubicin) and its highly lipophilic, less toxic analogue N
      benzyl-adriamycin-14-valerate (AD 198) were found to inhibit rat heart and liver
      carnitine palmitoyltransferases of both mitochondrial outer and inner membranes.
      The outer membrane enzyme was more sensitive to inhibition by these drugs than
      the inner membrane enzyme, and AD 198 was a more potent inhibitor of these
      enzymes than ADR. Other analogues of ADR, N-trifluoroacetyladriamycin-14-valerate
      (AD 32) and N-trifluoroacetyladriamycin-14-O-hemiadipate (AD 143), which are
      documented as being noncardiotoxic, were also more potent inhibitors of the
      mitochondrial carnitine palmitoyltransferases than ADR. Overall, the cardiac
      mitochondrial carnitine palmitoyltransferases seemed to be slightly more
      sensitive to the inhibitory effects of ADR and its analogues than the liver
      enzyme. ADR was an uncompetitive inhibitor with respect to palmitoyl-CoA and a
      noncompetitive inhibitor with respect to carnitine for both mitochondrial outer
      and inner membrane enzymes. Our data suggest that mitochondria can take up ADR
      and concentrate it within the matrix, as is known to happen with other positively
      charged compounds. More ADR was found associated with the mitochondrial inner
      membrane than with the outer membrane; this could be due to the greater protein
      content of the inner membrane rather than drug binding to cardiolipin. Although
      inhibition of cardiac inner membrane carnitine palmitoyltransferase has been
      implicated previously as part of the cardiotoxicity mechanism of ADR, the present
      findings with ADR and its noncardiotoxic analogues do not support this view.

PMID- 2222503
TI  - Depressive effects of lipid peroxides mediated via a purine receptor. Effect of
      lipid peroxide on the cortical synaptosomal GTPase activity.
AB  - A circadian rhythm of lipid peroxides (LPO) in mouse whole brain was observed
      with a negative correlation between LPO levels in cerebral cortex and the
      locomotor activity of mice. Intraperitoneal administration of t-butyl
      hydroperoxide (BPO) to mice decreased spontaneous locomotor activity in a dose
      dependent manner, and the effect was competitively antagonized by caffeine,
      suggesting a similar receptor. Cumene peroxide (CPO), BPO and known depressants
      such as phenobarbital and NaBr all stimulated GTPase activity in rat cerebral
      cortex synaptosomes. In contrast, stimulants, such as caffeine and amphetamine,
      inhibited GTPase activity. Using fresh and aged synaptosomes which differed
      markedly in endogenous LPO levels, it appeared as if the LPO competitively
      inhibited inosine-induced GTPase activity, suggesting that the receptor of LPO is
      the same as that of inosine. From these results, it is concluded that LPO in
      brain act as depressants whose activity can be competitively antagonized by
      caffeine, and that the effects of LPO are mediated through a purine receptor.

PMID- 2222504
TI  - Iron release and erythrocyte damage in allyl alcohol intoxication in mice.
AB  - Allyl alcohol administration in a toxic dose (1.5 mmol/kg) to starved mice causes
      the development of hemolysis in nearly 50% of the animals. Malonic dialdehyde
      (MDA) appears in plasma of the animals showing hemolysis. The treatment of mice
      with desferrioxamine after allyl alcohol intoxication completely prevents lipid
      peroxidation and hemolysis, suggesting the involvement of iron in the allyl
      alcohol-induced erythrocyte damage. Erythrocytes obtained from intoxicated mice
      before the development of hemolysis show, upon incubation, release of iron, lipid
      peroxidation and lysis. Studies carried out with reconstituted systems of
      erythrocyte lysates, containing ghosts and different fractions of erythrocyte
      cytosol and incubated in the presence of acrolein (the major metabolite of allyl
      alcohol), strongly suggest that iron is released from hemoglobin. This iron
      appears to promote lipid peroxidation which is accompanied by erythrocyte lysis.
      Thus, the allyl alcohol-induced hemolysis appears to be a model for iron
      delocalization from iron stores.

PMID- 2222505
TI  - Early mitochondrial disfunction in bromobenzene treated mice: a possible factor
      of liver injury.
AB  - The membrane potential of liver mitochondria isolated from bromobenzene treated
      mice was studied. Specifically, the efficiency of the energy-transducing
      mitochondrial membrane was measured during the phase between the occurrence of a
      massive loss of hepatic GSH, after 2-3 hr of bromobenzene intoxication, and the
      appearance of lipid peroxidation and cell death (12-15 hr after treatment).
      Partial uncoupling of oxidative phosphorylation was observed in mitochondria
      during the early period of intoxication (3-9 hr). These anomalies in oxidative
      metabolism did not result in irreversible damage to the mitochondrial inner
      membrane. The possibility that phenolic metabolites of bromobenzene are
      responsible for the uncoupling effects was examined. Orto- and especially para
      bromphenol reproduced the alterations of mitochondrial function when added to
      normal mitochondria at concentrations comparable to those found in the livers of
      the intoxicated animals. Since the concentration of the bromophenols (especially
      p-bromophenol) largely increases after the intoxication times as tested here,
      mitochondrial uncoupling may represent a mechanism of liver damage acting
      synergistically with or even independently of other factors such as oxidative
      stress and lipid peroxidation.

PMID- 2222506
TI  - Irreversible inhibition of rat S-adenosylmethionine decarboxylase by 5'-([(Z)-4
      amino-2-butenyl]methylamino)-5'-deoxyadenosine.
AB  - 5'-([(Z)-4-Amino-2-butenyl]methylamino)-5'-deoxyadenosine [Z)-AbeAdo) was tested
      in vitro and in vivo as a potential inhibitor of S-adenosyl-L-methionine
      decarboxylase (AdoMetDC), a pyruvoyl-containing enzyme, purified from rat liver.
      In vitro (Z)-AbeAdo produces a time- and dose-dependent irreversible inhibition
      of the enzyme. Saturation kinetics are observed when the enzyme is preincubated
      with (Z)-AbeAdo in the presence of 50 microM putrescine, a known activator of
      AdoMetDC. Under these conditions kinetic constants were measured (Ki = 0.56 +/-
      0.04 microM; tau 1/2 = 0.51 +/- 0.03 min). The inhibition is not relieved by
      prolonged dialysis of the inactivated enzyme. The turnover number for (Z)-AbeAdo,
      i.e. the number of inactivator molecules required to inactivate one enzyme
      molecule, is approximately 1.5. The selectivity of (Z)-AbeAdo was explored: the
      compound is not a substrate of adenosine deaminase, mitochondrial monoamine
      oxidase and diamine oxidase, but is slowly oxidized by benzylamine oxidase from
      rat aorta. The (E)-isomer of AbeAdo, is at least 100-fold less active than (Z)
      AbeAdo as a time-dependent inhibitor of rat liver AdoMetDC. In rats,
      intraperitoneal administration of (Z)-AbeAdo produces a rapid, long-lasting and
      dose-dependent decrease of AdoMetDC activity in ventral prostate, testis and
      brain.

PMID- 2222507
TI  - Failure of gentamicin to elevate cellular malondialdehyde content or increase
      generation of intracellular reactive oxygen species in primary cultures of renal
      cortical epithelial cells.
AB  - The role of lipid peroxidation in gentamicin cytotoxicity was assessed in primary
      cultures of renal cortical epithelial cells. The cellular content of
      malondialdehyde (MDA), one of the end products of lipid peroxidation, was
      determined, and the intracellular generation of reactive oxygen species, one of
      the events commonly occurring at the beginning of the process of lipid
      peroxidation, was estimated. Exposures to gentamicin were chosen that preceded or
      accompanied overt toxicity. MDA was determined by the thiobarbituric acid
      reactive substances assay. Intracellular generation of reactive oxygen species
      was estimated by quantitating the fluorescence of 2',7'-dichlorofluorescein
      (DCF'), a fluorophore formed by the reaction of the deacetylation product (2',7'
      dichlorofluorescein, DCF) of the fluorescent probe 2',7'-dichlorofluorescein
      diacetate (DCFDA) with reactive oxygen species. Neither elevated MDA content nor
      intracellular generation of reactive oxygen species was observed in primary
      cultures of renal cortical epithelial cells treated with gentamicin, using
      exposures which preceded or accompanied overt toxicity. We conclude that lipid
      peroxidation does not play a role in gentamicin cytotoxicity.

PMID- 2222508
TI  - An evaluation of the redox cycling potencies of paraquat and nitrofurantoin in
      microsomal and lung slice systems.
AB  - The redox cycling abilities of the pulmonary toxins paraquat and nitrofurantoin
      have been compared with those of the potent redox cyclers, diquat and menadione
      in lung and liver microsomes by using the oxidation of NADPH and consumption of
      oxygen. The relative potencies of these compounds to undergo redox cycling were
      in the order: diquat approximately menadione much greater than paraquat congruent
      to nitrofurantoin. This was partly attributed to the much lower affinity (Km) of
      lung and liver microsomes for paraquat and nitrofurantoin than for diquat and
      menadione. The potential to redox cycle was assessed in an intact cellular system
      by determining the oxygen consumption of rat lung slices in the presence (10(-6),
      10(-5) and 10(-4) M) or absence of each of the four substrates. At concentrations
      of paraquat (10(-5) M) known to be accumulated by lung slices, a small but
      significant stimulation of lung slice oxygen uptake was observed. Nitrofurantoin
      (10(-4)-10(-6) M) did not affect lung slice oxygen uptake in lung slices, an
      observation consistent with its being a poor redox cycling compound, which is not
      actively accumulated into lung cells. This data has important implications in
      assessing the risk of exposure to paraquat. Low levels of paraquat would not be
      expected to cause lung damage because insufficient compound is present in the
      lung to exert its toxicity by redox cycling (due to the high Km observed).

PMID- 2222509
TI  - Common pharmacological and physico-chemical properties of 5-HT3 binding sites in
      the rat cerebral cortex and NG 108-15 clonal cells.
AB  - On account of the postulated existence of 5-HT3 receptor subtypes, the respective
      physico-chemical and pharmacological properties of specific binding sites for the
      potent 5-HT3 antagonist [3H]zacopride were compared using membranes from the rat
      posterior cortex or neuroblastoma-glioma NG 108-15 clonal cells. In both membrane
      preparations, [3H]zacopride bound to a single class of specific sites with a Kd
      close to 0.5 nM. However, the Bmax value in NG 108-15 cell membranes (970 +/- 194
      fmol/mg protein) was approximately 50 times larger than that in cortical
      membranes (19 +/- 2 fmol/mg protein). The specific binding of [3H]zacopride was
      equally affected by temperature, pH and molarity of the assay medium, and equally
      insensitive to thiol- and disulfide-reagents (N-ethylmaleimide, p
      chloromercuribenzene sulfonic acid, dithiothreitol) and GTP in cortical as well
      as NG 108-15 cell membranes. Determination of the molecular size of [3H]zacopride
      specific binding sites by radiation inactivation yielded values close to 35 kDa
      for both membrane preparations. Finally, a highly significant positive
      correlation (r = 0.979) was found between the respective pKi values of 34
      different drugs for their inhibition of [3H]zacopride specific binding to
      cortical or NG 108-15 cell membranes. Among them, the most potent was S(
      )zacopride (pKi = 9.55), followed by BRL 43964, ICS 205-930, quipazine,
      R(+)zacopride, GR 38032F and MDL 72222. Atypical antidepressants (mianserin,
      amoxapine) and neuroleptics (clotiapine, loxapine and clozapine) were active in
      rather low concentrations (pKi less than 6.5), suggesting that recognition of 5
      HT3 sites might be relevant to part of the in vivo effects of these drugs. Such
      identical physico-chemical and pharmacological properties of [3H]zacopride
      specific binding in cortical and NG 108-15 cell membranes strongly suggest that
      the same 5-HT3 receptor (subtype?) exists in these two preparations.

PMID- 2222510
TI  - Stimulation and inhibition of adenylyl cyclase by distinct 5-hydroxytryptamine
      receptors.
AB  - 5-Hydroxytryptamine (serotonin, 5-HT) stimulates basal adenylyl cyclase activity
      in membranes from guinea pig or rat hippocampi, but 5-HT inhibits forskolin
      stimulated adenylyl cyclase activity in these same membranes. The opposing
      effects of 5-HT on adenylyl cyclase activity indicate that distinct 5-HT
      receptors, positively and negatively coupled to adenylyl cyclase, are present in
      these membranes. Stimulation of adenylyl cyclase activity is mediated by two
      distinct 5-HT receptors. The receptor with lower affinity for 5-HT, designated as
      RL, is apparently homologous with a 5-HT receptor present in rat collicular
      membranes, but it is not homologous with the stimulatory receptor characterized
      in neuroblastoma hybrid cell (NCB-20) membranes. The receptor with higher
      affinity for 5-HT is homologous with the 5-HT1A binding site. The magnitude of
      stimulation by 5-HT1A receptors is variable with respect to stimulation by RL and
      is sometimes completely absent. Inhibition of forskolin-stimulated adenylyl
      cyclase activity, in membranes from either rat or guinea pig hippocampus or rat
      cortex, is a functional correlate of the 5-HT1A binding site. This inhibitory
      response was used to determine the pharmacological characteristics of drugs that
      reportedly have high affinity for 5-HT1A binding sites, such as 1-[2-(4
      aminophenyl)ethyl]-4-(3-trifluoromethylphenyl)piperazine (PAPP) and (-)pindolol.
      PAPP inhibited adenylyl cyclase activity in guinea pig hippocampal membranes with
      an EC50 value of 27 +/- 3 nM. (-)Pindolol was a partial agonist in inhibiting
      adenylyl cyclase activity in guinea pig and rat hippocampal membranes. Because of
      the low intrinsic activity of (-)pindolol, it was tested as an antagonist of the
      inhibition produced by 5-HT1A receptor agonists in rat hippocampal membranes. The
      Kb of (-)pindolol was 40 nM as measured by a Schild plot. (-)Propranolol was a
      simple competitive antagonist at the rat hippocampal receptor with a Kb value of
      550 nM. In summary, guinea pig and rat hippocampal membranes possess two distinct
      populations of 5-HT receptors, a 5-HT receptor that mediates inhibition of
      adenylyl cyclase activity and is pharmacologically homologous with the 5-HT1A
      binding site, and a stimulatory receptor that appears to be homologous with the 5
      HT receptor first characterized in infant rat collicular membranes.

PMID- 2222511
TI  - Reversible inhibition of rat hepatic glutathione S-transferase 1-2 by bilirubin.
AB  - The inhibition of rat hepatic glutathione (GSH) S-transferase 1-2 by bilirubin
      exhibited pseudo first-order kinetics with k(obs) values of 0.0214 +/- 0.0005 and
      0.040 +/- 0.008 sec-1 at 4 and 8 microM bilirubin, when followed to 72 and 84%
      completion respectively. These correspond to calculated second-order rate
      constants of 5.3 +/- 0.1 x 10(3) and 5.0 +/- 1.0 x 10(3)/M.sec. The extent of
      inhibition of the transferase increased with bilirubin concentration, with half
      maximal inhibition at 4 microM bilirubin. Inhibition was reversed by 10-fold
      dilution of bilirubin or by increasing the pH from 6.0 to 7.4. Premixing 0.2 to
      0.5 microM albumin, hemoglobin or aldolase with bilirubin prevented inhibition of
      GSH S-transferase 1-2. Protection by these proteins occurred at a selected high
      concentration (0.2 to 0.4 microM) at which they reduced free bilirubin to
      concentrations (less than 0.5 microM) that did not inhibit isoenzyme 1-2
      significantly. No protection was afforded by a selected low protein concentration
      (0.001 to 0.01 microM) which did not strikingly reduce bilirubin levels in
      solution. We conclude that bilirubin inhibition of GSH S-transferase 1-2 appears
      to be a second-order process; the reaction is clearly first-order with respect to
      GSH S-transferase and appears also to be first-order with respect to bilirubin.
      It is proposed that (a) inhibition of GSH S-transferase 1-2 results from slow,
      reversible bilirubin binding, and (b) added proteins appear to prevent GSH S
      transferase inhibition by binding high molar ratios of bilirubin.

PMID- 2222512
TI  - The inhibition of human prostatic aromatase activity by imidazole drugs including
      ketoconazole and 4-hydroxyandrostenedione.
AB  - Ketoconazole, an orally active imidazole drug and bifonazole, clotrimazole,
      econazole, isoconazole, miconazole and tioconazole are known as inhibitors of
      cytochrome P450 dependent steroidogenic enzymes including human placental
      aromatase. The aim of the present study was to investigate the effectiveness of
      these imidazole drugs to inhibit human prostatic aromatase activity compared with
      the known inhibitor of aromatase 4-hydroxyandrostenedione (4-OHA). The imidazole
      drugs and 4-OHA inhibited prostatic aromatase activity in a dose-dependent
      manner. The order of decreasing inhibitory potency determined from IC50 values
      (mumol/L) was: 4-OHA (1.57) greater than bifonazole (1.6) greater than
      tioconazole (1.69) greater than clotrimazole (1.73) greater than econazole (1.87)
      greater than miconazole (2.0) greater than isoconazole (2.2) greater than
      ketoconazole (4.7). The IC50 values for the inhibition of prostatic homogenate
      aromatase activity are 3-9-fold higher than that for the inhibition of human
      placental aromatase activity, previously reported, except that of ketoconazole
      which was 1.5-fold lower than that for the inhibition of placental microsomal
      aromatase.

PMID- 2222514
TI  - Location and characterization of the suramin binding sites of human serum
      albumin.
AB  - The objective of the present study was to investigate the location of the high
      affinity suramin binding sites on the human serum albumin molecule. For this
      purpose, circular dichroism and equilibrium dialysis experiments were performed
      on the interaction between suramin and a large peptic and a large tryptic
      fragment of albumin, the former comprising domains one and two of the albumin
      structure and the latter domains two and three. The equilibrium dialysis
      experiments revealed that albumin and the fragments have a comparable total
      affinity for suramin. Furthermore, all three proteins display a similar pH
      dependence of the unbound fraction of suramin. The circular dichroism experiments
      revealed that only the suramin-albumin and the suramin-peptic fragment complexes
      can undergo the pH dependent neutral-to-base or N-B conformational change,
      whereas the suramin-tryptic fragment complex lacks this ability. It is likely
      that the main parts of the high-affinity binding sites for suramin are located in
      domain two of the albumin molecule. The nature of these binding sites is
      discussed. The deprotonation of histidine and other positively charged residues
      taking part in salt bridges between suramin and albumin is, in all probability,
      the main cause of the decrease in affinity of suramin for albumin as the pH is
      raised from 6 to 9.

PMID- 2222513
TI  - The effect of adriamycin on glycerolphosphate acyltransferase and lipid
      metabolism in rat hepatocytes in monolayer culture.
AB  - Total and mitochondrial glycerolphosphate acyltransferase activities were
      measured after 24 hr exposure of rat hepatocytes to Adriamycin. Both activities
      decreased with increasing concentrations of Adriamycin. The activity of the
      microsomal glycerolphosphate acyltransferase, which was determined from the
      difference between the total and mitochondrial enzyme activity, also decreased
      with increasing drug concentration. The effect on glycerolphosphate
      acyltransferase was specific as there was no change in lactate dehydrogenase or
      cytochrome oxidase activity in this time period. Adriamycin did not inhibit
      mitochondrial glycerolphosphate acyltransferase activity in vitro. After 24 hr
      exposure of hepatocytes to Adriamycin no change was observed in the biosynthesis
      of phosphatidylcholine or triacylglycerol. Secretion of lipid into the medium was
      measured over the subsequent 24 hr. There was a significant reduction in very low
      density lipoprotein secretion as measured by triacylglycerol secretion from cells
      incubated with 5 microM Adriamycin. Cells were damaged by the 48 hr exposure to 1
      microM and higher concentrations of Adriamycin as evidenced by a fall in lactate
      dehydrogenase activity in these cells. The secretion of lysophosphatidylcholine,
      as measured by the incorporation of [3H]glycerol into medium
      lysophosphatidylcholine, was significantly increased when cells were incubated
      with 5 microM Adriamycin. The results are discussed in relation to the effect of
      Adriamycin on hepatic lipid metabolism and the cardiotoxicity of the drug.

PMID- 2222515
TI  - In vivo evidence for protease-catalysed mechanism providing bioactive tumor
      necrosis factor alpha.
AB  - Mice pretreated by intravenous injection of 42 mg/kg of the serine protease
      inhibitor alpha 1-antitrypsin prior to a hepatotoxic dose of D
      galactosamine/lipopolysaccharide (GalN/LPS) were fully protected against
      hepatitis. Pretreatment with alpha 1-antitrypsin with doses up to 300 mg/kg at
      different times failed to protect galactosamine sensitized animals against tumor
      necrosis factor alpha (TNF alpha)-induced hepatitis. No bioactive TNF alpha was
      detectable in serum of mice protected against GalN/LPS-induced hepatitis by
      pretreatment with alpha 1-antitrypsin. In contrast, abundant amounts of TNF were
      found in sera of GalN/LPS-treated control animals. It is concluded that a serine
      protease sensitive to alpha 1-antitrypsin provides bioactive TNF alpha by
      proteolytic cleavage of a TNF alpha precursor.

PMID- 2222516
TI  - Inhibition of rat and human glutathione S-transferase isoenzymes by ethacrynic
      acid and its glutathione conjugate.
AB  - Ethacrynic acid, a potent inhibitor of glutathione S-transferases (GST), has been
      shown to enhance the cytotoxicity of chlorambucil in drug resistant cell lines,
      but a definite mechanism has not been established. Both covalent binding to GST
      and reversible inhibition of GST have been reported. In the present study no
      irreversible inhibition was observed: for all rat GST tested, inactivation was
      complete within 15 sec at 0 degree, and dialysis of GST after incubation with
      ethacrynic acid gave complete recovery of enzyme activity for all isoenzymes
      tested. Moreover, the inhibition was competitive towards 1-chloro-2,4
      dinitrobenzene and non-competitive towards glutathione for rat isoenzyme 1-1.
      Strong inhibition of both human and rat GST of the alpha-, mu- and pi-classes was
      obtained with ethacrynic acid, while conjugation of ethacrynic acid with
      glutathione did not abolish its inhibiting properties. For the alpha-, mu- and pi
      class I50 values (microM) were 4.6-6.0, 0.3-1.9 and 3.3-4.8, respectively for
      ethacrynic acid, and 0.8-2.8, less than 0.1-1.2 and 11.0, respectively for its
      glutathione conjugate. Of all isoenzymes tested the human isoenzyme mu is most
      sensitive to the action of both ethacrynic acid and its glutathione conjugate.

PMID- 2222517
TI  - Enantioselective and diastereoselective aspects of the oxidative metabolism of
      metoprolol.
AB  - Enantio- and diastereoselective aspects of oxidative metabolism of metoprolol (1)
      were examined in the presence of rat liver and human liver microsomes using a
      pseudoracemate of 1, made up of equal molar (2R)-1-d0 and (2S)-1-d2, as
      substrate. Both O-demethylation and alpha-hydroxylation showed only slight
      enantioselectivity, 2R/2S ratios being 1.18 and 0.93 for these pathways in rat
      liver microsomes and 1.09 and 0.92 in human liver microsomes. In the presence of
      the rat liver microsomal fraction, alpha-hydroxylation yielded predominantly the
      1'R-hydroxy product, 1'R/1'S ratio greater than 12, regardless of the
      stereochemistry of the side chain. In humans (extensive metabolizers)
      administered a single 50 mg oral dose of pseudoracemic metoprolol tartrate,
      urinary alpha-hydroxymetoprolol (2) accounted for 9.3 +/- 2.4% of the dose, 2R/2S
      ratio 0.85 +/- 0.14, and the carboxylic acid metabolite 4, accounted for 52.7 +/-
      6.8% of the dose, 2R/2S ratio 1.15 +/- 0.09. The data suggested that preferential
      O-demethylation of the (2R)-enantiomer of 1 could contribute to the 2S greater
      than 2R plasma ratio of metoprolol enantiomers observed in this population.

PMID- 2222518
TI  - 7-Alkoxyquinolines: new fluorescent substrates for cytochrome P450
      monooxygenases.
AB  - A series of 7-alkoxyquinolines was synthesized and tested as substrates with
      hepatic microsomes prepared from male Wistar rats. Microsomal O-dealkylation
      rates and kinetic constants were determined for the 7-alkoxyquinolines with
      microsomes from control, 3-methylcholanthrene (MC)-pretreated, and phenobarbitone
      (PB)-pretreated rats. Structure-activity relationship studies indicated that the
      7-benzyloxyquinoline was the most rapidly metabolized substrate for control
      microsomes and those from PB-pretreated rats, whereas the 7-ethoxy- and 7
      propoxyquinolines were O-dealkylated more rapidly by microsomes of MC-pretreated
      animals. Differences in activities occurred in Vmax and apparent Km values;
      however, there does not appear to be a correlation between these two values for
      the different quinoline substrates. Apparent Km and Vmax values for the 7
      alkoxyquinolines were: control microsomes, Km = 71-773 microM, Vmax = 0.37-8.4
      nmol 7-quinolinol/min/mg protein; MC microsomes, Km = 0.5-14 microM, Vmax = 0.29
      2.7 nmol 7-quinolinol/min/mg protein; PB microsomes, Km = 2.8-46 microM, Vmax =
      0.9-12 nmol 7-quinolinol/min/mg protein. All of the quinoline substrates gave
      Type I binding spectra with control and MC microsomes. With PB microsomes, Type
      I. Reverse Type I, and a mixture of the two types of binding spectra were
      observed. Comparisons of the structure-activity relationships, levels of
      induction, and kinetic constants were made with 7-alkoxycoumarin and 7
      alkoxyphenoxazone analogs. In addition, three new coumarin substrates (7-pentoxy
      , 7-hexoxy-, and 7-benzyloxycoumarin) are described.

PMID- 2222519
TI  - Modulation of doxorubicin-induced chromosomal damage by calmodulin inhibitors and
      its relationship to cytotoxicity in progressively doxorubicin-resistant tumor
      cells.
AB  - Modulation of doxorubicin (DOX) cytotoxicity by the calmodulin inhibitor
      trifluoperazine (TFP) in progressively doxorubicin-resistant L1210 mouse leukemia
      cells is unrelated to effects on drug accumulation. Based on the clastogenic
      activity of DOX, the effects of TFP and the selective calmodulin inhibitor 1,3
      dihydro-1-[1-[4-methyl-4H,6H-pyrrolo[1,2-a][4,1]- benzoxazepin-4-yl-methyl]-4
      piperidinyl]-2H-benzimidazol-2-o ne(1:1) maleate (CGS9343B) on DOX-induced
      chromosomal damage and its relationship to cytotoxicity were evaluated in
      sensitive and progressively DOX-resistant L1210 cells. Potentiation of DOX
      cytotoxicity by CGS9343B (a potent inhibitor of calmodulin which does not inhibit
      protein kinase C) was related to the level of resistance. Further, for equivalent
      cytotoxicity, cellular DOX levels in the absence versus the presence of TFP or
      CGS9343B were markedly higher. Exposure to calmodulin inhibitors following DOX
      treatment enhanced chromosomal aberrations and cytotoxicity. Maximal effects of
      calmodulin inhibitors were apparent when used during and after DOX treatment, and
      potentiation of cytotoxicity was related to modulation of DOX-induced chromosomal
      aberrations. Results suggest that inhibition of calmodulin-regulated processes is
      a potential target in the modulation of DNA damage/repair, and could play a
      pivotal role in the expression of "acquired resistance" to DOX.

PMID- 2222520
TI  - Effect of normal aging on the activity of human hepatic cytochrome P450IIE1.

PMID- 2222522
TI  - Interaction of cimetidine with human serum albumin.
AB  - Ultrafiltration studies have detected the existence of a weak interaction between
      cimetidine and human serum albumin, a finding supported by corresponding studies
      with this xenobiotic and bovine serum albumin. Furthermore, the binding
      characteristics of the interaction with human serum albumin (4 sites, K = 630 M
      1) more than suffice to account for the proportion of protein-bound drug in the
      serum of patients subjected to cimetidine therapy. Thus, although alpha 1-acid
      glycoprotein is usually regarded as the specific transporter of basic drugs, the
      present evidence implicates albumin as the likely binding protein for cimetidine
      in serum.

PMID- 2222523
TI  - Labeling of rat heart muscarinic receptors using the new M2 selective antagonist
      [3H]AF-DX 384.

PMID- 2222524
TI  - [Ligand-exchange chromatography of proteins and enzymes].
AB  - Current state of the ligand-exchange chromatography (metal chelate affinity
      chromatography) of proteins and enzymes is reviewed. This technique is based on
      the ability of proteins to bind metal ions immobilized on chelate gels. The
      influence of pH, composition of buffer, type of stationary ligand and nature of
      metal ions on the chromatographic behaviour of proteins is discussed.

PMID- 2222521
TI  - Metabolism of ethyl 2-carbamoyloxybenzoate (4003/2), a prodrug of salicylic acid,
      carsalam and salicylamide.
AB  - The metabolites of 4003/2 observed in vivo have been produced by incubation in
      vitro of 4003/2 with liver post-mitochondrial supernatants from rat, rabbit and
      dog. The metabolites were characterized by UV, i.r., NMR, MS and HPLC. All the
      metabolites detected have been or are in use as drugs for the relief of pain and
      inflammation. Hence, the new drug 4003/2 is a pro-drug of salicylic acid,
      carsalam and salicylamide.

PMID- 2222526
TI  - [Highly selective labeling of the E. coli RNA-polymerase promoter complex with
      reactive derivatives of oligonucleotide primers of various specificity].
AB  - A technique of highly selective affinity labelling, which includes covalent
      modification of the enzyme-T7A2 promoter complex with reactive oligonucleotide
      derivatives and subsequent elongation of the attached oligonucleotide residue
      with a radioactive substrate was used to study the product-binding site of E.
      coli RNA polymerase. Different oligonucleotides complementary to the T7A2
      promoter (with lengths ranging from 2 to 8 residues) containing 5'-terminal
      phosphorylating, alkylating or aldehyde groups were used for the labelling. The
      procedure resulted in labelling DNA and beta-, beta'- or sigma-subunits of the
      enzyme, which are therefore believed to contact with growing RNA in the course of
      initiation. Consideration of the labelling patterns as a functions of the
      oligonucleotide's length as well as of the structure and chemical specificity of
      the reactive groups led to a tentative topographic scheme of the RNA polymerase
      product-binding region.

PMID- 2222525
TI  - [Reconstruction of the synthetic gene for human interleukin-2].
AB  - Chemical-enzymatic synthesis and cloning of the DNA fragment coding for the human
      interleukin-2 signal sequence was accomplished. A hybrid plasmid pSIL-2
      containing the gene of the human interleukin-2 with this signal sequence was
      constructed for effective expression of the gene in eukaryotic systems. A variant
      permitting the removal of the interleukin-2 stop-codons was obtained, which is
      suitable for the construction of chimeric genes containing the interleukin-2 gene
      sequence at the 5'-end.

PMID- 2222527
TI  - [Complementary addressed alkylation of Escherichia coli 16S rRNA with 2',3'-O-[4
      N-methyl-N-(2-chloroethyl)aminobenzylidene]m derivatives of
      oligodeoxyribonucleotides. IV. Determination of binding sites of 16S rRNA with
      benzylidene derivatives of d(pACCTTGTT)rA, d(pTTACGACT)rU, d(TTTGCTCCCC)rA].
AB  - By site-directed alkylation of 16S rRNA with benzylidene derivatives of
      d(pACCTTGTT)rA (II), d(pTTACGACT)rU (III), d(pTTTGCTCCCC)rA (IV) (reagents (II)-
      (IV] followed by the RNase H treatment a number of 16S rRNA fragments have been
      obtained. Hybridisation of these fragments with restriction fragments of plasmid
      pKK 3535, containing operon rrnB of E. coli rRNAs, led to the identification of
      all reagents' binding sites in 16S rRNA. Good correlation is found between
      estimated stability of non-perfect 16S rRNA.oligodeoxyribonucleotide duplexes and
      the level of modification of this site with alkylating derivative of the same
      oligodeoxyribonucleotide. With high concentration of the reagents (II)--(IV) ((2
      5) x 10(-5) M) the site-directed alkylation proceeds not only at the desired site
      but also at other sites corresponding to non-perfect duplexes between 16S rRNA
      and the reagents. It should be noted that the modification mainly occurs in the
      non-perfect duplexes, carrying mismatched bases at the termini. Influence of the
      secondary structure of 16S rRNA on the site-directed modification is discussed.

PMID- 2222528
TI  - [The structure of carbohydrate chains of hemagglutinin and neuraminidase of
      influenza virus B/Leningrad/179/86].
AB  - The main surface glycoprotein, hemagglutinin (HA), was obtained by treatment of
      influenza virus B/Leningrad/179/86 with bromelain. Amino acid and monosaccharide
      compositions of HA and neuraminidase (NA, earlier isolated from the same virus)
      were determined, thus showing HA and NA to contain 8-10 and 2 carbohydrate
      chains, respectively. The carbohydrate fragments were cleaved off by the alkaline
      LiBH4 treatment, the oligosaccharides released were reduced with NaB3H4 and
      fractionated by two-step HPLC on Ultrasphere-C18 and Zorbax-NH2 columns. Some
      higher mannose and complex oligosaccharides were identified in both cases by
      comparison with nonlabelled oligosaccharides of the known structure. The data
      obtained show that surface glycoproteins of influenza virus A and B are rather
      similar with regard to structure and heterogeneity of their carbohydrate chains.

PMID- 2222529
TI  - [Synthesis and mass-spectrometric analysis of N-cycloalkyl derivatives of
      carminomycin, daunorubicin and their analogs].
AB  - Condensation of carminomycin or daunorubicin with glutaric dialdehyde in the
      presence of NaBH3CN yielded 3'-deamino-3'-piperidinocarminomycin or 3'-deamino-3'
      piperidinodaunorubicin and corresponding (13-R, S)-dihydroderivatives. To prepare
      similar derivatives of 14-hydroxycarminomycin or doxorubicin, 13-dimethylketals
      of 14-bromocarminomycin or 13-bromodaunorubicin were used in the reaction of
      reductive alkylation with glutaric or glycolic dialdehyde to give 3'-deamino-3'
      piperidino- or 3'-deamino-3'-morpholino derivatives of 13-dimethylketals of 14
      bromocarminomycin or daunorubicin, respectively. After deblocking and subsequent
      hydrolysis of these compounds 3'-deamino-3'-piperidino- and 3'-deamino-3'
      morpholino derivatives of 13-hydroxycarminomycin or doxorubicin were prepared.
      Reduction of the antibiotic derivatives under mass spectrometry conditions was
      demonstrated.

PMID- 2222530
TI  - [Analysis of highly tritium-labeled alanine using 3H- and 1H-NMR].
AB  - A method has been developed for the analysis of deuterium oxide solutions of
      tritiated alanine eight-component isotopic mixtures by using high resolution 3H
      and 1H NMR spectra at frequencies 266.8 and 500.13 MHc, respectively. Approaches
      have been worked out for the determination of qualitative composition of the
      mixtures and spectral parameters.

PMID- 2222531
TI  - Diminished incidence of severe rheumatoid arthritis associated with oral
      contraceptive use.
AB  - It has been suggested that the negative association between rheumatoid arthritis
      (RA) and oral contraceptive (OC) use might be limited to the more severe forms of
      RA. To investigate this further, we studied 121 consecutive female patients with
      definite RA, 52 female patients with probable RA, and 378 female controls. All
      patients had RA symptoms of recent onset. After a mean followup period of 6
      years, patients with definite RA were classified as having either a severe
      disease course (n = 76) or a mild disease course (n = 45). The negative
      association between OC use prior to the onset of RA symptoms and the development
      of RA was limited to those patients with definite RA who had a severe disease
      course. We therefore conclude that OC use prior to the onset of RA symptoms is
      only associated with a reduction in the incidence of severe RA. This may explain
      the divergent results of previous studies.

PMID- 2222532
TI  - Cellular immune response toward human articular chondrocytes. T cell reactivities
      against chondrocyte and fibroblast membranes in destructive joint diseases.
AB  - Articular cartilage is one of the major targets in destructive joint diseases in
      humans. We studied cellular immune reactions against cartilage cell-surface
      membranes, because it has recently been suggested that these represent possible
      antigenic structures, based upon the observation of autoantibodies with this
      specificity in certain joint diseases. A striking T cell reactivity toward
      chondrocyte membranes was found both in blood and synovial tissue from patients
      with rheumatoid arthritis. This reactivity was strongly dependent on the presence
      of monocytes and had all the characteristics of an antigen-driven process. Clonal
      analysis demonstrated high precursor frequencies in peripheral blood T cells that
      were reactive against chondrocyte membranes. This response to chondrocyte
      membranes greatly exceeded the T cell stimulation induced by membranes from other
      sources such as fibroblasts or epithelial cells. In contrast to patients with
      rheumatoid arthritis, individuals with osteoarthritis showed a strong peripheral
      blood and synovial fluid T cell response not only to chondrocyte membranes, but
      also to fibroblast membrane material. However, there was no reactivity to
      epithelial cell membranes. Normal donors generally did not show significant
      responses to any membrane preparation. These data indicate that there is a strong
      T cell reactivity toward chondrocyte membranes in destructive joint disorders,
      and this may significantly contribute to the pathogenetic processes that occur in
      these diseases.

PMID- 2222533
TI  - Relationship of glucocorticoid dosage to serum bone Gla-protein concentration in
      patients with rheumatologic disorders.
AB  - Serum bone Gla-protein (BGP) measurements in 50 rheumatic disease patients
      receiving long-term prednisone therapy revealed an inverse relationship (r = 
      0.71, P less than 0.001) between serum BGP levels and prednisone dosage. Multiple
      regression analysis demonstrated significant relationships (R2 = 0.72, P less
      than 0.001) between serum BGP1/2 and prednisone dosage, dosage2, serum
      creatinine, age, and an age-creatinine interaction. This model predicts the
      suppression of serum BGP with low dosages of steroids and 50% suppression with
      dosages of 20-25 mg/day.

PMID- 2222534
TI  - Collagen-collagen versus collagen-proteoglycan interactions in the determination
      of cartilage strength.
AB  - For articular cartilage to function as a stress-reducing layer in the joint, it
      must both deform to an appropriate level to achieve load-spreading as well as
      remain structurally coherent. Combined micromechanical and enzymatic studies of
      cartilage have demonstrated that the bulk of the extractable proteoglycans, while
      essential to the maintenance of compressive stiffness, contribute little to its
      cohesive strength. The study reported here clarifies fundamental aspects of the
      relationship between matrix components and the biomechanical function of
      cartilage.

PMID- 2222535
TI  - Binding of anti-DNA antibodies and inhibition of glomerulonephritis in MRL
      lpr/lpr mice by heparin.
AB  - Heparin was found to inhibit the DNA binding of antibodies eluted from kidneys of
      both humans and MRL-lpr/lpr mice with systemic lupus erythematosus. Treatment of
      MRL-lpr/lpr mice with low doses of heparin significantly inhibited renal damage.
      These results suggest that low-dose heparin might be useful in preventing renal
      damage in patients with lupus nephritis.

PMID- 2222536
TI  - Renal disease in chronic arthritis of childhood. A study of urinary N-acetyl-beta
      glucosaminidase and beta 2-microglobulin excretion.
AB  - Urinalyses of randomly obtained samples from children with various types of
      chronic arthritis revealed proteinuria in 2.3% of patients, hemoglobinuria in
      3.5%, erythrocyturia in 4.1%, and leukocyturia in 5.3%; these frequencies are
      within the range found by screening school children. However, raised urinary
      levels of N-acetyl-beta-glucosaminidase and/or beta 2-microglobulin (both
      sensitive measures of renal tubular damage) were found more frequently in
      children with chronic arthritis than in controls (P less than 0.0001).
      Abnormalities of either N-acetyl-beta-glucosaminidase or beta 2-microglobulin
      excretion were associated with active arthritis as measured by physician global
      estimate of disease activity, with a polyarticular onset of juvenile rheumatoid
      arthritis, and with the use of slow-acting antirheumatic drugs or the concurrent
      use of more than 1 nonsteroidal antiinflamtory drug. Abnormal renal tubular
      function appears to be common in chronic arthritis of childhood. The long-term
      consequences of this abnormality remain to be elucidated.

PMID- 2222537
TI  - Pseudotumor of the craniocervical junction during long-term hemodialysis.
AB  - A systematic study of the upper cervical spine was performed using magnetic
      resonance imaging in 25 patients (15 men and 10 women) who had been undergoing
      hemodialysis for more than 10 years. Seven pseudotumors of the periodontoid soft
      tissue were disclosed, which were similar to the pannus recently described in
      rheumatoid arthritis. Bone cystic radiolucencies were observed in association
      with these pseudotumors in 5 patients. The radiolucencies were located in the
      atlas (1 in the lateral mass and 1 in the anterior branch) and in the axis (3 in
      the odontoid process and 1 in the vertebral body). No horizontal or vertical
      atlantoaxial subluxation was demonstrated. These features were observed only in
      patients who had amyloid arthropathy. They could be a frequent, yet thus far
      little-recognized, feature of beta 2-microglobulin amyloidosis.

PMID- 2222538
TI  - Human immunodeficiency virus-associated psoriasis, psoriatic arthritis, and
      Reiter's syndrome: a disease continuum?
AB  - The presence of peripheral arthritis and HLA-A, B, C, DR, and DQ antigens was
      evaluated prospectively in 18 Caucasian men with human immunodeficiency virus
      associated psoriasis. An asymmetric polyarthritis occurred in 32% of the patients
      and correlated with the presence of HLA-B27. Extensive clinical overlap between
      psoriatic arthritis, psoriasis, and Reiter's syndrome was noted. No significant
      excess of the HLA antigens previously found to be associated with psoriasis was
      seen, which suggests that human immunodeficiency virus-associated psoriasis per
      se may instead constitute another form of spondylarthropathy that is more closely
      related to Reiter's syndrome.

PMID- 2222539
TI  - Intravenous pulse cyclophosphamide therapy in myositis and Sjogren's syndrome.
AB  - We describe a patient with primary Sjogren's syndrome who developed myositis. The
      results of muscle pathologic analysis before and after treatment with monthly
      pulses of cyclophosphamide (intravenously), are presented.

PMID- 2222540
TI  - D-penicillamine-induced lupus erythematosus.
AB  - We describe a patient who presented with polyarthritis, pleurisy, rash, and a
      positive antinuclear antibody result after 5 years of D-penicillamine therapy. D
      penicillamine-induced antinuclear antibodies were mainly high-titer IgG directed
      against the (H2A-H2B)-DNA complex. Weak IgM activity with H1 and H2B was also
      observed. Withdrawal of D-penicillamine therapy resulted in improvement in
      clinical symptoms and gradual resolution of serologic abnormalities.

PMID- 2222541
TI  - Amyloidosis in Behcet's syndrome.
AB  - We investigated the frequency of amyloidosis in 99 consecutive patients (65 men
      and 34 women) with Behcet's syndrome. Rectal biopsies performed on all patients
      showed no amyloidosis by polarizing microscopy. The results of urinalyses were
      normal in all patients. Among 1,130 patients registered in our Behcet's syndrome
      outpatient clinic, 5 were found to have systemic amyloidosis, all of the AA type.

PMID- 2222542
TI  - Sulfonamides as antiinflammatory agents in the treatment of Wegener's
      granulomatosis.

PMID- 2222543
TI  - Successful use of cyclosporine for the treatment of aggressive pulmonary fibrosis
      in a patient with rheumatoid arthritis.

PMID- 2222544
TI  - Comment on the article by Pope et al.

PMID- 2222545
TI  - Factor B activation in systemic lupus erythematosus.

PMID- 2222546
TI  - Comment on the article by Calin et al.

PMID- 2222547
TI  - [Biochemical aspects of the evaluation of fixed drug combinations].
AB  - Various disciplines have to contribute to the general problem of the evaluation
      of fixed dose combination drugs, as for instance (clinical) pharmacology,
      biometry, scientific drug regulations and public health officials. The EC
      guideline 75/318/EWG and its eludications as well as the German
      "Arzneimittelprufrichtlinien" of Dec. 14, 1989 (as referred to in the
      "Arzneimittelgesetz" of 1986) required that such issues concerning fixed dosage
      combination drugs must be considered and taken into account. In this framework it
      is the responsibility of biometry to both to guarantee the use of a valid study
      design to assure interpretation of the results and to quantify the reliability of
      pharmacological and clinical considerations. The following paper is concerned
      with biometrical aspects of the combination drug problem. Basic considerations
      from a clinical or a pharmacological point of view with respect to the question
      of whether fixed combination drugs are reasonable or not are not discussed. To
      support the use of combinations of drugs, a central argument is the improvement
      of the benefit risk relation compared with that of an adequate monotherapy.
      Beyond this the fixed combination drugs require additional arguments regarding
      the enhencement of the safety or the simplicity of the therapy fixing the ratio.
      It follows that fixed combination drugs have to be supported twice, first with
      respect to the combination itself, and second with respect to the fixed mixing
      ratio of its components. The biometrical aspects of the assessment of the gains
      from (fixed) drug combinations are related to the kind of benefit/risk
      improvement that is expected. In the first section we discuss some possible types
      of benefit and risk.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222549
TI  - Studies of antidote therapy for nisoldipine intoxication in experimental animals.
AB  - In anesthetized rats under artificial respiration, intravenous infusion of
      nisoldipine (0.1 mg/kg x min) caused significant decreases in blood pressure,
      heart rate, cardiac output and peripheral resistance. The animals died 54.7 +/-
      11.1 min after initiation of the infusion. The electrocardiogram showed sinus
      bradycardia, increasing AV blockade and displacement of the pacemaker into the AV
      node or the bundle of His. Survival time under nisoldipine infusion increased
      more than two-fold with simultaneous infusion of calcium gluconate, isoprenaline
      (isoproterenol) or dopamine. Norepinephrine (noradrenaline) had no significant
      effect on survival time; the latter decreased to 19.4 +/- 1.6 min by plasma
      volume expansion with polygeline. All antidotes prolonging survival time also
      normalized the cardiac output diminished after nisoldipine. Electrocardiographic
      changes were antagonized only by isoprenaline. Suitable antidotes for
      intoxication or over-dosage of nisoldipine are calcium salts as well as beta
      sympathomimetic drugs; sheer volume substitution and peripheral vascular
      constriction should not be resorted to.

PMID- 2222548
TI  - Effects of the new centrally acting muscle relaxant 7-chloro-N,N,3
      trimethylbenzo[b]furan-2-carboxamide on motor and central nervous systems in
      rats.
AB  - Effects of KW-6629 (7-chloro-N,N,3-trimethylbenzo[b]furan-2-carboxamide) were
      studied with special reference to the effect on motor and central nervous systems
      using rats. The drug effectively reduced the motor coordination (rotarod), the
      anemic decerebrate rigidity, the crossed extensor reflex, and the gamma-activity
      indirectly recorded from muscle afferent discharges without showing the direct
      inhibitory effect on muscle spindles. KW-6629 depressed the polysynaptic and
      dorsal root reflexes without showing marked effect on the monosynaptic reflex in
      intact spinal cord rats. KW-6629 produced high-amplitude slow wave in the
      cerebral cortex in electroencephalogram (EEG). KW-6629 did not reduce the EEG
      after-discharges and behavioral convulsion (amygdaloid kindling). KW-6629 had no
      effect on the neuromuscular junction. These results suggest that KW-6629 is a
      centrally acting muscle relaxant which has a site of action in supraspinal
      structures.

PMID- 2222551
TI  - In vitro studies on interactions of iron salts and complexes with food-stuffs and
      medicaments.
AB  - It has been shown in the present study that food components such as phytic acid,
      oxalic acid, tannin, sodium alginate, choline and choline salts, vitamins A, D3
      and E, soy oil and soy flour, do not undergo any interactions with iron(III)
      hydroxide polymaltose complex (Ferrum Hausmann). Phytic acid, oxalic acid, tannin
      and sodium alginate, however, react with iron(II) or iron(III)-salts at pH values
      of 3.0, 5.5 and 8.0, giving rise to iron complexes. Trimethylamine-N-oxide, which
      is present in fish meal, reacts with iron(II)-sulphate to produce iron(III)
      reaction products; it does not react with iron(III)-hydroxide polymaltose
      complex. Special soybean flours show no irreversible adsorption or precipitation
      with iron(III)-hydroxyide polymaltose complex over the pH range 3.0-8.0, in
      contrast to iron(II)-sulphate. Antacids containing aluminium hydroxide, talc, ion
      exchange resins or other unabsorbable, insoluble components absorb iron(III)
      hydroxide polymaltose complex in the pH range 3.0-8.0 in a reversible manner,
      while the strong adsorption or precipitation observed with iron(II)-sulphate at
      pH 8.0 is irreversible. No interaction was observed between the steroid hormones
      studied and iron(II)-sulphate or iron(III)-hydroxide polymaltose complex. On the
      basis of the measured compatibilities, iron(III)-hydroxide polymaltose complex
      can be administered orally simultaneously with many other drugs, without
      prejudicing the absorption of iron or of the other drug as is often seen with
      iron(II) and iron(III) salts.

PMID- 2222550
TI  - Pharmacokinetic evaluation of conventional and controlled release dosage form of
      propranolol.
AB  - A comparative pharmacokinetic study of a new controlled release multiple unit
      propranolol formulation and a conventional propranolol tablet was carried out in
      twelve healthy human volunteers in a randomized balanced crossover design. Under
      a single dosage regimen, subjects were administered either a single capsule
      containing controlled release propranolol equivalent to 160 mg of the drug or 80
      mg of conventional propranolol tablet, twelve hourly. Peak plasma propranolol
      concentrations were low which occurred later after controlled release
      administration than after the administration of the conventional tablet. Analysis
      of the area under the plasma concentration-time curve (AUC) for the two
      formulations indicate no significant difference of bioavailability despite a
      prolonged absorption time and maintenance of effective plasma concentration for
      the controlled release preparation.

PMID- 2222552
TI  - Effect of gelatin infusions on blood serum lipid pattern.
AB  - The effect of gelatin infusions in rat on the various serum lipid constituents
      was studied by measuring the mean values of total lipids, lipoprotein lipase,
      triglycerides, phospholipids, cholesterol, non-esterified fatty acids, and
      lipoproteins. These measurements were made immediately following a single
      intravenous infusion of gelatin solution (1 ml/100 g body wt) and at different
      time intervals post-infusion. Repeated intravenous infusions of gelatin were also
      given to another group of rats and the above mentioned lipid constituents were
      measured 24 h after each dose. The results obtained showed that gelatin infusions
      have a definite hypolipemic effect. There was a significant reduction in the
      levels of total lipids, triglycerides, cholesterol, and B + preB/alpha ratios
      immediately following infusion and at 5, 24 and 48 h postinfusion. This reduction
      was transient and the values were gradually normalized at the end of the first
      week postinfusion. In rats receiving repeated i.v. infusions, the results
      obtained showed a significant decrease in the same lipid constituents during the
      whole month of gelatin administration. Values of lipoprotein lipase, lipid
      phosphorous and non-esterified fatty acids showed insignificant changes from
      baseline values at all time intervals following single and repeated i.v.
      infusions of gelatin solution.

PMID- 2222553
TI  - Variations of skin sensitivity to intracutaneous histamine provocations with
      regard to provocation time.
AB  - Dermal provocation tests with histamine and other mediators of allergy are widely
      used as diagnostic tools and as clinical pharmacological models. Diurnal
      variations of skin reactivity e.g. flare reactions have been postulated earlier.
      Potential differences in skin reactivity using histamine provoked flare areas as
      model were investigated by means of five different placebo formulations (i.v.
      solution; p.o. solution; p.o. solid forms). Flare reactions have been provoked
      every 3rd hour within a time span of 29 h using a cross-over design with an H1
      antagonist positive control. No provocation was provided between 0:00 and 7:00
      a.m. There was no statistically significant variation of skin reactivity with
      respect to provocation times under placebo treatment conditions. No dependence on
      plasmacortisol levels was observed. Interindividual differences in skin
      reactivity are more pronounced than the intraindividual variations.

PMID- 2222555
TI  - Rough sets approach to the analysis of the structure-activity relationship of
      quaternary imidazolium compounds.
AB  - The relationship between chemical structure and antimicrobial activity of 201
      quaternary imidazolium compounds is analysed using the theory of rough sets. The
      compounds are described by 8 attributes concerning structure and are divided into
      5 classes of activity. The description builds up on information system. Using the
      rough sets approach, first a minimum set of 4 attributes significant for a high
      quality of classification has been found. The analysis of distribution of values
      of significant attributes in the best and worst class led to the definition of
      typical representatives of best and worst compounds in terms of significant
      attributes. Finally, a decision algorithm has been driven from information
      system, showing important relations between structure and activity. It may be
      helpful in supporting decisions concerning the synthesis of new antimicrobial
      compounds.

PMID- 2222554
TI  - Synthesis and antimicrobial activities of some new tetrahydro-2H-1,3,5
      thiadiazine-2-thione derivatives of amoxicillin.
AB  - A number of 6-[2-(dihydro-5-substituted-6-thioxo-2H-1,3,5-thiadiazine-3( 4H)-yl)
      2-(4-hydroxyphenyl)acetamido]penicillanic acids has been synthesized as prodrugs
      by incorporating the amine group of amoxicillin trihydrate into tetrahydro-2H
      1,3,5-thiadiazine-2-thione ring. The compounds have been prepared by the reaction
      of various alkyl or aralkyl amines with potassium hydroxide, carbon disulfide,
      formaldehyde and amoxicillin trihydrate. The structures of the compounds have
      been elucidated by UV, IR, 1H-NMR spectra and elementary analysis. The in vitro
      activity of these compounds 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) was investigated by the tube dilution
      method and compared with the activity of amoxicillin trihydrate. By this way
      their minimal inhibitory concentration (MIC), minimal bactericidal concentration
      (MBC) and minimal fungicidal concentration (MFC) values were determined. Compound
      I and Compound VII were significantly more effective than amoxicillin trihydrate
      against S. aureus (MBC: 6.25 micrograms/ml). Compound VI and Compound XI were
      effective against S. faecalis (MBC: 6.25 micrograms/ml) and Compound I and
      Compound VI were effective against E. coli (MBC: 12.5 micrograms/ml). All of the
      compounds and amoxicillin trihydrate were ineffective against P. aeruginosa (MIC:
      greater than 100 micrograms/ml). Compound IX and Compound X were the most active
      derivatives against yeast-like fungi; the MFC values for these compounds ranged
      between 6.25 and 37.5 micrograms/ml.

PMID- 2222556
TI  - Pharmacokinetics of 4-acetylaminophenylacetic acid. 1st communication:
      absorption, distribution, metabolism and excretion in mice, rats, dogs and
      monkeys after single administration of 14C-labeled compound.
AB  - Absorption, distribution, metabolism and excretion of 4-acetylaminophenylacetic
      acid (MS-932) were studied in mice, rats, dogs and monkeys after intravenous or
      oral administration of 5 or 10 mg/kg of 14C-MS-932. After the intravenous
      injection of 14C-MS-932, the radioactivity concentrations in the plasma decreased
      biexponentially. The half-lives of the elimination phase (t1/2, beta) were 2.58 h
      for mice, 2.35 h for rats, 1.88 h for dogs and 1.24 h for monkeys. After the oral
      administration of 14C-MS-932, the radioactivity concentrations in the plasma
      reached maximums between 0.4 and 1.3 h, thereafter decreasing with half-lives
      similar to those found for the intravenous injection. The systemic availability
      of this drug was 72-100% in all the species tested. No clear sex-related
      difference in radioactivity concentrations was found in rat plasma. After both
      intravenous and oral administrations, in all the species tested, almost all the
      radioactivity administered was excreted in the urine. Biliary excretion of
      radioactivity in bile duct-cannulated rats was only 1.42% of the intravenous dose
      over a 24-h period. Lymphatic absorption of radioactivity was negligible (0.2% of
      the dose over a 6-h period). After oral administration of 14C-MS-932, the
      radioactivity concentrations in the rat tissues tested reached maximums within 1
      h, decreasing rapidly thereafter similar to the decrease in the concentration in
      the plasma. Much higher concentrations were present in the kidney and gastro
      intestinal tract than in the plasma, whereas the concentrations in the other
      tissues were lower. Results obtained by whole-body autoradiography were
      consistent with those obtained for the radioactivity in excised tissues.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2222558
TI  - In vitro studies with the stabilized epoprostenol analogue taprostene. Effect on
      platelets and erythrocytes.
AB  - In vitro, the oxacyclic epoprostenol (prostacyclin) analogue taprostene like the
      native epoprostenol inhibited platelet aggregation and adhesion and induced
      deaggregation. Antiaggregatory action of taprostene was demonstrated towards
      arachidonic acid-, ADP-, thrombin- and norepinephrine-induced aggregations of
      human platelet rich plasma with IC50 values between 17 and 34 nmol/l. ADP-induced
      aggregations of human, dog or rabbit platelets were inhibited with an equivalent
      efficacy. Under the present conditions taprostene was about 3fold less active
      than epoprostenol. The deaggregatory effect, measured in arachidonic acid-induced
      aggregates of human PRP, could be detected only in concentrations from 1 mumol/l
      taprostene. The adhesion-inhibiting effect towards glass beads, measured in whole
      blood, appeared at comparable high concentrations (IC50 value: 2.4 mumol/l) and
      likewise the antihaemolytic effect on rat erythrocytes, which was exerted with a
      threshold concentration of 10 mumol/l. Heparin in a concentration range of 0.1
      1000 micrograms/ml increased thrombocyte adhesion and this effect was prevented
      by 1 mumol/l taprostene.

PMID- 2222557
TI  - Pharmacokinetics of 4-acetylaminophenylacetic acid. 2nd communication: tissue
      accumulation and enzyme induction in rats after repeated administration, and
      placental and milk transfer after single dosing.
AB  - The absorption, distribution, metabolism and excretion of 14C-labeled 4
      acetylaminophenylacetic acid (MS-932) were studied in male rats after
      administration of an oral dose of 10 mg/kg once a day for 21 days. Comparison
      with the single dosing showed no marked alterations in absorption, distribution,
      metabolism and excretion. There were no significant differences in the activities
      of hepatic aniline hydroxylase and aminopyrine N-demethylase between the MS-932
      treated group (10 mg/kg for 8 days) and the 0.5% aqueous sodium carboxymethyl
      cellulose control group (p greater than 0.05). Placental transfer of
      radioactivity was studied after single oral administration of 10 mg/kg of 14C-MS
      932 to pregnant rats on the 12-13th and 19-20th days of gestation. Radioactivity
      concentrations were highest in the maternal plasma and lowest in the amniotic
      fluid and fetus for both middle and late pregnancies. The concentrations in the
      amniotic fluid and fetus decreased more slowly than did the concentration in the
      maternal plasma. Excretion of radioactivity to milk was studied after single oral
      administration of 10 mg/kg of 14C-MS-932 to lactating rats on the 10th day after
      parturition. Radioactivity concentrations in the rat milk were maximal at 1 h
      after dosing and were lower than in the maternal plasma at all the sampling
      times.

PMID- 2222559
TI  - Pharmacokinetics of iopamidol in adults with renal failure.
AB  - The pharmacokinetics of iopamidol 370 (Iopamiro), a non-ionic water soluble
      organic iodine compound, were studied in adults with different degrees of chronic
      renal failure and in healthy volunteers. After 50 ml were administered i.v.,
      plasma and urine levels were determined. The main pharmacokinetic parameters were
      calculated on the basis of bi-compartimental open model. There were significant
      differences from healthy volunteers in t1/2 beta, which increased with the degree
      of renal failure as the clearance values decreased. t1/2 beta was equal to 1.67 h
      in healthy volunteers, 4.24 h in patients with mild renal failure and 10.03 h in
      patients with severe renal failure. The clearance decreased as follows: 0.11 (l/h
      kg) in healthy volunteers, 0.06 (l/h kg) in patients with mild renal failure and
      0.02 (l/h kg) in patients with severe renal failure. No significant differences
      were found in distribution volume values nor in t1/2 alpha.

PMID- 2222560
TI  - Safety aspects in biotechnology. Classifications and safety precautions for
      handling of biological agents.
AB  - The term "biotechnology" is today used much more widely than 10 years ago.
      According to the modern definition, biotechnology represents the "conveyor belt"
      which brings advances in the fields of molecular biology, cell biology, molecular
      genetics, microbiology, biochemistry and process engineering, etc., into the
      areas of application. It is attempted to indicate the development of safety
      standards concerning biotechnology. This development is in a state of flux, and
      the finding that the risks in handling r-DNA organisms are not larger than those
      arising when handling the known pathogens is becoming more accepted. Accordingly,
      these r-DNA organisms can also be classified into the known risk groups I-IV and
      handled under the corresponding safety conditions according to this
      classification: In the laboratory under the laboratory safety measures L1-L4
      described in the BMFT-Guidelines or guidelines for occupational health and
      hygiene (UVV Biotechnologie) and on a process scale under the process safety
      measures described in the OECD report. The discussion of aspects on waste
      disposal, education/training and public perception in the field of biological
      safety completes the report.

PMID- 2222561
TI  - Medicare denials: should you appeal?

PMID- 2222562
TI  - The fragile X syndrome.

PMID- 2222563
TI  - Sex chromosomal abnormalities. Etiology, phenotypic expression, and the role of
      lyonization.
AB  - Individuals with sex chromosomal abnormalities have significantly better chances
      of leading normal lives than individuals with autosomal abnormalities. This is
      due, in part, to the role of lyonization in the genetic inactivation of X
      chromosomes. In contrast to earlier studies contaminated with subject
      ascertainment bias, prospective studies of individuals with SCA generally
      indicate a relatively normal profile with respect to overall intellectual
      capacity and psychopathology. Although some SCAs affect neuromotor, speech,
      language, cognitive and emotional development to some degree, it is noteworthy
      that none of the effects necessarily occurs and that some of the deficits are
      amenable to corrective intervention. Results from prospective studies also
      indicate significant genotype-environment interactions that can have important
      implications for intervention.

PMID- 2222564
TI  - Prevention of chromosomal disorders. Roles for clinicians.

PMID- 2222565
TI  - Fragile X syndrome.

PMID- 2222566
TI  - Recommended guidelines for infant hearing screening: analysis.
AB  - This paper has identified problems with the guidelines and the disadvantages of
      the ASHA protocol. Some of these are significant. Others are less important but
      represent issues that should be considered when designing an EID protocol. The
      problems and disadvantages are summarized below. 1. The guidelines should have
      estimated and cost and performance of the recommended protocol. 2. The guidelines
      should have identified the true advantage of ABR screening (lower cost) and the
      disadvantage (lower hit rate) as compared to other protocols. 3. The guidelines
      should have evaluated other possible protocols. 4. The guidelines recommended the
      same protocol for all facilities (with adequate resources) independent of local
      factors. 5. The guidelines recommended the same screening strategy for the ICN
      and the WBN when different protocols may be appropriate. 6. The guidelines reject
      ABR screening of all WBN infants as too expensive without estimates of cost. More
      importantly, this is a decision that should be made by local institutions or
      governments. 7. The screening protocol was developed without a detailed
      description of the diagnostic component of the EID protocol. 8. The guidelines
      should have provided more information to hospitals that do not have the resources
      necessary to implement the recommended protocol. 9. The recommended protocol
      requires significant in-patient testing that can cause problems with
      reimbursement. 10. Some infants at risk for progressive loss can be lost from
      follow-up. Apparently, the guidelines were developed using a subjective,
      experiential approach. Although clinical experience is important, subjective
      impressions can be subject to bias and error. Some type of quantitative analysis
      is essential when developing test protocols. Perhaps a more rigorous theoretical
      foundation is needed to focus research and guide the development of EID
      protocols. The ASHA protocol is reasonable, but there is little evidence
      indicating that it is superior to, or even as good as, other possible protocols.
      Like all protocols, it has advantages and disadvantages. That is not to say that
      all possible protocols are appropriate. For example, protocols that delay
      diagnostic testing beyond 6 months should be rejected if the goal is habilitation
      by 6 months. Protocols that use screening tests with extremely poor hit rates may
      be undesirable in most situations. There remains one fundamental question. Is it
      even appropriate to recommend a particular protocol when, by necessity, many
      important local factors must be ignored? Perhaps it would be better to provide
      the basic data and techniques that would permit audiologists to design EID
      protocols that are optimum for their own circumstances.

PMID- 2222567
TI  - Guidelines for the delivery of speech-language pathology and audiology services
      in home care.
AB  - Due to changing demographics, consumer preference, and priorities of the total
      health care delivery system, home care services are increasingly vital to the
      safety, well-being, and quality of life of many people. Consequently, the number
      of persons who need home-based speech-language pathology and audiology services
      is increasing. These guidelines cover the professional service components and
      related aspects of the home care model. It is ASHA's position that home-based
      speech-language pathology and audiology services should be conducted by certified
      (and licensed where applicable) speech-language pathologists and audiologists, or
      by individuals who meet the educational requirements for certification and are
      receiving the supervised experience required for certification (Asha, 1981).
      These guidelines have been formulated to assist the speech-language pathologist
      and audiologist providing services in the unique environment of the home. The
      intent of these guidelines is to facilitate integration of services, cost
      effectiveness and quality of client care.

PMID- 2222568
TI  - Endocrine consequences of alcohol abuse.
AB  - The recognized endocrine consequences of alcohol abuse are reviewed on an organ
      by organ basis. The organ systems for which the most information is available
      (liver, heart, brain) are presented first followed by those where the information
      base is less.

PMID- 2222569
TI  - Alcohol and bone disease.
AB  - Alcohol is considered to be an important risk factor for various bone diseases
      but recent studies have shown that moderate alcohol intake can be beneficial to
      bone structure. Alcohol decreases osteoblastic activity, leading to decreased
      bone formation and defective mineralization. The changes reported in calciotropic
      hormones, mainly vitamin D and parathyroid hormone, are observed due in part to a
      deficient intestinal absorption of vitamin D and an inadequate synthesis of its
      hepatic metabolite, although greater emphasis has been given to dietary
      deficiencies or lack of exposure to sun. The changes in parathyroid hormone are
      not consistent and since there is no greater incidence of hyperparathyroidism in
      alcoholic patients, it suggests that alcohol does not have a long-term effect on
      the parathyroid glands. Alcohol increases calcitonin secretion acutely;
      calcitonin is an inhibitor of bone resorption and may be the mechanism by which
      moderate alcohol intake protects bone structure. Alcohol increases urinary
      calcium, magnesium and zinc excretion. Zinc deficiency has been postulated as a
      cause of oesteoporisis because it causes hypogonadism. The decrease in the levels
      of the gonadal hormones and the increase of cortisol, observed in chronic
      alcoholics, may indirectly cause osteopenia and aseptic necrosis. To these
      actions must be added the acidosis due to alcohol and the greater tendency of the
      alcoholic to fall, all of which influence bone changes and increase the incidence
      of bone fractures.

PMID- 2222570
TI  - T cell subsets (Tc, Th, Ts, Tsi) and IL2 receptor-bearing cells in peripheral
      blood of patients in the acute phase of alcoholic hepatitis.
AB  - The present study was designed to evaluate the proportion of T cell subsets and
      IL2 receptor positive cells in the peripheral blood of patients with acute
      alcoholic hepatitis (AAH) using monoclonal antibodies to T cell antigens and Tac
      in a double immunofluorescent technique. The results indicate that the percentage
      of the total T cells and the intensity of all the T cell antigens are
      significantly reduced and the percentage of T helper cells and the ratio between
      Th/Ts cells are significantly increased in AAH when compared to healthy controls.
      But, significant differences in values observed in this study were not found for
      the absolute number of these cells. These altered values returned to normal
      levels during convalescence.

PMID- 2222571
TI  - Estimation of the amount of alcohol ingested from a single blood alcohol
      concentration.
AB  - Capillary blood alcohol concentrations (BAL) measured in 22 young adult male
      volunteers each of whom received three different treatments of alcohol (total N =
      66) have been related quantitatively to the dose of alcohol ingested. Linear
      regression with reasonably homogeneous variances have been found when the BAL at
      2, 2.5 and 3 hr are divided by the person's body weight and plotted versus the
      g/kg (D/W) dose. Error analysis indicated that the least error in the predicted
      dose (D/W) was obtained for BAL measured at 2 hr post dosing. In the latter case
      the mean absolute error was 6.23%, 59% of the errors were within +/- 5% and 88%
      of the errors were within +/- 10%.

PMID- 2222573
TI  - Ethanol-inducible cytochrome P-450 activity and increase in acetaldehyde bound to
      microsomes after chronic administration of acetaldehyde or ethanol.
AB  - Chronic ethanol consumption results in acetaldehyde adduct formation with
      proteins such as haemoglobin and liver proteins in vivo. Our purpose was to study
      the binding of acetaldehyde to liver microsomal proteins, a site of ethanol
      oxidation via cytochrome P-450 (especially P-450 II E1), after chronic
      administration of ethanol or acetaldehyde for 21 days to rats. The liver
      microsomal oxidation of 1-butanol by the ethanol-inducible P-450 also was
      examined. Acetaldehyde bound to liver microsomal proteins was higher in ethanol
      fed rats compared with acetaldehyde-treated rats (0.735 vs 0.413 nmol/mg of
      protein respectively). The biotransformation of n-butanol to butyraldehyde by
      liver microsomes was increased (by 136%) in ethanol-fed rats vs controls, whereas
      in acetaldehyde-treated rats this increase was much lower (only 27%). However, in
      this last group, a significant negative relationship between the quantity of
      acetaldehyde bound to microsomal proteins and the monooxygenase-catalyzed
      transformation of butanol by liver microsomes was demonstrated (r = -0.79, P less
      than 0.01). These results suggest that proteins of liver microsomes are a target
      for acetaldehyde binding during ethanol oxidation and such adduct formation could
      impair the oxidative properties of the alcohol-inducible cytochrome P-450.

PMID- 2222572
TI  - Studies with cDNA probes on the in vivo effect of ethanol on expression of the
      genes of alcohol metabolism.
AB  - Mice (Mus musculus) from three genetic strains with variable responses to ethanol
      challenge (BALB/c, C57BL/6J and 129/ReJ) were used to evaluate the effect of
      ethanol feeding on hepatic mRNA specific to the two primary enzymes of ethanol
      metabolism; alcohol dehydrogenase (ADH; E.C. 1.1.1.1) and aldehyde dehydrogenase
      (ALDH; E.C. 1.2.1.3). Adh-1 (ADH) and Ahd-2 (ALDH) specific mRNA were evaluated
      on the livers of ethanol-fed mice and from their age, sex and genotype matched
      controls (using an isocaloric liquid diet). C57BL/6J (alcohol resistant) mice
      show a significant (approx. 200%) increase in ADH-1 mRNA levels after ethanol
      treatment, compared to their matched controls. BALB/c (alcohol sensitive) mice
      have approximately a 20% increase with ethanol treatment while 129/ReJ (alcohol
      sensitive) mice show a slight reduction in the ADH-1 specific mRNA following
      ethanol feeding. A strain-specific pattern is also apparent in the AHD-2 mRNA as
      a result of ethanol feeding in the experimental animals. C57BL/6J mice have an
      increase and BALB/c mice show no apparent change in the AHD-2 mRNA. 129/ReJ mice
      fed an ethanol diet, on the other hand, appear to have a decrease in the level of
      AHD-2 hepatic mRNA as compared to their matched controls. The relative mRNA
      levels of the two genes correlate well with the respective enzyme activity
      levels, but for mice on the control diet only. Ethanol feeding, which causes an
      apparent reduction in hepatic ADH enzyme activity in BALB/c and 129/ReJ and an
      apparent increase in ALDH activity in C57BL/6J (under the experimental protocols
      used) also alters the mRNA levels specific to the two genes. However, changes in
      the mRNA levels after ethanol feeding cannot be directly related to the changes
      seen in enzyme activity. The observed steady state level of AHD-2 mRNA and the
      increase in ALDH activity after ethanol feeding, which is unique to C57BL/6J
      mice, is expected to offer a faster clearance (metabolism) of acetaldehyde, the
      toxic metabolite, and may be responsible for, or contribute to, the relative
      resistance of this strain to ethanol.

PMID- 2222575
TI  - The effect of maternal ethanol infusion on placental blood flow and fetal glucose
      metabolism in sheep.
AB  - Intravenous infusion of 1 g ethanol/min over 1 hr to seven catheterised pregnant
      ewes decreased blood flow on both sides of the placenta. The reductions in blood
      flow were maintained for at least 2 hr after the infusion of ethanol had ceased.
      Although blood flow was reduced, fetal blood gases were unchanged. Plasma glucose
      concentrations were unchanged by ethanol, but fetal glucose supply and
      consumption were both decreased following maternal ethanol infusions. If
      maintained by chronic alcohol consumption these changes could contribute to the
      growth retardation seen in the Fetal Alcohol Syndrome.

PMID- 2222574
TI  - The effect of interrupted alcohol supply on spontaneous alcohol consumption by
      rhesus monkeys.
AB  - The alcohol supply (a 16% and a 32%, v/v, ethanol-in-water solution) for eight
      male rhesus monkeys, who already have had free access to water and ethanol
      solutions concurrently for about one year, was interrupted for 1, 2 or 7 days.
      The previously acquired ethanol consuming behaviour appeared very resistant to
      extinction, because ethanol consumption was immediately resumed after renewed
      access, even at a temporarily increased level. Since physical withdrawal distress
      was not observed and the increase was higher when interruption lasted longer, the
      observed behaviour could be attributed to the reinforcing effects of ethanol,
      leading to specific ethanol-directed behaviour.

PMID- 2222576
TI  - Attenuation of effects of phenylethylamine on social and individual behaviour in
      mice by ethanol pretreatment.
AB  - Beta-phenylethylamine (PEA, 10 mg/kg, intraperitoneally) exerts the following
      behavioural effects in mice: (1) a decrease in the rate and duration of contacts
      (sniffings), typical of anxiogens, in albino SHR (bred from Swiss) male mice and
      a decrease in the duration of contacts in C57l/6 mice; (2) a decrease in the
      duration of grooming in both strains; (3) an increase in locomotion and rearings
      in long-sleeping C57Bl/6 mice. Pretreatment with ethanol (100 mg/kg, orally)
      diminished these effects of PEA. It is suggested that the anxiolytic action of
      ethanol may be related to its antagonism of PEA.

PMID- 2222577
TI  - Alcohol use and depressive symptoms among Mexican Americans and non-Hispanic
      Whites.
AB  - Alcohol use is associated with depressive symptoms in several studies. Using data
      from a community survey, this study examined whether this relationship (a) can be
      accounted for by ethnic or sociodemographic differences among persons who engage
      in various levels of alcohol use; and (b) differs for Mexican Americans (N =
      1244) and non-Hispanic Whites (N = 1149). Using large quantities of alcohol, and,
      among men, daily drinking, were associated with depressed mood. These
      associations were similar for Mexican Americans and non-Hispanic Whites, and
      associations of quantity and frequency with depression were independent of each
      other. Among women, the cultural and demographic characteristics of high-quantity
      drinkers and abstainers (both of whom tended to be Mexican Americans) accounted
      for the association of alcohol use with depression. Among men, there was some
      suggestion that unemployment and unmarried status mediated the association of
      alcohol quantity with depression. People who drank greater quantities of alcohol
      per occasion reported more somatic depressive symptoms, and more frequent male
      drinkers reported more of most types of depressive symptoms.

PMID- 2222579
TI  - Trauma prevention: puzzlement or possibility?

PMID- 2222578
TI  - Is the Lieber-DeCarli liquid ethanol diet adequate in vitamin E?

PMID- 2222580
TI  - Trauma in the workplace. An overview.
AB  - To attenuate the incidence of occupational deaths and injuries, which occur at a
      rate of approximately 25 deaths and 10,000 injuries daily, occupational health
      nurses must focus on injury control for the entire population of workers.
      Knowledge of the mechanics of injury and populations at risk for various types
      and severities of injuries is essential to developing injury prevention programs
      and appropriately responding to emergent injuries. The lack of a comprehensive
      and reliable surveillance method has been described as a major obstacle in
      evaluating the occupational injury problem, as well as measuring progress toward
      achievement of the 1990 Objectives in Occupational Safety and Health. Variations
      in the estimates have been attributed to different methodologies used in
      collecting surveillance data, including diverse definitions, inclusion criteria,
      and data sources. Lost workdays due to injuries reported for 1983 cost an
      estimated $33.4 billion in direct and indirect costs. Mining, construction,
      agriculture, and transportation are the most hazardous industries in terms of
      both fatalities and injuries. Activities appropriate for the occupational health
      nurse in preventing injury include retrospective analysis of injury patterns and
      costs, proactive inspection of the workplace for high risk factors, preplacement
      screening of workers, ergonomic analysis of jobs, evaluation of the type and use
      of personal protective equipment, provision of safety training, and collaboration
      with other agents of the firm in evaluating and designing injury reduction
      strategies and disaster plans.

PMID- 2222582
TI  - Traumatic amputation. Mechanisms of injury, treatment, and rehabilitation.
AB  - Traumatic amputations are one of many injuries that can occur to the body's
      musculoskeletal systems. Degloving, partial and total amputations are common
      types of traumatic injuries. Since traumatic amputations are very life
      threatening, emergency treatment must be initiated quickly and directed toward
      profuse blood loss and potential hypovolemia. Not only do traumatic amputees
      undergo extreme physiological changes, but they must also encounter the
      psychological trauma of an amputation. Due to a loss of body part(s) and
      alteration in body image, the amputee often experiences the stages of grieving
      which may take months and years to resolve. Extensive rehabilitation with the use
      of an interdisciplinary team approach is one of the most successful ways to
      return the amputee to the work place. A combination of occupational therapy,
      physical therapy, vocational rehabilitation and psychological support generally
      promote a sense of well being and return the traumatic amputee to a level of
      independence.

PMID- 2222581
TI  - Trauma: the acute response.
AB  - Moderate to severe trauma is followed by a local response, which involves changes
      in cell function and an inflammatory reaction, and a systemic response
      coordinated by the nervous and endocrine systems. Early post-trauma alterations
      in cells are due primarily to decreased oxygen supply and include 1) the shifting
      of electrolytes and water, either into or out of cells, and 2) the production or
      release of various local tissue factors. These tissue factors produce changes in
      blood flow, increased vascular permeability, and other local manifestations of
      inflammation. Trauma activates nervous and hormonal pathways which help to
      restore blood volume and maintain the function of essential organs. The effects
      of these responses on cellular oxygen consumption and body temperature are
      described. Examples of respiratory system involvement in response to trauma in
      the lungs or elsewhere are given. These include increased capillary permeability
      in the lungs, pulmonary emboli, and damage from smoke and heat inhalation.

PMID- 2222583
TI  - Eye trauma in the workplace.
AB  - A baseline visual acuity should be on record for medical and legal purposes.
      Identifying an eye injury and referring the person for appropriate treatment can
      save vision. Immediate eye irrigation in the case of chemical burns can
      substantially decrease the possibility of permanent vision damage.

PMID- 2222584
TI  - Thermal injuries in the workplace.
AB  - Regardless of mechanism of injury, stop the burning process, assess the
      cardiopulmonary function, remove appropriate clothing and jewelry, and cool the
      burned area with tepid water. With a dry chemical, wipe off as much of a chemical
      as possible before beginning irrigation. Persons giving first aid must protect
      their own skin from contact with the chemical. All significant burns should be
      referred to a physician skilled in burn treatment. Occupational health nurses
      should join together and create a national tool to report all work related
      thermal injuries.

PMID- 2222585
TI  - Head injury in the workplace.
AB  - Work related head injuries do not occur frequently in comparison to other
      injuries, but their importance lies in their relative severity, both in terms of
      work days lost and long term morbidity, making it important for the occupational
      health nurse to have knowledge of how to deal with the initial injury and
      residual problems. In head injury, most of the treatment is aimed toward
      prevention of hypoxia, airway obstruction, hypercapnia, hypotension, and
      bleeding. The Glasgow Coma Scale is used for the severely head injured person.
      The residual cognitive impairment, emotional disturbances, and behavioral changes
      after head injury tend to continue long after the physical disabilities have
      resolved. Therefore, the occupational health nurse needs to assist recovering
      individuals and their families and coworkers to learn to cope with physical,
      cognitive, behavioral, and intellectual deficits.

PMID- 2222586
TI  - The question and the answer. Part 1: Levels of research questions.

PMID- 2222587
TI  - Using information to optimize case management.

PMID- 2222588
TI  - Rapid thawing of fresh frozen plasma in two-liter bags.
AB  - The authors hypothesized that plasma could be rapidly thawed in two-liter
      Transfer Pack Units, because of their greater surface area (993 cm2) compared to
      standard satellite bags (348 cm2) of Blood Pack Units (both from Fenwal, Baxter
      Healthcare Corp, Deerfield, IL). Five units of FFP were prepared in each bag. The
      Sterile Connection Device (DuPont, Wilmington, DE) was used to transfer plasma
      from the satellite to transfer pack units, and these were put in metal canisters
      before all units were frozen at -65 degrees C. Thawing time was 4.8 +/- 1.3 (SD)
      minutes and 15 +/- 3.2 (SD) min. for units prepared in modified and standard
      methods respectively (t = 6.33, P less than .01). The thermal rate constants were
      calculated as 0.0034 and 0.0033 for the two methods. The finding of similar
      values substantiate the theory that thawing time is related to the volume to
      surface area ratio.

PMID- 2222590
TI  - Bretylium tosylate versus lidocaine in experimental cardiac arrest.
AB  - Bretylium tosylate has been shown effective in the treatment of ventricular
      fibrillation and in the prevention of its recurrence. However, lidocaine is
      generally preferred because bretylium could have adverse hemodynamic effects
      related to its antiadrenergic action. To explore further the differences between
      these two antiarrhythmic agents, the authors compared the effects of bretylium,
      lidocaine, and saline on a standardized dog model of ventricular fibrillation
      followed by electromechanical dissociation (EMD). The protocol included three
      successive episodes of cardiac arrest in each animal. Three minutes before each
      episode of ventricular fibrillation, 5 mg/kg of bretylium tosylate (n = 11), 1
      mg/kg of lidocaine (n = 9) or saline (n = 12) were administered blindly. There
      was no difference in the duration of cardiac arrest (bretylium, 8 min 18 sec;
      lidocaine, 7 min 54 sec; saline, 8 min 20 sec) or the total doses of epinephrine
      required to resuscitate the animals. Both bretylium and lidocaine appeared to
      preserve cardiac function 5 minutes after recovery, as stroke volume increased
      from 17.8 +/- 6.7 to 18.7 +/- 6.7 mL (NS) after bretylium and from 17.7 +/- 7.7
      to 19.0 +/- 7.0 mL (NS) after lidocaine, but decreased from 19.0 +/- 5.3 to 14.6
      +/- 6.0 mL (P less than .05) after saline. During the first 10 minutes of EMD,
      ventricular fibrillation or ventricular tachycardia recurred in 4 dogs treated
      with lidocaine, 3 dogs treated with saline, but no dog treated with bretylium (P
      less than .05 between bretylium and saline).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222589
TI  - Controlling for the severity of injuries in emergency medicine research.
AB  - The injury severity score (ISS) and age have been used retrospectively to control
      for trauma severity. Other control variables such as the revised trauma score
      (RTS) and the TRISS method (which estimates the probability of survival for each
      patient) additionally require that values of blood pressure, Glasgow coma scale,
      and respiratory rate, be recorded in the emergency department. The authors
      question when the RTS, ISS, the ISS and age, or the probability of survival
      calculated using the TRISS method should be used to control for severity of
      injuries in trauma research. Relations between predictor variables and (1)
      survival to hospital discharge, (2) hospital length of stay for survivors, and
      (3) length of ICU stay were compared by cause of injury: penetrating, motor
      vehicle accident, low fall, or other blunt. Data were collected over 12 months
      for 2,914 consecutive adult patients who died or stayed in five nontrauma and
      three trauma centers for 48 hours or more. For survival, the false-negative rates
      of probability of survival calculated using the TRISS method were approximately
      half that of the ISS and age; no variable adequately explained survival among
      those with low falls. Combinations of ISS, RTS, and age explained the most
      variation in lengths of hospital stay among survivors, while ISS explained the
      most variation in lengths of intensive care unit (ICU) stay. Researchers should
      consider the ISS with RTS and age to control for severity when lengths of
      hospital or ICU stay are studied. The TRISS method should be used in studies of
      survival. In both cases, the RTS which requires data collection in the emergency
      department must be calculated.

PMID- 2222591
TI  - Urgent care center pediatric telephone advice.
AB  - Pediatric telephone advice is sought frequently by members of the community. This
      study was undertaken to evaluate the quality and accuracy of pediatric telephone
      advice given by free-standing urgent care centers. One hundred such facilities
      were telephoned and advice was requested by a research assistant. A case was
      presented that could have represented a pediatric medical emergency. Overall only
      17 centers gave adequate advice. The data suggest that under some circumstances
      free-standing urgent care center pediatric telephone advice may be inaccurate and
      inappropriate. Workable policies and protocols for pediatric telephone advice
      should be instituted by these facilities.

PMID- 2222592
TI  - Cardiopulmonary resuscitation skills retention in family members of cardiac
      patients.
AB  - The purpose of this study was to determine if the use of a retention strategy
      would maintain cardiopulmonary resuscitation (CPR) skills in family members of
      cardiac patients. Thirty-one subjects trained in CPR received retention packets 3
      and 6 months after CPR training. Sixteen subjects were tested for CPR retention
      at 7 months after initial training, and 15 at 12 months. Likelihood chi 2 was
      used to compare the 7- and 12-month groups. There were no differences between the
      7- and 12-month groups, because CPR retention overall was poor. Only 19.4% of
      subjects reported using the retention packet; therefore, subjects were regrouped
      into practice and no practice groups for purposes of further statistical
      analysis. There were significant differences in retention in subjects who
      practiced compared with subjects who did not. These findings underscore the
      importance of promoting practice/review after initial CPR training for family
      members of cardiac patients.

PMID- 2222593
TI  - What is the optimal volume of administration for endobronchial drugs?
AB  - During general anesthesia, three groups of six patients each received 2 mg/kg
      lidocaine as a marker substance endobronchially in either 10, 5, or 3 mL
      distilled water. It was found that the group receiving 10 mL initially exhibited
      the highest lidocaine plasma concentration with a mean of 2.01 micrograms/mL, in
      comparison with 1.25 micrograms/mL in the 5 mL group and 0.95 micrograms/mL in
      the 3 mL group. After about 10 minutes, concentration courses were almost the
      same in the 10 mL and the 5 mL groups. The PaO2 in the 10 mL group dropped
      initially by approximately 40 mm Hg on average and remained low over 60 minutes.
      By this time the PaO2 in the 5 mL group (initial drop 46 mm Hg) had come back to
      the original value (P less than .05). The 3 mL group exhibited even more
      favorable courses in the PaO2 (initial drop 16 mm Hg on average). However, the
      lidocaine plasma concentration was at the lowest at all times in this group and,
      moreover, under the therapeutic level of 1.5 micrograms/mL with the dosage used.

PMID- 2222594
TI  - Patients who initially refuse prehospital evaluation and/or therapy.
AB  - The authors performed a retrospective descriptive and analytical cohort study of
      prehospital patient initial refusal of care (PIRC) cases to characterize the
      types of patients encountered and to assess factors associated with their
      dispositions. During a 6-month period, 169 of 1715 (9.9%) base station calls in
      an urban emergency medical service (EMS) system were for physician involvement in
      a PIRC. Patients' dispositions were as follows: left at scene against medical
      advice (53%); taken by ambulance to the hospital (28%); left with friend (13%);
      other disposition (5%). While police were called to the scene 41 times, they
      placed a "legal hold" on only 10 patients. Leaving the patient at the scene
      against medical advice was associated (logistic regression analysis; P less than
      .05) with the absence of the following factors: family on the scene and a police
      hold, and with the presence of the following factors: treated hypoglycemia,
      alcohol use, orientation, and normal speech. The development of statutes that
      allow police hold placement under the guidance of the base station physician may
      be necessary. Such statutes would aid transportation of a patient considered by
      EMS personnel to have impaired mental capacity that may limit the patient's
      ability to understand medical care decisions.

PMID- 2222595
TI  - A controlled trial of nebulized isoetharine in the prehospital treatment of acute
      asthma.
AB  - Acute asthma is a potentially life-threatening disorder, recognizable to the
      prehospital care provider. While therapies are available to the prehospital care
      provider for treating acute asthma, no previous controlled studies have been
      performed demonstrating the treatment in the field is efficacious and safe. The
      authors conducted a controlled trial of the prehospital use of nebulized
      isoetharine in an urban emergency medical services system. Fifty-two patients
      with acute asthma were studied. Patients were initially evaluated with a peak
      flow meter. Half of the patients received isoetharine, while the control group
      received basic life support only. There was no difference in baseline values.
      Peak expiratory flow increased from 138 L/min to 148 L/min in the control group,
      while it increased from 149 L/min to 218 L/min in the treatment group (P less
      than .001). The authors conclude that paramedic treatment of acute asthma with
      nebulized isoetharine is effective in improving pulmonary function and clinical
      status during transport.

PMID- 2222596
TI  - Ectopic pregnancy: ten common pitfalls in diagnosis.
AB  - Ectopic pregnancy (EP) is a common, life-threatening complication of pregnancy.
      Modern technology (ultrasonography and improved pregnancy tests) should
      facilitate the diagnosis of EP. However, in a retrospective review of 65 cases of
      confirmed EP managed over 18 months at an urban teaching hospital, only 37 of 65
      patients (57%, Cl95 = 44%, 69%) received prompt diagnosis and treatment; delays
      occurred in 28 patients (43%). In 10 of the 27 delayed cases, the diagnosis of EP
      was not even considered at the time of the first visit. In patients with a
      delayed diagnosis, morbidity (transfusions, cardiovascular instability,
      progression of illness) did occur. Diagnostic pitfalls that resulted in delayed
      care were reviewed, delays most commonly occurred in patients with a benign
      examination or "atypical" pain. Risk factors for EP were missed (7 patients,
      25%), subtle clues to blood loss were often ignored (10 patients, 36%), and
      passage of tissue was thought to exclude EP (2 patients). Ultrasound was only
      helpful for half of the diagnoses and was misinterpreted in 27%. A dry or serous
      culdocentesis occurred frequently. In five patients, a falling or low
      quantitative human chorionic gonadotropin level was believed to indicate a
      completed abortion. The authors conclude that almost half of EPs are still missed
      on the first physician visit; errors and pitfalls in diagnosis are still common
      in the 1980s.

PMID- 2222597
TI  - Whole bowel irrigation and the cocaine body-packer: a new approach to a common
      problem.
AB  - Gastrointestinal drug smuggling is a common problem in many major cities. Though
      the majority of cases never require medical attention, the "body-packer"
      frequently presents with life-threatening symptoms of intoxication, including
      seizures and cardiorespiratory collapse, as well as mechanical obstruction from
      the ingested drug packets. The risk to asymptomatic smugglers may vary with
      packaging materials, and remains unknown. Lack of controlled studies, and
      variations in packaging materials and clinical outcomes have prevented
      formulation of a consistent management strategy. Current recommendations for
      asymptomatic body-packers vary from immediate surgical removal, to use of
      laxatives, to observation. The authors present the first reported case of an
      asymptomatic cocaine body-packer treated with whole bowel irrigation with
      polyethylene glycol electrolyte lavage solution. This strategy was safe, well
      tolerated, resulted in the rapid elimination of drug packets from the
      gastrointestinal tract, and facilitated assessment by contrast radiography. The
      potential benefits and limitations for the use of whole bowel irrigation in this
      difficult problem are discussed.

PMID- 2222598
TI  - The spectrum of emergency care of agricultural trauma in central Wisconsin.
AB  - Agriculture is among the most dangerous occupations in the United States. When
      injuries do occur, the emergency department (ED) is the primary source of care.
      Over a 2-year period, the emergency medicine section of the Marshfield Clinic/St
      Joseph's Hospital, cared for 913 victims of agricultural trauma. Although 11%
      were initially admitted and 4% were later treated, the remainder received their
      care solely in the ED. Unlike most occupational injuries, people of any age may
      be involved in agricultural injuries; 27% in this series were less than 18 years
      of age and 5% were 65 years or older. Just over half of all injuries were from
      mechanical devices, including tractor and farm machinery. The remainder were from
      animals, falls, or exposure. Although several different types of injuries
      occurred, the most common diagnoses were soft tissue injuries and fractures and
      the most common procedure was diagnostic radiography followed by wound and
      fracture care. An ED in a rural setting should be prepared to deal with
      agricultural trauma.

PMID- 2222599
TI  - Atrial fibrillation with cardiac tamponade as the initial manifestation of
      malignant pericarditis.
AB  - This article describes the case of a 72-year-old woman with cardiac tamponade and
      atrial fibrillation as the initial manifestation of a lymphoid malignancy. The
      pathogenesis of cardiac tamponade, various diagnostic modalities, and therapy of
      this condition are reviewed.

PMID- 2222600
TI  - Methylene chloride: report of five exposures and two deaths.
AB  - Five patients presented to the emergency department (ED) following exposure in an
      enclosed space to methylene chloride (dichloromethane), used for removing paint.
      Two workers and three rescuers were involved. Two rescuers complained only of
      dizziness and mild nausea, and were subsequently discharged from the ED. One
      rescuer was asymptomatic. Worker no. 1 arrived in cardiac arrest and eventually
      died in the ED despite resuscitation efforts. Worker no. 2 also presented to the
      ED in cardiac arrest, and was successfully resuscitated to pulse and blood
      pressure. However, he never regained consciousness or spontaneous respirations,
      and died on the fourth day. Of interest is that worker no. 2's carboxyhemoglobin
      level increased from 2% to 8% over the 9 hours following admission, despite
      administration of 40% to 50% oxygen by endotracheal tube. Among the conclusions
      that can be drawn are (1) the cause of death in these patients was not carbon
      monoxide poisoning, but solvent-induced narcosis; (2) carboxyhemoglobin levels
      may continue to rise following cessation of exposure, despite administration of
      high flow oxygen; (3) rescuers can easily become victims if proper protective
      clothing and respirators are not worn.

PMID- 2222601
TI  - Epidural hematoma: an unusual presentation.
AB  - The authors present a patient with a traumatic epidural hematoma who complained
      only of headache and presented to the emergency department 48 hours after a fall.
      Mental status and neurological examination were normal. This delayed presentation
      is more commonly seen when a subdural hematoma is present but may result from
      epidural bleeding. Delayed formation of a traumatic epidural hematoma may occur
      when the following are present: elevated intracranial pressure, hypovolemic
      shock, a concomitant mass lesion, coagulopathy, bleeding from dural or diploic
      veins, a dural sinus laceration, a traumatic pseudoaneurysm, or an arteriovenous
      fistula. Although criteria for computed tomography of patients with head injuries
      remain variable in the literature, delayed presentation of epidural bleeding must
      be considered in the differential diagnosis of posttraumatic headache
      irregardless of the time interval or neurological presentation.

PMID- 2222602
TI  - Buccal cellulitis.
AB  - Buccal cellulitis (BC) is an innocuous appearing infection of the cheek that is
      found in children and has a high incidence of concomitant bacteremia. Typically,
      the child is younger than 12 months and has a 2 to 8 hour prodrome of coryza and
      fever before developing the cellulitis on the cheek. A purplish hue on the
      cellulitic region is highly suggestive of Hemophilus influenzae bacteremia. The
      differential diagnosis is reviewed. A complete blood count, blood culture, and
      cellulitis aspirate culture, should be obtained on all patients with BC.
      Meningitis may be present despite the lack of meningeal signs. A lumbar puncture
      should be performed on all children at risk for bacteremic BC. The vast majority
      of these children are bacteremic and require parenteral antibiotics. A typical
      case of BC is presented and its management is reviewed.

PMID- 2222603
TI  - Near fatal subacute thallium poisoning necessitating prolonged mechanical
      ventilation.
AB  - The authors describe a case of severe sensory-motor polyneuropathy caused by
      subacute thallium-intoxication rapidly progressing to respiratory failure due to
      complete muscle paralysis. After more than 2 months of mechanical ventilation,
      weaning from the ventilator was possible. Further intensive physical
      rehabilitation required an additional 6 months hospital stay, and 18 months
      later, neurological recovery was complete except for the distal lower limbs
      muscles. The authors discuss the different forms of thallotoxicosis and the
      present treatment is reviewed. Maximal prolonged therapeutic support should be
      offered in severe thallotoxicosis because of possible near complete recovery.

PMID- 2222605
TI  - Is gut emptying all washed up?

PMID- 2222604
TI  - Critical care transportation medicine: new concepts in pretransport stabilization
      of the critically ill patient.
AB  - Regionalization of health care for trauma has become commonplace, and the same
      concept for critically ill medical/surgical patients is developing. Recent
      evidence suggests that current stabilization measures used by transport teams can
      be inadequate for this critically ill patient population. In trauma, speed has
      been considered a necessity to get the patient to a facility which cannot be
      carried out to the field, eg, an operating room. For acute medical illnesses,
      critical care transport teams can bring intensive care technology to the patient.
      Accumulating evidence supports the premise that speed of transport is not as
      important as stabilization before transport, knowledge of hemodynamics during
      transport, and early use of critical care monitoring systems. Other reports
      identify the need for initial evaluation and stabilization of critically ill
      patients by physicians at the critical care level of expertise. Accordingly,
      critical care transportation teams have evolved, creating new notions of
      pretransport stabilization not applicable to previous transport systems.

PMID- 2222606
TI  - Computer-assisted medical charting in the emergency department.

PMID- 2222607
TI  - Up in smoke: the MAST garment fuels more fires.

PMID- 2222608
TI  - Anaplastic astrocytoma in association with human immunodeficiency virus type 1
      infection.

PMID- 2222609
TI  - B(n)ite of the iguana.

PMID- 2222610
TI  - Unilateral pharmacologic mydriasis secondary to crack cocaine.

PMID- 2222611
TI  - Spontaneous migration of an intraspinal bullet following a gunshot wound.

PMID- 2222612
TI  - Salt poisoning in a two-year-old child.

PMID- 2222613
TI  - The demand for emergency medicine residency graduates.

PMID- 2222614
TI  - Emergency medicine and critical care.

PMID- 2222615
TI  - Effects of gestational weight gain in morbidly obese women: II: Fetal morbidity.
AB  - Recommended gestational weight gain is based on supplying adequate nutrition to
      the conceptus, ensuring normal growth and development. Since morbidly obese women
      have an overabundance of nutrients for fetal transfer, we examined the effects of
      weight gain on fetal outcome in women greater than 160% of ideal body weight.
      Gestational weight gains varied from -18 to +64 pounds, allowing analysis of
      fetal outcome based on maternal weight gain. No correlation between maternal
      weight gain and ketonuria, birthweight or length, placental weight, or Apgar
      scores was noted. Gestational age at delivery was inversely related to weight
      gain. When grouped by maternal weight gain, fetal outcome was no different if
      mothers gained less than or greater than 10 pounds. We conclude that limited
      weight gain in the morbidly obese women does not adversely affect fetal outcome,
      and prospective trials of limited weight gain diets in morbidly obese women are
      warranted.

PMID- 2222616
TI  - Management of varicella pneumonia complicating pregnancy.
AB  - We report five cases of varicella pneumonia during pregnancy. Prompt diagnosis
      along with aggressive management, including antiviral chemotherapy and
      ventilatory support, may improve maternal and neonatal outcome.

PMID- 2222617
TI  - Home death and hospital follow-up of the dying infant.
AB  - As technology and medical care have improved, increasing numbers of critically
      ill neonatal patients are surviving the immediate neonatal period. The hectic
      environment of the neonatal intensive care unit often makes it difficult for
      personnel to attend adequately to the needs of the dying infant and his family.
      Accordingly, the option of home death for such infants has been offered in our
      neonatal intensive care unit. Experience is described for six infants who were
      managed in this manner.

PMID- 2222618
TI  - Intrauterine sound levels: intrapartum assessment with an intrauterine
      microphone.
AB  - The complex mechanisms responsible for fetal hearing are in place and functional
      by 26 weeks of gestation, but little is known about the acoustic milieu of the
      amniotic cavity. We placed an electrically isolated microphone in the uterus of
      nine term gravid volunteers after amniorrhexis. Baseline levels of intrauterine
      sound were 72 to 88 db. Transabdominal vibroacoustic stimulation with an
      artificial larynx produced peak mixed frequency sound levels of 91 to 111 db. We
      conclude that the term fetus in labor is exposed to physiologic sound levels
      higher than we had anticipated; the application of a quantifiable sound stimulus
      to the maternal abdominal wall results in a small increment in intrauterine
      sound; and within the limits specified, experimental fetal acoustic stimulation
      should pose no major risks.

PMID- 2222619
TI  - Maternal cigarette smoking during pregnancy, adiposity, social class, and
      perinatal outcome in Cardiff, Wales, 1965-1977.
AB  - There have been several reports in which maternal nutritional status has been
      implicated as either a mediating or moderating factor in the relationship between
      maternal cigarette smoking and birthweight and perinatal survival. Also, there is
      evidence that the effects of maternal cigarette smoking on both intrauterine
      growth and fetal viability are more intense among women of lower social status.
      The well-maintained data set of the Cardiff Births Survey from 1965-1977 afforded
      an opportunity to review these issues among over 50,000 births in south Wales
      (the survey took place in Cardiff City through 1973 and subsequently included
      suburban areas of South Glamorgan). The major findings were: (1) Smoking was much
      more common with descending maternal social status; (2) among upper status women,
      smokers had similar or slightly greater mean Quetelet's indices (kg/m2) than
      nonsmokers. Among lower status women, smokers were considerably thinner than
      nonsmokers; (3) the greater the adiposity of the mother, the less the association
      between cigarette smoking and depressed birthweight; (4) perinatal mortality was
      significantly higher among heavy smokers (10 or more cigarettes a day) than among
      nonsmokers; and (5) neither the decrease in birthweight nor the excess mortality
      associated with smoking was greater among those of lower rather than upper social
      status, except among class I women, among whom smoking was only minimally
      associated with depressed birthweight. With the inclusion of the South Glamorgan
      suburban population in the survey after 1974, the excess mortality associated
      with heavy smoking dropped from 53 to 16%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222620
TI  - Logothetopulos pack for the management of uncontrollable postpartum hemorrhage.
AB  - This is the first reported case in which a Logothetopulos pack was utilized to
      achieve pelvic hemostasis in a patient requiring a cesarean hysterectomy for
      placenta accreta with postpartum hemorrhage. The Logothetopulos pack is an easily
      constructed gauze tamponade method that proved to be life-saving in this case.

PMID- 2222622
TI  - Use of thiazide diuretics to reduce the hypercalciuria of hypoparathyroidism
      during pregnancy.
AB  - A pregnant patient with idiopathic hypoparathyroidism is presented. Her
      hypomagnesemic hypocalcemia was unresponsive to conventional therapy, or
      magnesium supplementation. Sodium restriction with thiazide therapy successfully
      reduced her renal calcium wastage to control her symptoms and raise her serum
      calcium levels.

PMID- 2222623
TI  - Sonographic findings in septo-optic dysplasia in the fetus and newborn infant.
AB  - A 28-year-old primigravida woman was referred for ultrasound studies at 27 weeks'
      gestation. Sonographic examination found enlarged cerebral ventricles,
      communicating lateral ventricles, bilateral cleft lip and palate. A 2500 gm male
      infant was delivered at 36 weeks' gestation, after which the diagnosis of septo
      optic dysplasia was made.

PMID- 2222621
TI  - Medication administration via the umbilical arterial catheter: a survey of
      standard practices and review of the literature.
AB  - A survey of 100 institutions was conducted regarding the use of medications
      through the umbilical artery catheter (UAC). Of the 63 institutions that
      responded, 40 allow medication administration through the UAC. Data were
      collected on which medications were believed to be safe and those believed not to
      be safe for administration through the UAC. Responders were also asked to comment
      on any problems related to particular medications, who administered the
      medications, the method of administration, and the preferred placement of the tip
      of the catheter.

PMID- 2222624
TI  - Doppler umbilical artery velocimetry in fetuses with polyhydramnios.
AB  - Polyhydramnios is a condition of multiple etiologies, many of a benign nature,
      but some of which are incompatible with life. To evaluate Doppler velocimetry
      results as a prognostic parameter in these fetuses, we reviewed all of our cases
      of polyhydramnios that underwent Doppler analysis in the third trimester. Fifty
      four fetuses were studied. Eleven (20.4%) had abnormal waveforms and 43 (79.6%)
      had normal waveforms. An abnormal waveform was associated with a significantly
      higher incidence of congenital anomalies, perinatal mortality and intrauterine
      growth retardation. Six of the 11 fetuses had abnormal karyotypes. Macrosomia was
      present in 37.2% of fetuses with normal waveforms and in no fetus with an
      abnormal waveform. Doppler analysis may aid in the counseling and management of
      patients with polyhydramnios. In cases with an abnormal ratio, the physician and
      patients should be prepared for a poor outcome and third trimester genetic
      analysis should be strongly considered.

PMID- 2222625
TI  - Effect of intrauterine growth retardation on renal function on day one of life.
AB  - We measured inulin clearance per kilogram, fractional sodium excretion per
      kilogram, osmolality, and urinary prostaglandin concentration in seven growth
      retarded neonates and six appropriately grown neonates matched for gestational
      age during the first 24 hours of life to determine the effect of fetal growth
      retardation on renal function. There was a nonsignificant reduction in inulin
      clearance per kilogram in the growth-retarded neonates (p = 0.11). Inulin
      clearance correlated with gestational age in both groups. It was significantly
      correlated with birthweight in the growth-retarded group (p less than 0.05) but
      did not reach significance in the control group (p less than 0.06). Fractional
      sodium excretion was significantly higher in the growth-retarded fetuses (p less
      than 0.05). This increase was not explainable by differences in mean blood
      pressure and intravenous fluid intake, although differences in urinary
      prostaglandin concentrations during the study interval may be involved. In
      conclusion, we have demonstrated that growth retardation is associated with
      impaired renal maturation, which during the first 24 hours of life is manifest as
      decreased glomerular filtration rate and increased sodium excretion.

PMID- 2222626
TI  - Cervical internal os cerclage: description of a new technique and comparison with
      Shirodkar operation.
AB  - Internal os cerclage for cervical incompetence was performed in 90 patients who
      had previous McDonald procedure failure (70 patients) or had unfavorable cervical
      anatomy (short or lacerated cervix) for primary McDonald type cerclage (20
      patients). Two different techniques were used: the Shirodkar operation (n = 44)
      with Mersilene band, and a simpler new technique (n = 46). The new technique is
      characterized by anterior colpotomy for exposure of the internal os, and a 0.6 mm
      nylon suture encircling the cervix to be tied high in the posterior fornix. The
      pregnancy outcome for both groups was similar. Late abortions of 8.7 and 11% and
      premature deliveries of 13 and 18% occurred in the new technique and the
      Shirodkar groups, respectively. The removal of the suture was generally difficult
      in the Shirodkar group and in eight patients analgesia and sedation were
      required. In the new technique group, the removal was easier and in only one
      patient was sedation required (p less than 0.0001). Severe vaginal discharge was
      found in 52% of the Shirodkar patients and none in the other group. Apparently
      the monofilament nylon suture prevented this side effect. It seems that the new
      technique is simpler to perform, involves fewer side effects, the removal of the
      suture is easier, and it is as effective as the Shirodkar procedure.

PMID- 2222627
TI  - Spectrum and natural history of congenital hyperparathyroidism secondary to
      maternal hypocalcemia.
AB  - Fourteen cases of congenital hyperparathyroidism secondary to maternal
      hypocalcemia have been reported. We report two additional cases that highlight
      the wide spectrum of the disease. We extensively studied the parathyroid function
      of these infants to test the hypothesis that the biochemical hyperparathyroidism
      found in these infants would be transient in nature, since the presumed etiology
      (maternal and subsequent fetal hypocalcemia) should disappear soon after birth
      with establishment of enteral feedings. Infant 1 was born to a mother with
      idiopathic hypoparathyroidism with poor compliance to therapy and documented
      hypocalcemia in pregnancy. Severe congenital demineralization and intrauterine
      fractures with clinical and radiologic bowing of the long bones were obvious.
      Bone mineral content and bone mineral content/bone width ratio, measured by
      photon absorptiometry, were both markedly below normal. Infant 2 was born to a
      mother with postsurgical hypoparathyroidism with excellent compliance. The mother
      was normocalcemic. The infant was clinically and radiologically asymptomatic. The
      bone mineral content was just at the lower limit of normal, but bone mineral
      content/bone width ratio was below the normal limits. Biochemical features
      include elevation of cord serum parathyroid hormone (1-84, radioimmunoassay) in
      both cases, coexisting with serum calcium, phosphorus concentrations within
      normal limits. Serum parathyroid hormone fell to within normal ranges by 9 days
      of age in both infants. With no treatment, bone mineral content at 1 month of age
      was normal in both infants.

PMID- 2222628
TI  - Alpha-thalassemia: prenatal diagnosis and neonatal implications.
AB  - Homozygous alpha-thalassemia major, or Bart's hemoglobinopathy, is the most
      common etiology of nonimmune hydrops in those of Oriental descent. The prenatal
      diagnosis can now be made utilizing DNA hybridization technique from fetal cells
      obtained by either amniocentesis or chorionic villus sampling. A case is reviewed
      documenting the utilization of DNA studies in managing patients known or
      suspected to have a history of alpha-thalassemia major.

PMID- 2222629
TI  - Effects of T's and blues abuse on pregnancy outcome and infant health status.
AB  - T's and blues (pentazocine and tripelennamine) abuse during pregnancy has been
      reported to be associated with adverse maternal and fetal effects. In this study,
      conducted at Parkland Memorial Hospital in Dallas, Texas, pregnancy outcome and
      health status of infants born to 23 T's and blues abusers were compared to a
      group of 100 unexposed women and their infants. Infants born to T's and blues
      abusers had significantly reduced birthweight, length, head circumference, and an
      increased frequency of major congenital anomalies (3 of 23), including two
      congenital cardiac anomalies. However, one of these cardiac anomalies occurred in
      the offspring of a woman who also reported moderate to heavy daily alcohol use
      during pregnancy. The other cardiac anomaly occurred in association with in utero
      anoxia. We therefore surmise that a known teratogen (alcohol) and perinatal
      complications caused two of the major anomalies, and not the pentazocine
      tripelennamine combination per se.

PMID- 2222630
TI  - Effect of active management on latent phase labor.
AB  - The effect of active management on latent phase labor was assessed in 197
      consecutive nulliparous women. Active management resulted in a significant
      shortening of the latent phase but had no effect on active phase labor. Patients
      undergoing induction of labor had latent phases that were almost identical to the
      accepted norm. The effect of active management may be due to early diagnosis of
      labor and early intervention in the form of artificial rupture of membranes and
      selective high-dose oxytocin infusion.

PMID- 2222631
TI  - Safety and efficacy of combined ritodrine and magnesium sulfate for preterm
      labor: a method for reduction of complications.
AB  - Ritodrine hydrochloride and magnesium sulfate used in combination for preterm
      labor tocolysis have been cited for yielding excessively high complication rates.
      A retrospective chart review was performed to assess the frequency of these
      complications and to determine whether tocolysis can be continued despite
      complications. Of 95 patients managed with dual tocolytics, 61 had side effects
      sufficiently serious to warrant cessation of tocolytic therapy for an overall
      complication rate of 64%. After evaluation for objective evidence of pathologic
      conditions, 41 (67%) patients were restarted on dual tocolytics without further
      complication. It was deemed inappropriate to restart tocolysis in 20 patients,
      resulting in a 21% rate of complications. This allowed a significant increase in
      the number of patients delivering after 36 weeks (19.5% versus 50%, p less than
      0.02) and a decrease in neonatal intensive care unit days per infant (3 versus
      15.5 days, p less than 0.02). This suggests that aggressive continued tocolysis
      with multiple agents can be safe and efficacious with appropriate evaluation.

PMID- 2222632
TI  - Isolated fetal ascites: prenatal diagnosis and management.
AB  - The perinatal outcomes of four patients with isolated fetal ascites were
      evaluated. The ascites disappeared prior to delivery in 50% of the cases and was
      resolved shortly after delivery in the remainder. Excellent neonatal outcomes
      were observed. Thus, isolated fetal ascites may represent a separate condition
      that significantly differs from the general category of nonimmune hydrops in both
      perinatal courses and prognoses. The prenatal diagnosis and management of this
      condition are discussed.

PMID- 2222633
TI  - Risk factors for preterm premature rupture of the fetal membranes.
AB  - Preterm premature rupture of the membranes (PPROM) is a significant cause of
      prematurity, accounting for approximately one third of preterm births in the
      United States. PPROM occurs in approximately 0.7-2% of all pregnancies
      nationally, and has a reported recurrence rate of 21%. The elucidation of
      potential risk factors for PPROM could contribute to a better understanding of
      its etiology. To study the contributions of 20 potential risk factors, we
      undertook a case-control study in our clinic population, which has a 5-6%
      incidence of PPROM. One hundred and thirty-three patients experiencing PPROM were
      matched for race, age, parity and gestational age with undelivered patients.
      Studies performed included ultrasonographic examinations, blood levels of
      ascorbic acid and zinc, microbiologic assays, patient questionnaires, and chart
      reviews. After stratification of both groups into subgroups based on matching
      criteria, summary tests of significance and Mantel-Haenszel tests of odds ratios
      were performed. On univariate analysis the following factors achieved
      significance at the p less than 0.05 level with 95% confidence intervals: 1)
      previous history of PPROM 2) smoking (dose related) 3) fundal location of the
      placenta in the present pregnancy. 4) a prior history of cerclage. After
      regression analysis, we concluded that smoking and history of previous PPROM were
      found to be risk factors for PPROM in our inner city black population.

PMID- 2222634
TI  - Relationship of maternal to neonatal colonization with coagulase-negative
      staphylococci.
AB  - Infections with coagulase-negative staphylococci (C-S) have become problems of
      major clinical importance among very low birthweight infants in neonatal
      intensive care units. Colonization with slime-producing strains of C-S may be a
      risk factor for these infants in the development of invasive infections. The
      present study evaluated the maternal genital tract as a possible source for
      neonatal colonization with C-S. Specific objectives were to determine the
      incidence of vaginal colonization with C-S in pregnant women with special
      reference to slime-producing strains and whether transmission of C-S occurs from
      mother to infant during the process of vaginal delivery. Antenatal vaginal
      cultures were done on 465 women at different gestations of pregnancy.
      Additionally, 101 women and their newborn infants were cultured after vaginal
      delivery. Fifty-one percent of women were colonized with C-S during pregnancy,
      and no significant differences in colonization rates by trimester were found.
      Slime-positive isolates from pregnant women increased significantly from the
      first to the third trimester (40 to 68%; chi-square, 11.21, p less than 0.005).
      However, the proportion of slime-positive strains among the 30 infants who were
      colonized with C-S at birth was 40% (12 of 30). Although 30 infants were
      colonized with C-S at birth, only three were shown to have acquired the organism
      by maternal transmission determined by similarity of species, biotype, antibiotic
      sensitivity pattern, slime production, phage type, and plasmid pattern profile.
      Therefore 27 infants (26% of the total) most likely acquired C-S from
      environmental sources, including nursery attendants.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2222635
TI  - First trimester growth delay in Trisomy 18.

PMID- 2222636
TI  - Breastfeeding: can it compete in the marketplace?

PMID- 2222637
TI  - A standardized interview that differentiates pregnancy and postpartum symptoms
      from perinatal clinical depression.
AB  - In a prospective longitudinal study, 202 primigravidas were assessed for
      depression using the National Institute of Mental Health's (NIMH) standardized
      clinical interview, the Schedule for Affective Disorders and Schizophrenia
      (SADS), and Research Diagnostic Criteria (RDC) at four periods: 10 to 14 weeks of
      pregnancy, 30 to 32 weeks of pregnancy, 1 to 2 weeks postpartum, and 14 weeks
      postpartum. Women's responses did not fit the SADS standardized questions and
      prescribed ratings because pregnancy and postpartum symptoms often mimicked
      depression symptoms. This was addressed by adding questions and scoring criteria
      to separate out pregnancy and postpartum symptoms from depression symptoms.
      Results showed that, after accounting for pregnancy-postpartum symptoms, women
      consistently claimed eight symptoms with high frequency and higher mean ratings:
      dysphoric mood, worrying, somatic and psychic anxiety, insomnia, fatigue, anger,
      and irritability. The findings suggest that 1) depression in pregnant and newly
      delivered women may be underdiagnosed if caregivers attribute their complaints or
      symptoms to time-limited somatic conditions; 2) depression may be overdiagnosed
      if clinicians use self-report measures solely, or without carefully interviewing
      women to separate the symptoms of depression from symptoms of pregnancy and
      postpartum; and 3) women's reactions to perinatal symptoms may have some bearing
      on the development of depression then or later. Simple clinical and social
      amelioration of the symptoms of distress might reduce their effect and diminish
      the rate of mistaken diagnoses of depression.

PMID- 2222638
TI  - Postpartum depressive disorders: changing trends.
AB  - For centuries, there has been speculation regarding the etiology of postpartum
      depression. An improved diagnostic classification has emerged, however, as the
      universality of the syndrome has been recognized and the role of hormonal,
      genetic, and obstetric variables considered. In addition, different cultures have
      different perceptions of the needs of the new mother. The emphasis in
      investigative work now appears to be in the psychosocial and psychodynamic areas.
      Our recent research focused on identification of risk factors early in pregnancy,
      including a history of depression, separation from one or both parents in
      childhood or adolescence, poor parental emotional support in childhood and
      adulthood, poor relationship with husband or partner, economic problems, and
      dissatisfaction with amount of education. We suggest that physicians, nurses, and
      mental health professionals be aware of the emotional status of their patients,
      familiarize themselves with the risk factors, and initiate a program of careful
      postpartum follow-up. These measures will help to improve recognition and
      management of the woman at risk for postpartum depression.

PMID- 2222639
TI  - Midwifery in Ontario: a survey of interest in services.
AB  - Maternity care for women in Ontario is provided almost exclusively by physicians,
      the majority of whom are obstetricians. Using a self-administered questionnaire,
      pregnant women in one Ontario city were surveyed about their interest in
      midwifery care as an alternative to physician care. Although 3 percent of the
      women surveyed had used a midwife, 60 percent expressed an interest in midwifery
      care, particularly the counseling and support aspects. Over 11 percent showed an
      interest in complete primary midwifery care.

PMID- 2222640
TI  - Vaginal birth after two or more cesarean sections: a five-year experience.
AB  - Allowing a trial of labor in patients who have had a single low transverse
      cesarean section has become increasingly accepted and widespread in the United
      States. Evidence with regard to the safety of this practice in patients with two
      or more prior cesarean births has, however, been sparse. We performed a
      retrospective review of the charts of 170 patients who had undergone two or more
      low transverse cesarean deliveries and subsequently delivered at Wishard Memorial
      Hospital between January 1, 1983, and December 31, 1987. Of 35 of these women who
      underwent a trial of labor, 27 (77%) had a successful vaginal delivery. No
      increase in maternal or fetal morbidity or mortality was associated with labor.
      The women who underwent trial of labor had fewer postpartum complications and
      shorter hospital stays. Although the number of patients in this study was small,
      growing evidence appears to support a trial of labor in patients with two or more
      prior cesarean sections as a safe and successful alternative to elective repeat
      cesarean section.

PMID- 2222641
TI  - Treatment refusal, noncompliance, and substance abuse in pregnancy: legal and
      ethical issues.
AB  - Prenatal caregivers often note that the behavior of pregnant patients creates the
      risk of fetal harm. Three such cases are reviewed, together with care providers'
      responses and relevant law. Pregnant womens' rights to disregard medical advice
      are increasingly being overridden in courtrooms and bedside hearings. To preserve
      the patient-provider relationship, and to avoid coercive actions that may have
      little legal basis, emphasis should be on helping the woman act in her own best
      interest and that of her fetus, rather than on the law or the courts as a means
      of directly or indirectly controlling her behavior.

PMID- 2222642
TI  - Effects of epidural analgesia: some questions and answers.
AB  - The effects of epidural analgesia on first labors have been studied by Thorp and
      colleagues. One study has been published and is the subject of a question-and
      answer discussion, presented here. In this study 711 consecutive nulliparous
      women at term, with spontaneous onset of labor and cephalic presentation, were
      divided into one group (n = 447) who received epidural analgesia in labor and
      another group (n = 264) who received narcotics or no analgesia. The frequency of
      cesarean section for dystocia was significantly greater (p less than 0.005) in
      the epidural group (10.3%) than in the nonepidural group (3.8%), even after
      selection bias was corrected and the variables of maternal age and race;
      gestational age; cervical dilatation on admission; use, duration, and maximum
      infusion rate of oxytocin; labor duration; presence of meconium; and birth weight
      were controlled. For both groups the frequency of cesarean section for fetal
      distress was similar (p less than 0.20), and the frequency of low Apgar scores at
      5 minutes and cord blood gas values showed no significant differences. The
      authors concluded that "epidural analgesia in labor may increase the incidence of
      cesarean section for dystocia in nulliparous women".

PMID- 2222643
TI  - Lactation outcome.

PMID- 2222645
TI  - [Resistance and retention as critical factors in silver amalgam restoration of
      endodontic posterior teeth. A clinical focus].
AB  - The root canal therapy does not make sense if it is not going to be restored
      properly. Even though we must keep in mind all the steps necessary to build up
      any vital tooth, we should emphasize the retention and resistency due to the
      fragility of endodontically treated teeth and to the destruction of these teeth.
      Even though the use o silver amalgam has been often questioned, we still consider
      amalgam as a proper material of a good half worm life to build up endodontically
      treated posterior teeth. Resistency and retention were considered as the
      essential factors to achieve the integrity of final restorations. We have
      analyzed the remaining tooth structure, periodontal support, biomechanics
      properties of the most used restorative materials and the variations of the
      forces. The different opinions on the concepts and technics have been reviewed
      and the final practical conclusions discussed.

PMID- 2222644
TI  - [Fissure sealants: clinical study].
AB  - A total of 132 sealants are applied to 55 children, over a period of one to five
      years. The results show a Complete Retention of 76.5%, a Partial Loss of 12.8%
      and Complete Loss of 10.6%.

PMID- 2222646
TI  - [Fluoroprophylaxis by the parenteral route].
AB  - The author sustains the value parenteral fluoroprophylaxis; this method of
      administering fluoride is the most appropriate during the period of formation of
      the enamel and in the pre-eruptive stage of the tooth, and is thus an essential
      procedure in a fluoroprophylaxis programme, which should be used above all in the
      case of public health measures.

PMID- 2222648
TI  - [Metastatic hypernephroma in oral soft tissue].
AB  - Oral metastatic tumors are rare. A case of primary affection of oral soft tissues
      by metastatic hypernefroma, without radiologic evidence of bone involvement, is
      presented in this paper. Review of the literature reveals that the gingiva is the
      commonest location of metastatic hypernephroma in the oral soft tissues. The most
      important clinicopathology and therapeutic features are also reviewed.

PMID- 2222647
TI  - [Caries prevalence of a school population].
AB  - We have made a cross-sectional study about dental caries in 883 children between
      6 and 15 years old, belonging to 3 public schools representing the municipal
      district of Tetuan (Madrid). The studied variables, that were related with
      presence/absence of caries were: age, sex, school, social class, number of meals
      per day, tooth brushing and use of fluor. We have also established the indexes
      DMFT, dmft, DMFM, together with the affection percentage of each tooth and its
      graphic representation.

PMID- 2222649
TI  - [Periodontal treatment needs in a Spanish school population].
AB  - The aim of this study was to assess the periodontal treatment needs of the
      population under 20 years of age in Spain. 1469 young people, aged 7, 12 and 15
      19 years, and representing the urban (60%) and rural (40%) population from Spain
      were evaluated using the Community Periodontal Index of Treatment Needs
      (C.P.I.T.N.). In the first age group (7 years), 12% presented calculus or
      overhanging restorations, and 45% had bleeding upon probing only. In the age
      group of 12 years the proportion of individuals with calculus, overthanging
      restorations or moderate pocket depths was 39%, while 38% had gingivitis as their
      highest treatment need. In the oldest group (15-19 years) the number of subjects
      with bleeding upon probing decreased to 17%, while the percentage of individuals
      having moderate pockets, calculus or overhanging restorations increased to 67%.
      1% of this youngsters had pockets of 6 mm. or over. At age 7, only 30% had
      "acceptable gingival health", and no more than 15% of the 18 year-olds reached
      this condition.

PMID- 2222650
TI  - [Periodontal treatment needs in a Spanish school population. 2. Intraoral
      distribution of different signs].
AB  - The aim of this study was to assess the prevalence of the different periodontal
      disease indicators used in the C.P.I.T.N. per sextant in the Spaniard population
      under 20 years of age. We have examined a randomly chosen sample of 1450 school
      aged individuals, 7, 12 and 15 to 19 years old. We have observed a healthy
      periodontium more frequently in the upper anterior region, calculus predominates
      in the lower incisors close followed by molars, and periodontal pockets of 4 mm
      or deeper were commonly found in the molar regions. We could'nt detect important
      deviations from this distribution pattern in the different age groups or between
      males and females.

PMID- 2222651
TI  - [Prevalence of caries in Spanish school children and youth of 7, 12 and 15 to 19
      years of age].
AB  - The aim of this study was to assess the dental caries prevalence and severity of
      the population under 20 years of age in Spain. 1469 young people, aged 7, 12 and
      15-19 years, and representing the urban (60%) and rural (40%) population from
      Spain were evaluated, registering the decayed, extracted or filled teeth for
      primary and permanent dentition. Average D.M.F.T. for 7, 12 and 15-19-years-old
      were 1.5, 3.5 and 6.6 respectively. A comparison of the results with those of
      previous studies showed that the average D.M.F.T. scores have decreased since
      1984. We have also observed an increment in the number of caries-free children
      reaching the 57.9% in the age group of 7 years. But this excitement over the
      increase in the number of caries-free children must be tempered by the
      recognition that 35% of these individuals had 70% of the caries. We still need
      educational, preventive and restorative programs, and focus our efforts in
      detecting and treating the highly susceptible children.

PMID- 2222652
TI  - [Validity of partial systems of periodontal examination in epidemiological
      studies].
AB  - The purpose of the present study was to determine the representativeness of
      partial examination in the assessment of the average severity and the prevalence
      of periodontal disease. 343 subjects aged 7, 12 and 15-19 years were examined for
      the presence or absence of gingival bleeding after gentle probing, supra or
      subgingival calculus and pocket depths of 4-5 mm., or 6 mm. and over, of each
      tooth. Three sets of average severity and prevalence scores were prepared: based
      on the full mouth examination, on observations made from the index teeth of the
      P.D.I., and on the six teeth utilized for the C.P.I.T.N. in this age group.
      Partial indices tended to underestimate the real prevalence of the different
      signs, and slightly overestimate severity, being these observations statistically
      significant. Average severity scores were obtained more accurately with the six
      Ramfjord teeth, while real prevalence rates were better determined with the
      C.P.I.T.N. teeth. From an epidemiological point of view, the real significance of
      the differences observed should be further determined.

PMID- 2222653
TI  - [Caries prevalence and periodontal treatment needs in the same individuals].
AB  - The aim of this study was to determine whether dental caries and periodontal
      disease occur frequently in the same subjects 1469 young people, aged 7, 12 and
      15-19 years, and representing the urban (60%) and rural (40%) population from
      Spain were evaluated. Dental caries and periodontal treatment needs were
      registered according to the index D.M.F.T. and C.P.I.T.N., following the criteria
      of WHO. We have found a highly significant relation between both variables,
      average D.M.F.T. scores increased as periodontal treatment needs were more
      advanced. Those subjects with lower codes of C.P.I.T.N. presented also lower
      D.M.F.T. scores, while these individuals with higher D.M.F.T. scores, based on a
      great number of open carious lesions, were more affected for periodontal disease.
      It does not support either a directly synergistic or antagonistic correlation in
      the prevalence of these two diseases in the same subjects. Dental health status
      is at a certain time an end result of years of varying dental health behaviour.
      In industrialized countries a variety of factors seems to determine the
      prevalence of dental caries and/or periodontal disease: dietary habits, access to
      fluorides, efficacy of oral hygiene measures, utilization of dental health care
      services. These data and ideas supported the strategy of preventing the dental
      caries and periodontal disease simultaneously.

PMID- 2222654
TI  - [Relationship of dental treatment and oral hygiene to caries prevalence and need
      for periodontal treatment].
AB  - The aim of this study was to examine the relationship between differences in
      dental attendance and oral hygiene patterns and dental caries and periodontal
      treatment needs. 1469 young people, aged 7, 12 and 15-19 years, and representing
      the urban (60%) and rural (40%) population from Spain were evaluated. Dental
      caries and periodontal treatment needs were registered according to the index
      D.M.F.T. and C.P.I.T.N., following the criteria of W.H.O. Regular dental
      attendance was observed in 16.6% of subjects examined, and only 9.4 saw a dentist
      regularly for dental prophylaxis. Statistical analyses showed that while the more
      frequent the dental visits, the lower the rate of caries, and periodontal
      treatment needs, the higher, however, the average number of fillings and the
      D.M.F.T. scores. These individuals had the higher number of functioning teeth,
      restored or sound, but they also had the disadvantage of having higher levels of
      disease experience. By the other way the individuals who saw the dentist
      regularly for dental prophylaxis presented the lower caries rate and periodontal
      treatment needs, the fewer tooth loss, and also an important reduction in the
      D.M.F.T. scores. Similar observations had been made in the individuals who brush
      their teeth frequently or with a correct technique. The results suggested that
      while frequent dental visits do not apparently help to prevent the onset of
      further dental disease, we can achieve this goal with regular preventive oriented
      dental therapy.

PMID- 2222655
TI  - [Presence of caries and periodontal disease in Spanish students. Overview of
      results obtained in different localities].
AB  - Results of our survey in 11 locations of Spain are assembled in an overview
      showing percentages of persons according to the highest C.P.I.T.N. code defected
      for each one, the prevalence of caries-free-children and mean D.M.F.T. scores. We
      have also studied the differences between urban and rural populations. Rural
      children presented higher D.M.F.T. an D.T. scores.

PMID- 2222656
TI  - [Interviews with HIV seropositive subjects identified at the time of blood
      donation: consequences for pre-donation interviews].
AB  - This study is based upon an interview with 31 individuals recently detected human
      immunodeficiency virus (HIV) seropositive through the systematic screening of
      blood donations. The location of the blood donation, the type of blood donor, the
      risk of HIV infection, were established. Questions dealt with the use of blood
      donation as a diagnosis test and on the notion of an oral or written self
      exclusion before the blood donation. The majority of the individuals had a
      classical risk factor of HIV infection and had given blood for serological
      testing. This data can allow an adaptation of the medical interview preceding the
      blood donation to the present epidemiological context of HIV infection.

PMID- 2222658
TI  - [The "polymerase chain reaction" (PCR) in seronegative subjects at high risk for
      HIV infection (Report of a congress at San Francisco, June, 1990)].

PMID- 2222657
TI  - [The medical interview motivated by the discovery of markers of viral hepatitis
      permits the identification, in blood donors, of behavior at risk for HIV
      infection].
AB  - From December 1988 to September 1989, 973 blood donors, deferred for anti-HBc
      reactivity, Ag-HBs positivity, elevated ALT, isolated or associated, but negative
      for anti-HIV, were interviewed in our blood center in the weeks after donation.
      Among these 973 donors, 53 (5.4%, 46 males, 7 females) were found at risk for HIV
      infection: intravenous drug abuse: 24 cases; heterosexuality with multiple
      partners: 17 cases; homosexuality: 8 cases; sexual relations with persons at
      risk: 4 cases. These 53 donors did not recognize their risk behaviour during the
      medical talk before donation. 25 out of these 53 donors were seen afterwards and
      one of them, homosexual man, seroconverted for anti-HIV seven months after the
      anti HIV negative but anti-HBc positive blood donation. We conclude that, in our
      experience, director surrogate viral hepatitis markers help to identify donors at
      risk for HIV infection, and, in one case, earlier in the course of demonstrated
      HIV infection than the enzyme immunoassays currently licensed.

PMID- 2222659
TI  - [Attitudes, knowledge and behavior of 3 groups of Spanish dentists on methods of
      caries prevention].

PMID- 2222660
TI  - [Occlusal examination in the diagnosis and treatment of periodontal disease. 2.
      Examination of signs and symptoms in dental structures. Periodontal, radiographic
      and clinical evaluation of occlusion].

PMID- 2222661
TI  - [Erosive lichen planus with oral and plantar involvement].
AB  - We present herein a case of an unusual variant of lichen planus characterized by
      chronic and painful ulcerations of the feet, erosive oral lesions and nail
      alterations. We emphasized the importance of the oral lesions in the correct
      diagnostic of these patients.

PMID- 2222662
TI  - [Eosinophilic granuloma of the jaws. Presentation of 2 cases].

PMID- 2222663
TI  - [Bacteriocins of Streptococcus mutans: mutacins].
AB  - A bioliographic survey about the production of a certain bactericidal substance
      (mutacins) by Streptococcus mutans has been done. The importance of bacteriocins
      of this micro-organism is due to its utility as a possible anti-caries agent
      performing as an influential factor in the colonization of the oral cavity, and
      also for serving for the typing of bacteria as an epidemiological "finger
      printing", determining the way of transmission of this micro-organism. Besides of
      stressing its clinical and epidemiological utility, we develop a review of other
      microbiological aspects.

PMID- 2222664
TI  - [Dynamic orthodontics].

PMID- 2222665
TI  - [Fixed partial denture on implants. Prosthodontic and biomechanical
      considerations].
AB  - In this issue are analyzed the factors that support the selection of the partial
      edentulous patients, for the construction of partial fixed prosthesis
      implantosupported, and the biomechanical considerations that we have to consider
      in relation to: relation implant-bone, the use of natural teeth, part of the jaw,
      length of the space, opponent jaw and materials.

PMID- 2222666
TI  - [Retention using grooves in silver amalgam cavities].

PMID- 2222667
TI  - [Boxes and pits as retention systems in silver amalgam fillings].

PMID- 2222668
TI  - [Practical application in oral health of a health education program for
      students].
AB  - Oral health has been studied in a group of 680 students. E.F.H. program has been
      integred in the contents of the General teaching.

PMID- 2222669
TI  - [New aspects of the physiology of dental occlusion. 1. Morphology of the
      temporomandibular joint].
AB  - The present article review, in the recent literature, some anatomical and
      biomechanical concepts about the temporomandibular joint in order to the better
      understanding of the physiology and dysfunction of the articulation. We point out
      the references about the function of the meniscus in the mandibular dynamics and
      the functional matrix concept and its relationship to temporomandibular joint
      dysfunction.

PMID- 2222670
TI  - [Dendritic cells in chronic adult periodontal disease].
AB  - At the gingiva there are two cellular populations with mediation capacity in the
      immunoregulation, whose mechanisms seen to be implicated in the pathogenesis of
      the periodontal disease. One of these populations is formed by the macrophages
      and the other one by the Langerhans cells belonging to the epithelia. In this
      paper wr are demonstrating that both populations keep an inverse proportional
      relation in the two sides of gingival epithelium. In the oral side, the
      Langerhans cells are predomiating, while in the periodontal pocket they are in
      small number, in comparison with the macrophages, which are highly abundant and
      forming a subepithelial band.

PMID- 2222671
TI  - [Dens invaginatus].
AB  - Dens invaginatus is an abnormal enamel growth first described by Salter in 1855.
      It has an incidence between 0.4 - 10%, and the tooth most frequently affected is
      the lateral upper incisor. Its etiology is not explained. There are many
      asymtomatic cases and others with symptoms derived from periapical lesions.
      Treatment must be as conservative as possible. A bibliographic review has been
      made and we demonstrate a radiologic sequence of the many cases observed in our
      Service in the last two years.

PMID- 2222672
TI  - [Transverse fracture of the mandibular body. Analysis of a case].

PMID- 2222673
TI  - [Class III. Current criteria for diagnosis and treatment 1].

PMID- 2222674
TI  - [Pins as a retention system in silver amalgam fillings].

PMID- 2222675
TI  - [Current review of local anesthetics and their use in dental practice].

PMID- 2222676
TI  - [New aspects of the philosophy of dental occlusion. 2. Biomechanics of the
      temporomandibular joint].

PMID- 2222677
TI  - [Periodontal receptors. Review].

PMID- 2222678
TI  - [Anxiety before dental treatment. Its quantification].

PMID- 2222680
TI  - What is your diagnosis? Urticaria pigmentosa.

PMID- 2222679
TI  - [Twins in medicine and dentistry. Review].

PMID- 2222681
TI  - Rett syndrome. The Puerto Rican experience.
AB  - We have diagnosed and followed four Puerto Rican females with Rett Syndrome (RS).
      Their ages, when first examined, ranged from 10 months to 11 years. The classical
      symptoms of decreasing head size, onset of hand wringing movements with
      deterioration of milestones as well as EEG abnormalities were present in all.
      Case No. 1, considered our index case was evaluated by us and lost to follow-up
      for many years while residing in the mainland U.S.A. where multiple evaluations
      failed to give a definite diagnosis. Upon her return to Puerto Rico she was
      diagnosed by us in retrospect as having RS. These are the first Puerto Rican
      girls reported with RS and in doing so we hope for a better understanding of the
      syndrome by our medical community. Because of the devastating effects of RS,
      early diagnosis and parental counseling will be beneficial for patients and their
      families.

PMID- 2222682
TI  - [The future of public health in Puerto Rico].

PMID- 2222683
TI  - Fulminant Wilson's disease: a report.
AB  - A 21 y/o female presented with fulminant hepatic failure and hemolysis. On the
      basis of the clinical presentation, levels of ceruloplasmin and serum copper a
      presumptive diagnosis of Wilson's disease was made. In spite of supportive
      measures and hemodialysis, the patient died one week after admission. Postmortem
      examination showed cirrhosis and increased copper stores in the liver,
      corroborating the clinical diagnosis of Wilson's disease. Study of the four
      siblings revealed that two are carriers, one is healthy and one may have the
      disease. Wilson's disease is a rare cause of fulminant hepatic failure that must
      be suspected specially when hemolysis is associated to the clinical picture. This
      mode of presentation is virtually fatal and early liver transplantation is the
      best form of therapy.

PMID- 2222684
TI  - Phaeohyphomycosis--first case in Puerto Rico.
AB  - A 24 year-old woman with systemic lupus erythematosus developed a subcutaneous
      nodule on the back which upon histopathological examination was found to be a
      case of phaeohyphomycosis. To our knowledge, this is the first case of the
      condition to be reported in Puerto Rico.

PMID- 2222686
TI  - The role of diet in modulating brain metabolism and behavior.

PMID- 2222685
TI  - [Aspirin in the prevention and management of coronary artery disease].

PMID- 2222687
TI  - [Meniere's disease. An analysis of clinical findings].
AB  - During a period of about 25 years 500 patients with Meniere's disease underwent
      treatment for their disease in the ENT clinic of the Charite Hospital in Berlin.
      In a long-term follow-up study of the course of the disease, 170 patients (80
      female, 90 male) with a minimum duration of illness of 5 years could be
      registered. The detailed analysis based on differentiation of vertigo attacks,
      audiological and vestibular findings offered 3 different phases of the natural
      course of Meniere's disease: 1. Early phase: Vertigo attacks and fluctuating
      hearing loss mainly in the low-tone frequencies; 2. Chronic phase: Decrease of
      frequency and duration of attacks; 3. Late chronic phase: Hearing loss of nearly
      50-60 dB and loss of vestibular excitability (caloric response, side difference
      ca. 50%). In consideration of neurological symptoms in the late chronic phase
      symptoms of Meniere's disease are changing into symptoms of vertebrobasilar
      insufficiency. The natural course of Meniere's disease and resulting
      therapeutical and diagnostical aspects require long-term therapeutic planning. An
      appropriate schedule is suggested.

PMID- 2222688
TI  - [Temporary threshold shift after nuclear magnetic resonance tomography].
AB  - The third-octave band levels of the noises produced in a MR-imager (1.0 Tesla
      Magneton, Siemens) were measured. Corresponding sounds presented through
      earphones have been used in simulation experiments to produce in normal-hearing
      listeners a temporary threshold shift lasting several minutes. These effects
      could be verified objectively using otoacoustic emissions. The consequences
      especially for patients with already impaired hearing are discussed: ear
      protection is strongly recommended.

PMID- 2222689
TI  - [Improved inner ear diagnosis by controlled use of computerized tomography].
AB  - Problems in the examination of the inner ear using conventional CT are described.
      Intraoperative findings often differ from CT findings. A new development HR-CT is
      introduced. Findings of middle and inner ear malformations and otosclerosis are
      demonstrated. It is shown that HR-CT imaging using a new 1024 matrix, enables
      better spatial resolution. This new CT technique improves inner ear examination,
      especially in the preparation for cochlear implantation.

PMID- 2222690
TI  - [Accuracy of measurement and comparability of anterior rhinomanometry and whole
      body plethysmography in determination of nasal resistance. Studies with a
      mechanical model].
AB  - The degree of accuracy of anterior rhinomanometry and the plethysmographic method
      in determining nasal resistance was examined in a mechanical model. The
      plethysmographic method allows a precise estimation of nasal resistance. It was
      found that the absolute variation of the plethysmographically measured values is
      not greater than 5%. Anterior rhinomanometry as described by Bachmann (2) allows
      a valid estimation of the pressure-flow relation. Here, too, inaccuracy remains
      within a range of 5% if the values are recorded with an X-Y-plotter. With the
      system developed by EVG, a microprocessor-controlled analysis is also possible.
      The flow rate is measured at pressure rates of 75, 150, and 300 Pa. Inconstancies
      in respiratory flow cause deviations from the correct pressure-flow graph. Should
      these deviations accidentally coincide with the predefined points of evaluation
      these erroneously achieved results will be assumed to be representative for the
      whole graph. This analytical fault has meanwhile been corrected by interpolating
      the points at the predefined pressure rates. Due to the differences in analytic
      techniques the methods of determining nasal resistance are not comparable in
      practice. The authors therefore recommend that, in addition to the usual results
      of analysis, average value of nasal resistance be determined for each measuring
      procedure. Today, this can be done without any problem by using microprocessors.

PMID- 2222691
TI  - [Olfactory neuroblastoma--tumor entity or complex clinical picture?].
AB  - Clinical and radiological findings in seven cases of olfactory neuroblastoma are
      reviewed and discussed in the light of the international literature. The report
      provides further evidence of difficulties related to the predictability of the
      condition's clinical course, diagnosis, and therapeutic consequences. Moreover,
      the lack of uniform CCT and NMR features indicates that the discussion about the
      genesis, the biological action, the terminology, and therapy of these tumors has
      not yet reached a conclusion.

PMID- 2222692
TI  - [Principles of therapy with fission neutrons and boron neutron capture therapy
      for radioresistant head-neck malignancies].
AB  - Neutron therapy has proven to be clinically useful in cases of advanced, slow
      growing radioresistant head and neck carcinoma. Therapeutic effects might be
      based on direct DNA damaging and thus immediate cell-killing, on the generation
      of free oxygen radicals and, among others, on the fact that heavy particle
      radiation is said to be less dependent on the presence of oxygen than gamma rays,
      i.e. on a lower oxygen enhancement ratio (OER). The smaller difference in
      reaction between oxygenated and nonoxygenated cells could entail advantages as
      well as disadvantages, depending on the characteristics of the tumor cell
      population and of the normal tissue. It is therefore essential to select patients
      and tumours with an expectedly high therapeutic gain factor. Fission neutrons for
      tumour therapy: As evaluated by several in vitro and in vivo studies (11/13) the
      biological efficiency (RBE) of the RENT (Reactor Neutron Therapy) beam in Munich
      seems to be among the highest of all clinically used neutron beams. For a single
      dose range between 2 and 8 Gy the RBE for chronic radiation damage is relatively
      small (2). Consequently, patients with recurrent or metastatic carcinomas of the
      head and neck are treated with a single dose of 200-250 cGy after previous
      surgery and/or combined radiochemotherapy. The main limitation of fission
      neutrons is the small penetration depth. Possibilities of clinical implementation
      of boron neutron capture therapy (BNCT) in otorhinolaryngology: In near surface
      tumours it is possible to administer high doses of 10boron not selectively, i.e.
      no selective tumour-seeking compound is needed. Animal experiments with
      intratumoural injection of 10boron glycine have shown a strong effect on tumour
      growth delay (18).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222693
TI  - [Experimental studies for photodynamic therapy of malignant tumors of the mouth
      cavity, larynx and pharynx with the photosensitizer methylene blue].
AB  - Squamous-cell carcinomas of the upper aerodigestive tract can be destroyed in
      vitro through photosensitization with Methylene blue and subsequent radiation
      with red laser light. It is impossible to obtain the same results with
      sensitization or light radiation alone. The paper discusses the conditions under
      which this procedure might develop into a truly selective photodynamic therapy
      method.

PMID- 2222694
TI  - [The larynx--another organ manifesting Crohn disease].
AB  - A very rare case of Crohn's disease of the larynx in a 66-year-old male is
      reported. During the rapid development of Crohn's disease there was an
      involvement of the right vocal cord and the right arytenoid.

PMID- 2222695
TI  - [A short history of hearing research. I. Antiquity].
AB  - This review describes important steps in the history of basic research on the
      function of the hearing organ. The present, first part revisits the period
      between Empedocles and Galen, focussing on the ideas of Empedocles and Aristotle.
      It is unlikely that they knew the cochlea. Based upon a more general theory of
      interaction, however, Empedocles in the fifth century B.C. compared the hearing
      organ with a bell and claimed that it is capable of not only receiving, but also
      generating sound. Using Empedocles's theories of sound and the four elements,
      Aristotle proposed that sound is sensed by an air-filled resonant cavity in the
      head located behind the eardrum. The postulated cavity may have been identified
      with, or at least included, the middle ear. Aristotle's ideas dominated the
      theory of hearing for two millenniums.

PMID- 2222696
TI  - [Personal experiences. Photography of the tympanic membrane].

PMID- 2222697
TI  - The epidemiology and prevention of child pedestrian injury.
AB  - Of pedestrian injuries that occur every year, approximately 50,000, including
      1300 fatalities, are experienced by children between the ages of 1 and 14 years.
      Despite the importance of the problem, the pedestrian safety issue is often
      neglected in reports on vehicular injuries. Children between the ages of five and
      nine years, boys, and children in lower socioeconomic class are at higher risk of
      pedestrian injury than other children. Childhood pedestrian injuries take place
      predominantly in residential locations close to home and frequently occur while
      the child is at play. The risk of pedestrian injury to children is higher than
      that of other age groups when adjusted for traffic exposure, and a variety of
      developmental limitations may account for this fact. In spite of these
      limitations, children undertake collision avoidance maneuvers far more often than
      drivers do. Accident analyses have identified 15 different accident types, each
      reflecting a unique combination of human and environmental factors. Among
      children, the most frequently observed accident type is the midblock dart-out.
      Programs to modify pedestrian behavior, driver behavior, and vehicle design have
      met with modest success. In the United States, the cultural and political
      environments have not been favorable to the injury prevention effort. Urban
      designers and traffic engineers in Europe have undertaken a variety of
      modifications of the physical environment, and some of these have been successful
      in preventing pedestrian injuries to children.

PMID- 2222699
TI  - Youth and traffic safety: the effects of driving age, experience, and education.
AB  - This paper examines the effect of driving age, driving experience, and mandatory
      driver's education on traffic fatalities of youth. Data are examined for 47
      states, nine years and for ages 15-17. It is found that the age of drivers is an
      important determinant of fatalities, and that the propensity toward fatalities is
      greater at younger ages. This age effect is not offset to any major degree by the
      lack of experience of new drivers at later ages.

PMID- 2222700
TI  - Safety effects of relaxing California's clean-record requirement for driver
      license renewal by mail.
AB  - A pilot program was established in California in 1982 authorizing mail renewal of
      driver licenses for persons under age 70 lacking clean (accident- and conviction
      free) 4-year driving records, but showing clean 2-year records at selection. Such
      drivers constitute about 14% of California's renewal population, or about 500,000
      renewees per year. Eligible drivers whose licenses expired in 1983 were subjects
      of the present study. Half of them were randomly assigned to a group whose
      members were sent offers of renewal by mail and the other half were sent standard
      renewal notices requiring appearance in a field office and successful completion
      of vision and traffic law tests. Traffic accidents and convictions following the
      mailout of these documents were tracked for both groups; results presented here
      cover a 4-year period subsequent to mailout. During this period (a normal license
      term in California), no significant overall difference was shown between the
      groups with respect to subsequent convictions or accidents. However, significant
      detrimental effects on accidents were noted for a subgroup of drivers who had
      experienced recent traffic violations or accidents which were not on their
      records at selection. Implications of these results are discussed.

PMID- 2222698
TI  - Evaluation of the penetration test for bicyclists' helmets: comparative
      performance of hard shell and foam helmets.
AB  - A project was undertaken to evaluate the utility of the penetration test in the
      Australian Standard devoted to the testing of lightweight helmets for bicycle
      riders. The project revealed aspects of the protective performance of
      conventional hard shell helmets and recently developed helmets manufactured
      entirely from expanded polystyrene foam. Hard shell helmets were found to provide
      good performance in a range of loading conditions applied to them during testing.
      In contrast, foam helmets provided very poor resistance to concentrated loads
      produced during impacts with small, sharp objects but they had greater capacity
      than hard helmets to withstand distributed loads produced during impacts with
      flatter objects. The presence of the penetration test in the Australian Standard
      was determined to have produced the good all round performance of hard helmets
      which met its requirements. Two tests were proposed as alternatives to the
      penetration test. They would evaluate foam and hard helmets on equal terms at the
      cost of abandoning the requirement of helmets to withstand concentrated loads.

PMID- 2222701
TI  - Limitations of data compiled from police reports on pediatric pedestrian and
      bicycle motor vehicle events.
AB  - Police reports were compared to the information provided by a hospital monitoring
      system for children under 15 years old injured as pedestrians and bicyclists by
      moving motor vehicles in Orange County, California. The analysis was limited to
      identifying caveats in the police report database. Underreporting by police was
      conservatively estimated at 20% for pedestrians and 10% for bicyclists.
      Comparison of the pedestrian databases suggested underreporting by police of
      incidents involving 0-4-year-olds, nontraffic incidents, incidents in which the
      vehicle was backing up, and cases not involving a child crossing a street.
      Comparison of the bicyclist databases indicated an underreporting by police of
      nontraffic cases. These caveats, in part, are related to police agency reporting
      requirements. The police injury severity scale was found to correlate poorly with
      a scale based on medical diagnoses, and substantial underreporting by police of
      serious injuries was demonstrated. We suggest that utilization of police injury
      severity scales be limited to categories of fatal, injured, and not injured (when
      available).

PMID- 2222703
TI  - City curfew ordinances and teenage motor vehicle injury.
AB  - Several U.S. cities have curfew ordinances that limit the late night activities
      of minor teenagers in public places including highways. Detroit, Cleveland, and
      Columbus, which have curfew ordinances, were compared to Cincinnati, which does
      not have such an ordinance. The curfew ordinances were associated with a 23%
      reduction in motor vehicle related injury for 13- to 17-year-olds as passengers,
      drivers, pedestrians, or bicyclists during the curfew hours. It was concluded
      that city curfew ordinances, like the statewide driving curfews studied in other
      states, can reduce motor vehicle injury to teenagers during the particularly
      hazardous late night hours.

PMID- 2222702
TI  - The real number of road traffic accident casualties in The Netherlands: a year
      long survey.
AB  - Between August 1986 and July 1987 more than 24,000 households, containing nearly
      67,000 persons, were surveyed by telephone about traffic injuries during the past
      three months. Expressed on an annual basis, approximately 430,000 people, or
      about 1 in 34 of the Dutch population, had suffered some sort of injury in a road
      accident. The road traffic morbidity was, therefore, 2,942 per 100,000
      inhabitants. Of these, about 135,000 had to be treated in hospital (20,000 as
      inpatients). More than 100,000 did not need treatment. Cyclists formed by far the
      largest category of road user, but mopedists had the highest injury rate per
      kilometer travelled. 210,000 of these casualties fell within the definition for
      recording by the police. The police recorded only 49,748 traffic casualties, or
      about 25%, during the same period. The police data were not representative; the
      completeness declined according to severity of the injuries: inpatients, about
      70%; outpatients 26%; extramural about 11%. Cyclists (11%), children (9%), and
      single vehicle accidents (5%) were very much underrepresented. The largest
      category of road user is cyclists, not car occupants as indicated by the police
      data. A number of recommendations are made for supplementing the police data and
      the existing hospital inpatient data. These include extending the Home Accident
      Recording System of outpatients and the General Practitioner Panel to include
      road accident victims. Together a representative sample of 95% of all those
      receiving medical treatment would thus be obtained.

PMID- 2222704
TI  - Traffic accidents in Kuwait: an economic dimension.
AB  - The cost per traffic fatality in Kuwait is assessed, comparing three different
      studies, and is found to be in excess of US $500,000. The three studies employ
      somewhat different methods.

PMID- 2222705
TI  - Formulating accident occurrence as a survival process.
AB  - A conceptual framework for accident occurrence is developed based on the
      principle of the driver as an information processor. The framework underlies the
      development of a modeling approach that is consistent with the definition of
      exposure to risk as a repeated trial. Survival theory is proposed as a
      statistical technique that is consistent with the conceptual structure and allows
      the exploration of a wide range of factors that contribute to highway operating
      risk. This survival model of accident occurrence is developed at a disaggregate
      level, allowing safety researchers to broaden the scope of studies which may be
      limited by the use of traditional aggregate approaches. An application of the
      approach to motor carrier safety is discussed as are potential applications to a
      variety of transportation industries. Lastly, a typology of highway safety
      research methodologies is developed to compare the properties of four safety
      methodologies: laboratory experiments, on-the-road studies, multidisciplinary
      accident investigations, and correlational studies. The survival theory
      formulation has a mathematical structure that is compatible with each safety
      methodology, so it may facilitate the integration of findings across
      methodologies.

PMID- 2222706
TI  - Evaluating marine traffic safety at channels.
AB  - An approach for measuring effects of policy schemes for improving marine traffic
      safety at channels is presented. Operational models involving traffic, channel,
      and ship characteristics are provided, and both collision and channel deviation
      risks of actual channels are quantified using them. Moreover, traffic control,
      speed regulation, and center line indication are considered as channel safety
      policies, and their effects are also measured using the models. The results
      suggest that the speed regulation scheme is effective in reducing accident risk
      in channels. It is concluded that methodology demonstrated and knowledge obtained
      in this study are useful for planning and safe operation of channels.

PMID- 2222707
TI  - The Hinton train disaster.
AB  - In February of 1986 a head-on collision occurred between a freight train and a
      passenger train in western Canada killing 23 people and causing over $30 million
      of damage. A Commission of Inquiry appointed by the Canadian government concluded
      that human error was the major reason for the collision. This report discusses
      the factors contributing to the human error: mainly poor work-rest schedules, the
      monotonous nature of the train driving task, insufficient information about train
      movements, and the inadequate backup systems in case of human error.

PMID- 2222709
TI  - Age-related differences in timing of position and velocity identification.
AB  - The aim of this investigation was to study age-related differences in timing of
      position and velocity identification in a laboratory task. The skills required
      for performing this task are thought to be similar to those needed in real
      traffic situations. From this perspective, the results of this study may be taken
      into account in studies on accident analysis and prevention. To control for
      differences in the conscious experience of time and for simple reaction time to
      visual stimuli, young (25-34) and old (58-70) adults had to produce timed periods
      of 20 seconds and to time the arrival of a visible moving object at its goal. In
      these simple tasks no differences were found between young and old subjects. In
      the proper, more complex experiment, timing of position and velocity
      identification of a moving object were assessed with or without feedback on
      timing and velocity in the same old and young group. The object, moving from left
      to right at a constant velocity, was shown on a video screen during the first 40%
      of its trajectory. The moving object could have any of four (fixed) velocities
      which were presented in blocks with a regular or a mixed order. By pushing a
      button subjects estimated at which time the object would have reached the marked
      end of a trajectory. In a condition without feedback on timing of position, the
      timing error of older adults was higher than that of young adults and
      particularly with higher object velocities.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222708
TI  - Pattern of organ injuries in pelvic fracture: impact force implications for
      survival and death in motor vehicle injuries.
AB  - The direction of force impact, lateral or frontal crash force, was estimated from
      the mechanism of pelvic fracture (PF) and related to the pattern of organ
      injuries, physiologic consequences, and outcomes in 197 motor vehicle accident
      (MVA) patients who had all sustained a PF. These data showed that injuries due to
      anterior-posterior compression (APC) (frontal crashes) were associated with
      injuries of major severity to the bony pelvis with major retroperitoneal bleeding
      and massive volume loss shock. Death in the APC patient was frequently due to a
      late complication of the shock: sepsis, adult respiratory distress syndrome
      (ARDS), or lung infection. However, in lateral compression (LC) injuries (lateral
      crashes) with fatal outcomes, there was a significant increase in severe brain
      injuries and a rise in lung and upper abdominal visceral injuries with relatively
      minor PF. These data suggest the great vulnerability of the MVA patient, driver
      or passenger, to lateral crash forces and suggest important areas for occupant
      protection.

PMID- 2222710
TI  - Safety analysis of manual tasks in automatic production systems--implications for
      design.
AB  - A safety procedure for application in the design of automatic production systems
      is outlined. It involves the specification on safety requirements for a
      particular system on the basis of general safety requirements and of the results
      of a safety analysis. During the safety analysis, work tasks inside the danger
      zone of the system and potential accident scenarios related to these tasks are
      identified, and safety measures are evaluated. Various checklists have been
      developed to support each step in the analysis. The method for safety analysis
      has been tested in field studies of three automatic production systems in
      operation: two mechanical systems and one process plant. The aim has been to
      evaluate the method and to collect operational experience concerning accident
      risks and preventive measures to be considered in design. The main results of the
      studies are presented, and considerations for the use of the method during the
      design phases are discussed. It is concluded that the approach that has been
      selected satisfies the needs of a safety procedure for use in design.

PMID- 2222711
TI  - A bivariate negative binomial model to explain traffic accident migration.
AB  - The phenomenon of "regression to the mean" is now widely known in the study of
      the effectiveness of remedial treatment of traffic accident blackspots. What
      happens is that the criterion used for selection of sites at which treatment is
      to be applied gives rise to bias in the estimate of the effectiveness: the
      conditional expectation of the after frequency is less than the true mean, even
      if the treatment is totally ineffective. It has been reported in some previous
      studies that accident "migration" has been observed. This is the phenomenon
      whereby the accident rate apparently rises at sites that are untreated but that
      are neighbours to treated sites. If this were a genuine effect, it would have
      serious implications for the assessment of remedial treatments. This paper aims
      to explain this migration effect in purely probabilistic terms, without recourse
      to the concept of physical migration. The model used is a new bivariate negative
      binomial distribution, incorporating spatial correlation between the true mean
      site accident rates. As with the regression to mean effect, the migration effect
      can then be explained in terms of the conditioning implicit in the selection
      process.

PMID- 2222712
TI  - Differences in accident characteristics among elderly drivers and between elderly
      and middle-aged drivers.
AB  - A total of 5,853 elderly drivers, aged 55 and over, and 8,210 middle-aged drivers
      36-50 years old, all of whom were involved in accidents during 1986, were
      compared using discriminant function and univariate techniques. Substantial
      differences were found in accident characteristics not only between middle-aged
      and elderly drivers but also between three different age groups of the elderly.
      Support was found for the suspicion that, while the elderly have fewer accidents
      than younger drivers, their safety record, based on driving exposure with
      noncrash convictions as a surrogate measure of kilometres driven, is worse, and,
      in addition, they are more often at fault in accident involvements.

PMID- 2222714
TI  - Cardiac dysrhythmias during nasal surgery--a comparison with lignocaine
      adrenaline and prilocaine-octapressin during halothane anaesthesia.
AB  - The incidence of cardiac dysrhythmias and adequacy of haemostasis during nasal
      surgery under deep halothane anaesthesia were studied following nasal
      infiltration with 10 ml of either 1.5% lignocaine with adrenaline 1:200,000 or
      prilocaine 1.5% with octapressin 0.03 IU per ml. There was a significant
      difference in the incidence of cardiac dysrhythmias between patients given
      octapressin 2% and patients given adrenaline infiltration (18%) p greater than
      0.01. Adequate haemostasis was observed in 84% of patients who received
      octapressin with no adverse effects compared to 94% of the group which received
      adrenaline (p greater than 0.01). We suggest for the use of lignocaine-adrenaline
      during halothane anaesthesia that adequate ventilation is assured, deep halothane
      anaesthesia given, the infiltration delayed 10 minutes after tracheal intubation,
      the rate of injection adjusted to 10 ml in a 10-minute period and a total dose of
      adrenaline does not exceed 0.6 microgram/kg.

PMID- 2222713
TI  - [Halothane hepatitis in the differential diagnosis of postoperative jaundice].
AB  - Based on a case report the necessity of including halothane hepatitis in
      differential diagnosis of postoperative jaundice is described. Even in this case
      report, the diagnosis is a synopsis of the case history, clinical and biochemical
      findings and exclusion of other causes of disease. The detection of antibodies to
      halothane-altered hepatocyte components is at present only possible in a few
      special laboratories and does not succeed in all cases. Confirmation of the
      connection between halothane exposure and liver damage is of vital importance for
      the patient because a second exposure to halothane may result in fulminant
      hepatic failure. In choosing the appropriate anaesthetic method, other halothane
      anaesthesias carried out a short time ago should be considered.

PMID- 2222716
TI  - [The effect of barbiturates and diphenylhydantoin on the mitotic activity of
      thymocytes and bone marrow cells in mice and rats].
AB  - Phenobarbitone (PB) and diphenylhydantoin (DPH) inhibited the mitotic rate of
      thymocytes and bone marrow cells (colchicine blocked metaphases) dose- and time
      dependent (20-80 mg/kg i.p., 12-48 hours) in mice and rats in vivo. The
      inhibition of proliferation was evident also after repeated administration of the
      drugs and other barbiturates. Other substances with a depressive effect on the
      central nervous system (etomidate, ketamine, chlorpromazine and ethanol) did not
      influence the mitotic rate of the thymocytes. Inhibition of the mitotic rate by
      PB was also observed in adrenalectomised rats. In vitro PB and DPH inhibited the
      mitotic rate of thymocytes in therapeutic and toxicologically relevant
      concentrations (10(-5)-10(-3) mol/l). The investigations indicate a direct effect
      of PB and DPH on rats. Possible immunosuppressive effects are discussed.

PMID- 2222715
TI  - [Equipment for respiratory gas conditioning under hygienic conditions].
AB  - The significance of respiratory gas conditioning systems as sources of germ
      colonization and infection of the respiratory tract results from the principle of
      operation and the temperature. Six respiratory air humidifiers were tested for
      their hygienic risk in experiments with test germs. Contrary to several reports,
      some humidifiers were shown to accumulate microorganisms, whereas others do not
      promote germ population in the respiratory tract even though the water of the
      humidifier is heavily contaminated. It could be confirmed that basic differences
      exist between "blow over" and "blow through" humidifiers in the accumulation of
      microorganisms in respiratory air. Moreover, our investigations revealed that
      even "blow over" humidifiers should not be considered completely harmless. The
      "blow over" apparatuses Hydrotrop 200, Aquapor and VH 620 (infant) did not cause
      any germ propagation in the resuscitation tubes, whereas in the "blow through"
      apparatuses Bennett Cascade and VH 620 (adult) germ propagation is quite
      considerable. The mortality kinetics of the germs differ depending on the
      temperature and the type of apparatus used and should be taken into account when
      it comes to choosing or developing respiratory gas conditioning devices. Constant
      heating of the water in the humidifier to a minimum of 50 degrees C provokes a
      bactericide behaviour of the problem germs. Therefore, it is quite justifiable to
      do without expensive internationally recommended measures if the humidifier is
      well chosen. The requirement to replace the humidifier every 24 hours in long
      term artificial respiration need not be observed for devices classified as
      harmless if aseptic handling is guaranteed, i.e. if manual germ transmission by
      the staff is avoided.

PMID- 2222717
TI  - [The treatment of thoracic injuries from the anesthesiologic viewpoint].
AB  - Three quarters of thoracic injuries are combined with other traumas, firstly head
      injuries, secondly injuries of the extremities and thirdly injuries of the
      abdomen. Seventy-one such patients who were treated in the interdisciplinary
      intensive care department over 6 years were analysed. In 13 patients laparotomies
      because of ruptures or perforations of various organs became necessary. These
      combined injuries had a particularly bad prognosis. Forty-six patients (64.7%)
      had to be ventilated for more than 24 hours. The average ventilation period was
      10 days. The indication for respiratory treatment is stressed. The lethality of
      the 71 patients amounted to 32.4% (23 patients). During the first treatment even
      today simple methods of investigation and therapy are of great importance. A
      comprehensive rescue chain and good interdisciplinary cooperation are the basis
      of every therapy.

PMID- 2222718
TI  - [Bronchologic examination techniques for verifying abnormalities of the
      respiratory tract in early childhood].
AB  - With appropriate technique of endoscopy and contrast radiography adapted to the
      age and the respective problem, specific bronchological examinations in all age
      groups are feasible. Of all endoscopic techniques for the diagnosis of
      abnormalities in the upper respiratory tract, the most suitable method is
      laryngotracheoscopy only with the optic under halothane insufflation anaesthesia
      with spontaneous respiration maintained. For combined malformations of the septum
      that are considered problematic in diagnosis, sounding is suggested to determine
      the location of the tracheoesophageal fistula and color scanning is recommended
      to prove patency, as well as simultaneous contrast radiography of the two
      systems. In bronchography the insertion of contrast medium via the elevated
      orotracheal tube has proved suitable for documentation and for a differentiated
      demonstration of the abnormality type. In the case of skeleton malformations of
      the respiratory tract and vessel abnormalities stenosing the bronchial tree,
      biplanar radiographs in both respiratory phases are imperative.

PMID- 2222720
TI  - [Computer-assisted management in emergency medical aid practice].
AB  - After a two-year test period, a computer-aided analysis of the Emergency Medical
      Aid in Wolmirstedt was developed and has become an indispensable feature of the
      management structures. Using the computer detailed evaluation of speed, accuracy
      of diagnosis and suitable treatment is possible at short notice for basic medical
      and emergency needs. This information is available at all times. Twenty-five to
      30 computer hours are necessary for recording and processing the results of 1,000
      cases of EMA. The computer is not required for retrospective and analytical
      functions even in the control centre. However, for immediate solving of problems,
      e.g. the administration of risk patients and emergency regulations, the programme
      provides a considerable extension of general emergency treatment and is an
      inherent part of the EMA control centre.

PMID- 2222719
TI  - [A simple formula for calculating the CO2 flow in controlled hyperventilation of
      patients with solvent poisoning].
AB  - Controlled hyperventilation is a therapeutic measure for the treatment of
      intoxications with solvents. To avoid the occurrence of respiratory alkalosis,
      carbon dioxide must be added to the inspiratory gas flow. Up to now the addition
      of carbon dioxide was performed empirically and was adapted to the needs by
      repeated blood gas analyses. We developed a formula enabling us to calculate the
      necessary carbon dioxide flow. A case report explains the procedure.

PMID- 2222721
TI  - [Preservation of homeostasis following the onset of brain death].
AB  - One of the main problems faced by transplantation medicine is the lack of
      suitable donor organs. The success of organ transplantation depends on the
      quality of the organ to be transplanted. The initial function of the transplant
      depends on the quality of preparation. The aim of efforts after brain death is to
      maintain the morphological and functional integrity of the donor organ in situ.
      At our clinic, all potential organ donors undergo direct arterial pressure
      measurement and many receive a Swan-Ganz catheter. Catecholamine administration-
      varied on the basis of the hemodynamic parameters--is not associated with an
      impairment of organ function. Electrolyte determinations at 2-hour intervals and
      close laboratory controls are obligatory. These intensive-care measures are
      necessary because of the occurrence of severe metabolic and hemodynamic
      imbalances. A partly transient diabetes insipidus is the most frequent
      homeostatic disorder. In addition, severe electrolyte imbalances, disturbed
      glucose utilization and hypotension may be observed. Our investigations on the
      plasma concentration course of thyroid hormones, ACTH and cortisol after the
      onset of brain death suggest that the secretion of pituitary hormones is
      maintained until total necrosis of the pituitary gland occurs 30 to 40 hours
      later. The detection of circulating ADH up to 24 hours after the onset of brain
      death, despite the angiographically confirmed cessation of cerebral circulation,
      suggests that there may be a residual perfusion of hypothalamus and pituitary.
      The blood levels of epinephrine, norepinephrine and dopamine measured in brain
      dead patients not receiving catecholamines were in part considerably above the
      reference level. Our data suggest that vigorous intensive care management
      increases the number and quality of organs suitable for transplantation and
      reduces to a minimum the incidence of premature organ losses.

PMID- 2222722
TI  - Synthesis of 1-O-alkyl-2-O-methyl-glycerophospholipids with potential antitumor
      activity.
AB  - Some synthetic alkyl-lysophospholipid analogs have been described as a new class
      of immunopotentiating and antitumor agents. Among them, 1-O-octadecyl-2-O-methyl
      rac-glycero-3-phosphocholine has been reported to possess the highest antitumor
      activity. A new method for the synthesis of this compound and of the ethanolamine
      and serine-containing analog is reported. 1-Alkyl-2-methyl-rac-glycerol,
      prepared from 1,2-isopropylidene-glycerol, is phosphorylated and the intermediate
      is condensed either with N-t-BOC-protected ethanolamine or with N-t-BOC-protected
      serine benzhydryl ester. The choline-derivative is obtained by methylation with
      CH3I of the ethanolamine derivative. The same synthetic sequence has been used
      also for synthesizing compounds unsaturated at the fatty alkyl chain in position
      1 of the glycerol moiety. Preliminary observation are reported on the selective
      cytolytic action of the compounds on a tumor cell line.

PMID- 2222723
TI  - 3,5-Diphenyl-1H-pyrazole derivatives. VI--Esters and 2-dialkylaminoethyl ethers
      of 1(2-hydroxy-2-phenylethyl)-3,5-diphenyl-1H-pyrazole and N,N-disubstituted 1-(2
      amino-2-phenylethyl)-3,5-diphenyl-1H-pyrazoles with depressant and platelet
      antiaggregating activities.
AB  - The syntheses of 1-(2-hydroxy-2-phenylethyl)-3,5-diphenyl-1H-pyrazole 1 by
      reaction of 2-hydrazino-1-phenylethanol with dibenzoylmethane, of esters 2 and 2
      dialkylaminoethyl ethers 3 starting from 1 as sodium salt and acyl chlorides or 2
      chloroethyldialkylamines, respectively, as well as of N,N-disubstituted 1-(2
      amino-2-phenylethyl)-3,5-diphenyl-1H-pyrazoles 5 by reaction of secondary amines
      with the tosylate of 1, are described. Some of the above compounds showed a
      considerable sedative effect in mice and a remarkable platelet antiaggregating
      activity in vitro, as well as moderate local anesthetic, analgesic and
      antiinflammatory activities in mice and rats.

PMID- 2222724
TI  - 3,5-Diphenyl-1H-pyrazole derivatives. VII--Esters, 2-dialkylaminoethyl ethers and
      N-substituted carbamates of 1-(2-hydroxy-3-phenoxypropyl)-3,5-diphenyl-1H
      pyrazole with depressant and platelet antiaggregating activities.
AB  - The syntheses of 1-(2-hydroxy-3-phenoxypropyl)-3,5-diphenyl-1H-pyrazole 2 by
      reaction of 1-hydrazino-3-phenoxy-2-propranolol with dibenzoylmethane, of esters
      3 and 2-dialkylaminoethyl ethers 4 starting from 2 as sodium salt and acyl
      chlorides or 2-chloroethyldialkylamines, respectively, as well as of N-aryl
      carbamates 5 by reaction of 2 with aryl isocyanates, are described. Some of the
      above compounds showed a considerable sedative effect in mice and a remarkable
      platelet antiaggregating activity in vitro, as well as moderate local anesthetic,
      analgesic and antiinflammatory activities in mice and rats.

PMID- 2222725
TI  - Comparative in vitro dermatokinetics of ibuprofen (IBP).
AB  - IBP, a widely used non-steroidal antiinflammatory analgesic exhibits low
      solubility in acidic media (gastric environment) and inadequate pharmacokinetics
      when administered orally. Thus, IBP warrants investigation for better, more
      effective and faster localized therapeutic effect of the drug as an alternative
      to oral treatment. The potential of IBP of in vitro percutaneous uptake and
      dermal absorption was evaluated for possible topical therapy. IBP reservoir
      systems [IBP + various ointment bases] at various drug loading levels [doses:
      200, 400 and 600 mg] were evaluated for drug release rate as well as mechanism of
      drug release. Additionally, recommendations were generated for rational
      development of optimally effective dermal products of IBP. IBP reservoir systems
      were evaluated for in vitro dermal uptake by employing modified franz diffusion
      cell. A semipermeable membrane was sandwiched between the donor compartment
      containing the IBP-reservoir system and the receptor compartment containing
      Sorenson's buffer at pH 7.4. The release rate of IBP was followed for 12 h.
      Release of IBP from various systems exhibited linear relationship with square
      root of time dependence indicating adherence to diffusional pathway. The rate of
      release of IBP increased with increase in drug load [dose]. Cumulative Qmax/Dose
      as a function of Dose was employed to generate recommendations for development of
      dermal product(s) for IBP. An oil-in-water system [Acid Mantle Creme (A/M Creme)]
      exhibited superior drug release characteristics over others in this
      investigation. This study demonstrated that IBP release characteristics can be
      effectively manipulated by incorporating changes in the system composition as
      well as drug loading.

PMID- 2222726
TI  - Nursing care of the paranoid patient.

PMID- 2222727
TI  - Legal considerations for psychiatric patients.

PMID- 2222728
TI  - Potassium replacement.

PMID- 2222730
TI  - Creative teaching with word puzzles.

PMID- 2222729
TI  - Learning with video.

PMID- 2222732
TI  - Ethics and deontology--a Soviet's point of view.

PMID- 2222731
TI  - Skin cancer--sun worship.

PMID- 2222733
TI  - Yugoslavian connection.

PMID- 2222734
TI  - Interviewing the elderly client.
AB  - Obtaining a health history is an important part of planning care for the elderly
      patient. Presented are facilitating methods that the nurse may use to make this
      process accurate and easy.

PMID- 2222736
TI  - Classes for the diabetic patient. A five day format.
AB  - This article discusses the material and presentation of a diabetic education
      program using a five day format.

PMID- 2222735
TI  - 13 ways to ease the nursing shortage.

PMID- 2222738
TI  - Nursing's image. A historical focus.

PMID- 2222737
TI  - Pericarditis. Nursing care makes the difference.
AB  - Nursing care of the patient with pericarditis, a commonly seen syndrome in the
      clinical setting, is discussed in this article. Pericarditis is particularly
      prevalent in the patient following myocardial infarction. Astute nursing
      assessment is described. Goals of nursing care include management of pain,
      maintenance of adequate cardiac output, and provision of support to manage
      anxiety and fear. Interventions to meet the goals, as well as outcome criteria,
      are identified.

PMID- 2222740
TI  - Don't believe everything you hear about instructor's reputations.

PMID- 2222739
TI  - Acute psychosis: a psychiatric emergency on medical surgical units.

PMID- 2222741
TI  - Neurovascular assessment.
AB  - This article discusses the process for monitoring a client's neurovascular
      status. Assessment of neurovascular status is monitoring the 5 P's: pain, pallor,
      pulse, paresthesia, and paralysis. A brief description of compartment syndrome is
      presented to emphasize the importance of neurovascular assessments.

PMID- 2222742
TI  - Culture and space.
AB  - This article focuses on personal space in a multi-cultural health-care
      environment by discussing each of the four aspects of spacial behavior from a
      nursing perspective: proximity to others, objects in the environment, body
      posture, and movement in the setting.

PMID- 2222743
TI  - DNA antibody idiotypes. An analysis of their role in health and disease.

PMID- 2222744
TI  - The characterization of DNA antibody idiotypes--a description.

PMID- 2222745
TI  - Immunopathology.

PMID- 2222747
TI  - Future directions in anti-DNA antibody idiotype research.

PMID- 2222746
TI  - Idiotype-mediated intervention in systemic lupus erythematosus.

PMID- 2222748
TI  - Comparison of DNA antibody idiotypes in human sera: an international
      collaborative study of 19 idiotypes from 11 different laboratories.
AB  - The distribution of and relationships between 18 anti-DNA antibody idiotypes and
      one anti-acetylcholine receptor antibody idiotype have been tested in an
      international collaborative study of human sera from 180 individuals. The main
      finding is that the serum levels of many of these idiotypes, whether of murine or
      human origin, show a high degree of statistical correlation. The studies in a
      wide range of autoimmune rheumatic diseases confirm that none of the idiotypes
      tested is disease specific, but 13 of 15 (87%) whose levels were recorded as OD
      units or cpm correlated strongly with anti-ssDNA antibody levels and 11 of 15
      (73%) with total serum IgM. Expression of several idiotypes was found to
      fluctuate in parallel with disease activity in SLE; levels of others were also
      elevated in the healthy relatives of lupus patients whilst a few were also raised
      in the spouses of these patients. The data support the notion that there may be
      only a few groups of related DNA antibody idiotypes. The correlations between the
      idiotypes with regard to their quantities, association with disease activity, and
      wide distribution in different diseases and healthy individuals suggest at least
      two explanations. First, all of these idiotypes may be present in normal
      immunoglobulin repertoires and simply increase in response to poly- or
      oligoclonal B-cell activation in autoimmune diseases. Secondly, these idiotypes
      may be structurally linked to each other, so that their behaviour under
      conditions of specific antigenic stimulation is similar. Genetic and structural
      studies will be required to distinguish between these possibilities.

PMID- 2222749
TI  - Comparative study of idiotypes on monoclonal antibodies derived from patients
      with lupus and leprosy and from normal individuals.
AB  - A collaborative study was performed to compare the expression of a series of
      idiotypes defined on human anti-DNA and other autoantibodies. Three panels of
      human monoclonal antibodies were tested: eight derived from patients with
      systemic lupus erythematosus (SLE); 13 from an individual with lepromatous
      leprosy; and 38 from normal subjects. The following rabbit anti-idiotype sera
      were used: one (RId16/6) raised against the lupus-derived monoclonal anti-DNA
      antibody 16/6, four (RId8E7, RId4G7, RId4D5 and RIdTH9) against leprosy-derived
      monoclonal antibodies of various specificities, and one (anti-4.6.3) against a
      normal-derived anti-DNA monoclonal (KIM 4.6). In addition, two other anti
      idiotypes were used--one a murine monoclonal (3I), the other a rabbit polyclonal
      (RIdD)--which had been raised against polyclonal anti-DNA antibodies from lupus
      serum. Further experiments were performed with immunoabsorbed fractions of
      RId8E7. Direct-binding and competition assays were used. All of the anti
      idiotypes produced different patterns of positivity among the three panels of
      human monoclonal antibodies, with the exception of RId8E7 and RId4G7, which
      showed considerable concordance. There was a tendency towards anti-idiotypes
      being disease- or group-specific: thus anti-4.6.3 failed to bind to any of the
      lupus or leprosy-derived monoclonals, while RId16/6 and RId8E7 bound most
      strongly to the lupus- and leprosy-derived antibodies respectively. KIM 4.6
      itself was bound only weakly by RId16/6, while 16/6 was not recognized by anti
      4.6.3; 16/6 was, however, bound by 3I, while KIM 4.6 was not. 3I bound to several
      other monoclonals but RIdD, which has been shown to be specific for the anti-DNA
      fraction of lupus serum, did not bind to any of them. These results indicate that
      the majority of these anti-idiotype preparations recognize largely separate sets
      of determinants. The monoclonal antibodies which bind to DNA may be only partly
      representative of anti-DNA antibodies in the serum of lupus patients.

PMID- 2222750
TI  - Evidence for a role of anti-idiotypic antibodies in the induction of remission in
      Graves' disease.
AB  - Serum and Ig samples obtained from a patient with Graves' disease during
      exacerbation and remission were evaluated in the nu/nu bioassay. Blocking of the
      exacerbation serum's biological activity was demonstrated by several biological
      assay parameters after it was mixed with the remission serum. Since this blocking
      effect can be ascribed to immunoglobulins, anti-idiotypic antibodies in the
      remission serum and immunoglobulin samples are the most likely cause of this
      blocking effect. Therefore a role of anti-idiotypic antibodies in the induction
      of remission in Graves' disease is postulated.

PMID- 2222751
TI  - Differential regulation and expression of major histocompatibility complex (MHC)
      and Ly-6 gene products on mouse testicular Leydig and Sertoli cell lines.
AB  - The expression and regulation of Class I and Class II major histocompatibility
      complex (MHC) and Ly-6 antigens were examined in BALB/c testicular cells. Studies
      were performed utilizing differentiated murine Leydig (TM3) and Sertoli (TM4)
      cell lines. Neither Class I (Dd) nor Class II (IA/Ed) MHC antigens were
      detectable on untreated TM3 cells. However, concanavalin-A activated spleen cell
      supernatant (Con-A sup) or interferon-gamma (IFN-gamma) treatment resulted in the
      marked induction of both Class I and Class II MHC antigens on virtually all of
      the Leydig cells. MHC Class II mRNA, which was not detected in resting cells, was
      clearly induced following IFN-gamma incubation. Sertoli cells were found to
      constitutively express low levels of Class I (Dd) but not Class II (IA/Ed)
      antigens. However, in contrast to the enhanced MHC expression in TM3 cells, Con-A
      sup or IFN-gamma treatment of TM4 cells resulted in marked augmentation of Class
      I, but not Class II, MHC antigens. Northern blot analysis failed to detect Class
      II mRNA in either the resting or IFN-gamma treated TM4 populations. Neither
      ethanol nor tumor necrosis factor (TNF) alone, or together with IFN-gamma head
      significant effects on MHC expression by TM3 and TM4 cells. Ly-6 antigens,
      predominantly expressed on hematopoietic cells, were found to be present on both
      TM3 and TM4 cells. Expression of this non-MHC encoded product was also shown to
      be markedly enhanced by IFN-gamma treatment on both testicular cell lines. In
      total, these findings demonstrated that cytokines can differentially affect
      discrete cell populations arising from a particular tissue with respect to the un
      regulation of MHC and non-MHC gene products. These findings are discussed in the
      context of autoimmune responses directed against this tissue.

PMID- 2222752
TI  - Identification of the platelet glycoprotein IIb/IIIa complex as a target antigen
      in primary biliary cirrhosis-associated autoimmune thrombocytopenia. Evidence
      that platelet-reactive autoantibodies can also bind to the mitochondrial antigen
      M2.
AB  - A 67-year-old woman with a 4-year history of primary biliary cirrhosis (PBC)
      unexpectedly developed autoimmune thrombocytopenia. The platelet-bound IgG
      antibody was eluted from the patient's platelets to determine the platelet target
      antigen. The autoantibodies were found to precipitate the platelet glycoprotein
      complex IIb/IIIa of autologous and allogeneic platelets. A further precipitate of
      70 kDa was detectable under reducing conditions. In addition, platelet-reactive
      antibodies bound to the 70 kDa mitochondrial antigen M2. No cross-absorption
      studies were performed to confirm that a single antibody reacted with both
      antigens. Computer analysis of published peptide sequences of the mitochondrial
      protein and the platelet GPIIb/IIIa complex showed partial amino acid sequence
      homology suggesting the possibility of a common antibody binding site. These
      findings suggest a relationship between the development of autoimmune
      thrombocytopenia in PBC and the underlying liver disease.

PMID- 2222753
TI  - [Malocclusion in the primary dentition].
AB  - In this paper we analyze the type and frequency of malocclusions in a group of
      100 health children with complete primary dentition. Bjork's method for
      epidemiological registration was taken as a basis. Of the examined children, 78%
      had some malocclusion type. The most frequent was the increased horizontal
      overbite. In vertical overbite relation we find anterior open bite, increased
      overbite, anterior open bite, increased overbite.

PMID- 2222754
TI  - [Stages of formation and calcification of the third molar (radiographic study of
      500 Mexican children and adolescents)].
AB  - Five hundred orthopantomograph radiographs of mexican children and adolescent
      from 7 to 18 tears old were reviewed in order to establish the third molar
      formation and calcification stages and the most frequent anomalies related to
      these teeth. We find that tooth bud presence is between 9 and 11 years; Third
      molar is absent in 32.4% of the population; 7.4% of the molars presented early
      formation stage malposition; Therefore oligodontia diagnosis and third molar
      malposition can not be done before 13 years of age.

PMID- 2222755
TI  - [Panoramic radiograph in the pediatric radiographic examination].
AB  - In the present time the high value of panoramic radiography on diagnosis is
      recognized in all odontology areas. Panoramic radiography shows in one picture
      upper and lower arches and numerous adjacent structures that is why it has a
      special value in pediatric patient radiography examination.

PMID- 2222756
TI  - [Degree of sedation. Incidence of vomiting and time of postoperative sleep with 3
      different oral administration schedules of hydroxyzine chlorhydrate and chloral
      hydrate].
AB  - In this paper a comparison of sedation effectiveness, vomiting incidence and
      postoperative sleeping time with three sedation schemes: Chloral hydrate
      exclusively, hidroxicine chlorhydrate the night before and 15 minutes before
      chloral hydrate administration and hidroxicine chlorhydrate 15 minutes before
      chloral hydrate. We find that there is no significant differences between these
      three sedation schemes in sedation, degree of postoperative sleeping time and
      vomiting incidence, therefore we can expect an effective sedation degree using
      any of these sedation methods.

PMID- 2222757
TI  - In support of IL-8.

PMID- 2222758
TI  - Humoral effector mechanisms in the immunity to cancer.

PMID- 2222759
TI  - Anti-metatype antibody reactivity: a model for T-cell receptor recognition.
AB  - Anti-metatype (Met) antibodies are anti-immunoglobulins that specifically
      recognize an antibody-liganded active site but lack specificity for either the
      ligand or the idiotype. As proposed here by Edward Voss, anti-metatype-metatype
      immunoglobulin interactions may serve as a model for the interaction of the T
      cell receptor (TCR) with antigen-MHC (class I/class II) complexes: the anti
      metatype immunoglobulin reagent simulates the TCR and the liganded antibody
      mimics the antigen-MHC complex. Such a model addresses the dilemma of two
      macromolecules interacting with the same antigenic determinant and may represent
      a rational approach to improve understanding of the initiation and regulation of
      the immune response.

PMID- 2222760
TI  - The role of thymic epithelium in the acquisition of tolerance.
AB  - There are two separate mechanisms of induction of T-cell tolerance in the thymus.
      First, MHC molecules expressed on bone-marrow-derived cells can cause clonal
      deletion of autoreactive cells. Second, as discussed here by Elisabeth Houssaint
      and Martin Flajnik, thymic epithelial cells can generate a form of tolerance that
      does not eliminate self-reactive clones. This nondeletional mechanism, which is
      also a feature of the other MHC class-II-bearing epithelia, may contribute to the
      establishment of tolerance-maintaining regulatory networks.

PMID- 2222762
TI  - [Dermatitis from contact with perfume].
AB  - Contact dermatitis essentially involves those areas to which perfume is applied.
      The mixture of perfumes in the standard battery of the L.C.D.R.G. detects 70 to
      80% of sensitised cases. The allergens that are most often involved are oak moss,
      isoeugenol and cinnamic aldehyde. Prevention of dermatitis requires, at
      individual level, use of non-perfumed cosmetics and at the industrial level, good
      observance of the international rules of I.F.R.A., aimed at limiting the
      frequency of occurrence.

PMID- 2222761
TI  - Allelic variations of human TCR V gene products.
AB  - A central problem confronting the immune system is how to discriminate among vast
      numbers of antigens. Novel genetic ploys that aid the discriminative process,
      including complex gene rearrangements (in antibody and T-cell receptor (TCR)
      genes) and extensive allelic polymorphism (in major histocompatibility complex
      (MHC) genes), have been described. Recent evidence has suggested a further level
      of diversity; TCR V gene allelic variation. In this article David Posnett
      summarizes evidence in favour of this possibility and speculates on the possible
      functional consequences of TCR allelism.

PMID- 2222763
TI  - [Diagnosis of dermatitis due to plants].
AB  - Contact dermatitis from plants may occur by several mechanisms. It may arise as a
      result of simple irritation or by allergic mechanism; co-exposure to sunlight can
      evoke the phenomena of phototoxicity or photoallergy. Etiologic diagnosis require
      botanical, chemical and immunologic knowledges. Patch testing can be performed
      with pure allergens (primin, sesquiterpene lactones etc.), plant extracts
      (balsams, oleoresins etc.) or with the plant itself. The validity of patch test
      results is often difficult to determine: false positive reactions due to the
      presence of pesticides or herbicides, active sensitizations, cross-reactions.

PMID- 2222764
TI  - [Research on Kathon CG in cosmetic and personal hygiene products].
AB  - Kathon is an anti-microbial agent that is used as a preservative in cosmetics and
      bodily hygiene products. At the recommended levels of usage Kathon is innocuous
      and has a recognised efficacy. Nevertheless, following reappearance of contact
      allergic eczemas due to cosmetics and bodily hygiene products different authors
      have reported increase in sensitisation to it. We have met the same problems in
      the Service de Dermatology++ of the Hospital Sainte Marguerite at Marseille and
      we wished to make a deeper examination of the question and to ascertain whether
      the current cosmetics contained Kathon CG. For this we have developed a technique
      of liquid chromatography and tested 44 creams. Eight contained Kathon CG, of
      which 2 were responsible for contact eczema in patients.

PMID- 2222765
TI  - [Importance and limits of assay of TNF in pathology].

PMID- 2222766
TI  - [Rhinitis in a child induced by aspirin and by cow's milk].

PMID- 2222767
TI  - An assessment of a film enhancement system for use in a radiation therapy
      department.
AB  - The clinical uses of a radiotherapy film enhancement system are explored. The
      primary functions of the system are to improve the quality of poorly exposed
      simulator and portal films, and to perform comparisons between the two films to
      determine whether patient or block positioning errors are present. Other features
      include: the production of inexpensive, high quality hardcopy images of
      simulation films and initial portal films for chart documentation, the capacity
      to overlay lateral simulation films with sagittal MRI films to aid in field
      design, and a mode to zoom in on individual CT or MRI images and enlarge them for
      video display during chart rounds or instructional sessions. This commercially
      available system is comprised of a microcomputer, frame grabber, CCD camera with
      zoom lens, and a high-resolution thermal printer. The user-friendly software is
      menu driven and utilizes both keyboard and track ball to perform its functions.
      At the heart of the software is a very fast Adaptive Histogram Equalization (AHE)
      routine, which enhances and improves the readability of most portal films. The
      system has been evaluated for several disease sites, and its advantages and
      limitations will be presented.

PMID- 2222769
TI  - Blood irradiation: rationale and technique.
AB  - Upon request by the local American Red Cross, the Savannah Regional Center for
      Cancer Care irradiates whole blood or blood components to prevent post
      transfusion graft-versus-host reaction in patients who have severely depressed
      immune systems. The rationale for blood irradiation, the total absorbed dose, the
      type of patients who require irradiated blood, and the regulations that apply to
      irradiated blood are presented. A method of irradiating blood using a linear
      accelerator is described.

PMID- 2222768
TI  - Clinical applications of a CT-simulator: precision treatment planning and portal
      marking in breast cancer.
AB  - Breast cancer is frequently treated with radiation using opposed tangent portals
      to the involved breast, including the chest wall. Presented is a method for
      simulating such treatment fields on a CT simulator. A short series of CT images
      provides a three dimensional model for treatment planning prior to marking the
      patient. Gantry and collimator angles, as well as wedges or custom blocks, are
      determined in the planning stage. Upon receipt of an approved treatment plan, the
      portals are available for simulation. The cross-hair laser and computerized bed
      movement in the CT simulator aid in marking the entrance of the radiation fields
      on the patient's skin. Discussion of the clinical application of the described
      technique is included.

PMID- 2222770
TI  - The use of digitized port films in assessing new treatment modalities.
AB  - An inexpensive computer-based imaging system has been used to compare simulator
      and portal radiographs. The films were digitized, normalized, and then overlaid
      for measurement. In a test group of patients, a new treatment protocol for pelvis
      irradiation was evaluated using this technique. For 90% of the patients, the
      average error was found to be smaller than 5 mm, and there were no field
      placement errors greater than 1 cm.

PMID- 2222771
TI  - Cadmium free lead alloy for reusable radiotherapy shielding.
AB  - A low melting point cadmium free fusible lead alloy suitable for custom
      radiotherapy shielding blocks is described. The alloy, referred to here as Alloy
      203, differs in composition from the more common Lipowitz's metal (Cerrobend) by
      being cadmium free, having a slightly higher lead content and a 203 degrees F
      melting temperature. Attenuation properties have been studied for 4-18 MV X-rays.
      Alloy-203 has lower transmission than Lipowitz's metal, primarily due to the
      higher content of lead and bismuth. Daily use for the past 2 years at Mayo Clinic
      has not indicated any major problems associated with the use of this cadmium free
      alloy for custom shield fabrication.

PMID- 2222772
TI  - A unique nasopharynx brachytherapy technique.
AB  - To deliver a curative dose of radiation therapy to the nasopharynx using either
      external beam radiotherapy or conventional brachytherapy, it is often necessary
      to expose a large volume of normal tissue. Tolerance of normal tissue also limits
      the dose of radiation given for salvage therapy in failed nasopharyngeal
      carcinoma. A unique brachytherapy technique with associated treatment planning is
      presented as an alternative method of treatment. This technique combines a single
      linear cesium-137 source inserted in the nasopharynx via a modified cuffed
      endotracheal tube, in conjunction with a plaque of iridium-192 ribbons applied in
      the form of a modified upper denture appliance. This method allows additional
      treatment to the primary area while neither exposing more normal tissue than
      necessary nor exceeding tolerance doses to surrounding structures.

PMID- 2222773
TI  - Implementation of Beam's Eye View into routine treatment planning and delivery.
AB  - The use of oblique fields in the chest and abdomen is fraught with uncertainty,
      especially in the location of critical structures on simulator and port films.
      Targets near these structures may be underdosed because of the physician's
      uncertainty in shaping the treatment fields. To help alleviate this problem, we
      have found the Beam's Eye View option of the Theraplan Treatment Planning System
      to be a useful and effective tool. The Beam's Eye View program uses the external
      and internal contours we enter into the treatment planning system from CT scans.
      Once the necessary contours have been entered from the desired CT slices, the
      software will project the view that the beam would see as it passes through these
      structures. Using this "Beam's Eye View," we can determine the optimum angle and
      field shape to treat our target and minimize critical structure dose.

PMID- 2222774
TI  - Progesterone suppression of pregnancy lymphocytes is not mediated by
      glucocorticoid effect.
AB  - This study investigated whether the suppressive effect of progesterone on
      pregnancy lymphocytes is mediated by specific progesterone receptors. The effects
      of a competitive progesterone antagonist (RU486) and a specific glucocorticoid
      receptor blocker (RU43044) were tested on the release of a blocking factor by
      progesterone-treated pregnancy lymphocytes. RU 486 tested at an equal
      concentration as progesterone significantly inhibited the production of the
      blocking factor, while RU 43044 was without effect. These data suggest that in
      pregnancy, lymphocyte progesterone acts on specific progesterone receptors and
      glucocorticoid binding sites are not involved.

PMID- 2222775
TI  - Hydatidiform mole pregnancy trophoblast extracts differentially suppress
      interleukin-2-induced proliferation of human T-lymphocytes and PHA-blasts.
AB  - Immunoregulatory factors of trophoblast origin may partially abrogate maternal
      immune responses to the fetus during pregnancy. We have previously shown that
      soluble factors extracted from hydatidiform mole trophoblast suppress interleukin
      2 (IL-2)-dependent proliferation of a cloned murine cytotoxic T cell line (CTLL
      2). To characterize human T cell responses to this trophoblast extract, we
      measured the effects of molar tissue extracts (HME) on IL-2-stimulated
      proliferation of human T-lymphocytes and mitogen (PHA) transformed T-cell blasts
      (PHA-blasts). HME significantly (P less than 0.05) suppressed T-lymphocyte
      proliferation in response to 5 and 10 units/ml of IL-2 at 500 and 250
      micrograms/ml, while no effect was observed at the 100 micrograms/ml
      concentration. Suppression by HME of IL-2-stimulated T-cell proliferation was
      partially overcome by the addition of excess IL-2. HME also suppressed (P less
      than 0.05) IL-2-stimulated proliferation of PHA-blasts at 500 and 250
      micrograms/well at both 5 and 10 units/ml of IL-2. As observed with resting T
      cell responses, no suppression of PHA-blast proliferation was observed using 100
      micrograms/ml of HME. In contrast to the response of the resting T-cells to
      excess IL-2, HME suppression of IL-2-stimulated blast proliferation was not
      affected by increasing the concentration of IL-2. These results indicate that
      extracts from hydatidiform mole trophoblast contain immunosuppressive factors
      that block human T-cell clonal expansion by inhibiting the utilization and/or
      production of IL-2. Furthermore, the effects of HME are not reversed by excess IL
      2 when PHA-blasts are reacted compared to resting T-cell responses, which are
      partially reversed in the presence of excess IL-2.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2222776
TI  - The detection of antibodies in pregnancy: a comparison of two assay systems.
AB  - In this study we have compared the ability of two assay systems, erythrocyte
      antibody rosette inhibition (EAI) and cellular enzyme-linked immunospecific assay
      (CELISA) to detect maternal alloantibody activity during pregnancy. Antibody
      activity to antigens on paternal lymphocytes was present in nine of 23
      primigravid sera tested by EAI and in seven of 23 by CELISA. In multiparous sera,
      antibodies directed to paternal lymphocytes were detected in 11 of 15 individuals
      by EAI and in six of 15 by CELISA. The techniques correlated significantly when
      assaying the humoral response in sera from multiparous women. The lack of
      correlation when assaying primigravid sera suggests that both assays encounter
      difficulty in detecting the low titres of antibodies present.

PMID- 2222777
TI  - Nidation, tolerance, and immunotrophism.

PMID- 2222778
TI  - Human seminal plasma suppresses the chemiluminescence of polymorphonuclears
      without modifying phagocytosis.
AB  - The suppressive activity of human seminal plasma was confirmed on the luminol
      amplified chemiluminescent reaction of human polymorphonuclears. This suppression
      was found to be dose-dependent and noncytotoxic. The responsible factor appeared
      to be a radical scavenger of low molecular weight, acting selectively on hydrogen
      peroxide. Correlation with glandular markers of semen indicated this molecule to
      have a prostatic origin. Neither crude seminal plasma nor this factor were found
      to suppress intracellular engulfment and killing of bacteria. This molecule seems
      to cooperate with the other semen antioxidants to protect sperm cells from
      extracellular oxygen radicals.

PMID- 2222779
TI  - Multiple effects of tetrahydroaminoacridine on the cholinergic system:
      biochemical and behavioural aspects.
AB  - 9-Amino-1,2,3,4-tetrahydroaminoacridine (THA) in combination with lecithin has
      been reported to improve the memory of Alzheimer's disease patients. We have
      examined some properties of THA in vitro and in vivo so as to define some of the
      mechanism(s) by which THA might produce its therapeutic effects. In vitro, THA
      was more potent at inhibiting human plasma cholinesterase (IC50 = 0.03 microM)
      than human erythrocyte acetylcholinesterase (IC50 = 0.3 microM) and rat brain
      acetylcholinesterase (IC50 = 0.32 microM). Radioligand binding studies indicated
      that THA binds reversibly and competitively to primary M1 and M2 human cortical
      muscarinic receptors with similar affinities. Moreover, THA showed similar
      affinity for temporal cortices muscarinic receptors from Alzheimer and non
      Alzheimer (control) brains. In vivo, subcutaneous administration of THA (1-8
      mg/kg body weight) to adult rats (6 months old) produced a dose dependent
      decrease in general activity compared to saline-treated rats. However, at a
      concentration of 0.5 mg/kg body weight, the general activity of the rats was
      increased compared to saline-treated rats. The cognitive function of the THA
      treated adult rats (subcutaneously 2 mg/kg body weight) was not significantly
      improved compared to saline-treated rats. It is concluded that the mechanisms of
      action of THA on the cholinergic system involve reversible inhibition of
      cholinesterases and reversible and competitive interaction with muscarinic
      acetylcholine receptors. These effects might be of therapeutic value in the
      treatment of Alzheimer's disease.

PMID- 2222781
TI  - Increased platelet 3H-imipramine binding and monoamine oxidase B activity in
      Alzheimer's disease.
AB  - Several biochemical abnormalities in peripheral tissues have been reported in
      Alzheimer's disease (AD). With this in mind we studied platelet monoamine oxidase
      B (MAO B) activity and 3H-imipramine (IMI) binding in both AD patients and
      healthy subjects and found a significantly higher level of platelet MAO B
      activity and 3H-IMI Bmax values in the AD patients. In view of the part that MAO
      B plays in metabolizing serotonin (5HT) and of the relationship which exists
      between 3H-IMI binding and 5HT uptake, our results would suggest that with AD
      there occurs a complex dysfunction in the 5HT system, at least at a peripheral
      level.

PMID- 2222780
TI  - 5 HT2 receptors in dementia of Alzheimer type: a quantitative autoradiographic
      study of frontal cortex and hippocampus.
AB  - Using both quantitative autoradiography in sections and a homogenate preparation
      assay, the distribution and density of 3H-ketanserin binding to 5 HT2 receptors
      was examined in frontal cortex and the hippocampal region from six control
      subjects and seven subjects who had dementia of the Alzheimer type (DAT). There
      was no difference between control and DAT subjects in the levels of ketanserin
      binding in any region of the frontal cortex or hippocampus determined by
      quantitative autoradiography or in parallel experiments using homogenate
      preparations (e.g. left frontal cortex, layer III; controls, 34.4 +/- 1.6 pmol/g,
      DAT, 37.1 +/- 4.6 pmol/g). In all of the DAT brains there were abundant neuritic
      plaques (e.g. superficial layers of left frontal cortex; 35 +/- 7 plaques/mm2),
      and a marked reduction of choline acetyltransferase activity, (by 30-60% relative
      to controls), in both frontal cortex and the hippocampus. Thus, despite the
      presence of morphological abnormalities and a loss of cholinergic function, two
      classic features of DAT, 5 HT2 receptor binding was unaltered in this group of
      DAT brains compared to controls.

PMID- 2222782
TI  - [Status determination in discussion of benign stenosis of Vater's papilla].
AB  - Inflammatory and cicatrical alterations are the morphological basis of papillary
      stenosis in most cases due to canalicular or lymphatic spreading of bacterial
      infection in gallstone disease. The consequences of papillary stenosis are
      elevated pressure in the ducts and reduced bile flow. At surgery you find
      dilatation of the bile ducts, increase of residual pressure, decrease of outflow,
      and--in cicatrical stenosis--stop for the probe. Only the inflammatory stenosis
      is reversible, but permanent alteration is not to determine. Therefore therapy is
      necessary, at first instrumental dilation to 4-6 mm. Impossibility of dilatation
      indicates transduodenal sphincterotomy. Recurrencies are best treated by
      endoscopic sphincterotomy and exceptionally by choledochoduodenostomy.

PMID- 2222783
TI  - [The 25th anniversary of the East German Society of Gastroenterology. II.
      Development of the concept of the gastroenterology subdiscipline].
AB  - As like as the introduction of the gastric tube inaugurated new possibilities of
      investigation, the concept of gastroenterology was rounded up by the study of
      physiology and pathology of gut, liver, bile-ducts, and pancreas. In form of X
      ray examination, topographic gliding palpation, and endoscopy, gastroenterology
      gained valuable diagnostic methods. The development confirmed Boas' prediction
      that specialization in the end is for the benefit of total science.

PMID- 2222784
TI  - [Pathogenetic factors of hemorrhage from esophageal varices].
AB  - Esophageal varices nearly always rupture at or just above the gastro-esophageal
      junction. Mucosal changes on top of the varices, the so-called red colour sign,
      are found in the majority of patients with a positive bleeding history. An
      increase of intraabdominal pressure and consequently a sudden pressure rise in
      the varices is thought of as a trigger cause. The larger the esophageal varices
      the higher the intravariceal and the transmural varix pressures. The portal
      pressure in patients with portal hypertension is subjected to considerable
      changes. Therefore, hemodynamic measurements at rest may have a prognostic value
      with regard to predisposition to hemorrhage, but they are less significant than
      endoscopic parameters. Disturbances of blood hemostasis and ascites indicating an
      impaired liver function are essential predisponable factors for the onset of
      bleedings. A peptic lesion caused by acid gastric-esophageal reflux is of less
      importance for the occurrence of variceal hemorrhage.

PMID- 2222786
TI  - [Endoscopic treatment of acute biliary pancreatitis].
AB  - The authors examined the possibilities of the endoscopic treatment of acute
      gallstone pancreatitis on the basis of the results of retrospective investigation
      of 19 middle-european endoscopic centers. There were altogether 11,830 EST in
      these centers; in 261 out of them the indication of EST was acute gallstone
      pancreatitis. They consider the exact and early diagnosis very important that can
      be based on the typical clinical and laboratory signs and ultrasonography. The
      ERCP reassures the final diagnosis and at the same time the therapeutic solution-
      EST--can also be realized. This took place within the first 48 hours. The results
      were favourable, in 90.4%, the complaints decreased significantly within 24
      hours. The complication rate was 4.9%, and the mortality rate was 1.9%. These
      results are better than those of the conservative therapy.

PMID- 2222785
TI  - [Behavior of postoperative viscosity of bile fluid from T-drainage. A
      contribution to cholelithogenesis].
AB  - The results obtained by the examination of the post-operative bile viscosity
      behaviour sampled by T-drainages of 29 patients (investigations of the relative
      viscosity with the help of a modified horizontal capillary viscometer from the
      day of operation until the 9th postoperative day) confirm the importance of the
      biorheological classification of bile fluid as a Maxwell fluid (investigations of
      the absolute dynamic viscosity of 33 bile specimens with a Contraves-Low-Shear
      Viscometer and representation of flow curves for rheological characterization).
      The Maxwell flow behaviour is characterized--among other things--by an
      exponential increase in the case of prestasis. This fact is important in all "low
      flow-states" of different pathophysiological genesis and offers a concept with
      respect to a pathogenetically orientated cholelithiasis prophylaxis.

PMID- 2222788
TI  - [Complications of hepatic coma in liver cirrhosis].
AB  - 59 patients with exogenous liver coma in state III-IV were treated from 1980 to
      1989 in our clinic. Incidence and complications in these patients were evaluated
      retrospectively. The most frequent eliciting factors were gastrointestinal
      bleeding, infections and acute alcohol excess, more than 2/3 of them having
      severe portal hypertension with ascites and esophageal varices at the time.
      Altogether 55 of the 59 liver coma patients died. The most important
      complications were, beside bleeding and infections, disturbances of the renal
      function and of the coagulation. Severe acute or chronic liver injury is often
      associated with multiorgan failure.

PMID- 2222787
TI  - [Prevalence of cholelithiasis in relation to use of hormonal contraceptives].
AB  - 400 women in continuous care of a family planning clinic were examined for
      gallbladder stones by standard ultrasound technique. Gallstones (GS) are found
      infrequently in nulliparous women (3.1 percent). The prevalence of GS increases
      with number of births and with age: 11 percent of female under 25 years of age,
      who have ever born, have GS; women aged 45 years and older who have born two or
      more children have GS in 35 percent. Duration of use of HC increases with rising
      age and with number of births. There is no regular relationship between duration
      of use of HC or total dose respectively and prevalence of gallbladder stones.
      CONCLUSION: Intake of HC has no or only a marginal influence on prevalence of
      gallbladder stones.

PMID- 2222789
TI  - [Effect of an angiogenesis-promoting dipeptide on microcirculation in
      experimental chronic stomach ulcer in the rat].
AB  - The influence of an angiogenesis stimulating dipeptide (Lys-Pro-derivative) on
      the blood flow rate of the stomach was tested in rats suffering from ulcus
      ventriculi by microspheres technique. 21 days after operation (acetic acid model
      by Takagi) the ulcers in the group treated with the dipeptide were healed
      completely, but not in the control group. The higher blood flow in the ulcer area
      of the dipeptide group radiometrically gained, was not changed significantly (U
      test by Man-Whitney). These results demonstrate, that the process of rapid wound
      healing promoted by the dipeptide cannot entirely be explained by a higher blood
      flow of the stomach.

PMID- 2222790
TI  - [Metoclopramide antagonizes dopamine-induced inhibition of lower esophageal
      sphincter pressure in the awake beagle].
AB  - Different contradictory results, even in the same species of the DOP-effect on
      LESP have been reported. The aim of the present studies was to evaluate the
      effect of DOP on LES in purebread male beagles and whether in could be
      antagonised by the DOP-antagonist MCP. The LESP in beagles is sensitive to
      dopamine (DOP) and its "antagonist", metoclopramide (MCP). MCP raised the
      inhibited LESP after DOP-infusion in vivo, while it failed to change DOP-induced
      relaxation of opossum LES in vitro [1]. Data obtained after monotherapie with MCP
      did not exceed LESP-response to MCP after DOP-pretreatment. DOP applied as
      background counter-inhibition could be used to correct interdigestive phasic
      changements of LESP in order to reach a stable starting-point to investigate the
      action of LESP-stimulating compounds pharmacomanometrically. Due to DOP reflux
      facilitating side effect via its decrease of LESP, large doses of DOP, as used in
      the intensiv care unit, should be administered together with sphincter
      strengthening agents or antacid compounds.

PMID- 2222791
TI  - [Combination of glandular and foveolar hyperplasia of the gastric mucosa--a rare
      mixed type].
AB  - In a 28 year-old man with epigastric pain endoscopy detected giant gastric folds
      and multiple superficial erosions. Histologically a mixed form of glandular and
      foveolar hyper plasia of the gastric mucosa was suggested (Ming's type III).
      Basal and pentagastrin stimulated secretion volume and acid output were
      moderately elevated, hypersecretion of protein was not found. Serum levels of
      calcium and gastrin were normal, also after secretin stimulation. The mucosa of
      the corpus was extensively infested with Campylobacter pylori. Therapy with
      cimetidine, antacids, pirenzepine and metronidazol resulted in relief of symptoms
      but not of histological findings. Bismuth (JatroxR) was successful in eradicating
      Campylobacter pylori and decreasing inflammation of the mucosa. Cause and
      prognosis of this mixed hyperplasia are not known.

PMID- 2222792
TI  - A different kind of clinical evaluation instrument for use in a programme in
      radiography.
AB  - Clinical evaluation of radiography students during their performance of non
      routine radiographic examinations can be quantified if the proper instrument is
      used. Such an instrument, referred to as the non-routine radiography examination
      evaluation by radiographic science faculty at Idaho State University, requires
      the student to perform a variety of atypical radiography examinations including
      trauma, paediatrics and portables. This particular instrument provides a mean of
      documentation and evaluation in an area of student competency which can otherwise
      be difficult to assess and evaluate.

PMID- 2222793
TI  - Methods for teaching effective patient communication techniques to radiography
      students.
AB  - Teaching students to communicate effectively with patients has always been part
      of the radiography curriculum in the USA. However, developing these skills has
      become even more important in recent times due to several factors. Patients who
      have been well versed in what to expect from the examination being conducted are
      in a better position to co-operate with the radiographer. This increases the
      chances of producing optimal results from an examination at the first attempt,
      thus reducing radiation exposure, patient discomfort and the overall cost of
      conducting the procedure. Also, increased competition among health care providers
      has resulted in more emphasis being placed on patient, or customer, satisfaction.
      Radiographers are in the 'front line' of patient care. Patients often have more
      interaction with radiographers than with physicians or other medical specialists.
      Radiographers who practise effective communication techniques with their patients
      can alleviate anxiety and make an important contribution to the overall
      satisfaction of the patient with respect to the quality of service and care they
      receive. This article describes instructional methods being used in the USA to
      help develop effective patient communication techniques, and reports the findings
      of a study among radiography educators as to which of these methods are thought
      to be most successful.

PMID- 2222794
TI  - Ultrasound of the acute abdomen--Part III.

PMID- 2222795
TI  - Digital spot-film fluorography.
AB  - Initial assessment of the DSI unit proved the ergonomic advantages of the system
      compared with a conventional fluoroscopic/fluorographic system. Also, a decrease
      in radiation dose levels proved encouraging. Savings in respect of hard copy
      expenditure and higher patient throughout area which the DSI technique can
      exploit. However, spatial resolution is still not equal to that of conventional
      film/screen imaging, but the 1024 matrix option and the facility for post
      processing of the images in terms of contrast, brightness and edge enhancement
      have produced diagnostically acceptable images for all examinations undertaken
      (see figures 4 and 5).

PMID- 2222796
TI  - Amperometric immunoassay.
AB  - An exciting new analytical technique based on amperometric devices used to
      measure immunoassays is reviewed in this article. The utility, ease, speed,
      simplicity, and many other advantages of performing amperometric immunoassays
      (AIAs) are discussed throughout the review. Limitations are also described, with
      electrochemical comparisons being made between AIAs and other conventional
      analytical methods, including potentiometric immunoassays. The review essentially
      consists of a general AIA overview, followed by sections devoted to amperometric
      electrode types, assay design, basic principles, automation, application, and
      future use. Operational features of oxygen gas selective electrodes and
      oxidoreductase probes are discussed for a better understanding of AIA principles.
      Characteristics, limits, advantages, and disadvantages of these different devices
      are presented. A variety of homogeneous and heterogeneous AIAs are described,
      together with many applications of the different assay formats available. AIAs
      are classified according to the electrode type employed, enzyme labels required,
      or electrochemical components involved. Important related AIAs discussed include
      pulse agglutination reactions and bioaffinity or displacement assays.

PMID- 2222798
TI  - Muscle growth and exercise.
AB  - This paper first reviews muscle growth and then considers the influence of
      exercise in growth. Knowledge about how muscle cells grow and some factors that
      may influence the growth pattern are discussed first since these effects must be
      considered before the influence of exercise becomes clear. Growth of muscle can
      occur in three ways: (1) by an increase in muscle cell numbers, (2) by an
      increase in muscle fiber diameter, and (3) by an increase in fiber length. All
      three of these mechanisms are involved in muscle growth. However, growth in cell
      numbers is limited to the prenatal and immediately postnatal period, with the
      animals and man being born with or soon reaching their full complement of muscle
      cells. Thus, growth occurs by either hypertrophy of the existing muscle fibers by
      adding additional myofibrils to increase the muscle mass or by adding new
      sarcomeres to the ends of the existing muscle fibers to increase their length.
      Both of these mechanisms occur during the growth process. Growth in the girth of
      the muscle fibers appears to take place by splitting of the myofibrils. This may
      be stimulated by development of stress creating an unequal pressure with
      splitting at the Z-band and development of additional SR and T-tubule systems.
      This adds to the diameter or girth of myofibers without any hyperplasia. The
      growth in length occurs at either end of the fibers and results in addition of
      new sarcomeres. In both cases, new myofibrillar protein must be synthesized and
      deposited in the muscle cells. It is suggested that adaptation by adding or
      removing sarcomeres is physiologically determined by the degree of force a muscle
      can generate that is in turn dependent on the degree of overlap of the thick and
      thin filaments. Thus, the amount of tension would control the number of in-series
      sarcomeres in a single muscle fiber. Nutrition is also known to play an important
      role in muscle and was discussed from the standpoint of the effects of
      nutritional adequacy and restriction. Although a nutritionally balanced and
      calorically adequate diet is required to achieve optimum muscle growth, it may be
      less efficient in terms of protein deposition than a moderately restricted diet.
      Muscle and bone deposition, however, can be limited on severely restricting the
      dietary intake. Although fat deposition is the first tissue to suffer on a
      severely restricted diet, muscle and bone follow next with the nervous system,
      brain and eyes being the last systems to be affected.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2222797
TI  - Integrity of small data bases in computer analysis of dietary data.
AB  - The integrity of data bases to support microcomputer-based dietary analysis
      programs has become increasingly important to developers and users of nutritional
      analysis software. This paper reviews critical issues in maintaining data
      integrity during development of small nutritional data bases. Because a limited
      number of large, source data bases provides the data for smaller, special-purpose
      data bases, this review initially focuses on factors that affect the quality and
      precision of methodologies used in establishing large data bases. Issues
      discussed are accuracy of source data as determined by analytical methodology and
      imputation procedures, and methods for insuring representativeness of data. The
      effect of data transfer procedures on small data base integrity are discussed,
      including use of multiple sources and standardization of naming and coding
      conventions. Also reviewed are procedures for selecting reduced numbers of foods
      and nutrients without sacrificing accuracy of analysis, and methods currently in
      use for validating small data bases.

PMID- 2222799
TI  - Influence of dietary magnesium on mineral, ascorbic acid and glutathione
      concentrations in tissues of a freshwater fish, the common carp.
AB  - Supplementation with dietary Mg at a minimum level of 0.06% seems to be essential
      to prevent the hypercalcinosis of the kidney and hepatopancreas in a fish, the
      common carp. Mg deficiency appears to have no effect on the Mg level in kidneys
      and hepatic tissue, whereas the Fe level in those tissues was significantly
      diminished by increasing dietary Mg supplementation up to 3.2 g.kg-1. Both
      hypercalcinosis and accumulation of Fe in soft tissues were more pronounced in
      fish offered diets high in protein (44%) compared to fish on low dietary protein
      (25%). The ascorbic acid in the hepatopancreas and kidney was greatly depleted in
      fish fed the high-protein diets, and this depletion did not correlate with the
      dietary Mg level nor with a high level of tissue Ca. However, the increased Ca
      concentration in the kidney coincided with the greatest depletion of ascorbate in
      fish fed a high-protein diet. The concentration of ascorbate in the brain was
      much less affected by a low level of vitamin C in the diets than in other
      tissues. Depletion of ascorbate in soft tissues did not correspond to fish growth
      but might be rather related to the metabolic rate imposed by the dietary
      nutrients. It is suggested that the Mg and ascorbic acid requirements in the carp
      are considerably elevated by the increased dietary protein level.

PMID- 2222800
TI  - Severe hypermagnesemia without reduction in the anion gap.
AB  - The serum anion gap (AG) is usually calculated by the equation: AG = Na - (Cl +
      HCO3), reflecting the difference between the total level of unmeasured anions
      (all anions other than chloride and bicarbonate) and that of unmeasured cations
      (all cations other than sodium). Thus, several recent reviews have cited
      hypermagnesemia as a cause of a reduction in the AG. Whether this might occur
      depends in part on the nature of the accompanying anion (if the etiology of the
      hypermagnesemia is an exogenous load of magnesium), as well as on the presence of
      concomitant changes in endogenous unmeasured anions. In the present paper, we
      describe an unusual patient whose severe hypermagnesemia was not associated with
      AG reduction. Although multiple factors, including lactic acidosis, might have
      countervailed the effect of her hypermagnesemia on the AG, there is no actual
      substantiation in the literature of an association between increased serum Mg and
      AG lowering. In conclusion, the finding of a normal AG has no documented negative
      predictive value, and the finding of a low AG has no documented positive
      predictive value for the diagnosis of hypermagnesemia.

PMID- 2222801
TI  - Studies on the relationship between boron and magnesium which possibly affects
      the formation and maintenance of bones.
AB  - Recent findings are reviewed indicating that changes in dietary boron and
      magnesium affect calcium, and thus bone, metabolism in animals and humans. In
      animals, the need for boron was found to be enhanced when they needed to respond
      to a nutritional stress which adversely affected calcium metabolism, including
      magnesium deficiency. A combined deficiency of boron and magnesium caused
      detrimental changes in the bones of animals. However, boron deprivation did not
      seem to enhance the requirement for magnesium. In two human studies, boron
      deprivation caused changes in variables associated with calcium metabolism in a
      manner that could be construed as being detrimental to bone formation and
      maintenance; these changes apparently were enhanced by low dietary magnesium.
      Changes caused by boron deprivation included depressed plasma ionized calcium and
      calcitonin as well as elevated plasma total calcium and urinary excretion of
      calcium. In one human study, magnesium deprivation depressed plasma ionized
      calcium and cholesterol. Because boron and/or magnesium deprivation causes
      changes similar to those seen in women with postmenopausal osteoporosis, these
      elements are apparently needed for optimal calcium metabolism and are thus needed
      to prevent the excessive bone loss which often occurs in postmenopausal women and
      older men.

PMID- 2222802
TI  - Effects of vasoactive agents on isolated human umbilical veins in preeclamptic
      women.
AB  - Increased peripheral vascular reactivity has been noted in preeclampsia. However,
      in a recent study we found decreased reactivity to vasoactive agents in umbilical
      arteries of preeclamptic patients. A similar preliminary study, therefore, was
      carried out on umbilical veins to determine whether preeclampsia affected
      umbilical venous reactivity. Helical strips of human umbilical veins from 7
      preeclamptic and 8 control patients were set up isometrically in physiological
      salt solution. The resting tensions did not differ between the groups, but
      spontaneous rhythmic contractions began much earlier in the preeclamptic group
      than in the controls (8.29 +/- 4.14 vs. 49.22 +/- 9.71 min). There were no
      differences in the mean amplitudes of the contractions at their time of onset,
      but in 5 patients of each group the mean amplitudes progressively rose to a
      maximum at approximately 90 min after incubation, and this maximum was
      significantly lower in the preeclamptic group (234.43 +/- 72.95 vs. 751.64 +/-
      186.13 mg). The frequencies of the contractions did not vary with time or between
      groups. Log-dose response curves were made for serotonin and KCl, and there were
      no differences in threshold doses, ED50, maximal tensions or relaxation times
      between groups. These results are similar to those reported in human umbilical
      arteries from preeclamptic patients in that no increase in reactivity to
      vasoactive agents was noted. In conclusion, the differences in the spontaneous
      rhythmic contractions between preeclamptic patients and controls may be new
      evidence of pathological changes in the umbilical venous system in preeclampsia.

PMID- 2222803
TI  - Extracellular magnesium and potassium concentrations interact to modulate tone
      and reactivity of isolated canine cerebral vascular muscle.
AB  - In vitro studies were undertaken to investigate the effects of external potassium
      [K+]o, 0-7.1 mM, and magnesium [Mg2+]o, 0-4.8 mM, concentration on canine middle
      cerebral and basilar arterial basal tone and on 5-hydroxytryptamine (5-HT)
      induced contractions. The lower the [K+]o, the greater the degree of spontaneous
      contraction upon acute withdrawal of [Mg2+]o. An inverse linear relationship
      between the concentration of [K+]o and the degree of cerebrovasospasm upon acute
      withdrawal of [Mg2+]o was observed over the range of 1-6 mM [K+]o. As [K+]o was
      increased, stepwise, the slow phase of the contractions became attenuated, while
      the magnitude of the fast phase became progressively smaller. Acute withdrawal of
      [K+]o produced contraction of middle cerebral and basilar arteries which could be
      modulated by the concentration of [Mg2+]o. The higher the [Mg2+]o, the less the
      tension developed upon acute withdrawal of [K+]o. Contractility to 5-HT was
      depressed when [K+]o was lowered. This attenuation was reversed completely when
      [Mg2+]o was acutely withdrawn. Sensitivity (EC50) of canine middle cerebral and
      basilar arteries to 5-HT was inversely related to the [K+]o/[Mg2+]o ratio. These
      actions took place over pathophysiological ranges of [K+]o and [Mg2+]o.
      Maintenance of a constant [K+]o/[Mg2+]o ratio, irrespective of the exact [K+]o
      and [Mg2+]o, produced similar degrees of maximum tension and sensitivity (EC50)
      to 5-HT. Use of intact ring preparations and helically cut vascular strips
      produced similar results with varying [K+]o/[Mg2+]o. A variety of pharmacological
      receptor antagonists (phentolamine, propranolol, atropine, diphenhydramine,
      cimetidine), as well as a prostaglandin cyclo-oxygenase inhibitor, did not modify
      the altered contractile responses or basal tone evoked by varying the
      [K+]o/[Mg2+]o ratios. These experiments suggest: (1) that basal tone and
      contractility of canine cerebral vascular smooth muscle cells appear to be
      exquisitely sensitive to alterations in extracellular K+ and Mg2+ and (2) that 5
      HT receptor-operated Ca2+ channels, as well as those Ca2+ channels involved in
      the generation of cerebral arterial basal tone, are modulated and controlled by
      the precise concentrations of [K+]o and [Mg2+]o.

PMID- 2222804
TI  - Relationship between diabetes mellitus mortality rates and drinking water
      magnesium levels in Iowa.
AB  - A recent ecologic study has suggested a relationship between mortality from
      diabetes mellitus and levels of magnesium in drinking water. However, diabetes
      mortality rates were from aggregate data for the entire geographic area under
      study. The state of Iowa has data resources available to determine diabetes
      mortality rates for individuals on known water supplies in Iowa and magnesium
      levels for raw drinking water supplies. To determine the presence of this
      relationship in the state of Iowa, mortality rates from 1976 through 1985 for
      diabetes as an underlying cause of death and for major cardiovascular disease
      with diabetes as an ancillary cause of death were compared for individuals from
      towns in Iowa with populations of 1,000 to 10,000. At the stratification levels
      of magnesium in municipal drinking water used in this study, no significant
      differences were found in diabetes mortality rates.

PMID- 2222805
TI  - Measurement of ATP synthesis and flocculent matrix densities in mitochondria as a
      function of 'in vitro' ischemia in the heart and liver of rats.
AB  - We intended to determine the levels of adenosine triphosphate (ATP) synthesis at
      the time when mitochondria ultrastructurally show flocculent densities in the
      matrix space. For this purpose, mitochondria were isolated from rat heart and rat
      liver after the tissues have been maintained under controlled ischemic conditions
      in vitro at 37 degrees C for intervals of 15, 30, 45, 60, 120, 180, and 240
      (heart) min. The isolated mitochondria were tested for new ATP synthesis by
      luciferin/luciferase luminescence in the presence of substrate and adenosine 5'
      diphosphate (ADP). The luminescence peaks were standardized and related to an
      external measure by measuring absorbance of ATP at 259 nm where the extinction
      coefficient is 15,400. Mitochondrial yield was monitored by measuring succinate
      dehydrogenase activity in the first homogenate and in the final mitochondrial
      pellet. Alternatively, cytochrome oxidase activity was used and the protein in
      the mitochondrial pellet was also determined. We found that the yield of
      mitochondria was above 53-54% in both liver and heart at 2 h of ischemia. Longer
      intervals were accompanied by lower yields. The ability to synthesize new ATP
      declined at different time intervals in ischemia of the heart compared to the
      liver. After 30 min ischemia, the synthesis in heart mitochondria is 18% of
      control, while the synthesis of liver mitochondria reaches 16% of control after
      45 min of in vitro ischemia. Flocculent densities in heart mitochondria appeared
      at 45 min ischemia in vitro and in vivo, and at 60 min in liver mitochondria. We
      conclude that the decline of ATP synthesis is a significant early change in
      mitochondria and antedates the appearance of flocculent densities.

PMID- 2222806
TI  - Postmortem viability and early changes in organ culture of human and rabbit
      aortic endothelial cells.
AB  - In order to understand the role of the postmortem interval (PMI) on endothelial
      cell changes both in human and rabbit aortas, we have examined the
      ultrastructural cytomorphologic alterations of these cells. Human aorta (HA) and
      rabbit aorta (RA) were maintained in calcium-free, glucose-supplemented Hank's
      balanced salt solution (HBSS). Rabbit endothelial cells (REC) on the aorta (organ
      culture) assayed morphologically survive for at least 12 h in culture solution.
      The predominant morphological change in the RA was the formation of multiple
      subendothelial vacuoles (SEV). These vacuoles may form as the results of
      increased permeability of endothelial cells to ions and fluid or cell
      contraction. Cell to cell connection remained intact. Individual and dispersed
      endothelial cells were observed 8 h after removal from the animal when incubated
      in calcium-free HBSS. These necrotic endothelial cells were scattered among
      viable endothelial cells. Human aortic endothelial cells were also well preserved
      in the same media for periods of 6-8 h postmortem. Increased extracellular
      calcium (1.3 mM) in the incubation media caused accelerated cell death. These
      findings suggest that aortic endothelial cells can be preserved for longer
      periods of postmortem time than would be expected and that the use of calcium
      free HBSS media supplemented with glucose improves endothelial cell viability in
      vitro.

PMID- 2222807
TI  - Oncogene activation and hepatocarcinogenesis.
AB  - Dominant-transforming oncogenes are frequently detected in mouse liver tumors,
      but are rare or inconsistently detected in rat liver tumors. Most of those that
      have been identified are members of the ras family. While altered expression of
      many oncogenes has been reported, an increase in the expression of the c-myc gene
      is consistently observed in both rat and mouse hepatocellular tumors. Both
      hepatocytes and liver epithelial cells have been immortalized or transformed with
      viral or cellular oncogenes. Immortalization of cells occurs without the loss of
      differentiated functions, while transformation induces the expression of many
      genes/gene products associated with liver cancer in vivo. Cells transformed with
      chemical carcinogens or oncogenes display a phenotype of growth factor
      independence or greatly reduced growth factor requirements. Transformation is
      frequently associated with a substantial decrease in the expression of the
      exogenous growth factor receptor in the hepatocellular tumors.

PMID- 2222808
TI  - Differing roles of protein kinase C on the antiproliferative effects of tumor
      necrosis factor alpha and beta on LoVo cells.
AB  - In this study we examined whether the antiproliferative effects of tumor necrosis
      factor (TNF)-alpha and beta were associated with the activation of protein kinase
      C (PKC), using the LoVo human colon cancer cell line which is resistant to both
      TNFs. In combination with 12-O-tetradecanoylphorbol-13-acetate (TPA), a potent
      activator of PKC, TNF-alpha caused marked growth inhibition of LoVo cells, but
      TNF-beta had little antiproliferative effect. There was no difference in the
      effect when TPA was added 1 h before or 4 h after TNF-alpha administration. A PKC
      inhibitor, H-7, not only decreased the sensitivity of LoVo cells to TNF-alpha but
      also caused a slight promotion of cell proliferation and dose-dependently blocked
      the growth inhibition induced by TNF-alpha and TPA. These results suggested a
      possible regulatory function of PKC within the TNF-alpha-mediated intracellular
      signalling pathway. PKC may act at a later stage in the transduction pathway.

PMID- 2222809
TI  - Measurement of homing receptors on the surface of leukemic and nonleukemic cell
      lines.
AB  - Selective homing of hemopoietic progenitor cells to hemopoietic organs is the
      initial event in hemopoiesis. At a molecular level, it is mediated by a membrane
      receptor on the surface of hemopoietic progenitor cells. The receptor molecule
      then binds selectively to a glycoconjugate on the surface of bone marrow stromal
      cells. The molecular nature of this receptor has been shown previously to be a
      lectin with specificity for an as yet unknown configuration of galactosyl and
      mannosyl residues of the glycoconjugate. Normal murine progenitor cell lines,
      FDCP-1 and B6SUT, were found to possess this homing receptor on their cell
      membrane, and they also bind well to hemopoietic stroma. However, when three
      human leukemic cell lines, U937, HL60 and K562, were probed for the presence of
      this receptor, they were found to be deficient in the homing protein. Further,
      these cells showed little ability to bind the hemopoietic stromal cell line,
      GB1/6. These findings suggest that leukemic cells experience a loss, or at least
      alteration, of homing receptor molecule during leukemic transformation. This can
      result in a diminished ability to bind to marrow stroma. The lack of homing
      function may be of pathogenetic significance in the lack of differentiation of
      leukemic cells and may also contribute to the dissemination of leukemic cells in
      the circulation.

PMID- 2222810
TI  - Characterization of the cDNA coding for mouse prothrombin and localization of the
      gene on mouse chromosome 2.
AB  - A series of overlapping cDNAs coding for mouse prothrombin (coagulation factor
      II) have been isolated and the composite DNA sequence has been determined. The
      complete prothrombin cDNA is 1,987 bp in length [excluding the poly(A) tail] and
      codes for 18 bp of 5' untranslated sequence, an open reading frame coding for 618
      amino acids, a stop codon, and a 3' untranslated region of 112 bp followed by a
      poly(A) tail. The translated amino acid sequence predicts a molecular weight of
      66,087, which includes 10 residues of gamma-carboxyglutamic acid. There are five
      potential N-linked glycosylation sites. Mouse prothrombin is 81.4% and 77.3%
      identical to the human and bovine proteins, respectively. Comparison of the cDNA
      coding for mouse prothrombin to the human and bovine cDNAs indicates 79.9% and
      76.5% identity, respectively. Amino acid residues important for the structure and
      function of human prothrombin are conserved in the mouse and bovine proteins. In
      the adult mouse and rat, prothrombin is primarily synthesized in the liver, where
      is constitutes 0.07% of total mRNA as determined by solution hybridization
      analysis. The genetic locus for mouse prothrombin, Cf-2, has been mapped using an
      interspecies backcross and DNA fragment differences between the two species. The
      prothrombin locus lies on mouse chromosome 2, 1.8 +/- 1.3 map units proximal to
      the catalase locus. The gene order in this region is Cen-Acra-Cf-2-Cas-1-A-Tel.
      This localization extends the proximal boundary of the known region of homology
      between mouse chromosome 2 and human chromosome 11p from Cas-1 about 2 map units
      toward the centromere.

PMID- 2222811
TI  - Molecular cloning of cDNAs encoding bovine and human lactoperoxidase.
AB  - Peptide sequences obtained from cyanogen bromide fragments of bovine
      lactoperoxidase (bLPO) were used to design oligonucleotide probes for library
      screening. These probes were used to screen a cDNA library constructed from
      bovine mammary tissue. Three overlapping clones were obtained, the longest of
      which (T3) contained a reading frame of 712 amino acid residues. The encoded
      amino acid sequence was homologous to those recently reported for myelo-, thyro-,
      and eosinophil peroxidases. Two possible amino termini of the mature enzyme were
      identified, and the predicted mature protein matched previous molecular weight
      estimates of 78,500. Of eight bovine tissues tested, transcription of T3
      sequences were detected in mammary tissue only. Using the bLPO cDNA as a probe, a
      single hybridizing clone was found in a human mammary gland cDNA library. This
      clone (M1) encoded the carboxy-terminal 324 residues of a peroxidase distinct
      from the other three known human peroxidases, and was closely related to bLPO.
      This result confirms the presence of at least one distinct lactoperoxidase in
      humans.

PMID- 2222812
TI  - Tissue-specific expression of the rat growth hormone gene is due to the
      interaction of multiple promoter, not enhancer, elements.
AB  - Expression of the rat growth hormone (rGH) gene is highly tissue-specific, being
      limited to a subset of cells in the anterior pituitary. DNA sequences within 237
      bp of the transcription start site of the rGH gene play a major role in directing
      the expression of this gene in the pituitary. Transfection studies in cultured
      rat pituitary (GC) cells demonstrate that optimal expression of rGH requires the
      binding of at least two non-tissue-specific factors whose contribution to rGH
      expression is dependent on the binding of the pituitary-specific factor, Pit-1.
      Although the segment of DNA containing the elements to which these factors bind
      can direct pituitary-specific expression of a gene lacking upstream promoter
      elements, it cannot confer stimulation to either a heterologous or homologous
      promoter when placed downstream from the coding sequences. These results suggest
      that expression of the rGH gene exclusively in the pituitary is due to the
      activity of a tissue-specific promoter element, not an enhancer.

PMID- 2222813
TI  - Reliable hybridization of oligonucleotides as short as six nucleotides.
AB  - Although there are many new applications for hybridizing short, synthetic
      oligonucleotide probes to DNA, such applications have not included determining
      unknown sequences of DNA. The lack of clear discrimination in hybridization of
      oligo probes shorter than 11 nucleotides and the lack of a theoretical
      understanding of factors influencing hybridization of short oligos have hampered
      the development of their use. We have found conditions for reliable hybridization
      of oligonucleotides as short as seven nucleotides to cloned DNA or to
      oligonucleotides attached to filters. Low-temperature hybridization and washing
      conditions, in contrast to the high stringency conditions currently used in
      hybridization experiments, have the potential for allowing the simple use of all
      oligos of six nucleotides or longer in meaningful hybridizations. We also present
      the hybridization discrimination theory that provides the conceptual framework
      for understanding these results.

PMID- 2222814
TI  - Transcription vectors that facilitate the identification and mapping of RNA
      splice sites in genomic DNA.
AB  - Two transcription vectors were constructed that can identify the splice sites at
      exon-intron boundaries of inserted DNA fragments possessing the complementary
      splice site. One vector contains the 5' splice donor site and flanking exon
      intron sequences from the 3' end of the adenovirus first late leader. The other
      vector contains the 3' splice acceptor site and the branch acceptor site, plus
      the flanking exon-intron sequences from the 5' end of the adenovirus second late
      leader. Both vectors contain a multiple cloning site for insertion of DNA
      fragments. DNA fragments supplying the complementary splice site, including the
      adjacent exon and intron sequences, were inserted into the vectors. The vectors
      were used as templates for the synthesis of chimeric RNA transcripts that were
      spliced in in vitro splicing extracts. Chimeric transcripts from the vectors
      containing complementary splice site boundary regions from the human growth
      hormone gene were accurately spliced in vitro. A splice site from a human growth
      hormone intron that is not normally spliced in vitro was spliced when paired with
      an adenovirus splice site. These vectors can be used to identify splice sites and
      to determine the lengths of exons and their attached introns within a DNA
      fragment of unknown coding content.

PMID- 2222815
TI  - Legal issues in the practice of dental hygiene.

PMID- 2222816
TI  - Emergency medicine in dentistry.

PMID- 2222817
TI  - [Migraine. Various current concepts].
AB  - Migraine is a common disorder in children with a prevalence of 2.5% under seven
      years of age, 5% in those between the ages of seven and puberty and in
      postpuberal females it may be as prevalent as 10%. It is transmitted as an
      autosomally dominant trait and is frequently caused by precipitating factors. The
      vascular theory which stated that the aura was due to an intracranial vessel
      constriction and that the headache was due to an extracranial vasodilation has
      now be questioned due to new clinical and experimental data. Recently it is
      believed to be due to an unstable inherited serotonigenic neurotransmission which
      favors an increase in the frequency of neuronal discharge of the mid-brain raphe.
      Included is a classification and the diagnostic headache criteria used by the
      International Headache Society (1988). Treatment for migraine can be: a) abortive
      and b) preventive. Propranolol at a dosage of 2 mg/kg per day taken divided into
      three has shown to be the most beneficial in the prevention of migraine
      headaches. Certain calcium channel blockers, particularly flunarizine seem to
      have prophylactic value.

PMID- 2222818
TI  - [Results of the treatment of growth hormone deficiency with methionine
      somatotropin or recombinant somatotropin].
AB  - Sixteen children with hGH deficiency were treated for a year with methionyl
      somatotropin (Somatonorm) or recombinant-somatotropin (Genotropin). The hormone
      was administrated subcutaneously 3 time/week, 0.45-0.6 IU/kg/week. After a year
      of treatment, the mean growth rate in those who received Somatonorm increased
      from 3.96 +/- 0.8 cm/yr to 9.08 +/- 2.7 cm/yr, and in those who received
      Genotropin from 3.6 +/- 0.6 cm/yr to 8.58 +/- 1.1 cm/yr with no significant
      difference. No adverse effects were observed, but four children that received
      Somatonorm developed antihGH antibodies with a very low binding capacity, of less
      than 0.1 mg/L. All the children that received Genotropin were negative for
      antihGH antibodies.

PMID- 2222819
TI  - [Increase in glutamic-oxaloacetic and glutamic-pyruvic transaminases and lactic
      dehydrogenase as a diagnostic aid in perinatal asphyxia].
AB  - In order to determine the behavior of glutamic oxalacetic (GOT), glutamic-pyruvic
      (GPT) and lactic dehydrogenase (LDH) transaminases after a period of asphyxia, a
      study was conducted in 120 newborn children which were placed into two groups:
      group 1 of the asphyxiated children who were given oxygen at intermittent
      positive pressure for more than a minute and group 2 of healthy children with an
      Apgar greater than 7 after the first and five minutes and without any apparent
      pathology. The results showed a real increase in the quantities of all three
      transaminases among those in the group of asphyxiated children, which on the
      other hand did not occur in the healthy group of children where levels remained
      normal. There was statistical differences (P less than 0.001) by which we can
      conclude that the quantification of these enzymes can be useful as a diagnostic
      tool in cases of perinatal asphyxia.

PMID- 2222820
TI  - [Uncinariasis in younger infants].
AB  - In order to determine the main clinical and laboratory manifestations associated
      with the infestation by an uncinaria during the first year of life, 42 children
      were studied from a group hospitalized between the years 1980 and 1985 in whom
      the main diagnosis at their time of leave from the hospital was parasitosis. Over
      31 patients (74%) showed some degree of malnutrition, and severe in 24 of them
      (57% of the total). Clinical manifestations were mainly related to anemia
      (paleness, lack of air) and active intestinal bleeding (enterorrhagia, melena).
      Among the laboratory findings, 80% of the patients were shown to have anemia and
      in 24% of them, their hemoglobin levels were less than 5 g/dL, in more than half
      the anemia was normocytic normochromic. Also included are particularities
      concerning uncinariasis in the breast-feeding infant and some differences with
      the infection in the adult.

PMID- 2222821
TI  - [Measurement of the choroid plexus of the lateral ventricles in full-term
      newborns using ultrasonics].
AB  - Brain ultrasonography was carried out in 50 full-term, healthy newborns in order
      to obtain normal measurements of the choroid plexus of the lateral ventricles to
      have a basis to work with in future studies concerning Central Nervous System
      infections where the choroid plexus may be affected early on due to the bacterial
      infection. The parasagittal views demonstrated the anterior-posterior diameter of
      the left choroid was on the average 0.52 cm and 0.50 cm for the right one. The
      posterior coronal view showed the length of the left choroid plexus to be on the
      average 2.29 cm and 2.34 cm for the right. The transverse diameter as seen from a
      coronal view was 0.55 cm for the left choroid and on the average 0.52 for the
      right.

PMID- 2222822
TI  - [Hearing and language sequelae in survivors of a neonatal intensive care unit].
AB  - INTRODUCTION: The purpose of this study is to record the hearing and language
      sequelae in a sample of children from the Intensive Care Unit between the ages of
      two and three. MATERIALS AND METHODS: Forty-one children were studied after being
      submitted to neuropsychological, hearing and language tests. Both normal and
      abnormal parameters for each test allowed the categorization of the children.
      RESULTS: In the general sample there were 24 full-term children versus 17 preterm
      children. The neurological testing showed a tendency towards normality. The same
      was seen in language testing since the proportion of normality corresponded to
      those children born after a full term. There were practically no differences in
      those suspected from both groups and a greater percentage of abnormal children
      were found among the pre-term infants. From an audiological standpoint there was
      a predominance of normal children; there was only one patient with severe
      bilateral hypoacusis who needed an electric auxiliary hearing device and two
      other patients with peripheral ear dysfunction classified as serous middle ear
      otitis. CONCLUSIONS: The incidence of hypoacusis in this sampling type is similar
      to that reported in the literature. Those patients with a history of assisted
      mechanical ventilation have been later found to have, as a sequelae, serous
      middle ear otitis, which corresponds to that reported by Paradise. The
      development of language stages were altered more so in preterm children. In some
      patients, the lack of stimulation associated with a low socioeconomic back group
      favors the delay in the development of language skills.

PMID- 2222823
TI  - [Management of primary nocturnal enuresis in school children with slow learning
      ability: usefulness of imipramine].
AB  - A comparative, longitudinal, blind prospective study was carried out in 20
      students between the ages of 6 and sixteen with primary nocturnal bedwetting and
      slow learning abilities from the Fray Antonio Alcalde school, in order to
      evaluate the use of motivating reinforcement techniques, exercises in order to
      improve bladder function and treatment with imipramine. All of the patients were
      given motivation reinforcement and bladder exercises. They were later divided
      into two groups of 10 children; group A was given a placebo while group B was
      given imipramine. In group A a significant decrease was seen in the average
      number of days the children woke wet after the sixth month of treatment (13.2 +/-
      9.7 days to 3.7 +/- 7.15 days) with P less than 0.05; and in group B since the
      fourth month (16.6 +/- 7.8 days to 8.1 +/- 8.3 days) with a P less than 0.05. At
      the end of the study, seven patients from group A and five patients from group B
      decreased in over 80% the number of days which they woke up wet. The motivating
      reinforcement and the exercises used to improve bladder functional capacity are
      useful in the management of primary nocturnal enuresis. Imipramine, when combined
      with these other routines can shorten the time towards a favorable response.

PMID- 2222824
TI  - [Acute trichinosis in children. Intrafamilial epidemic outbreak in Mexico City].
AB  - Four cases of trichinosis found in a family living in Iztapalapa, Mexico, D.F.
      are reported. The family reported to frequently eat raw sausage originally from
      Villanueva, Zacatecas from which Trichinella spiralis larvae were isolated.
      Diagnosis was difficult in the first case since no epidemiological history was
      associated with the patient, besides the fact that the patient showed no signs of
      eosinophilia and blood tests were negative. The diagnosis in this case was
      confirmed through muscular biopsy. The predominating symptomatology consisted in
      the trilogy of fever, eyelid edema and myalgias.

PMID- 2222825
TI  - [Adrenal abscess in the newborn: a case report and review of the literature].
AB  - This is a case report concerning a 22 day newborn referred to us having an
      abdominal tumor, fever, an irritable nature and feeding refusal, born
      dystocically due to the retention of the shoulders and having an Apgar score of
      5/8. When admitted the presence of the tumor was corroborated in the right flank
      occupying the right renal fossa and measuring 5 x 8 cm, non-mobile and painless.
      Studies revealed a diagnosis of calcified right adrenal hemorrhage versus
      neuroblastoma. During surgery a right adrenal abscess was found which was drained
      and a biopsy sample was taken for further study. The culture of the pus developed
      Proteus mirabilis. Pathology reported it to be an abscessed right adrenal
      hematoma which was partially calcified. The patient's wound became infected but
      was later sent home under good conditions. Only 15 other cases with this
      pathology are reported in the literature, this would be the 16th case. An
      emphasis is placed on including this pathology as part of the differential
      diagnosis of retroperitoneal tumors in the newborn.

PMID- 2222826
TI  - [Water-electrolyte and acid-base disorders. VII. Metabolic alkalosis].
AB  - Metabolic alkalosis is defined as a primary increase in plasma bicarbonate
      concentration. As a consequence of this increase, systemic alkalemia and
      secondary hypercapnia develop. In most instances metabolic alkalosis arises from
      loss of acid through the kidney or gastrointestinal tract. The causes of
      metabolic alkalosis can be separated into two groups. Those forms of alkalosis
      responsive to chloride salt administration (e.g., vomiting), are associated with
      extracellular fluid volume and chloride depletion. In contrast, alkalosis
      resistant to administration of chloride salt (e.g., primary aldosteronism), is
      usually associated with extracellular fluid volume expansion and a urine chloride
      above 20 mEq/L (mmol/L). Metabolic alkalosis; causes; diagnosis; clinical
      manifestations.

PMID- 2222828
TI  - [Treatment of hyperkalemia using salbutamol].

PMID- 2222827
TI  - [Infantile-type adrenoleukodystrophy].

PMID- 2222830
TI  - Viral vaccines.

PMID- 2222829
TI  - [Abstracts of papers presented at the XXXV annual meeting of the Medical
      Association of the Federico Gomez Childrens Hospital of Mexico, November 1989.
      Morelia, Michoacan].

PMID- 2222831
TI  - Serum albumin beads possessing slow-release properties for vaccines.

PMID- 2222832
TI  - Use of combined viral vaccines.

PMID- 2222833
TI  - Vaccination against influenza viruses: current status.

PMID- 2222834
TI  - Cold-adapted influenza viruses for use as live vaccines for man.

PMID- 2222835
TI  - Vaccines against viruses associated with diseases in human central nervous
      system.

PMID- 2222836
TI  - Rabies vaccines from Pasteur's time up to experimental subunit vaccines today.

PMID- 2222837
TI  - World Health Organization attitude concerning the use of continuous cell lines as
      substrates for production of human virus vaccines.

PMID- 2222838
TI  - Subunit vaccines against infection by enveloped viruses.

PMID- 2222839
TI  - Baculovirus expression vector system for production of viral vaccines.

PMID- 2222840
TI  - Ethanol effects in an anxiety/defense test battery.
AB  - Two tests, components of an Anxiety/Defense Test Battery, have been designed to
      measure risk assessment, inhibition of nondefensive behaviors, and movement
      arrest, all of which occur in the natural defense patterns of rats to threatening
      stimuli. In these tests, which used a nonpainful threat stimulus (a cat), ethanol
      (0.6 and 1.2 g/kg) increased two risk assessment behaviors on an initial test
      day, and produced a wider pattern of changes in all three patterns on a retest
      (no cat) day, 5 days later. The pattern of results obtained is compatible with a
      view that defensive behaviors occur in a fixed sequence with the decreasing
      intensity of threat an important factor in the transition from one defensive
      behavior to the next, and with ethanol at these doses producing a mild and
      relatively nonspecific anxiolytic effect. Comparison of male and female subjects
      on these tasks also suggested that females are more defensive than males, a
      finding which agrees with a variety of human anxiety studies but is at variance
      with previous rodent literature.

PMID- 2222841
TI  - Interactive effects of ethanol intake and maternal nutritional status on skeletal
      development of fetal rats.
AB  - Skeletal development on gestation day 21 was examined in fetuses of alcohol
      consuming (A), pair-fed (PF) and ad lib-fed (C) Sprague-Dawley females. Ethanol
      (36% ethanol-derived calories) was administered in liquid diets that were
      marginal (Diet A1) or optimal (Diet A2) in terms of pregnancy requirements (18%
      vs. 25% total calories as protein, respectively). For each bone studied, a
      lengthwise measurement was made of the whole bone and of the ossified portion(s),
      and percent ossification was calculated. Number of sternebral ossification
      centers present was also determined. Alcohol-exposed fetuses showed retarded
      ossification of the tibia and radius, regardless of maternal protein intake.
      Increasing the protein content of the alcohol diet from 18% (Diet A1) to 25%
      (Diet A2) significantly increased ossification of the ulna, sternum, humerus and
      ilium-ischium. For the ulna, A2 fetuses showed greater ossification than A1
      fetuses but were still retarded compared to PF and C fetuses. For the sternum,
      humerus and ilium-ischium, however, ossification in A2 fetuses increased to the
      levels observed in the PF and C groups. In addition, number of sternebral
      ossification centers present was significantly increased in A2 compared to A1
      fetuses. These data indicate that skeletal development provides a sensitive index
      of ethanol-induced developmental delay as well as interactive effects of ethanol
      and nutrition.

PMID- 2222842
TI  - Methodological aspects of aldehyde dehydrogenase assay by spectrophotometric
      technique.
AB  - Aldehyde dehydrogenase (ALDH) activity was assayed spectrophotometrically by
      measuring the increase in delta A at 340 nm, as a criteria of NAD conversion to
      NADH in the presence of propionaldehyde. The effect of pH and substrate(s)
      concentration of nonenzymatic increase in absorbance at 340 nm was studied.
      Results indicate that the increase in absorbance at 340 nm is not entirely due to
      NAD conversion to NADH. It was observed that nonenzymatic interaction of NAD and
      aldehyde could as well result in increase in absorbance at 340 nm. The magnitude
      of the nonenzymatic contribution towards increase in absorbance at 340 nm is
      found to be pH, substrate(s) conc., and time dependent. Further, the observed
      nonenzymatic reaction product was found to be different from that of NADH as
      confirmed by u.v. spectral characteristics (lambda max. 346 nm) and its inability
      to activate NADH/NADPH-dependent glutathione reductase. Based on these findings,
      a final assay method comprising a substrate blank consisting of NAD and aldehyde,
      and the assay pH of 7.4 is recommended for measuring the ALDH activity. Further,
      under these experimental conditions the Km value of human RBC ALDH was found to
      be 0.59 mM for propionaldehyde substrate.

PMID- 2222843
TI  - Plasma beta-endorphin levels in chronic alcoholics.
AB  - In order to test the possible relationship between the chronic consumption of
      alcohol and the opioid system, we have measured the plasma levels of beta
      endorphin in a group of 31 alcoholic patients and compared the results with those
      of a control group of 16 subjects. Our results show that chronic consumption of
      alcohol induces a significant decrease in beta-endorphin (beta-end) plasma levels
      regardless of either the disease suffered by the alcoholic patient or of the time
      of abstinence studied (one month maximum). Thus we believe that the beta-end
      decrease may well be due to the patients' alcoholism and that it might be
      mediated by the tetrahydroisoquinoline system, or be a cause of alcoholism rather
      than a consequence.

PMID- 2222844
TI  - Effect of acute ethanol drinking on alcohol metabolism in subjects with different
      ADH and ALDH genotypes.
AB  - The effect of different amounts of orally ingested ethanol on plasma alcohol
      dehydrogenase (ADH) and erythrocyte aldehyde dehydrogenase (ALDH), as well as on
      the blood ethanol and acetaldehyde levels, was examined in healthy nonalcoholic
      subjects. The genotypes at ADH2 and ALDH2 locus were identified in enzymatically
      amplified blood DNA by hybridization with allele-specific oligonucleotides. While
      the Japanese subject was found to be genotypically heterozygous for both ADH2 and
      ALDH2, the Caucasian subjects were genotypically homozygous normal for these
      alleles. A faster ethanol elimination associated with a higher blood acetaldehyde
      level was observed in the Japanese subject as compared to Caucasian subjects.
      However, no significant change in ADH and ALDH enzyme activities was detected as
      the result of acute ethanol intake.

PMID- 2222845
TI  - Effect of ethanol on the morphohistogenesis and differentiation of cerebellar
      granule cells in the chick embryo.
AB  - In this present study we analyse, with the help of the Golgi method, the effect
      of ethanol on the morphological differentiation of the cerebellar granule cells
      in the chick embryo. Ethanol seems to affect the process of cell migration from
      the early stages of differentiation. Some granule cells appear to differentiate
      in an inverted position. These observations also confirm, on the basis of their
      axon morphology, the existence of three types of granule cells in the chick
      cerebellum.

PMID- 2222846
TI  - Comparison of sensitivity and alcohol consumption in four outbred strains of
      rats.
AB  - Differences in alcohol consumption and in sensitivity to the effects of ethanol
      were investigated in four outbred rat strains: Fischer 344, Long-Evans, Sprague
      Dawley and Wistar. Alcohol consumption was measured in all four strains in three
      separate subgroups for each strain, using three different concentrations of
      ethanol (5, 10 and 20% v/v). An intermittent forced alternate-day ethanol
      presentation procedure (ethanol as the sole fluid for one day followed by only
      water the next day), as well as a two-bottle choice paradigm, were employed for
      this purpose. Ethanol-induced hypothermia and motor impairment (tilting plane
      test) were used to assess sensitivity. Significant differences in alcohol
      consumption were found among these strains. The Long-Evans strain consumed the
      highest and Fischer 344 the lowest amount of ethanol. Wistar and Sprague-Dawley
      were intermediate. However, the strains did not differ in sensitivity to ethanol.
      Similarly, determination of sensitivity to ethanol on day 0 in separate groups of
      these four strains (same age and weight, and obtained at the same time from the
      same supplier) did not reveal graded differences in sensitivity (hypothermia and
      motor impairment) corresponding to differences in alcohol consumption. These
      results suggest that sensitivity does not correlate with alcohol consumption.

PMID- 2222847
TI  - In vivo proton magnetic resonance spectroscopy of alcohol in human brain.
AB  - The covariance between blood and brain alcohol levels and subjective reports of
      mood were examined in 6 healthy adult men after consumption of 0.7 g/kg of
      beverage alcohol. There was significant (p less than 0.01) temporal concordance
      between ascending and peak blood alcohol levels and regional brain alcohol levels
      as measured by in vivo proton Magnetic Resonance Spectroscopy (MRS) when N-acetyl
      aspartate (N-AA) concentration was used as an internal standard. The frequency of
      reports of both euphoria and dysphoria also paralleled the ascending limb of the
      blood and brain alcohol curve. However, peak blood alcohol levels were higher
      (125.67 +/- 10.91 mg/dl) and earlier (35 min postdrinking) than peak brain
      alcohol levels (26.25 +/- 6.38 mg/dl) detected 50 min after alcohol intake. This
      difference in brain and blood alcohol levels appears to be associated with the
      echo time (TE) parameters of the MRS. A decrease in TE from 270 msec to 50 msec
      resulted in a marked increase in brain alcohol detectability. MRS measures will
      permit analysis of regional differences in brain alcohol concentrations and
      covariance with behavioral, neurophysiologic and neuroendocrine concomitants of
      acute alcohol intoxication in man.

PMID- 2222848
TI  - Anatomical "circuitry" in the brain mediating alcohol drinking revealed by THP
      reactive sites in the limbic system.
AB  - The involvement of aldehyde adducts in the etiology of alcoholism continues to be
      supported by a number of experimental findings. These metabolites are synthesized
      endogenously from a condensation reaction of a biogenic aldehyde with a catechol-
      or indole-amine and act in the brain to augment or suppress the drinking of ethyl
      alcohol. When given by the intracerebroventricular route in an animal which does
      not prefer alcohol, certain tetrahydro-isoquinolines and beta-carbolines can
      augment significantly the voluntary intake of alcohol even in aversive
      concentrations. This paper describes the historical background and current status
      of the "Multiple Metabolite" theory of alcoholism. The recent identification of
      anatomical structures in the limbic-midbrain, limbic-forebrain of the Sprague
      Dawley rat, which mediate changes in the intake of alcohol induced by
      tetrahydropapaveroline (THP) is also described. When injected in a low dose of 25
      ng in a specific site, over a 3-day period, THP induces persistent increases in
      the intake of alcohol even in aversive concentrations. These THP-reactive sites
      comprise the substantia nigra, reticular formation, medial lemniscus, zona
      incerta, medial forebrain bundle, nucleus accumbens, olfactory tubercle, lateral
      septal nucleus, preoptic area, stria terminalis, and rostral hippocampus. A
      higher dose of 250 ng THP microinjected at homologous loci tends to inhibit the
      rat's self-selection of alcohol or exert no effect on drinking. Morphological
      mapping of histologically identified sites sensitive to THP revealed a distinct
      "circuitry" of neuronal structures overlapping both dopaminergic and
      enkephalinergic pathways. This "circuit" extends from the tegmental-nigral area
      of the midbrain rostrally to structures within the limbic-forebrain. When a THP
      reactive structure, the N. accumbens, was lesioned by either of two neurotoxins,
      6-hydroxydopamine or 5.7-dihydroxytryptamine, the rats' preference for alcohol
      increased sharply. This suggests that impairment of transmitter release,
      denervation supersensitivity or other perturbation of receptor function within
      this and other structures play a part in the aberrant drinking of alcohol. It is
      envisaged that a dopamine-enkephalin link underlies the mechanism for the onset,
      maintenance and permanency of alcohol preference generated by an aldehyde adduct.
      Finally, the "Two-Channel, Brain Metabolite" theory of alcoholism proposes that
      the transitory presence of an endogenously formed aldehyde adduct within cells of
      the brain causes a permanent perturbation of normal receptor processes and
      transmitter activity within synapses of specific structures of the limbic system.
      This theory thus explains the nature of the rewarding properties of alcohol as
      well as its complex addictive liability which is physiologically irreversible.

PMID- 2222849
TI  - EEG alpha activity and personality traits.
AB  - Comparisons between EEG spectral power in the fast alpha (9-12 Hz) range and
      scores obtained on the Millon Clinical Personality Inventory (MCMI) were made in
      two populations of subjects. The first was a group of 60 individuals who reported
      no personal or family history of alcoholism. The second was a subgroup of 13 sons
      of alcoholics and 13 matched control subjects. In the first population, 30% of
      the subjects were classified as "high" alpha based on the criteria that their EEG
      in the 9-12 Hz range was over 75 microV2/octave in amplitude. Using this same
      criteria, 69% of the sons of alcoholics and 31% of their matched controls were
      also classified as "high" alpha. In both populations, subjects with high
      amplitude fast frequency EEG alpha activity in lead P4-O2 scored significantly
      higher on the Histrionic-Gregarious scale of the MCMI than subjects with low
      amplitude activity in this lead. These results are consistent with some previous
      studies showing a positive relationship between EEG alpha activity and
      extroverted personality traits. These results suggest that fast frequency alpha
      activity may be associated with some definable personality traits.

PMID- 2222850
TI  - Event-related potentials in individuals at risk for alcoholism.
AB  - Visual event-related potentials (ERPs) were recorded to easy and difficult line
      orientation discriminations in high risk (HR) and low risk (LR) males between the
      ages of 19-24. The amplitude of the P3 component was significantly smaller in HR
      compared to LR males to all target stimuli. This result was more pronounced for
      the easy target. No differences in the latency of P3 were reported between
      groups. These results were obtained prior to the administration of alcohol and
      replicate our own findings and those of other laboratories with a different
      experimental paradigm.

PMID- 2222851
TI  - Ethanol-induced alterations in EEG alpha activity and apparent source of the
      auditory P300 evoked response potential.
AB  - The relationship among topographic brain electrical activity mapping, auditory
      evoked response potentials (ERPs), plasma ethanol levels and subjective reports
      of intoxication was examined in 4 male volunteers. The source of the auditory
      P300 ERP (a measure of selective attention and memory encoding) was estimated
      using a recently developed computer program. The effect of ethanol on the P300
      wave was studied using a standard oddball paradigm both with and without a
      concomitant divided attention task. Ethanol (0.7 g/kg) administration produced
      marked increases in EEG alpha activity during the ascending limb of the blood
      ethanol curve. Acute ethanol administration caused a delay in the latency and a
      reduction in the amplitude of the auditory P300 ERP. A similar effect on P300
      topography was noted in waves that were affected by the tones while the subjects
      also listened to a story (divided attention). After ethanol, the source of the
      P300 wave appeared to have shifted to a position posterior and inferior to its
      original location. P300 ERP's generated during the divided attention task were
      also disrupted and shifted to positions inferior to their original. However, the
      variability of the dipole vector was much greater during the divided attention
      task than after ethanol administration. These data demonstrate that ethanol's
      effects on cognitive processing skills may be similar to those produced when
      individuals experience distractions while concentrating on a task.

PMID- 2222852
TI  - Model estimates of CSF and skull influences on scalp-recorded ERPs.
AB  - Dipole source localization promises to enhance knowledge about the structural and
      functional processes underlying differences in scalp-recorded ERPs observed
      between normal and patient populations. In this paper the Cuffin and Cohen (1)
      four-compartment model of volume conduction is used to examine the effects of
      variations in size of different compartments on scalp-recorded potentials. Using
      single discrete current dipoles located various distances from the center of the
      head, the effect of varying the thickness of the superficial extra-sulcal
      subarachnoid layer of CSF and the thickness of the skull are examined. Changing
      the thickness of the CSF layer alters amplitude recorded at the scalp and also
      alters the topographic distribution of the potential; these effects are more
      pronounced the closer the dipole source is to the surface. Changes in skull
      thickness have similar, but even greater effects.

PMID- 2222853
TI  - The complete amino-acid sequence and the phylogenetic origin of phycocyanin-645
      from the cryptophytan alga Chroomonas sp.
AB  - The first complete amino-acid sequence of the cryptomonad phycobiliprotein
      phycocyanin-645 from Chroomonas sp. is presented. The alpha 1-subunit contains 70
      amino-acid residues and the alpha 2-subunit 80 residues. In each of the alpha
      subunits a green, 697-nm absorbing chromophore is covalently bound to Cys18. Both
      alpha-subunits contain a high number of charged residues. The phycocyanin-645
      beta-subunit consists of 177 amino-acid residues. Two phycocyanobilin
      chromophores are singly bound to Cys beta 82 and Cys beta 158. A purple
      cryptoviolin-like chromophore is doubly bound to Cys beta 50 and Cys beta 61.
      Sequence comparisons revealed that the phycocyanin-645 beta-subunit is closely
      related to red algal phycoerythrin (73% identical amino-acid residues) and not so
      close to C-phycocyanin (55% identical amino-acid residues). The phycocyanin-645
      alpha-subunits represent a special type of phycobiliprotein and a direct
      relationship to other phycobiliproteins or any light-harvesting polypeptide
      pigment complexes could not be derived by sequence comparisons.

PMID- 2222855
TI  - Brefeldin A prevents uncovering but not phosphorylation of the recognition marker
      in cathepsin D.
AB  - Brefeldin A (BFA) has been shown to inhibit transiently the subcellular transport
      of cathepsin D (Oda & Nishimura (1989) Biochem. Biophys. Res. Commun. 163, 220
      225). We studied the effect of this antibiotic on processing of the
      phosphorylated oligosaccharides in cathepsin D in human promonocytes U937. In the
      presence of the drug the phosphorylation of cathepsin D precursor continued at a
      diminished rate. The phosphorylated oligosaccharides in cathepsin D comprised
      mono- and bis-phosphorylated forms. The relative amounts of the two species were
      not changed in the presence of BFA. The uncovering of the phosphate groups and
      the proteolytic processing of the phosphorylated precursor were abolished. In an
      in vitro assay the uncovering enzyme, N-acetylglucosamine-1-phosphodiester N
      acetylglucosaminidase was not inhibited by BFA. We suggest that this drug
      interrupts the traffic between the compartments containing N-acetylglucosaminyl
      phosphotransferase and N-acetylglucosamine-1-phosphodiester N
      acetylglucosaminidase.

PMID- 2222857
TI  - Studies on the extraction of different proteoglycan populations in bovine
      articular cartilage.
AB  - Large proteoglycan monomers and small dermatan sulfate proteoglycans were
      extracted from explants of bovine articular cartilage with increasing (0-4 M)
      concentrations of guanidinium chloride (GuHCl). The first extractions were
      followed by a second extraction with 4 M GuHCl. The amount of proteoglycans
      extracted in the first buffer depended on the GuHCl concentration. At low
      concentrations of GuHCl, a relatively high amount of small proteoglycans was
      obtained. Fifty percent of the small proteoglycans was extracted in buffer with
      0.85 M GuHCl, while 2.0-2.2 M GuHCl was needed to extract half of the large
      proteoglycans. Immediately after synthesis, 35S-labeled large proteoglycans were
      extracted much easier (50% at 1.4 M GuHCl), and those extracted at low
      concentrations of GuHCl were less capable of aggregation with hyaluronic acid.
      After 7 days of 'chase' these differences between endogenous and 35S-labeled
      proteoglycans had disappeared.

PMID- 2222854
TI  - Hemocyanins in spiders, XXIII. Complete amino-acid sequence of subunit a of
      Eurypelma californicum hemocyanin.
AB  - The complete amino-acid sequence of subunit a of the hemocyanin of the tarantula
      Eurypelma californicum was determined by manual sequencing. By limited
      chymotrypsinolysis, subunit a is split into two fragments of 25 kDa and 40 kDa,
      respectively, only one single peptide bond being attacked. The whole chain
      contains 15 methionine residues, after cyanogen bromide cleavage, 15 peptides
      were identified indicating that one residue (Met85) was not split by the cyanogen
      bromide reaction. For subcleavages, trypsin, chymotrypsin, Staphylococcus aureus
      proteinase, and Astacus fluviatilis proteinase were employed. The total chain
      length comprises 627 amino-acid residues, carbohydrate side chains were not
      found.

PMID- 2222856
TI  - Different forms of human cystatin C.
AB  - Two isoelectric forms of human cystatin C with pI 9.2 and 7.8 have been isolated
      from urine of patients with different nephrological disorders. Treatment of both
      forms with alkaline phosphatase revealed that the difference between them is not
      due to the phosphorylation of some amino-acid residue. Further purification of
      cystatin C with pI 9.2 by hydrophobic chromatography and N-terminal sequencing
      showed that it consists predominantly of the full-length form of cystatin C with
      the N-terminal sequence SSPG-. Cystatin C with pI 7.8 was separated into two
      peaks. The first represented a pure form truncated by an octapeptide and
      beginning with the N-terminal sequence LVGG-. The second was a mixture containing
      33% of the first peak and 66% of a truncated form with the N-terminal sequence
      VGGP-. Inhibitory activity of the full-length cystatin C and the pure truncated
      form has been measured against cathepsins B, H and L and show no significant
      differences in Ki values. These results further support the proposed mechanism of
      interaction of cysteine proteinases with their inhibitors cystatins (Bode, W.,
      Engh, R., Musil, D., Thiele, U., Huber, R., Karshikow, A., Brzin, J., Kos, J. &
      Turk, V. (1988) EMBO J. 7, 2593-2599).

PMID- 2222858
TI  - Purification and N-terminal amino-acid sequence analysis of rat polymorphonuclear
      leukocyte cathepsin G.
AB  - Cathepsin G was purified by single-step cation-exchange chromatography from rat
      polymorphonuclear leukocytes, obtained from the peritoneal cavity after induction
      of a mild peritonitis. The 26 N-terminal amino acids were determined and showed
      73% identity to those of human cathepsin G. Total amino-acid composition
      demonstrated a high degree of basic amino acids in accordance with its high
      affinity for the cationic-exchange gel medium. The protein was found to be a
      glycoprotein with a glucosamine content of 7.4% of the calculated Mr28,900. On
      SDS/polyacrylamide-gel electrophoresis the protein showed a Mr of 28,400. It
      migrated as two bands in a gradient SDS/polyacrylamide-gel indicating isoforms.
      The pH optimum for the proteinase was determined to be 8.0-8.5 using Suc-Ala-Ala
      Pro-Phe-Nan as substrate (Suc = 3-carboxypropionyl; Nan = 4-nitroanilide). Km and
      Kcat/Km values for Suc-Ala-Ala-Pro-Phe-Nan were 0.86mM and 280M-1S-1 and for Suc
      Phe-Leu-Phe-Nan 0.24mM and 3600M-1S-1, respectively.

PMID- 2222859
TI  - Purification and characterization of bovine liver 3-cis-2-trans-enoyl-CoA
      isomerase.
AB  - The purification to homogeneity of 3-cis-2-trans-enoyl-CoA isomerase from bovine
      liver is described. This procedure has also been successfully applied to the
      isolation of the enzyme from rat liver mitochondria. Its molecular mass was
      determined to be 30 kDa by several methods. Km of the isomerase for 3-cis
      dodecanoyl-CoA, the physiological intermediate in the beta-oxidation of oleic
      acid and of the 3-trans-isomer was determined to be 3.2 x 10(-5) M. The velocity
      of isomerization of the 3-trans-substrate is reduced 10-15 times. Inhibition
      experiments and pH-dependency of the reaction kinetics suggest the participation
      of a histidine residue in the isomerization. Protein analytical studies revealed
      that the N-terminus is blocked (acetylated). Cyanogen bromide cleavage of the
      purified enzyme resulted in five fragments. The N-terminus of one fragment is
      blocked. Partial amino-terminal sequences of two of the fragments were obtained
      by Edman degradation, a prerequisite for further studies on the structure of this
      isomerase on the DNA level.

PMID- 2222860
TI  - Detection of cathepsin B, plasminogen activators and plasminogen activator
      inhibitor in human non-small lung cancer cell lines.
AB  - Human non-small lung cancer cell lines HS-24 (established from a primary squamous
      cell carcinoma) and SB-3 (established from a metastasis of a primary
      adenocarcinoma of the lung into the adrenal gland) were analysed for the
      proteinases tissue-type plasminogen activator (tPA), urokinase-type plasminogen
      activator inhibitor (PAI-1). The proteinases were characterized by activity
      measurements, inhibition studies, enzyme-linked immunosorbent assay (ELISA), and
      Western blot analysis. Cell-associated proteinases were determined in cell
      lysates, secreted proteinases in cell conditioned culture media. Both cell lines
      were found to secrete uPA and PAI-1, whereas tPA could be detected only in HS-24
      conditioned media. No cathepsin B activity could be detected in media of both
      cell lines. However, activation experiments and western blot analysis showed,
      that at least HS-24 secrete an inactive precursor. Cell lysates of HS-24 and SB-3
      show PA activity, but on a low level. Cathepsin B activity was also found to be
      low in HS-24 lysates. However, SB-3 lysates show high cathepsin B activity.
      Further characterization of the proteinases by their sensitivity against several
      inhibitors suggests that they are similar to the corresponding proteinases of
      normal, nonmalignant cells.

PMID- 2222861
TI  - Subcellular distribution of adenine nucleotides in two Ehrlich cell lines
      metabolizing glucose.
AB  - Adenine nucleotide compartmentation and cytochrome redox state were studied in
      two Ehrlich ascites tumor cell lines incubated in the presence of 5mM glucose to
      show differences between their energy metabolisms. Changes in the subcellular
      distribution of adenine nucleotides were very different in both cell lines.
      Glucose seemed to energize the less malignant cell line, as shown by the
      asymmetry of the ATP/ADP ratios between cytosolic and mitochondrial compartments,
      but this was not the case for the more malignant cell line. The cytochrome
      contents were similar in both cell lines, but the degree of cytochrome oxidation
      was higher in the less malignant cell line; this result is in agreement with a
      higher oxygen consumption in the less malignant cell line.

PMID- 2222862
TI  - Nucleotide sequences of Bacillus stearothermophilus ribosomal protein genes: part
      of the ribosomal S10 operon.
AB  - Restriction fragments from Bacillus stearothermophilus chromosomal DNA were cross
      hybridized with the Escherichia coli ribosomal protein L2 gene rplB. A 2-kb EcoRI
      fragment which showed cross-hybridization was cloned into the M13 phage and
      sequenced by the dideoxy chain-terminating method. Comparison of the deduced
      amino-acid sequences with the corresponding sequences of E. coli ribosomal
      proteins showed that this fragment contains the region encoding the C-terminus of
      L2, the genes encoding S19, L22, S3 as well as the N-terminus of L16. Thus the
      organization of this gene cluster is the same as that in the S10 operon of E.
      coli. The deduced sequences of proteins L22 and S3, which have not been
      determined so far, were found to have 52% or 55% amino-acid identity,
      respectively, with those of the corresponding proteins in E. coli. The deduced B.
      stearothermophilus S19 protein sequence was in accordance with the reinvestigated
      protein sequence (H. Hirano, personal communication).

PMID- 2222864
TI  - The complete primary structure of alpha-lactalbumin isolated from pig (Sus
      scrofa) milk.
AB  - The complete amino-acid sequence of pig alpha-lactalbumin has been determined. It
      was obtained by microsequencing of the native protein and the peptides derived
      after tryptic or cyanogen bromide cleavage. The tryptic peptides were separated
      by a rapid microbore HPLC method. Pig alpha-lactalbumin is 122 amino acids long
      and differs from the bovine homologue by 26 exchanged residues. Of the two
      prolines present in bovine alpha-lactalbumin, one has been deleted in the pig
      structure. All previously sequenced alpha-lactalbumins have shown glutamic acid
      at position 49, which is known to be the active site in the homologous lysozyme c
      structure. This residue is replaced by phenylalanine in pig alpha-lactalbumin
      indicating that the pig protein is the first alpha-lactalbumin with complete loss
      of all lysozyme functional residues.

PMID- 2222863
TI  - Primary structure and oxygen-binding properties of the hemoglobin from guanaco
      (Lama guanacoe, Tylopoda).
AB  - The primary structure of the hemoglobin from guanaco (Lama guanacoe, Tylopoda) is
      presented. It could be separated into the chains by CM-cellulose chromatography.
      The sequences have been determined by automatic Edman degradation with the film
      technique or gas phase method, using the native chains and the tryptic peptides
      of the oxidized chains as well as a fragment obtained by acid hydrolysis. Guanaco
      hemoglobin has identical alpha-chains with alpaca and identical beta-chains with
      all Lama species with the exception that one guanaco in this study had alanine
      and serine in the ratio 1:1 in position beta 135 whereas a second individual had
      alanine only. Since the data suggest that the domesticated species llama and
      alpaca originate from the guanaco, it seems likely that beta 135Ala is the common
      form. Guanaco, llama, and alpaca show a comparable high blood oxygen affinity,
      caused by the substitution beta 2(NA2)His----Asn, as an adaptation to life at
      high altitude.

PMID- 2222865
TI  - Prevention and management of complications occurring during treatment with
      clomifene.

PMID- 2222866
TI  - Adverse reactions and interactions with aspirin. Considerations in the treatment
      of the elderly patient.
AB  - Aspirin (acetylsalicylic acid) is probably the most frequently used medication,
      and its use is generally uneventful. However, aspirin is also noted for numerous
      side effects and drug interactions that can complicate the course of therapy. The
      elderly, especially those with complicated medical histories, are more prone to
      the adverse effects of salicylates and may develop gastrointestinal tract
      bleeding, renal insufficiency, asthma and CNS toxicity. In the clinical
      situation, important drug interactions can occur with concurrent use of
      anticoagulants, sulphonylureas, diuretics, methotrexate and antacids. In long
      term aspirin therapy, enteric-coated or nonacetylated forms of aspirin are
      associated with fewer side effects and may be better tolerated. Monitoring of
      therapy (especially in the higher risk patient), with frequent assessments of the
      clinical state and measurements of serum creatinine, electrolytes and salicylate
      concentrations, may diminish the likelihood of toxicity.

PMID- 2222871
TI  - Medico-legal collars--time for a consensus to agree to disagree.

PMID- 2222870
TI  - Poisoning by thallium. A study of five cases.
AB  - Thallium poisoning seldom occurs in Spain. This article reports 5 cases of
      thallium poisoning, of which 4 of the patients belonged to the same family. The
      cases occurred in or near Granada between 1985 and 1987. The symptoms were
      initially gastrointestinal (vomiting, abdominal pain, gastrointestinal
      haemorrhage, etc.) in the case of the family poisoning, and a sensitive-motor
      polyneuritis in the fifth case. The diagnosis was established by analysis carried
      out in the authors' laboratory; urinary thallium concentrations were determined
      by atomic absorption spectrophotometry with graphite furnace and monovalent
      hollow cathode lamp. Each case was followed up to confirm the efficacy of the
      treatment; recovery from the poisoning was complete in all cases after 3 to 9
      weeks.

PMID- 2222868
TI  - A risk-benefit assessment of estrogen therapy in postmenopausal women.
AB  - Estrogen therapy is extremely effective in relieving menopausal symptoms such as
      hot flushes, night sweats, urogenital atrophy and certain psychological symptoms.
      The short term side effects from this therapy are usually mild and self-limiting.
      They are more common in women who commence hormone replacement therapy some years
      after the menopause than in those who start treatment at about the time of the
      ovarian failure. Pre-existing gynaecological conditions such as fibroids and
      endometriosis can be worsened by estrogen therapy. The majority of published
      studies suggest a beneficial effect of postmenopausal estrogen therapy on
      cardiovascular and cerebrovascular disease. These effects may be mediated by
      favourable changes in lipids, but other mechanisms may also be involved. It is
      uncertain whether the adverse changes in lipids caused by progestogen therapy
      will reduce any of the benefits of estrogen therapy on the cardiovascular system.
      Osteoporosis is the major bone disease of the Western world; long term estrogen
      therapy will prevent its development in most postmenopausal women. The risk of
      endometrial carcinoma is increased with unopposed estrogen therapy; this
      increased risk appears to be abolished if a progestogen is added at an adequate
      dose and duration for each cycle. The risk of ovarian or cervical cancer is not
      increased with estrogen therapy. There may be an increased risk of breast
      carcinoma with long term postmenopausal estrogen use, but the studies show
      inconsistent results.

PMID- 2222872
TI  - Plasticity in the adult and neonatal central nervous system.
AB  - The adult nervous system is capable of plastic change; studies have shown that
      plasticity is part of normal adaptation to daily life as well as being part of
      the response to trauma. The structural substrates of plastic change are
      described, and the hypotheses for explaining functional recovery in adults
      following trauma are reviewed. Events in normal brain development are summarized,
      and experiments designed to investigate the processes involved are described. The
      brain of the neonate is a much more plastic structure than that of the adult,
      both in normal development and in response to trauma. Activity in pathways is an
      essential component for consolidation of connections, whether normal or
      compensatory. Experiments which elucidate the mechanisms of axonal/target
      recognition are described. Recent work on the possible development of therapeutic
      agents to enhance recovery from trauma, in both adults and neonates, is reviewed.
      An attempt is made to link the findings from basic research to the clinical
      field.

PMID- 2222867
TI  - Problems and pitfalls in the use of benzodiazepines in the elderly.
AB  - Benzodiazepines are frequently prescribed for elderly patients living in the
      community and for those in hospitals and institutions. Their use is more
      prevalent in women. Prolonged use of benzodiazepines is particularly likely in
      old age for the treatment not only of insomnia and anxiety, but also of a wide
      range of nonspecific symptoms. Long term users are likely to have multiple
      concomitant physical and psychological health problems. The distinction between
      benzodiazepine anxiolytics and hypnotics is difficult and somewhat arbitrary,
      since the differences between the compounds are less than their similarities,
      especially in respect of adverse reactions. Despite their wide therapeutic range,
      elderly patients are particularly prone to adverse reactions to benzodiazepines.
      The incidence of unwanted effects, predominantly manifestations of central
      nervous system depression, has been found to be significantly increased in
      hospitalised elderly patients, particularly in the frail elderly. Studies on
      unwanted effects during long term use are scarce, but there is some evidence of
      tolerance to side effects. However, benzodiazepines have been found to be
      frequently implicated in drug-associated hospital admissions. There is suggestive
      evidence that benzodiazepines, especially compounds with long half-lives, may
      contribute to the falls which are a major health problem in old age. The
      incidence of benzodiazepine dependence in elderly patients is unknown. The
      features of benzodiazepine withdrawal in the elderly may differ from those seen
      in young patients; withdrawal symptoms include confusion and disorientation which
      often does not precipitate milder reactions such as anxiety, insomnia and
      perceptual changes. Problems due to both adverse reactions and to benzodiazepine
      withdrawal may easily be overlooked in multimorbid elderly patients, particularly
      in those suffering from disorders of the central nervous system. There are
      numerous studies on benzodiazepine pharmacokinetics indicating that alterations,
      especially in distribution and elimination of certain compounds, occur in old
      age. Benzodiazepines with oxidative metabolic pathways and longer half-lives are
      likely to accumulate with regular administration. However, changes in
      pharmacodynamics may be more important to explain altered responses to
      benzodiazepines in the elderly. Although information on pharmacodynamics is still
      limited, there is convincing evidence of increased pharmacodynamic response in
      the elderly which may be further accentuated by disease factors. Since the
      variability of pharmacological response increases with age and is not always
      predictable, there is good reason at least to start therapy at lower doses and to
      titrate dosages individually. This may also be appropriate for the newer
      benzodiazepines, irrespective of advantageous pharmacokinetics.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2222873
TI  - Brain abscess in the 1980s.
AB  - Brain abscess was reviewed in 24 patients admitted to University Hospital,
      Nottingham over a period of 3 years. Chronic ear infection was the most common
      predisposing factor, but in 11 patients the focus of infection remained unknown.
      CT scanning, carried out in all patients, was negative in one patient with
      clinical signs of meningitis. Polymicrobial and anaerobic infections were common.
      Actinomyces species were isolated in mixed culture from seven patients; in five
      the abscess was located in the cerebellum. Therapy was most often a combination
      of surgical drainage and antimicrobial therapy with beta-lactam agents and
      metronidazole. Evidence suggests that cefotaxime may offer a suitable alternative
      to chloramphenicol and benzylpenicillin in the treatment of brain abscess.

PMID- 2222874
TI  - Cranial intradural abscess management of 641 patients during the 35 years from
      1952 to 1986.
AB  - The changes in management of intradural brain abscess at Groote Schuur Hospital
      for the 35 years 1952-1986 are reviewed. An improvement in mortality was found
      from 45% for 1952-1965 (period A), to 27% for 1966-1976 (period B); and lastly to
      17% for 1977-1986 (period C). The improvement in the results was associated with
      the use of computed axial tomography (CT) and metronidazole. Abscesses secondary
      to ear infection were the commonest while those following trauma represented the
      second most frequent etiological group. Among the 26 cases of pulmonary origin in
      period C, 12 had pulmonary tuberculosis. Comparison of the outcome for patients
      presenting with Glasgow coma scale (GCS) 15 showed 39% mortality for period A
      compared with 3.5% in period C. Those patients who were comatose with GCS 8-3 had
      mortalities of 70 and 59% in periods A and C, respectively, indicating the
      importance of early diagnosis which has been facilitated by the advent of CT.

PMID- 2222869
TI  - An introduction to the clinical toxicology of volatile substances.
AB  - Acute poisoning with organic solvents and other volatile compounds now usually
      follows deliberate inhalation (volatile substance abuse) or ingestion of these
      compounds. Solvents from adhesives, typewriter correction and dry cleaning
      fluids, cigarette lighter refills (butane) and aerosol propellants are commonly
      abused. The major risk is that of sudden death. Arrhythmias leading to cardiac
      arrest are thought to cause most deaths, but anoxia, respiratory depression and
      vagal stimulation leading to cardiac arrest may also contribute, as may indirect
      causes such as aspiration of vomit or trauma. In the United Kingdom (UK), 3.5 to
      10% of young people have at least experimented with volatile substance abuse and
      mortality is more than 100 per annum. The products abused are cheap and readily
      available despite legislation designed to limit supply. Volatile substance abuse
      is not illegal and only a minority of abusers are known to progress to heavy
      alcohol or illicit drug use. Prevention of abuse by education, not only of
      children but also of parents, teachers, retailers and health care workers, is
      important in limiting the problem. However, volatile substance abuse-related
      deaths are still increasing in the UK despite many measures aimed at prevention.
      Clinically, volatile substance abuse is characterised by a rapid onset of
      intoxication and rapid recovery. Euphoria and disinhibition may be followed by
      hallucinations, tinnitus, ataxia, confusion, nausea and vomiting. It is important
      not to further alarm the patient if signs of serious toxicity are present, since
      a cardiac arrest may be precipitated. Further exposure should be prevented and
      the patient resuscitated and given supplemental oxygen if necessary. Cardiac
      arrhythmias should be treated conventionally and respiratory failure managed
      supportively. Long term exposure to n-hexane is associated with the development
      of peripheral neuropathy, while prolonged abuse (notably of toluene or
      chlorinated solvents) can cause permanent damage to the central nervous system,
      heart, liver, kidney and lungs. Knowledge of the routes of absorption,
      distribution and excretion of volatile compounds, and of the rates governing
      these processes, is important in understanding the rate of onset, intensity and
      duration of intoxication, and rate of recovery after volatile substance abuse. In
      addition, such knowledge is helpful when the clinician is attempting to interpret
      the results of toxicological analyses performed on samples (blood, other tissues,
      urine) from such patients. Many volatile substances are partly metabolised, the
      metabolites being eliminated in exhaled air or in urine. Although metabolism
      normally results in detoxification, enhanced toxicity may also result as with
      carbon tetrachloride, chloroform, dichloromethane, n-hexane, trichloroethylene
      and possibly halothane.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2222875
TI  - Brain abscess: with special reference to infection by pseudomonas.
AB  - Eighty cases of brain abscess treated in the University Hospital, BHU, Varanasi,
      India have been reviewed. Chronic suppurative otitis media was the commonest
      cause, followed by compound injuries. The overall mortality was 15%. In seven
      cases the causative organism was pseudomonas, resistant to most antibiotics.
      Prior to the availability of CT the mortality was 23.3%; after the routine use of
      CT for diagnosis the mortality fell to 10%. A high mortality (57%) was observed
      in patients who had pseudomonas. The best results were in patients who had been
      managed by excision of the abscess capsule.

PMID- 2222876
TI  - The management of patients with an intrinsic supratentorial brain tumour.
AB  - The management of patients presenting with supratentorial glioma between 1978 and
      1986 is reviewed. Complete follow-up in 517 cases was obtained. One hundred and
      fifty eight patients were not submitted to any form of surgery, 299 patients were
      biopsied and 60 patients underwent craniotomy and internal decompression. The no
      surgery group contained a higher proportion of patients with poor prognostic
      indicators than either the biopsy or craniotomy groups. The craniotomy group
      consisted of patients with better prognostic indicators than the biopsy group, in
      particular, younger age and more favourable site, type and grade of tumour. This
      was reflected in the difference in outcome between the groups. Median survival
      was 14 months in the craniotomy group, four months in the biopsy group and 2.2
      months in the no surgery group. The outcome in patients with histologically
      proven malignant gliomas was best in those patients who received radiotherapy.
      The craniotomy group had a median survival of 18.5 months, a two year survival of
      48% and a five year survival of 9%. The median survival following radiotherapy of
      those patients with proven malignant gliomas who had a biopsy was 9.5 months with
      a two year survival of 16% and a five year survival of 2%. These results compare
      favourably with studies which have adopted a more aggressive approach, suggesting
      that outcome is determined as much by patient selection using favourable
      prognostic indicators as by the treatment itself. The need for prospective trials
      of the management of unselected consecutive glioma patients randomizing them to
      conservative and radical treatment groups in order to define the role of both
      conventional therapy and radical therapy is discussed.

PMID- 2222877
TI  - Facio-hypoglossal anastomosis for the treatment of facial palsy after acoustic
      neuroma resection.
AB  - Despite current micro-neurosurgical techniques the facial nerve may be
      irrecoverably damaged in up to 40% of operations for large acoustic neuromas. The
      results of 121 facio-hypoglossal anastomoses performed since 1960 for post
      operative facial palsy are reported. Patients began to recover facial function
      after an average of 2.5 months and at final follow-up 91% had good function
      (grade 2 or 3 according to Lye3). The functional result was dependent on the age
      of the patient, those over 50 years having a poorer, but still acceptable result.
      The result was not critically dependent on the delay in performing the procedure;
      in 10 patients with non-functioning but nevertheless intact nerves, the procedure
      was delayed for 12-15 months to allow for spontaneous recovery, with little
      detriment to outcome. There was no operative mortality and only minimal morbidity
      from hypoglossal loss.

PMID- 2222878
TI  - Recurrent lumbar disc protrusion.
AB  - Seventy-six patients who underwent re-operation for recurrent lumbar disc
      protrusion were analysed to define the pattern of disc recurrence and the outcome
      following the operation. Whereas recurrence after an L4/5 discectomy occurred at
      the same level in 66%, recurrence after an L5/S1 discectomy was as likely to
      occur at L4/5 as at L5/S1. Outcome was inversely related to the number of
      operations. A satisfactory outcome after the first procedure was usually
      associated with a satisfactory ultimate outcome. Associated complications were
      few but of a severe nature.

PMID- 2222879
TI  - Pain and spinal cysts in paraplegia: treatment by drainage and DREZ operation.
AB  - About 10% of paraplegics suffer from intractable pain. The onset of pain may be
      immediate or delayed for months to several years after the injury. The delayed
      onset of pain is highly suggestive of the development of a spinal cyst. This is a
      report of 18 paraplegics who developed a delayed onset of intractable pain who
      were found at the time of surgery to have associated spinal cord cysts. Treatment
      consisted of the dorsal root entry zone (DREZ) operation in addition to
      evacuation of the cyst. Burning pain was the most common complaint occurring
      years after the trauma. In this study we compared the relationship between the
      onset and character of the pain, the time of the spinal injury, the operative
      findings, and the results of the DREZ procedure and evacuation of the traumatic
      spinal cyst. We believe that the combination of paraplegia, pain and spinal cyst
      has not been emphasized in the neurosurgical literature although it is well known
      that cystic formation can follow spinal trauma. Two patients developed spinal
      cysts with nontraumatic lesions of the spinal cord. A single cyst was found in 14
      patients while four had two separate cysts. The diagnosis was made on the basis
      of history and clinical examination with radiographic confirmation using delayed
      CT scan and myelography and more recently magnetic resonance imaging.
      Intraoperative ultrasound was employed in the study of some patients. All
      patients were treated with combined DREZ lesions and evacuation of the cysts with
      good pain relief in 77.7%.

PMID- 2222880
TI  - Trephine approach to anterior midline aneurysms--an initial communication.
AB  - The outcome of two groups of patients wtih midline aneurysms exposed by two
      different approaches was compared. The initial results support a clinical
      impression that a trephine approach has the following advantages: (1) adequate
      exposure with the best possible anatomical orientation and (2) a reduced
      morbidity.

PMID- 2222881
TI  - Intracranial ectopic pituitary tumour.
AB  - Pituitary tumours originating primarily from sites other than the sella turcica
      are rare. A case of an ectopic pituitary tumour in the region of the lesser wing
      of the sphenoid is reported. The patient presented with signs and symptoms of a
      progressive increase in intracranial pressure. CT scan appearances resembled
      those of a sphenoid wing meningioma. The vascular lesion was partially excised.
      Histology showed it to be a pituitary tumour.

PMID- 2222882
TI  - Giant cell tumour of the sphenoid bone with coincidental galactorrhoea--a case
      report.
AB  - A case of the rare giant cell tumour involving the sphenoid bone is reported. The
      usual presentation of these tumours is headache and cranial nerve deficits. This
      25-year-old lady presented with oligomenorrhoea and galactorrhoea. Investigations
      demonstrated an asymptomatic erosive mass lesion in the sphenoid with suprasellar
      extension and extension into the nasopharynx. The tumour was partially resected
      via the transphenoidal route. The differential diagnosis and treatment of these
      lesions are discussed.

PMID- 2222883
TI  - Pituitary adenoma causing classical migraine.
AB  - A case of pituitary adenoma associated with classical migraine is described. The
      resolution of symptoms following removal of the tumour suggests a causal link.

PMID- 2222884
TI  - Traumatic aneurysm of the superficial temporal artery from fist injury.
AB  - A case of traumatic aneurysm of the superficial temporal artery (STA) from fist
      injury during a basketball game is described. The published cases of STA
      aneurysms secondary to sport trauma and their diagnosis and treatment are
      reviewed.

PMID- 2222886
TI  - Preservation of hearing in acoustic nerve tumours.

PMID- 2222885
TI  - Nimodipine and cerebral ischaemia following subarachnoid haemorrhage.

PMID- 2222887
TI  - Post-traumatic syringomyelia.

PMID- 2222888
TI  - Intra-operative brain swelling.

PMID- 2222889
TI  - Post-traumatic parosmia treated by olfactory nerve section.

PMID- 2222890
TI  - Distribution of GABA-like immunoreactivity in the central nervous system of the
      cockroach, Periplaneta americana (L.).
AB  - Gamma-aminobutyric acid (GABA) is one of the most frequently occurring
      neurotransmitters in the central nervous system. Using an antiserum against a
      GABA-protein conjugate, this has also been demonstrated for insects. The
      distribution of GABA-like immunoreactive neuronal elements within the central
      nervous system of the insect Periplaneta americana has been investigated by means
      of immunocytochemistry. An overview of the distribution of neuronal elements with
      GABA-like immunoreactivity (GLIR) in the brain is given. The ventral nerve cord
      was extensively investigated. The highest number of neurons with GLIR was
      estimated in the metathoracic ganglion (ca. 1000). The function of the
      suboesophageal ganglion as an inhibitory centre for the central nervous system
      was further confirmed by the high number of GABAergic elements and descending
      GABAergic pathways within the ventral nerve cord. A GABAergic innervation of
      skeletal musculature by so-called common inhibitory neurons was revealed for the
      legs of cockroaches. Nevertheless, GABA mainly seems to be a neurotransmitter in
      central interneurons. Identical distribution patterns of neuronal elements after
      immunofluorescence double-staining with anti-GABA antibodies and antibodies
      against the GABA-synthesizing enzyme glutamic acid decarboxylase demonstrated the
      high specificity of the anti-GABA serum used in this paper.

PMID- 2222891
TI  - Neuron-specific monoclonal antibodies raised against the low molecular weight
      fraction of a brain homogenate of the pond snail Lymnaea stagnalis immunoreact
      with neurons in the central nervous system of the cockroach, the guppy, the wall
      lizard, the rat and man.
AB  - Monoclonal antibodies were raised against the small molecular weight fraction
      (less than 30 kilodaltons) of an extract from 200 central nervous systems (CNS)
      of the freshwater snail Lymnaea stagnalis. In a first screening step the
      supernatants of the 297 emerging hybridomas were immunocytochemically tested on
      sections of the CNS of L. stagnalis. Sixty-six appeared to produce neuron
      specific antibodies, five reacted with non-neuronal elements. In a second step
      the 66 neuron-specific antibodies were tested on sections of the CNS of the
      guppy. Three reacted positively. In the third step the three antibodies were
      tested on the CNS of the rat. One antibody (Mab4H5) appeared to give positive
      results. In the snail brain Mab4H5 stains two identified giant neurons, one in
      the visceral ganglion (VD1), and one in the right parietal ganglion (RPD2)--these
      neurons form part of the network controlling the respiratory system--and a small
      number of cells in the cerebral ganglia (in the anterior and ventral lobes).
      Ultrastructural observations using immunogold labelling in VD1 showed the antigen
      to be localized to the secretory vesicles. In the guppy Mab4H5 stains fibres in
      the tectum and cell bodies in the reticular formation. In rat CNS staining was
      observed in Purkinje neurons of the cerebellum, in cortical pyramidal neurons and
      in neurons and fibres in other brain areas. Subsequent Mab4H5 staining of the CNS
      of the lizard, the cockroach and parts of the human CNS showed that these tissues
      also contain Mab4H5-positive neurons. In the human cortex and cerebellum the
      staining pattern appeared to be similar to that of the rat. On the basis of the
      results it is hypothesized that the antibody reacts with phylogenetically ancient
      amino acid sequences.

PMID- 2222892
TI  - Differential expression of protein kinase C isozymes in rat cerebellum.
AB  - Protein kinase C (PKC) is a family of enzymes found throughout the body, with the
      greatest diversity and concentration in brain tissue. To understand further the
      differential role of PKC isozymes in brain, we have raised antibodies against
      four PKC isoforms--alpha, beta I, beta II and gamma--using specific amino acid
      sequences predicted from cDNA sequences. On Western blot of rat cerebellar
      homogenate, these antibodies stained a band of Mr 80,000, a known molecular mass
      for PKC, except for anti-PKC(beta II), which stained an additional minor Mr
      90,000 band. On rat cerebellar sections, specific sets of cells were stained by
      each antibody. In the molecular layer, stellate and basket cells were stained
      with anti-PKC(alpha) but not with anti-PKC(beta I), -(beta II), or -(gamma). Anti
      PKC (alpha) and anti-PKC(beta II) seemed to stain the Bergmann glial fibre. In
      the Purkinje cell layer, Purkinje cells were stained with anti-PKC[beta I) and 
      (gamma). Anti-PKC (alpha) and -(beta II) were negative. Interestingly, a few
      Purkinje cells were not stained with anti-PKC(gamma). In the granule cell layer,
      both granule and Golgi cells were stained with anti-PKC(beta I) and -(beta II)
      but not with anti-PKC(alpha) or -(gamma). Glial cells were stained with anti
      PKC(beta II) but not with anti-PKC(alpha), -(beta I), or -(gamma). This study
      suggests a differential distribution of PKC isoforms in different cells,
      irrespective of their neurotransmitters. The presence of both positive and
      negative staining of Purkinje cells with anti-PKC(gamma) raised the possibility
      of their heterogeneity.

PMID- 2222893
TI  - Distribution of glutamic acid decarboxylase messenger RNA-containing nerve cell
      populations of the male rat brain.
AB  - The distribution of glutamic acid decarboxylase (GAD) mRNA was investigated
      throughout the rat brain by means of in situ hybridization. Hybridization was
      carried out with a 35S-radiolabeled cRNA probe transcribed from a cDNA from cat
      occipital cortex and cloned in a SP6-T7 promoter-containing vector. Fixed tissue
      sections were hybridized with 35S GAD probe (0.6 kb length). Signal was detected
      by means of film or emulsion autoradiography. The autoradiograms were
      semiquantitatively evaluated by means of computer-assisted image analysis. The
      results obtained with this evaluation were correlated with the results of the
      semiquantitative analysis of GAD immunoreactivity performed by Mugnaini and
      Oertel. Specific labeling was only observed in neuronal cell bodies, whereas no
      labeling was found over neuropil, glial and endothelial cells. The highest
      labeling was found in the bulbus olfactorius (internal plexiform and granular
      layers) and in the caudal magnocellular nucleus of the hypothalamus. Strong
      labeling was observed in the Purkinje layer of the cerebellar cortex, the
      interpeduncular nucleus, the interstitial nucleus of Cajal, the nucleus of
      Darkschewitsch and the suprachiasmatic nucleus. Intermediate or low levels of GAD
      mRNA were present in various brain nuclei, where gamma-aminobutyric acid (GABA)
      containing cell bodies had been observed with other techniques. Interestingly, a
      low level of GAD mRNA was found in the caudate-putamen and nucleus accumbens,
      where the vast majority of nerve cells is known to contain GAD immunoreactivity.
      Only a poor correlation was found between the present semiquantitative
      measurements of GAD mRNA content and previous analyses of the number of GAD
      immunoreactive cell bodies. The present study demonstrates that there exists a
      differential regional expression of GAD mRNA. The comparison with cell counts
      performed by immunocytochemistry suggests that some brain areas, such as caudate
      putamen and nucleus accumbens, contain a large number of GAD-immunoreactive cell
      bodies which express a low level of GAD mRNA. The opposite seems to be true for
      other nuclei, such as the globus pallidus, the zona reticulata of the substantia
      nigra and the inferior collicle, where few GAD-immunoreactive cell bodies contain
      high levels of GAD mRNA. In conclusion, the present study gives a low
      magnification map of GAD mRNA levels in the adult male rat brain. Marked
      biochemical heterogeneities may be present among GABA neuronal populations based
      on their expression of GAD mRNA. The comparison between the present in situ
      hybridization and previous immunocytochemical studies suggests that there may
      exist at least two populations of GABA neurons in the brain, having high and low
      levels respectively of both GAD mRNA and GAD enzyme.

PMID- 2222894
TI  - Immunohistochemical mapping of delta sleep-inducing peptide in the cat brain and
      hypophysis. Relationships with the LHRH system and corticotropes.
AB  - Using the indirect immunofluorescence method, the distribution of the delta sleep
      inducing peptide was studied in the cat brain and hypophysis. Delta sleep
      inducing peptide-like-immunoreactive cell bodies mostly visualized in colchicine
      pretreated animals were mainly found scattered throughout the diagonal band of
      Broca, the ventral septum and the anterior hypothalamic areas. A few
      immunoreactive cell somata were also seen in the ventrolateral hypothalamic area
      and more occasionally in the triangular septal nucleus. The heaviest
      concentrations of delta sleep-inducing peptide-like-immunoreactive varicose
      fibres and terminal-like structures were observed in the septo-preoptic region,
      in the median eminence and pituitary stalk. Some other brain regions supplied
      with few delta sleep-inducing peptide-immunoreactive fibres included the fimbria
      fornix, the dorsal part of the subfornical organ, the medial habenular nucleus
      and more caudally, the periaqueductal gray. Elution-restaining experiments
      revealed that delta sleep-inducing peptide-like immunoreactivity frequently
      occurred in luteinizing hormone-releasing hormone-immunoreactive neurons and vice
      versa. At the pituitary level, delta sleep-inducing peptide-like immunoreactivity
      was detected in most, if not all, melanocorticotropes of the pars intermedia and
      further in a large subpopulation of corticotropes mainly located in the zona
      tuberalis of the pars distalis. Taken together these anatomical findings support
      the view that delta sleep-inducing peptide (or a closely related molecular form)
      could play a modulatory role at various levels of the hypothalamo-pituitary
      system.

PMID- 2222895
TI  - Cancer and diabetes: are there similarities?

PMID- 2222896
TI  - The consumer's risk in clinical trials.
AB  - In any formal statistical test of the null hypothesis (the statement that a
      population parameter is equal to a specific value), there are two possible types
      of error. Type 1 or alpha error has occurred if the investigator rejects the null
      hypothesis when it is true. For example, an experimental treatment is declared an
      advance over standard treatment when it is not. Type 2 or beta error has occurred
      if the null hypothesis is not rejected when it is false. In this case, the
      investigator concludes that the experimental treatment is no different than the
      standard when it actually is. The two types of error can be conceptualized,
      respectively, as the consumer's risk and the producer's risk. In many reports of
      clinical trial methodology, it is the producer's risk that is emphasized. It is
      understandable why producer's risk would be of concern to authors of clinical
      studies. There are, however, numerous potential sources of consumer's risk. It is
      the latter type of risk that is the primary subject of this report.

PMID- 2222897
TI  - The phylogeny of oncology.
AB  - A review of reproductive biology and oncologic immunology reveals striking
      similarities between the tolerance of neoantigen as demonstrated in pregnancy and
      cancer. The author discusses the phylogeny of sexual reproduction and the
      oncologic condition, and suggests that an evolved mechanism of acquired tolerance
      to HLA-incompatible tissue necessitated by sexual reproduction consequently
      provides a mechanism for the tolerance of cancer.

PMID- 2222898
TI  - Subcutaneous interleukin-2 and interferon-alpha 2b in patients with metastatic
      renal cell cancer: the German outpatient experience.
AB  - A phase II clinical trial was conducted using subcutaneous recombinant human
      interleukin-2 (rIL-2, EuroCetus) and subcutaneous interferon-alpha 2b (rIFN-alpha
      2b, Essex) in patients with advanced cancer. Safety and tolerance of this
      outpatient regimen were assessed in 17 patients with progressive metastatic renal
      carcinoma, 14 of whom were evaluable for clinical response to combined rIL-2 and
      rIFN-alpha 2b. In this study, rIL-2 was administered every 12 hours, at 1.5
      million (Cetus) U/m2 on days 1 and 2, followed by 0.3 million U/m2 5 days per
      week for 6 consecutive weeks. Concomitantly, rIFN-alpha 2b was given as 5 million
      U/m2 three times weekly for 6 consecutive weeks. Patients presenting with stable
      or regressive disease after 6 weeks of rIL-2 and rIFN-alpha 2b (11 of 14) were
      scheduled to repeat combination therapy. After one treatment cycle, five of 14
      patients presented with partial remission; two of these patients achieved
      complete regression of metastatic lesions. After therapy, six patients have been
      in stable disease for up to 8 months. toxicity of this regimen was moderate, with
      local inflammation of the injection sites, grade I-II (World Health Organization
      criteria) fevers, chills, malaise, nausea and/or vomiting, and anorexia in 70% to
      100% of patients treated. After 6 weeks of rIL-2 and rIFN-alpha 2b, laboratory
      evidence of treatment-related hypothyroidism and hyperthyroidism was obtained in
      one and four patients, respectively. Immunogenicity of sc rIL-2 was mostly
      limited to the development of nonneutralizing antibodies that occurred in
      approximately 40% of patients. None of the patients exhibited antibodies specific
      to rIFN-alpha 2b.

PMID- 2222900
TI  - Chronic recurrent aphthous stomatitis: oral treatment with low-dose interferon
      alpha.
AB  - Recombinant human interferon alfa-2a (HuIFN alpha) was administered orally once
      daily in a low concentration (1,200 IU/day) to nine patients with chronic
      recurrent aphthous stomatitis (RAS), and a placebo solution was given to 10
      control chronic RAS patients in a double-blind study. All HuIFN alpha-treated
      patients had total remission of their aphthae within a 2-week period, while
      placebo control patients had no change in their condition. The 10 placebo control
      patients were then treated with HuIFN alpha in a manner identical to that used
      for the initial principal group. Within a 2-week period, all original placebo
      patients had complete remission of their aphthae. Eleven of the patients did not
      have a recurrence of RAS during a subsequent 6-month observation period. Eight
      patients had recurring aphthae; however, the lesions were resolved by retreating
      with oral HuIFN alpha for less than 1 week.

PMID- 2222899
TI  - Phase II study of recombinant interferon alpha-C in patients with metastatic
      renal cell carcinoma.
AB  - Recombinant interferon alpha-C is a new strain of the alpha interferon family. It
      was given to 33 patients with measurable metastatic renal cell carcinoma of whom
      31 were evaluable. Protocol consisted of 3 million U/d for 2 weeks, then 3
      million U/m2 every other day until progression. No complete response was
      observed. Three patients (9.7%) had partial response for a mean duration of 5.6
      months and eight patients (25.8%) were stabilized for a mean of 4.3 months.
      Responsive sites were mainly lung, bone, and kidney, while side effects were
      generally mild. better results were observed in previously nephrectomized
      patients who had not received chemotherapy or hormonotherapy for recurrent or
      metastatic disease (p less than 0.05), and also in patients with a brief disease
      free interval and short delay from presenting symptoms of the primary tumor until
      interferon treatment (p less than 0.05). Median survival was significantly longer
      in responders than in progressors (p less than 0.05). We suggest that the
      efficacy of recombinant interferon alpha-C in a low-dose regime versus other
      types of interferon as first-line therapy for inoperable, metastatic, or locally
      recurrent renal cell carcinoma should be investigated in a prospective,
      controlled, randomized study.

PMID- 2222901
TI  - Inhibition of SA-1 tumor growth in mice by human leukocyte interferon alpha
      combined with low-level direct current.
AB  - A preliminary study of the antitumor effect of partially purified human
      interferon alpha (IFN-alpha) and low-level direct current (DC) was carried out
      using a murine subcutaneous SA-1 experimental tumor model. Tumor-bearing animals
      were treated with 5 x 10(4) IU IFN-alpha peritumorally, or with 0.6 mA DC current
      for 15 minutes daily, for 6 consecutive days. Antitumor effect was manifested 2
      days after the beginning of each treatment modality. Combined treatment with DC
      current applied immediately after IFN-alpha application was more effective than
      IFN-alpha treatment alone (P less than 0.005), but not significantly better than
      DC current treatment (P less than 0.5). The results indicate that the combined
      treatment with IFN-alpha and DC current can be effective in tumor therapy;
      however, further work is required to determine optimal scheduling.

PMID- 2222902
TI  - The effects of cyclophosphamide on the toxicity and immunogenicity of ricin A
      chain immunotoxin in rats.
AB  - We conducted a study to determine if treatment with cyclophosphamide (CY) could
      suppress the formation of anti-murine and anti-ricin A chain antibodies in rats
      treated with a murine monoclonal antibody-ricin A chain immunotoxin (IT). Female
      Sprague-Dawley rats received intravenous doses of IT at a dose of 5 mg/kg body
      weight alone or in combination with CY at a dose level of either 10 or 20 mg/kg
      body weight. The IT was given as one or two courses consisting of five
      consecutive daily intravenous injections (days 0 to 4, or days 0 to 4 and days 21
      to 25 of the study). Cyclophosphamide was given on days 2, 4, 6, 13, and 17 of
      the study to the group receiving a single course of IT; additional doses of CY
      were administered on days 23, 25, and 27 to the group receiving two courses of
      IT. On days 4, 14, 21, 28, and 35, animals from each group were evaluated for
      antibodies to murine IgG and ricin A chain, and for clinical laboratory
      parameters and histopathology. Animals receiving IT alone developed significant
      titers of both anti-murine and anti-ricin A chain antibodies. Compared with the
      response in the animals receiving single-course IT, the response to both of the
      components of the IT was significantly increased on days 28 and 35 in the animals
      receiving a second course of IT. The groups receiving a combination of either one
      or two courses of CY and IT demonstrated a significantly decreased antibody
      response to both the murine IgG and the ricin A chain compared with the group
      receiving IT alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222903
TI  - Application of scattering techniques in the domain of amphiphiles.
AB  - Light and neutron scattering techniques are discussed in connection with
      experiments on micellar solutions of gangliosides--amphiphilic molecules of
      biological origin. Micellar properties, like molecular weight, hydrodynamic
      radius and shape, are obtained with precise scattering measurements in conditions
      of negligible intermicellar interactions. It has also been verified that the GM1
      ganglioside micelle does not change molecular weight and shape on addition of
      salt. Scattering techniques are also shown to be useful in studying intermicellar
      interactions, like the Coulomb repulsion between GM1 micelles, in the regime fo
      the long-range interactions obtainable at very low ionic strength.

PMID- 2222904
TI  - Interactions of lipases with lipid monolayers. Facts and questions.
AB  - Among the proteins, lipolytic enzymes provide a valuable model for studying
      protein-lipid interactions. Lipases having a catalytic action which is strictly
      dependent upon the presence of a lipid interface were used in the present study
      in order to gain better insight into protein-lipid interactions. Most of the data
      presented here were obtained using the monolayer technique, by recording (either
      independently or simultaneously) the lipolytic activity, the amount of protein
      adsorbed to the lipid monolayer, and the surface pressure variations following
      protein adsorption. Several non-enzymatic proteins were used as controls in order
      to determine how lipase behaviour differs from that of other proteins. At all
      initial surface pressures tested, with zwitterionic monolayers, a good
      correlation was observed between the amount of lipase bound to the monolayer and
      the surface pressure increase, in agreement with previous studies. Conversely,
      with neutral lipid monolayers the amount of lipase bound to the monolayer was not
      found to be surface pressure dependent. This latter behaviour observed with
      lipases on neutral films is not specific to lipases, since it was also observed
      with bovine serum albumin and beta-lactoglobulin A. Lipase activity in the
      presence of various proteins was investigated with monomolecular films of
      glycerol didecanoate, either at constant surface area or at constant surface
      pressure. Depending upon the nature of the lipase and the protein, inhibition of
      lipase activity was either observed or not. Inhibition was correlated with a
      decrease in lipase surface concentration. The ability of the various proteins to
      inhibit lipolysis is: (i) a function of their excess versus lipase in the bulk
      phase, and: (ii) correlated with their penetration capacity (i.e., the initial
      rate of surface pressure increase of a glycerol didecanoate monolayer having an
      initial surface pressure of 20 dyn/cm, after the injection-of the protein). Since
      lipase inhibition was observed with low surface densities of inhibitory proteins,
      a long-range effect is probably involved in the mechanism of interfacial lipase
      inhibition. The nature of the ionic charge added to the monolayer by the protein
      is not critical for determining lipase adsorption or desorption. It is
      hypothesized that the lack of lipase adsorption to, or desorption from, the lipid
      monolayer results from a change in the organization of the hydrocarbon moiety of
      the lipid.

PMID- 2222905
TI  - CPA/Niccol lecture. Leisure and lifestyle in later life.

PMID- 2222907
TI  - Leg ulcers. Prevention is better than cure.

PMID- 2222906
TI  - Pressure area care. How effective are sheepskins?

PMID- 2222908
TI  - Dental care: the problem of being 'long in the tooth'.

PMID- 2222909
TI  - Living wills: going gently into the dark night.

PMID- 2222910
TI  - Understanding confusion.

PMID- 2222912
TI  - The ACE objectives.

PMID- 2222911
TI  - Nursing models: team work for personal patient care.

PMID- 2222913
TI  - Focus on support for those who care.

PMID- 2222914
TI  - The Alzheimer's Disease Society.

PMID- 2222916
TI  - "Genetic counseling": a "new" discipline with increasing impact on individuals,
      families and society.

PMID- 2222915
TI  - The time is ripe for a takeover.

PMID- 2222918
TI  - The fetal akinesia deformation sequence. A fetopathological approach.
AB  - In this paper we review the present knowledge on the etiological factors and
      pathogenetic mechanisms of the fetal akinesia deformation sequence, based on a
      fetopathological approach. Special attention is given to two sever, lethal
      subgroups i.e. the Pena-Shokeir I syndrome and the lethal multiple pterygium
      syndrome.

PMID- 2222917
TI  - The lethal multiple pterygium syndrome: a nosological approach.
AB  - The Lethal Multiple Pterygium Syndrome (LMPS) is characterised by lethality,
      multiple pterygia and frequently hydrops and/or hygroma colli. In this paper, we
      review 36 published cases, discuss the clinical features, pathogenesis,
      differential diagnosis and mode(s) of inheritance. Most cases were diagnosed in
      the second trimester of pregnancy by hydrops/hygroma colli at ultrasonography
      and/or stillbirth. Pterygia were present in two or more body areas overlying
      predominantly the large joints; joint contractures always accompany the pterygia.
      Facial features are: hypertelorism, antimongoloid slanting of the palpebral
      fissures, flattened nasal bridge with hyproplastic nasal alae, micrognathia and
      cleft palate. Lung hypoplasia is the rule. Except for hypoplastic bones there
      were no consistent radiological findings. Cerebral abnormalities were
      occasionally found; muscular atrophy was mentioned in a number of cases.
      Chromosome abnormalities were never reported. Based on clinical presentation we
      propose an "early type" of LMPS and a "late type" of LMPS. Besides, we consider
      the cases described by Herva as a separate "Finnish type" LMPS. We found an
      excess of male cases, especially in young fetuses. LMPS is known as an autosomal
      recessive inherited trait. X-linked recessive inheritance however cannot be
      excluded in an isolated male case or in a sibship with males only. The Finnish
      type of LMPS appears to be an autosomal recessive trait.

PMID- 2222919
TI  - A retrospective study of pregnancy complications among 828 cases of
      arthrogryposis.
AB  - 828 cases with multiple congenital contractures (arthrogryposis) were categorized
      and histories were reviewed to identify pregnancy complications. 53.0% of cases
      had a specified diagnosis or known cause and no diagnosis was found for 47.0% of
      which 27.2% were though to probably have a genetic basis and 19.8% were of
      unknown etiology. Our data provides no evidence to support the suggestion that
      arthrogryposis is frequently a result of environmental or structural causes
      including uterine structural anomaly, intra-uterine infection, etc. Normal
      frequencies of bleeding, hormone treatment during gestation, amniotic fluid
      leakage, uterine anomaly, maternal illness, and maternal and paternal age were
      noted. Apparent, increased frequencies of twinning, severe nausea, polyhydramnios
      and oligohydramnios were observed. In particular, the frequency of polyhydramnios
      was dramatically increased among lethal cases (vs survivors) and thus,
      polyhydramnios appears to be a poor prognostic sign when associated with
      decreased fetal movement. Large case control studies with complete pregnancy
      histories are needed to confirm these results and to definitively identify
      pregnancy complications that are useful "flags" to indicate decreased fetal
      movement in utero and thus, aid in the identification of primary causes of
      arthrogryposis.

PMID- 2222920
TI  - The echographic diagnosis of fetal akinesia. A challenge towards etiological
      diagnosis and management.

PMID- 2222921
TI  - The fetal akinesia sequence: pitfalls and difficulties in genetic counseling.
AB  - In this paper, we review the difficulties of genetic counseling in the fetal
      akinesia sequence. The ongoing progress in the nosological subclassification,
      thanks to the increasing number of fetopathological studies, is the basis and a
      condition sine qua non for accurate genetic counseling.

PMID- 2222922
TI  - On the nosology of moderate mental retardation with special attention to X-linked
      mental retardation. A diagnostic genetic survey of 274 institutionalized
      moderately mentally retarded men.
AB  - In this paper we report the results of a genetic-diagnostic survey of 274
      institutionalized moderately mentally retarded adult males and compare these data
      with those from our previous studies in the severely mentally retarded and from a
      comparable population of 262 institutionalized moderately mentally retarded males
      and females (The Borgenstein experience). Special attention is paid to the
      nosology of X-linked mental retardation and familial mental retardation in
      general.

PMID- 2222923
TI  - Angelman's syndrome and 15q11-q13 deletion.
AB  - We discuss the results of cytogenetic reinvestigation in 10 patients with
      Angelman's syndrome reexamined during the last year. A deletion with 15q11-13
      could be demonstrated in 6 of them, confirming that with the available
      cytogenetic techniques a 15q11-13 deletion is visible and detectable in at least
      half of the patients with this MCA/MR syndrome. On the other hand, the deletion
      could not be seen in two affected siblings. This indicates that de novo visible
      15q11-13 deletions with low recurrence risk and autosomal recessively inherited
      cases combine to give an overall sib recurrence risk of less than 25%.

PMID- 2222924
TI  - Craniosynostosis and low middle frequency perceptive deafness in mother and son.
      A distinct entity?
AB  - A distinct entity?: In this report we describe the hitherto unreported
      association of low and middle frequency perceptive deafness and craniosynostosis
      in mother and son. The occurrence of hearing loss in the craniosynostosis
      syndromes is briefly reviewed.

PMID- 2222925
TI  - Anodontia as the sole clinical sign of the ectrodactyly-ectodermal dysplasia
      cleft lip (EEC) syndrome.
AB  - In this report we present another family with oligosymptomatic expression of the
      EEC syndrome. A mother with complete absence of the permanent teeth had two
      children with split hand/split foot deformity, as typically seen in the EEC
      syndrome. Cleft lip/cleft palate was also present in one of them. The great
      variability in expression of this autosomal dominant syndrome is discussed and
      the difficulties in genetic counseling are emphasized.

PMID- 2222926
TI  - Hydrops fetalis associated with red cell pyruvate kinase deficiency.
AB  - A hydrops fetalis and multicystic encephalomalacia were diagnosed in a neonate
      who was one of twins. The co-twin had died 5 weeks prior to delivery. The most
      likely explantation for both hydrops and multicystic encephalomalacia was fetal
      anemia caused by a red cell pyruvate kinase deficiency, and aggravated by an
      intrauterine disseminated intravascular coagulation.

PMID- 2222927
TI  - True hermaphroditism: a new case with complex mosaicism.
AB  - True hermaphroditism is a very rare disorder of human sexual differentiation. In
      the medical literature, more than 450 cases are described, and about 250 true
      hermaphrodites have been subjected to chromosome studies. A 21-year-old "man" was
      examined because of genital and phenotypic abnormalities: clinical, surgical and
      laboratory investigations showed a true hermaphroditism, with a quadruple
      mosaicism 45,X/46,XX/46,XY/47,XXY. We believe that this is the first case in
      which this peculiar type of multiple mosaicism has been documented.

PMID- 2222928
TI  - A possible negative correlation between the frequency of chromosome lesions
      induced by folate-deficiency and age in individuals with the fra-Xq27.3 syndrome.

PMID- 2222929
TI  - In memory of Professor A. Franceschetti (1896-1968).

PMID- 2222930
TI  - Synthesis and structure of cytosine dichloride cuprate: direct binding of copper
      to cytosine.
AB  - Dichlorobis(cytosine)copper(II), [CuCl2-(C4H5N3O)2], Mr = 356.65, monoclinic,
      P2(1)/n, a = 8.399 (2), b = 13.773 (2), c = 10.775 (2) A, beta = 90.8 (2)
      degrees, V = 1246.3 (9) A3, Z = 4, Dx = 1.901 Mg m-3, lambda (Mo K alpha) =
      0.7107 A, mu = 2.195 mm-1, F(000) = 716, T = 298 K, R = 0.032, wR = 0.037 for
      2313 reflections greater than 2 sigma(F). The crystal structure of the title
      compound consists of two crystallographically independent cytosine molecules
      attached together through the direct bonding of a Cu2+ ion with two N atoms of
      the pyrimidine rings. In addition to the N atoms, the Cu ions are coordinated to
      two Cl atoms forming approximately a square-planar environment. The bond
      distances of Cu to Cl(1), Cl(2), N(3) and N(3') atoms are 2.299 (1), 2.267 (1),
      1.985 (4) and 1.996 (3) A, respectively. Packing of the Cyt(I)-CuCl2-Cyt(II)
      complex in the crystal is ensured by an extensive extramolecular N--H...Cl and N-
      H...O network. Hydrogen bonds involving Cl, O and H atoms of the neighboring
      Cyt(I) and Cyt(II) induce a slight distortion in Cu--Cl, C = O distances but do
      not significantly affect intramolecular bond lengths and angles in the cytosine
      rings and their flatness.

PMID- 2222931
TI  - Structure of the cyclohexapeptide cleromyrine II trihydrate.
AB  - C29H40N6O7.3H2O, Mr = 638.7, trigonal, P3(1)21, a = 14.190 (2), c = 29.833 (4) A,
      V = 5202 (1) A3, Z = 6, Dx = 1.22 g cm-3, Cu K alpha, lambda = 1.54178 A, mu =
      7.8 cm-1, F(000) = 2052, T = 291 K, R = 0.069 for 1942 observed reflections. The
      new cyclohexapeptide cleromyrine II was isolated from Clerodendrum myricoides.
      Its structure was established by spectroscopic and X-ray diffraction methods as
      cyclo(-Gly-Tyr-Gly-Pro-Leu-Pro-). The conformation essentially consists of two
      beta-turns including the Pro residues and one central very short antiparallel
      beta-sheet stabilized by two intramolecular hydrogen bonds: N(Tyr2)...O(Leu5) =
      2.94 (2) A and N(Leu5)...O(Tyr2) = 3.02 (2) A.

PMID- 2222932
TI  - Structure of (+)-(7S,SS)-1,2,3,5,6,7-hexahydro-7-methyl-8-(p-tolylsulfinyl)-5
      indoli zinone.
AB  - C16H19NO2S, Mr = 289.39, orthorhombic, P2(1)2(1)2(1), a = 11.467 (5), b = 17.207
      (8), c = 7.566 (4) A, V = 1493 (2) A3, Z = 4, Dx = 1.29 g cm-3, lambda(Mo K
      alpha) = 0.71069 A, mu = 2.07 cm-1, F(000) = 616, T = 296 K, R = 0.049, 928
      unique observed reflections. The structure determination combined with the known
      S configuration at the sulfur site discloses the stereochemistry of the title
      compound to be 7S and SS.

PMID- 2222933
TI  - Structure of (+/-)-(1R*,4S*,6S*)-1-benzyloxy-4,8,11,11-tetramethyl-6- phenylthio
      bicyclo[5.3.1]undec-7-en-3-one.
AB  - C28H34O2S, Mr = 434.64, triclinic, P1, a = 8.9868 (7), b = 11.2933 (11), c =
      12.3497 (6) A, alpha = 80.937 (6), beta = 73.108 (5), gamma = 87.405 (7) degrees,
      V = 1184.32 (15) A3, Z = 2, Dx = 1.22 g cm-3, mu = 1.509 cm-1, Mo K alpha
      radiation, lambda = 0.7107 A, F(000) = 468, T = 298 K, R = 0.0583 for 6924
      reflections [Fo greater than or equal to 4 sigma(Fo)]. The cyclooctane portion of
      the [5.3.1] ring system is in the boat-chair conformation while the cyclohexene
      portion assumes the boat conformation. The carbonyl group and the alkene group
      are nearly parallel in the molecule with a dihedral angle of 14.9 (1) degree
      between planes through the two groups. Ring strain appears to cause distortion in
      the alkene functionality. The bond length [C7-C8 1.343 (2) A] is long for an
      isolated C-C double bond. The torsion angles deviate between 3.7 (2) and 18.39
      (14) degrees (absolute values) from ideality. This twist in the alkene group is
      reflected in the non-planarity of the group [max. deviation -0.177 (2) A for C9]
      and in the dihedral angle between the nearly planar portions (C6,C7,C8,C11 and
      C7,C8,C9,C16) which is 12.1 (1) degrees.

PMID- 2222935
TI  - Structure of 6 alpha-methyl-3,20-oxo-1,4,9(11)-pregnatrien-17 alpha-yl acetate.
AB  - C24H30O4, Mr = 382.5, orthorhombic, P2(1)2(1)2(1), a = 13.091 (2), b = 19.711
      (1), c = 8.242 (1) A, V = 2126.7 (5) A3, Z = 4, Dx = 1.195 Mg m-3, lambda(Cu K
      alpha) = 1.54184 A, mu(Cu K alpha) = 0.56 mm-1, F(000) = 824, T = 295 K. Final R
      = 0.045 for 2446 unique reflections. The planar A ring is bent relative to the
      rest of the steroid skeleton. The B ring has a typical chair conformation and the
      C and D rings assume 13 beta,14 alpha-half-chair and 13 beta-envelope
      conformations, respectively. The conformation of the progesterone side chain is
      similar to the conformation observed in other 17 alpha-ester pregnanes: C16-C17
      C20-O20 torsion angle -27.4 (3) degrees.

PMID- 2222934
TI  - Structure of (+/-)-(1S*,3S*)-3-hydroxy-8,11,11-trimethyl-9-oxobicyclo[5.3.1]undec
      7- en-1-yl benzoate.
AB  - C21H26O4, Mr = 342.43, monoclinic, P2(1)/n, a = 7.211 (2), b = 19.521 (6), c =
      12.674 (3) A, beta = 95.04 (2) degrees, V = 1777.2 (8) A3, Z = 4, Dx = 1.28 g cm
      3, Mo K alpha radiation, lambda = 0.7107 A, mu = 0.8152 cm-1, F(000) = 736, T =
      163 K, R = 0.0632 for 3754 reflections [Fo greater than or equal to 4 sigma(Fo)].
      The molecules exist as hydrogen-bonded dimers [O14-H14...O16 (related by -x, 1-y,
      1-z), O14...O16 2.775 (2), H14...O16 1.93 (2) A, O14-H14...O16 175 (2) degrees]
      which stack in columns along b. Distortion at the bridgehead double bond is
      observed. Deviations from ideal values for the torsion angles around the double
      bond, C7-C8, are as large as 17.8 (2) degrees. The dihedral angle between planes
      through C6-C7-C8-C11 and C7-C8-C9-C15, the planar portions of the alkene moiety,
      is 13.4 (9) degrees. The Csp2--Csp3 bond lengths involving C7 are asymmetric with
      C7-C6 1.501 (2) and C7-C11 1.538 (2) A. The bond length C7-C8 is elongated [1.352
      (3) A] for a C-C double bond. The enone system is also non-planar [max. deviation
      -0.404 (2) A for C10].

PMID- 2222936
TI  - Structure of (+/-)-encecanescin.
AB  - C24H30O4, Mr = 382.5, orthorhombic, P212121, a = 13.091 (2), b = 19.711 (1), c =
      8.242 (1) A, V = 2126.7 (5) A3, Z = 4, Dx = 1.195 Mg m-3, lamba (Cu K alpha) =
      1.54184 A, mu(Cu K alpha) = 0.56 mm-1, F(000) = 824, T = 295 K. Final R = 0.045
      for 2446 unique reflections. The planar A ring is bent relative to the rest of
      the steroid skeleton. The B ring has a typical chair conformation and the C and D
      rings assume 13 beta,14 alpha-half-chair and 13 beta-envelope conformations,
      respectively. The conformation of the progesterone side chain is similar to the
      conformation observed in other 17 alpha-ester pregnanes: C16-C17-C20-O20 torsion
      angle -27.4(3) degrees.

PMID- 2222938
TI  - Electrostatic properties of cytosine monohydrate from diffraction data.
AB  - The charge density distribution in deuterated cytosine monohydrate [4-(2H2)-amino
      2(1H)-(1-2H)-pyrimidinone], C4H2D3N3O.D2O, Mr = 134.15, monoclinic, P2(1)/c, a =
      7.714 (1), b = 9.825 (1), c = 7.506 (2) A, beta = 100.52 (1) degrees, Z = 4, has
      been determined from 1432 X-ray reflections [sin theta/lambda less than 1.15 A-1,
      Mo K alpha, lambda = 0.7093 (1) A] collected at 82 (2) K. Least-squares structure
      refinement assuming Stewart's rigid pseudoatom model gave R(F) = 0.041, with all
      nuclear positions and H/D anisotropic thermal parameters having fixed values
      previously determined by neutron diffraction. The cytosine and water molecules
      are both electrically neutral within experimental error (0.09 e). Molecular
      dipole moments are mu = 8.0 (1.4) debye for cytosine and 2.3 (3) debye for water.
      For the doubly hydrogen-bonded cytosine dimer (N1-D1...N3', N4-D4...O2') isolated
      from the crystal, the electrostatic energy of interaction is estimated to be -96
      (27) kJ mol-1. Maps of the electrostatic potential for molecules isolated from
      the crystal indicate that the electronegativity of the hydrogen-bonding acceptor
      sites can be ranked with the water O atom, cytosine N(3) and carbonyl O(2) in
      decreasing order.

PMID- 2222937
TI  - Structure of 3,4,5-trihydroxybenzoic acid octyl ester (octyl gallate) dihydrate
      at 123 K. A non-mesogenic amphiphilic molecule.
AB  - The crystal structure of 3,4,5-trihydroxybenzoic acid octyl ester (octyl gallate)
      dihydrate, C15H22O5.2H2O, is triclinic, P1, with a = 6.617 (1) [6.648 (1)], b =
      9.956 (2) [9.995 (3)], c = 14.088 (4) [14.327 (7)] A, alpha = 79.08 (2) [79.78
      (3)], beta = 85.58 (3) [86.59 (4)], gamma = 70.80 (2) [70.99 (3)] degrees, V =
      860.5 A3, Z = 2, Dx = 1.229 1.229 [1.183] g cm-3, lambda(Mo K alpha) = 0.7093 A,
      mu = 0.58 cm-1, F(000) = 344 at 123 K [290 K]. The structure was solved by direct
      methods and refined to R(F2) = 0.059 for 302 parameters and 3655 observations.
      The alkyl chain of the molecule is in the fully extended conformation. The
      molecular packing is head-to-head bilayer with interdigitizing alkyl chains. The
      gallate head groups are hydrogen bonded with the water molecules to form a strong
      system of intra- and intermolecular hydrogen bonds consisting of finite and
      infinite chains. The crystals undergo crystal-to-crystal phase transitions at 365
      K on heating and at 333 K on cooling, but despite the molecular packing which is
      analogous to that of the mesogenic alkyl glycosides, there is no thermotropic
      liquid crystal phase prior to the formation of the isotropic liquid phases at 376
      K. Similary, no lyotropic liquid crystal phases are observed at room temperature
      in contact with a mixture of water and propanediol in which the crystals are
      soluble.

PMID- 2222939
TI  - Alpha,beta-dehydro residues in the design of peptide and protein structures.
AB  - The results of X-ray studies on 19 structures containing dehydro residues have
      been analysed. The observed average C alpha = C beta distance in the dehydro
      residues is 1.331 (2) A. The average values of the C alpha = C beta - C gamma
      bond angle in dehydro-Phe and dehydro-Leu are 131.2 (2) and 127.3 (1) degrees,
      respectively. The dehydro residue is essentially planar. A beta-turn of type II
      is formed if the dehydro residue is placed either at the (i + 1) or at the (i +
      2) corner position of the beta-turn. If the dehydro residues occur consecutively
      in an amino-acid sequence, the backbone folds into an alternating right- and left
      handed alpha-helix. The peptide bond is planar in all these structures. The beta
      turn is stabilized by an intramolecular hydrogen bond between CO of the ith and
      NH of the (i + 3)th residue.

PMID- 2222940
TI  - The stereochemistry of the water molecules in the hydrates of small biological
      molecules.
AB  - An examination of the stereochemistry of the water molecules in the hydrates of
      amino acids and peptides, carbohydrates, purines and pyrimidines, and nucleosides
      and nucleotides, reveals a variety of hydrogen-bonded configurations within a
      radius of 3.0 A from the water oxygen atom. Water molecules which accept one
      hydrogen bond are more common than those that accept two, by a factor of 1.4.
      There are nine examples where the water is not a hydrogen-bond acceptor, but only
      one where it does not donate two hydrogen bonds. Of the 621 OWH...A bonds
      examined, 15% were three centered and 2% were four centered or three-center
      bifurcated. The amino-acid and peptide hydrates displayed the greatest variety
      with 15 different hydrogen-bond configurations. The coordination of the donor and
      acceptor atoms within 3.0 A of the water oxygen atom ranged from two to seven.

PMID- 2222941
TI  - The effects of caffeine on blood pressure in the work environment.
AB  - The ambulatory blood pressure and heart rate of twelve healthy volunteers were
      monitored on two separate days in the participants' work environment. All
      subjects were studied in a double-blind crossover design while they consumed
      caffeinated or decaffeinated coffee. We examined them at rest, during a
      standardized mental arithmetic task, and for 6 h of ambulatory monitoring in
      their regular work setting (research facility and hospital). On days of drinking
      caffeinated coffee, both systolic and diastolic blood pressure were consistently
      elevated at all time points (P less than .0005). In response to the mental
      arithmetic task, the increase in systolic blood pressure over the resting value
      was particularly exaggerated on caffeinated coffee (P = .0003). For heart rate,
      there were no effects from caffeine. The study demonstrates that the blood
      pressure-elevating effects of caffeine, well-known from laboratory studies, are
      sufficiently robust to be evident in patients' uncontrolled work environments. It
      implies the importance of caffeine restriction for hypertensive patients. It also
      indicates the utility of ambulatory blood pressure techniques in studying the
      blood pressure effects of various nutritional factors taken ad lib in the real
      world.

PMID- 2222943
TI  - Effect of captopril injection in patients with moderate to severe hypertension.
AB  - The effect of intravenous captopril was studied in 24 white patients who had
      moderate to severe hypertension. Patients received incremental doses of 1 to 10
      mg delivered at 10 min intervals over 50 to 80 min. Blood pressure (BP) was
      lowered within 5 to 10 min after the initial dose was administered and continued
      to decline, reaching a maximum response after 20 min (2 to 4 mg). At this time
      group mean BP fell from 175 +/- 3/111 +/- 1 to 166 +/- 3/97 +/- 2 mm Hg (P less
      than 0.01). Additional dose increments to an average cumulative dose of 40 mg did
      not increase the initial effect. No adverse side effects or symptomatic
      hypotension occurred in any subject. There was a significant correlation between
      diastolic BP decreases observed in response to intravenous captopril and
      subsequent long-term oral captopril therapy. The addition of hydrochlorothiazide
      increased the proportion of patients reaching normotension. We conclude that
      small intravenous bolus injections of captopril appear to be effective rapidly
      and are well tolerated in moderate to severe essential hypertension. Short-term
      intravenous administration seems to predict the response to chronic oral
      captopril therapy.

PMID- 2222942
TI  - Effects of n-3 fatty acids in essential hypertension.
AB  - We examined the effects on blood pressure, plasma lipoproteins, and platelet
      function when marine oil supplements (rich in n-3 fatty acids) or vegetable oil
      supplements (rich in n-6 fatty acids) were added to the usual diets of patients
      with mild essential hypertension. In a randomized, double-blind, parallel-group
      study, patients received 50 g of either marine oil (n = 8) or vegetable oil (n =
      8) daily for 6 weeks following a baseline observation period. Diastolic blood
      pressure declined during treatment with fish oil (mean +/- SEM, 96 +/- 2 v 89 +/-
      2 mm Hg, P = .02), but did not change with vegetable oil (92 +/- 1 v 94 +/- 1 mm
      Hg). Systolic blood pressure did not change significantly during either
      treatment. Serum triglycerides declined (by approximately 30%) in patients
      receiving only marine oil, but total cholesterol, LDL-, HDL-, HDL2-, and HDL3
      cholesterol-subfractions and apolipoproteins A-I and B were unchanged in both
      treatment groups. Bleeding time increased by 33% during treatment with marine oil
      but did not change with vegetable oil supplements. Marine oil did not alter in
      vitro platelet aggregation thresholds. The lack of a significant correlation
      between blood pressure changes and platelet membrane fluidity, plasma renin
      activity, aldosterone, norepinephrine, or epinephrine suggests that these
      variables did not mediate the antihypertensive effect of the marine oil. We
      conclude that large doses of marine oil reduce diastolic blood pressure, lower
      triglycerides, and increase bleeding time in patients with mild hypertension.

PMID- 2222944
TI  - The initial vasodilation and the later vasoconstriction of endothelin-1 are
      selective to specific vascular beds.
AB  - The regional hemodynamic effects of endothelin-1 (ET-1) were studied in Wistar
      Kyoto rats. Endothelin-1 caused a transient increase in blood flow in the carotid
      and femoral arteries but a decrease in flow in the renal and mesenteric arteries.
      The resistance in the carotid and femoral beds decreased while it increased in
      the renal and mesenteric beds. Subsequently there was a variable increase in
      resistance in all vascular beds with a maximal increase in the renal bed. Thus,
      ET-1 initially causes a selective vasorelaxation in musculocutaneous beds but not
      in visceral beds; the cause of this selectivity is unknown.

PMID- 2222945
TI  - Renal and hemodynamic effects of endothelin in anesthetized dogs.
AB  - The effects of endothelin on systemic hemodynamics and renal functions were
      investigated in anesthetized dogs. Infusion of endothelin at a dose of 1
      ng/kg/min decreased renal blood flow and increased renal vascular resistance and
      filtration fraction. Endothelin at doses higher than 10 ng/kg/min significantly
      decreased cardiac output, glomerular filtration rate, renal plasma flow, urine
      volume, and urinary sodium excretion. Mean arterial pressure showed a transient
      decrease at doses higher than 50 ng/kg/min. These results showed that endothelin
      in systemic administration has effects on renal functions as well as on systemic
      hemodynamics.

PMID- 2222946
TI  - What is blood pressure?

PMID- 2222947
TI  - Randomized trials in the study of antihypertensive drugs.
AB  - Heterogeneity in response to antihypertensive drugs can be addressed by
      randomized trials in individual subjects. In such a trial a patient receives
      pairs of treatment periods (one period of each pair active drug, one matched
      placebo, in random order); patient and clinician are blinded to allocation, and
      treatment targets are monitored. These trials can optimize antihypertensive
      therapy in clinical practice and facilitate the investigation of new drugs and
      the study of pathophysiology. Such trials also have potential in helping decide
      whether common, nonspecific symptoms reported by patients are really drug
      related.

PMID- 2222948
TI  - From the parallel group design to the crossover design, and from the group
      approach to the individual approach.
AB  - The consequences of heterogeneity in response to antihypertensive drugs for the
      clinical development programs of new antihypertensive drugs and for the care of
      the individual hypertensive patient have not previously been sufficiently
      recognized. They play a role in the inappropriate choice of too-high daily doses
      of some antihypertensive drugs at the end of extensive international development
      programs. They are also implicated in the insufficient control of blood pressure
      observed in the long-term multicenter trials in hypertension, where some patients
      have been treated for several years with drugs that were not the most appropriate
      for their disease and which did not adequately control their blood pressure. In
      addition to the parallel group studies, the use of double-blind two-period or
      multiple period crossover designs can provide valid data for the dose-finding of
      new antihypertensive drugs and their comparative evaluation. At the end of the
      trial, these designs also offer each patient the opportunity to be treated with
      the right dose of the drug most appropriate for his or her disease.

PMID- 2222949
TI  - Effect of captopril on renal function in hypertensive dogs with unilateral renal
      artery stenosis, studied with radionuclide dynamic scintigraphy.
AB  - The kidneys of five hypertensive dogs with experimental unilateral renal artery
      stenosis were examined by 99mTc-diethylenetriaminepentaacetic acid (DTPA) and
      131I-hippuran radionuclide dynamic scintigraphy at 10 and 40 min (respectively)
      following the administration of intravenous bolus injections of captopril. Doses
      of 0.2, 0.5, and 1.0 mg/kg captopril reduced mean arterial pressure by 33 +/- 4,
      31 +/- 7, and 51 +/- 4 mm Hg and increased plasma renin activity by 40.1 +/- 9.8,
      57.6 +/- 3.2, and 34.4 +/- 15.2 ng A1/mL/h, respectively. The time-activity
      curves of both 99mTc-DTPA and 131I-hippuran indicated that renal excretory
      function in the stenotic kidney was compromised with all three doses of
      captopril. However, if nitroprusside was used to reduce the mean arterial
      pressure to a level comparable to that with captopril, there was no appreciable
      increase in plasma renin activity and renal excretory function was only partially
      affected in the stenotic kidney. One hour after the administration of 0.5 mg/kg
      captopril, the function of the stenotic kidneys was partially restored and, by
      two hours, the time-activity curves were comparable to control scans. These data
      demonstrate a reversible, time-limited suppression of stenotic kidney function by
      captopril in renovascular hypertension and provide support for the use of
      captopril in the diagnosis of renovascular hypertension by radionuclide dynamic
      scintigraphy.

PMID- 2222950
TI  - Nonpeptide angiotensin II receptor antagonists.
AB  - Although the most direct way to interfere with the renin-angiotensin system (RAS)
      is at the level of the angiotensin II (AII) receptor, the currently available AII
      receptor antagonists are peptides still retaining significant agonistic
      properties with the obvious drawbacks of limited stability and lack of oral
      activity. We have characterized simple N-benzylimidazoles as weak, but selective
      AII receptor antagonists with a competitive mode of action. Chemical modification
      of these early leads led to EXP6155 and EXP6803, which show approximately 10- and
      100-fold higher affinity. Oral activity was obtained for EXP7711, and in
      particular for EXP9654. This class of compounds displaces 3H-AII from its
      specific binding sites in various tissues. They competitively antagonize AII
      induced responses in various in vitro and in vivo preparations, but do not
      influence AII-induced responses to KCl, norepinephrine, and vasopressin, nor do
      they affect converting enzyme or renin. In high renin models of elevated blood
      pressure, such as the renal hypertensive rat and sodium-depleted dog, these
      substances produce a sustained decrease in arterial pressure without changing
      heart rate after intravenous and oral (EXP7711 and EXP9654) administration. None
      of these compounds showed agonistic activity in any of the above test systems. In
      conclusion, the nonpeptide structures described herein are selective and
      competitive AII receptor antagonists and add another dimension to the arsenal of
      drugs manipulating the RAS.

PMID- 2222951
TI  - Humoral factors determining the blood pressure response to converting enzyme
      inhibition and calcium channel blockade.
AB  - Renin and catecholamine levels were determined in patients with mild to moderate
      hypertension before and after treatment with sustained release diltiazem or
      captopril and were correlated with the blood pressure response to these
      antihypertensives. Eight weeks of treatment with either agent led to equal
      decreases in both systolic and diastolic blood pressure. Pretreatment plasma
      renin activity (PRA) and plasma norepinephrine did not predict the blood pressure
      response to either agent. Diltiazem significantly increased both PRA and supine
      norepinephrine levels. However, in the diltiazem treated patients, there was no
      correlation between the change in plasma norepinephrine and the change in
      systolic or diastolic blood pressure. In contrast, there was a negative
      correlation (P less than .05) between the reactive rise in PRA and the decrease
      in systolic blood pressure. Thus, the antihypertensive response to a calcium
      channel blocker may be determined, in part, by the reactive response of pressor
      systems.

PMID- 2222952
TI  - Effects of felodipine on urinary albumin excretion and metabolic control in
      hypertensive non-insulin-dependent diabetics.
AB  - The effect of a blood pressure reduction by 10 mg extended release felodipine
      once daily on urinary albumin excretion (UAE) as well as the possible
      diabetogenic effect of felodipine was studied. A 2 X 12 week placebo-controlled
      double-blind crossover study was performed in 12 hypertensive non-insulin
      dependent diabetic (NIDDM) patients without nephropathy on concomitant treatment
      with beta-blocker and/or a diuretic agent. Metabolic control as estimated by
      fasting plasma glucose, hemoglobin A1c and fasting plasma C-peptide was unaltered
      after felodipine. Blood pressure was significantly reduced by felodipine:
      systolic 166 +/- 26 mm Hg (placebo) v 153 +/- 26 mm Hg (felodipine) (P less than
      .05) and diastolic 95 +/- 7 mm Hg v 90 +/- 8 mm Hg (P less than .05). Heart rate
      was unchanged. There was no correlation between blood pressure and UAE, but the
      relative change in UAE expressed as UAE placebo/UAE felodipine was significantly
      correlated to the fall in systolic blood pressure (r = 0.64, P = .03) and mean
      blood pressure (r = 0.66, P = .02). Since microalbuminuria predicts proteinuria
      and reduced survival, early antihypertensive treatment may be beneficial in NIDDM
      as it is in IDDM. Long-term consequences on kidney function and mortality
      remains, however, to be elucidated.

PMID- 2222953
TI  - Platelet norepinephrine and epinephrine concentration in patients with
      pheochromocytoma.
AB  - Platelet and plasma catecholamine concentrations were determined in 17 patients
      with surgically proven pheochromocytoma (mean age 42.3 years); in 31 patients
      with borderline hypertension (mean age 35.3 years) and in 9 healthy controls
      (mean age 39.3 years). Both platelet norepinephrine and epinephrine were
      significantly increased in patients with pheochromocytoma when compared with
      hypertensive and control groups (P less than .001). No correlation between
      platelet and plasma catecholamines was detected in all studied groups. The
      diagnostic accuracy of platelet catecholamine in pheochromocytoma is limited
      since increased platelet norepinephrine was found in 35.5% and increased platelet
      epinephrine was found in 19.4% of patients with essential hypertension.

PMID- 2222954
TI  - Normalization of increased sodium sensitivity by maintenance hemodialysis.
AB  - Blood pressure (BP) becomes more sodium and body fluid sensitive as renal
      function deteriorates. Thus, hypertension in chronic renal failure is mostly of
      the sodium sensitive type. We studied whether the increased sodium sensitivity
      (SS) can be restored to normal on the maintenance phase of hemodialysis (HD)
      therapy. Body weight (BW) and BP (specifically, mean arterial pressure [MAP])
      were measured after HD and before the next HD, and the body fluid sensitivity
      (BFS) was calculated as the ratio of changes in these factors on both
      introduction and maintenance phases in HD patients (n = 56) who were not taking
      any antihypertensive drugs (BFS = delta MAP/delta BW). In a preliminary study,
      the amount of interdialytic sodium intake (QNa+) was measured (n = 30), and SS
      was calculated as the ratio of the change in MAP to QNa+ (SS = delta MAP/QNa+).
      Interdialytic BW gain (3.1 +/- 0.1 kg) was correlated with the amount of sodium
      intake (136 +/- 17 mEq), resulting in a positive relationship between BFS and SS
      (r = 0.79, P less than .0001). Therefore, BFS was used as an index of SS. As a
      whole, BFS decreased from the introduction to the maintenance phase (6.5 +/- 1.0
      to 3.5 +/- 0.6 mm Hg/L, P less than .01). This decrease was marked (6.2 +/- 1.1
      to 2.9 +/- 0.6 mm Hg/L, P less than .01) in patients (n = 46) whose BP was
      normalized in the maintenance phase, while not significant (7.9 +/- 1.9 to 6.3 +/
      1.3 mm Hg/L) in patients (n = 10) whose BP was still high.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2222956
TI  - Chronic effects of synthetic endothelin on blood pressure and sodium excretion in
      rats.
AB  - Continuous infusion of endothelin at a rate of 60 micrograms/kg/day into the
      jugular vein of rats via osmotic minipumps induced a significant increase in
      systolic blood pressure, but did not induce any significant changes in urine
      volume and urinary sodium excretion, compared to those in vehicle-infused rats.
      When 6 mg/kg/day of benidipine, a newly developed calcium channel blocker, was
      administered simultaneously with 60 micrograms/kg/day of endothelin, the systolic
      blood pressure of conscious rats rose on Day 1 to only 137.0 +/- 2.4 mm Hg (P
      less than .05) compared to the rise to 163.8 +/- 4.7 mm Hg when endothelin alone
      was infused. The antihypertensive effect of benidipine was sustained. The present
      results suggest that endothelin can act as a circulating hormone. In addition,
      they clearly demonstrate that the calcium channel blocker attenuates the
      elevation of blood pressure induced by endothelin.

PMID- 2222955
TI  - Effects of endothelin on renal hemodynamics and renal function in anesthetized
      dogs.
AB  - Porcine endothelin was infused directly into the renal artery of anesthetized
      dogs to evaluate the renal action of endothelin. Endothelin (0.2 to 5.0
      ng/kg/min) elicited a dose-dependent reduction in the renal blood blow with no
      changes in systemic blood pressure. Endothelin infusion (0.2 ng/kg/min) decreased
      the renal blood flow by 30% and urinary sodium excretion by 50% without any
      changes in the glomerular filtration rate. However, higher doses did reduce
      glomerular filtration rate. These data suggest that endothelin preferentially
      constricts efferent arterioles and that endothelin may enhance the renal
      reabsorption of sodium.

PMID- 2222957
TI  - Alarm reaction and serum K+ in hypertensive patients.
AB  - The effect of serum K+ of the alarm reaction induced by the participation to an
      experimental noninvasive study was evaluated in 35 subjects with borderline
      hypertension and in 18 essential hypertensives. A group of 44 inpatients
      undergoing routine blood sampling served as a control. Serum K+, blood pressure
      and heart rate were measured before (casual) and after (baseline) 20 min of rest
      in the recumbent position. Baseline serum K+ values were significantly higher
      than casual values in patients participating to the experimental protocol while
      no change was observed in inpatients undergoing routine blood sampling. The
      increase in serum K+ induced by relaxation was significantly related to heart
      rate decrease (r = 0.73). After relaxation 75% of patients had an increase in
      serum K+ with a change greater than 10% in about 35% of patients. In a subgroup
      of patients who repeated the same test three times, the alarm reaction was still
      evident and not reproducible within each patient. These data suggest that when
      potassium levels are measured in outpatients undergoing diagnostic or
      experimental procedures falsely reduced levels can be found in a large proportion
      of subjects.

PMID- 2222958
TI  - Studies of salt intake in hypertension. What can epidemiology teach us?
AB  - It has been suggested that small changes in population blood pressure will have a
      major impact upon the incidence of cardiovascular disease caused by blood
      pressure elevation. Early reports indicated a close correlation between
      intercultural differences in salt intake and blood pressure. Before such
      epidemiological associations can be translated into population advice, certain
      conditions have to be met. The association has to be validated scientifically,
      and persuasive evidence has to be produced that the relationship is causal and
      reversible by changes in salt intake. Further, risk-benefit analysis should
      indicate that net harm is unlikely. Finally it has to be demonstrated that the
      population measures being advocated will produce an adequate change in dietary
      salt intake. The small individual effects upon blood pressure being examined, and
      the prevailing changes in blood pressure and cardiovascular mortality suggest
      that data will always fall short of the ideal and therefore that extrapolation
      will always be necessary. Nevertheless, a review of the present evidence
      indicates the inadequacies of the available data as a basis for population
      advice.

PMID- 2222959
TI  - Risks associated with dietary sodium reduction in the spontaneous hypertensive
      rat model of hypertension.
AB  - Sodium balance is maintained by a complex set up of hemodynamic, hormonal and
      neural mechanisms that affect intake, reabsorption and excretion. The focus of
      the following research was on the cardiovascular and neuroeffector effects of
      dietary Na reduction primarily in normotensive Wistar-Kyoto (WKY) and
      spontaneously hypertensive rats (SHR) raised from 4 to 15 weeks on a control Na
      diet (CNa: 12 mmol per 100 g food) or various low Na diets (LNa: 0.5 to 3 mmol
      per 100 g food). With regards to hemodynamics and volume regulation, the lowest
      Na diet reduced blood pressure 15% and raised resting heart rate (20%) in SHRs
      but not WKYs. Blood volume, hematocrit, plasma electrolytes, extracellular
      volume, and cardiac output were not different between diets or strains. However,
      both LNa strains were abnormally sensitive to blood loss and showed attenuated
      pressor responses to both acute and chronic stress situations. Cardiac function
      was not altered by LNa treatment in either rat strain although structural
      compensations occurred. LNa treatment significantly attenuated the pressor
      reduction in mesenteric blood flow during stress which was primarily due to
      reduction in noradrenergic transmitter release and not due to altered receptor
      sensitivity, density, or Na/K ATPase activity. Compensatory sympathetic activity
      was increased as was sodium conservation through humoral mechanisms which
      maintained homeostasis. However, further neurohumoral compensation was markedly
      reduced. The data suggests that the hygienic sodium intake in humans should be
      experimentally defined before generalized measures are taken to reduced dietary
      sodium use throughout society.

PMID- 2222960
TI  - Blood pressure response to dietary calcium intervention in humans.
AB  - Epidemiological and experimental studies have suggested that dietary calcium
      deficiency may lead to the development of hypertension. This article reviews
      findings in human trials on calcium intervention with special reference to the
      responses of blood pressure and biochemical variables. Calcium supplementation
      consistently resulted in decreased blood pressure in a subset of hypertensive and
      normotensive subjects, but led to increased blood pressure in some hypertensive
      patients. The variable blood pressure responses to calcium supplementation could
      not be predicted on the basis of routine biochemical parameters and appeared to
      be due to differences in the backgrounds of the subjects and/or the design and
      size of the trials. It is concluded that further studies are required on the
      hypotensive effect of calcium supplementation.

PMID- 2222961
TI  - Sodium-calcium interactions and salt-sensitive hypertension.
AB  - In humans with essential hypertension, salt-induced increases in blood pressure
      have been reported to correlate directly with salt-induced increases in
      intracellular free calcium [( Ca2+]i) in circulating mononuclear cells. These
      findings are consistent with the hypothesis that salt-induced increases in
      [Ca2+]i mediate the phenomenon of salt sensitivity. Circumstantial evidence
      suggests that salt-induced increases in intracellular sodium or in plasma levels
      of 1,25-dihydroxy vitamin D might mediate salt-induced increases in [Ca2+]i and
      blood pressure. However, in humans with salt-sensitive hypertension, it remains
      to be determined: (1) whether salt-induced increases in white blood cell [Ca2+]i
      reflect corresponding increases in vascular smooth muscle [Ca2+]i; (2) whether
      salt-induced increases in [Ca2+]i are a cause or consequence of salt-induced
      increases in blood pressure; and (3) whether salt-induced increases in 1,25
      dihydroxy vitamin D or intracellular sodium precede salt-induced increases in
      [Ca2+]i.

PMID- 2222962
TI  - Putative mechanism of blood pressure reduction induced by increases in dietary
      calcium intake.
AB  - An increase in dietary calcium intake lowers blood pressure in spontaneously
      hypertensive rats and in some patients with arterial hypertension. The mechanisms
      by which this decrease come about are not clear. A membrane-stabilizing effect
      wrought by an increase in extracellular calcium would appear unlikely, since the
      increases in extracellular calcium concentration with increased dietary intake
      are minimal. Calcium regulatory hormones may be the mediators, and a cybernetic
      framework has been suggested. Striking defects have been reported in the calcium
      handling and hormonal household of the spontaneously hypertensive rat. However, a
      clear cut relationship in terms of a hormonal "template" has not yet been
      identified in prospective experiments. Data have been presented to show that
      increased calcium intake has a direct effect on regulatory areas in the brain.
      However, the mechanisms by which such a response would be mediated are entirely
      unknown. Increased calcium intake may induce natriuresis. It has been suggested
      that increased calcium intake helps the "salt sensitive"; however, prospective
      studies to this effect have not been presented. Increased calcium intake may
      induce phosphaturia. However, the evidence that blood pressure lowering effects
      are mediated by phosphate depletion are unconvincing. Some evidence suggests that
      increased calcium intake may influence local regulatory processes which in turn
      influences cell integrity and growth. At this point, a unifying hypothesis is not
      available. However, the clues to various possibilities are intriguing.

PMID- 2222963
TI  - Calcium regulating hormones in essential hypertension. Importance of gender.
AB  - Alterations of calcium metabolism have been described in human essential
      hypertension and experimental hypertension. We investigated the interrelationship
      of parathyroid hormone (PTH) and 1,25(OH)2-vitamin D (1,25(OH)2D) in patients
      with untreated essential hypertension as compared to normotensive controls. The
      hypertensive subjects (n = 75; 43 men, 32 women) had a mean blood pressure of 138
      +/- 8/95 +/- 5 mm Hg as compared with 120 +/- 11/80 +/- 8 in the normotensive
      group (n = 40; 22 men, 18 women). Serum PTH was measured with an intact molecule
      immunochemiluminometric assay and 1,25(OH)2D was measured with radioimmunoassay
      after HPLC separation. Hypertensive men had PTH levels that were 36% higher than
      normotensive men (5.3 +/- 2.9 v 3.9 +/- 0.8 pmol/L, P = .005). When blood
      pressure was analyzed as a continuous variable, there was a direct correlation
      between it and serum PTH in men (r = .31, P = .004). In women, by contrast, there
      was no difference in serum PTH between hypertensive and normotensive subjects and
      no relationship between blood pressure and the serum PTH concentration. Blood
      pressure was inversely correlated with serum phosphorus levels in both sexes (r =
      -0.20, P = .04). In men, the elevated serum PTH levels and depressed serum
      phosphorus levels would have predicted that serum 1,25(OH)2D would be higher in
      the hypertensive subjects. However, that was not observed, as serum 1,25(OH)2D
      was slightly lower in hypertensive (38.3 +/- 15.2 pg/mL) than normotensive men
      (42.7 +/- 11.3, P = .21).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222964
TI  - Calcium, parathyroid hormone, and vitamin D in the "prehypertensive" Dahl salt
      sensitive rat.
AB  - The purpose of this study was to determine if alterations of calcium and calcium
      regulating hormones precede the onset of NaCl-induced hypertension in the Dahl
      salt-sensitive (S) rat. After a 5-day balance study, serum ionized calcium,
      parathyroid hormone (PTH), and 1,25-dihydroxy vitamin D concentrations were
      measured in Dahl-S and salt-resistant (R) rats that had been maintained on a
      "normal" (1%) or high (7%) NaCl intake. Blood pressure was higher in Dahl-S than
      Dahl-R (P less than .01), but was not affected by 5 days of high NaCl. On both
      NaCl intakes, urine calcium excretion was increased, serum calcium was decreased,
      and serum PTH and 1,25 dihydroxy vitamin D were increased in Dahl-S compared to
      Dahl-R (P less than .01). On the high NaCl intake, fecal calcium was greater in
      Dahl-S than in Dahl-R, and net 5-day calcium balance was less positive in Dahl-S
      (P less than .05). Thus, alterations of calcium, PTH, and vitamin D precede NaCl
      induced hypertension in Dahl-S. These alterations may contribute to the
      development of hypertension in this animal model.

PMID- 2222966
TI  - Vascular and calcemic effects of plasma of spontaneously hypertensive rats.
AB  - Circulating substances that increase intracellular calcium, and other circulating
      substances that increase blood pressure, have been described in hypertensive
      animals and humans. In this study, we report the existence of a factor of the
      plasma of spontaneously hypertensive rats that does both. These effects were dose
      dependent, and the time course for such effects was correlated with the time
      course for potentiation of pressor agents by the plasma. In addition, the plasma
      of spontaneously hypertensive rats was found to inhibit the depressor effects of
      parathyroid hormone. Our results confirm the presence of a circulating
      hypertensive factor in the plasma of spontaneously hypertensive rats, which may
      act by increasing calcium uptake in vascular smooth muscle. These findings may
      also help explain the secondary increase in parathyroid hormone noted in some
      forms of human and experimental hypertension.

PMID- 2222965
TI  - Calciotropic hormones in human and experimental hypertension.
AB  - Although altered cellular calcium handling plays a critical role in the
      pathophysiology of hypertension, little attention has been focused on the impact
      of calcium regulating hormones on this process. Recent research provides evidence
      that parathyroid hormone, calcitonin, 1,25-dihydroxyvitamin D, as well as newly
      described factors such as calcitonin gene-related peptide (CGRP), exert target
      organ-specific actions in cardiac and peripheral vascular tissues, are linked to
      the renin-aldosterone system, and thus to the control of sodium metabolism, and
      may directly participate in the hypertensive process, especially in low renin and
      salt sensitive forms of hypertensive disease. The metabolic set-point of these
      linked renin and calcium hormone systems, which serve to transduce environmental
      dietary mineral signals at the cellular level, determines the blood pressure
      consequences of sodium and calcium loading and/or restriction, and helps to
      explain the heterogeneous and seemingly inconsistent effects of these dietary
      maneuvers on blood pressure. Measurement of renin and calcium factors in
      hypertension thus provides a physiological basis for individualized therapeutic
      recommendations in human hypertension.

PMID- 2222968
TI  - Possible mechanisms of abnormal norepinephrine sensitivity and reactivity of
      resistance vessels and the development of hypertension in spontaneously
      hypertensive rats. A hypothesis.
AB  - This study examined structural and functional changes of mesenteric resistance
      vessels in early, developing, and established stages of hypertension development
      in spontaneously hypertensive rats in an attempt to identify possible mechanisms
      of the development and maintenance of hypertension. Our results suggest that the
      development of hypertension in spontaneously hypertensive rats may be caused by
      genetic structural and functional abnormalities of resistance vessels. Both
      abnormalities may be caused by hyperreactivity to norepinephrine through an
      altered signal transduction process, including the regulation of protein kinase C
      in smooth muscle cells of resistance vessels in spontaneously hypertensive rats.

PMID- 2222967
TI  - Epithelial abnormalities in intestine and kidney of the spontaneously
      hypertensive rat.
AB  - A variety of perturbations of calcium metabolism are reported to occur in the
      spontaneously hypertensive rat (SHR) compared to its genetic control the Wistar
      Kyoto rat (WKY), including significant dysfunction of calcium handling by the
      proximal renal tubule of the SHR, resulting in impaired active calcium transport
      in the gut and an apparent renal calcium leak. We explored the intestinal and
      renal epithelia of 12- to 14-week-old SHR and WKY using electron microscopy.
      Biochemical comparisons of these transport epithelia included measurements of
      three vitamin D dependent cellular proteins and one structural protein: alkaline
      phosphatase, intestinal CaBP9K, renal CaBP28K, and villin expression. Electron
      microscopy demonstrated a patchy loss in microvilli in the SHR, accounting for
      approximately 10 to 15% of the total microvillar surface. In the kidney,
      morphological abnormalities were observed only in the proximal renal tubule.
      Again, there was patchy loss of microvilli from the brush border membrane. In SHR
      duodenal alkaline phosphatase activity was significantly reduced compared to the
      WKY (0.145 +/- 0.002 v 0.186 +/- 0.002 integrated extinction/min/micron 3 X 10(3)
      brush border (P less than .001). Duodenal CaBP9K and renal CaBP28K were
      significantly reduced in SHR compared to WKY. There were no differences in villin
      expression. These data are consistent with the previously characterized
      disturbances of active calcium transport in the intestine and inappropriate renal
      calcium leak in the SHR. While a possible link between these disturbances and
      hypertension remains to be determined, this study provides supportive evidence
      for a primary disturbance in cell calcium handling and transporting epithelia in
      this form of genetic hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222970
TI  - Increase of calmodulin activator in hypertension. Modulation by dietary sodium
      and calcium.
AB  - The aim of this study was to investigate the effects of dietary calcium and
      sodium on blood pressure (BP) in normotensive rats (Wistar, WKY), spontaneously
      hypertensive rats (SHR) and Dahl rats and on calmodulin (CaM) activator, a newly
      discovered hydrophobic compound that increases CaM activity in SHR and
      spontaneously hypertensive mice (SHM) tissues (J Clin Invest 82:276, 1988). The
      CaM activator was assessed by its capacity to stimulate a CaM-dependent
      phosphodiesterase (CaM-PDE). In Wistar rats, which were fed a high sodium diet
      (3.5%), BP significantly increased (P less than .01) from 106 +/- 4 to 128 +/- 8
      mm Hg in parallel to an elevation of the CaM activator from 1.57 +/- 0.14 to 2.80
      +/- 0.18 U. WKY, SHR, and Dahl salt-sensitive (DS/JR) and salt-resistant (DR/JR)
      rats were given low (0.15%) or high (2.5%) Ca diets, both with 1% sodium. In rats
      receiving high dietary Ca the progression of hypertension diminished and BP was
      lower in SHR (156 +/- 4 mm Hg) and young DS/JR rats (125 +/- 3 mm Hg) than in
      those receiving low dietary Ca (192 +/- 10 and 183 +/- 2 mm Hg). There was a
      concomitant decrease of CaM activator in these animals to levels
      indistinguishable from those of WKY or DR/JR rats. The activator was also found
      in the heart, kidneys and erythrocytes from SHM. In the presence of exogenously
      added CaM, lipidic extracts from the SHM heart showed augmented CaM-PDE activity
      relative to normotensive preparations. This difference was eliminated by
      trifluoperazine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2222969
TI  - Contribution of calmodulin and protein kinase C to renin release in spontaneously
      hypertensive rats.
AB  - This study was designed to evaluate the contribution of calmodulin and protein
      kinase C to renin release from isolated glomeruli of spontaneously hypertensive
      rats (SHR, Okamoto and Aoki). Male 7-week-old SHR and age-matched control Wistar
      Kyoto rats (WKY) were used in this study. Isolated glomeruli were sealed in the
      superfusion chamber and perfused with Krebs-Ringer solution at a constant flow of
      0.3 mL/min. Renin release was increased by calmodulin inhibitor, W-7, and protein
      kinase C inhibitor, H-7, in both SHR and WKY. SHR showed higher maximal levels of
      renin release by W-7 and lower maximal levels by H-7 compared to WKY. These
      results indicate that calmodulin and protein kinase C play inhibitory roles in
      renin release from juxtaglomerular cells. The calmodulin-mediated suppression
      mechanism in renin release appears to be augmented in the SHR, whereas the
      protein kinase C-mediated system is attenuated.

PMID- 2222971
TI  - Roles of protein kinase C on the mechanical activity of vascular smooth muscles.
AB  - We investigated the role of protein kinase C in the mechanical responses evoked
      by high K or by acetylcholine (ACh) in intact vascular smooth muscle tissues, and
      by Ca in skinned vascular smooth muscle tissues. To activate protein kinase C,
      the phorbol ester 12-o-tetradecanoylphorbol-13-acetate (TPA), a potent tumor
      promoter, or 1,2-diolein, plus phosphatidylserine (PS) was used. TPA enhanced or
      reduced the amplitude of the contraction evoked by increased concentrations of K
      below 39 mmol/L or over 90 mmol/L, respectively, but consistently enhanced the
      resting tension at any given concentration of high K. Similar effects of TPA were
      observed on the Ca-induced contraction in saponin skinned muscle tissues. The
      enhancing action of TPA on the K-induced contraction was not related to
      activation of either the voltage-dependent Ca channel or the sarcoplasmic
      reticulum, and did not occur in the case of Ca-independent contraction in skinned
      muscle tissues. During the enhancement of the contraction induced by TPA, the
      phosphorylation of myosin light chain and the shortening velocity of contraction
      as measured using the slack test, were enhanced with no remarkable change in the
      free Ca concentration in the cytosol. TPA consistently inhibited the ACH-induced
      contraction accompanied by a marked reduction in free Ca due to inhibition of the
      hydrolysis of phosphatidyl inositol 4,5-bisphosphate. Under the assumption that
      TPA possesses the same action as DG, activation of protein kinase C increased the
      Ca sensitivity of contractile proteins in vascular smooth muscles.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2222972
TI  - Responses of cytosolic free calcium to ADP in platelets of spontaneously
      hypertensive rats.
AB  - Abnormalities of Ca2+ handling have been reported in patients with essential
      hypertension and in spontaneously hypertensive rats (SHR). In this study,
      responses of cytosolic Ca2+ to ADP in platelets of SHR were examined. Four- and
      seven-week-old male SHR and age- and sex-matched Wistar-Kyoto rats (WKY) were
      used. Basal levels of the intracellular Ca2+ concentration in platelets and
      responses to ADP were estimated using fluorescent indicator fura-2 in the medium
      containing 1 mmol/L CaCl2 and Ca2(+)-free buffer with 1 mmol/L EGTA. Basal levels
      of platelet cytosolic Ca2+ of SHR were significantly higher than those of WKY at
      4 and 7 weeks of age in the presence of external Ca2+. However, no significant
      difference was observed in basal levels of platelet cytosolic Ca2+ in the Ca2(+)
      free EGTA-containing buffer between SHR and WKY. The peak cytosolic Ca2+
      concentration evoked by ADP was significantly diminished in SHR compared with WKY
      in the absence of external Ca2+, whereas the responses of platelet cytosolic Ca2+
      to ADP were similar in SHR and WKY in the presence of external Ca2+. These
      results suggest that release from intracellular Ca2+ store is reduced in SHR and
      that the regulation of cytosolic Ca2+ in SHR is more dependent on extracellular
      Ca2+ compared with WKY.

PMID- 2222973
TI  - The cellular mechanism of action by vasoconstrictor hormones in cultured rat
      vascular smooth muscle cells.
AB  - The effects of angiotensin (Ang) II, arginine vasopressin (AVP), and serotonin (5
      HT) on inositol trisphosphate (IP3) production, cytosolic Ca2+ concentration [(
      Ca2+]i), and the phosphorylation of 20 kilodalton myosin light chain (MLC) were
      examined in cultured rat vascular smooth muscle cells (VSMC). These
      vasoconstrictors immediately induced dose-dependent and concomitant increases in
      IP3 production, [Ca2+]i, and phosphorylation of 20 kDa MLC. The agonist-induced
      increases in IP3 production, [Ca2+]i, and phosphorylation of 20 kDa MLC in VSMC
      were completely blocked by pretreatment with the receptor antagonists for Ang II,
      V1, and 5-HT2, respectively. These data suggest that receptor-mediated increases
      in IP3 production, [Ca2+]i, and phosphorylation of 20 kDa MLC by these
      vasoconstrictors are closely interrelated.

PMID- 2222974
TI  - Molecular pharmacology of calcium, calmodulin-dependent myosin phosphorylation in
      vascular smooth muscle.
AB  - The Ca2+, calmodulin (CaM)-dependent phosphorylation of the 20 kDa myosin light
      chain (LC20) is accepted as an important component of the regulatory mechanism in
      smooth muscle contraction. Since we have originally developed selective
      inhibitors of each process of the intracellular Ca2+ messenger system, the effect
      of a newly synthesized compound ML-9, a myosin light chain kinase (MLCK)
      inhibitor on superprecipitation of actomyosin, isometric tension development and
      phosphorylation of LC20 in vascular smooth muscle was investigated.
      Superprecipitation of actomyosin from bovine aorta was inhibited by the addition
      of ML-9 in a dose-dependent manner. In chemically skinned smooth muscle cells of
      the rabbit mesenteric artery, ML-9 inhibited both Ca2+ and Ca2+, CaM-independent
      MLCK-induced contraction. In the intact vascular strips, increase in LC20
      phosphorylation reached a maximal value within 10 sec from a resting value, and
      then declined to near the basal level during the maintained isometric force
      developed in response to 50 mmol/L KCl. Both the maximal rate and extent of KCl
      induced contraction and the phosphorylation of LC20 were also inhibited by ML-9.
      It antagonized the contraction induced by various contractile agonists, such as
      NE, 5HT, His, and Ang II concomitant with the inhibition of LC20 phosphorylation.
      These results suggest that ML-9 inhibits the actin-myosin interaction through the
      modulation of LC20 phosphorylation via the inhibition of MLCK activity. ML-9 will
      aid in determining pathophysiological functions of MLCK of increased vascular
      contractility in hypertension.

PMID- 2222975
TI  - Parathyroid hormone and the vascular response to norepinephrine.
AB  - Norepinephrine blood pressure reactivity is reduced in uremia, an effect
      attributed to excess parathyroid hormone (PTH). Most, but not all, animal and
      human studies support the theory that high PTH levels diminish the pressor
      response to norepinephrine. In hemodialysis patients in whom norepinephrine
      infusion tests were performed to determine the effect of parathyroidectomy on
      vascular responsiveness, the vascular response to norepinephrine (100 ng/kg/min)
      improved significantly (11.3 +/- 1.3 mm Hg before and 17.5 +/- 2.4 mm Hg after
      parathyroidectomy; P less than .01). Excess parathyroid hormone appears to play
      an active role in reduced vascular responsiveness to norepinephrine, although the
      mechanisms of this effect are unknown.

PMID- 2222977
TI  - Echocardiographic measurement of left ventricular mass and volume in normotensive
      and hypertensive rats. Necropsy validation.
AB  - Although rats are commonly used to study left ventricular (LV) hypertrophy,
      measurement of LV mass and dimensions has required killing the rat. To determine
      the accuracy of echocardiography in rats, blinded crossectional area (CSA) and LV
      mass measurements using either the cube function (LVM) or an elliptical model
      (LVMel) from high resolution M-mode echocardiograms were compared to necropsy LV
      weight (0.28 to 1.5 g), in 41 normotensive (body weight 116 to 762 g) and 17
      hypertensive rats (350 to 560 g). Postmortem chamber volumes in 28 normal rats
      (0.02 to 0.19 mL) were also compared to echocardiographic volumes derived from
      the elliptical model. Correlation with LV weight was r = 0.87 for LVM, 0.90 for
      CSA and 0.93 for LVMel (all P less than .00001). Comparison of hypertensive and
      body-weight-matched normotensive rats revealed the upper normal limit for both
      LVMel and CSA to have 89% sensitivity and 100% specificity for detection of post
      mortem LV hypertrophy. Necropsy LV volumes were more closely related to systolic
      echocardiographic volumes than to diastolic volumes (r = 0.78 v 0.71, both P less
      than .00001), compatible with the effects of post mortem contracture. Stroke
      volume determined invasively in 5 Wistar rats by thermodilution was similar to
      that obtained using elliptical model echo volumes in 5 rats of the same body size
      (0.35 +/- 0.05 v 0.30 +/- 0.06 mL/beat). Echocardiography can be used to evaluate
      LV structure and function in rats and to detect in vivo LV anatomic differences
      induced by hypertension.

PMID- 2222976
TI  - Effects of prostaglandin F2 alpha on the mobilization of cytosolic free calcium
      in vascular smooth muscle cells and on the tension of aortic strips from rats.
AB  - The possible mechanism of action of prostaglandin F2 alpha on vascular smooth
      muscle was investigated. Prostaglandin F2 alpha induced sustained tonic
      vasoconstriction of rat aortic strips, accompanied by rapid increase in the
      cytosolic free Ca2+ concentration [( Ca2+]i) in the vascular smooth muscle cells.
      Prostaglandin F2 alpha also evoked rapid increase in production of inositol
      1,4,5,-trisphosphate (Ins-P3). Moreover, it increased release of Ca2+ from
      nonmitochondrial pools in digitonin-permeabilized vascular smooth muscle cells,
      although this effect was much weaker than that of Ins-P3. These results suggest
      that the sustained action of prostaglandin F2 alpha may involve not only a rise
      in [Ca2+]i mediated by Ins-P3, but also a direct stimulation of Ca2+ from
      intracellular stores.

PMID- 2222978
TI  - The reliability of auscultatory measurement of arterial blood pressure. A
      comparison of the standard and a new methodology.
AB  - In 48 individuals with a wide range of arm circumferences blood pressure measured
      indirectly with two different cuffs was compared to direct intraarterial
      measurements. The two cuffs were a standard size cuff (12 X 35 cm) and a newly
      developed cuff, containing three rubber bags of different sizes, which
      automatically selects the appropriately sized bag in relation to arm
      circumference (Tricuff, Pressure Group AB, Sweden). The Tricuff correctly placed
      42 of the 43 patients in the "normotensive" range, ie, diastolic blood pressure
      less than 90 mm Hg, whereas the standard cuff put only 33 of 44 patients in this
      range (P less than .005). The discrepancy was not only due to the expected better
      performance in patients with obese arms, but also in the subgroup of patients
      with arms in the range 22 to 31 cm, in which group both cuffs would measure blood
      pressure with a 12 cm wide rubber bag. The number of correctly identified
      "normotensive" patients was noticeably higher with the Tricuff than with the
      standard cuff (30/31 v 25/32, P = .053). The better specificity of the new cuff
      thus offers an improvement over the standard cuff. There are several potential
      clinical advantages of this, mainly that the risk of erroneously labelling
      normotensive individuals as hypertensive is reduced.

PMID- 2222979
TI  - A validation study of the instromedix Baro-Graf QD home blood pressure monitor.
AB  - The purpose of this study was to assess the accuracy of the Instromedix Baro-Graf
      QD home blood pressure monitor. Forty subjects were divided among three blood
      pressure (BP) groups: low (BP less than 110/70, N = 11); medium (BP 110/70 to
      140/90, N = 17) and high (BP greater than 140/90, N = 12). Five seated readings
      were taken per subject. We examined the differences between simultaneous
      auscultatory and machine readings and assessed the machine's accuracy using ANOVA
      and correlation analysis. The results show that the device, while highly
      accurate, tended to become less so as pressure increased. However, its accuracy
      was superior compared to most other devices we have tested, and because of
      features, such as a computer memory that stores events and blood pressure over
      time, this monitor will likely be a useful tool for clinical trials of long term
      blood pressure change.

PMID- 2222980
TI  - Post-transplant hypertension.
AB  - Post-transplant hypertension remains an important risk factor for cardiovascular
      mortality and graft function. There are multiple mechanisms responsible for post
      transplant hypertension. The details of these mechanisms are poorly understood.
      Steroids, acute and chronic rejection, recurrent renal disease, native kidney
      disease, and renal artery stenosis have all been implicated in causing post
      transplant hypertension. With the addition of cyclosporine, a known hypertensive
      agent, to the immunosuppressive armamentarium, the evaluation of post
      transplantation hypertension has become difficult. Presently, medical therapy is
      initially directed toward the complications of cyclosporine nephrotoxicity.
      Empirically, converting enzyme inhibitors are added to the antihypertensive
      regimen. Further management is aimed at identification of specific causes of post
      transplant hypertension. Unfortunately, because of the multifactorial etiology of
      post-transplant hypertension and a lack of detailed information about the
      mechanisms, medical and surgical therapy are often unrewarding. Further study is
      needed to clarify the mechanisms involved in post-transplant hypertension, and
      thus direct therapy.

PMID- 2222982
TI  - Pain as an addiction (some people simply must have it!)

PMID- 2222981
TI  - How far should blood pressure be lowered? What is the role of the J-curve?

PMID- 2222983
TI  - The alien hand sign. Localization, lateralization and recovery.
AB  - The alien hand sign was first described by Brion and Jedynak as a "feeling of
      estrangement between the patient and one of his hands." The affected hand
      frequently shows a grasp reflex and an instinctive grasp reaction as well as
      elements of what Denny-Brown referred to as a "magnetic apraxia" associated with
      frontal lobe damage. Most notably, however, the affected hand is observed to
      perform apparently purposive behaviors that are perceived as being outside the
      volitional control of the patient. The patients interpret the behavior of their
      own affected limb as being controlled by an external agent. They do not feel that
      they are initiating or controlling the behavior of the hand and often express
      dismay at the hand's "extravolitional" activity. The patients attempt to control
      behavior of the alien hand with the unimpaired hand by forcibly restraining the
      affected limb, an act that may be termed "self-restriction." In this paper, we
      report an additional four cases of alien hand sign in right-handed subjects: two
      involving the right hand and two involving the left hand. In each case, the
      clinical findings were associated with extensive unilateral damage of the medial
      frontal cortex of the hemisphere contralateral to the affected hand. Furthermore,
      the alien movement gradually disappears over the course of 6-12 months after the
      stroke. These clinical case studies are presented and discussed in the context of
      the "dual premotoer systems hypothesis," an anatomicophysiological model that
      proposes that action is organized by two separate but interactive premotor brain
      systems corresponding to evolutionarily defined medial and lateral cortical
      moieties. It is hypothesized that the alien mode behavior results from
      unconstrained activity of the lateral premotor system in the damaged hemisphere.
      The residual volitional control in the limb occurs through the activity of the
      intact medial premotor system of the ipsilateral hemisphere. Recovery may occur
      through extension of these ipsilateral control mechanisms by compensatory changes
      in subcortical systems controlling hemispheric activation associated with
      adaptive behavior. This observation may be important in understanding mechanisms
      involved in motor recovery after stroke.

PMID- 2222984
TI  - The effect of local deep microwave hyperthermia on experimental zymosan-induced
      arthritis in rabbits.
AB  - The effect of local deep microwave hyperthermia (LDMWH) on normal and Zymosan
      induced arthritis has been evaluated in 12 rabbits (24 joints). LDMWH, four
      treatments to each joint (twice weekly for a period of 2 wk), was generated by an
      antenna operating at 915 MHz for 60 min, reaching an intraarticular temperature
      of 42.5 +/- 0.5 degrees C. A surface cooling system was used with the microwave
      apparatus. Two weeks after the last treatment, all animals were sacrificed. The
      application of LDMWH on normal joints induced a limited proliferation of the
      synovial lining cells with a minimal perivascular infiltration of mononuclear and
      neutrophil cells. However, no histologic damage to the skin, muscles, bone,
      cartilage or bone marrow adjacent to the heated joints could be noted. Induction
      of Zymosan arthritis (2 wk before LDMWH) was characterized by pannus formation
      and granulomatous reaction accompanied by fibrinoid deposits and disseminated
      necrotic foci in the synovial intima. The LDMWH treatment on the examined
      arthritic joints brought about a reduction in the degree of granulomatous
      reaction concomitant with the appearance of some fibrocytes and fine collagen
      fibrils. These findings suggest that LDMWH can be safely applied, even
      repeatedly, without morphologic evidence of damage to any normal mesenchymal
      tissue. Moreover, it reduces the inflammatory process in experimentally induced
      synovitis.

PMID- 2222985
TI  - Cardiac arrhythmias from a malpositioned Greenfield filter in a traumatic
      quadriplegic.
AB  - A case study is presented of premature Greenfield filter discharge with
      intracardiac migration and resulting life-threatening arrhythmias. These
      arrhythmias also interfered with the patient's transition from ventilatory
      support via orotracheal intubation to noninvasive positive airway pressure
      ventilatory support methods. The patient's arrhythmias were controlled by a
      demand cardiac pacemaker and cardiac glycoside therapy. No anticoagulants were
      used. She had no further filter migration nor significant complications for 16
      months after hospital discharge.

PMID- 2222986
TI  - The supraspinal anxiolytic effect of baclofen for spasticity reduction.
AB  - Recent studies in the psychiatric literature indicate that baclofen has an
      anxiolytic action in certain psychopathologic conditions. Clinical observation
      has shown that manifestations of spasticity are increased in anxious individuals,
      implicating a supraspinal site of mediation for these responses. The purposes of
      this study were to determine if baclofen reduced anxiety in individuals with
      traumatic spinal cord lesions and whether that reduction was correlated with
      decreased spasticity from the baclofen. Five adult males with traumatic spinal
      cord injury were randomly assigned to the study protocol. A double-blind,
      repeated measures, multiple base-line, single-case research design was employed.
      The independent variable was dose of medication with the three levels being
      placebo, 40 mg/day of baclofen and 80 mg/day of baclofen, in four evenly divided
      doses. The dependent variable was the score obtained on the Beck Inventory-A
      anxiety scale (BIA). The subjects were administered the BIA twice per week for a
      nine-week period of time, during which they received the doses of medication as
      described. Quantitative measurements of spasticity were also taken at each
      session. Visual inspection analysis of the data showed that two subjects had no
      measurable anxiety of the BIA throughout the study. Three subjects had measurable
      anxiety on the BIA during the base-line/placebo phase. They showed a decreased
      level of their BIA scores with 40 mg/day of baclofen, and a further level
      reduction with 80 mg/day of baclofen. The reduction in BIA scores was
      statistically significant using the standard deviation band test in one of these
      subjects. These data indicate that BIA probably has an anxiolytic effect for
      individuals status post-traumatic spinal cord injury.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2222987
TI  - Educational survey. Common questions asked by medical students about physiatry.

PMID- 2222988
TI  - Research in physical medicine and rehabilitation X. Information resources.
AB  - Researchers in physical medicine and rehabilitation require access to information
      regarding possible interventions and programs, available services and technology,
      research (published, unpublished and in progress), statistics on incidence,
      prevalence and expected recovery, and funding sources. This paper provides an
      overview to the most readily available sources of information, including 16
      abstracts and indexes, 6 sources of review articles, 9 population statistical
      databases and 84 journals specifically devoted to rehabilitation. Of these
      journals, 29 may be accessed through Medline and 32 through other sources. An
      additional 58 journals indexed in Medline publish more than 16 rehabilitation
      articles per year. The journals within Medline that publish the most
      rehabilitation articles are listed by topic area: geriatric rehabilitation,
      cardiac rehabilitation, pediatric rehabilitation, rehabilitation research, self
      help devices, sports medicine and rheumatologic rehabilitation. Specific search
      strategies that may be used for any computer assisted search of Medline are given
      to locate articles in these topic areas and also the following areas: amputee
      rehabilitation, spinal cord injury rehabilitation, traumatic brain injury
      rehabilitation, cerebral palsy rehabilitation, stroke rehabilitation, decubitus
      care, electrodiagnosis, rehabilitation engineering, pain rehabilitation,
      pulmonary rehabilitation, sexual rehabilitation and urologic rehabilitation. The
      user friendly Grateful Med software is introduced for simplified online Medline
      searching. Exercises are provided for starting a journal club with the retrieved
      articles.

PMID- 2222989
TI  - Pentobarbital inhibits extracellular release of dopamine in the ischemic
      striatum.
AB  - We examined whether pentobarbital (PB) inhibited the acute extracellular release
      of dopamine that occurs in the striatum following the onset of ischemic injury in
      the gerbil model of stroke. The cerebral dialysis technique was employed to
      monitor striatal extracellular dopamine concentrations before and after carotid
      artery occlusion while perfusing either a control solution of artificial
      cerebrospinal fluid (CSF) or a 1 mM solution of pentobarbital in CSF (PB/CSF).
      During perfusion with CSF, extracellular dopamine increased from a baseline
      concentration of 0.40 +/- 0.09 (SEM) pmoles/10 minute collection interval to 30.0
      +/- 9.0 pmoles/10 minutes after carotid artery occlusion. In contrast, during
      perfusion with PB/CSF, dopamine levels increased from a baseline of 1.37 +/- 0.3
      pmoles/10 minutes to 8.30 +/- 2.6 pmoles/10 minutes; this increase was
      significantly less than the increase in controls. In animals with established
      ischemia, repeatedly alternating the perfusion fluid between CSF and PB/CSF
      demonstrated that dopamine concentrations were significantly increased with CSF
      alone and decreased with PB/CSF. These findings demonstrate that pentobarbital
      perfusion either before or following the onset of ischemia inhibits extracellular
      release of dopamine in the striatum. Inhibition of neurotransmitter release may,
      in part, be responsible for the protective effect of pentobarbital in ischemic
      brain injury.

PMID- 2222990
TI  - Presynaptic effects of gamma-aminobutyric acid on norepinephrine release and
      uptake in rat pineal gland.
AB  - The effect of tau-aminobutyric acid (GABA) on pineal norepinephrine (NE) release
      was examined in vitro in the rat pineal gland. Exposure of pineal explants
      previously loaded with 3H-NE to 1-100 microM GABA caused a dose-dependent
      decrease of 3H-NE release triggered by 60 mM K+, with a threshold GABA
      concentration of 1 microM and IC50 of about 10 microM. The inhibitory effect of
      GABA was mimicked by the type B GABA agonist baclofen, displaying a similar dose
      response relationship as GABA. The type A GABA agonist muscimol increased
      depolarization-induced 3H-NE release, while the co-incubation with GABA and the
      type A receptor antagonist bicuculline augmented significantly GABA's depressive
      effect on 3H-NE release. Bicuculline alone brought about a significant decrease
      of 3H-NE release. Neither GABA, nor baclofen, muscimol or bicuculline, modified
      the spontaneous pineal 3H-NE efflux. Assessment of 3H-NE uptake at a low NE
      concentration (0.5 microM) indicated that GABA decreased it in a dose-dependent
      manner (IC50 = 100 microM) through an effect blocked by bicuculline and mimicked
      by muscimol but not by baclofen; at a 5 microM-3H-NE concentration a bicuculline
      sensitive GABA augmentation of uptake was found. A kinetic analysis study of the
      pineal NE uptake process indicated that GABA augmented both Vmax and Km of
      transmitter uptake. These results indicate that GABA may be a significant
      regulatory signal for rat pineal sympathetic synapses.

PMID- 2222991
TI  - Quantitative analysis of "synaptic" ribbon profiles in the pineal complex of male
      and female Pirbright-White guinea pigs.
AB  - Previous studies have pointed in the direction of sex differences as well as
      regional differences in the pineal gland of guinea pigs. In the present
      investigation these aspects were studied at the electron-microscopic level by
      quantitating different types of "synaptic" bodies, intrinsic to pinealocytes. The
      two major types of "synaptic" organelles, ribbons and spherules, did not exhibit
      regional or sex differences. "Synaptic" structures intermediate in appearance to
      ribbons and spherules were significantly larger in number in males in the distal
      region of the pineal gland, compared to females. As previous studies have shown
      that ribbon and spherule numbers undergo characteristic changes depending on the
      functional state of the pineal gland, it is concluded that, as far as the
      "synaptic" organelles are concerned, no clear-cut sex or regional differences
      appear to exist in the guinea pig pineal gland.

PMID- 2222992
TI  - Alterations in neocortical expression of nicotinic acetylcholine receptor mRNAs
      following unilateral lesions of the rat nucleus basalis magnocellularis.
AB  - We investigated the effect of a unilateral lesion of the nucleus basalis
      magnocellularis (nbm) on the expression of nicotinic acetylcholine receptors
      (nAChRs) in the rat cerebral cortex. Cortical nAChR concentration as determined
      by [3H]nicotine binding was unaffected by the nbm lesion. Expression levels of
      nAChR subunit mRNAs were measured using cDNA clones coding for the receptor
      subunits, alpha-3, alpha-4, and beta-2. At 1 week postlesion, expression levels
      of alpha-4, and beta-2 were increased by an average of 82% and 19%, respectively.
      On the other hand, expression levels of these mRNAs on the lesioned side 4 weeks
      after lesioning did not differ from those on the control side. Expression of
      alpha-3 was not altered by the nbm lesion. These results imply regulation of
      nAChR transcripts by cell to cell interactions. Co-increase of alpha-4 and beta-2
      transcripts may provide supporting evidence for the occurrence of
      supersensitivity in deafferentated cholinergic neurons.

PMID- 2222995
TI  - A stalk-specific wheat germ agglutinin binding protein, wst34, in Dictyostelium
      discoideum can be detected with antiserum raised against Dictyostelium mucoroides
      stalk.
AB  - A new stalk-specific wheat germ agglutinin (WGA) binding protein, wst34, has been
      identified in Dictyostelium discoideum and purified by the use of preparative
      sodium dodecyl sulfate - polyacrylamide gel electrophoresis and a WGA-affinity
      column. In normal development, wst34 appears during culmination and is maintained
      in stalk cells. It has a molecular mass of 34 kilodaltons and a pI value of 5.5
      6.5. A polyclonal antiserum raised against stalk cell proteins of Dictyostelium
      mucoroides recognizes wst34 in western blots of D. discoideum proteins.

PMID- 2222994
TI  - Biochemistry of natural freeze tolerance in animals: molecular adaptations and
      applications to cryopreservation.
AB  - For a wide variety of animals, winter survival in cold climates includes the
      ability to tolerate ice formation in extracellular body fluids. Among
      terrestrially hibernating vertebrates, freeze tolerance has been documented for
      five amphibian and two reptile species. These species may survive for days or
      weeks in a frozen state with no breathing and no heart beat, and with up to 65%
      of total body water as extracellular ice. The biochemical mechanisms involved in
      natural freeze tolerance include (i) the regulation of extracellular ice
      formation by proteinaceous ice nucleators in body fluids, (ii) the accumulation
      of high concentrations of low molecular weight carbohydrates as cryoprotectants
      to regulate cell volume reduction during freezing and stabilize macromolecular
      structure, and (iii) a well-developed ischemia tolerance that supports the
      survival of individual organs while frozen. The present article focuses on recent
      advances in our understanding of the biochemistry of natural freeze tolerance in
      lower vertebrates and the application of these studies to the improvement of
      cryopreservation technology for transplantable mammalian organs.

PMID- 2222993
TI  - Sensory transduction and the mammalian epidermis.
AB  - This paper constitutes, in its main intent, an introduction to the mammalian
      epidermis as a surface for biosensor applications. In particular, the structure
      and function of the epidermis of the newborn rat are examined as a model for
      studies of the human state. Data are presented illustrating an anisotropic
      organization of the dorsal surface of the neonatal rodent with regard to line of
      tension and thermal gradients. The dependence of the mechanical properties of the
      epidermis upon calcium is examined by means of an in-vitro assay of epidermal
      retraction. The potential role of keratin tonofilaments as piezoelectric and
      pyroelectric elements in the epidermis is introduced and the spatial alignment of
      these macromolecular arrays is demonstrated to be a function of physiological
      tensions. These findings are discussed in the context of noninvasive epidermal
      sensors utilized to understand mechanisms of sensory development and
      physiological regulation. Optoelectronic (infrared) imaging of the dorsal
      temperature field and the alteration in this field by treatment with epidermal
      growth factor are presented as examples of this methodologic approach. It is
      concluded that a detailed examination of the material and physical properties of
      mammalian epidermis is a reasonable goal of biosensor development and research.
      Hypothetically, such studies may reveal important molecular and cellular
      mechanisms by which sensory data are transmitted or transduced at the organism
      environmental interface.

PMID- 2222996
TI  - A possible mechanism for the in vitro activation of L-serine deaminase activity
      in Escherichia coli K12.
AB  - L-Serine deaminase is inactive in crude extracts of Escherichia coli K12, but can
      be activated by incubation with iron and dithiothreitol. This activation requires
      oxygen, and is inhibited by free radical scavengers and by diethylene triamine
      pentaacetic acid, which prevents Fe cycling. We suggest that in vitro activation
      of L-serine deaminase is catalyzed by an oxidant (perhaps hydroxyl radicals).
      Also, activation may be accompanied by a decrease in molecular weight and involve
      both a cleavage of the polypeptide chain and a reversible reduction of the
      molecule.

PMID- 2222997
TI  - Electroporation-mediated uptake of proteins into mammalian cells.
AB  - Proteins of up to 230 kilodaltons are taken up by chinese hamster ovary
      fibroblasts exposed to electroporation under conditions generally similar to
      those used to mediate DNA transfection. The uptake of catalase, ovalbumin, and
      histone H1 labelled with fluorescein was visualized by fluorescence microscopy.
      Under the same conditions, the uptake of colloidal gold particles (20 nm
      diameter) was visualized by electron microscopy. In optimum conditions, about 25%
      of the cells remained viable and grew normally and about 25% of these retained
      labelled proteins during two cycles of further growth. About 6 x 10(4) molecules
      of catalase were retained per cell. Proteins were taken up when presented to the
      cells up to 4 h after electroporation, suggesting that mechanisms other than
      classical electropore formation may operate in these conditions. The proteins
      were localized in the cytoplasm in a predominantly vesicular pattern and histone
      H1 entered the nucleus in some cells.

PMID- 2222998
TI  - Gangliosides and glycophorin inhibit T-lymphocyte activation.
AB  - Increased levels of gangliosides in the serum have been linked to tumour-induced
      immunosuppression in vivo. Both bovine brain gangliosides and human erythrocyte
      glycophorin were potent inhibitors of concanavalin A, periodate, and phorbol
      ester--ionomycin induced activation of murine T-lymphocytes. Structurally complex
      gangliosides were more inhibitory, while simpler glycolipids caused less
      inhibition. Lymphocytes exposed to these molecules for up to 24 h could still
      proliferate after washing. Substantial inhibition was observed only when
      gangliosides and glycophorin were present during the first 18 h of activation.
      Studies using Quin-2 showed that gangliosides did not block the initial rapid
      rise in cytoplasmic Ca2+ following mitogen stimulation. Interleukin-2 (IL-2)
      production by ganglioside- and glycophorin-treated lymphocytes was unchanged.
      After treatment with gangliosides for 24 h, lymphocytes proliferated normally in
      response to added IL-2. These results suggest that the first round of signal
      transduction in response to mitogen was unaffected by gangliosides. Addition of
      gangliosides to activated lymphocytes in the presence of IL-2 resulted in
      complete inhibition of proliferation. Immunosuppression by gangliosides and
      glycophorin thus appears to occur at the IL-2-dependent stage of proliferation
      and may be partially due to IL-2 binding to these molecules. However, high levels
      of IL-2 failed to reverse inhibition and IL-2-dependent cell lines were much less
      sensitive to ganglioside inhibition than T-lymphocytes, suggesting that more than
      one mechanism of inhibition likely exists.

PMID- 2222999
TI  - The effect of methyl lidocaine on lysophospholipid metabolism in hamster heart.
AB  - An important feature in the remodelling of fatty acyl chains in cellular
      phospholipids is the acylation of lysophospholipids. Since lysophospholipids are
      cytolytic at high concentrations, the acylation reaction may provide an alternate
      pathway for the removal of cellular lysophospholipids. However, the physiological
      role of the acylation process in the maintenance of lysophospholipid levels in
      mammalian tissues has not been clearly defined. In this study, methyl lidocaine
      was found to inhibit both lysophosphatidylcholine:acyl-CoA and
      lysophosphatidylethanolamine:acyl-CoA acyltransferase activities in the hamster
      heart, but the drug had no effect on the other lysophospholipid metabolic
      enzymes. When the heart was perfused with 0.5 mg methyl lidocaine/mL,
      acyltransferase activities were attenuated, but there was no change in the
      activities of phospholipase A or lysophospholipase. The levels of the major
      lysophospholipids in the heart were not altered by methyl lidocaine perfusion.
      When the hearts were perfused with labelled lysophospholipid in the presence of
      methyl lidocaine, there was a reduction in the formation of the phospholipid and
      an increase in the release of the free fatty acid. However, the labelling of
      lysophospholipid in the heart was not altered by methyl lidocaine. We postulate
      that the acylation reaction has no direct contribution to the maintenance of the
      lysophospholipid levels in the heart.

PMID- 2223000
TI  - Dual coenzyme activities of high-Km aldehyde dehydrogenase from rat liver
      mitochondria.
AB  - Various kinetic approaches were carried out to investigate kinetic attributes for
      the dual coenzyme activities of mitochondrial aldehyde dehydrogenase from rat
      liver. The enzyme catalyses NAD(+)- and NADP(+)-dependent oxidations of ethanal
      by an ordered bi-bi mechanism with NAD(P)+ as the first reactant bound and
      NAD(P)H as the last product released. The two coenzymes presumably interact with
      the kinetically identical site. NAD+ forms the dynamic binary complex with the
      enzyme, while the enzyme-NAD(P)H complex formation is associated with
      conformation change(s). A stopped-flow burst of NAD(P)H formation, followed by a
      slower steady-state turnover, suggests that either the deacylation or the release
      of NAD(P)H is rate limiting. Although NADP+ is reduced by a faster burst rate,
      NAD+ is slightly favored as the coenzyme by virtue of its marginally faster
      turnover rate.

PMID- 2223001
TI  - Esterase activity of high-Km aldehyde dehydrogenase from rat liver mitochondria.
AB  - Aldehyde dehydrogenase possessing an esterolytic activity has been purified to
      homogeneity from rat liver mitochondria. Steady-state kinetic studies suggest
      that the esterolytic reaction follows an ordered uni-bi mechanism. The formation
      of an acyl enzyme intermediate via nucleophilic catalysis during the esterase
      reaction is established kinetically using a series of substrates with varying
      acyl carbon chains and substituted phenyl octanoates with varying electronic
      effects. The enzyme was reconstituted into phospholipid vesicles. A significant
      increase in binding capacity is observed when the enzyme is encapsulated into
      liposomes containing 4% diphosphatidylglycerol.

PMID- 2223002
TI  - Purification and partial characterization of a mitogenic protein released from
      preadipocytes of massively obese subjects.
AB  - A protein released into the culture medium by omental preadipocytes of massively
      obese persons, which stimulates the replication of rat perirenal preadipocytes,
      has been purified to a high degree. By gel filtration chromatography, the
      molecular mass of the mitogenic protein was approximately 66,000 daltons (Da),
      while on sodium dodecyl sulfate - polyacrylamide gel electrophoresis, two
      subunits were obtained, relative masses (Mr) of approximately 31,000 and
      approximately 35,000. The isoelectric point of the approximately 66,000 Da entity
      was 5.6 +/- 0.2. By specific radioreceptor assay, the purified protein was
      related to epidermal growth factor and transforming growth factor alpha. It was
      not related to insulin-like growth factors I and II by radioimmunoassay and
      radioreceptor assay. We propose that the approximately 66,000 Mr protein, and
      other mitogenic proteins released by preadipocytes from massively obese persons,
      act through paracrine-autocrine mechanisms and may play a role in the development
      of the hyperplasia of enlarged fat cells characteristic of massive corpulence.

PMID- 2223003
TI  - S-adenosylmethionine and S-adenosylhomocysteine transitions in encysting Physarum
      flavicomum amoebae.
AB  - Previous studies from this laboratory suggested that in Physarum flavicomum an S
      adenosylmethionine (SAM) related metabolic flux is involved in the developmental
      control of microcyst formation. In the present study, this phenomenon was further
      analyzed by comparing the metabolic effects of compounds found to favor,
      stimulate, or inhibit the normal encystment process. The compounds utilized were
      adenine, cycloleucine, L-ethionine, DL-selenomethionine, cadaverine,
      cyclohexylammonium sulfate, papaverine, mycophenolic acid, decoyinine,
      putrescine, spermidine, and spermine. Following incubation with the compounds or
      combinations of the compounds, the intracellular levels of SAM and SAM
      metabolites were determined using high performance liquid chromatography. The
      actual level of the intracellular SAM pool varied considerably (notably after 15
      h of incubation), depending on the compound(s) in the incubation solution, but
      was always highest during inhibition of encystment. SAM was undetectable or
      barely detectable during stimulation of encystment or under conditions favoring
      encystment. In cells exposed to L-ethionine, we detected intracellular S
      adenosylethionine rather than SAM. The intracellular methionine pool in cells
      encysting normally for 15 h was found to be 1.3 mumol/pg DNA. Both SAM and S
      adenosylhomocysteine (SAH) were present in growing amoebae at concentrations
      greater than that of cells undergoing normal encystment. The developmental
      transition from growing amoebae to dormant cysts in P. flavicomum is
      metabolically characterized by the adjustment of the intracellular concentration
      of SAM and SAH to a minimal critical level of 0.31 and 0.70 fmol/pg DNA,
      respectively.

PMID- 2223004
TI  - Structural analysis of the specific capsular polysaccharide of Rhodococcus equi
      serotype 1.
AB  - The specific capsular polysaccharide produced by Rhodococcus equi serotype 1 was
      found to be a high molecular weight acidic polymer composed of D-glucose, D
      mannose, and D-glucuronic acid. Structural analysis of the polysaccharide
      employed a combination of chemical and nuclear magnetic resonance techniques,
      from which it was determined that the polysaccharide possessed a linear repeating
      tetrasaccharide unit containing a single O-acetyl substituent and and acetal
      linked pyruvic acid moiety: [formula: see text] The 1H and 13C nuclear magnetic
      resonances of O-deacetylated and pyruvic-free serotype 1 polysaccharides were
      fully assigned by homo- and hetero-nuclear chemical shift correlation methods.

PMID- 2223005
TI  - Endogenous heparin-binding lectin activity in human placenta: purification and
      developmental expression.
AB  - Human placental extracts contain a herapin-inhibitable lectin activity. The
      lectin, which closely resembles those from chicken and rat tissues, was purified
      by heparin-affinity chromatography. It shares many properties with the previously
      reported lectins, including hapten specificity, molecular weight of monomers, and
      immunological cross-reactivity. Sections from different stages of placental
      development, stained by immunohistochemistry procedures using lectin-specific
      antibody, showed that the lectin was initially present only in cytotrophoblasts
      of early first trimester villi. Later in the first trimester, both
      cytotrophoblasts and syncytiotrophoblasts were stained positively for lectin.
      From second trimester to term, the lectin was seen only in syncytiotrophoblasts.

PMID- 2223006
TI  - Acidic extracellular environment induces only a subset of heat-shock proteins in
      primary mouse kidney cell cultures.
AB  - Exposure of primary mouse kidney cell cultures to acidic medium (pH 5.5) induced
      the expression of a 70 kilodalton (kDa) protein. This protein was identified as
      the major inducible heat-shock protein 70 (hsp70) by immunoprecipitation with
      anti-hsp70 serum and Northern blot analysis with a hsp70 cDNA probe. Maximum
      induction of the 70-kDa protein at pH 5.5 after 240 min was about 30% of that
      observed after 60 min of thermal treatment at 43 degrees C. In addition, there
      was an apparent induction of the glucose-regulated proteins (GRPs) of 76-78 and
      98-100 kDa, but not of the other hsps. This subset induction of the heat-shock
      response by acidic medium suggests that different mechanisms are responsible for
      the induction of the various families of hsps.

PMID- 2223007
TI  - Cortisol catabolism by lymphocytes of patients with chronic lymphocytic leukemia.
AB  - A low rate of catabolism of cortisol by lymphocytes correlates with high
      sensitivity of the cells to the steroid and causes them to die at a greater rate
      than control samples. Since lymphocytes of patients with chronic lymphocytic
      leukemia respond to treatment with glucocorticosteroids and are cortisol
      sensitive, we attempted to see whether their capability to catabolize cortisol
      differs from that of normal lymphocytes. No difference was found between the two
      groups of cells with regard to the pattern of cortisol metabolites. However, the
      lymphocytes of the chronic lymphocytic leukemia groups showed a total cortisol
      catabolism per cell that was significantly lower than that of the control group.
      Patients with low lymphocyte count in peripheral blood showed a relatively higher
      cortisol metabolism by lymphocytes per cell than those with high counts.

PMID- 2223008
TI  - Effect of cellular growth state on indices of n - 6 polyunsaturated fatty acid
      status in human fibroblasts.
AB  - A 2 x 2 design was employed to examine the effect of cellular growth state and
      medium serum concentration on potential indices of n - 6 polyunsaturated fatty
      acid (PUFA) status in human skin fibroblasts. The cells were cultured either as
      nonmultiplying cell monolayers or as medium-density, log-phase multiplying cells.
      An interaction of cellular growth state and medium serum concentration influenced
      the accumulation of 20:3(n - 9), but not 22:3(n - 9), in the cellular
      phospholipids. The 20:3(n - 9)/20:4(n - 6) ratio was the most sensitive index of
      n - 6 PUFA status; however, the ratio was significantly affected by cellular
      growth state. The 22:3(n - 9)/22:4(n - 6) ratio appears to be an index of n - 6
      PUFA status in fibroblasts that is not significantly affected by the growth state
      of cells.

PMID- 2223009
TI  - Purification and properties of different isoforms of bovine cathepsin B.
AB  - A rapid purification procedure is described for cathepsin B from bovine liver.
      After preparation of crude lysosomal extracts, the method only involves DEAE Zeta
      Prep-Disk chromatography, gel filtration, and fast protein liquid chromatography
      on Mono-S column. Two active peaks (P1 and P2) of cathepsin B were distinguished.
      Both presented uncleaved (relative mass (Mr) 30,000) and cleaved (Mr 25,000 + Mr
      5000) chains, but different isoforms as revealed by isoelectrofocusing. These two
      different populations of cathepsin B isoforms nevertheless exhibited similar
      enzymatic properties. Km and kcat were 114 microM and 52 s-1, and 125 microM and
      75 s-1, for hydrolysis of Z-Arg-Arg-NMec by P1 and P2, respectively. Both were
      rapidly inhibited by low concentrations of E-64 or leupeptin, but were unaffected
      by cathepsin-L-specific inhibitor Z-Phe-Phe-CHN2.

PMID- 2223010
TI  - Image analysis of Feulgen-stained c-H-ras-transformed NIH/3T3 cells.
AB  - Feulgen-DNA content, nuclear phenotypes, and levels of chromatin condensation
      were evaluated by image analysis in NIH/3T3 cells transformed with the c-H-ras
      oncogene of T24 cells. Three nuclear phenotypes, differing from those of
      untransformed control cells and defined in terms of patterns of chromatin
      condensation, were demonstrated microspectrophotometrically for the tumor cells.
      Polyploidy could only be observed in nuclei with extensive and deeply stained
      areas covered with condensed chromatin, i.e., only in a small fraction of the
      tumor cell nuclear population. The increased chromatin condensation that appeared
      with cell transformation affected the euchromatin zones. The image analysis
      provided data that, compared with those obtained in other situations involving
      cell transformation, could be relevant to the understanding of changes in
      chromatin supraorganization related to tumorigenesis and to tumor cell diagnosis.

PMID- 2223011
TI  - Molecular characterization of three mutations in katG affecting the activity of
      hydroperoxidase I of Escherichia coli.
AB  - Hydroperoxidase I (HPI) of Escherichia coli is a bifunctional enzyme exhibiting
      both catalase and peroxidase activities. Mutants lacking appreciable HPI have
      been generated using nitrosoguanidine and the gene encoding HPI, katG, has been
      cloned from three of these mutants using either classical probing methods or
      polymerase chain reaction amplification. The mutant genes were sequenced and the
      changes from wild-type sequence identified. Two mutants contained G to A changes
      in the coding strand, resulting in glycine to aspartate changes at residues 119
      (katG15) and 314 (katG16) in the deduced amino acid sequence of the protein. A
      third mutant contained a C to T change resulting in a leucine to phenylalanine
      change at residue 139 (katG14). The Phe139-, Asp119-, and Asp314-containing
      mutants exhibited 13, less than 1, and 18%, respectively, of the wild-type
      catalase specific activity and 43, 4, and 45% of the wild-type peroxidase
      specific activity. All mutant enzymes bound less protoheme IX than the wild-type
      enzyme. The sensitivities of the mutant enzymes to the inhibitors hydroxylamine,
      azide, and cyanide and the activators imidazole and Tris were similar to those of
      the wild-type enzyme. The mutant enzymes were more sensitive to high temperature
      and to beta-mercaptoethanol than the wild-type enzyme. The pH profiles of the
      mutant catalases were unchanged from the wild-type enzyme.

PMID- 2223012
TI  - A soluble fatty acyl-acyl carrier protein synthetase from the bioluminescent
      bacterium Vibrio harveyi.
AB  - An enzyme catalyzing the ligation of long chain fatty acids to bacterial acyl
      carrier protein (ACP) has been detected and partially characterized in cell
      extracts of the bioluminescent bacterium Vibrio harveyi. Acyl-ACP synthetase
      activity (optimal pH 7.5-8.0) required millimolar concentrations of ATP and Mg2+
      and was slightly activated by Ca2+, but was inhibited at high ionic strength and
      by Triton X-100. ACP from either Escherichia coli (apparent Km = 20 microM) or V.
      harveyi was used as a substrate. Of the [14C]fatty acids tested as substrates (8
      18 carbons), a preference for fatty acids less than or equal to 14 carbons in
      length was observed. Vibrio harveyi acyl-ACP synthetase appears to be a soluble
      hydrophilic enzyme on the basis of subcellular fractionation and Triton X-114
      phase partition assay. The enzyme was not coinduced with luciferase activity or
      light emission in vivo during the late exponential growth phase in liquid
      culture. Acyl-ACP synthetase activity was also detected in extracts from the
      luminescent bacterium Vibrio fischeri, but not Photobacterium phosphoreum. The
      cytosolic nature and enzymatic properties of V. harveyi acyl-ACP synthetase
      indicate that it may have a different physiological role than the membrane-bound
      activity of E. coli, which has been implicated in phosphatidylethanolamine
      turnover. Acyl-ACP synthetase activity in V. harveyi could be involved in the
      intracellular activation and elongation of exogenous fatty acids that occurs in
      this species or in the reactivation of free myristic acid generated by
      luciferase.

PMID- 2223013
TI  - 15-Lipoxygenase products affect protein phosphorylation in Friend erythroleukemia
      cells.
AB  - Endogenous arachidonic acid metabolism and protein phosphorylation have been
      examined in Friend erythroleukemia cells in response to the induction of
      differentiation by dimethyl sulfoxide and hexamethylene bisacetamide. 15
      Hydroxyeicosatetraenoic acid levels were elevated in cells differentiated with
      hexamethylene bisacetamide or dimethyl sulfoxide compared with undifferentiated
      cells. Protein phosphorylation decreased markedly in differentiated cells
      compared with undifferentiated cells and the addition of 15
      hydroperoxyeicosatetraenoic acid specifically decreased the phosphorylation of a
      28-kilodalton protein. These findings indicate that products of 15-lipoxygenase
      may act as intracellular messengers in Friend erythroleukemia cells by affecting
      protein phosphorylation.

PMID- 2223015
TI  - Effect of sulfonates on the esterase activity of carboxypeptidase A.
AB  - The effects of sulfonates on the carboxypeptidase A catalyzed hydrolysis of the
      ester substrate benzoylglycyl-L-phenyllactate were determined. The modifiers
      examined were benzenesulfonate, p-toluenesulfonate, 2-phenylethane-sulfonate,
      methanesulfonate, ethanesulfonate, propanesulfonate, butanesulfonate,
      pentanesulfonate, hexanesulfonate, heptanesulfonate, and 2,2-dimethyl-2
      silapentane-5-sulfonate. Sulfonate activators of peptide hydrolysis were
      inhibitors of esterase activity. Of the sulfonates studied, 2,2-dimethyl-2
      silapentane-5-sulfonate was the most effective inhibitor. 2
      Phenylethanesulfonate, hexanesulfonate, heptanesulfonate, and 2,2-dimethyl-2
      silapentane-5-sulfonate exhibited uncompetitive inhibition. The remaining
      sulfonates either did not inhibit or the inhibition was too weak to properly
      characterize.

PMID- 2223014
TI  - Two stress proteins of the endoplasmic reticulum bind denatured collagen.
AB  - A differentiation-related gelatin-binding 46 kilodalton (kDa) glycoprotein in
      myoblasts (GP46, colligin) shares several properties with the 78-kDa glucose
      regulated protein (GRP78), including location in the endoplasmic reticulum and
      related C-terminal sequences. These similarities extend to stress inducibility,
      since we find that GP46 is a heat-shock protein; its synthesis is elevated at 42
      degrees C, resulting in a two- to three-fold increase in protein level. Further,
      GRP78 is a gelatin-binding protein; together with GP46 it is retained on gelatin
      Sepharose beads. GRP78 and GP46 do not interact; each protein can be individually
      eluted, GP46 at low pH and GRP78 by ATP. These results suggest that the proteins
      have distinct roles in the synthesis of collagen and point to a simple method for
      purification.

PMID- 2223016
TI  - Age-associated changes in the estrogen receptor-active proteases of female rabbit
      liver.
AB  - Female rabbit liver cytosol contains a receptor-modifying activity that converts
      the 250,000 estrogen receptor of liver and uterine cytosol to a 37,000 form.
      There is an age-dependent increase in this receptor-active protease and in the
      general protease activity of rabbit liver cytosol, measured with [14C]casein.
      Sephacryl S-200 chromatography of liver cytosol shows that in the young animal (5
      weeks old) the major receptor-modifying activity elutes near the void volume,
      while in the older animal (13 weeks old) activities having lower molecular
      weights are present. The general protease activity elution profile is similar to
      the receptor-active protease profile for the 5-week-old rabbit but not the 13
      week-old rabbit. The liver cytosol of the older animal has a high molecular
      weight protease active toward [14C]casein but not toward the estrogen receptor.
      The changes in the estrogen receptor forms and the receptor-modifying activity
      profiles of liver cytosol that occur during development in the rabbit suggest
      that receptor-modifying activity may initially be associated with the estrogen
      receptor to form a high molecular weight complex.

PMID- 2223018
TI  - Heat-stress stimulation of electron flow in a photosystem I submembrane fraction.
AB  - Oxygen uptake using methyl viologen as the terminal electron acceptor was
      recorded in digitonin-derived photosystem I submembrane fractions incubated at
      either 25 or 50 degrees C. A two- to four-fold heat-stress stimulation of
      electron flow was detected at 50 degrees C when reduced 2,6-dichlorophenol
      indophenol was used as the primary electron donor. However, no stimulation was
      seen with N,N,N',N'-tetramethylphenylenediamine as the donor. The stimulation was
      enhanced by specific cations (Mg2+, Na+, K+), but not by Mn2 or Ca2+. The
      enhancement obtained with Mg2+ could be eliminated by incubating for a prolonged
      period. It is proposed that the observed heat-stress stimulation is due to a
      conformational change at the level of the cytochrome b6-f complex. This change
      increased the affinity of the protein complex for 2,6-dichlorophenol-indophenol
      at its oxidation sites. The involvement of a conformational modification is
      demonstrated by the absence of heat-stress stimulation in submembrane fractions
      immobilized in an albumin-glutaraldehyde cross-linked matrix.

PMID- 2223017
TI  - Biochemical aspects of free radicals.
AB  - Toxic free radicals can be produced by many reactions required for the
      maintenance of normal metabolism and the production of energy in the cell. The
      reactivity of both primary and secondary radicals with biomolecules and in whole
      tissue systems is of interest, not only because of their importance in
      radiobiology but also because of the role these species play in toxicity and
      various disorders. Oxidant stress is known to increase the production of free
      radicals. In the presence of metals, especially iron, these radicals are
      converted into more damaging species. Trace elements play an important role in
      many systems that have evolved to deal with free radicals. The dietary status of
      the cell can affect the preventative antioxidant constituents of the cell. The
      chain-breaking antioxidant status can clearly be influenced by the dietary
      content of substances such as vitamins E and C.

PMID- 2223019
TI  - The mysterious cognitive disorder of Parkinson disease.

PMID- 2223020
TI  - Subcognitive processing in the frontocaudate "complex loop": the role of the
      striatum.
AB  - Anatomical connections between the frontal lobes and basal ganglia have long
      suggested joint participation in behavioural operations. Early experiments with
      nonhuman primates and patients are reviewed, followed by current research
      investigating the specific cognitive routines at risk in Parkinson disease. An
      hypothesis regarding the functional contribution of the basal ganglia to the
      frontostriate system is offered. The basal ganglia are considered to set limits
      on the context within which mental and motor events occur. It is argued that the
      nature of such processing is subcognitive.

PMID- 2223021
TI  - Spatial cognition in Parkinson disease.
AB  - Visuospatial deficits have been found repeatedly in patients with Parkinson
      disease (PD). However, their precise nature and significance remain
      controversial. Whereas it is often asserted that primary visuospatial impairments
      begin early in the disease, others argue that poor performance on visuospatial
      tasks reflects methodological artifact. This article reviews research on spatial
      cognition in PD. Five categories of spatial functions are described: visual
      analysis and synthesis; facial recognition; judgment of direction, orientation,
      and distance; constructional praxis; and spatial attention. Proposed guidelines
      for future research include the use of conceptual rather than operational
      definitions of visual spatial ability, greater attention directed at separating
      spatial from nonspatial task components, and studies examining basic mechanisms
      underlying spatial vision.

PMID- 2223022
TI  - Language and Parkinson disease.
AB  - Previously published reports of deficits in linguistically oriented tasks were
      reviewed for both demented and nondemented Parkinson disease (PD) patients in a
      discussion of the question of whether PD affects language. Additionally, to
      illustrate the methodological problems inherent in evaluating linguistic
      competence, the performance on four linguistically oriented tasks of 12 PD
      patients who scored 8 or better on the Mental Status Questionnaire was compared
      to that of 32 age- and education-matched control subjects. These tasks, from
      which a composite variable representing performance was formed, were oral object
      description, story retelling, the Peabody Picture Vocabulary Test, and the
      Similarities subtest of the Wechsler Adult Intelligence Scale (WAIS), a test of
      verbal associative reasoning. After controlling for the effects of disease
      severity, a significant effect was observed for the presence of PD. However, when
      the additional effects of performance on the Block Design subtest of the WAIS
      were controlled, the PD effect was of borderline significance. These results
      typify those in the literature, that is, whereas nondemented PD patients can be
      demonstrated to perform significantly more poorly on linguistically oriented
      tasks, the performance deficit cannot be conclusively demonstrated to result from
      a language deficit per se.

PMID- 2223023
TI  - The compassion of distinguishing punishing behavioral treatment from aversive
      treatment.

PMID- 2223024
TI  - The ideology and science of punishment in mental retardation.
AB  - The conflict between those who view aversive therapeutic interventions from an
      ideological perspective and those who view them from a scientific perspective was
      examined. Special attention was devoted to the most detailed review of punishment
      procedures in mental retardation that has been written from an ideological
      perspective, a monograph published by The Association for Persons With Severe
      Handicaps (Guess, Helmstetter, Turnbull, & Knowlton, 1986). The monograph was
      found to suffer from a number of serious conceptual and methodological flaws that
      militate against accepting its conclusions as bases for research and social
      policy in mental retardation. The conclusion was drawn that some of those who
      reject aversive therapeutic interventions do so out of a poor understanding of
      behavioral science and a primarily ideological frame of reference.

PMID- 2223025
TI  - Acceptability of behavioral interventions for self-injurious behavior:
      replication and interinstitutional comparison.
AB  - Using a case description methodology, Tarnowski, Rasnake, Mulick, and Kelly
      (1989) examined the effects of behavior problem severity and intervention type on
      staff ratings of six behavioral interventions used to treat self-injurious
      behavior (SIB). Results indicated that accelerative interventions were judged
      more acceptable than reductive treatments, and acceptability of treatments varied
      as a function of SIB severity. We hypothesized that judgments of treatment
      acceptability might vary as a function of specific institutional characteristics
      and conducted a replication of the previous study in a setting where the
      institutional treatment philosophy was explicitly behavioral. Results indicated
      that (a) accelerative interventions were preferred to reductive treatments, (b)
      acceptability ratings were not significantly influenced by SIB severity, and (c)
      interventions were generally found to be more acceptable by staff working in a
      behavioral treatment milieu.

PMID- 2223026
TI  - Teaching self-protection skills to persons with mental retardation.
AB  - A curriculum for teaching self-protection skills to eight adults with mild mental
      retardation was evaluated. The curriculum, which was presented in a small-group
      format across nine 25 to 30 minute sessions, uses instructions, modeling,
      rehearsal, feedback, and praise to teach skills needed to discriminate and safely
      respond to abduction and sexual abuse situations. Self-protection skills were
      assessed in in situ simulations involving solicitations from adults. Results
      showed that all but one subject learned the criterion skills and maintained them
      at a 6-month follow-up. Strengths and limitations of the study were discussed and
      future research directions suggested.

PMID- 2223027
TI  - Intellectual and adaptive functioning: some tables for interpreting the Vineland
      in combination with intelligence tests.
AB  - A set of tables was provided with the differences necessary for statistical
      significance between the Vineland Adaptive Behavior Scales and the Bayley Scales
      of Infant Development. McCarthy Scales of Children's Abilities, Stanford-Binet
      Intelligence Scale (4th ed.), and all current Wechsler intelligence scales. This
      information may be beneficial in determining whether discrepancies in the
      Vineland and measures of intelligence can be attributed to chance alone or
      whether they represent real differences. In light of normative sampling
      diversity, regression effects, and procedural factors, which result in varying
      and indeterminate error in the tables, the tables can only augment clinical
      decision, not replace it.

PMID- 2223028
TI  - Testing the robustness of the diagnostic overshadowing bias.
AB  - The robustness of the diagnostic overshadowing bias was examined by (a) testing
      the relation of overshadowing to level of mental retardation, (b) reexamining the
      effect of clinical experience in a more sensitive analysis, and (c) extending
      previous results to rehabilitation counselors. Diagnostic overshadowing was found
      with individuals with an IQ of 58, but did not generalize to those with IQs 70 or
      80. This finding does not support the saliency hypothesis proposed by Reiss and
      his colleagues. In contrast to earlier studies, experience was related to
      overshadowing, although results were mixed. Experience measured by number of
      clients seen was not significant, whereas longevity in the field of mental
      retardation was associated with increased overshadowing.

PMID- 2223029
TI  - Musical aptitude and adaptive behavior of people with mental retardation.
AB  - Musical aptitude was assessed in 16 adults nominated as having special musical
      interests and/or skills and 16 matched comparison adults. Information pertaining
      to strengths and weaknesses in adjustment was also obtained. Musical target
      subjects scored higher on the test of musical aptitude, particularly if they
      played a musical instrument. Evidence for difficulties in adjustment associated
      with musical skill or interest was mixed, although, in general, the results
      suggested no pervasive maladjustment among those with exceptional skill combined
      with mental retardation.

PMID- 2223030
TI  - Comment on Hore and Tryon's study of the similar structure hypothesis.

PMID- 2223031
TI  - EPA releases first interim report to Congress on medical waste management in the
      U.S.

PMID- 2223032
TI  - Sources and fates of lead and cadmium in municipal solid waste.
AB  - Lead and cadmium enter the municipal solid waste stream as components of a
      variety of consumer products. Average empirical data from several resource
      recovery plants were analyzed to obtain an estimate of the source and fate of the
      subject elements. The total amounts of lead and cadmium found in municipal solid
      waste, determined from empirical data sources, were found to agree closely with
      those based on materials flow data. It was determined that most of the cadmium
      enters the waste stream in the combustible fraction and can account for a major
      share of the cadmium observed in fly ash and in atmospheric particulates. The
      most likely sources of cadmium are plastics and pigments. The lead emissions
      appeared to be derived from both combustible and noncombustible discards of
      batteries, plastics, and pigments. The data suggests that it would be useful to
      perform mass balance studies to provide primary data for the determination of the
      most effective methods for managing discards containing lead and cadmium. The
      purpose of the suggested research is the reduction of lead and cadmium emissions
      into the environment from resource recovery plants.

PMID- 2223033
TI  - Indoor nitrogen dioxide exposure and children's pulmonary function.
AB  - Elevated concentrations of nitrogen dioxide (NO2) are produced in the home by the
      use of unvented gas appliances. In studies on potential health effects of indoor
      exposure to NO2, exposure has mostly been estimated from the presence or absence
      of sources like gas cookers in the home. This leads to misclassification of
      exposure, as NO2 concentrations in the home depend also on source use,
      ventilation habits, time budgets, etc. The availability of cheap, passive
      monitoring devices has made it possible to measure indoor concentrations of NO2
      directly in health effects studies, albeit with averaging times of one to several
      days. So far, it has not been evaluated whether this increases the sensitivity of
      a study to detect health effects of NO2. In this paper, a comparison is made
      between NO2 sources and weekly average indoor NO2 measurements, as predictors of
      pulmonary function in a study among children aged 6-12 years. The relationship
      between exposure and lung functions was found to be generally non-significant in
      this study. The results further suggested that in this study, measuring indoor
      NO2 concentrations with passive monitors offered no advantage over the simple use
      of source presence as exposure variable.

PMID- 2223035
TI  - Different types of mucosal adaptation in the ileal reservoir after restorative
      proctocolectomy. A two-year follow-up study.
AB  - A histomorphologic study of the pelvic pouch mucosa during the first two years of
      function was performed in 11 consecutive patients treated for ulcerative colitis.
      Two types of mucosal adaptation were delineated. Type A response (5 patients)
      showed stable slight atrophy, normal numbers of goblet cells, and numerous
      sulphated mucin positive cells. The frequency of mitoses was higher than in the
      normal ileum. The degree of acute and chronic inflammation was low and decreasing
      or stable. Dysplasia was never seen. Type B response (5 patients) comprised
      progressive, finally severe atrophy accompanied by increasing degree of acute
      inflammation. The number of mitoses was higher than in type A response. In two
      patients the number of goblet cells was moderately/severely decreased and
      epithelial atypia or low grade dysplasia occurred repeatedly. The response was
      regarded as indeterminate in one patient. The determination of the types of
      mucosal adaptation may help in the planning of the follow-up of these patients.

PMID- 2223034
TI  - The autopsy and epidemiology--Olmsted County, Minnesota and Malmo, Sweden.
AB  - The existence of high quality, population-based, medical data facilitates the
      practice of modern epidemiology with its concomitant benefits for clinical
      practice and public health policy. Two exceptional examples of such databases are
      provided by Malmo, Sweden, and Olmsted County, Minnesota. This paper outlines
      briefly the similarities between these two geographic entities, and focuses, in
      particular, on the central role of the autopsy in Olmsted County. Changing
      temporal and spatial patterns of autopsy are reviewed as well as two important
      related issues: the role of consent and the medico-legal autopsy. The paper
      concludes with a summary of some of the more noteworthy contributions of autopsy
      based epidemiological research in Olmsted County, and offers several
      recommendations for the establishment of a select network of special population
      based study areas. These epidemiological "laboratories", through the interchange
      of data and tissue specimens, could make significant contributions to the study
      of diseases both nationally and internationally. Their interactive efforts and
      high quality data bases would help to increase the efficiency of the expenditure
      of scarce societal resources in epidemiology and health care.

PMID- 2223036
TI  - Quartz-induced production of reactive oxygen metabolites by activated human
      monocyte-derived macrophages.
AB  - Quartz but not titanium dioxide (TiO2) induced the production of reactive oxygen
      metabolites (ROM) by human monocyte-derived macrophages, as measured by lucigenin
      dependent chemiluminescence. Activation of the macrophages with BCG, bacterial
      lipopolysaccharide and macrophage-activating factor (MAF) caused a prominent
      increase of quartz-induced ROM production, MAF having the strongest effect. The
      activation did not affect the TiO2 responses to the same extent. Assuming that
      ROM have a role in the pathogenesis of silica-induced disease in man, we suggest
      that enhancement of quartz-induced production of ROM by activated pulmonary
      macrophages may at least partly explain the experimental and epidemiological data
      indicating that activation of the immune system during infection promotes the
      development of silicosis.

PMID- 2223037
TI  - Intestinal microbial conversion of cholesterol to coprostanol in man. Influence
      of antibiotics.
AB  - The intestinal microbial conversion of cholesterol to coprostanol has been
      measured in groups of healthy subjects before, during and after they received the
      antibiotics ampicillin, bacitracin, clindamycin, co-trimoxazole, doxycycline,
      erythromycin, metronidazole, nalidixic acid, ofloxacin or vancomycin orally for 6
      days. Before they received antibiotics, the subjects demonstrated two distinct
      patterns of cholesterol conversion. One pattern was characterised by extensive
      conversion of cholesterol, the other by little or no conversion. Intake of
      bacitracin, clindamycin, erythromycin, metronidazole and vancomycin significantly
      reduced the conversion to coprostanol. In the groups receiving ampicillin or
      doxycycline, marked reductions were found in most of the subjects. No alterations
      were found in the groups receiving co-trimoxazole, nalidixic acid or ofloxacin.
      In 6 subjects no conversion of cholesterol to coprostanol was found up to 5 weeks
      after the end of the antibiotic intake. We conclude that orally given antibiotics
      may cause alterations in the intestinal conversion of cholesterol, reflecting
      changes in the anaerobic, Gram-positive component of the gut flora.

PMID- 2223038
TI  - DNA content and nuclear size of megakaryocytes in thrombocythaemia.
AB  - Total nuclear DNA content and nuclear size of megakaryocytes were studied in
      biopsies of the iliac bone marrow of individuals with normal or increased
      platelet counts. The DNA content was determined using Feulgen cytophotometry of
      bone marrow smears and the nuclear area by morphometric analysis of
      megakaryocytes of bone marrow sections. The mean DNA content and the mean nuclear
      area were both significantly larger in megakaryocytes of patients with
      thrombocytosis as a result of myeloproliferative disease than in patients with
      secondary thrombocytosis as well as in two control groups of individuals with
      normal platelets counts, one comprising healthy volunteers, the other with
      various non-haematological disorders. There was a statistically significant
      correlation between the DNA content and nuclear area of the megakaryocytes (r =
      0.92) in the entire group of bone marrows studied.

PMID- 2223039
TI  - Effect of astrocyte-derived factors on ischemic brain edema induced by rat MCA
      occlusion.
AB  - To clarify whether astrocyte-derived factors may protect cerebral tissue from
      ischemia, we examined brain edema, demyelination and astrocyte proliferation in
      brains with focal ischemia and treated with astrocyte-cultured medium. We
      occluded the left middle cerebral artery of rats and implanted the Osmotic
      Minipump, which continuously infused the glial-cultured medium or control medium
      into the left lateral ventricle. Animals were sacrificed at 3 days or 7 days
      after occlusion. Brains of both groups were compared by several markers, i.e.
      extravasation of Evans blue, demyelination by Woelcke's staining and glial
      proliferation by GFAP staining. We found the astrocyte-cultured medium reduced
      leakage of Evans blue-plasma protein complex from ischemic lesions and reduced
      the size of demyelinated lesions. However, the degree of astrocyte proliferation
      was similar in both groups. From these data, we speculate that humoral factors
      derived from cultured astrocytes lessened the brain edema by modifying the blood
      brain barrier. These factors might also induce proliferation of the microglia,
      and may protect the neurons from secondary injury by oxygen-free radicals.

PMID- 2223041
TI  - Interhemispheric EEG coherence during sleep and wakefulness in left- and right
      handed subjects.
AB  - REM sleep is associated with the production of complex imagery sequences. Yet
      research is divided as to whether different brain regions are more or less
      coordinated in their functioning at this time. Some research suggests that there
      may occur a functional disconnection of the left and right cerebral hemispheres
      during REM sleep which is similar to the disconnection syndrome seen after corpus
      callosotomy. Other research suggests that an increase in interhemispheric
      coordination occurs. On the assumption that hemispheric coordination is reflected
      in the EEG coherence measure, we explored differences in interhemispheric
      coherence recorded in six left- and six right-handed normal subjects during
      periods of wakefulness, stage REM, stage 2, and stage 3/4 sleep. Strong evidence
      was found that mean EEG coherence values are larger during sleep than during
      waking and that they are approximately equal for the different stages of sleep.
      Frontal electrode placements demonstrated a slightly different pattern of
      coherence than central, parietal, or occipital placements. Furthermore, coherence
      values were larger for left-handed subjects over the occipital region during
      wakefulness, stage 2, and stage REM sleep, but not during stage 3/4 sleep.
      Coherence was not different for male and female subjects. These findings oppose
      the interpretation that a functional disconnection of hemispheres occurs during
      REM sleep and favor the interpretation that sleep in general is a state of
      heightened cortical coordination. Moreover, greater interhemispheric coherence
      over occipital brain regions in left-handed subjects suggests possible
      differences in the cognitive processes of these subjects during waking and
      dreaming states.

PMID- 2223040
TI  - Unawareness of impaired face recognition.
AB  - We report investigations of the face processing abilities of SP, a right-handed
      woman who had suffered a subarachnoid haemorrhage from a right middle cerebral
      artery aneurysm. Although she could correctly assign visual stimuli to the 'face'
      category without difficulty, SP performed poorly on all other face processing,
      tasks, including 'closure' (Mooney faces), perception of facial expression,
      unfamiliar face matching, and identification of familiar faces. Identification of
      familiar people from nonfacial cues (names) remained relatively well-preserved,
      but severe impairments were evident on all face recognition tasks. Her errors
      mostly involved either failures to find a face familiar at all, or
      misidentification as another familiar person. In face-name learning tasks, there
      was evidence of 'covert' recognition of faces she failed to recognize overtly.
      SP's face processing impairment remained stable across a 20-month period of
      investigation, yet throughout this period she did not think that she had any
      problems in face recognition, and continued to show lack of insight into this
      impairment even when directly confronted with its consequences on formal testing.
      In contrast, SP showed adequate insight into other physical and cognitive
      impairments produced by her illness, including poor memory, hemiplegia, and
      hemianopia. We propose that her lack of insight into her face recognition
      problems involves a deficit-specific anosognosia, resulting from impairment of
      domain-specific monitoring abilities.

PMID- 2223042
TI  - Long-term effects of cerebellar pathology on cognitive functions.
AB  - Twelve patients with circumscribed chronic neocerebellar lesions but without CT
      evidence of forebrain damage (other than the effects of shunting) were
      investigated for deficits of cognitive functions. Two different mechanisms were
      considered as possible causes of cognitive impairment: (1) Damage to the dentato
      thalamo-cortical projection leading to impairments of cortical functions, and (2)
      prolonged intracranial pressure resulting in diffuse forebrain damage and
      subcortical dementia. Patients with lesions in the left neocerebellum showed
      deficits in cognitive operations in three dimensional space, consistent with the
      right forebrain dominance for spatial functions. Prolonged intracranial pressure,
      on the other hand, resulted in a mild overall cognitive impairment.

PMID- 2223043
TI  - Variations in sex-related cognitive abilities across the menstrual cycle.
AB  - Sex differences in human cognitive and motor skills may in part be due to
      organizational or activational effects of sex hormones on the brain. In this
      study, an extensive battery of cognitive and motor tests was administered to
      normally cycling women at two phases of the menstrual cycle, in order to detect
      any hormone-mediated changes in performance. Results confirmed changes across the
      menstrual cycle on a variety of speeded manual and articulatory measures, and on
      some nonverbal/spatial tests. The results provide qualified support for the
      hypothesis that the high levels of gonadal steroids provide qualified support for
      the hypothesis that the high levels of gonadal steroids present at the luteal
      phase of the cycle may facilitate skills favoring females, but be detrimental to
      skills favoring males. The implications of these results for research in the area
      of human sex differences are discussed.

PMID- 2223044
TI  - Locus of information in words and the right visual field effect.
AB  - The right visual field (RVF) advantage found for the identification or
      classification of words has usually been interpreted as evidence for left
      hemisphere language functions. It has more recently been explained as the result
      of the fact that the most informative part of the word, presumably the beginning,
      is in a region of better visual acuity. It is not clear from existing evidence
      that the beginnings of words are in fact more informative. The present study
      assessed the locus of information in words by deleting either the initial or
      terminal one or two letters. Subjects were required to generate a completion.
      Regardless of whether subjects were scored as correct for generating the original
      target word (as would be appropriate in a naming study) or for producing any
      legitimate word (as would be appropriate for a lexical decision study), the
      results indicated that most words have more information in the initial letters.
      Nevertheless, there are exceptions to this rule, and some words have more
      terminal information. Equal numbers of words with more initial information and
      with more terminal information were selected for two visual field studies in
      order to assess the effect of the locus of information on visual laterality. In
      neither a lexical decision study nor a naming study did locus of information
      affect the commonly observed right visual field superiority. Thus the
      distribution of information is not likely to be a major confounding variable in
      laterality studies employing horizontally presented words.

PMID- 2223045
TI  - The effects of precocious adrenarche on cognition and hemispheric specialization.
AB  - Cognitive skills were assessed in 13 females with a history of precocious
      adrenarche (PA). They were of average intelligence. In terms of lateralized
      cognitive skills, PA had no effect on verbal fluency. The spatial abilities of
      females with a history of PA, who had reached gonarche (were fully pubertal),
      were inferior to those of females tested in the midst of PA and to population
      controls. The physiologic/hormonal changes associated with normal adrenarche may
      curtail further specialization of the right hemisphere, resulting in a relative
      spatial deficit among females in general, who as a group reach adrenarche earlier
      than males. This spatial performance deficit is exaggerated in females with PA.

PMID- 2223046
TI  - Hemispheric asymmetries in attentional control: implications for hand preference
      in sensorimotor tasks.
AB  - Liepmann (1908) proposed that handedness reflects the greater capacity of one
      hemisphere to learn the execution of skilled movements. Although asymmetries in
      motor control are an important basis for hand asymmetries, recent studies have
      suggested that handedness may be determined by multiple factors. In the present
      study, we examine how attentional asymmetries may contribute to hand preferences.
      Right-handed subjects participated in a reaction time task in which they were
      given preliminary information about where a target stimulus would occur
      (selective attention) or which hand to use for responding (selective intention).
      Our findings indicate that these processes influence each other reciprocally and
      favor a state of optimal attentional and intentional preparation of the right
      hand. We suggest that these hemispheric asymmetries in attentional control
      contribute to hand preferences in certain sensorimotor tasks.

PMID- 2223047
TI  - Selective activation effects of concurrent verbal and spatial memory loads in
      left-handed and right-handed adults.
AB  - Thirty-two left-handed subjects, divided into four groups according to sex and
      familial sinistrality, and 16 right-handed subjects without familial sinistrality
      (8 male, 8 female) participated in a tachistoscopic unilateral letter
      identification task with concurrent verbal- and spatial-memory loads. Across
      groups, a significant right visual field advantage for letter-identification was
      found. In the majority of both left-handed and right-handed subjects, the
      concurrent verbal-memory load resulted in a selective activation, with the right
      visual field performance showing improvement. However, the group of left-handed
      males with a positive family history of sinistrality gave less evidence of
      selective left-hemispheric activation as a consequence of the verbal-memory load.
      The concurrent spatial-memory load did not result in a consistent pattern of
      selective activation.

PMID- 2223048
TI  - The lateralization of language comprehension using event-related potentials.
AB  - Event-Related Potentials were recorded over occipital and parietal scalp from
      left- and right-handed adults presented with a language and a non-language visual
      stimulus using a divided field, "oddball" paradigm. The major finding of interest
      was that the P300 component was larger over the left than the right hemisphere of
      the right-handers when the language stimulus was presented to the left
      hemisphere; there were no hemispheric differences for the left-handers,
      regardless of field of presentation. These results are discussed in the context
      of developing noninvasive measures to lateralize language function.

PMID- 2223049
TI  - Neurones in the dorsal motor vagal nucleus of the cat with non-myelinated axons
      projecting to the heart and lungs.
AB  - Extracellular recordings were made from ninety-four single motoneurones in the
      dorsal motor vagal nucleus of chloralose-anaesthetized or decerebrate cats. Fifty
      five neurones had axons in cardiac vagal branches and thirty-nine had axons in
      pulmonary vagal branches; the conduction velocities of the axons were in the C
      fibre range, i.e. the axons were non-myelinated. The neurons exhibited little or
      no spontaneous activity. Excitatory and inhibitory synaptic inputs were
      demonstrated by electrical stimulation of the vagus nerve or its branches. Twenty
      four neurones were tested by carotid sinus distension but only one was excited.
      Iontophoretic excitation of neurones projecting to cardiac vagal branches had no
      effect on heart rate. The properties of these neurones and their possible
      functions are discussed and contrasted with those of cardiac and pulmonary vagal
      motoneurones in the nucleus ambiguus.

PMID- 2223050
TI  - 5-Hydroxytryptamine mediates the post-embolic increase in respiratory rate in
      anaesthetized rabbits.
AB  - The effect of the neuronal 5-HT3 receptor antagonist MDL 72222 has been
      investigated on the reflex tachypnoeic response to pulmonary embolism in
      pentobarbitone-anaesthetized rabbits. Pre-treatment with MDL 72222 (640
      micrograms kg-1, 5 min prior to embolization) significantly attenuated the reflex
      tachypnoeic response associated with the injection of emboli. MDL 72222 had no
      effect on the bradycardia associated with embolization; however, it significantly
      reduced the decrease in arterial blood pressure and converted the decrease in
      tidal volume seen in pulmonary embolism to an increase. Furthermore, MDL 72222
      had no effect on the decrease in circulating platelet count associated with
      embolization. The data suggest that 5-hydroxytryptamine is of primary importance
      in mediating the post-embolic increase in respiratory rate seen in this model of
      pulmonary embolism.

PMID- 2223052
TI  - Lack of interaction between adenosine-induced vasodilatation and carotid
      baroreflex-induced changes in sympathetic activity in dog hindlimb artery.
AB  - In anaesthetized dogs, a hindlimb was vascularly isolated and perfused at a
      constant flow rate of 7.7 +/- 1.9 ml min-1 100 g-1 (mean +/- S.E.M.; n = 5)
      through the femoral artery. The carotid sinuses were isolated and perfused at
      high (greater than 145 mmHg) or low (less than 75 mmHg) pressure to enable reflex
      sympathetic tone on the hindlimb vessels to be controlled. Both vagi were
      sectioned in the neck and mean aortic blood pressure was held constant by
      connection of the aorta to a reservoir. The responses to infusion of three doses
      of adenosine at high and low carotid sinus pressures were not significantly
      different: infusion of 0.60 +/- 0.16 microM-adenosine reduced femoral arterial
      perfusion pressure (FAPP) by 11.6 +/- 3.2% (n = 6) at high carotid sinus pressure
      and by 12.6 +/- 5.1% (n = 4) at low carotid sinus pressure, while 4.71 +/- 0.49
      microM-adenosine reduced FAPP by 20.8 +/- 4.8% (n = 6) at high carotid sinus
      pressure and by 20.7 +/- 4.8% (n = 6) at low carotid sinus pressure; 50.1 +/- 7.3
      microM-adenosine reduced FAPP by 36.7 +/- 5.5% (n = 6) at high carotid sinus
      pressure and by 27.7 +/- 7.8% (n = 5) at low carotid sinus pressure.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2223051
TI  - The involvement of the midbrain periaqueductal grey in the cardiovascular
      response to injury in the conscious and anaesthetized rat.
AB  - Cell bodies within the periaqueductal grey (PAG) of the midbrain of the propofol
      anaesthetized rat were stimulated using the excitotoxin kainic acid. This
      resulted in a rise in arterial blood pressure and a tachycardia, together with a
      reduction in the sensitivity and a rightward resetting of the baroreflex. These
      changes mimicked the cardiovascular effect of bilateral hindlimb ischaemia in the
      rat. Further experiments in conscious rats indicated that electrolytic lesions in
      the PAG prevented the reduction in baroreflex sensitivity induced by limb
      ischaemia, but did not abolish the rightward resetting of the reflex or the
      pressor response and tachycardia when compared with sham-lesioned controls. It is
      postulated that the PAG, a site of importance both in the integration of the
      defence reaction and the processing of afferent nociceptive information, may form
      part of a pathway involved in the reduction of the sensitivity of the baroreflex
      following injury. This pathway is suggested to be separate from a second, as yet
      undefined, pathway mediating the baroreflex resetting and pressor responses
      associated with injury.

PMID- 2223053
TI  - The influence of bicycle exercise, with or without hand immersion in cold water,
      on forearm sweating in young and middle-aged women.
AB  - Forearm sweat production rate (SPR) and external auditory meatal temperature
      (TEAM) were examined in five young and five middle-aged women in response to
      intermittent exercise, on three separate occasions. The first experiment was a
      control study, while in the second study the left hand was immersed in cold water
      at the onset of sweating during each exercise bout, and in the third study this
      immersion was accompanied by venous occlusion of the upper left arm. TEAM
      increased by 0.5 degrees C during exercise with no significant differences
      between the groups on any occasion. The young women displayed a greater peak SPR
      during exercise in the control than the middle-aged women (52.5 +/- 23.9 vs. 16.7
      +/- 6.5 mg cm2 h-1, P less than 0.001). With hand immersion, peak SPR was
      depressed to 14.0 +/- 4.6 mg cm2 h-1 (P less than 0.001) in the young women and
      to 13.1 +/- 4.5 mg cm2 h-1 in the middle-aged (P less than 0.05). With hand
      immersion and venous occlusion the peak SPR in young women increased (43.0 +/-
      9.2 mg cm2 h-1). In the older women SPR was 14.9 +/- 6.1 mg cm2 h-1, which was
      not different from either control or cold-immersed values. Thus, forearm SPR
      during low-intensity intermittent exercise is greater in young compared with
      middle-aged women, despite similar changes in TEAM. The response to hand
      immersion in cold water was more marked in the young subjects.

PMID- 2223054
TI  - Amylin-amide: a new bone-conserving peptide from the pancreas.
AB  - Amylin-amide is a new member of the family of peptides encoded by the calcitonin
      multigene complex. In the present study, we have compared directly, the
      hypocalcaemic potency and duration of action of human amylin-amide and human
      calcitonin in an in vivo rat bioassay and an in vitro osteoclast bone resorption
      assay. Amylin-amide was found to have a potency approximately 40-fold lower than
      human calcitonin, whilst both peptides followed the same time course. This
      suggests that amylin-amide is the most potent non-calcitonin hypocalcaemic
      peptide so far reported. An important physiological implication follows. It would
      seem that amylin-amide can play a central role in the maintenance of the skeleton
      by virtue of its inhibitory influence on osteoclastic function.

PMID- 2223057
TI  - Ammonia absorption from the isolated reticulo-rumen of sheep.
AB  - In fistulated sheep (50-60 kg live weight) the absorption of ammonia from the
      reticulo-rumen in vivo was studied applying the technique of the temporarily
      isolated and washed reticulo-rumen. It was found that, at ammonia concentrations
      between 3 and 18 mM, ammonia efflux and ammonia net absorption were linearly
      related to the ammonia concentration in the artificial rumen fluid, whereas
      influx of ammonia nitrogen from endogenous sources remained almost constant. When
      the concentration of unionized NH3 was changed at the ratio 1:10:76 by varying
      the pH from 5.8 to 6.8 and 7.7, ammonia net absorption did not reflect the
      concentration ratio of unionized NH3, indicating either flux of NH4+ ions or
      titration of NH4+ to NH3 at the absorptive surface. In the experiments with
      buffer solutions without ammonium salts and extended over 2 h, ammonia
      concentrations in the artificial rumen fluid increased due to endogenous nitrogen
      influx and reached levels far beyond the expected plateau concentration of about
      2 mM. Labelling of the N pool in the isolated organ by 15N showed that ammonia
      efflux had almost ceased in these experiments. It is argued that as yet
      unidentified changes have taken place in the artificial rumen fluid during the
      experiment, but there is some reason to believe that volatile fatty acid (VFA)
      absorption was affecting ammonia absorption.

PMID- 2223056
TI  - The action of strophanthidin on calcium-activated current and contraction in
      single guinea-pig ventricular myocytes.
AB  - Calcium-activated tail current was used as a qualitative indicator of changes in
      [Ca]i in order to investigate the mechanism of strophanthidin-induced inotropy in
      single guinea-pig ventricular myocytes. Action potentials were interrupted (by
      application of a voltage clamp to -40 mV) in order to evoke Ca-activated current.
      Exposure to 10 microM-strophanthidin for 2 min resulted in an increase in
      contractions associated with complete action potentials and in an increase in Ca
      activated current. Strophanthidin appeared not to substantially modify the time
      course of the envelope of tail currents (recorded by interrupting action
      potentials at different durations), which is thought to reflect the time course
      of the systolic [Ca]i transient. Exposure to 1 microM-ryanodine slowed the
      development of the Ca-activated current envelopes and abolished the above effects
      of strophanthidin. Exposure to strophanthidin led to reduction in Ca current in a
      majority of cells (measured by a voltage-clamp step from -40 to 0 mV). These
      results are consistent with the hypothesis that in single guinea-pig ventricular
      myocytes strophanthidin causes an increased loading of ryanodine-sensitive
      intracellular stores of Ca, possibly through reduced extrusion of Ca from the
      cell by Na-Ca exchange during the action potential plateau.

PMID- 2223055
TI  - Effects of Ca2+ channel agonist-antagonist enantiomers of dihydropyridine 202791
      on insulin release, 45Ca uptake and electrical activity in isolated pancreatic
      islets.
AB  - This is the first study using the selective agonist/antagonist stereoisomers of
      dihydropyridine 202791 to investigate stimulus-secretion coupling in pancreatic
      islet cells. We studied effects of the (+)(Ca2+ channel agonist) and (-)(Ca2+
      channel antagonist) forms of the dihydropyridine, on 45calcium net uptake,
      insulin secretion, and membrane potential measured in rodent islets. The
      antagonist partially inhibited glucose-induced insulin secretion and Ca2+ uptake;
      however, the potassium-induced Ca2+ uptake was completely inhibited. The
      antagonist did not completely block glucose-evoked spike activity. Addition of
      the agonist enhanced insulin release and Ca2+ uptake in the presence of 5.6 mM
      glucose, but did not increase insulin release or Ca2+ uptake in 16.7 mM-glucose.
      In the presence of tetraethylammonium (TEA), (+)202791 increased and (-)202791
      decreased the duration of glucose-induced action potentials. The results again
      confirm the presence of a dihydropyridine-sensitive Ca2+ channel in pancreatic B
      cells. In addition these data suggest that in these cells there is activation of
      a dihydropyridine-insensitive Ca2+ entry in the presence of glucose.

PMID- 2223058
TI  - Vasoactive intestinal peptide stimulation of adenylate cyclase activity in
      isolated rabbit renal arterial microvessels.
AB  - Vasoactive intestinal peptide (VIP) at a concentration of 1 microM stimulates
      adenylate cyclase (AC) in isolated rabbit renal preglomerular arterial vessels by
      3.9 +/- 1.3 fold (n = 6) over basal values. A comparable stimulation of AC was
      observed with prostaglandin E1. Half-maximal VIP-stimulated activity was observed
      at 7.2 +/- 3.5 nM (n = 6), which was increased to 17.4 +/- 4.4 nM by 10 microM
      (4Cl-D-Phe6,Leu17)VIP, a VIP-receptor antagonist.

PMID- 2223059
TI  - Stimulation of ovine placental transport of calcium and magnesium by mid-molecule
      fragments of human parathyroid hormone-related protein.
AB  - Perfusion in situ of the placenta of intact or previously parathyroidectomized
      fetal lambs has been used to assess the ability of three mid-molecule fragments
      of the human parathyroid hormone-related protein (PTHrP) molecule to stimulate
      the placental transport of calcium and magnesium. PTHrP(67-86 amide) was most
      effective but some activity was also shown by PTHrP(75-86 amide) and by PTHrP (75
      84) in decreasing order. This placental action of PTHrP(67-86 amide) was rapid
      and could be observed using the placenta from an intact fetus, whereas it was
      necessary to use the placenta from a previously parathyroidectomized fetus to
      demonstrate stimulation of placental calcium transport by PTHrP(1-84). PTHrP(67
      86 amide) may resemble the molecule that activates the placental calcium pump.

PMID- 2223060
TI  - Abnormal expression of dipeptidylpeptidase IV activity in enterocyte brush-border
      membranes of children suffering from coeliac disease.
AB  - Dipeptidylpeptidase IV (DPP IV) activity has been shown cytochemically to
      decrease significantly in enterocytes of children suffering from coeliac disease.
      This decrease is due to a halving of the time available for enterocytes to
      express DPP IV in their brush-border membranes during development. This effect is
      compared with previous results showing coeliac disease to inhibit disaccharidase
      activities selectively.

PMID- 2223061
TI  - IgG subclass deficiency.
AB  - Although the occurrence of selective deficiencies of serum IgG subclasses has
      been known for 20 years, the large body of data presently available was collected
      only recently owing to the use of performing monoclonal antibodies. IgG subclass
      deficiency is frequent, both as an apparently isolated defect (about one fourth
      of patients suffering otherwise unexplained repeated infections) and in
      association with a number of primary and required immunodeficiency states. This
      paper briefly reviews the methodological problems of serum IgG subclass
      measurement and data on subclass deficiency in a variety of clinical conditions.

PMID- 2223062
TI  - Sialophorin (CD43) and the Wiskott-Aldrich syndrome.
AB  - Wiskott-Aldrich syndrome is an inherited deficiency of T-lymphocyte function and
      of platelets. The observation in 1981-84 of deficiency and/or defects in Wiskott
      Aldrich lymphocytes of the surface molecule sialophorin (CD43) spurred intensive
      study of this molecule. Sialophorin (CD43) is now known to be a prevalent
      molecule on most circulating blood cells; it is a transmembrane molecule subject
      to phosphorylation reactions and capable of intracellular signaling.
      Oligosaccharides constitute 60% of the molecule. The extracellular region
      resembles acidic mucin molecules with expanded structure and dense negative
      charge. The sialophorin (CD43) polypeptide is subject to alternative
      glycosylation pathways that are cell-specific. CD43 functions in vitro as the
      receptor of an independent pathway of T-lymphocyte and monocyte activation. CD43
      is hypothesized to regulate the survival of blood cells in the circulation. This
      review covers the distribution, chemistry, cDNA cloning, genetic analysis and
      functional analysis of CD43, and summarizes recent findings of related defects in
      Wiskott-Aldrich lymphocytes.

PMID- 2223063
TI  - Pediatric HIV infection: a review.

PMID- 2223064
TI  - Rapid alkaline transfer of low molecular weight DNA from NuSieve GTG agarose
      gels.
AB  - The rapid alkaline transfer of high molecular weight DNA from agarose gels to
      nylon membranes has greatly decreased the time required for setup of Southern
      transfers. This technique has been used to resolve genomic DNA greater than 1000
      base pairs by conventional electrophoresis on 1% agarose gels followed by
      alkaline transfer to nylon membrane. Now we report that this rapid alkaline
      method can be used for the transfer of low molecular weight DNA fragments (10 to
      1000 base pairs) from NuSieve GTG agarose gels to nylon membrane.

PMID- 2223065
TI  - Purification of a thermostable DNA polymerase from Thermus thermophilus HB8,
      useful in the polymerase chain reaction.
AB  - A thermostable DNA polymerase, isolated from the thermophilic strain Thermus
      thermophilus HB 8 was purified by a five-step procedure which provides a high
      yield and a homogeneous preparation. The molecular weight was estimated to be
      67,000 daltons and the extension rate was determined to be 1500 nucleotides per
      minute. The enzyme works in polymerase chain reaction conditions similar to those
      used for Taq polymerase from Thermus aquaticus.

PMID- 2223066
TI  - Expression studies of transfected multigene families by homologous DNA
      mutagenesis.
AB  - A valuable approach for multigene family studies where the expression product of
      at least one gene member of the family is measurable is described. In such cases,
      the effect on gene expression of nucleotide sequence differences or mutations
      occurring in other members of the family or at alleles can easily be determined.
      This is achieved by a strategy called homologous DNA mutagenesis. It consists of
      the insertion of mutated regions from homologous genes into the context of the
      gene coding for the assayable product. Here we demonstrate the feasibility of
      this approach using gene members of the human growth hormone and human placental
      lactogen (hGH-hPL) multigene family.

PMID- 2223067
TI  - Thermocycler temperature variation invalidates PCR results.
AB  - Among the factors which have to be optimized to ensure highest sensitivity and
      specificity of the polymerase chain reaction (PCR) is the processor which enables
      the automatic performance of the PCR assay. It has to guarantee temperature
      homogeneity for all samples of an individual run and run-to-run comparability.
      The following report illustrates that the present generation of PCR processors
      does not yet fulfill this requirement to satisfaction. It discusses examples of
      significant performance variations and their consequences for the outcome of the
      amplification reaction.

PMID- 2223068
TI  - A rapid method for the construction of synthetic genes using the polymerase chain
      reaction.

PMID- 2223069
TI  - A rapid and inexpensive procedure for desalting synthetic oligonucleotides.

PMID- 2223070
TI  - Effect of ionic and nonionic detergents on the Taq polymerase.

PMID- 2223071
TI  - Estimation of quantity of polymerase chain reaction products by ethidium bromide
      agarose plate assay.

PMID- 2223072
TI  - A DNA text code.

PMID- 2223073
TI  - Method for reducing microbial contamination in tissue culture incubators.

PMID- 2223074
TI  - Electrofused mammalian cells analyzed by free-flow electrophoresis.
AB  - Somatic cell fusion is a powerful and widely used technique. In recent years,
      electrofusion has become increasingly popular because it is a gentle process that
      can be optically controlled and carefully monitored using appropriate fusion
      chambers and because it permits the efficient fusion of smaller cell numbers.
      However, damage of the cell membrane and cell lysis occurs during application of
      the electrical field and is accompanied by changes in surface charge which can be
      detected by free-flow electrophoresis. In this study, we evaluated free-flow
      electrophoresis to detect changes in cell viability after application of electric
      field conditions employed in mammalian cell electrofusion and to separate dead
      cells and cell debris from intact unfused or fused cells.

PMID- 2223075
TI  - Selection of invasive and metastatic subpopulations from a heterogeneous human
      melanoma cell line.
AB  - The formation and propagation of several subpopulations of human melanoma cells
      from a heterogeneous parental population was accomplished with the use of the
      Membrane Invasion Culture System (MICS) in vitro under sterile conditions. Five
      sequentially selected subpopulations of melanoma cells showed an increasing
      ability to do the following: a) invade reconstituted basement membranes in vitro;
      b) form experimental lung metastases in vivo; and c) express steady-state levels
      of human type IV collagenase, a marker for metastatic potential. In addition, the
      morphology and expression of 35S-methionine-labeled cell surface proteins changed
      with sequential selection. The adaptation of the MICS assay for studying tumor
      cell subpopulations allows the morphological, biochemical and molecular
      characterization of events associated with tumor progression in an in vitro
      model.

PMID- 2223076
TI  - Sphere-linked immunodiagnostic assay (SLIDA): an electron microscopic method for
      detecting specific antibodies.
AB  - We have developed a sensitive method, sphere-linked immunodiagnostic assay, using
      specific antigens covalently bonded to microspheres for the detection of
      antibodies in serum. In this method, specific antigens, such as the capsid
      proteins of tobacco mosaic virus and tobacco etch virus, were independently,
      covalently bonded to plastic micropheres of 0.5 microns or 0.9 microns in
      diameter. The antigen-linked spheres were then exposed to normal serum or serum
      containing specific antibody, followed by treatment with gold-labeled secondary
      antibodies. The binding of the gold-labeled secondary antibodies to the specific
      primary antibodies on the spheres acted as an indication of the presence of the
      specific primary antibodies. The spheres were then examined and photographed by
      transmission electron microscopy. The number of gold particles bound to the
      spheres was counted manually using the photographs. The gold labeling was found
      to be specific and sensitive, enabling detection of antibodies present in highly
      diluted antisera. The efficiency and sensitivity of the technique for detection
      of antibodies were compared with those of the enzyme-linked immunosorbent assay
      and found to be highly sensitive. The technique was also used for testing for the
      presence of antibodies to herpes simplex virus as well as antibodies to
      Staphylococcus enterotoxin using microspheres coated with the respective
      antigens. We believe that this technique could be applied clinically when needed
      for detection of antibodies to other viruses, such as the Human Immunodeficiency
      Virus.

PMID- 2223077
TI  - An advanced affinity membrane for covalent binding of amino ligands.
AB  - We report here an advanced, chemically active and yet hydrolytically stable
      microporous membrane which allows permanent covalent binding of amino ligands
      such as proteins. Rapid, single-step immobilizations produce a high density of
      immobilized ligands. Surface chemistry of the membrane is specifically designed
      to have extremely low nonspecific binding. Binding characteristics of the
      UltraBind membrane, various immobilization techniques and optimum immobilization
      conditions for diagnostic immunoassays are described.

PMID- 2223078
TI  - Production of plasmid DNA in a simple, inexpensive and reusable fermentor.
AB  - Performance data for the production of plasmid DNA in bacterial cultures have
      been obtained using a new concept of simplified fermentor, the Lofstrand
      Bactolift. The unique design of this fermentor incorporates a standard 500-ml or
      1-liter centrifuge bottle as the bacterial growth vessel, thus eliminating the
      necessity to transfer the cultures for subsequent processing. Bacterial and
      plasmid yields have been shown to be equal to or greater than those obtained
      using conventional shake flasks. Twelve 1-liter Bactolift fermentors can be
      operated in a standard laboratory water bath that occupies less than two square
      feet of bench space, as compared to a limit of six 2.8-liter Fernbach flasks
      containing one liter of culture held in an incubator shaker cabinet that occupies
      nine square feet of laboratory floor space.

PMID- 2223079
TI  - Mouse zygotes express endogenous lectins.
AB  - Cell interactions during mouse development have been shown to involve
      carbohydrate-containing macromolecules (glycoconjugates). We have therefore used
      a series of fluorescein-labelled synthetic glycoproteins to determine if mouse
      oocytes and zygotes also express sugar binding molecules (endogenous lectins)
      which might participate in such interactions. Unfertilized secondary oocytes did
      not express endogenous lectins at 4 degrees C but a low level of expression of
      fucose, mannose, and galactose-binding activity could be detected at 37 degrees
      C. In contrast, the zygote clearly expressed three classes of endogenous lectins,
      with preferential binding for i) fucose or mannose, ii) glucose or galactose, and
      iii) lactose. The expression of these lectins was much reduced at 4 degrees C and
      maximal binding at 37 degrees C was achieved only after 2 h incubation. We
      therefore conclude that a low level of endogenous lectin expression in the mouse
      oocyte is greatly enhanced after fertilisation and that, at both stages,
      expression, or the detection of expression, is markedly temperature dependent.

PMID- 2223080
TI  - Chymotrypsin-like enzymes are involved in sperm penetration through the vitelline
      coat of Ciona intestinalis egg.
AB  - In Ciona intestinalis, sperm penetration through the egg vitelline coat is an
      essential event of fertilization. We investigated whether trypsin- and
      chymotrypsin-like enzymes are involved in this event. Inhibitors and peptide
      substrates for chymotrypsin-like enzymes blocked the overall process of
      fertilization in a concentration-dependent manner. The inhibitory activity was
      specifically exerted on the step of sperm penetration. Chymotrypsin-like protease
      activity was identified in spermatozoa with the fluorogenic synthetic substrate
      Suc-Ala-Ala-Phe-AMC, which was the most effective substrate in blocking sperm
      penetration. These data indicate that a chymotrypsin-like protease activity is a
      sperm lysin of Ciona intestinalis.

PMID- 2223081
TI  - Maturation-associated changes in the rat zona pellucida.
AB  - Rat follicular oocytes, arrested at prophase I, cannot be fertilized in vitro.
      This capacity is acquired following resumption of meiosis and a series of changes
      involving both the oocyte and the cumulus cells surrounding it. Oocytes exposed
      to sperm at different hours before ovulation show a gradual increase in the
      permeability of their zona pellucida (ZP). Our study examined whether the ZP, in
      response to the physiological stimulus for maturation and concomitant with the
      other oocyte--cumulus components, undergoes maturational changes. Two ZP
      characteristics were assessed, sensitivity to proteolysis and sperm binding. ZP
      surrounding oocytes and eggs were collected from five sources: 1) germinal
      vesicle (GV)-intact oocytes, 2) preovulatory eggs, 3) ovulated eggs isolated from
      oviducts of immature females, 4) fertilized eggs, 5) ovulated eggs isolated from
      oviducts of mature females. All ZP surrounding oocytes/eggs from groups 1-5 were
      dissolved by trypsin. When solubility by pronase and alpha-chymotrypsin was
      examined, a large variation between groups was found. All ZP from group 2 were
      dissolved by 0.001% pronase, compared to 0% solubility in group 4. Only 10% of
      the ZP surrounding GV-intact oocytes (group 1) were dissolved by this enzyme,
      compared to 82% in group 3. Solubility in 0.01% alpha-chymotrypsin showed a
      similar pattern. Capacitated sperm were incubated with eggs from groups 1 and 3.
      The number of sperm binding to ZP in group 3 was repeatedly higher than that in
      group 1. In both tests it was found that the ZP surrounding the mature eggs
      differ in their characteristics from ZP of GV-intact oocytes.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2223082
TI  - Immunocytochemical studies of hamster oocyte activation.
AB  - By indirect immunofluorescence, using rabbit anti-heparin-binding placental
      protein (HBPP) antiserum, we studied HBPP expression by physiologically and non
      physiologically (microsurgically) activated hamster gametes. Whereas mature
      gametes (sperm, metaphase II oocytes) were negative, in vivo conceived
      preimplantation embryos, from pronuclear to two- and four-cell stages, were HBPP
      positive. No HBPP was demonstrated in the zona pellucida, but HBPP-dependent
      immunofluorescence was localized in the perivitelline space. Oocytes incubated
      with hyaluronidase demonstrated variable responses from negative to positive.
      (Diluent or sperm) microinjected oocytes were all activated and HBPP positive
      within 4 h after stimulation. Thus neither activation by microinjection nor HBPP
      expression required paternal gametes. These kinetics suggest that HBPP may be a
      cortical granule secretogogue which can be applied to monitor oocyte responses
      during in vitro manipulations.

PMID- 2223083
TI  - Spermiogenesis in Xenopus laevis: from late spermatids to spermatozoa.
AB  - Spermatogenesis is a complex morphogenetic process in which microfilaments and
      microtubules have been shown to play an important role. The last steps of Xenopus
      spermatogenesis, i.e., the corkscrew shaping of the sperm head, have been
      followed to study actin and microtubule distribution by conventional and
      immunoelectron microscopy. During sperm head morphogenesis, actin is absent in
      the elongating spermatids, but it is present in the Sertoli cells where results
      localized at the periphery of their cytoplasm that surrounds the developing germ
      cells. Sertoli cell actin and microtubules may assist the elongation and the
      shaping of the spermatids and function in maintaining the Sertoli-spermatid
      association.

PMID- 2223084
TI  - Injection of isolated centriolar complex to induce mitosis in starfish eggs.
AB  - When centriolar complex isolated from starfish spermatozoa was injected into
      starfish immature oocytes (fully grown, germinal vesicle stage) followed by
      treating the latter with 1-methyladenine, mitotic events such as condensation and
      division of chromosomes of the female pronucleus and cytokinesis following
      completion of meiosis were observed. No cortical reaction detected in the
      oocytes. Essentially the same was noted for mature oocytes (pronuclear stage)
      into which the centriolar complex had been injected. The oocytes that had
      received sperm tail fraction or buffer alone did not initiate cleavage. It would
      thus appear that sperm centriolar complex is significantly essential to the
      initiation of cleavage.

PMID- 2223085
TI  - In vitro fertilization of horse follicular oocytes matured in vitro.
AB  - In vitro fertilizing ability of stallion spermatozoa was assessed using horse
      follicular oocytes matured in vitro. After collection, stallion spermatozoa were
      either: 1) washed and incubated in TALP medium with 3 mg/ml bovine serum albumin
      (BSA) and 10 micrograms/ml heparin for 4h, 2) washed and incubated in TALP with 3
      mg/ml BSA for 3 h and cultured for a further 1 h with 1 mM caffeine and 5 mM
      dbcAMP, 3) washed and incubated in TALP medium with 3 mg/ml BSA at pH 7.9-8.2 for
      2-4 h, or 4) diluted and incubated in TALP medium with 10 mg/ml BSA and 7.14
      microM calcium ionophore A 23187 for 5-10 min followed by washing. After a given
      pretreatment, suspensions were diluted into B2 medium to a concentration of 5 x
      10(6) sperm/ml and co-incubated with oocytes for 12 h or 24-48 h. In the
      ionophore-treated group, 18 of 54 oocytes (33%) were fertilized by 12 h, and 11
      of 45 (24%) cleaved by 24-48 h. Evidence of fertilization was not found in the
      oocytes incubated with spermatozoa from other treatment procedures.

PMID- 2223086
TI  - Changes in calmodulin compartmentalization throughout capacitation and acrosome
      reaction in guinea pig spermatozoa.
AB  - Calmodulin has been postulated as a mediator in the calcium-dependent processes
      that culminate in the acrosome reaction. Changes in calmodulin
      compartmentalization as a consequence of the increased permeability to
      extracellular calcium during capacitation and acrosome reaction have been
      suggested. In the present study the temporal localization of calmodulin in guinea
      pig spermatozoa was studied during in vitro capacitation and acrosome reaction by
      indirect immunofluorescence. Capacitation was achieved by incubation in Tyrode
      medium supplemented with pyruvate, lactate, and glucose in the presence and in
      the absence of calcium. Acrosome reaction was elicited in three different
      conditions: 1) by transfer to minimal culture medium containing pyruvate and
      lactate (MCM-PL) after in vitro capacitation 2) by 0.003% Triton-X 100 treatment,
      and 3) by A 23187 addition to sperm samples incubated in MCM-PL. During
      capacitation, calmodulin was observed both in the acrosome and in the flagellum;
      this localization seemed to be independent of the presence of extracellular
      calcium and of exogenous substrates. Throughout the acrosome reaction, different
      stages of calmodulin compartmentalization were observed. It became clustered
      around the equatorial region just before or a little after the acrosome reaction
      had occurred. Later, it was observed around the postacrosomal region in the
      acrosome-reacted sperm. The changes in calmodulin distribution were found to be
      dependent on the stage in the acrosome reaction.

PMID- 2223087
TI  - Effect of oviduct cells on the incidence of polyspermy in pig eggs fertilized in
      vitro.
AB  - The consequences of interactions between porcine sperm, eggs, and oviduct cells
      before and during fertilization in vitro (IVF) has been examined with particular
      reference to the block to polyspermy. The pattern of polypeptides secreted by
      porcine oviduct epithelial cells has been determined and its effects on sperm
      both during pre-fertilization co-culture and during fertilization have been
      examined. In standard IVF procedures with no oviduct cell involvement, high rates
      of penetration (91%) were accompanied by equally high rates of multiple sperm
      penetration (91% of penetrated eggs). Fertilization on oviduct cell monolayers or
      a combination of 1 h co-culture of sperm and oviduct cells before the addition of
      in vitro matured oocytes did not reduce polyspermy. However, a sperm-oviduct cell
      co-culture period of 2.5 h followed by IVF on oviduct cells selectively reduced
      the rate of polyspermy by 40% and 50% in two separate series of trials (United
      Kingdom and Japan, respectively): Overall fertilization rates after this
      treatment were high (95% or 84%, respectively). A 3.5 h period of pre
      fertilization co-culture further reduced polyspermy to only 14% of penetrated
      eggs, but this treatment was accompanied by a sharp drop in the fertilization
      rate from an overall mean of 88% for all other groups to 19% after 3.5 h co
      culture.

PMID- 2223088
TI  - Stage-specific expression of phosphoprotein p19 during spermatogenesis in the
      rat.
AB  - The expression of phosphoprotein p19, a 19-kDa cytosolic substrate for cyclic
      adenosine monophosphate (cAMP)-dependent protein kinase, occurs abundantly in
      brain and testis and is developmentally regulated. In the present study we have
      identified the cell types of adult rat testis that contain p19. Using cryostat
      sections, which were first incubated with rabbit anti-p19 for
      immunohistochemistry followed by counterstaining with periodic acid-Schiff (PAS)
      hematoxylin to reveal nuclear morphology, we demonstrate that immunoreactive p19
      is detectable only in germ cells and is restricted to a limited stage of
      spermatogenesis. Expression first appears after the differentiating gametes have
      entered the prophase of meiosis, is abundant in spermatocytes until meiosis is
      completed, and declines to undetectable levels in maturing spermatids. We have
      ruled out immunocross-reactivity with SCG10, a 22-kDa protein that is closely
      related in structure to p19, by demonstrating, using Northern blot analysis, that
      RNA transcripts encoding SCG10 are not detectable in adult rat testis, whereas
      p19 is abundantly expressed. The transient expression of p19 during
      spermatogenesis suggests that the protein plays a role during male gamete
      differentiation.

PMID- 2223089
TI  - Glycosaminoglycans in porcine follicular fluid promoting viability of oocytes in
      culture.
AB  - The viability of oocytes cultured in vitro was determined by the trypan blue
      exclusion test. Isolated porcine oocytes with or without cumulus cells cultured
      in modified Krebs-Ringer medium undergo cell death after 48 h. The addition of
      glycosaminoglycans (GAGs) prepared from porcine follicular fluid (pFF) to the
      medium delayed or prevented the onset of cell death in vitro. GAGs at
      concentrations of 0.25 mg/ml or greater prevented cell death in a dose-dependent
      manner. To identify the active factor, GAGs were purified from pFF by ethanol
      precipitation, chromatography on Dowex 1-x2, and high performance liquid
      chromatography (HPLC) on TSK gel DEAE-2 SW column. The fraction with a retention
      time nearly coincident with that of hyaluronic acid possessed high oocyte
      viability promoting activity. The present results suggest that the viability of
      oocytes in vitro is influenced by the presence of specific GAGs separated from
      follicular fluid.

PMID- 2223090
TI  - Two proliferative stages of the oligodendrocyte lineage (A2B5+O4- and O4+GalC-)
      under different mitogenic control.
AB  - Cell proliferation during successive stages of oligodendrocyte development was
      delineated in the rat brain and optic nerve. Surface antigens, A2B5, O4, and
      galactocerebroside (GalC) identified three cell populations emerging in sequence;
      the incorporation of bromodeoxyuridine into newly synthesized DNA identified the
      proliferative cells. In vivo, progenitor cells with phenotypes A2B5+O4- and
      A2B5+O4+GalC- were both proliferative, whereas differentiated GalC+
      oligodendrocytes were not. Under basal conditions of culture, the proliferation
      of both progenitor cell types of the optic nerve was nearly abolished. Activity
      was restored for A2B5+O4- precursor cells with medium conditioned by either type
      1 astrocytes, meningeal cells, or cerebellar interneurons. In contrast,
      intermediate O4+GalC- cells (proligodendrocytes) were refractory to the
      astroglial and meningeal signals, but remained as responsive as their precursor
      cells to the neuronal stimulus. These data further characterize the O4+GalC-
      proligodendrocyte as a distinct developmental stage, one that specifies a
      changing response of the cell to environmental mitogens.

PMID- 2223091
TI  - Antibodies that recognize astrotactin block granule neuron binding to astroglia.
AB  - To provide a rapid, specific assay for receptor systems involved in the binding
      of cerebellar granule neurons to astroglia, granule cells, purified from early
      postnatal mice, or from E15-E16 chicks, were radiolabeled with [35S]methionine
      and plasma membranes were prepared. The kinetics of binding of radiolabeled
      material to primary mouse or chick glia or to the mouse G26-24 astrocytoma cell
      line was measured in the presence or absence of antibodies against astrotactin,
      neural cell adhesion molecules, cadherins, or integrins. Addition of Fab
      fragments of astrotactin antibodies reduced the amount of granule cell membrane
      binding to astroglia by 70%. In contrast, Fab fragments of antibodies against the
      neural adhesion molecules N-CAM, L1, and N-cadherin and against integrin did not
      reduce the level of granule cell membrane binding to astroglia. Combinations of
      antibodies against N-CAM, L1, N-cadherin, and integrin also did not impair neuron
      binding to glia.

PMID- 2223092
TI  - A neuronal cell line (PC12) expresses two beta 1-class integrins-alpha 1 beta 1
      and alpha 3 beta 1-that recognize different neurite outgrowth-promoting domains
      in laminin.
AB  - Integrins mediate neuronal process outgrowth on components of the ECM. Integrin
      alpha subunit-specific antibodies have been used to examine the roles of
      individual beta 1 integrins in attachment and neurite outgrowth by the neuronal
      cell line, PC12, in response to laminin and collagen. alpha 1 beta 1 and alpha 3
      beta 1 were identified as the major beta 1 integrins expressed by PC12 cells. In
      functional assays, both alpha 1 beta 1 and alpha 3 beta 1 mediated PC12 cell
      interactions with laminin, whereas alpha 1 beta 1 alone mediated responses to
      collagen types I and IV. alpha 1 beta 1 and alpha 3 beta 1 were shown to
      recognize two different neurite-promoting sites in laminin: alpha 1 beta 1
      interacted with the cross-region of laminin present in proteolytic fragments E1-4
      and E1; alpha 3 beta 1 recognized a site in the long arm contained in laminin
      fragment E8. Thus, PC12 cells express two beta 1 integrins, which together
      function in attachment and neurite outgrowth on laminin and collagen. These
      integrins are candidates for mediating neurite outgrowth of sympathetic and other
      neurons in response to these ECM components.

PMID- 2223093
TI  - Phosphorylation affects voltage gating of the delayed rectifier K+ channel by
      electrostatic interactions.
AB  - The delayed rectifier K+ channel of the squid axon undergoes a series of
      modifications in its kinetic and conductive parameters when it is phosphorylated
      as the result of shifts in its voltage-dependent parameters. These effects can be
      interpreted as due to electrostatic interaction between the voltage sensor of the
      channel and the transferred phosphate from ATP. Using different concentrations of
      intracellular Mg2+, we determined the density of surface charges seen by the K+
      channel voltage sensor before and after phosphorylation. Values for the surface
      charge density in the cytoplasmic side of the membrane were between 1/350 and
      1/250 e-/A2 in the absence of ATP and between 1/160 and 1/155 e-/A2 under
      phosphorylating conditions. Incorporation of a surface potential into a kinetic
      model for the delayed rectifier channel can predict quantitatively
      phosphorylation-like changes in K+ currents. These results provide evidence for
      the importance of electrostatic interactions as one of the mechanisms by which
      phosphorylation modulates the behavior of voltage-dependent channels.

PMID- 2223094
TI  - A potassium channel gene is expressed at neural induction.
AB  - Voltage-dependent potassium currents exhibit specific time tables of functional
      differentiation and regulate the development of action potentials in amphibian
      spinal neurons. A Xenopus nucleotide sequence (XSha2) encoding a potassium
      current has been isolated by homology screening with the Drosophila Shaker gene.
      Functional expression in oocytes identifies it as a delayed rectifier. Southern
      analysis suggests that XSha2 is a member of a family of highly related genes.
      XSha2 is expressed in the nervous system but is not detectable in skeletal
      muscle. Transcripts are apparent at the neural fold stage, and subsequent levels
      parallel those of the neural marker N-CAM. Thus molecular events required for the
      establishment of electrical excitability in the vertebrate embryo occur early
      during neurogenesis.

PMID- 2223095
TI  - Cytosolic Ca2+, exocytosis, and endocytosis in single melanotrophs of the rat
      pituitary.
AB  - We have monitored cytosolic [Ca2+] with fura-2 and exocytosis by measuring the
      membrane capacitance, and we have studied the influence of cytosolic [Ca2+] on
      secretion in single endocrine cells. As in neurons, cytosolic Ca2+ is sufficient
      to trigger exocytosis. The rate of secretion grows with the fourth or fifth power
      of cytosolic [Ca2+], and paired stimuli reveal facilitation. Ca2+ influx through
      voltage-sensitive Ca2+ channels can stimulate secretion 1000-fold over the basal
      levels measured biochemically. Unlike neurons, however, melanotrophs continue to
      secrete for seconds afer a depolarizing pulse, while they extrude or sequester
      the Ca2+ that has entered through Ca2+ channels. Following episodes of secretion,
      pituitary cells can retrieve membrane with half-times around 30 s at 32 degrees
      C, even in the absence of cytosolic K+.

PMID- 2223096
TI  - The LEC-CAMs: an emerging family of cell-cell adhesion receptors based upon
      carbohydrate recognition.
AB  - Cell surface carbohydrates, because of their demonstrated and potential
      structural diversity, have long been considered as excellent candidates for
      determinants of cell-cell recognition. Recently, a gene family has been
      identified, which encodes a series of three adhesion proteins (pnHR, ELAM-1, and
      GMP-140), designated as the LEC-CAMs. Each receptor participates in highly
      specific cell-cell recognition events within the blood vascular compartment. The
      LEC-CAMs share a high degree of sequence homology and the same organization of
      protein motifs, which includes a calcium-type lectin domain at the extracellular
      amino-terminus of each. In the case of the pnHR (peripheral lymph node homing
      receptor), the lectin domain has been shown to be central to the adhesive
      function of the receptor, i.e., lymphocyte attachment to high endothelial venules
      (HEV) of lymph nodes. The cognate ligand for the pnHR on HEV is a sialylated
      glycoprotein. Sialic acid is required for the adhesive function of this ligand,
      and preliminary evidence suggests that this requirement may also apply to the
      ligand for GMP-140. It is not clear as yet whether sialic acid contributes
      directly to recognition determinants of these ligands or has a modulating effect
      on their function. Given the extreme diversity of sialyloligosaccharides, the
      former possibility is very attractive. The LEC-CAM family joins the three
      families of already identified cell-cell adhesion molecules (integrins,
      cadherins, and superimmunoglobulins). It remains to be seen whether additional
      examples of highly specific cell recognition events rely on as yet unidentified
      LEC-CAMs or related lectin-like receptors.

PMID- 2223097
TI  - The importance of mouse, rat, and dog mast cell lines.

PMID- 2223098
TI  - A chemical mismatch cleavage method useful for the detection of point mutations
      in the p53 gene in lung cancer.
AB  - Point mutations in genes can be etiologic of pulmonary diseases, as in the case
      of the inherited disorders alpha-1-antitrypsin deficiency and cystic fibrosis or
      in the context of dominant and recessive oncogenes in lung cancer. Various
      methodologies have been developed to screen for single-base mutations. These
      techniques include direct DNA sequencing, RNase protection, denaturing gradient
      gel electrophoresis, and chemical mismatch cleavage. The latter method offers the
      advantages of rapid and efficient analysis of genomic or cDNA and is thus ideally
      suited to screening applications. Furthermore, all possible single-base changes
      can theoretically be detected. In the present work, chemical mismatch cleavage
      was utilized to detect mutations in the p53 gene in small cell and non-small cell
      lung cancer. This technique was modified by using a two-step, hemi-nested PCR
      procedure for preparation of target genomic DNAs permitting an expanded target
      size for analysis. Evaluation by chemical mismatch cleavage of eight p53 cDNAs
      derived from lung tumors shown to have different mutations by DNA sequencing
      correctly detected the presence of a point mutation in all instances. Analysis of
      six additional tumor genomic DNAs with defined mutations in the corresponding p53
      cDNAs accurately confirmed the mutation at the level of the genome. The technique
      also identified codon 72 and intron 6 polymorphisms. Using the intron 6
      polymorphism, loss of heterozygosity at the p53 locus in tumor DNA was readily
      detected by chemical mismatch cleavage. Finally, utilizing this technique for
      scanning analysis of the p53 gene of uncharacterized lung tumor DNAs, additional
      mutations were identified in a prospective manner which were confirmed by
      sequence analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223099
TI  - Cyclic biaxial strain of pulmonary artery endothelial cells causes an increase in
      cell layer-associated fibronectin.
AB  - Bovine pulmonary artery endothelial (PAE) cells were cultured on an artificial
      compliant substrate (Mitrathane) and were strained biaxially at a frequency of
      1/s for 2, 4, 6, 7, or 24 h. Total protein synthesis, determined by estimating
      the incorporation of radiolabeled precursors into nondialyzable protein, was
      increased in cultures that had been biaxially strained for 6, 7, or 24 h, with
      differences more apparent in the cell layer fraction than in the medium fraction.
      Medium and cell layer-associated fibronectin were quantitated by enzyme-linked
      immunosorbent assay and by densitometric analysis of the autoradiograms of
      electrophoresed protein. Fibronectin levels in the medium of biaxially strained
      cells were initially depressed in comparison to nonstrained controls but, with
      time, began to approach control values. Cell layer-associated fibronectin of
      biaxially strained cultures was significantly elevated at 24 h, whereas DNA
      synthesis was not altered. Immunohistochemical localization of fibronectin and
      factor VIII-von Willebrand antigen revealed a more intense staining pattern in
      strained cultures. Distribution of stress fibers containing fibrous actin was
      visualized by staining with rhodamine-phalloidin and was altered in strained
      cultures. These observations indicate that cells respond to cyclic biaxial strain
      by selectively enhancing structural components associated with cell adhesion.

PMID- 2223101
TI  - Expression of mucin synthesis and secretion in human tracheobronchial epithelial
      cells grown in culture.
AB  - The effects of culture conditions on growth and differentiation of human
      tracheobronchial epithelial (HTBE) cells have been defined. Epithelial cells were
      dissociated from tissues by protease treatment and were plated on tissue culture
      dishes in F12 medium supplemented with insulin, transferrin, epidermal growth
      factor, hydrocortisone, cholera toxin, bovine hypothalamus extract, and retinol.
      HTBE cells did not express any mucociliary function (ciliogenesis or mucin
      secretion) on tissue culture plastic, but they could be passaged 3 to 5 times
      with a total of 10 to 25 population doublings. Cells from early passages re
      express both these functions when transplanted to tracheal grafts. When tissue
      culture plates were coated with collagen film or collagen gel substrata, cell
      attachment and proliferation were stimulated. However, the expression of mucous
      cell function in culture occurred only when cells were plated on collagen gel
      substrata and vitamin A (retinol) was present in the medium. Mucous cell
      differentiation under optimal conditions was defined by ultrastructural studies,
      by immunologic studies with mucin-specific monoclonal antibodies, and by
      carbohydrate and amino acid compositional analyses of mucin-like glycoproteins
      purified from culture medium. These results demonstrate for the first time that
      HTBE cells can express mucin synthesis and secretion under appropriate culture
      conditions.

PMID- 2223100
TI  - Hypoxic contraction of cultured pulmonary vascular smooth muscle cells.
AB  - The cellular events involved in generating the hypoxic pulmonary vasoconstriction
      response are not clearly understood, in part because of the multitude of factors
      that alter pulmonary vascular tone. The goal of the present studies was to
      determine if a cell culture preparation containing vascular smooth muscle (VSM)
      cells could be made to contract when exposed to a hypoxic atmosphere. Cultures
      containing only fetal bovine pulmonary artery VSM cells were assessed for
      contractile responses to hypoxic stimuli by two methods. In the first, tension
      forces generated by cells grown on a flexible growth surface (polymerized
      polydimethyl siloxane) were manifested as wrinkles and distortions of the surface
      under the cells. Wrinkling of the surface was noted to progressively increase
      with time as the culture medium bathing the cells was made hypoxic (PO2
      approximately 25 mmHg). The changes were sometimes reversible upon return to
      normoxic conditions and appeared to be enhanced in cells already exhibiting
      evidence of some baseline tone. Repeated passage in culture did not diminish the
      hypoxic response. Evidence for contractile responses to hypoxia was also obtained
      from measurements of myosin light chain (MLC) phosphorylation. Conversion of MLC
      to the phosphorylated species is an early step in the activation of smooth muscle
      contraction. Lowering the PO2 in the culture medium to 59 mmHg caused a 45%
      increase in the proportion of MLC in the phosphorylated form as determined by two
      dimensional gel electrophoresis. Similarly, cultures preincubated for 4 h with
      32P and then exposed to normoxia or hypoxia for a 5-min experimental period
      showed more than twice as much of the label in MLCs of the hypoxic
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223103
TI  - Surfactant apoprotein A (SP-A) is synthesized in airway cells.
AB  - The pulmonary surfactant apoproteins A, B, and C (SP-A, SP-B, and SP-C,
      respectively) function in concert with surfactant phospholipids to reduce surface
      pressure in the alveolus. Surfactant apoproteins also regulate surfactant
      synthesis, secretion, adsorption, and recycling. SP-A and B have been localized
      by immunocytochemistry to alveolar epithelial (type II) cells, alveolar
      macrophages, and nonciliated bronchiolar epithelial (Clara) cells. In contrast,
      in situ hybridization to SP-A and B mRNA in human lung has shown SP-A and B
      transcripts in type II cells, but only SP-B message in Clara cells, implying that
      synthesis of SP-A occurs exclusively in type II cells. In this report, in situ
      hybridization to SP-A mRNA was performed on adult and developing rabbit lung and
      on human lung. SP-A transcripts were found in type II cells and bronchiolar
      epithelium of both species. The distribution of SP-A message-containing cells in
      the bronchiolar epithelium of rabbits and humans was similar to the distribution
      of Clara cells in these two species. These data indicate that SP-A is not only
      synthesized in type II cells but also in Clara cells.

PMID- 2223102
TI  - Fatty acid supplementation protects pulmonary artery endothelial cells from
      oxidant injury.
AB  - Although supplemental fatty acids have been shown to alter the susceptibility of
      experimental animals to oxidant gases, the relationship between the degree of
      tissue fatty acyl unsaturation and resistance to oxidant exposure remains
      undefined. Because vascular endothelial cells have been demonstrated to be
      sensitive cellular targets in oxidant-induced lung injury, we evaluated the
      effects of a supplemental fatty acid on the lipid composition and oxidant
      susceptibility of pulmonary artery endothelial cells (PAEC) in monolayer culture.
      PAEC were incubated in culture medium supplemented with an ethanolic solution of
      0.1 mM cis-vaccenic acid (CVA), an 18-carbon monounsaturated fatty acid, or with
      the ethanol vehicle alone for 3 h. Cells were then exposed to either control or
      oxidant (hyperoxia: 95% O2; or hydrogen peroxide: 100 microM) conditions. Oxidant
      induced cell injury was assessed by phase-contrast microscopy and by measuring
      the release of intracellular lactate dehydrogenase. Incubation with CVA increased
      the CVA content of PAEC lipids and protected cells from oxidant-induced injury
      for up to 72 h after supplementation. CVA had no effect on nonoxidant-induced
      cell injury. Although the mechanism by which CVA protects cells against oxidant
      injury remains undefined, evidence is presented that indicates the mechanism does
      not involve induction of antioxidant enzyme activity, alterations in the physical
      state of PAEC membranes, or enhancement of PAEC nucleic acid repair mechanisms.
      These results define a useful model for exploring the relationship between lipid
      composition and oxidant susceptibility and suggest that fatty acid modifications
      may constitute an important strategy for protecting cells against oxidant injury.

PMID- 2223105
TI  - Myofibroblasts and subepithelial fibrosis in bronchial asthma.
AB  - A thickened bronchial epithelial basement membrane has long been regarded as a
      histopathologic characteristic of bronchial asthma. As we had previously
      demonstrated that this phenomenon is due to the deposition of interstitial
      collagens and fibronectin, we have now sought to determine the nature of the cell
      responsible for this process by studying endobronchial biopsies from eight normal
      and seven asthmatic volunteers by immunohistochemistry and electron microscopy.
      Biopsies were stained with PR 2D3, a monoclonal antibody to myofibroblasts of the
      pericrypt sheath of the colon and a monoclonal antibody to alpha-smooth muscle
      actin. The thickness of the subepithelial collagen and the organelle content of
      the cells therein were determined by electron microscopy. The subepithelial
      collagen thickness in the normal subjects ranged from 2.16 to 6.26 microns, while
      that in the asthmatic subjects ranged from 3.75 to 11.1 microns (Mann-Whitney
      test; P = 0.05). Elongated cells in the collagen layer were identified by
      staining with PR 2D3. As this antibody also stains smooth muscle, consecutive
      frozen sections were stained for alpha-smooth muscle actin and the number of
      positive cells per millimeter of basement membrane was subtracted from the count
      for PR 2D3. This yielded a count of 4.9 to 9.4 cells/mm in the normal subjects
      and 11.9 to 20.6 cells/mm in the asthmatics (P = 0.001). There was a highly
      significant correlation between the depth of subepithelial collagen and the
      number of PR 2D3-positive, alpha-smooth muscle actin-positive cells (Spearman
      rank correlation; r = 0.764 and P = 0.006). Electron microscopy confirmed the
      myofibroblastic nature of these cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223104
TI  - Human alveolar macrophage and blood monocyte interleukin-6 production.
AB  - Interleukin-6 (IL-6) modulates a number of processes relevant to host immunity
      and inflammation. We investigated the capacity of the human alveolar macrophage
      to elaborate IL-6 in response to lipopolysaccharide (LPS), recombinant
      interleukin-1 (rIL-1), and recombinant tumor necrosis factor (rTNF), and compared
      macrophage IL-6 production to that of blood monocytes and lung fibroblasts.
      Unstimulated and TNF-stimulated alveolar macrophages and monocytes produced
      little or no detectable IL-6. In contrast, macrophages and monocytes produced
      large amounts of IL-6 in response to LPS and monocytes produced lesser but
      readily detectable amounts in response to rIL-1. Monocytes and alveolar
      macrophages differed significantly in their capacity to produce IL-6, with
      macrophages making more IL-6 in response to LPS and less IL-6 in response to rIL
      1 than autologous blood monocytes. Monocytes aged in vitro produced little
      detectable IL-6 in response to LPS or rIL-1, suggesting that differences in cell
      maturity may account for the diminished capacity of the alveolar macrophage to
      produce IL-6 in response to IL-1 but not its enhanced capacity to produce IL-6 in
      response to LPS. Mononuclear phagocytes and lung fibroblasts also differed in
      their ability to produce IL-6. Lung fibroblasts produced more IL-6 in response to
      rIL-1 and less IL-6 in response to LPS than monocytes and macrophages. In
      addition, monocytes and macrophages elaborated electrophoretically identical IL-6
      moieties that differed from those produced by lung fibroblasts. These differences
      could be at least partially attributed to differences in sialylation and/or
      glycosylation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223106
TI  - The temporal bone: magnetic resonance imaging.
AB  - MRI has made a remarkable impact upon diagnostic evaluation of the temporal bone
      and its diseases. Although high resolution CT is preferable for study of common
      maladies of the middle ear and optic capsule, MRI is currently the study of
      choice for evaluation of the internal auditory canal, cerebellopontine angle, and
      brainstem. MRI is also very useful in evaluations of complications of chronic
      otitis media. This manuscript is divided into sections on inflammatory disease,
      internal auditory canal/cerebellopontine angle, vascular compartments, facial
      nerve, and trauma. In addition, several miscellaneous entities are discussed.

PMID- 2223107
TI  - Current status of magnetic resonance imaging of the orbit.
AB  - MR plays an important role in evaluating pathologic conditions that affect the
      orbit. MR appears to be superior to ultrasound and computed tomography in
      evaluation of intraocular tumors and fluid collections. In evaluation of
      noncalcified intraorbital tumors, MR can provide more information regarding
      orbital apex involvement and intracranial extension. Inflammatory lesions,
      particularly orbital pseudotumor, can be differentiated from metastatic disease
      based on differences in signal intensity providing greater specificity than CT.
      Specific prognostic information may be obtained regarding potentially treatable
      cases of Graves' disease. Using MR, vascular lesions of the orbit can be assessed
      for patency or thrombosis without use of intravenous contrast. Demonstration of
      secondary extension by para-orbital sinus tumors by MR is often helpful in
      evaluating involvement of the soft tissue structures of the orbit. Potential
      applications in evaluation of orbital trauma include characterization of orbital
      hematomas and orbital blow-out fractures.

PMID- 2223108
TI  - Magnetic resonance imaging of the paranasal sinuses.
AB  - MRI has been very helpful in evaluating tumors in the paranasal sinuses. MRI can
      differentiate retained secretions from tumors. The multiplanar capabilities of
      MRI are also very helpful in identifying tumor margins. Although a specific
      diagnosis can be suggested in most cases, demonstration of the extent of the
      disease and specifically the relationship to key surgical landmarks is more
      important. Structures of thin cortical bone are better seen with CT than MRI. For
      several reasons, CT is still the examination of choice for evaluation of the
      osteomeatal complex and inflammatory disease of the sinuses.

PMID- 2223109
TI  - Magnetic resonance imaging of the nasopharynx.
AB  - Imaging of the upper aerodigestive tract, mainly the nasopharynx and oropharynx,
      has always challenged the radiologist. It is clear that MRI has a leading role in
      the diagnosis and treatment planning of patients with diseases of the head and
      neck. This is especially true in the nasopharynx. Although improvements have been
      made in x-ray diagnosis through the years, subtle diagnoses have been difficult
      to make because of the variations in airway contour and the superimposition of
      areas of interest. CT allowed the deep soft tissue planes to be evaluated and
      provides a complement to the physical examination of the nasopharynx, oral
      pharynx, and skull base. MRI possesses many advantages over other imaging
      modalities. The ability to differentiate between inflammatory and neoplastic
      diseases is extremely important for tumor staging and patient management. At the
      present time it is not possible to predict the histology of a nasopharyngeal
      tumor, but the ability to differentiate between various histologic types would be
      of obvious importance. More experience is needed before this bridge can be
      crossed.

PMID- 2223110
TI  - Magnetic resonance imaging of the tongue and oropharynx.
AB  - In general, MRI produces superior soft tissue detail in evaluating the tongue and
      oropharynx than does CT. MRI is therefore considered the study of choice in this
      area. Lack of artifact from dental amalgam and beam hardening artifact from the
      mandible on MRI also eliminates two major shortcomings of CT in the examination
      of this area. Finally, the ability of MRI to obtain direct coronal and sagittal
      scan planes is a distinct advantage in recognizing intrinsic tongue musculature
      and assessing tumor volume and spread for treatment planning.

PMID- 2223111
TI  - Magnetic resonance imaging of the larynx.
AB  - The development of appropriate surface coils has resulted in outstanding
      depiction of the laryngeal anatomy using MRI. The multiplanar capability of MR
      allows superior definition of anatomy and tumor extent compared with CT scanning.
      MR appears to be more effective in detecting cartilage invasion. MR is as
      effective as CT in defining adenopathy and extension into the carotid sheath. MRI
      is therefore the primary modality in imaging the larynx.

PMID- 2223112
TI  - Magnetic resonance imaging of metastatic cervical adenopathy.
AB  - Detecting cervical adenopathy is critical in the management of carcinomas in head
      and neck. CT scanning remains a very effective modality in defining adenopathy.
      T1-weighted MRI scans are comparable to CT in detecting lymph nodes. T2-weighted
      images are less useful as the lymph nodes tend to have long T2 relaxation times
      similar to the surrounding fat. MR has not proved to be useful in detecting
      carcinoma in non-enlarged cervical nodes. The morphologic criteria developed for
      metastatic nodes with CT are appropriate with MRI (size, shape, signal,
      extracapsular spread). Gadolinium is sometimes useful in defining central
      necrosis in metastatic squamous cell adenopathy.

PMID- 2223113
TI  - Interventional magnetic resonance imaging in the head and neck.
AB  - Interventional MRI is clearly in its early stages of development. While the value
      of MR-guided aspiration cytology and MR evaluation of deep electrode implantation
      in the brain has already been confirmed with human clinical studies, the future
      of MR-guided interstitial laser therapy remains to be proven. Despite this, as we
      look ahead into the 1990s and the millennium, it is possible to imagine dedicated
      MR laser therapy units for combined radiological and surgical outpatient
      approaches in what may become the operating rooms of the 21st century.

PMID- 2223114
TI  - Congenital cystic adenomatoid malformation of the lung.
AB  - Twenty cases of cystic adenomatoid malformation of the lung were observed: 2 had
      died in utero; the diagnosis was made at birth in 13 infants of which 3 were
      premature. A Bochdalek's hernia had been diagnosed before birth in 2 cases by
      echo-tomography. The correct antenatal diagnosis had been made in 2 cases. Two
      infants had no symptoms, 3 were dyspneic, 8 were in respiratory distress and had
      to be intubated and ventilated. Two had a prune belly syndrome. Eight infants had
      a thoracotomy during their first week of life. Pulmonary resections concerning
      those 13 patients comprised 10 lower lobectomies, 1 of which was associated with
      a lingulectomy, and 2 upper lobectomies, 1 of which was associated with a middle
      lobe resection. Five patients were diagnosed and operated upon between 10 months
      and 8 years of age; 4 had recurrent bronchitis and 1 was diagnosed during the
      treatment of a gastroenteritis. They had 3 lower and 2 upper lobectomies.
      Recovery was uneventful in all patients except for 1 who was reoperated upon for
      intestinal obstruction. Antenatal diagnosis of cystic adenomatoid malformation
      should become standard. The malformation may be mistaken for a pulmonary
      sequestration or bronchogenic cyst. Differential diagnosis of a congenital hernia
      is important.

PMID- 2223116
TI  - Patch-closure of tracheal defects with pericardium/PTFE. A new technique in
      extended pneumonectomy with carinal resection.
AB  - Patch closure of a tracheal defect resulting from extended pneumonectomy
      including the main carina and a limited area of the lower trachea or the opposite
      bronchus is described in five cases of bronchogenic carcinoma and one case of
      metastatic melanoma. It was accomplished by the use of a PTFE soft-tissue patch
      and integrated pericardial flap. Airway continuity was satisfactorily restored in
      all but one case with a longest survival of 30 months. One patient developed an
      empyema and died from respiratory failure after 6 weeks. The method is
      technically easy and can serve as an alternative to resection of the whole
      bifurcation in selected cases. Intraoperative ventilation using double lumen
      tubes needs not be altered.

PMID- 2223115
TI  - Pulmonary complications after lung resection: the effect of continuous
      extrapleural intercostal nerve block.
AB  - To assess the efficacy of continuous extrapleural intercostal nerve block (CEINB)
      with 0.5% bupivacaine on postoperative pain, pulmonary function and pulmonary
      complications, a prospective, randomised, double blind controlled trial was
      conducted on comparable patients undergoing lung resections; n = 21 (control), n
      = 25 (bupivacaine). The bupivacaine group required less papaveretum in the first
      24 h (P less than 0.01) and had lower pain scores over 5 postoperative days (P
      less than 0.01). Pulmonary function recovered earlier in the bupivacaine group.
      Pulmonary complications occurred in 1 patient with normal lung function and 12
      patients with obstructive airways disease (COAD): FEV1/FVC less than 70%. There
      were no infusion-related complications. CEINB has been shown to be safe and
      effective in reducing postoperative pain and pulmonary complications. CEINB
      minimises the loss of lung function after thoracotomy and restores impaired
      pulmonary mechanics more rapidly.

PMID- 2223117
TI  - Thoracic injuries sustained by the survivors of the M1 (Kegworth) aircraft
      accident. The Nottingham, Leicester, Derby, Belfast Study Group.
AB  - On 8 January 1989, a Boeing 737 carrying 126 passengers and crew crashed onto the
      M1 motorway killing 39 passengers. Of 87 initial survivors, 74 had major injuries
      making this an unusual accident as most aircraft crashes result in very few
      severely injured survivors. This prompted the setting up of a major study group,
      the Nottingham, Leicester, Derby, Belfast Study Group (NLDB) to examine in detail
      the accident and its aftermath. This paper is part of that work and is an initial
      survey of the thoracic injuries sustained by the 87 survivors. Twenty-three
      passengers sustained major chest trauma and all had major injury to other parts
      of the body. Five of these patients died within 12 h of admission. Various
      patterns of chest trauma emerged from this study, including an increasing
      incidence of rib fractures with age and a distinctive pattern of upper zone
      pulmonary contusion in younger patients.

PMID- 2223118
TI  - Risk factors for morbidity and mortality in mitral valve replacement.
AB  - Risk factors of operative mortality and long term survival were identified in 219
      patients who underwent mitral valve replacement (MVR) using Bjork-Shiley
      mechanical prostheses. Early mortality was 7.3%. The accumulated follow-up time
      was 1134 patient-years, and the 5-year survival for the total cohort was 78 +/-
      3%. Independent prognostic factors of early mortality were poor NYHA class, which
      carried a relative risk (RR) of 3.2, and ischaemic aetiology, with a RR of 2.2.
      Ischaemic aetiology was the sole predictor of heart pump failure requiring intra
      aortic balloon pump support (RR = 2.7). Independent risk factors of total
      mortality (early and late) were male sex (RR = 2.3), NYHA class III-IV (RR =
      2.4), presence of mitral regurgitation (RR = 3.2) and relative heart volume (RR =
      1.6 for a 800 ml/m2 size compared to a heart of 550 ml/m2). Our results underline
      the importance of patient-related factors in MVR, and indicate that care is
      needed in comparing the quality of MVR from different institutions with respect
      to mortality and morbidity. The results of MVR are palliative rather than
      curative except in female patients with NYHA class II function and mitral
      stenosis, in whom cure was attained.

PMID- 2223119
TI  - Morphological comparison of primary tissue failure (PTF) in porcine mitral and
      aortic bioprostheses in the same patient.
AB  - Clinical and pathological studies have not clearly demonstrated whether primary
      tissue failure (PTF) in porcine bioprostheses occurs more often in the mitral
      than in the aortic position. We have studied morphological alterations in both
      positions in the same individual in 15 patients (14 mitroaortic and 1
      mitroaortotricuspid) reoperated upon for PTF. Bioprostheses explanted were
      photographed, radiographed and observed in transmitted polarizing light. All
      lesions received a score on the basis of morphological criteria. The creep of the
      stent was measured. Calcification was slightly heavier and the degree of creep
      was significantly greater in the mitral position. Tears, infiltration and pannus
      growth did not differ between the two positions. According to our study, there is
      no conclusive demonstration that bioprostheses degenerate earlier and more
      extensively in the mitral than in the aortic position.

PMID- 2223121
TI  - The effects of low, medium and high dose aspirin on intimal proliferation in
      autologous vein grafts used for arterial reconstruction.
AB  - Bilateral femoral vein grafts were implanted in 47 adult mongrel dogs to
      determine the effects of aspirin on intimal hyperplasia. The animals were fed a
      commercially-prepared 2% cholesterol diet before and for 6 weeks following
      operation. Twelve animals served as the controls while the remaining animals were
      divided into three groups receiving low, medium, and high dose aspirin. Eleven
      animals received 75 mg of aspirin daily, 11 animals were fed 225 mg of aspirin
      daily and the remaining 13 animals received 650 mg of aspirin daily. A
      coagulation profile was carried out before operation and at 2, 4 and 6 weeks
      following operation. The grafts were harvested at 6 weeks and intimal thickness
      was measured with a Zeiss computerized interactive image-analyzing system. The
      prothrombin time, partial thromboplastin time, and platelet count were unchanged
      in all animals. The bleeding time was prolonged in animals receiving aspirin (P
      less than 0.02). Intimal thickness measured 4 +/- 0.2 microns before implantation
      and increased at 6 weeks to 39 +/- 5 microns in the control group. Aspirin failed
      to reduce intimal hyperplasia. Intimal thickness measured 37 +/- 2 microns in
      those animals receiving 75 mg of aspirin daily, 35 +/- 3 microns after a daily
      dose of 225 mg of aspirin and 51 +/- 4 microns in the high dose group receiving
      650 mg of aspirin daily. Our data indicates that aspirin fails to reduce intimal
      proliferation in canine vein grafts which suggests that alternative or combined
      drug therapy may be necessary to reduce the incidence of late graft failure.

PMID- 2223120
TI  - Differences in the recovery of right and left ventricular function after
      ischaemic arrest and cardioplegia.
AB  - Differential susceptibility of right (RV) and left (LV) ventricles to plain
      ischaemia and the contribution of cardioplegia in reducing the ischaemic damage
      was evaluated in a sheep model of cardiopulmonary bypass. Sheep (n = 16) were
      equally divided for the two protocols of the study. Each sheep served as its own
      control. RV and LV functions were studied and compared by plotting ventricular
      function curves (Starling and Sarnoff). The mathematical centre of mass (COM) for
      each curve was computed by a polynomial regression program. The COM values of the
      contractility indices [stroke volume (SV), stroke work (SW)] represented
      ventricular heterometric reserve. RV and LV heterometric reserve was
      significantly (P less than 0.01) reduced after 1 h plain ischaemia, and
      quantitatively this change was more for RV than for LV (P less than 0.05). As
      compared to LV, a significantly greater reduction in RVSW was brought about by a
      significantly (P less than 0.01) greater reduction in RVSV, because there were no
      significant differences between the post-ischaemic recovery in the RV and LV
      afterloads. Cardioplegic protection nearly normalized filling pressure and
      contractility (SV, SW) of both ventricles, but major differences were observed in
      the recovery of compliance. Recovery in the RV compliance exceeded the control
      values, and quantitatively the recovery in RVSW was slightly more than in LVSW.
      The results of this study indicate that the RV suffers more damage from plain
      ischaemic arrest and hence benefits more from the cardioplegic protection.

PMID- 2223122
TI  - Epicardial cryosurgery as used in ablation of accessory atrioventricular
      pathways: effect on valvular function in the dog.
AB  - Epicardial cryosurgery for ablation of atrioventricular accessory pathways has
      surgical advantages. However, it is applied directly to the valve base. To assess
      the risk of valve impairment, 10 anaesthetized dogs were subjected to
      standardized epicardial cryosurgery of the right atrioventricular junction. Two
      of these underwent sham procedure (dissection only). Valve function was assessed
      by colour Doppler echocardiography preoperatively and at 2 days, 1 week, 2 weeks
      and 10 weeks postoperatively. Three out of the eight animals subjected to
      cryosurgery developed moderate (grade 2/4) tricuspid insufficiency, which
      appeared at 1 week postoperatively, following regression of congestive oedema.
      Two out of the three cases of TI were associated with leaflet prolapse. No
      tricuspid insufficiency was seen in the sham-operated animals. At the end of each
      interval two animals were killed for histological examination. Histological
      examinations showed that cryolesions extended a maximum of 3 mm into the valve
      leaflet. The tricuspid insufficiency is attributed to the extensive scarring
      (including chondroid metaplasia), which causes retraction and restricted motion
      of the annulus. It is concluded that cryolesions may impair atrioventricular
      valve function. Patients undergoing cryosurgery should be monitored
      postoperatively by echocardiography for atrioventricular valve insufficiency.

PMID- 2223123
TI  - Congenital bronchoesophageal fistula in adults. Report of three cases.
AB  - Persistence of congenital bronchoesophageal fistulae into adulthood is rare.
      Three patients, one male and two female, of 52, 27 and 63 years of age,
      respectively, are reported. All three presented with chronic respiratory symptoms
      and coughing spells associated with ingestion. The barium swallow confirmed
      diagnoses. Treatment was surgical and consisted of excision of the fistulous
      tract, suture of the oesophageal and bronchial orifices and the interposition of
      a parietal pleura flap in two cases, and of biological glue in one. All three
      patients recovered and are free of symptoms.

PMID- 2223124
TI  - Intramural oesophageal cyst as a cause of acute respiratory distress.
AB  - A case is reported of an intramural oesophageal cyst. Acute dyspnoea, due to
      compression of the trachea, was an indication for exploratory sternotomy.

PMID- 2223125
TI  - Anatomically guided surgery to the AV node. AV nodal skeletonization: experience
      in 46 patients with AV nodal reentrant tachycardia.
AB  - We report our combined experience with operative therapy for atrioventricular
      nodal tachycardia using an anatomically guided procedure. The operative rationale
      was to dissect the AV node with the intent of modifying perinodal tissues
      (skeletonization). The anterior septal and posterior septal regions were
      initially approached epicardially to facilitate endocardial dissection. Under
      normothermic cardiopulmonary bypass, the right atrial septum was mobilized and
      the intermediate AV node was exposed anterior to the tendon of Todaro. Ablation
      of concomitant accessory pathways was done prior to AV nodal skeletonization.
      Forty-six patients aged 9-71 years (mean 36) were operated upon. Five patients
      had accessory pathways in addition to AV nodal reentry. At electro-physiological
      study prior to discharge, no patient had an AV block although anterograde and
      retrograde Wenckebach cycle lengths were significantly prolonged. Ten patients
      had a retrograde AV block. The 46 patients were free of arrhythmia and not taking
      antiarrhythmic medication after a follow-up of 1-45 months (mean 17). Three
      patients had a recurrence of the tachycardia 10 days, 2 months and 7 months post
      operatively, respectively. All patients had a subsequently successful
      reoperation.

PMID- 2223126
TI  - Surgical treatment of chronic aortic dissections.
AB  - Between January 1976 and March 1987, 78 patients underwent surgery for chronic
      aortic dissection at our institution. The ascending aorta was involved in 66
      cases (Stanford type A) and was not involved in 12 cases (Stanford type B),
      wherever the initial dissection was suspected. Aortography remains the main
      preoperative investigation. The surgical technique varies according to the type
      of dissection. It seems essential to exclude the primary intimal tear and all
      dilated segments of the aorta must be replaced. The overall operative mortality
      was 11.5% (7.5% in type A, 33.3% in type B dissection). Sixty-three patients have
      been followed for a period varying between 6 months and 10 years (mean 5 years).
      The overall survival at 6 years is 60% +/- 5.6%. Because of the ultimate risk of
      aneurysmal dilatation of the false channel, these patients must be followed by CT
      scanning, colour flow Doppler echocardiography, magnetic resonance imaging, and
      in some cases, aortography.

PMID- 2223127
TI  - Median sternotomy and multiple lung resections for metastatic sarcomas.
AB  - In the attempt to apply salvage surgery to the majority of patients with
      pulmonary tumour relapse, we have adopted a new treatment plan consisting of
      early bilateral lung exploration and resection through median sternotomy in all
      cases of sarcoma with resectable lung metastases, including synchronous or
      previously resected ones. The present paper summarizes the early results achieved
      with this technique in 56 consecutive patients treated between 1985 and 1988.
      Perioperative mortality was zero, and morbidity negligible. Occult contralateral
      metastases were resected in about one third of subjects with monolateral clinical
      lesions. Overall actuarial survival from first pulmonary resection is 51% at 2
      years and 35% at 3 years. A slightly more favourable trend is evident for
      solitary lesions but the difference is not statistically significant. No
      difference in survival is observed in relation to the initial disease-free
      interval or to the histological type. The majority of relapses occurred within 6
      months of sternotomy (23/35) and were confined to the lungs (21/35). Ten of these
      21 patients with pulmonary relapse have undergone further resection and 5 of them
      are alive, with a median survival of 28 months. Present results are encouraging
      as far as resectability and early recurrence rate are concerned. Median
      sternotomy appears a most valuable therapeutic approach to pulmonary metastases
      from sarcomas, being safe and effective in local control of disease, and
      compatible with further surgical management of pulmonary recurrences.

PMID- 2223128
TI  - Coarctation of the aorta in complex congenital heart disease: simultaneous repair
      via sternotomy.
AB  - Coarctation of the aorta (CoA) is often associated with complex congenital heart
      disease. Patients with such a combination may not benefit from coarctectomy
      alone. Eight children who presented with complex malformations of the heart
      underwent simultaneous repair of CoA and intracardiac surgery via sternotomy.
      After extensive mobilization of the aortic arch, cardiopulmonary bypass was
      established. During the cooling phase for deep hypothermic circulatory arrest
      (six cases), a persistent temperature gradient between the upper and lower half
      of the body confirmed the significance of CoA. One child was operated upon in
      deep hypothermia with low flow and one underwent valve repair on cardiopulmonary
      bypass. Mobilization of the descending aorta enabled CoA resection and end-to-end
      anastomosis with a running absorbable suture. The average descending aortic cross
      clamping time was 15 min. By this time, the patient had been cooled sufficiently
      for the intracardiac procedure. There were two operative deaths not related to
      coarctectomy. The remaining children showed no arm-to-leg pressure gradient. Five
      were discharged from hospital and one patient died late from septicaemia. In our
      hands, this technique has served to accomplish simultaneous relief of CoA and
      repair of the intracardiac lesion thus sparing critically ill infants the hazards
      of repeated procedures.

PMID- 2223129
TI  - Paralysed diaphragm after cardiac surgery in children: value of plication.
AB  - Over a 2-year period (1987-1988), 31 children (3% of 960 operations) were found
      to have a paralysed diaphragm following cardiac surgery. The median age was 5
      months with 65% less than 1 year of age. In the 31 patients, 38 paralysed
      diaphragms were identified. The phrenic nerve injury was on the right in 8 cases,
      the left in 16, bilateral in 7 and 40% were related to modified Blalock Taussig
      shunts. The time to extubation was analysed for each patient in two separate
      groups: Group A: (greater than 1 year): 11 children of whom 5 were extubated
      without difficulty, 4 had non-respiratory reasons for prolonged ventilation and
      only 2 were plicated--both were extubated within 4 days. Group B: (less than 1
      year): 20 infants of whom 16 were plicated and 4 were not. Three of the children
      who were plicated died from cardiac causes. Of the 13 survivors, there were 3 who
      had other reasons for prolonged ventilation. Thus 10 infants required prolonged
      ventilation (mean 11 days) because of respiratory difficulties. All underwent
      plication and were extubated at a mean of 2.4 days postoperatively. The 4 who
      were not plicated were extubated at a mean of 11 days postoperatively. In infants
      in whom there is no cardiac cause for failure to wean from ventilation,
      diaphragmatic paralysis should be suspected and plication performed if not
      extubated 2 weeks after operation.

PMID- 2223130
TI  - Age-dependent changes in the tolerance of the rabbit heart to ischemia.
AB  - Many studies in several species have demonstrated an enhanced ischemic tolerance
      in the immature myocardium when compared with the adult. Little is known about
      the rate at which these changes occur. We have compared the extent of post
      ischemic recovery using isolated working hearts from rabbits of various ages (7
      90 days). Hearts (n = 8/group) from rabbits of 7, 14, 21, 28, 31, 40 and 60-90
      days of age were perfused aerobically (37 degrees C) for 20 min and control
      indices of cardiac function were recorded. The hearts were then arrested (2 min
      infusion) with the St. Thomas' Hospital cardioplegic solution and subjected to
      global ischemia for 45 min (37 degrees C). The hearts were then reperfused for 15
      min in the Langendorff mode and 20 min in the working mode. Leakage of creatine
      kinase (CK) during Langendorff reperfusion and the recovery of cardiac function
      during working perfusion were measured. Pre-ischemic cardiac output (CO) was 58.6
      +/- 2.6, 80.1 +/- 2.9, 117.5 +/- 4.5, 131.9 +/- 3.2, 134.1 +/- 2.1, 152.0 +/- 1.6
      and 165.8 +/- 4.6 ml/min in the 7, 14, 21, 28, 31, 40 and 60-90 day-old groups,
      respectively. Following ischemia, CO recovered to 82.9 +/- 3.6, 79.2 +/- 3.1,
      77.9 +/- 3.4, 72.3 +/- 2.7, 55.3 +/- 2.1, 35.7 +/- 2.9 and 33.1 +/- 6.9%,
      respectively. CK leakage correlated poorly with recovery and was 31.5 +/- 4.7,
      32.0 +/- 8.5, 33.6 +/- 7.9, 35.8 +/- 7.0, 37.3 +/- 4.4, 38.7 +/- 4.8 and 30.4 +/-
      5.9 IU/15 min per gram dry weight, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223131
TI  - Canine heart-lung transplantation after 24-hour hypothermic preservation.
AB  - We compared the efficacy of Belzer UW solution (UWS) with modified Collins
      solution (MCS) in a 24 h canine heterotopic heart-lung transplantation model.
      Nine pairs of mongrel dogs were divided into 2 groups: MCS group (n = 5) and UWS
      group (n = 4). The donor heart was arrested with cardioplegia. The heart and lung
      were flushed with MCS or UWS, excised en bloc and immersed in 4 degrees C MCS or
      UWS for 24 h. Graft function was adequate in 1 of 5 grafts in the MCS group and
      in all 4 grafts in the UWS group (P less than 0.05). In the UWS group, the
      prepreservation and posttransplantation cardiac output was 71.2 +/- 21.6 and 96.4
      +/- 44.4 ml/min per kg, the PaO2 was 80.8 +/- 12.9 and 74.1 +/- 2.7 mmHg, and the
      PaCO2 was 25.6 +/- 5.5 and 35.9 +/- 13.3 mmHg, respectively. No difference was
      significant. In the UWS group, the pulmonary vascular resistance increased
      significantly to 13.8 +/- 3.7 from 8.8 +/- 5.2 Wood units (P less than 0.05).
      Post-transplantation myocardial water content in the UWS group (78.6 +/- 2.0) was
      less than in the MCS group (81.1 +/- 1.4, P less than 0.05). The wet/dry ratio of
      the lung increased significantly to 8.3 +/- 1.6 from 4.4 +/- 0.6 in the UWS group
      (P less than 0.01) and to 10.3 +/- 0.8 from 4.1 +/- 0.1 in the MCS group (P less
      than 0.01), but was less in the UWS group (P less than 0.05). These results
      suggest that UWS is more effective than MCS in 24 h heart-lung preservation, but
      does not prevent pulmonary oedema adequately.

PMID- 2223132
TI  - Myocardial revascularization without extracorporeal circulation. Seven-year
      experience in 593 cases.
AB  - The authors present the results of 593 consecutive and non-selected patients who
      underwent direct myocardial revascularization without extracorporeal circulation
      in the period September 1981 to December 1988. The results are compared with 3086
      patients who underwent conventional bypass surgery over the same period of time.
      The ages varied from 33 to 80 years (mean = 56) with 40 patients older than 70.
      The overall mortality in the group without cardiopulmonary bypass (CPB) was 1.7%
      (10/593) compared with 3.8% for conventional revascularization. Our mortality in
      the last 3 years has been 0.5% and 0% in the last 203 patients revascularized
      without CPB. The number of grafts varied from 1 to 5 (average 1.6). The treated
      arteries were: anterior descending (557), right (282) marginal (5) and circumflex
      marginal (4). Immediate postoperative complications were fewer and hospital
      discharge was earlier in the group treated without CPB. The authors conclude that
      this tactical alternative has the advantages of: lower morbidity and mortality,
      lower cost and no need for blood transfusion. Drawbacks are the need for greater
      technical expertise and it seems to be possible in about 19% of all patients who
      undergo myocardial revascularization.

PMID- 2223133
TI  - Coronary surgery without extracorporeal circulation: benefit or additional risk
      for the patient?

PMID- 2223134
TI  - Patency of arm vein grafts used in aorto-coronary bypass surgery.
AB  - Arm veins have been used in myocardial revascularisation procedures as a last
      resort bypass conduit because of their associated low patency. Nevertheless, leg
      veins and mammary arteries, which are the most commonly used, are sometimes not
      sufficient, leaving little choice as to the bypass conduit. To assess the
      properties of arm veins in bypass surgery, we compared a group of 28 patients
      that underwent an arm vein graft coronary bypass procedure with a matched group
      of patients in which leg veins were used. In 28 patients, 40 arm vein grafts with
      77 distal anastomoses were used (mean 1.9 +/- 0.9; range 1-5). A cerebrovascular
      accident was the cause of the sole death (2%) during the study period. The mean
      follow-up was 4.6 years (Standard deviation, SD: 1.5 years). More antianginal
      medication was used in the arm vein group (P = 0.017). Additionally, the
      percentage of the expected maximal frequency during exercise testing was lower in
      the arm vein group as compared to the leg vein group. Digital subtraction
      angiography showed that the patency of the arm vein bypass grafts was 47% (70%
      confidence limits, CL: 32%-62%) while the patency of the leg vein grafts was 77%
      (CL: 64%-87%), which was statistically significant (P = 0.051). Comparison of
      these figures with the few published reports on arm veins used as coronary bypass
      grafts reveals similar results. We conclude that the arm vein as a coronary
      bypass graft is only to be used when mammary arteries and leg veins are not
      available.

PMID- 2223135
TI  - Type 1 aortic dissection with right coronary artery occlusion and fistula to
      right atrium and right ventricle.
AB  - A fistula between the aorta and right atrium which communicates with the right
      ventricle is an extremely rare and rapidly lethal complication of aortic
      dissection. There are only three previously reported cases of survival after
      operative repair of aorto-right atrial fistulae in the literature. We describe a
      patient who experienced acute aortic dissection with fistula formation to the
      right atrium and to the right ventricle. The patient underwent successful
      operative repair.

PMID- 2223136
TI  - False passage in the interventricular septum. Echocardiography in diagnosis and
      management of a rare complication after closed transventricular valvotomy for
      critical aortic stenosis.
AB  - A case of a false passage causing an aneurysm of the interventricular septum is
      reported. Two-dimensional echocardiography facilitates the correct preoperative
      diagnosis of critical aortic stenosis and is helpful in the postoperative
      management to assess the outcome and detect complications. Surgical intervention
      for a false passage was prevented by serial echocardiographic follow-up studies
      showing resolution of the aneurysm.

PMID- 2223137
TI  - The theoretical implications and experimental and clinical results of
      radiolabeled antiferritin.
AB  - Ferritin is produced in malignant and normal tissues. It acts both as an
      immunosuppressant and as an iron storage protein. As a tumor associated protein,
      it is related to virally induced tumors, and selective tumor targeting by
      radiolabeled antiferritin antibodies has led to its use in clinical trials. In
      patients with advanced Hodgkin's disease who have failed conventional therapy,
      131I antiferritin produced partial remissions, while 90Y antiferritin led to
      complete remissions and a demonstrable dose-response relationship. Combining the
      variable low-dose radiation patterns produced by radiolabeled antibody therapy
      with chemotherapy in the treatment of hepatocellular cancer has led to enhanced
      tumor cytotoxicity and, in some cases, the conversion of non-resectable hepatoma
      to resectable. Further, the potential for clinical and laboratory investigation
      of radiolabeled antibody therapy is discussed in light of new findings.

PMID- 2223138
TI  - The role of adjuvant chemotherapy in the treatment of advanced head and neck
      cancer.
AB  - The role of chemotherapy in the multidisciplinary treatment of advanced squamous
      cell carcinoma of the head and neck remains to be defined. Uncontrolled adjuvant
      studies integrating chemotherapy with local therapies utilizing a 'sequential' or
      'simultaneous' strategy have indicated that high response rates to initial
      chemotherapy and high complete remission rates are achievable. Both these factors
      appear to predict for improved survival. Unfortunately results of randomized,
      controlled studies generally have not confirmed any major overall survival
      advantage. However, these trials clearly failed to utilize optimal therapies:
      suboptimal trials yield suboptimal results. Encouraging data from large
      uncontrolled studies have now provided critical information regarding optimal
      trial design; a) Since primary tumor site has proved a significant predictive
      factor for response to treatment and survival, future trials must include
      sufficient numbers of patients for detailed site-by-site analyses, and b) radical
      surgery may be omitted without compromising survival by using initial
      chemotherapy followed by radiotherapy for advanced laryngeal cancer.

PMID- 2223139
TI  - The association between risk of breast cancer and age at first pregnancy and
      parity in Maribo County, Denmark.
AB  - The effect of age at first pregnancy and number of pregnancies was examined in a
      cohort of 14,421 women where reproductive informations were collected as part of
      a cervical cancer screening program. A total of 352 cases occurred in the cohort.
      In subgroups of women defined by age at first pregnancy the relative risk of
      breast cancer was lower among women who were first pregnant before 25 years of
      age (RR = 0.85 vs 1.20). In subgroups of women defined by parity the relative
      risk decreased with increasing number of pregnancies from about unity among women
      with 0-3 pregnancies to 0.7 among women with 6 or more pregnancies.

PMID- 2223140
TI  - Simple mastectomy with postoperative irradiation versus extended radical
      mastectomy in breast cancer. A twenty-five-year follow-up of a randomized trial.
AB  - From November 1951 to December 1957, all patients with untreated breast cancer
      admitted to the Radium Centre in Copenhagen were randomized before their
      operability was evaluated into two groups, if the patients were operable, viz.
      simple mastectomy with postoperative x-ray treatment or extended radical
      mastectomy. Twenty-five-year results are presented, showing no difference in
      survival or recurrence-free survival of the operable patients. Histological
      grading was performed in nearly all cases. Patients with grade 1 tumours had a
      better survival than grades 2 and 3, but there was no difference in survival
      between the two treatment groups, when histological grading was taken into
      account. Histological node positive patients had more grades 2 and 3, tumours,
      whereas node negative patients had more grade 1 than grades 2 and 3 tumours.
      Premenopausal women had a significantly better survival than postmenopausal in
      all stages.

PMID- 2223142
TI  - Axillary sampling and the risk of erroneous staging of breast cancer. An analysis
      of 960 consecutive patients.
AB  - Axillary nodal status was analysed in 960 consecutive cases of primary invasive
      breast cancer operated in two Danish hospitals. After stratification according to
      the number of nodes removed, the rate of node positivity in each subgroup was
      calculated. We found that the probability of finding at least one metastatic node
      increased continuously up to about 10 removed nodes. In lymph node negative
      patients, who did not receive any adjuvant treatment, there was a significant
      association between the recurrence-free survival and the number of nodes removed,
      provided that less than 8-10 nodes had been collected. The percentage of node
      positivity in each subgroup seemed to level off above 10 nodes at about 64%,
      suggesting that this represents the true rate of node positivity at the time of
      primary surgery. We conclude that about 10 axillary nodes should be removed in
      order to minimize the risk of erroneous classification of the axilla.

PMID- 2223141
TI  - Second line hormonal therapy with aminoglutethimide in metastatic breast cancer.
AB  - One hundred and twenty patients with metastatic breast cancer, whose disease
      progressed on hormonal therapy with tamoxifen, were treated with
      aminoglutethimide. The overall response rate was 34% and the median duration of
      response 9.5 months. Response to aminoglutethimide was achieved in all metastatic
      sites except lung and brain. Even 25% of patients who had failed to respond to
      prior tamoxifen did respond objectively to aminoglutethimide. The actuarial
      survival for all patients at 30 months was 22%. Although initial toxicity was
      high (70%), side effects of aminoglutethimide were transient, and treatment had
      to be discontinued in only four patients. The results of this trial confirm that
      aminoglutethimide is an effective treatment in metastatic breast cancer.

PMID- 2223143
TI  - Oral versus intravenous melphalan and prednisone treatment in multiple myeloma
      stage II. A randomized study from the Myeloma Group of Central Sweden.
AB  - Eighty-one previously untreated patients with multiple myeloma stage II entered a
      randomized trial comparing oral melphalan (0.25 mg/kg/day; n = 40) with
      intravenous melphalan (0.125 mg/kg/day; n = 41) in combination with oral
      prednisone (2 mg/kg/day). The courses were given for 4 days and repeated every
      sixth week. The treatment groups were well comparable with regard to major
      prognostic factors. There was no statistically significant difference in the
      response rates, the response duration times and the survival times. No
      significant difference in nonhematological and hematological toxicity was noted.
      Since intravenous administration of melphalan did not result in a substantial
      increase in response rate or survival, this study supports the use of oral
      melphalan/prednisone as first-line therapy for patients with multiple myeloma.

PMID- 2223144
TI  - Non-Hodgkin's lymphoma. A four-drug regimen suitable for elderly patients with
      advanced disease.
AB  - Twenty-eight patients with non-Hodgkin's lymphomas considered unsuitable for
      doxorubicin containing combination chemotherapy were given the four-drug
      combination chlorambucil, mitoxantrone, procarbazine and prednisolone every 3
      weeks. The median age of the patients was 69 years and 15 had received prior
      treatment. Non-haematological toxicity was WHO grade I or II in all cases. Five
      patients had grade 4 neutropenia of which 3 were associated with fever and one
      was fatal. The complete response rate was 32% and the overall response rate 61%.
      The actuarial survival of the 17 responding patients at 12 months was 68%. This
      outpatient regimen produced good compliance among elderly patients, and modest
      toxicity with acceptable response rate and survival for the study population.

PMID- 2223145
TI  - Carcinoma of the uterine cervix treated by irradiation alone. Results of
      treatment at the National Cancer Center, Tokyo.
AB  - Six hundred and twelve patients with previously untreated invasive carcinoma of
      the uterine cervix were treated by irradiation alone at the National Cancer
      Hospital from 1972 to 1983. The number of patients was 7, 39, 43, 127, 15, 319,
      28 and 34 in stages IA, IB, IIA, IIB, IIIA, IIIB, IVA and IVB respectively. Low
      dose-rate intracavitary irradiation with or without external irradiation was used
      in 383 patients, high-dose-rate intracavitary irradiation with or without
      external irradiation in 130, external irradiation alone in 98, and external
      irradiation combined with radon-222 seed implantation in one patient. Five-year
      survival rates were 85, 65, 57, 41, 14 11% for stages IB, IIA, IIB, IIIB, IVA,
      and IVB respectively. The rate of complications was rather high in the present
      series, and so we have been investigating whether it is possible to reduce the
      dose. Low-dose-rate intracavitary irradiation has been replaced by high-dose-rate
      irradiation by using a remotely controlled afterloading system.

PMID- 2223146
TI  - Microphotometric DNA analysis in moderate dysplasia of the uterine cervix.
      Correlation to the progression and regression of the lesion.
AB  - Nuclear DNA content was determined by microphotometry in 27 cases of moderate
      dysplasia of the uterine cervix. All these cases were followed from one to ten
      years to study the biological behavior of moderate dysplasia in relation to
      cervical carcinogenesis. Ten of them showed progression to carcinoma in situ
      during a period of one to six years (median 34.8 months) and 17 cases showed
      regression to inflammation and normalcy during a period of one to ten years
      (median 44.2 months). DNA analysis was performed both on initial cervical smear
      and on representative smears collected during follow-up. Amongst ten cases which
      progressed to malignancy, nine had aneuploid DNA pattern and one had polyploid
      DNA pattern throughout the follow-up period. Amongst 17 cases which regressed to
      inflammation, 11 had euploid and six polyploid DNA pattern. The observation that
      moderate dysplasia with aneuploid DNA value often develops into carcinoma in situ
      in contrast to dysplasia with euploid or polyploid DNA value strengthens the
      conception that DNA aneuploidy may be considered as 'high risk indicator' for
      cervical precancerous lesions.

PMID- 2223147
TI  - Microscopic and flow cytometric study of micronuclei in iododeoxyuridine labelled
      cells irradiated with soft x-rays.
AB  - Iododeoxyuridine labelled (IUdR(+)) and unlabelled (IUdR(-)) CHO cells irradiated
      with 2 Gy of soft x-rays showed only minor differences in the kinetics of
      micronuclei formation during the first 20 hours postirradiation period. Between
      20 to 40 hours, the IUdR(-) cells showed approximately a constant number # of
      micronuclei while the number of micronuclei in IUdR(+) cells was still
      increasing. The frequency of micronuclei was higher in IUdR(+) cells compared to
      IUdR(-) cells at 24 hours after irradiation with various doses up to 4.0 Gy. Dose
      modifying factors were found to be 1.3 (microscopic evaluation) and 1.8 (flow
      cytometric evaluation). Flow cytometry with use of two parameters, fluorescence
      from propidium iodide and light scattering, seems to be a good tool to estimate
      the frequency of micronuclei in CHO cells in the dose range up to about 4 Gy. At
      higher doses perturbation of the cell cycle and the appearance of dying cells
      will influence the results.

PMID- 2223148
TI  - The in vivo response of a C3H mammary carcinoma to treatment with misonidazole,
      cyclophosphamide and radiation.
AB  - The potential chemosensitizing effect of the nitroaromatic radiosensitizer
      misonidazole (MISO) on the alkylating agent cyclophosphamide (CTX), and the
      interactions of these agents with radiation, have been investigated in a C3H
      mammary carcinoma in CDF1 mice. MISO at 1,000 mg/kg caused a small increase in
      tumour growth time (TGT; time to reach 3 times treatment volume) from 3.6 days to
      4.5 days. CTX (100 mg/kg) increased the TGT to 15.7 days. The combined treatment
      of MISO and CTX given with intervals of either 15 min or 4 h increased the TGT to
      23.3 and 23.8 days respectively. The radiation enhancement ratio (ER) was found
      to be 2.13 and 1.10 for MISO administered before or after x-rays respectively.
      The corresponding ERs for CTX were 1.16 and 1.22. The two drugs given in
      combination resulted in significant radiation ERs of 2.68 (both drugs given
      within 30 min before x-rays), 3.00 (MISO 30 min before and CTX 3 1/2 h after x
      rays) and 1.40 (both drugs given after x-rays). In contrast to what has
      previously been reported, and in contrast to the tumour regrowth delay data, the
      results of the tumour control experiments were found to reflect no more than an
      additive action of the two drugs when used together with radiation in vivo.

PMID- 2223149
TI  - Melatonin and immunity.

PMID- 2223150
TI  - Prostatic acid phosphatase in cloacogenic carcinoma.

PMID- 2223151
TI  - Influence of bestatin on production of granulocyte-macrophage colony-stimulating
      factor from human peripheral blood mononuclear cells in vitro.
AB  - Bestatin, (25, 3R)-3-amino-2-hydroxy-4-phenylbutyryl-L-leucine, enhanced
      proliferation of normal human bone marrow granulocyte-macrophage progenitor cells
      to form CFU-GM colonies in viscous methylcellulose medium in vitro. To elucidate
      the mechanisms of this effect, the levels of colony-stimulating factor (CSF) in
      culture supernatant of 1 x 10(6)/ml peripheral blood mononuclear cells (PBMC)
      cocultured with various concentrations of bestatin were determined using our
      newly developed sandwich enzyme-linked immunosorbent assay (ELISA). The level of
      granulocyte/macrophage-CSF (GM-CSF) in the supernatant in the presence of 0.1
      microgram/ml bestatin was 312 pg/ml by this ELISA. The production of GM-CSF
      increased with increasing amounts of added bestatin.

PMID- 2223152
TI  - Inhibitory effect of bestatin on the growth of human leukemic cells.
AB  - We examined the effect of bestatin (Ubenimex) on the growth of human leukemic
      cells (i.e, HL-60, K562, MT-1, MT-2, Molt-4, and Raji cells). The growth of each
      cell line was inhibited by the cocultivation with bestatin at higher
      concentrations than employed for clinical use in Japan. [3H]TdR incorporation was
      also inhibited in MT-1 and MT-2 cells by treatment with bestatin. Degenerated
      cell-to-cell adhesion was observed among the treated cells. These findings
      suggest that the inhibitory effect on some leukemic cells, especially on MT-1
      cells, results from the inhibition of DNA synthesis.

PMID- 2223153
TI  - Bestatin treatment of myelodysplastic syndromes (MDS) and the effects of bestatin
      on hematopoiesis in MDS.
AB  - A high remission rate (75%) was achieved in a preliminary study using bestatin in
      patients with refractory anemia with excess blasts (RAEB) and RAEB in
      transformation (RAEB-t). One of 2 patients with RAEB-t and 3 of 6 patients with
      RAEB obtained complete response. Two patients with RAEB achieved good response,
      but one with refractory anemia failed. Clonogenic marrow cell culture studies in
      patients with myelodysplastic syndromes have demonstrated intrinsic hematopoietic
      stem cell abnormalities, in particular defective erythroid colony formation.
      After bestatin treatment, these abnormalities as well as hematologic findings
      were markedly improved. The results suggest that bestatin has an enhancing effect
      on burst promoting activity production of helper (CD4 positive) T lymphocytes and
      the effect on hematopoiesis of bestatin may be mediated by T lymphocytes.

PMID- 2223154
TI  - Adjuvant bestatin (Ubenimex) treatment following full-dose local irradiation for
      bladder carcinoma.
AB  - The clinical value of adjuvant bestatin (Ubenimex) immunotherapy has been
      examined in a group of patients with urinary bladder cancer. Patients with non
      metastatic transitional cell carcinoma of the bladder, scheduled for full-dose
      local irradiation therapy (64 Gy), were randomly allocated to adjuvant oral
      bestatin treatment (30 mg daily for at least 1 year), starting at completion of
      irradiation, or no bestatin. The trial included 194 evaluable patients with a
      follow-up period of 1.5-9.5 years. The overall survival of the two groups of
      patients did not differ statistically significantly (97 patients in each).
      Subgrouping of the patient material gave no evidence that the clinical efficacy
      of bestatin is related to sex, tumor category or malignancy grade.

PMID- 2223155
TI  - Effects of bestatin on the host immunity in patients treated for urogenital
      cancer.
AB  - To examine effects of bestatin on the host immunity of patients with urogenital
      cancer, 54 patients were randomized into 2 groups: bestatin treated and controls.
      In each group, the patients were divided into 2 subgroups: one which received
      basic treatment expected to greatly affect host immunity ('invasive treatment')
      while the other one received other types of basic treatment ('non-invasive
      treatment'). Peripheral lymphocyte, OKT 4/8 ratio and purified protein derivative
      (PPD) skin reaction were used as immunological markers. There were significant
      differences in the 'invasive' treatment group between bestatin treated patients
      and controls concerning lymphocyte counts and PPD skin reactions and in the 'non
      invasive' group concerning lymphocyte counts and OKT 4/8 ratios. These results
      suggest that bestatin may potentiate host immunity in patients with urogenital
      cancer. Further studies on larger materials are, however, needed before more
      definite conclusions can be drawn.

PMID- 2223156
TI  - Combination therapy with bestatin in inoperable lung cancer. A randomized trial.
AB  - A randomized trial of combination therapy with bestatin (30 mg daily, every day)
      was performed in 238 patients with inoperable primary lung cancer from August,
      1981 through April, 1984. Of the 238 patients, 227 were evaluable: 113 treated by
      bestatin combination therapy and 114 controls. There was no statistically
      significant difference in response rate or survival between the 2 groups. In
      squamous cell cancer response was observed in 34.5% of the bestatin group and
      17.9% of the control group. The analysis, including Cox's proportional hazard
      model, revealed that the survival tended to be longer in the bestatin group
      (median survival 40 weeks) than in the control group (median survival 24 weeks; p
      = 0.051). This suggests that addition of bestatin might be beneficial in squamous
      cell cancer of the lung but further, more rigidly controlled, clinical trials are
      necessary before more definitive conclusions can be drawn.

PMID- 2223157
TI  - Bestatin in resected lung cancer. A randomized clinical trial.
AB  - A randomized study with and without bestatin, a new biological response modifier,
      was conducted in order to evaluate its survival effect on resected lung cancer. A
      total of 153 patients (72 with squamous cell carcinoma, 66 with adenocarcinoma,
      and 15 with other types of cancer) were evaluated. Among the patients with
      squamous cell carcinoma, the bestatin-treated group had significantly prolonged
      survival compared to the control group. No significant difference between the two
      groups was seen in adenocarcinoma.

PMID- 2223158
TI  - [Origin of DNA replication of filamentous coliphages].

PMID- 2223159
TI  - Phylogeny and molecular evolution in primates.
AB  - Statistical methods for estimating the branching order and the branching dates
      from DNA sequence data, taking into account of the rate variation among lineages,
      are reviewed. An application of the methods to data from primates suggests that
      chimpanzee is the closest relative of man, and further suggests that these two
      species diverged about 4-5 million years ago.

PMID- 2223160
TI  - Avidin column as a highly efficient and stable alternative for immobilization of
      ligands for affinity chromatography.
AB  - The avidin/biotin system was applied as a general mediator in the
      adsorption/desorption or immobilization of biologically active macromolecules to
      solid supports. In this context, model biotinylated proteins (lectins and
      antibodies) were attached to avidin-coupled Sepharose. As examples for affinity
      chromatography, peanut agglutinin and anti-transferrin antibody were used to
      isolate asialofetuin and transferrin, respectively. The capacity and product
      yields were significantly better than those achieved with conventional affinity
      chromatography on CNBr-activated Sepharose columns containing the same lectin or
      antibody. Moreover, the columns were characterized by improved stability
      properties exhibiting remarkably low levels of leakage.

PMID- 2223161
TI  - Antibody affinity measurements.
AB  - The use of antibodies in immunoaffinity separations represents one of the most
      specific methods for purifying substances of biological interest. Since the
      binding affinity of antibody greatly influences its behavior in such separations,
      it is often important to know the value of the antibody affinity expressed as an
      equilibrium constant K. The present review discusses the equations used in the
      quantitative analysis of antigen/antibody interactions and describes currently
      used experimental methods for measuring K values. Advantages and shortcomings of
      the solution phase and solid phase approaches used for measuring antibody
      affinity are discussed.

PMID- 2223162
TI  - New developments in affinity chromatography.
AB  - The design, synthesis and chromatographic operation of a new range of stable and
      selective immobilized dye affinity adsorbents for potential application in the
      purification of pharmaceutical proteins is described. Computer aided molecular
      design has been exploited to design novel dye ligands which show a predictable
      selectivity for the target protein and which, when coupled to stable
      perfluoropolymer supports, yield high capacity, low leakage adsorbents for
      affinity chromatography. It is anticipated that these new materials will
      withstand the rigorous conditions required for sanitization and cleaning in situ
      of industrial scale processes.

PMID- 2223163
TI  - Investigation of dye/protein interaction and its application to enzyme
      purification.
AB  - In this review the results of the interaction of the active dyes used in the USSR
      textile industry with microbial enzymes and blood serum proteins are discussed.
      The complexity of dye/protein interaction and the dependence of this interaction
      on different factors is demonstrated. Some practical aspects of the use of dye
      containing sorbents are presented and discussed. Their suitability for RNA ligase
      and DNA ligase, acetate kinase, alcohol dehydrogenase, lactate dehydrogenase and
      glucose-6-phosphate dehydrogenase purification and blood serum protein
      fractionation is demonstrated.

PMID- 2223164
TI  - Diagnosis and treatment of impotence.
AB  - Among the common procedures used in the diagnosis of impotence, neither nocturnal
      penile tumescence testing nor inhome monitoring devices designed to measure
      tumescence or rigidity is regarded as reliable for evaluating impotence.
      Plethysmography as a nonspecific test of vascular competence is increasingly
      being supplanted by Doppler ultrasound as a safe and effective diagnostic
      modality. Arteriography, cavernosography, and cavernosometry are established
      techniques for evaluating penile vasculature. Intracavernosal injection of smooth
      muscle relaxing drugs, endocrine assays, and electrophysiological testing are
      widely used for the diagnosis of impotence. Excluding implanted devices, and
      intracavernosal injections. Aortoiliac reconstruction, endarterectomy, or
      arterial dilatations are regarded as safe and effective for the treatment of
      proximal occlusive lesions, and venous leakage surgery is regarded as
      investigational. Intracavernosal injections are widely employed in clinical
      environments and for self-injection at home. However, this currently represents
      the use of FDA-approved drugs for an unlabeled indication. The use of external
      vacuum devices has achieved widespread use and is regarded as being safe and
      effective for the treatment of impotence.

PMID- 2223165
TI  - Dependency, social factors, and the smoking cessation process: the doctors
      helping smokers study.
AB  - We analyzed data obtained from a representative sample of the smoking patients (n
      = 1,338) of 66 family physicians to determine predictors of attempts to stop
      smoking, desire to quit smoking, and successful smoking cessation. Compared to
      subjects who made no attempt to quit smoking, subjects who tried to quit smoking
      tended to be younger, had tried to quit smoking in the year prior to the study,
      waited longer before smoking their first cigarette of the day, had more desire to
      quit smoking, and had more social support for quitting. Education and cigarettes
      smoked per day were not independently related to the subject making a quit
      attempt. Desire to quit smoking was associated with an attempt to quit in the
      year prior to the study and social support for smoking cessation (support of
      spouse, second most important social contact, and physician). Desire to quit
      smoking was not independently related to age, education, or dependency on
      cigarettes (measured by the number of cigarettes smoked per day and the length of
      time a subject waited before smoking the first cigarette of the day). Compared to
      subjects who tried to quit and failed, subjects who succeeded were older, smoked
      fewer cigarettes per day, and waited longer to smoke their first cigarette of the
      day. Spouse support, support of the second most important social contact, and
      advice of a doctor to quit smoking were not independently related to whether or
      not a cessation attempt would be successful. These data suggest that successful
      smoking cessation requires two components: social support to make an attempt to
      quit and the ability to overcome dependency on cigarettes to make the attempt
      successful.

PMID- 2223166
TI  - Ethnicity and smoking: differences in white, black, Hispanic, and Asian medical
      patients who smoke.
AB  - To describe differences in the attitudes and behaviors of white, black, Hispanic,
      and Asian medical patients who smoke, we surveyed 2,835 patients of primary care
      physicians who participated in a controlled trial on smoking cessation. White
      smokers smoked more cigarettes per day, were more addicted to cigarettes, had
      more smoking-related symptoms and illnesses, and were more likely to relate
      smoking to their symptoms and illnesses. Black smokers found less pleasure in
      smoking, expressed the least concern about the health risks of smoking, but
      reported the greatest desire to quit and most confidence that they could quit.
      Hispanic and Asian smokers more often wanted to quit to keep their children from
      being exposed to smoking. We conclude that a single approach to helping patients
      quit smoking is less likely to be effective than one tailored to the ethnic
      differences among those patients.

PMID- 2223167
TI  - A smoking cessation incentive program for chemical employees: design and
      evaluation.
AB  - Worksite smoking cessation intervention programs have become increasingly
      popular, although program evaluations are often unavailable. In 1984, the Texas
      Operations of Dow Chemical USA offered a Smoking Cessation Incentive Program
      (SCIP) to its employees. SCIP was a highly publicized, upbeat program that had
      the active support of management and union. Altogether, 7,516 employees (95.4% of
      all employees) were surveyed about their smoking habits; 28.3% identified
      themselves as smokers. A total of 1,113 employees voluntarily enrolled in SCIP
      from March 1, 1984, through March 1, 1985. Smoking cessation methods included a
      buddy program, nicotine-containing chewing gum, American Lung Association self
      help material and group clinics, and incentive prizes. SCIP registrants, compared
      to employees identified as smokers in a pre-program survey who did not
      participate in SCIP, were significantly (P less than .01) more often females,
      whites, administrators, professionals, heavier smokers, and smokers who had tried
      to quit at least two times prior to SCIP. There were 326 (29.3%) SCIP
      participants who quit smoking for at least one month during SCIP. A total of 265
      (23.8%) succeeded at quitting for at least six months and remained ex-smokers at
      the end of the program. Logistic regression analysis showed administrators had
      significantly higher six-month or more rates of quitting than did professionals,
      craftsmen, operators or clerical workers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223168
TI  - Effectiveness of methods used to teach breast self-examination.
AB  - The efficacy of breast self-examination (BSE) is limited by the extent to which
      women can be taught to perform a frequent and proficient examination. We
      randomized 783 women from a health maintenance organization into group
      instruction, individual instruction, individual instruction with a reminder
      system, or minimal intervention designed to simulate an office encounter where
      BSE was encouraged but not taught. The percentage of lumps 1 cm and smaller
      detected in silicone breast models, the number of false-positive detections, the
      search technique, and the self-reported BSE frequency were measured before and
      four months after intervention. Multiple tests for comparisons of interventions
      showed that the interventions containing BSE instruction were comparable in
      increasing true- and false-positive detection of lumps and in improving search
      technique, but the minimal intervention resulted in lower scores for all three
      outcomes (P less than .0001). Women in all four intervention groups increased
      their BSE frequency over the four-month follow-up period, but the greatest
      improvement in frequency was reported among women receiving reminders.

PMID- 2223170
TI  - Health consciousness and health behavior: the application of a new health
      consciousness scale.
AB  - Self-consciousness has been an important trait in personality research. It seems
      logical to investigate whether health consciousness, involving a similar self
      focusing, might operate in a parallel manner. To this end, I developed the Health
      Consciousness Scale (HCS), primarily by modifying items of the Self-Consciousness
      Scale, and also tested it for reliability and validity. My study found the HCS to
      contain four first-order factors: (1) Health Self-Consciousness, (2) Health
      Alertness, (3) Health Self-Monitoring, and (4) Health Involvement. I found these
      four first-order factors, along with the overall HCS second-order factor, to
      relate to a number of self-reported, health-associated behavioral variables. The
      study also included comparisons with the Health Locus-of-Control Scale and other
      measures.

PMID- 2223169
TI  - Children's frequency of consumption of foods high in fat and sodium.
AB  - We administered a food frequency instrument to third-fifth grade students (n =
      943) in four Texas schools. Comparison of foods reported on the food frequency
      questionnaire and on 24-hour dietary recalls (n = 7) produced a percent agreement
      of 83.3. The most frequent 25 foods accounted for 64.0% of food choices across
      all meals, 93.5% of breakfast choices, 76.4% of lunch choices, 70.5% of supper
      choices, and 76.0% of snack choices. Breads, milk, hamburger or steak, soda pop,
      tomato sauce or tomatoes, and cheese were the most frequently consumed foods.
      Fruits and juices accounted for 6.1% of total selections for boys and 6.6% for
      girls, while vegetables accounted for 15.7% of total selections for boys and
      16.2% for girls. Fruit was more likely to be consumed for snacks than for meals,
      and vegetables were consumed in about the same frequency at lunch and supper and
      for snacks. We analyzed the total fat, saturated fat, and sodium content of the
      most frequently consumed foods. Seventeen of the top 25 foods for the total day
      and 13-16 for each meal or snack exceeded by at least 50% the recommended levels
      for fat, saturated fat, or sodium. The pattern of consumption was one of frequent
      consumption of a relatively small number of foods, many of which are high in fat
      or sodium.

PMID- 2223171
TI  - Bowen's disease (squamous cell carcinoma in situ) as a skin marker for internal
      malignancy: a case-control study.
AB  - Bowen's disease has been viewed as a skin marker for internal malignancy by
      dermatologists for decades. If substantiated, it certainly would help in early
      detection of an occult malignancy. We conducted a matched case-control study to
      evaluate the significance of this link. Ninety patients with Bowen's disease
      diagnosed between 1972 and 1986 were selected for study. These patients were
      matched by age, sex, race, and date of biopsy for diagnosis (or treatment) to 90
      other patients chosen as controls. Six patients in the Bowen's disease group and
      three patients in the control group had internal malignancy during the period
      after the date of biopsy or treatment (P greater than 0.4). The present study
      cannot substantiate the claim that Bowen's disease is a skin marker for internal
      malignancy.

PMID- 2223172
TI  - High-resolution computed tomography of the pulmonary parenchyma.

PMID- 2223173
TI  - Computed tomographic scanning of the thorax in workers at risk of or with
      silicosis.

PMID- 2223174
TI  - Computed tomography of benign pleural and pulmonary parenchymal abnormalities
      related to asbestos exposure.

PMID- 2223175
TI  - Acute radiation-induced pulmonary injury: computed tomography evaluation.

PMID- 2223176
TI  - High-resolution computed tomography in pulmonary sarcoidosis.

PMID- 2223178
TI  - [Perinatal brain injuries and subsequent epilepsy: a study on intraventricular
      hemorrhage in preterm infants and hypoxic-ischemic encephalopathy in full-term
      infants].
AB  - The clinical course of symptomatic epilepsy caused by intraventricular hemorrhage
      (IVH) in 7 preterm infants and hypoxic-ischemic encephalopathy (HIE) in 9 full
      term infants were followed up for more than 2 years and 6 months. West syndrome
      was the first manifestation of epilepsy in 10 cases (IVH: 4, HIE: 6), and all 16
      patients had severe neuropsychiatric deficits. Comparing with children without
      epilepsy, IVH grades III and IV, mechanical ventilation for more than 6 days and
      neonatal convulsions in the patients with IVH, and mechanical ventilation and
      neonatal convulsions in the patients with HIE, were significantly related to the
      risk of subsequent epilepsy. These findings suggest that the degree of brain
      injuries may be predictive of the development of epilepsy during infancy and
      early childhood in the patients with IVH or HIE.

PMID- 2223177
TI  - Computed tomographic assessment of bronchiectasis.

PMID- 2223179
TI  - [Meningoencephalitis in Kawasaki disease].
AB  - Kawasaki disease (KD) is a syndrome characterized by various degrees of
      vasculitis in small-and medium-sized arteries. We discussed the characteristic
      manifestations and prognosis of 5 KD patients (male 3, female 2) with
      meningoencephalitis in the acute stage. The incidence was 3.7% (5 of 138
      patients) in our institute. The age of onset was between 3 months and 15 months.
      The clinical manifestations included disturbance of consciousness and seizures;
      disturbance of consciousness developed in all patients in the early acute stage.
      The duration was between 2 and 11 days; seizures developed as status convulsions
      in two. Electroencephalograms (EEG) demonstrated certain abnormalities in 2 of 4
      patients studied. Computed-tomographic scanning (CT scan) revealed fluid
      collection in the frontal extracerebral space, and monocyte-predominant
      pleocytosis was observed in the cerebrospinal fluid (CSF) in all 5 patients
      studied. The age of onset in the 5 KD patients was significantly earlier than
      that in non-complicated cases (n = 138, P less than 0.01). Blood hemoglobin (P
      less than 0.05) and hematocrit (P less than 0.05), serum total protein (P less
      than 0.01), and serum albumin levels (P less than 0.01) were also significantly
      lower. Moreover the period until CRP values turned negative was significantly
      longer (P less than 0.05) and erythrocyte sedimentation rate was significantly
      lower (P less than 0.01) in these 5 patients. It was considered that
      meningoencephalitis in KD may develop in cases having more severe and prolonged
      inflammatory changes; the clinical findings revealed a serious form of KD. We
      suggest that this might because by vasculitis of small arteries, arterioles,
      capillaries, and venules, which consists of infiltration of lymphocytes and large
      mononuclear cells, and edema. There was no neurological sequela in 4 of the 5
      patients. However, one patient was found to have hearing difficulty 3 years after
      the onset. Therefore, the prognosis of meningoencephalitis in KD was considered
      to be generally favorable.

PMID- 2223180
TI  - [Mental deterioration in childhood epilepsy. I. Neuropsychological and
      electroencephalographic studies].
AB  - To clarify the pathogenesis of mental deterioration in epilepsy,
      neuropsychological and electroencephalographic studies were performed. Thirty
      seven children were classified into two groups: group I consisted of 24 children
      with mental deterioration during the clinical course of their epilepsy, and group
      II consisted of 13 children without mental deterioration. Mental deterioration
      was assessed on the basis of the intelligence test scores during follow-up
      studies. The mean intelligence quotient of 24 children in group I decreased from
      91.8 +/- 11.5 to 64.3 +/- 15.4 during a mean period of 4.4 years. Significant
      differences were found between the two groups in the levels of both
      representation (association function) and automation (auditory closure, visual
      recognition and visual-motor function). There were also significant differences
      between the two groups in the continuation of epileptic discharges on EEG, in the
      persistence of epileptic attacks at the final visit, and in the numbers of
      antiepileptic drugs at the neuropsychological examination. The degree of mental
      deterioration was correlated with the defect in the association function and,
      eleven children in group I showed mental deterioration even after their attacks
      had been suppressed.

PMID- 2223181
TI  - [Paradoxical alpha waves seen in the course of subacute sclerosing
      panencephalitis].
AB  - Serial EEG findings of two cases with subacute sclerosing panencephalitis were
      compared with concurrent clinical status and CT findings. Case 1, a 16-year-old
      boy, showed transient abnormal diffuse alpha waves during sleep record. That had
      been seen for six months after the disappearance of periodic synchronous
      discharges. Clinically this abnormal EEG finding was observed at the transitional
      phase from stage II to III, when CT showed severe brain atrophy. Case 2, an 11
      year-old boy, showed similar abnormal alpha waves for three months in the same
      phase as case 1. There have been many reports regarding the EEG findings of SSPE.
      However, these abnormal EEG findings were not reported. These abnormal alpha
      waves during sleep are considered to develop at the transitional phase from stage
      II to III, when pathologically SSPE goes from inflammation to destruction.

PMID- 2223182
TI  - [Experimental study on pathogenesis of neonatal hypoxic-ischemic encephalopathy.
      I. Histopathological study].
AB  - This experiment was undertaken to study the effect of hypoxic and/or ischemic
      condition on developing brain and also to investigate the pathogenesis of hypoxic
      ischemic encephalopathy. A unilateral common carotid artery of 7-day-old Sprague
      Dawlay rats was ligated and cut under ether inhalation. Three hours after the
      operation, these rats were exposed to hypoxia (8% oxygen and 92% nitrogen
      mixture) for two hours. Three days after manipulation, neuronal necrosis on the
      ligated hemisphere were recognized in 50% in the cortex, 66.7% in the
      hippocampus, 66.7% in the corpus striatum and 33.3% in the thalamus. Various
      sizes and degrees of necrotic regions were found in the cerebral cortex. In some
      cases, cuffs of radially arranged viable neurons alternating with stripes of full
      depth necrosis of the cortex were noticed. In the hippocampus, neuronal necrosis
      was found segmentally at the pyramidal cell layer. In the corpus striatum and the
      thalamus, the damage consisted of small focal or multifocal neuronal necrosis.
      After four and eight weeks of the manipulation, a large porencephalic cavity in
      the cerebral cortex of the ligated side was noticed as the severest manifestation
      in 16% of the cases. In some cases, multiple lobulation similar to poly
      microgyrus was noticed. Various sizes of gliosis were also numerous in the
      cerebral cortex, hippocampus, corpus striatum and thalamus of the ligated side
      hemisphere. Calcified lesions were also occasional in the basal ganglia.

PMID- 2223183
TI  - [Experimental study on pathogenesis of neonatal hypoxic-ischemic encephalopathy.
      II. Energy metabolism in the brain].
AB  - In a preceding paper, we showed that the exposure to hypoxia after unilateral
      carotid artery ligation of sucking rat on 7 days of age caused various
      pathological changes in the ipsilateral forebrain, which had close similarity to
      human perinatal hypoxic-ischemic encephalopathy. To evaluate the energy
      metabolism in various regions of the brain during hypoxia after unilateral
      carotid artery ligation, tissue pH was monitored in the cortex by direct
      insertion of an electrode. The contents of the lactate, pyruvate, ADP and ATP
      were also measured during hypoxia. The tissue pH in the cortex of ligated side
      declined rapidly after initiation of hypoxia as compared to non-ligated side. The
      contents of pyruvate and ADP showed no particular changes through various
      regions. Only in the cortex and hippocampus of ligated side, ATP was decreased,
      and elevation of lactate was more salient than in non-ligated side. In the
      striatum and thalamus, only elevation of lactate was indicated. However, the
      levels of lactate, pyruvate, ADP and ATP disclosed no significant difference
      between the ligated side and non-ligated side, although neuropathological changes
      were observed only in their ligated side. These results suggest that pathogenesis
      of the cerebral damage caused by hypoxic-ischemic condition may be different
      between the cerebral cortex and subcortical structures.

PMID- 2223184
TI  - [Repetitive rhythmic spikes in epileptic children].
AB  - Repetitive rhythmic spikes (RRSs') sometimes appear periodically for 0.2-2.0
      seconds at localized in epileptic children. We selected 11 patients (male 6,
      female 5) with RRSs for this study. Ages were 3-15 years (average 10.7 years). We
      counted the number of spikes which were recorded on the scalp EEG. The duration
      of RRSs and the differences of amplitude between large and small spikes on
      monopolar montages were examined. We also studied the appearance of spikes under
      different recording conditions; waking and sleep stages, photic stimulation and
      hyperventilation. Furthermore, we made two dimensional joint-dot plotting for the
      interval between repetitive spikes. RRSs were classified into two groups. In the
      first group, joint-dots of RRSs were locally observed between 0.2-0.8 sec. In the
      second, they were disseminated between 0.2-2.0 sec. In two groups, spikes were
      mainly observed in the sleep EEG (stage 1). The average number of spikes in the
      first group was 18.7/min, and that in the second was 25.7/min. The average
      difference of the amplitude between large and small spikes was 103 microV in the
      first group, and 88 microV in the second group. The average duration of spikes
      was 54.2 msec in the first group and 62.4 msec in the second group. From these
      results, it was assumed that some of spikes in the first group occurred in the
      surface of the cortex and that some of spikes in the second group were projected
      from the deep region in the cortex.

PMID- 2223185
TI  - [Electrophysiological studies on hydranencephaly].
AB  - Electrophysiological studies were performed on two children with hydranencephaly
      that was diagnosed by CT and/or magnetic resonance imaging (MRI). Case 1 was a 4
      months-old boy who had no rostral tissue above the midbrain. Case 2 was a 5-years
      old boy in whom CT showed the presence of the thalamus. Short latency
      somatosensory evoked potentials (SSEP) in both cases exhibited the absence of
      cortical activity (N1 and P4) with the preservation of waves of brainstem origin.
      However, in case 1, the wave component N0 was not observed, while N0 was seen in
      case 2. Thus, the N0 was component of SSEP on median nerve stimulation in
      children, which corresponds to N16 in adults, may originate in the thalamus.

PMID- 2223186
TI  - [Effect of high-dose methotrexate on cerebral metabolic rate of glucose in rats
      and children with acute lymphoblastic leukemia].
AB  - For assessment of high-dose methotrexate (HD-MTX) neurotoxicity, regional
      cerebral metabolic rates of glucose (rCMRGlu) in rats and children with acute
      lymphoblastic leukemia were measured. rCMRGlu in rats receiving HD-MTX (300 or
      600 mg/kg) was measured using 14C-deoxyglucose and autoradiographic technique.
      CMRGlu of the whole brain after HD-MTX was reduced by 31% on the average (p less
      than 0.01). CMRGlu of cerebral cortex was reduced more than that of white matter.
      Eight children with ALL (mean age 9.6 years) were studied using 18F
      fluorodeoxyglucose and positron emission tomography before and after HD-MTX (200
      mg/kg or 2,000 mg/M2) therapy. Although no patients clinically showed any
      neurological abnormalities during HD-MTX therapy, CMRGlu of the whole brain after
      HD-MTX was reduced by 21% on the average (p less than 0.05). Reduction rates of
      rCMRGlu after HD-MTX therapy were correlated with both total doses of intrathecal
      MTX (r = 0.717, p less than 0.05) and total doses of systemic HD-MTX (r = 0.784,
      p less than 0.05). The reduction rate of CMRGlu of cerebral cortex, particularly
      frontal and occipital cortex, was greater than either that of basal ganglia or
      white matter. It is suggested that measurement of rCMRGlu after HD-MTX is useful
      for detecting accumulated neurotoxicity of MTX.

PMID- 2223187
TI  - [Vestibular function in severely retarded children in relation to their motor
      disabilities].
AB  - We examined vestibular functions of thirty-one severely retarded children with
      caloric test and rotation nystagmus test, in combination with auditory brainstem
      response (ABR) recordings and measurement of brainstem width on cranial CT scans.
      The laterality of vestibular response was over 20% in most of the bedridden cases
      and was under 20% who could move. Abnormal findings in ABR had no relationship
      with the degree of motor disabilities, but decreased width of brainstem on CT
      scan showed some relationship with the degree of motor disabilities. We conclude
      that vestibular function tests are useful to predict future motor development in
      severely retarded children.

PMID- 2223189
TI  - [Visual evoked potential abnormalities in a girl with brain stem encephalitis
      (Bickerstaff)].
AB  - A 16-month-old girl was admitted because of bilateral ophthalmoplegia, left
      blepharoptosis, and disturbance of consciousness. Her symptoms resolved
      spontaneously within a week after admission, but mild left abducens palsy
      remained. The cranial computed tomography showed a mild non-specific brain
      atrophy. The auditory brain stem response was normal. Visual evoked potentials
      (VEPs) to flash stimuli were repeated serially after the onset. No significative
      patterns of VEP were evoked during the acute stage. However, three months after
      the onset, an asymmetrical pattern, namely left-sided abnormalities (not
      identified P 100 wave, etc.), was observed. The asymmetrical pattern of VEP
      diminished six months after. And a bilaterally normal VEP pattern was found
      twelve months after.

PMID- 2223188
TI  - [A case of herpes simplex encephalitis with cerebral white matter lesion after
      acyclovir administration].
AB  - Herpes simplex virus (HSV) is regarded as an agent that selectively affects
      temporal and frontal lobes with necrosis and hemorrhage, and no case of herpes
      simplex encephalitis (HSE) with white matter lesion in a diffuse fashion has
      previously been reported. A 2-year-old boy developed high fever, right hemi
      convulsions and lethargy. Computed tomography (CT) showed wedge-shaped areas of
      high density in the left frontal region, whereas, cerebral angiography disclosed
      no vascular abnormality. T1-weighted magnetic resonance imaging (MRI)
      demonstrated cortical changes which were similar to those illustrated by CT.
      However, T2-weighted images depicted further spread high intensities of the
      lesion. The patient's symptoms spontaneously disappeared before an antiviral
      drug, acyclovir, was administered. After the significant increase of HSV antibody
      titers in serum and cerebro-spinal fluid (CSF) established a definite diagnosis,
      acyclovir was intravenously given at a daily dosage of 30 mg/kg for a period of 6
      days in order to prevent the recurrence of HSE. Two months later, T2-weighted MRI
      visualized a diffuse lesion of increased signal intensities involving the white
      matter of both hemispheres, while both CSF protein and myelin basic protein were
      significantly elevated. Despite of these changes of the white matter, our patient
      developed a few symptoms such as mild speech disturbance, slight weakness of the
      right upper limb and sialorrhea. Although the mechanism of these changes in the
      white matter remains obscure, it is postulated that a direct invasion of HSV to
      the white matter, an immunological disorder following HSV infection and a side
      effect of acyclovir could have triggered a reversible process of demyelination of
      the cerebral white matter.

PMID- 2223191
TI  - [A case of hemorrhagic shock and encephalopathy].

PMID- 2223190
TI  - [Chronological change of EEG findings in a case of pyridoxine dependency
      seizures].
AB  - A patient of pyridoxine dependent seizures was reported. He was born at 34 weeks'
      gestation and weighted 2,760 g. Apgar scores were 6 and 9 at 1 and 5 minutes,
      respectively. He showed the first seizure 2 hours after his birth. Phenobarbital,
      phenytoin, sodium valproate, diazepam and clonazepam were not effective.
      Pyridoxal phosphate (50 mg) was given intravenously, resulting in suppression of
      convulsions. However, muscle tonus was severely depressed. In EEG, a
      discontinuous pattern was found in quiet and indeterminate sleep on the 2nd day
      of life. At 5th week multifocal spikes were found, and the discontinuous pattern
      persisted. Ictal discharges at 13th week showed generalized, continuous,
      irregular and high voltage slow waves with multifocal spikes. At 27th week of
      life, high voltage slow waves disappeared and multifocal spike discharges
      decreased. At 2 years and 10 months of age, the patient was suffering from
      athetotic cerebral palsy and severe mental retardation. Pyridoxal phosphate at
      the doses of 35-40 mg/kg/day had been administered. Irritability sometimes
      occurred and additional 50 mg of pyridoxal phosphate controlled this irritability
      effectively.

PMID- 2223192
TI  - [A single case of autosomal recessive muscular dystrophy of childhood-
      histological and immunocytochemical studies on biopsied muscle].

PMID- 2223193
TI  - [Inequality of bioavailability in commercial tablets of valproic acid].

PMID- 2223194
TI  - Behavioural change and the stress-coping paradigm: some comments on modelling the
      European code on avoiding cancer.
AB  - The Europe Against Cancer Campaign's ten-point code is considered. The
      difficulties involved in conceptualizing an extremely diverse set of behaviours
      are highlighted. A framework for modelling the code, based upon the stress-coping
      paradigm, is presented.

PMID- 2223195
TI  - Leukaemia incidence, social class and estuaries: an ecological analysis.
AB  - Leukaemia incidence data for 1984-1986 for 22 counties of England and Wales have
      been collected by a specialist registry. The present study is an ecological
      analysis in which incidence in electoral wards has been tested for association
      with two predefined ward characteristics: socio-economic status and proximity to
      estuaries. Small but statistically significant associations have been observed
      with relative risks in the range 1.05-1.50. Adjustments have been made in the
      analysis for variation in the underlying regional incidence and also for
      statistical artefacts consequent upon the rarity of the condition. The results
      for socio-economic status confirm those of other recent studies, with increased
      incidence linked to higher status. The results for estuaries are new although
      derived from a prior hypothesis.

PMID- 2223196
TI  - A study of selected death certificates from three Dublin teaching hospitals.
AB  - One hundred death certificates were compared over two time periods with the
      corresponding autopsy reports on the cases to ascertain if the causes of death
      from the two sources were similar. There was poor concordance between the two and
      it seems likely that reasons for requesting an autopsy did not extend to using
      the information to complete the death certificates. There were 55 errors on 45
      certificates, and 19 certificates were so inaccurate as to warrant a change in
      the underlying cause of death. In only 10 cases was the certificate signed before
      the autopsy report was available; however, should clinicians have wished to add
      autopsy findings to the certificate later, there is no facility on the Irish
      death certificate to do so. A revision of the format of the certificate is
      recommended. An examination of death certificates from varied medical sources
      would be welcome to see if the serious errors identified in this study are more
      widespread.

PMID- 2223197
TI  - Measles/mumps/rubella vaccine (MMR): an audit of Leeds health professionals'
      knowledge of contraindications and intention to vaccinate assessed by postal
      questionnaire.
AB  - An audit of Leeds health professionals' knowledge of valid contraindications to
      measles/mumps/rubella (MMR) vaccine was undertaken by postal questionnaire, three
      months after its introduction. The health professional groups were health
      visitors, clinical medical officers, general practice trainers and general
      practice vocational trainees. The results indicate that some health professionals
      would give MMR vaccine to children when it was contraindicated (e.g. to a child
      receiving chemotherapy or radiotherapy). However, a much greater problem was the
      number of health professionals stating that they would not vaccinate children
      with MMR vaccine in clinical situations where there were no valid
      contraindications to its use. Some health professionals were also applying
      contraindications to the use of pertussis vaccine to the use of MMR vaccine. The
      information contained in the Joint Committee on Vaccination and Immunisation
      handbook Immunisation against infectious disease on contraindications to MMR
      vaccine use is also reviewed. It is important that false contraindications are
      not used by health professionals to wrongly deny children the protection provided
      by MMR vaccine.

PMID- 2223198
TI  - Possible factors affecting response to postal questionnaires: findings from a
      study of general practitioner services.
AB  - Poor response rates affect the validity of results from postal questionnaires.
      The effect of three controllable factors upon response rates was examined in a
      recent study of patients' experiences and views of general practitioner services.
      The factors studied were the institution from which questionnaires were
      dispatched, the length of the questionnaire and the inclusion of a potentially
      sensitive question about ethnic origin. Questionnaires sent out by local Family
      Practitioner Committees were more likely to be returned than those sent out by a
      London-based independent research unit, but there were no differences in the
      nature of replies obtained. Neither the length of the questionnaire nor the
      inclusion of the potentially sensitive question affected response rates. The
      results of the study indicate that Family Practitioner Committees wishing to
      carry out postal surveys of users of general practitioner services can obtain
      satisfactory response rates.

PMID- 2223199
TI  - Communicable disease report October to December 1989. From the PHLS Communicable
      Disease Surveillance Centre.

PMID- 2223200
TI  - Confidence limits for Nottingham Health Profile scores: some empirical results.

PMID- 2223201
TI  - A lesson from Europe?

PMID- 2223202
TI  - Blood cholesterol, social class and height.

PMID- 2223203
TI  - Meningitis Resource Pack (the Meningitis Trust 1989)

PMID- 2223204
TI  - Quality assurance of medical care.

PMID- 2223205
TI  - [The use of skeletal muscles for assisting the failing myocardium].

PMID- 2223206
TI  - [Surgical treatment of patients with tetralogy of Fallot in combination with a
      double aortic arch].
AB  - A late congenital anomaly--double arch of the aorta (DAA)--was combined with
      Fallot's tetrad (FT) in 4 patients whose ages ranged from 21 months to 11 years.
      The diagnosis of DAA and FT was established before the operation in 3 patients,
      in one patient DAA was discovered during the operation. In three children DAA was
      manifested clinically by dysphagia and stridor. A palliative operation (FT) was
      carried out through a left posterolateral approach along the third intercostal
      space. One-stage separation of the vascular ring by cutting the smaller left arch
      of the aorta at its junction with the descending aorta and formation of
      anastomosis between this arch and the left pulmonary artery by the end to side
      method were conducted. In deficient length of the cut arch of the aorta the left
      subclavian artery was divided; in equal diameter of both arches the lumen of the
      arch was reduced to 0.5 cm with stitches before formation of the anastomosis so
      as to prevent hyperfunction of the shunt. In the case in which DAA was not
      recognized before the operation, an attempt to dilate the hypoplastic segment of
      the left arch led to rupture of the thinned wall and the patient died from
      hemorrhage. The advantages of one- and two-stage radical correction of both
      developmental anomalies (DAA and FT) are still debatable.

PMID- 2223207
TI  - [The surgical treatment of an aortic aneurysm following a prior correction of its
      coarctation].
AB  - In a group of 381 patients who were operated on for coarctation of the aorta 34
      (8.9%) were found to have an aneurysm of the aorta in the zone of the correction
      in the late-term postoperative period. The frequency of aneurysm formation was
      greater in patients with flap plastics. Fifteen patients underwent a second
      operation for aneurysm of the aorta, 2 (13.3%) of them died. In the group of
      patients who were not operated on 6 (31.6%) died.

PMID- 2223208
TI  - [The topographic-anatomical rationale for using the right gastro-epiploic artery
      for direct revascularization of the myocardium].
AB  - The topographic anatomy of the right gastroepiploic artery was studied on
      anatomical material and a model of an operation was elaborated for direct
      revascularization of the myocardium with the use of the right gastroepiploic
      artery as a pedicled shunt. The study showed that the anatomical characteristics
      of the artery (length, diameter) allow it to be used as an autoarterial shunt to
      the coronary arteries. The authors discuss two methods for installing the
      vascular graft by means of which shunting of the coronary arteries of both the
      anterior and the posterior myocardial wall can be accomplished with a graft of
      the right gastroepiploic artery.

PMID- 2223209
TI  - [Experience in hemoconcentration by ultrafiltration in operations using
      artificial circulation at the All-Union Scientific Center of Surgery of the USSR
      Academy of Medical Sciences].
AB  - The article deals with the results of using ultrafiltration hemoconcentration in
      649 operations conducted on the open heart with extracorporeal circulation at the
      All-Union Scientific Center of Surgery, USSR AMS during 1983-1989. The method
      allows control of hemodilution and colloid-osmotic pressure of plasma during the
      indicated interventions, lessens the loss of blood, and reduces the expenditure
      of donor blood.

PMID- 2223210
TI  - [Methods of solving the problem of the surgical treatment of post
      thrombophlebitic disease of the lower extremities].

PMID- 2223211
TI  - [Tactics and indications in the surgical treatment of patients with combined
      extra- and intracranial lesions of the carotid arteries].
AB  - The article deals with the results of surgical treatment of 159 patients with
      concomitant extra-intracranial and bilateral lesions of the carotid arteries; 163
      operations were conducted for the formation of an extra-intracranial
      microanastomosis (EICMA) among which 75 operations comprised reconstruction of
      extracranial segments with creation of EICMA. In 66 cases EICMA was performed in
      contralateral stenosis of the internal carotid artery (in 22 with subsequent
      carotid endarterectomy), in 14 cases as the first stage before reconstruction of
      the iliofemoral segment, and in 8 cases in occlusion of the middle cerebral
      artery or in tortuous carotid arteries. Complex examination was conducted,
      including ultrasonic dopplerography, transcranial dopplerography, study of
      cerebral blood flow according to Xe-133 clearance, and angiography. The late-term
      results of surgery were studied in follow-up periods of 6 months to 5 years. It
      was found that to appraise the indications for surgical treatment it is necessary
      to take into account the data obtained in studying the regional cerebral blood
      flow. Surgical treatment is indicated in occlusion of the internal carotid artery
      (with preliminary reconstruction of extracranial segments when they are involved)
      in patients with unstable type of cerebral hemodynamics, which is most
      characteristic in patients with transitory ischemic episodes, dyscirculatory
      encephalopathy, small apoplexy and predominantly with mild sequelae of ischemic
      apoplexy.

PMID- 2223212
TI  - [Disorders in the sequence of regional metastasis and long-term results of the
      surgical treatment of complicated lung cancer].
AB  - To ascertain the frequency of disturbance of the stage character of regional
      metastasis in lung carcinoma complicated by disintegration or obstructive
      pneumonitis, and its influence on certain results of surgical treatment, the
      authors analysed the data on 175 patients who underwent lung resection. The stage
      character of regional lymphogenous metastasis was found to be disturbed in 61
      (34.8%) patients, in 52 (85.2%) of them the main disease was complicated by
      obstructive pneumonitis. Five-year survival in the group of patients without
      disturbance of the stage character of metastasis was 28 +/- 4.8%, which was
      significantly greater than that in the group of patients with a disturbed stage
      character (15.5 +/- 5.2%).

PMID- 2223213
TI  - [Lung cancer in women in Moscow (epidemiology, etiology and surgical treatment)].
AB  - In the studied period (1973-1987) the lung carcinoma morbidity rate among females
      of Moscow, in general intensive indices (per 100,000 females), showed a tendency
      to reduce (18.4 in 1973 and 15.1 in 1987). A reverse tendency is mostly
      encountered in other countries. More than half of patients with lung carcinoma
      were over 70 years of age. The ratio of males with lung carcinoma to that of
      females grew from 3.0:1.0 in 1973-1977 to 3.6:1.0 in 1983-1987. In the period
      from 1979 to 1988, 380 females suffering from carcinoma of the lung were
      hospitalized to the thoracic department of the clinic. Operations were performed
      on 215 of them, 174 of the operations were radical. The ratio of operated on
      males to females was 7.4:1.0. The frequency of central carcinoma among females
      was 28.8%, which was half that among males (56%). The number of operations
      according to volume was as follows: pulmonectomy 37, lob- and bilobectomy 119,
      wedge resection 18. More than half of the female patients had the glandular form
      of lung carcinoma and its incidence was 3-5 times that among males who were
      operated on (10-15%). According to the authors, the principal etiological factors
      are smoking, a history of another malignant tumor, and the exogenous effect of
      the consequences of urbanization.

PMID- 2223214
TI  - [The role of developmental disorders of the respiratory, digestive and vascular
      systems in pathology of the lungs in children].
AB  - The results of diagnosis and treatment of bronchopulmonary pathology in 680
      children were analysed. It was found that besides developmental anomalies of the
      lungs and trachea, those of the esophagus, mediastinal organs, diaphragm, and the
      aorta and its vessels play an important role in the pathogenesis of pulmonary
      diseases in infants and young children. Traditional and special methods of
      examination must be used in the diagnosis of these developmental anomalies.
      Timely correction of the developmental anomalies makes it possible to arrest the
      bronchopulmonary complications which are associated with them.

PMID- 2223215
TI  - [The importance of the compensatory powers of the lungs in determining the
      indications for surgical treatment of hypoplasia of the lungs].
AB  - The author studied the compensatory possibilities of pulmonary respiration, gas
      exchange and hemodynamics of pulmonary circulation to determine the indications
      for operative treatment of simple hypoplasia of the lungs. The work is based on
      the results of examination of 58 patients. Forty-five patients underwent an
      operation. It was established that simple hypoplasia of the lungs is
      characterized by mild ventilation disorders and deep disorders of gas exchange
      leading to manifest and latent hypoxia in 94.6% of cases. Deficiently developed
      pulmonary-arterial channel, the presence of morphological foundations of
      pathological blood shunting (up to 24-32% of minute pulmonary circulation volume)
      were the causes of disturbed hemodynamics of pulmonary circulation and the
      development of pulmonary hypertension in 30.6% of cases. The indications and
      contraindications for surgical correction of simple hypoplasia of the lungs are
      discussed on the basis of study of the functional condition of ventilation, gas
      exchange, and hemodynamics of pulmonary circulation.

PMID- 2223216
TI  - [Therapeutic endoscopy in hemorrhages from varicose veins of the esophagus in
      patients with portal hypertension].
AB  - The article discusses 6-year experience in the treatment and prevention of
      esophageal hemorrhage by endoscopic sclerotherapy using 96% and 70% ethanol as
      the sclerosant. There were 99 patients under observation whose ages ranged from
      27 to 70 years, 74 were admitted to the clinic with profuse hemorrhage.
      Sclerotherapy arrested the bleeding in 65 (90%) patients. Seven patients died
      from persisting bleeding, 5 from increasing hepatic insufficiency, and one
      patient from perforation of the esophagus and purulent mediastinitis. After
      discharge from the clinic 54 patients were kept under observation for periods of
      6 to 20 months; 16 episodes of bleeding occurred in 13 of them. Repeated
      sclerotherapy proved effective in 10 patients, 3 patients died from continuing
      bleeding and hepatic insufficiency.

PMID- 2223217
TI  - [A case of successful conservative treatment of acute purulent mediastinitis
      following heart surgery in conditions of artificial circulation].

PMID- 2223218
TI  - [Angina pectoris developing 9 years after a heart wound not accompanied by
      injuries of the coronary arteries].

PMID- 2223219
TI  - [The use of the deep femoral artery for restoring the blood circulation in the
      leg in the case of a gunshot wound].

PMID- 2223220
TI  - [Bullous disease complicated by bilateral spontaneous pneumothorax in pregnancy].

PMID- 2223221
TI  - [A neurofibroma of the esophagus].

PMID- 2223222
TI  - [A congenital esophagotracheal fistula in an adult].

PMID- 2223223
TI  - [Repeat surgery occasioned by the incompetence of the primary tissue in
      biological prostheses].
AB  - The authors analyse the causes of repeated operations on 42 among a group of 157
      patients with implanted biological cardiac valve prostheses and a postoperative
      follow-up period of 3.5 to 13 years. The main cause of dysfunction of biological
      prostheses is calcification which develops mostly in xenopericardial valves
      irrespective of their localization. Detachment of the cusps from the frame and
      their destruction is characteristic of allogeneic prostheses and those formed
      from the dura mater. Dysfunction of bioprostheses in the tricuspid position
      develops much later.

PMID- 2223224
TI  - [Cardiomyoplasty].
AB  - The article analyses the current state of the problem of cardiomyoplasty as a new
      method for the treatment of patients with myocardial cardiac insufficiency. The
      authors show the experimental and clinical material on the possibility and
      efficacy of using skeletal muscles for improving myocardial contractility and
      raising the cardiac index. Experience gained in our country (6 operations) in
      cardiomyoplasty in patients with severe form of ischemic heart disease is
      discussed. The authors used an original Soviet produced cardiosynchronized
      electroneurostimulator "Stiminak" for stimulation of the muscles. Analysis of
      personal experimental material allows new ways for the development of the problem
      to be planned.

PMID- 2223225
TI  - [The use of skeletal muscles for assisting the failing heart].

PMID- 2223226
TI  - [Diagnosis and surgical treatment of traumatic damage to the sinus of Valsalva
      following penetrating wounds of the heart].
AB  - The authors had three patients with traumatic damage of the sinus of Valsalva,
      caused by penetrating injury of the thorax inflicted with a knife. The patients
      were brought to the clinic in a grave condition with decompensation of systemic
      and pulmonary circulation. The anomaly called for emergency surgical correction
      under conditions of extracorporeal circulation. The diagnosis was based on the
      complaints, medical history, clinical picture, the results of functional methods
      of examination including echocardiography and catheterization with
      angiocardiography. The operations consisted in total correction of the heart
      anomaly. The immediate and late-term results were good.

PMID- 2223227
TI  - [A new method of surgical treatment of vasculogenic impotence].
AB  - The authors describe a method of surgical management of vasculogenic impotence
      consisting in the formation of an anastomosis of an autovenous shunt with the
      dorsal artery of the penis. To prevent revascularization of the cavernous bodies
      of the penis with the restoration of erection, the dorsal artery of the penis is
      divided transversely at the root of the penis, the distal end of the autovenous
      shunt is given the shape of a trapezium with the upper side sutured, after which
      the autovenous shunt is anastomosed end to end with both the distal and proximal
      segments of the dorsal artery of the penis at the lateral sides of the trapezium
      where the angles were not sutured. The method allows incompetence and thrombosis
      of the vascular anastomosis to be prevented, raises the efficacy of
      revascularization of the cavernous bodies of the penis by creating favourable
      hemodynamic conditions through separation of the blood flow into the distal and
      proximal segments of the dorsal artery of the penis, which provides retrograde
      supply of blood into the deep artery of the penis sufficient for adequate
      revascularization of the cavernous bodies.

PMID- 2223228
TI  - [Criteria for the selection of patients with a single heart ventricle for
      anatomical correction].
AB  - The work deals with study of the functional condition of the myocardium in 34
      patients with a solitary ventricle of the heart (SVH). The regional function of
      the myocardium was disturbed in all patients; the degree of the disturbance was
      determined by the anatomical variant of the SVH and was characterized by
      different distribution of the hypofunctioning segments in the ventricular
      myocardium. In view of that, to solve the problem of the possibility of
      accomplishing anatomical correction, the regional function in the zones of the
      future (after septation) ventricles must be evaluated. Radical correction may be
      performed with the least degree of risk in patients in whom the ejection fraction
      in each of the new ventricles will be greater than or equal to 55%. In the group
      of 17 patients only 5 conformed to this criterion.

PMID- 2223229
TI  - [Surgical aid in chest traumas].
AB  - The article analyses the results of surgical treatment of 360 patients with
      traumatic damages of the thoracic organs in the Crimean Region from 1981 to 1989.
      The results proved to be best in patients who underwent operation in the Crimean
      Regional Pulmono-Surgical Center (RPSC). The clinical outcome was positive in
      89.8% of patients. The results of treatment were somewhat poorer in patients who
      were operated on by thoracic surgeons at surgical departments and then
      transferred to the PRSC. No complications occurred in the postoperative period in
      79.9% of cases. The results were poorest in patients who were operated on by
      general surgeons and transferred subsequently to the RPSC. Postoperative
      complications developed in 38.6% of cases. All complications in patients who
      underwent operation at general surgical departments were characteristically
      connected with inadequate evacuation of the exudate and air and inadequate
      cleansing of the bronchial tree. In view of this, organization of emergency aid
      in regional thoracic departments is the optimal variant. General surgical
      departments must be equipped with the appropriate apparatus.

PMID- 2223230
TI  - [Surgical tactics in bilateral resections of the lungs].
AB  - The article generalizes experience in 118 bilateral resections of the lungs
      carried out within 4 years at the Chelyabinsk Regional Antituberculosis Hospital,
      among which 63% (74) were one-stage bilateral operations. A clinical effect was
      produced in 97.5% of patients. Postoperative mortality was 1.7%. The authors
      prefer one-stage bilateral resections and resort to stage-by-stage operations
      only in cases with severe concomitant diseases, marked respiratory insufficiency,
      in a large volume of the resection, particularly if it is combined with
      thoracoplasty. A transsternal approach in one-stage bilateral resections is
      indicated when the upper parts of the lung must be resected in a large volume, in
      cases in which difficulties in exposure of the lungs are not expected; one-stage
      opening of both pleural sacs is recommended in this case for adequate inspection
      of the lungs before their resection.

PMID- 2223231
TI  - [Experimental evaluation of different methods of intraoperative aerostasis in
      surgery of the lungs].
AB  - The work deals with the results of comparative evaluation of different variants
      of intraoperative aerostasis by means of glue and bioplastic materials in
      experiments on 75 animals. The authors give in detail a clinicomorphological
      characteristics of each method for rendering the lung wound airtight. It is
      concluded from the obtained data that aerostasis by means of fibrin glue and
      collagenous film is highly effective.

PMID- 2223232
TI  - [Injury to the posterior wall of the left ventricle during mitral valve
      prosthesis].

PMID- 2223233
TI  - [Surgical correction of preductal aortic coarctation in combination with
      hypoplasia of the aortic arch and patent ductus arteriosus].

PMID- 2223234
TI  - [Prostaglandins as a means of emergency aid in critical stenosis of the pulmonary
      artery].

PMID- 2223236
TI  - [A hemangioma of the hourglass type].

PMID- 2223235
TI  - [Staged surgical treatment of incompetence of the stump of the main bronchus and
      a bronchial fistula following pulmonectomy on account of lung cancer].

PMID- 2223237
TI  - Cytotoxic activity against HIV-infected monocytes by recombinant interleukin 2
      activated natural killer cells.
AB  - Natural killer (NK) cells have long been known to aid in the control of viral
      infections by killing virus-infected cells, including those infected with human
      immunodeficiency virus (HIV). Among the possible NK-susceptible target cells in
      an infected individual, the monocyte/macrophages are of special significance
      since they may serve as both a reservoir of HIV and aid in dissemination of the
      virus throughout the body. A new technique for the enrichment and cultivation of
      large numbers of recombinant interleukin 2 (rIL-2)-stimulated NK cells has been
      developed which provides cells with high cytotoxic activity. These IL-2-activated
      NK cells, adherent lymphokine-activated killer cells (A-LAK), can kill monocytes
      infected with HIV for 24 h to 7 days, with optimal target sensitivity between 3
      and 7 days. Recognition and killing of the infected monocytes did not appear to
      be restricted by the major histocompatibility complex (MHC) antigens and could be
      cold-target inhibited by tumor cell lines. A-LAK cells may be useful in newer
      therapeutic approaches to treatment of HIV infection.

PMID- 2223238
TI  - Macrophage tropism of HIV-1.
AB  - Both in vivo and in vitro studies clearly demonstrate that cells of the
      mononuclear phagocyte lineage are major hosts for human immunodeficiency virus
      type 1 (HIV-1) replication. Presumably these cells play a key role in the
      pathogenesis of acquired immunodeficiency syndrome (AIDS). To further delineate
      the interactions between HIV-1 and host cells, the susceptibility and
      permissivity of normal human peripheral blood-derived monocyte/macrophages (M/M)
      and T lymphocytes, and neoplastic monocytoid and lymphoid cell lines to various
      HIV-1 isolates was assessed. The results suggest: (1) "fresh" isolates recovered
      from patients and propagated only in normal host cells exhibit a dual tropism for
      both M/M and T cells, regardless of their tissue of origin or the cell type from
      which they were isolated; (2) the repeated passage of an HIV-1 isolate through
      normal M/M does not generally result in the loss of the ability to infect normal
      T cells nor vice versa; (3) the majority of fresh HIV-1 isolates do not infect
      neoplastic cells of either origin, and those that do show no preference for
      monocytoid or lymphoid targets, regardless of their cell origin.

PMID- 2223239
TI  - Extrachromosomal HIV-1 DNA in persistently infected U937 cells.
AB  - Persistent human immunodeficiency virus type 1 (HIV-1) infection of U937
      monocytic cells resulted in the accumulation of novel forms of extrachromosomal
      viral DNA. These DNA species are larger than the genome size of HIV-1 and persist
      indefinitely. The extrachromosomal viral DNA species (E-DNA) were shown to be
      structurally stable by subcloning of infected cell lines and restriction fragment
      analysis. Similar E-DNA structures were observed in independent infections.
      Persistently infected monocytic cells had low levels of viral antigens,
      reflecting the low levels of viral RNA that were detected. These results support
      a role for E-DNA in persistent HIV-1 infection of monocytic cells.

PMID- 2223240
TI  - Effects of GLQ223 on HIV replication in human monocyte/macrophages chronically
      infected in vitro with HIV.
AB  - GLQ223 is a formulated version of tricosanthin, a single-chain ribosome
      inactivating protein that was shown in earlier studies to inhibit human
      immunodeficiency virus (HIV) replication in T-lymphoblastoid cells and to
      decrease HIV p24 levels in HIV-infected monocyte-derived macrophages as measured
      by flow cytometry. The current studies were performed to test the selectivity of
      the observed inhibitory effects on HIV replication in chronically infected
      macrophages infected in vitro. Peripheral blood-derived monocyte/macrophages were
      infected in vitro and cultivated in suspension for at least two weeks prior to
      GLQ223 treatment. Anti-HIV effects were quantitated by measurement of cytoplasmic
      HIV p24, by both enzyme-linked immunosorbent assay (ELISA) and flow cytometry and
      HIV RNA levels were measured by slot blot analysis. Incorporation of [3H]leucine
      into trichloroacetic acid- (TCA) precipitable protein was also evaluated as an
      index of nonspecific inhibitory effects mediated by the compound in infected and
      uninfected cultures. Five days after a single 3-h treatment with GLQ223 there was
      a concentration-dependent decrease in all measurable HIV parameters within
      infected cultures. The anti-HIV effects persisted at least 28 days without
      evidence for increasing HIV expression. GLQ223 treatment of parallel uninfected
      macrophage cultures showed no significant inhibition of tritiated leucine uptake.
      These experiments demonstrate that a single pulsed exposure with GLQ223 of
      macrophages infected with HIV in vitro caused a sustained, concentration
      dependent decrease in both HIV p24 antigen levels as well as HIV RNA without
      causing measurable toxicity in uninfected cultures.

PMID- 2223241
TI  - Ability of anti-HIV agents to inhibit HIV replication in monocyte/macrophages or
      U937 monocytoid cells under conditions of enhancement by GM-CSF or anti-HIV
      antibody.
AB  - Monocyte/macrophages (M/M) are an important target cell for human
      immunodeficiency virus (HIV) infection in the body. The study of HIV infection in
      these cells, however, is rather complicated because they represent a variable
      population, and because HIV entry and replication in M/M may be markedly
      influenced by a number of factors. These must be considered in therapeutic
      approaches to HIV infection. In the present set of experiments, we studied the
      interaction between certain agents which increase the infection of
      monocyte/macrophages (M/M) by HIV and two groups of anti-HIV agents:
      dideoxynucleosides and specific inhibitors of gp120-CD4 binding. We found that
      the cytokine granulocyte-macrophage colony-stimulating factor (GM-CSF), which
      markedly enhances HIV replication in M/M, does not affect the activity of
      recombinant soluble CD4 (sCD4) or OKT4A, two agents which block gp120-CD4
      binding. However, it had varying effects on different dideoxynucleosides: GM-CSF
      increased the net anti-HIV activity of 3'-azido2',3'-dideoxythymidine (AZT),
      while at the same time it reduced the activity of 2',3'-dideoxycytidine (ddC) and
      2',3'-dideoxyinosine (ddI). These effects probably represent an interplay between
      varying effects of GM-CSF on drug entry and phosphorylation. In additional
      experiments, we showed that very low concentrations of anti-HIV antibodies could
      enhance HIV infection of the U937 monocytoid cell line. Interestingly, while this
      effect has been hypothesized to occur through a CD4-independent mechanism, we
      found that the anti-HIV activities of both sCD4 and OKT4A were unchanged under
      conditions of enhancement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223242
TI  - Role of the monocyte-macrophage in influenza virus infection of lymphocytes:
      implications for HIV infection.
AB  - Knowledge of the pathogenesis of viruses which are less virulent than human
      immunodeficiency virus (HIV) may provide valuable insights into the pathogenesis
      of HIV infection. Influenza virus, an enveloped RNA virus, infects monocyte
      macrophages, although the infection is brief and abortive. Isolated purified
      lymphocytes are completely resistant to infection. In contrast, mixtures of
      lymphocytes and macrophages can synthesize all virus proteins. Infection requires
      physical association of monocyte-macrophages and lymphocytes in "clusters." These
      studies with influenza virus suggest that the pathogenesis of virus infections in
      mixed cell cultures may be very different from that observed in purified cell
      populations, and they suggest that similar studies should be performed with HIV.

PMID- 2223243
TI  - Macrophages as susceptible targets for HIV infection, persistent viral reservoirs
      in tissue, and key immunoregulatory cells that control levels of virus
      replication and extent of disease.
AB  - Although macrophages are major targets for human immunodeficiency virus (HIV)
      infection in vivo, study of HIV-macrophage interactions in vitro was hindered
      because many laboratory strains of HIV would not replicate in macrophages, and
      because survival of macrophages in culture was poor. Addition of purified
      macrophage colony-stimulating factor (M-CSF) to cultured macrophages markedly
      improves their survival, but does not induce proliferation. HIV isolates that
      replicate in macrophages will also replicate in lymphocytes; however, isolates
      adapted to lymphoid cells (such as HIV-HTLVIIIB) will not replicate in
      macrophages. The envelope gene appears to be a major determinant of the cell
      tropism of viral isolates. T-cell grown virus stocks synthesize abundant gp120,
      while virus grown in macrophages contains relatively much less gp120. Electron
      microscopy of virions from macrophages shows them to be depleted of gp120 surface
      "spikes." Recombination studies show that the portion of the genome coding for
      the envelope glycoprotein appears to determine cell tropism. Lastly, rsCD4
      neutralized macrophage-tropic isolates less efficiently than T-cell tropic
      isolates. HIV replication in macrophages is partially under the control of
      cellular factors, although these have been less well characterized than they have
      in lymphocytes.

PMID- 2223244
TI  - The effect of interleukin 4 (BSF-1) on infection of peripheral blood monocyte
      derived macrophages with HIV-1.
AB  - The effects of various cytokines were examined in an in vitro model of human
      immunodeficiency virus type 1 (HIV-1) infection of human peripheral blood
      monocyte-derived macrophages (MDM). Monocytes were obtained from blood of normal
      donors by Ficoll/hypaque gradient centrifugation and adherence. These cells were
      allowed to mature in the presence of varying concentrations of cytokines. After
      five days in culture, cells were harvested, counted, and inoculated with S5G7, an
      HTLV-IIIB subclone. The cells were replated in the presence of the same
      concentrations of cytokines. Culture supernatants were sampled over 28 days for
      p24 antigen (Ag) as measured by Ag capture assay. In repeat experiments, the
      following observations were made: 1. MDM from some donors could be infected only
      in the presence of tumor necrosis factor-alpha (TNF-alpha),
      granulocyte/macrophage colony-stimulating factor (GM-CSF) or interleukin 4 (IL
      4); 2. The effect of GM-CSF was variable; TNF alpha also enhanced HIV replication
      above controls; 3. IL-4 was the most potent enhancer of HIV-1 replication in MDM
      of the cytokines tested, inducing p24 Ag levels 75-230 times those seen in
      control cultures run simultaneously. This effect was dose dependent. Ag
      production was not observed until Day 14 postinfection in most experiments.
      Multinucleated giant cell formation was observed only in the presence of IL-4.

PMID- 2223245
TI  - Antibody-enhanced infection of monocytes as the pathogenetic mechanism for severe
      dengue illness.
AB  - Antibody-dependent enhancement of certain virus infections can occur in cells
      expressing Fc receptors. This mechanism plays an important pathogenetic role in
      the development of complications associated with dengue virus infection,
      including dengue hemorrhagic infection and dengue shock syndrome. The virulence
      of the virus, characterized by the ability to infect Fc receptor-bearing
      monocytes also influences the development of these severe illnesses.

PMID- 2223247
TI  - [Incidence of epidermoid cancer of the esophagus in Asturias (1975-85)].
AB  - We present the incidence the esophageal squamous cell carcinoma in Asturias,
      based on the review of the clinical histories of eleven years (1975-85). Of 356
      total cases, 92.4% were male patients and the remaining 7.6% females; the
      relation M:F was 12.2:1. Mean age at the time of diagnosis was 59.4 +/- 9.6 for
      males and 70 +/- for females. Total annual incidence was 2.8 +/- 0.8 cases/10(5)
      + population/year. Maximal annual incidence was registered in 1981: 1.1
      cases/10(5) population/year. Asturias has eight health districts; those with
      highest incidence were mining areas: Mieres, Cangas de Narcea and Riano. Compared
      to that of some developing countries, the incidence of esophageal cancer in
      Asturias is low, similar to that in European countries (except France) and white
      population of the USA; there is an aggregation of cases in males living in mining
      areas.

PMID- 2223248
TI  - [Smoking and serum gastrin and pepsinogen I levels in patients with duodenal
      ulcers].
AB  - At present the mechanisms by which the use of tobacco produces a damaging effect
      on duodenal ulcerous disease are not clearly understood. This paper reports the
      results of a study of basal and postprandial gastrin and pepsinogen I (PG I)
      levels of 74 duodenal ulcer (DU) patients and 18 controls in relation to their
      smoking habits. There was no difference between the UD group and the control
      group as far as basal gastrin levels were concerned, but there was in the PG I
      levels (107 +/- 54 ng/ml in UD vs. 69 +/- 30 ng/ml in control) (p less than
      0.05). The postprandial gastrin and PG I responses in 34 UD subjects only
      differed in relation to smoker/non-smoker status; there was no correlation with
      age less than greater than 35, positive family history or duration of illness.
      Patients who had had UD less than 10 years showed higher postprandial PG I
      levels; however, this group included the 83.3% smokers with UD. It was concluded
      that chronic smoking is clearly related to the existence of hyperpepsinogenemia
      I, and probably also to postprandial hypergastrinemia in UD sufferers.

PMID- 2223249
TI  - [Surgical treatment of gastric cancer. Evaluation of results in 313 consecutive
      cases].
AB  - The results of 313 gastric adenocarcinomas, treated by the same surgical team
      during 10 years have been evaluated retrospectively. The pathological
      characteristics, operability (88.8%) and resectability (69.8%) rates, surgical
      technique and morbility and mortality rates are analyzed. The causes of late
      mortality, total five-year survival, depending on the stage of the tumors, and
      survival in relation to treatment are reported.

PMID- 2223246
TI  - FcR-mediated enhancement of HIV-1 infection by antibody.
AB  - Although CD4 is a major receptor for human immunodeficiency virus (HIV) infection
      of cells, studied by ourselves and others clearly show that the Fc receptor (FcR)
      also plays a role in infection, perhaps in conjunction with other surface
      receptors. IgG antibodies to HIV-1 will enhance infectivity in cells (such as
      monocyte-macrophages) that have surface Fc receptors; F(ab')2 fragments of
      antibodies did not enhance, and blocking of FcR inhibited enhancement. The high
      affinity FcR for IgG (Fc gamma RI) appeared to be functional. Sera from HIV-1
      infected patients had neutralizing activity at high concentrations, but enhanced
      infection at low concentrations (i.e., high dilutions). Our studies show that the
      CD4 receptor is required for antibody-mediated enhancement of infection, as
      enhancement can be blocked by recombinant soluble CD4 and by Leu3 antibody.
      Although enhancement can be demonstrated in vitro, the in vivo importance of
      enhancing antibodies remains to be defined in HIV-1 infection.

PMID- 2223250
TI  - [Percutaneous cholecystostomy guided by ultrasonography. A preliminary
      experience].
AB  - Surgical cholecystostomy is a palliative treatment for cholecystitis and distal
      biliary obstructions when the general condition of the patient does not allow
      complex techniques. Percutaneous cholecystostomy (PC) guided by ultrasonography
      is an alternative to that procedure as well as a method of direct access to the
      biliary tract for diagnostic examinations (bacteriologic study of bile and
      percutaneous cholangiography). During one year, 9 female patients, mean age 74
      (49 to 90) underwent this approach; 5 patients had cholecystitis, 2 were
      suspicious of biliary sepsis and 2 had angiocholitis. Because of poor general
      condition, no other approach was possible in any of the cases. There were no
      relevant complications. All 5 cases of cholecystitis improved after the procedure
      although 3 patients died within 30 days of causes unrelated to PC. In two cases
      biliary sepsis was ruled, and the probe was withdrawn, without complications. The
      two patients with angiocholitis improved significantly; in both cases it was
      shown that the cause was cholelithiasis: later on, they were treated by different
      methods (endoscopic sphincterotomy in one case and surgery in the third case).
      These preliminary results suggest that PC guided by echography should be included
      as a routine therapeutic and diagnostic method in the management of digestive
      diseases.

PMID- 2223251
TI  - [Absence of effect of atropine on exocrine pancreatic secretion stimulated by
      cerulein].
AB  - The effect of atropine, 0.9, 1.8, 7 and 29 nmol/kg-1/h-1, on pancreatic exocrine
      secretion has been measured in seven dogs with gastric and pancreatic fistula in
      response to IV administration of increasing doses of cerulein (3.7 to 118 pmol/kg
      1/h-1). Secretin was perfused continuously, at a rate of 20.5 pmol/kg-1/h-1,
      starting one hour before perfusion of cerulein. The administration of atropine, 7
      and 29 nmol/kg-1/h-1, significantly (p less than 0.05) decreased the protein
      response to secretin. Only the injection of 29 nmol/kg-1/h-1 of atropine produced
      a significant decrease in the secretion of bicarbonate in response to secretin.
      The administration of 3.7 pmol./kg-1/h-1 and larger doses of cerulein
      significantly increased the secretion of bicarbonate and protein, compared to the
      levels obtained with the administration of secretin alone. None of the atropine
      doses showed a significant effect on the pancreatic response to the
      administration of cerulein. Only the highest dose of atropine, 29 nmol/kg-1/h-1,
      modified cardiac rate. These findings are consistent with the hypothesis that
      cholinergic innervation does not modify the effect of cerulein, a CCK analogue,
      on the pancreatic secretion of protein and bicarbonate in the dog.

PMID- 2223252
TI  - [A model of experimental acute pancreatitis in the conscious rat].
AB  - We describe an experimental model of acute pancreatitis in conscious rats, based
      on biliary reflux; sodium deoxycholate was injected while maintaining the common
      duct (biliary and pancreatic) temporally occluded. A progressive increase of
      serum amylase, cardiac rate and hematocrit value, as well as a decrease of plasma
      proteins are characteristic of this experimental model. Blood pressure was
      maintained until shortly before death, which occurred after 85 minutes. This is a
      simple model, reliable and reproducible, which requires minimal surgical
      manipulation.

PMID- 2223253
TI  - [Morgagni's hernia. A case report].
AB  - A case of Morgagni's hiatal hernia is presented. Because of clinical symptoms
      (dizziness and chest pain) the patient was referred to the Cardiology Department
      and the diagnosis was a casual finding. The hernia sac contained transverse
      colon, great omentum and round ligament. We comment on the mechanism, etiologic
      factors, diagnosis, and surgical treatment. The present case was treated by an
      abdominal approach.

PMID- 2223254
TI  - [Intra-arterial infusion with urokinase for embolism of the superior mesenteric
      artery].
AB  - We report the case of a 65 year old male patient in whom an early diagnosis of
      embolism of the superior mesenteric artery was made and successfully treated by
      an intraarterial infusion of urokinase.

PMID- 2223256
TI  - [Hemangiopericytoma of the rectal mesentery].
AB  - The authors present a case of hemangiopericytoma of the rectal mesentery, this is
      an uncommon type of vascular tumor, exceptional in this localization. We analyze
      the difficulty of a preoperative diagnosis, the lack of specificity of the
      clinical signs and the importance of the radical resection linked to the
      biological aggressiveness and the frequency of local recurrences and distant
      metastases.

PMID- 2223255
TI  - [Torsion of an ectopic spleen as a cause of acute abdomen].
AB  - A case of torsion of an ectopic spleen is presented. Diagnosis was obtained by
      echography, CAT and arteriography. We review the cases reported in literature and
      discuss the diagnostic and therapeutic problems raised by this rare condition as
      the cause of acute abdomen as well as for the differential diagnosis of abdominal
      masses.

PMID- 2223257
TI  - [Peroxisomes and neurological disorders].

PMID- 2223258
TI  - [Neurophysiological study on hemifacial spasm--the abnormality and origin of the
      electromyographic response to stimulation of the facial nerve].
AB  - Electromyographic responses (MD-OC) of the orbicularis oculi muscle to
      stimulation of ipsilateral marginal mandibular branch of the facial nerve were
      recorded in 20 patients with hemifacial spasm, pre-, post-operatively and during
      operations to relieve it by microvascular decompression, and the abnormal
      features and origin of the MD-OC were investigated. On the affected side, the MD
      OC were recorded in pre- and during operative state, and disappeared with
      disappearance of hemifacial spasm after microvascular decompression, while no
      response was recorded in pre-, during and post-operative state on the healthy
      side. In 17 patients, the MD-OC was recorded continuously during operation. In
      all cases except for one case in whom the MD-OC was recorded even the end of
      operation, the MD-OC disappeared on several stage of procedure from dural opening
      through vascular mobilization. The compound nerve action potential (MD-VII) to
      stimulation of the marginal mandibular branch was recorded from the facial nerve
      near its root entry zone after exposure of the intracranial portion. There were
      two patterns in the records, i.e., one group consisting of early component and
      the other consisting of early and late component. The MD-VII was only consisted
      of the early component in 12 cases in whom the MD-OC have already disappeared,
      and was consisted of the early and late component in 5 cases in whom the MD-OC
      still recorded. And in 2 cases of the later, the late component disappeared
      simultaneously with disappearance of the MD-OC during vascular
      mobilization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223259
TI  - [Resemblance of magnesium and zinc distribution in soft tissues and bone of rats
      fed unbalanced mineral diets in situ].
AB  - Although the role of zinc (Zn) and magnesium (Mg) in situ may be of a critical
      importance in replication, transcription and repair of DNA, to our knowledge, the
      relationship between Mg and Zn has been described. This study, therefore, was
      designed experimentally to investigate the relationship between Mg and Zn in soft
      tissues and bone of rats after fortification of unbalanced mineral diets, and
      minerals and metals in soft tissues and bone were determined by inductively
      coupled plasma emission spectrometry. In the groups fed low calcium (Ca) diet,
      low Ca-Mg diet and low Ca-Mg plus high Al diet, serum Mg level was lower in the
      group fed low Ca-Mg diet and low Ca-Mg plus high Al diet than those in the groups
      fed standard diet and low Ca diet. However, there was no significant difference
      in Mg content of CNS tissues in rats fed unbalanced and standard diets except for
      that in the spinal cord of rats fed low Ca-Mg plus high Al diet. Whereas, Zn
      content of CNS showed lower values in the unbalanced mineral diet groups,
      especially in all CNS regions of the low Ca-Mg plus high Al diet group, than
      those in the standard and the low Ca diet group. And Zn contents in heart, kidney
      and abdominal aorta of rats fed low Ca-Mg diet and low Ca-Mg plus high Al diet
      were more decreased than those of the standard and the low Ca diet
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223260
TI  - [Changes in epidural pulse pressure in brain edema following experimental focal
      ischemia].
AB  - It is well known that epidural pulse pressure (PP) increases with rising
      intracranial pressure (ICP). However, PP at the same ICP is not always identical
      in various intracranial pathologies. Many authors have investigated PP at
      increased states of ICP, but few studies related to brain edema have been done.
      This study was carried out in order to clarify the changes of PP in brain edema
      following focal ischemia. ICP and PP were measured in two groups of anesthetized
      dogs; 1) increased volume of CSF by cisternal saline injection (control, n = 5),
      2) brain edema caused by focal ischemia (edema, n = 11). Ischemia was induced by
      electro-coagulation of the right anterior cerebral artery and by clipping the
      right middle cerebral artery and right internal carotid artery transorbitaly. The
      brain was recirculated for 6 hours after 2 hours of ischemia. The ischemic areas
      were identified by Evans blue, triphenyl tetrazolium chloride (TTC) or
      histological examination. Water content of the brain was measured by the wet-dry
      weight method. The canine focal ischemic model showed consistent ischemic damage
      in the caudate nucleus and produced brain edema successfully. PP increased
      linearly with rising ICP to 35 mmHg, and PP in the edema group was significantly
      smaller than that in the control group at the same ICP value. The slopes of the
      regression equation of ICP and PP were significantly different between the edema
      and control group (edema: 0.061 +/- 0.030, control: 0.107 +/- 0.015, mean +/- SD,
      p less than 0.01). These results suggest that PP is easily affected by ischemic
      brain edema.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223261
TI  - [A case of syphilitic meningitis presenting the seventh nerve and the eighth
      nerve palsies].
AB  - Here we described a case of syphilitic meningitis presenting the seventh nerve
      and the eighth nerve palsies. A 56-year-old man was admitted because of left
      facial palsy and hearing loss of bilateral ears. He had a penile chancre five
      months before admission. Cerebrospinal fluid examination showed high pressure,
      pleocytosis predominantly with mononuclear cells and high protein content. STS
      and TPHA of serum and CSF were positive. High dose penicillin G was effective,
      and he was discharged with only mild hearing loss in the left. Considering the
      penetration of penicillin G into the CSF and the minimum fully treponemicidal
      concentration of penicillin, the administration of large doses of aqueous
      penicillin G intravenously or intramuscularly was effective in such a case to
      prevent permanent deafness, though CDC recommends relatively low dose.

PMID- 2223262
TI  - [Infarction in the territory of the anterior choroidal artery due to embolic
      occlusion of the internal carotid artery--report of two cases].
AB  - A case with infarction in the territory of the anterior choroidal artery (AChA)
      due to embolic occlusion of the internal carotid artery (ICA) is rare. We
      described two cases and investigated the mechanism of the territory of the AChA.
      Case 1 was a 69-year-old man. Case 2 was a 71-year-old woman. The neurological
      examination in both cases showed left homonymous hemianopsia, left facial palsy,
      left hemiparesis and left hemisensory disturbance. CT scan in these cases showed
      infarctions of the right uncus, amygdaloid nucleus, genu and posterior limb of
      the internal capsule, globus pallidus, lateral geniculate body and tail of the
      caudate nucleus. The right common carotid angiogram showed a complete occlusion
      of the ICA at its cervical segment in case 1 and at its carotid siphon in case 2.
      In both cases, the left carotid injection visualized the right anterior cerebral
      artery and right middle cerebral artery via the anterior communicating artery
      well, but the right AChA was not visualized. In case 1, the collateral pathways
      from the right external carotid artery (ECA) and the right posterior
      communicating artery (PCoA) to the right ICA were not supplied and the
      precommunicating segment of the right posterior cerebral artery was hypoplastic.
      In case 2, the collateral pathway from the right ECA to the right ICA was not
      supplied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223263
TI  - [Effect of dilazep on experimental vasospasm--evaluation of angiographical
      vasospasm and cerebral blood flow].
AB  - The effects of dilazep dihydrochloride on angiographic vasospasm and regional
      cerebral blood flow after subarachnoid hemorrhage were evaluated in double
      hemorrhage canine model. Severe angiographic vasospasm of basilar artery (percent
      reduction of intra-luminal diameter; 52.4%) was shown in untreated dogs. Daily
      intra-venous administration of dilazep (0.3 mg/kg for one hour) significantly
      inhibited angiographic vasospasm (percent reduction of intra-luminal diameter;
      33.2%, p less than 0.05). Dilazep had a marked vasodilatory effect even in severe
      vasospasm in untreated dogs, and had a tendency to increase cerebral blood flow
      of the cerebral cortex in spite of reduced blood pressure. From these
      characteristics of action, intra-venous administration of dilazep would be useful
      agent for the treatment of cerebral vasospasm after subarachnoid hemorrhage.

PMID- 2223264
TI  - [Multiple hemorrhagic cerebral amyloid angiopathy associated with
      leukoencephalopathy].
AB  - The authors present a case of cerebral amyloid angiopathy (CAA) which caused
      multiple recurrent subcortical hemorrhages and leukoencephalopathy similar to
      Binswanger's disease. CT scan revealed bilateral hypodensity of the hemispheric
      white matter in addition to multiple subcortical hemorrhages. The difference
      between white and gray matter densities was 14 approximately 15 HU. T2-weighted
      MRI showed the hemispheric white matter as high intensity. These findings on CT
      and MRI are compatible with those observed in leukoencephalopathy like
      Binswanger's disease. A biopsy of the cortex was performed and histological
      examination revealed amyloid deposition in the arterial wall. In addition to
      amyloid deposition, obliterative intimal proliferation and hyaline degeneration
      of the vessel were observed. It is thought that the occlusive vascular change due
      to CAA may induce chronic hypoperfusion of the hemispheric white matter and
      consequently the leukoencephalopathy may develop. In the aged population, CAA is
      noteworthy as a cause of both hemorrhagic and ischemic lesions, because the
      incidence of CAA is increasing with age.

PMID- 2223265
TI  - [Biochemistry of mitochondrial encephalomyopathy].

PMID- 2223266
TI  - [A case of solitary thalamic abscess treated by sterotactic aspiration].
AB  - The Solitary thalamic abscess appears to be uncommon, 17 cases have been reported
      since 1973. We successfully treated a case of thalamic abscess associated with
      diabetes mellitus by sterotactic aspiration with external drainage. A 55 years
      old man presented right hemiparesis. A computed tomographic (CT) scan revealed
      solitary thalamic low density lesion with ringed contrast enhancement. We started
      the administration of antibiotics, but on the 9th day he became drowsy and his
      eyes were deviated downward and inward. CT scan on the 10th day showed the edema
      had been spread to the tectum. We aspirated purulent fluid material with
      confidence by sterotactic operation. We considered the mid brain tectum to be
      responsible for the downward and medial deviation of the eyes, because it
      appeared only when the edema and abscess were spread to that area, and
      disappeared after aspiration of the abscess with subsidence of the edema.

PMID- 2223267
TI  - [Effects of unilateral temporal lobectomy on verbal dichotic listening test].
AB  - Verbal dichotic listening test was conducted before and after anterior temporal
      lobectomy on 25 patients who underwent the operation because of their medication
      resistant epileptic seizures. Their speech dominance by Wada test was all left
      sided. 1. Preoperatively, patients having the epileptogenic focus in the right
      temporal lobe (R-TLE) and those having the focus in the left (L-TLE) were, as
      expected, all right-ear dominant. The mean number of correct responses was fewer
      in L-TLE than in R-TLE group. 2. Postoperatively, no detrimental effects for
      recognition of verbal auditory stimuli by the ear contralateral to the focus was
      observed both in L-TLE and in R-TLE group. 3. Postoperatively, the ear-dominance
      shifted: to the left in patients with L-TLE, and to the right more conspicuously
      in patients with R-TLE compared to the preoperative scores. In other words, the
      recognition ability by the ears ipsilateral to the side of focus, or of resected
      temporal lobe, was ameliorated. Summarizing, the unilateral anterior temporal
      lobectomy did not cause "lesion effect" but yielded improvement of verbal
      auditory recognition by ears ipsilateral to the epileptogenic focus. Diminished
      epileptic bombardment resulted in by the resection surgery may be a possible
      explanation.

PMID- 2223268
TI  - [Disturbances of visual perception and the lesions on spastic diplegia].
AB  - In a study of 12 cerebral palsy with spastic diplegia, the relationship between
      their disturbances of visual perception and their lesions was discussed. All of
      them were performed Frostig Developmental Test of Visual perception and Tanaka
      Binet Intelligence Test. Six of them showed disturbances of visual perception on
      Frostig Test. Subtest II, figure-ground, was the lowest of all subtests. The mean
      of perceptual quotient was under that of intelligence quotient significantly (p
      less than 0.05 t-test). MRI examination was performed to all and the lesions were
      detected at 10 of them. Six who showed disturbances of visual perception had the
      lesions and two who showed good visual perception had no lesions. The lesions
      were periventricular white matter and extended to semioval center and subcortical
      white matter at parietal and occipital lobes. Anatomically, their lesions
      correspond to superior longitudinal bundle and vertical occipital bundle and
      their bundles have important functions as the pass way of visual perception.
      Therefore, it was suggested that the disturbances of visual perception detected
      at spastic diplegia were based on the lesions and the mechanism was disconnection
      of higher visual pass way.

PMID- 2223269
TI  - [Aging effect on frontal lobe function-evaluation by the new modified Wisconsin
      Card Sorting Test].
AB  - New Modified Wisconsin Card Sorting Test (WCST) was administered to ninety-five
      individuals to assess the effects of age on frontal lobe functions. The
      correlations between ages and scores were evaluated in the following five
      subgroups which were classified into whole subjects (TOL, n = 95), normals and
      patients who were neurologically diagnosed as only having cervical spondylosis
      (NOR, n = 20), individuals whose age-corrected total intelligence quotients (TIQ)
      by the Wechsler Adult Intelligence Scale were higher than or equal to 100 (HIQ, n
      = 30), individuals whose TIQ were less than 100 (LIQ, n = 27), and individuals
      whose Mini-Mental State Examination scores were full (MMS, n = 28). Scores of the
      WCST including Categories Achieved, Total Errors, Difficulty of Maintaining Set
      and Perseveration were significantly correlated to ages in four groups such as
      TOL, NOR, HIQ, and MMS. The correlation of WCST's scores of the four groups
      indicated almost the same tendency. Some subcategories of the WCST, indicating
      perservation which were characteristic signs of the frontal lobe dysfunction
      correlated with ages in these four groups. The groups indicating NOR, HIQ, and
      MMS were thought to be regarded as being normal controls. And, the scores of Mini
      Mental State Examination were not correlated with ages. So, the WCST scores of
      the MMS group were no thought to be effected by the age-related decline of
      intelligence. The results might suggest that the age-related decline of the
      frontal lobe function precedes that of intelligence.

PMID- 2223270
TI  - [Alteration of prolactin secretion after transsphenoidal adenomectomy for
      prolactinomas].
AB  - The author studied the dynamics of prolactin (PRL) secretion after adenomectomy,
      and considered the treatment for prolactinomas. The study group comprised a total
      of 74 patients with prolactinomas who underwent transsphenoidal surgery between
      1979 and 1986, and 61 patients out of them were followed up more than one year.
      Post-operatively, hyperprolactinemia was cured (under 20 ng/ml) in 19 of 36
      microadenomas (53%), and 7 of 38 macroadenomas (18%). Pre-operatively, PRL
      response to TRH was blunt except 3 patients, but it recovered in 16 patients
      after surgery, and 5 more patients during follow-up. Recurrence of
      hyperprolactinemia occurred in only one of 19 patients who were followed up more
      than one year, and she was not a PRL responder to TRH. Bromocriptine was
      administrated to 46 patients after surgery, and hyperprolactinemia was restored
      to normal in 40 patients. And in 7 patients whose basal PRL levels were between
      23 and 41 ng/ml after surgery, hyperprolactinemia was cured still after
      withdrawal of bromocriptine. During pregnancy, PRL levels were relatively low in
      surgically cured patients, but in most of others they became over 200 ng/ml
      promptly after withdrawal of bromocriptine. Recurrence of hyperprolactinemia was
      rare, and PRL response to TRH recovered in most of surgically cured patients.
      Even if it is not cured surgically, lowered PRL levels have a good effect on the
      additional bromocriptine therapy. I prefer transsphenoidal surgery in respect of
      curative treatment for prolactinomas.

PMID- 2223271
TI  - [Thrombus propagation and venous drainage disturbance in cerebral sinus-vein
      thrombosis--38 autopsied cerebral sinus-vein thrombosis].
AB  - 38 autopsied cases of cerebral sinus-vein thrombosis (CSVT) in our institute were
      studied. In this study, special attention was paid for the evolution and fate of
      venous thrombus. 18 cases showed hemorrhagic infarction or intracerebral hematoma
      (group 1; G 1). In contrast, no cerebral parenchymal changes were observed in the
      other 20 cases (group 2; G 2). In 13 of 18 cases of G 1, superior sagittal sinus
      (SSS) were thrombosed. 10 of these 13 cases showed thrombosed cerebral cortical
      veins (CV) or deep cerebral veins (DV). In contrast, none of 16 cases of G 1 with
      thrombosed SSS showed thrombosed CV or DV. All cases of the solitary thrombosis
      of CV or DV (each 2 cases) belong to G 1. Venous thrombi were divided into three
      stages according to its process of organization; recent thrombus (R), hyalinized
      thrombus (H), organized thrombus (O). In the venous thrombi of G 1, 6 cases were
      R, 6 were partly H, 6 were partly 0. In addition to O, R and H were also observed
      in group O. Distribution of various stage of thrombus in same case suggested that
      gradual thrombus evolution had occurred before or after the clinical onset in
      CSVT. This study suggested: (1) CV or DV occlusion may play an important role for
      the advent of cerebral parenchymal changes in CSVT. (2) Gradual thrombus
      evolution after the onset is one of possible causes of slow clinical deteoration
      after the onset. Therefore, prevention of these thrombus propagation with anti
      platelet drugs or fibrinolotic therapy should be recommended for the treatment of
      CSVT. On the contrary, hyperosmolar agents and diuretics may produce potential
      risk of dehydration, and as a result, accelerate secondary thrombus extension.

PMID- 2223272
TI  - Menarcheal age and endemic goitre.
AB  - A total of 13,566 school girls from 17 districts in Sri Lanka recalled their date
      of menarche for a study on the prevalence of goitre. Seventy-four percent
      (10,036) did not have any signs of goitre, and the recalled mean age of menarche
      for this group was 13.6 years. This figure was significantly lower than the mean
      age of 13.9 years observed in the goitrous group. The mean age was lowest for
      thyroid grade 0 and highest for thyroid grades 1b and above. The mean age in high
      prevalence areas was significantly higher both among goitrous and nongoitrous
      groups, and in different areas of prevalence the mean age was higher among the
      goitrous than the nongoitrous. These findings strongly suggest a delay in sexual
      maturation among girls living in endemic goitre areas and among girls with
      evidence of goitre.

PMID- 2223273
TI  - Pattern of medical care services utilization in Fiji.
AB  - The present study was designed to analyze sociodemographic and health related
      factors that influence the utilization of medical care services in Fiji by using
      the method of discriminant function. Some sociodemographic and health related
      independent variables had significant effects on the two patterns of modern and
      traditional medical services utilization. Discriminant function coefficients for
      sex, age and race are large enough to suggest the importance of discriminating
      between two patterns of medical care utilization. This suggests that traditional
      medical service is coexistent with modern medicine in Fiji and might play an
      extremely important role in providing health care for rural communities in the
      same way as modern medicine.

PMID- 2223275
TI  - Motorcyclist traffic accidents and risk factors: a Singapore study.
AB  - Motorcyclist accidents cause significant morbidity and mortality in Singapore. To
      elucidate personal and environmental factors associated with such accidents, we
      studied 198 motorcyclists who were hospitalized in Singapore General Hospital
      between April 1986 and June 1987. The patients were mostly young and almost
      exclusively male with a high proportion of Malays. Most accidents occurred on
      Sundays and at night. Ten percent of the victims took alcohol before the
      accident. Most had low injury severity scores (ISS). Less experienced drivers had
      a significantly higher ISS than those with one year or longer of driving
      experience. Vigorous control of drunken driving, through public education and
      intensive breath testing, should reduce the incidence of traffic accidents.

PMID- 2223274
TI  - A randomised controlled trial of counseling in a workplace setting for coronary
      heart disease risk factor modification: effects on blood pressure.
AB  - This paper reviews a prospective study of occupational factors in coronary heart
      disease risk incorporated in a randomised controlled trial of a worksite based
      occupational health nurse counseling program for reducing coronary heart disease
      risk factors. The aim of the trial was to evaluate the longterm effectiveness of
      the counseling program in persons with mildly elevated risk factor levels. Of the
      2,489 Australian government employees with mildly elevated risk factor levels who
      entered the intervention trial, 1,937 (78%) attended a followup examination three
      years later. This paper reports on changes in systolic and diastolic blood
      pressure. Multiple linear regression models were used with three-year blood
      pressure reduction as the dependent variable, intervention status as the main
      determinant, and sex, age, initial risk level and initial blood pressure as
      covariates. Although systolic and diastolic blood pressure fell in both the
      intervention and control groups, intervention was significantly associated with
      systolic blood pressure change only.

PMID- 2223276
TI  - The leadership challenge of tobacco use in Asia: towards health promotion and
      health for all.
AB  - Tobacco use in Asia is sharply on the rise. Present trends in increased smoking
      behavior will result in epidemics of smoking related diseases and deaths of
      millions annually in the foreseeable future. Collective leadership for health
      from several sectors is needed to reverse the trend in increased tobacco use. An
      agenda for action by leaders is presented, and an intersectoral approach is
      advocated with a focus on proactive measures to promote positive behaviors for
      health and to prevent a pandemic of unprecedented proportions.

PMID- 2223277
TI  - Socioeconomic and health programme effects upon the behavioral management of
      diarrhoeal disease in northeast Thailand.
AB  - This study investigates the effects of socioeconomic and health programme factors
      on preventive and curative health behaviors and assesses the impact of preventive
      health behaviors on the incidence of diarrhoea among children under five years of
      age. Methodological approaches included focus groups to uncover local definitions
      of diarrhoeal disease, a baseline survey which collected data on maternal
      preventive health behaviors for 1,364 children, and a monitoring system which
      collected data on the incidence of diarrhoea and on maternal curative behaviors
      among the same group of children. Results indicate that socioeconomic status and
      exposure to health programmes showed significant relationships with selected
      maternal preventive behaviors. Children whose mothers washed their hands before
      breastfeeding, gave their child food immediately after cooking and warmed foods
      each time before meals had significantly lower proportions with diarrhoea than
      children of mothers who did not practice these behaviors, and 70 percent of the
      children with diarrhoea were exposed to high risk of severe dehydration and
      related health complications. Implications of these findings for health
      programmes are discussed.

PMID- 2223278
TI  - Child survival and beyond.

PMID- 2223280
TI  - The cultural definition of an infantile diarrhea in Tambon Korat and Koongyang,
      northeast Thailand: community perceptions in diarrhea control.
AB  - In Tambon Korat and Koongyang in Northeastern Thailand, 88% (n = 60) of the
      mothers and significant other careproviders interviewed believe in poh, a mild,
      self-limiting diarrhea in infants which is considered a normal prerequisite in
      child development. The local definition of poh as to its nature, symptomatology
      and home management and implications for diarrhea control activities are
      presented in this paper.

PMID- 2223281
TI  - Nutritional problems of Malaysian children and approaches taken to overcome them.
AB  - Nutritional status of children is an important factor in child survival,
      especially in developing countries. It is therefore important that nutritional
      problems are addressed and overcome. This paper reviews the many studies
      conducted in Malaysia on nutritional problems among children. It also documents
      the approaches, including intersectoral approaches, that have been taken to
      overcome these problems. Possible actions that have to be taken in the future to
      further improve the nutritional status of Malaysian children are discussed.

PMID- 2223279
TI  - Nutritional intervention: a key to child survival.
AB  - In a collaborative relationship, researchers from the Cebu Institute of Medicine
      and from the United States have carried out a series of longitudinal studies of
      breast feeding and infant growth in a rural Philippine community. On the basis of
      our findings, we have conducted field experiments designed to have mothers
      improve their infants' diets using locally available food. Contingent
      reinforcement strategies were used successfully to get mothers to change their
      behavior and beliefs about infant feeding practices. The use of reinforcements
      resulted in improved diets and very high rates of continuation of participation
      in the field experiments. We believe that this is a highly productive and cost
      effective way to approach the problem of gaining cooperation and continued
      involvement in a nutrition intervention effort.

PMID- 2223282
TI  - Motor vehicle injuries in Taiwan.
AB  - In Taiwan, motor vehicle fatalities have increased significantly in the past two
      decades and are now a leading cause of mortality, especially among younger age
      groups. In this paper, we review vital statistics and hospital morbidity data to
      provide an overview of the problem of motor vehicle injuries in Taiwan and make
      several suggestions for improving injury surveillance.

PMID- 2223283
TI  - The use of the Nabarro Thinness Chart in identifying children for nutrition
      supplementation in Sri Lanka.
AB  - This study compares the use of the Nabarro Thinness Chart with other nutritional
      screening tools among school children in Sri Lanka. It concludes that this method
      is a simpler, more precise approach to assess students requiring food
      supplementation in community programmes than others which are commonly utilized.

PMID- 2223284
TI  - Delivering health care to the Pacific.

PMID- 2223285
TI  - Reduced funding affects dental schools.

PMID- 2223286
TI  - 'Surgical emphysema during restorative dentistry'.

PMID- 2223287
TI  - 'Temporary elective tooth separation as a diagnostic aid in general dental
      practice'.

PMID- 2223288
TI  - Intra-oral hair implant: a delayed complication of facial trauma.

PMID- 2223289
TI  - Working conditions of resident SHOs.

PMID- 2223290
TI  - 'Supplemental and congenitally absent premolar teeth'.

PMID- 2223291
TI  - A reappraisal of the value of the bitewing radiograph in the diagnosis of
      posterior approximal caries.
AB  - The aim of this paper was to re-assess the available literature examining the
      value of the bitewing radiograph in the diagnosis of approximal caries and to
      compare the relative values of radiographic and clinical examinations. To this
      end, results from 29 research studies have been re-presented and tabulated. These
      results show that the use of the bitewing radiograph is essential if much
      approximal caries is not to be missed. It is particularly important in the
      detection of the small lesion which may be managed preventively rather than
      operatively. Although there is a proper need to ensure that radiographic
      exposures are minimised, the evidence suggests that both clinicians and
      epidemiologists must balance this need with the ethical issues associated with
      failing to employ an established diagnostic aid.

PMID- 2223292
TI  - Root caries in older people attending a general dental practice in East Sussex.
AB  - With increasing numbers of older people retaining their natural dentitions,
      dentists are becoming increasingly aware of the problem of dental caries
      occurring on exposed root surfaces--root caries. This study reports the
      prevalence of root caries in a selected older population, living in the community
      and attending a general dental practice in Bexhill, East Sussex. A total of 146
      non-institutionalised people, aged at least 55 years with at least 12 teeth, were
      examined. Most of the subjects (88.4%) had evidence of root caries, males and
      denture wearers having more lesions than females and non-denture wearers,
      respectively. Active coronal caries was present in only 11.6% of the subjects,
      whereas active (soft or leathery) root caries lesions were present in 31.5% of
      the subjects. The teeth and surfaces most commonly affected by root caries were
      found to be similar to those seen in previous epidemiological surveys. The
      majority of active root caries lesions were within 1 mm of the gingival margin,
      while inactive lesions tended to be greater than or equal to 1 mm from the
      gingival margin. Colour of root caries lesions was not diagnostic of caries
      activity. A more detailed method of recording root caries lesions is also
      described.

PMID- 2223293
TI  - Central neurilemma of the mandible.
AB  - A rare case of symptomless central neurilemmoma of the mandible is reported. Post
      operative recovery was uneventful and, in particular, post-surgical paraesthesia
      was followed by a return to normal sensation.

PMID- 2223294
TI  - 'The Yankee dodge': some new observations on the discovery of anaesthesia.
AB  - The discovery of general anaesthesia is arguably the most important advance in
      the practice of surgery. To whom the credit belongs has, however, remained
      controversial. A first-hand account has now indicated that this controversy can
      finally be resolved, and that the credit for the discovery of anaesthesia should
      be given to Horace Wells.

PMID- 2223295
TI  - Badges of the dental profession. The International Federation of Dental
      Anesthesiology Societies.

PMID- 2223296
TI  - The problems of running a phantom department.

PMID- 2223297
TI  - Decentralization: problems and approaches.

PMID- 2223298
TI  - So you think you're different.

PMID- 2223299
TI  - Endocavitary ablation of atrioventricular conduction.

PMID- 2223300
TI  - Mitral valve surgery: to repair or replace?

PMID- 2223301
TI  - Systemic pattern of free radical generation during coronary bypass surgery.
AB  - Diffuse impairment of ventricular function after cardiac surgery may be related
      to the generation during reperfusion of the myocardium of free radicals derived
      from oxygen. Fifteen patients undergoing elective coronary bypass surgery were
      studied by previously described assays for peroxidised lipids and for isomerised
      lipids which were used as indices of free radical activity. Serial blood samples
      were obtained from systemic arterial, mixed venous, and coronary sinus catheters
      before, during, and after the ischaemic period. The patients underwent coronary
      artery surgery on cardiopulmonary bypass with a membrane oxygenator, relative
      hypothermia 30-34 degrees C, and intermittent cross-clamping of the aorta. During
      the ischaemic periods there were no significant changes in the indices of free
      radical activity. During the reperfusion phase there was a significant increase
      in free radical indices in arterial and mixed venous blood. A small rise in free
      radical indices in coronary venous blood was not statistically significant. These
      data indicate that free radical activity is increased in patients shortly after
      the cessation of cardiopulmonary bypass. The pattern of distribution between the
      different sampling sites suggests that much of the observed increase in
      isomerised and peroxidised lipids originates from tissues other than the
      myocardium.

PMID- 2223302
TI  - Does blood rheology revert to normal after myocardial infarction?
AB  - After myocardial infarction there is an acute deterioration of the flow
      properties of blood. The present study was designed to test whether the
      abnormality persists. Blood and plasma viscosity, red cell aggregation and
      deformability, haematocrit, erythrocyte sedimentation rate, white cell count,
      cholesterol, and triglycerides were measured in 51 patients who had had a
      myocardial infarction 5.4 (mean) years before. Results in patients and controls
      were compared and matched pairs with identical cardiovascular risk factors were
      also selected. Blood viscosity and red cell aggregation were increased and red
      cell deformability was decreased in the 51 patients. The abnormalities were
      independent of the interval since infarction and persisted for years. The
      rheological abnormalities present after myocardial infarction are at least partly
      independent of the acute event and acute phase reactions. They contribute to the
      reduced perfusion of the microcirculation of the heart.

PMID- 2223303
TI  - Prospective evaluation of a protocol for induction of sustained ventricular
      tachycardia in patients referred to a tertiary centre.
AB  - All eight stages of a stimulation protocol that used one then two extrastimuli
      from the right ventricular apex in sinus rhythm and three ventricular drive rates
      (100, 120, and 140 beats/min) were performed in 24 patients with recurrent
      spontaneous sustained ventricular tachycardia despite drug treatment. Twenty two
      of the patients had sustained a previous myocardial infarct and 18 were on long
      term treatment with amiodarone. Sustained (greater than 30 s) ventricular
      tachycardia was induced in all patients. Two extrastimuli were significantly more
      likely to induce sustained ventricular tachycardia than one extrastimulus, both
      overall and individually for the three ventricular drive rates. A ventricular
      drive rate of 140 beats/min was significantly more likely to induce ventricular
      tachycardia than ventricular drive rates of 100 and 120 beats/min which were
      significantly more effective than sinus rhythm. A ventricular drive rate of 140
      beats/min with one or two extrastimuli induced ventricular tachycardia in 23/24
      (95%) of the patients in this study. The full eight stage protocol was
      progressive separately for both extrastimuli and ventricular drive rate but the
      last two stages (ventricular drive rate of 140 beats/min with one or two
      extrastimuli) were as effective as the entire protocol in inducing ventricular
      tachycardia.

PMID- 2223304
TI  - Use of computed tomographic scanning and aortography in the diagnosis of acute
      dissection of the thoracic aorta.
AB  - Before the introduction of computed tomographic (CT) scanning, aortography was
      the investigation of choice for acute aortic dissection. Between 1978 and 1982,
      24 patients were referred to the Brompton Hospital with suspected acute thoracic
      aortic dissection; all had aortography with diagnosis confirmed at surgery (n =
      12) or necropsy (n = 2) or supported by clinical outcome (n = 8). One patient in
      whom aortography was negative had type B dissection at necropsy and another
      patient was lost to follow up. CT scanning became available in this unit in 1983
      and between 1983 and 1987 was used as the only imaging investigation in 32
      patients with suspected acute dissection of the thoracic aorta while in a further
      22 patients aortography was used alone. Results were confirmed at surgery (n =
      18), necropsy (n = 3), or supported by clinical outcome (n = 31). Two patients
      were lost to follow up. In an additional 16 patients both aortography and CT
      scanning were performed with concordant findings in 10. In six in whom the
      results were discordant, aortography was normal in three in whom subsequent CT
      scanning showed type B dissection and CT scanning was normal in three patients in
      whom aortography showed type A dissection. Both CT scanning and aortography are
      reliable techniques for assessment of suspected acute dissection of the thoracic
      aorta. Both techniques misdiagnose occasionally and the frequency of misdiagnosis
      will be minimised by performing both investigations in patients where the level
      of clinical suspicion is high and the initial investigation negative. CT scanning
      tends to miss type A dissection and in view of the success of surgery in this
      condition this failing has the more serious clinical consequences.

PMID- 2223305
TI  - Abnormal diastolic function in patients with type 1 diabetes and early
      nephropathy.
AB  - Left ventricular diastolic function was assessed by pulsed Doppler
      echocardiography in non-diabetic controls (n = 11) and in patients with type 1
      diabetes without microvascular disease (n = 16; diabetic controls), with
      microalbuminuria (n = 9), or with early persistent proteinuria (n = 11). The peak
      filling velocities during the early and atrial phases of left ventricular
      diastole and their ratio (E:A ratio) were measured. All patients with diabetes
      had a normal serum concentration of creatinine and exercise electrocardiogram.
      The mean E:A ratio was significantly lower in those with proteinuria than in the
      diabetic controls because of an increase in peak atrial filling velocity; most
      patients with proteinuria had an abnormal E:A ratio of less than 1.0. Multiple
      regression analysis showed that systolic blood pressure was the major determinant
      of both the peak filling velocity during the atrial phase of diastole and also
      left ventricular mass. Blood pressures were significantly higher in the
      proteinuria group than in the diabetic controls. Glycaemic control and autonomic
      function did not influence diastolic filling. The slightly raised blood pressures
      at the earliest stages of diabetic nephropathy are sufficient to alter left
      ventricular diastolic compliance--this may reflect early hypertensive heart
      disease. These data do not preclude a specific heart muscle disease related to
      diabetes, but suggest that these slightly raised blood pressures contribute
      significantly to left ventricular dysfunction in these patients, in whom the risk
      of cardiovascular disease is already greatly increased.

PMID- 2223306
TI  - Doppler echocardiographic evaluation of pulmonary artery flow after modified
      Fontan operation: importance of atrial contraction.
AB  - Doppler echocardiography was used to evaluate blood flow in the pulmonary artery
      in 14 patients 2 to 42 months (mean (SD) 17 (12) months) after a modified Fontan
      operation incorporating a direct atriopulmonary anastomosis. Preoperatively six
      patients had tricuspid atresia, six had a double inlet left ventricle, and two
      had pulmonary atresia with an intact ventricular septum. The postoperative rhythm
      was sinus in 11 patients, junctional in one, ventricular pacing in one, and
      atrioventricular sequential pacing in one. In one patient the Doppler trace was
      unsatisfactory for analysis. In all patients forward flow in the pulmonary artery
      had biphasic peaks related to both atrial and ventricular contraction. The mean
      (SD) peak flow velocity that was synchronous with atrial contraction was 80 (30)
      cm/s and that synchronous with ventricular contraction was 74 (23) cm/s. The
      atrial contribution to total pulmonary artery flow, assessed by velocity-time
      integrals, varied between 22% and 73% (mean (SD) 45 (14)%). In patients with
      tricuspid atresia the mean (SD) peak flow velocity with atrial contraction was 90
      (27) cm/s and that with ventricular contraction was mean (SD) 68 (24) cm/s. In
      patients with double inlet left ventricle the mean (SD) peak flow velocity was 67
      (36) cm/s with atrial contraction and 80 (25) cm/s with ventricular contraction.
      The atrial contribution to total pulmonary blood flow in patients with tricuspid
      atresia was significantly higher (53 (11)%) than in those with double inlet left
      ventricle (37 (14)%). Pulmonary artery flow after modified Fontan operation was
      biphasic and was related to both atrial and ventricular contraction. The atrial
      contribution to pulmonary blood flow is greater in patients with tricuspid
      atresia than in those with a double inlet left ventricle. The mechanism of the
      second peak related to ventricular contraction is unknown.

PMID- 2223307
TI  - Primary balloon dilatation of coarctation of the aorta in neonates.
AB  - Primary balloon dilatation of coarctation of the aorta was attempted in 10
      consecutive neonates (age range 2-23 days). The coarctation site was crossed and
      the balloon inflated in all but one patient. In two patients with associated
      severe isthmal hypoplasia there was no change in the gradient after dilatation.
      In the remainder, the residual gradients were trivial and angiography showed
      complete relief of coarctation. Severe recoarctation developed 5-12 weeks after
      dilatation in five patients, each considered to have had an excellent initial
      result. The coarctation was rapidly progressive in three patients in whom Doppler
      studies within two weeks of the development of recoarctation had shown no
      significant gradient. In the other two patients progressive restenosis was
      charted by Doppler examinations over the course of 6-8 weeks. Three patients had
      a second, initially successful, dilatation procedure. One patient remained well
      with no residual gradient 18 weeks later. Stenosis recurred within eight weeks in
      the other two, and both have undergone successful surgical repair. Balloon
      dilatation of a native coarctation of the aorta gave excellent immediate results
      in most neonates. Severe isthmal hypoplasia is, however, a contraindication to
      balloon dilatation and early restenosis is an important problem. These results do
      not support the continued use of primary balloon dilatation of coarctation of the
      aorta in neonates.

PMID- 2223308
TI  - Transoesophageal echocardiography in the longitudinal axis: correlation between
      anatomy and images and its clinical implications.
AB  - Transoesophageal echocardiographic imaging in the longitudinal axis is a recent
      addition to the non-invasive evaluation of congenital and acquired heart disease.
      The technique provides unique images of intracardiac anatomy but their
      interpretation remains difficult. A heart specimen was therefore cut according to
      the echocardiographic imaging planes to elucidate the morphological details. The
      results suggested that longitudinal transoesophageal imaging complements the
      transverse axis approach. It gave new imaging information on the right
      ventricular outflow tract and the pulmonary trunk, the atrioventricular valves,
      the interventricular septum, the cardiac apex, and the thoracic aorta. In
      particular, it showed the entire length of the right ventricular outflow tract.
      When longitudinal imaging was used in combination with transverse imaging almost
      all the thoracic aorta could be examined. Imaging in the longitudinal axis may
      also allow better assessment of the mechanisms of atrioventricular valve
      regurgitation.

PMID- 2223310
TI  - Trauma.

PMID- 2223309
TI  - Rash after treatment with anistreplase.
AB  - A palpable purpura developed on the legs and lower abdomen of a woman of 54 five
      days after she was treated with anistreplase anisoylated plasminogen
      streptokinase activator complex (APSAC) for an acute myocardial infarction.
      Histological examination of a skin biopsy specimen taken 6 days after treatment
      showed leucocytoclastic vasculitis. The rash resolved within two weeks and there
      were no other complications.

PMID- 2223311
TI  - Trauma.

PMID- 2223313
TI  - The pathophysiology of multi-system organ failure in the trauma patient.
AB  - Multiple trauma mortality in the critical care setting most often occurs as a
      result of multi-system organ failure (MSOF). Mortality rates increase
      exponentially as successive organ systems fail. Although the role of shock in
      determining patient outcome has been extensively investigated, inflammatory
      factors and sepsis are becoming increasingly implicated in the development of
      MSOF. The physiologic effect of these factors on individual organ systems is
      explained. Signs, symptoms, and key criteria for determining organ system failure
      also are presented to assist the nurse in recognition and prevention.

PMID- 2223314
TI  - Clinical management of the pregnant trauma victim.
AB  - The pregnant trauma victim presents unique challenges to medical care providers
      because two lives must be treated concurrently. Physiologic changes inherent in
      the normal pregnancy, modify the assessment and treatment routines. Care directed
      to the mother impacts the fetus. Management of the pregnant trauma victim
      requires a high index of suspicion. Accurate assessment and timely interventions
      will enhance the probability of healthy outcomes for both mother and infant.

PMID- 2223312
TI  - Air transport of the trauma patient.
AB  - Flight nursing is a rapidly growing field in critical care nursing. An
      understanding of the types of trauma patients that warrant helicopter transport
      is important to any well functioning trauma system. The assessments and
      interventions necessary in transporting trauma patients are addressed. Safety,
      environmental, and psychosocial issues that surround the use of air transport are
      discussed.

PMID- 2223315
TI  - Caring for trauma victims: the emotional impact.
AB  - The potential for significant emotional trauma exists for nurses working with
      trauma victims and their families. There is very little in the nursing literature
      that addresses the wide range of normal feelings that nurses may experience
      during or following the care of trauma victims. There is also a scarcity of
      articles identifying strategies that nurses may employ to assist them through
      these significant incidents. This article describes the range of feelings that
      nurses may experience in the course of delivering care and relates these feelings
      to the traumatic event. Potential aggravating factors are discussed, and
      strategies are provided that nurses can use to survive the psychologic impact of
      these incidents and to achieve a higher level of emotional functioning.

PMID- 2223316
TI  - Physiologic response to traumatic shock.
AB  - Traumatic injury results in major physiologic alterations that begin at the time
      of injury and persist until recovery is complete. The response of the body is
      divided into two phases--the acute phase and the flow phase. The acute phase is
      characterized by shock with changes in hormone concentration. These hormones,
      either alone or in combination, result in lipolysis, amino acid release,
      gluconeogenesis,, and glycolysis. The flow phase of injury is a catabolic process
      that is characterized by an increased protein metabolism. Hypermetabolism and
      increased nitrogen losses are seen. The magnitude of these alterations is
      directly related to the severity of injury. Tissues with the highest oxygen
      consumption are more susceptible to injury and death. Cellular function does not
      depend on oxygen alone but also on the ability of the cells to use available
      oxygen. If the body is unable to compensate through biochemical, hormonal, and
      metabolic activities, an irreversible state results unless appropriate
      interventions are instituted promptly.

PMID- 2223317
TI  - Families experiencing a traumatic accident: implications and nursing management.
AB  - Families experiencing a traumatic accident experience significant psychosocial
      disruption. The traumatic event is sudden and unexpected. Families have no
      opportunity to prepare themselves emotionally, have limited experience with such
      catastrophic events, and are overwhelmed by the magnitude of the patient's
      injuries. Critical care nurses have an important role in the psychosocial
      assessment, support, and management of these families. Many critical care nurses
      are uncomfortable interacting with families with significant
      psychosocial/emotional needs due to a lack of understanding of their needs, lack
      of knowledge of how to manage their needs, lack of confidence in communicating
      with families, and generalized discomfort and awkwardness when confronted with
      grief and bereavement issues. This article presents important information for
      critical care nurses to help them understand and manage families psychosocial
      needs and to feel more confident interacting with these families. Information
      presented includes (1) impact of the traumatic event, (2) emotional responses,
      (3) assessment of psychosocial needs, and (4) nursing interventions for the care
      and management of these families. Special considerations impacting on families'
      psychosocial needs, including dysfunctional families, ineffective coping
      mechanisms, suicide, and the patient's death, are presented.

PMID- 2223318
TI  - Inhalation injuries.
AB  - Inhalation injuries comprise three distinct clinical entities that may be
      classified according to the time of onset of symptoms, etiologic agents, and the
      anatomic location of injury. These entities are carbon monoxide toxicity, upper
      airway obstruction, and smoke inhalation or chemical injury. Each has a distinct
      pathophysiology, clinical manifestations, treatment, and prognosis. The emergency
      management of inhalation injury is frequently based on the health professional's
      degree of suspicion despite the availability of sophisticated diagnostic tests.
      Early aggressive treatment, including maintaining a patent airway, administering
      humidified oxygen and bronchodilators, and providing pulmonary toilet, is
      necessary to ensure the best possible outcome. Understanding the pathophysiology,
      clinical manifestations, diagnosis, medical management, and nursing implications
      of inhalation injuries can improve patient survival.

PMID- 2223319
TI  - Wound care.

PMID- 2223320
TI  - Physiology of wound healing and risk factors that impede the healing process.
AB  - In the critically ill patient, wound repair can be impeded by processes inherent
      to the illness, its treatment, and the critical care environment. This
      vulnerability to wound complications increases patient morbidity and mortality as
      well as length of stay, resource consumption, and hospital cost. The physiology
      of wound healing and factors that impede wound repair are discussed. Those
      factors commonly seen in critical illness include advanced age, diabetes
      mellitus, compromised immunocompetence, inadequate perfusion, and oxygenation,
      infection, malnutrition, obesity, and preoperative illness. Knowledge of
      management of the physiologic factors that affect wound healing enables the nurse
      to maximize tissue repair and prevent wound complications.

PMID- 2223322
TI  - Choosing a wound dressing: a systematic approach.
AB  - Wound care presents a particular challenge in the critical care setting.
      Decisions about how to cleanse a wound and which dressing to use are often
      complicated by unexpected changes in the patient's condition, or the sudden
      occurrence of a wound infection. In this high-risk patient population, timely
      changes in topical therapy often can mean the difference between a wound that
      heals, or one that rapidly deteriorates. Much of the confusion over wound care
      and wound care products can be minimized by using a systematic approach to wound
      assessment. This chapter describes such an approach and summarizes local
      treatment options based on wound appearance.

PMID- 2223321
TI  - Human wound assessment: status report and implications for clinicians.
AB  - Wound care has long been carried out by professional nurses. Yet, as a result of
      their increasing qualifications and changes in health care practices, the nurse's
      role in and responsibility for wound care has expanded. Despite this, there is a
      paucity of valid and reliable methods by which nurses and physicians alike can
      evaluate healing status. This chapter provides an overview of the instruments
      designed to evaluate healing in humans, focusing particular attention on those
      intended to measure healing noninvasively. Implications for clinical practice and
      suggestions for research also are offered. Additionally, this article is written
      to raise clinicians' awareness to the need for concentrated efforts in devising
      clinically usable, valid, and reliable instruments to evaluate human tissue
      repair.

PMID- 2223323
TI  - The influence of tissue oxygen and perfusion on wound healing.
AB  - The availability of oxygen (O2) to cells in the wound area and the presence of
      adequate blood flow are important factors to the healing process. Oxygen plays a
      critical role in the formation of collagen, the growth of new capillaries, and
      the control of infection. Perfusion and delivery of O2 to tissue are closely
      related. Although an adequate blood flow does not guarantee a sufficient supply
      of O2, without it the provision of O2 to healing tissues will be impaired. Basic
      scientific studies have clarified how O2 and blood flow influence healing. Recent
      research has focused on clinical populations and begins to provide direction for
      additional clinical studies and interventions to support the healing process.
      Based on existing research, clinical interventions aimed to maintain perfusion
      and supply of O2 include fluid volume assessments, pulmonary hygiene regimens,
      postoperative position changes, and ambulation.

PMID- 2223324
TI  - Nutrition: a critical component of wound healing.
AB  - Nutrients are essential to wound healing and patients in critical care are often
      at risk for lack of sufficient nutrients that may result in impaired healing.
      Understanding the role of the various nutrients in healing provides the basis for
      assessment and therapy. Use of a practical and consistent nutritional assessment
      technique is an important part of care for critically ill patients with wounds.
      The health care team must provide care based on current knowledge of the effects
      of nutrition on wound healing and work collaboratively in doing nutritional
      assessment and providing nutritional support to optimize wound healing outcomes.

PMID- 2223325
TI  - Wound healing in the surgical patient: influence of the perioperative stress
      response on perfusion.
AB  - The clinical effect of surgical stress created by pain, cutting, cold, fear, and
      hypovolemia is peripheral vasoconstriction which limits wound perfusion and
      oxygenation and impairs wound healing. Correction of all factors as
      simultaneously as possible is the goal.

PMID- 2223326
TI  - Pressure ulcer prevention in critical care: state of the art.
AB  - Prevention of pressure ulcers in the critically ill patient is a major
      responsibility of the critical care nurse. The authors review the causes of
      pressure ulcer development and the methods of identifying the patient at
      increased risk. Pressure relief strategies for use in critical care are
      presented, and currently available pressure reduction and relief devices are
      discussed. Because few research studies address pressure ulcer prevention in the
      critical care setting, future research in this area is needed to develop a
      reliable predictive tool for use with the critically ill patient. Level of risk
      needs to be linked with intervention to assist the nurse in managing the pressure
      relief options available in today's market. In the meantime, prevention of
      pressure ulcers in critical care patients requires vigilance and the best use of
      available knowledge in the field.

PMID- 2223327
TI  - Studies on the expression of intracellular and surface polarity in animal pole
      cells of Xenopus embryos cultured on various substrata.
AB  - The expression of intracellular and surface polarity in animal pole cells of
      Xenopus embryos (stage 10) cultured on various substrata was studied by electron
      microscopy. When animal pole cells of Xenopus embryos were cultured on type I
      collagen- or gelatin-coated dishes until control embryos reached stage 23, the
      cells in confluent layers expressed an apical-basal polarity so that the apical
      surface membrane domain faced the culture medium. However, the cells in confluent
      layers cultured on naked plastic dishes were suppressed to express intracellular
      and surface polarity. In addition, single attached cells which were formed by
      being sparsely plated neither spread on any substrata nor displayed the apical
      basal polarity perpendicular to the dishes. These results indicate that the
      expression of intracellular and surface polarity in cultured animal pole cells of
      Xenopus embryos requires not only cell-cell contact but also an adhesive
      substrata such as type I collagen or gelatin.

PMID- 2223328
TI  - The process of new plasmalemma formation in focally injured skeletal muscle
      fibers.
AB  - The major ultrastructural events in murine skeletal muscle fibers were examined 3
      to 24 hr after segmental injury induced by painting with aldehyde fixative. At 3
      hr the viable stump of injured myofibers was separated from the necrotic segment
      by a zone of supercontracted myofibrils. No demarcating membrane was evident at
      this time, although occasionally collapsed segments of plasmalemma partially
      covered the viable stump. By 12 hr after injury myonuclei near the viable stump
      were centrally placed and numerous whorls of membrane material appeared in the
      vicinity of the Golgi apparatus. At this stage a convoluted, tortuous membrane
      exhibiting extensive interdigitations has sealed the structurally normal part of
      the injured fiber. The myoplasm immediately within this demarcating membrane
      possessed few myofilaments but numerous vesicles and tubules, several of which
      were continuous with the demarcating membrane; most degraded sarcoplasmic
      organelles remained external to the demarcating membrane and leukocytes were
      observed internalizing the debris. It appears that after segmental injury to
      skeletal muscle fibers, active production of new sarcoplasmic membranes occurs,
      which contributes to the formation of the part of the plasmalemma that demarcates
      the viable portion of the muscle fiber from the injured area.

PMID- 2223329
TI  - Characteristic views of Escherichia coli RNA polymerase core enzyme in the
      scanning transmission electron microscope.
AB  - Eight characteristic views of Escherichia coli RNA polymerase core enzyme are
      presented which were found using multivariate statistical image processing of
      about 1000 individual molecular images. The data set was obtained from negatively
      stained specimens with a scanning transmission electron microscope (STEM)
      operated in dark field mode. The molecular projections were found to a resolution
      of around 30 A, thus visualizing new structural details of the core enzyme. An
      approximate twofold axis seems to relate the beta to the beta' subunit as well as
      both alpha units to each other.

PMID- 2223330
TI  - Total i.v. anaesthesia with propofol and alfentanil: dose requirements for
      propofol and the effect of premedication with clonidine.
AB  - We determined in 51 healthy patients undergoing body surface surgery the dose
      requirements for propofol, as part of a total i.v. anaesthesia technique with an
      alfentanil infusion. After premedication with temazepam, patients received
      alfentanil 50 micrograms kg-1 followed by an infusion of 50 micrograms kg-1 h-1.
      Patients were anaesthetized with a loading dose of propofol followed by a three
      stage infusion designed to reach one of five preselected blood concentrations of
      propofol. The motor response to the initial surgical incision was noted and
      probit analysis was used to derive the ED50 (2.94 mg kg-1 h-1; 95% confidence
      limits: 2.35-3.37 mg kg-1 h-1) and ED95 (4.98 mg kg-1 h-1; 95% limits: 4.13-8.8
      mg kg-1 h-1) for the final propotol infusion rate under these conditions. Whole
      blood concentration!of propofol at the time of the incision was related linearly
      to the inf!sion rate and the EC50 and EC95 (probit analysis) were derived as !.44
      (95% confidence limits 0.62-1.87) and 4.05 (95% confidence lim!ts 2.78-30.5)
      micrograms ml-1, respectively. Post-operative recovery was!rapid, uncomplicated
      and uneventful. In a subgroup of eight patients,!the addition of clonidine 0.6 mg
      to the premedication significantly decreased the requirement for propofol (P less
      than 0.05) during surgery, but resulted in prolonged recovery times.

PMID- 2223331
TI  - Analgesic efficacy of i.m. alfentanil.
AB  - We have studied the analgesic, respiratory, cardiovascular and sedative effects
      of alfentanil 30 micrograms kg-1 i.m. in two experiments in six healthy
      volunteers. In the first experiment, recordings were made up to 120 min after
      injection. Thresholds (sensory and pain) and pain-related evoked potentials
      (amplitude and latency) to cutaneous argon laser stimulation were used for
      quantitative assessment of onset, efficacy and duration of analgesia. Pain was
      significantly reduced from 5 to 60 min after injection. The onset phase of
      analgesia was faster than the recovery phase. In the second experiment, the
      alfentanil-induced analgesia was antagonized by naloxone 0.4 mg i.v. The reaction
      time to pain was prolonged significantly 15 min after injection, whereas the
      latency of the pain-related potential remained constant. No clinically
      significant changes were observed in respiratory and cardiovascular measurements.

PMID- 2223332
TI  - Effect of surgery on sensory threshold and somatosensory evoked potentials after
      skin stimulation.
AB  - We have studied the effect of surgical injury on cutaneous sensitivity and
      somatosensory evoked potentials (SSEP) to dermatomal electrical stimulation in 10
      patients undergoing hysterectomy. Forty-eight hours after surgery, sensory
      threshold increased from 2.2 (SEM 0.3) mA to 4.4 (1.1) mA (P less than 0.01) and
      SSEP amplitudes in P1, N1, P2 and the peak-to-peak amplitudes decreased (P less
      than 0.05). Latency was prolonged only in the N3 component (P less than 0.05). No
      changes were seen in threshold and SSEP in a control group studied over the same
      interval. The results suggest that surgical injury activates antinociceptive
      modulatory systems.

PMID- 2223333
TI  - Pharmacokinetics of propofol infusions in patients with cirrhosis.
AB  - We have compared the pharmacokinetics of propofol as an infusion in 10 control
      and 10 patients with cirrhosis. Anaesthesia was induced within 3-4 min during
      administration of an infusion of propofol 21 mg kg-1 h-1. After 5 min, the
      infusion was decreased in a stepwise manner to 12 mg kg-1 h-1 and subsequently 6
      mg kg-1 h-1. The mean recovery time after discontinuation of the infusion was
      significantly longer in the cirrhotic group; however, when patients opened their
      eyes, blood concentrations of propofol were similar in both groups (1 micrograms
      ml-1). Pharmacokinetic analysis was performed from the beginning of infusion to 8
      h after termination. Total body clearance was not reduced significantly in
      cirrhotic (1.56 (SD 0.48) litre min-1) compared with control (1.75 (0.32) litre
      min-1) patients. The volume of distribution at steady state was significantly
      greater in patients with cirrhosis than in control patients (202 (82) litre vs
      121 (49) litre). However, this difference did not change terminal elimination
      half-life. The pharmacokinetics of propofol given by infusion to maintain general
      anaesthesia were not affected markedly by moderate cirrhosis.

PMID- 2223334
TI  - Effect of propofol on peripheral vascular resistance during cardiopulmonary
      bypass.
AB  - Twenty-eight patients undergoing elective coronary artery bypass surgery were
      allocated randomly to receive either propofol 2 mg kg-1 or an equivalent volume
      of its vehicle during cardiopulmonary bypass with constant pump flow. Peripheral
      vascular resistance (PVR) was calculated from perfusion pressure and pump flow.
      After propofol, PVR decreased from 1767 (SD 415) dyn s cm-5 to a minimum of 1263
      (283) dyn s cm-5 at 2 min, and remained significantly less than the control value
      until 12.5 min after administration of propofol. In the group given the vehicle,
      PVR did not change significantly. In a second study in 10 patients, venous blood
      samples were withdrawn before and 2, 4, 6, 8, 10, 20 and 30 min after injection
      of propofol 2 mg kg-1 during cardiopulmonary bypass, for measurement of blood
      concentrations of propofol. Concentrations were greater than predicted by a
      computer simulation based on published pharmacokinetic data. The decrease in PVR
      may be an important factor in the hypotension caused by propofol during induction
      of anaesthesia.

PMID- 2223335
TI  - Effect of flumazenil on midazolam-induced amnesia.
AB  - We have studied the effect of i.v. flumazenil 0.01 mg kg-1 on the amnesia and
      sedation caused by midazolam 2 mg and 5 mg i.v. in volunteers in order to
      determine the relationship between the actions of the antagonist on these two
      effects. Midazolam caused dose-dependent central neural depression as assessed by
      critical flicker fusion frequency, and dose-dependent amnesia for word cards. In
      subjects given flumazenil 5 min after administration of midazolam, fusion
      frequency readings and memory were restored to levels comparable to those before
      midazolam administration. These two effects of flumazenil were similar in time
      course and extent, suggesting that they share the same mechanism of action.
      Flumazenil given alone had no effect on memory. The study has demonstrated
      anterograde amnesia following benzodiazepine administration and antagonism by
      flumazenil. There was neither retrograde amnesia nor retrograde antagonism of
      amnesia.

PMID- 2223336
TI  - Measurement of entrainment ratio during high frequency jet ventilation.
AB  - We have measured tidal (VT), entrained (Ve) and "blowback" (Vbb) volumes during
      high frequency jet ventilation (HFJV) through a Mallinckrodt Hi-Lo Jet tracheal
      tube in anaesthetized patients. The above volumes were calculated by digital
      integration of the appropriate regions of flow curves derived from a
      pneumotachograph placed between the bias flow tubing and the tracheal tube. At a
      driving pressure of 1 bar, lung minute ventilation increased with increasing
      ventilatory frequency, whilst tidal volumes decreased. The contribution of
      entrainment to tidal volume (Ve/VT) remained constant, although the volumes
      entrained were relatively small and varied widely from subject to subject.
      Blowback volumes were considerable, especially at ventilatory frequencies used
      clinically (1-2 Hz). We conclude that it is not possible to entrain predictable
      concentrations of volatile agents from the low pressure bias flow during HFJV.

PMID- 2223337
TI  - Plasma concentrations of methadone during postoperative patient-controlled
      extradural analgesia.
AB  - Plasma concentrations of methadone were measured by gas chromatography in 16
      patients receiving extradural methadone by continuous infusion for relief of
      postoperative pain. Venous blood samples were taken after a loading dose of
      extradural methadone 2 mg and during infusion of 0.46 mg h-1 plus patient
      controlled increments of 0.2-1 mg. Mean (SD) plasma concentration of methadone
      was 9.8 (2.1) ng ml-1 at 15 min; this did not change significantly during the
      first 2 h, after which it increased gradually to 32.2 (4.6) ng ml-1 (P less than
      0.001) at the end of 24 h. The mean quantity of extradural methadone required to
      produce effective analgesia was 10.3 (1.8) mg during the first 12 h after
      operation and 6 (1.0) mg for the subsequent 12 h. The mean amount of methadone
      for effective analgesia on the second day was 7.6 (1.1) mg. No adverse effects
      were detected during the 2-3 days of methadone therapy. Plasma concentration of
      methadone increased significantly during patient-controlled infusion of
      extradural methadone in the first 24 h after operation, suggesting rapid vascular
      uptake. Systemic activity of the drug contributes to the analgesic effect of
      extradural methadone.

PMID- 2223338
TI  - Effects of nitrous oxide on cerebral metabolic rate in rats anaesthetized with
      isoflurane.
AB  - It has been demonstrated in several species that a significant increase in
      cerebral blood flow (CBF) occurs when nitrous oxide is added to a volatile
      anaesthetic. This blood flow response could result from an increase in cerebral
      metabolic rate or from a direct effect of nitrous oxide on cerebral vessels. To
      investigate this, the cerebral metabolic rate for glucose (CMRglu) was determined
      autoradiographically in rats receiving isoflurane anaesthesia with or without
      nitrous oxide. An increase in anaesthetic depth from 0.5 to 1.0 MAC achieved with
      isoflurane alone caused a significant reduction in CMRglu (52 (SD11) mumol/100 g
      min-1 vs 39 (8)mumol/100 g min-1). In contrast, the addition of 70% nitrous oxide
      (0.5 MAC) to 0.5 MAC isoflurane anaesthesia (1 MAC total) left CMRglu unchanged
      (54 (4) mumol/100 g min-1). We conclude that 70% nitrous oxide does not alter
      cerebral metabolic rate when administered with 0.5 MAC isoflurane. Because CBF
      increases substantially under very similar conditions, our data indicate that the
      CBF effects of nitrous oxide, when administered with a volatile agent, were
      direct and mediated by factors other than changes in cerebral metabolic rate.

PMID- 2223339
TI  - IV lignocaine fails to attenuate the cardiovascular response to laryngoscopy and
      tracheal intubation.
AB  - I.v. lignocaine has been used with varying success to attenuate the
      cardiovascular responses to laryngoscopy and tracheal intubation. We determined
      the optimal time of administration in 45 ASA I and II Chinese patients
      premedicated with morphine and hyoscine, and anaesthetized with thiopentone and
      suxamethonium. Patients were allocated randomly to a control group or three
      treatment groups to receive lignocaine 1.5 mg kg-1 i.v. 1, 2, or 3 min before
      laryngoscopy. Analysis of variance for measured and derived cardiovascular
      variables failed to show any significant difference between any of the groups.

PMID- 2223340
TI  - Dose-dependent effect of metoclopramide on cholinesterases and suxamethonium
      metabolism.
AB  - In obstetric patients undergoing postpartum tubal ligation, we found that
      metoclopramide produced dose-dependent prolongation of suxamethonium-induced
      neuromuscular block. Mean block times after suxamethonium 1 mg kg-1 were 8.0 min,
      9.83 min and 12.45 min for control and metoclopramide 10 mg and metoclopramide 20
      mg groups, respectively. A laboratory study was therefore conducted on the
      inhibition of human plasma cholinesterase (PCHE) and erythrocyte
      acetylcholinesterase (ACHE) activity by varying concentrations of metoclopramide
      using acetylthiocholine as substrate. PCHE showed a greater sensitivity to
      inhibition by metoclopramide; the concentration of metoclopramide producing 50%
      inhibition of activity (I50) was 3.16 x 10(-7) mol litre-1, which is within the
      therapeutic range. ACHE was less sensitive to inhibition by metoclopramide (I50
      2.24 x 10(-5) mol litre-1). Analysis of enzyme kinetics at varying substrate
      concentrations revealed that metoclopramide produced a potent non-competitive,
      dose-dependent inhibition of both ACHE and PCHE. The inhibition constant, Ki, was
      1.88 x 10(-7) mol litre-1 for PCHE and 9.5 x 10(-8) mol litre-1 for ACHE. As
      metoclopramide is a potent inhibitor of PCHE, interactions might be expected to
      occur between metoclopramide and drugs that require PCHE for biotransformation,
      such as suxamethonium and ester local anaesthetics.

PMID- 2223341
TI  - Extradural, spinal or combined block for obstetric surgical anaesthesia.

PMID- 2223342
TI  - Spinal anaesthesia with hypobaric 0.19% or plain 0.5% bupivacaine.
AB  - Hypobaric 0.19% bupivacaine (plain 0.5% bupivacaine 3 ml + distilled water 5 ml)
      was compared with 0.5% plain bupivacaine 3 ml for spinal anaesthesia in 29
      healthy patients undergoing orthopaedic surgery of the lower extremities. The
      solutions were injected at the L3-4 interspace in 40 s, and patients were kept
      sitting for 2 min after injection. The mean maximal cephalad spread of sensory
      block was to the T1 segment (SD 3.6) and to T8 (4.1) in the hypobaric and plain
      bupivacaine groups, respectively (P less than 0.0001). The study was interrupted
      after observing the sensory block of the 29th patient (hypobaric bupivacaine)
      spread to C2 within 5 min of injection. In most patients, the hypobaric
      bupivacaine block affected the upper thoracic nerves, and in three patients the
      cervical nerves also. The high levels of block were accompanied by marked
      hypotension. The extensive spread of the blocks makes this hypobaric spinal
      anaesthesia technique unsuitable for routine use.

PMID- 2223343
TI  - Extradural anaesthesia in patients with previous lumbar spine surgery.
AB  - We studied prospectively 1381 patients undergoing extradural anaesthesia for
      total hip or total knee replacement, to determine if extradural anaesthesia can
      be performed reliably in patients who have had previous lumbar spine surgery.
      Fifty-two of the 57 patients (91.2%) who had undergone lumbar spine surgery
      received a successful extradural anaesthetic, and 1307 of 1324 patients without
      previous back surgery had successful extradural anaesthesia (98.7% success) (P
      less than 0.0001). No late complications were observed. Causes for failure of
      extradural anaesthesia in patients who had previously undergone lumbar spine
      surgery included technical difficulty (three) and inadequate spread (two).

PMID- 2223344
TI  - Double-blind comparison of topical lignocaine-prilocaine cream (EMLA) and
      lignocaine infiltration for arterial cannulation in adults.
AB  - In a double-blind, double-dummy study, the efficacy of topical 5% EMLA cream was
      compared with that of lignocaine infiltration in alleviating the pain of arterial
      cannulation. Forty unpremedicated adults were allocated randomly to four groups
      to receive EMLA cream alone, EMLA and 0.9% saline infiltration, EMLA and 1%
      lignocaine infiltration or placebo cream and 1% lignocaine infiltration.
      Following arterial cannulation, pain was assessed by the patient using a visual
      analogue score and by an independent observer using a four-category verbal rating
      score. Significantly lower pain scores were observed in all patients receiving
      EMLA compared with those receiving placebo cream and lignocaine infiltration by
      both patient (P less than 0.01) and observer (P less than 0.001) assessments.
      There were no significant differences between the three EMLA groups.

PMID- 2223345
TI  - Plasma concentrations of bupivacaine after stellate ganglion block using two
      volumes of 0.25% bupivacaine plain solution.
AB  - Plasma concentrations of bupivacaine were measured in patients after stellate
      ganglion block using either 10 or 20 ml of 0.25% plain solution. The mean peak
      concentrations were greater in the larger volume group, but this was not
      statistically significant. From 30 min after injection, there was a significantly
      greater plasma concentration in the larger volume group. The concentrations
      approached the limit of detection in the smaller volume group at 2 h after block.

PMID- 2223346
TI  - Comparison of four pulse oximeters: effects of venous occlusion and cold-induced
      peripheral vasoconstriction.
AB  - The ability of four pulse oximeters (the Ohmeda 3700, Nellcor N100 and N200 and
      the Datex Oscar) to detect hypoxaemia was determined in the presence of venous
      obstruction and cold-induced peripheral vasoconstriction. Significant increases
      in detection time for hypoxaemia were found in both cases. There were no
      significant differences in detection time between the instruments, although the
      Ohmeda 3700 displayed smaller values of SaO2 under certain conditions. Peripheral
      vasoconstriction was induced using three differing methods which gave differing
      results, thus emphasizing the importance of methodology in assessments of pulse
      oximetry.

PMID- 2223347
TI  - Critical volume for pulmonary acid aspiration: reappraisal in a primate model.
AB  - We have studied, in the monkey, the critical volume for the production of severe
      pneumonitis following pulmonary aspiration of gastric contents. Aspiration of 0.4
      ml kg-1 and 0.6 ml kg-1 at pH1 produced mild to moderate clinical and
      radiological changes, but no deaths. Aspiration of 0.8 ml kg-1 and 1.0 ml kg-1 at
      pH1 was associated with an increasingly severe pneumonitis. At 1.0 ml kg-1, 50%
      of the animals died--a mortality rate considerably less than that reported
      previously in animal studies. If these results were to be extrapolated to humans,
      the critical volume for severe aspiration could be increased from 25 ml to 50 ml
      (0.8 ml kg-1), considerably reducing the percentage of patients perceived to be
      "at risk".

PMID- 2223348
TI  - Site of action of fentanyl in inhibiting the pituitary-adrenal response to
      surgery in man.
AB  - To determine the site of action of fentanyl in attenuating the pituitary-adrenal
      response to surgery, we have measured serum concentrations of cortisol and growth
      hormone during and after a standardized surgical procedure in two groups of
      patients. One group received fentanyl 15 micrograms kg-1 i.v. immediately before
      the start of surgery; a second group received fentanyl 15 micrograms kg-1 i.v.
      together with corticotrophin releasing factor 100 micrograms i.v., growth hormone
      releasing hormone 100 micrograms i.v. and arginine vasopressin 10 units i.m. The
      concomitant administration of the releasing factors with the opioid resulted in a
      significantly greater serum concentration of cortisol 30, 60, 120 and 240 min
      after surgery commenced, compared with the group which received fentanyl alone.
      Similarly, the growth hormone response in the combined group was significantly
      greater than in the fentanyl-alone group 30 min after the start of surgery. We
      conclude that the inhibitory effect of fentanyl on surgically-induced secretion
      of pituitary hormone was mediated directly or indirectly via the hypothalamus.

PMID- 2223350
TI  - Rapidity and accuracy of tracheal intubation in a mannequin: comparison of the
      fibreoptic with the Bullard laryngoscope.
AB  - Successful tracheal intubation with the flexible fibreoptic bronchoscope requires
      a certain amount of skill which is acquired by practice. It has been suggested
      that the new Bullard laryngoscope may be mastered more easily. To determine if
      learning was superior with a flexible fibreoptic or the Bullard device, the ease
      of tracheal intubation with both devices was compared by first-year anaesthetic
      residents, using a mannequin modified to make intubation difficult. The Bullard
      laryngoscope was as easy to master as the flexible fibreoptic device, but passage
      of the tracheal tube took longer. Both devices require a similar amount of
      practice.

PMID- 2223349
TI  - Anaesthetic management of systemic mastocytosis.
AB  - Systemic mastocytosis is an uncommon disorder of mast cell proliferation in
      connective tissues. Mast cell degranulation may occur on exposure to various
      stimuli and drugs. The release of histamine, heparin and vasoactive substances
      such as prostaglandin D2 may cause severe hypotension and other anaphylactoid
      manifestations. Anaesthetic management should include perioperative stabilization
      of mast cells and avoidance of the use of histamine-releasing drugs. Intradermal
      skin testing is useful in predicting the sensitivity to drugs that may be used
      during anaesthesia. We present a patient with systemic mastocytosis who underwent
      uneventful cholecystectomy.

PMID- 2223351
TI  - Proceedings of the Anaesthetic Research Society. Southhampton, April 6-7, 1990.
      Abstracts.

PMID- 2223352
TI  - Subcutaneous flumazenil and recovery from midazolam.

PMID- 2223353
TI  - Organophosphorus insecticide poisoning.

PMID- 2223354
TI  - Blind nasal intubation--the only option.

PMID- 2223355
TI  - Spinal obstetric anesthesia with a 29-gauge needle.

PMID- 2223356
TI  - EMLA: complications.

PMID- 2223357
TI  - The Animals (Scientific Procedures) Act 1986 and research into anaesthesia.

PMID- 2223358
TI  - Quantitative EEG and brainstem auditory evoked potentials: comparison of
      isoflurane with halothane using the cerebral function analysing monitor.
AB  - We studied EEG and brainstem auditory evoked potentials (BAEP) during routine
      surgery at various concentrations of isoflurane (12 patients) or halothane (11
      patients) or during prolonged (mean 2.5 h, range 1.9-3.5 h) administration of 1%
      isoflurane (five patients). Recording and analysis was performed with the
      cerebral function analysing monitor (CFAM). At equivalent MAC, the two agents
      exhibited distinctive neurophysiological profiles. Increasing concentrations of
      isoflurane produced a clear sequence of EEG changes (decreasing fast and
      increasing slow components) then burst suppression activity suggesting cortical
      depression. With halothane, changes in EEG amplitude were less pronounced and
      those in frequency content less systematic, with no periods of suppression.
      Simultaneous BAEP showed greater latency increase with halothane than with
      isoflurane. Prolonged administration of 1% isoflurane was associated with a
      stable EEG (no periods of suppression) and BAEP.

PMID- 2223359
TI  - Isoflurane prevents EEG depression during trimetaphan-induced hypotension in man.
AB  - We have studied the EEG analysed with the cerebral function analysing monitor
      (CFAM) during trimetaphan (TMP)-induced hypotension to a mean arterial pressure
      (MAP) of 40 mm Hg in 20 normocapnic patients anaesthetized with either 1% end
      tidal isoflurane or 0.5% halothane. During the acute reduction in MAP, the
      average reduction in mean EEG amplitude with halothane was 14%, two patients
      showing short periods of EEG suppression; the decline in EEG amplitude correlated
      with declining MAP in four patients. In contrast, the average reduction in mean
      EEG amplitude with isoflurane was only 0.3% and there were neither periods of
      suppression nor any correlation between EEG amplitude and MAP. No significant
      changes in EEG frequency occurred in either group. Isoflurane prevented EEG
      amplitude depression during TMP-induced hypotension.

PMID- 2223360
TI  - Lower oesophageal contractility and detection of awareness during anaesthesia.
AB  - We have investigated the value of lower oesophageal contractility (LOC) in
      detecting awareness during anaesthesia in 20 human volunteer patients. LOC was
      measured either with subjects awake or after induction with propofol, during
      induction with propofol, and then as consciousness returned. Statistically
      significant changes were observed in the frequency of spontaneous contractions,
      peak and mean amplitude of spontaneous and provoked contractions, and the
      oesophageal contractility index as subjects lost consciousness and also as it was
      regained. The differences in LOC which occurred when subjects were conscious and
      unconscious support the view that LOC is related to the depth of anaesthesia, but
      its unreliability at the interface between consciousness and unconsciousness
      prevents selective detection of awareness, although the response in the presence
      of painful stimuli has not been tested.

PMID- 2223361
TI  - Extradural methadone and bupivacaine in labour.
AB  - We performed a double-blind placebo-controlled study of the effects of extradural
      administration of methadone 5 mg or saline, followed by bupivacaine, in 42 women
      in early labour. Motor block and pain scores were significantly less in the
      methadone group. The requirement for bupivacaine also was reduced by methadone,
      but this was not statistically significant. There were no troublesome side
      effects attributable to methadone.

PMID- 2223362
TI  - Plasma concentrations of the stereoisomers of prilocaine after administration of
      the racemate: implications for toxicity?
AB  - A chiral high pressure liquid chromatography method was developed to measure the
      separate isomers of prilocaine in plasma after administration of the racemate.
      The concentrations of the isomers in six patients were similar (S(+)/R(-) = 1.06
      (SD 0.06)) after brachial plexus block with 1.5% (RS)-prilocaine hydrochloride 35
      ml, suggesting that a higher systemic safety margin may not be achieved by
      substituting racemic prilocaine by one of its isomers. Much higher plasma
      concentrations of the S(+)- than the R(-)-form after oral administration of 300
      mg of the racemate (n = 4) indicated a large difference in intrinsic metabolic
      clearance of the isomers on first pass through gut, liver or both organs.

PMID- 2223363
TI  - Effect of different rates of infusion of propofol for induction of anaesthesia in
      elderly patients.
AB  - The effect of changing the rate of infusion of propofol for induction of
      anaesthesia was studied in 60 elderly patients. Propofol was administered at 300,
      600 or 1200 ml h-1 until loss of consciousness (as judged by loss of verbal
      contact with the patient) had been achieved. The duration of induction was
      significantly longer (P less than 0.001) with the slower infusion rates (104, 68
      and 51 s), but the total dose used was significantly less (P less than 0.001) in
      these patients (1.2, 1.6 and 2.5 mg kg-1, respectively). The decrease in systolic
      and diastolic arterial pressure was significantly less in the 300-ml h-1 group at
      the end of induction and immediately after induction (P less than 0.01). The
      incidence of apnoea was also significantly less in the slower infusion group.

PMID- 2223364
TI  - Cardiovascular effects of propofol and of thiopentone anaesthesia in the sheep.
AB  - We have examined the effects on the cardiovascular system and on regional blood
      flow of propofol and thiopentone when administered with IPPV (FIO2 0.4). A
      longitudinal study design was used in which 16 studies were performed in eight
      sheep for 30 min before, during the last 30 min of 70 min anaesthesia, and for 6
      h after anaesthesia. During anaesthesia with propofol and thiopentone, mean total
      body oxygen consumption decreased, respectively, by 47% (P less than 0.001) and
      24% (P less than 0.01) of pre-anaesthesia baseline values, mean heart rate
      increased by approximately 50% (P less than 0.05) with both agents, mean arterial
      pressures increased by approximately 50% (P less than 0.05) with both agents and
      the mean cardiac output was unaltered with propofol anaesthesia but was decreased
      by 20% (P less than 0.05) with thiopentone anaesthesia. The changes in arterial
      pressure and heart rate were unexpected and may have been a result of a species
      specific effect. Mean hepatic blood flow decreased consistently by a mean of 17%
      (P less than 0.01) during propofol anaesthesia, and inconsistently during
      thiopentone anaesthesia so that it was not significantly different from baseline
      values. Mean renal blood flow decreased during propofol anaesthesia by 7% (P less
      than 0.05) and by 27% (P less than 0.001) during thiopentone anaesthesia. Whereas
      most variables returned to baseline values within 2 h after propofol anaesthesia,
      this took 5 h after thiopentone anaesthesia.

PMID- 2223365
TI  - Effects of propofol and of thiopentone anaesthesia on the renal clearance of
      cefoxitin in the sheep.
AB  - We have examined the renal extraction ratios and clearances of cefoxitin in three
      groups of adult merino ewes. One group (n = 3) was studied for 12 h without
      perturbation; these were designated control studies. The other two groups (n = 4
      each) were studied before (baseline values), during and after the induction and
      70-min maintenance of anaesthesia with propofol or thiopentone. In the control
      studies, mean renal extraction ratio and clearance for cefoxitin were,
      respectively, 0.67-0.92 and 0.66-0.91 litre min-1 and were consistent throughout
      the entire study period in individual animals. Comparable values were obtained as
      baseline values in the anaesthesia groups. Compared with individual baseline
      values, blood concentrations of cefoxitin doubled during anaesthesia with each
      agent. At the same time, renal extraction ratio and clearance for cefoxitin each
      decreased significantly to about 50-60% of their control values. Recovery to
      control values of arterial blood concentrations and renal extraction ratio of
      cefoxitin took at least 5 h, but recovery of renal clearance was more rapid. The
      results indicate that renal elimination of an organic anion such as cefoxitin may
      be affected by changes in renal blood flow and in renal function produced by
      propofol and thiopentone; these effects may last for several hours after recovery
      of renal blood flow.

PMID- 2223366
TI  - Effects of propofol and of thiopentone anaesthesia on the regional kinetics of
      pethidine in the sheep.
AB  - We have examined the extraction ratios, net fluxes and clearances of pethidine by
      the liver, kidneys and hindquarters in sheep before, during and after continuous
      anaesthesia (70 min) with propofol or thiopentone. Before anaesthesia, the
      overall mean respective regional pethidine extraction ratios were 0.98 (SD 0.01),
      0.20 (0.06) and 0.44 (0.13), the corresponding net fluxes were 47 (7), 5 (2) and
      20 (10)% dose min-1 and the clearances 1.44 (0.22), 0.17 (0.07) and 0.80 (0.39)
      litre min-1. During propofol anaesthesia, arterial blood concentrations of
      pethidine approximately doubled (P less than 0.05), mean pethidine hepatic
      extraction ratio was unchanged, flux was increased to 145 (20)% and clearance
      decreased to 79 (10)% (P less than 0.05) of baseline values; mean pethidine renal
      extraction ratio, flux and clearance were 73 (34), 112 (43) and 69 (31)% of
      baseline values; mean hindquarter pethidine extraction ratio decreased to 65
      (25)% (P less than 0.05) of baseline values. During thiopentone anaesthesia,
      arterial blood concentrations of pethidine approximately doubled (P less than
      0.01), mean pethidine hepatic extraction ratio was 97 (2)% of baseline values and
      flux and clearance were unchanged, mean pethidine renal extraction ratios, flux
      and clearance decreased to 37 (21), 54 (18) and 27 (19)% (all P less than 0.05)
      of baseline values and mean pethidine hindquarter extraction ratio was 81 (20)%
      of baseline values. In spite of only modest changes in hepatic and renal blood
      flow during anaesthesia, blood concentrations of pethidine doubled and pethidine
      kinetics were disturbed for several hours after anaesthesia. Overall, however,
      the changes were of smaller magnitude and shorter duration than those that have
      been described for anaesthesia with the volatile anaesthetic agents.

PMID- 2223367
TI  - Effect of general anaesthesia on whole body protein turnover in patients
      undergoing elective surgery.
AB  - To determine if general anaesthesia alone or in conjunction with surgery alters
      body protein turnover, we studied six healthy, unpremedicated females undergoing
      elective total abdominal hysterectomy. Changes in protein metabolism, synthesis
      and breakdown were estimated by an isotope dilution technique using a continuous
      infusion of the stable isotope tracer, L-[1-13C]leucine, before anaesthesia (4
      h), during anaesthesia alone (1 h), during anaesthesia and surgery (1 h) and in
      the recovery period (2 h). General anaesthesia comprised thiopentone,
      pancuronium, enflurane (1 MAC) and oxygen-enriched air. An isotopic steady state
      in plasma 13C-alpha-ketoisocaproate (13C alpha-KIC) and expired 13C-carbon
      dioxide were obtained during the four periods. Collections of plasma and expired
      air were made during the steady state periods and plasma alpha-KIC enrichment
      measured to indicate precursor pool labelling from which leucine flux (equal to
      protein breakdown in the post-absorptive state) and oxidation were calculated,
      and whole body protein synthesis was derived. Whole body protein breakdown did
      not change with anaesthesia, but decreased with both surgery and during the acute
      recovery period (P less than 0.05). Protein synthesis did not change with
      anaesthesia and surgery, but decreased significantly after surgery (P less than
      0.05).

PMID- 2223368
TI  - Cerebral effects of sevoflurane in the dog: comparison with isoflurane and
      enflurane.
AB  - The cerebral effects of sevoflurane were compared in dogs with those of enflurane
      and isoflurane. Initially, the minimum alveolar concentrations (MAC) of
      sevoflurane and enflurane were determined and the electroencephalographic (EEG)
      responses to increasing doses of sevoflurane (1.5, 2.0 and 2.5 MAC) or enflurane
      (1.5 and 2.0 MAC) in unparalysed animals were examined. Administration of
      sevoflurane was not associated with seizure activity at any concentration either
      during normocapnia (PaCO2 5.3 kPa) or hypocapnia (PaCO2 2.7 kPa), even in the
      presence of intense auditory stimuli. All dogs anaesthetized with enflurane
      demonstrated sustained EEG and motor evidence of seizure activity induced by
      auditory stimuli at concentrations of enflurane greater than 1 MAC, particularly
      during hypocapnia. In a separate group of dogs, the effects of increasing
      concentrations of sevoflurane and isoflurane (0.5, 1.5 and 2.15 MAC) were
      compared directly on arterial pressure, cardiac output and heart rate, cerebral
      blood flow and the cerebral metabolic rate for oxygen (CMRO2) using the venous
      outflow technique. Sevoflurane, in common with isoflurane, had minimal effects on
      cerebral blood flow at the concentrations studied, but significantly reduced the
      CMRO2 at end-tidal concentrations sufficient to produce a burst suppression
      pattern on the EEG (approximately 2.15 MAC). Both sevoflurane and isoflurane
      significantly decreased arterial pressure in a dose-dependent manner, but neither
      drug significantly altered cardiac output.

PMID- 2223369
TI  - Failed tracheal intubation.

PMID- 2223370
TI  - Pupillary effects of alfentanil and morphine.
AB  - We have measured the onset and extent of the miotic effect of morphine and
      alfentanil in conscious patients. Forty unpremedicated ASA I and II patients were
      allocated randomly to four groups to receive either i.v. saline (control group),
      morphine 0.1 mg kg-1, alfentanil 4.0 micrograms kg-1 or a combination of these
      doses, and pupil diameters were measured for the next 30 min. There were no
      significant differences in the control diameters. In the opioid groups, a
      significant decrease in diameter (about 1 mm), occurred 4 min after
      administration of the drug and persisted throughout the study. The opioid groups
      behaved similarly for 25 min. After 10 min the mean diameter of the alfentanil
      group began to increase, but this did not reach statistical significance until
      after 25 min.

PMID- 2223371
TI  - Muscle relaxation rates in individuals susceptible to malignant hyperthermia.
AB  - Muscle relaxation rate following a tetanic stimulus of adductor pollicis muscle
      was measured prospectively in 26 patients potentially susceptible to malignant
      hyperthermia (MH) the day before a muscle biopsy was obtained for MH in vitro
      screening. Eleven subjects were found to be MH susceptible (MHS) and 15 subjects
      MH-negative (MHN). In all patients, relaxation rate was recorded at three
      different temperatures of the skin overlying adductor pollicis (30, 34 and 38
      degrees C) achieved by a small surface heating unit placed over the thenar
      eminence. The MHS group exhibited slightly higher relaxation rate at 34 and 38
      degrees C compared with the MHN group and this difference was accentuated with
      increasing temperature, but was not statistically different. The results of the
      present study suggest that relaxation rates are normal in MHS individuals under
      physiological conditions and cannot be used diagnostically for MH screening.

PMID- 2223372
TI  - Pivoting larynx--an unusual clinical observation at laryngoscopy.
AB  - Rigid oesophagoscopy was planned in the investigation of a young patient with
      dysphagia. During laryngoscopy for tracheal intubation an unusual pivoting
      manoeuvre was required to see the vocal cords. Although the initial diagnostic
      investigations were unhelpful, follow up directed at explaining the clinical
      observations led to an eventual diagnosis of anterior tubercles of C6, which
      explained the observation and accounted for the dysphagia.

PMID- 2223373
TI  - Prolonged paralysis following suxamethonium and the use of neostigmine.
AB  - A case of prolonged neuromuscular block following the administration of
      suxamethonium is reported. Three hours after administration of suxamethonium, a
      well defined, recovering phase II block was demonstrated with a T4:T1 ratio of
      0.25, and neostigmine was administered. Although the T4:T1 ratio was improved to
      0.9, T1 remained at 25% of control, and significant paralysis persisted which
      responded to administration of cholinesterase. It is concluded that neuromuscular
      monitoring cannot reliably predict reversibility in such cases and that, even
      after 3 h, antagonism of prolonged suxamethonium block should commence with
      cholinesterase, followed by neostigmine if necessary.

PMID- 2223374
TI  - Foam cuffed tracheal tubes: clinical and laboratory assessment.
AB  - The efficiency of a foam cuffed tracheal tube has been studied in protecting the
      pulmonary tree from aspiration of oropharyngeal and gastric contents. Following
      instillation of methylene blue dye above the cuff, subsequent fibreoptic
      bronchoscopy revealed no instance of dye staining of the tracheal mucosa. A
      "bench" study was undertaken subsequently to estimate the likely pressure that
      the cuff would exert on the tracheal mucosa as a result of elastic recoil
      properties of the foam. The results suggested that, under normal clinical
      conditions, the pressure is not likely to exceed a value at which impairment of
      the mucosal blood supply would occur.

PMID- 2223375
TI  - Axillary brachial plexus block: choice of technique?

PMID- 2223376
TI  - Body temperature and anaesthesia.

PMID- 2223377
TI  - Postoperative patient-controlled analgesia.

PMID- 2223378
TI  - The influence of age on N-isopropyl-p-[123I]iodoamphetamine accumulation in the
      human heart.
AB  - Variations in heart intensity in the 30 min and 4 hr chest images of the
      radiolabelled lipophilic amine, N-isopropyl-p-[123I]iodoamphetamine (123I-IMP)
      were observed in 130 patients with lung diseases, aged 23 to 85 yrs. The heart
      intensity had a significant positive linear correlation with age (r = 0.43 at 30
      min, 0.66 at 4 hr). The ratio of 4 hr heart intensity to 30 min heart intensity
      also had a positive linear correlation (r = 0.59), suggesting slower clearance of
      the radioactivity from the heart in older than in younger patients during this
      interval. Other parameters including sex, EKG findings, liver function, blood
      pressure, the presence of diabetes mellitus and smoking history had no
      relationship to heart intensity. A significant difference between heart
      intensities in bronchogenic carcinoma and pneumonia patient groups might be
      probably due to the age difference between the two groups. Therefore heart
      intensity in the 4 hr 123I-IMP image may reflect certain metabolic and/or
      myocardial change(s) with aging.

PMID- 2223379
TI  - Bone scanning in patients with pleural effusion--experience in 76 cases.
AB  - Seventy-six patients with malignant or benign pleural effusion were studied to
      determine the incidence of accumulation of 99mTc-MDP in relation to effusion, and
      reveal the mechanism. Of 76 patients, 46 (61%) were found to have diffuse uptake
      of 99mTc-MDP in the hemithorax, with almost the same positive rate in malignant
      and benign effusions, i.e. 62% and 57%, respectively. Of 46 patients, 32 (70%)
      showed diffuse, slight accumulation in the hemithorax, and the positive rate had
      a tendency to be higher with the increase in the effusion volume. We are
      convinced that the major mechanism of unilateral intrathoracic accumulation of
      99mTc-MDP in pleural effusion is a passive transudation.

PMID- 2223382
TI  - Topographic EEG study of visual display terminal (VDT) performance with special
      reference to frontal midline theta waves.
AB  - Operators of visual display terminals (VDT) often complain of physical, as well
      as psychological stress. Under certain circumstances, increased psychological
      stress among VDT operators is seen to create serious problems in their
      occupations, yet few studies have dealt directly with this problem. It is not
      clear how this should be measured and evaluated. We report the results of
      experiments where psychological stress was induced during VDT tasks such as
      visual search and computer mouse operations. The relationship between spatio
      temporal analysis of EEG activity and productivity of VDT work was investigated.
      The subjects were divided into three age groups: young adults (18-22 years old),
      middle-aged (38-42 years old) and the elderly (58 years and over). Characteristic
      EEG changes occurred during VDT tasks. These consisted of frontal midline theta
      waves with maximum amplitude at Fz. Statistically significant relationships were
      found between duration of working, EEG electrode location on the head, as well as
      correlations between work speed and variation of theta waves. It was concluded
      that some factors relating to the severity of a mental task and the distribution
      of cortical EEG potentials are closely related. When long lasting theta waves
      appear in the EEG, a rest period should be considered, before the subjects
      complain of fatigue. An effective method to optimally determine the duration of
      work and rest periods can be designed using the EEG.

PMID- 2223380
TI  - Evaluation of viral myocarditis in children by radionuclide method.
AB  - Evaluation of viral myocarditis is essential for the clinician to assess the
      prognosis. In this study, Tl-201 myocardial scintigraphy and Tc-99m gated cardiac
      blood pool scan were performed in 16 patients with myocarditis diagnosed by
      clinical symptoms and laboratory findings and these nuclear medicine techniques
      were followed up for 5 years. Exercise Tl-201 scintigraphy using a bicycle
      ergometer was performed in 8 patients by SPECT imaging. There were mild to severe
      persistent defects found in all cases (100%), but pressure rate products showed
      normal response. The Tl-201 defect ratio improved gradually, but did not change
      significantly. In the resting Tl-201 image one of 16 patients showed severe
      multifocal defects. LVEF increased significantly from 1 year to 5 years after
      onset, while RVEF measured by gated blood pool scans showed slight increases 3
      years to 5 years after diagnosis. It was concluded that myocardial perfusion
      improved only incompletely. Cardiac function (LVEF and RVEF) improved gradually,
      and pressure rate products were normal. Myocarditis should therefore be followed
      up in order to assess the prognosis; moreover, the relationship of myocarditis to
      dilated cardiomyopathy needs to be further studied.

PMID- 2223381
TI  - Radioimmunoscintigraphy of human pancreatic carcinoma xenografts in nude mice
      with 131I-labeled monoclonal antibody.
AB  - Encouraged by reports of radioimmunoimaging of colorectal carcinomas and by
      examining an immunohistochemical report on resected pancreas cancer tissues, we
      studied the diagnostic potential of radioimmunoimaging with the
      radioiodinelabeled monoclonal antibody to the surface antigen of a pancreas
      cancer cell line. A monoclonal antibody (MoAb; HC-1) to a human pancreas cancer
      cell line (HGC25)5 was labeled with radioiodine and injected into athymic nude
      mice implanted with human pancreas cancer cells. Antibody HC-1 was cleared from
      the circulation and accumulated significantly in the implanted tumor sites.

PMID- 2223383
TI  - A topographic study of differences in the P300 between introverts and extraverts.
AB  - This paper presents results of a study to establish a link between neurocognitive
      psychophysiological and psychological type data through the investigation of
      differences in topographic auditory event-related potential (AERP) (P300)
      patterns in strongly introverted (n = 17) and strongly extraverted ( = 16) high
      school males as identified by the Myers Briggs Type Indicator. Group data files
      were created for the auditory event related potential task and converted to ASCII
      form. Amplitude values were evaluated at each scalp site. Kruskal Wallis one way
      analysis of variance was performed to evaluate group differences. In processing
      of infrequent, target stimuli, the amplitude of the P300 waveform for introverts
      was higher than for extraverts. When processing for non-target stimuli was
      subtracted from target stimuli, statistical differences were found over nine
      central, parietal, and occipital sites. The findings support and extend theories
      of biologically-based and bio-psycho-social typology.

PMID- 2223384
TI  - Spatial patterns underlying population differences in the background EEG.
AB  - A method is described which can be used to extract common spatial patterns
      underlying the EEGs from two human populations. These spatial patterns account,
      in the least-squares sense, maximally for the variance in the EEGs from one
      population and minimally for the variance in the other population and therefore
      would seem to be optimal for quantitatively discriminating between the individual
      EEGs in the two populations. By using this method, it is suggested that the
      problems associated with the more common approach to discriminating EEGs,
      significance probability mapping, can be avoided. The method is tested using EEGs
      from a population of normal subjects and using the EEGs from a population of
      patients with neurologic disorders. The results in most cases are excellent and
      the misclassification which occurs in some cases is attributed to the
      nonhomogeneity of the patient population particularly. The advantages of the
      method for feature selection, for automatically classifying the clinical EEG, and
      with respect to the reference-free nature of the selected features are discussed.

PMID- 2223385
TI  - Comparison of conventional P3 determination with global field power in epilepsy
      patients.
AB  - The usefulness of global field power (GFP) determinations in assessing the
      cognitive event-related potential latency to an auditory "odd-ball"
      discrimination paradigm was explored in thirty epileptic patients. Relationships
      to measurements of intellectual and neuropsychologic test parameters were
      compared between conventional peak determinations and those obtained by GFP.
      Latencies as determined by GFP showed a greater number and more consistent
      relationships with neuropsychologic test measures than those obtained by
      conventional peak determinations. In some instances, GFP gave however also
      ambiguous results and the method cannot be substituted for conventional peak
      determinations, but must be used in conjunction in order to avoid spurious
      results.

PMID- 2223386
TI  - Advanced workshop on topographic EEG. Valle d'Aosta, Italy, September 7-10, 1989.
      Abstracts.

PMID- 2223387
TI  - Transforming collaborations between ras and nuclear oncogenes.
AB  - Nuclear proteins encoded by both cellular oncogenes and DNA tumor viruses enable
      activated ras oncogenes to transform a variety of cell types to a tumorigenic
      state. The interactions are complementary, suggesting that collaborating
      oncogenes release cells from controls that preclude transformation by ras alone.
      The nuclear oncoproteins bind both protein and nucleic acid targets and affect
      processes important in transcription and cell cycle control. Transforming
      collaborations between oncogenes provide a genetic context to study biochemical
      interactions involved in normal growth control and to identify mechanisms
      important in multistep carcinogenesis.

PMID- 2223389
TI  - Activation of programmed cell death by anticancer agents: cisplatin as a model
      system.
AB  - The anticancer drug cisplatin exerts its action as a consequence of interaction
      with DNA. Cell cycle progression facilitates sensitivity to the drug, but
      inhibition of DNA synthesis is not necessarily the critical step. Lethally
      damaged cells can progress to and arrest for several days in the G2 phase of the
      cell cycle before dying. Certain features of cisplatin-induced cell death, such
      as chromatin condensation and the activation of a DNA endonuclease, are
      reminiscent of apoptosis, or programmed cell death. Many other anticancer drugs
      produce the same phenotypic effects, suggesting that these agents may all
      interact with the same signal transduction pathway leading to cell death.

PMID- 2223388
TI  - The pS2 gene, mRNA, and protein: a potential marker for human breast cancer.
AB  - Approximately 50% of human breast tumors secrete a small cysteine-rich protein
      called pS2. In the human breast cancer cell line MCF-7, expression of the pS2
      protein is strongly induced by estrogen, and cloning and sequence analysis of the
      pS2 gene has revealed an "estrogen responsive element" in the gene's 5'-flanking
      region. The results of immunohistochemical assays and radioimmunoassays on breast
      cancer biopsies indicate that the pS2 protein is a marker for hormone-dependent
      breast tumors and that its expression is associated with longer overall, and
      disease-free, survival. The pS2 protein is also expressed in normal stomach
      mucosa and in regenerative tissues in ulcerative diseases of the gastrointestinal
      tract. Its physiological function is unknown.

PMID- 2223390
TI  - Transforming properties of the HTLV-I tax gene.

PMID- 2223391
TI  - Murine models for human chronic myelogenous leukemia.

PMID- 2223392
TI  - Antimetabolites.

PMID- 2223393
TI  - New anticancer agents.

PMID- 2223394
TI  - Monoclonal antibody therapy of cancer.

PMID- 2223395
TI  - Adoptive cellular therapy.

PMID- 2223396
TI  - Alkylating agents.

PMID- 2223398
TI  - Leukemias and myeloma.

PMID- 2223397
TI  - Clinical use of differentiating agents in cancer therapy.
AB  - Conceptually, the use of cytodifferentiation agents to suppress oncogenicity may
      prove most effective in long-term continuous treatment of patients whose tumors
      display some inherent expression of differentiated characteristics. This is the
      case in many pre-malignant lesions. The difficulty in evaluating the therapeutic
      role for HMBA, the retinoids, and cytosine arabinoside is oftentimes in
      separating in vivo cytotoxic from cytodifferentiation effects. Only with further
      studies will it be determined whether these and other cytodifferentiation agents
      are therapeutically useful and whether they can provide additional understanding
      of the processes of cellular transformation and differentiation with which they
      interact.

PMID- 2223399
TI  - Lymphomas.

PMID- 2223400
TI  - Treatment of acquired immunodeficiency syndrome.

PMID- 2223401
TI  - Head and neck cancer.

PMID- 2223403
TI  - Upper gastrointestinal tumors.

PMID- 2223402
TI  - Anthracyclines.
AB  - After twenty years, understanding the mechanisms of tumor cells kill by
      anthracyclines still remains an active area of research. Of many mechanisms
      described for this class of drugs, efforts in the last year have focused on
      defining the role of free radical formation, topoisomerase II-induced DNA
      breakage, and P-170-dependent cellular accumulation of anthracyclines in tumor
      cell kill and resistance. First, in a number of tumor cell lines, the formation
      of free radical species from anthracyclines has been implicated in the cell
      killing. Modulation of detoxification pathways in a drug-resistant cell line e.g
      depletion of GSH, a substrate for peroxidase and transferase, enhanced both the
      formation of oxy-radicals and adriamycin cytotoxicity. It should be noted,
      however, that these findings are not true for every cell line examined, and free
      radical-mediated tumor kill may be cell- or tissue-specific. Second,
      anthracyclines-mediated topo II-dependent DNA cleavage was observed in most cell
      lines and reduced breaks were found in resistant cells. The decrease in single
      strand breaks, however, neither correlated with the degree of resistance nor with
      differences in the relative topo II activity, which was in most cases only two
      fold less in resistant cells than in sensitive cells. Finally, the reduced
      accumulation of the drug does not appear to be the only contributing factor in
      multidrug resistant cells and P-170 is not the only protein overexpressed in
      certain cells, e.g., an 85,000 Da protein may also be linked to adriamycin
      resistance. Although GST protein is overexpressed in most adriamycin resistant
      cells along with mdr1 gene, current evidence suggests that this protein may not
      be directly involved in adriamycin resistance. Taken together, both the mechanism
      of action and resistance to this class of drug likely vary among cell lines.
      Clinical studies in the past year have brought about interesting refinements in
      anthracycline-containing chemotherapy; ICRF-187 (by itself also cytotoxic) seems
      to offer protection against cardiac toxicity, while implicating iron in the
      mediation of cardiac damage. Out of a large number of newer anthracycline
      derivatives, clinical evidence indicates only a modest increase in therapeutic
      index with a few analogs, perhaps idarubicin and epirubicin. It is not yet clear
      that being able to receive more milligrams (or more cycles) of anthracycline
      eventually translates into a significantly better response rate or in a survival
      advantage. Much less clear is whether patients refractory to adriamycin may
      derive any benefit from newer anthracyclines.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2223405
TI  - Breast cancer.
AB  - Numerous important issues in breast cancer were debated this past year. Several
      examples include: the role of screening mammography in women aged 40-49, the
      management of carcinoma in situ, adjuvant chemotherapy for postmenopausal node
      positive women, adjuvant therapy for node-negative women, the primary management
      of elderly women with breast cancer, the use of a composite of prognostic factors
      for better predictive power and measures to improve the therapeutic index of the
      anthracyclines.

PMID- 2223404
TI  - Endocrine tumors.

PMID- 2223406
TI  - Malignant melanoma.
AB  - The papers reviewed in this chapter emphasise the continued difficulties in
      making progress with the management of advanced malignant melanoma. Data is
      consistently accrued to confirm the relatively favourable prognosis of thin
      lesions and hence the importance of early detection and educational programmes to
      help patients to seek medical assistance when early changes appear. The papers on
      regional perfusion show some encouraging results but for systemic metastases,
      cytotoxic drugs show very little if any true benefit. Conversely, the increased
      interest in biological response modifiers does hold out some genuine promise of
      being able to influence the course of this unpredictable and refractory malignant
      disease.

PMID- 2223407
TI  - Soft tissue and bone sarcomas.

PMID- 2223408
TI  - Brain tumors.

PMID- 2223409
TI  - Biological effects and clinical applications of human colony-stimulating factors.

PMID- 2223410
TI  - Podophyllotoxin derivatives.

PMID- 2223411
TI  - Cisplatin.

PMID- 2223412
TI  - A graphical presentation of the results of crossover trials.
AB  - 1. Crossover designs are widely used in clinical trials. A graphical method of
      describing the data as well as visually indicating the extent of treatment *
      period interaction and overall treatment effect is presented. This plots the
      treatment differences between the periods for each individual against the mean of
      their treatment outcomes. It is recommended that this plot accompany the analysis
      of crossover trials in order to aid summary and interpretation especially for the
      non-statistician.

PMID- 2223413
TI  - Assessment of quality of life in the treatment of hypertension.

PMID- 2223414
TI  - The measurement of quality of life in hypertensive patients: a practical
      approach.

PMID- 2223415
TI  - A comparison of verapamil and nifedipine on quality of life.
AB  - 1. Aspects of quality of life (symptoms, psychological well-being and activity)
      were evaluated by self-administered questionnaires in a 4 month randomised double
      blind trial of titrated doses of verapamil slow release (n = 41) compared with
      nifedipine retard (n = 40). An untreated diastolic blood pressure of 95-115 mm Hg
      was required for inclusion in the trial. 2. 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). 3. 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). 4. 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- 2223416
TI  - Attenuation of the pupillary light reflex in anxious patients.
AB  - 1. The miotic responses evoked by brief light stimuli were compared between a
      group of 10 patients suffering from generalized anxiety disorder and 10 age- and
      sex-matched healthy control subjects. 2. Resting pupil diameter in the dark did
      not differ significantly between the two groups. 3. In both groups, the amplitude
      of the light reflex was linearly related to the logarithm of the intensity of the
      light stimulus; responses in the anxious patient group had consistently lower
      amplitudes than those in the control group. 4. In both groups, the time taken for
      75% recovery of the baseline pupil diameter following a light stimulus was
      linearly related to the logarithm of the light intensity; the 75% recovery times
      did not differ significantly between the two groups. 5. It is suggested that
      these results are consistent with a greater supranuclear inhibition of the
      parasympathetic oculomotor reflex arc in the anxious patients.

PMID- 2223417
TI  - The effect of miglitol and acarbose after an oral glucose load: a novel
      hypoglycaemic mechanism?
AB  - 1. Alpha-glucosidase inhibitors such as miglitol and acarbose lower blood glucose
      after a starch load in healthy volunteers and diabetic patients by interfering
      with the conversion of disaccharide to monosaccharide in the gastrointestinal
      tract. 2. The effect of placebo, 100 mg miglitol and 100 mg acarbose given 30 min
      prior to a 75 g oral glucose load was investigated in nine healthy Caucasian
      volunteers. 3. Miglitol produced a statistically significant fall in post-peak
      blood glucose levels when compared with placebo and acarbose. Serum insulin did
      not change significantly. 4. As miglitol is well absorbed and acarbose is not, it
      is suggested that miglitol has a systemic hypoglycaemic effect, probably related
      to its close structural similarity to glucose, which warrants further
      investigation.

PMID- 2223419
TI  - A correlation between severity of migraine and delayed gastric emptying measured
      by an epigastric impedance method.
AB  - 1. This study examined the ability of a bioimpedance method to detect the delay
      in gastric emptying which occurs during attacks of migraine. 2. In 64 non
      migraineur control patients and 46 migraine patients outside an attack, gastric
      emptying rates were within the predicted normal range. 3. In contrast, rates in
      14 migraineurs during 20 attacks were delayed during severe or moderate attacks
      and were significantly correlated with the intensity of headache, nausea and
      photophobia. 4. The epigastric impedance method was generally well tolerated by
      patients and appears to merit further investigation as a clinical method of
      monitoring gastric emptying of liquids.

PMID- 2223418
TI  - Comparative effects of quinine and quinidine on glucose metabolism in healthy
      volunteers.
AB  - 1. To investigate the relative effects of quinine and quinidine on glucose
      metabolism, 11 healthy males aged 17-32 years were given three separate 1 h
      intravenous infusions; normal saline alone, quinine dihydrochloride 10 mg base kg
      1 body weight (BW) in normal saline, and quinidine dihydrochloride 10 mg base kg
      1 BW in normal saline. A constant infusion of 5 mg glucose kg-1 ideal BW min-1
      was given for 1 h before and during each study. 2. Assessment of pancreatic beta
      cell function and tissue insulin sensitivity from plasma glucose and insulin
      concentrations at the end of the first hour using the Continuous Infusion of
      Glucose with Model Assessment (CIGMA) technique confirmed normal glucose
      tolerance for each subject on each test day. 3. Plasma glucose concentrations at
      1 h were similar to those at 2 h. There was no significant difference between the
      plasma glucose profiles during the three infusion regimes (P greater than 0.05).
      Plasma insulin rose significantly during the second hour (P less than 0.0001);
      increments after quinine (geometric mean [-1 s.d- +1 s.d.]; 47.0 [27.8-79.4] mu l
      1) were significantly greater than those after quinidine (19.8 [6.1-65.2] mu l-1)
      and saline (7.5 [0-21.5] mu l-1; P less than 0.05). Plasma quinine concentrations
      at the end of the infusion (6.5 +/- 4.4 mg l-1) correlated with insulin
      increments during the second hour (r = 0.662, P = 0.028) and were significantly
      greater than those of quinidine (3.0 +/- 0.8 mg l-1; P less than 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2223420
TI  - Bioactivation of dapsone to a cytotoxic metabolite: in vitro use of a novel two
      compartment system which contains human tissues.
AB  - 1. A two compartment system, comprising two adjacent teflon chambers separated by
      a semi-permeable membrane, has been devised with which to investigate the
      generation of drug metabolites that are toxic to human cells in vitro. 2.
      Compartment A contained a drug-metabolising system (human liver microsomes +/-
      NADPH) and compartment B contained target cells (human mononuclear leucocytes).
      The semi-permeable membrane retained protein (m.w. greater than 10,000) but
      allowed equilibration (within 1 h) of drug and drug metabolites, during which
      time cells remained viable. 3. Incubation of dapsone (100 microM) with human
      microsomal protein (2 mg ml-1) and NADPH (1 mM) in compartment A caused cell
      death (8.7 +/- 1.8%) in compartment B, which was reduced significantly (P less
      than 0.05) by the addition of glutathione (500 microM). Dapsone in the absence of
      NADPH was not cytotoxic. 4. Chemical analysis showed the presence of dapsone
      hydroxylamine as the only stable metabolite in both compartment A (5.2 +/- 0.4%
      incubated drug) and compartment B (3.5 +/- 0.5%). 5. Irreversible binding of
      dapsone to cells was significantly (P less than 0.05) reduced by omission of
      NADPH (85 +/- 13 pmol/10(6) cells) or addition of glutathione (103 +/- 9)
      compared with control values (153 +/- 51).

PMID- 2223421
TI  - Conjugation pathways in liver disease.
AB  - 1. The activities of microsomal glucuronyltransferase and thiomethyltransferase,
      and those of cytosolic sulphotransferase, acetyltransferase, glutathione
      transferase and thiomethyltransferase were measured in abnormal (cirrhosis and
      chronic hepatitis) and normal livers. 2. Glucuronyltransferase and
      sulphotransferase were investigated with 2-naphthol and ethinyloestradiol as
      substrates. p-Aminobenzoic acid, benzo(a)pyrene-4,5-epoxide and 2-mercaptoethanol
      were the substrates of acetyltransferase, glutathione transferase and
      thiomethyltransferase, respectively. 3. Enzyme activities are expressed as nmol
      min-1 incubation mg-1 protein and the averages (+/- s.d.) are given. With 2
      naphthol as substrate, the glucuronyltransferase activity was 6.55 +/- 4.10
      (abnormal liver, n = 33) and 7.81 +/- 4.02 (normal liver, n = 26) (NS); whereas
      sulphotransferase activity was 0.28 +/- 0.18 (abnormal liver, n = 35) and 0.68 +/
      0.43 (normal liver, n = 26) (P less than 0.01). Glucuronyltransferase activity
      towards ethinyloestradiol was 102.5 +/- 56.9 (abnormal liver, n = 30) and 107 +/-
      59.9 (normal liver, n = 26) (NS), whereas sulphotransferase activity was 57.2 +/-
      36.0 (abnormal liver, n = 35) and 122 +/- 67.6 (normal liver, n = 28) (P less
      than 0.01). Acetyltransferase activity was 0.84 +/- 0.83 (abnormal liver, n = 35)
      and 3.84 +/- 1.65 (normal liver, n = 26) (P less than 0.01). Glutathione
      transferase activity was 0.83 +/- 0.68 (abnormal liver, n = 35) and 2.90 +/- 1.59
      (normal liver, n = 25) (P less than 0.01) and thiomethyltransferase activity was
      1.00 +/- 0.69 (abnormal liver, n = 34) and 3.99 +/- 1.49 (normal liver, n = 25)
      (P less than 0.01). 4. Liver disease lowers the activities towards the substrates
      studied of sulphotransferase, acetyltransferase, glutathionetransferase and
      thiomethyltransferase but not that of glucuronyltransferase.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2223422
TI  - A comparison of a short half-life marker (low-dose isoniazid), a long half-life
      pharmacological indicator (low-dose phenobarbitone) and measurements of a
      controlled release 'therapeutic drug' (metoprolol, Metoros) in reflecting
      incomplete compliance by volunteers.
AB  - 1. Although, long half-life compounds appear to be more appropriate
      pharmacological indicators of compliance with treatment, short half-life markers
      or measurements of short half-life therapeutic drugs are frequently used. 2. We
      have compared the usefulness of low-dose phenobarbitone (a long half-life
      indicator), low dose isoniazid (a short half-life marker) and controlled release
      metoprolol (Metros) (a controlled release formulation of a short half-life
      'therapeutic' drug) in seven volunteers with simulated partial (two thirds)
      compliance. 3. Detection of isoniazid metabolites in urine had an 83% sensitivity
      and 94% specificity for detecting ingestion within the previous 24 h and 100%
      sensitivity and 82% specificity for detecting ingestion within the past 6 h but
      gave no indication of the longer term pattern of compliance. 4. At 28 days (a
      time when steady-state would be obtained for all three drugs) phenobarbitone
      plasma levels were 70% (66-76%)--median and interquartile range--of the expected
      steady-state level if compliance had been complete. Corresponding figures for
      metoprolol were 82% (37-100%). 5. Measurement of phenobarbitone was much superior
      to isoniazid or metoprolol measurements in reflecting partial compliance over the
      previous 1 to 4 weeks.

PMID- 2223423
TI  - A prospective study of cyclosporine concentration in relation to its therapeutic
      effect and toxicity after renal transplantation.
AB  - 1. Cyclosporine (CsA) concentrations in plasma and whole blood were monitored
      prospectively in 66 consecutive kidney transplant recipients for 6 months after
      transplantation or until graft loss. Immunosuppression was based on treatment
      with CsA and prednisolone in 27 patients and CsA, azathioprine and prednisolone
      in 39 patients. 2. Whole blood and plasma samples (separated at 37 degrees C)
      were collected 10-12 h after CsA dosage twice weekly over the first 3 months and
      thereafter once weekly. CsA concentrations were measured by high pressure liquid
      chromatography (h.p.l.c.) in plasma, by specific and non-specific monoclonal
      radioimmunoassays (r.i.a.) in whole blood, and by polyclonal r.i.a. and
      polyclonal fluorescence polarization immunoassay (f.p.i.a.) in whole blood and
      plasma. 3. There were no differences between the treatment schedules regarding
      graft or patient survival, occurrence of acute rejection, nephrotoxicity or
      infection. 4. CsA concentrations were significantly lower at the time of acute
      rejection than one week earlier based on all of the analytical methods used
      except f.p.i.a. 5. The lowest CsA concentration, recorded during the first month
      after transplantation, was significantly lower in patients with than in patients
      without experience of acute rejection episodes when the CsA concentrations were
      measured by polyclonal r.i.a. in whole blood and plasma and by specific and non
      specific monoclonal r.i.a. in whole blood, but not by h.p.l.c. in plasma or
      polyclonal f.p.i.a. in whole blood or plasma. 6. The highest CsA concentration
      recorded during the second post-transplantation month, was higher in patients
      with acute nephrotoxicity than in those without nephrotoxicity when CsA was
      measured by specific monoclonal r.i.a. in whole blood (471 +/- 409 ng ml-1 vs 327
      +/- 150 ng ml-1, P less than 0.05), but not by the other methods. 7. The mean
      plasma h.p.l.c. concentration of CsA measured by h.p.l.c. during the first month
      after transplantation was significantly higher in patients who suffered from
      systemic infection than in patients who did not (116 +/- 70 ng ml-1 vs 82 +/- 52
      ng ml-1; P less than 0.05). 8. Thus, significant relationships between CsA
      concentrations and clinical events were apparent using assay methods specific for
      CsA as well as using polyclonal r.i.a., but not using polyclonal f.p.i.a. When
      h.p.l.c. was used, however, plasma drug concentrations were often below the limit
      of determination. Our results suggest that specific analysis of CsA in whole
      blood allows the best distinction between patients who respond favourably and
      less favourably to treatment with CsA.

PMID- 2223424
TI  - Actions of zopiclone and carbamazepine, alone and in combination, on human
      skilled performance in laboratory and clinical tests.
AB  - 1. Possible interactions of zopiclone and carbamazepine on human skilled
      performance were studied in a randomized, double-blind, crossover trial with 12
      healthy young subjects. 2. Psychomotor performance (coordination, reactions,
      attention, cognition) and subjective effects (VAS) were measured and venous blood
      sampled before and 1.5, 3, 4.5 and 6 h after single oral doses of placebo, 7.5 mg
      of zopiclone and 600 mg of carbamazepine, which were given alone or combined.
      Clinical test for drunkenness (CTD) was done 2 and 5 h after drug intake. 3. Both
      zopiclone and carbamazepine, when administered alone, impaired performance on
      laboratory tests, the decrements being recorded 1.5 to 6 h after intake. In line
      with the plasma concentrations, the zopiclone effects peaked earlier (at 1.5 h)
      and lasted for a shorter time than those of carbamazepine. Zopiclone had a more
      pronounced effect on perceptual and cognitive functions (digit substitution) and
      it affected extraocular muscle tone (Maddox wing), whereas carbamazepine had
      stronger effects on attention. Additive pharmacodynamic actions were found in
      most tests after the combined treatment with zopiclone and carbamazepine. 4. CTD
      proved to be less sensitive than the laboratory tests in revealing drug-induced
      decrement of performance after administration of one agent alone. However, it
      revealed the combined decremental effects of zopiclone and carbamazepine. 5. When
      the drugs were given together, the absorption of drugs was retarded.
      Carbamazepine-10,11-epoxide levels were lower after intake of the drug
      combination than those measured after intake of carbamazepine alone. 6. The
      results suggest that the clinical tests developed to detect alcohol effects do
      not necessarily reveal drug-induced impairment of performance.

PMID- 2223425
TI  - Daytime wakefulness following a bedtime oral dose of zolpidem 20 mg,
      flunitrazepam 2 mg and placebo.
AB  - 1. The effects of zolpidem 20 mg, flunitrazepam 2 mg and placebo, administered at
      bed time, were studied in 12 healthy young male volunteers. 2. The assessments
      included, at awakening, subjective ratings of overnight sleep, cognitive
      function, psychomotor performance (digit symbol substitution, choice reaction
      time, flicker fusion threshold), subjective ratings of alertness, and plasma
      assay of residual drug concentration. Daytime sleep propensity during the day
      after dosing was evaluated with the multiple sleep latency test. 3. Compared with
      placebo, both active drugs improved subjective assessment of the ease of getting
      to sleep. At awakening, under flunitrazepam treatment, the reduction of
      performance, on memory and psychomotor tests, paralleled an increased subjective
      rating of sleepiness, but zolpidem treatment left subjects unimpaired compared
      with placebo. Similarly, daytime sleep propensity was enhanced throughout the
      following day under flunitrazepam treatment, but not under zolpidem treatment.
      Plasma assay for residual drug concentration at awakening found significant
      amounts of flunitrazepam and marginal amounts of zolpidem. 4. Results indicate
      that zolpidem 20 mg is devoid of residual effects in a range of tasks that were
      sensitive enough to demonstrate a prolonged wakefulness impairment following
      flunitrzepam 2 mg in healthy volunteers.

PMID- 2223428
TI  - The heart rate-PR interval relationship: a model for evaluating drug actions on
      SA and AV nodal function.
AB  - The relationship between heart rate (HR) and PR interval (PR) has been
      investigated to determine inter-subject variability, within-subject variability
      and potential reference standards. Eight healthy male volunteers underwent
      upright graded submaximal treadmill exercise during eight separate study
      sessions. All subjects exhibited statistically significant negative linear
      relationships between PR and HR. Although there was considerable inter-subject
      variability, there was little within-subject variability in the interpolated PR
      at HR between 80 and 120 beats min-1. The HR-PR regression model has greatest
      validity within this HR range and for individual subjects rather than pooled or
      group data.

PMID- 2223426
TI  - Induction of polymorphic 4'-hydroxylation of S-mephenytoin by rifampicin.
AB  - Studies were performed in 13 healthy subjects to determine whether treatment with
      rifampicin results in induction of the metabolism of mephenytoin. Daily dosing
      with 600 mg rifampicin for 22 days caused a three to eightfold increase in the 0
      8 h urinary R/S ratio of mephenytoin following oral administration (100 mg) of
      racemic drug to extensive metabolizers of the anticonvulsant. This was
      accompanied by a 40 to 180% increase in the 0-8 h urinary excretion of the 4'
      hydroxy metabolite. Four weeks after discontinuing rifampicin, both metabolic
      indices had returned to their baseline values. By contrast, rifampicin had no
      effect on either measures of metabolism in subjects of the poor metabolizer
      phenotype. Thus, it appears that the activity of the enzyme (P-450 MP) mediating
      the genetically determined 4'-hydroxylation of S-mephenytoin can be significantly
      modulated by enzyme inducing agents such as rifampicin and possibly environmental
      agents with a similar ability.

PMID- 2223427
TI  - Single-dose effects of ibopamine hydrochloride on renal function in patients with
      congestive heart failure.
AB  - To examine the renal effects of ibopamine HCl we evaluated 15 patients with New
      York Heart Association Class II-III congestive heart failure and mild renal
      insufficiency (creatinine clearance [CLcr] = 45-85 ml min-1). Diuretics and
      vasodilators were withheld and a sodium (Na+)-restricted diet was initiated. All
      patients exhibited positive Na+ balance at the time of evaluation. Hourly urine
      volumes, urine chemistries, serum chemistries, PAH and inulin/iothalamate
      clearances were determined 2 h pre and 4 h post a single 200 mg oral dose of
      ibopamine. Effective renal plasma flow, creatinine clearance, filtration
      fraction, and the fractional excretion of sodium and potassium were not
      significantly altered postdose. A significant increase in urine output and
      decrease in urine osmolality were seen at all time points postdose. A significant
      reduction in serum potassium (2 and 3 h) and blood urea nitrogen (1, 3 and 4 h)
      concentrations occurred. Measurements of glomerular filtration rate by inulin or
      [125I]-iothalamate produced differing results in the patient groups studied. We
      conclude that a single dose of ibopamine does not produce significant
      improvements in renal function in patients with congestive heart failure, mild
      renal insufficiency and positive sodium balance.

PMID- 2223429
TI  - Nitrendipine therapy in asthmatic subjects.
AB  - Nitrendipine was given to eight patients with chronic stable asthma prior to a
      histamine challenge study and compared in a double-blind cross-over fashion with
      placebo. There were no significant differences in either the bronchoconstrictor
      effects of histamine, or in oxygen saturation during the histamine challenges,
      suggesting that nitrendipine should be safely tolerated if used to treat
      hypertension in patients with airflow obstruction.

PMID- 2223431
TI  - Nicardipine does not influence the pharmacokinetics and pharmacodynamics of
      atenolol.

PMID- 2223430
TI  - Effect of activated charcoal on frusemide induced diuresis: a human class
      experiment for medical students.
AB  - We have introduced to the course in pharmacology for medical students a simple
      human experiment that demonstrates the efficacy of activated charcoal in
      gastrointestinal drug binding. Sixty-one students were given 40 mg frusemide with
      water, water only, or 40 mg frusemide and 8 g activated charcoal with water
      either immediately or after different time intervals. The diuretic effect of
      frusemide was totally prevented when taken together with charcoal, but became
      apparent gradually when charcoal was taken after a lag time. This experiment is
      simple to carry out and demonstrates vividly the treatment principles of acute
      intoxications.

PMID- 2223432
TI  - Calcium antagonists in the management of subarachnoid haemorrhage.
AB  - The development of delayed cerebral ischaemia and hence neurological deficit
      remains a serious problem following subarachnoid haemorrhage. Over recent years,
      attention has focussed on the use of the dihydropyridine class of calcium channel
      blocking agents ("calcium antagonists"), in particular nimodipine, as drug
      therapy in the prophylaxis and treatment of this condition. The theoretical basis
      for this is briefly discussed and then the clinical experience of the use of
      calcium antagonists following subarachnoid haemorrhage reviewed. In particular,
      attention is focussed on the randomised controlled trials that have eventually
      been able to show that such treatment is beneficial, both in terms of reduction
      of ischaemic deficit attributable to cerebral "vasospasm" and in clinical
      outcome, when given prophylactically, although not apparently therapeutically
      once deficit has developed. The evidence of the mode of action of calcium
      antagonists in this situation is discussed, again with particular reference to
      clinical data obtained in situ in the course of such trials. Although the
      mechanism of action remains unclear, it appears likely that it is at least in
      part due to the selective cerebral vasodilation induced by these compounds. The
      necessity for large well-controlled, prospective, randomised clinical trials in
      the assessment of therapeutic efficacy is stressed.

PMID- 2223433
TI  - Primary malignant bone tumors.

PMID- 2223434
TI  - Secondary bone tumors, myeloma, cryoglobulinemia, and paraproteinemias.

PMID- 2223435
TI  - Soft tissue tumors.

PMID- 2223436
TI  - Clinical disorders of vitamin D, renal osteodystrophy, and hypophosphatasia.

PMID- 2223437
TI  - Miscellaneous synovial lesions.

PMID- 2223438
TI  - Iatrogenic bone malignancy and pseudomalignancy.

PMID- 2223439
TI  - Hip surgery in adults.

PMID- 2223440
TI  - Surgical treatment of septic arthritis and infected prostheses.

PMID- 2223441
TI  - Knee surgery.

PMID- 2223442
TI  - Shoulder surgery.

PMID- 2223443
TI  - Elbow, wrist, and hand surgery.

PMID- 2223444
TI  - Surgical management of cervical spine instability.

PMID- 2223445
TI  - Surgical correction of severe forefoot deformities in rheumatoid arthritis.

PMID- 2223446
TI  - Scoliosis.

PMID- 2223447
TI  - Metabolic bone disease.

PMID- 2223449
TI  - Vasculitic syndromes.

PMID- 2223448
TI  - Parathyroid gland disease and hypercalcemia.

PMID- 2223450
TI  - Tumors of bones and joints.

PMID- 2223451
TI  - Orthopedic conditions and surgery.

PMID- 2223452
TI  - Avascular necrosis of bone.

PMID- 2223453
TI  - Collagen disorders and skeletal dysplasias.

PMID- 2223454
TI  - Osteoporosis.

PMID- 2223455
TI  - Fluorosis, osteopetrosis, and ectopic calcification.

PMID- 2223457
TI  - Giant cell arteritis.

PMID- 2223456
TI  - Wegener's granulomatosis and other systemic granulomatous conditions.

PMID- 2223458
TI  - Cutaneous vasculitis, hypersensitivity vasculitis, erythema nodosum, and pyoderma
      gangrenosum.

PMID- 2223459
TI  - Polychondritis and Behcet's disease.

PMID- 2223461
TI  - Paget's disease and fibrous dysplasia.

PMID- 2223460
TI  - Buerger's disease and inflammatory aspects of atherosclerosis.

PMID- 2223462
TI  - Kawasaki disease.

PMID- 2223463
TI  - Vasculitic syndromes associated with other rheumatic conditions and unclassified
      systemic vasculitis.

PMID- 2223464
TI  - Benign tumors of bone.

PMID- 2223465
TI  - [Surgical treatment of hydatid cysts of the hepatic dome ruptured into the
      thoracic cavity].
AB  - Two cases of hydatid cyst of the hepatic dome, complicated by rupture in the
      thoracic cavity, are reported. The Authors stress the frequency of human
      hydatidosis, still high in Italy, and the severity of the above mentioned
      complication. Surgical treatment is also discussed.

PMID- 2223466
TI  - [Autologous dermal graft in the treatment of hernia of the abdominal wall. A
      clinical contribution].
AB  - The A.A. after reporting the different methods of treatment of the abdomen wall
      herniation relate about the advantages of autologous dermis graft. Pointing out
      their experience they conclude that dermis for its perfect tolerability and
      absence of complications gives considerable probabilities of success.

PMID- 2223467
TI  - [Postoperative hypo-osmolar coma: presentation of a clinical case].

PMID- 2223468
TI  - [Villous adenoma of the rectum. Review of the literature and personal
      experience].
AB  - Potential malignancy of rectal villous adenomas is referred as varying from 20 to
      30%; an appropriate surgical excision is required in order to insure an effective
      cancer prophylaxis and to improve the accuracy of the pathologic assessment. The
      Authors review their series concerning 15 patients with one or more polyps of
      villous type, located at the lower third of the rectum and with precise
      indications for transanal excision. In 13 cases histology demonstrated the
      presence of an adenoma with different grade of dysplasia, which simply entered a
      follow-up together with a case of an adenoma with carcinoma in situ. The latter,
      because of the presence of invasive carcinoma, underwent radical surgery. No
      postoperative morbidity was observed. Recurrence rate was 8%. After an accurate
      review of the Literature, a radical management of the rectal villous tumour
      performed on routine basis seems unjustified. The Authors suggest the indication
      for a modern proceeding.

PMID- 2223469
TI  - [Angiodysplasia of the colon].
AB  - The Authors report their experience with a case of angiodysplasia of the colon.
      It is outlined how these lesions can be demonstrated by angiography and
      colonoscopy. The pathophysiology, diagnosis and management are discussed as well.

PMID- 2223470
TI  - [PTC with percutaneous biliary drainage in obstructive jaundice. Considerations
      on the diagnostic validity and reducing of surgical morbidity and mortality].
AB  - Indications, diagnostic validity, and effective reduction of surgical mortality
      and morbidity of the PTC with PTBD in obstructive jaundice are evaluated. A brief
      note on the existing controversy in this particular field introduces to the
      Author's personal opinion based on a small series of 13 cases treated from April
      '87 to January '89.

PMID- 2223471
TI  - [Integrated anastomosis using the Knight and Griffen technique].
AB  - The widespread use of mechanical staplers in gastrointestinal surgery has
      recently resulted in a simpler and faster operative technique. The double-stapled
      anastomosis (Knight and Griffen, 1980) seems to further simplify the technique of
      colo-rectal anastomosis, with reduced risks of pelvic contamination. Moreover,
      this technique can be used to reconstitute bowel continuity following an
      Hartmann's procedure or to perform an ileo-rectal anastomosis. The results
      obtained in 21 patients treated by this technique are presently reported.

PMID- 2223472
TI  - [Use of mechanical staplers in surgical therapy of morbid obesity].
AB  - The Author reports the experience of the III Surgical Department of the
      University of Milan on stapling devices in bariatric surgery. The use of stapling
      devices is now almost irreplaceable for some surgical interventions like
      gastroplasty, jejuno-ileal bypass, and intestinal bypass revision because
      staplers simplify and shorten operating procedures, also reducing surgical risk.

PMID- 2223473
TI  - [Use of a new compression circular mechanical stapler in surgery of the large
      intestine].
AB  - Clinical application in surgery of the large bowel of a compression anastomotic
      device developed by the Authors is described. The device consists of three
      plastic rings carried by an instrument that assembles the rings while the bowel
      is being joined. The rings remain by the anastomotic site until complete healing
      of anastomosis, then fall into the intestinal lumen and are evacuated with the
      feces. Sixty-nine patients underwent large bowel anastomosis using this device in
      our department from May 1986 through June 1989. Forty percent of the anastomoses
      were located at less than 8 cm from the anal verge. Five intraoperative diverting
      colostomies were performed (7.2%). The rings were evacuated in average 11 days
      after the operation, with no or very little discomfort. Operative mortality was
      1.4% (one patient died of myocardial infarction). Anastomotic complications were:
      two (2.8%) clinical and two (2.8%) subclinical dehiscences. This initial clinical
      experience shows that the anastomotic device is reliable.

PMID- 2223475
TI  - [A bladder tube construction using a stapler with absorbable stitches (Poly CS
      57)].
AB  - A new technique for the construction of a bladder tube, using a Poly CS-57
      stapler, has been tested on six pigs. With this procedure the operative time is
      shortened without complications. In fact, no crystal formation, dehiscence or
      infection was observed during a 3 month follow-up.

PMID- 2223474
TI  - [Stapling techniques in exeresis surgery of bronchogenic carcinoma].
AB  - From January 1983 to October 1989, 221 bronchogenic carcinomas were surgically
      treated at our Department. Different stapling techniques were employed in 153
      cases: 138 stapled sutures of main and lobar bronchi, 33 stapled parenchymal
      sutures and 21 stapled sutures of the pulmonary artery. Stapling-related
      complications were observed in 3 patients: 1 bronchopleural post-pneumonectomy
      fistula (0.72%); 2 persisting air leakages following stapled parenchymal suture
      (6%). The use of vascular staplers, though, has never been associated with
      complications. The advantages related to the use of stapling devices are
      represented by lower air leakage and bleeding rates, with a reduced operative
      trauma; on the other hand, disadvantages seem to be more theoretical than
      realistic. At our Department stapling devices nowadays represent the choice in
      thoracic surgery either for main and lobar bronchi or parenchymal sutures.

PMID- 2223477
TI  - [Comparison of manual and mechanical anastomosis in colorectal surgery].
AB  - Between 1981 and 1989, 494 patients had anastomosis involving the colon or rectum
      (233 ileo-colonic, 156 colo-colonic, 96 colo-rectal and 9 ileo-rectal) in our
      Institute. 383 patients had manual anastomosis (Group 1), 111 patients had
      stapled anastomosis (Group 2). There was no statistically significant difference
      when comparing major anastomotic complications, reoperations and operative
      mortality of stapled and manual anastomoses. In group 1 a significant increase in
      complication was related to the presence of obstruction (p. less than 0.01), and
      to emergency surgery (p less than 0.01). In Group 2 malnutrition had a
      significant effect on anastomotic complications (p less than 0.01). Therefore,
      colonic obstruction, emergency surgery and malnutrition have a significant role
      in anastomotic complications, and particular care should be taken when these
      factors are present.

PMID- 2223476
TI  - [Digestive reconstruction using mechanical staplers after total gastrectomy].
AB  - From 1980 up to nowadays, after total gastrectomy for gastric cancer, the
      intestinal continuity was assured by oesophago-jejunostomy and oesophago
      duodenoplasty using stapling devices. Two patients died for causes not related to
      the technique, and other two patients developed a stenosis of the oesophago
      jejunostomy, which was easily managed by endoscopic dilatation. In one patient a
      partial dehiscence of the oesophago-jejuno-anastomosis was treated by total
      parenteral nutrition. The Authors have systematically adopted mechanical sutures
      after total gastrectomy. However, possible intraoperative accidents and
      complications should not be underestimated, although most of them may be due to
      the operator's inexperience or stapler misuse.

PMID- 2223479
TI  - [Mechanical duodenopancreatectomy].
AB  - Pancreaticoduodenectomy with stapler devices is presented. Three patients
      affected by pancreatic malignant neoplasm were successfully treated, and the
      technique used is here reported.

PMID- 2223478
TI  - [Manual versus mechanical sutures in gastric surgery in cancer].
AB  - The Authors, on the basis of their experience in San Camillo Hospital of Rome,
      compare the results between manual and mechanical sutures in 597 gastric cancers
      operated in the last 12 years. They confirm that at present staplers are of great
      reliability.

PMID- 2223480
TI  - [Mechanical anastomosis without purse-string suture in esophageal surgery].
AB  - A new surgical procedure for oesophago-enterostomy using staplers without purse
      string suture is described. This technique is possible only using the CEEAP
      stapler, thanks to its new technical features.

PMID- 2223481
TI  - [Mechanical staplers in resective surgery of the pancreas].
AB  - In this study 8 pancreatic resections were performed using the Autosuture
      stapler. No fistula developed among 5 cases of distal pancreatectomy, conversely
      2 pancreatic fistula occurred in 3 cases of pancreaticoduodenectomy; one patient
      died for fistula. It is concluded that distal pancreatectomy with staplers is a
      reasonable and safe alternative to pancreaticojejunostomy, and may be preferred
      because of its facility and rapidity. Staple closure of the transected pancreas
      in pancreaticoduodenectomy doesn't seem to be so safe and further evaluation is
      needed.

PMID- 2223483
TI  - [Mechanical staplers in exeresis surgery of pulmonary cancer].
AB  - Surgical stapling devices are widespread in many branches of surgery and are
      employed with success in thoracic surgery. Our experience is in line with that of
      other Authors: stapling of the bronchus is faster, does not contaminate the
      operative field and reduces the incidence of bronchopleural fistulas (4.76% to
      1.59%). Parenchymal stapling is indicated for resection of bullae, metastases and
      peripheral lesions. The mechanical suture is air-tight and faster than manual
      suture. Pulmonary vessels may also be closed mechanically; however, we do not
      advocate the use of stapling devices especially in the closure of the pulmonary
      artery.

PMID- 2223482
TI  - [100 cases of bronchial mechanical sutures].
AB  - The Authors report their experience with stapler model T.A. 30 in lung
      resections; 100 stapled sutures were carried out in the IV Surgical Department of
      the University "La Sapienza" of Rome, during the period 1980-88. The use of
      stapler with two rows of staples allows a secure closure of the bronchial stump.
      Moreover, it prevents granulomas caused by suture material. The bronchopleural
      fistulas, serious complications of manual suturing, did not occur. Finally, this
      method is simpler and rapidly feasible in comparison with classic ones.

PMID- 2223484
TI  - [In vitro study of Staphylococcus epidermidis adhesiveness to suture materials].
AB  - In surgical divisions, where you can find the highest percentage of hospital
      infections, the surgical wounds are definitively the most frequent localization.
      The aim of our study was to evaluate whether bacterial-biomaterial interactions
      could influence the growth of infections in sutured tissues. We prepared a method
      for in vitro bacterial adhesiveness testing based on turbidimetric analysis. The
      results obtained show a different grade of bacterial adhesion in relation to
      physical and chemical characteristics of the material examined.

PMID- 2223485
TI  - [Influence of suture materials on cell viability: a comparative experimental
      study].
AB  - Among the conditions that a material must satisfy to be considered biocompatible,
      most important is the non negative influence on the cellular viability of the
      surrounding tissue (cytocompatibility). The aim of our work was to evaluate in
      vitro, whether different types of materials (usually used in surgery), alter the
      viability parameters or the morphological characteristics of the cultured cells
      in contact with them.

PMID- 2223486
TI  - [Gastroduodenal surgery using mechanical staplers: our experience].
AB  - Results of 71 operations of the gastroduodenal tract performed with stapling
      devices are reported (51 for malignant diseases and 20 for benign diseases). 20
      total gastrectomies, 21 Billroth II gastrectomies, 17 Roux en-Y
      gastrojejunoplasty, 6 Billroth II to Roux-ex-Y-conversion and 7 palliative
      gastroenteroanastomosis were performed, using TA, GIA and EEA stapling
      instruments. The analysis of the reported data brought us to some considerations
      regarding the safety and versatility of mechanical viscerosynthesis, also in
      relation to some technical aspects.

PMID- 2223487
TI  - [J-reservoir in the treatment of ulcero-hemorrhagic rectocolitis].
AB  - The Authors report their experience on ileal-anal anastomosis with a J-pouch. A
      videotape illustrates the surgical technique. At last functional results are
      shown.

PMID- 2223488
TI  - [Malfunctioning of linear staplers as a cause of gastro-gastric fistula in
      vertical gastroplasty].
AB  - The Authors reviewed their series of patients submitted to VBG in order to
      investigate the rate and cause of gastric partition disruption. This complication
      was found only in patients who had the gastric partition done by means of a
      double application of TA-90. No gastric partition disruption was found in those
      patients in which TA-90-B was used. The partition breakdown might be due to
      occasionally defective closure mechanism in the traditional staplers.

PMID- 2223489
TI  - [The duodenal "Y" proximal jejunostomy: the reason of a new reconstructive choice
      after gastric surgery].
AB  - The Author reports a new reconstructive technique after gastric surgery pointing
      out its advantages confirmed by few clinical cases. Some technical improvements
      are suggested.

PMID- 2223490
TI  - [Use of fibrin glue in the treatment of entero-cutaneous fistulas].
AB  - The Authors present methods and results of the treatment of chronic fistulas
      complicating abdominal surgery in 5 patients. The use of human fibrin glue is
      described and its therapeutical usefulness is pointed out.

PMID- 2223491
TI  - [Automatic sutures in bronchopulmonary surgery].
AB  - Efficacy of automatic staplers in broncho-pulmonary surgery was evaluated in a
      series of 316 consecutive patients. The results confirm that utilization of
      staplers has drastically reduced the incidence of post-resection bronchial
      fistulae; moreover on parenchymal tissue such instruments guarantee excellent
      haemostasis and air tightness. On the contrary, indications for their use on
      pulmonary vessels seem to be very limited.

PMID- 2223492
TI  - [Our experience in the use of mechanical staplers in the execution of step-by
      step subtotal gastrectomy].
AB  - The Authors describe their reconstruction technique after a "step" gastric
      resection for peptic or neoplastic pathology. The use of staplers such as TA 30
      or GIA for the duodenum is reported. After skeletonizing the lesser curve up to
      the cardias by sectioning the left gastric artery at its origin and up to the
      penultimate short vessel on the greater curve, the stomach is resected distally
      to this two points using a TA90 staplers. So it is possible to remove the greater
      part of the acid-secreting area in order to avoid ulcers of the anastomosis or of
      the gastric stump, and also to achieve a complete lymphadenectomy in case of
      neoplasm. Then a Roux-en-Y gastro-jejunal anastomosis is performed using an EEA28
      circular stapler. The jejunal stump is closed with a TA30. Finally, a manual
      jejuno-jejunal anastomosis is made at least at 50 cm from the previous one. From
      November 1987 to January 1989, 13 patients were operated: 9 for peptic ulcer and
      4 for antrum neoplasms. There were no complications during and after the
      operations. Mortality was 0%. The patient, usually starts eating on the 6th or
      7th day after operation, and is discharged on the 10th day. After 6 months an EGD
      scopy is required: the 8 performed till now have demonstrated excellent
      anastomosis and no peptic lesions. Scintigraphic evaluations and pH monitoring
      are still in course to define the gastric stump acid secretion and the absence of
      biliary reflux.

PMID- 2223493
TI  - [Use of mechanical staplers in gastric resection].

PMID- 2223494
TI  - [Mechanical staplers. Our experience].
AB  - The Authors report their experience concerning 237 stapled sutures performed
      during 93 gastro-intestinal operations. Intraoperative technical advantages are
      described and improved postoperative courses are outlined; in particular earlier
      recovery of intestinal function, minimal rate of complications and 11-day average
      post-operative stay are reported.

PMID- 2223495
TI  - [Definite colostomy using a circular stapler: a technique to be reconsidered].
AB  - Personal experience on a particular utilization of circular stapler is reported.
      At the beginning the fast and easy execution emphasized its use. However, the
      constant appearance of a late complication was observed, i.e. the progressive
      stenosis of the stoma. This event occurred even when maximal size of the
      instrument was used and it reappeared after repeated procedures of instrumental
      or surgical dilatation. The effective validity of this technique was evaluated by
      the Authors. On the other hand, the Burk alternative technique, with a second
      purse-string on the cutaneous ring seems to prevent the stenosis. However, it is
      slow and difficult as traditional procedure. The causes of the neostoma stenosis
      performed by circular stapler, reported by the Authors in 100% of cases, are
      easily explained with the absence of biological barrier of colonic mucosa that
      normally prevents excessive tissue growth.

PMID- 2223496
TI  - [Slowly reabsorbable suture threads in arterial microsurgery].
AB  - Authors present the results of an experimental research to evaluate the
      effectiveness of a slow resorbable suture (Polyglactyn 910) in arterial
      microsurgery. Healing of vascular wall, histologically evaluated, showed good
      reliability, compared to other suture materials.

PMID- 2223497
TI  - [Staplers in bladder sutures].
AB  - Staplers are still little used for suturing a cystotomy. The basic reason for
      this reluctance is the inadvisability of using non-absorbable material in the
      lumen of the urinary tract, as this may be the nucleus for the formation of
      stones. It must be remembered, however, that a correct suture of a cystotomy
      should be carried out in two layers: one internal mucous layer, consisting of a
      continuous suture of absorbable material, and a more superficial suture of the
      margins of the vesical detrusor. The latter can be performed with a linear
      stapler, as it is completely outside the mucous layer. More recently, linear
      staplers with absorbable staples have appeared on the market, by which cystotomy
      sutures can be performed in a single layer.

PMID- 2223498
TI  - [Continent pre-peritoneal uretero-ileostomy with a hydraulic valve. A personal
      technique].
AB  - A continent ileal reservoir has been realized. The reservoir is placed outside
      the peritoneum, in a pre-peritoneal position, in order to allow its fixation by
      adhesions to the abdominal wall. Furthermore, a Benchekroun's hydraulic valve,
      adopted as a continent mechanism, is placed distant from the reservoir, by means
      of a long anti-peristaltic ileal loop, which further prevents the effects of the
      reservoir enlargement. The reservoir is made up using 40 cm of detubulized ileum;
      on the afferent loop (10 cm long) the right ureter is implanted according to the
      Camey-Le Duc technique, on the efferent loop (25 cm long) the left ureter is
      implanted according to the same technique. The remaining 15 cm of the ileum are
      used to realize a Benchekroun's hydraulic valve which is exteriorized by means of
      a skin stoma, placed on the left abdominal wall. With this technique, 18 patients
      have been operated; the follow-up period is 3 years for the first cases.

PMID- 2223499
TI  - [Mechanical staplers in our surgical practice].
AB  - On the basis of our experience from 1981 to 1989, advantages of staplers in
      digestive surgery are reported. Complications such as bleeding and stenosis are
      not clinically important, however, in most cases, they can be avoided if the
      instruments are properly used.

PMID- 2223500
TI  - [Personal experience in the area of colorectal anastomoses without protective
      colostomy].
AB  - The Authors report their past 3-year-experience in colorectal anastomosis without
      protective colostomy. General results in terms of complications and mortality
      rates are similar if not even better than those referred by the international
      Literature.

PMID- 2223501
TI  - [Esophagogastric anastomosis at the inferior cricoid margin].
AB  - In esophageal resections, esophagogastric anastomosis can be performed either at
      cervical or intrathoracic level. A recent paper showed a greater incidence of
      postoperative leakages in cervical vs. intrathoracic anastomosis (26% vs. 4%). In
      the present paper we describe 55 cases of esophagectomy with a modified technique
      of cervical stapled anastomosis, where the incidence of fistula was 5%.

PMID- 2223502
TI  - [French Association of Viscero-Synthesis: history].

PMID- 2223503
TI  - [Realities and prospects of viscero-synthesis].

PMID- 2223504
TI  - [Critical considerations on circular staplers].
AB  - After a careful review of the literature and a critical evaluation of personal
      experience on stapling technics in visceral anastomoses, some critical
      considerations on circular devices are reported. The Authors emphasize the well
      known qualities of staplers which brought to their routine use in digestive
      surgery. Some complications exclusively due to an "imperfect" firing of the
      instrument are then reported. Personal experience on a particular utilization of
      circular stapler for definitive colostomy is also reported. The Authors finally
      suggest some simple technical improvements.

PMID- 2223505
TI  - [Education (university training in mechanical sutures)].
AB  - The advances in surgical sciences and their evolution, besides the increasing
      number of surgical residents and the low availability of the operating-rooms,
      have made clear the limits of the usual teaching methods and of the integrative
      theoretical learning instruments. The teaching of viscero-synthesis, particularly
      mechanical suture training, emphasizes such problems and encourages the
      development of additional training programmes, including simulation, before the
      admittance to operative procedures.

PMID- 2223506
TI  - [Experiences with mechanical staplers: hemorrhoidectomy using a circular
      stapler].

PMID- 2223507
TI  - [Esophagojejunal anastomosis after total gastrectomy].
AB  - The Authors discuss the technical criteria of digestive reconstruction after
      total gastrectomy for gastric cancer. Usually they employ stapling devices which
      are easy and quick to use and give good technical results. Performing a Roux-en-Y
      with an end-to-side esophagojejunostomy a circular device is preferred and a
      linear cutter for a side-to-side jejunojejunal anastomosis is used. Alternatively
      the jejunojejunal anastomosis may be performed with a circular and a linear
      stapler. Between 1970 and 1989, out of 160 total gastrectomies for cancer, 2
      dehiscences were recorded in 103 mechanical anastomosis and none out of 57 manual
      anastomosis (p: n.s.); stenosis was observed in 2 cases after mechanical
      esophagojejunostomy and in none after manual anastomosis.

PMID- 2223508
TI  - [Experimental microsurgery: the main technical bases for research].

PMID- 2223509
TI  - Veno-venous bypass in experimental liver transplantation: portal-jugular versus
      caval-portal-jugular.
AB  - This study was undertaken to compare the changes in physiologic variables caused
      by the use of two different types of pump-assisted veno-venous bypass during
      experimental liver transplantation. The experiments, performed on female pigs
      weighing 30 +/- 2 kg, were divided into two groups depending on the bypass used.
      During the anhepatic phase a pump-assisted portal-jugular (PJ) bypass was used in
      Group 1 (n = 8) at a flow rate of 15 ml kg-1-min-1, while a pump-assisted caval
      portal-jugular (CPJ) bypass was used in Group 2 (n = 8) at a flow rate of 20 ml
      kg-1-min-1. Intraoperative haemodynamics, pulmonary gas exchange, haematological
      and serum biochemical parameters were evaluated. Postoperative animal survival
      rate and complications associated with the bypass used were evaluated. Mean
      pulmonary artery pressure (Ppa) and pulmonary vascular resistance (Pvr) showed
      significantly different behaviour in the two groups, whereas the remaining
      parameters all showed the same trend. Thus an earlier and more substantial
      increase in Ppa and Pvr values was found in Group 1 when compared to Group 2
      during the anhepatic phase. The different behaviour shown by Group 1 may depend
      on the release of circulating vasoactive substances generated following pelvic
      venous congestion caused by the temporary clamping of the inferior vena cava. In
      conclusion, this study indicates that the pump-assisted CPJ bypass is more
      suitable than the pump-assisted PJ bypass. Furthermore, in order to obtain better
      results it should be used routinely in porcine liver transplantation.

PMID- 2223510
TI  - [Aneurysms of the abdominal aorta].
AB  - The authors report 73 cases of abdominal aortic aneurysms with particular
      emphasis to early and long-term results as well as postoperative complications: 4
      patients died at admission, 16 were treated with medical therapy, and 53
      underwent surgery. Surgical patients were stratified in two groups: 18 emergency
      cases (group 1) and 35 elective cases (group 2). Early results showed the highest
      mortality in group 1 cases presenting with shock. Late results, at the end of the
      follow up, (6 months-8 years), showed a 56.6% 5-year survival rate, with
      overlapping survival rates after the immediate postoperative period. The most
      frequent postoperative complications were thrombosis of prosthesis and
      lymphorrhea. Survival rates of emergency cases were influenced by early diagnosis
      and prompt aorta clamping. Before surgery an haemodynamic evaluation of all
      vascular districts seems necessary in elective cases to prevent complications of
      atherosclerotic disease.

PMID- 2223511
TI  - [Diverticula of the cecum. Our experience].
AB  - On the basis of their experience in right colonic emergencies, the Authors report
      two cases of diverticular disease presenting with acute abdomen. Pointing out the
      difficulty of a correct pre- and intraoperative diagnosis, different surgical
      procedures are analysed.

PMID- 2223513
TI  - [Intra- and postoperative complications in the surgical treatment of
      cholelithiasis].
AB  - The authors report their experience in biliary tract surgery. From 1974
      throughout 1988, 1.186 patients underwent surgery and the commonest operation was
      cholecystectomy. The most significant complications and the causes of death are
      reported. Mortality rate was 0.82%.

PMID- 2223512
TI  - [Pancreatic pseudocysts: a rare complication of the Warren distal splenorenal
      shunt].
AB  - The authors report a case of distal splenorenal shunt with splenopancreatic
      disconnection complicated by a huge pancreatic pseudocyst. This complication has
      not been described in the literature so far. The etiology and the opportunity of
      the splenopancreatic disconnection are discussed.

PMID- 2223515
TI  - Effect of clindamycin on adherence of coagulase-negative Staphylococcus to
      surgical nets.
AB  - The authors studied the effect that a subinhibitory concentration of Clindamycin
      has on adherence of coagulase negative S. epidermidis to surgical nets.
      Clindamycin, as expected, interferes with the adhesivity to the nets of coagulase
      negative S. epidermidis slime producing when sub-MICs are used. The documentation
      obtained by scanning electron microscope, after treatment of the strains with
      doses of Clindamycin equal to 1/6 of the MIC after 3 and 6 hours, confirms the
      anti-adherent effect of the antibiotic.

PMID- 2223514
TI  - [The reliability of the grading assessment of the biopsy samples in malignant
      colorectal neoplasms].
AB  - The authors evaluate the results of preoperative bioptic grading compared with
      those obtained from postoperative specimens. Altogether, there was nonagreement
      in 45% of cases; therefore there is the risk of underestimating the biological
      aggressiveness of the disease. In fact, 68% of patients who were assessed as G1
      in preoperative staging were found to have a higher degree of neoplastic
      dedifferentiation.

PMID- 2223517
TI  - [I.V. ketorolac in the therapy of postoperative pain].
AB  - Forty-one patients suffering from postoperative pain were admitted to an open,
      noncomparative trial. A dose of 10 mg of Kerotolac was administered i.v. to
      patients complaining severe pain. The analgesic efficacy of the drug was
      evaluated at 5, 15, 30 minutes and at 1, 1.5, 2, 3, 4, 6 hours after injection;
      the patients were asked to score their pain relief on the VRS comparing the pre
      injection evaluation to each post-injection period. A significant decrease of
      pain intensity (less than p 0.01) was observed at 45 minutes after injection. No
      side effects were observed. These results suggest that Ketorolac can be
      successfully used in the treatment of postoperative pain.

PMID- 2223516
TI  - [The use of mammary echotomography in the diagnosis and monitoring of the
      pregnant and puerperal breast. 3 cases of galactocele].
AB  - Three cases of galactocele appeared as breast nodule during lactation are
      reported. From our experience and the recent literature, ultrasound shows a good
      reliability for the diagnosis of breast diseases during pregnancy and lactation
      in spite of oedema and breast turgidity, distinctive of these periods.

PMID- 2223518
TI  - [Tumors of the testicle].
AB  - The authors describe, in the light of the current literature, the clinical,
      diagnostic, and therapeutic characteristic of testicular cancer. They remark the
      good results of adjuvant therapy in this type of tumor.

PMID- 2223519
TI  - Temperature limits of growth, TNase and enterotoxin production of Staphylococcus
      aureus strains isolated from foods.
AB  - For 77 strains of Staphylococcus aureus freshly isolated from different foods,
      growth, enterotoxin and TNase production were determined in intervals of 1.5
      degrees C +/- 0.5 degrees C by cultivating them in a temperature-gradient
      incubator between 5 and 50 degrees C for up to 7 days. All the strains were
      coagulase, DNase and lysostaphin positive but only 58% formed one or two
      enterotoxins type SEA, SEB or SEE. All strains grew within 7 days in brain heart
      infusion and had lower and upper temperature limits for growth and TNase
      production of between 6.5 and 12.5 degrees C, and 39.5 and 48.5 degrees C
      respectively. The lower and upper temperature limits for production of
      enterotoxins were between 14 and 38 degrees C, and between 35 and 44 degrees C
      respectively. Enterotoxin forming isolates either showed narrow (3 to 4 degrees
      C) or wide (10 to 20 degrees C) ranges of enterotoxin production, irrespective of
      their temperature range of growth and TNase production. None of the 12 specific
      physiological attributes used for differentiation could be correlated to toxin
      type or the temperature requirement of the toxin production. No correlation
      between the origin and the physiological characters could be detected.

PMID- 2223520
TI  - Evaluation and interpretation of data obtained with immunoassays and DNA-DNA
      hybridization techniques.
AB  - During the last decade several new analytical techniques have been developed for
      testing food products and clinical samples. One technique uses sensitive
      immunoassays such as enzyme-linked immunosorbent assay (ELISA) and latex
      agglutination. The most important step in developing sensitive immunoassays is
      the evaluation of the assay for specificity, cross-reactivity and sensitivity.
      False-negative results can easily be detected by adding known quantities of
      antigen to the sample. The most appropriate way to detect false-positive results
      is the specific inhibition of the immunological reaction by addition to the test
      sample of either synthetic epitopes or anti-idiotype antibodies. The progress in
      recombinant DNA techniques now offers opportunities for application as analytical
      tools in food and clinical microbiology. Methods are being developed to detect
      microorganisms by their nucleic acid sequence using the so-called hybridization
      procedure. With this technique, labelled DNA fragments (probes) are hybridized
      with a complementary base sequence present in the microorganism. Foodborne
      pathogens can be detected by using a probe with a complementary base sequence
      which codes for toxin production. DNA-DNA hybridization techniques may replace
      the traditional cultural techniques for assaying pathogenic micro-organisms.
      However, more experience with these techniques is needed before further
      evaluation can be given.

PMID- 2223521
TI  - The bacterial flora of non-carbonated, natural mineral water from the springs to
      reservoir and glass and plastic bottles.
AB  - Quantitative and qualitative determinations of the bacterial flora of non
      carbonated natural mineral water at the most important steps during bottling at a
      large water source yielded the following results: (i) Colony counts (on 1:10
      diluted plate count agar, incubated at 20 degrees C for 14 days) for water of the
      five springs and the mixed water were less than 1 to 4 cfu ml-1. The Gram
      negative bacterial flora (n = 50 isolates) showed a very different but constant
      spring specific species distributions with predominance of either eutrophic
      fluorescent pseudomonads, oligotrophic non-fluorescent pseudomonads or
      oligotrophic yellow bacteria. (ii) In the reservoir and immediately after
      bottling the counts were in the range of 10 cfu ml-1. But nearly 30% of the
      species of the spring water were no longer detectable and there was a significant
      increase of Gram-positive bacteria. (iii) After 1 week of storage at 20 degrees C
      colony counts of more than 10(5) cfu ml-1 were found in plastic bottles, but only
      about 10(4) cfu ml-1 in glass bottles. Besides, a very distinct change of the
      composition of the microflora occurred. In glass bottles slow-growing
      oligotrophic non-fluorescent pseudomonads, yellow bacteria and Acinetobacter
      predominated. In plastic bottles fast-growing eutrophic and mesotrophic
      fluorescent pseudomonads, Flexibacter and Acinetobacter were dominating. In
      mineral water, bottled into thoroughly cleaned glass bottles, colony counts of
      more than 10(5) cfu ml-1 were found within 4 days. In bottles, cleaned
      mechanically as usual, the increase was significantly slower with a maximum of
      only 5 x 10(3) cfu ml-1 after 8 days. The results of inoculation experiments in
      sterile filtered mineral and distilled water led to the suggestion that the
      difference between the two types of bottles is caused firstly by an inhibition of
      growth due to residues of cleaning detergents in the glass bottles. Growth
      promotion by dissolved organic substances in the plastic bottles only played a
      minor role. After repairing of the pump at a depth of 300 m in a warm mineral
      water spring, the colony counts at 20, 37 and 42 degrees C on 1:10 diluted and
      normal plate count agar increased beyond the limits required by the EC directive
      for mineral water stored a month. Then colony counts decreased slowly and reached
      the initial level after 1 year, except for the colony counts 1:10 diluted agar at
      20 degrees C which stabilized at a relatively high number and a significant
      alteration of the microflora.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2223522
TI  - Occurrence and formation of biologically active amines in foods.
AB  - Attention is given to the toxicology of biogenic amines and their occurrence and
      formation in foods, with special emphasis on fermented foods. The role of the
      associated flora, the starter cultures used and their interaction is discussed.

PMID- 2223523
TI  - The effects of irradiation and temperature on the immunological activity of
      staphylococcal enterotoxin A.
AB  - The effects of irradiation and temperature on purified staphylococcal enterotoxin
      A were investigated using sensitive ELISA systems. Thermal inactivation of
      staphylococcal enterotoxin A in phosphate-buffered saline was considerably faster
      at temperatures of 60, 70, 115 and 121 degrees C than at 90 and 100 degrees C. In
      gelatin phosphate buffer, staphylococcal enterotoxin A was completely inactivated
      by irradiation at 8.0 kGy; in a 15% mince slurry, however, 27-37% of
      staphylococcal enterotoxin A remained at this level of irradiation. Even at a
      dose of 23.7 kGy, 16-26% residual staphylococcal enterotoxin A could still be
      detected. Generally, increasing the mince concentration increased the protection
      against the effect of irradiation on staphylococcal enterotoxin A. However, the
      protective effect of mince at a concentration of 50% was less than at a mince
      concentration of 30%. Both irradiation and heat processing of food should only be
      used in conjunction with good manufacturing practices to prevent proliferation of
      microorganisms and toxin productions.

PMID- 2223525
TI  - The presentation of research in clinical practice.

PMID- 2223524
TI  - Standard plate counts of drinking water: a comparison between incubation
      temperatures of 20 and 30 degrees C.
AB  - Standard plate counts of 5085 drinking water samples gathered in the Region of
      Basle were carried out over a period of 9 years (1977 to 1985). Two conditions of
      incubation were evaluated: 20 degrees C and 30 degrees C for 72 h. In ground
      water samples (3048 samples) colony forming units (cfu) at 30 degrees C were
      found to be higher than counts at 20 degrees C incubation, 45% of the samples
      contained greater than or equal to 2 cfu/ml at 30 degrees versus 35% at 20
      degrees C. The median was 1 cfu/ml at both temperatures. In spring water samples
      (2036 samples) bacterial counts at 20 degrees C were found to be higher than
      counts at 30 degrees C incubation, 61% of the samples contained greater than 10
      cfu/ml at 20 degrees C versus 51% at 30 degrees C. The median was 19 cfu/ml at 20
      degrees C incubation versus 11 cfu/ml at 30 degrees C. These differences were
      statistically significant with p less than 0.001 (Wilcoxon matched-pairs signed
      rank test). No correlation was found between bacterial counts at 20 degrees C and
      bacterial counts at 30 degrees C, nor between bacterial counts and original water
      temperatures. It appears that incubation temperatures of 20 degrees C and 30
      degrees C favor the growth of different populations of bacteria and temperature
      is not the only factor. However, from a practical point of view the use of only
      one incubation temperature seems to be justified for the purpose of judging the
      sanitary quality of drinking water.

PMID- 2223526
TI  - Displaced boxers' fractures: a simple and effective method of external splintage.
AB  - Forty patients with fractures of the fifth metacarpal neck (boxers' fractures)
      having a volar angulation of 30 degrees or more were treated by closed reduction
      and external immobilisation. A combination of malleable aluminium alloy splint
      and plaster of Paris cast was used. The results show a significant improvement in
      fracture angulation after reduction and at follow-up (3/5 weeks) using this form
      of external splintage. There were no complications. Our results compare
      favourably with those of other recently published series. We advocate the use of
      this method of treatment for these fractures with significant volar angulation.

PMID- 2223527
TI  - Topical anaesthesia with lignocaine-prilocaine cream (EMLA) for carbon dioxide
      treatment to the cervix--a pilot study.

PMID- 2223528
TI  - Hypertension in the elderly: a study of a combination of atenolol,
      hydrochlorothiazide and amiloride hydrochloride.
AB  - The anti-hypertensive effects of atenolol (Tenormin) 50 mg, a potassium-sparing
      diuretic (half-strength Moduretic) comprising hydrochlorothiazide 25 mg plus 2.5
      mg amiloride hydrochloride, and the 'free' combination of atenolol and diuretic
      were compared in elderly hypertensive patients aged 60-79 years. After a four
      week run-in period on placebo, patients were randomly assigned, in a double-blind
      manner, to atenolol or diuretic treatment, each for four weeks. Thereafter
      patients were given the 'free' combination for a further four weeks and this
      treatment was continued for six months. Blood pressure and heart rate were
      measured after the patient had rested for five minutes supine and after two
      minutes standing. These blood pressure measurements were made at least 24 hours
      after the preceding dose using a Random Zero sphygmomanometer. Results from 26 of
      the 27 patients entered into the study showed an advantage for combination
      therapy combined with either atenolol or diuretic treatment alone. No significant
      difference was found between treatments in the frequency of supraventricular and
      ventricular ectopic beats occurring in six patients who underwent 24-hour
      ambulatory ECG monitoring. However, ectopic activity was reduced in some patients
      during beta-blocker treatment. Few adverse effects occurred with any treatment.
      Three patients withdrew during the placebo period and three withdrew while taking
      active treatment. This study has shown that the combination of atenolol,
      hydrochlorothiazide and amiloride hydrochloride is an effective, safe, well
      tolerated antihypertensive drug regimen when used once daily in elderly
      hypertensive patients.

PMID- 2223529
TI  - Medical eponyms updated: 1. Behcet's disease.

PMID- 2223530
TI  - Colonic bleeding may cause melaena.

PMID- 2223531
TI  - Pseudo-pyloric tumours.
AB  - Two infants presenting with vomiting were thought to have palpable pyloric
      tumours. At operation hypertrophic pyloric stenosis was not present, but other
      conditions causing duodenal obstruction were, and these required surgical
      treatment. The cases illustrate that other abnormalities may masquerade as
      pyloric stenosis.

PMID- 2223532
TI  - Mycotic aneurysm caused by group B streptococcus: a cautionary tale of management
      problems and a rare organism.
AB  - We report a case of mycotic aneurysm of the femoral artery which highlights the
      diagnostic features and management problems of the condition. Our patient
      required emergency ligation of the artery for life-threatening haemorrhage and
      subsequently his leg was not viable. The alternative treatment options of simple
      ligation and excision versus ligation, excision and immediate bypass grafting of
      the artery are discussed. The causative organism, beta-haemolytic group B
      streptococcus (S. Agalactiae), is an extremely rare cause of embolic mycotic
      aneurysm. This rarity is unexplained and is surprising since this organism is a
      well-known cause of infective endocarditis, which can be complicated by mycotic
      aneurysms. Mycotic aneurysms may become more common because of the rise of
      intravascular drug abuse, which combines the risk factors of vessel trauma,
      endocarditis and immunosuppression, notably from HIV infection.

PMID- 2223533
TI  - Apparent relapse of Legionella pneumonia.

PMID- 2223534
TI  - Acute appendicitis secondary to metastatic carcinoma of the breast.
AB  - A patient developing acute appendicitis and intestinal obstruction secondary to
      metastatic breast carcinoma is described. This rare occurrence may become more
      common with improved survival in cases of advanced breast malignancy. The
      intrinsic nature of malignant metastases in the appendix, with or without
      concurrent immunosuppressive chemotherapy, leads to a late presentation of
      appendicitis with a high incidence of perforation, associated with an increased
      mortality and morbidity. It is suggested that appendicectomy should be undertaken
      as a routine in patients with carcinoma of the breast when oophorectomy or
      laparotomy is to be performed.

PMID- 2223535
TI  - Polymyositis presenting with dyspnoea, greatly raised muscle enzymes, but no
      apparent muscular weakness.

PMID- 2223536
TI  - Thyrotoxicosis in a patient with Addison's disease.
AB  - We report the case of a patient who suffered recurrent episodes of hypoadrenal
      crisis, despite conventional replacement therapy for Addison's disease. She was
      found to have hyperthyroidism and after this was treated, she had no further
      relapse. Thyrotoxicosis should be considered when patients taking replacement
      therapy for Addison's disease present in hypoadrenal crisis.

PMID- 2223537
TI  - Femoral hernia in children.
AB  - Femoral hernia is rare in children. Unfamiliarity with the occurrence of this
      condition may lead to incorrect diagnosis and delayed treatment. This mistake can
      be obviated by careful clinical examination.

PMID- 2223539
TI  - Selective use of arteriography in the assessment of aortic aneurysm repair.
AB  - Routine preoperative arteriography is advocated by many vascular surgeons before
      abdominal aortic aneurysm repair. We have used a selective approach based on the
      facts that arteriography is expensive, time-consuming, potentially hazardous, and
      often unwarranted. Based on preoperative indications, arteriography was used
      selectively in 41 of 100 consecutive patients prior to abdominal aortic
      aneurysmectomy. Many patients had more than one indication. A total of 82
      specific indications were recognized. The most frequent indications were
      diminished lower extremity pulses (24), claudication (20), severe coronary artery
      disease (11), cerebrovascular disease (7), prior arterial reconstruction (8),
      hypertension in patients 60 years of age or less (5), evidence of other aneurysms
      (4), major renal anomaly (1), blue toe syndrome (1), and thoracic aneurysm (1).
      The 41 arteriograms produced 125 specific arteriographic abnormalities with an
      average of three per study. The most arteriographic abnormalities were in those
      patients with claudication and the least for those with hypertension. The
      arteriogram revealed information that would not have been obvious at operation,
      nor would it have led to operative procedure modification in only 10 patients. In
      the 59 patients not having arteriography, three had intraoperative findings which
      demanded a modification of the operative procedure. Thus, in only 13 patients was
      arteriography definitely useful. Presumably it was not indicated in the other 87.
      By comparing the cases in which the operation was modified with the presence of a
      specific indication, we have developed a predictability index as a guide for
      performing arteriography. Multiple indications increased the likelihood of
      operation modification only if four or more indications were present.

PMID- 2223538
TI  - Vascular injuries in the urban battleground: experience at a metropolitan trauma
      center.
AB  - The increasing frequency and severity of urban violence and vehicular injuries
      have brought with them a rise in the number of complex vascular injuries. To
      examine the cause, incidence, management, and outcome of this problem, we created
      a vascular trauma registry which includes all such cases treated at a Level I
      metropolitan trauma center over the past nine years. This constitutes a summary
      report of that registry. During the period 1979-1988, 411 patients (355 men, 56
      women) with 478 vascular injuries were treated. There were 18 deaths (4%).
      Primary diagnosis was grouped by anatomic region: (1) head and neck vessels, 62
      (15%); (2) thoracic, 39 (10%); (3) abdominal and pelvic, 63 (15%); (4) upper
      extremity, 161 (39%); and (5) lower extremity, 86 (21%). Surgery was required in
      241 cases (60%). Operative techniques consisted of ligation or resection in 26
      (12%) and direct repair in 212 (88%). Associated procedures included: (1)
      laparotomy (n = 83); (2) craniotomy (n = 4); (3) thoracotomy (n = 49); (4)
      orthopedic procedures (n = 118); and (5) peripheral neurological repair (n = 70).
      Mechanisms of injury were: (1) gunshot wounds (32%); (2) stab wounds (45%); (3)
      motor vehicle accidents (18%); (4) fall (3%); and (5) other mechanisms (2%). We
      conclude: (1) vascular injuries were found frequently in the severely injured
      patient; (2) multiple vascular repairs were required in a significant proportion
      of these patients; and (3) outcome is dependent more upon associated trauma than
      on the vascular injuries themselves.

PMID- 2223540
TI  - Endovascular occlusive intervention in the management of trauma.
AB  - This report summarizes a 10-year experience (1978-1987) in a metropolitan
      hospital with 102 patients sustaining a variety of complex or inaccessible
      vascular injuries. Management included the application of occlusive
      interventional arteriographic techniques. Regional injuries included head and
      neck (56%), trunk (13%), and extremity (32%). Techniques of vascular occlusion
      were often performed in conjunction with the initial arteriographic evaluation
      and were comprised of particulate embolization (42%), placement of mechanical
      devices (36%), or tissue adhesives (1%), or a combination (21%). There were no
      deaths in this series and the only complications included four cases of
      dislodgement of the occlusive agent. We demonstrate that endovascular occlusion
      is a useful, safe and efficacious procedure in selected patients with complex,
      inaccessible or life-threatening vascular trauma.

PMID- 2223541
TI  - Doppler ultrasound in aortic dissections: a study of cephalic and peripheral
      arteries.
AB  - We investigated the role of continuous-wave Doppler ultrasound in predicting the
      presence of an aortic dissection prospectively in 28 patients whose diagnosis was
      confirmed either by arteriography or surgery (26 cases) or at autopsy (two
      cases). We hypothesized that dissections, by creating two channels for flow,
      would produce velocity disturbances detectable in accessible arteries such as the
      carotid, brachial, and femoral arteries. Of the 28 patients, 20 had Type I, two
      Type II, and six Type III dissections. Two abnormalities of the Doppler signals
      were found: in 18 of Type I dissections, notching was found in the systolic
      upslope of the velocity tracing from those arteries that were either involved in
      or distal to the dissection sites. Notching was much less frequent for Type II
      and III dissections: only one patient with Type II and two patients with Type III
      dissections showed notching. In addition diastolic backflow with marked aortic
      valvular insufficiency was present. Notching in brachiocephalic artery continuous
      wave Doppler signals appears to have a high positive predictive value for Type I
      dissections.

PMID- 2223543
TI  - Long-term survival in patients undergoing resection of abdominal aortic aneurysm.
AB  - The long-term survival of patients undergoing abdominal aortic aneurysm surgery
      is presented. Three-hundred and thirty-eight patients who presented with
      elective, urgent, or emergency abdominal aortic aneurysms, have been followed
      retrospectively for five years. We found no statistical difference in the long
      term survival in these three groups of patients. As expected patients who had
      successful operation survived better than patients who were not offered surgery
      because of their poor medical condition. Interestingly, advancing years, history
      of myocardial infarction or hypertension did not significantly influence long
      term survival.

PMID- 2223542
TI  - Functional status of the deep venous system after an episode of deep venous
      thrombosis.
AB  - An episode of deep venous thrombosis is often followed by the opening of
      collaterals, fibrinolysis, recanalization and valvular dysfunction. The effect of
      these processes on the peak flow velocity in the superficial femoral and
      popliteal veins after simulated contraction of the calf muscles was tested in a
      group of normal subjects and three groups of patients who had deep venous
      thrombosis. There were 12 patients followed less than two years with no skin
      changes. The second group consisted of 12 patients followed for 8-15 years
      without ulceration. The third group of 12 patients had active or healed ulcers.
      The peak flow velocity in the superficial femoral and popliteal veins was
      assessed by rapidly inflating cuffs about the calf and ankle to 100 mmHg. The
      velocities generated by cuff compression were lower in patients than in normal
      subjects. This was particularly true in the superficial femoral vein. This change
      in velocity may be secondary to incomplete recanalization with resulting stenosis
      or valvular incompetence in the calf.

PMID- 2223544
TI  - Accuracy of B-mode ultrasonography in detecting carotid plaque hemorrhage and
      ulceration.
AB  - A prospective study comparing the accuracy of B-mode ultrasound with evaluation
      of gross appearance in detecting plaque hemorrhage and ulceration is reported.
      Ultrasonography was performed on 78 vessels in 66 patients undergoing carotid
      endarterectomy. Carotid bifurcation atheroma were classified ultrasonographically
      as smooth, irregular, or ulcerated. Sonolucent areas were considered to be plaque
      hemorrhage. Analysis of carotid plaques removed at operation included macroscopic
      and microscopic findings. Duplex Doppler was only 44% sensitive but 78% specific
      for plaque hemorrhage. If all irregular atheroma were considered ulcerated, the
      sensitivity of Duplex Doppler was 81% with specificity only 33%. If only lesions
      with a clearly visualized crater were considered ulcerated, B-mode ultrasound was
      85% specific but only 17% sensitive. False B-mode ultrasound diagnoses of
      ulceration were mainly due to culs-de-sac or pits in fibrotic plaque that looked
      like ulcers. Ulceration was not noticed on B-mode when there was a two
      dimensional problem or calcification with shadowing. False B-mode diagnoses of
      plaque hemorrhage were due to atheromatous debris, ulcerated plaque hemorrhage,
      or calcification. Problems still exist in the B-mode ultrasound diagnosis of
      carotid plaque hemorrhage and ulceration.

PMID- 2223545
TI  - Renal artery revascularization with polytetrafluoroethylene bypass graft.
AB  - Between January 1979 and December 1986, a total of 74 renal revascularizations
      were performed in 68 patients using the reinforced expanded
      polytetrafluoroethylene prosthetic graft. These 74 revascularizations represent
      29% of 251 surgical renal revascularizations performed during the same period of
      time. Eight patients had a total of nine revascularizations in the emergency
      setting (group I) for ruptured suprarenal aneurysm or acute thrombosis of the
      renal arteries. Only one patient survived and six years later, his anatomic and
      functional results are satisfactory. Sixty-five revascularizations were performed
      electively in 60 patients (group II). This group consisted of 19 renal
      revascularizations alone, and 46 combined aortic and renal revascularizations.
      One patient died of respiratory complications two months after operation after
      his thoracoabdominal aneurysm was cured. Early repeat postoperative arteriography
      showed that six reconstructions had occluded (three major renal arteries, three
      polar arteries). One patient was lost to follow-up. The remaining patients were
      followed for a mean of 41 months. Follow-up arteriograms obtained during 1987
      showed that there were two late occlusions and two distal anastomotic stenoses.
      Actuarial patency was 85 +/- 10% at 72 months. Polytetrafluoroethylene prosthetic
      grafts constitute a reliable material for renal revascularization and combined
      aortic and renal reconstruction in certain anatomic conditions.

PMID- 2223546
TI  - Routine exercise testing to detect coronary artery disease in patients with
      atherosclerotic vascular disease.
AB  - The ability of patients with peripheral vascular disease to perform exercise
      studies on a conventional treadmill is often hampered by claudication,
      amputation, ischemic ulceration or rest pain. This study was undertaken to
      investigate the use of the arm ergometer in these patients. Eighty-three patients
      admitted with peripheral vascular or carotid artery disease were subjected to
      electrocardiographic-monitored exercise testing, using both the arm ergometer and
      conventional treadmill, where possible. Coronary arteriography was performed
      consecutively on 32 of these patients to establish a control group from which the
      sensitivity, specificity and predictive accuracy of both methods of exercise
      testing could be calculated. Nineteen of the 70 arm ergometry tests and 22 of the
      48 treadmill tests were positive. Nineteen of the patients with a positive test
      using either of the methods were asymptomatic for cardiac disease. All five
      patients who developed cardiac events during surgery had positive exercise tests,
      preoperatively. The sensitivity of arm ergometry in detecting coronary artery
      disease was 45.5% and the specificity 100%, while the figures for treadmill
      testing were 82.4% and 83.3%, respectively. The combined sensitivity for the two
      tests was 81.8% and the specificity 87.5%. Using a combination of these two tests
      thus provided a highly specific and adequately sensitive means of detecting the
      presence of coronary artery disease in patients presenting for peripheral
      vascular surgery.

PMID- 2223547
TI  - The silent brain infarct before and after carotid surgery.
AB  - Routine computed tomography was prospectively performed pre- and postoperatively
      in 114 consecutive patients undergoing a total of 131 procedures on the carotid
      artery. Hemispheric cerebral infarction was found preoperatively in three of the
      16 hemispheres corresponding to symptomatic lesions (19%), in 18 of 109
      hemispheres corresponding to transient ischemic attacks (16.5%), and in one of
      four hemispheres corresponding to lesions responsible for a fixed cerebral
      vascular accident (25%). Two surgical procedures (1.5%) were complicated by early
      cerebral infarctions as detected on postoperative computed tomographic scan.
      These complications resulted in death in one case, and left the patient with
      major sequelae in the other. Five procedures (3.8%) were complicated by transient
      ischemic attacks, three of which were associated with minimal cerebral
      infarctions visible on computed tomographic scan. Neurologic status was unchanged
      after 124 (94.6%) procedures, whereas four of these procedures were complicated
      by silent brain infarctions as visualized on postoperative computed tomographic
      scans (3.1%). This study confirms that existing pre- and postoperative neurologic
      classifications are far from perfect and that surgery is rarely responsible for
      cerebral infarction. Carotid surgery should no longer be performed without
      obtaining pre- and postoperative computed tomographic scans.

PMID- 2223548
TI  - Surgical treatment of complete renal artery occlusion in pediatric patients.
AB  - Two children, 8 and 11 years old, presented with severe hypertension secondary to
      unilateral and bilateral total occlusion of the renal arteries, respectively. The
      11-year-old developed sudden anuria requiring hemodialysis. Successful surgical
      reconstruction allowed recovery of renal function and normal blood pressure in
      both patients. Routine blood pressure control in the pediatric patient
      population, high clinical awareness, and judicious use of arteriography, provide
      the best chance for early diagnosis of renovascular disease. Surgical
      revascularization or transluminal angioplasty are the treatment modalities of
      choice in appropriately selected cases of renal artery stenosis. When total
      occlusion occurs, retrieval or preservation of renal function can be successfully
      achieved by direct surgical intervention.

PMID- 2223549
TI  - The use of internal jugular vein as interposition graft for femoral vein
      reconstruction following traumatic venous injury: a useful approach in selected
      cases.
AB  - Complex venous injuries remain a controversial and interesting challenge to the
      vascular and trauma surgeon. Data from the Vietnam Vascular Registry, combined
      with experience from recent civilian series, seem to indicate that the best
      results are obtained when venous repair is undertaken. This is especially true of
      combined arterial and venous injury where compromised venous outflow may lead to
      limb loss in spite of patent arterial reconstruction. The larger size of veins,
      however, has required the construction of complex and time-consuming panel and
      spiral-vein grafts. This makes them far from ideal in the trauma treatment
      setting, where minimization of blood loss and operating room time are high
      priorities. We present a case of combined injury to both femoral artery and vein,
      where the femoral vein injury was repaired using autologous internal jugular vein
      as interposition graft while the arterial injury was repaired with autologous
      saphenous vein from the opposite limb. The avoidance of prosthetics, ease of
      harvest, size match, and little associated morbidity all make a strong case for
      use of the internal jugular vein where speedy reconstruction of large venous
      conduits is indicated.

PMID- 2223551
TI  - Acute visceral ischemia secondary to aortic graft occlusion.
AB  - This report describes a case of acute visceral ischemia precipitated by aortic
      graft occlusion. The importance of recognizing and treating visceral artery
      lesions at the time of aortic reconstruction is emphasized.

PMID- 2223550
TI  - Bilateral congenital aplasia of the deep femoral arteries.
AB  - A patient with bilateral congenital aplasia of the deep femoral arteries is
      described. The condition was accompanied by aneurysms of the popliteal arteries.
      Besides the academic interest of such an anatomical rarity, the abnormality is of
      clinical importance insofar as acute ischemia of the extremity may occur in the
      presence of superficial femoral artery occlusion.

PMID- 2223552
TI  - Rupture of a superior mesenteric artery aneurysm in a child.
AB  - A 13-year-old child presented with a ruptured aneurysm of the trunk of the
      superior mesenteric artery most likely due to incipient fibromuscular disease
      localized in the adventitia. The aneurysm was resected and replaced by an
      autologous saphenous vein graft. The postoperative course was uneventful.
      Diagnosis and operative strategy are discussed.

PMID- 2223553
TI  - Congenital anomalies of the external iliac artery: case report and review of the
      literature.
AB  - Routine arteriograms obtained during work-up for occlusive arterial disease of
      the lower limbs disclosed a rare congenital anomaly in a 47-year-old man. The
      common femoral artery arose directly from a pelvic artery which followed the
      normal course of the internal iliac artery. Congenital anomalies involving the
      external iliac artery can be classified into three groups: (1) anomalies of
      origin or course which are in fact anatomic curiosities; (2) hypoplasia or
      atresia coexisting with persistent sciatic artery; and, (3) isolated hypoplasia
      or atresia which can occasionally cause chronic ischemia of the lower limbs. The
      anomaly reported herein can be classified either as agenesia or abnormal course
      of the external iliac artery.

PMID- 2223555
TI  - Expression of a p55 interleukin-2 receptor-like molecule on corneal epithelial
      cells.
AB  - We observed a molecule on the surface of mouse corneal epithelial cells that is
      similar or identical to the p55 subunit of the high affinity interleukin-2
      receptor (p55 IL-2R). The presence of this molecule in normal corneas was
      demonstrated by immunoperoxidase staining with a monoclonal antibody (mAb)
      specific for p55 IL-2R (7D4). Staining was observed only in the corneal
      epithelium. The staining intensity was greatest in the central cornea, becoming
      weaker toward the corneal scleral limbus, and was very weak or absent in the
      conjunctival epithelium. Other ocular tissues were not stained. Epithelial cells
      grown in tissue culture from corneal explants retained expression of the molecule
      recognized by 7D4 as demonstrated by immunoperoxidase staining. Western Blot
      analysis of an extract of corneal epithelium demonstrated the presence of a 55 kD
      protein that reacted with 7D4. Our findings suggest that a molecule similar both
      antigenically and in molecular size to the p55 IL-2R subunit is constitutively
      produced by corneal epithelial cells.

PMID- 2223554
TI  - A novel microwell indirect immunofluorescence assay to detect antibodies against
      islet cell surface antigens in insulin-dependent diabetes mellitus.
AB  - End-point titers of islet cell surface antibodies (ICSA) were determined in 144
      patients with newly diagnosed insulin-dependent diabetes mellitus (IDDM), 98
      siblings to such patients, and 188 controls using a microwell indirect
      immunofluorescence assay with an insulin-producing cell line of Syrian hamster
      origin. The prevalence of ICSA of a titer equal to or greater than 1:4 was 33% (p
      less than 0.001) in IDDM patients and 15% (p less than 0.01) in siblings,
      compared to 5% among the controls. In patients under 15 years of age at clinical
      onset, the prevalence of ICSA was 43% (37/77), which was higher than the 30%
      (20/67) found in patients older than 15 years at onset (p less than 0.05). The
      ICSA titer at the time of diagnosis varied between 1:4 and 1:32; however, 43%
      (23/53) of ICSA positive IDDM patients had a titer equal to or greater than 1:8.
      Although gender did not affect ICSA prevalence, 56% (15/27) of the female IDDM
      patients had ICSA titers exceeding 1:8 which was higher than 30% (8/26) among
      male patients (p less than 0.05). These results confirm that IDDM patients have a
      high prevalence of ICSA and that this convenient, high capacity
      immunofluorescence assay allows studies of large numbers of serum samples. The
      cell-specific reaction following absorption should also allow the islet cell
      surface antigens to be characterized.

PMID- 2223556
TI  - Mast cells in the murine oral mucosa are of the connective tissue-type.
AB  - The distribution, histochemistry, and functional properties of oral (cheeks, soft
      palate, and tongue) mast cells (MC) was compared to those of peritoneal,
      cutaneous, and intestinal MC. The ultrastructure of oral MC was also studied.
      Fresh tissue and peritoneal cells were fixed either in absolute ethanol or in
      periodate lysine 2% paraformaldehyde and embedded in paraffin. For electron
      microscopy, specimens were fixed in 1% glutaraldehyde in formol and embedded in
      epon. Serial paraffin sections were stained with Giemsa, toluidine blue (0.5% and
      0.005%), astra blue/safranin, alcian blue/safranin, berberine sulfate, safranin
      alone, and fluorescein-labelled avidin to determine the staining properties,
      incidence, and distribution of both connective tissue-type MC and mucosal-type MC
      at these sites. Oral, peritoneal, and cutaneous MC granules stained positively
      with Giemsa, toluidine blue (0.5 and 0.005%), alcian blue, astra blue, berberine
      sulfate, safranin used alone, and avidin-FITC, but failed to stain with safranin
      when used in sequence with alcian blue or astra blue. Intestinal MC stained with
      the same dyes as oral MC except for 0.005% toluidine blue, berberine sulfate, and
      safranin. Oral and lingual MC are located in the deep lamina propria, around
      blood vessels and salivary secretory ducts, in close association with nerve
      endings, and between muscle fibers. In the cheeks and soft palate, but rarely in
      the tongue, MC were also found around and between glandular acini. MC constitute
      a predominant immune component in oral tissues, being more numerous in the soft
      palate and cheek-labial junction (4800/mm3) and in the tongue (4000/mm3), than in
      the duodenal mucosa (2650/mm3).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223557
TI  - Inhibition of DNA synthesis in human peripheral and lamina propria lymphocytes by
      5-aminosalicylic acid and hydrocortisone.
AB  - 5-Aminosalicylic acid (5-ASA) and hydrocortisone (HC) have potent
      antiinflammatory activity, and are commonly used in the treatment of patients
      with inflammatory bowel disease. Both agents have been reported to modulate
      immune function in human and animal models. We investigated the effect of 5-ASA
      and HC on cell proliferation of normal human peripheral blood lymphocytes (PBL)
      and normal colonic lamina propria lymphocytes (LPL). Both 5-ASA (0.01-4 mM) and
      HC (0.01-10 microM) significantly inhibited 3H-thymidine incorporation (Thd) into
      PBL and LPL in a dose dependent manner. Maximal inhibition occurred with the
      highest concentration tested of both 5-ASA and HC. We found a significantly
      greater inhibition of DNA synthesis for 5-ASA (4 mM) upon LPL vs. PBL (94 vs.
      32%, p less than 0.001). However, DNA synthesis inhibition by HC was similar in
      PBL and LPL. The profoundly greater inhibitory effect of 5-ASA upon LPL suggests
      a specific modulation of the mucosal immune system.

PMID- 2223560
TI  - Surveillance of tetanus, 1987 and 1988.

PMID- 2223558
TI  - Compartmentalization and kinetics of lymphoid cells in the lung.

PMID- 2223559
TI  - Ultrastructural study of liposome uptake by M cells of rat Peyer's patch: an oral
      vaccine system for delivery of purified antigen.
AB  - Liposomes (phospholipid artificial membrane vesicles) have been used in targeted
      drug delivery and recently in the development of oral vaccines using purified
      soluble antigens for the induction of mucosal immune responses. Although the
      mechanisms by which liposomes promote the induction of responses to soluble
      antigens have not been clearly shown, it has been suggested that these vesicles,
      when given orally, are taken up by M cells for delivery of antigen to underlying
      lymphoid cells of the Peyer's patch. This study investigated in vivo the uptake
      of liposomes by cells of Peyer's patch. Following exposure of surgically
      constricted segments of rat small intestine to small unilamellar liposomes or
      gold-labelled solid core liposomes, Peyer's patches were removed, fixed, and
      processed for examination by transmission electron microscopy. Sections of
      Peyer's patch from experimental animals showed M cells with endocytic vesicles
      containing liposomes. Vesicles containing liposomes were also observed between M
      cells and lymphoid cells. These results indicate that intact liposomes are
      endocytosed by M cells and provide evidence for a possible mechanism by which M
      cells deliver antigen to lymphoid cells in the Peyer's patch. These findings
      support the potential usefulness of liposomes in oral vaccine development.

PMID- 2223561
TI  - Measles. Surveillance in England and Wales, 1960-1989.

PMID- 2223562
TI  - Expanded programme on immunization. Neonatal tetanus survey.

PMID- 2223563
TI  - Injury prevention. Cost of injury--a report to Congress, 1989.

PMID- 2223564
TI  - Acquired immunodeficiency syndrome (AIDS)--data as at 31 August 1990.

PMID- 2223565
TI  - Meningococcal disease. Situation from 1983 to 1989.

PMID- 2223566
TI  - Acquired immunodeficiency syndrome (AIDS)--data as at 30 September 1990.

PMID- 2223567
TI  - Epidemiological surveillance. Development of an international sentinel network of
      general practitioners (Eurosentinel).

PMID- 2223568
TI  - Sexually transmitted diseases. Gonorrhoeae.

PMID- 2223570
TI  - Malnutrition.

PMID- 2223569
TI  - Surveillance of sexually transmitted diseases, 1989.

PMID- 2223571
TI  - The Cotswolds report on the investigation and staging of Hodgkin's disease.

PMID- 2223572
TI  - Modification of the 31P magnetic resonance spectra of a rat tumour using
      vasodilators and its relationship to hypotension.
AB  - The effects of different doses of hydralazine and prostacyclin on the 31P
      magnetic resonance spectra of the LBDS1 fibrosarcoma were investigated and
      related to their effects on mean arterial blood pressure (MABP) and heart rate.
      The effect of reducing MABP by bleeding the animals, via the tail artery, was
      also investigated. Tumour spectral changes following high dose drug treatment (an
      increase in inorganic phosphate, a reduction in nucleotide triphosphates and a
      reduction in pH) were consistent with nutrient deprivation. These changes were
      dose dependent. Changes in MABP and heart rate were consistent with
      vasodilatation in normal tissues. However, for the same fall in MABP, hydralazine
      produced a greater rise in tumour inorganic phosphate (Pi) and a greater fall in
      tumour pH than did prostacyclin. Controlled bleeding was effective in reducing
      MABP. It also reduced tumour pH but had no significant effect on tumour Pi. The
      clinical application of the two drugs for reducing tumour blood flow and pH for
      therapy is likely to be limited by the large degree of hypotension necessary to
      produce an effect. The differential effect of the two drugs for the same fall in
      MABP may be related to different degrees of direct tumour vasodilatation or to a
      direct effect of hydralazine on tumour energy metabolism. The observation that
      controlled bleeding does not change tumour Pi is further evidence indicating that
      the degree of arterial hypotension is not the sole factor in determining tumour
      energy status.

PMID- 2223573
TI  - The role of colon fibroblasts in malignant large bowel obstruction--an
      experimental in vitro model.
AB  - The mechanism of bowel obstruction in colorectal cancer is likely to involve
      interactions between tumour cells, host fibroblasts and the extracellular matrix.
      The role of fibroblast-mediated matrix reorganisation in malignant structures of
      the large bowel was examined in an in vitro collagen matrix model in which tumour
      cells and fibroblasts were cultured under serum-free conditions. Colon cancer
      cells secreted a factor(s) which enhanced the ability of colon fibroblasts to
      contrast a collagen matrix without an associated mitogenic response by the
      fibroblasts. Within uncontracted collagen gels marked elongation of fibroblast
      cell processes was observed in the presence of the tumour-derived factor(s). We
      propose that matrix reorganisation by host fibroblasts in the wall of the human
      colon is responsible, at least in part, for malignant large bowel obstruction.

PMID- 2223574
TI  - Radioimmunotargeting of human tumour cells in immunocompetent animals.
AB  - A tumour model system is reported that for many purposes may be an alternative to
      xenografted nude mice. The model allows immunotargeting of human tumour cells in
      immunocompetent animals. The target cells are contained in i.p. diffusion
      chambers (DC) with micropore membrane walls that are permeable to molecules,
      including the cell specific monoclonal antibodies (MoAb), but impermeable to
      cells. Thus, the tumour cells are protected from the host immunocompetent cells.
      In the work here presented the model was tested in immunocompetent mice and pigs,
      with tumour cells and antibody preparations that had demonstrated specific
      targeting in the nude mouse xenograft model. Hence, the DC were filled with cells
      from the human cell lines Hep-2 (expressing placental alkaline phosphatase,
      PLALP), or OHS (a sarcoma cell line), and the MoAb preparations injected i.v.
      were a 125I-labelled Fab fragment of the PLALP specific antibody H7, or a 125I
      labelled F(ab')2 fragment of the sarcoma specific antibody TP-1. Specific
      targeting of the human tumour cells was demonstrated in both mice and pigs. The
      target: blood ratios were comparable in the two species, reaching a maximum of
      about 15 after 24 h with the Fab preparation, and a ratio of 25 after 72 h with
      the F(ab')2. The target uptake relative to injected dose was lower in pigs than
      in mice, but the difference between the two species was smaller than expected,
      presumably due to a slower antibody clearance in the pigs than in the mice. An
      artificial cell targeting system like this has several advantages in the search
      for solutions to many of the fundamental problems experienced in immunotargeting.
      Firstly, parallel binding experiments can be carried out in vitro with the same
      target. Because in vitro results are only influenced by the diffusion into the DC
      and the immunological binding characteristics of the antibodies, targeting
      differences between antibody preparations due to these factors can then be
      distinguished from differences due to pharmacokinetical properties. Secondly, the
      animals can be implanted with any type and number of target cells, or with
      antigen negative control cells. Thirdly, and perhaps most important, the system
      opens a possibility for evaluation of the murine MoAb in xenogenic species, and
      this may predict the clinical targeting potential better than experiments on
      mice.

PMID- 2223575
TI  - Production and response of a human prostatic cancer line to transforming growth
      factor-like molecules.
AB  - Serum-free media conditioned by the androgen insensitive human prostate cancer
      cell line DU145 showed immunological transforming growth factor-alpha (TGF alpha)
      activity, as well as competing activity in epidermal growth factor (EGF)
      radioreceptor assays (RRA). Furthermore, there were factors in the conditioned
      media which inhibited and stimulated DNA synthesis by DU145 cells in a dose
      dependent fashion. Fractionation of the concentrated conditioned media by reverse
      phase high performance liquid chromatography revealed several peaks containing
      EGF-like competitive activity only one of which demonstrated TGF alpha activity.
      However, none of the peaks corresponded to immunoreactive EGF. Measurement of EGF
      receptors on DU145 cells by competition and saturation analysis revealed high
      levels of receptors (mean +/- s.d. = 2.5 +/- 1 x 10(5) surface receptors per
      cell) which were of high affinity (Kd +/- s.d. = 1.0 +/- 0.5 nmol l-1). Although
      DU145 cells express high levels of EGF receptors, DNA synthesis was only
      minimally affected by exogenous EGF and TGF alpha.

PMID- 2223576
TI  - The polyoxyethylene castor oil Cremophor EL modifies multidrug resistance.

PMID- 2223577
TI  - HAB-1, a new heteromyeloma for continuous production of human monoclonal
      antibodies.
AB  - To obtain suitable cell lines for the immortalisation of human lymphocytes, we
      constructed a heteromyeloma between the murine myeloma Ag8 and human lymphocytes
      from a highly malignant polymorphic, centroblastic B-cell lymphoma. The
      thioguanine-resistant and HAT-sensitive heteromyeloma HAB-1 neither secretes nor
      contains cytoplasmatic immunoglobulins, the cells being EBV negative but
      positively stained for HLA-BC and the human proliferation marker Ki-67. The
      karyotype consists of about 50 murine and 20 human chromosomes. The HAB-1 cells
      grow in suspension and have a doubling rate of about 25-30 h. In fusion
      experiments with spleen cells from stomach carcinoma patients HAB-1 cells show a
      5-7 times higher fusion efficiency than murine Ag8 cells or another heteromyeloma
      SPM4-0 and give stable antibody producing products. The cell line will be made
      available to interested scientists.

PMID- 2223578
TI  - Glutathione S-transferase (placental) as a marker of transformation in the human
      cervix uteri: an immunohistochemical study.
AB  - Using an indirect immunohistochemical technique on paraffin sections, employing a
      polyclonal antibody to the acidic (placental) form of glutathione-S-transferase
      (GST), we have evaluated cytoplasmic and nuclear staining in a series of 67
      cervical biopsies including normal non neoplastic tissue, immature squamous
      metaplasia, all grades of cervical intraepithelial neoplasia (CIN) and invasive
      carcinomas of keratinising and non-keratinising types. No differences in
      cytoplasmic staining between the varied lesions studied were seen. However, there
      were marked differences in nuclear staining. While normal non-neoplastic
      stratified squamous epithelium showed weak staining of the lower one-third of the
      epithelium only, in immature squamous metaplasia and in all grades of CIN there
      was intense nuclear staining in all layers of the epithelium. Invasive carcinomas
      showed generally less intense nuclear staining than CIN lesions. Endocervical
      cell nuclei also showed intense nuclear staining. These findings indicate that
      GST is of limited use as a marker of transformation in the human cervix uteri.

PMID- 2223579
TI  - Is group psychotherapy feasible for oncology outpatients attenders selected on
      the basis of psychological morbidity?
AB  - Of 120 consecutive attenders at an oncology outpatients department, 108 were
      screened for psychological symptoms using the Hospital Anxiety and Depression
      Scale (Zigmond & Snaith, 1983). Thirty-nine patients had significant scores
      indicating moderate anxiety and/or depression. We felt that this warranted an
      offer of group psychotherapy in the belief that sharing issues and exploring
      personal concerns may alleviate some of the experienced psychological distress.
      Only 10 patients consented to and were able to attend this group, with which five
      patients persisted. Thus in this group of patients with advanced cancer group
      psychotherapy was applicable only to a limited number of selected patients. The
      nature of this study and the size of the population markedly limited our ability
      to comment on the usefulness of group psychotherapy. Many patients, particularly
      the most severely psychologically distressed, continued to require other forms of
      support, particularly domiciliary individual therapy.

PMID- 2223580
TI  - Sex hormones in women in rural China and in Britain.
AB  - Plasma concentrations of certain hormones linked to breast cancer risk were
      measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and
      300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64
      respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less
      than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women,
      and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less
      than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women.
      The difference in testosterone concentrations between the two countries appeared
      to be due largely to the lower average body weight in the Chinese women. Sex
      hormone binding globulin did not differ significantly between the two countries
      in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than
      in the Chinese women at ages 55-64. Prolactin concentrations did not differ
      significantly between the two countries in any age group.

PMID- 2223581
TI  - Intrathecal administration of 131I radiolabelled monoclonal antibody as a
      treatment for neoplastic meningitis.
AB  - Fifteen patients with neoplastic meningitis received a single intrathecal
      injection of between 11 and 60 mCi of a 131I radiolabelled monoclonal antibody
      (MoAb), chosen for its immunoreactivity to tumour. Major toxicity was manifest as
      nausea, vomiting and headache (7/15 patients), reversible bone marrow suppression
      (3/8 patients) and seizures (2/15 patients). Nine patients were evaluable for
      either a tumour or clinical response. Six of these demonstrated an event-free
      response that was maintained for periods of between 7 and 26 months.

PMID- 2223583
TI  - The first 2 years of the Gambian National Cancer Registry.
AB  - We describe the creation, and the first 2 years experience, of the Gambian
      National Cancer Registry. The major problems involved in the creation of such a
      registry in a developing country are discussed. The data accumulated show a low
      overall rate of cancer incidence compared to more developed parts of the world
      and indicate that the prevalent cancers, hepatoma, carcinoma of the cervix and
      lymphoma, are likely to be due to infectious agents. It is hoped that
      immunisation of children under one year against hepatitis B will drastically
      reduce the incidence of hepatocellular carcinoma.

PMID- 2223582
TI  - Prolactin receptor does not correlate with oestrogen and progesterone receptors
      in primary breast cancer and lacks prognostic significance. Ten year results of
      the Naples adjuvant (GUN) study.
AB  - The correlation between prolactin (PRLR) and oestrogen (ER) or progesterone
      receptors (PgR) in breast cancer and a possible prognostic significance of PRLR
      at 10 year follow-up have been investigated in the Naples (GUN) adjuvant trial. A
      total of 308 pre- and post-menopausal patients with early breast cancer, who
      entered the trial from 1 February 1978 to 31 December 1983, received randomly
      Tamoxifen (TM), 30 mg per die for 2 years, or no therapy. PRLR status was known
      in 229 (74.3%) patients. Values of specific binding less than 1% were considered
      negative. PRLR was positive in 75/229 (32.8%). ER was assayed in 210/229 (91.7%)
      patients and PgR in 188/229 (82.1%). No significant correlation, by the Spearman
      test, was found between PRLR and ER or PgR, while ER status was highly
      interrelated with PgR status. By the Cox model no evidence of an independent
      prognostic role of PRLR on disease-free survival (DFS) was observed, nor an
      interaction between PRLR and adjuvant treatment with TM was found.

PMID- 2223584
TI  - Vitamin A, vitamin E and the risk of cervical intraepithelial neoplasia.

PMID- 2223585
TI  - Immunohistochemical analysis of the cerebrospinal fluid for carcinomatous and
      lymphomatous leptomeningitis.
AB  - To evaluate the sensitivity and specificity of immunohistochemical analysis in
      relation to the standard cytological examination of the cerebrospinal fluid (CSF)
      in patients with either a solid tumour or a haematological malignancy and
      possible leptomeningeal disease, 68 CSF-samples derived from 68 patients were
      examined. The sensitivity of immunohistochemical analysis was 0.54 and its
      specificity 0.98. Only one patient had a positive immunohistochemistry and a
      negative cytology. The gain of adding immunohistochemistry to cytology is nearly
      8%. It is concluded that immunohistochemistry should not be used as a screening
      test for leptomeningeal disease in patients with cancer.

PMID- 2223586
TI  - Survival of intravenous chemotherapy infusion sites.
AB  - Factors associated with the failure of intravenous infusions due to phlebitis and
      extravasation were studied with 218 infusions delivering cytotoxic drugs. The
      survival rate of these infusions was not significantly different from that of 56
      non-cytotoxic infusions in oncology patients. Although survival analysis
      indicated that cisplatin was associated with longer survival, this was probably
      an artifact caused by this drug usually being preceded by 24 h prehydration.
      Multivariate analysis indicated that etoposide was the only drug associated with
      decreased infusion survival and that bleomycin, cyclophosphamide, doxorubicin,
      ifosphamide, methotrexate, treosulphan and 5-fluorouracil had no significant
      effects. Also age of patient, infusion site and flow rate had no effects but
      survival was shorter in women. Follow-up indicated that failure of an infusion
      tended to result in loss of the vein. It is suggested that irritancy of the large
      volumes of intravenous fluids given to hydrate these patients rather than the
      cytotoxic drugs was the main factor reducing the survival of these infusions.

PMID- 2223587
TI  - Thymidine kinase in breast cancer.
AB  - The enzyme thymidine kinase is associated with DNA synthesis. Thymidine kinase
      serum levels were studied in normal controls (n = 20), patients with primary
      breast cancer (n = 60), patients with systemic breast cancer (n = 20) and as a
      non-cancer disease control group in patients with inflammatory gastrointestinal
      disorders (n = 20). Comparison of pretreatment values in the cancer patients with
      the normal controls showed a significant difference between the three groups in
      relation to stage of disease: mean values 4.22 (+/- 1.08), 6.22 (+/- 2.24) and
      9.79 (+/- 7.56) pmol ml-1 h-1 for normal controls, operable breast cancer and
      systemic breast cancer respectively (P less than 0.005; analysis of variance).
      Patients with systemic breast cancer had a significantly elevated serum thymidine
      kinase level compared to controls (P less than 0.01) and patients with primary
      operable cancer (P less than 0.05). Patients with primary operable cancer had
      significantly higher serum thymidine kinase levels over normal controls (P less
      than 0.01). Mean serum TK in patients with inflammatory gastrointestinal diseases
      was similar to normal controls but significantly less than both patients with
      primary operable breast cancer and patients with systemic breast cancer. Twenty
      patients with operable breast cancer were followed up after primary surgery by
      serial 3-monthly thymidine kinase levels in the disease free interval. Four
      patients have developed systemic recurrence with a rise in the mean thymidine
      kinase value to 14.3 pmol ml-1 h-1. Ten patients with advanced breast cancer had
      serial thymidine kinase levels measured 2-monthly during the first 6 months of
      primary hormone therapy. The serum values fell in all five responders (mean 9.12
      4.78 pmol ml-1 h-1) and rose in all five progressors (mean 8.62-38.5 pmol ml-1 h
      1). Serum thymidine kinase reflects stage of disease in breast cancer. Serial
      thymidine kinase levels in patients with systemic breast cancer reflected
      response to systemic therapy.

PMID- 2223588
TI  - Elevated CA125 levels in patients with metastatic breast carcinoma.

PMID- 2223589
TI  - Using mathematical models to estimate drug resistance and treatment efficacy via
      CT scan measurements of tumour volume.
AB  - A previously described mathematical model designed to evaluate resistance and
      tumour-kill for individual patients, and to predict changing tumour sizes, has
      been applied to patients with small cell lung cancer. The model requires tumour
      volume measurements, and these were obtained via computed tomography scans of the
      chest. The model fitted the data well, and was able to predict later tumour
      volumes using earlier ones, as well as suggesting times at which to change or
      abandon treatment for individual patients. The model gave estimates for
      resistance and tumour-kill which may provide additional useful outcome measures
      for clinical trials, and help in the design of future studies.

PMID- 2223590
TI  - Serum CA125 level is a good prognostic indicator in lung cancer.
AB  - The serum CA125 level was determined by a one-step immunoradiometric assay method
      in patients with lung cancer. Increased serum CA125 levels were observed in 37.8%
      of patients with squamous cell cancer, in 30.0% of those with adenocarcinoma and
      in 60.0% of those with small call cancer. Most patients with increased serum
      CA125 levels were in stages 3 or 4. Patients with pleural effusions or ascites
      showed high serum CA125 levels. The survival time was significantly shorter in
      patients with increased serum CA125 levels than in those within normal limits.
      Among patients with advanced disease (stages 3 and 4), an increased serum CA125
      level was again a poor prognostic factor (P less than 0.01). The existence of a
      pleural effusion did not correlate with the survival time. We conclude that CA125
      is a good indicator of disease extent and serum levels correlate to the length of
      survival.

PMID- 2223591
TI  - Recruitment, follow-up and analysis times in clinical trials of cancer treatment:
      a case study.
AB  - A study has been made of the way in which the number of events available for
      analysis in a clinical trial was dependent on the recruitment period, the maximum
      follow-up time on individual patients and the length of time between the start of
      the trial and its analysis. The events considered were deaths, local recurrences
      and late radiation effects on normal tissue in patients treated for cancer of the
      laryngo-pharynx by two different fractionation regimes. The relationship is
      demonstrated between the number of events and the 95% confidence intervals that
      can be placed on differences between results in the two arms of the trial. It was
      found, in this particular trial, that no significant improvement in precision was
      gained by following up patients beyond 5 years or carrying out the analysis later
      than 2 years after the end of recruitment. The results are discussed in the
      context of the initial design of clinical trials, particularly those in which the
      aim is to test therapeutic equivalence.

PMID- 2223592
TI  - Predicting response to chemotherapy for patients with epithelial ovarian cancer
      using urinary polyamine excretion patterns.
AB  - Urinary polyamine (UPA) excretion patterns were measured in 39 patients with
      clinically evaluable epithelial ovarian cancer immediately before they were
      treated with a cycle of chemotherapy and 24-48 h after chemotherapy to ascertain
      if changes in UPA excretion patterns correlated with eventual response to
      treatment. Almost all of the 19 patients who responded to chemotherapy had a rise
      in the excretion of all UPA fractions after treatment while most patients with
      chemoresistant cancer showed only an increase in the excretion of the putrescine
      and spermine fractions. However, a two-fold increase in excretion of the
      spermidine fractions occurred exclusively in patients who would eventually
      respond to chemotherapy. This phenomenon was not seen in patients with
      chemoresistant cancer. If, 48 h after chemotherapy, a patient with epithelial
      ovarian cancer does not show at least a doubling of the urinary levels of
      spermidine, acetylspermidine or total polyamine excretion that chemotherapy
      should be stopped since it is unlikely to be effective.

PMID- 2223594
TI  - Bifidobacterium gallicum sp. nov. isolated from human feces.
AB  - A bifidobacterial isolate from human feces was found to have very low genetic
      relatedness to any previously described species of the genus. This strain, which
      also contained a unique type of peptidoglycan, L-lysine-L-alanine-L-serine (A3
      alpha), is considered to represent a new species, which is designated
      Bifidobacterium gallicum. Its description is presented. The type strain is strain
      DSM 20093. gallicum. Its description is presented. The type strain is strain DSM
      20093.

PMID- 2223593
TI  - Can the Spitzer Quality of Life Index help to reduce prognostic uncertainty in
      terminal care?
AB  - Data from an on-going trial of co-ordinating care for terminally ill cancer
      patients are used to investigate whether the Spitzer Quality of Life (QL) Index
      can be used to reduce prognostic uncertainty in terminal care. Four questions are
      addressed. First, can doctors and nurses distinguish between patients with a
      prognosis of more or less than 1 year? Second, do the medical and nursing staff
      differ in their ability to estimate prognosis? Third, are there differences in
      the length of life remaining between groups of patients with different QL Index
      scores? Fourth, how well does the QL Index predict the likelihood of individual
      patients dying within 6 months of assessment? Doctors and nurses assigned between
      17 and 25% of patients to the wrong prognostic group and were as likely to over
      estimate as to under-estimate life expectancy. Medical and nursing staff did not
      differ in their ability to make prognostic judgements. Patients with a low QL
      Index score were more likely to die within 6 months than those with higher
      scores, but scores on the Index were not strong predictors of 6-month survival in
      individual patients. The Index is not accurate enough to be used to predict what
      sort of treatment terminally ill patients will require in the future and for how
      long. Nevertheless, it may prove valuable for those planning services for
      terminally ill cancer patients who require information on the levels of need in a
      population.

PMID- 2223595
TI  - Actinomadura fibrosa sp. nov. isolated from soil.
AB  - A new species of the genus Actinomadura which belongs to the Actinomadura madurae
      group of Goodfellow et al. was isolated from soil collected in Togo, West Africa.
      Traditional taxonomic methods plus contemporary fatty acid analysis techniques
      were used to establish the position of this species. Both physiological
      characteristics and fatty acid composition differentiate this strain from
      previously described species. This culture produces a new polyether antibiotic.
      It is characterized by the production of white to pink aerial hyphae on a limited
      number of media. The aerial hyphae appear asporogenous, forming thick fibers and
      projections instead of true spores. The reverse side is a distinctive reddish
      orange. This organism is resistant to 5% NaCl and grows at temperatures between
      20 and 45 degrees C. Whole cells contain meso-diaminopimelic acid, galactose,
      glucose, mannose, madurose, phosphatidylinositol, and diphosphatidylglycerol. The
      menaquinones detected were MK-9(H6) and minor amounts of MK-9(H8). The name
      proposed for this new species is Actinomadura fibrosa; the type strain is strain
      NRRL 18348.

PMID- 2223596
TI  - Ureaplasma felinum sp. nov. and Ureaplasma cati sp. nov. isolated from the oral
      cavities of cats.
AB  - Seven ureaplasma strains isolated from the oral cavities of domestic cats (Felis
      domestica) were characterized and compared with the type strains of the three
      previously established species of this genus, Ureaplasma urealyticum (humans),
      Ureaplasma diversum (cattle), and Ureaplasma gallorale (chickens). The feline
      strains hydrolyzed urea but not arginine or glucose, were membrane bound, lacked
      cell walls, passed through 0.45-micron membrane filters, required cholesterol for
      growth, and formed minute (15- to 140-microns) colonies on agar medium. The seven
      feline strains fell into two distinct groups based on (i) their antigenic
      properties (determined by using the metabolism and growth inhibition and indirect
      immunoperoxidase procedures), (ii) their genomic properties (determined by using
      DNA-DNA hybridization and DNA cleavage pattern procedures), and (iii) their
      polypeptide profiles (determined by using sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis analyses). Based on these properties, the two feline groups
      were unrelated to each other or to the three previously established species, and
      each group represents a distinct Ureaplasma species. Thus, we propose that
      ureaplasmas with these phylogenetic and genomic properties be given taxonomic
      status as Ureaplasma felinum and Ureaplasma cati, with strain FT2-B (= ATCC 49229
      = NCTC 11709) and strain F2 (= ATCC 49228 = NCTC 11710) as the type strains,
      respectively.

PMID- 2223598
TI  - Phylogenetic relationships among species of Sterigmatomyces and Fellomyces as
      determined from partial rRNA sequences.
AB  - Sequence comparisons of selected regions from small (18S) and large (25S) subunit
      rRNAs were used to examine species relationships in the anamorphic yeast genera
      Sterigmatomyces, Fellomyces, Tsuchiyaea, and Kurtzmanomyces. On the basis of
      sequence similarity, the genus Sterigmatomyces is comprised of Sterigmatomyces
      halophilus and Sterigmatomyces elviae, while the genus Fellomyces contains three
      recognized species, Fellomyces fuzhouensis, Fellomyces penicillatus, and
      Fellomyces polyborus. Tsuchiyaea wingfieldii and Kurtzmanomyces nectairii are
      well separated from the other species which we examined. Comparison with selected
      teleomorphs indicated that the genus Fellomyces is closely related to the genus
      Sterigmatosporidium, whereas the genus Sterigmatomyces exhibited somewhat closer
      relatedness with the genus Leucosporidium. Impacting on our estimates of
      relatedness was the finding that nucleotide substitution in the rRNA regions
      which we examined seems relatively constant only among closely related species.

PMID- 2223599
TI  - Arylsulfatase activity of Mycobacterium avium, M. intracellulare, and M.
      scrofulaceum.
AB  - A rapid (3-h) arylsulfatase assay for cell suspensions of mycobacteria, in which
      p-nitrophenyl sulfate is used as the substrate, was developed. Arylsulfatase
      activity was found in cell suspensions of representative strains of Mycobacterium
      avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum grown without
      the substrate in either Middlebrook 7H9 medium containing 0.2% (wt/vol) glucose
      and 0.05% (vol/vol) Tween 80 or Dubos broth medium, but was absent in cells grown
      in a low-pH, minimal medium containing 1% (vol/vol) Tween 80 as the sole carbon
      source. The levels of arylsulfatase activity of representatives of all three
      species were equal whether the activity was measured at pH 5.5, 6.5, or 7.5 and
      whether the cells were suspended in phosphate or Tris buffer. The addition of
      high levels of sulfate (present in the low-pH, Tween 80-containing medium) to
      Middlebrook 7H9 medium resulted in significantly lower levels of arylsulfatase
      activity in strains of M. scrofulaceum, but did not affect the levels in either
      M. avium or M. intracellulare. The levels of arylsulfatase activity were highest
      in M. avium, intermediate in M. intracellulare, and lowest in M. scrofulaceum
      strains. Polyacrylamide gel electrophoresis of crude extracts from late-log-phase
      cells of representatives of each species produced activity bands of unique
      mobility (one in M. avium, three in M. intracellulare [82, 5, and 13%], and two
      in M. scrofulaceum [60 and 40%]).

PMID- 2223597
TI  - DNA relatedness among established Ureaplasma species and unidentified feline and
      canine serogroups.
AB  - The levels of DNA relatedness among two unclassified feline ureaplasma
      serogroups, four unclassified canine ureaplasma serogroups, and the three
      previously established Ureaplasma species were examined and compared. The strains
      examined included five feline strains representing two feline serogroups, four
      canine strains representing four canine serogroups, and the type strains of the
      three established species. Each strain representing each species or serogroup
      exhibited 78% or more actual DNA homology with its homologous DNA, but less than
      10% DNA homology with DNAs from the heterologous strains. These findings indicate
      that each of these human, bovine, avian, feline, and canine strains is
      genomically distinct. In addition, the three previously recognized species
      (Ureaplasma urealyticum [human], Ureaplasma diversum [bovine], and Ureaplasma
      gallorale [avian]), which were established on the basis of phenotypic properties,
      were also shown to be genomically distinct. The three feline serogroup SI strains
      were genomically related (from 89 to 100% DNA homology) to each other but were
      unrelated (less than 10% DNA homology) to the feline serogroup SII strains,
      indicating that these two feline serogroups are also genomically distinct.
      Conversely, the two feline serogroup SII strains were genomically very similar
      (from 83 to 100% DNA homology) to each other but were unrelated (less than 10%
      DNA homology) to the three feline serogroup SI strains. However, canine serogroup
      SI strain D1M-C exhibited 73% DNA homology with serologically distinct canine
      serogroup SII strain D29M, indicating that these strains representing two
      separate serogroups belong to the same genomic species.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2223600
TI  - Recognition of biovar C of Fusobacterium necrophorum (Flugge) Moore and Holdeman
      as Fusobacterium pseudonecrophorum sp. nov., nom. rev. (ex Prevot 1940).
AB  - The cellular morphology, colonial morphology, biochemical properties, DNA base
      compositions, and DNA-DNA homolgies of three biovars of Fusobacterium necrophorum
      were examined. Some differences were found among the three biovars in cellular
      morphology, colonial morphology, and biochemical properties. The guanine-plus
      cytosine contents of DNAs from biovar C strains Fn521T (T = type strain), Fn522,
      and Fn520 were 30.4, 29.3, and 28.0 mol%, respectively, and the guanine-plus
      cytosine contents of DNAs from strains VPI 2891 (biovar A) and VPI 6161 (biovar
      B) were 31.3 and 32.0 mol%, respectively. Labeled DNA from biovar C strain Fn521T
      exhibited 96 and 82% relatedness to DNAs from biovar C strains Fn522 and Fn520,
      respectively; however, it exhibited only about 10% relatedness to DNAs from
      strains of biovars A and B. Labeled DNAs from strains VPI 2891 and VPI 6161
      exhibited more than 70% relatedness to each other, but about 6 to 20% relatedness
      to DNAs from biovar C strains. Therefore, Fusobacterium pseudonecrophorum sp.
      nov., nom. rev. (ex Prevot 1940) is proposed for Fusobacterium necrophorum biovar
      C. The type strain is strain Fn521 (= JCM 3722).

PMID- 2223601
TI  - Proposal of three subspecies of Fusobacterium nucleatum Knorr 1922: Fusobacterium
      nucleatum subsp. nucleatum subsp. nov., comb. nov.; Fusobacterium nucleatum
      subsp. polymorphum subsp. nov., nom. rev., comb. nov.; and Fusobacterium
      nucleatum subsp. vincentii subsp. nov., nom. rev., comb. nov.
AB  - Heterogeneity among isolates of Fusobacterium nucleatum has been recognized for
      many years. The phenotypic properties of 340 strains considered to be F.
      nucleatum were examined. While these strains were phenotypically similar and fit
      the description of F. nucleatum, they could be differentiated into three groups
      on the basis of electrophoretic patterns of whole-cell proteins and DNA homology.
      Strains in groups I and II showed greater than 80% DNA homology within groups and
      less than 75% similarity between groups. Strains of group III demonstrated
      greater than 85% DNA homology to each other and less than 65% similarity to
      strains in groups I and II. We propose that Fusobacterium nucleatum be divided
      into the following three subspecies: Fusobacterium nucleatum subsp. nucleatum,
      with type strain ATCC 25586; Fusobacterium nucleatum subsp. polymorphum, with
      type strain ATCC 10953; and Fusobacterium nucleatum subsp. vincentii, with type
      strain ATCC 49256.

PMID- 2223602
TI  - Taxonomy of alkaliphilic Bacillus strains.
AB  - The DNA base compositions of 78 alkaliphilic Bacillus strains were determined.
      These strains were grouped as follows: DNA group A, guanine-plus-cytosine (G+C)
      content of 34.0 to 37.5 mol% (17 strains); DNA group B, G+C content of 38.2 to
      40.8 mol% (33 strains); and DNA group C, G+C content of 42.1 to 43.9 mol% (28
      strains). DNA group A includes the type strain of Bacillus alcalophilus Vedder
      1934. DNA-DNA hybridization studies with DNA group A strains revealed that only
      one strain, strain DSM 2526, exhibited a high level of DNA homology with B.
      alcalophilus DSM 485T (T = type strain). Neither strain DSM 485T nor any other
      DNA group A strain is homologous to any of the Bacillus type strains with
      comparable base compositions. Six strains formed a distinct group containing
      three highly homologous strains and three strains exhibiting greater than 50% DNA
      homology.

PMID- 2223603
TI  - Leptospira interrogans serovar unipertama isolated in Malaysia.
AB  - A leptospiral isolate from a bovine kidney was found to be antigenically
      different from all previously recognized serovars of Leptospira interrogans based
      on the cross-agglutinin absorption test. The new serovar belongs to the Sejroe
      serogroup, and the name Leptospira interrogans serovar unipertama is proposed for
      it, with strain K2-1 as the reference strain.

PMID- 2223604
TI  - Description of Bacillus naganoensis sp. nov.
AB  - A new species, Bacillus naganoensis, is proposed for an obligately aerobic,
      moderately acidophilic, endospore-forming bacterium that produces a thermostable,
      aciduric pullulanase (EC 3.2.1.41). The organism was isolated from soil by
      selection on solid, pullulan-containing medium at pH 4.0 and 30 degrees C. The
      isolate required a medium pH of less than 6.5 for growth initiation. Fatty acid
      composition studies revealed that the major fatty acid of cells grown in nutrient
      broth supplemented with 1% starch was 14-methylpentadecanoic acid (iso-C16) at 45
      mol%. The guanine-plus-cytosine content of the DNA of this organism was 45 +/- 2
      mol%. A type culture has been deposited with the American Type Culture
      Collection, Rockville, Md., as strain ATCC 53909.

PMID- 2223605
TI  - Inter- and intrafamilial similarities of rRNA cistrons of the Pasteurellaceae.
AB  - We performed hybridizations between labeled rRNAs from seven representative
      members of the family Pasteurellaceae and from three other taxa on the one hand
      and DNAs from 53 strains known or presumed to belong to the Pasteurellaceae on
      the other hand. The members of the Pasteurellaceae are most closely related to
      members of the Enterobacteriaceae, the Vibrionaceae, the Aeromonadaceae, and the
      genus Alteromonas. The family Pasteurellaceae is very heterogeneous. There are at
      least seven rRNA branches. Several organisms with the same genus name are
      dispersed over the entire dendrogram. The "Histophilus ovis," [Haemophilus]
      ducreyi, [Actinobacillus] actinomycetemcomitans, and [Haemophilus] aphrophilus
      rRNA branches are separate and quite remote from the three authentic genera in
      this family; this might justify eventual later separate generic status. DNA-rRNA
      hybridization with suitable, labeled rRNA probes is an excellent method to
      establish whether an organism belongs in the Pasteurellaceae; e.g., some strains
      of Bisgaard's taxa 7, 13, and 16 and of the gas-producing "SP" group certainly
      belong in this family, whereas three bovine lymphangitis organisms (strains NCTC
      10547, NCTC 10549, and NCTC 10553), [Haemophilus] piscium ATCC 10801T (T = type
      strain), and [Pasteurella] piscicida ATCC 17911 belong in the Enterobacteriaceae,
      the Aeromonadaceae, and the Vibrionaceae, respectively.

PMID- 2223606
TI  - Mycoplasma lactucae sp. nov., a sterol-requiring mollicute from a plant surface.
AB  - Strain 831-C4T (T = type strain), isolated from the surface of lettuce plants
      (Lactuca sativa) obtained from a retail food market, was shown to be a sterol
      requiring mollicute. Morphological examination of this organism by electron and
      dark-field microscopic techniques showed that it consists of small, nonhelical,
      nonmotile, pleomorphic coccoid cells, with individual cells surrounded by a
      single cytoplasmic membrane. No evidence of a cell wall was observed. The
      organism grew rapidly in all conventional culture medium formulations for
      mollicutes in either aerobic or anaerobic environments. The optimum temperature
      for growth was 30 degrees C, but multiplication occurred at 18 to 37 degrees C.
      Strain 831-C4T catabolized glucose, but hydrolysis of arginine or urea could not
      be demonstrated. The genome size of strain 831-C4T was determined to be about 569
      megadaltons, while the base composition (guanine-plus-cytosine content) of the
      DNA was 30.0 mol%. Recent studies in which we compared the 16S rRNA sequences of
      strain 831-C4T with those of more than 40 other mollicutes indicated that this
      organism is phylogenetically related to the Spiroplasma-Mycoplasma mycoides
      clade. Strain 831-C4T was serologically unrelated to the type strains of
      previously described Mycoplasma species and to 18 other unclassified sterol
      requiring isolates cultivated from various animal, plant, or insect sources.
      Strain 831-C4T (= ATCC 49193) is the type strain of Mycoplasma lactucae sp. nov.

PMID- 2223607
TI  - Mycoplasma melaleucae sp. nov., a sterol-requiring mollicute from flowers of
      several tropical plants.
AB  - Three sterol-requiring mollicutes from floral surfaces of two tropical plant
      species (Melaleuca quinquenervia and Melaleuca decora) and a single isolate from
      a flower of the silk oak (Grevillea robusta) were serologically
      indistinguishable. Strain M1T (T = type strain), isolated from Melaleuca
      quinquenervia, was chosen for characterization. Light and electron microscopic
      observations of strain M1T revealed nonhelical, nonmotile, pleomorphic coccoid
      cells surrounded by a single cytoplasmic membrane. No evidence of a cell wall was
      observed. The organism grew well in SP-4 medium, but no sustained growth occurred
      in conventional mycoplasma media containing horse serum. The optimum temperature
      for growth was 23 degrees C, but multiplication occurred over a temperature range
      of 10 to 30 degrees C. Growth was not observed at temperatures above 30 degrees
      C. Strain M1T and related strains (strains M5, M10, and SO1) catabolized glucose
      but hydrolyzed neither arginine nor urea. The size of the strain M1T genome was
      about 561 megadaltons, while the guanine-plus-cytosine content of the DNA was
      about 27.0 mol%. The organism was serologically unrelated to the type strains of
      the 80 previously recognized Mycoplasma species or to 18 other unclassified
      sterol-requiring strains cultivated from animal, plant, or insect sources. Recent
      sequencing studies of 16S rRNA demonstrated that strain M1T is a member of a
      clade that contains the type species of the genus Mycoplasma. Strain M1 (= ATCC
      49191) is the type strain of Mycoplasma melaleucae sp. nov.

PMID- 2223608
TI  - Actinobacillus rossii sp. nov., Actinobacillus seminis sp. nov., nom. rev.,
      Pasteurella bettii sp. nov., Pasteurella lymphangitidis sp. nov., Pasteurella
      mairi sp. nov., and Pasteurella trehalosi sp. nov.
AB  - Evidence from numerical taxonomic analysis and DNA-DNA hybridization supports the
      proposal of new species in the genera Actinobacillus and Pasteurella. The
      following new species are proposed: Actinobacillus rossii sp. nov., from the
      vaginas of postparturient sows; Actinobacillus seminis sp. nov., nom. rev.,
      associated with epididymitis of sheep; Pasteurella bettii sp. nov., associated
      with human Bartholin gland abscess and finger infections; Pasteurella
      lymphangitidis sp. nov. (the BLG group), which causes bovine lymphangitis;
      Pasteurella mairi sp. nov., which causes abortion in sows; and Pasteurella
      trehalosi sp. nov., formerly biovar T of Pasteurella haemolytica, which causes
      septicemia in older lambs.

PMID- 2223609
TI  - Evidence that Bacteroides nodosus belongs in subgroup gamma of the class
      Proteobacteria, not in the genus Bacteroides: partial sequence analysis of a B.
      nodosus 16S rRNA gene.
AB  - The taxonomic status of the anaerobe Bacteroides nodosus has for some time been
      uncertain. To resolve this uncertainty, the distal portion of a 16S rRNA gene
      from this important ovine pathogen was cloned, mapped, and sequenced. A
      comparison of the sequence with the sequences of 16S rRNA molecules from other
      bacteria indicated that B. nodosus is more closely related to Escherichia coli
      and other members of the class Proteobacteria than to Bacteroides fragilis or the
      bacteroides-flavobacterium-cytophaga phylum. The evidence from the comparison of
      sequence signatures suggests that B. nodosus is not a member of the genus
      Bacteroides but that it belongs in subgroup gamma of the class Proteobacteria.

PMID- 2223610
TI  - Mycoplasma somnilux sp. nov., Mycoplasma luminosum sp. nov., and Mycoplasma
      lucivorax sp. nov., new sterol-requiring mollicutes from firefly beetles
      (Coleoptera: Lampyridae).
AB  - Strain PYAN-1T (T = type strain), which was isolated from a pupal gut of the
      firefly beetle Pyractonema angulata, and strains PIMN-1T and PIPN-2T, which were
      isolated from guts of adult Photinus marginalis and Photinus pyralis fireflies,
      respectively, were demonstrated to be sterol-requiring mollicutes. Cells of the
      three strains were shown by electron and dark-field microscopy to be small,
      pleomorphic, nonhelical, nonmotile bodies surrounded by single membranes. No
      evidence of a cell wall was observed, and the organisms were not susceptible to
      500 U of penicillin per ml. The three strains grew rapidly in SP-4 broth medium.
      Strains PIMN-1T and PIPN-2T grew in medium supplemented with bovine serum
      fraction, but strain PYAN-1T did not. All three strains grew on solid media when
      the cultures were incubated aerobically, but only strains PYAN-1T and PIPN-2T
      formed colonies when anaerobic conditions were employed. The three strains
      catabolized glucose but hydrolyzed neither arginine nor urea. All of the strains
      grew at temperatures of 18 to 32 degrees C; strains PYAN-1T and PIMN-1T also grew
      at 10 degrees C. The optimal temperature for growth for strains PYAN-1T and PIPN
      2T was 30 degrees C; strain PIMN-1T grew equally well at 30 or 32 degrees C. None
      of the three strains grew at 37 degrees C. The genome sizes of strains PYAN-1T,
      PIMN-1T, and PIPN-2T were about 527 (478 to 589), 570 (480 to 630), and 762 (635
      to 871) megadaltons, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223611
TI  - Amycolatopsis methanolica sp. nov., a facultatively methylotrophic actinomycete.
AB  - The generic position of a gram-positive, facultatively methylotrophic
      actinomycete known as Nocardia sp. strain 239 was determined by comparing reverse
      transcriptase sequences of 16S rRNA. The assignment of the organism to the genus
      Amycolatopsis was strongly supported by chemotaxonomic and morphological data. A
      comparison with the type strains of validly described Amycolatopsis species
      showed that the organism formed the nucleus of a new species. The name proposed
      for this new species is Amycolatopsis methanolica. The organism has been
      deposited in the National Collection of Industrial Bacteria as NCIB 11946.

PMID- 2223613
TI  - Revised nomenclature of Campylobacter laridis, Enterobacter intermedium, and
      "Flavobacterium branchiophila".

PMID- 2223612
TI  - Prevotella, a new genus to include Bacteroides melaninogenicus and related
      species formerly classified in the genus Bacteroides.
AB  - It was recently proposed that the genus Bacteroides should be restricted to
      Bacteroides fragilis (the type species) and closely related organisms (viz., B.
      caccae, B. distasonis, B. eggerthii, B. merdae, B. ovatus, B. stercoris, B.
      thetaiotaomicron, B. uniformis, and B. vulgatus). By contrast, the moderately
      saccharolytic, predominantly oral Bacteroides species, which include B.
      melaninogenicus, B. oralis, and related species, form a phenotypically and
      phylogenetically coherent group of species which differ so significantly from the
      emended description of the genus Bacteroides that they should not be classified
      in the same genus. Therefore, we formally propose that these species be
      reclassified in a new genus, Prevotella. The type species is Prevotella
      melaninogenica.

PMID- 2223614
TI  - [Bone marrow transplantation in children. Nursing aspects].

PMID- 2223615
TI  - [Bone marrow transplantation in childhood].

PMID- 2223617
TI  - [Pioneers in pediatrics. Charles West (1816-1898)].

PMID- 2223616
TI  - [Modern aspects of insulin treatment of diabetic children and adolescents].

PMID- 2223618
TI  - [A look into the past. Infant care at the turn of the century].

PMID- 2223619
TI  - [Treatments for children].

PMID- 2223620
TI  - [Pathology of the external female genitalia].

PMID- 2223622
TI  - [Diseases of the hematologic cell systems. 2. Diseases of the white blood cells].

PMID- 2223621
TI  - [Report on experiences in Japan].

PMID- 2223623
TI  - [Alternative nutritional possibilities for neonates and infants].

PMID- 2223625
TI  - [Cooperation between pediatricians and pediatric nurses in the home].

PMID- 2223624
TI  - [Pioneers in pediatrics. Himself a pioneer. Letter to Dr. Johannes Oehme on the
      occasion of his 75th birthday on 3 September 1990].

PMID- 2223626
TI  - [Sickle and pigeon-toed foot].

PMID- 2223627
TI  - The use of unrelated marrow donors for transplantation.

PMID- 2223629
TI  - Reactivity of a human monoclonal antibody against Rh D with the intermediate
      filament protein vimentin.
AB  - The human IgM anti-Rh D antibody MAD-2 has previously been shown to react with
      human and animal tissues and leucocytes. Double labelling immunofluorescence with
      MAD-2 and a mouse monoclonal antibody against vimentin, the intermediate filament
      protein of cells of mesenchymal origin, showed coincidental staining which was
      distinct from that seen with antibodies against other cytoskeletal proteins.
      Using immunoblotting, both MAD-2 and anti-vimentin reacted with a 55 kDa tissue
      component, and with purified vimentin. These results show that the major tissue
      and leucocyte protein recognized by MAD-2 is vimentin.

PMID- 2223628
TI  - Induction of patching and its reversal on surface-activated human platelets.
AB  - Fibrinogen coupled to colloidal gold (Fgn/Au) has been used to follow GPIIb-IIIa
      receptors on surface-activated platelets and to evaluate the effects of the anti
      actin agent, cytochalasin B (CB), on the movement of receptor-ligand complexes.
      Fgn/Au binds diffusely to spread platelets, but is translocated rapidly from the
      peripheral margin to cell centres and to channels of the open canalicular system
      (OCS). CB added after spreading and incubation with Fgn/Au reverses the
      centripetal movement of receptor-ligand complexes. Fgn/Au particles move back
      toward the margins of spread cells and form patches. The patches of receptor
      ligand complexes overlie segments of the OCS filled with Fgn/Au. Washing out the
      CB reverses the process and receptor-ligand complexes are again translocated
      toward platelet centres.

PMID- 2223631
TI  - Molecular charge heterogeneity of human serum erythropoietin.
AB  - The charge heterogeneity of human serum erythropoietin (S-Epo) was studied in 89
      serum specimens from 78 subjects by zone electrophoresis in 0.17% agarose
      suspension at pH 8.6. The electrophoretic elution profiles of S-Epo were
      determined with a radioimmunoassay for Epo. The number of Epo peaks indicated
      that at least 20-30 different forms of Epo were present in a single serum
      specimen. The median charge of Epo, estimated as its median electrophoretic
      mobility, was determined for each serum specimen. This median charge was measured
      in 10 healthy adults, 46 patients with anaemia, six patients with secondary
      polycythaemia, one patient with polycythaemia vera treated by phlebotomy, and six
      healthy newborn infants (cord sera). Forty-four of the patients with anaemia had
      a median charge of S-Epo within the reference range for healthy adults, while all
      the patients with polycythaemia and the newborn infants had less negatively
      charged forms of S-Epo. In nine patients in whom the S-Epo level had a circadian
      rhythm, the forms of S-Epo in the evening were less negative than those in the
      morning. The median charge of recombinant preparations was much less negative
      than that of S-Epo in healthy individuals, while that of the 2nd International
      Reference Preparation was more negative than in any of the 78 subjects analysed.
      A significant change to less negatively charged S-Epo forms was observed 24 h
      after a subcutaneous injection of recombinant Epo in one patient, who before the
      injection had a normal median charge and concentration of S-Epo. In conclusion,
      Epo exhibits a considerable charge heterogeneity in individual serum specimens,
      the forms of S-Epo in the morning may differ from those in the evening, those in
      adults differ from those in newborn infants, and those in patients with anaemia
      differ from those in polycythaemia. The results also suggest that the methods
      used in this study may be useful for detecting the presence of injected
      recombinant Epo in the blood in persons with a normal endogenous Epo production.

PMID- 2223630
TI  - Interaction of monocytes and T cells in the regulation of normal human
      megakaryocytopoiesis in vitro: role of IL-1 and IL-2.
AB  - Autologous or allogeneic peripheral blood T cells can stimulate the human
      megakaryocyte progenitor cell (CFU-Meg)-derived colony formation in a dose
      dependent fashion in agar cultures of nonadherent (NA), T cell-depleted (NT) bone
      marrow (BM) cells. Low concentrations of monocytes and T cells can collaborate in
      the stimulation of CFU-Meg colony formation or in the production of megakaryocyte
      colony stimulating factor (Meg-CSF) by T cells in the presence of mitogens or IL
      2. Monocytes alone can produce only negligible Meg-CSF under any conditions. When
      monocyte conditioned medium (CM) was added to T cell-stimulated NA, NT BM cell
      cultures, CFU-Meg colony growth was appreciably increased compared with that
      stimulated by T cells alone. Dose-dependent increase in CFU-Meg colony growth was
      noted when varying concentrations of IL-1 were added to T cell-stimulated NA, NT
      cell cultures, although IL-1 itself could support no CFU-Meg colony growth in the
      absence of T cells. These data suggest that a synergistic interaction between T
      cells and monocytes during the production of Meg-CSF by T cells could be partly
      mediated by IL-1. IL-2 was found to stimulate Meg-CSF production by T cells in
      the presence or absence of mitogens. IL-2-stimulated Meg-CSF production by T
      cells was augmented by the addition of monocytes. Although IL-2 itself had no
      stimulatory effect on CFU-Meg colony growth, dramatic augmentation in the CFU-Meg
      colony number was noted when IL-2 was added to T cell-stimulated NA, NT cell
      cultures. High concentrations of monocytes and prostaglandin E (PGE) inhibited
      the CFU-Meg colony formation. These results suggest that IL-1 and IL-2 may play a
      stimulatory role on the normal human in vitro megakaryocytopoiesis, and may be
      involved in the development of reactive thrombocytosis and bone marrow
      megakaryocytic hyperplasia in various inflammatory diseases.

PMID- 2223632
TI  - Serum erythropoietin changes in autologous and allogeneic bone marrow transplant
      patients.
AB  - Sequential changes in serum erythropoietin (sEPO) levels were measured by
      radioimmunoassay in six patients receiving autologous rescue (AR) and 11 patients
      receiving an allogeneic bone marrow transplant (BMT) for malignant disease.
      Longitudinal studies showed an inverse relationship between sEPO and haemoglobin
      levels in the autologous rescue and allogeneic transplant patients throughout the
      130 d post-transplant study period. Early post-conditioning EPO responses were
      normal for the haemoglobin level in both groups, but after day 14 post
      transplant, erythropoietin production in response to anaemia became impaired in
      one autologous rescue patient and eight of the 11 allogeneic transplant patients.
      There was no clear association between late impairment of sEPO production and
      conditioning therapy, infection, graft-versus-host disease, immunosuppressive
      therapy or serum creatinine. Blood transfusion requirements were similar for both
      groups in the first month after transplantation, but from days 31 to 90 post
      transplant, BMT patients required an average of 5.5 units per patient compared
      with 1 unit per patient for the autologous group. Marrow transplant procedures do
      not affect early EPO responses but may diminish late responses. The potential
      value of exogenous rHuEPO in hastening engraftment and decreasing transfusion
      requirements, particularly for those patients who appear to have impaired EPO
      responses, remains to be shown by clinical trials.

PMID- 2223633
TI  - A splicing mutation accounts for the lack of p53 gene expression in a CML blast
      crisis cell line: a novel mechanism of p53 gene inactivation.
AB  - Alterations of the p53 anti-oncogene have recently been found to occur frequently
      in the blast crisis of chronic myelocytic leukaemia. The p53 gene may be altered
      by gross structural alterations or by point mutations in the coding sequence. We
      now report a novel mechanism of gene inactivation in a blast crisis cell line
      where a mutation in a splice donor site at the 5' end of the fifth intron of the
      gene interrupts RNA processing and gene expression.

PMID- 2223634
TI  - Long-term stable mixed chimaerism following allogeneic marrow transplantation for
      severe aplastic anaemia.

PMID- 2223635
TI  - Deferoxamine-induced restoration of haematopoiesis in myelofibrosis secondary to
      myelodysplasia.

PMID- 2223636
TI  - Sporadic HTLV-I associated adult T-cell leukaemia (ATL) in the U.K.

PMID- 2223637
TI  - Regression of diffuse osteosclerosis in hairy cell leukaemia after treatment with
      interferon.

PMID- 2223639
TI  - Transient spontaneous remission in a case of adult acute myelogenous leukaemia.

PMID- 2223638
TI  - The first reported case of hypoglycaemia as the presenting feature of invasive
      plasmacytoma with a paraprotein band and grossly elevated insulin levels.

PMID- 2223640
TI  - Lack of reversal with verapamil of drug resistance in multiple myeloma.

PMID- 2223641
TI  - Translocations involving 5q35 may also be associated with plasma cell leukemia.

PMID- 2223642
TI  - The distribution of CD45R, CD29 and CD45RO (UCHL1) antigens in mature CD4
      positive T-cell leukaemias.

PMID- 2223643
TI  - Use of leukocyte-poor blood components in acute myeloblastic leukemia does not
      affect disease-free survival in first complete remission.

PMID- 2223645
TI  - A study of prognostic factors in blast crisis of Philadelphia chromosome-positive
      chronic myelogenous leukaemia.
AB  - In 80 patients with Ph-positive chronic myelogenous leukaemia the main clinical,
      haematological and cytogenetical data were recorded at diagnosis of blast crisis
      and evaluated for prognostic significance. At the time of the analysis 73
      patients had died, with a median survival of 4-8 months from diagnosis of blast
      crisis for the whole series. When analysed as a time-dependent variable, the
      achievement of a favourable response to chemotherapy resulted in a longer
      patient's survival. On the other hand, the univariate analysis identified six
      pretreatment characteristics associated with a poorer prognosis: a longer chronic
      phase, presence of extramedullary blastic involvement, a platelet count below 200
      x 10(9)/l, a less marked leucocytosis, a blood blast cell percentage higher than
      10%, and presence of trisomy 8. The latter parameters were included in a multiple
      regression model together with the blast cell phenotype (lymphoid versus non
      lymphoid), and only four of them (trisomy 8, duration of chronic phase, platelet
      count, and leucocyte count) retained their prognostic influence. When the
      therapeutical response was also included in the regression model, it proved to be
      the most important prognostic variable, followed by trisomy 8, length of chronic
      phase, extramedullary disease, and platelet count, whereas the leukocyte count
      lost its predictive value. Thus, in spite of the short overall survival of blast
      crisis patients, the identification of prognostic factors in such a
      haematological condition may be of interest, especially in the interpretation of
      new therapeutical approaches.

PMID- 2223644
TI  - Different sensitivity of normal and leukaemic progenitor cells to Ara-C and IL-3
      combined treatment.
AB  - In the present study the effects of a combined treatment with cytosine
      arabinoside (Ara-C) and interleukin-3 (IL-3) on acute myeloblastic leukaemia
      clonogenic cells and on normal haemopoietic progenitors was investigated, with
      the aim of improving the tumoricidal effect of cycle specific drugs. Blast cells
      from 24 acute myeloblastic leukaemia (AML) patients were screened with a short
      term proliferative assay based on 3H-thymidine (3H-TdR) uptake for their response
      to IL-3. To evaluate the synergism between the growth factor and Ara-C, the cells
      were pretreated for 3 d in liquid culture in the presence or absence of IL-3 (10
      U/ml) and for the last 24 h with Ara-C (3 micrograms/ml). The cells were then
      washed and seeded in semisolid media to assess their clonogenic ability. The
      results showed that, in those cases which were good responders to IL-3 in the 3H
      TdR uptake assay (19 out of 24), Ara-C exposure eliminated a greater proportion
      of clonogenic cells if pretreated with IL-3 than if untreated (P less than
      0.001), while in cases unresponsive to IL-3 this effect was not significant.
      Moreover, when the same protocol was applied to bone marrow cells from normal
      donors, it was found that IL-3 pretreatment did not significantly enhance the
      toxic effect of Ara-C on day 14 granulocyte-macrophage colony forming units (CFU
      GM) and erythroid burst forming units (BFU-E). Finally IL-3 pretreatment was also
      able to increase the cytotoxic effect of Ara-C on leukaemic cells co-cultured, to
      simulate clinical AML remission, with normal bone marrow cells. The results
      indicate that IL-3 may improve the therapeutic index of cycle-specific drugs in
      AML therapy.

PMID- 2223646
TI  - The role of alternative splicing patterns of BCR/ABL transcripts in the
      generation of the blast crisis of chronic myeloid leukaemia.
AB  - Three major types of mRNA can be expressed as a result of the Philadelphia
      translocation, dependent on the position of the break within the BCR gene on
      chromosome 22. In addition, alternative splicing of the mRNA transcribed from the
      BCR/ABL fusion gene has been reported and it has been suggested that this may
      play a role in the generation of the acute phase of Philadelphia positive chronic
      myeloid leukaemia (CML). We have examined the fusion RNA present in 24 cases of
      chronic phase CML and 21 cases of patients with CML in blast crisis using the
      polymerase chain reaction. In no case was it possible to detect the presence of
      the e1a2 junction which encodes the p190 hybrid protein product. We conclude that
      the acquisition of the p190 does not play a significant role in the generation of
      the blast crisis of CML. Neither could we detect a significant difference in the
      number of cases which simultaneously express both b2a2 and b3a2 junction products
      in samples isolated from chronic phase and blast crisis. In the series analysed
      by ethidium bromide stained gels, there was, however, an increase in the
      percentage of cases expressing the b3a2 junction in the mononuclear cells of
      blast crisis patients as compared to the white blood cells of patients in chronic
      phase.

PMID- 2223647
TI  - ABL proteins in Philadelphia-positive acute leukaemias and chronic myelogenous
      leukaemia blast crises.
AB  - The Philadelphia chromosome (Ph1) is present in 95% of chronic myelogenous
      leukaemias (CML) and 15% of acute lymphoblastic leukaemias (ALL). This
      cytogenetic marker is due to a t(9;22) translocation, which causes a
      rearrangement of the ABL oncogene. In order to better define the relationship
      between type of genomic rearrangement, variant ABL protein expressed and
      haematological phenotype, a series of Ph1-positive acute leukaemias, both
      myeloblastic (AML) and lymphoblastic, and several CML lymphoid blast crises have
      been analysed at the DNA and protein level. The results confirm the presence of
      the ABL protein P210 in all cases of CML, ALL and AML positive for rearrangement
      in the bcr region of chromosome 22, and, surprisingly, in one AML case apparently
      negative for bcr rearrangement. The ABL protein P190 was found to be present only
      in cases of ALL negative for bcr rearrangement. Polymerase chain reaction (PCR)
      analysis of the types of 9/22 junctions present in the mRNA of CML lymphoid blast
      crises showed no evidence of 'ALL-type' transcripts.

PMID- 2223648
TI  - Natural history of stage A chronic lymphocytic leukaemia untreated patients.
      French Cooperative Group on Chronic Lymphocytic Leukaemia.
AB  - In chronic lymphocytic leukaemia (CLL), stage A was defined in 1979 as the best
      prognostic group of the three-stage (A, B, C) classification which was thereafter
      adopted by an International Workshop on CLL. Recently, the question of whether or
      not all stage A patients should be treated was raised by authors who described
      potential harmful effects of treatment among stage A patients and heterogeneity
      of stage A with respect to survival and disease progression. In this work, we
      studied the natural history of stage A-CLL in order to determine on which grounds
      a decision to treat should be made. We performed a prognostic study on 309
      untreated stage A-CLL patients enrolled in a randomized clinical trial from 1980
      to 1985. Our aim was to segregate a subgroup with a low probability of disease
      progression and death. We used three endpoints: overall survival (50 deaths),
      disease progression to stage B or C (78 events) and disease progression to stage
      C (39 events). Multivariate analyses, using Cox's model, selected nine variables
      as having a prognostic value for at least one endpoint, namely age, sex, general
      symptoms, involved axillary lymph node, splenomegaly, haemoglobin, platelets,
      lymphocyte count and bone-marrow infiltration. By considering the three endpoints
      jointly, we obtained a proposed definition of smouldering CLL based on four
      variables, namely haemoglobin level, lymphocyte count, the number of enlarged
      areas and bone-marrow infiltration. However, we did not succeed in better
      defining smouldering CLL than in a previous proposal, based on haemoglobin level
      and lymphocyte count. Moreover, whatever the definition used, including other
      previous works, disease progression within 5 years was still observed for about
      10% of patients with smouldering CLL. Future attempts to define smouldering CLL
      could perhaps benefit from using biological markers.

PMID- 2223649
TI  - The 14;18 translocation in European cases of follicular lymphoma: comparison of
      Southern blotting and the polymerase chain reaction.
AB  - The 14;18 chromosomal translocation is widely recognized as a cytogenetic
      abnormality associated with follicular lymphomas, but estimates of its frequency
      in this type of lymphoma vary widely from less than 50% to almost 90%.
      Furthermore, no extensive data have been published on the frequency of t(14;18)
      in European cases of follicular lymphoma. Lymph nodes from 51 patients with
      follicular lymphomas obtained from two European centres (Oxford and Copenhagen)
      were examined for the presence of this translocation. Southern blotting and the
      polymerase chain reaction (PCR) were used in 26 cases and the PCR alone in 25
      cases (from which only degraded DNA or formalin fixed samples were available).
      DNA probes capable of detecting rearrangement at both the major and the minor
      breakpoint regions were employed. We could detect t(14;18) in only 21 out of 51
      cases (41%). However, a review of the literature showed that comparable results
      have been obtained previously using both cytogenetic and molecular biological
      techniques and our results support the view that the global incidence of t(14;18)
      in follicular lymphoma is no greater than 70%. Furthermore, this study has
      indicated that the PCR is a reliable method for identifying t(14;18) when only
      formalin-fixed paraffin-embedded tissue or degraded DNA is available.

PMID- 2223650
TI  - Translocation of bcl-2 gene in non-Hodgkin's lymphomas in Hong Kong Chinese.
AB  - The close association between translocation of the proto-oncogene bcl-2 and
      follicular lymphomas has been well established in Caucasian patients and the de
      regulation of bcl-2 has been implicated in follicular lymphomagenesis. Similar
      molecular structural alterations have also been detected in diffuse lymphomas
      with a previous history of a follicular pattern as well as in a smaller
      proportion of de novo diffuse lymphomas. There is a lower incidence of follicular
      lymphomas in Chinese. In order to investigate further this phenomenon, we used
      bcl-2 translocation as a genetic marker of follicular lymphomas, to study 31
      cases of B cell non-Hodgkin's lymphomas in Chinese patients by Southern blot
      analysis. Eight out of 16 cases of follicular lymphomas showed bcl-2
      translocation with involvement of the major breakpoint region (MBR). Six of these
      cases utilized breakpoints within the 4.3 kb HindIII fragment, while in two cases
      the breakpoints were more dispersed, but still within the BamHI fragment. An
      additional case of follicular lymphoma showed translocation of bcl-2 gene with
      involvement of the minor cluster region (mcr), making a total of nine out of 16.
      None of the 15 cases of diffuse lymphomas showed similar molecular structural
      alterations. These data show that bcl-2 translocation is present in 57% of
      follicular lymphomas in Chinese patients, and support the notion that bcl-2
      translocation is a consistent marker for follicular lymphomas irrespective of
      ethnic differences. As the translocation is not detected in the diffuse
      lymphomas, there is no evidence to suggest that the low incidence of follicular
      lymphomas in Chinese patients is due to a greater tendency for follicular tumours
      to progress rapidly and present as diffuse lymphomas.

PMID- 2223651
TI  - Interleukin-4 regulates mRNA accumulation of macrophage-colony stimulating factor
      by fibroblasts: synergism with interleukin-1 beta.
AB  - We demonstrate that macrophage-colony stimulating factor (M-CSF) is expressed in
      human fibroblasts at the mRNA and protein level. Following activation with both
      interleukin (IL)-1 beta and IL-4, fibroblasts synthesized M-CSF transcripts
      detectable by Northern blot analysis with peak expression occurring at 8 h and 12
      h, respectively. Exposure of fibroblasts to both cytokines resulted in M-CSF
      protein release at 60 h of c. 500 U/ml (for IL-1 beta) and 1000 U/ml (for IL-4),
      relative to a control preparation of recombinant human M-CSF in a murine bone
      marrow colony assay. Both interleukins synergized to enhance M-CSF mRNA
      accumulation and their ability to induce M-CSF transcripts could be abolished by
      treatment with specific neutralizing antibodies. These observations provide
      support for the idea that fibroblasts may control monocyte/macrophage development
      and function, and that IL-1 beta and IL-4 are involved in the regulation of this
      process.

PMID- 2223652
TI  - Antithrombotic potencies of heparins in relation to their antifactor Xa and
      antithrombin activities: an experimental study in two models of thrombosis in the
      rabbit.
AB  - Our purpose was to determine the relative contribution of the antifactor Xa and
      antithrombin activities of heparin to its antithrombotic potency. The
      antithrombotic activities of unfractionated heparin (UH), two low molecular
      weight heparins (LMWH, CY 216 and CY 222) with increasing anti-factor
      Xa/antithrombin ratio and a synthetic pentasaccharide (PS) with high affinity to
      antithrombin III and no antithrombin activity were evaluated. In the Wessler
      thromboplastin model, the most potent antithrombotic agent, on a weight basis,
      was UH followed by CY 216, CY 222 and the PS which was 40 times less potent than
      UH. On an antithrombin unit basis, the antithrombotic potencies of UH, CY 216 and
      of CY 222 were equivalent. Thus, in this model, the antithrombotic effect results
      from the catalytic action of UH or LMWH on thrombin inhibition. In the Wessler
      serum model, on a weight basis, the antithrombotic effectiveness of UH was
      unchanged, those of CY 216 and CY 222 were doubled, and that of the PS was
      increased 10 times. On an anti-factor Xa unit basis, CY 216 was as effective as
      UH, and PS as effective as CY 222. On an antithrombin unit basis, CY 216 and CY
      222 were equivalent and more potent than UH. Thus, in this model, the antifactor
      Xa activity of heparin becomes important for its antithrombotic property. After a
      single subcutaneous injection of 1000 antifactor Xa U/kg, the antithrombotic
      effects of UH were maintained for more than 14 h in the two models. After
      injection of the same dose of CY 216 significant antithrombotic effects were
      observed only for 9 h, in the Wessler-thromboplastin model but for 18 h in the
      Wessler-serum model. At that time, no detectable antithrombin activity was
      measurable in the plasma while 0.11 units of antifactor Xa activity/ml was
      detected. Thus, the relative contribution of the anti-factor Xa and antithrombin
      activities to the antithrombotic effect of a LMWH differs according to the nature
      of the thrombogenic stimulus.

PMID- 2223654
TI  - [The effects of treatment with unpurified milk-based preparations in experimental
      influenza virus infection in mice].

PMID- 2223653
TI  - The continuous decrease in the number of SSPE annual cases ten years after
      compulsory anti-measles immunization.
AB  - The record of SSPE cases diagnosed immunochemically and serologically in our
      laboratory, standing for about 60% of the total new cases reported in our
      country, shows a significant decrease in the incidence in 1988-89 (from 5.21 new
      cases per year per million total population in 1987 to 1.82 cases in 1988). In
      85% of the patients, SSPE onset occurred at the age of 10 years or more,
      suggesting the possibility of a primary measles infection before anti-measles
      immunization became compulsory. High serum and CSF anti-measles antibody titres
      in recently diagnosed patients show subclinical long-term courses. Further
      serologic tests for viruses inducing persistent infections (herpes viruses, AgHBs
      and HIV) do not show any difference when compared to a control group excepting an
      increased incidence of anti-cytomegalic titres.

PMID- 2223655
TI  - [The mechanisms of persistent measles virus infection in HEp-2 cells].
AB  - Persistent infection with Edmonston strain of measles virus was established in a
      highly susceptible clone of HEp-2 cells. The morphological and cytogenic aspects
      of persistent infection are presented. Carriage of measles virus in cells
      persistently infected is marked by important differences between standard
      Edmonston strain and virus stocks isolated from time to time from the carrier
      state. It is especially significant that cell fusion capacity decreased in amount
      concordant with the drop in the yield of infectious virus. Addition of UV
      inactivated Sendai virus, trypsin treatment or incubation at suboptimal
      temperatures precipitate the cytocidal effect of measles virus. Some clinical
      implications of reactivation of the lytic cycle in the carrier state are
      suggested.

PMID- 2223656
TI  - [Inframicrobiological research on cases of insulin-dependent diabetes mellitus].
AB  - A group of 55 patients with insulin-dependent diabetes mellitus, aged from 8 to
      40 years, was followed and compared to a group of controls, in view of detecting
      a possible relation between the presence of inframicrobial agents and diabetes
      pathogenesis. The investigations revealed, in patients, significantly higher
      positivity rate of antibodies against mumps (27% versus 16.3% in controls),
      parainfluenza type 1 (45.4% versus 29.1%) and Epstein-Barr (54.5% versus 10.9%)
      viruses, and Mycoplasma pneumoniae (43.6 versus 18.2%).

PMID- 2223657
TI  - Evaluation of efficacy of pooled sera in a human immunodeficiency virus antibody
      prevalence in population surveys.
AB  - The pooling of five individual serum samples for the detection of human
      immunodeficiency virus type 1 (HIV-1) antibodies was examined to assess whether
      testing pooled versus individual sera was technically feasible. Detection of HIV
      1 antibodies was performed using a competitive enzyme immunoassay (EIA)
      Wellcozyme HIV Recombinant commercially available kit. Positive, weak positive
      and negative sera or HIV-1 antibody from Wellcozyme HIV Recombinant, Du Pont
      ELISA, SERODIA HIV Mast Diagnostica and from "Stefan S. Nicolau" Institute of
      Virology (NIV) collection were pooled in various dilutions with control negative
      sera for HIV-1 antibodies. When positive sera were pooled 1:4 with negative sera,
      results remained reactive in the same range of positivity and when cut off
      control sera were pooled 1:4 with negative sera samples remained in the cut off
      range. For reliability we considered cut of values of pooled sera probes an A 450
      absorbance 0.2 units higher than the absorbance of cut-off-control from
      Wellcozyme HIV Recombinant kit B. Samples of pooled sera that have absorbance A
      450 lower, equal or 0.2 units higher than the absorbance of cut off-control of
      Wellcozyme were considered positive and the five sera were tested as individual
      probes. The positive probes thus found were retested in duplicate using the
      original sample source. Negative samples of pooled sera do not have to be
      retested, this being the main advantage of this technique. Also positive sera
      (controls of from NIV collection) were pooled with HIV-1 antibody negative sera
      which were positive for rheumatoid factor (RF).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223658
TI  - Pregnant women at work: a study of ethnic minority risk in Leicestershire.
AB  - Possible reasons for the excess risk of perinatal mortality experienced by Asian
      women living in Leicestershire who work during pregnancy were investigated. This
      entailed a detailed examination of the work undertaken locally by a group of
      pregnant Asian women and comparison with the work undertaken by an occupationally
      matched group of pregnant non-Asian women. A total of 306 pregnant women were
      interviewed. The results suggest that the two ethnic groups experienced similar
      working conditions, and most of the women continued working until the 29th week
      of pregnancy. The Asian women worked significantly longer hours on average than
      the non-Asian group, and were more likely to report financial dependence by the
      family upon their earnings.

PMID- 2223659
TI  - Mortality of a cohort of tin miners 1941-86.
AB  - The mortality patterns of United Kingdom tin miners were examined in relation to
      calendar period and duration of underground work with particular attention to
      lung cancer and exposure to radon. Subjects were all men who had worked for at
      least one year between 1941 and 1984 at one of two United Kingdom tin mines and
      for whom a complete work history could be constructed from mine records.
      Standardised mortality ratios (SMRs) were calculated using national (England and
      Wales) rates. The pattern of SMRs in relation to potential explanatory variables
      was analysed using Poisson regression methods. Mortalities from lung cancer and
      silicosis (including silicotuberculosis) were significantly raised and showed a
      significant relation with duration of underground work (mortality from stomach
      cancer was raised in both underground and surface workers, but not
      significantly). Excess mortality from silica related disease declined steeply
      from 35% among workers first exposed before 1920 to 1% among those first exposed
      after 1950. Thirteen surface workers with known exposure to arsenic had high
      rates of lung and stomach cancer. The SMR for lung cancer showed a consistent
      pattern in relation to duration of underground exposure, rising from 83
      (observed/expected = 8/9.6) for surface workers (without exposure to arsenic) to
      447 (15/3.4) for workers with more than 30 years underground exposure.
      Examination of the SMR for lung cancer by total underground exposure, age, and
      time since last exposure gave rise to a model for the expression of risk which
      depends only on total exposure and time since exposure. The fitted model implies
      that the effect of exposure to radon in a given year has no effect on risk for 10
      years, then rapidly rises to a maximum from which the excess risk then declines,
      halving every 4.3 years. There were no direct measurements of historic radon
      levels. A conservative estimate based on measurements taken since 1969 by the
      National Radiological Protection Board and the Mines and Quarries Inspectorate is
      that the annual dose to an underground worker was about 10 working level months
      (WLM). Given this assumption, the risk/exposure slope implied by the present
      data, and the model fitted to it, was somewhat lower than that given in the
      fourth Committee on the Biological Effects of Ionisation Radiation (BEIR IV)
      report (about 40% lower for lifetime exposures). The present data also imply
      different risks depending on the age at exposure, with relatively higher lifetime
      risks for exposure at older ages, and relatively lower risks for exposures at
      younger ages. In conclusion, there was a clear relation between exposure to radon
      and death from lung cancer. The relative risk of lung cancer due to exposure to
      radon was not constant in cessation of exposure. The lifetime excess risk of lung
      cancer implied by these data for 40 years exposure at the current statutory limit
      of four WLM a year starting at age 20, was about 8% (79 excess deaths per 1000
      exposed), assuming average smoking habits among the exposed workers. Control of
      dust concentrations in the mines has substantially reduced--and may have
      eliminated--direct mortality from silica related disease.

PMID- 2223660
TI  - Age, sex, and region adjusted concentrations of chromium and nickel in lung
      tissue.
AB  - Chromium (Cr) and nickel (Ni) concentrations were measured in lung tissue from
      110 random necropsies by means of atomic absorption spectrometry. The subjects
      originated from the Ruhr district (Bochum (71 cases) and Dortmund (16 cases)
      areas), which has been defined as a particular pollution area with locally high
      Cr and Ni emissions, and from Munster and vicinity (23 cases). The Cr and Ni
      concentrations in lung tissue of the subjects from the Ruhr district (3.09 (SD
      2.99) micrograms Cr/g, 0.65 (SD 0.94) micrograms Ni/g dry weight of lung) were
      4.8 and 2.8 times higher than those from Munster (0.66 (SD 0.49) micrograms Cr/g,
      0.17 (SD 0.11) micrograms Ni/g dry weight of lung). Concentrations of Cr and Ni
      in men were twice those in women. All data showed an age dependent increase of Cr
      and Ni in the lung (about 2.4% a year for Cr and 3% a year for Ni) and Cr and Ni
      values showed a high correlation (r greater than or equal to 0.9). Thus it was
      possible to calculate age, sex, and region adjusted expected values of pulmonary
      Cr and Ni concentrations, and to identify the difference between expected and
      observed values. This might be helpful to interpret measurements in individual
      cases and in epidemiological studies. With this procedure the six cases of
      bronchial carcinoma in the series were shown to have pulmonary Cr and Ni
      concentrations that were mostly well above the predicted values, and it was
      possible to give a rough estimate of the degree of deviation.

PMID- 2223661
TI  - Toxic risks from inhalation of bacterial endotoxin.
AB  - A potential risk for workers exposed to inhalation of endotoxin, as well as the
      primary tissue changes, is the possibility of subsequent development of adult
      respiratory distress syndrome. Accordingly, hamsters were administered one hour
      aerosols of Enterobacter agglomerans and allowed to rest for six hours to produce
      maximum microlesions in the lung. One hour before this peak, the animals were
      injected intravascularly with the same suspension used in the aerosol. After one
      hour the animals were killed and bronchopulmonary lavages were made for analysis
      of free lung cells. As anaesthesia alone has been reported to be one of the
      operative procedures that enhance the effect of previous exposure to endotoxin,
      controls had to include sham anaesthesia with no intravascular injection.
      Endotoxin inhalation induced significant increases in total number of pulmonary
      leucocytes, mostly neutrophils, but with a concomitant relative decrease in
      number of alveolar macrophages. These polymorphonuclear neutrophils are not seen
      in morphometric analysis of the alveoli. Of greater interest was the large
      increase in erythrocytes suggesting pulmonary haemorrhages. Such changes were not
      due to intravenous bacterial alone, and were only significant when the bacteria
      were inhaled. Taken together with the other known inflammatory effects of inhaled
      bacteria or bacteria containing endotoxin, such inhalation in an occupational
      setting constitutes an increasingly recognised risk for workers.

PMID- 2223662
TI  - Effect of alkali treatment on physiological activity of cotton condensed tannin.
AB  - Cotton dusts contain condensed tannins and endotoxins, which are suspected of
      contributing to the development of acute and chronic biological responses in some
      cotton textile mill workers. Condensed tannin extracted from cotton dust was
      coated on to cellulose powder, and the tannin coated powder was treated with an
      alkali solvent system previously developed to reduce the endotoxin content and
      pulmonary toxicity of cotton dust. Physiological activities of the dusts and
      powders were compared by assaying the production of the arachidonic acid
      metabolites prostaglandin F2 alpha (PGF2 alpha), thromboxane A2 (TxA2) (the
      precursor to thromboxane B2 (TxB2], leukotriene C4 (LTC4), and prostaglandin E2
      (PGE2) by guinea pig pulmonary cells obtained by lung lavage. Cotton dust
      stimulated the pulmonary cells to produce a total of 29 pg metabolites per 10(6)
      cells. Production of metabolites by cells stimulated with tannin coated cellulose
      powder was reduced to 8.3 pg/10(6) cells. Alkali treatment of the tannin coated
      cellulose powder resulted in a further decrease in its ability to stimulate the
      cells, producing 3.5 pg metabolites per 10(6) cells. The ability of the dusts and
      powders to stimulate production of metabolites of arachidonic acid by pulmonary
      cells from guinea pigs was highly correlated with tannin content of the
      materials, but not with endotoxin content as measured by the Limulus amoebocyte
      lysate (LAL) assay.

PMID- 2223663
TI  - Neuropsychiatric symptoms among welders exposed to neurotoxic metals.
AB  - Neuropsychiatric symptoms in 65 welders exposed to aluminium and 217 railroad
      track welders were studied with the aid of a previously validated questionnaire.
      Semiquantitative data on exposure to the metals aluminium, chromium, lead,
      manganese, and nickel were also recorded by questionnaire. Logistic regression
      was employed to study the relation between exposure and the prevalence of
      symptoms. Welders exposed to aluminium, lead, or manganese for a long period had
      significantly more neuropsychiatric symptoms than welders not exposed to these
      metals. The results indicate that detailed psychometric studies should be
      performed on welders exposed long term to specific metals as such exposures might
      affect their nervous system.

PMID- 2223664
TI  - Reduced vibration perception in right hands of normal subjects: an acquired
      abnormality?

PMID- 2223666
TI  - [Precious metal onlays].
AB  - In prosthetics, various options are available to the orthodontist for repairing
      dental arches. The basic choice is between full crowns and partial crowns. Full
      crowns are primarily indicated for aesthetic reasons, in order to correct tooth
      axes and in cases of recurrent caries. Partial crowns in precious alloys are
      indicated when the need is not essentially aesthetic. They continue today to
      offer advantages in restoring posterior teeth. Because of their supragingival
      limits, they alleviate periodontal problems and preserve tooth structure.

PMID- 2223665
TI  - Risk assessment of leukaemia and occupational exposure to benzene.

PMID- 2223668
TI  - [Preparations for anterior composites].
AB  - This paper sets forth and discusses the various preparations used in aesthetic
      restoration of anterior teeth with composite resins. The clinical description of
      contours involves treatment of class III and IV carious lesions and correction of
      aesthetic imperfections which justify resorting to direct techniques of cosmetic
      dentistry.

PMID- 2223667
TI  - [Bonding of ceramic onlays. The effect on contour form].
AB  - Ceramic onlays have come into much wider use and experience has led to gradual
      modification of preparation contours. The aim was to improve two complementary
      aspects, aesthetics and mechanical strength. The use of ceramics to rebuild cusps
      enhances the structures' mimetic effect and mechanical qualities. If an isthmus
      exists connecting the occlusal and proximal cavities, it must be enlarged; if
      not, none must be created. The use of bonded ceramic overlays offers an original
      therapeutic result. They are indicated in order to even out occlusal patterns.

PMID- 2223669
TI  - [Ceramic bonded veneers. Toward a minimal prosthesis].
AB  - For years, odontology for aesthetic purposes meant significant tissue mutilation.
      Now, with bonded porcelain veneers, it is possible to achieve both an aesthetic
      result and a veneer preparation while restoring the function of anterior teeth.
      The clinical forms of such thin bonded restorations may vary considerably, from a
      simple veneer to a 3/4 crown. Although after five years of experience, prosthetic
      "enamelling" appears to be totally reliable, only long-term clinical results will
      determine the fatigue of thinly applied ceramics.

PMID- 2223670
TI  - [Amalgams. Traditional and modern].
AB  - The amalgam continues to be the most widely used material for durable restoration
      of decayed bicuspids and molars. After a discussion of this material's relative
      drawbacks, the author describes the restoration possibilities now offered by the
      advanced high-copper alloys available today. The latest developments involve both
      "conservative" preparations and extensive pre-prosthetic occlusal restorations.

PMID- 2223671
TI  - [Marginal adaptation of posterior composites. A complex clinical problem].
AB  - In this article, the authors deal with the problem of marginal fit for posterior
      composites, where direct class-II aesthetic restoration is involved. For
      different materials, they analyse and discuss the influence of their
      physicochemical properties, the contour of preparations, and composite handling.
      Three types of clinical cases are described: preparation using the tunneling
      technique, adhesive preparation, conventional preparation.

PMID- 2223672
TI  - [Coronal filling biomaterials. Criteria for selection].
AB  - The aim of this paper is to assess filling biomaterials according to
      specification criteria, the foremost of which is the respective ability of each
      to form a tight seal along cavity walls. Their direct or indirect (cementing or
      bonding) adhesive potential is the determining factor in their durability and the
      biocompatibility of the restoration achieved. Gold inlay alloys and amalgams
      appear as yet to be the most reliable and well-tolerated biomaterials for
      posterior restorations. For filling small cavities in the anterior sector,
      microfilled composites are clearly indicated; bonded porcelain, while not yet
      validated over time, would seem to be a good alternative for more extensive
      restorations.

PMID- 2223674
TI  - Regional Anesthesia. Volumes 1-5. October-December 1976--October-December 1980.
      Reprinted.

PMID- 2223673
TI  - [Composite resin inlays. Convincing solution or uncertain compromise?].
AB  - This is a report on the authors' clinical experience years of using laboratory
      composites. They describe the contours of composite resin preparations for
      inlays, discuss the advantages drawbacks of such restorations and provide limited
      indications. The illustrations also involve specific clinical cases.

PMID- 2223675
TI  - Rest in hospital and twin pregnancy.

PMID- 2223676
TI  - The effects of hospitalization for rest on fetal growth, neonatal morbidity and
      length of gestation in twin pregnancy.
AB  - OBJECTIVE: To test whether a policy of hospitalization for bed rest, from 28-30
      weeks gestation until delivery, lengthens the duration of gestation, improves
      fetal growth and decreases neonatal morbidity in twin pregnancy. DESIGN: A
      randomized controlled trial. SETTING: Harare Maternity Hospital, Zimbabwe.
      SUBJECTS: 118 women with an uncomplicated twin pregnancy between 28 and 30 weeks
      gestation. INTERVENTION: Hospitalization for bed rest. Encouraged to rest in bed
      as much as possible, although voluntary ambulation was allowed. MAIN OUTCOME
      MEASURES: Gestational age at delivery and number of infants delivered preterm
      (less than 37 weeks); birthweight and number of small-for-gestational age (SGA)
      infants; neonatal morbidity was assessed by number of infants requiring admission
      to the neonatal unit and the length of stay. RESULTS: There was no effect on
      duration of gestation or the occurrence of preterm delivery. Mean birthweight was
      greater in the hospitalized group (t = -2.28, df 234, P = 0.02) and there were
      fewer SGA infants (OR 0.57, 95% CI 0.33-0.96). No differences were found in
      neonatal morbidity. CONCLUSIONS: Hospitalization for bed rest does not prolong
      pregnancy but can improve fetal growth, although this was not reflected in
      improved neonatal morbidity. Whether twin fetal growth can be enhanced similarly
      in other populations should be investigated.

PMID- 2223677
TI  - Failure to prevent preterm labour and delivery in twin pregnancy using
      prophylactic oral salbutamol.
AB  - A double blind, controlled study was performed to see whether the use of
      prophylactic oral salbutamol would reduce the incidence of preterm labour in twin
      pregnancy. Of the 144 women studied, 74 took salbutamol and 70 placebo. No
      difference was found in the length of gestation, birthweight or fetal outcome,
      although fewer babies suffered from respiratory distress syndrome in the
      salbutamol group. Women did not experience troublesome side-effects from
      salbutamol.

PMID- 2223678
TI  - The relative risks of caesarean section (intrapartum and elective) and vaginal
      delivery: a detailed analysis to exclude the effects of medical disorders and
      other acute pre-existing physiological disturbances.
AB  - OBJECTIVE: To compare maternal mortalities attributable to vaginal delivery,
      elective caesarean section (CS) and intrapartum CS. DESIGN: The number of deaths
      associated with each method of delivery was ascertained among unselected and
      among low-risk women by detailed retrospective review of the case-notes of women
      who died after delivery. The frequency of each method of delivery throughout the
      study period was ascertained from the computer database and enhanced by analysis
      of the case-notes of unselected groups of women. SETTING: The Peninsula Maternity
      Services (Cape Town) during the years 1975-1986 inclusive. SUBJECTS: A total of
      108 maternal deaths arising from 263,075 maternities provided accurate
      information. The relative frequency of vaginal and abdominal delivery was
      determined from the computer database. The ratio of elective CS to emergency
      prepartum CS to intrapartum CS was obtained by review of the first 200 operations
      in the years 1975, 1977, 1979, 1982 and 1984. MAIN OUTCOME MEASURES: (i)
      Mortality rates associated with the different methods of delivery in unselected
      women and in women who were healthy before surgery; (ii) mortality rates
      apparently attributable to the method of delivery. RESULTS: The overall relative
      risk of mortality associated with caesarean section compared with vaginal
      delivery was 7 decreasing to 5 after the exclusion of women with medical or life
      threatening antenatal complications (eg, haemorrhage, hypertension). The relative
      risk associated with intrapartum compared with elective sections was 2.3
      decreasing to 1.4 after the exclusion of women with medical disorders or life
      threatening complications. The relative risk of maternal mortality which was
      apparently attributable to intrapartum compared with elective sections was 1.7.
      However, the 95% confidence intervals of these values, even from this large data
      set, are wide. Nevertheless, these rates are in broad agreement with an
      approximation derived from the British confidential enquiries into maternal
      deaths. CONCLUSION: The attributable relative mortalities of caesarean section
      compared with vaginal delivery and intrapartum compared with elective caesarean
      section are lower than the overall relative mortalities of these modes of
      delivery and are approximately 5:1 and 1.5:1 respectively. These data are
      crucially important in the decision to recommend elective caesarean section
      compared with trial of labour.

PMID- 2223679
TI  - Idiopathic thrombocytopenic purpura in pregnancy: a randomized trial on the
      effect of antenatal low dose corticosteroids on neonatal platelet count.
AB  - OBJECTIVE: To determine the efficacy of antenatal low dose oral betamethasone in
      preventing neonatal thrombocytopenia and/or bleeding in infants of mothers with
      idiopathic thrombocytopenic purpura (ITP). SETTING: Hospital department of
      obstetrics and gynaecology, referral centre. PATIENTS: 41 pregnancies in 38 women
      were randomized. The results of 13 pregnancies were considered non-assessable.
      The final analysis involved 14 in the betamethasone group and 14 in the non
      treatment group. All fulfilled the criteria for ITP. INTERVENTIONS: The treated
      group received 1.5 mg betamethasone orally per day, from day 259 till day 273 and
      1 mg from day 273 till delivery. MAIN OUTCOME MEASURES: Effects of treatment were
      assessed in terms of maternal platelet counts after the first trimester and
      neonatal platelet counts at birth and the first week of life and neonatal
      bleeding episodes. RESULTS: There were no significant differences in neonatal
      platelet counts at birth. Two infants in the betamethasone group and one in the
      untreated group had a severe thrombocytopenia either at birth or during the first
      week of life (less than 50 x 10(9)/l). Seven infants in the betamethasone group
      and six in the non-treatment group had a mild thrombocytopenia. The overall
      frequency of neonatal thrombocytopenia was similar: 64% in the betamethasone
      group and 57% in the untreated group (95% CI of the true difference: -43.5% to
      +29.5%). There was also no significant difference in neonatal bleeding episodes.
      CONCLUSIONS: Low-dose betamethasone in pregnant women with ITP does not prevent
      thrombocytopenia or bleeding in their newborn infants.

PMID- 2223680
TI  - Normal early pregnancy: serum hCG levels and vaginal ultrasonography findings.
AB  - Vaginal sonography and determination of serum hCG levels were carried out in 22
      healthy pregnant women every 2 to 4 days after the first positive pregnancy test
      until a living fetus was observed. Gestational age was calculated from the day of
      ovulation, assessed by LH surge or hCG administration, plus 14 days. A
      gestational sac of 1-3 mm was detected at a mean (SEM) of 31.2 (0.2) days of
      gestation (range 30-33 days). The corresponding mean hCG level was 730 iu/l (30)
      and the range 467-935 iu/l (International Reference Preparation). The yolk sac
      was detected at a mean of 36.0 (0.2) days, range 34-38 days, at a mean hCG level
      of 4130 iu/l (370), range 1120-7280 iu/l. Fetal heart motion was visible at a
      mean of 41.1 (0.3) days, range 39-43 days and the corresponding mean hCG level
      was 12,050 iu/l (1240), range 5280-22,950, iu/l. The yolk sac and the fetal heart
      motion were always seen when the sac exceeded 10 and 18 mm in mean diameter,
      respectively.

PMID- 2223681
TI  - Diagnosis of ectopic pregnancy by vaginal ultrasonography in combination with a
      discriminatory serum hCG level of 1000 IU/l (IRP)
AB  - The diagnostic value of vaginal sonography in combination with a discriminatory
      serum hCG level of 1000 iu/l (International Reference Preparation) was tested
      prospectively in 200 pregnant women suspected of having an ectopic pregnancy. An
      ectopic pregnancy was diagnosed in 68 women (34%), a miscarriage in 56 (28%) and
      a normal pregnancy in 76 (38%). On admission, an intrauterine sac was seen in 89%
      of the intrauterine pregnancies, but in none of the ectopic pregnancies.
      Detection of an adnexal mass separate from the ovaries was diagnostic of ectopic
      pregnancy with a sensitivity of 93%, a specificity of 99%, a positive predictive
      value of 98% and a negative predictive value of 96%. In 19 patients (9%) the
      initial sonogram was non-diagnostic and the final diagnosis was obtained after a
      repeated scan within 6 days. Five of these women had an ectopic pregnancy, 12 a
      miscarriage and two a normal pregnancy. On admission the hCG level exceeded 1000
      iu/l in 77% of all patients and in 67% of those with ectopic pregnancies. In
      patients with an initial level exceeding 100 iu/l, an intrauterine sac was found
      in all the intrauterine pregnancies but in none of the ectopic pregnancies. The
      use of this threshold in combination with sonographic detection of an adnexal
      mass was diagnostic of ectopic pregnancy with a sensitivity of 97%, a specificity
      of 99%, a positive predictive value of 98% and a negative predictive value of
      98%.

PMID- 2223682
TI  - Randomized comparison of routine vs highly selective use of Doppler ultrasound
      and biophysical scoring to investigate high risk pregnancies.
AB  - OBJECTIVE: To compare routine versus highly selective use of Doppler ultrasound
      and biophysical scoring in higher risk pregnancy. DESIGN: A pragmatic randomized
      trial. SETTING: St James's University Hospital, Leeds. SUBJECTS: 500 pregnant
      women at high risk of intrauterine growth retardation or still birth.
      INTERVENTIONS: Regular monitoring with biophysical profile assessment and Doppler
      velocity waveform recording in umbilical and uteroplacental arteries. Results
      immediately available to clinicians. MAIN OUTCOME MEASURES: Gestational age at
      delivery, obstetric intervention rates and short-term neonatal morbidity.
      RESULTS: Risk factors were distributed very evenly between the 250 patients in
      the study and control groups respectively. A total of 902 biophysical profile and
      Doppler assessments were done in the 250 study group patients and only in 12
      patients in the control group. In the study group, absent end-diastolic flow was
      found in only 2.7% of all 902 measurements. A persistently abnormal biophysical
      score was always associated with absence of end-diastolic flow. The mean
      gestational age at induction of labour was statistically and clinically similar
      in the two groups and there was no overall statistically significant difference
      in intervention rates between the two groups. There was a statistically
      significant lower frequency of depressed 5-min Apgar scores in the study group.
      Serious neonatal morbidity was also statistically significantly more common in
      the control group than in the study group. CONCLUSIONS: The use of Doppler
      ultrasound in higher risk pregnancies does not lead to an increase in iatrogenic
      preterm delivery. The total rate of positive tests on Doppler ultrasound is very
      low and persistently abnormal biophysical scores are unlikely to be found in
      patients where umbilical end-diastolic blood flow is present. Surrogate measures
      for fetal damage seem to be improved when clinicians have access to Doppler
      ultrasound assessments.

PMID- 2223683
TI  - Hormone implants and tachyphylaxis.
AB  - The serum oestradiol levels of 1388 women treated with hormone implants at a
      menopause clinic were reviewed in 1988. Thirty-eight (3%) were found to be above
      1750 pmol/l. Of these 38 women with supraphysiological oestradiol levels 23 had
      started therapy for menopausal symptoms and 15 for the premenstrual syndrome
      (PMS). Of the 23 women treated for menopausal symptoms 11 had a history of
      psychiatric referral for depression and nine had undergone a surgical menopause.
      Nine of the 15 women with PMS had a history of psychiatric referral for
      depressive symptoms. We conclude that the women who attain supraphysiological
      levels of oestradiol on implant therapy have a high frequency of psychopathology
      or surgical menopause and may require higher oestradiol levels for adequate
      control of symptoms.

PMID- 2223685
TI  - Serum CA 125 levels during the menstrual cycle.
AB  - Serum concentrations of CA 125 were measured in different phases of the menstrual
      cycle in 16 women with ovulatory and 12 women with anovulatory cycles. CA 125
      levels were significantly elevated during menstruation in both groups. In women
      with anovulatory cycles, but not in those with ovulatory cycles, CA 125 levels
      were already increased in the premenstrual phase. A negative correlation was
      found between serum CA 125 and progesterone concentrations in the premenstrual
      phase of the cycle. We suggest that premenstrual elevation of serum CA 125 in
      women with anovulatory cycles is related to premature endometrial vascular
      changes which are the result of the low serum progesterone concentration leading
      to insufficient endometrial control. Thus the effect of progesterone seems to be
      indirect rather than a direct effect on CA 125 synthesis. When the CA 125 assay
      is used for diagnosis of cancer, sampling should not be done immediately before
      or during menstruation because the physiological elevation of the CA 125 levels
      may give false positive results.

PMID- 2223684
TI  - A risk of malignancy index incorporating CA 125, ultrasound and menopausal status
      for the accurate preoperative diagnosis of ovarian cancer.
AB  - Age, ultrasound score, menopausal status, a clinical impression score and serum
      CA 125 level were assessed to see how they could best distinguish between
      patients with benign (n = 101) and malignant (n = 42) pelvic masses. Each
      criteria used alone provided statistically significant discrimination. The most
      useful individual criteria were a serum CA 125 level of 30 U/ml (sensitivity 81%,
      specificity 75%) and an ultrasound score of 2 (sensitivity 71%, specificity 83%).
      Three criteria could be combined in a risk of malignancy index (RMI) which is
      simply calculated using the product of the serum CA 125 level (U/ml), the
      ultrasound scan result (expressed as a score of 0, 1 or 3) and the menopausal
      status (1 if premenopausal and 3 if postmenopausal). This index was statistically
      virtually as effective a discriminant between cancer and benign lesions as more
      formal methods. Using an RMI cut-off level of 200, the sensitivity was 85% and
      the specificity was 97%. Patients with an RMI score of greater than 200 had, on
      average, 42 times the background risk of cancer and those with a lower value 0.15
      times the background risk.

PMID- 2223686
TI  - The effect of abdominal surgery on the serum concentration of the tumour
      associated antigen CA 125.
AB  - The CA 125 assay is used to monitor the course of disease in women with
      adenocarcinoma of the genital tract. We measured serum CA 125 levels
      longitudinally in three different groups of patients who had normal serum CA 125
      levels (less than or equal to 16 U/ml) before extensive intraperitoneal abdominal
      surgery (group 1, second-look laparotomy in 28 women with ovarian cancer; group
      2, radical hysterectomy in 42 patients with cervical cancer; group 3, 13 men and
      one woman who had aortic surgery for atherosclerotic occlusive disease or
      aneurysm formation). Following surgery, rising serum CA 125 levels were observed
      in 69 out of the 84 patients (82%), irrespective of the primary diagnosis, type
      of operation or sex. The highest levels were found during the second week after
      the operation (range 3-336 U/ml) and decreased gradually thereafter, to become
      normal at 8 weeks after surgery. It was concluded that abdominal surgery
      interferes with the specificity of CA 125 as a tumour marker during the early
      postoperative period.

PMID- 2223688
TI  - Double survival despite cord entwinement in monoamniotic twins. Case report.

PMID- 2223687
TI  - Haemostatic changes during continuous oestradiol-progestogen treatment of
      postmenopausal women.
AB  - To identify changes in haemostatic balance during continuous oestradiol
      progestogen treatment, 60 postmenopausal women with climacteric complaints, mean
      age 55.4 years (range 44-68) were randomly allocated to receive one of four
      hormone replacement regimens for one year. All four formulations were
      administered daily and continuously, each contained 2 mg of 17 beta-oestradiol in
      combination with either norethisterone acetate, 1 mg (group A) or 0.5 mg (group
      B) or megestrol acetate, 5 mg (group C) or 2.5 mg (group D). No significant
      changes occurred during treatment within or between the groups in platelet count,
      fibrinogen and 2-antiplasmin. Activated partial thromboplastin time was shortened
      (P less than 0.05) in group D and a decline in factor VII activity and antigen (P
      less than 0.001) and in ATIII activity (P less than 0.05) was noted in group A.
      Protein C tended to decline in all treatment groups but statistically significant
      changes were noted only in groups A and C. Two women developed crural thrombosis
      during the observation period.

PMID- 2223689
TI  - Mucinous ascites associated with rupture of benign ovarian teratoma. Case report.

PMID- 2223690
TI  - Non-immune hydrops in trisomy-18. Diagnosis by vaginosonography and chorionic
      villus sampling in the first trimester. Case report.

PMID- 2223691
TI  - Fetal macrosomia in potential diabetics with normal oral glucose tolerance: a
      case control study.

PMID- 2223692
TI  - Early identification of placenta praevia.

PMID- 2223693
TI  - Pipelle: a more acceptable technique for outpatient endometrial biopsy.

PMID- 2223694
TI  - The obstetric forceps--are we using the appropriate tools?

PMID- 2223695
TI  - Change in ovarian arterial compliance during the human menstrual cycle assessed
      by Doppler ultrasound.

PMID- 2223696
TI  - Cesarean section for the birth of the second twin.

PMID- 2223697
TI  - Fluorosilicone oil for retinal detachment.

PMID- 2223699
TI  - Intraocular pressure changes and postural changes of intraocular pressure in
      experimentally induced Hansen's disease of rhesus, mangabey, and African green
      monkeys.
AB  - In our long term evaluation of patients with Hansen's disease we have frequently
      found reduction of their intraocular pressure. Furthermore, we noted changes in
      their intraocular pressure on change of posture. To determine if these changes
      have any significance we measured the intraocular pressures of 24 experimentally
      infected and 39 control monkeys in both sitting and reclining positions. We found
      significant reduction of intraocular pressure in 66.7% compared with controls in
      the sitting position, and a significant increase in intraocular pressure in 79%
      when checked first in the sitting then in the reclining position. We offer a
      possible pathophysiological explanation as to why the changes occur.

PMID- 2223698
TI  - Fluorosilicone oil in the treatment of retinal detachment.
AB  - We evaluated the use of a heavier-than-water fluorinated silicone oil in the
      treatment of 30 selected cases of complicated retinal detachment from January
      1988 to July 1989. Proliferative vitreoretinopathy grade C-2 or greater accounted
      for 19 cases, proliferative diabetic retinopathy with traction detachment for two
      cases, giant retinal tears five, ruptured globe with retinal detachment two,
      massive choroidal effusion with retinal detachment one, and acute retinal
      necrosis with retinal detachment one. Initial retinal reattachment was achieved
      in all cases. Complications included redetachment seven (23%), cataract six (75%
      of phakic patients), raised intraocular pressure four (13%), hypotony four (13%),
      keratopathy three (10%), uveitis-synechia formation three (10%), phthisis two
      (3%), choroidal haemorrhage one (3%), and vitreous haemorrhage one (3%).
      Postoperative visual acuities with at least six months' follow-up range from no
      light perception to 20/50, with seven patients (23%) 20/400 or better.

PMID- 2223700
TI  - A survey of the initial referral of children to an ophthalmology department.
AB  - We report on a survey of the referral of 525 children making their first visit to
      an ophthalmology department. Information was gathered by interviewing the parents
      and reviewing the case notes. Parents and relatives initiated the referrals in
      223 cases (42%) and health visitors initiated a further 123 cases (23%). General
      practitioners were rarely the first to notice a condition, though they played a
      major part in the subsequent referral process. Of 556 reasons for referral squint
      was the most important (319 cases, 57%), followed by poor vision (106 cases,
      19%). There were 44 confirmed cases of amblyopia, of which 15 (34%) were not
      detected until the child was aged 5 years or over. The overall accuracy of
      referral was 66% (367 reasons for referral confirmed). In 109 cases (21%) the
      child was found to be normal. Parents and relatives first noticed 54% of cases of
      confirmed squint but only 15% of the cases of poor vision. Health professionals,
      especially health visitors, were of great importance in first detecting poor
      vision.

PMID- 2223702
TI  - Aqueous humour and serum zinc and copper concentrations of patients with glaucoma
      and cataract.
AB  - Serum and aqueous humour zinc and copper concentrations of 44 patients with
      glaucoma and cataract were determined. Serum values were found within normal
      ranges. The highest mean copper concentration was seen in the glaucoma group. In
      addition there was a significant negative correlation between the aqueous humour
      levels of zinc and copper in patients with glaucoma. It was concluded that an
      increased copper value together with a low zinc value might be of importance in
      patients with glaucoma.

PMID- 2223701
TI  - Biometry of the crystalline lens in early-onset diabetes.
AB  - Lenticular biometry on non-cataractous lenses has been studied by means of
      Scheimpflug photography and digital image analysis in 153 patients with early
      onset insulin-dependent diabetes and 153 non-diabetic controls. Anteroposterior
      axial lens thickness, cortical thickness, nuclear thickness, anterior and
      posterior lenticular curvatures, and anterior chamber depth were assessed. Highly
      significant differences between the lenses of the diabetic subjects and non
      diabetic controls were found. After the effect of age had been accounted for
      within the diabetic subgroup, diabetic duration was found to be a highly
      significant determinant of lens dimensions, such that age-related dimensional
      changes for various biometric parameters were accelerated by between 52% and 121%
      after the onset of diabetes. Because the diabetic duration of the early-onset
      diabetic subjects studied in this work was accurately known, this report is the
      first in which a precise assessment of the effect of 'true' diabetic duration on
      lens biometry has been possible.

PMID- 2223703
TI  - Topical timolol and serum lipoproteins.
AB  - Oral timolol taken for the treatment of systemic hypertension has been shown to
      affect adversely serum lipoprotein levels. In a 15-week study on 19 patients
      topical timolol therapy for raised intraocular pressure was found to have no
      significant adverse effect on serum lipoprotein levels. This is reassuring in
      view of the large number of patients on this form of long term therapy, and
      selection of the type of beta blocker to use should not be influenced by lipid
      changes associated with the oral form of the drug.

PMID- 2223704
TI  - Haemorheological changes in patients with retinal vein occlusion after
      isovolaemic haemodilution.
AB  - In 83 patients with central retinal vein occlusion and branch vein occlusion we
      measured the haematocrit (HCT), plasma viscosity (PV), red cell aggregation
      (RCA), red cell filterability (RCF) and apparent whole blood viscosity (WBV). A
      control group (n = 41) was matched for sex, age, and cardiovascular risk factors.
      Measurements were performed before and after treatment with isovolaemic
      haemodilution (IHD). We found no significant differences between patients with
      retinal vein occlusion (RVO) and control subjects in haematocrit, plasma
      viscosity, red cell aggregation, and red cell filterability and no increased
      whole blood viscosity in the patient group. Patients with ischaemic retinal vein
      occlusion and non-ischaemic retinal vein occlusion did not show different
      haemorheological parameters either. After treatment with haemodilution, only the
      haematocrit and whole blood viscosity were significantly decreased, and there
      were no changes in plasma viscosity, red cell aggregation or red cell
      filterability.

PMID- 2223705
TI  - Pupillary responses in amblyopia.
AB  - Relative afferent pupillary defects (RAPD) were detected in 32.3% of patients
      with amblyopia by a modification of the swinging flashlight test and the
      synoptophore. After consideration of various clinical investigations the
      significant factors identified in patients showing a RAPD were: anisometropia,
      early age of onset where strabismus was present, level of visual acuity following
      treatment, longer period of occlusion therapy. These points bear similarities to
      the results of pattern electroretinograms (PERG) in amblyopes, and the
      possibility of the causative defect being at ganglion cell level is discussed.
      The effect of occlusion treatment cannot be predicted from the presence or
      absence of a RAPD.

PMID- 2223706
TI  - The electroretinogram in minimal diabetic retinopathy.
AB  - The pattern and diffuse flash electroretinograms were measured in 20 normal
      subjects and 40 diabetic patients who had either normal fundi or microaneurysms
      only. The amplitudes of the pattern electroretinogram were found to be similar in
      both normals and diabetics. In the case of the flash electroretinogram the
      diabetic patients showed a division into two main groups. One group was not
      dissimilar to the group of normal subjects, while the second group showed
      hypernormal amplitudes. No explanation could be given, from the data collected,
      for this subdivision, though it is suggested it might reflect the degree of
      metabolic disturbance.

PMID- 2223707
TI  - Supply of corneal tissue in the United Kingdom.

PMID- 2223709
TI  - Linear scleroderma associated with ptosis and motility disorders.
AB  - A case is reported in which an 11-year-old girl developed progressive ptosis and
      a subsequent motility disorder of the right eye. The diagnosis linear scleroderma
      en coup de sabre was established. Atrophy of the upper levator palpebral and
      superior rectus muscle could be shown on CT scan.

PMID- 2223708
TI  - Multifocal posterior uveitis: clinical and pathological findings.
AB  - A pathological study was performed on the necropsy eyes of a 59-year old-woman
      who had suffered for nine years from multifocal posterior uveitis. The disease
      had been controlled by steroid therapy with good preservation of visual function.
      Extensive investigation did not reveal the aetiology. On macroscopic examination
      numerous focal lesions with various degrees of pigmentation were observed
      scattered across the fundi. These lesions were studied by light and electron
      microscopy and immunohistochemistry. There was ongoing chorioretinal inflammation
      in the foci, producing destruction of Bruch's membrane, the retinal pigment
      epithelium (RPE), and the outer retina. The focal scars showed migration of RPE
      and glial cells and neovascularisation. Capillary and venule endothelial cells
      were swollen at the inflammatory sites. Attempts to establish a cause for this
      condition were unsuccessful.

PMID- 2223710
TI  - Homocystinuria presenting as central retinal artery occlusion and longstanding
      thromboembolic disease.
AB  - A case of central retinal artery occlusion in a patient with a 10-year history of
      unexplained thromboembolic disease due to a secondary hypercoagulable state is
      presented. Ophthalmological examination led to the final diagnosis.

PMID- 2223711
TI  - Chickenpox chorioretinitis.
AB  - Chickenpox infection in an adult was complicated by peripheral chorioretinitis
      and treated with oral acyclovir. Similarities of this case to the recently
      proposed mild type of acute retinal necrosis syndrome are discussed.

PMID- 2223713
TI  - Lobular pattern of choriocapillaris in pre-eclampsia with aldosteronism.
AB  - We report a case of geographic or mosaic pattern yellowish opaque foci in the
      left eye of a 36-year-old woman who suffered from severe pre-eclampsia. Though
      the geographic lesions resulted in chorioretinal atrophy, the mosaic lesion led
      to no significant atrophy. These two findings were both diagnosed as
      manifestations of choroidal ischaemia, the former due to choroidal artery
      occlusion, the latter to transient insufficiency of choroidal circulation, which
      reflects the lobular pattern of the choriocapillaris.

PMID- 2223712
TI  - Choroidal osteoma (osseous choristoma): an atypical case.
AB  - A case of choroidal osteoma presenting in a 22-year-old girl is reported. The
      tumour, unilateral and in a juxtapapillary site, appeared markedly elevated on
      the retinal plane, not flat or slightly elevated as in previous reports. Visual
      acuity was not affected, and there was a complete absence of subjective symptoms.
      Echography, fluorangiography, computerised tomography, and visual field tests
      were performed. Echography is the best method for identifying and differentiating
      this lesion from a malignant tumour.

PMID- 2223715
TI  - Diabetes and retinal function.

PMID- 2223714
TI  - Compact field charts.

PMID- 2223716
TI  - [The current stage of thoracic surgery].

PMID- 2223718
TI  - [The integration of antitubercular treatment into the activities of 3 rural
      medical dispensaries in the area of the Constanta Phthisiology Office].

PMID- 2223717
TI  - [The recovery of work capacity within the framework of short-term antitubercular
      chemotherapy].
AB  - The authors compare the results of chemotherapy reflected in the proportion of
      recoveries of work capacity and the number of retired persons in two groups of
      patients--one including 102 cases treated between 1970 and 1971 by a 3/6 regimen,
      and another one including 91 patients treated in 1986 by a modern intensive 3 + 3
      regimen. The data indicate better results with the 1986 lot as compared with the
      1970-1971 lot. In the 1986 group there were no fatalities and the persons that
      recovered their work capacity represented 90.1% of the total. By contrast, in the
      group treated between 1970 and 1971 there were two fatalities and only 84.3% of
      all the patients did recover the work capacity. The number of retired persons
      decrease from 11.7% in the first group to 7.7% in the second. Temporary
      incapacity decreased from an average of 321 days to an average of 267 days in the
      second group. All these results were obtained by shortening the treatment from an
      average of 9 months to an average of 6 months.

PMID- 2223719
TI  - [The efficacy of the intensive, short-duration chemotherapy of patients with
      cavitary pulmonary tuberculosis].
AB  - This study was carried out on 100 cases of cavitary pulmonary tuberculosis in
      patients eliminating tuberculosis bacilli, as noted at microscopic study. The
      treatment included four drugs (RHSZ) in 95 case, and 3 drugs in the remaining
      patients. All the treatments were tailored to individual needs. The duration of
      chemotherapy was of 6 months in 62 cases. It was prolonged to 9 months in 33
      cases and to 12 months in 5 cases. In 81 patients the drugs were applied
      regularly. The results have demonstrated that at 6 months negative cultures were
      obtained in 98 patients although the excavations were closed in only 55 cases. At
      9 months all the patients were negative but excavations were closed in only 71.
      Suppression of elimination of bacilli was achieved in 99 of the cases at 12
      months, but the excavations were closed in only 92 of the patients. Ninety-nine
      patients were investigated after 2.5-3.0 years. Five of them were again positive,
      94.5% were negative and the excavations were closed in 91.9%. The importance of
      the cavitary score is discussed with regard to the risk of renewed positivity,
      and an association is recommended of surgical collapsing and exeresis at the
      right time.

PMID- 2223720
TI  - [The involvement of the respiratory apparatus in leukemias].
AB  - In 13 cases of leukemia, different clinical forms showed pleuropulmonary and
      mediastinal lesions consisting in: mediastinal-hilar adenopathies without the
      parenchyma involvement (2 cases), with involvement of the pulmonary parenchyma (6
      cases) and only one case of pulmonary lesions without adenopathies. In 3 cases
      leukemia overlapped pulmonary TB, TB sequela (2 cases) or active-evolutive TB (1
      case). One case developed to bronchopulmonary neoplasm. While the treatment of
      parenchymatous complications, appeared by nonspecific infections, and of the
      single case of active tuberculosis proved adequate, the ganglionic-mediastinal
      lesions continued their acute or chronic unfavourable evolution.

PMID- 2223721
TI  - [The evolution of pulmonary ventilation under conditions of occupational exposure
      to irritant vapors].

PMID- 2223722
TI  - [Immunopathogenic processes in infectious pulmonary diseases].

PMID- 2223723
TI  - [Toxic pulmonary and neuronal reactions to nitrofurantoin].

PMID- 2223724
TI  - [Tuberculosis localized in the skull bones in a child].
AB  - A case is presented, of a child aged 2.8 years with tumor-like formations in the
      parietal and the frontal bones, showing lacunar lesions on the radiography of the
      skull. This case raised a large number of hypotheses concerning the etiologic
      diagnosis of the lacuna lesions. Histologic investigations showed that lesions
      were due to tuberculosis of the skull bones. In this case probability and
      certitude criteria were present supporting this diagnosis.

PMID- 2223725
TI  - [Biopsy of the cervical lymph nodes in the diagnosis of sarcoidosis].

PMID- 2223726
TI  - [Liver determinations in sarcoidosis].

PMID- 2223727
TI  - [Hepatic sarcoidosis with portal hypertension].

PMID- 2223728
TI  - [The role of the lymphocytes in sarcoidosis].

PMID- 2223729
TI  - [The role of the macrophages in sarcoidosis].

PMID- 2223730
TI  - [The involvement of eicosanoids in the pathogenesis of inflammatory granuloma].

PMID- 2223732
TI  - [Granulomatous disorders mimicking sarcoidosis].

PMID- 2223731
TI  - [The role of oxygen metabolites in sarcoidosis].

PMID- 2223733
TI  - [The intradermal tuberculin test and the Kveim-Siltzbach test in sarcoidosis].

PMID- 2223734
TI  - [The coagulation and fibrinolysis systems in sarcoidosis].

PMID- 2223735
TI  - Dietary recommendations: how do we move forward?

PMID- 2223736
TI  - Linear programming and pediatric dietetics.
AB  - The composition of 500 foods has been stored in a computer in order to analyse a
      child's diet. The methodology of operations research is applied to a very simple
      problem: a diet with only two foods. The geometrical representation of the
      'feasible region' and of the 'objective function' is illustrated. One of the
      analytical methods employable with many variables (foods) is considered. This
      method was used in trying to find diets allowing for the preferential use of
      selected foods while respecting recommended dietary allowances, the tastes of the
      child and other constraints. The theoretical difficulty of transferring this
      methodology to pediatric dietetics was examined. We solved a simple case
      utilizing this procedure.

PMID- 2223737
TI  - Dietary behaviours and sociocultural demographics in Northern Ireland.
AB  - Subjects aged 16-64 years (592; 258 men and 334 women), randomly selected from
      the population of Northern Ireland, kept a 7 d weighed record of all food and
      drink consumed. Social, personal and anthropometric data were also collected.
      From the weighed records food consumption was described in terms of forty-one
      food groups. Using principal components analysis, four distinct dietary patterns
      were generated which were identified as a traditional diet, a cosmopolitan diet,
      a convenience diet and a 'meat and two veg' diet. These dietary patterns were
      then correlated with sociocultural, lifestyle and anthropometric variables. It is
      clear that dietary behaviour is influenced by a number of inter-related
      sociocultural demographics and that identifiable population groups in Northern
      Ireland have different dietary behaviours.

PMID- 2223738
TI  - Haematological studies on pre-menopausal Indian and Caucasian vegetarians
      compared with Caucasian omnivores.
AB  - Full blood counts, serum ferritin, vitamin B12 and folate, erythrocyte folate
      concentrations and nutrient intakes were estimated in twenty-three Indian
      vegetarian, twenty-two Caucasian omnivores and eighteen Caucasian vegetarian
      women aged 25-40 years. Energy and copper intakes were lower in the Indian women
      than in the Caucasians. Intakes of dietary fibre, vitamin C and folate were
      greater and the proportion of energy derived from fat was lower in the
      vegetarians than in the omnivores. Vitamin B12 and protein intakes were lower in
      both vegetarian groups than in the omnivores. Fe intake was similar in all the
      groups but haem Fe provided one-quarter of the Fe intake of the omnivores.
      Haemoglobin concentrations were generally inside the normal range in all groups,
      but were lower in the Indians as were mean corpuscular volume (MCV) and mean
      corpuscular haemoglobin (MCH). Higher MCV, MCH and lower erythrocyte (RBC) counts
      were observed in Caucasian vegetarians compared with the Caucasian omnivores. In
      both groups of vegetarians, concentrations of serum vitamin B12 and ferritin were
      markedly lower than in the omnivores. RBC folate concentrations were lower in the
      Indians than in either of the Caucasian groups when subjects taking supplements
      were excluded. It is concluded that vegetarians need to ensure they have adequate
      intakes of Fe and vitamin B12.

PMID- 2223739
TI  - The effect of methylxanthines on milk volume and composition, and growth of rat
      pups.
AB  - A study was conducted to investigate the effect of differential dose levels of
      methylxanthines on lactational performance, with respect to milk volume and
      composition and pup growth. The methylxanthines; caffeine, theophylline and
      theobromine, were administered via drinking water in the proportions occurring in
      tea, at a dose of 50, 1 and 2 mg/kg body-weight respectively to Wistar albino
      rats throughout pregnancy and for up to the 14th day of lactation. A fourth group
      received a mixture of all three methylxanthines. Maternal food and fluid intake
      and weight changes, as well as weight gain in the litter were monitored thrice
      weekly. Milk samples were collected from the dams on days 7 and 14 of lactation,
      while milk volume was measured on days 12-13 by a method using tritiated water.
      Results showed that caffeine and theobromine significantly enhanced litter weight
      (P less than 0.01 and 0.05 respectively). In the caffeine group, enhanced litter
      growth was due to a significant increase (P less than 0.05) in milk volume,
      consequent to increased maternal food intake (P less than 0.05). In the
      theobromine group there was only a weak association between increased litter
      weight and milk volume. Theophylline had no effect on the volume or composition
      of milk, or litter weight. The combination of all three methylxanthines also
      failed to produce any of the positive effects observed with separate drug
      treatments.

PMID- 2223740
TI  - Effect of vitamin A supplementation on haemoglobin and vitamin A levels during
      pregnancy.
AB  - About 450 pregnant women from a low-income group were recruited to study the
      effect of vitamin A supplementation on plasma vitamin A levels in the mother and
      cord and on the birth weights of the neonates. Results showed that
      supplementation with 1800 micrograms vitamin A/d for more than 12 weeks prevented
      the decline in plasma vitamin A that otherwise occurs during the last few weeks
      of pregnancy. This improvement in maternal values for vitamin A at a critical
      time of development favourably affected availability to the fetus, as reflected
      by the marked elevation in cord levels. Supplementation for a period of 12 weeks
      was found to be sufficient, since subsequent discontinuation did not alter the
      beneficial response. Apart from increasing maternal and cord vitamin A levels,
      vitamin A supplementation along with iron prevented, in this study, the
      significant decline in haemoglobin occurring at 26-28 weeks of gestation. The
      birth weights were not altered by vitamin A supplementation.

PMID- 2223741
TI  - The effect of the level of dietary protein, carbohydrate and fat on urea kinetics
      in young children during rapid catch-up weight gain.
AB  - The kinetics of urea metabolism were measured in children recovering from severe
      malnutrition. For a period of up to 10 d they received one of four diets which
      provided 711 kJ (170 kcal)/kg per d. Two groups received a diet with a high
      protein:energy (P:E) ratio of 10-6% (HP), enriched with either fat (HP/F) or
      maize starch and sucrose (HP/C). Two groups received a diet with a low P:E ratio
      of 8.8% (LP), enriched with either fat (LP/F) or maize starch and sucrose (LP/C).
      The rate of weight gain on the HP diets was significantly greater than on the LP
      diets. There was no difference in urea production between any of the four diets:
      HP/F 1.23 (SE 0.12), HP/C 1.37 (SE 0.14), LP/F 1.64 (SE 0.22), LP/C 1.15 (SE
      0.15) mmol nitrogen/kg per h. On the HP diets urea excretion was 0.77 (SE 0.07)
      mmol N/kg per h, 61% of production. There was significantly less urea excreted in
      the urine on diet LP/C than on LP/F (0.36 (SE 0.05) and 0.64 (SE 0.04) mmol N/kg
      per h respectively). A significantly greater percentage of the urea production
      was hydrolysed on the LP diets (61%) compared with the HP diets (39%), with the
      consequence that 50% of urea-N produced was available for synthetic activity on
      the LP diets compared with 30% on the HP diets. The increase in the urea
      hydrolysed on the LP diets was equivalent in magnitude to the decreased intake of
      N, so that overall intake plus hydrolysis did not differ between the LP and the
      HP diets. Crude N balance was similar on diets HP/F, HP/C and LP/C, but was
      significantly reduced on diet LP/F. These results show that there is an
      accommodation in urea kinetics during rapid catch-up weight gain, which becomes
      evident when the P:E ratio of the diet falls to 8.8%. It is proposed that, for a
      P:E ratio of 8.8%, protein is limiting for catch-up growth. When the intake has a
      P:E ratio of 8.8% the pattern of urea kinetics can be modified by the relative
      proportions of fat and carbohydrate in the diet. The measurement of urea kinetics
      provides a useful approach to the definition of the adequacy of the protein in
      the diet.

PMID- 2223742
TI  - The effect of dietary nitrate on nitrate and nitrite excretion in man.
AB  - Dietary nitrate and nitrite may affect colonic pathophysiology. These anions
      influence fermentation, and nitrite has been shown to augment sodium absorption
      by the colon and participate in the formation of N-nitroso compounds. There is,
      however, no general agreement as to how much dietary nitrate and nitrite reaches
      the colon. To help resolve this question, balance studies were performed on six
      healthy ileostomy subjects who were given diets that varied in nitrate content
      from 0.83 to 5.20 mmol/d. Nitrate and nitrite excretion in ileal effluent and
      urine were measured by anion-exchange chromatography with conductivity detection.
      There was no significant nitrite in the diets, urine or ileal effluent. Dietary
      nitrate was largely excreted in urine (1.31-4.25 mmol/d). The urinary excretion
      findings indicated net synthesis of nitrate at low dietary intakes and net
      catabolism of nitrate at high intakes. Nitrate losses in ileal effluent were very
      low (0.03-0.05 mmol/d, 0.03-0.06 mmol/kg) and unrelated to intake for all the
      diets. It is concluded that dietary nitrate and nitrite do not enter the colon
      from the small intestine in amounts that would affect fermentation and mucosal
      metabolism in man. The possibility of significant amounts of nitrate reaching the
      colon via blood in normal subjects has not been excluded.

PMID- 2223743
TI  - Tissue and whole-body oxygen uptake in fed and fasted steers.
AB  - The effect of feeding v. fasting, on tissue blood flow, oxygen uptake and
      proportional contributions of the portal drained viscera (PDV), liver (Expts 1
      and 2) and hindquarters (HQ; Expt 2) to whole-body O2 uptake were studied in beef
      steers. The combined techniques of indirect calorimetry and net tissue flux, the
      latter being the product of arterio-venous concentration difference and blood
      flow, were used in the experiments. In response to fasting, whole-body O2
      consumption decreased as did O2 uptake by all measured tissues except the liver
      (trend only in Expt 1). Blood flow to all measured tissues decreased during
      fasting and fractional uptake of O2 decreased in PDV and increased in liver and
      HQ (Expt 2). Proportional contribution of specific tissues to whole-body O2
      uptake changed when animals were switched from the fed to the fasted state. The
      percentage consumed by PDV decreased from 25.4 to 19.9, by liver increased from
      20.5 to 26.4 and by HQ was unchanged (9.6 and 10.5) in Expt 2. These significant
      responses in Expt 2 were observed as trends in Expt 1. The changes in
      proportional contribution of tissues to whole-animal O2 uptake reflect the
      changing metabolic role of specific tissues to lack of food supply. These
      findings emphasize the central role of the liver in metabolism and indicate that
      fasting (catabolic) measurements may not reflect the previous fed (anabolic)
      physiological state.

PMID- 2223744
TI  - The effects of underfeeding for 7 d on the thermogenic and physiological response
      to glucose and insulin infusion (hyperinsulinaemic euglycaemic clamp).
AB  - The effect of underfeeding for 7 d (at 60 kJ/kg ideal body-weight) on the thermic
      and physiological responses to glucose and insulin infusions (hyperinsulinaemic
      euglycaemic clamp) was studied in six healthy women. Underfeeding had no
      significant effect on baseline metabolic rate, heart rate, forearm blood flow,
      diastolic blood pressure, blood intermediary metabolites, plasma insulin or
      catecholamines, but reduced both respiratory exchange ratio (RER; control (C)
      0.86 (SE 0.02), underfed (U) 0.75 (SE 0.01); P less than 0.01) and systolic blood
      pressure (by approximately 10 mmHg, P less than 0.01). Baseline forearm glucose
      uptake and oxygen consumption were similar in both states. During the final 30
      min of the glucose and insulin infusion, metabolic rate rose by 0.43 (SE 0.05)
      kJ/min in the C state, but no rise was seen in the U state (P less than 0.01).
      Glucose disposal rate (C 47.9 (SE 1.8), U 47.3 (SE 4.1) mumol/kg per min) and
      storage rate (C 27.5 (SE 2.4), U 31.6 (SE 3.6) mumol/kg per min) were similar in
      both states, but glucose oxidation rate was reduced in the U state (C 20.5 (SE
      1.7), U 15.4 (SE 0.7) mumol/kg per min; P less than 0.05). RER rose to a higher
      value in the C state than in the U state (C 0.97 (SE 0.2), U 0.80 (SE 0.01); P
      less than 0.01). During hyperinsulinaemia, the forearm glucose uptake and O2
      consumption rose in both states. No significant differences were seen in the
      cardiovascular responses to hyperinsulinaemia in either state. Thus underfeeding
      abolishes the rise in thermogenesis and reduces glucose oxidation during glucose
      and insulin infusions in healthy women, but does not affect the glucose disposal
      or storage rates or the other measured responses.

PMID- 2223746
TI  - Glucose partitioning in the pregnant ewe: effects of undernutrition and exercise.
AB  - Maternal whole-body glucose entry rate and uterine and umbilical net uptakes of
      glucose and oxygen were measured in single-pregnant ewes which were either well
      fed throughout, or fed at 0.3-0.4 predicted energy requirement for 7-21 d during
      late pregnancy. All ewes were studied while standing at rest and then while
      walking on a treadmill at 0.7 m/s on a 10 degrees slope for 60 min. Underfed ewes
      suffered significant decreases in live weight and had lower fetal, but not
      placental, weights at 140-144 d gestation. Undernutrition also caused large
      decreases in maternal glycaemia and glucose entry rate, which were associated
      with equally large decreases in uterine and umbilical net uptakes and O2
      quotients of glucose, and with a decrease in placental glucose transfer capacity.
      Exercise caused increases in maternal blood concentration, entry rate and uterine
      net uptake of glucose, the magnitudes of which were not significantly affected by
      plane of nutrition. Umbilical glucose uptake and placental glucose transfer
      capacity increased during exercise in underfed but not fed ewes. The fractional
      distribution of maternal glucose to the pregnant uterus, and of uterine glucose
      uptake to the fetus, were unaltered by undernutrition; during exercise, a
      disproportionately small fraction of the increased maternal glucose supply went
      to the uterus. The results confirm that the ovine conceptus responds to
      nutritional reduction in maternal glucose availability in a manner similar to non
      uterine maternal tissues. Major reductions in glucose supply appear to override
      putative glucose-sparing mechanisms which may operate to favour the conceptus in
      better-nourished animals.

PMID- 2223745
TI  - Level of nutrition and visceral organ size and metabolic activity in sheep.
AB  - Thirty-two crossbred wether lambs (initial live-weight 31 kg) were fed on a diet
      (metabolizable energy (ME) 12.8 MJ/kg) ad lib. (ADLIB) or restricted to maintain
      body-weight (MAINT) for a 21 d period. On days 0, 7, 14 and 21, four lambs per
      treatment were slaughtered, visceral organs weighed and tissues sampled. During
      the 21 d period, ME intake in ADLIB lambs increased quadratically with an average
      rate of live-weight gain of 425 g/d. In MAINT lambs, live weight (30 kg) was
      maintained, and daily ME intake (kJ/kg empty body-weight (EBW)0.75) declined (P
      less than 0.01) quadratically with time. Weights of liver, stomach and small
      intestines as a percentage of EBW were increased in ADLIB lambs and decreased by
      10-33% in MAINT lambs (treatment x day, P less than 0.01). In vitro liver oxygen
      consumption was not affected by level of feed intake. Estimates of whole-liver O2
      consumption (mmol O2/d per kg EBW) increased in ADLIB lambs and were relatively
      constant in MAINT lambs. These findings suggest that level of feed intake changes
      the relative proportion of visceral organs to body mass. In addition, the effect
      of level of feed intake on changes in the relative contribution of visceral
      organs to whole-body metabolic rate appears to be primarily a result of
      differences in organ size rather than tissue-specific metabolic activity.

PMID- 2223747
TI  - Effects of maternal undernutrition and exercise on glucose kinetics in fetal
      sheep.
AB  - Fetal glucose kinetics were measured using a combination of isotope-dilution and
      Fick-principle methodology in single-pregnant ewes which were either well-fed
      throughout, or fed at 0.3-0.4 predicted energy requirement for 7-21 d during late
      pregnancy. All ewes were studied while standing at rest and then while walking on
      a treadmill at 0.7 m/s on a 10 degree slope for 60 min. Underfed ewes suffered
      major decreases in fetal total disposal rate, fetal-placental transfer and
      umbilical net uptake of glucose, each of which were significantly related to
      declines in maternal and fetal blood glucose concentrations respectively. In well
      fed ewes, fetal endogenous glucose production was negligible, as indicated by the
      similarity between fetal utilization rate (total glucose disposal rate minus
      placental uptake of fetal glucose) and umbilical net uptake of glucose, and by
      nearly identical fetal and maternal arterial blood specific radioactivities of
      maternally infused D-[2-3H]glucose. By contrast, in underfed ewes, fetal
      utilization rate greatly exceeded umbilical net uptake of glucose, and the
      fetal:maternal [3H]glucose specific activity ratio declined significantly,
      suggesting induction of a substantial rate of fetal endogenous glucogenesis.
      Exercise caused increases in fetal total glucose disposal rate and glycaemia in
      fed and underfed ewes. In underfed ewes only, this was accompanied by increased
      placental uptake of fetal glucose and umbilical net glucose uptake, unchanged
      fetal glucose utilization and decreased fetal endogenous glucose production. It
      is concluded that fetal gluconeogenesis makes a major contribution to fetal
      glucose requirements in undernourished ewes. Increased maternal supply of fetal
      glucose during exercise substitutes for rather than adds to fetal endogenous
      glucogenesis.

PMID- 2223748
TI  - Dietary animal proteins and cholesterol metabolism in rabbits.
AB  - The effect in rabbits of giving isonitrogenous purified diets containing casein,
      ovalbumin, fish protein, milk-whey protein and soya-bean protein were compared.
      The diets were balanced for cholesterol and for the amount and type of fat. When
      incorporated into low-cholesterol diets (0.08 g cholesterol/kg), casein,
      ovalbumin and soya-bean protein produced similar levels of serum cholesterol.
      With a high background of dietary cholesterol (1.5 g/kg), serum cholesterol
      concentrations increased with soya-bean protein, whey protein, casein and fish
      protein, in that order. Thus, the hypercholesterolaemic effect of casein in
      carefully balanced diets was only seen against a high-cholesterol background. The
      development of hypercholesterolaemia produced by giving fish protein was
      different from that produced by casein. First, less cholesterol accumulated in
      the very-low-density-lipoprotein fractions and more in the lipoproteins of higher
      density with fish protein than with casein. Second, fish protein, unlike casein,
      did not increase liver cholesterol. Third, transfer of rabbits from a diet
      containing soya-bean protein to one containing casein resulted in an immediate
      marked depression in neutral steroid and bile acid excretion in faeces. However,
      when rabbits were fed on the diet with fish protein after the diet with soya-bean
      protein, there was no significant depression in neutral steroid output and the
      depression in bile acid output was delayed. The present study suggests that
      different animal proteins cause hypercholesterolaemia by different mechanisms.

PMID- 2223749
TI  - Lipid absorption and intestinal tumour incidence in rats fed on varying levels of
      calcium and butterfat.
AB  - The purpose of the 2 x 2 factorial study was to determine the effect of varying
      levels of dietary calcium (2.5 and 10 g/kg) and butterfat (50 and 200 g/kg) on
      lipid utilization and on development of colon tumours in animals initiated with
      1,2-dimethylhydrazine dihydrochloride. Among rats fed on 200 g butterfat/kg, the
      fourfold increase in Ca intake induced more than a sevenfold increase in faecal
      excretion of total lipids and almost a fortyfold increase in faecal excretion of
      acid-extractable lipid. Among rats fed on 50 g butterfat/kg, the ingestion of
      supplemental Ca had a less dramatic effect and induced only a twofold increase in
      faecal excretion of total lipids and a threefold increase in acid-extractable
      lipid. The volume of intestinal adenocarcinomas was correlated with the excretion
      of acid-extractable lipid in faeces (R 0.369, P less than 0.02). Caecal enzymic
      activity was not correlated with tumour incidence or size or faecal lipid
      excretion. Overall, the fourfold increase in Ca intakes decreased total lipid
      absorption significantly but by less than 6%.

PMID- 2223750
TI  - Iron absorption from typical West African meals containing contaminating Fe.
AB  - Iron absorption from three typical West African meals was measured in fourteen
      subjects using the extrinsic-tag technique with 59Fe and 55Fe. All meals
      consisted of maize as the staple food. Meals were prepared in Benin under
      realistic conditions from locally grown foods. Of the non-haem-Fe in the meals 39
      73% did not exchange with the added inorganic radio-Fe tracer, depending on the
      degree of Fe contamination of meals. Non-haem-Fe absorption was low in each maize
      meal, but was even lower for those eaten with a vegetable sauce than for those
      eaten with a fish sauce. When haem-Fe absorption was included, 70.0-160
      micrograms Fe was absorbed. Expressed on an energy basis, the bioavailable
      nutrient density was 3.2-7.0 micrograms/100 kJ (13.4-29.5 micrograms/100 kcal).
      These findings suggest that total Fe available in the typical diets of West
      African countries does not meet the physiological requirements of large
      proportions of the population.

PMID- 2223751
TI  - Effect of caffeine on zinc absorption and Zn concentration in rat tissue.
AB  - The purposes of the present study were to determine whether caffeine has an
      effect on zinc absorption and tissue levels of Zn. Under anaesthesia, one side of
      the intestine of female rats was connected to infusion pumps and an infused
      solution (first caffeine and later Zn solution) was collected from the other side
      of the intestine using either 300 mm or the whole small intestine to determine Zn
      absorption. In a further study, different doses of caffeine solution were
      injected directly into the femoral vein and a saline or Zn solution was infused
      into the intestine to measure Zn absorption and tissue Zn concentrations. The
      results consistently showed that the caffeine solution infused into the intestine
      did not affect intestinal Zn absorption nor was absorption affected by the direct
      injection of caffeine into the vein. In contrast, injection of different doses of
      the caffeine solution significantly decreased Zn tissue levels for the heart
      only. Calcium concentrations in the heart tissue were also decreased, but not
      magnesium concentrations. Tissue Zn levels recovered immediately on infusion of a
      Zn solution into the intestine.

PMID- 2223752
TI  - Large bowel fermentation in rats given diets containing raw peas (Pisum sativum).
AB  - The digestion of non-starch polysaccharides (NSP) was studied in rats given semi
      purified diets containing 0-500 g raw peas (Pisum sativum)/kg. NSP were equally
      well digested at all inclusion levels with digestibilities for individual
      constituents ranging from 0.58 for xylans to 0.99 for arabinose-containing
      polymers with a total NSP digestibility of 0.79. Increasing the dietary pea
      inclusion rate increased the amount of substrate flowing to the large bowel (LB)
      and this was associated with marked increases in caecal tissue and contents
      masses, a reduction in caecal transit time from 0.88 to 0.43 d and a threefold
      increase in faecal bacterial output. Caecal pH fell as did the molar proportions
      of acetate, isobutyrate, isovalerate and valerate whilst butyrate increased when
      peas were included in the diet. Possible mechanisms for these fermentation end
      product changes are discussed. Pea inclusion in the diet was associated with
      increased volatile fatty acid and 3-hydroxy butyrate concentrations in portal and
      heart blood. It was concluded that peas are a rich source of fermentable
      polysaccharides which produce a LB fermentation pattern of potential health
      benefit.

PMID- 2223753
TI  - Rhodopsin-stimulated activation-deactivation cycle of transducin: kinetics of the
      intrinsic fluorescence response of the alpha subunit.
AB  - The intrinsic tryptophan fluorescence of the alpha subunit of transducin (alpha
      T) has been shown to be sensitive to the binding of guanine nucleotides, with the
      fluorescence being enhanced by as much as 2-fold upon the binding of GTP or
      nonhydrolyzable GTP analogues [cf. Phillips and Cerione (1988) J. Biol. Chem.
      263, 15498-15505]. In this work, we have used these fluorescence changes to
      analyze the kinetics for the activation (GTP binding)-deactivation (GTPase) cycle
      of transducin in a well-defined reconstituted phospholipid vesicle system
      containing purified rhodopsin and the alpha T and beta gamma T subunits of the
      retinal GTP-binding protein. Both the rate and the extent of the GTP-induced
      fluorescence enhancement are dependent on [rhodopsin], while only the rate (and
      not the extent) of the GTP gamma S-induced enhancement is dependent on the levels
      of rhodopsin. Comparisons of the fluorescence enhancements elicited by GTP gamma
      S and GTP indicate that the GTP gamma S-induced enhancements directly reflect the
      GTP gamma S-binding event while the GTP-induced enhancements represent a
      composite of the GTP-binding and GTP hydrolysis events. At high [rhodopsin], the
      rates for GTP binding and GTPase are sufficiently different such that the GTP
      induced enhancement essentially reflects GTP binding. A fluorescence decay, which
      always follows the GTP-induced enhancement, directly reflects the GTP hydrolytic
      event. The rate of the fluorescence decay matches the rate of [32P]Pi production
      due to [gamma-32P]GTP hydrolysis, and the decay is immediately reversed by
      rechallenging with GTP. The GTP-induced fluorescence changes (i.e., the
      enhancement and ensuing decay) could be fit to a simple model describing the
      activation-deactivation cycle of transducin. The results of this modeling suggest
      the following points: (1) the dependency of the activation-deactivation cycle on
      [rhodopsin] can be described by a simple dose response profile; (2) the rate of
      the rhodopsin-stimulated activation of multiple alpha T(GDP) molecules is
      dependent on [rhodopsin] and when [alpha T] greater than [rhodopsin], the
      activation of the total alpha T pool may be limited by the rate of dissociation
      of rhodopsin from the activated alpha T(GTP) species; and (3) under conditions of
      optimal rhodopsin-alpha T coupling (i.e., high [rhodopsin]), the cycle is limited
      by GTP hydrolysis with the rate of Pi release, or any ensuing conformational
      change, being at least as fast as the hydrolytic event.

PMID- 2223755
TI  - Pairwise specificity and sequential binding in enzyme catalysis: thymidylate
      synthase.
AB  - The structures of thymidylate synthase (TS) from Escherichia coli, in ternary
      complexes with substrate and an analogue of the cofactor, are the basis of a
      stereochemical model for a key reaction intermediate in the catalyzed reaction.
      This model is used to compare the reaction chemistry and chirality of the
      transferred methyl group with structures of the components, to identify those
      residues that participate, and to propose a stereochemical mechanism for
      catalysis by TS. Effects of chemical modification of specific amino acid residues
      and site-directed mutations of residues are correlated with structure and effects
      on enzyme mechanism. The ordered binding sequence of substrate deoxyuridine
      monophosphate and methylenetetrahydrofolate can be understood from the structure,
      where each forms a large part of the binding site for the other. The catalytic
      site serves to orient the reactants, which are sequestered along with many water
      molecules within a cavernous active center. Conformational changes during the
      reaction could involve nearby residues in ways that are not obvious in this
      complex.

PMID- 2223754
TI  - Structure, multiple site binding, and segmental accommodation in thymidylate
      synthase on binding dUMP and an anti-folate.
AB  - The structure of Escherichia coli thymidylate synthase (TS) complexed with the
      substrate dUMP and an analogue of the cofactor methylenetetrahydrofolate was
      solved by multiple isomorphous replacement and refined at 1.97-A resolution to a
      residual of 18% for all data (16% for data greater than 2 sigma) for a highly
      constrained structure. All residues in the structure are clearly resolved and
      give a very high confidence in total correctness of the structure. The ternary
      complex directly suggests how methylation of dUMP takes place. C-6 of dUMP is
      covalently bound to gamma S of Cys-198(146) during catalysis, and the reactants
      are surrounded by specific hydrogen bonds and hydrophobic interactions from
      conserved residues. Comparison with the independently solved structure of
      unliganded TS reveals a large conformation change in the enzyme, which closes
      down to sequester the reactants and several highly ordered water molecules within
      a cavernous active center, away from bulk solvent. A second binding site for the
      quinazoline ring of the cofactor analogue was discovered by withholding addition
      of reducing agent during crystal storage. The chemical change in the protein is
      slight, and from difference density maps modification of sulfhydryls is not
      directly responsible for blockade of the primary site. The site, only partially
      overlapping with the primary site, is also surrounded by conserved residues and
      thus may play a functional role. The ligand-induced conformational change is not
      a domain shift but involves the segmental accommodation of several helices, beta
      strands, and loops that move as units against the beta-sheet interface between
      monomers.

PMID- 2223756
TI  - Folding and stability of trp aporepressor from Escherichia coli.
AB  - Equilibrium and kinetic studies of the urea-induced unfolding of trp aporepressor
      from Escherichia coli were performed to probe the folding mechanism of this
      intertwined, dimeric protein. The equilibrium unfolding transitions at pH 7.6 and
      25 degrees C monitored by difference absorbance, fluorescence, and circular
      dichroism spectroscopy are coincident within experimental error. All three
      transitions are well described by a two-state model involving the native dimer
      and the unfolded monomer; the free energy of folding in the absence of denaturant
      and under standard-state conditions is estimated to be 23.3 +/- 0.9 kcal/mol of
      dimer. The midpoint of the equilibrium unfolding transition increases with
      increasing protein concentration in the manner expected from the law of mass
      action for the two-state model. We find no evidence for stable folding
      intermediates. Kinetic studies reveal that unfolding is governed by a single
      first-order reaction whose relaxation time decreases exponentially with
      increasing urea concentration and also decreases with increasing protein
      concentration in the transition zone. Refolding involves at least three phases
      that depend on both the protein concentration and the final urea concentration in
      a complex manner. The relaxation time of the slowest of these refolding phases is
      identical with that for the single phase in unfolding in the transition zone,
      consistent with the results expected for a reaction that is kinetically
      reversible. The two faster refolding phases are presumed to arise from slow
      isomerization reactions in the unfolded form and reflect parallel folding
      channels.

PMID- 2223757
TI  - Structure and function of hemoglobin variants at an internal hydrophobic site:
      consequences of mutations at the beta 27 (B9) position.
AB  - We have studied the structure-function relationships in newly discovered
      hemoglobin (Hb) mutants with substitutions occurring at the tight and highly
      hydrophobic cluster between the B and G helices in the beta chains, namely, Hb
      Knossos or beta A27S and Hb Grange-Blanche or beta A27V. The beta A27S mutant has
      a 50% decrease in oxygen affinity relative to native human Hb A, while the beta
      A27V mutant has an increased oxygen affinity. We have also engineered the
      artificial beta A27T mutation through site-directed mutagenesis. This new mutant
      exhibits functional properties similar to those of Hb A. None of these mutants is
      unstable. X-ray analyses show that the substitution of Val for Ala may reduce the
      relative stability of the T structure of the molecule through packing effects in
      the beta chains; for the beta A27S mutant a new hydrogen bond between serine and
      the carbonyl O at beta 23 (B5) Val is observed and is likely to increase the
      relative stability of the T structure in the mutant hemoglobin. However, no
      significant changes in the crystals were observed for these mutants between the
      quaternary R and T structures relative to native Hb A. We conclude that small
      tertiary structural changes in the tight hydrophobic B-G helix interface are
      sufficient to induce functional abnormalities resulting in either low or high
      intrinsic oxygen affinities.

PMID- 2223758
TI  - Mechanistic studies of ionizing radiation and oxidative mutagenesis: genetic
      effects of a single 8-hydroxyguanine (7-hydro-8-oxoguanine) residue inserted at a
      unique site in a viral genome.
AB  - T4 RNA ligase was used to construct a deoxypentanucleotide containing a single 8
      hydroxyguanine (7-hydro-8-oxoguanine; G8-OH) residue, which is one of the
      putatively mutagenic DNA adducts produced by oxidants and ionizing radiation. The
      pentamer d(GCTAG8-OH)p was prepared by the ligation of a chemically synthesized
      acceptor molecule, d(GCTA), to an adducted donor, 8-hydroxy-2'-deoxyguanosine
      5',3'-bisphosphate. The acceptor was efficiently converted to the reaction
      product (greater than 95%), and the final product yield was 50%. Following 3'
      dephosphorylation, the pentamer was characterized by UV spectroscopy, by high
      pressure liquid chromatography, and by gas chromatography-mass spectrometry of
      the nucleosides released by enzymatic hydrolysis. Both d(GCTAG8-OH) and an
      unmodified control were 5'-phosphorylated by using [gamma -32P]ATP and
      incorporated covalently by DNA ligase into a five-base gap at a unique NheI
      restriction site in the otherwise duplex genome of an M13mp19 derivative. The
      ligation product contained G8-OH at the 3' residue of an in-frame amber codon (5'
      TAG-3') (genome position 6276) of the phage lacZ alpha gene. The adduct was part
      of a nonsense codon in a unique restriction site in order to facilitate the
      identification and selection of mutants generated by the replication of the
      modified genome in Escherichia coli. Both control and adducted pentamers ligated
      into the genome at 50% of the maximum theoretical efficiency, and nearly all
      (approximately 90%) of the site-specifically adducted products possessed
      pentanucleotides that were covalently linked at both 5' and 3' termini. The G8-OH
      lesion in the NheI site inhibited the cleavage of the site by a 200-fold excess
      of NheI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223759
TI  - Differential scanning calorimetry study of mixed-chain phosphatidylcholines with
      a common molecular weight identical with diheptadecanoylphosphatidylcholine.
AB  - To examine the thermotropic phase behavior of various mixed-chain
      phosphatidylcholines in excess water and to compare it with the known behavior of
      identical-chain phosphatidylcholines, we have carried out high-resolution
      differential scanning calorimetric (DSC) studies on aqueous dispersions of 10
      different mixed-chain phosphatidylcholines. These lipids, C(16):C(18)PC,
      C(18):C(16)PC, C(15):C(19)PC, C(19):C(15)PC, C(14):C(20)PC, C(20):C(14)PC,
      C(13):C(21)PC, C(21):C(13)PC, C(12):C(22)PC, and C(22):C(12)PC, have a common
      molecular weight which is the same as that of C(17):C(17)PC, an identical-chain
      phosphatidylcholine with a molecular weight of 762.2. When the values of any of
      the thermodynamic parameters (Tm, delta H, and delta S) of the mixed-chain
      phosphatidylcholines and C(17):C(17)PC are plotted against the normalized chain
      length difference (delta C/CL), a linear function with negative slope is obtained
      provided that the value of delta C/CL is within the range of 0.09-0.4. The linear
      relationship suggests that these mixed-chain phospholipids are packed in the gel
      state bilayer similar to the bilayer structure of C(17):C(17)PC at T less than
      Tm; however, the negative slope suggests that the conformational statistics of
      the hydrocarbon chain and the lateral lipid-lipid interactions of these
      phosphatidylcholines in the gel-state bilayer are perturbed proportionally by a
      progressive increase in the chain-length inequivalence between the two acyl
      chains within each lipid molecule. When the value of delta C/CL for mixed-chain
      phosphatidylcholines reaches the range of 0.44-0.55, the thermotropic phase
      behavior deviates markedly from that of less asymmetric phosphatidylcholines,
      suggesting that these highly asymmetric lipids are packed into mixed
      interdigitated bilayers at T less than Tm. The heating and cooling pathways of
      aqueous dispersions prepared from the 10 mixed-chain phospholipids are also
      discussed.

PMID- 2223760
TI  - Differential scanning calorimetric study of a homologous series of fully hydrated
      saturated mixed-chain C(X):C(X + 6) phosphatidylcholines.
AB  - The successive high-resolution differential scanning calorimetric (DSC)
      thermograms for aqueous dispersions of a homologous series of mixed-chain
      phosphatidylcholines, C(X):C(X + 6)PC, have been recorded and analyzed. In this
      series of saturated mixed-chain phosphatidylcholines, the total number of carbon
      atoms in the sn-1 acyl chain increases from 11 to 20, and the sn-2 acyl chain is
      always 6 methylene units longer than the sn-1 acyl chain. In the initial heating
      DSC thermograms, two prominent endothermic transitions are detected for all the
      samples prepared from the various C(X):C(X + 6)PCs except C(12):C(18)PC. In
      contrast, a single exothermic transition is observed on cooling for all the
      samples except C(13):C(19)PC. The temperature difference between the two
      endothermic transitions increases linearly as the acyl chain length of C(X):C(X +
      6)PC becomes progressively longer. Interestingly, the main phase transition
      occurs before the subtransition for C(11):C(17)PC dispersions. Our DSC data
      further demonstrate that the thermodynamic parameters (Tm, delta H, and delta S)
      associated with the main phase transition for fully hydrated C(13):C(19)PC and
      other identical MW phosphatidylcholines are inversely related to the
      corresponding values of the chain-length inequivalence (delta C/CL) for these
      lipids. This linear relationship can be employed to map the Tm values for aqueous
      dispersions prepared from a large number of mixed-chain phosphatidylcholines
      whose values of delta C/CL are within the range of 0.1-0.4.

PMID- 2223761
TI  - Ca2+, Mg2+, Li+, Na+, and K+ distributions in the headgroup region of binary
      membranes of phosphatidylcholine and phosphatidylserine as seen by deuterium NMR.
AB  - The binding of calcium, magnesium, lithium, potassium, and sodium to membrane
      bilayers of 5 to 1 (M/M) 1-palmitoyl-2-oleoylphosphatidylcholine (POPC) and 1
      palmitoyl- 2-oleoylphosphatidylserine (POPS) was investigated by using deuterium
      nuclear magnetic resonance (2H NMR). Both lipids were deuteriated on their polar
      headgroups, and spectra were obtained at 25 degrees C in the liquid-crystalline
      phase as a function of salt concentration. The spectra obtained with calcium were
      correlated with 45CaCl2 binding studies to determine the effective membrane-bound
      calcium at low calcium binding, up to 0.78 calcium per POPS. Deuterium
      quadrupolar splittings of both POPC and POPS headgroups were shown to be very
      sensitive to calcium binding. The behavior of these two headgroups over a wide
      range of CaCl2 concentrations suggests that Ca2+ binding occurs in at least two
      steps, the first step being achieved with 0.5 M CaCl2, with a stoichiometry of
      0.5 Ca2+ per POPS. Correlations of the deuterium Ca2+ binding data with related
      data obtained after incorporation of a cationic integral peptide showed that the
      effects of these two cationic molecules of the POPS headgroup are qualitatively
      similar, and provided further support for two-step Ca2+ binding to the POPC/POPS
      5:1 membranes. The corresponding data obtained with magnesium, lithium, and
      potassium indicate that these cations interact with both the choline and serine
      headgroups. The amplitudes of headgroup perturbations could be partly correlated
      to the relative affinities of the metallic cations for the lipid membrane. The
      two-step binding described with Ca2+ appears to be relevant to the Mg2+ data, and
      in certain limits to the Li+ data. The data were interpreted in terms of
      conformational changes of the lipid headgroups induced by an electric field due
      to the charges of the membrane-bound metallic cations. A conformational change of
      the serine headgroup induced by the membrane-bound charges is proposed. We
      propose that the metallic cations can be differentiated on the basis of their
      respective spatial distribution functions relative to the choline and serine
      headgroups. According to this interpretation, the divalent cations Ca2+ and Mg2+
      are more deeply buried in the membrane than monovalent Na+ and K+, the case of
      Li+ being intermediate of the latter two. This conclusion is discussed in
      relation to fundamental theories of the spatial distribution of ions near the
      interface between water and smooth charged solid surfaces.

PMID- 2223762
TI  - Isolation and characterization of a novel eukaryotic monofunctional NAD(+)
      dependent 5,10-methylenetetrahydrofolate dehydrogenase.
AB  - An NAD(+)-dependent 5,10-methylenetetrahydrofolate (THF) dehydrogenase has been
      purified to homogeneity from the yeast Saccharomyces cerevisiae. The purified
      enzyme exhibits a final specific activity of 5.4 units mg-1 and is represented by
      a single protein of apparent Mr = 33,000-38,000 as determined by sodium dodecyl
      sulfate gel electrophoresis. A native Mr = 64,000 was determined by gel
      filtration, suggesting a homodimer subunit structure. Cross-linking experiments
      with dimethyl suberimidate confirmed the dimeric structure. The enzyme is
      specific for NAD+ and is not dependent on Mg2+ for activity. The forward reaction
      initial velocity kinetics are consistent with a sequential reaction mechanism.
      With this model, Km values for NAD+ and (6R,S)-5,10-methylene-THF are 1.6 and
      0.06 mM, respectively. In contrast to all other previously described eukaryotic
      5,10-methylene-THF dehydrogenases, the purified enzyme is apparently
      monofunctional, with undetectable 5,10-methenyl-THF cyclohydrolase and 10-formyl
      THF synthetase activities. Subcellular fractionation of yeast indicates the
      enzyme is cytoplasmic, with no NAD(+)-dependent 5,10-methylene-THF dehydrogenase
      detectable in mitochondria. The activity was found in all yeast strains examined,
      at all stages of growth from the lag phase through the stationary phase.

PMID- 2223763
TI  - Design and characterization of hirulogs: a novel class of bivalent peptide
      inhibitors of thrombin.
AB  - A novel class of synthetic peptides has been designed that inhibit the thrombin
      catalytic site and exhibit specificity for the anion-binding exosite (ABE) of
      alpha-thrombin. These peptides, called "hirulogs", consist of (i) an active-site
      specificity sequence with a restricted Arg-Pro scissile bond, (ii) a polymeric
      linker of glycyl residues from 6 to 18 A in length, and (iii) an ABE recognition
      sequence such as that in the hirudin C-terminus. Hirulog-1 ([D-Phe)-Pro-Arg-Pro
      (Gly)4-Asn-Gly-Asp-Phe-Glu-Glu-Ile- Pro-Glu-Tyr-Leu] inhibits the thrombin
      catalyzed hydrolysis of a tripeptide p-nitroanilide substrate with Ki = 2.3 nM.
      In contrast, the synthetic C-terminal hirudin peptide S-Hir53-64, which binds to
      the thrombin ABE, blocked the fibrinogen clotting activity of the enzyme with Ki
      = 144 nM but failed to inhibit the hydrolysis of p-nitroanilide substrates at
      concentrations as high as 1 mM. In addition, the pentapeptide (D-Phe)-Pro-Arg-Pro
      Gly, which comprises the catalytic-site inhibitor moiety of hirulog-1, was
      determined to have a Ki for thrombin inhibition greater than 2 microM. Hirulog-1,
      but not S-Hir53-64, was found to inhibit the incorporation of [14C]diisopropyl
      fluorophosphate in thrombin. Hirulog-1 appears specific for thrombin as it lacks
      inhibitory activities toward human factor Xa, human plasmin, and bovine trypsin
      at inhibitor:enzyme concentrations 3 orders of magnitude higher than those
      required to inhibit thrombin. The optimal inhibitory activity of hirulog-1
      depends upon all three components of its structure.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2223765
TI  - Affinity labeling of bovine liver glutamate dehydrogenase with 8-[(4-bromo-2,3
      dioxobutyl)thio]adenosine 5'-diphosphate and 5'-triphosphate.
AB  - Bovine liver glutamate dehydrogenase reacts with 8-[(4-bromo-2,3
      dioxobutyl)thio]adenosine 5'-diphosphate (8-BDB-TA-5'-DP) and 5'-triphosphate (8
      BDB-TA-5'-TP) to yield enzyme with about 1 mol of reagent incorporated/mol of
      enzyme subunit. The modified enzyme is catalytically active but has decreased
      sensitivity to inhibition by GTP, reduced extent of activation by ADP, and
      diminished inhibition by high concentrations of NADH. Since modified enzyme, like
      native glutamate dehydrogenase, reversibly binds more than 1 mol each of ADP and
      GTP, it is unlikely that 8-BDB-TA-5'-TP reacts directly within either the ADP or
      GTP regulatory sites. The rate constant for reaction of enzyme exhibits a
      nonlinear dependence on reagent concentration with KD = 89 microM for 8-BDB-TA-5'
      TP and 240 microM for 8-BDB-TA-5'-DP. The ligands ADP and GTP alone and NADH
      alone produce only small decreases in the rate constant for the reaction of
      enzyme with 8-BDB-TA-5'-TP, but the combined addition of 5 mM NADH + 200 microM
      GTP reduces the reaction rate constant more than 10-fold and the reagent
      incorporation to about 0.1 mol/mol of enzyme subunit. These results suggest that
      8-BDB-TA-5'-TP reacts as a nucleotide affinity label in the region of the GTP
      dependent NADH regulatory site of bovine liver glutamate dehydrogenase.

PMID- 2223764
TI  - Probing the coenzyme specificity of glyceraldehyde-3-phosphate dehydrogenases by
      site-directed mutagenesis.
AB  - By combining our knowledge of the crystal structure of the glycolytic NAD
      dependent glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and the sequence of
      the photosynthetic NADP-dependent GAPDH of the chloroplast, two particular amino
      acid residues were predicted as the principal determinants of differing coenzyme
      specificity. By use of site-directed mutagenesis, the amino acids Leu 187 and Pro
      188 of GAPDH from Bacillus stearothermophilus have been replaced with Ala 187 and
      Ser 188, which occur in the sequence from the chloroplast enzyme. The resulting
      mutant was shown to be catalytically active not only with its natural coenzyme
      NAD but also with NADP, thus confirming the initial hypothesis. This approach has
      not only enabled us to alter the coenzyme specificity by minimal amino acid
      changes but also revealed factors that control the relative affinity of the
      enzyme for NAD and NADP.

PMID- 2223766
TI  - Substrate-dependent shift of optimum pH in porcine pancreatic alpha-amylase
      catalyzed reactions.
AB  - Porcine pancreatic alpha-amylase (EC 3.2.1.1, abbreviated as PPA) hydrolyzes
      alpha-D-(1,4) glucosidic bonds in starch and amylose at random, and the optimum
      pH for the substrates is 6.9. The optimum pH, however, shifted to 5.2 for the
      hydrolytic reaction of low molecular weight oligosaccharide substrates such as p
      nitrophenyl alpha-D-maltoside, gamma-cyclodextrin, maltotetaitol, and
      maltopentaitol. The optimum pH for the oligosaccharides consisting of more than
      five glucose residues, such as maltopentaose and maltohexaitol, was 6.9. From the
      analysis of the hydrolysates, it was clear that the shift of the optimum pH
      occurred only when the fifth subsite of PPA in the productive binding modes was
      occupied by a glucosyl residue of the substrates. The value of Km was independent
      of pH between 4 and 10 but that of kcat was dependent on pH. The pH profiles of
      kcat for the above substrates did not fit a simple bell-shaped curve predicted by
      a two-catalytic-group mechanism. Instead, they were well analyzed theoretically
      by three pK values and two intrinsic kcat values. Enthalpy changes for the three
      pK's (4.90, 5.35, and 8.55 at 30 degrees C) were determined from the temperature
      dependence of pH profiles for maltopentaitol and maltohexaitol to be 0.0, 2.87,
      and 7.33 kcal/mol, respectively. These results indicate that productive binding
      modes of the substrates directly affect the catalytic function of the enzyme.
      From the present thermodynamic analysis and reported three dimensional structure
      at the active site of PPA [Buisson, G. (1987) EMBO J. 6, 3909-3916], one can
      assume that a histidyl residue (101, 201, or 299) acts as a proton donor and two
      carboxyl groups (Asp 197, Glu 233, or Asp 300) act as proton donors or acceptors,
      and the productive binding mode covering the fifth subsite changes configurations
      between the catalytic residues and the glucosidic bond hydrolyzed and modulates
      kinetic parameters depending on pH.

PMID- 2223767
TI  - Changing the insulin receptor to possess insulin-like growth factor I ligand
      specificity.
AB  - To examine the role of the N-terminal part of the insulin-like growth factor I
      (IGF-I) receptor and insulin receptor in determining ligand specificity, we
      prepared an expression vector encoding a hybrid receptor where exon 1 (encoding
      the signal peptide and seven amino acids of the alpha-subunit), exon 2, and exon
      3 of the insulin receptor were replaced with the corresponding IGF-I receptor
      cDNA (938 nucleotides). To allow direct quantitative comparison of the binding
      capabilities of this hybrid receptor with those of the human IGF-I receptor and
      the insulin receptor, all three receptors were expressed in baby hamster kidney
      (BHK) cells as soluble molecules and partially purified before characterization.
      The hybrid IGF-I/insulin receptor bound IGF-I with an affinity comparable to that
      of the wild-type IGF-I receptor. In contrast, the hybrid receptor no longer
      displayed high-affinity binding of insulin. These results directly demonstrate
      that it is possible to change the specificity of the insulin receptor to that of
      the IGF-I receptor and, furthermore, that the binding specificity for IGF-I is
      encoded within the nucleotide sequence from 135 to 938 of the IGF-I receptor
      cDNA. Since the hybrid receptor only bound insulin with low affinity, the insulin
      binding region is likely to be located within exons 2 and 3 of the insulin
      receptor.

PMID- 2223768
TI  - Primary structure of the major pepsin inhibitor from the intestinal parasitic
      nematode Ascaris suum.
AB  - The major pepsin inhibitor from Ascaris suum was isolated by affinity
      chromatography and chromatofocusing. Its amino acid sequence was determined by
      automated Edman degradation of peptide fragments. Peptides were produced by
      chemical and enzymatic cleavage of pyridylethylated protein and were purified by
      reverse-phase high-performance liquid chromatography. The inhibitor consists of
      149 residues with the following sequence:
      QFLFSMSTGP10FICTVKDNQV20FVANLPWTML30EGDDIQVGKE40
      FAARVEDCTN50VKHDMAPTCT60KPPPFCGPQD70MKMFNFVGCS80VLGNKLFIDQ90KYVRDLTAK D100
      HAEVQTFREK110IAAFEEQQEN120QPPSSGMPHG130AVPAGGLSPP140PPPSFCTVQ149. It has a
      molecular weight of 16,396. All cysteines are engaged as disulfide bonds: Cys(13)
      Cys(59), Cys(48)-Cys(66), and Cys(79)-Cys(146). The protein is probably composed
      of two domains connected by a short hydrophobic region. This is the first
      aspartyl protease inhibitor of animal origin that has been sequenced. The
      sequence has no significant homology with any other known protein.

PMID- 2223769
TI  - The cytochrome P-450cam binding surface as defined by site-directed mutagenesis
      and electrostatic modeling.
AB  - Cytochrome P-450cam cationic surface charges at Lys 344, Arg 72, and Lys 392 have
      been altered by site-directed mutagenesis techniques. The residues at Lys 344 and
      Arg 72 were previously suggested as salt bridge contacts in the cytochrome b5
      cytochrome P-450cam association complex and implicated in the physiological
      putidaredoxin-cytochrome P-450cam complex [Stayton, P. S., Poulos, T. L., &
      Sligar, S. G. (1989) Biochemistry 28, 8201-8205]. Mutations to neutralize the
      basic charge at Arg 72 (R72Q) and to both neutralize and reverse the charge at
      Lys 344 (K344Q, K344E) resulted in alteration of NADH oxidation rates in the
      reconstituted physiological electron-transfer system, which is rate limited by
      putidaredoxin-cytochrome P-450cam electron transfer. The steady-state Vmax values
      were apparently unperturbed, suggesting that the observed rate differences were
      largely attributable to Km effects. The Km values observed for the K344Q (24
      microM) and K344E (32 microM) mutants are in the direction expected for
      neutralization and reversal of a salt bridge charge interaction. A control
      mutation at a basic surface charge located away from the proposed site of
      interaction, Lys 392 (K392Q), resulted in overall activities quantitated by NADH
      oxidation rates that are similar to that of wild-type cytochrome P-450cam.
      Calculation of the cytochrome P-450cam electrostatic field revealed a patch of
      positive potential at the modeled cytochrome b5 interaction site lying directly
      above the nearest proximal approach to the buried heme prosthetic group. These
      results provide experimental and theoretical evidence for the modeled cytochrome
      P-450cam binding site implicated in both cytochrome b5 and putidaredoxin
      association.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223771
TI  - Proton nuclear magnetic resonance assignments and secondary structure
      determination of the ColE1 rop (rom) protein.
AB  - The complete resonance assignment of the ColE1 rop (rom) protein at pH 2.3 was
      obtained by two-dimensional (2D) proton nuclear magnetic resonance spectroscopy
      (1H NMR) at 500 and 600 MHz using through-bond and through-space connectivities.
      Sequential assignments and elements of regular secondary structure were deduced
      by analysis of nuclear Overhauser enhancement spectroscopy (NOESY) experiments
      and 3JHN alpha coupling constants. One 7.2-kDa monomer of the homodimer consists
      of two antiparallel helices connected by a hairpin loop at residue 31. The C
      terminal peptide consisting of amino acids 59-63 shows no stable conformation.
      The dimer forms a four-helix bundle with opposite polarization of neighboring
      elements in agreement with the X-ray structure.

PMID- 2223770
TI  - Analysis of the backbone dynamics of interleukin-1 beta using two-dimensional
      inverse detected heteronuclear 15N-1H NMR spectroscopy.
AB  - The backbone dynamics of uniformly 15N-labeled interleukin-1 beta are
      investigated by using two-dimensional inverse detected heteronuclear 15N-1H NMR
      spectroscopy. 15N T1, T2, and NOE data at a spectrometer frequency of 600 MHz are
      obtained for 90% of the backbone amide groups. The data provide evidence for
      motions on three time scales. All the residues exhibit very fast motions on a
      time scale of approximately less than 20-50 ps that can be characterized by a
      single-order parameter with an average value of 0.82 +/- 0.05. For a model
      comprising free diffusion within a cone, these residue-specific order parameters
      translate to an average cone semiangle of 20.7 +/- 3.3 degrees. Thirty-two
      residues also display motions on a time scale of 0.5-4 ns, slightly less than the
      overall rotational correlation time of the protein (8.3 ns). These additional
      motions must be invoked to account for the discrepancy between experiment and the
      simplest theoretical formulation in which the internal motions are described by
      only two parameters, a generalized order parameter and an effective correlation
      time [Lipari, G., & Szabo, A. (1982a) J. Am. Chem. Soc. 104, 4546-4559]. In
      particular, while the simple formulation can account for the 15N T1 and T2 data,
      it fails to account for the 15N-1H NOE data and yields calculated values for the
      NOEs that are either too small or negative, whereas the observed NOEs are
      positive. With the introduction of two internal motions that are faster than the
      rotational correlation time and differ in time scales by at least 1-2 orders of
      magnitude [Clore, G. M., Szabo, A., Bax, A., Kay, L. E., Driscoll, P. C., &
      Gronenborn, A. M. (1990) J. Am. Chem. Soc. 112, 4989-4991], all the relaxation
      data for these 32 residues can be fitted by two order parameters and an effective
      correlation time for the slower of the two internal motions. A simple model for
      these two motions is one in which the very fast motion involves axially symmetric
      diffusion within a cone, while the slower motion comprises jumps between two
      different orientations of the NH vector. For such a model the jump angle
      (excluding the C-terminal residue) ranges from 15 degrees to 69 degrees with a
      mean value of 28.6 +/- 14.0 degrees. Another 42 residues are characterized by
      some sort of motion on the 30-ns-10-ms time scale, which results in 15N line
      broadening due to chemical exchange between different conformational substates
      with distinct 15N chemical shifts.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2223772
TI  - Modification of the adipocyte lipid binding protein by sulfhydryl reagents and
      analysis of the fatty acid binding domain.
AB  - The adipocyte lipid binding protein (ALBP) is a member of a multigene family of
      low molecular weight proteins which stoichiometrically and saturably bind
      hydrophobic ligands and presumably facilitate intracellular lipid metabolism. To
      probe the structure-function relationship of the binding domain of ALBP, chemical
      modification has been employed. Modification of the two cysteinyl residues of
      ALBP (Cys1 and Cys117) with a variety of sulfhydryl reagents decreased the
      apparent affinity for oleic acid in the following order of effectiveness: methyl
      methanethiosulfonate much much less than p-(chloromercuri)benzenesulfonic acid
      less than N-ethylmaleimide (NEM) = 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB).
      Thiol titration of ALBP with DTNB in the presence of bound oleate resulted in the
      modification of a single cysteinyl residue. The oleate-protected cysteine was
      identified as Cys117 by modification with a combination of reversible (DTNB) and
      irreversible (NEM) sulfhydryl reagents in the presence or absence of saturating
      oleic acid. Cys117-NEM ALBP exhibited a large decrease in binding affinity while
      Cys1-NEM ALBP exhibited normal binding properties. Neither the modification of
      ALBP with NEM nor the addition of oleic acid had a significant effect on protein
      structure, as judged by circular dichroic analysis. These results suggest that
      Cys117 of ALBP resides in the ligand binding domain and that site-specific
      modification can be utilized to assess the conformational flexibility of the
      binding cavity.

PMID- 2223773
TI  - Nucleotide sequence and expression of a cDNA encoding chick brain actin
      depolymerizing factor.
AB  - Chick brain actin depolymerizing factor (ADF) is a 19-kDa protein that severs
      actin filaments and binds actin monomers. We have obtained a cDNA encoding ADF by
      screening a chick embryo lambda gt11 cDNA library with both a rabbit anti-ADF
      antiserum and two oligonucleotide probes. Several non-full-length clones of 636
      bases and one full-length clone of 1886 bases were isolated and sequenced. The
      full-length cDNA encodes a protein of 165 amino acids with a calculated molecular
      weight of 18,520. The deduced amino acid sequence shows 73% identity with the
      porcine brain actin binding protein cofilin. The coding region of the ADF cDNA
      has been placed in an expression vector, and the resulting protein shows
      immunoreactivity with an anti-ADF antiserum but not with an anti-cofilin
      antibody. The expressed ADF has been purified and has an actin depolymerizing
      activity identical with that of brain ADF. Like cofilin, ADF contains a sequence
      similar to the nuclear transport signal sequence of the SV40 large T antigen and
      a calcium/calmodulin-dependent protein kinase II phosphorylation consensus
      sequence. Northern blots of both embryonic chick brain and muscle RNA revealed
      two ADF mRNAs of length 2.1 and 0.9 kilobases. Southern blots suggest that the
      ADF gene is present in a single copy within the chicken genome. ADF contains
      regions of homology with other actin binding proteins including tropomyosin,
      gelsolin, and depactin.

PMID- 2223774
TI  - Sequential assignment of the 1H nuclear magnetic resonance spectrum of barnase.
AB  - Two-dimensional nuclear magnetic resonance spectroscopy has been used to study
      the bacterial ribonuclease barnase (MW 12,382). Resonance assignments have been
      made for protons in all of the 110 residues. Analysis of medium- and long-range
      contacts in NOESY spectra has demonstrated that the major elements of secondary
      structure in barnase in solution are essentially identical with those found in
      the crystal structure.

PMID- 2223775
TI  - Fluorescence and NMR investigations on the ligand binding properties of adenylate
      kinases.
AB  - A new system for measurement of affinities of adenylate kinases (AK) for
      substrates and inhibitors is presented. This system is based on the use of the
      fluorescent ligand alpha,omega-di[(3' or 2')-O-(N-methylanthraniloyl)adenosine
      5'] pentaphosphate (mAP5Am), which is an analogue of the bisubstrate inhibitor
      diadenosine pentaphosphate (AP5A). It allows the determination of dissociation
      constants for any ligand in the range of 1 x 10(-9) to 5 x 10(-2) M. Affinities
      for different bisubstrate inhibitors (AP4A, AP5A, AP6A) and substrates (AMP, ADP,
      ATP, GTP) were determined in the presence and absence of magnesium. An analysis
      of the binding of bisubstrate inhibitors is proposed and applied to these data.
      The techniques are used to describe the properties of a mutant enzyme with Gln-28
      ---His (Q28H) prepared by site-directed mutagenesis in comparison to those of
      wild-type AK from Escherichia coli. This newly introduced histidine is already
      present in most other adenylate kinases and was regarded to be important or even
      essential for the catalytic reaction of AK. Temperature denaturation experiments
      indicate that the mutant enzyme has the same thermal stability as the wild-type
      enzyme and, as NMR studies indicate, also a very similar structure. However,
      steady-state catalytic studies and binding experiments showed that the affinities
      for substrates and inhibitors are elevated from 3-fold (AMP) to 5-fold (ATP) to
      15-fold (AP5A) compared to those of the wild-type enzyme. Together with the
      results obtained by Tian et al. [Tian, G., Sanders, C. R., Kishi, F., Nakazawa,
      A., & Tsai, M.-D. (1988) Biochemistry 27, 5544-5552] on the effect of replacement
      of the conserved His-36 in the cytosolic AK (AK1) from chicken by glutamine and
      asparagine, this shows that residues 28 of AK from E. coli (AKec) and 36 of AK1
      are situated in a comparable environment and are not essential for catalytic
      activity.

PMID- 2223776
TI  - Structurally and catalytically important residues in the phosphate binding loop
      of adenylate kinase of Escherichia coli.
AB  - Amino acids in the phosphate binding loop of adenylate kinase of Escherichia coli
      were mutated by site-directed mutagenesis. The mutant proteins with a Pro-9---
      Gly (P9G) and with a Lys-13----Gln (K13Q) exchange were overexpressed and
      purified. They were characterized by steady-state kinetics, fluorescence binding,
      and structural studies, together with the phosphate binding loop mutants P9L and
      G10V prepared earlier [Reinstein, J., Brune, M., & Wittinghofer, A. (1988)
      Biochemistry 27, 4712-4720]. The results obtained show that all these mutations
      change the structure of the protein as evidenced by NMR spectroscopy and
      temperature-stability studies. All the mutant proteins have increased
      dissociation constants for substrates and inhibitors, but their catalytic
      activity, except for K13Q, is not reduced. The results obtained with K13Q suggest
      that this lysine residue, which is conserved in all guanine and many adenine
      nucleotide proteins, might have an important role in catalysis.

PMID- 2223777
TI  - Complexes of Escherichia coli adenylate kinase and nucleotides: 1H NMR studies of
      the nucleotide sites in solution.
AB  - One- and two-dimensional nuclear magnetic resonance (NMR) studies, in particular
      substrate--protein nuclear Overhauser effect (NOESY) measurements, as well as
      nucleotide and P1,P5-bis-(5'-adenosyl) pentaphosphate (AP5A) titrations and
      studies of the temperature-dependent unfolding of the tertiary structure of
      Escherichia coli adenylate kinase (AKEC) were performed. These experiments and
      comparison with the same type of experiments performed with the porcine enzyme
      [Rosch, P., Klaus, W., Auer, M., & Goody, R. S. (1989) Biochemistry 28, 4318
      4325] led us to the following conclusions: (1) At pH 8 and concentrations of
      approximately 2.5-3 mM, AKEC is partially unfolded at 318 K. (2) ATP.Mg2+ binds
      to the ATP site with a dissociation constant of approximately 40 microM under the
      assumption that ATP binds to one nucleotide site only. (3) AP5A.Mg2+ binds to
      both nucleotide sites and thus simulates the active complex. (4) The ATP.Mg2+
      adenine in the AKEC.AP5A.Mg2+ complex is located close to His134 and Phe19. (5)
      The AKEC "G-loop" with bound ATP.Mg2+ is structurally highly homologous to the
      loop region in the oncogene product p21 with bound GTP.Mg2+.

PMID- 2223778
TI  - Catalytic activity of the serine proteases alpha-chymotrypsin and alpha-lytic
      protease tagged at the active site with a (terpyridine)platinum(II) chromophore.
AB  - Incubation of alpha-chymotrypsin and alpha-lytic protease with chloro(2,2':6',2''
      terpyridine)platinum(II), [Pt(trpy)Cl]+, results in attachment of Pt(trpy)2+ tags
      at both His 57 and His 40 in the former and His 57 in the latter. The
      [Pt(trpy)His]2+ chromophores are readily detected and quantitated owing to their
      characteristic, strong UV absorption. Although the tagging of His 57 modifies the
      catalytic triad (Ser 195, His 57, and Asp 102) and disrupts the charge relay, the
      platinated enzymes retain significant esterase and amidase activity for both
      specific and nonspecific substrates. Unlike suicide inhibitors, which inactivate
      the enzymes by filling the active site and imitating the tetrahedral
      intermediate, [Pt(trpy)Cl]+ reacts with a particular amino acid and permits
      binding of substrates. The kinetic constants for the following are reported: two
      esters and two amides with alpha-chymotrypsin and an amide with alpha-lytic
      protease. The kcat values are between 1 and 25% of, and the Km values are a
      little higher than, the corresponding values for the native enzymes. The
      catalytic activity is not due to the native enzymes, trypsin, or some zinc
      containing protease. Activities of the native and of the platinated alpha
      chymotrypsin depend similarly on pH although the pKa of His 57 is raised to 9.7
      upon platination. The platinated enzymes undergo autodigestion slower than do the
      native enzymes. Because the Pt(trpy)2+ tags are noninvasive, stable, and yet
      easily removable by thiourea, [Pt(trpy)Cl]+ may be used to retard autodigestion
      of stored proteolytic enzymes.

PMID- 2223779
TI  - Hierarchical binding of DNA fragments derived from scaffold-attached regions:
      correlation of properties in vitro and function in vivo.
AB  - On its upstream side, the human interferon-beta gene is flanked by a 7-kb SAR
      (scaffold-attached region) DNA element. The core of this element is determined
      and subjected to in vitro reassociations with isolated scaffolds. Binding
      properties of SAR fragments with decreasing length are quantified and related to
      consensus sequences like the topoisomerase II box and an ATATTT motif.
      Characteristics as the stoichiometry, affinity, and cooperativity of the binding
      process are shown to depend on the length of SAR DNA and suggest a model
      involving a multiple-site attachment to protein scaffolds. We propose a rational
      approach for predicting the SAR mediated transcriptional enhancements in vivo
      from their binding properties in a standardized in vitro assay. The efficiency of
      this approach is demonstrated for a marker (huIFN-beta) and a selector gene
      (neor).

PMID- 2223780
TI  - DNA solution conformation via infrared circular dichroism: experimental and
      theoretical results for B-family polymers.
AB  - Infrared (vibrational) circular dichroism (VCD) has been observed for the DNA
      models d(CG)5, poly(dG-dC).poly(dG-dC), poly(dG).poly(dC), poly(dA-dT).poly(dA
      dT), and poly(dA).poly(dT) in the B-conformation in buffered, aqueous solution.
      The observed results are quantitatively interpreted in terms of the exciton model
      for coupled carbonyl stretching vibrational states.

PMID- 2223781
TI  - Studies of the mechanism of the delta 5-3-ketosteroid isomerase reaction by
      substrate, solvent, and combined kinetic deuterium isotope effects on wild-type
      and mutant enzymes.
AB  - delta 5-3-Ketosteroid isomerase (EC 5.3.3.1) catalyzes the isomerization of delta
      5-3-ketosteroids to delta 4-3-ketosteroids by a conservative tautomeric transfer
      of the 4 beta-proton to the 6 beta-position using Tyr-14 as a general acid and
      Asp-38 as a general base [Kuliopulos, A., Mildvan, A. S., Shortle, D., & Talalay,
      P. (1989) Biochemistry 28, 149]. On deuteration of the 4 beta-position (97.0%) of
      the substrate, kcat(H)/kcat(4 beta-D) is 6.1 in H2O and 6.3 in D2O. The solvent
      isotope effect, kcat(H2O)/kcat(D2O), is 1.6 for both the 4 beta-H and 4 beta-D
      substrates. Mutation of Tyr-55 to Phe lowers kcat 4.3-fold; kcat(H)/kcat/4 beta
      D) is 5.3 in H2O and 5.9 in D2O, and kcat(H2O)/kcat(D2O) with the 4 beta-H and 4
      beta-D substrates is 1.5 and 1.7, respectively, indicating concerted general acid
      base catalysis in either the enolization or the ketonization step of both the
      wild-type and the Tyr-55----Phe (Y55F) mutant enzymes. An additional slow step
      occurs with the Y55F mutant. Smaller isotope effects on Km are used to estimate
      individual rate constants in the kinetic schemes of both enzymes. On deuteration
      of the 4 alpha-position (88.6%) of the substrate, the secondary isotope effect on
      kcat/Km corrected for composition is 1.11 +/- 0.02 with the wild-type enzyme and
      1.12 +/- 0.02 with the Y55F mutant. These effects decrease to 1.06 +/- 0.01 and
      1.07 +/- 0.01, respectively, when the 4 beta-position is also deuterated, thereby
      establishing these to be kinetic (rather than equilibrium) secondary isotope
      effects and to involve a proton-tunneling contribution. Deuteration of the 6
      position of the substrate (92.0%) produces no kinetic isotope effects on kcat/Km
      with either the wild-type (1.00 +/- 0.01) or the Y55F mutant (1.01 +/- 0.01)
      enzyme. Since a change in hybridization from sp3 to sp2 occurs at C-4 only during
      enolization of the substrate and a change in hybridization at C-6 from sp2 to sp3
      occurs only during reketonization of the dienol intermediate, enolization of the
      substrate constitutes the concerted rate-limiting step. Concerted enolization is
      consistent with the right angle or antarafacial orientations of Tyr-14 and Asp-38
      with respect to the enzyme-bound substrate and with the additive effects on kcat
      of mutation of these catalytic residues [Kuliopulos, A., Talalay, P., & Mildvan,
      A. S. (1990) Biophys. J. 57, 39a].

PMID- 2223782
TI  - Effect of central-residue replacements on the helical stability of a monomeric
      peptide.
AB  - The peptide acetylYEAAAKEARAKEAAAKAamide exhibits the dichroic features
      characteristic of a monomeric helix/coil transition in aqueous solution. Nineteen
      variants of this peptide each containing a different residue at position 9 were
      prepared by solid-phase peptide synthesis and purified by reversed-phase
      chromatography. The thermal dependence of the far-ultraviolet dichroic spectrum
      of each of these peptides except that containing proline is characteristic for an
      alpha-helix/coil transition. The relative stability of the helical forms of these
      peptides does not correlate with the preference of the variable amino acid to
      occupy a middle position in a protein helix. It is likely that the specific
      interactions of the variable residue with its local environment obscure any
      inherent preference of the residue to reside in an alpha-helix.

PMID- 2223783
TI  - Sequence-specific 1H NMR assignments and determination of the secondary structure
      for the activation domain isolated from pancreatic procarboxypeptidase B.
AB  - Nearly complete sequence-specific 1H NMR assignments are presented for amino acid
      residues 3-81 in the 81-residue globular activation domain of porcine pancreatic
      procarboxypeptidase B isolated after limited tryptic proteolysis of the zymogen.
      These resonance assignments are consistent with the chemically determined amino
      acid sequence. Regular secondary structure elements were identified from nuclear
      Overhauser effects and the sequence locations of slowly exchanging backbone amide
      protons. The molecule contains two alpha-helices, including residues 20-30 and
      approximately residues 58-72, and a three-stranded antiparallel beta-sheet with
      the individual strands extending approximately from 12 to 17, 50 to 55, and 75 to
      77. The identification of these secondary structures and a preliminary analysis
      of additional long-range NOE distance constraints show that isolated activation
      domain B forms a stable structure with the typical traits of a globular protein.
      The data presented here are the basis for the determination of the complete three
      dimensional structure of activation domain B, which is currently in progress.

PMID- 2223784
TI  - Binding and precipitating activities of Lotus tetragonolobus isolectins with L
      fucosyl oligosaccharides. Formation of unique homogeneous cross-linked lattices
      observed by electron microscopy.
AB  - We have recently observed that certain asparagine-linked oligosaccharides are
      multivalent and capable of binding and precipitating with the D-mannose-specific
      lectin concanavalin A [cf. Bhattacharyya, L., & Brewer, C. F. (1989) Eur. J.
      Biochem. 178, 721-726] and with a variety of D-galactose-specific lectins
      [Bhattacharyya, L., Haraldsson, M., & Brewer, C. F. (1988) Biochemistry 27, 1034
      1041]. In the present study, we have examined the binding and precipitating
      activities of a variety of mono- and biantennary L-fucosyl oligosaccharides with
      three L-fucose-specific isolectins from Lotus tetragonolobus, LTL-A, LTL-B, and
      LTL-C. The results show that certain difucosyl biantennary oligosaccharides are
      capable of cross-linking and precipitating with tetrameric isolectins, LTL-A and
      LTL-C, but not with dimeric isolectin, LTL-B. Quantitative precipitation analyses
      show that biantennary oligosaccharides containing the Lewis(x) antigen (or type 2
      chain of Lewis(a)), Gal beta (1-4)[Fuc alpha (1-3)]GlcNAc, at the nonreducing
      terminus of each arm are bivalent ligands. However, a biantennary oligosaccharide
      containing a Lewis(x) determinant on one arm and a type 2 chain of blood group
      H(O) determinant, Fuc alpha (1-2)Gal beta (1-4)GlcNAc, on the other arm and a
      monoantennary oligosaccharide containing two fucose residues (analogue of the
      Lewis(y) antigen) bind but do not precipitate with the isolectins, indicating
      that the positions and linkage of fucose residues are critical for cross
      linking.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223785
TI  - Isopentenyldiphosphate:dimethylallyldiphosphate isomerase: construction of a high
      level heterologous expression system for the gene from Saccharomyces cerevisiae
      and identification of an active-site nucleophile.
AB  - Isopentenyldiphosphate:dimethylallyldiphosphate isomerase (IPP isomerase) is an
      enzyme in isoprene metabolism which catalyzes the interconversion of the
      fundamental five-carbon homoallylic and allylic diphosphate building blocks for
      the pathway. The gene encoding IPP isomerase has recently been isolated from
      Saccharomyces cerevisiae [Anderson, M. S., Muehlbacher, M., Street, I.P.,
      Proffitt, J., & Poulter, C. D. (1989) J. Biol. Chem. 264, 19169-19175]. A
      heterologous expression system was constructed for the gene and used to
      overexpress IPP isomerase in Escherichia coli. In transformants carrying the
      expression vector, IPP isomerase activity was increased by over 100,000-fold
      relative to that of the untransformed host strain. The overexpressed enzyme
      constitutes 30-35% of the total soluble cell protein and can be purified to
      homogeneity in two steps. Recombinant IPP isomerase was indistinguishable from
      that purified from yeast. 3-(Fluoromethyl)-3-butenyl diphosphate (FIPP) is a
      specific active-site-directed inhibitor of IPP isomerase from Claviceps purpurea
      [Muehlbacher, M., & Poulter, C. D. (1988) Biochemistry 27, 7315-7328].
      Inactivation of yeast IPP isomerase by FIPP was active-site-directed, and
      inhibition resulted in formation of a stoichiometric enzyme-inhibitor complex.
      The site of covalent attachment in the enzyme-inhibitor complex was determined by
      inactivating IPP isomerase with [4-3H]FIPP, followed by digestion of the labeled
      enzyme with trypsin and purification of the resulting radioactive peptides by
      reversed-phase high-performance liquid chromatography. The primary site of
      attachment was Cys-139.

PMID- 2223786
TI  - Identification and purification of the carnitine carrier from rat liver
      mitochondria.
AB  - The carnitine carrier from rat liver mitochondria, solubilized in Triton X-100
      and partially purified on hydroxyapatite, was identified and completely purified
      by specific elution from celite in the presence of cardiolipin. On SDS-gel
      electrophoresis, the purified celite fraction consisted of a single band with an
      apparent Mr of 32,500. When reconstituted into liposomes the carnitine transport
      protein catalyzed an N-ethylmaleimide-sensitive carnitine/carnitine exchange. It
      was purified 970-fold with a recovery of 43% and a protein yield of 0.04% with
      respect to the mitochondrial extract. The properties of the reconstituted
      carrier, i.e., requirement for a countersubstrate, substrate specificity and
      inhibitor sensitivity, were similar to those of the carnitine transport system as
      characterized in intact mitochondria.

PMID- 2223787
TI  - Temperature dependence of the ripple structure in dimyristoylphosphatidylcholine
      studied by synchrotron X-ray small-angle diffraction.
AB  - The ripple structure of 1,2-dimyristoyl-L-phosphatidylcholine (DMPC) multibilayer
      containing excess water (60 wt%) was studied by synchrotron X-ray small-angle
      diffraction. The (0,1) spacing which corresponds to the ripple repeat distance
      depends on temperature: At 13 degrees C the (0,1) spacing is 14.15 nm, the
      spacing decreases at higher temperatures and reaches 12.1 nm at 23.5 degrees C,
      just below the main transition temperature. The spacing is in good agreement
      between heating process and cooling process except for the supercooling region.
      The result suggests that the rearrangement of the ripple structure takes place
      during temperature change successively. The Landau-de Gennes free energy equation
      explains well the temperature dependence of the ripple repeat distance.

PMID- 2223788
TI  - Insertion of bacteriorhodopsin into polymerized diacetylenic phosphatidylcholine
      bilayers.
AB  - We have developed a method to incorporate the membrane protein bacteriorhodopsin
      into polymerized bilayers composed of a diacetylenic phosphatidylcholine, 1,2
      bis(tricosa-10,12-diynoyl)-sn-glycero-3-phosphocholine (DC8,9PC) and a non
      polymerizable phospholipid, dinonanoylphosphatidylcholine (DNPC). The extent of
      DC8,9PC polymerization in the bilayer was significantly improved when 2:1 mole
      ratio DNPC-DC8,9PC was used. Octyl glucopyranoside-solubilized bacteriorhodopsin
      was inserted into the polymerized DNPC-DC8,9PC bilayers by overnight incubation
      at 4 degrees C followed by dialysis to remove the detergent. The protein was
      inserted into the membranes after photo-polymerization to avoid inactivation of
      the protein due to the UV irradiation. The insertion of bacteriorhodopsin into
      the polymerized DNPC-DC8,9PC membranes was confirmed by density gradient
      centrifugation, UV/visible spectroscopy, and freeze fracture electron microscopy.
      The polymerized DNPC-DC8,9PC membranes containing bacteriorhodopsin were about
      10% protein by weight. These results suggest that mixed lipid systems such as the
      DNPC-DC8,9PC can be used to improve both the extent of polymerization and the
      efficiency of membrane protein incorporation in the polymerized bilayer.

PMID- 2223789
TI  - Specific electropermeabilization of leucocytes in a blood sample and application
      to large volumes of cells.
AB  - Electropermeabilization is obtained when the membrane potential difference
      reaches a critical threshold. This is performed by submitting cells to an
      external electric field pulse. The field modulates the endogenous potential
      difference in a cell-size-dependent way. Computer simulations predict that large
      cells would be specifically permeabilized in a mixture with smaller cells. This
      was examined on a mixture of Chinese hamster ovary (CHO) cells and erythrocytes.
      CHO cells were permeabilized to Trypan blue without any occurrence of haemolysis.
      A similar 'size' specificity was observed on blood samples. This agreement
      between prediction and experimental observation indicates that induction of
      electropermeabilization is mainly under the control of the size of the target
      cell. Its physiology plays only a minor role, if any. Treating blood with 10
      square wave pulses lasting 100 microseconds of an intensity of 1.6 kV/cm induced
      the permeabilization of 70% of the leucocytes (polymorphs and monocytes) but did
      not affect erythrocytes. No washing of the sample was needed in a procedure in
      which cells were pulsed in the plasma. A flow electropulsing process allows the
      treatment of large blood volumes under conditions where cells are kept viable.
      These results show that electropermeabilization could be used as an effective way
      to obtain immunocompatible drug vehicles.

PMID- 2223790
TI  - Transport overshoot during 2-methyl-4-amino-5-hydroxymethylpyrimidine uptake by
      Saccharomyces cerevisiae.
AB  - The transport overshoot during 2-methyl-4-amino-5-hydroxymethylpyrimidine
      (hydroxymethylpyrimidine) uptake by the thiamin transport system in Saccharomyces
      cerevisiae was investigated. The overshoot was found to be temperature- and
      energy-dependent and affected by the growth phase of the yeast. The efflux system
      for hydroxymethylpyrimidine appeared to be more sensitive to 2,4-dinitrophenol
      than the influx system, resulting in the loss of the overshoot of the pyrimidine
      in the presence of the uncoupler. Furthermore, the overshoot did not occur after
      the preincubation of yeast cells with inhibitors of protein synthesis such as
      cycloheximide and anisomycin. These results suggest that an active efflux system
      for hydroxymethylpyrimidine, which is rapidly synthesized, is involved in the
      overshoot of this pyrimidine during its transport in S. cerevisiae.

PMID- 2223791
TI  - Influence of amino acid side-chain modification on the uptake system for beta
      lactam antibiotics and dipeptides from rabbit small intestine.
AB  - The influence of chemical modification of functional amino acid side-chains in
      proteins on the H(+)-dependent uptake system for orally active alpha-amino-beta
      lactam antibiotics and small peptides was investigated in brush-border membrane
      vesicles from rabbit small intestine. Neither a modification of cysteine residues
      by HgCl2, NEM, DTNB or PHMB and of vicinal thiol groups by PAO nor a modification
      of disulfide bonds by DTT showed any inhibition on the uptake of cephalexin, a
      substrate of the intestinal peptide transporter. In contrast, the Na(+)-dependent
      uptake systems for D-glucose and L-alanine were greatly inhibited by the thiol
      modifying agents. With reagents for hydroxyl groups, carboxyl groups or arginine
      the transport activity for beta-lactam antibiotics also remained unchanged,
      whereas the uptake of D-glucose and L-alanine was inhibited by the carboxyl
      specific reagent DCCD. A modification of tyrosine residues with N-acetylimidazole
      inhibited the peptide transport system and did not affect the uptake systems for
      D-glucose and L-alanine. The involvement of histidine residues in the transport
      of orally active alpha-amino-beta-lactam antibiotics and small peptides (Kramer,
      W. et al. (1988) Biochim. Biophys. Acta 943, 288-296) was further substantiated
      by photoaffinity labeling studies using a new photoreactive derivative of the
      orally active cephalosporin cephalexin, 3-[phenyl-4-3H]azidocephalexin, which
      still carries the alpha-amino group being essential for oral activity. 3
      Azidocephalexin competitively inhibited the uptake of cephalexin into brush
      border membrane vesicles. The photoaffinity labeling of the 127 kDa binding
      protein for beta-lactam antibiotics with this photoprobe was decreased by the
      presence of cephalexin, benzylpenicillin or dipeptides. A modification of
      histidine residues in brush-border membrane vesicles with DEP led to a decreased
      labeling of the putative peptide transporter of Mr 127,000 compared to controls.
      This indicates a decrease in the affinity of the peptide transporter for alpha
      amino-beta-lactam antibiotics by modification of histidine residues. The data
      presented demonstrate an involvement of tyrosine and histidine residues in the
      transport of orally active alpha-amino-beta-lactam antibiotics across the
      enterocyte brush-border membrane.

PMID- 2223792
TI  - Determination of cell membrane passive electrical properties using frequency
      domain dielectric spectroscopy technique. A new approach.
AB  - To take into account the highly irregular surface morphology of cell membranes we
      have analyzed impedance measurements of biological cell suspensions in general
      terms using a fractal description of the surface roughness of the cell membrane.
      This analysis has been applied to human erythrocytes in different solutions of
      alkaline metal salts and to human lymphocytes, since these cells present a
      different surface irregularity. The passive electrical properties (dielectric
      constant and electrical conductivity) deduced from conductivity measurements at
      radiowave frequencies have been discussed on the basis of the fractal dimension
      of the membrane surface.

PMID- 2223793
TI  - Interleukin-2 binds to gangliosides in micelles and lipid bilayers.
AB  - Gangliosides shed from the surface of tumour cells may be involved in tumour
      induced immunosuppression. These anionic sialoglycolipids are known to be potent
      inhibitors of lymphocyte proliferation, and it has been suggested that they
      interfere with processes mediated by the growth factor interleukin-2 (IL-2). We
      have thus investigated the interaction of IL-2 with gangliosides in micelles and
      lipid bilayers. Gel filtration FPLC showed that 125I-IL-2 can bind to micellar
      gangliosides in aqueous solution, and this interaction was strongly promoted by
      low concentrations of serum. Binding to ganglioside micelles was specific in that
      it required a native IL-2 molecule. IL-2 binding remained unchanged in the
      presence of 40% ethylene glycol, suggesting that it was not due to hydrophobic
      interactions. Ganglioside oligosaccharides alone were not able to bind to IL-2.
      Direct binding studies and gel filtration chromatography indicated that both
      multilamellar liposomes and 100 nm unilamellar vesicles containing gangliosides
      were able to interact with IL-2. Bilayers of lipid alone showed no binding. The
      interaction of IL-2 with bilayer gangliosides was highly dependent on the bilayer
      lipid composition, but appeared independent of lipid phase state. These results
      suggest that gangliosides may be a physiologically relevant target for IL-2
      binding.

PMID- 2223794
TI  - Ethanol induces interdigitated gel phase (L beta I) between lamellar gel phase (L
      beta') and ripple phase (P beta') in phosphatidylcholine membranes: a scanning
      density meter study.
AB  - Effects of ethanol on dipalmitoylphosphatidylcholine (DPPC) and
      distearoylphosphatidylcholine (DSPC) dispersions were investigated with an
      automated scanning density meter and a differential scanning calorimeter (DSC).
      The temperature-dependent profile of specific volume measured by the density
      meter clearly exhibited phase transitions of the DPPC and the DSPC dispersions as
      drastic changes in the thermal expansion coefficients. On increasing the ethanol
      concentration in the DPPC dispersions, the pretransition temperature was reduced
      faster than the main transition temperature was. An interdigitated gel phase (L
      beta I) appeared as a region of lower specific volume at the pretransition
      temperature when the ethanol concentration reached 40 mg/ml. The L beta I phase
      spread both its ends in an ethanol-dependent fashion, and the high-temperature
      end merged to the main transition at 50 mg/ml of ethanol. The temperature-ethanol
      phase diagram has been determined for DPPC. The transitions L beta' to L beta I
      and from L beta I to P beta' were also observed on the thermograms of DSC
      measurements. In the DSPC dispersions, the L beta I phase was induced between the
      L beta' and the P beta' phases by a lower ethanol concentration (about 20 mg/ml).

PMID- 2223795
TI  - Inhibition of autoxidation of egg yolk phosphatidylcholine in homogenous solution
      and in liposomes by oxidized ubiquinone.
AB  - The aim of this study was to obtain a quantification of the antioxidant activity
      of ubiquinone. To this purpose the oxidation of egg yolk phosphatidylcholine both
      in solvent and in liposomes initiated by an azocompound has been studied either
      in the absence or in the presence of ubiquinone-3, using alpha-tocopherol as a
      reference antioxidant. The two experimental systems gave similar results. In the
      presence of ubiquinone-3 the oxidation rate was reduced with respect to control
      experiments but was faster than that in the presence of alpha-tocopherol. The
      amount of ubiquinone required to decrease the autoxidation rate was so high as to
      prevent detection of the induction period. The stoichiometric factor was greater
      than 2 and the rate constant of inhibition was two orders of magnitude lower than
      that of alpha-tocopherol. It is concluded that high concentrations of ubiquinone
      are required to exhibit significant antioxidant activity. A possible mechanism
      compatible with the stoichiometric factor larger than 2 for the inhibiting effect
      of ubiquinone is also suggested.

PMID- 2223796
TI  - Na(+)-ionophore, monensin-induced rise in cytoplasmic free calcium depends on the
      presence of extracellular calcium in FRTL-5 rat thyroid cells.
AB  - Calcium is an important regulator of cell function, and may be influenced by the
      intracellular sodium content. In the present study, the Na(+)-ionophore,
      monensin, was used to investigate the interrelationship between changes in
      intracellular Na+ concentration ([Na+]i) and elevation of cytosolic Ca2+
      concentration ([Ca2+]i) in FRTL-5 thyroid cells. Cytoplasmic Ca2+ levels were
      measured using the fluorescent dye, indo-1. Monensin induced a dose-dependent
      increase in [Ca2+]i in FRTL-5 cells. Inhibitors of intracellular Ca2+ release,
      TMB-8 and ryanodine, were unable to prevent the monensin effect on [Ca2+]i. The
      alpha 1-receptor antagonist, prazosin, did not block the monensin-stimulated
      increase in [Ca2+]i. In the absence of extracellular calcium there was a marked
      diminution in the monensin effect on [Ca2+]i, yet calcium channel antagonists
      (nifedipine, diltiazem and verapamil) did not inhibit the response. Replacement
      of Na+ by choline chloride in the medium depressed the monensin-evoked rise in
      [Ca2+]i by up to 84%. Furthermore, addition of the Na(+)-channel agonist,
      veratridine, elicited an increase in [Ca2+]i, even though less dramatic than that
      caused by monensin. Ouabain increased the resting cytosolic Ca2+ concentration as
      well as the magnitude of the monensin effect on [Ca2+]i. The absence of any
      effect on the Na(+)-ionophore evoked increase in [Ca2+]i upon addition of
      tetrodotoxin (TTX) excluded a possible involvement of TTX-sensitive Na+ channels.
      These data show that the rise in [Ca2+]i induced by increasing [Na+]i is largely
      dependent on both external Na+ and Ca2+. Calcium entry appears not to involve
      voltage-dependent or alpha 1-receptor sensitive Ca2+ channels, but may result
      from activation of an Na(+)-Ca2+ exchange system.

PMID- 2223797
TI  - Two different types of lysis of chromaffin granules characterised by freeze
      fracture electron microscopy and photon correlation spectroscopy.
AB  - When bovine chromaffin granules are incubated in hyperosmolar sucrose solutions
      and subsequently transferred back towards isoosmolarity they undergo lysis
      ('hyperosmotic relaxation lysis'). This type of lysis was compared with the
      common effect of hypotonic lysis by means of photon correlation spectroscopy
      (PCS) and freeze-fracture electron microscopy. Both methods revealed differences
      regarding mean sizes and size distributions of granules lysing under either
      hypotonic or hypertonic conditions. However, the results obtained by these two
      methods were not consistent. In the case of hypotonic lysis, a nonmonotonic
      behaviour of the mean diameter as a function of the sucrose concentration was
      observed by PCS, but not in the micrographs. From EM size determinations we
      obtained a decrease in the mean diameter and an increase of the width of the
      distribution due to the appearance of small (50-200 nm) vesicles. Probably these
      vesicles are intragranular vesicles released during lysis. The maximum in photon
      correlation spectroscopy (PCS) diameter being 140% of the isotonic diameter is
      shown to be caused by the changing size distribution and geometry of the lysing
      granules. In the case of hyperosmotic relaxation, micrographs revealed that
      originally shrunken, nonspherical granules regained their spherical shape and
      formed small (60 nm) vesicles upon lysis. In contrast, no difference was observed
      between the sizes of granules prior to and after hyperosmotic relaxation by means
      of PCS. The paper discusses the validity of intensity-weighted light scattering
      data of polydisperse particle suspensions with changing size distributions. The
      mechanism of hyperosmotic relaxation lysis is considered.

PMID- 2223798
TI  - The effects of the extracellular manganese concentration and variation of the
      interpulse delay time in the CPMG sequence on water exchange time across
      erythrocyte membranes.
AB  - There has been broad disagreement in the literature regarding the dependence of
      water exchange times (Te) across erythrocyte membranes studied by the 1H-NMR Carr
      Purcell-Meiboom-Gill (CPMG) pulse sequence on extracellular Mn2+ concentration.
      While some workers saw no change in Te with Mn2+, others reported a 35-50%
      decrease in Te with this extracellular paramagnetic relaxation agent. We present
      1H-NMR evidence that a 30-50% change in Te can be produced by interdependence of
      the interpulse delay time of the CPMG pulse sequence and the external Mn2+
      concentration. Such a large dependency is interpreted in terms of the diffusional
      effect as a major source. However, it is shown experimentally that if a large
      number of refocusing pi pulses are used, the observed transverse relaxation times
      are unaffected by Mn2+. Under these conditions excellent agreement of Te obtained
      in our study (13.0 +/- 0.64 ms (N = 36) at 21 degrees C) and that of 12.8 +/- 3.6
      ms at 20-23 degrees C reported by the radiotracer method was found. Our findings
      suggest new and important implications for evaluating the previous reports of the
      1H-NMR CPMG method concerning the [Mn2+] effect in the decrease of Te, and
      provide conditions where studies of water transport across erythrocyte membranes
      using this magnetic resonance method can be used with confidence.

PMID- 2223799
TI  - Chromatographic characterization of nitrobenzylthioinosine binding proteins in
      band 4.5 of human erythrocytes: purification of a 40 kDa truncated nucleoside
      transporter.
AB  - DEAE-column-purified band 4.5 polypeptides of human erythrocyte membranes are
      mostly glucose transporters with nucleoside transporters as a minor component.
      The purpose of the present work was to differentially identify and isolate the
      nucleoside transporters in band 4.5 free from glucose transporters. Equilibrium
      binding studies demonstrated that the band 4.5 preparation binds
      nibrobenzylthioinosine (NBTI), a potent nucleoside transport inhibitor, at two
      distinct sites, one with a high affinity (dissociation constant, KD of 1 nM) with
      a small capacity, BT (0.4 nmol/mg protein), and the other with a low affinity (KD
      of 15 microM) with a large BT (14-16 nmol/mg protein). The BT of the low-affinity
      site was equal to that of the cytochalasin B binding site in the preparation. A
      gel-filtration chromatography of band 4.5 photolabeled with [3H]NBTI and
      [3H]cytochalasin B identified three polypeptides of apparent Mr 55,000, 50,000
      and 40,000. Of these, the 55 kDa polypeptide was specifically labeled by
      cytochalasin B (p55GT), indicating that it is a glucose transporter. Both the 50
      and 40 kDa polypeptides were labeled with NBTI at low ligand concentrations (less
      than 0.1 microM), which was abolished by an excess (20 microM) of
      nitrobenzylthioguanosine, indicating that they are two forms (p50NT and p40NT,
      respectively) of the high affinity NBTI binding protein or nucleoside
      transporter. At higher (not less than 10 microM) NBTI concentrations, however,
      p55GT was also labeled with NBTI, indicating that the low-affinity NBTI binding
      is due to a glucose transporter. Treatment of band 4.5 with trypsin reduced the
      p50NT labeling with a concomitant and stoichiometric increase in the p40NT NBTI
      labeling without affecting the high-affinity NBTI binding of the preparation.
      These findings indicate that the nucleoside transporter is slightly smaller in
      mass than the glucose transporter and that trypsin digestion produces a truncated
      nucleoside transporter of apparent Mr 40,000 which retains the high-affinity NBTI
      binding activity of intact nucleoside transporter. Both p55GT and p50 NT were
      coeluted in a major protein fraction, P1 in the chromatography, while p40NT was
      eluted separately as a minor protein fraction, P1a. All three polypeptides formed
      mixed dimers, which were eluted in a fraction PO. We have purified and partially
      characterized the truncated nucleoside transporter, p40NT. The purified p40NT may
      be useful for biochemical characterization of the nucleoside transporter.

PMID- 2223800
TI  - Characterization of Na(+)-dependent, active nucleoside transport in rat and mouse
      peritoneal macrophages, a mouse macrophage cell line and normal rat kidney cells.
AB  - Peritoneal rat macrophages expressed solely an Na(+)-dependent, concentrative
      nucleoside transporter, which possesses a single Na(+)-binding site and
      transports purine nucleosides and uridine but not thymidine or deoxycytidine. The
      Michaelis-Menten constants for formycin B and Na+ were about 6 microns and 14 mM,
      respectively, and the estimated Na+:formycin B stoichiometry was 1:1. Rat
      macrophages accumulated 5 microM formycin B to a steady-state level exceeding
      that in the medium by about 500-fold during 60 min of incubation at 37 degrees C.
      Concentrative formycin B transport was resistant to inhibition by
      nitrobenzylthioinosine, lidoflazine, dilazep and nifedipine, but was slightly
      inhibited by high concentrations of dipyridamole (greater than 10 microM) and
      probenecid (greater than 100 microM). Mouse peritoneal macrophages and lines of
      mouse macrophages and normal rat kidney cells expressed Na(+)-dependent, active
      nucleoside transport but in addition significant Na(+)-independent, facilitated
      nucleoside transport. Facilitated nucleoside transport in these cells was
      sensitive to inhibition by nitrobenzylthioinosine, dilazep and dipyridamole. The
      presence of these inhibitors greatly enhanced the concentrative accumulation of
      formycin B by these cells by inhibiting the efflux via the facilitated
      transporter of the formycin B actively transported into the cells. Whereas rat
      macrophages lacked high-affinity nitrobenzylthioinosine-binding sites, mouse
      macrophages and normal rat kidney cells possessed about 10,000 such sites/cell.
      Rat and mouse erythrocytes, rat lymphocytes, and lines of Novikoff rat hepatoma
      cells, Chinese hamster ovary cells, Mus dunni cells and embryonic monkey kidney
      cells expressed only facilitated nucleoside transport.

PMID- 2223801
TI  - Lamellar packing of a chiral N,N-dimethylphosphatidylethanolamine: electron
      diffraction. Evidence for a lecithin-type headgroup conformation.
AB  - Lamellar electron diffraction intensity data from epitaxially crystallized 1,2
      dipalmitoyl-sn-glycerophospho-N,N-dimethylethanolamine were used to determine the
      layer packing in order to compare the chiral structure to the crystal structure
      of a racemic homologue. After finding the chain orientation, the structure was
      determined by interpretation of the Patterson function, followed by independent
      crystallographic phase assignments with conventional direct methods (use of three
      phase structure invariants). The phase determination was verified by a
      translational search with a molecular model based on a similar lecithin
      structure. The final R-value is 0.29, and this is lowered to 0.18 after a
      correction is made for incoherent multiple electron scattering. The layer packing
      is found to be very much like that of a diacyl phosphatidylcholine with the N,N
      dimethylethanolamine moiety parallel to the bilayer surface rather than the
      perpendicular arrangement of headgroups involved in an interdigitated layer, as
      seen for racemic homolog.

PMID- 2223802
TI  - Unequal distribution of membrane components between pseudopodia and cell bodies
      of platelets.
AB  - Platelet pseudopodia were compared to platelet cell bodies with respect to their
      lipid composition, fatty acid distribution and protein composition. The
      methodology for producing pseudopodial preparations of platelets stimulated with
      thrombin, ADP or calcium ionophore was established. The separation of pseudopodia
      and cell bodies was verified by electron microscopic examination of the
      respective platelet components. Lipid analyses demonstrated a preponderance of
      lysophospholipids and sphingomyelin in pseudopodial preparations and a large
      increase in mono-, di- and tri-ene fatty acids as compared to cell bodies.
      Changes were also evident in the protein composition evaluated by one- and two
      dimensional SDS-polyacrylamide gel electrophoresis and by [32P]ATP labeling of
      exofacial membrane proteins. A protein of approximately 68 kDa which reacted
      strongly with antibody to PlA1, was prominantly displayed in platelet
      pseudopodia. Thus, our studies demonstrate a heterogeneous distribution of lipids
      and proteins in a mammalian membrane system which may have important implications
      for the functional behavior of the cell.

PMID- 2223803
TI  - Effects of divalent cations on lipid flip-flop in the human erythrocyte membrane.
AB  - Treatment of human erythrocytes with ionophore A23187 (10 mumol.l-1) and Ca2+
      (0.05-0.5 mmol.l-1) or Sr2+ (0.2-1 mmol.l-1) in results in a concentration
      dependent acceleration of the transmembrane reorientation (flip) of the lipid
      probes lysophosphatidylcholine and palmitoylcarnitine to the inner membrane
      leaflet after their primary insertion into the outer leaflet. Mg2+, Mn2+, Zn2+
      and La3+ do not accelerate flip. Ca2(+)-induced flip acceleration depends also on
      the ionophore concentration. It is reversed by removal of Ca2+ with EDTA. A
      causal role of Ca2(+)-induced membrane protein degradation and decrease of the
      polyphosphoinositide level in flip acceleration could be excluded. Likewise,
      calmodulin-dependent processes are probably not involved since the calmodulin
      antagonist calmidazolium (2-10 mumol.l-1) does not suppress but even enhances the
      Ca2(+)-induced flip acceleration. The same is true for the Ca2+ antagonist
      flunarizine. These drugs do not alter flip rate in the absence of Ca2+. At high
      Ca2+ (1-5 mmol.l-1) an initial flip acceleration is followed by flip
      normalization. High concentrations of Mn2+ and Mg2+ slow down flip rates. The
      selective acceleration of flip by Ca2+ and Sr2+ is discussed to be due to a local
      detachment of the membrane skeleton from the bilayer, whereas the unselective
      slow down of flip by divalent cations might be due to a stabilization of the
      membrane bilayer by the cations. After loading of cells with Ca2+ (but not with
      Mn2+) the inner membrane leaflet phospholipid phosphatidylserine becomes rapidly
      exposed to the outer membrane surface, as detectable by its accessibility to
      phospholipase A2 (5 min).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2223804
TI  - Selectivity of lipid-protein interaction with myelin proteolipids PLP and DM-20.
      A fluorescence anisotropy study.
AB  - The two main myelin proteolipids, PLP (30 kDa) and DM-20 (25 kDa), differ by an
      internal deletion in DM-20. The deleted fragment, of 35 amino acids (116-150),
      corresponds to the major hydrophilic domain of PLP. Fluorescence anisotropy
      experiments using diphenylhexatriene as a fluorescent probe were performed to
      detect the phase separation induced by these two proteolipids in multilamellar
      vesicles of binary composition. We found that in vesicles composed of 30% L-alpha
      PS and 70% DPPC, the PLP boundary layer contained about 18 motionally restricted
      phospholipids, almost exclusively L-alpha-PS. On the contrary, the DM-20 boundary
      layer contained only 14 to 15 phospholipids, with a composition no different from
      that of the bulk vesicle. In mixtures of DMPG and DPPC, the selectivity of PLP
      for the acidic phospholipid DMPG was maintained, but was lower than that observed
      for L-alpha-PS. We assume that this selectivity of PLP stems mainly from
      electrostatic interactions between the charged residues of the 116-150 fragment,
      deleted in DM-20, and the acidic phospholipids. These results suggest that
      fragment 116-150 may play a specific role in the interaction of PLP with the
      lipid bilayer of the myelin membrane.

PMID- 2223805
TI  - A solid-solution theory of anesthetic interaction with lipid membranes:
      temperature span of the main phase transition.
AB  - Anesthetics (or any other small additives) depress the temperature of the main
      phase transition of phospholipid bilayers. Certain anesthetics widen the
      temperature span of the transition, whereas others do not. The widening in a
      first-order phase transition is intriguing. In this report, the effects of
      additive molecules on the temperature and its span were explained by the solid
      solution theory. By assuming coexistence of the liquid-crystal and solid-gel
      phases of lipid membranes at phase transition, the phase boundary is determined
      from the distribution of anesthetic molecules between the liquid-crystal membrane
      versus water and between the solid-gel membrane versus water. The theory shows
      that when the lipid concentration is large or when the lipid solubility of the
      drug is large, the width of the transition temperature increases, and vice versa.
      Highly lipid-soluble molecules, such as long-chain alkanols and volatile
      anesthetics, increase the width of the transition temperature when the
      lipid:water ratio is large, whereas highly water-soluble molecules, such as
      methanol and ethanol, do not. The aqueous phase serves as the reservoir for
      anesthetics. Depletion of the additive molecules from the aqueous phase is the
      cause of the widening. When the reservoir capacity is large, the temperature
      width does not increase. The theory also predicts asymmetry of the specific heat
      profile at the transition.

PMID- 2223806
TI  - Antioxidant activity of probucol and its effects on phase transitions in
      phosphatidylcholine liposomes.
AB  - The effect of probucol on the phase behavior of dimyristoylphosphatidylcholine
      (DMPC) was examined by fluorescence polarization and differential scanning
      calorimetry (DSC). Probucol broadens and shifts the temperature of the main phase
      transition of DMPC liposomes as measured by fluorescence polarization with
      diphenylhexatriene and trimethyl-ammonium-diphenylhexatrine at concentrations as
      low as 5 mole%. As measured by DSC, probucol reduces the transition temperature
      of the gel----liquid-crystalline phase transition of DMPC by approx. 2 C degrees
      at all concentrations above about 5 mole% probucol and eliminates the
      pretransition at less than 1 mole%. In addition, the phase transition of DMPC is
      broadened and the enthalpy of the transition reduced by approx. 50%. Even at high
      concentrations of probucol, the gel----liquid-crystalline phase transition of
      DMPC is not eliminated. Similar effects are observed with
      dipalmitoylphosphatidylcholine liposomes. Based on these DSC measurements,
      measurements of the melting of probucol in dry mixtures with DMPC and
      observations of probucol mixtures with DMPC under polarizing optics, the maximum
      solubility of probucol in DMPC is approx. 10 mole%. This concentration exceeds
      that required (approx. 0.5 mole%) to prevent peroxidation of 10 mole% arachidonic
      acid in DMPC liposomes for 30 min in the presence of 0.05 mM Fe(NH4)(SO4)2 at 4
      degrees C. Thus, probucol has a limited solubility in saturated
      phosphatidylcholine bilayers, but is an effective antioxidant at concentrations
      lower than its maximum solubility.

PMID- 2223807
TI  - Action potential duration and activation of ATP-sensitive potassium current in
      isolated guinea-pig ventricular myocytes.
AB  - It is difficult to associate the ATP-sensitive potassium (K-ATP) channel of
      cardiac muscle with hypoxia/ischemia induced action potential shortening because
      this occurs before intracellular ATP falls to levels associated in vitro with
      channel opening. This leaves the cardiac K-ATP channel without any obvious
      physiological function. We have quantitatively examined the relationship between
      action potential duration and K-ATP channel activity in enzymatically isolated
      ventricular myocytes of the guinea-pig. In whole-cell voltage-clamp recording
      experiments when the K-ATP channel opener SR 44866 (2-10 microM) stimulated an
      outward membrane current greater than 50 pA at 0 mV membrane potential (the
      equivalent of 30 open K-ATP channels or 1% of the cell K-ATP channel population)
      action potential duration was reduced by more than 50%. In the majority of cell
      attached membrane patch recordings metabolic inhibition stimulated K-ATP channel
      open probability of 1-2% which continued for long periods (7-25 min) before cell
      contracture and coincident major K-ATP channel activation (open probability 65%).
      Our quantitative analysis thus shows that physiologically relevant activity of K
      ATP channels in cardiac muscle is confined to a very small percentage of the
      possible cell K-ATP current and thus intracellular ATP would not have to fall
      very far before the opening of K-ATP channels would influence cardiac
      excitability.

PMID- 2223808
TI  - Formation of the antiplanar-antiplanar phosphate conformation of
      dilauroylphosphatidylcholine bilayers.
AB  - Infrared spectroscopy was used to investigate lipid conformational changes that
      occur in dilauroylphosphatidylcholine (diC12PC) bilayers with and without fatty
      acid-amino-acids as guest molecules in the membrane. Incorporating 2.5 mole% N
      decanoylglycine (decgly) into diC12PC liposomes caused formation of the
      antiplanar-antiplanar (ap-ap) phosphodiester conformation which was stable in
      room temperature IR spectra. Several other fatty-acid-amino-acids incorporated
      into diC12PC bilayers were found to also elicit the ap-ap phosphodiester
      conformation. Unlike these diC12PC/fatty-acid-amino-acid mixed bilayers, pure
      diC12PC bilayers would form the ap-ap phosphodiester conformation only under low
      temperature incubation conditions. Dry diC12PC films incubated at 5 degrees C for
      0.5 h (brief incubation) or 16 h (prolonged incubation), and then rapidly
      hydrated (i.e., vortexed at 25 degrees C in D2O), caused the ap-ap phosphodiester
      conformation to persist in the diC12PC liposomes equilibrated to room
      temperature. Slow hydration for 16 h at 5 degrees C in both buffered and non
      buffered D2O of diC12PC lipid films also produced the ap-ap phosphodiester
      conformation. In contrast, slow hydration for 16 h at 5 degrees C in PBS/D2O of
      diC12PC/decgly mixed films caused the greatest number of ap-ap phosphodiester
      conformers. Using pure diC12PC bilayers, infrared data indicate that incubation
      of diC12PC films causes the headgroup phosphodiester conformation to change from
      gauche-gauche (g-g) conformation to the ap-ap conformation. Under all liposome
      formation conditions examined, no changes in hydration of either the phosphate
      group or the carbonyl ester group were detected and in addition, no trans/gauche
      conformational changes in the acyl chain were observed.

PMID- 2223810
TI  - Biomembrane-modulated, lysosomal phospholipase A2 contamination of chromaffin
      granule ghosts.
AB  - It was reported that subcellular fractionation of bovine adrenal medulla results
      in the separation of distinct, non-calcium-dependent phospholipases A2--one
      associated with chromaffin granule ghosts, another with lysosomes. The basis of
      this distinction is pH optimum: in routine assays utilizing neat liposomal
      substrates, the chromaffin granule ghost-associated enzyme is alkaline-active
      whereas the lysosomal enzyme is acid-active (Husebye, E.S. and Flatmark, T.
      (1987) Biochim. Biophys. Acta 920, 120-130). We now report that biomembranes
      after liposomal substrates and/or lysosomal phospholipase A2 such that the enzyme
      now hydrolyzes them (at low cation concentration) with an alkaline pH optimum. In
      a lysosomal membrane fraction, phospholipase A2 activity at pH 7.5 relative to
      activity at pH 5.0 increases as increasing amounts of lysosomal membranes are
      assayed. The pH optimum of chromaffin granule ghost-associated phospholipase A2
      toward liposomal substrates is likewise biomembrane-dependent and, when assayed
      carefully, is indistinguishable on the basis of optimal pH from the lysosomal
      enzyme. Although chromaffin granule ghost-associated phospholipase A2 is most
      likely a lysosomal contaminant, its broad, biomembrane-modulated pH range may
      still allow it to participate in catecholamine secretion. More importantly,
      however, sensitivity of adrenal medullary lysosomal phospholipase A2 to
      biomembranes broadens its potential physiologic pH range and may also play a role
      in the regulation of this potentially deleterious activity.

PMID- 2223809
TI  - Increased aminophospholipid translocase activity in human platelets during
      secretion.
AB  - Fluorescent labeled analogs of phosphatidylcholine (NBD-PC) and
      phosphatidylserine (NBD-PS) were used to study transport of phospholipids from
      the outer to the inner leaflet of the plasma membrane of human platelets.
      Platelets were stimulated with thrombin or Ca2(+)-ionophore at various
      extracellular [Ca2+]. No significant transport of NBD-PC could be observed either
      in resting or stimulated platelets. NBD-PS transport in platelets stimulated with
      thrombin (with or without extracellular Ca2+), or ionophore in the presence of
      EGTA, was enhanced 4-fold (t1/2 approximately 2 min) compared to unstimulated
      controls (t1/2 approximately 8 min). Stimulation with ionophore at extracellular
      [Ca2+] exceeding 8 microM caused a gradual decrease in inward transport of NBD
      PS. At 100 microM Ca2+, NBD-PS transport becomes as slow as that of NBD-PC. We
      conclude that platelet activation by agonists that induce secretion without
      appreciable shedding is accompanied by an increase in translocase activity that
      maintains asymmetry during fusion which occurs during exocytosis.

PMID- 2223811
TI  - The influence of general, volatile anesthetics on the dynamic properties of model
      membranes.
AB  - The microscopic mechanism of general anesthesia is still not known but it may be
      located in the membrane region of nerve cells. In the present article microwave
      experiments on model membrane systems are discussed. At these particular
      frequencies a significant decrease of the systems' complex dielectric function is
      measured when it is exposed to volatile anesthetics. This effect is reversible as
      well as being identical for chemically quite different anesthetics. The
      corresponding anesthetic concentrations in the samples are relevant for medical
      anesthesia. The underlying microscopic mechanism is a decrease in the Debye
      relaxation frequency (and correspondingly an increase in viscosity) of those
      water molecules which are localized at the membranes' surfaces. General
      anesthesia might be a consequence of such a viscosity change at hydrophilic
      surfaces.

PMID- 2223812
TI  - An electrophysiological technique to measure change in hepatocyte water volume.
AB  - We have applied an electrophysiologic technique (Reuss, L. (1985) Proc. Natl.
      Acad. Sci. USA 82, 6014) to measure changes in steady-state hepatocyte volume
      during osmotic stress. Hepatocytes in mouse liver slices were loaded with
      tetramethylammonium ion (TMA+) during transient exposure of cells to nystatin.
      Intracellular TMA+ activity (alpha 1TMA) was measured with TMA(+)-sensitive,
      double-barrelled microelectrodes. Loading hepatocytes with TMA+ did not change
      their membrane potential (Vm), and under steady-state conditions alpha iTMA
      remained constant over 4 min in a single impalement. Hyperosmotic solutions (50,
      100 and 150 mM sucrose added to media) and hyposmotic solutions (sucrose in media
      reduced by 50 and 100 mM) increased and decreased alpha iTMA, respectively, which
      demonstrated transmembrane water movements. The slope of the plot of change in
      steady-state cell water volume, [(alpha iTMA)0/(alpha iTMA)4min] -1, on the
      relative osmolality of media, (experimental mosmol/control mosmol) -1, was less
      predicted for a perfect osmometer. Corresponding measurements of Vm showed that
      its magnitude increased with hyposmolality and decreased with hyperosmolality.
      When Ba2+ (2 mM) was present during hyposmotic stress of 0.66 X 286 mosmol
      (control), cell water volume increased by a factor of 1.44 +/- 0.02 compared with
      that of hyposmotic stress alone, which increased cell water volume by a factor of
      only 1.12 +/- 0.02, P less than 0.001. Ba2+ also decreased the hyperpolarization
      of hyposmotic stress from a factor of 1.62 +/- 0.04 to 1.24 +/- 0.09, P less than
      0.01. We conclude that hepatocytes partially regulate their steady-state volume
      during hypo- and hyperosmotic stress. However, volume regulation during
      hyposmotic stress diminished along with hyperpolarization of Vm in the presence
      of K(+)-channel blocker, Ba2+. This shows that variation in Vm during osmotic
      stress provides an intercurrent, electromotive force for hepatocyte volume
      regulation.

PMID- 2223813
TI  - Solubility properties of the alkylmethylglucamide surfactants.
AB  - The critical micelle concentration (CMC) and the ability to solubilize and form
      vesicles from phospholipids are important criteria for the selection of a
      surfactant for reconstitution protocols. The CMC and its temperature dependence
      were determined for an homologous series of alkylmethylglucamides (MEGA-8, MEGA
      9, MEGA-10). Each detergent was added continuously from a concentrated solution
      to a saline buffer with the environment-sensitive fluorescent probe ANS, held in
      a thermojacketed cuvette; ANS fluorescence increases at the CMC. The CMCs at 25
      degrees C were 51.3, 16.0 and 4.8 mM for MEGA-8, MEGA-9 and MEGA-10. The free
      energy change for transfer to a micellar environment per -CH2- was -740 cal/mol,
      similar to other alkyl series. The CMCs decreased slightly with increasing
      temperature (T = 5-40 degrees C) for MEGA-9 and MEGA-10 while that of MEGA-8 was
      virtually insensitive to temperature in this range. MEGA-9 solubilization of egg
      PC in aqueous solutions was determined as a function of [PC] and temperature. The
      lamellar-micellar phase boundaries were determined by simultaneous 90 degrees
      light scattering and the resonance energy transfer using the headgroup labeled
      lipid probes NBD-PE and Rho-PE. The [MEGA-9] at solubilization was linear with
      [PC]; the MEGA-9 to egg PC ratio in the structures at optical clarity was 2.3
      while the monomeric [MEGA-9] was 14.3 mM or slightly lower than the CMC at 25
      degrees C. Solubilization of egg PC by MEGA-9 was somewhat more temperature
      dependent than the CMC of this detergent. Vesicles formed from MEGA-9 tended to
      be multilamellar. MEGA-9 is clearly different from octyl glucoside, despite its
      chemical similarity, in terms of its temperature sensitivity and vesicle forming
      characteristics.

PMID- 2223814
TI  - Uptake of fluorescent plasmalogen analogs by cultured human skin fibroblasts
      deficient in plasmalogen.
AB  - One of the consequences of hereditary peroxisomal dysfunction in the cerebro
      hepato-renal (Zellweger) syndrome (CHRS) is a dramatic decrease in the
      biosynthesis and cellular content of ether lipids. In the present study effects
      of reduced cellular plasmalogen levels on membrane-membrane interactions were
      investigated. Cultured CHRS fibroblasts were incubated with unilamellar
      phospholipid vesicles consisting of 1-O-alkenyl-2-acyl- or 1,2-diacyl-sn
      glycerophosphocholines and ethanolamines, carrying either the trans-parinaroyl or
      the 1,6-diphenyl-1,3,5-hexatriene propionyl group in position 2. Transfer of the
      fluorogenic phospholipids from vesicles to cells was followed by measuring the
      concomitant increase in fluorescence intensity. Transfer of phospholipids from
      cells to vesicles was monitored by incubating cells, prelabeled with [3H]oleic
      acid, in the presence of phospholipid vesicles. Fibroblasts from healthy donors
      or CHRS fibroblasts supplemented with the plasmalogen precursor 1-O
      hexadecylglycerol served as controls. Plasmalogen-deficient cells exhibited a
      significantly increased tendency to take up exogenous choline or ethanolamine
      plasmalogens. Cellular plasmalogens were transferred from control cells to
      vesicles at a higher rate if the acceptor vesicles consisted of plasmalogens as
      compared to diacylglycerophosphocholine. Thus, it appears as if mechanisms
      existed which preserve cellular plasmalogen levels during interaction with
      exogenous phospholipid pools. Preliminary experimental evidence suggests that the
      observed exchange of phospholipids between cultured fibroblasts and vesicles
      occurs by a protein-catalyzed process.

PMID- 2223815
TI  - Influence of 2,3-diphosphoglycerate on the deformability of human erythrocytes.
AB  - Effect of 2,3-diphosphoglycerate (2,3-DPG) on the deformability of human
      erythrocytes was examined with a rheoscope under shear stress of 8-82 dyn/cm2.
      With increasing 2,3-DPG in erythrocytes (from 5 to 15 mM/l cells) by incubating
      with inosine and pyruvate in isotonic 50 mM phosphate-buffered saline,
      erythrocyte deformability under uniform shear stress was remarkably impaired. But
      reduction of 2,3-DPG (from 5 to 2.2 mM/l cells) did not affect the deformability.
      In 2,3-DPG-enriched erythrocytes, increased intracellular hemoglobin
      concentration (MCHC), decreased intracellular pH, and increased contents of ATP
      and IMP (and ITP) were observed. (1) When the MCHC (i.e., the internal viscosity)
      was normalized by suspending in hypotonic medium, the deformability of 2,3-DPG
      enriched erythrocytes was greatly improved, but still decreased. (2) The change
      of intracellular pH between 6.5 and 7.5 (as compared adjusting to same MCHC) did
      not alter the deformability. (3) The changes of purine nucleotides, ATP (0.6-2.1
      mM/l cells), IMP (0-0.9 mM/l cells) and ITP (0-0.5 mM/l cells) did not alter the
      erythrocyte deformability. In conclusion, decreased deformability of erythrocytes
      induced by augmentation of 2,3-DPG is due mainly to the increased internal
      viscosity and due partly to the increased membrane viscoelasticity.

PMID- 2223816
TI  - Liposomes for the sustained drug release in vivo.
AB  - New lipidic carriers suitable for the sustained drug release in vivo are
      presented. They consist of middle sized, compact phospholipid vesicles with one
      or up to few lipid bilayers which are sterically stabilized with a small amount
      of large-head phospholipids. As an example, phosphatidylcholine (PC) liposomes
      casted with up to 10 mol% of phosphatidylethanolamine with a covalently attached
      polyethyleneglycol 5000 headgroup (PE-PEG) are discussed. Such vesicles exhibit a
      very long circulation time after an i.v. administration in mice; the improvement
      over pure phosphatidylcholine liposomes within the first 24 h exceeds 8000%, at
      this point nearly 25% of the applied PE-PEG liposomes being still in the
      circulation. This advantage is a consequence of reduced phagocytosis of the
      lipidic carriers, as shown by an in vitro assay with blood monocyte cells in the
      flow cytometric experiments. For example, after 6 h incubation with THP-1
      monocyte cells in human plasma the difference between the uptake of standard
      distearoylphosphatidylcholine (DSPC) and novel liposomes containing 10%
      distearoylphosphatidylethanolamine-PEG is by 1000%. Vesicles with 2.5 mol% DSPE
      PEG are also taken-up via phagocytosis relatively slowly. But the latter
      vesicles, moreover, retain most of the enclosed model-drug carboxyfluorescein
      after an incubation in plasma. The rate of permeation of the encapsulated
      substance from such DSPE-PEG liposomes is below 2.4% per h. This is by
      approximately a factor of two less than for pure DSPC liposomes; vesicles with a
      higher PE-PEG content are inferior in this respect. Long circulation time and
      high retention of the newly developed liposomes open up ways for the future
      systemic use as such stabilized drug carriers for the therapeutic applications in
      vivo.

PMID- 2223817
TI  - Kinetics and specificity of L-alanine transport across the basolateral cell
      surface in isolated oxyntic glands.
AB  - The time course, kinetics, specificity and sodium-dependence of alanine uptake by
      isolated oxyntic glands were studied. The uptake of alanine by the hydrolyzed
      cells was measured directly, after incubation of the glands with L-[3H]alanine. L
      Alanine total influx was saturable and apparently mediated by a single entry
      system (Kt = 7.93 mM and Vmax = 8.0 mumol.mg-1.30s-1). The Kt was comparable to
      previously reported values for L-alanine transport in other epithelial cells.
      Kinetic studies performed in the presence and absence of Na+ suggest L-alanine
      uptake is mainly mediated by a Na(+)-dependent carrier system, but in addition, a
      minor diffusional component has been detected. Cross inhibition experiments
      performed over a wide range of concentrations (1 to 100 mM) suggest that the
      Na(+)-dependent transport system for alanine resembles system A and displays
      higher affinity for L-serine (Ki = 1.81 mM) than for L-alanine (K't = 4.86 mM); a
      lower affinity was found for L-cysteine (Ki = 16.30 mM). Results obtained with
      MeAIB support the hypothesis that system A is present at the basolateral membrane
      of the gland cells.

PMID- 2223818
TI  - Biochemical and molecular aspects of the hepatic uptake of organic anions.

PMID- 2223819
TI  - Membrane electrostatics.
AB  - In conclusion, charged membrane together with their adjacent electrolyte solution
      form a thermodynamic and physico-chemical entity. Their surfaces represent an
      exceptionally complicated interfacial system owing to intrinsic membrane
      complexity, as well as to the polarity and often large thickness of the
      interfacial region. Despite this, charged membranes can be described reasonably
      accurately within the framework of available theoretical models, provided that
      the latter are chosen on the basis of suitable criteria, which are briefly
      discussed in Section A. Interion correlations are likely to be important for the
      regular and/or rigid, thin membrane-solution interfaces. Lateral distribution of
      the structural membrane charge is seldom and charge distribution perpendicular to
      the membranes is nearly always electrostatically important. So is the interfacial
      hydration, which to a large extent determines the properties of the innermost
      part of the interfacial region, with a thickness of 2-3 nm. Fine structure of the
      ion double-layer and the interfacial smearing of the structural membrane charge
      decrease whilst the surface hydration increases the calculated value of the
      electrostatic membrane potential relative to the result of common Gouy-Chapman
      approximation. In some cases these effects partly cancel-out; simple
      electrostatic models are then fairly accurate. Notwithstanding this, it is at
      present difficult to draw detailed molecular conclusions from a large part of the
      published data, mainly owing to the lack of really stringent controls or
      calibrations. Ion binding to the membrane surface is a complicated process which
      involves charge-charge as well as charge-solvent interactions. Its efficiency
      normally increases with the ion valency and with the membrane charge density, but
      it is also strongly dependent on the physico-chemical and thermodynamic state of
      the membrane. Except in the case of the stereospecific ion binding to a membrane,
      the relatively easily accessible phosphate and carboxylic groups on lipids and
      integral membrane proteins are the main cation binding sites. Anions bind
      preferentially to the amine groups, even on zwitterionic molecules. Membrane
      structure is apt to change upon ion binding but not always in the same direction:
      membranes with bound ions can either expand or become more condensed, depending
      on the final hydrophilicity (polarity) of the membrane surface. The more polar
      membranes, as a rule, are less tightly packed and more fluid. Diffusive ion flow
      across a membrane depends on the transmembrane potential and concentration
      gradients, but also on the coulombic and hydration potentials at the membrane
      surface.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2223820
TI  - Purification and some properties of cyclodextrin-hydrolyzing enzyme from Bacillus
      sphaericus.
AB  - An intracellular cyclodextrin-hydrolyzing enzyme from Bacillus sphaericus E-244
      isolated from soil was purified to a homogeneous state by means of Triton X-100
      extraction, DEAE-Sepharose column chromatography, hydrophobic and molecular-sieve
      HPLC. The enzyme was estimated to have an Mr of 72,000 by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and 144,000 by HPLC gel filtration on TSK gel
      G 3000 SW. It had a pH optimum of 8.0, and the enzyme, stable at 25 degrees C and
      pH 5.5-9.5 for 24 h, was inactivated at 50 degrees C for 10 min. The enzyme
      hydrolyzed beta-cyclodextrin more effectively than linear maltooligosaccharides
      such as maltopentaose, maltohexaose and maltoheptaose or polysaccharides such as
      starch, amylopectin, amylose and pullulan.

PMID- 2223821
TI  - Biosynthesis of GM1b and similar neolactoseries gangliosides by a partially
      purified chicken skeletal muscle sialyltransferase. Effect of sphingomyelin and
      acetylcholine.
AB  - An alpha 2----3 glycolipid galactosyl sialyltransferase (SAT3/4) has been
      partially purified from embryonic chicken skeletal muscle. It is preserved in 50
      mM Hepes buffer (pH 6.8) containing 1% Triton CF-54 and 20% glycerol at -70
      degrees C for a period of 6 months without loss of activity. The SAT3+4
      preparation transfers sialic acid to nLcOse4Cer, nLcOse6Cer and GgOse4Cer with
      respective Km values of 1.4, 0.83 and 0.45 mM. The activity is stimulated 2-3
      fold at high substrate concentration and 6-8-fold at low substrate concentration;
      0.01 and 0.005 mumol for asialo GM1 and 0.025 and 0.01 mumol for other
      glycolipids in the presence of phosphatidylcholine (PC) and sphingomyelin (SM) at
      an optimum concentration 0.75%. A higher concentration is inhibitory. SM from
      chicken muscle is more effective than that from bovine brain and the stimulation
      is qualitatively proportional to that of the saturated fatty acyl content of SM.
      Free fatty acids (palmitic and stearic), their sodium salts, other choline
      compounds including choline chloride, phosphorylcholine and acetylcholine either
      do not have any effect or are inhibitory. Acetylcholine, even in the presence of
      SM and PC, is strongly inhibitory (70%).

PMID- 2223822
TI  - Induction and regulation of cytochrome P450 K-5 (lauric acid hydroxylase) in rat
      renal microsomes by starvation.
AB  - The effects of starvation on rat renal cytochrome P-450s were studied. The
      content of spectrally measured cytochrome P-450 in the renal microsomes of male
      rats increased 2-fold with 72 h starvation, but cytochrome b5 and NADPH
      cytochrome P-450 reductase were not induced. 7-Ethoxycoumarin O-dealkylation and
      aniline hydroxylation activities of the renal microsomes of control male rats
      were very low but were induced 2.5-3-fold by 72 h starvation. Aminopyrine N
      demethylation and lauric acid hydroxylation activities were induced 1.5-2-fold by
      72 h starvation. The changes in catalytic activities suggested that the contents
      of individual cytochrome P-450s in the renal microsomes were altered by
      starvation. The contents of some cytochrome P-450s were measured by Western
      blotting. P450 DM (P450IIE1), a typical form of cytochrome P-450 induced by
      starvation in rat liver, was barely detected in rat kidney and was induced 2-fold
      by 72 h starvation. P450 K-5, a typical renal cytochrome P-450 and lauric acid
      hydroxylase, accounted for 81% of the spectrally measured cytochrome P-450 in the
      renal microsomes of control male rats and was induced 2-fold by 72 h starvation.
      P450 K-5 was not induced in rat kidney by treatment with chemicals such as
      acetone or clofibrate. The renal microsomes of male rats contained 6-times as
      much P450 K-5 as those of female rats. These results suggest that P450 K-5 is
      regulated by an endocrine factor.

PMID- 2223823
TI  - The formation of oxalate from glycolate in rat and human liver.
AB  - In this study, we attempted to elucidate the metabolic pathway and enzymes
      actually involved in oxalate formation from glycolate in rat and human liver. In
      rat liver, the formation of oxalate from glycolate appeared to take place
      predominantly via glyoxylate. The oxalate formation from glycolate observed with
      crude enzyme preparations was almost entirely accounted for by the sequential
      actions of glycolate oxidase and xanthine oxidase (XOD) or lactate dehydrogenase
      (LDH). Under the conditions used, no significant activity was attributable to
      glycolate dehydrogenase, an enzyme reported to catalyze the direct oxidation of
      glycolate to oxalate. Among the three enzymes known to catalyze the oxidation of
      glyoxylate to oxalate, glycolate oxidase and XOD showed much lower activities (a
      higher Km and lower Vmax) toward glyoxylate than those with the respective
      primary substrates. As to LDH, none of the LDH subunit-deficient patients
      examined showed profoundly lowered urinary oxalate excretion. Based on the
      results obtained, the presumed efficacies in vivo of individual enzymes, as
      catalysts of glyoxylate oxidation, and the in vivo conditions assumed to allow
      their catalysis of oxalate production are discussed.

PMID- 2223824
TI  - Purification and properties of an extracellular conidial trehalase from Humicola
      grisea var. thermoidea.
AB  - An extracellular trehalase (alpha, alpha-trehalose glucohydrolase, EC 3.2.1.28)
      was purified from conidia of Humicola grisea var. thermoidea. The purified enzyme
      is a glycoprotein and migrates as a single polypeptide band during polyacrylamide
      gel electrophoresis under non-denaturing conditions. The apparent molecular
      weight of the enzyme was estimated as 580,000 by gel filtration chromatography.
      The enzyme is separable into three polypeptide bands of 105,000, 98,000 and
      84,000 daltons on SDS-PAGE. It is specific for trehalose and its activity is not
      inhibited by other disaccharides. It has a Km of 2.3 mM, an optimum pH of 5.6 in
      sodium acetate buffer and a temperature optimum of 60 degrees C. The enzyme is
      activated by Ca2+, Co2+ and Mn2+ and inhibited by inorganic phosphate, AMP, ADP
      or ATP. The inhibitory effect of phosphate, AMP and ADP, but not that of ATP, was
      abolished in the presence of Ca2+.

PMID- 2223825
TI  - N-linked oligosaccharides of the murine transferrin receptor from a plasmacytoma
      cell line. Comparison with total cellular N-glycans.
AB  - The N-linked oligosaccharides synthesised by the murine plasmacytoma cell line NS
      1 have been analysed by lectin affinity chromatography on columns of immobilised
      concanavalin A (Con A), Lens culinaris (lentil), Ricinus communis agglutinin
      (RCA) and leuko-phytohemagglutinin (L-PHA). The majority of complex N-glycans in
      this transformed cell line were branched structures with only a low level of
      biantennary complex chains detected. The analysis showed the major complex N
      glycan fraction consisted of a minimum sialylated triantennary structure.
      [3H]Mannose-labelled transferrin receptor was isolated from NS-1 cells by
      immunoprecipitation followed by electroelution from SDS polyacrylamide gels. The
      isolated receptor was digested with Pronase and the 3H-labelled glycopeptides
      analysed by lectin affinity chromatography. Analysis by Con A-Sepharose indicated
      that approx. 50% of the labelled glycopeptides were branched complex N-glycans
      (unbound fraction) while the remainder were oligomannose structures (strongly
      bound). The presence of tri and/or tetraantennary structures in the Con A unbound
      fraction was further suggested by the interaction of 61% of the fraction with L
      PHA. The lectin profiles obtained for the complex N-glycans of the transferrin
      receptor glycopeptides were similar to those for the total cellular glycopeptides
      of NS-1 cells. Reverse-phase HPLC analysis of tryptic glycopeptides of the
      isolated [3H]mannose-labelled transferrin receptor gave three 3H-labelled peaks,
      indicating that all three potential N-glycosylation sites on the receptor are
      utilised. The Con A-Sepharose profiles of the three fractions indicated the
      presence of branched complex N-glycans and high mannose chains at each site. The
      profiles of two of the tryptic glycopeptide fractions were very similar, while
      the third had a higher content of oligomannose oligosaccharides.

PMID- 2223826
TI  - Purification and characterization of an NAD(+)-dependent dehydrogenase that
      catalyzes the oxidation of thromboxane B2 at C-11 from porcine liver. Development
      and application of 11-dehydro-thromboxane B2 radioimmunoassay to enzyme assay.
AB  - 11-Dehydro-thromboxane B2 has been identified as a major metabolite of infused as
      well as endogenous thromboxane B2 in mammalian plasma and urine. This metabolite
      is derived from thromboxane B2 by enzymatic oxidation at C-11 catalyzed by 11
      hydroxythromboxane B2 dehydrogenase. A radioimmunoassay for 11-dehydro
      thromboxane B2 has been developed and used for enzyme assay, purification and
      characterization. Antibodies were generated against 11-dehydro-thromboxane B2
      conjugated to bovine thyroglobulin. Labeled marker was prepared by
      radioiodinating 11-dehydro-thromboxane B2-tyrosine methyl ester conjugate. A
      sensitive radioimmunoassay capable of detecting 10 pg of 11-dehydro-thromboxane
      B2 per assay tube was developed. The antibodies showed minimal crossreaction with
      thromboxane B2 (0.03%), prostaglandin D2 (2.76%) and other eicosanoids (less than
      0.03%). The enzyme activity was determined by assaying NAD(+)-dependent formation
      of immunoreactive 11-dehydro-thromboxane B2 from thromboxane B2. The enzyme was
      found to be enriched in liver although significant activity was also detected in
      gastrointestinal tract and kidney in pig. The enzyme was purified from porcine
      liver cytosol to apparent homogeneity using conventional and affinity
      chromatography. The purified enzyme exhibited coenzyme specificity for NAD+ and
      used thromboxane B2 as a substrate. The enzyme also catalyzes NADH-dependent
      reduction of 11-dehydro-thromboxane B2 to thromboxane B2 indicating the
      reversibility of the enzyme catalyzed reaction. The apparent Km values for
      thromboxane B2, 11-dehydro-thromboxane B2 and NAD+ are 8.1, 8.0 and 23 microM,
      respectively. Subunit Mr was shown to be 55,000, whereas the native enzyme Mr was
      found to be 110,000 indicating that the enzyme is a dimer. The enzyme is
      sensitive to sulfhydryl inhibitions suggesting cysteine residues are essential to
      enzyme activity. The availability of a homogeneous enzyme preparation should
      allow further studies on the substrate specificity and the structure and function
      of the enzyme.

PMID- 2223827
TI  - Differential utilization of long chain fatty acids during fasting-induced
      triacylglycerol depletion. III. Comparison of n-3 and n-6 fatty acids in rat
      plasma and liver.
AB  - Previous research has shown that arachidonic acid (20:4(n-6)) is preferentially
      retained in liver triacylglycerol in fasted compared to fed rats consuming a diet
      containing n-6 fatty acids. It was hypothesized that eicosapentaenoic (20:5(n-3))
      and docosahexaneoic acids (22:6(n-3)) would be similarly retained in liver and
      plasma triacylglycerol of fasted rats consuming a diet containing n-3 fatty
      acids. In comparison with fed rats, it was observed that in partially fasted rats
      consuming diets which contained 5% sunflower oil (78% 18:2(n-6)) or 5% marine
      fish oil (30% 20:5(n-3) and 22:6(n-3)), both liver and plasma had significantly
      depleted triacylglycerol levels containing higher proportions of both arachidonic
      and docosahexaneoic acids but a lower proportion of eicosapentaenoic acid (marine
      fish oil group only). Separation of liver and plasma triacylglycerol by silicic
      acid column chromatography and silver nitrate TLC showed that the majority of
      long chain fatty acids utilized during fasting were derived from the
      triacylglycerol subclasses containing palmitic acid (16:0), palmitoleic acid
      (16:1(n-7)) and oleic acid (18:1(n-9)) with retention o both highly saturated and
      polyunsaturated subclasses. Greater utilization of eicosapentaenoic acid than
      either arachidonic acid or docosahexaenoic acid during fasting may be due to
      triacylglycerol speciation of the former with readily oxidized monounsaturated
      fatty acids.

PMID- 2223828
TI  - An EXAFS, and preliminary X-ray crystallographic, investigation of an iron
      containing product from the lichen Cladonia deformis.
AB  - An iron-containing product in the acetone extract from the lichen Cladonia
      deformis has been investigated using chemical, spectroscopic and X-ray
      crystallographic methods. Visible-near UV, EPR and IR spectra indicate that the
      iron is present as high-spin Fe(III) and coordinates in an oxygen-containing
      environment arising from graciliformin (or graciliformin-like) ligands. This has
      been confirmed by an XAS (X-ray absorption) study using synchrotron radiation.
      Comparison of the EXAFS and XANES results with those obtained from a model,
      tris(pent-2,4-dionato)Fe(III), and detailed fitting using the single-scattering,
      curved-wave formalism for the EXAFS strongly supports the presence of a Fe(III)
      coordinated to five oxygen atoms from the graciliformin.

PMID- 2223829
TI  - Is adenosine a second metabolic substrate for human red blood cells?
AB  - Adenosine is present in the micromolar range in human plasma. In this study,
      metabolism of adenosine, which was maintained between 0.62 +/- 0.03 and 2.92 +/-
      0.43 microM by means of a continuous infusion using a Harvard infusion pump, was
      investigated in human red blood cells. It was found that lactate production
      increases linearly as the adenosine concentration was raised. Cells infused with
      an average adenosine concentration of 2 microM produced lactate comparable to
      that produced by 5 mM glucose. The extent to which ATP concentration is
      maintained by adenosine also depends on its concentration. After a 4 h infusion
      with an average adenosine concentration of 0.7 microM, ATP content amounts to 75%
      of the glucose control. Raising the adenosine infusion concentration to 1.5
      microM results in a full maintenance of ATP levels and at concentrations higher
      than 1.5 microM, adenosine produces a net synthesis of ATP. A net synthesis of
      ATP also occurs with adenosine concentration below 1.5 microM, if supplemented
      with glucose. In contrast, inosine infusion provides only a partial support of
      ATP and fails to produce a net synthesis of ATP in the presence of glucose. In
      addition, the presence of purine nucleoside and glucose together influence the
      metabolism of each other, depending on inorganic phosphate content (Pi). At a Pi
      concentration of 1 mM, the glucose consumption rate is reduced by approx. 25% by
      purine nucleoside infusion and vice versa. In sharp contrast, glucose consumption
      at 16 mM Pi is potentiated by adenosine. These findings suggest that plasma
      adenosine contributes significantly to human red cell energetics, even though it
      is present at a concentration several orders of magnitude lower than glucose.

PMID- 2223830
TI  - Comparison of the binding of anthracycline derivatives to purified DNA and to
      cell nuclei.
AB  - Fluorescence method was used to study the interactions of anthracyclines with
      purified DNA and with cell nuclei at 37 degrees C, at pH ranging from 6.8 to 8.
      Four anthracyclines were used; adriamycin (ADR), 4'-o-tetrahydropyranyladriamycin
      (THP-ADR), daunorubicin (DNR) and aclacinomycin (ACM). The values of pKa of
      deprotonation of these four drugs in the pH range 6.5-8.5 are 8.4, 7.7, 8.4 and
      7.0 for ADR, THP-ADR, DNR and ACM, respectively. The overall binding constants K*
      of these four drugs to purified DNA was determined at various pH values. The
      binding constants K0 and K+ of the respectively neutral form and once protonated
      form of the drugs to DNA were calculated. Using cell nuclei from K562 cells, the
      amount of drug intercalated (CN) within the nuclei of K562 cells and the amount
      of free drug (CE) in the solution were determined at various pH values: measuring
      at the same pH values, a linear correlation occurred between K* and CN/CE.

PMID- 2223831
TI  - Identification of non-equilibrium glycolytic reactions in suspension-cultured
      plant cells.
AB  - Levels of all enzymes and metabolites involved in glycolysis were determined in
      suspension-cultured Catharanthus roseus cells. From both the maximum catalytic
      activities of the enzymes and comparisons of mass-action ratios with the apparent
      equilibrium constants for the reactions, it is concluded that the reactions
      catalysed by hexokinase, fructokinase, phosphofructokinase and pyruvate kinase
      are far from equilibrium, whereas the other reactions including that catalysed by
      pyrophosphate-fructose-6-phosphate 1-phosphotransferase, are close to equilibrium
      in vivo.

PMID- 2223832
TI  - Characterization of ent-kaurene oxidase activity from Gibberella fujikuroi.
AB  - Cell extracts of wild-type and mutant strains of Gibberella fujikuroi were
      assayed for kaurene oxidase activity, using ent-[3H]kaurene as the substrate.
      Extracts from strain SG78 exhibited the highest specific activity, and were used
      in subsequent experiments. The microsomal enzyme activity was solubilized with
      buffers or salt solutions at a concentration of 400 mM. Both the soluble and
      microsomal preparations showed characteristic cytochrome P-450 spectra, ligand
      binding spectra with the substrate and with the plant growth regulator,
      paclobutrazol, and inhibition of enzymic activity by carbon monoxide. The
      addition of 20% glycerol to the extraction buffer stabilized the activity to some
      extent. Loss of enzymic activity on storage was accompanied by conversion of P
      450 to P-420. Michaelis-Menten kinetic parameters for the membrane-bound and
      soluble enzyme have been estimated, as have constants for the binding of ent
      kaurene and paclobutrazol to the P-450 and P-420 forms of the protein.

PMID- 2223833
TI  - Histamine tautomerism and its mode of action.
AB  - An established combination of quantum mechanical calculations and molecular
      dynamics simulations (Worth, C.A., King, P.M. and Richards, W.G. (1989) Biochim.
      Biophys. Acta 993, 134-136; Cieplak, P., Singh, U.C. and Kollman, P.A. (1987)
      Int. J. Quant. Chem. QBS14, 65-74; Reynolds, C.A., King, P.M. and Richards, W.G.
      (1988) Nature 334, 80-82) has been used to calculate the tautomer ratios of
      histamine species in aqueous solution. The results are in good agreement with
      experiment and provide a bridge between experimental data and earlier theoretical
      calculations.

PMID- 2223834
TI  - Isolation and characterization of a new lectin from plasma of fish Channa
      punctatus.
AB  - A soluble lectin is purified to apparent homogeneity from plasma of Channa
      punctatus by affinity chromatography on N-acetyl-D-galactosamine coupled to epoxy
      activated cellulose. The lectin has 140 kDa native molecular mass and 68 kDa
      subunit molecular mass, as determined by native and sodium dodecyl sulphate
      denaturing polyacrylamide gel electrophoresis, respectively. The lectin
      agglutinates human A and AB blood groups and rat, mice and guinea pig
      erythrocytes in the presence of Ca2+ and Mg2+ or Mn2+ ions. These divalent
      cations, but not thiol group, are obligatory requirements for the lectin
      activity. Gal(beta 1----3)GalNAc (0.09 mM) is the most potent inhibitor of the
      lectin.

PMID- 2223835
TI  - Phospholipid hydroperoxide glutathione peroxidase in various mouse organs during
      selenium deficiency and repletion.
AB  - An assay for the determination of the newly discovered selenoenzyme, phospholipid
      hydroperoxide glutathione peroxidase (PH-GPx) in biological material is
      described. Dietary selenium deficiency and repletion was used as a tool in order
      to modify this enzyme activity in various mouse organs and to compare it to the
      activity of the 'classical' selenium-dependent glutathione peroxidase (GPx) (EC
      1.11.1.9). A semipurified diet containing less than 12 ppb Se was used for
      depletion. Controls received this diet supplemented with 500 ppb Se in the form
      of Na2SeO3. The results showed that a rapid loss of GPx activity occurred in
      liver, kidney and lungs of selenium-deficient mice which reached undetectable
      levels within 130 days. In the heart, about 24% of control GPx activity was still
      present. In contrast, PH-GPx activity was more slowly depleted by Se deficiency
      and resulted in residual activities ranging from 30 to 70% in the different
      organs even after 250 days of depletion. In repletion experiments with a single
      application of 10 or 500 micrograms/kg Se, only the high dose restored either
      enzyme activity. The data demonstrate that the need for selenium of the two
      glutathione peroxidases is different. A markedly distinct organ distribution of
      both enzymes suggests that the heart may be the organ more sensitive to oxidative
      stress.

PMID- 2223836
TI  - A physicochemical comparison of the isozymes of creatine kinase from rabbit brain
      and muscle.
AB  - A comparison of specific structural features of creatine kinase from rabbit
      muscle and brain was undertaken to determine if the observed isozyme specific
      differences in catalytic cooperativity are related to conformational differences,
      particularly differences in packing density. The intrinsic fluorescence of the
      brain isozyme is 2-fold higher than the muscle isozyme. In the denatured state,
      both proteins display the characteristic red shift in emission maximum; however,
      the emission intensity of the brain isozyme increases only 5% upon denaturation
      compared to nearly 100% increase for the muscle protein. The fluorescence
      lifetimes are 2.65 ns (67%) and 0.48 ns for native muscle enzyme and 4.38 ns
      (65%) and 0.80 ns for brain enzyme. Upon denaturation, the lifetimes are 3.98 ns
      (77%) and 0.99 ns for muscle protein and 3.82 ns (79%) and 0.86 ns for brain
      protein. Stern-Volmer plots of quenching by acrylamide are essentially the same
      for both native isozymes indicating that the differences of the intrinsic
      fluorescence of the native proteins are not due to differences in solvent
      accessibility. The spectral and lifetime differences in the isozymes in the
      native state and changes accompanying denaturation are consistent with the
      occurrence of energy transfer in native muscle isozyme. The rotational
      correlation times of 5-[2-(iodoacetyl)aminoethyl]aminonaphthalene-1-sulfonate
      conjugated proteins, derivatized at the active site reactive thiol, are best
      described by two term decay laws. The slower rotations, 45.1 ns (75%) and 40.6 ns
      (71%) reflect overall macromolecular rotation for the muscle and brain isozymes,
      respectively. The faster motions, 2.4 ns for muscle isozyme and 0.4 ns for the
      brain isozyme, are attributed to the probe or probe associated segmental motions
      and indicate these motions are more restricted in the muscle protein. Reactivity
      of creatine kinase (2.5-10 microM) with the amino-specific reagent
      trinitrobenzene sulfonate (0.4-2 mM) was analyzed by pseudo-first-order and
      second order models, neither of which was adequate for the entire range of data.
      However, in every case, the rate constants were faster for brain creatine kinase
      but the extent of reaction was greater for muscle creatine kinase. The faster
      initial reactivity of the brain isozyme is consistent with greater accessibility
      for lysine derivatization.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2223837
TI  - A Fourier transform infrared spectroscopic (FTIR) study of porcine and bovine
      pancreatic phospholipase A2 and their interaction with substrate analogues and a
      transition-state inhibitor.
AB  - Fourier transform infrared spectroscopy has been used to investigate the
      secondary structure of porcine and bovine pancreatic phospholipase A2 (PLA2) and
      the zymogen of porcine PLA2, prophospholipase A2 (proPLA2), in both H2O and D2O
      media. Detailed qualitative analysis was made of these proteins using second
      derivative and deconvolution techniques. Quantitative studies of the proteins in
      solution made using Factor Analysis gave average values of 54% alpha-helix, 15%
      beta-sheet and 23% beta-turns. These values agree well with the secondary
      structures deduced from previous studies of single crystals using X-ray
      techniques. No significant differences in secondary structure were observed for
      porcine pancreatic (pro)phospholipase A2 in the presence or absence of Ca2+ ions,
      or in the temperature range 10-45 degrees C. The binding of the non-degradable
      phospholipid analogue, n-alkylphosphocholine, in monomeric form produced no
      significant difference in the secondary structure of either enzyme.
      Conformational differences were, however, observed between the enzyme lyophilised
      in a solid film and in aqueous solution. The change is probably due to the
      formation of beta-sheet upon hydration, coupled with a loss of random structures.
      Conformational differences in both porcine and bovine pancreatic PLA2 were
      observed on binding to n-alkylphosphocholine micelles. This change may be due to
      a small increase in the alpha-helical structure and a decrease in the beta-sheet,
      and/or possibly beta-turn content. Similar conformational changes were observed
      for the interaction of porcine and bovine PLA2 with the substrate analogue
      inhibitor 1-heptanoyl-2-heptanoylamino-2-deoxy-sn-glycero-3-phospho glycol in
      micellar form.

PMID- 2223838
TI  - Functional modification of an arginine residue on salicylate hydroxylase.
AB  - Salicylate hydroxylase from Pseudomonas putida (EC 1.14.13.1, salicylate,
      NADH:oxygen oxidoreductase) is an FAD-containing monooxygenase, which catalyzes
      decarboxylative hydroxylation of salicylate to produce catechol in the presence
      of NADH and O2. By chemical treatment of the enzyme with dicarbonyl reagents,
      such as glyoxal, the original oxygenase activity was converted to the salicylate
      dependent NADH-dehydrogenase activity with free FAD as electron acceptor. One of
      twenty arginine residues of this enzyme is concerned with this alteration of
      activity, as shown by the result of its modification at pH 6.9. This result is
      further supported by the isolation of one arginine-modified enzyme by
      chromatographic methods on DEAE-Sephadex, A-50 columns. It exhibits the
      dehydrogenase activity predominantly. This modified enzyme is
      spectrophotometrically and electrophoretically characterized by a minute
      conformational change around the active site, and kinetically by a 7-fold
      increase in an apparent Km for NADH and a decrease of more than 5-fold in an
      apparent Km for FAD as electron acceptor, with an apparent Vmax of 22 s-1 for the
      dehydrogenase activity. Flow kinetics also showed a marked decrease in the rate
      for oxygenation of the reduced enzyme-salicylate complex from 21 s-1 (native
      enzyme) to 3.3 s-1 (modified enzyme). These facts suggest that one arginine
      residue of the enzyme is responsible for the NADH binding site, and chemical
      modification of one arginine residue of the enzyme induces some conformational
      change around the active site to alter the catalytic activity from oxygenation to
      dehydrogenation.

PMID- 2223839
TI  - Fluorescence-quenching-resolved spectra of melittin in lipid bilayers.
AB  - The interaction of bee venom melittin with dimyristoylphosphatidylcholine (DMPC)
      unilamellar vesicles has been studied by means of fluorescence quenching of the
      single tryptophan residue of the protein, at lipid-to-peptide ratio, Ri = 50 and
      at high ionic strength (2 M NaCl). The method of fluorescence-quenching-resolved
      spectra (FQRS), applied in this study with potassium iodide as a quencher,
      enabled us to decompose the tryptophan emission spectrum of liposome-bound
      melittin into components, at temperatures above as well as below the main phase
      transition temperature (Tt) of DMPC. One of the two resolved spectra exhibits
      maximum at 342 and 338 nm for experiments above and below Tt, respectively, and
      is similar to the maximum of tryptophan emission found for tetrameric melittin in
      solution (340 nm). This spectrum is characterized by the Stern-Volmer quenching
      constant, Ksv, of about 4 M-1 and it represents the fraction of melittin
      molecules whose tryptophan residues are exposed to the solvent to a degree
      comparable with tetrameric species in solution. The other spectrum component,
      corresponding to the quencher-inaccessible fraction of tryptophan molecules (Ksv
      = 0 M-1) has its maximum blue-shifted up to 15 nm, indicating a decrease in
      polarity of the environment. For experiments above Tt, the blue spectrum
      component revealed the excitation-wavelength dependence, originating probably
      from the relaxation processes between the excited tryptophan molecules and lipid
      polar head groups. We conclude that melittin bound to DMPC liposomes exists in
      two lipid-associated forms; one, with tryptophan residues exposed to the solvent
      and the other, penetrating the membrane interior, with tryptophan residues
      located in close proximity to the phospholipid polar head groups of the outer
      vesicle lipid layer. We also discuss our data with current models of melittin
      bilayer interactions.

PMID- 2223840
TI  - Thermodynamic properties of globular proteins and the principle of stabilization
      of their native structure.
AB  - A semi-empirical method has been used to estimate the thermodynamic parameters of
      hydration of buried surface areas of ribonuclease S, lysozyme and myoglobin from
      the model of complete unfolding according to Ooi et al. ((1987) Proc. Natl. Acad.
      Sci. USA 84, 3086-3090). The buried surface area of proteins is considered as the
      difference between the accessible surface area of native protein and the
      completely extended polypeptide chain according to Lee and Richards ((1971) J.
      Mol. Biol. 55, 379-400). The contributions of nonpolar and polar protein groups
      to the general value of Gibbs energy, enthalpy, entropy and heat capacity of
      hydration have been determined. The obtained results on the thermodynamic
      behavior of proteins in the process of complete unfolding are in good agreement
      with the results of microcalorimetric studies of thermal denaturation.

PMID- 2223841
TI  - Interaction of human leukocyte elastase with soluble and insoluble protein
      substrates. A practical kinetic approach.
AB  - A progress-curve kinetic method was developed to investigate the interaction
      between human leukocyte elastase and macromolecular substrates, such as insoluble
      elastin and soluble plasma proteins. A fluorogenic, synthetic peptide (reporter
      substrate) was incubated in the presence of finely powdered elastin and enzyme
      under continuous stirring. The progress curves, which corresponded to the release
      of product from the reporter substrate, were very sensitive to the presence of
      various amounts of the macromolecular substrate. The kinetic parameters for the
      interaction between elastase and elastin were calculated using a pre-steady-state
      approach characteristic of slow-binding inhibitors. The interaction of elastase
      with the soluble protein substrates was studied with similar techniques, but
      formally treating the substrates as classical, fully competitive inhibitors. The
      adsorption of elastase on insoluble elastin was a time-dependent process
      consisting of at least three observable phases: The first step was a rapid
      formation of an encounter complex followed by a very slow step lasting several
      minutes, and the third step consisted of a steady-state release of products. On
      the contrary, elastase very rapidly formed productive complexes with bovine serum
      albumin and a human monoclonal immunoglobulin G. The progress-curve method was
      also suitable for analyzing the behavior of inhibitors in the presence of protein
      substrates. The kinetic parameters which characterize the interaction between
      elastase and protein substrates represent a practical tool to formulate
      hypotheses on the efficiency of inhibitors in vivo.

PMID- 2223842
TI  - Hydrostatic pressure studies of native and synthetic thick filaments: II. Native
      thick filaments from rabbit skeletal muscle.
AB  - Native thick filaments isolated from freshly prepared rabbit psoas muscle were
      found to be resistant to pressure-induced dissociation. With increasing pressure
      application and release, a bimodal distribution of filament lengths was observed.
      The shorter filament length is associated with filament breakage at the center of
      the bare zone, while the longer length is associated with relatively intact
      filaments. Intact filaments and filament halves decrease in length by no more
      than 20% after exposure to and release of 14,000 psi. Bimodal distributions were
      not observed in equivalent experiments performed on filaments isolated from
      muscle glycerinated and stored at -20 degrees C for 6 months. Instead, filament
      dissociation proceeds linearly as a function of increasing pressure. Filaments
      prepared from muscle glycerinated and stored for 2 and 4 months exhibited
      pressure-induced behavior intermediate between the filaments prepared from fresh
      muscle and filaments prepared from muscle stored for 6 months. Since there
      appears to be no difference in the protein profiles of the various muscle
      samples, it is possible that stabilization of the native thick filament against
      hydrostatic pressure arises from trapped ions that are leached out over time.

PMID- 2223843
TI  - The histone H1 globular region. A possible supersecondary structure from
      spectroscopic and statistical studies.
AB  - The central region of the basic nuclear protein, histone H1, has a highly
      conserved amino acid sequence and a globular structure which is still not known
      at atomic resolution. A possible secondary and supersecondary structure was
      predicted by combining experimental measurements of circular dichroism and NMR
      spectroscopy with a statistical method based on the amino acid sequence. Our
      results showed the protein fragment as being highly structured and having a total
      alpha-helix content of about 40%.

PMID- 2223844
TI  - Primary sequence of duck metallothionein.
AB  - Only one metallothionein appears in domesticated duck upon zinc induction. The
      complete amino acid sequence has been elucidated. This metallothionein has the
      same sequence as the chicken metallothionein, as determined by chemical
      sequencing of overlapping peptides produced by selective proteinase digestion and
      confirmed by mass spectrometry. The observation that animals of divergent origins
      share a common gene product presents an example of extreme conservation of a
      stress-inducible protein.

PMID- 2223845
TI  - Chloroplast glyceraldehyde-3-phosphate dehydrogenase (NADP): amino acid sequence
      of the subunits from isoenzyme I and structural relationship with isoenzyme II.
AB  - The structural relationship between isoenzymes I and II of chloroplast
      glyceraldehyde-3-phosphate dehydrogenase (D-glyceraldehyde-3-phosphate: NADP+
      oxidoreductase (phosphorylating) EC 1.2.1.13) has been established at the protein
      level. The complete primary structure of subunits A and B of glyceraldehyde-3
      phosphate dehydrogenase I from Spinacia oleracea has been determined by sequence
      analysis of the corresponding tryptic peptides, aligned by fragments derived from
      cyanogen bromide and Staphylococcus proteinase V8 digestions and by partially
      sequencing each intact subunit. Subunit A has an Mr of 36,225 and consists of 337
      amino acid residues, whilst subunit B (Mr 39,355) consists of 368 residues. The
      amino acid sequence of subunit B, as determined through direct analysis of the
      protein, is identical to that recently deduced at cDNA level (Brinkmann et al.
      (1989) Plant Mol. Biol. 13, 81-94). The two subunits share a common portion of
      amino acid sequence which differs by 66 amino acid residues. Subunit B has an
      extra C-terminal sequence of 31 amino acid residues. Chloroplast glyceraldehyde-3
      phosphate dehydrogenase II was partially characterized by sequencing the N
      terminal portion of the intact protein and some of its tryptic peptides. The
      sequences of all the examined fragments fit precisely that of the corresponding
      regions of subunit A from glyceraldehyde-3-phosphate dehydrogenase I.

PMID- 2223846
TI  - A kinetic study on the suicide inactivation of peroxidase by hydrogen peroxide.
AB  - In the absence of reductant substrates, and with excess H2O2, peroxidase (donor:
      hydrogen-peroxide oxidoreductase, EC 1.11.1.7) shows the kinetic behaviour of a
      suicide inactivation, H2O2 being the suicide substrate. From the complex
      (compound I-H2O2), a competition is established between two catalytic pathways
      (the catalase pathway and the compound III-forming pathway), and the suicide
      inactivation pathway (formation of inactive enzyme). A kinetic analysis of this
      system allows us to obtain a value for the inactivation constant, ki = (3.92 +/-
      0.06) x 10(-3) x s-1. Two partition ratios (r), defined as the number of
      turnovers given by one mol of enzyme before its inactivation, can be calculated:
      (a) one for the catalase pathway, rc = 449 +/- 47; (b) the other for the compound
      III-forming pathway, rCoIII = 2.00 +/- 0.07. Thus, the catalase activity of the
      enzyme and, also, the protective role of compound III against an H2O2-dependent
      peroxidase inactivation are both shown to be important.

PMID- 2223848
TI  - Proteolytic activity in mouse urine: relationship to the kidney metallo
      endopeptidase, meprin.
AB  - Meprin, a brush border kidney metallo-endopeptidase is present as the major
      endopeptidase in mouse urine. The enzyme is freely soluble and can be detected
      enzymically or immunologically. Mice can be partitioned into two phenotypes that
      differ by 10-20-fold in the amount of meprin in kidney membranes; this phenotypic
      variation is reflected in urinary activities. We propose a role for meprin in the
      degradation of other urinary proteins.

PMID- 2223847
TI  - Conditions affecting the activity of glucocerebrosidase purified from spleens of
      control subjects and patients with type 1 Gaucher disease.
AB  - Glucocerebrosidase was purified to homogeneity from spleens of control subjects
      and Type 1 Gaucher disease patients by immunoaffinity chromatography. Activation
      of the enzyme by taurocholate, phosphatidylserine and sphingolipid activator
      protein 2 (saposin C; SAP-2) was investigated by titration of combinations of
      various effectors in the absence and presence of Triton X-100. The specific
      activity of Type 1 Gaucher glucocerebrosidase was found to be less than 20% of
      the corresponding control value under most conditions. However, in the presence
      of optimal amounts of activator protein SAP-2 and phosphatidylserine (and in the
      absence of Triton X-100 and/or taurocholate), the specific activity of mutant
      enzyme towards artificial and natural lipid substrates was close to normal when
      measured at pH 5.0-5.5. At pH values below 5.0, the specific activity of mutant
      enzyme decreased more rapidly compared to that of control enzyme. The activity of
      Type 1 Gaucher glucocerebrosidase in the intact cell might, in a comparable
      manner, be highly dependent on the extent of activation by endogenous activators
      and on the intralysosomal pH. Values for residual glucocerebrosidase activity, as
      measured in vitro in extracts of cells and tissues from Type 1 Gaucher disease
      patients, are indeed highly dependent on the assay conditions employed.
      Consequently such measurements are of little value in the assessment of the
      actual capacity for glucosylceramide hydrolysis and for prediction of the
      clinical severity of the disease.

PMID- 2223849
TI  - Increased nucleophile reactivity of amino acid beta-naphthylamides in alpha
      chymotrypsin-catalyzed peptide synthesis.
AB  - Alpha-chymotrypsin-catalyzed acyl transfer from Boc-L-MetONp, Ac-L-TyrOEt, Bz-L
      TyrOMe, Mal-L-PheOMe to the C-protected amino acids (L-AlaNH2, L-LeuNH2, L-ArgOMe
      and beta-naphthylamides of L-Arg, L-Leu, L-Ala and L-Glu) has been studied.
      Modification of the carboxylic groups with beta-naphthylamide was shown to
      increase the reactivity of nucleophiles in these reactions by a factor of more
      than 100 in comparison with amides and esters of the same amino acids. This
      effect can be accounted for by the effective formation of the nucleophile
      acylenzyme complex due to hydrophobic interactions of the beta-naphthylamide
      moiety with the corresponding subsite of alpha-chymotrypsin. The reaction
      kinetics follows the scheme involving hydrolysis of the nucleophile-acylenzyme
      intermediate. The contribution of this pathway depends on the structures of both
      the acyl-group donor and the added nucleophile. The competitive inhibition by
      amino acid beta-naphthylamides is also observed. The results obtained show that
      modification of the COOH-group of added nucleophiles by beta-naphthylamide
      strongly affects the reactivity of these compounds in the alpha-chymotrypsin
      catalyzed peptide synthesis.

PMID- 2223850
TI  - Dimensional mapping of the active site of cholesterol esterase with alkylboronic
      acid inhibitors.
AB  - The cholesterol esterase-catalyzed hydrolysis of the water-soluble substrate p
      nitrophenyl butyrate occurs via an acylenzyme mechanism, and is competitively
      inhibited by boronic acid transition state analog inhibitors. Accordingly, we
      undertook to dimensionally map the enzyme's active site via synthesis and
      characterization of a series of n-alkyl boronic acid inhibitors. The most potent
      of these is n-hexaneboronic acid, with a Ki = 13 +/- 1 microM, since inhibitor
      potency declines for both longer and shorter boronic acids. No inhibition is
      observed for methaneboronic acid and n-octaneboronic acid inhibits poorly, with a
      Ki of 7 mM. These results indicate that the ability of the enzyme to form tight
      complexes with boron-containing transition state analog inhibitors is sensitive
      to alkyl chain length. The trend in inhibitor potency is discussed in terms of
      substrate specificity of and transition state stabilization by cholesterol
      esterase, and has important implications for the design of optimal reversible
      inhibitors of the enzyme.

PMID- 2223851
TI  - Interaction of aromatic donor molecules with manganese(III) reconstituted
      horseradish peroxidase: proton nuclear magnetic resonance and optical difference
      spectroscopic studies.
AB  - The interaction of aromatic donor molecules with manganese(III) protoporphyrin
      apohorseradish peroxidase complex [Mn(III)HRP] was investigated by optical
      difference spectroscopy and relaxation rate measurements of 1H resonances of
      aromatic donor molecules (at 500 MHz). pH dependence of substrate proton
      resonance line-widths indicated that the binding was facilitated by protonation
      of an amino acid residue (with a pKa of 6.1), which is presumably distal
      histidine. Dissociation constants were evaluated from both optical difference
      spectroscopy and 1H-NMR relaxation measurements (pH 6.1). The dissociation
      constants of aromatic donor molecules were not affected by the presence of excess
      of I-, CN- and SCN-. From competitive binding studies it was shown that all these
      aromatic donor molecules bind to Mn(III)HRP at the same site, which is different
      from the binding site of I-, CN- and SCN-. Comparison of the dissociation
      constants between the different substrates suggests that hydrogen bonding of the
      donors with distal histidyl amino acid and hydrophobic interaction between the
      donors and active site contribute significantly towards the associating forces.
      Free energy, entropy and enthalpy changes associated with the Mn(III)HRP
      substrate equilibrium have been evaluated. These thermodynamic parameters were
      found to be all negative. Distances of the substrate protons from the
      paramagnetic manganese ion of Mn(III)HRP were found to be in the range of 7.7 to
      9.4 A. The Kd values, the thermodynamic parameters and the distances of the bound
      aromatic donor protons from metal center in the case of Mn(III)HRP were found to
      be very similar as in the case of native Fe(III)HRP.

PMID- 2223852
TI  - Acyl carrier protein interacts with melittin.
AB  - Acyl carrier protein (ACP) from Escherichia coli has been shown to form complexes
      with melittin, a cationic peptide from bee venom. ACP is a small (Mr 8847),
      acidic, Ca2(+)-binding protein, which possesses some characteristics resembling
      those of regulatory Ca2(+)-binding proteins including interaction with melittin.
      Complexing between melittin and ACP which occurred both in the presence and
      absence of Ca2+ was evident by chemical cross-linking the two peptides,
      fluorescence changes (including anisotropy measurements), and inhibition by
      melittin of the activity of a nonaggregated fatty acid synthetase from Euglena.
      Also, anti-Apis mellifera antibodies which contained antibodies against melittin
      specifically inhibited the same enzyme system activity relative to non-immune
      IgG.

PMID- 2223853
TI  - Polar lipids of non-alkaliphilic Halococci.
AB  - Until recently, only one species of Halococcus has been recognized, namely, H.
      morrhuae, but a large number of extremely halophilic non-alkaliphilic cocci have
      now been isolated from hypersaline habitats in Spain and classified into four
      phenons (A-D); one of the phenon D strains has been classified as a new species,
      Halococcus saccharolyticus. Examination of the lipids of H. saccharolyticus and
      four strains of phenons A-C showed the presence in all of them of C20-C20 and C20
      C25 diether molecular species of phosphatidylglycerophosphate (PGP),
      phosphatidylglycerol (PG) and phosphatidic acid (PA); a monounsaturated
      isoprenoid C20-C20 (phytanyl-phytenyl) species of PGP; a sulfated diglycosyl
      diphytanylglycerol (S-DGD) with structure 2,3-diphytanyl-1-(6-HSO3-mannosyl-1-2
      glucosyl)-glycerol, which is identical to the S-DGD-1 in Haloferax mediterranei;
      a phosphoglycolipid (P-TGD) tentatively identified as a phytanyl-phytenyl-(H2PO3
      galactosyl-mannosyl-glycosyl)-glyce rol, and two unidentified glycolipids present
      only in traces. No phosphatidylglycerosulfate (PGS) was detected in any of the
      strains examined. This pattern of lipids appears to be characteristic of the
      strains of Halococcus from salterns in Spain, but studies of a larger number and
      variety of Haloccus are necessary to establish this conclusion with certainty.

PMID- 2223854
TI  - Influence of polyunsaturated and saturated dietary lipids on adipose tissue,
      brain and mitochondrial membrane fatty acid composition of a mammalian
      hibernator.
AB  - Dietary lipid composition profoundly influences the hibernation pattern of the
      chipmunk Eutamias amoenus. The object of the present study was to investigate
      whether these physiological changes following feeding of saturated and
      unsaturated lipids were associated by compositional changes of fatty acids of
      tissues and membranes. Animals were fed with rodent chow (control diet), rodent
      chow with 10% sunflower seed oil (unsaturated diet) and rodent chow with 10%
      sheep fat (saturated diet). Diet-induced changes in the fatty acid composition of
      depot fat and brain total lipids and of mitochondrial phospholipids were
      determined. The fatty acid unsaturation index was lower in animals on saturated
      diet than in animals on unsaturated diet (depot fat 86.1 vs. 145.9; heart
      mitochondria 207.6 vs. 247.1; liver mitochondria 148.4 vs. 173.5). Pronounced
      differences between dietary groups were also observed in n-3 or n-6 fatty acids
      or their ratios of depot fat, brain and liver mitochondria. Generally, the diet
      induced differences in tissue and membrane fatty acid composition in E. amoenus
      were more pronounced than those observed previously in non-hibernating species.
      Selective feeding and incorporation of high amounts of unsaturated fatty acids
      into tissues and cell membranes may be an important preparation for hibernation
      of E. amoenus which lowers its body temperature during torpor to about 0 degrees
      C.

PMID- 2223855
TI  - Metabolism of 13-hydroxy-9,11-octadecadienoic acid by MOLT-4 lymphocytes.
AB  - MOLT-4 lymphocytes metabolize 13-hydroxy-9,11-octadecadienoic acid, via the beta
      oxidation pathway with retention of the omega 6 hydroxyl group and the conjugated
      diene system. The products which accumulate include 11-hydroxy-7,9
      hexadecadienoic acid and 9-hydroxy-5,7-tetradecadienoic acid. In addition, it was
      possible to isolate two beta-hydroxy acids which were shown to be 3,13-dihydroxy
      9,11-octadecadienoic acid and 3,11-dihydroxy-7,9-hexadecadienoic acid. The odd
      chain aldehyde, 12-hydroxy-8,10-heptadecadien-1-al, also was detected. However,
      neither the pathway nor the immediate precursor for the synthesis of this
      compound was established.

PMID- 2223856
TI  - Differential induction of peroxisomal oxidation of palmitic acid and 3 alpha,7
      alpha,12 alpha-trihydroxy-5 beta-cholestanoic acid in rat liver.
AB  - The effect of feeding rats 20% partially hydrogenated marine oil (PHMO), 20%
      soybean oil, or clofibrate on the conversion of 3 alpha,7 alpha,12 alpha
      trihydroxy-5 beta-cholestanoic acid to cholic acid was studied in light
      mitochondrial (L) fractions prepared from liver. 20% PHMO gave a doubling both of
      the specific and of the total activity of the cholic acid formation compared to
      those found in the L-fraction from animals given standard pellets. 20% soybean
      oil induced the specific and the total activity to a lesser extent, 1.4- and 1.2
      fold, respectively. The specific and total activity of the peroxisomal beta
      oxidation of palmitic acid were induced 2.4- and 2.7-fold, respectively, by PHMO
      feeding. Soybean oil gave a smaller increase, 2-fold, in both specific and total
      activity. Clofibrate, a known peroxisomal proliferator, induced the specific and
      total activity of the peroxisomal fatty acid beta-oxidation 5.2- and 5.7-fold,
      respectively, whereas the specific activity of the cholic acid formation remained
      unchanged compared to standard pellet feeding. The same pattern was found in the
      postnuclear supernatants (E-fractions), excluding the possibility that different
      treatments caused different distributions of organelles between the fractions.
      This differential induction of two similar peroxisomal reaction sequences
      suggests that at least two mechanisms for peroxisomal induction exist.

PMID- 2223858
TI  - Purification and characterization of phospholipase A2 from rat stomach.
AB  - Phospholipase A2, which is localized in the mucosal part of the corpus of rat
      stomach (Hirohara et al. (1987) Biochim. Biophys. Acta 919, 231-238), was
      purified 990-fold from the supernatant of a tissue homogenate by heat treatment
      at acidic pH, ammonium sulfate fractionation, ion-exchange chromatography, gel
      filtration and reverse-phase high-performance liquid chromatography (reverse
      phase HPLC). The purified enzyme gave a single protein band on sodium dodecyl
      sulfate (SDS)-polyacrylamide gel electrophoresis with a molecular mass of approx.
      17 kDa. The enzyme had a pH optimum of 8.0 and hydrolyzed the 2-arachidonoyl
      residue of phosphatidylcholine preferentially to the 2-oleoyl residue, the Vmax
      and Km values for the two being 227 and 29 mumol/min per mg protein and 0.037 and
      0.019 mM, respectively. The activity was calcium-dependent and was markedly
      increased by SDS and dimethyl sulfoxide (DMSO). The enzyme showed typical product
      inhibition. Free unsaturated fatty acids (oleic, arachidonic and docosahexaenoic
      acids), which are supposedly the main enzymatic products in vivo, inhibited the
      activity. Arachidonic acid caused noncompetitive inhibition and its concentration
      for its maximal inhibition (50% inhibition) was 5 x 10(-5) M.
      Lysophosphatidylcholine, free saturated fatty acids (palmitic and stearic acids)
      and arachidonic acid metabolites (leukotrienes and prostaglandins) had no effect
      on the activity.

PMID- 2223857
TI  - Hydrolysis of lipid mixtures by rat hepatic lipase.
AB  - The hydrolysis of phospholipid mixtures by purified rat hepatic lipase, also
      known as hepatic triglyceride lipase, was studied in a Triton X-100/lipid mixed
      micellar system. Column chromatography of the mixed micelles showed elution of
      Triton X-100 and binary lipid mixtures of phosphatidic acid, phosphatidylcholine,
      phosphatidylethanolamine and phosphatidylserine as a single peak. This indicated
      that the mixed micelles were homogenous and contained all components in the
      designated molar ratios. The molar ratio of Triton X-100 to lipid was kept
      constant at 4 to 1. Labeling one lipid with 3H and the other lipid with 14C
      enabled us to determine the hydrolysis of both components of these binary lipid
      mixed micelles. We found that the hydrolysis of phosphatidylcholine was activated
      by the inclusion of small amounts of phosphatidic acid (2.5-fold),
      phosphatidylethanolamine (1.5-fold) or phosphatidylserine (1.4-fold). The maximal
      activation of phosphatidylcholine hydrolysis was observed when 5 mol% of
      phosphatidylethanolamine, 7.5 mol% phosphatidic acid or 5 mol% phosphatidylserine
      was added to Triton X-100 mixed micelles. The hydrolysis of phosphatidic acid was
      activated 30%, and that of phosphatidylserine was inhibited 30% when the molar
      proportion of phosphatidylcholine was less than 50 mol%. The hydrolysis of
      phosphatidylethanolamine was slightly activated when the mol% of
      phosphatidylcholine was below 5. The hydrolysis of phosphatidylserine was
      inhibited by phosphatidylethanolamine when the mol% of the latter was 50 or less
      whereas phosphatidylethanolamine hydrolysis was not affected by
      phosphatidylserine. Under the conditions used sphingomyelin and cholesterol did
      not have a significant effect on the hydrolysis of the phospholipids studied. In
      agreement with our previous study (Kucera et al. (1988) J. Biol. Chem. 263, 1920
      1928) these studies show that the phospholipid polar head group is an important
      factor which influences the action of hepatic lipase and that the interfacial
      properties of the substrate play a role in the expression of the activity of this
      enzyme. The molar ratios of phosphatidic acid, phosphatidylethanolamine and
      phosphatidylserine which activated phosphatidylcholine hydrolysis correspond
      closely to the molar ratios of these lipids found in the surface lipid film of
      lipoproteins e.g., high density lipoproteins.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2223859
TI  - Eutectic interactions between saturated and unsaturated chain cholesteryl esters:
      comparison of calculated and observed phase diagrams.
AB  - Binary phase behavior of saturated chain with unsaturated chain cholesteryl
      esters is evaluated by analysis of the phase diagrams in terms of ideal solution
      theory. Cholesteryl palmitate, which crystallizes in the bilayer structure, forms
      a eutectic with either cholesteryl oleate or cholesteryl linoleate and, as
      indicated by low angle X-ray data, the components are nearly totally fractionated
      in the solid state. The fit of the two experimental liquidus curves by a
      calculation of freezing point depression for an ideal solution indicates that the
      molecular interactions are nonspecific in the binary liquid state. Cholesteryl
      caprylate and cholesteryl oleate, both of which crystallize as the monolayer II
      form, also form a eutectic. X-ray data again indicate nearly total fractionation.
      The liquidus curve is reasonably well matched by calculation of ideal freezing
      point depression. However, dissimilar molecular volumes can cause the melt
      cholesteric transition line to deviate from an ideal concentration dependence.
      Possible fractionation mechanisms for cholesteryl esters in arterial lesions are
      thereby indicated. For example, when the molecules have greatly different
      volumes, clustering can occur in the liquid crystalline state. Even when the
      molecular volumes are similar, the saturated component can solidify in regions
      where it is relatively abundant, because of the incompatibility of two crystal
      structures with greatly different layer structures.

PMID- 2223860
TI  - Rates of lipogenesis and plasma insulin concentrations in inbred lines of mice
      differing in fatness.
AB  - Rates of lipogenesis de novo and plasma concentrations of insulin were compared
      during post-natal growth in two inbred lines of mice (VL/fDk (VL) and SWR/fNIMR
      (SWR] in which differences in growth and fatness are probably due to multiple not
      single gene effects. Irrespective of sex, the lipogenic rate/g was higher in the
      fatter VL mice in the liver and all other tissues except the head, where it was
      lower, and the gonadal fat pad, where it was not different. Adult mice in general
      had lower lipogenic rates than those measured soon after weaning. In both lines
      the lipogenic rate/g of tissue was higher in males in the liver and in females in
      the gonadal fat pad. Plasma insulin concentrations were higher in VL mice and
      tended to rise with age. These results demonstrate that metabolic differences
      associated with differences in fatness in inbred lines of mice in which fatness
      is controlled by more than one gene, are qualitatively but not quantitatively
      similar to those observed by other workers in lines of mice differing in fatness
      due to a single gene mutation.

PMID- 2223861
TI  - Lipid peroxidation in rat liver microsomes. II. Response of hydroperoxide
      formation to iron concentration.
AB  - When rat liver microsomes were incubated with NADPH, the major products were
      hydroperoxides which increased with time indicating that endogenous iron content
      is able to promote lipid peroxidation. The addition of either 5 microM Fe2+ or
      Fe3+ ions strongly enhanced the hydroperoxide formation rate. However, due to the
      hydroperoxide breakdown, hydroperoxide concentration decreased with time in this
      case. Higher ferrous or ferric iron concentration did not change the situation
      much, in that both hydroperoxide breakdown and formation were similar to those
      when NADPH only was present in the incubation medium. After lipid peroxidation,
      analysis of fatty acids indicated that the highest amount of peroxidized PUFA
      occurred in the presence of 5 microM of either Fe2+ or Fe3+. This analysis also
      showed that after 8 min incubation with low iron concentration, PUFA depletion
      was about 77% of that observed after 20 min, whereas without any iron addition or
      in the presence of 30 microM of either Fe3+, PUFA decrease was only about 37% of
      that observed after 20 min. As far as the optimum Fe2+/Fe3+ ratio required to
      promote the initiation of microsomal lipid peroxidation in rat liver is
      concerned, the highest hydroperoxide formation was observed with a ratio ranging
      from 0.5 to 2. These results indicate that microsomal lipid peroxidation induced
      by endogenous iron is speeded up by the addition of low concentrations of either
      Fe2+ or Fe3+ ions, probably because free radicals generated by hydroperoxide
      breakdown catalyze the propagation process. In experimental conditions
      unfavourable to hydroperoxide breakdown the principal process is that of the
      initiation of lipid peroxidation.

PMID- 2223862
TI  - Low fatty acid elongation rate in the presence of NADH in the liver endoplasmic
      reticulum. Overinhibition by BSA at the beta-ketoreductase level.
AB  - The rate of NADH-dependent palmitoyl-CoA elongation was only 41% of that of NADH
      dependent elongation in microsomes from rats fed a fat-free diet, in the absence
      of BSA. This value was markedly lowered to 5%, when the assay was performed in
      the presence of BSA. The determination of the intermediate products showed that
      93% of the total products accumulated as beta-ketostearate in the presence of BSA
      and NADH, whereas the accumulated beta-ketostearate was only 25% of the total
      products in the presence of BSA and NADPH. BSA was shown to be responsible for
      the low rate of NADH-dependent elongation by inhibiting the beta-ketoreductase in
      the presence of NADH and, thereby, inducing beta-ketostearate accumulation. These
      results indicate that NADH is probably not the physiological electron donor to
      the elongation pathway.

PMID- 2223863
TI  - Role of bovine pulmonary surfactant-associated proteins in the surface-active
      property of phospholipid mixtures.
AB  - The surfactant-associated proteins, SP-A, SP-B and SP-C have been isolated from
      bovine pulmonary surfactant. The biophysical roles of SP-B and SP-C in
      reconstituted surfactants, with various phospholipid mixtures subjected to
      different thermal treatments, have been examined using a pulsating bubble
      surfactometer. The phospholipid mixtures were: (A) dipalmitoylphosphatidylcholine
      (DPPC)/egg phosphatidylcholine (PC)/egg phosphatidylglycerol (PG) (6:2:2, w/w);
      (B) DPPC/PG (9:1); and (C) DPPC/PG (7:3). Thermal treatments involved mixing SP-B
      or SP-C, at room temperature, with lipids in chloroform/methanol (9:1, v/v) and
      removing the solvent under N2 by (1) evaporation at room temperature; (2)
      evaporation at 45 degrees C; or (3) incubation at 45 degrees C overnight prior to
      evaporation at 45 degrees C. In all cases, 45 degrees C solvent evaporation was
      the most effective treatment. DPPC/egg PG (7:3) was the most favourable lipid
      composition. With either a static or a pulsating bubble, SP-C promoted a rapid
      decrease in surface tension with little change thereafter. This implies that SP-C
      is effective in enhancing phospholipid adsorption but does not play an important
      role in the removal of non-DPPC lipid from the monolayer. While SP-B was not as
      effective in facilitating phospholipid absorption, samples containing this
      protein could achieve near zero surface tension upon pulsation. A very low
      surface tension could also be attained during the initial pulsation of DPPC/PG
      plus SP-B mixtures which had been allowed to adsorb until equilibrium. This
      observation indicates that SP-B promotes the removal of PG from the monolayer. SP
      A alone had only a slight effect on the surface activity of the DPPC/PG (7:3)
      mixture, and did not accelerate adsorption of samples containing SP-C. However,
      SP-A facilitated phospholipid adsorption and may also enhance the removal of PG
      from monolayers in the presence of SP-B.

PMID- 2223864
TI  - Inhibition of phospholipase A2 by heparin.
AB  - Phospholipase A2 (PLA2) is an important enzyme in the regulation of cell
      behavior. The hydrolysis of phosphatidylcholine in vitro catalyzed by porcine
      pancreatic PLA2 was inhibited by heparin. Other glycosaminoglycans inhibited PLA2
      activity to a significantly lesser extent, with a pattern of inhibition: heparin
      much greater than chondroitin sulfate (CS)-C greater than CS-A greater than CS-B
      greater than keratan sulfate. Hyaluronic acid and heparan sulfate caused no
      inhibition. Heparin's ability to inhibit PLA2 activity did not depend on
      substrate concentration, but did depend on ionic strength, with inhibition
      decreasing with increasing ionic strength. Heparin inhibition also varied with
      pH, being more effective at pH 5-8 than at pH 10. As a consequence, heparin
      induced a shift of the pH optimum of PLA2 from 7 to 8. Histone IIA and protamine
      sulfate, heparin-binding proteins, reversed heparin-induced PLA2 inhibition. The
      concentration of heparin which inhibited PLA2 activity by 50% increased with
      increasing enzyme concentration. Furthermore, PLA2 bound to heparin-Affigel. The
      data indicate that the catalytic potential of PLA2 can be regulated by heparin or
      heparin-like molecules and that inhibition is contingent on the formation of a
      heparin-PLA2 complex.

PMID- 2223865
TI  - Purification and characterization of a phospholipase A2 associated with rabbit
      lung microsomes: some evidence for its mitochondrial origin.
AB  - Phospholipase A2 (EC 3.1.1.4) activity appeared to be unevenly distributed among
      the subcellular fractions of rabbit lung homogenates. The mitochondrial/lysosomal
      fraction, which possessed the highest specific activity, was the second most
      abundant source of enzyme, following the 1000 x g pellet. Crude microsomes, which
      were the poorest source of enzyme, had a specific activity intermediate between
      that of crude mitochondria and of cytosol. Despite these observations, in view of
      the putative role of microsomal phospholipase A2 in remodelling
      phosphatidylcholines for pulmonary surfactant biosynthesis, the purification of
      phospholipase A2 from microsomal membranes was investigated. The activity was
      solubilized from rabbit lung microsomes with 1 M KCl and resolved into two
      distinct peaks by ion-exchange chromatography. The larger peak (95% of the
      recovered activity) was subjected to a combination of hydroxyapatite and gel
      filtration chromatography, resulting in a purification factor in excess of 70,000
      relative to the microsomal membranes. There was no indication for the removal of
      endogenous inhibitor(s) during the purification. Application of the same
      purification protocol to a 1 M KCl extract of lung mitochondria resulted in
      phospholipase A2 profiles in each of the four columns employed that had exactly
      the same elution characteristics as those generated by the microsomal extracts.
      The purified enzyme is specific for the sn-2 ester bond of phosphatidylcholine,
      requires Ca2+ for activity and has an alkaline pH optimum. It is heat-labile and
      susceptible to treatment by p-bromophenacyl bromide and by 2-mercaptoethanol but
      remains unaffected by NaF, diisopropylfluorophosphate and thiol reagents.

PMID- 2223866
TI  - 1,2-Dimethylhydrazine-induced alterations in lipid peroxidation in preneoplastic
      and neoplastic colonic tissues.
AB  - To determine whether alterations in lipid peroxidation existed in the
      preneoplastic and neoplastic colonic tissues of animals treated with the
      procarcinogen 1,2-dimethylhydrazine, rats were injected subcutaneously with this
      agent (20 mg/kg body weight per week) or diluent for 5, 10, 15 and 26 weeks. At
      each of these time periods, animals from both groups were sacrificed, their
      distal colonic mucosa and/or tumors harvested, and examined and compared with
      respect to malondialdehyde and lipofuscin-like pigments levels. Additionally, at
      26 weeks, the fatty acid composition of microsomes prepared from control,
      'uninvolved' and tumor colonic tissues were analyzed and compared. The results of
      these experiments demonstrated that: (1) the levels of these products of lipid
      peroxidation were similar in the distal colons of all animals at 5 and 10 weeks;
      (2) at 15 weeks, however, lipid peroxidation was decreased in the distal colons
      of animals treated with dimethylhydrazine; (3) at 26 weeks, the levels of these
      products of lipid peroxidation remained lower in dimethylhydrazine-treated distal
      'uninvolved' colonic mucosa and was, moreover, markedly decreased in colonic
      tumors; and (4) at this latter time period, differences in the fatty acid
      composition between tumor, 'uninvolved' and control tissues were found. These
      differences, however, did not appear to underlie the changes noted in the lipid
      peroxidation products seen in these tissues. Taken together, these findings
      suggest that alterations in lipid peroxidation may be involved in the colonic
      malignant transformation process in this experimental model.

PMID- 2223868
TI  - The occurrence of soluble and membrane-bound non-specific lipid transfer protein
      (sterol carrier protein 2) in rat tissues.
AB  - The occurrence and subcellular distribution of the non-specific lipid transfer
      protein (nsL-TP; sterol carrier protein 2) in rat tissues was investigated by the
      immunoblotting technique using the affinity purified antibody against rat liver
      nsL-TP. Highest levels of the protein were found in the homogenates of liver,
      lung and adrenals, whereas it could hardly be detected in brain. In other tissues
      (i.e., testis, kidney, heart and intestine) the protein was present at
      intermediate concentrations. Analysis of subcellular fractions obtained by
      differential centrifugation demonstrated that in all tissues except for the
      liver, nsL-TP was predominantly present in the particulate fractions. In the
      particulate fractions of all tissues, an immunoreactive 58 kDa-protein was
      detected. Density centrifugation of a nuclear-free homogenate from liver and
      testis indicated that the 58 kDa-protein did, and nsL-TP did not, cofractionate
      with catalase. This suggests that in these tissues the bulk of nsL-TP is
      extraperoxisomal. Membrane-bound nsL-TP in testis was sensitive to trypsin
      treatment, suggesting that it is exposed to the cytosol. Release of nsL-TP by
      washing the membranes with 0.1 M Na2CO3 (pH 11.5), indicated that nsL-TP is a
      periferal protein. It was shown by chromatofocussing that nsL-TP extracted from
      membrane fractions was more basic than nsL-TP present in the cytosol fraction
      from rat liver (isoelectric point of 8.7).

PMID- 2223867
TI  - Metabolism of fatty acids and their incorporation into phospholipids of the
      mitochondria and endoplasmic reticulum in isolated hepatocytes determined by
      isolation of fluorescence derivatives.
AB  - Isolated hepatocytes were incubated in the presence of [14C]palmitic,
      [14C]linoleic or [14C]linolenic acid and the time-courses of incorporation of
      radioactivity into phosphatidylcholine and phosphatidylethanolamine of microsomes
      and mitochondria were followed. For this purpose a procedure was developed for
      HPLC separation of 9-diazomethylanthracene (ADAM) derivatives of fatty acids.
      When [14C]palmitic acid was used, the major product of elongation and
      desaturation was octadecadienoic acid, which accounted for 35-65% of the total
      radioactivity. Labeled palmitoleic, stearic and oleic acids could also be
      isolated. In fatty acids which do not participate to any large extent in
      deacylation-reacylation reactions, the pattern of incorporation was
      characteristic: a high rate of incorporation into microsomal and a low rate of
      incorporation into mitochondrial phospholipids during the first 40 min, followed
      by a decrease in the former and an increase in mitochondrial labeling. This
      pattern is consistent with the fact that de novo synthesis of these two
      phospholipids occurs in the endoplasmic reticulum in vivo. When cells were
      incubated in the presence of [14C]linoleic acid, 70-90% of the radioactivity
      recovered in phospholipids was in this same form, whereas the remaining label was
      mainly in arachidonic acid and, to some extent, in eicosatrienoic acid. When
      hepatocytes were incubated in the presence of [14C]linolenic acid, 70-85% of the
      radioactivity in isolated phospholipids was associated with linolenic acid. As
      much as 20% of the label was recovered in docosahexanoic acid and 5-10% in
      arachidonic acid. In the case of the two latter labeled substrates the exchange
      reactions seem to dominate over de novo synthesis. For phospholipids synthesized
      de novo the transfer from the endoplasmic reticulum to mitochondria requires
      about 3 h.

PMID- 2223869
TI  - Cholesterol metabolism in dystrophic mice. II. Altered enzyme activities.
AB  - In a previous study we found that free cholesterol (FC) and cholesterol ester
      (CE) concentrations in fast-glycolytic (FG) muscle tissue from dystrophic mice
      are significantly higher than normal. This increase is not due to an increased
      capacity for de novo cholesterol biosynthesis. HMG-CoA reductase (HMGR) (the
      enzyme which catalyzes the rate limiting step) activity is significantly
      decreased in dystrophic muscle compared to normal. This decrease is paralleled by
      an increased capacity for both CE production and hydrolysis, i.e., both Acyl
      CoA:cholesterol acyltransferase (ACAT) activity and the activities of both
      lysosomal and sarcoplasmic cholesterol ester hydrolases (CEH) are greatly
      increased. These enzyme changes in dystrophic FG muscle are similar those
      observed in normal tissues with elevated levels of cholesterol, which suggests
      that such changes are not the cause of the altered cholesterol concentrations but
      are rather the response of the tissue to elevated levels of cholesterol.

PMID- 2223870
TI  - A 31P-NMR study of phosphate transport and compartmentation in Candida utilis.
AB  - The recovery of Candida utilis from phosphate starvation was studied using 31P
      NMR. The phosphate analogue methylphosphonate was found to be a useful indicator
      of cytosol pH. Added orthophosphate was rapidly accumulated by the cells and
      stored mainly In a stable pool of polyphosphate of mean chain-length at least 200
      units. Observed pH changes in the medium and cytosol during uptake of
      orthophosphate and methylphosphonate are consistent with the transport of these
      compounds across the plasma membrane by a proton/phosphate symport. However,
      transport of phosphate across the vacuole membrane occurs by a mechanism for
      which methylphosphonate is not a substrate. In the cytosol pH changes are
      strongly correlated with changes in orthophosphate concentration, however, this
      is not the case in the vacuole.

PMID- 2223871
TI  - Phosphatic metabolites, intracellular pH and free [Mg2+] in single, intact
      porcine carotid artery segments studied by 31P-NMR.
AB  - Superfused porcine carotid artery segments (approximately 7 cm lengths) were
      analyzed by 31P-NMR spectroscopic methods to characterize the 31P spectrum of
      arterial smooth muscle and to determine the influence of passive stretch
      (intraluminal pressurization, 95-100 mmHg) on cellular phosphatic metabolite
      levels, intracellular pH and free magnesium concentration ([Mg2+free]i).
      Equilibrated, single, intact arteries were studied under steady-state, constant
      flow conditions at 37 degrees C. Phosphoethanolamine, phosphocholine, inorganic
      phosphate (Pi), phosphocreatine (PCr) and nucleoside triphosphates (NTP),
      primarily ATP, were the principle metabolites detected in the 31P-NMR spectrum of
      intact arterial smooth muscle. The concentration of these metabolites and
      intracellular pH, as determined from the referenced chemical shift of Pi, were
      unaffected by pressurization. The PCr:Pi ratios determined for nonpressurized
      (flaccid) and pressurized arteries were 1.2 +/- 0.1 and 1.3 +/- 0.3,
      respectively. Intracellular pH averaged 7.02 +/- 0.02 (mean +/- 1 S.D.) for
      flaccid arteries vs. 7.03 +/- 0.05 for pressurized arteries. The upfield chemical
      shift of the beta-ATP peak, which has been described in other types of smooth
      muscle, was also observed in these experiments. Interestingly, pressurization
      significantly shifted the resonance position of this peak, which was interpreted
      to represent a change in [Mg2+free]i. The average [Mg2+free]i of flaccid artery
      preparations was computed to be 0.54 +/- 0.03 x 10(-3) M, as compared to 0.99 +/-
      0.10 x 10(-3) M for pressurized arteries. This change in [Mg2+free]i was evident
      within the first hour following pressurization and persisted thereafter. These
      findings suggest that altering the resting length of vascular smooth muscle
      produces a change in [Mg2+free]i. This shift in free Mg2+ levels may act as a
      metabolic signal triggering a change in vascular smooth muscle metabolism, an
      effect which has been reported to occur in smooth muscle in response to stretch.

PMID- 2223872
TI  - Bilirubin-neural cell interaction: characterization of initial cell surface
      binding leading to toxicity in the neuroblastoma cell line N-115.
AB  - The toxicity of bilirubin to the nervous system might be due to its effect on
      several key enzyme reactions occurring in the intracellular compartment as
      suggested by in vitro studies. The question of how bilirubin, a molecule with
      poor solubility in water and organic solvents, interacts with the plasma membrane
      and reaches intracellular targets is unclear. In an attempt to get some insight
      into this problem, we have measured the uptake of bilirubin from bilirubin
      albumin solutions by the murine neuroblastoma cell line N-115. At a constant
      total concentration of bilirubin, the initial rate, as well as the extent of
      uptake, increases with increasing bilirubin to albumin molar ratio (B/A). The
      binding is reversible, at least partially, as indicated by the ability of albumin
      to extract cell-bound bilirubin. The cellular uptake of bilirubin was found to
      depend also on the concentration of bilirubin, on temperature and on pH. The
      results are not consistent with either a carrier-mediated transport or passive
      diffusion across the plasma membrane. The data, however, seem to fit a multistep
      binding of bilirubin to the plasma membrane proposed for the interaction of
      bilirubin with synaptosomal plasma membrane vesicles, erythrocyte ghosts and
      lipid vesicles. These studies, thus, reveal the complexity of the binding
      interaction at the level of the plasma membrane and leave open the question of
      transport across the membrane.

PMID- 2223873
TI  - Insulin secretagogues induce Ca(2+)-like changes in cytoplasmic Mg2+ in
      pancreatic beta-cells.
AB  - The effects of insulin secretagogues on the cytoplasmic Mg2+ concentration
      ([Mg2+]i) of pancreatic beta-cells were studied in suspensions and in individual
      beta-cells using dual-wavelength fluorometry and the indicator mag-fura-2.
      Average [Mg2+]i was in the 800-900 microM range in a medium containing 3 mM
      glucose. When the sugar concentration was raised to 20 mM, the cells reacted with
      an initial lowering of [Mg2+]i followed by an increase. The sugar apparently also
      stimulated leakage of the Mg2+ indicator. Addition of 100 microM tolbutamide or
      raising the K+ concentration by 25 mM caused relatively rapid increases of
      [Mg2+]i. Methoxyverapamil prevented the [Mg2+]i-increasing actions of glucose, K+
      and tolbutamide. The greatest change in [Mg2+]i was obtained when beta-cells were
      exposed to 100 microM carbachol. In this case there was a more than 10% lowering,
      which was reversed upon removal of the agonist. Measurements of [Mg2+]i are
      important not only for understanding fluctuations of this ion, but may also aid
      to elucidate the mechanisms involved in the regulation of cytoplasmic Ca2+.

PMID- 2223874
TI  - The mammalian dihydrofolate reductase locus.

PMID- 2223876
TI  - The yeast 5S rRNA binding ribosomal protein YL3 is phosphorylated in vivo.
AB  - The 5S rRNA-ribosomal protein YL3 ribonucleoprotein particle was isolated from
      yeast cells labeled with [32P]orthophosphate. The protein moiety was purified and
      found to be radioactive. Labeled phosphoserine was detected after partial
      hydrolysis of the protein. Up to two phosphate residues are sterified per mole of
      YL3 ribosomal protein.

PMID- 2223875
TI  - Evidence for DNA binding activity of numatrin (B23), a cell cycle-regulated
      nuclear matrix protein.
AB  - Stimulation of various cell types with growth factors is associated with a rapid
      induction in the synthesis of a nuclear matrix protein, termed 'numatrin' which
      was shown to be identical to the nucleolar protein B23. The abundance of numatrin
      was shown to be correlated with entry and progression through the S-phase. Thus,
      experiments were undertaken to examine whether numatrin also has DNA binding
      activity. Using whole nuclear extract, we showed that numatrin binds to both
      double-stranded (DS) DNA and to single-stranded (SS) DNA cellulose columns.
      Purified numatrin, which was extracted either under native conditions (in
      oligomeric form) or under urea conditions (in monomeric form), demonstrated
      significant binding to either [3H]DS-DNA or [3H]DS-DNA as shown by nitrocellulose
      filter binding assay. However, numatrin binding to DS-DNA was qualitatively and
      quantitatively different from its binding to SS-DNA. Thus, the binding of
      numatrin was several fold higher to DS-DNA as compared to SS-DNA. The binding to
      DS-DNA was reduced by 77% in the presence of 0.5 M NaCl, while the binding to SS
      DNA was not affected under this condition. Furthermore, treatment of the native
      numatrin under conditions which caused monomerization of the protein resulted in
      a significant enhancement of numatrin binding to SS-DNA but did not affect the
      binding to DS-DNA. Following heparin-Sepharose chromatography purification (under
      native conditions), numatrin at picomole amounts showed significant binding to
      both DS-DNA and SS-DNA. Finally, numatrin was found to copurify with the complex
      of DNA polymerase alpha primase together with other proteins required for SV-40
      in vitro replication activity. These results demonstrate that numatrin has DNA
      binding activity, and imply a possible role for numatrin/B23 in DNA-associated
      processes.

PMID- 2223877
TI  - Genetic engineering, isolation and characterization of a truncated Escherichia
      coli elongation factor Tu comprising domains 2 and 3.
AB  - A deletion mutant of a plasmid born Escherichia coli tufA gene, which codes for a
      truncated elongation factor Tu comprising domains 2 and 3, has been constructed
      by genetic engineering. This gene was overexpressed in E. coli, and a polypeptide
      representing the truncated elongation factor Tu was isolated, purified to near
      homogeneity, crystallized and characterized physico-chemically as well as
      biochemically. Circular dichroism spectroscopy and limited tryptic digestion
      demonstrate that the isolated domain pair 2 and 3 behaves like an independent
      folding unit which adopts a similar secondary and most likely, tertiary,
      structure to that present in the intact elongation factor Tu. However, the
      isolated domain pair 2 and 3 does not interact with aminoacyl-tRNA or the
      antibiotic kirromycin, two ligands which were shown previously by cross-linking
      experiments to be in contact with amino acid residues located in domains 1 and 2,
      and domain 3, respectively. The results suggest that the isolated domain pair 2
      and 3 by itself forms too few contacts with these ligands to form a stable
      complex. Furthermore, the data suggest that domain 1 in intact EF-Tu, in a subtle
      but nevertheless decisive manner, alters the conformation of the other two
      domains in such a way that all three domains cooperatively create a high affinity
      binding site for aminoacyl-tRNA and the antibiotic kirromycin.

PMID- 2223878
TI  - Mammalian drug resistant mutants with multiple gene amplifications: genes
      encoding the M1 component of ribonucleotide reductase, the M2 component of
      ribonucleotide reductase, ornithine decarboxylase, p5-8, the H-subunit of
      ferritin and the L-subunit of ferritin.
AB  - Hydroxyurea was used to select two very highly drug resistant cell lines,
      designated HR-15 and HR-30. Both drug resistant lines contained elevated levels
      of ribonucleotide reductase activity. Northern and Southern blot analysis
      indicated that the two drug resistant lines contained increased levels of mRNA
      for the two components, M1 and M2, of ribonucleotide reductase, and M1 and M2
      gene amplifications. Alterations in M1 and M2 protein levels were also evident in
      Western blot analysis. Further studies of HR-15 and HR-30 cells by Northern and
      Southern blot analysis showed that the drug resistant cell lines had elevated
      levels of ornithine decarboxylase mRNA and p5-8 mRNA, as well as increased
      ornithine decarboxylase and p5-8 gene copy numbers, respectively. Furthermore,
      characterization of HR-15 and HR-30 drug-resistant cell lines revealed increased
      mRNA levels for both H- and L-ferritin. Both cell lines exhibited by Southern
      blot analysis, amplification of the H- and L-ferritin genes. Increases in the
      cellular levels of H- and L-ferritin subunit proteins were also observed in both
      HR-15 and HR-30 cells, by Western blot analysis. This is the first description of
      mutant cell lines containing this complex combination of modified gene
      expressions and gene amplifications. The alterations exhibited by these lines
      confirm and extend present models of hydroxyurea resistance, are in agreement
      with and help substantiate models of ribonucleotide reductase regulation and
      provide interesting links between the expressions of several cellular activities
      important in proliferation.

PMID- 2223879
TI  - Cation-dependent solubilization of rat thymocyte chromatin is closely related to
      decondensation of the nuclei.
AB  - The cation-dependent solubilization of rat thymocyte chromatin has been compared
      with decondensation of the nuclei as a function of sodium phosphate-mediated
      changes in the concentration of Mg2+ and Na+. After digestion of the nuclei with
      DNase I or Micrococcus nuclease for a time just sufficient to permit extraction
      of a maximal amount of chromatin (minimum digestion), solubilization of most of
      the chromatin was found to occur with the same cation dependency as
      decondensation of untreated nuclei, while further digestion changed the ionic
      requirements for solubilization. The cation-dependency of the chromatin
      solubility and of the nuclear decondensation also exhibited the same variations
      with temperature. The chromatin in the nuclei became up to 4-times more sensitive
      to DNase I by decondensation, which also induced a shift in the DNase I cleavage
      mode from a 200 bp to a 100 bp repeat pattern. In contrast, the sensitivity to
      Micrococcus nuclease appeared to be nearly unchanged. These results suggest that
      solubilization of chromatin prepared by a mild endonuclease treatment occurs as a
      direct consequence of structural changes in the chromatin which take place during
      decondensation of the nuclei.

PMID- 2223881
TI  - Unique hairpin structures occurring at the replication origin of phage G4 DNA.
AB  - Recently we reported that a DNA fragment, GCCAAAGC, forms an extraordinarily
      stable hairpin structure with two G-C pairs at the terminus and A-A-A stacked
      structure. The sequence is present at the replication origin of bacteriophage G4
      ssDNA, and so on. Several kinds of possible hairpin structures, corresponding to
      the replication origin of phage G4, were synthesized and their secondary
      structures were examined. It was found that the fragments are able to form
      interconvertible hairpin structures depending on the length of the base-paired
      regions. The hairpin structure consisting of GCGAAAGC was not digested by the
      exonuclease activity of T4 DNA polymerase and it was stable enough to be only
      minimally bound by a single-stranded DNA binding protein.

PMID- 2223880
TI  - Structural organization of the human CaMIII calmodulin gene.
AB  - The complete structural organization of the human calmodulin III gene has been
      determined. This gene specifies the mRNA represented by the previously reported
      cDNA ht6. The gene contains six exons spread over a total of approx. 10 kb of
      DNA. Its exon-intron organization is identical to that of the only known chicken
      calmodulin gene and to that of two of the three characterized rat calmodulin
      genes. As in many other genes encoding Ca2+ binding proteins, intron 1 separates
      the ATG initiation codon from the remainder of the coding region. The major and
      two minor sites of transcription initiation have been determined by primer
      extension and ribonuclease protection assays. The DNA sequence in the promoter
      and 5' untranslated region is extremely GC-rich. No typical TATA and CAAT boxes
      are present upstream of the major transcriptional start site; however, a
      consensus CAAT box sequence is found further upstream and may play a role in
      transcriptional initiation from the minor start sites. Six sequence elements with
      high similarity to monkey SV40-like Sp1-binding regions are present in the
      putative promoter region, two of which contain perfect GGGCGG core sequences. The
      structure of the human calmodulin III gene promoter indicates that this gene
      belongs to a class of 'house-keeping' genes but that its level of expression may
      also be specifically regulated.

PMID- 2223882
TI  - Expression of active human hypoxanthine-guanine phosphoribosyltransferase in
      Escherichia coli and characterisation of the recombinant enzyme.
AB  - A plasmid, pRG1, has been constructed by incorporating the coding sequence of
      human hypoxanthine-guanine phosphoribosyltransferase (HPRT) into the expression
      vector pT7-7. Expression of human HPRT has been achieved in HPRT- Escherichia
      coli cells transformed with pRG1 and pGP1-2, as shown by: (1) exclusive labelling
      with [35S]methionine of a polypeptide with the same mobility as purified human
      HPRT on SDS-PAGE; and (2) measurement of HPRT activity after cell lysis. Although
      the majority of the recombinant HPRT was present in the particulate fraction
      after cell lysis and centrifugation, sufficient HPRT activity was present in the
      supernatant fraction to allow comparison with the HPRT purified from human
      erythrocytes and the activity in human haemolysates and lymphoblast lysates.
      Small differences in electrophoretic mobility on native gels were found between
      HPRT activity from these sources. The Km values of recombinant HPRT for the
      substrates 5-phospho-alpha-D-ribosyl-1-pyrophosphate and guanine were compared
      with those of lymphoblast and erythrocyte HPRT.

PMID- 2223883
TI  - Partial apolipoprotein E-beta-galactosidase fusion protein expressed in
      Escherichia coli retains binding activity to the LDL(B/E) receptor.
AB  - A partial rat apo E-beta-galactosidase fusion protein was produced in Escherichia
      coli Y1089 infected with recombinant lambda GT11 obtained by immunoscreening of a
      rat liver cDNA library with an anti-rat LDL antiserum. Partial cDNA overlapped
      the apo E mRNA sequence coding for apo E binding domain towards the LDL(B/E)
      receptor up to codon for Arg-139. Fusion protein specifically bound to human
      fibroblasts. The high-affinity component exhibited a Kd of 5 x 10(-8) M and 4.1 x
      10(5) sites per cell. Fusion protein binding to fibroblasts was mediated by their
      apo E moiety and not by beta-galactosidase since: (1) specific binding of fusion
      protein was competed out by human LDL; (2) beta-galactosidase did not compete
      with fusion protein binding; and (3) human fibroblasts from a patient with
      familial hypercholesterolemia, deficient in LDL(B/E) receptor, bound fusion
      protein 10-times lower than control fibroblasts. It was demonstrated that partial
      fusion protein retained the functional activity of the native apo E. However,
      compared to full-length native or engineered apo E, fusion protein was able to
      bind fibroblasts without being complexed with phospholipids. Fusion proteins
      might be a useful tool for studying the functional efficiency of the LDL(B/E)
      receptor and for mapping residues and domains involved in the binding process.

PMID- 2223884
TI  - Glutaminyl-tRNA synthetase as a component of the high-molecular weight complex of
      human aminoacyl-tRNA synthetases. An immunological study.
AB  - The human glutaminyl-tRNA synthetase is three times larger than the corresponding
      bacterial and twice as large as the yeast enzyme. It is possible that the
      additional sequences of the human glutaminyl-tRNA synthetase are required for the
      formation of the multienzyme complex which is known to include several of
      aminoacyl-tRNA synthetases in mammalian cells. To address this point we prepared
      antibodies against three regions of the human glutaminyl-tRNA synthetase, namely
      against its enzymatically important core region, and against two sections in its
      large C-terminal extension. In intact multienzyme complexes the core region was
      accessible to specific antibody binding. However, the C-terminal sections became
      available to specific antibody binding only when certain components of the
      multienzyme complex were either absent or degraded. These findings allow first
      conclusions as to the relative position of some components in the mammalian
      aminoacyl-tRNA synthetase complex.

PMID- 2223885
TI  - Islet amyloid polypeptide: structure and upstream sequences of the IAPP gene in
      rat and man.
AB  - Islet amyloid polypeptide (IAPP) or amylin is a pancreatic islet hormone which
      was first found in amyloid in insulinomas and in pancreases of patients with type
      2 diabetes. In rat a similar polypeptide occurs; however, pancreatic amyloid in
      this species has not been described. Here we report the structure of the rat and
      human IAPP gene. Both consist of three exons and two introns which are very
      similar. The upstream sequence of the rat IAPP gene contains a TATA-box, a CCAAT
      sequence and a GT-element, whereas the upstream sequence of the human IAPP gene
      contains a TATA-box and a rat insulin enhancer-like sequence. This suggests that
      the rat and human IAPP gene may be controlled differently at the transcriptional
      level.

PMID- 2223886
TI  - Nucleotide sequence of cDNA and primary structure for hard tail growth hormone.
AB  - Full-length cDNA for hard tail growth hormone (htGH) has been cloned, and the
      nucleotide and deduced amino acid sequences have been analyzed. htGH is composed
      of 188 amino acid residues, and it shows 79, 74, 72, 59, 56, 37, 33 and 30%
      identity of amino acid with yellow tail, tuna, sea bream, flounder, salmon, blue
      shark, bullfrog and human GHs, respectively.

PMID- 2223887
TI  - A novel creatine kinase cDNA whose transcript shows enhanced testicular
      expression.
AB  - A cDNA (TCK1) encoding a creatine kinase (CK) subunit has been isolated from a
      cDNA library prepared from rainbow trout testis poly(A) + RNA. The predicted
      amino acid sequence for this CK subunit showed a novel amino-terminal coding
      region. Northern blot analyses demonstrated preferential expression of this CK
      subunit in testis relative to other CK containing organs. Southern blot analysis
      suggested a single copy number for this CK gene.

PMID- 2223889
TI  - On clinical efficacy: why biofeedback does--and does not--work.
AB  - Questions of clinical efficacy are becoming more prominent in this era of
      diminishing funds for research and clinical care, and new treatment procedures,
      in particular, are being rigorously scrutinized. This presents a challenge for
      the relatively recent field of biofeedback and applied psychophysiology. This
      field has a strong scientific orientation and a rapidly expanding research base,
      which includes many well-controlled clinical outcome studies. The point is
      raised, and illustrated with data from current clinical outcome studies, that it
      is time for a shift in emphasis away from simply piling study upon study and
      toward more thoughtful interpretation of experimental and clinical findings and
      the development of a clearer conceptual framework for biofeedback therapy and
      research.

PMID- 2223888
TI  - Mouse asialoglycoprotein receptor cDNA sequence: conservation of receptor genes
      during mammalian evolution.
AB  - The asialoglycoprotein receptor internalizes galactose-terminated glycoproteins
      into mammalian hepatocytes for degradation in lysosomes. We report the cloning
      and sequencing of one murine asialoglycoprotein receptor cDNA which exhibits
      homology with rat and human receptor forms. Conserved regions may correlate with
      functional domains. The membrane-bound M (mouse) HL polypeptide does not contain
      a cleavable N-terminal signal sequence and is probably anchored to the membrane
      via an internal insertion sequence.

PMID- 2223890
TI  - Biofeedback treatments of essential hypertension.
AB  - Fifteen years of research in the self-regulatory treatment of hypertension by the
      author is summarized. A model relating expectations, task performance, home
      practice, and biochemical variables to the thermal biofeedback treatment of
      hypertension is presented.

PMID- 2223891
TI  - Exercise intervention attenuates emotional distress and natural killer cell
      decrements following notification of positive serologic status for HIV-1.
AB  - The impact of aerobic exercise training as a buffer of the affective distress and
      immune decrements which accompany the notification of HIV-1 antibody status in an
      AIDS risk group was studied. Fifty asymptomatic gay males with a pretraining
      fitness level of average or below (determined by predicted VO2 max) were randomly
      assigned to either an aerobic exercise training program or a no-contact control
      condition. After five weeks of training, at a point 72 hours before serostatus
      notification, psychometric, fitness and immunologic data were collected on all
      subjects. Psychometric and immunologic measures were again collected one-week
      postnotification. Seropositive controls showed significant increases in anxiety
      and depression, as well as decrements in natural killer cell number following
      notification whereas, seropositive exercisers showed no similar changes and in
      fact, resembled both seronegative groups. These findings suggest that concurrent
      changes in some affective and immunologic measures in response to an acute
      stressor might be attenuated by an experimentally manipulated aerobic exercise
      training intervention.

PMID- 2223892
TI  - Effects of paced respiration on anxiety reduction in a clinical population.
AB  - The purpose of this study was to examine the effects of paced respiration on
      autonomic and self-report indices of affect within a clinical population. Thirty
      six alcohol-dependent inpatients scoring high in trait anxiety were randomly
      assigned to either a pacing or attention control group. The paced subjects
      received 10 minutes of slow-breathing training during the first experimental
      session, while control subjects simply counted the pacing tones. In a second
      session, paced subjects were asked to breathe at the same lowered rate (10 cycles
      per minute) on their own, while the remaining subjects were instructed to relax.
      Prior to and following each session, self-ratings of tension level and state
      anxiety were collected. As expected, paced subjects evidenced greater reductions
      in self-rated tension, state anxiety, and skin conductance levels compared to the
      control subjects. It was concluded that respiratory pacing is an easily learned
      self-control strategy and potentially may be a useful therapeutic tool.

PMID- 2223893
TI  - Structural classification of multi-input nonlinear systems.
AB  - We present new structural classification and parameter estimation results that
      are applicable to multi-input nonlinear systems. The mathematical relationships
      between the self- and cross-(Volterra and Wiener) kernels are derived for a basic
      two-input nonlinear structure. These results are then used to develop
      classification methods for more complicated two-input structures. Algorithms for
      estimating the parameters (linear and nonlinear subsystems) of these structures
      are also presented.

PMID- 2223894
TI  - Some conjectures on the design of a rod outer segment.
AB  - Photoreceptor diameter and spacing have been extensively analyzed with respect to
      diffraction, wave-guiding and other phenomena and have been found to be
      consistent with optimal design criteria. Photoreceptor length, on the other hand,
      has received but little attention. It is proposed here that the outer segment
      length of rods is optimal with respect to the competing demands of maximal photon
      absorption and minimal noise. This is borne out by our calculations based on the
      experimental data.

PMID- 2223896
TI  - [Biochemistry of organometallic compounds].
AB  - Recent studies have demonstrated that organometallics can be substrates of
      enzymes and may undergo biotransformations in the presence of microorganisms.
      Latest achievements in organometallic biosynthesis, applications of
      organometallics in biosensor systems and the properties and models of novel
      enzymes which attack the core of organometallic compounds, i.e., the metal-carbon
      bond, are discussed.

PMID- 2223895
TI  - Postural maintenance during movement: simulations of a two joint model.
AB  - Voluntary movements of the upper body are accompanied by anticipatory postural
      adjustments to the lower body in a standing subject. The long-standing hypothesis
      is that these anticipatory adjustments serve to counteract the perturbation to
      the body's center of gravity caused by the voluntary arm movement. This paper
      presents model simulations investigating the possible roles of anticipatory
      postural activity that accompanies a rapid, upward arm swing. The model
      incorporates two (idealized) antagonistic muscle pairs controlling the movements
      of a double-joint system, with a "shoulder joint" between the arm and stiff body
      links, and an "ankle joint" between the stiff body-leg segment and the ground.
      Each muscle is represented by a nonlinear viscoelastic element and also includes
      proprioceptive feedback. Four inputs to the model define the motor control
      signals for muscle force generation in both the arm and the postural muscle
      pairs. The neurological component of the model describes consequences of
      alternate strategies for cocontractions, stretch reflex activity, and
      anticipatory and synchronous postural activities (or combinations thereof).
      Simulations with this model show that: (1) none of the postural maintenance
      schemes considered in these simulations (including varying anticipation) could
      suppress the initial backward thrust on the body link; (2) the more important
      destabilizing perturbation is a subsequent forward sway that, left uncountered by
      postural activity, would eventually leave the body to fall flat on its face; and
      (3) anticipatory silencing of the postural extensor followed by a brief period of
      extensor activation (descending control) and synchronous reflex activity
      (feedback control) appears to be the most likely postural stabilizing strategy
      that inhibits the continuous forward sway and is consistent with the experimental
      evidence.

PMID- 2223897
TI  - [The role of hydroxyl groups of tyrosine residues in RNA-ligase].
AB  - The stability of the AMP-RNA-ligase complex was studied. The complex was found to
      be stable for at least two weeks upon storage at 0 degrees. Approximately 50% of
      the initial radioactivity was retained after storage at 9 degrees for 49 days.
      The formation of adenosine in the complex decomposition products suggested the
      possible involvement of the tyrosine hydroxyl group in the formation of AMP-RNA
      ligase complexes. In order to study the structure of the enzyme active site, the
      hydroxyl groups of the RNA-ligase tyrosine residues were modified with N-acetyl
      imidazole. It was found that four out of 25 tyrosine residues are exceptionally
      susceptible to chemical modification with resultant complete suppression of the
      enzyme ability to form a complex with ATP. The kinetic parameters (Km, V) of
      native and modified RNA-ligase were determined and compared. A hypothetical
      scheme of the tyrosine hydroxyl group participation in RNA-ligase-catalyzed
      reactions is proposed.

PMID- 2223898
TI  - [Diazepam metabolism by multiple forms of cytochrome P-450 in rat liver
      microsomes].
AB  - The synthesis of pharmacologically active diazepam metabolites (oxazepam, 4
      hydroxydiazepam, N-demethyldiazepam) in liver microsomes of intact and
      phenobarbital-, 3-methylcholanthrene- and dexamethasone-induced male and female
      Wistar rats as well as in a reconstituted system with isolated forms of
      cytochrome P-450 (P-450a, P-450b, P-450c, P-450d and P-450k according to the Ryan
      nomenclature) was studied. Marked sex-dependent differences in the rates of
      diazepam metabolism in liver microsomes of intact and induced animals were
      revealed. The changes in the spectrum of diazepam metabolites in liver microsomes
      of induced rats (as compared to control animals) were revealed. In a
      reconstituted system only phenobarbital-induced cytochromes P-450b and P-450k
      were found to be active participants of diazepam N-demethylation; none of the
      isoenzymes tested were shown to be involved in diazepam hydroxylation.

PMID- 2223899
TI  - [The effect of calmodulin inhibitors and the new cardiotonic drug DPI 201-106 on
      the formation of interprotein bonds in the cardiac troponin complex].
AB  - Using the binding of labeled [125I]troponin C (TnC) to troponin I (TnI) and
      troponin (TnT) immobilized on a polyvinylchloride matrix, the Ca-dependent
      formation of interprotein bonds in the cardiac troponin complex and the effects
      of various drugs on the above reaction were studied. It has been found that in
      the absence of Ca2+ the dissociation constant, Kd, for the TnC-TnI complex in
      equal to (2.5 +/- 1.03).10(-7) M. In the presence of Ca2+ the number of binding
      sites increases twofold; the Kd value for the bonds formed thereby is (1.74 +/-
      0.18).10(-7) M. The complex is stable to the effect of 5 M urea. TnC binding to
      immobilized TnT is nonspecific and is completely abolished by an addition of 5 M
      urea. DPI 201-106 used at concentrations up to 10(-3) M does not affect the Ca
      dependent binding of TnC to TnI; trifluoperazine inhibits this interaction by
      60%, whereas substance 48/80 inhibits the reaction by 50% when used at a
      concentration of 210 micrograms/ml. It is supposed that the compounds interacting
      with TnC affect, primarily, the cation-binding properties of troponin. These
      compounds can also inhibit the formation of interprotein bonds but only when used
      at much higher concentrations.

PMID- 2223900
TI  - [Isolation of low molecular weight cytoplasmic regulators from the rat liver
      inducing the electrophoretic transport of K+ ions and phosphate across the inner
      mitochondrial membrane].
AB  - A water-soluble thermostable factor from rat liver cytoplasm whose activity
      decreases during starvation, causes the uncoupling of oxidative phosphorylation
      and stimulates pyruvate oxidation in rat liver mitochondria. The activity of this
      factor is insensitive to pronase treatment. Gel filtration and ion-exchange
      chromatography resulted in three low molecular weight water-soluble fractions
      which bear a negative charge at alkaline values of pH and induce electrophoretic
      transport of K+ and phosphate across the inner mitochondrial membrane. The effect
      of this factor on K+ transport is manifested at pH less than or equal to 7.0,
      that on phosphate transport-at pH 6.5-7.6.

PMID- 2223901
TI  - [DNA-bound lipids from eukaryotic (loach spermatozoa, pigeon erythrocytes) and
      prokaryotic (E. coli B, phage T2) cells].
AB  - Using thin-layer chromatography, some specific DNA-bound neutral lipids and
      phospholipids of loach spermatozoa, pigeon erythrocytes, E. coli B and phage T2
      cells were studied. These lipids are represented by loosely and firmly bound
      components. The content of neutral lipids in the above DNAs (per mg of DNA) is
      10.6, 4.8, 7.81 and 1.43 micrograms, respectively; that of phospholipids is 4.31,
      1.28, 1.14 and 0.54 micrograms, respectively. The eucaryotic DNA-bound lipids are
      highly deficient of free cholesterol, phosphatidylcholine, phosphatidylinositol
      and phosphatidylserine but are rich in cardiolipin, phosphatidylethanolamine,
      cholesterol esters, diglycerides and free fatty acids. The quantitative and
      qualitative composition of DNA-bound lipids of loach spermatozoa changes during
      the transition from the superhelical to the relaxed conformation of DNA.
      Procaryotic DNA-bound neutral lipids are also represented by the free
      cholesterol, diglyceride and free fatty acid fractions, whereas the DNA-bound
      phospholipids of procaryotes consist of only two fractions, i.e., cardiolipin and
      phosphatidylethanolamine. The role of DNA-bound lipids in the structural and
      functional organization of eucaryotic and procaryotic genomes is discussed.

PMID- 2223902
TI  - [The effect of translation inhibitor cycloheximide on expression of mammalian
      genes].
AB  - The data concerning the cycloheximide influence on individual mRNA content,
      transcription rate and chromatin structure in mammalian cells are reviewed. The
      putative mechanism of cycloheximide effect is explained as being due to the
      existence of short-living regulatory proteins. It is concluded that cycloheximide
      is a helpful tool in the study of regulation of gene expression in mammalian
      cells.

PMID- 2223903
TI  - [Various physico-chemical and kinetic properties of metalloproteinase from
      bacteriolytic lysoamidase preparation].
AB  - The amino acid composition of metalloproteinase was determined. It was shown that
      the enzyme is made up of four cysteinyl residues which makes it distinct from
      other known neutral metalloproteinases from Bacillus brevis, Bacillus subtilis
      and thermolysine that are devoid of cysteinyl residues. The inhibiting effect of
      amino acids and some di- and tripeptides on the metalloproteinase activity was
      studied. The pH-dependence of the Michaelis constant (pKm0) of native and
      diethylpyrocarbonate-modified metalloproteinase (pKm) suggests that the enzyme
      active center contains two imidazole groups of histidine with pK alpha 1 = 6.75
      +/- 0.1 and pK alpha 2 = 5.4 +/- 0.1. The experimental results are compared to
      those obtained with other microbial metalloproteinases.

PMID- 2223904
TI  - [Caldesmon and myosin subfragment-1 act differently on the structural state of
      1,5-IAEDANS-modified tropomyosin in ghost muscle fibers].
AB  - The effect of caldesmon (CD) and subfragment 1 of myosin (S1) on the structural
      state of tropomyosin (TM) modified with N-(iodoacetyl)-N-(1-naphthyl-5-sulfo)
      ethylene-diamine (1.5-IAEDANS) in single myosin-free skeletal muscle fibers was
      studied using polarized microfluorimetry. S1 was performed from skeletal muscles
      of rabbits, whereas CD and TM were prepared from the smooth muscle of chicken
      gizzards. An analysis of experimental data revealed that CD initiates and
      increases the motility of 1.5-IAEDANS-TM, while S1 decreases it. In the presence
      of CD S1 binding to actin is accompanied by significant changes in the
      fluorescent label motility. It is supposed that CD and S1 induce in TM
      conformational changes which interfere with the protein interaction with F-actin.

PMID- 2223906
TI  - [A method for producing peptide maps of picomolar quantities of protein labelled
      with the Bolton-Hunter reagent in polyacrylamide gel].
AB  - A method of radioiodination to high specific activity by Bolton Hunter reagent of
      fixed and stained histones in polyacrylamide gel is described. The comparative
      peptide maps of the histones H1 and H3, labelled in solution and the gel are
      presented.

PMID- 2223905
TI  - [The mechanism of photodamage of eye structures. IV. Changes in the reactivity of
      crystalline SH-groups during UV irradiation].
AB  - The kinetics of individual crystalline SH-group modification by DTNB were
      studied. According to the rates of their interaction with the modifier, the thiol
      groups in the native protein molecule can be classified as free, accessible,
      weakly modified and "masked" ones. Denaturation by the detergent (CTAB) caused an
      increase in the SH-group modification rate. In this case the SH-groups were
      modified as free and accessible ones. Illumination with UV-light resulted in a
      decrease in the number of SH-groups, opening of "masked" SH-groups in almost all
      crystallines except for alpha-crystalline, and essential changes in the SH-group
      modification rate.

PMID- 2223907
TI  - [The effect of acute alcoholic intoxication on the morphofunctional properties of
      the peripheral blood erythrocytes].
AB  - In experiments on rabbits it has been established that the acute alcoholization
      causes prolonged uncompensated alterations of such physical and chemical
      properties of erythrocytes as the average volume, the concentration of dry
      substance and water, the density, the content of endoerythrocytal hemoglobin, as
      well as the concentration of erythrocytes and hemoglobin in blood.

PMID- 2223908
TI  - [The evaluation of the age-related characteristics of the structural status of
      the plasma membrane lipid phase in rat fatty tissue by using the method of
      inductive-resonance energy transfer].
AB  - Using the method of inductance-resonance energy transfer from tryptophanyl
      residues to fluorescent pyrene probe the structural state of plasmatic membranes
      from adipose tissue of different age rats has been studied. The structural
      heterogeneity of membrane lipid phase has been revealed. The differences in
      physical properties of annular and bilayer lipids don't depend on age. During
      aging the membrane lipid viscosity including lipids of near protein area
      decreases, the conformation of membrane protein components alters during aging as
      well. The data on various effectiveness of energy transfer from tryptophanyls to
      pyrene probe in young and aged animals with stable polypeptide composition of
      membrane proteins indicates that. The structure of membrane lipid phase is
      suggested to be the main factor affecting the conformational state and functional
      activity of membrane-bound proteins during aging.

PMID- 2223909
TI  - [The microbiological transformation and degradation of pyridine and alkyl
      pyridines].
AB  - The scientific literary data on the microbiological transformation and
      degradation of pyridine, methylpyridines (picolines), dimethylpyridines
      (lutidines) and some ethylpyridines are summarized and analysed in this review.
      These highly toxic compounds are on the one hand the raw materials for medicinal
      preparation production with microorganisms, on the other hand they are industrial
      wastes polluting the environment which may be degraded microbiologically.

PMID- 2223910
TI  - Neonatal and adult patterns of lectin binding to rat small intestinal microvillus
      membranes.
AB  - To investigate postnatal developmental changes of rat small intestinal
      microvillus membrane (MVM) sugar components, binding studies were done using
      peanut agglutinin (PNA) and soybean agglutinin (SBA). MVM were prepared from rats
      of different ages (new-borns to 12 weeks). The Airfuge method was used for
      separation of unbound material. Characteristics of sugar ligand specificity were
      different for PNA and SBA, although D(+)galactose was used as an inhibitor for
      both lectins. Concentration curves and Scatchard plots showed partial saturation
      of total binding, and at least two groups of MVM ligands. Differences in lectin
      binding between newborn and adult MVM were opposite for PNA and SBA (newborns
      bound more PNA, but less SBA). During the first few postnatal weeks in rats, SBA
      binding changed early, and PNA binding exhibited an intermediate change, not
      related to weaning. Changes in MVM glycoproteins shown by lectin binding appear
      to be part of a complex postnatal maturational process in rats, involving
      different biochemical, functional, and biophysical membrane characteristics.

PMID- 2223911
TI  - Lactate movements in the term human placenta in situ.
AB  - Movements of lactate through the human placenta in situ were derived from
      maternal and fetal blood sampling performed under conditions that approximate as
      closely as possible the normal fetal metabolic state. It is reported that, at the
      end of pregnancy, the human fetus produces lactate which is transferred to the
      placenta. The actuality of this lactate transfer coupled with proton transfer is
      discussed taking into account the results of multiple linear regression analysis
      determined between the umbilical arterio-venous lactate differences and fetal and
      maternal lactate and proton concentrations. It is finally assumed that this
      lactate is partly metabolized in the placenta, the remaining part being
      transferred from the placenta to the mother.

PMID- 2223912
TI  - Implantation and in vivo antagonistic effects of antibiotic-susceptible
      Escherichia coli strains administered to premature newborns.
AB  - Two antibiotic-susceptible and non-pathogenic Escherichia coli strains were
      administered to hospitalized premature infants in order to protect them from
      intestinal colonization by hospital-acquired antibiotic-resistant enteric
      organisms (EOs). Three groups of 16 premature newborns received respectively
      strain ECA, strain EMO and both strains simultaneously. A fourth group was used
      as a control. Resistant EOs became spontaneously established in the digestive
      tract of a majority of the unadministered children. Both ECA and EMO were able to
      colonize the digestive tract of a majority of the subjects, and reached high
      population numbers (greater than 10(7)/g) in the faeces. Both strains appeared as
      able to reduce significantly the establishment of antibiotic-resistant EOs. This
      effect was more prominent with EMO, which also impaired the implantation of ECA
      when both strains had been administered simultaneously. The use of such innocuous
      microorganisms could thus constitute an additional means of preventing nosocomial
      infections of intestinal origin.

PMID- 2223913
TI  - Dependency of Doppler parameters in the anterior cerebral artery on behavioural
      states in preterm and term neonates.
AB  - To investigate changes of intracerebral blood flow velocity correlated to
      different behavioural states, pulsed Doppler measurements were performed on
      anterior cerebral artery in 12 preterm and term neonates under polygraphic
      recordings and in view of the infants' behavioural state. Under very strict
      definition of the behavioural states there were significant differences in the
      parameters Vm (+25%), Vd (+75%), and Vs (+11%) in active compared to quiet sleep
      state. MABP was not significantly different in all examined behavioural states.
      From our results we conclude that in further Doppler studies the infants'
      behavioural state at the time of measurement should be assessed carefully.

PMID- 2223914
TI  - Effects of adenosine and its analogues on isolated internal carotid arteries from
      newborn and adult pigs.
AB  - Vasorelaxant effects of adenosine and its analogues, 5'-N-(ethylcarboxamide)
      adenosine (NECA), N6-(l-phenylisopropyl)-adenosine (l-PIA) and N6
      cyclohexyladenosine (CHA), on isolated internal carotid arteries from newborn (1
      3 days) and adult (6 months) pigs were compared. The order of vasorelaxant
      potencies of adenosines was: NECA greater than l-PIA greater than adenosine
      greater than CHA for the adult arteries and NECA greater than l-PIA greater than
      adenosine = CHA for the newborn arteries. Sensitivities of vessels from the
      newborn and mature animals to CHA and l-PIA did not differ. However, carotid
      arteries from the newborn pigs were less sensitive to NECA and adenosine than the
      adult arteries (p less than 0.05). Theophylline caused an approximately 3-fold
      shift to the right of the relaxant concentration-response curves to all the four
      adenosines on arteries from pigs of both age groups. These data suggest that
      adenosine is not as effective a vasodilator in the newborn as it is in the adult.

PMID- 2223915
TI  - Effect of a popular Chinese herb on neonatal bilirubin protein binding.
AB  - A study on the effects of a popular Chinese herb commonly given to newborn
      infants was undertaken. 'Chuen-Lin', Coptis chinensus/japonicum, which is
      consumed by 28-51% of Chinese infants, was found to have a significant effect in
      displacing bilirubin from its serum protein binding as assessed by the peroxidase
      oxidation method. Taking this herbal tea may thus increase the risk of brain
      damage by free bilirubin in jaundiced infants. As neonatal hyperbilirubinaemia is
      highly prevalent among Southern Chinese, the use of Chuen-Lin in the perinatal
      period must be strongly discouraged.

PMID- 2223916
TI  - The side effects of lithium.

PMID- 2223917
TI  - Autoantibodies against brain septal region antigens specific to unmedicated
      schizophrenia?
AB  - Health et al. (1989) reported that serum from 96% of unmedicated schizophrenic
      patients contained IgG autoantibodies specific for the septal region of rhesus
      monkey brain, compared with 0% of nonschizophrenic control subjects and 6% of
      schizophrenic patients who were on neuroleptic medication. Using the same
      technique of crossed immunoelectrophoresis, we have tried to replicate this
      finding. In contrast to the original report, we observed "positive" precipitin
      arcs with IgG concentrates from all 14 serum samples tested. The failure of
      immunoelectrophoretic methods to provide convincing evidence of pathogenic
      autoantibodies in schizophrenia in no way detracts from the hypothesis that
      autoimmune processes are involved in some forms of schizophrenia. Such methods
      have not proved useful in established autoimmune diseases such as Graves' disease
      and myasthenia gravis in which the pathogenic autoantibodies against cell-surface
      receptors can only be detected by assays which measure functional interactions
      with such receptors.

PMID- 2223918
TI  - Computerized EEG in schizophrenic patients.
AB  - We undertook a study of electroencephalograms (EEGs) in 30 right-handed,
      untreated patients (27.3 +/- 10.0 years; hebephrenic, 16; paranoid, 12; residual,
      2) who fulfilled ICD-9 criteria for schizophrenia and compared them with sex- and
      age-matched controls by using the percentage of power in six EEG frequency bands
      calculated as a fraction of total power. T-statistic significance probability
      mapping (t-SPM) showed that, compared with normal controls, schizophrenics had
      more slow activity (delta, theta, and alpha 1) in the parieto-occipital regions,
      and more fast activity (beta 1) in the occipital regions. In contrast, alpha 2
      activity decreased strikingly in the occipital regions and this decreased
      activity extended over much of the head. These findings were thought to indicate
      both cerebral hypofunction and excitability in acute untreated schizophrenia.

PMID- 2223919
TI  - Increased serum phospholipase A2 activity in schizophrenia: a replication study.
AB  - Phospholipase A2 (PLA2) is a key enzyme in the metabolism of phospholipids.
      Because a disordered phospholipid metabolism has frequently been reported in
      schizophrenia, we investigated the PLA2 activity in serum from 14 drug-free
      paranoid schizophrenic patients, 20 healthy controls, and 8 nonschizophrenic
      psychiatric patients. Schizophrenics showed significantly higher PLA2 activity
      than healthy controls and nonschizophrenic patients. The increment in
      schizophrenics was not due to increased concentration of pancreatic secretory
      PLA2, as concerning pancreatic PLA2 no differences were found among the 3 proband
      groups. The present findings confirm the results of our previous study and
      suggest that increased serum PLA2 activity might reflect an increment in the
      intracellular enzyme activity in schizophrenia. In the brain the activation of
      intracellular PLA2 results in changes in neuronal activity due to alterations in
      receptor sensitivity and in neurotransmitter metabolism. The possibility that
      such PLA2-induced mechanisms are involved in the pathogenesis of schizophrenia
      should be investigated in further experiments.

PMID- 2223920
TI  - Fluoxetine and neuroleptic malignant syndrome.
AB  - The authors present a case report of neuroleptic malignant syndrome (NMS) in a
      patient commencing treatment with fluoxetine alone who had previously been
      treated with several antipsychotic and antidepressant combinations. On reviewing
      the literature on the pathogenesis of NMS, the authors hypothesize a facilitative
      role of the neurotransmitter serotonin (5-HT) in conjunction with central
      dopaminergic blockade in the precipitation of NMS.

PMID- 2223921
TI  - Comparison of urinary-free cortisol in depressed and nondepressed patients with
      malignancy.

PMID- 2223922
TI  - The plasma tetrahydrobiopterin levels in patients with affective disorders.

PMID- 2223923
TI  - The influence of cigarette smoking on haloperidol pharmacokinetics.

PMID- 2223924
TI  - Abnormal plasma catecholamines in hyperkinetic children.

PMID- 2223925
TI  - EPS, NMS, and AIDS.

PMID- 2223926
TI  - Importance of treatment follow-up.

PMID- 2223927
TI  - Getting away with murder.

PMID- 2223928
TI  - Effects of daily oral m-chlorophenylpiperazine in elderly depressed patients.
      Initial experience with a serotonin agonist.
AB  - Six patients (mean age 62.5 +/- 7.6 years) with major depression were treated for
      2 weeks with the serotonin agonist m-chlorophenylpiperazine (m-CPP), 80 mg/day in
      a double-blind, placebo-controlled, crossover-design pilot study. Two patients
      showed clinically significant improvement in depressive symptoms during active
      drug treatment, whereas two others showed modest effects. All patients tolerated
      the drug, with no major side effects and no changes in vital signs or in liver,
      renal, thyroid, or hematological function. Further studies are needed to
      determine the characteristics of the possible antidepressant effects of m-CPP;
      such work may yield greater understanding of the role of serotonin in affective
      and other psychiatric disorders.

PMID- 2223929
TI  - Elevated CSF protein in male patients with depression.
AB  - Elevation of total protein is the most frequent pathologic finding in the
      cerebrospinal fluid (CSF) examination. It occurs in a variety of situations, such
      as inflammation or tumors of the central nervous system (CNS), degenerative
      disorders, and subarachnoid hemorrhage, or as a result of traumatic taps. It has
      also been reported, for unknown reasons, in patients with psychiatric disease. In
      a study of hormone changes in depression, 9 of 24 (38%) patients (13 male, 11
      female) were found to have elevated CSF protein levels (greater than 45 mg/dl),
      whereas no elevations were found in healthy controls (8 male, 9 female). Eight of
      the patients with the elevated CSF protein levels were male (62%) and one was
      female (9%). Depressed patients had significantly higher CSF protein levels (44.7
      +/- 18.0 mg/dl) than controls (31.5 +/- 6.0 mg/dl) (t = 3.32, df = 30.37, p =
      0.002). No relationship was found between CSF protein levels and (1) the use of
      medication (tricyclic antidepressants, lithium carbonate, or monoamine oxidase
      inhibitors) or (2) post-dexamethasone suppression test cortisol levels. Female
      controls, however, tended to have lower protein levels than male controls,
      whereas female patients had significantly lower levels than male patients.
      Protein electrophoresis was performed on 21 of the 41 subjects (13 patients, 8
      controls). Male patients had nonsignificantly higher absolute concentrations of
      CSF albumin and the globulin fractions when compared to male controls. These
      differences in CSF protein do not suggest monoclonal CSF protein production, nor
      are they the result of this elevated peripheral protein.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2223930
TI  - The plasma level of methylphenidate in the single-dose oral methylphenidate test.

PMID- 2223931
TI  - Platelet serotonin uptake in bulimia nervosa.

PMID- 2223932
TI  - The impact of increasing blood glucose on psychological functioning.
AB  - In the first experiment, after taking a drink containing either glucose or a
      placebo, subjects performed a task that involved watching a screen for 25 min,
      during which they had to press a space bar when one of four digits appeared. Over
      the duration of the task the performance of both groups improved, but in those
      taking the glucose drink the improvement occurred significantly earlier. In a
      second experiment subjects for 20 min performed a task requiring hand-eye
      coordination. The taking of a glucose-containing drink was not associated with a
      change in performance. A review of the relevant literature suggested that glucose
      is beneficial when performing tasks demanding little mental capacity.

PMID- 2223933
TI  - Precortical filtering and selective attention: an evoked potential analysis.
AB  - Attention-related changes in the human auditory brainstem response and the short
      latency somatosensory evoked potential (SLSEP) were demonstrated in separate
      experiments. In Experiment 1, ABRs were recorded during conditions in which
      subjects awaited the presentation of either auditory or somatosensory target
      stimuli. In Experiment 2, median nerve SLSEPs were recorded in a similar task
      context. Analyses of ABR and SLSEP component amplitudes and latencies revealed
      that the auditory nerve (wave II) and rostral brainstem (wave V) components of
      the ABR, and the cervical component (N12) of the SLSEP, were facilitated when
      attention was directed toward stimuli that were presented in the same sensory
      modality and receptive field as the EP-eliciting stimuli. These results suggest
      that central mechanisms can modulate the transmission of auditory and
      somatosensory information at an early, precortical stage and that these
      mechanisms play a role in auditory and somatosensory selective attention.

PMID- 2223934
TI  - Reflex modification in the electrodermal system: conceptual and methodological
      issues.
AB  - Reflex modification (RM) is the inhibition or facilitation of a reflex response
      by a stimulus (S1) occurring prior to a reflex-eliciting stimulus (S2). The
      present experiment investigated two issues: (1) whether RM may be confounded by
      orienting generated by changes in the experimental procedure, or habituation
      generated by repeated stimulus presentations; (2) whether the strength of RM is
      influenced by repeated pairing of S1 and S2, that is, classical conditioning. Two
      groups of subjects were given two series of stimulus presentations. Group A
      received first 10 S2-alone presentations, before 10 S1-S2 presentations. Group B
      received the stimuli in reversed order, that is, first 10 S1-S2 presentations,
      and then 10 S2-alone presentations. This design permits a comparison of
      unconfounded with confounded RM, as well as assessment of influences of learning.
      The results showed RM to be influenced by orienting caused by changes in the
      experimental procedure. The strength of RM tended to be gradually reduced as a
      function of the number of S1-S2 pairing, indicating that the orienting response
      to S1 habituated across trials. It is concluded that RM may be useful in the
      objective investigation of more complex cognitive processes.

PMID- 2223935
TI  - Effects of conditioned stimulus pre-exposure on human electrodermal conditioning
      to fear-relevant and fear-irrelevant stimuli.
AB  - The effects of conditioned stimulus (CS) pre-exposure and fear-relevance of the
      CS on human Pavlovian electrodermal conditioning were investigated. A
      differential delayed conditioning paradigm was used with a CS-unconditioned
      stimulus (US; shock) interval of 8 s. In Experiment 1, 64 subjects were
      randomized into four groups, two of which received fear-relevant stimuli and the
      other two fear-irrelevant stimuli. Half of the subjects were pre-exposed to the
      to-be-CSs and the other half to two not-to-be-CSs, with 15 exposure of each
      stimulus. During acquisition, subjects received 8 reinforced and 8 nonreinforced
      CS+ and CS- trials, and during the extinction phase 15 nonreinforced trials of
      each CS. Pre-exposure to the to-be-CSs retarded conditioning for the first and
      second interval anticipatory responses (FIRs and SIRs); that is, a latent
      inhibition effect was demonstrated, although the results for the FIR were
      inconclusive. The expected effects of fear-relevance were not revealed.
      Experiment 2 addressed the question whether the long pre-exposure period
      interfered with the frequently observed "preparedness effect" of higher
      resistance to extinction to fear-relevant stimuli. The design was similar to that
      of Experiment 1, but for half of the subjects the acquisition phase was initiated
      immediately after a short rest period, and for the other half acquisition started
      after an extended rest period, equal to the duration of the pre-exposure phase in
      Experiment 1. Twenty extinction trials of each CS were presented. A reliable
      difference in arousal in terms of spontaneous fluctuations was produced by the
      rest periods, but although differential conditioning was observed, no effect of
      fear-relevance was seen during extinction.

PMID- 2223936
TI  - Behavioral responsiveness in sleeping older adults.
AB  - The control of behavior by stimuli presented during sleep, and related effects on
      sleep and daytime sleepiness, were investigated in 17 older (age = 60-74 years)
      adults. Experimental subjects (N = 8) were trained while awake to terminate tone
      presentations by taking a deep breath. Tones were then presented following sleep
      onset for four consecutive nights with a mean intertone interval of 4 min.
      Control subjects (N = 9) slept in the laboratory but did not receive tones. The
      daytime sleepiness of both groups was assessed by recording latency to sleep
      onset in a morning and afternoon nap test. It was found that the experimental
      subjects responded reliably to the tones. Responding, however, was almost
      invariably accompanied by disruption of sleep and overall sleep structure was
      markedly altered. Surprisingly, the daytime sleepiness of experimental subjects
      was not reliably greater than that of control subjects.

PMID- 2223937
TI  - ERPs during continuous recognition memory for words.
AB  - Event-related brain potentials (ERPs) were recorded from 10 young adults during a
      version of the continuous recognition memory paradigm. Words were presented after
      lags of either 2, 8 or 32 intervening items (equiprobable) following their first
      presentation, and subjects were required on each trial to make a choice: new
      (never presented previously) or old (previously presented) response. To assess
      the effect of probability of new to old items, words were presented in separate
      blocks with ratios of new to old of 2:1 and 1:1. Reaction time increased and
      successful recognition decreased systematically as the lag between first and
      second presentations of an item increased, supporting the distinction between
      primary (immediate memory) and secondary memory for verbal material. However,
      there were no systematic effects of item lag on the ERP components. ERPs to new
      items were characterized by larger N300 and smaller P300 amplitudes (from about
      250 to 700 ms) than those to old items. These amplitude differences between old
      and new ERPs were interpreted as primarily reflecting repetition as opposed to
      semantic priming effects. These old/new effects did not interact with
      probability, suggesting that frequency of occurrence is not a major determinant
      the ERP old/new difference. Old items elicited a late negativity following the
      behavioral response that was interpreted as due to the presence of a "positive
      slow wave," with a frontally oriented distribution to new words that was absent
      in the ERPs to old words. Similarly, subtraction of ERPs elicited by new items
      that were subsequently unrecognized from those subsequently recognized, showed
      that underlying the ERP subsequent "memory effect" was a "frontal positive slow
      wave," dissociable from P300 on the basis of differences in scalp distribution.
      Since positive slow wave has been interpreted as reflecting "further processing,"
      the data suggest that such processing, possibly similar to elaboration (Graf &
      Mandler, 1984), enhanced the probability of subsequent recognition.

PMID- 2223938
TI  - [Laser spectroscopic assessment of induced hyperoxia--an animal experiment in
      lambs].
AB  - The noninvasive determination of biochemical parameters has become an important
      aspect of intensive care medicine. The newly developed monitors for laser
      reflectometry provide the possibility of spectroscopic monitoring. The equipment
      consists of a near-infrared data collection unit and a personal computer. The
      four laser diodes emit light at wavelengths of 775, 805, 845 and 904 nm. By
      analyzing the changes in optical density during laser irradiation of biological
      tissue, information is obtained about the relative changes in the concentration
      of hemoglobin and the blood volume. In animal experiments with ten fetal lambs we
      evaluated the reliability of near infrared laser spectroscopy. Fetal hyperoxia
      was achieved by means of an extracorporeal circuit with interposition of a
      membrane oxygenator (0.8 m2, Scimed). During the induced hyperoxia the laser
      spectroscopic tracings showed a rise in the HbO2 signal with a synchronous
      decrease in the HbR signal. Additionally, the spectroscopic pattern showed a
      characteristic initial rise in the intracerebral blood volume, which stabilized
      after 4 minutes. We found a significant correlation between the intermittently
      measured PO2 values of the arterial blood samples and the laser spectroscopic
      HbO2 and HbR signals (r = 0.87, and r = -0.82, respectively; p less than 0.001).
      Furthermore, hyperoxia was indicated by the laser system with a short lag time.
      We conclude that laser spectroscopy is a reliable method with a high potential
      for clinical routine use in intensive care, as it provides noninvasive continuous
      information at comparatively low costs using portable monitors.

PMID- 2223939
TI  - Broadband method for measuring the ultrasonic absorption spectrum of biological
      tissues.
AB  - An apparatus is described which in the frequency range from about 5 to 500 MHz
      allows the ultrasonic absorption coefficient of biological tissues to be measured
      with 1% accuracy. This apparatus is based on a pulse transmission method in which
      a computer-controlled mode of operation is combined with a RF substitution
      technique. Superheterodyne detection of the transmitted signal, multiple data
      recording and signal averaging result in a high sensitivity of the measuring
      method. The apparatus can be also used to analyze the ultrasonic pulse reflected
      by the sample.

PMID- 2223941
TI  - [Determination of standards for hydroxyapatite as bone substitute].
AB  - Hydroxyapatite ceramic for surgical implants is a material that meets the ASTM F
      1185-88 standard. A standard defines specifications for the manufacturer, in
      particular in the area of quality control. A standard like this provides the
      necessary basis for clinical use, but only the approval of the public health
      department provides a fully adequate basis for broader application.

PMID- 2223942
TI  - [Lectures of the 15th annual meeting of the Austrian Society for Biomedical
      Techniques. Innsbruck, June 7-9, 1990. Proceedings].

PMID- 2223940
TI  - [Error analysis, biological modification factors and variance of peri-ungual
      video-capillary microscopy].
AB  - Error analysis or the evaluation of the precision of microscopic measurements
      must distinguish between technical errors inherent in the measuring system, and
      biological variability. The technical error inherent in the overall system in the
      case of linear measurements is smaller than the lengths to be measured by 1 or 2
      orders of magnitude. Thus, the erythrocyte column lengths can be correctly,
      reproducibly and linearly quantified over the entire measuring range. The
      biological influencing factors can largely be taken into account or excluded by
      suitable standardisation of the measuring process. Despite a considerable
      individual fluctuation in the erythrocyte velocity, there is, on average, no
      significant dependence of the measuring parameter within the daily profile or
      from day to day. Differences in capillary perfusion in the presence of diseases
      associated with microcirculatory disorders or a therapeutic influence on
      erythrocyte velocity can thus be reliably demonstrated.

PMID- 2223943
TI  - [Thin-film electrodes for medical diagnosis].

PMID- 2223944
TI  - [pH-ISFETs--technical recording aspects in relation to clinical use].

PMID- 2223945
TI  - [Regional resolution power of pulsed Doppler ultrasound as a function of signal
      amplitude].

PMID- 2223946
TI  - [Analysis and modeling of backscattering from ultrasound signals for tissue
      characterization].

PMID- 2223947
TI  - [Doppler ultrasound detection of thrombocyte aggregation].

PMID- 2223948
TI  - [Effect of high frequency spin resonance on image production in nuclear magnetic
      resonance tomography].

PMID- 2223949
TI  - [Image communication and image storage in the hospital].

PMID- 2223950
TI  - [Visual aspects of the man-machine interface].

PMID- 2223951
TI  - [Development of new biosensors in blood analysis].

PMID- 2223952
TI  - [Electrochemical glucose sensors with selectively permeable polypyrrole membranes
      for suppressing artifacts].

PMID- 2223953
TI  - [Electrocatalytic glucose sensor for subcutaneous application].

PMID- 2223954
TI  - [A new type of magnetic position sensor].

PMID- 2223955
TI  - [New optoelectronic sensors for measuring pulse].

PMID- 2223956
TI  - [Determination of the force system of fixed orthodontic appliances].

PMID- 2223957
TI  - [Treatment of spinal and supraspinal spasticity by intrathecal administration of
      baclofen using a computer-assisted pump system].

PMID- 2223958
TI  - [24-hour pH measurement in ulcer patients].

PMID- 2223959
TI  - [Development of a modified galvanic probe for treatment of esophageal varices].

PMID- 2223960
TI  - [Implantable neurostimulator with programmable logic].

PMID- 2223961
TI  - [The problem area of biological effects of technical electromagnetic energy
      fields].

PMID- 2223962
TI  - [The class E concept as a principle for efficient transcutaneous signal and power
      transmission].

PMID- 2223963
TI  - [Diaphragm-synchronous functional stimulation of the glottis].

PMID- 2223964
TI  - [Respiration-synchronous bilateral direct electric posticus stimulation in animal
      experiments].

PMID- 2223965
TI  - [Optimizing high frequency data and energy transmission for electrostimulation
      implants].

PMID- 2223966
TI  - [Chronic electrostimulation: effects on the morphology of the nerve].

PMID- 2223967
TI  - [Impulse pattern in the auditory nerve in speech-coded electric stimulation of
      the cochlea].

PMID- 2223968
TI  - [Prototype of an HDO speech processor for the Vienna auditory prosthesis--results
      of a comparative clinical study with a conventional and HDO speech processor in
      patients with the Vienna auditory prosthesis].

PMID- 2223969
TI  - [CAP--a new cochlear implant system for combined analog and pulsatile
      electrostimulation of the auditory nerve].

PMID- 2223970
TI  - [Value of 3-D reconstruction in CT of the shoulder].

PMID- 2223972
TI  - [Use of a personal computer for digital image processing in radiotherapy].

PMID- 2223971
TI  - [Functional disorders of cardiac pacemakers caused by irradiation with a linear
      accelerator and telecobalt equipment].

PMID- 2223973
TI  - [Use of 1H-31P magnetic resonance spectroscopy for evaluating growth of tumors in
      the area of the head].

PMID- 2223974
TI  - [Calculation and graphic presentation of the Kaplan-Meier product moment
      correlation using the personal computer program KAPLGRAPH].

PMID- 2223975
TI  - [Electronic axiography of temporomandibular joint fractures for directing
      physical therapy].

PMID- 2223976
TI  - [Effect of static magnetic fields on biosignal processing in humans].

PMID- 2223977
TI  - [3-dimensional movement analysis as a clinical method of objective assessment of
      lameness in the horse].

PMID- 2223978
TI  - [Concomitant monitoring of glucose-dependent variables].

PMID- 2223979
TI  - [Complex processing of sensor values].

PMID- 2223980
TI  - [Autonomous monitoring with the personal computer-assessment].

PMID- 2223982
TI  - [Development of a medical information and documentation system for surgery].

PMID- 2223981
TI  - [System for documenting and optimizing metabolic control in type I diabetes
      mellitus].

PMID- 2223983
TI  - [Computer-assisted expert evaluation of the motor system].

PMID- 2223984
TI  - [Medical image processing using a personal computer; digital bone density
      measurement with a new non-invasive procedure].

PMID- 2223986
TI  - [The TFS system: a system for testing, fitting and speech processing for the
      Vienna cochlear implants].

PMID- 2223985
TI  - [Use of digital signal processing in medical technique exemplified by audiologic
      measurements].

PMID- 2223987
TI  - [Non-invasive determination of the anaerobic threshold].

PMID- 2223988
TI  - [Use of simple mathematical models in sports medicine performance diagnosis].

PMID- 2223989
TI  - [Eccentric load on leg extensor muscles in exactly defined biomechanical
      conditions].

PMID- 2223990
TI  - [MRT--detection of muscle changes following physical stress].

PMID- 2223991
TI  - [Presentation of a mixed local area network with Apple Macintosh computers, MS
      Dos compatible PC's and/or a Sun workstation].

PMID- 2223992
TI  - [Wheelchair ergometry: technical principles and practical applications].

PMID- 2223993
TI  - [Measuring plasma membrane viscosity on-line using flow cytometry].

PMID- 2223995
TI  - [Digital method for elimination of ECG artefacts in surface EMG].

PMID- 2223994
TI  - [Need assessment for medical technical equipment in health facilities].

PMID- 2223996
TI  - [Current supply for medical equipment with accumulators].

PMID- 2223997
TI  - [Classification of injuries and severity of injuries in collision automobile
      accidents].

PMID- 2223998
TI  - [Monitoring movement in sports medicine using amorphous ferromagnetic sensors].

PMID- 2223999
TI  - [A 2-dimensional model of biological joints].

PMID- 2224000
TI  - [Use of electronic axiography in diagnosis and therapy].

PMID- 2224001
TI  - [Intra-articular pressure measurements of the elbow joint of the dog using a
      personal computer-assisted system].

PMID- 2224002
TI  - [Cervicomotography].

PMID- 2224003
TI  - The properties of deposited metal clusters generated by laser evaporation.
AB  - Metal clusters have been produced using a laser evaporation source. A Nd-YAG
      laser beam focused onto a solid silver rod was used to evaporate the material,
      which was then cooled to form clusters with the help of a pulsed high pressure He
      beam. TOF mass spectra of these clusters reveal a strong occurrence of small and
      medium sized clusters (n less than 100). Clusters were also deposited onto grid
      supported thin layers of carbon-films which were investigated by transmission
      electron microscopy. Very high resolution pictures of these grids were used to
      analyze the size distribution and the structure of the deposited clusters. The
      diffraction pattern caused by crystalline structure of the clusters reveal 3- and
      5-fold symmetries besides the pattern reflecting the fcc bulk structure. This can
      be explained in terms of icosahedron and cuboctahedron type clusters deposited on
      the surface of the carbon layer. There is strong evidence that part of these
      cluster geometries had already been formed before the deposition process. The non
      linear dependence of the cluster size and the cluster density on the generating
      conditions is discussed.

PMID- 2224004
TI  - [Corrosion behavior of antithrombogenic coating of silicon carbide].

PMID- 2224005
TI  - Microfabricated sensors for medical applications.

PMID- 2224006
TI  - [Biomaterial: cartilage--use in oromandibulofacial surgery].

PMID- 2224007
TI  - [Determining vitality parameters of cartilage transplants using magnetic
      resonance spectroscopy].

PMID- 2224008
TI  - [Biocompatible materials in middle ear surgery].

PMID- 2224009
TI  - [A high resolution ECG mapping procedure for examinations during coronary
      dilatation].

PMID- 2224010
TI  - Three dimensional localization of the pathological area in cerebro-vascular
      accidents with multichannel magnetoencephalography.

PMID- 2224011
TI  - [3-D postprocessing in magnetic resonance tomography].

PMID- 2224012
TI  - [A new device for continuous ambulatory 24-h fractionated blood sampling].

PMID- 2224013
TI  - [Endoscopic microsurgery--challenge for the surgeon, biomedical specialist and
      technician].

PMID- 2224014
TI  - [Electrode forms for reducing tumor mass using high frequency current].

PMID- 2224015
TI  - [Expert systems in medicine: attempt at assessing the consequences].

PMID- 2224016
TI  - [Computer simulation of tachycardia in the human heart].

PMID- 2224017
TI  - [Electrostimulation--medicine of the third millenium].

PMID- 2224018
TI  - [Functional rehabilitation using technical aids--a new strategy for medical
      technicians].

PMID- 2224019
TI  - [Sensors in medicine].

PMID- 2224020
TI  - [The importance of microelectronics in implant technology].

PMID- 2224021
TI  - [Technique of movement analysis--current aspects and future prospects].

PMID- 2224023
TI  - [The future development of medical technique--trends and perspectives].

PMID- 2224022
TI  - [New aspects of biomedical technique in sports medicine].

PMID- 2224024
TI  - [Measuring microfluctuations of action potential propagation in heart tissue
      samples].

PMID- 2224025
TI  - [Modeling cardiovascular flow with a technical model].

PMID- 2224026
TI  - [Cardiomyoplasty--technique and initial animal experiment results].

PMID- 2224027
TI  - [Non-invasive continuous monitoring of heart function using miniaturized
      scintillation detectors and attached computer system].

PMID- 2224028
TI  - [Functional heart replacement with the screw-spindle pump--initial results].

PMID- 2224029
TI  - [Effect of a static 0.2 Tesla magnetic field on somatosensory evoked potentials
      and the EEG arousal spectrum in periodic stimulation of the median nerve].

PMID- 2224030
TI  - [Clinical experiences with applications of implantable systems for gait
      correction in patients with hemiparesis].

PMID- 2224031
TI  - Correction of scoliosis by implantable electrical stimulator.
AB  - Intramuscular electrical muscle stimulation has been used to treat spinal
      curvature. Five single-channel implantable stimulators with two alternating
      outputs each output supplying electrical stimuli to one reference (+) and two
      active (-) platinum corkscrew electrodes inserted into the deep paraspinal
      musculature were implanted. Stimulation is applied daily during rest, and
      nightly, during sleep, through implanted electrodes, evoking muscle contractions
      which cause correction of the curvature. Arrest of rapid progression in five
      patients with single primary curve, treated up to almost four years, (44 months)
      was observed in 60%. In one case the implantable system was removed after 10
      months of treatment.

PMID- 2224032
TI  - [The course of mobility with the 6-channel surface stimulation belt in
      rehabilitation of patients with paraplegia].

PMID- 2224033
TI  - [Electrostimulation in neurology--what does direct muscle stimulation contribute
      in flaccid paralysis?].

PMID- 2224034
TI  - [Restorative neurology of central nervous system lesions with supraspinal
      spasticity--results of epidural spinal electrostimulation].

PMID- 2224035
TI  - [Analysis of the ECG in diagnosis of graft rejection following heart
      transplantation].

PMID- 2224037
TI  - [Personal computer use in the medical office exemplified by evaluation of
      echocardiography].

PMID- 2224038
TI  - [Programming language for programming an 8-channel FESE stimulator].

PMID- 2224036
TI  - [Computer simulation of the cardiovascular system in mechanical heart
      assistance].

PMID- 2224039
TI  - Application of computer techniques for the measurement of efficiency of patients
      with disfunction of motorial organs.

PMID- 2224040
TI  - [Microcomputer-assisted 64-channel EEG amplifier (DC-2kHz) with digital filter
      and 16 bit resolution].

PMID- 2224041
TI  - [Simultaneous continuous EEG evoked potential monitoring using a personal
      computer].

PMID- 2224042
TI  - Computer-based sleep monitoring in SIDS-risk infants--preliminary results.
AB  - A computerized, PC-based system is introduced for sleep monitoring in infants.
      The system is capable of digitizing and storing 22 physiological variables over a
      whole-night sleep period. The preprocessed data can be displayed on a single
      page; further processing can be done on the digitally stored data.

PMID- 2224043
TI  - [Microminiaturized multiple temperature sensor for measuring blood flow].

PMID- 2224044
TI  - [Miniaturized pH sensors].

PMID- 2224045
TI  - [Miniaturized electrode for measuring pH of the tooth surface].

PMID- 2224046
TI  - Helix-coil stability constants for the naturally occurring amino acids in water.
      XXIII. Proline parameters from random poly (hydroxybutylglutamine-co-L-proline).
AB  - Water-soluble random copolymers containing L-proline and N5-(4-hydroxybutyl)-L
      glutamine were synthesized by copolymerization of the tripeptides H-L-Glu(OBzl)-L
      Glu(OBzl)-L-Glu(OBzl)-OH and H-L-Glu(OBzl)-L-Pro-L-Glu(OBzl)-OH, using
      benzotriazolyl-N-oxy-tris(dimethylamino)-phosphonium hexafluorophosphate as
      condensing reagent, and subsequent aminolysis of the Bzl ester groups with 4
      amino-1-butanol. These copolymers were found to contain significant amounts of N5
      (4-hydroxybutyl)-D-glutamine, thus requiring the synthesis of a binary copolymer
      containing only D- and L-N5-(4-hydroxybutyl)glutamine residues in order to
      evaluate the possible effects of the D-residues on the conformational properties
      of poly(hydroxybutylglutamine-co-L-proline). The different copolymers were
      fractionated, and their thermally induced helix-coil transition curves were
      obtained in water at neutral pH. When proper corrections were applied for the
      helix-destabilizing properties of N5-(4-hydroxybutyl)-D-glutamine, the Zimm-Bragg
      parameters sigma and s for L-proline could be deduced from the melting curves of
      poly(hydroxybutylglutamine-co-L-proline). The results indicate that L-proline
      acts as a very strong helix breaker over the entire temperature range from 0 to
      60 degrees C.

PMID- 2224047
TI  - Polarized electronic spectra of Z-DNA single crystals.
AB  - Polarized electronic absorption spectra of the (100) face of single crystals of
      the Z-form double helical duplex of d(m5CGUAm5CG) have been obtained from Kramers
      Kronig analysis of reflection data. The c crystallographic axis is parallel to
      the helix axis and shows but weak absorption. The b axis is perpendicular to the
      helix axis and shows a structureless absorption band centered at 270 nm with an
      oscillator strength of 0.26. Calculations of the crystal spectra utilizing
      available transition moment data for the individual chromophores are carried
      through using the oriented gas model (no interbase interactions) and, again,
      employing all base-base interactions (point dipole) in the duplex. The calculated
      hypochromism of the 270 nm band is much less than the experimental value obtained
      from the crystal data. The crystal spectra appear to be representative of Z-form
      double helices of essentially infinite length and not of a collection of twelve
      base duplexes. No evidence for n pi* transitions polarized parallel to the helix
      axis is found.

PMID- 2224049
TI  - Stereochemical behavior of acyclic peptide-cation complexes.
AB  - The role of the beta-turns in the peptide interaction with several cations was
      investigated. In this work we report the solution studies of four linear
      peptides: Z-Aib-Aib-Aib-L-Val-OMe, Boc-D-aIle-L-Ile-D-aIle-L-Ile-OMe, Boc-L-Leu-L
      Leu-L-Leu-L-Leu-OMe, and Boc-L-Phe-D-Phe-L-Phe-D-Phe-OMe. CD and 1H-nmr spectra
      reveal the presence of multiple ion-bonding equilibria. The stoichiometry and
      binding constant of the four peptides in the presence of Ca2+ ions in
      acetonitrile solution has been determined. Variable-temperature nmr spectra in
      the absence and in the presence of a large excess of cation have shown that the
      complexation process is not critically dependent on the conformation of the free
      peptide.

PMID- 2224048
TI  - On the multiple-minima problem in the conformational analysis of polypeptides.
      IV. Application of the electrostatically driven Monte Carlo method to the 20
      residue membrane-bound portion of melittin.
AB  - The conformational space of the membrane-bound portion of melittin has been
      searched using the electrostatically driven Monte Carlo (EDMC) method with the
      ECEPP/2 (empirical conformational energy program for peptides) algorithm. The
      former methodology assumes that a polypeptide or protein molecule is driven
      toward the native structure by the combined action of electrostatic interactions
      and stochastic conformational changes associated with thermal movements. The
      algorithm produces a Monte Carlo search in the conformational hyperspace of the
      polypeptide using electrostatic predictions and a random sampling technique,
      combined with local minimization of the energy function, to locate low-energy
      conformations. As a result of 8 test calculations on the 20-residue membrane
      bound portion of melittin, starting from six arbitrary and two completely random
      conformations, the method was able to locate a very low-energy region of the
      potential with a well-defined structure for the backbone. In all of the cases
      under study, the method found a cluster of similar low-energy conformations that
      agree well with the structure deduced from x-ray diffraction experiments and with
      one computed earlier by the build-up procedure.

PMID- 2224050
TI  - A new mechanism of mechanochemical coupling: stretch-induced increase in carboxyl
      pKa as a diagnostic.

PMID- 2224051
TI  - Phase transitions of concentrated DNA solutions in low concentrations of 1:1
      supporting electrolyte.
AB  - Transitions between isotropic and liquid crystalline phases of concentrated
      solutions of DNA with an average contour length (500 A) near the persistence
      length were examined in 0.01 M supporting 1:1 electrolyte (predominantly NaCl). A
      quantitative phase diagram describing the transitions occurring over a DNA
      concentration range from 100 to 290 mg/mL and temperatures from 20 to 60 degrees
      C was constructed from solid-state 31P-nmr data and examination of the
      morphologies of the mesophases by polarized light microscopy. Three anisotropic
      phases were observed in solutions with DNA concentrations of 160-290 mg/mL: an
      unidentified, weakly birefringent phase termed "precholesteric," a true
      cholesteric phase with pitch approximately 2 microns, and a third, presumably
      more highly ordered phase. Comparison with previous studies showed that the
      critical concentration for anisotropic phase formation and the nature of the
      phases formed by these DNA molecules are not strongly affected by decreasing the
      supporting electrolyte concentration from approximately 0.2 M to 10 mM. There
      are, however, profound effects of decreasing the supporting electrolyte
      concentration on the width of the transition from isotropic to totally
      anisotropic solutions, and the nature of the transitions between phases.
      Decreasing the supporting electrolyte concentration significantly increases the
      concentration range of persistence of the isotrophic phase, and results in the
      formation of triphasic solutions (isotropic and two liquid crystalline phases).
      Values of the critical DNA concentrations for anisotropic phase formation from
      the theory of A. Stroobants et al. [(1986) Macromolecules 19, 2232 to 2238] were
      found to be significantly lower than the observed values for any reasonable
      estimate of the effective radius, probably because of the relatively short
      lengths of DNA fragments examined in the present study. Comparison of the
      experimentally determined DNA concentrations required for anisotropic phase
      formation with the values predicted from Flory's lattice statistics theory, which
      explicitly considers the rod length, permitted estimation of the effective DNA
      radius. The estimated radius was inconsistent with effective radii calculated
      from Poisson-Boltzmann (P-B) theory based on a supporting electrolyte
      concentration of 10 mM, but was in fair agreement with P-B theory assuming that
      Na+ DNA contributes approximately 0.24 Na+ counterions/nucleotide to the
      effective free sodium ion concentration.

PMID- 2224053
TI  - Peptide growth factors and cell cycle control.
AB  - Research on mammalian cell cycle control focuses on the points discussed below.
      Peptide growth factors are multifunctional regulators of growth and
      differentiation that act by autocrine and paracrine mechanisms. Gene
      transcription changes are key steps in the control of the G0 in equilibrium with
      G1----S transition of the cell cycle. Both peptide growth factors and classical
      tropic hormones, are capable of rapidly modulating transcription through the
      induction of genes (fos/jun) that encode nuclear transregulator proteins.

PMID- 2224052
TI  - Crystal structure and solution conformation of S,S'-bis(Boc-Cys-Ala-OMe):
      intramolecular antiparallel beta-sheet conformation of an acyclic cystine
      peptide.
AB  - The conformation of the acyclic biscystine peptide S,S'-bis(Boc-Cys-Ala-OMe) has
      been studied in the solid state by x-ray diffraction, and in solution by 1H- and
      13C-nmr, ir, and CD methods. The peptide molecule has a twofold rotation symmetry
      and adopts an intramolecular antiparallel beta-sheet structure in the solid
      state. The two antiparallel extended strands are stabilized by two hydrogen bonds
      between the Boc CO and Ala NH groups [N...O 2.964 (3) A, O...HN 2.11 (3) A, and
      NH...O angle 162 (3) degrees]. The disulfide bridge has a right-handed
      conformation with the torsion angle C beta SSC beta = 95.8 (2) degrees. In
      solution the presence of a twofold rotation symmetry in the molecule is evident
      from the 1H- and 13C-nmr spectra. 1H-nmr studies, using solvent and temperature
      dependencies of NH chemical shifts, paramagnetic radical induced line broadening,
      and rate of deuterium-hydrogen exchange effects on NH resonances, suggest that
      Ala NH is solvent shielded and intramolecularly hydrogen bonded in CDCl3 and in
      (CD3)2SO. Nuclear Overhauser effects observed between Cys C alpha H and Ala NH
      protons and ir studies provide evidence of the occurrence of antiparallel beta
      sheet structure in these solvents. The CD spectra of the peptide in organic
      solvents are characteristic of those observed for cystine peptides that have been
      shown to adopt antiparallel beta-sheet structures.

PMID- 2224054
TI  - Microexplants of human thymus: how do the thymic epithelial cells react to
      lymphocyte death?
AB  - The early steps which follow the seeding in culture of human thymic tissue
      fragments are characterized by a rapid disappearance of lymphatic cells. Under
      these experimental conditions thymic epithelial cells (TECs) quickly modify their
      reticular arrangement, assuming an "islet" organization similar to those of
      epithelial parenchymatous organs. The cytoplasmic projections of TECs surrounding
      the few surviving thymocytes are lost. Further, the loss of TECs cytoplasmic
      organelles parallels the reduction of thymocytes, leading to an ultrastructural
      picture of "undifferentiated" epithelial cells. These findings favour the
      hypothesis of "one" thymic epithelial cell type, acting as a dynamic unit which
      adapts its cytological organization to microenvironmental conditions. Further,
      these observations contribute towards elucidating the reaction of TECs to a
      selective T-lymphocyte reduction, such as occurs in some human pathological
      conditions.

PMID- 2224055
TI  - Utilization of 2',3'-dideoxyguanosine 5'-triphosphate as an inhibitor and
      substrate for DNA polymerase alpha.
AB  - The activity of DNA polymerase alpha was strongly inhibited by low concentrations
      (less than 1 microM) of 2',3'-dideoxyguanosine 5'-triphosphate (ddGTP) in the
      presence of Mn2+, although the incorporation of [3H]ddGTP into the product DNA
      was not detectable under the same reaction conditions. ddGTP competitively
      inhibited the incorporation of [3H]dGTP into the DNA. The Kis of DNA polymerase
      alpha for ddGTP were as low as 0.035 microM with activated DNA and 0.044 microM
      with (dC)n.(dG)12-18 as respective template.primers. By increasing [3H]ddGTP
      concentration (greater than 1 microM), however, it became an efficient substrate
      for DNA polymerase alpha. Under the assay conditions with activated DNA as the
      template.primer and Mg2+ as the divalent cation, the maximum incorporation rate
      of [3H]ddGTP reached 14.5% when compared to that of the corresponding normal
      substrate [3H]dGTP. These results indicate that the observed inhibition of DNA
      polymerase alpha activity by low concentrations of ddGTP in the presence of Mn2+
      cannot be explained by the incorporation of ddGTP followed by chain termination
      of the growing DNA, and the results also support the previously presented
      hypothesis that the inhibition is caused by competition between the
      dideoxynucleotide inhibitor and its corresponding deoxynucleotide substrate at
      the same enzyme binding site. Thus ddGTP acts as an inhibitor or a substrate for
      DNA polymerase alpha depending on its concentration and the species of divalent
      cation. Some of the kinetic properties of DNA polymerase alpha connected with
      ddGTP are also described.

PMID- 2224056
TI  - The gill lipids of spawning Pacific salmon.
AB  - The gill phospholipids of 2 Pacific salmon species, Oncorhynchus keta and O
      gorbuscha, were composed of 38-43% phosphatidylcholine (PC) and 19-22%
      phosphatidylethanolamine (PE). Ether phosphoglycerides constituted 4-8% of the
      total PC fraction and 37-51% of the PE fraction. No significant changes in gill
      phospholipids were observed between those of pre-spawning fish in sea water and
      those of spawned salmon in the river. Cholesterol, however, was higher in the
      latter (0.59% vs 0.38%).

PMID- 2224057
TI  - Colony promoting activity: differences from interleukin-3 and similarities to
      interleukin-6.
AB  - The supernatant of long-term bone marrow culture contains colony promoting
      activity (CPA) which does not have granulocyte-macrophage colony stimulating
      activity (CSF) but which enhances granulocyte-macrophage (GM) colony formation in
      the presence of CSF. CPA might consist of IL-3 or IL-3-like activity, since CPA
      stimulates proliferation and differentiation of more immature cells to CSF
      responding granulocytes-macrophage progenitors (GM-CFC), and since IL-3 also
      stimulates immature hemopoietic cells to proliferate and differentiate to
      functional blood cells. IL-1 and IL-6 are also known to enhance GM colony
      formation. One or both of these molecules can accordingly be another candidate
      for CPA. In the present study, GM-CSF activity of IL-3 was dependent on the batch
      of serum: it was negative in the presence of fetal calf serum, but positive in
      the presence of horse serum. In contrast, GM-CSF and CPA showed no such
      dependence on the batch of serum. The addition of IL-3 to GM colony assay system
      did not enhance but rather suppressed GM colony formation. The supernatant of
      long-term bone marrow culture which contains substantial levels of CPA did not
      stimulate proliferation of IL-3 dependent DA-1 cells, but facilitated the
      proliferation of IL-6 dependent, MH60.BSF2 cells. No detectable level of IL-1
      activity was found in the supernatant. These results indicate that CPA is
      different from IL-1, IL-3 or GM-CSF, but similar to or the same as IL-6.

PMID- 2224058
TI  - Pathobiology of myelodysplastic syndromes.
AB  - The myelodysplastic/preleukemic syndromes represent unique clinical situations
      since patients with initially mild hemopoietic abnormalities can be singled out
      from those progressing into frank myeloid leukemia. Here we confront data focused
      on the identification of critical cellular, molecular biological, cytogenetic and
      physiological defects leading to leukemic progression. An increasing amount of
      data supports our earlier hypothesis according to which the impairment of an
      endogenous (intracellular) life-cycle suppressor gene-product, or functionally
      related regulatory genes, plays the decisive role in the course of disease
      progression. The identification of systemic as well as clonally transmissible
      defects have clinical importance since in some cases the therapeutic application
      of the appropriate physiological substances may result in long lasting
      hematological remission.

PMID- 2224060
TI  - Randomized controlled study of chemoimmunotherapy with bestatin of acute
      nonlymphocytic leukemia in adults.
AB  - A new immunomodulating agent, bestatin (INN: Ubenimex has low toxicity even after
      long-term oral administration and has significant modifications in immunological
      response. A cooperative randomized controlled study of bestatin immunotherapy in
      combination with remission maintenance chemotherapy for adult acute
      nonlymphocytic leukemia (ANLL) was performed. After induction of complete
      remission, patients were randomized to the bestatin group (30 mg/bw per os (po)
      daily) and the control group. The 101 eligible cases (bestatin: 48, control: 53)
      were analyzed; the bestatin group achieved longer remission than the control
      group and a statistically significant longer survival. Though this prolongation
      of remission was not significant in the bestatin group compared to the control
      group in the 15-49 yr age group, in the 50-65 yr age group it was significantly
      longer. Bestatin is shown to be a clinically useful drug for immunotherapy of
      adult ANLL, since it has prolonged survival and remission especially in elderly
      patients, with few side-effects.

PMID- 2224059
TI  - Hematopoietic and hematologic properties of bestatin in normal and
      cyclophosphamide myelosuppressed mice.
AB  - Bestatin is a potent inhibitor of aminopeptidase, an enzyme found in abundance in
      the membrane of monocytes and macrophages. Following binding of bestatin to cells
      in the histiocytic lineage, the production of colony stimulating activity is
      upregulated (both in vitro and in vivo) with subsequent increases in
      hematopoietic and hematologic parameters. We report that the frequency and
      absolute numbers of CFU-GM as well as entry of CFU-GM into S phase (a measure of
      progenitor cell activity) is upregulated by treatment of animals with bestatin.
      This results in an increase in bone marrow cellularity in cyclophosphamide
      suppressed mice and an increase in the absolute neutrophil count in normal and
      suppressed mice. The therapeutic application of this hematopoietic modulator has
      been demonstrated in combination cyclophosphamide and bestatin therapeutic
      protocols. Because this indication for bestatin has only recently been
      recognized, few clinical studies have been undertaken utilizing appropriate
      surrogates of hematopoietic activity. However, preliminary clinical evidence of
      hematopoietic activity by this non-toxic dipeptide, as reviewed here, suggests
      that this may be an appropriate strategy for the treatment of myelosuppressed
      patients.

PMID- 2224062
TI  - Heparin and atherosclerosis: an investigative report on the treatment of
      atherosclerosis.
AB  - Both animal and clinical evidence of the special role of long-term low-dose
      heparin as a preventative of atherosclerosis is presented. Some of the many
      beneficial effects of heparin aside from its anticoagulant capability are
      mentioned. Concern about hemorrhage and osteoporosis which can occur when taken
      in the usual anticoagulant doses does not apply to long-term administration of
      low-dose heparin. Taken by the intrapulmonary route using an ultrasonic nebulizer
      weekly or fortnightly, heparin is safe and assures patient compliance. Further
      clinical trials are strongly indicated.

PMID- 2224061
TI  - The biological approach to radioimmunoscintigraphy.
AB  - The authors have analysed the theoretical and clinical implications of a
      biological approach to radioimmunoscintigraphy (RIS), a new diagnostic technique
      based on the in vivo reaction between radiolabelled monoclonal antibodies and
      tumor-associated antigens expressed by the neoplastic cells. The assumption is
      that, as in all radioisotopic procedures, the radioimmunoscintigraphic image is
      the expression of differences in concentration (and not in density) between
      adjacent tissues. This "biological premise" is analysed to demonstrate a possible
      role of RIS not only in diagnosis but also in prognosis and therapy. A comparison
      with other imaging procedures and with histopathology, considered as the "gold
      standard" of the present-day morphological approach to diagnosis, is also
      discussed. Finally, biological premises, as well as the initial results and
      prospects regarding the use of high doses of radiolabelled monoclonal antibodies
      for therapeutic purposes are presented.

PMID- 2224063
TI  - Down-regulation of LAK cell-mediated cytotoxicity: cancer and ageing.
AB  - A comparative study was made of the generation of lymphokine-activated killer
      (LAK) cells in patients with melanoma and healthy donors of different age groups.
      Significant reduction of effector cell cytotoxicity in patients following 72 h
      culture with 1,000 U/ml or recombinant IL-2 (rIL-2) as well as a decreased
      ability to generate LAK cells in elderly individuals were shown to be correlated
      with suppressor cell activation in rIL-2 stimulated cell population. Suppressor
      effect depends on monocytes and T-lymphocytes: partial abolition of suppression
      in LAK cells was observed following removal of adherent cells or treatment with
      OKT8 monoclonal antibodies and complement.

PMID- 2224064
TI  - Effects of membrane lipid and fluidity modifications on HIV-1 infectibility of
      primate lymphocytes in vitro.
AB  - Although most non-human primates, except the chimpanzee and the gibbon in vivo
      are not infectible by HIV-1, lymphocytes of several of these species can be
      infected by HIV-1 in vitro. In order to investigate whether the in vitro
      infectibility of primate lymphocytes might be attributed to plasma membrane
      adaptation processes or to serum factors, we compared HIV-1 infectibility of
      cultivated peripheral blood lymphocytes of macaques and of baboons on day one and
      on day ten of cultivation. These data were correlated to plasma membrane lipid
      composition and membrane fluidity. We found a correlation between increased HIV-1
      in vitro infectibility and changes in plasma membrane lipid composition resulting
      in decreased membrane fluidity of cultured primate lymphocytes.

PMID- 2224065
TI  - Protein kinase C and casein kinase II activities in two human colon carcinoma
      cell lines, HT-29 and CaCo-2: possible correlation with differentiation.
AB  - Protein kinase C (PK-C) and casein kinase II (CK-II) activities were studied in
      two human colon carcinoma cell lines (HT-29 and CaCO-2) undergoing
      differentiation in vitro resulting, in small-intestine-like cells. CaCo-2 cells,
      when grown under standard conditions, appear to undergo spontaneous
      differentiation. In these cells PK-C and CK-II activities were determined on day
      5, 10 and 15. No significant differences in activities were seen either in PK-C
      or CK-II activity. HT-29 cells, when grown in glucose-free medium can be
      stimulated to undergo differentiation which is completed within 20 days. PK-C and
      CK-II activities were determined after 5, 10, 15, 20 and 25 days, respectively.
      PK-C activity rose from 7.9 +/- 3.5 pmole 32P/mg protein/min at day 5 to 37.5 +/-
      14.8 pmole 32P/mg protein/min at day 20. After 25 days the activity was reduced
      to 20.0 +/- 7.8 pmole 32P/mg protein/min. CK-II activity did not change
      significantly during day 5 to 20, but on day 25 there was a significant decrease
      in CK-II activity from 94.9 +/- 6.4 pmole 32P/mg protein/min (day 20) to 62.6 +/-
      3.9 pmole 32P/mg protein/min (day 25) p = 0.003. The results in this study
      indicate a role for PK-C and CK-II in cell growth and differentiation.

PMID- 2224066
TI  - Mevalonate-derived proteins in liver regeneration.
AB  - Sixteen hours after partial hepatectomy in the rat, the synthesis of mevalonate
      (MVA) is not committed to produce cholesterol and only partially utilized for
      dolichol formation. In order to investigate the fate of MVA in this replicative
      system, slices of the remaining liver were incubated with 5-3H-MVA. Labeled
      proteins from whole liver and purified nuclei were analyzed after extensive
      delipidation and separation by SDS-PAGE. Many MVA-derived proteins were
      identified at 16 hours, while only two labelled peptides were detectable at 24
      hours. The radioactivity was localized in covalently bound lipid moieties. A
      highly labeled 26 kD peptide was detectable in the nucleus at 16 hours,
      suggesting its involvement in the cell cycle progression.

PMID- 2224067
TI  - Consequences for retinal growth when vision occurs in S2 space.
AB  - We postulate that the process of vision occurs in the S2 space. The retina is
      endowed with the topology of a part of a two-sphere S2, roughly, the topology of
      a hemisphere. There is a corresponding topology on the tectal surface, induced by
      the anatomy of the retino-tectal connections. Our analysis predicts the
      experimentally observed "near-neighbour" relationships between points in the
      visual field and their representation in the tectum. Further, in this context,
      topological arguments are presented to indicate that if the normal developing
      retinal disc in goldfish undergoes a process of deformation, a discontinuity is
      generated at the retinal surface. This discontinuity makes the differential
      patterns of the retinal and tectal tissues more compatible, and also enables the
      retina (which grows throughout the life of the animal) to conveniently connect to
      the tectum.

PMID- 2224068
TI  - Investigation of the conditions for oscillations in two-variable models of
      biological processes.
AB  - A procedure is presented for the direct determination of possible limit cycles
      that might occur in two-coupled differential equations that can arise in the
      modeling of certain biological phenomena. Mathematical expressions are given so
      that for a particular pair of differential equations the possible limit cycles,
      their parameters, and stability properties can be calculated by a purely
      algebraic process. Several examples are used to illustrate the procedure.

PMID- 2224069
TI  - Network study of integrated biochemical switching system. I: Connection of basic
      elements.
AB  - As a first step to network study, a series of integrated biochemical switching
      systems (prototype of artificial neuronic device) was assumed based on Rosen's
      work and on the results of our previous studies. The effects of an excitatory
      stimulus on the switching properties of the proposed system were examined using
      computer simulations. The results can be summarized as follows: (i) the number of
      excited elements in sequentially connected systems is proportionally related to
      the value of the excitatory stimulus; (ii) when the introduction of the
      excitatory stimulus is too late, it can no longer be transmitted to any elements;
      (iii) the excitatory stimulus (signal) is amplified to a certain limit and is
      attenuated during propagation; (iv) by assuming several excitatory stimuli and
      varying their frequencies, the so-called long-term potentiation phenomenon can be
      observed; (v) supposing reversible interactions between two elements, a
      continuous switching pattern of the output is observed.

PMID- 2224070
TI  - Sheathed nuclear division in primary spermatocytes of Orgyia antiqua
      (Lepidoptera, Insecta).
AB  - The restructuring of spermatocytes during the first meiotic division is examined
      in the moth Orgyia antiqua (Lymantriidae, Lepidoptera) using transmission
      electron microscopy. Particular emphasis was placed on the behaviour of the
      perispindle membrane system. These membranes develop from layers of smooth
      endoplasmic reticulum wrapped around the prophase I nucleus and are retained
      until early telophase I. The original nuclear envelope is dissolved in metaphase
      I. Polar fenestrae in the perispindle membrane stacks are filled with numerous
      irregular membrane elements. The formation of new nuclear envelopes around the
      daughter nuclei takes place inside the perispindle membrane system. Finally, the
      membrane stacks rupture concomitantly with spindle elongation in late telophase
      I. Thus, division of primary spermatocytes in Orgyia antiqua has a surprising
      degree of similarity with the so-called closed mitosis. This mode of division is
      typical for many protozoa, algae and fungi. In the pertinent cells, the original
      nuclear envelope persists around the spindle area during nuclear division. In
      order to distinguish the closed mitosis from the situation in Orgyia antiqua
      spermatocytes, the term 'sheathed nuclear division' is suggested for the latter.

PMID- 2224071
TI  - Protein phosphorylation: a motive force for adaptive evolution.
AB  - Spontaneity and diversity are the intrinsic properties of protein
      phosphorylation. They provide living systems with opportunities for polyvariant
      transformation of expressed genetic information and alteration of their energy
      metabolism under change of living conditions. Thus, protein phosphorylation can
      be regarded as a molecular mechanism for adaptation and selection of mutant
      proteins useful for the cell, i.e. a motive force for adaptive evolution.

PMID- 2224073
TI  - Detection of cancer predisposition: laboratory approaches.

PMID- 2224072
TI  - The geometry of evolution.
AB  - Some structures are more suitable for self-organization through the Darwin
      Wallace mechanism of variation and selection than others. Such evolutionary
      adaptability (or evolvability) can itself evolve through variation and selection,
      either by virtue of being associated with reliability and stability or by
      hitchhiking along with the advantageous traits whose appearance it facilitates.
      In order for a structure to evolve there must be a reasonable probability that
      genetic variation carries it from one adaptive peak to another; at the same time
      the structure should not be overly unstable to phenotypic perturbations, as this
      is incompatible with occupying a peak. Organizations that are complex in terms of
      numbers of components and interactions are more likely to meet the peak-climbing
      condition, but less likely to meet the stability condition. Biological structures
      that are characterized by a high degree of component redundancy and multiple weak
      interactions satisfy these conflicting pressures.

PMID- 2224074
TI  - Epidemiologic evidence of genetic susceptibility to cancer.

PMID- 2224075
TI  - Detection of cancer predisposition by hypervariable region analysis.

PMID- 2224076
TI  - The use of comparative mapping to identify loci involved in human carcinogenesis.

PMID- 2224077
TI  - Hereditary polymorphisms of human drug metabolizing enzymes and cancer
      susceptibility.

PMID- 2224078
TI  - Legal and ethical issues in the laboratory assessment of genetic susceptibility
      to cancer.

PMID- 2224079
TI  - Acetylation.
AB  - The human acetylation polymorphism has been known for more than three decades
      since its discovery during the metabolic investigation of the antituberculous
      hydrazine drug, isoniazid. The trait was originally known as the "isoniazid
      acetylation polymorphism" but is now usually abbreviated to the "acetylation
      polymorphism" because the acetylation of numerous hydrazine and arylamine drugs
      and other chemicals are subject to this trait. A. Individuals phenotype as "slow"
      acetylators, homozygous for the slow acetylator gene, or "rapid" acetylators
      either heterozygous or homozygous for the rapid acetylator gene. Differences in
      individual acetylating capacity are ascribed to differences in the activities of
      the arylamine acetylating enzymes (isozymic N-acetyltransferase variants) of the
      liver, intestinal mucosa and certain other tissues. The chromosomal locus of the
      human gene has not been determined, but linkage analysis in mice indicates that
      the N-acetyltransferase gene is closely linked to Esterase-1 on mouse chromosome
      8. RECOMMENDATION: 1) That the chromosomal locus of the human acetylator gene(s)
      be determined. B. The acetylator phenotype is a lifelong, stable characteristic
      of the individual that can be determined by procedures using any of several test
      agents (eg, caffeine, isoniazid, sulfamethazine, sulfapyridine). All suitable
      test agents discriminate rapid and slow acetylator phenotypes, whereas caffeine
      enables homozygous and heterozygous rapid acetylators to be discriminated from
      each other and from slow acetylators. These procedures can be used with
      confidence to determine the acetylator status of healthy adults and children but
      caution is necessary in interpreting this information for infants, in altered
      physiologic states and in the presence of certain diseases and environmental
      substances. RECOMMENDATIONs: 1) That investigators should strongly consider the
      use of the caffeine test for acetylator phenotype determination in human
      epidemiologic studies of acetylation because of its advantages over other test
      agents that are available. 2) That efforts to determine the structure of the
      acetylator genes responsible for the human acetylator polymorphism, and to
      determine the genes responsible for the hereditary acetylator polymorphisms in
      animal models for the human trait be continued apace with efforts on the human
      system. 3) That an improved test to determine the acetylator status utilizing
      that information and current molecular biology approaches and techniques applied
      to tissues that are readily available in human subjects (eg, leukocytes) be
      developed at a high priority. C. The hereditary acetylator status of individuals
      provides valuable information about their therapeutic, pharmacologic and
      toxicologic responses and is a prognosticator of unusual susceptibility to
      toxicity from drugs widely used for the treatment of diverse diseases.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2224080
TI  - Fragile sites, genomic rearrangements and cancer predisposition.

PMID- 2224081
TI  - The chromosome-breakage syndromes: rare disorders that provide models for
      studying somatic mutation.

PMID- 2224082
TI  - [Electric activity of striated muscles of the cervical part of the rabbit
      esophagus under conditions of hunger, food intake and satiation].
AB  - The experiments of free-moving rabbits have shown that the muscles of the
      proximal zone in the esophageal cervical part functions as the superior
      esophageal sphincter. In hunger stage the motor unit activity of the sphincter
      has regular low-amplitude discharge with monomodal distribution of interspike
      intervals. The process of food satisfaction leads to the appearance of burst-like
      unit activity with bimodal distribution of interspike intervals. During the food
      intake reorganization of the motor unit activity of the esophageal cervical part
      is manifested in characteristic patterns of interspike interval distribution.

PMID- 2224083
TI  - [Improvement of the morphometry method and its use in electron microscopic
      studies].
AB  - The paper describes morphometric device for electron microscope. Using this gauge
      one can get morphometric data from the screen of the electron microscope.
      Perspectives of morphometric analysis of ultra-structures in the electron
      microscope are discussed.

PMID- 2224084
TI  - [Structural organization of the adrenal cortex in rats with different types of
      autonomic reactivity under standard conditions and after exposure to different
      altitudes].
AB  - The structural organization of adrenal cortex has been studied in intact rats and
      after short-term hypoxia exposure on different altitudes (2, 6, 8, 11 km).
      Previously rats have been divided into 3 groups by adrenaline test for
      determining of vegetative reactivity type. It has been found that some
      histochemical and morphometric indices of adrenal cortex had peculiarities with
      respect to type of vegetative reactivity (width of zones, their ratio, nuclear
      diameter, ascorbic acid content and its distribution and other) in intact rats.
      Under altitude these differences form individual character of steroidogenesis and
      determine resistance and reactivity of organism.

PMID- 2224085
TI  - [Effects of extracts of different parts of the brain of kindled animals on
      seizure activity of recipient rats].
AB  - The peptide-containing fraction was emitted from the hippocampal and ventral
      mesencephalic region tissue of rats kindled with subconvulsant doses of corazol.
      Extracts were prepared by the help of hot acetic acid on the stage of generalized
      clonic-tonic seizure development. The intraventricular injection of VMR-extracts
      in relatively high dose increased seizure reactions which were induced in intact
      recipient rats by intraperitoneal corazol injection. The intraventricular
      injection of the extract in relatively low dose (100 times less) suppressed
      corazol-induced seizures in recipients. Data are discussed from the point of view
      of pathological epileptic system formation and the role played by peptides in
      supporting it's activity during pharmacological kindling.

PMID- 2224086
TI  - [Impulsive neuron activity of several structures of the brain after
      administration of benzene and its homologues].
AB  - The obtained findings have shown that dominating inter-impulse intervals in the
      area of 1000 and more ms, and multimodality of their distribution occur in
      benzene, toluol, xylol injection within time-structure of some neurons activity
      of sensomotor cortex, hippocampus, thalamus and lateral hypothalamus. The
      particularities of neuronal activity of the studied structures were revealed by
      the injection of chemical substances in natural and artificially produced food
      motivation. The mechanism of neurons activity blockade in benzene and its
      homologous injection was suggested to be linked with their influence upon
      mediator process, and perhaps, peptide factors participating in the formation of
      neuronal activity.

PMID- 2224087
TI  - [Preliminary administration of perfluorocarbon emulsion: a new method of
      myocardial protection against ischemia].
AB  - The study was conducted to determine if myocardium can be protected against
      ischemic and reperfusion damage by means of the preliminarily injected
      perfluorocarbon emulsion. Injection of the emulsion into rabbit 1, 12, 24 h prior
      to ischemia was found to decrease the extent of ischemic and reperfusion damage
      to myocardium. The cardiotropic effect of the injected emulsion is shown to be
      dose- and time dependent.

PMID- 2224088
TI  - [Oxygen consumption in the lungs of dogs with external hemorrhage and after
      reinfusion of blood].
AB  - In experiments on 10 dogs with external blood loss and reinfusion it was
      demonstrated, that in hemorrhagic and posthemorrhagic periods oxygen consumption
      by the organism is determined not only by O2 demands of the large circulation
      tissues, but to a great extent by demands in O2 in the system of lesser
      circulation, what is being evidenced by activation of the metabolic function of
      the lungs. It turned out that in pathogenesis of postinfusion respiratory
      insufficiency reactions of lipid oxidation in the lungs play a significant role.

PMID- 2224089
TI  - [Restriction of functional disorders by the use of a regulatory peptide dalargin
      in burned rats infected with Staphylococcus aureus].

PMID- 2224090
TI  - [Index of microcirculatory changes in experimental dehydration in animals].
AB  - On the basis of morphokinetic synthesis principles the method of determination of
      summarizing criterion of microcirculatory system changes was developed. It
      consists of marked characteristics of changes of a number of the most important
      morphofunctional phenomena of each of this system compartments -- interstitial,
      lymphatic, blood and cellular -- with their successive summation to obtain the
      systemic microcirculation index. The experimental dehydration in rats being a
      model has shown that systemic microcirculatory index was 2 times as large in 3
      days of dehydration, more than 3 times -- in 6 days, and 4, 5 times -- in 12
      days. In the initial stage of the experiments maximal changes were found in
      interstitial compartment of the microcirculatory system. The intermediate period
      of dehydration differed by predominant changes of vascular compartment when the
      lymphatic phenomena were more evident than the hemomicrocirculatory ones. In the
      later stage of dehydration the cellular component changes of tissues and organs
      were predominant.

PMID- 2224091
TI  - [Role of bone marrow glycosaminoglycans in the reaction of the hematopoietic
      tissue to extreme conditions].
AB  - The authors studied medullary glucosaminoglycans of rats and mice in extreme
      effects (hypoxia, hyperbaric oxygenation, inflammation, radiation, cooling,
      hemorrhage). Four types of reaction were determined which cause different changes
      of proliferation of hematopoietic cells. Hematopoiesis stimulation is accompanied
      by regular change of types of reaction of hematopoietic microenvironment. Its
      disturbance affects the changes of hematopoiesis and blood regeneration rate. It
      was shown that the increase of neutral glucosaminoglycans concentrations in bone
      marrow depended on the play ground and proliferative activity of erythroid sprout
      and that of acid glucosaminoglycans--primarily of granulocytic sprout.

PMID- 2224092
TI  - [Angiotensin mechanism of auriculo-acupuncture dental analgesia].
AB  - In unanaesthetized rabbits auriculo-acupuncture electrostimulation with frequency
      of 15 Hz decreased the amplitude of somatosensory EP second component in response
      to the tooth pulp electrostimulation which was blocked by intravenous injection
      of naloxone but not by intraventricular injection of saralasin. The same effect
      of auriculo-acupuncture electrostimulation with frequency 100 Hz was blocked by
      saralasin, was increased by angiotensin II, was diminished by methysergide but
      wasn't changed by naloxone. It's suggested that there is angiotensinergic
      antinociceptive mechanism of dental pain which is activated by auriculo
      acupuncture electrostimulation with frequency 100 Hz.

PMID- 2224093
TI  - [Possibilities of enteral correction of posthemorrhagic disorders depending on
      the absorption function of the small intestine].
AB  - Physiologic and morphologic research on animals in chronic experiment shows that
      depression of small intestine absorption function takes place during the first
      hour after hemorrhage of 30-40 ml/kg for 30-50% of animals and after hemorrhage
      of 50 ml/kg for 100% animals. This excludes except the possibility of efficient
      post-hemorrhage hypovolemia enteral correction without additional treatment.
      Enteral correction appears to be sufficient to preserve animal's life, being
      applied in 30 minutes after the hemorrhage of 30-40 ml/kg or in 90 minutes after
      the hemorrhage of 20 ml/kg.

PMID- 2224094
TI  - [Aggregates of modified low density lipoproteins indicate accumulation of lipids
      in human aortic intima cells in vitro].
AB  - Spontaneous aggregation of glycosylated, desialated, oxidized and malondialdehyde
      modified low density lipoprotein (LDL) as well as LDL of coronary heart disease
      patients has been discovered using methods for determination of light
      transmission fluctuations in suspensions and gel filtration. At the same time;
      LDL of healthy donors failed to aggregate under conditions of cellular culture.
      On the other hand, human aortic cells from unaffected intima incubated with
      modified LDL, but not native LDL of healthy donors, showed a rise in esterified
      cholesterol levels. There was a strong correlation between the degree of LDL
      aggregation and intracellular cholesterol ester accumulation (r-0.86, p 0.001, n
      21). Removal of aggregates by passing preparations through and 0.1 um filter
      significantly inhibited the accumulation of cholesterol esters. The obtained data
      point to the essential, if not decisive, role of LDL aggregation in the processes
      of lipid accumulation by intimal cells in vitro.

PMID- 2224095
TI  - [Metabolic pool of purine compounds in erythrocytes of mice during growth of
      transplanted tumors].
AB  - The pattern of purine derivatives was studied in the erythrocytes of C3HA and ICR
      mice during Hepatoma 22 and Ehrlich ascites tumor cells growth. Host erythrocytes
      purine nucleotides, nucleosides and bases were affected by the implanted tumors.
      The results indicated that the host erythrocytes markedly concentrated adenine
      and guanine nucleotides on the 5th and 11th-12th day of tumor growth. By
      contrast, content of nucleosides and bases were sharply decreased during the log
      growth phase (5th day) with the restoring of these precursors within the 11th
      12th day (plateau phase). These observations indicate that aspects of the purine
      compounds metabolism in host erythrocytes are linked with tumor development.

PMID- 2224096
TI  - [Effects of protamine on blood lipoproteins in the early period of
      hypercholesterolemia in rabbits].
AB  - The content of protein, cholesterol and triglycerides in chylomicrons and
      different classes of blood serum lipoproteins was studied under protamine action
      in early (1 month) hypercholesterolemia. Except the low density lipoproteins the
      amount of triglycerides in the particles studied was practically unchanged. The
      content of proteins in all classes of lipoproteins was greatly increased and this
      may indicate that protamine activates the blood lipoprotein system. The
      enrichment of lipoproteins with cholesterol may be taken as being a result of
      protamine action in early hypercholesterolemia. The peculiar feature in the
      effect of protamine on mentioned lipoprotein components was that the
      protein/cholesterol ratio didn't change in chylomicrons, decreased in very low
      density lipoproteins and low density lipoproteins and increased in high density
      lipoproteins as compared with controls.

PMID- 2224097
TI  - [Heparin-sepharose affinity chromatography and reduction conditions as a method
      of a selective process for separate isoforms of apolipoprotein A].
AB  - Gel permeation chromatography of VLDL apoproteins on Sepharose CL-6B in
      denaturing conditions and affinity chromatography on heparin-sepharose 4B in the
      presence of reducing agent dithiothreitol were used for preparative isolation of
      apolipoprotein E of high purity from human plasma VLDL. Sequential elution of
      apolipoprotein E from affinity column using increasing ionic strength solutions
      (0.4 M NaCl and 1.0 M NaCl) permitted to obtain "high affinity" apo E preparation
      with increased relative apoprotein isoform content with the highest positive
      charge.

PMID- 2224098
TI  - [Modeling of damage to cell membranes during photodynamic therapy:
      photosensitization of planar lipid bilayers by hematoporphyrin dimethyl ether].
AB  - The variations of electrical conductance of planar bilayer lipid membranes (BLM)
      sensitized by hematoporphyrin dimethyl ether under visible light illumination
      were studied. The conductance of BLM does not change for some period after
      switching on the light, then an increase in the conductance starts and the
      membrane breaks. This "induction" time does not depend on addition of azide or
      ferricyanide to the solution, on addition of BHT to the lipid and on substitution
      of air for argon in the cell. The induction time for any new BLM, formed in the
      same cell immediately after the previous membrane was broken, is shorter. The
      variation of BLM boundary potentials during induction time was not observed. The
      results obtained suggest that the photodamage of BLM sensitized by HPD leads to
      accumulation of uncharged reaction products and oxygen does not take part in this
      process.

PMID- 2224099
TI  - [Detection of protease specifically splitting actin in revertants of Shigella
      flexneri L-forms].
AB  - Proteolytic activity of cell extracts from revertants of Shigella flexneri L
      forms as well as biochemical properties of these strains and their sensitivity to
      antibiotics were studied. The protease found earlier in cells of strain E. coli
      A2 was shown to be synthesized by one of 8 revertants under study. This protease
      split actin and did not split some other proteins, its activity was inhibited by
      inhibitors of metalloproteases. Strain 5a2c which produced the protease was
      similar to the strain E. coli A2 and differed from other revertants in some
      biochemical properties, resistance to ampicillin and sensitivity to furazolidone.
      Thus the protease activity can be a marker of structural and functional
      transformation of Sh. flexneri under the influence of furazolidone.

PMID- 2224101
TI  - [Antiradical activity of retinal lipids under illumination].
AB  - Antiradical activity (ARA) of lipids from cattle in norm and under strong
      illumination with and without antioxidants was studied by chemoluminiscence
      method of initiated ethylbenzol oxidation. Lipids ARA from the retina in norm was
      established to be sufficiently high-3.0 X 10(6) l/mol. s. alpha-tocopherol was
      proposed to be the main component influencing lipids ARA. Under strong
      illumination (15 min:, 0.8 J/s) lipids ARA decreased due to intensification of
      lipid peroxidation (the content of MDA was increased). The antioxidants (alpha
      tocopherol, potassium phenozan, ionol) in 0.1 mM concentrations increased the ARA
      of lipids in spite of light action. Changes in overall inhibitory activity of
      natural antioxidants and MDA content was antibat.

PMID- 2224100
TI  - [Comparative characterization of reactions of skeletal muscle arterial and venous
      vessels to combined adrenergic effects].
AB  - In experiments with the constant blood flow perfusion of the cat calf muscle and
      combined actions of adrenalin and noradrenaline were tested as to the blood flow
      resistance changes of the arterial and venous blood vessels. Separately applied
      the catecholamines evoked vascular resistance changes practically similar in
      value; combined effects of catecholamines realized in greater increase of
      arterial than venous resistance. In contrast to arterial vessels supramaximal
      stimuli resulted in much lesser constrictive effect as compared with reaction of
      intramural veins to separately applied catecholamines. Greater doses of
      catecholamines being combined, stability of effector system of skeletal muscle
      veins is decreased as compared to arteries.

PMID- 2224102
TI  - [Restoration by T-activin and its subfractions of splenocyte membrane structures
      in thymectomized animals].
AB  - It was shown that thymectomy induces the injury of plasma membranes of mouse
      splenocytes. This membrane disorders completely inhibit T-cell response on
      Concanavalin. A. The incubation of splenocytes with Tactivin or injection of
      Tactivin or its subfractions to the animals restore the membrane structure and T
      cell response.

PMID- 2224103
TI  - [Effects of desoxycorticosterone on 5-nucleotidase and adenosine deaminase
      activity in the hypothalamus and hippocampus of the rat brain].
AB  - Influence of single (enzyme activities was determined 5h after the preparation)
      and multiple (for 7 days) DOCA administration on 5'-nucleotidase (EC 3.1.3.5) and
      adenosine deaminase (ES 3.5.4.4) activities in homogenate and subcellular
      fractions of the hypothalamus and hippocampus of the rat brain has been studied.
      It has been shown that DOCA enhances adenosine metabolism in the hypothalamus
      activating both the enzymes while in the hippocampus 5'-nucleotidase activity
      increases whereas adenosine deaminase activity decreases. Possible ways of
      mineralocorticoid effects on adenosine system and the role of this nucleoside in
      these hormones mechanism of action on CNS functional activity are being
      discussed.

PMID- 2224104
TI  - [Molecular-biochemical mechanisms of the effects of nootropic agents].
AB  - It is a known fact that prophylactic hypodermic injection of non-typical
      lithonite tranquillizer in the day's dose of 30 mg/kg during 10 days prevents the
      exhaustion of antioxidant system of the body, normalizes qualitative and
      quantitative correlation of separate fractions of phospholipids, stabilizes the
      permeability of erythrocytic membranes and prevents the development of
      hypercholesterolemia of the stress. It is concluded that the lithonite's stress
      protecting effect is the result of its membrane stabilizing influence.

PMID- 2224105
TI  - [Antihypoxic effects of quinones connected with restoration of electro-transport
      and function of the respiratory chain of the isolated rat heart].
AB  - The effect of hypoxia of middle severity (H50) has been investigated on the
      contractile activity, oxidative metabolism and bioenergetic function of the
      myocardium in the isolated rat heart. It has been shown that differences in the
      functional-metabolic parameters sensitivity in the resistant and non-resistant to
      hypoxia animals are defined by the primary utilization of different pathways of
      substrates oxidation--the succinate-oxidative pathway of oxidation or the NADH
      oxidative pathway, correspondingly. It is possible to correct the early hypoxic
      injuries of the electron-transfer function of the myocardium respiratory chain at
      the NADH-CoQ region (the first enzyme complex) with the help of quinones (vitamin
      K3, hydroquinone). The mechanism of this correction depends on the donor-acceptor
      properties of these compounds and it is the same both in the myocardium of the
      isolated heart and in the isolated mitochondria. Vitamin K3 is recommended to be
      utilized on the early stages of hypoxic injuries in myocardium as an antihypoxant
      of the energized type.

PMID- 2224106
TI  - [Molecular mechanisms of the membrane-protective effect of litonit in chronic
      stress].
AB  - It is confirmed that prophylactic use of Pyracetam (500 mg/kg), Pikamilon (10
      mg/kg) and new product of GABA B-44 (30 mg/kg) for 10-days in the conditions of
      chronic stress normalizes the activity of the key enzymes of antiradical defence
      and the content of lipid peroxides, warns the decrement of phospholipids and the
      changes in its qualitative ratio, prevents multidirectional changes in the
      activity of ferments-markers in the membrane of the brain and erythrocytes. It is
      concluded that nootropic agents give membrane stabilizing effects.

PMID- 2224107
TI  - [Changes in the level of dopamine and its metabolites in brain structures and
      immunocompetent organs in the formation of immune response].
AB  - By the method of liquid chromatography with electrochemical detection dopamine
      level increase was shown within 2 min after immunization of rats with sheep red
      blood cells in n. caudatus. In 20 min after the immune response the acceleration
      of dopamine metabolism was observed in nuclei A9, A10, A11, accumbens, in
      amygdala, hypothalamus and hippocampus. In immunocompetent organs dopamine level
      was changed in 24 h after the immunization.

PMID- 2224108
TI  - [Axial shift of erythrocytes in arteries supplying blood to the cerebral cortex].
AB  - In experiments with rabbits the widths of the axial flows of erythrocytes and of
      the parietal plasma layers were assessed in pial arterial ramifications supplying
      the cerebral cortex after their in vivo and in situ fixation under conditions of
      control and vasodilatation. A strict proportional relationship was revealed
      between the width of red cell flows and the diameter of pial arteries of 15-200
      microns wide. However, the relative plasma volume in the microvessels below 50
      microns in diameter was comparatively greater than in the larger vessels. The
      obtained results prove the feasibility of assessing the microvessels' diameters
      in tissues where one can see the red cell flow but the vascular walls are
      invisible. One of the reasons for the lower hematocrit in smaller blood vessels
      as compared to the larger ones was also elucidated.

PMID- 2224109
TI  - [Use of plasma clot in the evaluation of fibroblast progenitor cells of human
      bone marrow].
AB  - Cultivation of human bone marrow cells in plasma clot resulted in high efficiency
      of cloning. It probably results from additional thrombin stimulus on fibroblast
      cell proliferation. Another cause of high cloning efficiency is independent of
      adherence to culture flask surface. Plasma clot system permits clearcut
      morphological examination. Plasma clot system is in superiority to other culture
      systems. In this culture system several types of stromal-hemopoietic cells
      interactions were found, which probably correlate to in vivo interaction of these
      cells.

PMID- 2224110
TI  - [Effects of trophoblastic beta 1-glycoprotein (TBG) on the functional activity of
      different cell lines].
AB  - The effect of TBG on the functional activity of different cell lines, spontaneous
      and Con A induced proliferation of PBL was studied. If concentration of TBG is
      higher than 50 mu kg/ml it suppresses the proliferation in many used cell lines,
      except choriocarcinoma and cancer of uterus. The reliable increasing of
      spontaneous proliferation of PBL, Jurkat and K-562 cells may be observed if
      concentration is more lower (0.5-15 mu kg/ml). However proliferation of other
      cell lines corresponds to control level, and Con A induced proliferation of PBL
      is inhibited. The effect was more marked at 48, as compared to 24 hours of cell
      incubation with TBG.

PMID- 2224111
TI  - [Polyanions inhibit the binding of autoantibodies with some cellular proteins].
AB  - Effect of polyanions on reaction of the Ig from sera of patients with systemic
      lupus erythematosus and scleroderma with cellular proteins was studied by
      immunoblotting. It has been shown that dextran sulfate, heparin, denatured DNA
      and poly I inhibited the binding of autoantibodies with some polypeptides. The
      molecular weight of these antigens was determined. The molecular mechanism of
      immunological reactions studied and it's role in pathogenesis of autoimmune
      diseases is discussed.

PMID- 2224112
TI  - [Lack of species specificity in the action of immunosuppressive factors of tumor
      cells and absence of competition between them and recombinant interleukin-2 and
      phytohemagglutinin for lymphocyte membrane receptors].
AB  - We studied some possible mechanisms of action of immunosuppressor factors (ISF)
      produced by tumor cells on lymphocyte proliferation. ISF of murine tumor cell
      lines inhibited the mitogen induced proliferation of murine splenocytes as well
      as human mononuclear blood cells. Normal human mononuclear blood cells or
      concanavalin A-activated murine spleen cells preincubated with phytohemagglutinin
      (PHA) or interleukin 2 (IL-2) respectively, were strongly suppressed by ISF in
      response to these activators. When preincubated with splenocytes or blood cells
      for 2 h at 4 degrees C following washing, ISF suppressed the lymphocyte
      proliferation as effectively as when being with cells during all period of
      cultivation. ISF inhibited mitogen-induced lymphocyte proliferation at low
      dilutions. There was no competition for lymphocyte membrane receptors between
      these functionally heterogenic kinds of ISF. Collectively, these results show
      that ISF acted when being attached to some lymphocyte membrane receptors.

PMID- 2224113
TI  - [Susceptibility of cells with different stage of malignancy to cytostatic action
      of resident peritoneal macrophages of Syrian hamsters].
AB  - Syrian hamster non-activated resident peritoneal cells (PC) and peritoneal
      macrophages (Mph) was demonstrated. The in vivo selection of highly tumourigenic
      and highly metastatic variants of this strain correlated with their resistance to
      CSA PC and Mph in four cell variants out of five examined. The highly
      tumourigenic Syrian hamster embryo cells in vitro transformed by Rous sarcoma
      virus were highly resistant to CSA PC without selection in vivo. The resistance
      of highly malignant cells to CSA PC appeared to be unrelated to their ability to
      produce immunosuppressing prostaglandins of E type.

PMID- 2224114
TI  - [Intensive growth of human melanoma cells in a fibrin clot implanted in
      immunosuppressed mice].
AB  - BRO human melanoma cells encapsulated within a fibrin clot grew rapidly in mice
      immunosuppressed (IS) by wholebody irradiation (5.5 or 6.5 Gy). After 8 days
      growth under the sub-renal capsule (SRC) of IS mice, the tumor volume increased
      40-fold on the average, and histological and cytological examination showed that
      the growth consisted almost entirely of viable tumor cells. Marked tumor growth
      in IS mice also was observed after intraperitoneal implantation of fibrin clots
      containing BRO cells. SRC implantation of encapsulated BRO cells in pre
      irradiated mice offers a practical and reproducible method for evaluating the
      growth of human tumors in vivo.

PMID- 2224115
TI  - [Study of the effects of amyotrophic leukospongiosis causative agent on neuroglia
      cells in vitro].
AB  - The influence of amyotrophic leukospongiosis (AL) causative agent on the
      ultrastructure of different types of cells of dissociated rat embryo brain and
      spinal cord cultures was studied. The AL agent belongs to the unconventional
      viruses (prions) and causes degenerative changes in the CNS. Large neurons and
      fibrous astrocytes were shown to be most sensitive. It was noted that the time of
      development and the degree of the dystrophic changes depend on the agent
      concentration. The destruction of cell membranes resulted in the pair neuron
      confluence. The formation of giant mitochondria with intramitochondrial
      inclusions was detected. It is supposed that the energetic apparatus of sensitive
      cells is primarily damaged by the infectious agent.

PMID- 2224116
TI  - [Role of stromal microenvironment in the regulation of bone marrow hemopoiesis
      after curantyl administration].
AB  - Role of the stromal microenvironment in regulation of bone marrow hemopoiesis at
      the administration of the thrombocyte disaggregant curantyl was studied by the
      method of heterotopic transplantation of the mice bone marrow. It is shown that
      the action of curantyl on hemopoiesis is realised through the stem stromal cells
      of the bone marrow. It is noted that the inhibitory action of the preparation on
      proliferation of osteogenic precursor-cells is followed by activation of bone
      resorption processes in regenerating ectopic hemopoietic organ. Under the action
      of curantyl at low bone marrow cellularity in the focus of heterotopic
      hemopoiesis and femur an increase of mitotic activity in hemopoietic elements is
      noted. It is revealed that a phenomenon of ineffective megakaryocytopoiesis with
      intramedullary destruction of megakaryocytes leads to the local excretion of the
      thrombocyte released growth factor (TRGF) which has a compensatory character.

PMID- 2224117
TI  - Acute promyelocytic leukemia: another pseudoleukemia?

PMID- 2224118
TI  - Bleeding complications associated with cardiopulmonary bypass.
AB  - Bleeding after CPB has been difficult to characterize and its treatment equally
      difficult to standardize. The complexity of this problem is related to the
      hemostatic process, the technical variations in the operative procedures, and the
      many uncontrolled variables associated with CPB, including the effects of
      anesthetic or pharmacologic agents, the nature of the priming solution,
      hemodilution, hypothermia, the type of oxygenator, and the use of transfused
      blood products. Although there are multiple and generally predictable complex
      changes in the hemostatic mechanism during CPB, the temporary loss of platelet
      function is the most common and clinically relevant. This transient platelet
      dysfunction occurs in all patients undergoing CPB; however, it only causes
      excessive bleeding in a small percentage of patients. Unfortunately, it has not
      yet been possible to predict which patients will develop hemorrhagic
      complications, although prolonged pump times are a contributing risk factor. Over
      the past decade there has been extensive investigation into the management of
      bleeding associated with CPB, provoked primarily by the increased awareness of
      transfusion-transmitted viral diseases and the inappropriately excessive use of
      homologous blood products. Several approaches to autotransfusion of shed blood
      and autologus blood donation have been developed to minimize perioperative
      homologous blood transfusion. Pharmacologic agents such as desmopressin,
      aprotinin, and topical fibrin glues have also been introduced to improve
      hemostasis during CPB. The protease inhibitor aprotinin is particularly promising
      in the reduction of bleeding associated with CPB when given prophylactically.
      Aprotinin may provide new insights into the mechanism of CPB-induced platelet
      dysfunction. Desmopressin is indicated only for the treatment of bleeding after
      CPB. The management of bleeding associated with CPB will undoubtedly

PMID- 2224120
TI  - All-trans retinoic acid in acute promyelocytic leukemias. II. In vitro studies:
      structure-function relationship.
AB  - All-trans retinoic acid induces leukemic cells from patients with acute
      promyelocytic leukemia (M3) to differentiate in vitro to mature granulocytes
      which express the CD15 antigen and are capable of respiratory burst function. Of
      35 M3 samples, only one failed to respond. In eight cases, we compared the
      efficacy of two naturally occurring isomers of retinoic acid, all-trans RA and 13
      cis RA. Both isomers induce maximal differentiation at 10(-6) mol/L. The maximal
      response was maintained at 10(-7) mol/L for the all-trans but not for the 13-cis
      RA. We also observed that the metabolites 4-oxo-all-trans and 4-oxo-13-cis were
      effective at 10(-6) mol/L. This 1 order of magnitude difference in the in vitro
      differentiating potencies of all-trans RA and 13-cis RA in the blasts of
      promyelocytic leukemias predicts a difference in the clinical efficacy of the two
      drugs.

PMID- 2224119
TI  - All-trans retinoic acid as a differentiation therapy for acute promyelocytic
      leukemia. I. Clinical results.
AB  - Twenty-two patients with acute promyelocytic leukemia were treated with all-trans
      retinoic acid (RA, 45 mg/m2 per day) for 90 days. Of the 22, four patients were
      previously untreated, two were resistant after conventional chemotherapy, and 16
      were in first (n = 11), second (n = 4), or third (n = 1) relapse. We observed 14
      complete response, four transient responses, one failure, and three early deaths.
      Length of hospitalization and number of transfusions were notably reduced in
      complete responders. Correction of coagulation disorders and an increase of WBCs
      were the first signs of all-trans RA efficacy. Morphologic analysis performed at
      days 0, 15, 30, 45, 60, and 90 showed that complete remissions were obtained
      without bone marrow (BM) hypoplasia. Presence of Auer rods in the maturing cells
      confirmed the differentiation effect of the treatment. At remission, the t(15;17)
      initially present in 20 patients was not found. The in vitro studies showed a
      differentiation in the presence of all-trans RA in 16 of the 18 tested cases. The
      single nonresponder to all trans RA in vitro did not respond in vivo. Adverse
      effects of RA therapy--skin and mucosa dryness, hypertriglyceridemia, and
      increase of hepatic transaminases--were frequently noted. We also observed bone
      pain in 11 patients and hyperleukocytosis in four patients. Whether maintenance
      treatment consisted of low-dose chemotherapy or all-trans RA, early relapses were
      observed. Five patients are still in complete remission (CR) at 4 to 13 months.
      Our study confirms the major efficacy of all-trans RA in M3, even in relapsing
      patients. Remissions are obtained by a differentiation process.

PMID- 2224121
TI  - Pharmacokinetics and effects of recombinant human erythropoietin after
      intravenous and subcutaneous injections in healthy volunteers.
AB  - A double-blind, placebo-controlled study of the pharmacokinetics and safety of
      multiple doses of recombinant human erythropoietin [rHuEPO 150 or 300 U/kg either
      by intravenous (IV) bolus or subcutaneously (SC)] in normal male subjects
      demonstrated that rHuEPO had a dose-related effect on the hematocrit independent
      of the route of administration and that multiple doses of rHuEPO had no direct
      pressor effects. When rHuEPO was injected IV, a monoexponential decrease in serum
      EPO level was evident for 18 to 24 hours postdose. Absorption of SC injected
      rHuEPO occurred more slowly, with relatively low serum EPO levels being
      maintained for 48 hours. All rHuEPO antibody titer determinations were negative.
      With the exception of significant increases in hemoglobin and hematocrit, no
      clinically significant changes occurred. No hypertensive, convulsive, or
      thrombotic events were observed. Of the adverse experiences observed in 10
      subjects, none was considered clinically significant, and none of the subjects
      dropped out because of adverse experiences.

PMID- 2224123
TI  - Identification and characterization of plasma cells in normal human bone marrow
      by high-resolution flow cytometry.
AB  - The low frequency of plasma cells and the lack of specific cell surface markers
      has been a major obstacle for a detailed characterization of plasma cells in
      normal human bone marrow. Multiparameter flow cytometry enabled the
      identification of plasma cells in normal bone marrow aspirates. The plasma cells
      were located in a unique position in the correlation of forward light scattering,
      orthogonal light scattering, and immunofluorescent-labeled CD38. The identity of
      the sorted cell populations was confirmed by microscopic examination of Wright's
      stained slides and slides stained for cytoplasmic immunoglobulin using polyclonal
      antibodies reactive with light chains; ie, anti-kappa fluorescein isothiocyanate
      and anti lambda phycoerythrin (PE). The purity of the sorted plasma cells was
      greater than 97% (n = 4). The average frequency of plasma cells in normal bone
      marrow aspirates was low--0.25% of the nucleated cells (n = 7)--but surprisingly
      consistent between individuals (SD = .05; range 0.14% to 0.30%). A detailed
      analysis showed two distinct populations of plasma cells: (1) A population
      relatively smaller by forward light scattering expressed CD22, CD35, and sigE and
      was identified as early plasma cells (ie, lymphoplasmacytoid), and (2) a
      population larger by forward light scattering lacked these markers and was
      identified as mature plasma cells. The antigenic profile of the normal plasma
      cells was determined in two-color immunofluorescence studies. The expression of
      cell surface immunoglobulin G (IgG), IgA, IgE, IgD, IgM, and the cell surface
      antigens CD10, CD11b, CD13, CD11c, CD14, CD15, CD16, CD19, CD22, CD20, CD33,
      CD35, CD45, and HLA-DR was determined on the plasma cells. A significant
      heterogeneity in cell surface antigen expression was observed within the plasma
      cell population. Unexpectedly, myeloid-specific cell surface antigens such as
      CD33 and CD13 and the early B-cell antigen identified by CD10 were expressed on a
      proportion of plasma cells. These observations imply that the association of
      myeloid and early B-cell markers described in multiple myeloma may not be
      associated with the neoplasia but is a normal phenomenon.

PMID- 2224122
TI  - Autologous bone marrow transplantation in high-risk remission T-lineage acute
      lymphoblastic leukemia using immunotoxins plus 4-hydroperoxycyclophosphamide for
      marrow purging.
AB  - Fourteen patients with high-risk T-lineage acute lymphoblastic leukemia (ALL) in
      complete remission underwent autologous bone marrow transplantation (BMT) in an
      attempt to eradicate their residual disease burden. A combined immunochemotherapy
      protocol using a cocktail of two immunotoxins directed against CD5/Tp67 and
      CD7/Tp41 T-lineage differentiation antigens in combination with the in vitro
      active cyclophosphamide congener 4-hydroperoxy-cyclophosphamide (4-HC) was used
      to purge autografts. Despite high dose pretransplant radiochemotherapy and
      effective purging of autografts, 9 of 14 patients relapsed at a median of 2.5
      months (range, 1.2 to 16.8 months) post BMT. Two patients remain alive and
      disease free at 26 and 28 months post BMT. We used a novel quantitative minimal
      residual disease (MRD) detection assay, which combines fluorescence activated
      multiparameter flow cytometry and cell sorting with leukemic progenitor cell
      (LPC) assays, to analyze remission bone marrow (BM) samples from T-lineage ALL
      patients for the presence of residual LPCs. Notably, high numbers of residual LPC
      detected in remission BM before BMT constituted a poor prognostic indicator,
      providing the first evidence for the biologic significance and clinical value of
      in vitro T-lineage ALL LPC assays. The median value for the residual leukemia
      burden before BMT, was approximately 8.6 x 10(3) LPC/10(8) mononuclear cells
      (MNC) (approximately 0.0086% LPC). Patients with a residual leukemia burden less
      than this median value appeared to have a better outlook for remaining free of
      relapse after autologous BMT than patients with a greater leukemia burden (53 +/-
      25% v 14 +/- 13%, P = .006, Mantel-Cox). By comparison, the log kill efficacy of
      purging, the remaining numbers of LPC in purged autografts, or the estimated
      numbers of reinfused LPC, did not correlate with the probability of disease-free
      survival (DFS). These results indicate that the primary reason for the recurrence
      of leukemia was inefficient pretransplant radiochemotherapy rather than
      inefficient purging of autografts.

PMID- 2224124
TI  - The hematopoietic defect in aplastic anemia assessed by long-term marrow culture.
AB  - Thirty-two patients with aplastic anemia (AA) have been studied using the long
      term bone marrow culture (LTBMC) system. Of these patients, 26 had been treated
      with immunosuppressive therapy including antilymphocyte globulin (ALG) with or
      without androgens or high-dose methyl prednisolone. The remaining six patients
      either required no treatment or were studied before therapy was begun. Thirty-one
      of 32 patients (96%) had defective hematopoiesis in LTBMC with little or no
      evidence for the generation of primitive progenitor cells. The only exception was
      a patient with spontaneous recovery of aplasia in whom the defect was less
      marked. Crossover LTBMC experiments were performed in 23 cases by inoculating (1)
      patient marrow hematopoietic cells that had been depleted of adherent cells onto
      preformed, irradiated, normal stromas to assess the proliferative capacity of the
      hematopoietic cells, and (2) normal marrow hematopoietic cells that were depleted
      of adherent cells onto preformed, irradiated stromas from patients with AA to
      assess stromal function. Results of these experiments demonstrated a
      hematopoietic defect in all patients that was independent of the degree of
      hematologic recovery after ALG therapy. Only one patient had a probable stromal
      defect and this coexisted with a defect in the regenerative capacity of
      hematopoietic cells. We conclude that LTBMC is a sensitive method for detecting
      and defining the hematopoietic failure in AA. We suggest that the defective
      hematopoiesis present in all patients studied may be important in the
      pathogenesis of clonal evolution in AA.

PMID- 2224125
TI  - Developmental regulation of granulocytic cell binding to hemonectin.
AB  - Hemonectin (HN), a component of the bone marrow (BM) extracellular matrix which
      promotes adhesion of cells in the granulocytic lineage, was purified to near
      homogeneity and tested for its ability to mediate attachment of normal and
      leukemic cells of granulocytic lineage. Purified HN immobilized on plastic
      substrates promoted serum-free attachment of normal granulocyte/macrophage
      progenitor cells (CFC-GM), using an in situ attachment assay in which cell
      attachment is inhibited by specific polyclonal antisera. When unfractionated BM
      cells were allowed to attach to purified HN and stained in situ, HN
      preferentially bound cells at earlier stages of granulocytic differentiation.
      These observations were confirmed using cells of the HL-60 progranulocytic cell
      line which mirrored this differentiation-stage specific binding to HN. HN
      promoted attachment of 60% of uninduced HL-60 cells which were arrested at the
      progranulocyte stage, whereas only 15% of uninduced HL-60 cells attached to
      uncoated plastic and 4% to attached plastic coated with equal microgram
      quantities of bovine serum albumin (BSA). When HL-60 cells were induced to
      differentiate along the granulocytic pathway by incubation with dimethylsulfoxide
      (DMSO), attachment to hemonectin was reduced. Thus, both primary BM granulocytic
      cells and a granulocytic cell line show preferential attachment of those cells at
      earlier stages of differentiation. This developmentally regulated binding
      suggests a mechanism for release of maturing BM into the peripheral circulation.

PMID- 2224126
TI  - Enhanced endogenous leukotriene biosynthesis in patients treated with granulocyte
      macrophage colony-stimulating factor.
AB  - The hematopoietic cytokine granulocyte-macrophage colony-stimulating factor (GM
      CSF) is being used in clinical trials for its potential in the treatment of
      hematopoietic insufficiency due to various causes. Involvement of leukotrienes in
      the effects of GM-CSF is suggested by analytical and pharmacologic evidence
      obtained in vitro. However, until now no data in support of a role of
      leukotrienes in GM-CSF action in vivo have been presented. In the present
      investigation this question was approached by measurement of endogenous cysteinyl
      leukotriene formation in patients treated with the cytokine for cytopenia induced
      by cytostatic drugs or for refractory anemia with excess of blasts (RAEB).
      Endogenous cysteinyl leukotriene formation was assessed by determination of
      urinary leukotriene metabolites using combined high-performance liquid
      chromatography and radioimmunoassay analysis. After GM-CSF administration a
      distinct increase in urinary cysteinyl leukotrienes was found in the cytopenic
      and the RAEB patients that ranged from 2.3- to 57-fold and 2.4- to 333-fold,
      respectively. In the cytopenic patients the increase in leukotriene production
      was correlated to an expansion of peripheral blood leukocytes; RAEB patients
      responded to GM-CSF with enhanced leukotriene biosynthesis even if the peripheral
      leukocytes decreased, possibly due to an abnormal number and/or irritability of
      leukotriene-producing cells. The increase in endogenous leukotriene production
      during therapy with GM-CSF may indicate that leukotrienes play a role in GM-CSF
      action in vivo.

PMID- 2224127
TI  - Isolation of large numbers of enriched human megakaryocytes from liquid cultures
      of normal peripheral blood progenitor cells.
AB  - Investigations linking human megakaryocyte development and cell biology have been
      hindered by an inability to obtain large, relatively pure megakaryocyte cell
      preparations from in vitro stem cell cultures. We report here that such
      preparations can be generated from liquid cultures of normal human peripheral
      blood mononuclear cells stimulated by a serum source of megakaryocyte colony
      stimulating activity (Meg-CSA, the 0% to 60% ammonium sulfate protein fraction of
      aplastic canine serum). Adherent-depleted peripheral blood mononuclear cells are
      suspended at 5 x 10(5) to 10(6) cells/mL in supplemented liquid culture medium,
      platelet-poor human plasma 20% (vol/vol) and 1 to 2 mg/mL serum Meg-CSA protein.
      After 12 to 14 days of incubation, megakaryocytes constitute 3.0 +/- 2.9% (mean
      +/- SD, n = 8) of the unseparated cultured cell population. Megakaryocytes can be
      enriched by counterflow centrifugal elutriation to a purity of 58 +/- 14% (+/-
      SD) with a recovery of 13 +/- 7% and a viability of 67 +/- 19%. This algorithm
      results in the average isolation of approximately 3 x 10(5) enriched
      megakaryocytes from a 100-mL starting volume of peripheral blood. Cultured
      megakaryocytes exhibit normal light and ultrastructural morphology by Wright
      Giemsa staining and electron microscopic analysis. After a 12-day culture
      interval, enriched megakaryocyte preparations exhibit morphologic stage
      distributions that are similar to normal human marrow. Stage distributions move
      rightward with culture duration indicating partial synchrony of megakaryocyte
      maturation. On cytospin preparations, megakaryocyte diameter averages 30.2 +/-
      1.5 microns and increases with maturation stage. Flow cytometric analyses
      demonstrate the expression of platelet glycoproteins (GP) Ib and IIb/IIIa by the
      cultured megakaryocytes. The modal ploidy of the enriched cells at day 12 of
      culture is 16N and most remaining megakaryocytes are 8N or 32N. Liquid culture of
      serum Meg-CSA-stimulated human peripheral blood mononuclear cells represents a
      valuable investigative tool that should permit studies of human megakaryocyte
      biology that have not been possible in the past.

PMID- 2224128
TI  - Human macrophage colony-stimulating factor induces macrophage colonies after L
      phenylalanine methylester treatment of human marrow.
AB  - Macrophage-colony stimulating factor (M-CSF) has well-known effects on murine
      bone marrow, but its colony stimulating activity for human bone marrow is
      controversial. After treatment of human bone marrow with L-phenylalanine
      methylester (PME), macrophage-colonies (CFU-M) were induced by M-CSF in a dose
      dependent fashion. The optimal concentration of recombinant human-macrophage
      colony stimulating factor (rhM-CSF) was 1,000 U/mL. Purified human urine M-CSF
      had colony stimulating activity similar to rhM-CSF. Further studies were
      performed to determine the factors responsible for the enhanced CFU-M formation
      from PME treated marrow. Compared with nylon wool and carbonyl iron monocyte
      depletion methods, PME eliminated significantly more monocytes and myeloid cells.
      This observation suggested that these cells may release hematopoietic inhibitory
      factors for CFU-M. Low concentrations (1%) but not normal (10%) concentrations of
      blood monocytes were inhibitory (mean inhibition, 48%) to CFU-M. High
      concentrations of monocytes (50%) augmented CFU-M colonies. HL-60 conditioned
      media was used to simulate secretory products of early myeloid cells. HL-60
      conditioned media (1%) inhibited CFU-M formation but not granulocyte macrophage
      or granulocyte colonies. We conclude that M-CSF has colony stimulating activity
      for human marrow that can be recognized after removal of inhibitory cells by PME
      treatment.

PMID- 2224129
TI  - New type of Bcr/Abl junction in Philadelphia chromosome-positive chronic
      myelogenous leukemia.
AB  - A new and rare type of Bcr/Abl junction between exon C3 of the 3' portion of the
      Bcr gene and Abl exon 2 has been identified in the leukemic cells of two Ph1
      positive chronic myelogenous leukemia patients in chronic phase. This is the
      fourth type of Bcr/Abl junction so far identified in Ph1-positive hematologic
      malignancies and is a consequence of an unusual breakpoint position on chromosome
      22 that falls approximately 20 kb downstream of the major breakpoint cluster
      region (bcr) of the Bcr gene. The new hybrid mRNA is 540 base pairs (bp) longer
      than that expressed by the K562 cell line and could codify for a Bcr/Abl protein
      carrying 180 additional aminoacids with respect to the larger P210 protein so far
      identified. The hematologic phenotype expressed by the two patients carrying this
      unusual type of Bcr/Abl rearrangement does not significantly differ from that
      commonly seen in chronic myelogenous leukemia.

PMID- 2224130
TI  - Shared idiotype expression by chronic lymphocytic leukemia and B-cell lymphoma.
AB  - Antiidiotype (Id) antibodies identify unique determinants within the surface
      immunoglobulin (Ig) that are present on B-cell tumors. Anti-Ids have been used
      for diagnosis and therapy of B-cell lymphoma and leukemia. A panel of 29 anti-Id
      monoclonal antibodies (MoAbs) that recognize shared idiotypes (SIds) on B-cell
      lymphomas was tested for reactivity with both B-cell leukemias and lymphomas. Ten
      of 40 (25%) cases of chronic lymphocytic leukemia (CLL) reacted with at least one
      of the 29 anti-SId MoAbs. Three cases reacted with more than one anti-SId MoAb,
      but there was no repetitive pattern of a single anti-SId MoAb reacting with a
      large proportion of CLL cases. In contrast, for B-cell lymphoma, in which 11 of
      31 (36%) cases reacted, one anti-SId (B4-1) reacted with five of the positive
      cases; all were diffuse histology. Restricted anti-SId reactivity may lead to
      important insights into the etiology of certain B-cell lymphomas. In addition,
      these anti-SIds may obviate the need to develop "tailor-made" antibodies for
      individual patients.

PMID- 2224131
TI  - Transcellular biosynthesis of sulfidopeptide leukotrienes during receptor
      mediated stimulation of human neutrophil/platelet mixtures.
AB  - The ability of different cell types to cooperate in the metabolism of reactive
      intermediates of arachidonic acid such as leukotriene A4 (LTA4) is currently
      receiving considerable attention. Of critical importance is the demonstration
      that transfer of LTA4 could occur under conditions when relatively low amounts of
      LTA4 are produced such as would be expected for in vitro receptor-mediated
      stimulation. Stimulation of human neutrophils with a combination of chemotactic
      factor (formyl-methionyl-leucyl-phenylalanine, FMLP) and phagocytosable particles
      (opsonized zymosan) resulted in little production of LTC4 alone, but measurable
      quantities appeared when platelets were coincubated. When these agonists were
      added to platelets alone in the absence of neutrophils, no LTC4 was produced. In
      the presence of stimulated neutrophils, the final synthesis of LTC4 was shown to
      occur within the platelets (from neutrophil-derived LTA4) by experiments using
      platelets that had been prelabeled with 35S-cysteine to label intracellular
      platelet glutathione. Other 35S-labeled sulfidopeptide leukotriene metabolites
      were also produced in this coincubation of neutrophils and platelets. The
      observed synergy between FMLP and opsonized zymosan in the production of LTC4
      when neutrophils and platelets were coincubated may involve priming the
      neutrophil for LTA4 production. Activation of platelets or endothelial cells with
      thrombin did not alter the capacity of either cell to convert exogenously added
      LTA4 into LTC4. This would support the suggestion that even when platelets are
      activated they retain their capacity to metabolize LTA4 into LTC4. Finally,
      previous exposure of the platelets to LTA4 did not affect subsequent metabolism
      of arachidonic acid by the cyclooxygenase pathway to thromboxane A2 (TXA2) except
      at very high concentration of LTA4. These results suggest that cell-cell
      interactions may be critical determinants of the profile of eicosanoids produced
      in physiologic and pathophysiologic circumstances. In particular, we believe that
      both endothelial cells and platelets can, together with neutrophils, contribute
      relatively large amounts of sulfidopeptide leukotrienes to inflammatory and
      thrombotic events. These cell-cell interactions are aspirin-insensitive;
      therefore, aspirin-treated platelets are capable of synthesizing the
      vasoconstrictor LTC4 from neutrophil LTA4 at a time when they can no longer
      produce thromboxane.

PMID- 2224132
TI  - In vitro rosetting, cytoadherence, and microagglutination properties of
      Plasmodium falciparum-infected erythrocytes from Gambian and Tanzanian patients.
AB  - To understand the molecular mechanisms that lead to sequestration of red blood
      cells infected with mature stages of Plasmodium falciparum and to examine the
      relevance of earlier studies on adherence properties of laboratory-derived P
      falciparum parasites to the natural parasite population, we analyzed Gambian and
      Tanzanian isolates for in vitro cytoadherence and antibody-mediated
      microagglutination. Eighteen cryopreserved isolates of ring-stage parasites were
      cultured for 20 to 30 hours in vitro, in the patients original erythrocytes, to
      the trophozoite and schizont stage. All parasites were positive in the
      microagglutination assay with at least one of four African hyperimmune sera. In a
      rosetting assay, only 2 of the 18 isolates were strongly positive (35% and 41% of
      parasitized erythrocytes with more than two uninfected cells bound). Thirteen
      isolates showed either intermediate (5% to 18%) or low (less than 5%) rosetting
      while three isolates did not form rosettes. Infected cell-binding of the
      different isolates to immobilized CD36 or thrombospondin, or C32 melanoma cells
      correlated with the percentage of mature parasites in the blood samples (r = .932
      for CD36, r = .946 for thrombospondin, and r = .881 for C32 melanoma cells).
      There was a high correlation between binding to CD36 and thrombospondin (r =
      .982). The extent of infected cell rosetting with uninfected cells in these blood
      samples was not correlated with these other receptor properties. We also observed
      coexpression of rosetting and cytoadherence receptors on the same parasitized
      erythrocytes.

PMID- 2224133
TI  - Autologous bone marrow transplantation in multiple myeloma: identification of
      prognostic factors.
AB  - Multiple myeloma remains a universally fatal malignancy with a median survival
      time not exceeding 3 years. A clinical trial was undertaken to determine
      feasibility and efficacy of marrow-ablative chemoradiotherapy supported by
      unpurged autologous bone marrow (ABMT) and to define prognostic variables. Total
      body irradiation and either melphalan or thiotepa were administered to 55
      patients (median age 53 years; range 20 to 66 years). The group of 21 patients
      with resistance to standard melphalan-prednisone and to continuous infusions of
      vincristine and Adriamycin with high dose dexamethasone (VAD) included 7 with
      primary unresponsive disease and 14 with resistant relapse; among the 34 patients
      achieving remission with the VAD regimen, 14 were in first and 20 in a subsequent
      remission. Marked cytoreduction by greater than or equal to 75% was observed
      among all 21 patients with refractory myeloma, whereas further cytoreduction of
      this magnitude was noted in only 56% of the 34 patients already in remission
      after VAD. Five of the 6 early deaths among all 55 patients occurred in the 14
      patients with resistant relapse, none of whom achieved complete remission and
      who, as a group, had median durations of relapse-free and overall survival of
      only 8 and 7 months, respectively. Among the 41 remaining patients, there was
      only one early death, and 27% achieved complete remission including a 36%
      incidence among the 14 patients treated in first remission; their projected 4
      year survival rate was 82% regardless of their disease status (first or later
      remission or primary resistance). When information about sensitivity to prior
      therapy is unavailable, the presence before ABMT of both high beta-2
      microglobulin levels (greater than 3 mg/L) and non-IgG isotype helped identify 9
      among the 55 patients with a very poor prognosis: all 8 responders relapsed
      within 9 months, and 8 patients died within 15 months. By contrast, a 4-year
      projected survival rate of over 70% for the other patients (about 80% of this
      series) justifies further investigation of this novel treatment approach in
      comparison with standard dose regimens. Our results indicate that marrow-ablative
      therapy cannot be recommended for myeloma patients with resistant relapse or
      those with a combination of risk factors (advanced tumor burden, absence of IgG
      isotype). The apparent lack of an adverse effect of even marked plasmacytosis in
      autografts (up to 30%) emphasizes the need for better cytoreduction rather than
      bone marrow purging.

PMID- 2224134
TI  - Allogeneic marrow transplantation in patients with acute myeloid leukemia in
      first remission: a randomized trial of two irradiation regimens.
AB  - A randomized trial of 12.0 Gy versus 15.75 Gy of total body irradiation (TBI) was
      performed in patients with acute myeloid leukemia undergoing allogeneic marrow
      transplantation while in first complete remission. All patients received 120
      mg/kg cyclophosphamide followed by TBI and marrow from HLA-identical siblings.
      Cyclosporine and methotrexate were used for prophylaxis against acute graft
      versus-host disease (GVHD). Thirty-four patients received 2.0-Gy fractions of
      irradiation daily for 6 days and 37 received 2.25-Gy fractions daily for 7 days.
      The 3-year actuarial probabilities for relapse-free survival were 0.58 for the
      patients who received 12.0 Gy and 0.59 for those who received 15.75 Gy. The 3
      year probabilities of relapse were 0.35 for the 12.0 Gy group and 0.12 for the
      15.75 Gy group (P = .06). The 3-year probabilities of transplant-related
      mortality were 0.12 and 0.32, respectively (P = .04). The probability of moderate
      to severe acute GVHD was 0.21 for the 12.0 Gy group and 0.48 for the 15.75 Gy
      group (P = .02). Patients exposed to the higher irradiation dose received less
      immunoprophylaxis against, and had a higher incidence of, acute GVHD. The
      increased dose of TBI significantly reduced the probability of relapse but did
      not improve survival because of increased mortality from causes other than
      relapse.

PMID- 2224135
TI  - Induction of donor-type chimerism in murine recipients of bone marrow allografts
      by different radiation regimens currently used in treatment of leukemia patients.
AB  - Three radiation protocols currently used in treatment of leukemia patients before
      bone marrow transplantation (BMT) were investigated in a murine model (C57BL/6---
      C3H/HeJ) for BM allograft rejection. These include (a) a single dose of total
      body irradiation (8.5 Gy TBI delivered at a dose rate of 0.2 Gy/min), (b)
      fractionated TBI (12 Gy administered in six fractions, 2 Gy twice a day in 3
      days, delivered at a dose rate of 0.1 Gy/min, and (c) hyperfractionated TBI (14.4
      Gy administered in 12 fractions, 1.2 Gy three times a day in 3 days, delivered at
      a dose rate of 0.1 Gy/min). Donor-type chimerism 6 to 8 weeks after BMT and
      hematologic reconstitution on day 12 after BMT found in these groups were
      compared with results obtained in mice conditioned with 8 Gy TBI delivered at a
      dose rate of 0.67 Gy/min, routinely used in this murine model. The results in
      both parameters showed a marked advantage for the single dose 8.5 Gy TBI over all
      the other treatments. This advantage was found to be equivalent to three- to
      fourfold increment in the BM inoculum when compared with hyperfractionated
      radiation, which afforded the least favorable conditions for development of donor
      type chimerism. The fractionated radiation protocol was equivalent in its
      efficacy to results obtained in mice irradiated by single-dose 8 Gy TBI, both of
      which afforded a smaller but not significant advantage over the hyperfractionated
      protocol. This model was also used to test the effect of radiation dose rate on
      the development of donor-type chimerism. A significant enhancement was found
      after an increase in dose rate from 0.1 to 0.7 Gy/min. Further enhancement could
      be achieved when the dose rate was increased to 1.3 Gy/min, but survival at this
      high dose rate was reduced. These results demonstrated indirectly that dose rate
      affects the expression of host-type pluripotent stem cells, the progeny of which
      appear 3 to 6 weeks after treatment with 8 Gy TBI delivered at a dose rate of 0.1
      Gy/min, but which are eradicated if radiation is delivered at a dose rate of 1.3
      Gy/min.

PMID- 2224136
TI  - Contamination of peripheral blood stem cell harvests by circulating neuroblastoma
      cells.
AB  - Peripheral blood stem cells (PBSC) are being used as one alternative to
      autologous marrow rescue for patients with neuroblastoma and other solid
      malignancies. Some physicians prefer use of PBSC because less risk of tumor
      contamination is believed to exist. This hypothesis was evaluated by
      immunocytologic analysis of blood samples and concurrently drawn bone marrow (BM)
      samples and of PBSC harvests obtained from 31 patients with disseminated
      neuroblastoma. We found circulating neoplastic cells in 75% of specimens analyzed
      at diagnosis, in 36% during therapy, and in 14% of PBSC harvests. Tumor cells in
      blood obtained during therapy did not appear until 3 months after the time of
      diagnosis. Clearance of circulating neuroblastoma cells was documented after two
      courses of induction chemotherapy. Six of 13 patients with minimal or no BM
      disease had positive blood specimens. We conclude that substantial risk of tumor
      contamination of PB harvests exists and recommend that induction chemotherapy be
      administered before hematopoietic progenitor cells are collected from blood.

PMID- 2224138
TI  - Involvement of the p53 tumor suppressor gene in Ph1-positive and Ph1-negative
      myeloid leukemia.

PMID- 2224137
TI  - Adenine and guanine nucleotide metabolism during platelet storage at 22 degrees
      C.
AB  - Adenine and guanine nucleotide metabolism of platelet concentrates (PCs) was
      studied during storage for transfusion at 22 +/- 2 degrees C over a 7-day period
      using high-pressure liquid chromatography. There was a steady decrease in
      platelet adenosine triphosphate (ATP) and adenosine diphosphate (ADP), which was
      balanced quantitatively by an increase in plasma hypoxanthine. As expected,
      ammonia accumulated along with hypoxanthine but at a far greater rate. A fall in
      platelet guanosine triphosphate (GTP) and guanosine diphosphate (GDP) paralleled
      the fall in ATP + ADP. When adenine was present in the primary anticoagulant, it
      was carried over into the PC and metabolized. ATP, GTP, total adenine
      nucleotides, and total guanine nucleotides declined more slowly in the presence
      of adenine than in its absence. With adenine, the increase in hypoxanthine
      concentration was more rapid and quantitatively balanced the decrease in adenine
      and platelet ATP + ADP. Plasma xanthine rose during storage but at a rate that
      exceeded the decline in GTP + GDP. When platelet ATP + ADP was labeled with 14C
      adenine at the initiation of storage, half of the radioactivity was transferred
      to hypoxanthine (45%) and GTP + GDP + xanthine (5%) by the time storage was
      completed. The isotopic data were consistent with the presence of a radioactive
      (metabolic) and a nonradioactive (storage) pool of ATP + ADP at the initiation of
      storage with each pool contributing approximately equally to the decline in ATP +
      ADP during storage. The results suggested a continuing synthesis of GTP + GDP
      from ATP + ADP, explaining the slower rate of fall of GTP + GDP relative to the
      rate of rise of plasma xanthine. Throughout storage, platelets were able to
      incorporate 14C-hypoxanthine into both adenine and guanine nucleotides but at a
      rate that was only one fourth the rate of hypoxanthine accumulation. All of these
      data should be helpful in improving the function and viability of PC as currently
      stored for 5 days, in devising methods for storage beyond 5 days, and in the
      development of synthetic media for PC storage.

PMID- 2224139
TI  - Three-base deletion in exon 3 of the beta-globin gene produced a novel variant
      (beta gunma) with a thalassemia-like phenotype.

PMID- 2224140
TI  - The Brazilian type of nondeletional A gamma-fetal hemoglobin has a C----G
      substitution at nucleotide -195 of the A gamma-globin gene.

PMID- 2224141
TI  - Treatment of Cooley's anemia: deferoxamine provocation test.

PMID- 2224142
TI  - HLA 1990.
AB  - The HLA system encompasses approximately one thousandth of the human genome and
      contains a series of closely linked loci coding for molecules which provide the
      context for the recognition of antigens by T lymphocytes. Within the HLA system,
      several phenotypically expressed and genomic polymorphisms can be distinguished.
      These polymorphisms are described and the main objectives for the future research
      are discussed.

PMID- 2224144
TI  - Patterns of contact phase proteins indicating neuropathy in diabetic patients.
AB  - In 42 outpatients of the diabetology division, coagulation and fibrinolysis
      variables were determined in order to detect typical patterns of results with
      which it was possible to discriminate between three groups with different
      diabetic complications (17: no complication, 7: angiopathy alone, 18: neuropathy
      with or without other complications). There was a statistically significant
      discriminatory function involving C1-inhibitor concentration, high molecular
      weight kininogen coagulant activity and fibrinogen as the most decisive
      variables. The neuropathy group was appropriately separated from the others with
      an 81% correct reclassification. Heparin cofactor II, histidine-rich
      glycoprotein, alpha 2-macroglobulin, pre-kallikrein and factor XII had no
      discriminative power.

PMID- 2224143
TI  - Capillary leak syndrome during low dose granulocyte-macrophage colony-stimulating
      factor (rh GM-CSF) treatment of a patient in a continuous febrile state.
AB  - A 20 years old man with peripheral primitive neuroectodermal tumor involving the
      bone marrow received 12 Gy fractionated total body irradiation, 140 mg/m2
      melphalan, 1800 mg/m2 etoposide, and 1500 mg/m2 carboplatin for consolidation of
      first remission. Thereafter, 250 micrograms/m2/day recombinant human granulocyte
      macrophage colony-stimulating factor (rh GM-CSF) (Behring Werke) were
      administered as continuous infusion 4 days after infusion of autologous bone
      marrow and peripheral stem cells to accelerate granulocyte reconstitution for
      control of a continued febrile state. The clinical picture of capillary leak
      syndrome developed with weight gain, pleural effusions and peripheral edema. The
      patient's condition stabilized after discontinuation of rh GM-CSF. Eight days
      later he died of invasive aspergillosis. The clinical course of our patient
      suggests a potentially fatal toxic effect of rh GM-CSF, even in low dose, in the
      setting of septicemia or fungemia.

PMID- 2224146
TI  - Transient pancytopenia. A report from the International Agranulocytosis and
      Aplastic Study.
AB  - From a population-based study on the incidence of potentially drug-associated
      blood dyscrasias 28 cases were identified with pancytopenia. Who recovered within
      90 days after diagnosis. Early recovery occurred more frequently in patients
      showing normal or increased cellularity of the bone marrow than in patients with
      bone marrow hypoplasia. Median recovery times of leukocytes were 14 and 10 days
      and of platelets 21 and 9 days in patients with and without bone marrow
      hypoplasia, respectively. Age and sex distribution were similar in both groups.
      Of 28 patients, 11 reported a period of fever before onset of pancytopenia.
      Sixteen patients in whom information on drug use was available had taken a median
      of 4 drugs before the onset of symptoms that were related to pancytopenia. From
      these results we present the hypothesis that transient pancytopenia with or
      without marrow hypoplasia can be the expression of the same type of bone marrow
      injury and that drugs or viral infections should be considered as etiological
      factors.

PMID- 2224145
TI  - Sugar receptors of the stromal cell layer in human long-term bone marrow
      cultures: their presence, modulatory responses to changes in the microenvironment
      and potential role in cellular adhesion.
AB  - Intimate cellular contacts and coordinated supply of regulatory factors are
      required to maintain the still inexplicable dynamic equilibrium of hemopoiesis.
      To infer the potential participation of protein-carbohydrate interaction in this
      complex process, human long-term bone marrow cultures were initiated from eleven
      donors, and the adherent cell layer was characterized enzyme- and
      immunohistochemically. Utilizing an array of carrier-immobilized carbohydrate
      ligands and sulfated polysaccharides as probes, specific binding of various
      constituents of the carbohydrate chains of cellular glycoconjugates to the
      stromal cells was unmistakably disclosed. Biochemical analysis, employing
      glycocytologically effective ligands in affinity chromatography, corroborated
      this result. The extent of binding was markedly lower in the two samples, derived
      from leukemia patients. Pronounced adaptive responses for this characteristic
      followed changes in the culture microenvironment that are known to influence
      qualitative and quantitative aspects of hemopoiesis in vitro, namely omission of
      hydrocortisone and horse serum or addition of cytokines. Similarly, such adaptive
      modulation occurred on the level of accessible cell surface receptors, monitored
      by neoglycoenzymes. These binding sites can be involved in mediation of cellular
      interactions, as revealed in a model system by the interference of N-acetyl-D
      galactosamine in cell adhesion. Overall, the results support the idea that
      glycobiological recognition may contribute to the functional integrity of the
      stromal cell layer as well as provide the basis for further analysis.

PMID- 2224148
TI  - Hairy cell leukemia with ring-shaped nuclei.

PMID- 2224147
TI  - Congenital diserythropoietic anemia type I. Report on monozygotic twins with
      associated hemochromatosis and short stature.
AB  - We report the first occurrence of congenital dyserythropoietic anemia type I in
      monozygotic twins and the seventh familial occurrence to our knowledge. Mild
      hemochromatosis is present in the two children but has not yet required iron
      chelation. Moderate growth retardation, which seems to be related to pituitary
      failure, is also present.

PMID- 2224149
TI  - Blood transfusion: the impact of new technologies.

PMID- 2224150
TI  - Automation in blood grouping: impact of microplate technology.

PMID- 2224151
TI  - Flow cytometry: its applications to immunohaematology.
AB  - Flow cytometry, using fluorescent probes, has only recently been applied to
      practical aspects of immunohaematology. It has been used for the detection and
      quantitation of cell-bound immunoglobulins and complement, minor cell
      populations, cellular antigens, and platelet and granulocyte antibodies.
      Practical applications of detecting minor cell populations have been successful
      in determining the extent of fetal maternal haemorrhage; determining the survival
      of transfused RBCs (small and large volumes); demonstrating RBC chimaerism (e.g.
      following bone marrow transplantation) and RBC mosaicism (e.g. demonstration of
      the McLeod phenotype carrier status). A large variety of cellular antigens have
      been demonstrated on RBCs, platelets and white cells using flow cytometry.
      Quantitation of RBC antigens by flow cytometry has been found to be much more
      objective and accurate than the routinely used serological approaches for
      establishing zygosity in paternity studies. Flow cytometry has been found to be a
      sensitive, objective and reproducible method for detecting platelet auto-and
      alloantibodies, and has also been used to detect granulocyte antibodies. More
      recently, it has been used to detect antibodies to monocytes and lymphocytes. As
      flow cytometers become more commonly available, many of these applications may
      become routine in clinical pathology laboratories.

PMID- 2224152
TI  - ADCC and other cellular bioassays for predicting the clinical significance of red
      cell alloantibodies.

PMID- 2224153
TI  - Microbiological screening of blood donations.

PMID- 2224154
TI  - Intraoperative blood salvage.
AB  - Interest in and use of IBS have increased recently. This form of haemotherapy
      involves the retrieval of blood shed perioperatively. IBS, together with other
      forms of ABT, has gained a prominent role in transfusion medicine, largely due to
      an increased awareness of the risks associated with transfusion of homologous
      blood. In addition to conserving erythrocytes, IBS prevents disease transmission,
      other adverse transfusion reactions, and alloimmunization to antigens in blood
      cells and plasma which may result from homologous blood use. An array of IBS
      devices is presently available, ranging from disposable canisters to complete
      processing systems. The devices are capable of recovering, filtering, washing and
      reinfusing shed erythrocytes. They can be divided into slow-flow and rapid-flow
      systems based on the rapidity of blood processing. Most systems use a dual
      channel aspiration cannula through which shed blood is aspirated and mixed with
      anticoagulant solution. The salvage procedure requires operator control at every
      step, even for the highly automated instruments. Various health care personnel
      have been trained to operate IBS equipment; a transfusion service nurse with
      blood bank expertise has proved to be a highly reliable operator in our practice.
      Extensive clinical observation has shown that salvaged erythrocytes function and
      survive normally. IBS has been applied in many surgical fields; it has two
      relative contraindications: its use in areas affected by infection or malignancy.
      Operative procedures characterized by large blood losses provide a cost-efficient
      application of IBS, including cardiac surgery, orthopaedic procedures, trauma,
      vascular surgery, and liver transplantation. New, highly efficient technology is
      emerging that is capable of recovering other blood components. Consequently, what
      presently amounts to erythrocyte recovery will be expanded shortly to include
      platelets and plasma, with its many constituents.

PMID- 2224156
TI  - Novel intravenous immunoglobulins and their applications.

PMID- 2224155
TI  - Application of computers in blood transfusion.

PMID- 2224157
TI  - Genetically engineered and affinity purified plasma proteins.

PMID- 2224158
TI  - [Agent orange. Passion and reason].

PMID- 2224159
TI  - [Proto-oncogenes activation in human solid tumors].
AB  - Genetic alterations in solid human tumors occur in several groups of genes, one
      of which contains the proto-oncogenes. These genes are involved in the control of
      cell proliferation and become activated in oncogenes by various mechanisms. These
      activations are reviewed herein.

PMID- 2224161
TI  - [Incidence of nosocomial infections in an cancer center: clinical and
      bacteriologic data].
AB  - Over a 5 month period, a study of the incidence of nosocomial infections (NI) was
      carried out in the Leon Berard Oncology Center (Lyons). It comprised 1,551
      patients classified in groups according to the site of origin of the underlying
      malignancy. The respective frequency of the different types of nosocomial
      infections and the responsible agents was evaluated in each group and the
      incidence was calculated per day of hospitalization. The overall incidence of NI
      was 11.29 per 1,000 patient-days, with a maximal value of 20.04 for patients
      suffering from lymphomas. The most frequently encountered infections were
      bacteremias (22.7%), followed by urinary tract infections (20.8%) and wound
      infections (20.5%). The most frequent causative agents of NI were Escherichia
      coli (25.8%), Pseudomonas aeruginosa (13.9%), Staphylococcus aureus (9.8%) and
      Staphylococcus epidermidis (9.8%). The latter micro-organism together with
      Escherichia coli were the most frequent causative agents of bacteremias. Even
      though cancer patients are particularly prone to developing infections, the
      incidence of NI could be reduced thanks to a program of control and surveillance
      of infectious episodes during hospitalization.

PMID- 2224160
TI  - [Response in patients with melanoma to immunization using melanoma oncolysates of
      vaccine virus].
AB  - Thirty-two patients with high risk melanoma (either primary melanoma of the limbs
      or trunk, or recurrent melanoma) and clinically disease-free following
      appropriate surgical treatment were immunized with a vaccinia virus oncolysate
      made from a pool of 4 human melanoma cell lines. Injections were given id weekly
      for 3 months, and then bi-monthly for a further 21 months or until relapse.
      Treated patients have been under study for 11-72 months, and 15 of them for more
      than 36 months. Twelve patients received a full 24-month treatment: 3 relapsed
      and 10 are alive (9 of them disease-free) with a survival of 34-72 months. One
      patient is still under treatment. Nineteen patients relapsed during treatment:
      among the 13 patients that relapsed early during the course of treatment, 9
      patients died after a survival of 5-30 months and 4 are alive with a survival of
      30-59 months; among the 6 patients that later relapsed, 2 patients died after a
      survival of 21 and 29 months and 4 are alive with a survival of 16-69 months. An
      analysis of the patients' disease-free survival and overall survival was made
      using the actuarial method, and limited to 5 years: the disease-free survival
      curve shows a 35% plateau reached after 40 months, and the survival curve shows a
      60% plateau reached after 30 months. The patients' responses to the immunization
      antigens expressed by the oncolysate were studied. Lymphocytes from immunized
      patients do respond in vitro to the stimulation by oncolysate in the presence of
      low amounts of IL-2, and this response is greater than that of normal
      individuals. IgG antibody production to gangliosides with N-glycolyl neuraminic
      acid is of prognostic significance, the increase in IgG anti-ganglioside antibody
      in patients after 3 and 6 months of treatment being linked to the absence of
      relapse in these patients. Finally, preliminary results show, in several patients
      under treatment, the appearance of antibodies directed against a 31 kD protein of
      the oncolysate not detectable in the vaccinia virus or in melanoma cell lysates.
      Such results are in accordance with previously reported ones from similar studies
      conducted by other investigators and tend to indicate the efficacy of vaccinia
      virus oncolysate immunization in the treatment of high risk melanoma.

PMID- 2224163
TI  - [Antihormonal treatments in breast cancer in the woman. Role of estrogen
      antagonists].
AB  - Hormone treatment of breast cancer has been common practice for many years. More
      recently, findings on the hormonal mechanism of action on the target cells have
      provided a better approach of hormone-dependency and prognosis. Moreover, new
      hormonal synthetic molecules are now available. They are effective on specific
      activities of the endocrine system in well defined conditions. Administration of
      these drugs requires caution and previous evaluation of the patients' hormonal
      status conjugated to biological data of the tumor itself in view of obtaining
      efficient control of tumor growth.

PMID- 2224162
TI  - [Resection of the thoracic wall in oncology].
AB  - Based on our experience with 12 patients who underwent wide anterior chest wall
      resection in our institute, we attempt to define the indication of the different
      techniques for reconstruction by musculo-cutaneous flaps according to the extent
      of resection and location in the chest wall. The pectoralis major flaps are
      simple and important in the reconstruction of sternal defects; especially when
      dense retrosternal fibrosis has already developed after radiotherapy. The
      latissimus dorsi flaps are reliable and thick and suitable for coverage of major
      tissue loss. A new technique is also described for reconstruction of major
      anterolateral chest wall defects as well as sternal defects by a latissimus dorsi
      osteo-muscular flap. The external oblique musculo-cutaneous flaps are used to
      cover defects in the lateral chest wall below the 5th rib. Pedicled omental flaps
      are complementary flaps and can be used when muscle flaps are insufficient to
      replace significant tissue loss. Respiratory problems arising from paradoxical
      chest wall movement are temporary and may be encountered in the immediate post
      operative period. Because of the development of fibrosis and of a better
      adaptation of the patient, this condition is well tolerated during the month
      following operation.

PMID- 2224164
TI  - [Conservative treatment of breast cancer (the Lyon experience during 1963-1983)].
AB  - Over a 20-year period (1969-1983), 570 infiltrating primary breast carcinomas
      were conservatively treated in Lyons. Two different protocols were used: a first
      group of 162 patients with T1 T2 less than 3 cm NO lesions was treated, between
      1963 and 1973, by lumpectomy and external beam irradiation with 60cobalt. The 5
      and 10 year overall survival rates are 86% and 66% respectively. Local and
      regional failure rates are 10% and 2.5%. Cosmetic result was good or excellent in
      70% of patients with only 5% poor results; a second group of 408 patients with T1
      T2 less than 3 cm lesions was treated between 1973 and 1983 by tumorectomy and
      axillary dissection, followed by cobalt irradiation and 192iridium boost. The 5
      year overall survival rate was 90% and, at 5 years, the probability of failure is
      5% in the breast and 2% in the axilla. Cosmetic results are comparable in the 2
      groups. Comparison of these 2 groups indicates an improvement in local control
      with Iridium boost. No obvious change in axillary recurrence rate and overall
      survival rate was observed. Boost modalities are discussed, with regard to
      cosmetic results. A prospective randomized study was initiated in 1986, in order
      to assess the value of the boost in the conservative treatment of breast cancer.

PMID- 2224165
TI  - [Adoptive immunotherapy with interleukin 2 in oncology].
AB  - Forty-seven patients with renal carcinoma were included in first line or rescue
      protocols of immunotherapy including IL2 alone or in association with LAK cells,
      INF alpha or TNF. The toxicity was mild and the mortality was 2% (1 patient). The
      response rate was 26%. Nineteen children with neuroblastoma received IL2 either
      alone or in combination with LAK cells. The morbidity and mortality were higher
      in patients with end stage disease who had previously received high dose and
      prolonged chemotherapy. In contrast, the toxicity was mild and transient in
      patients treated in the months following autologous bone marrow transplantation.
      The only complete response observed was in 1 child treated with IL2, 4 months
      after high dose chemotherapy and ABMT. Immunological analysis showed that the
      immunomodulatory effect of IL2 is very different depending on whether IL2 is used
      alone or in combination with other cytokines; moreover, the biological effect of
      IL2 is dependent on the immunological status of the patients prior to IL2
      therapy.

PMID- 2224166
TI  - [Developments in the treatment of osteosarcoma since 1979. Report of the
      statistics at the Centre Leon-Berard].
AB  - Seventy-two patients with a localized osteosarcoma were treated between September
      1979 and December 1987 by neoadjuvant chemotherapy, local surgery and post
      operative chemotherapy. Chemotherapy regimens varied throughout the years but
      always comprised high dose methotrexate with leucovorin rescue and adriamycin pre
      operatively for children under the age of 15, and ifosfamid and cis platinum in
      adults. Post-operative chemotherapy for bad responders (greater than 10% of
      residual malignant cells), was at first an association of adriamycin and cis
      platinum, and later of holoxan and cis platinum. Surgery changed from amputation
      to local conservative surgery (graft or prosthesis) which is now the most
      frequent surgery--61% of the patients are alive and disease-free at 5 years. Good
      responders to pre-operative chemotherapy have a much better prognosis (81% at 5
      years) than bad responders (45%). There is no significant difference according to
      age or pre-operative chemotherapy regimen.

PMID- 2224167
TI  - [Prognostic factors in the response of a first line chemotherapy in advanced
      breast cancer].
AB  - Anthracyclines containing regimen are widely used in advanced breast cancer. The
      response to first line chemotherapy varies according to many individual factors
      and the theoretical response to a given protocol cannot predict the response of a
      patient. A randomized clinical trial (ERASME) was initiated in order to evaluate
      the more appropriate first line chemotherapy scheme in advanced breast cancer.
      Prognostic factors were included in a multiple logistic regression to explain the
      response after the first 3 chemotherapy courses (monthly FEC). Three factors were
      found to be statistically significant: adjuvant hormonotherapy, loco-regional
      metastases, adjuvant adriamycin containing regimen (pejorative prognostic
      factor). By combining these factors, this statistical model enables us to predict
      a response rate to a first line chemotherapy from 27 to 87%. Such a model can be
      taken into account in a decision-making procedure of first line chemotherapy in
      advanced breast cancer.

PMID- 2224168
TI  - Social connections and risk for cancer: prospective evidence from the Alameda
      County Study.
AB  - The association between social connections and cancer incidence, mortality, and
      prognosis during 17 years of follow-up was examined in a population-based sample
      of 6,848 adults who lived in Alameda County, California, in 1965. Estimates of
      relative hazards were derived from Cox regression modeling, adjusting for age,
      smoking, physical health at baseline, alcohol consumption, and adjusted household
      income. Women who were socially isolated were at significantly elevated risk of
      dying of cancer of all sites and of smoking-related cancers. Social connections
      were not prospectively associated with cancer incidence or mortality among men,
      but men with few social connections showed significantly poorer cancer survival
      rates. These patterns of risk are consistent with the biology of different cancer
      outcomes. They also suggest a different role for social isolation in cancer among
      men and women.

PMID- 2224169
TI  - Behavioral differences in the interactions between Type A and B mothers and their
      children.
AB  - Fifty-seven women participating in a study of family reorganization following
      parental separation were grouped as Type A or B on the basis of the Jenkins
      Activity Survey. They were observed interacting with their children during two
      tasks, one of which elicited more directive and involved interaction than the
      other. Type A mothers were particularly directive, especially when interacting
      with sons and during the task-oriented condition. Although children's behavior
      was coded and analyzed as a function of mothers' Type A or B status, few
      differences in children's behavior were found.

PMID- 2224170
TI  - Manifest hostility may affect habituation of cardiovascular reactivity in blacks.
AB  - In a study of cardiovascular reactivity to dietary manipulation of sodium and
      calcium, we pretested 30 young black normotensive males who were equally divided
      by positive and negative parental histories of hypertension with a 12-item anger
      questionnaire we devised and the Cook-Medley Hostility, Manifest Hostility,
      Overcontrolled Hostility, and Inhibited Hostility scales of the Minnesota
      Multiphasic Personality Inventory. Contrary to expectations, we found no
      correlation of resting blood pressure or cardiovascular reactivity to repeated
      mental demands with the two measures of inhibited hostility. We did, however,
      find resistance to habituation of cardiovascular reactivity in subjects with high
      Manifest Hostility and positive family histories of essential hypertension. Our
      findings suggest that vulnerability to hypertension may be revealed by the
      perseveration of blood pressure reactivity to repeated mental challenge. We
      propose that the perseveration of blood pressure reactivity is a disinhibitory
      phenomenon caused by a difficulty in the management of multiple inhibitory
      demands that disrupts the natural course of habituation and could be an important
      etiologic factor in essential hypertension.

PMID- 2224171
TI  - Life stress and social supports in depressed inpatients.
AB  - The presence of adequate social supports has been associated with a reduced
      incidence of psychological symptoms. It is unclear, however, whether the
      protective influence of social supports is because of a direct positive effect on
      psychological functioning or a stress-buffering effect. Furthermore, most
      research on life stress and social supports has focused on community-based rather
      than clinical samples. The present study attempts to clarify the relationship
      between life stress and social supports related to psychological symptoms in 84
      adult, nonpsychotic, depressed inpatients. Subjects were categorized according to
      their responses on the Life Experiences Survey and the Social Supports Inventory.
      Subjects were then assessed using both structured interviews and self-report
      measures of depression and suicide potential, as well as other psychological
      symptoms. Although both life stress and social supports were significantly
      related to a variety of psychological symptoms, the interaction between these
      variables was not significantly related to psychological symptomatology. Life
      events and social supports were found to exert their effects independently. This
      argues against the stress-buffering theory in favor of the direct-effects theory
      of social supports, at least when applied to inpatient samples.

PMID- 2224172
TI  - Lipids and lipoproteins in a triethnic sample of 5- or 6-year-old Type A or Type
      B children.
AB  - The Type A behavior pattern (TABP) has been proposed as a risk factor for
      coronary heart disease (CHD). Several studies have indicated an association
      between Type A behavior and serum cholesterol levels. If the effects of TABP are
      mediated by conventional CHD risk factors, evidence for a causal relationship
      between TABP and CHD would be strengthened if associations were detected among
      the young. This paper addresses the following: (1) Do levels of serum lipids and
      lipoproteins among young children vary by ethnicity, gender, or TABP? (2) Can
      obtained differences be accounted for by possible confounding factors, such as
      SES or body composition? ANCOVA revealed no significant ethnic, gender, or TABP
      effects for total serum cholesterol or HDLc. Analyses of LDLc and triglycerides
      disclosed significant main effects for gender and for ethnicity. A Competition
      subscale by ethnicity interaction was the only effect to approach statistical
      significance for TABP. The strongest findings were a replication of differences
      in lipid and lipoprotein risk factors by ethnicity.

PMID- 2224173
TI  - Charity, translation, and the language of medical learning in medieval England.

PMID- 2224174
TI  - The German model of training physicians in the United States, 1870-1914: how
      closely was it followed?

PMID- 2224175
TI  - Rural medical practice in the 1880s: a view from central Wisconsin.

PMID- 2224176
TI  - American military medicine in the mid-nineteenth century: the experience of
      Alexander H. Hoff, M.D.

PMID- 2224177
TI  - The wealth of nineteenth-century American physicians.

PMID- 2224178
TI  - In memoriam: Thomas Rogers Forbes (1911-1988).

PMID- 2224179
TI  - Optimization and application of particle beam high-performance liquid
      chromatography/mass spectrometry to compounds of pharmaceutical interest.
AB  - Particle beam high-performance liquid chromatography/mass spectrometry (HPLC/MS)
      parameters were optimized for the sensitive analysis of several drugs in
      agricultural products such as milk and tissue. Sensitivity of the particle beam
      interface was greatest for solvents with low heat capacities (methanol greater
      than acetonitrile greater than isopropanol greater than water). Furthermore,
      optimal sensitivity was obtained at low solvent flow rates (about 0.4-0.6 ml min
      1). Parameters such as desolvation temperature, helium flow rate to the nebulizer
      and nebulizer position resulted in minimal change in sensitivity. The source
      temperature was optimized to obtain suitable vaporization with minimal thermal
      degradation (200-300 degrees C). The determination of a variety of compounds
      (including beta-lactams, cephapirin, tetracyclines, methylene blue, furosemide,
      spectinomycin, cytidine, 2-chloro-4-nitrobenzamide and thiamine) was possible
      using the particle beam interface. Under full-scan conditions, detection limits
      were in the 100 ng range for most drugs. With selected ion monitoring, particle
      beam HPLC/MS was demonstrated for the analysis of p.p.m. levels of these drugs in
      milk and tissue extracts. Precision of the particle beam analysis was usually
      better than 15% RSD. For the same compounds, HPLC/MS with a thermospray interface
      often resulted in less structural information (single ion spectra) then obtained
      by particle beam with thermospray detection limits varying from 10 ng to 1
      microgram.

PMID- 2224180
TI  - Liquid chromatography/mass spectrometry of plasma glucose and secreted
      glucuronate for metabolic studies in humans.
AB  - Negative ion thermospray liquid chromatographic/mass spectrometric methods have
      been developed for the determination of isotopic enrichments for glucose and
      acetaminophen-uridine diphosphate glucuronate from (1-2H1)glucose, (1
      2H1)galactose and (2-13C)acetate in humans. The error of estimate ranged from
      below 1% to 5%. The advantages of the method include fast analysis (up to 35 per
      hour), eased sample preparation, good precision, sensitivity comparable with gas
      chromatography/mass spectrometry and better than with isotope ratio mass
      spectrometry.

PMID- 2224181
TI  - Mixtures of porcine and bovine insulin analysed by fast atom bombardment mass
      spectrometry with selected ion monitoring.
AB  - Mixtures of bovine and porcine insulin have been analysed by fast atom
      bombardment mass spectrometry with selected ion monitoring of M + H ions at m/z
      5733.9 (bovine) and 5778.0 (porcine). Porcine insulin could be detected in a
      mixture of 2% porcine and 98% bovine insulin and with bovine insulin as the minor
      component as little as 1% could be detected.

PMID- 2224182
TI  - In vitro metabolism of cannabigerol in several mammalian species.
AB  - Microsomal incubations were prepared from the livers of male mice, rats, cats,
      guinea-pigs, hamsters and gerbils and both male and female rabbits and were
      incubated with cannabigerol (CBG), a constituent of marihuana. Metabolites were
      extracted with ethyl acetate, concentrated by chromatography on Sephadex LH-20
      and examined as trimethylsilyl (TMS) and (2H9)TMS derivatives by gas
      chromatography/mass spectrometry. Structural elucidation was aided by
      hydrogenation of the metabolites to tetrahydro derivatives. Similar metabolites
      were produced by each of the species but the ratios of the individual compounds
      differed considerably. Twelve metabolites were identified. The major metabolites
      were monohydroxy compounds with the hydroxyl group at C-8', C-9', C-4' or at one
      of any position of the pentyl chain. Reduction of the delta-6' double bond was
      prominent in the cat to give 8'-hydroxy-6',7'-dihydro-CBG. The other major
      metabolic route was epoxidation of this double bond and hydrolysis to give 6',7'
      dihydroxy-6',7'-dihydro-CBG. Although epoxidation of the other double bond was
      detected, the resulting metabolite was present in low concentration and
      hydrolysis was not observed. The mass spectral fragmentation of CBG and its
      metabolites was dominated by formation of the tropylium ion by cleavage of the C
      1'--C-2' bond and by ions formed by cleavage of the C-3'--C-4' and C-4'--C-5'
      bonds. In addition, compounds containing hydroxylation at C-1"--C-4" (pentyl
      chain) gave rise to the same abundant diagnostic ions that have been observed for
      corresponding metabolites of other cannabinoids.

PMID- 2224183
TI  - Measurement of stable isotopic enrichment of underivatized acetate by gas
      chromatography/mass spectrometry: application to in vivo estimation of acetate
      production.
AB  - In order to assess endogenous and colonic production of acetate, we have
      developed an assay for determining the isotopic enrichment of plasma acetate
      using gas chromatography/mass spectrometry (GC/MS). Acidified, deproteinized
      plasma (200 microliters) was extracted into ethyl ether, and the ether phase was
      then injected into a gas chromatograph/mass spectrometer fitted with a 30 m x
      0.252 mm i.d. capillary column (temperature program 50-245 degrees C at 10
      degrees C min-1). Using electron impact GC/MS and selected ion monitoring, peak
      areas of ions with m/z 60 and 61 (M + 1) were determined. Triplicate extractions
      of enriched plasma samples (mol.% excess 1.38-1.5%) resulted in a coefficient of
      variation of 1.6-5.9%. Unenriched plasma samples were found to have an enrichment
      close to theoretical natural abundance, and analysis of our (1-13C)acetate tracer
      (99 at.% excess) revealed an ion at m/z 61 and no ion at m/z 60. To verify
      accuracy, we conducted an in vivo isotope dilution study. In a 1-month-old
      piglet, fasted for 24 h, changing the rate of a 4 h infusion (mmol h-1) of (1
      13C)acetate from 0.141 to 0.282 doubled the isotope enrichment (2.08 x) of the
      second plateau. The rate of appearance of acetate was 26.0 mumols kg-1 min-1,
      which is comparable to that reported in fasting sheep.

PMID- 2224184
TI  - In vitro metabolism of cannabidiol in the rabbit: identification of seventeen new
      metabolites including thirteen dihydroxylated in the isopropenyl chain.
AB  - The metabolism of cannabidiol (CBD) was studied in liver microsomes from the
      female New Zealand white rabbit. Metabolites were extracted with ethyl acetate,
      concentrated by chromatography on Sephadex LH-20 and examined as trimethylsilyl
      (TMS), methyl ester/TMS and (2H9)TMS derivatives by gas chromatography/mass
      spectrometry. Thirty-nine metabolites, mainly mono-, di- and tri-hydroxy
      compounds, were identified; 17 of these have not been reported before. New
      metabolites included 8,9-dihydroxy-8,9-dihydro-CBD (two isomers) and seven
      monohydroxy derivatives of each of these two compounds. The mass spectra of the
      TMS derivatives of metabolites not hydroxylated in the isopropenyl group were
      generally dominated by the ion produced by retro-Diels-Alder cleavage of the
      terpene ring. Other structurally informative ions included the tropylium ion and
      fragments diagnostic of hydroxylation at C-1", C-2", C-3", C-4" and C-7. The
      spectra of the TMS derivatives of metabolites hydroxylated in the isopropenyl
      group were generally dominated by the ion at m/z 143. This involved loss of
      CH2OTMS and a retro-Diels-Alder fragmentation analogous to that seen in the other
      metabolites, but with charge retention by the other (smaller) fragment. Other,
      related fragment ions also characterized these metabolites.

PMID- 2224185
TI  - Fast atom bombardment mass spectrometric analysis of haemoglobin variants: use of
      V-8 protease in the identification of Hb M Hyde Park and Hb San Jose.
AB  - The characterization of two human haemoglobin variants, Hb M Hyde Park and Hb San
      Jose, by fast atom bombardment mass spectrometry is reported. The identification
      of the site and nature of the amino acid substitution was performed by analysis
      of the peptide mixture generated by proteolytic digestion of the variant beta
      globin chains with V-8 protease. The use of this protease was instrumental in the
      unambiguous identification of the replaced residues because the tryptic map alone
      was unable to unequivocally locate the modification. Spectra obtained were easily
      interpreted and the characterization of Hb M Hyde Park (beta, 92 Hys leads to
      Tyr) and Hb San Jose (beta 7 Glu leads to Gly) was accomplished essentially by
      the same procedure already described for the tryptic map. These results are
      suggestive of alternative approaches in haemoglobin variants characterization
      using different proteolytic enzymes when tryptic data alone do not lead to
      unambiguous results.

PMID- 2224186
TI  - Identification of cyclic metabolites of isopropylated phenyl phosphates in rabbit
      bile.
AB  - Some organophosphorous compounds, especially tri-o-cresylphosphate (TOCP), induce
      delay neuropathy. The cyclic saligenin phosphate (PSP) has been suggested to be
      the active metabolite of the protoxicant TOCP. The o-isopropylated triphenyl
      phosphates have been proven not to be neurotoxic. Studying the metabolism of
      these compounds we found the following cyclic metabolites: 2-phenyl-4H-4,4
      dimethyl-1,1,3,2-benzodioxaphosphoran-2-oxide and 2-(o-isopropylphenyl)-4H-4,4
      dimethyl-1,1,3,2-benzodioxaphospho ran-2-oxide. Additionally, monohydroxylated
      metabolites of the parent esters were detectable. The effect of glucuronidation
      on the formation of the cyclic metabolites is discussed in this paper.

PMID- 2224187
TI  - A selected ion monitoring method for quantifying simvastatin and its acid form in
      human plasma, using the ferroceneboronate derivative.
AB  - Simvastatin, a pro-drug lactone, forms the open carboxylic acid as a major
      metabolite that inhibits the activity of 3-hydroxy-3-methylglutaryl coenzyme A
      reductase. Simvastatin and the acid in plasma were quantified by a gas
      chromatography/mass spectrometry/selected ion monitoring (GC/MS/SIM) method.
      These drugs were separated by solid-phase extraction and independently converted
      into a 1,3-diol-type compound. This compound reacted with ferroceneboronic acid
      to yield the cyclic boronate that gave satisfactory mass spectra for GC/MS/SIM
      measurements. The serum was dominated by the molecular ion appearing as the base
      peak, thereby leading to a sensitive and selective assay. The calibration curves
      for simvastatin and the acid were linear in their concentration range of 0.1-10
      ng ml-1, where the values of coefficient of variation for both drugs were below
      8%, except for the value of 11% for simvastatin at a concentration of 0.1 ng ml
      1. The quantification limit for both drugs was 0.1 ng ml-1 on the basis of a
      signal-to-noise ratio of 4:1.

PMID- 2224188
TI  - Bandits on the run: the oral snuff debate.

PMID- 2224189
TI  - Oral tobacco: prevalence, health risks, dependence potential and public policy.
AB  - This paper discusses public health policy with regard to oral tobacco use. It
      notes that in the UK, oral tobacco use is extremely rare. Concern that it might
      become prevalent among schoolchildren has proved unfounded. Smokeless tobacco
      almost certainly carries health risks but these risks are probably less than from
      smoking. What little evidence exists suggests that smokeless tobacco may be less
      dependence-inducing than cigarettes. In the light of this, the UK Government's
      decision to ban oral tobacco products is hard to reconcile with their continuing
      to permit the sale and advertising of cigarettes. A cynic would view the
      Government's ban as a 'no cost' measure to placate the public health lobby and
      ease the pressure for more restrictions on cigarette promotion. The inconsistency
      in the Government's approach to Skoal Bandits and cigarettes may be used as a
      focus for pressure to change in the laws governing promotion of cigarettes.

PMID- 2224190
TI  - Moist snuff in Sweden--tradition and evolution.
AB  - Snuff-dipping was already widespread in Sweden in the 19th century. After the
      1920s snuff sales went down, but Sweden still kept its position as world leader
      in per capita consumption of moist snuff. Following a major advertising campaign
      snuff consumption began rising again in the late 1960s. The Swedish Tobacco
      Company claims that Swedish snuff is a 'less harmful' alternative to cigarettes.
      Swedish epidemiological studies indicate that there is a cancer risk from snuff
      dipping, but it is low compared with smoking. Accordingly, the STC claims to "do
      a good job replacing cigarettes with snuff". However, an analysis of the trends
      in tobacco usage patterns in Sweden during the last few decades does not support
      this claim. The marketing of moist snuff has not primarily attracted older
      smokers who would seek help in order to stop smoking, but young people. The use
      of snuff is no prerequisite and no guarantee for a decrease of smoking. On the
      contrary, taking up snuff must be seen as an introduction to the tobacco habit
      and possibly a first step towards taking up cigarettes.

PMID- 2224191
TI  - Being positive: drug injectors' experiences of HIV infection.
AB  - There is a growing concern within Britain, Europe and North America that
      injecting drug users may pose the greatest risk of transmitting HIV infection to
      the wider heterosexual non-drug injecting population. However, we know very
      little about the reactions of injecting drug users to the knowledge of being HIV
      positive and thus are hampered in our attempts at estimating the actual risks
      such individuals pose to others. This paper is based upon interviews with 26
      seropositive injecting drug users and examines their experiences in relation to
      the following areas: (1) hearing the news; (2) communicating the diagnosis to
      others; (3) current drug use and sexual behaviour; and (4) perceptions of the
      future. It is shown that injecting drug users have a wide range of responses in
      relation to each of these areas and while the implications for their care and
      counselling are drawn out it is suggested that the fact of this variability
      undermines any single approach to patient or client management.

PMID- 2224192
TI  - AIDS-related risk behaviour, polydrug use and temazepam.
AB  - In a study of AIDS-related risk behaviour among injecting drug users in the north
      west of England it was found that 90% were polydrug users, and 28% were using
      temazepam. A third of all polydrug users had regularly used more than three drugs
      in addition to their preferred drug in the previous year. Statistical analysis
      revealed that the use of temazepam and extensive polydrug use were associated
      with sharing injecting equipment. Significant associations were also found with
      indices of sexual risk behaviour. It was concluded that multiple drug use and the
      use of temazepam were associated with behaviour that could increase exposure to
      HIV infection.

PMID- 2224193
TI  - Metyrapone-induced withdrawal symptoms.
AB  - The metyrapone test is widely used in endocrinological testing to assess the
      integrity of hypothalamic-pituitary-adrenal axis function; we have used it to
      study the metabolic basis of addictive disease and opioid dependence. In recent
      studies, we have observed that metyrapone administration in long-term methadone
      maintained patients and in patients undergoing slow dose reduction to drug-free
      status following chronic treatment may induce a narcotic withdrawal-like
      syndrome. Although metyrapone is known to produce mild adverse reactions in non
      opiate dependent subjects, narcotic withdrawal-like symptoms have not been
      previously observed or reported. The metyrapone test was administered to 15
      former heroin addicts: 10 (8 male, 2 female) in steady-state methadone
      maintenance therapy (30 to 90 mg/d) and 5 (3 male, 2 female) in the final phase
      of a slow methadone dose reduction procedure (0 to 10 mg/d). Eight out of 15
      methadone maintenance subjects exhibited a narcotic withdrawal-like syndrome
      ranging from 'moderate' to 'severe' and four additional subjects had 'mild'
      symptoms, occurring within 1 h after metyrapone administration, and resolving
      within 2 h of onset. No significant symptoms were seen in 3 methadone maintained
      subjects nor in any of 9 normal volunteers (7 male, 2 female). The mechanism by
      which metyrapone induces symptoms resembling narcotic withdrawal in opiate
      dependent individuals is unknown but physicians performing this test should be
      aware of this possible response.

PMID- 2224194
TI  - Familial transmission of alcohol use, III. Impact of imitation/non-imitation of
      parent alcohol use (1960) on the sensible/problem drinking of their offspring
      (1977).
AB  - Imitation/non-imitation by adult offspring of alcohol-related parent behavior was
      examined in the context of the 'fall-off effect' and of sensible/problem alcohol
      use, two processes which tend to constrain drinking. Evidence indicates there is
      more imitation by adult offspring of abstemious parents (both abstainer and low
      volume) than of high volume parents. Adult offspring drink significantly less, on
      the average, than their high volume parents, a phenomenon here termed 'fall-off
      effect' for both men and women with respect to either their fathers or mothers.
      This fall-off among social drinkers appears when the mother approaches or the
      father consumes at or more than a typical daily drinking level (greater than or
      equal to 1 drink per day). More sensible drinking occurs among adult offspring
      when (1) the parent has no drinking problem-signs than when the parent has
      drinking problems (this pattern appears at all levels of offspring consumption),
      and (2) when parents drink at high volume and have no problems for those
      offspring who do not imitate parent volume. Drinking 'sensibly' appears to be
      associated directly with the level of parent alcohol use and offsprings' own
      drinking levels (considered as imitation or non-imitation of parents), and
      indirectly with offspring recall of problematic intake by parents. Drinking
      sensibly is a medical, education and public health issue.

PMID- 2224195
TI  - Communicative competence in sons of alcoholics.
AB  - Sons of alcoholic (SA), depressive (SD), and social drinking (SN) fathers gave 3
      min speeches under low- and high-stress conditions. Trained raters, unaware of
      group membership, scored each speech on a variety of communicative competence
      dimensions. The results gave evidence that the SA group, relative to the SN
      group, showed deficits in all six speech variables. Further results suggested
      that the SA group was unaffected by level of stress, while the SD group showed a
      decrease in communicative clarity from speech 1 (low stress) to speech 2 (high
      stress). The results suggest lower levels of communicative competence among adult
      sons of alcoholics. The implication of this finding with regard to the
      psychosocial functioning of children of alcoholics is discussed.

PMID- 2224196
TI  - Alcohol consumption and unemployment among men: the Scottish Heart Health Study.
AB  - There is growing concern about the relationship between health-related behaviour
      and employment status. Data from the Scottish Heart Health Study included
      information on the self-reported drinking habits of 4170 full-time employed and
      479 unemployed men. This enabled the patterns of alcohol consumption in the
      unemployed to be compared to those of the full-time workers. There were
      appreciable differences in both frequency and quantity of reported alcohol
      consumption between the two groups and a higher percentage of the unemployed
      reported being non-drinkers. Nevertheless, the unemployed drinkers drank more
      alcohol than those in employment, even after standardization for both age and
      social class (27.9 units vs 20.7 units per week). Binge drinking was common in
      both groups, but the proportion was higher among the unemployed (58.8% of the
      unemployed reported drinking more than eight units in any day in the previous
      week compared to 33.5% among the full-time workers). In an attempt to validate
      these findings and to assess the possible health consequences of heavy drinking,
      serum gamma-glutamyltransferase levels were analysed. Overall, the unemployed
      were found to have higher levels, this finding being largely influenced by the
      excess of heavy drinkers. The reasons behind these differences in drinking
      behaviour between the employed and unemployed need to be identified before any
      cause and effect hypotheses can be generated, and counselling given where needed.

PMID- 2224197
TI  - How much alcohol is in a 'standard drink'? An analysis of 125 studies.
AB  - A group of researchers have undertaken a review of 125 international, published,
      epidemiological studies that relate various physical harms to different levels of
      alcohol consumption. For this review it was necessary to be able to compare the
      data from the different studies directly. The different measures of alcohol
      quoted in the studies were converted to the standard measure of grammes of
      alcohol. The present paper discusses the problems involved in doing this, and
      gives details of the conversion methods used.

PMID- 2224198
TI  - Assisted natural recovery from alcohol problems: effects of a self-help manual
      with and without supplementary telephone contact.
AB  - One hundred and seven problem drinkers responding to a newspaper advertisement
      were randomly assigned to groups receiving: (1) a general advice and information
      booklet; (2) a behaviourally-based self-help manual; (3) in addition to the
      manual, an opportunity to make progress reports to a telephone answering service;
      and (4) in addition to the manual, an opportunity to make telephoned progress
      reports to an interviewer. Eighty-seven (81.3%) respondents were successfully
      followed-up and collateral information was available for 54 (61.1%) of these.
      Results showed a higher proportion drinking above recommended limits at six
      months follow-up in the control group (78%) than in the groups receiving the
      manual (53%). There were no significant differences due to presence or type of
      telephone contact and poor use was made of the opportunity for telephone contact.
      Findings justify the widespread promotion of self-help materials as a means of
      assisting the natural recovery process among problem drinkers.

PMID- 2224199
TI  - Inebriate institutions in North America, 1840-1920.
AB  - This paper analyses two contemporaneous types of 19th-century North American
      inebriate institutions and attempts by their promoters to develop a public
      treatment system. Inebriate 'homes' or 'retreats' descended from a tradition of
      therapeutic temperance that originated in the Washingtonian Movement of the
      1840s. They were small, urban, private and charitable, dedicated to voluntaristic
      and Christian principles, and were intimately connected with local temperance
      groups that provided support after residential treatment. Inebriate asylums took
      inspiration from insane asylums and were large, public, coercive and isolated in
      rural areas. Their promoters were steeped in the deterministic, hereditarian
      neurologism of Victorian psychiatry. Asylum enthusiasts dominated the public
      treatment movement, but developed a largely disciplinary and custodial vision
      that undermined their political appeal. As inebriate asylums could not easily be
      distinguished from insane asylums, almshouses or jails, legislators regarded them
      as superfluous and very few were established. Prohibition destroyed what public
      inebriate institutions existed. Inebriate colonies, usually connected with county
      jails, were the only survivors of the 19th-century treatment movement apart from
      private sanitaria and a few inebriate wards in city or county hospitals.

PMID- 2224201
TI  - ICAA Berlin.

PMID- 2224202
TI  - UK: MRC AIDS research 1990.

PMID- 2224200
TI  - Dynamics and dilemmas in a DDU.

PMID- 2224203
TI  - Hypocalcemia in cancer.
AB  - Hypocalcemia based on total calcium measurement is frequent in certain cancers
      (especially prostate) in association with osteosclerotic bone metastases. In a
      majority of these patients hypocalcemia is related to the low serum albumin
      and/or renal failure. True ionized hypocalcemia may be seen as a toxic effect of
      certain chemotherapeutic agents or as a consequence of hyperphosphatemia due to
      rapid tumor lysis. In addition, tumors may produce osteoblast-stimulating
      factor(s) which cause massive accretion of calcium by the skeleton. Isolation and
      purification of these factors may provide us with unique osteoblast-stimulating
      factors which may have therapeutic applications.

PMID- 2224204
TI  - Collagen synthesis and mineralization in the early phase of distraction bone
      healing.
AB  - Corticotomy of the distal radius followed by gradual distraction by external
      fixation was performed on three sheep. Collagen synthesis and mineral deposition
      were analysed from sequential biopsies obtained from the center of the
      distraction area during the first 4 weeks of distraction. The whole distraction
      area was rapidly filled with organic matrix the amount of which, due to
      fluctuation in its nonprotein component, initially decreased from 88 to 66% of
      the level in control bone but gained its initial level in 4 weeks. Total protein
      in the matrix represented 70% of that in the control bone during the 4-week
      follow up period while the proportion of collagen of the total protein increased
      from 53 to 88%, a level comparable with the unoperated bone. Determination of the
      type of fibrillar collagen by characterization of their cyanogen bromide peptides
      showed that in the distraction area production of type II collagen does not occur
      but the heteropolymer type I (alpha 1(I)2 alpha 2(I)1) collagen represents almost
      totally the collagen synthesized. Deposition of mineral into the distraction gap
      was detectable already after 2 weeks and increased rapidly after 3 weeks of
      distraction. The results suggest that unlike in other processes, e.g., direct
      osteonal and callus-type bone repair, in distraction bone healing gradual
      distraction of osteotomized bone leads directly to synthesis of mature fibrous
      organic matrix of bone followed by its rapid mineralization.

PMID- 2224205
TI  - Histomorphometry of iliac crest bone in 346 normal black and white South African
      adults.
AB  - We examined undecalcified transiliac bone samples from 346 normal black and white
      South African adults (age range 21-83 years) by routine histomorphometry. The
      results were analysed for race-, age- and sex-dependent characteristics of
      trabecular microstructure (bone volume, trabecular thickness, trabecular number,
      trabecular separation) and static bone turnover variables (osteoid surface,
      osteoid volume, osteoid thickness, erosion surface). Trabecular thickness was
      greater in blacks than in whites, and bone volume was greater in black males, but
      not in black females, than in their white counterparts. Values for osteoid
      surface, volume and thickness, and for erosion surface were greater in blacks
      than in whites. Age-related changes were: a decline in bone volume in all
      race/sex groups; a decline in trabecular thickness in all groups except black
      males; a decline in trabecular number in all groups except black females; and a
      rise in trabecular separation in all groups except black females. There was an
      increase with age in osteoid surface in all groups except white males, in osteoid
      volume in all groups, and in erosion surface in blacks only. When correcting for
      age there were no sex-dependent differences in microstructure but values of some
      osteoid variables were greater in males than in females. If the greater osteoid
      and erosion values in blacks reflect greater bone turnover, then trabecular bone
      in blacks would be renewed more frequently, be subjected to fewer loading cycles
      and be less prone to fatigue failure. Blacks may thus have trabecular bone of
      better quality and sturdier microarchitecture. These features could contribute to
      the lower spontaneous fracture rate in blacks.

PMID- 2224206
TI  - Bone mineral content of Gambian and British children aged 0-36 months.
AB  - The influence of age, sex and body size on the bone mineral content of the radius
      (BMC) measured by single-photon absorptiometry has been studied in 134 British
      and 243 rural Gambian children aged 0-36 months. Growth rates and childhood
      nutrition, including calcium intakes, were markedly different in the two
      communities. In both groups BMC increased with age and was higher in boys (8%, P
      less than 0.001). Adjustment for body size (height, weight, bone width), using
      multiple regression analysis, removed the age effect and reduced the sex
      difference to 4% (P less than 0.01). Gambian children had significantly lower
      BMCs than British children of the same age (P less than 0.001), averaging 11%
      close to birth and diverging to a calculated difference of 31% at 36 months. The
      differential was reduced after adjustment for body size but remained significant
      (P less than 0.01) with BMC values diverging from birth to a predicted difference
      of 12% at 15 kg body weight. The extent to which these results reflect the low
      calcium intakes of Gambian children requires further study.

PMID- 2224207
TI  - Stimulation of bone resorption and cell proliferation in vitro by human gingival
      fibroblasts from patients with periodontal disease.
AB  - In the present communication we report that fibroblasts, isolated from human
      gingiva obtained from 13 different patients, secreted soluble product(s) which
      can promote bone resorption in vitro. Fibroblasts were isolated from explants of
      human gingiva, subcultured, grown to confluent monolayers, subsequently cultured
      in growth arrest media for 0-72 h and conditioned media harvested. Bone
      resorption was assessed in cultured mouse calvarial bone by quantifying the
      mobilization of minerals and the release of lysosomal enzymes. Human fibroblast
      conditioned media (HFCM) dose-dependently stimulated the release of 45Ca from
      prelabelled bones and the mobilization of stable calcium and inorganic phosphate
      from unlabelled bones. In addition, HFCM increased the release of beta
      glucuronidase and beta-N-acetylglucosaminidase from the calvaria. No effect of
      HFCM on the release of 45Ca from dead bones could be seen. HFCM caused a dose
      dependent increased degradation of bone matrix proteins, as assessed by the
      release of 3H from [3H]proline-labelled calvaria. The stimulation of 45Ca release
      could already be seen after 3-12 h of treatment. Treatment of the bones with HFCM
      for 12 h was sufficient to obtain a prolonged stimulation of 45Ca release. Bones
      cultured in the presence of HFCM showed an increased number of osteoclasts.
      Calcitonin, but not indomethacin, inhibited 45Ca release stimulated by HFCM.
      Ultrafiltration of HFCM did not cause any loss of the 45Ca release response. The
      amount of bone-resorbing activity produced by the gingival cells was proportional
      to the number of cells. In addition, HFCM stimulated the proliferation of human
      fibroblasts and osteoblast-enriched mouse calvarial bone cells. It is concluded
      that human gingival fibroblasts secrete one or several factors that can stimulate
      osteoclastic bone resorption in vitro by a prostaglandin-independent pathway.

PMID- 2224208
TI  - Bone mineral mass associated with postmenopausal vertebral deformities.
AB  - Vertebral morphometry on thoracic and lumbar spine radiographs and bone mass
      measurements were carried out on 215 patients investigated for postmenopausal
      osteoporosis. Bone mineral mass was measured on the central third of the skeleton
      by neutron activation analysis and the result, normalized for body size,
      expressed as a calcium bone index (CaBI). The normal CaBI value for females (20
      40 years) is 0.97 (0.11) with a lower limit for these young, normal women, of
      0.75. Vertebral compression deformity was defined as a mean height more than 15%
      lower than adjacent normal vertebrae. Thoracic and lumbar anterior wedge
      deformities and central compression were defined as anterior/posterior (A/P) or
      mid/posterior (M/P) height ratios of less than 0.75. For the 129 patients without
      vertebral deformities, the mean CaBI was 0.80 (0.12) (1 SD) and 32% of these
      patients had CaBI values below the normal young adult range (CaBI less than
      0.75). In 20 patients, vertebral deformities were limited to 1 or 2 mid-thoracic
      vertebrae, and the mean CaBI values for these 20 patients was 0.81 (0.15), equal
      to that for patients without any vertebral deformity. For the remaining 67
      patients, (i.e., patients with one or more vertebral deformities involving at
      least one distal thoracic or one lumbar vertebra) the mean CaBI value was 0.66
      (0.10), 17% below the value for patients without vertebral deformities. Low CaBI
      values (CaBI less than 0.75) were observed in 87% of these patients, consistent
      with the diagnosis of osteoporotic fractures. Based on our CaBI results, however,
      mid-thoracic deformity was not associated with significant osteopenia and is not,
      therefore, diagnostic of osteoporotic fracture.

PMID- 2224209
TI  - Abstracts of the 5th Sydney Bone Symposium. Sydney, 23-25 April 1990.

PMID- 2224210
TI  - Abstracts of the 1st annual scientific meeting of the Australian and New Zealand
      Bone and Mineral Society. Perth, 26-27 September 1990.

PMID- 2224211
TI  - Influenza vaccination and the elderly.

PMID- 2224212
TI  - Vasectomy and the human testis.

PMID- 2224213
TI  - Hirsutism.

PMID- 2224214
TI  - The epidemiology of malpractice.

PMID- 2224215
TI  - Interventions in chronic renal failure.

PMID- 2224216
TI  - Sodium-lithium countertransport activity in red cells of patients with insulin
      dependent diabetes and nephropathy and their parents.
AB  - OBJECTIVE: To determine whether there are familial and genetic aspects of sodium
      lithium countertransport activity in red cells in diabetic nephropathy. DESIGN:
      Case-control study. SETTING: Teaching hospital diabetic clinic. SUBJECTS: 40
      Patients with insulin dependent diabetes, both of whose parents were alive: 20
      with persistent proteinuria and 20 with normal albumin excretion matched for age,
      duration of diabetes, and body mass index. All 80 parents. MAIN OUTCOME MEASURES:
      Sodium-lithium countertransport activity in red cells and arterial blood
      pressure. RESULTS: Sodium-lithium countertransport activity in red cells was
      higher in the patients with proteinuria than in the patients with
      normoalbuminuria (mean (95% confidence interval) 0.47 (0.39 to 0.54) v 0.33 (0.28
      to 0.38) mmol/l red cells/h respectively, p = 0.0036; mean difference 0.14 (0.04
      to 0.22)). The mean countertransport activity for the two parents of each patient
      was calculated, and from this the mean value for each group of parents was
      calculated; the value was higher in the parents of the patients with proteinuria
      than in the parents of the patients with normoalbuminuria (0.40 (0.32 to 0.48) v
      0.30 (0.26 to 0.33) mmol/l red cells/h respectively, p = 0.016; 0.10 (0.02 to
      0.19)). Twenty-eight of the parents of the patients with proteinuria compared
      with 12 of the parents of the patients with normoalbuminuria had a
      countertransport activity that was above the median value in all 80 parents (p
      less than 0.001). Mean arterial blood pressure in the parents of the patients
      with proteinuria was related to that of their offspring (r = 0.46; p less than
      0.01). There was a positive correlation between the sodium-lithium
      countertransport activity in red cells in the parents and their offspring when
      all parents and patients were considered (r = 0.37; p less than 0.001).
      CONCLUSIONS: Increased sodium-lithium countertransport activity in red cells in
      the parents of diabetic patients with nephropathy provides further evidence that
      familial, and possibly genetic, factors related to a predisposition to arterial
      hypertension have a role in the susceptibility of diabetic renal disease.

PMID- 2224217
TI  - Prediction of hip fracture in elderly women: a prospective study.
AB  - OBJECTIVE: To assess the relative importance of osteoporosis of the os calcis,
      cognisance, and mobility in the risk of subsequent fracture of the hip in elderly
      women. DESIGN: Prospective study of elderly women in residential care over two
      years. SETTING: 21 Private or 38 local authority residential homes for the
      elderly and 4 geriatric hospitals in Doncaster and Hull. SUBJECTS: 1414 Ambulant
      women aged over 69, in private or local authority residential care or geriatric
      care. Those who had had bilateral hip surgery were excluded. MAIN OUTCOME
      MEASURES: Broad band ultrasonic attenuation (BUA) index, Clifton assessment
      procedures for the elderly test (for cognisance), and mobility on a six point
      scale, and fracture of the hip in the subsequent two year period. RESULTS: 73
      Women fractured their hip during the two years. Their mean age was not
      significantly different from that of the women who did not have a fracture (85.3
      (SD 5.6) v 83.9 (6.3); p = 0.07), but their mean BUA index (40.3 (19.3) v 50.9
      (22.2) db/MH2), and score for cognisance (median 19 (interquartile range 10.5
      27.0) v 24 (17-30)) were significantly lower (both p less than 0.001). These
      variables had independent associations with fracture of the hip. Women with
      fractures had a significantly lower score for the psychomotor component of the
      cognisance test (4.5 (1-8) v 7 (2-10); p less than 0.0025 and were significantly
      more mobile (1(1-3) v 3 (1-6); p less than 0.02). Subdividing women according to
      high, medium, and low scores for BUA index and cognisance testing disclosed a
      high risk group (118 women) with low BUA index and cognisance score, whose
      incidence of fracture was 12.8%; in the group at lowest risk (136 women) with
      high BUA index and cognisance score, the incidence of fracture was only 1.5%
      (relative risk 8.4 (95% confidence interval -2.0 to 35.5]. Further analysis
      showed that those most at risk were, additionally, most mobile but that less
      mobile women with good cognisance had a low incidence of fractures, regardless of
      the BUA index, (1.2%, high index, v 0.9%, low index). CONCLUSIONS: Elderly women
      most at risk of sustaining hip fractures were those with low BUA index, low
      cognisance test score, and high mobility. Improving bone strength and cognisance
      in elderly women may reduce their incidence of hip fracture.

PMID- 2224218
TI  - Four and a half year follow up of women with dyskaryotic cervical smears.
AB  - OBJECTIVE: To determine the proportion of women with mild or moderate dyskaryosis
      in cervical smears who (a) progress to cervical intraepithelial neoplasia grade
      III or worse or (b) regress. DESIGN: Four and a half year cytological follow up
      study of women with mild or moderate dyskaryosis in cervical smears. SETTING: 666
      Women (mean age 28 (SD 8) years; range 14-74) found to have borderline, mild, or
      moderate dyskaryosis on routine screening. RESULTS: 45 Women (6.8%) had a cone
      biopsy recommended on the basis of an abnormal follow up smear (severe
      dyskaryosis suggestive of cervical intraepithelial neoplasia grade III or
      invasive cancer), and in one patient cervical intraepithelial neoplasia grade III
      was reported in a biopsy specimen after dilatation and curettage. Life table
      analysis gave a 14% probability of a patient being recommended for a biopsy after
      four and a half years of follow up (95% confidence interval 12% to 15%). There
      was a significant excess incidence of invasive cancer of the cervix in the series
      compared with the general population (five cases observed compared with less than
      0.1 expected). 157 Patients (24%) showed reversion to a normal cell pattern
      sustained in several smears over more than 18 months but a single negative smear
      was an unreliable indicator of apparent regression. Having two successive smears
      showing mild dyskaryosis or a smear at any time showing moderate dyskaryosis was
      a significant predictor of a subsequent severely dyskaryotic smear. CONCLUSIONS:
      Women found to have mild or moderate dyskaryosis in cervical smears should be
      kept under regular surveillance. The optimum management of these patients--by
      cytology or colposcopy--needs to be determined by randomised controlled trials.

PMID- 2224219
TI  - Why costs of consultations in general practice vary.

PMID- 2224220
TI  - Effectiveness of eye protection in the metal working industry.

PMID- 2224221
TI  - Differences in disability between people with mental handicaps who were resettled
      in the community and those who remained in hospital.

PMID- 2224222
TI  - Consultation rates among middle aged men in general practice over three years.
AB  - OBJECTIVE: To provide data on consultation rates in general practice for middle
      aged men over three years according to their age and social class. DESIGN:
      Prospective study of men over eight years. Data on consultation rates during
      years 6-8 were collected retrospectively from practice records. SETTING: Over
      1000 general practices in Great Britain by year 8. Initially (in 1978-80) the men
      had been selected at random from one practice in each of 24 towns. SUBJECTS: 7013
      Men aged 46-65 in the sixth year of follow up. MAIN OUTCOME MEASURE: Number of
      consultations a year over three years. RESULTS: The mean annual consultation rate
      over the three years rose steadily with age (7.0 at age 46-50 to 9.7 at age 61
      65) and with social class (6.4 in class I to 10.0 in class V) but was potentially
      misleading as the distribution was skew: 10.5% of men (736) did not consult over
      the three years and 17.2% (1209) consulted only once or twice, whereas 11.4%
      (798) of men were seen more than 18 times. The percentage of men who did not
      consult over three years fell only slightly with age and was unrelated to social
      class, with roughly a tenth of all age and social class groups not consulting.
      Two thirds of non-consulters in year 6 (1598/2334) consulted in year 7 or 8.
      CONCLUSIONS: The mean is not an appropriate summary measure of consultation rates
      and may conceal important differences among practices or other groups. The new
      general practitioner contract stipulates that all patients aged 16-74 must be
      provided with information to promote health and prevent illness at least once
      every three years. Most practices will have to approach a tenth of their men aged
      46-65 specially to provide this service even if one consultation in three years
      is regarded as sufficient to allow a service to be provided.

PMID- 2224223
TI  - Mucocutaneous leishmaniasis.

PMID- 2224224
TI  - ABC of major trauma. Transport of injured patients.

PMID- 2224225
TI  - Crisis in admission beds.

PMID- 2224226
TI  - Effect of erythropoietin in patients with myeloma.

PMID- 2224228
TI  - Referral letters and replies from orthopaedic departments.

PMID- 2224227
TI  - Rectal examination in general practice.

PMID- 2224229
TI  - Dystonic dysphagia associated with fluspirilene.

PMID- 2224230
TI  - Captopril and systemic lupus erythematosus syndrome.

PMID- 2224232
TI  - One hand clapping.

PMID- 2224231
TI  - Inhibitors of hydroxymethylglutaryl coenzyme A reductase for treating
      hypercholesterolaemia.

PMID- 2224233
TI  - What future for the BMA?

PMID- 2224234
TI  - Medicine's need for kaizen.

PMID- 2224235
TI  - Looking at the pictures.

PMID- 2224236
TI  - The population bomb has exploded already.

PMID- 2224237
TI  - Reflections on the changing times.

PMID- 2224238
TI  - The movement towards the professionalization of medicine.

PMID- 2224239
TI  - Medicine as a profession: times of change.

PMID- 2224240
TI  - The evolution of the NHS.

PMID- 2224241
TI  - The state and the profession: the politics of the double bed.

PMID- 2224242
TI  - The new new general practice: the changing philosophies of primary care.

PMID- 2224244
TI  - 120 years on: voices on child abuse.

PMID- 2224243
TI  - Ernest Hart and the social thrust of Victorian medicine.

PMID- 2224245
TI  - Medical men and military matters: the BMJ and the Victorian army.

PMID- 2224246
TI  - Medicine in the armed services.

PMID- 2224247
TI  - The rise of the British pharmaceutical industry.

PMID- 2224248
TI  - Development of a rational practice of therapeutics.

PMID- 2224249
TI  - The BMJ and poverty.

PMID- 2224250
TI  - How soon is now? Public health and the BMJ.

PMID- 2224251
TI  - A toast to the BMJ.

PMID- 2224252
TI  - Marking times.

PMID- 2224254
TI  - Hugh Clegg: recollections of a great editor.

PMID- 2224253
TI  - The "top 50": a perspective on the BMJ drawn from the Science Citation Index.

PMID- 2224256
TI  - World medicine. A sort of obituary.

PMID- 2224255
TI  - Journalology--or what editors do.

PMID- 2224257
TI  - Rediscoveries.

PMID- 2224258
TI  - Guidelines for the management of asthma in adults.

PMID- 2224259
TI  - Oxalate, livers, and kidneys.

PMID- 2224260
TI  - Milk for babies and children.

PMID- 2224261
TI  - Diagnosing cancer of the pancreas.

PMID- 2224263
TI  - European meeting on HIV testing.

PMID- 2224262
TI  - Justice versus equity for haemophiliacs with AIDS.

PMID- 2224264
TI  - Getting an AIDS vaccine to the developing world.

PMID- 2224265
TI  - Unawareness of hypoglycaemia and inadequate hypoglycaemic counterregulation: no
      causal relation with diabetic autonomic neuropathy.
AB  - OBJECTIVE: To examine the traditional view that unawareness of hypoglycaemia and
      inadequate hypoglycaemic counterregulation in insulin dependent diabetes mellitus
      are manifestations of autonomic neuropathy. DESIGN: Perspective assessment of
      unawareness of hypoglycaemia and detailed assessment of autonomic neuropathy in
      patients with insulin dependent diabetes according to the adequacy of their
      hypoglycaemic counterregulation. SETTING: One routine diabetic unit in a
      university teaching hospital. PATIENTS: 23 Patients aged 21-52 with insulin
      dependent diabetes mellitus (seven with symptoms suggesting autonomic neuropathy,
      nine with a serious clinical problem with hypoglycaemia, and seven without
      symptoms of autonomic neuropathy and without problems with hypoglycaemia) and 10
      controls with a similar age distribution, without a personal or family history of
      diabetes. MAIN OUTCOME MEASURES: Presence of autonomic neuropathy as assessed
      with a test of the longest sympathetic fibres (acetylcholine sweatspot test), a
      pupil test, and a battery of seven cardiovascular autonomic function tests;
      adequacy of hypoglycaemic glucose counterregulation during a 40 mU/kg/h insulin
      infusion test; history of unawareness of hypoglycaemia; and response of plasma
      pancreatic polypeptide during hypoglycaemia, which depends on an intact and
      responding autonomic innervation of the pancreas. RESULTS: There was little
      evidence of autonomic neuropathy in either the 12 diabetic patients with a
      history of unawareness of hypoglycaemia or the seven patients with inadequate
      hypoglycaemic counterregulation. By contrast, in all seven patients with clear
      evidence of autonomic neuropathy there was no history of unawareness of
      hypoglycaemia and in six out of seven there was adequate hypoglycaemic
      counterregulation. Unawareness of hypoglycaemia and inadequate hypoglycaemic
      counterregulation were significantly associated (p less than 0.01). The response
      of plasma pancreatic polypeptide in the diabetic patients with adequate
      counterregulation but without autonomic neuropathy was not significantly
      different from that of the controls (change in plasma pancreatic polypeptide
      226.8 v 414 pmol/l). The patients with autonomic neuropathy had a negligible
      plasma pancreatic polypeptide response (3.7 pmol/l), but this response was also
      blunted in the patients with inadequate hypoglycaemic counterregulation (72.4
      pmol/l) compared with that of the controls (p less than 0.05). CONCLUSIONS:
      Unawareness of hypoglycaemia and inadequate glucose counterregulation during
      hypoglycaemia are related to each other but are not due to autonomic neuropathy.
      The blunted plasma pancreatic polypeptide responses of the patients with
      inadequate hypoglycaemic counterregulation may reflect diminished autonomic
      activity consequent upon reduced responsiveness of a central glucoregulatory
      centre, rather than classical autonomic neuropathy.

PMID- 2224266
TI  - Postoperative analgesic requirements in patients exposed to positive
      intraoperative suggestions.
AB  - OBJECTIVE: To establish whether positive suggestions given to a patient under
      general anaesthesia reduce postoperative pain and analgesic requirements. DESIGN:
      Prospective double blind randomised study. SETTING: Operating theatre and
      gynaecology ward of a teaching hospital. PATIENTS: 63 Woman undergoing elective
      abdominal hysterectomy were randomised to be played either a tape of positive
      suggestions or a blank tape during the operation through a personal stereo
      system. INTERVENTIONS: Three women were withdrawn from the study. Anaesthesia was
      standardised for all of the women. Postoperative analgesia was provided through a
      patient controlled analgesia system for the first 24 hours. Pain scores were
      recorded every six hours. MAIN OUTCOME MEASURES: Morphine consumption over the
      first 24 hours after the operation; pain scores. RESULTS: Mean morphine
      requirements were 51.0 mg (95% confidence interval 42.1 to 60.0 mg in the women
      played positive suggestions; and 65.7 mg (55.6 to 75.7 mg) in those played a
      blank tape. The point estimate (95% confidence interval) for the difference of
      means was 14.6 mg (22.4%) (1.9 (2.9%) to 27.3 mg (41.6%] (p = 0.028). Pain scores
      were similar in the two groups. CONCLUSION: Positive intraoperative suggestions
      seem to have a significant effect in reducing patients' morphine requirements in
      the early postoperative period.

PMID- 2224268
TI  - Widespread cerebral ischaemia treated with nimodipine in a patient with
      eclampsia.

PMID- 2224267
TI  - Bone mineral loss in young women with amenorrhoea.
AB  - OBJECTIVE: To examine the impact of amenorrhoea on bone mineral density in women
      of reproductive age. DESIGN: Cross sectional study of 200 amenorrhoeic women
      compared with normally menstruating controls. SETTING: Teaching hospital
      outpatient clinic specialising in reproductive medicine. SUBJECTS: 200 Women aged
      16-40 with a past or current history of amenorrhoea from various causes and of a
      median duration of three years, and a control group of 57 age matched normal
      volunteers with no history of menstrual disorder. MAIN OUTCOME MEASURE: Bone
      mineral density in the lumbar spine (L1-L4) as measured by dual energy x ray
      absorptiometry. RESULTS: The amenorrhoeic group showed a mean reduction in bone
      mineral density of 15% (95% confidence interval 12% to 18%) as compared with
      controls (mean bone mineral density 0.89 (SD 0.12) g/cm2 v 1.05 (0.09) g/cm2 in
      controls). Bone loss was related to the duration of amenorrhoea and the severity
      of oestrogen deficiency rather than to the underlying diagnosis. Patients with a
      history of fracture had significantly lower bone density than those without a
      history of fracture. Ten patients had suffered an apparently atraumatic fracture.
      CONCLUSIONS: Amenorrhoea in young women should be investigated and treated to
      prevent bone mineral loss. Menopausal women with a past history of amenorrhoea
      should be considered to be at high risk of osteoporosis.

PMID- 2224269
TI  - Should general practitioners call patients by their first names?
AB  - OBJECTIVE: To assess the acceptability to patients of the use of patients' first
      names by doctors and doctors' first names by patients in general practice.
      DESIGN: An administered questionnaire survey. SETTING: 5 General practices in
      Lothian. PATIENTS: 475 Patients consulting 30 general practitioners. MAIN OUTCOME
      MEASURE: Response by patients to questionnaire on attitude to use of first names.
      RESULTS: Most of the patients either liked (223) or did not mind (175) being
      called by their first names. Only 77 disliked it, most of whom were aged over 65.
      Most patients (324) did not, however, want to call the doctor by his or her first
      name. CONCLUSIONS: General practitioners should consider using patients' first
      names more often, particularly with younger patients.

PMID- 2224270
TI  - Screening children from overseas for infections: is it justified?
AB  - OBJECTIVES: To investigate current practice of screening children from abroad for
      infections after coming to the United Kingdom, and to make recommendations for
      future practice. DESIGN: A review of literature and a questionnaire sent to all
      health authorities and boards in the United Kingdom. SETTING: All health
      authorities and boards in the United Kingdom. SUBJECTS: 167 Health authorities or
      boards that completed questionnaires (response rate 80%), 59 of which used a
      screening programme. MAIN OUTCOME MEASURE: Response to questionnaire on policies
      for screening children for infections on their return from overseas. RESULTS: 12
      Of the 59 authorities screened all children and one screened only those from the
      West Indian subcontinent. 13 Authorities excluded children from school while
      awaiting results; 58 screened for tuberculosis and four for diphtheria.
      CONCLUSIONS: There is a wide variation in screening policies around the country
      with no national consensus. Screening for diphtheria, typhoid, and salmonellosis
      is hard to justify and is probably not effective. Screening for tuberculosis,
      however, is supported by many authorities, is widely practised, and probably is
      effective. There is a strong case for rationalisation of screening.

PMID- 2224273
TI  - Surely a natural cancer remedy can't be dangerous.

PMID- 2224271
TI  - Invasive aspergillosis in immunosuppressed patients: potential hazard of hospital
      building work.

PMID- 2224272
TI  - ABC of major trauma. Radiological assessment--I.

PMID- 2224274
TI  - Lowering cholesterol concentrations and mortality.

PMID- 2224275
TI  - Hereditary (primary) haemochromatosis.

PMID- 2224276
TI  - Symptoms of low blood pressure.

PMID- 2224277
TI  - Choice cuts for patients with AIDS?

PMID- 2224278
TI  - Caseload or workload?

PMID- 2224279
TI  - How easy is it to contact the duty doctor responsible for admissions?

PMID- 2224280
TI  - Interpretation and management of PACT (prescribing analysis and cost) data on
      formularies.

PMID- 2224281
TI  - Ciprofloxacin and myasthenia gravis.

PMID- 2224282
TI  - Interaction between fluconazole and rifampicin.

PMID- 2224283
TI  - Analysis of binary trees when occasional multifurcations can be considered as
      aggregates of bifurcations.
AB  - The geometrical properties of neurons are important for the way they function
      within neural circuits. The arborescent processes of neurons that are necessary
      for the transmission of the information are formed by branching and elongation of
      segments. In studies that model the outgrowth the tree structures have generally
      been considered as binary. However, multifurcations do occur. It will be shown
      that if the multifurcations can be considered as aggregates of bifurcations they
      may be included in the topological analysis of neuronal branching patterns.

PMID- 2224286
TI  - International Collegium of Rehabilitative Audiology.

PMID- 2224285
TI  - Comparison of isoeffect relationships in radiotherapy.
AB  - Irradiation affects numerous physiological processes within cells and tissues and
      can lead to damage or death. If the damage is not too severe, cells have the
      ability to repair and regenerate. Many small injuries are repaired more easily
      than ones causing extensive damage and, consequently, tissues typically respond
      differently to one large dose of radiation than to many small doses, separated in
      time. In the radiotherapy of tumors, the choice of the fractionation regimen of
      dose over time is therefore as crucial as the total radiation dose. The
      interdependence between total dose, fractionation regimen, and radiation effect
      has been described mathematically with various isoeffect relationships. These
      relationships appear to be fundamentally distinct and have been considered
      unrelated; some even claim that one class of isoeffect relationships is
      appropriate whereas other relationships are rather useless. We examine how
      alternative isoeffect models relate to each other and test the reliability of
      estimating parameter values of one model from the other.

PMID- 2224284
TI  - Starvation survival and body composition in mammals with particular reference to
      Homo sapiens.
AB  - A computer model of body mass and composition in relation to gross energy balance
      is constructed. The model is built using conventional empirical physiological
      formulae rather than statistical or analytical mathematical techniques. The model
      is applied to the Minnesota and other experiments and produces as good or better
      simulations of observed values of changes in body weight than reported for other
      formulae or models. Alternative physiological mechanisms concerning metabolic
      adaptions to starvation, changes in time activity budgets and the energy
      equivalents of weight loss offer equally good simulations of experimental
      results. The present analysis highlights the survival value of a basal metabolic
      depression during starvation and indicates an optimal body composition of 10%
      mobilizable fat for starvation survival for a 70 kg man. Proper quantification of
      the effects of the physiological mechanisms involved depends on new experimental
      data, however. Long term continuous monitoring of time activity budgets are a
      necessary part of such experiments.

PMID- 2224287
TI  - Transition from pre-linguistic to linguistic communication in hearing-impaired
      infants.
AB  - This paper examines the development of the ability to signal intentionality in
      hearing-impaired infants. Four infants were monitored from the time aids were
      accepted and worn consistently until an expressive vocabulary of ten words was
      recorded. The focus of the study was the child's developing ability to coordinate
      attention to both a person and an object. Longitudinal video-taping allowed
      analysis of the stages and rate at which these infants achieved this pattern of
      attention. These infants were found to follow a sequence of steps similar to that
      reported in studies of hearing children. This finding and its possible
      implications for early identification of hearing impairment are discussed.

PMID- 2224288
TI  - Comparison of hearing aids and cochlear implants in profoundly and totally deaf
      persons.
AB  - Cochlear implants are increasingly used in the rehabilitation of the profoundly
      and totally deaf. Usually, insufficient gain of speech discrimination with a
      powerful conventional hearing aid is considered as a prerequisite for a cochlear
      prosthesis. With recent improvements of electronic systems, the criterion for
      this decision may change. To keep pace with the technical progress, a battery of
      speech sound tests suited for minimal auditory capabilities (MAC-battery) was
      developed and applied to groups of patients fitted with conventional instruments
      and with two different types of cochlear implants. Based on the comparison of the
      MAC-battery results of hearing aid groups, with the average performance of an
      implanted group, most conventionally fitted regular users of hearing aids should
      not be considered as candidates for cochlear implantation. The MAC-battery,
      although not a strictly standardized procedure, is a useful instrument for
      patient counselling and for the selection of implant candidates.

PMID- 2224289
TI  - Measures for the assessment of hearing aid provision and rehabilitation.
AB  - To determine the effectiveness of the provision of a hearing aid, some measure of
      benefit is desirable. Direct determination of benefit is difficult, not least due
      to the problems inherent in defining what benefit actually is. An alternative
      approach is to assess aspects of hearing aid use of performance that relate to
      benefit. Hours of daily use, satisfaction and self-rated performance are measures
      that might be expected to relate to benefit. The studies reported in this paper
      examine the relevance and repeatability of these measures. It is concluded that
      this three-parameter approach provides a simple, relevant and useful way of
      assessing benefit from amplification which has application in both individual and
      group studies.

PMID- 2224291
TI  - Digital/programmable hearing aids--an eye towards the future.

PMID- 2224290
TI  - Clinical trials with a programmable hearing aid set for various listening
      environments.
AB  - A conventional hearing aid has a frequency response that does not change much at
      normal listening levels. It is therefore unlikely that optimal speech
      intelligibility and optimal listening comfort can be obtained simultaneously, or
      in different listening environments. With a programmable hearing aid with
      multiple memories the listener can choose between a range of sound pictures,
      which increases the chance of finding a suitable frequency curve for each
      listening situation. The programmable hearing aid with eight separate settings
      stored in eight memories, was compared with personal hearing aids fitted
      according to the recommendations of the National Acoustic Laboratories (NAL) by
      22 experienced hearing aid users. One memory of the programmable hearing aid was
      initially fitted according to the NAL recommendation. The other memories were
      programmed to give variations around that recommendation. One aim was to
      investigate whether the hearing-impaired user took advantage of different
      frequency responses to achieve listening improvements in acoustically different
      environments. Another aim was to evaluate the ergonomic and acoustical features
      of the programmable hearing aid, compared with other well fitted hearing aids.
      The evaluations were based on comparisons of the test hearing aid to the personal
      aid for each subject, looking at speech tests, direct paired comparison
      judgements, sound quality judgements and interviews. A majority of the subjects
      experienced substantial benefit from being able to use different frequency
      response curves in different environments. With the test hearing aid the subjects
      performed better in speech discrimination tests in noise.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2224292
TI  - The reluctance to acknowledge hearing difficulties among hearing-impaired
      workers.
AB  - The reluctance to acknowledge hearing difficulties was studied with two groups of
      hearing-impaired workers and their spouses. One investigation involved a group
      interview with workers who participated in a pilot rehabilitation programme and
      who experienced the disclosure of their hearing difficulties to others by being
      the subject of a newspaper story on occupational deafness. Analysis of the
      transcript showed that they were strongly stigmatized as being deaf especially by
      co-workers. In a second investigation, interviews conducted with hearing-impaired
      workers who have had no previous contact with hearing specialists were analysed.
      A selection was made of the interviews containing several examples of
      contradiction in the worker's discourse or between the worker and his wife about
      the experience of hearing difficulties. The reluctance to acknowledge hearing
      difficulties was expressed through various forms of denial, minimization of the
      problem, uneasiness in talking about the problem and in attempts to normalize
      oneself. All these expressions can be found in the same individual's discourse.
      It is concluded that reluctance to acknowledge hearing difficulties is part of an
      adaptive process that should be taken into account in rehabilitative
      interventions. It also calls for interventions that would prevent hearing people
      from stigmatizing hearing-impaired people.

PMID- 2224293
TI  - The active fitting (AF) programme of hearing aids: a psychological perspective.
AB  - Rehabilitation of the majority of hearing handicapped in Sweden consists of
      hearing aid fitting, provision of technical devices and information during about
      four visits to a Hearing Centre. Generally there is no structured guidance of the
      hearing handicapped on how to proceed with the hearing aid at home between
      appointments. A programme of active fitting (AF) of hearing aids, with a task
      oriented diary, 'Try Your Hearing Aid' as a basic part, was therefore developed.
      We conducted a series of studies from 1985 to 1988 with the aim of investigating
      the benefit and applicability of the programme. A total of 128 new hearing aid
      candidates participated in three studies at the Sahlgrens hospital and at four
      other hearing centres in smaller Swedish towns. In a controlled study the AF
      group was more positive to their hearing aids and to the fitting period after 10
      months. They used their hearing aids more frequently and felt psychologically
      more secure with them. It was established that the AF programme could well be
      applied in the clinical routine for a majority of new hearing aid patients. Old
      age per se was not found to be a relevant exclusion criterion. The positive
      outcome of the AF programme has stimulated the Swedish Institute of the
      Handicapped to print 'Try Your Hearing Aid' with a manual, and to introduce it to
      all hearing centres in Sweden.

PMID- 2224294
TI  - The international scene in biological and medical libraries.
AB  - This article introduces the Bulletin's special issue devoted to international
      health sciences librarianship with a discussion of the formal structures of
      international cooperation. The International Federation of Library Associations
      and Institutions' (IFLA) Biological and Medical Sciences Libraries Section
      conducts activities along four strands: world and regional health sciences
      library directories, mutually supportive regional groupings, a quarterly
      newsletter, and the quinquennial International Congress on Medical Librarianship.
      These activities, as well as those of other organizations, make up the formal
      international structure of health sciences librarianship.

PMID- 2224295
TI  - Bibliometric aspects of medical information in Arab countries.
AB  - This paper discusses the current state and development of health and biomedical
      literature in Arab countries. The study concentrates on the Arabic sources of
      medical articles, and surveys and analyzes the size of the literature and its
      development in the past 100 years. Two aspects of these sources are covered: the
      Arab medical information sources published within the Arab region, and those
      published outside the region. This includes the quantity of material available
      within and outside the Arab region. The size of the Arab medical literature
      indicates that it is worthy of collection. Treatment of the Arab medical
      literature, a pressing and urgent issue, is needed to assist in the research and
      development of an Arab medical infrastructure.

PMID- 2224296
TI  - Analysis of external and internal interlibrary loan requests: aid in collection
      management.
AB  - The analysis of 60,779 external interlibrary loan requests for copies of
      periodical articles from the collection of Erasmus University Medical Library in
      1988 is described. The study was used for planning the length of backruns to be
      retained due to space limitations that forced the disposal of older volumes. More
      than 50% of requests were for the most recent two-year period, and 90% of
      requests could be filled with a twenty-year run of periodicals. In 1989, 4,157
      internal requests were received for periodicals not owned; these were analyzed to
      determine those most commonly requested. Prior to subscribing, new titles were
      reviewed as to price, bibliometric indicators, number of requests, length of
      backfile, and the number of requesting departments. The Library Advisory Board
      decides on cancellation or purchase of periodicals; the elements considered are
      described.

PMID- 2224297
TI  - The need for a drug abuse documentation center in India.
AB  - The problems of alcoholism and drug addiction are major concerns in India.
      Alcohol and drugs were used in the past to obtain relief from pain and misery and
      to attain a state of forgetfulness. India is presently facing the problem of
      increased trafficking in drugs; heroin and hashish are supplied to the west
      through the subcontinent. Addiction has become a major problem in metropolitan
      centers. The Ministry of Welfare is responsible for drug abuse prevention
      programs and the rehabilitation of addicts. The Ministry of Health and Family
      Welfare is concerned with drug treatment. A deaddiction center, established at
      the All India Institute of Medical Sciences, became operational in 1988; it is
      responsible for health manpower training, research, and documentation. India has
      witnessed an exponential growth in the literature on drug abuse; it is no longer
      possible for a single library to acquire all of the international literature.
      There is a clear need to establish a drug abuse information center in India. This
      paper describes the aims, objectives, and planning for such a center and
      recommends the establishment of a national center in New Delhi with regional
      centers in other geographic areas.

PMID- 2224298
TI  - The use of grey literature in health sciences: a preliminary survey.
AB  - The paper describes some initiatives in the field of grey literature (GL) and the
      activities, from 1985, of the Italian Library Association Study Group. The major
      categories of GL are defined; a survey that evaluates the use of GL by end users
      in the health sciences is described. References in selected periodicals and
      databases have been analyzed for the years 1987-1988 to determine the number of
      articles citing GL, the number of GL citations found in selected periodicals, the
      various types of GL found, and the number of technical reports cited and their
      country of origin and intergovernmental issuing organization. Selected databases
      were also searched to determine the presence of GL during those same years. The
      paper presents the first results obtained.

PMID- 2224299
TI  - Regional health library service in northern Ireland.
AB  - The regional medical library service provided to physicians, hospitals, nurses,
      social workers, and health care administrators throughout Northern Ireland by the
      Queen's University of Belfast is described. A brief outline of the National
      Health Service in the United Kingdom is given, and the library service is
      described in terms of collections, cataloging, interlibrary loan, and reference.

PMID- 2224300
TI  - Health sciences libraries and information services in Bangladesh.
AB  - Basic problems relating to the status of health sciences libraries and
      information centers in Bangladesh are highlighted and discussed; strategies for
      improving the country's health sciences information services are suggested. A
      survey of libraries is reported, the country's national science and technology
      information policy is defined, and recommendations for action are proposed.

PMID- 2224301
TI  - National bias: a comparison of citation practices by health professionals.
AB  - It is hypothesized that health professionals in the United States and the United
      Kingdom are nationally biased in their citation practices. Articles published in
      the New England Journal of Medicine and Lancet were used to study citation
      practices of U.S. and U.K. authors. Percentages of cited references to material
      published in a specific country were calculated for both the New England Journal
      of Medicine and Lancet. Using a variation of a citation publication ratio based
      on Frame and Narin's original ratio, an attempt was made to quantify author bias.
      To calculate these ratios, values from SERLINE* and the British Library Lending
      Division were employed to find world journal counts. The results suggest that
      U.S. authors publishing in the New England Journal of Medicine and U.K. authors
      publishing in Lancet tend to cite material produced in their own countries more
      than would be warranted by the amount of material produced by these countries. In
      addition, these authors cited material produced in non-U.S. and non-U.K.
      countries far less than the amount of material produced by these countries would
      indicate.

PMID- 2224302
TI  - Information needs of academic medical scientists at Chulalongkorn University.
AB  - The information needs of scientists in English-speaking countries have been
      studied and reported in the library literature. However, few studies exist on the
      information-seeking patterns of scientists in developing countries, and no study
      has examined the information needs of medical scientists in developing Asian
      countries. This study investigated the information needs of academic medical
      scientists at Chulalongkorn University in Bangkok, Thailand. The results indicate
      that medical scientists have three types of information needs: identifying up-to
      date information, obtaining relevant studies and data, and developing research
      topics. Thai scientists' information-seeking behavior was different from that of
      scientists in developed countries. The study shows a high use of libraries as
      information providers; Thai medical scientists rely heavily on information from
      abroad.

PMID- 2224303
TI  - Options for the disposal of unwanted donations.
AB  - Donations of biomedical books and journals frequently duplicate the holdings of a
      receiving library. A decision must then be made concerning the distribution of
      the material to other libraries that may need it. What options are available to
      the librarian? Are many volumes of valuable material destroyed each year because
      libraries lack the necessary staff, space, or money to distribute donated
      materials? Are libraries restricted in choice of methods for distribution or
      unaware of available options? A survey questionnaire was mailed to 150 health
      sciences libraries in the spring of 1988 to determine the various methods used to
      dispose of unwanted gift materials. A total of 113 responses was received (75%
      return rate). This paper reports the results and discusses some of the creative
      methods used by receiving libraries to place unneeded materials. Statistical
      comparisons are included for the methods used by academic, hospital, and other
      types of health sciences libraries.

PMID- 2224304
TI  - An evaluation of CD-ROM MEDLINE use in Thailand.
AB  - An analysis of requests for CD-ROM MEDLINE* searches from June to December 1987
      at the Medical Library, Chulalongkorn University, was performed. Requests were
      received from eighty-two places, in Bangkok and the provinces; 97.8% were from
      government organizations. MEDLINE on CD-ROM was available from 1982 to date. Most
      users requested searches covering the previous five or six years. Users were
      surveyed regarding the service: just over 87% found the service user-friendly. In
      addition, users suggested that the library conduct search training programs, and
      more than half of the users noted that a single work station could not meet the
      search load.

PMID- 2224305
TI  - Research activities among health sciences librarians: a survey.

PMID- 2224306
TI  - MLA's international program.

PMID- 2224307
TI  - Project HOPE archive.

PMID- 2224308
TI  - The world of health sciences libraries.

PMID- 2224310
TI  - The information explosion.

PMID- 2224309
TI  - Government documents.

PMID- 2224311
TI  - To amputate or not? Information needed PDQ!

PMID- 2224312
TI  - BIOSIS previews.

PMID- 2224313
TI  - Influencing our future.

PMID- 2224314
TI  - [The various uses of in-vitro reconstituted skin].
AB  - Skin is one of the most suitable organ to assess reconstruction in vitro. After
      forming dermis, by incubation of fibroblasts within a network of collagen fibers,
      a layer of cultured keratinocytes reconstruct the epidermis. This tissue, even
      though imperfect, represents a valuable tool for the study of cell physiology,
      the demonstration of interaction between cell and their support and exchange of
      information between cells of different types. Within the model, cells acquire a
      state of differentiation close to that observed in vivo. Reconstructed skin may
      be used for the study of physiopathology of various cutaneous diseases and allows
      pharmacotoxicological studies. Keratinocytes in culture, as well as the
      reconstructed skin, have been successfully used for grafting cutaneous defects.

PMID- 2224315
TI  - [The latissimus dorsi territory: a privileged donor site].
AB  - The latissimus dorsi is one of the most used donor areas in various fields of
      reconstructive surgery. After a short historical review, the main anatomical
      features, classical as well as new, are outlined in the view of reconstructive
      procedures. If it now demonstrated that the exceptional reliability of this
      myocutaneous territory allows to perform operations that belong to the routine
      like taking part in mammary reconstructions or to more sophisticated techniques,
      like in head and neck reconstruction. Among future prospects, we will consider
      the total mammary reconstruction and the cardiomyoplasty.

PMID- 2224316
TI  - The changing agenda for health care in America: balancing need and commitment.
      Annual Health Conference, May 9-10, 1989.

PMID- 2224317
TI  - New initiatives for children's services.

PMID- 2224318
TI  - New entitlement programs.

PMID- 2224319
TI  - The nation's health goals: social change, problems and opportunities.

PMID- 2224320
TI  - The nation's health goals. The new political dynamics: federal and state
      initiatives.

PMID- 2224321
TI  - Policy implications of socioeconomics.

PMID- 2224322
TI  - Physician payment and the resource based relative value scale.

PMID- 2224323
TI  - Dilemmas in payment, reimbursement and regulation. Achieving a balanced
      perspective on state regulation.

PMID- 2224324
TI  - A hospital administrator's perspective on regulation.

PMID- 2224325
TI  - Dilemmas in payment, reimbursement, and regulation. A practicing physician's
      experience.

PMID- 2224327
TI  - Treatment of the asthmatic child.
AB  - At the end of 1983 the outpatient clinic at the National Children's Hospital in
      San Jose, Costa Rica, adopted a new program for treating children with asthmatic
      crises. Use of adrenaline was discontinued, and administration of salbutamol in
      aerosol and short courses of corticosteroids was introduced; also, a special
      outpatient room was set aside for treating pediatric asthma cases. Between 1984
      and 1986 this program's marked superiority was demonstrated by many developments-
      including reduction of both initial hospitalizations and readmissions for
      pediatric asthma by nearly 70%.

PMID- 2224326
TI  - Physicians and managed care programs.

PMID- 2224328
TI  - Health and tourism in the Caribbean.
AB  - Health and tourism impact on each other in the Caribbean, so it is both
      appropriate and necessary that those concerned with tourism in the region should
      consider health issues. The health and environment of the Caribbean can have good
      or bad effects upon the health of visitors, and tourism has health consequences
      for local residents. Tourism for health purposes also needs to be considered.
      This article points out the major issues related to these interactions, indicates
      where more data are needed, and suggests lines of future action.

PMID- 2224329
TI  - Prevalence of Wuchereria bancrofti in Georgetown, Guyana.
AB  - A random sample bloodsmear survey was conducted during evening hours in
      Georgetown, Guyana, to determine the prevalence of Wuchereria bancrofti
      microfilariae. In all, 182 of 2,818 persons tested (6.5%) yielded positive
      results--indicating that the overall prevalence of Bancroftian filariasis has not
      diminished and may be on the rise. Relatively high prevalences found in children
      and adolescents point to active transmission. It appears likely that certain
      socioeconomic and environmental factors have been contributing to such
      transmission, and that similar factors could encourage increased transmission
      elsewhere in the Americas as well.

PMID- 2224330
TI  - Field evaluation of Bacillus thuringiensis var. israelensis for control of black
      flies in the North Littoral Zone of Brazil's Sao Paulo State.
AB  - The impact of three flowable concentrate formulations of Bacillus thuringiensis
      var. israelensis (H-14) upon Simulium pertinax larvae was evaluated in 24 coastal
      streams of Brazil's Sao Paulo State. While no significant differences were found
      regarding the three formulations' effectiveness, significant correlations were
      found between the discharge rates of individual streams and the distances over
      which at least two of the formulations were carried effectively downstream to
      produce 80% mortality. The relatively short carry distances found for small
      streams could pose difficulties for control programs that need to treat large
      numbers of such streams, and suggests a need for research directed at increasing
      the distances B. thuringiensis (H-14) formulations can be carried.

PMID- 2224331
TI  - The elderly in Barbados: problems and policies.
AB  - Empirical data on conditions affecting elderly people in the Caribbean are very
      limited. To help deal with this lack of information in the specific case of
      Barbados, in 1982 a survey was conducted of 525 randomly selected people 65 years
      of age or older. This article summarizes data derived from that survey in order
      to provide an overview of the social and economic circumstances affecting
      Barbados' elderly population. While it is true that these circumstances do not
      necessarily mirror those found elsewhere, they clearly have elements in common;
      and it seems likely that the survey approach applied in this instance could prove
      useful elsewhere in obtaining worthwhile information.

PMID- 2224332
TI  - Aging: a challenge beyond the year 2000.

PMID- 2224334
TI  - The role of social security in the provision of medical care in the English
      speaking Caribbean.

PMID- 2224333
TI  - Combating AIDS in the Caribbean: a coordinated subregional approach.

PMID- 2224335
TI  - Prevention and control of hospital infections in Latin America and the Caribbean.

PMID- 2224336
TI  - Safe current limits.

PMID- 2224337
TI  - Technology management in the health care environment--yesterday, today, and
      tomorrow: Part 1.

PMID- 2224338
TI  - Designing and implementing a computerized parts-inventory management system.

PMID- 2224339
TI  - Surviving and growing in the '90s: managerial methods for the hospital-based
      BME/CE department.

PMID- 2224340
TI  - The design of a microcomputer-controlled voice onset time analyzer.
AB  - In spoken syllables such as "ta," the interval between the release of the tongue
      constriction for the stop consonant /t/ and the onset of the vowel is called
      voice onset time, or VOT. Voice onset time is an important determinant of whether
      the initial consonant will be heard as a /t/(values of 60-90 ms) or as a /d/
      (values of 0-30 ms). VOT information, immediately following a spoken syllable,
      can provide a speaker with feedback for modifying speech production. Such
      information can help the hearing-impaired learn to speak. It may also help people
      who learn English as a second language, since they often produce /b,d,g/ and
      /p,t,k/ with inappropriate VOT values. A prototype portable device measures VOT
      for initial voiced and voiceless stop consonants (e.g., "da" and "ta"). A dual
      microphone method is used for acoustic measurement. A microphone in front of the
      mouth picks up the radiated acoustic signal; another over the larynx transduces
      vocal vibrations that mark the beginning of a vowel. Analog circuits process the
      transducer signals and provide gain and filtering. Filters were designed on the
      basis of the acoustic properties of stop consonants. The output from each analog
      circuit is fed to a comparator that compares the signal level with a fixed
      threshold voltage reference. A digital timer starts when the amplitude of the
      oral signal voltage exceeds a threshold and stops when the laryngeal signal
      voltage exceeds a threshold. VOT values obtained by the device were compared with
      those made from digital waveforms of words spoken by five talkers.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2224341
TI  - A pressure-sensitive mat for measuring contact pressure distributions of patients
      lying on hospital beds.
AB  - The authors describe a novel system for sensing and displaying the distribution
      of contact pressure caused by a patient's lying on a hospital bed. The system
      includes a flexible, pressure-sensitive mat, electronics to activate the mat, a
      small computer to process data, and a color video display. The present prototypes
      can sense pressure at 1,536 discrete locations in a rectangular grid of 24 x 64
      nodes, each node representing an area of 4 cm2. The computer receives data from
      each node and displays the results as a false-color map, refreshable every 5
      seconds. The pressure-sensitive mat itself includes two orthogonal arrays of
      ribbon-like conductors, composed of silver-coated nylon fabric, which are
      separated by insulating open-cell foam rubber. The system monitors the electrical
      capacitance between selected pairs of horizontal and vertical conductors on
      opposite sides of the foam. The crossing points form pressure-sensitive nodes.
      Increased contact pressure compresses the foam, thereby decreasing the distance
      between the conductors and increasing the capacitance. Node capacitance is
      determined by measuring the current through it from a voltage source. The outputs
      of the various nodes are scanned, normalized, and converted to pressures using
      the known compressive stress-strain relationship for the foam, and the data are
      then displayed as a false-color image of the pressure distribution.

PMID- 2224342
TI  - The accuracy of rapid oscillometric blood pressure determination.
AB  - The Dinamap 1846SX (DIN) offers a "stat mode" (SM) for rapid repetitive blood
      pressure determinations, but its accuracy has not been reported. Thirty patients
      who required an intra-arterial catheter (IAC) for management of anesthesia
      underwent induction with concomitant noninvasive blood pressure measurement
      provided by a DIN set in SM. Computerized automated data acquisition recorded
      digital outputs from both monitors at the time of new SM readings. Systolic
      pressure mean absolute error (MAE) was 13.3 +/- 5.7 mmHg (mean +/- SEM) and the
      mean error (bias) was -8.7 +/- 9.8 mmHg. Mean pressure MAE was 6.8 +/- 3.4 mmHg
      and bias was -0.5 +/- 6.3 mmHg. Diastolic pressure MAE was 7.0 +/- 3.3 mmHg and
      bias was -0.3 +/- 6.5 mmHg. There was a tendency for systolic pressure readings
      to underestimate IAC pressures at higher pressures. These findings echo results
      reported previously for DIN operating in its normal mode. Rapid arterial pressure
      determination by SM does not appear to compromise accuracy.

PMID- 2224343
TI  - Organizing a study program for BMETs.

PMID- 2224344
TI  - The venous drainage of nerves; anatomical study and clinical implications.
AB  - The venous drainage of the peripheral nerves was studied in the upper and lower
      limbs of two human fresh cadaver subjects after total body perfusion with a radio
      opaque lead oxide mixture. Four patterns of extraneural drainage were identified
      in which the venae nervosa drained: directly to the venae comitantes of the
      neurovascular bundle; indirectly via nearby veins, derived usually from muscles;
      to the periarterial venous plexus; or, in the case of the cutaneous nerves, to
      the perivenous plexus. The various patterns of the drainage along the length of
      the radial, median, ulnar, sciatic, anterior and posterior tibial nerves were
      identified. A rich longitudinal plexus of veins exists on and within the nerve
      which appears to be mainly free of valves. The large venae nervosa usually
      contained valves, whereas the tiny veins draining the nerves were valveless or
      exhibited a sentinel valve at their entry point into a larger venous channel. The
      clinical implications of these results are discussed in relation to the
      mobilisation of nerves, the use of island nerve flaps, possible donor sites for
      free arteriolised neurovenous flaps and the compressive nerve syndromes.

PMID- 2224346
TI  - Titanium in reconstructive surgery of the skull and face.
AB  - Titanium is widely used as an implant material. This report describes its use for
      cranioplasty and malar defects and the technique used to fashion these prostheses
      in a centre which does not have the facility for producing computer-generated
      full-size craniofacial models. The use of these prostheses has produced very
      satisfactory results with minimal morbidity and no complications.

PMID- 2224345
TI  - Epidermoid cyst and cholesterol granuloma of the orbit.
AB  - Epidermoid cyst and cholesterol granuloma have been confused, but these are
      different lesions. A case of recurrent orbital epidermoid cyst and another case
      of orbital cholesterol granuloma are presented in order to describe their
      distinct pathological, clinical and imaging characteristics and their surgical
      management. Advanced investigation using our custom-designed three-dimensional
      imaging allowed a better appreciation of the exact location, and optimal planning
      of the surgical treatment. The same surgical approach was used for both lesions:
      total resection via a coronal incision and immediate reconstruction of residual
      defects using skull bone grafts.

PMID- 2224347
TI  - Three anteromedial fasciocutaneous leg island flaps for covering defects of the
      lower two-thirds of the leg.
AB  - Three different fasciocutaneous island flaps based on the medial septocutaneous
      vessels of the leg have been successfully transferred in eight patients. The
      flaps are based on three segments of the anteromedial aspect of the leg where
      their feeding vessels were most frequently identified. These anteromedial
      fasciocutaneous leg island flaps are thin, reliable and safe. They are relatively
      easy to elevate and are useful for covering defects of the lower two-thirds of
      the leg.

PMID- 2224348
TI  - Distally-based random fasciocutaneous flaps for multi-staged reconstruction of
      defects in the lower third of the leg, ankle and heel.
AB  - Distally-based random pattern fasciocutaneous flaps were used to reconstruct
      defects of the lower third of the leg, the ankle and the heel in eight patients.
      Though a multi-staged procedure, this simplified fasciocutaneous flap design
      ensured safe transfer of tissue to defects in which it would otherwise have been
      very difficult to have obtained cover. This paper discusses the anatomical basis
      of the distally-based random pattern fasciocutaneous flaps and reviews the
      design, surgical technique, advantages, limitations and complications of these
      flaps.

PMID- 2224349
TI  - Lateral sural cutaneous artery island flap in the treatment of soft tissue
      defects at the knee.
AB  - This paper describes a flap for covering defects around the knee. Dissections of
      20 legs showed that in the majority the lateral sural cutaneous artery branched
      from the popliteal artery and descended along the posterolateral aspect of the
      leg together with two venae comitantes and the lateral sural cutaneous nerve. An
      island flap was designed, pedicled on these vessels and nerve, and was used in 17
      patients with defects around the knee, including acute trauma (three cases), soft
      tissue tumours (three cases), unstable scar or ulcer (seven cases), and chronic
      osteomyelitis or infected open fractures with tissue loss (four cases). All the
      flaps survived entirely and possessed normal sensation. Furthermore, it was not
      necessary to sacrifice the main vessels of the lower leg.

PMID- 2224350
TI  - A comparative study of surgical results with rotation-advancement and triangular
      flap techniques in unilateral cleft lip.
AB  - This paper presents a randomised comparative study of surgical results of
      unilateral cleft lip repair with 58 rotation-advancement and 50 triangular flap
      repairs, the two commonly used types of repair at present, carried out over a
      period of 6 years. The surgical results following both repairs were assessed on a
      scoring basis. No significant difference was found in overall postoperative
      appearance of lip and nose between the two types of repair. As a result, we
      recommend either technique for unilateral cleft of the lip.

PMID- 2224351
TI  - Open reverse-U incision technique for secondary correction of unilateral cleft
      lip nose deformity.
AB  - A new technique for secondary correction of unilateral cleft lip nose deformity
      is described. It is a combination of Tajima's reverse-U incision and Rethi's
      columella-alar rim incision techniques. It gives a markedly increased exposure
      under better direct vision and enables easier and more accurate handling of the
      nasal framework in secondary correction of the unilateral cleft lip nose
      deformity.

PMID- 2224352
TI  - The redistribution of collagen in expanded pig skin.
AB  - Silicone tissue expanders were inserted subcutaneously in the buttocks of nine
      young pigs and gradually inflated to maximum capacity over 5 weeks. On the
      control side the expanders were left uninflated. Island buttock flaps were then
      raised, the expanders removed and the flaps spread into the same sites for 10
      days. The tissue was harvested. Area measurements and full thickness skin
      biopsies were taken 10 days after flap inset in order to study the changes in
      collagen composition and isotypes in the skin layers. Ten days after inset of the
      flap the expanded skin had a mean 47% increase in surface area, was 9% thinner
      (from surface to implant), mostly due to thinning of the subcutaneous zone, but
      was not significantly different in water content, relative to the control skin.
      The expanded skin had a significant 9.3% increase (p less than 0.01, t test) in
      collagen content of the dermis. The relative proportions of Types I and III were
      not significantly changed by skin expansion in either the dermal/epidermal or
      subcutaneous/capsular zones. It is speculated that tensile factors during
      expansion stimulate the biosynthetic activity and/or mitotic activity of
      fibroblasts in the dermis to produce this gain in collagen in the expanded
      compared with unexpanded tissue.

PMID- 2224353
TI  - Foetal wound healing in a large animal model: the deposition of collagen is
      confirmed.
AB  - Foetal wound healing occurs without scarring. A scar is a collagen-rich repair
      tissue, and the absence of scarring in the foetus has raised questions concerning
      the presence and nature of collagen deposition in foetal wounds. Studies of
      collagen deposition in foetal wounds in small animals, performed late in
      gestation, have been equivocal. In this study, using a large animal with a long
      gestational period, the sheep, the deposition of collagen is confirmed.

PMID- 2224354
TI  - Lymph node transfer for the treatment of obstructive lymphoedema in the canine
      model.
AB  - The efficacy of transferring vascularised lymph nodes into lymphoedematous limbs
      was investigated. Stable below-knee lymphoedema was established in one hind limb
      of 10 dogs. The superficial inguinal lymph node and perinodal tissue from the
      normal hind limb was moved to the popliteal region of the lymphoedematous leg as
      a free vascularised transfer. In five dogs lymphaticolymphatic anastomoses
      between lymphatics of the node and proximal recipient site lymphatics were also
      performed. Circumferential measurements of the foot, ankle and midleg were
      obtained preoperatively and postoperatively at 3 and 6 months. These measurements
      showed postoperative reduction of the lymphoedematous legs compared to controls,
      with no added benefit from lymphaticolymphatic anastomoses. Technetium 99 scans
      and lymphangiography demonstrated re-establishment of lymphatic continuity in all
      recipient legs at 3 and 6 months post-transfer. Histological examination at 3 and
      6 months revealed normal architecture in 9 of 10 nodes, although areas of
      lymphocyte depletion were common. Vascularised lymph node transfer to a
      lymphoedematous leg re-established lymphatic continuity and resulted in partial
      reduction of limb size. The addition of lymphaticolymphatic anastomosis to
      vascularized node transfer is neither necessary nor beneficial.

PMID- 2224355
TI  - Can chlorpromazine prevent flap necrosis?
AB  - The influence of chlorpromazine hydrochloride on failing, cranially-based dorsal
      flaps of female rats (Uje:WIST) was studied. The drug was injected subcutaneously
      into the abdomen pre- and postoperatively. The dosage was 1.5 mg/100 g
      preoperatively and 0.75 mg/100 g body weight every 12 hours following flap
      replantation for 10 consecutive days. No improvement in the survival rate was
      achieved by administration of chlorpromazine hydrochloride in this rat strain.

PMID- 2224356
TI  - A prospective trial of adrenaline infiltration for controlling bleeding during
      surgery for gynaecomastia.
AB  - Twenty patients with gynaecomastia undergoing operations on 33 breasts were
      entered into a prospective randomised controlled clinical study. The breasts were
      randomised to receive nothing or adrenaline infiltration prior to mastectomy.
      Blood loss during surgery and drainage afterwards were compared between the two
      groups. Statistical analysis using the Wilcoxon rank sum test (two-tailed) showed
      a statistically significant reduction in operative blood loss (p less than 0.01)
      but no difference in postoperative drainage. There was no adverse effect on the
      viability of the skin flaps or the nipple-areola complex.

PMID- 2224357
TI  - A radical approach in the treatment of the deviated nose.
AB  - Surgical attempts to straighten a deviated nose do not always produce a
      satisfactory result, partly due to the surgeon's inability to straighten the
      anterior part of the nasal septum or to maintain it in a correct position
      postoperatively. In a radical departure from accepted norms we have, in eight
      cases, excised the deviated part of the anterior nasal septum and replaced it
      with a bone graft. The background and the need for this procedure are explained,
      followed by a case report in some detail. Details of the eight cases are given in
      a table and representative cases are presented with illustrations and comments
      regarding the problems encountered with the present method.

PMID- 2224358
TI  - Immediate exposed skin grafting in children's burns.
AB  - The technique of immediate exposed skin grafting following early tangential
      excision of burns in children overcomes the difficulties of applying dressings
      with the attendant risk of graft loss from shearing forces. We report on 36
      patients treated by this method. Wound healing was achieved in all patients
      without the need for further surgery.

PMID- 2224359
TI  - Malignant melanoma of the external ear.
AB  - Twelve patients with primary melanoma of the external ear were treated during a
      10-year period. Ten patients were males. Median melanoma depth was 2.1 mm and
      seven patients had lesions deeper than 2 mm. Eight of 12 lesions were either
      Clark level IV or V. Six patients had wedge excisions of the primary lesion and
      all developed recurrent disease (local: three). Six patients underwent wide
      excision and none developed local recurrence. All patients with primary disease
      less than 2 mm are alive. Only two of seven patients with lesions deeper than 2
      mm have survived. The definitive excision for melanoma of the ear should
      encompass wide margins despite the cosmetic consequences. Lesser procedures
      inevitably lead to local recurrence. Melanoma deeper than 2 mm penetration on the
      ear in our series had a poor prognosis.

PMID- 2224360
TI  - Buccal mucosal flaps in nasal reconstruction.
AB  - Buccal mucosal flaps provide a simple and effective method of replacing nasal
      mucosal lining. This technique has been used in 15 patients requiring
      reconstruction of full thickness defects of the lateral nasal wall and tip of
      nose, in combination with a variety of local flaps for skin cover. The buccal
      mucosal flap is of particular value in reconstructing the common defect of the
      lower lateral nasal wall and alar rim where more bulky reconstructions often
      distort the airway.

PMID- 2224361
TI  - Successful replantation of nose by microsurgical technique, and review of
      literature.
AB  - We present a case of total amputation of a major portion of the nose of a 10-year
      old boy, which was successfully replanted by microsurgical technique. A 489-year
      review of the literature revealed the rarity of successful nasal replacement
      following amputation.

PMID- 2224363
TI  - Vascularised reconstruction of the clavicle.
AB  - A rare malignant tumour presented as a pathological fracture in the clavicle of
      an 11-year-old girl. This was resected and the defect reconstructed using a
      pedicled bilobed flap based on the thoracodorsal system with latissimus dorsi and
      serratus anterior with a rib to replace the clavicle. The innervation of both
      donor muscles was preserved. The reconstruction was cosmetically acceptable and
      maintained the function of the thoracohumeral articulation. Although the use of
      vascularised rib grafts in composite flaps is well documented, this is the first
      report of clavicular reconstruction using the technique.

PMID- 2224362
TI  - Immediate reconstruction of the penis with an iliac flap.
AB  - Immediate reconstruction of the penis can save time and significantly reduce
      postoperative psychological morbidity. A patient suffered a cancerous lesion in
      his glans penis. After total amputation, an iliac flap based on the superficial
      circumflex iliac artery was used to reconstruct the penis. The subcutaneous
      tissue around the vascular pedicle was carefully preserved for enhancing the
      venous drainage of the new penis. A self-sculptured silicone implant was inserted
      later to increase the penile rigidity. The advantages of this technique include
      ready availability, easy mobilisation, hairlessness, elimination of multi-staged
      procedures, and saving time. The patient is pleased with the operative results.

PMID- 2224364
TI  - A simple penile dressing following hypospadias surgery.
AB  - A single layer of surgical gauze applied with adhesive provides a simple and
      inexpensive dressing for use following hypospadias repair. It splints the penis
      to the abdomen, supports the wound and secures the catheter while permitting
      observation and wound care.

PMID- 2224365
TI  - A chair for patients with burns of the back.

PMID- 2224366
TI  - Confusion of the use of the term "septocutaneous".

PMID- 2224367
TI  - Educating the psychiatrist of the 21st century.
AB  - Psychiatry is under threat from developments within mental health care. In
      educating future psychiatrists, more emphasis should be placed upon:
      collaborative research; integrated teamwork, without interprofessional rivalry;
      work in primary care; the non-scientific components of psychiatry, centred upon
      relationships with patients; less dogmatic attitudes for or against
      psychoanalysis: psychiatry as a branch of medicine; and modern management and
      audit methods. Younger psychiatrists should be encouraged to take responsibility
      for shaping the future of the profession.

PMID- 2224368
TI  - Further investigation of the predictors of outcome following first schizophrenic
      episodes.
AB  - The outcome at two years of patients who were eligible for a study of first
      schizophrenic episodes was assessed in terms of occupation (n = 237) and in terms
      of number of days spent as an in-patient from the time of first admission (n =
      252), and was related to social, behavioural, mental state and neurological
      measures during the initial admission. Poor outcome was in general associated
      with more social withdrawal, inactivity and abnormal social presentation and with
      more 'neurological soft signs'. Good occupational outcome in patients with a
      relatively short pre-treatment duration of illness was associated with the
      prescription of placebo medication during the follow-up period.

PMID- 2224369
TI  - Alcoholism: a follow-up study of participants in an alcohol treatment programme.
AB  - One hundred and twelve alcoholic patients treated by an intensive one-month
      residential programme were followed up for one year. As a group, they were
      socially disadvantaged and highly dependent on alcohol. Outcome of treatment was
      assessed at six months and one year following discharge by multiple measures
      which included assessments of drinking behaviour, measurements of social
      stability, neuroticism and self-esteem, and self-ratings of satisfaction with
      important aspects of day-to-day living. During the first six months following
      treatment, 37% were abstinent or drinking in controlled fashion; during the
      second six months, 53% achieved this status. Improvement in drinking status was
      positively related to improvements in all other outcome variables.

PMID- 2224370
TI  - 3H-imipramine binding to previously frozen platelet membranes from depressed
      patients, before and after treatment.
AB  - 3H-imipramine binding in 39 drug-free patients with major depression and 44
      healthy controls did not differ significantly between the two groups, in male or
      female subjects or in subgroups of depressed patients divided by endogenicity or
      dexamethasone suppression test result. 3H-imipramine binding in depressed
      patients drug-free for less than three weeks did not differ from those drug-free
      for longer intervals or from controls. A significant seasonal variation of 3H
      imipramine Bmax was found, with lower values in summer and autumn. Treatment of
      depressed patients with imipramine or lofepramine for six weeks increased KD and
      Bmax. Methodological modification (in preparation and storage of platelets) does
      not explain the major differences in results between this study (using frozen
      platelets), a previous one (using freshly prepared platelets) and others in
      general, although it might contribute to the range of values reported.

PMID- 2224371
TI  - Multimodal imaging in Alzheimer's disease. The relationship between MRI, SPECT,
      cognitive and pathological changes.
AB  - Patients with a clinical diagnosis of Alzheimer's disease were studied using MRI,
      SPECT, and psychometric tests. Significant correlations between focal perfusion
      deficits and focal cognitive deficits were found. Significant correlations
      between regional relaxation time of white matter and psychometric tests of
      diffuse and focal categories were also found. Pathological examination confirmed
      Alzheimer's disease as the only diagnosis.

PMID- 2224372
TI  - Daughters of people with dementia. Expressed emotion, strain and coping.
AB  - Twenty-five women who were the primary carers for a parent with dementia rated
      for expressed emotion (EE) and then divided into two groups: 11 with low-EE
      ratings and 14 with high-EE ratings. Although there were no differences between
      these groups in the levels of their parents' cognitive impairment, when such
      impairment was taken into account, high-EE subjects were found to report higher
      levels of strain and distress. More efficient coping strategies were reported by
      subjects who made fewer critical comments and more positive remarks. High-EE
      subjects more frequently had no living siblings, and were more likely to have had
      a respite break from caring. EE status was not associated with continuing care in
      the community at a nine-month follow-up.

PMID- 2224373
TI  - Further change in the pattern of mental illness in the elderly.
AB  - The methods of Roth's 1948-49 Graylingwell study, previously applied to a
      Crichton cohort of elderly patients of the years 1974-76, were repeated in 1984
      86. The results support the continuing validity of Roth's classification of
      mental illness in the elderly, but changes in the diagnostic distribution of the
      cohort, previously observed in the 1970s study, are further in evidence in the
      1980s one. Admissions of dementia cases continued to increase both relatively and
      absolutely, while the trend of increasing survival in dementia also continued.

PMID- 2224374
TI  - A double-blind placebo-controlled study of buspirone in diazepam withdrawal in
      chronic benzodiazepine users.
AB  - A double-blind placebo-controlled trial of 23 chronic benzodiazepine users showed
      that overall, buspirone did not appear to be helpful in alleviating
      benzodiazepine withdrawal symptoms. Buspirone (5 mg t.d.s.) or placebo was
      administered for four weeks before, during and after diazepam withdrawal.
      Patients taking buspirone had a markedly higher dropout rate (seven out of 11)
      than those taking placebo (one out of 12). Mean daily diazepam dosage at entry
      was significantly higher in the buspirone group, but overall initial diazepam
      dosage was not related to outcome. Higher subjectively rated anxiety at the start
      of withdrawal was significantly related to higher dropout rate, irrespective of
      treatment, and was greater (although not significantly so) in the buspirone
      group.

PMID- 2224375
TI  - Accounting for delusional misidentifications.
AB  - Accounts of the major DMSs are given using theoretical models of the functional
      components underlying recognition of familiar people. Thus, Capgras' syndrome is
      suggested to involve impairment of processes that can support 'covert'
      recognition of familiar faces in prosopagnosia. It therefore forms a potential
      'mirror image' of the impairments underlying prosopagnosia, and earlier attempts
      to link the two conditions directly are questioned. Fregoli syndrome and
      intermetamorphosis are explained as defects at different stages of an information
      processing chain. Not only are these accounts consistent with the association of
      different DMSs with different brain injuries, but they also offer both
      suggestions for new inquiries and predictions about possible preserved and
      impaired abilities.

PMID- 2224376
TI  - Factors related to self-reporting of the pre-menstrual syndrome.
AB  - Menstrual health questionnaires were completed by a self-selected sample of the
      readership of a woman's magazine (n = 5457). Sixty-one per cent of subjects
      described themselves as suffering from pre-menstrual syndrome (PMS) and this was
      largely corroborated by ratings of symptoms pre-menstrually, menstrually and post
      menstrually for the most recent cycle. Mood symptoms were more strongly
      implicated than physical ones. Self-report of PMS was found to be modestly
      associated with aspects of parity and oral contraceptive use, but strongly and
      positively related to the duration of 'natural' menstrual cycles (i.e.
      uninterrupted by pregnancy or steroidal contraception) and to psychosocial
      stress. There were interactions among psychosocial factors and between
      psychosocial load and duration of natural cycles.

PMID- 2224377
TI  - A controlled study of psychological and social change after surgical gender
      reassignment in selected male transsexuals.
AB  - Of two groups of 20 patients accepted for gender reassignment surgery, one was
      offered early operation and therefore had had surgery by follow-up two years
      later, while the second was still awaiting operation at two-year follow-up.
      Although the groups were similar initially, significant differences between them
      emerged at follow-up in terms of neuroticism and social and sexual activity, with
      benefits being enjoyed by the operated group.

PMID- 2224378
TI  - Clinical features of patients attending a gender-identity clinic.
AB  - Of 106 patients attending a gender-identity clinic, 73% satisfied DSM-III
      criteria for transsexualism. These DSM-III positives had a significantly younger
      age of onset and were less likely to experience sexual arousal with cross
      dressing than those who did not satisfy DSM-III criteria. They were also
      significantly more likely to fulfil a definition of 'core transsexualism'. 'Core
      transsexualism' may represent a subgroup within DSM-III criteria for
      transsexualism and its defining features in this study were an early age of
      onset, low sexual activity, lack of sexual arousal with cross-dressing and
      homosexual orientation. Of the whole sample, 23% were referred for gender
      reassignment surgery, of whom 100% were DSM-III positive and 60% were 'core
      transsexuals'.

PMID- 2224379
TI  - Is parental age related to the risk of Alzheimer's disease?
AB  - Advanced maternal and paternal age were investigated as putative risk factors for
      AD in 198 clinically diagnosed Alzheimer patients and in 198 randomly selected
      healthy controls. No significant differences in average age of fathers and of
      mothers at birth of the subject were observed. The risk of AD was not
      significantly different across categories of maternal and paternal age. The
      association with parental age was not different for sporadic and familial AD.
      These findings do not support the view of a maternal or paternal age effect on
      AD.

PMID- 2224380
TI  - Do-Do abuse.
AB  - Three cases of prolonged abuse of Do-Do tablets, an over-the-counter remedy for
      "coughs, wheezing and breathlessness", are reported. They have an amphetamine
      like action and were used as easily obtained amphetamine substitutes, in one case
      to relieve social anxiety. Withdrawal symptoms similar to those following
      cessation of amphetamines occurred in two cases. Do-Do tablets are CNS stimulants
      and their abuse may be accounted for by the fact that they perhaps affect amine
      neurotransmitters.

PMID- 2224381
TI  - A psychiatric study of deviant eating behaviour among mentally handicapped
      adults.
AB  - A study of deviant eating behaviour among mentally handicapped adults in
      community placements is reported. Those individuals with a psychiatric disorder
      showed more deviant eating behaviour. Depressed subjects, in particular, showed
      an excess of the amount eaten and time spent searching for food, as well as the
      tendency to eat all sweet food presented to them. Non-food pica was uncommon,
      even among the autistic subjects.

PMID- 2224382
TI  - Firesetting in an adolescent boy with Asperger's syndrome.
AB  - Firesetting in children and adolescents is commonly associated with other
      antisocial acts that comprise conduct disorders. Asperger's syndrome is a rare
      pervasive developmental disorder. In the case presented we argue that the
      firesetting arose from the disabilities inherent in Asperger's syndrome. This
      also indicates that antisocial acts may be symptoms in other psychiatric
      syndromes as well as a specific conduct disorder.

PMID- 2224383
TI  - The validation of the Edinburgh Post-natal Depression Scale on a community
      sample.
AB  - The Edinburgh Post-natal Depression Scale (EPDS) was validated on a community
      sample of 702 women at six weeks post-partum using Research Diagnostic Criteria
      for depression. The estimates of sensitivity, specificity and positive predictive
      value, being based on a large random sample, offer improved guidelines for the
      use of the EPDS by the primary care team.

PMID- 2224384
TI  - Folie a trois among two Soviet-Jewish immigrant families to Israel.
AB  - In two cases of folie a trois, affecting two Soviet-Jewish families who emigrated
      to Israel, both elderly parents in both cases shared the paranoid delusional
      beliefs of an only child. Severe trauma in the past and social maladjustment in
      the present may be among the precipitating factors for the development of the
      shared paranoid disorder.

PMID- 2224385
TI  - The 'new cross-cultural psychiatry'.

PMID- 2224386
TI  - Impact of participating in research.

PMID- 2224387
TI  - Psychiatric sequelae of listeriosis.

PMID- 2224388
TI  - Limitations of double-blind trials.

PMID- 2224389
TI  - ROC analysis.

PMID- 2224390
TI  - The Lomax affair.

PMID- 2224391
TI  - Brain transplants: myth or monster?

PMID- 2224392
TI  - First-rank symptoms.

PMID- 2224393
TI  - Comparing the effects of alcohol and intelligence on text recall and recognition.
AB  - Forty male subjects were divided into two groups on the basis of their scores on
      a computerized intelligence test administered in a preliminary session. They then
      participated in a text recall and recognition experiment in which they received
      alcohol (1.0 ml/kg body weight) in one session and no alcohol in another session
      (the order being counterbalanced). Subjects were required to read a short
      passage, immediately recall as much of it as possible and then select from sets
      of four sentences the ones that appeared in the original passage (recognition).
      Although two different passages were used, and subjects knew about the memory
      tasks in advance, there was nevertheless a significant practice effect: subjects
      recalled 10.6 per cent more propositions on the second occasion than on the
      first, but this could be at least partly explained by the fact that they spent
      10.0 per cent longer reading the second passage. There was also a significant 7.8
      per cent slowing of reading time due to alcohol. Practice did not interact with
      either intelligence or alcohol on any measure of performance. Alcohol impaired
      the performance of high intelligence test scorers more than low scorers. The
      effects of intelligence and alcohol on free recall were quantitatively similar:
      high intelligence test scorers recalled 8.7 more propositions than low scorers;
      with alcohol, subjects recalled 8.3 fewer propositions than without alcohol.
      However, the effects were qualitatively different. The effect of intelligence was
      primarily on the recall of lower level propositions, whereas alcohol impaired the
      recall of both higher and lower level propositions. Furthermore, while there was
      no effect of intelligence on recognition, alcohol impaired performance such that
      more incorrect sentences were erroneously recognized, particularly those which
      altered the meaning of the original sentence, rather than merely its surface
      structure. In terms of Kintsch & van Dijk's (1978) model of text processing, the
      results are interpreted as suggesting that, while both intelligence and alcohol
      affect the capacity of the short-term memory buffer, there is an additional
      impairment with alcohol in the ability to select between higher and lower level
      propositions prior to filling the buffer.

PMID- 2224394
TI  - The psychometric properties of the Bortner Type A Scale.
AB  - Recent evidence indicates that the relationship between Type A behaviour pattern
      (TABP) and coronary heart disease (CHD) is dependent upon the method of measuring
      TABP. This suggests that the psychometric properties of TABP measures should be
      carefully investigated. This article examines one widely used TABP measure, the
      Bortner Scale, using data from 1320 working adults divided into three random
      samples. The reliability of the Bortner Scale as an overall TABP index is
      unacceptably low. However, further analyses indicate that, rather than reflecting
      a single dimension, the Bortner Scale contains two independent dimensions, one
      reflecting speed and the other reflecting competitiveness. The speed dimension
      was negatively related to job satisfaction and, to a lesser extent, positively
      related to anxiety and somatic symptoms, whereas the competitiveness dimension
      was positively related to job satisfaction. Implications for the use of the
      Bortner Scale are discussed.

PMID- 2224395
TI  - Name recall performance across the adult life-span.
AB  - Everyday name-recall tests were administered to 1205 adults ranging in age from
      18 to 90 years. They were asked to recall sets of four, six, or 14 names of
      individuals who introduced themselves on videotape. Immediate recall,
      acquisition, and delayed retention were examined. The results showed consistent
      age-related declines in name recall. Declines in performance were more evident on
      sets of 14 names rather than four or six names. Age deficits remained across
      several acquisition trials within the set of 14 names. The largest declines were
      evident for the old-old (over 70), although there were also significant
      performance differences, on some analyses, between the young and middle-aged
      groups. Changes in performance were less apparent during the middle-aged years
      (40-60 years). Name recall was related to individual differences factors,
      reaction time and paired-associate memory for names. The value of assessment and
      intervention with name recall was stressed.

PMID- 2224397
TI  - The effects of photic stimulation and private self-consciousness on the
      complexity of visual imagination imagery.
AB  - Three levels of photic stimulation (6, 10, 18 Hz) were employed to induce visual
      imagination imagery in 40 female undergraduates, half of whom had been selected
      because they had an habitual interest in their own internal states and half
      because they had no such interest (high and low on a Private Self-conscious (PSC)
      scale). It was predicted, and found, that more complex images would be reported
      (1) under the averaged 6 and 10 Hz condition than under the 18 Hz condition, (2)
      under the 6 than under the 10 Hz condition, and (3) under the high PSC than under
      the low PSC condition. An interaction effect was also obtained such that the
      complexity of visual imagination imagery was greatest for the high PSC group,
      compared with the low PSC group, under the 6 Hz condition and least under the 18
      Hz condition. Additional analyses were undertaken on the types of colour, form
      and movement reported by the high and low PSC groups under combined conditions of
      photic stimulation. The results of the complexity scores were discussed in terms
      of West's (1962) 'perceptual release' theory and several suggestions were made
      for future research.

PMID- 2224396
TI  - Understanding face recognition with an interactive activation model.
AB  - In this paper we describe how the microstructure of the Bruce & Young (1986)
      functional model of face recognition may be explored and extended using an
      interactive activation implementation. A simulation of the recognition of
      familiarity of individuals is developed which accounts for a range of published
      findings on the effects of semantic priming, repetition priming and
      distinctiveness. Finally, we offer some speculative predictions made by the
      model, and point to an empirical programme of research which it suggests.

PMID- 2224398
TI  - Anti-RNP antibodies and their clinical significance.

PMID- 2224399
TI  - How assiduously should one investigate for occult malignancy in an elderly or
      middle-aged patient with dermatomyositis or polymyositis?

PMID- 2224400
TI  - Impaired iron uptake and transferrin binding by erythroblasts in the anaemia of
      rheumatoid arthritis.
AB  - Serum and bone marrow from 18 patients with rheumatoid arthritis (RA) and five
      healthy controls were studied in order to establish a possible role of impaired
      iron uptake and transferrin binding by erythroblasts in the pathophysiology of
      anaemia of chronic disease (ACD) in RA. Iron incorporation into erythroblasts was
      reduced in patients with ACD using a method based on incubation of erythroblasts
      with radiolabelled 59Fe-125I-transferrin. It correlated negatively with C
      reactive protein (CRP). In iron deficient RA patients it tended to be reduced as
      well. These patients had the same level of RA disease activity as in ACD.
      Transferrin binding by erythroblasts was significantly impaired in ACD compared
      to controls, although it tended to be reduced in all RA groups. These findings
      suggest that impaired iron uptake by erythroblasts, probably due to decreased
      transferrin binding to erythroblasts, might be a pathophysiological factor in ACD
      in RA.

PMID- 2224401
TI  - The sulphated glycosaminoglycan levels in synovial fluid aspirates in patients
      with acute and chronic joint disease.
AB  - Proteoglycan levels were measured in a series of synovial fluid samples from
      patients with acute and chronic joint diseases using a modified chemical dye
      binding method. Levels found in 50 miscellaneous inflammatory arthritis fluids
      (mean = 173.2 +/- 90.9 micrograms/ml) were higher than found in either 50 with
      rheumatoid arthritis (96.3 +/- 31.3 micrograms/ml) or 50 with osteoarthritis
      (83.8 +/- 27.3 micrograms/ml). For comparison, proteoglycan levels were measured
      in 15 cadaver synovial fluids (98.9 +/- 44.2 micrograms/ml) and 12 synovial
      fluids from patients with sports injury (163.7 +/- 79.4 micrograms/ml). Patients
      were recruited into a trial where synovial fluid was aspirated as often as
      possible over a 6-month period during which the patients were followed using a
      number of well proven clinical parameters. No correlation was found between the
      degree of joint destruction as measured by X-ray damage and the concentration or
      total amount of proteoglycan in the synovial fluid. In addition, there was no
      correlation between the level or total amount of proteoglycan and any clinical
      parameter of disease activity.

PMID- 2224402
TI  - Patients with arthritis and anti-U1-RNP antibodies: a 10-year follow-up.
AB  - Five hundred and forty patients attending a rheumatology ward were screened for
      antinuclear antibodies (ANA) by indirect immunofluorescence (IFL). Seventy had a
      significant titre of ANA. Twenty-three had U1-ribonucleoprotein antibodies (U1
      RNP-ab). The clinical findings in U1-RNP-ab-positive patients were consistent
      with mixed connective tissue disease (MCTD). Disease was more serious in the U1
      RNP-ab-positive patients in terms of polyarthritis severity as well as mortality
      due to rheumatic disease. Thus, in this arthritis patient population, U1-RNP-ab
      positivity predicted an aggressive disease characterized by an erosive arthritis.

PMID- 2224403
TI  - Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder: a cause of
      shoulder pain?
AB  - Shoulder pain is a common complaint and shoulder hyperostosis a frequent
      radiological condition. However, little is known about the association between
      the clinical and radiological findings. To evaluate the clinical relevance of
      shoulder hyperostosis we performed a controlled, blind study of 99 hospitalized
      probands with and without thoracospinal hyperostosis on lateral chest X-rays. The
      study included grading of the shoulder hyperostosis on the basis of three
      bilateral standard radiographs, assessing shoulder pain in a standardized way by
      an interviewer and recording extraskeletal causes of shoulder pain. The
      prevalence of shoulder hyperostosis was doubled in probands with thoracospinal
      hyperostosis compared to controls (chi 2 = 5.90, P less than 0.025, n = 99).
      Shoulder hyperostosis, irrespective of thoracospinal hyperostosis, predisposed to
      shoulder pain (40% versus 18%, chi 2 = 4.06, P less than 0.05, n = 74). Shoulder
      hyperostosis in combination with thoracospinal hyperostosis (shoulder DISH)
      predisposed to shoulder pain to an even greater extent (46% versus 12%, chi 2 =
      6.64, P less than 0.01, n = 47). We conclude that shoulder hyperostosis is a
      radiological finding of potential clinical relevance.

PMID- 2224404
TI  - The inhibition of NK cell function by azathioprine during the treatment of
      patients with rheumatoid arthritis.
AB  - Treatment with azathioprine of patients with rheumatoid arthritis leads to a
      dramatic reduction in the 4 h NK cytotoxicity against K562 cells. The 24 h
      cytotoxicity against K562 and U937 cells, however, remains intact. The generation
      of cell-free supernatant cytotoxic factor(s) after incubating non-adherent
      mononuclear cells with U937 cells for 24 h is similar in the azathioprine
      patients and the controls. A large part of this supernatant cytotoxicity is due
      to tumour necrosis factor alpha which can be inhibited by a specific monoclonal
      antibody. The mechanism of the reduced 4 h NK cytotoxicity remains unknown but is
      probably not related to the anti-inflammatory properties of azathioprine.

PMID- 2224405
TI  - Effect of non-steroidal anti-inflammatory drugs on neutrophil chemotaxis--an in
      vitro and in vivo study.
AB  - We have studied the effects of the two non-steroidal anti-inflammatory drugs
      (NSAIDs), nabumetone and indomethacin, on neutrophil chemotaxis in vitro and in
      vivo. When used in therapeutic concentrations in vitro, neither agent had any
      effect on the chemotactic response of neutrophils isolated from healthy
      volunteers. This was true for the three chemotactic agents studied: FMLP, zymosan
      activated serum and purulent sputum. Nabumetone and indomethacin decreased
      neutrophil chemotaxis over a period of 2 weeks in 12 normal subjects in vivo. The
      average chemotactic response to 10(-8) mol/l FMLP for all 12 during the control
      period was 42.1 +/- 6.1 cells per high power field and this fell to 26.1 +/- 4.9
      (P less than 0.025) after 7 days and to 15.6 +/- 2.5 (P less than 0.005) after 14
      days. The results were similar for both drugs analysed independently. The results
      suggest that NSAIDs have no effect on the chemotactic response of mature cells in
      vitro, but suppress chemotaxis progressively when given in vivo. This may be
      explained by an effect of NSAIDs on maturing cells prior to release into the
      circulation.

PMID- 2224407
TI  - Racial variation in serum creatine kinase unrelated to lean body mass.
AB  - In a group of 30 black and 30 white healthy workers, matched for age, sex and
      body weight, serum creatine kinase was significantly higher in black males than
      in white males (P less than 0.01). Seventeen blacks but only four whites had
      levels above the accepted upper limit of normal of 195 IU/l. There was no
      correlation with lean body mass. Elevation of serum creatine kinase need not
      signify disease in blacks, for whom a separate reference range should be
      established. Two cases are reported of physically healthy black men subjected to
      unnecessary investigation on the basis of persistently elevated serum creatine
      kinase.

PMID- 2224406
TI  - Does primary fibromyalgia exist?
AB  - Twenty-one of 25 consecutive primary fibromyalgia or fibrositis patients,
      identified during a 5-year period in a tertiary care day-ward for pain syndromes,
      were re-examined. Fifteen fulfilled criteria for fibromyalgia but unexpectedly,
      all cases had either psychiatric disturbance or thyroid dysfunction. Of the four
      patients not seen at follow-up, two had developed neurological diseases, another
      rheumatoid arthritis and one other hypothyroidism. Thus, after 5 years no patient
      fulfilled the criteria for primary fibromyalgia. Women occupied as manual workers
      were over-represented. Most patients reported beneficial effects of
      physiotherapy. None of the patients has been able to return to full time work.

PMID- 2224409
TI  - Patients' perceptions of staff in a department of rheumatology.
AB  - Three groups of 44 rheumatic patients were studied in a Regional Rheumatology
      Centre, and two out-patient clinics (one conducted by a consultant, the other by
      a nurse practitioner). A questionnaire determined their perceptions of staff
      members, their spouses, and the patients with whom they had most contact. In the
      usual in- and out-patient setting, patients preferred to be told about their
      condition by the consultant. In the clinic where they saw a nurse practitioner
      regularly, over half preferred to be told by her. The patients found it easier to
      discuss their condition with a nurse (particularly of a lower rank than a
      sister). Much came from spouses and other patients. The consultant and sister had
      important roles in reassuring the patients, but doctors were not successful in
      making patients feel useful and needed. Nurses were somewhat better--but not that
      good (30%). This was a vital role for the spouse, who nevertheless in hospital
      produced much anxiety, closely followed by visitors, other patients and doctors.
      Nurses and occupational therapists were very calming and relaxing people.

PMID- 2224410
TI  - Lesions of the mid-shaft of the humerus presenting as shoulder capsulitis.
AB  - We describe three patients who presented with pain and restriction of movement at
      the shoulder suggestive of capsulitis, but proved to have lesions of the mid
      shaft of the humerus. It is important to be aware of the possibility of this
      cause of a 'frozen shoulder', since radiographs of the shoulder are usually
      cropped at the mid-humerus and lesions at this level may easily be missed. A
      radiograph of the entire humerus, or an isotope bone scan, may be more useful
      than repeated shoulder radiographs in patients whose shoulder symptoms do not
      respond to standard treatment.

PMID- 2224408
TI  - Why is the supraspinatus tendon such a common site for calcification?

PMID- 2224411
TI  - Review of UK data on the rheumatic diseases--3. Osteoarthritis.

PMID- 2224412
TI  - Sacral osteitis after sonographically controlled follicular puncture for in vitro
      fertilization.

PMID- 2224413
TI  - Photochemotherapy for rheumatoid arthritis.

PMID- 2224414
TI  - Effects of D-penicillamine treatment on antioxidant enzymes in rheumatoid
      arthritis.

PMID- 2224415
TI  - Diagnosis of eosinophilic fasciitis.

PMID- 2224416
TI  - Age and calendar year of onset in sibling pairs with rheumatoid arthritis.

PMID- 2224417
TI  - Age and year of onset differences in siblings with rheumatoid arthritis.

PMID- 2224418
TI  - Primary care--the educational need.

PMID- 2224419
TI  - Free testosterone and depression in male rheumatoid arthritis (RA)

PMID- 2224420
TI  - Acute inflammatory polyarthritis following streptokinase.

PMID- 2224421
TI  - Effects of oral N-acetylcysteine on gold levels in rheumatoid arthritis.

PMID- 2224422
TI  - Vertebral involvement in tertiary syphilis.

PMID- 2224423
TI  - Behcet's syndrome and spondyloarthritis.

PMID- 2224424
TI  - Social facilitation effects in recognition memory.
AB  - This study investigates the effects of observer presence on recognition memory.
      The number of learning repetitions, the degree of association of category
      instance word pairs, and the time interval between acquisition and testing were
      manipulated. While the basic recognition data conformed well to previous findings
      in the learning and memory literature, predictions, derived from the drive theory
      of social facilitation found little support. Instead, study results seem best
      explained by descriptions of the cognitive processes employed by subjects both
      during the initial acquisition and later recognition of the category-instance
      pairs.

PMID- 2224425
TI  - The influence of permeability of group boundaries and stability of group status
      on strategies of individual mobility and social change.
AB  - According to social identity theory, striving of group members for enhancement of
      their social identity may be resolved through individual mobility (i.e. by
      dissociation from one's own group in order to gain membership of a higher status
      group), or by social change (i.e. by upgrading the status position of the in
      group as a whole). Individual mobility may only be achieved when group boundaries
      are permeable; social change is only feasible when group status is unstable. This
      study investigates how these structural characteristics of the intergroup
      situation affect group members' preference for the individual mobility or social
      change strategy. In a laboratory setting subjects were given bogus feedback to
      induce differential levels of individual ability and group status. Additionally,
      the permeability of group boundaries and the stability of group status were
      manipulated. The main results are that, generally, members of high status groups
      show more satisfaction and in-group identification than members of low status
      groups. Permeable group boundaries apparently induce a tendency to strive for
      individual mobility, regardless of the in-group's status position. In relation to
      members of impermeable groups, members of groups with permeable boundaries show
      decreased in-group identification; there is evidence of (anticipatory)
      identification with the higher status group instead. A collective attempt at
      social change seems to be evoked when group status is unstable. In all groups
      with unstable status, members indicate their readiness to try to improve their
      group's status position. Moreover, members of low status groups with unstable
      status positions show relatively strong in-group identification, despite the lack
      of positive distinctiveness available to the in-group at the time.

PMID- 2224428
TI  - Calcium oxalate crystallisation kinetics and the effects of calcium and gamma
      carboxyglutamic acid.
AB  - gamma-carboxyglutamic acid (GLA) is an amino acid with a high affinity for
      calcium. It is found in urine both as the free amino acid and incorporated into
      proteins such as osteocalcin. Free and bound GLA have been reported to be found
      at higher concentrations in the urine of stone formers than controls. We have
      investigated the effect of GLA and calcium, at physiological levels, on the
      crystallisation of calcium oxalate using a mixed suspension mixed product removal
      continuous crystalliser. GLA caused very significant changes in the
      crystallisation kinetics, but the effect was dependent on the calcium
      concentration. At 4 mM calcium, GLA decreased the growth rate and increased the
      nucleation rate; at 12 mM the reverse occurred. At all concentrations of calcium
      tested, GLA caused a significantly increased crystal mass to be produced. Our
      evidence supports the hypothesis that GLA modifies calcium oxalate
      crystallisation and could be a promoter of stone formation in vivo, particularly
      at moderately elevated levels of calcium excretion.

PMID- 2224426
TI  - The clam cystoplasty.

PMID- 2224427
TI  - Sedoanalgesia in urology: a safe, cost-effective alternative to general
      anaesthesia. A review of 1020 cases.
AB  - Sedoanalgesia is a technique developed to provide safe and satisfactory operating
      conditions for a wide range of patients independent of age and overall level of
      fitness (although its use in children remains to be established). It is suitable
      for both endoscopic and open procedures, day-cases and in-patients. When used in
      day-case surgery it significantly improves overall efficiency. It is recognised
      that day-case surgery is an important and cost-effective element in surgical
      care. With increasing restraints being imposed upon hospital finances, patient
      beds and staffing levels, any strategies designed to improve efficiency in this
      sphere of surgical activity are to be welcomed. That 93% of patients prefer
      sedoanalgesia to conventional general anaesthesia attests to its high degree of
      acceptability. The technique of sedoanalgesia, its applications and potential
      impact for urology are detailed.

PMID- 2224429
TI  - Chronic dehydration stone disease.
AB  - A study was made of 819 patients attending a metabolic stone clinic. A firm
      diagnosis was made in 708 (86%) and in 132 of these (19%) the diagnosis was
      thought to be chronic dehydration. The records were available for study for 87
      males and 11 females in the chronic dehydration group. The mean age at
      presentation was 43 years. The causes of chronic dehydration were hot climate
      (62%), with hot occupation and low water intake almost equal in second place. In
      patients with a single cause of chronic dehydration, 57% also had a dietary risk
      factor for urolithiasis and this was most commonly high oxalate intake. Following
      dietary advice, the mean urinary volume increased from 1720 to 2475 ml/24 h. This
      was accompanied by a rise in mean urinary calcium from 6.02 to 6.96 mmol/24 h,
      presumably due to the calcium in the additional water drunk. Urinary oxalate did
      not change significantly. The mean follow-up time was 4.85 years and the stone
      recurrence rate was low. It was concluded that chronic dehydration is a common
      cause of urolithiasis; this can be treated satisfactorily by increasing water
      intake plus dietary advice in certain cases.

PMID- 2224430
TI  - The use of internalised ureteric stents in renal transplant recipients.
AB  - Since 1982, we have used internal indwelling ureteric stents for the management
      and prevention of ureteric reconstruction complications in 28 renal allograft
      recipients. A total of 30 stents were placed in 18 patients either diagnostically
      or therapeutically in the management of allograft ureteric obstruction. In 16
      patients internal stents were placed at the time of reconstruction for primary
      ureteropyelostomy (3), secondary ureteropyelostomy (8), repeat reimplant (3) and
      repair of ureteric or pelviureteric junction injury (2). Complications included 3
      episodes of transplant pyelonephritis, proximal stent migration (1), persistent
      bacteriuria (1) and prolonged healing of a ureteropyelostomy (1). Internalised
      ureteric stenting is a safe and effective means of managing or preventing
      ureteric reconstruction complications in renal transplant recipients.

PMID- 2224431
TI  - Ureteric substitution with Boari bladder flap.
AB  - Between 1986 and 1989, 12 patients underwent ureteric substitution with a Boari
      bladder flap at this Institute. The indications were ureteric injury following
      hysterectomy, difficult forceps delivery, difficult ureterolithotomy, ureteric
      strictures caused by a Dormia basket and previous ureteric surgery, tuberculosis,
      retroperitoneal fibrosis and a post-ureteric reimplantation fistula. There were 2
      patients with a solitary kidney and 2 in acute renal failure. Double J stenting
      was carried out in 11 patients and the stent was removed 3 to 6 weeks post
      operatively. Good results, with no morbidity or mortality, were achieved in all
      but 1 patient where a simple Silastic stent had migrated to the pelvis and
      required open surgery to remove it. We attribute our success to the tension-free
      anastomosis, a wide based posterior flap with preservation of its vascular
      supply, the use of a double J stent and vicryl suture material.

PMID- 2224432
TI  - Initial evaluation and response criteria for patients with superficial bladder
      cancer. Report of a workshop.

PMID- 2224433
TI  - Variations in urethral and bladder pressure during stress episodes in healthy
      women.
AB  - Pressure variations in the urethra and bladder during stress episodes and their
      time separations were investigated in 30 healthy female volunteers. The pressure
      was measured by means of a double microtip transducer catheter with the distal
      sensor in the bladder and the proximal sensor at the bladder neck, the mid
      urethra and the distal urethra. In advance of the pressure spike during cough a
      pressure rise was demonstrated in the bladder and at all 3 sites of measurement
      in the urethra. The urethral pressure increments preceding and following the
      pressure spike were statistically significantly higher in the mid-urethra than
      the corresponding bladder pressures. This active urethral pressure generation in
      the mid-urethra and distal urethra was initiated 200 ms before the bladder
      pressure began to rise. The pressure in the urethral high pressure zone was
      higher than the bladder pressure in all cases. Passive pressure transmission to
      the urethral high pressure zone can take place only insignificantly due to a
      continuous higher pressure inside the urethra than in the bladder and due to the
      location of the high pressure zone in the demarcation of the abdominal cavity. It
      was concluded that the urethral pressure rise in the high pressure zone during
      stress episodes is mainly generated actively by intra- and/or peri-urethral
      structures.

PMID- 2224434
TI  - Prostatic carcinoma: histological and immunohistological factors affecting
      prognosis.
AB  - Neuro-endocrine or paracrine cells of the human prostate and urethra have been
      identified by various methods, predominantly silver stains and
      immunocytochemistry. The incidence of neuro-endocrine differentiation in
      prostatic carcinoma has varied considerably from 10 to 100%, but has not been
      studied previously as an independent factor affecting prognosis. Nucleolar
      organiser regions (NORs) are loops of ribosomal RNA occurring in the nucleoli of
      cells which ultimately process RNA genes. NORs have been demonstrated by silver
      (Ag) staining techniques and have been studied in numerous malignant tumours. A
      pilot study from this laboratory has shown a distinct and significant difference
      in AgNOR staining between prostatic carcinoma and benign prostatic epithelial
      hyperplasia. A retrospective study was performed with at least 6 years' follow
      up. This confirmed the presence of neuro-endocrine cells in more than half of the
      patients under investigation. A significant correlation between survival and the
      absence of neuro-endocrine cells was demonstrated. AgNOR staining was shown to be
      of no prognostic value.

PMID- 2224435
TI  - Distribution of bony metastases in prostatic carcinoma.
AB  - Fifty-five prostate cancer and 55 breast cancer patients with positive bone
      scintigrams were studied. The pattern of spread in the axial skeleton and pelvis
      showed differences between the 2 groups. This difference was not related
      primarily to bone volume at the site of metastasis. The difference in
      distribution of bony metastases between breast and prostate is explained by our
      knowledge of Batson's vertebral venous plexus.

PMID- 2224436
TI  - Increased survival of patients with massive lymphadenopathy and prostate cancer:
      evidence of heterogeneous tumour behaviour.
AB  - The survival of patients with prostate cancer and radiologically detectable lymph
      node enlargement has been studied prospectively over an 8-year period. Computed
      tomography in 108 patients presenting with symptoms, signs or biochemical results
      suggesting lymphatic spread revealed pelvic or abdominal node masses in 60
      patients; in 29 (48%), the masses measured more than 4 cm and the maximum node
      diameter was 15 cm. Two-thirds of patients had advanced (T3/T4) tumour stage.
      Following treatment, actuarial survival in all 60 patients with nodal enlargement
      was 40% at 5 years. Within this group, survival in 22 patients with
      lymphadenopathy but negative bone scans at diagnosis was significantly better
      than that of 38 patients with both node and bone disease (70% vs 20% at 5 years).
      This improvement was related both to an apparent inability of certain tumours
      initially to progress and seed within bone and to a marked sensitivity of the
      node masses to subsequent hormonal manipulation. Primary tumour grade was
      proportionally similar in both groups. Unexpectedly, 6 of the 38 patients with
      combined disease obtained a complete remission after treatment. The reason for
      this heterogeneous biological behaviour remains unclear; but these observations
      underscore the importance of vigorous treatment in all patients with advanced
      lymph node disease.

PMID- 2224437
TI  - Persistent carcinoma in situ of the testis after chemotherapy for advanced
      testicular germ cell tumours.
AB  - The chemosensitivity of testicular carcinoma in situ (CIS) was analysed in 25
      testes excised 10 weeks to 4.5 years following platinum-based chemotherapy. CIS
      was present in 8 of the 23 evaluable cases (35%), in 5 of which the lesion
      coexisted with invasive germ cell tumour. It is concluded that CIS may persist or
      recur after chemotherapy. This has implications for occult presentation of
      metastatic germ cell tumours and also for the management of the contralateral
      testis in patients with testicular germ cell tumours.

PMID- 2224438
TI  - The importance of prognostic factors in the individual treatment of patients with
      disseminated germ cell tumours.
AB  - Following chemotherapy for disseminated testicular cancer, 55 patients underwent
      surgery because of residual tumour. The histological findings were viable tumour
      in 12 patients, mature teratoma in 12 and fibrosis and/or necrosis in 31.
      Retroperitoneal abdominal masses were evaluated radiographically before and after
      chemotherapy. The reduction in size of these masses after chemotherapy appeared
      to have prognostic significance. A decrease of more than 70% was always
      associated with fibrosis. A residual mass over 50 mm indicated viable tumour or
      mature teratoma. Seminoma or embryonal carcinoma was more likely to result in
      fibrosis/necrosis in the resected tissue. Both the Indiana and the EORTC
      classification models can be used for prognosis. Radiographic measurements before
      and after chemotherapy are of considerable prognostic significance. These
      objective indicators help in planning treatment and so diminish the side effects
      of therapy and maintain or even increase the high cure rate in disseminated
      testicular cancer.

PMID- 2224439
TI  - Vesicocutaneous fistula secondary to bladder instability.

PMID- 2224440
TI  - Thirteen-year survival of patient with recurrent metastatic renal carcinoma.

PMID- 2224441
TI  - Granulomatous hepatitis following intravesical BCG therapy.

PMID- 2224442
TI  - Testicular haematoma: a delayed complication of testicular vein ligation.

PMID- 2224443
TI  - A giant renal stone.

PMID- 2224444
TI  - Primary amyloidosis of the bladder.

PMID- 2224445
TI  - Complete prolapse of the urinary bladder.

PMID- 2224446
TI  - Pelvic irradiation, the ureter and extracorporeal shockwave lithotripsy.

PMID- 2224447
TI  - Minimisation of stone deflection during extracorporeal shockwave lithotripsy
      monotherapy for ureteric calculi in situ.

PMID- 2224448
TI  - Confirmation of position of double J stent inserted at open operation.

PMID- 2224449
TI  - Multiple transverse taeniamyotomy of the caecum after restorative
      cystoprostatovesiculectomy for bladder cancer.

PMID- 2224450
TI  - Re: Circumcision--which dressing?

PMID- 2224452
TI  - Thrombolytic therapy in peripheral vascular disease.

PMID- 2224451
TI  - Infection and the burn patient.

PMID- 2224453
TI  - Bile acids and the increased risk of colorectal tumours after truncal vagotomy.
AB  - An association between colorectal cancer and previous peptic ulcer surgery is
      reported. In a prospective screening study, 100 asymptomatic patients (80 men and
      20 women) who had undergone truncal vagotomy at least 10 years previously were
      investigated by barium enema, colonoscopy and gallbladder ultrasonography.
      Control data were obtained from forensic autopsy subjects. The incidence of
      neoplasms greater than or equal to 1.0 cm in the vagotomized group was 14 per
      cent (11 adenomas, 3 carcinomas) and 3 per cent in controls (P = 0.01). Duodenal
      bile obtained at endoscopy from 21 vagotomized patients with normal gallbladders
      and from 21 control patients undergoing endoscopy was analysed by high
      performance liquid chromatography. The mean percentage of cholic (CA),
      chenodeoxycholic (CDCA), deoxycholic (DCA) and lithocholic (LCA) acids in the
      bile of vagotomized patients was 32.3, 45.6, 20.7 and 1.4 per cent respectively
      compared with 45.3, 36.2, 17.9 and 0.7 per cent respectively in controls. The
      increased proportions of CDCA and LCA and decreased proportions of CA in the
      duodenal bile of vagotomized patients were significant (P less than 0.001; P =
      0.02; P = 0.007). Abnormalities in bile acid metabolism may help to explain the
      increased risk of colorectal neoplasia 10 years after truncal vagotomy.

PMID- 2224454
TI  - Urinary tissue factor activity in colorectal disease.
AB  - Procoagulant activity (PCA) in normal urine has been recognized for over 50
      years. Although tissue factor (TF) is produced by certain tumours, and is
      increased in both tumour-associated macrophages and blood monocytes, the
      possibility that it might also be increased in urine has not been studied in
      patients with cancer. We have measured urinary PCA in hospital controls without
      inflammatory or neoplastic disease (n = 79), in patients with rheumatoid
      arthritis (n = 8), inflammatory bowel disease (n = 19), colorectal cancer (n =
      70) and in patients undergoing colonoscopy (n = 50). Urinary PCA was higher (P
      less than 0.001) in patients with colorectal cancer and inflammatory bowel
      disease than controls or patients with rheumatoid arthritis. Fourteen (88 per
      cent) out of 16 colonoscopy patients subsequently found to have carcinoma or
      inflammatory bowel disease had levels above the control upper quartile, compared
      with 8 (24 per cent) out of 34 with normal colonoscopy (P less than 0.001). TF
      inhibitors confirmed the nature of the PCA and Western blotting studies indicated
      a urinary TF molecular weight of approximately 38,000. These studies provide
      further evidence of abnormal haemostasis in malignancy and suggest that
      determination of urinary TF may provide a useful screening test in patients
      undergoing colonoscopy.

PMID- 2224456
TI  - Intraoperative testing of colorectal anastomosis can be misleading.

PMID- 2224455
TI  - Malignant left-sided large bowel obstruction managed by subtotal/total colectomy.
AB  - Of 60 patients presenting with acute obstructing carcinoma of the left colon, 49
      underwent immediate resection either by radical subtotal/total colectomy (31
      patients, group I) or by radical segmental resection (18 patients, group II) of
      whom three had immediate anastomosis after on-table bowel irrigation and 15 had a
      planned staged procedure. The operative mortality rate was 3 per cent in group I
      and 11 per cent in group II (not a statistically significant difference).
      However, substantial differences were found for major morbidity (6 versus 44 per
      cent in groups I and II respectively; P less than 0.01) and mean length of
      hospital stay (17 days in group I versus 35 days in group II; P less than 0.05).
      All three patients who had on-table lavage developed anastomotic leaks which
      necessitated a second operation to form a stoma. Six patients (19 per cent) in
      group I required antidiarrhoeal medication in the immediate postoperative period.
      However, subsequent improvement in stool frequency was noted in all patients. It
      is concluded that subtotal/total colectomy is an acceptable means of managing
      patients with obstructing carcinoma of the left colon in that it is associated
      with a low morbidity and mortality rate and good functional results.

PMID- 2224457
TI  - Blood transfusion and recurrence of colorectal cancer: the role of platelet
      derived growth factors.
AB  - Efforts to explain the possible effects of blood transfusion on the recurrence of
      colorectal cancer have been based entirely on the immunosuppressive effects of
      blood transfusion. However, the relationship between solid tumour development and
      the immune system is inconclusive. We have investigated an alternative mechanism
      involving the potential role of growth factors in this phenomenon. Using a human
      fibroblast: [125I]deoxyuridine uptake mitogenesis assay, the relative amounts of
      growth factor in the plasma of stored blood were measured. There was a
      progressive increase in mitogenesis from day 0 (n = 6) to day 28 (n = 6; P less
      than 0.001, Mann-Whitney U test). The effect of growth factors on the development
      of liver and intraperitoneal metastases was studied in Hooded Lister rats.
      Following an intraportal injection of 10(5) MC28 tumour cells, the experimental
      group (n = 25) received 2 ml of syngeneic serum intravenously for 4 days.
      Likewise, colonic anastomoses were performed on omentectomized rats and the
      peritoneal cavity seeded with 10(3) cells. The experimental groups (n = 20)
      received either 2 ml serum intravenously repeatedly or 3 ml serum
      intraperitoneally (n = 19). There was no significant increase in liver metastases
      or peritoneal disease following intravenous infusion of serum but serum delivered
      intraperitoneally resulted in a significant increase in tumour from 22 per cent
      in the controls to 89 per cent in the study group (P less than 0.01). Growth
      factors released from platelets following blood loss into the peritoneal cavity
      may be important in enhancing local recurrence of colorectal cancer.

PMID- 2224458
TI  - Mastalgia refractory to drug treatment.
AB  - Management of the patient with mastalgia who fails to respond to first line
      therapy is a difficult problem and there is a group of patients who do not
      respond to any therapy. A group of 126 patients with mastalgia who failed to
      respond to first line therapy and completed further treatment options was
      studied. The response rate of those with cyclical mastalgia fell to 57 and 25 per
      cent for second and third line therapy respectively. Equivalent figures for non
      cyclical mastalgia were 24 and 21 per cent. Danazol maintains a high response
      rate after the failure of other drugs, whereas the second line response to
      bromocriptine and evening primrose oil is poor. Unresponsive patients were
      matched to a group of patients who responded to first line therapy, and
      reproductive and historical factors were compared using the chi 2 test, but
      failed to identify which patients would respond to therapy.

PMID- 2224459
TI  - Experimental study of starch-induced intraperitoneal adhesions.
AB  - The effects of starch on the development of postoperative adhesions were examined
      in 144 Sprague Dawley rats. Groups of rats were injected intraperitoneally with
      suspensions of washings from starched gloves, starch-free gloves and starch-poor
      washed gloves, and after operative manipulation of the bowel. The incidence of
      adhesions was greatest (78 per cent) after laparotomy and injections of starch
      rich washings and least when starch-poor (33 per cent) or starch-free glove
      suspensions (37 per cent) were used, confirming an advantage for washing gloves
      or switching to starch-free products.

PMID- 2224460
TI  - Through-knee amputation in high-risk patients with vascular disease: indications,
      complications and rehabilitation.
AB  - During a 10-year period 104 patients (mean age 72 years) had 106 through-knee
      amputations. Indications for surgery were: limb gangrene, 67 (64 per cent);
      ischaemic ulceration, 22 (21 per cent); rest pain, 9; knee contractures, 6.
      Thirty patients had had previous unsuccessful vascular reconstructive surgery and
      five had had a failed femoral embolectomy. The through-knee disarticulation used
      lateral skin flaps. The mortality was 21 (20 per cent). Of the 83 survivors, 59
      (71 per cent) underwent uncomplicated primary wound healing; 36 (43 per cent) of
      the survivors were unsuitable for rehabilitation on a prosthesis. The remaining
      47 (57 per cent) were walking before discharge 30-130 days (mean 68 days) after
      amputation. Through-knee amputation is a rapid, relatively bloodless, amputation
      and is a useful debridement procedure. The many surgical and functional
      advantages, in conjunction with the recent reports of better rehabilitation
      compared with the above-knee or Gritti-Stokes amputation, suggests that the
      through-knee amputation deserves greater consideration.

PMID- 2224461
TI  - Graft stenosis: justification for 1-year surveillance.
AB  - In all, 412 femorodistal grafts (femoropopliteal and femorocrural), performed
      between 1984 and 1988, have been prospectively studied at 6 weeks and 3, 6, 9 and
      12 months after operation and at intervals of 6 months thereafter by duplex
      scanning and intravenous digital subtraction angiography. The overall incidence
      of stenoses was 16 per cent (femorocrural 20 per cent, femoropopliteal 15 per
      cent). All stenoses were detected in the first year after operation and none
      occurred after this. Twenty-four non-haemodynamically significant stenoses were
      not treated but were followed at intervals of 3 months. Forty-two
      haemodynamically significant stenoses were detected and secondary procedures were
      performed in 30 grafts at a mean of 8 months after surgery. Thirteen had
      percutaneous balloon dilatation and six (46 per cent) remain patent at a mean
      follow-up of 22 months. Two grafts which occluded within 30 days and three which
      restenosed at a mean of 8 months had tertiary procedures. Seventeen grafts were
      surgically revised, nine with patch grafts and eight with bypass grafts. Eleven
      of these remain patent at a mean follow-up of 30 months. One occluded immediately
      and three occluded late. Two grafts which restenosed at a mean of 19 months had
      successful tertiary procedures. In total, seven grafts had tertiary procedures
      (two had balloon dilatation and five had surgery) and six of these remain patent
      at a mean follow-up of 13.5 months. In conclusion, 37 procedures have been
      performed on 30 grafts, of which 23 (77 per cent) remain patent at a mean follow
      up of 12 months. Approximately one-quarter of femorodistal grafts will develop
      graft-related stenoses and graft surveillance is worthwhile, but only for the
      first year after operation.

PMID- 2224462
TI  - Conservative management of asymptomatic popliteal aneurysm.
AB  - Historical review shows that the treatment of popliteal aneurysm has developed by
      trial and error and there is disagreement about the proper management of the
      symptomless patient. In 1981 a policy of conservative management for asymptomatic
      popliteal aneurysm was adopted in this unit. Since that time we have also managed
      nine patients with thrombosed popliteal aneurysms by arteriography and low-dose
      intra-arterial streptokinase. Six patients treated within 72 h of occlusion
      achieved significant (70-100 per cent) lysis, but streptokinase was ineffective
      in those treated 10 or more days after the thrombosis. Of the six patients with
      significant lysis, three were treated by elective reconstruction and two by
      anticoagulation. One patient who had significant lysis died. Vascular patency of
      all five successfully treated limbs was maintained and no limb loss occurred in
      those who presented late and failed to achieve significant lysis. These results
      reinforce the view that thrombolysis is the treatment of choice for thrombosed
      popliteal aneurysms. The low complication rate for asymptomatic popliteal
      aneurysms and the advent of safe, effective thrombolysis indicate that operation
      for symptomless popliteal aneurysm is no longer required.

PMID- 2224463
TI  - Acute limb ischaemia: the place of intravenous streptokinase.
AB  - Intravenous streptokinase infusions (100,000 units/h) have been used to treat 48
      patients, with 50 episodes of acute limb ischaemia who were unlikely to benefit
      from a surgical approach. These included 17 acute thromboses, 14 late or distal
      emboli and 19 bypass graft occlusions. Overall, 17 (34 per cent) instances had
      complete lysis with reappearance of distal pulses and a further 28 per cent had
      clinical improvement without change in pulse status. Final outcome after 30 days
      was limb salvage in 60 per cent, amputation in 24 per cent and death in 16 per
      cent, but this was achieved after eight patients without lysis had vascular
      reconstructive surgery. Serious complications were infrequent, but included a
      fatal stroke, a haematemesis and two episodes of distal embolization. The outcome
      was not related to the duration of ischaemia or the site of occlusion. Lysis was
      more frequent with emboli (50 per cent) and graft occlusions (47 per cent) than
      arterial thromboses (6 per cent). Limb salvage was more likely in patients with
      no neurological deficit in the limb (70 per cent) than if a deficit was present
      (37 per cent). In conclusion, intravenous streptokinase produced a moderate
      benefit with low morbidity and has a role in acute limb ischaemia if surgery is
      inappropriate and intra-arterial lysis unavailable. In particular, selected
      patients with emboli or graft occlusions without a neurological deficit may be
      most suitable.

PMID- 2224464
TI  - On-table pancreatography: importance in planning operative strategy.
AB  - We describe our experience with 124 on-table pancreatograms performed during 117
      operative procedures on 112 patients in a wide variety of clinical settings.
      Endoscopic retrograde cholangiopancreatography (ERCP) was performed on 84
      occasions with a 73 per cent success rate for visualization of the main
      pancreatic duct. On-table pancreatography (OTP) was performed by one of five
      different techniques: retrograde, prograde or ambigrade ductography, cystography
      and ascending loopography after pancreaticojejunostomy. OTP provided important
      information about the main pancreatic duct when endoscopic visualization was
      unsuccessful (n = 23), incomplete (n = 17) or not performed (n = 33); there was a
      failure rate of 4 per cent. In 35 patients either the additional information or
      discrepancies between ERCP and OTP findings resulted in a change of operative
      plan (19 extra procedures, 16 altered procedures). Complete ductography was
      especially helpful in the 63 patients with chronic pancreatitis. OTP is
      technically simple, free from complications and invaluable for planning operative
      strategy.

PMID- 2224465
TI  - Stress in surgeons.
AB  - A sample of 1000 members of the Association of Surgeons of Great Britain and
      Ireland was circulated with a postal questionnaire relating to their occupational
      stressors, their type A coronary-prone behaviour and their mental health. Six
      hundred and seventy-two (67 per cent) useable forms were returned anonymously.
      The major individual stressors were: (1) the interference of the job with
      personal life, (2) general administration, and (3) the number of patients in
      clinics. Type A behaviour was similar to that of other professional groups.
      Surgeons showed mean scores significantly higher than the general population on
      two subscales of the mental health index (free-floating anxiety and hysterical
      anxiety). The findings for the few female surgeons (2 per cent) were similar to
      those in men but they did not exhibit raised free-floating anxiety levels.

PMID- 2224466
TI  - Aetiology of pancreatic cancer.
AB  - Curative surgery is possible in only a small minority of patients with pancreatic
      cancer and, to date, responses to chemotherapy and radiotherapy have been
      disappointing. To make any impact on the incidence of the disease a clearer
      understanding of its aetiology is required. This review explores present
      knowledge of the aetiology and epidemiology of pancreatic cancer.

PMID- 2224467
TI  - Parathyroid autotransplantation.
AB  - This paper reviews the technique, indications and results of parathyroid
      autotransplantation. Autotransplantation is most commonly indicated following
      parathyroidectomy for renal osteodystrophy, but can also be used in primary
      hyperplastic hyperparathyroidism, re-exploration of the neck and radical neck
      surgery. The success of the technique ranges from 75 to 100 per cent.

PMID- 2224469
TI  - Premorphological metabolic changes in human breast carcinogenesis.
AB  - Malignant breast tissue is characterized by morphological and metabolic changes
      when compared with normal breast tissue. In this study, the cytochemical
      measurement of glucose-6-phosphate dehydrogenase (G6PD) activity was used to
      detect abnormal metabolism in breast tissue and to determine whether abnormal
      metabolic activity precedes morphological change during human breast
      carcinogenesis. Normal and benign breast tissue, morphologically normal tissue
      from cancer-containing breasts, and malignant breast tissue were studied. In
      malignant tissue, mean(s.e.m.) G6PD activity was significantly increased when
      compared with normal and benign tissue (9.69(2.3) versus 27.02(1.7) mean
      integrated extinction (MIE) x 100, P less than 0.01). G6PD activity was increased
      in morphologically normal tissue from cancer-containing breasts when compared
      with normal and benign breast tissue from breasts with no known cancer
      (27.02(1.7) versus 18.42(2.6) MIE x 100, P less than 0.05). These findings
      suggest that metabolic abnormalities precede morphological changes in breast
      carcinogenesis. Abnormal metabolism can be detected widely within a cancer
      containing breast. The detection of such abnormality may prove helpful in
      identifying patients at high risk of developing breast cancer.

PMID- 2224468
TI  - Surgery in patients on long-term steroid therapy: a tentative model for risk
      assessment.
AB  - Increased morbidity after operation has been associated with long-term steroid
      therapy. To determine the correlation between steroid therapy and such morbidity,
      the perioperative course of 55 steroid-treated patients was reviewed: 27 had
      bronchopulmonary disorders (group P) and 28 had non-pulmonary diseases (group
      NP). There were six (11 per cent) deaths, of which three were steroid related.
      Among the 13 non-lethal postoperative complications, eight were considered to be
      steroid related in group P and one in group NP. The duration of steroid therapy
      was for a median of 24 months (range 1-408 months) in group P and for a median of
      6 months (range 1-240 months) in group NP (P less than 0.01). In contrast, the
      daily dose of hydrocortisone or equivalent before operation was significantly
      lower in group P, with a median of 0.51 mg kg-1 day-1 (range 0.20-2.56 mg kg-1
      day-1) than in group NP, with a median of 1.20 mg kg-1 day-1 (range 0.23-7.38 mg
      kg-1 day-1) (P less than 0.01). In conclusion, bronchopulmonary disorders
      requiring a long duration of steroid therapy are associated with a higher risk of
      steroid-related complications after surgery. A convenient mathematical model is
      proposed which may allow a preoperative assessment of surgical risk, using
      steroid dose and duration of treatment.

PMID- 2224470
TI  - Selection of patients with internal intussusception of the rectum for posterior
      rectopexy.

PMID- 2224471
TI  - Treatment for paraphimosis: the 'puncture' technique.

PMID- 2224472
TI  - Treatment of trans-sphincteric fistulae by full thickness anorectal advancement
      flaps.

PMID- 2224473
TI  - Cholecystectomy through a 5 cm subcostal incision.

PMID- 2224474
TI  - Localization of impalpable breast lesions: a new device.

PMID- 2224475
TI  - Epidural analgesia in colonic surgery.

PMID- 2224476
TI  - Usefulness of anorectal myectomy.

PMID- 2224477
TI  - Diagnosis and management of mesenteric infarction.

PMID- 2224478
TI  - Early operative fracture management of patients with multiple injuries.

PMID- 2224479
TI  - Impact of AIDS on surgery.

PMID- 2224480
TI  - Vacuum drainage of groin wounds after vascular surgery.

PMID- 2224481
TI  - Potential hazards of mechanized surgical retractors.

PMID- 2224482
TI  - Transport animals promoted.

PMID- 2224483
TI  - Exfoliative vaginal cytology during the oestrous cycle of the cow, after
      ovariectomy, and after exogenous progesterone and oestradiol-17 beta.
AB  - Vaginal exfoliative cytology was studied in five normal cyclical Friesian cows
      over 10 oestrous cycles each. Oestrus was assessed by the use of KaMaR heat mount
      detectors, whilst progesterone concentrations were measured in the peripheral
      blood using radioimmunoassay. Apart from oestrus, the exfoliative cytology was
      not consistent in appearance and did not appear to be influenced directly by the
      changes in endogenous ovarian steroid hormones. Four of the cows were
      subsequently ovariectomized and the vaginal exfoliative cytology monitored before
      and after the administration of 2 g of progesterone in a slow release vehicle
      and, following a rest period, after the administration of 12.5 mg oestradiol
      benzoate in oil. Peripheral progesterone and oestradiol-17 beta concentrations
      were measured in the peripheral plasma. Although the total number of epithelial
      cells increased after both hormone treatments no specific changes were observed.

PMID- 2224484
TI  - Serum thromboxane generation by platelets in several domestic animal species.
AB  - Blood collected from calves, sheep, goats, pigs, dogs, horses, ponies and
      donkeys, was allowed to clot under standard conditions. Thromboxane B2 generated
      during the clotting process was measured by radioimmunoassay in serum harvested
      from each sample. Highly significant differences were found between species and
      also between genera within a species. Highest concentrations of thromboxane B2
      were detected in the dog samples (887.7 +/- 123.7 ng/ml) and lowest
      concentrations in samples from sheep (2.7 +/- 0.2 ng/ml). The amount of
      thromboxane produced per unit number of circulating platelets or per unit volume
      of platelets in each species was not the same and it would appear that platelets
      from each species have different inherent ability to produce thromboxane under
      the stimulus applied, or that some species generate thromboxane from other
      sources during the clotting process.

PMID- 2224485
TI  - Isometamidium in goats: disposition kinetics, mammary excretion and tissue
      residues.
AB  - The pharmacokinetics of the antitrypanosomal drug isometamidium were studied in
      lactating goats after intravenous and intramuscular administration at a dose of
      0.5 mg/kg body weight, in a crossover design at an interval of 6 weeks. Following
      intravenous administration, the half-life of the disappearance of the drug from
      plasma during the terminal phase was 3.2 h, and the mean residence time was 2.4
      h. The apparent volume of distribution averaged 1.52 l/kg, and the mean total
      body clearance was 0.308 l/kg/h. After intramuscular administration, the absolute
      bioavailability was low, averaging 27%. This was consistent with a low mean
      maximum concentration of 24 ng/ml which occurred after 6 h. No drug was
      detectable (less than 10 ng/ml) in milk samples collected over a period of 14
      days following drug administration by either the intravenous or intramuscular
      route. In tissues analysed when the goats were killed 6 weeks after
      administration of the second dose, no drug was detectable (less than 0.4
      micrograms/g wet tissue) in the liver, kidney and muscle. However, at the
      injection site, drug concentrations varied from less than 0.4 to 18.8
      micrograms/g wet tissue.

PMID- 2224486
TI  - Changes in liveweight gain, blood constituents and worm egg output in goats
      infected with a sheep-derived strain of Trichostrongylus colubriformis.
AB  - Two groups of goats were dosed with 20,000 and 40,000 sheep-derived strain (SDS)
      larvae of Trichostrongylus colubriformis respectively. Over a period of 42 days,
      goats dosed with 40,000 larvae lost more weight than goats dosed with 20,000
      larvae. Anaemia was not observed in infected goats, but total serum proteins,
      albumins and phosphorus fell with infection.

PMID- 2224487
TI  - Effects of age, environmental temperature and relative humidity on the
      colonization of the nose and trachea of calves by Mycoplasma spp.
AB  - Nasal and tracheal swabs sequentially collected from three groups of eight calves
      between the ages of 1 and 98 days indicated that the nose and trachea were
      colonized by Mycoplasma spp. during the first weeks of life. Over 92% of all
      calves harboured Mycoplasma spp. in their noses when they were 2 weeks old, the
      rate of recovery falling gradually thereafter. The peak period of recovering
      mycoplasmas from the noses and tracheas of calves was at 6 weeks old. M.
      bovirhinis, M. arginini and Acholeplasma laidlawii predominated in the nose while
      M. dispar and M. bovirhinis predominated in the trachea. There was no association
      between rates of isolation and clinical signs of respiratory disease. There were
      no significant differences between the frequencies of isolation of Mycoplasma
      spp. from groups of calves kept under different environmental temperatures and
      relative humidities.

PMID- 2224489
TI  - In-vitro antimicrobial susceptibility of Bacteroides and Fusobacterium isolated
      from footrot in goats.
AB  - The agar dilution method was used to determine the antimicrobial activity of 17
      antimicrobial agents against 132 strains belonging to the genus Bacteroides and
      25 strains from the genus Fusobacterium, all isolated from 120 clinical cases of
      caprine footrot between October 1987 and November 1988. Josamycin,
      chloramphenicol and rifampin proved to be the most effective antibiotics in
      vitro. Significant resistance was found to the other antimicrobial agents
      studied.

PMID- 2224488
TI  - Mast cells in the bovine lower respiratory tract: morphology, density and
      distribution.
AB  - The lower respiratory tract of six 8-day-old calves and six adult cows was fixed
      in either isotonic formal-acetic-acid or neutral buffered formalin in order to
      study the morphology, density and distribution of mast cells. They were found at
      all levels of the tract with the highest density in the major bronchi. Tissues
      from cows had significantly more mast cells than those from calves. There were
      significantly more mast cells detected in calf airways fixed with isotonic formal
      acetic-acid compared with those seen in the same tissues fixed with neutral
      buffered formalin. Regardless of the age and fixation, mast cells were located
      predominantly in the alveolar septa and in the lamina propria of airways. They
      were also commonly encountered within the mucosal epithelium of the trachea.
      Ultrastructurally, mast cells in bovine airways and lung contained two types of
      intracytoplasmic granules as described in other species.

PMID- 2224490
TI  - Characteristics of Staphylococcus aureus from subclinical bovine mastitis in
      Brazil.
AB  - A total of 127 Staphylococcus aureus strains isolated from milk samples of cows
      with subclinical bovine mastitis was examined for biotype, phage pattern, in
      vitro antibiotic susceptibilities and ability to produce enterotoxins. The
      majority of the strains showed features consistent with bovine rather than human
      origin. All strains were sensitive to the antibiotics tested, except penicillin
      and streptomycin. Enterotoxigenicity was observed in 6 (4.7%) strains and only
      enterotoxins A and C were produced.

PMID- 2224491
TI  - Thin sow syndrome (TSS): the effect of amperozide.
AB  - Sixty sows suffering from typical post-weaning TSS were divided into three
      groups: (1) 20 as negative controls (NC); (2) 20 as positive controls (PC)
      treated with vitamins, trace elements and antibiotics; and (3) 20 injected with
      amperozide (2 mg/kg body weight), a new neuroleptic compound with antistress and
      anxiolytic properties. Amperozide treated sows fully recovered (P less than 0.05)
      and 80% became pregnant, while figures for the PC and NC groups were only 15% and
      10% respectively. Mortality was up to 50% in the NC, 40% in the PC and only 15%
      in the amperozide treated group (P less than 0.05). These field results warrant
      further studies in unravelling the aetiology and prevention of this condition.

PMID- 2224492
TI  - Plasma beta-endorphin increase following electrical stunning in sheep.
AB  - Plasma concentrations of beta-endorphin were assayed in 10 sheep during the
      conscious state and in relation to electrical stunning. There was a 2 fold
      increase after stunning, and a further elevation following recovery. On this
      basis it is possible that recovery from electrical stunning at slaughter may
      cause undue distress, and it is suggested that exsanguination must be carried out
      promptly.

PMID- 2224493
TI  - Brain responses to semantic incongruity in bilinguals.
AB  - Event-related potentials were examined in the first and second languages of
      bilinguals, and in monolinguals. Stimuli were anomalous sentences presented one
      word at a time on a CRT monitor. The principal dependent measure was the N400
      component, and an accompanying frontal negativity, which provided an estimate of
      the amount of time the nervous system takes to determine the semantic incongruity
      of a given word. The results indicate that N400 latency is slightly, but
      significantly, delayed in bilinguals, with monolinguals having the shortest mean
      N400 latency, the first language of bilinguals next, and the second language of
      bilinguals longest. The frontal negativity varied in amplitude somewhat
      independently of the parietal N400. The amplitude of the frontal negativity was
      sometimes reduced in the second language, tending to be smaller in those subjects
      who used their second language the least. Neither N400 nor the frontal negativity
      varied as a function of age of acquisition of the second language. The results
      are discussed with reference to the relative automaticity of language in
      bilinguals, and the sensitivity of N400 to variations in the automaticity of
      language processing.

PMID- 2224494
TI  - Reading in callosal agenesis.
AB  - It has been suggested that deficits in explicit phonological processing are
      causal in developmental dyslexia. Deficits in such skills have been reported in
      developmental phonological dyslexia, though not in developmental surface
      dyslexia. The reading performance of two children with callosal agenesis, who
      have been previously shown to have impairments on rhyming tasks, are reported.
      Neither child is dyslexic in the traditional sense, since word reading levels are
      appropriate for age. However, both children have impaired development of the
      phonological reading route despite normal lexical skills. The pattern of their
      reading is therefore comparable to developmental phonological dyslexia. Problems
      in explicit phonological processing may be causal in the failure to establish an
      efficient phonological reading route but this is insufficient to create
      difficulty with word recognition itself. The corpus callosum may be essential for
      the normal development of a phonological reading route.

PMID- 2224495
TI  - Repetition and verbal STM in transcortical sensory aphasia: a case study.
AB  - The repetition performance of a patient (S.T.) with transcortical sensory aphasia
      is examined in four experiments with particular emphasis on the STM capacities
      underlying her performance. S.T.'s repetition of word strings exceeding her span
      (two words) is characterized by good recall of the final items and a strong
      tendency to lose the initial items in the input string. This pattern contrasts
      with the serial position effects observed in a phonologically based STM
      impairment, and it is suggested that a lexical-semantic impairment, also evident
      in S.T.'s naming and lexical comprehension, contributes to her inability to
      retain the primacy portions of the input string. Lexical effects obtained in her
      reproduction of words and nonwords, as well as word strings (Experiments 1 and
      2), indicate that under conditions of impaired semantics S.T. is relying on
      lexical phonological information to repeat. Priming by repeated exposure
      (Experiment 3) failed to improve her repetition performance, indicating that
      access to lexical information is brief and dependent on recent phonological
      input. In Experiment 4, the role of syntactic structure in S.T.'s sentence
      repetition was examined, and it was shown that syntactic structure affects the
      recall of order information, but not the number of items recalled. The repetition
      and verbal STM abilities of this patient, in light of her total language profile,
      are then evaluated in the context of a language-based view of verbal STM.

PMID- 2224497
TI  - The effects of processing requirements on neurophysiological responses to spoken
      sentences.
AB  - Ten English speaking subjects listened to sentences that varied in sentential
      constraint (i.e., the degree to which the context of a sentence predicts the
      final word of that sentence) and event-related potentials (ERPs) were recorded
      during the presentation of the final word of each sentence. In the Control
      condition subjects merely listened to the sentences. In the Orthographic
      processing condition subjects merely listened to the sentences. In the
      Orthographic processing condition subjects decided, following each sentence,
      whether a given letter had been present in the final word of the preceding
      sentence. In the Phonological processing condition the subjects judged whether a
      given speech sound was contained in the terminal word. In the Semantic processing
      condition subjects determined whether the final word was a member of a given
      semantic category. A previous finding in the visual modality that the N400
      component was larger in amplitude for low constraint sentence terminations than
      for high was extended to the auditory modality. It was also found that the
      amplitude of a N200-like response was similarly responsive to contextual
      constraint. The hypothesis that N400 amplitude would vary significantly with the
      depth of processing of the terminal word was not supported by the data. The
      "N200" recorded in this language processing context showed the classic
      frontocentral distribution of the N200. The N400 to spoken sentences had a
      central/centroparietal distribution similar to the N400 in visual modality
      experiments. It is suggested that the N400 obtained in these sentence contexts
      reflects an automatic semantic processing of words that occurs even when semantic
      analysis is not required to complete a given task. The cooccurrence and
      topographical dissimilarity of the "N200" and N400 suggest that the N400 may not
      be a delayed or a generic N200.

PMID- 2224496
TI  - MRI evaluation of the size and symmetry of the planum temporale in adolescents
      with developmental dyslexia.
AB  - MRI technique was used to examine the size and symmetry of the plana temporale in
      19 dyslexic students in grade 8 and in carefully matched control subjects. The
      results demonstrated a high frequency of planum symmetry among the dyslexics
      (70%) whereas symmetry was observed in only 30% of the control subjects. It was
      not possible to demonstrate any clear association between symmetry/asymmetry of
      planum temporale and handedness. Word-reading strategies among the dyslexics and
      control subjects were investigated with computerized tasks where accuracy and
      naming latency were recorded. All subjects with pure phonological deficits in
      reading had symmetrical plana temporale indicating a possible neuroanatomical
      basis for a characteristic symptom of linguistic processing deficiency in
      developmental dyslexia.

PMID- 2224498
TI  - Asymmetrical transfer of braille acquisition between hands.
AB  - Two experiments are presented which demonstrate asymmetrical transfer for tactual
      recognition of individual braille letters in sighted subjects, a task usually
      associated with right hemisphere specialization. Right-handers were studied in
      Experiment 1, left- and right-handers in Experiment 2. Poor transfer of training
      from the right hand to the left hand was observed for right-handed subjects in
      both experiments. The same was true for one group of left-handers (who wrote with
      the "inverted" position). For another group (who wrote with the "noninverted"
      position), no disadvantage was associated with opposite-hand training for either
      hand. The role of hemispheric specialization of function in determining the
      direction of greater transfer is discussed, and it is argued that handwriting
      posture may be an index of the degree of functional "connectedness" of the two
      hemispheres in left-handers.

PMID- 2224499
TI  - Evidence for cortical dysfunction in spasmodic dysphonia: regional cerebral blood
      flow and quantitative electrophysiology.
AB  - Cortical function was evaluated in 26 subjects with spasmodic dysphonia.
      Quantitative topographic electrophysiologic mapping (QTE) was employed to provide
      quantitative analyses of EEG spectra and auditory and visual long-latency evoked
      potentials. Single-photon emission computed tomography (SPECT) of the cerebral
      transit of Xenon-133 was used to evaluate regional cerebral blood flow. Left
      hemispheric abnormalities in cortical function were found by both techniques in
      10 subjects and by at least one technique in 18 subjects. Right hemispheric
      abnormalities were observed by both techniques in 8 subjects and by at least one
      technique in 18 subjects. Most patients with cortical dysfunction in one
      hemisphere had cortical dysfunction in the other, while only 4 subjects had
      unilateral lesions as found by one of the two techniques. Eight subjects were
      normal by all measurements. Underlying structural abnormalities were detected by
      magnetic resonance imaging in 5/24 subjects. However, functional abnormalities
      (SPECT or QTE) were not observed at sites of structural abnormalities. SPECT and
      QTE were significantly related in identification of left hemispheric dysfunction
      (p = .037) with a trend in the right hemisphere (p = .070), and a significant
      congruence of SPECT and QTE findings occurred in the left anterior cortical
      quadrant (p = .011). These findings indicate that dysfunction of cortical
      perfusion and/or cortical electrophysiology is associated with spasmodic
      dysphonia in the majority of subjects studied.

PMID- 2224500
TI  - Afferent connections of the thalamic paraventricular and parataenial nuclei in
      the rat--a retrograde tracing study with iontophoretic application of Fluoro
      Gold.
AB  - The origin of the afferents of the thalamic anterior paraventricular and
      parataenial nuclei (PVA-PT) in the rat was studied with fluorescent retrograde
      tracing method. After iontophoretic application of Fluoro-Gold into PVA-PT, many
      labeled cells were found in the medial frontal cortex, ventral subiculum,
      claustrum, septum, ventral pallidum, thalamic reticular nuc., zona incerta,
      hypothalamus, central gray, dorsal raphe nuc., parabrachial nuc., and the
      laterodorsal tegmental nuc. A few cells were labeled in the medial amygdaloid
      nuc., amygdalohippocampal area, median raphe nuc., and the locus coeruleus.
      Occasional neurons were labeled in the ventral lateral geniculate nuc., pretectal
      area, and in the solitary nuc. and the lateral reticular nuc. in the medulla.

PMID- 2224501
TI  - Presence of VIP fibers of sensory origin in the rat trachea.
AB  - The presence of vasoactive intestinal peptide (VIP) immunoreactive nerve fibers
      (LI) in the respiratory tract of mammals is well documented. These fibers are
      known to originate from parasympathetic postganglionic neurons and to be
      associated with blood vessels, submucosal glands, and with smooth muscle. We
      found that, in addition to this, the epithelial layer of the rat trachea also
      contains VIP-LI fibers. Vagotomy or ligation of the cervical portion of the vagus
      nerve resulted respectively in a decrease of VIP-LI fibers within the epithelium
      or in the accumulation of VIP in axons proximal to the site of transection or
      ligation, whereas no changes were seen in other parts of the trachea. On the
      other hand, capsaicin pretreatment also caused similar changes to the surgical
      procedures. These findings indicate that VIP-LI fibers in the tracheal epithelium
      of the rat are supplied by the sensory ganglia of the vagus nerve.

PMID- 2224502
TI  - Influences of neonatal and adult exposures to testosterone on the levels of the
      beta-subunit of nerve growth factor in the neural tissues of mice.
AB  - In our previous report, we have shown the sex difference in the concentration of
      the beta-subunit of nerve growth factor (beta-NGF) in the neural and paraneural
      tissues of mice. In this investigation, we examined the effects of castration of
      adult males, and of neonatal and/or adult treatments with testosterone on levels
      of beta-NGF in the several tissues of mice. Castration caused a marked reduction
      in the levels of serum testosterone and of beta-NGF in the brain, spinal cord and
      submandibular glands, but not in the pancreas and kidneys. Continuous infusion of
      testosterone for one week into adult males that had been castrated at 2 months of
      age restored the level of beta-NGF in the three tissues mentioned above. A single
      injection of testosterone to 5-day-old female pups to masculinize the brain gave
      no effect on the level of beta-NGF in any tissue dissected after 4 months. A one
      week infusion of testosterone into adult females slightly increased levels of
      beta-NGF in the brain and spinal cord, but the same treatment of adult females
      given in advance a single dose of testosterone at 5 days of age caused a
      significant increase in its levels over those of untreated females. These results
      suggest that neonatal and adult exposures to testosterone can influence the
      endogenous concentration of beta-NGF in the brain and spinal cord.

PMID- 2224503
TI  - Axotomy affects density but not properties of potassium leak channels, in the
      leech AP neurons.
AB  - Leech AP neurons react to axotomy by increasing excitability and resting
      potential of the cell body membrane. In a previous report we described single
      potassium channels contributing to the leak conductance in the soma membrane of
      AP cells. Here we compare both properties and density of single potassium leak
      channels in cell-free patches from normal and axotomized AP neurons. We show that
      properties such as single channel conductance, outward rectification, time
      constants of open and shut interval distributions and absence of inactivation do
      not significantly differ between normal and axotomized cells. On the other hand,
      we find that the number of channels per patch progressively increases with time
      after axotomy. We conclude that changes in density rather than alterations in
      properties of single channels can account for the increase in the resting
      potential, observed after axotomy.

PMID- 2224504
TI  - Clonidine and phenylephrine injected into the lateral hypothalamus inhibits water
      intake in rats.
AB  - It has been demonstrated that peripheral or intracerebroventricular (i.c.v.)
      administration of the alpha 2-adrenoceptor agonist, clonidine, blocks the water
      intake induced by several dipsogenic stimuli in rats. In the present
      investigation we studied the effect of the injection of clonidine, phenylephrine,
      prazosin or yohimbine into the lateral hypothalamic area (LHA) on the water
      intake induced by water deprivation or central angiotensin II (AII) in rats. Rats
      with chronic cannulas implanted into the lateral ventricle and LHA were used.
      Injection of clonidine or phenylephrine into the LHA reduced the water intake
      produced by both water deprivation and i.c.v. injection of AII. Previous
      injection of the alpha 1- or alpha 2-adrenoceptor antagonists, prazosin or
      yohimbine, into the LHA reduced the antidipsogenic effect of clonidine or
      phenylephrine injected into the same area. These results suggest that the alpha 1
      and alpha 2-adrenergic receptors of the hypothalamus are part of the central
      inhibitory system for the thirst produced by dehydration or central AII.

PMID- 2224505
TI  - Effects of anesthesia on efferent phrenic activity in neonatal swine.
AB  - The effects of two levels of Saffan anesthesia (standard recording level: 2-4
      mg/kg/min, and 10X recording level) and a single level of pentobarbital (5 mg/kg)
      on the power spectral density of efferent phrenic discharge were investigated in
      piglets aged from less than 1 day to 50 days. The phrenic high frequency
      oscillation (HFO) was present in decerebrate, unanesthetized piglets and in
      piglets anesthetized with Saffan, albeit reduced at 10 times recording level, but
      was absent under pentobarbital. The results indicate that Saffan does not have a
      significantly depressant effect on the phrenic HFO in developing swine.

PMID- 2224506
TI  - Suprathreshold brain stimulation activates non-corticospinal motor evoked
      potentials in cats.
AB  - In the feline model of the motor evoked potential (MEP) test, a multiphasic
      spinal cord signal can be elicited in response to bipolar or transcranial brain
      stimulation. Previous studies have shown that signals produced by threshold
      stimulation travel mostly in the corticospinal tract. However, from this study we
      show that suprathreshold stimulation produces very large amplitude MEPs which
      travel in the ventral funiculus and therefore are most likely associated with
      extrapyramidal tract activation. The data supporting this conclusion are: (1)
      apparent conduction velocities of the first two large amplitude peaks are at
      least 80 m/s with transcranial stimulation; (2) latency of the transcranial MEP
      at L2 in the cord is less than or equal to 3.50 ms; (3) large amplitude, positive
      monophasic potentials are recorded in the ventral but not dorsal-lateral
      funiculus for either bipolar or transcranial MEPs; (4) both bipolar and
      transcranial MEPs are significantly reduced or abolished by selective lesion of
      the ventral funiculus. The two tracts which we believe are responsible for
      mediating the suprathreshold MEP in the cat are the reticulospinal and
      vestibulospinal tracts. This is significant because suprathreshold MEPs can be
      used to monitor feline ventral cord function. Furthermore, combining the use of
      threshold and suprathreshold MEPs may provide a differential diagnostic test for
      pyramidal vs. extrapyramidal motor function.

PMID- 2224507
TI  - Repeated low doses of morphine do not induce tolerance but increase the opioid
      antinociceptive effect in rats with a peripheral neuropathy.
AB  - In rats with a mononeuropathy, repeated low doses of morphine slightly enhanced
      its own effect in a paw pressure test of the lesioned limb. While the very
      effectiveness of morphine in neuropathic rats suggests that at least some
      nociceptive components of neuropathic pain might be sensitive to opioid receptor
      mechanisms, the absence of a rapid tolerance in this model indicates that
      tachyphylactic phenomena do not contribute to the reputed clinical
      ineffectiveness of opioids in neuropathic pain.

PMID- 2224508
TI  - Cerebellar evoked potential elicited by stimulation of C-fiber in saphenous nerve
      of cat.
AB  - Stimulation of the saphenous nerve above C-fiber threshold strength evoked a
      field potential which consisted of an early component with latency of 11.8 +/-
      3.5 ms and a late component with latency of 312.1 +/- 17.5 ms on the cerebellar
      cortex. After the A-fibers in saphenous nerve were blocked by the polarizing
      current selectivity, the stimulation at C-fiber suprathreshold elicited a C-fiber
      cerebellar evoked potential (C-CEP) with latency of 134.2 +/- 18.4 ms. C-CEP had
      the maximal amplitude on the vermian lobule VI of the contra- and ipsilateral
      cerebellar cortex and its phases reversed in the deep layer of this area. It was
      suggested that the selective C-fiber input could reach the cerebellar cortex and
      elicit a characteristic evoked potential. However, when A- and C-fiber inputs
      were elicited simultaneously, C-CEP might be inhibited by the A-fiber input.

PMID- 2224509
TI  - Delay, discriminatory, and modality specific neurons in striatum and pallidum
      during short-term memory tasks.
AB  - The function of the striatum and its integrative capacities is addressed. The
      activity of single neurons in behaving Macaca mulatta is studied. Two new classes
      of neurons were found. In the striatum, but not in the pallidum, these neurons
      were visual modality specific. These neurons may represent a conjunction of
      sensory, mnemonic and motor information, and may be concerned with decisions
      about the emission or withholding of movements. The frontal dysfunction
      hypothesis of cognitive deficits in Parkinson's disease is considered.

PMID- 2224510
TI  - Alterations in brain hexokinase activity associated with streptozotocin-induced
      diabetes mellitus in the rat.
AB  - The effects of streptozotocin-induced diabetes mellitus on the activity of
      discrete regions of the brain were studied with histochemical localization and
      photodensitometric quantification of the metabolic enzyme, hexokinase. Two weeks
      after a single injection of streptozotocin (65 mg/kg, i.p.), plasma glucose and
      osmolarity levels were elevated, and plasma sodium concentrations were depressed.
      These changes were reversed in diabetic rats treated with insulin. Accompanying
      these symptoms of diabetes were significant increases in hexokinase activity in
      the magnocellular division of the paraventricular nucleus of the hypothalamus
      (mPVH, 12.1%), the medial subdivision of the nucleus of the tractus solitarius
      (mNTS, 15.5%), and the commissural subdivision of the NTS (cNTS, 10.9%). An
      increase, though just below the level of significance, was also observed in the
      supraoptic nucleus of the hypothalamus (SON, 11.5%). The increases in hexokinase
      activity were completely reversed in the cNTS (and SON) and only partly reversed
      in the mPVH and mNTS of insulin-treated diabetic rats. No changes in hexokinase
      activity were seen in the subfornical organ, medial preoptic area, parvocellular
      division of the PVH, locus coeruleus, or dorsal motor nucleus of the vagus of
      diabetic rats. These results reinforce the idea that the brain is not exempt from
      changes associated with diabetes mellitus and suggest that metabolic alterations
      in the mPVH (and SON) and two divisions of the NTS are likely related to changes
      in vasopressin production and blood volume, respectively.

PMID- 2224511
TI  - Retinal direction-sensitive input to the accessory optic system: an in vitro
      approach with behavioral relevance.
AB  - Retinal application of gamma-aminobutyric acid (GABA) antagonists block direction
      sensitive (DS) responses in turtle in two ways: (1) the selectivity of DS retinal
      ganglion cells in vitro, and (2) the eye's ability to track the direction of full
      field image motion. The experiments described below demonstrate that an important
      locus for retinal slip computation by the accessory optic system (AOS) occurs in
      the retina. Visual responses were measured physiologically and behaviorally from
      turtles which had their telencephalon removed. Physiological responses to visual
      field movement were recorded in the AOS using an in vitro brain preparation. DS
      responses of single cells were blocked by intravitreal application of
      bicuculline. The behavioral approach was to measure optokinetic nystagmus (OKN)
      in lesioned animals. OKN occurred in the absence of the telencephalon, yet was
      disrupted following an intravitreal injection of bicuculline. Thus, both
      experimental approaches showed that DS processing exists without the
      telencephalon, yet is disrupted by GABA antagonists applied to the retina.

PMID- 2224512
TI  - Mn2(+)-activated aspartate aminopeptidase activity, subcellular localization in
      young and adult rat brain.
AB  - The levels of soluble and membrane-bound aminopeptidase activities were assayed
      in subcellular fractions from young (4 weeks old) and adult (20 weeks old) rat
      brains, using Asp-2-naphthylamide as substrate. The young rats showed the highest
      soluble and membrane-bound levels of activity in the microsomal fraction but no
      differences among fractions were found at 20 weeks of age. The membrane-bound
      activity was significantly higher than the soluble one in all subcellular
      fractions of young rats. Soluble activity of the homogenate and the mitochondrial
      fraction was significantly increased in adult animals when compared to that of
      younger ones.

PMID- 2224513
TI  - Perinatal exposure to anoxia alone does not alter the susceptibility to
      amygdaloid-kindled seizures in the adult rabbit.
AB  - It is suggested that asphyxia on newborns increases the susceptibility to
      epileptic syndromes. The effect of perinatal and postnatal anoxia on subsequent
      seizure susceptibility was assessed by amygdaloid kindling in adult rabbits.
      Rabbits from 1 day pre-term to 53 days were exposed to 100% N2 for an average of
      7 min or until the heart rate was reduced by 70%. Non-anoxic littermates served
      as controls. At 2 months of age, animals were implanted with bilateral amygdalae
      electrodes. After a postsurgical recovery period, afterdischarge (AD) thresholds
      were determined for the electrode sites and a kindling paradigm was performed.
      There were no significant differences in the rate of kindling in all groups
      studied (control, anoxic at 1 day pre-term or at term, anoxic at 44 and 53 days).
      These results demonstrate that perinatal anoxia did not alter the seizure
      susceptibility in the adult rabbit kindling model.

PMID- 2224514
TI  - Topography of movement-related cortical potentials is abnormal in Parkinson's
      disease.
AB  - We studied the scalp-recorded, movement-related cortical potentials occurring
      immediately before and after the onset of movement in 5 patients with asymmetric
      Parkinson's disease. The topographic distribution of the initial slope of motor
      potential (isMP) was diffuse for voluntary finger movements of the more affected
      hand but normal for movements of the less affected hand. The frontal peak of
      motor potential (fpMP) was located more posterior in patients than in normal
      subjects. The peak amplitudes of the potentials were normal in all patients. The
      topographic abnormalities might reflect inadequate excitatory activity from the
      basal ganglia to the primary motor cortex and the supplementary motor area.

PMID- 2224515
TI  - Differential firing patterns of the peptide-containing cholinergic motor neurons
      B15 and B16 during feeding behavior in Aplysia.
AB  - During egestive responses neuron B16 fires at 20 Hz, while neuron B15 is not
      active. During ingestive responses B16 fires for 0.5-1.0 s at 15-20 Hz, then B15
      and B16 fire together, with B15 firing at 7.5-12 Hz. The duration of activity
      during ingestive responses depends on consumption of food: when food is not
      consumed, bursts are shorter (e.g. 2 vs 4 s). This study establishes a basis for
      investigating the role of peripheral neuromodulation under physiologically
      relevant conditions.

PMID- 2224516
TI  - Partial involvement of monoamines and opiates in the inhibition of rat spinal
      nociceptive neurons evoked by stimulation in midbrain periaqueductal gray or
      lateral reticular formation.
AB  - In rats anesthetized with sodium pentobarbital, we tested the effects of systemic
      or intrathecal administration of the opiate antagonist naloxone, the serotonergic
      antagonist methysergide, or the adrenergic antagonist phentolamine, on inhibition
      produced by electrical stimulation in midbrain periaqueductal gray (PAG) or
      lateral reticular formation (LRF) of the responses of single lumbar dorsal horn
      neurons to noxious heating (50-54 degrees C, 10 s) of hindpaw skin. Systemically
      administered naloxone (1-10 mg/kg i.v.) reduced (greater than 20% below predrug
      inhibition) inhibition from PAG and/or LRF in 5/12 units and had no effect in the
      remainder. Systemic methysergide (2-6 mg/kg i.v.) selectively reduced PAG-evoked
      inhibition in 6 units, while inhibitions from both PAG and LRF stimulation were
      reduced in one unit and unaffected in 8 units. Systemic phentolamine (2-4 mg/kg)
      reduced LRF-evoked inhibition in 4 units, while inhibitions from PAG and LRF were
      reduced in one unit and unaffected in 5. Intrathecally applied methysergide
      reduced or abolished PAG-evoked inhibition in 8/16 units and reduced or abolished
      LRF-evoked inhibition in 6/14 units. Reductions in the level of inhibition were
      reversible in one-half of the cases, whereas they persisted for over 2 h in the
      remainder. The mixed effects of both systemically and intrathecally administered
      drugs suggest that monoamines and opiates may be partly involved in spinal
      inhibitory mechanisms activated from the midbrain.

PMID- 2224517
TI  - Brown adipose tissue thermogenesis is activated by electrical and chemical (L
      glutamate) stimulation of the ventromedial hypothalamic nucleus in cold
      acclimated rats.
AB  - Experiments were conducted to determine if both electrical and chemical
      stimulation of the ventromedial hypothalamic nucleus (VMH) could activate brown
      adipose tissue (BAT) thermogenesis. Age-matched, room-acclimated (21 degrees C)
      and cold-acclimated (4 degrees C for 3 weeks prior to testing) male Sprague
      Dawley rats were given unilateral electrical or chemical stimulation to the VMH
      by way of a 'chemotrode apparatus'. The devised 'chemotrode' allowed both
      electrical stimulation (insulated piano wire stimulating electrode) and chemical
      stimulation (23 gauge stainless steel intracranial cannula of equal length) to be
      performed at the same VMH site using a common 19 gauge stainless steel outer
      guide tube. The first unilateral VMH electrical stimulation (0.5 ms pulse, 50 Hz
      and 120 microA for 30 s) caused no significant rise in interscapular brown
      adipose tissue temperature (TIBAT) colonic (Tc) or tail surface temperatures
      (Tt), compared to respective prestimulation control values in rats acclimated to
      21 degrees C. In the 4 degrees C-acclimated group the first VMH electrical
      stimulation caused a significant rise in IBAT temperature. L-Glutamate
      administration to the same VMH site (60 nmol in 600 nl volume) also caused a
      significant increase in IBAT temperature in the 4 degrees C but not the 21
      degrees C-acclimated rats. The rise in IBAT temperature following the L-glutamate
      injection to the 4 degrees C-acclimated group was similar to that found following
      the first electrical stimulation to this group. Interestingly, a second
      unilateral electrical stimulation of the VMH to 4 degrees C-acclimated rats could
      not evoke a similar increase in IBAT temperature suggesting that overall L
      glutamate was acting in vivo as an excitotoxin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2224519
TI  - Latex nanosphere delivery system (LNDS): novel nanometer-sized carriers of
      fluorescent dyes and active agents selectively target neuronal subpopulations via
      uptake and retrograde transport.
AB  - A wide range of latex particles are described which are capable of carrying high
      concentrations of fluorescent dyes, drugs, and photoactive agents selectively to
      subpopulations of neurons in vitro and in vivo. Particle size, charge, and
      concentration were all found to influence uptake into cultured neurons or
      retrograde transport in vivo. Chromophore loadings of greater than 14% (w/w) were
      obtained. Incorporation of a photoactivated dye (chlorin e6) into the polymer did
      not compromise the ability of the dye to produce singlet oxygen following light
      exposure. We refer to this unique family of latex particles as the latex
      nanosphere delivery system (LNDS). The LNDS will be usefull for studies of
      neuroanatomy and nervous system development, as well as more general areas of
      biomedical research where it is desirable to selectively label subpopulations of
      cells. The LNDS also offers a means of providing targeted delivery of drugs or
      photoactive agents to selected subpopulations of cells; this will allow
      experimentation not currently possible using any existent methodology.

PMID- 2224518
TI  - Antagonism of the gerbil's sweetener and Polycose gustatory responses by copper
      chloride.
AB  - Antagonism of the gerbil's whole chorda tympani nerve taste responses by CuCl2
      was studied. A 30 min pretreatment of 0.1 mM CuCl2 suppressed responses to single
      concentrations of the following sweeteners: L-alanine, L-proline, D-tryptophan, 6
      chloro-D-tryptophan, L-valine, glycine, sucrose, maltose, lactose, tetrachloro
      galacto-sucrose, glucose, fructose, methyl alpha-D-glucopyranoside, glycerol,
      sorbitol, sodium saccharin, L-4'-cyano-3'-(2-2-2-trifluoro acetamido)succinanilic
      acid, phenethyurea, and stevioside. The responses to L-serine and the starch
      hydrolysate, Polycose were depressed to a lesser degree. The responses to glycine
      HCl and NaCl were slightly suppressed by CuCl2. The 0.1 mM CuCl2 had no effect on
      the shape of the sucrose concentration-response curve or its 1/2 maximal response
      (CR50), but did suppress the maximum response (Rmax), characteristic of non
      competitive antagonism. Our work suggests the presence of 2 separate receptor
      sites on the gerbil's taste receptor cell membrane, one of which interacts with
      sugar sweeteners and most other non-sugar sweeteners and the other with Polycose.

PMID- 2224520
TI  - Cardiovascular responses to electrical stimulation of the ventrolateral medulla
      of the spontaneously hypertensive rat.
AB  - Cardiovascular responses to electrical microstimulation of the ventrolateral
      medulla were investigated in both Wistar-Kyoto rats (WKY) and spontaneously
      hypertensive rats (SHR) under pentobarbital anesthesia. The threshold intensity
      required to elicit a change in blood pressure (BP) and the cardiovascular
      responses in these two groups of rats upon electrical stimulation were compared.
      It was found that the region with the lowest threshold intensities was located in
      the rostral ventrolateral medulla (RVL) and the threshold intensities were much
      lower in SHR than in WKY. Electrical stimulation of this brain region also
      resulted in a greater increase in BP during stimulation in SHR, compared to
      control. In SHR, upon termination of stimulation, the BP dropped to a level above
      the pre-stimulation level and this was followed by a prolonged, sustained
      elevation in BP before returning to the control level, whereas in WKY, the BP
      showed an initial drop to below the pre-stimulation level and then returned to
      the control level. These results suggest an enhanced responsiveness to electrical
      stimulation in SHR. Although the heart rate (HR) increased to a similar extent
      during electrical stimulation in both groups of rats, upon termination of
      stimulation WKY exhibited bradycardia followed by tachycardia before the HR
      returned to the pre-stimulation level, whereas SHR exhibited tachycardia which
      was maintained for a substantial period of time before returning to the pre
      stimulation level. The results suggest a lower baroreceptor sensitivity in SHR.
      The change in HR/change in BP was smaller in SHR than in WKY, suggesting that the
      increase in HR may not contribute to the increase in BP during stimulation as
      much in SHR as in WKY.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2224521
TI  - Evidence for the in vivo polymerization of ependymin: a brain extracellular
      glycoprotein.
AB  - Ependymin, a glycoprotein of the brain extracellular fluid, has been implicated
      in synaptic changes associated with the consolidation process of long-term memory
      formation and the activity-dependent sharpening of connections of regenerating
      optic nerve. In vitro experiments have demonstrated that ependymin has the
      capacity to form fibrous insoluble polymers (FIP) when the solvent Ca2+
      concentration is reduced by the addition of EGTA. Such products, once formed, do
      not dissolve in 2% sodium dodecyl sulfate (SDS) in 5 M urea. This property was
      used to develop a method for isolating brain FIP. A reproducible quantity of FIP
      was found in goldfish and mouse brain. This was highly concentrated in the
      synaptosomal fraction and had identical immunoreactivity properties to FIP
      obtained by the polymerization of pure ependymin in vitro as well as a cross
      reactivity to other protein components of the extracellular matrix such as
      fibronectin and laminin. Labeling studies with [35S]methionine showed that
      labeled FIP aggregates are synthesized in vivo and become associated with the
      synaptosomal fraction. A comparison of the amino acid sequence of ependymin with
      those for proteins of the extracellular matrix indicated that common sequences 5
      6 amino acids long exist in the molecules. These homologies may explain why
      antibodies to fibronectin, laminin and tubulin can recognize the FIP prepared
      from pure ependymin. These results suggest that ependymin can polymerize in vivo
      to form FIP aggregates which have similar immunoreactivity properties to major
      components of the brain extracellular matrix.

PMID- 2224522
TI  - Effects of lesions of a sexually dimorphic nucleus in the preoptic/anterior
      hypothalamic area on the expression of androgen- and estrogen-dependent sexual
      behaviors in male ferrets.
AB  - The male nucleus of the preoptic/anterior hypothalamic area (MN-POA/AH) is a
      sexually dimorphic structure present in male, but not in female ferrets.
      Ovariectomized female ferrets given increasing dosages of estradiol benzoate (EB)
      normally run faster towards a stud male in an L-maze (i.e. become more
      proceptive). In two separate experiments, only gonadectomized males with
      bilateral damage to the MN-POA/AH following large or small electrolytic lesions
      approached stud males more quickly in response to EB. By contrast, males which
      received sham lesions, unilateral large POA/AH lesions, or bilateral lesions
      which missed the MN-POA/AH on at least one side failed to show EB-induced
      reductions in approach latencies in pre- or post-operative tests. Males with
      large POA/AH lesions also displayed significant post-operative decrements in
      masculine sexual behaviors during treatment with a high dose of testosterone
      propionate (TP). Less severe, but statistically significant deficits in masculine
      coital performance were also observed in males with small lesions which damaged
      the MN-POA/AH bilaterally; however, the ability of these males to achieve
      intromissions appeared normal. Together, these results suggest that the MN-POA/AH
      of the male ferret exerts an inhibitory influence on estrogen-dependent
      proceptive responsiveness, but play only a minor role in the control of masculine
      coital behavior.

PMID- 2224523
TI  - Cell culture of cryopreserved human fetal cerebral cortical and hippocampal
      neurons: neuronal development and responses to trophic factors.
AB  - Past knowledge of the human brain at the cellular and molecular levels has come
      largely from studies of postmortem fixed tissue or by way of extrapolation from
      studies of lower mammalian species. The ability to study living human brain
      neurons would provide a new avenue for further insight into mechanisms operative
      in human brain development, function, and disease. The present study established
      procedures for the cryopreservation and culture of human fetal cerebral cortical
      and hippocampal neurons, and characterized the development of the cells in
      culture. The predominant cell type in both cortical and hippocampal cultures was
      pyramidal-like neurons that extended one long axon-like process and a few minor
      dendrite-like processes. Bipolar and stellate cells, as well as astrocyte-like
      glia were also present in cultures from both brain regions. Fibroblast growth
      factor (FGF), but not nerve growth factor (NGF), enhanced long-term neuronal
      survival in both cerebral cortical and hippocampal cultures. Immunocytochemistry
      demonstrated the presence of both FGF- and NGF-like immunoreactivities in neurons
      and glia, from both cerebral cortex and hippocampus, suggesting that these
      endogenous growth factors may play roles in human fetal brain development. The
      ability to cryopreserve large numbers of viable dissociated human fetal brain
      neurons, and subsequently study them in cell cultures, provides new opportunities
      to understand dynamic aspects of the human brain at the cellular and molecular
      levels.

PMID- 2224524
TI  - Characterization of a glucocorticoid-sensitive hippocampal protein.
AB  - Increased synthesis of a rat hippocampal protein with an apparent molecular
      weight (Mr) of 35,000 Da occurs in response to elevation of serum corticosterone
      levels. Subcellular fractionation has localized this protein in the cytosol. Two
      dimensional gel electrophoresis indicated that this protein has an isoelectric
      point (IEP) of 6.6. A similar protein in liver has a slightly higher Mr and an
      IEP of 6.8. Increased synthesis of one additional hippocampal protein with an Mr
      of 46,000 Da and an IEP of 6.2 and of two other liver proteins, one with an Mr of
      53,000 Da and an IEP of 6.2 and the other with an Mr of 45,000 Da and a range of
      IEPs from 8.7 to 7.8, was also seen after injection of corticosterone into rats.
      One possible identity of the 35,000 Da protein is glycerol 3-phosphate
      dehydrogenase (GPDH), based upon the reported Mr and IEP of this enzyme. The
      35,000 Da hippocampal protein co-eluted from a gel filtration column with GPDH
      activity. No alteration of hippocampal GPDH activity was seen in intact rats 4 or
      24 h after injection of either corticosterone or the type II receptor-specific
      agonist RU 28362. However, daily administration of corticosterone to rats
      beginning 10 days after adrenalectomy returned hippocampal GPDH activity to
      normal values after 2-3 days. In contrast, synthesis of the 35,000 Da protein was
      maximally increased 4 h after a single injection of steroid and not elevated at
      later times.

PMID- 2224525
TI  - Muscimol injections in the medial septum impair spatial learning.
AB  - These experiments examined the role of GABAergic systems in modulating
      septohippocampal cholinergic influences on learning. Microinjections of the
      GABA(A) agonist muscimol (0.5, 1.0 or 5.0 nmol) or physiological saline were
      administered (0.5 microliters) into the medial septum of rats via chronically
      implanted cannulae just prior to daily training in the Morris water maze spatial
      learning task. The animals received 3 training trials on each of 4 days. The
      escape latencies of rats trained with a submerged escape platform at a fixed
      location were significantly shorter than those trained with a randomly located
      platform. Rate of learning of the fixed location was significantly impaired in
      rats given pretraining muscimol injections in the medial septum at doses (1.0 and
      5.0 nmol) that significantly reduced hippocampal high-affinity choline uptake
      (HACU). Analyses of responses on a probe trial with no pretraining injections and
      no platform revealed that, in comparison with controls, animals that had received
      muscimol prior to each training session were likely to swim in the region where
      the platform had been located. The finding that muscimol-injected rats were
      subsequently able to learn the task when trained without muscimol injections
      indicates that the acquisition impairment was not due to a lasting effect of the
      drug injections. Our results are consistent with the view that the septal
      GABAergic modulation of the septohippocampal cholinergic pathway is involved in
      regulating the acquisition of spatial information.

PMID- 2224526
TI  - Protocerebral circadian pacemakers in crayfish: evidence for mutually coupled
      pacemakers.
AB  - Similar to intact crayfish, animals with an isolated protocerebrum-eyestalk
      complex, exhibit competent circadian rhythms in the electroretinogram (ERG). The
      ERG rhythms of the two eyes remain in phase after isolation of the protocerebrum
      but can be desynchronized after surgical bisection of the protocerebrum. The
      desynchrony of the two ERG rhythms reveals the existence of at least two
      circadian pacemakers in the eyestalk-protocerebrum complex. In addition, the fact
      that desynchrony of the ERG rhythms only occurs in bisected preparations suggests
      that pathways between the protocerebral lobes normally couple the two pacemakers.

PMID- 2224527
TI  - Potassium currents recorded in type I carotid body cells from the neonatal rat
      and their modulation by chemoexcitatory agents.
AB  - Whole cell patch clamp recordings were made from type I cells of the neonatal rat
      carotid body, isolated and maintained in primary culture for up to 48 h.
      Depolarizing voltage steps applied from a holding potential of -70 mV evoked
      outward currents positive to approximately -30 mV. Currents were strongly blocked
      by extracellular tetraethylammonium (25 mM), and were therefore attributed to
      activation of voltage-dependent K+ channels. Currents were also suppressed by 4
      aminopyridine, removal of extracellular Ca2+, and replacement of extracellular
      Ca2+ with Ba2+. These results suggest there are Ca2(+)-dependent and Ca2(+)
      independent components of the K+ currents. No evidence was found to suggest that
      ATP-sensitive K+ channels were present. The effects of 3 chemoexcitatory agents
      (NaCN, almitrine and reduced extracellular pH) on K+ currents in isolated type I
      cells were investigated. All three agents suppressed K+ currents to similar
      degrees. The effects of lowered pH and NaCN were reversible, and NaCN-induced
      reductions occurred regardless of the presence of intracellular ATP. The effect
      of almitrine was irreversible for up to 30 min of recording. It is concluded that
      the reduction of K+ currents by chemoexcitants may play a role in the mechanism
      of chemotransduction in the carotid body.

PMID- 2224528
TI  - A subtype of cerebellar Golgi cells may be cholinergic.
AB  - In cerebellar sections of the feline brain processed for choline
      acetyltransferase-like immunoreactivity, a population of distinctly stained cells
      was discovered in the granular layer of the cortex in both vermis and
      hemispheres. Their position and morphology qualify them as Golgi cells, but their
      density indicated that they comprise less than 5% of all cerebellar Golgi cells.
      Varicose immunoreactive fiber nets in all cortical layers also contribute to
      seemingly widespread cholinergic systems in the cerebellar cortex.

PMID- 2224529
TI  - Distribution of 'non-specific' cholinesterase histochemical staining in the
      dorsal thalamus: a comparative study in rodents.
AB  - Histochemical studies in rat dorsal thalamus demonstrate that 'non-specific'
      cholinesterase (ChE) enzyme activity is characteristic of neurons of the anterior
      dorsal (AD) and reuniens (Re) nuclei and in a cell group found as part of the
      central lateral (CL) and lateral dorsal (LD) nuclei. Extra-somatal ChE staining
      also is seen in the anterior ventral (AV) nucleus. Parallel histochemical studies
      in other rodents reveal slight ChE activity in neurons of the mouse AD and LD,
      but not in other thalamic nuclei. The dorsal thalami of hamsters, gerbils and
      guinea pigs show no detectable cellular staining of ChE, although low levels of
      extra-somatal ChE appear in AV and the internal medullary lamina. These data
      indicate that 'non-specific' cholinesterase activity is not found commonly in
      neurons of the dorsal thalamus and prominent ChE staining may be unique to the
      laboratory rat.

PMID- 2224531
TI  - Characterization of oxytocin immunoreactivity in human sympathetic paravertebral
      ganglia.
AB  - Immunoreactive oxytocin (IR-OXT) detected in extracts of human lumbar sympathetic
      paravertebral ganglia was characterized by high-performance liquid chromatography
      (HPLC). The immunoreactive substance was found to elute at the same position as
      the reference preparation of oxytocin (OXT). The results revealed the presence of
      chromatographically identified OXT in human sympathetic ganglia.

PMID- 2224532
TI  - Precursor of respiratory pattern in the early gestation mammalian fetus.
AB  - Recordings of respiratory muscle activity in fetal lambs from early in gestation
      provide insight into the organization of the central pattern generator for
      respiration in mammals. Evidence presented here is consistent with the recent
      hypothesis that production of the respiratory pattern involves two separate
      neural modules: one, the 'rhythm' module, which specifies the respiratory cycle
      and another, the 'form' module, which creates the characteristic shape of each
      burst of activity within this cycle. The rhythm module is already functional when
      gestation is 35% complete while the form module appears to be constructed
      gradually over the second half of gestation.

PMID- 2224530
TI  - The interpeduncular nucleus excites the on-cells and inhibits the off-cells of
      the nucleus raphe magnus.
AB  - The interpeduncular nucleus (IPN) was stimulated electrically while single-cell
      activity was recorded in the nucleus raphe magnus (NRM) of rats under
      pentobarbital anesthesia. Two classes of NRM cell were examined, those inhibited
      (off-cells) and those excited (on-cells) by noxious mechanical skin stimulation.
      Off-cells (92%) were found to be inhibited by IPN stimulation, whereas on-cells
      (50%) were excited. Based on previously suggested roles for the NRM neurons, we
      argue that both effects are hyperalgetic.

PMID- 2224533
TI  - Direct projections from the anterior and tuberal regions of the lateral
      hypothalamus to the rostral part of the pineal complex of the rat. An anterograde
      neuron-tracing study by using Phaseolus vulgaris leucoagglutinin.
AB  - The anterograde tracer, Phaseolus vulgaris leucoagglutinin, was injected into the
      lateral hypothalamic division of the Wistar rat. After 7 days of survival the
      animals were fixed by perfusion, and cryostat sections processed for
      visualization of the tracer by immunohistochemistry. Injections into the anterior
      and tuberal regions of the lateral hypothalamic division labeled neurons which
      projected caudally to the rostral part of the pineal complex, e.g. the deep
      pineal gland and the pineal stalk. Labeled fibers were in this study not observed
      in the superficial pineal gland. Due to the direct innervation of the lateral
      hypothalamic region from the retina and the involvement of this area in circadian
      rhythmicity, the projections, demonstrated in this study, from the lateral
      hypothalamic region to the pineal gland are suggested to transmit impulses which
      modulate the circadian activity of the rat pineal gland.

PMID- 2224535
TI  - Retinal ganglion-cell densities and soma sizes are unaffected by long-term
      monocular deprivation in the cat.
AB  - Three cats were raised with monocular deprivation for 5.2-7.2 years, and ganglion
      cell densities and soma sizes were measured in their flat-mounted retinae. The
      retinae were Nissl-stained so that ganglion cells could be measured whether or
      not they maintained normal central projections. Measurements were made in the
      area centralis, peripheral binocular segment, and monocular segment of the
      retinae. There were no significant differences between the deprived and non
      deprived retinae in the densities or soma-sizes of alpha cells or other (non
      alpha) ganglion cells at any of these retinal locations. These results support
      the view that the most distal effects of monocular deprivation occur at the
      retino-geniculate contact, and they suggest that even after long-term monocular
      deprivation, effects in the lateral geniculate nucleus do not produce secondary,
      retrograde changes in the retina.

PMID- 2224534
TI  - Cellular localization of proenkephalin mRNA and enkephalin peptide products in
      cultured astrocytes.
AB  - To identify the possible cellular sites of opioid gene expression during
      ontogeny, proenkephalin mRNA and enkephalin peptide expression were examined,
      respectively, by in situ hybridization and immunocytochemistry in organotypic
      explants of rat cerebellum and in astrocyte-enriched cultures of murine cerebral
      hemispheres. High levels of proenkephalin mRNA and enkephalin immunoreactivity
      were detected in immature cells identified as astrocytes. Double-labeling studies
      combining in situ hybridization and immunocytochemical localization of the
      astrocytic marker, glial fibrillary acidic protein, provided direct evidence that
      proenkephalin mRNA is expressed by astrocytes in culture. Based on previous
      studies that Met-enkephalin can inhibit astrocyte growth in vitro, the present
      results suggest that proenkephalin gene expression by astrocytes is important
      during central nervous system maturation.

PMID- 2224536
TI  - Vasoactive intestinal peptide affects the GABAergic system in the hypothalamic
      pituitary axis.
AB  - The effect of a specific antiserum against vasoactive intestinal peptide (VIP) on
      GABA in the hypothalamic-pituitary axis was studied. The administration of anti
      VIP serum (A-VIP) increased anterior pituitary GABA concentration in control
      rats, but decreased this neurotransmitter in rats with hyperprolactinemia induced
      by acute or chronic treatments with estrogens, or by the implanting of anterior
      pituitary glands under the kidney capsule. Besides, the injection of the A-VIP
      serum in the morning in proestrous rats causes a decrease in anterior pituitary
      GABA concentration, measured in the afternoon of the same day. The in vitro
      effect of A-VIP and VIP on endogenous GABA release from hypothalamic fragments
      and on anterior pituitary GABA concentration was studied. A-VIP increased both
      basal and high K(+)-evoked GABA effluxes whereas VIP produced a decrease in
      evoked GABA efflux from hypothalamic fragments. Furthermore, A-VIP inhibited the
      normal degradation of GABA that occurs in the isolated gland whereas VIP
      increased it. These results suggest that VIP modifies hypothalamic GABA release
      and anterior pituitary GABA concentration.

PMID- 2224537
TI  - Estradiol in the striatum: effects on behavior and dopamine receptors but no
      evidence for membrane steroid receptors.
AB  - Estradiol was applied directly to the striatum of ovariectomized female rats by a
      unilateral intracerebral cannula for three hr or four days. Following four days
      of estradiol treatment, rats increased the number of rotations in the direction
      away from the side of the hormone treatment. Cholesterol-treated animals did not
      change their rotational behavior. Dopamine receptors were assayed in the same
      animals by autoradiography; D2 receptors increased on the hormone-treated side
      relative to the untreated side after four days of treatment, only in the lateral
      striatum. D1 dopamine receptors did not change. The D2:D1 receptor ratio was
      related to the direction of rotation. Measurements of membrane fluidity with a
      fluorescent probe revealed no effect of estradiol on striatal membrane fluidity.
      Membrane proteins were labeled with estrogen agonist and antagonist affinity
      labels and analyzed by gel electrophoresis, but no saturable membrane binding
      sites were detected. The results indicate that estradiol acts directly in the
      striatum to affect behavior and dopamine receptors, but the neurochemical
      mechanisms remain to be determined.

PMID- 2224538
TI  - Effects of serotonin on the hypothalamic-pituitary GABAergic system.
AB  - The effects of serotonin (5-HT) and its precursor, 5-hydroxytryptophan (5-HTP) on
      the GABAergic system in the mediobasal hypothalamus (MBH) and the anterior
      pituitary were studied. The IP administration of 5-HTP produced a transient
      increase (only at 45 min after the injection) in glutamate decarboxylase activity
      (GAD) of MBH and in GABA concentration in anterior pituitary. Besides, 5-HTP
      administration increased the in vitro evoked GABA release from MBH. The
      administration of 5-HTP to hypophysectomized rats partially reversed the
      inhibitory effects of hypophysectomy on GABA concentration in MBH. We also
      examined the direct effect of 5-HT on some parameters on the hypothalamic
      GABAergic system. The presence of 5-HT in the incubation medium increased GAD
      activity and evoked GABA release from MBH. These observations indicate that the
      serotoninergic stimulation of the hypothalamic GABAergic system could be a direct
      effect which may, at least partially, be independent of the feedback mechanism
      induced by prolactin on the GABAergic neurons. The serotoninergic increase of
      prolactin secretion could be accomplished through stimulation of the hypothalamic
      GABAergic transmission.

PMID- 2224539
TI  - Effect of haloperidol on immunoreactive neuropeptide Y in rat cerebral cortex and
      basal ganglia.
AB  - To clarify the dopaminergic regulation of neuropeptide Y (NPY) neurons, the
      effect of haloperidol on NPY in basal ganglia and the cerebral cortex of the rat
      brain was investigated by sensitive radioimmunoassay and immunocytochemistry
      using antiserum against rat NPY. After repeated intraperitoneal injections of
      haloperidol (5 mg/kg) for 6 days, the content of immunoreactive NPY was
      significantly decreased in the caudate-putamen, but significantly increased in
      the lateral prefrontal cortex. After treatment for 21 days, the content of
      immunoreactive NPY in the caudate-putamen remained significantly low, but the
      extent of change in the lateral prefrontal cortex diminished. In the medial
      prefrontal cortex, piriform cortex, parietal cortex and nucleus accumbens, no
      significant changes were found after treatment for either 6 or 21 days. These
      findings were compatible with those obtained by immunocytochemistry using the
      same antiserum: an increase of immunoreactive fibers and terminals in the lateral
      prefrontal cortex and their decrease in the caudate-putamen. However, in the
      nucleus accumbens the density of immunoreactive fibers and terminals was
      decreased in the rostral portion, but not in the caudal portion after haloperidol
      treatment for 6 and 21 days. These findings suggest that dopaminergic afferents
      region-specifically regulate dopamine-sensitive NPY neurons in the rat brain.

PMID- 2224540
TI  - Changes in retention of a visual discrimination task following unilateral and
      bilateral transections of temporo-entorhinal connections in rats.
AB  - In a previous study, it was shown that the lateral entorhinal cortex (LEC) in the
      left hemisphere contains higher concentration of glutamate than in the right
      hemisphere. The purpose of the present study was to examine potential
      relationship between this neurochemical asymmetry and behavior. Rats with either
      left, right, or bilateral transections of the fiber connections between the
      temporal cortex and LEC were tested for postoperative retention of a visual
      discrimination task. Because histological verification of lesions was crucial in
      this study, analyses of neurochemistry had to be omitted. The results showed that
      both left and bilateral lesions resulted in impaired retention, but the bilateral
      group was even more impaired than the left group. The rats with lesions in the
      right hemisphere, however, used fewer trials to reach the learning criterion than
      the control group, but they did not make fewer errors than the controls. The
      results are discussed in terms of lateralization of mnemonic processes.

PMID- 2224541
TI  - Axonal guidance of adenosine deaminase immunoreactive primary afferent fibers in
      developing mouse spinal cord.
AB  - This study examined the precision of central fiber growth in a subpopulation of
      dorsal root ganglion neurons in developing mouse spinal cord. Immunohistochemical
      techniques using a monospecific, polyclonal antiserum to mouse adenosine
      deaminase (ADA) were utilized to label a population of primary sensory afferents
      that have been found to exclusively innervate laminae I and II of the dorsal horn
      in adult mice. Initial growth of ADA-immunoreactive (ADA-IR) primary afferents
      occurred very early in development, embryonic day 10 (E10), a time coincident
      with the earliest settling time of dorsal root ganglion neurons. Adenosine
      deaminase immunoreactive primary afferents were observed throughout the cross
      sectional area of the primordial dorsal funiculus (DF) as early as E10.
      Immunostained fibers remained quiescent in the DF during its growth and
      separation into the tract of Lissauer and dorsal column pathway. By E15, the two
      pathways had formed and ADA-IR fibers were observed exclusively in the tract of
      Lissauer. This segregation of fibers remained throughout development and
      reflected the adult pattern. Growth was reinitiated at E16 when the fibers
      advanced into the dorsal horn and proceeded directly to laminae I and II
      mimicking their adult distribution. Exuberant fiber growth was not detected
      throughout their development. These results strongly suggest that ADA-IR fibers
      exhibit precise fiber guidance to a preferred pathway, the tract of Lissauer, and
      accurate laminar innervation of the dorsal horn.

PMID- 2224542
TI  - Hippocampal muscarinic supersensitivity after AF64A medial septal lesion excludes
      M1 receptors.
AB  - Stereotaxic injection of AF64A, into the medial septum of the rat, resulted in
      significant loss of presynaptic cholinergic markers in this structure. No
      significant change was observed for the presynaptic neuronal markers for dopamine
      and serotonin-containing neurons in either the medial septum or hippocampus. The
      AF64A lesion also resulted in a significant reduction of muscarinic receptors as
      demonstrated by a loss of [3H]QNB binding in the medial septum. Subtype analysis
      showed the decrease of receptor binding in the medial septum to be due to a loss
      of M1 receptors as well as other muscarinic receptor subtypes. In the hippocampal
      formation, [3H]hemicholinium-3 binding was significantly reduced in the molecular
      layer of the dentate gyrus, and in the stratum oriens and stratum radiatum of the
      hippocampus. AF64A lesion resulted in a significant increase (Bmax) in non-M1
      muscarinic receptors in hippocampal stratum oriens, in areas CA2, CA3, and CA4.
      AF64A lesion of the medial septum did not result in muscarinic receptor
      alterations in any other region of the hippocampal formation examined. These
      results indicate that postsynaptic muscarinic receptors in the stratum oriens of
      the CA2 to CA4 region of the hippocampus mediate primarily the function of the
      cholinergic cell bodies of the medial septum. These receptors are not of the M1
      subtype.

PMID- 2224543
TI  - Gerbil hippocampal extracellular glutamate and neuronal activity after transient
      ischemia.
AB  - In order to elucidate the role of glutamate in the pathogenesis of delayed
      neuronal death, we analyzed changes in extracellular levels of glutamate induced
      by transient ischemia in the Mongolian gerbil hippocampus by a new brain
      microdialysis method combined with an enzymatic cycling technique. We also
      studied the effect of this change in glutamate on CA1 spontaneous neuronal
      discharges. The level of glutamate significantly increased during the 5 min of
      ischemia and during the first 5 min of recirculation. However, neuronal
      hyperactivity anticipated as a result of the increased extracellular glutamate
      was not observed. Spike discharges disappeared during and shortly after 5 min of
      ischemia; CA1 spontaneous spike discharges reappeared about 15 min after the
      recirculation. The frequency and amplitude of the discharges of CA1 neurons
      returned to normal by 30 min of the recirculation. However, the pattern of
      discharges was different from that recorded before the ischemia. CA1 neurons were
      found dead 4 days after the ischemia. Brief exposure to toxic concentrations of
      glutamate may cause the delayed neuronal death.

PMID- 2224545
TI  - An inexpensive guide cannula and collar for microdialysis experiments.
AB  - Microdialysis experiments often require that a dialysis probe be fixed into
      position within the brain during a testing trial but that the probe be easily
      removed and precisely repositioned within the brain site on subsequent tests. The
      present paper describes an inexpensive guide cannula and locking collar that is
      easily fabricated for such experiments.

PMID- 2224544
TI  - Effects of paraventricular hypothalamic microinjections of phenylpropanolamine
      and d-amphetamine on mash intake in rats.
AB  - The present experiment compared the effects of unilateral microinjections (40, 80
      and 160 nmol/0.5 microliter) of phenylpropanolamine (PPA: d,l-norephedrine) and d
      amphetamine sulfate within the paraventricular hypothalamus (PVN) on consumption
      of a palatable sweetened-mash diet in 15-hour food-deprived adult male rats.
      Intracranial microinjections were administered 5 minutes prior to each 30-minute
      feeding trial. PPA, at a dose of 160 nmol, suppressed feeding by 42%, whereas a
      similar dose of amphetamine suppressed feeding by 49%. Amphetamine or PPA doses
      of 40 and 80 nmol were without significant effect on feeding behavior. A
      relatively high dose of 160 nmol amphetamine was required to suppress feeding
      after injection into the PVN whereas much lower amphetamine concentrations are
      required to suppress feeding after injection into the perifornical hypothalamus.
      In contrast, PPA has some anorexic activity within the PVN but not within the
      perifornical hypothalamus.

PMID- 2224546
TI  - Characterization of the dynamic nature of microglial cells.
AB  - Dynamic properties of ramified microglia were investigated in tissue cultures of
      rat brain cells. Microglia were identified in viable cultures based on previously
      determined aspects of their morphology and location, and this identification was
      confirmed through immunohistochemical staining for type-three complement
      receptors. When living microglial cells were monitored using time-lapse video
      recording, an extremely dynamic nature was revealed. These cells exhibited
      morphological alteration, surface and cytoplasmic activity, and migration. All of
      these properties were both constant and rapid, with individual cells being
      capable of assuming a completely different overall morphology within a period as
      short as 5-10 min. These dynamic properties were consistently observed in
      microglia and appeared specific to this cell type. Thus, ramified microglia
      appear to possess a unique and highly dynamic nature, and this feature is
      proposed as a potential marker for these cells. Additionally, the significance of
      microglial cellular dynamics in the functional role of this cell population in
      vivo is considered.

PMID- 2224547
TI  - [Internal medicine at the crossroads].
AB  - General internal medicine is falling into subspecialities as the scope presented
      by individual specialities is no longer manageable. With respect to the patient,
      however, particularly concerning indications for medication and surgical
      treatment of polymorbid patients, as well as in solving problems of the aged,
      general internal medicine is a necessary and expedient branch. The training of
      specialists in this branch requires the presentation of classified information
      aimed at diagnosis and therapy. To fulfill the tasks expected of a specialist in
      internal medicine he has to build up a bank of diagnostic and therapeutic data of
      high quality.

PMID- 2224548
TI  - [Perioperative myocardial infarct in association with surgical treatment of
      coronary heart disease].
AB  - Perioperative myocardial infarction is a major complication of revascularization
      surgery of the heart which can negatively affect both the quality and duration of
      the patient's life. The aim of the paper is to contribute to the understanding of
      the problem which involves the definition, incidence, pathogenesis, diagnosis,
      complications, therapy and prognosis of perioperative myocardial infarction. One
      of the basic factors implicated in the development of perioperative derangement
      of the cardiac muscle is closely analyzed, namely insufficient protection of the
      myocardium with subsequent ischemia-reperfusion induced myocardial damage.
      Pitfalls of electrocardiographic diagnosis are pointed out and the rather
      complicated interpretation of increased enzyme levels following cardiac surgery
      is discussed. Complications, management, as well as early and late prognosis of
      patients with perioperative myocardial infarction are also dealt with.

PMID- 2224550
TI  - [Laminotomy and reconstruction of the spinal canal in an experiment].
AB  - Surgical access into the spinal canal allowing reconstruction of the axis of the
      body is reported. The technique of laminotomy was first tested on 5 dogs which
      were to be involved in other experiments. Healing of the spinal column and
      overall outcome were followed up on further 4 dogs surviving three months after
      the procedure. The operation, carried out in general anesthesia induced by IV
      administration of thiopental (SPOFA), proved to be relatively simple in all the 9
      dogs, weighing 10-24 kg. Plain radiologic, perimyelographic, as well as
      histologic examinations performed in 4 dogs after three-month survival showed
      virtually perfect healing of the reconstructed spinal canal and no stenosis at
      the site of the procedure.

PMID- 2224549
TI  - [Changes in circulating catecholamine levels in old rats under basal conditions
      and during stress].
AB  - The aim of the paper was to study the levels of circulating catecholamines in
      unrestrained cannulated rats under basal resting conditions and after exposure to
      two stressors. Catecholamines were determined radioenzymatically in 4-, 11-, 12-,
      24-, and 28-month-old rats. Immobilization and exposure to ether vapors were used
      as stress models. The results confirmed a definite trend to increased
      norepinephrine (NA) levels, concerning partially also epinephrine (ADR) levels in
      older animals compared to young ones. During immobilization the plasma NA
      response was markedly increased in 11-month-old rats, whereas in 28-month-old
      rats the increase was only mild. Plasma ADR concentration was only slightly
      elevated in 11-month-old rats, whereas in the older animals no changes were
      recorded compared to 4-month old rats. On comparing the age groups studied after
      exposure to ether vapors, the oldest age group of 24-month-old rats showed a
      slower return of the stress-induced higher plasma NA levels to initial values. On
      balance, the response of circulating catecholamines depends on the age of the
      animals and on the stressor used.

PMID- 2224551
TI  - [Experience with postmortem chromosome analysis].
AB  - Over the years 1986-1988 necroptic material, collected according to 5 established
      indication groups, was cultured. A total of 202 samples of necroptic material
      cultured and 122 of these samples were analyzed cytogenetically. Seventeen
      pathologic karyotypes were diagnosed in the material, namely 7 cases of Down's
      syndrome, 2 cases of Klinefelter's syndrome, 2 cases of D/D translocation, 1 case
      of Turner's syndrome, 1 case of gonosomal mosaicism, and 1 case of Patau's
      syndrome.

PMID- 2224552
TI  - [Systolic and diastolic intervals in patients with hypertrophic obstructive
      cardiomyopathy before and after withdrawal of verapamil].
AB  - Mechanocardiographic investigations were carried out in a group of eight patients
      with hypertrophic obstructive cardiomyopathy (HOCM) who had been implanted a DDD
      pacemaker which allowed efficient therapy to be administered in the combination
      of metoprolol in the dose of 300 mg/day and verapamil in doses of 240-480 mg/day.
      The investigation was repeated one week after temporary withdrawal of verapamil.
      The control group consisted of six patients with idiopathic third-degree-complete
      AV block with implanted DDD pacemakers. Over the period of 24 hours before
      investigation, these patients received 300 mg of metoprolol. All the patients had
      the same heart rate (70 bpm) and a constant PQ interval (0.18 s). Statistical
      analysis of the obtained data revealed the following findings: 1. There was no
      difference between the control group and the group of HOCM patients treated with
      verapamil. 2. Withdrawal of verapamil in HOCM patients resulted in a significant
      prolongation of the 2-0 interval and shortening of the O-c interval recorded on
      apexcardiogram compared to the control group. In conclusion, verapamil affects LV
      diastolic parameters in patients with HOCM and the changes are compatible with
      the beneficial effects of verapamil. These changes may however result partly from
      increased left atrial pressure due to atrial poisoning with verapamil.

PMID- 2224553
TI  - [Determination of functional "lipid age" on the basis of analysis of serum fatty
      acids].
AB  - The composition of total fatty acids was analyzed in the serum of subjects with
      normal lipid and glycide metabolism, aged 20 to 89 years. A mathematico-empirical
      procedure was applied and on using the method of multiple linear regression the
      formulas of biological function age, designated as lipid age, were established,
      with individual serum fatty acids and their ratios in relation to characteristic
      attributes of markers of aging as independent variable parameters. Further
      correction of lipid age to the chosen level of 60 years was described and the
      thus corrected lipid age was expressed in percentages. Application of the
      obtained formulas of lipid age in the series studied showed that the increase
      rate of lipid age was higher in men by an average of 5.5% compared to women,
      which represents a difference of 3.8 years. The obtained results demonstrate a
      significant relationship of fatty acids to the process of aging and their
      potential use in evaluating processes affecting lipid metabolism.

PMID- 2224554
TI  - [Functional status of thrombocytes in men of various age groups].
AB  - The functional state of thrombocytes was compared in men of three age groups,
      i.e. below 46 years, within the range of 46 to 59 years, and above 59 years.
      Thrombocytes of old people were found to be more sensitive to such aggregation
      inductors as ADP, collagen, arachidonic acid, and adrenaline compared to
      thrombocytes of subjects from the younger age groups. A further finding was that
      blood platelets of old men produced significantly greater amount of ATP than
      recorded in young men and this may account for hyperactivity of thrombocytes in
      old age.

PMID- 2224555
TI  - [Present trends in the treatment of occlusive diseases of the peripheral arteries
      of the lower extremities].
AB  - Occlusive diseases of arteries of the lower extremities with underlying
      atherosclerosis present a serious medical problem. Despite some generally
      accepted principles, the diagnostic and therapeutic process in this disease keeps
      constantly developing. The author deals not only with verified therapeutic
      procedures such as reconstructive surgery of arteries, endarterectomy,
      profundoplastics, sympathectomy, but also with the diapeutic method of treatment,
      percutaneous transluminal angioplasty, which is being used ever more frequently.
      In indicated cases, percutaneous transluminal angioplasty is considered to be the
      alternative method to arterial reconstructive surgery. The algorithm of treatment
      applied in the author's department is presented.

PMID- 2224556
TI  - [Local complications worsening the results of surgical treatment of colorectal
      carcinoma in older patients].
AB  - The authors compare the results of surgical treatment for colorectal carcinoma in
      150 patients aged over 69 years, seen over the years 1979-1988, who had developed
      local complications requiring urgent surgery. Of gerontologic patients with
      colorectal carcinoma these represented 24.6%. The cause of the complications was
      late diagnosis mostly due to the patient's neglect who failed to appreciate an
      even evident symptomatology. These serious complications of colorectal carcinoma
      did not present an inoperable condition and in 34% the tumor could be radically
      removed. The advanced age of the patients along with the necessity of urgent
      surgery are the major risk factors responsible for the high mortality rate
      compared to patients who underwent elective surgery.

PMID- 2224557
TI  - [Phospholipids in the human myometrium in various stages of contraction before
      and during labor].
AB  - A detailed analysis of the myometrium showed that the physical state of
      phospholipids--fluidity--depends on the ratio of their individual components and
      changes in relation to the state of contractile activity. The results indicate
      that before term of labor changes in the fluidity of myometrial phospholipids as
      well as increased availability of arachidonic acid for prostaglandin synthesis
      can induce preterm onset of contractile activity. Possibilities of affecting
      these mechanisms, which belong to the many potential factors inducing preterm
      labor, are discussed.

PMID- 2224558
TI  - [The effect of sex hormones on calcium ion transport in the myometrial cells in
      rabbits].
AB  - The effect of estradiol, progesterone, and testosterone on calcium ion transport
      was studied in the rabbit uterus. To investigate the effect of sex hormones on
      voltage-dependent calcium channels, the isolated uterus was incubated in Ca2(+)
      free depolarizing K+ solution. In this solution cumulative dose-response curves
      to CaCl2 were obtained by increasing the Ca2+ concentration (10(-5)-10(-3) mol.l
      1). A decrease of the maximal contractile response to CaCl2 was recorded after in
      vitro pretreatment with estradiol (1.8 x 10(-5) mol l-1), (6.4 x 10(-1) mol) and
      testosterone (5.8 x 10(-5) mol.l-1). The pD2 values were unchanged. The
      possibility of affecting calcium ion release from intracellular stores by sex
      hormones was observed indirectly on using Ca2(+)-free Tyrode's solution with 0.8
      nmol EDTA. Contractile responses of the isolated uterus were induced by single
      application of norepinephrine (NE) in the dose of 2 x 10(-4) mol.l-1.
      Pretreatment with sex hormones decreased the contractile responses of the uterus
      to NE. The obtained results suggest an important involvement of calcium ions in
      the mechanism of action of sex hormones upon the myometrial smooth muscle.

PMID- 2224559
TI  - [Foot pain in the elderly].
AB  - The paper draws attention to the problem of the aging foot characterized by a
      complex of degenerative changes and other accompanying diseases--multimorbidity.
      Affections of the foot rank fourth in the examinations carried out in
      outpatients. A series of 100 randomly selected patients above the age of 60 who
      presented with affections of the foot for orthopedic examination was analyzed. In
      order to establish optimal preventive and therapeutic measures, correlation
      between foot pain and foot deformity was assessed and the most frequent
      etiologies of the painful foot and the most frequent localizations of maximal
      pain in the foot were determined. In relation to pain the author emphasizes the
      necessity to set up the present functional diagnosis and to apply a complex
      approach considering not only diseases which conventionally fall under the care
      of the orthopedist. The latter issue is particularly important in the setting of
      policlinics with narrow specialties where synthesis of the established findings
      is sometimes lacking. Frequent affections of the foot encountered in orthopedic
      practice require a complex analysis of the problem.

PMID- 2224560
TI  - Endocrine--metabolic crises.

PMID- 2224561
TI  - Endocrine and metabolic issues in critical care: a practitioner's perspective.

PMID- 2224562
TI  - Pheochromocytoma.

PMID- 2224563
TI  - Hypertensive crisis.

PMID- 2224564
TI  - Disorders of calcium, phosphorus, and magnesium.

PMID- 2224565
TI  - Serum potassium concentration abnormalities.

PMID- 2224566
TI  - Thyroid disorders.

PMID- 2224567
TI  - Anterior pituitary disease.

PMID- 2224568
TI  - Adrenal disorders.

PMID- 2224569
TI  - Nursing responsibilities in endocrine emergencies.

PMID- 2224570
TI  - Serum sodium concentration abnormalities.

PMID- 2224572
TI  - The urea-soluble low molecular weight cuticle proteins from the different
      developmental stages of Dacus oleae.
AB  - The cuticle proteins of the insect Dacus oleae have been isolated by extraction
      with a solution of 7 M urea. The affinity properties of cuticle proteins,
      isolated from the third instar larvae (L3DCPs 1-7), to chitin have been studied.
      Purified cuticle antigens were polymerized by glutaraldehyde and used for raising
      antibodies. The developmental appearance of the cuticle proteins has been studied
      by two-dimensional electrophoresis.

PMID- 2224571
TI  - Endochondral mineralization in cartilage organoid culture.
AB  - In the development of secondary bone, mineralization of the cartilage matrix is
      the first step in endochondral mineralization. The circumstances of cartilage
      mineralization are not known. Influences of the periosteal tissue have been
      mentioned. In order to investigate the role of osteoblastic cells in endochondral
      mineralization, cartilage organoid cultures were induced to mineralize by the
      addition of beta-glycerophosphate (beta-GP). In cartilage organoid culture,
      embryonic mouse limb bud mesenchymal cells were grown at high-density. The cells
      differentiated into mature chondrocytes and produced hyaline cartilage matrix.
      When cartilage had formed after 6 days in vitro, 10 mM beta-GP was added. The
      developed mineralized cartilage was investigated by morphological means. Seven
      days after the addition of beta-GP, the first mineralized spots were visible
      mainly in the internodular, noncartilage tissue. After 12 to 14 days, large areas
      of cartilage were mineralized, and after 21 days, nearly the whole culture had
      been mineralized. Electron microscopic investigations showed a dramatic
      alteration of the cartilage matrix followed by a homogeneous mineralization of
      the cartilage matrix. The chondrocytes in the mineralized area died and faded.
      Typical rod-like apatite crystals were visible at the border between the
      mineralized and the unmineralized matrix. This result closely resembles the in
      vivo situation of cartilage mineralization. Addition of osteoblastic calvarial
      cells enhanced the mineralization process, as did the addition of conditioned
      medium of calvarial cell monolayers. Under these treatments, mineralization
      started after 3 days and reached a maximum after 14 days. On the other hand,
      addition of mouse skin fibroblast-like cells without a direct contact to the
      cartilage inhibited cartilage mineralization. These results indicate that
      osteoblastic cells induce endochondral mineralization, whereas fibroblast-like
      cells inhibit this mineralization via soluble factors.

PMID- 2224573
TI  - Lectin binding beneath the epithelium and in smooth muscle cells in the
      developing bronchial tree.
AB  - Components of the subepithelial stratum in developing rat lung reacted
      transiently with Maclura pomifera agglutinin (MPA) and Aleuria aurantia
      agglutinin (OFA) conjugated to horseradish peroxidase. These lectins possess
      selective affinity for and serve to localize glycoconjugates (GCs) with terminal
      Gal/GalNAc and Fuc, respectively. Staining was strongest with both lectins in the
      proximal bronchial tree and decreased peripherally to growing buds where it was
      absent. MPA staining of subepithelial structures decreased from the
      pseudoglandular through the canalicular period and disappeared by the terminal
      sac stage. Disappearance of this subepithelial reactivity coincided with
      appearance of apical MPA-positive glycoconjugate in the canalicular period. OFA
      stained selectively a layer of flattened cells and a thin extracellular stratum
      under the epithelium of proximal bronchi in the canalicular period. This lectin
      affinity extended farther peripherally in the pseudoglandular interval and
      diminished thereafter. The layer of OFA-positive cells underlying the epithelium
      was identified immunohistochemically as immature smooth muscle. These muscle
      cells gained contractile protein while losing surface lectin reactivity during
      fetal development. The high iron diamine method localized sulfated GC in basement
      membrane of proximal respiratory passages in the fetal lung. The results attest
      to the involvement of specific GCs in mediating epithelial-mesenchymal cell
      interaction during critical stages of bronchial morphogenesis.

PMID- 2224574
TI  - Immunological evidence for the presence in sea urchin embryos of a cell adhesion
      protein similar to mouse uvomorulin (E-cadherin).
AB  - A tryptic fragment (88 kDa), obtained from external digestion of sea urchin
      embryos carried out in the presence of calcium, shows immunological cross
      reactivity with polyclonal and monoclonal antibodies (DECMA-1) against mouse
      teratocarcinoma uvomorulin. Fab fragments obtained from anti-mouse terato
      carcinoma uvomorulin mono- and polyclonal antibodies, and from polyclonal
      antibodies against the partially purified 88-kDa tryptic fragment, decompact
      early sea urchin embryos and block reaggregation of dissociated sea urchin
      blastula cells. These data indicate the presence of an uvomorulin-like protein in
      sea urchin embryos and suggest an important role for this protein in embryonic
      development.

PMID- 2224575
TI  - A morphological study of primordial germ cells at pregastrular stages in the
      chick embryo.
AB  - The spatial distribution, germ layer location, number and appearance of
      primordial germ cells (PGCs) are studied. Blastoderms from stage X (Eyal-Giladi
      and Kochav, 1976) to stage 2 (Hamburger and Hamilton, 1951) were serially
      sectioned and distribution patterns of PGCs were reconstructed. The presence of
      PGCs in clusters was noted at all stages examined. PGCs were found in relation to
      the epiblast, the primary hypoblast and in the blastocoel, during the whole
      period under examination. These observations show that PGCs can be directly
      studied at blastula stages. The results are consistent with observations on an
      early segregation of chick germ line that begins as early as stage X.

PMID- 2224576
TI  - Transdifferentiation of quiescent parenchymatous cells into tracheary elements.

PMID- 2224577
TI  - The current developments and their implication for the health system in the
      future.

PMID- 2224578
TI  - Computers and the future practice of medicine: issues and options.

PMID- 2224579
TI  - Technology assessment of pharmaceuticals. The necessity of user perspective.

PMID- 2224581
TI  - Re-organizing primary health care in Finland: from growth to quality.

PMID- 2224583
TI  - The future of "the peoples' home": development and challenges for the Swedish
      welfare state in the coming decades.

PMID- 2224582
TI  - Service management: New Zealand's solution to the problems of quality assurance
      and financial control.

PMID- 2224580
TI  - Developments in Dutch health care policy: the ideology of market mechanism.

PMID- 2224584
TI  - [Probable impact of the policy of health service decentralization in Latin
      America].

PMID- 2224585
TI  - Lessons from health care competition in the United States during the 1980s.

PMID- 2224586
TI  - The viral etiology of Paget's disease of bone: a new perspective.

PMID- 2224587
TI  - Health and hormonal characteristics of premenopausal women with lower bone mass.
AB  - A study of clinical renal and endocrinologic status was undertaken to determine
      whether the lowest maximal bone mass observed in premenopausal women, aged 20-40
      years, was a result of undiagnosed disease or represented a continuum of
      measurement in young adult women. A clinical sample (n = 53) was generated from
      an epidemiologic cross-sectional study (n = 535) designed to characterized
      correlates of maximal bone mass. Cases were 28 premenopausal women whose femoral
      bone mass as in the lowest 5th percentile of the distribution, less than 0.75
      g/cm2 at the femoral neck. Controls were 25 randomly selected premenopausal women
      whose femoral bone mass was within 1 SD of the mean of the femoral bone mass
      distribution. There was no indication of increased frequency of disease among the
      cases as compared with the controls. No occult hypogonadism, thyrotoxicosis,
      hyperparathyroidism, myeloma, or renal insufficiency was observed to explain
      lower bone mass measurement. However, cases had significantly lower estradiol
      levels (75 versus 106 pg/ml, P less than 0.05) and higher luteinizing hormone
      levels (3.8 versus 3.1 mIU/ml, P less than 0.07) than controls. Though
      preliminary, these findings suggest that lower estradiol levels may contribute to
      significant differences in bone mass even among healthy women at the time of
      maximal bone accumulation.

PMID- 2224588
TI  - Human pharmacokinetics of orally administered strontium.
AB  - Pharmacokinetics of orally administered SrCl2 (2.5 mmol) were studied in six
      healthy male volunteers. In the overall plasma concentration time (C-t) curves,
      two absorption phases were observed due to two dominant intestinal absorption
      loci. A method was devised to obtain separately the plasma C-t curves associated
      with each of the two absorption loci (curve 1 and curve 2). These curves and the
      overall plasma C-t curve were analyzed with a nonlinear estimation program
      (PCNONLIN). Pharmacokinetic parameters (mean +/- SD, n = 6) calculated from the
      overall curve were as follows: peak plasma concentration (Cmax) 3.55 +/- 1.22
      micrograms/ml and area under the plasma C-t curve (AUC affinity) 9138 +/- 1930
      micrograms.min/ml. The pharmacokinetic parameters calculated from curve 1 were as
      follows: terminal plasma elimination half-life time 47.3 +/- 7.9 hour, the plasma
      elimination half-life time of the preceding phase 5.2 +/- 3.3 hour, Cmax 1 3.09
      +/- 0.95 micrograms/ml, the first-order absorption rate constant for absorption
      locus 1 (Ka,1) 5.7 +/- 1.2 * 10(-2) minute-1 and the time lag (tlag,1) 11.7 +/-
      7.9 minute. In three of the subjects the pharmacokinetic parameters of absorption
      locus 2 could be evaluated: Ka,2 = 4.6 +/- 0.4 * 10(-2) minute-1, tlag,2 = 77.3
      +/- 4.0 minute, tmax,2 = 153 +/- 16 minute, Cmax,2 = 0.9 +/- 0.4 micrograms/ml
      and AUC 2 affinity = 1204 +/- 565 micrograms. minute/ml. and AUC2 affinity =
      0.14, indicating that 14% of the absorbed dose was absorbed via the second
      locus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2224589
TI  - Effects of tumor necrosis factor alpha on proliferation and expression of
      differentiated phenotypes in rabbit costal chondrocytes in culture.
AB  - Tumor necrosis factor alpha (TNF alpha) decreased the synthesis of
      glycosaminoglycan (GAG) in rabbit costal chondrocytes in culture, but did not
      stimulate the release of GAG from cell layers. Like chondrocytes cultured in
      control medium, chondrocytes cultured in the presence of TNF alpha produced
      putative "cartilage-specific" proteoglycans identified by density gradient
      centrifugation under dissociative conditions. Although TNF alpha decreased the
      synthesis of the proteoglycans, it did not change their monomeric size, which is
      a marker of cartilage phenotypes. Moreover, TNF alpha did not affect the
      responsiveness to parathyroid hormone, insulin-like growth factor I, or
      transforming growth factor beta, which is known to stimulate GAG synthesis in
      cultured chondrocytes. TNF alpha decreased the alkaline phosphatase activity in
      the chondrocytes dose dependently. On the other hand, it stimulated their DNA
      synthesis slightly, but significantly. The stimulatory effect of TNF alpha on DNA
      synthesis was potentiated by fibroblast growth factor, epidermal growth factor,
      and fetal bovine serum. These findings suggest that in the presence of hormones
      and growth factors, TNF alpha promotes the proliferation of chondrocytes while
      suppressing their further differentiation at the stage of synthesis of cartilage
      specific proteoglycans.

PMID- 2224590
TI  - 1,25 Dihydroxyvitamin D3 modifies cyclosporine-induced bone loss.
AB  - We have previously shown that cyclosporin A (CsA) produces high bone remodeling
      with resorption exceeding formation and loss of bone volume in the rat. This may
      have important clinical implications where CsA is widely used in organ
      transplantation. 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) is a bone mineralizing
      hormone which also has immune modifying properties. Consequently, we studied the
      effect of combined CsA and 1,25(OH)2D3 administration over 28 days in four groups
      of rats. Group A received vehicle (n = 10), group B CsA (15 mg/kg) (n = 10)
      alone, group C 1,25(OH)2D3 plus CsA (n = 15), and group D 1,25(OH)2D3 alone (20
      ng/100 g) (n = 15). Rats were bled periodically at day 0, 7, 14, and 28 and Ca,
      parathyroid hormone (PTH), 1,25(OH)2D, osteocalcin (bone Gla-protein, BGP), BUN,
      and creatinine were measured. Rats were sacrificed on day 28 and bones were
      examined histomorphometrically. Compared to controls, CsA resulted in significant
      elevation of BGP and a transient increase in 1,25(OH)2D with excess bone
      remodeling and loss of bone volume. 1,25(OH)2D3 administration produced
      hypercalcemia, a significant rise in BGP, with suppression of PTH and increased
      osteoid volume. Combined therapy prevented the loss of bone volume probably due
      to increased osteoid tissue and enhanced osteoblast activity. Renal dysfunction,
      a side-affect of CsA, was not a factor. In conclusion, 1,25(OH)2D3 combined with
      CsA restores bone volume which is accompanied by increases in serum calcium and
      BGP.

PMID- 2224591
TI  - A model for investigating the local action of bone-acting agents in vivo: effects
      of hPTH(1-34) on the secondary spongiosa in the rat.
AB  - Cytokines and other local factors are likely to play an important role in bone
      remodeling. The purpose of this study was to develop an experimental model for
      evaluating the local action of various hormones and other agents on rat femur
      trabecular bone in vivo. Through a 1 mm diameter hole (1 mm deep) on the lateral
      aspect of the distal cortex of a rat femur (0.9 cm above the joint), a
      polyethylene tube was inserted and glued onto the bone. This tube was connected
      to a vascular-access-port which was implanted subcutaneously in the hip area of
      male Sprague-Dawley rats weighing 190-210 g. To evaluate this model, a single 50
      microliters injection of 10(-8), 10(-10), or 10(-12) M hPTH(1-34) was given 1 day
      after catheter implantation and the number of osteoclasts was estimated 30 hours
      later. Bones were fixed, embedded, and stained with Masson's Trichrome stain and
      subjected to histomorphometric analysis. The single local parathyroid hormone
      (PTH) injection caused a dose-dependent increase in osteoclast number from 1.7 +/
      0.3 for phosphate-buffered saline (PBS) controls to 3.4 +/- 0.5, 5.8 +/- 0.9,
      and 5.4 +/- 1.0/mm for 10(-12), 10(-10), and 10(-8) M PTH, respectively. There
      was no increase in osteoclast number in the femurs of PBS-injected control rats,
      in the femurs of sham-operated rats, or in the untreated contralateral femur of
      the PTH-injected rat. The local injection of hPTH(1-34) did not change serum
      calcium, serum phosphate, or the urinary phosphate/creatinine ratio.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2224592
TI  - Effects of vitamin D-binding protein on bone resorption stimulated by 1,25
      dihydroxyvitamin D3.
AB  - Vitamin D and its metabolites are tightly bound to the serum vitamin D-binding
      protein (DBP) and only the free hormone is considered to be physiologically
      active. On the other hand, DBP could interact with cell membranes and even favor
      its intracellular entry. The present study was undertaken to examine the effects
      of DBP on bone resorption stimulated by 1,25-dihydroxyvitamin D3 [1,25(OH)2D3].
      Forelimb bones from 19-day-old fetal rats were cultured for 5 days in the
      presence of purified human or rat serum albumin (hSAP or rSAP) and 1,25(OH)2D3,
      with or without human or rat DBP (hDBP or rDBP). Bone resorption was assessed by
      measuring the release of previously incorporated 45Ca. We found that the
      resorptive response to 1,25(OH)2D3 was minimally altered by hDBP (5 microM). The
      minimal effects of hDBP on 1,25(OH)2D3 activity on rat bones might be explained
      by a 6-fold lower affinity of hDBP (1.1 x 10(7) M-1) than rDBP (5.9 x 10(7) M-1)
      for 1,25(OH)2D3 or by species differences in cellular recognition of DBP. In a
      homologous rat system, however, rDBP at low (0.5 microM) or physiological (5
      microM) concentration significantly decreased 1,25(OH)2D3-induced bone
      resorption. These data therefore support the hypothesis that free rather than DBP
      bound 1,25(OH)2D3 is physiologically important.

PMID- 2224595
TI  - Eagles and turkeys.

PMID- 2224593
TI  - The effect of swimming on bone modeling and composition in young adult rats.
AB  - The purpose of this study was to investigate the adaptability of long bones of
      young adult rats to the stress of chronic aquatic exercise. Twenty-eight female
      Sabra rats (12 weeks old) were randomly assigned to two groups and treatments:
      exercise (14 rats) and sedentary control (14 rats) matched for age and weight.
      Exercised animals were trained to swim in a water bath (35 degrees +/- 1 degree
      C, 1 hour daily 5 times a week) for 12 weeks loaded with lead weights on their
      tails (2% of their body weight) (BW). At the end of the training period following
      blood sampling for alkaline phosphatase, all rats were sacrificed and the humeri
      and tibiae bones were removed for the following measurements: bone morphometry,
      bone water compartmentalization, bone density (BD), bone mineral content (BMC),
      and bone ions content (Ca, Pi, Mg, Zn). The results indicate that exercise did
      not significantly affect the animals' body weight, bone volume, or length and
      diameters. However, bone hydration properties, BD, bone mass, and mineralization
      revealed significant differences between swim-trained rats and controls (P less
      than 0.05). Longitudinal (R1) measurement was higher by 43% for both humerus and
      tibia, and Transverse (R2) relaxation rates of hydrogen proton were higher by 117
      and 76% for humerus and tibia, respectively; fraction of bound water was higher
      by 36 and 46% for humerus and tibia, respectively. BD, bone weight, and ash were
      higher by 13%. BMC and bone ions content were higher by 10%, and alkaline
      phosphatase was higher by 67%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2224596
TI  - An interview with Gilles Dube, CDA President. Interview by P. Ralph Crawford.

PMID- 2224594
TI  - Radiation-sterilized insoluble collagenous bone matrix is a functional carrier of
      osteogenin for bone induction.
AB  - The influence of gamma radiation on the role of the collagenous substratum as a
      carrier for proteins which cause bone induction was examined. Osteoinductive
      demineralized bone matrix was extracted by 4 M guanidinium hydrochloride. The
      insoluble collagenous bone matrix (ICBM) obtained was not osteoinductive;
      however, when reconstituted with partially purified osteogenin, bone induction
      was restored. In order to apply the principle of bone induction to clinical use,
      methods of sterilization must be optimized to maintain the osteoinductive
      activity of bone allografts. The inactive substratum was irradiated and
      reconstituted with an active, partially purified bone extract and bioassayed.
      Irradiation of the ICBM by a Cobalt 60 source at a dose of 1 and 3 Mrads had no
      deleterious effect on the functional role of the substratum.

PMID- 2224597
TI  - 'Scholarly case report'.

PMID- 2224598
TI  - Unusual dental calculus.

PMID- 2224599
TI  - What dental phobics say about their dental experiences.
AB  - Previous surveys have indicated that there is a substantial proportion of
      dentally anxious individuals in the general population. Many of these individuals
      avoid contact with dentistry as much as possible, while fearful individuals who
      present themselves for treatment are probably too uncomfortable or too afraid to
      make their views known. Consequently, a study of the feelings and attitudes of a
      group of dental phobics was carried out as part of a larger study of the efficacy
      of psychological treatments for excessive dental anxiety. The subjects were
      recruited by means of a newspaper advertisement and asked to complete a
      questionnaire designed to obtain information regarding their dental experiences
      and attitudes. Twenty-three individuals provided enough data for analysis. They
      were distributed widely in terms of age, education, income levels, and general
      fearfulness. They reported less satisfaction with the level of understanding or
      acceptance found in the last dentist they had seen than with the dentist's level
      of technical competence and the diagnostic information they received. Dental
      phobics who had been to a dentist in the past year were generally more satisfied
      with their dentist than those who had not. It is suggested that a good dentist
      patient relationship based on understanding and acceptance is an important factor
      in overcoming the avoidance of fearful patients.

PMID- 2224600
TI  - [Oral manifestations of skin diseases].
AB  - There exists a multitude of systemic diseases which exhibit consequential oral
      manifestations. Dermatologic disorders frequently involve intraoral and perioral
      tissues which dental practitioners should be familiar with. A compilation of
      disorders including; bullous diseases (such as Pemphigus Vulgaris, Erythema
      Multiforme, Pemphigoid, Dermatitis Herpetiformis, Epidermolysis Bullosa, and
      Darier's disease), as well as non bullous diseases (such as Lichen Planus,
      Psoriasis, Lupus erythematosus, Scleroderma, and Perioral Dermatitis); and their
      oral manifestations are presented in order to facilitate their early diagnosis
      and subsequent treatment.

PMID- 2224601
TI  - Optimal placement of osseointegrated implants.
AB  - In summary, there is no substitute for thorough diagnosis, treatment planning,
      and meticulous surgical and prosthetic treatment. Proper utilization of surgical
      and radiographic correction-stents is one of the important aspects of the
      presurgical phase. The stents facilitate the accurate placement of implants in
      optimal positions where sufficient bone is present. In cases with insufficient
      bone, the stents may help in making a strategic alteration of the chosen implant
      site.

PMID- 2224602
TI  - The City of Toronto's geriatric dental program.
AB  - The past four years have witnessed the development of a comprehensive dental
      program for the seniors of the City of Toronto. This program is based upon the
      principles of dental health promotion and prevention. It recognizes the distinct
      needs of seniors who are institutionalized. It also addresses the needs of those
      low-income seniors living in the community. The overall result is an integrated
      program aimed at improving the dental health of all seniors in Toronto.

PMID- 2224604
TI  - [Subcutaneous sarcoidosis--a case report].
AB  - A 35 year-old female patient suffered from several brownishred nodule-plaques
      over both legs and left knee for two months. General malaise and exertional
      dyspnea were also noted. Skin biopsy shows multiple epithelioid cell tubercles
      with asteroid body in multinucleated giant cell located in the deep dermis and
      subcutis. No fungus, mycobacterium or foreign body could be found by special
      stains. Chest X-ray reveals bilateral hilar lymphadenopathy. She had neither
      sensory impairment nor DM history. Based on the above findings, we believed that
      she is a victim of subcutaneous sarcoidosis.

PMID- 2224603
TI  - [Evaluation of compensator used in radiation therapy].
AB  - A radiation beam incident on an irregular or sloping surface produces skewing of
      isodose curves and may give rise to unacceptable nonuniformity of the dose
      distribution within the target volume or cause excessive irradiation of sensitive
      tissues. The concept of using a compensator, first introduced by Ellis, to
      circumvent the skewness of isodose curves was elegant. Other workers followed
      suit elaborating further and extending the procedures. The treatment of chest
      wall tumors is of special interest and compensators were frequently used in their
      management. The compensators of aluminum and copper were systematically examined
      for 6 and 10 MV X-rays. Compensating thickness ratios was determined from
      equivalent dose measurement at compensating depth by placing compensator at the
      regular blocking tray for maintaining the skin sparing feature of high energy
      photon beams. The compensator must compensate not only for the reduction of the
      primary beam attenuation due to tissue deficit, but also for the loss of
      scattering by the missing tissues. It was found that the compensating thickness
      ratios (CTR) was not a constant value and was dependent on the tissue deficit,
      field size, compensating depth and the material of compensator, but was
      independent of the energy. As the tissue deficit is increased, the CTR decreases,
      since the loss of scattering for the deficit volume can be compensated by the
      lowered attenuation of the compensator. As the field size is increased, the CTR
      decreases. From the study of central axis depth dose for various deficit
      thickness, normalized at the median plane of no tissue deficit, it was found that
      compensator can compensate the dose accurately to one depth only and the
      compensation to other depth is approximate, and that the compensating error is
      increased with greater tissue deficit and further depth. The effectiveness of the
      compensating system with a stair-step polystyrene phantom representative of
      varying tissue deficits over a small treatment field (20 cm x 20 cm) was also
      studied with film dosimetry and the error was within 3%. The compensator
      thickness ratios must be measured in different radiation beams from different
      treatment machines and in different irradiation conditions because there are
      major difference between the CTR data obtained directly from experiments and the
      data besed on calculation from attenuation coefficient mu, physical density rho
      or electronic density, rho e. The specific CTR reported for aluminum and copper
      in the literature should only be used as a guideline.

PMID- 2224605
TI  - [Growth catch-up in the case of congenital hypothyroidism after delayed treatment
      -a case report].
AB  - We report a case of congenital hypothyroidism, presenting with growth and mental
      retardation since childhood, but in which the diagnosis was not made until he was
      17 years old. Because of such an unusually long delay in treatment, we focussed
      on the growth catch-up. This included the change of skeletal growth, puberty and
      mentality after a 4-year treatment period. He was 114 cm in height (height age
      5.5 years) with the upper segment measuring 60 cm and lower segment 54 cm (U/L
      ratio 1.1). His bone age was that of a six year old and he had no secondary
      sexual characteristics. IQ testing showed a full scale IQ of 68, verbal IQ 74 and
      performance IQ 64. After 4 years of treatment, his height caught up to 152 cm
      (height age 12.5 years), with the upper segment 77.2 cm, and that of lower
      segment 74.8 cm (U/L ratio 1.03). The bone age had advanced to that of a 17 year
      old. His pubic hair emerged after 18 months of therapy (at a chronologic age of
      18.5 years), accompanied by a normalization of testosterone and a normal response
      to a GnRH test. His IQ test was rechecked after 2 years of treatment. His full
      scale IQ was 78, verbal IQ 77 and performance IQ 83. In the mean time, the
      patient got a job being more alert, active and self-confident following his
      growth catch-up.

PMID- 2224606
TI  - Insulin autoimmune syndrome as a cause of hypoglycemia--report of four cases.
AB  - Insulin autoimmune syndrome is a syndrome consisting of fasting hypoglycemia,
      hyperinsulinemia and detectable insulin-binding antibodies in patients who have
      never been exposed to exogenous insulin. Four cases who developed symptoms of
      hypoglycemic attack with self-limited duration and spontaneous remission were
      collected in our hospital from 1984 to 1988. The elevated serum total and free
      insulin and C-peptide levels, as well as the titer of insulin autoantibodies,
      decreased gradually; but insulin autoantibodies were still present in the serum
      for more than six months after the initial episodes of hypoglycemia. Three of
      four patients had Graves' disease and developed the syndrome after methimazole
      treatment. The fourth one had a history of hemorrhagic cystitis and denied
      history of specific drug exposure. The cause or stimulus for insulin autoantibody
      formation is still unknown, but drugs containing a sulfhydryl group like
      methimazole may play a role in the development of the syndrome. Extremely high
      insulin antibodies in patients with fasting hypoglycemia along with elevated
      serum levels of insulin and C-peptide suggest a diagnosis of insulin autoimmune
      syndrome and usually exclude the possibility of insulinoma or factitious
      hypoglycemia.

PMID- 2224607
TI  - Goodpasture's syndrome--a case report.
AB  - Goodpasture's syndrome is a disease characterized by diffuse pulmonary hemorrhage
      and glomerulonephritis with circulating anti-glomerular basement membrane
      antibody (anti-GBM antibody). Although it is reported in the western world, it is
      rarely diagnosed in Taiwan. We report a 26-year-old male admitted due to
      pulmonary hemorrhage and rapid progressive glomerulonephritis. Renal biopsy
      showed diffuse glomerular proliferation and 90% crescent formation, and
      immunofluorescence stain showed diffuse linear staining of IgG, C3, IgA, IgM
      along glomerular basement membranes and tubular basement membranes. He was
      treated with immunosuppressive agents. Pulmonary hemorrhage improved rapidly, but
      his renal function was severely impaired and he remained dialysis dependent.

PMID- 2224609
TI  - [Gastric volvulus in childhood--report of two cases].
AB  - Gastric volvulus is a rare acute abdominal condition, especially in the pediatric
      field. We reported 2 cases of gastric volvulus presenting with acute abdominal
      pain, abdominal distension and vomiting. Both were found to be mesentero-axial
      type gastric volvulus on operation; one was associated with gastrosplenic and
      gastrocolic ligment laxacity, the other with left side diaphragmatic hernia. Both
      of them recovered uneventfully with no evidence of recurrence on follow up.

PMID- 2224608
TI  - [Perinatal listeriosis--a case report].
AB  - Listeria monocytogenes, an uncommon perinatal infection in human, has been
      reported to be correlated with abortion, premature labor, intrauterine fetal
      sepsis, intrauterine fetal death and neonatal infections. Reported here was the
      first case of perinatal listeriosis complicated with Listeria monocytogenes
      chorioamnionitis at 33 weeks' gestation in Taiwan. The transabdominal
      amniocentesis in this particular case confirmed the diagnosis. An live premature
      male fetus was delivered by emergency cesarean section on the next day of
      hospitalization due to acute fetal distress. The acute ill baby developed signs
      of meningitis on the following day. Blood culture of Listeriosis monocytogenes
      indicated early onset neonatal listeriosis. Brain sonography showed hydrocephalus
      after a one-month period antibiotic treatment, he was lost to follow-up one month
      later. A review of the literature is presented to describe the clinical,
      epidemiological and pathological findings and to highlight their variable
      presentations and procedures for management. Thus it is of great importance for
      obstetricians to include listeriosis as a differential diagnosis in cases of
      fever of unknown origin during pregnancy. Promptly obtaining proper cultures and
      instituting appropriate antibiotics therapy is emphasized.

PMID- 2224610
TI  - Post-traumatic fat embolism syndrome--a 10 year retrospective study in Chang Gung
      Memorial Hospital.
AB  - Forty patients with post-traumatic fat embolism syndrome (FES) from January 1977
      through December 1986 were retrospectively analyzed. Diagnosis was made according
      to the criteria modified by Guard. All 40 patients had at least two major
      criteria, namely change in consciousness and hypoxia. Twenty patients (50%)
      presented with full-blown clinical features. Prompt respiratory support with
      oxygen mask or nasal prongs was the first line of treatment. Forty per cent of
      patients responded well, whereas the others had to be advanced to endotracheal
      intubation and mechanical ventilation with positive end expiratory pressure.
      Steroids were given to 80% of patients and better results were achieved than in
      the group not treated with steroids. The mortality rate was low (2.5%) and only
      four patients suffered prolonged cerebral sequelae. The clinical course and
      prognosis cannot be predicted from the severity of the fracture.

PMID- 2224611
TI  - Safety and efficacy of 2% topical minoxidil in the management of male pattern
      baldness in Chinese.
AB  - Topic 2% minoxidil solution has been proved to be effective for hair regrowth in
      30-40% of male pattern baldness in the United States and Europe. There was no
      report concerning topical minoxidil in Chinese patients, therefore, we selected
      40 patients to investigate the efficacy and safety from December 1988 to January
      1989. Those selected patients were consistent with male pattern baldness without
      systemic disease, and had never used topical hair regrowth agents. Patients
      applied topical medication 1 ml twice daily and were examined at 1 month
      intervals. Thirty two patients completed 6 to 12 months (average 9.6 months) of
      the study, moderate hair growth was found in 22% while minimal growth in 59% of
      the studied patients. All patients noted their shedding decrease after the
      application of drugs for 1 to 3 months. Scalp dryness and mild scaling appeared
      in 2 patients, but were tolerable. Before and after the trial, all patients had a
      chest roentgenogram, EKG, complete blood counts, urinalysis and blood chemistry
      studies, and no apparent abnormality was found. The efficacy of 2% minoxidil
      solution application in our study was less than that in the United States. which
      might be because some patients did not follow the application order regularly and
      a more strict evaluation standard was adopted in our series. However, the safety
      of no systemic adverse effect and the potential of inhibiting progressive
      shedding of hair were valuable as a topical drug.

PMID- 2224612
TI  - Atherosclerosis and the lung.

PMID- 2224613
TI  - Malignant primary cardiac tumour presenting as superior vena cava obstruction
      syndrome.
AB  - A 71-year-old male with a malignant primary cardiac lymphoma nearly filling the
      right atrium presented with symptoms of obstruction of the tricuspid valve and
      inflow to the right atrium. The tumour was resected as fully as possible;
      however, a portion of the tumour that had invaded the inferior aspect of the
      right atrium and the atrioventricular groove could not be excised. Eighteen
      months after initial presentation, the patient is well and the tumour has not
      recurred. This is the first case of symptom-free survival of primary cardiac
      lymphoma for as long as 18 months.

PMID- 2224614
TI  - Right atrial myxoma with cyanosis due to right-to-left shunting.
AB  - Primary cardiac tumours are uncommon entities, and myxoma is the most common,
      comprising about 50% of all these neoplasms. A case of a 43-year-old woman with
      right atrial myxoma and a shunt through a patent foramen ovale producing severe
      cyanosis is reported.

PMID- 2224615
TI  - Near fatal angioedema associated with captopril.
AB  - Two markedly hypertensive patients in their 70s both had been on captopril for
      months when they each developed life threatening angioedema. Their families and
      physicians responded promptly and effectively in saving their lives with one
      patient receiving tracheotomy and the other 24 h of intensive care with
      adrenaline, hydrocortisone and antihistamines. Angiotensin converting enzyme
      inhibitors are not without their significant risks and should not be used when
      less dangerous but equally efficacious medication is available.

PMID- 2224617
TI  - The role of coronary angioplasty in patients with associated noncardiac medical
      and surgical conditions.
AB  - Percutaneous transluminal coronary angioplasty was performed in 22 patients with
      associated significant medical or surgical conditions. It was successful in 22
      patients. Two had procedure-related complications: one femoral hematoma and one
      small myocardial infarction. The patients were divided into a 'medical' group (12
      patients) and a 'surgical' group (10 patients). In the medical group, mean
      coronary artery stenosis decreased from 87 +/- 5% to 20 +/- 13% and mean coronary
      artery stenosis decreased from 57 +/- 2% to 16 +/- 7%. In the surgical group
      coronary artery stenosis decreased from 83 +/- 9% to 18 +/- 9% and the gradient
      from 49 +/- 16 to 16 +/- 6 mmHg. Percutaneous transluminal coronary angioplasty
      allowed the safe management of underlying conditions in all patients so that
      medical treatment could be continued and noncardiac surgery performed.

PMID- 2224616
TI  - First coronary heart disease event rates in relation to major risk factors:
      Quebec cardiovascular study.
AB  - The incidence of first coronary heart disease (CHD) events was evaluated
      prospectively in relation to the baseline measurements of systolic and diastolic
      blood pressure, serum cholesterol, smoking status and education in a cohort of
      4576 Quebec men aged 35 to 64 and free from CHD at entry in 1974. From 1974 to
      1986, 603 first CHD events were documented. The most frequent first manifestation
      was angina (6.7/1000 person-years) followed by nonfatal myocardial infarction
      (4.7/1000) and CHD death 2.2/1000). There was a positive relationship between the
      first CHD event and systolic (Z = 4.67) and diastolic (Z = 6.50) blood pressure.
      This relation was observed for angina, nonfatal myocardial infarction and CHD
      death. Serum cholesterol was also related to all events (Z = 4.99) but more
      specifically to angina and nonfatal myocardial infarction. Cigarette smoking was
      significantly related to first CHD manifestations. This relationship for specific
      CHD events was observed in men who smoked more than 20 cigarettes per day. Men
      who discontinued smoking one year before the study had a risk not different from
      those who never smoked. No relationship was observed between years of schooling
      and CHD events. Blood pressure, cholesterol and smoking constituted nearly two
      thirds of the attributable risk of first CHD events.

PMID- 2224618
TI  - Altered antioxidant status in ischemic/reperfused rabbit myocardium: reperfusion
      time-course study.
AB  - A progressive impairment in antioxidant status of rabbit hearts was observed when
      a fixed period (40 mins) of ischemia produced by coronary artery ligation was
      followed by increasing periods of reperfusion. This was reflected in a reduction
      in myocardial glutathione levels and an increase in glutathione depletion and
      production of thiobarbituric acid-reactive substances following in vitro
      oxidative challenge with t-butylhydroperoxide. Correlation analysis, in which
      activities of antioxidant enzymes were viewed in relation to biochemical indices
      of antioxidant status, indicated the functionally relevant suppression of Cu,Zn
      superoxide dismutase and glutathione reductase activities in ischemic/reperfused
      tissues. These results and the demonstration of significant decreases in the
      activity of glutathione-dependent antioxidant enzymes under acidotic conditions
      suggest that transient impairment in the functioning of antioxidant enzymes may
      be involved in the triggering of irreversible myocardial ischemia-reperfusion
      injury.

PMID- 2224619
TI  - An overview of noninvasive methods of deep vein thrombosis detection.

PMID- 2224620
TI  - Degenerative lumbar spine disorders in gradient refocused echo axial magnetic
      resonance images.
AB  - The axial images of 58 lumbar disks having degenerative disorders imaged by
      gradient refocused echo (GRE) and spin echo (SE) magnetic resonance imaging (MRI)
      pulse sequences at high field strength were compared for diagnostic quality. The
      vacuum phenomenon, calcified disk, and bony hypertrophic changes were better
      demonstrated by GRE images than by SE images due to magnetic susceptibility
      effect. Axial GRE images are therefore useful adjuncts to SE images for effective
      MRI of degenerative lumbar spine disorders at high field strength.

PMID- 2224621
TI  - MR imaging in hypertrophic neuropathy: a case of hereditary motor and sensory
      neuropathy, type I (Charcot-Marie-Tooth).
AB  - We describe findings of Charcot-Marie-Tooth disease in magnetic resonance imaging
      (MRI). The MRI examination of the lumbar spine with and without gadolinium DTPA
      showed diffusely enlarged cauda equina, nerve roots, and ganglia. In the setting
      of appropriate family history and clinical presentation, the findings of
      diffusely enlarged nerve roots support the diagnosis of hereditary motor and
      sensory neuropathy, Type I (HMSN I, Charcot-Marie-Tooth).

PMID- 2224622
TI  - Computed tomography of retroperitoneal perforation after barium enema.
AB  - A case of retroperitoneal perforation of the rectum complicating a single
      contrast barium enema is presented. The appearances on computed tomography (CT)
      allowed accurate depiction of the extent of barium extravasation not appreciated
      on plain films. Although this is an unusual complication of the barium enema, CT
      may prove useful when the suspicion of perforation arises.

PMID- 2224623
TI  - Fibrous dysplasia: magnetic resonance imaging appearance at 1.5 tesla.
AB  - Fibrous dysplasia has been described in a small number of cases in the literature
      as showing low signal intensity on T1- and T2-weighted magnetic resonance images.
      We reviewed magnetic resonance scans of 13 patients with fibrous dysplasia to
      determine if there might be a characteristic appearance. All lesions had sharply
      defined borders and were of intermediate signal intensity on T1-weighted images.
      With T2 weighting, six lesions (46%) showed high signal intensity, four (31%)
      showed persistent intermediate signal intensity, and three (23%) showed mixed
      intermediate and high signal intensity. Ten lesions (77%) had inhomogeneous
      signal intensity and three (23%) had homogeneous signal intensity. We concluded
      that fibrous dysplasia does not have a characteristic appearance on magnetic
      resonance imaging. However, magnetic resonance may be helpful in establishing the
      diagnosis of fibrous dysplasia if low to intermediate signal intensity is seen on
      both T1- and T2-weighted images. This situation occurred in 54% of our cases,
      whereas the other 46% had nonspecific signal characteristics indistinguishable
      from many other bone lesions.

PMID- 2224624
TI  - Prospective comparison of computed tomography and duplex sonography in the
      evaluation of recently inserted Kimray-Greenfield filters into the inferior vena
      cava.
AB  - A prospective comparison of contrast-enhanced computed tomography (CT) and duplex
      sonography (DS) was performed to examine the Kimray-Greenfield filter in the
      inferior vena cava (IVC) in the immediate postoperative period. Fourteen patients
      were studied for five complications: IVC thrombosis, malpositioning, pericaval
      hematoma, filter angulation, and prong perforation. Our results found CT to be
      more efficacious because it was a) able to evaluate more patients with fewer
      technically inadequate scans and b) more definitive in all categories. However,
      when visualized, DS was as accurate as CT in the evaluation of thrombosis.

PMID- 2224625
TI  - Opacification of ascitic fluid on delayed contrast computed tomography scans.
AB  - Ascitic fluid opacification on delayed intravenous contrast computed tomography
      scans was observed in eight consecutive patients imaged. This apparently common
      phenomenon may alter both the sensitivity and the specificity of ascitic fluid
      detection. It may also serve as a diagnostic aid by making nonascitic intra
      abdominal fluid collections (ie, pseudocyst and cystic tumor) more apparent.

PMID- 2224626
TI  - Intra-aortic counterpulsation balloon pumps: CT appearance.
AB  - Intra-aortic counterpulsation balloon pumps (ICBP) used in the setting of
      cardiogenic shock or high risk cardiac surgery, have been identified on chest
      films in the inflated state during diastole (1). We report characteristic
      computed tomography (CT) findings of an inflated ICBP, discuss its
      radiographically identified complications, and suggest that the presence of this
      device should be excluded before suspecting other etiologies for intra-aortic
      gas.

PMID- 2224627
TI  - Computed tomography of ruptured aneurysm of the profunda femoris artery.

PMID- 2224628
TI  - Renal oncocytoma: report of a case with bilateral multifocal oncocytomas.
AB  - Renal oncocytomas are uncommon, benign tumors that classically are treated by
      local excision or heminephrectomy. Preoperative differentiation from renal cell
      carcinoma is invaluable in the planning of treatment. Cases of renal oncocytoma
      treated conservatively have been reported. This is a case report of bilateral
      multifocal renal oncocytomas of which only three previous cases have been
      reported. Diagnosis was made from multiple fine needle biopsies and present
      treatment consists only of conservative observation.

PMID- 2224629
TI  - Nonmucosal predominantly serosal eosinophilic enteritis. A case report.
AB  - A unique case of eosinophilic enteritis with predominant serosal involvement and
      mucosal sparing, ascites and abdominal adenopathy is reported with computed
      tomography (CT) and barium study correlation. The clinical presentation may mimic
      lymphoma or granulomatous disease, (e.g. tuberculosis) but peripheral
      eosinophilia is a strong differentiating point.

PMID- 2224631
TI  - Intradural spinal arachnoid cyst. Case report.
AB  - An intradural spinal arachnoid cyst presenting with spinal cord compression is
      discussed. This case illustrates the value of magnetic resonance imaging in the
      diagnosis and follow-up of intradural spinal arachnoid cysts.

PMID- 2224630
TI  - Right perirenal space. Computed tomography evidence of communication between the
      bare area of the liver.
AB  - Computed tomography (CT) images from one cadaver and 11 patients with perirenal
      fluid collection were reviewed to study whether the right perirenal space
      communicates with the bare area of the liver. CT of a cadaver obtained after
      meticulous right perirenal injection of contrast media showed that contrast media
      extended superiorly into the bare area of the liver. CT of 11 patients with right
      perirenal hemorrhage or infection showed that fluid collection within the right
      perirenal space continued upward, crossing the coronary ligament, extending into
      the bare area of the liver. The inferior vena cava were completely or partially
      surrounded by fluid. CT of two patients with bleeding hepatocellular carcinoma
      showed that blood in the bare area continued extending downward into the
      perirenal space. We conclude that the right perirenal space is open toward the
      bare area of the liver and fluid collection within one space may communicate with
      the other space across the coronary ligament.

PMID- 2224633
TI  - A 58-year-old Vietnamese woman with a 1-month history of an enlarging right
      infraclavicular mass.

PMID- 2224632
TI  - Unusual computed tomography findings in hepatic amyloidosis.
AB  - An unusual pattern of delayed enhancement in a patient with a focal hepatic
      defect due to amyloidosis is presented. Without the aid of region-of-interest
      density measurements, the lesion was not appreciated on unenhanced computed
      tomography scans.

PMID- 2224634
TI  - Decision support and outcomes of nurses' care planning.
AB  - One hundred forty-three nurses served as their own controls in planning care for
      hypothetical patients under three different manipulated conditions of decision
      support: (A) use of traditional resources; (B) use of a printout of a
      computerized protocol for care planning (NPC); and (C) use of an NPC protocol and
      a self study guide. A series of 3 x 5 repeated measures analyses of variance
      (ANOVAs) were used to evaluate the main effects and interactions of the
      experimental treatment conditions and the two nurse attribute variables of
      education and experience (each with five levels). The case problems and
      conditions were counterbalanced to control for extraneous variables. The repeated
      measures ANOVA demonstrated significantly higher mean ratings of quality for care
      planned under both computerized decision support conditions than the traditional
      condition on all three patient problem situations F(2, 270) = 7.9, p less than
      .01. Time on task was also significant F(2, 272) = 5.8, p less than .01 with use
      of the decision support consultants tending to increase time in planning.

PMID- 2224635
TI  - Creative use of microcomputer software by graduate nursing students.
AB  - Educating nurses to use computer technology involves complex strategies. As adult
      students, many are eager to learn uses of computers for nursing education,
      nursing research, nursing practice, and nursing administration. It is the role of
      the faculty member to make the computer laboratory experiences meaningful and
      pragmatic for these 'first time' computer users. This article describes a method
      that promotes learning by requiring students to solve a nursing problem relevant
      to their practice using available microcomputer software.

PMID- 2224636
TI  - RN education flexibility utilizing laptop computers.
AB  - In a geographic region that is largely rural, baccalaureate faculty teaching RNs
      needed a program of study that provided flexibility. This article describes a
      project that incorporates CAI and PCs into RN education. Difficulties and
      successes of the project are also discussed.

PMID- 2224637
TI  - The CAREPLAN knowledge base. A prototype expert system for postpartum nursing
      care.
AB  - With the growth of scientific knowledge in the health care disciplines, it has
      become increasingly difficult for practicing health care professionals to store
      and manipulate the information required to make clinical decisions. Where the
      decision making process can be defined and validated, expert systems will be able
      to assist beginning professionals to learn appropriate patterns of decision
      making. This article discusses the rationale for utilization of expert systems in
      a nursing environment. A prototype expert system called CAREPLAN, developed for
      use in an obstetrical environment, was built using Personal Consultant Plus, a
      software tool based on the LISP language. The project demonstrates that it is
      feasible to develop and validate an expert system for a specialized clinical
      environment in a relatively short period of time in comparison to traditional
      development methods. Graphics were used to enhance textual information and to
      increase user appeal. Strategies for future implementation and evaluation are
      outlined.

PMID- 2224638
TI  - A historical perspective on recent studies of social learning about foods by
      Norway rats.
AB  - Early naturalists explained field observations of social influences on animal
      learning in terms of spoken language, deliberate tuition of one animal by
      another, or intentional imitation. During the first half of the present century,
      experimental psychologists analyzed instances of social learning by animals in
      laboratory tasks as special cases of operant or classical conditioning. Neither
      of these traditional approaches provided much insight into the complex processes
      that often support animal social learning. By combining ethological focus on
      social learning as it occurs in natural habitat with analytical techniques
      developed in the psychological laboratory, contemporary researchers have made
      considerable progress in describing the many ways in which social interactions
      influence behavioural development in animals. The author's investigations of
      social influences on food selection by Norway rats provide one example of such an
      ethopsychological approach to the study of animal social learning.

PMID- 2224639
TI  - Additive latency effects of selective and nonselective restricted priming types.
AB  - The purpose of this investigation was to examine further the contention of Alain
      et al. (1988) that a third priming type exists, called nonselective restricted
      (NSR) and controlled by response probability, which is distinct from those types
      influenced by foreperiod duration (nonselective general priming) and prediction
      probability (selective priming). In a four-choice reaction time (RT) task,
      prediction probability (.5, .7, & .9, indicating the likelihood of a particular
      response) and response probability (.5, .9, denoting the likelihood that a
      response would be needed at all) exerted significant but noninteractive effects
      on RTs for prepared responses (most probable), suggesting that each of these
      probabilities influence different priming types (Sternberg, 1969; selective and
      NSR, respectively). This was further indicated by the fact that prediction
      probability, but not response probability, significantly altered RTs for the
      unprepared (lesser probable) responses. Finally, the hypothesized nonselective
      character of NSR priming (i.e., all outputs controlled by response probability
      are equally affected by its value changes) was supported when responses were
      equiprobable, and, while the null effect of response probability just mentioned
      seemingly argued against this property when selective priming took place, the
      interpretation provided herein negated this opposition.

PMID- 2224640
TI  - Search behaviour of cats (Felis catus) in an invisible displacement test:
      cognition and experience.
AB  - An invisible displacement test was administered to cats in order to test the
      hypothesis that search behaviour in this species is influenced by their limited
      capacity for object permanence as well as by their previous experience with the
      environment. Experiment 1 compared three groups of cats in a five-choice hiding
      task in which the hiding places could be discriminated by their spatial
      positions. Two groups received a visible displacement training before the
      invisible displacement test and one group did not. Experiment 2 compared two
      groups of trained subjects in the same task, but the hiding places could be
      discriminated by spatial and visual cues. The results confirmed that cats are
      unable to solve problems with invisible displacements. The visible displacement
      training improved their performance, but was not sufficient to make them succeed.
      Experience with the hiding potential of the covers also gives more persistence to
      search behaviour. Finally, the distribution of search attempts is not determined
      by the proximity to the target and is influenced only partially by the subjects'
      previous experience. Like Stage 5 infants, cats rely mainly on their immediate
      perception. They search for an object in the last location they have seen it
      disappear or under the nearest cover from this location.

PMID- 2224641
TI  - Seeing versus imagining movement in depth.
AB  - Subjects judged the quality of rigid motion between pairs of three-dimensional
      drawings that differed by a rotation in depth. The figures were aligned with, and
      rotated around, either the vertical axis or an axis that was oblique with respect
      to the XYZ co-ordinate system. Rated quality of motion decreased with increasing
      angular disparity between the figures and with decreasing stimulus duration,
      regardless of whether the figures were vertical or oblique. The same subjects
      then participated in a mental rotation task using the same stimuli and angular
      disparities. An effect of principal axis emerged, such that subjects took longer
      to make decisions about obliquely aligned stimuli than about vertically aligned
      stimuli, especially if they received the oblique stimuli first. These data imply
      that perceived versus imagined movement through the same trajectory involves
      different processes. Whereas the apparent motion system performs its computations
      relatively automatically, the processes involved in mental rotation are more
      strategic in nature.

PMID- 2224642
TI  - The object-line effect: is it attributable to intercontext differences or the
      structural properties of contexts and task demands?
AB  - Briefly presented target lines are reported more accurately when part of an
      object-like context than alone (Williams & Weisstein, 1978). Efforts to explain
      this effect have tended to focus on structural properties that contexts must
      possess in order to be effective in facilitating target-line discrimination
      (e.g., Weisstein, Williams, & Harris, 1982). Enns and Prinzmetal (1984) take
      issue with this approach. They propose that contexts differ more from one another
      than do target lines presented alone, and it is this fact, and not the general
      structural properties of contexts, that underlies their effectiveness. Two
      experiments examined intercontext differences and structural factors as
      determinants of context effectiveness. Subjects were found to use intercontext
      differences to narrow the range of possible alternatives, but when this factor
      was controlled, structural properties determined context effectiveness. The
      structural interpretation of context effectiveness was found not be as
      straightforward as generally assumed, however. A third experiment showed context
      effectiveness to be affected by the character of the discrimination task
      employed.

PMID- 2224643
TI  - Auditory grouping based on fundamental frequency and formant peak frequency.
AB  - The perceptual grouping of a four-tone cycle was studied as a function of
      differences in fundamental frequencies and the frequencies of spectral peaks.
      Each tone had a single formant and at least 13 harmonics. In Experiment 1 the
      formant was created by filtering a flat spectrum and in Experiment 2 by adding
      harmonics. Fundamental frequency was found to be capable of controlling grouping
      even when the spectra spanned exactly the same frequency range. Formant peak
      separation became more effective as the sharpness (amplitude of the peak relative
      to a spectral pedestal) increased. The effect of each type of acoustic difference
      depended on the task. Listeners could group the tones by either sort of
      difference but were also capable of resisting the disruptive effect of the other
      one. This was taken as evidence for the presence of a schema-based process of
      perceptual grouping and the relative weakness of primitive segregation.

PMID- 2224644
TI  - Pathogenicity of Staphylococcus lugdunensis, Staphylococcus schleiferi, and three
      other coagulase-negative staphylococci in a mouse model and possible virulence
      factors.
AB  - Staphylococcus lugdunesis and Staphylococcus schleiferi, two newly described
      species, have been isolated from numerous types of human infections. We compared
      the pathogenicity of 30 strains of S. lugdunensis, S. schleiferi, Staphylococcus
      epidermidis, Staphylococcus warneri, and Staphylococcus hominis, using a mouse
      model in which a foreign body preadhered with the test strain was implanted
      subcutaneously, followed by injection of the test strain. All five species of
      staphylococci produced abscesses. Staphylococcus epidermidis, S. schleiferi, and
      S. lugdunensis yielded species means of 76-91% abscess formation; 80-100% of the
      infected foreign bodies and tissues were culture positive. These three species
      were more virulent than S. warneri or S. hominis, which produced abscesses in 54
      and 65% of mice, respectively; only 10-48% of the infected samples were culture
      positive. Transmission electron microscopy of pure cultures of selected strains
      showed that all species possessed glycocalyx. All species produced a variety of
      possible virulence factors, such as alpha and delta hemolysins, as well as the
      aggressins lipase and esterase. The production of exoenzymes did not always
      correlate with virulence as demonstrated by abscess formation in mice.

PMID- 2224645
TI  - Effect of various biophysicochemical conditions on toxigenicity of Vibrio
      cholerae 01 during survival with a green alga, Rhizoclonium fontanum, in an
      artificial aquatic environment.
AB  - Toxigenic and nontoxigenic strains of Vibrio cholerae 01 occur in the natural
      aquatic environment. It is not clear whether V. cholerae 01 lose toxigenicity and
      become nontoxigenic during survival in the aquatic environment as a result of the
      effect of various biophysicochemical conditions (e.g., sunlight, pH, temperature,
      competition with other bacteria for nutrients, etc.). Five toxigenic strains were
      exposed to artificial aquatic environments in the presence of a filamentous green
      alga. Rhizoclonium fontanum, and recovered after different time intervals (0 and
      0.5 h, 3, 6, 9, and 15 days). This experimental system was exposed to sunlight
      and the V. cholerae 01 were in competition for nutrients with resident bacterial
      flora from R. fontanum. The toxigenicity of Vibrio cholerae 01 that were
      recovered at different time intervals was assessed by tissue culture assay using
      Vero cells. The toxigenicity of recovered strains was compared with that of the
      parent strains. The results demonstrated that toxigenic V. cholerae 01 are
      unlikely to lose their toxigenicity in aquatic environments as a result of the
      effects of various biophysicochemical conditions. These results are consistent
      with the hypothesis of environmental reservoirs of V. cholerae.

PMID- 2224646
TI  - Induction and repair of DNA strand breaks in Bacteroides fragilis.
AB  - Alkaline sucrose gradient sedimentation was used to establish whether strand
      breakage and repair take place in the DNA of UV-irradiated Bacteroides fragilis
      during the removal of pyrimidine dimers. A B. fragilis wild-type strain and two
      of its repair mutants, a mitomycin C sensitive mutant (MTC25) having wild-type
      levels of UV survival, and a UV-sensitive, mitomycin C sensitive mutant (UVS9),
      were investigated. Under anaerobic conditions, far-UV irradiation induced
      metabolically regulated strand breakage and resynthesis in the wild-type strain,
      but this was markedly reduced in both the MTC25 and UVS9 mutants. Approximately
      half of the strand breaks generated by the various strains were rejoined during
      further holding in buffer. Under replicating conditions, complete repair of
      strand breaks in the wild type was observed. Caffeine treatment under anaerobic
      conditions caused direct DNA strand breakage in B. fragilis cells but did not
      inhibit UV-induced breakage or repair.

PMID- 2224648
TI  - Early gastric cancer--making the asymptomatic better.

PMID- 2224647
TI  - Incidence of bacteriocinogeny among fresh isolates of Streptococcus mutans.
AB  - Among 139 Streptococcus mutans fresh isolates tested, using the deferred
      antagonism test and Streptococcus sanguis Ny 101 as the indicator strain, we
      observed that the frequency of detection of inhibition zones was reduced by 19%
      (from 53 to 34%) when arginine (1%) was used in the overlay agar. Among pigmented
      strains, the frequency of mutacin-like production was 70%. The frequency with
      which inhibition zones were detected varied from 7 to 91%, depending on the
      indicator strain used. These results indicate that the ability to detect the
      presence of mutacin-like substances varies widely and is dependent to a great
      extent on the methodology used.

PMID- 2224649
TI  - Reproductive conservation.

PMID- 2224650
TI  - Classification systems for colorectal carcinoma.

PMID- 2224651
TI  - Bikini appendectomy incision as an alternative to the McBurney approach for
      appendicitis.

PMID- 2224652
TI  - Canadian general surgery: alive and well.
AB  - General surgery in Canada is alive and well because general surgeons remain
      versatile and adaptable. If this were not the case, the specialty of general
      surgery would go the way of the dinosaur. The continuing evolution of general
      surgery can only be maintained by reviewing the following: (a) training; (b)
      continuing education; (c) maintenance of competence; (d) manpower and economic
      aspects; and (e) interaction of general surgeons with other surgeons and
      specialties. The Canadian Association of General Surgeons will continue to play a
      vital role in maintaining liaison between all types of general surgeons across
      the country and help, in any way possible, to support the ever-changing face of
      general surgery.

PMID- 2224653
TI  - Early gastric cancer: is it a distinct clinical entity?
AB  - Of 199 patients with gastric cancer seen at The Montreal General Hospital between
      1970 and 1981, 104 were considered to have had a curative resection, and 26 of
      these were early gastric cancers (EGC). The authors compared early gastric
      cancers with advanced, but resectable, gastric cancers to determine whether EGC
      is a distinct entity or a stage in the progressive evolution of gastric cancer.
      They found that depth of invasion was the primary determinant of outcome, but
      that there was no discrete cut-off point between the depth of invasion associated
      with early and with advanced gastric cancers. The pathological features normally
      associated with a favourable prognosis in gastric cancer, such as absence of
      lymph-node metastases, an expanding growth pattern, intestinal metaplasia, and
      well-differentiated histologic features correlated highly with depth of invasion
      but did not appear to change abruptly between EGC and advanced resectable
      lesions. The authors conclude that EGC is not a distinct pathological or clinical
      entity but a stage in the progressive growth of gastric cancer.

PMID- 2224654
TI  - Management of pyogenic liver abscess in the era of computed tomography.
AB  - The advent of high-resolution imaging has allowed earlier diagnosis of pyogenic
      liver abscess. Because radiologically guided percutaneous drainage (PCD) of liver
      abscesses is controversial, the authors studied 40 patients with liver abscess
      admitted to the Toronto Hospital between 1982 and 1987 to determine the role of
      PCD versus operative drainage (OD). The diagnosis of pyogenic liver abscess was
      made at autopsy (4 patients), at laparotomy (6) or by radiologically guided
      aspiration of pus (30). Ultrasonography and computed tomography were highly
      sensitive (85% and 96% respectively) in detecting liver abscess. Of the 36
      patients treated for liver abscess all received antibiotics intravenously; 31
      also underwent a drainage procedure. Treatment with antibiotics alone was
      associated with a success rate of 80% and a death rate of 20%. The success rate
      for those who had PCD was 75% with a death rate of 13%; 2 patients in this group
      of 16 subsequently required OD for cure. In the 15 patients initially treated
      with OD, success and death rates were 87% and 13% respectively. For solitary
      abscesses, success rates wer comparable for PCD and OD (86% and 90%
      respectively). For unilobar multiple abscesses the success rate was 100% for both
      PCD and OD, but for bilobar multiple abscesses the rates were only 40% and 67%
      respectively. Complication rates were similar for both methods of drainage. The
      authors conclude that pyogenic liver abscess can now be safely and efficaciously
      managed with a combination of antibiotics and PCD.

PMID- 2224655
TI  - Ex-vivo microvascular reconstruction before renal allograft and autograft
      transplantation.
AB  - Microvascular reconstruction was performed ex vivo on 50 kidneys that had
      vascular anomalies or had sustained vascular injury during procurement before
      allograft transplantation or autotransplantation. The authors review the various
      surgical techniques used to facilitate the in-situ vascular anastomoses during
      transplantation and to salvage otherwise an unusable allograft. The complications
      associated with the microvascular repair were negligible. The authors conclude
      from the results of their study that ex-vivo microvascular reconstruction is a
      valuable adjunct to renal transplantation.

PMID- 2224656
TI  - Vagotomy and antrectomy revisited.
AB  - A retrospective review of 185 patients who underwent truncal vagotomy and
      antrectomy for duodenal ulcer disease was carried out to determine the mortality
      and morbidity of the procedure. There were no deaths within 30 days of operation
      and only one patient died while in the hospital (0.54%). Twenty-one patients
      (11.4%) suffered early morbidity, 3 of them requiring a second operation. Follow
      up was obtained in 83 patients and averaged 13.5 years. According to Visick's
      classification 75 patients (90.4%) were in class I or II; 5 patients (6%) were in
      class III and 3 patients (3.6%) in class IV. A recurrent ulcer developed in 2 of
      the 83 patients. In contrast, after highly selective vagotomy, the literature
      supports an unacceptable incidence of recurrent ulcer. Therefore, we must not
      prematurely cast aside vagotomy and antrectomy; it still remains a safe and
      acceptable procedure for duodenal ulcer disease.

PMID- 2224657
TI  - Ductal adenoma of the breast.
AB  - Ductal adenoma is a recently described benign tumour of the breast that can be
      mistaken for carcinoma in both frozen and paraffin sections. Such a case is
      presented. Fortunately a mastectomy was not performed, but the patient did
      undergo axillary node dissection. Surgeons and pathologists should familiarize
      themselves with this lesion so that patients do not have to undergo unnecessary
      mastectomies and axillary node dissections.

PMID- 2224658
TI  - Antibiotic handbook and pre-printed perioperative order forms for surgical
      antibiotic prophylaxis: do they work?
AB  - The authors attempted to compare the value of two strategies--an educational
      (antibiotic handbook) and a control (perioperative pre-printed physician order
      form, which contained antibiotic orders)--in modifying physicians' patterns of
      antibiotic prophylaxis for preventing infection in patients who undergo elective
      surgery. They reviewed the charts of 240 such patients on five different surgical
      services in one teaching hospital. Use of the antibiotic handbook (educational
      strategy) increased overall compliance with the recommended regimens from 11% to
      18% (p = 0.06). The control strategy (perioperative pre-printed physician order
      form) increased compliance from 17% to 78% (p less than 0.01).

PMID- 2224659
TI  - Factors influencing the effectiveness of extracorporeal shock-wave lithotripsy of
      biliary duct calculi.
AB  - The authors examined the effectiveness of extracorporeal shock-wave lithotripsy
      on patients who had bile-duct stones. Thirty-eight patients were treated with an
      unmodified HM-3 Dornier lithotripter; 35 (92%) patients either passed the stone
      fragments spontaneously or had them reduced to a size which allowed removal by
      percutaneous or endoscopic techniques. As stone size increased so did the number
      of shocks required for satisfactory fragmentation, the number of treatments and
      the rate of post-treatment manipulation. The number of stones was not as
      important a variable as the authors expected. Pre-treatment sphincterotomy was
      not always necessary and was of no benefit in terms of spontaneous passage of
      fragments. Complications were minor. Extracorporeal shock-wave lithotripsy of
      stones throughout the biliary tree is a safe, effective and invaluable adjunct in
      the management of bile-duct stones.

PMID- 2224660
TI  - Is tube repair of aortic aneurysm followed by aneurysmal change in the common
      iliac arteries?
AB  - To address the concern that tube repair of an abdominal aortic aneurysm might be
      followed by aneurysmal change in the common iliac arteries, 23 patients who had
      undergone the operation were re-examined 3 to 5 years later. Although 9 had had
      minimal ectasia of these arteries preoperatively, in none of the 23 was there
      symptomatic or radiologic evidence of aneurysmal change on follow-up.
      Measurements of the maximum intraluminal diameters were made by computed
      tomography; they indicated no significant differences between the preoperative
      and follow-up sizes of the common iliac arteries. The variation in time to follow
      up also showed no significant correlation with change in artery diameter.

PMID- 2224661
TI  - Spontaneous rupture of splenic artery aneurysm: maternal and fetal survival.
AB  - Because the diagnosis of ruptured splenic artery aneurysm in pregnancy is seldom
      made before operation, maternal and fetal mortality continues to be high. The
      authors describe the case of a 22-year-old woman who had a ruptured splenic
      artery aneurysm at 32 weeks' gestation. The attending obstetrician considered
      this condition in the differential diagnosis and it was confirmed by
      ultrasonography, leading to a successful outcome.

PMID- 2224662
TI  - Cholesterol granuloma of the peritoneum.
AB  - Cholesterol granulomas are common in the mastoid region but have rarely been
      reported in other areas. The authors report the case of a 40-year-old man who had
      a cholesterol granuloma of the peritoneum. They discuss the morphology of the
      condition and the difficulties of diagnosis. It is likely that chronic or
      recurrent inflammation plays a major role in the pathogenesis and that, when
      dealing with such lesions preoperatively or intraoperatively, a radical approach
      may not be necessary.

PMID- 2224663
TI  - Imipenem versus tobramycin--antianaerobe antibiotic therapy in intra-abdominal
      infections.
AB  - The authors compared broad-spectrum monotherapy with imipenem to an
      aminoglycoside-based antibiotic regimen for the management of intra-abdominal
      infections. One hundred and four patients who had intra-abdominal infection were
      randomly allocated to receive imipenem (52) or tobramycin plus clindamycin or
      metronidazole (52). Patients treated with imipenem had fewer febrile episodes and
      occurrences of breakthrough bacteremia, less antibiotic resistance and need for
      drug change; their hospital stay was shorter. The death rate from sepsis was 4%
      in patients who received imipenem and 13% in those who received the combined
      regimen (p = 0.08). Treatment was successful in 79% of patients on imipenem
      versus 67% of those receiving an aminoglycoside. Patient stratification by the
      APACHE II system and probability of death calculation using delayed-type
      hypersensitivity scores predicted a similar death rate for the two treatment
      groups. Imipenem appears to be a safe and efficacious alternative broad-spectrum
      antibiotic for treating patients who are seriously ill with intra-abdominal
      infection.

PMID- 2224664
TI  - Small-bowel lipoma: an uncommon cause of obstruction.
AB  - Small-bowel tumours are an uncommon cause of small-bowel obstruction. The
      symptoms are unusually nonspecific and intermittent. Contrast studies of the
      small bowel are the best means of delineating the lesion. The authors present a
      case in which obstruction was treated with small-bowel resection, and they give a
      brief account of the occurrence of small-bowel tumours in a major teaching
      hospital.

PMID- 2224665
TI  - Preventing alcohol problems: preparing physicians for their roles and
      responsibilities.

PMID- 2224666
TI  - Disease transmission and cardiopulmonary resuscitation. Emergency Cardiac Care
      Committee, Heart and Stroke Foundation of Canada.

PMID- 2224667
TI  - Effects of patient, physician and hospital characteristics on the likelihood of
      vaginal birth after previous cesarean section in Quebec.
AB  - Repeat cesarean section is a major factor contributing to the rising cesarean
      section rate. Although vaginal birth after a previous cesarean section (VBAC) is
      advocated in most cases, it has not yet been adopted as widespread policy. In a
      case-control study we compared 400 women in Quebec who underwent VBAC with 1600
      women who had a repeat cesarean section from 1985 to 1987 in an attempt to
      identify factors that favour vaginal delivery. Using both simple and multiple
      logistic regression analyses we examined the effect of independent variables
      linked to the patients (two variables), the attending physicians (seven) and the
      hospitals (two) on the dependent variable (type of birth) with the use of odds
      ratios. We found that the physician characteristics related to type of practice
      and the degree of hospital specialization were significant factors in predicting
      the type of delivery. Women who gave birth vaginally were more likely than those
      who had a repeat cesarean section to be attended by a physician with a
      specialized practice and to give birth in a hospital providing an intermediate or
      high level of care. This suggests that VBAC is still perceived as a high-risk
      option and is managed by only a minority of specialized obstetricians.

PMID- 2224668
TI  - Hospital-based utilization management: a cross-Canada survey.
AB  - Utilization management attempts to measure, understand and, when appropriate,
      reduce hospital use. We conducted a telephone survey to determine the status of
      utilization management in Canadian hospitals. The sample comprised a random
      selection of 30% of acute-care hospitals with over 100 beds for adults in Ontario
      and Quebec and all such hospitals in the other provinces. Of the 123 chief
      executive officers contacted 99 (80%) claimed to have a utilization management
      program. Of those, 90 (91%) agreed to participate in an in-depth survey or to
      designate a senior administrator to be interviewed who was most knowledgeable
      about the program. High occupancy rates and funding issues were the most common
      environmental triggers for the development of utilization management programs;
      funding issues were listed more frequently by respondents in Ontario than by
      those elsewhere (p = 0.0008). Retrospective review alone was used in half of the
      hospitals, concurrent review or some mixed approach being used in the other half.
      Ontario and the Atlantic provinces were more reliant than the rest of the country
      on retrospective review alone (p = 0.0032). Most of the hospitals used peer
      review and education to stimulate corrective action. Of the respondents 67%
      indicated that the medical staff supported the utilization management program,
      and 53% reported that the program had a positive impact on the relationship
      between administrative and medical staff. Most of the respondents were unsure of
      the program's impact on the quality of care or the rate of unnecessary hospital
      admission. However, retrospective review alone was found to be less successful in
      reducing inappropriate utilization than either concurrent review or combined
      review (p = 0.0048).

PMID- 2224669
TI  - Acute interstitial nephritis due to 5-aminosalicylic acid.

PMID- 2224670
TI  - Endothelial cell growth factors in atherogenesis.

PMID- 2224672
TI  - The role of medical schools in the prevention of alcohol-related problems.
AB  - There is agreement that physicians can play a major role in the prevention of
      alcohol problems among their patients and that medical schools should prepare
      physicians for this role by teaching three major subject areas: knowledge,
      attitudes and clinical skills. Despite this agreement and the acknowledged high
      prevalence of alcohol problems in clinical populations, medical school coverage
      of these problems is not proportional to their importance. Barriers to adequate
      coverage of alcohol problems are traditional attitudes, confusion as to whether
      such problems are "medical" and lack of adequate faculty role models. These
      problems could be remedied by encouragement and training of interested faculty
      members, establishment of substance abuse centres in university medical schools,
      integration of alcohol-related material with relevant topics in all departments
      and inclusion of alcohol-related questions on medical qualifying exams.

PMID- 2224671
TI  - The physician's role.
AB  - Physicians can play an important role in society's response to alcohol problems.
      In diagnosis, alcohol problems among patients are frequently overlooked.
      Physicians should routinely ask patients about alcohol intake. In light of
      evidence on the effectiveness of brief interventions, especially with heavy
      drinking but nondependent patients, physicians' treatment efforts should be
      focused in this direction. Patients who are alcohol dependent might best be
      treated by nonphysicians. Research contributions of physicians should be
      concentrated on topics for which physician input is needed: longitudinal studies
      of health consequences, factors contributing to mortality and health service
      costs, biochemical markers of alcohol use and basic pharmacology. Strong evidence
      links population alcohol consumption levels to overall harm. Therefore,
      prevention efforts should be aimed at the population as well as at people who may
      be at risk. Physicians can contribute to these efforts by influencing public
      policy and by setting healthy examples in their own alcohol use.

PMID- 2224673
TI  - Spectrum of drinkers and intervention opportunities.
AB  - Most adults in North America are either light drinkers or abstainers, so alcohol
      does not cause them problems. However, a small but often highly visible minority-
      approximately 5% of the adult population--show major symptoms of alcohol
      dependence. Between these extremes, there is a sizable group of about 20% of the
      population, particularly young men, who are drinking at risk levels and have
      encountered some problems related to their alcohol use. Traditionally,
      physicians' efforts have focused on diagnosing and treating patients with a
      substantial history of alcohol dependence, and relatively little attention has
      been given to early intervention with nondependent problem drinkers, such as
      identifying patients who present in primary care settings with alcohol-related
      morbidity or an accidental injury. Recent evidence indicates that early
      intervention by primary care physicians is an effective strategy for reducing
      alcohol problems among patients.

PMID- 2224675
TI  - Brief intervention strategies for harmful drinkers: new directions for medical
      education.
AB  - Recent advances in the technology of behavioural interventions for harmful
      drinkers have created a new role for clinical practice and new challenges for
      medical education. Several reports from expert committees have recommended new
      initiatives in the secondary prevention of alcohol problems through physician
      based interventions at the primary care level. The conceptual and scientific
      bases for these recommendations are discussed in terms of recent studies of
      harmful and hazardous drinkers. The behavioural principles thought to account for
      the effectiveness of brief interventions are explained. Despite these promising
      developments, difficulties are inherent in the introduction of new technologies,
      especially behavioural technologies, into medical practice. A major challenge to
      medical education will be the development of academic programs that not only
      teach skills and competencies in secondary prevention but also deal with the
      socialization of physicians as behavioural practitioners.

PMID- 2224674
TI  - Early identification of alcohol problems.
AB  - A high proportion of patients seen in clinical practice have an underlying
      alcohol problem. This is often difficult to detect, but failure to make the
      diagnosis may result in unnecessary investigations and inappropriate treatment.
      Furthermore, there is now good evidence of the effectiveness of brief
      intervention for problem drinking when it is still at an early stage. Several
      questionnaires and procedures based on clinical examination findings and
      laboratory tests are available to help in early diagnosis. They can be
      incorporated into the standard medical assessment and form the basis for
      screening programs for health risk factors.

PMID- 2224676
TI  - Preventing alcohol problems: survey of Canadian medical schools.
AB  - In preparation for a national conference on medical education in the prevention
      of alcohol problems, a survey of conference participants was conducted.
      Participants were undergraduate and postgraduate representatives from each
      Canadian medical school and representatives from 11 provincial and territorial
      alcohol and other drug agencies. There was agreement that physicians and medical
      schools have important roles in prevention and treatment of alcohol problems,
      with "traditional" medical roles seen as the most important. Current training is
      variable and was seen as inadequate, with more time devoted to treatment than
      prevention. To correct this situation, renewed priorities and faculty leadership
      are needed. Respondents felt that there should be uniform standards for assessing
      undergraduate students' skills in dealing with alcohol problems. Provincial
      alcohol and other drug agencies are underused in medical education in the
      prevention and treatment of alcohol problems.

PMID- 2224677
TI  - The development of medical education on alcohol- and drug-related problems at the
      University of Toronto.
AB  - Medical education on alcohol- and drug-related problems at the University of
      Toronto covers undergraduate, residency and graduate programs, a result of
      collaboration since 1959 between the university and the Addiction Research
      Foundation of Ontario. An undergraduate core curriculum, developed in the early
      1970s, is offered in year 2; it has been supplemented by electives, selectives
      and comprehensive clinics. The undergraduate program is rated highly by students;
      since 1978, 3024 have completed the core program. Residency training started in
      1974 and is available through electives lasting from 1 to 12 months in internal
      medicine, psychiatry, and family and community medicine. To date, 370 residents
      have completed one of these electives; 129 have completed graduate programs in
      which their theses concerned alcohol- and drug-related topics, and there have
      been an additional 13 research and postdoctoral fellows. Despite the progress,
      there is still a need to improve and expand the undergraduate and residency
      programs and to develop an effective program of continuing medical education. The
      goals should be to ensure that, as far as possible, all medical graduates from
      the University of Toronto have the knowledge, attitudes, skills and behaviours
      needed to contribute effectively to the prevention and treatment of alcohol- and
      drug-related problems in their chosen field of practice and to avoid problems
      from their personal use of alcohol and other drugs.

PMID- 2224678
TI  - Medical education for alcohol and other drug abuse in the United States.
AB  - Initiatives by individuals, private foundations and government have led to
      improvements in the United States in medical education dealing with alcohol and
      drug-related problems. Progress has been made, particularly in the past 5 years,
      in developing new medical school curricula and in faculty development. Greater
      activity by national professional organizations has helped raise the priority of
      training in alcohol- and drug-related areas for undergraduate and postgraduate
      medical education. As an example, Project ADEPT (Alcohol and Drug Education for
      Physician Training in primary care) at Brown University in Providence, Rhode
      Island, is described. The importance of positive and motivated faculty role
      models and of skills training is emphasized.

PMID- 2224679
TI  - An agenda for action.

PMID- 2224680
TI  - Risk of aerosol inhalers.

PMID- 2224682
TI  - The Ottawa Heart Institute: it's good, but can we afford it?

PMID- 2224681
TI  - New drugs for hypertension: should data precede conclusions?

PMID- 2224683
TI  - Dr. Maude Abbott deserves better.

PMID- 2224685
TI  - Hypernatremia associated with N-acetylcysteine therapy for meconium ileus in a
      premature infant.

PMID- 2224684
TI  - Decoding prescriptions.

PMID- 2224687
TI  - The fetus as a person.

PMID- 2224686
TI  - Tryptan: no association with eosinophilia-myalgia syndrome.

PMID- 2224689
TI  - Computer multitasking with Desqview 386 in a family practice.

PMID- 2224688
TI  - Alcohol consumption and plasma lipoproteins.

PMID- 2224691
TI  - Physician attrition and future manpower needs.

PMID- 2224690
TI  - Medical ethics and women.

PMID- 2224693
TI  - Nuclear medicine physicians and radiation safety.

PMID- 2224692
TI  - Women and HIV infection and AIDS in Canada: should we worry?

PMID- 2224694
TI  - Zidovudine (Retrovir) update.
AB  - Zidovudine (AZT) is the first antiretroviral agent to be licensed for the
      treatment of human immunodeficiency virus (HIV) infection. Since the initial
      placebo-controlled trial showing improved survival among patients with acquired
      immunodeficiency syndrome (AIDS) or symptomatic HIV infection (AIDS-related
      complex [ARC]) zidovudine has been evaluated in other stages of HIV infection.
      This review offers physicians who treat patients with HIV infection a
      comprehensive analysis of the current data on the clinical efficacy of zidovudine
      in various stages of HIV infection and on zidovudine's adverse effects. After a
      search of MEDLINE for pertinent articles published since 1985, controlled studies
      and studies of long-term zidovudine therapy, of zidovudine therapy for HIV
      related conditions and of the incidence and management of adverse reactions were
      evaluated. In addition, abstracts from international meetings were reviewed. No
      significant difference in clinical outcome was found between high-dose and low
      dose zidovudine therapy, but there were significantly fewer toxic effects in the
      low-dose group. In two other studies zidovudine was found to delay disease
      progression in patients with asymptomatic or mildly symptomatic HIV infection who
      had an absolute CD4 count of less than 0.5 x 10(9)/L; the low incidence of
      adverse reactions may have been due to either the early stage of the infection or
      the low dose used. The demonstration of zidovudine-resistant isolates after at
      least 6 months of therapy has yet to be correlated with clinical deterioration.
      When to begin zidovudine therapy among asymptomatic patients with a CD4 count of
      less than 0.5 x 10(9)/L remains unclear. Zidovudine can be used safely to delay
      progression to AIDS or ARC in certain patients with asymptomatic or mildly
      symptomatic HIV infection and can prolong survival in those with more severe
      infection. Further studies are necessary to identify indicators that could better
      define when to start treatment and how to alleviate toxic effects. Combination
      therapy with such agents as interferon alpha may become the preferred choice of
      therapy to prevent toxic effects and zidovudine resistance. Zidovudine
      prophylaxis has been used after HIV exposure. Although studies with animal models
      have had encouraging results infection has occurred despite immediate prophylaxis
      and thus further investigation is required.

PMID- 2224695
TI  - An anonymous seroprevalence survey of HIV infection among pregnant women in
      British Columbia and the Yukon Territory.
AB  - We performed an anonymous seroprevalence survey of human immunodeficiency virus
      (HIV) type 1 infection through HIV antibody testing of blood samples from 22,512
      women aged 15 to 44 years receiving prenatal care in British Columbia and the
      Yukon Territory from Mar. 15 to Sept. 30, 1989. Of the samples six were confirmed
      to be HIV positive; this yielded a crude overall seroprevalence rate of 2.7 per
      10,000 pregnant women (95% confidence interval [CI] 1.0 to 5.8). All of the
      positive samples were from women 20 to 29 years of age; four were from Vancouver,
      one was from Victoria, and one was from elsewhere. The highest seroprevalence
      rates were among women aged 15 to 29 years in Vancouver and Victoria (7.2 and 9.4
      per 10,000 pregnant women respectively). Thus, 1 in 1300 pregnant women in that
      age group in the metropolitan areas of British Columbia was HIV positive.
      Application of seroprevalence rates to the total female population in British
      Columbia and the Yukon Territory revealed that as many as 401 women had HIV
      infection in 1989. Our estimates likely represent the minimum. As a subset of
      women of childbearing age pregnant women are likely at lowest risk of HIV
      infection, and so the true number of women 15 to 44 years of age with HIV
      infection is probably several times higher. Our study has provided a baseline
      assessment and will be repeated annually to analyse trends in HIV seroprevalence
      among pregnant women in British Columbia and the Yukon Territory.

PMID- 2224696
TI  - Five-year results of the peer assessment program of the College of Physicians and
      Surgeons of Ontario.
AB  - The office practices of 918 physicians selected through stratified random
      sampling from the College of Physicians and Surgeons of Ontario (CPSO) registry
      were assessed by peers and the Peer Assessment Committee of the CPSO from 1981 to
      1985. The sample comprised 662 general practitioners (GPs) and family physicians
      (FPs) and 256 specialists in 11 fields. Of the physicians 749 (82%) had neither
      deficient records nor an unsatisfactory level of patient care. Of the GPs and FPs
      97 (15%) had serious deficiencies in one or both areas, as compared with 4 (2%)
      of the specialists (p2 less than 0.00001). The proportions of certificants of the
      Royal College of Physicians and Surgeons of Canada and of the College of Family
      Physicians of Canada (CFPC) with serious deficiencies were low (2% and 3%
      respectively). Three statistically significant predictors of physician
      performance were found among the GPs and FPs: age, CFPC membership status and
      type of practice. Of the 56 physicians who were reassessed 6 to 12 months later
      29 (52%) had made the improvements recommended by the committee. Our findings
      demonstrate the need, feasibility and acceptance of a peer assessment program of
      office practices in Ontario.

PMID- 2224698
TI  - Women focus of this year's World AIDS Day.

PMID- 2224697
TI  - Catatonic reaction to omeprazole and disulfiram in a patient with alcohol
      dependence.

PMID- 2224699
TI  - Guides, manuals for dealing with AIDS in workplace now available.

PMID- 2224700
TI  - Role of physicians key in national AIDS strategy, Ottawa says.

PMID- 2224701
TI  - Justice minister tries to allay doctors' fears about abortion bill.

PMID- 2224703
TI  - Cocaine users may not fit MDs' stereotype, FPs warned.

PMID- 2224702
TI  - Restraint is needed in our use of patient restraints.

PMID- 2224704
TI  - HIV antibody testing: CMA counselling guidelines.

PMID- 2224705
TI  - Risk factors for HIV seropositivity among people consulting for HIV antibody
      testing.

PMID- 2224706
TI  - Abortion and the DPG ratio.

PMID- 2224707
TI  - Third World aid.

PMID- 2224708
TI  - Medical licensure: let's not lose sight of the objective.

PMID- 2224710
TI  - Continuity of care: its importance in maintaining a teaching family practice.

PMID- 2224709
TI  - Assisting suicide.

PMID- 2224711
TI  - Guidelines for the release of laboratory test results, reports and specimens to
      patients, interested groups and other institutions. Canadian Association of
      Pathologists.

PMID- 2224712
TI  - Report of the Expert Advisory Committee on the Use of Drugs in the Treatment of
      Abuse and Dependence to Narcotic and Controlled Drugs.

PMID- 2224713
TI  - Periodic health examination, 1990 update: 4. Well-baby care in the first 2 years
      of life. Canadian Task Force on the Periodic Health Examination.

PMID- 2224714
TI  - Electrical safety in patient care areas.

PMID- 2224716
TI  - HIV infection among Quebec women giving birth to live infants.
AB  - This is the first anonymous unlinked seroprevalence study in Canada to use serum
      samples from newborns to determine the seroprevalence rate of human
      immunodeficiency virus (HIV) infection among childbearing women. Of the 68,808
      samples tested 42 were confirmed as positive, for an overall crude seroprevalence
      rate of 6.1 per 10,000 live births (95% confidence interval [CI] 4.4 to 8.3), or
      1 woman in 1638. Women who lived on Montreal island had an overall rate of 17.9
      per 10,000 live births (95% CI 12.2 to 25.4), or 1 woman in 559. We observed a
      significant association between revenue index and seroprevalence; the rates were
      as high as 46.4 per 10,000 live births (95% CI 18.7 to 95.3), or 1 woman in 216,
      for Montreal island postal code areas with revenue indexes 20% or more below the
      provincial median. Extrapolation of the data suggested that 56 women with HIV
      infection gave birth to a live infant during 1989 in Quebec. Even though attempts
      to generalize the data from childbearing women to women of childbearing age have
      an inherent conservative bias, the results of our study suggest that 988 women
      (95% CI 713 to 1336) aged 15 to 44 years in Quebec had HIV infection in 1989. The
      actual number is likely substantially higher. The need for well-designed,
      creative interventions to prevent further HIV transmission to women is evident.
      Planning for the provision of medical and psychosocial services sensitive to
      specific needs of women who are already infected should start immediately.

PMID- 2224718
TI  - Trends in Canadian tobacco consumption, 1980-89.

PMID- 2224715
TI  - Early detection and treatment of hyperlipidemia: physician practices in Canada.
AB  - We surveyed primary care physicians in Canada to determine their current
      practices regarding the detection and treatment of hyperlipidemia in asymptomatic
      adults 20 years of age or more and to determine the role of selected patient
      characteristics (age, sex and the presence of coronary heart disease [CHD] risk
      factors) in their management decisions. The self-administered questionnaire was
      completed by 428 of 804 family physicians and general practitioners. The
      proportion of physicians who reported having tested at least 50% of their adult
      patients varied from 29% to 85% and was related to the number of CHD risk factors
      present and the patient's age. The proportion of respondents who reported
      starting dietary or drug therapy among patients with a cholesterol level of 6.2
      mmol/L or less increased as the number of CHD risk factors increased and was not
      related to patient age or sex. According to the factors examined our results
      suggest that primary care physicians in Canada select patients for screening and
      treatment mainly on the basis of CHD risk factors present and that their approach
      is more conservative than that recommended by the Canadian and US consensus
      conferences.

PMID- 2224719
TI  - Canadian lab to produce HIV immunogen for clinical trials.

PMID- 2224721
TI  - "Come south, young doctor", Humana tells Canadian MDs.

PMID- 2224717
TI  - Susceptibility of Haemophilus influenzae to antimicrobial agents used in Canada.
      Canadian Study Group.
AB  - We evaluated the incidence of Haemophilus influenzae resistance to selected
      antimicrobials used in Canada. From 1985 to 1987, 2503 H. influenzae isolates
      obtained in 14 hospitals across Canada were sent to the Centre hospitalier de
      l'universite Laval (CHUL) for identification, serotyping, biotyping and testing
      for beta-lactamase production. Susceptibility tests were done with the use of 12
      antibiotics. Of the strains 424 (16.9%) produced beta-lactamase; the proportion
      varied from 12.8%, in Newfoundland, to 19.6%, in Ontario. Of the strains 18.3%
      were type b; 19.4% of those produced beta-lactamase. Almost 82% of the strains
      were not type b. The proportion of beta-lactamase-producing strains varied
      according to the isolation site, from 15.3% in the respiratory tract to 25.6% in
      the blood. The overall level of resistance was 19.3% to ampicillin, 24.2% to
      erythromycin, 3.8% to trimethoprim-sulfamethoxazole, 1.7% to amoxicillin
      potassium clavulanate, 1.4% to cefaclor, 1.3% to tetracycline, 1.0% to rifampin,
      0.7% to cefuroxime and 0.1% to cefamandole. Disc diffusion susceptibility testing
      revealed 64 strains (2.6%) that did not produce beta-lactamase but were resistant
      to ampicillin and 9 (0.4%) that produced beta-lactamase but were susceptible to
      ampicillin. The results of beta-lactamase production tests were identical
      regardless of whether the tests were done by the CHUL or by the other hospitals,
      but there was a marked difference in the susceptibility test results between the
      CHUL and the other centres. Our results suggest that the level of resistance of
      H. influenzae to antibiotics is increasing in Canada and that the initial choice
      of drug therapy may have to be modified.

PMID- 2224720
TI  - The bottom line.

PMID- 2224723
TI  - Report on UK cancer survival rates raises questions about alternative medicine.

PMID- 2224722
TI  - Cleveland's physicians say no to Canadian-style health care.

PMID- 2224724
TI  - Physician remains defiant in bid to withhold defence portion of income tax.

PMID- 2224725
TI  - The unkindest cut of all.

PMID- 2224726
TI  - Stand-alone HIV clinic expected to save money, help patients.

PMID- 2224728
TI  - History and modern concepts.

PMID- 2224727
TI  - Dr. Ignatz Nascher and the birth of geriatrics.

PMID- 2224729
TI  - Animal models for amyloidosis.

PMID- 2224730
TI  - Treatment.

PMID- 2224731
TI  - Clinical features of cutaneous amyloidoses.

PMID- 2224732
TI  - Epidemiology of primary cutaneous amyloidoses in southeast Asia.

PMID- 2224733
TI  - Epidemiology of primary cutaneous amyloidoses in South America.

PMID- 2224734
TI  - Histopathology of primary cutaneous amyloidoses and systemic amyloidosis.

PMID- 2224735
TI  - Electron microscopy of primary and secondary cutaneous amyloidoses and systemic
      amyloidosis.

PMID- 2224737
TI  - Elastic fiber and cutaneous amyloidoses.

PMID- 2224736
TI  - Amyloid P-component and the skin.

PMID- 2224738
TI  - Mucocutaneous manifestations in systemic amyloidosis.

PMID- 2224739
TI  - Collagen and cutaneous amyloidoses.

PMID- 2224740
TI  - Tissue culture and cutaneous amyloidoses.

PMID- 2224741
TI  - Unique aspects of diabetes mellitus in the elderly.
AB  - Diabetes mellitus is a common condition in the geriatric population. In older
      subjects it may present in unusual ways and may be associated with unusual
      conditions. Hyperglycemia produces a variety of effects, including osmotic
      diuresis and cognitive dysfunction, which seriously impair the quality of life of
      the older individual. Older diabetics need to have their diabetes well
      controlled. The approach to diabetic control in older individuals is similar to
      that in younger individuals, with some notable exceptions.

PMID- 2224743
TI  - Atypical presentation of diabetes mellitus in the elderly.
AB  - Diabetes mellitus is a common problem affecting the elderly. Unfortunately, many
      people learn they have a problem only after late sequelae of the disease are
      present. Classic symptoms of hyperglycemia may be lacking or confused with other
      age-prevalent problems or the aging process itself. Any change in condition,
      whether medical or psychological, deserves a glucose control assessment. Because
      of problems in diagnosis, glucose screening has been advocated. Only by
      diagnosing diabetes mellitus early can late complications be prevented and a high
      quality of life assured.

PMID- 2224742
TI  - Epidemiology of diabetes mellitus among the elderly in the United States.
AB  - Diabetes mellitus is one of the most common chronic diseases affecting the
      elderly in the United States. It has been diagnosed in 9.6% of people 65 years of
      age and older, and an additional 9.3% meet oral glucose tolerance test criteria
      for the disease but have not been diagnosed. Taken together, diagnosed and
      undiagnosed diabetes affects almost one in every five people 65 years of age and
      older. An additional 23% of the elderly meet diagnostic criteria for impaired
      glucose tolerance, a condition that conveys excess risk for macrovascular
      disease. Prevalence of diagnosed diabetes in the elderly is expected to increase
      44% in the next 20 years, to an estimated population of 3.9 million people.
      Elderly people with diabetes make an average of 3.7 visits per year to physicians
      specifically for care of their diabetes. Over 80% of this care is delivered by
      general and family physicians and internists. About 30% of diabetics 65 to 74
      years of age are hospitalized each year, a rate that is almost twice that of
      elderly people without diabetes. Cardiovascular and peripheral vascular
      complications are often twice as prevalent as among people without diabetes. Risk
      factors for macrovascular disease are also highly prevalent among the elderly,
      including obesity, hypertension, and hypercholesterolemia. Three fourths of
      deaths of diabetic patients 65 years of age and older are caused by diseases of
      the circulatory system, primarily ischemic heart disease and stroke. The death
      rate from cardiovascular disease among elderly diabetic patients is twice that of
      people without diabetes in the same age range.

PMID- 2224744
TI  - Cognitive and affective disorders in elderly diabetics.
AB  - In non-insulin-dependent diabetes mellitus, performance of complex cognitive
      tasks requiring the storage and retrieval of new information is poorer than in
      age-matched controls. By contrast, performance of less demanding tasks such as
      immediate memory and simple reaction time is essentially equivalent for NIDDM
      patients and controls. This pattern parallels the cognitive change observed with
      normal aging, in which age differences are minimal on less demanding immediate
      memory tasks but older adults perform more poorly than young adults on secondary
      or long-term memory tasks. Age-related changes in cognitive performance have been
      attributed to a reduction in processing resources or working memory capacity.
      Although the explanation for NIDDM-related deficits remains to be identified,
      reduced glucose control and elevated levels of triglycerides appear to play some
      role in cognitive impairment. Non-insulin-dependent diabetes is associated not
      only with elevated levels of depression, but with an increased frequency of self
      reported memory problems. Moreover, elevated levels of depression are associated
      with various indicators of neuropathy and with significant reductions in self
      regulated control of glucose at the time of medical office visits. Diabetic
      patients may perceive less control over their lives as a result of the many
      restrictions associated with the disease. When provided with the opportunity to
      exercise control, however, performance on many cognitive tasks can be improved in
      NIDDM as well as in age-matched controls. This suggests that by providing NIDDM
      patients with opportunities to exercise increased control over their lives it may
      be possible to enhance motivation and to increase the likelihood of the patient's
      adopting more effective self-regulatory behaviors.

PMID- 2224745
TI  - Foot ulceration and infections in elderly diabetics.
AB  - Foot lesions occur commonly among patients with diabetes, particularly the
      elderly and those with sensory neuropathy. Because of serious or recurrent
      infections and impaired healing processes, initially trivial lesions may progress
      to chronic nonhealing wounds, gangrene, or untreatable infections that can lead
      to limb amputation. Strategies to prevent amputation depend on understanding the
      multifactorial nature of diabetic foot disease; providing effective ongoing
      preventive care, including patient education; and prompt and aggressive treatment
      of foot lesions when they occur. The approach to treatment of infections depends
      on many factors, including the severity of the soft tissue infection, whether or
      not underlying bone or joints are involved, the types of infecting organisms, the
      patient's social situation, and his other medical problems. Proper diagnostic
      studies followed by appropriate antimicrobial therapy and local wound care can
      usually lead to resolution of these potentially serious infections.

PMID- 2224746
TI  - Diabetes-related impotence in the elderly.
AB  - Because many elderly men with chronic illnesses such as diabetes have multiple
      causes contributing to their impotence and may still retain an interest in sexual
      activity, those who still are unable to adequately perform sexually after
      treatment of their medical problems should be informed of the alternative methods
      of treatment of their impotence or alternative methods of sexual fulfillment and
      gratification and, when necessary, should be offered supportive counseling and
      psychotherapy.

PMID- 2224747
TI  - The diabetic hyperosmolar state.
AB  - The diabetic hypersomolar state is defined by a serum glucose greater than 600
      mg/dl and a serum osmolarity greater than 320 m Osm/L. Ketoacidosis or lactic
      acidosis may co-exist with DHS in the same patient. The incidence of this acute
      complication of diabetes is high enough (17.5 cases per 100,000 person-years) for
      primary care physicians to encounter a case every year or two. Predisposing
      factors include older age, female sex, nursing home residence, and infection. A
      substantial proportion of cases occur in patients with no prior history of
      diabetes. Common presenting signs include fatigue or weakness, polydipsia,
      polyuria, nausea, and alteration of consciousness. The mainstay of therapy is
      intravenous fluid replacement with close monitoring of glucose and electrolytes
      in a hospital setting. Current mortality figures are high, at 10% to 20%, and the
      chance of survival is adversely affected by older age, higher osmolarity, and the
      presence of an associated severe illness. Prevention includes screening for
      diabetes, educating diabetic patients and their care givers about the symptoms of
      hyperglycemia, prompt treatment of any infection in a diabetic person, avoidance
      of drugs that increase carbohydrate intolerance in diabetic people, and
      encouraging compliance with treatment of diabetes.

PMID- 2224748
TI  - Renal complications in non-insulin-dependent diabetes mellitus.
AB  - Renal failure among elderly individuals with diabetes is a substantial clinical
      and public health problem. These individuals account for the majority of renal
      failure among people with diabetes mellitus in the United States. Although
      limited population-based data directly provide evidence regarding the incidence
      of and risk factors for ESRD, extant data suggest that blacks and Pima Indians
      have a markedly increased risk of ESRD compared with whites in the United States.
      Proteinuria and microalbuminuria appear to be extremely common in elderly
      individuals with NIDDM and are strongly associated with overall survival,
      cardiovascular morbidity and mortality, and the development of ESRD. Although
      randomized clinical trials are needed to test intervention strategies to reduce
      morbidity and mortality associated with renal disease among individuals with
      NIDDM, extant data suggest that management efforts directed at hypertension
      control and, possibly, moderate restriction of protein intake may be important
      therapeutic modalities for prevention of renal disease and its associated
      sequelae among elderly individuals with diabetes.

PMID- 2224749
TI  - Ocular problems in older Americans with diabetes.
AB  - Data from the Wisconsin Epidemiologic Study of Diabetic Retinopathy from persons
      with diabetes of older onset whose average age was 65.4 years indicate that 9.9%
      of the men and 13.3% of the women had some degree of visual impairment, and 1.4%
      of men and 1.7% of women were legally blind (with an visual acuity of 20/200 or
      worse in the better eye). Poorer visual acuity was strongly associated with
      increasing duration of diabetes, but age was also an important factor, with rates
      of legal blindness increasing markedly after the seventh decade of life in groups
      of any duration. Conditions responsible for legal blindness were diabetic
      retinopathy or maculopathy, cataracts, glaucoma, and macular degeneration.
      Incidence of blindness 4 years after the initial evaluation was related to
      insulin use, younger age at examination, longer duration of diabetes, and more
      severe retinopathy at baseline. Worsening of vision was related to higher levels
      of glycosylated hemoglobin and the presence of macular edema on diabetic
      retinopathy at baseline. These data indicate that there is a high prevalence of
      ocular problems among people with diabetes of older onset. The practitioner
      should suggest to these patients that, soon after the diagnosis of diabetes, they
      have an ophthalmologic evaluation to determine whether asymptomatic problems are
      present. This action may lead to timely intervention to prevent loss of vision in
      some patients.

PMID- 2224750
TI  - Screening for non-insulin-dependent diabetes mellitus in the elderly.
AB  - There are three major obstacles to a recommendation for screening the elderly for
      NIDDM. The first is the conflicting evidence as to whether early detection and
      treatment reduce complications. The second is that treatment of hyperglycemia
      with attainment of euglycemia is difficult to achieve in the elderly. Nondrug
      therapy often fails because of lifelong eating habits, denture problems, fixed
      income, and physical handicaps. Drug therapy is fraught with the dangers of
      hypoglycemia and drug interactions. Compliance with therapy often is poor and
      leads to conflicts between physician and patient that may be detrimental in the
      treatment of other diseases in which intervention has proven worthwhile. The
      third obstacle is the lack of data regarding the adverse effects of labeling and
      noncompliance issues in the face of a positive screening test. Because obesity is
      a risk factor for NIDDM and hypertension in conjunction with NIDDM leads to
      atherosclerosis, screening and treatment for these two conditions are warranted
      whether or not NIDDM is present concurrently. Medicine is in a dynamic state of
      flux and, undoubtedly, conflicts over the benefits of early treatment and patient
      compliance will be resolved. Until then, there is no justification for screening
      for NIDDM in the elderly.

PMID- 2224751
TI  - Effect of physical activity on age-related glucose intolerance.
AB  - Glucose tolerance tends to deteriorate with age, but a major portion of this
      deterioration can be explained by changes in other age-related variables-
      obesity, physical inactivity, use of medications, and chronic illness. This
      review has focused on the role that physical activity can play in preventing the
      age-associated decline in glucose tolerance. Pathophysiologically, most of the
      decline in glucose tolerance appears to be caused by a decrease in insulin action
      with aging. Given that it has been shown that exercise increases insulin action,
      there is a plausible biologic mechanism explaining the observed association
      between physical activity and the preservation of insulin sensitivity and glucose
      tolerance with aging. Finally, it appears from the published data that it is life
      long maintenance of physical activity, beginning long before individuals reach
      the geriatric age group, that will be most beneficial to the health of aging
      Americans.

PMID- 2224752
TI  - Functional status measurement in elderly diabetic patients.
AB  - Elderly diabetic subjects are at particularly high risk for a wide range of
      physical, emotional, cognitive, and social functional impairments. The primary
      physician therefore is well advised to systematically assess the functional
      status of such patients, either by traditional informal methods or, preferably,
      by implementing some systematic approach. One practical three-step approach
      involves identifying which abilities are particularly important to or endangered
      in a given patient, listing these on the Diabetes Data Flow Sheet and briefly
      reviewing them with the patient on a periodic basis, and using a functional
      problem list as a guide to effective and timely intervention and follow-up.

PMID- 2224753
TI  - Nutritional status and dietary management of elderly diabetic patients.
AB  - Dietary treatment of diabetes has long been the cornerstone of management of this
      common disease. Recent recommendations to increase the proportion of carbohydrate
      with concomitant reduction of dietary fat appear to be prudent, but scant data
      are available to support this supposition in the elderly. Modification of the
      source of carbohydrate as a means of providing better blood glucose control is
      based on limited data in controlled settings and needs to be tested in community
      settings before widespread alterations in the dietary composition can be widely
      recommended. Current recommendations for protein composition of the diet are
      probably adequate for the elderly diabetic patient who does not have obvious
      protein depletion. General guidelines for the dietary management of elderly
      diabetic patients are summarized in Table 5. Management of the elderly diabetic
      patient presents a strong challenge to the physician. Dietary recommendations for
      such patients should be highly individualized; patients' food preferences, ethnic
      background, financial resources, and support system should be taken into
      consideration. Simple recommendations drafted with the help of the patient are
      more likely to be successful. The elderly are often at risk for nutritional
      deficiency, and the presence of chronic disease such as diabetes profoundly
      affects metabolism, putting these individuals at still higher risk.
      Unfortunately, our current understanding of this problem is limited and
      additional research in this area is essential.

PMID- 2224754
TI  - Use of sulfonylurea agents in older diabetic patients.
AB  - The elderly patient with type II diabetes should be treated in much the same
      fashion as a younger person with the same disease, although emphasis needs to be
      placed on minimizing side effects, drug interactions, and hypoglycemia.
      Chlorpropamide should not be used in these patients, unless there is no other
      choice. The remaining agents--tolbutamide, acetohexamide, tolazamide, glyburide,
      and glipizide--should be started at low doses and gradually increased until
      optimal diabetic control is reached. The initial treatment goal is a FPG level of
      less than 180 mg/dl and a final goal is a 1- to 2-hour PPG concentration between
      140 and 180 mg/dl. The glycosylated hemoglobin value should be no greater than
      1.5% above the upper limit of normal, and should be lower, if possible. It must
      be kept in mind, however, that the closer diabetic patients are to achieving
      euglycemia, the more likely is hypoglycemia. Treatment goals therefore may have
      to be relaxed in someone at increased risk of hypoglycemia (e.g., patients with
      irregular eating habits or renal insufficiency) or when hypoglycemia may pose a
      greater hazard (e.g., patients with coronary artery or cerebral vascular
      disease). Patients on sulfonylurea agents should have blood glucose values
      measured once a month and glycosylated hemoglobin levels determined once every 3
      months to alert the clinician to the possible need to adjust therapy. In this
      way, potential hypoglycemia can be avoided if blood glucose levels are drifting
      too low and chronic hyperglycemia can be identified and treated within a short
      period of time. When a patient's status changes--e.g., he is placed on new
      medication, becomes depressed and anorexic, or develops another medical problem-
      care must be taken to re-evaluate his diabetes management. Drugs such as
      sulfonamide antibiotics can potentiate the action of the sulfonylureas and cause
      hypoglycemia, renal insufficiency may necessitate changing the type of
      sulfonylurea agent or decreasing the dose, and malnutrition may obviate any need
      for therapy with an oral hypoglycemic agent. If these guidelines are kept in
      mind, the older diabetic patient can be managed on a sulfonylurea agent in
      conjunction with the appropriate diet. Should these measures prove to be
      ineffective, then insulin therapy should be instituted. Controlling chronic
      hyperglycemia will help improve the quality of life for patients with diabetes
      and decrease the probability of developing some of the devastating complications
      associated with this disease.

PMID- 2224755
TI  - Insulin treatment in the elderly diabetic patient.
AB  - Type II diabetes mellitus may affect as many as 20% of the elderly US population.
      In the absence of data to support the need to maintain a specific level of
      glucose beyond that necessary to relieve symptoms, choice of therapy is
      problematic. Clearly, supervised dietary therapy for the obese type II diabetic
      patient represents a safe and cost-effective treatment. For those patients who
      fail dietary therapy because they fail to lose weight or regain lost weight, or
      because blood glucose levels remain high despite weight loss, further therapy
      must be individualized. The only rational criteria for drug treatment supportable
      by currently available data are (1) persistent symptoms associated with
      hyperglycemia, (2) ketonuria in the unstressed state, and (3) certain cases of
      hyperlipidemia, especially with triglyceride levels greater than 1000 mg/dl. In
      these clinical settings, drug therapy is necessary to eliminate symptoms, prevent
      development of ketoacidosis, and reduce the risk of pancreatitis, respectively.
      Consideration of drug therapy should also be made in the case of very elevated
      blood glucose levels, even in the absence of symptoms, when dehydration and risk
      of severe hyperosmolarity exist. The issues regarding insulin versus
      sulfonylureas have not been examined specifically in the elderly population.
      Extrapolating from published studies that generally include patients older than
      65 years leads to the following conclusions: Caution regarding adverse side
      effects of insulin (hypoglycemia, theoretic risk of hyperinsulinemia) and
      sulfonylureas (hypoglycemia, drug interactions, increased risk of cardiovascular
      death) must be balanced against the theoretic benefit of treatment in the absence
      of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2224756
TI  - Glycemic control in elderly people with diabetes.
AB  - Hyperglycemia is only one of several metabolic derangements that are prevalent in
      diabetes mellitus. Of these, hyperlipidemia, obesity, and co-existent
      hypertension may make more important contributions to complications than
      persistently elevated blood sugars. The role of hyperglycemia in the genesis of
      diabetic complications is uncertain and there is little evidence from prospective
      randomized controlled studies to support rigorous hypoglycemic treatment. Adverse
      consequences of pharmacologic therapy can be severe, including death, and are
      most frequent in the elderly. The group of elderly diabetic ambulatory patients
      is markedly heterogeneous and individualization of therapy is required. Obese
      persons require dietary therapy, and additional dietary manipulations are needed
      for patients with the complications of hyperlipidemia, hypertension, and
      nephropathy. Pharmacologic hypoglycemic therapy may be required to control
      symptoms, but its use in asymptomatic diabetic persons is for the most part
      unwarranted.

PMID- 2224757
TI  - Home care of the elderly diabetic patient.
AB  - As the anticipated growth of sophisticated diabetic services continues to
      accelerated in homes across America, physicians must first be educated as to the
      potentially unlimited spectrum of diabetic home care products and services that
      will become increasingly available to the patients whom they serve. Second, much
      research must be completed to critically examine the safety, quality, and cost
      issues of diabetic home care, to provide the necessary data to assure that home
      care services will be neither under- or over-utilized and will meet the necessary
      acute and long-term health care needs of our diabetic patients. Third, physicians
      must take a leadership role in examining the pitfalls of our existing expensive
      and often fragmented acute care-oriented health care model, which has not
      effectively addressed the increasing costs and incidence of chronic diseases,
      such as diabetes, in our society. With computerization and the explosive
      mobilization of high-technology health care products and services, we are
      witnessing an exponential growth in the list of services available in the home
      setting for diabetic patients. There has never been a time in the history of
      medicine that we, as physicians, have needed to create new, innovative, high
      quality approaches to necessary, accessible, and cost-effective alternative
      health care delivery systems as is the case now. I believe that the renewal of
      home care, with physician vision, direction, and review, will be a major step
      toward the highest-quality medical care provided to our diabetic patients at
      home.

PMID- 2224759
TI  - A phase I study of a new cisplatin derivative for hematologic malignancies.
AB  - DWA2114R (DWA) is a new derivative of platin compounds that is currently being
      used in Phase II studies of solid tumors in Japan. The dose-limiting factor is
      myelotoxicity with mild extramedullary toxicity. This Phase I study consisted of
      adult patients with relapsed hematologic malignancies. Eight patients received a
      total of 15 treatment courses of DWA. The starting dose was 800 mg/m2 over 24
      hours by continuous infusion. The dose was first increased to 1200 mg/m2 and then
      to 1600 mg/m2. Clinical toxicity and urinary excretion studies of DWA suggested
      that 1200 mg/m2/d for successive days would be the best type of administration.
      When 1200 mg/m2/d was given for 5 days, Grade 2 to 3 diarrhea and nausea and
      vomiting were encountered requiring parenteral fluids and nutritional support.
      This suggested that the dose-limiting factor with this schedule was
      gastrointestinal toxicity. Myelotoxicity was severe, as expected, but tolerable.
      One of the five patients with acute nonlymphocytic leukemia (ANLL) entered into
      complete remission and one patient with chronic myelogenous leukemia (CML) in
      crisis returned to the chronic phase. A Phase II trial of DWA is warranted for
      hematologic malignancies, especially in myeloid diseases.

PMID- 2224760
TI  - Toxicity of high-dose cytosine arabinoside in the treatment of advanced childhood
      tumors resistant to conventional therapy. A Pediatric Oncology Group study.
AB  - Experience with high-dose cytosine arabinoside (HDAC) in pediatric solid tumors
      is limited. Sixteen children with solid tumors resistant to conventional
      therapies were registered in a pilot Pediatric Oncology Group (POG) study that
      required the administration of HDAC at 3 g/m2 every 12 hours for four doses.
      There were four cases of rhabdomyosarcoma, two cases of fibrosarcoma, four cases
      of neuroblastoma, and one case each of germ cell tumor, Wilm's tumor,
      retinoblastoma, hepatocellular carcinoma, Ewing's sarcoma, and Burkitt's
      lymphoma. All eligible patients had advanced diseases and had previously received
      extensive chemotherapy. Thirteen patients received one course of HDAC and three
      patients received two courses of HDAC. Due to prior treatments, patients had less
      than normal marrow reserves. Short-term toxicity included nausea, vomiting,
      suppression of hemopoiesis, drug fever, and increased blood urea nitrogen (BUN),
      creatinine, and liver enzymes. All evaluable patients recovered from their
      toxicities. There were no drug-related deaths. None of the patients had
      neurologic problems, including the only patient with prior irradiation to the
      skull. With the above schedule, HDAC appears to have manageable toxicity.

PMID- 2224758
TI  - Economic impact of diabetes mellitus in the elderly.
AB  - Diabetes mellitus is a prevalent disease in Americans aged 65 years and older. It
      leads to significant morbidity, mortality, and utilization of health care
      services. Using extant data, we estimated that health care services provided to
      elderly persons with diabetes cost $5.16 billion annually, nearly 80% of which
      were attributed to hospital costs. Treatment for cardiovascular disease as a
      complication of diabetes accounted for the largest proportion of these costs. In
      addition to admissions for uncomplicated diabetes, substantial portions of
      inpatient costs were attributed to renal and neurologic diseases. Expenditures
      per capita for medical care were 50% higher in the elderly diabetic population
      than in an elderly nondiabetic population. The average yearly expenditure per
      diabetic patient was estimated to be $4265, $900 of which were out-of-pocket
      expenses. We conclude that increased vigilance to prevent or delay the incidence
      of morbidity leading to hospital admissions must take priority in caring for
      patients with DM. Intensifying outpatient care may offer the opportunity to
      accomplish this goal.

PMID- 2224762
TI  - A phase I study of 4'-0-tetrahydropyranyladriamycin. Clinical pharmacology and
      pharmacokinetics.
AB  - A Phase I study of intravenous (IV) bolus 4'-0-tetrahydropyranyladriamycin
      (Pirarubicin) was done in 55 patients in good performance status with refractory
      tumors. Twenty-six had minimal prior therapy (good risk), 23 had extensive prior
      therapy (poor risk), and six had renal and/or hepatic dysfunction. A total of 167
      courses at doses of 15 to 70 mg/m2 were evaluable. Maximum tolerated dose in good
      risk patients was 70 mg/m2, and in poor-risk patients, 60 mg/m2. The dose
      limiting toxic effect was transient noncumulative granulocytopenia. Granulocyte
      nadir was on day 14 (range, 4-22). Less frequent toxic effects included
      thrombocytopenia, anemia, nausea, mild alopecia, phlebitis, and mucositis.
      Myelosuppression was more in patients with hepatic dysfunction. Pharmacokinetic
      analyses in 21 patients revealed Pirarubicin plasma T 1/2 alpha (+/- SE) of 2.5
      +/- 0.85 minutes, T beta 1/2 of 25.6 +/- 6.5 minutes, and T 1/2 gamma of 23.6 +/-
      7.6 hours. The area under the curve was 537 +/- 149 ng/ml x hours, volume of
      distribution (Vd) 3504 +/- 644 l/m2, and total clearance (ClT) was 204 + 39.3
      l/hour/m2. Adriamycinol, doxorubicin, adriamycinone, and
      tetrahydropyranyladriamycinol were the metabolites detected in plasma and the
      amount of doxorubicin was less than or equal to 10% of the total metabolites.
      Urinary excretion of Pirarubicin in the first 24 hours was less than or equal to
      10%. Activity was noted in mesothelioma, leiomyosarcoma, and basal cell
      carcinoma. The recommended starting dose for Phase II trials is 60 mg/m2 IV bolus
      every 3 weeks.

PMID- 2224761
TI  - Primary chemotherapy with or without radiation therapy and/or surgery for
      children with localized sarcoma of the bladder, prostate, vagina, uterus, and
      cervix. A comparison of the results in Intergroup Rhabdomyosarcoma Studies I and
      II.
AB  - A major objective of the second Intergroup Rhabdomyosarcoma Study (IRS-II) (1978
      to 1984) was to preserve the bladder without compromising the survival of
      children with localized genitourinary sarcomas arising in or near the bladder.
      After incisional biopsy, 109 patients with localized, gross residual sarcoma of
      the prostate (43 patients), bladder (43 patients), vagina (20 patients), or
      cervix/uterine corpus (3 patients) were treated with vincristine, dactinomycin,
      and cyclophosphamide (VAC). After two to four drug courses, radiation therapy
      and/or surgery were used to treat patients with residual or recurrent tumor. The
      3-year survival rate of patients treated on this primary chemotherapy regimen
      (70%) was similar to that of the primary surgery regimens of IRS-I (78%; P =
      0.46), but the 3-year disease-free survival rate was significantly inferior (52%
      versus 70%; P = 0.02). Since the IRS-II encouraged bladder preservation at the
      onset of therapy, the percentage of patients with bladder and prostate tumors who
      retained the bladder was initially substantially higher in IRS-II (97%) than in
      IRS-I (58%). However, the percentages of 95 patients with bladder-prostate (BP)
      tumors in IRS-II who retained the bladder and were alive at 2 and 3 years after
      starting treatment were only 33% and 22%, respectively, compared with 26% and
      23%, respectively, in the 66 patients with BP tumors in IRS-I. Thus, sequential
      treatment with primary chemotherapy, followed by radiation therapy and/or surgery
      as given in IRS-II, failed to improve the eventual bladder salvage rate.

PMID- 2224763
TI  - Testicular relapse in children with acute nonlymphoblastic leukemia.
AB  - The clinical course and other distinctive features of five children who developed
      a testicular relapse 4 months to 25 months after the diagnosis of acute
      nonlymphoblastic leukemia (ANLL) are described. The chief presenting feature at
      relapse was painless testicular enlargement, as is also seen in children with
      acute lymphoblastic leukemia who relapse in the testes. By French-American
      British convention, the malignant cells were classified as M4 (myelomonoblastic)
      in four cases and M2 (myeloblastic) in one. All children received a course of
      multiagent reinduction chemotherapy and all but one received local irradiation to
      the testes. Only one of these children, whose relapse was a late event after
      elective cessation of therapy, is a long-term survivor. A comparison with six
      previously published cases shows similar clinical characteristics and outcome.
      Given the poor responses of such patients to conventional treatment, it seems
      worthwhile to consider the use of intensive reinduction chemotherapy with
      concomitant bilateral testicular irradiation followed by remission
      intensification and an autologous or allogenic marrow transplant.

PMID- 2224765
TI  - Surgical treatment of brain metastases in malignant melanoma.
AB  - The authors report the results of a retrospective review of 13 patients who
      underwent 19 craniotomies for resection of metastatic malignant melanoma at the
      University of Colorado (Denver, CO) between 1983 and 1989. There was preoperative
      evidence of extracranial disease in 11 patients. Eight patients had more than one
      intracranial metastasis at operation. Intraoperative ultrasound was used in 18 of
      the 19 craniotomies to minimize surgical trauma to the brain. The 30-day
      mortality was zero. The 30-day morbidity was minimal. No patient acquired a new
      neurologic deficit as a result of surgery. All patients regained at least their
      preoperative level of functioning. Six of the patients who were living at the
      time of review have been followed for 4 to 25 months (median, 7.5 months). The
      seven patients who were dead at the time of review survived 4 to 18 months
      (median, 10 months). These results compare favorably with the survival of
      untreated patients with metastatic melanoma to the brain (median, 1 month),
      patients treated with radiation therapy alone (median, 2-4 months), and those
      treated with chemotherapy alone (median, 2-4 months). The excision of metastatic
      melanoma from the brain, although not curative, may increase survival in patients
      with this problem with little morbidity and mortality even in the presence of
      other metastases.

PMID- 2224764
TI  - Structural and ultrastructural study of the ovary in childhood leukemia after
      successful treatment.
AB  - Ovarian biopsy specimens from ten girls (three postmenarcheal) who had undergone
      antiblastic treatment for acute lymphoblastic leukemia (ALL) and were in complete
      remission were examined by light microscope. The biopsy specimens from four of
      these patients (three postmenarcheal) were also observed by electron microscope.
      The structural and ultrastructural analysis showed a reduction in the number of
      follicles which were otherwise normal. No follicles were found in the thin
      sections from two of the three postmenarcheal girls, whereas normal follicles
      were observed in the third. The cortical stroma showed moderate to severe signs
      of fibrosis and changes of capillaries. All of these alterations were more
      evident in patients where ALL was diagnosed at an older age and this finding
      suggests that they are at a higher risk for low fertility or early menopause.

PMID- 2224766
TI  - Expression of major histocompatibility complex class II antigens and interleukin
      1 by epithelial cells of Warthin's tumor.
AB  - The immunoreactivity for class II antigens of the major histocompatibility
      complex and interleukin-1 (IL-1) in Warthin's tumor (WT) cells was studied. In
      addition to macrophages, dendritic cells, and capillary endothelia, the luminal
      tumor cells and some keratinocytes in the metaplastic squamous foci exhibited
      immunoreactivity for both class II antigens and IL-1. The distribution of the
      class II antigens in the luminal tumor cells was limited to their basolateral
      membrane. These data, together with previous findings, strongly suggest that the
      luminal tumor cells of WT introduce the luminal antigen to the underlying
      lymphoid tissue and, thus, act as an antigen-presenting cell.

PMID- 2224767
TI  - Loss of expression of blood group antigen H is associated with cellular invasion
      and spread of oral squamous cell carcinomas.
AB  - Membrane-bound carbohydrates may influence the metastatic behavior of cancer
      cells. Forty-two squamous cell carcinomas (SCC) of the buccal and maxillary
      alveolar mucosa were studied retrospectively using a monoclonal antibody (BE2)
      that reacts with blood group H (type 2 chain) structure and an immunoperoxidase
      (avidin-biotin peroxidase complex) staining technique. H-antigen staining within
      the entire tumor did not correlate with the stage of the tumor, i.e., tumor
      spread. However, loss of staining within the most invasive sites of the tumors
      correlated significantly with the stage of tumor development and histologic grade
      of malignancy. These findings support the view that features regarding the cells
      of deeper parts of the carcinomas are very important for the clinical behavior of
      the tumors and that loss of H-antigen expression is related to the stage of the
      tumor and invasion of carcinoma cells.

PMID- 2224768
TI  - Cell lineage markers in human pancreatic cancer.
AB  - The normal pancreas consists of three major cell types or lineages that share a
      common embryologic origin from pluripotent endodermal precursors. The type of
      cell that undergoes neoplastic transformation to form a pancreatic carcinoma is
      controversial and may influence the phenotype and biologic behavior of the tumor.
      In this study, immunohistologic techniques were used to determine the cell
      lineage differentiation expressed in 29 primary exocrine pancreatic
      adenocarcinomas, five metastatic exocrine pancreatic adenocarcinomas, and five
      islet cell neoplasma. Specimens of normal pancreas and chronic pancreatitis were
      used for comparison. The cell lineage markers consisted of monoclonal and
      polyclonal antibodies against trypsin and lipase (acinar cells); secretory
      component, carbonic anhydrase II, and pancreatic cancer mucin SPan-1 (ductal
      cells); and chromogranin-A and somatostatin (islet cells). The expression of
      carcinoembryonic antigen (CEA) and lysozyme were also determined. This collection
      of markers allowed the differentiation between acinar, ductal, and islet cells of
      normal pancreas and chronic pancreatitis specimens. The expression of cell
      lineage markers in islet cell tumors was homogeneous and restricted to
      chromogranin-A. In contrast, the expression of these markers in primary and
      metastatic exocrine pancreatic adenocarcinomas was variable. Reactivity with
      monoclonal anti-CEA was absent in normal pancreas, and was present in 83% of
      chronic pancreatitis specimens as well as 90% of exocrine pancreatic
      adenocarcinomas. In addition, lysozyme reactivity was absent in normal pancreas;
      however, lysozyme was expressed in one case of chronic pancreatitis, 17 cases of
      primary carcinoma, and three cases of metastatic carcinoma. These findings
      support the concept that the original transformed cell type in many pancreatic
      exocrine carcinomas resemble endodermal "stem cells" that retain the capability
      of differentiation along more than one cell lineage pathway.

PMID- 2224769
TI  - Expression of pancreatic secretory trypsin inhibitor gene in human colorectal
      tumor.
AB  - Expression of pancreatic secretory trypsin inhibitor (PSTI) gene was examined by
      Northern blotting analyses in 31 human colorectal tumors that included two benign
      adenomas and 26 adenocarcinomas. Among the total of 28 cases which proved to be
      adequate for mRNA analyses, all but one showed the expression of PSTI at various
      levels. In contrast, PSTI expression was not detected in two malignant lymphomas
      of the rectum. The level of PSTI expression was not correlated with the patient's
      age, sex, tumor location or size, stage of differentiation, lymph node
      metastasis, or progression stage. Some colorectal adenocarcinomas were also shown
      to express genes that can hybridize with human trypsinogen cDNA probe. It looks
      as though in these tumors, a protease(s) and its inhibitor are produced
      simultaneously as part of a cellular self-defense mechanism.

PMID- 2224770
TI  - An analysis of abnormalities of the retinoblastoma gene in human ovarian and
      endometrial carcinoma.
AB  - The altered expression of the human retinoblastoma (RB) gene has been
      demonstrated to play an important role in the pathogenesis of RB and other
      tumors. To determine whether the RB gene might be involved in the pathogenesis of
      human ovarian and endometrial cancer, DNA from 24 human ovarian tumors, 3 normal
      ovaries, 3 endometrial carcinomas, and 1 endometrial hyperplasia was examined
      with an RB complementary DNA probe. Evidence for homozygous deletion of the RB
      gene was observed in only one specimen. Interestingly, the specimen was an
      endometrioid tumor of the ovary of low malignant potential (LMP). This patient
      experienced rapid progression of the tumor and died 8 months after diagnosis.
      Abnormalities of the RB gene may be involved in the aggressive biologic behavior
      of certain forms of ovarian carcinoma, particularly those of LMP.

PMID- 2224771
TI  - Distribution of immunoglobulins and secretory component in gastric cancer of the
      aged.
AB  - The secretory immune system plays an important role in the local humoral immunity
      of the gastrointestinal tract. In order to evaluate humoral immunity in gastric
      cancer, distribution of immunoglobulins (Ig) and secretory component was
      immunohistochemically studied in 74 early and 15 advanced primary gastric
      cancers. In non-cancerous gastric mucosa, IgA and IgM, and secretory component
      were mainly identified in the cytoplasm of the intestinal metaplasia. In early
      gastric cancer of well-differentiated type, the localization of IgA and IgM, and
      secretory component was similar to that of intestinal metaplasia. In advanced
      gastric cancer, they were faintly observed and showed low positivity. The number
      of Ig-containing cells infiltrating cancerous stroma was enumerated.
      Immunoglobulin A-containing cells were dominant in the stroma of early gastric
      cancer. On the other hand, there were few Ig-containing cells in the stroma of
      advanced gastric cancer, and the number of IgA-containing and IgM-containing
      cells was also decreased. These results suggest that local humoral immunity is
      suppressed in gastric cancer, especially in advanced gastric cancer.

PMID- 2224772
TI  - DNA analysis of multiple synchronous renal cell carcinomas.
AB  - The authors used retrospective quantitative DNA analysis to study
      interrelationships between multiple synchronous renal cell carcinomas in seven
      patients. DNA content was determined by image analysis on Feulgen-stained nuclear
      smears prepared from multiple paraffin blocks from each tumor. Tumors were
      unilateral in four cases and bilateral in three. Ten tumors had homogeneous, and
      four heterogeneous DNA stemlines. Intertumoral heterogeneity in four cases
      suggested multifocal origin. Identical DNA aneuploid indices in bilateral tumors
      in one case suggested metastasis from a solitary origin. Abnormal DNA content and
      heterogeneous populations began to appear in the size range 2.0 to 5.0 cm. All
      tumors over 5.0 cm contained nondiploid populations. Although the
      interrelationships between these multiple synchronous neoplasms are not entirely
      clear, the DNA analysis suggests that the occurrence of nondiploid stemlines and
      heterogeneous DNA content may parallel both tumor growth and more aggressive
      behavior.

PMID- 2224774
TI  - Hyperthermia alone in the treatment of recurrences of malignant tumors.
      Experience with 60 lesions.
AB  - Localized hyperthermia alone has been used for the treatment of cancer
      recurrences in which previous conventional therapies have failed. Since 1983 and
      1988, 57 patients with 60 lesions have been heated by means of a microwave and
      radiofrequency system. Treatment protocol provided 45 minutes of heating at the
      intratumor temperature of at least 42 degrees C, twice a week, for a total number
      of six, eight, or ten heating sessions. Invasive intratumor thermometry was
      performed for all lesions. Complete response (CR) was obtained in ten cases
      (16.6%) and partial response (PR) in 14 (23.4%). Higher rates of CR were observed
      in the chest wall (38.5%) compared with the head and neck area (11.4%), trunk
      (10%), and limbs (none). Adenocarcinoma was the most responsive histologic type
      (40%). Squamous cells carcinoma had 7.7% CR. The only case of undifferentiated
      carcinoma showed CR; there were none on five sarcomas. Long-term local control
      (24 months) was approximately 7%. The multivariate analysis showed the
      statistical significance of the histologic variety (adenocarcinoma versus others,
      P less than 0.0001). Side effects and complications of the treatment were
      minimal.

PMID- 2224773
TI  - Giant cell tumor of bone. A clinicopathologic and DNA flow cytometric analysis.
AB  - Flow cytometric DNA analysis was performed on 60 cases of giant cell tumor of
      bone and the results were correlated with the clinicopathologic features. Tumors
      studied were from 31 men and 29 women whose ages ranged from 18 to 62 years
      (median, 29 years). The most common sites were the distal end of the femur and
      proximal end of the tibia, accounting for 75% of the lesions. Treatment consisted
      of resection in 29 patients (48%), curettage with bone chip packing in 15
      patients (25%), or curettage with cement packing in 16 patients (27%). Ten
      patients (17%) had local relapse within 1 to 3 years, and two had lung
      metastases. Forty-two patients (70%) exhibited tumors with a diploid DNA content,
      16 aneuploid (27%), and two tetraploid (3%). Six (37.5%) of the aneuploid
      patients had relapses: one of those had been treated by resection of the tumor
      and five by curettage. Of the remaining ten (62.5%) unrelapsed aneuploid
      patients, nine had been treated by resection of the tumor and one by curettage.
      Four of the 42 diploid patients (9.5%) had relapses; all had been treated by
      curettage of the tumor. The two tetraploid tumors were treated by resection and
      none relapsed. Histologic parameters did not correlate with relapse rate or DNA
      pattern. Although relapse was more common among aneuploid tumors, our study shows
      that this appears to be influenced by the treatment modality rather than the
      ploidy status. Based on this study the DNA analysis of giant cell tumor of bone
      has a limited utility for predicting the tumor's biologic behavior.

PMID- 2224775
TI  - Time trends in Hodgkin's disease incidence. The role of diagnostic accuracy.
AB  - A prior study of Hodgkin's disease (HD) incidence using national cancer survey
      data (1969-1980) identified unprecedented rate declines among white persons older
      than 40 years, and rate increases among young adults aged 15 through 39. These
      trends could be due to improved diagnostic accuracy. To investigate this
      hypothesis, the authors updated incidence rates in whites by age, sex, and
      histologic subtype through 1984; quantified diagnostic accuracy in corresponding
      detail using Repository Center for Lymphoma Clinical Studies data, which include
      original and expert review diagnoses on lymphoma patients; and recalculated HD
      incidence rates (1969-1984) corrected for diagnostic error. Updated HD incidence
      rates through 1984 continued to decline in older adults and showed persistent
      increases for young adults with the nodular sclerosis (NS) histologic subtype.
      The percentage of original HD diagnoses confirmed on review (confirmation rate)
      decreased with age and increased over time; in older adults, these patterns
      opposed observed incidence trends. However, for young adults, confirmation rates
      of NS, the most common subtype at these ages, were high and changed little over
      time. After adjustment for diagnostic error, incidence rates for older adults
      were lower than previously observed and showed no secular changes. However, young
      adults with NS had slightly larger rate increases than in uncorrected data. Thus,
      contemporary changes in HD incidence for whites primarily involve growing risk to
      persons at the start of adult life. These patterns are compatible with trends in
      suspected sociodemographic risk factors that suggest an infectious etiology for
      HD.

PMID- 2224776
TI  - Nasal lymphoma. A retrospective analysis of 60 cases.
AB  - Sixty cases of nasal lymphomas were reviewed. There were 42 men and 18 women. The
      median age was 49 years. The histologic types were low grade in four cases,
      intermediate grade in 33, high grade in seven, and unclassifiable in 16. Thirteen
      cases had features of polymorphic reticulosis. The immunophenotype was available
      in 18 cases and a majority of 67% of them were T-cell. Forty-one of them (68%)
      had clinically localized (Stage I and II) disease which often spread locally to
      neighboring tissues and they presented predominantly with nasal symptoms. Nasal
      lymphoma appeared to carry a poor prognosis. Although our patients with
      clinically localized disease had significantly better prognosis than those with
      advanced disease, the 5-year survival of Stage I and II patients was only 55%.
      Chemotherapy did not appear to be more effective than radiotherapy alone in
      preventing relapses but the patient number was too small to allow a firm
      conclusion to be made. Patients with advanced disease had even poorer prognosis
      with a 5-year survival of only 17%. Innovative therapy has to be developed for
      these patients.

PMID- 2224777
TI  - Clear cell adenocarcinoma of the lower genital tract. Correlation of mother's
      recall of diethylstilbestrol history with obstetrical records.
AB  - The written obstetric records of maternal exposure to diethylstilbestrol (DES)
      were used as a criterion standard and compared with the DES exposure history
      recalled by mothers of women with vaginal, cervical, or indeterminable
      vaginal/exocervical clear cell adenocarcinoma. Among cervical cases, the
      sensitivity of maternal recall was 50% (N = 2), and its specificity was 100%.
      Among vaginal and vaginal/exocervical cases, this sensitivity was 72%;
      specificity was 60%; and the majority of these mothers who said they did not take
      DES were DES positive by written records. Thus investigators should avoid using
      maternal recall alone to measure DES exposure. Among subjects for whom written
      maternal obstetric records were available, 88% of vaginal cases and 46% of
      cervical cases were DES positive. The authors conclude that few cases of vaginal
      clear cell adenocarcinoma should occur in young women as the cohort of women
      exposed in utero to DES continues to age, whereas cases of cervical origin may
      continue to occur.

PMID- 2224778
TI  - Multiple spinal metastases from paraganglioma.
AB  - Isolated vertebral body metastases from paraganglioma are exceedingly rare. They
      have been reported to occur in the presence of active primary tumor in the neck,
      local recurrence, or widespread metastases. A unique case of carotid body tumor
      (paraganglioma) is reported with the following features: (1) multiple vertebral
      body metastases (C6, T9, and L3) presenting with spinal cord compression, and no
      evidence of local recurrence or other metastatic disease; (2) absence of mitoses
      on the original specimen or the metastatic deposit; and (3) a prolonged interval
      (9 years) to the development of symptomatic metastases.

PMID- 2224779
TI  - Genetic diagnosis of Lynch syndrome II in an extended colorectal cancer-prone
      family.
AB  - Knowledge of colon cancer genetics, with particular attention to precision in
      hereditary cancer syndrome diagnosis, can often enable highly targeted
      surveillance and management strategies for patients at high genetic risk.
      Unfortunately, the patient's family history of cancer is often given minimal
      attention, and knowledge of hereditary cancer syndromes is frequently limited.
      Indeed, many physicians still consider familial adenomatous polyposis (FAP) as
      the only genetic risk factor for colorectal cancer. This concern with FAP was
      noted in a colorectal cancer-prone kindred which for decades had been thought to
      manifest that syndrome. However, after meticulous genetic, medical, and
      pathologic studies, the cardinal phenotypic characteristics of Lynch syndrome II
      were observed. The potential for cancer control in current and future generations
      of families like this one clearly mandates the need for computerized registries
      which could transmit current information about hereditary colon cancer syndrome
      diagnosis, surveillance, and management.

PMID- 2224780
TI  - Cancer in the families of children with soft tissue sarcoma.
AB  - The cancer experience among 754 first-degree relatives (mothers, fathers, and
      siblings) of a population-based series of 177 children with soft tissue sarcoma
      is reported. The current study represents an extension of our earlier work in
      which the authors found an excess of breast cancer in the mothers of 143 of these
      children. There were 40 cancers among all first-degree relatives, compared with
      24.82 expected (relative risk [RR] 1.61, P = 0.006). There was no excess in
      fathers, but an excess of borderline significance was seen in mothers (RR 1.67, P
      = 0.0545), and a significant excess in siblings (RR 4.55, P = 0.0002), mainly due
      to carcinoma of the breast and pediatric tumors. Results of a step forward Cox
      multivariate analysis identified three variables in the index child which were
      independently associated with high cancer risk in relatives, as follows: age
      younger than 24 months at diagnosis; histologic type, embryonal rhabdomyosarcoma
      or other and unspecified soft tissue sarcoma; and male sex. It was possible,
      therefore, to identify a subgroup of children whose relatives are at high risk of
      early onset cancer (RR in this group 10.14). The pattern of cancers is consistent
      with the Li-Fraumeni syndrome. The authors conclude that a marked proportion of
      childhood soft tissue sarcoma has a genetic basis.

PMID- 2224781
TI  - Cholecystectomy and right colon cancer in Puerto Rico.
AB  - A case-control study was undertaken to evaluate the possible relationship between
      cholecystectomy and right colon cancer. Two hundred patients with adenocarcinoma
      of the cecum or ascending colon (diagnosed between 1984 and 1989) were compared
      with 200 matched neighborhood controls. Cholecystectomy history was obtained
      through interviews using structured questionnaires and subsequently validated
      from hospital records. A statistically significant association (odds ratio =
      2.14) was found between right colon cancer and a history of prior
      cholecystectomy. The altered bile metabolism which occurs after removal of the
      gallbladder may have a carcinogenic effect on the right colon. Dietary habits of
      the colon cancer patients in our study were consistent with prior reports in the
      literature, showing that this group has a lower intake of vegetables and cereal
      fiber than the control population.

PMID- 2224782
TI  - Concomitant cisplatin chemotherapy and radiotherapy in advanced mucosal squamous
      cell carcinoma of the head and neck. Long-term results of the Radiation Therapy
      Oncology Group study 81-17.
AB  - One hundred twenty-four eligible patients with advanced mucosal squamous cell
      carcinoma of the head and neck were entered into a pilot study of concomitant
      cisplatin (100 mg/m2 given every 3 weeks for three doses) and standard
      irradiation. The initial complete response (CR) was 71% with an additional two
      cases salvaged by surgery for an overall 73% CR. When no keratin was identified
      in the histologic specimen (41 patients) the CR was 90%. The nasopharynx showed
      the best CR (89%) among the sites. At 4 years after treatment, the estimated
      locoregional tumor control rate was 43% and the survival, 34%. When no keratin
      was present in the specimen, the estimated locoregional control of tumor was
      superior (56% versus 38% with keratin identified, P = 0.02) and the estimated
      survival was also superior (48% versus 26%, P = 0.008). Acute treatment-related
      toxicities included one death due to renal damage and two patients with life
      threatening renal damage. The delivery of radiotherapy was not altered. Late
      toxicity included necrosis -3%, fibrosis -4%, and one fistula. The results of
      this study justify a randomized trial for the comparison of this combination of
      cisplatin and radiotherapy versus radiotherapy alone in advanced mucosal
      carcinomas of the head and neck.

PMID- 2224783
TI  - Final report of the French multicenter phase II study of the nitrosourea
      fotemustine in 153 evaluable patients with disseminated malignant melanoma
      including patients with cerebral metastases.
AB  - One hundred sixty-nine patients with histologic evidence of disseminated
      malignant melanoma, including patients with cerebral metastases, were entered
      into a Phase II study of the nitrosourea fotemustine. The treatment regimen
      consisted of a 100 mg/m2 1 hour IV infusion every week for 3 consecutive weeks,
      followed by a 4- to 5-week rest period (induction therapy). In responding or
      stabilized patients, maintenance therapy consisted of 100 mg/m2 every 3 weeks
      until the disease progressed. One hundred fifty-three patients were evaluable for
      response. Three complete responses and 34 partial responses were observed
      (according to the World Health Organization criteria), leading to an objective
      response rate of 24.2% (95% confidence interval: 17.4% to 31.0%). Responses were
      also documented on cerebral (25.0%), visceral (19.2%), or nonvisceral (31.8%)
      metastatic sites. The median duration of response was 22 weeks (range, 7 to 80
      weeks). The objective response rate in previously untreated patients was 30.7%
      (19 of 62 patients). The main toxicity was hematologic with delayed and
      reversible leukopenia and/or thrombopenia. The objective response rate observed
      (especially in untreated patients), the activity on cerebral metastases, and the
      small amount of extra-hematologic toxicity encountered suggest that fotemustine
      is an effective drug in disseminated malignant melanoma.

PMID- 2224784
TI  - Treatment of advanced neuroblastoma with emphasis on intensive induction
      chemotherapy. A report from the Study Group of Japan.
AB  - One hundred nine newly treated patients with advanced neuroblastoma were entered
      in this study between January 1985 and May 1989. The eligible patients included
      infants younger than 12 months of age with Stage IVA disease (bone cortex,
      distant lymph node, and/or remote organ metastases) and patients aged 12 months
      or older with Stage III or IV disease (IVA plus IVB with tumor crossing the mid
      line and with metastases confined to bone marrow, liver, and skin). The patients
      first received six cyclic course of intensive chemotherapy (regimen A1),
      consisting of cyclophosphamide (1200 mg/m2), vincristine (1.5 mg/m2),
      tetrahydropyranyl adriamycin (pyrarubicin; 40 mg/m2), and cisplatin (90 mg/m2).
      Original tumors and the regional lymph node metastases were removed some time
      during these first six cycles of chemotherapy. The patients were further divided
      into three groups. Patients in course 1 received alternating treatment by regimen
      B (cyclophosphamide and ACNU) and intensified regimen A1, and those in course 2
      were treated with alternating administration of regimen C (cyclophosphamide and
      DTIC) and intensified A1. Patients in course 3 were treated with bone marrow
      transplantation (BMT) preceded by high-dose preconditioning chemotherapy.
      Survival rates were 77% in Stage III and 54% in Stage IV at 2 years, and 70% in
      Stage III and 45% in Stage IV at 3 years. The major toxicities encountered were
      bone marrow suppression with leukocyte counts down to 100/mm3, mild cystitis, and
      hearing impairment. The 2-year survival rate was 78% in 21 patients who underwent
      BMT when complete remission was achieved. We concluded that our intensive
      induction chemotherapy is of significant value in increasing the rate of complete
      response, and in widening the indications for and achieving improved results of
      treatment with BMT.

PMID- 2224785
TI  - Toxic dermatitis induced by 10-ethyl-10-deaza-aminopterin (10-EdAM), a novel
      antifolate.
AB  - A new methotrexate analog, 10-ethyl-10-deaza-aminopterin (10-EdAM), was found to
      induce a particular form of skin toxicity different than the skin rash reported
      to result from methotrexate. At histologic examination, it was found to be a
      toxic dermatitis that clinically most often first appears on the lower legs but
      can occur anywhere in the body, especially if treatment is continued. Nine cases
      are reported. A specific risk factor could not yet be identified. Discontinuation
      of 10-EdAM administration leads to complete healing; concomitant corticosteroid
      treatment also induces healing.

PMID- 2224786
TI  - Chemotherapy-related hemolytic-uremic syndrome after the treatment of head and
      neck cancer. A case report.
AB  - A 62-year-old woman who was being treated for squamous cell carcinoma of the head
      and neck developed a chemotherapy-related hemolytic-uremic syndrome during the
      second cycle of neoadjuvant chemotherapy consisting of cisplatin, bleomycin, and
      methotrexate. Though the syndrome was suspected early, attempts at reversing the
      hematologic and renal abnormalities were unsuccessful. At postmortem examination,
      the characteristic microvascular lesions of the hemolytic-uremic syndrome were
      found in the kidneys.

PMID- 2224787
TI  - Primary carcinoma of the upper urinary tract. Effect of primary and secondary
      therapy on survival.
AB  - The pathologic material and medical records of 76 patients with primary upper
      urinary tract carcinomas were reviewed to identify the role of grade and stage in
      predicting survival; to determine any differences in survival between ureteral
      and renal pelvic carcinoma; to understand the role of local therapy in low grade,
      low stage tumors; and to establish the usefulness of adjuvant therapies in
      metastatic disease. Kaplan-Meier survival curves with Cox-Mantel analysis for
      statistical significance revealed both grade and stage to be excellent predictors
      of survival. No differences in survival were noted between renal pelvic and
      ureteral carcinomas for equivalent stage tumors. For low grade, low stage tumors,
      although there was an increased risk of local recurrence with local therapy,
      there were no differences in survival between patients treated with local therapy
      or radical surgery. Finally, cisplatin-based chemotherapy seemed to improve
      survival in patients with metastatic disease.

PMID- 2224788
TI  - Osteosarcoma of the maxilla in Hong Kong Chinese postirradiation for
      nasopharyngeal carcinoma. A report of four cases.
AB  - Postirradiation osteosarcoma of the maxilla was seen in four Hong Kong Chinese
      patients treated for nasopharyngeal carcinoma. These cases represent four of 42
      (9%) cases of osteosarcoma at all sites in this institution during the period
      1979 to 1989, when more than 1000 patients were treated with radiotherapy for
      nasopharyngeal carcinoma. The latent periods varied from 8 to 11 years from
      completion of radiotherapy treatment to development of osteosarcoma. The
      radiation dosage varied from 6000 to 6280 cGy in three of the patients. These
      cases fit the criteria for diagnosis of postirradiation sarcomas. Maxillary
      osteosarcomas after irradiation for nasopharyngeal carcinoma do not appear to
      have been described. The very high incidence of nasopharyngeal carcinoma (for
      which radiotherapy is the treatment of choice) in Hong Kong Chinese would make
      the occurrence of such tumors more likely in Hong Kong, although the small risk
      does not contraindicate the use of radiation in the treatment of nasopharyngeal
      carcinoma in view of its well-documented efficacy.

PMID- 2224789
TI  - Perinatal infection of human T-lymphotropic virus type I, the etiologic virus of
      adult T-cell leukemia/lymphoma. DNA amplification of specific human T
      lymphotropic virus type I sequences.
AB  - A gene amplification technique, polymerase chain reaction, was used to detect
      human T-lymphotropic virus type I (HTLV-I), the etiologic agent of adult T-cell
      leukemia/lymphoma, in mononuclear cells in peripheral blood and breast milk of
      ten HTLV-I carrier gravida. The DNA in umbilical cord blood mononuclear cells of
      the neonates born to the HTLV-I carrier gravida were also amplified and examined
      for the possibility of HTLV-I infection via placenta during pregnancy. The HTLV-I
      sequences were detected both in the peripheral blood and milk of all ten carrier
      gravida by Southern blot analysis of amplified DNA. However, HTLV-I proviral DNA
      could not be detected in the cord blood of the carriers' neonates, indicating
      that transplacental infection of HTLV-I should be rare and that postpartum
      infection via breast milk is a likely major perinatal transmission route.

PMID- 2224790
TI  - Immune deficiency in family members of patients with Hodgkin's disease.
AB  - Indirect data supporting a preexisting immunologic impairment in patients with
      Hodgkin's disease (HD) have been presented in recent years. These immunologic
      defects are supposed to be related to genetic and/or environmental factors. In
      this study, 65 first-degree relatives and 12 spouses of 21 consecutive patients
      with HD were studied immunologically. Furthermore, seven twin pairs in which one
      partner had HD and four additional nonmatched healthy co-twins were also included
      in the study. A decreased lymphocyte DNA synthesis induced by Concanavalin A, a
      high spontaneous DNA synthesis, or a low CD4+/8+ ratio was found in 21 (32%)
      consanguineous, two (17%) nonconsanguineous relatives, and five (50%) healthy co
      twins. The corresponding figures for the untreated patients with HD and the
      control series were 14 of 21 (65%) and 21 of 127 (16%), respectively. Total
      lymphocyte counts or lymphocyte subpopulations did not differ between HD
      relatives and controls. The increased frequency of blood lymphocyte defects among
      consanguineous first-degree relatives favors the existence of a genetically
      determined immune deficiency in at least a proportion of apparently healthy
      relatives of patients with HD. However, nongenetic factors such as age and
      environment may add to the defect.

PMID- 2224791
TI  - Impaired production of tumor necrosis factor in breast cancer.
AB  - Spontaneous and lipopolysaccharide (LPS)-induced production of tumor necrosis
      factor (TNF) by peripheral blood macrophages was investigated in breast cancer.
      Whereas spontaneous TNF production by macrophages derived from patients with
      breast cancer was comparable with the one found in healthy controls (P greater
      than 0.1), LPS-stimulated macrophages derived from patients in the disease-free
      interval as well as with metastatic breast cancer were found to produce
      significantly lower amounts of TNF, as compared with macrophages derived from
      healthy control individuals (P less than 0.0005). However, the production of TNF
      did not significantly differ between the two patient populations (P greater than
      0.05). The impairment of LPS-induced TNF production did not depend upon such
      characteristics of the primary tumor as size, axillary lymph node and estrogen
      receptor status, or upon the fact of administration of adjuvant chemotherapy and,
      in patients with metastatic disease, hormone treatment. To further investigate
      cytokine production by macrophages, spontaneous and LPS-induced interleukin-1 (IL
      1) production was investigated also. However, no difference was found between
      patients and controls concerning IL-1 generation. The authors thus conclude that
      LPS-induced TNF production was impaired in breast cancer independent of the
      presence of detectable metastatic disease, whereas IL-1 production remained
      unimpaired.

PMID- 2224792
TI  - Possible involvement of the retinoblastoma gene in undifferentiated sinonasal
      carcinoma.
AB  - Retinoblastoma tumor formation is initiated by the loss of function of both
      alleles of the RB-1 gene on chromosome 13. Patients with the hereditary form of
      retinoblastoma carry a germ line mutation at one of the two homologous gene loci
      in all cells and have an increased risk for nonocular tumors (mainly osteosarcoma
      and other mesenchymal tumors) in later life. The authors studied a 38-year-old
      patient with sinonasal undifferentiated carcinoma (SNUC) who had been treated for
      bilateral retinoblastoma by enucleation (left eye) and irradiation (right eye),
      respectively. Using molecular probes for the RB-1 gene and other loci on
      chromosome 13, the authors detected a deletion at the RB-1 locus in metastatic
      SNUC cells that was not present in normal tissue. These findings indicate that
      somatic mutations at RB-1 locus may be involved in the formation or progression
      of ectodermal tumors.

PMID- 2224793
TI  - Sialosyl-Tn. A novel mucin antigen associated with prognosis in colorectal cancer
      patients.
AB  - Colon cancers typically produce mucin. However, it is not known whether tumor
      mucin plays a biological role in cancer cell behavior. To address this issue, the
      expression of a mucin-associated antigen, sialosyl-Tn, was examined by
      immunohistochemical study in 128 primary colorectal carcinoma specimens from 137
      patients who underwent curative surgical resection. Antigen expression was
      correlated with disease-free and overall 5-year survival. Sialosyl-Tn antigen
      expression occurred in 112 (87.5%) tumors, and was independent of age, gender,
      tumor location, Dukes' stage, depth of invasion, degree of differentiation, and
      ploidy status. Survival at 5 years for patients with sialosyl-Tn-negative versus
      sialosyl-Tn-positive tumors was 100% versus 73% (P less than 0.05) and disease
      free survival was 94% versus 73%, respectively (P = 0.12). Although more advanced
      Dukes' stage, deeper invasion, and aneuploidy were all associated with poorer
      overall 5-year survival, antigen-negative tumors within each of these groups had
      much better prognoses than antigen-positive tumors. Multivariate regression
      analysis revealed that tumor ploidy (P less than 0.001) and sialosyl-Tn
      expression (P less than 0.05) were the two variables of most importance for
      predicting both disease-free and overall survival. The authors conclude that
      sialosyl-Tn expression is an independent predictor of poor prognosis in colon
      cancer, and therefore suggest that qualitative mucin alterations may reflect
      important differences in the biological behavior of these neoplasms.

PMID- 2224794
TI  - Characterization of epidermal growth factor receptor in normal and neoplastic
      human endometrium.
AB  - Growth factors, including epidermal growth factor (EGF), have been implicated in
      the growth of several types of cancer. This study compares EGF receptors in
      normal and neoplastic endometrium. Membrane fractions were isolated from surgical
      specimens. Radioreceptor assays demonstrated the presence of receptors with a
      dissociation constant of 0.64 nmol/l in normal endometrium. Affinity cross
      linking revealed receptor molecular weight of 150 to 170 kiloDaltons (KD). A
      survey of samples (n = 37) revealed progressive decrease of EGF receptors in
      cancers of increasing grade: Grade 1-2 adenocarcinoma decreased 34% from control
      (n = 6, P less than 0.01), whereas Grade 3 adenocarcinoma decreased 90% (n = 7, P
      less than 0.01) and sarcoma decreased by 72% (n = 3, P less than 0.01). The
      dissociation constant and molecular weight of the receptor in neoplastic
      endometrium did not differ significantly from normal. The inverse relationship
      with grade suggests receptor alteration or down regulation by hormones and/or
      growth factors.

PMID- 2224796
TI  - Increased expression of the multidrug-resistance gene in undifferentiated
      sarcoma.
AB  - We analyzed multidrug-resistance gene (mdr1 gene) expression in a patient with
      undifferentiated sarcoma of the liver using the cloned cDNA for the mdr1 gene.
      Tissue samples were available at the time of initial diagnosis and of two
      intracranial relapses after chemotherapy with a regimen including doxorubicin and
      teniposide. The level of mdr1 gene expression was increased sevenfold in the
      intracranial tumor at the time of first relapse and 11-fold at the second
      relapse. This case may be an example of acquired multidrug resistance associated
      with overexpression of the mdr1 gene.

PMID- 2224795
TI  - Parathyroid hormone-like peptide in normal and neoplastic mesothelial cells.
AB  - Mesothelioma has not been commonly reported as a cause of hypercalcemia of
      malignancy. We have studied a patient with malignant mesothelioma and
      hypercalcemia in association with elevated plasma concentrations of parathyroid
      hormone-like peptide (PLP). Immunohistochemical analysis of the tumor and seven
      of eight other mesotheliomas that were not associated with hypercalcemia revealed
      the presence of PLP cytoplasmic immunopositivity. PLP immunopositivity was also
      detected in normal and reactive mesothelial cells. The results of these studies
      suggest that PLP immunoreactivity is common in normal and neoplastic mesothelial
      cells and raises the possibility that PLP production may play a role in the
      pathogenesis of hypercalcemia associated with mesothelioma.

PMID- 2224797
TI  - Non-Hodgkin's lymphoma in the elderly. I. Pathologic features at presentation.
AB  - The pathologic findings of 118 patients aged 70 years or older with non-Hodgkin's
      lymphoma (NHL) are reported. These patients formed 27.2% of 433 consecutive cases
      of NHL seen in a single institution over a 5-year period. Thirty-one of 433 NHL
      cases were histologically not classified, whereas the remaining 402 could be
      classified according to the International Working Formulation (WF) of NHL for
      clinical usage. Immunophenotypic analyses were carried out in 112 NHL cases; of
      this group 28 were NHL in elderly patients. Of the 95 elderly NHL that could be
      classified in the histologic categories of the WF 28 cases were in the low-grade,
      41 in the intermediate-grade, and 26 in the high-grade categories. Eighty-one
      cases had diffuse histologic types and 14 had follicular/nodular histologic
      types. Thirty-five cases were of the G (diffuse large cell) + H (large cell,
      immunoblastic) categories. No significant differences in the prevalence of the
      different subtypes were observed among patients younger or older than 70 years.
      Immunohistologically, most NHL cases in the elderly expressed B-cell phenotype.
      Sixty-two NHL in the elderly were extranodal at presentation. The results of this
      study indicate that elderly patients form a relevant proportion of patients
      developing NHL and thereby present a very difficult management problem. The
      pathologic features of NHL in the elderly does not differ significantly from
      those of their younger counterparts, although an increase in diffuse versus
      follicular histologic patterns, and in extranodal versus nodal disease was
      observed with advancing age.

PMID- 2224798
TI  - Diffuse intermediate lymphocytic lymphoma. A clinicopathologic study and
      comparison with small lymphocytic lymphoma and diffuse small cleaved cell
      lymphoma.
AB  - Controversy has recently arisen as to whether diffuse intermediate lymphocytic
      lymphoma (ILL) should be considered a low-grade or an intermediate-grade non
      Hodgkin's lymphoma for clinical purposes. Therefore, the authors performed a
      clinicopathologic study to determine the biologic course of diffuse ILL (40
      cases) and compared it with small lymphocytic lymphoma (SLL; 51 cases) and
      diffuse small cleaved cell lymphoma (DSCCL; 14 cases). They found that patients
      with diffuse ILL having pseudofollicular proliferation centers (PC) had a
      significantly longer median survival (84 months) than those without PC (46.5
      months; P = 0.03). The median survival of patients with SLL was 72 months,
      whereas those with DSCCL had a median survival of only 18 months. Based on these
      findings, the authors conclude that diffuse ILL with PC should be included in the
      low-grade category of SLL for clinical purposes, whereas diffuse ILL without PC
      (true diffuse ILL) should be considered an intermediate-grade non-Hodgkin's
      lymphoma. True diffuse ILL is similar to centrocytic lymphoma in the Kiel
      classification and should be accorded a similar status in a modified Working
      Formulation.

PMID- 2224799
TI  - Cerebral tumor staging in patients with bronchial carcinoma by computed
      tomography.
AB  - Computerized tomographic (CT) scans of 271 patients with histologically proven
      bronchial carcinoma accomplished for initial tumor staging were retrospectively
      evaluated for signs of cerebral metastasis. The results for the histologic
      subtypes were quite different. In 13.8% of patients with small cell carcinoma and
      limited disease the authors found signs of brain metastasis. However, routine
      cerebral staging in these patients did not seem to be useful because of lack of
      therapeutic consequences. On the other hand, no patient with non-small cell
      carcinoma (N-SCC) and tumor Stage I or II had brain metastases. All patients with
      brain metastasis from N-SCC had been classified as tumor Stage III before
      cerebral imaging. Among these patients, however, the authors found brain
      metastasis in 17.5% of those without known distant metastatic disease (III/M0),
      especially in large cell carcinoma and in adenocarcinoma. Stage III/M0 patients
      should undergo routine cerebral imaging if their tumor is surgically resectable
      and thoracotomy is planned.

PMID- 2224800
TI  - Infiltration of dendritic cells in relation to tumor invasion and lymph node
      metastasis in human gastric cancer.
AB  - The infiltration of dendritic cells determined in 210 patients with gastric
      carcinoma was investigated from the standpoint of tumor invasion, lymph node
      metastasis, and prognosis. Dendritic cell infiltration was graded as "slight" and
      "marked." The 39% frequency in the marked infiltration group at the mucosal stage
      did not change in proportion to invasion into the deeper layers. The 5-year
      survival rate was 60.4% in patients with marked infiltration and 38.8% in those
      with slight infiltration, which was statistically different (P less than 0.01).
      The difference in survival rates was only statistically significant in those with
      cancer emerging from the serosa (P less than 0.001). There was a similar
      incidence of lymph node metastasis between the marked and slight infiltration
      groups in each grade of tumor invasion. However, marked infiltration of dendritic
      cells prevented widespread nodal involvement beyond the primary node in cases of
      advanced carcinoma (P less than 0.05). These findings indicate that infiltrating
      dendritic cells do not prevent the spread of tumor invasion but do prevent nodal
      involvement; therefore, for patients with a gastric cancer emerging from the
      serosa, the prognosis will be good.

PMID- 2224801
TI  - Thromboembolism. A complication of weekly chemotherapy in the treatment of non
      Hodgkin's lymphoma.
AB  - In a retrospective survey of 85 patients who received chemotherapy as treatment
      for non-Hodgkin's lymphomas, the authors found that clinically apparent
      thromboembolic disorders occurred in four of 11 patients receiving weekly
      chemotherapy, and in none of 74 patients who were treated on less intensive
      schedules, suggesting that intensive weekly chemotherapy is thrombogenic. The
      possible mechanisms of this effect are discussed.

PMID- 2224802
TI  - Predicting distant metastases in operable breast cancer patients.
AB  - Risk factors for distant metastases following mastectomy and axillary node
      dissection for breast cancer were analyzed in a review of 1022 women. From
      diagnosis until the end of the adjuvant treatment, six stages were identified
      that corresponded well to patient data acquisition. At each stage, a prognosis
      study based on the Cox model was carried out using all acquired information from
      the first stage. The results demonstrated that tumor size, nuclear pleomorphism,
      mitotic index, and nodal status at the top of axilla were stable independent risk
      factors in predicting metastasis-free survival (MFS). These analyses also
      revealed those factors that were significantly related to MFS at one or several
      stages and losing their significance at a subsequent stage. This was the case
      with clinical node status, age, and vascular tumor emboli. Other factors such as
      estrogen, progesterone, histologic grade, and clinical stage were never
      identified as independent factors at any stage. The four major stable risk
      factors were used to define a stratification of reference. The results
      demonstrated that the mere knowledge of clinical information such as tumor size,
      clinical node status, and age would enable 51% of the patients to be universally
      well classified according to that stratification. Knowledge of additional
      factors, such as nuclear pleomorphism and mitotic index, would bring the rate up
      to 61%, and then to 64% if supplementary information such as vascular tumor
      emboli were acquired. These percentages did not appear high enough to claim that
      the physician may make a reliable prognosis of operable breast cancer patients
      before acquiring information from the axillary node dissection. However, it was
      proven that there exist some subsets of patients with stable prognosis, i.e.,
      subsets of patients who will belong permanently to the same risk group through
      the stages.

PMID- 2224803
TI  - Familial testicular cancer in five members of a cancer-prone kindred.
AB  - Of a family of 13 siblings, four brothers have developed testicular neoplasms,
      one embryonal cell carcinoma and three testicular seminomas. A first cousin once
      removed on their mother's side of the family (fourth-degree relative) has
      developed an embryonal carcinoma. After treatment they are all alive and well.
      Their mother is a dizygous twin and one of ten siblings. Multiple other cancers
      have been diagnosed among her siblings and their offspring including breast
      carcinoma at age 30 years in monozygous twin nieces. Associated urogenital
      abnormalities, concordance of age, and discordance of pathology in the five males
      with testicular cancer is discussed. Further identification and reporting of this
      risk factor is encouraged.

PMID- 2224804
TI  - Familial occurrence of gastric cancer in the 2-year experience of a population
      based registry.
AB  - The authors studied the familial occurrence of tumors in 154 individuals with
      gastric cancer by reviewing the clinical data and the genealogical tree of all
      patients registered in 1986 through 1987 in the Local Health Care District of
      Modena, Italy, for cancer of the stomach. Crude and age-adjusted (world
      population) incidence rates of gastric cancer were 34.0 and 21.4 new
      cases/100,000/year, respectively, in men, and 24.5 and 10.9 in women,
      respectively. Among first-degree relatives of the registered patients there were
      30 cases of gastric carcinoma versus 15 cases in a control group matched for age
      and sex (Mantel-Haenszel odds ratio [M-H OR] 3.14, P less than 0.01). This excess
      of gastric neoplasms was observed in siblings (17 versus 7, M-H OR 4.33, P less
      than 0.02) but not in parents (13 versus 8, not significant). Besides gastric
      cancer, there was no significant excess of other type of tumors in case families.
      The familial occurrence of gastric cancer tended to be more frequent in patients
      with "diffuse" carcinoma (52%) than in subjects with "intestinal" cancer (33%),
      although the difference was not statistically significant. In conclusion, the
      current investigation suggests that a "family history" for gastric neoplasms is
      usually observed in approximately 10% to 15% of the registered cases. As already
      described for other common malignancies, therefore, the familial occurrence of
      gastric carcinoma suggests the existence of a genetic susceptibility to cancer of
      the stomach, at least in a fraction of these patients.

PMID- 2224805
TI  - Common ground.

PMID- 2224807
TI  - Self-esteem: a problem for nurses.

PMID- 2224806
TI  - Excellence.

PMID- 2224808
TI  - A celebration of love and care.

PMID- 2224809
TI  - Technology for health care education.

PMID- 2224810
TI  - Recombinant human erythropoietin.

PMID- 2224811
TI  - Tough times, are we ready?

PMID- 2224812
TI  - The special care unit.

PMID- 2224813
TI  - [Subcutaneous analgesic administration].
AB  - In March 1989, Saint Luke's Hospital in Montreal piloted the use of continuous
      and intermittent subcutaneous injection of analgesics. This practice involved
      patients whose pain could not be relieved by traditional methods of analgesic
      administration. The article describes the positive results of the project, and
      clearly identifies suitable patients. It also outlines the advantages, limiting
      factors and risks involved with each type of infusion. Procedures for set-up and
      monitoring are briefly explained. The authors conclude that family members of
      patients can be easily taught to perform the procedure at home.

PMID- 2224815
TI  - Forgetting MHAs.

PMID- 2224814
TI  - [Nursing research and you].
AB  - In this article the author shows how important it is for nurses at all levels of
      the profession to get involved in nursing research. She highlights the advantages
      of research, in terms of job satisfaction and quality care. The article answers
      the five most frequently asked questions: What is nursing research? What purpose
      does it serve? How is it carried out? What role does the health care provider
      play? What are the benefits?

PMID- 2224816
TI  - Fighting AIDS abroad.

PMID- 2224817
TI  - Caring for patients with AIDS.

PMID- 2224818
TI  - The sleeping giant awakes.

PMID- 2224819
TI  - Managing decubitus ulcers.

PMID- 2224821
TI  - When a nurse dies.

PMID- 2224820
TI  - Values in maternal and newborn care.

PMID- 2224822
TI  - The daily news.

PMID- 2224823
TI  - Coordinating a preceptorship program.

PMID- 2224824
TI  - The road to Aus.

PMID- 2224825
TI  - [Injections].
AB  - This article deals with the injection techniques used for administering
      medication in the vastus lateralis and the ventral gluteal muscles. Both sites
      are easy to locate and safe for injection. The vastus lateralis site, in
      particular, is commonly used for babies, children and adults.

PMID- 2224826
TI  - [Sexuality in the Cree culture].
AB  - This study focuses on the traditional elements of Cree sexuality, and the impact
      that white society has had on Cree culture. A questionnaire, administered to
      persons knowledgeable of the Cree, reveals the reasons for marriage, the nature
      of sexual relations and the importance of fertility. The author points out
      specific challenges in the areas of sexuality and family planning that face
      professionals working with the Cree.

PMID- 2224827
TI  - Taking issue.

PMID- 2224829
TI  - Neuron imaging with Neurolucida--a PC-based system for image combining
      microscopy.
AB  - Neurolucida is a new software package for performing 3-D neuron mapping and
      tracing to 0.5 micron precision through the oculars of a microscope. It
      incorporates computer controlled stage movement in three dimensions. Sections are
      limited in size only by the stage dimensions. An on-line, direct view image
      editor is provided as are dynamic image rotations in color and morphometric
      analyses. Neurolucida is written in 'C' and runs on PC ATs, XTs, and PS/2s using
      DOS and VGA, EGA, or NTSC graphics. Neurolucida has a video mode compatible with
      frame grabbers, thereby permitting its application to video microscopy.

PMID- 2224828
TI  - Image analyzers for bioscience applications.
AB  - Image analysis systems are becoming more sophosticated, less costly, and very
      common in research laboratories. Therefore, the bioscience researcher is faced
      with a bewildering array of choices in establishing an image analysis facility.
      Critical components and characteristics of commercial image analyzers are
      discussed. State-of-the-art systems feature a graphical user interface, a
      powerful operating system (e.g., Microsoft OS/2), 1000 line image acquisition,
      processing and display, true color imaging, and very flexible scanner interfaces.
      Such systems are best suited to technically difficult applications, such as ratio
      fluorescence, or to automated analysis of anatomical features, particularly in
      stained material. Less powerful image analyzers offer medium resolution, and
      typically work with monochrome data acquired from video cameras. Such systems are
      suitable for many bioscience applications, including quantitative autoradiography
      and routine morphometry.

PMID- 2224830
TI  - CARTOS II semi-automated nerve tracing: three-dimensional reconstruction from
      serial section micrographs.
AB  - The paper describes the history of tracing activities in the Levinthal lab from
      1965 to the present. It also focuses on the evolution of electron micrograph (EM)
      tracing from early hand tracing reconstruction to the current, nearly fully
      automated CARTOS II tracing system. The present hardware systems and tracing
      algorithms are described in detail. Also presented are the partial tracing
      results of one EM data set in two and three dimensions.

PMID- 2224831
TI  - The variation in user drawn outlines on digital images: effects on quantitative
      autoradiography.
AB  - Variation in user outlines drawn to delineate neural regions is the only source
      of error added to autoradiographic images after the images have been digitized.
      By analyzing data compiled from many outlines drawn by several different
      investigators, it was demonstrated that this variation constitutes a major source
      of error affecting quantitative autoradiography. Both the gray level variation
      and average within a region, as well as the specific pixels included in an
      outline, were affected. However, using the intersection of multiple outlining
      attempts surrounding any given region and a consistent set of outlining criteria,
      it was possible to delineate a region which remained consistent from user to
      user. A technique for automating the consistent outlining process is discussed.

PMID- 2224832
TI  - Recognition of regions in brain sections.
AB  - This paper addresses the problem of region identification in sequential brain
      sections and presents a recognition system that finds and tracks region
      boundaries in those sections. The characteristics of the areas of interest are
      unique in one sense because they are not stationary. Some regions are hardly
      discernible. In others, parts of the boundary are missing or so completely
      blurred that parts of the background may be considered as an extension of the
      region itself. Moreover, outliers are likely to exist in many cases. Due to the
      unique properties of brain regions, the emphasis is on robustification and
      efficiency. The region segmentation problem was expressed as a multi-hypothesis
      test seeking boundaries that maximize a performance criterion which is general in
      terms of blur and noise. Boundary candidates are restricted to an adaptive search
      area around a reference boundary which is usually the outcome of the algorithm
      from the previous section. The search for the maximum criterion uses a fast first
      order dynamic programing (DP) procedure, reducing the processing time. Outlier
      rejection techniques are integrated with the multi-hypothesis test to compensate
      for both outliers and noise. The result is the reference for the next section.
      Experimental results on boundary detection are presented. The algorithm is
      successful in tracing boundaries when the contrast is smaller than the noise
      power, and when parts of the outlines are missing.

PMID- 2224833
TI  - A PC-based 3D imaging system: algorithms, software, and hardware considerations.
AB  - Three-dimensional (3D) imaging in medicine is known to produce easily and quickly
      derivable medically relevant information, especially in complex situations. We
      intend to demonstrate in this paper, that with an appropriate choice of
      approaches and a proper design of algorithms and software, it is possible to
      develop a low-cost 3D imaging system that can provide a level of performance
      sufficient to meet the daily case load in an individual or even group-practice
      situation. We describe hardware considerations of a generic system and give an
      example of a specific system we used for our implementation. Given a 3D image as
      a stack of slices, we generate a packed binary cubic voxel array, by combining
      segmentation (density thresholding), interpolation, and packing in an efficient
      way. Since threshold-based segmentation is very often not perfect, object-like
      structures and noise clutter the binary scene. We utilize an effective mechanism
      to isolate the object from this clutter by tracking a specified, connected
      surface of the object. The surface description thus obtained is rendered to
      create a depiction of the surface on a 2D display screen. Efficient
      implementation of hidden-part removal and image-space shading and a simple and
      fast antialiasing technique provide a level of performance which otherwise would
      not have been possible in a PC environment. We outline our software emphasizing
      some design aspects and present some clinical examples.

PMID- 2224834
TI  - A data exchange format for neuroanatomy workstations.
AB  - The development of the microprocessor has enabled biomedical researchers to use
      powerful computers as single user workstations. Many such systems are now in use-
      some developed for use within individual laboratories, and others purchased
      commercially. These systems typically mix computer graphics and image processing
      capabilities. No standard exists that allows users of these workstations to
      exchange anatomical data in graphical or image form. This paper considers issues
      involved in designing a flexible format for exchanging digital anatomical data
      between laboratories.

PMID- 2224835
TI  - Is there a role for lactobacilli in prevention of urogenital and intestinal
      infections?
AB  - This review describes the importance of microbial adhesion in the ecology of the
      urogenital and intestinal tracts and the influence of host and microbial factors
      in bacterial interference. In a recent revival of interest in bacterial
      interference, lactobacillus administration has been studied as a means of
      treating and preventing disease. Although evidence is conflicting, Lactobacillus
      acidophilus appears to be involved in beneficial antagonistic and cooperative
      reactions that interfere with establishment of pathogens in the gastrointestinal
      tract. The mechanisms of action are believed to involve competitive exclusion and
      production of inhibitory substances, including bacteriocins. These
      characteristics, as well as demonstrated adherence abilities in vitro, led to
      selection of certain Lactobacillus strains for clinical studies of cystitis.
      Weekly intravaginal Lactobacillus therapy reduced the recurrence rate of
      uncomplicated lower urinary tract infections in women. Use of Lactobacillus
      strains resistant to Nonoxynol-9, a spermicide that kills members of the
      protective normal vaginal flora, may have potential for use in women with
      recurrent cystitis using this contraceptive agent. In veterinary studies,
      bacterial interference by administration of probiotics has also been beneficial
      in disease prevention in animals. Carefully selected bacterial mixtures integrate
      with the gastrointestinal flora of the animals and can confer disease resistance
      and improve physiological function. Additional human and animal trials are needed
      to determine the practical, long-term usefulness of bacterial interference as a
      protective mechanism against infectious diseases.

PMID- 2224838
TI  - Unusual reaction to chlorambucil: a case report.
AB  - In this brief report we describe a case of cutaneous reaction during treatment of
      chronic lymphatic leukemia (CLL) with chlorambucil. The patient developed a
      confluent maculopapular erythema and large flaccid bullae of trunk, legs, feet
      and mucous membranes, with fever up to 38 degrees C. Toxic epidermal necrolisis
      (TEN) was supposed and the diagnosis was confirmed by a skin patch test followed
      by cutaneous biopsy. TEN by chlorambucil is a rare syndrome that may be
      considered in presence of cutaneous reaction to this drug.

PMID- 2224839
TI  - Persistence of cytogenetic damage induced by alkylating antineoplastic drug
      phopurinum in human lymphocytes in vivo and in vitro.
AB  - Sister chromatid exchanges (SCEs) and structural chromosome aberrations (CAs)
      induced by cytostatic drug phopurinum in vivo and in vitro were studied in human
      lymphocytes. Phopurinum was found to cause a significant increase of CAs in
      lymphocytes of patients undergoing cytostatic therapy. Increased CA rates,
      however, declined rapidly after the cessation of treatment. This decline observed
      in vivo is in agreement with experimental results obtained in vitro, where it is
      found that the induction of SCEs and CAs occur only during the 1st cell cycle
      after pulse-treatment as G1 stage with phopurinum. Thus, phopurinum induced short
      lived DNA damage both experimentally and in vivo.

PMID- 2224840
TI  - Synergistic cytotoxic effect of human recombinant tumor necrosis factor alpha
      combined with dihydroambazone.
AB  - Dihydroambazone (DHA) is a water-soluble derivative of the experimental
      anticancer drug ambazone. In vitro, a combination of DHA and human recombinant
      tumor necrosis factor alpha (TNF) exerted a strong synergism of cytotoxicity
      against both mouse melanoma B16K cells and the TNF-sensitive mouse fibroblast
      line L-M (S). Furthermore, in a colony-forming assay with B16K cells a
      combination of TNF and DHA inhibited colony-formation much more severely than
      either drug alone. An increased antiproliferative efficiency was also confirmed
      in vivo against established subcutaneous melanoma B16 tumors of C57BL/6 mice.

PMID- 2224841
TI  - Increased therapeutic efficacy of intra-arterial carboquone chemotherapy on a
      limb tumor in rats, by using an acidic vehicle adjusted with lactate.
AB  - We previously reported that the cytotoxicity of carboquone (CQ) was potentiated
      in vitro and in vivo under acidic conditions. In this study, an acidic vehicle
      adjusted with lactate at various low pHs was used for CQ intra-arterial (i.a.)
      injection, in order to enhance the antitumor effects of i.a. CQ chemotherapy.
      Treatments were evaluated in Wistar/KA rats bearing a limb tumor 5 days after the
      inoculation of 3 x 10(6) syngeneic RBT-1 tumor cells into the hind limb. In
      chemotherapy experiments using an intrafemoral injection of CQ at 1.5 mg/kg in
      phosphate-buffered saline (PBS, pH 7.4) or in an acidic vehicle at pH 5.0 or 6.0,
      the antitumor effects seen in rats given CQ in acidic vehicles, evaluated by
      tumor weight 14 days after treatment, were significantly greater than that seen
      in rats given CQ in PBS. There were no significant differences either in changes
      of body weight or in the number of leukocytes after treatment between the groups
      given CQ in PBS and in an acidic vehicle at pH 6.0. Although in the group given
      CQ at 2.0 mg/kg in PBS, the antitumor effect was the same as that observed in
      rats given CQ at 1.5 mg/kg in an acidic vehicle at pH 6.0, the side effects
      observed in the former group were much severer than in the latter group. These
      data suggest that the antitumor effect of i.a. CQ chemotherapy can be potentiated
      by using an acidic vehicle.

PMID- 2224842
TI  - O6-alkyltransferase activity in normal human gastric mucosa.
AB  - The spectrum of activity of the DNA repair enzyme O6-alkyltransferase has been
      studied in a large series of normal stomachs in order to establish the baseline
      range of values for this enzyme. Sixty-eight patients with histologically normal
      stomachs were biopsied during the course of upper gastrointestinal endoscopy and
      the biopsies assayed for O6-alkyl-transferase activity. A wide spectrum of
      activity was found with values ranging from 38 fmol O6-guanine extracted/mg
      protein to over 400 fmol/mg. This suggests that there may be wide inter
      individual differences in susceptibility to alkylating actions in the human
      gastric mucosa.

PMID- 2224843
TI  - Induction of N-nitrosodimethylamine metabolism in rat liver and lung by ethanol.
AB  - The metabolic activation of N-nitrosodimethylamine (NDMA) to an active metabolite
      is important in the manifestation of its carcinogenic effect. The lung and liver
      were compared for their responses to the induction of NDMA demethylation by 10%
      ethanol in the drinking water and by repeated bolus injections. Ethanol in the
      drinking water increased NDMA metabolism several-fold in both the liver and the
      lung. Repeated ip injections with 0.6 and 3.0 ml ethanol/kg for 7 days also
      enhanced this activity in a dose-dependent fashion. These results suggest that in
      the lung, as in the liver, ethanol may influence the metabolic activation of this
      nitrosamine.

PMID- 2224844
TI  - Role of cyclic AMP receptor proteins in growth, differentiation, and suppression
      of malignancy: new approaches to therapy.
AB  - Two isoforms of the regulatory subunits of cyclic AMP (cAMP)-dependent protein
      kinase that bind cAMP are inversely expressed during ontogeny and cell
      differentiation. These cAMP-binding receptor proteins in harmony may regulate the
      growth of normal cells and their differentiation into nondividing states. Cancer
      cells can also be made to differentiate and stop growing when the functional
      balance of these cAMP receptor proteins is restored by treatment with site
      selective cAMP analogues or by the use of an antisense oligodeoxynucleotide,
      suggesting new approaches to cancer treatment.

PMID- 2224845
TI  - Changes in intratumor pH by two heatings.
AB  - It is a known fact that pH in rodent tumors decline significantly upon heating
      most likely due to breakdown of the tumor blood circulation. We recently observed
      that tumor blood vessels become thermotolerant after being heated with a
      sublethal thermal dose. The purpose of the present study was to reveal whether
      heating can reduce intratumor pH when the tumor vessels are thermotolerant. When
      the SCK tumors of A/J mice were heated at 42.5 degrees C for 1 h, the tumor
      vessels became most thermotolerant at 18 h postheating, as measured with the 86Rb
      uptake method. The intratumor pH in the control SCK tumors was 7.05 +/- 0.14
      (SD), and it significantly decreased to 6.70 +/- 0.08 (P less than 0.001) after
      heating at 44.5 degrees C for 1 h. However, when the tumor vessels were
      thermotolerant, i.e., 18 h after heating at 42.5 degrees C for 1 h, reheating at
      44.5 degrees C for 1 h could not reduce the intratumor pH. We concluded that such
      a failure to increase tumor acidity by a second heating at temperatures as high
      as 44.5 degrees C was due to vascular thermotolerance developed by the first
      heating.

PMID- 2224846
TI  - Patterns of mate drinking in a Brazilian city.
AB  - Mate drinking, a hot infusion of Ilex paraguayensis commonly drunk in parts of
      South America, has been associated with increased risks of upper digestive
      cancers. In a population-based survey, we have studied the patterns of mate
      drinking in a sample of 1400 adults living in a southern Brazilian city.
      Approximately one third of the population drank mate less than once a month or
      not at all; another third drank mate at least once a month, but less than once a
      day; while the remaining third drank mate daily. Daily drinking was most common
      among individuals aged under 60, those who migrated from rural areas, and among
      cigarette smokers. Drinkers ingested on average about 1800 ml/day at a mean
      temperature of 69.5 degrees C. Individuals who had never attended school tended
      to ingest larger quantities. The temperature of the drink was higher for males
      and for drinkers of alcoholic beverages. This information may contribute to the
      design of preventive interventions, since a large proportion of upper digestive
      cancer cases in those regions might be due to mate drinking.

PMID- 2224837
TI  - The dengue viruses.
AB  - Dengue, a major public health problem throughout subtropical and tropical
      regions, is an acute infectious disease characterized by biphasic fever,
      headache, pain in various parts of the body, prostration, rash, lymphadenopathy,
      and leukopenia. In more severe or complicated dengue, patients present with a
      severe febrile illness characterized by abnormalities of hemostasis and increased
      vascular permeability, which in some instances results in a hypovolemic shock.
      Four distinct serotypes of the dengue virus (dengue-1, dengue-2, dengue-3, and
      dengue-4) exist, with numerous virus strains found worldwide. Molecular cloning
      methods have led to a greater understanding of the structure of the RNA genome
      and definition of virus-specific structural and nonstructural proteins. Progress
      towards producing safe, effective dengue virus vaccines, a goal for over 45
      years, has been made.

PMID- 2224848
TI  - Effect of tamoxifen on DNA synthesis and proliferation of human malignant glioma
      lines in vitro.
AB  - Previous studies in our laboratory have shown that proliferation of human
      malignant gliomas in vitro depends in part upon the activation of protein kinase
      C (PKC) and, conversely, can be blocked by inhibitors of PKC. Here, we examined
      the effect of tamoxifen, a known PKC inhibitor, on DNA synthesis and
      proliferation of an established human glioma line (U138) and two low passage
      cultures of explanted human glioblastomas. Tamoxifen produced a profound, dose
      dependent inhibition of both [3H] thymidine incorporation and cell proliferation,
      with a 50% effective dose of 20 ng/ml under serum-free conditions and 50 to 200
      ng/ml in the presence of 10% serum. These tumors were estrogen receptor negative
      and showed no mitogenic response to estradiol. Furthermore, concentrations of
      estradiol as high as 10 micrograms/ml had no effect on the tamoxifen-induced
      inhibition. This suggests that the mechanism of growth inhibition by tamoxifen in
      these gliomas did not involve an estrogen receptor-mediated process but may
      instead result from its inhibition of PKC. In view of the profound effect of
      tamoxifen on cultured gliomas at concentrations that can safely be achieved
      therapeutically, further in vitro and in vivo studies of this agent are
      warranted.

PMID- 2224847
TI  - Occupations of parents of children with retinoblastoma: a report from the
      Children's Cancer Study Group.
AB  - A matched case-control study was conducted by the Children's Cancer Study Group
      to investigate the role of parental occupation in the etiology of sporadic
      heritable and nonheritable retinoblastoma. Eligible cases were those patients
      with retinoblastoma diagnosed in 1982-1985 at any of the Children's Cancer Study
      Group member hospitals. Telephone interviews of 201 parents of cases and their
      pair-matched controls selected by random digit dialing were completed. Of the 201
      cases, 19 were familial, 67 were sporadic heritable, and 115 were nonheritable.
      The 19 familial cases were excluded from the analysis. Paternal employment in the
      military [odds ratio (OR) 2.8, 95% confidence interval (CI) 1.1-8.8, P = 0.04]
      and in the metal industry (OR infinity, 95% CI 1.4-infinity, P = 0.02) was
      associated with sporadic heritable retinoblastoma (N = 67). For nonheritable
      retinoblastoma (N = 115), a significant association was observed for a job
      cluster consisting mostly of welders and machinists (OR 4.0, 95% CI 1.1-22.1, P =
      0.04). Occupations of maternal grandparents were also studied and an association
      was observed with farming and nonheritable retinoblastoma (OR 10.0, 95% CI 1.4
      433, P = 0.02). Many comparisons were made and the number of significant findings
      did not exceed that expected by chance. Thus, the results need to be interpreted
      very cautiously. However, the findings related to metal exposure corroborate
      observations on other childhood cancers.

PMID- 2224849
TI  - Effects of fatty acids and inhibitors of eicosanoid synthesis on the growth of a
      human breast cancer cell line in culture.
AB  - Dietary lipids may influence breast cancer progression and prognosis. The MDA-MB
      231 human breast cancer cell line was used to examine the direct effects of the
      various classes of free fatty acids (FAs) on growth in serum-free medium and the
      involvement of eicosanoid biosynthesis. Linoleic acid, an omega 6 FA, stimulated
      MDA-MB-231 cell growth with an optimal effect at a concentration of 0.75
      microgram/ml, whereas oleic acid, an omega 9 FA, produced growth stimulation at
      0.25 microgram/ml but was inhibitory at higher concentrations. Docosahexaenoic
      acid exhibited a dose-related inhibition of cell growth at concentrations ranging
      from 0.5 to 2.5 micrograms/ml; eicosapentaenoic acid, also an omega 3 FA, was
      less effective. Similar inhibitory effects occurred with saturated FAs.
      Indomethacin, which at high concentrations is an inhibitor of both the
      cyclooxygenase- and lipoxygenase-catalyzed pathways of eicosanoid synthesis,
      suppressed cell growth stimulation by an otherwise optimal dose of linoleic acid
      when present at 40 micrograms/ml. Experiments with piroxicam,
      nordihydroguaiaretic acid, and esculetin, other inhibitors of eicosanoid
      biosynthesis with varying selectivity for enzymes of the prostaglandin and
      leukotriene pathways, indicated that MDA-MB-231 cell growth was dependent on
      leukotriene rather than prostaglandin production.

PMID- 2224851
TI  - Correlation between seric antitumor activity and concomitant resistance in mice
      bearing nonimmunogenic tumors.
AB  - Serum from mice bearing five weakly immunogenic or nonimmunogenic tumors inducing
      concomitant resistance exhibited a growth-inhibitory activity on in vitro
      proliferation of the tumor cells. This activity was proportional to the intensity
      of concomitant resistance and correlated with the capacity to restrain metastatic
      development. It was not attributable to cytotoxic antibodies, was relatively
      nonspecific, and operated through a cytostatic and reversible mechanism. All
      attempts to transfer antitumor resistance in vivo by serum inoculation have
      failed, but this could be attained by parabiosis. Physical and chemical serum
      treatments suggest that heat-, acid-, and alkali-resistant peptide(s) with
      molecular weights ranging from 1000 to 3000 could account for this inhibitory
      effect.

PMID- 2224850
TI  - In vitro migration of lymphocytes through collagen matrix: arrested locomotion in
      tumor-infiltrating lymphocytes.
AB  - Antitumor immunity requires (a) extravasation of lymphocytes from the blood
      stream to interstitium, (b) locomotion through extracellular matrix to the site
      of the tumor, (c) effector cell recognition of the tumor target with cell/cell
      contact and binding of adhesion receptors, (d) T-cell receptor binding to
      histocompatibility and tumor antigens, and (e) tumor cell lysis. We hypothesize
      that the tumor microenvironment inhibits lymphocyte locomotion through
      extracellular matrix as one mechanism by which tumors may avert host defense.
      Lymphocyte locomotion was investigated in vitro using a three-dimensional
      collagen gel model. Fresh tumor-infiltrating lymphocytes (TIL) were obtained by
      enzymatic digestion of melanomas and renal cell carcinoma, and mononuclear cells
      were isolated by discontinuous Ficoll-Hypaque gradient. The lymphocytes were
      analyzed for motility from a point of origin between basal and overlay layers of
      collagen gel. Results showed that TIL migration was almost completely inhibited,
      compared with migration of normal and cancer patient peripheral blood leukocytes
      and lymphocytes from lymph nodes. Short-term (24-h) exposure of lymphocytes to
      cytokines during the assay in the collagen gel matrix had no effect on locomotor
      ability. Long-term (19, 30, or 35 days) culture of TIL in 200 units/ml of
      interleukin 2 reinstated locomotor ability. Short-term exposure of any of the
      lymphocyte populations to interleukin 1-alpha, interleukin 1-beta, interleukin 2,
      interleukin 3, interleukin 4, alpha-interferon, or gamma-interferon had no effect
      on migration. Thus, TIL display a uniquely arrested ability to locomote through
      collagen gel. Inhibition of the locomotion of infiltrating effector cells is
      possibly a mechanism by which the tumor evades the host immune system.

PMID- 2224836
TI  - Some infectious causes of diarrhea in young farm animals.
AB  - Escherichia coli, rotaviruses, and Cryptosporidium parvum are discussed in this
      review as they relate to enteric disease in calves, lambs, and pigs. These
      microorganisms are frequently incriminated as causative agents in diarrheas among
      neonatal food animals, and in some cases different strains or serotypes of the
      same organism cause diarrhea in humans. E. coli causes diarrhea by mechanisms
      that include production of heat-labile or heat-stable enterotoxins and synthesis
      of potent cytotoxins, and some strains cause diarrhea by yet undetermined
      mechanisms. Rotaviruses and C. parvum induce various degrees of villous atrophy.
      Rotaviruses infect and replicate within the cytoplasm of enterocytes, whereas C.
      parvum resides in an intracellular, extracytoplasmic location. E. coli,
      rotavirus, and C. parvum infections are of concern to producers, veterinarians,
      and public health officials. These agents are a major cause of economic loss to
      the producer because of costs associated with therapy, reduced performance, and
      high morbidity and mortality rates. Moreover, diarrheic animals may harbor,
      incubate, and act as a source to healthy animals and humans of some of these
      agents.

PMID- 2224852
TI  - Ether-linked phosphoglyceride content of human leukemia cells.
AB  - The glycerolipids of most cells are characterized by a specific proportion of
      ether linkages at the sn-1 position of the glycerol backbone. A number of tumors
      are known to have altered concentrations of ether-linked lipids compared to
      normal tissues. However, no through examination of the ether-lipid content of
      human leukemia cells has been reported despite the importance of these lipids in
      normal leukocyte function. In the present study samples were obtained from adults
      with acute myelogenous leukemia (AML), chronic granulocytic leukemia in blast
      crisis, and acute lymphocytic leukemia and from healthy human donors. The
      cellular lipids were extracted, the individual phospholipid classes were
      isolated, lipid phosphorus content was determined, and the lipids were converted
      to diglyceride benzoate derivatives for separation and quantitation of the
      subclasses by high performance liquid chromatography. The data indicate that all
      the leukemic cells analyzed have an altered phospholipid composition compared to
      their respective normal leukocytes. Furthermore, among the AML patients both the
      percentage of the choline-containing phosphoglyceride fraction (PC) which is
      alkyl linked and the nmoles alkyl-PC/10(6) cells differ significantly by FAB
      subtype. A positive correlation between the levels of alkyl-PC and the degree of
      cellular differentiation is observed. Although no differences are observed
      between chronic granulocytic leukemia in blast crisis and AML lipids, the
      leukemic cells contain dramatically lower levels of alkyl-linked PC than do
      normal polymorphonuclear leukocytes. In contrast, no differences are observed
      between the alkyl-PC content of normal and leukemic lymphocytes. In light of the
      relations among ether-lipids, protein kinase C, and cell differentiation, these
      data suggest the ether-linked lipids are important in myeloid cell function and
      differentiation.

PMID- 2224854
TI  - Phase I trial of dipyridamole with 5-fluorouracil and folinic acid.
AB  - We have performed two Phase I trials of the combination of dipyridamole, 5
      fluorouracil (5-FU), and folinic acid in patients with advanced refractory
      malignancy, based upon in vitro evidence that dipyridamole can modulate the
      cytotoxicity of 5-FU. In the first trial, patients were treated every 4 wk with
      dipyridamole (50 mg/m2) p.o. every 6 h on Days 0 to 6, beginning 24 h prior to
      the i.v. administration of folinic acid (200 mg/m2) and escalating doses of i.v.
      5-FU on Days 1 to 5. The maximum tolerated daily dose of 5-FU that could be given
      with this combination was 375 mg/m2. Because dipyridamole is extensively bound to
      plasma proteins, it was hypothesized that the concentrations of free dipyridamole
      achieved with a dose of 50 mg/m2 were inadequate to modulate the cytotoxicity of
      5-FU and folinic acid. Therefore, a second Phase I trial of escalating dose of
      p.o. dipyridamole was performed. Folinic acid (200 mg/m2) and 5-FU (375 mg/m2)
      were given i.v. on Days 1 to 5 every 4 wk, beginning 24 h after the start of
      therapy with dipyridamole; dipyridamole was administered p.o. on Days 0 to 6 at
      doses of 75, 100, 125, 150, 175, or 200 mg/m2/dose to successive cohorts of
      patients. Dose-limiting neutropenia, mucositis, and nausea were produced at a
      dose of 200 mg/m2/dose; the recommended dose of dipyridamole for use in Phase II
      studies is 175 mg/m2 p.o. every 6 h, or 700 mg/m2/day. At this dose, a mean peak
      plasma concentration of total dipyridamole of 16.32 mumol and a mean peak plasma
      concentration of free dipyridamole of 38.30 nmol were observed. Trough
      concentrations of free dipyridamole averaged 60% of the peak concentrations.
      Objective antitumor responses were seen in a number of tumor types; five of 13
      patients with breast cancer treated with high-dose p.o. dipyridamole, 5-FU, and
      folinic acid responded. High-dose p.o. dipyridamole can produce plasma
      concentrations of free dipyridamole within the range shown to modulate the
      cytotoxicity of 5-FU and other agents. Phase II trials of this combination are
      justified.

PMID- 2224853
TI  - Role of insulin-like growth factor-related peptides in the estradiol-, prolactin
      , and progesterone-stimulated growth of N-nitrosomethylurea-induced rat mammary
      tumors in soft agar.
AB  - The present experiments were designed to test the role of insulin-like growth
      factor-related peptides (IGF-RPs) in hormonally stimulated N-nitrosomethylurea
      (NMU)-induced mammary tumor colony formation in soft agar. To evaluate production
      of IGF-RP by NMU cells, we tested the abilities of a monoclonal antibody directed
      against insulin-like growth factor I (alpha sm 1.20B) and of a polyclonal
      antibody raised against the insulin-like growth factor I (Ab 134) to inhibit the
      colony-stimulating effects of conditioned media (CM) obtained from estradiol (E2)
      , prolactin (PRL)-, and progesterone (Pg)-treated NMU-induced rat mammary tumors.
      Both Abs abolished the colony-stimulating action of genuine insulin-like growth
      factor I while having no effect when added alone or with control CM. The addition
      of either alpha sm 1.20B or Ab 134 (but not that of an irrelevant Ab)
      consistently blocked the colony-stimulating action of E2-CM, PRL-CM, and Pg-CM,
      suggesting that IGF-RPs are produced by NMU mammary tumor cells exposed to these
      hormones. Next, we directly tested the role of IGF-RPs as mediators of hormonally
      stimulated growth. We indeed observed that the addition of alpha sm 1.20B
      markedly inhibited the colony-stimulating actions of E2, PRL, and Pg added to NMU
      mammary tumor cells in soft agar in the absence of serum. We conclude that, in
      our experimental system, IGF-RPs not only are produced upon exposure to E2, PRL,
      and Pg, but also are important mediators of hormonally stimulated growth.

PMID- 2224855
TI  - Inhibitory effects of estrogen on the growth of a human esophageal carcinoma cell
      line.
AB  - In order to accurately determine sex hormone dependency and hormone
      responsiveness in human esophageal carcinoma, the effects of sex hormones on the
      growth of esophageal carcinoma cell lines, KSE-1 and KSE-2 cells, were examined
      in vitro and in vivo. Cell proliferation of cultured KSE-1 cells was inhibited by
      treatment of estradiol and enhanced by dihydrotestosterone (DHT), whereas KSE-2
      cells were unaffected by these sex hormones. The heterotransplanted tumors of KSE
      1 cells in nude mice possessed estrogen receptor (ER) and androgen receptor (AR),
      while the tumors of the KSE-2 cells had neither ER nor AR. When the tumor growth
      rates and serum hormone levels were monitored during the continuous
      administration of either estradiol or DHT, no significant differences were
      observed in either the serum hormone levels or tumor growth rates between male
      and female mice. The administration of estradiol significantly inhibited the
      growth of ER-positive and AR-positive KSE-1 tumors in both males and females in
      conjunction with an increase in the estradiol levels and a decrease in the DHT
      levels in the serum. However, the growth of ER-negative and AR-negative KSE-2
      tumors was not influenced by either estradiol or DHT administration. These
      results suggest that the in vivo growth of human esophageal carcinoma cells with
      sex hormone receptor is influenced by circulating hormone levels and can be
      manipulated by systemic estradiol administration.

PMID- 2224856
TI  - Phorbol ester-induced macrophage-like differentiation of human promyelocytic
      leukemia (HL-60) cells occurs independently of transferrin availability.
AB  - Human promyelocytic leukemia (HL-60) cells can be induced to differentiate into
      macrophage-like cells by the tumor-promoting phorbol ester, 12-O
      tetradecanoylphorbol-13-acetate (TPA). Addition of this agent to HL-60 cells
      causes a rapid internalization of surface transferrin receptor, followed by long
      term receptor down-regulation at the level of gene expression. These effects
      precede the inhibition of proliferation and the acquisition of differentiation
      markers, and it has been suggested that transferrin receptor down-regulation may
      play a mediating role in these later events. Here we show that HL-60 cells will
      grow indefinitely in serum-free medium supplemented with either 5 micrograms ml-1
      transferrin or 300 microM ferric citrate and that TPA inhibits cell proliferation
      (assayed by cell density and rate of thymidine incorporation) and induces
      macrophage-like differentiation (assayed by induction of cell adhesion and
      increased nonspecific esterase activity) with identical dose curves in both
      media. Furthermore, a neutralizing anti-transferrin antibody completely inhibits
      transferrin-dependent cell proliferation but has no effect on differentiation in
      the presence or absence of transferrin. We conclude that TPA-induced down
      regulation of transferrin binding and internalization does not mediate the
      subsequent growth arrest and differentiation of HL-60 cells.

PMID- 2224857
TI  - Radiolocalization of human pancreatic tumors in athymic mice by monoclonal
      antibody DU-PAN 1.
AB  - Monoclonal antibodies that selectively bind to pancreatic tumors may be useful in
      the therapy and diagnosis of pancreatic carcinoma. In this study we have examined
      the tumor localization of radioiodinated DU-PAN 1, a mouse monoclonal antibody
      that is selective for a human pancreatic cancer-associated antigen. After
      radiolabeling, both DU-PAN 1 intact monoclonal antibody and F(ab')2 fragments
      retained immunoreactivity and showed high affinity for the pancreatic tumor cell
      line CA13 in vitro. Paired-label biodistribution studies in nude mice bearing
      CA13 s.c. xenografts were performed. Mice received both 131I-labeled DU-PAN 1
      immunoglobulin G2a or F(ab')2 fragment and 125I-labeled mouse myeloma
      immunoglobulin G2a or F(ab')2 fragment. Tumor uptake for 5-micrograms doses of DU
      PAN 1 immunoglobulin ranged from 4.8 to 11.83% injected dose/g. Tumor uptake
      values for mice given 5-micrograms doses of DU-PAN 1 F(ab')2 ranged from 3.9 to
      6.9% injected dose/g. Tumor uptakes of the respective myeloma controls were lower
      in all cases when compared with the DU-PAN 1 preparations. Tumor localization
      indices for 5-micrograms doses of DU-PAN 1 immunoglobulin were 3.0 and 24 h and
      2.9 at 48 h. For 5-micrograms doses of DU-PAN 1 F(ab')2, tumor localization
      indices were 29.9 at 24 h and 90.0 at 48 h. In most cases, tumor:normal tissue
      ratios were greater than 3 at all time points, indicative of tumor selectivity
      for both DU-PAN 1 preparations, but the ratios were considerably higher using the
      DU-PAN 1 F(ab')2. The F(ab')2 fragment thus displays better tumor localization
      characteristics when compared with the intact immunoglobulin. Protein doses of DU
      PAN 1 F(ab')2 of between 5 and 10 micrograms gave the best localization, although
      protein doses of up to 100 micrograms could be administered before apparent tumor
      saturation was seen.

PMID- 2224858
TI  - Pharmacokinetics in patients of an anti-carcinoembryonic antigen antibody
      radiolabeled with indium-111 using a novel diethylenetriamine pentaacetic acid
      chelator.
AB  - The pharmacokinetics of the C110 anti-carcinoembryonic antigen antibody
      radiolabeled with 111In via a novel benzylisothiocyanate derivative of
      diethylenetriamine pentaacetic acid have been determined in 12 patients. The
      chelator was attached to the protein via a thiourea bond and in such a way that
      all 5 carboxymethyl arms were presumably able to participate in chelation.
      Patients with known or suspected colorectal carcinoma received between 5 and 20
      mg of the IgG antibody labeled with 5 mCi of 111In. Individual organ
      radioactivity levels were quantitated, and serum and urine samples were analyzed,
      principally by size exclusion high-performance liquid chromatography (HPLC).
      Total urinary excretion averaged 0.18% of the injected dose/h with large patient
      to patient variation. At early times postadministration (less than 8 h) the
      predominant radiolabeled species in urine was free diethylenetriamine pentaacetic
      acid most probably administered as a small radiocontaminant in the injectate.
      Thereafter, radioactivity in urine was primarily present as a low molecular
      weight catabolic product. Analysis of serum by size exclusion HPLC occasionally
      showed 3 radioactivity peaks, 2 of which are due to circulating immune complexes
      and labeled antibody. The third peak is of low molecular weight and is due to one
      or more products of antibody catabolism. Transchelation of 111In to circulating
      transferrin was observed but at modest levels. Quantitation of organ
      radioactivity showed that 18 +/- 4 (SD)% of the injected dose was in the liver at
      1 day postadministration and 1.4 +/- 1.1 and 1.2 +/- 0.9% was in the spleen and
      in both kidneys, respectively, at this time. The mean half-life for clearance of
      total injected radioactivity was fitted to a single exponential and was found to
      be 34 h (SD, 14 h; N = 13) and that for antibody alone, assessed by size
      exclusion HPLC analysis of serum samples, was calculated to be 22 h (SD, 8 h; N =
      10). Neither of these values nor organ radioactivity levels were affected by
      antibody-loading dose.

PMID- 2224860
TI  - Inhibition of in vivo tumor growth by a monoclonal IgM antibody recognizing tumor
      cell surface carbohydrates.
AB  - We have shown previously that IgM from Ehrlich tumor (ET)-immunized mice,
      recognizing ET cell surface carbohydrates, protects control mice to a subsequent
      tumor challenge. The factors involved in such IgM-mediated protection were
      unknown, since it was independent of complement activation. Here, we have
      extended these in vivo studies by means of monoclonal IgM antibodies. Two of them
      (A10 and E1), strongly recognizing ET cells and with specificity to ET cell
      surface carbohydrates, were selected. The results show that A10 (but not E1 or
      unrelated IgM antibodies) is able to protect nonimmunized mice against ET growth.
      Protection by A10 was also seen by reducing 800-fold the initial dose; however,
      E1 was unsuccessful whatever the dose used. A10-mediated protection was observed
      in C3-defective mice (cobra venom factor treated) or in C5-deficient DBA/2, but
      not in silica-treated animals. Endotoxin removal did not affect the protection
      afforded by A10 while specific IgM depletion prevented any protective effect. In
      addition, the relationship between natural antibodies of IgM isotype recognizing
      ET cell surface carbohydrates and mouse strain resistance to this tumor is
      established. Similarly, this natural resistance seems to be complement
      independent but macrophage mediated. Therefore, these results indicate that some
      IgM molecules recognizing cell surface carbohydrates may participate in in vivo
      tumor suppression by a macrophage-dependent mechanism.

PMID- 2224859
TI  - Characterization of a receptor-negative, hormone-nonresponsive clone derived from
      a T47D human breast cancer cell line kept under estrogen-free conditions.
AB  - We have established an estrogen receptor- and progesterone receptor-negative,
      hormone-nonresponsive breast cancer cell line from a receptor-positive, hormone
      responsive line grown under estrogen-free conditions. T47D breast cancer cells
      were cultured under estrogenized conditions (in phenol red-containing medium
      supplemented with whole fetal bovine serum) and cloned to produce line T47D:A18.
      The parental T47D line was also estrogen deprived (in phenol red-free medium
      supplemented with dextran-coated charcoal-treated fetal bovine serum) for more
      than 1 year and subsequently clone T47D:C4 was established. T47D:A18 was estrogen
      receptor and progesterone receptor positive as determined by both ligand binding
      assay analysis and enzyme immunoassay analysis. T47D:C4 cells were estrogen
      receptor and progesterone receptor negative and mRNA for these receptors was not
      detected. Incubation of hormone-responsive T47D:A18 cells with 17 beta-estradiol
      caused a 3-fold increase in cell growth over 8 days when compared to control.
      This stimulation of growth was completely inhibited by the anti-estrogens 4
      hydroxytamoxifen (0.1 microM) and ICI 164,384 (1.0 microM). Receptor-negative
      T47D:C4 cells were refractory to the effects of both 17 beta-estradiol and the
      antiestrogens. T47D:A18 cells grown under both estrogen-containing and estrogen
      free conditions expressed low levels of transforming growth factor (TGF)-alpha
      and epidermal growth factor receptor mRNA. In the presence of estrogen, high
      levels of TGF-beta 1 mRNA were detected in T47D:A18 cells. These levels decreased
      when T47D:A18 cells were grown in estrogen-free media. Conversely, TGF-beta 2
      mRNA was not detected in T47D:A18 cells cultured under estrogenic conditions;
      however, message was detected after the cells were cultured under estrogen-free
      conditions. T47D:C4 cells expressed low levels of TGF-alpha, epidermal growth
      factor receptor, TGF-beta 1, and TGF-beta 2 mRNA. These studies characterize a
      novel hormone-nonresponsive cell line which has been established from a hormone
      responsive cell line grown under estrogen-free and drug-free conditions. Further
      analysis of these lines should provide valuable information concerning the
      development of antiestrogen-resistant breast cancer.

PMID- 2224861
TI  - Characterization and distribution in human tissues of a glycoproteic antigen
      defined by monoclonal antibody 1BE12 raised against the human breast cancer cell
      line T47D.
AB  - Spleen cells from inbred Biozzi mice, immunized against the human breast cancer
      cell line T47D, were fused with murine myeloma SP2O cells to generate monoclonal
      antibodies. One of these, 1BE12, of IgM isotype, reacted with five of six human
      breast tumor cell lines, while no binding was detectable with normal lymphocytes,
      RBC, or fibroblasts. The antigen recognized by monoclonal antibody 1BE12 was
      localized on the surface of T47D and MCF7 cells and was detected in cell-free
      supernatants of cultures. The antigen was found also on the surface of milk
      secretory cells. Immunohistochemical staining of frozen and paraffin-embedded
      sections of human tissues showed apical polarized reactivity in normal breast
      glands, while in all breast cancers staining was either cytoplasmic or membranous
      and heterogeneously distributed. Immunostaining was also observed in some other
      normal epithelia, including salivary gland, gastroduodenal mucosa, exocrine
      pancreas, and cervix. The antigen was not detectable in secretory endometrium,
      whereas proliferative endometrium was strongly stained. Colon carcinoma, and
      cancers of the bladder and endometrium were strongly reactive. No staining was
      detected in melanoma, lymphoma, mesothelioma, non-small cell lung carcinoma, and
      thyroid, renal, and ovarian carcinomas. Lectin absorption of MCF7 membrane
      extracts reduced 1BE12 binding. A large reduction in 1BE12 reactivity was
      observed after digestion of T47D and MCF7 membrane extracts with proteases.
      Treatment with sodium periodate resulted in complete loss of antigenicity, while
      neuraminidase treatment did not affect 1BE12 binding. These findings suggest that
      the 1BE12 epitope is expressed on the carbohydrate moiety of a glycoprotein and
      does not contain sialic acid. Immunoblotting of the perchloric acid-soluble
      fraction of MCF7 membrane extracts after electrophoresis in 1% agarose detected
      the antigen as a high molecular weight species (Mr greater than 900,000). The
      antigen was purified by perchloric acid extraction of MCF7 membrane preparations
      followed by affinity chromatography on 1BE12 antibody coupled to Sepharose-4B and
      gel exclusion fast protein liquid chromatography. No reactivity of the purified
      material was found with monoclonal antibodies directed against human milk fat
      globule membrane-associated mucins HMFG1 and DF3.

PMID- 2224862
TI  - Interleukin 2 and lymphokine-activated killer cell therapy: analysis of a bolus
      interleukin 2 and a continuous infusion interleukin 2 regimen.
AB  - Several groups have described the efficacy of interleukin 2 (IL-2) plus
      lymphokine-activated killer (LAK) cells in the treatment of cancer patients with
      significant response rates noted in patients with renal cell cancer and malignant
      melanoma; however, the optimum regimen remains undefined. The Biological Response
      Modifiers Program of the National Cancer Institute conducted two consecutive
      Phase I/II studies evaluating the toxicity and clinical efficacy of different
      methods of IL-2 and LAK cell therapy. In the first trial, we modified the
      standard Rosenberg regimen by decreasing the duration of priming in an attempt to
      reduce the toxicity related to this phase of the therapy and thereby administer
      more IL-2 doses with the LAK cells. In the second trial, we used a continuous
      i.v. infusion IL-2 regimen and altered both the leukapheresis procedure and the
      LAK cell culture techniques based on our in vitro and preclinical studies
      suggesting that 2-day LAK cells were superior. Thirty cancer patients received
      i.v. bolus IL-2 at 100,000 units/kg every 8 h for 3 days during priming and for 5
      days during LAK cell administration. A second group of 22 cancer patients
      received IL-2 by continuous i.v. infusion at 3 x 10(6) units/m2 for 5 days during
      priming and an additional 5 days of IL-2 with the LAK cell phase of the
      treatment. The timing of the start of the leukapheresis procedures, their
      duration and number, and the LAK cell culture techniques differed in the two
      trials. Overall, 52 patients with various cancers were treated. The toxicities
      associated with each regimen were similar to those seen in other IL-2 plus LAK
      cell trials. Four patients (one each with melanoma and diffuse large cell
      lymphoma and two with renal cell cancer) exhibited partial responses lasting 2,
      4, 10, and 15+ mo. Serial tumor biopsies from treated patients demonstrated that
      therapy can produce a marked mononuclear cell infiltrate and an increase in HLA
      DR expression on tumor cells. There was no difference in the overall response
      rate between the two regimens, but toxicity was less with continuous i.v.
      infusion IL-2. The 5-day continuous i.v. infusion regimen resulted in
      significantly higher rebound lymphocytosis, cell yield from leukapheresis, and
      number of LAK cells harvested from culture.

PMID- 2224863
TI  - In vivo invasion assay of low passage cultured cells derived from human lung
      cancer using deepithelialized rat tracheas xenotransplanted into nude mice.
AB  - Human lung tumor-derived cell lines with low passage generation were transplanted
      into nude mice to determine their growth behavior and invasive potential. Six
      cell lines (HKT-2, HKT-3, HKT-5, HKT-6, HKT-7, HKT-8) were inoculated into
      deepithelialized rat trachea (5 x 10(5) cells/trachea). After cell inoculation,
      the tracheas were sealed and transplanted into the subcutis of nude mice. In a
      parallel experiment, these cell lines (1 x 10(6) cells) were injected s.c. In the
      subcutis, the tumor take rate of HKT-3, the lowest of all, was only 13% with a
      long latency period of 18 weeks, and 3 cell lines (HKT-2, HKT-3, HKT-7) did not
      show any invasive growth to the surrounding tissue. In rat tracheas, all cell
      lines proliferated within 3 weeks, and 4 of them (HKT-2, HKT-5, HKT-6, HKT-8)
      showed invasive growth to the tracheal wall within 1-2 weeks. Cells growing in
      the tracheal wall showed higher [3H]thymidine labeling indexes and greater
      atypia, such as larger nuclei and prominent nucleoli, than those in the tracheal
      lumen. The s.c. tumor take rate correlated with the incidence of invasive growth
      to the tracheal wall. The survival of the patients originally bearing the six
      tumors also correlated closely with the invasive potential of this system. These
      results indicate that the system using low passage cell lines can evaluate the
      invasive potential shortly after the inoculation of a relatively small number of
      cells and can be used as a clinically reliable biological invasion assay.

PMID- 2224864
TI  - Down-regulated c-myb expression inhibits DNA synthesis of T-leukemia cells in
      most patients.
AB  - We have investigated the functional relevance of c-myb expression for DNA
      synthesis in patients' T-leukemia cells. [3H]Thymidine incorporation assays of 32
      patients' leukemia cells exposed in vitro to c-myb sense or antisense
      oligodeoxynucleotides served to define two groups of patients: a responder group
      whose leukemia cells showed 2- to 16-fold lower levels of [3H]thymidine
      incorporation in c-myb antisense-treated cultures than in c-myb sense-treated
      cultures (20 patients) and a nonresponder group whose cells showed comparable
      [3H]thymidine incorporation levels in either c-myb sense- or antisense-treated
      cultures (12 patients). Down-regulation of c-myb mRNA levels in cells exposed to
      c-myb antisense oligodeoxynucleotides was comparable in both groups of patients,
      indicating that differential sensitivity to c-myb antisense oligodeoxynucleotides
      was not due to differential uptake of these oligodeoxynucleotides. DNA polymerase
      alpha mRNA levels were down-regulated in cells from the responders but were
      unaffected in the nonresponder group. These results suggest that c-myb is
      required for DNA synthesis in cells of many but not all T-leukemia patients and
      that leukemia cells in which DNA synthesis is not inhibited despite down
      regulation of c-myb expression may have undergone some genetic change(s) that
      obviate(s) the requirement for myb protein.

PMID- 2224865
TI  - Contrast-enhanced magnetic resonance imaging of tumor-bearing mice treated with
      human recombinant tumor necrosis factor alpha.
AB  - Pharmacological effects of recombinant human tumor necrosis factor alpha (TNF)
      were studied in a mouse fibrosarcoma model using magnetic resonance imaging
      enhanced with a macromolecular contrast agent, albumin(gadolinium
      diethylenetriamine pentaacetic acid)35. TNF was administered i.v. in a dose of
      150 micrograms/kg, 60 to 80 min prior to imaging. Contrast-enhanced and
      nonenhanced magnetic resonance images of TNF-treated (n = 10) and untreated (n =
      8) Meth A fibrosarcomas were obtained at 2.0 Tesla using T1-weighted spin-echo
      pulse sequences. Serial images spanning an interval of 60 to 120 min after TNF
      administration showed that the TNF-treated tumors enhanced significantly more
      overall than did untreated tumors (43% versus 31%). The most marked differential
      tumor enhancement was observed in the tumor rim (59% versus 40%). Nontumorous
      tissue, including muscle and brain, revealed no significant enhancement
      differences between TNF-treated animals and controls. The observed tumor
      enhancement corresponded strongly with Evans blue staining; the TNF-treated
      tumors stained deep blue, while untreated tumors and normal tissues observed did
      not stain. The different enhancement and Evans blue staining patterns between TNF
      treated tumors and untreated tumors are attributed to TNF-induced changes in
      tumor capillary integrity. The data indicate that TNF effects on tumors include
      an increased capillary permeability for macromolecules at early times after
      administration. The ability to detect changes in capillary permeability in vivo
      using contrast-enhanced magnetic resonance imaging may prove to be clinically
      useful to monitor tumor response to TNF.

PMID- 2224867
TI  - Cancer Research. Index to Volume 50.

PMID- 2224866
TI  - Pharmacokinetic analysis of immunotoxin uptake in solid tumors: role of plasma
      kinetics, capillary permeability, and binding.
AB  - The delivery of cell-specific protein toxins to the interstitium of solid tumors
      was examined in athymic mice bearing s.c. human rhabdomyosarcoma (TE671) tumors.
      The toxins are diphtheria toxin (DT), Mr = 60,000, and an immunotoxin, Mr =
      210,000. The immunotoxin is a chemical conjugate of a mutant DT defective in
      binding and a monoclonal antibody specific for the human transferrin receptor.
      The plasma, tumor, and muscle concentrations of DT, immunotoxin, and closely
      related nonbinding controls were measured 2, 6, and 24 h after i.v. injection
      into tumor-bearing mice. Both DT and immunotoxin are specific for the human
      xenograft in the mouse because DT is very toxic to human cells but not to murine
      cells and immunotoxin is directed against a human cell receptor. A compartmental
      pharmacokinetic model was developed for the analysis of the in vivo data to
      provide plasma-to-tissue transport constants (capillary permeability-area
      products), binding parameters (products of the association constant and the
      initial binding site concentration), and the interstitial fluid flow rate. The
      model also provides a simple mathematical framework for understanding the effect
      of these variables on the localization of macromolecules in tumors. The plasma-to
      tissue transport constant of immunotoxin in TE671 tumor was 0.13
      microliters/min/g, compared to 0.29 microliters/min/g for DT. However, despite
      the lower capillary permeability of the larger molecular weight toxin, the
      cumulative tumor exposure to immunotoxin was 80% higher than that to DT after 24
      h. A longer plasma half-life and higher apparent in vivo binding parameter of
      immunotoxin compared to DT contributed to the higher tumor exposure. Plasma-to
      tissue transport constants for tumor were 60 to 100% higher than those for
      muscle. This finding is consistent with observations by others that tumor
      vasculature is more permeable than are normal muscle capillaries. Also, the
      interstitial fluid flow of the tumor, 0.80 microliters/min/g, was higher than
      that of muscle, 0.58 microliters/min/g. The product of the binding affinity and
      binding site concentration for immunotoxin in vivo was 530 times lower than that
      predicted based on in vitro measurements. Lower expression of antigen binding
      sites, inaccessibility of binding sites in vivo, and degradation of the toxin are
      several possible factors that may account for the in vitro-in vivo differences in
      binding. This study illustrates the interrelationship of plasma kinetics,
      capillary permeability, and binding and their effects on toxin concentrations
      that are achieved in the tissue interstitium.

PMID- 2224869
TI  - The pattern of metastases in human breast cancer: methodological aspects and
      influence of prognostic factors.

PMID- 2224868
TI  - Long-term adjuvant tamoxifen therapy for breast cancer: the prelude to
      prevention.

PMID- 2224870
TI  - Chemotherapy for brain metastases: recent developments and clinical
      considerations.

PMID- 2224871
TI  - Radiation therapy for squamous cell carcinomas of the oral cavity and oropharynx:
      a review of recent techniques.

PMID- 2224872
TI  - Trying to bridge a gap.

PMID- 2224873
TI  - Intracranial hemorrhage in hypothermic low-birth-weight neonates.
AB  - We studied periventricular/intraventricular type intracranial hemorrhage (ICH) by
      cranial ultrasonography in 82 low-birth-weight (LBW) newborn infants with
      admission hypothermia against the gestational-age-matched 82 normothermic
      neonates. The incidence of ICH was higher in the hypothermic infants during the
      1st week of life (34/82 vs 20/82, P less than 0.02). Although the distribution of
      individual grades of ICH was not significantly different between the groups, the
      first ultrasound scan showed higher incidence of major ICH (grades 3 and 4) in
      the hypothermic infants. Most of the minor ICH (grades 1 and 2) after the first
      ultrasound appeared in infants who were small for their gestational age. Our data
      do not support the contention that admission hypothermia can precipitate the
      development of IVH in LBW infants. However, the detection of admission
      hypothermia in a LBW neonate should make one suspect the possibility of ICH and
      regard it as a manifestation of the severity of ICH rather than the cause. Most
      likely, this close relationship between hypothermia and neonatal ICH originates
      from perinatal asphyxia and the cumulative adverse effects of asphyxia-related
      events.

PMID- 2224874
TI  - Cerebral blood-flow velocity patterns in post-hemorrhagic ventricular dilation.
AB  - To evaluate the effect of ventricular dilation (VD) on cerebral hemodynamics,
      serial cerebral bloodflow velocity patterns from the anterior and middle
      cerebral, and circle of Willis arteries were examined by range-gated, pulsed
      Doppler sonography in premature infants developing post-hemorrhagic VD. Nine
      infants (25 to 30 weeks gestation) without a patent ductus arteriosus were
      studied until resolution of VD. Forty-nine cranial sonograms from all nine
      infants were reviewed independently and grouped cross-sectionally into mild,
      moderate and severe VD prior to shunt. The corresponding pulsatility index (PI)
      showed a consistent trend of increase with VD in all three studied vessels. In
      six infants, absent or reversed diastolic flow was observed at the height of VD.
      Four of these infants required V-P shunt. Immediate fall in PI occurred in all
      three vessels. Serial measurement of PI during VD reflects global changes in
      cerebrovascular resistance. Results confirmed PI could be a useful index in
      monitoring cerebral hemodynamic changes.

PMID- 2224875
TI  - The risk of convulsions: a longitudinal study of normal babies and infants with
      neonatal damage in the first 6 years of life.
AB  - After carefully reviewing the epidemiological literature on this subject, we
      assessed the risk of febrile, isolated or epileptic convulsions in normal babies
      and infants with neonatal damage. We considered 417 term or preterm infants with
      birth injury and compared them with 400 healthy full-term newborns, all born
      between 1978 and 1980, studying each one individually until at least the age of 6
      using the chi 2 test, the risk factors in relation to the convulsive outcome in
      all the groups were processed. We also calculated the relative risk of outcome of
      both febrile convulsions and epilepsy. Our results show that as far as the onset
      of seizure disorders in the term infant is concerned, the predisposing factors
      are asphyxia, neurological syndrome, and previous barbiturate intake. In contrast
      with this, for premature infants the risk factors are severe apnea and severe
      prematurity.

PMID- 2224876
TI  - Tethered cord syndrome versus low-placed conus medullaris in an over-distended
      spinal cord following initial repair for myelodysplasia.
AB  - We present findings obtained from a total of 100 patients who had previously
      undergone surgery for spina bifida and whose progress had been monitored by
      magnetic resonance imaging (MRI) in our meningomyelocele clinic. Fourteen of
      these patients (14.0%) developed delayed symptom(s) of progressive spinal
      neurologic dysfunction. In those with myeloschisis, increase of motor deficit was
      the most common clinical manifestation during infancy and early childhood (mean
      age: 6.8 years), whereas pain on back flexion was seen in patients who were over
      15 years of age (mean age: 17.3 years). MRI carried out in myeloschisis patients
      invariably demonstrated that the conus medullaris was in an abnormally low
      position, suggesting over-distension of the spinal cord. This was irrespective of
      whether symptom(s) developed or not and did not correlate with the initial
      surgical procedure (reconstructive or otherwise) used. Patients with symptom(s)
      were revealed by MRI to have an extremely low conus set at the spinal level of S
      1 or below; neurological examinations showed that the motor deficit occurred at
      high levels in the spine. Results from lipomeningocele patients were more erratic
      in terms of conus position and delayed development of neurological
      defects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2224878
TI  - A case of "accessory falx cerebri".
AB  - We report on a 12-year-old boy who underwent a right frontotemporoparietal
      craniotomy for complete extirpation of three cavernous hemangiomas of the
      temporal lobe. On this occasion, an accessory dural septum was observed that
      spanned, in the direction of the corona, the temporo-occipital base upward to the
      lower parietal area. It produced a deep notch in the cortex, was supplied by a
      small leptomeningeal artery, and probably contained small venous sinus.
      Embryological considerations and clinical relevance are discussed.

PMID- 2224879
TI  - XVIII annual meeting of the International Society for Pediatric Neurosurgery.
      Paris, 17-20 September 1990. Abstracts.

PMID- 2224877
TI  - Clinical experience with a pressure-adjustable valve SOPHY in the management of
      hydrocephalus.
AB  - Seventy-four patients with hydrocephalus due to a variety of causes were treated
      with a cerebrospinal fluid (CSF) shunt, incorporating a recently developed
      pressure-adjustable valve SOPHY (PAVS). The PAVS may be changed percutaneously
      with the help of an externally applied magnet in order to select a high-, medium-
      or low-valve opening pressure, whenever the need for a change in pressure
      characteristics seems necessary to the neurosurgeon. The percutaneous pressure
      adjustment obviated up- or downgrading of a medium pressure position by surgical
      means in half of our patients during the follow-up time (up to 39 months; mean
      follow-up 16.7 months). In 66 patients (89%) decreased ventricle volume and
      improvement of the clinical sign of increased intracranial pressure were
      established. In 11 patients a valve or a catheter infection occurred; in 6 of
      these patients the valve had to be removed. Half of this group consisted of
      patients under 2 years of age. Significant technical complications related to the
      PAVS did not occur in our series but until a somewhat smaller PAVS is available,
      we cannot recommend its use in neonates or in small infants. In all other
      patients the PAVS is a very valuable instrument in the surgical management of
      hydrocephalus because it makes shunt revisions for inadequate valve pressure
      obsolete in individual patients.

PMID- 2224880
TI  - X-ray and conformational investigations of a 4:1 mixture of 6-(N-benzyl-N-tert
      butoxycarbonylamino)-2,3,6,7-tetradeoxy-alpha- DL-ery thro- and -beta-DL-threo
      hept-2-enopyranos-4-uloses.
AB  - The crystals of a 4:1 mixture of 6-(N-benzyl-N-tert-butoxycarbonylamino)-2,3,6,7
      tetradeoxy-a-DL-er ythro- and -beta-DL-threo-hept-2-enopyranos-4-ulose were
      monoclinic, space group P2(1)/c, with cell dimensions: a = 9.490(2), b =
      21.516(5), c = 10.279(2) A, beta = 115.31(1) degrees, Z = 4. The ulose ring had a
      half-chair conformation deformed towards the sofa (envelope) form.

PMID- 2224881
TI  - Semisynthetic epsilon-isorhodomycins: their synthesis using glycals and their
      structure-activity relationship.
AB  - Syntheses and structure-activity relationships of 7-O-(3-amino-2,3,6-trideoxy-a-L
      lyxo- (18), -L-arabino- (20) and -L-ribo- hexopyranosyl)-epsilon-isorhodomycins
      (25) and their 3'-dimethylamino derivatives 22, 23 and 26 are described.
      Condensation (trimethylsilyl triflate, molecular sieves 4 A, 10:1 dichloromethane
      acetone, -15 degrees) of epsilon-isorhodomycinone (epsilon-isoRMN, 6) with 1,5
      anhydro-4-O-p-nitrobenzoyl-3-trifluoroacetamido-L-lyxo- (5) -L-arabino- (9) or -L
      ribo-hex-l-enitols (10) afforded mainly the 7-O-a-glycosyl-epsilon-isoRMNs 7, 11,
      and 12. Similar glycosylation of 6 with 1,5-anhydro-3-azido-4-O-p-nitrobenzoyl
      2,3,6-trideoxy-L-arabino-hex-1-++ +enitol (15) yielded a-glycoside 16. Removal (M
      NaOH) of the p-nitrobenzoyl and trifluoroacetyl groups from 7, 11, and 12 gave
      the 7-O-(3-amino-2,3,6-trideoxy-a-L-hexopyranosyl)-epsilon-isoRMNs 18, 20, and
      25. Reductive alkylation (CH2O, NaCNBH3) of these products afforded the 3'-N,N
      dimethyl analogues 22, 23, and 26. The cytotoxic effect (IC50) of the
      semisynthetic epsilon-isorhodomycins was tested in vitro in leukemia cell line
      L1210.

PMID- 2224882
TI  - Synthesis of O-alpha-D-glucopyranosyl-(1----4)-O-alpha -D-xylopyranosyl-(1----4)
      O-alpha -D-xylopyranosyl-(1----4)-D-glucopyranose as a substrate analogue of
      alpha amylase.
AB  - The tetrasaccharide a-D-Glcp-(1----4)-a-D-Xylp-(1----4)-a-D-Xylp-(1----4)-D- Glcp
      (1) has been synthesized, as a substrate analogue of alpha amylase, by silver
      perchlorate-catalyzed glycosylation of benzyl 2,3,6-tri-O-benzyl-4-O-(2,3-di-O
      benzyl-a-D-xylopyranosyl)-beta-D- glucopyranoside (30) with 2,3-di-O-benzyl-4-O
      (2,3,4,6-tetra-O-benzyl-a-D- glucopyranosyl)-a-D-xylopyranosyl chloride or by
      methyl triflate-promoted condensation of 30 with methyl 2,3-di-O-benzyl-4-O
      (2,3,4,6-tetra-O-benzyl-a-D-glucopyranosyl)-1-thio- beta-D-xylopyranoside,
      followed by removal of protecting groups of the resulting tetrasaccharide
      derivative 40.

PMID- 2224883
TI  - Structure of the type 5 capsular polysaccharide of Staphylococcus aureus.
AB  - The Staphylococcus aureus type 5 capsular polysaccharide is composed of 2
      acetamido-2-deoxy-L-fucose (1 part), 2-acetamido-2-deoxy-D-fucose (1 part), and 2
      acetamido-2-deoxy-D-mannuronic acid (1 part). On the basis of methylation
      analysis, optical rotation, high-field one- and two-dimensional 1H- and 13C
      n.m.r. experiments, and selective cleavage with 70% aqueous hydrogen fluoride,
      the polysaccharide was found to be a partially O-acetylated (50%) polymer of the
      repeating trisaccharide unit, [----4)-3-O-Ac-beta-D-ManpNAcA-(1----4)-a-L-FucpNAc
      (1----3) -beta-D-FucpNAc-(1----]n.

PMID- 2224884
TI  - An asymmetric approach to 2-deoxynucleosides via organosulfur building blocks as
      chemical chameleons.
AB  - An asymmetric synthesis of 6-N-benzoyl-5'-O-benzyl-2'-deoxyadenosine and its a
      anomer from non-carbohydrate building blocks is achieved in 7 steps. The sequence
      builds the basic structures using bis(methylthio)methane and methylthiomethyl
      phenyl sulfone as both nucleophilic and electrophilic building blocks, a feature
      that suggests their behavior as chemical chameleons. The asymmetric induction is
      achieved utilizing a kinetic resolution based upon catalytic asymmetric
      epoxidation.

PMID- 2224885
TI  - Effect on human liver glycosidases and short syntheses of 1 alpha,2 alpha,6
      alpha,7 alpha,7a beta-1,2,6,7-tetrahydroxypyrrolizidine from D-glycero-D-gulo
      heptono-1,4-lactone.
AB  - The synthesis of 1 alpha,2 alpha,6 alpha,7 alpha,7a beta-1,2,6,7
      tetrahydroxypyrrolizidine (1) from D-glycero-D-gulo-heptono-1,4-lactone (6) by
      two different routes is reported. The effects of 1 on the inhibition of 15 human
      liver glycosidases are described.

PMID- 2224886
TI  - Synthesis of 1-deoxy-6-epicastanospermine and 1-deoxy-6,8a-diepicastanospermine.
AB  - Extension of the carbon spine of 2,3;4,5-di-O-isopropylidene-beta-D
      fructopyranoside by oxidation at C-1 followed by a Wittig reaction using the
      phosphorane Ph3P = CHCO2Et gave an oct-4-ulose derivative, which was then
      transformed into the key intermediate 1-azido-1,2,3-trideoxy-D-arabino-oct-4
      ulose. Catalytic hydrogenolysis of this azide, followed by reductive amination
      between the resulting 1-amino substituent and the 4-keto-group then gave a
      mixture of pyrrolidines. After sulphonylation at the terminal 8-position, the
      pyrrolidines were then cyclised further between the nitrogen and C-8 to give 1
      deoxy-6-epicastanospermine and 1-deoxy-6,8a-diepicastanospermine.

PMID- 2224887
TI  - De novo synthesis of carbohydrates by stereoselective aldol reaction: L
      cladinose.
AB  - Aldol reactions of methyl 2-methoxypropanoate (4), the corresponding ester of 2
      methoxypropanoic acid with 4-methyl-2,6-di-(tert-butyl)phenol (13), and
      silylketene acetals 14 and 15 with (S)-2-(phenyl-methoxy)propanal (17) have been
      investigated. The lithium enolate of 4 reacts with 17 to give primarily beta
      hydroxy ester 18a. If the reaction is carried out with the bis-silylketene acetal
      14 under the influence of stannic chloride, beta-hydroxy acid 20c is produced.
      Compound 20c is cleanly inverted, via the beta-lactone 26, to provide beta
      hydroxy acid 19c. Compound 18a has been converted into L-cladinose by the
      sequence of steps: 18a----35----39----40----41----42----1.

PMID- 2224888
TI  - The use of N-alkoxycarbonyl derivatives of 2-amino-2-deoxy-D-glucose as donors in
      glycosylation reactions.
AB  - 1,3,4,6-Tetra-O-acetyl-2-alkoxycarbonylamino-2-deoxy-beta-D-glu copyranoses and
      3,4,6-tri-O-acetyl-2-alkoxycarbonylamino-2-deoxy-alpha-D-glucopyra nosyl bromides
      have been used as donors in glycosylation reactions with model alcohols. beta
      Glycosides were obtained in good yields and with a high degree of 1,2-trans
      stereoselectivity. An oxazolidinone was formed as the main product from the
      reaction of some of the glucopyranosyl bromides with alcohols of low reactivity,
      but the formation of all products could be interpreted by a strong participation
      of the alkoxycarbonylamino group.

PMID- 2224889
TI  - Total synthesis of globotriaosylceramide (Gb3) and lysoglobotriaosylceramide
      (lysoGb3).
AB  - We have recently reported a highly efficient and stereocontrolled synthesis of
      globotriaosylceramide (Gb3, 1) in optically pure form. Key to our synthetic
      strategy was the implementation of the two-stage activation of thioglycosides for
      formation of the glycosidic bonds and the utilization of (2S, 3S, 4E)-2-azido-3-O
      (tert-butyldimethylsilyl)-4-octadecen-1,3-di ol (9) as a sphingosine equivalent.
      The syntheses of Gb3 (1) and lysoGb3 (2) were achieved by stereocontrolled
      coupling of 2,3,4,6-tetra-O-benzyl-alpha-D-galactosyl fluoride (15) with phenyl O
      (6-O-benzoyl-2,3-di-O-pivaloyl-beta-D-galactopyranosyl)- (1----4)-2,3,6-tri-O
      pivaloyl-1-thio-beta-D-glucopyranoside (14) to form the P kappa antigen
      trisaccharide masked as a phenyl 1-thioglycoside at the reducing end.
      Thioglycoside 16 was converted into glycosyl fluoride 19, which was coupled to 9
      in high yield. The coupled product 20 was converted into the title compounds 1
      and 2 in four and three steps, respectively. This article presents the total
      synthesis of 1 and 2 in full experimental detail.

PMID- 2224890
TI  - Muramic acid derivatives as glycosyl donors for the synthesis of muramyl
      containing glycosphingolipids and fatty acids.
AB  - 2-Azido-2-deoxy-4,6-O-isopropylidene-3-O-[(1R)-(methoxycarbonyl)ethyl]- alpha-D
      glucopyranosyl trichloroacetimidate (3 alpha) has been used as the glycosyl donor
      in the synthesis of glycosphingolipids 14 and 27. Reaction of 3 alpha with (2S,
      3R, 4E)-2-azido-3-benzoyloxy-4-octadecen-1-ol (6) gave (2S, 3R, 4E)-2-azido-1-(2
      azido-2-deoxy-4,6-O-isopropylidene-3-O-[(1R)-1-(m ethoxycarbonyl)ethyl]-beta-D
      glucopyranosyloxyl)-3-benzoyloxy-4- octadecene (7), which was converted into (2S,
      3R, 4E)-1-(2-deoxy-2-hexadecanoylamino-3-O-[(2R)-propanoyl-(L-alanyl-D 
      isoglutamine benzyl ester)-2-yl]-beta-D-glucopyranosyloxy)-2-hexadecanoylamino-4
      oc tadecen-ol (14). Reaction of 3 alpha with tert-butyldimethylsilyl 2-azido-3,6
      di-O-benzyl-2-deoxy-beta-D-glucopyranoside (15) gave tert-butyldimethylsilyl 2
      azido-4-O-(2-azido-2-deoxy-4,6-O-isopropylidene-3-O-[(1R)-1-(methox
      ycarbonyl)ethyl]-beta-D-glucopyranosyl)-3,6-di-O-benzyl-2-deoxy-be ta- D-gluc
      opyranoside (16 beta), which was converted into 1,3,6-tri-O-acetyl-2-deoxy-4-O
      (4,6-di-O-acetyl-2-deoxy-2-hexadecanoy lam ino-3-O-[2R)-propanoyl-(L-alanyl-D
      isoglutamine methyl ester)-2-yl]-beta-D-glucopyranosyl)-2-hexadecanoylamino-D
      glucopyranose (27).

PMID- 2224891
TI  - Synthesis of glycopeptides with the TN and T antigen structures, and their
      coupling to bovine serum albumin.
AB  - Glycopeptides with TN and T antigen structures that represent the N-terminal
      tripeptide of asialoglycophorin with blood-group M specificity have been
      synthesized using fluorenylmethoxycarbonyl (Fmoc) and 2-pyridylethoxycarbonyl
      (Pyoc) groups for amino protection and the benzyl ester as the carboxyl-blocking
      function. The Fmoc and the Pyoc groups could be removed by treatment with the
      weak base morpholine under conditions where the base-sensitive O-glycosyl-serine
      and -threonine linkages were stable. Ester groups were removed from the
      carbohydrate moieties with methanolic hydrazine, to give the TN and T antigen
      glycopeptides which were coupled to bovine serum albumin (BSA) via a carbodi
      imide procedure and without any spacer groups. The resulting conjugates contained
      an average of greater than 20 glycopeptides per protein molecule. They are not
      microheterogeneous in the carbohydrate part as is commonly found for
      glycoproteins isolated from biological sources.

PMID- 2224893
TI  - Syntheses of trisaccharide C-D-E and tetrasaccharide B-C-D-E fragments found in
      orthosomycins.
AB  - 1,5-Anhydro-3-O-benzyl-2,6-dideoxy-4-O-(3,4-di-O-benzyl-2,6-dideoxy-beta -D-
      arabino-hexopyranosyl)-D-arabino-hex-1-enitol (17), which corresponds to the B-C
      fragment of various orthosomycins, was prepared from phenyl 2,3-di-O-benzyl-6
      deoxy-4-O-(3,4-di-O-benzyl-2,6-dideoxy- beta-D-arabino-hexopyranosyl)-1-thio-beta
      D-glucopyranoside (16) by reductive lithiation. The synthesis of 16 involved a
      stereoselective coupling of phenyl 2,3-di-O-benzyl-6-deoxy-1-thio-beta-D
      glucopyranoside (9) and 1,2-di-O-acetyl-3,4-di-O-benzyl-6-deoxy-beta-D
      glucopyranose (14) followed by deoxygenation at C-2'. Glycosylation of methyl 2-O
      benzyl-6- deoxy-4-O-methyl-beta-D-galactopyranoside (25) with 3,4,6-tri-O-acetyl
      2-deoxy- 2-phthalimido-beta-D-glucopyranosyl trichloroacetimidate, followed by
      deamination at C-2', led stereospecifically to methyl 2-O-benzyl-6-deoxy-4-O
      methyl-3-O-(3,4,6-tri-O-acetyl-2-deoxy-beta-D-ara bino- hexopyranosyl)-beta-D
      galactopyranoside (26). The 2-deoxy unit of 26 was then modified by consecutive
      axial introduction of a C-Me group at position 3', protection of HO-3', and
      deoxygenation at C-6', in order to obtain methyl 3-O-(3-O-benzoyl-2,6-dideoxy-3-C
      methyl-beta-D-arabino-hexopyranosyl)-2- O- benzyl-6-deoxy-4-O-methyl-beta-D
      galactopyranoside (39), which corresponds to the D-E fragment of orthosomycins. A
      glycosyloxyselenation-oxidation-elimination sequence was performed on 39 and
      either 1,5-anhydro-3,4-di-O-benzyl-2,6- dideoxy-D-arabino-hex-1-enitol (40) or
      1,5-anhydro-3-O-benzyl-2,6-dideoxy-4-O-(3,4-di-O-benzyl-2,6- dideoxy-beta-D
      arabino-hexopyranosyl)-D-arabino-hex-1-enitol (17) to give the C-D-E tri-and B-C
      D-E tetrasaccharide fragments, respectively. Each fragment contained the spiro
      ortholactone junction with an (R) configuration at the anomeric carbon atom of
      the C-unit.

PMID- 2224892
TI  - 1,3,4,6-Tetra-O-acetyl-2-chloroacetamido-2-deoxy-beta-D-glucopyranose as a
      glycosyl donor in syntheses of oligosaccharides.
AB  - 1,3,4,6-Tetra-O-acetyl-2-chloroacetamido-2-deoxy-beta-D-glucopyran ose was tested
      as a glycosyl donor for oligosaccharide synthesis via a ferric chloride-catalyzed
      coupling reaction. Glycosyl acceptors tried (6 in all) were O-benzyl-protected D
      galactosides having free OH groups at positions 3 and 4, respectively, and
      similarly protected glycosides of D-glucose and 2-acetamido-2-deoxy-D-glucose
      unsubstituted on O-4. Existing syntheses of all the acceptors were improved, in
      four instances by exploitation of Garegg and Hultberg's cyanoborohydride
      procedure for the conversion 4,6-O-benzylidene----6- O-benzyl [Carbohydr. Res.,
      93 (1981) c10-c11; 108 (1982) 97-101]. Good to excellent yields of beta-linked
      disaccharides were obtained from the galactoside and glucoside acceptors, but
      with allyl 2-acetamido-3,6-di-O-benzyl-2-deoxy-alpha-D-glucopyranoside,
      stereoselectivity was lost (alpha:beta-ratio 1:2). Allyl and benzyl 2-acetamido
      3,6-di-O-benzyl-2-deoxy-beta-D-glucopyranosides gave, respectively, the allyl and
      benzyl beta-glycosides of the donor as major products. A mechanism is proposed
      for this transglycosidation reaction. The N-chloroacetyl groups in the
      disaccharide products were readily converted into N-acetyl by reduction with zinc
      acetic acid.

PMID- 2224894
TI  - Synthesis of L-gulose, L-galactose, and their acetylated aldehydo forms from 6-S
      phenyl-6-thio-D-hexoses.
AB  - Methyl 6-S-phenyl-6-thio-a-D-glucopyranoside, prepared in high yield from methyl
      a-D-glucopyranoside by the action of diphenyl disulfide and tributylphosphine in
      pyridine, was converted into 6-S-phenyl-6-thio-D-glucitol pentaacetate (7) by
      sequential hydrolysis, borohydride reduction, and acetylation. Oxidation of 7
      with 3-chloroperoxybenzoic acid gave the corresponding S-epimeric sulfoxides,
      which underwent Pummerer rearrangement to 1-epimeric L-gulose S-phenyl
      monothiohemiacetal hexaacetates. Boron trifluoride-catalyzed reaction of the
      latter with thiophenol gave the analogous diphenyl dithioacetal, whereas base
      catalyzed methanolysis led to free L-gulose. Treatment of 7 with N
      chlorosuccinimide afforded 1-epimeric 1-chloro-1-S-phenyl-1-thio-L-gulitol
      pentaacetates, which were hydrolyzed to provide aldehydo-L-gulose pentaacetate.
      The same reaction sequences were performed with 6-S-phenyl-6-thio-D-galactose,
      synthesized in two steps from 1,2:3,4-di-O-isopropylidene-a-D-galactopyranose,
      furnishing ultimately L-galactose, its diphenyl dithioacetal pentaacetate, and
      aldehydo-L-galactose pentaacetate. Similar reaction sequences for the chain
      terminal interchange of oxidation state in other omega-S-phenyl-omega-thioaldoses
      may prove useful for the preparation of less-common sugar derivatives.

PMID- 2224895
TI  - Multiple and long-range participation of benzyl groups in intramolecular C
      arylation reactions of benzylated glycosides.
AB  - The intrinsic reactivity of furanosides bearing activated O-benzyl substituents
      (3-methoxybenzyl), in the presence of bidentate Lewis acids such as tin(IV)
      chloride, was explored. These glycosides were found to exhibit extremely
      interesting chemical properties. Thus, with three reactive substituents (at O
      2,3,5), the corresponding glycosides (1 and 7) underwent a novel internal bis-C
      arylation process, which involved successive alkylations of the benzyl groups at
      O-2 and O-3 ("multiple participation"), leading to the formal replacement of the
      two C-O bonds at the anomeric center of the glycoside by two C-C bonds. The bis-C
      arylated constitution of the resulting polycyclic compounds 4 and 8, and the cis
      configuration of their fused ring system (a tetrahydro-[2]benzopyrano[3,4
      d][2]benzoxepin derivative), were determined on the basis of their n.m.r.
      spectral parameters. With two 3-methoxybenzyl substituents (at O-3 and O-5,
      compound 6), intramolecular alkylation of the benzyl group at O-3 or O-5 occurred
      when glycoside 6 was reacted with titanium(IV) chloride or tin(IV) chloride,
      respectively, thereby leading to novel bicyclic internal aryl C-glycosides (9 and
      12) as major products ("long-range participation"). The constitution of compounds
      9 and 12 was unambiguously established by the reactions of analogs of 6 bearing
      only one 3-methoxybenzyl substituent at a specific position (at O-3: 15; at O-5:
      20). The unexpected divergent behavior of 6 in the presence of titanium(IV) and
      tin(IV) chloride remains to be explained. The availability of compound 9 made it
      possible to independently prepare the bis-C-arylated derivative 8 (by way of the
      reverse sequence of internal C-arylation reactions) and thereby to definitively
      demonstrate its constitution. These unprecedented reactions extend the scope of
      the intramolecular C-glycosidation of substituted sugars and provide novel
      methodologies in synthetic carbohydrate chemistry.

PMID- 2224896
TI  - Synthesis of methyl 3-O-alpha-D-galactopyranosyl-6-O-alpha-D-mannopyranosyl-
      alpha-D-mannopyranoside, methyl 3-O-alpha-D-glucopyranosyl-6-O-alpha-D-
      mannopyranosyl-alpha-D-mannopyranoside, methyl 6-O-alpha-D-galactopyranosyl-3- O
      alpha-D-mannopyranosyl-alpha-D-mannopyranoside, and methyl 6-O-alpha-D
      glucopyranosyl-3-O-alpha-D-mannopyranosyl-alpha-D- mannopyranoside.

PMID- 2224897
TI  - Separation of yeast asparagine-linked oligosaccharides by high-performance anion
      exchange chromatography.
AB  - Oligosaccharides obtained from Saccharomyces cerevisiae mannoproteins by
      digestion with endo-N-acetyl-beta-D-glucosaminidase H were fractionated by anion
      exchange chromatography, by elution with 50-100mM NaOH without or with a sodium
      acetate gradient, and detected with a pulsed amperometric detector (PAD). The
      elution times of homologous oligosaccharides fell on a straight line having a
      slope characteristic of the structural type. The response of the PAD detector per
      mole of oligosaccharide increased about 2-fold going from Man3GlcNAc to
      Man13GlcNAc, and appeared to depend primarily on the oxidation of the reducing
      end N-acetylglucosamine unit common to all the oligosaccharides. The digestion of
      a Man10GlcNAc with jack-bean alpha-mannosidase was monitored by injecting
      portions of the crude reaction mixture, and the intermediates were characterized
      by their elution positions and n.m.r. spectra in the anomeric proton region. One
      commercial jack-bean alpha-mannosidase preparation contained a novel endolytic
      activity that released N-acetylglucosamine from the reducing ends of the
      oligosaccharides and was shown to convert P----6 alpha Man----6 alpha Man----6
      beta Man----4 alpha beta GlcNAc to P----6 alpha Man----6 alpha Man----6 alpha
      beta Man plus free N-acetylglucosamine. Another commercial jack-bean alpha
      mannosidase converted the Man10GlcNAc to a Man3GlcNAc having the structure alpha
      Man----6 beta Man----4 alpha beta GlcNAc, [formula: see text] whereas the
      Oerskovia sp. alpha-mannosidase converted the same oligosaccharide to a
      Man4GlcNAc having the structure alpha Man----6 alpha Man----6 beta Man----4 alpha
      beta GlcNAc. [formula: see text]

PMID- 2224898
TI  - Structure of an exocellular beta-D-glucan from Pediococcus sp., a wine lactic
      bacteria.
AB  - Pediococcus sp. produces an exocellular slime containing exclusively D-glucose.
      The structure of the polysaccharide was determined by methylation analysis, Smith
      degradation, enzymic hydrolysis, and 13C-n.m.r. spectroscopy as having a
      trisaccharide repeating unit, ----3)-beta-D-Glcp-(1---- 3)-[beta-D-Glcp-(1----2)]
      beta-D-Glcp-(1----.

PMID- 2224899
TI  - Alteration of the properties of Aspergillus sp. K-27 glucoamylase on limited
      proteolysis with subtilisin.
AB  - An active derivative (mol. wt. 48,000) of Aspergillus sp. K-27 glucoamylase (mol.
      wt. 76,000) was obtained by limited proteolysis with subtilisin. The amino acid
      sequences of native and modified enzymes at the N-termini were Ala-Gly-Gly-Thr
      Leu-Asp and Ala-Val-Leu, respectively. The proteolysis greatly decreased the
      affinity of the enzyme for amylopectin and glycogen, but not for
      oligosaccharides. It also reduced the ability of the enzyme to degrade raw
      starch, abolished the ability of the enzyme to adsorb onto starch granules, and
      eliminated the synergistic action of the enzyme in the hydrolysis of starch
      granules with alpha-amylase. These findings imply that the enzyme has a specific
      affinity site for polysaccharide substrates besides the catalytic site, i.e., a
      starch-binding site, and that the former is removed by proteolysis. The extent of
      the reduction in the activity for raw starches caused by the modification varied
      with the starch source, as the modified enzyme digested raw potato starch better
      than either raw corn or sweet potato starches. A new method for evaluation of the
      raw starch-digesting activity of glucoamylase is described.

PMID- 2224900
TI  - Uncertainties in structural determinations of oligosaccharide conformation, using
      measurements of nuclear Overhauser effects.
AB  - A fundamental problem in the determination of molecular structure by n.m.r.
      spectroscopy is insufficient experimental constraints. This problem is
      particularly marked for oligosaccharides, where few constraints are available
      across glycosidic linkages. By calculating distances as a function of dihedral
      angle, it is shown that, in general, two n.O.e. constraints result in two
      possible conformations for each glycosidic linkage, one of which can usually be
      discarded on the basis of model building or energy calculations. Using these
      calculations, an estimate of the uncertainty in the structure can be obtained.

PMID- 2224901
TI  - Synthesis of methyl O-(2-O-methyl-beta-D-galactopyranosyl)-(1----4)-O-(2-
      acetamido-2-deoxy-beta-D-glucopyranosyl)-(1----3)-beta-D- galactopyranoside and 4
      nitrophenyl O-beta-D-galactopyranosyl-(1----4)-O-(2-acetamido-2-deoxy-beta-D-
      glucopyranosyl)-(1----3)-beta-D-galactopyranoside.

PMID- 2224902
TI  - Synthesis of benzyl O-(2-O-methyl-beta-D-galactopyranosyl)-(1----3)-2- acetamido
      2-deoxy-beta-D-glucopyranoside [benzyl 2'-O-methyllacto-N-bioside I], and its
      higher saccharide containing an O-(2-O-methyl-beta-D- galactopyranosyl)-(1----3)
      2-acetamido-2-deoxy-beta-D-glucopyranosyl group as a potential substrate for (1--
      4)-alpha-L-fucosyltransferase.
AB  - Treatment of benzyl O-beta-D-galactopyranosyl-(1----3)-2-acetamido-2- deoxy-4,6-O
      isopropylidene-beta-D-glucopyranoside with tert-butylchlorodiphenylsilane
      afforded the 6'-O-tert-butyldiphenylsilyl ether, which was converted into the
      3',4'-O-isopropylidene derivative. Methylation and subsequent removal of
      protecting groups afforded benzyl O-(2-O-methyl-beta-D-galactopyranosyl)- (1---
      3)-2-acetamido-2-deoxy-beta-D-glucopyranoside (7). The trisaccharide methyl O-(2
      O-methyl-beta-D-galactopyranosyl)-(1----3)-O-(2- acetamido-2-deoxy-beta-D
      glucopyranosyl)-(1----3)-beta-D-galactopyranosi de (17) and the tetrasaccharide O
      (2-O-methyl-beta-D-galactopyranosyl)-(1----3)-O-(2-acetamido-2-deoxy-b eta-D-
      glucopyranosyl)-(1----3)-O-beta-D-galactopyranosyl-(1----4)-D-glucopyran ose
      (32), both containing the 2'-O-methyllacto-N-biose I unit at the nonreducing end,
      were synthesized, and the structures of 7, 17, and 32 were confirmed by 13C
      n.m.r. spectroscopy.

PMID- 2224903
TI  - High-pressure glycosylations of unreactive alcohols and the formation of N
      glycosyl collidinium salts.
AB  - The yields of disaccharide glycosylation products in tetramethylammonium bromide
      or silver triflate-collidine activated reactions between hindered alcohols and
      glycosyl halides were not greatly ++affected when a pressure of 15 kbar was
      applied. The formation of orthoester products was greatly increased under
      pressure. When orthoester formation was not possible both disaccharides and the
      related N-glycosyl collidinium salts were found.

PMID- 2224904
TI  - Enzymic synthesis of useful chito-oligosaccharides utilizing transglycosylation
      by chitinolytic enzymes in a buffer containing ammonium sulfate.
AB  - A chitinase purified from culture filtrates of Trichoderma resei KDR-11
      efficiently catalyzed a transglycosylation reaction on tetra-N
      acetylchitotetraoside in a buffer medium containing ammonium sulfate, converting
      the tetrasaccharide into hexa-N-acetylchitohexaose (39.6%) and di-N
      acetylchitobiose (55.7%) as the major products. Sugar-chain elongation from di-N
      acetylchitobiose as the initial substrate to hexa-N-acetyl-chitohexaose and hepta
      N-acetylchitoheptaose was also efficiently induced through lysozyme catalysis in
      the presence of ammonium sulfate at high (30%) concentration. In this case, the
      addition of ammonium sulfate to the reaction system resulted in a remarkable
      increase of the hexamer and heptamer productions, which are desirable as
      biologically active oligosaccharides.

PMID- 2224905
TI  - Isolation and analysis by the reductive-cleavage method of linkage positions and
      ring forms in the Mycobacterium smegmatis cell-wall arabinogalactan.
AB  - The Mycobacterium smegmatis arabinogalactan polysaccharide has been isolated from
      the cell wall by saponification and extraction to remove lipids and subsequent
      solubilization by treatment with lysozyme. Analysis for neutral sugars
      demonstrated the presence of D-arabinose and D-galactose in a ratio of 3:1,
      respectively. Reductive cleavage of the fully methylated polysaccharide in the
      presence of triethylsilane and trimethylsilyl trifluoromethanesulfonate and
      subsequent acetylation in situ gave six partially methylated 1,4-anhydroalditol
      acetates as the major products and three partially methylated 1,5-anhydroalditol
      acetates as minor products. Partially methylated 1,5-anhydroalditol acetates were
      not formed when reductive cleavage was accomplished with triethylsilane and a
      mixture of trimethylsilyl methanesulfonate and boron trifluoride etherate as the
      catalyst, demonstrating that the polysaccharide is exclusively comprised of
      furanosyl residues. The partially methylated anhydroalditols so produced were
      identified by comparison to authentic standards. Their identifies are consistent
      with the presence in the M. smegmatis arabinogalactan of an octasaccharide
      repeating unit comprised of a nonreducing terminal D-arabinofuranosyl group, a 2
      O-linked D-arabinofuranosyl residue, three 5-O-linked D-arabinofuranosyl
      residues, a 3,5-di-O-linked D-arabinofuranosyl residue, a 5-O-linked D
      galactofuranosyl residue, and a 6-O-linked D-galactofuranosyl residue.

PMID- 2224906
TI  - Lymphoproliferative diseases in disorders of the immune system.
AB  - Severe immunodeficiency diseases are complicated by the development of
      malignancies of the immune system itself, mainly non-Hodgkin's lymphoma (NHLs).
      These occur in immunosuppressed organ allograft recipients; in cancer
      chemotherapy patients; in patients with primary immunodeficiency diseases; in
      chronic dialysis patients; in victims of the Acquired Immunodeficiency Syndrome
      (AIDS); and in persons with various autoimmune diseases either untreated or given
      immunosuppressive therapy. Most of these NHLs are reticulum cell sarcomas or
      immunoblastic sarcomas. Immunologically, most are of B-cell origin. Most tumors
      are extranodal in distribution. They show a remarkable predilection for the
      brain. Possible causes of the NHLs include oncogenic viruses; disturbed immune
      surveillance; chronic antigenic stimulation; impaired immunoregulation;
      carcinogenic effects of immunosuppressive, cytotoxic or other drugs; and genetic
      susceptibility to lymphomagenesis.

PMID- 2224907
TI  - Pathoepidemiological features of adult T-cell lymphoma/leukemia in an endemic
      area: Kagoshima, Japan.
AB  - In order to elucidate the pathological and epidemiological features of malignant
      lymphoma (ML), particularly of adult T-cell lymphoma/leukemia (ATLL) in the
      Kagoshima district, age-adjusted and age-specific incidence rates of malignant
      lymphomas were estimated on 3239 histologically confirmed cases between the years
      1963 and 1987. There was a marked increase in the incidence rate from 1976 (4.9)
      to 1982 (8.5) due to the increase of T-cell lymphomas. The increase was not
      conspicuous after 1982. Immunohistochemically, all of the 429 MLs found in 1985
      and 1986 were examined on paraffin sections and 70 ATLL cases on fresh frozen
      sections. T-cell ML comprised 65.3%, B-cell ML 30.5%, Hodgkin disease 2.6%, and
      histiocytic ML 1.2%. Most of ATLL cells were phenotypically CD4+ CD8-, 14% of
      ATLL cases showed CD4+ CD8+, 6% were CD4- CD8+, and 7% were CD4- CD8-. The
      simulataneous expression of IL 2 and IL 2R was seen in 8 (16%) out of 56 patients
      examined. Therefore, a proliferation by autocrine mechanism does not seem to be a
      major course of ATLL progression.

PMID- 2224908
TI  - Detection of preleukemic state of adult T-cell leukemia (pre-ATL) in HTLV-1
      carriers.
AB  - The prevalence of the preleukemic state of adult T-cell leukemia (pre-ATL) was
      studied in Nagasaki prefecture, one of the endemic human T-lymphotropic virus
      type 1 (HTLV-1) areas in Japan. Pre-ATL cases have the monoclonal proliferation
      of abnormal lymphocytes, without signs of malignant proliferation or clinical
      signs and symptoms related to leukemia. HTLV-1 carriers who have monoclonal
      integration of HTLV-1 proviral DNA may be at high risk of developing ATL.
      Abnormal lymphocytes with either bilobular or large and chromatin-rich nuclei
      were found in 63/356 (17.7%) of HTLV-1 carriers among inhabitants. We analyzed
      DNA of peripheral lymphocytes from 108 carries with abnormal lymphocytes by
      Southern blot technique. Monoclonal integration of HTLV-1 has been detected in 12
      cases (11.1%). These results lead to the conclusion that the prevalence rate of
      pre-ATL among all HTLV-1 carriers is about 2%. Pre-ATL is presumed to be the
      clinical stage which precedes ATL, although the possibility remains that the HTLV
      1 carrier may develop symptoms of ATL directly, without going through the pre-ATL
      stage.

PMID- 2224909
TI  - Viral oncogenesis and the immune system.
AB  - Oncogenic transformation of normal cells and the establishment of transformed
      cells to form malignant tumors is a complex, multistep process influenced by
      viruses in multiple ways. The relationship between viruses and the immune system
      manifests itself, in part, through various roles of viruses in transformation of
      host cells, including cells of the immune system. A large number of viruses
      participate in oncogenic transformation of cells in many animal species.
      Candidates for oncogenic transformation in man are human T lymphotropic viruses I
      and II, certain human papillomavirus types, hepatitis B virus, and Epstein-Barr
      virus. Various mechanisms, which may overlap with one another, have been proposed
      to account for viral oncogenesis. These include introduction of a directly
      transforming viral gene, retroviral transduction of protooncogenes, mutagenesis,
      uncoupling of cellular protooncogene expression from normal regulatory controls,
      overexpression of normal cellular genes resulting from effects of viral cis- or
      trans-acting factors, and inactivation of tumor suppressor genes. A second
      critical area of interaction between viruses and the immune system is in the
      selection of transformed cells. When cell transformation is accompanied by
      expression of tumor antigens, the immune system may influence tumor cell
      establishment and selection of transformed cells for metastatic outgrowth.
      Finally, host well-being may be severely compromised when viruses infect cells of
      the immune system, leading to an inability to mount immunological responses
      specific for opportunistic microorganisms and for cells transformed by viruses or
      nonviral agents. Human immunodeficiency virus infection exemplifies this
      phenomenon, although other viruses also negatively affect the immune system. The
      role of normal immune responses in limiting tumor cell growth is evident from the
      increased incidence of malignancies in immunocompromised hosts.

PMID- 2224911
TI  - Immunogenicity of the tumor determines the outcome of immunotherapy with
      interleukin-2, ABPP, and cyclophosphamide of micro- and macrometastatic
      intraperitoneal tumor.
AB  - We have shown previously that interleukin-2 (IL-2) and the interferon inducer
      ABPP can induce lymphokine activated killer (LAK) cell activity in vivo after
      intraperitoneal (i.p.) administration. The antitumor effects of various
      immunotherapy regimens with IL-2, LAK cells, ABPP, and cyclophosphamide (CY) on
      microscopic (day 3) and on macroscopic (day 8) i.p. tumors, differing in
      histology and immunogenicity, were studied in C57BL6 mice. The immunogenic
      sarcomas MCA-105, -106, and the colon adenocarcinoma MCA-38, and the
      nonimmunogenic sarcomas MCA-101, -102 were used. After i.p. inoculation of 1 X
      10(5) tumor cells i.p. on day 0, therapy with IL-2 +/- LAK cells consisted of 1 X
      10(8) LAK cells, i.p., on day 3 and IL-2, 10k to 25k U, i.p., b.i.d., on days 3
      to 7. Treatment with ABPP +/- CY consisted of CY, 50 mg/kg, i.p., on day 3 and/or
      8 ABPP, 250 mg/kg on days 3, 4 and/or 8, 9. In the treatment of micrometastases,
      IL-2 + LAK cell therapy was effective against all tumors. Therapy with low dose
      IL-2 alone was effective only against immunogenic tumors. Combined therapy with
      CY was very effective against the immunogenic tumors and prolonged survival
      significantly. Only marginal antitumor effects were seen against nonimmunogenic
      tumors. In the setting of advanced tumor, chemoimmunotherapy was only successful
      against immunogenic tumors. These observations demonstrate that the
      immunogenicity of the tumor is of major importance in the outcome of
      immunotherapy, especially in the setting of advanced disease. This indicates
      that, apart from LAK cells, the in vivo activation of other cytotoxic effector
      cells is important in the rejection of immunogenic tumors.

PMID- 2224910
TI  - Tumor-cytolytic human macrophages cultured as nonadherent cells: potential for
      the adoptive immunotherapy of cancer.
AB  - Tumor-cytolytic lymphokine (e.g., interleukin-2; IL-2)-activated killer cells are
      currently being evaluated in IL-2/LAK cell adoptive immunotherapy regimens for
      the treatment of cancer. Monocyte-derived macrophages (M phi) are also known to
      be efficient tumor killer cells; accordingly, M phi that have been activated in
      vitro may also be of therapeutic merit. However, attempts to cultivate M phi for
      morphological and functional studies have often been compromised because M phi
      adhere rapidly and tenaciously to cultureware. Studies that we have conducted to
      address this problem have proven successful in developing procedures for the long
      term cultivation of non-adherent immunocompetent M phi in serum-free medium using
      petri dishes containing a thin Teflon liner. The utility of this technology is
      documented by the results of studies presented herein in which light and scanning
      electron microscopy was used to analyze tumor-cytolytic human M phi. In these
      experiments, we demonstrated that nonadherent immunocompetent human M phi can be
      prepared for detailed examinations of their pleomorphic membrane architecture.
      Moreover, nonadherent human M phi could readily be collected for preparing
      conjugates of M phi and tumor cells. It is anticipated that this technology
      should prove useful for future structure-function studies defining the
      topographical location and spatial distribution of antigens and receptors on M
      phi membrane ultrastructures, particularly the microvilli-like projections that
      bridge together an immunocompetent effector M phi and target cell (e.g., tumor
      cells and microbial pathogens) and which provide the physical interaction
      required for the initial phases of a cellular immune response that includes
      antigen recognition and cell-to-cell adhesion.

PMID- 2224912
TI  - Clinical evaluation of liposomal tumor antigen vaccines in patients with stage
      III melanoma.
AB  - In this study, we report the results of an active-specific immunotherapy phase I
      study using autologous tumor-associated antigens (TAA) incorporated within
      liposomal carriers in patients with metastatic malignant melanoma. A group of 13
      patients were entered into the study and given subcutaneous (s.c.) injections of
      liposome-TAA preparations at 2- to 4-week intervals. Clinical and laboratory
      monitoring did not reveal any short- or long-term systemic or local toxicity.
      Three patients had a complete response, and two patients had a partial response
      (50% or greater size reduction in one or more tumor sites). The remaining eight
      patients showed no response with disease progression. Two of these eight patients
      are still undergoing treatment. The TAA preparations stimulated peripheral blood
      lymphocyte proliferation (PBL) in vitro in those patients exhibiting a clinical
      response: no such responses were observed in the nonresponder patients. NK cell
      activity did not correlate with PBL proliferation or clinical response status,
      whereas PBL cytostatic activity against heterologous melanoma tumor cells
      correlated with clinical responsiveness. This form of immunotherapy appears to be
      a safe and feasible candidate for a much larger phase I/II study.

PMID- 2224913
TI  - The impact of passive smoking: cancer deaths among nonsmoking women.
AB  - In order to obtain an estimate of the impact of passive smoking on cancer
      mortality, a retrospective study was conducted examining the cancer mortality of
      nonsmoking wives with no known or minimal exposure in contrast to nonsmoking
      wives with moderate to life-time exposure to tobacco smoke. The study was based
      on the data from 906 deceased nonsmoking women who resided in Erie County,
      Pennsylvania, who were divided into the following three categories: 1. No known
      exposure. 2. Exposed nonemployed. 3. Employed (assumed to be exposed to
      environmental tobacco smoke in the workplace). The data were analyzed by the
      retrospective case-control method using cancer deaths as the cases and non-cancer
      related deaths as the controls. Also, the data from 401 smoking women were used
      for comparative purposes of the total percentage of cancer deaths among three
      groups: 1. Nonsmoking, nonexposed women. 2. Combined nonsmoking unemployed and
      employed exposed women. 3. Smoking women. The major findings from the study are:
      1. Only (2.2%) of the total deaths reported among the nonsmoking women with no
      known or minimal exposure to tobacco smoke were due to cancer of any site. 2. No
      cases of lung cancer deaths were reported for the nonexposed, nonsmoking women,
      and eight lung cancer deaths were reported among the nonsmoking women who were
      exposed to passive smoking. Also, for this small group of 170 nonsmoking
      nonexposed women, there were no reported cases of breast cancer, genitourinary or
      lymphatic cancer. 3. Employed nonsmoking women experienced proportionately more
      cancer deaths (34.3%) than both nonexposed (2.2%) and exposed nonemployed wives
      (18.9%). The combined groups of exposed nonsmoking wives (nonemployed and
      employed) contracted 25.5% cancer deaths. 4. Age-adjusted data showed similar
      trends. 5. Cancer death rates for women smokers was 35.5% of the total deaths of
      women smokers. Public health officials should consider requiring that the
      workplace be free from tobacco smoke since these data imply that passive smoking
      has a very detrimental effect upon nonsmokers. Also, smokers should be made aware
      of the potential damage they inflict on others in their home as well as the
      workplace.

PMID- 2224914
TI  - Theoretical and experimentally quantifiable determinants of tobacco smoking
      behavior for the development of successful smoking cessation strategies.
AB  - Death rates from a number of diseases linked epidemiologically to tobacco use
      continue to rise despite major reductions in per capita tobacco consumption,
      despite reductions in the total number of smokers, and despite very significant
      reductions in "tar", in other tumorigens and in essentially all classes of
      potential toxins in smoke delivered to the consumer. One concern is that smokers
      consume low delivery cigarettes differently and in a potentially more hazardous
      way than higher delivery cigarettes. The effect of nicotine reduction in
      cigarettes on human smoking behavior was studied in 102 human subjects by
      quantifiable determinants of tobacco-smoking behavior. This study indicates that
      reduction in nicotine delivery results in some accommodation in smoking behavior
      to titrate nicotine needs. In addition, smokers appear to adjust their smoking
      behavior as a function of taste preference, and this adjustment is as strong as
      the accommodation for nicotine. The theoretical application of these observations
      to the development of successful smoking cessation strategies is reviewed.

PMID- 2224915
TI  - "Tar", nicotine, and carbon monoxide content of Thai cigarettes, and implications
      for cancer prevention in Thailand.
AB  - This report presents new findings on the very high contents of nicotine (i.e.,
      1.64 to 5.77 mg) and "tar" (i.e., 21.3 to 28.1 mg) in major brands of
      commercially produced Thai cigarettes and local tobacco used for rolled
      cigarettes. These nicotine levels are relevant to the addictive properties of
      Thai cigarettes, while the "tar" levels are related to risk of cancer of the lung
      and other sites. Consumption of tobacco products nearly tripled over the last 2
      decades (1966 to 1987). The relative frequency of lung cancer in Thailand in 1982
      was high in both urban and rural areas, with geographic differences particularly
      for females, and increased from 1975 to 1982 in both males and females. The
      important implications of cigarette contents and consumption are presented in
      relation to future cancer patterns and cancer prevention in Thailand. Labeling of
      cigarettes, in terms of "tar" and nicotine contents is needed along with
      educational programs dealing with the harmful and addictive effects of these
      substances.

PMID- 2224916
TI  - Chemoprevention for lung cancer--evidence for a high degree of compliance.
AB  - Studies of treatment efficacy are important for the development of cancer
      chemoprevention strategies. Recruitment aims for motivated, compliant subjects.
      The Concerned Smoker Study targets smokers with at least a 15-pack-year history
      and bronchial atypia on sputum sampling. Subjects receive etretinate 25 mg daily
      or identical placebo and are followed for 6 months. Compliance was monitored by
      assessing timely return for follow-up visits, return of monthly sputum samples,
      pill counts, and serum etretinate levels. Contamination, in the control group,
      was assessed by measuring etretinate levels. With half of the subjects having
      completed the study, this report assesses compliance: 88% follow-up visits
      occurred on schedule with only 9 missed visits of a possible total of 380; 443
      (97.1%) of 456 possible sputum samples were returned. Pill counts indicated a
      high degree of compliance which was supported by the serum etretinate levels.
      Contamination was insignificant. The results suggest a very high degree of
      compliance. Only minor protocol changes will be required.

PMID- 2224917
TI  - Chromosome abnormalities in cancer.
AB  - Karyotypic abnormalities have been described in more than 10,000 human neoplasms
      analyzed by means of chromosome banding. These aberrations are of three different
      kinds: primary abnormalities, which are essential in establishing the tumor;
      secondary abnormalities, which develop only after the neoplasm is established but
      which nevertheless may be important in tumor progression; and cytogenetic noise,
      which is the background level of nonconsequential aberrations. These latter
      changes are, in contrast to the primary and secondary aberrations, randomly
      distributed throughout the genome. The primary abnormalities, of which more than
      100 have been identified, are strictly correlated with particular neoplastic
      disorders and even with histopathological subgroups within a given tumor type. To
      these purely cytogenetic data implicating specific genetic changes in
      carcinogenesis may now be added the growing evidence of molecular specificity
      emerging from recombinant DNA studies. It appears that both currently known
      classes of directly cancer-relevant genes, the dominant oncogenes and the
      recessive anti-oncogenes, are located at precisely those genomic sites that are
      visibly involved in neoplasia-associated chromosomal rearrangements. The
      molecular genetic data thus support the cytogenetic conclusion that the
      distribution of consistently cancer-associated breakpoints reflects the genomic
      position of genes that, either directly or through the control function they
      exert, are essential in the proliferation and differentiation of human cells.

PMID- 2224918
TI  - Cancer genetics and cancer suppression.
AB  - Identification of normal growth and differentiation-inducing proteins and how
      they interact in normal development has made it possible to identify the
      molecular basis of normal development and the mechanisms that uncouple growth and
      differentiation so as to produce malignant cells. When normal cells have been
      changed into cancer cells, the malignant phenotype can again be suppressed.
      Results on the molecular control of growth and differentiation in normal myeloid
      hematopoietic cells, changes in the normal developmental program in myeloid
      leukemia, and the suppression of malignancy in myeloid leukemia and sarcomas have
      shown that (1) malignancy can be suppressed either with or without genetic
      changes in the malignant cells, (2) suppression of malignancy by inducing
      differentiation does not have to restore all the normal controls, and (3) genetic
      abnormalities which give rise to malignancy can be bypassed and their effects
      nullified by inducing differentiation which stops cells from multiplying.

PMID- 2224919
TI  - Cancer incidence in young offspring of Jewish immigrants to Israel. A
      methodological study. I. Nasopharyngeal malignancies and Ewing sarcoma.
AB  - Differences in cancer incidence among various immigrant groups in Israel raised
      the question of persistence in their descendants. The methodological problems of
      identification of both parents and their origins, the choice of the denominator,
      and the long period of observation necessary for the rare childhood tumors have
      been examined. From 22-years data of the Israel Cancer Registry (ICR), three
      malignancies were chosen as examples: epithelial carcinoma of nasopharynx (31
      cases), non-Hodgkin's lymphoma of nasopharynx (14 cases), and Ewing sarcoma (55
      cases). The actual number of cases, in spite of the long period of incidence, is
      small and the computed significance must be accepted with reservation. There are
      two outstanding findings: the higher incidence in males as well as in females for
      nasopharynx carcinoma corresponds to that of their African-born parents; an
      increasing trend in the second 11-years period for Ewing sarcoma. Similar studies
      on leukemias, lymphomas, and others with a greater number of cases can be
      expected to have more reliable results. This survey relied on the majority of
      patients with immigrant parents, mostly of the same origin. In the following
      years, second and later generations of Israel-born and an increasing part of
      intermarriages will severely impede similar studies.

PMID- 2224920
TI  - Dietary, total body, and intracellular potassium-to-sodium ratios and their
      influence on cancer.
AB  - One of the greatest changes in the human diet, a change that has occurred only
      within the past few thousand years, is the immense increase in the intake of
      sodium (Na) caused by use of table salt in the preparation and preservation of
      food. At the same time, man's intake of potassium (K) has decreased. The result
      is that from Paleolithic times to modern times the dietary K/Na ratio has been
      reduced by a factor of about 20. Based on a comparison of modern people in
      civilized areas with the primitive Yanomamo Indians in South America (who do not
      eat salt but who do grow and eat potassium-rich cooking bananas), this factor may
      even be on the order of 100 to 200. Humans, who initially had to adapt to retain
      sodium from a sodium-poor diet and to excrete potassium from a potassium-rich
      diet, have not yet evolutionarily adapted to today's high-sodium, low-potassium
      diet. This failure has caused increased rates of a number of diseases in
      civilized man, among them cancer. The influence of the K/Na ratio on cancer
      development--first discovered by epidemiologic studies--has been confirmed by
      various means, such as dietary studies, gerontological studies, studies of
      relationships between hyper- and hypokalemic diseases and cancer, and review of
      the cellular changes of this ratio induced by carcinogenic and anticarcinogenic
      agents. Recently, animal experiments have also confirmed the results. The
      recommended dietary K/Na ratio should be well above 1, preferably 5 or higher,
      and the cellular K/Na ratio should be above 10.

PMID- 2224921
TI  - Nutrition and lifestyle factors in fibrocystic disease and cancer of the breast.
AB  - Within a study on diet as a risk factor for fibrocystic disease and breast
      cancer, 68 patients with breast cancer, aged from 40 to 59, participating in the
      National Breast Screening Study in Montreal, were compared to 340 patients with
      fibrocystic disease and to 343 controls. The personal and family history was
      collected from medical records and completed by an interview. The nutritional
      assessment was done by a food frequency questionnaire with a special attention to
      the quantity and quality of fat, vitamins A, C, E, as well as life style habits.
      The cancer patients were significantly heavier (64.9 vs. 60.8 kg), had higher
      body mass index (24.9 vs. 23.4), menstrual cycle more often irregular, later
      menopause (47.5 vs. 44.5 years), and shorter school attendance (10.3 vs. 12.6
      years). No significant differences were found in the use of contraceptives,
      menopausal hormones, analgesics and tobacco, marital status, number of
      pregnancies and children, age at menarche, duration of menstrual cycle, and the
      age at the first pregnancy. The cancer patients consumed significantly more
      poultry, fish, pastry, margarine, and alcohol and less milk, raw vegetables,
      pastas, sugar, butter, and coffee.

PMID- 2224922
TI  - Breast screening compliance following a statewide low-cost mammography project.
AB  - Public health educational campaigns can attract large numbers of one-time
      participants, but the impact on subsequent behavior remains unstudied. The
      American Cancer Society Texas Division, Inc. sponsored a statewide $50.00
      mammography screening project in early 1987. More than 64,000 mammograms were
      completed at 306 centers; 37,000 screenees answered a 31-item questionnaire.
      Attitudes toward screening were assessed, and screening history was recorded.
      Eighteen months after the project, a follow-up questionnaire was sent to 1000
      screenees; 411 women returned the questionnaires. In the year following the
      project, 51% of the women 50 years and older reported having a subsequent
      mammogram. Among the women in this group who had never had a mammogram prior to
      1987, 42% had screening mammography repeated in the following year. These data
      show that media-based public education projects can be effective mechanisms for
      improving and maintaining compliance with mammography screening recommendations.

PMID- 2224923
TI  - The effect of mild stress on DMH-induced colorectal cancer.
AB  - Epidemiologic studies suggest that certain psychosocial factors increase the risk
      of cancer. Yet, animal studies suggest that psychosocial stress inhibits the
      development of chemically induced tumorigenesis. The purpose of this study was to
      examine the effect of three different chronic mild stressors on the development
      of dimethylhydrazine (DMH)-induced colorectal carcinoma in rats. Results of this
      study show that the development of DMH-induced colorectal carcinoma was not
      significantly inhibited or altered by each individual stress treatment.
      Additionally, results indicate that mild stressors can induce neurochemical
      changes commonly associated with stress, without the confounding effects of more
      aversive stressors that are likely to compromise the nutritional and
      physiological status of the animal and thereby alter tumor formation.

PMID- 2224924
TI  - In vitro ultrastructural localization of the catalytic activity of adenosine
      deaminase in murine C-1300 neuroblastoma.
AB  - Adenosine deaminase (ADA) activity was localized at the surface membrane of the
      mouse C-1300 neuroblastoma by incubation of a confluent tissue culture monolayer
      grown on Lux-Permanox cultureware with 6-chloropurine ribonucleoside (CPR). This
      substrate is dechlorinated by ADA to form Cl-. At loci of ADA activity, Cl- is
      precipitated with added silver ion (Ag+), and electron dense metallic silver (Ag
      degree) is formed upon exposure to light. The incubation was conducted in 0.2 M
      HEPES buffer (277 mOs) at 37 degrees C, pH 7.4, which contained 1 mM CPR, for 5
      min (in this buffer, this is four times the Km); the control lacked the
      substrate. After completion of the incubation, the monolayer was briefly rinsed
      with 0.2 M HEPES and 2.5% glutaraldehyde in 0.2 M HEPES containing AgNO3 at a
      final concentration of 2 mM. Dehydration was accomplished in a graded series of
      ethanol followed by embedment in the L. R. White resin at 60 degrees C overnight.
      Thin sections (80 to 100 mm), cut parallel to the monolayer, showed ADA activity
      at the cells' surface membrane with a smaller amount of activity evenly
      distributed in the subadjacent ectoplasmic zone. The control lacked any silver
      grain localization. Since in preliminary studies of neuronal tissue the ADA
      activity was minimal, these findings may contribute to developing a diagnostic
      cancer screening test.

PMID- 2224925
TI  - Cardiovascular response to exercise.

PMID- 2224926
TI  - Intracoronary adenosine causes angina pectoris like pain--an inquiry into the
      nature of visceral pain.
AB  - STUDY OBJECTIVE: The aim was to study the tentative role of adenosine as a
      messenger between myocardial ischaemia and angina pectoris. DESIGN: Adenosine was
      administered in serial doses of 0.1-20 mg either as an intravenous bolus, or
      intra-arterially over 10 s into the left coronary artery, the aorta and the iliac
      artery. Coronary sinus flow was determined by thermodilution. ECG was monitored
      continuously. The patient was not aware of which site or dose was used. After
      each injection, the start of, maximum, end, magnitude, and location of pain were
      noted. PATIENTS: Six patients with angina pectoris referred for coronary
      angiography entered the study. MEASUREMENTS AND RESULTS: After intracoronary
      adenosine injection in the absence of ischaemic ECG changes, a dose dependent
      degree of chest pain was experienced not different in quality or location from
      the patients' habitual angina pectoris. Adenosine into the aorta provoked pain in
      lower chest and upper abdomen, whereas injection into the iliac artery provoked
      pain in the ipsilateral leg. On intravenous injection equipotent doses of
      adenosine caused chest pain of the same degree and quality as after intracoronary
      injection. Immediately after intracoronary injection the coronary sinus blood
      flow started to increase, but the onset of chest pain was delayed. Onset of pain
      was earlier the higher the dose, the maximum dose resulting in onset after 18(SEM
      2) s. Coronary sinus blood flow increased dose dependently after left coronary
      artery injection but following intravenous injection no further increase was seen
      beyond that induced by the lowest dose. CONCLUSIONS: We suggest that adenosine is
      an important messenger for the sensation of angina pectoris and the effect is not
      due to coronary steal leading to myocardial ischaemia.

PMID- 2224927
TI  - Different histamine actions in proximal and distal human coronary arteries in
      vitro.
AB  - STUDY OBJECTIVE: The aim was to investigate the receptor mechanisms for different
      histamine actions in proximal and distal human coronary arteries. DESIGN:
      Postmortem human coronary rings precontracted by 50 mM KCl were exposed to
      histamine (10(-8)-10(-4) M) in control and after treatment with 10(-5) M
      pyrilamine (an H1 receptor antagonist), or 10(-4) M cimetidine (an H2 receptor
      antagonist), and/or endothelial removal. Tension changes at the point of maximum
      relaxation (at 10(-5) M in most rings) were obtained. MEASUREMENTS AND RESULTS:
      Endothelium dependent relaxations to histamine were clearly distinguished from
      endothelium independent relaxations by their transient nature and their
      inhibition by pyrilamine, but not by cimetidine. While most distal rings (group
      I, n = 42/58) and only some of the proximal rings (group II, n = 10/83) showed
      greater than 50% relaxation with histamine, nearly half the proximal rings (group
      III, n = 40/83) showed only contraction. Significant differences were found
      between group I and III, but not II, in control [-66(SD 15.2)% v +25(20.4)%, p
      less than 0.001] and after pyrilamine treatment [-66(9.2)% v -25(12.0)%, p less
      than 0.001], cimetidine treatment [-30(25.5)% v +42(20.9)%, p less than 0.001]
      and endothelial removal [-24(37.1)% v +36(20.2)%, p less than 0.01]. However, a
      combination of cimetidine and endothelial removal resulted in a contraction to
      histamine which was similar among the three groups. CONCLUSIONS: These results
      suggest that hypercontractility to histamine was found in proximal human coronary
      arteries, but not in distal ones, probably due to the reduction of both direct
      and endothelial mediated relaxations rather than to an increase in the
      contraction itself.

PMID- 2224928
TI  - Non-invasive evaluation of segmental pressure drop and resistance in large
      arteries in humans based on a Poiseuille model of intra-arterial velocity
      distribution.
AB  - STUDY OBJECTIVE: The aim of the study was to evaluate in hypertensive subjects
      the longitudinal pressure drop and segmental resistance in a large artery in
      relation to shearing forces of the circulating blood column at the arterial wall.
      DESIGN: Arterial diameter, blood velocity, and flow were measured in the brachial
      artery using pulsed Doppler apparatus. Blood viscosity was measured at 96 s-1
      with a low shear viscometer. Segmental resistance per unit arterial length was
      calculated using the basic Poiseuille resistance expression from the ratio
      between blood viscosity and the fourth power of arterial diameter. Longitudinal
      pressure drop was deduced as the product between segmental resistance and blood
      flow. The Poiseuille model of velocity distribution also enabled wall shear rate
      and stress to be calculated from the ratio between blood velocity and arterial
      diameter and from the product between shear rate and blood viscosity
      respectively. PATIENTS: 19 ambulatory male patients with mild to moderate
      hypertension and 11 normotensive male controls of similar age were studied.
      RESULTS: Compared to controls, hypertensive patients had higher arterial diameter
      (p less than 0.001) lower blood velocity (p less than 0.05), higher blood
      viscosity (p less than 0.01), lower segmental resistance and pressure drop (p
      less than 0.001, p less than 0.01) and lower shear rate and stress (p less than
      0.01, p less than 0.05). A negative correlation existed in the overall
      normotensive and hypertensive population between pressure drop and mean blood
      pressure (r = -0.55, p less than 0.01). CONCLUSION: The hypertensive state is
      associated with a clear reduction in large artery segmental resistance and
      longitudinal pressure drop concomitantly with a decrease in shear conditions at
      the arterial wall. The mechanisms of reduced resistance and pressure drop are
      related to decreased wall shear and increased diameter of the artery, both of
      which reduce the frictional forces at the blood-arterial wall interface.

PMID- 2224929
TI  - Cardiac baroreflex function during postural change assessed using non-invasive
      spontaneous sequence analysis in young men.
AB  - STUDY OBJECTIVE: The aim was to assess the value of baroreflex sensitivity
      estimates calculated from analyses of spontaneous systolic blood pressure and
      pulse interval sequences derived from continuous non-invasive finger blood
      pressure recordings during sitting and active standing. DESIGN: Continuous
      recordings of digital systolic blood pressure and pulse interval were obtained
      non-invasively using a Finapres FD5 during 5 min trials of sitting and standing.
      SUBJECTS: Subjects were healthy males aged 19-28, divided into those with "high"
      normal (n = 18) and "low" normal (n = 17) blood pressure. MEASUREMENTS AND MAIN
      RESULTS: Recordings were scanned for spontaneous sequences of three or more
      cardiac cycles over which systolic blood pressure increased progressively in
      conjunction with prolonged pulse interval, or decreased while pulse interval
      became shorter. Regressions between blood pressure and pulse interval (r greater
      than 0.80) provided estimates of cardiac baroreceptor reflex control.
      Computations were carried out with concurrent blood pressure and pulse interval
      measurements, and with a delay or lag of one and two cycles between the two
      variables. Pulse interval was reduced from an average 870.3 ms sitting to 571.3
      ms on standing. Mean baroreflex sensitivity while sitting averaged 17.5 ms.mm Hg
      1 at a delay of one cycle, failing to 7.65 ms.mm Hg-1 with standing. The decrease
      in sensitivity was correlated with the change in pulse interval between trials.
      The number of sequences was also significantly reduced with standing as opposed
      to sitting. Three cycle sequences were most frequent, with a lesser number of
      sequences involving 4, 5, and 6 or more cycles. No significant differences
      between "high" and "low" normal blood pressure groups were observed. CONCLUSIONS:
      The analysis of spontaneous sequences from non-invasive recordings may provide
      useful information concerning cardiac baroreflex control in different postural
      and behavioural states. A lag of one cycle between systolic blood pressure and
      pulse interval may provide the most representative estimates of baroreflex
      sensitivity.

PMID- 2224930
TI  - Effect of acute cardiac tamponade on left ventricular pressure-volume relations
      in anaesthetised dogs.
AB  - STUDY OBJECTIVE: The aim was to determine whether depressed myocardial
      contractility is responsible for the decline in stroke volume that occurs with
      cardiac tamponade. DESIGN: Left ventricular contractile performance was assessed
      before and after beta adrenergic blockade using the end systolic pressure-volume
      relation, the left ventricular dP/dtmax-end diastolic volume relation, and the
      left ventricular stroke work-end diastolic volume relation during acute cardiac
      tamponade in dogs. EXPERIMENTAL MATERIAL: In eight pentobarbitone anaesthetised
      dogs (15.7-24.8 kg), transducer tipped and volume impedance catheters were
      positioned in the left ventricle. Through a median sternotomy incision, a
      pericardial catheter was inserted to produce varying stages of cardiac tamponade.
      By the use of transient bicaval occlusions, variably loaded pressure-volume loops
      were recorded. MEASUREMENTS AND RESULTS: Incremental tamponade reduced mean
      arterial pressure from 105(SEM 3) to 89(2) mm Hg (mild tamponade), 75(2) mm Hg
      (moderate tamponade), and 59(10) mm Hg (severe tamponade). The slope of the end
      systolic pressure-volume relation was 6.3(1.2) mm Hg.ml-1 at baseline and
      increased slightly to 7.7(1.8), 8.5(1.3), and 9.2(1.5) mm Hg.ml-1 with the
      progressive levels of tamponade (NS). The role of autonomic reflexes was assessed
      by repeating the tamponade sequence after beta adrenergic blockade with 10 mg of
      metoprolol intravenously. The slope of the end systolic pressure-volume relation
      was reduced by metoprolol, at 4.9(1.0) mm Hg.ml-1 (p less than 0.01), but was not
      significantly altered by the sequence of tamponade following beta blockade
      [5.6(0.9), 6.0(1.0), and 5.5(7.0) mm Hg.ml-1, respectively (NS)]. Neither were
      changes found indicative of depressed contractile function with progressive
      tamponade in the slopes of the left ventricular dP/dtmax-end diastolic volume and
      stroke work-end diastolic volume relations. CONCLUSIONS: Left ventricular
      contractility was not altered during acute cardiac tamponade in an anaesthetised,
      closed chest canine model. Depressed left ventricular contractile function was
      not responsible for the observed haemodynamic deterioration.

PMID- 2224931
TI  - Cardiac muscle function following chronic dietary potassium depletion in the
      rabbit.
AB  - STUDY OBJECTIVE: The aim was to investigate a possible defect in cardiac muscle
      contractile performance following chronic K+ depletion. DESIGN: Cardiac muscle
      force development, membrane potential, and action potential configuration were
      measured in isolated superfused right ventricular papillary muscles or trabeculae
      from control or K+ depleted NZW rabbits. The effects of adrenaline,
      strophanthidin, and changes in external [Ca2+] and [K+] were investigated.
      EXPERIMENTAL MATERIALS: Experiments were performed on 50 adult NZW rabbits,
      average weight 2.3 kg, which were fed either a control diet (n = 25), or a K+
      deficient diet (n = 25) for 25 d. MEASUREMENTS AND MAIN RESULTS: There was a
      significant reduction in contractile force in preparations from the K+ depleted
      group compared to those from control animals. This was associated with an
      increased positive inotropic response to low [K+], but an apparent reduction in
      response to adrenaline. There was no significant difference between groups as to
      the effect of strophanthidin. CONCLUSIONS: It is suggested that the reduction in
      response to adrenaline reflects a down regulation in beta receptor density, due
      to an increased level of circulating catecholamines, and that the defect in
      myocardial function is a result of adaptive changes to Ca2+ handling mechanisms
      within the cell.

PMID- 2224932
TI  - Antiarrhythmic effect of amiodarone on doxorubicin acute toxicity in working rat
      hearts.
AB  - STUDY OBJECTIVE: The clinical application of doxorubicin, a potent cytotoxic
      agent, is limited by a dose dependent cardiotoxicity and by the acquired
      resistance of the neoplastic cells. Recently, the sensitivity of resistant cancer
      cells to doxorubicin has been enhanced by the acute administration of amiodarone.
      The aim of this study was to investigate whether or not this potentiates the
      cardiotoxicity of doxorubicin. DESIGN: Hearts from rats pretreated or not with
      amiodarone 50 mg.kg-1.d-1 for 5 d were perfused via the left atrium with a Krebs
      Henseleit solution containing, or not, doxorubicin 6 mg.litre-1. After 40 min of
      perfusion, the left main coronary artery was ligated and the ligature was
      maintained for 10 min. It was then cut and reperfusion continued for 10 min. The
      cardiac output, heart rate, and mean fibrillation duration induced by the
      reperfusion were measured by timed collections and ECG recordings. SUBJECTS: 32
      adult male Sprague-Dawley rats (250-300 g) were used throughout the study.
      MEASUREMENTS AND RESULTS: After 40 min of perfusion, the cardiac output in the
      control and amiodarone groups was constant, but significant decreases of 25.5 and
      30.4% were noted in both doxorubicin groups. The mean fibrillation durations
      observed during reperfusion were 331(73), 66(22), 444(86), and 22(9) s for the
      control, amiodarone, doxorubicin and amiodarone-doxorubicin groups respectively.
      CONCLUSION: Amiodarone, while maintaining its antiarrhythmic effect, did not
      potentiate the negative inotropic effect of doxorubicin. These results suggest
      that the cardiotoxicity produced by the clinically acute administration of
      amiodarone with doxorubicin is not greater than that caused by doxorubicin given
      alone.

PMID- 2224933
TI  - Effect of activation sequence on ventricular refractoriness as determined by
      extrastimuli.
AB  - STUDY OBJECTIVE: The aim was to determine by the extrastimulus method the effect
      on the right and left ventricular effective refractory periods of moving the site
      of the pacing train away from the site of the extrastimulus. DESIGN: The
      ventricular effective refractory period was measured at the right and left
      ventricular apices using pacing trains at two heart rates, delivered to the
      ipsilateral ventricle, the contralateral ventricle, and the right atrium.
      SUBJECTS: Seven patients (six male), mean age 52 years (range 26-75 years), with
      either documented (six) or suspected (one) ventricular tachycardia were studied.
      Four had ischaemic heart disease and the remaining three had morphologically
      normal hearts. MEASUREMENTS AND MAIN RESULTS: The pacing train and extrastimulus
      delivered in the right ventricle produced the shortest effective refractory
      period at both heart rates: 220.8(SD 19) ms and 207.9(16) ms respectively. As the
      pacing train was moved to the right atrium, the effective refractory period
      lengthened to 246.4(22) ms and 219.3(20) ms at the two heart rates. There was
      further lengthening as the site of the pacing train was moved to the left
      ventricle, to 269.2(20) ms and 240.7(35) ms respectively. The same pattern was
      observed in the left ventricular effective refractory periods as the pacing train
      was moved from left ventricle to right ventricle and to right atrium.
      CONCLUSIONS: The ventricular effective refractory period lengthens as the site of
      the pacing train is moved away from the site of the extrastimulus. This may be
      explained by the effects of the distribution of the pacing energy within the
      myocardium and by intercellular electrotonic interactions. This has important
      clinical implications for the arrhythmogenic mechanisms of ventricular
      tachyarrhythmias.

PMID- 2224934
TI  - Loss of blood platelet adhesion after heating native and cultured human
      subendothelium to 100 degrees Celcius.
AB  - STUDY OBJECTIVE: Balloon angioplasty produces mechanical vessel wall injury that
      leads to substantial blood platelet deposition at the angioplasty site. The aim
      of the study was to determine whether thermal angioplasty might, by contrast,
      reduce platelet adhesion by denaturation of subendothelial adhesive proteins.
      DESIGN: Native and cultured human subendothelium was briefly heated to greater
      than or equal to 100 degrees C by laser irradiation or to 50-100 degrees C by
      immersion in preheated phosphate buffered saline (PBS). Subsequently, the
      subendothelium was exposed for 5 min to flowing human blood at a shear rate of
      1300 s-1. Blood platelet adhesion to the subendothelium was determined
      quantitatively. EXPERIMENTAL MATERIAL: Human umbilical arteries were used and the
      subendothelial matrix derived from cultured umbilical vein endothelial cells.
      MEASUREMENTS AND RESULTS: After heating arterial subendothelium by laser
      irradiation to greater than or equal to 100 degrees C, zero platelet adhesion was
      found v 36(SD 2)% adhesion to the non-heated surface (p less than 0.001). After
      laser heating of the subendothelial matrix to greater than or equal to 100
      degrees C, platelet adhesion was absent in 10/10 experiments (p less than 0.01).
      After heating the matrix to 100 degrees C by immersion in PBS, platelet adhesion
      was reduced to 5(5)% v 31(7)% at 37 degrees C (p less than 0.001). CONCLUSIONS:
      These in vitro results, if extrapolated to catheter interventions, suggest that
      thermal injury to the vessel wall by laser angioplasty or other thermal
      angioplasty methods may provide a basic and clinically relevant advantage over
      mechanical angioplasty modalities, because of a potentially reduced risk of
      complications related to platelet adhesion.

PMID- 2224935
TI  - Effects of the free radical generating system FeCl3/ADP on reperfusion
      arrhythmias of rat hearts and electrical activity of canine Purkinje fibres.
AB  - STUDY OBJECTIVE: The aim was to evaluate the arrhythmogenic effect of a free
      radical generating system, FeCl3/ADP using two different approaches. DESIGN:
      Ventricular arrhythmias were studied in isolated rat hearts subjected to regional
      ischaemia and reperfusion without or with simultaneous treatment with nicergoline
      (0.4 mg.litre-1). In the second part of this study the electrophysiological
      effects of FeCl3/ADP (0.1/1.0 microM) were investigated in normal Purkinje fibres
      and in Purkinje fibres from dog surviving infarction, by using conventional
      microelectrode method. EXPERIMENTAL MATERIALS: Hearts were obtained from male
      Sprague-Dawley rats, weight 250-300 g. Purkinje fibres were dissected from hearts
      of mongrel dogs of either sex (10-15 kg) with or without prior myocardial
      infarction. MEASUREMENTS AND RESULTS: FeCl3/ADP (0.1/1.0 microM and 1.0/1.0
      microM respectively) weakly changed the incidence of reperfusion induced
      arrhythmias. In nicergoline pretreated hearts, in which the incidence of
      reperfusion arrhythmias was reduced, FeCl3/ADP (0.1/1.0 microM and 1.0/1.0
      microM) did not change the incidence and the duration of reperfusion arrhythmias.
      In normal Purkinje fibres, FeCl3/ADP (0.1/1.0 microM) induced a decrease in
      action potential duration without any pronounced effect on Vmax, diastolic
      potential, and activation potential. In Purkinje fibres from post infarct
      myocardium, FeCl3/ADP decreased action potential duration, diastolic potential,
      and activation potential. CONCLUSIONS: Free radical generation did not antagonise
      the antiarrhythmic activity of alpha adrenergic blockade. Free radical generation
      induced slow and minor changes in electrophysiological activity of Purkinje
      fibres both from normal and ischaemic hearts. Our data suggest that free radical
      generation may not be the only mechanism involved in the genesis of reperfusion
      arrhythmias.

PMID- 2224936
TI  - Photoactivation of porphyrins: studies of reactive oxygen intermediates and
      arrhythmogenesis in the aerobic rat heart.
AB  - STUDY OBJECTIVE: In situ production of reactive oxygen intermediates (singlet
      oxygen and superoxide) during the photoactivation of rose bengal can induce
      arrhythmias in the aerobically perfused rat heart. The present study was
      undertaken (1) to assess whether these effects occur with other photosensitizers;
      (2) to identify the injurious intermediates; (3) to probe the site of action of
      these phenomena. DESIGN - The study involved the use of meso-tetra-(4
      sulphonatophenyl)-porphine (TPPS), a porphyrin which, in contrast to rose bengal,
      promotes the production of singlet oxygen alone when illuminated. After 10 min of
      TPPS free perfusion, rat hearts (n = 6 per group) were perfused aerobically with
      TPPS (1, 5, 10 or 50 mumol.litre-1) for 25 min; during the last 20 min, the
      hearts were illuminated (3600 lux). In additional studies, TPPS (50 mumol.litre
      1) was washed out before illumination. EXPERIMENTAL MATERIAL: Hearts from 30 male
      Wistar rats, weighing 220-280 g, were excised and perfused retrogradely.
      MEASUREMENTS AND MAIN RESULTS: Cardiac function was unaffected with TPPS alone.
      Upon illumination, electrocardiographic changes (increase in QT interval and/or T
      wave changes) and arrhythmias developed in a dose dependent manner. At the
      highest dose, electrocardiographic changes occurred within 7.0(SEM 0.4) s; all
      hearts exhibited ventricular premature beats and complete atrioventricular block;
      67% developed ventricular tachycardia and 17% ventricular fibrillation. During
      illumination, hearts also exhibited a dose and time dependent decrease in
      coronary flow. In additional studies, despite the absence of TPPS in the
      perfusate, all hearts exhibited complete atrioventricular block, 67% developed
      ventricular premature beats and 33% ventricular tachycardia; none exhibited
      ventricular fibrillation. CONCLUSIONS: The results suggest that singlet oxygen,
      as opposed to superoxide, is responsible for the injury which occurs at tissue
      surfaces to which photosensitizer is bound.

PMID- 2224937
TI  - Nisoldipine inhibits lipid peroxidation induced by coronary occlusion in pig
      myocardium.
AB  - STUDY OBJECTIVE: The aim was to investigate the effect of the Ca++ channel
      blocker nisoldipine on the content of lipid peroxidation products in pig
      myocardium after acute coronary occlusion. DESIGN: Open chest pigs were subjected
      to the occlusion of the left anterior coronary artery (LAD) with or without
      nisoldipine. After 30 min ischaemia, myocardial samples were taken from the
      ischaemic area and from the non-ischaemic posterior wall of the left ventricle
      for determination of lipid peroxidation products. SUBJECTS: Subjects were farm
      pigs of either sex. In 10 pigs, the LAD was occluded without drug pretreatment;
      11 pigs were infused with nisoldipine (10 micrograms.kg-1) 30 min before the LAD
      occlusion. Sham operated controls received no drug (n = 7) or nisoldipine (n =
      9). MEASUREMENTS AND MAIN RESULTS: Myocardial samples were assayed for the
      content of lipid peroxidation products: malondialdehyde, conjugated double bonds,
      and fluorescent end products. Plasma nisoldipine concentration was measured in
      some experiments. Following the LAD occlusion, the content of lipid peroxidation
      products increased in both ischaemic and non-ischaemic myocardial regions as
      compared to the hearts of sham operated pigs. Pretreatment with nisoldipine
      completely prevented these increases. At a time of the coronary occlusion, plasma
      nisoldipine concentrations were within the therapeutic range. CONCLUSION: Ca++
      antagonist prevents the excessive peroxidation of myocardial membrane lipids
      which affects the whole myocardium when there is acute local ischaemia.
      Prevention of myocardial damage in the non-ischaemic region may determine
      survival of the infarcted heart.

PMID- 2224938
TI  - Occlusion time dependency of regional noradrenaline release and cardiac
      arrhythmias during reperfusion of acutely ischaemic heart in the dog in vivo.
AB  - STUDY OBJECTIVE: The aim was to study the occlusion time dependency of
      reperfusion induced increases in regional cardiac noradrenaline release from the
      ischaemic area in relation to the incidence of ventricular arrhythmias. DESIGN:
      The left anterior descending coronary artery was ligated for 15, 30 and 60 min in
      three separate groups of dogs (n = 10 per group). Each occlusion period was
      followed by a 30 min reperfusion period. The coronary sinus and the epicardial
      vein running in parallel with the left anterior descending coronary artery were
      cannulated for measurement of noradrenaline and lactate. EXPERIMENTAL MATERIAL:
      30 adult mongrel dogs, 22.5(SEM 1.1) kg, were used for the study. The animals
      were anaesthetised with sodium pentobarbitone. MEASUREMENTS AND MAIN RESULTS:
      During occlusion, epicardial venous blood noradrenaline concentrations remained
      unchanged up to 30 min, but increased from 0.133(0.027) ng.ml-1 to 0.289(0.069)
      ng.ml-1 after 60 min of occlusion (p less than 0.05). However, epicardial venous
      blood lactate concentrations increased immediately upon occlusion, and remained
      elevated (p less than 0.05) during the whole period of occlusion in all groups.
      Neither noradrenaline nor lactate concentrations in coronary sinus blood
      increased during occlusion. During reperfusion, nine dogs showed early
      ventricular fibrillation. The highest incidence of fibrillation (n = 5/10) was
      found in the 15 min occlusion group, but the difference was not significant
      between groups. Epicardial venous blood noradrenaline concentrations increased to
      0.371(0.076) ng.ml-1, 0.470(0.178) ng.ml-1, and 1.824(0.713) ng.ml-1 upon
      reperfusion following 15, 30 and 60 min occlusion, respectively (each p less than
      0.05). Maximum increases in epicardial venous blood noradrenaline concentrations
      during reperfusion were correlated with duration of preceding occlusion (r =
      0.60, n = 21, p less than 0.01). Maximum increases in mean arrhythmic ratios
      observed during the first 10 min of reperfusion were proportionally related to
      mean epicardial venous blood noradrenaline concentrations. The increases in
      epicardial venous blood noradrenaline concentrations and the incidence of
      ventricular arrhythmias in the 60 min occlusion group were greater (p less than
      0.05) than in the other two groups. CONCLUSIONS: This study shows that
      noradrenaline is released progressively from the ischaemic area during occlusion
      for 60 min. The amount of noradrenaline washed out upon reperfusion and the
      incidence of reperfusion ventricular arrhythmias both appear to be dependent upon
      duration of preceding occlusion. The results suggest that cardiac noradrenaline
      released locally from the ischaemic region may contribute to the genesis of
      reperfusion ventricular arrhythmias, but not to that of reperfusion ventricular
      fibrillation.

PMID- 2224939
TI  - Effects of nifedipine on systemic hydraulic vascular load in patients with
      hypertension.
AB  - STUDY OBJECTIVE: The aim of the study was (1) to determine the difference in
      aortic input impedance and derived parameters between hypertensives and
      normotensives; and (2) to assess the acute effects of nifedipine on the aortic
      impedance, compliance, and resistance in patients with hypertension. DESIGN: A
      high fidelity multisensor catheter (Millar) was used to obtain the aortic
      pressure and flow signals for impedance analysis. The acute effects of nifedipine
      on the impedance parameters were evaluated at steady state before and after (10
      30 min) a sublingual dose of 10 mg. PATIENTS: The patients included seven
      normotensive (mean blood pressure, 97 mm Hg) and nine hypertensive (mean blood
      pressure, 135 mm Hg), age matched, ethnic Chinese. Patients with clinical
      evidence of heart failure and valvular or congenital heart diseases were
      excluded. MEASUREMENTS AND MAIN RESULTS: Pulsatile aortic flow and pressure were
      measured by Millar catheter inserted into the ascending aorta. Cross sectional
      area of aorta was estimated by echocardiograms. Cardiac output was determined by
      Fick principle with an oximeter. These data were subjected to Fourier analysis
      for impedance spectra. In comparison with normotensives, hypertensives had
      increased peripheral vascular resistance R, at 2751(705) v 1651(363) dyne.s.cm-5;
      increased characteristic impedance Zc, at 193(64) v 122(27) dyne.s.cm-5; and
      increased first zero crossing frequency of impedance phase angle fo, at 4.8(0.9)
      v 3.4(0.7) Hz. Arterial compliances corresponding to peak systolic pressure Cs
      were lower, at 0.32(0.19) v 0.90(0.32) ml.mm Hg-1, as was mean pressure Cm, at
      0.55(0.25) v 1.24(0.38) ml.mm Hg-1, and end diastolic pressure Cd, at 0.83(0.29)
      v 1.65(0.44) ml.mm Hg-1. Although the values of external ventricular hydraulic
      power were higher in hypertensive subjects, the difference was not statistically
      significant. Nifedipine administration in 7/9 hypertensives significantly reduced
      R, from 2806(721) to 2433(664) dyne.s.cm-5; mean aortic pressure Pm, from 138(22)
      to 112(12) mm Hg; total external ventricular power Wt, from 1452(306) to
      1121(135) mW; and steady external power Ws, from 1251(310) to 939(119) mW; but
      did not reduce Zc, fo, Cs, Cm, Cd, and oscillatory external power Wo.
      CONCLUSIONS: The results indicate that (1) the stiffness of proximal aorta and
      vascular tone of peripheral arterioles are higher in hypertensives than in
      normotensives; (2) in hypertensive subjects, sublingual administration of
      nifedipine reduces the arterial pressure and peripheral arteriolar tone, but not
      the stiffness of proximal aorta; (3) the decrease in total external ventricular
      power in hypertensives treated with nifedipine results from a reduction in the
      steady, but not the oscillatory, component of hydraulic external ventricular
      power.

PMID- 2224940
TI  - Indomethacin suppresses the coronary flow response to hypoxia in exercise trained
      and sedentary rats.
AB  - STUDY OBJECTIVE: The aim was to determine if prostaglandin like activity might be
      involved in changes due to exercise training in the coronary flow responses to
      hypoxia. DESIGN: The coronary flow response to hypoxia was measured under
      constant perfusion pressure in isolated perfused hearts from 12 endurance
      exercise trained rats and 12 control rats. Eight hearts were perfused with a
      solution containing indomethacin, a cyclo-oxygenase inhibitor, to determine its
      effect on any training induced changes in the coronary flow response to hypoxic
      stress. EXPERIMENTAL MATERIAL: 24 male Sprague-Dawley rats, 517 (SD 51) g, were
      used for this study. The animals were anesthetised and the hearts rapidly excised
      and perfused with a modified Langendorff perfusion system. MEASUREMENTS AND MAIN
      RESULTS: Under constant perfusion pressure, the hearts of endurance exercise
      trained rats had a greater increase in coronary flow during hypoxia relative to
      normoxia than did hearts of untrained rats, at 13.52(2.15) v 9.56(1.05) ml.min
      1.g-1 dry heart weight. Indomethacin treatment abolished this difference and
      lowered coronary flow: exercise -3.81(3.75) ml.min-1.g-1; control 0.38(2.44)
      ml.min-1.g-1. CONCLUSIONS: The inhibition by indomethacin of the endurance
      exercise training induced potentiation of the coronary fluid flow response to
      hypoxia suggests that prostacyclin or a related compound may be involved in this
      adaptation to exercise.

PMID- 2224941
TI  - Capillary permeability of 131I-albumin in the resting human forearm.
AB  - STUDY OBJECTIVE: The aim was to examine capillary permeability of 131I-albumin in
      the normal, resting human forearm. DESIGN: A bolus injection of 131I-albumin was
      injected into the brachial artery, and the residue function was measured by
      external registration over the forearm tissues. The results were analysed by
      indicator kinetic "black box" theory using the single injection, residue
      detection method which is based on indicator diffusion principles. SUBJECTS:
      Seven normal volunteers participated in the study. MEASUREMENTS AND MAIN RESULTS:
      The mean capillary extraction fraction of 131I-albumin was 0.023 (SD 0.0056), n =
      7, at a mean plasma flow rate of 2.1 (0.34) ml.100 g-1.min-1. At an estimated
      capillary surface area of 70 cm.g-1 the permeability coefficient was 11.10(-8)
      cm.s-1. CONCLUSIONS: According to the theories of restricted diffusion and
      equivalent pores the results are compatible with an equivalent pore radius
      estimate of 113 A using additional previously published results from experiments
      with 51Cr-EDTA.

PMID- 2224942
TI  - Influence of electrogenic Na/Ca exchange on the action potential in human heart
      muscle.
AB  - STUDY OBJECTIVE: The plateau of the action potential in heart muscle is largely
      due to the inward Ca2+ current, ica; however, Ca2+ extrusion via Na+/Ca2+
      exchange may also generate a significant current, ina/ca. The aim was to assess
      the influence of ina/ca on the action potential in isolated human heart muscle.
      DESIGN: Action potentials and force of isometric contractions were recorded in
      ventricular trabeculae. The muscle was subjected to various stimulus patterns,
      Ca2+ antagonists, and variations in the ionic composition of the extracellular
      medium. PATIENTS: From 49 patients, aged 0.5 to 14 years, small right ventricular
      trabeculae were obtained during open heart surgery. The operations concerned
      corrections of ventricular septal defects. Data presented in this paper were from
      nine preparations in which action potentials were recorded during several hours.
      MEASUREMENTS AND MAIN RESULTS: The results confirmed that: (1) the amplitude of
      the early part of the plateau was depressed by low [Ca2+] and by Ca2+
      antagonists, showing that ica dominates this early part; and (2) that low [Na2+]
      and post-extrasystolic potentiation also depressed the early component of the
      plateau of the action potential, which can be explained by inactivation of ica
      due to increased levels of intracellular Ca2+. A novel observation was that post
      extrasystolic potentiation led to an increase in action potential duration (APD).
      An explanation is that the potentiated contraction follows from an increased
      amount of intracellular Ca2+ which also activates an inward current, possibly
      ina/ca. This assumption is strengthened by the finding that lengthening of APD
      after extrasystoles was abolished: (a) at low [Ca2+], ie, when force was small
      and there was little Ca2+ to be extruded; and (b) at low [Na+], ie, when force
      was large but the driving force of the Na+ gradient for extrusion of Ca2+ was
      small. CONCLUSIONS: The early part of the plateau is dominated by ica, whereas
      ina/ca is relatively more important during the later part, and tends to lengthen
      the action potential.

PMID- 2224944
TI  - Dexamethasone and nonsteroidal anti-inflammatory agents in the treatment of
      bacterial meningitis.
AB  - It has been shown in experimental models of bacterial meningitis that bacterial
      cell-wall components produce an inflammatory response in the subarachnoid space,
      probably by stimulating the release of inflammatory cytokines, such as tumor
      necrosis factor, interleukin-1, and prostaglandins. Interleukin-1 increases the
      concentration of prostaglandin E2 and leukotriene B4, metabolites of arachidonic
      acid, which are potent mediators of inflammation. Steroidal and nonsteroidal anti
      inflammatory agents decrease formation of these metabolites and minimize the
      damage to the blood-brain barrier. There is also evidence that anti-inflammatory
      agents decrease cerebral edema in bacterial meningitis. The results of clinical
      trials in patients with bacterial meningitis demonstrate that dexamethasone can
      prevent sensorineural hearing loss and reduce mortality, without interfering with
      the antimicrobial action of antibiotics.

PMID- 2224943
TI  - Effects of increased pericardial pressure on the coupling between the ventricles.
AB  - STUDY OBJECTIVE: The mechanical coupling between the ventricles occurs directly
      through the myocardium (ventricular-ventricular coupling) and indirectly through
      the pericardium (ventricular-pericardial-ventricular coupling). We postulated
      that the magnitude of ventricular-pericardial-ventricular coupling would increase
      at high pericardial pressures, while ventricular-ventricular coupling would be
      unaltered. DESIGN: Canine hearts were removed and placed in cold cardioplegic
      solution. Balloons were inserted into each ventricle and the left and right
      ventricular pressure (dP1, dPr) and volume (dV1, dVr) changes caused by
      increasing the pressure and volume of the other ventricle and by increasing
      pericardial pressure (dPp) were measured. EXPERIMENTAL MATERIALS: Hearts from 10
      random source dogs, weight 12.5-18 kg, were used. MEASUREMENT AND MAIN RESULTS:
      At control pericardial pressure levels, the magnitude of the pericardial
      ventricular interactions was greater than the ventricular-ventricular
      interactions: dP1/dPp was significantly greater than dP1/dPr, at 0.71 (SEM 0.04),
      n = 6, v 0.18 (0.03), p less than 0.01, and dV1/dPp was significantly greater
      than dV1/dPr, at -0.83 (0.09) v -0.24 (0.06), p less than 0.05. Raising the
      pericardial pressure increased the mechanical coupling between the ventricles:
      dP1/dPr approximately, dV1/dPr approximately, dPr/dP1 approximately, and dVr/dP1
      approximately increased significantly (p less than 0.05) by 0.48 (0.03), 0.67
      (0.13), 0.38 (0.05), and 0.61 (0.09) respectively. This increased coupling
      occurred through pericardial pressure changes. If pericardial pressure was
      maintained constant, the coupling between the ventricles was unaltered. This same
      pattern was observed in four in situ experiments. For these experiments, at the
      raised pericardial pressure levels, dP1/dPr increased, from 0.51 (0.03) to 0.79
      (0.01), p less than 0.05, if pericardial pressure was allowed to vary, but was
      unaltered with a constant pericardial pressure, at 0.42 (0.03) v 0.44 (0.04), p
      greater than 0.5. CONCLUSIONS: Ventricular interdependence was increased with
      raised pericardial pressure and this increased coupling was due primarily to an
      increased ventricular-pericardial-ventricular coupling. This increased coupling
      may help to explain the paradoxical pulse observed in cardiac tamponade.

PMID- 2224945
TI  - Choosing a target for cognitive enhancers.
AB  - The development of drugs to improve cognitive functions (cognitive enhancers) has
      been hampered by the failure to define pharmacologic targets. The justifications
      for the development of cognitive enhancers for medicine, the pharmaceutical
      industry, and society are outlined. The procedures required for the development
      of these drugs and their therapeutic objectives are discussed. It is concluded
      that a better definition of the direct targets of cognitive enhancers can
      guarantee cost and time savings for the industry and produce a therapeutically
      effective agent.

PMID- 2224946
TI  - Inhibitory effects of ulinastatin on the production of cytokines: implications
      for the prevention of septicemic shock.
AB  - The study was designed to determine whether ulinastatin can be used as a
      biological response modifier for the prevention of septicemic shock. Monocytes
      from heparinized blood of three healthy volunteers were incubated with 0.125 or
      1.25 U/ml of ulinastatin, and then endotoxin (Escherichia coli
      lipopolysaccharide) was added at concentrations of 0.1, 1.0, and 10.0
      micrograms/ml. A dose-dependent increase in the production of tumor necrosis
      factor alpha, interleukin-1 alpha, and interleukin-1 beta was noted after
      endotoxin stimulation. Production of these cytokines was inhibited by the
      addition of ulinastatin in a dose-dependent manner. The results indicate that
      ulinastatin could be useful in the prevention of septicemic shock.

PMID- 2224947
TI  - Effects of a new calcium channel blocker, TA 3090, on serum lipoprotein levels in
      mild to moderate essential hypertension.
AB  - The 25 hypertensive patients received 20 to 40 mg of TA 3090 daily for 12 weeks.
      Blood pressures declined significantly during treatment, from a mean of 162/98 to
      145/88 mmHg. There were no significant changes in levels of total or very low
      density lipoprotein cholesterol or triglyceride, in levels of low-density
      lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, HDL2
      cholesterol, HDL3 cholesterol, or in levels of apolipoprotein (apo) B, C-II, C
      III, or E. Apo A-I and A-II levels increased significantly from 130 and 29.2
      mg/dl before treatment to 152 and 31.4 mg/dl at 12 weeks. Mean serum creatinine
      levels decreased significantly from 0.92 to 0.80 mg/dl. No other drug-related
      changes in laboratory test results or side effects were noted. It is concluded
      that TA 3090 is a safe and effective treatment for mild to moderate hypertension.

PMID- 2224948
TI  - Nicardipine in the prevention of cerebral infarction.
AB  - Two hundred and sixty-four patients were included in an open, randomized,
      multicenter trial, with the aim of determining whether nicardipine can be useful
      in the prevention of cerebral infarction. The patients had experienced one or
      more transient ischemic attacks, reversible ischemic neurologic defect, or stroke
      with minor permanent neurological deficit in the 12 months before enrolling in
      the study. Each patient was randomly assigned to received 250 mg of aspirin once
      daily plus 20 mg of nicardipine thrice daily (n = 170) or 250 mg of aspirin once
      daily (n = 94) for 12 months. During the 12-month treatment period, 12% of the
      aspirin-plus-nicardipine group and 19% of the aspirin-only group experienced an
      ischemic cerebrovascular event; at six months, the cumulative incidence of events
      was significantly lower in the aspirin-plus-nicardipine group than in the aspirin
      only group. One patient in each group died of a recurrent stroke. Aspirin-related
      side effects were dyspepsia (reported by four patients), heartburn (by seven),
      nausea and vomiting (by four), and melena (by five); nicardipine-related side
      effects were transient hypotension (by two), headache (by four), ankle edema (by
      three), and constipation (by four). Results indicate that the addition of
      nicardipine to antiplatelet treatment may safely prevent the recurrence of
      ischemic cerebrovascular events.

PMID- 2224949
TI  - Evaluation of IPM/CS in gram-negative bacillus infections: use of an endotoxin
      specific assay.
AB  - The subjects were 26 patients hospitalized with severe trauma or burns. Twice
      daily for seven to 14 days, 1 gm of IPM/CS (a 1:1 combination of imipenem and
      cilastatin sodium) was administered by intravenous drip infusion to each patient.
      Clinical outcome was rated excellent in nine patients, good in 12, and fair in
      five. Bacteria, isolated in 21 of the 26 patients, were eliminated in 18 and
      decreased in three. Mean endotoxin levels, assessed by the Endospecy method, were
      reduced from 167.8 pg/ml before treatment to 5.1 pg/ml after treatment. No
      treatment side effects were noted.

PMID- 2224950
TI  - Desmopressin acetate in children with severe primary nocturnal enuresis.
AB  - Desmopressin acetate, a synthetic antidiuretic drug, was evaluated in two US
      multicenter studies involving a total of 176 children with severe primary
      nocturnal enuresis. Patients who qualified during the screening period, entered a
      double-blind treatment phase during which they received 20 micrograms or 40
      micrograms of desmopressin acetate or placebo at bedtime for four weeks. This
      phase was followed by a four-week open-label period, during which all patients
      received 20 or 40 micrograms of desmopressin acetate. In both studies, children
      given desmopressin acetate had significantly fewer wet nights after two and four
      weeks of therapy than did children given placebo. During the open-label period,
      patients crossed over from placebo to desmopressin acetate showed similar
      reductions in enuresis. Global evaluations by the patients, their parents, or the
      investigators further confirmed the good results with desmopressin acetate. No
      serious adverse experiences were reported. Thus the results of these studies
      corroborate previously published reports of the efficacy and safety of
      desmopressin acetate in the treatment of primary nocturnal enuresis.

PMID- 2224951
TI  - Milestones in clinical pharmacology. Tuberculosis.

PMID- 2224952
TI  - A quantitative histochemical study of the microvasculature of irradiated skin.
AB  - Short-term X-ray damage to the microvasculature of the skin of newborn rats has
      been quantitated using Horseradish Peroxidase as a tracer. Image analysis of
      thick sections on which peroxidase was demonstrated histochemically revealed a
      radioinduced increase in vascular volume coupled with a decrease in vascular
      length and an altered frequency distribution of blood vessel calibers which
      resulted in early telangiectasia. The results afforded by direct counting of
      peroxidase positive macrophagic cells and microphotometric evaluation of
      peroxidase present in the connective tissue indicate a progressive increase in
      capillary permeability as a function of dose and time post-irradiation. The
      accuracy with which the affected region of blood vessels coincided with the area
      exposed to the beam favours the hypothesis of direct damage to the vessel wall as
      a major cause of radioinduced lesion.

PMID- 2224953
TI  - Phosphorylation of ornithine decarboxylase by casein kinase II from RAW264 cells.
AB  - Casein kinase II and ornithine decarboxylase were purified from a virally
      transformed macrophage-like cell line, RAW264. The addition of casein kinase II
      to a reaction mixture containing [tau-32P]GTP, Mg++, and ornithine decarboxylase
      led to the phosphorylation of a 55,000 dalton protein band in the purified
      preparation of ornithine decarboxylase. Stoichiometric estimates indicated that
      casein kinase II incorporated 0.15 mole of phosphate per mole of ornithine
      decarboxylase, which was increased to 0.3 mole/per mole in the presence of
      spermine. The apparent Km and Vmax values for the casein kinase II-mediated
      phosphorylation of ornithine decarboxylase were 0.36 microM and 62.5 nmol/min./mg
      kinase. The addition of spermine to the reaction did not alter the Km but
      increased the Vmax to 100 nmol/min./mg kinase. The phosphorylation of ornithine
      decarboxylase by casein kinase II affected neither the rate of maximal ornithine
      decarboxylase activity nor the affinity of the enzyme for ornithine.

PMID- 2224954
TI  - Effect of a luteinizing-hormone-releasing-hormone (LHRH)-analogue on the
      histochemistry of the secondary alcohol-dehydrogenase in the Leydig cells of the
      cat testis.
AB  - The histochemical activities of the enzymes alcohol dehydrogenase with propanol
      (A-D I) and isopropanol (A-D II) as substrates, 3- beta-hydroxysteroid
      dehydrogenase (3 beta .OHST-D), nicotinamideadenine dinucleotide phosphate
      (reduced form)-tetrazolium reductase (NADPH2-TR) and glucose-6-phosphate
      dehydrogenase (G6P-D) were studied in the testis of 6 cats daily injected with 20
      micrograms/kg of the LHRH-analogue DTRP6-DGLY-10, LHRH-ethylamide (LHRH-A Group)
      and 3 cats injected with saline during 67 days. A morphometric analysis was done
      to evaluate the activity of the enzymes, its distribution and volume fractions of
      the Leydig cells with every activity. A-D II displayed a significant inhibition
      in the Leydig cells of the LHRH-A Group. There were no changes in the activities
      of G6P-D, 3 beta .OHST-D and NADPH2-TR, but it was possible to disclose some
      reduction of the volume fraction of the Leydig cells when the first two enzymes
      were used as its marker. This study corroborates that A-D II is a reaction in the
      pathway of steroidogenesis but does not explain whether it corresponds actually
      to 20-22 desmolase as proposed in the work by Hardonk (1965) or to another
      reaction linked to the activities of the cytochromes P450.

PMID- 2224955
TI  - Effects of human recombinant IL-1 beta on rheumatoid and non rheumatoid human
      synovial cell growth.
AB  - The growth of adherent synovial cells passaged once was studied in response to
      human recombinant interleukin 1 (hr IL-1) beta. Human synovial cell cultures were
      established from tissues obtained during therapeutic joint surgery for patients
      with rheumatoid arthritis (rheumatoid synovial cells, RSC) or non inflammatory
      rheumatic diseases (non rheumatoid synovial cells, NRSC). The effect of IL-1 beta
      (0.1 to 10 ng/ml) on the time course of proliferation showed that values for DNA
      synthesis and cell numbers in RSC cultures were higher than in NRSC cultures.
      Similarly, untreated control RSC cultures grew more quickly than NRSC. These
      results demonstrate that RSC, which are continuously stimulated by IL-1 beta
      produced in the rheumatoid pannus in vivo, have a higher capacity for
      proliferation than NRSC but are less responsive to IL-1 beta. A dose-response
      curve of proliferation was established 72 hrs. after the addition of IL-1 to the
      medium. The stimulating effect of IL-1 beta (0.001 to 10 ng/ml) was dose
      dependent in both RSC and NRSC and reached a plateau at 10 ng/ml; the response of
      NRSC was stronger than that of RCS.

PMID- 2224956
TI  - Effects of lectins on cytoskeleton and morphology or cultured chick embryo
      fibroblasts.
AB  - The microfilaments and microtubules of cultured chick embryo skin fibroblasts
      were studied in the presence of exogenous lectins by an indirect
      immunofluorescence technique. Lectin treatment induced modifications in the
      arrangement of myosin, actin and tubulin, determined depolymerization of the
      proteins and caused changes in cell shape and size. The results suggest that the
      interaction between lectins and their specific membrane receptors triggers a
      series of changes in the cytoskeletal pattern via transmembrana as yet unknown
      mechanisms and that these are responsible for the alterations in cell shape and
      size.

PMID- 2224957
TI  - Messenger-dependent action of guanylylimidodiphosphate and translation inhibitors
      on rat brain polypeptide synthesis.
AB  - The effects of the Guanosine 5'-triphosphate analog guanylylimidodiphosphate and
      several antibiotics on protein synthesis in a cell-free system from rat brain
      were investigated as a function of the template used. Polypeptide chain
      elongation was promoted by the analog only in the system coded by the endogenous
      template but not when coded by polyuridylic acid. The effects of the antibiotics
      were also dependent on the template used. This suggest that the template
      conditioned the ribosomal conformation which determine the inhibitory effect of
      the antibiotics.

PMID- 2224958
TI  - Influence of the structure of alkanols on their inhibition of protein synthesis
      in Saccharomyces cerevisiae var. ellipsoideus.
AB  - The effects of several short chain alcohols on protein synthesis by intact
      Saccharomyces cerevisiae var. ellipsoideus cells were studied. The results show
      that the relative inhibitory potencies correlate well with the size of the carbon
      backbone, thus suggesting that a hydrophobicity-related effect is involved in the
      inhibitory action of these alcohols. Additionally, the branching nature of the
      carbon backbone contributes to determining the action of the alcohol, as proved
      by the relative potencies of the four-carbon alcohol series.

PMID- 2224960
TI  - [Academician Vilem Laufberger and the Czechoslovak Academy of Sciences].
AB  - Academician Vilem Laufberger participated in a significant way in the work of the
      Czechoslovak Academy of Sciences. He was one of its founders as a member of the
      preparatory commission for its establishment, an important official in its
      presidium, founder and director of one of its institutes and a permanent long
      term critical observer and commentator of its activities. He greatly appreciated
      the steep rise of biomedical research at the beginnings of the Academy as a
      worthy development of the traditions of world reknown physiologists J. E. Purkyne
      and I. P. Pavlov. He evaluated favourably also its subsequent development. At the
      very beginning he drew attention to some shortcomings which during subsequent
      development influenced the activities of the Academy in an adverse way. Their
      elimination is a task for the present time.

PMID- 2224959
TI  - Coupling of Na+ with the spermidine transporter protein in NIH BALB/c 3T3 cells.
AB  - This study demonstrates that polyamine spermidine (Spd) transporter protein is
      directly coupled with the Na+ in a ternary complex form, Na(+)-Spd-carrier. The
      Spd is transported with Na+ in a 1:1 stoichiometry relationship. Interestingly,
      addition of 2-deoxyglucose in the assay medium did not influence significantly
      the Spd uptake demonstrating the ATP independency of Spd transport.

PMID- 2224961
TI  - [Metamorphosis today].
AB  - In conjunction with the 100th anniversary of birth of the Czech physiologist V.
      Laufberger who discovered in 1913 the possibility to induce metamorphosis in
      neotenous larvae of axolotls by feeding them with thyroid gland, the author gives
      an account on the development of knowledge regarding metamorphosis in amphibia.
      He analyzes the participation of endocrine glands, in particular thyroid hormones
      and prolactin. Special attention is devoted to mechanisms leading to resorption
      of the tail in tadpoles, i. e. the activation of lysosomal enzymes due to the
      action of thyroid hormones. Prolactin has an inhibitory effect on metamorphosis.
      An important part is obviously played by deiodination of the prohormone thyroxine
      in target tissues to active triiodothyronine. Recently it was demonstrated that
      during metamorphosis a significant role is played by apoptosis (controlled non
      inflammatory absorption of superfluous cells).

PMID- 2224962
TI  - [Laufberger's excitation theory].
AB  - The author gives an account of V. Laufberger's Excitation theory at the occasion
      of the 100th anniversary of his birthday. This work was published as a monograph
      in 1947 and contains many data which foresee the further development of neuro
      sciences and other scientific disciplines. From a certain aspect it is more
      cybernetic than Wiener's "Cybernetics" published one year later. It applies in a
      genial way the principle of logical elements made up of binary functional
      elements, backfeeds, parallel organization of neuron networks, and memories based
      on so-called spinning excitations. It is the first modern model of cerebral
      activity. It combines within one system the neuron and psychic level of
      organization of the brain.

PMID- 2224963
TI  - [The electrocardiologic period of scientific work of academician Vilem
      Laufberger].
AB  - Laufberger contributed in a fundamental way to the solution of practically all
      basic problems of the electric field theory of the heart (EPS). He defined the
      centre of EPS and elaborated the procedure of its determination by means of
      mirror image ECG and derived the mathematical relationship by means of which it
      is possible to assess the distance of the surface electrode from the given point
      inside the chest (1952, 1953) and to correct thus the magnitude of the ECG. On
      these findings he based his individually corrected vector cardiographic system of
      leads. By the term cardiale (1961, 1963)--the spatial curve of tension maxima
      which develop in the EPS during the electric systole of the heart--Laufberger
      resolved the problem of the physical basis of electrocardiography. Its correlate
      is the spatioelectrocardiogram (1953)--a spatial curve which developed by
      "synthesis" of orthogonal ECG of the vector cardiographic system of axes. In
      orbital spatiocardiography (1961, 1963) he expressed synthetically the topography
      of shapes of the set of surface ECG, the amplitudes of which correspond to the
      global area, equidistant in relation to the centre of EPS (orbit). He foresaw by
      many years the inverse problem solution (i.e., assessment of properties of the
      EPS source from properties of the body surface potential distribution) by
      orthogonal transformations, in particular in the shape of the multipole theory.
      Laufberger generalized the mentioned findings in a mathematical model of EPS
      (1970-1980) which made it possible to study all laws he revealed and their mutual
      action on the formation of the set of surface ECG.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2224964
TI  - [The development of theories on the mechanisms of insulin action].
AB  - In 1924 Laufberger formulated his block theory on the action of insulin. Its
      basic thesis that insulin prevents the new formation of glucose and its supply
      into the blood stream is still valid, although knowledge on the multiple action
      of insulin expanded substantially. The theory put forward in 1955 by Levine and
      Goldstein which ascribed all insulin actions to the influence on the cellular
      membrane permeability for glucose, could, however, not explain all data
      associated with insulin, the knowledge of which was expanded steadily. At present
      the mechanism of insulin action is explained most comprehensively by the concept
      based on the bond of insulin to its membrane receptor which by activation of
      tyrosine kinase it contains induces either cascade phosphorylation of
      intracellular protein kinases or (and) leads to the release of the "second
      messenger" from the cell membrane, i.e. of glycosyl-phosphatidyl inositol. In
      both instances activation of the glucose and amino acids transmitter from the
      medium into the cells results, as well as activation of enzymes catalyzing in the
      cell various degrees of carbohydrate, fat and protein metabolism.

PMID- 2224965
TI  - [Survival and differentiation of pyramidal cells of the hippocampus after
      transplantation].
AB  - Pyramidal neurons of the CA3 hippocampal area were eliminated by means of the
      kainic acid. Subsequent transplantation of the embryonal hippocampal tissue
      suspension brought about an increase of the number of neurons. Groups of nerve
      cells were located at the tips of the implantation tracts. Neurons formed
      dendritic trees of various complexity. Most of them had an irregular dendritic
      branching pattern. Only those located within the pyramidal layer, had the typical
      arrangement of several basal and one apical dendrite.

PMID- 2224966
TI  - [Vilem Laufberger--scientist, teacher and physician].

PMID- 2224967
TI  - [Health care and the church].
AB  - The article is devoted to some basic problems of the relationship of the health
      services and Church which may appear under the present new circumstances. After a
      long period of repression of the church to the periphery of society it is
      necessary to attempt to answer with new courage and mutual confidence what the
      health services may expect and demand from the church and what the church may
      expect and what the health services can offer the church. The author deals in
      more detail with several areas where collaboration between churches and health
      services seems promising: psychiatry and clinical psychology, nursing,
      thanatology, prevention. The author mentions the necessity of mutual meeting and
      enrichment in theoretical areas.

PMID- 2224968
TI  - [Immunocomplex vasculitis].
AB  - The clinician suspects immunocomplex vasculitis when he cannot find a common
      denominator for the concurrent affection of various neighbouring organs and
      tissues. These affections result from the inflammatory response of the organism
      to the deposition of non-phagocytized circulating immunocomplex into the vascular
      wall. Despite the delicacy of attempts to classify them, the author tried to
      differentiate them into non-progressing immunocomplexes vasculitis, which
      recedes, and progressing immunocomplex vasculitis which may be either primary or
      secondary. Among primary ones he includes nodose polyarteritis and its
      granulomatous variant, Churg-Strauss' disease, Henoch-Schonlein anaphylactoid
      purpura and granulomatous vasculitis of the Wegener granulomatosis type, Horton's
      temporal arteritis, Takayasu's pulseless disease and Winiwarter-Buerger's
      obliterating thromboangiitis, which may be of the peripheral or more rarely the
      visceral type. Secondary progressing vasculitis is encountered in so-called
      "collagenoses" (e.g. systemic lupus erythematodes), where the clinical picture is
      to a considerable extent conditioned by vasculitis. The clinical picture is due
      to the generalized affection of the microcirculation. Symptoms of ischaemic
      affection of all organs and tissues may be encountered. A typical feature are
      different types of damage of the same adjoining system, e.g. a combination of
      asymmetric central and peripheral pareses in affections of the nervous system.
      The author discusses the most frequent clinical pictures, the importance of
      different examination procedures and therapeutic possibilities. Assessment of the
      diagnosis of immunocomplex or autoaggressive systemic disease is very difficult,
      as a typical picture corresponding clearly to a defined nosological unit is
      encountered rarely.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2224969
TI  - [Analgesia in extracorporeal shock wave lithotripsy. Experience with a
      lithotripsy apparatus made in Czechoslovakia].
AB  - The authors describe their experience with the use of analgesia during
      lithotripsy by an extracorporeal impulse wave (LERV). They made a total of 253
      lithotripsies in various indications in a total of 150 patients. Most frequently
      ataracoanalgesia was administered (a combination of diazepam and phentanyl),
      however, administration of midazolam (Dormicum) is also adequate. This is due
      among others to the favourable physical properties of the impulse waves generated
      by the apparatus used. In the discussion the authors give a brief account of the
      causes of painfulness of LERV, based on contemporary ideas and experience.

PMID- 2224970
TI  - [Contribution of automatic sphygmomanometers for one-time measurement of blood
      pressure].
AB  - Due to high intra-individual variability of arterial blood pressure, single
      measurements provide only estimates of true actual values. Two or three
      recordings made in sequence in one or a few minutes' intervals are recommended in
      some clinical studies of antihypertensive therapy, with the aim of decreasing the
      variability. In order to examine the value of repeated measurements made on one
      occasion, four sequential resting recordings of blood pressure and heart rate
      made in one minute intervals with the automatic oscillometric Nippon Colin BP
      103N sphygmomanometer were evaluated in 66 subjects, using the analysis of
      variance methods. Means of three recordings showed a significantly lower
      variability than single measurements (almost by one half), while the difference
      between three and four readings was not significant. The Page's rank test
      revealed that the first measurements are not uniformly the highest ones, and
      therefore the medians of three readings made in sequence are recommended as
      characteristics of resting blood pressure. An advantage of the oscillometric
      method is the possibility of measuring mean arterial pressure. The recorded
      values were significantly higher than those calculated from the systolic and
      diastolic pressures according to the current formula, being situated between one
      third and one half of the pulse pressure. The intra-individual coefficient of
      variation of the recorded mean arterial pressure was comparable with that of
      systolic and significantly lower than that of diastolic pressure.

PMID- 2224972
TI  - [Confession, reflection and profession].

PMID- 2224971
TI  - [Larval stages of the filaria Mansonella (Dipetalonema) perstans in a student
      from Africa].
AB  - Microfilariae were found in blood samples of a 32 year-old-student from Guinea
      Bissau (Africa). Based on parasite morphology as well as some other features the
      microfilariae were identified as Mansonella perstans. The course of infection was
      asymptomatic (except for slight urticarial skin lesions). The microfilariae
      disappeared from peripheral blood after mebendazole treatment (200 mg daily for 1
      month).

PMID- 2224973
TI  - [Salutogenesis and behavioral medicine].
AB  - As the opposite number of the classical biomedical model the author presents the
      bio-psycho-social model which attempts to supplement relatively omitted subjects
      of health and disease. Against the emphasis on pathogenesis he puts salutogenesis
      -problems leading to "firm health", a good health status despite unfavourable and
      risk factors, and health promotion. Behavioural medicine associates with this
      concept the problem of social influences on the development of diseases and their
      prevention and treatment. At the same time he pays attention to lifestyle, living
      pattern, habits, attitudes, behaviour and action which influence the health
      status. The author gives an account of theoretical concepts, subjects and
      emphasizes aspects of this approach.

PMID- 2224974
TI  - [Lyme borreliosis in the West Bohemian Region. 2 years' experience].
AB  - During the period between 1988-1989 529 cases of Lyme borreliosis were reported
      to the hygiene service of the West Bohemian region. Of these 164 (31.0%) were
      confirmed by indirect immunofluorescence. 342 (64.6%) patients reported contact
      with a tick, another 108 patients reported contact with other arthropods. Among
      the affected systems the skin and nervous system predominated. From the total
      number of 443 cases of erythema chronicum migrans the aetiology was confirmed
      serologically in 84 (19.0%). Comparison of skin diseases confirmed and not
      confirmed by laboratory tests, classified by age, sex, monthly incidence and
      contact with arthropods revealed that the clinical diagnosis of skin symptoms of
      Lyme borreliosis in the West Bohemian region is of a high standard.

PMID- 2224975
TI  - [An epidemic of type B influenza in the geriatric psychiatry department of a
      psychiatric hospital].
AB  - The authors submit an epidemiological and aetiological analysis of a local
      epidemic of influenza type B which occurred in April 1989 in a mental hospital at
      the geronto-psychiatric department. In the course of two weeks 26 patients and 5
      health workers from a total of 72 exposed subjects contracted influenza. 50% of
      the patients who contracted influenza died. The authors emphasize the necessity
      of early preventive epidemiological provisions in institutions of this type.

PMID- 2224976
TI  - [External lumbar cerebrospinal fluid drainage with controlled flow-- its use in
      pediatric neurosurgery].
AB  - The authors describe cases of external lumbar CSF drainage with a regulated flow
      inserted lumbally or in the pseudomeningocele in children. During flow regulation
      during operation they were guided by the finding in the surgical field, during
      therapeutic use (in the course of 1-8 days) by setting the CSF output at 15
      ml/hour. Drainage was used in extradural approach to the orbit, for treatment of
      liquorrhoea in surgical wounds of the posterior fossa, frontal and temporal
      drainage to clear the CSF in meningitis and to make inner drainage possible. CSF
      fistulae healed even after major craniectomies and infections due to the
      resistance of allogenic and xenogenic dural transplants. For external CSF
      drainage the authors used lumbar needles, intravenous Portex kits or original
      Cordis kits. The latter proved to be the best.

PMID- 2224977
TI  - [Serum levels and urinary excretion of amino acids during high intensity physical
      exertion in healthy men].
AB  - The authors investigated the effect of a physical load on a bicycle ergometer on
      serum concentrations and urinary excretion of 19 amino acids. The initial load of
      1 W/kg was increased after 5-minute intervals by 10-20 W to achieve the maximum
      after 50 minutes exercise. During the last 2-3 minutes of the maximal load a
      spiroergometric examination was made. The serum alanine concentration increased
      under these conditions significantly from 474 +/- 133 to 739 +/- 171 mumol/l (p
      less than 0.001), while the serum threonine concentration declined significantly
      from 155 +/- 39 to 143 +/- 37 mumol/l (p less than 0.05). Urinary excretion and
      renal clearance of amino acids declined significantly (p less than 0.05-0.001).
      The authors found a significant correlation between the drop of the urinary
      excretion and the rise of serum concentration of alanine (p less than 0.05). The
      drop of the urinary alanine excretion can contribute to its elevated serum
      concentration. The fractional amino acid excretions did not decline and the
      decline of amino acid and creatinine clearances was more or less proportional.
      The authors conclude that the decline of amino acid excretion is directly
      associated with a drop of glomerular filtration. The revealed, correlations
      between the drop of gin, lys, pala, thr and Na excretion suggest that the sodium
      transport through the nephron can influence the transport of these amino acids.

PMID- 2224978
TI  - [UNICEF report for 1990].

PMID- 2224979
TI  - [Chelating agents].
AB  - The problem of chelating agents used as antidotes in intoxications with metals is
      intensively studied during the past 20 years. Due to the complex nature of the
      action of these substances in the organism their investigation is a typically
      interdisciplinary problem. The submitted review gives the theoretical background
      of the formation of chelate in the organism, the strategy of research of new
      substances is discussed and findings on the main groups of chelating agents used
      in human medicine are summarized.

PMID- 2224980
TI  - [Relation of diabetic polyneuropathy to vascular and organ complications in type
      I diabetes mellitus].
AB  - The authors investigated in 194 type I diabetics the incidence and severity of
      diabetic polyneuropathy in relation to other organ and vascular complications,
      incl. autonomous neuropathy. It was revealed that the increasing severity of
      polyneuropathy was significantly v seru (Cr equal to or less than 130-200
      mumol/l); 4--Cr greater than 200 mumol/l; associated with severe stages of
      nephropathy and proliferative retinopathy with amaurosis. The concurrent presence
      of hypertension and polyneuropathy was surprising and striking--even in patients
      with the mildest grade 1 polyneuropathy hypertension was present in 10% and the
      incidence increased significantly with the increasing severity of polyneuropathy.
      Ischaemic heart disease and ischaemia of the lower extremities was significantly
      more frequent only in patients with grade 5 polyneuropathy. In patients with
      grade 4 and 5 neuropathy there was a 100% incidence of autonomous neuropathy in
      the cardiovascular sphere. The authors did not reveal significant differences
      between men and women as regards the relationship between the incidence of
      polyneuropathy and organ and vascular complications.

PMID- 2224981
TI  - [Therapeutic effectiveness of thrombocyte concentrates in relation to the results
      of the lymphocytotoxicity test].
AB  - The authors analyze the effect of transfusions of 211 thrombocyte concentrates to
      polytransfused patients in relation to the results of the crossover test between
      donor and recipient, using the lymphocytotoxic test (LCT). In negative LCT tests
      the adequate and inadequate effect was 50%. After elimination of non-immune
      influences (splenomegaly, febrile temperature) the percentage of adequate effects
      rose to 70%. In LCT positive results the effect of administration of thrombocyte
      concentrates declined to 30%. The authors discuss practical possibilities and
      ways to select suitable donors to achieve an optimal therapeutic effect of
      substitution therapy.

PMID- 2224982
TI  - [The President-Liberator in the memories of his physician].

PMID- 2224983
TI  - [Thomas Garrigue Masaryk and Eduard Albert].

PMID- 2224984
TI  - [Sleep in old age and its disorders].
AB  - Ageing is associated with deterioration of the quality of nocturnal sleep, more
      frequent siestas in the afternoon, a forward shift of sleep in the 24-hour cycle.
      In old age sleep disorders are more frequent such as sleep apnoea, the restless
      feet syndrome, periodic movements of the lower extremities and others. The
      authors present an account of changes of sleep and vigilance and the most
      frequent sleep disorders in old age.

PMID- 2224985
TI  - [The practicum in physiology: from Laufberger to today].
AB  - An outline of Prof. Laufberger's concept of practical exercises in physiology,
      proposed just after the Second World War, is given. Especially, his new
      pedagogical approach is emphasized, here. Further, the development of the
      organization of practical courses in the Institute of Physiology in Prague is
      described: e.g. the modernization of the methods used, and of the educational
      process in early 70 s'. Today, the importance of biocybernetics is growing.

PMID- 2224986
TI  - [Comparative histomorphometric study of acromegalic spongy bone. Formative static
      parameters].
AB  - The authors used static histomorphometric parameters obtained by processing of
      bioptic bone specimens for comparison of normal and acromegalic spongious bone.
      Parameters of the bone volume (V), osteoid volume (Vos), the extent of osteoid
      bone surfaces (Sf) in the two groups do not differ statistically. The two groups
      do not differ as to age distribution. The width of bone trabeculae is greater in
      acromegalic bone; the difference as compared with normal bone specimens is
      statistically significant (p less than 0.05). The authors conclude that STH in
      acromegalics subjects does not stimulate osteoid production in trabecular bone to
      shift the balance between bone resorption and formation significantly in favour
      of formation. Only restructuring of trabecular acromegalic bone occurs.

PMID- 2224987
TI  - [Possibilities of measurement of obstruction in status asthmaticus].
AB  - Basic treatment of status asthmaticus comprises among others the use of
      artificial pulmonary ventilation with all advantages and risks. The authors tried
      to express objectively the extent of obstruction of the airways from the
      relationship of ventilation parameters obtained from a display unit of Siemens
      Elema 900C ventilator and the period of intubation. Based on the investigated
      parameters, the inspiration pressure, the median intrathoracic pressure and
      pulmonary compliance, they assessed the correlation coefficient, using a
      computer. The value of the coefficient is postulated as the extent of
      obstruction. It can be also used for evaluation of the therapeutic effect and as
      a prognostic factor.

PMID- 2224988
TI  - [The effect of controlled hypotension on kidney function in spinal surgery].
AB  - The authors investigated the influence of controlled hypotension on renal
      function in patients operated on account of idiopathic scoliosis of the spine.
      The deformity was corrected by posterior fusion with Harrington instrumentation
      under general anaesthesia during controlled hypotension induced by sodium
      nitroprusside (n = 20). The control group was formed by 20 patients with the same
      deformity and the same surgical procedure without hypotension. The renal function
      was assessed before operation, during operation and continuously for 102 hours
      after operation. In the group of patients with controlled hypotension (median
      arterial pressure 8.0 kPa) during operation a significant decline of the
      creatinine clearance occurred (0.7 ml/s), as compared with the control group (1.3
      ml/s), as well as compared with the value before operation (1.7 ml/s). After
      terminated hypotension the mean value of creatinine clearance rose to 2.0-2.2
      ml/s for a period of 42 hours. In the control group the creatinine clearance
      persisted at a slightly reduced level, recorded during operation, for another 30
      hours. Sodium retention as a manifestation of hyperaldosteronism was less marked
      in patients with controlled hypotension. During the investigation period no
      biochemical signs of retention of nitrogenous substances were recorded.

PMID- 2224989
TI  - [Vulvoplethysmographic reaction in homosexually-oriented women].
AB  - The author examined, using an electrocapacitance VPG apparatus, 50 women
      reporting homosexual orientation. The results were compared with a control group
      of 50 women volunteers who reported a defined heterosexual orientation and had no
      marked complaints and problems in their sexual life. The general vasomotor
      reactivity in response to erotic stimuli did not differ in the two groups of
      women (the number of recorded vasomotor reactions differed only insignificantly).
      During evaluation of the total number of positive reactions to heterosexual and
      homosexual categories of stimuli the difference between the two groups was highly
      significant (similarly as during evaluation of the number of positive reactions
      which were described as major reactions). Women of the homosexually oriented
      group responded as expected, significantly more frequently and more markedly to
      homosexual stimuli. As compared with the control group of heterosexually oriented
      women, they had a generally poorer capacity to differentiate between different
      categories of erotic stimuli and a lower reactivity during projection of slides
      of homosexual partnership activities than during projection of slides of
      homosexual objects (nudes). In all examined women of the control group an
      unequivocal heterosexual orientation was recorded, in the group of homosexual
      women a more or less defined homosexual orientation was confirmed. In both groups
      was a high correlation between the subjectively reported sexual orientation and
      the results of the VPG examination. The authors confirmed that it is possible to
      use electrocapacitance vulvoplethysmography as evidence of the homosexual
      orientation in women and that this psychophysiological examination method is
      relatively reliable in the diagnosis of female homosexuality.

PMID- 2224992
TI  - [Comments on heart transplantation in Czechoslovakia].

PMID- 2224990
TI  - [HLA antigens on erythrocytes. III. Detection using the absorption and bromelin
      test].
AB  - HLA antigens on erythrocytes were assessed concurrently by three tests--the
      indirect antiglobulin, two-stage bromelin and absorption test--using polyspecific
      and monospecific sera against HLA antigens A1, A2, B7, B8 and B12. Evidence
      obtained by the bromelin test was successful only in rare instances. The
      positivity of the absorption test increased with the number of saturations: after
      triple saturation of the HLA serum with erythrocytes of the same subject readings
      were obtained twice to three times more frequently than after single absorption.
      As compared with the indirect antiglobulin test, the positive erythrocyte
      reactions in the absorption test were less frequent: with polyspecific HLA sera
      in 36.97% as compared with 78.15%, with monospecific HLA sera in 63.64% as
      compared with 100%. The absorption test is a suitable method for detection of HLA
      antigens on erythrocytes, supplementing the indirect antiglobulin test.

PMID- 2224991
TI  - [25 years since the death of Dr. Albert Schweitzer].

PMID- 2224993
TI  - [Adverse trends in the development of mortality in lung cancer in the Czech
      Republic].
AB  - The mortality from malignant tumours of the respiratory system in men in the
      Czech Republik increased steeply during 1950-1967 from the initial value of 22.3
      per 100,000 men to more than triple, while in women the values persisted during
      this period with minor accidental deviations at a level of cca 5.7 per 100,000
      women (with standardization for the world population). During the subsequent 20
      year period there was a rising trend in both sexes; in 1987 the value for men was
      77.4 per 100,000, for women 9.1 per 100,000. The age-specific mortality from
      malignant tumours of the respiratory system had in none of the evaluated age
      groups of men and women a declining trend, while in the USA and in Great Britain
      in younger men and in the group of youngest women a decline is recorded. The
      cigarette consumption in the Czech Republic after the Second World War increased
      steeply to the end of the sixties; in 1971-1987 it did not rise further and
      varied mostly within the range of 19 and 20 billion cigarettes per year, i. e.
      2500 cigarettes per inhabitant above 15 years of age, regardless whether he
      smoked or not. To change the hitherto adverse development of mortality from
      malignant tumours of the respiratory system it is essential to reduce in the
      first place the intoxication of the population with carcinogens of tobacco smoke,
      by influencing smoking habits and by reducing carcinogenic substances in
      cigarettes and by some modifications of the working and living environment, by
      provision of an optimal content of probably protective substances in foods and
      some other measures.

PMID- 2224994
TI  - [Risk factors in persons with early manifestations of ischemic heart disease and
      in their offspring. I. Hyperlipoproteinemia].
AB  - In a group of 70 probands affected with ischaemic heart disease before the age of
      55 years and in their 126 grade I and 8 grade II offspring the ratio of risk
      factors of the disease was assessed. In the first part of the investigation
      attention was focused on the frequency of hyperlipoproteinaemias. Elevated total
      cholesterol and/or triacylglycerols were found in 41% of the probands and 6.4% of
      the grade I offspring. The most frequently diagnosed type of
      hyperlipoproteinaemia in probands as well as their offspring was
      hypertriacylglycerolaemia. Twenty-five per cent of the hyperlipoproteinaemic
      probands had also a hyperlipoproteinaemic grade I offspring. The author
      emphasizes that early active screening of offspring of subjects suffering from
      ischaemic heart disease in young age is essential, in particular those where one
      of the risk factors is hyperlipoproteinaemia.

PMID- 2224995
TI  - [Risk factors in persons with early manifestations of ischemic heart disease and
      in their offspring. II. Additional risk factors].
AB  - In a group of 70 probands treated on account of ischaemic heart disease
      manifested before the age of 55 years and in the grade I and II offspring the
      presence of other risk factors of the disease was assessed--smoking, arterial
      hypertension, obesity and diabetes mellitus. This part II is a continuation of
      the previous paper where the ratio of hyperlipoproteinaemias in the group was
      assessed. The probands comprised 62.9% smokers, 25.7% hypertonic subjects, 68.6%
      obese subjects and 20% diabetics. Risk factors were found only in grade I
      offspring--29.4% smokers, 2.4% hypertonic subjects and 16.7% obese subjects. The
      author emphasizes the fact that almost 40% of the offspring under 35 years of age
      with a family-history of early ischaemic heart disease have at least one risk
      factor of the disease.

PMID- 2224996
TI  - [Comparison of plasmatic and renal clearance of lithium].
AB  - The authors elaborated a method for assessment of the renal lithium clearance,
      CLr, the results of which correlate well with the plasmatic clearance (CLp] (r =
      0.785, p less than 0.05). This correlation improved substantially after
      correction of CLr to the clearance of endogenous creatinine, CLcr (r = 0.945; p
      less than 0.05). The mean values of CLr of the investigated group--26.4 ml/min
      are in agreement with the results published by other authors. A significant
      correlation between CLr and CLcr (r = 0.826, p less than 0.05) along with
      comparison of the intraindividual variability of assessed results indicates that
      it is better to use as a parameter of sodium absorption from the proximal tubule
      the fractional lithium clearance rather than absolute values of CLr.

PMID- 2224998
TI  - [Physician-martyrs of the Czech resistance during World War II. I].

PMID- 2224997
TI  - [How can the Williams-Beuren syndrome be recognized?].
AB  - In a girl with Williams-Beuren's syndrome psychological examination revealed
      mental retardation with a special mental profile, angiography revealed peripheral
      pulmonary stenoses, echocardiography a slight stenosis in the supravalvular
      aortal area and anthropometry typical facial signs. Indirect signs of
      hypercalcaemia were clinical signs of poor progress during infancy. The authors
      emphasize that accurate analysis of basic clinical signs and the natural
      development of the disease are the key to its diagnosis.

PMID- 2224999
TI  - [The use of Bayes' theorem in controlling the coming epidemic peak of epidemic
      meningitis in the 1980s].
AB  - To control the coming epidemic peak of epidemic cerebrospinal meningitis (ECM) in
      the 1980s in the regions with 100 million population in China, the mathematical
      models based upon Bayes' theorem (BT) were established and used respectively in
      provincial, regional and county's level. Reports of ECM from each ten-day's
      period or each month during the meningitis season were analysed to create
      forecast models. Records of ECM vaccinating rate in previous years were fully
      taken into account to modify the theoretical values. Calibration, split-sample,
      random-sample selection, as well as actual forecast tests, were used to check the
      efficiency of the models. The distribution of meningitis vaccine was planned
      according to the final predictive results. The incidence rates of ECM of above
      regions decreased obviously faster than other areas in China. Attributing the
      application of BT forecast research, it was estimated only in Henan province
      79795 ECM cases; 4388 deaths and 21 million Yuan economic damage were avoided
      during the 4 years period, from 1985 to 1988.

PMID- 2225000
TI  - [An outbreak of epidemic bronchiolitis].
AB  - During January to March in 1986, there was an outbreak of epidemic bronchiolitis
      in Yunchen, Shanxi province. Thirteen counties and cities were involved in
      Yunchen. On the basis of a survey in 7 counties, there were 6070 cases, with the
      attack rate of 13.77%. Most patients were infants and young children. The highest
      attack rate was in 0-age-group (89.06%), next was in 1-age-group (55.71%). The
      attack rate decreased with the increase of age. The lowest attack rate was in the
      10-age-group (0.53%). The attack rate in males was higher than that in females
      (chi 2 = 101.09, P less than 0.01), and the sex ratio (males to females) was
      1.4:1. The clinical symptoms of most patients were serious. Most patients (75.7%)
      had symptoms of obstructive asthma. In this outbreak, the fatality rate was one
      percent. Family aggregation of this outbreak of epidemic bronchiolitis was found
      by binominal distribution method (chi 2 = 9.51 P less than 0.05). Both etiologic
      and serologic studies showed that the major pathogen causes this epidemic
      bronchiolitis was RSV. The risk factors in this outbreak were studied. It
      appeared that the outbreak of epidemic bronchiolitis was related to the variation
      of temperature: the bigger variation of daily temperature, the more the cases
      were found (rs = 0.4799, P less than 0.05). The occurrence of the disease was
      also related average space in the house each person had. The smaller the house,
      the higher attack rate it showed (trend chi 2 = 5.58, P less than 0.05).

PMID- 2225001
TI  - [The seroepidemiological observation on hepatitis delta virus infection].
AB  - To assess the relationship between hepatitis delta virus (HDV) infection and HBV
      and reveal the distribution of HDV infection and the feature of epidemic, we
      collected 271 cases of HBV infected people in Shijiazhuang area and tested anti
      HD with EIA from April 1987 to October 1988. This study found the prevalence of
      HDV infection was as high as 12.92% (35/271), and male prevalence of anti-HD was
      14.06% (27/192) and female 10.13% (8/79), but there was no significance
      difference (P greater than 0.05). This suggested that the area of Shijiazhuan was
      a spot where HDV infection was high. Among these people, the positive rate of
      anti-HD in chronic active hepatitis, chronic persistent hepatitis and cirrhosis
      was much higher than that in HBsAg carriers. These finding indicated that HDV
      infection (coinfection and superinfection) was important in pathogenesis of
      chronic hepatitis B and in exacerbating liver disease to cirrhosis. This study
      confirmed that there was no significant difference between HDV infection and age,
      sex and occupation among HBV infected people.

PMID- 2225002
TI  - [Quantitative epidemiological investigation on social, economic and geographic
      factors contributing to falciparum malaria in southern Henan province].
AB  - A case-control study was conducted at Xinyang prefecture, Henan province in 1988
      to investigate social, economic and geographic factors believed to be associated
      with the occurrence of residual falciparum malaria cases. Data were obtained from
      65 residual cases and 195 matched control samples from neighbours, residents in
      the same village and extravillage. The questionnaire contained a total of 27
      relevant items. The results of analysis of conditional logistic multi-regression
      model with IBM PC/XT microcomputer showed that six important risk factors related
      to residual falciparum malaria cases, i.e., the type of breeding places, yellow
      brown soil, the knowledge of malaria transmission, open-sleep habit, family's
      malaria history and number of livestock. The epidemiological significance of
      these findings was discussed briefly.

PMID- 2225003
TI  - [Conditional logistic regression analysis and path analysis of risk factors of
      cervical cancer].
AB  - A case-control study of 125 pairs was carried out in Jinan during 1987-1988. 39
      variables were analysed with the single factor analysis, 14 factors were
      confirmed as the suspicious risk factors. Conditional Logistic regression
      analysis of the above 14 factors was used. Results showed that the following five
      risk factors were associated with cervical cancer, i.e., cervical erosion, low
      family income, poor personal hygiene during menstrual period, sexual factors and
      early age at marriage. The causal model with 9 risk factors of cervical cancer
      was set up and studied with path analysis. The result indicated that 4 risk
      factors had direct and indirect influence on the occurrence of cervical cancer
      respectively.

PMID- 2225004
TI  - [Research into risk factors of bladder cancer in Heilongjiang].
AB  - This article reports a 1:2 matched case-control study on 80 cases of bladder
      cancer in Heilongjiang province. Multiple logistic regression analysis for risk
      state suggested that three factors, i.e., cigarette smoking, use of saccharin and
      reduced intake of vegetables are closely associated with development of bladder
      cancer. Giving up smoking, using no saccharin and eating more fresh vegetables
      are main ways to reduce the incidence of bladder cancer.

PMID- 2225005
TI  - [Isolation and identification of the W-88 strain of spotted fever group
      rickettsiae from a human case in Tongliao City, Inner Mongolia].
AB  - One strain of spotted fever group (SFG) rickettsiae was isolated from a patient
      with febrile and headache who was missdiagnosed as common cold. The rickettsia
      was isolated by inoculation of yolk sacs of embryonated hen eggs with the
      patient's blood. The isolate was named as W-88 following the initial letter of
      the patient's name. It is the first time to report the isolation of SFG
      rickettsiae from human being who lived in city in China. In this study we
      compared the antigens of W-88 strain with seven prototype strains of SFG
      rickettsiae and six Chinese strains of SFG rickettsiae with one species-specific
      monoclonal antibody and one group reactive monoclonal antibody by indirect
      immunofluorescence assay. The results demonstrated that W-88 strain and other
      Chinese strains JH-74, An-84, FT-84, MT-84, Se-85, To-85 of SFG rickettsiae were
      found identical to Rickettsia sibirica (strains 232 and 246) and differ from
      other prototypes of SFG rickettsiae.

PMID- 2225006
TI  - [Study of factors associated with preterm delivery].
AB  - A case-control study of preterm delivery was undertaken at the district of
      Qiaokou in Wuhan during October, 1987 to May, 1988. The study population
      consisted of 130 mothers of singleton preterm infants and 260 mothers of
      singleton term infants. The result of logistic regression analysis showed that
      significant factors of preterm delivery included low maternal stature, the young
      age of menarche, a previous induced abortion, a history of infertility problems,
      vaginal bleeding during the pregnancy, low weight gain during the pregnancy,
      premature rupture of membranes, hyperemesis gravidarum, and lack of antenatal
      care. The result also showed that psychosocial stress in pregnancy might be
      related to preterm delivery.

PMID- 2225007
TI  - [1:2 matched case-control study of congenital deficiency of newborn].
AB  - Among 5959 perinatal newborn, 135 cases of congenital deficiency were detected.
      The frequency was 22.66 per 1,000 newborns. In order to explore possible factors
      related to congenital deficiency, for 103 cases a 1:2 matched case-control study
      was performed. Mantel-Haentel chi 2 test and conditional logistic regression
      model was used to identify factors which associated with the disease
      significantly in statistics. It was found that six factors, i.e. common cold and
      fever in the early stage of pregnancy, illiteracy of mother, family history of
      congenital disease, haemorrhage of genital tract, alcohol drinking and marriage
      within blood relatives, are risk factors related to congenital deficiency of
      newborn.

PMID- 2225008
TI  - [Plasmid DNA transformation of Yersinia pseudotuberculosis by electroporation].
AB  - Rendering cells permeable to DNA molecules, electroporation involves the
      application of high intensity electric fields of short duration to reversibly
      change the biomembranes, which has been used successfully in some species of both
      gram negative and positive bacteria. We first reported the electro-transformation
      technics of Yersinia pseudotuberculosis. The plasmid pJGX20 was constructed by
      cloning the 9.5 kb plasmid encoding pesticin into Pst I site of pBR328.
      Transformation efficiency of 103 transformants/micrograms DNA was obtained at
      voltage of 1300V or 1400V, capacity of 25 microF, time constant of 48-52 msec,
      with 10% glycerol as electroporation buffer. The pesticin gene of pJGX20 was
      expressed well in Y. pseudotuberculosis.

PMID- 2225009
TI  - [Establishment and application of serologic diagnosis method in human
      immunodeficiency virus].
AB  - Using immunoenzymatic method (IE) for human immunodeficiency virus type 1 (HIV-1)
      serologic detection, and comparing with indirect immunofluorescence method (IIF).
      This method had same specificity and reproducibility but more sensitivity than
      IIF. Because it is simple, practical and suitable, IE method can replace IIF as
      the HIV serologic screening method suited to base application. Using HIV-1
      immunoenzymatic reagent kit in Ivory Coast obtained good results.

PMID- 2225010
TI  - [Passive hemagglutination assay (PHA) in detection of antibodies against
      measles].
AB  - By using passive hemagglutination test and hemagglutination inhibition test, 1771
      specimens of sera from healthy people were simultaneously tested. The titers of
      antibodies against measles GMT were respectively 52.54 and 25.22. The related
      coefficient was 0.71. P less than 0.001. When the two methods were used to 77
      children, the rate of active conversion was 97.40%. When the two methods were
      used to 28 patients suffering from measles, they gave out same results.

PMID- 2225011
TI  - [Advances in the research of pathogenicity of Campylobacter pylori and
      epidemiology of its infection].

PMID- 2225012
TI  - The role of fiberoptic transbronchial lung biopsy in diagnosis of chronic
      infiltrative pulmonary disease in Nigeria.
AB  - Over a three-year period, fibreoptic transbronchial lung biopsy (FTLB) was
      performed in 28 adult Nigerian patients with chronic infiltrative lung disease
      after sputum examination, haematological, biochemical and serological tests
      failed to provide a definite diagnosis. Definitive histological diagnosis was
      obtained in 11 patients (39.3 per cent) while another seven (25 per cent) had
      distinct histological abnormalities but no specific diagnosis. Tuberculosis and
      sarcoidosis were the commonest findings. No patient had haemorrhage of more than
      50mls while only one had asymptomatic mild pneumothorax. FTLB is very safe and
      spares a substantial proportion of patients with chronic diffuse lung infiltrates
      more invasive and expensive diagnostic procedures. This is especially very
      relevant in developing countries where there is a shortage of surgeons, theatre
      space and other relevant facilities.

PMID- 2225013
TI  - An approach to the management of volvulus of the sigmoid colon.
AB  - The colon involved with the sigmoid volvulus is much thicker than the normal
      colon. It is easy to handle and holds sutures well. Patients who have sigmoid
      colon volvulus do not have much faecal loading. Most of the distension is
      gaseous. In the hands of experienced surgeons primary anastomosis can be done
      after sigmoid colectomy with safety and excellent results.

PMID- 2225015
TI  - The system of health services planning in Zimbabwe.

PMID- 2225014
TI  - Carcinoma of the thyroid at Harare histopathology laboratory (Zimbabwe).
AB  - The carcinoma of the thyroid gland seen at Harare Histopathology Laboratory
      (Zimbabwe) has been reviewed and analysed. There was a male to female ratio of
      1:4. The commonest histological type of tumour was follicular carcinoma (70%).
      There were equal numbers of papillary and anaplastic types (14% each). Only two
      cases of medullary carcinoma were found, one of these being in a twelve-year-old
      female patient. The finding of a high occurance of follicular carcinoma is
      consistent with Zimbabwe being a country where endemic goitre is common.

PMID- 2225016
TI  - Neuro anaesthesia--a review of the basic principles and current practices.
AB  - The changes in intracranial pressure which occur following a change in one of the
      constituent volumes within the skull are governed by the Monro-Kellie doctrine,
      stated in the late 18th century and describes how an increase in one of the
      constituent volumes must be reflected by a reciprocal decrease in another volume
      to avoid any change in pressure and that if this does not occur, there is a rapid
      rise in intracranial pressure. Cerebral blood flow is affected by many
      physiological and pharmacological factors, and is relevant as a change in
      cerebral blood flow results in a similar alteration in cerebral arterial volume
      which will affect intracranial dynamics. Another important concept to be
      understood is cerebral perfusion pressure, how it is related to intracranial and
      arterial pressures and its relevance during the conduct of any neuroanaesthetic.
      Both carbon dioxide and the volatile agents are potent vasodilating agents and
      will cause a catastrophic rise in intracranial pressure and fall in cerebral
      perfusion pressure if hypercapnia develops in the presence of more than one MAC
      of a volatile agent. The volatile agents are reviewed and it is stressed that
      while isoflurane may have advantages over the older volatile agents it is not
      without complication and nitrous oxide which has always been regarded as an
      innocuous agent may also have some significant intracranial affects. The use of
      propofol, as an infusion and the neuromuscular blocking agents and narcotics are
      described. Recently the use of induced hypotension during clipping of cerebral
      aneurysms has been questioned and this view and the treatment of vasospasm is
      discussed in some detail.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225017
TI  - The "string-sign" in sonographic diagnosis of diamniotic twin pregnancy.
AB  - A consistent echogenic line, the "String-sign" resulting from opposed amniotic
      membranes in diamniotic twin pregnancy as seen at sonography is reported. The
      string sign is especially useful in the detection of unsuspected twinning in late
      pregnancy and it should be taken as a definite pointer to multiple pregnancy
      whenever its presence is established at any stage in pregnancy.

PMID- 2225018
TI  - Acute suppurative thyroiditis in a malignant thyroid gland.
AB  - A case of acute suppurative thyroiditis in a malignant thyroid gland is
      presented. The patient was an elderly woman with several years' history of pre
      existing goitre. A diagnosis of acute suppurative thyroiditis was not difficult
      to make because clinical features of an infected thyroid swelling appeared
      obvious. With the help of intravenous antibiotics and early incision and drainage
      the patient did well and is now receiving radiotherapy.

PMID- 2225019
TI  - Gall bladder disease as seen in a Harare referral hospital centre.
AB  - A five-year study of patients treated for gall bladder disease in Harare was done
      from 1984-1988. The aim of the study was to highlight the importance of the
      disease and its unusual presentation as compared to the typical European pattern.
      The disease is relatively uncommon since only 54 patients were treated while the
      total hospital admission for the period was 41,891. The disease affected mainly
      middle-aged housewives. The patients tend to present as semi surgical
      emergencies. Diagnosis was made most often by Ultrasound scan (U/S) and oral
      cholangiogram. A few patients had radio opaque gall stones. The majority of the
      patients, 33, had straightforward cholecystectomy. Ten needed exploration of
      common bile duct (ECBD) and four were difficult enough to need ECBD, Duodenotomy
      and sphincterotomy. Operative complications were few considering the mode of
      presentation. Two patients died, a mortality rate of 3.7 percent.

PMID- 2225020
TI  - Incidence and parametric determinants of post-operative wound infections in a
      university teaching hospital.
AB  - The incidence and determinants of post-operative wound infections in the
      University of Nigeria Teaching Hospital, Enugu was studied. During the period of
      study (July 1983-June 1984) 218 surgical operations from adult males and females
      were investigated. The overall infection rate was found to be 27.98 percent. The
      incidence rate in clean wounds was 14 percent; in clean-contaminated 50 percent;
      in contaminated 66.66 percent and in dirty wounds 80 percent. Factors such as
      age, sex, nature of surgery, and antibiotic prophylactic cover which were found
      to have influenced the infection are discussed. The study underlines the need for
      a policy that will promote a more rational use of antibiotics, strict observance
      of ward aseptic routines and the establishment of effective Infection Control
      Programme where non exists.

PMID- 2225021
TI  - Ceftriaxone in the treatment of septicaemia due to multiple drug resistant
      bacteria.
AB  - Ceftriaxone, a highly effective, B-Lactamase resistant broad spectrum parenteral
      cephalosporin was used in the treatment of 26 consecutive patients with
      clinically and/or bacteriologically resistant infections at the Addis Ababa
      University Tikur Anbessa and Ethio-Swedish Paediatric Teaching Hospitals. The
      patients who had failed to respond to a combination of two or more previously
      appropriate antibiotics were treated with ceftriaxone administered in two divided
      doses (daily 50-100 mg/kg) in children and a single dose of 2-3 gm in adults for
      an average duration of 9.9 days. Of the 21 evaluable cases 16 (76%) were cured,
      three died and two developed superinfection with Pseudomonas and Staphylococcus
      species. Primary pathogenic bacteria were eradicated from all the 21 bacteraemic
      patients on the third day of therapy. Twelve of the 21 patients had serious
      underlying conditions. Except for the two superinfections, the results of the
      trial confirm that ceftriaxone is a very potent and effective agent in the
      treatment of resistant bacteraemic infections. No significant adverse effect of
      the drug was encountered during the therapy.

PMID- 2225022
TI  - Therapeutic review: antibiotic prophylaxis for bacterial endocarditis.
AB  - A recent survey of antibiotic prophylaxis found that local practice often
      differed from that recommended by authoritative bodies such as the British
      Society for Antimicrobial Chemotherapy (BSAC) and the American Heart Association
      (AHA). Practitioners found the subject confusing and requested guidance. For
      these reasons we present current recommendations. Unfortunately all
      recommendations are based on animal studies and an understanding of the
      pathogenesis of bacterial endocarditis in humans. There are no controlled trials
      in humans on which to base guidelines, so rigidity is inappropriate. It is also
      important to realise that optimal prophylaxis will not eliminate bacterial
      endocarditis. In developed countries it has been estimated that only 10% of cases
      of endocarditis are theoretically preventable.

PMID- 2225023
TI  - Essentials of open heart surgery.
AB  - As Parirenyatwa continues its successful OPEN-HEART SURGERY PROGRAMME, it becomes
      important to emphasize that the essential determinants for cardiac surgical
      success include a comprehensive preoperative assessment of the patient; accurate
      definition of the fundamental lesion; ameliorative treatment of secondary effects
      such as cardiac failure, electrolyte imbalance and arrhythmia. In addition to the
      application of technical expertise in the performance of the operation, an
      optimal outcome depends on good intraoperative anesthetic management, the
      collaboration of pump technicians, and dedicated intensive care management in the
      postoperative period.

PMID- 2225024
TI  - Fracture of bone with an aneurysmal bone cyst during lactation.
AB  - A case is presented of a 28-year-old lactating Nigerian mother who developed a
      pathological fracture of the left humerus following inapparent physical stress.
      There was radiographical and histological evidence of aneurysmal bone cyst
      disease involving both humerus. A possible pathogenetic role of bone-calcium
      dyshomeostasis during pregnancy and, indeed, lactation is entertained. A strong
      case is made for calcium supplementation in the pregnant and/or lactating mother,
      especially in the developing countries with an increased probability of marginal
      nutrition status.

PMID- 2225026
TI  - Beware the scorpion parabuthus.

PMID- 2225025
TI  - Effects of two pulmonary tuberculosis drug treatments and acetylator status on
      liver function in a Zimbabwean population.
AB  - In Zimbabwe patients with pulmonary tuberculosis who are acid-fast bacilli (AFB)
      negative in the sputum are treated in the two month intensive phase with
      isoniazid, thiacetazone pyrazinamide and streptomycin (regimen A). Sputum
      positive patients receive regimen A plus rifampicin (regimen B). Both groups
      continue treatment with isoniazid and thiacetazone. 21 patients on regimen A and
      19 on regimen B had clinical assessment and liver function tests performed at
      weeks 0, 2, 4, 8, and 12 weeks of treatment (during and four weeks after, the
      intensive phase of 8 weeks). Acetylator status was also assessed, no significant
      difference was found between patients on regimen A or B (41 per cent and 45 per
      cent fast acetylators respectively). Liver function tests results (alanine
      aminotransferase and alkaline phosphatase) showed a persisting rise during the
      intensive phase on both regimens, and further rise after four weeks in the
      continuation phase, this further rise reaching statistical significance in
      regimen B. These results are unexpected when compared to other studies but the
      regimens under investigation are not used elsewhere. The significant rise after
      stopping intensive therapy in regimen B suggests some protective effect of
      rifampicin against the hepatotoxicity of the regimen, possibly the
      isoniazid/thiacetazone component. Acetylator status did not influence the degree
      of hepatotoxicity.

PMID- 2225027
TI  - Seasonality of births in the North West Province, Cameroon: implications for
      family planning programme.
AB  - This article presents an analysis of the seasonal variation of births between
      1978 and 1987 (10 years) in the North West Province. A total of 157,316 births
      were recorded during the 10 years in question. Highest delivery peaks noticed in
      the second half of the year for 8/10 years. This gives conception peaks between
      October and March. Minimum for all the 10 years taken together occurs in July
      while maximum occurs in September. Considering 40 weeks as normal gestation
      period, conception peak for the 10 years taken together occurs in December. This
      peak is related to the festivities that take place within this month. The
      findings have important implications for family planning. Family planning
      education needs to be intensified during the period of highest conception or that
      which leads up to it.

PMID- 2225028
TI  - Onchocerciasis prevalence in Tanzania.
AB  - Prevalence of human onchocerciasis in Tanzania is described. The prevalence is
      high in Bwakira (63.6 per cent), Mahenge (58.6 per cent) and Ruvuma (31.9 per
      cent); and low in Amani (22.4 per cent) foci when compared to that reported in
      1970. The increase and decrease on the prevalence indicate that the disease
      transmission has been increasing and decreasing in the respective foci. It is
      speculated that bush clearing and deforestation in general, has positive effects
      on the transmission of onchocerciasis where Simulium damnosum complex is a vector
      and negative effects where Simulium neavei complex exists.

PMID- 2225029
TI  - Mandibular fractures, analysis of 541 cases.
AB  - A retrospective analysis of 541 patients with mandibular fractures seen at Harare
      Central Hospital, Harare, Zimbabwe, was undertaken. The aetiology, sex incidence
      and anatomical sites of fractures are different from those in other series; with
      89.8 per cent of the fractures due to assaults, 5.6 per cent due to road traffic
      accidents; 90.9 per cent of the patients were males, the body of the mandible
      being most commonly fractured, 42.3 per cent.

PMID- 2225030
TI  - Catheterization of coronary artery bypass graft from the descending aorta.
AB  - The increasing frequency of reoperation for coronary artery disease has led to
      the use of a variety of grafts. This report describes the catheter technique for
      selective opacification of a saphenous vein graft from the descending thoracic
      aorta to the posterior coronary circulation.

PMID- 2225031
TI  - Coronary angioplasty of anomalous coronary arteries: notes on technical aspects.
AB  - Five patients with significant atherosclerotic lesions of anomalous coronary
      arteries underwent coronary angioplasty of the anomalous vessel. Four patients
      had anomalous circumflex artery and 1 had an anomalous right coronary artery.
      Angiographic and clinical success was achieved in all 5 patients. To ensure
      adequate equipment selection special consideration should be given to
      angiographic characteristics of these vessels, such as the orifice configuration,
      exit angulation, the route the artery traverses and the location of the stenotic
      lesions. Major determinants for successful angioplasty in these patients are
      guiding catheter selection and advancement of the balloon catheter to the very
      proximal portion of the anomalous vessel to subsequently facilitate guide wire
      advancement. This data indicates that balloon angioplasty can be successfully
      utilized in patients with significant atherosclerotic disease of anomalous
      coronary arteries.

PMID- 2225033
TI  - Angioplasty of occluded coronary arteries: use of thin shaft balloon over-the
      wire system without pre-dilatation.
AB  - A retrospective review was done on 13 consecutive patients who underwent PTCA of
      totally occluded coronary arteries using a recently released thin shaft balloon
      over-the-wire angioplasty system. Balloon size was determined by the closest fit
      to the arterial size and used without predilatation techniques. This technique
      was initially successful in 12 patients with only 2 clinically insignificant
      episodes of distal embolization and one probable early reclosure. Using thin
      shaft angioplasty systems, balloon dilatation of totally occluded coronary
      arteries can be done safely with a single balloon in many cases resulting in
      simplified procedures and economic benefits.

PMID- 2225032
TI  - Interpretation of cardiac pathophysiology from pressure waveform analysis: I. The
      stenotic aortic valve.

PMID- 2225034
TI  - Probe angioplasty of total coronary occlusion using the Probing Catheter
      technique.
AB  - Coronary angioplasty (PTCA) of total coronary occlusion is limited by the
      inability of guidewires and conventional dilating catheters to cross all such
      lesions. A new technique was therefore prospectively evaluated for PTCA of these
      lesions using the ultra-low-profile Probe "balloon on a wire" device. An
      intracoronary Probing Catheter was used to facilitate crossing the stenosis with
      a guidewire and then to deliver a Probe into the obstruction for balloon
      dilatation. This technique was utilized in 64 consecutive patients with
      "absolute" coronary occlusions demonstrating no angiographically detectable
      antegrade coronary flow. Successful dilatation was achieved in 47 (73%). Among 33
      occlusions of less than 3 mo duration 31 (94%) were successfully dilated whereas
      only 16 of 31 more chronic occlusions were dilated (P less than .01). Chronic
      occlusions with a tapered morphology and those located more than 1 cm from a
      branch point were more frequently dilatable. There were no serious complications
      including no vessel perforations with this technique. The Probing Catheter
      technique offers a safe and effective method for the dilatation of recent
      coronary occlusions by using balloon on a wire technology.

PMID- 2225035
TI  - Anomalous aortic origin of the left anterior descending coronary artery with
      dilated cardiomyopathy.

PMID- 2225037
TI  - Angiographic quantitation of the results of coronary angioplasty: where do we
      stand?

PMID- 2225036
TI  - Hydrogen test for the detection of left-to-right shunting.

PMID- 2225038
TI  - Influence of catheter technology and adjuvant medication on acute complications
      in percutaneous coronary angioplasty.
AB  - We report on the complication rates in 660 consecutive coronary angioplasties
      (725 lesions) performed using four procedures that differed with respect to
      catheter technology and adjuvant medication. After the PTCA regimen in our
      laboratory had been changed from conventional steerable systems to the monorail
      technique, we observed a significant increase in the incidence of transient
      vessel occlusions from 2.6% to 7.7%, of permanent occlusions from 3.6% to 8.8%,
      and of intracoronary thrombus-formation from 2.6% to 5.5%. This was associated
      with the frequent observation of thrombotic material on the partially Teflon
      coated guidewires. Coronary perfusion with urokinase (1,670-6,670 U/min) lead to
      a further increase in the complication rates (10.4%/10.3%/6.5%). Our present
      percutaneous transluminal coronary angioplasty (PTCA)-regimen (monorail technique
      with P.E.T. balloons, fully silicon-coated guidewires, no urokinase) shows an
      incidence of 3.8% for intermittent and recurrent coronary occlusions and 1.9% for
      permanent occlusions. Urokinase did not prevent intracoronary thrombus formation
      with the monorail technique. Furthermore, we suspect that in the case of PTCA
      induced regional intimal dissection, fibrinolysis can prevent reestablishment of
      intima adherence to the vessel wall. Because five procedural deaths were observed
      in the 212 patients treated with i.c. urokinase as opposed to three deaths in the
      448 procedures without urokinase, we feel that i.c. urokinase in PTCA is a
      potentially harmful regimen. We suggest that the monorail technique should be
      performed with fully silicon-coated guidewires and without urokinase.

PMID- 2225039
TI  - Regression of infundibular pulmonary stenosis after successful balloon pulmonary
      valvuloplasty in adults.
AB  - Between July 1985 and March 1988, 22 adult patients with congenital pulmonary
      stenosis underwent balloon pulmonary valvuloplasty. There were 10 males and 12
      females aged 16-45 (average 25 +/- 9.9) years. All patients had additional mild
      to severe infundibular stenosis; 16 were restudied 6-36 (mean 12.6) months later
      by repeat catheterization. Student's t-test was used for comparison of data.
      Right ventricular (RV) systolic pressure before dilatation was 84-196 (mean 129
      +/- 32.3) mm Hg, and the peak pulmonary gradient (PPG) was 60-176 (mean 111 +/-
      33.2) mm Hg immediately after dilatation. The RV systolic pressure dropped to 32
      140 (mean 59.2 +/- 27) (P less than 0.001); and PPG dropped to 10-113 (mean 37.8
      +/- 26.4) (P less than 0.001), and the infundibular gradient ranged from 8 to 113
      (mean 35.1 +/- 25.8) mm Hg. The infundibular diameter, before dilatation, ranged
      from 2 to 15 (mean 9.5 +/- 4) mm Hg. At repeat catheterization, the RV systolic
      pressure dropped further to 33-66 (mean 42.8 +/- 9.7) mm Hg and the PPG was
      reduced to 0-48 (mean 18.4 +/- 10.9) mm Hg (P less than 0.001). The infundibular
      gradient regressed to 0-34 (mean 15 +/- 8.8) mm Hg (P less than 0.001). The
      infundibular diameter increased to 8-25 (mean 15.8 +/- 5.4) (P less than 0.001).
      It is concluded that moderate to severe infundibular stenosis, in adults, can
      regress after successful pulmonary valvuloplasty.

PMID- 2225041
TI  - Balloon rupture due to lesion morphology during coronary angioplasty.
AB  - We report a case of coronary angioplasty of a left anterior descending artery
      lesion that was complicated by the rupture of three successive balloon catheters.
      Each rupture occurred as a pinhole jet of contrast into a diagonal side branch,
      causing subintimal staining. This case demonstrates that balloon rupture may
      result from lesion morphology.

PMID- 2225040
TI  - Method of measurement of the cardio-thoracic ratio.
AB  - The authors describe the use of a table for rapid measurement of the cardio
      thoracic ratio on a standard PA chest film. The method is free of calculations.

PMID- 2225042
TI  - Death at cardiac catheterization: coronary artery embolization of calcium debris
      from Ionescu-Shiley bioprosthesis.
AB  - The case described is a death due to embolization of calcium debris from a
      bioprosthesis, dislodged at cardiac catheterization. As more bioprosthetic valves
      are implanted, and more of them fail long-term with calcification, such
      complications of the invasive study of these valves may be expected.

PMID- 2225043
TI  - Unusual case of pacemaker lead migration.
AB  - Pulmonary artery migration of pacemaker lead is rare and may result in pulmonary
      emboli originating from the thrombus around the infected catheter and causing
      multiple pulmonary infarcts. We report an unusual case of pacemaker lead
      migration to the right pulmonary artery with septic pulmonary embolism. While
      being treated with intravenous Cefuroxamine, the patient had spontaneous
      migration of the lead to the left pulmonary artery with subsequent left pulmonary
      embolism.

PMID- 2225044
TI  - Percutaneous aspiration of thrombus occluding a saphenous vein graft.

PMID- 2225045
TI  - Severe mitral insufficiency post-balloon valvuloplasty: the late changes found in
      a disrupted mitral valve.
AB  - The case of a 45-yr-old woman who had balloon valvuloplasty for rheumatic mitral
      stenosis is presented. An anterior mitral leaflet tear occurred as a complication
      of the procedure. Both partial healing of the anterior mitral leaflet and gradual
      dilatation of the left atrium occurred which allowed the damaged valve to remain
      in situ for several months. Some of the late changes which occur after such a
      complicated valvuloplasty are illustrated here, as this patient eventually
      required surgery and valve excision for definitive repair.

PMID- 2225046
TI  - Guidelines for balloon valvuloplasty: credentials and training.

PMID- 2225047
TI  - Physical examination and echo Doppler study in the assessment of femoral arterial
      complications following cardiac catheterization.
AB  - Femoral arterial complications following cardiac catheterization have been well
      recognized. The development of an inguinal mass in these patients can represent a
      simple hematoma, a pseudoaneurysm, or an arteriovenous fistula. The utility of
      the physical examination in diagnosing these complications was assessed by using
      the echo Doppler study for comparison. This study shows that any single clinical
      sign should not be used in isolation, but a constellation of physical findings
      can suggest the correct diagnosis.

PMID- 2225048
TI  - Inflation pressure requirements during coronary angioplasty.
AB  - To examine the balloon inflation pressures required for successful percutaneous
      transluminal coronary angioplasty (PTCA), the maximal inflation pressure required
      for 477 coronary lesions in 200 consecutive patients was determined
      retrospectively. When graded balloon inflations just sufficient to achieve full
      expansion were used, the maximal inflation pressure used was less than or equal
      to 8 atm in 412 stenoses (86%) and was less than or equal to 10 atm in 463
      stenoses (97%). Successful PTCA was achieved in 98% of lesions with a 3.5% major
      procedural complication rate. In a second group of 100 patients studied
      prospectively, the inflation pressure required to achieve full balloon expansion
      was less than or equal to 8 atm in 214 of 232 stenoses (92%) and less than or
      equal to 10 atm in 228 stenoses (98%). Thus, PTCA of coronary stenoses can be
      achieved with high success rates and low complication rates when graded
      inflations to pressures just sufficient to achieve full balloon expansion are
      performed. Most coronary stenoses will respond to pressures less than or equal to
      8-10 atm.

PMID- 2225049
TI  - Evaluation of catheters and metallic catheter markers as calibration standard for
      measurement of coronary dimension.
AB  - Measurement of coronary dimension requires an accurate and reproducible
      dimensional reference. Angiographic catheters are frequently used for this
      purpose. We measured the angiographic diameters of a broad range of diagnostic
      and angioplasty guiding catheters by using two commonly used edge-detection
      algorithms. Angiographic diameters are significantly less than true catheter
      outer diameter. Therefore the use of contrast-filled catheters as a dimensional
      reference may lead to considerable error in vessel measurement with
      overestimation of absolute dimension. Tables of reference values for multiple
      catheter as calibration standard, tested under a variety of angiographic
      conditions. The metallic-tipped marker was found to have a better degree of
      reproducibility than catheters. These findings have implications for studies
      employing serial measurements of coronary artery dimension and for the clinical
      practice of estimating vessel diameter for choice of balloon size during
      angioplasty.

PMID- 2225050
TI  - Standby percutaneous transluminal coronary angioplasty for coronary artery bypass
      surgery.

PMID- 2225051
TI  - Percutaneous puncture of a nondeflatable coronary artery angioplasty balloon.
AB  - We report a case in which a balloon catheter became permanently inflated in a
      coronary artery saphenous vein bypass graft. While still inflated, the balloon
      was forcibly withdrawn from the graft into the external iliac artery and
      successfully deflated via percutaneous puncture using a CHIBA needle.

PMID- 2225052
TI  - Treatment of ventricular tachycardia induced cardiogenic shock by percoronary
      chemical ablation.
AB  - Incessant ventricular arrhythmias pose an especially challenging therapeutic
      dilemma. We describe the successful treatment and follow-up of a patient with
      refractory ventricular tachycardia-induced cardiogenic shock with percoronary
      chemical ablation. After endocardial mapping was used to identify the
      "tachycardia-related" coronary artery, temporary termination of the arrhythmia
      with balloon occlusion and subselective intracoronary installation of iced saline
      as previously advocated was unsuccessful. This was probably due to a dual
      arterial blood supply to the arrhythmogenic focus. However, infusion of 2 cc
      ethanol (99%) permanently terminated the arrhythmia. Contrary to previous
      experience, ethanol-induced arrhythmia termination did not result in arterial
      occlusion, further supporting a direct toxic effect on the myocardium as its mode
      of action. Use of standard angioplasty balloon inflation prevents "backwash" of
      distally infused ethanol and more generalized cell death. The only complication
      of this procedure was temporary third-degree AV block, requiring permanent
      pacemaker implantation.

PMID- 2225053
TI  - Percutaneous transluminal coronary angioplasty of gastroepiploic artery graft.
AB  - The right gastroepiploic artery is being used as a third arterial conduit for
      coronary artery bypass surgery. Presented here is a case demonstrating successful
      percutaneous transluminal coronary angioplasty of the gastroepiploic artery
      graft. This successful accomplishment may avoid repeat surgical revascularization
      in case of failure of the gastroepiploic artery graft, hence may encourage people
      to use it more often.

PMID- 2225054
TI  - Angioplasty of a recently occluded coronary artery bypass graft.

PMID- 2225055
TI  - Usefulness of digital angiography in the assessment of left ventricular ejection
      fraction.
AB  - With modern digital cardiac systems the image data are digitized on-line and in
      real-time, allowing the replay and subsequent interpretation and analysis during
      or directly after the cardiac catheterization procedure. In this study we have
      evaluated the advantages and limitations of a manual tracing technique for left
      ventricular digital angiograms on the Phillips DCI system. Thirty-three patients
      who were catheterized for suspected coronary artery disease were studied. The
      manual tracings were performed by a senior cardiologist and an experienced
      function-analyst. It was found that the short- and long-term intraobserver
      variabilities in the assessment of the global ejection fraction were very small;
      short-term mean difference +/- standard deviation (correlation coefficient): 0.5
      +/- 2.7 (r = 0.97) global EF%-units; long term; 0.7 +/- 2.7 (r = 0.96) EF%-units.
      The interobserver variabilities (5.1 +/- 4.8 (r = 0.93) EF%-units) were slightly
      higher than the intraobserver variabilities. A decrease by 25% in the amount of
      contrast medium administered did not significantly influence the variabilities in
      the contour tracings, which would suggest the use of smaller doses. At the
      average, the cardiologist and the function-analyst required 6 and 11 min of
      analysis time for a left ventricular study, respectively, emphasizing the need
      for further developments towards automated contour detection. Finally, an
      excellent correlation was found with a standard off-line cinefilm analysis
      procedure. Thus, it may be concluded that quantitative digital left ventricular
      angiography based on manual tracing of the outlines performed immediately
      following the cardiac catheterization (post-processing) is feasible as a routine
      procedure for the assessment of left ventricular function.

PMID- 2225056
TI  - Temporary cardiac pacing using a new, steerable, balloon-tipped pacing catheter.
AB  - A new balloon-tipped, flow-directed, steerable pacing catheter for unipolar
      temporary ventricular pacing is presented. It was successfully and uneventfully
      tested in 25 patients with acute myocardial infarction in the coronary care unit.
      The main advantage of the new catheter is the ease with which a stable contact
      may be achieved between the pacing electrode and the endocardium.

PMID- 2225057
TI  - Guidelines for professional staff privileges in the cardiac catheterization
      laboratory. Laboratory Performance Standards Committee.

PMID- 2225058
TI  - Exit block or reentry?

PMID- 2225059
TI  - How do polypeptides cross the mitochondrial membranes?

PMID- 2225060
TI  - The fork head domain: a novel DNA binding motif of eukaryotic transcription
      factors?

PMID- 2225061
TI  - Recent insights in phosphatidylinositol signaling.
AB  - Studies of phosphatidylinositol signaling pathways are entering a new phase in
      which molecular genetic techniques are providing powerful tools to dissect the
      functions of various metabolites and pathways. Studies with phospholipase C are
      most advanced and clearly indicate that phosphatidylinositol turnover is critical
      for vision in Drosophila and cell proliferation in various cultured cells.
      Expression of cDNA constructs and microinjection of PLC or antibodies against it
      clearly establish a role for PtdIns signaling distinct from its role in calcium
      mobilization and protein kinase C activation. The importance of inositol cyclic
      phosphates is also beginning to be realized from the study of cyclic hydrolase
      using similar techniques. Elucidation of the function of the 3-phosphate inositol
      phospholipid pathway awaits similar studies. The recent cDNA cloning of inositol
      monophosphatase (Diehl et al., 1990), Ins(1,4,5)P3 3-kinase (Choi et al., 1990),
      and inositol polyphosphate 1-phosphatase (York and Majerus, 1991) should provide
      tools to define further the cell biology of the phosphatidylinositol signaling
      pathway.

PMID- 2225062
TI  - Activins are expressed early in Xenopus embryogenesis and can induce axial
      mesoderm and anterior structures.
AB  - We show that mammalian and Xenopus activins induce dorsal axial mesoderm and
      anterior structures in explants of Xenopus blastula cells that would otherwise
      form epidermis. The induced explants of animal cap cells can form notochord,
      muscle, neural tissue, and eyes all arranged in a rudimentary axial pattern.
      Activin A shares inductive properties and antigenic determinants with PIF, an
      inducing factor recently isolated from mouse macrophage culture supernatants.
      Genes encoding Xenopus activin beta A and beta B chains were cloned. Activin beta
      B transcripts are first detected in Xenopus blastula, whereas activin beta A
      transcripts do not appear until the late gastrula stage. Recombinant Xenopus
      activin beta B protein induces mesodermal and neural tissues similar to those
      induced by mammalian activin A and PIF. Furthermore, ectopic expression of
      Xenopus activin beta B produces a second body axis in embryos injected with
      synthetic mRNA. Our results suggest that early induction and axial patterning are
      accomplished by endogenous activin B, not activin A, in Xenopus.

PMID- 2225064
TI  - Colocalized transmembrane determinants for ER degradation and subunit assembly
      explain the intracellular fate of TCR chains.
AB  - The intracellular fate of T cell antigen receptor (TCR) subunits (alpha beta
      gamma delta epsilon zeta 2) is determined by their assembly in the endoplasmic
      reticulum (ER). To study the structural bases for this tight correlation between
      assembly and intracellular fate, we sought to define the nature of determinants
      for both ER degradation and subunit assembly within the TCR-alpha chain. We found
      that a 9 amino acid transmembrane sequence of the TCR-alpha chain, containing 2
      critical charged residues, was sufficient to cause ER degradation when placed in
      the context of the Tac antigen, used here as a reporter protein. CD3-delta
      assembled with chimeric proteins containing this short transmembrane sequence,
      and this assembly resulted in abrogation of targeting for ER degradation. Thus,
      the colocalization of determinants for ER degradation and sites of subunit
      interactions explains how the fate of some newly synthesized TCR chains can be
      decided on the basis of their assembly status.

PMID- 2225063
TI  - Activin can induce the formation of axial structures and is expressed in the
      hypoblast of the chick.
AB  - We show that PIF/activin can induce the formation of axial structures including a
      full-length notochord, segmented somites, and a neural tube in isolated epiblasts
      from chick blastulae. Using degenerate PCR primers, we have cloned a fragment of
      the activin beta B chain from chick hypoblast cDNA, and a fragment of the activin
      beta A chain from chick genomic DNA. Furthermore, we show that in the chick,
      activin is transcribed precisely when axial mesoderm is being induced. Since
      exogenous PIF/activin can induce the formation of axial structures and since
      activin beta B is transcribed at the time and place where the mesodermal axial
      structures are being induced, we propose that in the chick, activin B is the
      endogenous inducer of the body axis.

PMID- 2225065
TI  - A role for integrin in the formation of sarcomeric cytoarchitecture.
AB  - We propose that integrins help to coordinate the differentiation of the internal,
      sarcomeric cytoarchitecture of a muscle fiber with its immediate environment and
      are essential for correct integration of muscle cells into tissue. We found that
      integrin alpha PS2 beta PS accumulated at contact regions of Drosophila embryo
      cells cultured in D-22 medium on Drosophila laminin. Myotubes formed, but
      subsequent addition of serum or fibronectin was needed for sarcomere formation:
      integrin and actin became concentrated at Z-bands; myosin and actin occurred
      between the Z-bands. This change failed to occur in the multinucleate myotubes
      derived from integrin beta PS null myospheroid mutants. In normal embryos/early
      larvae, integrin was located at Z-bands and at muscle insertions. Myogenesis and
      Z-bands were defective in myospheroid embryos. Attachment, spreading, and growth
      of myoblasts and neurons on the laminin substrate utilized different binding
      proteins and were independent of integrin.

PMID- 2225066
TI  - Spatial expression of the Drosophila segment polarity gene armadillo is
      posttranscriptionally regulated by wingless.
AB  - armadillo (arm) is one of a group of Drosophila segment polarity genes that are
      required for normal patterning within the embryonic segment. Although arm RNA is
      uniformly distributed in embryos, arm protein accumulates at higher levels in
      regions that contain wingless, another segment polarity gene which encodes a
      secreted protein that regulates patterning via cell-cell communication. These
      local increases in arm protein require wingless activity, and mutations that
      alter wingless distribution produce corresponding changes in the arm protein
      pattern. These results suggest that wingless regulates accumulation of arm
      protein by a posttranscriptional mechanism. Two other segment polarity genes,
      porcupine and dishevelled, are required for this effect. We also show that arm
      protein is closely associated with the plasma membrane in virtually all cell
      types and often colocalizes with F-actin.

PMID- 2225067
TI  - Overexpression of TAR sequences renders cells resistant to human immunodeficiency
      virus replication.
AB  - Overexpression of TAR-containing sequences (TAR decoys) was used to render cells
      resistant to HIV replication. A chimeric tRNA(meti)-TAR transcription unit
      contained in a double copy murine retroviral vector was used to express high
      levels of HIV-1 TAR-containing transcripts in CEM SS cells. Replication of HIV-1
      was inhibited over 99% in cells expressing chimeric tRNA-TAR transcripts, but an
      amphotropic murine retrovirus replicated normally in these cells. Expression of
      TAR sequences in CEM SS cells had no adverse effects on cell viability,
      indicating that essential cellular factors are not being sequestered in these
      cells. TAR decoy RNA-mediated HIV inhibition may also be effective against
      natural HIV isolates in spite of their hypervariable nature, as suggested by the
      fact that replication of SIVmac was also inhibited in cells expressing HIV-1 TAR
      decoys.

PMID- 2225068
TI  - Exon mutations uncouple 5' splice site selection from U1 snRNA pairing.
AB  - It has previously been shown that a mutation of yeast 5' splice junctions at
      position 5 (GUAUGU) causes aberrant pre-mRNA cleavages near the correct 5' splice
      site. We show here that the addition of exon mutations to an aberrant cleavage
      site region transforms it into a functional 5' splice site both in vivo and in
      vitro. The aberrant mRNAs are translated in vivo. The results suggest that the
      highly conserved G at the 5' end of introns is necessary for the second step of
      splicing. Further analyses indicate that the location of the U1 snRNA-pre-mRNA
      pairing is not affected by the exon mutations and that the precise 5' splice site
      is selected independent of this pairing.

PMID- 2225069
TI  - The HIV-1 Tat protein: an RNA sequence-specific processivity factor?

PMID- 2225070
TI  - Self superantigens?

PMID- 2225071
TI  - Globin gene regulation and switching: circa 1990.
AB  - Suggestions that the field of hemoglobin regulation and erythroid cell molecular
      biology was undergoing a tortuous and slow death, awash in the scientific
      community several years ago, were dispelled by the findings presented at the
      Seventh Conference on Hemoglobin Switching. After a phase in which neither the
      cis-elements nor trans-factors important for globin and erythroid gene expression
      were evident, recent progress has been rapid. Once again, studies in this area
      are providing fundamental insights into eukaryotic biology. The long-distance
      influence of LCR elements on chromatin structure and gene expression is
      remarkable and likely to be encountered in the analysis of other developmentally
      regulated, multigene loci. How LCR elements influence chromatin structure and
      maintain an open configuration is a problem at the core of gene regulation. We
      can be optimistic that further dissection of LCRs will delineate DNA sequences
      critical for these effects and associated proteins. The interaction of LCRs with
      individual genes must depend on specific protein-protein interactions, most
      likely involving a small, but elite, group of regulators. At least one critical
      transcriptional regulator of erythroid-expressed genes, GATA-1, is firmly
      established. Others are being pursued. The mechanisms by which they collaborate
      with each other should provide the missing pieces to the puzzle of cell-specific
      gene expression in the erythroid lineage. As the phenomenology of Hb switching is
      mimicked in transgenic mice, the elements mediating competitive and non
      competitive (or autonomous) modes of regulation will be systematically
      delineated. Whether knowledge of the cis- and trans- components involved in
      switching will lead to the development of therapeutic approaches aimed at
      altering their complex interactions is uncertain. Fortunately, recent progress in
      hematopoietic stem cell biology once again raises hopes that gene transfer
      strategies for management of hemoglobin disorders may be more than a distant,
      impractical goal.

PMID- 2225072
TI  - The hepatitis B virus-encoded transcriptional trans-activator hbx appears to be a
      novel protein serine/threonine kinase.
AB  - To study the functional mechanism of the hepatitis B virus (HBV) X (hbx) gene
      product, we have expressed the hbx protein in E. coli and purified it by HPLC.
      The purified hbx protein was shown to be active in transactivating transcription
      directed by the LTR sequence of HIV-1. The hbx protein was found to have an
      intrinsic serine/threonine protein kinase activity. The hbx protein was detected
      in hepatitis B virions, and tryptic phosphopeptide maps of the hbx protein
      phosphorylated in the virion and of the in vitro phosphorylated bacterially
      expressed hbx protein were similar. Inactivation of the hbx protein by heat,
      protein-denaturing agents, or an ATP affinity analog, p-fluorosulfonylbenzoyl 5'
      adenosine, resulted in loss of both protein kinase activity and trans-activation
      activity. These results suggest that the HBV-encoded trans-activator hbx is a
      novel protein kinase.

PMID- 2225073
TI  - V beta 17 gene polymorphism in wild-derived mouse strains: two amino acid
      substitutions in the V beta 17 region greatly alter T cell receptor specificity.
AB  - Of 41 wild-derived mouse strains analyzed, 14 contained T cells bearing V beta 17
      receptors in spite of the concomitant expression of I-E antigens. Reciprocal F1
      and F2 hybrids of one of these strains, PWK, with laboratory strains revealed
      different patterns of V beta 17 T cell deletions from those observed with V beta
      17 T cells from SJL, implying that the two V beta 17 regions are associated with
      recognition of distinct superantigens. The structures of the V beta 17 alleles
      differ by two amino acid substitutions, which lie together in an area distant
      from the predicted site of T cell receptor interaction with peptide-MHC complexes
      but overlapping with that implicated in V beta 8.2 recognition of Mls-1
      superantigen. This demonstrates that the self-superantigen leading to V beta 17 T
      cell deletion varies with the allele of the receptor gene and confirms that T
      cell deletions by such ligands involve interactions with a region of the V beta
      domain that is distinct from the conventional combining site.

PMID- 2225074
TI  - RAP1 protein interacts with yeast telomeres in vivo: overproduction alters
      telomere structure and decreases chromosome stability.
AB  - The protein encoded by the RAP1 gene of S. cerevisiae binds in vitro to a
      consensus sequence occurring at a number of sites in the yeast genome, including
      the repeated sequence C2-3A(CA)1-6 found at yeast telomeres. We present two lines
      of evidence for the in vivo binding of RAP1 protein at telomeres: first, RAP1 is
      present in telomeric chromatin and second, alterations in the level of RAP1
      protein affect telomere length. The length changes seen with under- and
      overexpression of RAP1 are consistent with the interpretation that RAP1 binding
      to telomeres protects them from degradation. Unexpectedly, overproduction of the
      RAP1 protein was also shown to decrease greatly chromosome stability, suggesting
      that RAP1 mediates interactions that have a more global effect on chromosome
      behavior than simply protecting telomeres from degradation. Such interactions may
      involve telomere associations both with other telomeres and/or with structural
      elements of the nucleus.

PMID- 2225075
TI  - Position effect at S. cerevisiae telomeres: reversible repression of Pol II
      transcription.
AB  - S. cerevisiae chromosomes end with the telomeric repeat (TG1-3)n. When any of
      four Pol II genes was placed immediately adjacent to the telomeric repeats,
      expression of the gene was reversibly repressed as demonstrated by phenotype and
      mRNA analyses. For example, cells bearing a telomere-linked copy of ADE2 produced
      predominantly red colonies (a phenotype characteristic of ade2- cells) containing
      white sectors (characteristic of ADE2+ cells). Repression was due to proximity to
      the telomere itself since an 81 bp tract of (TG1-3)n positioned downstream of
      URA3 when URA3 was approximately 20 kb from the end of chromosome VII did not
      alter expression of the gene. However, this internal tract of (TG1-3)n could
      spontaneously become telomeric, in which case expression of the URA3 gene was
      repressed. These data demonstrate that yeast telomeres exert a position effect on
      the transcription of nearby genes, an effect that is under epigenetic control.

PMID- 2225076
TI  - The controlling sequence for site-specific chromosome breakage in Tetrahymena.
AB  - Site-specific chromosome breakage occurs in many ciliated protozoa during nuclear
      differentiation. We have determined the cis-acting sequence that controls this
      process in Tetrahymena thermophila. The Tetrahymena ribosomal RNA gene is bounded
      by two breakage sites. Injection of this gene into developing macronuclei leads
      to breakage at these sites. Deletion analysis has localized the sequences
      essential for breakage to a 28 bp region that includes a 15 bp sequence (Cbs)
      known to be present in other breakage sites. Insertions of Cbs allow breakage to
      occur at new sites, which is accompanied by elimination of surrounding DNAs and
      formation of telomeric sequences, as it is at natural sites. Thus, Cbs is the
      necessary and sufficient sequence signal for chromosome breakage in Tetrahymena.

PMID- 2225077
TI  - HIV-1 Tat protein trans-activates transcription in vitro.
AB  - Tat protein of human immunodeficiency virus 1 is a potent trans-activator of
      viral gene expression. We show that purified Tat protein stimulates transcription
      from viral promoters greater than 10-fold in vitro. A Tat protein mutant that
      does not trans-activate in vivo did not stimulate transcription in vitro. Tat
      trans-activation required a functional TAR RNA sequence; trans-activation was
      competed by the addition of in vitro synthesized wild-type TAR RNA but not by
      mutant TAR RNAs. That Tat protein directly interacts with the TAR RNA during
      trans-activation in vitro was suggested by competition with Tat peptides.
      Preliminary evidence suggests the involvement of a cellular factor in recognition
      of TAR RNA during Tat trans-activation. Analysis of Tat trans-activation in vitro
      will provide new mechanistic insights into this process and allow a more detailed
      study of the relationship between Tat protein structure and function.

PMID- 2225078
TI  - The v-rel oncogene encodes a kappa B enhancer binding protein that inhibits NF
      kappa B function.
AB  - Studies of NF-kappa B suggest that this enhancer binding activity corresponds to
      a family of at least four proteins (p50, p55, p75, and p85) differentially
      induced with biphasic kinetics during T cell activation. While p55 and p50 are
      closely related to the 50 kd DNA binding subunit of NF-kappa B, p75 and p85
      exhibit DNA binding properties that distinguish them from this 50 kd polypeptide
      and its regulatory subunits I kappa B and p65. All four members of this kappa B
      specific protein family are structurally related to the v-Rel oncoprotein and
      one, p85, appears identical to human c-Rel. v-Rel, but not nontransforming v-Rel
      mutants, binds to the kappa B enhancer and inhibits NF-kappa B-activated
      transcription from the IL-2 receptor alpha promoter and HIV-1 LTR. These findings
      suggest a Rel-related family of kappa B enhancer binding proteins and raise the
      possibility that the transforming activity of v-Rel is linked to its inhibitory
      action on cellular genes under NF-kappa B control.

PMID- 2225079
TI  - T lymphocyte stress response. II. Protection of translation and DNA replication
      against some forms of stress by prior hyperthermic stress.
AB  - We have compared the effects of a mild heat shock and febrile temperatures on
      heat-shock protein (hsp) synthesis and development of stress tolerance in T
      lymphocytes. Our previous studies demonstrated that febrile temperatures (less
      than or equal to 41 degrees C) induced the synthesis of hsp110, hsp90, and the
      constitutive or cognate form of hsp70 (hscp70; a weak induction of the strongly
      stress-induced hsp70 was also observed. In the studies reported herein, we
      demonstrate that a mild heat shock (42.5 degrees C) reverses this ratio; that is,
      hsp70 and not hscp70 is the predominate member of this family synthesized at this
      temperature. Modest heat shock also enhanced the synthesis of hsp110 and hsp90.
      In order to assess the relationship between hsp synthesis and the acquisition of
      thermotolerance, purified T cells were first incubated at 42.5 degrees C
      (induction temperature) and then subsequently subjected to a severe heat-shock
      challenge (45 degrees C, 30 min). T cells first incubated at a mild heat-shock
      temperature were capable of total protein synthesis at a more rapid rate
      following a severe heat shock than control cells (induction temperature 37
      degrees C). This phenomenon, which has been previously termed translational
      tolerance, did not develop in cells incubated at the febrile temperature
      (induction temperature 41 degrees C). Protection of translation also extended to
      immunologically relevant proteins such as interleukin-2 and the interleukin-2
      receptor. Because clonal expansion is a critical event during an immune response,
      the effects of hyperthermic stress on DNA replication (mitogen-induced T cell
      proliferation) was also evaluated in thermotolerant T cells. DNA synthesis in
      control cells (induction temperature 37 degrees C) was severely inhibited
      following heat-shock challenge at 44 degrees C or 45 degrees C; in contrast, T
      cells preincubated at 42.5 degrees C rapidly recovered their DNA synthetic
      capacity. T cells preincubated at a febrile temperature were moderately protected
      against hyperthermic stress. The acquisition of thermotolerance was also
      associated with enhanced resistance to chemical (ethanol)-induced stress but not
      to heavy metal toxicity (cadmium) or dexamethasone-induced immunosuppression.
      These studies suggest that prior hsp synthesis may protect immune function
      against some forms of stress (e.g., febrile episode) but would be ineffective
      against others such as elevated glucocorticoid levels which normally occur during
      an immune response.

PMID- 2225082
TI  - The nucleolar chromatin and the secondary constriction.
AB  - We have traced the nucleolar chromatin from early prophase to the metaphase
      stage. In prophase this chromatin begins to condense and in metaphase it is fully
      condensed. In mitotic chromosomes, this chromatin remains surrounded by
      achromatic materials resembling the fibrillar centre. As such this region of the
      chromosomes appears as a gap or constriction at the light microscope level. The
      possible role of this achromatic material in relation to nucleologenesis and
      satellite association has been discussed.

PMID- 2225080
TI  - Thymic hormone modulation of age-induced changes in the induction of graft-versus
      host disease by DBA/2J lymphocytes.
AB  - Aging induces a number of changes in the immune system, including the involution
      of the thymus which results in the loss of thymic hormone production and
      alteration in T cell function. One age-dependent change in immune response is the
      increasing risk of developing acute or chronic form of graft-versus-host disease
      (GVHD) following bone marrow transplantation as the age of the recipient
      increases. A murine model of GVHD that has been extensively studied is one in
      which injection of C57BL/6 spleen cells into unirradiated B6D2F1 mice results in
      an acute form of GVHD characterized by cytolytic T lymphocytes (CTL), suppressor
      cells, runting, and occasionally death. In contrast, injection of DBA/2J spleen
      cells results in a chronic form of GVHD characterized by a lack of CTL and
      hyperproduction of immunoglobulin and autoantibodies. This study shows that the
      GVHD response of DBA/2J spleen cells is dependent on the age of the donor DBA/2J
      mice. If spleen cells from DBA/2J mice older than 3 months are injected into
      B6D2F1 recipients, CTL and lack of immunoglobulin production indicative of acute
      GVHD result. Administration of thymosin fraction 5, a collection of thymic
      hormones, to DBA/2J mice older than 3 months caused spleen cells from these
      treated mice to give a GVHD response characteristic of the chronic form of GVHD
      in B6D2F1 recipients. Thus, thymic hormones were able to modulate the changes in
      GVHD responses of DBA/2 lymphocytes that occur as the mice age. Preliminary
      fractionation of TF5 has indicated that there are at least two active thymic
      peptides present in TF5.

PMID- 2225081
TI  - Mechanisms of pertussis toxin inhibition of lymphocyte-HEV interactions. I.
      Analysis of lymphocyte homing receptor-mediated binding mechanisms.
AB  - The molecular mechanisms by which pertussis toxin (PTX) inhibits lymphocyte
      homing to peripheral lymph nodes (PLN) remain poorly understood. PTX-treated
      lymphocytes express homing receptors, yet cannot extravasate into PLN in vivo.
      Methylation of PTX, a procedure known to inactivate the B-oligomer of the toxin,
      restored high endothelial venule (HEV) binding capacity. In vitro studies
      established that toxin exposure inhibited the accessory role of LFA-1 in HEV
      binding. In contrast, PTX-exposed lymphocytes exhibited normal MEL-14-mediated
      HEV binding. Analysis of membrane fluidity revealed a 20% decrease in
      fluorescence polarization in PTX-exposed lymphocytes. On the basis of the current
      experiments, we propose a "zipper" model of lymphocyte-HEV interaction, in which
      lateral mobility of adhesion receptors in the cell membrane toward a site of
      endothelial contact is necessary to maintain adhesion against the shear force due
      to blood flow. PTX inhibits these processes by decreasing membrane fluidity, and
      by altering accessory adhesion molecule function.

PMID- 2225083
TI  - The fluorescent probe BCECF has a heterogeneous distribution in sea urchin eggs.
AB  - Sea urchin eggs were loaded with the pH-sensitive fluorescent probe BCECF.
      Homogenization of these eggs, followed by centrifugation, resulted in 25% of the
      total homogenate fluorescence remaining with the pellet. Fluorescence microscopy
      revealed brightly fluorescing punctate organelles whose fluorescence was not
      quenched by acidification. The excitation spectrum of intracellular BCECF was
      markedly red-shifted compared to probe calibrated in buffer. Model excitation
      spectra based on a two compartment model mimicked the intracellular BCECF
      spectrum, therefore, supporting the possibility that organelles in sea urchin
      eggs accumulate large amounts of BCECF in a relatively pH-insensitive form.

PMID- 2225084
TI  - Study of fibronectin expression in tumour cells by dot-blot and in situ
      hybridization: quantitative evaluation by image analysis.
AB  - An Image Analysis program was used for the quantitative evaluation and comparison
      of the fibronectin (FN) mRNA detected by dot-blot and in situ hybridization in
      different cell lines. These techniques were applied for the evaluation of FN mRNA
      synthesized by human normal fibroblasts (Flow 7000) and by four tumour-derived
      cell lines (HeLa, epithelioid carcinoma; 8387, fibrosarcoma; RD,
      rhabdomyosarcoma; SK Hep-1, hepatocarcinoma). Dot-blot analysis showed that the
      cell types analysed synthesize different levels of FN mRNA. Flow 7000 are the
      highest producers while HeLa the lowest. In situ hybridization confirmed these
      results and furthermore showed that while Flow 7000, 8387 and HeLa cells
      synthesized homogeneous levels of FN mRNA, RD and SK Hep-1 could be subdivided
      into two populations expressing high or low levels of FN mRNA. The combined
      analysis of dot-blot, in situ hybridization and Image Analysis allowed the
      quantitation of the number of FN mRNA molecules expressed by single cells. This
      approach is therefore an invaluable tool when evaluating mRNA expression in
      heterogeneous cell populations like tumour-derived cell lines, during cell cycle
      or in histological tissue sections.

PMID- 2225085
TI  - Location of nuclear antigen(s) recognized by DSB389 MAb, a monoclonal antibody
      against desmin, observed by confocal laser scanning fluorescence microscopy.
AB  - The location of antigen(s) of DSB389 MAb, a monoclonal antibody which was raised
      against an intermediate filament protein, desmin, was investigated in HeLa S3
      cells by indirect immuno-electron microscopy and by confocal laser scanning
      fluorescence microscopy. At interphase, the antigen(s) locates mainly in the
      intra-nuclear space adjacent to chromatin and sometimes near the nuclear
      periphery. At mitosis, they locate at the periphery of the chromosomes -first at
      each chromosome, then around the mass of chromosomes. The antigen(s) are thought
      to be a component of one type of nuclear matrix which is present outside both
      chromatin and chromosomes and which has some structural role(s) in organizing
      them in the nucleus or in the nuclear region.

PMID- 2225086
TI  - Immunocytochemical identification of cytoskeletal linkages to smooth muscle cell
      nuclei and mitochondria.
AB  - In avian smooth muscle cells, desmin-containing intermediate filaments (IFs) are
      a prominent component of the cytoskeleton and are readily seen in several
      domains, including the axial intermediate filament bundle (IFB). Both the nucleus
      and some of the mitochondria are partly surrounded by elements of the IFB. By
      using anti-desmin and protein-A-colloidal gold labeling, we have identified
      intermediate filaments that form linkages with the nuclear envelope and with
      mitochondria. These linkage regions seem to occupy a proportionately greater part
      of the mitochondrial surface than of the nuclear envelope. The existence of these
      linkages in smooth muscle cells is consistent with results that support similar
      linkages to mitochondria and other cellular structures in various cells that
      contain either vimentin or keratin IFs. These linkages could functionally
      restrain or assist in homeostatically restoring organelles to their normal
      position after the rearrangement that accompanies the substantial shortening of
      smooth muscle cells.

PMID- 2225087
TI  - Identification and characterization of a novel mammalian intermediate filament
      associated protein.
AB  - A novel monoclonal antibody, designated M1.4, recognizes the high molecular
      weight microtubule-associated protein MAP1A (ca. Mr 380 kD) in both bovine and
      rat brain. In HeLa cells, however, M1.4 binds to a 240 kD polypeptide on
      immunoblots and co-localizes with both vimentin and cytokeratin filaments using
      double-label immunofluorescence microscopy. Immunoelectron microscopy indicates
      that the 240 kD polypeptide localizes along bundled intermediate filaments in a
      periodic manner. Two-dimensional electrophoretic analysis indicates that the 240
      kD polypeptide has a basic pI of 7.7. When HeLa cell intermediate filaments are
      isolated using standard non-ionic detergent/high-salt conditions the 240 kD
      polypeptide does not sediment with the intermediate filaments, unlike the
      established intermediate filament-associated protein plectin. Immunoblot analysis
      with M1.4 shows the 240 kD polypeptide is expressed in a number of mammalian cell
      lines. Additionally, double-label immunofluorescence shows the 240 kD polypeptide
      to associate with vimentin filaments in African Green Monkey kidney (CV-1) and JC
      neuroblastoma cells. Due to its unique biochemical and biological
      characteristics, the 240 kD polypeptide is clearly a novel intermediate filament
      associated protein for which we have proposed the designation gyronemin (Gr.
      gyros: around; nemin: filament).

PMID- 2225088
TI  - Effects of trypsin and low Ca2+ on zonulae adhaerentes between chick retinal
      pigment epithelial cells in organ culture.
AB  - The junctional complexes in chick retinal pigment epithelial (RPE) cells in situ
      contain unusually large zonulae adhaerentes (ZAs) composed of subunits termed
      zonula adhaerens complexes (ZACs). To determine whether the properties of the ZAs
      differ between RPE cells which contain ZACs, and MDCK cells which lack ZACs, we
      investigated the effects of treatment with trypsin and/or low Ca2+ by
      transmission electron microscopy and staining for F-actin. Treatment of RPE cells
      for 1 h with trypsin alone has no apparent effect on the morphology of the ZA in
      either MDCK or RPE cells. In contrast to the ZAs in MDCK cells, which split after
      3 min in low Ca2+, the ZAs in chick RPE cells stay intact even after 2 h,
      although the intermembrane discs, i.e., the extracellular components of the ZACs,
      are no longer visible. After 30 min of treatment with trypsin and low Ca2+, the
      ZAs split in both cell types. The CMBs start to contract, translocate toward the
      cell interior, and eventually disappear. This process continues even when the RPE
      cells are returned to normal medium. New ZAs, composed of ZACs, form between RPE
      cells 3 h after return to normal medium. These findings suggest that the ZACs in
      the ZAs of RPE cells are not directly responsible for the increase in resistance
      to low Ca2+. They also show that the ZA-junctions in RPE cells are not only
      structurally different from those previously examined, but also behave
      differently in response to experimental manipulation.

PMID- 2225089
TI  - Behavior of C-shaped microtubule endings in the cell.
AB  - The association of incomplete microtubule assemblies with either another
      incomplete structure or complete microtubules was studied in two organisms, the
      phytoflagellate Polytoma papillatum and the phorid fly Megaselia scalaris, using
      transmission electron microscopy. In the alga, hook-shaped appendages on
      cytoplasmic and spindle microtubules were detected. These resulted from the
      lateral association of a curved ribbon of protofilaments with the surface of a
      complete microtubular wall. In the fly, an S-shaped protofilament sheet was found
      embedded in the kinetochore plate of a prometaphase I spermatocyte. Tracing of
      the S-shaped element towards the spindle pole revealed that it was formed by the
      lateral junction of two curved protofilament sheets. In all cases, the C-shaped
      protofilament sheets represented the endings of complete microtubules. Incomplete
      microtubules are generally considered as representing intermediates of
      microtubule assembly and disassembly. Since high molecular weight proteins are
      believed to be responsible for maintaining microtubule-microtubule spacing, it is
      hypothesized that the endings of growing and shrinking microtubules are sparsely
      studded with these proteins; their depletion allows lateral microtubule contacts.
      In addition, the microtubule-microtubule contacts may be rendered possible by the
      flexibility of the slender elongated microtubule-associated molecules. Relatively
      long C-shaped protofilament appendages (0.6-1.4 microns) were detected in this
      study. Therefore, it is plausible to assume that the protofilament sheets are
      stabilized by contact with one another or with an intact tubule wall.

PMID- 2225090
TI  - Tension as a regulator and integrator of axonal growth.

PMID- 2225091
TI  - Opioid peptides and stress.

PMID- 2225092
TI  - The role of endogenous opioid peptides in the regulation of pain.

PMID- 2225093
TI  - Central stimulation-induced analgesia in humans--modulation by endogenous opioid
      peptides.
AB  - Stimulation of the endogenous opiate system produced relief of somatosensory
      induced pain states. Stimulation of the nonopiate system can control pain from
      somatosensory causes as well as damage to the nervous system. Neither of these
      systems in themselves are rewarding or produce self-stimulation in humans, who
      have free choice of whether to use stimulation or not, except to reduce
      discomfort. Lack of pain in general produces lack of use of the stimulation
      system. Apparently, the descending opiate system for somatosensory pain control
      involves descending norepinephrine and serotonin pathways at an intermediate step
      through the dorsolateral funiculus of the cord. Enhancement of the opiate system
      can be produced by administration of L-Tryptophan and L-Dopa due to precursor
      loading of serotonin and norepinephrine. The endogenous opiate system, when
      activated by electrical stimulation, usually produces excellent control of
      somatosensory induced pain, but often is not effective for centrally produced
      pain. Stimulation of areas that produce analgesia that are nonopiate-dependent
      are usually more effective in reducing pain from damage to the nervous system
      itself than the opiate-dependent system, but this is sometimes the converse.
      While cross tolerance to morphine from electrical stimulation of the endogenous
      opiate system exists in animals, it does not seem to be a problem clinically as
      the abstinence syndrome and tolerance have not been a problem in humans.

PMID- 2225094
TI  - Effects of opioid peptides on peripheral stimulation and "stress"-induced
      analgesia in animals.
AB  - This review has established the basis for an opiate pain-inhibitory system as
      well as pharmacological and physiological evidence suggesting alternative
      nonopiate systems. The concept of multiple forms of pain inhibition became
      apparent through the study of stress-induced analgesia and the classification of
      effects across opioid/nonopioid and neural/neurohormonal dimensions. These
      effects were compared with traditional pathways identified for opiate pain
      inhibition, and the use of other environmental forms of analgesia (cervical
      probing, defeat) were explored similarly. To conceptualize how these multiple
      analgesic systems might interact, a collateral inhibition model was described for
      opioid and nonopioid systems, while a synergy model examined two responses from
      the same class. The existence and further characterization of these multiple
      systems have obvious clinical and therapeutic importance, and systematic
      approaches to the mechanisms involved have been identified for further empirical
      investigation.

PMID- 2225095
TI  - Cerebral vasospasm.
AB  - Cerebral vasospasm (specifically, intracranial arterial spasm) is variously
      defined as: (1) an arteriographically evident narrowing of the lumen of one or
      more of the major intracranial arteries at the base of the brain due to
      contraction of the smooth muscle within the arterial wall, or due to the
      morphological changes in the arterial wall and along its endothelial surface that
      occur in response to vessel injury; (2) the delayed onset of a neurological
      deficit following subarachnoid hemorrhage, thought to be due to ischemia or
      infarction of a portion of the brain; or (3) the combination of these two
      features (symptomatic vasospasm). The arterial contraction of intracranial
      arterial spasm typically develops a few days after the rupture of an intracranial
      aneurysm and lasts 2 to 3 weeks. Such arterial spasm can also occur in other
      conditions such as head trauma. If it is severe enough it can lead to cerebral
      infarction. The pathogenesis of this condition is still unclear. Many ingenious
      attempts have been made to prevent or treat cerebral vasospasm, but most have
      failed. The best current approach is to ensure adequate blood volume, and to
      elevate the patient's blood pressure (especially if the aneurysm has been secured
      by an early operation). The continuing investigation of drugs such as calcium
      channel blocking agents to improve the cerebral circulation has begun to provide
      additional help.

PMID- 2225096
TI  - [Determination of gestational age by ultrasound].
AB  - The authors elaborated a procedure for correction of the gestation age by
      ultrasonic examination in pregnant women in the second and third trimester of
      gestation. The method was tested in a group of 500 pregnant women who were
      examined within the framework of a special ultrasound screening. In 5% of the
      group the gestation age calculated according to the last menstrual bleeding was
      not consistent with the results of the ultrasound examination. In these instances
      a correction was made in case the difference between the ultrasonic finding and
      the gestation age according to menstruation was two weeks or more, in the first
      as well as second trimester. In these instances the correction was made with
      regard to the difference in the first trimester. In the group of women where the
      correction was made there was in 44% a case-history of irregular menstrual
      cycles, as compared with 13% in the group where the ultrasonic finding was
      consistent with the gestation age according to the date of menstruation. In the
      majority of women (73%) with a shift of the conceiving ovulation the difference
      of the ultrasonic finding, as compared with the gestation age according to the
      last menstruation was three weeks or more.

PMID- 2225097
TI  - [The effect of chronic exposure to lead on lysosomal levels in amniotic fluid in
      an experimental model].
AB  - Groups of female rats were exposed for prolonged periods to different lead
      concentrations in drinking water; in one group was also added to the drinking
      water, in the amniotic fluid of exposed females greatly reduced lysozyme values
      were found, as compared with controls. Concurrent Zn administration considerably
      reduced the effect of lead. Long-term exposure to low concentrations of lead
      caused a greater drop of lysozyme levels in amniotic fluid than that found in
      previous experiments after short-term exposure to higher lead concentration.

PMID- 2225098
TI  - [Clinical problems in postpartum psychoses].
AB  - The authors analyzed post-partum psychoses treated at the Psychiatric Clinic of
      the Faculty Hospital in 1985-1986. The group comprised 41 patients. Post-partum
      psychoses are not considered a separate nosological unit nor symptomatic mental
      disorders but are classified as endogenous psychoses, provoked by childbirth. As
      to endogenous psychoses, most frequently manic depression is involved, as
      suggested by the clinical picture and course. Schizophrenia is found less
      frequently, as compared with manic depression, the cca 1:10. In rare instances
      post-partum symptomatic psychosis may develop.

PMID- 2225099
TI  - [Fertility in gonadal dysgenesis].
AB  - At the Second Gynaecological and Obstetric Clinic in Prague there are at present
      78 phenotypic women with dysgenetic gonads in dispensary care. In 61.5% the main
      reason for examination in a specialized department was infertility. Based on a
      comprehensive examination, the authors demonstrate the relationship between
      chromosomal complement and histology of the gonads on one side and fertility on
      the other. 31% of women with dysgenetic sclerocystic gonads became pregnant after
      surgical and hormonal treatment. In 27% of the dispensarized group genital and
      extragenital tumours were detected.

PMID- 2225100
TI  - [The first 10 pregnancies in the in vitro fertilization and embryo transfer
      program of the Institute for Maternal and Child Care using transvaginal
      follicular puncture].

PMID- 2225101
TI  - [Changes in cholinergic innervation of the fallopian tube in women during the
      menstrual cycle].

PMID- 2225102
TI  - [Initial experience with early amniocentesis].

PMID- 2225103
TI  - [SP1 levels in maternal serum in the second half of pregnancy with a genetically
      stigmatized fetus].

PMID- 2225104
TI  - [Childbirth in women in the care of a single obstetrician].

PMID- 2225105
TI  - [Negative HCG in extrauterine pregnancy].

PMID- 2225106
TI  - [The Wissler-Fanconi syndrome after hysterectomy].

PMID- 2225107
TI  - [Aphrodisiacs in gynecology].

PMID- 2225108
TI  - [Developmental morphology of the human corpus luteum].

PMID- 2225109
TI  - [History of the cesarean section].

PMID- 2225110
TI  - [Comments on the work of L. Barnet et.al. "Our experience with monitoring drug
      prescriptions in pregnancy"].

PMID- 2225111
TI  - [Trends in the frequency of cesarean section and its indications in
      Czechoslovakia].

PMID- 2225112
TI  - [Regional differences in the number of abortions on demand in the Czech
      Republic].

PMID- 2225115
TI  - [Contraception and risk factors for the development of diseases of the uterine
      cervix].
AB  - In a group of 350 women operated on account of diseases of the uterine cervix in
      1986-1988 risk factors associated with cancerogenesis were evaluated. The author
      provided evidence of a significant rise of CIN in conjunction with contraception.
      The rise of number of CIN cannot be differentiated from social factors and sexual
      behaviour of women which are directly related to the increased risk of cancer of
      the uterine cervix.

PMID- 2225114
TI  - [Morphologic basis of hemorrhage during hormonal therapy in the climacteric
      syndrome].
AB  - In a group of 133 postmenopausal women in the course of nine years the
      relationship between two types of hormonal treatment and one of the side-effects-
      metrorrhagia--was investigated. This symptom was found in 37 patients. The
      authors followed two aims. To evaluate the relationship between treatment of the
      climacteric syndrome and the morphological state of the uterine mucosa and to
      assess the optimal therapeutic pattern under local conditions. The insignificant
      frequency of proliferating endometrial changes supports some data in the
      literature which draw attention also to other causes of haemorrhage. With regard
      to therapeutic regimes, the authors consider continual administration of
      conjugated oestrogens--0.625 mg and medroxyprogesterone acetate 5 mg per day as
      suitable. They emphasize the necessity to follow up the patients in a special
      clinic with the opportunity to make hormonal examinations and to ensure
      interdisciplinary collaboration.

PMID- 2225113
TI  - [Spontaneous and induced fetal movement activity in the 2d trimester of
      pregnancy].
AB  - During routine screening in the first half of pregnancy the authors evaluated in
      3446 foetuses the incidence of spontaneous movements and movements after their
      attempted induction by movement of the uterus, when no spontaneous movements were
      recorded during examination. The examinations were made by means of a rotation
      probe 3.5 MHz of a Sonoline 2 apparatus (Siemens) always between 7.30 and 11.30
      a.m. It was revealed that: 1. Spontaneous motor activity of the foetus depends
      significantly ot the foetal age; during the period between the 12th and 16th week
      it was recorded in 94.4%, in the 17th to 21st week it declines to 87.4% and
      during the 22nd-25th week it rises again to 94.7%. 2. The number of foetuses
      where movements were recorded after the first movement of the uterus depends also
      significantly on foetal age: in the 12th-16th week it is 57.5% of the number of
      foetuses without spontaneous movement, in the 17th to 21st week 66.3% and in the
      22nd to 25th week 66.7%. 3. On the basis of preliminary work it is not possible
      to decide whether the movements observed after movement of the uterus are
      spontaneous or induced, however, if attempts to induce movements would imply only
      prolonged examination and recording of spontaneous activity, it is justified. 4.
      In one foetus where we did not observe spontaneous activity nor movements after
      movement of the uterus we revealed during a check-up examination rapidly
      developing polycystic kidneys. 5. Observation of foetal movements during
      screening is not time consuming and should become a matter of routine.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2225116
TI  - [Endomitoses and squamous pearls in cervix dysplasia].
AB  - The authors describe the cytological and histological picture of intraplasmic
      inclusions in dysplasias of the cervix, apparent under the microscope. Their
      development may be due to cellular cannibalism or incomplete cell separation
      after abnormal nuclear division. The latter mode of cell division is probably
      associated with the development of squamous pearls observed in advanced
      dysplasias. Squamous pearls in cervical dysplasias do not attain the dimensions
      and degree of keratinization as pearls in squamous carcinoma, their similarity
      is, however, striking.

PMID- 2225117
TI  - [Clinical study of morbidity in children in relation to the method of guiding the
      2d stage of labor].

PMID- 2225118
TI  - [Therapy of mycotic colpitis with terconazole (Gyno-Terazol)].

PMID- 2225120
TI  - [The occurrence of Chlamydia, Mycoplasma and Ureaplasma in sterile married
      couples].

PMID- 2225119
TI  - [Personal experience with SolcoTrichovac].

PMID- 2225121
TI  - [Screening for endometrial carcinoma using our special aspiration cannula].

PMID- 2225122
TI  - [Concurrent acute leukemia and pregnancy].

PMID- 2225123
TI  - [Combination of intrauterine and extrauterine pregnancy].

PMID- 2225124
TI  - [Giant subserous pendulous liquefied uterine myoma].

PMID- 2225126
TI  - [Methods of assisted reproduction].

PMID- 2225125
TI  - [Current opinion on the pathogenesis of prolonged pregnancy].

PMID- 2225127
TI  - [Barrier contraception increases the risk of pre-eclampsia].

PMID- 2225128
TI  - [Obstetrical surgery at the Brno Clinic during the 1st Czechoslovak Republic].

PMID- 2225129
TI  - [Problems in artificial insemination and the activity of sperm banks].

PMID- 2225130
TI  - [Screening for precancerous conditions and preclinical carcinoma of the uterine
      cervix in the Western Bohemian Region].

PMID- 2225131
TI  - [100 years since the birth of Vilem Laufberger].

PMID- 2225132
TI  - [V. Laufberger on metamorphosis in the axolotl].

PMID- 2225133
TI  - [Physiological aspects of electrical fields of the heart].

PMID- 2225134
TI  - [Development of modern electrocardiography--100th anniversary of the birth of
      Academician Vilem Laufberger].

PMID- 2225135
TI  - [Electrocardiology problems in orthotopic heart transplantation].

PMID- 2225136
TI  - [From the breaking up of cells to molecular physiology].

PMID- 2225137
TI  - [Transferrin, transferrin receptors and incorporation of iron into cells].

PMID- 2225138
TI  - [Laufberger's "excitation theory" today].

PMID- 2225139
TI  - [Laufberger's Practical Physiology (1946)].

PMID- 2225140
TI  - [A remembrance of academician Vilem Laufberger].

PMID- 2225141
TI  - [A list of the works of Academician V. Laufberger 1975-1984 (part 3)].

PMID- 2225142
TI  - The RAD50 gene, a member of the double strand break repair epistasis group, is
      not required for spontaneous mitotic recombination in yeast.
AB  - Mutations in the RAD50 gene of Saccharomyces cerevisiae have been shown to reduce
      double strand break repair, meiotic recombination, and radiation-inducible
      mitotic recombination. Several different point mutations (including ochre and
      amber alleles) have been previously examined for effects on spontaneous mitotic
      recombination and did not reduce the frequency of recombination. Instead, the
      rad50 mutations conferred a moderate hyper-rec phenotype. This paper examines a
      deletion/interruption allele of RAD50 that removes 998 of 1312 amino acids and
      adds 1.1 kb of foreign DNA. The results clearly indicate that spontaneous mitotic
      recombination can occur in the absence of RAD50; in fact, the frequency of
      recombination is elevated over the wild-type cell. One possible interpretation of
      these observations is that the initiating lesion in spontaneous recombination
      events in mitosis might not be a double strand break.

PMID- 2225143
TI  - The mitochondrial nad5 gene of sugar beet (Beta vulgaris) encoding a subunit of
      the respiratory NADH dehydrogenase.
AB  - We have isolated the nad5 gene from the N-cytoplasm of Beta vulgaris, by
      heterologous hybridization with a nad5 probe from Chlamydomonas reinhardtii, and
      have determined the DNA sequence. The gene has a length of 3082 bp and consists
      of three exons and two introns, 459, 1269, 270, 848 and 357 bp in length,
      respectively. It has a similarity of 95.1% at the DNA level to the nad5 gene of
      Oenothera and the two respective proteins show an overall level of amino acid
      identity of 88.7%. Compared to Oenothera the reading frame of the first exon is
      extended in the 5' direction and in the third exon there is a frameshift
      shortening the reading frame by 96 bp and changing the last 48 codons. The nad5
      gene is a single copy gene in the N- and S-cytoplasm of Beta vulgaris and the
      organisation of the gene shows no apparent differences in the two cytoplasms. The
      gene is actively expressed; three major transcripts are detectable. The
      transcript patterns have been compared between the two cytoplasms and between
      different plant tissues.

PMID- 2225144
TI  - Translational accuracy and sexual differentiation in Chlamydomonas reinhardtii.
AB  - A renewal of ribosomes has been previously reported to occur during gametogenesis
      in C. reinhardtii. In order to further characterize these new ribosomes, we
      performed pulse-labelling experiments on whole cells of C. reinhardtii, during
      gametogenesis and in the presence of various aminoglycosides known to alter
      translational accuracy: Hygromycin and Paromomycin are assumed to increase the
      rate of translational errors at the level of 80S and 70S ribosomes whereas
      Kasugamycin is assumed to induce the opposite effect. Three lines of evidence
      support an increased inaccuracy in protein translation during gametogenesis: (1)
      gamete cells displayed a higher sensitivity than vegetative cells to Hygromycin
      and Paromomycin; 4 micrograms/ml Hygromycin cancelled cytoplasmic protein
      synthesis in gametes but not in vegetative cells; Paromomycin induced the
      synthesis of new polypeptides of high molecular weight and of nuclear origin in
      gametes but not in vegetative cells. In addition, chloroplast protein synthesis
      was more sensitive to Hygromycin and Paromomycin in gametes than in vegetative
      cells. (2) Kasugamycin-sensitive alterations of thylakoid membranes were detected
      during gametogenesis. (3) 35S-misincorporation in the OEE3 polypeptide, of
      nuclear origin and normally devoid of sulphur containing amino acids, was more
      than three times higher in gametes than in vegetative cells. This increase was
      prevented by Kasugamycin, suggesting that 80S translation in gametes was more
      inaccurate than in vegetative cells. The possible significance of these changes
      occurring during gametogenic differentiation is discussed in light of the
      importance of a modulation of translational accuracy at particular stages of the
      life cycle in other lower eukaryotes.

PMID- 2225145
TI  - Cloning and expression of a second Aspergillus niger pectin lyase gene (pelA):
      indications of a pectin lyase gene family in A. niger.
AB  - Using the previously cloned Aspergillus niger N756 pectin lyase D gene as a
      probe, the corresponding pelD gene has been isolated from a genomic library of
      the laboratory strain A. niger N400. This gene encodes PLD, previously described
      as PLI, which is one of the two major pectin lyases isolated from the commercial
      pectinase preparation Ultrazym. Heterologous hybridization of the A. niger N400
      genomic library with the pelD gene led to the isolation of another five genes:
      pelA, B, C, E, and F. These genes differ in their hybridization patterns with
      probes containing either the entire pelD gene, or 5' or 3' parts thereof. By
      partial sequencing, and expression in an A. niger transformant containing
      multiple copies of the pelA gene, we show that this gene, which hybridizes
      strongest with the pelD gene, encodes the other major pectin lyase from Ultrazym,
      PLII.

PMID- 2225147
TI  - [Clinico-genetic problems in retinoblastoma. Retinoblastoma and heredity
      (review)].

PMID- 2225146
TI  - The influence of GAP promoter variants on hirudin production, average plasmid
      copy number and cell growth in Saccharomyces cerevisiae.
AB  - The yeast Saccharomyces cerevisiae has been engineered to synthesize and secrete
      desulfato-hirudin (hirudin), a thrombin inhibitor from the leech Hirudo
      medicinalis. The synthetic gene coding for hirudin was expressed constitutively
      under the control of four size-variants of the yeast glyceraldehyde-3-phosphate
      dehydrogenase promoter (GAP) and cloned into a 2 mu based multicopy yeast vector.
      The constitutive action of the four promoter variants was confirmed by
      demonstrating that the expression and secretion of hirudin is growth-related. The
      different efficiencies of the promoter variants not only affected hirudin
      expression but also led to changes in several cellular parameters, such as cell
      growth, average plasmid copy number and plasmid stability. The observed changes
      show that yeast cells establish a specific equilibrium for each promoter variant.
      We conclude, that the adjustment of cellular parameters in response to the
      expression levels of a heterologous protein is regulated by two counteracting
      selective forces: (1) the need for complementation of the auxotrophic host marker
      by the plasmid-encoded selection gene which, in the case of dLEU2, requires
      several plasmid copies; and (2) a selective advantage of cells with a lower copy
      number enabling them to escape the burden of heterologous protein production.

PMID- 2225148
TI  - [Clinical analysis of 35 patients with retinoblastoma followed-up for 25 years].
AB  - The author presents a comprehensive analysis of a group of 35 patients with
      retinoblastoma followed up for 20 years at the Ophthalmological Clinic of the
      Faculty Hospital in Bratislava, focused on the aetiology, diagnosis, treatment
      and prognosis of the disease. Special emphasis is laid on the investigation of
      indicators which differentiate hereditary and non-hereditary retinoblastoma and
      on the application of these indicators for the evaluation of the clinical picture
      and for genetic consultations.

PMID- 2225149
TI  - [Surgery in sequelae of chemical and thermal burns of the eye].
AB  - The treatment of sequelae of chemical and thermal burns of the eye is sometimes
      very difficult. Previous to a event, keratoplasty all symblephara have to be
      removed. If there is no conjunctiva, transplantation from the second eye or from
      a donor is necessary. A method of transplantation of donor conjunctiva with a
      corneal lamella has been worked out as preparation for keratoplasty. Epithelium
      than can migrate to the transplant. In quantitative or qualitative alterations of
      the tears, the condition can be improved by soft contact lenses. In about one
      third of serious burns longtermed good results can be gained.

PMID- 2225150
TI  - [Prostanoids and leukotrienes in ophthalmology. I. Basic biochemistry and
      physiology of prostanoids and leukotrienes].
AB  - The authors give a brief account of hitherto assembled knowledge on the
      biochemistry and physiology of prostanoids and leucotrienes. They describe the
      history of investigations of these substances, their properties and patterns of
      synthesis. The authors evaluate possibilities of the pharmacotherapeutic use of
      inhibitors of prostanoid and leucotriene synthesis.

PMID- 2225151
TI  - [Prostanoids and leukotrienes in ophthalmology. II. Role of prostanoids and
      leukotrienes in the physiology and pathophysiology of the eye].
AB  - The authors give an account on the development and contemporary knowledge
      regarding the participation of prostanoids and leukotrienes in physiological and
      pathophysiological processes of the eye. According to many data in the literature
      of all intraocular tissues of the human eye the greatest prostaglandin production
      was found in the anterior segment of the choroid. The authors describe the role
      played by these substances in the pathogenesis of inflammations, their importance
      in the regulation of intraocular pressure and in the development of cystoid
      macular oedema.

PMID- 2225152
TI  - [Prostanoids and leukotrienes in ophthalmology. III. Results of a clinical study
      of local administration of indomethacin in preoperative and postoperative care].
AB  - The authors submit results of the clinical investigation involving indomethacin
      administration during preoperative and postoperative care of patients with
      primary glaucoma who were submitted to trabeculectomy. The investigation was made
      by the method of a double blind trial. Indomethacin 0.5% eye drops or placebo
      were administered on the day prior to operation to the 10th day after operation,
      three times a day. During the final comparison of the two groups after
      indomethacin a reduction of the number of postoperative complications was
      observed, as well as a shorter hospitalization period, and the result of the
      filtering operation was not affected.

PMID- 2225153
TI  - [Risk factors for diabetic retinopathy in children and adolescents with type I
      diabetes mellitus].
AB  - Based on repeated fluoroangiographic examinations in a group of 28 children with
      type I diabetes mellitus the authors observed progressing diabetic retinal
      changes. At the end of the three-year observation period they found progress in
      32% of the children. They investigated influence of risk factors such as age,
      duration of the basic disease, its metabolic compensation, sex and HLA typing on
      the development of diabetic retinopathy.

PMID- 2225154
TI  - [Microsurgery knives with crystalline blades].
AB  - In collaboration with the national enterprise Monokrystaly Turnov and the
      workshops of the Medical Faculty, Charles University, Hradec Kralove the authors
      designed and produced microsurgical knives with an exchangeable inserted blade
      made from leucosapphire. They describe their experience with the manufacture and
      clinical use of these new local instruments.

PMID- 2225155
TI  - [Use of soft contact lenses in the treatment of corneal erosions].
AB  - The author gives an account of favourable experience with gel contact lenses,
      produced locally, in the treatment of traumatic corneal erosions. Patients
      treated by means of therapeutic contact lenses recovered more rapidly (by 1.2
      days, as compared with a control group treated by covering the eye). The great
      advantage of the contact lens method is that the patients could use the injured
      eye during treatment. In some instances even work incapacity was not necessary.
      Contact lenses can be resterilized and the cost of treatment is relatively small.
      Daily check-ups are, however, necessary and contact lenses should be inserted by
      an experienced ophthalmologist.

PMID- 2225157
TI  - [Information on Fresnel prisms and hyperopic spectacles].

PMID- 2225156
TI  - [The research work of Dr. Jiri Franta in the shadow of his death sentence].
AB  - A report on three manuscripts written in German by Doc. Dr. J. Franta (1899-1945)
      in prison after his death verdict (May 7, 1943) for his activity in the
      resistance movement. The first manuscript--a contribution on the genesis and
      medicamentous treatment of cataract--was a conspectus (16 pp.). After a positive
      review by prof. Dr. H. Rieger it served as the basis for five chapters which
      formed the second manuscript (52 pp.). The working hypothesis on the influence of
      infrared radiation on the intraocular metabolism and the suggested detailed local
      and general, clinical and experimental examination of subjects with a transparent
      and opaque lens was important. In the third manuscript (12 pp.) the author
      outlined his plan of biochemical examinations in keratoplastic operations, in
      particular as regards material from donors. Even after reading Franta's letters
      from prison addressed to his family, the circumstances under which the
      manuscripts were written are not quite clear--permission to do research given to
      a person sentenced to death is quite exceptional.

PMID- 2225159
TI  - [Personal experience with adjuvant chemotherapy of malignant tumors in
      otorhinolaryngology].
AB  - The authors give an account on the therapeutic results of adjuvant
      polychemotherapy in advanced squamous-cell carcinomas in the ENT region. Based on
      their conclusions they recommend in these malignities (stage III, IV)
      comprehensive treatment comprising neo-adjuvant polychemotherapy, surgery
      supplemented by simultaneous radiopolychemotherapy along with cyclic adjuvant
      chemotherapy and hyperthermia.

PMID- 2225158
TI  - [Personal experience with antibiotic prophylaxis in extensive
      otorhinolaryngologic procedures].
AB  - The authors compare the effectiveness of three types of antibiotic prophylaxis
      (1. cephazoline, 2. combination ampicillin + oxacillin, 3. clindamycin) in a
      group of 32 patients with resection of oropharyngeal carcinomas and in a group of
      47 laryngectomies with cervical block resection. The criterium is the incidence
      of postoperative infections, which called for a change of antibiotic treatment.
      The authors evaluates favourably prophylaxis with cephazoline and clindamycin;
      the incidence of complications is within the range of 17-30%. In ampicillin +
      oxacillin therapy unsatisfactory results with a 46% incidence of inflammatory
      complications were recorded. A gram-negative flora causes 45% infectious
      complications; the author also draws attention to the danger of anaerobic
      infections. In a primarily contaminated oropharyngeal area there is an incidence
      of postoperative infections by 30% higher in all types of evaluated prophylaxis,
      as compared with the laryngocervical area.

PMID- 2225160
TI  - [Surgical treatment of patients with carcinoma of the larynx at the
      Otorhinolaryngology Clinic in Martin].
AB  - In 1973-1985 at the ENT Clinic of the Faculty Hospital with policlinic in Martin
      559 patients with carcinoma of the larynx were treated: 23 women and 529 men.
      Thirteen women and 286 men were operated. Partial resection was performed in 137
      patients. The best results were recorded after chordectomy, the poorest results
      after horizontal partial resection of the larynx. The author discusses the
      effectiveness of laryngectomy after previous partial surgical operation of the
      larynx, early diagnosis and corrected indication for surgical operation.

PMID- 2225161
TI  - [Present trends in endoscopy in otorhinolaryngology].
AB  - The author emphasizes new endoscopic trends in otorhinolaryngology, in particular
      rhinoscopy with microsurgery of the lateral nasal wall, sinuscopy and the use of
      lasers in microlaryngoscopy. Attention is also drawn to the specific position of
      endoscopy in otorhinolaryngology, using not only flexible and rigid technique but
      also possibilities of concurrent examination of the respiratory and deglutition
      pathways--i. e. so-called double endoscopy. The possibility of a comprehensive
      endoscopic examination of the deglutition and respiratory pathways led also to
      the formulation of the principle of panendoscopy the importance of which for
      oncological diagnosis is already generally accepted.

PMID- 2225162
TI  - [Importance of laryngomicroscopy and fibrolaryngostroboscopy in the early
      diagnosis and surgical treatment of laryngeal cancer].

PMID- 2225163
TI  - [Rhinogenous phlegmons of the orbit].
AB  - During the past 15 years we treated at the ENT department and ophthalmological
      department of the hospital with policlinic type III in Nitra 10 patients with
      orbital phlegmons or an abscess of the eyelid after an eye injury treated and
      cured by antibiotic treatment and external drainage. Twelve patients had a
      rhinogenic phlegmon or abscess in the orbit (one patient had a dentogenic
      aetiology of the inflammation). This group of 12 patients were treated in
      addition to antibiotics in different combinations also surgically (in one case
      also by drainage of the abscess from a lateral quadrant of the orbit). In five
      instances the authors found in addition to the phlegmon of the periorbital tissue
      also an abscess in the depth of the orbit and six times an abscess of the eyelid.
      Despite the radical approach to the inflammation of the paranasal sinuses and
      inflammation of the orbit, two patients developed blindness of the damaged eye
      and one patient died from rhinogenic suppurative meningitis.

PMID- 2225164
TI  - [The significance of the supratubal recess in the surgical treatment of chronic
      otitis].
AB  - The processus supratubalis is a complicated space from the topographical aspect.
      The author emphasizes the need of careful peroperative examination of the area
      which may be the site of a residual cholesteatoma. The pathological process at
      this site may, due to topographic relations with important structures, cause
      serious functional disorders.

PMID- 2225165
TI  - [Saturation of middle ear reflexes in occupational hearing loss].
AB  - In the ENT department of the Factory Institute of National Health of the uranium
      industry in Pribram a group of 196 men (392 ears) was examined who worked exposed
      to the risk of noise in different occupations, mostly as miners in the uranium
      mines. The noise exposure was 17.5 +/- 6.5 years, age 60.2 +/- 11.7 years, the
      total percentage hearing loss (calculated according to Fowler) 54.7 +/- 21.1%.
      The group was formed by 144 men who were examined during a preventive follow-up
      examination, 52 men where hypacusia was evaluated as an occupational disease. The
      examination of all patients was supplemented by a record of middle-ear reflexes
      induced by contralateral stimulation at frequencies of 0.5 kHz, 1 kHz, 2 kHz and
      4 kHz and by white noise (WN). The regression equation y = 50.54-0.044X (y =
      percentage hearing loss per ear, x = noise exposure in years) was calculated from
      data of the group subjected to the preventive follow up examination and made it
      possible to divide the group into sub-groups, sensitive and resistant to noise.
      The group of occupational hypacusia comprised only sensitive subjects. The
      authors tested the frequency and thresholds of middle ear reflexes at different
      frequencies and WN, the frequency and thresholds of saturation of reflexes
      separately in groups sensitive and resistant to noise. It was not possible to
      draw conclusions from the results which would permit a forecast of the individual
      development of occupational hypacusia as regards early evaluation of sensitivity
      or resistance to noise.

PMID- 2225166
TI  - [Etiology of congenital hearing disorders in children].
AB  - The author analyzes factors which may play a part in the aetiology of severe
      congenital bilateral perception deafness--practically complete deafness--in
      children. The group of patients comprises 177 deaf children, 135 siblings with
      normal hearing and 70 deaf parents and other relatives. Pathological factors
      during pregnancy were detected in 20, perinatal and neonatal pathology in 32
      instances. If the anamnestically detected risk factors in the aetiology of the
      hearing deficit played a part, theoretically by their elimination a considerable
      proportion of the congenital hearing affections in children could be prevented.
      The author emphasizes the necessity of collaboration with a geneticist in the
      prevention of inborn hereditary deafness.

PMID- 2225167
TI  - [Spatial positional orientation in deaf-mute individuals with bilateral
      vestibular areflexia].
AB  - Ten deaf-mute subjects with total vestibular areflexia were subjected to
      positional tests, i.e. assessment of the postural subjective vertical and
      horizontal plane by deviations in the frontal and sagittal plane. The tests were
      performed in the author's modification of a Grahe table. Comparison with the
      results of 10 healthy subjects revealed that extinction of vestibular activity
      increases the inaccuracy of assessment of the body position in space. The
      conclusion is: the vestibular (otolith) apparatus supplements and makes the
      activity of all other gravireceptors more accurate but not hold a dominant place
      among them.

PMID- 2225168
TI  - [Personal experience with sialography].
AB  - The author emphasizes the importance of sialography in the diagnosis of diseases
      of the salivary glands. By using an intravenous polyethylene cannula it is
      possible to combine functional examination of the salivary glands (sialometry and
      sialochemistry) with X-ray examination after filling the glands with contrast
      substance. In a group of 34 patients sialography contributed to a correct
      diagnosis in 26 patients, i.e. 76.5%. False positive results were recorded in 1
      case (2.9%), false negative results in three (8.8%). From a total of eight
      tumours of the salivary glands the examination in two cases (25%) did not lead to
      a correct diagnosis. In 16 instances (47%) the conclusion of the sialographic
      examination was compared with results of the histological and cytological
      examination.

PMID- 2225169
TI  - [Hemangiomas of the larynx in children--results of surgical treatment].
AB  - Surgical treatment of six cases of haemangiomas of the larynx. Surgery was used
      only after all conservative means were exhausted. After complete removal of the
      tumour after a two-year interval no relapse was recorded. The function of the
      larynx was not impaired.

PMID- 2225171
TI  - [An unusual early complication of tonsillectomy].
AB  - The authors describe the observation of a localized tissue emphysema of the right
      cheek, which developed in an eight-year-old child as the early complication of
      tonsillectomy performed under local anaesthesia. In addition to reflections on
      the possible pathways of the gas from the tonsillar bed into interstitial spaces
      of the cheek, the authors draw attention also to possible concurrent penetration
      into the soft tissues of the neck and mediastinum.

PMID- 2225170
TI  - [Iatrogenic injuries of the facial nerve in the mastoid region].
AB  - During the past ten years nine patients were referred to our hospital with
      lesions of the VIIth nerve. These lesions were inflicted during operation on
      account of chronic otitis media. One patient recovered after conservative
      treatment. Based on the EMG examination and clinical picture, eight patients were
      operated. In one who had an extensive lesion it did not prove possible to find
      the proximal stump and the patient improved after Normann-Dott's operation. In
      the remaining seven subjects also severe damage was involved: five times complete
      severing of the nerve occurred, twice partial severing and contusion, always in
      the mastoid portion of the VIIth nerve. The authors achieved as a rule a 50-75%
      restoration of function of the VIIth nerve Ballance-Duel's operation, using a
      graft of the n. suralis with microsuture of the epineurium and gluing of the
      nerve by plasma. Evaluation of late functional results was made 1-8 years after
      Ballance-Duel's operation. The authors recommend to reduce the risk of iatrogenic
      lesions of the VIIth nerve in beginners by assistance of experienced surgeons at
      several operations.

PMID- 2225172
TI  - [Malignant neurofibroma of the cervical portion of the vagus nerve].
AB  - The authors give an account of a malignant neurofibroma of the cervical portion
      of the vagus in Recklinghausen's disease in a 29 year-old man. The tumour was
      removed with part of the nerve. Relatively shortly after operation a local
      relapse of the tumour developed, with propagation into the posterior cranial
      fossa, which proved fatal. The authors discuss diagnostic difficulties,
      possibilities of treatment and the prognosis of malignant neurogenic tumours.

PMID- 2225173
TI  - [Diabetic neuropathy. Diagnosis and classification].

PMID- 2225174
TI  - "Pseudodementia" and "pseudodepression": a short review on the coexistence of
      cognitive and affective impairment in the elderly.

PMID- 2225175
TI  - [Psychological aspects of pain].

PMID- 2225176
TI  - [Vascular epilepsy].

PMID- 2225177
TI  - [Cerebral circulation using transcranial and extracranial doppler ultrasonography
      in a patient with vertigo and ischemia in the area of the brain stem].
AB  - The authors examined 32 patients with vertigo, 17 patients with focal ischaemia
      of the brain stem and 24 patients without signs of affections of the central
      nervous system by transcranial and extracranial Doppler ultrasonography. They
      measured the flow velocity in the basilar artery (BA), in the intracranial
      portion of the vertebral artery (VA) and in the extracranial portion of the
      internal carotid artery (ICA). In patients with vertigo they investigated
      functional and organic changes in the area of the cervical spine. They found
      significant differences in the flow velocities between groups as well as in
      different indices calculated from the assessed values. The lowest flow velocities
      were recorded in patients with focal ischaemia of the brain stem. The authors
      evaluate the influence of haemodynamics and disease of the cervical spine on the
      development of vertigo.

PMID- 2225178
TI  - [Trigeminal evoked potentials. Normal values].
AB  - The author describes the examination technique of trigeminal evoked potential
      (TEP) by electric stimulation with paired skin electrodes separately for each
      side of the maxillary and mandibular branch of the trigeminal nerve. The obtained
      evoked response contains two negative and two positive deflections N11, P19, N27,
      P39, whereby wave P39 could not be evaluated in 47.8%; therefore it was not
      processed by statistical method. The other latency values are stable against a
      major variability of amplitudes. Evaluation by linear regression displayed only a
      minor correlation of latencies of the trigeminal evoked potential with advancing
      age. The author present normal latency and amplitude values for every side of
      maxillary and mandibular part of the Vth nerve as well as maximal lateral
      differences. With regard to the hypothetical possibility to influence results of
      the trigeminal potential by afferentiations of the VIIth nerve in patients with
      idiopathic paresis of the fascial nerve, this method in not a suitable model for
      testing the selectivity of examinations of TEP. The submitted method of
      trigeminal evoked potential is reliable and simple and can be used as a
      diagnostic aid in examinations of the functional state of the pathway of the Vth
      nerve, e.g. in multiple sclerosis, neuralgia of the Vth nerve, tumours of the Vth
      nerve and in conditions after operation of the Vth nerve.

PMID- 2225179
TI  - Electrophysiological characterization of central sensory and motor pathway
      function in patients with moderate hemiparesis. I. Methodical approach.
AB  - The central sensory and motor pathway function in healthy persons and patients
      with several neurological disorders was selectively characterized by evaluation
      of latencies of short (R1) and long (R2) latency EMG responses as well as
      simultaneously recorded somatosensory potentials (N19, N26) evoked by electrical
      stimulation of N.medianus and N.peroneus. On the basis of these latencies the
      peripheral and central sensory/motor conduction times were calculated. By using
      this investigation procedure a selective quantification of central pathway
      functions is possible.

PMID- 2225181
TI  - [Laryngeal voice production: neurological aspects. Possibilities of laryngeal
      voice production analysis].

PMID- 2225180
TI  - Electrophysiological characterization of central sensory and motor pathway
      function in patients with moderate hemiparesis. II. Clinical results.
AB  - The central sensory and motor pathway function in patients with moderate
      hemiparesis and in healthy persons was selectively characterized by evaluation of
      latencies of short (R1) and long (R2) latency EMG responses as well as
      simultaneously recorded sensorimotor potentials (N19, N26) evoked by electrical
      stimulation of median and peroneal nerve (additionally, calculation of peripheral
      and central sensory/motor conduction times). This investigation procedure permits
      a noninvasive quantification of disturbed central sensory and motor pathway
      function in hemiparetic patients. The results found are in agreement to clinical,
      CT and other examination findings.

PMID- 2225182
TI  - [The basilar artery terminal branch syndrome. Paramedian meso-thalamic infarct].
AB  - The author describes two cases of paramedian mesothalamic infarction as part of
      multiple infarctions in occlusions of the top of the basilar and peduncular
      segment of the posterior cerebral artery. Based on published work and the
      author's own observations, the clinical syndrome of this infarction was defined
      and comprises five symptoms: impaired consciousness, amnestic syndrome and
      paralysis of vertical views due damage of formations in the area of paramedian
      thalamo-subthalamic (thalamoperforate) arteries by neuropsychic abnormalities and
      contralateral hemidefects due to damage of structures in the neighbouring
      thalamic and parathalamic areas.

PMID- 2225183
TI  - [Spectrophotometry of native cerebrospinal fluid: artificial "bilirubin"
      xanthochromia].

PMID- 2225185
TI  - [Initial experience with elements of the clinical psychology information system].
AB  - The authors report on their initial experience with the evaluation of standard
      records of psychological examinations in a mental asylum. These evaluations are
      limited by the assembled indicators, but despite these limitations they help to
      give an idea on the usefulness of psychological examinations. The author
      discusses also other possibilities how to develop the clinical psychological
      information system.

PMID- 2225186
TI  - [Jellinek's developmental stages and their reality under our sociocultural
      conditions].
AB  - In a group of 250 hospitalized male patients with the diagnosis 303 the author
      tested the aptness of Jellinek's developmental stages of alcoholism which are
      widely used in Czechoslovak alcohology. It was demonstrated that the
      developmental stages are not integrated developmental stages, that they lack the
      necessary compactness in the chronological sequence and in the frequency of
      individual phenomena. Loss of control (8) in the reported form is closer to the
      onset of development and the frequency of palimpsests (7) develops later, usually
      is overlaps with prolonged drunkedness (31). At the onset of development
      dominates "non-adaptive" drinking evaluated frequently as loss of control and in
      the more advanced stage the constant incidence of palimpsests causes frequent
      intoxication and declining tolerance. Among individual phenomena the following
      are important: in stage I regular contact with the drug (04) and increased
      tolerance (05), in stage II secret drinking (2) and frequency of palimpsests (7),
      in stage III signs derived mostly from rationalization and alcohol-centered
      behaviour and finally in stage IV impaired thinking (33), reduced tolerance (37)
      and possible ethic degradation (32). As to different developmental stages the
      chronic stage sounds most convincing.

PMID- 2225184
TI  - [Results of treatment of schizophrenic and schizoaffective patients with
      sulpiride (Eglonyl Alkaloid) in comparison with perphenazine (Perfenazin Spofa)].
AB  - In a three-week crossover controlled the authors administered alternately
      sulpiride and perphenazine with an intermittent placebo interval, to 40
      hospitalized patients with acute exacerbation of schizophrenic and
      schizoaffective psychosis. According to evaluation recommended by Serejsky
      significantly more complete remissions type AB were achieved especially in
      schizodepressive patients given sulpiride. The global score of BPRS and FKP
      scales after administration of the two tested neuroleptic drugs differed:
      sulpiride had a more favourable effect on depression, emotional withdrawal,
      reduced affectivity, slower motor activity, worry about the somatic state and
      hallucinations, while perphenazine gave better results in patients with reduced
      compliance, lack of cooperation, hostility and excitation. Sulpiride is well
      tolerated by the patients. Pharmacological parkinsonoid was observed only in cca
      half the patients, as compared with perphenazine and therefore also the need of
      correction by antiparkinsonian drugs was significantly smalled. The low incidence
      of extrapyramidal, hypnosedative and autonomous undesirable effects gave
      sulpiride the optimal position in our classification of 16 tested neuroleptic
      drugs. In one third of the patients no undesirable side--effects were observed.

PMID- 2225187
TI  - [Sulpiride (Eglonyl Alkaloid) in the treatment of functional disorders of the
      digestive tract].
AB  - Sulpirid was administered in an open clinical trial--150 mg/day for 4 weeks--to
      31 patients (15 man and 16 women, mean age 31.5 years, mean duration of
      complaints 1 month to 6 years) suffering from functional disorders of the
      digestive system. Their health status was evaluated by a specialist in internal
      medicine, by a psychiatrist and a self-administered SCL-90 questionnaire before
      the onset of treatment and after four weeks. In 29 patients the complaints
      disappeared or improved markedly and this improvement persisted also after
      discontinuation of the drugs. In the entire group a significant drop of the mean
      initial intensity of psychopathological feature in all dimensions of the
      questionnaire occurred; the improvement was more marked in men where the mean
      baseline values of psychopathology were higher. There was also a significant
      decline of the mean numbers of positively evaluated items in 9 of 10 dimensions
      of the questionnaire. The drug was well tolerated by the patients with the
      exception of one transient allergic skin reaction. So far the exact ratio of
      improvement of psychopathology as a therapeutic response to sulpirid
      administration and the placebo effect on the patient's complaints cannot be
      exactly evaluated. Sulpirid has some advantages, as compared with other
      psychopharmaceutic preparations used in this indication (e.g. amitriptyline,
      dosulepine).

PMID- 2225188
TI  - [Psychoreactive disorders: clinical description of pathologic reactions,
      pathologic reactive states and reactive psychoses].
AB  - After the introduction to the problem presented in the first part, the author
      submits a description of clinical units. The aim is to provide documentation of
      his concept and to unify the understanding of these conditions into a uniform
      system; conditions which, although adequately described, are included among
      different disorders and their classification and description is not uniform. The
      need of this description is urgent not only because the new generation of
      psychiatrists does not know the original classification but also because
      knowledge of these conditions has expended and this calls for new evaluation and
      description.

PMID- 2225190
TI  - [Relation between the effect of therapy and the course of neuroses in a day care
      sanatorium].
AB  - In 152 patients who in 1979-1986 had a complete seven-week course of stationary
      treatment with daily group psychotherapy and who returned catamnestic
      questionnaires six months after termination of treatment, the relationship
      between the course of treatment and its effect was investigated. The effect of
      treatment was evaluated by the paired t-test. Ninety-eight patients improved
      significantly and 54 improved but not significantly. In these two groups the
      authors compared also the graphic presentation of the course of treatment as
      regards the grade of neurotic complaints, severity of the problem, activity at
      sessions and position in the group. The results indicate a favourable prognosis
      of treatment in patients with a subjectively conceived/higher position in the
      group and a rising activity at sessions. From what has been said ensues the
      importance to create an emphatic atmosphere in the group and to stimulate the
      activity of group members during treatment.

PMID- 2225189
TI  - [Psychiatric rehabilitation from the viewpoint of a large psychiatric facility].
AB  - The paper makes the reader familiar with the results of activities of the central
      rehabilitation department in the Psychiatric Sanatorium in Kromeriz. It
      postulates views regarding the technique of work with patients and pays special
      attention to the rehabilitation of patients with schizophrenic psychosis. In
      these patients the results of rehabilitation care at different rating levels were
      evaluated. In the field of ergotherapy the schizophrenic patients were evaluated
      by the therapists and instructors of occupational therapy on entry of and
      departure from the workshop or class, using the Engelsman--Hajek scale. Based on
      the results the hypothesis was confirmed of a lower working performance of
      patients with schizophrenic psychosis, as compared with other diagnostic groups.
      In the field of remedial exercise and special forms of psychiatric
      rehabilitation, such as educational and recreational activities, patients with
      schizophrenic psychosis were evaluated by a doctor and psychologist of the
      rehabilitation department of the psychiatric sanatorium for after--treatment of
      psychoses. The patients were evaluated by Wing's scale for chronic schizophrenia
      and by means of the Scale for Evaluation of Working Performance and Behaviour.
      According to the results of both scales no significant differences were found
      between the experimental groups where different forms of rehabilitation were
      accentuated, as compared with the control group engaged only in occupational
      therapy. Both scales revealed in both experimental groups highly significant
      improvement as regards resocialization within a very short period during which
      the patients were subjected to intense rehabilitation. Based on these results the
      author recommends further rehabilitation provisions.

PMID- 2225191
TI  - [Canadian geriatric psychiatry and psychopharmacology 1987-1988].
AB  - The paper offers a brief outline of the current state of geriatric psychiatry and
      psychopharmacology in Canada and partially in the USA. Major trends are described
      in clinical care, in organization and education, along with some basic historical
      comments. The important role of self-help groups is sketched. The contents of
      recent major scientific meetings illustrate the increasing emphasis in research
      in ageing, geriatric psychiatry and geriatric psychopharmacology. The
      developments are characterized by intimate connections between basic and applied
      research, and between clinical observations and experimental neurobiology. The
      analysis of developments in the current practice and research offers some insight
      into upcoming treatment strategies. The next decade in geriatric psychiatry will
      probably belong in particular to molecular biology, genetic, psycho-immunology
      and psychopharmacology.

PMID- 2225192
TI  - [80 years of social medicine in Prague].

PMID- 2225193
TI  - [80 years of the Institute of Social Medicine, Organization and Health Care
      Administration of the School of General Medicine of Charles University].

PMID- 2225194
TI  - [80 years of social medicine as an academic discipline].

PMID- 2225195
TI  - [The profile of the physician-specialist in the field of social medicine and
      health care administration].
AB  - The contributions to the discussion on the profile of medical specialists in
      social medicine and the organization of the health services were discussed by the
      Advisory Board of the main specialist of the Ministry of Health and Social
      Affairs CSR for the discipline of social medicine and organization of the health
      services on April 17, 1989. They are also in the already published first version
      published n Ceskoslovenske zdravotnctvi 37, 1989, No. 4, p. 145-150.

PMID- 2225196
TI  - [The status of implementation of the 38 goals of the WHO document "Health for All
      by the Year 2000" which were accepted by European member nations of WHO].
AB  - The author gives an account of 38 targets adopted by 33 member countries of the
      European Region of WHO to implement the global world strategy "Health for All by
      2000". Some required approaches for monitoring of the implementation of these
      targets are mentioned, as well as research trends outlined by WHO to promote
      these targets. The present position is evaluated, as well as prerequisites for
      the further implementation of WHO targets and relations with targets of the
      health policy in Czechoslovakia. In 1990 the European Regional Office of WHO will
      evaluate the regional targets in cooperation with member countries to simplify
      the monitoring.

PMID- 2225197
TI  - [Pharmacotherapy at the Ostrava area 1 pediatric first aid station].
AB  - The author investigated the prescription of the most frequently recommended drugs
      at the medical first aid station in Ostrava 1 during the period 1985-1988, when a
      total of 53,212 children were treated. Most frequently antibiotics were
      prescribed--on average 33.8% with a maximum of prescription in the winter months.
      The second place was held by antipyretics, most frequently Acylpyrin, during the
      summer months--20.4%.

PMID- 2225198
TI  - [Teaching of medical ethics and law at a medical school].
AB  - Medical practice calls for a highly ethical approach and responsibility codified
      also by law. Doctors should be trained in this respect also during undergraduate
      studies. At the Medical Faculty, Comenius University Bratislava there is
      relatively enough space for training in ethics and law which begins already in
      the introduction to medical studies and proceeds in the 5th, 9th and 10th
      semester in several medical and sociological disciplines. Knowledge evaluated by
      an investigation among sixth year students was only general, not adequate as
      regards medical law and even less adequate as regards medical ethics. Evaluation
      of the assembled knowledge by the students themselves slightly overestimates the
      legal responsibility and legal regulations and rated adequately their training in
      the sphere of ethics.

PMID- 2225199
TI  - [Present problems in health services and health care].
AB  - In order to deal with and resolve contemporary problems of the health services
      and health care it is important to outline their concept, contents and definition
      as well as those of their fundamental constituents--the material, technical
      basis, workers and their activities, which determine the state health policy. The
      author analyzes from this aspect the hitherto accomplished development with
      regard to all basic constituents and discusses the problem of the relationship of
      the intensity and extensity of activities of the health services and health care.
      A foremost part is played by medical is played by medical science--medicine, its
      state, knowledge assembled by students during their undergraduate studies and
      medical graduates during their postgraduate training. A substantial and decisive
      component of the health services as regards therapeutic and preventive care is
      formed by health workers and the quality of their work which depends on objective
      as well as subjective factors which are analyzed. Health services do not comprise
      only practical activities but social medicine and the organization of health
      services are very important scientific disciplines which participate in the
      quality of activities. This scientific discipline was founded by prominent
      personalities. It must be stated that in practical medical work leading
      authorities do not always respect the scientific character of the discipline and
      thus very complicated problems arise as regards scientific control. All these
      problems from the aspect of the department of social medicine and organization of
      health services as well as subjective and scientific control must be resolved
      from the aspect of reconstruction of society.

PMID- 2225200
TI  - [The medical school and its training center at the District Institute of National
      Health in Nove Zamky from the viewpoint of medical students engaged in
      professional and social medicine summer practice].
AB  - Within the framework of professional and social practice of medical students in
      the district institute of national health in Nove Zamky a questionnaire survey
      was made concerned with the attitudes and views of students as regards training
      at the medical faculties and as regards summer practice. The authors consider the
      information obtained from 37 students of different medical faculties in the SSR
      and CSR, ensuing from their first empirical experience in the field, a valuable
      feedback as regards the standard of training and shaping of the profile of the
      qualified doctor for practice. On the whole the students are satisfied with the
      conditions of practical work in Nove Zamky but have also some concrete
      concructive comments and suggestions for optimation and intensification of
      undergraduate training and therapeutic and preventive care. The participation of
      medical students in the above activities is a significant factor shaping their
      professional identity.

PMID- 2225201
TI  - [The creation and implementation of a information system for the health
      services].
AB  - The author gives an account of the present state and near future as regards the
      use of computer technique in the health services, in particular the establishment
      of information systems. The author mentions the results achieved so far, comments
      on the preparation of a new orientation of Czechoslovak research in this sphere
      in 1990-1993. Finally he describes experience with the implementation of results
      of research into practice of Czechoslovak health facilities.

PMID- 2225202
TI  - [Relation of morbidity from gastric and duodenal ulcers with work disability and
      dispensarization].
AB  - A retrospective investigation of the morbidity from peptic ulceration of the
      stomach and duodenum associated with work incapacity in 1985-1987 in workers of a
      large engineering factory provided evidence that personal data on this morbidity
      processed on a computer are along with the medical documentation of individuals a
      useful source of information for the selection and enlistment of patients into
      dispensary care and for its evaluation. The investigation revealed at the same
      time some methodological aspects of dispensarization.

PMID- 2225204
TI  - [Reform of the health services in West Germany and its economic impact].
AB  - As a result of rationalization of labour, innovations in economy and the state
      administration, within the framework of scientific and technical development the
      FRG has greatly increased its investments and great social changes were
      implemented. The system of health services in the FRG is considered very
      efficient. The services are built on the principle on the patient's completely
      free selection of doctors. Specialists, research and technical facilities have a
      high standard. In 1988 a fundamental structural reform of the health services was
      implemented, due to the fact that the cost of health insurance has increased
      since 1960 three times faster than wages, whereby 13% of the insurance money has
      to be met by various additional payments. A further increase is not possible and
      therefore the entire reform of the structure of the health services was
      conditioned and governed by economic reasons.

PMID- 2225203
TI  - [Social determinants of health in the Czechoslovak population].
AB  - The purpose of the submitted paper is to attempt to detect fundamental social
      factors which shaped the health status of the Czechoslovak population during the
      period since the Second World War. First attention is paid to the development of
      the health status. Subsequently the author characterizes briefly the basic
      spheres which influence health, i.e. the lifestyle, living and working
      environment and the activities of the health services. In the conclusion the
      author presents a characteristic of the socio-economic structure of Czechoslovak
      society as regards social relations. The author emphasizes the need of rapid
      transition to a truly democratic set-up of society and the implementation of
      fundamental economic reforms as the prerequisite for gradual improvement of the
      health status of the Czechoslovak population. Part of the contemplated social
      changes and at the same time an essential prerequisite of success is the
      implementation of the strategy of restoration and promotion of national health.

PMID- 2225206
TI  - [Methodical approaches to surveys of general morbidity in the population of other
      countries].
AB  - General morbidity surveys of the population in western countries are based on
      interviews, while in socialist countries general morbidity surveys are usually
      done by direct medical examination or by assessment of the attended morbidity,
      most frequently, however, a combination of both approaches is used. Neither in
      interviews nor in the method based on direct or indirect medical examination so
      far sufficient unification of methodological approaches has been achieved to
      compare, based on these results, the health status of the population in different
      countries.

PMID- 2225205
TI  - [Methodical approach to a survey of general morbidity in Czechoslovakia].
AB  - The author analyzes the method of general morbidity surveys conducted in
      Czechoslovakia between 1951 and 1985. The method of direct medical examinations
      was used as well as the method of "attended morbidity", but as a rule a
      combination of both these methods. During the mentioned period the procedure was
      not unified to make comparison of results possible.

PMID- 2225207
TI  - [Ambulatory care of diseases in children in selected areas of the Czech
      Republic].
AB  - The author submits the results of a five-year investigation of ambulatory
      treatment of children in selected areas of the CSR. The original idea was to
      assess the morbidity of children in oecologically threatened areas. However,
      during the first two years it was revealed that the results do not meet the
      expectations of hygienists. The baseline material was the "Daily working record
      of the community paediatrician". The sample comprised 3% of the child population
      aged 0-14 years from all Czech regions except the South Bohemian one.

PMID- 2225208
TI  - [Prognosis in the mentally retarded child under the present conditions of
      institutional care].
AB  - The environment of mentally retarded children suffers from fluctuations of staff
      in institutes for social care. The reasons are subjective and in the organization
      of work. As compared with other countries, there are differences in the
      categories of workers of these institutions as well as in their numbers and
      training. The concept of care of mentally retarded children has not been fully
      elaborated in this country so far. This has adverse repercussions on the working
      results in social care institutes and on the health status of mentally retarded
      children.

PMID- 2225209
TI  - [Possibilities of prevention of congenital developmental defects].
AB  - One of the still open questions of teratology is the relationship between
      experimental teratological investigations and their validity in human medicine.
      The aetiology of the development of inborn developmental defects comprises
      factors the ratio of which is the subject of discussions. The category of still
      unknown factors is the largest one. This means that in 70% of inborn
      developmental defects there is nothing to go by. The influence of the
      deteriorated living or working environment need not be manifested by a higher
      incidence of seriously damaged foetuses. Comprehensive preconception care is a
      way which may lead to improvement in the sphere of prevention, although its
      application is not unequivocal. An essential prerequisite of effective prevention
      of inborn developmental errors is recognition of the causes of and laws governing
      their development.

PMID- 2225210
TI  - [Problems in home visit services in pediatrics].

PMID- 2225211
TI  - [Registration of patients with chronic diseases].
AB  - The authors describe registers of chronic diseases, provisions regarding their
      contents and organizational aspects. They make the reader familiar with the
      collection, storage and evaluation of data and some problems with their
      safeguarding. They report their experience with recommended questionnaires and
      the structure of forms. They describe the activities of the doctor completing the
      forms as well as the activities associated with recording in the centre. The
      authors demonstrate possible types of outputs and whom they serve. They
      illustrate the results of their work on the example of data from the register for
      diabetes mellitus of the juvenile type I and rheumatic fever. They discuss the
      role of registers in the health services, their role in ensuring the health
      status of the population, planning and management of the health services. In the
      conclusion they mention new technical possibilities.

PMID- 2225212
TI  - [Problems in our health services].
AB  - The author draws attention to some problems of the contemporary health services
      which must be resolved in the near future. They comprise in particular the better
      use of the existing number of available beds and ambulatory diagnostic services.
      Among reasons for inadequate numbers of doctors the author mentions in particular
      superfluous consulting, examinations in conjunction with assessment of the work
      capacity, and administrative work done by many doctors. The author also mentions
      training of doctors, in particular for general practice. Among the causes of the
      low attractiveness of this discipline he mentions among others that examinations
      by the GP are, without any sound reason, not considered specialized examinations.
      Demands for a family doctor imply the patients' call for a more human approach.
      In the subsequent part the author pays attention to complaints and asks for the
      creation of a social climate in favour of new life as well as adequate terminal
      care of moribund patients. Finally he talks about a reform of our health services
      which will seek ways stimulating initiative, moral and material interest.

PMID- 2225213
TI  - [Socio-psychological, ethical and socio-hygienic aspects of preparation for the
      medical profession].

PMID- 2225215
TI  - [Health status of the economically active population and drug consumption. II.
      Analysis of drug consumption].
AB  - The authors pay attention to one of the indicators of the health status of the
      economically active population--to the consumption of drugs. The analysis was
      based on outpatient records on health and disease in a selected group of 2,080
      patients (25.9% of the basic group) in relation to sex, age and work capacity.
      The drug consumption of persons unable to work was cca 40% of the total drug
      consumption, whereby a higher consumption was recorded in women. With advancing
      age the drug consumption in diseases not associated with work incapacity rises
      markedly. Age practically does not influence the drug consumption on account of
      diseases causing work incapacity.

PMID- 2225214
TI  - [The present status of tuberculosis in the Slovak Republic].
AB  - In 1988 the incidence of newly detected cases of TB in the Slovak Republic was
      31.6/100,000 population. As compared with 1987, a decline of the disease by 9.8%
      was recorded. Its incidence in the SR shifts to higher age groups. The prevalence
      of active tuberculosis reached in 1988 34.4 and the mortality 0.4/100,000
      population. Despite these relatively favourable indicators, TB remains in the SR
      a public health issue which will require also in future systematic attention and
      care.

PMID- 2225216
TI  - [Personal experience with examination of the small intestine using the
      enteroclysis method].
AB  - Enteroclysis is rightly included to modern diagnostic methods for detecting
      damage to alimentary canal. It enables to visualize even small morphological
      changes on the mucous membrane of intestine, to prove fistulas if present and to
      evaluate functional changes if correctly applied. It significantly contributes to
      establishing early diagnosis in affections of the intestine and consequent use of
      adequate therapy. The authors in their communication summarized their experience,
      obtained in the examination of one hundred patients. They selected a modified
      procedure of examination according to Herlinger with the use of Prontobarium
      suspension and methyl cellulose. The application was made with a controlled
      duodenal probe from the Nicholas Company, introduced by nose. The average
      duration of one examination was 44 minutes.

PMID- 2225217
TI  - [Computer tomography in the diagnosis of hyperparathyroidism].
AB  - The paper presents long-term experience in the diagnosis of hyperparathyroidism
      by means of computer tomography. A large number of examinations (164) of
      parathyroid glands, the possibility of verification and comparison with
      sonography or with other diagnostic methods of visualization make it possible to
      define the role of computer tomography in hyperparathyroidism and to show
      advantages and limitations of the method. For the high diagnostic precision the
      CT examination may be considered to be the reliable method in the demonstration
      of enlarged parathyroid glands.

PMID- 2225218
TI  - [The picture of focal liver disease in ultrasound, computer tomography and
      angiography].
AB  - In a group of 25 patients examined by sonography, computer tomography and
      angiography with diagnoses confirmed during operation and by histology, the
      author compared the efficiency of the individual methods and a complex
      examination. Computer tomography proved to be the most efficient method which
      enabled, in addition to precise localization, appreciation of size and relation
      of the pathological focus to adjacent structures, to determine their nature in
      some. The complex examination in indicated cases significantly increased the
      diagnostic efficiency.

PMID- 2225219
TI  - [Tracheobronchography in neonates and infants with obstruction of the upper
      respiratory tract].
AB  - In the period of 1980 to 1989 the authors performed contrast examinations of
      tracheobronchial tree in 38 children up to one year of age, three of them being
      newborns. In 29 examined children (74.4%) there was an anatomical defect causing
      the obstruction of upper respiratory pathways. In 15 of them the trachea
      compression was caused by pressure of hyperplastic thymus on the brachiocephalic
      arterial truncus crossing trachea. For visualization of upper respiratory
      pathways Hexabrix 320 (Byk Gulden) was used in 30 children, administered in 10
      cases by jet ventilation. The filling was recorded by radiocinematographic
      method.

PMID- 2225220
TI  - [Thermography findings in the hands in relation to the age of the examined
      individual].
AB  - The authors compared thermographic findings of hands in two groups of apprentices
      (average age 15 and 16 years) with a group of students (average age 21 years) and
      a group of young workers (average age 29 years). There was a highly significant
      difference in the number of cold hands before and after vibration test in the
      apprentices and adults (29 years). The authors arrive at the conclusion that 1)
      thermoregulation reaches its final shape only after 20 years of age, 2) in the
      apprensitive thermographic finding must be verified by regular thermographic
      control examinations.

PMID- 2225221
TI  - [Pseudotumor of the left epigastrium].
AB  - The authors describe the case of a patient with an accessory spleen located
      between the spleen and upper pole of the left kidney. A repeated sonographic
      examination suggested a suspicion for a kidney tumour, shape anomaly of the
      spleen, accessory spleen or kidney, but did not exclude even benign tumour in
      retroperitoneum. Computer tomography proved a formation between the upper pole of
      the kidney and the spleen, whose density characteristic after a rapid intravenous
      injection of 60% Verografin at the amount of 1 ml per kg body weight was the same
      as that of the spleen. Only angiographic examination revealed that the case is an
      accessory spleen and not a tumour.

PMID- 2225222
TI  - [Anomalous branching of the inferior thyroid artery from the left vertebral
      artery].
AB  - In a 53 years old woman hospitalized for a suddenly developed picture of vascular
      insufficiency in the verterobrobasillary vascular bed the authors detected an
      anomalous division of the left vertebral artery from aortic arch. Moreover, at
      the level of thyroid gland there was the division of inferior thyroid artery from
      the vertebral artery. We express the opinion that the finding did not participate
      in the clinical symptomatology.

PMID- 2225223
TI  - [Occlusion of a pseudoaneurysm of the internal carotid using a catheterization
      technic].
AB  - The authors describe a successful therapeutic occlusion of the left internal
      carotid artery in a five years old boy by the catheterization technique. The
      intervention treated a pseudoaneurysm originating after incision of a
      peritonsillar abscess.

PMID- 2225224
TI  - [Amiodarone pulmonary toxicity].
AB  - The authors describe their observation of the amiodarone toxic lung not having
      been published in this country before. Data in its occurrence in literature with
      an outline of differential diagnostic possibilities in a successful establishment
      of diagnosis in this female patient are presented.

PMID- 2225225
TI  - [Results of transabdominal chemical sympathectomy of the lower extremities
      directed by computer tomography].
AB  - The authors evaluated 47 transabdominal lumbar sympatectomies by ethyl alcohol
      with a control by computer tomography in surgically unsolved disorders in the
      passage through lower extremity arteries. In four fifths of the patients there
      was an increase in ischaemia manifestations, in one fifth there was no
      improvement. No substantial difference was found between the results of
      sympatectomy in diabetic and nondiabetic patients. The method should be applied
      sooner than a cutaneous ischaemic defect develops.

PMID- 2225226
TI  - [Microdosimetry characteristics of ionizing radiation in the nanometer range].
AB  - A calculation method of microdosimetrical quantities epsilon D and yD using the
      proximity function t(x) of the delta rays of an incidental radiation is
      introduced. In comparison with classical Monte-Carlo calculation, the presented
      method is simpler and faster. Therefore there is the possibility to calculate
      effectively the microdosimetrical quantities in a large scale of the dimension of
      the volumes from 10(-9) to 10(-6) m and for various energy spectra of ionizing
      particles of a different kind. The presented method was verified low energy
      electrons and X-ray. Our results are in good agreement with published data.

PMID- 2225227
TI  - Oxygen radicals in intestinal ischemia and reperfusion.
AB  - Intestinal ischemia, however, caused, is still a serious and growing clinical
      problem with an unacceptable mortality rate of over 60%. This high mortality rate
      is mainly due to the fact that the patients are not admitted to the hospital or
      not treated early enough. Even if the patients are operated on within 24 h, their
      mortality rate is still over 50%, and those surviving the initial treatment
      suffer from postischemic complications. These damages have been accounted until
      now to tissue ischemia. It has been proven experimentally that also reperfusion
      or revascularization after time-limited ischemia add to the tissue damages
      observed, due to the formation of O2-radicals. Thereby the prerequisites for the
      production of these radicals (the conversion of xanthine dehydrogenase to
      xanthine oxidase and the increase of hypoxanthine concentrations in the tissue
      and plasma) are generated during tissue ischemia. These radicals damage directly
      or initiate several vicious circles leading to mucosal lesions, impaired
      intestinal function and an enhanced absorption of bacteria and endotoxin. Various
      substances (SOD, catalase, DMSO, allopurinol, deferoxamine etc.) detoxify oxygen
      radicals or inhibit the pathomechanisms leading to the enhanced radical
      generation. Hopefully, the combination of early revascularization with these
      already available scavengers will improve the high mortality and morbidity of
      patients suffering from intestinal ischemia.

PMID- 2225228
TI  - Effects of 1-ethynylpyrene and related inhibitors of P450 isozymes upon
      benzo[a]pyrene metabolism by liver microsomes.
AB  - The effects of three aryl acetylenes, 1-ethynylpyrene (EP), 2-ethynylnaphthalene
      (EN) and 3-ethynylperylene (EPE), upon the metabolism of benzo[a]pyrene (BaP) by
      microsomes isolated from rat liver were investigated. These aryl acetylenes all
      inhibited the total metabolism of BaP. Formation of BaP 7,8-dihydrodiol and BaP
      tetrol products by microsomal preparations from rats that had been pretreated
      with 3-methylcholanthrene (3MC) were preferentially inhibited. The effects of EP
      upon the metabolism of BaP 7,8-dihydrodiol by microsomes from rat liver were also
      studied. This aryl acetylene strongly inhibited the formation of BaP tetrols from
      BaP 7,8-dihydrodiol by liver microsomes both from untreated rats and from rats
      pretreated with 3MC, but enhanced the conversion of the BaP dihydrodiol into
      other metabolites.

PMID- 2225229
TI  - The oxidation of the highly tumorigenic benz[a]anthracene 3,4-dihydrodiol by rat
      liver dihydrodiol dehydrogenase.
AB  - Rat liver dihydrodiol dehydrogenase (DDH, EC 1.3.1.20) has been shown to reduce
      the mutagenicity of benz[a]anthracene (BA) in the bacterial Ames test. BA-3,4
      dihydrodiol is a highly mutagenic and tumorigenic metabolite of BA. In order to
      test the hypothesis that this dihydrodiol may be a substrate of DDH, we
      established two novel assay systems for the NADP(+)-dependent oxidation of BA-3,4
      dihydrodiol by rat liver DDH, an HPLC-based assay procedure and a radiometric
      assay with specifically labelled [3,4-3H]-BA-3,4-dihydrodiol as substrate. With
      the HPLC-based assay, the kinetic constants of the enzymatic catalysis were as
      follows: Km(app) = 21 microM for BA-3,4-dihydrodiol and Vmax = 20.0 nmol/min.mg
      enzyme. The reaction product was identified by cochromatography, fluorimetry and
      mass spectroscopy as BA-3,4-catechol, but interconversions between the catechol
      and the corresponding o-quinone during the analytical procedures were detected.
      With the radiolabelled substrate, a linear relationship between substrate
      concentration and reaction velocity was found. The V/K value for labelled
      substrate was 0.155 ml/min.mg enzyme and a (V/K)H/(V/K)T kinetic isotope effect
      of 6.7 was observed. The non-labelled substrate acted as a competitive inhibitor
      of the enzymatic oxidation of tritiated BA-3,4-dihydrodiol with a Ki value of
      56.4 microM. The reaction rates determined in this study suggest an important
      role of DDH activity in the metabolism of BA.

PMID- 2225230
TI  - Quinone imine-induced Ca2+ release from isolated rat liver mitochondria.
AB  - Incubation of Ca2(+)-loaded rat liver mitochondria with N-acetyl-p-benzoquinone
      imine (NAPQI) or its two dimethylated analogues resulted in a concentration
      dependent Ca2+ release, with the following order of potency: 2,6-(Me)2-NAPQI
      greater than NAPQI greater than 3,5-(Me)2-NAPQI. The quinone imine-induced Ca2+
      release was associated with NAD(P)H oxidation and was prevented when NAD(P)+
      reduction was stimulated by the addition of 3-hydroxybutyrate. Mitochondrial
      glutathione was completely depleted within 0.5 min by all three quinone imines,
      even at low concentrations that did not result in Ca2+ release. Depletion of
      mitochondrial GSH by pretreatment with 1-chloro-2,4-dinitrobenzene enhanced
      quinone imine-induced NAD(P)H oxidation and Ca2+ release. However, 3
      hydroxybutyrate protected from quinone imine-induced Ca2+ release in GSH-depleted
      mitochondria. Mitochondrial membrane potential was lost after the addition of
      quinone imines at concentrations that caused rapid Ca2+ release; however,
      subsequent addition of EGTA led to the complete recovery of the transmembrane
      potential. In the absence of Ca2+, the quinone imines caused only a small and
      transient loss of the transmembrane potential. Taken together, our results
      suggests that the quinone imine-induced Ca2+ release from mitochondria is a
      consequence of NAD(P)H oxidation rather than GSH depletion, GSSG formation, or
      mitochondrial inner membrane damage.

PMID- 2225231
TI  - Differences in sequence selectivity of DNA alkylation by isomeric intercalating
      aniline mustards.
AB  - Two DNA-targeted mustard derivatives, N,N-bis(2-chloroethyl)-4-(5-[9
      acridinylamino]-pentamido)aniline and 4-(9-[acridinylamino]butyl 4-(N,N-bis[2
      chloroethyl]-aminobenzamide, which are isomeric compounds where the mustard is
      linked to the DNA-binding 9-aminoacridine moiety by either a -CONH- or a -NHCO-
      group, show significant differences in the sequence selectivity of their
      alkylation of DNA. The CONH isomer is a more efficient alxylating agent than the
      NHCO compound by an order of magnitude, consistent with the larger electron
      release of the CONH group to the aniline ring. However, the pattern of alkylation
      by the two compounds is also very different, with the CONH isomer preferring
      alkylation of guanines adjacent to 3'- or 5'-adenines and cytosines (for example
      those in sequences 5'-CGC, 5'-AGC, 5'-CGG and 5'-AGA) while the isomeric NHCO
      compound shows preference for guanines in runs of Gs. In addition, both isomers
      alkylate 3'-adenines in runs of adenines. Both compounds also show completely
      different patterns of alkylation to their untargeted mustard counterparts, since
      4-MeCONH-aniline mustard alkylates all guanines and adenines in runs of adenines,
      while 4-Me2NCO-aniline mustard fails to alkylate DNA at all. These differences in
      alkylation patterns between the CONH- and its isomeric NHCO- compounds and their
      relationships between the alkylation patterns of the isomers and their biological
      activities are discussed.

PMID- 2225232
TI  - Renal proximal tubular cells in suspension or in primary culture as in vitro
      models to study nephrotoxicity.
AB  - The kidney forms a frequent target for xenobiotic toxicity. The complex
      biochemical mechanisms underlying nephrotoxicity are best studied in vitro
      provided that reliable and relevant in vitro models are available. Since most
      nephrotoxicants affect primarily the cells of the proximal tubules (PTC), much
      effort has been directed towards the development of in vitro models of PTC. This
      review focuses on the preparation of PTC and the use of these cells. Discussed
      are important criteria such as the viability (survival time) of the cells and the
      parameters to assess toxicity. Recent studies have shown that isolated PTC in
      suspension are especially suitable for studies on the biochemical mechanisms of
      'acute' nephrotoxicity, whereas PTC in primary culture may be used to investigate
      mechanisms of nephrotoxic damage at very low concentrations, upon prolonged
      exposure. PTC cultured on porous filter membranes provide new possibilities to
      study toxicity in relation to cell and transport polarity. Primary cell cultures
      of human PTC have been set up. Although a further characterization of these
      systems is needed, recent data indicate their usefulness.

PMID- 2225233
TI  - Thiol antidotes effect on lipid peroxidation in mercury-poisoned rats.
AB  - The effect of thiol antidotes 2,3-dimercapto-1-propanesulfonic acid (DMPS) and D
      penicillamine (PA) on lipid peroxidation and on activities of some protecting
      enzymes in blood, liver and kidneys of mercury-poisoned rats has been studied. It
      has been found that Hg-poisoning is associated with increased lipid peroxidation
      in the liver and in the kidneys and with inactivation of superoxide dismutase
      (SOD) and catalase. Inhibition of SOD is caused by thiols treatment too, but in
      this case acceleration of lipid peroxidation has not been observed. Evidence is
      presented that in the liver, protection against mercury-induced lipid
      peroxidation is afforded by both thiols, while in the kidneys only PA has
      protective effect. In in vitro experiments it has been demonstrated that both
      antidotes can act as O2- scavengers and lipid peroxidation inhibitors, but PA is
      significantly more effective. On the basis of the obtained results a conclusion
      is drawn that in addition to the metal-removing ability, the antioxidant
      properties of the chelating agents may play an important role in manifestation of
      their beneficial effect in metal intoxications.

PMID- 2225234
TI  - Schedule dependence of buthionine sulfoximine in reversing resistance to
      cisplatin.
AB  - We have found that the potentiation of antiproliferative effects by buthionine
      sulfoximine (BSO) of cell growth inhibition induced by cisplatin are highly
      schedule dependent in resistant BE colon carcinoma cells. Maintenance of low GSH
      levels during the 12-h interval after cisplatin (cis-DDP) treatment is critical.
      A schedule of BSO exposure that results in low GSH levels for 12 h after
      cisplatin exposure is associated with a marked increase in DNA interstrand cross
      link formation as analyzed by alkaline elution. These findings are consistent
      with a central role of GSH in interfering with the conversion of cis-DDP DNA
      monoadducts to DNA interstrand cross-links and may prove relevant to the design
      of clinical trials of BSO with cisplatin.

PMID- 2225235
TI  - Acute and long-term effects of carbon tetrachloride on DNA modifications (I
      compounds) in male mouse liver.
AB  - I-compounds are recently discovered species and tissue dependent covalent DNA
      modifications which are detectable by the 32P-postlabeling assay for DNA adducts
      and tend to increase with the animal's age. The effects of the hepatocarcinogen
      carbon tetrachloride (CCl4) on hepatic I-compounds were studied in 10-12-month
      old male ICR mice using the 32P-postlabeling assay. CCl4 was dissolved in corn
      oil (20%, v/v) and intraperitoneally (i.p.) injected in doses of 0.75 ml/kg
      (0.375 ml/100 g body weight, 20% CCl4 in corn oil) while control mice received
      corn oil only (0.375 ml/100 g body wt). Twenty-four h after a single injection of
      CCl4, the intensity of non-polar I-spots in liver DNA was significantly increased
      as compared with corn oil treated controls, while the level of one polar I
      compound was reduced at 24 h. DNA synthesis (as indicated by [3H]thymidine
      incorporation) was not significantly affected at 24 h after a single dose of
      CCl4. To study the long-term effects of CCl4, five groups of mice were given two
      consecutive weekly injections of 0.75 ml/kg CCl4 (as above) and were sacrificed
      1, 4, 8, 12 and 22 weeks after the second treatment. In these groups the total
      liver I-compound levels were reduced to 17.3-49.0% compared with corresponding
      controls. The maximum decline was observed at 4 weeks (17.3% of control).
      Comparison of thymidine incorporation showed no significant increase between
      control and treated liver DNAs at 1, 4 and 8 weeks after CCl4, suggesting that
      the decrease in I-compound levels was probably not a secondary effect of
      increased DNA synthesis during postnecrotic proliferation. Even though there was
      a trend of recovery between 8 and 22 weeks, I-compound levels still remained
      significantly lower at 22 weeks (49.0%). Since I-compounds appear to be normal
      DNA modifications, the results suggest that persistent reduction of I-compound
      levels contributes to the hepatocarcinogenic effect of CCl4.

PMID- 2225236
TI  - Magnetic alignment and orientational order of dipalmitoylphosphatidylcholine
      bilayers containing palmitoyllysophosphatidylcholine.
AB  - Mixed bilayers of 1-palmitoyl-sn-glycero-3-phosphocholine
      (palmitoyllysophosphatidylcholine; PaLPC) and 1,2-dipalmitoyl-sn-glycero-3
      phosphocholine (dipalmitoyl phosphatidylcholine; DPPC) have been investigated by
      2H-NMR and 31P-NMR spectroscopy. Binary phospholipid mixtures were studied in
      which the acyl chains of one or the other component were perdeuterated. At
      temperatures below the main order-disorder phase transition, the mixed PaLPC/DPPC
      bilayers appear to coexist with PaLPC micelles. The micelles disappear at
      temperatures above the phase transition, where mixed bilayers in the liquid
      crystalline state are formed. The orientational order of the alkyl chains of the
      PaLPC component is essentially identical to that of the DPPC component in the
      mixed bilayers, both in the low temperature and liquid-crystalline phases.
      However, the presence of PaLPC perturbs the segmental ordering of DPPC as
      compared to the pure system. The order is increased in the low-temperature phase,
      where effective diffusion of the chains about their long axes occurs, but is
      decreased in the liquid-crystalline phase compared to pure DPPC bilayers. The
      mixed liquid-crystalline bilayers orient preferentially with their director axes
      perpendicular to the magnetic field. This alignment is easily observed in 31P-
      and 2H-NMR spectra, where the intensity of the perpendicular edges of the
      lineshapes is pronounced. One possible explanation of the magnetic alignment
      involves alteration of the curvature free energy of the DPPC bilayer due to
      incorporation of PaLPC in the mixed membranes.

PMID- 2225237
TI  - Mass spectrometric analysis of O-peracetylated derivatives of 1
      monomycoloylglycerol isolated from Corynebacterium pseudotuberculosis,
      Rhodococcus rhodochrous and R. lentifragmentus.
AB  - 1-Monomycoloylglycerols from Corynebacterium pseudotuberculosis, Rhodococcus
      rhodochrous and R. lentifragmentus were reacted with acetic acid ahydride in the
      presence of pyridine. On infrared spectra the reaction products showed a sharp
      characteristic absorption of the acetyl ester group at 1235 cm-1; the hydroxyl
      group absorption (3400 cm-1) was absent. O-Peracetylated monomycoloylglycerols
      were analyzed by mass spectrometry under electron impact mode. The most common
      and representative peaks were associated to the following remarkable fragments:
      (a) peak at m/z 159 represented the backbone of the glycerol unit of
      peracetylated monomycoloylglycerols; it constituted the diagnostic and base peak
      of that group of compounds; (b) peak representing the glycerol moiety together
      with the alpha-subunit of the mycolic acid moiety; it gave the size of the chain
      length of the hydrocarbon side chain of that mycolic acid; and (c) a series of
      peaks of acylium ions minus 60 mass units (acetic acid) indicated the size of the
      chain length of the esterified mycolic acid. Therefore, acetylation of
      monomycoloylglycerol becomes the derivatized compound suitable for mass
      spectrometry. Moreover, the derivatives are more thermostable and resistant to
      pyrolysis. By associating these properties, separation and identification of
      homologs of monomycoloylglycerols are further expected.

PMID- 2225239
TI  - Nursing research is not progressing.

PMID- 2225240
TI  - The health needs of the black elderly population in certain areas of rural and
      urban Kwazulu.
AB  - The health needs of Black elderly in rural and urban KwaZulu was investigated
      through a survey. Interviews with 240 elderly was done, looking at the first and
      second level of the health facilities plan, as well as social support and health
      indicators. It was found that urban elderly are generally better off than rural
      elderly and a profile of need is described.

PMID- 2225238
TI  - Influence of alkali metal cations on the transport of calcium by phosphatidate in
      multi-phase systems.
AB  - The effects of alkali metal cations on the rates at which Ca2+ and phosphatidic
      acid were cotransported from aqueous to hydrocarbon medium were examined. The
      alkali metal cations remained in the aqueous phase yet specifically influenced
      the transport of Ca2+ into the hydrocarbon solvent. For the physiological
      cations, Na+ and K+, there were critical concentration ranges in which small
      changes in concentration effected sharp changes in transport rates. The maximal
      rate observed with Na+ was an order of magnitude greater than that with K+;
      however, unlike Na+, K+ promoted low levels of transport below the critical
      concentration range. Li+ effected only low levels of transport even at high
      concentrations, whereas Rb+ and Cs+ induced transport at rates proportional to
      their concentrations. These results are discussed in terms of a classical
      ionophore model for the complex composed of a neutral phosphatidic acid dimer
      bridged by Ca2+.

PMID- 2225241
TI  - Standards for the nursing care of the frail aged.
AB  - In this project standards for the nursing care of the institutional care of the
      frail aged were formulated and then validated by groups of nurses. An instrument
      was then designed to measure to what extent these standards are reached. The
      instrument was then tested for reliability and validity in a sample of 12
      institutions in the Eastern Cape and Natal.

PMID- 2225243
TI  - The quality of nursing care of the frail aged in selected institutions in eastern
      Cape and Natal.
AB  - An investigation was undertaken to establish standards for the care of the frail
      aged and to develop an instrument to measure this care. In this process the care
      in 12 institutions was monitored. In general, the care was found to be of good
      quality, with an average of 74.3%, but there are residences where the percentage
      is up to 10% lower. The influence of some internal and external factors on the
      quality of care were investigated.

PMID- 2225242
TI  - The combating of tuberculosis: health perceptions, intentions and vaccination of
      children.
AB  - This study was part of a comprehensive research project undertaken at the request
      of the SANTA Health Education Committee to evaluate the tuberculosis guidance
      programme. The aim of the research was to examine factors influencing black
      people's health perceptions and intentions concerning the combating of
      tuberculosis as well as vaccination of their children. Data were collected by
      means of a questionnaire based on the Health Belief Model. The research was
      conducted in selected areas of the OFS, the Transvaal and Natal (N = 1,198). It
      was found that factors indicating a greater degree of development of the
      individual (e.g. literacy) were positively associated with positive health
      perceptions such as that medical treatment can cure TB completely. Some positive
      associations were also found between perceptions/modifying factors and
      intentions/vaccination. Indications were also found of an inability on the part
      of health personnel to influence the public positively.

PMID- 2225244
TI  - The role of the nursing staff in promoting the development of preterm infants
      through their contribution to mother-infant interaction.
AB  - Preterm birth constitutes a potential risk factor for infant development. There
      is evidence that parental sensitivity and responsivity can compensate for
      biological risk. Since the birth of a preterm infant often constitutes a crisis
      for parents, they may be impaired in their ability to relate appropriately to
      their infants. The nursing staff can play a vital role in enhancing the
      interaction between parents (in particular mothers) and their preterm infants,
      thereby indirectly promoting optimal infant development. This paper describes the
      psychological tasks faced by mothers of preterm infants, parents' experiences of
      preterm birth and suggestions as to what the nursing staff can do to facilitate
      healthy relationships between parents and their preterm infants, thereby
      preventing possible pathological development.

PMID- 2225245
TI  - [A study of job satisfaction of nurses of the RSA (South Africa Nurses'
      Association)].
AB  - The purpose of this study was to determine whether changes had occurred in the
      work satisfaction of nursing services after the establishment of private
      initiative in health care due to the deregulation program currently conducted by
      the government. In a survey conducted in the latter part of 1988 700
      questionnaires were sent out of which 213 were returned which gives a response of
      30.43 percent. The analysis was based on this data. The attitudes of the members
      of the nursing services ranged from antipathy to lively enthusiasm. It was,
      however, clear from the response that there exists a strong negative view amongst
      the nursing profession regarding remuneration, communication, training and
      promotion. These are tendencies that can harm the profession as a whole on the
      long run and should therefore receive special managerial attention.
      Recommendations include market related remuneration, continued nursing training,
      and planned career paths, as well as an appeal that only minimum admission
      requirements should be accepted as preconditions to training in order to cope
      with the growing Third World demands on health care services.

PMID- 2225246
TI  - The experience of black parents/caretakers with the births and care of a child
      with profound congenital defects.
AB  - The reaction of Black families to the birth and care of a baby with profound
      congenital defects was researched using twenty case studies. It was found that
      the families went through stages of the grieving process, that they shifted from
      the Western/Christian viewpoint to the traditional viewpoint in their struggle to
      cope and that they find the existing services grossly inadequate.

PMID- 2225247
TI  - Dealing with a patient with a profound congenital defect.

PMID- 2225248
TI  - Teaching caring in nursing: a needs assessment.
AB  - Despite the fact that caring is the heart of nursing, there is growing evidence
      that nurses are not as effective as they ought to be in their caring role. This
      signifies that more attention needs to be given to the teaching of caring. The
      aim of this study was to pave the way to initiate the process of research on
      teaching caring, by suggesting priority areas. The needs assessment design was
      used for the study. Five steps were involved to achieve the aims. The first was
      to explore the nature and meaning of caring as presented in the literature. The
      second was to review completed research on aspects of caring within the nursing
      context. The third was to investigate the position of caring in the present
      nursing education system. The fourth was to investigate ways of promoting the
      teaching of caring as advocated in the literature and the final step based on
      inferences made from the first four steps was to suggest priority areas for
      research on teaching caring in nursing.

PMID- 2225249
TI  - [Standards of patient education for nursing practice in general hospitals].
AB  - A lack of patient education standards was identified and the researchers
      attempted in this study to develop standards for patient education. An instrument
      for the evaluation of patient knowledge was also developed.

PMID- 2225250
TI  - [Standards for making a community diagnosis].
AB  - Standards for the making of a community diagnosis were formulated and validated
      on a national basis. These standards can be utilised by the community health
      nurse to improve the quality of community diagnoses. The quality of community
      diagnosis by community health nurses, was analysed by means of a retrospective
      audit. Incomplete diagnosis were observed in the compilation of a community
      profile and data resources were inadequately utilised. Important health
      indicators were not taken into account during the interpretation of data and
      planning strategies were incomplete. It appears as if the community health nurse
      tends to pay more attention to data that is readily available or can be utilised
      for quick results in his/her community planning.

PMID- 2225251
TI  - [Our experience with Yag laser in the treatment of secondary cataract].
AB  - The authors report 168 cases of opacification of posterior capsule treated by Yag
      laser capsulotomy. They describe the operating technique, the results, the
      complications and the indications.

PMID- 2225252
TI  - [Retinal detachment in patients with pseudophakia].
AB  - 49 eyes with pseudophakic retinal detachments are operated with 44 good anatomic
      results (90% success). These detachments are characterised by the high frequency
      of anterior proliferative vitreoretinopathy.

PMID- 2225253
TI  - [MALT conjunctival lymphoma: how to treat?].
AB  - A case of conjunctival lymphoma belonging to the MALT tissue is reported hereby.
      It is very uncommon in the literature, but special tools are needed to recognize
      this conjunctival involvement: Frozen sections of tissue to perform
      immunocytochemical studies. Investigations of the other lymphoid tissue, to
      assess the localized feature of the conjunctival disease.

PMID- 2225254
TI  - [Neonatal dacryocystitis. A case report].
AB  - The authors report one case of neonatal dacryocystitis. They consider the
      diagnostic and therapeutic problems. One surgical intervention, with a large
      orifice of the lacrimal meatus, upon the catheter, with rhinoscopy, seems them
      the best solution, in this precise case.

PMID- 2225255
TI  - [Poisoning of retinal pigment epithelium by deferoxamine. A case report].
AB  - A patient undergoing hemodialysis was treated intravenously with desferrioxamine
      (3 g) for an aluminum encephalopathy. He presented a sudden xanthopsia with
      visual loss. Fundus examination showed diffuse macular irregular pigmentary
      disturbances. We discuss current knowledge and possible pathogenesis of these
      observations published since 1983. Awareness of the side effects of
      desferrioxamine implies an ophthalmologic follow up similar as chloroquine.

PMID- 2225256
TI  - [Uncommon site of retinal periphlebitis in a case of multiple sclerosis].
AB  - The authors study an observation of unusual localisation, near the optic disc, of
      periphlebitis associated to multilocular sclerosis. There are some cicatricial
      periphlebitis and active others, which are more peripheral, alone without any
      uveitis. These ones resolved in two months with cortisone treatment.

PMID- 2225257
TI  - [Intravitreous hemorrhage caused by retinal tear with a bridge vessel. Discussion
      on management of 4 cases].
AB  - The authors report 4 cases of recurrent vitreous hemorrhage related to retinal
      breaks without detachment, bridged by a retinal vessel. Clinical and evolutive
      features of this type of breaks are emphasized according to a review of available
      literature. Fluoroscopic evaluation of vascular permeability appears as a
      promising prognostic tool. Management should be directed to the prevention of
      both retinal detachment and vitreous hemorrhage recurrence. Cryoapplication and
      scleral buckling is far more effective than photocoagulation.

PMID- 2225258
TI  - [Corneal transplantation and histocompatibility of the HLA system].
AB  - The HLA antigens appear to be involved in the rejection of corneal allografts. A
      relationship exist between HLA compatibility and the corneal rejection-free
      transplant survival. Eleven corneal transplants are performed on the basis of the
      best available HLA A and B match. Rejection-free transplant in this group is
      compared to a control group. The estimate rejection-free survival is 82%.

PMID- 2225259
TI  - [Oculorespiratory reflex].
AB  - The lack of interest about oculorespiratory reflex (ORR) in surgery and
      experimental studies is obvious. However the authors insist on the importance of
      its clinical traduction. The purpose of this study is to determinate an
      experimental model with titration of stimulus (pressure or traction) and
      therapeutic test. Our first Results prove the clinic entity of O.R.R. In first
      conclusion, we can insist on the importance of ventilatory assistance during
      squint surgery and on the monitoring of PE CO2 and Sa O2.

PMID- 2225260
TI  - [Epidemiologic aspects of acute anterior optic neuropathies].
AB  - The authors report 34 cases of anterior ischemic optic neuropathy, in 31 patients
      with one complete etiological examination. The modes of revelation, the symptoms
      and the results of the etiological inquest are related.

PMID- 2225262
TI  - [A new anesthetic protocol in experimental ocular surgery in rabbits].
AB  - The authors describe a new anaesthetic protocol for laboratory rabbits. The
      surgery consists in an extracapsular lens extraction with intraocular lens
      implantation in the bag. The anaesthetic protocol requires: an intravenous
      induction with ketamine (20.2 mg/kg +/- 5) and midazolam (0.65 mg/kg +/- 0.3) and
      after an oral endotracheal intubation with a simple method, and at last
      maintaining halothane anaesthesia with a concentration between 3 and 4%. 45
      anaesthesia were performed: the average time of the anaesthesia was 77 min +/-
      16. No rabbit died because of this anaesthesia. The anaesthesia was a success for
      the surgeon who could operate in the best working conditions.

PMID- 2225261
TI  - [Intraocular penetration of topical norfloxacin in humans. Preliminary study].
AB  - The aim of this bicentric study was to assess the intraocular penetration of
      topical Norfloxacin. Herein, are only reported the results from one center.
      Topically applied Norfloxacin 0.3% was given to patients who underwent cataract
      surgery. The first group received 5 drops between 7.55 A.M. to 8 A.M. and after
      each hour until cataract surgery. The second one received one drop each quarter
      from 7 A.M. until the surgery. Aqueous and sera samples were dosed using HPLC. In
      the first group, the aqueous average was 0.066 mg/l and 0.112 mg/l in the second
      group. Using a T test and Mann Whitney test, we could not find a significant
      difference between the two groups.

PMID- 2225263
TI  - [Chorioretinal coloboma and neovascular membrane].
AB  - Retinochoroidal coloboma results from an incomplete closure of the ocular
      embryonic fissure. Uni or bilateral, the coloboma can be associated with
      cataract, microphthalmia, retinal detachment... but rarely with
      neovascularization. This association is comparable with subretinal
      neovascularization in high myopia, angioid streaks, choroiditis and choroidal
      ruptures. The disruption of the normal anatomy of the Bruch's membrane is a
      possible entry site of choroidal blood vessels. But the reason why only rare
      cases are reported is unknown.

PMID- 2225264
TI  - [Pyocyanic corneal abscess].
AB  - The authors report 3 different cases of pseudomonas abscess of the corneal
      layers: these occurred; one on a soft lens; the second one apparently without any
      reason; the last one 2 days after a corneal traumatism. In spite of rapidly
      administrated antibiotherapy, the abscess spread very rapidly and left a residual
      corneal macula.

PMID- 2225265
TI  - [Bacteriologic examination of the conjunctiva immediately prior to surgery].

PMID- 2225266
TI  - [Iatrogenic pigmentary glaucoma after implantation (Iogel)].

PMID- 2225267
TI  - [Functional outcome of advanced chronic glaucoma after trabeculectomy].
AB  - We studied the risk of sudden loss of visual fields after trabeculectomy on 17
      eyes with primary open angle glaucoma and small residual visual fields. We think
      that it is possible to try to these patients filtering procedures with
      precautions before and during surgery.

PMID- 2225268
TI  - [Preoperative biometry. Statistics and conclusions. Report of 330 artificial lens
      implantations].

PMID- 2225270
TI  - [Keratoscopy in cataract surgery].
AB  - The peroperative keratoscopy is a subjective method with approximates results
      (error of 30% on medium power of astigmatisme postoperative). Its advantages with
      regard to peroperative keratometry are its simplicity, quickness, non-expansivity
      and efficiency.

PMID- 2225269
TI  - [Uselessness of electroretinogram for detecting retinal poisoning by synthetic
      antimalarials].
AB  - Authors present two cases of typical macular "bull's eyes" other APS treatment
      with subnormal electric answer. They evocate the poor sensibility of the
      different methods used to detect and follow these patients and propose a more
      sensible, easier and test accepted test: static perimetry within the 12 central
      degrees, once or twice a year.

PMID- 2225272
TI  - [Subretinal neovessels in diffuse retinal epitheliopathy].

PMID- 2225271
TI  - [Macular manifestations of acute lymphoblastic leukemia. A case report].
AB  - The authors report a case of ocular involvement by acute lymphoblastic leukemia,
      in a young woman. The initial symptom was a bilateral diminution of visual
      acuity. The examination revealed a bilateral aspect of serous detachment of neuro
      epithelium. A literature review of macular manifestations of leukosis is
      envisaged.

PMID- 2225273
TI  - [Contrast sensitivity].

PMID- 2225274
TI  - [Basedow's neuropathy].
AB  - A case report of grave's neuropathy. The symptoms appeared in a treated patient
      when there was a biologic hypothyroidy. A total remission was observed after
      corticotherapy. Nevertheless, a recurrence of disease happened for reduced doses,
      so an orbital radiotherapy was requisited. Student of differents treatments for
      dysthyroid neuropathy.

PMID- 2225275
TI  - [Optic disk drusen and intracranial tumor].
AB  - A fifty-one year old woman with a Lindau sickness presented bilateral optic disc
      swelling and peripapillary haemorrhage. Intracranial hypertension was suspected.
      Perimetry, echography and fluorescein fundus angiography revealed optic disc
      drusen.

PMID- 2225276
TI  - [Pachymetry in radial keratotomy].

PMID- 2225277
TI  - [Automatic perimetry. The myth and reality].

PMID- 2225278
TI  - [Visual aids using hypernegative artificial lens in age-related macular
      degeneration].

PMID- 2225280
TI  - [10 years' evaluation of systematic refraction under cycloplegia in children from
      6 months to 3 years of age].

PMID- 2225279
TI  - [Use of collagen lenses].

PMID- 2225281
TI  - DNA analysis of periampullary cancers.
AB  - The nuclear DNA content in 71 cases of periampullary cancer (27, cancer of the
      head of the pancreas (Ph); 24, cancer of the ampulla of Vater (A); and 20, cancer
      of the inferior common bile duct (Bi] was measured cytofluorometrically using the
      archival paraffin-embedded specimens of the primary lesions. They were analyzed
      in relation to prognosis, tumor size, histological differentiation, lymph node
      metastasis, lymphatic invasion, venous invasion, perineural invasion, and growth
      pattern. The results show that "Ph" has more unfavorable prognosis compared with
      the other two and it has more DNA content under the same conditions such as tumor
      from 2.1 to 4 cm in its greatest dimension, well differentiated adenocarcinoma,
      with or without lymph node metastasis, with or without venous invasion, with
      lymphatic invasion, with perineural invasion, and in the intermediate growth
      pattern between expansive and infiltrative. In conclusion, this study
      demonstrates a close correlation between the DNA content and prognosis and the
      significant clinical value of DNA analysis for predicting the prognosis in
      patients of periampullary cancer.

PMID- 2225282
TI  - Comparison of arteriosclerosis obliterans of lower limbs between China and Japan.
AB  - Clinical data on 50 patients with arteriosclerosis obliterans (ASO) in China
      (Group A) and Japan (Group B) respectively were studied for better understanding
      of these changing trends. The results showed that the incidence of ASO peaked in
      Group A in the 50 to 69 age range (88%) and in Group B in the 55 to 74 age range
      (78%). Group A had a lower ratio of smokers and cases of diabetes mellitus than
      Group B but a higher ratio of hypertension and a higher total cholesterol level.
      Angiography showed that the prevalence of atherosclerotic lesions in the lower
      extremities as a whole was similar for both groups. They were different in
      location, extent and severity of the arteries involved between the two groups. We
      believe that this study has shown various differences between the two groups but
      that the causes are probably multifactorial.

PMID- 2225283
TI  - Squamous cell carcinoma antigen in oral squamous cell carcinomas.
AB  - Squamous cell carcinoma (SCC) antigen is a tumor-associated antigen isolated from
      the squamous cell carcinoma of the uterine cervix. In order to estimate the
      usefulness of the SCC antigen in monitoring the clinical behaviors of oral
      squamous cell carcinomas, we analyzed clinicopathologically and
      immunohistochemically 54 cases of squamous cell carcinoma of the oral cavity.
      Elevated serum SCC antigen levels were detected in 23 (42.6%) out of 54 oral
      squamous cell carcinomas. The positive rate of serum SCC antigen levels was
      significantly higher in the patients with advanced clinical stages and poorly
      differentiated carcinoma. The serum levels declined rapidly after the surgical
      operation. It is considered that the serum SCC antigen levels could be useful in
      monitoring the extension, effectiveness of therapy, recurrence and metastases of
      the oral squamous cell carcinomas. Immunohistochemically, strong staining was
      seen in the cytoplasm of the well-differentiated carcinoma cells.

PMID- 2225284
TI  - Ultrastructural study on effects of cisplatin on VX2 carcinoma cells.
AB  - The effects of intraarterial chemotherapy with cisplatin on rabbit VX2 carcinoma
      transplanted to the hind legs of animals were studied. Following intraarterial
      (IA) or intravenous (IV) administration of cisplatin (2.5 mg/kg), changes in the
      tumor cells were examined electron microscopically. The treated cells showed
      enlargement with decrease in the amount of nuclear chromatin and prominent
      nucleolar segregation. In many cells, the cytoplasmic organelles had migrated to
      the paranuclear area. The most striking change was the appearance of numerous
      microvilli-like cytoplasmic projections. Multinucleated giant cells were also
      observed. The changes were more prominent following IA cisplatin. The author
      concludes that significant ultrastructural changes can be demonstrated by the
      regional administration of cisplatin in rabbit VX2 carcinoma and that these
      promising results should be followed by clinical trials.

PMID- 2225285
TI  - Autologous blood transfusion in orthopedic and oral surgical patients.
AB  - The procedure for autologous blood transfusion in the orthopedic and oral
      surgical patients in our university hospital is described. The collection of
      blood was begun from 3 weeks prior to the scheduled surgery. Each time 200 or 400
      ml were collected, making three collections possible. The collected blood was
      stored in liquid form up to the day of the operation and returned to the same
      patient. Without any difficulty, 600-1200 ml of blood were collected from many
      patients. All patients were prescribed an oral iron supplement (200 mg/day). No
      significant decrease in the serum iron and ferritin levels after two or three
      collections was observed. Eighty-nine percent of the orthopedic patients and 87%
      of the oral surgical patients were transfused only with autologous blood during
      the operation. Homologous blood transfusion was performed in the patients with
      more than 2,200 ml of blood loss. The autologous blood collection of 800 ml may
      be sufficient enough in at least 80% of these patients.

PMID- 2225286
TI  - Patient-controlled analgesia--does it provide more than comfort?

PMID- 2225287
TI  - Ropivacaine--a worthy replacement for bupivacaine?

PMID- 2225288
TI  - Reduction of postoperative morbidity following patient-controlled morphine.
AB  - The present study examined the impact of two methods of pain management on
      recovery in 38 women undergoing hysterectomy. One group received IV morphine in
      the recovery room and IM morphine on the ward on a PRN basis (PRN group). In the
      other group, a loading dose of morphine 8 mg IV was given when the patient first
      complained of pain and patient-controlled IV morphine (PCA) was initiated and
      continued for 48 h (PCA group). Both groups received similar amounts of morphine
      overall, differently distributed over time. The PCA patients received 8 mg.h-1 in
      the recovery room (approximately 2.5 hrs) and less thereafter. The PRN patients
      received approximately 2 mg.h-1 for the entire 48-hr period. Pain control was
      better throughout convalescence and less variable across time with PCA
      management. Minute ventilation also recovered faster and by day four was 25 per
      cent above the preoperative baseline in the PCA group. In addition, oral
      temperature became normal one day earlier, ambulation recovered more rapidly and
      patients were discharged from hospital earlier. The data suggest that early
      treatment with relatively high, self-titrated morphine doses may alter the course
      of the metabolic response to surgery.

PMID- 2225289
TI  - Brachial plexus block with a new local anaesthetic: 0.5 per cent ropivacaine.
AB  - A new local anaesthetic, ropivacaine hydrochloride, was used in a concentration
      of 0.5 per cent in 32 patients receiving a subclavian perivascular block for
      upper extremity surgery. One group (n = 15) received 0.5 per cent ropivacaine
      without epinephrine and a second group (n = 17) received 0.5 per cent ropivacaine
      with epinephrine in a concentration of 1:200,000. Anaesthesia was achieved in 87
      per cent of the patients in both groups in all of the C5 through T1 brachial
      plexus dermatomes. Motor block was profound with 100 per cent of patients in both
      groups developing paresis at both the shoulder and hand and 100 per cent
      developing paralysis at the shoulder. There was a rapid initial onset of sensory
      block (a mean of less than four minutes for analgesia) with a prolonged duration
      (a mean of greater than 13 hr of analgesia). The addition of epinephrine did not
      significantly affect the quality or onset of sensory or motor block. The duration
      of sensory block was reduced by epinephrine at T1 for analgesia and at C7, C8,
      and T1 for anaesthesia. The duration of sensory block in the remaining brachial
      plexus dermatomes as well as the duration of motor block was not effected by
      epinephrine. There was no evidence of cardiovascular or central nervous system
      toxicity in either group with a mean dose of 2.5-2.6 mg.kg-1 ropivacaine.

PMID- 2225290
TI  - Neurological phenomena during emergence from enflurane or isoflurane anaesthesia.
AB  - During emergence from anaesthesia, transient neurological signs that would
      usually be considered pathological may appear. The objective of this randomized,
      patient (n = 30) and observer-blinded study was to compare prospectively the
      incidence and duration of post-anaesthetic neurological abnormalities in healthy
      patients undergoing minor elective procedures following thiopentone and
      succinylcholine induction, and enflurane-N2O or isoflurane-N2O anaesthesia.
      Patients were studied for 60 min after anaesthesia. Arousal state, muscle tone,
      deep tendon reflexes, plantar reflex, sustained clonus, shivering, intense
      muscular spasticity and temperature were assessed. Results of neurological
      examination were correlated with the patient's state of arousal. Transient
      emergent neurological abnormalities occurred more frequently following enflurane
      N2O anaesthesia than isoflurane N2O anaesthesia. This was statistically
      significant (P less than 0.05) for quadriceps hyperreflexia, upgoing toes
      (positive Babinski reflex) and intense muscular spasticity. Neurological
      abnormalities occurred most commonly 5-20 min after anaesthesia and all
      abnormalities resolved within 60 min. Following enflurane anaesthesia, as
      patients became more alert the incidence of abnormalities declined, while the
      arousal state did not affect the incidence of abnormalities after isoflurane.
      There was no significant difference between axillary temperatures of those
      patients who shivered and those who did not. In conclusion, temporary emergent
      neurological abnormalities occurred more often following enflurane-N2O than after
      isoflurane-N2O anaesthesia.

PMID- 2225291
TI  - Hyperkalaemia during rapid blood transfusion and hypovolaemic cardiac arrest in
      children.
AB  - A morbidity and mortality review documented a high occurrence of hyperkalaemia in
      cardiac arrests associated with rapid blood transfusion, which resulted in
      further study. In order to stimulate events during rapid blood transfusion and
      cardiac arrest, the central circulation was modeled as a linear one compartment,
      and used to stimulate a child who suffered a hypovolaemic cardiac arrest and was
      resuscitated with rapid blood transfusion (RBT). The simulation suggested that
      the combination of RBT and a low cardiac output state could be associated with
      hyperkalaemia, if the potassium concentration in the plasma fraction of the
      transfused blood was greater than or equal to 10 mmol.L-1. In an associated
      clinical study the plasma potassium concentration during cardiac arrest was
      documented from a retrospective review of 138 cardiac arrests in a paediatric
      population. Patients were divided into two groups. The RBT-group received a rapid
      blood transfusion during resuscitation. The non-RBT group did not receive blood
      during resuscitation. During cardiac arrest the plasma [K] in the non-RBT group
      was 5.63 +/- 2.39 mmol.L-1 compared with 8.23 +/- 1.99 mmol.L-1 in the RBT-group
      (P less than 0.05). The hyperkalaemia during cardiac arrest in the RBT-group
      could be explained as a consequence of RBT to a hypovolaemic child with a low
      cardiac output.

PMID- 2225292
TI  - Alfentanil controls the haemodynamic response during rapid-sequence induction of
      anaesthesia.
AB  - Laryngoscopy and tracheal intubation often cause hypertension and tachycardia,
      which may be exaggerated during rapid-sequence induction of anaesthesia. A
      placebo-controlled, double-blind study was conducted in 60 patients to determine
      dose-response and effects on myocardial performance of alfentanil when used to
      attenuate this cardiovascular response. Patients were divided into four groups to
      receive a pre-induction bolus from a coded syringe, which contained either normal
      saline (PLAC), alfentanil 30 micrograms.kg-1 (ALF 30), alfentanil 45
      micrograms.kg-1 (ALF 45) or alfentanil 60 micrograms.kg-1 (ALF 60). Anaesthesia
      was induced in rapid sequence with thiopentone 4.0 mg.kg-1 and succinylcholine
      1.5 mg.kg-1, and the trachea was intubated 60 sec later. Increases in heart rate
      (21 +/- 10 bpm), mean arterial pressure (28 +/- 13 mmHg), and systemic vascular
      resistance index (1420 +/- 780 dynes.sec-1.cm-5) were observed in response to
      intubation with PLAC but in none of the 3 ALF groups (P less than 0.05). However,
      heart rate and mean arterial pressure decreased significantly in both the ALF 45
      and ALF 60 groups (P less than 0.05), whereas ALF 30 resulted in no change in
      these variables over time. Cardiac index, stroke volume index, and ejection
      fraction tended to decrease in all four groups, but none of these variables was
      different at corresponding time when comparing the ALF groups with PLAC.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2225295
TI  - Continuous suprascapular nerve block for analgesia of scapular fracture.
AB  - Fracture of the scapular is uncommon but painful. A case is described in which a
      comminuted scapular fracture was treated with a continuous suprascapular nerve
      block. With the patient lying supine an epidural needle was directed towards the
      scapular notch via a superior approach and an epidural catheter was placed when
      the notch was believed to have been identified. Repeat injections of 10 ml
      bupivacaine 0.25 per cent with 1/200,000 epinephrine provided analgesia within
      minutes and a duration of 8-10 hr. Injection of 10 ml radio-opaque dye
      demonstrated the catheter to be lateral to the scapular notch. However, dye
      dispersed throughout the supraspinous fossa including the scapular notch thus
      blocking the suprascapular nerve. This case demonstrates that continuous
      suprascapular nerve block can be performed for five days and that location of the
      scapular notch is less important than previously thought.

PMID- 2225293
TI  - Brain protection: physiological and pharmacological considerations. Part II: The
      pharmacology of brain protection.
AB  - Neuroprotective agents may exert their effect by reducing cerebral oxygen demand
      (CMRO2), increasing cerebral oxygen delivery, or by altering ongoing pathological
      processes. Barbiturates provide neuroprotection by reducing the CMRO2 necessary
      for synaptic transmission while leaving the component necessary for cellular
      metabolism intact. Isoflurane may exert a neuroprotective effect by a similar
      mechanism but its efficacy is likely less than that of barbiturates due to
      adverse effects on cerebral blood flow. Lidocaine reduces CMRO2 by affecting both
      cellular metabolic processes and synaptic transmission and thus resembles
      hypothermia in its mechanism of action. Benzodiazepines reduce CMRO2 by reducing
      synaptic transmission and their use as neuroprotectants produces less
      haemodynamic compromise than barbiturates. The mechanism of protection by calcium
      entry blocking agents appears to be due to improved blood flow as opposed to
      altering abnormal Ca++ fluxes. In contrast, agents such as ketamine and MK-801
      may prevent abnormal Ca++ fluxes through their competitive interaction with N
      methyl-D-aspartate receptors. Phenytoin prevents K(+)-mediated ischaemic events
      from progressing. Agents worthy of further investigation include corticosteroids,
      free radical scavengers, prostaglandin inhibitors and iron chelators.

PMID- 2225296
TI  - Epidural catheter migration during labour: an hypothesis for inadequate
      analgesia.
AB  - The purpose of this study was to determine the incidence and factors associated
      with poor analgesia during epidural block for labour pain. Emphasis was placed on
      determining the incidence, magnitude and factors associated with epidural
      catheter migration as well as any relationship between catheter migration and the
      quality of analgesia. Catheter movement was assessed, prospectively, in 211
      consecutive parturients who had an epidural catheter placed for labour analgesia.
      The magnitude and direction of catheter movement was assessed by measurement of
      the length of the catheter at the skin at the time of epidural placement, and
      immediately before removal of the catheter, after delivery. Fifty-four per cent
      of the catheters migrated during labour and 70 per cent of these migrated out of
      the epidural space. The quality of analgesia provided by the epidural block was
      assessed by the caseroom nurse caring for the patient. Seventeen per cent of the
      patients had unsatisfactory analgesia. There was an increase in poor analgesia in
      those patients whose catheters migrated compared with those in whom the catheters
      were stable (P less than 0.05). We conclude that catheter migration during labour
      results in a greater incidence of inadequate block and unsatisfactory analgesia.

PMID- 2225294
TI  - Anaesthesia for renal transplantation in sickle cell disease.
AB  - Sickle cell disease (SCD) is associated with many pathological and functional
      abnormalities affecting all organ systems. Renal manifestations of SCD may result
      in end-stage renal disease (ESRD), which can be treated by chronic haemodialysis
      or renal transplantation. Renal transplantation was successfully performed in a
      25-yr-old male with sickle cell beta-thalassaemia and nephrotic syndrome. We
      present a case report of this patient, a discussion of the renal complications
      associated with SCD and the perioperative management of a patient with SCD
      undergoing renal transplantation.

PMID- 2225297
TI  - Side effects of nalbuphine while reversing opioid-induced respiratory depression:
      report of four cases.
AB  - Nalbuphine hydrochloride, an agonist-antagonist opioid, is reported to reverse
      the respiratory depression of moderate doses of fentanyl (20 micrograms.kg-1) and
      still provide good analgesia. We report four patients having abdominal aortic
      aneurysm repair in which we attempted to reverse the respiratory depression of
      large doses of fentanyl (50-75 micrograms.kg-1) with nalbuphine (0.3 mg.kg-1, 0.1
      mg.kg-1 or 0.05 mg.kg-1). Nalbuphine reversed respiratory depression in all four
      patients and the respiratory rate increased from 10 to 23 breaths per minute, end
      tidal CO2 decreased from 7.0 +/- 0.3 per cent to 5.6 +/- 0.7 per cent, and peak
      inspiratory pressure after 0.1 seconds increased from 4 +/- 1.4 to 13 +/- 2.6
      mmHg. However, hypertension, increased heart rate, and significant increase in
      analogue pain scores accompanied reversal of respiratory depression. Agitation,
      nausea, vomiting, and cardiac dysrhythmias also were observed frequently. We do
      not recommend the use of nalbuphine to facilitate early extubation of the trachea
      after large doses of fentanyl for abdominal aortic surgery.

PMID- 2225298
TI  - The prophylactic use of octreotide in a patient with ovarian carcinoid and
      valvular heart disease.
AB  - This case report describes the use of octreotide, a long-acting somatostatin
      analogue, in the management of a patient with an ovarian carcinoid tumour and
      severe cardiac valvular disease. This patient underwent laparotomy and tumour
      resection without complication. Anaesthesia was induced with midazolam, fentanyl,
      and vecuronium, and maintained with isoflurane as well as additional fentanyl and
      vecuronium. However, we feel that it was the use of octreotide that prevented a
      life-threatening crisis intraoperatively, and recommend its use in patients with
      carcinoid syndrome undergoing anaesthesia and surgery.

PMID- 2225300
TI  - Vertigo after epidural morphine.
AB  - Severe complications from the use of epidural morphine for analgesia after
      Caesarean section are rare. A case is reported of extreme prostrating vertigo
      several hours after epidural morphine injection, where the time of onset of the
      symptom coincided with the expected time of arrival of the morphine within intra
      cerebral cerebro-spinal fluid.

PMID- 2225299
TI  - Elevated serum bromide concentrations following repeated halothane anaesthesia in
      a child.
AB  - A 20-month-old child received 25 brief halothane general anaesthetics over a five
      week period to allow cranial irradiation treatments for a posterior fossa
      ependymoma. Personality change during the last week of the treatment protocol
      raised the question of possible bromide intoxication. Serum bromide
      concentrations, using a gold chloride assay technique, were monitored at that
      time, and at four- and six-week intervals thereafter. Serum bromide
      concentrations demonstrated a four-fold change during this period ranging from
      peak levels of 2.2 mEq.L-1 (176 micrograms.kg-1) during the fifth week of
      treatment decreasing to less than 0.5 mEq.L-1 (less than 40 micrograms.ml-1) six
      weeks following the end of treatments. This demonstrates the possibility for
      repetitive, short halothane exposures to result in elevations of serum bromide
      and the potential of bromide intoxication in paediatric neuro-oncology patients.

PMID- 2225301
TI  - Anaesthetic management of the brain dead for organ donation.
AB  - An increasing number of anaesthetists is being called upon to manage organ donors
      during organ retrieval procedures. We briefly describe the technical aspects of
      the surgical procedure together with a guide to the anaesthetic management. The
      aims of the latter may be summarized as the "Rule of 100": systolic blood
      pressure greater than 100 mmHg, urine output greater than 100 ml.hr-1, PaO2
      greater than 100 mmHg, haemoglobin concentration greater than 100 g.L-1. Common
      management problems (hypotension, arrhythmias, diabetes insipidus, oliguria, and
      coagulopathy) are discussed in detail. The intraoperative management of the brain
      dead organ donor provides the anaesthetist with the challenge of a major surgical
      procedure in a subject with important physiological derangements.

PMID- 2225302
TI  - Thoracic epidural anaesthesia combined with enflurane anaesthesia reduces
      atrioventricular conduction in dogs.
AB  - Cardiac electrophysiological variables during thoracic epidural lidocaine (TEL)
      were compared with those during continuous intravenous lidocaine (IVL) infusion
      in 14 mongrel dogs anaesthetized with enflurane in order to investigate the
      combined effects of thoracic epidural anaesthesia (TEA) and enflurane anaesthesia
      on intracardiac conduction. Thoracic epidural lidocaine suppressed intracardiac
      conduction. Sinus cycle length (SCL) and Atrium-His (AH) interval increased by 9
      and 11 per cent respectively (P less than 0.05), 30 min after TEL. Intravenous
      lidocaine did not increase either SCL or AH. The functional refractory period of
      the atrioventricular node increased five per cent above the control value 15 min
      after TEL (P less than 0.05), while it was unchanged in the IVL group. The mean
      plasma concentrations of lidocaine ranged from 0.48 +/- 0.07 to 1.00 +/- 0.14
      micrograms.ml-1 in the TEL group and from 0.98 +/- 0.13) to 1.21 +/- 0.15
      micrograms.ml-1 in the IVL group. There were no significant differences in plasma
      concentrations of lidocaine in both groups during the observation period.
      Therefore, it is concluded that the depressant effects of TEA on intracardiac
      conduction were caused by blocking of the sympathetic efferent activity. Caution
      may be advised in administering TEA when cardiac conduction is already
      compromised.

PMID- 2225303
TI  - Bupivacaine-induced slow-inward current inhibition: a voltage clamp study on frog
      atrial fibres.
AB  - The effects of various concentrations of bupivacaine on the characteristics of
      the slow-inward current (isi) were studied over a ten-minute period on isolated
      frog atria. At a concentration of 10(-7) M, bupivacaine did not modify isi. At
      10(-6) M, the maximal amplitude of the slow-inward current (i max) was depressed
      by 11 per cent. At 10(-5) M, i max was depressed by 24.5 per cent, the time-to
      peak current value (tpeak) was increased by 13.4 per cent and the inactivation
      time constant (tau in) by 29.8 per cent. At 10(-4) M, i max was depressed by 32.9
      per cent, tpeak increased by 30.4 per cent and tau in by 58.7 per cent. In
      conclusion, bupivacaine produced only moderate inhibition of the slow-inward
      current. The findings might explain the decline in sinus impulse formation with
      sinus bradycardia, and the slowing of atrio-ventricular node conduction produced
      by bupivacaine. However, the decrease in contractility previously reported does
      not seem to be due only to inhibition of the slow-inward current.

PMID- 2225304
TI  - A simple technique for topical anaesthesia of the airway.

PMID- 2225306
TI  - Obstruction of a preformed armoured tracheostomy tube.

PMID- 2225305
TI  - Venous tolerance to etomidate in lipid emulsion or propylene glycol (hypnomidate)

PMID- 2225309
TI  - A new syringe holder.

PMID- 2225308
TI  - Acute pulmonary oedema after tourniquet release.

PMID- 2225307
TI  - Fatal air embolism.

PMID- 2225312
TI  - Comparison of acute effects of anthracyclines on cardiac electrophysiological
      parameters of isolated guinea-pig hearts.
AB  - This study was performed to evaluate the acute effects of two anthracycline
      derivatives, doxorubicin and 4'O-tetrahydropyranyl-doxorubicin [(THP)
      doxorubicin], on the conduction intervals, heart rate and refractoriness of
      isolated spontaneously beating guinea-pig hearts using a high-resolution ECG
      recording technique (SST-ECG). Doxorubicin as well as (THP)-doxorubicin were
      added to the perfusate in increasing concentrations of 0.1, 1 and 10 microM.
      Doxorubicin did not significantly alter the heart rate or conduction intervals.
      Only the rate-dependent QT interval was significantly shortened under the
      influence of 10 microM doxorubicin. In contrast, 10 microM (THP)-doxorubicin led
      to a significant reduction in the heart rate (-13% +/- 3%; P less than 0.01, n =
      7) and to a prolongation of atrioventricular conduction time (24% +/- 10%; P less
      than 0.05, n = 7). The rate-dependent repolarization period (QT interval) was
      only insignificantly shortened in the presence of 10 microM (THP)-doxorubicin.
      The maximal following frequencies of each part of the conduction system were not
      changed by 10 microM doxorubicin. In the presence of (THP)-doxorubicin, the
      maximal following frequency of the ventricular myocardium was increased by as
      much as 36% +/- 8% (P less than 0.01, n = 7), indicating a shortening of the
      effective refractory period of the ventricular myocardium (V-ERP). These results
      show that the activation of (THP)-doxorubicin resembles the effects of Ca
      antagonistic compounds on the heart (i.e. decrease in the spontaneous sinus rate
      and prolongation of the AV-nodal conduction interval). Changes in the QT interval
      exerted by doxorubicin and the shortening of the ventricular effective refractory
      period by (THP)-doxorubicin may indicate an alteration of the K(+)-conductance of
      the membrane. As the acute electrophysiological effects of doxorubicin and (THP)
      doxorubicin are modest and occur only at excessive concentrations (10 microM), a
      direct influence on the generation of arrhythmias in healthy hearts is unlikely.

PMID- 2225313
TI  - Clinical pharmacokinetics of intravenously injected tritiated vinzolidine.
AB  - Vinzolidine (VZL), a novel, semi-synthetic vinca alkaloid showing evidence of
      oncolytic activity in phase I/II clinical trials, was studied in six patients for
      its pharmacokinetic and metabolic behavior. Following i.v. administration of [3H]
      VZL at doses of 5, 6.7, and 9 mg/m2, blood and urine samples were collected and
      analyzed by sample oxidation and HPLC. Following a single i.v. dose, decay of
      total tritium in plasma was tetraphasic, with a rapid initial t1/2 alpha of 0.044
      +/- 0.013 h, followed by a t1/2 beta of 0.54 +/- 0.22 h and a t1/2 gamma of 9.48
      +/- 4.89 h; the terminal t1/2 gamma was 219 +/- 57 h. The mean plasma clearance
      of total tritium was 0.054 +/- 0.044 l.kg/h, and the mean volume of distribution
      was 14.3 +/- 5.4 l/kg; mean urinary excretion was 13.6% +/- 4.3% of the delivered
      radioactivity. Qualitative analysis of plasma and urine revealed the predominance
      of unchanged VZL plus two unidentified metabolites with different elution times.
      In comparison with oral VZL, as previously reported, i.v. injected VZL showed
      comparable values with respect to the volume of the central compartment (VC),
      plasma clearance (Clp), and terminal t1/2 for total tritium. Qualitatively, the
      metabolites observed in plasma and urine were comparable in number and quantity
      with values obtained in analyses after oral administration.

PMID- 2225310
TI  - Cellular glutathione as a protective agent against 4-hydroperoxycyclophosphamide
      cytotoxicity in K-562 cells.
AB  - Exposure of cells of the K-562 erythroleukemia cell line to 4
      hydroperoxycyclophosphamide (4-HC), an analog of activated cyclophosphamide,
      causes a concentration-dependent inhibition of in vitro colony formation by these
      cells. For investigation of the role of glutathione (GSH) in the metabolism of 4
      HC, GSH levels of K-562 cells were modulated by exposing the cells to buthionine
      sulfoximine (BSO), a specific inhibitor of GSH synthesis, and/or to GSH ethyl
      esters. Both the mono- and diethyl esters of GSH were synthesized in our
      laboratories and their identities were determined by chromatographic methods and
      fast-atom-bombardment mass spectrometry. An HPLC method including electrochemical
      detection used for thiol determination was applied for the measurement of GSH
      esters. Incubation of the cells with BSO depleted GSH levels to approximately 11%
      of control values and potentiated the cytotoxicity of 4-HC. By contrast, exposure
      to GSH esters approximately doubled GSH levels and protected the cells against
      the toxicity of 4-HC. Moreover, when cellular GSH levels were first depleted by
      BSO exposure and then replenished by incubation with GSH esters, the BSO
      associated potentiation of 4-HC cytotoxicity was abolished. The work described
      herein extends the application of an HPLC method used for thiol determination to
      the measurement of GSH ethyl esters. In addition, it established that GSH acts as
      a competitive protecting agent against the in vitro toxicity of 4-HC in the K-562
      cell line.

PMID- 2225311
TI  - Pharmacokinetics of the recombinant fusion protein DAB486IL-2 in animal models.
AB  - The kinetics of the in vitro cytotoxicity of DAB486IL-2, a genetically engineered
      fusion protein containing a portion of diphtheria toxin and human interleukin-2,
      were examined in the C91/PL cell line, which constitutively expresses IL-2
      receptors. Maximal inhibition of protein synthesis was observed by 4-6 h after
      DAB486IL-2 addition at a concentration of 300 ng/ml. The tissue distribution,
      urinary excretion, and plasma pharmacokinetics of DAB486IL-2 in the rat and its
      plasma pharmacokinetics in the monkey were also examined. In rats the primary
      site of distribution of [35S]-DAB486IL-2 outside the vasculature appears to be
      the liver, followed by the kidney, spleen, and lung. Persistence of radioactive
      material in the liver and urinary excretion of metabolic degradation products
      suggest that labeled protein is metabolized by hepatic tissue. Following i.v.
      bolus administration of DAB486IL-2, the initial serum half-life for both the rat
      and the monkey was approximately 5 min. The overall clearance rate of drug for
      the two species differed, with DAB486IL-2 being cleared from circulation 2-3
      times more rapidly in the monkey. Presence of high levels of neutralizing
      antibodies to diphtheria toxin in the rat significantly influenced the clearance
      of bioactive DAB486IL-2. However, the question as to whether the presence of in
      vitro biological activity for the molecule is masked by the presence of
      antibodies cannot be clearly answered.

PMID- 2225314
TI  - Characterisation of urinary metabolites of temozolomide in humans and mice and
      evaluation of their cytotoxicity.
AB  - The experimental antineoplastic agent temozolomide was not metabolised in vitro
      at a measurable rate by mouse liver fractions. In contrast, the temozolomide
      analogue 3-methylbenzotriazinone was metabolically N-demethylated by hepatic
      microsomes to yield benzotriazinone. The major route of excretion of [14C]
      labelled temozolomide in mice was via the kidneys. An acidic metabolite of
      temozolomide, probably a conjugate, was found in the urine of mice, but its
      identity could not be established unambiguously. Spectroscopic analysis and
      chemical tests revealed that it possesses an intact NNN-linkage. Another
      metabolite was found in the urine of patients but not of mice. This metabolite
      was identified as the 8-carboxylic acid derivative of temozolomide. Unlike the
      unknown species, this metabolite was cytotoxic against TLX5 lymphoma cells in
      vitro.

PMID- 2225315
TI  - Cross-resistance pattern of cell lines selected for resistance towards different
      cytotoxic drugs to membrane-toxic phospholipids in vitro.
AB  - The synthetic ether lipids ET-18-OCH3 and BM41.440 and a derivative,
      hexadecylphosphocholine, were tested for inhibition of [3H]-thymidine uptake into
      a Chinese hamster ovarian cell line (AUXBl) and its multidrug-resistant subline
      selected for colchicine resistance (CHRC5). The activity of all three compounds
      against the multidrug-resistant subline was equal to or higher than that against
      the parent line. The same result was found for their activity against a human
      leukemic lymphoblastic cell line (CEM/O) and its methotrexate-resistant subline
      (CEM/MTX). In contrast, two multidrug-resistant cell lines selected for
      resistance to Adriamycin, the mouse leukemia cell line P388/ADR and the murine
      sarcoma cell line S180/ADR, expressed modest cross-resistance to the lipids as
      measured by thymidine uptake. Experiments performed using the trypan-blue dye
      exclusion assay yielded comparable results, although this system revealed a
      slightly different sensitivity in showing the cytotoxicity of the drugs. By this
      assay, modest cross-resistance for ET-18-OCH3 and BM41.440 to Adriamycin was
      found only after 24 h incubation and decreased after 48 h incubation, with almost
      equal sensitivity to both drugs being shown by the parental (P388/W) and
      resistant lines (P388/ADR). Furthermore, findings from a human tumor-cloning
      assay were in accordance with these data, although they did not indicate cross
      resistance for the P388/ADR cell line. These results suggest that certain ether
      lipids and derivatives might represent valuable anticancer drugs warranting
      further study in the setting of resistant disease.

PMID- 2225316
TI  - The influence of partial hepatectomy on the pharmacokinetics of preoperatively
      injected 4'-epidoxorubicin in rats.
AB  - Preoperative administration of 4'-epidoxorubicin (Epi-A) has been suggested as
      adjuvant therapy in patients undergoing liver resection for hepatocarcinoma. To
      assess the influence of partial hepatectomy on the pharmacokinetics of Epi-A, an
      experimental study in rats was undertaken in which 5 mg/kg Epi-A was given i.v.
      10 min prior to a 2/3 hepatic resection or sham operation. Epi-A levels in liver
      tissue and plasma were determined using a sensitive and specific HPLC method. A
      marked uptake of Epi-A in liver tissue was found at 10 min after injection. The
      partially hepatectomized rats showed a 2-fold increase in AUC between 4 and 72 h
      as compared with the sham-operated controls. The terminal half-life from 24 to 72
      h was not significantly changed by the partial hepatectomy. The plasma binding of
      Epi-A was measured at 4 h post-surgery. The fraction of unbound Epi-A was 0.16 in
      partially hepatectomized animals and 0.20 in sham-operated rats. The results
      indicate that when Epi-A is given prior to liver resection, a dose reduction
      might be necessary to avoid increased side effects due to the rise in AUC.

PMID- 2225317
TI  - Weekly fluorouracil and high-dose leucovorin: efficacy and treatment of cutaneous
      toxicity.
AB  - Intensive therapy with 5-fluorouracil (FU) and leucovorin (LV) has proved to be
      effective in the treatment of advanced colorectal cancer. The toxicity of this
      regimen has not been systematically evaluated. In the present study, 52 patients
      with advanced colorectal and refractory cancers received sequential 2-month
      cycles of weekly FU and high-dose LV and were monitored for toxicity as well as
      response in 103 cycles. Of 24 evaluable patients with colorectal cancer, 1
      complete and 9 partial responses were seen (42%); 4 of 10 patients who had been
      refractory to conventional FU treatment responded to the FU/LV regimen. One
      partial response was observed among six patients with gastric carcinoma, and
      three minor responses were seen in five women with refractory breast cancer. A
      total of 24 patients (46%) completed the first cycle on schedule, although 7
      subjects required a reduction in the dose of FU. The majority of patients
      required treatment breaks because of toxicity. Gastrointestinal toxicity proved
      to be dose-limiting on this schedule, necessitating FU dose modification and
      treatment of both diarrhea in 15 subjects and acute abdominal pain in 7 cases. No
      patient required a further treatment delay of FU dose adjustment.
      Myelosuppression was an uncommon complication on this regimen. Cutaneous toxicity
      was also prominent in this series of patients, with the hand-foot syndrome
      developing in 14 cases (27%); 11 subjects who developed this complication were
      treated with pyridoxine (150 mg daily), and all experienced improvement in their
      symptoms within 1 week. Partial and complete responses were observed in 41% of
      evaluable patients with colorectal cancer and in one of six evaluable patients
      with gastric carcinoma. We conclude that FU and high-dose LV can safely be given
      on a weekly basis, although acute gastrointestinal and cutaneous toxicity are
      common.

PMID- 2225319
TI  - Renal effects of S10036 in man.
AB  - The renal hemodynamic and tubular effects of S10036 (fotemustine) were evaluated
      in seven patients with advanced malignancy. Initial evaluation carried out prior
      to treatment and repeated 1 day after the first fotemustine infusion and 7 days
      after the second included clinical, haematological parameters, liver-function
      tests, and determination of the glomerular filtration rate, renal blood flow and
      enzymuria. The glomerular filtration rate was 108 +/- 3.7 ml/min before treatment
      and remained stable after the first (117 +/- 5 ml/min) and second (124 +/- 6
      ml/min) fotemustine infusions. Renal blood flow and urinary beta 2-microglobulin
      and N'-acetylglucosaminidase excretion were also not modified by fotemustine
      administration. We conclude that fotemustine does not acutely alter renal
      haemodynamics, nor does it have direct tubular toxicity.

PMID- 2225318
TI  - Phase II trial of carboplatin and vinblastine in advanced squamous-cell carcinoma
      of the head and neck.
AB  - A chemotherapy regimen consisting of carboplatin and vinblastine was given to 30
      patients with recurrent or previously untreated, locally advanced squamous
      carcinoma of the head and neck region. The main aim of the study was to assess
      the toxicity of this regimen, the feasibility of its outpatient administration
      and the tumour response. A total of ten patients (33%) achieved an objective
      response, including two who achieved a complete response. The combination offered
      useful palliation for patients with recurrent disease; it was well tolerated and
      can be given on an outpatient basis. This regimen could be combined with other
      active agents such as methotrexate or bleomycin.

PMID- 2225320
TI  - Peroxisome proliferation and modulation of rat liver carcinogenesis by 2,4
      dichlorophenoxyacetic acid, 2,4,5-trichlorophenoxyacetic acid, perfluorooctanoic
      acid and nafenopin.
AB  - Using an initiation--selection--promotion protocol for induction of liver tumors
      in Wistar rats, the modulating action of various peroxisome proliferators on
      neoplasia as well as on selected biochemical parameters was studied. After
      treatment with diethylnitrosamine (DEN), the animals were subsequently subjected
      to a selection procedure involving feeding of 2-acetylaminofluorene (2-AAF), and
      in the middle of the 2-AAF treatment, a single necrogenic dose of carbon
      tetrachloride. Following a recovery period, the rats were fed a diet containing
      0.1% nafenopin (NAF), 0.015% perfluorooctanoic acid (PFOA), 0.05% 2,4
      dichlorophenoxyacetic acid (2,4-D), 0.05% 2,4,5-trichlorophenoxyacetic acid
      (2,4,5-T) or 0.05% phenobarbital (PB) as a positive control. When the animals
      were killed, 7 months after initiation, the incidence of hepatocellular carcinoma
      was 83, 33 and 16% in the animals treated with NAF, PFOA or 2,4,5-T respectively.
      No cancers were observed in controls, or in the 2,4,-D groups. In comparison with
      controls, NAF and PFOA caused a 60-and 24-fold increase inthe peroxisomal beta
      oxidation of fatty acids respectively, but only about a 2-fold increase in the
      catalase activity, 2,4-D and/or 2,4,5-T were much less active in this respect,
      giving approximately a doubling in the rate of fatty acid oxidation. The specific
      activity of D-amino acid and glycolate oxidases were significantly depressed,
      whereas the urate oxidase levels were apparently unaffected by the NAF and PFOA
      treatment. The results suggest that the selective induction of peroxisomal fatty
      acid oxidation is consistent with the hypothesis that imbalance between H2O2
      overproduction and its destruction could play a role in the modulation of
      hepatocarcinogenesis by peroxisome proliferators.

PMID- 2225321
TI  - Serological characterization of polycyclic aromatic hydrocarbon diolepoxide-DNA
      adducts using monoclonal antibodies.
AB  - Polycyclic aromatic hydrocarbons (PAHs) are a group of structurally related
      compounds that are present in the environment in complex mixtures as common
      pollutants. These compounds have been studied extensively because of their
      carcinogenic and toxic properties to humans. We reported previously that humans
      exposed to certain PAHs produce antibodies that bind to different PAH diolepoxide
      DNA (PAH-DNA) adducts. The ability to detect and measure antibodies to PAH-DNA
      adducts in human blood samples could prove useful as a biological dosimeter for
      identifying persons that have been exposed to high levels of PAHs, i.e. persons
      who may be at high cancer risk. In our initial studies we found that it was
      common for persons who were exposed to PAH to produce antibodies against PAH-DNA
      adducts. However, we were unable to identify the actual chemical types of PAH-DNA
      adducts that were recognized by the serum antibodies because many serum samples
      contained antibody activity to more than one adduct. These data indicate that
      different PAH-DNA adducts may be serologically similar or that humans actually
      produce immune responses against more than a single PAH-DNA adduct. We have used
      monoclonal antibody technology to determine the extent to which different PAH-DNA
      adducts share serologically recognized epitopes. Monoclonal antibodies were
      produced against two different PAH-DNA adducts, benzo[a]pyrene diolepoxide-DNA
      (BPDE-DNA) and benz[a]anthracene diolepoxide-DNA (BADE-DNA). The binding of these
      antibodies to five PAH-DNA adduct preparations and to soluble PAHs was assessed.
      We found that most monoclonal antibodies bound to more than a single type of PAH
      DNA adduct, documenting the serological relatedness of different PAH-DNA adducts.
      However, two monoclonal antibodies were produced that bound only to BPDE-DNA.
      Soluble non-metabolized PAHs and PAH tetraols were not recognized by these
      antibodies, thus demonstrating their specificity for PAH-DNA adducts and not the
      PAHs alone. Monoclonal antibodies produced against BADE-DNA also bound to
      chrysene diolepoxide-DNA but not to BPDE-DNA or to two other PAH-DNA adducts.
      These data demonstrate that significant serological cross-reactivity exists
      between different PAH-DNA adducts and support our contention that human
      antibodies to PAH-DNA can often bind to more than a single type of PAH-DNA
      adduct. However, our ability to produce monoclonal antibodies with restricted
      specificity suggest that the production of highly monoclonal antibody reagents
      for use in assays designed to measure PAH-DNA adducts in biological samples is
      feasible.

PMID- 2225322
TI  - Sex differences in the dietary modulation of pancreatic cancer in Syrian hamsters
      treated continuously with N-nitroso(2-hydroxypropyl)(2-oxopropyl)amine.
AB  - The effect of continuous week-long administration of N-nitroso(2-hydroxypropyl)(2
      oxopropyl)amine (HPOP) by s.c. implanted osmotic pumps was examined in male and
      female Syrian hamsters given access to three isocaloric synthetic diets
      containing 10 (LP), 20 (MP) and 30% (HP) casein respectively. At a total dose of
      210 mg/kg, toxicity of HPOP, expressed as acute liver injury, was greater in male
      than in female hamsters. Such toxicity increased with protein intake in male, but
      not in female animals. Twenty-five weeks after initiation, female and male
      hamsters developed pancreatic ductal adenocarcinomas and to a lesser degree liver
      cholangiocellular and hepatocellular carcinomas. The highest incidence of
      pancreatic cancer was observed under HP diet regimens and was 75 and 67% in
      female and male hamsters respectively. Decrease of protein intake resulted in the
      reduction of the incidence of pancreatic cancer, which was more striking in males
      than in females. In males fed the MP and LP diets respectively, such an incidence
      declined to 33 and 6%. Although significant differences in the incidence of
      pancreatic cancer were not observed among female groups fed the above three
      diets, the multiplicity and the number of such tumors were significantly greater
      at the HP than the LP level. Differences in the incidence of pancreatic tumors
      between males and females were statistically significant only at the LP level.
      However, such differences were also significant at the MP level when comparisons
      were based on tumor number and multiplicity. Since the incidence, tumor
      multiplicity and size were generally greater in female than male hamsters,
      estrogenic hormones may play a role in the development of pancreatic ductal
      adenocarcinomas in this species.

PMID- 2225323
TI  - The initiator tRNA acceptance assay as a short-term test for carcinogens. 6.
      Results with 78 polycyclic aromatic compounds.
AB  - A total of 78 polycyclic aromatic compounds (PAH), including pure hydrocarbons,
      PAH metabolites, aromatic amines and nitroarenes, were tested in the initiator
      tRNA acceptance assay (tR assay) for carcinogens. Among the pure hydrocarbons,
      all strong carcinogens were highly active in the tR assay. Some weak carcinogens
      showed moderate positive responses, others as well as all possible non
      carcinogens were inactive. Various PAH metabolites, including phenols,
      dihydrodiols, arene oxides, dihydrodiol epoxides, quinones and benzylic sulfate
      esters, were positive as well. Strikingly, however, their effects rarely reached
      the levels observed with the strong carcinogens among the pure hydrocarbons.
      Moreover, the correlation with carcinogenicity was less clear, partially due to
      limitations in the available carcinogenicity data. The activities in the tR assay
      were also compared with the mutagenicity in Salmonella typhimurium. No
      appreciable correlation was observed. For example, trans-9,10-dihydroxy-9,10
      dihydrobenzo[c]chrysene, in the absence of a mammalian metabolic system, was
      highly active in the tR assay, but non-mutagenic. Upon addition of rat liver
      enzymes, the reverse result was obtained. syn-Benzo[c]chrysene-9,10-dihydrodiol
      11,12-oxide, on the other hand, was a potent direct mutagen, but required the
      presence of liver microsomes for a positive response in the tR assay. Thus, the
      metabolic basis for these two activities is different, and not yet understood for
      the tR assay. The partial correlations in the tR assay and in the Salmonella
      mutagenicity assay with carcinogenicity, and the pronounced discrepancies between
      these in vitro tests, may suggest that they detect different mechanisms involved
      in carcinogenicity. However, the tR assay was less predictive for the
      carcinogenicity of PAHs as compared to the previously investigated N-nitroso
      compounds and mycotoxins.

PMID- 2225324
TI  - Effects of steroids on the synthesis and metabolism of phosphatidylethanol in
      phorbol ester-activated lymphocytes.
AB  - The phorbol ester 12-O-tetradecanoylphorbol-13-acetate activates the
      phospholipase D pathway in bovine lymphocytes, leading to a synthesis of
      phosphatidylethanol (PEt) from exogenous alcohol. Concomitant treatment of the
      cells with 10(-8) M etiocholanolone, dehydroepiandrosterone or 16 alpha-bromo
      epiandrosterone results in the production of phosphatidylethanols that carry
      metabolically altered forms of arachidonic acid at position 2. The observed
      steroid response appears to be mediated by a receptor mechanism in that it
      depends on the synthesis of new RNA and protein. The spectrum of steroids
      producing the response suggests that the postulated receptor system may be
      distinct from the well-studied glucocorticoid, progesterone, estrogen and
      androgen specific receptors. The possible relevance of these new metabolites of
      ethanol to the problem of alcoholism in humans and to the field of carcinogenesis
      in general is discussed.

PMID- 2225326
TI  - Uptake and biological transformation of beta NiS and alpha Ni3S2 by human
      embryonic pulmonary epithelial cells (L132) in culture.
AB  - The cytotoxicity, biological transformation and interaction with plasma membranes
      of alpha Ni3S2 and beta NiS were studied on human embryonic pulmonary epithelial
      cells (L132 cell line) in culture. By establishing growth curves and survival
      curves, it was found that at equal molarity beta NiS has a higher inhibitory
      effect on cell growth than alpha Ni3S2 but a lower cytotoxic effect: the CL50
      being 60 and 40 mumols/l respectively. As to their uptake, beta NiS crystals are
      preferentially phagocytized in their original form and then probably dissolved in
      the vacuoles, whereas alpha Ni3S2 is transformed in the extracellular space and
      in the phagocytic vacuoles into minute particles (10 nm) that are recovered bound
      to the cell membrane, phagocytic vacuoles and lysosomal membranes respectively.
      Energy dispersive spectrometry revealed that the particles bound to cell
      membranes no longer contain sulfur but only phosphorus and nickel as inorganic
      compounds. This observation suggests the formation of a Ni/P complex with the
      phosphate groups of membranous phospholipids and/or phosphotransferring proteins.
      The steady-state fluorescence polarization analysis, however, revealed a
      significant increase of membrane fluidity either induced by desaturation of
      aliphatic chains or directly by the cleavage of the fatty acid chains. These
      results clearly show a difference between beta NiS and alpha Ni3S2 concerning
      their cytotoxic effects, uptake, biological transformation and interaction with
      cell membranes.

PMID- 2225325
TI  - Differential effects on cell killing in metallothionein overexpressing CHO mutant
      cell lines.
AB  - An increased level of metallothionein (MT) within the cytosol has been associated
      with the development of resistance to the cytotoxic effects of alkylating agents,
      but the mechanism of this effect is unclear. To verify the possible role of MT as
      a direct scavenger of alkylating agents we transfected two alkylating agent
      sensitive CHO mutant cell lines, methyl methanesulphate-1 and -2 (MMS-1 and MMS
      2), with the human metallothionein II-A (hMTII-A) gene. From each mutant two
      transfected cell clones were isolated which were found to bear episomally 50 to
      70 copies of the plasmid pMTII-BPV coding for the hMTII-A gene. The transfected
      cell lines contained between 1.4 and 4.9 micrograms of MT per 10(7) cells. This
      could be increased 2- to 9-fold by heavy metal induction. Transfectants derived
      from mutant MMS-1 were equally sensitive as the parental cells to a set of
      alkylating agents. However, transfectants derived from mutant cell line MMS-2
      gained significant resistance to both N-methyl-N'-nitro-N-nitrosoguanidine and N
      nitroso-N-methylurea, whilst retaining sensitivity to MMS. The degree of
      resistance was not increased by MT induction after heavy metal ion exposure.
      These results indicate that although resistance to alkylating agents may be
      mediated by a process which involves MT expression, this is not due to simple
      scavenging of the cytotoxic agent by the MT protein.

PMID- 2225327
TI  - The biochemical basis for the species difference in hepatic microsomal 4
      vinylcyclohexene epoxidation between female mice and rats.
AB  - Mice but not rats are susceptible to 4-vinylcyclohexene (VCH)-induced ovarian
      toxicity and carcinogenicity. This is due in part to a 4- to 6-fold greater rate
      of hepatic microsomal bioactivation of VCH to the ovotoxicant VCH-1,2-epoxide.
      The biochemical basis for this difference was investigated in microsomes using
      enzyme induction, enzyme inhibition with chloramphenicol or specific inhibitory
      antibodies, and correlation with marker steroid hydroxylase activities to
      associate VCH epoxidation with particular cytochrome P450 forms. Testosterone 6
      beta- and 15 alpha-hydroxylase activities and VCH epoxidation were decreased in
      microsomes from chloramphenicol-treated mice, initially suggesting the possible
      involvement of P450IIIA and P450IIA forms in VCH metabolism. Although both
      testosterone 6 beta-hydroxylase and VCH epoxidase activities were increased by
      dexamethasone treatment (P450IIIA inducer), anti-rat P450IIIA IgG inhibited
      testosterone 6 beta-hydroxylase (68%) but not VCH epoxidase activity. These
      latter results do not support the involvement of mouse P450IIIA forms in VCH
      epoxidation. However, results were obtained which indicated that mouse P450IIA
      forms are involved in VCH epoxidation. In microsomes from untreated female mice
      VCH epoxidase activity was inhibited 48% by antibodies to mouse P45015 alpha
      (P450IIA3) at a concentration that inhibited testosterone 15 alpha-hydroxylase
      activity by 86%. No protein immunochemically related to mouse P45015 alpha was
      detected in female rat hepatic microsomes. VCH epoxidation by hepatic microsomes
      was increased in female mice and rats by phenobarbital treatment and was
      inhibited by approximately one-third by anti-rat-P450IIB1 IgG in microsomes from
      untreated animals of both species. Furthermore, microsomal VCH epoxidase and
      testosterone 16 alpha-hydroxylase activities were lower (34%) in female 129/J
      mice (deficient in constitutive expression of P450IIB forms) than in B6C3F1 mice.
      These results suggested partial involvement of P450IIB forms in the microsomal
      epoxidation of VCH. Therefore, P450 forms IIA and IIB account for the majority of
      VCH bioactivation in female mouse liver, which explains in part the
      susceptibility of mice to VCH-induced ovarian toxicity and carcinogenicity.

PMID- 2225328
TI  - Fluorine probes for investigating the mechanism of activation of indeno[1,2,3
      cd]pyrene to a tumorigenic agent.
AB  - Indeno[1,2,3-cd]pyrene (IP) is a non-alternant polycyclic aromatic hydrocarbon
      that has tumor-initiating activity on mouse skin and is carcinogenic in newborn
      mice and in rat lungs. Previous studies have shown that 8- and 9-hydroxyIP and IP
      1,2-diol are major metabolites formed in vivo in mouse skin. 8-HydroxyIP-1,2-diol
      and 9-hydroxyIP-1,2-diol are also observed as in vivo metabolites of IP. Although
      8-hydroxyIP had marginal tumor-initiating activity on mouse skin, IP-1,2-diol and
      its epoxide precursor, IP-1,2-oxide, had similar tumorigenic activity as IP. In
      the present study fluorine probes have been employed to investigate the
      contribution of metabolic activation at the 1,2 and 7-10 positions of IP. At a
      total initiating dose of 4.0 mumol, 2-fluoroIP induced skin tumors in 76% of the
      treated animals with an average of 3.9 tumors/mouse. At the same dose, IP induced
      a 72% incidence of tumor-bearing mice with 2.1 tumors/mouse. In contrast, 8,9
      difluoroIP elicited a tumorigenic response in 40% of the treated animals with 0.6
      tumors/animal. Five mice from each experimental group were killed at the
      conclusion of the initiation phase of the bioassay and DNA was isolated from the
      treated areas of skin. 32P-Postlabeling analysis of the hydrolyzed DNA indicated
      that IP forms one major detectable DNA adduct that migrates close to the origin.
      This adduct is absent in mice treated with 8,9-difluoroIP. In contrast, 2
      fluoroIP forms one major adduct spot with different retention behavior as
      compared with the adduct formed from IP. DNA from mice treated topically with IP
      1,2-diol and IP-1,2-oxide was subjected to 32P-postlabeling analysis. IP-1,2-diol
      forms one major DNA adduct spot with mobility similar to that observed for the IP
      DNA adduct. IP-1,2-oxide displayed an intense pattern of DNA adducts centered
      around the location of the IP-DNA adduct. No adducts were detected which had
      mobility similar to that formed from 2-fluoroIP. These results are consistent
      with IP undergoing metabolic activation at positions 7-10 either alone or in
      conjunction with dihydrodiol formation at the 1,2 position.

PMID- 2225329
TI  - Enhancing effects of various gastric carcinogens on development of pepsinogen
      altered pyloric glands in rats.
AB  - To assess the possibility of establishing an in vivo, medium-term bioassay system
      for gastric carcinogens and promoters, a total of 220 male WKY rats were divided
      into two groups. Group 1 animals were treated first with a single dose of N
      methyl-N'-nitro-N-nitrosoguanidine (MNNG) (160 mg/kg body wt) and starting 2
      weeks later administrated one of five gastric carcinogens, a gastric promoter,
      one of five non-gastric carcinogens or no treatment, as a control, for 14 weeks.
      Saturated sodium chloride solution (1 ml) treatments were given by gastric
      intubation at weeks 4, 6, 8 and 10. Group 2 rats received 1 ml of DMSO instead of
      MNNG and were then treated in the same way as group 1. Analysis of pyloric mucosa
      sections for pepsinogen altered pyloric glands (PAPG) detected
      immunohistochemically after the animals were killed at week 16 revealed increased
      lesion numbers in group 1, with all gastric carcinogens and promoters examined.
      However, none of the five non-gastric carcinogens exerted any significant
      modification of PAPG development. The results strongly suggest that the
      experimental protocol consisting of the following four components: (i) adoption
      of PAPG as the end-point marker lesion; (ii) single dose of MNNG as initiator;
      (iii) test chemical administration for 14 weeks; and (iv) administration of
      saturated sodium chloride solution during the test chemical exposure, could be
      used effectively for the detection of gastric carcinogens as well as promoters of
      gastric carcinogenesis in a relatively short time period.

PMID- 2225330
TI  - Initiating activity of 3-tert-butyl-4-hydroxyanisole (3-BHA) and its metabolites
      in two-stage transformation of BALB/3T3 cells.
AB  - 3-tert-Butyl-4-hydroxyanisole (3-BHA) and its metabolites, tert-butyl-1,4
      benzoquinone (BQ) and 3-tert-butyl-5-methoxy-1,2-benzoquinone (BHAoQ), were
      tested for initiating activity in a two-stage transformation assay using BALB/3T3
      cells. Cells were treated first with a test chemical and then with the tumor
      promoter 12-O-tetradecanoylphorbol 13-acetate (TPA). In the absence of TPA the
      test chemicals did not induce cell transformation. With the promoting treatment,
      3-BHA and BQ induced dose-dependent cell transformation. There were statistically
      significant increases in the proportion of dishes with transformed foci in the
      cultures treated with 30 micrograms/ml 3-BHA plus TPA (15 of 24 dishes, P less
      than 0.005) and with 0.4 microgram/ml BQ plus TPA (12 of 22 dishes, P less than
      0.02) as compared to the cultures treated with DMSO plus TPA (5 of 24 dishes).
      BHAoQ caused a non-significant increase in transformation frequency in the
      presence of TPA. In conclusion, 3-BHA and BQ had an initiating activity in the
      cell transformation system and the potency of BQ was approximately 100 times
      higher than that of 3-BHA.

PMID- 2225331
TI  - Copper phthalocyanine labelled magnetic microcapsules: preparation, and binding
      properties in vitro and in vivo for mutagens having planar molecular structure.
AB  - Copper phthalocyanine tetrasulphonic acid (CPTS) functions were introduced into
      magnetic semi-permeable polyethyleneimine (PEI) microcapsules in order to create
      a recoverable scavenging system for trapping and biomonitoring, within the
      gastrointestinal cavity, of mutagens having a planar molecular structure. Stable
      ionic CPTS and covalent (thionylated CPTS, TCPTS) adducts to the microcapsule PEI
      were produced and shown to trap benzo[a]pyrene (B[a]P) in vitro in relation to
      the porphyrin/B[a]P ratio employed. 3-hydroxy B[a]P and B[a]P 3,6-dione from a
      crude B[a]P metabolite mixture, and a set of planar mutagens from crude
      opium/morphine pyrolysate mixtures could also be recovered in 7-86% yields after
      shaking with modified microcapsules followed by methanol/ammonia (50:1)
      desorption. Tetraols derived from B[a]P 7,8-diol-9,10 epoxide could also be
      recovered. Modified microcapsules were recovered magnetically from faeces of rats
      treated with [14C]B[a]P, and 45-51% of trapped radioactivity could be directly
      desorbed for HPLC assay compared with 30% for unmodified microscapsules. The
      relative extent of trapping by unmodified or CPTS- or TCPTS-modified
      microcapsules was different for various substrates, and it appears that the
      copper phthalocyanine tetrasulphonic acid moiety competes with another
      unidentified absorption/desorption structure in the microcapsules. These results
      show that selective and reversible trapping of carcinogens/mutagens having planar
      molecular structure can be achieved within the gastrointestinal tract.

PMID- 2225332
TI  - Complexes involving quercetin, DNA and Cu(II).
AB  - The genotoxic flavonoid, quercetin, was shown to bind to both double-stranded and
      single-stranded DNA with concomitant changes in absorption spectrum and
      fluorescence emission spectrum of quercetin. Quercetin and Cu(II) were shown to
      form a charge transfer complex that decayed in oxygen-dependent reaction(s) and
      this decay was accelerated by DNA. Analysis of the three component system, DNA-
      querectin--Cu(II), led to a discussion of the complexes likely to be involved in
      the initial reactions that lead, ultimately, to strand scission of DNA.

PMID- 2225333
TI  - Characterization and genotoxicity of DNA adducts caused by 2-naphthyl isocyanate.
AB  - Calf thymus DNA and M13mp9 RF DNA were modified with [ring-3H]2-naphthyl
      isocyanate (NIC) and analyzed by reverse-phase HPLC following enzymatic
      hydrolysis. In each case, essentially, a single radioactive component, which co
      chromatographed with authentic N4-2-naphthyl-carbamoyl-2'-deoxycytidine (NCdC),
      was detected. In order to explore the biological potential of this adduct, mp9 RF
      DNA modified with NIC was introduced into Escherichia coli strains using a
      calcium chloride technique. The plaque-forming efficiencies of DNA decreased with
      increasing adduct level, and the decreases were more pronounced in Uvr
      endonuclease-deficient strains (i.e. AB1886, uvrA; AB1885, uvrB; AB1884, uvrC) as
      compared to JM103 (Uvr endonuclease proficient) and JM101 RH03 (recA). These
      results suggest that these lesions, NCdC adducts, can be removed by the Uvr
      endonuclease repair system. Mutations were detected as the loss of ability of the
      bacteriophage to complement the defective beta-galactosidase of the host cells.
      Induction of SOS functions in the host cells enhanced the mutation frequency to
      0.089%, i.e. greater than or equal to 4-fold greater than in non-SOS-induced
      cells, in transfections with RF DNA that contained 100 adducts/molecule. The
      mutagenic potency of this cytidine lesion is lower than that of the guanine-C8
      adducts of 2-aminofluorene and 2-acetylaminofluorene as reported previously for
      this mutagenesis system.

PMID- 2225334
TI  - Specific inhibitory effect of dietary eicosapentaenoic acid on N-nitroso-N
      methylurea-induced mammary carcinogenesis in female Sprague-Dawley rats.
AB  - We have investigated the effects of two qualitatively different types of
      unsaturated fatty acids on N-nitroso-N-methylurea (NMU)-induced mammary
      carcinogenesis in female Sprague-Dawley rats. Semipurified diets containing 4.7%
      eicosapentaenoic acid (EPA) plus 0.3% linoleic acid or 5% linoleic acid were
      prepared. Animals maintained on these diets were given an i.v. injection of NMU
      (50 mg/kg body wt) at 50 days of age and killed 20 weeks later. Both tumor
      incidence and tumor number per rat were significantly lower in the EPA diet group
      (60.0% and 2.3 +/- 2.5 versus 93.3% and 5.1 +/- 4.5 respectively) for the 5%
      linoleic acid diet. Furthermore, the average weight of tumor material (total) per
      rat was significantly lower in the EPA as compared to linoleic acid diet group
      (2.9 +/- 4.2 g and 11.4 +/- 12.2 g respectively). Analysis of phospholipid fatty
      acids in the mammary tumors in the EPA diet group showed a higher proportion of
      C16:0, C18:2, omega-3 fatty acids C20:5 and C22:6 and a lower proportion of
      C20:4. Furthermore, mammary tumors in rats fed the EPA diet demonstrated
      significant reduction in prostaglandins. The results thus suggest that inhibition
      by EPA of NMU-induced mammary carcinogenesis may be mediated via the modulation
      of lipid metabolism and associated reduction in prostaglandin synthesis.

PMID- 2225335
TI  - Formation of 5-hydroxymethyl-2'-deoxyuridine in hepatic DNA of rats treated with
      gamma-irradiation, diethylnitrosamine, 2-acetylaminofluorene or the peroxisome
      proliferator ciprofibrate.
AB  - The peroxisome proliferator ciprofibrate was tested for its ability to induce DNA
      damage in the form of 5-hydroxymethyl-2'-deoxyuridine (HMdU), an adduct that
      results from the reaction of thymine in DNA with hydroxyl radicals. In order to
      quantify HMdU, DNA containing [3H]thymidine of high specific activity had to be
      obtained. Since hepatocytes normally have a very low rate of DNA synthesis, rats
      were subjected to partial hepatectomy to stimulate DNA synthesis and then were
      administered [methyl-3H]thymidine by three p.o., i.p. or i.v. injections 20, 22
      and 24 h after partial hepatectomy; or by slow infusion through the portal vein,
      starting 20 h after partial hepatectomy for 4 h. The specific activity of DNA in
      rats receiving [3H]thymidine through the portal vein was considerably higher than
      in rats receiving p.o., i.p. or i.v. injections. Rats were then exposed to
      various doses of gamma-irradiation after partial hepatectomy and infusion of [6
      3H]thymidine through the portal vein. DNA from the liver was extracted,
      enzymatically hydrolyzed and analyzed by HPLC. The percentage of HMdU in DNA
      increased in a dose-dependent manner. Rats were then treated with the carcinogens
      2-acetylaminofluorene (AAF) or diethylnitrosamine (DEN) in conjunction with
      partial hepatectomy and infusion of [methyl-3H]thymidine. There was an increase
      in HMdU formation after a single administration of DEN or AAF. Another group of
      rats was fed a diet containing the peroxisome proliferator ciprofibrate for 3
      weeks. After partial hepatectomy and infusion of [6-3H]thymidine, these rats were
      fed the same ciprofibrate-containing diet for 2-4 more weeks. HMdU was detected
      in DNA at 2-4 weeks after [6-3H]thymidine infusion, but the level at 4 weeks was
      nearly 50% less than at 2 weeks. This study shows that oxidative DNA damage in
      the form of HMdU is induced in the liver by gamma-irradiation, DEN, AAF and
      peroxisome proliferation.

PMID- 2225336
TI  - Analysis of the polycyclic aromatic hydrocarbon content of petrol and diesel
      engine lubricating oils and determination of DNA adducts in topically treated
      mice by 32P-postlabelling.
AB  - Engine lubricating oils are known to accumulate carcinogenic polycyclic aromatic
      hydrocarbons (PAHs) during engine running. Oils from nine petrol-powered and 11
      diesel-powered vehicles, in addition to samples of unused oil, were analysed for
      PAH content and ability to form DNA adducts when applied topically to mouse skin.
      The levels of 19 PAHs, determined by GC, were in total, approximately 22 times
      higher in used oils from petrol engines than in oils from diesel engines. Male
      Parkes mice were treated with 50 microliters of oil daily for 4 days before they
      were killed and DNA isolated from skin and lung tissue. DNA samples were analysed
      by nuclease P1-enhanced 32P-postlabelling. Used oils from both diesel and petrol
      engines showed several adduct spots on PEI-cellulose plates at total adduct
      levels of up to 0.57 fmol/microgram DNA [approximately 60 times greater than in
      experiments with samples of unused oil in which adduct levels (0.01-0.02 fmol
      adducts/microgram DNA) were close to the limit of detection]. Higher adduct
      levels were generally formed by petrol engine oils than by diesel engine oils.
      Lung DNA contained similar total adduct levels to those in skin although the
      adduct maps were less complex. Total adduct levels correlated with extent of oil
      use in the engine, the total PAH concentration in oils and with the
      concentrations of certain individual PAHs present in the oils. An adduct spot
      that co-eluted with that of the major benzo[a]pyrene-DNA adduct accounted for 9
      26% of the total adducts in skin DNA, and approximately 8% of the adducts in lung
      DNA, of mice treated with petrol engine oils. A major, and as yet unidentified,
      adduct spot comprised up to 30% of the total adducts in skin DNA, and up to 89%
      of the total adducts in lung DNA, of these animals.

PMID- 2225337
TI  - Distribution and metabolism of the natural anticarcinogen phenethyl
      isothiocyanate in A/J mice.
AB  - The distribution and metabolism of phenethyl isothiocyanate (PEITC), a naturally
      occurring anticarcinogen, was investigated in A/J mice. Mice were administered 5
      mumol of [14C]PEITC (2 microCi/mouse) by gavage and killed at 1, 2, 4, 8, 24, 48
      or 72 h after dosing. Radioactivity present in the spleen, heart, liver, lung,
      kidney, brain, urine and feces was measured. Lung, the target tissue of PEITC
      inhibition of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) lung
      tumorigenesis, showed maximum radioactivity between 4 and 8 h after dosing,
      suggesting this time period would be optimal for maximal inhibition by PEITC in
      A/J mice. Approximately 50% of the total radioactivity was excreted within 24 h
      after dosing with nearly 80% of radioactivity found in urine and feces at 72 h.
      Two metabolites were isolated by reverse-phase HPLC from urine of mice treated
      with PEITC. The identities of these metabolites were determined by comparison
      with synthetic standards and by NMR and MS. The major metabolite was a cyclic
      mercaptopyruvic acid conjugate, whereas the minor metabolite was an N
      acetylcysteine conjugate. Approximately 25% of the administered dose of PEITC was
      excreted as the cyclic mercaptopyruvic acid conjugate and 10% as the N
      acetylcysteine conjugate. These results suggest that urinary metabolites of PEITC
      may provide potentially useful dosimeters for this natural anticarcinogen.

PMID- 2225338
TI  - Metabolism of 2S-hydroxy-3-methylcholanthrene by rat liver microsomes.
AB  - Products formed in the metabolism of 2S-hydroxy-3-methylcholanthrene (2S-OH-3MC)
      by liver microsomes prepared from phenobarbital-treated rats were isolated by
      sequential use of reversed-phase and normal-phase HPLC. Metabolites of 2S-OH-3MC
      were characterized by UV-visible absorption, mass and circular dichroic spectra,
      and chiral stationary phase HPLC analyses. The metabolites that had been
      identified were 2S-hydroxy-3-hydroxymethylcholanthrene (2S-OH-3-OHMC), 3MC-2-one,
      3MC-2-one 9,10-dihydrodiol, 8-hydroxy-2S-OH-3MC, a pair of stereoisomers 3MC
      (trans)-1R,2R-diol and (cis)-1S,2R-diol in a ratio of approximately 11:89, a pair
      of diastereomers 2S-OH-3MC 9R,10R-dihydrodiol and 2S-OH-3MC 9S,10S-dihydrodiol in
      a ratio of approximately 9:1, and a pair of diastereomers 2S-OH-3MC 11R,12R
      dihydrodiol and 2S-OH-3MC 11S,12S-dihydrodiol in a ratio of approximately 77:23.
      A few tentatively identified minor metabolites were 3-OHMC trans-1R,2R-diol, 10
      hydroxy-2S-OH-3MC, a 9,10-dihydrodiol derived from 3MC cis-1S,2R-diol, and a
      11,12-dihydrodiol and two diastereomeric 9,10-dihydrodiols derived from 2S-OH-3
      OHMC. Since the racemic 2-OH-3MC is a known potent carcinogen and 2S-OH-3MC is
      the most abundant metabolite of 3MC, some of the 2S-OH-3MC metabolites identified
      in this study may be further converted to proximate and ultimate carcinogens
      which may contribute to the overall carcinogenicity exhibited by 3MC.

PMID- 2225339
TI  - Conjugated diene and trans fatty acids in a choline-devoid diet
      hepatocarcinogenic in the rat.
AB  - It has been postulated that the hepatocarcinogenicity of a choline-devoid diet in
      rats stems from peroxidation of liver lipids. We have investigated whether the
      diet contains conjugated dienes that could account directly for those detected in
      liver lipids of rats fed a choline-devoid diet. Analyses were performed on
      samples of corn oil and of a partially hydrogenated fat used to prepare
      semipurified choline-devoid and choline-supplemented diets, and on fat extracted
      from two pairs of diets, one set containing 5% corn oil and 10% partially
      hydrogenated fat, and the other only corn oil (15%). The analyses consisted of
      quantitation of conjugated dienes by UV spectrophotometry, separation of fatty
      acids with conjugated dienes by HPLC, and quantitation of trans fatty acids by IR
      spectrophotometry. Small levels of conjugated diene and trans fatty acids were
      present in the corn oil, but much higher amounts were found in the partially
      hydrogenated fat. HPLC analysis yielded distinct elution profiles for the fatty
      acids with conjugated dienes present in the two fats, and similar results were
      obtained with fat extracted from the diets. However, no differences were observed
      between choline-devoid and control choline-supplemented diets. The results
      indicate that caution must be exercised in interpreting data from UV analysis of
      tissue lipids of rats fed diets containing a partially hydrogenated fat.

PMID- 2225340
TI  - Conjugated diene and trans fatty acids in tissue lipids of rats fed an
      hepatocarcinogenic choline-devoid diet.
AB  - Groups of male Fischer-344 rats were fed two pairs of semi-purified choline
      devoid and choline-supplemented diets, one set containing 5% corn oil and 10%
      partially hydrogenated fat, and the other only corn oil (15%). Analyses were
      performed on lipids extracted from whole liver, liver nuclei and adipose tissue
      of the rats. The analyses consisted of quantitation of conjugated dienes by UV
      spectrophotometry, separation of fatty acids with conjugated dienes by HPLC and
      quantitation of trans fatty acids by IR spectrophotometry. Conjugated dienes and
      conjugated diene and trans fatty acids were observed in adipose tissue total
      lipids, at concentrations that reflected those in the diets fed. The same was
      true of trans fatty acids in liver lipids. However, no conjugated dienes, or
      fatty acids with conjugated dienes, were detected in liver lipids of rats fed the
      diets formulated with only corn oil. In contrast, conjugated dienes were detected
      in total and neutral lipids, but not in phospholipids, of whole liver and liver
      nuclei of rats fed the diets formulated with partially hydrogenated fat. The
      neutral lipids contained fatty acids with conjugated dienes that eluted with the
      retention time of conjugated diene fatty acids, present in the dietary partially
      hydrogenated fat. It is concluded that a choline-devoid diet, which is
      hepatocarcinogenic in the rat, does not induce a peroxidation of liver cell
      membrane lipids, and that not only trans fatty acids, but also fatty acids with
      conjugated dienes present in a partially hydrogenated fat, are absorbed and
      assimilated in rat tissue lipids.

PMID- 2225342
TI  - Distribution of phorbol ester TPA-induced structural chromosomal aberrations in
      HeLa cells.
AB  - In order to gain further insight into the mechanism of clastogenic action of the
      phorbol ester 12-O-tetradecanoyl-phorbol-13-acetate (TPA), the localization and
      distribution of structural chromosomal aberrations on HeLa chromosomes was
      investigated. We have shown by the G-banding technique that TPA-induced
      chromosomal aberrations in HeLa cells have practically the same distribution as
      that occurring spontaneously in control cultures. About two-thirds of the
      breakpoints are located in areas of known fragile sites; about one-third is
      located in regions near known oncogenes. The tumor promoter TPA thus appears to
      enhance pre-existing mechanisms of an 'endogeneous' clastogenesis.

PMID- 2225341
TI  - Formation of cyclic deoxyguanosine adducts in Chinese hamster ovary cells by
      acrolein and crotonaldehyde.
AB  - Acrolein and crotonaldehyde are alpha,beta-unsaturated carbonyl compounds that
      form 1,N2-propanodeoxyguanosine adducts when reacted with DNA in vitro. These
      compounds are mutagenic in Salmonella, and crotonaldehyde is tumorigenic in rats.
      This study used immunoassay and 32P-postlabeling methods to determine if acrolein
      and crotonaldehyde form these adducts in cultured mammalian cells. Adduct levels
      were highest in Chinese hamster ovary cells exposed to acrolein (1 mM) with 162
      mumol adduct/mol deoxyguanosine. Crotonaldehyde (10 mM) formed adduct at a level
      of 75 mumol/mol deoxyguanosine. 32P-Postlabeling analysis confirmed the presence
      of adducts in crotonaldehyde-treated cells. Persistence studies showed that
      adduct levels were unchanged if the cells were cultured for 6 h before DNA
      isolation. Mutagenicity studies were performed to determine the biological
      consequences of these adducts. Mutations were not observed due to the toxicity of
      the compounds.

PMID- 2225343
TI  - DNA sequencing of a mouse liver protein that binds selenium: implications for
      selenium's mechanism of action in cancer prevention.
AB  - Complementary DNA clones for liver protein 56K (SLP-56) were isolated by
      screening a lambda Zap mouse liver library. The cloned cDNAs represented the
      complete message. The correct reading frame was verified by alignment of the
      deduced amino acid sequence with that of peptides sequenced from the purified
      protein. The primary sequence has not been reported previously since homologous
      DNA sequences were not found in GenBank. Most importantly, the DNA sequence did
      not contain an in-frame TGA codon that would code for seleno-cysteine, as occurs
      in the prototypic selenoprotein, glutathione peroxidase. Hydropathy analysis
      suggested the protein was not a membrane-spanning protein. SLP-56 was previously
      localized as a cytosolic-soluble protein on the basis of cell fractionation
      experiments. The results suggest that SLP-56 is different from proteins whose
      synthesis and concentration are dependent upon selenium and require TGA to encode
      for selenocysteine. In this respect, SLP-56 appears to be similar to liver fatty
      acid binding protein (SLP-14) for which selenium is a ligand. Our working
      hypothesis is that selenium exerts its inhibitory effects on cell growth by
      modulating the properties of existing growth regulatory proteins. The two
      proteins that are readily labeled by selenium in many rodent tissues, SLP-56 and
      SLP-14, would fit into this category.

PMID- 2225344
TI  - Educational and occupational outcome in Prader-Willi syndrome.
AB  - An educational and occupational history was obtained for affected members of the
      Prader-Willi Syndrome Association (UK). Of 32 females and 29 males over 16 years
      of age (mean 23 years), over 45% attended mainstream infant schools, but by the
      time they reached junior and secondary schools the majority were in schools for
      children with learning disabilities. On reaching adulthood, 31% were attending
      adult training centres or day centres. Nearly one in six were in employment,
      usually of a sheltered type. The majority had no formal educational
      qualifications, but over 10% had at least one Certificate of Secondary Education
      and one person had three O levels. Nearly three-quarters of those with known
      intelligence quotients had IQs in the 70 to 100 range. The physical and
      behavioural characteristics of the study population closely resembled those
      reported in Prader-Willi syndrome by other authors, although it is possible that
      some members of the Prader-Willi Syndrome Association (UK) may not have Prader
      Willi syndrome. The findings highlight the heterogeneity in educational
      achievements associated with Prader-Willi syndrome, and illustrate the importance
      of assessing individual educational strengths and needs.

PMID- 2225346
TI  - Scene schemata and scripts in children's understanding of hospital.
AB  - In a first study, 90 children (aged 3-5 years) were shown a photograph of a
      hospital scene, and then asked to identify which of 12 separate items were
      present in the original scene. Children made more plausible than implausible
      errors, suggesting that they had well-organized schemata for hospital scenes. In
      a second study, we investigated children's knowledge of hospital-related routines
      and activities. A total of 152 children (aged 3-5, 6-8 and 9-10 years) were shown
      five photographs of hospital and five photographs of school, and asked to arrange
      each set to 'tell a story'. Children in different age groups showed relatively
      high agreement in their orderings, and also in selecting the 'most important
      photograph'. The data suggest that children's knowledge of hospital is organized
      around rudimentary schemata and scripts, which enable them to make very plausible
      inferences about hospital scenes and activities.

PMID- 2225345
TI  - Night waking in 1-year-old children in England.
AB  - A national sample of 1500 mothers of 1-year-old children received a postal
      questionnaire concerned with the sleeping patterns of their children. The
      response rate was 69%. Seventeen per cent of mothers reported that their 1-year
      old presented a moderate or severe sleep problem and 26% said their child woke at
      night on at least five nights a week. While these two measures correlated, 10% of
      those who reported their infant woke on at least five nights a week did not
      consider this to be a problem. Neither sex of infant, social class, method of
      infant feeding or numbers of house moves were associated with sleep problems. The
      pattern of results strongly suggest an association between night waking and other
      sleeping difficulties and stress for mothers. This was indicated by the
      association we found with complaints about housing, overcrowding, more negative
      attitudes toward motherhood, lower assessments of maternal well-being, lack of
      practical support from partners, the use of more negative adjectives to describe
      their baby and more frequent feelings of being dominated by their baby. While
      these associations may be explained by the stresses of living with a night-waking
      baby, it is also likely that a mother who is feeling somewhat depressed and
      negative toward her baby is more likely to see night waking as significant and as
      a problem. There were class differences in how parents coped with a shortage of
      space. Middle-class parents were more likely to put a baby in with a sibling
      while working class parents more often had the baby in their own room. Middle
      class parents were more likely to leave a night-waking baby to cry.

PMID- 2225347
TI  - Mutual support for families of children with eye cancer.
AB  - For parents to be told that their child has been diagnosed as having
      retinoblastoma is totally devastating. Retinoblastoma is a cancerous condition of
      the eye which occurs mostly in children, usually before the age of 3 years. To be
      confronted with the problem of sight loss and cancer is a tremendous shock. In
      appreciation of this, the staff of Moorfields Eye Hospital in London were well
      aware of the need and desire of parents to form a self-help group for mutual
      support during this traumatic period in parents' lives. The purpose of this
      article is to discuss the importance of forming a self-help group for families
      with children affected by retinoblastoma and to describe how the Retinoblastoma
      Society was established.

PMID- 2225348
TI  - Electrotonic influences on action potentials from isolated ventricular cells.
AB  - This work combines a theoretical study of electrical interactions between two
      excitable heart cells, using a variable coupling resistance, with experimental
      studies on isolated rabbit ventricular cells coupled with a variable coupling
      resistance to a passive resistance and capacitance circuit. The theoretical
      results show that the response of an isolated cell to an increased frequency of
      stimulation is strongly altered by the presence of a coupling resistance to
      another cell. As the coupling resistance gradually is decreased, the stimulated
      cell becomes able to respond successfully to more rapid stimulation, and then, at
      levels of coupling resistance that allow conduction between the two cells, the
      coupled pair of cells exhibits arrhythmic interactions not predicted by the
      intrinsic properties of either cell. The experimental results show that the
      isolated rabbit ventricular cell is extremely sensitive to even a very small
      electrical load, with shortening of the action potential by 50% with electrical
      coupling to a model cell (of similar input resistance and capacitance to the
      ventricular cell) as high as 1,000 M omega, even though the action potential
      amplitude and current threshold are very insensitive to the electrical load.

PMID- 2225350
TI  - Lymphatic pumping in response to changes in transmural pressure is modulated by
      erythrolysate/hemoglobin.
AB  - Red blood cells and lysate products (erythrolysate) are observed consistently in
      lymph draining acute and chronic inflammatory reactions and from tissues
      subjected to trauma or surgical procedures. Using hemoglobin as a marker for
      erythrolysate, we have measured hemoglobin in lymph up to the 10(-6) M range in a
      number of pathophysiological states. Data demonstrate that erythrolysate alters
      the pumping characteristics of lymphatic vessels. To test the effects of
      erythrolysate on lymphatic pumping, bovine lymphatics were suspended in an organ
      bath preparation with the vessels cannulated at both inflow and outflow ends. By
      raising the heights of the Krebs reservoir and the outflow catheters
      appropriately, a transmural pressure that stimulated pumping activity could be
      applied to the vessels. With a fixed transmural pressure of 6 cm H2O applied to
      the ducts, sheep erythrolysate depressed pumping activity between 40% and 100%,
      with dilutions containing between 10(-8) and 10(-5) M hemoglobin. Although the
      active principle in the red blood cells has not been characterized, evidence from
      precipitation purification experiments suggests that hemoglobin is an important
      component. Once suppressed, pumping could be restored in many but not all vessels
      (often to control levels) by elevating the distending pressure above 6 cm H2O.
      The relation between transmural pressure and fluid pumping is expressed as a bell
      shaped curve, with pumping increasing up to a peak pressure (usually 8 cm H2O)
      and declining at pressures above this level. By comparing pressure/flow curves,
      we were able to ascertain that hemoglobin shifted the lymphatic function curve to
      the right and, on average, reduced the maximum pumping capability of the vessels.
      We speculate that the presence of erythrolysate/hemoglobin in lymph may modulate
      the ability of lymphatic vessels to drain liquid and protein from the tissue
      spaces.

PMID- 2225349
TI  - Energy demand, supply, and utilization in hypoxia, and force recovery after
      reoxygenation in rabbit heart muscle.
AB  - In rabbit papillary muscle contracting at 20 degrees C in nitrogen at 0.2 Hz,
      glycolytic ATP formation is just enough to support the diminished contractile
      activity. Basal metabolism, important to maintain cellular function and
      integrity, is strongly inhibited. In the present study, we address the question
      of whether the inhibition of basal processes in hypoxia determines redevelopment
      of force in reoxygenation. By not stimulating the muscle during hypoxia, we try
      to make more ATP available for basal processes. Isometric force of papillary
      muscles (0.2-Hz stimulation) is measured before, during, and after 40 minutes of
      hypoxia. ATP formation and utilization in hypoxia are estimated from lactate
      production and changes in nucleotides and creatine compounds. After
      reoxygenation, muscles stimulated during hypoxia produce a steady-state force of
      78% of the aerobic control; resting muscles recover to 94%. In contrast to
      expectation, lactate production in hypoxic resting muscles is only 30% of that in
      contracting ones. The findings indicate that basal metabolic rate of hypoxic
      muscles at rest is 14% of that of quiescent, well-oxygenated myocardium. We
      conclude that in hypoxic myocardium little ATP is available for basal metabolism,
      irrespective of the energy demand of the contractile system. It is therefore
      unlikely that the lower force found after reoxygenation in muscles stimulated
      during hypoxia is related to the degree of inhibition of basal processes.

PMID- 2225351
TI  - Nonuniform regional deformation of the pericardium during the cardiac cycle in
      dogs.
AB  - We hypothesized that local contact forces between the pericardium and the heart
      cause regional variation in pericardial deformation during the cardiac cycle,
      reflecting volume changes of the underlying cardiac chambers. To test this, we
      measured regional pericardial area over the right atrium (RA) and right ventricle
      (RV) with orthogonal pairs of sonomicrometers in six open-chest dogs. At a left
      ventricular end-diastolic pressure of 5 mm Hg, RV pericardial area paralleled RV
      volume, that is, shrinkage during ejection by 10 +/- 8% and expansion during
      filling. RA pericardial area was reciprocally related to RV pericardial area,
      with average expansion during ventricular ejection of 2 +/- 2%, thus paralleling
      RA volume during RV ejection. With volume loading, RV pericardial shrinkage
      during ejection increased to 14 +/- 6%, but the RA pericardial area change was no
      longer reciprocal (0 +/- 3% change during RV ejection). Elimination of contact
      forces by cardiac tamponade resulted in both marked attenuation of RV pericardial
      area changes and synchronization of the RV and RA pericardial area pattern; that
      is, both shrank during RV ejection. In two additional dogs, measurement of
      pericardial area over left ventricle and atrium showed similar results. We
      conclude that dynamic pericardial contact forces cause regional variation in
      pericardial deformation, which reflects volume changes of the underlying
      chambers. These findings imply that the influence of the pericardium on filling
      and ejection may be more complex than previously recognized, varying both by
      chamber and dynamically over the course of the cardiac cycle.

PMID- 2225352
TI  - Interrelation between pinacidil and intracellular ATP concentrations on
      activation of the ATP-sensitive K+ current in guinea pig ventricular myocytes.
AB  - The patch-clamp technique was used to study the relation between pinacidil and
      intracellular ATP concentration [( ATP]i) on the activation of the outward K+
      current in guinea pig ventricular myocytes. Pinacidil shortened the action
      potential duration, exhibiting stronger effect at 2 mM [ATP]i than at 5 mM
      [ATP]i. Pinacidil at 5 microM or higher concentrations activated the time
      independent outward current at potentials positive to -80 mV, and the pinacidil
      activated current was suppressed by increasing [ATP]i from 2 to 5 mM. The dose
      response curve of pinacidil at different [ATP]i showed a shift to the right and a
      depression of the maximum response at increased [ATP]i. The pinacidil-induced
      shortening of the action potential duration and outward current were inhibited by
      application of 0.3-1.0 microM glibenclamide. In single-channel current
      recordings, pinacidil activated the intracellular ATP-sensitive K+ channel
      current without changing the unitary amplitude, and increased open probability of
      the channel, an effect dependent on [ATP]i. The pinacidil-activated single
      channel current was blocked by glibenclamide. These results prove the notion that
      pinacidil activates the ATP-sensitive K+ channel current, which explains the
      action potential shortening in cardiac cells after application of pinacidil.

PMID- 2225354
TI  - Evidence for decreased coronary flow reserve in viable postischemic myocardium.
AB  - To try to unravel the complexity and heterogeneity of the "no-reflow" phenomenon
      and its underlying mechanisms, we studied tissue perfusion in reperfused heart
      muscle by using tracer microspheres in an anesthetized dog model of 90-minute
      coronary occlusion followed by reperfusion for 2 1/2 hours, 24 hours, or 1 week.
      Regional myocardial blood flow was determined both in basal flow conditions and
      during reactive hyperemia. The effect of intracoronary adenosine administration
      was examined, and the ultrastructure of postischemic myocardium was analyzed. In
      viable reperfused tissue (as delineated by triphenyltetrazolium chloride
      staining), reflow in basal conditions is unimpaired. Coronary flow reserve (as
      approximated by peak reactive hyperemic flow) is intact at the start of
      reperfusion, decreases by more than half after 2 1/2 hours, and recovers
      completely within 1 week. This impairment of coronary reserve can be relieved by
      intracoronary adenosine administration. On ultrastructural examination, the
      capillaries are patent. On the other hand, in irreversibly damaged myocardium,
      both the basal reflow impairment and the decrease in coronary flow reserve are
      severe and permanent. Coronary flow reserve is already decreased at the start of
      reperfusion, and the pharmacological intervention has no beneficial effect.
      Ultrastructurally, extracellular and intracellular edema invariably are present,
      whereas the vascular endothelium is damaged and the capillaries are packed with
      red blood cells. We conclude that the no-reflow phenomenon (i.e., mechanical
      obstruction to blood flow) is limited to infarcted tissue. In viable myocardium,
      however, coronary flow reserve is transiently diminished, probably because of
      washout and subsequent insufficient availability of the chemical mediator
      adenosine after breakdown and slow recovery of the precursor ATP pool.

PMID- 2225353
TI  - Neuropeptide Y modulates vasoconstriction in coronary microvessels in the beating
      canine heart.
AB  - The purpose of this study was to determine whether neuropeptide Y has a direct
      vasoconstrictor effect at low doses, mimicking the physiological plasma
      concentration on the specific site(s) of coronary arterial microvessels in in
      situ beating canine left ventricles. Coronary microvessels were directly observed
      by means of an intravital microscope and video system equipped with a floating
      objective. Epi-illuminated fluorescence coronary microangiography was performed
      in open-chest anesthetized dogs (n = 14) to examine the changes in internal
      diameter of epimyocardial arterial microvessels. Flow velocity of fluorescently
      labeled microshperes in capillaries was also measured (n = 6). To eliminate
      secondary effects of neuropeptide Y on coronary microvessels via autonomic
      nervous modulation, experiments were conducted under pharmacological blockade of
      the regional autonomic nervous system by intracoronary injection of propranolol,
      50 micrograms/kg; phentolamine, 100 micrograms/kg; and atropine, 5 micrograms/kg.
      Aortic pressure and heart rate were kept constant during the experiments.
      Intracoronary infusion of three different doses of neuropeptide Y (1, 10, and 100
      pmol/kg/min) for 5 minutes significantly constricted small microvessels (less
      than 100 microns in diameter) (-5.2 +/- 1.4%, -8.5 +/- 1.5%, and -14.0 +/- 1.7%;
      p less than 0.05 versus before neuropeptide Y at each dose), medium microvessels
      (100-200 microns in diameter) (-5.5 +/- 1.6%, -10.6 +/- 1.8%, and -16.8 +/- 2.1%,
      p less than 0.05 versus before neuropeptide Y at each dose), and large
      microvessels (greater than 200 microns in diameter) (-3.6 +/- 0.6%, -5.8 +/-
      0.8%, and -10.0 +/- 1.1%; p less than 0.05 versus before neuropeptide Y at each
      dose) in a dose-dependent manner. Capillary flow velocity was reduced by 17.2 +/-
      3.1% by an intracoronary dose of 100 pmol/kg/min of neuropeptide Y (p less than
      0.05). The present study indicates that low doses of neuropeptide Y exert a
      homogeneous direct vasoconstrictor effect on various sizes of coronary arterial
      microvessels and reduce capillary flow velocity. These results suggest that
      neuropeptide Y may play a physiological role in modulating coronary microvascular
      tone.

PMID- 2225355
TI  - Reperfusion and readmission of oxygen. Pathophysiological relevance of oxygen
      derived free radicals to arrhythmogenesis.
AB  - We have examined the pathophysiological role of readmission of oxygen (and hence
      production of oxygen-derived free radicals) in the initiation of reperfusion
      induced arrhythmias by separating, on a temporal basis, readmission flow from
      readmission of oxygen. Isolated rat hearts (n = 12/group) were subjected to 10
      minutes of regional ischemia and 10 minutes of reperfusion. In controls
      reperfused with oxygenated solution (Po2 greater than 600 mm Hg), 92% of hearts
      developed ventricular fibrillation (VF) during the first 20 seconds of
      reperfusion, whereas in hearts reperfused with hypoxic solution (Po2 9.3-12.2 mm
      Hg), the incidence of VF was only 17% (p less than 0.05). Subsequent readmission
      of control solution (Po2 greater than 600 mm Hg) to the latter group led, within
      20 seconds, to the appearance of VF in seven of the 10 hearts (70%) that had not
      previously fibrillated. To examine whether hypoxic reperfusion had prevented VF
      or merely delayed its onset, the studies were repeated in separate groups of
      hearts with the duration of hypoxic reperfusion extended to 5 minutes. In
      addition, to examine the partial pressure dependence of the relation, the Po2 in
      the reperfusion solution was set at one of five different levels: greater than
      600, 150-192.7, 69-85.6, 9.2-14.8, or 0.0 mm Hg. It was found that hypoxia merely
      delayed VF onset by 20-40 seconds and did not significantly reduce the incidence
      of VF, which was 83%, 92%, 67%, 58%, and 58%, respectively. This indicated that
      readmission of oxygen is unnecessary for the initiation of VF during reperfusion.
      The hearts that reverted to sinus rhythm during the ensuing 5 minutes (n = 8, 4,
      5, 9, and 8, respectively) were used to assess the arrhythmogenic consequences of
      readmission of oxygen. When control solution (Po2 greater than 600 mm Hg) was
      readmitted, new episodes of VF were elicited within 20 seconds in a manner that
      was inversely proportional to the preceding Po2 (p less than 0.05), the incidence
      of new episodes of VF being 0%, 0%, 40%, 67%, and 86%, respectively. The
      arrhythmogenic effect of readmission of oxygen was not the result of a sudden
      increase in heart rate, because a similar arrhythmogenic effect of readmission of
      oxygen was seen in separate groups of hearts that were paced (350 beats/min)
      throughout hypoxia and readmission of oxygen. In conclusion, readmission of flow
      and readmission of oxygen are independent determinants of reperfusion-induced
      arrhythmias.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2225356
TI  - Pulmonary model to predict the effects of series ventricular interaction.
AB  - To fully describe the mechanisms of diastolic interaction between the right
      ventricle and left ventricle, it is necessary to understand how a change in right
      ventricular output (Qrvo) is transmitted across the pulmonary circulation. This
      series ventricular interaction is manifest as the temporal response in left
      ventricular filling (Qlvf) to a change in Qrvo. To quantify series interaction we
      used a three-element, two-parameter model of the pulmonary circulation. The
      parameters represented the pulmonary arterial and venous resistance and pulmonary
      vascular compliance. Using beat-to-beat values of mean pressure and flow measured
      at the input and output of the pulmonary circulation during the transient
      response to caval or pulmonary artery occlusion, we estimated the parameters for
      this model in eight open-chest dogs under control conditions, after autonomic
      blockade, and after fully opening the pericardium. From 110 separate data
      episodes, the average values of the pulmonary arterial and venous resistance and
      pulmonary vascular compliance were 0.14 +/- 0.08 mm Hg.sec/ml and 4.81 +/- 3.17
      ml/mm Hg (+/- SD). These estimates were insensitive to the simultaneous effects
      of autonomic reflexes and direct ventricular interaction, so they uniquely
      measure the bulk transport properties of the pulmonary circulation. The time
      constant, which measures the response of Qlvf to a change in Qrvo, averaged 0.26
      +/- 0.15 second, which implies that effects of series interaction on Qlvf are
      manifest within one beat. The model was also able to predict the dynamic response
      of Qlvf to changes in Qrvo and thus can be used to measure and predict the
      effects of series interaction in the intact cardiopulmonary system.

PMID- 2225357
TI  - Time course of cellular enzyme release in dog heart injury.
AB  - The transport time of enzyme from heart to plasma was studied in two experimental
      models. First, the enzyme alanine aminotransferase was slowly infused into the
      left ventricular wall in open-chest dogs. The half-life for the washout of
      alanine aminotransferase activity into plasma was 20 +/- 4 minutes (mean +/- SEM,
      n = 8) and was not different in ischemic and normally perfused tissue. From
      measurements of arteriovenous differences in alanine aminotransferase activity
      and left ventricular blood flow, it was concluded that 77 +/- 14% of total enzyme
      washout from ischemic tissue occurred by direct entry into the bloodstream. The
      corresponding value for the vascular permeability-surface area product was 264 +/
      55 ml.kg-1.hr-1. For a second model, we studied myocardial enzyme release into
      plasma after abrupt heart injury induced by 10 minutes of calcium-free coronary
      perfusion followed by reintroduction of calcium (calcium-paradox mechanism). The
      half-life for the release into plasma was 1.9 +/- 0.2 hours (mean +/- SEM, n = 6)
      and was again not influenced by sustained ischemia. Slower washout, as observed
      for this second model, is consistent with increased interstitial protein space
      and corresponds to a permeability--surface area product between 135 and 285 ml.kg
      1.hr-1. These results were used to calculate the time course of cellular enzyme
      leakage from the rate of enzyme release into plasma in various forms of heart
      injury. Significant shifts between the time curves of evolving cellular injury
      and enzyme release into plasma are observed after 2 hours of ischemia followed by
      coronary reperfusion, but not after permanent ischemia.

PMID- 2225358
TI  - Stimulation of serotonin2 receptors in the ventrolateral medulla of the cat
      results in nonuniform increases in sympathetic outflow.
AB  - Topical application of the serotonin2 agonist, 1-(2,5-dimethoxy-4-iodophenyl)-2
      aminopropane or DOI, in a dose of 30 micrograms/side to the intermediate area of
      the ventrolateral surface of the medulla produced a significant increase in mean
      arterial pressure with no significant change in heart rate both in intact animals
      (n = 8) and in cervically vagotomized animals (n = 3). The pressor response of
      DOI was blocked by pretreatment of the intermediate area with ketanserin, a
      serotonin2 antagonist (n = 7). Pretreatment with intravenous phentolamine did not
      block the pressor response of DOI (n = 3). However, this pressor response could
      be counteracted by intravenous propranolol (n = 5) or by bilateral stellate
      ganglionectomy (n = 3). These data suggest that sympathoexcitation by centrally
      applied DOI selectively increased cardiac inotropy but not chronotropy. Further
      studies indicate that DOI increased contractile force without increasing heart
      rate and that the positive inotropic effect of DOI could be counteracted by
      bilateral stellate ganglionectomy. Bilateral microinjections of DOI into the
      subretrofacial nucleus in a dose of 100 ng (n = 3) and a dose of 300 ng (n = 3)
      increased mean arterial blood pressure by 23 +/- 2 and 44 +/- 6 mm Hg,
      respectively, without producing any changes in heart rate. These data suggest
      that DOI has a central site of action in the ventrolateral medulla, presumably at
      the subretrofacial nucleus, which leads to selective sympathoexcitation of the
      cardiac ventricles.

PMID- 2225359
TI  - Studies of recombinant plasminogen activator inhibitor-1 in rabbits.
      Pharmacokinetics and evidence for reactivation of latent plasminogen activator
      inhibitor-1 in vivo.
AB  - The pharmacokinetics of human recombinant plasminogen activator inhibitor-1 (rPAI
      1) was studied in rabbits. Latent rPAI-1 (0-2 units of tissue-type plasminogen
      activator neutralizing activity per microgram protein); reactivated rPAI-1
      (approximately 150 units/micrograms); and chloramine T-oxidized, nonreactivatable
      rPAI-1 (approximately 0.7 units/microgram) were studied. The pharmacokinetic
      parameters for the disposition of rPAI-1 antigen after an intravenous bolus
      injection of 1.0 or 2.5 mg/kg rPAI-1 were very similar for all three forms: the
      initial volume of distribution was approximately 60 ml/kg, the initial half-life
      in plasma was 6 minutes, and the plasma clearance was approximately 4 ml/kg/min.
      The disposition of PAI activity after injection of reactivated rPAI-1 was similar
      to that of rPAI-1 antigen. Injection of latent rPAI-1 was associated with a
      nearly threefold increase in the specific activity of circulating PAI-1 from 2
      units/micrograms to 5.0 +/- 1.1 units/micrograms (p less than 0.01) within 1
      minute, followed by a cumulative 25-fold increase in specific activity over 1
      hour (p = 0.01). In contrast, the specific activity of oxidized or reactivated
      preparations of rPAI-1 did not increase in the first several minutes after
      injection. These findings support the existence of a fast-acting but low-capacity
      mechanism for the reactivation of rPAI-1 in vivo.

PMID- 2225360
TI  - Differences in transient outward currents of feline endocardial and epicardial
      myocytes.
AB  - Whole-cell voltage-clamp experiments were performed on enzymatically dissociated
      single ventricular myocytes harvested from feline endocardial and epicardial
      surfaces. The studies were designed to test the hypothesis that the differences
      in the amplitude of transient outward current (Ito) contribute to the difference
      in action potential configuration between endocardial and epicardial myocytes. In
      the control state, action potentials recorded from epicardial cells demonstrated
      a prominent notch between phases 1 and 2, and membrane current recordings
      displayed a prominent Ito, whereas in endocardial cells the notch in action
      potentials and Ito were small. External application of 4-aminopyridine (2 mM)
      reduced the amplitudes of notch and Ito in epicardial cells but not in
      endocardial cells. After application of 4-aminopyridine (2 mM) and caffeine (5
      mM), the notch and Ito were abolished completely in both endocardial and
      epicardial cells. The first component of Ito (Ito1) was present in all epicardial
      cells studied (n = 20); it was absent in 12 of the 20 endocardial cells, and a
      small Ito1 was present in the remaining eight endocardial cells. The mean
      amplitude of Ito1 was significantly greater in epicardial than in endocardial
      cells. At a test voltage of +80 mV, the amplitude of Ito1 was 102.0 +/- 47.7
      pA/pF in epicardial cells and 3.3 +/- 3.3 pA/pF in endocardial cells (p less than
      0.01). The second component of Ito (Ito2) was present in all endocardial (n = 30)
      and epicardial (n = 30) cells studied. The amplitude of Ito2 was significantly
      greater in epicardial than in endocardial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225361
TI  - Beta-adrenergic regulation of the muscarinic-gated K+ channel via cyclic AMP
      dependent protein kinase in atrial cells.
AB  - Cholinergic and beta-adrenergic stimulations of ionic currents are major
      physiological mechanisms in the regulation of heart rate and contractility.
      Muscarinic receptor stimulation is known to reduce beta-adrenergic effects on
      calcium current via reduction of cyclic AMP. Whether the beta-adrenergic
      stimulation affects the muscarinic response is not known. I report here that the
      beta-adrenergic agonist isoproterenol enhanced the muscarinic-activated K+
      channel activity in rat atrial cells. Application of cyclic AMP-dependent protein
      kinase or its catalytic subunit to the cytoplasmic side of the membrane augmented
      the acetylcholine-activated K+ channel activity twofold to threefold. Increases
      in channel activity produced by isoproterenol or cyclic AMP-dependent protein
      kinase were associated with fourfold to fivefold and approximately twofold
      increases in the mean open and closed time durations, respectively. Alkaline
      phosphatase treatment reversed these effects. These results suggest that cyclic
      AMP-dependent phosphorylation of the K+ channel or associated regulatory proteins
      modulates the gating kinetics of the channel. This mechanism may be important in
      the regulation of pacemaker activity and, thus, the heart rate during beta
      adrenergic stimulation.

PMID- 2225362
TI  - Comments on "Effect of cellular uncoupling by heptanol on conduction in infarcted
      myocardium".

PMID- 2225363
TI  - Clinical spectrum of ventricular tachycardia.

PMID- 2225364
TI  - Effects of adenosine on human coronary arterial circulation.
AB  - Adenosine is a potent vasodilator used extensively to study the coronary
      circulation of animals. Its use in humans, however, has been hampered by lack of
      knowledge about its effects on the human coronary circulation and by concern
      about its safety. We investigated in humans the effects of adenosine,
      administered by intracoronary bolus (2-16 micrograms), intracoronary infusion (10
      240 micrograms/min), or intravenous infusion (35-140 micrograms/kg/min) on
      coronary and systemic hemodynamics and the electrocardiogram. Coronary blood flow
      velocity (CBFV) was measured with a 3F coronary Doppler catheter. The maximal
      CBFV was determined with intracoronary papaverine (4.5 +/- 0.2.resting CBFV). In
      normal left coronary arteries (n = 20), 16-micrograms boluses of adenosine caused
      coronary hyperemia similar to that caused by papaverine (4.6 +/- 0.7.resting
      CBFV). In the right coronary artery (n = 5), 12-micrograms boluses caused maximal
      hyperemia (4.4 +/- 1.0.resting CBFV). Intracoronary boluses caused a small, brief
      decrease in arterial pressure (similar to that caused by papaverine) and no
      changes in heart rate or in the electrocardiogram. The duration of hyperemia was
      much shorter after adenosine than after papaverine administration. Intracoronary
      infusions of 80 micrograms/min or more into the left coronary artery (n = 6) also
      caused maximal hyperemia (4.4 +/- 0.1.resting CBFV), and doses up to 240
      micrograms/min caused a minimal decrease in arterial pressure (-6 +/- 2 mm Hg)
      and no significant change in heart rate or in electrocardiographic variables.
      Intravenous infusions in normal patients (n = 25) at 140 micrograms/kg/min caused
      coronary vasodilation similar to that caused by papaverine in 84% of patients
      (4.4 +/- 0.9.resting CBFV). At submaximal infusion rates, however, CBFV often
      fluctuated widely. During the 140-micrograms/kg/min infusion, arterial pressure
      decreased 6 +/- 7 mm Hg, and heart rate increased 24 +/- 14 beats/min. One
      patient developed 1 cycle of 2:1 atrioventricular block, but otherwise, the
      electrocardiogram did not change. In eight patients with microvascular
      vasodilator dysfunction (delta CBFV, less than 3.5 peak/resting velocity after a
      maximally vasodilating dose of intracoronary papaverine), the dose-response
      characteristics to intracoronary boluses and intravenous infusions of adenosine
      were similar to those found in normal patients.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2225365
TI  - Sex differences in control of cutaneous blood flow.
AB  - Women are far more likely than men to suffer from Raynaud's disease. The purpose
      of this study was to determine whether there are gender differences in local or
      central control of cutaneous blood flow that could account for the increased
      incidence of Raynaud's disease in women. To assess cutaneous blood flow, hand
      blood flow (HBF), finger blood flow (FBF), or skin perfusion (SP) was measured by
      fluid plethysmography, mercury strain-gauge plethysmography, or laser Doppler
      spectroscopy, respectively, in 47 volunteers. Basal HBF in men exceeded that of
      women (12.1 +/- 2.0 versus 6.2 +/- 1.5 ml/100 ml/min). Likewise, FBF in men
      surpassed that of women (19.5 +/- 4.1 versus 7.7 +/- 1.8 ml/100 ml/min).
      Similarly, SP in men was greater than that of women (270 +/- 42 versus 81 +/- 16
      perfusion units). However, after total body warming (to induce a thermal
      sympatholysis), HBF in women exceeded that of men, suggesting that the lower
      basal HBF in women was due to increased sympathetic outflow to the extremities.
      Mental stress and deep inspiration reduced HBF and SP in men. Paradoxically, both
      of these maneuvers increased HBF and SP in women. To determine whether these
      paradoxical responses in women were due to the women's elevated basal sympathetic
      tone, these experiments were repeated after total body cooling in men to increase
      sympathetic tone and after total body warming in women to reduce sympathetic
      tone. Total body cooling reduced HBF and SP in men. Under these conditions,
      mental stress and deep inspiration induced vasodilation. In women, total body
      warming for 10 minutes increased HBF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225366
TI  - Mortality after 10 1/2 years for hypertensive participants in the Multiple Risk
      Factor Intervention Trial.
AB  - The Multiple Risk Factor Intervention Trial (MRFIT) is a randomized primary
      prevention trial that tested the effect of a multifactor intervention program on
      coronary heart disease (CHD) mortality in 12,866 high-risk men aged 35-57 years.
      Men were randomly assigned to either a special intervention (SI) program, which
      consisted of dietary advice for lowering blood cholesterol levels, counseling
      aimed at cessation for cigarette smokers, and stepped-care treatment for
      hypertension for those with elevated blood pressure, or to their usual sources of
      health care within the community (UC). Among the 12,866 randomized men, 8,012
      (62%) were hypertensive at baseline. For this subgroup, mortality rates with 10.5
      years of follow-up were lower for the SI than for the UC group by 15% (p = 0.19)
      for CHD and 11% (p = 0.13) for all causes. These results reflected more favorable
      outcomes for SI compared with UC hypertensive men during the 3.8 posttrial years
      (March 1982 through December 1985) than during the preceding 6-8 years (through
      February 1982). During the posttrial years, death rates were lower for SI than
      for UC men by 26% (p = 0.09) for CHD and 23% (p = 0.02) for all causes. For those
      with diastolic blood pressure equal to or more than 100 mm Hg, this posttrial
      trend was a continuation of a trend during the trial; therefore, with 10.5 years
      of follow-up, death rates were markedly lower for SI than for UC by 36% (p =
      0.07) for CHD and 50% (p = 0.0001) for all causes. Similarly, for those without
      baseline resting electrocardiographic abnormalities, the favorable posttrial
      outcome for the SI group was a continuation of a trend during the trial. In
      contrast, for those with baseline diastolic blood pressure of 90-99 mm Hg and for
      those with baseline resting electrocardiographic abnormalities, the favorable
      posttrial mortality findings for the SI group were a reversal of unfavorable
      trends recorded during the trial. Two factors appear to have contributed to this
      more favorable mortality trend for the SI group: 1) a change in the diuretic
      treatment protocol for SI men about 5 years after randomization, which involved
      replacement of hydrochlorothiazide with chlorthalidone at a daily maximum dose of
      50 mg; and 2) a favorable effect of intervention on nonfatal cardiovascular
      events during the trial years. In addition, delay until the full impact of
      beneficial effects on mortality end points from smoking cessation and cholesterol
      lowering could have contributed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2225367
TI  - Ten-year follow-up of survival and myocardial infarction in the randomized
      Coronary Artery Surgery Study.
AB  - The Coronary Artery Surgery Study (CASS) randomized 780 patients to an initial
      strategy of coronary surgery or medical therapy. Of medically randomized
      patients, 6% had surgery within 6 months and a total of 40% had surgery by 10
      years. At 10 years, there was no difference in cumulative survival (medical, 79%
      vs. surgical, 82%; NS) and no difference in percentage free of death and nonfatal
      myocardial infarction (medical, 69% vs. surgical, 66%; NS). Patients with an
      ejection fraction of less than 0.50 exhibited a better survival with initial
      surgery treatment (medical, 61% vs. surgical, 79%; p = 0.01). Conversely,
      patients with an ejection fraction greater than or equal to 0.50 exhibited a
      higher proportion free of death and myocardial infarction with initial medical
      therapy (medical, 75% vs. surgical, 68%; p = 0.04) although long-term survival
      remained unaffected (medical, 84% vs. surgical, 83%; p = 0.75). There were no
      significant differences either in survival and freedom from nonfatal myocardial
      infarction, whether stratified on presence of heart failure, age, hypertension,
      or number of vessels diseased. Thus, 10-year follow-up results confirm earlier
      reports from CASS that patients with left ventricular dysfunction exhibit long
      term benefit from an initial strategy of surgical treatment. Patients with mild
      stable angina and normal left ventricular function randomized to initial medical
      treatment (with an option for later surgery if symptoms progress) have survival
      equivalent to those patients randomized to initial surgery.

PMID- 2225369
TI  - Blood pressure level, trend, and variability in Dunedin children. An 8-year study
      of a single birth cohort.
AB  - In a birth cohort of children in the Dunedin Multidisciplinary Health and
      Development Study in New Zealand, resting blood pressures were recorded
      biennially five times from age 7 to 15 years. Using previously described methods,
      we examined the level, trend, and variability of blood pressures in those
      children with at least three readings. The level, trend, and variability of
      height, weight, and body mass index were compared among six separate groups of
      children. Two groups were categorized on the basis of high systolic pressure
      levels, one with low variability and the other with high variability, which was
      thought to resemble adult labile hypertension. Two additional groups were
      categorized on the basis of increasing and decreasing blood pressure trends; the
      fifth group had consistently low blood pressures, and the sixth group consisted
      of the remaining children. There were significant differences among the groups
      for the level of all the physical measurements and for the trend of body mass
      index. No significant differences were found among the groups for gender or
      socioeconomic status. A parental history of high blood pressure, stroke, or heart
      attack was significantly more common in the first two groups.

PMID- 2225368
TI  - Change of left atrial systolic pressure waveform in relation to left ventricular
      end-diastolic pressure.
AB  - The relation between the left atrial systolic pressure waveform and left
      ventricular end-diastolic pressure was observed in 17 patients who underwent
      diagnostic cardiac catheterization. Left atrial pressure and left ventricular
      pressure were simultaneously recorded from a multisensor catheter before and
      during angiotensin infusion. Left ventricular systolic pressure and left
      ventricular end-diastolic pressure were 133 +/- 17 and 12.3 +/- 3.2 mm Hg,
      respectively, before angiotensin infusion and increased to 168 +/- 18 (p less
      than 0.01) and 19.4 +/- 4.5 mm Hg (p less than 0.01), respectively, during
      infusion. The left atrial systolic pressure curve consisted of two positive waves
      -a first wave (A) and a second wave (A'). The A and A' wave pressures were 11.6
      +/- 2.3 and 10.2 +/- 3.9 mm Hg, respectively, before angiotensin infusion and
      16.5 +/- 2.9 (p less than 0.01) and 18.1 +/- 4.7 mm Hg (p less than 0.01),
      respectively, during infusion. The ratio of A'/A of left atrial systolic pressure
      was 0.81 +/- 0.27 before angiotensin infusion and 1.08 +/- 0.14 (p less than
      0.01) during infusion. The ratio of A' to A of left atrial systolic pressure was
      linearly related to left ventricular end-diastolic pressure before and during (p
      less than 0.01) angiotensin infusion. The amplitude of the A wave exceeded that
      of the A' wave at normal left ventricular end-diastolic pressures. However, as
      the left ventricular end-diastolic pressure increased either at rest or during
      angiotensin infusion, the amplitude of the A' wave increased and often exceeded
      that of the A wave. These results suggest that the second (A') wave might be
      attributed to the increased reflection associated with increased left ventricular
      end-diastolic pressure.

PMID- 2225371
TI  - Late potentials and inducible ventricular tachycardia in surgically repaired
      congenital heart disease.
AB  - We compared signal-averaged electrocardiography with invasive
      electrophysiological study in patients after surgical repair of congenital heart
      disease to determine if potentially useful correlations exist between the two
      methods for assessment of risk for ventricular tachycardia. Thirty-one patients
      (age, 1-49 years; mean, 10.6 years) with congenital heart disease repaired with
      right ventriculotomy or postrepair right bundle branch block (77% postoperative
      tetralogy of Fallot) who had electrophysiological study were studied with signal
      averaged electrocardiography. Patients were classified by electrophysiological
      study results as having no inducible ventricular tachycardia, nonsustained
      ventricular tachycardia, or sustained ventricular tachycardia. Signal-averaged
      electrocardiograms were examined for the duration of low-amplitude (less than or
      equal to 40 microV) QRS signal, duration of total QRS, and root-mean-square
      voltage of the terminal 40 msec of the QRS. Low-amplitude terminal root-mean
      square voltage of 100 microV or less had 91% sensitivity and 70% specificity for
      ventricular tachycardia inducible by electrophysiological study. Similar
      sensitivity but less specificity were seen using the criterion of 20 msec or more
      total low-amplitude QRS signal (initial plus terminal) or using total QRS
      duration of 128 msec or more. There was a weaker association between terminal low
      amplitude QRS signal of 15 msec or more and inducible ventricular
      tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225370
TI  - Baffle fenestration with subsequent transcatheter closure. Modification of the
      Fontan operation for patients at increased risk.
AB  - Ventricular dysfunction, elevated pulmonary vascular resistance, and residual
      distal pulmonary artery distortion contribute to early mortality after a Fontan
      operation; they may be transient or reversible. A baffle fenestration, allowing
      right-to-left shunting, maintains cardiac output and limits right atrial
      pressure. A baffle fenestration was surgically created at the time of a modified
      Fontan repair in 20 consecutive patients. Risk factors included pulmonary artery
      pressure of 18 mm Hg or more, end-diastolic pressure of 12 mm Hg or more, valvar
      regurgitation, pulmonary artery distortion, pulmonary vascular resistance of 2
      Woods' units or more, ventricular outflow obstruction, and complex anatomy.
      Nineteen of 20 patients survived. After the operation, mean arterial oxygen
      saturation was 86%, mean right atrial pressure was 15 mm Hg, and mean duration of
      pleural effusions was 6 days. Twelve of 19 survivors tolerated early test
      occlusion and had permanent transcatheter umbrella closure. Four patients failed
      early test occlusion, with a significant decrease in venous O2 saturation and a
      rise in central venous pressure, due to ventricular dysfunction, pulmonary artery
      distortion, or aortopulmonary collaterals. Three of four had successful late
      closure of the fenestration after correction of these abnormalities.

PMID- 2225373
TI  - Prognostic value of electrophysiology testing in asymptomatic patients with Wolff
      Parkinson-White pattern.
AB  - The prognostic value of electrophysiology testing was studied in 75 asymptomatic
      patients with the Wolff-Parkinson-White electrocardiographic pattern. All
      patients underwent electrophysiology testing at entry to the study and were
      followed up annually for a total of 348 patient-years (median, 4.3 years). There
      were 44 male and 31 female patients, and age at enrollment ranged from 7 to 77
      years (mean, 34 +/- 14 years). The median effective refractory period of the
      accessory pathway was 293 msec (interquartile range, 280-310 msec), and the
      median shortest RR interval between preexcited beats during atrial fibrillation
      (SRR) [corrected] was 274 msec (240-320 msec). Twenty-three patients had an SRR
      of 250 msec or less and eight patients had a median shortest SRR interval of 200
      msec or less. Twelve patients had inducible sustained reciprocating tachycardia,
      10 patients had inducible nonsustained reciprocating tachycardia, and 23 patients
      had inducible sustained atrial fibrillation. Twenty patients (27%) lacked
      retrograde conduction over the accessory pathway. No patient died suddenly during
      a median follow-up of 4.3 years. Six patients (8%) became symptomatic with
      documented supraventricular tachycardia, of whom two underwent operative ablation
      of their accessory pathways. No patient with absent retrograde accessory pathway
      conduction during the electrophysiology study became symptomatic. Inducible
      sustained or nonsustained reciprocating tachycardia at electrophysiology study
      did not predict the development of subsequent symptomatic supraventricular
      tachycardia. Nine patients lost preexcitation during follow-up. Age at enrollment
      (relative risk/decade, 1.4; 95% confidence interval, 1.0-1.8) and anterograde
      accessory pathway refractory period (relative risk, 1.06/10 msec; 95% confidence
      interval, 1.0-1.12) were independent predictors of loss of
      preexcitation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225372
TI  - Prognostic value of radionuclide angiography in medically treated patients with
      coronary artery disease. A comparison with clinical and catheterization
      variables.
AB  - To evaluate the usefulness of multiple measures from rest and exercise
      radionuclide angiography (RNA) in predicting cardiovascular death and
      cardiovascular events (death or nonfatal myocardial infarction) and to assess the
      prognostic usefulness of the RNA relative to clinical and catheterization data,
      we studied 571 stable patients with symptomatic coronary artery disease who had
      upright rest/exercise first-pass RNA within 3 months of catheterization and were
      medically treated. With a median follow-up of 5.4 years, 90 patients have died
      from cardiovascular causes, and 147 patients have either died or suffered a
      nonfatal myocardial infarction. Using the Cox regression model and a preselected
      group of RNA variables, the most important RNA predictor of mortality was
      exercise ejection fraction (chi 2 = 81, p less than 0.00001). Neither rest
      ejection fraction nor the change in ejection fraction from rest to exercise
      contributed additional predictive information. Two other RNA study variables, the
      change in heart rate from rest to exercise and rest end-diastolic volume index,
      did contribute additional prognostic information to the exercise ejection
      fraction (chi 2 = 23, p less than 0.0001). Compared with noninvasive clinical
      data (history, physical examination, electrocardiogram, and chest radiograph),
      RNA variables were considerably more predictive of mortality (chi 2 = 71
      [clinical variables] versus chi 2 = 104 [RNA]). Remarkably, the strength of the
      relation of RNA variables with mortality was equivalent to that of the set of
      catheterization variables previously demonstrated in our large angiographic
      population to be prognostically important (chi 2 = 104 [RNA] versus chi 2 = 102
      [catheterization variables]). The RNA contained 84% of the information provided
      by clinical and catheterization descriptors combined. Furthermore, the RNA
      contributed significant additional prognostic information to the clinical and
      catheterization data (chi 2 = 13.6, p = 0.0035). For cardiovascular events, the
      relative prognostic usefulness of the RNA was similar, although relations with
      this outcome were generally weaker. Descriptors from the rest/exercise RNA
      exhibit a powerful relation with long-term outcomes and can be useful in defining
      risk, even when clinical and catheterization data are available.

PMID- 2225374
TI  - Hormones regulating cardiovascular function in patients with severe congestive
      heart failure and their relation to mortality. CONSENSUS Trial Study Group.
AB  - There is a varying hormonal activation in heart failure. To be able to evaluate
      this activation and relate it to prognosis, we took blood samples at baseline and
      after 6 weeks from 239 patients with severe heart failure (all in New York Heart
      Association class IV) randomized to additional treatment with enalapril or
      placebo. In this study (CONSENSUS), which has previously been reported, there was
      a significant reduction in mortality among patients treated with enalapril. The
      present data show in the placebo group a significant positive relation between
      mortality and levels of angiotensin II (p less than 0.05), aldosterone (p =
      0.003), noradrenaline (p less than 0.001), adrenaline (p = 0.001), and atrial
      natriuretic factor (p = 0.003). A similar relation was not observed among the
      patients treated with enalapril. Significant reductions in mortality in the
      groups of patients treated with enalapril were consistently found among patients
      with baseline hormone levels above median values. There were significant
      reductions in hormone levels from baseline to 6 weeks in the group of patients
      treated with enalapril for all hormones except adrenaline. There were no
      correlations between these changes in hormone levels. Summarily, there is a
      pronounced but variable neurohormonal activation in heart failure even in
      patients with similar clinical findings. This activation is reduced by enalapril
      therapy. The results suggest that the effect of enalapril on mortality is related
      to hormonal activation in general and the renin-angiotensin system in particular.

PMID- 2225375
TI  - Excretion of thromboxane A2 and prostacyclin metabolites before and after
      exercise testing in patients with and without signs of ischemic heart disease.
AB  - We addressed the hypothesis that platelets are not activated in association with
      effort-induced myocardial ischemia in stable coronary disease. Seventy-two
      patients undergoing a diagnostic bicycle exercise test were stratified according
      to the development of chest pain (yes/no, 33/39) and of exercise-induced ST
      segment depression of at least 200 microV in the electrocardiogram (yes/no,
      12/60). Noninvasive indexes of platelet activation and of platelet/vessel wall
      interaction (urinary excretion of the 2,3-dinor-metabolites of thromboxane A2 [Tx
      M] and prostacyclin [PGI-M], respectively) were analyzed in samples collected in
      the basal state and after the test. Basal Tx-M and PGI-M did not differ in
      patients with (236 +/- 35 and 131 +/- 22 pg/mg creatinine, respectively) and
      without (185 +/- 16 and 101 +/- 13 pg/mg creatinine, respectively) chest pain, or
      in those with (178 +/- 45 and 162 +/- 41 pg/mg, respectively) and without (216 +/
      22 and 104 +/- 11 pg/mg, respectively) ST-segment depression during the test.
      Patients without chest pain or without ST-segment depression moderately increased
      (p less than 0.05) their urinary Tx-M (by 21% and 13%, respectively) and PGI-M
      (by 28% and 23%, respectively) after exercise. No significant increases were
      observed in those developing chest pain or ST depression during exercise. These
      data indicate that effort-induced myocardial ischemia is not associated with an
      increase in platelet activation or platelet/vessel wall interaction in patients
      with stable coronary disease.

PMID- 2225376
TI  - Effect of long-term exercise on regional myocardial function and coronary
      collateral development after gradual coronary artery occlusion in pigs.
AB  - The effect of myocardial ischemia, induced by long-term exercise, on regional
      myocardial function and coronary collateral development was examined in pigs
      after gradual occlusion of the left circumflex coronary artery (LCx) with an
      ameroid occluder. Thirty days after surgery, regional myocardial function and
      blood flow were assessed during exercise in 22 pigs separated into exercise (n =
      12) and sedentary groups (n = 10). The exercise group trained on a treadmill for
      25 +/- 1 days, 30-50 min/day, at heart rates of 210-220 beats/min. After 5 weeks,
      another exercise test was performed. In the exercise group, after training, we
      observed an improvement in systolic wall thickening, expressed as a percentage of
      rest, in the collateral-dependent LCx region from 64 +/- 8% to 87 +/- 6% (p less
      than 0.01) at moderate exercise levels (220 beats/min) and from 45 +/- 7% to 73
      +/- 7% (p less than 0.01) at severe exercise levels (265 beats/min). Transmural
      myocardial blood flow in the LCx region expressed as a ratio of flow in the
      nonoccluded region of the left ventricle also increased significantly (p less
      than 0.01) during severe exercise after 5 weeks. The sedentary group showed an
      improvement in systolic wall thickening in the LCx region during moderate
      exercise compared with the initial exercise test (p less than 0.05) but no
      significant change in systolic wall thickening or myocardial blood flow ratios
      during severe exercise after 5 weeks. We conclude that long-term exercise after
      gradual LCx coronary artery occlusion in pigs improves myocardial function and
      coronary collateral reserve in collateral-dependent myocardium during exercise.

PMID- 2225377
TI  - Are the kinetics of technetium-99m methoxyisobutyl isonitrile affected by cell
      metabolism and viability?
AB  - To investigate the role of cell viability and metabolism on the myocardial
      kinetics of a new tracer, technetium-99m-methoxyisobutyl isonitrile (Tc-99m
      MIBI), 250 microCi/l Tc-99m-MIBI was infused in isolated rat hearts under
      constant flow conditions. The hearts were studied after inducing irreversible
      damage by cytochrome c oxidase inhibitor sodium cyanide (n = 8) or sarcolemmal
      membrane detergent Triton X-100 (n = 8). The control hearts (n = 6) received no
      toxins. Mean Tc-99m-MIBI peak accumulation activity was significantly reduced
      after cyanide (51.1 +/- 44.2% of control, p less than 0.01) and Triton (13.8 +/-
      2.7% of control, p less than 0.001) administration. Kinetic studies also showed
      marked reduction in accumulation rates and marked increase in clearance rates for
      cyanide (p less than 0.01) and Triton (p less than 0.01) groups compared with
      controls. Potential changes in regional flow distribution were assessed using
      microspheres. When peak accumulation activity was corrected for these changes,
      there remained significant differences between the groups. In the cyanide and
      Triton groups, irreversible cell injury was confirmed by creatine kinase and
      lactate dehydrogenase release, triphenyl tetrazolium chloride staining, and
      electron microscopy. All the cells were viable in the control group. We conclude
      that the accumulation and clearance kinetics of Tc-99m-MIBI are significantly
      affected by cell viability. Tc-99m-MIBI kinetics appear to be dependent on
      sarcolemmal integrity and to a lesser extent on aerobic metabolism.

PMID- 2225378
TI  - Effect of tachycardia on regional function and transmural myocardial perfusion
      during graded coronary pressure reduction in conscious dogs.
AB  - The purpose of the present study was to examine subendocardial flow and function
      during graded coronary pressure reduction to determine the effect of tachycardia
      on the lower autoregulatory pressure limit (critical coronary pressure) in
      unanesthetized dogs. During atrial pacing at a rate of 200 beats/min,
      subendocardial flow measured by radioactive microspheres averaged 1.55 +/- 0.34
      ml/min/g and remained unchanged as pressure was reduced over the autoregulatory
      plateau from 84 +/- 10 to 59 +/- 7 mm Hg. Further reductions in coronary pressure
      to below a critical coronary pressure of approximately 60 mm Hg were associated
      with concomitant reductions in subendocardial flow and the endocardial-epicardial
      flow ratio during tachycardia. Although regional function remained constant over
      the autoregulatory plateau, there was a rightward shift of the coronary pressure
      function relation during ischemia in response to a steady-state increase in rate
      from 100 to 200 beats/min. Reductions in regional wall thickening began when
      coronary pressures reached 38 +/- 7 mm Hg at a heart rate of 100 beats/min and 61
      +/- 6 mm Hg at a heart rate of 200 beats/min (p less than 0.005). Similar
      critical coronary pressure values were obtained for subendocardial segment
      shortening. Relations between subendocardial flow and myocardial function
      measured by both transmural wall thickening and subendocardial segment shortening
      were linear during pacing at a heart rate of 200 beats/min with relative
      reductions in wall thickening related to reductions in subendocardial flow on a
      nearly one-to-one basis. The results of this study demonstrate that there is a
      shift in the lower limit of subendocardial autoregulation during tachycardia as
      manifest by the onset of subendocardial ischemia at a higher distal coronary
      artery pressure. The shift in critical coronary pressure relates to an increase
      in resting flow requirements due to increased demand and diminished
      subendocardial vasodilator reserve at any given coronary pressure secondary to a
      reduction in the time available for diastolic subendocardial perfusion during
      tachycardia.

PMID- 2225379
TI  - Uptake and retention of hexakis (2-methoxyisobutyl isonitrile) technetium(I) in
      cultured chick myocardial cells. Mitochondrial and plasma membrane potential
      dependence.
AB  - The fundamental myocellular uptake and retention mechanisms of hexakis (2
      methoxyisobutyl isonitrile) technetium(I) (Tc-MIBI), a technetium-99m-based
      myocardial perfusion imaging agent, are unresolved. Because of the lipophilic
      cationic nature of Tc-MIBI, it may be distributed across biological membranes in
      response to transmembrane potential. To test this hypothesis, net uptake and
      retention of Tc-MIBI in cultured chick embryo ventricular myocytes were
      determined under conditions known to alter mitochondrial and plasma membrane
      potentials. Isovolumic depolarization of plasma membrane potentials in 130 mM
      extracellular K (Ko) 20 mM extracellular Cl buffer reduced net accumulation of Tc
      MIBI from 171 +/- 16 (control) to 29 +/- 3.3 fmol intracellular Tc-MIBI/mg
      protein.nM extracellular Tc-MIBI. Unidirectional influx of Tc-MIBI in cells
      depolarized in 30 mM Ko buffer was also reduced; a resting plasma membrane
      potential of -87 +/- 6 mV was calculated from the Goldman flux equation using
      normal Ko/high Ko Tc-MIBI influx ratios. Addition of the potassium ionophore
      valinomycin to cells incubated in 130 mM Ko buffer to additionally depolarize
      mitochondrial membrane potentials further reduced net uptake of Tc-MIBI to levels
      comparable to that found in nonviable freeze-thawed preparations ([Tc-MIBI]i/[Tc
      MIBI]o = 1). By depolarizing mitochondrial (and in part plasma membrane)
      potentials with the protonophores 2,4-dinitrophenol and carbonyl cyanide m
      chlorophenylhydrazone (CCCP) Tc-MIBI was rapidly depleted from 181 +/- 16
      (control) to 16 +/- 2.6 and 31 +/- 4.2 fmol/mg protein.nMo, respectively, with
      kinetics that did not correlate with loss of cellular ATP content. CCCP alone
      inhibited 90 +/- 3% of net accumulation or 66 +/- 3% of unidirectional influx of
      Tc-MIBI in a concentration-dependent manner. By hyperpolarizing mitochondrial
      membrane potentials with the K+/H+ ionophore nigericin or the ATP synthase
      inhibitor oligomycin, net uptake and retention of Tc-MIBI were increased by 60 +/
      9% and 375 +/- 20%, respectively. Caffeine, as well as the respiratory chain
      electron transport inhibitor rotenone, did not significantly alter net cell
      uptake (p greater than 0.2). These data indicate that the fundamental myocellular
      uptake mechanism of Tc-MIBI involves passive distribution across plasma and
      mitochondrial membranes and that at equilibrium Tc-MIBI is sequestered within
      mitochondria by the large negative transmembrane potentials.

PMID- 2225380
TI  - Optimizing the exercise test for pharmacological investigations.
AB  - Exercise trials in cardiology are often hindered by inconsistent approaches to
      exercise testing. These inconsistencies include the choice of exercise protocol,
      exercise end points, points of analysis, and absence or misuse of gas exchange
      data. Gas exchange techniques greatly enhance the accuracy with which
      cardiopulmonary function is assessed by exercise. Commonly used protocols are not
      always appropriate for all patients or all studies. Both cardiovascular disease
      and the exercise protocol can have an important impact on the relation between
      changes in work rate and oxygen uptake. Ramp protocols appear to offer the
      greatest promise for assessing cardiopulmonary function. Analyzing hemodynamic
      and gas exchange responses at several points submaximally, in addition to those
      at peak exercise, can add important information concerning the efficacy of a
      drug. A great deal of confusion continues to hinder the application of the gas
      exchange anaerobic threshold, and many of the commonly used testing end points
      are not reliable.

PMID- 2225381
TI  - Left ventricular ejection fraction may not be useful as an end point of
      thrombolytic therapy comparative trials.
AB  - In the era of comparative and adjunctive trials in reperfusion therapy, the need
      to develop alternative end points for mortality reduction is clear. Left
      ventricular ejection fraction, which has been commonly used as a surrogate, is
      problematic due to missing values, technically inadequate studies, and lack of
      correlation with mortality results in controlled reperfusion trials performed to
      date. In this paper, we present a composite clinical end point that includes, in
      order, severity of adverse outcome death, hemorrhagic stroke, nonhemorrhagic
      stroke, poor ejection fraction (less than 30%), reinfarction, heart failure, and
      pulmonary edema. Such a composite index may be useful to detect true therapeutic
      benefit in reperfusion trials without necessitating greater than 20-30,000
      patient enrollment.

PMID- 2225382
TI  - Adenosine. Renewed interest in an old drug.

PMID- 2225383
TI  - Extension of clinical trials. 10 1/2 year follow-up of the Multiple Risk Factor
      Intervention Trial.

PMID- 2225384
TI  - Coronary artery surgery study revisited. Limitation of the intent-to-treat
      principle.

PMID- 2225385
TI  - Level, trend, and variability of blood pressure in childhood and adolescence.

PMID- 2225386
TI  - The partial Fontan procedure. A new concept and its clinical application.

PMID- 2225387
TI  - Arterial complications of interventional cardiac catheterization in patients with
      congenital heart disease.

PMID- 2225388
TI  - Clinical electrophysiological studies and the Wolff-Parkinson-White pattern.

PMID- 2225389
TI  - Autoregulation and heart rate.

PMID- 2225390
TI  - Coarctation of the aorta in infants.

PMID- 2225391
TI  - Reversible segmental cardiac dysfunction.

PMID- 2225392
TI  - Clinical competence in exercise testing. A statement for physicians from the
      ACP/ACC/AHA Task Force on Clinical Privileges in Cardiology.

PMID- 2225393
TI  - Cardiovascular surgery 1989. Council on Cardiovascular Surgery, American Heart
      Association scientific sessions. New Orleans, Louisiana, November 13-16, 1989.
      Proceedings.

PMID- 2225394
TI  - Splenic septic emboli in endocarditis.
AB  - The significance of septic emboli to the spleen is inferred by the frequency of
      septic emboli in general seen in patients with left-sided infective endocarditis
      who are referred for valve replacement. To determine the proper management of
      splenic infarcts and abscess due to septic emboli, we retrospectively reviewed
      the records of 108 patients with left-sided endocarditis who underwent valvular
      surgery at the University of Illinois Hospital from 1980 through 1988.
      Intravenous drug abuse was the etiology in 68% (n = 73). The incidence of splenic
      infarcts and abscess was 19% (n = 20), but an incidental finding of splenic
      infarcts was found in 38% (n = 11) of 29 asymptomatic patients who had computed
      tomograms. Streptococci and staphylococci were the causative organisms in 85% (n
      = 17). Localized findings were absent in 90% of splenic infarcts and abscesses.
      Abdominal computed tomograms were diagnostic of the sequelae of splenic septic
      emboli in 100%. No patient had intra-abdominal bleeding complications associated
      with cardiopulmonary bypass. Splenectomy was performed in 50% (n = 10) of
      patients 3-24 days (mean, 11.2 days) after valve replacement. Indications for
      splenectomy included persistent sepsis in 60% (n = 6), large (greater than 2 cm)
      and peripheral lesions in 30% (n = 3), and splenic rupture in 10% (n = 1).
      Perioperative mortality of patients who underwent splenectomy was 30% (n = 3).
      The following conclusions can be drawn: 1) Splenic septic embolus is common in
      endocarditis. 2) Abdominal computed tomography should be performed for all
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225395
TI  - Clinical and Doppler echocardiographic evaluation of bioprosthetic valve failure
      after 10 years.
AB  - Four hundred thirteen consecutive patients underwent valve replacement with a
      bioprosthesis between 1976 and 1982. Aortic valve replacement was performed in
      240 patients, mitral valve replacement in 132 patients, and multiple valve
      replacement in 41. The Carpentier-Edwards porcine (n = 336), Angell-Shiley
      porcine (n = 23), Hancock porcine (n = 11), and the Ionescu-Shiley pericardial
      valves (n = 43) were inserted. Follow-up between 5 and 12 years postoperatively
      was 98% complete. Freedom from structural valve deterioration was 72 +/- 7%, 59
      +/- 9%, and 59 +/- 9%, respectively, after aortic, mitral, and double valve
      replacement. The risk of structural valve deterioration and reoperation for valve
      related complications was significantly increased with the Ionescu-Shiley
      pericardial prosthesis. The risk for reoperation was inversely related to patient
      age. Postoperative Doppler echocardiographic studies in 87% of available patients
      revealed a subgroup of asymptomatic patients with evidence of structural valve
      deterioration. These patients (n = 61) had significantly reduced prosthetic valve
      areas (aortic less than 1 cm2, mitral less than 1.7 cm2), elevated resting
      transvalvular gradients (aortic greater than 40 mm Hg), or moderate-to-severe
      regurgitation. In summary, postoperative Doppler echocardiographic examination
      identified asymptomatic patients with structural valve dysfunction. These
      patients must be followed up carefully to determine the optimal timing of
      reoperation.

PMID- 2225396
TI  - Differences in Hancock and Carpentier-Edwards porcine xenograft aortic valve
      hemodynamics. Effect of valve size.
AB  - We prospectively compared the hemodynamic performance of Hancock and Carpentier
      Edwards bioprosthetic aortic valves in a randomized study of 100 patients. A
      total of 47 patients received the Hancock valve, and 53 received the Carpentier
      Edwards valve. Mean pressure gradients were measured using micromanometer
      catheters and cardiac outputs by thermodilution. Multiple measurements were made
      in each patient with atrial pacing, volume infusion, and inotropic drugs for a
      total of 319 observations. The pressure gradients and Gorlin valve areas showed
      significant scatter caused by both flow-dependent and patient-dependent
      variability. Mean transvalvular pressure gradients were therefore compared after
      adjustment for flow rate and for random interpatient differences using analysis
      of variance and covariance. Pressure gradients were lower and Gorlin valve areas
      larger for the Hancock valve than for the Carpentier-Edwards valve, but the
      differences were significant only for the smaller valve sizes. Compared with the
      Carpentier-Edwards valve, the mean pressure gradients were significantly lower
      for the Hancock 19-mm modified orifice (MO) valves (16.9 versus 31.7 mm Hg, p =
      0.04), for the 21-mm valves (15.2 versus 22.4 mm Hg, p = 0.003), and for the 23
      mm MO valve (9.2 versus 13.8 mm Hg, p = 0.04). The Gorlin areas were also
      significantly larger for the Hancock 19-mm MO valve (0.85 versus 0.77 cm2, p =
      0.004) and the 21-mm MO valve (1.11 versus 0.89 cm2, p = 0.0009) but not for the
      23-mm MO valve (1.59 versus 1.14, p = 0.08). Mean gradients and valve areas were
      not different for any of the larger valve sizes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225397
TI  - Chordal replacement in mitral valve repair.
AB  - Chordal replacement greatly extends the possibility of repair of atrioventricular
      valves. Both glutaraldehyde-tanned xenograft pericardial chordae (GTXP) and
      extruded polytetrafluorethylene chordae (ePTFE) heal to papillary muscles and
      cusps. Neither type elongates or shrinks. GTXP may thicken and stiffen with time.
      ePTFE is covered by a normal fibrosa and intima (a new chorda is grown around the
      ePTFE suture) experimentally and in small sizes (e.g., CV 5), retains
      flexibility. The results of late follow-up (5-10 years) with GTXP chordae and
      early follow-up (6-58 months) with ePTFE chordae are encouraging.

PMID- 2225398
TI  - Coronary artery pattern and outcome of arterial switch operation for
      transposition of the great arteries.
AB  - A successful outcome of an arterial switch operation (ASO) for dextro
      transposition of the great arteries (D-TGA) depends in large part on the transfer
      of the coronary arteries to the neoaorta without distortion or narrowing.
      However, the origins and distribution of the coronary arteries are quite variable
      in D-TGA; therefore, the entire experience with ASO at the Children's Hospital in
      Boston was reviewed. From 1983 through November 1989, 314 patients underwent
      surgery for D-TGA with the intent to perform an ASO. An ASO was actually
      performed in 290 patients, and 20 patients died, with 12 deaths (4.2%) clearly
      related to problems with the coronary arteries (CA deaths). The ASO was aborted
      to a Senning operation in 24 patients (7.6%), primarily due to coronary anatomy.
      Eight coronary patterns were identified and related to the outcome of the ASO. In
      182 patients with the "usual" coronary pattern for D-TGA (i.e., anterior
      descending and circumflex arteries from the left sinus and right coronary artery
      from the right sinus), five CA deaths occurred, and two patients had Senning
      operations. Sixty-seven patients had right coronary and circumflex arteries from
      the right sinus and anterior descending arteries from the left sinus. Three CA
      deaths occurred, and one patient had a Senning operation. Single right coronary
      artery was found in 14; 12 had ASOs with three CA deaths (25%); and two had
      Senning operations. One late death was due to diffuse narrowing of the single
      right coronary artery. Single left coronary artery occurred in 11 patients, and
      seven had ASO with no early but one late "sudden" death, whereas four had Senning
      operations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225399
TI  - Midterm surgical results of arterial switch operation for transposition of the
      great arteries with intact septum.
AB  - Between April 4, 1984, and December 31, 1987, 156 consecutive neonates with
      simple transposition of the great arteries underwent an arterial switch operation
      (ASO) at our institution. Surgery was performed before the age of 15 days in 96%,
      and patient weight was less than 3 kg in 28%. Seventeen patients (10.9%) died
      after surgery. One patient was lost to follow-up. Of the 138 survivors, two died
      of myocardial infarction 35 and 40 days, respectively, after surgery. They were
      the only late deaths, and actuarial survival rates were 87% (70% confidence level
      [CL], 83-89%) at 45 days and 87% (70% CL, 68-95%) at 52 months. Another patient
      had a myocardial infarction 50 days after surgery and is well 50 months later.
      Pulmonary stenosis was observed in 14 patients (10.3%) during the first year
      after surgery; two patients were reoperated on 10 and 12 months, respectively,
      after ASO. Aortic regurgitation was observed in 17 patients: two had grades II
      and III, respectively, aortic regurgitation on aortography; in 15 patients, it
      was detected only by Doppler examination. At the last follow-up (2-52 months
      after ASO; mean, 27.3 +/- 11.3 months), all patients were asymptomatic and taking
      no medication. On bidimensional echocardiography, left ventricular fractional
      shortening was normal at rest in all survivors but one. One patient had
      junctional rhythm, and one had Wenckebach periods; the remainder were in sinus
      rhythm. For as long as 5 years after ASO, late death and reintervention were
      rare; 99% of the survivors were asymptomatic and had sinus rhythm and good
      systemic ventricular function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225400
TI  - Right ventricular growth after transventricular pulmonary valvotomy and central
      aortopulmonary shunt for pulmonary atresia and intact ventricular septum.
AB  - We performed transventricular pulmonary valvotomy as initial surgery in 22
      consecutive patients with pulmonary atresia and intact ventricular septum who had
      a patent infundibulum. Nineteen patients also had placement of a central
      aortopulmonary shunt. All patients survived surgery, and 16 patients have had
      preoperative and later postoperative catheterizations. The purpose of this study
      was to determine the response of the right ventricle to transventricular
      pulmonary valvotomy with regard to relief of right ventricular hypertension and
      growth of the entire right ventricle, including tricuspid valve, right
      ventricular volume, and right ventricular outflow tract. Right ventricular
      systolic pressure decreased from 111.3 +/- 31.7 mm Hg before initial surgery to
      65.6 +/- 26.2 mm Hg. Right ventricular end-diastolic volume increased from 59.1
      +/- 39.3% of predicted normal before initial surgery to 114.6 +/- 63.2% at late
      follow-up catheterization. Tricuspid valve anulus circumference also increased in
      size from 73.2 +/- 21.3% of predicted normal before initial surgery to 90.4 +/-
      22.8% at late follow-up catheterization. Only one patient (6%) required a
      transanular right ventricular outflow tract patch at the time of biventricular
      repair. Twenty of 22 patients (91%) either have had or are awaiting biventricular
      repair. We conclude that transventricular pulmonary valvotomy and central
      aortopulmonary shunt can be performed safely in newborn infants with pulmonary
      atresia and intact ventricular septum who have a patent infundibulum. Effective
      valvotomy relieves right ventricular hypertension, allows for excellent right
      ventricular and tricuspid valve growth, and optimizes potential for biventricular
      repair.

PMID- 2225402
TI  - Early diagnosis and surgical intervention of acute aortic dissection by
      transesophageal color flow mapping.
AB  - To determine whether transesophageal color Doppler echocardiography (TEE) is
      useful for the early diagnosis and surgical intervention in acute aortic
      dissection, 57 serial patients with acute aortic dissection were examined. These
      patients were evaluated by TEE with either the single-plane probe (39 patients)
      or the biplanar probe (18 patients) just after admission. The intimal flap was
      detected in all patients, and there were 18 patients with type A dissection and
      39 patients with type B dissection. The entry was visualized in 83% of type A
      dissection cases and in 90% of type B dissection cases. In two of 18 patients
      examined with the biplanar probe technique, the entry was detected in the
      longitudinal view only. Emergency operations were performed in 18 patients with
      type A dissection and in 10 patients with ruptured type B dissection. Twenty-nine
      of 39 patients with type B dissection were treated conservatively. The operative
      mortality rate of patients with type A dissection was 22%, and that of patients
      with ruptured type B dissection was 60%. The major advantage of TEE is its ease
      of application at the bedside or in the operating room, which allows immediate
      and accurate diagnosis of acute aortic dissection for emergency surgical
      intervention. Biplanar TEE provides additional acoustic windows, ease of spatial
      orientation, and more accurate visualization of entry. TEE is a useful and
      powerful diagnostic tool for acute aortic dissection, and by using this method,
      one may achieve a more rapid and aggressive surgical approach for patients with
      acute aortic dissection.

PMID- 2225401
TI  - Atrial cardiomyoplasty after Fontan-type procedures.
AB  - The purpose of right atrial cardiomyoplasty is to increase atrial-pulmonary flow
      in patients undergoing Fontan-type procedures. We developed two surgical
      techniques to bypass the right ventricle, followed by right atrial
      cardiomyoplasty with a stimulated latissimus dorsi muscle flap (LDMF). In 10
      goats, the left LDMF was transferred into the chest by removal of the second rib.
      After sternotomy, the right atrial appendages of five goats (group 1) were
      connected to the distal main pulmonary artery with polytetrafluoroethylene tubing
      and the proximal pulmonary trunks were ligated. In the other five goats (group
      2), under cardiopulmonary bypass, bioprosthetic valves were implanted into the
      inferior venae cavae. The tricuspid orifice was closed, and the atriopulmonary
      connection was performed. The left LDMF was sutured over the right atrium and
      stimulated using synchronous 30-Hz bursts of impulses delivered by a Medtronic
      Cardiomyostimulator. Hemodynamic studies were performed in the acute phase. Right
      atrial, pulmonary arterial, and aortic pressures were assessed. Cardiac output
      was measured using ultrasonic flow studies. LDMF stimulation restored pulsatile
      pressure patterns in the pulmonary artery and increased the cardiac output. These
      observations were more evident in the model with caval valvular implant. This
      functional "ventricularization" of the right atrium could improve long-term
      results after Fontan-type procedures and extend operative indications. Chronic
      experimental studies are necessary to evaluate the diastolic and systolic
      functions of the neo-right ventricle.

PMID- 2225403
TI  - Perioperative arrhythmias after Fontan repair.
AB  - Arrhythmias are well-recognized sequelae of the Fontan repair. A prospective
      analysis of perioperative arrhythmias after Fontan repair was performed. Thirty
      three patients had 24-hour ambulatory monitoring on the day before surgery and
      for 24 hours immediately after surgery; the 27 surviving patients had an
      additional 24-hour study on the seventh postoperative day. The most common
      preoperative rhythm was normal sinus, which was present in 79%. Hemodynamically
      significant preoperative arrhythmias were present in only two patients-atrial
      flutter (n = 1) and complete heart block (n = 1). Other asymptomatic preoperative
      arrhythmias included ectopic atrial rhythm (n = 2), supraventricular tachycardia
      (n = 1), accelerated junctional rhythm (n = 1), and frequent ventricular
      premature beats (n = 1). On the first postoperative day, the most common rhythm
      was accelerated junctional rhythm, which was present in 48%. Hemodynamically
      significant arrhythmias were present in nine patients (27%) -rapid accelerated
      junctional rhythm (rate, greater than 190 beats/min) (n = 3), complete heart
      block (n = 2), atrial flutter (n = 2), supraventricular tachycardia (n = 1), and
      ventricular tachycardia (n = 1). Three of six deaths occurring between
      postoperative days 2 and 7 were in patients with rapid accelerated junctional
      rhythm and associated low cardiac output. On the seventh postoperative day, the
      most common rhythm was normal sinus, which was present in 41%. Nine of the 27
      surviving patients had complete resolution of their arrhythmias between
      postoperative days 2 and 7. On postoperative day 7, hemodynamically significant
      arrhythmias were present in four patients-atrial flutter (n = 2) and complete
      heart block (n = 2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225404
TI  - Partial anomalous pulmonary venous return.
AB  - Anomalous pulmonary venous return from the left lung is an extremely rare
      condition that is reported sporadically and in general in case reports. From 1964
      through 1988, we identified 13 patients with this condition, all of whom
      underwent surgical correction. This represents the single largest reported
      institutional experience with this anomaly. The patients ranged in age from 15
      months to 40 years. Seven were asymptomatic, and six had symptoms ranging from
      recurrent pulmonary infection to moderate congestive heart failure. Six had
      anomalous venous return from the entire left lung, and seven had anomalous return
      from the upper lobe only. Eight of the patients had associated cardiovascular
      anomalies. Four of the patients underwent surgical correction via a sternotomy
      approach with cardiopulmonary bypass to allow correction of coexisting
      intracardiac anomalies. The remaining patients underwent surgical repair through
      a left thoracotomy. The technique included high ligation and division of a
      persistent left superior vena cava with anastomosis to the left atrium at the
      site of partial excision of the atrial appendage. There were no deaths and only
      one complication in our series.

PMID- 2225405
TI  - Hypoplastic left heart syndrome. Outcome after initial reconstruction and before
      modified Fontan procedure.
AB  - The outcome and clinical course before modified Fontan procedure were reviewed
      for 200 patients with hypoplastic left heart syndrome who underwent initial
      reconstructive surgery between August 1985 and March 1989. The median age at the
      time of initial reconstruction was 6 days (range, 1 day to 7.2 months). In 28
      patients, a right modified Blalock-Taussig shunt was used; in 172 patients, a
      central shunt was placed. Additional procedures (n = 41) performed in 38 patients
      (median age, 5 months; range, 6 days to 17.5 months) were revision of systemic-to
      pulmonary shunt (n = 15), arch reconstruction (n = 8), balloon angioplasty of
      arch obstruction (n = 7), atrial septectomy (n = 4), pulmonary artery angioplasty
      (n = 2), tricuspid valve annuloplasty or replacement (n = 4), and modified Glenn
      shunt (n = 1). There was no significant difference in the frequency of additional
      procedures performed more than 30 postoperative days in the survivors compared
      with the nonsurvivors. Actuarial survival rates were 0.66 (1 month), 0.48 (12
      months), and 0.44 (18 months). Seventy percent of all deaths occurred during the
      initial admission, with 32% resulting from acute cardiovascular collapse during
      the first postoperative day. There was no statistical difference in actuarial
      survival when assessed by the type of shunt used or by anatomical subtype or when
      the influence of additional interventions was considered. Substantial improvement
      in outcome may be possible if immediate perioperative mortality can be reduced.
      We speculate that some of the intermediate mortality (30 days to 1 year) may be
      related to the effects of chronic exposure of the right ventricle to volume
      overload at systemic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225406
TI  - Resource use and cost of initial coronary revascularization. Coronary angioplasty
      versus coronary bypass surgery.
AB  - Although there is intense interest in the cost-saving potential of therapeutic
      alternatives, most studies have analyzed hospital charges rather than actual
      economic costs. To analyze cost differences rigorously, we studied 115 patients
      undergoing initial elective angioplasty (percutaneous transluminal coronary
      angioplasty, PTCA) and 274 patients undergoing initial elective surgery (coronary
      artery bypass graft surgery, CABG). Detailed resource consumption profiles were
      constructed and used to estimate the cost savings from switching a patient from
      CABG to PTCA. Four cost-accounting methods were used in the analysis; each method
      made different assumptions about the costs that would vary and the costs that
      would be fixed according to the number of procedures performed. The variable
      costs in the four methods were the 1) cost of supplies, 2) cost of personnel and
      supplies, 3) average direct costs, and 4) average direct costs plus allocated
      hospital overhead. The mean hospital charges for CABG patients were $19,644
      versus $9,556 for PTCA patients (p less than 0.0001). The estimated cost
      difference between CABG and PTCA was substantially less than the $10,088
      difference in charges, however, with net savings of 19%, 46%, 53%, and 78% of
      charges using cost-accounting methods 1-4, respectively. Thus, although the
      initial hospital charges for PTCA are significantly less than for CABG, the
      actual economic cost savings may be significantly overestimated by the use of
      hospital charge data.

PMID- 2225407
TI  - Clinical evaluation of single versus multiple mammary artery bypass.
AB  - The superior patency and clinical advantages of internal mammary artery (IMA)
      grafting are well established. However, the relative benefits of routine multiple
      IMA grafting remain uncertain. To determine whether routine multiple compared
      with single IMA utilization improved survival of patients undergoing coronary
      bypass procedures, 1,063 patients were prospectively allocated, beginning in
      1984, to divergent management strategies of single (group 1, n = 420) versus
      multiple IMA grafting (group 2, n = 643). Subsequent analysis of anatomical
      extent of disease and preoperative baseline risk factors showed no differences (p
      = NS) between the two groups. All variables reflecting operative technique were
      similar (p = NS) for the two groups, except 74% of group 1 patients with
      multivessel disease received a single IMA graft, whereas 71% of group 2 patients
      with multivessel disease received multiple IMAs (p less than 0.05). By
      multivariate analysis, impairment of left ventricular ejection fraction, acute
      evolving myocardial infarction, advanced age, and unstable angina were
      incremental risk factors for mortality (all p less than 0.03), but group
      assignment (p = 0.4) and ultimate therapy were not (p = 0.6). Survival
      probabilities (expressed as 30-day group 1/group 2; 4-year group 1/group 2) were
      overall (0.97/0.98; 0.93/0.90), elective (0.98/0.99; 0.97/0.92), acute
      (0.95/0.97; 0.89/0.88), age of less than 65 years (0.98/0.99; 0.97/0.93), age of
      65 years or older (0.93/0.97; 0.84/0.89), ejection fraction of 0.40 or more
      (0.97/0.99; 0.95/0.94), ejection fraction of less than 0.40 (0.95/0.96;
      0.87/0.82), nondiabetic (0.98/0.98; 0.94/0.91), and diabetic (0.92/0.97;
      0.88/0.87). No differences in survival were significant (p = NS).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2225408
TI  - Use of single internal mammary artery grafts in older patients.
AB  - The indications for use of the internal mammary artery as a coronary bypass
      conduit in older patients are not clearly established. Between January 1985 and
      December 1988, 786 patients received single internal mammary artery grafts alone
      (717) or in conjunction with other procedures (69). Of these patients, 341 were
      65 years of age or older (mean, 69.3 years). This group was compared with those
      patients less than 65 years of age (mean, 56.2 years). There were no significant
      differences between the two groups in the incidence of diabetes mellitus; the
      number of distal coronary anastomoses; left ventricular wall motion score; the
      frequency of isolated bypass procedures, reoperations, or emergent operations; or
      the durations of aortic clamping and cardiopulmonary bypass. The older group
      contained more women (34.9% versus 20.7%) and more patients with left main
      coronary artery disease (15.5% versus 9.4%) (p less than 0.01). No significant
      differences in the frequency of reoperation for hemorrhage, perioperative
      infarction, neurological deficits, requirements for intra-aortic balloon pumping,
      sternal wound infections, necessity for prolonged ventilatory support, or 30-day
      mortality (2.7% versus 3.2%) were observed. The length of postoperative
      hospitalization was greater in the older group (11.8 versus 10.2 days) (p =
      0.02). Blinded histological examination of biopsies from 61 internal mammary
      artery grafts (34 patients less than 65 years, 27 patients greater than or equal
      to 65 years) showed no significant differences in luminal area or wall thickness.
      No significant degenerative changes were observed in either group. We conclude
      that the use of the internal mammary artery for bypass grafting in older patients
      is safe and may provide long-term benefit.

PMID- 2225409
TI  - Early and late results after isolated coronary artery bypass surgery in 159
      patients aged 80 years and older.
AB  - We have studied 159 patients 80 years of age or older who have had isolated
      coronary artery bypass grafting (CABG) since 1977. Eighty-seven percent have had
      surgery since 1984. Two thirds of the patients were male, and the mean age was 82
      years. Most patients (97%) were in New York Heart Association (NYHA) functional
      class III or IV, 89% had unstable/postinfarction angina pectoris, and 67% had
      rest pain. Almost half (47%) required preoperative admission to the coronary care
      unit, 6% required preoperative use of an intra-aortic balloon pump, and 20% were
      operated on emergently. Significant left main coronary artery disease (greater
      than or equal to 50% stenosis) was present in 41%. Ten patients (6.3%) died
      within 30 days of surgery, with seven more patients dying during the same
      hospital admission or soon after transfer to another institution. This resulted
      in an overall hospital mortality of 10.7%. The median hospital stay was 10 days.
      On univariate analysis, the significant predictors of hospital mortality were
      NYHA IV, angina at rest, preoperative admission to the coronary care unit,
      emergency operation, ejection fraction less than 0.50, and the presence of mitral
      regurgitation. On multivariate analysis, ejection fraction less than 0.50 was the
      only significant risk factor (p less than 0.01). Of hospital survivors, 98% have
      been followed for a mean of 29 months. The estimated 5-year survival (+/- SEM) of
      all patients was 71 +/- 4.5%, and for hospital survivors, 80 +/- 4.5%. The most
      important predictor of adverse survival was an ejection fraction less than 0.50.
      Seventy-nine percent are angina-free, and 89% are in NYHA classes I and II. The
      majority of patients felt that they were improved by surgery. We conclude that
      CABG in patients 80 years or older, although associated with increased operative
      risk, gives excellent relief of symptoms and good 5-year survival. Patients
      should not be denied CABG because of age alone.

PMID- 2225410
TI  - Internal mammary artery and saphenous vein graft patency. Effects of aspirin.
AB  - As part of two Department of Veterans Affairs Cooperative Trials, we obtained
      angiographic patency data for internal mammary artery (IMA) and saphenous vein
      grafts to the left anterior descending (LAD) coronary artery at 1 year after
      coronary artery bypass surgery. Patients received either aspirin 325 mg q.d.,
      aspirin 325 mg t.i.d., aspirin 325 mg and dipyridamole 75 mg t.i.d., or placebo.
      Aspirin was initiated either 12 hours before or 6 hours after operation. Patients
      were stratified preoperatively for extent of disease and randomized to the
      therapies outlined above. There was no randomization to IMA versus saphenous vein
      grafts to the LAD. When the patients taking placebo were compared with those
      taking aspirin, there were no differences in the IMA (100.0% versus 92.1%, p =
      0.385) or vein graft (88.8% versus 90.4%, p = 0.675) patency rates. The patency
      rate, irrespective of treatment, for all IMA grafts was 92.8% (220 of 237) versus
      90.1% (345 of 383) for all vein grafts to the LAD (p = 0.309). Thus, both the IMA
      and vein grafts had excellent patency rates at 1 year. Aspirin did not alter this
      at 1 year, and there were no differences between IMA and vein graft patency to
      the LAD.

PMID- 2225411
TI  - Dissection of the aorta and dissecting aortic aneurysms. Improving early and long
      term surgical results.
AB  - We report the improving surgical results in a consecutive series of 690 patients
      referred to one of us (E.S.C.) for aortic dissection between December 1956 and
      September 1989, a substantial portion of whom had dissection as a complication of
      either previous aortic (n = 113, 16) or previous cardiac (n = 54, 8%) operation.
      Our initial operation of choice in patients requiring multiple operations in this
      group of 690 patients was based on the most life-threatening or symptomatic
      aortic segment involved, which was ascending aorta and/or aortic arch (Asc/Arch)
      in 301 (44%) patients, descending thoracic aorta (Desc) in 195 (28%) patients,
      and thoracoabdominal aorta (TaA) in 194 (28%) patients. As detailed below,
      considerable improvement occurred in the 30-day survival rates over time,
      particularly for acute dissection: [table; see text] The independent determinants
      of both early and long-term mortality were identified. Independent determinants
      of late fatal rupture, reoperation, and neuromuscular dysfunction for distal
      dissectors were also identified. In our experience, continued aggressive surgical
      intervention for aortic dissection with modern operative techniques has resulted
      in markedly improved 30-day operative survival (approaching 95% including those
      patients with acute dissection) and significant improvement in late results.

PMID- 2225412
TI  - Relative risks of left ventricular aneurysmectomy in patients with akinetic scars
      versus true dyskinetic aneurysms.
AB  - From 1971 to 1988, 303 patients underwent left ventricular aneurysm resection. We
      analyzed preoperative and procedure-related variables to ascertain risk factors
      for surgery. A distinction was made between akinetic and dyskinetic aneurysms to
      assess potential relation with postoperative outcome. Indications for surgery
      were arrhythmia in 20 patients, congestive heart failure in 81, angina in 133,
      congestive heart failure and angina in 42, and other combinations in the
      remaining 27 patients. The left ventricular aneurysm was dyskinetic in 180
      patients and akinetic in 121. Risk factors and surgical procedures were similar
      in both groups. Left ventricular ejection fraction was less than or equal to 30%
      in 98 patients. Coronary bypass grafting was performed in 269 patients, with an
      average of 2.3 grafts per patient. Mitral valve replacement, the most common
      concomitant procedure, was performed in 16 patients. Intra-aortic balloon assist
      was required postoperatively in 47 patients. Overall operative mortality was 13%
      (38 patients) and was due to low cardiac output in 23 patients and arrhythmia in
      12 patients. Univariate and multivariate analyses related early mortality to New
      York Heart Association functional classification of heart failure, the
      predominant indications of arrhythmia or congestive heart failure, left
      ventricular ejection fraction less than or equal to 30%, the need for intra
      aortic balloon support, and the excision of an akinetic (18%) rather than
      dyskinetic (8%) left ventricular aneurysm. Over a follow-up period averaging
      nearly 5 years, the actuarial survival at 5 years was 63% in the dyskinetic group
      and 51% in the akinetic group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225413
TI  - Latissimus dorsi cardiomyoplasty in the treatment of patients with dilated
      cardiomyopathy.
AB  - Stimulated skeletal muscle grafts have been proposed as a means to reinforce
      ventricular wall in the treatment of severe myocardial failure. Latissimus dorsi
      cardiomyoplasty was performed in 11 patients with advanced heart failure due to
      cardiomyopathy who were in New York Heart Association (NYHA) class III or IV
      despite maximal medical therapy. There were no operative deaths. Eight patients
      were followed for a mean of 10.8 months. Two patients remain in muscle
      conditioning protocol. One patient died with latissimus dorsi ischemia and
      congestive heart failure. Four of the eight patients in long-term follow-up are
      in NYHA class I, three in class II, and one in class III. At 3 months of follow
      up, rest radioisotopic left ventricular ejection fraction increased from 20.5 +/-
      3.6% to 26.8 +/- 8.1% (p less than 0.01). Doppler-echocardiography demonstrated
      that left ventricular segmental wall shortening improved from 11.3 +/- 2.5% to
      16.5 +/- 3.9% (p less than 0.01) and left ventricular stroke volume from 22.9 +/-
      4.6 to 33.1 +/- 10 ml (p less than 0.01). Cardiopulmonary exercise test showed
      that maximal oxygen consumption during treadmill test increased from 14.8 +/- 3.7
      to 18.2 +/- 3.3 ml/kg.min (p less than 0.05). At 6 months of follow-up, all the
      above values remained essentially unchanged. Furthermore, nonsustained
      ventricular tachycardia was abolished without specific medical therapy in four
      patients. Thus, cardiomyoplasty improves left ventricular function, reverses
      congestive heart failure, and may improve long-term survival in severe
      cardiomyopathies.

PMID- 2225414
TI  - Long-term preservation of baboon hearts. Effects of hypothermic ischemic and
      cardioplegic arrest on high-energy phosphate content.
AB  - Baboon hearts were preserved ex vivo after hypothermic ischemic or cardioplegic
      arrest and were stored cold (0.5 degrees C) for 24 hours. Ischemic arrest was
      induced on cardiopulmonary bypass after general cooling to 25 degrees C.
      Cardioplegic arrest was induced using either a hyperkalemic standard cardioplegic
      solution National Institutes of Health [( NIH] solution) or the recently
      developed University of Wisconsin (UW) organ preservation solution. ATP and
      catabolites were assessed in serial transmural biopsies. Cardioplegia
      significantly delayed the breakdown of ATP during storage. After infusion of the
      adenosine-supplemented UW solution, myocardial content of adenosine was high as
      compared with that in NIH-arrested hearts (9.12 versus 0.01 mumol.g-1 dry wt).
      During cold storage, however, adenosine converted to inosine in spite of profound
      hypothermia. This renders unlikely the potential of fast resynthesis of ATP out
      of the supplemented nucleoside pool after reoxygenation.

PMID- 2225415
TI  - Progressive coronary luminal narrowing after cardiac transplantation.
AB  - Accelerated coronary disease is a major factor limiting long-term survival in
      cardiac transplant recipients. Coronary angiography was obtained a mean of 5.1
      weeks posttransplantation and annually thereafter. Replicate projections recorded
      after nitroglycerine administration were quantitated using computer-assisted edge
      detection. Five hundred and fifteen coronary segments in 25 patients having 1
      year follow-up and 353 segments in 18 patients reaching 2-year follow-up were
      compared with baseline angiograms. Significant change was defined as +/- 0.10 mm,
      equal to 3.8% change in diameter based on three standard deviations obtained from
      estimation of measurement error. Mean coronary diameter fell from 2.44 +/- 0.26
      mm at baseline to 2.21 +/- 0.34 mm (p less than 0.001) at 1-year follow-up. This
      rate of diameter decline was 20-fold more rapid during the initial
      posttransplantation year than the rate of change of visually normal segments in
      nontransplant patients with coronary atherosclerosis elsewhere. There was no
      significant drop in mean diameter between the first and second year in those
      patients who had second-year studies. Decrease in absolute diameter for vessels
      greater than 2.9 mm significantly exceeded diameter reduction for smaller vessels
      but did not differ when considered as a ratio of vessel diameter. In 21 of 25
      patients, mean coronary diameter reduction exceeded the three-standard deviation
      threshold at their last angiogram, but only two of these patients had visually
      detectable transplant coronary disease.

PMID- 2225416
TI  - Five-year experience with triple-drug immunosuppressive therapy in cardiac
      transplantation.
AB  - Although triple-drug immunosuppression with a combination of cyclosporine,
      prednisone, and azathioprine has been shown to improve short-term survival after
      cardiac transplantation, its long-term effects still are unknown. From December
      1983 through December 1988, all patients (N = 139) who underwent orthotopic
      cardiac transplant at our institution received triple-drug immunosuppressant
      therapy. Follow-up averaged 32.2 +/- 15.8 months. Twenty-one patients died; 134
      survived more than 30 days. Actuarial survival was 92% at 1 year, 85% at 3 years,
      and 78% at 5 years. Twenty-five episodes of acute graft rejection were diagnosed
      in 21 of the 139 recipients (0.18 episode per patient). In patients, the
      incidence of infection was 0.82 episode; 72% of infections were viral, with 10%
      due to cytomegalovirus. The incidence of coronary artery disease was 10% at 1
      year, 25% at 3 years, and 36% at 5 years. Coronary artery disease was responsible
      for 60% of late deaths. Arterial hypertension developed in 81% of patients,
      despite relatively well-maintained renal function (serum creatinine, 1.7 +/- 0.3
      mg/dl). Skeletal complications occurred in 15.8% and lymphoma in 1.4% of
      recipients. Complete long-term rehabilitation was achieved in all but two of the
      surviving patients. These data support the short- and long-term effectiveness of
      triple-drug therapy. This regimen reduces the incidence of rejection, infection,
      and lymphoma, as well as the degree of renal failure. However, the incidence of
      posttransplant coronary artery disease has not been reduced, and graft
      atherosclerosis represents the major cause of late graft failure and death.

PMID- 2225417
TI  - Low-dose lovastatin safely lowers cholesterol after cardiac transplantation.
AB  - Hypercholesterolemia occurs in many cardiac transplant patients and may aggravate
      graft coronary arteriopathy as well as contributing to peripheral vascular
      disease. Lovastatin, which inhibits 3-hydroxy-3-methylglutaryl coenzyme A
      reductase, in doses of 40-80 mg/day effectively lowers cholesterol in the general
      cardiac population but has been associated with rhabdomyolysis in cardiac
      transplant recipients. To determine whether lower doses of lovastatin would be
      effective and safe for lowering cholesterol after cardiac transplantation, 44
      patients with blood cholesterol greater than 200 mg/dl at least 6 months after
      cardiac transplantation received 10-20 mg lovastatin daily. In addition,
      lovastatin enzyme inhibitor level was assayed in six patients to determine
      whether metabolism of the drug was abnormal. Lovastatin decreased total
      cholesterol by 28% from 282 +/- 54 to 208 +/- 62 mg/dl (p less than 0.005),
      primarily because of reduction in the low-density lipoprotein fractions, and was
      well-tolerated without any symptoms or abnormal creatine phosphokinase levels in
      43 of 44 patients. One patient developed rhabdomyolysis and reversible renal
      failure when lovastatin was increased to 40 mg daily. Enzyme inhibitor levels in
      the six transplant patients were 4.2-7.8 times higher than those measured in
      normal volunteers. Low-dose lovastatin effectively lowers cholesterol in patients
      after transplantation, but metabolism is altered, perhaps by cyclosporine.
      Monitoring of enzyme inhibitor levels may be required to allow safe
      administration of this drug to cardiac transplant recipients.

PMID- 2225418
TI  - Mechanical myocardial actuation during ventricular fibrillation improves
      tolerance to ischemia compared with cardiopulmonary bypass.
AB  - Direct mechanical ventricular actuation (DMVA) is a unique non-blood-contacting
      biventricular assist device that provides circulatory support during ventricular
      fibrillation without demonstrating adverse effects on the myocardium. The purpose
      of this study was to assess the preservation of myocardial energy stores and
      myocardial responses to ischemia after circulatory support during ventricular
      fibrillation with direct mechanical ventricular actuation versus cardiopulmonary
      bypass. Twenty adult mongrel dogs were randomized to receive circulatory support
      with either cardiopulmonary bypass or direct mechanical ventricular actuation.
      After 4 hours of ventricular fibrillation, hearts were defibrillated and left
      ventricular transmural biopsies were obtained. Hearts were then excised and
      subjected to 90 minutes of normothermic total ischemia. Serial biopsies were
      obtained at 15-minute intervals to determine regional depletion of high energy
      phosphates. The time-to-peak ischemic contracture was recorded by using needle
      tipped Millar catheters placed in the left ventricular endocardium, epicardium,
      septum, and right ventricle. Time-to-peak ischemic contracture of the endocardium
      (62.6 +/- 1.4 vs. 58.8 +/- 1.0 minutes, p less than 0.05) and septum (61.1 +/-
      6.9 vs. 46.9 +/- 6.2 minutes, p less than 0.004) were significantly prolonged
      after direct mechanical ventricular actuation versus cardiopulmonary bypass,
      respectively. Similar trends were noted in the epicardium and right ventricular
      regions; however, these differences were not statistically significant. Left
      ventricular adenosine triphosphate (ATP) levels were better preserved after
      direct mechanical ventricular actuation (22 +/- 1.5 mumols/g dry wt) compared
      with cardiopulmonary bypass (17 +/- 1.9 mumols/g dry wt). The depletion of left
      ventricular endocardium ATP during normothermic ischemia was significantly
      delayed after direct mechanical ventricular actuation compared with
      cardiopulmonary bypass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225419
TI  - Late complications in pediatric cardiac transplant recipients.
AB  - Late complications occurring more than 3 months after cardiac transplantation
      were analyzed in 29 pediatric patients in whom 31 cardiac transplantations were
      performed. Age at transplantation ranged from 3 months to 18 years (mean, 11.3
      years) with follow-up ranging from 3.5 to 54 months (mean, 21.6 months). There
      were seven late deaths and two patients with retransplantations. Of nine grafts
      lost, eight were due to acute rejection, and one was due to coronary disease.
      Four of the grafts lost were secondary to patient noncompliance with prescribed
      immunosuppression. The mean rejection frequency more than 1 year after cardiac
      transplantation was significantly higher in those patients who eventually lost
      their grafts; however, these patients could not be distinguished by their
      rejection frequency in the first year. Eight patients had coronary disease, with
      five diagnosed at autopsy, two at cardiac retransplantation, and one by
      angiography. All eight patients were on double immunosuppression; none of the 19
      patients on triple therapy had coronary disease with similar follow-up. There
      were 12 serious infections in eight patients (four associated with OKT3) with no
      deaths. Five patients had arrhythmias requiring treatment including two
      pacemakers; four of the five were associated with rejection episodes. Twelve of
      29 patients developed early hypertension, and five developed late hypertension
      (greater than 1 year). There were two malignancies; one patient with Hodgkin's
      lymphoma was cured with chemotherapy, and one patient with histiocytic lymphoma
      was discovered at autopsy. Two patients had cholecystectomies, and five patients
      required laser gingivectomies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225421
TI  - High-risk reparative surgery. A neglected alternative to heart transplantation.
AB  - The selection of patients for either high-risk reparative operations on the heart
      or for transplantation has become increasingly difficult as a result of improved
      results with both modalities. A retrospective review was done of patients
      referred for heart transplantation who were not considered candidates for
      conventional cardiac surgery, yet instead underwent reparative procedures rather
      than transplantation. Of 23 adult patients referred during a 7-year period, 18
      had coronary artery disease, and five had valvular heart disease. All had New
      York Heart Association class IV symptoms. Preoperative left ventricular ejection
      fractions were in the range 0.08-0.63 (mean, 0.28). Ten of 18 patients with
      coronary artery disease required insertion of an intra-aortic balloon pump for
      hemodynamic support perioperatively. Seven patients had primary coronary artery
      bypass grafts, and 10 had reoperative coronary bypass procedures. One patient had
      a left ventricular aneurysmectomy, and one had endocardial stripping in addition
      to myocardial revascularization procedures. Of the patients with valvular
      disease, three had aortic valve replacement, of which two were reoperations, and
      two others had mitral valve replacements with tricuspid annuloplasties. With a
      mean follow-up of 25 months, 1-, 3-, 12-, and 24-month actuarial survival rates
      were 91%, 87%, 82%, and 76%, respectively. One patient who underwent aortic valve
      replacement in this study successfully received heart transplantation 19 months
      postoperatively. These results compare favorably with the current results for
      patients undergoing first-graft heart transplantation. All survivors enjoy New
      York Heart Association class I or II functional capacity.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2225420
TI  - The changing clinical spectrum of thromboangiitis obliterans (Buerger's disease).
AB  - Between 1970 and 1987, 112 patients were diagnosed as having thromboangiitis
      obliterans (TAO). The age was 42 +/- 11 years (mean +/- SD; range, 20-75 years);
      23% were women, and 7% were more than 60 years old when they were first
      diagnosed. Ischemic ulcerations were present in 85 (76%) patients: 24 (28%)
      patients with upper-extremity, 39 (46%) patients with lower-extremity, and 22
      (26%) patients with both upper- and lower-extremity lesions. Ninety-one (81%)
      patients had rest pain, 49 (44%) patients had Raynaud's phenomenon, and 43 (38%)
      patients had superficial thrombophlebitis. We were able to follow up 89 of the
      112 (79%) patients for 1-460 months (mean follow-up time, 91.6 +/- 84 months).
      Sixty-five (73%) patients had no amputations, while 24 (27%) had one or more of
      the following amputations: finger, six (15%) patients; toe, 13 (33%) patients;
      transmetatarsal, four (10%) patients; below knee, 14 (36%) patients; and above
      knee, two (5%) patients. Forty-three (48%) patients stopped smoking for a mean of
      80 +/- 105 months (median, 46.5 months; range, 1-420 months), and only two (5%)
      patients had amputations after they stopped smoking, while 22 (42%) patients had
      amputations while continuing to smoke (p less than 0.0001). The spectrum of
      patients with TAO is changing in that the male-to-female ratio is decreasing
      (3:1), more older patients are being diagnosed, and upper-extremity involvement
      is commonly present. In the 48% of patients who stopped smoking, amputations and
      continued disease activity were uncommon.

PMID- 2225422
TI  - Optimal temperature for preservation of donor myocardium.
AB  - The ideal method for the preservation of donor hearts for transplantation is
      unclear. To assess the optimal temperature for donor myocardium preservation, the
      recovery of isolated canine hearts (n = 20) exposed to 4 hours of either standard
      ice-chest hypothermia (0-4 degrees C) or constant moderate hypothermia (12
      degrees C) were compared. Functional and metabolic data were acquired before
      hypothermia and every 30 minutes during 3 hours of reperfusion with oxygenated
      blood. Mean end-systolic pressure-volume slopes were 2.11 +/- 0.06 and 2.09 +/-
      0.06 mm Hg/ml for ice-chest hypothermia and constant moderate hypothermia,
      respectively (p = NS), which were unchanged from control. All y intercepts during
      reperfusion were decreased compared with control (p = 0.002) without any
      differences between groups. End-diastolic pressures were greater than control
      throughout the reperfusion period for both groups (p = 0.02), but there was a
      difference in change of end-diastolic pressures with time between groups (p =
      0.04). Dry/wet ratios were similar after preservation and reperfusion in both
      groups. ATP recovered to control levels during reperfusion for both groups
      although energy charge ratios were greater for hearts exposed to constant
      moderate hypothermia (p = 0.007). These data indicate that intracellular energy
      stores are well maintained by preservation using either technique. Changes in
      function appear to be related to altered compliance irrespective of preservation
      temperature. These data suggest that a wide range of temperatures may be
      acceptable for donor heart preservation.

PMID- 2225423
TI  - Bradyarrhythmia after heart transplantation. Incidence, time course, and outcome.
AB  - From June 1980 to April 1989, 72 of 401 (18%) adult recipients of orthotopic
      heart transplantation developed prolonged (greater than 24 hours)
      bradyarrhythmias (less than 60 beats/min) within 5 days after transplantation.
      Junctional bradycardia occurred in 50 (69%) recipients, sinus bradycardia in 18
      (25%), and slow ventricular response during atrial fibrillation in four (6%).
      Fifty-five of 72 (76%) patients had bradyarrhythmias of less than 20 days'
      duration (less than 7 days, 50 patients; 7-20 days, five patients). Fifty
      patients returned to sinus rhythm (greater than 60 beats/min) by the time of
      discharge. Five patients expired within 20 days. Seventeen of 72 (24%) patients
      had bradyarrhythmia for more than 20 days, which was symptomatic in 11. All 17
      patients (junctional bradycardia, 13 patients; sinus bradycardia, four patients)
      received a permanent pacemaker within 40 days after transplantation. Between 1
      and 12 months (mean, 4 +/- 3 months) after pacemaker implantation, 12 patients
      recovered sinus rhythm (greater than 70 beats/min). The other five patients had
      intrinsic rates of 32-57 beats/min (mean, 48 +/- 10 beats/min) during 1-9 months
      (mean, 4 +/- 3 months) of follow-up. The donor ischemic time in bradyarrhythmia
      patients was 202 +/- 34 minutes, which was significantly longer (p less than
      0.01) than the 173 +/- 43 minutes for those patients without bradyarrhythmia.
      Conclusively, the incidence of posttransplantation bradyarrhythmia is relatively
      high. It is usually temporary, however, even in patients with a prolonged
      duration of bradyarrhythmia. A relation appears to exist between donor ischemic
      time and the incidence of bradyarrhythmia.

PMID- 2225424
TI  - Factors affecting survival in total artificial heart recipients before
      transplantation.
AB  - To identify factors affecting the successful bridge to transplantation,
      experience with 32 recipients of the Jarvik-7 artificial heart was reviewed.
      Between patients with and without a successful bridge, there were no significant
      differences in preoperative hepatorenal function or postoperative hemodynamics,
      but there were significant differences in body size. When recipients were divided
      according to body surface areas of less than or greater than 1.8 m2, the smaller
      patients more frequently developed respirator dependence (73% vs. 18%, p less
      than 0.01), renal failure (53% vs. 18%, p less than 0.05), and hepatic failure
      and sepsis, resulting in less frequent qualification for transplantation (20% vs.
      65%, p less than 0.05). There were no successful bridge operations in seven
      patients with body surface areas of less than 1.7 m2, and only one success in
      nine patients who were less than 170 cm in height, despite use of a smaller
      stroke volume model. The smaller patients had poorer ventricular filling, which
      was largely compensated for by the drive controls set for significantly longer
      diastole and higher vacuum, resulting in similar hemodynamics between the groups.
      The results suggest that device fitting as manifested by body size is an
      important factor affecting major organ recovery and subsequent transplantation in
      recipients of the Jarvik-7 artificial heart. A paracorporeal device may be
      advisable for patients with body surface areas of less than 1.8 m2 or who were
      less than 175 cm in height until an even smaller model with a better fit in the
      thorax becomes available.

PMID- 2225425
TI  - Right ventricular function and metabolism.
AB  - Right ventricular protection may be limited with current methods of cardioplegic
      delivery. Sensitive measurements of right and left ventricular function and
      metabolism were made in 30 patients undergoing elective coronary artery bypass
      surgery with cold cardioplegic arrest. Myocardial adenine nucleotide
      concentrations decreased with cardioplegia and reperfusion in both the right and
      left ventricles despite adequate levels of precursors, suggesting perioperative
      mitochondrial dysfunction. Postoperatively, right and left ventricular pressures
      were measured with micromanometer catheters and volumes were measured by nuclear
      ventriculography. Right and left ventricular systolic elastance was calculated by
      the isochronic method and by the end-systolic method. Both methods provided
      sensitive indexes of end-systolic elastance. This study demonstrated that right
      ventricular function and metabolism can be evaluated by methods analogous to
      methods used in the left ventricle. These results suggest that right ventricular
      functional and metabolic recovery are delayed despite apparently adequate
      myocardial protection. Sensitive measurements may permit improved assessment of
      alternative methods of right ventricular protection.

PMID- 2225426
TI  - Is adenosine 5'-triphosphate derangement or free-radical-mediated injury the
      major cause of ventricular dysfunction during reperfusion? Role of adenine
      nucleoside transport in myocardial reperfusion injury.
AB  - The aim of this study was to determine the dual role of ATP as an energy
      substrate and as a major source of oxygen-derived free-radical-mediated
      reperfusion injury by using adenine nucleoside blocker, p-nitrobenzylthioinosine
      (NBMPR), and adenosine deaminase inhibitor, erythro-9-(2-hydroxy-3-nonyl)adenine
      (EHNA). In a randomized study, 16 dogs were instrumented with minor-axis LTZ
      piezoelectric crystals and intraventricular pressure transducers to monitor, off
      bypass, left ventricular performance by using a sensitive and load-independent
      index of contractility (slope of the stroke work-end-diastolic length relation).
      Hearts were subjected to 60 minutes of normothermic global ischemia and 120
      minutes of reperfusion. Normal saline without (Group 1, n = 8) or with (Group 2,
      n = 8) NBMPR and EHNA was infused in three boluses into the cardiopulmonary
      bypass reservoir before ischemia and reperfusion. Transmural serial biopsies were
      obtained before and during ischemia and reperfusion and analyzed for myocardial
      adenine nucleotide pool intermediates by using high-performance liquid
      chromatography. In the control group, three hearts developed ischemic contracture
      and another three hearts exhibited cardiogenic shock during reperfusion. In the
      EHNA/NBMPR-treated group, left ventricular performance recovered within 30
      minutes of reperfusion (p less than 0.05 vs. control). Myocardial ATP was
      depleted to 20% of normal in both groups by the end of ischemia (p less than
      0.05). Intramyocardial adenosine in the EHNA/NBMPR-treated group was 12-fold
      greater (15.09 +/- 1.6 nmol/mg protein) than the control group at the end of the
      ischemic period (p less than 0.05). Inosine was about fourfold higher in the
      control group (19.07 +/- 1.50 nmol/mg protein) compared with the drug-treated
      group (p less than 0.05). During reperfusion, myocardial ATP levels increased to
      approximately 50% of normal in the EHNA/NBMPR group while remaining depressed
      (20% of normal) in the control group. Thus, despite the dramatic loss of
      myocardial ATP during ischemia, complete recovery of ventricular performance and
      significant repletion of ATP during reperfusion were observed when adenosine
      transport and deamination were modulated during ischemia and reperfusion. These
      results suggest that 1) the myocardium may have more ATP than is needed for basic
      cardiac functions and 2) washout of ATP diffusible catabolites is detrimental to
      ventricular performance during reperfusion. Specific blockade of nucleoside
      transport resulted in complete functional recovery despite low but critical ATP
      levels.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2225427
TI  - Prolonged cardiac preservation. Evaluation of the University of Wisconsin
      preservation solution by comparison with the St. Thomas' Hospital cardioplegic
      solutions in the rat.
AB  - The University of Wisconsin solution differs from other types of solutions used
      for organ preservation because it contains high-energy phosphate precursors
      (adenosine and phosphate), impermeants (lactobionate and raffinose), an oncotic
      agent (pentafraction), and antioxidants (allopurinol and glutathione). These
      components have the potential to enhance the preservation of ATP, reduce
      intracellular and extracellular edema, and attenuate free-radical-mediated
      injury. The University of Wisconsin solution has been demonstrated to enhance and
      extend the preservation of the liver, pancreas, and kidney, but its potential
      role in the heart remains unproven. We have evaluated the University of Wisconsin
      solution (Du Pont) by comparing it with the St. Thomas' Hospital cardioplegic
      solutions No. 1 and No. 2 (Plegisol), which are used in Europe and the United
      States for routine cardiac surgery and transplantation. For each solution, 10
      isolated working rat hearts were arrested by 10 ml of the solution (at 4 degrees
      C) and then maintained immersed in the same solution for 4 hours at 4 degrees C.
      Mean recovery of functional indexes (expressed as a percentage of their
      preischemic control values) after use of the University of Wisconsin solution
      were as follows: peak aortic pressure, 90.6 +/- 1.0; dP/dt, 71.5 +/- 5.5; aortic
      flow, 81.6 +/- 4.7; coronary flow, 87.5 +/- 3.5; and cardiac output, 82.6 +/-
      3.5. In contrast, the mean recoveries after St. Thomas' Hospital solution No. 1
      were as follows: peak aortic pressure, 82.8 +/- 1.3; dP/dt, 49.7 +/- 3.0; aortic
      flow, 58.4 +/- 5.3; coronary flow, 79.6 +/- 5.9; and cardiac output, 63.0 +/-
      4.9. In contrast still, mean recoveries after St. Thomas' Hospital solution No. 2
      were as follows: peak aortic pressure, 83.1 +/- 1.2; dP/dt, 40.7 +/- 6.1; aortic
      flow, 37.0 +/- 5.1; coronary flow, 65.8 +/- 3.6; and cardiac output, 43.1 +/-
      5.6. The recovery of all indexes were significantly superior (p less than 0.005)
      after preservation with University of Wisconsin solution compared with either of
      the St. Thomas' Hospital solutions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225429
TI  - Identification of patients at greatest risk for developing major complications at
      cardiac surgery.
AB  - As part of a prospective program to use risk-adjusted outcome (operative
      mortality and morbidity) as a measure of quality of care, we have analyzed
      perioperative complication data in 10,634 patients representing 73% of all
      patients undergoing cardiac surgery requiring cardiopulmonary bypass at Veterans
      Administration medical centers between April 1, 1987, and March 31, 1989. One or
      more complications occurred in 15% of patients undergoing coronary artery bypass
      grafting, and in 24% of patients undergoing valve and other cardiac surgery.
      Patients experiencing one or more complications had an eightfold to 10-fold
      increase in operative mortality compared with patients with no perioperative
      complications. The most frequent complication was requirement for mechanical
      ventilation for at least 48 hours occurring in 8% of patients undergoing coronary
      artery bypass and in 15% of patients undergoing valve and other cardiac surgery;
      24-25% of these patients died within 30 days of surgery or as a direct result of
      a surgical complication. Previous heart surgery was a strong predictor of
      development of one or more complications in both groups of patients, being
      associated with an adjusted relative risk of 1.6-2.0. Other important predictors
      in both surgical groups were surgical priority, older age, peripheral vascular
      disease, and higher serum creatinine. Although a number of preoperative risk
      factors could be identified for the development of renal failure, low cardiac
      output, and requirement for prolonged mechanical support, few risk factors could
      be identified for the development of mediastinitis and reoperation for bleeding.
      This observation suggests that mediastinitis and reoperation for bleeding are
      more likely the result of technical factors rather than patient-related risk
      factors.

PMID- 2225428
TI  - Efficacy of recombinant-derived human superoxide dismutase on porcine left
      ventricular contractility after normothermic global myocardial ischemia and
      hypothermic cardioplegic arrest.
AB  - A porcine model of normothermic global ischemia (40 minutes) followed by systemic
      cooling to 25 degrees C with 4 degrees C crystalloid cardioplegic arrest (90
      minutes) was used to assess the efficacy of recombinant-derived human superoxide
      dismutase (r-HSOD) on postreperfusion left ventricular function while on
      cardiopulmonary bypass. Isovolumic hemodynamic function was monitored, and
      adenine nucleotide pool was measured in myocardial biopsy specimens and coronary
      sinus effluent. The treatment group of pigs (n = 7) received 15 mg/kg r-HSOD
      immediately before warm reperfusion, both left ventricular peak systolic pressure
      and developed pressure were significantly better in the r-HSOD group of pigs (p
      less than 0.05 vs. placebo). This improvement persisted at 60 minutes of
      reperfusion (p less than 0.05 vs. placebo). Myocardial ATP and total adenine
      nucleotides did not differ, nor did adenine nucleotide catabolites in the
      coronary sinus effluent differ between treatment groups of pigs. The exception to
      this was the nucleotide catabolite inosine, which was significantly elevated in
      coronary sinus effluent of pigs treated with r-HSOD at 30 minutes of reperfusion
      (p less than 0.05 vs. placebo). In this model of global ischemia and reperfusion,
      a recombinant-derived human free-radical scavenger provides significant
      protection of systolic but not diastolic function. Values for myocardial ATP and
      total adenine nucleotide content suggest that the improvement in mechanical
      function during reperfusion is not due to enhanced preservation of myocardial
      bioenergetics.

PMID- 2225430
TI  - Iron chelation by deferoxamine inhibits lipid peroxidation during cardiopulmonary
      bypass in humans.
AB  - Iron catalysis is involved in oxygen-derived free radical generation and
      subsequent lipid peroxidation, which have been reported to occur during
      cardiopulmonary bypass in humans. We assessed the effects of the iron chelator
      deferoxamine on the susceptibility of circulating low density lipoproteins (LDLs)
      to induced peroxidation in 20 adult patients (10 controls and 10 treated)
      undergoing cardiopulmonary bypass for coronary or valve procedures. Deferoxamine
      was given both intravenously (30 mg/kg body wt, starting 30 minutes before bypass
      and extending for the next 4 hours) and as an additive to the cardioplegic
      solution (250 mg/l). Blood samples were taken from both atria before and
      immediately after the end of cardiopulmonary bypass. Plasma lipid peroxidation
      was assessed by measuring spectrophotometrically the thiobarbituric acid reactive
      substances (TBARS) content of selectively isolated LDLs after their exposure to a
      peroxidizing agent. Before cardiopulmonary bypass, the right and left atrial
      blood values of LDL-TBARS were not significantly different between the two
      groups. Cardiopulmonary bypass resulted in a lipid peroxidation of significantly
      greater magnitude in control than in treated patients. Postbypass right atrial
      values for LDL-TBARS (expressed in mumol/mmol LDL-phospholipids) were 45.7 +/-
      17.2 (mean +/- SEM) in control patients and 6.9 +/- 2.9 in treated patients (p
      less than 0.02), whereas in the left atrial blood, LDL-TBARS yielded values of
      62.7 +/- 20.5 and 10.3 +/- 3.9, respectively (p less than 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2225431
TI  - Adverse hemodynamic effects and echocardiographic consequences of pericardial
      closure soon after sternotomy and pericardiotomy.
AB  - The acute hemodynamic and echocardiographic effects of pericardial closure on
      cardiac function were studied in 11 pigs during steady-state anesthesia and
      ventilation. Observations were made after sternotomy, both while the pericardium
      was open and after it had been closed, and then after closure of the chest, after
      the pericardium had been reopened by removing the pericardial suture through the
      chest wall. In five pigs, further observations were made when a suture was
      tightened to close the pericardium while the chest remained closed. Closure of
      the pericardium when the chest was open reduced cardiac output by 14% and mean
      stroke volume by 19% (both p less than 0.05). Systemic vascular resistance
      increased by 15% when the pericardium was closed while the chest was open (NS),
      and increased by 19% when it was closed while the chest was closed (p less than
      0.05). Heart rate did not change significantly, and the systemic blood pressure
      was maintained (-8%, NS). All these effects were reversed by opening the
      pericardium. Intrathoracic epicardial echocardiographic monitoring of the left
      ventricle showed that its end-diastolic dimension increased (by 11%, p less than
      0.05) when the pericardium was opened. After chest closure, paradoxical motion of
      the interventricular septum was consistently demonstrated only during
      ventilation, and it was not related to whether or not the pericardium was open.
      This study suggests that cardiac function may be impaired by pericardial closure
      after cardiac surgery because of some degree of constriction of the heart
      chambers, although acute circulatory responses compensate for the mild decrease
      in stroke volume. Monitoring of blood pressure alone cannot document the subtle
      circulatory changes induced by pericardial closure, and therefore it is not a
      reliable guide to decisions of whether to close the pericardium or leave it open
      in individual patients.

PMID- 2225432
TI  - Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary
      bypass.
AB  - We tested the hypothesis that insulin-dependent diabetic patients with coronary
      artery bypass graft surgery experience altered coupling of cerebral blood flow
      and oxygen consumption. In a study of 23 patients (11 diabetics and 12 age
      matched controls), cerebral blood flow was measured using 133Xe clearance during
      nonpulsatile, alpha-stat blood gas managed cardiopulmonary bypass at the
      conditions of hypothermia and normothermia. In diabetic patients, the cerebral
      blood flow at 26.6 +/- 2.42 degrees C was 25.3 +/- 14.34 ml/100 g/min and at 36.9
      +/- 0.58 degrees C it was 27.3 +/- 7.40 ml/100 g/min (p = NS). The control
      patients increased cerebral blood flow from 20.7 +/- 6.78 ml/100 g/min at 28.4 +/
      2.81 degrees C to 37.6 +/- 8.81 ml/100 g/min at 36.5 +/- 0.45 degrees C (p less
      than or equal to 0.005). The oxygen consumption was calculated from jugular bulb
      effluent and increased from hypothermic values of 0.52 +/- 0.20 ml/100 g/min in
      diabetics to 1.26 +/- 0.28 ml/100 g/min (p = 0.001) at normothermia and rose from
      0.60 +/- 0.27 to 1.49 +/- 0.35 ml/100 g/min (p = 0.0005) in the controls. Thus,
      despite temperature-mediated changes in oxygen consumption, diabetic patients did
      not increase cerebral blood flow as metabolism increased. Arteriovenous oxygen
      saturation gradients and oxygen extraction across the brain were calculated from
      arterial and jugular bulb blood samples. The increase in arteriovenous oxygen
      difference between temperature conditions in diabetic patients and controls was
      significantly different (p = 0.01). These data reveal that diabetic patients lose
      cerebral autoregulation during cardiopulmonary bypass and compensate for an
      imbalance in adequate oxygen delivery by increasing oxygen extraction.

PMID- 2225433
TI  - Treatment with desmopressin acetate in routine coronary artery bypass surgery to
      improve postoperative hemostasis.
AB  - Desmopressin acetate (DDAVP) has been shown to decrease blood loss and
      transfusions in complex cardiac operations with long extracorporeal times. Its
      use in routine cardiac valve operations has been shown not to be beneficial, but
      its role in routine coronary artery bypass grafting operations has not been
      defined. We examined the effect of DDAVP in a prospective study of 60 patients
      undergoing uncomplicated primary coronary artery bypass grafting operations.
      Thirty consecutive patients received DDAVP (0.3 micrograms/kg) after
      cardiopulmonary bypass and were compared with 30 consecutive patients who did not
      receive DDAVP. No significant differences were seen in 12-hour mediastinal blood
      loss (465 +/- 207 ml with DDAVP versus 511 +/- 221 ml without DDAVP) or 12-24
      hour mediastinal blood loss (236 +/- 127 ml with DDAVP versus 260 +/- 112 ml
      without DDAVP). Transfusion of blood products were similar for both groups.
      Platelet aggregometry at intraoperative and postoperative time points using ADP,
      collagen, and ristocetin was not significantly different from baseline values in
      either group. In a subgroup of patients with poor initial ristocetin-induced
      platelet aggregometry, a significant increase (p less than 0.05) in ristocetin
      induced platelet aggregometry was seen postoperatively only in those patients who
      had received DDAVP. A decrease in blood loss and transfusions, however, was not
      demonstrable. In those patients who had been on aspirin or nonsteroidal anti
      inflammatory drugs preoperatively, DDAVP did not improve mediastinal blood loss
      or transfusion needs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225434
TI  - Neurological and ophthalmological phenomena after aortic conduit surgery.
AB  - Transient neurological and visual signs have been observed in some patients after
      valved conduit replacement of the aortic valve and ascending aorta. Twenty-seven
      patients having valved conduit replacement between February 1982 and October 1988
      were compared with 21 patients having combined aortic valve replacement (AVR) and
      ascending aorta (AA) graft replacement. Follow-up in 100% of both groups was
      obtained for 0.3-6.6 years (mean, 2.6 +/- 0.3 years). Among 20 surviving valved
      conduit patients, 10 (50.0%) experienced repetitive neurological and visual
      signs, including scotomata (seven), transient motor ischemic attacks (two),
      amaurosis fugax (four), and recurring attention lapses suggesting petit mal
      seizures (one). No patient with AVR + AA graft experienced any events (p =
      0.004). All valved conduit and seven (53.8%) of AVR + AA graft patients were on
      warfarin (p = 0.0016). These events retained the same pattern although they
      diminished in frequency after 12 months in seven patients (70.0%) and after
      initiation of dipyridamole in two patients. Rehabilitation was similar in both
      groups: 18 of 20 (90.0%) valved conduit and 12 of 16 (75.0%) AVR + AA graft
      patients (p = NS). Transient, repetitive, nonprogressive neurological and
      ophthalmological phenomena are frequent after valved conduit replacement. The
      pathophysiological mechanism is unclear, but antiplatelet therapy may provide
      symptomatic control.

PMID- 2225435
TI  - Reappraisal of the mechanism for cerebrospinal fluid hypertension during aortic
      surgery.
AB  - Cerebrospinal fluid (CSF) hypertension during aortic surgery is a poorly
      understood, multifactorial event that may increase the risk of spinal cord
      injury. To assess the factors that may contribute to changes in CSF pressure
      during aortic surgery, measurements of ascending arterial and CSF pressures were
      made in 17 anesthetized mongrel dogs. Changes in CSF patterns were monitored
      under several conditions tested in random sequence. These included systemic
      hypertension produced by an infusion of phenylephrine, cross-clamping of the
      descending thoracic aorta, and manual, superior displacement of the transverse
      aortic arch (arch elevation), either alone or in conjunction with the cross
      clamp. Hypertension, cross-clamping, and cross-clamping combined with arch
      elevation all produced significant increases in ascending mean arterial pressure
      (204 +/- 20, 170 +/- 8, and 158 +/- 11 mm Hg, respectively, vs. 117 +/- 8 mm Hg
      [control]; (p less than 0.01). Small, nonsignificant increases in CSF pressure
      were detected in the cross-clamp group, but none were detected with hypertension
      alone, despite significant increases in ascending arterial blood pressure in both
      groups. Thus, neither arterial hypertension nor cross-clamping alone could be
      demonstrated directly to cause significant CSF hypertension. However, when aortic
      elevation (displacement) was combined with cross-clamping, the rise in CSF
      pressure increased to significant levels, even though the ascending arterial
      hypertension was least severe in this group. In contrast, arch elevation alone
      did not produce any significant increase in ascending arterial pressure but did
      produce an approximately 114% increase in CSF pressure (15.2 +/- mm Hg vs. 7.7 +/
      1 mm Hg [control]; p less than 0.01.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225436
TI  - Comparison of rigid and flexible rings for annuloplasty of the porcine mitral
      valve.
AB  - Seven rigid (Carpentier) and six flexible (Duran) annuloplasty rings were
      implanted in healthy pigs. First, in the intact pig, cinefluoroscopy was used to
      record movements of the anulus. Results were compared with data from three pigs
      instrumented with a continuous radiopaque marker on the anulus. Pump function of
      all hearts with annuloplasty rings and function of the mitral valve were studied
      4-6 weeks after the operation, first in the exposed heart and then subsequently
      in the isolated heart in a perfusion chamber at maximal filling pressure and
      normal or low arterial pressure. Separation of the blood-perfused coronary
      circulation from the crystalline solution pumped by the left heart allowed
      videoendoscopy of the working valve. Flexible rings interfered less with normal
      movements of the mitral anulus than rigid rings and caused less impairment of
      filling of the basal part of the ventricle, and the unloaded stroke volume was
      16% larger. For normal arterial pressures, the differences were smaller and will
      be difficult to detect in clinical situations. A stiff anulus was seen to be
      pushed underneath the aortic valve during systole, which caused a mild
      subvalvular obstruction. The mean diastolic pressure gradient across rigid
      annuloplasty rings was slightly larger than across flexible rings of the same or
      slightly smaller diastolic size. Rigid rings change the pattern of movement of
      the leaflets; the mural leaflet remains immobile throughout diastole. Although
      Duran rings interfere less with valvular function and filling of the basal part
      of the ventricle than do Carpentier rings, the differences are small and probably
      only of limited clinical importance.

PMID- 2225437
TI  - Late results with Carpentier-Edwards porcine bioprosthesis.
AB  - From 1977 to 1984, 429 patients underwent aortic valve replacement (AVR), and 339
      underwent mitral valve replacement (MVR) with a Carpentier-Edwards bioprosthesis.
      Early mortality for AVR was 4.6% (isolated AVR, 1.9%) and for MVR was 5.3%
      (isolated MVR, 4.1%). Follow-up was 99.3% complete at a mean of 5.9 years.
      Actuarial event-free rates at 10 years for AVR and MVR were, respectively, 1) for
      structural valve deterioration, 91.4 +/- 3.2% versus 75.1 +/- 4.0% (p less than
      0.01); 2) for nonstructural dysfunction, 100% versus 97.8 +/- 1.6% (p = NS); 3)
      for thromboembolism, 90.6 +/- 2.3% versus 87.3 +/- 2.6% (p = NS); 4) for
      anticoagulant-related bleeding, 95.3 +/- 1.1% versus 88.6 +/- 2.4% (p = 0.05); 5)
      for endocarditis, 87.8 +/- 5.7% versus 90.6 +/- 2.4% (p = NS); 6) for
      reoperation, 91.0 +/- 2.5% versus 74.4 +/- 3.7% (p less than 0.01); 7) for valve
      related mortality, 76.1 +/- 6.9% versus 71.4 +/- 5.2% (p = 0.01); 8) for
      permanent physical impairment, 85.0 +/- 3.0% versus 71.5 +/- 3.6% (p less than
      0.01); and 9) for combined operative mortality, valve-related mortality, and
      reoperation, 68.7 +/- 6.4% versus 51.5 +/- 4.9% (p = 0.01). No structural valve
      dysfunction was observed in any AVR patient whose valve was inserted after age
      70. Age at operation was the only factor that predicted structural valve
      deterioration (p less than 0.01).

PMID- 2225438
TI  - Hemodynamic comparison of Hancock and Carpentier-Edwards mitral bioprosthetic
      valves.
AB  - Although it is known that pressure gradients and calculated valve areas in
      bioprosthetic valves are highly flow dependent, no studies have compared
      bioprosthetic valve performances while adjusting for differences in flow rate. We
      therefore studied 75 patients undergoing mitral valve replacement who were
      randomized to receive either Hancock (n = 35) or Carpentier-Edwards (n = 40)
      bioprosthetic valves. Pressure gradients were measured using transducer-tipped
      catheters to record left ventricular and left atrial pressures and cardiac
      outputs by thermodilution. Repeated measurements were made in each patient after
      either pacing, fluid infusion, or pharmacological intervention to vary flow rates
      for a total of 239 measurements (mean, 3.2 measurements per patient). Using
      analyses of variance and covariance, mean valve gradients and the calculated
      Gorlin area were adjusted for flow rate, valve size, valve type, and interpatient
      differences to compare hemodynamics. Without flow and interpatient adjustment,
      the univariate analysis suggested higher mean gradients in the Carpentier-Edwards
      29-mm valves (p = 0.038), with a trend toward higher gradients and smaller areas
      in the Hancock 33-mm valves (p = 0.057 and 0.059, respectively). After adjustment
      for flow rate and interpatient differences, however, there was no difference at
      any valve size in the mean pressure gradients (p = 0.13-0.89) or Gorlin valve
      areas (p = 0.34-0.96). Although measurements within a given patient were
      consistent, marked interpatient variabilities in gradients and areas were
      observed for identical valve types and sizes, which were as significant as flow
      dependent or size-dependent changes. We conclude that comparisons of valve
      performance should adjust for variations in flow rate and for interpatient
      differences with the use of repeated-measures designs.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2225439
TI  - Importance of the mitral subvalvular apparatus for left ventricular segmental
      systolic mechanics.
AB  - The relative importance of the anterolateral (ANTLAT) and posteromedial (POSTMED)
      papillary muscle (PM) chordae tendineae for left ventricular (LV) segmental wall
      function was assessed in 12 in situ ejecting canine hearts. Pairs of
      piezoelectric crystals were placed in the regions subtending PM insertions and
      the ANTLAT LV free wall to measure wall thickness. After mitral valve replacement
      with complete preservation of the subvalvular apparatus, chordal attachments to
      either the ANTLAT PM or POSTMED PM were randomly severed using exteriorized
      snares, followed by subsequent division of the remaining chordae tendineae.
      Segmental wall function in each region was determined at each stage by segmental
      preload recruitable stroke work (sPRSW, slope of the segmental stroke work-end
      diastolic wall thickness relation). The order in which the chordae were severed
      was unimportant (p greater than 0.530 in all regions). When the ANTLAT PM chordae
      were severed first, there were significant declines in sPRSW without a change in
      the wall thickness intercept in both the ANTLAT (-71.0 +/- 18.3 vs. -57.7 +/-
      16.8 mmHg, p less than 0.05) and POSTMED (-81.8 +/- 23.1 vs. -65.4 +/- 17.3 mmHg,
      p less than 0.05) PM insertion sites. No further significant reductions in sPRSW
      in either region were detected after severing the remaining chordal attachments
      to the POSTMED PM. sPRSW in the ANTLAT LV free wall decreased progressively,
      reaching statistical significance when both sets of chordae tendineae were
      divided (-88.3 +/- 14.3 vs. -74.0 +/- 15.2 mm Hg, p less than 0.05). When the
      POSTMED PM chordae were severed first, no significant changes in sPRSW or the
      wall thickness intercept in either region of PM insertion were detected.
      Subsequent division of the ANTLAT PM chordal attachments reduced sPRSW
      significantly in both the ANTLAT PM (-65.9 +/- 21.1 vs. -56.1 +/- 22.1 mm Hg, p
      less than 0.05) and POSTMED PM (-78.8 +/- 24.7 vs. -67.2 +/- 24.0 mm Hg, p less
      than 0.05) insertion sites, without a shift in the wall thickness intercept. In
      the ANTLAT LV free wall, sPRSW again fell progressively, achieving statistical
      significance only when both chordal attachments were severed (-78.6 +/- 14.8 vs. 
      62.2 +/- 13.7 mm Hg, p less than 0.05). In conclusion, division of the chordae
      tendineae resulted in a decline in segmental LV function not only in the areas
      subtending PM insertions but also in remote LV regions. Furthermore, the
      influence of the ANTLAT PM chordae predominated local LV systolic function at
      both PM insertion sites.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2225441
TI  - Recognition and treatment of cocaine abuse.

PMID- 2225440
TI  - The reversibility of canine vein-graft arterialization.
AB  - We assessed the reversibility of functional and morphological changes of
      arterialized vein segments by returning them to the venous circulation. Thirteen
      dogs underwent right carotid and femoral veno-arterial grafting. After 12 weeks,
      veno-arterial grafts were removed for contractility (norepinephrine [NE] and 5
      hydroxytryptamine [5-HT]), luminal prostacyclin (PGI2), and morphometric
      analyses; the remaining segments were used as left jugular and femoral veno
      venous grafts. After another 12 weeks, the veno-venous grafts were harvested. To
      NE, veno-arterial grafts (ED50, 5.4 +/- 0.1 [-log M]) were less sensitive than
      control veins (ED50, 6.0 +/- 0.2) or veno-venous grafts (ED50, 6.4 +/- 0.2) but
      were more sensitive than control arteries (ED50, 4.0 +/- 0.1); the maximum
      tension of veno-arterial grafts (6.2 +/- 0.6 g) was greater than that of veins,
      less than that of arteries (9.8 +/- 1.0 g), and comparable with that of veno
      venous grafts (5.1 +/- 1.1 g). To 5-HT, veno-arterial (ED50, 7.5 +/- 0.1) and
      veno-venous (ED50, 7.3 +/- 0.2) grafts were more sensitive than arteries (ED50,
      6.0 +/- 0.3), while the vein was unresponsive; the maximum tension of veno
      arterial grafts (5.0 +/- 0.7 g) was less than that of arteries (6.9 +/- 0.9 g)
      and greater than that of veno-venous grafts (1.4 +/- 0.3 g). PGI2 production in
      veins (3.6 +/- 0.8 ng/ml), veno-arterial grafts (3.9 +/- 0.8 ng/ml), and veno
      venous grafts (3.3 +/- 0.9 ng/ml) was comparable and less than that of arteries
      (6.4 +/- 0.9 ng/ml). Veno-arterial graft intimal thickness (127 +/- 8 microns)
      and intimal area (15.6 +/- 1.8 x 10(3) microns 2) tended to be greater than that
      in the veno-venous graft (113 +/- 9 microns and 12.4 +/- 1.8 x 10(3) microns 2);
      also, the veno-arterial graft medial area (103.0 +/- 7.3 x 10(3) microns 2) was
      greater than that of the veno-venous graft (80.3 +/- 6.9 x 10(3) microns 2),
      thereby resulting in a similar relative intimal area (13 +/- 1%). Therefore, some
      changes associated with arterialization, for example, adrenergic sensitivity,
      maximum tension to 5-HT, medial thickening, and perhaps intimal hyperplasia,
      reverted toward venous values when replaced in the venous environment, possibly
      due to variations in pressure, flow, shear stress, and/or graft preparation
      techniques. Luminal PGI2 was unchanged in the grafts, implying that graft
      contractility was not modulated by luminal PGI2.

PMID- 2225442
TI  - Key steps in evaluating the dizzy patient.

PMID- 2225443
TI  - Lipoprotein abnormalities in the progression of renal disease.
AB  - Chronic renal disease is a progressive process. Implicated factors include
      abnormalities of the clotting cascade, altered prostaglandin metabolism,
      increased dietary protein intake, and abnormalities of lipoprotein metabolism.
      Several animal models have associated increased serum concentrations of
      cholesterol and triglycerides with progressive decline in renal function. The
      mechanism(s) of lipid-associated renal injury are unknown but may relate to lipid
      uptake by glomerular mesangial cells, hyperviscosity secondary to the
      hyperlipidemia, and a direct effect of the lipids on the glomerular basement
      membrane. Patients with chronic renal disease have well recognized increases in
      serum lipid concentrations. Whether lowering these concentrations will delay or
      prevent progressive renal failure or renal histologic abnormalities is unknown,
      but studies are underway to evaluate the effect of lipid-lowering agents in
      patients at risk for chronic progressive renal disease.

PMID- 2225444
TI  - Visual compromise in the diabetic patient.

PMID- 2225445
TI  - Managing diabetic retinopathy.
AB  - Diabetic retinopathy is a leading cause of visual impairment and blindness. The
      disease is more likely in patients with insulin-dependent diabetes mellitus, and
      the incidence is higher in diabetes of long duration. In background diabetic
      retinopathy, the vascular changes are confined to the retina; in proliferative
      retinopathy, vessels grow onto the posterior vitreous surface or wedge between
      the retina and the vitreous. Diagnostic accuracy is more likely with an
      ophthalmologic consultation. A team approach between the ophthalmologist and the
      primary care physician is recommended for effective overall management of these
      patients.

PMID- 2225446
TI  - Electrocardiographic criteria for anterior myocardial infarction.
AB  - In a two-stage review, electrocardiographic patterns associated with anterior
      infarction were determined in 135 patients whose diagnoses were established by
      contrast ventriculography. The five most common findings were tested in 1,324
      consecutive patients to assess sensitivity, specificity, and predictive
      accuracies for anterior myocardial infarction. The criteria were shown to have
      high positive predictive accuracy and specificity levels, and confirmed the value
      of the standard 12-lead electrocardiogram for detecting anterior myocardial
      injury.

PMID- 2225447
TI  - Serial electrophysiologic testing of drug therapy in supraventricular tachycardia
      related to accessory pathways.
AB  - Data are limited on the use of serial electrophysiologic testing of drug therapy
      in patients with supraventricular tachycardia associated with accessory pathways,
      including the Wolff-Parkinson-White syndrome. Twenty-four highly symptomatic
      patients (aged 36 +/- 11 years) with SVT related to accessory pathways underwent
      electrophysiologic studies to select an effective chronic oral treatment.
      Conventional (verapamil, propranolol, quinidine, disopyramide) and
      investigational (amiodarone, aprindine, propafenone) drugs were used alone and in
      combination if necessary. It was determined that serial electrophysiologic
      studies could identify potentially effective treatments in 66% of patients with
      reentrant SVT involving accessory pathways, and the findings were highly
      predictive of long-term clinical outcome.

PMID- 2225448
TI  - Pharmacology and use of headache medications.
AB  - Treatment of headache disorders is most likely to be successful when the
      pathophysiology of the disease is correlated with the pharmacologic actions of
      the available drugs. Beta blockers generally are considered first-line therapy
      for migraine prophylaxis, but calcium blockers also are appropriate for some
      patients. Antidepressants are the primary modality for treatment of tension type
      headaches, although they are also used for migraine prophylaxis. Mixed headache,
      which has features of both migraine and tension-type headache, usually requires
      treatment with more than one drug. Habituation to analgesics is common among
      patients with mixed headache.

PMID- 2225449
TI  - Metastatic carcinoma of the prostate with hypercalcemia.
AB  - A patient presented with advanced cancer of the prostate and underwent bilateral
      orchiectomy. After 2 years, hypercalcemia developed and was managed successfully
      with saline diuresis, furosemide, and oral glucocorticoid therapy. It is believed
      that the patient's hypercalcemia was caused by a metabolic complication of
      progressive, advanced disease.

PMID- 2225450
TI  - Parenteral nitrogen mustard for inflammatory arthritis.
AB  - A patient with progressive psoriatic arthritis refractory to methotrexate therapy
      was treated empirically with intravenous nitrogen mustard, or HN2. His response
      to therapy was compared with the responses of five rheumatoid arthritis patients
      treated with the same regimen. At 14 days after therapy was begun the patient
      with psoriatic arthritis showed significant improvement, at least comparable to
      that observed in the rheumatoid arthritis group. Intravenous HN2 therapy may be
      an alternative to methotrexate for progressive psoriatic arthritis.

PMID- 2225451
TI  - The effects of steroid therapy on pulmonary hypertension secondary to fibrosing
      mediastinitis.
AB  - Mediastinal fibrosis, a rare cause of pulmonary hypertension, may produce cough,
      dyspnea, and hemoptysis. Steroid therapy has been suggested for individuals with
      progressive symptoms, but data demonstrating the efficacy of such therapy are
      lacking. We present a case of pulmonary hypertension secondary to fibrosing
      mediastinitis. Hemodynamic and scintigraphic studies performed before and after a
      trial of corticosteroid therapy were unable to demonstrate any therapeutic
      benefit from the corticosteroids. In order to achieve better use of steroids for
      the treatment of this disease, we suggest that similar determinations be made on
      other patients with mediastinal fibrosis who receive such treatment.

PMID- 2225452
TI  - The electrocardiogram in remote myocardial infarction: reassessment of criteria.

PMID- 2225453
TI  - NACB 13th annual symposium: diagnostic applications of nucleic acid probes in the
      clinical laboratory. Toronto, Canada, June 2-3, 1989. Proceedings.

PMID- 2225454
TI  - Current concepts in quantitative molecular hybridization.
AB  - Knowledge of the molecular biology of cancer and other diseases has grown
      enormously in the past decade. The role certain genes play in disease states is
      clearer, creating new opportunities for diagnostic applications of molecular
      biological techniques in clinical medicine. The measurement of an abundance of
      certain nucleic acids could be valuable as a diagnostic or prognostic test. For
      example, aberrant expression of growth-promoting genes has correlated with the
      type and severity of certain neoplasias. Also, the determination of an abundance
      of exogenous sequences, arising from viruses or other pathogens, can be useful
      for evaluating virus load and activity during infection. Changes in the levels of
      these sequences could provide a means to determine the efficacy of therapy.
      Nucleic acid sequences can be measured by molecular hybridization using
      complementary nucleic acids as probes. Strategies for performing quantitative
      molecular hybridization, and their application in the clinic, are discussed.

PMID- 2225455
TI  - Nucleic acid hybridization in viral diagnosis.
AB  - Since 1982, numerous studies have been published utilizing a variety of
      hybridization techniques to detect viral nucleic acid directly in clinical
      specimens and in tissue sections. However, hybridization techniques are still not
      widely used in the clinical laboratory. Other recent advances, such as the
      development of monoclonal antibodies for virus identification and ELISA kits for
      virus detection, and the introduction of centrifugation cultures for rapid
      diagnosis, have postponed the clinical application of hybridization techniques.
      Furthermore, the use of hybridization for diagnosis has been limited by its
      insensitivity when compared to cell culture, the need for radioisotopes to
      increase sensitivity, and the difficulties inherent in transferring a basic
      research tool to the clinical laboratory. Nevertheless, with recently developed
      amplification techniques and further advances in nonradioactive labelling of
      probes, it can be expected that nucleic acid hybridization will be an established
      technique in diagnostic laboratories in the near future.

PMID- 2225456
TI  - Aspartate aminotransferase isoenzymes.
AB  - Aspartate aminotransferase (AST, EC 2.6.1.1) exists in human tissues as two
      distinct isoenzymes, one located in the cytoplasm (c-AST), and the other in
      mitochondria (m-AST). Striated muscle, myocardium, and liver tissues are the main
      sources of AST. A growing body of information suggests that determination of AST
      isoenzymes in human serum is useful in evaluating damage to some of these organs.
      In hepatic disease, the test is used to assess liver necrosis and for determining
      prognosis. It may also assist in identifying patients with active alcoholic liver
      disease. In patients with acute myocardial infarction, measurement of AST
      isoenzymes provides diagnostic information that differs from that obtained by
      determination of total creatine kinase and lactate dehydrogenase enzymes, and
      their isoenzymes.

PMID- 2225457
TI  - Comparison of tartrate resistant acid phosphatase in a giant cell bone tumor and
      a spleen infiltrated with hairy cells.
AB  - Acid phosphatase (E.C.3.1.3.2) in a giant cell bone tumor and a spleen
      infiltrated with hairy cells was extracted by citrate buffer and then by 0.3
      mol/L NaCl. The cationic acid phosphatase in the crude extract was isolated by CM
      cellulose chromatography, and further separated by high pressure liquid
      chromatography. The majority of the tartrate resistant acid phosphatase in the
      hairy cell spleen was unabsorbed on CM-cellulose and was insensitive to iron. A
      much larger portion of the acid phosphatase in the bone tumor, than in the
      spleen, was cationic and was eluted from the column by 0.8 mol/L NaCl. The
      cationic acid phosphatase was further separated into consecutive peaks of acid
      phosphatases with different sensitivity to iron. A major portion of acid
      phosphatase in the giant cell bone tumor was enhanced by iron, while the amounts
      of iron-enhanced and iron-insensitive acid phosphatase were about the same in the
      spleen. The differences of the phosphatases in these two types of pathologic
      specimens indicate the occurrence of two types of enzymes with different
      biological significance.

PMID- 2225458
TI  - A time-resolved fluoroimmunoassay for the determination of prostaglandin F2
      alpha.
AB  - We describe a solid-phase immunoassay based on fluorescence detection for
      Prostaglandin F2 alpha (PGF2 alpha). Europium was used as the fluorescence
      marker. Prostaglandin F2 alpha was covalently bound to poly-L-lysine (PL) and
      labelled by coupling Eu3+ via the complexonate diethylenetriaminepentaacetic acid
      (DTPA). The labelled PGF2 alpha was tested in a competitive immunoassay. The
      detection limit for PGF2 alpha was about 2.2 pg per microtiter well. The
      intraassay-variation was 17.2% at 1.1 pg, 4.1% at 10 pg and 7.6% at 90 pg. The
      precision was determined by measuring various amounts of unlabelled PGF2 alpha
      (2.5 to 2,400 pg) in the assay buffer. The regression line for these studies
      resulted in a good correlation (y = 1.01x +/- 0.03; r = 0.996; n = 21). The
      results of a radioimmunoassay and of the fluoroimmunoassay were similar (y =
      0.983 +/- 0.04; r = 0.988; n = 15). The new method enables PGF2 alpha analyses at
      concentrations in the fmolar range.

PMID- 2225459
TI  - Immunochemical detection of human blood in feces.
AB  - We have developed a new immunochemical test for fecal occult blood utilizing
      enzyme-linked immunosorbent assay (ELISA) of human hemoglobin (HbAo) and
      transferrin (Tf) simultaneously. The ELISA had a sensitivity of about 15 ng/ml
      Hb, and the measurable range was 1.5-750 micrograms Hb per g feces. The stability
      of Tf in feces was greater than that of Hb. In 17 out of 18 patients with colon
      cancer, 8 out of 15 patients with colon polyps, and 11 out of 20 patients with
      upper-gastrointestinal disorders. The Hb and Tf values were more than 10
      micrograms/g feces, in terms of Hb concentration. The ELISA for human fecal HbAo
      and Tf might be useful for the diagnosis of gastrointestinal disorders.

PMID- 2225460
TI  - Apolipoprotein B-48 analysis by high-performance liquid chromatography in VLDL: a
      sensitive and rapid method.
AB  - Apolipoprotein (apo) B subspecies were separated by high-performance liquid
      chromatography (HPLC) to analyze Apo B-48 contents in very-low-density
      lipoproteins (VLDL) more easily. Apo B-100 and B-48 were eluted through two
      connected column of Shim-pack Diol-300 at a retention time of 24 min and 32.3
      min, respectively. The molecular masses estimated by this method were
      approximately 600 kDa in apo B-100, 220 kDa in apo B-48. % apo B-48 in total apo
      B (% B-48) determined by measuring peak area of HPLC-separated apo B in a healthy
      subject was 76% in chylomicrons, 13% in fasting VLDL, and 20% in 2 h-postprandial
      VLDL. No peak of apo B-48 was detected in LDL. Recovery of Apo B determined by re
      chromatography of HPLC-separated sample was 91 +/- 4.0% and 95 +/- 3.6% in Apo B
      100 and apo B-48, respectively. 125I-labeled apo B in VLDL were also analyzed by
      both HPLC and SDS-PAGE. Percent radioactivity of apo B-48 fraction in the total
      apo B determined by the HPLC (17.3%) was similar to the value obtained through
      the measurement of radioactivity separated by the SDS-PAGE (17.6%). Coefficient
      of variation in % B-48 determined by the peak area was 2.5%. Percent B-48
      determined by the HPLC method was significantly correlated with % B-48 by SDS
      PAGE, but 6-8 times higher, which might be accounted for in part by the reported
      difference of chromogenicity between apo B-100 and apo B-48. % B-48 in VLDL
      separated from fasting plasma were 17.1 +/- 5.6% in 14 healthy subjects, and
      positively related to VLDL triglyceride and cholesterol concentrations. Apo B
      isoprotein analysis by the HPLC method is reliable and easy to perform for
      studying apo B metabolism in triglyceride-rich lipoproteins in physiological as
      well as pathological conditions.

PMID- 2225461
TI  - Enzymatic diagnosis of 3-hydroxy-3-methylglutaryl-CoA lyase deficiency with high
      performance liquid chromatography.
AB  - A new non-radiochemical method for determination of 3-hydroxy-3-methyl-glutaryl
      CoA (HMG-CoA) lyase is described. Acetyl-CoA, the product of the enzymatic
      reaction, is separated from the substrate by high-performance liquid
      chromatography and is quantified. The mean 3-hydroxy-3-methylglutaryl-CoA lyase
      activity in control fibroblasts was 7.8 +/- 2.1 (SD) nmol/min per mg protein, and
      its apparent Km value was 77.8 +/- 14.3 microM (R/S mixture) with a calculated
      Vmax of 12.4 +/- 2.2 nmol/min per mg protein. Using this method, we could easily
      differentiate a patient with 3-hydroxy-3-methylglutaryl-CoA lyase deficiency from
      control subjects.

PMID- 2225462
TI  - Lipoamidase activity in human serum is due to biotinidase.
AB  - Lipoamidase, as determined by lipoyl-p-aminobenzoic acid (L-pABA) hydrolyzing
      activity, and biotinidase in human serum have similar pH profiles, molecular
      weights, thermostabilities, and are similarly inhibited by p
      hydroxymercuribenzoate and not inhibited by phenylmethylsulfonylfluoride. A
      monospecific polyclonal antibody prepared against biotinidase immunoprecipitated
      greater than 95% of serum L-pABA hydrolyzing activity and an identical proportion
      of biotinidase activity. In addition, children with profound biotinidase
      deficiency (less than 10% normal serum activity) have greatly reduced levels of L
      pABA hydrolyzing activity in serum (less than 15% of mean normal activity) and
      obligate heterozygotes have activities intermediate between that of normal and
      profoundly deficient individuals. These results indicate that most, if not all,
      of the L-pABA hydrolyzing activity in human serum is due to biotinidase.
      Moreover, since the Km of L-pABA hydrolysis by serum is high, it is unlikely that
      lipoic acid is recycled in the serum by biotinidase.

PMID- 2225463
TI  - Rapid diagnosis of 3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency via
      enzyme activity measurements in leukocytes or platelets using a simple
      spectrophotometric method.
AB  - Patients with 3-hydroxy-3-methylglutaric aciduria due to a deficiency of 3
      hydroxy-3-methylglutaryl Coenzyme A lyase usually present with a life-threatening
      crisis of hypoglycemia, metabolic acidosis and hyperammonemia. Diagnosis of this
      inborn error of leucine degradation is usually based upon gas-chromatographic
      analysis of organic acids in a patient's urine. In this paper we describe a
      simple spectrophotometric method allowing the activity of HMG-CoA lyase to be
      measured in leukocytes or platelets within a few hours, thus contributing to a
      rapid, unequivocal diagnosis and subsequent treatment. The validity of the method
      was established by demonstrating a deficient activity of HMG-CoA lyase in two
      patients with 3-hydroxy-3-methylglutaric aciduria. Furthermore, using this
      method, heterozygote detection can be done with great reliability.

PMID- 2225464
TI  - Evidence of acid hydrolysis as responsible for 2-(2-furoyl)-4(5)-(2-furanyl)-1H
      imidazole (FFI) production.

PMID- 2225465
TI  - The Gibbs' Boston years: early developments in epilepsy research and
      electroencephalography at Harvard. Interview by James L. Stone and John R.
      Hughes.

PMID- 2225466
TI  - The Gibbs' Chicago years: from Harvard in the past to Illinois in the present.
      Interview by John R. Hughes and James L. Stone.

PMID- 2225467
TI  - Intermediate and long latency SEPs in relation to clinical disability in
      traumatic brain injury patients.
AB  - Intermediate (0-60 ms) and long latency (0-500 ms) somatosensory evoked potential
      (SEP) patterns were compared in terms of their relationship to degree of clinical
      disability in severe traumatic brain injury patients. Long latency (LL) SEP
      patterns correlated significantly with clinical disability as measured by the
      Disability Rating scale while intermediate latency (IL) SEP patterns did not.
      Evoked potential abnormality (EPA) scores based upon LL SEP patterns appear
      better able to reflect extent and severity of brain dysfunction and overall
      clinical condition than do IL SEP patterns for severe traumatic brain injury
      patients.

PMID- 2225468
TI  - Auditory evoked potentials in narcolepsy and sleep terrors.
AB  - Dysfunction of brainstem reticular activating centers has been suggested in some
      sleep disorders, including narcolepsy and sleep terrors. Previous studies have
      suggested normal brainstem auditory evoked potentials (BAEPs) in narcolepsy and
      enhancement of long-latency auditory event-related potentials (ERPs) in sleep
      deprivation and conditions of pathological somnolence. Sleep terrors have not to
      date been studied neurophysiologically. We recorded early latency BAEPs and long
      latency auditory ERPs in 8 patients with narcolepsy and 5 individuals with sleep
      terrors, and compared them to 10 normal controls. Narcolepsy patients and
      controls did not differ significantly in absolute or interpeak latency of BAEPs.
      Sleep terror patients had significant prolongation relative to controls of III-V
      and I-V interpeak latencies. The N1, N2, and P3 AEP components were prolonged in
      latency in narcoleptic patients as compared to controls, while sleep terror
      patients did not differ from controls. No significant differences in amplitude
      were found. These findings suggest that a disturbance of integration of brainstem
      centers subserving wakefulness and sleep may play a role in the disordered
      arousal of sleep terrors, but suggest no specific abnormality in brainstem
      function in narcolepsy. The AEP changes in narcolepsy may be a manifestation of
      pathological sleepiness.

PMID- 2225469
TI  - Psychiatric correlates of repetitive rhythmic blinking on a routine EEG.
AB  - Our findings suggest that EEG tracings dominated by repetitive rhythmic blinking
      (RRB) may be indicative of a functional rather than an organic brain disorder.
      Evaluation of organicity in psychiatric patients is the most common reason for
      obtaining an EEG. As a normal EEG does not totally rule out organic involvement,
      such findings as the presence of RRB on the record may strengthen the value of
      EEG in such evaluations. More research is necessary to further delineate the
      relation between increased blinking and functional psychiatric disorders.

PMID- 2225470
TI  - Brain mapping in a case of multiple personality.
AB  - Brain maps were recorded on a patient with a multiple personality disorder (10
      alternate personalities). Maps were recorded with eyes open and eyes closed
      during 2 different sessions, 2 months apart. Maps from each alternate personality
      were compared to those of the basic personality "S", some maps were similar and
      some were different, especially with eyes open. Findings that were replicated in
      the second session showed differences from 4 personalities, especially in theta
      and beta 2 frequencies on the left temporal and right posterior regions. A rank
      ordering of the differences in the brain maps of the alternate personalities from
      S were similar to the rank ordering of the differences in personality
      characteristics, as judged by the psychiatrist dealing with this patient. Maps
      from S acting like some of her personalities or from a professional actress
      portraying the different personalities did not reveal significant differences.
      Some of these findings are consistent with those in the literature, and the
      importance of detecting artifact in the raw EEG recording is emphasized.

PMID- 2225471
TI  - Alpha-like rhythmical activity of the temporal lobe.
AB  - In addition to the classical posterior alpha rhythm and Rolandic mu rhythm, a
      third type of rhythmical activity in alpha- (or sub-alpha-) frequency can be
      recorded over the temporal lobe and especially over the midtemporal region. This
      rhythm usually escapes detection in the scalp EEG but is commonly seen over bone
      defects ("breach rhythm"). With the use of epidural electrodes, however, this
      rhythm becomes quite prominent and dominates the activity of the temporal lobe
      unless there is excessive local EEG abnormality and/or pathology. This temporal
      rhythm lies in the range of 6-11/sec and thus often extends into the theta
      frequency range. There is no proven blocking effect; this mere fact sets it apart
      from posterior alpha and Rolandic mu rhythm. It is essentially a rhythm of the
      waking state but may linger into drowsiness and even into light NREM sleep. It is
      also separable from the highly controversial frontotemporal "kappa rhythm" of
      bygone times. EEG recordings from the depth of the temporal lobe (limbic
      structures) do not demonstrate such a rhythm that is likely to originate from the
      neocortical portion. Its neurophysiological and psychophysiological significance
      is enigmatic.

PMID- 2225472
TI  - Temporal minor slow and sharp activity in psychiatric patients.
AB  - TMSSA was found in 51 (4.7%) of 1091 psychiatric patients, with a higher
      incidence found in the older group (40 years of age or over). Although TMSSA was
      found in various disorders, a close association with cerebrovascular dementia was
      suggested. It was uncommon in patients with primary degenerative dementia. No
      increase of TMSSA was noted in cerebrovascular disorders without dementia. TMSSA
      was found fairly often in patients with affective disorders, neurosis, and other
      functional disorders, suggesting underlying mild cerebral dysfunction in some.
      TMSA, a variant of TMSSA, was very similar to TMSSA except for its greater
      frequency in cerebrovascular disorders without dementia.

PMID- 2225473
TI  - Pattern-reversal visual evoked potentials recorded in children with generalized
      epilepsy.
AB  - Visual potentials evoked by pattern reversal (PRVEPs) were studied in 64 normal
      subjects (age range 7 to 15 years) and in 15 patients with primary generalized
      epilepsy (age range 8 to 13 years), 10 of whom were without anticonvulsant
      medication. Most of them were studied during sodium valproate (VPR) therapy and
      some during carbamazepine (CBZ) medication. A Quadristim set (Alvar) was used to
      present checkerboard patterns on a TV monitor, to amplify the EEG signals and to
      average and plot the evoked potentials. The potentials were elicited by binocular
      full-field 2/s checkerboard reversals, recorded from an electrode 4 cm above the
      inion, and analyzed for latency, amplitude and waveform. Our PRVEP measurements
      examined peak latency of positive P2 (or P100) component and trough-to-peak
      amplitude on N1P2 wave complex. The degree of similarity between pairs of PRVEP
      plots were determined by Pearson correlation coefficient r for an analysis time
      of 150 ms. In most of our patients, no pronounced influence of the disease itself
      on the parameters and waveform of the normal PRVEP pattern was demonstrated if
      anticonvulsant drugs were not taken. In patients who were under complete seizure
      control, the anticonvulsant did not change the PRVEP morphology as well. The
      PRVEP abnormality was most pronounced in patients who were taking anticonvulsant
      medication, but whose seizures were poorly controlled. This pattern distortion
      can be revealed by the correlation coefficient, but not by other PRVEP
      parameters. Therefore, this coefficient may be useful as a sensitive and
      objective measure both of PRVEP distortion and PRVEP improvement. Our results
      give further evidence that nondemyelinating disorders, but with synaptic
      transmission defects, can produce measurable changes in PRVEP morphology.

PMID- 2225474
TI  - Bone mineral density and thyroid hormone therapy.
AB  - The purpose of this study was to evaluate prospectively the evolution of femoral
      and vertebral bone mineral density (BMD) in hypothyroid subjects treated with
      replacement doses (mean +/- SD dose of L-thyroxine = 135 +/- 32 micrograms/day)
      as compared to an untreated group. Vertebral bone density was also measured in
      other patients who had been treated for at least 2 years with either suppressive
      (mean dose = 154 +/- 36 micrograms/day, n = 28) or replacement doses (mean dose =
      104 +/- 52 micrograms/day, n = 21) according to the thyrotrophin response (TSH)
      to the thyrotrophin releasing hormone (TRH) administration. In primary
      hypothyroid patients, a mean decrease of 5.4% (P less than 0.01) for vertebral
      BMD, 7.3% (P less than 0.01) for trochanter and 7% (P less than 0.001) for
      femoral neck was observed after 1 year of treatment. This loss was unrelated
      either to age or to menopausal status (ANOVA). A clinical and hormonal state of
      euthyroidism was reached since the 3rd month of treatment. Fasting urinary
      calcium/creatinine excretion was increased significantly (P less than 0.05) at
      the 3rd month, and plasma osteocalcin (OC) increased significantly from the 3rd
      month onwards (P less than 0.05) up to the 12th month (P less than 0.025). In the
      cross-sectional study, vertebral BMD was not significantly different from age
      matched normal values in patients receiving either substitutive or suppressive
      doses of LT4. These results suggest that in the case of primary hypothyroidism
      even appropriate thyroid replacement therapy could lead during the first year of
      treatment to a significant reduction in vertebral and femoral BMD. However, the
      fact that an increased fracture rate has not been documented in long-term treated
      patients, and the results of our cross-sectional study, suggest that this bone
      mass reduction could be transient and reversible due to new bone formation at the
      end of the resorptive sequence.

PMID- 2225475
TI  - Rapid and long-lasting suppression of prolactin secretion and shrinkage of
      prolactinomas after injection of long-acting repeatable form of bromocriptine
      (Parlodel LAR).
AB  - Five patients with PRL-secreting macroadenoma and nine patients with PRL
      secreting microadenoma or idiopathic hyperprolactinaemia were treated with
      monthly administrations of long-acting bromocriptine suitable for repeatable
      injections (Parlodel LAR) for 1-12 cycles of treatment. A significant shrinkage
      of tumour mass and the recovery of visual field defects were observed in patients
      with macroprolactinoma. Plasma PRL levels decreased to 16.8 and 18.1% of
      pretreatment values, in macroprolactinoma and idiopathic or microadenomatous
      hyperprolactinaemic subjects, respectively, during the first cycle of treatment,
      reaching the normal range in three patients of each group. During the following
      cycles of treatment, two patients with macroprolactinoma and one patient with
      idiopathic or microadenomatous hyperprolactinaemia became normoprolactinaemic.
      Adverse reactions generally did not last beyond the first days of administration
      and decreased with the progression of the treatment. In conclusion, its
      effectiveness and the fact that it is well tolerated, may suggest that this form
      of bromocriptine may be used as a first therapeutic approach for patients with
      PRL-secreting adenomas, particularly when shrinkage of a macroadenoma is urgently
      required.

PMID- 2225476
TI  - Role of cholinergic muscarinic pathways on the free fatty acid inhibition of GH
      responses to GHRH in normal men.
AB  - In order to explore the mechanisms by which free fatty acids (FFA) inhibit GH
      secretion, we studied the effect of the acetylcholinesterase inhibitor
      pyridostigmine (120 mg p.o.) on the FFA blockade of GH responses to the
      administration of GHRH (100 micrograms i.v.) in seven normal subjects. GHRH
      induced GH secretion was significantly reduced following elevation of circulating
      FFA levels by lipid-heparin infusion and significantly potentiated by previous
      pyridostigmine treatment. Peak GH levels following combined administration of
      pyridostigmine plus lipid-heparin plus GHRH were significantly higher (P less
      than 0.01) than after GHRH alone and significantly lower than after
      pyridostigmine plus GHRH (P less than 0.01). In conclusion, central cholinergic
      activation by pyridostigmine, with the presumed reduction in somatostatin
      discharge, reversed the blocking effect of FFA on GHRH-stimulated GH release.
      Conversely, FFA were able to reduce even a maximal GH stimulation by
      pyridostigmine plus GHRH.

PMID- 2225477
TI  - Baroreflex-governed sympathetic outflow to muscle vasculature is increased in
      hypothyroidism.
AB  - Microelectrode recording of muscle nerve sympathetic activity (MSA), which is
      baroreflex-governed and involved in cardiovascular homeostasis, was made in five
      patients with hypothyroidism and in seven patients with hyperthyroidism prior to
      treatment and after recovery to euthyroidism. Patients with hypothyroidism had a
      higher level of MSA when hypothyroid than after recovery (mean +/- SEM 39.3 +/-
      7.1 and 26.8 +/- 7.9 bursts/min, respectively, P less than 0.05), whereas
      hyperthyroidism was not accompanied by a change in the number of sympathetic
      bursts/min. The response of MSA to manouvres known to influence the neural
      outflow via baroreceptors and other receptor inputs was not changed with altered
      thyroid function. The findings provide direct evidence of an increased
      sympathetic activity in hypothyroidism, but suggest that other physiological
      properties of MSA are intact in thyroid disease.

PMID- 2225478
TI  - The effect of amiodarone on the control of hyperthyroidism by propylthiouracil.
AB  - We studied the efficacy of amiodarone (800, 600, 400 and 200 mg orally daily
      during weeks 1, 2, 3 and 4, respectively) plus propylthiouracil (PTU, 100 mg
      orally every 8 h) in comparison to PTU alone in the early treatment (28 days) of
      Graves' disease patients. Circulating T3 and T4 decreased earlier and more
      markedly in the amiodarone plus PTU-treated group. An initial rise of circulating
      rT3 above the base-line value followed by a gradual decline was observed in the
      former group while only a decline below the base-line values was observed in the
      latter group. The resting pulse rate decreased and body weight increased
      significantly in the amiodarone plus PTU-treated group. In the PTU-treated group,
      significant weight gain was observed later in the course of treatment while no
      significant reduction in pulse rate was observed. No major side-effects of
      amiodarone were observed during the course of treatment. This study suggested
      that the combination of amiodarone and PTU was more efficacious than PTU alone in
      reducing circulating T3, T4 and clinical hyperthyroidism early in the course of
      treatment of patients with Graves' disease. This regimen has an additional
      potential advantage because of the antiarrhythmic property of amiodarone,
      especially in situations when a beta-blocker is contraindicated.

PMID- 2225479
TI  - Overnight urinary growth hormone measurement in the diagnosis of acromegaly.
AB  - Several studies report higher urinary GH excretion in acromegalic patients
      compared to control subjects. We investigated the diagnostic potential of
      overnight urinary GH excretion in acromegaly, using a recently developed enzyme
      linked immunosorbent assay. Overnight urine samples were obtained from 117
      control subjects and nine patients with untreated acromegaly. GH excretion was
      higher in acromegalic patients compared to control subjects, with geometric mean
      total overnight values of 46.35 and 5.73 microU respectively. The range for total
      overnight urinary GH in control subjects was 0.75-21.75 microU and two of the
      nine patients with untreated acromegaly had GH measurements within this range.
      Urinary GH measurements were corrected using predictive clinical variables but
      this resulted in minimal improvement in discrimination between control subjects
      and acromegalic patients. Lack of complete discrimination between control
      subjects and acromegalic patients limits the usefulness of a single overnight
      urinary GH measurement as a screening test for acromegaly.

PMID- 2225480
TI  - Thyroid function in choriocarcinoma: demonstration of a thyroid stimulating
      activity in serum using FRTL-5 and human thyroid cells.
AB  - Hyperthyroidism is a well recognized complication of gestational trophoblastic
      tumours (GTT) and may be due to high circulating concentrations of human
      chorionic gonadotrophin (hCG) or its variants. We have studied 24 clinically
      euthyroid women with GTT. Eight were biochemically hyperthyroid with low or
      undetectable serum thyrotrophin (TSH) and had a mean serum hCG of 361.2 x 10(3)
      IU/l compared to 76.2 x 10(3) IU/l in the other patients (P less than 0.01).
      Purified hCG stimulated iodide uptake into FRTL-5 cells with 25 x 10(3) IU/l
      being equivalent in potency to 1 mU/l of thyrotrophin (TSH). Sixteen out of the
      24 sera (67%) stimulated iodide uptake when applied to the cells at a 1:10
      dilution. Sera from all eight hyperthyroid patients contained thyroid stimulating
      activity. The mean hCG concentration in the 16 stimulatory sera was 238.2 x 10(3)
      IU/l compared to 37.1 x 10(3) IU/l in the other eight sera (P less than 0.01).
      Six men with hCG-secreting testicular tumours were biochemically euthyroid
      although three of their sera stimulated iodide uptake into FRTL-5 cells. In human
      thyroid cells the mean cAMP production over 4 h with sera from five healthy
      controls was 54.2 +/- 1.81 pmol/mg cell protein compared to 67.0 +/- 3.8 pmol/mg
      protein with sera from five choriocarcinoma patients (P less than 0.02). Serum
      from patients with gestational trophoblastic tumours contains a thyroid
      stimulating activity which may be hCG and whose presence correlates with
      hyperthyroidism.

PMID- 2225481
TI  - Subcutaneous growth hormone-releasing hormone augments pulsatile nocturnal GH
      release in GH-insufficient children, but may also raise basal GH secretion.
AB  - Growth hormone-releasing hormone (GHRH) when given s.c. to GH-insufficient
      children either as pulses, or once or twice daily, promotes linear growth. These
      treatment regimens, however, are not ideal as they require frequent drug
      administration and a significant proportion of patients do not show improved
      growth. We have now investigated the GH response to a nocturnal s.c. infusion of
      GHRH (1-29)NH2, at two dosages, 5 and 10 micrograms/kg/h, in a group of five GH
      insufficient children. The s.c. infusion of GHRH between 2100 h and 0600 h
      augmented nocturnal pulsatile GH release in all five children. There was a dose
      dependent response for the GH area under the curve (AUC), and mean total GH
      concentration. The AUC for GH was significantly greater after the 10 than 5
      micrograms/kg/h GHRH which in turn was greater than that after placebo; mean (SD)
      AUC: 14816 (3978), 8125 (1931), 3032 (1582) mU min/l respectively (P less than
      0.01 and P less than 0.05). There was no significant change in the number of GH
      pulses during the 9-h infusions when the subjects were infused with GHRH 10 or 5
      micrograms/kg/h compared to placebo, and they occurred at similar times although
      the number of pulses tended to be greater after GHRH; the mean (SD) numbers of GH
      pulses were 5.0 (0.7), 3.8 (0.8), 3.2 (0.8), respectively. There was however a
      significant rise in the mean baseline GH concentration in all patients during the
      infusion of GHRH 10 micrograms/kg/h compared to placebo, but not with 5
      micrograms/kg/h. Thus, GHRH(1-29)NH2 given s.c. augmented nocturnal pulsatile GH
      release in GH-insufficient children but it also increased baseline GH secretion.
      These results suggest that a sustained release preparation of GHRH could be a
      potential treatment for GH-insufficient children, and that a dose of 5
      micrograms/kg/h would promote pulsatile GH release, but that at higher dosage it
      may also raise basal GH secretion.

PMID- 2225482
TI  - The epidemiology of thyrotoxicosis in New Zealand: incidence and geographical
      distribution in north Canterbury, 1983-1985.
AB  - In a 3-year (1983-1985) epidemiological study of thyrotoxicosis in North
      Canterbury, New Zealand, the annual incidence was 25.8 per 100,000 (female 40.7,
      male 10.5). Thyroid scintiscanning showed that 64% had diffuse hyperplasia (DH),
      27% toxic multinodular goitre (TMG), 7% toxic uninodular goitre (TUG), and 2%
      zero uptake. The calculated annual incidence of toxic diffuse goitre (DH) was 15
      per 100,000, and for toxic nodular goitre (TMG and TUG combined) was 8 per
      100,000. The age-related incidence for toxic diffuse goitre peaked in middle life
      whereas toxic nodular goitre showed an increasing incidence with age. There was
      no significant seasonal variation or rural/urban difference in incidence.
      Analysis of geocoded addresses did not identify areas of high incidence. The
      variable duration of symptoms prior to diagnosis limits the search for possible
      environmental trigger factors. North Canterbury was an endemic goitre area prior
      to the introduction of iodized salt 50 years ago, and the incidence of toxic
      nodular goitre is likely to fall in future.

PMID- 2225483
TI  - Diurnal salivary cortisol patterns during pregnancy and after delivery:
      relationship to plasma corticotrophin-releasing-hormone.
AB  - The circadian rhythm of salivary cortisol was studied in 10 healthy women every 4
      weeks throughout pregnancy. In addition, in 12 women the diurnal patterns of
      salivary cortisol, serum cortisol, plasma ACTH, plasma CRH and serum progesterone
      were analysed in late third trimester pregnancy and again 3-5 days after
      delivery. Salivary cortisol profiles exhibited a clear circadian rhythm during
      pregnancy with an increase in mean salivary cortisol from the 25th to 28th week
      onwards reaching concentrations in late pregnancy more than twice as high as in
      non-pregnant controls, rapidly returning to normal concentrations after delivery.
      The coefficient of variation of salivary cortisol profiles decreased in third
      trimester pregnancy due to a parallel upward shift of cortisol concentrations
      (40.2 +/- 3.4% vs 77.6 +/- 6.6% after delivery, P less than 0.01). A diurnal
      pattern was also found for plasma ACTH and serum cortisol before and after
      delivery with lower concentrations post-partum (P less than 0.01). In late
      pregnancy, progesterone concentrations were significantly higher in the evening
      (930 +/- 85 nmol/l vs 813 +/- 74 nmol/l at 0900 h, P less than 0.01) but showed
      no diurnal variation post-partum. Plasma CRH was significantly elevated in late
      third trimester pregnancy (1.22 +/- 0.23 micrograms/l at 0900 h) but showed no
      diurnal change (1.30 +/- 0.28 micrograms/l at 1900 h). Moreover, no correlation
      between the free cortisol increase in late pregnancy and plasma CRH was noted
      despite a wide range of CRH levels (0.13-3.60 micrograms/l). In contrast, a
      significant correlation was observed between the serum progesterone increase and
      the salivary cortisol increase in late pregnancy (r = 0.70, P less than 0.05).
      These findings demonstrate that placental CRH is not the only regulator of
      maternal ACTH and cortisol release. Instead, our study suggests that placental
      CRH has little influence on baseline maternal adrenocortical function in
      pregnancy. The elevated salivary cortisol levels in pregnancy may be explained by
      glucocorticoid resistance owing to the antiglucocorticoid action of high
      progesterone concentrations.

PMID- 2225484
TI  - Effect of enhancement of endogenous cholinergic tone with pyridostigmine on
      growth hormone (GH) responses to GH-releasing hormone in patients with Cushing's
      syndrome.
AB  - Growth hormone (GH) secretion in patients with Cushing's syndrome is diminished
      to all the stimuli tested so far but the precise mechanisms through which this
      occurs are unknown. In order to investigate whether increased somatostatinergic
      tone might be responsible for this alteration, we studied the effect of
      pyridostigmine (120 mg p.o. at -60 min), which activates cholinergic synapses and
      thus suppresses hypothalamic somatostatin release on GH responses to GHRH (100
      micrograms, i.v. at 0 min), in six patients with Cushing's syndrome. We found
      that while pyridostigmine markedly potentiated GH responses to GHRH, in all the
      normal subjects tested (n = 12), neither GHRH alone nor GHRH plus pyridostigmine
      elicited any increase in GH secretion in any of the patients with Cushing's
      syndrome. This suggests that chronic glucocorticoid excess induces marked
      alterations in the hypothalamic control of GH secretion.

PMID- 2225485
TI  - The influence of octreotide treatment on pulsatile growth hormone release in
      acromegaly.
AB  - The pulsatile release of GH was investigated in eight active acromegalic patients
      before and during a subcutaneous infusion of 300 micrograms octreotide/24 h for 4
      weeks. The number of GH pulses increased from a basal value of 14.4/24h to
      16.3/24h during octreotide therapy. At the same time the mean GH concentration,
      valley concentration, peak height and amplitude decreased significantly. The
      inhibitory effect of octreotide on pulse characteristics did not depend on the
      time of day. IGF-I levels also decreased significantly; in five patients normal
      levels were reached. IGF-I levels correlated significantly with the mean GH level
      (r = 0.714, P less than 0.001), mean valley concentration (r = 0.697, P less than
      0.001) and, to a lesser extent, area under the curve (r = 0.436, P = 0.033), but
      not the number of pulses. Plasma octreotide levels did not correlate with pulse
      parameters. In all but one patient a circadian rhythm was present during both the
      basal study and octreotide therapy. Compared with surgically treated
      acromegalics, the number of GH pulses was higher in untreated and octreotide
      treated patients. This study demonstrates the pulsatile release of GH in active
      acromegaly both before and during octreotide therapy. This result suggests that
      endogenous GHRH is important for the generation of GH pulses in this disease.

PMID- 2225486
TI  - A role for epidermal growth factor in the follicular paracrine system?

PMID- 2225487
TI  - Familial benign hypercalcaemia: hypercalciuria and hypocalciuria in affected
      members of a small kindred.
AB  - Familial benign hypercalcaemia has also been termed familial hypocalciuric
      hypercalcaemia because a major feature of this condition has been a relative
      hypocalciuria in relation to the hypercalcaemia, such that the calcium to
      creatinine clearance ratio is less than 0.016. The following is a report of a
      small kindred of patients with familial benign hypercalcaemia in which two of the
      affected members have frank hypercalciuria.

PMID- 2225488
TI  - Factors influencing urinary 6-sulphatoxymelatonin, a major melatonin metabolite,
      in normal human subjects.
AB  - 6-Sulphatoxymelatonin (aMT6s) has been measured, by a direct radioimmunoassay, in
      urine from 130 normal volunteers aged 2-80 years. Its relationship to a number of
      physiological parameters has been assessed. Total urinary excretion of aMT6s did
      not vary in a group of 40 children aged 2-20 years (24 boys and 16 girls) except
      when expressed as a function of body weight. In this case, total aMT6s excretion
      over 24 h decreased as a function of age. In 90 adult volunteers (44 men and 46
      women) aged 20-80 years, there was an age-related decline in total 24 h aMT6s
      excretion with significantly lower values in elderly subjects. In this same adult
      group no relationships were found between total aMT6s excretion and body weight
      or height. No sex differences were found either in the 2-20 years or the 20-80
      years groups. Pineal calcification was assessed by lateral skull X-ray in 26
      adult volunteers (17 men and 9 women) aged 20-50 years. No significant
      differences in aMT6s excretion were found as a function of pineal calcification.
      In 16 of these subjects plasma melatonin and aMT6s also showed no relationship to
      pineal calcification. These studies confirm the usefulness of aMT6s as an index
      of melatonin secretion in normal volunteers.

PMID- 2225489
TI  - Long-term follow-up of low-dose external pituitary irradiation for Cushing's
      disease.
AB  - Twenty-four patients (three male) with Cushing's disease, aged between 11 and 67
      years, were treated with low-dose external pituitary irradiation (20 Gy in eight
      fractions over 10-12 days) and followed for between 13 and 171 months (median 93
      months). Eleven patients (46%) went into remission 4-36 months after irradiation,
      but five subsequently relapsed. Two of these received no further active
      treatment, one underwent successful pituitary surgery, one underwent a second
      course of low-dose external irradiation (as yet unsuccessful) and one has been
      treated with metyrapone for a total of 75 months. One of the 13 patients who did
      not respond received a further course of low-dose pituitary irradiation with
      prompt remission and two have received metyrapone for 41 months and 15 years
      without ill effect. One patient died from cerebrovascular disease. The remaining
      nine patients underwent bilateral adrenalectomy (one after unsuccessful pituitary
      surgery) with rapid resolution of hypercortisolism. Five of these patients have
      developed hyperpigmentation and elevated ACTH levels (range 505-1150 ng/l). A
      pituitary microadenoma has been demonstrated on CT scan in three and successfully
      removed by microadenomectomy. In the present series, the low incidence of
      radiation-induced hypopituitarism and absence of other complications attributable
      to radiotherapy suggest that low-dose pituitary irradiation may be a useful
      treatment option in selected patients. However, long-term follow-up has
      demonstrated a high relapse rate and failure to prevent Nelson's syndrome in
      adrenalectomized patients, indicating that it should not be used as primary
      treatment in preference to selective adenomectomy.

PMID- 2225490
TI  - Insulin secretion, insulin sensitivity and glucose-mediated glucose disposal in
      thyrotoxicosis: a minimal model analysis.
AB  - In order to evaluate simultaneously in thyrotoxic subjects the relative
      contributions of insulin secretion, insulin-sensitivity (SI) and glucose-mediated
      (SG) glucose disposal to overall glucose tolerance, seven non-obese patients with
      thyrotoxicosis were studied by the minimal model analysis of the frequently
      sampled intravenous glucose tolerance test, before and greater than 1 month after
      being rendered euthyroid, and compared with eight healthy control subjects. Basal
      glucose, C-peptide and glucagon levels were similar in all groups but, in the
      toxic and euthyroid states, basal insulin levels were significantly elevated
      compared to the control group (11.2 +/- 2.0 and 7.9 +/- 1.1 vs 5.1 +/- 0.6
      microU/ml, mean +/- SE, P less than 0.02). FFA levels were raised in the
      thyrotoxic subjects prior to treatment (0.95 +/- 0.11 vs 0.68 +/- 0.08 and 0.54
      +/- 0.08 mmol/l, P less than 0.02). Glucose tolerance (Kg) was reduced in the
      thyrotoxic subjects compared to the euthyroid state (1.16 +/- 0.12 vs 1.44 +/-
      0.13 per min, P less than 0.025) and control group (1.44 +/- 1.0 per min, 0.05
      less than P less than 0.1). First phase (phi 1) and second phase (phi 2) insulin
      release were both significantly elevated in the thyrotoxic and euthyroid states
      compared to the control group (phi 1 7.10 +/- 1.88 and 5.29 +/- 1.03 vs 1.72 +/-
      0.17 microU/mg/min X 10(-2), P less than 0.01; phi 2 18.64 +/- 3.14 and 16.74 +/-
      4.48 vs 9.23 +/- 0.74 microU/mg/min X 10(-2) respectively, P less than 0.02). SG
      was similar in all groups but SI was significantly reduced in the thyrotoxic
      subjects compared to the control group (2.24 +/- 0.62 vs 5.92 +/-
      1.50/min/microU/ml X 10(4), P less than 0.02) and rose post-treatment in the
      euthyroid subjects (4.23 +/- 1.75/min/microU/ml X 10(4)). In the thyrotoxic
      subjects before and after treatment, log SI correlated negatively with basal FFA
      levels (r = -0.57, P less than 0.05) and with phi 2 (r = -0.58, P less than
      0.05). The fractional clearance rate of insulin was unaltered by the thyrotoxic
      state. It is concluded that in thyrotoxicosis the impairment of Kg is due to
      reduced insulin sensitivity in the presence of enhanced insulin secretion, but
      glucose-mediated glucose disposal is unaltered by the toxic state.

PMID- 2225491
TI  - The influence of growth hormone on sleep in adults with growth hormone
      deficiency.
AB  - Eight patients with isolated growth hormone deficiency (IGHD), 20-30 years old
      were studied with polysomnography before and after 6 months of treatment with
      growth hormone (GH). During GH treatment total sleep time decreased and REM sleep
      time increased significantly. Delta sleep time (stage 3 + 4) did not change
      significantly. All patients reported improved well-being and none wished to
      discontinue the treatment with growth hormone. These findings suggest that GH has
      an effect on sleep. The effect of increased REM sleep in humans is incompletely
      understood, but sleep recordings may be one way of directly monitoring the effect
      of GH on the central nervous system.

PMID- 2225492
TI  - The prevalence of polycystic ovaries in patients with congenital adrenal
      hyperplasia and their close relatives.
AB  - Seventy-seven female patients (36 adults and 41 children aged under 16 years)
      with congenital adrenal hyperplasia (CAH) were assessed using pelvic ultrasound,
      as well as with standard endocrine tests and HLA typing. Forty-six close female
      relatives were also tested for ovarian morphology using ultrasound after
      assessment of their heterozygous state using HLA typing. The association of CAH
      with ultrasonically detected polycystic ovaries (PCO) was confirmed in 30/36
      (83%) adult patients, 4/10 (40%) postpubertal girls and 1/31 (3%) pre and
      peripubertal girls: in all, 35/46 (76%) postmenarcheal patients. Six out of nine
      (67%) pre-menopausal mothers of patients with PCO, and 8/10 (80%) sisters of
      patients with PCO also had PCO. The proportions of both CAH patients and
      heterozygote subjects with PCO were significantly greater than that found in a
      normal population (P less than 0.0001). The finding, however, of two homozygous
      non-CAH-affected adult sisters with PCO and, conversely, of 10 heterozygous adult
      relatives and of 12 postmenarcheal CAH patients with normal ovaries, indicates
      that the ovarian morphological change may be independent of the adrenal lesion.

PMID- 2225493
TI  - The management of classical congenital adrenal hyperplasia due to 21-hydroxylase
      deficiency.

PMID- 2225495
TI  - Informed consent in head and neck surgery.
AB  - Informed consent is the fastest growing problem in the medical negligence debate.
      It was highlighted recently in the United Kingdom in the Sidaway case. Informed
      consent comprises the advice you would give the patient, the consequences of not
      taking your advice, the specific risks of the surgery or treatment you have in
      mind, and the risks of surgery in general. In an attempt to identify what the
      present practice in otolaryngology was, a postal survey was carried out of the
      members of the Scottish and North of England Otolaryngological Societies.

PMID- 2225494
TI  - Neurodegeneration and the nose.

PMID- 2225496
TI  - Repair of salivary fistulae after laryngectomy.
AB  - A new surgical technique is described for the repair of salivary fistulae. It has
      been used in three patients. The fistulae occurred after laryngectomy and had
      been unsuccessfully treated with local and regional flaps. The principle of the
      technique is to use a bipedicled jejunal patch as a free microvascular transfer.
      One patch is used for reconstruction of the pharynx and after excising the mucosa
      the skin defect is closed with the other patch. The mucosa is excised to expose
      the muscle and to create a recipient site for a split skin graft.

PMID- 2225497
TI  - The influence of calcium alginate haemostatic swabs upon operative blood loss in
      adenotonsillectomy.
AB  - Although adenotonsillectomy is regarded as a minor procedure, it has been shown
      that 18% of patients may experience an operative blood loss of 10-20% of the
      total blood volume. The aim of this study was to determine whether calcium
      alginate haemostatic swabs reduce operative blood loss in adenotonsillectomy.
      Seventy-two patients (ages 2-12 years) entered a prospective trial in which the
      operation was performed either with normal gauze swabs or calcium alginate swabs.
      Thirty-six children were randomized to each group. The mean blood loss was found
      to be 34.9 ml (2.07% of total blood volume) and 47.8 ml (2.97% of total blood
      volume) respectively. Although there was no significant reduction in operative
      blood loss using calcium alginate, in both groups the blood loss was much smaller
      than that stated by the majority of previous workers.

PMID- 2225498
TI  - Obstructive sleep apnoea in children undergoing routine tonsillectomy and
      adenoidectomy.
AB  - Sleep screening was used to discover the incidence of sleep apnoea in 50 children
      undergoing routine adenotonsillectomy for recurrent upper respiratory tract
      infections, randomly selected from the waiting list. Preoperative assessment
      included a detailed parental history, physical examination, and lateral
      cephalometry, in order to identify factors that might alert the clinician to a
      diagnosis of obstructive sleep apnoea. There were 2 equal groups of snorers and
      non-snorers (grade 0); 1 patient was found to have the sleep apnoea syndrome
      (IV), 9 patients had obstructive snoring with apnoeic episodes (III), 3 patients
      had snoring with a disrupted sleep pattern (II), and 12 patients snored with no
      disruption of sleep (I). In identifying patients with apnoea, a history of
      snoring was unhelpful, whereas one of breathing irregularities was found to be
      highly specific. Nasal obstruction correlated poorly; however, there was a
      significant relationship between tonsillar position and size and sleep grade (Chi
      squared P less than 0.01). Stepwise regression analysis showed a large
      contribution to the grading was made by the size of the oropharyngeal airway
      measured by lateral cephalometry. The children in grade II-IV were re-studied 3
      months post-operatively and all reverted to grades 0 or I.

PMID- 2225499
TI  - Ear drops and grommets.
AB  - The relative ease with which different ear drops pass through grommets of
      different designs has been investigated using a laboratory model. The viscosities
      of the various ear drop preparations tested have also been determined. There is a
      considerable variation in the volume of ear drops required to penetrate
      ventilation tubes. Their ease of passage is determined by the size of the tube
      and is probably also related to the ease with which a preparation wets the
      surface of the grommet. There is no relationship between ease of penetration and
      viscosity. The penetration of ear drops through grommets during episodes of aural
      discharge was studied in vivo. Penetration into the middle ear was observed only
      when the drops were introduced using the displacement technique. It was more
      readily achieved when the grommet lumen was free of discharge.

PMID- 2225500
TI  - Hearing aids for high-frequency hearing loss.
AB  - This cross-over study compares the relative benefits of a standard NHS contracted
      hearing aid with a high-frequency emphasis commercial aid in subjects with high
      frequency hearing loss. Disability questionnaires and free-field speech-in-noise
      (FAAF II) tests were used to assess subjects unaided and after 6 weeks of wearing
      each aid. Total FAAF II test scores showed no significant difference with either
      aid, but analysis of frequency-specific subscores demonstrated less use of low
      frequency information when using the high-frequency emphasis aid. Overall
      questionnaire responses relating to conversation showed more benefit with the
      high-frequency emphasis aid. Subjects generally preferred this aid, possibly due
      to less low-tone gain than the standard NHS aid.

PMID- 2225501
TI  - Peak flow nasal patency indices and self-assessment in septoplasty.
AB  - The present study evaluates the results of septoplasty monitored by the objective
      peak flow nasal patency indices and the subjective patient self-assessment scores
      of nasal obstruction. Mini-Wright peak flow meters were used. The peak flow nasal
      patency index was defined as the ratio between nasal and oral peak flow rates.
      Uni and bi-lateral, as well as ex and in-spiratory, indices were calculated. Both
      peak ex and in-spiratory flow nasal patency indices were significantly increased
      1 and 6 months post-operatively, indicating improved nasal patency. The most
      marked post-operative increase of the nasal patency indices was seen for the
      preoperatively worst airway and the total airway. A weak significant positive
      correlation was found between the peak flow nasal patency indices and the patient
      mean self-assessment scores of the uni and bi-lateral nasal obstruction. The
      change of the peak flow nasal patency indices measured 6 months post-operatively
      correlated well with the patient overall assessment of the operative changes of
      the total nasal patency. The method was found quick and easy to handle in
      monitoring the effect of functional septoplasty and is recommended as an
      alternative to rhinomanometry.

PMID- 2225502
TI  - Advice to candidates sitting the Final Fellowship Examination.
AB  - This paper is intended to provide guidance to candidates sitting the Final
      Fellowship Examination in Otolaryngology of the Royal College of Surgeons of
      Edinburgh. Although some of the advice given is specific to the Fellowship in
      Otolaryngology of that College, much of it is of relevance to any examination.

PMID- 2225503
TI  - Analgesia and removal of nasal packing.
AB  - We present a prospective controlled trial, comparing methods of analgesia for the
      relief of discomfort on removing nasal packing, including a general discussion on
      the considerations for, and methods of, nasal tamponade. On the basis that nasal
      packing is likely to continue to be used frequently, nitrous oxide (as Entonox)
      is advocated as a safe and relatively cheap means of pain relief with a
      statistically significant advantage over papaveretum.

PMID- 2225504
TI  - A randomized comparison of manipulation of the fractured nose under local and
      general anaesthesia.
AB  - Reduction of simple nasal fractures may be performed under local or general
      anaesthesia: the latter is by far the most popular method in Britain, though why
      is hard to define. We have attempted to compare the 2 approaches by means of a
      randomized, prospective trial. Fifty consecutive, adult patients with
      radiologically proved fractures of the nasal bones were randomized to a local or
      general anaesthesia group and underwent manipulation with Asch's and Walsham's
      forceps between 7 and 15 days post-injury. Analysis of results at 4 h and 8 weeks
      post-operatively showed no significant benefit conferred by fracture reduction
      under general anaesthesia as opposed to local anaesthesia with respect to post
      operative airway patency or cosmesis. It is suggested that significant benefits
      can be obtained in terms of patient convenience and cost effectiveness if nasal
      fractures are reduced under local anaesthesia as an outpatient procedure.

PMID- 2225505
TI  - Trimming of the inferior turbinates: a prospective long-term study.
AB  - The aim of this study was to determine whether the initial benefits of radical
      trimming and anterior trimming of the inferior turbinates on nasal airflow
      persisted in the long term. Radical trimming significantly reduced nasal
      resistance at 2 months following operation (n = 12) (P less than 0.005). There
      was no significant change in nasal resistance over the next 20 months. Symptom
      scores for nasal obstruction also showed a significant reduction (n = 16) (P less
      than 0.005), at 2 months, and did not change significantly over the next 20
      months. Radical trimming of the inferior turbinates is a highly effective
      operation in patients with hypertrophy of the inferior turbinates with few
      initial complications. However, further analysis of the data revealed that up to
      20% of patients lose the initial subjective benefit of relief of nasal
      obstruction within 2 years of follow-up. Late onset crusting occurs in some
      patients though this is not directly attributable to an increase in nasal
      airflow. This study also concludes that anterior trimming of the inferior
      turbinates cannot be recommended as a form of treatment.

PMID- 2225506
TI  - Sensorineural hearing loss in bullous myringitis. A prospective study of eighteen
      patients.
AB  - Eighteen patients were seen over a period of 3 years. Twenty of their ears were
      diagnosed as having bullous myringitis. Pure tone audiograms and stapedial
      reflexes were performed within 48 h of referral. Six ears demonstrated
      sensorineural hearing loss, 7 ears mixed loss and 4 conductive loss. Recovery of
      sensorineural hearing loss complete in 8 out of 13 ears. Stapedial reflexes were
      elicited in 5 patients and all showed recruitment. The findings of this study
      confirms the fact that sensorineural hearing loss is more common in bullous
      myringitis than previously thought and that it is temporary in many cases. The
      stapedial reflex results suggest that the site of the lesion is in the cochlea.

PMID- 2225507
TI  - Vitreous carbon: a new material for middle ear ventilation tubes.
AB  - Synthetic allotropic carbons have been used for nearly 20 years as biomedical
      implants. Vitreous carbons in particular appear to possess very favourable
      biocompatibility characteristics. The middle ear compatibility of Sigradur has
      been tested in the mastoid bulla of gerbils. The period of implantation varied
      from 1 to 13 months. Light and electron-microscopic examination revealed good
      middle ear tolerance of the material, especially when the surface had not been
      modelled. Our animal experiments suggest that this material could be suitable for
      ventilation tubes, but was less ideal for ossicular replacement prostheses,
      particularly because of the specific surface properties. Consequently, we have
      used such carbon ventilation tubes in 38 patients. The results obtained using
      this material were excellent thanks to the favourable biocompatibility,
      advantageous surface properties, and low weight.

PMID- 2225509
TI  - The Netherlands ENT Society. 168th meeting. Maastricht, 4-5 November 1988.
      Proceedings.

PMID- 2225508
TI  - Chest infection following head and neck surgery: a pilot study.
AB  - This paper reports the results of a pilot study which examined factors associated
      with chest infection following head and neck surgery. The overall rate of chest
      infection was 11%, but was 20% in those patients having a tracheotomy. No
      infection developed in patients with an intact airway. Other factors which
      emerged as possibly important were the duration of surgery and heavy regular
      alcohol intake. We recommend that prophylactic antibiotics be continued for at
      least 48 h in patients requiring a tracheotomy as part of their head and neck
      surgery. This is against the trend of shorter antibiotic regimens recommended for
      prevention of wound infections.

PMID- 2225510
TI  - A model for instruction in myringotomy and grommet insertion.

PMID- 2225511
TI  - Wegener's granulomatosis: otorhinolaryngological manifestations.

PMID- 2225512
TI  - Long-term intragastric pH measurement in man. Selected papers from an
      international workshop. London, September 14, 1987. Proceedings.

PMID- 2225513
TI  - Royal Free Hospital protocol for 24-hour intragastric acidity and plasma gastrin
      concentration.
AB  - The Royal Free Hospital protocol for simultaneous measurement of 24-hour
      intragastric acidity and plasma gastrin concentration is described in detail. The
      methods of analysing such data are discussed, with recommendations for a standard
      four-way analysis: median hourly 24-hour intragastric acidity or pH, or plasma
      gastrin concentration; integrated 24-hour intragastric acidity, or plasma gastrin
      concentration; analysis of integrated values according to meal-related intervals;
      and quantification of the percentage of time in a 24-hour period that
      intragastric pH is greater than 3.

PMID- 2225514
TI  - Electrochemical aspects of pH electrodes.
AB  - When a pH electrode is applied intragastrically for long-term pH metry, problems
      may occur which are related to the specific conditions of gastric juice and to
      the possible difference between the temperature of buffer solutions and the body
      temperature. The fact that pH electrodes measure the activity of the hydrogen ion
      instead of its concentration may, in concentrated solutions (i.e. pH less than
      2), lead to an error that is even compounded if other ions are present in high
      concentrations. This error normally does not influence comparisons between
      measurements obtained under the same conditions. It is, however, important to
      check which correction procedures are provided for the particular devices being
      used when comparing results obtained by different research groups. Calibration of
      the electrode at a temperature differing from body temperature may result in an
      important error. Complete correction for this error may be achieved for glass
      electrodes by a modified version of the Nernst equation; for monocrystalline
      antimony electrodes an empirically derived formula is available allowing for
      partial correction. In general, all types of electrodes should be calibrated
      using two different buffer solutions (one with a pH value between 6 and 8 and
      another with a pH of 2 or less) and the double-point interpolation method.

PMID- 2225515
TI  - Comparison of gastric aspiration and continuous pH monitoring with antimony
      electrode: methodological remarks.
AB  - In an attempt to eliminate the noise affecting continuous 24-hour intragastric pH
      metry curves in order to obtain a more appropriate identification of hourly
      intraluminal pH values to which the corresponding aspirate ones were compared,
      the raw data of one of our previous experiments were treated using a smoothing
      technique (removal of noise peaks was followed by moving averages on three
      adjacent points, 1 min apart, which were applied both singly and combined with
      Fourier's filtration employing the first 32 harmonics) A gradual improvement of
      all parameters of regression analysis from original data to those achieved with
      the two above-mentioned methods was found. In particular, the regression
      coefficient r increased from 0.83 to 0.88 with the singly moving averages
      technique and even to 0.95 when Fourier's filtration was combined. Both
      techniques provided also similar improvement as far as slope and elevation values
      were concerned: the slope was almost equal to 1 and the elevation was very low,
      so that paired data might be assumed to be proportional. It can be concluded that
      hourly pH values of continuous intraluminal monitoring and those of simultaneous
      gastric aspiration appear better correlated if the elimination of noise
      disturbing the in vivo pH metry curves is obtained. With regard to this, the use
      of a combined smoothing-filtering technique, such as moving averages plus
      Fourier's filtration after removal of the noise peaks, seems a very advantageous
      modality.

PMID- 2225516
TI  - Gastric aspiration technique for pH recording: a critical evaluation of this
      method.
AB  - The most often used methods for the measurement of intragastric acidity are
      repeated mostly hourly aspirations of gastric contents or continuous pH measuring
      with an electrode. Intragastric pH, volume of aspirated gastric juice and total
      acid secretion have been tested over relatively short periods of time (2-12 h)
      and through an entire 24-hour period. Nearly every clinical antiulcer drug which
      neutralizes acidity or inhibits acid secretion has been investigated with this
      method. pH monitoring with the gastric aspiration procedure is a reliable and
      reproducible method. There is a remarkable global agreement in the results. While
      pH electrodes provide an alternative means of measuring pH, they have the
      disadvantage of not allowing measurement of volume and/or acid secretion.

PMID- 2225517
TI  - Do hourly averaged pH readings correlate with those from point readings of
      aspiration? Comparison of two different electrode positions with simultaneous
      aspiration.
AB  - Hourly averaged data from continuous intraluminal pH recording were compared with
      the point aspiration in five 24-hour studies performed on healthy volunteers. Two
      different electrode positions were compared simultaneously with aspiration. The
      correlation was performed using the median from the whole hour's recording of the
      electrode against the aspiration point. There was a significant correlation
      between both electrodes and aspiration (p less than 0.001), although both
      electrodes read consistently lower than aspiration: electrode A (gastric antrum),
      median pH = 1.4; electrode B (gastric body), pH = 1.9; aspiration, pH = 2.3.
      These findings show that data reported in clinical trials using different
      recording techniques are not directly comparable and must be interpreted
      appropriately. The position of the electrode may also be important.

PMID- 2225518
TI  - Simultaneous comparison of 24-hour intragastric pH recording using glass and
      antimony electrodes in man.
AB  - Based upon the results of in vitro studies, antimony electrodes are generally
      considered to have inferior electrochemical properties when compared with glass
      electrodes. Since a direct comparison in man is lacking, a 24-hour ambulatory
      intragastric pH recording was performed in 10 healthy male subjects
      simultaneously using glass and antimony electrodes. In the first set of
      experiments (when both electrodes were calibrated in buffers of pH 7 and 1 at 37
      degrees C: beaker calibration) significantly lower pH recordings during fasting
      periods were registered with the antimony electrode. This difference could be
      corrected by a modified calibration, using the external skin reference electrode
      of the antimony electrode (finger calibration). In the second series of
      experiments (performed after finger calibration) comparable recordings of 24-hour
      intragastric pH could be obtained with antimony and glass electrodes in the same
      subjects. The reason for statistically insignificant differences of pH recordings
      with both electrodes in the early hours of the morning remains uncertain. The
      drift of glass and antimony electrodes did not differ. It is concluded from these
      data that, after adequate calibration, inferior electrochemical properties of
      antimony electrodes do not influence intragastric pH recordings in man.

PMID- 2225519
TI  - Standardization of electrode positioning and composition of meals for long-term
      intragastric pH metry in man.
AB  - In these prospective studies the influence of two different intragastric
      positions of electrodes and of four different compositions of standardized meals
      on 24-hour ambulatory pH recording were compared intraindividually in healthy
      male subjects. Simultaneous pH monitoring in 12 subjects demonstrated a more
      pronounced postprandial pH elevation in the fundus body compared to the antral
      area. The intraindividual comparison of an identical diet given on two different
      days to 10 subjects revealed nearly identical pH profiles. Variations of
      carbohydrate, protein and fat content of isocaloric meals given in a randomized
      order did not significantly alter 24-hour intragastric pH profiles. It is
      concluded from these data that positioning of the pH electrode in the fundus body
      area is superior to an antral position. 24-hour ambulatory intragastric pH
      monitoring in man is well reproducible. A strict standardization of the
      composition of meals is mandatory only for scientific investigations.

PMID- 2225520
TI  - Intragastric pH pattern analysis in patients with duodenogastric reflux.
AB  - The intention of the present study was to apply 24-hour intragastric pH
      monitoring as a diagnostic tool for the detection of pathologic duodenogastric
      reflux. Therefore, an evaluation system was developed which is able to recognize
      and quantify specific intraluminal gastric pH patterns regarding their
      specificity for the disease. pH parameters, stored during 24 h and processed,
      according to the evaluation system, were obtained for a healthy control
      population (n = 30) and for patients with pathologic duodenogastric reflux (n =
      11). These data were subjected to computerized discriminant analysis to identify
      pH changes with a high probability of resulting from pathologic duodenogastric
      reflux. The computer analysis identified 16 discriminating pH parameters to
      separate a physiologic pH pattern from a 24-hour intragastric pH pattern with a
      high probability of being associated with pathologic duodenogastric reflux.

PMID- 2225521
TI  - Simultaneous measurement and recording of gastric potential difference and
      intragastric pH in man.
AB  - Gastric potential difference (GPD) is used increasingly as an index of mucosal
      integrity. The technique for GPD measurement currently employed is however
      laborious due to the preparation and check of KCl-agarose bridges prior to each
      experiment. In addition, calculations - usually handmade - are time-consuming and
      inaccurate. Therefore, a new apparatus allowing continuous recording of basal and
      drug-induced changes in GPD values was developed. A commercially available 24
      hour pH monitor (Proxima Light, Synectics Medical) was modified in order to allow
      GPD measurement and recording with subsequent elaboration of data. Furthermore,
      simultaneous measurement of GPD and intragastric pH through the use of a single
      stomach probe was made possible. The new method was checked towards the classical
      PD measuring system employing KCl-agarose bridges. The readings obtained with
      both systems, either in basal conditions or after aspirin, correlated in a highly
      significant way. Readings proved to be quite stable with a variation, for 150
      consecutive values, of less than 2 mV. With this system the effect of pH
      modifications, obtained through H2 receptor stimulation and inhibition, on the
      behaviour of GPD values was investigated in healthy volunteers. Analysis of
      paired data obtained from these experiments showed an inverse relationship
      between these two parameters. This suggests that GPD and pH should be measured
      together, especially during experiments aiming to study drug effects on gastric
      mucosa. Although the apparatus described was developed for PD measurement and
      recording in the stomach, it can be used easily for PD measurement across the
      mucosa of the entire digestive tract, for example in the esophagus, colon or
      rectum.

PMID- 2225522
TI  - Relationship between fluctuations of pH and pressure in the human stomach and
      duodenum.
AB  - The normal patterns of pressure activity in the antrum, pylorus and duodenum and
      associated pH changes were monitored in 9 healthy volunteers under fasted
      conditions and after ingestion of 300 ml of chocolate milk. The manometric
      assembly incorporated three side holes in the antrum, four side holes in the
      duodenum, a sleeve sensor positioned across the pylorus, and pH electrodes
      situated in the terminal antrum and proximal duodenum. The most common motor
      pattern recorded under fasting conditions consisted of regular co-ordinated
      contractions, most of which involved the antrum and duodenum, showed evidence of
      propagation and was associated with transient decreases in duodenal pH and
      transient increases in antral pH. Ingestion of milk changes the motor pattern to
      one that was composed of pressure waves which were confined to the pylorus with
      few or no pressure waves in the terminal antrum or proximal duodenum. Isolated
      pyloric pressure waves were gradually replaced by propagated antropyloroduodenal
      contractions which were associated with transient decreases in duodenal pH.
      Isolated pyloric pressure waves were not associated with episodes of duodenal
      acidification under fed conditions.

PMID- 2225523
TI  - Graphical display and statistical evaluation of data gained by long-term
      ambulatory intragastric pH monitoring.
AB  - The graphical display of data gained by long-term ambulatory intragastric pH
      monitoring requires different methods to present (1) the circadian time course of
      each individual, (2) data from all individuals belonging to the same group, and
      (3) data from two or more groups in a summary plot. Data reduction is normally
      required in all three cases; for this purpose, it is advisable to use median
      values from consecutive time periods, e.g. of 10-20 min each. All data from a
      total group of comparable individuals may be displayed using a pseudo-3D-graph
      allowing for easy recognition of interindividual variability. Summary curves from
      all data of one group may be gained by calculating medians from time-equivalent
      pH values and plotted together in one graph. The study design should take into
      consideration that intraindividual reproducibility of intragastric pH metry is
      excellent, while large variations may occur between individuals. Therefore,
      repeated measurements in the same individual under the different conditions to be
      tested are highly recommended. If two measurements are performed in each
      individual, the data are statistically evaluated using Wilcoxon paired rank test;
      Friedman rank test and subsequent multiple comparison according to Wilcoxon
      Wilcox are proposed in the case of more than two groups. Alternatively, multiple
      single tests may be used; this procedure, however, requires appropriate
      correction of the alpha-error which is best done using the exact versions of the
      test.

PMID- 2225524
TI  - Analysis and statistical evaluation of continuous pH recordings.

PMID- 2225525
TI  - Friedreich's ataxia: a descriptive epidemiological study in an Italian
      population.
AB  - All the cases of Friedreich's ataxia (FA) diagnosed between 1945 through 1984
      among residents of a defined area of northwestern Italy were ascertained (N =
      59). Cases were diagnosed according to the criteria of the "Quebec Cooperative
      Study on Friedreich's Ataxia (QCSFA)" with minor modifications. We identified 39
      families with 47 probands and 12 secondary cases. Therefore ascertainment
      probability was 80%. Male to female ratio was 1:1. Pedigrees were compatible with
      autosomal recessive inheritance. Segregation ratio was 0.28 with both Weinberg's
      method and the "singles" method (under incomplete ascertainment). Point
      prevalence ratio was 1.2/100,000 population. Birth incidence rate was 1/36,000
      live births. Gene frequency was estimated to be 1/191. The ratio of first-cousin
      marriages observed among parents of FA patients (3%) was lower than expected from
      Dahlberg's formula (8%). This finding is not compatible with the hypothesis of
      genetic heterogeneity for FA.

PMID- 2225526
TI  - Familial caudal dysgenesis: evidence for a major dominant gene.
AB  - Four sibs with varying degrees of caudal dysgenesis are described. Case 1 showed
      aberrant umbilical cord vasculature with a single umbilical artery near the
      placental insertion. Cases 2 and 3 showed full sirenomelia, one with a complex
      congenital heart defect. Case 4 had an imperforate anus and an excessively long
      umbilical cord. The father's half-sib had an imperforate anus, rectovaginal
      fistula and genitourinary anomalies. A dominant gene with reduced penetrance is
      likely.

PMID- 2225527
TI  - Phenotypic variability in Meckel-Gruber syndrome.
AB  - Five Bedouin sibs are described with Meckel-Gruber syndrome (MGS), an autosomal
      recessive disorder with multiple abnormalities. Each affected sib manifested only
      two of the three cardinal signs of MGS: occipital encephalocele and polycystic
      kidneys, lacking polydactyly. The phenotypic variability of the MGS pleiotropic
      gene is briefly discussed.

PMID- 2225528
TI  - Congenital cardiovascular malformations (CCVM) and structural chromosome
      abnormalities: a report of 9 cases and literature review.
AB  - Nine cases of congenital cardiovascular malformations (CCVM) with associated
      unbalanced structural chromosomal abnormalities were ascertained in a population
      based study of heart defects, constituting 0.4% of the 2,103 cases of CCVM in the
      Baltimore-Washington Infant Study (BWIS). This represents a four-fold increase
      over the general population rate. In an effort to determine possible
      phenotype/karyotype correlations, the literature was searched for cases with
      similar karyotypic abnormalities. This comparison of 223 literature cases of
      karyotypic abnormalities with nine similar cases ascertained by heart
      malformation has provided the opportunity to review cardiac defects reported in
      cases of structural abnormalities of chromosomes 1, 3, 7, 8, 9, 10, 11, 15, and
      18. The most common cardiac malformation present in the chromosomal cases was
      ventricular septal defect (VSD) (39%); similarly VSD is the most common CCVM
      among children with heart defects, although it is the primary defect in only 20%
      of the BWIS cases. Among all heart defects in the BWIS, atrial septal defect
      (ASD) represents 5.5% of all cases, but in cases of 8p duplication, ASD is
      present in 41%. In addition, 40% of cases of 9p duplication had an ASD.
      Similarly, 35% of cases of 11q duplication had an ASD. While the suggestion of
      specific karyotype/phenotype association is premature, information on additional
      cases might clarify the possibility that genetic determinants related to septum
      formation may reside on chromosome 8, 9, and/or 11. The variety of chromosomal
      abnormalities in cases with ventricular septal defect indicates one type of
      genetic heterogeneity that may be involved in this very common heart defect.

PMID- 2225529
TI  - An evaluation of 75 terminations of pregnancy based on abnormal laboratory
      findings at first trimester CVS.
AB  - Seventy-five selective terminations, based on abnormal laboratory findings at
      first-trimester CVS, were performed in 1581 consecutive pregnancies. In all cases
      a (semi-) direct method of cytogenetic analysis was used. The 75 abortions were
      analysed in number of ways. Confirmatory studies showed that three cases had to
      be considered as false-positive findings, and in one other case the results were
      inconclusive. Based on literature data, it was estimated that 41 of the 75
      pregnancies would have resulted in seriously handicapped children, surviving
      beyond the age of 1 year, if no termination of pregnancy had taken place.
      Negative side-effects of the procedure include: spontaneous abortion of
      chromosomally normal fetuses due to the CVS procedure itself and the need for a
      number of secondary amniocenteses (5.1%). The advantage of DNA diagnosis in X
      linked diseases is illustrated by comparing the CVS results with a previously
      published amniocentesis study.

PMID- 2225530
TI  - Activity of glucocerebrosidase in extracts of different cell types from type 1
      Gaucher disease patients.
AB  - Glucocerebrosidase activity in extracts of leukocytes, Epstein-Barr virus
      transformed lymphocytes and fibroblasts from Portuguese Type 1 Gaucher disease
      patients was studied. The residual glucocerebrosidase activity in all extracts
      from patients was less than 25% if measured in the presence of bile salt
      taurocholate. However, if measured in the absence of bile salt the residual
      enzyme activity in extracts from patients was cell type specific: it was severely
      reduced in the case of fibroblasts, mildly reduced in the case of lymphoblasts
      and not significantly reduced in the case of leukocytes. The glucocerebrosidase
      activity in extracts from all control cell types was stimulated by taurocholate.
      In the patients the enzyme activity in fibroblasts extracts was also stimulated
      but that in lymphoblasts and leukocytes was inhibited by the bile salt. The
      differences in glucocerebrosidase activity (in the absence of taurocholate) in
      extracts from different cell types from Gaucher disease patients are attributable
      to differences in the proportion of glucocerebrosidase present as a monomer with
      low activity (form I) and as a highly active aggregate (form II) that may also
      contain sphingolipid activator protein 2 (SAP-2). In extracts from leukocytes and
      lymphocytes from Type 1 Gaucher disease patients, but not in those from
      fibroblasts, a relatively high proportion of enzyme is present in aggregated form
      with near normal specific activity.

PMID- 2225531
TI  - Lacrimo-auriculo-dento-digital (LADD) syndrome with renal and foot anomalies.
AB  - A patient who presented with most features of lacrimo-auriculo-dento-digital
      (LADD) syndrome, an autosomal dominant trait, is described. There was no
      deafness, and anomalies of the external ear and the upper limbs were discrete.
      Renal anomalies, consisting of progressive caliectasis with stone formation, were
      revealed by macroscopic hematuria. There were also skeletal anomalies of both
      feet, a feature not previously described. Renal and distal limb anomalies are
      probably features of LADD syndrome.

PMID- 2225532
TI  - Frontonasal dysplasia or craniofrontonasal dysplasia and the Poland anomaly?
AB  - We describe a 10-year-old girl with features of a frontonasal dysplasia and a
      right-sided Poland anomaly. As there has been one previous case report of
      pectoral muscle hypoplasia in association with craniofrontonasal dysplasia, the
      relationship between these two conditions is discussed.

PMID- 2225533
TI  - The second family with Spahr-type metaphyseal chondrodysplasia: autosomal
      recessive inheritance confirmed.

PMID- 2225534
TI  - Childhood sexual abuse--a dermatological perspective.

PMID- 2225535
TI  - Lichen planus in children--a review of six cases.
AB  - We present the features of six children who have been seen amongst 154
      consecutive new patients with lichen planus in our outpatients clinic. All but
      one of the children had unusual forms of the disease and there was a family
      history of lichen planus in three. Lichen planus is rare in childhood and often
      assumes atypical clinical patterns.

PMID- 2225536
TI  - Ranking of the antipsoriatic effect of various topical corticosteroids applied
      under a hydrocolloid dressing--skin-thickness, blood-flow and colour measurements
      compared to clinical assessments.
AB  - In 10 patients with chronic plaque type psoriasis one or two plaques affected
      equally with psoriasis were chosen for study. Five punched out rings of a
      hydrocolloid dressing were applied to the psoriasis plaque(s). In each circular
      test area 20 mg of one of the following creams was applied: base, 1%
      hydrocortisone (DAK), 0.1% triamcinolone acetonide (Kenalogue), 0.1%
      betamethasone-17-valerate cream (Betnovate), and 0.05% clobetasol proprionate
      cream (Dermovate). The areas were occluded with a thin film of transparent
      hydrocolloid dressing (Comfeel Transparent Dressing), for 1 week. Non-invasive
      measurements (ultrasound skin thickness, laser-Doppler flowmetry, colorimetry)
      were performed before and after treatment. Therapeutic response was evaluated
      blindly by clinical score. The measurements showed a decline in blood flow, a
      decrease in skin thickness, and normalization of colour approaching that of
      normal skin, the more potent the corticosteroid used. The clinical scores showed
      the same: the more potent a corticosteroid used, the closer to the score of
      normal skin. Data on variability and applications of the methods are presented.
      The study concludes that potent corticosteroids occluded with a hydrocolloid
      dressing can clear psoriasis in 1 week. Short-course corticosteroid therapy
      appears harmless and relevant for clinical dermatology.

PMID- 2225537
TI  - Unilateral naevoid basal-cell-carcinoma syndrome--an individually controlled
      study of fibroblast sensitivity to radiation.
AB  - A patient with unilateral naevoid basal-cell-carcinoma syndrome (NBCCS, Gorlin's
      syndrome) provided a unique opportunity to compare the radiation sensitivity of
      fibroblasts from the affected and unaffected sides of the same individual.
      Although the growth rate of the fibroblast strain established from the affected
      side was faster than that from the unaffected side there was no difference in X
      ray, UV-B or UV-C radiation sensitivity between fibroblasts from the two sides.
      These results are discussed in the context of previous studies of radiation
      sensitivity in NBCCS.

PMID- 2225538
TI  - Introital adenosis associated with the Stevens-Johnson syndrome.
AB  - A young woman presented with erosive lesions of the labia minora, which appeared
      3 years ago after Stevens-Johnson syndrome. Pathological examination showed
      'vulval adenosis'. A similar case has been previously reported. Vaporization by
      carbon-dioxide laser gave satisfactory results, and after 2 years the patient
      remains totally cured. We discuss several embryological theories which may
      explain the mechanism of the vulval adenosis in this patient.

PMID- 2225539
TI  - Methotrexate and trimethoprim-sulphamethoxazole--a potentially hazardous
      combination.
AB  - A 74-year-old woman had been treated with methotrexate over 2 years for
      rheumatoid arthritis. She was admitted to the hospital because of non-healing leg
      ulcers. After being treated with trimethoprim-sulphamethoxazole for a urinary
      tract infection, she developed severe pancytopenia, followed by pneumonia and
      septic shock. The patient died shortly after. Concomitant treatment with
      methotrexate and sulphonamides should be strongly discouraged.

PMID- 2225540
TI  - Mosaic acral keratosis.
AB  - We describe two patients with acral keratosis with a striking mosaic or jigsaw
      puzzle pattern of keratotic papules on the dorsal aspects of the feet and
      adjacent parts of the legs. Both patients also showed mild diffuse palmoplantar
      keratosis and clavus-like lesions over the interphalangeal joints of the toes;
      one patient also had keratotic papules on the hands and hyperkeratotic plaques
      over the knees. The differential diagnosis of acral keratoses, including several
      recently described forms, is briefly discussed.

PMID- 2225541
TI  - UV-B-induced bullous pemphigoid restricted to mycosis fungoides plaques.
AB  - We describe a 77-year-old female patient with plaque-stage mycosis fungoides (MF)
      who developed bullous lesions in lesional skin only, while receiving short-wave
      ultraviolet radiation (UV-B) therapy. Histopathological and immunohistochemical
      examination resulted in a diagnosis of bullous pemphigoid (BP). Withdrawal of the
      UV-B treatment and application of a high-potency topical corticosteroid cream
      resulted in a rapid regression of the BP. As the bullous lesions were strictly
      confined to the MF plaques, the cutaneous infiltrate was probably involved also
      in the development of the BP. To our knowledge, this is the second case report of
      the coexistence of MF and BP and the first one in which the BP might be UV-B
      induced.

PMID- 2225542
TI  - Chronic bullous disease of childhood in three patients of Polynesian extraction.
AB  - Chronic bullous disease of childhood is an acquired subepidermal bullous disease.
      Its true incidence is unknown and to our knowledge there have been no reported
      cases in Polynesians. We report three cases who presented within 1 year to the
      Dermatology Department, Auckland Public Hospital, New Zealand.

PMID- 2225543
TI  - Adult xanthogranulomatosis associated with abnormal plasma apolipoprotein levels.
AB  - A case of adult xanthogranulomatosis was investigated in depth for lipid
      abnormalities. The xanthogranulomatous lesion was shown to be composed primarily
      of cholesterol esters and triglycerides. Fasting plasma lipid levels and
      lipoprotein concentrations were within normal limits. Plasma lipoprotein
      electrophoresis and immunoelectrophoresis demonstrated normal high-density
      lipoprotein (HDL) and low-density lipoprotein mobilities. Polyacrylamide-gel
      isoelectric-focusing electrophoresis revealed increased levels of very-low
      density apolipoprotein (apo) E, especially apo E-III. In the HDL fraction, apo-C
      III and apo-E levels were both found to be slightly elevated. These findings
      might imply a causal relationship between the abnormal plasma apolipoprotein
      levels and the xanthogranulomatous disease.

PMID- 2225544
TI  - Arthro-osteitis with palmoplantar pustulosis.

PMID- 2225545
TI  - Rippled hyperpigmentation resembling macular amyloidosis--a feature of atopic
      eczema.
AB  - We present a patient with long-standing refractory atopic eczema who developed a
      pattern of lichenification and hyperpigmentation resembling macular amyloidosis.
      Histology showed changes of chronic lichenification only. We suggest that this
      appearance is a feature of her eczema rather than amyloidosis.

PMID- 2225546
TI  - Orofacial granulomatosis associated with delayed hypersensitivity to cobalt.
AB  - Orofacial granulomatosis is a distinct clinical and pathological entity
      characterized by swelling of the lips and lower half of the face. Ulceration of
      the oral mucosa may also occur. Granulomas are seen histologically. Orofacial
      granulomatosis may occur in the Melkersson-Rosenthal syndrome, granulomatous
      cheilitis of Miescher, oral Crohn's disease, sarcoidosis and focal dental sepsis.
      The increased prevalence of atopy in patients with orofacial granulomatosis and
      the association with food intolerance suggests the possibility of a role for
      allergy in at least some cases.

PMID- 2225547
TI  - Pulsed 2.94-microns erbium-YAG laser skin ablation--experimental results and
      first clinical application.
AB  - In the present study we compared skin-ablative effects produced by 2.94-microns
      pulsed erbium-YAG radiation on pig skin with those of the pulsed 308-nm UV
      excimer laser, continuous-wave CO2 laser, electrocautery and cold-knife surgery.
      Pulsed 2.94-microns radiation led to clean ablation craters and precise cuts with
      only minimal adjacent tissue damage followed by excellent healing without
      apparent scarring. These experimental results are consistent with those obtained
      from first clinical applications in the treatment of epidermal naevi and tattoos.
      However, since coagulation was insufficient to prevent bleeding and because of
      low repetition rates provided, the Er-YAG lasers currently available seem as yet
      of limited value for effective removal of deeper or larger lesions.

PMID- 2225548
TI  - Erythema elevatum diutinum--a solitary lesion in a patient with rheumatoid
      arthritis.
AB  - Erythema elevatum diutinum is a rare disease of unknown aetiology. It is usually
      symmetrical with multiple lesions. An association with rheumatoid has previously
      been reported. We report a case of atypical erythema elevatum diutinum affecting
      the right elbow of a female patient with seropositive rheumatoid arthritis.

PMID- 2225549
TI  - Localized scleroderma--response to 1,25-dihydroxyvitamin D3.
AB  - 1,25-Dihydroxyvitamin D3 [1,25(OH)2 D3] may be an immunomodulatory drug which
      could have a role in controlling collagen deposition, and inducing reversal of
      fibrosis in some tissues. These observations prompted a study of the possible use
      of this hormone for the treatment of scleroderma. A 35-year-old woman, who had
      been suffering from localized scleroderma for 2 years, was given oral 1,25(OH)2
      D3 for 6 months. The effects of the treatment were evaluated using clinical and
      physical measurements (skin thickness, extensibility properties of the skin). The
      evolution of the patient's condition during the 6-month therapy suggests that
      1,25(OH)2 D3 is beneficial in localized scleroderma. The mechanisms of action are
      discussed in relation to the literature, which suggests both immunoregulatory and
      inhibitory effects on fibroblast growth.

PMID- 2225551
TI  - Proceedings of the Australasian Society of Clinical and Experimental
      Pharmacologists. 24th annual scientific meeting, 10-12 December 1990, Victoria.
      Abstracts.

PMID- 2225550
TI  - Oxygen consumption in psoriasis.

PMID- 2225552
TI  - Comparison of pathological lesions on repeated renal biopsies in 73 patients with
      primary IgA glomerulonephritis: value of quantitative scoring and approach to
      final prognosis.
AB  - In order to improve our possibility of establishing a long-term prognosis in IgA
      nephritis, 73 patients out of a cohort of 282, followed over a mean period of 12
      years at the same institution for an IgA nephritis, had a prospective second
      renal biopsy 5 years later. For all biopsies (RB1 and RB2), we developed a
      quantitative scoring for all elementary lesions with a glomerular, an
      interstitial, a tubular and a vascular index. The sum of these 4 indexes gave a
      global optical score (GOS). Pathological improvement on light microscopy (delta
      GOS less than or equal to -2) was noticed only in 3 patients (4%), stability (-2
      less than delta GOS less than +2) in 30 patients (41%), mild deterioration (+2
      less than or equal to GOS less than 5) in 23 patients (32%) and major progression
      (delta GOS greater than or equal to 5) in 17 patients (23%). We observed no
      pathological remission, even in the 14 patients with complete clinical remission.
      The pathological progression was characterized by an increase in all elementary
      lesions, mainly the tubulo-interstitial and vascular ones. By immunofluorescence
      mesangial IgA deposits remained stable with no disappearance; however, the number
      and intensity of vascular C3 deposits were significantly greater on RB2. Chronic
      renal failure (serum creatinine greater than 1.5 mg/dl) correlated best with
      major pathological progression and mainly with the progression of extraglomerular
      lesions. IgA nephritis is a slowly progressive disease with no pathological
      remission, and its evolution is characterized by progression of extraglomerular
      lesions, mainly vascular, which might play a major role in the ultimate
      development of chronic renal failure.

PMID- 2225553
TI  - IgA nephritis in Behcet's disease: case report and review of the literature.
AB  - We describe a 13-year-old girl with the incomplete type of Behcet's disease who
      had recurrent oral and genital ulcers, folliculitis, proteinuria and hematuria.
      Renal biopsy specimens revealed diffuse proliferative glomerulonephritis with
      strongly positive IgA deposits in the glomerular mesangial area, which is
      histologically indistinguishable from primary IgA nephritis. Further studies of
      the IgA subclasses showed that IgA1 deposits were predominant in the glomerular
      mesangium. Primary IgA nephritis is thought to be associated with polymeric IgA1.
      So it appears that there may be a common underlying disease or mechanism involved
      in both primary IgA nephritis and the IgA nephritis in Behcet's disease.

PMID- 2225554
TI  - Glomerular IgA deposits in patients with celiac disease.
AB  - Glomerular immunopathology was studied in 25 patients with newly diagnosed celiac
      disease. None had clinical signs of renal disease. Glomeruli were obtained by
      fine-needle aspiration biopsy. The specimens were processed and studied by
      indirect immunofluorescence for immunoglobulins and complement. Mesangial IgA was
      found in 8 of the patients. It occurred occasionally together with slight IgG or
      IgM, but C3 was not seen in these patients. IgA-class circulating immune
      complexes (CIC), antireticulin antibodies (ARA), antigliadin antibodies (AGA),
      and rheumatoid factor (RF) occurred significantly more often in the patients with
      mesangial IgA than in the 17 patients having no mesangial IgA. The patients with
      mesangial IgA also had significantly higher mean levels of serum IgA, IgA-ARA and
      IgA-AGA than those without. The results suggest that glomerular mesangial
      deposits of IgA occur frequently in untreated celiac disease and that they are in
      some way associated with circulating IgA-class antibodies and immune complexes.
      In this situation IgA seems to be deposited without being able to induce
      clinically overt glomerulonephritis, a circumstance that may be related to the
      lack of complement in the deposits.

PMID- 2225555
TI  - Diffuse proliferative lupus nephritis: long-term observations in patients treated
      with ancrod.
AB  - Twenty-two patients with histologically demonstrated diffuse proliferative lupus
      nephritis (DPLN) and glomerular thrombosis received a 14-day course of ancrod,
      followed in most by nitrogen mustard (mechlorethamine hydrochloride) 0.4 mg/kg.
      Many were referred when renal function was deteriorating despite large doses of
      prednisone. The patients had severe disease; there was a high degree of
      glomerular sclerosis; the median serum creatinine was 137 mumol/l, the diastolic
      blood pressure 101 mm Hg. Reported previously was a short-term improvement in
      renal function, blood pressure, and renal histology. Reported here is the long
      term follow-up on all 22 patients for an average of 58 months. Three died of
      causes other than renal failure. Eleven developed end-stage renal disease an
      average of 27 months after ancrod treatment. The other 8 are alive with no
      deterioration of renal function after an average of 70 months. This outcome seems
      satisfactory when disease severity is taken into consideration. Factors present
      at treatment start that might be associated with subsequent renal function
      deterioration were: prior prolonged prednisone treatment, extensive glomerular
      sclerosis, high plasma alpha 2-antiplasmin and possibly triglycerides. During the
      follow-up period after completion of treatment, later relapses of SLE and DPLN
      appeared to be an important predictor of deterioration of renal function.

PMID- 2225556
TI  - Disappearance of renin-induced proteinuria by an ACE-inhibitor: a case report.
AB  - A 55-year-old man developed renovascular hypertension that was characterized by
      high plasma renin activity. This was accompanied by nephrotic range proteinuria.
      Treatment with nifedipine and furosemide lowered the blood pressure to normal
      values, but proteinuria persisted. However, treatment with an ACE-inhibitor
      brought resolution of the proteinuria, suggesting a role for angiotensin II in
      urinary protein loss.

PMID- 2225557
TI  - Post-traumatic acute renal failure, 1956-1988.
AB  - Eighty patients with acute renal failure secondary to trauma treated between 1956
      and 1988 are reviewed. The overall mortality was 46.3%. Factors associated with
      increased mortality were age, high Injury Severity Score, and injury to the
      abdomen and pelvic contents. The number of injuries, the delay between injury and
      the institution of dialysis, and the level of urea on starting dialysis did not
      affect mortality. The declining incidence of traumatic acute renal failure
      highlights the importance of prompt effective resuscitation of injured patients.

PMID- 2225558
TI  - Changes in intact parathyroid hormone levels during hemodialysis following
      exposure to either differing dialyzate calcium concentrations or calcium-free
      dialysis with varying calcium infusion rates.
AB  - To determine the optimal infusion rate for calcium, when using a dialyzate which
      was calcium free, six patients were treated sequentially, in random order, with
      six different dialyzates. Three were calcium free and they were infused with
      replacement calcium at either 10, 15 or 20 ml/hour using 10% CaCl2. The other
      three used standard bicarbonate dialyzate with either 1.25, 1.5 or 1.75 mmol/l
      calcium. Ionized calcium and intact parathyroid hormone (Nichols IRMA PTH) were
      measured at the start and end of each dialysis. Ionized calcium rose slightly
      with 15 ml/hour calcium infusion and PTH fell 137 +/- 111 pg/ml. These changes
      were similar to those of 1.5 mmol/l calcium in standard bicarbonate. More PTH
      suppression and higher end dialysis calcium resulted from 20 ml/hour infusion or
      1.75 mmol/l dialyzate calcium. It was concluded that 15 ml/hour is a suitable
      calcium infusion rate under normal conditions when using calcium-free dialyzate.

PMID- 2225559
TI  - Lack of effect of captopril in cystinuria.

PMID- 2225560
TI  - The treatment of mesangial IgA nephropathy with cyclophosphamide, dipyridamole
      and warfarin: a two-year prospective trial.
AB  - Of 52 patients with mesangial IgA nephropathy, 25 were allocated to treatment
      with cyclophosphamide (6 months), and dipyridamole and warfarin (2 years) and 27
      to no treatment in a randomized prospective 2-year study. At entry, the treated
      and untreated groups of patients did not differ in mean serum creatinines,
      urinary protein excretions, quantitative urinary erythrocyte counts or blood
      pressure readings. At the end of the trial mean (+/- SEM) serum creatinine values
      had gone from 0.12 +/- 0.01 to 0.13 +/- 0.01 mmol/l (p less than 0.05) in
      untreated patients and from 0.10 +/- 0.01 to 0.12 +/- 0.01 mmol/l (p less than
      0.05) in treated patients. Mean (+/- SEM) log values of urinary erythrocyte (rbc)
      counts had not changed significantly from 5.47 +/- 0.09 to 5.21 +/- 0.14 log
      rbc/ml in untreated patients, from 5.45 +/- 0.11 to 5.49 +/- 0.19 log rbc/ml in
      treated patients. However, in treated patients, mean (+/- SEM) urinary protein
      excretions decreased from 1.67 +/- 0.35 to 1.15 +/- 0.31 g/24 h (p less than
      0.01) whereas in untreated patients urinary protein was unchanged between initial
      values of 1.76 +/- 0.34 and follow-up at 1.89 +/- 0.45 g/24 h. No significant
      changes in blood pressure occurred in either group. This study supports the
      observation that treatment of IgA nephropathy with cyclophosphamide, dipyridamole
      and warfarin is associated with a reduction of urinary protein excretion but a
      significant effect on preservation of renal function, at least as determined by
      serum creatinine values, could not be confirmed over this two-year study.

PMID- 2225561
TI  - Membranous glomerulonephritis induced by 2-mercaptopropionylglycine (2-MPG).
AB  - Thirty-two patients suffering from cystinuria were treated with 2
      mercaptopropionylglycine (2-MPG) for 0.5-10 years (average 6.3 years). After 4-14
      months of treatment at daily doses ranging from 500 to 2500 mg, three patients
      developed slight to moderate proteinuria. Two patients were subjected to renal
      biopsy which showed membranous glomerulonephritis. In one biopsy signs of
      progressive glomerular lesions were observed. In seven patients (22%) antinuclear
      antibodies were demonstrated. In one patient with biopsy-proven membranous
      glomerulonephritis, the antinuclear antibodies consisted of antihistone
      antibodies. The observations presented in this report indicate that 2-MPG, like D
      penicillamine, could induce autoimmune reactions, in some cases leading to
      membranous glomerulonephritis. The prognosis seemed to be favorable. However, the
      occurrence of irreversible glomerular lesions as reported by us should be borne
      in mind when considering long-term treatment with 2-MPG. A continuous, close
      follow-up of patients on 2-MPG treatment is recommended.

PMID- 2225562
TI  - Acute deterioration of renal function associated with enteric hyperoxaluria.
AB  - Enteric hyperoxaluria due to malabsorption syndromes has been well documented to
      cause renal calculi and chronic tubulointerstitial renal damage. Rarely, in the
      setting of intestinal bypass operations for morbid obesity, enteric hyperoxaluria
      has produced acute renal failure. We report two patients who suffered acute
      deterioration of renal function associated with increased intestinal absorption
      and renal excretion of oxalate associated with steatorrhea. One patient had a
      large portion of his small bowel resected many years prior to the onset of the
      renal failure and the second patient had chronic pancreatitis causing
      steatorrhea. Both patients had renal biopsy documentation of the acute nature of
      the tubular damage produced by oxalate deposition. The mechanisms of their
      deterioration of renal function may relate to sudden increases in steatorrhea in
      association with episodes of volume depletion. Enteric hyperoxaluria may be an
      easily overlooked and potentially preventable etiology of acute renal
      dysfunction.

PMID- 2225563
TI  - Is preliminary binephrectomy necessary in patients with autosomal dominant
      polycystic kidney disease undergoing renal transplantation?
AB  - Patients with end-stage chronic renal failure due to autosomal dominant
      polycystic kidney disease who underwent renal transplantation with or without
      preliminary binephrectomy were retrospectively studied to determine the effect of
      binephrectomy on outcome. Nineteen patients were identified. Thirteen patients
      had no surgery prior to transplantation and six underwent preliminary
      binephrectomy. One patient died as a result of the nephrectomy. Twenty-one renal
      allografts were performed on 18 patients of whom seven have died of sepsis; 10
      have functioning grafts and one has returned to dialysis. Patients not undergoing
      preliminary binephrectomy had a statistically significant (p less than 0.05)
      increase in mortality and morbidity due to septic complications related to
      polycystic kidney disease. Indications for bilateral nephrectomy should be
      reconsidered.

PMID- 2225564
TI  - Hypophosphatemia in infants on continuous ambulatory peritoneal dialysis.
AB  - Three infants with irreversible renal failure and treated with continuous
      ambulatory peritoneal dialysis (CAPD) developed hypophosphatemia. In one of them
      rachitic lesions were observed on X-ray and bone biopsy showed osteomalacic
      osteodystrophy. Different mechanisms may have been at the origin of the
      hypophosphatemia: high doses of phosphate binders, low phosphorus intake,
      phosphate loss with the dialysate and possibly nutritional repletion. Dietary
      phosphorus restriction and use of phosphate binders should be applied with
      caution and serum phosphate should be monitored regularly in infants treated with
      CAPD.

PMID- 2225565
TI  - SLE nephritis: an ultrastructural immunogold study to evaluate the relationship
      between immune complexes and the basement membrane components type IV collagen,
      fibronectin and heparan sulphate proteoglycans.
AB  - The nature of immune complexes and their relationship to the normal glomerular
      basement membrane (GBM) components type IV collagen, fibronectin, and heparan
      sulphate proteoglycans (HSPG) have been examined in the glomeruli of 7 cases of
      systemic lupus erythematosus (SLE) glomerulonephritis using an ultrastructural
      immunogold technique. In paraformaldehyde-fixed, Lowicryl resin-embedded tissue,
      the electron-dense deposits contained IgG, IgM, IgA, and C3 whether they were
      subepithelial, intramembranous, subendothelial, or mesangial and there was no
      particular relationship between the class of immunoglobulin and site of immune
      complex localization within the glomerulus. The normal GBM components type IV
      collagen, fibronectin, and HSPG were found within all the glomeruli, but did not
      have the same distribution. Type IV collagen and fibronectin were found
      predominantly on the inner aspect of the GBM and diffusely throughout the more
      central regions of the mesangial matrix. By contrast the HSPG was seen mainly on
      the outer aspect of the GBM and at the periphery of the mesangial matrix. In none
      of the cases were GBM antigens localized within the electron-dense deposits,
      results which suggest that autoantibodies to these GBM components may not play a
      role in the development of the glomerulonephritis.

PMID- 2225566
TI  - In vitro effects of bone- and platelet-derived transforming growth factor-beta on
      the growth of Walker 256 carcinosarcoma cells.
AB  - Conditioned media from fetal rat calvarial cultures has previously been shown to
      stimulate the growth of the bone-metastasizing Walker 256 carcinosarcoma cell
      line. In the current investigation we looked at the possibility that transforming
      growth factor-beta (TGF-beta), present in conditioned media, and positively
      correlated with resorption in vitro, may be responsible for the enhanced
      proliferation of Walker cells cultured in these conditioned media. Purified
      platelet-derived TGF-beta produced a dose-dependent growth response in Walker
      cells with an ED50 equal to 0.05 ng/ml. Bone-derived TGF-beta activity in
      conditioned media, measured by NRK fibroblast colony formation, correlated well
      with percentage resorption in bone cultures, and growth activity in Walker cell
      culture. In addition to this, the growth response normally seen with conditioned
      media cultures of Walker cells was significantly inhibited by the addition of
      anti-TGF-beta 1 neutralizing antibody. We conclude that TGF-beta is an important
      growth stimulatory component from fetal rat calvaria.

PMID- 2225567
TI  - Immunotherapy of the rat 13762SC mammary adenocarcinoma by vaccinia virus
      augmentation of tumor immunity.
AB  - We studied whether vaccinia virus (VV) functioned as an immunogenic carrier in
      augmenting anti-tumor immunity in rats bearing a syngeneic metastatic tumor. The
      primary tumor was induced by injecting 10(6) 13762SC mammary adenocarcinoma cells
      subcutaneously into the right hind footpad of Fischer 344 rats. A concomitant
      anti-tumor response is induced by the tumor as demonstrated by the inhibited
      growth of a second tumor challenge given in the contralateral footpad 3-15 days
      later. Attempts were made to increase the concomitant immunity by injecting tumor
      bearing animals intramuscularly with irradiated, VV-infected or uninfected
      13762SC cells without adjuvant. Provided the immunotherapy was done within 5 days
      of the tumor challenge, administration of 10(6)-10(7) irradiated, VV-infected
      13762SC cells resulted in significantly slower tumor growth, or led to complete
      tumor regression, compared to control animals given no treatment. In contrast,
      tumor growth in animals given only VV or given irradiated, uninfected 13762SC
      cells, alone or mixed with VV, was the same as that in control animals. Kinetics
      of early primary tumor growth were predictive of a longer-term anti-tumor effect.
      Rechallenge of 13762SC tumor-cured animals with either the homologous or with a
      heterologous syngeneic mammary adenocarcinoma showed the animals to be
      specifically 13762SC tumor-resistant, since only rats challenged with the
      heterologous mammary adenocarcinoma developed progressive tumors. We interpret
      these results to mean that early immunotherapy with irradiated, VV-infected
      13762SC cells enhances an on-going anti-tumor immune response sufficiently to
      cause rejection of the primary tumor and any metastases that have occurred. We
      also believe that later immunotherapy with irradiated, VV-infected cells has no
      effect due to tumor-induced immunosuppression becoming paramount.

PMID- 2225570
TI  - Annual meeting of the Canadian Cardiovascular Society. October 17-20, 1990,
      Halifax, Nova Scotia. Program and Abstracts.

PMID- 2225571
TI  - Obstetric emergencies.

PMID- 2225568
TI  - Tumor progression- and metastasis-associated proteins identified using a model of
      locally recurrent rat mammary adenocarcinomas.
AB  - A recently established model for local breast cancer recurrence using the 13762NF
      rat mammary adenocarcinoma was used to evaluate biologic and biochemical
      properties related to clinical outcome for this class of tumors. Sublines
      isolated from local tumor regrowths following surgical resection differed from
      each other and from the 'parental' cell lines for multiple phenotypes, including
      metastatic propensity. Local recurrence- and primary tumor-derived sublines were
      examined by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE), lectin
      binding to electrophoretically separated proteins, and lactoperoxidase-catalyzed
      cell surface iodination; and differential protein patterns were compared to tumor
      progression and metastatic potential. 2D-PAGE revealed several quantitatively
      different spots which correlated with lung colonization potential. In particular,
      quantities of an apparently unique, non-cell-surface protein, P50.9 (Mr
      approximately 50,900, pI approximately 7.3) correlated inversely with metastatic
      propensity, suggesting that it may be associated with, among other possibilities,
      the negative regulation of the metastatic phenotype. P50.9 was unrelated to four
      similarly sized metastasis-associated proteins--tumor autocrine motility factor;
      the rat analog of tumor suppressor, p53; rat cytokeratin 14 or procathepsin D--as
      determined by amino acid analysis. A major wheat germ agglutinin binding
      sialoglycoprotein, gp93 (Mr approximately 93,000), was present in smaller amounts
      as cells were passaged in vivo and re-established as in vitro cultures [MTF7
      greater than 'primary' tumor-derived lines (sc1, sc3) much greater than local
      recurrence-derived lines (LR1, LR1a, LR3, LR4, LR5, LR6)]. Besides cell surface
      glycoprotein losses, two of six local recurrence-derived sublines expressed a
      wheat germ agglutinin-binding sialoglycoprotein, gp110 (Mr approximately
      110,000), previously undetected on any of the other cell lines including the
      parental populations. gp110 was found in LR3 and LR6 which were relatively highly
      metastatic; however, correlation with metastatic potential failed because gp110
      was not present on the metastatic parental cell line, MTF7. These results
      demonstrate specific quantitative and qualitative protein differences associated
      with the selection of locally recurrent mammary tumors.

PMID- 2225569
TI  - Measurement of DNA content and nuclear pleomorphism in metastatic variants of the
      B16 murine melanoma and hamster lymphoma and its liver metastasis using image
      analysis techniques.
AB  - The DNA content and nuclear pleomorphism (NPM), which are two cellular features
      consistently employed in the assessment of tumour malignancy, have been measured
      in B16 murine melanoma metastatic variants and in hamster primary lymphoma and
      its liver metastasis as tumour models using image analysis techniques. The three
      melanoma variants studied were the low metastasis variant F1, the BL6 variant
      selected for high lung metastasis and invasive ability, and ML8, a line isolated
      from pulmonary metastasis of the BL6 tumour. The cellularity of the melanomas
      bore no relationship to metastatic ability. The cell cycle distribution of nuclei
      based on integrated nuclear density (IND) was studied. The ML8 tumour showed
      higher DNA ploidy. Also, in this tumour the S-phase fraction was approximately
      2.0-fold larger than that of the BL6 tumour. Flow cytometry of nuclei isolated
      from paraffin-embedded tumour tissue showed all three melanomas were aneuploid.
      In both F1 and BL6, two distinct subpopulations (p2 and p3) of nuclei, based on
      the degree of their pleomorphism, could be discerned. A significantly higher
      proportion of the more pleomorphic subpopulation (p2) occurred in BL6 than in F1.
      In the ML8 alone, a third subpopulation (p1), which was more pleomorphic than p2,
      was found. The hamster lymphomas (HALY-malignant and N-HALY-non-malignant) were
      less cellular than the metastatic tumour (HALY-met) in liver. The lymphomas N
      HALY and HALY-met had a higher DNA ploidy as compared with its primary tumour
      HALY. However, the non-malignant lymphoma N-HALY and the moderately malignant
      hamster fibrosarcoma were also found to be hyperdiploid. The metastatic lymphoma
      (HALY-met) showed a more pleomorphic nuclear subpopulation as compared with the
      primary. No differences were found in the size of the S-phase fractions of the
      hamster tumours. The present work shows that image analysis techniques enable one
      to make objective measurements of DNA content and nuclear pleomorphism of tumour
      cells, and suggests that in the tumour models investigated there is increased
      nuclear pleomorphism and DNA ploidy associated with tumour progression.

PMID- 2225572
TI  - Placenta previa.
AB  - A placenta previa, whether found fortuitously by ultrasound or with the clinical
      emergency of maternal hemorrhage, carries significant maternal and fetal risk.
      Accurate diagnosis, judicious expectant management with transfusion as required,
      and delivery at the time of fetal lung maturation can lead to the most favorable
      outcome. Anticipation of the clinical complication of placenta accreta may avoid
      some serious consequences. Clinical judgement and skill in the performance of
      cesarean sections, dilatation and curettage, and other forms of uterine invasive
      techniques may help to keep subsequent incidence of placenta previa at a
      reasonably low rate.

PMID- 2225573
TI  - Postpartum hemorrhage: placenta accreta, uterine inversion, and puerperal
      hematomas.
AB  - Puerperal hematomas, although rare, can be potentially morbid or life-threatening
      events. Early surgical management, including clot evacuation, layered closure,
      drainage, antibiotics, and fluid replacement (including blood), usually result in
      satisfactory outcome. Prevention is clearly preferable and often achievable with
      careful initial repair of episiotomies and lacerations.

PMID- 2225574
TI  - Uterine rupture.
AB  - Uterine rupture is a sudden, unforeseeable event that carries a high rate of
      maternal and perinatal mortality. When the diagnosis of uterine rupture is
      suspected, prompt surgical intervention with an experienced pelvic surgeon and
      blood product replacement should be considered. At the time of uterine rupture,
      the patient should be evaluated for possible repair or hysterectomy. It appears,
      based on the aforementioned information, that repair is a reasonable
      consideration. In those patients who have undergone a repair, early delivery by
      elective cesarean after assessment of fetal lung maturity at or around 36 weeks
      gestation would appear prudent. In those patients with a prior cesarean,
      continuous electronic fetal monitoring to detect intrapartum fetal distress would
      appear prudent. In these patients fetal distress is the most common sign or
      symptom of uterine rupture and frequently precedes any other clinical
      manifestations of this complication.

PMID- 2225575
TI  - Emergent management of abdominal pregnancy.

PMID- 2225576
TI  - Ectopic pregnancy: a look at changing concepts and problems.

PMID- 2225577
TI  - Hypovolemia due to hemorrhage.

PMID- 2225579
TI  - Cerebrovascular emergencies in pregnancy.

PMID- 2225578
TI  - Eclampsia.
AB  - Early detection and hospitalization in women with mild preeclampsia may prevent
      eclampsia. In the event of severe preeclampsia or eclampsia, delivery is
      indicated for the benefit of both mother and fetus. Thereafter, pathologic
      changes of preeclampsia and eclampsia, including major multiple organ system
      dysfunction, undergo complete reversal.

PMID- 2225580
TI  - Amniotic and thromboembolism.
AB  - Embolic phenomena in pregnancy demand rapid investigation and treatment.
      Regardless, some patients will not survive due to the enormity of the insult.
      Optimally, such patients should be treated in tertiary care centers, but this is
      not always possible.

PMID- 2225581
TI  - Obstetric septic shock: a pathophysiologic basis for management.

PMID- 2225582
TI  - Acute respiratory failure.
AB  - Pregnancy entails many unique physiologic changes that make the management of
      ARDS both challenging and unique. Most of these women are young and in excellent
      health before their acute injury, and their survival should exceed that of the
      general population who develop ARDS. We advocate aggressive management of the
      suspected lung injury including early intubation and the institution of invasive
      hemodynamic monitoring. This approach ensures the most thorough assessment of the
      extent of the initial injury and allows rapid assessment of therapeutic maneuvers
      and their subsequent adjustment. Our goal is to reverse the initial insult early
      while avoiding further iatrogenic injury. Optimal management of the maternal
      fetal pair requires the cooperation of an obstetrician well versed in
      cardiopulmonary physiology and physicians skilled in intensive care medicine.

PMID- 2225583
TI  - Preterm labor.

PMID- 2225584
TI  - Intrapartum assessment of fetal well-being.

PMID- 2225585
TI  - Shoulder dystocia.

PMID- 2225586
TI  - Reproductive endocrinology update.

PMID- 2225587
TI  - The ovarian follicle: life cycle of a pelvic clock.

PMID- 2225588
TI  - Reproductive steroid hormones: generation, degradation, reception, and action.

PMID- 2225589
TI  - Hormonal assay methodology: present and future prospects.

PMID- 2225590
TI  - Hyperprolactinemic disorders.

PMID- 2225591
TI  - Hyperandrogenic disorders.

PMID- 2225592
TI  - Polycystic ovary syndrome.

PMID- 2225594
TI  - Interhemispheric cysts in association with agenesis of the corpus callosum.
AB  - Two cases of complete agenesis of the corpus callosum each with large
      interhemispheric cysts are presented. The first case is an adult patient with
      chronic renal failure secondary to adult polycystic renal disease who was
      neurologically asymptomatic until she had a seizure during hemodialysis. The
      second case is an infant, who was diagnosed in utero as hydrocephalic, with
      severe mental and motor retardation and intractable seizures. The
      clinicopathologic findings in the two cases are presented, along with a
      discussion of the possible etiologies and clinical significance.

PMID- 2225593
TI  - Infantile inflammatory multisystem disease: clinicopathological findings and
      review of the literature.

PMID- 2225596
TI  - Medical induction of abortion.

PMID- 2225597
TI  - Termination of pregnancy--a global view.

PMID- 2225595
TI  - Aqueductal atresia as a feature of arhinencephalic syndromes.
AB  - Two cases are presented of aqueductal atresia associated with arhinencephalic
      syndromes. The first case was one of semilobar holoprosencephaly with occipital
      encephalocele, the second one of lobar holoprosencephaly (callosal agenesis with
      interhemispheric cyst). Only the second case was associated with obstructive
      hydrocephalus. The absence of hydrocephalus in the first case may be ascribed
      either to the greater distensibility of the encephalocele, or to the displacement
      of the choroid plexuses from the intracranial portion of the common ventricle
      into the hernial sac.

PMID- 2225598
TI  - Uterine contractility during pregnancy and the effect of abortifacient drugs.
AB  - There are a number of compounds in clinical use for termination of pregnancy.
      Treatment with all of them will result in increased uterine contractility. PGF2
      alpha and PGE2 as well as different prostaglandin analogues all have a direct
      stimulatory effect on the myometrium, while other compounds such as hypertonic
      saline and Rivanol seem to act mainly through a stimulation of the endogenous
      production of PGF2 alpha. Treatment with antiprogestins which compete with
      progesterone at the receptor level or which inhibit progesterone biosynthesis
      results in an increased uterine contractility probably through a release from
      progesterone inhibition. If the withdrawal of progesterone also induces an
      increased endogenous prostaglandin production is unclear. The medical method to
      induce abortion which best resembles the physiological events during a
      spontaneous abortion is probably treatment with antiprogestins (receptor blockers
      or progesterone biosynthesis inhibitors) followed by prostaglandin.

PMID- 2225599
TI  - The physiology of cervical ripening and cervical dilatation and the effect of
      abortifacient drugs.
AB  - The mechanical properties of the human uterine cervix are determined mainly by
      the connective tissue component, whereas it is doubtful whether the scanty smooth
      muscle component is of any physiological importance. Histological and biochemical
      analyses reveal a fibrous connective tissue similar to that found in skin and
      tendon. Degradation of the collagen and an increase in some special dermatan
      sulphate proteoglycans can at least partly explain the pregnancy-associated
      softening of this connective tissue. Relatively high oestrogen levels seem to be
      an absolute condition for the process, even when it is induced pharmacologically.
      Treatment with progesterone-receptor blockers, PGE2, PGF2 alpha or relaxin in
      pregnancy induce cervical softening as well as histological and biochemical
      changes which cannot be distinguished from the physiological cervical softening
      which takes place in late pregnancy. Prostaglandins and relaxin might interact
      and could include cytokines such as interleukin-1 during the process. The effect
      of cervical tents cannot be explained only by the radial pressures they exert.
      Most probably stimulation of local prostaglandin synthesis is also involved.

PMID- 2225600
TI  - Post-ovulatory contraception.
AB  - It is possible to prevent pregnancy after unprotected intercourse by suppressing
      ovulation, inhibiting fertilization or interfering with tubal transport and/or
      implantation of the early embryo. IUCDs probably prevent implantation by
      stimulating the release of prostaglandins from the endometrium but are not
      acceptable to many women. Post-coital contraceptive steroids, e.g. high-dose
      oestrogens, are associated with a relatively high incidence of side-effects and
      must be taken within 72 hours of coitus. As these agents are effective by
      creating a uterine environment unfavourable for implantation, it may be possible
      to use antigestagens or antioestrogens in this way. It is already known that an
      antigestagen in combination with a prostaglandin is a highly effective method of
      inducing abortion in very early pregnancy. The corpus luteum is essential for the
      maintenance of pregnancy and its destruction by a luteolytic agent should
      dislodge the implanting embryo. If an effective method of preventing implantation
      could be developed which was relatively free from side-effects, it should be
      possible to use it as a regular form of contraception to be taken only when the
      risk of pregnancy had occurred.

PMID- 2225601
TI  - Medical methods to terminate early pregnancy.

PMID- 2225602
TI  - Pretreatment of the cervix prior to surgical evacuation of the uterus in the late
      first and early second trimester of pregnancy.

PMID- 2225603
TI  - Intrauterine administration of drugs for termination of pregnancy in the second
      trimester.
AB  - Medical methods have been used for many years to terminate mid-trimester
      pregnancy, ranging from irritant chemicals and traditional plants to ecbolic
      agents and solutions instilled locally into the uterus. These methods had serious
      limitations, with relatively high rates of maternal mortality and morbidity.
      Surgical evacuation requires special skills not available to all practitioners
      and many doctors consider second trimester dilatation and evacuation as a
      surgical taboo. In recent years several approaches evolved and reached the
      clinics, presenting safer and more effective options. Intra-amniotic instillation
      of hypertonic solutions, particularly saline or urea, proved in many hands to be
      a good method for pregnancies beyond 15 weeks of gestation. Due to a long latency
      period after instillation, these agents are often supplemented by an intravenous
      oxytocin infusion. Extraovular hypertonic saline or ethacridine (Rivanol) have
      their advocates, particularly in the grey-zone of pregnancy range from 13-15
      weeks. In the last two decades, intrauterine prostaglandins were added to the
      methods in current use. Extra-amniotic prostaglandins (E2, F2 alpha or 15-methyl
      F2 alpha) were originally given in repeated doses or as a continuous local drip,
      but later a single instillation was used, usually mixing the drug with a viscous
      solution or gel. Intra-amniotic prostaglandins, in much higher doses,
      particularly the 15-methyl analogue, proved highly effective and relatively safe,
      especially when combined with laminaria tent insertion in the cervix. Various
      combinations of methods have provided a wide spectrum of data which is difficult
      to evaluate at present. Studies comparing different methods were mainly attempted
      in the mid-seventies. The outcome raised many pertinent questions and left many
      major issues unresolved. Most of the comparisons were not randomized or well
      controlled and only referred to the natural prostaglandin compounds. The
      analogues, however, seem to offer several advantages and the role of additional
      methods such as laminaria or antiprogestins remains to be further evaluated.

PMID- 2225604
TI  - Non-invasive methods for termination of second trimester pregnancy.

PMID- 2225605
TI  - Medical management of abnormal pregnancy.

PMID- 2225606
TI  - Acceptability of abortion methods.
AB  - This chapter has reported the findings of acceptability of prostaglandin
      pessaries compared with vacuum aspiration as methods for inducing abortion in a
      very early stage of pregnancy. Acceptability has been defined by the WHO as the
      degree with which a treatment method has attributes that make it perceived by a
      user or potential user to be consonant with his or her own sense of well-being
      and therefore will be used or preferred. The acceptability of the medical and
      surgical procedures for inducing abortion was studied in Swedish abortion
      patients using a pre- and post-abortion design for obtaining observations.
      Methods used included interview schedules, questionnaires, rating scales and
      attitude measuring techniques. Patients consenting to take part in the
      acceptability study had agreed to be randomly assigned to prostaglandin
      treatment, given at the clinic or self-administered by the patient at home, or to
      vacuum aspiration. A high degree of acceptability for the prostaglandin treatment
      was obtained in this group of patients who had applied for an abortion very soon
      after one missed menstrual period. This was indicated from the finding that the
      very high preference for this procedure remained unchanged in the group randomly
      assigned to it. Other measures of attitudes to prostaglandin treatment also
      indicated the unchanged positive attitude. There was a significant change in the
      attitude to vacuum aspiration among those assigned to this treatment, indicating
      that post-abortion it was more acceptable to these patients. However, 30% of them
      would still prefer the prostaglandin treatment, especially self-administered, in
      the event of another abortion. There were consistent and significant
      relationships found between the degree of negative emotional arousal before and
      after abortion and preference for the medical or surgical procedure and also the
      amount of complaints after abortion. Those patients who pre-abortion had
      preferred the self-administered procedure were, regardless of which treatment
      they had been assigned to, those who were least emotionally upset both before and
      after the treatment and also complained the least. This chapter also reported on
      findings of how acceptable the medical and surgical procedures can be inferred to
      be from comparisons of preferences and attitude measures obtained from abortion
      patients before treatment and from women in the same age group (who would not
      exclude an abortion if pregnant) in samples from outside the clinical setting. In
      the non-patient groups about half the subjects would prefer the medical
      alternative.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2225607
TI  - The effect of pregnancy termination on future reproduction.
AB  - A variety of conditions have been anecdotally ascribed to induced abortion,
      including subsequent reproductive complications. Since most women obtaining
      induced abortions are at the beginning of their reproductive life, the effect of
      induced abortion on subsequent reproduction becomes a very significant one. Our
      review of the literature confirms findings reported previously. First, except in
      the case where an infection complicates induced abortion, there is no evidence of
      an association between induced abortion and secondary infertility or ectopic
      pregnancy. Second, the risk of midtrimester abortion, premature delivery and low
      birthweight in women whose first pregnancy is terminated by vacuum aspiration is
      not higher than that in women in their first pregnancy or women in their second
      pregnancy whose first pregnancy was carried to term. However, the risk of having
      a premature delivery or a low birthweight baby tends to be higher (but not
      significantly) among women whose first pregnancy is terminated by induced
      abortion when compared with women in their second pregnancy than when compared
      with women in their first pregnancy. This suggests that an induced abortion does
      not protect a women against the known risk of low birthweight for first-born
      offspring. Finally, women whose pregnancy is terminated by dilatation and
      evacuation may have an increased risk of subsequent premature delivery and a low
      birthweight baby. Very little has been published and no conclusions can be made
      regarding the effects of instillation procedures and repeat abortions on future
      reproduction. In conclusion, except for the association between pregnancies
      following dilatation and evacuation procedures and premature delivery and low
      birthweight, no significantly increased risk of adverse reproductive health has
      been observed following induced abortion.

PMID- 2225608
TI  - Future direction of abortion technology.
AB  - Reliable statistical data indicate that even today abortion is widely used in the
      regulation of human reproduction, irrespective of whether it is well or badly
      tolerated. Medical responsibility therefore dictates that abortions should be
      made as safe as possible in order to safeguard the health of women who cannot
      avoid abortion. The most advanced development in abortion technology is medical
      abortion. At present, the best available method is the combination of an
      antiprogesterone (RU-486) and a low dose of prostaglandin, either in an injection
      (sulprostone) or in a vaginal pessary (gemeprost). The currently employed
      treatment schedules are still not optimal. The treatment lasts for at least 48 or
      72 hours and close follow-up is needed to assess whether the treatment has been
      successful or not. The side-effects, however, are negligible, and the medical
      method is free from the complications of the surgical methods and those of
      anaesthesia. The high efficacy (95% complete abortion rate at a gestational age
      up to eight weeks) restricts the risk of surgery and anaesthesia to the 5%
      failures. Further research is required to develop a more appropriate treatment
      schedule, preferably a single-shot treatment. At the same time, the prevention of
      misuse of the medical methods must be guaranteed to achieve a better acceptance
      of these safe abortion methods by society. For the time being, medical
      supervision and follow-up seems to be mandatory, and a 'do-it-yourself' home
      method providing complete privacy must be regarded as unsafe and medically
      unacceptable.

PMID- 2225609
TI  - 1990 proceedings of the Knee Society. A symposium.

PMID- 2225610
TI  - Scintigraphic determination of patellar viability after excision of infrapatellar
      fat pad and/or lateral retinacular release in total knee arthroplasty.
AB  - A prospective study ascertained the effect of lateral retinacular release and/or
      excision of the infrapatellar fat pad on patellar vascularity after total knee
      arthroplasty. Fifty patients (70 knees) had postoperative technetium bone scans,
      which revealed a higher incidence of vascular compromise of the patella after
      lateral release than without lateral release. Excision of the infrapatellar fat
      pad, commonly performed to enhance exposure and simplify access to the proximal
      tibia, did not compromise patellar vascularity.

PMID- 2225611
TI  - Treatment of juxtaarticular nonunion fractures at the knee with long-stem total
      knee arthroplasty.
AB  - A retrospective study of ten patients with juxtaarticular nonunions at the knee
      treated with long stem total knee arthroplasty was performed. The average age of
      the patients was 76 years old, with an average follow-up of 36 months. The
      nonunions were present for an average of 36 months. There were six patients in
      the series with prior total knee arthroplasty. Clinical union was achieved in all
      ten patients. All patients improved their ambulatory status. Range of motion
      improved from an average preoperative range of 40 degrees to an average
      postoperative range of 85 degrees. Complications occurred in three of ten
      patients, with one being a postoperative infection. Surgical techniques are
      described to aid in treatment of difficult juxtaarticular nonunion fragments.

PMID- 2225612
TI  - Patellar resurfacing in total knee arthroplasty.
AB  - Technical errors in patellar resurfacing at the time of total knee arthroplasty
      (TKA) are responsible for many of the complications that affect the
      patellofemoral joint. Instability, patellar fracture, and wear of metal-backed
      patellar implants are significantly affected by errors of patellar resurfacing. A
      review of 50 TKAs using a condylar prosthesis and a standardized technique for
      patellar resurfacing was performed to evaluate the accuracy of the technique. The
      patients were evaluated at a mean of 2.5 years (range, two to five years) after
      surgery. The Hospital for Special Surgery Knee Score improved from a preoperative
      mean of 56 to 92 at the last evaluation. The Hospital for Special Surgery Knee
      Scores were excellent in 92% and good in 8%. The Knee Society Knee Score improved
      from a preoperative mean of 28 for pain and 49 for function to a last evaluation
      mean of 96 for pain and 85 for function. None of the patients had symptoms
      referable to the patellofemoral joint. There were no patellar fractures,
      dislocations, or instances of implant loosening of the patella. Roentgenograms
      revealed nine asymmetrically resurfaced patellae and five tilted patellae. There
      were no patellar subluxations. Patellar thickness was maintained at the
      preoperative level of 21 mm. Joint-line height was elevated 1 mm. The patellar
      height was decreased 2 mm from the preoperative height. Using a standard
      technique, satisfactory clinical results can be achieved, but minor errors in
      resurfacing and alignment will still occur.

PMID- 2225613
TI  - Radionuclide imaging of asymptomatic versus symptomatic total knee
      arthroplasties.
AB  - Ninety-eight total knee prostheses were evaluated by roentgenograms and bone
      scans. Fifty-three were asymptomatic, and 45 were symptomatic. Thirteen
      prostheses required revision surgery. At a mean of 54 months, asymptomatic knee
      replacements generally showed only mild uptake in one or more zones. Only one
      knee had uptake equal to surrounding bone. However, symptomatic knee replacements
      showed significantly greater uptake in the patella, femur, and medial and lateral
      tibial plateau regions (Mann-Whitney two-sample rank test). Bone scans in the
      symptomatic group were obtained at a mean of 44 months. Excluding those patients
      who had revision surgery, the differences remained significant. Furthermore,
      symptomatic knee replacements with normal roentgenograms also had significantly
      greater uptake. Radiolucent lines were noted in 30% of asymptomatic patients,
      whereas 29% of symptomatic knees had radiolucencies. Radiolucencies were not
      generally associated with significantly greater uptake. Lateral release had no
      effect on the patellar score.

PMID- 2225614
TI  - Cemented total knee arthroplasty for gonarthrosis in patients 55 years old or
      younger.
AB  - The results of 68 cemented total knee arthroplasties (TKAs) in 50 patients with
      gonarthrosis who were 55 years old or younger at the time of surgery were
      reviewed. These patients were operated on between 1979 and 1987 and were followed
      for an average of 6.2 years. The average age of the patients was 50 years.
      Patients were evaluated by the Hospital for Special Surgery knee score. The
      average preoperative score was 53, and the average follow-up score was 90.
      Overall, 55 TKAs were rated as excellent and 13 as good. Using the knee rating
      score advocated by the Knee Society, the average postoperative score was 92 for
      pain and 84 for function. There were four successful reoperations for patellar
      component loosening, all in metal-backed patellae. The femoral and tibial
      components in these patients were intact, and at the follow-up period, two knees
      were rated as excellent and two as good. Detailed roentgenographic evaluation
      demonstrated that 20% of tibial components had radiolucencies in at least one
      zone on the anteroposterior roentgenogram and in 11% on the lateral
      roentgenogram. Femoral radiolucencies occurred in only 2% of knees. Patellar
      radiolucencies in one or more zones occurred in 20% of knees that had not had
      patellar revision. No complete or progressive radiolucencies at the bone-cement
      interface were noted for any component, and no components were considered to be
      roentgenographically loose. Cemented TKAs can achieve excellent long-term results
      in patients younger than 55 years old with gonarthrosis of the knee. These
      results compare with those obtained in published reports on older age
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225615
TI  - Total knee arthroplasty in diabetes mellitus.
AB  - A retrospective study was done of 59 total knee arthroplasties (TKAs) in 40
      patients diagnosed with diabetes mellitus. The overall infection rate was 7%,
      with an overall revision rate of 10% and an average follow-up period of 4.3
      years. Wound complications were present in 12% of the TKAs. The rate of deep
      joint infections in diabetic patients was statistically higher than the reported
      incidence of sepsis in nondiabetic patients. Therefore, maximum precautions
      should be taken for diabetic patients having TKA to minimize both wound
      complications and joint sepsis.

PMID- 2225616
TI  - Bone loss in the distal anterior femur after total knee arthroplasty.
AB  - Bone loss in the distal anterior femur in asymptomatic total knee arthroplasty
      (TKA) patients has been noted roentgenographically and during revision surgery. A
      retrospective roentgenographic review of 147 TKA cases was carried out to
      document bone loss. The influence that the mode of fixation (porous coated and
      cemented) and the implant design have on bone loss was examined. The time of
      onset and the progression of bone loss were studied. Bone loss occurred in the
      distal anterior femur in the majority of cases reviewed (68%). The prevalence of
      bone loss was independent of the mode of fixation and the implant design. By
      qualitative observation, roentgenographically detectable bone loss occurred
      within the first postoperative year and did not progress further. Previously
      three-dimensional finite element analysis demonstrated that the replacement of
      the bearing surface of the femur with a stiff metallic implant reduces the stress
      in the distal anterior femur by at least one order of magnitude. It is therefore
      speculated that the observed bone loss results from stress shielding. The
      apparent lack of progression may reflect the development of a new remodeling
      equilibrium under the altered stress conditions. The bone loss in the distal
      anterior femur described has not been implicated as a source of failure. However,
      since the bone strength in the femoral region is compromised as it becomes
      osteopenic, bone failure may occur with longer periods of cyclic loading.
      Furthermore, as a result of bone loss, revision arthroplasty may be more
      difficult.

PMID- 2225617
TI  - Massive allografts in salvage revisions of failed total knee arthroplasties.
AB  - Ten patients with failed total knee arthroplasties and severe bone loss were
      treated with massive whole distal femur and proximal tibial allografts in
      combination with prosthetic implants. Fourteen allografts were inserted either as
      invaginated or segmental grafts and were rigidly fixed to the host bone.
      Clinically and roentgenographically, 12 of 14 grafts (86%) seemed to have united
      to the host bone. The average range of motion was 92 degrees. Five patients
      developed complications; two of these involved the allograft (nonunion and
      fracture) and two were caused by inadequate healing at the ligament-allograft
      junction. One patient had a late infection. With careful planning and improved
      surgical techniques, these complications can be avoided. The massive allograft
      prosthesis composite techniques is a viable reconstructive alternative worthy of
      further clinical trials.

PMID- 2225618
TI  - Reconstruction of patellar tendon rupture after total knee arthroplasty with an
      extensor mechanism allograft.
AB  - Although patellar tendon rupture after total knee arthroplasty (TKA) is a rare
      complication, the consistently poor outcome of conventional tendon repair has
      convinced some to abandon such reconstruction in favor of a prospective protocol
      using an allograft distal extensor mechanism. The graft consists of a quadriceps
      tendon, a patella with a cemented prosthesis, a patellar tendon, and a tibial
      tubercle. Since December 1985, 13 knees in 12 patients were reconstructed using
      this method. Ten knees were followed for six to 51 months; five of these knees
      were followed for more than 24 months. Knee extension power and improved function
      were ultimately attained in all cases, although minimal extensor lags were
      present in three cases. Preoperative motion returned in all but one knee. Healing
      of the allograft to the host tissue was attained primarily at all of the tibial
      junctions. Two graft complications occurred, both in the first three months after
      surgery: one quadriceps junction treated by resuture failed at the one-month
      mark, and the other graft had to be revised for extensor weakness from rupture of
      the graft at the patella-patellar tendon junction, which was attributed to
      surgical damage to the tendon. After completion of healing to the host and
      rehabilitation of the knee joint, no grafts in the series failed during the
      course of normal daily activities. One patient fractured the allograft patella in
      a severe fall. The long-term durability of this construct needs to be studied
      further.

PMID- 2225619
TI  - Long-term survivorship analysis of cruciate-sparing versus cruciate-sacrificing
      knee prostheses using meniscal bearings.
AB  - A comprehensive, interchangeable, low-contact-stress, mobile-bearing knee
      prosthesis system was developed and used over a 12-year period with both cemented
      and cementless fixation. Individual components of the system included a
      bicruciate-retaining meniscal bearing, a posterior cruciate-retaining meniscal
      bearing, and a cruciate-sacrificing, rotating-platform tibial component mated to
      the same femoral and rotating patellar components. Survivorship analysis of each
      implant type was performed to identify specific failure modes and trends for long
      term survival of the implants in a wide variety of primary knee arthroplasties.
      Clinically, there were 46 prostheses of the bicruciate type followed for up to 12
      years, 57 prostheses of the posterior-cruciate type followed for up to six years,
      and 108 prostheses of the rotating-platform type followed for up to ten years.
      All knees in this study had rotating-bearing patellar prostheses. Cumulative
      survivorship analysis using an end point of implant revision or a poor knee score
      revealed a small early failure rate of each implant in the first three years,
      associated with technical positioning or undersizing errors. This study indicates
      a predictable long-term survival of both cruciate-retaining and cruciate
      sacrificing mobile-bearing knee prostheses as well as rotating-bearing patellar
      prostheses when used in primary knee arthroplasties that minimized technical
      errors of insertion.

PMID- 2225620
TI  - A sequential three-step lateral release for correcting fixed valgus knee
      deformities during total knee arthroplasty.
AB  - An approach to mild, moderate, and severe fixed valgus deformities of the knee is
      described. The sequential approach to soft-tissue releases in the fixed valgus
      knee allows the surgeon to regain a neutral alignment in valgus deformities of up
      to 90 degrees. An additional benefit of the approach is spontaneous correction of
      fixed external tibial rotation deformities. Using this approach, early and late
      stability allows the use of unconstrained knee implants, including those with
      mobile-bearing elements.

PMID- 2225622
TI  - Anaphylactic shock associated with chymopapain skin test. A case report and
      review of the literature.
AB  - The allergic response to chymopapain intradiscal therapy has been well
      documented. The most serious of these reactions is anaphylactic shock, which may
      result in death. Various screening methods, including skin tests, have been
      proposed to identify susceptible patients. Anaphylactic shock occurred in a 40
      year-old woman from application of the screening skin test. Appropriate
      therapeutic intervention should be readily accessible when this test is
      performed.

PMID- 2225621
TI  - Magnetic resonance imaging and computer tomography of acute spinal cord trauma.
AB  - Spinal cord lesions are not detectable on roentgenograms and computed tomography
      (CT) scans. Magnetic resonance images (MRIs) are able to make soft-tissue lesions
      visible. Interpretations of MRIs, CT scans, and roentgenograms were compared in
      25 patients and three postmortem specimens with spinal cord injuries. In 14
      patients and one specimen with normal roentgenograms and CT scans, the MRI
      demonstrated ten soft-tissue injuries as minimal displacement of the vertebral
      bodies or as a high signal intensity in the disc space, indicating a hematoma.
      Seven of the ten patients demonstrating soft-tissue injuries also had an
      intramedullary lesion, while in five of the 15 patients with normal CT scans,
      only a medullary lesion was present on MRI. In 11 patients and two postmortem
      specimens, fractures were seen on roentgenograms and CT scans. In these patients,
      the CT was superior to the MRI in detecting small bony fragments, but the
      medullary lesions were visible only on the MRIs. An intramedullary low signal
      intensity corresponded to macroscopically visible hemorrhages in the three
      postmortem specimens. The MRI provided important information in patients with
      neurologic deficits. No obvious pathologic changes were evident on the
      roentgenograms and CT scans. The MRI also demonstrated intramedullary and
      extramedullary soft-tissue lesions and was useful in establishing a diagnosis and
      in choosing appropriate therapy. CT, on the other hand, was superior in detecting
      small bony fragments and fracture lines.

PMID- 2225623
TI  - HTLV-I viral-associated myelopathy after blood transfusion in a multiple trauma
      patient.
AB  - This may be the first documented case in the United States and in the orthopedic
      literature of transfusion-transmitted human T-cell leukemia virus Type I (HTLV-I)
      associated myelopathy (HAM). Progressive myelopathy occurred in a 58-year-old
      white man with serologic and molecular evidence of HTLV-I infection after
      multiple trauma and subsequent transfusion with multiple units of banked blood
      products. Symptoms of myelopathy occurred 15 months after the transfusions.
      Myelopathy from HTLV-I infection simulates a disorder of orthopedic interest.
      Physicians should be aware of the symptoms of HAM and unexplained myelopathy.

PMID- 2225624
TI  - Anterior acromioplasty for treatment of the shoulder impingement syndrome.
AB  - Between 1975 and 1979, anterior acromioplasty was performed in 65 patients with
      66 involved shoulders. The procedure appears to be safe and reasonably effective.
      Of the 65 patients in this study, 50 had chronic tendon inflammation with
      fibrosis, and 16 also had a small supraspinatus tendon tear. These 16 had rotator
      cuff repairs. Twenty-six patients were also treated with distal clavicle
      excision, and seven had tenodesis of the long head of the biceps brachii. The
      average age of the patients was 50 years (range, 23-75 years). All patients were
      followed for an average of eight years (range, three to 13 years). At final
      evaluation, no or slight pain was present in 77% of the shoulders: 39 of 50
      without tendon tearing and 12 of 16 with tendon tearing and repair. Active
      shoulder abduction averaged 167 degrees. Ninety-two percent returned to
      employment, including 18% with some job modification. Eighty-six percent returned
      to recreational athletics, 20% with some modification of activities. Seven
      patients had additional surgical treatment. The progression of rotator cuff
      disease is not always prevented, but the need for subsequent shoulder treatment
      generally decreases.

PMID- 2225625
TI  - Humeral head retroversion in patients with unstable humeroscapular joints.
AB  - Humeral head retroversion and shoulder rotation in both the frontal and scapular
      plane were studied in 34 patients with anterior glenohumeral instability. Twenty
      two patients had traumatic anterior shoulder dislocations and another 12 patients
      had nontraumatic dislocations with generalized joint laxity. Patients with
      traumatic recurrent dislocations had a smaller than normal retroversion angle in
      the unstable shoulder. The angles were 26 degrees on the dominant side and 23
      degrees on the nondominant side compared with 33 degrees and 29 degrees,
      respectively, in normal shoulders. The stable contralateral shoulder joint was
      clinically and roentgenographically similar to the normal shoulder. The patients
      with nontraumatic dislocations had increased rotation and smaller retroversion
      angles, irrespective of stability in the shoulder joint. The retroversion angles
      were 18 degrees for unstable shoulders on the dominant side and 15 degrees on the
      nondominant side. The retroversion angle of the stable contralateral joint in
      these patients was less in five of eight shoulders.

PMID- 2225626
TI  - Chondrosarcoma complicating total hip arthroplasty in Maffucci's syndrome.
AB  - A 70-year-old woman who was followed for 60 years for Maffucci's syndrome
      required a total hip arthroplasty (THA) of the right hip for degenerative
      arthritis. This did not relieve pain. Three years later, chondrosarcoma of the
      femur developed around the femoral component and was fatal. The roentgenographic
      changes after the THA were incorrectly interpreted as being caused by infection.

PMID- 2225627
TI  - Total hip arthroplasties in patients younger than 45 years. A nine- to ten-year
      follow-up study.
AB  - Eighty-one cemented total hip arthroplasties in patients younger than 45 years
      were reviewed with an average 9.2-year follow-up interval. The results were
      compared with the same group previously reported at an average follow-up time of
      4.5 years. Clinically satisfactory results were 58% compared with 78% at 4.5
      years. The revision rate almost tripled to 33%. Impending failure was present in
      56% of those hips not yet revised. In the first study, technique was a primary
      determinant of success. In this report there was no influence of technique on the
      incidence of revision. Age did not influence revision rates either, with 35% in
      patients younger than 30 years and 32% in patients aged 30-45 years. Patients
      younger than 30 years had fewer satisfactory clinical results and a higher rate
      of impending failure. As in the first study, the best results were obtained in
      patients with inflammatory collagen disease aged from 30 to 45 years.

PMID- 2225628
TI  - Femoral neck fractures in patients receiving long-term dialysis.
AB  - The morbidity and mortality of 11 femoral neck fractures were analyzed to compare
      operative and conservative management of femoral neck fractures in dialysis
      patients. All fractures occurred in older men with severe cardiac, pulmonary,
      gastro-intestinal, and neurologic conditions and with advanced renal
      osteodystrophy. Six of the seven operated patients survived the surgery and
      achieved varying degrees of ambulation. Stability of the operated hip was
      excellent in each case. Post-operative complications included transient
      confusional state related to narcotics, pneumonia, decubitus ulcers, and severe
      hypoalbuminemia. All four patients who were managed conservatively died from
      complications of the fracture. Progressive deterioration was noted in each
      nonoperated patient, with confusion caused by narcotics and analgesics,
      pneumonia, hepatic coma, decubitus ulcers, severe depression, and severe
      hypoalbuminemia. Therefore, operative management was superior to conservative
      management for femoral neck fractures of patients receiving chronic dialysis with
      multiple medical problems and advanced renal osteodystrophy. Narcotics must be
      used with great caution, and efforts should be directed toward prevention of
      malnutrition and decubitus ulcers.

PMID- 2225630
TI  - Complications associated with limb salvage for extremity sarcomas and their
      management.
AB  - A retrospective clinical review of 100 consecutive patients with extremity
      sarcomas managed by limb salvage operations was performed to evaluate local tumor
      control and morbidity. The mean follow-up period was 45.1 months. Overall
      survival was 86%. There were local recurrences in 3% of patients, and 26
      complications in 22 patients. Wound necrosis was the most frequent complication.
      Failure of allogeneic bone graft operations occurred in 25 patients. Most of the
      complications were salvageable without loss of limb. Limb salvage is an
      acceptable surgical treatment of extremity sarcomas based on adequate local
      control and minimal morbidity.

PMID- 2225629
TI  - Mechanical measures in the prophylaxis of postoperative thromboembolism in total
      knee arthroplasty.
AB  - Total knee arthroplasty patients are at high risk for deep venous thrombosis and
      pulmonary embolism. Prophylaxis against deep venous thrombosis and pulmonary
      embolism in these patients seems mandatory. Pharmacologic agents such as dextran
      40, aspirin, and warfarin are effective but may be associated with significant
      complications such as drug reaction, bleeding, hematoma, and hemarthrosis.
      Heparin was not effective and was associated with significant bleeding
      complications. Mechanical methods such as continuous passive motion and
      sequential pneumatic compression stockings were without complications and seemed
      equal to or more effective than pharmacologic agents. Adding warfarin to
      mechanical methods did not seem to augment the antithromboembolic effect of the
      mechanical methods.

PMID- 2225631
TI  - Giant-cell reparative granuloma of the hand and foot bones.
AB  - Giant-cell reparative granuloma (GCRG) is an uncommon benign reactive
      intraosseous lesion. It occurs in the skull, jaw, hand, foot, and facial bones
      and rarely in other skeletal sites. It is a solitary, lytic, expanded lesion and
      infrequently may extend into the surrounding soft tissue. Histologically, it is
      composed of fibrous stroma with spindle-shaped fibroblasts, multinucleated giant
      cells, and inflammatory mononuclear cells. Areas of hemorrhage are uniformly
      present. It may be difficult to distinguish this entity from an aneurysmal bone
      cyst, giant-cell tumor, or brown tumor of hyperparathyroidism because of
      roentgenographic and histologic similarities. Accurate diagnosis is essential for
      appropriate treatment; serum calcium, phosphorus, and parathyroid hormone levels
      should be measured. Curettage and bone graft are effective treatments for both
      primary lesions and recurrences. Second recurrences are rare.

PMID- 2225632
TI  - Leiomyoma of a digital artery.
AB  - Benign, soft-tissue masses of the hand are common. A vascular leiomyoma is an
      unusual tumor of smooth-muscle origin. In a 62-year-old man, the tumor arose from
      within a digital artery. Persistent symptoms prompted an excisional biopsy,
      requiring resection of a portion of the artery. Adequate collateral circulation
      preempted the need for a vascular graft. Vascular repair or grafting may be
      necessary if collateral circulation is not adequate.

PMID- 2225633
TI  - Immune responses to allogeneic and xenogeneic implants of collagen and collagen
      derivatives.
AB  - Whereas xenogeneic collagen has provided a safe and effective biomaterial for
      numerous medical applications, there are few instances in which data permit the
      correlation of the immunologic profile of well-defined devices with their
      clinical sequelae. A major exception is the use of injectable bovine dermal
      collagen for soft-tissue contour correction. The low incidence of
      hypersensitivity has been studied in the context of clinical efficacy and safety
      with several devices. The findings indicate that such immunity usually results in
      the manifestation of local symptoms of dermal inflammation at sites of treatment
      that resolve as the implant is resorbed by the host. In contrast, more
      immunogenic hemostatic agents may elicit a more frequent or vigorous immune
      response that is not clinically visible or relevant in that application. Recent
      experiences with collagen-based devices for the repair and regeneration of bone
      have also demonstrated that the presence of immunity to their collagenous or non
      collagenous components does not necessarily predict adverse clinical sequelae.
      Indeed, numerous specific data indicate that this immunity can exist as an
      epiphenomenon with no effect on osteogenesis. To get a true composite picture of
      biocompatibility, significant steps must be taken to characterize biomaterials
      properly and to ensure that immunologic, clinical, histologic, and other
      pertinent laboratory data are viewed in relation to one another and not in
      isolation.

PMID- 2225634
TI  - Primary inflammatory reaction in synovial fluid and tissue in rabbit
      immobilization osteoarthritis.
AB  - The kinetics and composition of the primary cellular inflammatory process were
      studied in the synovial fluid (SF) and synovial tissue (ST) compartments of a
      rabbit knee immobilization osteoarthritis model. Immobilization induced rapid
      migration of neutrophils (59% +/- 26% of all cells) into SF in three days, which
      was accompanied by nonspecific esterase-positive monocytes (71% +/- 8% of all
      mononuclear cells). This finding suggests that non-specific inflammation mediated
      by phagocytic leukocytes predominates the cellular response in the SF
      compartment. In contrast, morphometric analysis of ST proper showed an
      inflammatory mononuclear cell response, the intensity of which diminished over
      time during the study period from Day 3 (416 +/- 59 cells per 0.049 mm2 ST
      tissue) through Day 10 (305 +/- 32 cells) to Day 35 (174 +/- 36 cells). A dotlike
      T-pattern alpha-naphthyl acetate esterase (ANAE) was found in the T-cell
      dependent areas of secondary lymphatic tissue in the spleen, enabling
      immunocytologic ANAE marker studies. The ST response in situ was predominated by
      tissue macrophage, though infiltrates rich in T lymphocytes were present in the
      immediate sublining stroma. There was a significant correlation between the
      intensity of the SF cell response (total recovery) and the percentage of
      neutrophils, but there was no correlation between the intensity of the ST
      response and the proportion of T lymphocytes. These T-cell accumulations together
      with the local proliferation of fibroblastlike lining cells and stromal
      fibroblasts suggest that the primary inflammatory cell response is not caused by
      either wear and tear or mechanically by cartilage fragments.

PMID- 2225635
TI  - Long-term morphology of spastic or flaccid muscles in spinal cord-transected
      rabbits.
AB  - Despite difficulty in long-term maintenance of spinalized rabbits, muscular
      pathologic changes in chronic spinalized rabbits could be observed for a period
      of four weeks. Rabbits were prepared by spinal cord transection at T10 (spastic
      paralysis) or by spinal cord removal below L7 (flaccid paralysis). Spastic
      preparations showed hind-limb spasticity and reflex incontinence one to two days
      after operation. Hypertrophic fibers began to appear in spastic muscles after two
      weeks. This hypertrophy, thought to be caused by phasic repetitive contraction,
      was verified by electron microscopy to be different from normal exercise
      hypertrophy. Flaccid preparations maintained hind-limb flaccidity and overflow
      incontinence. In flaccid muscle, marked muscle fiber necrosis indicated rapid
      atrophy. Spinal deformity and joint contracture inactivate spinalized rabbits,
      and cause pressure sores. However, feeding assistance and avoidance of
      complications make long-term maintenance possible.

PMID- 2225636
TI  - A double-blind study on the effects of a capacitively coupled electrical field on
      bone ingrowth into porous-surfaced canine total hip prostheses.
AB  - The effect of a capacitively coupled electrical field on bone ingrowth into
      titanium fiber mesh porous-surfaced canine total hip arthroplasties (THAs) was
      investigated in a double-blind experiment. The electrical field was induced by an
      external source delivering a 60-kHz 5-6-V peak-to-peak sinusoid voltage through
      skin electrodes. No significant increase in the ingrowth of bone into the porous
      coating occurred at the end of six weeks of electrical stimulation. The amount of
      bone that grew into the porous surface, the areal density of bone within the
      available pore space, and the extent of the prosthesis surface area with bone
      ingrowth or apposition were not significantly different in the control and
      stimulated groups. This particular form of electrical stimulation does not
      improve bone ingrowth into porous-surfaced canine THAs by six weeks.

PMID- 2225637
TI  - An operation for displaced semilunar cartilage. 1885.

PMID- 2225638
TI  - Important modality available in the diagnostic armamentarium of septic arthritis
      of the hip is ultrasonography.

PMID- 2225639
TI  - High tibial osteotomy (HTO) is an effective procedure for medial and
      patellofemoral disease.

PMID- 2225641
TI  - The effect of femoral component position on patellar tracking after total knee
      arthroplasty.
AB  - In a laboratory study, seven fresh anatomic knee specimens were evaluated to
      define the three-dimensional motions of the patella before and after total knee
      arthroplasty (TKA) with the AMK knee. The patella was displaced medially by an
      average of 4 mm and tilted medially by an average of 4 degrees after standard
      TKA. Medial translation or internal rotation of the femoral component further
      displaced and tilted the patella medially, but lateral translation or external
      rotation of the femoral component produced less predictable changes in patellar
      tracking. The patterns of patellar tracking after external rotation of the
      femoral component came closer to reproducing those of the intact knee than any
      other femoral component position. The high lateral ridge on the femoral component
      effectively prevents patellar dislocation but may produce abnormally high
      stresses on the patellar implant, especially if the implant is medially displaced
      or internally rotated. This could lead to accelerated wear or loosening of the
      patellar component.

PMID- 2225640
TI  - Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee
      arthroplasty.
AB  - Twenty-five patients who received bilateral total knee prostheses were studied to
      evaluate the advantages and disadvantages of patellar resurfacing. Only patients
      with advanced patellofemoral disease were included in the study. In all patients,
      patellar resurfacing had been done in the right knee but not in the left knee.
      The DePuy porous-coated implant was used in all cases. Subjective criteria were
      compared with objective criteria, which included range of motion, knee flexion
      and extension, and roentgenographic evaluation. The findings in this study
      suggest that patellar resurfacing can offer the patient a superior knee with
      regard to pain relief and strength.

PMID- 2225642
TI  - The use of metal-backed patellar prostheses in total knee arthroplasty.
AB  - Metal backing of polyethylene prosthesis components decreases deformity of the
      overlying polyethylene and enhances fixation to the underlying bone. Previous
      metal-backed patellar designs have often failed, primarily because of implant
      design and implantation technique. In 451 total knee arthroplasties using metal
      backed patellar prostheses, there were no implant failures. The implants were
      dome shaped and did not have a metal endoskeleton. The component was inset into
      the patellar bone so that the base plate was below the superficial surface of the
      bone. These factors maximized polyethylene thickness and prevented wearing
      through to the metal base plate. The advantage of metal backing is that it
      strengthens the component and allows for possible biologic ingrowth. In this
      series, the combination of implant design and implantation technique may have
      eliminated serious problems seen with other metal-backed patellar implants.

PMID- 2225643
TI  - The inwardly pointing knee. An unrecognized problem of external rotational
      malalignment.
AB  - Twelve patients with inwardly pointing knees had chronic knee pain and disability
      suggestive of patellofemoral subluxation. None had responded well to conservative
      measures or surgical correction at the level of the soft tissues. Their pattern
      of limb alignment was studied roentgenographically and was found to differ
      significantly from the control group of 49 healthy young adults. The deformities
      primarily related to the tibia were external tibial torsion, excess varus
      angulation of the tibial plateau, and varus knees. Angulation of the femoral
      condyles was normal and femoral anteversion did not appear to contribute
      significantly to the deformity. Surgery in seven cases (nine knees) was by
      derotation valgus Maquet osteotomy of the tibia and lateral release realignment
      of the patellae. Outcome assessments after a three-year follow-up period (five
      knees) were excellent. Early results on the remaining cases were satisfactory.

PMID- 2225644
TI  - Tibial tubercle osteotomy for exposure of the difficult total knee arthroplasty.
AB  - Tibial tubercle osteotomy provides a safe and reliable means of extensile
      exposure of the knee. A technique was developed using a long osteoperiosteal
      segment including the tibial tubercle and upper tibial crest leaving lateral
      muscular attachments intact to this bone fragment. The bone fragment was
      reattached to its bed with two cobalt-chromium wires passed through the fragment
      and through the medial tibial cortex. The procedure was used in 71 knees to
      expose the joint for total knee arthroplasty, and the follow-up period was one to
      five years. All healed uneventfully, and no significant complications occurred.
      Mean postoperative flexion was 97 degrees. No extension lag occurred, and mean
      flexion contracture was 2.5 degrees. Excellent exposure can be achieved by means
      of a viable bone flap below the knee. Early rehabilitation and weight bearing can
      be done with low potential for complications.

PMID- 2225645
TI  - Late recurrence of varus deformity after proximal tibial osteotomy.
AB  - One hundred thirteen knees with medial gonarthrosis in 95 patients were treated
      by valgus-producing proximal tibial osteotomy and followed clinically and
      roentgenographically for a minimum of five years (mean, 6.3 years). Sixty-four
      knees (57%) were pain free or had only mild discomfort when walking. The standing
      femorotibial angle decreased from a postoperative average of 9.3 degrees valgus
      to 7.8 degrees valgus at the final follow-up examination. The tendency for varus
      recurrence greater than 5 degrees and for medial- or lateral-compartment
      arthritic progression was evaluated using the Kaplan-Meier survival method. Varus
      recurred in 18%, lateral-compartment arthritic progression in 60%, and medial
      compartment arthritic progression in 83% by nine years after surgery. The
      probability of arthritic progression is much higher than the probability of
      significant varus recurrence in long-term roentgenographic follow-up studies of
      patients with valgus-producing proximal tibial osteotomies.

PMID- 2225646
TI  - Total knee arthroplasty fixation. Comparison of the early results of paired
      cemented versus uncemented porous coated anatomic knee prostheses.
AB  - The results of 18 matched pairs of Porous Coated Anatomic knee prostheses were
      studied to compare the early clinical and functional performance of cemented
      versus uncemented fixation with an average five-year follow-up period for both.
      The knee score improved from a preoperative average of 35 points to a
      postoperative average of 90 points in the cemented group, and from 38 points to
      93 points in the uncemented group. In particular, the individual pain scores and
      the range-of-motion values were well matched at the three-, six-, and 12-month
      follow-up visits and showed a steady improvement. Subjectively, all patients were
      pleased with the results of surgery; one-third preferred the cemented side, one
      third preferred the uncemented side, and one-third found no difference in the
      performance of either knee. The clinical and functional performance of knee
      prostheses in patients who had one cemented knee and one uncemented knee were
      comparable and possibly unrelated to the type of fixation method.

PMID- 2225647
TI  - Cemented and ingrowth fixation of the Miller-Galante prosthesis. Clinical and
      roentgenographic comparison after three- to six-year follow-up studies.
AB  - One hundred thirty-nine cemented and 132 cementless Miller-Galante total knee
      prostheses were followed between three and six years (average, 43-44 months). The
      fixation technique was based on patient age, bone quality, and ability to delay
      full-weight bearing. Clinical follow-up studies were possible on 116 cemented
      knees. Fifteen knees were lost because of death before the three-year follow-up
      study, and eight knees required component removal. One hundred twenty-three
      cementless knees were available for clinical follow-up studies; there were three
      deaths, and six failures required component removal. No cemented failure was due
      to fixation, and three cementless failures were due to lack of tibial ingrowth in
      two and pain of undetermined etiology in one. Preoperative knee scores were
      slightly significant with cemented knees averaging 48 points and cementless knees
      averaging 52 points. A similar significant difference was maintained at the final
      follow-up study. No significant differences were noted for pain, limp, or support
      scores. Average range of motion was similar in the two groups. Radiolucent lines
      about the femoral component were rare. Cementless tibial radiolucencies were
      partial in up to 20% of examined zones, and complete tibial tray radiolucency was
      seen in only three patients. No correlation between radiolucency and knee scores
      was seen.

PMID- 2225648
TI  - Two- to four-year results of posterior cruciate-sparing condylar total knee
      arthroplasty with an uncemented femoral component.
AB  - One hundred fourteen hybrid Press-Fit Condylar total knee arthroplasties (TKAs)
      were reviewed an average of 2.8 years after surgery to determine if this method
      of implantation provided satisfactory results compared with conventional cemented
      TKAs. Ninety-three percent of the knees had good or excellent results, and 94% of
      the knees had at most only mild or occasional pain. One knee with a metal-backed
      patella was revised for mechanical failure of the patellar button.
      Roentgenographic analysis of the femoral component interface showed that 30% of
      knees had a radiolucent line in at least one zone. However, none of the lines was
      wider than 1 mm, and none was about the central stem. There were no signs of
      loosening about any of the components. It was concluded that hybrid TKA provides
      a good and predictable result that is comparable to cemented TKA.

PMID- 2225649
TI  - Review of the all-polyethylene tibial component in total knee arthroplasty. A
      minimum seven-year follow-up period.
AB  - A retrospective analysis of 144 total knee arthroplasties was performed between
      1975 and 1981 with a minimum follow-up period of seven years. A posterior
      cruciate condylar prosthesis was used in each procedure. Patients were followed
      clinically and roentgenographically, and a set of statistical variables was
      established based on elevation in joint line, tibial component angular alignment,
      overall limb alignment, and position of the tibial component on anteroposterior
      and lateral roentgenograms. Review of the study group found that the Hospital for
      Special Surgery knee scores improved from a preoperative score of 55 to a
      postoperative score of 88, with 94.5% having good or excellent results. The mean
      postoperative range of motion was 106 degrees with a mean extension of -0.3
      degrees. Radiolucencies developed in 41% of the knees with 5% of the knees having
      progressive radiolucencies. Eight knees were considered failures based on
      clinical and roentgenographic evaluations. Factors found to significantly affect
      the formation of radiolucent lines included a shift of the tibial component
      medially by greater than 4 mm, a varus tilt of the tibial component greater than
      2 degrees, and the diagnosis of rheumatoid arthritis. The only variable
      associated with aseptic loosening was an elevation of the joint line by greater
      than 8 mm.

PMID- 2225650
TI  - An all-polyethylene cementless tibial component. A five- to nine-year follow-up
      study.
AB  - An all-polyethylene cementless tibial component was used in 221 total knee
      arthroplasties. With one exception, failures did not occur before three years.
      Failure was characterized by medial subsidence of the tibial component. There was
      abrasion of the polyethylene on the undersurface of all components that failed.
      Survivorship was seven to nine years (87.1%). This study demonstrated that a
      flexible cementless component can function well when used with any type of bone.
      However, abrasion of the polyethylene that occurs from shearing forces is a
      concern. Polyethylene components need adequate provisions to prevent shearing or
      need surface treatment to prevent abrasion.

PMID- 2225651
TI  - A correlative study of the geometry and anatomy of the distal femur.
AB  - Sixteen knees were examined roentgenographically in the lateral plane. Ten knees
      were examined from autopsy subjects. The distal articular femur may be
      represented by three circular surfaces: (1) the floor of the patellar groove
      (articulating with the patella from 10 degrees to 100 degrees), (2) the posterior
      femoral condyles (articulating with the tibia from 10 degrees to 150 degrees),
      and (3) the distal condyles (articulating with the tibia from 0 degrees to 10
      degrees). The radii of these surfaces, their angular arcs, and the distances
      between their centers varied with the size of the femur but fell within a narrow
      range. The radii of the patellar groove and the posterior femoral condyles
      averaged 24 mm and 21 mm, and the average angle subtended by these arcs was 90
      degrees and 140 degrees, respectively. The average distance between the centers
      of these two circles was 20 mm. The femoral attachment of the synovial and
      patellar retinacular reflections was found in the area of the center of the
      patellar groove circle. The femoral attachments of the medial collateral and
      posterior cruciate ligaments and of the lateral collateral and anterior cruciate
      ligaments were found to be in the area of the center of the circle of the medial
      and lateral posterior femoral condylar circles, respectively.

PMID- 2225652
TI  - [Short-latency somatosensory evoked potentials and magnetic resonance imaging in
      the medial medullary syndrome].
AB  - A 57-year-old woman was admitted to Kakeyu Hospital complaining of paresis of the
      left upper and lower extremities which suddenly developed three years ago.
      Neurological examination revealed spastic paresis of the left upper and lower
      limbs without facial and lingual paresis. The reflexes were abnormally brisk on
      both sides but they were more remarkable on the left side, which also showed
      Babinski's sign. Sensitivity to light touch and vibration was moderately
      decreased and sensitivity to pinprick and joint position was minimally decreased
      in the left upper and lower extremities. No cerebellar sign was observed. Needle
      EMG disclosed large motor units with an amplitude of 4-5 mV and a duration of 8
      msec in the light half of the tongue during weak contraction. MRI using a 0.5-T
      superconducting magnetic resonance unit detected a small, wedge-shaped infarction
      in the anterior medial portion of the medulla just below the pontomedullary
      junction. Somatosensory evoked potentials (SEPs) after median nerve stimulation
      with a non-cephalic reference were recorded. After stimulation of the left side,
      the scalp-recorded P13 was recognized at the normal latency, but the later
      components, N16 and N18, were apparently absent. On the other hand, SEPs in
      another case with thalamic hemorrhage revealed normal N16 potential with absence
      of N18 on the affected side. From these SEP findings and the reports on SEPs in
      lesions of the brain stem or thalamus, it was suggested that P13 is abnormal in
      lower medullary lesions and is preserved in upper medullary lesions, and that N16
      is abnormal in brain stem lesions and is preserved or changed a little in
      thalamic lesions.

PMID- 2225653
TI  - [An MRI study of hereditary spinocerebellar degenerations].
AB  - We evaluated magnetic resonance image (MRI) in 21 cases of hereditary
      spinocerebellar degenerations (SCD) of autosomal dominant trait. By the
      discriminant formula based on size of the cerebellar vermis and ventral pons,
      which was reported in our previous study, the patients were classified into three
      types. Group 1 included the cases with atrophies in the vermis and pons; OPCA
      type. Group 2 showed vermian atrophy and less significant atrophy in pons; LCCA
      type. And Group 3 was no significant atrophies both in vermis and pons. Cases in
      Group 1 were furthermore divided into two groups according to width of the
      midbrain tegmentum. Group 1A, with normal midbrain tegmentum, was consisted of
      five cases. Four cases were diagnosed as Menzel type OPCA. Another case showed
      various clinical symptoms and relatively mild atrophies for his duration of
      illness. His family members were classified to Group 3. Seven cases in Group 1B
      showed reduced midbrain tegmentum. Four cases showed ataxia, spasticity, ocular
      symptoms, bladder dysfunction and amyotrophy with or without fasciculation, and
      they seemed to be a special type of SCD mimicking Joseph disease. One case showed
      bulging eyes, ocular movement palsy and dystonia. However, his sister manifested
      only ataxia with very mild ocular movement disorder. Their MRI demonstrated
      severe atrophies in the cerebellum, pons and afferent cerebellar peduncli, and
      this pedigree was thought to be Menzel type OPCA with various associated
      disorders. Another case was clinically diagnosed as dentate-rubro-pallido-luysian
      atrophy. Group 2 was consisted of 6 cases who were clinically diagnosed as Holmes
      type LCCA. MRI demonstrated medial dominant cerebellar atrophy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2225654
TI  - [Biochemical study on different situations of type 2C fiber in rats].
AB  - Type 2C fibers from the soleus, gastrocnemius and extensor digitorum longus
      muscles of the rats were histochemically and biochemically examined in three
      different conditions; muscles in the neonatal stage, after neonatal denervation
      and on regenerating process after bupivacaine induced injury. On histochemical
      examination, neonatal muscles contained 100% of type 2C muscle fibers in all
      muscles examined, denervated muscles 94% in soleus, 42% in gastrocnemius and 57%
      in extensor digitorum longus and bupivacaine treated muscles 90%, 61% and 73% of
      type 2C fibers, respectively. On biochemical analyses, the triglyceride was the
      smallest and glycogen the largest in amount in all neonatal muscles, triglyceride
      was the largest and glycogen low in amount in neonatally denervated muscles, both
      triglyceride and glycogen were low in amount in bupivacaine treated regenerating
      muscles. And the fatty acid compositions of triglyceride were also different in
      different type 2C fibers. These results suggested that though histochemical
      characteristics are the same, significant differences in biochemical properties
      are present between type 2C fibers of these three conditions in that there are
      the smallest amount of triglyceride and the largest amount of glycogen in
      denervated muscles, are both low amount of triglyceride and glycogen in
      regenerating fibers.

PMID- 2225656
TI  - [A case of flexion myelopathy presenting juvenile segmental muscular atrophy of
      upper extremities--a successful treatment by cervical spine immobilization].
AB  - A 24-year-old man was well until 1982, when he noticed weakness and atrophy of
      right arm especially those of biceps muscles. These symptoms did not progress
      until 1988. In 1988 weakness of left elbow flexion appeared and he was admitted
      to our hospital. On examination, he had weakness and atrophy of both upper
      extremities. Fasciculation was noticed in the proximal part of right arm. When
      his head was bent forward, dysesthesia appeared around radial side of his arm.
      There were no long tract sign or objective sensory loss. EMG showed neurogenic
      change over both his upper extremities. In plain cervical roentgenogram there
      existed abnormal kyphosis of cervical vertebrae. In MRI imaged with his neck
      flexed, cervical cord was compressed by the posterior surface of 4th cervical
      vertebral body, which corresponded to the top of cervical kyphosis. Based on
      these signs and examinations, a diagnosis of flexion myelopathy was made. Spinal
      immobilization by wiring and bone graft implantation ranging from C2 to C6 was
      performed to limit the range of anterior nuchal flexion. After this operation,
      improvement of muscle strength along with the disappearance of dysesthesia on
      neck flexion was observed. Clinically, this case closely resembles to juvenile
      type of distal and segmental muscular atrophy of upper extremities (Hirayama
      type). From our study, pathomechanism of this case seems to be a flexion
      myelopathy at C4 level. This view is supported also by the good recovery after
      the operation. This case suggests that nonprogressive atrophy of upper
      extremities due to flexion myelopathy can be successfully treated by cervical
      spine immobilization.

PMID- 2225655
TI  - [Calf impedance plethysmographic evaluation of peripheral sympathetic nerve
      activity--comparison with microneurographic analysis].
AB  - Although the method of impedance plethysmography made it possible to evaluate the
      vascular resistance of lower extremities, the actual correlation to the
      sympathetic nerve activity is not known. We performed examinations of
      microneurography and impedance plethysmography of the lower extremities, in six
      healthy volunteers, placed on a tilting table. Blood pressure, heart rate, muscle
      nerve sympathetic activity to calf muscles (microneurography), calf vascular
      resistance (impedance plethysmography) were simultaneously recorded with
      increasing angles of the head-up tilting (0, 30, 60 degrees). With the increase
      of tilting angles, sympathetic nerve activity and the calf vascular resistance
      significantly increased and these values were statistically correlated to the
      increase of tilting angles (expressed as sine function). Moreover, a
      statistically significant positive correlation was observed between the
      sympathetic nerve activity and vascular resistance. We concluded that the
      impedance plethysmographic method for measurement of calf vascular resistance is
      a good indicator for evaluating the peripheral sympathetic nerve activity.

PMID- 2225657
TI  - [A case of acute mountain sickness with bilateral lesion of pallidum].
AB  - The patient was 56-year-old female, who suffered from ataxia and then fell into
      coma on the next day after she had moved from the sea level to an altitude of
      4,200 m. After she was brought to lower altitude, consciousness recovered within
      several hours. For about 2 days thereafter, disorientation was observed, and she
      was diagnosed as AMS (acute mountain sickness). Only insomnia continued in
      chronic stage. The results of X-ray computed tomography (CT) on 25th day after
      the onset of the disease revealed no abnormal finding except the slightly
      increasing uptake of contrast material. Symmetrical low density regions were seen
      in bilateral basal ganglia after one year, and the globus pallidus lesions were
      confirmed by magnetic resonance imaging. In the past, cerebral edema has been
      reported in most cases of AMS, and the neurotic symptoms of AMS have been
      attributed to cerebral edema, while the essential condition of this disease is
      not yet elucidated. In the present case, the globus pallidus lesions could be
      identified through the following-up of the central nervous system by X-ray CT and
      MRI as the first attempt for the case of AMS. There has been no report of globus
      pallidus lesions in the cases of AMS. Whereas low oxygen partial pressure is the
      primary cause of AMS, and it is highly probable that the disorders in globus
      pallidus as reported in the cases of carbon monoxide poisoning, anesthetic
      accident, etc. are related to the occurrence of AMS.

PMID- 2225658
TI  - [A case of idiopathic hypoparathyroidism with extrapyramidal signs and insulin
      dependent diabetes mellitus].
AB  - A case of a 29-year-old woman with idiopathic hypoparathyroidism was reported.
      There were neither endocrine nor neurological disorders among her family, except
      for her mother's hearing loss. She had been suffering from insulin-dependent
      diabetes mellitus since 21 years of age, and was noticed to be hard of hearing
      for several years, but never been examined. At the age of 27, choreic movement on
      her left upper limb and gait disturbance appeared. A year before admission, gait
      disturbance gradually developed and she could not walk any more. On admission,
      her height was 137.2 cm and her weight 36.5 kg. She had a round face, uneven
      teeth and borderline metacarpal sign on her right hand. On neurological
      examination, Parkinsonism, bucco-lingo-masticatory dyskinesia and bilateral
      extensor planter reflex were present, but tetany was not observed anywhere. Serum
      calcium was 3.9 mEq/l, and serum phosphorus 5.3 mEq/l. A CT scan of brain
      revealed calcifications in the bilateral basal ganglia and thalami, low density
      area in the left putamen, and atrophy of both caudate nuclei. Serum PTH was less
      than 100 pg/ml. Ellsworth-Howard's test showed hyperresponsiveness in the
      secretion of urinary phosphorus and cyclic-AMP. Other endocrinological studies
      showed no abnormality except for hyporesponsiveness in the secretion of insulin
      on glucose tolerance test. On the basis of these results, a diagnosis of
      idiopathic hypoparathyroidism with insulin-dependent diabetes mellitus was made.
      Administration of alfacalcidol returned serum calcium and phosphorus to normal
      with considerable clinical benefit. Parkinsonism was gradually improved and she
      became to be able to walk with a cane after one year of treatment. But buco-lingo
      masticatory dyskinesia were not reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225659
TI  - [A case of Cogan's syndrome associated with multiple cranial neuropathy].
AB  - A 52-year-old woman was admitted to our hospital because of disturbance of right
      visual acuity and double vision. At 38-year-old she became deaf bilaterally and
      experienced many vertigo attacks. She was diagnosed as Meniere disease. At 45
      year-old vertigo attacks disappeared. At 47-year-old right peripheral facial
      nerve palsy developed transiently with interstitial keratitis and episcleritis of
      the both eyes. Oral adrenocorticosteroid therapy produced an improvement of
      interstitial keratitis and episcleritis. On admission, ophthalmological
      examination revealed bilateral interstitial keratitis and episcleritis, right
      retrobulbar optic neuritis and she was proven to have bilateral sensorineural
      deafness by otologist. Neurological examination revealed right abducens nerve
      paresis. Laboratory examinations revealed slightly increased erythrocyte
      sedimentation rate. CRP was positive. Serological tests for syphilis were
      negative. CSF showed mildly elevated protein level. Orbital CT scans revealed the
      swelling of right optic nerve. Cerebral MRI showed multiple high spotty areas in
      left thalamus, bilateral basal ganglia and deep white matter in T2 weighted
      images. After treatment with adrenocorticosteroid, right optic neuritis and
      abducens nerve paresis improved together with bilateral interstitial keratitis
      and episcleritis. Multiple cranial neuropathy may develop with Cogan's syndrome.

PMID- 2225660
TI  - [Duchenne muscular dystrophy carrier presenting with mosaic X chromosome
      constitution and muscular symptoms--with analysis of the barr bodies in the
      muscle].
AB  - A 53-year-old female with muscular symptoms and incomplete Turner's syndrome was
      presented. She had two sons with Duchenne type muscular dystrophy (DMD). Her
      muscular symptoms became apparent at age 52 years, and her elevated serum CK, EMG
      and pathological findings of the biopsied muscle were consistent with muscular
      dystrophy. Her cytogenetic analysis from the cultured lymphocytes and fibroblasts
      showed a 45XO/46XX/47XXX chromosome constitution. Analysis of number of Barr
      bodies in the muscle specimen revealed that the total number of the bodies were
      significantly decreased in this case than in the control muscles. The result
      indicated that nuclei of 45XO karyotype were evidently present in her muscle and
      contributed to the process of muscle fiber breakdown as a major pathogenetic
      factor. However, inactivation of normal X chromosome also concerned the
      pathologic process because there were nuclei with Barr bodies in the damaged
      fibers as well. Only seven cases with X chromosome mosaicism and muscular
      symptoms attributable to DMD gene were seen in the literature. Four of them
      showed rather typical clinical features of DMD, but the muscular symptoms were
      much milder in the remainder, and patients were still able to walk in their
      middle lives. It was presumed that the severity of the clinical symptoms was
      parallel to the ratio of 45XO karyotype in the total number of muscular nuclei.

PMID- 2225661
TI  - [A case of juvenile Alzheimer's disease with various neurological features such
      as myoclonus, showing grumose degeneration in the dentate nucleus].
AB  - A case of juvenile Alzheimer's disease with various neurological features such as
      myoclonus, also showing grumose degeneration in the dentate nucleus was reported.
      In a 35 year old woman, at first myoclonus, and 5 years later, progressive
      dementia were found. She, then, fell into apallic syndrome 9 years later, and
      died of pneumonia at the age of 53. She had no particular family history.
      Neurological examination disclosed cerebellar ataxia, left hemiparesis,
      convulsion in addition to myoclonus. Neuropathologically, there were a lot of
      senile plaques and neurofibrillary tangles in the cerebral cortex. A marked
      myelin loss in the white matter and a neuronal loss in the basal ganglia were
      also found. And grumose degeneration in the cerebellar dentate nucleus
      distinctively characterize the present case. The myoclonus and cerebellar ataxia
      could be attributed to the grumose degeneration. Two similar cases had been
      previously reported. Juvenile Alzheimer's disease with grumose degeneration like
      the present case was considered to be one of the subgroups of Alzheimer's
      disease.

PMID- 2225662
TI  - [A case of narcolepsy with increased cataplectic attacks after suffering from
      cerebrovascular disease].
AB  - It is well known that narcoleptic patients have DR2 and DQw-1 on HLA typing. The
      development of narcolepsy is considered to depend on the two factors; genetic
      predispositions and exogenous factors such as head trauma, encephalitis, etc.,
      mainly affecting the brainstem or diencephalon. We reported a 46-year-old man who
      had occasional sleep attacks after suffering from left thalamic hemorrhage and
      pontine vascular disorders. Rehabilitation was markedly disturbed due to frequent
      episodes of cataplectic attacks which was triggered by emotional lability such as
      laughing, anxiety, and excitement. HLA type examination showed both DR-2 and DQw
      1 loci in the proband and his four other siblings. His elder brother also
      suffered from mild excessive daytime sleepiness during his younger age, but it
      subsided gradually. Analysis of overnight polysomnography in the patient revealed
      remarkable paradoxical alpha-blocking and frequent sleep onset REM stages as
      typically observed in narcoleptic patients. MRI examination showed multiple small
      hemorrhages and infarctions in the pontine tegmentum, in addition to the left
      thalamic hemorrhage and multiple subcortical ischemic lesions. Concerning the
      mechanism of frequent cataplexy in this patient, it is postulated that increased
      emotional incontinence might have stimulated the descending reticular system in
      the brainstem which in turn may inhibit anterior horn motor cell activities.
      Methylphenidate was initially given to the patient, resulting in some relief of
      attacks, and addition of imipramine dramatically suppressed cataplectic attacks.
      Imipramine is considered to inhibit the excitatory afferent pathway to the
      brainstem suppressing the hyperactivity of descending motor inhibitory system due
      to its anti-muscarinergic action.

PMID- 2225663
TI  - [MRI findings of the tongue in neurodegenerative diseases with bulbar sign].
AB  - We examined the magnetic resonance image (MRI) of the tongue in cases of
      amyotrophic lateral sclerosis (ALS), bulbo-spinal muscular atrophy (SBMA) and Shy
      Drager syndrome (SDS) with sleep apnea. ALS case with severe bulbar disorder
      showed atrophic, irregularly margin tongue with increased signal intensity in T1
      weighted MRI. ALS with less severe bulbar disorder demonstrated mixed
      hyperintensity and normointensity areas in the tongue. ALS without lingual
      symptoms showed increased intensity of tongue which suggested subclinical
      involvement of lingual muscle. BSMA case also showed atrophic tongue with
      diffusely increased signal intensity. SDS case with sleep apnea was revealed to
      have round shaped tongue without increased signal intensity, but his tongue fell
      into the posterior oral cavity, indicating hypotonus of genioglossus muscle. We
      concluded that MRI of the tongue is useful to determine the bulbar symptoms due
      to lower neuron disorder or not.

PMID- 2225664
TI  - [A microneurographic analysis of minor reflex sympathetic dystrophy with
      increased skin sympathetic activity--report of a case].
AB  - A 48-year-old man developed swelling, redness, and allodynia in his left palm.
      Routine physical and neurological examinations revealed no abnormal findings
      except for left palmar hyperhidrosis. A clinical diagnosis of minor reflex
      sympathetic dystrophy with causalgia was made. Skin sympathetic activity (SSA),
      dominating palm sweating and skin vasoconstriction, and discharges of single
      afferent fiber from the rapidly adapting-type I (RA-I) unit were recorded
      microneurography from the median nerve at the cubital fossa. SSA obtained from
      the affected side was significantly increased compared with that from the normal
      (right) side. The receptive field of RA-I unit in this case was larger than those
      of normal controls. Enlargement of the receptive field might suggest presence of
      collateral sprouting in the injured nerve fibers. Allodynia in the left palm was
      suspected to be resulted from misdirect sprouting between A alpha . beta to A
      delta . C fibers. Excessive sympathetic out flow to the skin is considered to be
      the cause of palmar hyperhidrosis, swelling with redness, and lowered pain
      threshold, since pain threshold is under regulation of SSA. It is concluded that
      these sensory and autonomic symptoms were resulted from increased sympathetic out
      flow to the skin and collateral sproutings in the peripheral nerve fibers.

PMID- 2225665
TI  - [Vasopressin effect and pathophysiological analysis on postprandial hypotension].
AB  - In order to clarify the effect of arginine vasopressin (AVP) on postprandial
      hypotension (PPH) in patients with multiple system atrophy, a loading test of 75
      g glucose in 225 ml water was performed during infusion of AVP (0.3 U/min). AVP
      (0.3 U/min) infusion prior to the loading was significantly effective for PPH in
      all patients: PPH following to oral intake of glucose was completely prevented.
      We conclude that infusion of AVP maintained circulating systemic blood volumes by
      reduced portal venous flow (after a reduction of portal venous inflow) as a
      result of vasoconstrictive effect of AVP on the splanchnic vessels in patients
      with PPH.

PMID- 2225666
TI  - Incidental demonstration of cerebral infarction on bone scintigraphy in sickle
      cell disease.

PMID- 2225667
TI  - Hepatic infarction detected on Tc-99m sulfur colloid imaging.
AB  - Hepatic infarctions are rarely encountered, and scintigraphic findings are
      reported even less frequently in this entity. A patient who developed a left
      hepatic lobe infarct after surgical resection of a celiac axis aneurysm is
      described and a brief review of hepatic infarction is presented.

PMID- 2225668
TI  - Fractionated doses of radioiodine for ablation of postsurgical thyroid tissue
      remnants.
AB  - Patients who have differentiated thyroid carcinoma and have undergone total
      thyroidectomy are treated with radioiodine for ablation of functional thyroid
      remnants. Administration of a single therapeutic dose in excess of 30 mCi of l
      131 requires hospitalization. In an attempt to obviate the necessity for
      hospitalization, the prospective ablative dose was divided into two or three
      fractions given at weekly intervals on an ambulatory basis. To assess the
      effectiveness of this approach, this group of patients was compared to a cohort
      of hospitalized patients treated with a single dose. Ablation was achieved in 9
      out of 12 patients treated in a fractionated manner (a 75% success rate), whereas
      in 16 out of 20 patients given a single dose the thyroid remnants were completely
      eradicated (an 80% success rate). That the use of split, smaller doses
      administered at weekly intervals on an ambulatory basis presents a reasonable
      alternative for ablation of postsurgical, residual-functioning thyroid tissue.

PMID- 2225669
TI  - The incidence of serious hemodynamic changes in physically-limited patients
      following oral dipyridamole challenge before thallium-201 scintigraphy.
AB  - Dipyridamole has liberalized referrals for stress TI-201 chloride (thallium)
      studies at the Iowa City Veterans Administration Medical Center. Seventy-five
      percent of referrals now receive dipyridamole and, unlike patients who tolerate
      conventional exercise testing, these patients are often quite debilitated.
      Therefore, the hemodynamic consequences of dipyridamole were reviewed in 120
      consecutive, physically-limited patients referred for thallium scintigraphy
      following an average oral dose of 5.4 mg/kg. Each patient's blood pressure was
      measured every 5 minutes for 1 hour after dipyridamole and compared with several
      clinical factors to determine if blood pressure change was predictable. In all
      patients, blood pressure changed from 136 +/- 21/83 +/- 15 (mean +/- 1 SD) to 117
      +/- 25/72 +/- 15 following dipyridamole administration. One hundred nine of the
      120 patients had a blood pressure decline from 137 +/- 21/82 +/- 12 to 113 +/-
      21/70 +/- 13. Of the 109, 43% (N = 47) had a systolic blood pressure decline
      greater than 20 mmHg, 16% (n = 18) greater than 40 mmHg, and 13% (n = 14) greater
      than 50 mmHg. Thirteen percent (n = 14) required emergent reversal of the
      dipyridamole with aminophylline. Significant hypotension is relatively common but
      generally unpredictable after oral dipyridamole. Therefore, patient eligibility
      criteria should be carefully considered; strict hemodynamic monitoring must be
      routine in the usual patient undergoing thallium scintigraphy after oral
      dipyridamole challenge.

PMID- 2225670
TI  - Ventilation-perfusion scintigraphy in an adult with congenital unilateral
      hyperlucent lung.
AB  - A variety of congenital and acquired etiologies can give rise to the radiographic
      finding of a unilateral hyperlucent lung. An unusual case of congenital lobar
      emphysema diagnosed in a young adult following the initial discovery of a
      hyperexpanded, hyperlucent lung is reported. Although subsequent bronchoscopy and
      radiologic studies detailed extensive anatomic abnormalities, functional imaging
      also played an important role in arriving at this rare diagnosis. In particular,
      ventilation-perfusion scintigraphy identified the small contralateral lung as the
      functional lung and helped narrow the differential diagnosis to etiologies
      involving obstructive airway disorders.

PMID- 2225671
TI  - Effect of proximal vagotomy and Roux-en-Y diversion on gastric emptying kinetics
      in asymptomatic patients.
AB  - The role of the distal stomach in gastric emptying was studied. Ten patients with
      proximal gastric vagotomy (PV) and 10 age-matched patients with Roux-en-Y gastro
      jejunostomy (R-Y) were compared with 10 healthy controls. Gastric emptying of
      solids and liquids was determined by the use of Tc-99m SC scrambled eggs and In
      111 DTPA. In PV, gastric emptying of both solids and liquids was delayed; the
      prolongation with solids was mainly accounted for by an abnormal lag phase. In R
      Y patients, no lag phase was observed, and the solid emptying curve pattern was
      characterized by early rapid emptying followed by very slow emptying. Both the
      solid and liquid phases were prolonged. The lag phase is affected by proximal
      vagotomy and is mainly determined by the distal stomach, which appears to be
      essential for normal emptying.

PMID- 2225672
TI  - Metastatic calcification in a patient with malignant parathyroid carcinoma.
      Correlation of clinical, surgical, radiographic, and scintigraphic findings.
AB  - A patient whose bone scan showed features typical of a "superscan," having
      extensive pulmonary, cardiac, and renal calcifications is described. Metastatic
      parathyroid carcinoma with renal insufficiency and phosphate retention are cited
      as the cause. Early diagnosis and surgical extirpation offer the best chance for
      cure or palliation. Pitfalls of plain film radiography in identifying metastases
      and pathologic soft tissue calcifications in the setting of severe
      hyperparathyroidism are discussed, and the advantages of functional radionuclide
      imaging assessments are emphasized.

PMID- 2225673
TI  - Heterotopic ossification. Effect on dual-photon absorptiometry of the hip.
AB  - Dual-photon absorptiometry (DPA) is now widely used to determine bone mineral
      density of the lumbar spine and hips. Because the resulting images are often not
      of sufficient resolution to identify many bone or soft tissue abnormalities that
      may influence results, clinical and radiographic correlation is necessary.
      Presented are two cases in which results of DPA of the hips were elevated because
      of the presence of heterotopic ossification.

PMID- 2225674
TI  - A porcelain gallbladder affecting the assessment of bone mineral content.
AB  - Dual-photon absorptiometry is a reliable method for the assessment of bone
      mineral content (BMC). The presence of focal bone disease, degenerative joint
      disease, or aortic calcifications may complicate the evaluation of BMC and may
      lead to erroneous findings. The misleading effect of a porcelain gallbladder is
      described.

PMID- 2225675
TI  - Deposition of radioaerosol throughout the major airways in tracheobronchitis.

PMID- 2225676
TI  - Breast uptake of gallium-67 citrate in disseminated Mycobacterium chelonei.

PMID- 2225677
TI  - Intravenous dipyridamole thallium-201 SPECT imaging methodology, applications,
      and interpretations.
AB  - Dipyridamole TI-201 imaging is an ideal alternative to exercise TI-201
      scintigraphy in patients who are unwilling or unable to perform maximum exercise
      stress. The use of intravenous dipyridamole, alone or in combination with
      exercise, has not been approved for clinical practice by the Food and Drug
      Administration. Once approval is granted, the test will become a widely used and
      important component of the cardiac work-up. The indications, methodology, side
      effects, and utility of dipyridamole cardiac imaging in the clinical setting are
      discussed and a variety of examples presented.

PMID- 2225678
TI  - Intravenous dipyridamole. Reflections while waiting for FDA approval.

PMID- 2225679
TI  - Bone scan abnormalities in a child with Lyme disease.

PMID- 2225680
TI  - Insufficiency fractures of the upper femurs. Five-year lapse between occurrence
      on opposite sides.

PMID- 2225681
TI  - Rapid detection of a giant aneurysm of right sinus of Valsalva by radioisotopic
      angiography.

PMID- 2225682
TI  - Intense Tl-201 uptake in a "cold" bone lesion due to metastatic thyroid
      carcinoma.

PMID- 2225683
TI  - Tc-99m MDP accumulation in lymphoma.

PMID- 2225684
TI  - Bone scan in inferior vena cava obstruction.

PMID- 2225685
TI  - Renal uptake of Tc-99m sulfur colloid in disseminated intravascular coagulation.

PMID- 2225686
TI  - Clinical approach to prenatal detection of human structural defects.
AB  - Tremendous advances in prenatal diagnosis have allowed clinicians to recognize a
      variety of structural defects in the developing fetus. Guidelines for fetal
      ultrasonography and an approach to fetal evaluation are outlined. The
      developmental morphologic approach is emphasized as a way of categorizing
      congenital anomalies whether they are detected during prenatal or postnatal life.
      The use of this approach for diagnosing and managing fetal malformation syndromes
      is illustrated.

PMID- 2225687
TI  - Teratogenically induced fetal anomalies.
AB  - A variety of infectious and physical agents, maternal diseases and altered
      metabolic states, and drugs and chemicals have been shown to cause postnatal
      structural or functional disabilities when embryonic or fetal exposure occurs
      during human pregnancy. These disabilities are potentially preventable through
      public education and awareness. Health-care providers must be equipped to collect
      relevant data regarding exposures of concern from their pregnant patients, locate
      and evaluate pertinent current teratology information resources, and sensitively
      counsel these women regarding the associated potential teratogenic risks.
      Comprehensive care of the patient exposed to a human teratogen may also include
      discussion of prenatal diagnostic procedures and other pregnancy management
      options.

PMID- 2225688
TI  - Aberrant morphogenesis of the central nervous system.
AB  - This overview of congenital defects of the CNS has emphasized pathogenesis. As
      developmental pathways continue to be elucidated, this approach remains to an
      extent hypothetical. When, however, an understanding of the features of
      morphogenesis and dysmorphogenesis helps to indicate time of onset or to
      elucidate causal factors, important steps toward the prevention of birth defects
      are taken.

PMID- 2225690
TI  - Posterior nuchal cystic hygroma.
AB  - When cystic hygroma is detected antenatally, the prognosis is usually poor, and
      intrauterine or neonatal death are common. This seems especially true for Turner
      syndrome (the largest etiologic group associated with cystic hygroma) and the
      lethal multiple pterygium syndromes. However, some fetuses with Turner syndrome,
      and also with certain other diagnoses, had a good outcome, and further study of
      these conditions is required before more definite prognostic indicators and risk
      figures will be available. Increasing numbers of syndromes are being reported in
      association with fetal cystic hygroma, and lymphedema may be a common element in
      their pathogenesis. Mild, short-lived, or otherwise uncomplicated jugular
      lymphatic obstruction may be a cause of the neck webbing seen in the Noonan,
      familial pterygium colli, and distichiasis-lymphedema syndromes. With earlier and
      more widespread fetal ultrasonography, and more sensitive techniques, a greater
      number of resolving fetal cases may be reported. This may clarify the natural
      history and provide prospective criteria for the conditions that have better
      prognoses. The associated conditions include autosomal dominant and recessive
      genetic traits. Careful ultrasound study for other malformations, polyhydramnios
      and fetal growth parameters, a fetal karyotype, and, if appropriate, pathologic
      examination are required to determine the etiology and recurrence risk. The
      parents should be asked about exposure to alcohol or other agents and should be
      examined for signs of pterygium colli or Noonan syndrome. If the decision is made
      to continue the pregnancy, and there is doubt about the natural history and
      prognosis, multi-disciplinary supervision should include social services,
      neonatology, pediatric surgery, cardiology, and genetics specialties when
      indicated.

PMID- 2225689
TI  - Ultrasound imaging of the cranium and spine.
AB  - A general description and discussion of the normal head and spine, and major
      fetal anomalies has been presented. It is important to remember that there can be
      wide variability in the structural findings noted in the fetus with ventricular
      dilatation or abnormal cerebellar development. If an abnormality of the fetal
      head and spine is seen, it is important to carefully assess other areas of fetal
      anatomy because of the increased likelihood of coexisting anomalies. Because of
      the increased incidence of chromosomal abnormalities, evaluation by percutaneous
      umbilical blood sampling, amniocentesis or placental biopsy is recommended for
      all structural abnormalities of the fetal head and spine. The best clinical
      approach for the ultrasonologist is to accurately describe and quantify the
      abnormalities for geneticist, pediatrician and or neurosurgeon to discuss the
      prognosis. Accurate evaluation of the type, location and extent of a neural tube
      defect is important to enable the family to understand possible outcomes of the
      pregnancy.

PMID- 2225691
TI  - Congenital heart defects in malformation syndromes.
AB  - This article presents a comprehensive review of the type and frequency of
      congenital heart defects found in malformation syndromes which have been
      categorized by etiology. Certain cardiac phenotypes can be as helpful in
      identifying certain syndromes as can be seen with the more familiar facial, body,
      and behavioral phenotypes. An awareness of syndromes with a higher risk of
      congenital heart defect, and knowledge concerning heart defects which are
      distinctive for certain syndromes, focuses prenatal diagnosis efforts and fetal
      echocardiography. By using a mechanistic classification in which congenital heart
      defects are regarded as families of related defects rather than individual
      lesions, patterns can be recognized among different syndromes.

PMID- 2225692
TI  - Fetal abdominal abnormalities associated with genetic syndromes.
AB  - Sonographic technology has given the prenatal diagnostician the ability to
      accurately visualize fetal malformations. This article demonstrates the currently
      available capability of applying sonographically derived information concerning
      fetal dysmorphology to our knowledge of genetic disorders and syndromes. As a
      result, there can be a significant improvement in the management and counseling
      of these patients. After an initial discussion of normal embryology, principles
      of abdominal ultrasonography are discussed and applied to the following
      anomalies: omphalocele, gastroschisis, diaphragmatic hernia, duodenal atresia,
      other intestinal atresias and stenoses, renal anomalies, and obstructive
      uropathies.

PMID- 2225693
TI  - Fetal imaging in the skeletal dysplasias.
AB  - Second-trimester diagnosis of fetal skeletal dysplasia is becoming increasingly
      common. By careful examination of the fetus for skeletal mineralization, shape
      and size of long bones and cranium, and abnormalities of other organ systems, a
      definitive diagnosis can often be achieved by ultrasound. Fetal radiography is
      very helpful in giving more information about bone shape and mineralization as
      well as in confirming the diagnosis. Subsequent obstetric management should be
      dictated by the natural history of the disease, the parents' wishes, and the
      gestational age at diagnosis. Because many of these disorders have a high
      recurrence risk, genetic counseling and follow-up are an important part of the
      management of these patients.

PMID- 2225695
TI  - How to interpret studies of adverse drug reactions.

PMID- 2225694
TI  - A protocol for the investigation of pregnancy loss.
AB  - A protocol for the evaluation of pregnancy loss should include a maternal
      history, dysmorphic examination of the fetus or abortus, photographs, autopsy,
      chromosome studies (in most cases), and radiographic or xeroradiographic studies.
      Selected cases with suspected ascending or transplacental infection may require
      microbiologic investigation. Increasing specialized laboratory techniques may
      help in the diagnosis of inborn errors of metabolism or storage disorders.
      Coordination of studies requires the interaction of OB/GYN, pathology, genetics,
      cytogenetics, and nursing in order to assure delivery of this clinical service.
      Knowledge of the causes of pregnancy loss and their typical time and mode of
      presentation can facilitate a focused evaluation, with a high chance of achieving
      an accurate diagnosis. The goal of all investigations is to provide families with
      recurrence risk data on which to base future childbearing decisions, as well as
      information on potential prenatal monitoring.

PMID- 2225696
TI  - Kinetic effects of multiple oral doses of acetaminophen on a single oral dose of
      lamotrigine.
AB  - In this double-blind, randomized, crossover, placebo-controlled study, the effect
      of multiple oral doses of acetaminophen on lamotrigine disposition was examined
      in healthy volunteers. Eight volunteers received two single 300 mg oral doses of
      lamotrigine, administered 20 days apart. Acetaminophen (2.7 gm/day) or placebo
      was taken for 24 hours before and continued for 10 days after each lamotrigine
      dose. Area under the plasma concentration-time curve for lamotrigine [AUC(O
      infinity)] and lamotrigine half-life were statistically decreased by 20% (229.0
      +/- 62.5 micrograms.hr/ml versus 191.2 +/- 42.1 micrograms.hr/ml, p less than
      0.01) and 15% (35.7 +/- 9.3 hours versus 30.2 +/- 7.3 hours, p less than 0.01),
      respectively, when concurrently administered with acetaminophen. There was no
      significant difference in the peak plasma concentration or the time to reach peak
      plasma concentration. The percentage of the dose of lamotrigine recovered in the
      urine (total) was significantly higher during the acetaminophen treatment (65.9%
      +/- 12.3% versus 72.5% +/- 5.7%, p = 0.048). Acetaminophen seems to facilitate
      lamotrigine removal through a yet to be determined mechanism(s).

PMID- 2225697
TI  - Exercise hemodynamics and catecholamine metabolism after catechol-O
      methyltransferase inhibition with nitecapone.
AB  - The effect of catechol-O-methyltransferase inhibition with nitecapone (OR-462) on
      the hemodynamic responses to exercise and catecholamine metabolism was studied in
      10 healthy male volunteers (aged 19 to 26 years). Nitecapone, a new specific and
      selective catechol-O-methyltransferase inhibitor, was given at increasing single
      oral doses up to 100 mg. Nitecapone did not influence resting or exercise heart
      rate, blood pressure, systolic time intervals, or plasma catecholamine levels. It
      altered the metabolic profile of catecholamines as shown by (1) an increase of
      140% in the plasma concentration of the monoamine oxidase-dependent metabolite
      3,4-dihydroxyphenylethyleneglycol (p less than 0.001), (2) a decrease of 27% in
      the plasma concentration of its methylation product 3-methoxy-4
      hydroxyphenylethyleneglycol (p less than 0.05), and (3) a 25% reduction in the
      urinary excretion of the methylated metabolites 3-methoxy-4-hydroxymandelic acid
      and homovanillic acid (p less than 0.05). Nitecapone was well tolerated and
      seemed to be hemodynamically safe in humans.

PMID- 2225698
TI  - Human liver catechol-O-methyltransferase pharmacogenetics.
AB  - Catechol-O-methyltransferase activity and thermal stability in the human red
      blood cell are controlled by a common genetic polymorphism. Approximately 25% to
      30% of a randomly selected population sample is homozygous for the traits of low
      catechol-O-methyltransferase activity and thermolabile enzyme in the red blood
      cell. We tested the hypothesis that the catechol-O-methyltransferase genetic
      polymorphism might also control those same characteristics of the enzyme in an
      important human drug-metabolizing organ, the liver. Catechol-O-methyltransferase
      enzyme activity and thermal stability were measured in 99 hepatic biopsy samples
      obtained during clinically indicated surgery. The frequency distribution of
      heated/control ratios, a measure of enzyme thermal stability, was bimodal, with
      28% of samples included in a subgroup with thermolabile enzyme. There were no sex
      related differences in hepatic catechol-O-methyltransferase thermal stability.
      However, catechol-O-methyltransferase enzyme activity in hepatic tissue from male
      subjects was significantly higher than that in samples from female subjects: 61.3
      +/- 20.2 units/mg protein (mean +/- SD; n = 50) versus 46.6 +/- 22.2 units/mg
      protein (n = 49; p = 0.0002). There was a significant correlation of hepatic
      catechol-O-methyltransferase activity and thermal stability in samples from both
      female (rs = 0.698; p = 0.0001) and male subjects (rs = 0.429; p = 0.002).
      Finally, when both red blood cell catechol-O-methyltransferase activity and
      thermal stability were measured in blood samples from 34 of these patients, there
      was a significant correlation between catechol-O-methyltransferase heated/control
      ratios and levels of enzyme activity in hepatic tissue and in red blood cell
      lysates. These findings indicate that the genetic polymorphism that controls
      catechol-O-methyltransferase activity level and thermal stability in red blood
      cells also controls those same properties of the enzyme in the human liver.

PMID- 2225699
TI  - Monitoring glucocorticoid therapy: a pharmacokinetic approach.
AB  - Although glucocorticoid therapy is essential for the treatment of severe
      inflammatory disorders, there is no systematic approach to patient variables that
      may affect availability of a steroid dose. After the development of a data base
      of pharmacokinetic parameters, we examined glucocorticoid pharmacokinetics in 54
      patients between 2 and 70 years of age using 70 pharmacokinetic studies after
      administration of intravenous methylprednisolone (n = 25), oral
      methylprednisolone (n = 15), intravenous prednisolone (n = 18), and oral
      prednisone (n = 12). Eleven patients had unusually rapid methylprednisolone
      elimination (clearance, 565 to 837 ml/min/1.73 m2; population mean, [+/- SD] 380
      +/- 100 ml/min/1.73 m2) without an identifiable cause. Incomplete absorption of
      methylprednisolone and prednisone was observed in three patients and one patient,
      respectively. Evaluation of glucocorticoid pharmacokinetics in children aged 1
      year 8 months to 18 years demonstrated a significant inverse correlation (r =
      0.88; p less than 0.001) between prednisolone clearance and age. It is therefore
      important to consider age in the interpretation of pharmacokinetic data. To
      simplify measurement of prednisolone clearance, a single-dose single-point method
      was developed. This was based on a highly significant relationship between the 6
      hour postdose prednisolone concentration and prednisolone clearance (log
      prednisolone clearance = 2.66 + [6-hour postdose concentration] [-0.00167]; r2 =
      0.96; p less than 0.0001). Evaluation of glucocorticoid pharmacokinetics in the
      clinical setting can be used to identify abnormalities in absorption,
      elimination, and patient compliance. This technique can be used to individualize
      glucocorticoid dosing regimens.

PMID- 2225700
TI  - Mefloquine kinetics in cured and recrudescent patients with acute falciparum
      malaria and in healthy volunteers.
AB  - Mefloquine pharmacokinetics were compared in a randomized clinical trial in
      Thailand among patients with malaria and healthy volunteers. A single oral dose
      of 1500 mg mefloquine hydrochloride was administered to 11 patients and 5
      volunteers and 750 mg was given to 16 patients and 5 volunteers. Efficacy was 82%
      for 1500 mg and 63% for 750 mg. In cured patients taking 750 mg mefloquine, peak
      plasma drug concentration (Cmax) and area under the plasma concentration-time
      curve (AUC) were significantly greater than in the patients for whom treatment
      failed (p less than 0.0005 and p less than 0.01, respectively), and plasma
      mefloquine levels were significantly higher from 8 hours to 18 days after
      treatment. Mefloquine AUC was reduced and variable in the presence of diarrhea.
      Compared with noninfected volunteers, clinically ill patients displayed a delayed
      time to reach peak concentration (p less than 0.01) and significantly higher
      mefloquine plasma levels in the first 2 days after administration of either the
      750 mg or the 1500 mg dose. Mefloquine AUC was similar in patients with malaria
      and healthy volunteers. Because plasma levels increased in temporal relationship
      with clinical illness, mefloquine volume of distribution or clearance (or both)
      was reduced during the acute phase of illness.

PMID- 2225701
TI  - Caffeine and theophylline attenuate adenosine-induced vasodilation in humans.
AB  - In this study the local vasoactive effects of adenosine were explored in the
      human forearm. Adenosine (15 micrograms/100 ml forearm/min) infused into the
      brachial artery (n = 6) increased forearm blood flow by 572% +/- 140%, versus -
      0.5% +/- 5.8% during placebo infusion (p less than 0.01). Lower adenosine
      infusion rates (5 micrograms/100 ml forearm/min, three times) induced forearm
      blood flow increments to 330% +/- 94%, 339% +/- 67% and 330% +/- 79%,
      respectively (n = 8). These forearm blood flow responses were reduced (p = 0.02)
      during concomitant intra-arterial infusion of two doses of caffeine (30 and 90
      micrograms/100 ml forearm/min) to 150% +/- 45% and 98% +/- 28%, respectively.
      Theophylline (30 micrograms/100 ml forearm/min; n = 6) also significantly
      attenuated the adenosine-induced increase in forearm blood flow. Enprofylline (30
      micrograms/100 ml forearm/min), a related xanthine with a low affinity to
      adenosine receptors in vitro, did not change the response to adenosine.
      Nonspecific vasodilation by sodium nitroprusside infusion (50 ng/100 ml
      forearm/min) was not inhibited by caffeine compared with placebo (forearm blood
      flow responses were 202% +/- 21% versus 216% +/- 40%; n = 6). This study
      demonstrated that caffeine and theophylline specifically reduce adenosine-induced
      vasodilation in humans, supporting the existence of functional human vascular
      adenosine receptors.

PMID- 2225702
TI  - The antihypertensive efficacy of hydrochlorothiazide is not prostacyclin
      dependent.
AB  - We tested the hypothesis that vascular prostacyclin synthesis is stimulated by
      hydrochlorothiazide and could account for some of the drug's antihypertensive
      effect. We studied 13 patients with mild essential hypertension in a randomized,
      double-blind design to assess the effects of indomethacin on
      hydrochlorothiazide's ability to lower blood pressure, alter body weight,
      stimulate plasma renin activity, and modulate vascular prostacyclin biosynthesis
      as assessed by the urinary excretion of the major enzymatically produced
      metabolite of prostacyclin, 2,3-dinor-6-keto-prostaglandin F1 alpha (PGF1 alpha),
      measured by GC/MS. Administration of hydrochlorothiazide, 50 mg daily for 2
      weeks, was associated with a significant decrease in both systolic and diastolic
      blood pressure in both supine (systolic, 148 +/- 3 to 136 +/- 3 mm Hg; diastolic,
      97 +/- 2 to 94 +/- 3 mm Hg) and upright (systolic, 151 +/- 4 to 131 +/- 2 mm Hg;
      diastolic, 103 +/- 2 to 97 +/- 3 mm Hg) positions. Hydrochlorothiazide
      administration resulted in a 1 kg weight loss and stimulation of plasma renin
      activity from 1.7 +/- 0.4 to 5.3 +/- 1.1 ng angiotensin I/ml/hr. However, the
      urinary excretion of 2,3-dinor-6-keto-PGF1 alpha was unchanged after
      administration of hydrochlorothiazide (86 +/- 13/ng/gm creatinine during placebo,
      74 +/- 13 ng/gm during week 1 of hydrochlorothiazide, and 70 +/- 9 ng/gm during
      week 2 of the drug). Administration of indomethacin, 50 mg twice a day, resulted
      in greater than 60% inhibition of 2,3-dinor-6-keto-PGF1 alpha excretion but did
      not affect the antihypertensive response to hydrochlorothiazide. Indomethacin did
      not oppose the diuretic effect of hydrochlorothiazide as assessed by weight loss
      but did attenuate the rise in plasma renin activity. Our data demonstrate that
      the blood pressure-lowering effect of a thiazide diuretic does not require
      enhanced prostacyclin synthesis and the cyclooxygenase inhibitor indomethacin
      does not antagonize the antihypertensive efficacy of hydrochlorothiazide.

PMID- 2225703
TI  - Pharmacodynamics of propranolol on left ventricular function: assessment by
      Doppler echocardiography.
AB  - The relationship of left ventricular systolic function and heart rate to serum l
      propranolol concentrations was determined in 10 healthy male volunteers during
      maximal exercise treadmill testing. Peak aortic blood flow acceleration (ACL),
      measured by Doppler ultrasonography, was used to evaluate left ventricular
      systolic function. Repeated exercise testing was performed on two separate days
      after long-term oral administration of 40 mg propranolol or placebo every 6 hours
      in a randomized, double-blind, crossover fashion. Pharmacodynamic relationships
      were determined by fitting percent change in ACL and heart rate at maximal
      exertion with 1-propranolol with the Emax model (maximal effect) and nonlinear
      regression. Reductions in systolic function and heart rate during exercise were
      related directly to 1-propranolol. Propranolol was significantly (p less than
      0.05) more potent in reducing heart rate (EC50, 10.6 +/- 9.2 ng/ml) compared with
      ACL (EC50, 19.2 +/- 8.9 ng/ml). However, Emax of propranolol for reducing ACL was
      significantly greater than that for reducing heart rate (-46.7% +/- 6.9% versus 
      29.5% +/- 15.9%; p less than 0.05). These data indicate that the concentration
      effect relationship for 1-propranolol and its negative inotropic effect differ
      from its negative chronotropic effect.

PMID- 2225704
TI  - Suppression of deferoxamine mesylate treatment-induced side effects by
      coadministration of isoniazid in a patient with Alzheimer's disease subject to
      aluminum removal by ionspecific chelation.
AB  - Deferoxamine treatment may produce serious side effects that can be eliminated by
      modification of treatment and by control of deferoxamine metabolism. A patient
      suffering from dementia of the Alzheimer type with normal liver and kidney
      function who was treated with deferoxamine initially tolerated a dose of 7 mg/kg
      deferoxamine mesylate injected intramuscularly twice a day for a total of 5 days
      a week. After several months nausea and weight loss gradually developed in the
      patient that could be controlled initially by dose reduction, leading to levels
      inappropriate for aluminum chelation. HPLC analysis of blood and urine revealed
      several metabolites including, as a major component, a plasma monoamine oxidase
      (MAO) catalyzed end product MFO1. Coadministration of isoniazid, a plasma MAO
      inhibitor, with deferoxamine resulted in reduction of MFO1 from 81% to 8%
      accompanied by increases in the amounts of metabolite 2 (MFO2) from 2% to 24% and
      unmetabolized deferoxamine from 17% to 68% after 6 months of treatment. The side
      effects subsided, the patient regained weight, and treatment could be continued.

PMID- 2225705
TI  - Quality of life among hypertensive patients with a diuretic background who are
      taking atenolol and enalapril.
AB  - The cardioselective beta-blocker atenolol and the angiotensin-converting enzyme
      inhibitor enalapril were compared for efficacy, safety, and quality-of-life
      factors in 30 patients with hypertension whose hypertension was inadequately
      controlled with diuretic alone. Atenolol (50 to 100 mg once a day) and enalapril
      (2.5 to 40 mg once a day), combined with hydrochlorothiazide (25 mg once a day),
      had similar levels of efficacy and safety. A comprehensive battery of psychologic
      assessments for quality of life was administered, including measures of anxiety,
      depression, psychiatric symptoms, memory, and psychomotor function. These five
      conceptually based clusters were first analyzed by multivariate analysis of
      variance procedures, followed by univariate analyses of the individual variables
      composing each domain. In general, neither atenolol nor enalapril was associated
      with major changes in psychologic functioning. The only data cluster with a
      statistically significant change was memory function, primarily as a result of
      lower scores of the digit span (backward) test, for atenolol relative to
      enalapril. These preliminary findings suggest that atenolol and enalapril have
      comparable degrees of efficacy and safety, with no major disparities in quality
      of-life effects, for hypertensive patients with a history of taking diuretics and
      this sort of quality-of-life assessment can be performed during trials of
      antihypertensive drugs.

PMID- 2225706
TI  - Does alternate-day cloprednol therapy prevent bone loss? A longitudinal double
      blind, controlled clinical study.
AB  - Osteoporosis is a serious side effect of systemic treatment with steroids.
      Cloprednol, a synthetic glucocorticoid with an anti-inflammatory potency twice
      that of prednisone, causes less calcium and nitrogen excretion than does
      prednisone in equipotent doses. Therefore a double-blind study was undertaken
      comparing the effects of alternate-day cloprednol and prednisone therapy on bone
      mineral density in 39 patients (cloprendol: 13 men and 8 women aged 48.5 +/- 2.8
      years; prednisone: 9 men and 9 women aged 49.7 +/- 1.7 years) with lung diseases.
      Ten patients with asthma (9 men and 1 woman aged 37.8 +/- 3.7 years) inhaling
      daily beclomethasone served as control subjects. Trabecular and total bone
      density of the distal tibia and radius was determined quarterly during 1 year
      with a special-purpose computed tomographic system. Initial mean trabecular bone
      density of the patients receiving cloprednol and prednisone was 17% below normal.
      After a treatment period of 1 year, we found a loss of radial trabecular bone
      density (mean +/- SEM) of 1.33% +/- 0.49% in the cloprednol group and 2.38% +/-
      0.69% in the prednisone group. In postmenopausal women, prednisone but not
      cloprednol therapy caused significant (p less than 0.01) trabecular bone loss
      (5.29% +/- 0.99% versus 0.70% +/- 0.65%). The control group lost 0.91% +/- 0.79%.
      Loss of cortical bone was insignificant in all three groups. In post-menopausal
      women, 1 year of alternate-day cloprednol therapy was associated with
      significantly less bone loss than was prednisone therapy in equipotent dosages.

PMID- 2225707
TI  - Effects of lovastatin in diabetic patients treated with chlorpropamide.
AB  - Patients with non-insulin dependent diabetes mellitus (NIDDM) have a higher risk
      of atherosclerotic cardiovascular disease than nondiabetic subjects. In seven
      patients with both hypercholesterolemia and NIDDM controlled by chlorpropamide,
      lovastatin (20 mg b.i.d. for 6 weeks) lowered low-density lipoprotein cholesterol
      by 28%, total cholesterol by 24%, and apolipoprotein B by 24%. Lovastatin levels
      for a 4-hour period (measured as 3-hydroxy-3-methylglutaryl coenzyme A reductase
      inhibitory activity) were similar to those measured previously in nondiabetic
      patients. Lovastatin did not alter chlorpropamide kinetics or glycemic profiles.
      No patient had an elevation in serum transaminases or creatinine phosphokinase,
      and no patient had any other laboratory or clinical drug-related adverse
      experience during the study. Lovastatin was as effective in reducing low-density
      lipoprotein cholesterol in patients with NIDDM as in nondiabetic subjects.
      Diabetic control was unaltered, and no evidence of alteration in lovastatin or
      chlorpropamide blood levels was noted.

PMID- 2225708
TI  - Nicotine metabolism in nonsmokers.

PMID- 2225709
TI  - Diazepam metabolism in native Chinese poor and extensive hydroxylators of S
      mephenytoin: interethnic differences in comparison with white subjects.
AB  - A single oral 5 mg dose of diazepam was given to 16 healthy native Chinese Han
      volunteers. Eight volunteers were extensive metabolizers of S-mephenytoin, and
      eight were poor metabolizers of S-mephenytoin. Plasma levels of diazepam and its
      demethyl metabolite were determined by HPLC in blood samples drawn during 4
      weeks. There was no difference in diazepam disposition between the two
      phenotypes. However, the plasma half-life of demethyldiazepam was longer in poor
      metabolizers than in extensive metabolizers of mephenytoin (mean +/- SD: 161 +/-
      37 and 116 +/- 29 hours, respectively; p less than 0.02). The plasma
      concentrations of demethyldiazepam at 7, 14, and 21 days after intake of diazepam
      were significantly higher in poor metabolizers than in extensive metabolizers. We
      compared the pharmacokinetic parameters of diazepam in Chinese subjects with our
      previously reported data from white subjects. The mean plasma half-life values of
      diazepam in Chinese extensive metabolizers (85.1 hours) and poor metabolizers
      (88.3 hours) were very similar to those in white subjects who were poor
      metabolizers (88.3 hours), and more than twice those in white subjects who were
      extensive metabolizers (40.8 hours). In parallel, the mean clearance of diazepam
      in Chinese subjects (independent of phenotype) was similar to that in white
      subjects who were poor metabolizers, but half that in white subjects who were
      extensive metabolizers. Chinese subjects had a slightly larger volume of
      distribution of diazepam than white subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2225710
TI  - Validity of creatinine clearance estimates in the assessment of renal function.
AB  - In clinical practice, estimations of renal function are commonly used to
      calculate the appropriate dose for drugs that are renally cleared. Continuous
      infusion inulin clearance (CLIN), 4-hour creatinine clearance (CLCR,m), and 24
      hour creatinine clearance (CLCR,a) were measured in 109 subjects (86 men and 23
      women) with varying degrees of stable renal function (CLIN, 6 to 209 ml/min) and
      compared with CLCR values as predicted by five equations on the basis of plasma
      creatinine concentrations, age, weight, and/or height. The CLCR,m was positively
      correlated with CLIN (r = 0.92; p less than 0.0001) but exceeded CLIN by 15%
      between the range of 30 and 209 ml/min (CLIN). Similarly, CLCR,a correlated well
      with both CLCR,m (r = 0.84; p less than 0.0005) and CLIN (r = 0.84; p less than
      0.0001). The relative role of tubular secretion in the overall clearance of
      creatinine increased with declining CLIN and exceeded 40% when CLIN was below 30
      ml/min. CLCR estimated by the Cockcroft-Gault and Mawer methods did not
      significantly differ from either CLCR,m or CLCR,m, whereas the other equations
      generally underestimated CLCR. Among the numerous mathematical equations, CLCR as
      estimated by the method proposed either by Mawer or Cockcroft and Gault was the
      best predictor of CLIN (CLIN = 1.05CLRCR - 18.38 or CLIN = 1.12CLCR - 20.60,
      respectively; r = 0.81; p less than 0.0001). The present data support the use of
      estimator equations proposed by Cockcroft and Gault or Mawer for rapid estimation
      of renal function in the clinical setting.

PMID- 2225711
TI  - Labetalol pharmacokinetics and pharmacodynamics: evidence of stereoselective
      disposition.
AB  - Labetalol pharmacokinetics and pharmacodynamics were evaluated in nine subjects
      before and during enzyme inhibition with cimetidine. Pharmacologic response was
      assessed by use of standardized treadmill tests during 24 hours after
      administration of oral labetalol. Oral clearance of labetalol decreased with
      cimetidine administration (58.7 +/- 23.3 to 32.9 +/- 13.2 ml/min/kg; p less than
      0.05), thereby causing a 79% increase in area under the curve. Labetalol systemic
      clearance also decreased (23.2 +/- 5.3 to 17.7 +/- 3.7 ml/min/kg; p less than
      0.05), but the volume of distribution was unchanged. Labetalol caused significant
      beta-blockade for 8 hours after the last oral dose, but cimetidine did not alter
      pharmacologic response. The Emax model provided a good description of the
      concentration-effect relationship. At peak labetalol concentrations after oral
      administration, (R,R)-labetalol concentrations were significantly lower than
      those of the other three stereoisomers (p less than 0.05). Cimetidine caused an
      increase in the concentrations of each stereoisomer, but the difference was
      significant (p less than 0.05) for only the (S,R)-, (S,S)-, and (R,S)-isomers.
      This first evidence of labetalol stereoselective disposition is consistent with
      the findings of previous (R,R)-labetalol pharmacokinetic studies and with
      previous pharmacodynamic investigations of labetalol and (R,R)-labetalol.

PMID- 2225712
TI  - Influence of the menstrual cycle on the absorption and elimination of D-xylose.
AB  - Thirteen healthy female volunteers with regular menstrual cycles (28 +/- 2 days)
      received 25 gm oral and 5 gm intravenous doses of D-xylose on 2 successive days
      during the follicular, ovulatory, and luteal phases of two consecutive menstrual
      cycles. The ovulation time was characterized by luteinizing hormone levels, body
      basal temperatures, and progesterone and estradiol serum levels. D-Xylose was
      assayed in plasma and urine with a phloroglucinol-based colorimetric method. The
      findings of this study indicated that menstrual cycle did not significantly
      affect D-xylose absorption. After oral administration, the total clearance was
      significantly increased in cycle 2 during the luteal phase (p = 0.004). After
      intravenous administration in both cycles, D-xylose total clearance was also
      significantly faster during the luteal phase (p = 0.038 and p = 0.041,
      respectively). After oral administration, the renal clearance tended to be higher
      during the luteal phase in both cycles studied. After intravenous administration,
      this parameter was increased during the luteal phase by 24% and 25% in cycle 1
      and by 8% and 12% in cycle 2. These findings are consistent with those of others
      showing an increase in glomerular filtration rate (GFR) during the luteal phase
      of the menstrual cycle. The findings of this study seem to be explained by the
      hormonal changes occurring during the menstrual cycle. Further investigations are
      warranted with use of specific probes of renal processes (GFR, renal reabsorption
      and tubular secretion) to confirm our findings and to elucidate the underlying
      mechanisms.

PMID- 2225713
TI  - Electroencephalographic effects of benzodiazepines. I. Choosing an
      electroencephalographic parameter to measure the effect of midazolam on the
      central nervous system.
AB  - The goal of this investigation was to determine a numerical
      electroencephalographic parameter that best indicated the degree of the effect of
      midazolam, administered in hypnotic doses, on the central nervous system. This
      electroencephalographic parameter could then be used to relate midazolam plasma
      concentrations and electroencephalographic drug effect (pharmacodynamic
      modeling). Intravenous doses of midazolam (3.75 to 25 mg) were given to five men
      at an infusion rate of 5 mg/min. A cortical electroencephalogram was continuously
      recorded. Two waveform analysis approaches were examined: fast Fourier
      transformation and aperiodic analysis. From fast Fourier transformation and
      aperiodic analysis a set of parameters were examined as measures of drug effect.
      We conclude that the voltage per second from aperiodic analysis provided the
      electroencephalographic parameter that optimally measured the effect of midazolam
      on the central nervous system.

PMID- 2225714
TI  - Electroencephalographic effects of benzodiazepines. II. Pharmacodynamic modeling
      of the electroencephalographic effects of midazolam and diazepam.
AB  - The comparative pharmacodynamics of midazolam and diazepam were examined by use
      of the electroencephalogram as a measure of drug effect on the central nervous
      system. Intravenous doses of 7.5, 15, and 25 mg midazolam and 15, 30, and 50 mg
      diazepam were given on repeated occasions to three volunteers. Arterial plasma
      concentration and electroencephalogram voltage were related with nonparameteric
      and parametric pharmacodynamic models. The peak increases in voltage (maximal
      effect) and the slopes of the plasma concentration versus effect curve were
      similar for both drugs. The half-time of blood:brain equilibration was
      significantly longer for midazolam than diazepam (4.8 minutes versus 1.6
      minutes). Midazolam was found to have an intrinsic steady-state potency that was
      approximately five times greater than that of diazepam (152 ng/ml versus 958
      ng/ml).

PMID- 2225715
TI  - Effects of caffeine on baroreflex activity in humans.
AB  - The effects of caffeine or placebo on blood pressure, heart rate, and baroreflex
      activation (elicited by phenylephrine) were studied on young normotensive
      volunteers after a 7-day caffeine-free period. Subjects received oral doses of
      either 250 mg caffeine (n = 6) or placebo (n = 4), and hemodynamic changes were
      studied at 0, 30, 60, 120, and 180 minutes after drug administration. Thirty
      minutes after the caffeine dose, blood pressure had risen from 127 +/- 8/57 +/- 4
      mm Hg to 136 +/- 3/68 +/- 5 mm Hg, heart rate was unchanged, and the baroreflex
      slope had decreased from 31 +/- 7 msec/mm Hg to 11.6 +/- 2 msec/mm Hg. Baroreflex
      sensitivity remained inhibited for the rest of the single-dose experimental
      period. In contrast, no significant changes were observed after either long-term
      caffeine ingestion in the same group or in the placebo group during the single-
      or multiple-dose study. These findings indicate that single but not multiple
      caffeine administration inhibits baroreflex activation in normotensive volunteers
      and this could contribute to the acute hemodynamic effects of caffeine.

PMID- 2225717
TI  - Extrathyroidal physiology of monoiodotyrosine in humans.
AB  - Normal serum monoiodotyrosine (MIT) levels (n = 152) were 0.69 +/- 0.20 nmol/l.
      There was wide variation of MIT levels in a 24-hour period without diurnal
      pattern, and there was no change throughout the menstrual cycle. MIT levels
      declined upon aging, but levels in hypo- and hyperthyroidism were not
      significantly different. MIT levels were detected in athyrotic patients (0.32 +/-
      0.08 nmol/l). Desiccated thyroid raised the athyrotic MIT levels to the normal
      range, while levothyroxine did not. Diiodotyrosine (DIT) infusion caused an MIT
      rise which paralleled but lagged 1 h behind the DIT rise. These data suggest
      thyroidal as well as nonthyroidal sources of MIT, one of which is deiodination of
      DIT. Ingestion of 1 g MIT increased serum MIT to 10.6 +/- 1.7 mumol/l in women,
      and 7.1 +/- 2.3 mumol/l in men 30 min after ingestion; the serum half-life was 45
      min.

PMID- 2225716
TI  - Effect of indecainide in patients with left ventricular dysfunction.
AB  - Indecainide, a new antiarrhythmic agent classified as type Ic was evaluated in 11
      patients with heart disease who had greater than or equal to 30 ventricular
      premature complexes/hour, moderate-to-marked left ventricular dysfunction, and
      mean ejection fraction 34% +/- 8%. Patients received indecainide, 50 mg by mouth,
      every 6 hours and the dose was increased until greater than or equal to 80%
      suppression was noted, adverse effects occurred, or a maximum dose of 100 mg
      indecainide was given every 6 hours. Ventricular premature complexes were
      suppressed greater than or equal to 80% in nine patients (p less than 0.05) and
      ventricular tachycardia episodes were completely suppressed in five of eight
      patients. The effective or maximal mean daily indecainide dose was 191 +/- 32 mg;
      half of the responders achieved achieved efficacy at serum drug concentration
      greater than or equal to 600 ng/ml. Serum drug concentration was directly related
      to gender (r = 0.78, p less than 0.04) and inversely related to creatinine
      clearance (r = 0.74, p less than 0.05) and ejection fraction (r = 0.71, p less
      than 0.02). Indecainide prolonged mean PR and QRS intervals (p less than 0.05)
      but not QT or QTc. There was a linear relation between percent change in PR (r =
      0.80, p less than 0.001) and QRS (r = 0.66, p less than 0.001) intervals and
      serum drug concentration. After starting or increasing the dose, careful
      observation of patients with decreased renal function or reduced ejection
      fraction should be exercised because they attain higher drug concentration than
      normal subjects.

PMID- 2225718
TI  - Changes in muscle proteins following different neural lesions.
AB  - The influence of various nerve lesions on the relative concentrations of proteins
      in the extensor digitorum longus (EDL), plantaris (PLN), and soleus (SOL) muscles
      from adult female rats was examined by electrophoresis on polyacrylamide gels.
      After cordotomy, levels of myosin light chains Lcs1 and -2 decreased with
      concomitant increases in Lcf1, -2, and -3 in SOL but not in EDL and PLN. The
      relative levels of several other proteins in all three muscle types were changed
      also. Following section of the sciatic nerve, corticospinal tract and removal of
      the motor cortex, the relative levels of distinct sets of protein bands in all
      three muscle types were altered. Only a 14,000-dalton protein band appeared to be
      affected by all four types of lesions. This experimental evidence supports the
      view that neural influences upon muscle properties are exceedingly complex. Some
      of these influences may be exerted via separate, central pathways to the motor
      neurons.

PMID- 2225719
TI  - Different effects of human and porcine insulin on hypoglycemia-induced
      abnormalities of brainstem sensory function.
AB  - Following a switch from porcine insulin (PI) to human insulin (HI), a subgroup of
      diabetic patients complained of unawareness of hypoglycemia. In the present
      study, a glucose clamp technique was used to assess changes in auditory evoked
      brainstem responses (ABR) during infusion of HI and PI (0.015 IU/kg/min) under
      conditions of euglycemia (about 5.00 mM) and of hypoglycemia (3.40 and 2.60 mM)
      in 9 healthy volunteers. Serum insulin and plasma glucose did not differ between
      HI and PI conditions. ABR components remained unchanged during the euglycemic
      clamp, but increased in latency during hypoglycemia in all subjects. At mean
      glucose levels of 2.60 mM, the increase in latency of ABR wave V ranged between
      50 and 400 microseconds during PI infusion, and between 100 and 2,460
      microseconds during HI infusion. Thus, compared to the PI condition, changes
      during HI infusion were significantly more variable (p less than 0.01) due to
      some subjects displaying extremely prolonged ABR latencies. These findings
      suggest that hypoglycemia induced by HI can be more detrimental to early sensory
      processing in humans as compared to PI.

PMID- 2225720
TI  - Potential mediation of prostaglandin E2 release from isolated human parietal
      cells by protein kinase C.
AB  - Parietal cells are a major source of gastric mucosal prostaglandins in various
      species. We examined cholinergic stimulation of prostaglandin E2 (PGE2) release
      from human parietal cells; using activators of the protein kinase C we attempted
      to get an indirect insight into cellular mechanisms which control PGE2 release.
      Gastric mucosal specimens were obtained at surgery and the cells were dispersed
      by collagenase and pronase E. Parietal cells were enriched to 65-80% by a Percoll
      gradient, and were incubated for 30 min. PGE2 release into the medium
      (radioimmunoassay) was 74-126 pg/10(6) cells/30 min under basal conditions and
      was 2.6-fold increased by carbachol (10(-5) and 10(-4) M). Similarly, PGE2
      release was stimulated by phospholipase C (20-200 mU/ml, 364% above basal), 1
      oleoyl-2-acetyl-sn-glycerol (10(-9)-10(-5) M, 229%), 12-O-tetradecanoylphorbol-13
      acetate (TPA; 10(-9)-10(-5) M, 283%) and calcium ionophore A23187 (10(-7)-10(-5)
      M, 219%). Simultaneous presence of A23187 and TPA synergistically induced
      stimulation which was slightly higher than the sum of the individual responses. N
      (6-aminohexyl)-5-chloro-1-naphthalene sulfonamide W-7, a putative calmodulin
      antagonist, inhibited TPA-induced PGE2 release at concentrations regarded
      specific for blocking calmodulin (IC50 = 1.5 X 0(-6) M). We conclude that in
      human parietal cells PGE2 is released upon cholinergic stimulation and that
      phospholipase C and protein kinase C are involved in the control of PGE2 release.
      We speculate that calmodulin might interact with a protein phosphorylated by
      protein kinase C to cause PGE2 release.

PMID- 2225721
TI  - Effect of vitamin E on the oxidative state of glutathione in plasma.
AB  - Reduced and oxidized glutathione levels in red blood cells and plasma from humans
      were determined after oral vitamin E treatment. The experiments confirmed that
      vitamin E enhances reduced glutathione levels in red blood cells. Moreover,
      vitamin E supplement resulted in a significant reduction of the plasma oxidized
      glutathione content. Thus, it seems that the effect of vitamin E on the reduced
      glutathione content is not exerted via direct modulation of the glutathione
      synthesizing enzymes, but rather by a more general mechanism of preserving
      reduced glutathione consumption by reducing the burden of the glutathione system.

PMID- 2225722
TI  - Role of glucagon in the splanchnic and systemic hemodynamic changes induced by
      portal-systemic blood shunting.
AB  - Portal-systemic blood shunting is often accompanied by hyperglucagonemia and
      hemodynamic changes. To determine this causal relation, splanchnic and systemic
      hemodynamics (radioactive microspheres) and plasma glucagon levels
      (radioimmunoassay) were assessed in conditions of total portal-systemic shunting
      in portacaval-shunted (PCS) rats and in sham-operated (SO) normal rats. To
      compare these results, another hemodynamic study was undertaken basally and
      during glucagon infusion in nonoperated normal rats. PCS rats showed a threefold
      greater plasma glucagon concentration than SO animals (924 +/- 134 vs. 309 +/- 18
      pg/ml, p less than 0.01), and they developed a hyperdynamic splanchnic
      circulation with higher portal venous inflow than SO rats (8.29 +/- 1.1 vs. 5.09
      +/- 0.4 ml/min/100 g, p less than 0.05). Infusion of a pharmacological dose of
      glucagon in normal rats increased portal venous inflow (from 4.92 +/- 0.33 to
      6.24 +/- 0.48 ml/min/100 g, p less than 0.05) so as to imply this hormone in the
      development of the hyperdynamic splanchnic circulation in conditions of portal
      systemic shunting. However, the discrepancies in systemic hemodynamics between
      PCS and glucagon-infused rats may be a result of the different plasma glucagon
      levels reached in the two groups.

PMID- 2225723
TI  - Is the endogenous digitalis-like factor the link between hypertension and
      metabolic disorders as diabetes mellitus, obesity and acromegaly?
AB  - Endogenous factors cross-reacting with antidigoxin antibodies have been found in
      several tissues and body fluids of animals and humans, using commercially
      available digoxin radioimmunoassay or enzyme immunoassay methods. The chemical
      characteristics of these endogenous factors are, at present, unknown, although it
      has been suggested that they could be substances with low molecular weight.
      Experimental studies and theoretical considerations indicate that endogenous
      digitalis-like factors (DDLFs), in addition to the ability to react with
      antibodies, might also bind to the specific cellular receptor of the cardiac
      glycosides and thus inhibit the membrane Na+/K(+)-ATPase (sodium pump).
      Therefore, EDLF can be an endogenous modulator of the membrane sodium-potassium
      pump and several authors have suggested that EDLF could play a role in the
      regulation of fluids and electrolytes, muscular tone of myocardial and also in
      the pathogenesis of arterial hypertension. In this review, the authors discuss
      the hypothesis that, in metabolic diseases such as diabetes mellitus, obesity and
      acromegaly, the sodium retention and volume expansion, possibly due to
      exaggerated sodium intake, and/or exogenously induced peripheral hyperinsulinemia
      and high levels of growth hormone, could trigger a sustained release of EDLF,
      which in turn increases the blood pressure.

PMID- 2225724
TI  - Diagnostic radiologists and nuclear medicine.

PMID- 2225725
TI  - General practice radiology--the poor relation.

PMID- 2225726
TI  - CT in renal and perirenal lymphoma: a further look.
AB  - The CT appearances of renal and perirenal lymphoma detected in 26 patients are
      presented. Twenty-four patients had non-Hodgkin's lymphoma and two patients
      Hodgkin's disease. This represented 3% of all patients scanned for routine
      staging of known lymphoma. Eleven patients had involvement at the time of relapse
      only, having had no previous evidence of renal involvement. Forty-three per-cent
      of all patients with renal lymphoma had no retroperitoneal lymph node
      involvement. Most patients had other extranodal disease at the time of
      presentation, most commonly bone.

PMID- 2225727
TI  - High resolution computed tomography of Pneumocystis carinii pneumonia in AIDS.
AB  - High resolution computed tomography (CT) was performed on 11 homosexual men with
      the Acquired Immune Deficiency Syndrome (AIDS). All had bronchoscopically proven
      Pneumocystis carinii pneumonia (PCP). Six patients were re-scanned following
      treatment and symptomatic recovery. All the scans were abnormal, most showing
      fine diffuse bilateral alveolar consolidation with bronchial wall thickening,
      despite having a normal or near-normal chest radiograph in three cases. A variety
      of unexpected changes such as peripheral consolidation only, upper or lower zone
      predominance, unilaterality, bronchial dilatation, cystic air spaces and sub
      pleural sparing were also seen. Following therapy, resolution of CT changes was
      shown to be incomplete despite clinical recovery, and whilst all the cases showed
      a reduction in alveolar consolidation, other findings such as new interstitial
      shadowing, peripheral predominance, and persistent cystic changes were observed,
      suggesting the healing process to be complex. Whilst the changes of PCP and its
      progression following treatment are well described on the plain chest radiograph,
      this is the first specific documentation of its appearances on narrow section CT,
      and its response to therapy. The usefulness of high resolution CT scanning to
      show early infection with PCP in the face of a normal chest radiograph is
      discussed, and the wide variety of CT changes occurring once the disease is
      established is emphasized.

PMID- 2225728
TI  - Chest radiographs after permanent pacing. Are they really necessary?
AB  - The chest radiographs of 600 consecutive patients undergoing insertion of a
      permanent cardiac pacemaker were reviewed to determine the incidence and nature
      of abnormalities present. Abnormalities were detected on the chest radiographs of
      131 patients (21.8%). Unsatisfactory electrode tip position and other features
      related to the electrode wire were commonest (14.4%). Complications related to
      the lungs and pleura were present in 5.5%, and those related to the generator and
      pouch least frequent (1.9%). Complications occurred more frequently following
      installation of a replacement system (48.3%) compared to new systems (17.2%).
      Important complications not initially detected included pneumothorax (8/15) and
      poor electrode loop (26/27). Chest radiographs following permanent cardiac pacing
      frequently demonstrate significant abnormalities whose detection is improved by
      awareness of their incidence and nature.

PMID- 2225729
TI  - Atraumatic sternal fractures secondary to osteoporosis.
AB  - We describe two cases of spontaneous sternal fracture with no underlying
      pathology other than a severe dorsal kyphosis resulting from osteoporosis. Both
      patients complained of chest pain. Sternal fractures are particularly likely to
      occur in the elderly when the costal cartilages become ossified and there is an
      associated thoracic kyphosis. In elderly patients with a kyphosis the lateral
      thoracic radiograph should include the sternum to ensure recognition of this
      complication.

PMID- 2225731
TI  - Erosive osteoarthritis: is it a separate disease entity?
AB  - Erosive osteoarthritis (EOA) characteristically involves the hands of middle-aged
      women. The diagnosis is essentially radiological and depends upon the presence of
      articular surface erosions. This study investigates whether this radiological
      feature is a marker of a specific clinical entity. From a series of 500
      consecutive patients attending a rheumatology clinic with symptomatic limb joint
      osteoarthritis, 24 were identified by radiological criteria to have EOA. These
      were age-sex matched with 24 patients from the same series who presented with
      osteoarthritis of the hand. Those with EOA had nearly twice as many
      radiographically abnormal joints in the hands as the controls (274: 144). This
      was almost entirely due to an increase in distal (134: 68) and proximal (79: 24)
      interphalangeal joint involvement, 71% of which were erosive. Erosions were found
      apart from the hands in both elbows of one patient with EOA. Otherwise only minor
      differences were present between the two groups in terms of distribution and
      incidence of osteoarthritic changes. There were no distinguishing serological or
      other clinical differences. This study has demonstrated that erosions in EOA are
      associated with more severe hand disease but are not apparently a marker of a
      separate disease entity. EOA appears to be an aggressive acute form of hand
      osteoarthritis and may represent the hand equivalent of similar forms of
      osteoarthritis in the shoulder, hip and knee.

PMID- 2225730
TI  - The role of discography in lumbar disc disease: a comparative study of magnetic
      resonance imaging and discography.
AB  - This study reviews prospectively a series of 29 patients who were examined by
      magnetic resonance imaging (MRI) and discography for degenerative disc disease.
      All had persistent low-back pain and non-diagnostic initial investigations,
      including plain films, myelography and/or computed tomography (CT). The imaging
      characteristics for degenerative disc disease correlated in 65 out of 73
      intervertebral levels. All symptomatic discs were degenerate on both MRI and
      discography. Features of degenerative disc disease on MRI were assessed
      retrospectively, with a view to identifying the symptomatic level as defined by
      discography. MRI could not reliably detect this level, particularly in those with
      multi-level degenerative disc disease. Positive reproduction of symptoms at
      discography was the criteria used for surgery. All 12 patients in this group had
      posterior spinal fusion performed. Nine improved and three were unchanged. Of the
      ancillary features associated with disc degeneration, only a bulging annulus
      fibrosis proved to be of any value on MRI. Nonetheless, MRI should be used as the
      primary investigation in this patient group as it can lead to a marked reduction
      in the number of disc levels requiring injection.

PMID- 2225732
TI  - Magnetic resonance imaging in extranodal pelvic lymphoma.
AB  - A practical MRI strategy for the investigation of pelvic pain in patients with
      suspected recurrent lymphoma is described and illustrated in five patients. A T1
      weighted sagittal examination of the lumbo-sacral spine is used to examine the
      vertebral bone marrow, spinal canal, exit foraminae and para-aortic lymph nodes.
      T2-weighted and balanced images are obtained in the axial plane through the
      pelvis. The balanced images give an excellent demonstration of pelvic lymph nodes
      and the T2-weighted images are sensitive to the presence of abnormal soft tissue
      masses and marrow disease.

PMID- 2225733
TI  - Fibrinolytic therapy for infra-inguinal synthetic graft occlusions.
AB  - The results of infra-inguinal graft fibrinolysis are variable, and the true
      success rates are frequently disguised by the inclusion of patients receiving
      adjunctive surgery, such as surgical thrombectomy, anastomosis revision and graft
      extension. Follow-up is sparse. As part of a larger prospective study, we have
      offered fibrinolysis using streptokinase to 10 patients with occluded infra
      inguinal synthetic grafts. In one patient the graft could not be entered with a
      catheter. The remaining nine patients received local low-dose intra-arterial
      streptokinase. Six patients experienced complete lysis and were discharged with
      functioning grafts. Significant stenoses were dilated by transluminal
      angioplasty. The median graft patency duration was 7 months. Two patients have
      since required above-knee amputations. Our results using transluminal angioplasty
      are comparable to those results where adjunctive surgery has been used to treat
      underlying anastomotic stenoses. Further research into graft anastomotic stenosis
      management is indicated.

PMID- 2225734
TI  - Oesophageal stenosis distal to oesophageal atresia.
AB  - Oesophageal atresia with or without tracheo-oesophageal fistula is often
      associated with a functionally abnormal distal oesophagus. The association of
      oesophageal atresia and a distal oesophageal stenosis is less well recognized and
      is usually regarded as a rarity. We describe four cases of oesophageal stenosis
      distal to oesophageal atresia and review the literature relating to this
      condition.

PMID- 2225735
TI  - The complications of high brachial artery puncture.
AB  - Fifty-two angiograms via a high brachial puncture were performed in Sheffield
      from 1986 to 1988 in patients in whom femoral artery catheterization was not
      possible or was contraindicated. Follow-up was obtained in 49 procedures. The
      procedure was initially successful in 43 cases. Twelve patients developed
      haematomas, graded large in 5, but no intervention for haematoma was required.
      The radial pulse was diminished or absent at the end of examination in four
      patients; three of these patients had no associated ischaemia, the pulse
      returning spontaneously within 24 hours, although remaining chronically reduced
      in one patient. One patient developed ischaemia due to acute occlusion of the
      brachial artery--this was successfully treated with immediate angioplasty.
      Paraesthesiae in the median nerve distribution were noted in two patients. These
      resolved spontaneously and no permanent neurological problem was seen. We
      conclude that high brachial artery puncture is a useful alternative when femoral
      artery puncture is not possible.

PMID- 2225736
TI  - Cholesterol embolization following angiography.
AB  - A case of cholesterol embolism following mesenteric angiography is reported.
      Although usually associated with a difficult study in atheromatous vessels this
      lethal complication occurred in an otherwise uncomplicated examination. This
      serves as a reminder of the attendant hazards of vascular studies in such
      patients and emphasizes the need for a careful technique to minimize any vessel
      wall trauma.

PMID- 2225737
TI  - Subcutaneous herniation of gall-bladder with spontaneous cholecystocutaneous
      fistula.
AB  - Spontaneous cholecystocutaneous fistula is now a clinical rarity due to
      improvements in the treatment of biliary tract diseases. This case report
      describes a 67-year-old woman in whom subcutaneous herniation of a pathologically
      dilated gall-bladder was followed by spontaneous discharge of pus and mucus with
      formation of a cholecystocutaneous fistula. The use of serial computed tomography
      examinations enabled this unusual diagnosis to be made.

PMID- 2225738
TI  - Uterine metastasis from stomach cancer: radiological findings.
AB  - The uterus is an unusual site for metastasis from an extrapelvic neoplasm. We
      report a case of uterine metastasis with extensive calcification. Plain
      radiography, ultrasonography and CT showed diffuse calcification within the
      uterine wall and T2-weighted MR images showed abnormally high signal intensity of
      the entire myometrium.

PMID- 2225739
TI  - Tuberculous dactylitis in childhood. The need for continued vigilance.
AB  - A case of tuberculous dactylitis in a 3-year-old Chinese boy is presented and the
      radiographic findings and differential diagnosis discussed. Although this is a
      rare condition, the diagnosis should be considered when a member of the immigrant
      community presents with an unusual bony lesion.

PMID- 2225740
TI  - Solitary plasmacytoma of the frontal bone.
AB  - We report a case of a solitary, painless, lytic lesion in the frontal bone in an
      otherwise asymptomatic patient. This was investigated with plain radiographs,
      computed tomography (CT), angiography and finally biopsy. Histology showed it to
      be a plasmacytoma. The radiological features of this lesion are discussed.
      Solitary plasmacytoma of bone has an uncertain relationship to multiple myeloma;
      it has only rarely been described in the skull and very rarely in the frontal
      bone.

PMID- 2225741
TI  - Delayed cardiac tamponade following NDA.

PMID- 2225742
TI  - The basic radiology system.

PMID- 2225743
TI  - Children with urinary tract infection.

PMID- 2225744
TI  - The telephone: servant or tyrant? You decide.

PMID- 2225745
TI  - Spinal cord injuries cost Colorado $8 million per year.

PMID- 2225747
TI  - Panel reviews therapy for early breast cancer; explicit advice on adjuvant
      therapy lacking.

PMID- 2225748
TI  - Levamisole approved for use in adjuvant regimen for colon cancer.

PMID- 2225749
TI  - New class I antiarrhythmic, moricizine, approved by FDA.

PMID- 2225750
TI  - Red-neck syndrome associated with intraperitoneal vancomycin.

PMID- 2225751
TI  - Comparison of two microcomputer Bayesian pharmacokinetic programs for predicting
      serum gentamicin concentrations.

PMID- 2225752
TI  - Vancomycin pharmacokinetics in infants undergoing extracorporeal membrane
      oxygenation.

PMID- 2225753
TI  - Discovery of the gene defect in cystic fibrosis: implications for diagnosis and
      treatment.

PMID- 2225754
TI  - Criteria for use of intravenous vancomycin for treatment of infections.

PMID- 2225755
TI  - Processing distinctions between stems and affixes: evidence from a non-fluent
      aphasic patient.
AB  - In this paper, we study the ability of a non-fluent aphasic patient, BN, to
      comprehend morphologically complex words when they appear in utterance contexts.
      We first establish that he is insensitive to the contextual appropriateness of
      both derived and inflected words. In a further experiment we show that he has no
      difficulty processing the stems of complex words and conclude that his problem is
      with the bound morphemes themselves. We then ask whether this problem is due to
      his inability to access either the phonological form of a morphologically complex
      word or its semantic and/or syntactic content. We find that only the access of
      semantic and syntactic content is impaired. We conclude from these six studies
      that: (a) BN presents a counter-example to the claim that non-fluent patients
      have particular difficulty with those aspects of morphology which have a
      syntactic function; (b) BN processes both derived and inflected words by mapping
      the sensory input onto the entire full-form of a complex word, but the semantic
      and syntactic content of the stem alone is accessed and integrated into the
      context. The semantic and syntactic implications of the suffix are never
      evaluated. This implies separate representation of the stems and suffixes of some
      types of morphologically complex words.

PMID- 2225756
TI  - Children's understanding of counting.
AB  - This study examines the abstractness of children's mental representation of
      counting, and their understanding that the last number word used in a count tells
      how many items there are (the cardinal word principle). In the first experiment,
      twenty-four 2- and 3-year-olds counted objects, actions, and sounds. Children
      counted objects best, but most showed some ability to generalize their counting
      to actions and sounds, suggesting that at a very young age, children begin to
      develop an abstract, generalizable mental representation of the counting routine.
      However, when asked "how many" following counting, only older children (mean age
      3.6) gave the last number word used in the count a majority of the time,
      suggesting that the younger children did not understand the cardinal word
      principle. In the second experiment (the "give-a-number" task), the same children
      were asked to give a puppet one, two, three, five, and six items from a pile. The
      older children counted the items, showing a clear understanding of the cardinal
      word principle. The younger children succeeded only at giving one and sometimes
      two items, and never used counting to solve the task. A comparison of individual
      children's performance across the "how-many" and "give-a-number" tasks shows
      strong within-child consistency, indicating that children learn the cardinal word
      principle at roughly 3 1/2 years of age. In the third experiment, 18 2- and 3
      year-olds were asked several times for one, two, three, five, and six items, to
      determine the largest numerosity at which each child could succeed consistently.
      Results indicate that children learn the meanings of smaller number words before
      larger ones within their counting range, up to the number three or four. They
      then learn the cardinal word principle at roughly 3 1/2 years of age, and perform
      a general induction over this knowledge to acquire the meanings of all the number
      words within their counting range.

PMID- 2225757
TI  - Numerical abstraction by human infants.
AB  - Across several experiments, 6- to 8-month-old human infants were found to detect
      numerical correspondences between sets of entities presented in different sensory
      modalities and bearing no natural relation to one another. At the basis of this
      ability, we argue, is a sensitivity to numerosity, an abstract property of
      collections of objects and events. Our findings provide evidence that the
      emergence of the earliest numerical abilities does not depend upon the
      development of language or complex actions, or upon cultural experience with
      number.

PMID- 2225759
TI  - Acoustic signaling in the black rat (Rattus rattus).
AB  - This study surveyed the vocalization repertoire of descendants of wild-trapped
      Rattus rattus. Sound recordings synchronized with behavioral observations were
      conducted in an animal colony living undisturbed under seminatural conditions.
      Analyses of sound recordings revealed 10 distinct acoustic signals, 5 of which
      were in the ultrasonic frequency range. The time course and the frequency pattern
      of the analyzed sounds were similar to those described for R. norvegicus, and
      they occurred in comparable situations. A species-specific difference may be the
      intensity of the emitted sounds. The possible communicative function of the
      acoustic signals is discussed.

PMID- 2225758
TI  - Inferences about guessing and knowing by chimpanzees (Pan troglodytes).
AB  - The visual perspective-taking ability of 4 chimpanzees (Pan troglodytes) was
      investigated. The subjects chose between information about the location of hidden
      food provided by 2 experimenters who randomly alternated between two roles (the
      guesser and the knower). The knower baited 1 of 4 obscured cups so that the
      subjects could watch the process but could not see which of the cups contained
      the reward. The guesser waited outside the room until the food was hidden.
      Finally, the knower pointed to the correct cup while the guesser pointed to an
      incorrect one. The chimpanzees quickly learned to respond to the knower. They
      also showed transfer to a novel variation of the task, in which the guesser
      remained inside the room and covered his head while the knower stood next to him
      and watched a third experimenter bait the cups. The results are consistent with
      the hypothesis that chimpanzees are capable of modeling the visual perspectives
      of others.

PMID- 2225760
TI  - Social transmission of food preferences in Japanese monkeys (Macaca fuscata)
      after mere exposure or aversion training.
AB  - In Experiment 1, 3 mother-child pairs of Japanese monkeys (Macaca fuscata) were
      given simultaneous choice tests between raisins and popcorn. The mothers and
      offspring showed different choice patterns. Cofeeding opportunities were then
      alternated with individual choice tests. In Experiment 2,2 other pairs were
      added. Each animal was again offered simultaneous choice tests between
      marshmallows and almonds. Food aversion conditioning was used to create different
      choice patterns for mothers and offspring. After cofeeding and choice tests, the
      differences in choice patterns disappeared in both experiments. The changes after
      contact with the other's eating pattern during cofeeding was as follows: foods
      consumed by either came to be eaten by both; foods consumed by both continued to
      be eaten by both; and foods consumed by neither continued to be ignored. The
      results provide evidence for social transmission of food preferences in this
      species.

PMID- 2225761
TI  - Number-related discrimination and summation by squirrel monkeys (Saimiri sciureus
      sciureus and S. boliviensus boliviensus) on the basis of the number of sides of
      polygons.
AB  - In Experiment 1, with the number of sides or angles of irregular polygons as
      cues, programmed training, and a 90% correct criterion (36 of 40), 2 squirrel
      monkeys' (Saimiri sciureus sciureus and S. boliviensus boliviensus) best
      performances were to discriminate heptagons from octagons, a 3rd's best was
      hexagons from heptagons, and a 4th's best was pentagons from heptagons. In
      Experiment 2, on most trials 2 polygons on one or both discriminanda had to be
      summed to determine which discrimination had the total fewer sides. Only 1 monkey
      met criterion (27 of 30) on the 2 tasks, 6 vs. 8 and 7 vs. 8 sides, but the other
      3 performed better than chance on the 6 vs. 8 task. We conclude that previous
      studies of animals' discrimination of polygons in terms of complexity were
      minimally relevant to this work, and counting and subitizing were rejected in
      favor of a prototype-matching process to explain our monkeys' performances.

PMID- 2225762
TI  - Geometric modules in animals' spatial representations: a test with chicks (Gallus
      gallus domesticus).
AB  - Recent work has shown that in place-finding tasks rats rely on the geometric
      relations between the goal object and the shape of the environment. We tested
      young chickens (Gallus gallus domesticus) on similar tasks in a reference memory
      paradigm to determine whether differences exist between species in the ability to
      use geometric and nongeometric spatial information. The main findings were that
      chicks: (a) encoded and used both geometric and nongeometric (featural)
      information; (b) did not use the overall spatial arrangement of the features; (c)
      relied primarily on nongeometric cues when faced with contradictory information.
      Two mechanisms are evident in chicks' spatial representations: a metric frame for
      encoding the spatial arrangement of surfaces as surfaces and a cue-guidance
      system for encoding conspicuous landmarks near the target. The possibility of
      hierarchical organization and species differences in these two mechanisms are
      discussed.

PMID- 2225763
TI  - Changes in mating vocalizations over the ejaculatory series in rats (Rattus
      norvegicus).
AB  - Rats (Rattus norvegicus) produce ultrasonic calls during mating. We examined
      changes in the structure and pattern of such vocalizations over the ejaculatory
      series. In Experiment 1, vocalizations were recorded from 11 pairs of rats
      through 3 ejaculatory series and analyzed spectrographically. We classified 4
      categories of call by spectral frequency and duration. Calls of low frequency,
      long duration, and high intensity occurred more often shortly before the
      ejaculation and were associated with mounting without intromission, a behavior
      that often occurs shortly before ejaculation. The high-frequency calls did not
      vary in number across the series. In Experiment 2, vocalizations were recorded
      from males paired with devocalized females. Males produced all vocalization
      patterns produced by pairs in Experiment 1. Results suggest that most pre
      ejaculatory calls are produced by males and may potentially affect female sexual
      behavior.

PMID- 2225765
TI  - Differences in affiliative behavior, pair bonding, and vaginal cytology in two
      species of vole (Microtus ochrogaster and M. montanus).
AB  - Prairie voles (Microtus ochrogaster) and montane voles (M. montanus) display
      marked differences in social organization in the field. Trios of 1 male and 2
      females were studied in a large enclosure for a 10-day period. Prairie voles
      spent 59% of the observation time in side-by-side contact, whereas montane voles
      spent only 7% of the time in contact. Vaginal smears indicated female-female
      suppression of estrus in prairie voles; female montane voles appeared to cycle in
      the presence of males. Male prairie voles preferentially paired and nested with 1
      of the females, and vaginal estrus generally followed pair formation by 2 days.
      Male montane voles did not spend time preferentially with either female, even
      after mating. These results suggest that the contrasting mating systems of these
      species result from differences in the propensity for affiliative behavior and
      social bonding rather than from mate availability or female receptivity.

PMID- 2225764
TI  - An unusual pattern of copulatory behavior in a South American cricetid rodent:
      Akodon molinae.
AB  - We describe the copulatory behavior and the morphology of the male genital tract
      of a member of a tribe (Akodontini) for which no information on copulatory
      behavior has been available. Copulation in Akodon molinae is characterized by
      multiple intromissions with no intravaginal thrusting, a single ejaculation, and
      a brief lock with the deposit of a plug. This pattern is unusual because of the
      combination of locking with both multiple intromissions and plugs. The latter
      combination, and similar standard measures of copulatory behavior, have been
      reported for Acomys cahirinus, a murid that frequently shows more than 1
      ejaculation. Also, the standard measures of copulation in A. molinae resemble
      those of Calomys callosus, another South American cricetid, which shows
      intravaginal thrusting and infrequent locks. The functional significance and the
      anatomical correlates of locking and plug deposition in this species are
      discussed.

PMID- 2225766
TI  - Hand preference and performance on unimanual and bimanual tasks in capuchin
      monkeys (Cebus apella).
AB  - Patterns of manual preference and the extent to which preference provided a
      benefit in performance (movement time) were evaluated in 7 young adult capuchin
      monkeys (Cebus apella). Directions of preference were inconsistent within
      individual animals across home-cage activities, unimanual, and bimanual
      experimental tasks. Preferences were more strongly expressed in the experimental
      tasks than in the home cage. A left bias in the population for prehension,
      predicted by recent theories, was not evident in any setting. Movement time was
      moderately negatively correlated with degree of preference within experimental
      tasks. The benefit to performance conferred by lateral preference was not
      dependent on whether the right or left hand was preferred. Lateralization of
      prehension appears to be a flexible process in these monkeys, which can result in
      quickly realized benefits in some conditions.

PMID- 2225767
TI  - Light-dark variation and changes across the lactational period in the behaviors
      of undisturbed mother and infant guinea pigs (Cavia porcellus).
AB  - Lactating guinea pigs (Cavia porcellus) and their litters were observed by
      videophotography across the light/dark cycle at 1, 11, 21, and 31 days
      postpartum. The highest level of behavioral activity was seen in the dark,
      particularly in the hour after light offset. This circadian pattern was evident
      from Day 1 in mothers and from Day 11 in pups. Contact between mothers and pups
      was inversely related to activity, occurring more frequently during light.
      Maternal grooming of pups occurred on Day 1 and then declined: self-grooming by
      pups increased across days. Intake of solid food and water by pups occurred on
      Day 1 and increased thereafter. A nearly complete transition from nursing to
      independent ingestion was observed between 21-31 days of age. Overall, we
      document several ontogenetic changes in young guinea pigs and demonstrate that
      under laboratory conditions mother and infant guinea pigs exhibit a nocturnal
      activity pattern.

PMID- 2225769
TI  - Paramyosin and the catch mechanism.
AB  - 1. Catch is a mechanism found in many molluscan smooth muscles in which tension
      is maintained at relatively low energy cost. 2. Paramyosin forms the core of
      thick filaments. In catch muscle paramyosin concentrations are high and the thick
      filaments are relatively long. 3. The mechanism of catch is not understood, but
      the consensus is that tension during catch is borne by slowly-cycling cross
      bridge attachments to actin. 4. Stimulation by acetylcholine increases
      intracellular Ca2+ and initiates a contraction characterized by a relatively
      rapid cross-bridge cycling. Reduction of Ca2+ can lead to relaxation or catch.
      Relaxation occurs only when a second neurotransmitter, serotonin, is present. 5.
      The catch state is released by serotonin, via activation of adenylate cyclase,
      increased levels of cAMP and phosphorylation of one or more contractile proteins,
      possibly paramyosin. Other targets for phosphorylation are discussed. 6. The
      contractile cycle of catch muscles, therefore, is controlled by both Ca2+ and
      cAMP.

PMID- 2225768
TI  - The HSP70 multigene family of Caenorhabditis elegans.
AB  - 1. The heat shock response of the nematode Caenorhabditis elegans has been
      characterized. 2. There are at least nine genes in the hsp70 multigene family of
      C. elegans. 3. Five of the hsp70 genes have been characterized and assigned to
      one of at least three hsp70 gene subfamilies. One of the subfamilies consists of
      an hsp70 protein that has the potential to be translocated into the endoplasmic
      reticulum and another subfamily consists of a protein that has the potential to
      be translocated into the mitochondria. 4. The C. elegans hsp70 multigene family
      has several unique characteristics including introns in the heat inducible hsp70
      genes, at least one trans-spliced hsp70 mRNA and two grp78 related genes, one of
      which is highly heat inducible. 5. The identification and characterization of C.
      elegans hsp70 multigene family is the basis for a genetic characterization of the
      regulation and function of a gene family during the development of a
      multicellular eukaryote.

PMID- 2225770
TI  - Phosphorus nuclear magnetic resonance of diverse phosvitin species.
AB  - 1. High resolution 31P nuclear magnetic resonance (NMR) spectra, with and without
      proton decoupling, of the principal egg phosphoproteins--phosvitins--of a bird
      (Gallus gallus), an amphibian (Xenopus laevis) and a fish (Salmo gairdneri) were
      obtained. 2. The spectra were evaluated with special reference to available amino
      acid sequences and the major NMR resonance in all three spectra was assigned to
      phosphoserine clusters. 3. The resolution of numerous additional phosphorus
      resonances provides the basis for further investigation of the particular
      molecular environments of phosvitin-bound phosphoryl groups and their involvement
      in the diverse binding modes for metal complex formation by phosvitins.

PMID- 2225771
TI  - Hepatic alcohol dehydrogenase activity in chick hepatocytes towards the major
      alcohols present in commercial alcoholic beverages: comparison with activities in
      rat and human liver.
AB  - We have compared hepatic alcohol dehydrogenase activities in chick, rat and human
      liver with the major alcohols in commercial alcoholic beverages. 1. Chick and rat
      hepatic alcohol dehydrogenase was greater when assayed at a physiological pH in
      buffer containing chloride ions, as compared with the activity in pyrophosphate
      buffer at alkaline pH. 2. In contrast to reports of instability of ADH to
      freezing, we found the enzyme from all three species stable to freezing in 0.25 M
      sucrose. 3. Rat liver enzymatic activity was unstable in the presence of
      substrate, where as that of chick and human was not. 4. For all three species,
      the Km of hepatic ADH for substrate decreased with increasing chain length of
      alcohols. In both chick and human samples, the Vmax values for the higher chain
      alcohols were similar to that with ethanol, while in rat samples, ADH activity
      was dramatically lower with the higher chain alcohols compared to ethanol.

PMID- 2225773
TI  - Comparison of delta-aminolaevulinic acid dehydratase activity in chick liver
      during sex steroid hormone dependent primary and secondary stimulation.
AB  - 1. Comparative study on primary and secondary stimulation of hepatic delta
      aminolaevulinic acid dehydratase (ALAD) (EC 4.2.1.24) was carried out after
      oestradiol-17 beta and/or testosterone administration in immature female chicken.
      2. When 2 mg/day oestradiol was administered to birds for 15 days successively,
      hepatic total ALAD activity increased to 170% by day 15 of primary stimulation,
      whereas a more rapid increased rate was observed within day 3 of secondary
      stimulation and thereafter the hepatic ALAD activity maintained the same high
      level from day 3 to day 15. 3. Testosterone (2 mg/day) alone decreased hepatic
      total ALAD activity during both primary and secondary stimulation. 4. When
      testosterone (0.25-10 mg/day) was injected into birds in combination with 2 mg
      oestradiol for 15 days during primary and secondary stimulation, only an
      antagonistic effect of testosterone on oestradiol-stimulated total ALAD activity
      in liver was observed independently of the testosterone amount administered.
      However, the extent of suppression of hepatic ALAD activity by testosterone
      during primary stimulation was markedly different from that of secondary
      stimulation.

PMID- 2225772
TI  - Comparative study of lens proteins of gray squirrel and human.
AB  - 1. The four crystallins of the gray squirrel lens have been characterized using
      gel filtration chromatography, polyacrylamide gel electrophoresis, and
      immunoblotting. Alpha, beta-heavy, beta-light, and gamma crystallins of squirrel
      lenses have been identified immunologically, and they cross-react strongly with
      rabbit polyclonal antibodies. The gamma-24 crystallin of the squirrel lens also
      reacts strongly with monoclonal anti-human lens gamma-24, as shown by its
      inhibition of the ELISA reaction by 85%. 2. The water-insoluble urea soluble
      proteins represent non-covalently associated species of soluble crystallins and
      the lens cytoskeletal proteins. The membrane intrinsic protein in the urea
      insoluble pellet has a mol. wt of 27,000 but other lower and higher mol. wt
      components are also present, which were removed by washing with 0.1 NaOH. The N
      terminal 30 amino acid of squirrel lens gamma crystallin was found to be
      identical to that of the bovine (and human) lens. 3. Measurements of the
      distribution and state of SH and SS compounds in the squirrel lens have shown
      greater similarities to those of primates than those of rodents. The findings
      show that on the basis of both protein and sulfur chemistry the squirrel lens is
      a representative model for studies of oxidative lens changes in diurnal animals,
      including man.

PMID- 2225774
TI  - Mouse mammary carcinoma delta-aminolevulinate dehydratase.
AB  - 1. Aminolevulinate dehydratase (ALA-D) was studied in crude extract from mouse
      mammary carcinoma, normal mouse liver and tumour bearing mouse liver. 2. A
      Michaelis-Menten behaviour and Km values between 0.24 and 0.31 mM were obtained
      for the enzyme in either source. 3. In all three tissues there was a linear
      relationship between porphobilinogen formation and incubation time, up to 120
      min, ALA-D was thermostable and optimum pH was at 6.8. 4. There seems to be no
      structural alterations in tumoural ALA-D as compared with the enzyme from liver
      of both normal and tumour bearing mice.

PMID- 2225775
TI  - A comparative study of alkaline phosphatases among human placenta, bovine milk,
      hepatopancreases of shrimp Penaeus monodon (Crustacea: Decapoda) and clam
      Meretrix lusoria (Bivalvia: Veneidae): to obtain an alkaline phosphatase with
      improved characteristics as a reporter.
AB  - 1. Alkaline phosphatases were purified from human placenta, bovine milk, shrimp
      and clam with a final spec. act. of 67,000, 32,000, 22,000 and 15,000 U/mg of
      protein respectively. 2. The alkaline phosphatase from Meretrix lusoria is unique
      with its thermostability at 65 degrees C for 30 min; whereas the remaining
      enzymes studied, including the human placental alkaline phosphatase, are
      inactivated and have negligible activities. 3. The alkaline phosphatase from
      Penaeus monodon can be differentiated by its pH optimum at 9.0; the remaining
      enzymes studied have their optimal pH at 10.0. 4. The alkaline phosphatases from
      shrimp and clam are proposed to be applied as "reporters" in the study of
      mammalian cells.

PMID- 2225776
TI  - Sterols in the plasma and digestive gland-gonad complex of Biomphalaria glabrata
      snails, fed lettuce versus hen's egg yolk, as determined by GLC.
AB  - 1. Gas-liquid chromatography studies were done on sterols in plasma and the
      digestive gland-gonad (DGG) complex of Biomphalaria glabrata snails fed lettuce
      vs hen's egg yolk. 2. The major sterols present in the DGG of both populations
      were cholesterol, stigmasterol, beta-sitosterol, campesterol, and desmosterol. 3.
      The percentage composition of cholesterol in the DGG of yolk vs lettuce fed
      snails was 82 and 51, respectively. 4. The elution profiles of sterols in the
      plasma of yolk vs lettuce fed snails were similar; both contained desmosterol,
      campesterol, and stigmasterol, negligible amounts of cholesterol, and
      unidentified sterols. 5. The high lipid diet increased the level of cholesterol
      in the DGG but not in the plasma.

PMID- 2225777
TI  - A comparative study of glycosylated haemoglobin level in the Arabian camel
      (Camelus dromedarius) during different seasons.
AB  - 1. The extent of haemoglobin glycosylation from 60 camels has been determined
      (4.39%) in blood samples drawn during winter. 2. Phosphate (9.45 mg/dl), DPG (2.9
      mumol/ml) and glucose (138 mg/dl) levels were also recorded. 3. In addition the
      P50 at pH 7.4 was measured (22.8 Torrs). 4. The data obtained compared with human
      blood levels and with levels reported for camels during summer sampling. 5.
      Despite the fact that camels have higher blood glucose levels than humans, the
      extent of glycosylation is much less in camel blood than in human blood.

PMID- 2225778
TI  - A CPU benchmark for protein crystallographic refinement.
AB  - The CPU time required to complete a cycle of restrained least-squares refinement
      of a protein structure from X-ray crystallographic data using the FORTRAN codes
      PROTIN and PROLSQ are reported for 48 different processors, ranging from single
      user workstations to supercomputers. Sequential, vector, VLIW, multiprocessor,
      and RISC hardware architectures are compared using both a small and a large
      protein structure. Representative compile times for each hardware type are also
      given, and the improvement in run-time when coding for a specific hardware
      architecture considered. The benchmarks involve scalar integer and vector
      floating point arithmetic and are representative of the calculations performed in
      many scientific disciplines.

PMID- 2225779
TI  - A computer program in BASIC for calculating gradients used in chromatography,
      electrophoresis and centrifugation.
AB  - Concentration gradients are often used in separations based on chromatographic,
      electrophoretic and centrifugal methods. In this report, a BASIC computer program
      for calculating and graphically representing gradients is described. This
      GRADIENT program is intended to be run on IBM-compatible computers.

PMID- 2225780
TI  - An algorithm for the computer calculation of the coefficients of a polynomial
      that allows determination of isoelectric points of proteins and other
      macromolecules.
AB  - The isoelectric point (pI) of a macromolecule containing any number of acid-base
      residues can be expressed as a polynomial whose coefficients are related to both
      the number of acid-base residues present in the molecule and their K values.
      Polynomials of degree higher than 5 are too complicated to be solved manually. An
      algorithm is here presented which allows, with few sentences written in BASIC,
      the calculation of the polynomial coefficients. With this knowledge and using
      standard polynomial solving programs, the isoelectric point of the macromolecule
      can be calculated.

PMID- 2225781
TI  - Automatic chart reader--an example of computer systems for patients' data
      interpretation.
AB  - A new approach to the processing of circular medical charts based on "odd
      symmetry digital subtraction" is presented. The technique allows automatic
      digitisation of these charts using an image processing system based on a flat bed
      scanner. This approach is simple, fast, and reliable; and provides a system in
      which the digitised image is processed by a microcomputer to extract and quantify
      the plotted information. The main features and the potential applications of this
      approach in medical and nonmedical fields are discussed.

PMID- 2225782
TI  - A computerized bioelectrical cardiac monitor.
AB  - The use of a micro-computer improves the performance of an impedance cardiograph.
      The impedance signals and the ECG are real-time processed and four analog signals
      are displayed on the screen. A beat-to-beat estimation of cardiac output and
      several indexes are computed and displayed. User's interface is by interactive
      screen menus. Some facilities permit data identification, storage and post
      processing. The software has been designed in such a way as to be adaptable to
      each specific application and to enable the development of new routines for
      cardiac signal processing. The signals recorded in healthy patients are in
      agreement with the results of other similar studies.

PMID- 2225783
TI  - A provider-interactive medical record system can favorably influence costs and
      quality of medical care.
AB  - The Geriatric Record and Multidisciplinary Planning System (GRAMPS) is a provider
      interactive computerized medical record system designed to support outpatient
      geriatric practice in Department of Veterans Affairs (DVA) clinics. In a
      controlled prospective study, physician use of the system was demonstrated to be
      associated with a reduction of the costs, and improvement in the quality and
      outcomes of patient care. The system was well-accepted by users, and provided a
      practical approach to physician data-entry. The system's text-handling and
      narrative generation capabilities support an extensive clinical content domain,
      contributing to overall performance. These features will be described in detail.

PMID- 2225784
TI  - Design of the diagnostic encyclopedia workstation (DEW).
AB  - The Diagnostic Encyclopedia Workstation (DEW) contains reference knowledge for
      diagnostic support in pathology. Illustrations are accessible via a video disc
      device. DEW can hold more knowledge, pictures and case histories than books, and
      its information is accessible via several entries. Software for data entry has
      been written in MUMPS with use of the relational database toolkit AIDA, which is
      particularly suited for manipulation of free text. The graphical mouse-driven
      user interface is written in C using MetaWindows. The DEW contains 85 diagnoses
      in ovarian pathology, covering all frequent cases and many rarities, illustrated
      by approximately 3000 pictures, divided among 158 cases.

PMID- 2225785
TI  - Comments on "Respiratory waveform pattern recognition using digital techniques".

PMID- 2225787
TI  - SAPHIRE--an information retrieval system featuring concept matching, automatic
      indexing, probabilistic retrieval, and hierarchical relationships.
AB  - SAPHIRE (Semantic and Probabilistic Heuristic Information Retrieval Environment)
      is an experimental computer program designed to test new techniques in automated
      information retrieval in the biomedical domain. A main feature of the program is
      a concept-finding algorithm that processes free text to find canonical concepts.
      The algorithm is designed to handle a wide variety of synonyms and convert them
      to canonical form. This allows natural language to be used for query input and
      also serves as the basis for a new approach to automatic indexing based on a
      combination of probabilistic and linguistic methods.

PMID- 2225786
TI  - Automatic geometrical registration of fluorescein retinal angiograms.
AB  - Changes in retinal microvascular perfusion revealed by fluorescein angiography
      have been reported in patients undergoing coronary artery surgery. Quantification
      of these changes is important and current techniques depend on careful visual
      inspection of the angiograms by humans. Computer image processing methods can be
      used to identify and highlight differences, but geometrical registration of the
      images is a prerequisite to the comparisons. Automatic methods for locating and
      matching reference points have therefore been developed. In combination with an
      iterative process which used least-squares error to calculate the transformation
      coefficients, subsets of reference points were selected and used to register
      successfully 20 image pairs.

PMID- 2225788
TI  - A programming language and a system for automated time- and laboratory test level
      dependent decision-making during patient monitoring.
AB  - A programming language specifically designed for automated time-dependent
      decision-making during patient monitoring (obtaining test requests, scheduling of
      test requests, cancelling of test requests, the issuing of messages to clinician
      or laboratory) has been developed. The output from a program written in this
      language is a set of decision rules in tabular form (a patient type), intended to
      solve a specific problem related to patient monitoring. A system for automated
      decision-making based on this language utilizes a file of patient types and a
      patient file. Whenever a new patient record is created, the patient's type is
      defined and the corresponding patient type is copied from the patient type file
      and linked to the patient's record. The system is activated, i.e., the decision
      rules are implemented and the tables of the patient's type updated, when
      laboratory results are available, when a clinician wants to order tests, and at
      regular user-defined intervals.

PMID- 2225789
TI  - A method for conforming the pH dependence of the michaelis parameters of
      nonallosteric enzymes to four kinetic schemes.
AB  - A nonlinear regression program for the analysis of the effect of pH on enzyme
      activity has been developed for the IBM micro range and compatible machines. The
      program conforms the V and Km pH profiles to one of four commonly occurring
      kinetic schemes. By using multiple linear regression the program computes initial
      estimates for the nonlinear search which are thus not required from the user. Two
      nonlinear optimization methods are included in order to effectively handle the
      nonnegativity constraints on the parameters. The program is user-friendly and
      provides plots of the fit and residual plots to help the user decide on the
      goodness of fit obtained. The program was coded in Turbo Pascal version 4.0 and
      runs on IBM micros or close compatibles with four types of graphics cards.

PMID- 2225790
TI  - Conducting a matched-pairs historical cohort study with a computer-based
      ambulatory medical record system.
AB  - We describe techniques for using the Computer-Stored Ambulatory Record (COSTAR)
      at the Massachusetts General Hospital to conduct a historical cohort study of the
      effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on blood pressure
      control. A query language was used to identify patients satisfying clinical and
      data-availability criteria, to match these patients with clinically similar
      patients not exposed to NSAIDs, and to collect data from the COSTAR records of
      both groups of patients to determine any differences in outcome. We analyzed over
      30,000 patient records to select 90 pairs of patients used in the study. This
      approach to clinical research uses data collected for purpose of patient care and
      so does not require the separate recording of patient data for clinical research.
      Using computer-based medical record systems with a query language allows
      selection and matching of patients using detailed demographic and clinical
      criteria. The ability to conduct such studies is an advantage of computer-based
      medical record systems over the paper record system.

PMID- 2225791
TI  - Frequency-domain digital filtering techniques for the removal of powerline noise
      with application to the electrocardiogram.
AB  - This paper presents two new local processing frequency-domain methods for the
      removal of powerline noise from electrophysiological signals. The first is based
      on an iterative division or a multiplication of a set of frequencies centered at
      60 Hz. The second users a basic property of the natural logarithm to smooth the
      60-Hz noise. Both methods are intended to reduce powerline noise without
      affecting the frequency spectrum of the signal in the regions surrounding 60 Hz.
      For illustration, these local processing methods are applied to artificial and
      real electrocardiographic (ECG) data and are compared to a fixed IIR notch
      digital filter which is designed by pole-zero placements on the unit circle. The
      performance of each method is measured by the error squared, which is the square
      of the difference between the original noise-free signal and the filtered noisy
      ECG. Finally, since the two methods are iterative processes, comparison of their
      rate of convergence to a predefined noise reduction level is considered.

PMID- 2225792
TI  - Determination of first and second derivatives of progress curves in the case of
      unknown experimental error.
AB  - The first and second derivatives of progress curves are obtained from the cubic
      spline function. The new approach is based on a development of the splining
      quality test which was used for estimating the precision of the splining. The
      proposed method is used on a computer with a FORTRAN 77 program. The method may
      also be applied for an approximate estimation of experimental error.

PMID- 2225793
TI  - Two BF*F subtypes found by isoelectric focusing have restricted distributions in
      the Finnish MHC haplotypes.
AB  - The factor B (BF) polymorphism revealed by immunofixation of plasma samples is
      made up of more than 20 variants, of which 2 variants are common, S and F, 2 less
      common, F1 and S07, and the rest of the variants are very rare. In this work we
      have adapted a rapid method to subdivide the BF*F allele into *FA and *FB by IEF
      in nontoxic agarose gel. The FA subtype manifested as two major bands and FB as
      one band both in native and desialylated samples. *F1, *S and *S07 were shown as
      monomorphic proteins, but differ in their sensitivities to degradation caused by
      neuraminidase treatment. *FA and *FB showed restricted distributions among the
      HLA haplotypes of the homogenous Caucasoid Finnish population. *FA was positively
      associated with the haplotypes Cw3,Bw62,C4A3BQ0 (or A3B1) and *FB with the
      haplotypes A3,Cw4,B35,DR1,C4A3BQ0 (or A2BQ0, A3,2BQ0).

PMID- 2225794
TI  - Elutable factors from latex-containing materials activate complement and inhibit
      cell proliferation. An in vitro biocompatibility study of medical devices.
AB  - Eluates from one all-silicone and two different combined silicone-latex catheters
      and one latex and one vinyl procedure glove were mixed with normal human serum
      and tested in a C3 complement activation assay. Simultaneously the eluates were
      tested in a cellular assay to measure inhibition of cellular proliferation. The
      combined silicone-latex catheters and the latex procedure glove caused a
      pronounced complement activation and inhibited cell proliferation. However, the
      response ranging was opposite in the two assays, suggesting that different
      soluble factors were responsible for the observed reactions. No complement
      activation or inhibition of cellular proliferation was observed for the all
      silicone catheter and the vinyl procedure glove. Our results demonstrate that
      different assays should be taken into account when biocompatibility is evaluated.

PMID- 2225795
TI  - Study of genetic polymorphism of seventh complement component in two families
      with hereditary deficit.
AB  - The results of an allelic segregation of C6 and C7 were studied in two Spanish
      families that have members with C7 deficiency. Absence of C7 in the affected
      siblings and half of the normal values in their parents were found in both
      families. The variant responsible for the deficiency (C7Q*0) follows a codominant
      autosomic inheritance pattern. Establishing allotypes of C6 and C7 by
      isoelectrofocusing followed by electrophoretic immunoblotting allowed haplotype
      assignments. In both families the haplotype form responsible for the deficiency
      seemed to be related to the C6B allotype.

PMID- 2225796
TI  - A novel immunoassay for the quantitation of human C4 gene products.
AB  - Utilizing mouse monoclonal antibodies which recognize Rodgers 1 and Chido 1
      epitopes carried on the C4A and C4B molecules, and heat-aggregated IgG to
      activate C1, an immunoassay was developed for the quantitation of total C4 as
      well as C4A and C4B. Interassay variation was 12.4, 11.5 and 10.8%, respectively.
      The immunoassay was compared to the quantitation of total C4 by radial
      immunodiffusion by testing 103 random white controls and gave a Pearson's product
      moment correlation coefficient of 0.81. Three genetic total-C4-deficient
      individuals were nonreactive in all three assays. This activated assay is
      specific, reproducible, and superior to existing methods for the quantitation of
      C4A and C4B and detection of the heterozygous C4 null state.

PMID- 2225797
TI  - On defining delusions.
AB  - The DSM-III-R definition of delusions bears inconsistencies and does not account
      for the way delusions are detected clinically. It can be traced back to Karl
      Jaspers who was the first to mention the three criteria of delusions, which are
      to be found in the textbooks ever since: (1) certainty, (2) incorrigibility, and
      (3) impossibility or falsity of content. Psychiatrists always felt uncomfortable
      with the third criterion, and Kurt Schneider pursued the most thorough attempt to
      dispose of this criterion by his definition of delusional perception. It can be
      shown that while his definition is wrong, the phenomena he had in mind do, in
      fact, have some distinctive features. Proceeding from the first two criteria of
      Jaspers, a new definition is proposed that emphasizes the way certain contents
      are stated and disregards the issue of right or wrong. Advantages of this
      definition are discussed and a distinction between delusions (about external
      reality) and certain actual experiences (happening in the patient's mind) is
      proposed.

PMID- 2225798
TI  - Care strategies for schizophrenic patients in a transcultural comparison.
AB  - This study was conducted in order to test the hypothesis derived from the
      International Pilot Study of Schizophrenia (IPSS) that the existence of extended
      families in developing countries contributes to the more favorable course and
      outcome of schizophrenia in these countries in comparison with industrial
      countries. For this purpose, we compared data from the 5- and 10-year follow-up
      obtained within the IPSS at Cali, Colombia with data from two 5- to 8-year follow
      up studies of former schizophrenic inpatients of the Max Planck Institute of
      Psychiatry (MPIP) in Munich, FRG. Although, in Cali, schizophrenics are
      hospitalized and treated with drugs only during acute episodes of the psychosis
      and no facilities exist for long-term treatment, the psychopathological outcome
      was, on the whole, not worse than in Munich. Furthermore, the duration of
      hospitalization during the follow-up period was much lower at Cali and a
      significantly lower number of Colombian than of German patients was not separated
      from their families. However, contrary to the hypothesis, family size did not
      predict course and outcome at both centers.

PMID- 2225799
TI  - Delimitation of generalized anxiety disorder: clinical comparisons with panic and
      major depressive disorders.
AB  - We compared 40 outpatients with "pure" generalized anxiety disorder (GAD) with
      152 panic disordered patients with varying degrees of phobic avoidance, and 241
      primary major depressives with single and recurrent episodic patterns. Despite
      sociodemographic and symptomatologic overlaps with these comparison groups, GAD
      emerged as a relatively distinct disorder, characterized by chronic low-grade
      symptomatology with observed anxiety at interview, as well as nausea, headache,
      tension, and insomnia. These anxious "traits," which appear to be part of the
      habitual self of the patient, are subject to fluctuation over time, and may form
      the temperamental substrate or precursor of panic and other anxiety and
      depressive disorders.

PMID- 2225800
TI  - A clinical and demographic profile of a sample of adults with attention deficit
      hyperactivity disorder, residual state.
AB  - It is becoming increasingly recognized that one third to one half of children
      diagnosed as having attention deficit/hyperactivity disorder (ADHD) continue to
      exhibit symptoms of the disorder into adulthood. The nature of the clinical
      picture is not well understood by a substantial number of clinicians. The purpose
      of this study is to report on the demographic and clinical profile of 56 adults,
      age 19 to 65 years (48 men, eight women) who present with adult ADHD and meet DSM
      III-R criteria for the disorder. Patients underwent a diagnostic work-up
      consisting of medical and psychiatric evaluation, a structured interview Schedule
      for Affective Disorders and Schizophrenia-Lifetime Version [SADS-L]), the
      Symptoms Checklist Revised (SCL-9OR), Conners Attention Deficit Disorder With
      Hyperactivity (ADDH) scale, structured interview of ADDH, the Global Assessment
      of Functioning Scale (GAF), and, when available, information from parents was
      obtained. Ninety-one percent of our sample met the Utah Criteria for adult ADHD.
      The majority of the sample had additional DSM-III-R diagnoses and only seven had
      ADHD diagnosis alone. Fifty-three percent of the sample met the criteria for
      generalized anxiety disorder, 34% alcohol abuse or dependence, 30% drug abuse,
      25% dysthymic disorder, and 25% cyclothymic disorder. These findings were similar
      to those reported in the literature.

PMID- 2225801
TI  - Psychological mindedness as a predictor of psychotherapy outcome: a preliminary
      report.
AB  - This study investigated the properties of a new measure of psychological mindness
      (PM). A 45-item self-report questionnaire was administered to consecutive
      admissions to a large outpatient clinic that provides primarily psychodynamically
      oriented individual psychotherapy. The PM scores of a sample of 44 of these
      patients who attended a median of 15 sessions were correlated with several
      outcome measures obtained from retrospective chart reviews. These measures
      consisted of the number of sessions attended, discharge ratings, and change
      scores on a Global Assessment Scale (GAS) and on a symptom checklist. Coefficient
      alpha for the Psychological Mindedness (PM) Scale indicated high reliability.
      Total PM score correlated significantly with three of the outcome measures.
      Twenty of the 45-items were good predictors of one or more outcome measures.

PMID- 2225802
TI  - DSM-III personality disorders in obsessive-compulsive disorder: changes with
      treatment.
AB  - Twenty-seven patients meeting DSM-III diagnostic criteria for obsessive
      compulsive disorder (OCD) completed the Personality Diagnostic Questionnaire
      (PDQ; a self-rating scale designed to assess the axis II personality disorders
      [PDs] from the DSM-III) before and after 12 weeks of treatment with clomipramine.
      Treatment was accompanied with reduction on several personality variables,
      including the number of personality diagnoses assigned, the distribution of
      traits in the sample, and the number of items endorsed in each personality
      category. The data also showed that improvement in personality functioning was
      significantly greater in responders compared with nonresponders or partial
      responders. Further investigation of the relationship between personality and
      treatment outcome did not provide strong support for the notion that personality
      factors may have prognostic significance in the treatment of OCD. These findings
      suggest similarities and differences with panic/agoraphobia which are briefly
      discussed.

PMID- 2225803
TI  - Andre G. Ombredane and the psychiatry of multiple sclerosis: a conceptual and
      statistical history.
AB  - By means of conceptual history and statistical analysis of historical data, this
      report shows that studies into the psychiatry of multiple sclerosis (MS)
      underwent a qualitative improvement between the Great War and the publication of
      A.G. Ombredane's great work. Analysis of his database, collected 60 years ago,
      shows that some of his conclusions (later to be influential) were unwarranted,
      but that, on the other hand, it enshrined hidden information showing a relative
      independence between euphoria (and other affective changes) and chronicity and
      illness duration. An earlier knowledge of this point might have had a corrective
      effect on later claims about the neuropsychiatry of MS.

PMID- 2225804
TI  - Capgras' delusion: an example of coalescent psychodynamic and organic factors.
AB  - The case of a 33-year-old woman with a right hemisphere lesion after subarachnoid
      bleed is reported. She developed the false belief that her husband, her mother,
      her children, and herself had been replaced by doubles after the birth of her
      fourth daughter. The multifactorial etiology of the Capgras delusion is discussed
      with a brief review of the literature.

PMID- 2225806
TI  - The symptom pattern variations of unipolar depression during life span: a cross
      sectional study.
AB  - The psychopathological syndromes are analyzed for 436 patients suffering from a
      unipolar affective psychosis, depressed type, without any further psychiatric or
      somatic diagnosis, separately for the second to eighth decade of life. The
      intensity of the depressive syndrome, as well as the apathy syndrome according to
      the Manual for the Assessment and Documentation of Psychopathology (AMDP) system,
      does not decrease. The autonomic syndrome increases for the group in the
      involutional age, and the psycho-organic syndrome for the group in the old age.
      The analysis of special symptom patterns, as for the agitated behavior or
      symptoms of the psycho-organic syndrome, is presented.

PMID- 2225805
TI  - A self-report measure of violence risk, II.
AB  - A brief self-report scale designed to measure the risk of violence was developed.
      Scale scores were found to be significantly related to a history of violence, or
      violence as a reason for admission, in psychiatric inpatients. Internal
      reliability was found to be high. A group of psychiatric inpatients could be
      significantly discriminated from a normal group of individuals, both on total
      scale score as well as on each individual item. Sensitivity and specificity were
      also determined. The value of the scale is in its brevity, in its focus on overt
      behavior as well as feelings, and in the fact that it defines a profile of
      characteristics that have been found to be associated with violent behavior. It
      thus represents a useful tool for future research on human aggression.

PMID- 2225807
TI  - Toward a new nosology of obsessive compulsive disorder.
AB  - Obsessive compulsive disorder (OCD) is receiving increasing attention in the
      clinical research literature. This review briefly summarizes data concerning
      diagnosis, phenomenology, and epidemiology of OCD and examines other disorders
      that closely resemble OCD. In addition, the nosological and treatment
      implications of these data are discussed. We find that OCD is characterized by a
      focal anxiety point(s) reflected in obsessions and by behavioral or cognitive
      compulsions. The appearance of these characteristics in other disorders suggests
      some relation between them and, consequently, the treatment of these disorders
      may be enhanced by conceptualizing them as OCD "variants".

PMID- 2225808
TI  - Heart-lung transplantation: initial experience in New England.
AB  - Between May 1988 and June 1989, five combined heart-lung transplants were
      performed. There were two males, age 16 and 19 years, and three females age 33,
      34, and 19 years. Three patients had primary pulmonary hypertension, one had
      cystic fibrosis, and the fifth had doxorubicin-induced cardiomyopathy with
      associated pulmonary hypertension. All patients were severely restricted in
      functional capacity and were oxygen-dependent. Four grafts were distantly
      procured (ischemic times 1:15, 2:35, 2:45, 3:45); one was procured on-site
      (ischemic time 0:58). Four of five grafts functioned well (PO2 on FIO2 30%
      postoperatively: 102, 120, 180, and 129 torr). One graft (distantly procured with
      an ischemic time of 1:15) showed total failure of oxygenation secondary to fluid
      overload during donor surgery; the recipient could not be weaned from
      cardiopulmonary bypass. All patients were extubated 24 to 30 hours
      postoperatively. Rejection episodes have been infrequent and all have been
      successfully treated with pulse steroids. Four of the five patients are alive and
      well with normal cardiopulmonary function and normal functional capacity 15, 12,
      8, and 6 months after surgery. Heart-lung transplantation is an effective therapy
      for properly selected patients with end-stage cardiopulmonary disease resulting
      from a variety of primary disorders.

PMID- 2225809
TI  - Babesiosis in a Connecticut resident.
AB  - Fewer than 200 confirmed cases of babesiosis have been reported in the last
      decade. Most cases in the United States have occurred on Cape Cod, Nantucket
      Island, and Long Island. Babesia microti, a malaria-like protozoan that
      parasitizes erythrocytes, is responsible for this illness in the United States.
      Infection is often subclinical but may be fulminant, especially in infants, the
      elderly, and in asplenic patients. Symptoms are nonspecific, usually consisting
      of fever and myalgias. Common laboratory abnormalities include evidence of
      hemolysis and thrombocytopenia. We report a case of babesiosis in an elderly male
      manifested by high fevers, confusion, hemolytic anemia, and thrombocytopenia.

PMID- 2225810
TI  - Fluconazole.

PMID- 2225811
TI  - Surgery for epilepsy. National Institutes of Health.

PMID- 2225812
TI  - Dam the blood.

PMID- 2225813
TI  - Confidentiality and the courts.

PMID- 2225815
TI  - Role of MRI in meningiomas: with and without gadopentetate.
AB  - Seventeen patients (15 newly diagnosed and two recurrent) with meningiomas were
      studied by magnetic resonance imaging (MRI) operating with 0.3, 0.5, and 1.5
      Tesla magnets. In four patients gadopentetate dimeglumine was administered,
      following a noncontrast scan. In all the patients the tumors were isointense with
      the cortex at short relaxation and echo times (TR and TE) and became hyperintense
      with the increase in TR and TE on 0.3, 0.5, and 1.5 Tesla magnet systems. MRI
      correlated well with angiography in the detection of sagittal sinus thrombosis,
      and delineated tumor from edema as in computed tomography. Elimination of bony
      artifacts made detection of posterior fossa tumors easier with MR scanning.
      Gadopentetate dimeglumine shortened the scan time, displaying small tumors as
      well as sagittal sinus involvement to advantage. In these respects, we believe
      MRI is more effective than computed tomography in the diagnosis and management of
      meningiomas.

PMID- 2225816
TI  - Colocolic intussusception in a three-year-old child caused by a colonic polyp.
AB  - Colocolic intussusception is an uncommon cause of pediatric intestinal
      obstruction in North America; 95% of cases are ileocolic in location, with an
      equal percentage in which no pathologic lead point is evident on barium enema or
      laparotomy. In the last 20 years less than 3% of approximately 32,500 reported
      cases of intussusception originated in the colon. In a significant number of
      these cases juvenile polyps were identified as leading points. The majority of
      juvenile polyps occur in the rectosigmoid colon within the reach of a standard
      pediatric sigmoidoscope. These tumors most often cause painless hematochezia.
      Occasionally, juvenile polyps may grow large and serve as lead points for
      colocolic intussusception when located in the proximal colon. Pediatric patients
      presenting with documented colocolic intussusception should suggest the
      possibility of a colonic polyp or other mass lesion. Careful physical examination
      and barium studies should provide important diagnostic clues. Treatment is aimed
      at removing the lead point in patients presenting with intestinal obstruction.
      Colonoscopic polypectomy performed by an experienced endoscopist may serve as an
      alternative to surgical removal of the polyp. We report a case in a three-old
      child of colocolic intussusception caused by a colonic polyp, and review some of
      the salient features of this clinical entity.

PMID- 2225814
TI  - Connecticut's new abortion statute.

PMID- 2225817
TI  - Creosote: a short history of its medicinal uses.

PMID- 2225818
TI  - Variations in coding practices among Connecticut urologists for the Medicare
      population.
AB  - As health care costs continue to rise, alternatives to the traditional fee for
      service system of physician reimbursement are being explored. Recently a resource
      based relative-value system was enacted by Congress to correct some of the
      perceived inequities of Medicare reimbursement. Since reimbursement for
      evaluation and management services, also known as cognitive services, are based
      on Current Procedural Terminology (CPT-4) codes, we reviewed Medicare claims data
      for fiscal year 1986-87 to identify the coding habits of Connecticut urologists.
      We found that Connecticut urologist file 99% of their claims for cognitive
      services in one of six categories. Furthermore, we found that within these broad
      categories an average of 82% of the claims were filed under one primary practice
      specific code. The particular code selected, however, varied markedly between
      practices. Our data suggest that Connecticut urologists have adopted different
      standards for using CPT-4 codes and have adjusted for these differences through
      their fee schedules. These findings highlight the need for increased precision in
      CPT code definitions for cognitive services before they can be adapted to a
      reimbursement system based upon relative-value scales.

PMID- 2225819
TI  - Consensus conference. The treatment of sleep disorders of older people. National
      Institutes of Health.

PMID- 2225820
TI  - National Practitioner Data Bank begins. American Medical News.

PMID- 2225821
TI  - The National Practitioner Data Bank and credentialing.

PMID- 2225822
TI  - Insurance companies intrude in doctor-patient relationships.

PMID- 2225823
TI  - Love and service.

PMID- 2225824
TI  - Exasperating the ways of death.

PMID- 2225825
TI  - The abortion czar.

PMID- 2225827
TI  - Terminal renal failure: therapeutic problems, possibilities, and potentials.
      International symposium of renal failure: past, present, and future. Malmo/Lund,
      Sweden, June 9-11, 1989. Proceedings.

PMID- 2225826
TI  - Historical overview of renal failure therapy--a homage to Nils Alwall.

PMID- 2225828
TI  - Protein metabolism and nutrition in hemodialysis patients.

PMID- 2225829
TI  - Membranes for blood purification: state of the art and new developments.

PMID- 2225830
TI  - Possibilities of selective and unselective adsorbent development in blood
      purification.

PMID- 2225832
TI  - The clinical practitioner and expert systems.

PMID- 2225831
TI  - A bioartificial pancreas to prevent diabetic microangiopathy?

PMID- 2225833
TI  - Treatment of terminal renal failure in the western European countries.

PMID- 2225834
TI  - Present status of ESRD treatment in Japan. Report from the Patient Registries of
      Dialysis and Kidney Transplantation.

PMID- 2225835
TI  - Quantity and quality of ESRD treatment in the United States of America.

PMID- 2225836
TI  - Treatment of ESRD in eastern Europe.

PMID- 2225837
TI  - Dialysis hypotension.

PMID- 2225838
TI  - Pathophysiologic aspects of plasma volume preservation during dialysis and
      ultrafiltration.

PMID- 2225839
TI  - Cardiovascular problems in end-stage renal failure: haemofiltration.

PMID- 2225840
TI  - Towards new therapeutic strategies in renal disease.

PMID- 2225841
TI  - The anemia of chronic renal failure: pathophysiology and effects of recombinant
      erythropoietin.

PMID- 2225842
TI  - Renal osteodystrophy: past and future.

PMID- 2225843
TI  - Dialysis amyloidosis: current disease concepts and new perspectives for its
      treatment.

PMID- 2225844
TI  - Hypertension and glomerular sclerosis: where, when and how?

PMID- 2225846
TI  - Angiotensin, ACE inhibition, and the renal circulation: pathogenesis of
      nonmodulation in essential hypertension.

PMID- 2225847
TI  - Radionuclides in nephro-urology. 7th international symposium. Williamsburg, Va.,
      May 7-10, 1989. Proceedings.

PMID- 2225845
TI  - Preventing or postponing renal disease in insulin-dependent diabetes by glycemic
      and nonglycemic intervention.

PMID- 2225848
TI  - The uses and interpretation of modified diuresis renography.

PMID- 2225849
TI  - Prospective evaluation of radionuclide monitoring in renal transplantation.

PMID- 2225850
TI  - The intrarenal kinetics of hippuran in acute rejection of renal allograft.

PMID- 2225851
TI  - The effects of increased dialysate sodium concentration on skeletal muscle and
      subcutaneous blood flow during hemodialysis. Dialysate sodium and regional blood
      flow.

PMID- 2225852
TI  - Assessment of renal volume in vivo using SPECT.

PMID- 2225853
TI  - Long-term follow-up of separate glomerular filtration rate in partially
      obstructed kidneys.

PMID- 2225854
TI  - Comparison of conventional furosemide diuresis renography with direct intrapelvic
      infusion renography.

PMID- 2225855
TI  - Serial furosemide renography in asymptomatic hydronephrosis diagnosed by
      ultrasound in utero and neonatally.

PMID- 2225856
TI  - Paradoxical increased glucoheptonate uptake in experimental renovascular
      hypertension.

PMID- 2225857
TI  - Captopril-stimulated renography versus renal vein renins in two-kidney, two-clip
      hypertension.

PMID- 2225858
TI  - Detection of renal artery stenosis by means of captopril renography with 99mTc
      DTPA.

PMID- 2225859
TI  - Captopril renography and duplex sonography: comparison of two noninvasive methods
      for the diagnosis and follow-up in renovascular hypertension.

PMID- 2225860
TI  - Results of quantification of frusemide response in 123I-hippuran renal studies of
      unilateral renal artery stenosis.

PMID- 2225861
TI  - Usefulness of renal sequential scintigraphy for the evaluation of
      antihypertensive drugs.

PMID- 2225862
TI  - Captopril radionuclide test in renovascular hypertension. A European multicenter
      study.

PMID- 2225863
TI  - Captopril scintirenography: a protocol to assess efficacy and methodology. A
      collaborative study.

PMID- 2225864
TI  - Lasix captopril renography in the diagnosis of renovascular hypertension.

PMID- 2225865
TI  - Renal imaging of thallium-201 during cardiac evaluation.

PMID- 2225866
TI  - The permeability of the human bladder to water assessed using tritiated water.

PMID- 2225867
TI  - Prolonged constant dual-isotope infusion for determination of renal function
      after water loading in hypertensive diabetic men.

PMID- 2225868
TI  - Simultaneous measurement of glomerular filtration rate and effective renal plasma
      flow reveals increased glomerular capillary pressure among teenage diabetic
      subjects.

PMID- 2225869
TI  - Clinical evaluation of the filtration fraction: multivariate statistical
      analysis.

PMID- 2225870
TI  - Renal tubular reabsorption of calcium in primary hyperparathyroidism.

PMID- 2225871
TI  - The impact of different urinary flow rates on renoscintigraphy.

PMID- 2225872
TI  - Renal function, urinary flow rates and diuresis renography.

PMID- 2225873
TI  - Validation of a new method for quantifying renal function.

PMID- 2225874
TI  - The radionuclide renal scan: past, present and future.

PMID- 2225875
TI  - Abnormal renal mobility: radionuclide features and clinical relevance.

PMID- 2225876
TI  - Acute effect of urapidil on peripheral serotonin metabolism.
AB  - In a cross-over study, the effect of 25 mg urapidil infusion (U, Ebrantil 25, Byk
      Gulden, FRG) on serotonin (5HT) metabolism and platelet aggregation (PA) was
      compared with the effect of placebo (P) in 7 patients with essential
      hypertension. No changes in 5HT and 5-hydroxyindolacetic acid (5HIAA) plasma
      levels and platelet 5HT content were observed. PA induced ex vivo by ADP
      decreased significantly. 5HIAA urinary excretion and fractional excretion (FE)
      increased, while 5HT renal metabolism changed only moderately. No changes in
      adrenaline and noradrenaline excretion were observed. In in vitro studies, U in
      therapeutic levels decreased ADP-induced PA and completely inhibited 5HT-induced
      PA (platelets of healthy volunteers). It is suggested that U has a direct
      antiaggregatory effect through 5HT2 receptors of platelets.

PMID- 2225877
TI  - New methods of diagnosing receptor metabolism disturbances of low density
      lipoproteins.
AB  - The authors present new approaches to assessment of various aspects of receptor
      metabolism for low density lipoproteins in patients with atherosclerosis: the
      ability of lipoproteins to interact with cell receptors in culture in the
      presence of nonfractionated serum; analysis of the genetically determined number
      of LDL receptors on culture cells, and the in vivo lipoprotein uptake in the
      liver. The ability of apo B-containing lipoproteins in patients with
      atherosclerosis to interact effectively with cell receptors was confirmed, the
      activity of LDL receptors on cells in cultures from patients with
      hypercholesterolaemia was analysed, and a decrease in 99mTc-labelled LDL uptake
      in the liver of patients with the heterozygous form of familial
      hypercholesterolaemia was demonstrated. The above approaches could be useful in
      the choice of individual treatment of clinically manifest atherosclerosis and
      evaluation of therapeutic efficacy.

PMID- 2225878
TI  - Significant X-ray patterns in cardiomyopathy--an approach improving noninvasive
      diagnosis.
AB  - To identify their characteristic patterns, the X-ray dorso-ventral chest images
      of 118 patients with cardiomyopathy (63--dilated cardiomyopathy, 25--hypertrophic
      obstructive cardiomyopathy, 30--hypertrophic nonobstructive cardiomyopathy) were
      analyzed and compared with those of 22 patients without cardiac abnormalities.
      All 140 patients underwent comprehensive invasive cardiac examinations. In
      dilated and hypertrophic nonobstructive cardiomyopathy transvasal endomyocardial
      biopsy was performed. Irrespective of the type and the aetiology of
      cardiomyopathy, 4 characteristic patterns of X-ray findings could be identified:
      a class of left heart abnormality (class L) and 3 types of bilateral cardiac
      abnormalities with various stages of left heart failure (class L + R). An
      association between the image patterns and haemodynamic parameters (left
      ventricular end-diastolic pressure, wall mass index, pulmonary mean pressure) was
      demonstrated which was most obvious in dilated and less evident in hypertrophic
      obstructive cardiomyopathy. Mitral insufficiency in all types and classes
      frequently corresponded with the X-ray findings of left atrial enlargement. The X
      ray classification method proved to be an efficient approach and superior to the
      heart-to-lung ratio.

PMID- 2225879
TI  - Cardioprotective conditioning with glucose and insulin prior to cardiac surgery
      involving ischaemic cold arrest.
AB  - The study describes cardioprotective conditioning by means of high doses of
      glucose together with insulin and potassium. Eighteen hours before cardiac
      surgery, nine patients received continuous infusion of 1000 ml of 40% glucose
      solution along with 112 U of insulin and 60 mmol of potassium. Before and after
      ischaemic cold arrest, the myocardial a--v differences of lactate, pyruvate,
      glucose, Na, K, Cl, Ca, P, free fatty acids and triglycerides were analysed in
      all patients. Blood collections were performed in parallel with ultramicroscopy
      of biopsy specimens from the right atrium. The results were compared with those
      obtained in a control group of 22 patients without cardioprotective conditioning
      with glucose, insulin and potassium. Neither the analysis of the myocardial a--v
      differences of metabolites, nor the finding on the mitochondria and myofibrils
      documented statistically significant differences between the control and
      conditioned groups. Following termination of ischaemic cold arrest, patients in
      the conditioned group exhibited more glycogen grains in myocardial cells than
      those in the control group. While 34% of patients in the control group were
      defibrillated after revascularization, it was not necessary in any of the
      conditioned patients.

PMID- 2225880
TI  - Different levels of cardiovascular risk factors in type-2 diabetic patients with
      lower limb proximal and distal vessel macroangiopathy.
AB  - The levels of some cardiovascular risk factors (lipids, apolipoproteins and
      fibrinogen) were measured in groups of Type-2 diabetic patients with lower limb
      proximal (ileofemoral) and distal (trifurcational) artery macroangiopathy,
      diagnosed by Doppler ultrasound, and in a group of diabetics without
      macroangiopathy. The highest mean levels of total and LDL-cholesterol,
      apolipoprotein B and triacylglycerols were observed in patients with proximal
      vessel involvement. Significant correlations were found between the thigh/arm
      index and total cholesterol, LDL-cholesterol, apolipoprotein B and stroke
      prevalence. On the other hand, a significant correlation was found between
      ankle/thigh index and fibrinogen. The results of the study suggest that different
      pathogenetic mechanisms may play a role in the development of ileofemoral and
      trifurcational vessel disease.

PMID- 2225881
TI  - The amputation level: noninvasive methods and clinical criteria.
AB  - Before undergoing amputation of a lower limb, one hundred and forty-six patients
      suffering from arteriosclerosis were studied with the purpose of finding
      prognostic indicators of success at the most distal level. The best results were
      obtained when skin perfusion pressure was above 60 mmHg in diabetics and above 40
      mmHg in non-diabetics. Lower limb systolic blood pressure and skin thermometry
      also proved to be useful. The method proposed might be helpful to the surgeon in
      choosing the best treatment for the patient. It is a nonivasive procedure which
      can be easily performed and does not require sophisticated or expensive
      equipment.

PMID- 2225882
TI  - The number and some other characteristics of isolated human ventricular
      cardiomyocytes under pathological conditions.
AB  - Using a modified method for alkalic dissociation, isolated ventricular
      cardiomyocytes were obtained from eight patients who had died of different
      diseases. The absolute number of cardiomyocytes, counted in the Fuchs-Rosenthal
      chamber, ranged between 1.10 x 10(9) and 3.25 x 10(9) in the left ventricle, and
      between 0.58 x 10(9) and 1.42 x 10(9) in the right ventricle depending on
      myocardial mass. Mean volume of cells ranged between 75 x 10(3) and 344 x 10(3)
      microns3, and the content of polynuclear, predominantly binucleated,
      cardiomyocytes amounted to 14 to 49%. An increase in ventricular myocardium mass
      was associated with an increase in cardiomyocyte volume. A negative correlation
      was demonstrated between the absolute number of cardiomyocytes on the one hand,
      and their mean volume and proportion of polynuclear cells on the other.

PMID- 2225883
TI  - Romano-Ward syndrome: case report, family study and signal averaged
      electrocardiogram.
AB  - A family with the Romano-Ward syndrome is described. A 28-year-old woman had
      episodes of syncope due to self-terminating ventricular tachycardia torsades de
      pointes. During lidocaine treatment she developed a sustained ventricular
      tachycardia and cardiopulmonary resuscitation was necessary. Propranolol reduced
      ventricular ectopic activity, but the QTc interval remained prolonged. A
      "threshold" in QT duration for the generation of complex ventricular arrhythmias
      was observed in the patient. There were no late ventricular potentials noted in
      the signal averaged ECG in the patient and in members of her family.

PMID- 2225884
TI  - Use of myocardial skinned fibres for the study of mitochondrial oxidative
      phosphorylation during ischaemia.
AB  - The authors studied mitochondrial oxidative phosphorylation in the skinned
      myocardial fibres of the rat and the rabbit during ischaemia. Saponin action on
      tissue was used to remove the sarcolemma while leaving the interior of
      intracellular structures intact. Mitochondrial oxidative phosphorylation was
      measured by polarography using Clark's oxygen electrode in the presence of NAD-
      and FAD-substrates. The skinned fibre method is rapid and very simple. The fact
      no more than 5-10 mg of tissue is needed to perform it makes it suitable for the
      study of metabolic processes in experimental and clinical cardiology, under
      physiologic conditions as well as during ischaemia.

PMID- 2225885
TI  - Depression and recovery of right ventricular function after cardiopulmonary
      bypass.
AB  - Transient left ventricular dysfunction is commonly described in association with
      cardiopulmonary bypass (CPB). We evaluated changes in right ventricular (RV)
      function after elective cardiac surgery in 24 patients with normal preoperative
      cardiac function. In all, irrespective of distribution of coronary artery disease
      or use of pharmacologic support, a transient depression of RV systolic function
      with respect to both preinduction and initial postoperative (Postop) values
      occurred 262 +/- 116 min post-CPB as represented by a decrease in RV stroke
      volume index (25.0 +/- 1.7 vs. 33.4 +/- 1.9 ml/m2 Postop) and RV ejection
      fraction (31.0 +/- 2.2 vs. 45.6 +/- 2.5% Postop), and an increase in RV end
      systolic and end-diastolic volume indices. This depression responded readily to
      pharmacologic therapy within 2 h, resolved within 24 h, and had no adverse
      consequences in these otherwise healthy patients. Further studies are needed to
      identify the cause of this phenomenon and its importance in patients with
      preexisting cardiac dysfunction.

PMID- 2225886
TI  - Community-acquired pneumonia: evidence of functional inactivation of alpha 1
      proteinase inhibitor.
AB  - Quantitative and qualitative elastase inhibitory capacity (EIC) alpha 1
      proteinase inhibitor (alpha 1 PI) was measured in pulmonary arterial and systemic
      arterial blood of patients with community-acquired pneumonia (CAP). Eleven
      patients with uncomplicated CAP were compared with 16 patients with fulminating
      pneumonia requiring intensive care management. An appropriate increase in
      quantitative alpha 1 PI was demonstrated in all patients. A significant
      functional inactivation of alpha 1 PI was demonstrated in the ICU-treated
      patients that was not apparent in the uncomplicated CAP patients (p less than
      .01). This low EIC returned to normal 4 wk after hospital discharge in all
      survivors. A significant (p less than .02) difference in EIC between the
      pulmonary arterial and systemic arterial blood was found in the nonsurvivors on
      admission, which suggests that alpha 1 PI is inactivated in the lungs of patients
      with fulminating CAP. The present data demonstrate that alpha 1 PI is
      functionally inactivated in patients with fulminating CAP. This low serum
      functional alpha 1 PI may result in proteolytic lung damage and an unfavorable
      outcome.

PMID- 2225887
TI  - Hypophosphatemia--incidence, etiology, and prevention in the trauma patient.
AB  - Hypophosphatemia is associated with a number of undesirable physiologic
      consequences and has been reported to occur frequently in trauma patients. We
      studied patients in the immediate posttraumatic period to document a) the
      decrease in serum P, b) renal P excretion, and c) the response to prophylactic
      PO4 administration. In both group 1 (n = 12) and group 2 (n = 10) patients, we
      measured serum P, creatinine, ionized Ca, urinary P excretion, and creatinine
      clearance daily for the first 3 to 4 days postinjury. Patients in group 2 also
      received 0.5 mmol/kg.day of PO4 for the first 48 h after admission. Group 1
      patients exhibited a significant (p less than .05) decrease in serum P over the
      first 24 h (1.00 +/- 0.30 to 0.75 +/- 0.23 mmol/L). In contrast, group 2 patients
      did not demonstrate a decrease in serum P. Urinary P excretion in group 1
      accounts for the observed decrease in serum P. The results of our study show that
      the immediate posttraumatic period is associated with a decrease in serum P and
      massive urinary P excretion. We also showed that prophylactic administration of
      0.5 mmol PO4/kg.day prevents serum P decrease.

PMID- 2225888
TI  - Hypocalcemia and hypercalcitoninemia in critically ill children.
AB  - To study Ca metabolism in critically ill children, we measured ionized Ca (Ca2+),
      parathyroid hormone (PTH), calcitonin, 25 hydroxycholecalciferol (25[OH] D3), 1
      25 dihydroxycholecalciferol (1-25[OH]2D3, and gastrin levels in critically ill
      children and in healthy controls. Patients were considered hypocalcemic if Ca2+
      was less than 1.1 mmol/L. Six (14%) of 45 patients were hypocalcemic. Five
      hypocalcemic patients were studied and were found to have higher calcitonin
      levels than normocalcemic patients and healthy controls and higher PTH levels
      than healthy controls. 25(OH)D3 and 1-25(OH)2D3 were not significantly different
      in the three groups of patients. Gastrin levels were low in critically ill
      patients, whether or not they were hypocalcemic. We conclude that hypocalcemia
      occurs frequently in critically ill children. It is associated with raised levels
      of calcitonin and PTH. The mechanism for the increase in calcitonin is unknown.

PMID- 2225889
TI  - Jugular bulb catheterization: experience with 123 patients.
AB  - Jugular bulb catheterization (JBC) provides cerebral venous access for titration
      of brain-specific therapy. Little has been written about the catheterization
      procedure. We prospectively studied the time, number of punctures, success rate,
      and complications during JBC for a 24-month period in our ICUs. One hundred
      twenty-three patients (mean age 6.7 yr, range 12 hours to 21 yr) underwent JBC.
      Procedure time was 15.6 +/- 5.0 (SD) min. Median number of skin punctures was
      two. All but four were successful on first attempt. Three of the remaining were
      catheterized on second attempt. Inadvertent carotid puncture occurred in 3%. No
      other significant complications were noted. Radiography confirmed proper position
      in 97%. Duration of indwelling venous catheters was 2.5 +/- 1.6 days. All
      catheters functioned well until removal. We conclude that our technique of JBC is
      safe and highly successful. It compares favorably with previous, smaller series
      and with standard anterograde internal jugular catheterization in both children
      and adults.

PMID- 2225890
TI  - Assessment of creatinine clearance in intensive care patients.
AB  - Assessment of creatinine clearance (CC) in ICU patients was compared using three
      methods. The reference method (CC 24 h) used measurements of serum creatinine and
      urinary creatinine after collection of urine over a 24-h period. The other two
      methods were predictive methods: the Kampmann nomogram and the formula developed
      by Gault and Cockcroft. The two predictive methods correlated well with one
      another. Correlation between the predictive and the reference methods was poor or
      absent. A discriminant analysis revealed that measurement of urinary creatinine
      was a major factor in CC estimation. In conclusion, the reference method of CC
      assessment is preferred to obtain a reliable estimation of glomerular filtration
      rate in ICU patients.

PMID- 2225891
TI  - Timing of intensive care unit admission in relation to ICU outcome.
AB  - This study assessed the relationship between admission time (from hospital
      admission to ICU admission) and mortality predicted by the Mortality Prediction
      Model (MPM), actual mortality, and resource use. All admissions, except elective
      surgery patients, to the general medical/surgical ICU of a tertiary care hospital
      during a 24-month period were studied (n = 1,889). Patients admitted to the ICU
      within 1 day of hospital admission had lower predicted and actual mortality, and
      used fewer resources than patients admitted later. Predicted mortality was higher
      than actual mortality for patients admitted to the ICU early and was lower than
      actual mortality for later ICU admissions. Transfers had higher predicted and
      actual mortality, and used more resources than nontransfer patients. Time from
      hospital admission to ICU admission can be a potentially useful variable in
      models of ICU outcome.

PMID- 2225892
TI  - Tracheostomy in children with Guillain Barre syndrome.
AB  - During the 10-yr period beginning January 1979, 59 infants and children with
      Guillain Barre syndrome (GBS) were admitted to our hospital. Tracheostomies were
      performed in 15 patients and their records were reviewed. Fourteen patients were
      recalled for assessment of pulmonary function and respiratory muscle strength
      (RMS). The median duration of assisted ventilation (including endotracheal [ET]
      intubation) was 21 days and the median duration of tracheostomy was 39 days. Only
      two patients were discharged with the tracheostomy in situ. All patients were
      successfully decannulated at the first attempt. No tracheostomy-related
      complications or symptoms were reported apart from croup in two patients. On
      review, lung volumes and maximal inspiratory and expiratory flows were normal.
      There was no evidence of tracheal stenosis or significant tracheomalacia. RMS
      tests were normal. In this hospital, tracheostomy is a safe, well-tolerated
      procedure in the management of infants and children with GBS who need long-term
      ventilation. There were no deaths and all patients returned to their normal
      school or were gainfully employed after their illness, although 12 patients had
      mild persistent weakness of at least foot dorsiflexion.

PMID- 2225893
TI  - Prevention of nosocomial lung infection in ventilated patients: use of an
      antimicrobial pharyngeal nonabsorbable paste.
AB  - A comparative, prospective study was made of the incidence of infection in the
      lower airway (purulent tracheobronchitis and pneumonia) in long-term patients who
      were mechanically ventilated due to respiratory failure of noninfectious origin.
      Twenty-eight patients were randomly allocated into a study group (A, n = 13) in
      which a nonabsorbable paste containing 2% tobramycin, 2% amphotericin B, and 2%
      polymyxin E was administered locally to decontaminate the oropharynx, and a
      control group (B, n = 15) in which a paste without antibiotics was also applied
      to the oropharynx. We studied the effectiveness of the prophylactic technique in
      decontaminating the oropharynx and trachea of organisms potentially pathogenic
      for the respiratory system. Decontamination was successful in ten of 13 patients
      in group A vs. one of 15 patients in group B (p less than .001). The results
      demonstrated a lower rate of infection in the lower respiratory tract in the
      study group (three patients with tracheobronchitis and no pneumonias) than in the
      control group (three patients with tracheobronchitis and 11 with pneumonia), the
      difference between both being highly significant (p less than .001). Two (15%)
      patients in group B developed sepsis of pulmonary origin. None of the patients on
      prophylactic treatment developed this complication. Although the overall
      mortality was similar in both groups (group A, 30% vs. group B, 33%), we believe
      that infection contributed to a great extent to the death of two of five patients
      in group B. We conclude that nosocomial pneumonia, which is a frequent
      complication in critically ill patients on mechanical ventilation, could be
      prevented by local application of nonabsorbable antibiotics to the oropharynx.

PMID- 2225894
TI  - Iatrogenic illness in pediatric critical care.
AB  - Iatrogenic illness may be an important determinant of the need for pediatric
      intensive care. We prospectively evaluated consecutive admissions to a pediatric
      ICU (PICU) over two time periods totaling 6 months. Twenty-five (4.6%) admissions
      were necessitated by iatrogenic illnesses. Drug-induced conditions accounted for
      eight (32%) of the iatrogenic patients, and complications of medical-surgical
      acts accounted for 17 (68%). Diagnoses included six respiratory failures due to
      seizure medications, six chronic upper airway complications of neonatal intensive
      care, four posttonsillectomy and postadenoidectomy complications, two chronic
      postcardiac surgery complications, two cardiac catheterization complications, and
      five miscellaneous conditions. One (3.7%) patient with iatrogenic illness died.
      As a group, patients with iatrogenic illness were at a risk of dying similar to
      other patients. We conclude that iatrogenic illness is a significant cause of
      PICU admission.

PMID- 2225895
TI  - Effects of intravenous immunoglobulin on hemorrhage-induced alterations in plasma
      cell repertoires.
AB  - Hemorrhage produces decreases in serum immunoglobulin (Ig) levels and alterations
      in the number and frequency of B cells producing antibodies against bacterial
      antigens. These abnormalities in immune response may contribute to the increased
      susceptibility to infection after injury and hemorrhage. To examine the
      relationship between serum Ig levels and bacterial antigen-specific plasma cell
      numbers and frequencies after blood loss, we treated hemorrhaged mice with
      intravenous Ig (IVIG). Hemorrhaged mice given IVIG had increased total numbers of
      splenic plasma cells compared with normal or hemorrhaged, untreated mice.
      Immunization with the bacterial polysaccharide antigen levan immediately after
      hemorrhage resulted in approximately 60% fewer levan-specific splenic plasma
      cells than those seen in normal unhemorrhaged mice. Treatment of hemorrhaged mice
      with IVIG did not correct the decrease in levan-specific plasma cells. These
      results demonstrate that hemorrhage-induced alterations in the numbers and
      frequencies of bacterial antigen-specific B cells are not related to changes in
      serum Ig levels and cannot be corrected through administration of IVIG.

PMID- 2225896
TI  - High-frequency oscillation during simulated altitude exposure.
AB  - Ventilatory requirements using high-frequency oscillation (HFO) during simulated
      altitude exposure were investigated in control dogs and animals with oleic acid
      induced lung injury. FIO2 values of 0.21 and 1.0 were supplied by bias flow to
      the normal and injured dogs, respectively. After a control period, animals were
      exposed to a simulated altitude of 8,000 ft (barometric pressure 564 torr),
      followed by a second control period at ground level. Both experimental groups had
      similar values of PaCO2 at ground level and during exposure to reduced barometric
      pressure. The tidal volume necessary to maintain eucapnia was higher in oleic
      acid-injured animals compared with the control group; cardiac output and
      functional residual capacity were lower. The alveolar-arterial oxygen difference
      was substantially larger in the oleic acid group. Adequate gas exchange can be
      maintained with HFO during exposure to altitude provided that ventilation and
      inspired PO2 are not reduced below normobaric levels.

PMID- 2225897
TI  - Effects of clinical maneuvers on sonographically determined internal jugular vein
      size during venous cannulation.
AB  - We sought to define variations in internal jugular vein (IJV) anatomy and the
      effect of recommended cannulation maneuvers on a population of ICU patients.
      Maneuvers that decreased IJV lumen cross-sectional area were carotid artery
      palpation (1.48 to 0.82 cm2, p less than .05) and advancement of the needle (1.57
      to 0.75 cm2, p less than .001). The head-down (modified Trendelenburg) position
      increased IJV lumen cross-sectional area (1.18 to 1.62 cm2, p less than .05).
      There was wide variability in IJV anatomic features, although most patients had
      patent veins.

PMID- 2225898
TI  - Stroke volume measurements by electrical bioimpedance and echocardiography in
      healthy volunteers.
AB  - To evaluate the validity of three equations for estimation of thoracic electrical
      field size in a new bioimpedance algorithm, stroke volume (SV) as calculated by
      these equations was compared with that calculated by Doppler echocardiography in
      48 healthy volunteers, both lean and obese. When the volume of electrically
      participating tissue was estimated from body height (modified Sramek) or body
      height corrected for body habitus (Sramek-Bernstein), there was considerable
      variation between bioimpedance and Doppler stroke volumes. When the volume of
      electrically participating tissue was estimated from the actual measurement of
      the height of the thorax and the circumference at the base of the thorax, the
      variation in SV differences decreased substantially (Sramek equation), although
      still considerable for clinical use, and there was no relationship between SV
      thus obtained and body habitus. Analysis of calculated stroke indices derived by
      our Doppler echocardiographic standard, as compared with values in the
      literature, revealed a systematic underestimation. We conclude that the original
      Sramek equation systematically underestimates SV by 15% to 20%, and the modified
      Sramek and Sramek-Bernstein equations systematically underestimates SV by 15% to
      20%, and the modified Sramek and Sramek-Bernstein equations systematically
      overestimate SV in females by about 15%, but provide SV values in males in the
      predicted range. Further studies on the current assumption that the electrical
      field size is a truncated cone may improve precision of the bioimpedance method.

PMID- 2225899
TI  - Use of a palatal stabilizing device in prevention of palatal grooves in premature
      infants.
AB  - A prospective, randomized study using an acrylic palatal stabilizing device (PSD)
      was conducted to evaluate the effectiveness of this device in preventing
      disruptions in palatal architecture. A total of 26 premature infants with birth
      weights of 540 to 1740 g, and intubated orally for a period varying from 7 to 109
      days were randomized to control and experimental groups. All neonates in the
      control group developed palatal grooving ranging from 2 to 5 mm in depth, whereas
      those in the experimental group (with a PSD) showed no evidence of palatal
      grooving. We conclude that a PSD is an effective preventive device in premature
      orally intubated infants.

PMID- 2225900
TI  - National estimates of intensive care utilization and costs: Canada and the United
      States.
AB  - Although ICUs generate attention as consumers of resources, no national data on
      utilization and costs were available in Canada. U.S. estimates are too old for
      current comparison. Based on national hospital survey data from Statistics
      Canada, we calculated the utilization of ICUs in all Canadian general hospitals
      from 1969 to 1986 and estimated costs for 1986. Using the American Hospital
      Association's Annual Survey, we estimated comparable trend data from U.S.
      hospitals for the period of 1979 to 1986, and national ICU costs for 1986. The
      results demonstrated steady growth in Canadian utilization from 1969 to 1986,
      with increased ICU patient days (17 to 42 days/1000 population). National costs
      for 1986 were estimated at $1.03 billion (Canadian), which was roughly 8% of
      total inpatient costs and 0.2% of Canada's gross national product (GNP).
      Utilization trend data for the United States showed a rapid increase from 1979
      through 1982 with slower growth after that. In the United States, ICU utilization
      in 1986 was estimated at 108 patient days/1000 population. Total ICU costs were
      estimated at $33.9 billion (U.S.), which is 20% of all inpatient hospital costs
      and accounts for 0.8% of the GNP. ICU utilization in the United States is 2.5
      times that of Canada.

PMID- 2225901
TI  - Pneumocephalus caused by a nasopharyngeal oxygen catheter.

PMID- 2225902
TI  - Chemoreceptor injury as probable cause of respiratory depression after a
      simultaneous, bilateral carotid endarterectomy.

PMID- 2225903
TI  - Use and abuse of the balloon tip pulmonary artery (Swan-Ganz) catheter: are
      patients getting their money's worth?

PMID- 2225905
TI  - Is the timing of intensive care unit admission important?

PMID- 2225904
TI  - Acquired immunodeficiency syndrome and critical care.

PMID- 2225906
TI  - Critically ill polyneuropathy and weaning failure.

PMID- 2225907
TI  - Use of survivors' cardiorespiratory values as therapeutic goals in septic shock.

PMID- 2225908
TI  - Comparison of two impedance cardiographic techniques for measuring cardiac output
      in critically ill patients.

PMID- 2225909
TI  - Succinylcholine and atropine for premedication of the newborn infant before
      nasotracheal intubation: randomized, controlled trial.

PMID- 2225910
TI  - Cold denaturation of proteins.
AB  - This article summarizes all experimental facts concerning the cold denaturation
      of single-domain, multi-domain, and multimeric globular proteins in aqueous
      solutions with and without urea and guanidine hydrochloride. The facts obtained
      by various experimental techniques are analyzed thermodynamically and it is shown
      that the cold denaturation is a general phenomenon caused by the very specific
      and strongly temperature-dependent interaction of protein nonpolar groups with
      water. Hydration of these groups, in contrast to expectations, is favorable
      thermodynamically, i.e., the Gibbs energy of hydration is negative and increases
      in magnitude at a temperature decrease. As a result, the polypeptide chain,
      tightly packed in a compact native structure, unfolds at a sufficiently low
      temperature, exposing internal nonpolar groups to water. The reevaluation of the
      hydration effect on the base of direct calorimetric studies of protein
      denaturation and of transfer of non-polar compounds into water leads to revision
      of the conventional conception on the mechanism of hydrophobic interaction. The
      last appears to be a complex effect in which the positive contributor is van der
      Waals interactions between the nonpolar groups and not the hydration of these
      groups as it was usually supposed.

PMID- 2225911
TI  - RATG: implications for nursing care in organ transplantation.
AB  - Proper immunosuppression is a key element determining the survival of patients
      undergoing organ transplantation. RATG is one of several immunosuppressive agents
      available for use. Nurses need to recognize the unique challenges that RATG poses
      for patient and dosage preparation, along with those affecting its administration
      and post administration. Doing so can effectively aid the transplanted patient in
      achieving optimal immunosuppression with the least amount of unpleasant effects.
      The hospital stay for a transplant patient can be very frustrating and
      exhausting. Nursing interventions that limit these effects can foster a more
      desirable patient experience.

PMID- 2225912
TI  - Insulinoma: diagnosis and treatment.
AB  - A patient with an insulinoma, although rare, can be an interesting challenge to
      the critical care nurse. Recognition of signs and symptoms pointing to possible
      insulinoma is vital to prevent delays in appropriate treatment. Intensive nursing
      care is necessary in the preoperative, intraoperative, and postoperative stages
      of this condition.

PMID- 2225913
TI  - Effect of lead selection on atrial-paced rhythm.

PMID- 2225914
TI  - ANA policies regarding HIV disease.

PMID- 2225915
TI  - Care plan for the patient undergoing intracardiac myxoma excision.

PMID- 2225916
TI  - Acute esophageal bleeding and endoscopic injection sclerotherapy.
AB  - Endoscopic injection sclerotherapy in the critical care setting is a recently
      developed method for controlling bleeding from esophageal varices. Since this
      therapy is often employed as an emergency measure, nurses in ERs and ICUs should
      be familiar with the procedure. The enclosed outline can be modified to fit the
      needs of individual physicians, units, and institutions.

PMID- 2225917
TI  - Postoperative care of the renal transplant patient.

PMID- 2225918
TI  - Critical care nursing in the 21st century.
AB  - This paper has explored some of the major trends that we can anticipate
      encountering as we enter the 21st century. Critical care nurses who wish to
      participate proactively in shaping their professional destiny will listen closely
      to what futurists have to say about life in the decades ahead. The more we know
      about what to anticipate, the more informed our decisions will be, and the more
      likely we will make our desired future a reality.

PMID- 2225919
TI  - Dual-chamber update.

PMID- 2225920
TI  - People and environment protected from medical sharps with new disposal system.

PMID- 2225921
TI  - Bladder cancer.
AB  - Bladder cancer is largely a preventable disease; epidemiologic studies indicate
      that the majority of cases occur as a result of cigarette smoking or occupational
      exposures. The impact of screening high-risk populations is uncertain, but prompt
      and early diagnosis is essential for optimal therapeutic results. The management
      of different stages of disease varies greatly and is currently in a state of
      evolution. The majority of cancers are superficial, of low malignant potential,
      and can generally be treated cystoscopically. Few studies have addressed whether
      intravesical therapy will prevent high-risk patients with superficial disease
      from developing muscle invasion or distant metastases. Controversy exists as to
      optimal management of patients with invasive cancers. Improvements in technique
      and methodologies of urinary diversion have made cystectomy more tolerable for
      patients. Although cystectomy remains the "gold standard," probably not all
      patients require it. The careful selection of those patients whose bladders can
      be preserved is currently being evaluated. Combination chemotherapy for patients
      with metastatic bladder cancer is very active, appears to prolong survival, and
      may offer durable remissions to some patients. Whether chemotherapy will permit
      greater numbers of patients with invasive bladder cancer to be cured and bladders
      preserved remains to be determined.

PMID- 2225922
TI  - Neurologic conditions affecting the cardiovascular system.

PMID- 2225923
TI  - Sexual abuse of children.

PMID- 2225924
TI  - Inaugural address.

PMID- 2225925
TI  - A dermatologic diary. Portrait of a practice.

PMID- 2225926
TI  - The management of eyelid dermatitis in patients with "status cosmeticus": the
      cosmetic intolerance syndrome.

PMID- 2225927
TI  - Recent developments in sexually transmitted diseases: is heterosexual
      transmission of human immunodeficiency virus a major epidemiologic factor in the
      spread of acquired immunodeficiency syndrome? III: AIDS in Sub-Saharan Africa.

PMID- 2225929
TI  - Epilation.
AB  - An ancient manual technique of epilation still in common usage, and modern
      electrical epilating devices, are compared. Folliculitis may occasionally be
      produced by either type of procedure.

PMID- 2225928
TI  - Swimmer's itch: a cercarial dermatitis.

PMID- 2225930
TI  - Lobomycosis (keloidal blastomycosis): case reports and overview.
AB  - Lobomycosis is a deep fungal disease of the skin without involvement of internal
      organs or mucous membranes. The disease is characterized by skin nodules and
      plaques resembling keloid involving the earlobes, distal parts of the upper and
      lower extremities, and buttocks. In severe cases, large skin areas can be covered
      by disseminated or grouped and confluent nodules. Most cases are reported from
      South and Central America. The fungus Paracoccidioides (Glenosporella) loboi is
      abundant in lesions but is extremely difficult to culture. Lobomycosis is
      resistant to chemotherapy, but in some cases it can successfully be treated by
      excision. Although the diagnosis is easily established by its typical clinical,
      histologic, and microbiological features, it is often misdiagnosed by physicians
      not familiar with the disease. We describe here five patients and present an
      overview of this rare disease.

PMID- 2225931
TI  - Incarceration for excoriation.
AB  - A thirty-six-year-old man experienced acute, severe, generalized pruritus. His
      scratching was erroneously interpreted as lewd and indecent behavior. He was
      arrested. Results of the history and physical examination led to the diagnosis of
      fiberglass dermatitis, which prompted a dismissal of the charges. Although many
      societies have looked askance at persons with certain skin diseases (such as
      leprosy) and at scratching in public since at least biblical times, we are not
      aware of any prior reports of incarceration for excoriation.

PMID- 2225932
TI  - Noonan's syndrome with extensive verrucae.
AB  - We report the case of a patient with multiple findings characteristic of Noonan's
      syndrome, including a severe lymphedema present since early infancy,
      hypertelorism, low-set and prominent ears, broad facies, low posterior hairline,
      high arched palate, broad short neck, slightly short stature, and moderate dental
      malocclusion. In addition, extensive verrucae planae, verrucae vulgares, and
      condylomata acuminata occurred and were refractory to conventional therapy. To
      our knowledge, this is the first report of an association of Noonan's syndrome
      with extensive verrucae. We speculate that it is related to immunodeficiency as a
      consequence of loss of immunoglobulins and lymphocytes from intestinal
      lymphangiectasia. Cutaneous findings and other physical anomalies reported in
      patients with Noonan's syndrome are reviewed.

PMID- 2225933
TI  - Tumefactive amyloidosis: a plantar pedal presentation.
AB  - Tumefactive or nodular amyloidosis represents an uncommon variant of the disease.
      Localized tumorous masses, which are lardaceous in appearance, rubbery in
      texture, and approaching several centimeters in diameter, typify the
      presentation. Such lesions pose unique problems when situated on the weight
      bearing regions of the plantar foot. The author discusses the use of
      accommodative weight-dispersing insoles as an alternative to surgical excision
      for the treatment of such lesions.

PMID- 2225934
TI  - Vitiligo and pernicious anemia presenting as congestive heart failure.
AB  - The skin often provides diagnostic clues to systemic disorders. Vitiligo is an
      acquired disease characterized by depigmentation of the skin due to destruction
      of melanocytes. Vitiligo may be an autoimmune disease and is associated with
      other disorders that may also arise due to autoimmune mechanisms. We present the
      unusual case of vitiligo associated with pernicious anemia in a patient who
      presented to the hospital because of hyperdynamic congestive heart failure.

PMID- 2225935
TI  - Impact of pretreatment (imprinting) with insulin on insulin-induced mitotic
      activity in Chang and CHO cell lines.
AB  - Primary interaction with insulin increased the mitotic activity of Chang liver
      and Chinese hamster ovary (CHO) cells. Re-exposure to insulin accounted for a
      significant increase of mitoses over the control, but for a considerable decrease
      thereof relative to the effect of primary exposure. The hormone had a more
      pronounced effect on its direct target cells (Chang liver cells) than on the CHO
      cells.

PMID- 2225936
TI  - A further study on the regulation of microbial proteases.
AB  - Various agents were tested for their effects on microbial proteases, which
      activity was monitored by the analysis of cleaved peptide bands in SDS
      polyacrylamide gel electrophoresis. Using casein as a substrate, fungal protease
      (type XIX) was inhibited by the phenyl methyl sulphonyl fluoride, chymostatin,
      antipain and leupeptin, while bacterial protease (type XXVI) was inhibited by
      phosphatidyl glycerol, phosphatidyl inositol and sphingosine. MS2 RNA exerted
      minor inhibition on the bacterial proteolysis of regulatory subunits of cyclic
      AMP-dependent protein kinase (A-PK). The cleavage of DNA binding protein by both
      proteases was inhibited, in the presence of MS2 RNA and lambda DNA. In
      comparison, phosphatidyl serine slightly stimulated the fungal protease on the
      cleavage of ribonuclease T1. RNA polymerase is a good substrate of the bacterial
      protease as indicated by the generation of multiple cleaved peptide fragments,
      whereas alkaline phosphatase is not susceptible to proteolysis.

PMID- 2225937
TI  - Percutaneous tracheostomy. A cautionary note.

PMID- 2225938
TI  - Take a doctor to dinner.

PMID- 2225939
TI  - Tuberculosis in the time of AIDS. The facts and the message.

PMID- 2225940
TI  - Angiotensin-converting enzyme inhibitors and cough.

PMID- 2225941
TI  - Hepatopulmonary syndrome.

PMID- 2225942
TI  - Thermodilution right ventricular ejection fraction. Remaining questions.

PMID- 2225943
TI  - Undiagnosed tuberculosis in patients with human immunodeficiency virus infection.
AB  - We describe the clinical features of 11 patients with human immunodeficiency
      virus infection in whom tuberculosis was undiagnosed and untreated prior to
      death. Most patients (9 of 11) had pulmonary complaints and 8 of 11 had
      roentgenographic findings suggestive of tuberculosis (hilar or mediastinal
      adenopathy, pleural effusion, apical infiltrate or miliary pattern). Despite
      these findings, tuberculin skin tests were not performed in any of the patients.
      Acid-fast smears of sputum were obtained in three cases and bronchoscopy
      performed in only four, reflecting the low index of suspicion for tuberculosis.
      Pneumocystis carinii pneumonia was the presumptive diagnosis in nine cases but
      was confirmed in only one case. Autopsy revealed tuberculosis as the cause of
      death in four patients. Of the seven patients who did not undergo autopsy,
      disseminated tuberculosis, manifest by mycobacteremia, was the only life
      threatening illness identified and probably contributed to death. Increased
      awareness of the clinical and roentgenographic features of tuberculosis in HIV
      infected patients, combined with more intensive use of acid-fast smears and
      tuberculin skin testing, are necessary in order to decrease mortality from this
      treatable complication of HIV-infection.

PMID- 2225944
TI  - Pulmonary manifestations of disseminated cryptococcosis in patients with AIDS.
AB  - Forty-eight patients with disseminated cryptococcosis and AIDS were
      retrospectively studied to define the pulmonary manifestations. Cryptococcus
      neoformans (CN) was first isolated from a pulmonary site in 12 patients.
      Disseminated disease was subsequently documented in all these patients. Symptoms
      and roentgenographic manifestations (normal, nodular/circumscribed infiltrates,
      pleural effusions, lobar consolidation) were diverse. Interstitial infiltrates
      predicted the presence of another opportunistic lung infection besides
      cryptococcosis in five patients (three untreated and two treated patients).
      Infectious causes other than cryptococcosis were established by culture and
      clinical course in five of the ten patients who developed chest roentgenographic
      abnormalities during amphotericin B therapy. Endobronchial abnormalities were
      identified in four patients at bronchoscopy. Bronchoalveolar lavage (9/9) and
      pleural fluid (3/3) cultures were sensitive tests for detection of pulmonary
      involvement with CN.

PMID- 2225945
TI  - Mortality from pulmonary embolism in the United States: 1962 to 1984.
AB  - To examine the effect of advances in the prevention of and therapy for PE, we
      reviewed mortality for PE in the United States from 1962 to 1984. Age-adjusted PE
      mortality increased by 67 to 100 percent between 1962 and 1974 for white and non
      white men and women. From 1975 to 1984, these rates declined by 20 to 28 percent.
      Non-white PE mortality was greater than white PE mortality; men had a greater
      risk of PE death than women. Age-specific patterns (more than 40 years of age) of
      PE mortality followed those of the age-adjusted death rates, with increases noted
      in all groups between 1962 and 1974 and declines during the 1975-1984 period.
      These patterns might reflect improved ascertainment of cases and better
      prevention of disease. The magnitude of the rates suggests that the list of
      indications for prophylactic anticoagulation should be re-examined for possible
      expansion.

PMID- 2225946
TI  - Exercise performance of polycythemic chronic obstructive pulmonary disease
      patients. Effect of phlebotomies.
AB  - The purpose of this study was to determine the effects of phlebotomy on the
      exercise tolerance and right and left ventricular ejection fraction of
      polycythemic patients with chronic obstructive pulmonary disease. Ten patients
      with COPD (mean FEV1 = 1.32 +/- 0.55 L) and polycythemia (mean Hct = 62 +/- 3
      percent) were studied before and after their hematocrits had been reduced to
      approximately 50 percent. Post-phlebotomy the maximal oxygen consumption
      increased from 1.09 +/- 0.34 L/min to 1.26 +/- 0.43 L/min (p less than 0.05) and
      the maximum workload increased from 56.5 +/- 32.6 watts to 74.5 +/- 23.4 watts (p
      less than 0.05). The increase in the exercise tolerance appeared to be primarily
      due to an increased cardiac output at Emax. There was no relationship between the
      increases in the upright exercise capacity and changes in the supine ejection
      fractions of the right or left ventricular either at rest or during exercise.

PMID- 2225947
TI  - Computed tomography in patients with esophageal perforation.
AB  - Contrast esophagram is the diagnostic procedure of choice in patients with
      clinically suspected perforation of the esophagus. In patients in whom the usual
      clinical signs or symptoms are unrecognized and in whom the diagnosis is obscure,
      the diagnosis of a perforated esophagus may be suggested by the finding of
      mediastinal fluid and air on CT. Three patients are reviewed. The perforations
      included one spontaneous, one from erosion of an esophageal carcinoma, and one
      iatrogenic. In two of the three patients, the diagnosis of perforated esophagus
      had not been made initially and in one patient the initial esophagram was
      interpreted as normal. Computed tomography of the chest in each patient led to
      the suspected diagnosis of perforated esophagus. Prompt appropriate surgical
      intervention followed. The findings of mediastinal fluid and more importantly
      mediastinal air on CT of the chest are strongly suggestive of esophageal
      perforation.

PMID- 2225948
TI  - Quality of well-being before and after antibiotic treatment of pulmonary
      exacerbation in patients with cystic fibrosis.
AB  - General quality of life has only recently been measured with an objective tool in
      patients with cystic fibrosis (CF), and there have been no reported attempts to
      document changes in patients' overall well-being over time, as patients
      deteriorate or respond to intervention. We applied the Quality of Well-Being
      scale (QWB) in 28 patients with CF before and after a two-week course of oral
      ciprofloxacin used to treat pulmonary exacerbations. There were significant
      correlations between changes in QWB and various pulmonary function test results;
      QWB vs FEV1: r = 0.4, p less than 0.03; QWB vs FVC: r = 0.5, p less than 0.01;
      and QWB vs SaO2: r = 0.4, p less than 0.05. Thus, the QWB can track changes in
      general well-being in CF patients over a brief time and detect changes associated
      with pulmonary exacerbation and its treatment.

PMID- 2225949
TI  - Bronchial hyperreactivity in patients with mitral valve disease.
AB  - To elicit the mechanism of bronchial hyperreactivity (BHR) in chronic heart
      failure (CHF), a methacholine inhalation test, pulmonary function test, and
      cardiac catheterization were performed in 19 patients with mitral valve disease
      (MVD), and the change of severity of BHR before and after mitral valve
      replacement (MVR) was also examined in seven of 19 patients with MVD. Sixteen of
      19 patients with MVD showed significant increase in respiratory resistance in
      methacholine inhalation test, while all normal subjects did not. The maximal
      expiratory flow at 25 percent of vital capacity (Vmax25), a parameter of small
      airway disease, correlated significantly with log cumulative dose producing a 35
      percent decrease in respiratory conductance (PD35Grs) (r = 0.536) and the
      duration of symptoms (r = -0.682). There was a significant correlation between
      log PD35Grs and mean pulmonary artery wedge pressure (r = -0.466). After MVR, log
      PD35Grs was significantly improved in all seven operated-on patients, although
      six patients retained BHR. We conclude that patients with long-term MVD have
      marked BHR and that BHR in long-term MVD is related to peripheral airway
      narrowing with organic remodeling, which was not ameliorated with MVR procedure,
      in addition to pulmonary congestion.

PMID- 2225950
TI  - Respiratory muscle strength in congestive heart failure.
AB  - In experimental animals, conditions which drastically decrease cardiac output may
      reduce the strength and endurance of respiratory muscles leading to hypercapnic
      respiratory failure. Because patients with chronic CHF have reduced cardiac
      output and vital capacity (FVC), we measured PImax and PEmax and maximal handgrip
      force in 16 patients with CHF and 18 AMNs. The patients with CHF had a mean left
      ventricular ejection fraction of 26 +/- 7 percent. Maximal respiratory pressures
      were significantly reduced; group mean values (+/- SD) for PImax at FRC were 41.4
      +/- 5.6 cm H2O (CHF) and 102.1 +/- 27.4 cm H2O (AMN) (p less than 0.001), with
      PImax values in five patients with CHF as low as 20 to 30 cm H2O. In most
      patients, PEmax was comparably reduced. Handgrip force was less dramatically
      reduced, suggesting selective respiratory muscle weakness. Possible explanations
      include reduction in respiratory muscle blood flow or generalized muscular
      atrophy and weakness related to cardiac cachexia.

PMID- 2225951
TI  - Comparison of aerosolized glycopyrrolate and metaproterenol in acute asthma.
AB  - The efficacy of nebulized glycopyrrolate compared with metaproterenol was
      evaluated in 46 patients with acute asthma. In a double-blinded, randomized
      fashion, patients received, as sole therapy, either 2 mg of glycopyrrolate or 15
      mg of metaproterenol every 2 h over a 6-h study period. Of the 35 patients
      completing the study, analysis of variance demonstrated no difference in
      percentage of change in FEV1 between glycopyrrolate and metaproterenol. Two hours
      after the initial dose, there was a 30 percent increase in FEV1 for
      glycopyrrolate compared with a 25 percent increase for metaproterenol (p greater
      than 0.05, NS). In contrast to the comparable bronchodilator activity, the side
      effects profile of the two agents were markedly dissimilar. Not only were
      subjective complaints of tremor, palpitations, and paresthesias increased for
      metaproterenol, but the heart rate response was significantly elevated (p less
      than 0.05) compared with glycopyrrolate. Based on these data, administration of
      the aerosolized anticholinergic agent, glycopyrrolate, is a reasonable
      therapeutic alternative for acute asthma.

PMID- 2225952
TI  - Myocardial revascularization for the third time. Clinical characteristics and
      follow-up.
AB  - Twenty-five patients presenting for a third revascularization procedure were
      retrospectively reviewed at Loyola University Medical Center, Maywood, IL. This
      represents 0.5 percent of the total revascularization cases over a five-year
      period extending from 1985 through 1989. Perioperative mortality was none, and
      seven complications occurred in six patients. Internal mammary arteries were used
      for revascularization in 60 percent of this group. Follow-up reveals that only
      one patient has died secondary to an arrhythmia. All patients except one are
      symptomatically improved, and 18 patients remain angina free at a mean follow-up
      of 22.3 months. It is therefore concluded that patients are clinically improved
      with a third revascularization, and this procedure should be offered as an
      effective means of treatment.

PMID- 2225953
TI  - The effects of phenylephrine on right ventricular performance in patients with
      pulmonary hypertension.
AB  - Pulmonary hypertension causes right ventricular ischemia and failure as a result
      of increased afterload combined with reduced coronary blood flow. Increasing
      coronary driving pressure by raising aortic pressure with phenylephrine has been
      shown to reverse right ventricular ischemia from pulmonary hypertension in
      animals. Since vasodilators often fail to reduce afterload, we tested whether
      raising the coronary driving pressure would improve right ventricular function in
      man. Ten patients with pulmonary hypertension had hemodynamics and right
      ventricular coronary driving pressure measured before and 10 minutes after a
      steady state was reached with a phenylephrine infusion titrated to raise aortic
      pressure by 25 percent. Phenylephrine caused a significant (p less than .01)
      increase in mean aortic pressure (84 to 108 mm Hg) and right ventricular coronary
      driving pressure (46 to 69 mm Hg). In response, there was a significant (p less
      than .01) rise in mean pulmonary artery pressure (58 to 67 mm Hg), right
      ventricular end-diastolic pressure (10 to 16 mm Hg) and wedge pressure (5 to 9 mm
      Hg), and an insignificant fall in cardiac output (3.26 to 3.09 L/min) and
      pulmonary artery O2 saturation (57 to 49 percent). Although phenylephrine
      increased right ventricular coronary driving pressure, it worsened right
      ventricular function as manifest by a rise in end-diastolic pressure and fall in
      cardiac output. Any benefit of raising right ventricular coronary driving
      pressure may have been offset by alpha vasoconstriction of right ventricular
      coronary blood flow and/or pulmonary arterial vasoconstriction. Phenylephrine
      does not appear to be a useful therapy of right ventricular failure from
      pulmonary hypertension in patients who fail vasodilators.

PMID- 2225954
TI  - Single lung transplantation for primary pulmonary hypertension.
AB  - Single lung transplantation has become a therapeutic option for end-stage
      interstitial lung disease and obstructive lung disease. Our group recently
      extended this treatment to three patients with primary pulmonary hypertension.
      All patients had marked decreases in pulmonary artery pressures and pulmonary
      vascular resistance and increases in cardiac output following single lung
      transplantation. Spirometry, lung volumes, and diffusion capacity were not
      different in comparison to preoperative studies. Quantitative ventilation
      perfusion scans revealed the majority of perfusion distributed to the
      transplanted lung, with ventilation approximately equally divided between the
      native and the transplanted lung. Despite ventilation-perfusion imbalance, there
      was no resting hypoxemia and there was no arterial oxygen desaturation with
      exercise. One patient expired on the 30th postoperative day due to
      cytomegalovirus infection of the lungs. In the remaining two patients, maximum
      exercise capacity following transplantation was near normal in one recipient and
      reduced in the second recipient. Of note, there was no evidence of ventilatory
      limitation or impaired oxygenation during exercise in these two recipients.
      Although an exaggerated exercise ventilatory response was present, this did not
      limit exercise performance. This report supports the use of single lung
      transplantation for the treatment of primary pulmonary hypertension.

PMID- 2225955
TI  - Subpleural mononuclear cell infiltration. Significance in the differential
      diagnosis of pleuritis showing nonspecific histologic findings.
AB  - To determine if patients who had lymphocyte-rich pleural effusion and a pleural
      biopsy without any specific findings could be histopathologically differentiated
      between those with tuberculous and nontuberculous pleuritis, we histologically re
      evaluated the pleural biopsies of all patients whose pleural effusion was
      predominant with lymphocytes and contained no malignant cells. A total of 40
      patients with a nonspecific histologic findings of pleural biopsy specimen were
      categorized based on their ultimate diagnosis as having tuberculous (n = 15),
      carcinomatous (n = 10) or nontuberculous, benign pleuritis (n = 15). The pleural
      biopsy specimen of patients with nontuberculous, benign pleuritis frequently
      showed a band-like infiltration of mononuclear cells in the subpleural adipose
      tissue with minimal pleural inflammatory infiltrate (10 out of 15 patients),
      while the same finding was infrequent in those with tuberculous pleuritis (0 out
      of 15, p = 0.0001) and pleuritis associated with carcinoma (three out of 10, p =
      0.082). Based on these results, the presence of band-like infiltration of
      mononuclear cells in the subpleural adipose tissue with minimal pleural
      inflammatory infiltrate in pleural biopsy specimens of patients with lymphocyte
      rich pleural effusion suggests that the pleuritis is nontuberculous in its
      nature.

PMID- 2225956
TI  - Bronchial cartilage alterations in lung transplantation.
AB  - Changes in the hyaline cartilage of the proximal bronchial tree were investigated
      in a group of combined heart-lung and double-lung recipients with and without OB.
      Ossification, calcification and fibrovascular ingrowth into the normally
      avascular hyaline bronchial cartilage were observed in almost all patients and
      were independent of small or large airway inflammation. Alterations in the
      integrity of hyaline cartilage have been produced by others in animals by
      ligation of the blood supply. Finding similar changes in airway cartilage of all
      transplanted lungs argues that there is relatively poor perfusion to the proximal
      air-conducting passage. Such a mechanism may contribute to the development of OB,
      bronchiectasis and a predilection for infections following pulmonary
      transplantation.

PMID- 2225957
TI  - Hyperresponsiveness of the extrathoracic airway in patients with captopril
      induced cough.
AB  - It has been suggested that cough from captopril may originate from an increased
      sensitivity of receptors in the extrathoracic airway (EA). To explore this
      hypothesis, we assessed the responsiveness of EA and bronchi and the cough
      sensitivity to inhaled histamine in nine hypertensive patients with captopril
      induced cough (group 1) during treatment and one month after withdrawal of the
      drug treatment. Nine patients who were asymptomatic while receiving captopril
      (group 2) and nine patients receiving no current treatment (group 3) served as
      controls. The EA responsiveness was assessed by using the maximal midinspiratory
      flow (MIF50) as an arbitrary index of EA constriction and was expressed as the
      histamine concentration causing a 25 percent decrease in MIF50 (PC25MIF50).
      PC15FEV1 was the index of bronchial responsiveness and PCcough (dose causing five
      or more coughs) was that of cough sensitivity. Airway hyperresponsiveness (EA-HR
      or BHR) was diagnosed when PC25MIF50 or PC15FEV1 were 8 mg/ml or lower. Patients
      with captopril-cough, as compared with controls, had significantly lower values
      of PC25MIF50, PC15FEV1, and PCcough; EA-HR and BHR were found, respectively, in
      seven and three of these patients and in none of the control subjects. In all the
      patients of group 1, cough and EA-HR resolved after withdrawal of captopril
      treatment, while BHR persisted in one. PC25MIF50, PC15FEV1, and PCcough were all
      significantly improved. Our findings suggest that cough during captopril therapy
      may originate from receptors in the EA.

PMID- 2225958
TI  - Cardiopulmonary assessment in beta-thalassemia major.
AB  - Thalassemia patients succumb at a young age to congestive heart failure.
      Hitherto, attention has been focused on left ventricular function. This report
      emphasizes right ventricular dysfunction and abnormal pulmonary function. We
      performed cardiopulmonary evaluation, including echo-Doppler, spirometry, CO
      diffusion (DCO), and blood gas analyses in 35 patients with homozygous beta
      thalassemia maintained by multiple blood transfusions. Six autopsy lung specimens
      were studied. Thalassemia patients exhibited pulmonary dysfunction, characterized
      by hypoxemia (85 percent of the patients were outside the 95 percent confidence
      limits), reduced lung volumes (51 percent), flow rates (63 percent) and DCO (50
      percent). Right ventricular dysfunction was more prevalent than left ventricular
      dysfunction. Furthermore, 75 percent of the patients had evidence of pulmonary
      hypertension consistent with more frequent right ventricular rather than left
      ventricular dysfunction. Our findings suggest that in thalassemia patients,
      complex cardiopulmonary abnormalities precede the final outcome of congestive
      heart failure.

PMID- 2225959
TI  - The entrainment of low frequency breathing periodicity.
AB  - It has been predicted by mathematical models of the respiratory control system
      that the delay between the lung and the respiratory controller may determine the
      cycle time found in periodic breathing. We examined cycle time of periodic
      breathing and circulation time in 11 patients known to have circulation delay due
      to heart failure. We did not find a significant relationship between the amount
      of periodic breathing and circulation delay, but found a very high correlation
      between circulation delay and the cycle time of periodic breathing (r2 = 0.825; p
      = 0.0001).

PMID- 2225960
TI  - Feasibility of intraoperative cytodiagnosis of lung cancer.
AB  - Of 354 thoracotomies, 114 cases involved intraoperative cytopathologic
      evaluation. The study included 86 men and 28 women, and 184 specimens were
      examined. Smears were taken from the lung lesion or lymph node and the chest wall
      or bronchial stump by imprint or needle aspiration. Intraoperative evaluations
      were compared with histologic findings. In 85 cases not diagnosed as malignant
      preoperatively, malignancy was confirmed in 97.6 percent of cases and histologic
      type in 71.8 percent. In the 28 cases diagnosed as malignant preoperatively,
      there was only one false-negative. The most important finding during thoracotomy
      is whether a lesion is malignant or not. The time required to obtain a pathologic
      diagnosis also is important. We are able to obtain the results of a cytologic
      diagnosis within 10 min. Cytologic diagnosis of malignancy during thoractomy may
      be a feasible and convenient method of diagnosis, especially where malignancy is
      suspected.

PMID- 2225961
TI  - Concentration of tumor-associated trypsin inhibitor (TATI) in pleural effusions.
AB  - We measured the concentration of tumor-associated trypsin inhibitor (TATI) in
      plasma and pleural fluid of 84 patients with pleural effusions of various causes.
      We observed elevated (greater than 30 micrograms/L) TATI levels in pleural fluid
      in 45 percent of patients with pleural effusion associated with malignant disease
      and in 15 percent of patients with benign disease. Similar results were obtained
      for TATI in plasma. The concentration of TATI in pleural fluid closely
      parallelled that in plasma. In patients with renal insufficiency and in patients
      with biliary obstruction, the TATI levels were elevated both in plasma and
      pleural fluid. A positive correlation was seen between the concentration of TATI
      and the activity of alkaline phosphatase in plasma. The results show that
      simultaneous determination of TATI in plasma and pleural fluid improves the
      diagnosis of cancer only marginally. Our results also support the hypothesis that
      elevated TATI levels may reflect an acute phase reaction caused by inflammatory
      disease or tissue destruction associated with cancer not only in inflammatory
      conditions, but also in malignant disease where the tumor itself is not producing
      TATI.

PMID- 2225962
TI  - Progressive functional deterioration of bioprostheses assessed by Doppler
      ultrasonography.
AB  - Doppler echocardiography was used to study the function of bioprosthetic heart
      valves by noninvasive means in 32 patients aged 29 to 72 years at various
      postoperative intervals. There were 24 Ionescu-Shiley, four Hancock, and four
      Carpentier-Edwards prostheses, 19 in the aortic and 13 in the mitral position.
      Initial studies were performed at a mean of 2.3 years after implantation and were
      repeated one, two, and three years thereafter. Flow velocities in the mitral
      orifice, left ventricular outflow tract, and ascending aorta, as well as mitral
      pressure half-time, were measured from pulsed-wave or continuous-wave Doppler
      recordings. Mitral and aortic valve areas and aortic pressure gradients were
      calculated. In aortic prostheses the valve area decreased and pressure gradient
      increased progressively in relation to the time from implantation. The mean value
      (+/- SD) of the aortic valve area was 67 +/- 17 percent of the manufacturer's
      nominal value at the first examination and 57 +/- 20 percent one year later, 51
      +/- 14 percent two years later, and 46 +/- 11 percent three years later (overall
      differences, p less than 0.01). In mitral prostheses, reduction of the valve area
      was not related to the time from implantation. The mean mitral valve area was 45
      +/- 12 percent of the nominal value at rest and increased to 68 +/- 18 percent
      during exercise at a mean of 45 months after implantation. There was no change in
      these values at the one-year repeat study. It is concluded that in a population
      with predominantly pericardial bioprostheses, (1) aortic tissue prostheses showed
      a progressive functional deterioration demonstrable by Doppler echocardiography,
      most probably due to degenerative changes; and (2) in mitral tissue prostheses,
      there was no significant reduction of orifice area in relation to time from
      implantation. Reduction of mitral valve areas may, to some extent, reflect a less
      than full opening at rest.

PMID- 2225963
TI  - Abnormal hemodynamic response to Valsalva maneuver in patients with atrial septal
      defect evaluated by Doppler echocardiography.
AB  - Hemodynamic responses to the Valsalva maneuver were studied in eight healthy
      subjects (group 1) and eight patients with ASD (group 2) using Doppler
      echocardiography. The acute changes of aortic blood flow profiles during the
      Valsalva maneuver were investigated on a basis of beat-to-beat estimation. During
      the active strain phase (phase 2), group 1 showed a significant decrease in
      systolic blood pressure, SV and CO with reflex tachycardia; in group 2, there was
      a significant decrease in SV and CO with reflex tachycardia, but not systolic
      blood pressure. The percentage decreases in SV and CO in group 2 were
      significantly less than those in group 1 (23 +/- 16 percent vs 48 +/- 10 percent
      for SV, p less than 0.01; 17 +/- 12 percent vs 40 +/- 13 percent for CO, p less
      than 0.05). After release of strain phase (phase 4), group 1 showed significant
      reversed changes in systolic blood pressure, SV and heart rate, indicating an
      overshoot effect which was, however, not observed in group 2. Thus, patients with
      ASD presented abnormal Valsalva response which was characterized by the absence
      of phase 4 overshoot and a less marked phase 2 change. The findings suggest that
      the decremental effect of impaired venous return on stroke output during active
      strain may be attenuated by the increased pulmonary blood volume due to left-to
      right shunt. In patients with ASD, the lesser decrement of CO during phase 2 may
      not provoke sufficient sympathetic activity to induce overshoot response in phase
      4.

PMID- 2225964
TI  - Neural respiratory drive and neuromuscular coupling in patients with chronic
      obstructive pulmonary disease (COPD).
AB  - In 15 spontaneously breathing patients with chronic obstructive pulmonary disease
      (COPD) divided into two groups, one with normocapnia (A) and one with chronic
      hypercapnia (B), we evaluated the maximal voluntary inspiratory muscle strength
      (MIP), the pattern of breathing, the mouth occlusion pressure (Po.1), the neural
      respiratory drive (NRD), assessed by surface electromyographic (EMG) activity of
      the diaphragm (EMGd) and EMG activity of intercostal muscles (EMGint), and the
      chest wall neuromuscular coupling, assessed in terms of Po.1/EMGd ratio. Compared
      with an age-matched normal control group, both A and B groups exhibited lower
      MIP, significantly greater EMGd and EMGint, and lower Po.1/EMGd ratio. However, a
      similar pattern, along with a rapid and shallow breathing, differentiated group B
      from group A. In group B we found a significant direct relationship between
      Po.1/EMGd ratio and MIP, and an inverse relationship between PaCO2 and Po.1/EMGd
      ratio. These data seem to indicate the following: (1) EMG is a more precise
      method than Po.1 in assessing the magnitude of the NRD; (2) NRD is increased in
      these patients; and (3) clinical manifestations probably associated with
      inspiratory muscle fatigue (marked decrease in muscle strength, rapid and shallow
      breathing, and alveolar hypoventilation) may be accompanied by a greater NRD and
      a more marked derangement in chest wall neuromuscular coupling in COPD.

PMID- 2225965
TI  - Real and pseudo late asthmatic reactions after submaximal exercise challenge in
      patients with bronchial asthma. A new definition for late asthmatic responses
      after exercise challenge.
AB  - The late asthmatic reaction after exercise challenge remains a controversial
      issue. In this study, 21 patients recorded peak expiratory flow rate (PEFR) on
      two control days without performing exercise. There was no difference between
      both control days when PEFR at 1 h was compared with baseline PEFR and when PEFR
      at 4 to 13 hours was compared with baseline PEFR. After analyzing variation
      coefficients of baseline PEFR on a control day and exercise day, PEFR was not
      allowed to differ more than 15.3 percent in the same patient when comparing
      exercise day and control day for the late fall in PEFR in the study. In 17 of 81
      patients, a late asthmatic reaction after exercise challenge was present when
      PEFR fall was greater than or equal to 20 percent compared with baseline PEFR
      value. In eight of the 17 patients, a real late asthmatic reaction to exercise
      challenge was present with a PEFR fall greater than or equal to 20 percent on at
      least three successive time points and who had a PEFR fall greater than or equal
      to 20 percent compared with corresponding clocktime on a control day. The late
      asthmatic reaction to exercise challenge is characterized not as a nonspecific
      epiphenomenon, but as a fall in PEFR of greater than or equal to 20 percent
      compared with baseline PEFR value and with corresponding clocktime on a control
      day on at least three successive time points. Graphic illustration of airway
      responses following exercises may facilitate the detection of a late asthmatic
      response.

PMID- 2225966
TI  - Hemodynamic status in critically ill patients with and without acute heart
      disease.
AB  - Physicians have been urged to reduce the use of the pulmonary artery catheter.
      However, there are no guidelines to help the clinician make the decision to use
      or withhold invasive monitoring in the individual patient. This study was
      designed to examine the accuracy of physician estimates of cardiac function in a
      spectrum of patients with hemodynamic instability to determine whether
      differences in accuracy among subgroups would suggest subgroups of patients who
      could be managed without invasive measurements. Physician estimates of cardiac
      index were found to be sufficiently accurate in patients without acute heart
      disease that initial management without invasive monitoring may be appropriate in
      selected cases. However, due to the general inaccuracy of physician estimates,
      efforts to improve the accuracy of clinical judgments of cardiac function and
      hemodynamic status should be pursued with vigor in patients both with and without
      acute cardiac dysfunction.

PMID- 2225967
TI  - The impact of right ventricular infarction on the prevalence of ventricular
      arrhythmias during acute inferior myocardial infarction.
AB  - To determine the impact of RV infarction on the prevalence and complexity of
      ventricular arrhythmias during inferior AMI, 57 patients with no prior MI were
      studied by 24-hour Holter monitoring on the first and tenth days of AMI. Based on
      radionuclear studies, patients were allocated into two groups: (1) group A, 21
      patients (37 percent) with normal RVEF (greater than or equal to 40 percent); and
      (2) group B, 36 patients (63 percent) with depressed RVEF (less than 40 percent).
      There were no significant differences between the groups regarding age and LVEF.
      Values of RVEF were 47 +/- 6 percent and 31 +/- 6 percent, respectively (p less
      than 0.05). The RVEF had no influence on the prevalence and complexity of early
      and late arrhythmias. Stratification of patients in group B into two subgroups
      based on the extent of RV dysfunction did not reveal any differences in the
      occurrence of all forms of ectopy (when both groups were matched to group A).
      Therefore, patients with inferior AMI, with or without RV infarction, have a
      similar prevalence of arrhythmias. Ventricular ectopic beats may be related to
      the severity and spread of LV involvement, rather than to RV dysfunction.

PMID- 2225968
TI  - Systemic hemodynamic and cardiac function changes in patients undergoing
      orthotopic liver transplantation.
AB  - The objective of this study was to determine the changes in systemic hemodynamics
      (systemic vascular resistance [SVR], cardiac output [CO], systemic blood pressure
      [SBP]) and cardiac function (pulmonary artery pressure [PAP] and pulmonary wedge
      pressure [PWP]) during the 96 hours following orthotopic liver transplantation
      (OLT) and correlate these with changes in hepatic and renal function and patient
      outcome. The study took place in a 12-bed medical respiratory intensive care unit
      in a large teaching hospital. Twenty-one patients had OLT performed over a 21.5
      month period (January 1988 to October 15, 1989) for end stage liver disease
      (ESLD) from a variety of causes. A flow-directed right heart catheter and an
      indwelling arterial cannula were inserted for hemodynamic monitoring over a 96
      hour postoperative period. Liver and renal function studies, total serum calcium,
      serum albumin, and fluid balance were determined daily. The SVR increased
      significantly to 12.8 +/- 0.6 U at 48 hours compared with immediate (less than 8
      hours) postoperative levels (p less than 0.05) and remained elevated for 96
      hours. The CO fell progressively and was significantly lower than baseline values
      from 64 to 96 hours. There was significant inverse correlation between the
      increase in SVR and the fall in CO (r = .85, p less than 0.01). The SBP was
      stable except for a small, but significant fall at 16 and 24 hours
      postoperatively. The PWP increased significantly from a baseline value of 12.5 +/
      0.9 mm Hg to 15 +/- 0.9 mm Hg at 32 hours and remained elevated through 96 hours
      (p less than 0.05). The serum bilirubin level fell progressively postoperatively
      and the prothrombin time and partial thromboplastin time (PTT) shortened
      significantly. Bile flow increased progressively from 107 +/- 120 ml/24 hours at
      the end of the first 24 hours to 188 +/- 125 ml/24 hours by 96 hours
      postoperatively. Five patients died from nine to 43 days postoperatively. These
      patients' hemodynamic parameters were not significantly different from the
      patients who survived. Successful OLT is associated with a rapid increase in SVR
      and a fall in CO without changes in SBP. These findings tend to parallel the
      improvement found in results of liver function tests. However, there is no
      correlation between the improvement in the hemodynamic state and long-term
      survival.

PMID- 2225969
TI  - Permeability pulmonary edema following lung resection.
AB  - The etiology of edema associated with pulmonary resection was investigated in
      five patients during the immediate postoperative period. Three patients received
      pneumonectomy while two patients had one lobe resected. All patients suffered
      from severe respiratory distress and had x-ray evidence of diffuse interstitial
      pulmonary edema within 12 hours of surgery. Hemodynamic data were obtained with
      radial and pulmonary artery catheters. Edema fluid was obtained along with blood
      samples for simultaneous determination of protein and albumin content. All
      patients studied had normal or high cardiac output, normal cardiac filling
      pressures, and edema fluid protein to serum protein ratio of 0.6 or greater
      suggestive of permeability changes contributing to edema fluid accumulation.
      Calculated shunt fraction exceeded 25 percent in all patients. Pulmonary edema
      has been noted in patients following pulmonary resection in the early
      postoperative period. In patients reviewed here, two factors appeared to be
      significant. First is an increase in pulmonary capillary pressure associated with
      passage of a normal to high cardiac output in a reduced volume pulmonary vascular
      bed. The second factor, as demonstrated by protein content in the edema fluid, is
      injury to the alveolar capillary membrane.

PMID- 2225970
TI  - Diagnosis of tracheal injury in mechanically ventilated premature infants by
      flexible bronchoscopy. A pilot study.
AB  - Flexible bronchoscopy (FB) is uniquely suited for the study of large airway
      lesions in the ventilated premature infant. However, no standardized clinical
      scoring system of distal tracheal injury exists and the adverse consequences of
      FB in ventilated premature infants are not well described. Using a prototype
      Olympus fiberoptic ultrathin bronchoscope with a directable tip and an outer
      diameter of 2.2 mm, we serially scored distal tracheal injury in conventionally
      ventilated premature infants on the basis of mucosal and obstructive changes
      observed at bronchoscopy. In addition, we prospectively evaluated the incidence
      of adverse cardiovascular and pulmonary effects during, immediately after, and
      within 1 h of FB. We performed 21 FBs in eight conventionally ventilated
      premature infants with birth weight of 1,239 +/- 438 g and gestational age of 30
      +/- 3 weeks. The carina and mainstem bronchi were easily visualized in all
      infants using the prototype bronchoscope. During the first several days of life,
      moderate-to-severe distal tracheal mucosal injury occurred frequently, while
      moderate-to-severe obstructive injury occurred infrequently. Distal mucosal
      injury appeared to improve during the fourth week of life. Mild distal
      obstructive injury began to appear during the second week of life. Adverse
      consequences of FB observed in our patient population included transient
      hypoxemia and bradycardia during FB, changes in systolic blood pressure
      immediately and within 1 h after FB, and emesis immediately after FB. Serious
      adverse cardiovascular or pulmonary effects were not observed. We conclude that
      FB can be performed safely with appropriate monitoring and is a useful tool in
      the clinical assessment and serial evaluation of distal tracheal injury in
      ventilated premature infants. We speculate that moderate-to-severe distal
      tracheal mucosal injury may be associated with the development of later
      obstructive injury. On the basis of this preliminary study, further prospective
      investigations of tracheal injury in ventilated premature infants appear to be
      warranted.

PMID- 2225971
TI  - Pulmonary complications of leukemia.

PMID- 2225972
TI  - Measuring crackles.
AB  - Crackles heard on auscultation can be represented graphically as a time-amplitude
      plot of the associated waveform. To assess the relative merits of several
      measures which might be considered for machine implementation in diagnostic
      instruments, we compared the reproducibility of those based on the initial
      voltage deflection which begins a crackle with those based on the largest
      deflection. The latter group showed less interobserver and less intraobserver
      variability when the same crackles were measured twice by each of two observers.
      Crackles from a teaching tape, categorized as fine and coarse, were used in this
      study. The ability of the various measures tested to distinguish between fine and
      coarse crackles on an individual basis was assessed and found to favor the
      measures based on the largest deflection. They showed an average of 9.96 percent
      incorrectly classified crackles, as opposed to 19.53 percent for the two measures
      based on the initial deflection.

PMID- 2225973
TI  - Pulse oximetry. Uses and abuses.
AB  - Pulse oximetry has made a significant contribution to noninvasive monitoring in a
      wide variety of clinical situations. It allows for continuous reliable
      measurements of oxygen saturation while avoiding the discomfort and risks of
      arterial puncture. As the extent of hypoxic episodes during various procedures
      and clinical settings is better appreciated, the role of continuous noninvasive
      monitoring will undoubtedly expand. An understanding of the principles and
      technology of pulse oximetry will allow physicians to obtain maximal clinical
      benefit from its use.

PMID- 2225974
TI  - Diagnostic thoracentesis.

PMID- 2225975
TI  - Gravity-dependent infiltrates in a patient with lipoid pneumonia.

PMID- 2225976
TI  - Anti-Kveim monoclonal antibody. New monoclonal antibody reacting to epithelioid
      cells in sarcoid granulomas.
AB  - A monoclonal antibody to the sarcoid granulomagenic agent contained in Kveim
      suspension was prepared by immunizing mice with Kveim suspension. One monoclonal
      antibody (IHY-1) that reacted with the epithelioid cells in sarcoid granulomas on
      immunoperoxidase technique was selected. The immunoperoxidase technique was used
      to compare this monoclonal antibody's binding to sarcoidosis- or tuberculosis
      affected lymph nodes. IHY-1 is a monoclonal antibody of IgM class. This antibody
      did not react to erythrocytes, lymphocytes, monocytes, alveolar macrophages, or
      the macrophage-derived cell lines such as U-973 and KG-1. It reacted to granuloma
      epithelioid cells of sarcoidosis-affected lymph nodes. The monoclonal antibody
      also reacted positively to epithelioid cells in tuberculous granulomas although
      the reaction was not as strong. Since IHY-1 was found to bind to both types of
      granulomas, this suggests that the epithelioid cells in sarcoidosis have
      antigenicity common to the epithelioid cells in tuberculosis.

PMID- 2225977
TI  - Thermodilution right ventricular ejection fraction. Catheter positioning effects.
AB  - Right ventricular (RV) ejection fractions have been difficult to estimate
      clinically. It has been demonstrated recently that RV ejection fractions can be
      calculated by thermodilution techniques using a rapid response thermistor and
      computer. This method critically depends on adequate mixing of the thermal bolus
      and sensing of the rapid response thermistor. This study examined the effects of
      the thermistor position within the pulmonary artery and injectate site within the
      right atrium on RV thermodilution ejection fraction measurements. Ten pigs were
      instrumented with a RV thermodilution catheter in the pulmonary artery, an
      injectate catheter in the right atrium, an atrial-pacing electrode, and a
      systemic arterial catheter. The RV ejection fractions were determined using
      thermodilution in two ways: (1) with incremental increases in pulmonic valve to
      thermistor distance, and (2) with incremental increases in injectate port to
      tricuspid valve. These measurements were obtained at a paced rate of 107 +/- 1
      beats per minute (bpm) and then repeated with pacing-induced tachycardia (140
      bpm). The highest RV ejection fraction with the lowest coefficient of variation
      was with the thermistor 2 cm from the pulmonic valve (50 +/- 2 percent), with a
      significant decline from this value at 10 cm (42 +/- 4 percent, p less than
      0.05). This reduction in RV ejection fraction values with increased pulmonic
      valve to thermistor distance became more pronounced with tachycardia where a
      significant decline in RV ejection fraction occurred at 4 cm from the valve when
      compared with 0 cm (38 +/- 6 percent vs 47 +/- 3 percent, respectively, p less
      than 0.05). There was no significant change in RV ejection fraction at any
      injectate port to tricuspid valve distance at the lower heart rate. With
      tachycardia, however, a significant decline in RV ejection fraction occurred with
      the injectate port located 7 cm from the tricuspid valve (p less than 0.05).
      These results demonstrate that RV ejection fractions can be reliably obtained
      using thermodilution. Positioning of the thermodilution catheter is an important
      consideration for obtaining optimal RV ejection fraction measurements. Care
      should be taken to position the catheter with the thermistor a minimal distance
      from the pulmonic valve and the injectate port within the central body of the
      right atrium.

PMID- 2225978
TI  - Rapid percutaneous tracheostomy.
AB  - We describe a new method of performing percutaneous tracheostomy rapidly and
      safely using a specialized instrument kit. The technique permits the safe
      insertion of a full-sized 7.0 (ID) or 7.5 mm (ID) cuffed cannula into the trachea
      within 1-2 min, through the membranous second intercartilagenous space. Animal
      studies have demonstrated a superior healing process compared to that seen after
      conventional tracheostomy techniques.

PMID- 2225979
TI  - Pseudoinfarction pattern on electrocardiogram after coronary artery bypass.

PMID- 2225980
TI  - Hemoptysis in a 49-year-old man. An unusual presentation of a sporadic disease.
AB  - Although amebiasis is prevalent in tropical and subtropical areas, it occurs
      sporadically in the United States. Pleuropulmonary involvement is seen in about
      20 percent of the patients with amebic liver abscesses. We describe a patient
      with pleuropulmonary amebiasis who complained of hemoptysis but had no
      gastrointestinal symptoms. This rather unusual presentation caused a considerable
      delay in securing the diagnosis.

PMID- 2225981
TI  - Mechanism of intermittent preexcitation in the Wolff-Parkinson-White syndrome.
      The concept of electronically mediated conduction across an inexcitable gap.
AB  - A man with intermittent preexcitation in the Wolff-Parkinson-White syndrome is
      reported. Once a sinus impulse was blocked in the accessory pathway, the block
      (ie, loss of preexcitation) was continued for a while until a PP interval reached
      or exceeded a critical period inducing sudden reappearance of preexcitation. This
      critical period was considerably longer than the effective refractory period of
      the accessory pathway. These findings are explained by the use of the concept of
      electronically mediated conduction across an inexcitable gap in the accessory
      pathway. It seems that when loss of protection was maintained, the sinus impulse
      was blocked at the site proximal to the gap, but the impulse passing through the
      atrioventricular node always reached retrogradely the site distal to the gap, and
      therefore, the next sinus impulse was blocked again.

PMID- 2225982
TI  - Axillosubclavian vein thrombosis produced by retrosternal thyroid.
AB  - Several causes of axillosubclavian vein thrombosis have been described. Trauma to
      the subclavian vein by pacemaker wires or central venous lines as well as the so
      called effort thrombosis have been recognized as frequently diagnosed
      precipitating factors. A patient is herein presented with thrombosis of the
      subclavian vein caused by a giant substernal thyroid compressing the innominate
      vein.

PMID- 2225983
TI  - Rounded atelectasis complicated by obstructive pneumonia and pulmonary arterial
      thrombosis.
AB  - A patient with a history of asbestos exposure developed rounded atelectasis. The
      mass was associated with local bronchial obstruction, obstructive pneumonia and
      arterial thrombosis. Autopsy demonstrated marked pleural thickening and
      radiographically inapparent asbestosis. This is the first reported case in which
      seemingly benign rounded atelectasis not only increased morbidity, but also
      contributed to mortality through airway obstruction and local arterial
      thrombosis.

PMID- 2225984
TI  - Dialysis-induced respiratory acidosis.
AB  - The inability to increase alveolar ventilation can lead to CO2 retention and
      acute respiratory acidosis in patients with ventilatory limitation. In this case,
      a young woman receiving maximum ventilatory support was unable to excrete excess
      CO2, associated with increasing dianeal concentrations of peritoneal dialysis.
      Since the patient's lung disease had necessitated a large amount of ventilatory
      support, the patient was unable to increase VE appropriately to handle excess
      CO2. Peritoneal dialysate was an additional source of carbohydrates. Peritoneal
      dialysate is an additional carbohydrate source that may result in hypercapnia and
      respiratory acidosis in patients with respiratory compromise. To our knowledge,
      this is the first case report in an adult which demonstrates that peritoneal
      dialysis with high glucose loads produced an acute respiratory acidosis that was
      reversed by decreasing the glucose concentrations in the dialysate. Excess CO2
      production should be considered with respiratory disorders associated with
      dialysis.

PMID- 2225985
TI  - Occult fatal pulmonary embolism with disseminated intravascular coagulation. An
      unusual case masquerading as miliary tuberculosis.
AB  - We report a fatal case of occult pulmonary embolism complicating bronchogenic
      carcinoma which presented with rapidly progressive pulmonary miliary shadows and
      respiratory failure. A clotting profile abnormality compatible with disseminated
      intravascular coagulation was noted. Postmortem examination showed extensive
      clots occluding the major pulmonary vessels and areas of pulmonary infarcts.
      Histologic examination revealed fibrin deposition in the microvasculature
      compatible with DIC. Cases of pulmonary embolism with DIC have previously been
      reported, but this is the first case with pathologic confirmation. Thus, unusual
      presentation with diffuse lung shadow and DIC should not deter the clinician from
      correct diagnosis so that appropriate treatment can be promptly started.

PMID- 2225986
TI  - Labetalol and MRI as initial medical and diagnostic modalities in a marfanoid
      patient with expanding ascending aortic aneurysm.
AB  - Marfan syndrome is a hereditable disorder of connective tissue that causes
      several distinct cardiovascular abnormalities, including aortic regurgitation,
      dissection, and aneurysm. These cardiac manifestations can be identified with
      echocardiography, computer tomography, and angiography. Standard treatment of an
      acute hypertensive crisis in Marfan syndrome uses propranolol and sodium
      nitroprusside. This patient with Marfan syndrome whose case is reported herein
      presented with chest pain, hypertensive crisis, and aortic insufficiency;
      labetalol was used successfully to treat the acute hypertensive crisis and
      magnetic resonance imaging (MRI) was used to differentiate between aortic
      dissection and an expanding aortic aneurysm. This report is unique in that
      labetalol was used to control the hypertensive crisis in Marfan syndrome and MRI
      was used as the initial diagnostic modality in an emergency setting.

PMID- 2225987
TI  - Pulmonary malignant angioendotheliomatosis. Presentation with fever and syndrome
      of inappropriate antidiuretic hormone.
AB  - A 64-year-old man presented with protracted fever, hyponatremia, and mononeuritis
      multiplex. Inappropriate antidiuretic hormone secretion was established. The
      absence of pulmonary infiltrates precluded any lung biopsy. Autopsy revealed
      malignant angioendotheliomatosis involving multiple organs including the alveolar
      septa and pulmonary vasculature. An early diagnosis of MAE in the setting of
      fever and SIADH may be possible via transbronchial biopsy.

PMID- 2225988
TI  - Electrocardiographic J waves after resuscitation from cardiac arrest.
AB  - A patient was monitored prior to, during, and after cardiac arrest with a Holter
      monitor and an electrocardiograph. The arrest occurred without any premonitory
      signs on the ECG. At the onset of the arrest, torsades de pointes ventricular
      tachycardia occurred, which quickly degenerated into ventricular fibrillation.
      After a successful second defibrillation, the patient developed Osborn waves,
      which subsided within a few minutes.

PMID- 2225989
TI  - Utility of angiograms in patients with catamenial hemoptysis.
AB  - Pulmonary endometriosis is the likely cause in patients with hemoptysis during
      menses. While we describe two cases of catamenial hemoptysis, which were
      localized with chest CT scanning, angiograms revealed normal appearance. We
      suggest that angiograms may have little value in the evaluation of patients with
      pulmonary endometriosis.

PMID- 2225990
TI  - Kyphoscoliosis and respiratory failure. A patient treated with assisted
      ventilation for 27 years.
AB  - A 62-year-old woman had had kyphoscoliosis since age 12 years. Respiratory
      failure developed at age 35 years following a respiratory infection. A
      tracheostomy was done and she required assisted ventilation using a respiratory
      (Bird). Many attempts at weaning her from the ventilator were unsuccessful. She
      has remained dependent on assisted ventilation for more than 27 years but has had
      a relatively comfortable and meaningful life. In 1983, a left pleuroscopy was
      done related to recurrent pneumothorax and numerous small bullae were seen on the
      lung surface. Recent investigation using computed tomographic scanning has shown
      patchy areas of emphysema in both lungs. Emphysema is not a feature of
      kyphoscoliosis and it is suggested that intermittent positive pressure applied to
      the lung over long duration may cause the lung destruction of emphysema.

PMID- 2225991
TI  - Use of Nd:YAG laser in endobronchial Kaposi's sarcoma.
AB  - An unusual case of endobronchial Kaposi's sarcoma causing right middle and lower
      lobe atelectasis is reported. The lesion was successfully removed with Nd-YAG
      laser photoresection.

PMID- 2225992
TI  - The malignancy-sarcoidosis syndrome.
AB  - In a retrospective review of six patients with malignancy preceding sarcoidosis,
      we found four cases of malignant lymphoproliferative disease (LD) and one case
      each of ovarian cancer and breast cancer. The median interval from onset or
      relapse of malignancy to sarcoidosis was nine months. Of the four patients with
      LD, sarcoidosis appeared within six months of termination of chemotherapy for
      three of the patients and 15 months after allogeneic bone marrow transplantation
      for the fourth patient. At the time of diagnosis of sarcoidosis, there was no
      clinical or pathologic evidence of malignancy in the chest. We conclude that in
      contradistinction to the previously described syndrome of sarcoidosis preceding
      LD, there exists a syndrome of sarcoidosis following malignancy with or without
      chemotherapy.

PMID- 2225993
TI  - Septic pulmonary emboli. A rare cause of bilateral pneumothorax in drug abusers.
AB  - An intravenous drug abuser presented with bilateral pneumothorax. This is a
      previously unreported (to our knowledge) complication of septic pulmonary emboli
      secondary to right-sided endocarditis. This possibility must be considered in the
      differential diagnosis of pneumothorax in drug addicts.

PMID- 2225994
TI  - A case of massive true thymic hyperplasia with non-Hodgkin's lymphoma.
AB  - A case of massive true thymic hyperplasia with non-Hodgkin's lymphoma of the
      mediastinum is reported in a 14-year-old boy. Computed tomographic scan of the
      chest showed a mass of the anterior mediastinum and conspicuous swelling of the
      lymph nodes in the upper and lower mediastinum. They were grossly resected. The
      tumor of the anterior mediastinum was histologically diagnosed as true thymic
      hyperplasia. All of the mediastinal lymph nodes were diagnosed as non-Hodgkin's
      lymphoma, diffuse, mixed small and large cell type.

PMID- 2225995
TI  - Confirmation of endotracheal tube positioning.

PMID- 2225996
TI  - Allergies and asthma.

PMID- 2225997
TI  - Sources of endobronchial metastases.

PMID- 2225998
TI  - Advertising and clinical investigation.

PMID- 2225999
TI  - Choosing tidal volume for ventilation.

PMID- 2226000
TI  - Cardiac fossa.

PMID- 2226002
TI  - Occupational asthma.

PMID- 2226001
TI  - Environmental and occupational asthma.

PMID- 2226003
TI  - Role of the physician in environmental and occupational asthma.

PMID- 2226004
TI  - Epidemiology and surveillance.

PMID- 2226005
TI  - Surveillance of occupational asthma under the SENSOR model.

PMID- 2226006
TI  - Asthma surveillance in the United States. A review of current trends and
      knowledge gaps.

PMID- 2226007
TI  - Epidemiologic studies of asthma epidemics in Barcelona.

PMID- 2226008
TI  - Asthma and persistent wheeze in the Harvard Six Cities Study.

PMID- 2226009
TI  - Clinical surveillance and management of occupational asthma. Tertiary prevention
      by the primary practitioner.

PMID- 2226010
TI  - Clinical assessment of bronchial hyperresponsiveness due to nonspecific and
      specific agents.

PMID- 2226011
TI  - Use of immunologic technology in the diagnosis of environmental and occupational
      immunologic lung disease.

PMID- 2226012
TI  - Environmental and occupational asthma. Exposure assessment.

PMID- 2226013
TI  - Evaluation of a proposed NIOSH surveillance. Case definition for occupational
      asthma.

PMID- 2226014
TI  - Clinical management when the environment can be changed.

PMID- 2226015
TI  - A framework for assessing impairment from asthma.

PMID- 2226016
TI  - Assessing disability from occupational asthma. A perspective on the AMA guides.

PMID- 2226017
TI  - Environmental and occupational asthma. Reports of the Working Groups.

PMID- 2226018
TI  - [Use of conscious sedation by inhalation in dental practice and oral surgery].

PMID- 2226019
TI  - ["Master surgeons" and "privileged surgeons"].

PMID- 2226020
TI  - [Essentials of the biochemical profile].

PMID- 2226022
TI  - [Giving meaning to work. Comments on the occupational structure of medical
      careers].

PMID- 2226021
TI  - [Use of Kevlar fibers in semi-permanent periodontal splinting].

PMID- 2226023
TI  - [The physician must present newspaper articles, of possible advertising value for
      his services, for approval before their publication].

PMID- 2226024
TI  - [Diagnosis and prognostic assessment of bronchial cancer].

PMID- 2226025
TI  - [Surgical therapy of bronchial carcinoma].

PMID- 2226026
TI  - [Long-term results after surgical treatment of lung metastases].

PMID- 2226027
TI  - [Surgical therapy of lung complications of long-term ventilation for severe adult
      respiratory distress syndrome].
AB  - Long-term respiratory therapy with high pressure levels in case of ARDS can lead
      to several symptoms requiring surgical treatment. Various forms of manifesting
      barotrauma predominate (bronchopleural fistula, pneumothorax, pneumatocele and
      soft tissue emphysema), while hematothorax, infected necrosis of parenchyma or
      esophagotracheal fistula are rare. Most of the operations became necessary
      because of bronchopleural fistula resp. pneumothorax, and with this indication
      the number of reoperations was especially high. Of 21 patients 13 (62%) survived.

PMID- 2226028
TI  - [Preoperative assessment of perirectal lymph nodes by ultrasound].
AB  - Endorectal ultrasound is a new technique which is having an increasing impact on
      the surgical community. Beyond the assessment of tumor penetration depth two
      kinds of lymph nodes are to be differentiated by ultrasound in the perirectal
      fat. 1) Inflammatory enlarged lymph nodes which appear hyperechoic, unsharply
      limited to the surrounding tissue and 2) lymph node metastases which are
      hypoechoic having the same density as the tumor. Sensitivity and specificity of
      endorectal ultrasound in the detection of lymph node metastases in 97 patients
      was 80%, the positive predictive value was 78%, the negative 82%. In an in vitro
      study we examined 27 lymph nodes of patients with either inflammatory or
      cancerous colon diseases by computerized B-scan texture analysis. An HP-77020 A
      realtime electronic sector-scanner was connected with HP-1000 microcomputer which
      permitted the selection and texture-analysis of a region of interest (ROI).
      Afterwards the lymph nodes were examined histologically. Independent of size and
      surrounding fat tissue there was a highly significant difference between
      inflammatory and cancerous enlarged lymph nodes concerning mean grey level and
      mean gradient. Tumor infiltrated lymph nodes are hypoechoic with poor contrast
      within the node whereas inflammatory enlarged nodes are more hyperechoic and show
      more contrast. Thus, we can state that it is possible by consideration of
      echogenity and contrast to distinguish sonographically between tumor infiltrated
      and inflammatory enlarged lymph nodes.

PMID- 2226029
TI  - [Is liver biopsy in gallbladder operations still indicated?].
AB  - Biopsy of the liver with the Tru-cut needle was done as a routine diagnostic
      procedure during gallbladder surgery in 166 cases. The data of history,
      ultrasonography and laboratory were compared with the microscopic liver findings.
      Preoperatively in 89% of the cases there was an indication for liver biopsy. In
      11% of the cases, where there was no indication for preoperative biopsy, we found
      severe changes in liver histology. Therefore we recommend liver biopsy during
      gallbladder surgery as a routine procedure.

PMID- 2226030
TI  - [Primary therapy of polytraumatized patients and reasons for early transfer to a
      specialty hospital].
AB  - 200 polytraumatized patients were treated at our institution between 1.1.1987 to
      28.2.1989. 58 patients had been submitted from other hospitals. Reasons for
      submissions were complex cranio-facial-trauma in 27 patients, thoracic trauma in
      9 patients and complex abdominal injury in 8. In 13 of 44 patients (29.5%),
      submitted in between the first 24 h after trauma, severe and partially life
      threatening injuries had not been diagnosed at the first hospital. Failures in
      decision making burden especially patients with cranio-facial injuries, in whom
      intraabdominal and thoracical injuries are often overseen. Patients with
      abdominal trauma were often submitted after an operative attempt demonstrating
      complex traumatisation which was underestimated at primary diagnosis.
      Polytraumatized patients need to have a multidisciplinary management performed by
      a specified crew with all diagnostic facilities available to avoid overestimation
      or neglection of additive injuries. Direct submission into a specified medical
      center is therefore recommended and seems preferable to submission after failed
      or insufficient primary therapy in inadequately equipped smaller hospitals.

PMID- 2226031
TI  - [Managing bile duct defects by pedicled ligamentum teres hepatis].

PMID- 2226032
TI  - [Invagination of the left colon in adults].

PMID- 2226033
TI  - [First fully implantable intramedullary system for callus distraction-
      intramedullary nail with programmable drive for leg lengthening and segment
      displacement. Principles and initial clinical results].

PMID- 2226034
TI  - [Comment on the contribution by D. Kistler et al.: Combined surgical-radiologic
      procedure in closure of a hemodialysis shunt].

PMID- 2226035
TI  - [Spiroid fractures of the thoracic and lumbar spine].
AB  - The review of our observations of fractures of the thoracic and lumbar spine (588
      files could be used from 1969 to 1989) allowed us to demonstrate fractures not
      included in the usual classification. In our opinion, the fracture line is
      spiral. The mechanism therefore includes a very likely axial rotation. The
      fracture line may be confined to the vertebral body (this is the type called S1)
      or extends to the posterior arch as well (S2 type). The fractures often cause
      nerve root lesions. However, no complications involving the cord were noted in
      our series, even in the few cases showing considerable displacement. Note the
      tendency to axial telescoping of the focus, which requires specific modalities of
      treatment.

PMID- 2226036
TI  - [Do peroperative blood transfusions have a negative effect on the developmental
      prognosis of colorectal cancers].

PMID- 2226037
TI  - [Experience in hepatic transplantation. Report of 118 cases].
AB  - From February 1978 to November 1989, 118 orthotopic liver transplantations were
      performed in 106 patients, including 100 adults and 6 children; 11 of these
      grafts were performed before 1984. The study of this series emphasizes the
      casuistical peculiarities, with high incidence of alcoholic cirrhosis, 24/106
      (22.6%) and of fulminating hepatitis, 17/106 (16%). The study of the results
      yields a real survival rate of 61% in the total series, 78% for the recent period
      including the past 3 years, and 86% if excluding the emergent cases. The comments
      also deal with the changes in the procedure and in postoperative complications,
      with some immunological issues and with the peculiar features connected with the
      insertion of this operation into a combined medical and surgical program of multi
      organ transplantation.

PMID- 2226038
TI  - [Crohn's disease of the small intestine].
AB  - Any symptomatic manifestation of Crohn's disease results not from the disease
      itself but from some complication. The first complication is stenosis, which
      precedes and favors the appearance of abscesses, fistulae, perforations and
      sometimes hemorrhages. The ideal treatment consists in identifying and treating
      the disease as early as the appearance of stenosis and before the other
      complications occur. In our series, mortality most often was caused by an
      infection that was not or poorly managed, even when the primary cause of death
      was embolism or sometimes a massive hemorrhage. In many patients, the risks of
      septic complications are all the higher as the subject's immunological defense is
      weakened by immunodepressive corticosteroid treatments and by malnutrition. All
      septic foci must therefore be located and drained before any extensive surgical
      operation. Malnutrition can be improved by parenteral nutrition, and often by
      enteral feeding as well. After severe surgical complications, the next operation
      should not be performed until 12 weeks have elapsed, in order to reduce both
      technical difficulties and risks.

PMID- 2226039
TI  - [Pulmonary metastases of colorectal origin].
AB  - From January 1979 to December 1988, 18 patients with pulmonary metastases from
      colorectal cancers were operated in our division. This series included 11 men and
      7 women (average age 57 years). The primary cancer was colic in 6 cases and
      rectal in 12. In 3 cases, the metastases were synchronous and discovered during
      the initial assessment. In 15 cases, they were metachronous, without symptoms in
      12 cases and symptomatic in 3. These metastases were single in 14 cases, multiple
      in 3, bilateral in 1. They were peripheral in 15 cases. The histological
      diagnosis was obtained preoperatively in 5 cases (27.7%). The procedures uses
      were lobectomy for 11 patients, segmentectomy for 1, wedge resection for 10.
      Postoperative chemotherapy was given to 7 patients. Benign complications occurred
      in 2 cases during the postoperative period. No perioperative death was noted. One
      patient was lost to follow-up without recurrence after 1 year, 6 patients died
      from neoplastic evolution 4, 8, 15, 17, 22 and 28 months after being operated. In
      May 1989, 11 patients were still living: -2 scheduled for the excision of a
      contralateral lesion, -2 with pulmonary recurrence. 7 patients were alive without
      recurrence 12, 14, 17, 46, 52, 68 and 108 months after being operated. The
      probability of occurrence of pulmonary metastases in the evolution of colorectal
      cancer is estimated between 20 and 50%. Only 1% of the patients can be treated
      surgically. When screening these lesions, one must bear in mind that their
      appearance is sometimes quite delayed, and often asymptomatic. The repeated use
      of tracers is necessary but not sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226040
TI  - [Lightning injuries in high mountain areas. Report of 29 cases].
AB  - Lightning, usually scarce, is a frequent phenomenon in high mountains. Due to our
      location at the foot of the Mont-Blanc, we have been able to examine twenty nine
      cases of people struck by lightning in the Chamonix Hospital. Lightning that has
      interested people since old times is the result of complex meteorological
      phenomenons, able to deliver a huge instant power. Several types of lightning
      have been described. They give different sorts of injuries; the most frequent
      affect the brain, the heart and the skin. The analysis of the results of
      seventeen victims admitted at the hospital does not allow to conclude to a
      clinical and biological specificity of the lightning stricken in high mountains.
      It makes it however possible to determine precisely the clinical disorders and
      the features of the injured and to emphasize the part due to the high mountains
      and consider the non specific therapeutic to set to work as soon as possible.

PMID- 2226042
TI  - [Pericystic pathology and surgery of hepatic hydatidosis. Studies and personal
      experiences].
AB  - In the general study of the consequences of hydatid cysts on the parenchyma of
      the organ involved, particular interest was given to the conditions of the
      pericyst. Thus a genuine pericystic pathology was systematized for most evolved
      pericysts. The signs vary according to the various conditions, sometimes
      including simple fibrosis, sometimes calcifications with specific and different
      appearances, almost always chronic inflammation. Fissuration was rare and, more
      importantly, exogenous vesiculation, a frequent cause of recurrence, was more
      often noted. The treatment is chosen on these bases, and determined by the local
      situation, hepatobiliary complications and the general condition of the patient.
      The author demonstrates the surgical evolution he followed in relation with the
      progress made in liver surgery, from plain drainage methods to radical
      pericystectomy and hepatic resection procedures. The conclusions he has drawn as
      a Symposium moderator during the World Congress of Hydatology held in Madrid in
      1985, which will be summed up in the report, still seem to be perfectly valid.

PMID- 2226041
TI  - [Emergency surgery of complicated diverticular disease of the colon].
AB  - Emergency surgery is aimed at achieving the same results as elective surgery, but
      still has specific limitations in the case of CDDC, in spite of significant
      progress. We describe the physiopathological bases of the emergent treatment of
      the septic, occlusive and hemorrhagic complications of the CDDC, as well as the
      experience acquired in the Emergency Unit and Department 3 Hospital San Jose with
      54 cases operated since 1981. The modern means of intensive care and preparation,
      including powerful antibiotics, make primary resection (1) as a principle
      possible, but do not allow yielding to the temptation of immediately creating an
      anastomosis as long as the local conditions have not improved. On the other hand,
      we emphasize the advantages of performing primary resection-anastomosis surgery
      in elective operations for non-emergent cases.

PMID- 2226043
TI  - [Pharyngoesophageal reconstruction using a vascularized free jejunal graft.
      Indications--technique and surveillance. Report of 90 cases].
AB  - Several procedures have been proposed for pharyngoesophageal reconstruction. The
      use of a revascularized free jejunal graft currently appears to be a method of
      choice for anatomical, physiological and technical reasons. The authors currently
      look back on a series of 90 patients having received a revascularized free
      jejunal graft between 1978 and 1989 inclusive. The indications predominantly
      include cancer of the pharynx invading the posterior wall and preserving the
      cervical esophagus, requiring total circular pharyngolaryngectomy (77 cases).
      Some benign lesions involve reoperated patients (13 cases). The technique for
      obtaining the jejunal graft is accurately codified: use of the 3rd jejunal loop
      in isoperistaltic conditions, refrigeration during the period of ischemia,
      revascularization by the cervical vessels. If a salvage operation is needed, it
      is necessary to prepare a saphenous venous graft at the beginning of the
      operation (3 cases). These grafts must be observed daily. Early negative signs
      include unexplained epistaxis, blood in the saliva, cervical skin suffering.
      Emergency fiberscopy must be performed with a bronchoscope or a rhinofiberscope.
      In case of suffering or necrosis of the graft, the patient must be reoperated
      immediately and a second free jejunal graft must be placed. The absence of
      postoperative mortality, low morbidity and good functional results obtained in
      the series are convincing reasons for using this procedure.

PMID- 2226044
TI  - [Cancer of the anus. Current role of surgery].
AB  - 70 cases of carcinoma of the anus are described in a retrospective study. All
      patients had been operated, since surgical treatment was regarded as the method
      of choice at that time. Our work therefore consists in assessing the role of
      surgery in the treatment of such carcinomas. In the initial forms, extended
      sphincter saving exeresis allowed excellent results (100% survival over a 1- to
      10-year follow-up). In more advanced lesions, treated with abdominoperineal
      resection, the survival rate was 50% after 5 years. The same figure was obtained
      in case of extension to the female genital organs (the invasion of which is not a
      pejorative sign), while the prognosis was considerably worsened for the patients
      who had had lymph node resection due to invasion of inguinal nodes (20% survived
      after 5 years). Local surgical exeresis currently is as valuable as radiation
      therapy, but the latter is clearly indicated for advanced carcinomas, for which
      mutilating surgery has not demonstrated its superiority.

PMID- 2226045
TI  - [Supraselective or proximal gastric vagotomy. Report of 1,250 surgical cases. 777
      special cases with objective follow-up for over 10 years].
AB  - From August, 1970 to February, 1989, we performed 1,105 elective and 145
      emergency PGVs (proximal gastric vagotomy). The emergent cases included 118
      perforations and 27 bleeding lesions. Since September, 1973, we have been able to
      measure the pH of the mucosa using a GR282C transesophageal electrode. Two cases
      of exitus (0.2%) were noted. With an intraoperative test (pH) or the systematic
      section of the gastroepiploic nerve (n.ge) (randomized with 269 cases followed up
      over 57 months) the rate of recurrence does not exceed 2%. Without these "tools",
      it is as high as 10%. Since this rate is still a cause of confusion in this 20th
      year of PGV, we analyse 684 "stabilized" (excluding the first 10 patients of each
      surgeon). PGVs followed up (88% of 777 PGVs) over 10 to 17 years. The study was
      clinical and radiological in 100% of cases, based on acid secretion in 2/3, and
      fiberscopic in 47%. Between 5 and 17 years, 318 patients had a fiberscopic study
      and 325 an analysis of the basal and stimulated acid secretion (76% were already
      evaluated preoperatively). Two types of recurrence were defined: those due to
      failure of the surgeon or technique (gastroepiploic nerve in 1/5 of cases)
      involving acidity--this being the "persistent" ulcer (3/4 of cases during the
      first years); and disorders in gastric evacuation (?) with a very low acidity
      level, also causing more delayed gastric ulcers. The non-cumulative probability
      of R in successive years stays around 0.2 to 0.1% after the 3rd or 4th year
      following the PGV, and the total rate after 10 years or more is about 10%. If
      performed by experienced surgeons and with the intraoperative test (or systematic
      section of the n.ge), PGV should have only a low rate of failure, these cases
      being more amenable to treatment than an anastomotic mouth ulcer following
      resection, for instance.

PMID- 2226046
TI  - Ultradian rhythms in the EEG and task performance.
AB  - The purpose of this work was to investigate the presence of ultradian rhythms in:
      1. levels of electroencephalographic activation; 2. interhemispheric correlation
      and 3. the performance of two cognitive tasks, and the correlation between these
      variables. Eight volunteers, aged 20 to 30, participated in the experiment. Two
      sessions were carried out: one from 0800 to 1400 on one day and the other from
      1400 to 2000 another day. Samples of EEG activity were taken every 15 min at rest
      with eyes open in left and right temporal, central, parietal and occipital
      derivations referred to the ipsilateral earlobe the performance on two tasks, one
      logico-analytical (left hemisphere functions) and one spatial test (right
      hemisphere functions) was assessed. As control, body and environmental
      temperature were recorded. To test for the presence of ultradian rhythms, the
      data were subjected to a Fourier analysis. Different EEG variables showed
      rhythmicity throughout the sessions, principally with slow oscillation periods (3
      and 6h); ultradian rhythms with 3h periods were also found in body temperature,
      while task performance showed no significant rhythmic patterns during sessions.
      Finally, no significant correlations were found between physiological variables
      evaluated and task performance.

PMID- 2226047
TI  - A chronobiological study on the relation between heart rate and QT interval
      duration in newborn infants.
AB  - The relation between heart rate and QT interval is the result of the autonomic
      nervous system control on cardiac function in healthy adults; accordingly,
      chronobiological studies have shown that adult subjects have circadian rhythms of
      heart rate (expressed as R-R interval) and QT interval in phase. We have employed
      chronobiological methods to study heart rate and QT interval relation in 10
      newborn infants, who are known to have an immature cardiac control. Findings from
      this study indicate that not all the newborns show circadian rhythms of heart
      rate and QT interval and that when both rhythms are present they do not correlate
      like in the adults. Likely, this lack of relationship between heart rate and QT
      interval in newborns is due to different maturational stages of the newborns
      studied. As a practical implication, in newborn infants, mathematical correction
      of QT interval by heart rate is not a reliable method.

PMID- 2226048
TI  - Lunar phase influence on the glycemia of worker honeybees.
AB  - The variations of the concentrations of trehalose and glucose, the major
      components of the haemolymph of emerging worker honeybees, have been examined
      with respect to the lunar phase. Two series of experiments were performed
      independently, from April to June and from July to September respectively. The
      results revealed significant peakings for both carbohydrates at full moon and at
      new moon, and also a minor peak at last quarter. The data obtained for trehalose
      in the July-September period are consistent with the existence of a circaseptan
      subcomponent of period tau congruent to 132h.

PMID- 2226049
TI  - [Etiological and influential factors of involutional osteoporosis in old
      Chinese].
AB  - A comprehensive analysis is reported in 376 healthy middle and old-age persons,
      including measurements of bone mineral content (BMC) of the mid-radias, pituitary
      sex hormones (RIA), serum calcium, phosphate, albumin, alkaline phosphatase,
      urinary calcium, phosphate, hydroxyproline (BCA), daily intake of protein and
      calcium, physical exercise and activity, body weight, amenorrhea etc. Results
      showed that the preponderance of bone resorption over bone formation is the
      essential pathophysiological change of involutional osteoporosis. For females,
      bone loss is regulated mainly by estrogen in presenile group, co-regulated by
      estrogen and androgen in senile group. For males, urinary hydroxyproline
      excretion is also regulated by estrogen A remarkable correlation was observed
      between BMC and the following factors: serum calcium, urinary calcium,
      hydroxyproline, body weight, physical exercise, amenorrhea, intake of protein and
      calcium. Our data indicated that the intake of calcium daily in old chinese
      should not be lower than 700 mg (male) and 900 mg (female), protein should not be
      lower than 60-70 g. The age of onset, prevalence rate and BMC average reduction
      rate of osteoporosis in chinese were also observed in the studies.

PMID- 2226050
TI  - [Factors affecting parameters of left ventricular diastolic function derived from
      Doppler echocardiography].
AB  - According to the data from left ventricular catheterization as well as M-mode and
      two-dimensional echocardiography in 36 patients, the influence of left
      ventricular diameter, systolic function, systolic and diastolic filling pressures
      on the parameters of left ventricular diastolic function derived from Doppler
      echocardiography was analysed. The results indicate: (1) the left ventricular end
      diastolic pressure, rapid filling wave pressure and the ratio of the both
      significantly affect the Doppler diastolic function parameters; (2) the decrease
      of the ratio of early-to-late diastolic mitral flow velocities (E/A) is only a
      manifestation of early stage of left ventricular diastolic dysfunction and the
      E/A ratio returns to normal (false improving) at advanced stage of left
      ventricular diastolic dysfunction.

PMID- 2226051
TI  - [Sulfur dioxide-induced bronchial constriction in asthmatics and its prophylaxis
      by salbutamol].
AB  - Patients with bronchial asthma often develop acute attack in kitchen while
      burning honeycomb briquet which is widely used for cooking in southern China.
      Burning of a honeycomb briquet produces 0.6-4.3 ppm sulphur dioxide (SO2) in the
      kitchen air. To assess whether the above concentration of SO2 can induce
      bronchial constriction, we performed SO2 bronchial provocation test on 21
      asthmatics (male 11, female 10, average age 28.8 +/- 2.0 years), 10 patients with
      allergic rhinitis (male 3, female 7.28 +/- 1.6 years) and 20 healthy non-smokers
      (male 13, female 7, 28.1 +/- 1.5 years). FEV1 showed no significant change in
      both healthy and rhinitis group even a maximal amount of SO2 (10 ppm) was given.
      The calculated PC20 FEV1 and PC35 SGaW in asthmatics were 3.7 +/- 0.22 ppm and
      2.5 +/- 0.18 ppm respectively, which fell into the SO2 range yielded by a burning
      honeycomb briquet. Orally administered slow release salbutamol created protective
      effect in 5 out of 8 patients. Salbutamol inhalation, however, completely blocked
      SO2 induced bronchial constriction. We suggest that patient with bronchial asthma
      should receive salbutamol aerosol inhalation before cooking with burning
      honeycomb briquet.

PMID- 2226053
TI  - [Endogenous creatinine clearance rate and normal values in healthy young
      subjects].
AB  - Serum creatinine (Scr) and creatinine clearance rate (Ccr) were measured for
      their normal values in young and youngster. The subjects included 251 health
      individuals between the age of 15 and 29.251 of them were tested actually. The
      datum had been treated by a computer. The Scr normal values are 72.49 and 50.39
      mumol/L respectively in the males and females. Their means showed significance
      differences between the males and females. The upper limit of 95% of normal
      values were 94.59 and 66.3 mumol/L respectively. The Ccr means of the males and
      females were 136.89 and 132.13 ml/min/1.73 m2 respectively. Their means showed no
      significance difference between them. A common lower limit of 95% of normal
      values was 75.03 ml/min/1.73 m2. It is expected that the information above
      provide a scientific base and important reference in the future.

PMID- 2226052
TI  - [Detection and clinical significance of anti-histone antibody in systemic lupus
      erythematosus and rheumatoid arthritis].
AB  - Determinations of anti-histone antibodies (AHA) by ELISA were carried out in 109
      cases of SLE, 117 of RA, the positive rate being 50.5%, 23.1% respectively, with
      titres in SLE patients higher than in RA. AHA was 90.2% positive in active cases
      of SLE patients. SLE patients with AHA showed a higher incidence of pericarditis
      and arthritis, but a lower rate of malar rash than SLE patients without AHA. In
      RA, there is a higher incidence of extraarticular manifestations in AHA positive
      patients IgM-AHA was this predominant AHA in RA while in SLE patients it was the
      IgG-AHA. For SLE, IgG-AHA which was more closely associated with anti-ds DNA was
      more significant than IgM-AHA.

PMID- 2226054
TI  - [Androgen treatment of hematologic diseases].

PMID- 2226056
TI  - Functional assessment of the anorectum in faecal incontinence.
AB  - The functional ability of the anorectum to maintain continence is best assessed
      by a provocative assessment of continence to a standard load of rectally infused
      saline. Faecal incontinence is not caused by one condition. The combination of
      multiport anorectal manometry, electrophysiology and rectal sensory testing can
      identify several causes, which logically require different treatments. Only time
      and carefully conducted trials will establish whether such functional testing
      will be useful.

PMID- 2226055
TI  - Neurobiology of incontinence. A symposium. London, 11-13 October 1989.
      Proceedings.

PMID- 2226057
TI  - Functional assessment of the bladder.
AB  - The urinary bladder has two functions: to store and to empty. A frequency-volume
      chart completed by the patient provides useful information about voiding
      intervals, possible factors provocative for incontinence, functional bladder
      capacity and daily urine volume. Filling cystometry is used primarily to evaluate
      reflex function in the storage phase, giving information about the presence or
      absence of detrusor instability and (in combination with urethral EMG) about
      detrusor-sphincter coordination. Information is also obtained about bladder
      sensation, bladder capacity and bladder compliance. Detrusor function during
      emptying is closely related to outflow conditions and therefore demands
      simultaneous registration of detrusor pressure and urinary flow rate. An inverse
      relation exists between detrusor pressure and flow rate, which means that reduced
      flow rate causes increased detrusor pressure for the same detrusor power.
      Underactive detrusor function will result in low detrusor pressure and low flow
      rate. The finding of a non-contractile detrusor may indicate psychogenic
      inhibition or a neurogenic lesion. Sacral evoked potentials and denervation
      supersensitivity tests may help to distinguish between these conditions.

PMID- 2226058
TI  - The neurogenic hypothesis of stress incontinence.
AB  - There are a number of causes of incontinence. The common forms of urinary
      incontinence, faecal incontinence or double incontinence, are stress related, in
      that voiding of urine or faeces occurs in response to a sudden increase in
      pressure in the bladder or anorectum that is not opposed by an adequate pressure
      increase in the sphincteric region. This weakness of the sphincter mechanism is
      due to chronic partial denervation of the striated sphincter muscles of the
      pelvic floor, comprising the external and sphincter muscle and puborectalis
      (puboanalis) components of the voluntary anal sphincter musculature, and the
      periurethral and intramural components of the urinary striated sphincter
      musculature. Denervation of these muscles occurs progressively following injury
      initiated during childbirth and then sustained by repeated stretch-induced injury
      during straining behaviour at stool. Age-related changes to this innervation may
      also be important. Weakness of the pelvic floor, and perineal descent during
      straining, lead to secondary changes in the anatomy of the bladder neck, of the
      anorectal angle, and of the smooth muscle of the internal urinary and anal
      sphincters. The cystometric and anal manometric changes found in patients with
      stress incontinence are secondary to this neurogenic weakness of the pelvic
      floor.

PMID- 2226059
TI  - Stress urinary incontinence.
AB  - Stress urinary incontinence due to urethral sphincter incompetence (genuine
      stress incontinence) afflicts some 5-15% of women. The mechanism of continence is
      imperfectly understood, as is the precise mode of its cure, whether conservative
      or surgical. The pathophysiology is a reduction in urethral resistance in the
      absence of detrusor activity. Aetiological factors include congenital
      malformation of the bladder neck, denervation of the pelvic floor and sphincter
      mechanism following childbirth, trauma causing disruption of the urethral
      sphincter mechanism, fibrosis associated with bladder neck surgery for prolapse,
      oestrogen deprivation at the menopause, and urethral relaxation or instability.
      Conventional investigations include urethral pressure measurement, urethral
      electric conductance, electrophysiological tests, and cystometry or
      videocystourethrography (the latter procedures diagnose by exclusion). A more
      precise evaluation of the role of urethral resistance is hampered by lack of
      suitable techniques for measuring urethral and sphincteric function. Treatments
      include pelvic floor exercise, drugs to increase urethral resistance, and
      surgery, either to evaluate the bladder neck or to increase urethral resistance.

PMID- 2226060
TI  - Detrusor-external sphincter dyssynergia.
AB  - Detrusor-external sphincter dyssynergia (DESD) is characterized by involuntary
      contractions of the external urethral sphincter during an involuntary detrusor
      contraction. It is caused by neurological lesions between the brainstem (pontine
      micturition centre) and the sacral spinal cord (sacral micturition centre). These
      include traumatic spinal cord injury, multiple sclerosis, myelodysplasia and
      other forms of transverse myelitis. There are three main types of DESD. In Type 1
      there is a concomitant increase in both detrusor pressure and sphincter EMG
      activity. At the peak of the detrusor contraction the sphincter suddenly relaxes
      and unobstructed voiding occurs. Type 2 DESD is characterized by sporadic
      contractions of the external urethral sphincter throughout the detrusor
      contraction. In Type 3 DESD there is a crescendo-decrescendo pattern of sphincter
      contraction which results in urethral obstruction throughout the entire detrusor
      contraction. In patients with sufficient manual dexterity the most reasonable
      treatment option is to abolish the involuntary detrusor contractions (to ensure
      continence) and then to institute intermittent self-catheterization (in order to
      empty the bladder). The bladder may be paralysed pharmacologically or may be
      surgically converted to a low pressure urinary reservoir by the technique of
      augmentation enterocystoplasty. In quadriplegic men, transurethral external
      sphincterotomy may be performed and the incontinence managed with an external
      urinary appliance. Without proper treatment over 50% of men with DESD develop
      serious urological complications within about five years. In women these
      complications are much less common.

PMID- 2226061
TI  - The physiological evaluation of operative repair for incontinence and prolapse.
AB  - Women with incontinence were divided into 30 with anorectal incontinence and 63
      with complete rectal prolapse. The former group comprised 14 with a sphincter
      disruption and the remainder with intact sphincters. After anterior sphincter
      repair 70% were restored to acceptable continence. Success was associated with a
      rise in resting and voluntary contraction pressures and improved anal sensation.
      Patients with prolapse underwent either anterior and posterior rectopexy, or
      resection rectopexy. Continence was improved in both groups. Postoperatively, 90%
      following resection rectopexy and 80% following anterior and posterior rectopexy
      were restored to acceptable continence. Postoperative defaecatory straining and
      incomplete evacuation were reduced, with no significant differences between the
      two procedures. Restoration of continence was not associated with any change in
      sphincter pressures. However, rectal sensory threshold and anal sensation were
      both improved.

PMID- 2226062
TI  - Surgical approaches to anal incontinence.
AB  - Primary repair of acute anal sphincter injuries by direct apposition of the
      severed external sphincter without tension is advisable whenever feasible.
      However, the majority of patients who are candidates for surgical treatment of
      anal incontinence will undergo a secondary repair, the type of which will depend
      on the underlying aetiology and the surgeon's preference and experience. The most
      successful of these procedures is sphincter reconstruction with or without
      levatoroplasty for a disrupted anal sphincter (due to surgical, obstetrical or
      other trauma) in the absence of underlying neurological damage. Success rates are
      reported at 80-90%. Post-anal repair is advocated for patients with a poorly
      functioning sphincter with an obtuse anorectal angle, most of whom have a
      neurogenic basis for their incontinence. Success rates vary from 60 to 75% of
      cases but long-term results have been less satisfactory. Rectal procidentia is
      associated with faecal incontinence in 65-75% of cases. Abdominal repair (we
      favour suture rectopexy with sigmoid resection) restores continence in 50-80% of
      such patients. Patients with persisting incontinence are candidates for post-anal
      repair. Anal encirclement with an elastic, Dacron-impregnated Silastic sleeve has
      a limited role in selected patients. For more severe incontinence, muscle
      transfers (gracilis, gluteus maximus, etc.) can achieve some success but
      continence is less than perfect. We are currently assessing the use of an
      artificial anal sphincter (a modification of the AMS 800 urinary sphincter). For
      patients who fail all therapeutic options, a stoma will provide a better
      lifestyle than coping with the consequences of faecal incontinence.

PMID- 2226063
TI  - Treatment of urinary and faecal incontinence by surgically implanted devices.
AB  - Three kinds of implant to treat incontinence are considered. The sacral anterior
      root stimulator (with sacral posterior rhizotomy) is already effective in urinary
      incontinence due to spinal cord injury, and will have wider application. The
      conditional pudendal nerve stimulator and the conditional gracilis nerve
      stimulator are, respectively, almost untried and entirely untried devices; but
      they show promise, and if successful may help very many patients.

PMID- 2226064
TI  - Central neural control of the lower urinary tract.
AB  - The lower urinary tract has two main functions, the storage and periodic
      elimination of urine, which are regulated by a complex neural control system in
      the brain and spinal cord. This neural system exhibits switch-like patterns of
      activity that are generated by visceral reflex circuits, some of which are under
      voluntary control. Experimental studies in animals indicate that the micturition
      reflex is mediated by a spinobulbospinal pathway passing through a coordination
      centre (the pontine micturition centre) located in the rostral brainstem. This
      reflex pathway is, in turn, modulated by higher centres in the cerebral cortex
      which are presumably involved in the voluntary control of micturition. Several
      neurotransmitters (including GABA, opioid peptides and glutamic acid) appear to
      have a role in the central pathways controlling micturition. Since
      pharmacological manipulation of putative inhibitory transmitter mechanisms
      increases bladder activity and decreases bladder capacity it is possible that
      similar changes induced by pathological conditions may underlie bladder
      dysfunctions occurring in patients with neurogenic urinary incontinence. Further
      study of these neurotransmitter systems may yield new therapeutic approaches for
      the treatment of hyperactive bladder disorders.

PMID- 2226065
TI  - Urinary incontinence: classification and pharmacological therapy.
AB  - Pharmacological therapy has been developed which can have significant impact in
      the management of many forms of urinary incontinence and voiding dysfunction. In
      general the clinical laboratory studies which have supported or challenged the
      efficacy of many of the commonly prescribed drugs for voiding dysfunction are
      often difficult to interpret and contradictory. The available clinical studies
      often do not demonstrate a lack of bias. Nor do they include an adequate number
      of subjects, use appropriate and sensitive methods of evaluation, employ double
      blind placebo-controlled design, or appear statistically valid. Although the
      contribution of laboratory research has been of unquestionable value in the
      development of our current knowledge of lower urinary tract pharmacology it is
      difficult to interpret the results of in vitro pharmacological studies because of
      the array of experimental models used and the need to extrapolate to in vivo
      activity. This paper utilizes a functional scheme which classifies agents by
      their effects on urinary storage and emptying. The purpose of this review is to
      promote discussion of the application of uropharmacological investigation to the
      development of newer, more efficacious forms of drug therapy.

PMID- 2226066
TI  - Functional anatomy of the female lower urinary tract and pelvic floor.
AB  - Stress continence depends upon three factors: proximal urethral support, vesical
      neck closure, and urethral contractility. The position of the vesical neck is not
      static but mobile and under voluntary control. Its support depends upon
      connections of the urethrovaginal endopelvic fascia to the medial aspect of the
      levator ani. In addition, these fasciae are attached to the arcus tendineus
      fasciae pelvis which supports the urethra during levator relaxation, and probably
      during stress. Levator contraction supports the proximal urethra and also pulls
      the vesical neck anteriorly against a band of endopelvic fascia which is
      suspended between the arcus tendinei, compressing it closed. Relaxation of the
      muscles allows the vesical neck to descend, and facilitates its opening. The
      connective tissue and smooth muscle of the trigonal ring encircles the vesical
      neck's lumen, and may contribute to closure of this area. The striated urogenital
      sphincter muscle can contract to assist in maintaining continence in continent
      women whose vesical neck is not competent. It has a circular sphincteric portion
      from 20 to 60% of urethral length. From 60 to 80% it has a considerable bulk of
      muscle which forms an arch at the perineal membrane that would compress the
      urethra from above.

PMID- 2226067
TI  - The dual function of capsaicin-sensitive sensory nerves in the bladder and
      urethra.
AB  - The sensory innervation of the urinary bladder and urethra plays a key role in a
      variety of reflexes involved in urine storage and voiding. Dysfunction of these
      systems is a possible cause of many disturbances related to urine continence but
      basic knowledge in this field has been hampered by the lack of tools for studying
      sensory nerves. The use of capsaicin, the pungent ingredient of red peppers,
      allowed us to investigate the anatomical and functional properties of a specific
      subset of sensory neurons in the lower urinary tract. These 'capsaicin-sensitive'
      neurons play a dual sensory and 'efferent' function, determined by transmitter
      release from their central and peripheral nerve endings. Tachykinins, including
      substance P, and other neuropeptides such as calcitonin gene-related peptide,
      mediate the functions of these sensory neurons. The 'sensory' function includes
      regulation of micturition threshold, activation of cardiovascular reflexes and
      perception of pain from the urinary bladder. The 'efferent' function includes
      local regulation of muscle cell activity, nerve excitability, blood flow and
      plasma protein extravasation. Recent data suggest that capsaicin-sensitive
      sensory nerves could be present in the human bladder.

PMID- 2226068
TI  - Introduction, spread and subsequent disappearance of the brown ear-tick,
      Rhipicephalus appendiculatus, from the southern lowveld of Zimbabwe.
AB  - According to the climate-matching model CLIMEX the hot, dry lowveld of Zimbabwe
      is unsuitable for the survival of the brown ear-tick Rhipicephalus
      appendiculatus. There is evidence that the tick was absent from the lowveld in
      the 1960s but was introduced in 1973 and spread over a large area before
      disappearing in 1983. It was introduced at the start of a wet cycle when,
      according to CLIMEX predictions, conditions were suitable for its survival, and
      it disappeared at the end of a dry cycle when conditions were unsuitable. The
      most important factor in the disappearance of the tick appeared to be heat
      stress. The study has provided an illustration of the dynamic distribution of R.
      appendiculatus and field validation of the CLIMEX model.

PMID- 2226069
TI  - House-dust mite (Pyroglyphidae) populations in mattresses, and their control by
      electric blankets.
AB  - A reduction in house-dust-mite populations of 19-84% in beds in regular use could
      be achieved by heating the mattresses with electric blankets, when the beds were
      not being slept on. The effect of the heating treatment on the temperature and
      relative humidity inside the mattress is discussed. House-dust mites in the
      heated portions of the mattress migrated deeper inside the mattress to a depth of
      3.5-5.0 cm. Evidence was also found that house-dust mites in non-heated
      mattresses do not only live near the surface, but that they are also present deep
      inside the mattress.

PMID- 2226070
TI  - Effects of five insect growth regulators on laboratory populations of the North
      American house-dust mite, Dermatophagoides farinae.
AB  - The potential of insect growth regulators (methoprene, hydroprene, fenoxycarb,
      diflubenzuron and triflumuron) to control populations of the North American house
      dust mite Dermatophagoides farinae (Hughes) was assessed in laboratory bioassays.
      Methoprene was most effective at suppressing population growth, especially at
      concentrations of 1.0% (10,000 ppm) and 5.0% (5000 ppm) active ingredient.
      Hydroprene, structurally related to methoprene, also suppressed house-dust mite
      populations but not as consistently as methoprene. Fenoxycarb may be effective at
      controlling house-dust mites but at greater concentrations than were tested.
      Diflubenzuron and triflumuron, two chitin-synthesis inhibitors, failed to
      suppress mite numbers and may, in fact, stimulate reproduction in some cases.
      Almost all concentration of the insect growth regulators were shown to be
      ineffective when assayed 90 days after treatment.

PMID- 2226071
TI  - Effect of heat treatments on the house-dust mites Dermatophagoides pteronyssinus
      and D. farinae (Acari: Pyroglyphidae) in a mattress-like polyurethane foam block.
AB  - The behaviour and survival of the house-dust mites Dermatophagoides pteronyssinus
      and D. farinae were studied under laboratory conditions in a mattress-like
      polyurethane foam block that was heated by an electric blanket. Mites obtained
      from a laboratory culture were introduced into the foam block which was sliced
      into seven horizontal layers and covered with an electric blanket. Measurements
      of temperature and relative humidity were taken between the layers and the number
      of living mites was established using the heat-escape method.

PMID- 2226072
TI  - Ultrastructure and distribution of intracellular rickettsia-like microorganisms
      in various organs of the laboratory-reared adult tick Argas (Persicargas)
      arboreus (Ixodoidea: Argasidae).
AB  - Rod (RS) and coccoid (CS) rickettsia-like microorganisms were found in single and
      group forms in organs of the laboratory-reared adult ticks Argas (Persicarges)
      arboreus. RS are distributed in most organs but are mainly concentrated in the
      salivary glands, mid-gut, and testes. CS single forms were concentrated in the
      rectal sac, while the group forms were limited to Malpighian tubules and
      haemocytes of both sexes. The primary oocytes were heavily infected with both
      forms of CS. No RS or CS were detected in the muscles. Despite the structural
      differences between RS and CS, they are suggested to be different morphotypes of
      the same organism.

PMID- 2226073
TI  - Organ culture of ixodid-tick salivary glands.
AB  - This work describes an organ-culture method for isolated salivary glands of the
      ixodid tick Amblyomma hebraeum Koch. The support medium is a TC 199-1% agarose
      gel with no hormonal or undefined supplements. I used a fluid-transport assay for
      measuring viability of salivary glands. When cultured at 26 degrees C, female
      glands secreted fluid at 65% on day 2, 59% on day 4 and 42% on day 6 post-culture
      compared to glands tested on day 0. Fluid secretory rates in culture were higher
      than rates of glands from partially fed ticks (about 180-250 mg) on days 2, 4 or
      6 post-removal from the host. Salivary glands from fed males cultured for 4 days
      lost only 5% of their fluid secretory competence, whereas glands dissected from
      males 4 days post-removal lost 63% of their fluid secretory competence.

PMID- 2226074
TI  - Effect of 20-hydroxyecdysone on the salivary glands of the male tick, Amblyomma
      hebraeum.
AB  - Female ticks (Acari: Ixodidae) feed only once in the adult stage, dying after
      laying a large batch of eggs. During the early post-engorgement stage, haemolymph
      ecdysteroid titre rises, which is probably responsible for autolysis of the
      salivary glands that takes place at this time. Males, on the other hand, can re
      attach and feed numerous times during the adult stage. Males were fed on rabbits
      for either 7 or 14 days. Haemolymph was collected either the day of removal from
      the host or 4 days later, and ecdysteroid titre was measured by radioimmunoassay.
      The approximate titre in all 4 groups was 20 ng of 20-hydroxyecdysone (20-OHE)
      equivalents/ml haemolymph. Fluid secretory competence in vitro can be used as an
      index of salivary-gland degeneration. The glands dissected from fed males which
      had been left off the host for 4 days lost 62% of their fluid secretory
      competence compared to glands dissected shortly after the males were removed.
      This loss in fluid secretory competence was reversed by allowing ticks left off
      the host of 4 days to resume feeding. Male salivary glands lost fluid secretory
      competence when exposed for 4 days in organ culture to 20-OHE; the effect was
      maximal at the lowest concentration tested (20 ng/ml). Thus, although male
      salivary glands were highly sensitive to 20-OHE, it is still not clear whether
      this hormone causes the tissue to degenerate.

PMID- 2226075
TI  - Vital signs.

PMID- 2226076
TI  - Urogenital dysfunction after abdominoperineal resection for carcinoma of the
      rectum.
AB  - The long-term urogenital dysfunctions in 46 of 104 surviving patients submitted
      to abdominoperineal resection for rectal carcinoma between 1972 and 1986 were
      collected and assessed. Urinary retention was present in 41 percent of the men
      and 35 percent of women, while incontinence was present in 10 percent of men and
      29 percent of women. Impotence was reported by 59 percent of the males, all
      sexually active before surgery. Dyspareunia was present in 50 percent of the
      women in the study. The possibility of treating prostatic hypertrophy
      concurrently with abdominoperineal resection in selected cases to avoid urinary
      retention is discussed. The limited number of responders to the survey may
      interfere with the global statistical significance.

PMID- 2226077
TI  - A critical review of chemical lymph node clearance and staging of colon and
      rectal cancer at Ferguson Hospital, 1977 to 1982.
AB  - A unique opportunity to evaluate the method of chemical lymph node clearance for
      colorectal cancer exists at Ferguson Hospital. Lymph node clearance has been used
      at the institution since 1977, and this retrospective analysis was undertaken to
      ascertain its validity there. Furthermore, the node positive group was evaluated
      to ascertain if the current staging system (Turnbull, 1967) is prognostically
      accurate for the Dukes' C group. Specifically evaluated for possible prognostic
      variance was the survival of those patients whose tumors demonstrated partial
      bowel wall penetration and only one to four positive nodes, a "C1 subset,"
      previously reported to have favorable prognosis. Eight hundred sixty-four cases
      of colon and rectal cancer treated surgically from 1977 to 1982 were analyzed.
      There was a mean of 27 lymph nodes retrieved per specimen and a mean of 4.5
      positive nodes per Dukes' C specimen. There were 43 C1 and 201 C2 cases with five
      year survival rates of 73 and 38 percent, respectively. The results of chemical
      clearance at Ferguson Hospital were found to be comparable with that of other
      centers using chemical clearance and superior to hand dissection. The C1 subset
      clearly is noted to have prognostic advantage and should occupy a separate
      designation in any staging system.

PMID- 2226078
TI  - Colonoscopic screening of asymptomatic patients with a family history of colon
      cancer.
AB  - The records of 201 asymptomatic patients who underwent colonoscopy based solely
      on a family history of colon cancer were reviewed. Eighty-five patients (42
      percent) had a total of 166 lesions. Fifty-four (27 percent) patients of the
      screened population had neoplastic lesions, while 31 (15 percent) patients had
      nonneoplastic polyps. Four carcinomas were found. Twenty-five of the patients
      with polyps (29 percent) had no polyps distal to the splenic flexure; these
      proximal polyps (and two carcinomas) would have been missed on screening with
      fiberoptic sigmoidoscopy. Nineteen of these 25 patients had polyps smaller than
      0.5 cm, which likely would have been missed with contrast enemas. Almost one half
      (47 percent) of all polyps discovered at screening colonoscopy were proximal to
      the descending colon. Only one patient younger than 40 years old had adenomas.
      The yield of polyps and cancer in patients with familial risk indicates screening
      colonoscopy should be considered after age 40.

PMID- 2226079
TI  - A randomized trial comparing direct current therapy and bipolar diathermy in the
      outpatient treatment of third-degree hemorrhoids.
AB  - Fifty patients with third-degree hemorrhoids were randomized to receive
      outpatient treatment with either bipolar diathermy or direct current therapy.
      Direct current therapy was used to treat 26 patients and bipolar diathermy was
      used to treat 24 patients. Twenty patients in each group were successfully
      treated as judged by resolution of symptoms and shrinkage of hemorrhoidal tissue.
      Both treatments are effective in the outpatient management of large, prolapsing
      hemorrhoids. Bipolar diathermy is less time consuming and better tolerated.

PMID- 2226080
TI  - Perirectal abscess in Crohn's disease. Drainage and outcome.
AB  - The role of surgical intervention in the treatment of patients with anorectal
      Crohn's disease is controversial. To clarify the success of aggressive drainage
      and the subsequent clinical course of patients with Crohn's disease and
      perirectal abscesses, the authors reviewed the records of 38 patients who
      presented with this condition during an eight-year period. Twenty-two male and 16
      female patients (median age, 32 years; range, 17 to 61 years) with clinically or
      pathologically confirmed Crohn's disease of the bowel underwent operation for
      perirectal abscesses. Thirty-two percent of patients had no previous history of
      anorectal Crohn's disease. Thirty simple abscesses and 8 complex horseshoe
      abscesses were treated. At operation, 53 percent of patients underwent incision
      and drainage whereas 26 percent received loop indwelling drains and 21 percent
      had mushroom catheters placed. After resolution of the index abscess, recurrent
      abscesses occurred in 45 percent of the patients who underwent catheter drainage
      and 56 percent of the patients who underwent incision and drainage. More
      importantly, 44 percent of the incision and drainage group and only 31 percent of
      the catheter drainage group required subsequent proctectomy to control perineal
      sepsis. The healing time of the perineal wound was longer than six months in 83
      percent of patients requiring rectal excision. We concluded that long-term
      catheter drainage may offer substantial benefit in the overall outcome of the
      treatment of patients with Crohn's disease and perirectal abscess.

PMID- 2226081
TI  - Survival in patients with large-bowel cancer. A population-based investigation
      from the Melbourne Colorectal Cancer Study.
AB  - Five-year survival data were obtained in 97 percent or 1105 of 1140 new patients
      with histologically confirmed colorectal adenocarcinoma during a 12-month period
      in 1981 and 1982, as part of a large comprehensive population-based study of
      colorectal cancer incidence, etiology, and survival, The Melbourne Colorectal
      Cancer Study. Fifteen percent of patients were Dukes' A stage, 32 percent were
      Dukes' B, 25 percent were Dukes' C, and 29 percent were Dukes' D. At five years
      after diagnosis, the observed survival rate was 36 percent and the adjusted rate
      was 42 percent. Dukes' staging was a highly discriminating factor in survival (P
      less than 0.001). Survival rates were better in women than in men and better for
      patients with colon cancer than for patients with rectal cancer. Survival by
      Dukes' staging was not affected by colon subsite or by the tumor being the first
      and single tumor, metachronous tumor, or synchronous tumor. The survival of
      younger patients was better for Dukes' stages A, B, and C, and worse for Dukes'
      D. Survival was worse in the presence of bowel perforation in Dukes' C and D
      stages. Within Dukes' D (incurable cases), survival was best in the absence of
      hepatic metastases, slightly worse when only hepatic metastases were present, and
      poorest in the presence of both hepatic and extrahepatic metastases. Statistical
      modeling of survival determinants other than staging indicated that cell
      differentiation had the largest effect (survival decreasing with poor cell
      differentiation), followed by site (survival worse for rectal cancer than colon
      cancer), then age (survival better for younger patients), while bowel perforation
      had the smallest effect on survival.

PMID- 2226082
TI  - The surgical management of children with ulcerative colitis. The old vs. the new.
AB  - The authors' experience with children who have chronic ulcerative colitis was
      reviewed to compare their current surgical approach (ileoanal anastomosis) with
      earlier methods of management. Between 1960 and 1984, 137 children with chronic
      ulcerative colitis underwent surgery (mean duration of follow-up, 7.1 years). In
      91 patients, the procedures were a total proctocolectomy with ileostomy or Kock
      pouch (66) or a lesser colectomy with either an ileostomy (16) or an ileorectal
      anastomosis (9) (group I). Forty-six patients underwent an ileoanal anastomosis
      procedure (group II). Children in group I were more likely to have significant
      preoperative loss of weight, a debilitated condition, and malnutrition. Urgent or
      emergency surgical intervention was required in 25 percent of patients in group I
      but in only 4 percent of patients in group II. Trends included 1) a younger age
      at operation in group II, 2) a higher mortality in group I (7.7 percent) than
      group II (0 percent), and 3) a higher perioperative mortality with emergency
      operations (23 percent) than elective procedures (1.6 percent). In group I, 98
      percent of patients had an abdominal ostomy, but no patients in group II had an
      abdominal ostomy. The children with an ileoanal anastomosis had an average of 4.8
      stools during waking hours and 1.3 stools each night. On the basis of this
      experience, the authors recommend use of the ileoanal anastomosis procedure in
      the surgical treatment of chronic ulcerative colitis in children.

PMID- 2226083
TI  - Accumulation and pepsin solubility of collagens in the bowel of patients with
      Crohn's disease.
AB  - The collagen content of resected strictured intestine, with and without fistulas,
      from patients with Crohn's disease has been compared with that in macroscopically
      normal intestine removed from the same patients and from others without
      inflammatory bowel disease. Collagen content per unit wet or dry weight of tissue
      was significantly increased in all grossly diseased tissue whether fistulated or
      not. Although there was a significant increase in collagen types I, III, and V in
      diseased tissue, the relative proportions of major collagen types extracted by
      limited pepsin digestion were similar for both Crohn's and non-Crohn's intestine
      (type I, 65 to 70 percent; type III, 25 to 30 percent; type IV, 2 to 3 percent;
      and type V, 2.5 to 3 percent). CNBr digestion of pepsin insoluble material showed
      a similar relative abundance of types I and III, indicating no major change in
      collagen type distribution between older (insoluble) and more newly synthesized
      collagen. There was no evidence of the presence of type I trimer collagen. Type
      VI collagen, although not quantitated, was observed in 70 percent of intestinal
      specimens. The proportion of total collagen solubilized by pepsin treatment was
      significantly greater in both grossly diseased and macroscopically normal Crohn's
      bowel compared with non-inflammatory bowel disease bowel. These findings suggest
      that there are disturbances of collagen metabolism in Crohn's intestine, which
      account for the stricturing process and which may predate gross pathologic
      changes.

PMID- 2226084
TI  - Endometrioma. An intra-abdominal troublemaker.
AB  - A ten-year review of intestinal and abdominal wall endometriomas is reported.
      Seven cases of intestinal and two cases of abdominal wall endometriomas are
      presented. Symptoms were varied but a majority had some gynecologic complaint. In
      this select group of patients, preoperative investigations did not assist in
      establishing the diagnosis. All patients underwent surgery and coexisting
      inflammatory bowel disease was present in two patients. This review suggests that
      endometrioma of the intestine requires a high index of suspicion for diagnosis
      and that danazol does not appear to be effective treatment for these patients.

PMID- 2226085
TI  - Enteroglucagon and peptide Y-Y response after construction of a pelvic reservoir
      in humans.
AB  - The results of an investigation of plasma levels of gastrointestinal hormones in
      patients after the construction of a pelvic reservoir are reported.
      Enteroglucagon (EG) and peptide tyrosine-tyrosine (PYY), two hormones believed to
      play a relevant role in the adaptive response to bowel resection, were
      investigated using a specific radioimmunoassay in basal conditions and after a
      standard meal. Pouch patients showed a statistically significant increase in
      basal levels of both enteroglucagon and PYY compared with control subjects (P
      less than 0.02 and P less than 0.001, respectively). The response of
      enteroglucagon to food ingestion, evaluated by means of the total integrated
      response, was similar in patients and controls. Conversely, the response of PYY
      was significantly increased in pouch patients compared with control cases (P less
      than 0.02). Results of this investigation suggest that gut hormones may be
      involved in mediating the adaptive response of the intestine to pouch
      construction. Changes of gut peptides may explain, at least in part, the
      functional results observed after pouch construction.

PMID- 2226086
TI  - Retroperitoneal air after routine hemorrhoidectomy. Report of a case.
AB  - Retroperitoneal air as a complication after routine hemorrhoidectomy has not been
      reported in the literature. This occurred recently after hemorrhoidectomy in a 34
      year-old patient receiving glucocorticoid therapy for rheumatoid arthritis.
      Adverse steroidal effects of wound healing have been well documented. It is
      believed that steroid-induced tissue changes contributed to the development of
      this unique complication.

PMID- 2226087
TI  - Association of anterior ectopic anus and partial absence of levator musculature
      in a woman with impaired defecation. Report of a case.
AB  - A 25-year-old nulliparous woman with adult onset constipation and slight anterior
      displacement of the anus underwent pelvic magnetic resonance imaging and was
      diagnosed with congenital hemiabsence of the levator ani sling. Impaired
      defecation was confirmed by anorectal function studies and defecography
      demonstrated an anterior rectocele, perineal descent at the upper limit of
      normal, and partial obstruction of defecation, which appeared related to the
      levator sling abnormality. To our knowledge, this combination of findings has not
      been previously described as a cause of adult onset constipation.

PMID- 2226088
TI  - Colonic lipoma as a source of massive hemorrhage. Report of a case.
AB  - Colonic lipomas are a rare source of massive lower gastrointestinal bleeding
      requiring operative intervention. A case of massive hemorrhage from cecal
      lipomatosis is presented. The methods of preoperative diagnosis and treatment are
      discussed.

PMID- 2226089
TI  - Malignant potential of juvenile polyposis coli. Report of a case and review of
      the literature.
AB  - Juvenile polyps of the colon and rectum traditionally have been viewed as being
      benign inflammatory or harmartomatous lesions without potential for malignant
      change. The authors report a case of adenocarcinoma developing in a patient with
      sporadic juvenile polyposis. Juvenile polyposis was diagnosed in the patient at
      age 4 years. He underwent subtotal colectomy at age 6 years. At age 12, he
      underwent a proctectomy and a Swenson pull-through because of adenomatous changes
      in the rectal stump. At age 19 surveillance endoscopy revealed invasive cancer in
      a juvenile polyp.

PMID- 2226090
TI  - Yersinia enterocolitica abscess of the transverse colon. Report of a case.
AB  - Yersinia enterocolitica abscess of the bowel is a rare entity. Only five cases
      have previously been reported--none in the surgical literature. A unique
      presentation for Yersinia infection, abscess of the transverse colon, is
      described, and the literature of Y. enterocolitica intestinal perforation and
      abscess is reviewed.

PMID- 2226091
TI  - Ileocolic nipple valve anastomosis for preventing recurrence of surgically
      treated Crohn's disease. Long-term follow-up of six patients.
AB  - To prevent coloileal reflux after ileocecal resection, an ileocolic nipple valve
      anastomosis was constructed in six patients with Crohn's disease. The patients
      were observed for more than 7 years and were compared with 21 Crohn patients in
      whom conventional end-to-end ileocolic anastomosis was performed during the same
      period. The outcome was more favorable in the group with nipple valve
      anastomosis, i.e., longer interval between surgery and symptomatic relapse, and
      tendency to less frequent recurrence and re-resection. An association was found
      between radiologically preserved nipple valve and remission, and two patients
      with intact valve at long-term follow-up remained symptom-free. The observations
      implied that protection of the terminal ileum from coloileal reflux after
      ileocecal resection for Crohn's disease may favorably influence the prognosis.

PMID- 2226093
TI  - Gastric contents retained in rat stomach following mild irritant exposure
      contribute to adaptive cytoprotection.
AB  - Fluid retained in the gastric lumen immediately preceding the administration of a
      damaging product will dilute that product and decrease its injurious capacity. In
      an attempt to explain the phenomenon of adaptive cytoprotection, we studied the
      effect of mild irritant exposure on the volume of fluid retained in the gastric
      lumen. Rats treated with 0.2 N-0.4 N HCl had a larger volume of gastric fluid
      retained as compared to animals treated with 0.4 N NaCl. Additionally, a mixture
      of gastric juice derived from rats exposed to 0.4 N HCl with 2 ml ethanol was
      significantly less damaging to the gastric mucosa than a similar mixture
      containing an equal volume of gastric juice derived from 0.4 N NaCl-exposed rats.
      We conclude from our observations that in mild irritant-exposed stomachs, the
      gastric juice is a main contributor to the protection against ethanol injury.

PMID- 2226092
TI  - Putative mechanisms of cytoprotective effect of certain antacids and sucralfate.
AB  - An investigation of cytoprotective activity of certain antacids and inert
      particles was carried out by treating ethanol-induced gastric mucosal damage in
      rats in order to clarify possible mechanisms by which aluminum-containing
      antacids act. Al(OH)3 inhibited gastric mucosal damage in a dose-related and time
      dependent manner. Neither aluminum ions themselves nor the particle size of the
      Al(OH)3 complex were responsible for the observed cytoprotection, since neither
      AlCl3, chemically inert Al2O3*C, nor sea sand showed protective effects.
      Hyperosmolality in the gastric lumen was not a deciding factor in inducing
      cytoprotection. Silicic acid and titanium dioxide, with superficial charge
      similar to Al(OH)3 proved to be effective in inhibiting gastric hemorrhagic
      lesions and releasing PGE2, suggesting that the surface charge of Al(OH)3 may be
      important in its cytoprotective properties. The same may also be valid for
      sucralfate. Since antacid-induced cytoprotection was only partly reduced by
      pretreatment with indomethacin, it is likely that additional mechanisms and
      mediators other than prostaglandins, such as nonprotein sulfhydryls, also are
      involved in gastric cytoprotection arising from aluminum-containing antacids.

PMID- 2226094
TI  - Modulatory action of adenosine on gastric function and ethanol-induced mucosal
      damage in rats.
AB  - This study examines the gastric effects of adenosine and its antagonist,
      theophylline, on secretory function, mucosal blood flow, and on ethanol-induced
      glandular mucosal damage in rats that were fasted for 24 hr before
      experimentation. The animals were anesthetized with sodium pentobarbitone (50
      mg/kg intraperitoneal) and their tracheae cannulated. An ex vivo stomach chamber
      then was prepared. The luminal bathing solution was collected every 15 min and
      the concentrations of H+ and Na+ were determined by a pH autotitrator and an
      ionmeter, respectively. The glandular mucosal blood flow was measured by a laser
      Doppler flowmeter and the severity of lesions was determined by measuring the
      hemorrhagic areas. Adenosine administration (2.5 or 7.5 mg/kg, subcutaneous)
      markedly lowered the H+ and Na+ output but increased the secretory volume and
      mucosal blood flow in a dose-dependent manner. The same doses of the nucleoside
      also prevented ethanol-induced mucosal damage. These effects were prevented by
      pretreatment with theophylline (30 or 60 mg/kg, subcutaneous). Ethanol given
      alone significantly depressed the H+ and Na+ secretion. Both effects were not
      modified by adenosine treatment. However, the depressive action of ethanol on
      mucosal blood flow was prevented by adenosine. These findings indicate that
      adenosine modulates the physiological function of the stomach. It also directly
      activates the defensive mechanism of the stomach, which is partially mediated by
      the improvement of the gastric mucosal blood flow and an increase in the nonacid
      component of gastric secretion.

PMID- 2226095
TI  - Early gastric cancer. Endoscopic diagnosis of depth of invasion.
AB  - In order to decide on a treatment strategy against gastric cancers, an accurate
      preoperative evaluation of the depth of cancer invasion is essential.
      Preoperative endoscopic diagnosis of the depth of invasion was compared with
      pathological results of the resected specimen in 206 early gastric cancers and 32
      early-like advanced gastric cancers. The endoscopic distinction between early and
      early-like advanced cancers was correctly made in 83.6% of the cases. Among the
      early gastric cancers, mucosal and submucosal invasion was correctly presumed in
      71.9% of the cases. When the tumor was an elevated type, or located in the
      antrum, the endoscopic diagnosis tended to be deeper than the true depth. The
      size of tumor contributed little to the depth diagnosis. Pathomorphological
      changes on the tips of converging folds were the important clue for diagnosing
      depth.

PMID- 2226096
TI  - Measurement of gastric emptying rate in humans. Simplified scanning method.
AB  - Simultaneous measurements of the gastric emptying rate of the solid and liquid
      phase of a dual-isotope-labeled test meal were made using a gamma camera and a
      simple scintillation detector, similar to that used in a hand-held probe. A
      simple scanning apparatus, similar to that used in a hand-held scintillation
      probe, was compared with simultaneous measurements made by a gamma camera in 16
      healthy males. A dual-labeled test meal was utilized to measure liquid and solid
      emptying simultaneously. Anterior and posterior scans were taken at intervals up
      to 120 min using both a gamma camera and the scintillation probe. Good relative
      agreement between the methods was obtained both for solid-phase (correlation
      range 0.92-0.99, mean 0.97) and for liquid-phase data (correlation range 0.93
      0.99, mean 0.97). For solid emptying data regression line slopes varied from 0.75
      to 1.03 (mean 0.84). Liquid emptying data indicated that slopes ranged from 0.71
      to 1.06 (mean 0.87). These results suggested that an estimate of the gamma
      measurement could be obtained by multiplying the scintillation measurement by a
      factor of 0.84 for the solid phase and 0.87 for the liquid phase. Correlation
      between repeat studies was 0.97 and 0.96 for solids and liquids, respectively.
      The application of a hand-held probe technique provides a noninvasive and
      inexpensive method for accurately assessing solid- and liquid-phase gastric
      emptying from the human stomach that correlates well with the use of a gamma
      camera, within the range of gastric emptying rate in the normal individuals in
      this study.

PMID- 2226097
TI  - Evaluation of antral mast cells in nonulcer dyspepsia.
AB  - Two hundred twenty-five patients with the symptoms of nonulcer dyspepsia
      underwent clinical and endoscopic evaluation including histologic assessment of
      endoscopic biopsies. Mast cells were counted after special staining with low pH
      Alcian blue. Of 225 patients, 31 (13%) were found to have 11 or greater mast
      cells per high-power field. Endoscopic and routine histologic findings were
      similar between the subset of 31 patients with 11 or more mast cells and the
      entire group of 225. The 31 patients with increased antral mast cells had failed
      treatment with standard drug used for peptic ulcer disease. H1-antagonists
      improved symptoms in the majority of patients (79%) in whom we had adequate
      follow-up. Patients with increased mast cells on antral biopsy appear to be
      subset of patients with nonulcer dyspepsia amenable specific treatment with H1
      antagonists.

PMID- 2226098
TI  - Cholecystokinin stimulates growth of human pancreatic adenocarcinoma SW-1990.
AB  - The effect of a synthetic analogue of CCK (Thr4,Nle7CCK-9) on growth of SW-1990
      human pancreatic cancer was examined in two experimental models. Nude mice
      bearing SW-1990 pancreatic cancer xenografts were injected with CCK (5, 15, or 25
      micrograms/kg) or vehicle twice daily for 20 days. Animals were then sacrificed
      and tumor volume, weight, protein, and deoxyribonucleic acid (DNA) content were
      evaluated. SW-1990 cells were grown in vitro and the effects of CCK, secretin,
      vasoactive intestinal peptide (VIP), and proglumide (a CCK-receptor antagonist)
      on cell number and DNA synthesis were determined. The highest dose of CCK, 25
      micrograms/kg, significantly increased tumor weight, protein content, and DNA
      content (P less than 0.005). In vitro, CCK caused significant increases in cell
      counts of up to 47% at six days and 66% at 12 days compared to control. Graded
      concentrations of CCK had a biphasic effect on DNA synthesis with significant
      increases of up to 65% (P less than 0.005). CCK-induced cell proliferation was
      inhibited by proglumide. Secretin slightly increased cancer cell growth, although
      not as potently as CCK, VIP or secretin in combination with CCK did not show
      potentiation. These results indicate that growth of some human pancreatic cancers
      may be influenced by gastrointestinal peptides, of which CCK is the most potent.

PMID- 2226099
TI  - Improved scintigraphic assessment of severe cholestasis with the hepatic
      extraction fraction.
AB  - In previous studies, we found that biliary scintigraphy with technetium-99m
      labeled iminodiacetic acid ([99mTc]IDA) provided excellent discrimination between
      intrahepatic and extrahepatic cholestasis, except in patients with profound
      cholestasis who had poor visualization of the biliary tree. In this study, we
      have used deconvolution analysis to determine the hepatic extraction fraction
      (HEF) of a hypothetical single circulatory pass of [99mTc]IDA. Our hypothesis was
      that extraction of radionuclide from the blood would be normal in patients with
      extrahepatic obstruction alone, but would be impaired in patients with
      intrahepatic disease (IHD). The purpose of this study was to compare the HEF in
      patients with profound cholestasis (bilirubin greater than or equal to 3.0 mg/dl)
      due to either IHD or common bile duct obstruction (CBDO). Normal subjects (N =
      13) had an HEF of 100%. Patients with CBDO (N = 13) had slightly reduced HEF
      values (92.8 +/- 3.2%) despite profound hyperbilirubinemia (6.1 +/- 1.0 mg/dl).
      Patients with IHD (N = 23) had a markedly reduced HEF (43.1 +/- 4.1%) which was
      significantly lower than patients with CBDO and normal subjects (P less than
      0.001). We conclude that the determination of the HEF during biliary scintigraphy
      is helpful in distinguishing between intrahepatic and extrahepatic disease in
      patients with hyperbilirubinemia (bilirubin greater than or equal to 3.0 mg/dl).

PMID- 2226100
TI  - Effect of race upon organ donation and recipient survival in liver
      transplantation.
AB  - The effect of the race of the donor on organ donation and on the outcome of
      clinical liver transplantation has not been addressed previously. The aims of
      this study were to determine: (1) the number of organs donated by each of the
      major racial groups of the United States, (2) the outcome of transplantation of
      these organs across racial groups, and (3) the pattern of liver disease that
      required transplantation in each of these racial groups. A significantly higher
      proportion of organs were donated by white non-Hispanic Americans than either
      black or Hispanic Americans. There was no significant difference in survival when
      an organ was transplanted between black and white Americans and vice versa.
      Postnecrotic cirrhosis from a variety of causes was the most common indicator
      affecting black and white recipients, while primary biliary cirrhosis and primary
      sclerosing cholangitis were uncommon in the black population. While the number of
      organs donated by blacks was low, it was, however, proportional to the number of
      black recipients in this study. Reasons for the low rate of donation by the black
      and white Hispanic population are discussed. It is concluded that race is not a
      criteria to be used in selection of donors for liver transplantation. Educational
      programs addressing issues of organ donation and transplantation directed towards
      the black and Hispanic populations are recommended.

PMID- 2226101
TI  - Short-term effect of hepatic arterial versus portal venous reperfusion on energy
      levels of liver tissue.
AB  - The hepatic artery and the portal vein blood vary in flow, oxygenation, and
      hormonal content. It was uncertain which blood supply has a greater effect on the
      recuperative process of the hepatocytes in the ischemic liver during the initial
      reperfusion. The ability of the liver cells to restore its energy phosphates is
      related to the viability of the liver. This study was designed to determine the
      differences of the high energy phosphate in the liver predicated upon whether
      reflow was first provided by either the hepatic artery or the portal vein
      followed by subsequent reperfusion from both vessels. The recovery of ATP upon 10
      min of only hepatic arterial reperfusion after 15 min of total ischemia was much
      slower compared to the portal venous reperfusion only. It may be undesirable,
      therefore, to reperfuse the liver with hepatic arterial blood first immediately
      after warm liver ischemia.

PMID- 2226102
TI  - Cirrhosis of the liver. A risk factor for development of cholelithiasis in males.
AB  - An ultrasonographic study about the prevalence of cholelithiasis was performed in
      410 cirrhotic patients and in 414 controls matched for age and sex. Gallstone
      disease was found more often in cirrhotic patients (31.9%) than in controls
      (20.7%) (P less than 0.001). The female-to-male ratio of gallstones prevalence in
      cirrhotic patients approached to 1:1. Gallstone disease in cirrhotic patients vs
      controls was significantly higher (30.2% vs 16.5%) (P less than 0.001) in males
      only. No difference was found, for gallstone disease prevalence in cirrhosis of
      different etiology. The prevalence of cholelithiasis increased from Child's A to
      Child's C with a significant trend (P less than 0.001); this difference was
      significant in males (12.3% vs 40.5%) (P less than 0.001) but not in females.
      This study shows that cirrhosis represents a risk factor for the development of
      cholelithiasis in males. We suggest that high levels of estrogens could play a
      role in these patients, by an impairment of gallbladder emptying similar to that
      observed in pregnant women.

PMID- 2226104
TI  - Diagnosis of metastatic lesions to the stomach by salvage cytology. A report of
      three cases.
AB  - Secondary neoplasms of the stomach are rare and are often clinical and diagnostic
      problems. Three patients with bleeding "volcano-like" ulcers were diagnosed by
      combined endoscopic "salvage" cytology and surgical biopsy as having metastatic
      submucosal lesions from hematologic spread. The combination of endoscopic
      appearance, clinical findings, and tissue and cytologic examination can lead to
      the correct diagnosis. The results from these cases support the utility of this
      cytologic technique in combination with biopsy in this clinical setting.

PMID- 2226103
TI  - Prospective study of alcohol intake and large bowel cancer.
AB  - The alcohol intake of a cohort of Japanese men in Hawaii is directly and
      significantly related to the risk of developing rectal cancer, whether assessed
      on the basis of amount consumed or as a percent of total calories. Wine and
      whiskey are directly related to rectal cancer, but beer is the only alcoholic
      beverage that displays a statistically significant dose-response (P = 0.008).
      Colon cancer risk also is related directly to alcohol intake, but the association
      is statistically significant only when measured as a percent of energy intake.
      This suggests that alcohol might displace cancer inhibitors from the diet.
      Calcium, vitamin C, and dietary fiber are inversely related to colon cancer risk
      in this cohort, and each of these micronutrients displays statistically
      significant negative correlation with alcohol intake. A possible positive
      association between alcohol and lung cancer was ruled out after adjusting for
      cigarette smoking. Cancers of the prostate and stomach were unrelated to alcohol
      intake, but the risk of acquiring cancer at all other sites combined was strongly
      related to alcohol intake.

PMID- 2226105
TI  - Primary non-Hodgkin's T-cell lymphoma of the esophagus. A case with peculiar
      endoscopic ultrasonographic pattern.
AB  - We report a case of primary esophageal non-Hodgkin's T-cell lymphoma in a young
      white female. At admission, endoscopy revealed large, irregularly shaped,
      esophageal ulcerations with super imposed candidiasis. Endoscopic ultrasonography
      to assess submucosal alterations and periesophageal involvement revealed a
      diffuse hypoechogenic thickening (up to 5 mm) of the esophageal wall, a pattern
      consistent with lymphomatous infiltration. Definitive diagnosis was made with the
      aid of histology and immunohistochemistry.

PMID- 2226106
TI  - Small bowel phytobezoar mimicking presentation of Crohn's disease.
AB  - A case of small bowel phytobezoar formed from unusual ingested vegetation is
      described. The patient presented with recurrent subacute obstruction and a right
      iliac fossa mass mimicking the presentation of Crohn's disease. None of the usual
      gastrointestinal disorders that predispose to bezoar formation were present. The
      phytobezoar passed spontaneously following small bowel enema and colonoscopy. It
      is possible that relaxation of the gut secondary to the antispasmodics
      administered at investigation or the physical disturbance during these procedures
      enabled migration through the ileocecal valve. Antispasmodics may be of use in
      the conservative management of bezoars obstructing otherwise normal bowel.

PMID- 2226107
TI  - Sulfhydryls protect patients against complications of erosive gastritis.

PMID- 2226108
TI  - Insulin use in NIDDM. Rationale based on pathophysiology of disease.
AB  - Because basal hyperglycemia is a major feature in non-insulin-dependent diabetes
      mellitus, diabetes control can be monitored by the fasting blood glucose
      concentration. A hierarchical sequence of therapies is proposed in which the
      major aim is to maintain near-normal fasting blood glucose concentrations, in the
      expectation that this will help prevent development of long-term complications.
      When diet and tablet therapy are no longer effective in keeping the fasting blood
      glucose level less than 6 mM, a basal insulin supplement from a long-acting
      insulin such as ultralente can be added. When monitored by fasting blood glucose
      concentration, there is little risk of hypoglycemia, and the patient can continue
      a normal life-style without restrictions concerning exercise or the size of
      individual meals. A basal insulin supplement does not induce marked weight gain.
      The dose of insulin required can be predicted from the level of the fasting blood
      glucose and the degree of obesity, which provides an index of the accompanying
      insulin resistance. Based on current evidence, insulin therapy is equally
      appropriate in patients with insulin deficiency and insulin resistance, because
      the benefit from maintaining near-normal glucose concentrations probably
      outweighs a putative risk of hyperinsulinemia. In more severely affected
      patients, additional regular insulin to cover meals is needed. Lowering fasting
      blood glucose to normal with a basal insulin supplement reduces endogenous
      insulin production, and this may be advantageous if accompanying production of
      islet amyloid polypeptide and islet amyloid formation are also reduced.

PMID- 2226109
TI  - Insulin administration via liposomes.
AB  - Liposomes have been used in insulin therapy as a means to selectively target
      insulin to the liver, enhance oral absorption of insulin, and prolong insulin
      action. Liposomes are an effective means of delivering insulin specifically to
      hepatocytes. The usefulness of hepatically targeted liposomes in the treatment of
      diabetes is restricted due to the requirement that they be given intravenously,
      the dilute concentration of insulin present in liposomal preparations, and the
      cost associated with liposome production. Encapsulating insulin in liposomes
      results in enhanced oral absorption of insulin. The high doses of liposome
      entrapped insulin required perorally, coupled with extreme variability in the
      glycemic response to peroral liposomes, limits the value of peroral liposomal
      insulin as a viable diabetic therapy. Insulin action can be sustained via
      encapsulation of insulin in liposomes given subcutaneously. Most insulin appears
      to remain at the injection site, and the presence of a lipid matrix for
      subcutaneous insulin delivery raises concerns over enhanced antigenicity of
      liposomal insulin given subcutaneously. Viewed in the light of the limitations
      outlined above, the contribution of liposomal insulin to understanding and
      treatment of diabetes mellitus will probably be via use of hepatically targeted
      liposomes as a pharmacological probe to decipher the role of the liver in the
      metabolic complications associated with diabetes mellitus.

PMID- 2226110
TI  - Monomeric insulins and their experimental and clinical implications.
AB  - Due to the inherent pharmacokinetic properties of available insulins,
      normoglycemia is rarely, if ever, achieved in insulin-dependent diabetic patients
      without compromising their quality of life. Subcutaneous insulin absorption is
      influenced by many factors, among which the associated state of insulin
      (hexameric) in pharmaceutical formulation may be of importance. This review
      describes the development of a series of human insulin analogues with reduced
      tendency to self-association that, because of more rapid absorption, are better
      suited to meal-related therapy. DNA technology has made it possible to prepare
      insulins that remain dimeric or even monomeric at high concentration by
      introducing one or a few amino acid substitutions into human insulin. These
      analogues were characterized and used for elucidating the mechanisms involved in
      subcutaneous absorption and were investigated in preliminary clinical studies.
      Their relative receptor binding and in vitro potency (free-fat cell assay),
      ranging from 0.05 to 600% relative to human insulin, were strongly correlated (r
      = 0.97). In vivo, most of the analogues exhibited approximately 100% activity,
      explainable by a dominating receptor-mediated clearance. This was confirmed by
      clamp studies in which correlation between receptor binding and clearance was
      observed. Thus, an analogue with reduced binding and clearance gives higher
      circulating concentrations, counterbalancing the reduced potency at the cellular
      level. Absorption studies in pigs revealed a strong inverse correlation (r =
      0.96) between the rate of subcutaneous absorption and the mean association state
      of the insulin analogues. These studies also demonstrated that monomeric insulins
      were absorbed three times faster than human insulin. In healthy subjects, rates
      of disappearance from subcutis were two to three times faster for dimeric and
      monomeric analogues than for human insulin. Concomitantly, a more rapid rise in
      plasma insulin concentration and an earlier hypoglycemic response with the
      analogues were observed. The monomeric insulin had no lag phase and followed a
      monoexponential course throughout the absorption process. In contrast, two phases
      in rate of absorption were identified for the dimer and three for the normal
      hexameric human insulin. The initial lag phase and the subsequent accelerated
      absorption of soluble insulin can now be explained by the associated state of
      native insulin in pharmaceutical formulation and its progressive dissociation
      into smaller units during the absorption process. In the light of these results,
      the effects of insulin concentration, injected volume, temperature, and massage
      on the absorption process are now also understood.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2226111
TI  - Devices for insulin administration.
AB  - There is a significant need for revised, safe, and more effective insulin
      delivery methods than subcutaneous injections in the treatment of both type I
      (insulin-dependent) and type II (non-insulin-dependent) diabetes. The aim of this
      review is to describe the rationale and methods for better use of injection and
      infusion devices for intensive insulin therapy and to describe results of animal
      and human research that will lead to an implantable artificial pancreas.
      Injection devices, e.g., jet injectors, insulin pens, and access ports, cannot be
      considered as a major breakthrough in the quest for improved control, although
      they may improve the patient's comfort. External pumps have benefits over
      multiple injections and conventional insulin therapy only in specific subgroups
      of patients, e.g., those with recurrent severe hypoglycemia, but only when used
      by experienced personnel. The external artificial pancreas (Biostator) is also to
      be used by experienced personnel for limited clinical and research applications,
      e.g., surgery of the diabetic patient. The development of an implantable version
      of the artificial pancreas is linked to progress in the field of reliable long
      duration glucose sensors. Finally, programmable implantable insulin pumps, used
      as an open-loop delivery system, are the most promising alternative to intensive
      subcutaneous insulin strategies in the short term, although clear evidence of
      improved safety and efficacy remains to be documented.

PMID- 2226112
TI  - Role of insulin in management of surgical patients with diabetes mellitus.
AB  - Because surgery is a likely event during the lifetime of patients with diabetes,
      health-care team members need to be aware of the metabolic problems that may
      occur during the perioperative period. Surgery, especially in the presence of
      general anesthesia, will produce a diabetogenic response. This is generally due
      to an elevation of counterregulatory hormones, although endogenous insulin is
      also suppressed. The excessive lipolysis and ketogenesis that can occur during
      surgery can have particularly deleterious effects for patients with diabetes.
      Thus, sufficient insulin must be provided during this period to suppress these
      catabolic processes. The major controversy regarding surgery and diabetes
      concerns the route of insulin administration. This article reviews the various
      treatment options for patients with insulin-dependent and non-insulin-dependent
      diabetes mellitus, with particular emphasis on the role of insulin. Special
      situations, e.g., outpatient surgery, coronary artery bypass, and emergency
      surgery, are also discussed.

PMID- 2226113
TI  - Natural history of beta-cell dysfunction in NIDDM.
AB  - Non-insulin-dependent diabetes mellitus (NIDDM) is characterized by insulin
      resistance and beta-cell dysfunction. This review focuses on the beta-cell, what
      defects occur when and why. Two major anatomic observations have been made in
      NIDDM. The beta-cell mass is mildly reduced, especially when obesity is taken
      into account. Also, amyloid deposits are frequently observed in the islets. It is
      unclear whether these changes are genetically mediated or result secondary to the
      loss of glucose homeostasis. Many studies have looked at some aspect of insulin
      secretion in NIDDM, and two types of distinct abnormalities have been described.
      Early on, there is a marked disruption in pulsatile insulin delivery, which is
      potentially an important contributor to the insulin resistance. It is unclear
      whether the loss of pulsatile delivery is acquired or genetically induced. Later,
      after glucose intolerance has started, several other secretory abnormalities
      develop coincident with loss of beta-cell glucorecognition. The net result is
      further deterioration in timing of insulin delivery and postprandial
      hyperglycemia. A second important consequence of the glucose blindness is that
      the inherent compensatory beta-cell mechanisms that guard against hyperglycemia
      are bypassed. We propose that the loss of glucose responsiveness is a direct
      result of an elevated glucose concentration (so-called glucotoxicity) and have
      generated substantial data in rat models that support this idea. The logical
      conclusion is that beta-cell function in NIDDM can be maximized by achieving the
      best metabolic control possible.

PMID- 2226114
TI  - TCI left ventricular assist device: nursing implications.
AB  - The use of left ventricular devices as a bridge to transplantation has gained
      considerable acceptance in transplant centers nationwide. A new, innovative
      assist device that allows for greater patient mobility with a decreased incidence
      of patient complications is now being used at St. Luke's Episcopal Hospital to
      support the potential transplant recipient while waiting for a donor heart. The
      authors discuss the pathophysiology related to this type of assist device, along
      with two case studies and the nursing diagnoses indicated for patients using this
      unique device as a bridge to transplant.

PMID- 2226115
TI  - Intravenous amrinone therapy: nursing implications.
AB  - Intravenous amrinone (Inocor) is the latest in a line of cardiotonic agents
      approved for the treatment of heart failure. A thorough knowledge of the
      pharmacology of this agent is essential in the development of a plan of care for
      this critically ill patient.

PMID- 2226116
TI  - Needs of parents of critically ill children.
AB  - When a child becomes critically ill, stable patterns of parental routines are
      changed. Although the resulting stress on parents has long been recognized by
      clinicians, only recently has research addressed parental needs during a child's
      illness.

PMID- 2226117
TI  - Attitudes of critical care nurses toward organ donation.
AB  - In October, 1987, federal legislation requiring hospitals to develop protocols to
      encourage organ and tissue donation went into effect. Despite required request
      legislation, a lack of donors still exists. The attitudes of the critical care
      nurses caring for potential organ donors may have an effect on the actual
      donation of organs. This author describes how knowledge level and experience with
      organ donors and recipients affected the attitudes of two groups of critical care
      nurses towards organ donation.

PMID- 2226118
TI  - Critical care RN student elective: a recruitment approach.
AB  - Recruiting experienced RNs into critical care is a valuable goal. In this
      article, the authors describe a senior year critical care nursing elective for
      registered nurse students in a BSN completion program entirely developed and
      presented by nursing service personnel. This program increases the exposure of
      RNs to critical care as a specialty which they might want to continue after
      graduation.

PMID- 2226119
TI  - Peripheral sympathetic neuropathy evaluated by recording the evoked electrodermal
      response using an impedance reactometer.
AB  - Autonomic nervous dysfunction was indirectly evaluated on the basis of the skin
      electrical resistance relative variation (SERV), recorded by our recently
      developed system, with two pairs of surface electrodes placed on the palm and on
      the sole of the foot, after the application to the subject of a sensory stimulus
      (sound 60 dB, 860 Hz, 0.5 s duration) or in the course of a Valsalva manoeuvre.
      The results were digitally measured and recorded on thermosensitive millimetric
      paper analysing the following parameters: latency (LT), i.e. the time interval(s)
      between application of the stimulus and onset of SERV, both at palm (LTh) and
      foot (LTf); amplitude of the response (mm) recorded and evaluated in the form of
      SERV; velocity of the response as rate of time change (Vr) and autonomic
      conduction velocity, -ACV (m/s), calculated by the height/LT ratio. The present
      study refers to a group of 60 diabetic patients: 32 F/28 M; mean age +/- SD 46.8
      +/- 11.8 years; 29 insulin-dependent, 21 non-insulin-dependent; duration of
      diabetes 8.6 +/- 4.6 years. The data were compared to those recorded in a group
      of 50 nondiabetics (22 F/28 M; mean age 47.5 +/- 14.1 years) who were apparently
      healthy. A significant statistical difference (P less than 0.001) was found
      between diabetic patients and controls for all studied parameters: LTh (s) 2.65
      +/- 1.2 vs. 1.91 +/- 0.6; LTf(s) 3.6 +/- 1.4 vs. 2.6 +/- 0.7; SERV (mm) 7.5 +/-
      4.8 vs. 18.5 +/- 6.6; Vr (mm) 4.4 +/- 2.1 vs. 13.5 +/- 5.3; ACT (m/s) 0.41 +/-
      0.23 vs. 0.97 +/- 0.18.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226120
TI  - Comparison of islet cell antibodies, islet cell surface antibodies and anti
      bovine serum albumin antibodies in type 1 diabetes.
AB  - The present study was undertaken to compare the changes in islet cell antibodies
      (ICA), islet cell surface antibodies using rat insulinoma cells (RINr-ICSA), and
      anti-bovine serum albumin antibodies (BSA-Ab) in the clinical course of type 1
      (insulin-dependent) diabetes. Sera were obtained from 57 patients with type 1
      diabetes and 47 normal controls. ICA, RINr-ICSA and BSA-Ab were detected by an
      enzymatic immunohistochemical method, an indirect immunofluorescence method and
      an enzyme-linked immunosorbent assay, respectively. The incidence of ICA
      significantly decreased with the duration of diabetes: less than 1 year: 5/6
      (83%); 1-2 years: 3/6 (50%); 2-3 years; 2/6 (33%); greater than 3 years 6/39
      (15%). There was a significant positive correlation between RINr-ICSA and BSA-Ab
      (P less than 0.05). These findings suggest that RINr-ICSA or BSA-Ab may be
      produced by some similar immune mechanism which is, however, different from ICA,
      and that they have no direct relation to the clinical course of diabetes.

PMID- 2226121
TI  - Islet cell antibodies are not specifically associated with insulin-dependent
      diabetes in Tanzanian Africans.
AB  - The prevalence of islet cell antibodies (ICA and CF-ICA) together with other
      organ-specific auto-antibodies was investigated in 122 newly presenting black
      Tanzanian diabetic patients in Dar es Salaam. ICA were found in three (8.6%) IDDM
      patients and five (6.8%) insulin-requiring NIDDM patients; six of the eight were
      also CF-ICA positive. Altogether 22% of patients showed one or more positive
      autoantibody result but there was no clustering of response, and no association
      of ICA with other antibodies except for two NIDDM subjects who showed one other
      positive result. There were no differences between insulin-requiring (IDDM) and
      NIDDM subjects or between younger (less than 30 years) and older patients. We
      conclude that there is no major association between diabetes and islet cell
      antibodies in black Tanzanians.

PMID- 2226122
TI  - Effect of acute hyperglycemia on plasma triglyceride concentration and
      triglyceride secretion rate in non-fasted rats.
AB  - The effect of an intravenous infusion of glucose on plasma triglyceride (TG)
      concentration in fed rats was determined in order to partially elucidate the
      mechanism of diabetes-induced hypertriglyceridemia. Glucose infused at 8 mg/kg
      per min caused the plasma TG concentration to be elevated significantly when
      compared to controls infused with saline alone. In rats which were euglycemic
      (clamped, insulin infused at 2.5 mU/kg per min), plasma TG concentration remained
      constant throughout the glucose infusion period (8 mg/kg per min). Hyperglycemic
      rats infused with insulin (2.5 mU/kg per min) as well as with glucose (16 mg/kg
      per min) were also hypertriglyceridemic. Infusion of insulin alone did not change
      the concentration of plasma TG over a 150 min period. Glucose was also infused (8
      mg/kg per min) with somatostatin (1 micrograms/kg per min) to block endogenous
      production of insulin. Somatostatin infusion did not suppress glucose-induced
      hypertriglyceridemia. For all treatments, the net change in TG concentration was
      found to positively correlate with the net change in plasma glucose concentration
      at 150 min after the infusions (r = 0.83, P less than 0.001). The higher TG
      concentration in the glucose infused, hyperglycemic clamp and glucose plus
      somatostatin groups reflected an increased rate of TG secretion, in the presence
      of a lower concentration of plasma free fatty acids. These results suggest that
      in a non-fasted state, acute hyperglycemia increases plasma TG by stimulating
      hepatic TG secretion, in a manner which is independent of either plasma insulin
      or free fatty acids levels.

PMID- 2226123
TI  - Abnormalities of ascorbic acid metabolism and diabetic control: differences
      between diabetic patients and diabetic rats.
AB  - Ascorbic acid is required in the synthesis of collagen and is also an important
      anti-oxidant. In a previous study, plasma ascorbic acid concentration was found
      to be decreased in diabetic patients but there was no relationship with blood
      glucose level. In the current study of diabetic patients, both plasma ascorbic
      acid and its urinary excretion correlated inversely with glycosylated hemoglobin
      level. Plasma ascorbic acid was also lower in diabetic rats but urinary ascorbic
      acid was elevated. The divergent trend in urinary ascorbic acid excretion
      observed in diabetic patients and diabetic rats may be due to difference in the
      ability of these two species to synthesize ascorbic acid. Difference in renal
      reabsorption of ascorbic acid may also be a relevant factor. The lower plasma and
      urinary ascorbic acid levels in diabetic patients with more severe hyperglycaemia
      indicates that this group of patients is particularly at risk of developing
      deficiency of this vitamin. As ascorbic acid has many important functions in the
      body, it may be necessary to supplement this vitamin in patients with chronically
      poorly controlled diabetes.

PMID- 2226124
TI  - Beta-endorphin levels of children in acute stress.
AB  - In this study aiming to clarify the relationships between beta-endorphin and
      glucose levels, beta-endorphin levels were determined in children in acute
      stress. The study was carried out on 32 critically ill children between 5 days
      and 12 years presenting with clinical symptoms of acute infectious conditions. 11
      healthy children were taken as controls. The results showed that although beta
      endorphin levels were elevated in all critically ill patients, these levels were
      significantly higher than control values in hyperglycaemic cases. The insulin
      levels were also elevated. A follow-up of nine of the hyperglycaemic cases showed
      a significant decline in beta-endorphin and insulin levels with recovery. Glucose
      tolerance was also normal. These results confirm the reports of many other
      studies on the role of beta-endorphin as a stress hormone.

PMID- 2226125
TI  - Human insulin dosage and distribution at the onset of type 1 diabetes mellitus.
AB  - The total insulin dosage and its distribution throughout the day were evaluated
      in newly diagnosed Spanish IDDM patients treated with semisynthetic human
      insulin. We assessed the insulin dosage and its distribution modifications
      related to an inpatient versus outpatient setting. We compared our results with
      classical theoretical algorithms based on patients treated with animal insulin
      and with alimentary habits which differ from our geographical area. The initial
      total daily dose (0.68 +/- 0.27 U/kg per day) did not substantially differ from
      the usual recommended dose (0.70-0.80 U/kg per day). A substantial decrease in
      total insulin dose was observed in ambulatory patients (0.55 U/kg per day). The
      reduction in dosage when we substituted regular insulin for intermediate acting
      insulin was smaller than what is commonly advised. A very low proportion of
      patients needed to add extra regular insulin to the pre-dinner intermediate
      insulin dose to achieve acceptable glucose control. Moreover, in these cases
      regular insulin comprised only 10% of total daily dosage, a proportion clearly
      inferior to that recommended. The majority of this group of patients needing
      regular insulin plus intermediate insulin at pre-dinner were treated with human
      zinc insulin. Most of our patients were acceptably controlled with a regular
      insulin dose before breakfast and lunch and an intermediate dose before dinner.
      Finally, human insulin pharmacokinetics plus our Mediterranean alimentary habits
      might be the explanation to our findings.

PMID- 2226126
TI  - In vivo metabolic activity of des-(B26-B30)-insulin-B25-amide and related
      analogues in the rat.
AB  - Metabolic potency of des-(B26-B30)-insulin-B25-amide, [TyrB25]des- (B26-B30)
      insulin-B25-amide and [HisB25]des-(B26-B30)-insulin-B25-amide was studied in
      anaesthetized rats. Compared to insulin, full potency for des-(B26-B30)-insulin
      B25-amide and an enhanced potency for both substituted analogues has been
      described previously on rat adipocytes in vitro. Hypoglycaemic effects following
      i.v. injection of all of these analogues were almost identical to those of native
      insulin with a half-maximal effective dose of approximately 3 nmol.kg-1.
      Stimulation of glucose metabolism during euglycaemic hyperinsulin-/analogueaemic
      clamp studies was indistinguishable from that of the native hormone with a
      maximal stimulation of approximately 19 mg.kg-1.min-1 and half-maximal effective
      hormone concentrations of approximately 1 pmol.ml-1. Analogue action on
      individual peripheral tissues estimated by the uptake of 2-deoxyglucose as well
      as stimulation of lipogenesis in epididymal fat was not different to that of
      insulin. These data demonstrate that C-terminal amidation of des-(B26-B30)
      insulin results in a shortened molecule with full in vivo metabolic potency. When
      substituting phenylalanine in position B25 by tyrosine or histidine, the insulin
      identical potency is preserved.

PMID- 2226127
TI  - The influence of dietary education in diabetic children.
AB  - The aim of our study was to evaluate the efficacy of dietary education in
      inducing modification of the diet and to measure biochemical parameters in 36
      children and adolescents with IDDM. At the beginning of the study, each patient
      was evaluated as follows: food intake (by the method of the 24-h recall for 3
      days), auxological parameters, biochemical parameters. Thereafter a program of
      nutritional guidelines was provided. Subsequent meetings took place at 1-month
      intervals. The study ended 3 months later, when all the parameters were
      completely revalued. We observed improved nutrition in our patients both in terms
      of total caloric intake and calorie distribution. In particular there was an
      increase in carbohydrates and a reduction in lipids, reaching the percentage
      levels recently recommended. With a reduction in lipid intake a significant
      decrease in LDL cholesterol and a significant increase in HDL cholesterol were
      noticed in our patients. These modifications are very important for the
      prevention of arteriosclerosis and thus macrovascular disease. We maintain that
      dietary education plays an important role in helping children and adolescents
      with IDDM to follow a suitable diet.

PMID- 2226129
TI  - [Regeneration of the skeletal muscle of young and old rats after total cross
      cutting].

PMID- 2226128
TI  - Effects of glucose and insulin on cultured human microvascular endothelial cells.
AB  - The prolonged effects of glucose and insulin on cultured human microvascular
      endothelial cells from omental tissue (HOMEC) were observed to identify the
      contribution of sustained hyperglycemia and/or hyperinsulinemia to the
      pathogenesis of diabetic microangiopathy. When the cells were cultured for 10
      days in Medium 199 with 100 or 500 mg/dl glucose, the number of cells was reduced
      to 78% in the culture of 500 mg/dl glucose as opposed to that of 100 mg/dl
      glucose. The difference in the number of cells between these two groups became
      obvious between the 5th and the 7th culture days. The replacement of D-glucose
      with L-glucose did not show any reduction in the number of cells, indicating the
      impertinence of high osmolarity, induced by high glucose (305 mOsm/kg) to the
      number of cells. This reduction resulted from the cellular damage during the
      culture period rather than the retardation of growth, according to the
      experiments of [3H]thymidine uptake and the 51Cr release assay. Since the uptake
      of glucose, measured as the uptake of 3-O-methyl-alpha-D-glucose, was higher and
      the Na+/K+ pump activity decreased in high glucose condition, it is suggested
      that the excessive intracellular accumulation of glucose caused the damage of
      cells through the disturbance of ion exchange. Insulin augmented the reduction in
      the number of cells induced by high glucose when supplemented together for 10
      days at concentrations of 10(-6)-10(-12)M. The uptake of glucose increased
      further to 154% by the addition of insulin to high glucose as compared to that of
      high glucose alone, however, the decreased Na+/K+ pump activity by high glucose
      was restored to the control level by insulin. The aggravating effect of insulin
      to the cellular damage induced by high glucose seems to be mediation via the
      mechanism other than the decreased Na+/K+ pump activity. In conclusion, HOMEC
      were gradually damaged by high glucose and by insulin, and hyperglycemia and
      hyperinsulinemia would be of pathogenetic importance for diabetic
      microangiopathy.

PMID- 2226130
TI  - [Cloning and primary sequence of the gene coding for major heat shock protein
      (HSP70) in the silkworm].

PMID- 2226131
TI  - [UV-photolysis of amino acids and peptides. Cleavage of peptide bond during laser
      irradiation].

PMID- 2226133
TI  - [The effect of elevated functional load on the activation of satellite cells in
      skeletal muscles of adult rats].

PMID- 2226132
TI  - [Immunogenicity and protective activity of water-soluble polymer-metal complexes
      of protein antigens].

PMID- 2226134
TI  - [A drop in oxygen tension along the capillary in skeletal muscle: experimental
      study].

PMID- 2226135
TI  - [Phenomenon of non-random large-scale fragmentation of DNA in cell nuclei].

PMID- 2226136
TI  - [The mechanism of potentiating effect of glutamate on gastric secretion].

PMID- 2226137
TI  - [Latent excitation after termination of long-term potentiation in the
      hippocampus].

PMID- 2226138
TI  - [Organization of transcriptionally inactive regions of interphase chromosomes].

PMID- 2226139
TI  - [A fragment of human DNA lacking hybridization with chimpanzee DNA].

PMID- 2226140
TI  - [ATP synthesis in mitochondria: interaction of redox-chains in outer and inner
      membranes].

PMID- 2226141
TI  - [C-terminal polyarginine tract of hepatitis B core antigen is located on the
      outer capsid surface].

PMID- 2226142
TI  - [Metabolism of phosphorus-containing compounds in the liver of the ground
      squirrel (Citellus undulatus) during various physiological states].

PMID- 2226143
TI  - [Phorbol ester (TPA) modulation of the responses of the snail neuronal membrane
      to the rapid application of acetylcholine].

PMID- 2226144
TI  - [Changes in the respiration and intracellular pH in a cell culture under the
      action of oligomycin].

PMID- 2226145
TI  - [Inhibition of the reproduction of the human immunodeficiency virus in a cell
      culture with antisense oligonucleotide derivatives].

PMID- 2226146
TI  - [A new positively charged nonhistone protein participates in the condensation of
      inactive chromatin at the terminal stage of the differentiation of chick
      erythrocytes].

PMID- 2226147
TI  - [The effect of unilateral homotopic neural transplantation on the recovery of the
      motor function of the hindlimbs in rats with bilateral removal of the
      sensorimotor area of the cortex].

PMID- 2226148
TI  - [The role of rhythmic activity in the processes of information fixation and
      reproduction in a model network made up of nerve-like elements].

PMID- 2226149
TI  - [Discrete levels of cell activation].

PMID- 2226150
TI  - [The specialized contact of an astrocyte containing a vesicle aggregation with
      the dendritic spine in the cerebral cortex of the cat].

PMID- 2226151
TI  - [The formation of specific sebaceous skin glands in the early postnatal
      ontogeny].

PMID- 2226152
TI  - [The retransplantation of embryonic nerve tissue into the mammalian brain].

PMID- 2226153
TI  - [The differential expression of crystallins and concanavalin A-binding proteins
      in different cellular "compartments" of the amphibian crystalline lens].

PMID- 2226154
TI  - [The characteristics of the progeny of irradiated males from 2 lines of
      Drosophila virilis differing by the level of genetic instability].

PMID- 2226155
TI  - [Lessons from reoperations in 55 patients with primary hyperparathyroidism].
AB  - On the basis of 70 re-operations in 55 patients (34 women, 21 men, median age 58
      [43-83] years) suffering from primary hyperparathyroidism the reasons for failure
      of the first operations were analysed. The main reasons were inadequate
      exploration of the neck (failure to identify all four glands), failure to
      recognize multiple gland involvement, or inadequate resection in cases where more
      than one gland was affected. An abnormally situated gland was a less common
      cause, as shown by the fact that 41 out of the 73 glands removed at the last re
      operation were situated in the normal position or in its immediate vicinity; in
      20 cases the surgeon had failed to recognise multiple gland disease. Next in
      order of importance were anatomical variations in the location (32 out of 73
      tumours) or the number of the glands (9 patients with hyperplasia of 5 glands).
      At the re-operations 89% of the parathyroid tumours were found in the neck region
      or would have been accessible from the neck at the time of the first operation.
      Overall, the hypercalcaemia was permanently rectified in 96.6% of the patients.
      During the last 10 years 94% of patients have been normocalcaemic
      postoperatively, thanks mainly to the re-implantation of autologous parathyroid
      tissue, preserved by low-temperature storage. The incidence of permanent
      unilateral recurrent nerve paresis attributable to the re-operations was 6%.

PMID- 2226156
TI  - [Paroxysmal non-hereditary angioedema].
AB  - Recurrent hypovolaemic shock had been occurring over the last five and four
      years, respectively, in a 53-year-old woman and a 46-year-old man who had
      previously been healthy. The attacks were characterized by a tension feeling and
      sometimes oedema in the limbs, as well as increased thirst. Within a few hours
      sweating, tachycardia, orthostatic complaints and shock would occur. The woman's
      systolic blood pressure would fall to 70 mm Hg and the pulse rate rise to
      150/min. The man's blood pressure was not measurable by sphygmomanometer during
      his first attack. Haematocrit rose to 61 and 71.5%, haemoglobin concentration to
      20.7 and 21.3 g/dl, respectively. On administration of plasma expanders all
      abnormal clinical and biochemical changes quickly disappeared, only to recur
      within weeks or months. The cause of the condition is an increased permeability
      of the tissue capillaries, while renal, pulmonary and cerebral vessels apparently
      are unaffected. During ketotifen and tebonin (gingko biloba extract)
      administration to the man, he required no further hospitalization for nine
      months, after which he had three severe attacks. The woman had a severe attack of
      hypovolaemic shock one month on this treatment. The prognosis of capillary leak
      syndrome is bad.

PMID- 2226157
TI  - [Atypical joint symptoms as initial symptoms of varicella infection in chronic
      myeloid leukemia].
AB  - A 25-year-old man, known to have chronic myeloid leukaemia for four years,
      acutely developed a fever of 39.5 degrees and severe pain in the shoulder and hip
      joints. There was no evidence of joint disease. Treatment with indomethacin
      briefly improved the symptoms, but within 72 hours the patient developed a
      fulminant illness with high fever and clinical as well as biochemical signs of a
      severe consumption coagulopathy. Herpetiform efflorescences appeared over the
      head and trunk shortly before death. At autopsy there was histological and
      immunohistochemical evidence of a varicella infection with hepatitis, oesophageal
      involvement and severe internal organ bleedings. In immune-compromised patients
      with atypical prodromal symptoms a varicella infection must be considered so that
      causal treatment with acyclovir and hyperimmune-globulin can be begun in time.

PMID- 2226158
TI  - [Acute emphysematous cholecystitis as a cause of pneumoperitoneum].
AB  - A 48-year-old man developed progressively more severe epigastric pain, pain on
      pressure in the right upper abdomen and fever up to 38.6 degrees C so that acute
      cholecystitis was suspected. Ultrasound did not demonstrate a gall-bladder but a
      sickle shaped, dense echo with a distal adjoining echo-free zone. Computed
      tomography revealed air in the gall-bladder lumen as well as intramural and
      pericholecystic air pockets, findings pathognomonic for emphysematous
      cholecystitis. In addition pneumoperitoneum was diagnosed. Subsequent
      cholecystectomy intraoperatively revealed a gangrenous, nonperforating gall
      bladder in which E. coli was demonstrated. During the first postoperative week,
      there were no complications under transitory antibiotic treatment with tobramycin
      and ticarcillin with clavulanic acid. Then, an abscess developed in the residual
      gall bladder bed; this abscess was cured after drainage, local irrigation and re
      initiation of antibiotic treatment. The patient was finally discharged well.

PMID- 2226159
TI  - [Extracorporeal shockwave lithotripsy: what system and for what purpose?].

PMID- 2226160
TI  - [Therapy of sickle cell crisis].

PMID- 2226161
TI  - [Autotransplantation of splenic tissue].

PMID- 2226162
TI  - [Balloon catheter recanalization and local thrombolysis in pulmonary embolism].

PMID- 2226164
TI  - [Cardiac pacemaker implantation in unrecognized obstructive sleep apnea
      syndrome].
AB  - A cardiac pacemaker was implanted because of nocturnal sinus arrhythmia into a 53
      year-old man with hypersomnia. After other patients had reported loud snoring and
      breathing pauses, which appeared to be dangerously long, polysomnography was
      performed. It indicated a marked obstructive sleep apnoea syndrome with an apnoea
      index of 55 and an average apnoea duration of 35 seconds. The nocturnal cardiac
      arrhythmias disappeared under continuous nasal raised pressure ventilation.

PMID- 2226163
TI  - [Pneumocystis carinii pneumonia in HIV infection: better prognosis because of
      early diagnosis].
AB  - The clinical presentation of 60 consecutive Pneumocystis carinii pneumonias in 58
      HIV-infected patients (48 men, 10 women, mean age 34 [22-53] years) was
      prospectively evaluated from April to August 1989 and compared with 60
      consecutive P. carinii pneumonias in 59 HIV-infected patients (55 men, 4 women,
      mean age 37.5 [22-60] years) between 1981-88. Mortality rates within 14 days
      after diagnosis of P. carinii pneumonia were 50% (8 of 16 patients) until 1985,
      20.5% (9 of 44) between 1986 and August 1988, and 1.7% (one of 60) in 1989. The
      degree of severity of the pneumonias at time of diagnosis was markedly lower in
      1989, as shown by following parameters (averages of 1989, compared with averages
      of 1981-88): lactate dehydrogenase 540 (250-1419) U/l versus 680 (235-1920) U/l
      (not significant); alveolo-arterial difference of partial oxygen tension (pA-aO2)
      22.9 (0.5-73.5) mmHg versus 39.7 (19-70) mmHg (P less than 0.001); score of
      radiological findings 1.4 (0-3) versus 2.7 (0-4) (P less than 0.001). In 1989,
      mainly clinical symptoms (dry cough: 57 of 60 cases, dyspnea: 44 of 60 cases,
      fever: 43 of 60 cases) initiated the diagnostic procedure: chest radiographs,
      lactate dehydrogenase and pA-aO2 were normal in 13, 25 and 33 episodes,
      respectively. The lower mortality rate of P. carinii pneumonia could not
      primarily be explained by therapeutical progress since the treatment of choice
      did not change fundamentally since 1981. Above all, early diagnosis fundamentally
      determined the probability of survival.

PMID- 2226165
TI  - [Misdiagnosis of psychic symptoms of hyperthyroidism in affective psychosis].
AB  - A 71-year-old woman known to have suffered from a depressive illness for fifty
      years developed further psychological and somatic symptoms 18 months ago
      (agitation, increased impulsiveness, depressive mood, decreased appetite,
      diarrhoea and weight loss). Within five days there occurred nocturnal confusion
      with disordered word finding and counting. Biochemical tests indicated
      hyperthyroidism and scintigraphy showed multifocal activity increase. The
      psychological and somatic symptoms responded to thyrostatic treatment with
      carbimazole, 30 mg daily. This case demonstrates that added somatic causes of
      psychological symptoms should be thought of in previously known psychiatric
      illness.

PMID- 2226166
TI  - [Diagnosis of Barrett esophagus].

PMID- 2226167
TI  - [Therapy of Barrett esophagus].

PMID- 2226168
TI  - [Pathogenesis and therapy of listeriosis].

PMID- 2226169
TI  - [Glycosylated hemoglobin or fructosamine: what must one measure?].

PMID- 2226170
TI  - [Transfer factor].

PMID- 2226171
TI  - [Hydrostatic pressure in esophageal varices and the risk of an esophageal
      variceal hemorrhage].

PMID- 2226172
TI  - [Modern methods for the regulation of type 1 diabetes?].

PMID- 2226173
TI  - [Proglottids of Taenia solium].

PMID- 2226174
TI  - [Crohn's disease: disease activity and recurrence following surgery].
AB  - The data from 238 patients (108 men, 130 women, mean age 29 [15-71] years), who
      had undergone operations for Crohn's disease between 1968 and 1988, were analysed
      retrospectively with the purpose of ascertaining the significance of an
      endoscopically demonstrated "early recurrence". In 170 patients postoperative
      colonoscopy had been performed at least once. In 130 patients the activity of the
      disease in the years before and after operation was compared in terms of such
      parameters as haemoglobin, erythrocyte sedimentation rate, serum albumin, body
      weight and the frequency of acute flare-ups of the disease and admissions to
      hospital. The probability of an endoscopically demonstrable recurrence was 90%
      after 5 years, while the corresponding figure for a symptomatic recurrence was
      40%. This indicates that the routine performance of postoperative colonoscopies
      is of no value in assessing the prognosis. The probability of a reoperation was
      21% after 5 years; in cases where both the ileum and colon were involved the
      probability was three times as high as in those with isolated involvement of
      either the small or the large intestine. Post-operatively, a substantial
      reduction in disease activity of several years' duration was achieved in the
      overall majority of cases.

PMID- 2226175
TI  - [The implantation of hip joint endoprostheses: with or without cement?].

PMID- 2226176
TI  - [The duties of the employer in continuing medical education. The judgement of the
      Federal Labor Court of 22 February 1990].

PMID- 2226177
TI  - [Coffee and serum cholesterol].

PMID- 2226178
TI  - [The nephrotoxic effect of therapy with fumaric acid esters in psoriasis].
AB  - Two sisters, aged 25 and 29 years, with generalized psoriasis guttata since
      childhood, developed nausea, upper-abdominal pain, loss of appetite, palpitations
      and flushes in the course of local and oral administration of fumaric acid
      esters. Because of these side effects the treatment was discontinued after about
      two weeks, and the symptoms disappeared. But proteinuria and haematuria were
      subsequently noted, creatinine concentration rose to 2.2 and 2.5 mg/dl,
      respectively, while creatinine clearance fell to 44 and 27 ml/min, respectively.
      Examination of urinary sediments and analysis of urinary proteins gave results
      compatible with tubular-interstitial renal damage. The abnormal renal functions
      and urinary findings proved reversible within three weeks.

PMID- 2226179
TI  - [Extraintestinal strongyloidiasis in the acquired immunodeficiency syndrome].
AB  - A 41-year old man of Brazilian origin, suffering from AIDS for one year, fell ill
      with pyrexia of over 39 degrees C, dyspnoea, chest pain and deterioration in his
      general condition. At the same time he noted a discrete skin eruption, mainly on
      the upper limbs. Diarrhoea began later. A chest radiograph revealed bilateral
      infiltrates. The blood showed leucocytosis (11,000/microliters) with pronounced
      increase of eosinophil granulocytes (47.5%). Alkaline phosphatase was raised to
      170 U/l. Suspicion of strongyloidiasis was confirmed by the discovery of numerous
      Strongyloides stercoralis larvae in the faeces. A few days after starting
      treatment with mebendazole, 400 mg daily, he felt better and the diarrhoea
      stopped. However, as the lung infiltrates remained unchanged and hilar lymph node
      enlargement now appeared, the dose of mebendazole was raised to 2500 mg daily.
      The abnormal findings then cleared up: Strongyloides stercoralis larvae ceased to
      be demonstrable and the patient gained 10 kg in weight.

PMID- 2226180
TI  - [The differential diagnosis of Alzheimer's dementia from the neurological
      viewpoint].

PMID- 2226181
TI  - [The "tuberculin intoxication" of 1890].

PMID- 2226182
TI  - [Gout without hyperuricemia?].

PMID- 2226183
TI  - [Pacemaker aftercare: malfunction in magnetic exposure].

PMID- 2226184
TI  - [The growth hormone as a geriatric agent?].

PMID- 2226185
TI  - [Epidemiology of hypercalcemia. Significance of the determination of intact
      parathyroid hormone for differential diagnosis].
AB  - Serum-calcium levels were determined in 9666 hospital inpatients during one year.
      Hypercalcaemia was present in 101 patients (51 women, 50 men, mean age 57 years).
      In 46 patients, hypercalcaemia was caused by malignancy. The second commonest
      cause was primary hyperparathyroidism (pHPT) in 35 cases. In the other 20
      patients, hypercalcaemia was related to thiazid medication (8 patients), elevated
      25-hydroxy-vitamin-D3-levels (six patients) or immobilisation (two patients). In
      four patients, no cause was found. Intact parathyroid hormone levels reliably
      distinguished patients with pHPT (values greater than 60 ng/l) from patients with
      hypercalcaemia of other causes (values less than 40 ng/l). Other laboratory tests
      were less useful. Serum-calcium levels greater than 2.9 mmol/l were found only in
      pHPT and hypercalcaemia of malignancy. In pHPT, the medical history frequently
      revealed nephrolithiasis (12 patients) and gastrointestinal ulcers (8 patients),
      whereas weight loss was far more common in hypercalcaemia of malignancy (28
      patients).

PMID- 2226186
TI  - [Penile plication for the treatment of severe penile deviations].
AB  - Penile plication procedure was performed on 27 patients (median age 24 years) to
      correct marked penile deviation (mean deviation angle 50 degrees). On average 4
      (2-10) sutures were necessary. Normal intercourse and potency was restored in
      all. 26 patients were fully satisfied with the result, while in three there were
      suture problems (fistula, granuloma). There was one recurrence, three weeks
      postoperatively, in a patient who failed to follow the recommended six-week
      period of sexual abstinence. But this recurrence was lastingly corrected by a
      second penile plication procedure. No lasting complications were noted a mean of
      48 months postoperatively. This type of operation is the treatment of choice for
      significant penile curvature.

PMID- 2226187
TI  - [Acute segmental hemorrhagic penicillin-associated colitis].
AB  - Four days after beginning a perioperative antibiotic prophylaxis with amoxicillin
      and clavulanic acid a 33-year-old patient developed an acute haemorrhagic
      diarrhoea with cramp-like lower abdominal pain. Coloscopy revealed diffuse
      mucosal oedema with map-like ulcerations, increased susceptibility to trauma and
      submucous haemorrhages extending from the middle of the ascending to the middle
      of the descending colon. Granulocytic inflammation with cryptal atrophy was seen
      histologically. Stool cultures, including tests for Clostridium difficile toxin,
      were normal. All symptoms disappeared within three days of discontinuing the
      medication. Coloscopy after one week revealed marked improvement, after three
      months nothing abnormal. Acute segmental haemorrhagic penicillin-associated
      colitis is rare and must be distinguished from antibiotic-associated
      pseudomembranous colitis.

PMID- 2226188
TI  - [Floating right atrial thrombus as the cause of recurring pulmonary embolisms].
AB  - After an attack of pleuropneumonia a 25-year-old woman developed persistent
      dyspnoea due to pulmonary emboli, as demonstrated by scintigraphy. There was no
      clinical or phlebographic evidence of the peripheral venous system as the source.
      Two-dimensional echocardiography demonstrated a floating spherical tumour in the
      right atrium, attached to the interatrial septum and prolapsing into the right
      ventricle during ventricular diastole. Because of the risk of further
      thromboembolic episodes the tumour was removed operatively without any
      complication. It proved to be myxoma-like, 3 x 3 cm in diameter. Histologically
      it was a thrombus without evidence of myxoma. No further thromboemboli occurred
      under phenprocoumon anticoagulation.

PMID- 2226189
TI  - [Diagnosis and therapy of adrenal cortex insufficiency].

PMID- 2226191
TI  - [Early detection of type I diabetes].

PMID- 2226190
TI  - [Amylin, islet amyloid and diabetes mellitus type II].

PMID- 2226192
TI  - [Long-term success of coronary angioplasty after repeated treatment].
AB  - To ascertain the long-term results after second and third angioplasties for
      coronary stenosis the coronary angiograms from 1504 consecutive patients with
      coronary heart disease (1211 men, 293 women, mean age 57 [27-82] years) were
      retrospectively surveyed. A good initial response (at least 20% reduction in
      stenosis) was achieved in 295 out of 306 second angioplasties (95.5%), and in all
      36 third angioplasties. Viewed overall, these results are significantly better (P
      less than 0.005) than those achieved at the initial angioplasty (1386 out of 1504
      patients; 92.2%). The reduction in the severity of the stenosis achieved at the
      second angioplasty (from 86 to 24%) and at the third angioplasty (from 86 to 26%)
      was the same as at the first angioplasty (from 88 to 28%). Serious complications
      after the first angioplasty were infrequent (death in 0.2%, emergency bypass in
      0.4%, myocardial infarction in 0.5%), and no complications were noted after
      second and third angioplasties. A good long-term outcome (at least 20% reduction
      in stenosis at 3-4 months) was slightly more frequent after the second and third
      angioplasties (103 out of 170 [60.6%] and 14 out of 17 patients, respectively)
      than after the first intervention (532 out of 926 patients; 57.5%). In keeping
      with these results, the degree of stenosis found at follow-up angiography was
      significantly lower (first intervention 54.8%, second intervention 50.3%, third
      intervention 36.9%). There were only 57 patients (3.8%) who ultimately required
      operative treatment. These figures indicate that the probability of a good long
      term outcome from coronary angioplasty increases each time the stretching
      operation is repeated. Only a very small proportion of patients will require
      bypass surgery.

PMID- 2226193
TI  - [Results of therapy in Hodgkin's disease].
AB  - The results of therapy in 239 patients (161 men, 78 women, median age 33 [13-80]
      years) who had been treated for Hodgkin's disease between 1972 and 1986 were
      evaluated retrospectively. The proportion of complete remissions depended on the
      stage of the disease and was 90% (35 out of 39 patients) for stage IA, 90% (9 out
      of 10) for stage IB, 84% (40 out of 48) for stage IIA, 88% (22 out of 25) for
      stage IIB and 86% (37 out of 43) for stage IIIA. At five and ten years, survival
      rates among patients in stages IA to IIB were 76 and 69%, respectively, and for
      patients in stage IIIA 81 and 52%, respectively. For patients who enjoyed
      complete remissions the probability of surviving for 5 or 10 years without
      recurrence was 62% or 54%, respectively, for stages IA to IIB, and 75 or 43%,
      respectively, for stage IIIA. There were no statistically significant differences
      between stages I, II and IIIA as regards remission rate, survival time or
      recurrence-free survival time. During these stages the patient's age proved to be
      the only prognostic factor of any statistical significance. For stages IIIB and
      for IVA and IVB the proportion of complete remissions achieved by combined
      chemotherapy with COPP was 62%. At 5 and 10 years the proportion of these
      patients in permanent remission was 63 and 53%, respectively, while survival
      rates in the entire series were 46% and 40%, respectively. A genuine cure--in the
      sense of at least 10 years' survival without recurrence after the first complete
      remission--can be expected in one third of patients in stages IIIB to IVB.

PMID- 2226194
TI  - [Computed tomographic detection of liver hemangiomas].
AB  - A 67-year old woman had noticed increasing growth of hair on the face and
      extremities for eight months. The testosterone level was raised at 2.6
      micrograms/l and 24-hour urinary cortisol excretion was 160 micrograms.
      Ultrasound scanning showed a tumour measuring 14 x 10 x 10 cm in the left
      suprarenal, as well as several irregular space-occupying lesions in the liver,
      some of which were echo-rich. By computed tomography these structures were
      hypodense and did not concentrate any contrast medium. A provisional diagnosis of
      suprarenal carcinoma with hepatic metastases was accordingly made. After surgical
      removal of the suprarenal carcinoma the hormonal parameters unexpectedly returned
      to normal. Repetition of the computed tomography failed to elucidate the nature
      of the liver lesions. However, superselective hepatic angiography revealed the
      typical picture of haemangiomas of the liver. The existing computed tomograms
      were therefore reviewed. The diagnostic error was found to be due to incorrect
      timing of the interval between injection of contrast medium and performance of
      computed tomography.

PMID- 2226195
TI  - [Therapy of tuberculosis].

PMID- 2226196
TI  - ["Functional" gastrointestinal pain].

PMID- 2226197
TI  - [Fatal lung embolism during ultrahigh-dose streptokinase treatment].

PMID- 2226198
TI  - A widely distributed antigen developmentally regulated in the nervous system.
AB  - We have identified a glycoprotein (BEN) of 95-100 x 10(3) Mr using a monoclonal
      antibody. This protein is transiently expressed at the cell surface of the
      peripherally projecting neurons, i.e. motoneurons of the spinal cord and cranial
      nuclei, sensory neurons of the dorsal root and cranial sensory ganglia and
      sympathetic, parasympathetic and enteric neurons. In vitro cultures of dorsal
      root and sympathetic ganglia have shown that BEN is expressed on neurons but not
      on glial cells. On motor and sensory neurons, BEN first appears at the level of
      the cell body just after withdrawal from the cell cycle. Soon afterwards,
      expression of the antigen extends to the elongating axon. After a few days, BEN
      is no longer expressed by the motor and sensory neurons, disappearing first from
      the cell body and then progressively from the fibres. The loss of expression is
      concomitant with the onset of intense proliferation of satellite and Schwann
      cells. This modulated expression within the nervous system is unlike that of any
      surface glycoprotein so far described in vertebrates. Preliminary biochemical
      analysis indicates that, although it bears the adhesion-associated epitope HNK-1,
      BEN does not share characteristics with any previously described axonal
      glycoprotein. Consequently, we speculate that this glycoprotein might be a novel
      molecule implicated in selective adhesion phenomena, such as axonal
      fasciculation.

PMID- 2226199
TI  - The induction of anterior and posterior neural genes in Xenopus laevis.
AB  - We have investigated the interactions between mesoderm and ectoderm that result
      in the formation of a regionally differentiated nervous system in Xenopus
      embryos. We have used genes expressed at different positions along the neural
      tube as regional markers of neural induction in both whole, and in experimentally
      manipulated embryos. By comparing transcription from the anterior marker, XIF3,
      with that from the posterior marker, X1Hbox6, and the general neural marker XIF6,
      we have shown that the normal induction process requires interactions between
      ectoderm and mesoderm that persist through gastrulation into the late neurula
      stages. We have found that competence of the ectoderm to respond to induction is
      lost at the same early neurula stage for all three marker genes. Using rhodamine
      dextran-labelled mesoderm, we have established that the duration of contact
      between ectoderm and mesoderm required for gene activation in conjugates is the
      same for each of the markers. We have, however, identified regions of the
      mesoderm that can induce different combinations of neural marker gene expression.
      The anterior mesoderm induces expression of the anterior marker, XIF3, and the
      later migrating posterior mesoderm induces the ectoderm overlying it to express
      the posterior marker X1Hbox6. It has been proposed that neural inducing signals
      reach the ectoderm by two different routes: from mesoderm lying directly beneath
      the ectoderm or along the plane of the ectoderm. We have assessed the
      contribution of each route in respect of our three neural markers and find that a
      signal passing directly from mesoderm to ectoderm fully accounts for neural gene
      expression. We were unable to detect an inducing signal that passes along the
      plane of the ectoderm.

PMID- 2226200
TI  - Autonomous determination of anterior structures in the early Drosophila embryo by
      the bicoid morphogen.
AB  - A small number of maternal effect genes determine anterior-posterior pattern in
      the Drosophila embryo. Embryos from females mutant for the maternal gene bicoid
      lack head and thorax. bcd mRNA becomes localized to the anterior tip of the egg
      during oogenesis and is the source for the morphogen gradient of bcd protein.
      Here we show that in vitro transcribed bicoid mRNA that has its own leader
      sequences substituted by the Xenopus beta-globin 5' untranslated sequences is
      translated more efficiently than bicoid mRNA with the natural 5' mRNA leader when
      tested in vitro and in Drosophila Schneider cells. When injected into bicoid
      mutant embryos, only the bcd mRNA with the beta-globin leader sequence,
      substituted for the natural leader, is able to induce anterior development. We
      used P-transformation to show that sequences in the 5' leader are neither
      necessary for localization of the transcript nor for the translational block of
      the bcd mRNA during oogenesis. For our injection experiments, we used only one of
      the identified splicing forms of bcd mRNA. The bcd protein species derived from
      this mRNA is able to induce anterior development at any position along the
      anterior-posterior axis. Thus bicoid protein can induce development of head and
      thorax independent of any other specifically localized morphogenetic factor. Our
      findings further support the notion that the concentration gradient of bcd
      protein, and not the existence of different forms of bcd protein, is responsible
      for specifying subregions of the embryo.

PMID- 2226201
TI  - Single cell transplantation reveals interspecific cell communication in
      Drosophila chimeras.
AB  - Cell-cell communication is not only a common strategy for cell fate specification
      in vertebrates, but plays important roles in invertebrate development as well. We
      report here on experiments testing the compatibility of mechanisms specifying
      cell fate among six different Drosophila species. Following interspecific
      transplantation, the development of single ectodermal cells was traced in order
      to test their abilities to proliferate and differentiate in a heterologous
      environment. Despite considerable differences in cell size and length of cell
      cycle among some of the species, the transplants gave rise to fully
      differentiated clones that were integrated into the host tissue. Clones comprised
      cells of epidermal and/or neural histotypes, indicating that mechanisms mediating
      the epidermal/neural dichotomy in the ectoderm are conserved between the species.
      Cells of the neural lineages differentiated into neurones, glia, or both.
      Moreover, heterologous neurones sent out axons that followed major pathways along
      nerves and within the neuropile, demonstrating their ability to recognize
      positional cues in the heterologous CNS of the host.

PMID- 2226202
TI  - Organogenesis and pattern formation in the mouse: RNA distribution patterns
      suggest a role for bone morphogenetic protein-2A (BMP-2A).
AB  - Bone morphogenetic protein-2A (BMP-2A) is a member of the transforming growth
      factor beta (TGF beta) gene family that has been implicated in cartilage and bone
      formation. Here we use in situ hybridization to show that BMP-2A RNA is expressed
      in a variety of embryonic epithelial and mesenchymal tissues outside of the
      developing skeletal system, including cell populations known to play important
      roles in morphogenesis. Thus, high levels of transcripts are found in developing
      limb buds (ventral ectoderm and apical ectodermal ridge), heart (myocardium of
      the atrioventricular canal), whisker follicles (ectodermal placodes, hair matrix
      and precortex cells), tooth buds (epithelial buds, dental papilla and
      odontoblasts), and craniofacial mesenchyme, as well as a number of other sites.
      The expression patterns of BMP-2A are different from those of TGF beta-1, -2 and 
      3, and this is illustrated in detail in the developing whisker follicles. These
      results suggest that BMP-2A plays multiple roles in morphogenesis and pattern
      formation in the vertebrate embryo.

PMID- 2226203
TI  - Localization of the DER/flb protein in embryos: implications on the faint little
      ball lethal phenotype.
AB  - Antibodies were raised against the Drosophila EGF receptor homolog (DER) and used
      for immunohistochemical analyses of Drosophila embryos. We found that DER is
      localized in a wide array of embryonic tissues, displaying a dynamic pattern of
      expression. DER appears to be expressed in all cells at the cellular blastoderm
      and gastrula stages. In extended-germ-band embryos, it is found predominantly in
      the mesoderm and the head. Finally, in retracted-germ-band embryos, DER
      immunoreactivity is most pronounced at sites of somatic muscle attachments and
      along the ventral midline of the CNS. We have thus observed that DER is expressed
      in the diverse tissues which are affected in the DER faint little ball (flb)
      embryonic lethal phenotype. The different pattern and extent of expression in
      each tissue suggests that the disparate aspects of the flb phenotype may result
      from different mechanisms of DER function. To understand the basis for the CNS
      phenotype of DER/flb mutants, we have closely followed the collapse of the CNS in
      mutant embryos. Our observations on the evolution of the final CNS phenotype, in
      combination with the temporo-spatial pattern of appearance of DER in the ventral
      neuroepithelium, suggest that this receptor participates in the second phase of
      neuron-glia interactions, namely in stabilization of the ladder-like CNS
      scaffolding formed by outgrowth of pioneer axonal processes along the glial pre
      pattern.

PMID- 2226204
TI  - The Notch locus of Drosophila is required in epidermal cells for epidermal
      development.
AB  - The Notch locus of Drosophila plays an important role in cell fate decisions
      within the neurogenic ectoderm, a role thought to involve interactions at the
      cell surface. We have assayed the requirement for Notch gene expression in
      epidermal cells by two kinds of genetic mosaics. First, with gynandromorphs, we
      removed the wild-type gene long before the critical developmental events to
      produce large mutant clones. The genotype of cells in large clones was scored by
      means of an antibody to the Notch protein. Second, using mitotic recombination,
      we removed the gene at successively later times after completion of the
      mitotically active early cleavage stages, to produce small clones. These clones
      were detected by means of a linked mutation of cuticle pattern, armadillo. The
      results of both experiments demonstrate a requirement for Notch expression by
      epidermal cells, and thus argue against the model that the Notch product acts as
      a signal required only in the neuroblast to influence neighboring epidermal
      cells. The mitotic recombination experiment revealed that Notch product is
      required by epidermal cells subsequent to neuroblast delamination. This result
      implies that the Notch gene functions to maintain the determined state of
      epidermal cells, possibly by mediating cell surface interactions within the
      epidermis.

PMID- 2226205
TI  - Identification of a novel growth factor with transforming activity secreted by
      individual chick embryos.
AB  - Previously we have developed a microassay for anchorage independent growth (AIG)
      of fibroblasts in soft agar, which can detect very small quantities of
      transforming growth factors (TGFs). Using this assay, we have shown that small
      pieces of dissected chick embryo tissue will stimulate AIG of both NR6 and NRK
      49f cells, and that this property can be used to map production of growth factors
      with transforming activity in individual early embryos. We now show that this
      activity can be transferred to conditioned medium (CM) prepared using chick
      embryo tissue. Using two cell lines with differential responsiveness to TGFs, and
      by coincubating normal and heat-treated CM with trypsin, Con-A and neutralising
      antibodies, we show that CM contains at least two different growth factors with
      transforming activity. One of these is heat-stable, and stimulates colony
      formation in NRK 49f cells in the presence of EGF, but not in its absence. This
      activity corresponds to a TGF beta-like molecule. The other component is a heat
      labile glycoprotein, which has TGF alpha-like properties, but does not appear to
      behave like known TGFs with these properties. It therefore appears to be a novel
      growth factor. Both activities are present from the intermediate primitive streak
      stage of development.

PMID- 2226206
TI  - The effects of embryonic retinal neurons on neural crest cell differentiation
      into Schwann cells.
AB  - Amongst the many cell types that differentiate from migratory neural crest cells
      are the Schwann cells of the peripheral nervous system. While it has been
      demonstrated that Schwann cells will not fully differentiate unless in contact
      with neurons, the factors that cause neural crest cells to enter the
      differentiative pathway that leads to Schwann cells are unknown. In a previous
      paper (Development 105: 251, 1989), we have demonstrated that a proportion of
      morphologically undifferentiated neural crest cells express the Schwann cell
      markers 217c and NGF receptor, and later, as they acquire the bipolar morphology
      typical of Schwann cells in culture, express S-100 and laminin. In the present
      study, we have grown axons from embryonic retina on neural crest cultures to see
      whether this has an effect on the differentiation of neural crest cells into
      Schwann cells. After 4 to 6 days of co-culture, many more cells had acquired
      bipolar morphology and S-100 staining than in controls with no retinal explant,
      and most of these cells were within 200 microns of an axon, though not
      necessarily in contact with axons. However, the number of cells expressing the
      earliest Schwann cell markers 217c and NGF receptor was not affected by the
      presence of axons. We conclude that axons produce a factor, which is probably
      diffusible, and which makes immature Schwann cells differentiate. The factor does
      not, however, influence the entry of neural crest cells into the earliest stages
      of the Schwann cell differentiative pathway.

PMID- 2226207
TI  - Interaction between satellite cells and skeletal muscle fibers.
AB  - Single myofibers with attached satellite cells isolated from adult rats were used
      to study the influence of the mature myofiber on the proliferation of satellite
      cells. The satellite cells remain quiescent when cultured in serum containing
      medium but proliferate when exposed to mitogen from an extract of crushed adult
      muscle. The response of satellite cells to mitogen was measured under three
      situations with respect to cell contact: (1) in contact with a viable myofiber
      and its basal lamina, (2) detached from the myofiber by centrifugal force and
      deposited on the substratum and (3) beneath the basal lamina of a Marcaine killed
      myofiber. The results show that satellite cells in contact with the plasmalemma
      of a viable myofiber have reduced mitogenic response. Since inhibiting growth may
      induce differentiation, I tested whether satellite cells proliferating on the
      surface of a myofiber would fuse. Although the satellite cell progeny were fusion
      competent, they did not fuse with the myofiber. To determine whether fusion
      competence of the myofiber changes with time in culture, embryonic myoblasts were
      challenged to fuse with myofibers that had been stripped of satellite cells and
      cultured for several days. The myoblasts fused with pseudopodial sprouts growing
      from the ends of the myofiber, but did not fuse with the original myofiber
      surface. These results indicate that contact with the surface of a mature
      myofiber suppresses proliferation of myogenic cells but the cells do not fuse
      with the myofiber.

PMID- 2226208
TI  - Differentiation of tropomyosin-containing myofibrils in cleavage-arrested
      ascidian zygotes expressing acetylcholinesterase.
AB  - Two muscle differentiation programs, acetylcholinesterase and tropomyosin
      containing filaments and fibrils, occur together in the same cleavage-arrested
      zygotes (1-celled) of the ascidian Ciona intestinalis. Coexpression in such
      undivided but developing 'embryos' is consistent with the idea that separate
      elements of muscle differentiation are related at some regulatory level, perhaps
      through a single multi-gene regulatory factor. Fertilized Ciona eggs were exposed
      to cytochalasin B for 20 h and then briefly reacted histochemically for
      acetylcholinesterase activity. Strongly reacting specimens were selected and
      processed for transmission electron microscopy to reveal regions of muscle
      ultrastructure. Every acetylcholinesterase-reactive zygote tested contained
      muscle contractile elements; no example lacking acetylcholinesterase was found
      with myofilaments and myofibrils. As demonstrated by immunogold labelling, a
      polyclonal antibody to tropomyosin from Ciona adult body wall reacted
      differentially with the presumed ultrastructural muscle elements in cleavage
      arrested zygotes. Site-specific reactions were also observed in larval tail
      muscle and the siphon muscles of postmetamorphic zooids.

PMID- 2226209
TI  - Double anterior chick limb buds and models for cartilage rudiment specification.
AB  - Most models for the specification of the skeletal elements in the developing limb
      bud are based on a chemical specification well before overt cartilage
      differentiation. By contrast, a physico-mechanical model proposes that the
      process of condensation--an early feature of cartilage differentiation--is itself
      the basis for patterning the elements. The models thus make quite different
      predictions as to when the rudiments are specified. Double anterior limb buds
      have been constructed at stages earlier than condensation, with the expectation
      that, if specification of the humerus occurs before cartilage condensation, then
      limbs containing two humeri should develop, since the presumptive humerus lies
      largely in the anterior region. The development of anterior and posterior parts,
      on their own, was in general, consistent with the fate map; both developed a
      humerus that was thinner than normal. Double anterior limbs developed two humeri
      in 28% of cases and a much thicker humerus in 39%. These results strongly support
      models based on an early specification of limb rudiments and cannot be accounted
      for by the physical model. Double anterior limbs in which the two parts were from
      different stages, developed such that a digit 3 could lie adjacent to the radius,
      giving further striking evidence for early specification and local autonomy of
      development.

PMID- 2226210
TI  - Identification in Xenopus of a structural homologue of the Drosophila gene snail.
AB  - We have cloned a Xenopus cDNA that is related to snail, a gene that is required
      for mesoderm formation in Drosophila. The cDNA encodes a protein that contains
      five zinc-fingers that closely resemble those of snail. In the non-canonical
      parts of the DNA-binding loop, there is almost 90% homology between snail and
      xsna. The corresponding mRNA (xsna) is expressed strongly at the start of zygotic
      transcription simultaneously with the transcription factor EF1 alpha. In early
      gastrulae, xsna is equally distributed between the dorsal and ventral halves of
      the equatorial zone. The possibility that the capacity to synthesise xsna is more
      localised before the start of zygotic transcription has been investigated by
      culturing fragments of stage 8 embryos until xsna is synthesised. The capacity to
      synthesise xsna at stage 8 is located principally in the dorsal half of the
      equatorial zone. A small amount of maternal xsna is localised in the vegetal
      hemisphere before zygotic transcription starts. xsna is not present in isolated
      animal caps but can be induced by the mesoderm-inducing factors XTC-MIF and bFGF.
      Synthesis of xsna does not occur autonomously in dispersed cells but is restored
      when cells reaggregate in the presence of calcium and magnesium.

PMID- 2226211
TI  - Centrally acting sympatholytic agents in the treatment of congestive heart
      failure. A review of the literature.

PMID- 2226213
TI  - Management of menopause when estrogen cannot be used.
AB  - Estrogen deficiency, whether surgically induced or as a consequence of natural
      ovarian failure, has destructive effects on many organ systems. With current
      levels of life expectancy, untreated women may expect to spend a third of their
      lifetime in this state. Appropriate estrogen replacement therapy (ERT) can avert
      (if started promptly) or ameliorate these devastating consequences, some of which
      (osteoporotic fractures, increased cardiovascular morbidity) can be lethal.
      Nevertheless, from 10 to 20% of postmenopausal women may have significant
      contraindications to ERT. Treatment of symptoms and improving the quality of life
      is imperative, yet many physicians abjure intervention, for reasons which are not
      entirely clear. Recent studies of conventional intervention with sedatives or
      tranquilisers show results equivalent to placebo therapy. On the other hand,
      specific agents with demonstrated effectiveness are available for management of
      the major estrogen-deficiency effects, although none of them are truly adequate
      replacement for the effect of estrogen itself.

PMID- 2226214
TI  - Current concepts in the management of sarcoidosis.
AB  - Sarcoidosis can affect almost every organ. It has diverse clinical presentations
      and a variable natural history. Lungs and intrathoracic lymph nodes are the most
      commonly involved tissues. A major challenge to clinicians is the early
      identification of those patients with aggressive disease in whom therapy might
      arrest progression. Although lung uptake of 67Ga citrate, elevated serum
      angiotensin converting enzyme (ACE) levels and elevated T lymphocyte count in
      bronchoalveolar lavage fluid are all thought to reflect disease activity, they
      are by no means reliable markers. Because recent studies have shown that
      corticosteroid treatment does not avert pulmonary fibrosis and permanent
      impairment of pulmonary function, the use of these agents is restricted to the
      palliative treatment of disabling symptoms and physiological derangements.
      Corticosteroids are effective in reducing ocular inflammation, correcting
      hypercalcaemia, improving pulmonary function and alleviating symptoms related to
      hepatic, splenic, articular, myocardial, neural and cutaneous involvement. In the
      small proportion of patients who do not respond to moderate tolerable doses of
      steroids, alternative drug therapy such as immunosuppressives or immune
      modulators must be considered.

PMID- 2226215
TI  - Ticlopidine. An updated review of its pharmacology and therapeutic use in
      platelet-dependent disorders.
AB  - Ticlopidine inhibits platelet aggregation induced by adenosine diphosphate (ADP)
      and most other platelet agonists in ex vivo studies of human platelets. The drug
      also improves other abnormalities of platelet function seen in patients with
      cerebrovascular disease, peripheral arterial disease, ischaemic heart disease or
      other conditions involving platelet hyperaggregation. Abnormal platelet activity
      has been implicated in a variety of clinical conditions in which patients are at
      high risk of thromboembolic events, and thus the effectiveness of ticlopidine has
      been investigated in such patients. Since the initial review of the drug appeared
      in the Journal, data from several large multicentre studies have shown that
      ticlopidine has a substantial benefit to offer patients who have experienced
      transient ischaemic attacks or stroke, and in those with peripheral arterial
      disease or ischaemic heart disease. Ticlopidine reduces the incidence of further
      stroke, myocardial infarction or vascular death, and is superior to placebo and
      aspirin in this regard in studies of patients with recent stroke or transient
      ischaemic attacks, or intermittent claudication. Ticlopidine is equally effective
      in both men and women and also improves symptoms of claudication in patients with
      peripheral arterial disease, and appears to reduce anginal pain. Patients with
      subarachnoid haemorrhage and sickle cell disease have shown some improvement with
      ticlopidine administration. The drug reduces thromboembolic events and re
      stenosis in patients undergoing haemodialysis and cardiac surgery, and appears to
      prevent the progression of nonproliferative diabetic retinopathy. Ticlopidine in
      large clinical trials is associated with a higher incidence of adverse effects
      than placebo and an overall incidence similar to aspirin. Most adverse effects do
      not require withdrawal of treatment. Gastrointestinal symptoms (particularly
      diarrhoea) are most common, occurring almost twice as frequently with ticlopidine
      as with aspirin. Other adverse effects associated with ticlopidine include skin
      rash, haemorrhagic disorders, and haematological effects; these latter effects
      require careful monitoring of patients during the initial weeks of therapy. In
      conclusion, ticlopidine is a valuable addition to the prophylactic treatments
      available for the management of patients with cerebrovascular disease, peripheral
      arterial disease or ischaemic heart disease, who present a high risk of
      thromboembolic events. Although tolerability may be a problem for some patients,
      the overall benefit conferred by the drug would appear to outweigh this potential
      disadvantage. Because of its antiplatelet activity, ticlopidine has a promising
      role in other disorders mediated by platelet dysfunction. However, the precise
      role of the drug in these additional therapeutic indications awaits clarification
      with wider clinical experience.

PMID- 2226212
TI  - Effects of drugs on glucose tolerance in non-insulin-dependent diabetics (Part
      II).

PMID- 2226217
TI  - Zolpidem. A review of its pharmacodynamic and pharmacokinetic properties and
      therapeutic potential.
AB  - Zolpidem is an imidazopyridine, a chemically novel nonbenzodiazepine hypnotic
      agent which acts at the benzodiazepine omega 1-receptor subtype in the brain.
      With a rapid onset of action and short elimination half-life, it reduces the
      latency to and prolongs the duration of sleep in patients with insomnia, yet has
      no major effects on sleep stages when given in dosages of 5 to 20 mg nightly.
      Rebound effects on withdrawal of the drug have not been observed. Unlike
      benzodiazepines, zolpidem has no myorelaxant or anticonvulsant effects and its
      effects on anxiety appear to be minor. While zolpidem aids sedation, and may
      reduce memory or psychomotor function within the first 2 hours after
      administration of single oral doses, its use as a surgical premedicant remains to
      be established. Adverse effects are predominantly CNS and gastrointestinal in
      nature. Altered pharmacokinetics may lead to an increase in dose-proportionate
      adverse effects in the elderly and in patients with renal dysfunction. Limited
      evidence to date suggests that the dependence liability of zolpidem is minimal.
      Thus, zolpidem is an interesting alternative to benzodiazepines in the treatment
      of insomnia, with properties that potentially offer worthwhile advantages in this
      therapeutic area if they are confirmed with wider clinical experience.

PMID- 2226216
TI  - Fenofibrate. A review of its pharmacodynamic and pharmacokinetic properties and
      therapeutic use in dyslipidaemia.
AB  - Fenofibrate is a lipid-regulating drug which is structurally related to other
      fibric acid derivatives, such as clofibrate. At the recommended dosage of 200 to
      400 mg daily, it produces substantial reductions in plasma triglyceride levels in
      hypertriglyceridaemic patients and in plasma total cholesterol levels in
      hypercholesterolaemic patients. High density lipoprotein (HDL)-cholesterol levels
      are generally increased in patients with low pretreatment values. Fenofibrate
      appears to be equally effective in diabetic patients with hyperlipoproteinaemia
      without adversely affecting glycaemic control. The influence of fenofibrate on
      the plasma lipid profile is sustained during long term (2 to 7 years) treatment.
      Comparative studies conducted to date have involved only small groups of patients
      -in overall terms fenofibrate was at least as effective as other fibrates, but
      larger comparative studies are needed before valid conclusions on its relative
      efficacy compared with nonfibrate lipid-lowering drugs can be drawn. The
      influence of fenofibrate on morbidity and mortality from cardiovascular disease
      has not been studied. Clinical adverse reactions to fenofibrate have mainly
      consisted of gastrointestinal disturbances, headache and muscle cramps. Transient
      elevations in transaminase and creatine phosphokinase levels commonly occur.
      Isolated cases of hepatitis with substantially elevated transaminase levels have
      been reported. Fenofibrate induces hepatomegaly, peroxisome proliferation and
      hepatic carcinomas in rodents, but this type of hepatotoxicity has not been
      observed in humans. The biliary lithogenic index is increased by fenofibrate, but
      this has not been shown to have increased the incidence of gallstones in treated
      patients. Thus, fenofibrate offers an effective and well tolerated alternative to
      clofibrate or other fibric acid derivatives, but its relative efficacy and
      tolerability compared with other types of lipid-lowering drugs, and its effect on
      cardiovascular morbidity and mortality, remain to be clarified.

PMID- 2226218
TI  - Emerging indications for the use of cyclosporin in organ transplantation and
      autoimmunity.

PMID- 2226220
TI  - Current treatment recommendations for topical burn therapy.
AB  - Infections in burn patients continue to be the primary source of morbidity and
      mortality. Topical antimicrobial therapy remains the single most important
      component of wound care in hospitalised burn patients. The goal of prophylactic
      topical antimicrobial therapy is to control microbial colonisation and prevent
      burn wound infection. In selected clinical circumstances topical agents may be
      used to treat incipient or early burn wound infections. At the present time
      silver sulfadiazine is the most frequently used topical prophylactic agent; it is
      relatively inexpensive, easy to apply, well tolerated by patients, and has good
      activity against most burn pathogens. In patients with large burns the addition
      of cerium nitrate to silver sulfadiazine may improve bacterial control. Mafenide
      acetate has superior eschar-penetrating characteristics, making it the agent of
      choice for early treatment of burn wound sepsis. However, the duration and area
      of mafenide application must be limited because of systemic toxicity associated
      with prolonged or extensive use. Other agents, such as nitrofurazone or
      chlorhexidine preparations, may be useful in isolated clinical situations. The
      undesirable side effects of silver nitrate solution limit its use by most
      clinicians at the present time.

PMID- 2226223
TI  - Sexually transmitted diseases and HIV-1: interactions in transmission and role in
      control programs.

PMID- 2226219
TI  - Angiotensin converting enzyme inhibitors and moderate hypertension.
AB  - Recently there has been extensive development of orally active angiotensin
      converting enzyme (ACE) inhibitors in addition to those already marketed, for
      example, captopril, enalapril, lisinopril and ramipril. It was initially thought
      that ACE inhibitors were likely to be most useful as antihypertensive agents in
      conditions in which circulating renin and angiotensin II were elevated. However,
      it is now clear that they can also lower arterial pressure when plasma renin is
      not high. In addition, they have beneficial effects in cardiac failure. Thus,
      captopril, enalapril, lisinopril and ramipril can be used in the treatment of
      mild to moderate hypertension either alone or in conjunction with diuretics or
      calcium antagonists. Broadly speaking, efficacy appears to be similar to that of
      beta-blockers or diuretics. Unfortunately, however, there are no long term
      studies comparing one ACE inhibitor with another or with other classes of
      antihypertensive agents. Furthermore, there are no prognostic studies which show
      that use of ACE inhibitors reduces morbidity or mortality in hypertension. Many
      new ACE inhibitors are undergoing clinical assessment, including alacepril,
      cilazapril, fosenopril, perindopril, quinapril and ramipril. The drugs vary, in
      that some exist in the active form whereas others are prodrugs which are
      converted to the active agent following absorption. In addition they each possess
      one of several ligands, for example, carboxyl, phosphinyl or sulfhydryl groups,
      and so vary in their affinity for ACE. Although many of these agents are renally
      excreted, a small number are metabolised via the liver (e.g. quinapril and
      spirapril) and this may prove advantageous in the presence of renal impairment.
      In common with captopril and enalapril, the new ACE inhibitors inhibit the renin
      angiotensin system and initial results suggest that they are effective in
      lowering blood pressure in essential hypertension. Furthermore, they reduce
      systemic vascular resistance in the absence of a reflex tachycardia. There are a
      number of adverse effects which are attributable to the pharmacological mechanism
      of the ACE inhibitors as a group; these include hypotension, particularly in
      patients with high renin levels, prior diuretic use, renal impairment or in the
      elderly. Additional adverse effects may relate to chemical structure. The high
      incidence of adverse effects noted in early studies related to excess dosage and
      to the presence of a sulfhydryl group, which the more recently developed ACE
      inhibitors lack. The adverse effects most commonly reported with established and
      new ACE inhibitors include headache and fatigue, cough, skin rashes, hypotension
      and diarrhoea. As a group, ACE inhibitors have an acceptable but not negligible
      adverse effect burden.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2226224
TI  - Prevalence of antibodies to human T-lymphotropic virus type 1 (HTLV-1) in an HIV
      endemic region of Africa.
AB  - Serum samples from 267 healthy subjects and patients either infected or not
      infected with HIV-1 in Dar es Salaam, Tanzania, were examined by enzyme-linked
      immunosorbent assay and western blot techniques for evidence of HTLV-1 infection.
      Specific antibodies were detected in only 1% of the sera. Positive sera were
      likely to be from individuals infected with HIV-1. Tanzania and probably the
      other East African countries are non-endemic for HTLV-1. Prevalences are too low
      to provide justification for screening of blood donations. However, screening of
      donor blood for HIV-1 will limit transmission of HTLV-1 by this route as well.

PMID- 2226221
TI  - Mexiletine. A review of its pharmacodynamic and pharmacokinetic properties, and
      therapeutic use in the treatment of arrhythmias.
AB  - As a member of the class Ib antiarrhythmic drugs mexiletine's primary mechanism
      of action is blocking fast sodium channels, reducing the phase 0 maximal upstroke
      velocity of the action potential. It increases the ratio of effective refractory
      period to action potential duration, but has little effect on conductivity.
      Unlike quinidine it does not prolong QRS and QT (QTc) intervals. In the dosage
      range 600 to 900 mg daily mexiletine effectively suppresses premature ventricular
      contractions (PVCs) in 25% to 79% of patients, with or without underlying cardiac
      disease. In comparative studies the response rate was comparable to that with
      quinidine or disopyramide. However, the use of antiarrhythmic therapy in patients
      with asymptomatic arrhythmias is controversial. More importantly, mexiletine
      abolishes spontaneous or inducible ventricular tachycardia or fibrillation in the
      short term in 20% to 50% of patients with refractory arrhythmias. Arrhythmia
      suppression is maintained in 57% to over 80% of these early therapeutic successes
      in the long term, with mexiletine alone or in combination with another
      antiarrhythmic drug. As with other antiarrhythmic drugs, there is no substantial
      evidence that administration of mexiletine after acute myocardial infarction
      improves long term prognosis. Although the incidence of adverse effects
      associated with mexiletine is high, the majority are minor gastrointestinal or
      neurological effects which can be adequately controlled through dosage
      adjustment. Furthermore, mexiletine has minimal effects on haemodynamic
      variables, or on cardiac function in patients with or without pre-existing
      deterioration of left ventricular function, and it appears to have a low
      proarrhythmic potential. Thus, while the therapeutic efficacy of mexiletine for
      the prevention or suppression of symptomatic ventricular arrhythmias may be no
      greater than that of other antiarrhythmic drugs, and less than that of some (e.g.
      amiodarone), it is effective in a significant proportion of patients refractory
      to other treatments and can be administered without causing adverse haemodynamic
      effects to patients with complicating factors such as acute myocardial infarction
      or congestive heart failure.

PMID- 2226222
TI  - Ketotifen. A review of its pharmacodynamic and pharmacokinetic properties, and
      therapeutic use in asthma and allergic disorders.
AB  - Ketotifen is an orally active prophylactic agent for the management of bronchial
      asthma and allergic disorders. Accumulated evidence indicates that after 6 to 12
      weeks of administration, ketotifen significantly reduces respiratory symptoms and
      the need for concomitant antiasthmatic drugs in about 70% and 50%, respectively,
      of patients with mild to moderate bronchial asthma. However, absolute improvement
      in lung function is generally slight. Ketotifen also has pronounced
      antihistaminic and antianaphylactic properties which result in moderate to marked
      symptom improvement in the majority of patients with atopic dermatitis, seasonal
      or perennial rhinitis, allergic conjunctivitis, chronic or acute urticaria or
      food allergy. Comparative trials with established agents--notably sodium
      cromoglycate (cromolyn sodium) in asthma and histamine H1-antagonists in allergic
      disorders--indicate that ketotifen has comparable clinical utility. Unlike
      inhaled sodium cromoglycate, ketotifen ameliorates the symptoms of asthma,
      rhinitis and dermatitis when present together in atopic patients. Patient
      acceptance of ketotifen is good, although sedation can be troublesome in older
      children and adults for the initial 2 weeks of treatment. Weight gain is another
      notable effect in a small percentage of patients. Thus, ketotifen appears to be a
      useful agent for the management of allergic disorders and bronchial asthma,
      particularly in patients for whom oral therapy is preferred. Although a lengthy
      run-in period is needed in the treatment of asthma, in those patients who
      respond, continued reduction in the frequency and severity of symptoms and in the
      use of additional antiasthmatic drugs can be anticipated.

PMID- 2226225
TI  - HIV infection surveillance in Mogadishu, Somalia.
AB  - A group of 89 prostitutes and 45 patients attending sexually transmitted disease
      clinics in Mogadishu, Somalia were examined for evidence of HIV infection. Both
      groups reported more than 1 sexual partner routinely and had sexual contacts with
      prostitutes. There was a significant amount of sexually transmitted diseases
      (STDs) in these two groups, with 11.2% and 6.7% respectively being culture
      positive for N. gonorrhoea. Among the prostitutes, 28.1% were positive for
      antibodies to T. pallidum while only 4.4% of the STD patients were positive. One
      isolate of N. gonorrhoea was resistant to penicillin. All study participants were
      negative for antibodies to HIV suggesting an extremely low prevalence of HIV in
      high risk behaviour groups in the capital city of Somalia.

PMID- 2226227
TI  - Prevalence of concurrent Chlamydia trachomatis infections among men with
      gonococcal urethritis in Lusaka.
AB  - The prevalence of Chlamydia trachomatis infections among male patients with
      gonococcal urethritis in the sexually transmitted diseases (STDs) clinic at UTH,
      Lusaka, was determined by two methods to be around 4.7%. Methods used were
      specific for C. trachomatis (Syva Microtrak), and second isolation of C.
      trachomatis. The results indicate that with a prevalence rate of 4-7% for
      concurrent gonococcal and chlamydial infection, it is not financially or
      medically practical to treat all cases of gonorrhoea in Zambia for possible
      chlamydial infection, as is advocated in some countries. The findings further
      suggest that the commercially available Syva Microtrak test should probably be
      considered positive when one or two monoclonal-stained elementary bodies are
      seen, rather than ten, to avoid false-negative results.

PMID- 2226228
TI  - Stroke at Kenyatta National Hospital.
AB  - Seventy two patients presenting with stroke to Kenyatta National Hospital were
      studied between January 1986 and January 1987. The majority were from the rural
      areas. There were about equal numbers between left and right sided hemipareses.
      The majority of the patients were in their 6th and 7th decades. 22 of the
      patients were hypertensive. Diabetes mellitus, cigarette smoking, alcohol
      consumption, and valvular heart disease were some of the other factors associated
      with strokes. 46% of the patients died while the remainder had residual
      neurological deficits.

PMID- 2226226
TI  - Prevalence of gonorrhoea, syphilis and trichomoniasis in prostitutes in Burkina
      Faso.
AB  - Prevalence of syphilis, gonorrhoea and trichomoniasis among 127 prostitutes in
      Ougadougou, Burkina Faso, was investigated. 22% were positive of syphilis, 20%
      for intracellular gram negative diplococci, and 17% for Trichomonas vaginalis
      infection. Demographic data revealed that the prostitutes were a young group,
      with 69% between 15 and 25 years old. 14% of the women were from Burkina Faso;
      the majority (73%) were of Ghanaian origin. Our data highlight alarming rates of
      STDs in prostitutes working in Ouagadougou. Education campaigns which consider
      sociodemographic and cultural characteristics of the prostitutes should be
      established to reduce these rates. Upgrading of diagnostic capabilities and focal
      mass drug administration among prostitutes should also be considered. Data for
      this study were collected at Yalgado Ouedraogo Hospital, Ouagudougou, Burkina
      Faso, and analyzed at Columbia University School of Public Health and at
      Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA.

PMID- 2226229
TI  - Megaloblastic anaemia in Zimbabwe: the pernicious anaemias.
AB  - This study of 16 patients with pernicious anaemia (PA) (9 males and 7 females);
      serves as further evidence that the disease is not as infrequent in Africans as
      the literature stressing its rarity in the past appears to have suggested. The
      age-old preconceptions about racial incidence; age of onset; and absence of
      adequate laboratory facilities particularly in the African setting have hitherto
      greatly contributed to under-diagnosis of this disorder in Africans.

PMID- 2226230
TI  - Foam slipper in place of the walking heel for lower limb plaster of Paris casts.
AB  - Avoidable delays in the application of weight-bearing lower limb plaster of Paris
      casts on our patients caused by shortages of the standard walking heels (rockers)
      made us try the common and always--available foam slippers in their place. Their
      use in the treatment of 450 patients is reported here. The slippers performed all
      the usual functions of the rockers well and there were no complications due to
      their use. The patients felt very steady and comfortable on them and particularly
      appreciated the cushioning effect of their soft soles and the fact that they
      could use the other slipper on the uninjured leg comfortably. On the basis of the
      excellent results obtained in this study and in view of their cheapness and ready
      availability, the author recommends a wider use of slippers in place of the
      conventional rockers.

PMID- 2226231
TI  - Inter-relationships between HIV infection and other sexually transmitted
      diseases.
AB  - The HIV is a typical sexually transmitted disease (STD) agent which depends for
      its transmission through sex on contact between raw body tissues of infected and
      uninfected individuals independent of sexual inclination. The dynamics of HIV
      transmission and its control in a community can be inferred from studying the
      socio-cultural and epidemiological aspects of acute STD. There is strong evidence
      to suggest that the main cause of rampant heterosexual transmission of the HIV in
      sub-Saharan Africa in contrast to the rarer heterosexual HIV transmission in
      Europe and the USA is the high prevalence of ulcerative STD in Africa. Studying
      the trend and response to treatment of conventional acute STD are quick and
      indirect ways of assessing the impact of control measures against AIDS and HIV
      infection in an HIV endemic area. Further research is needed to determine the
      extent and detailed mechanism of interaction between HIV infection and other STDs
      as well as studying the efficacy of AIDS control through control of other STDs.

PMID- 2226233
TI  - Herpes Zoster Ophthalmicus in a child with acquired immune deficiency syndrome.
AB  - A case is described of an 8 year old child who presented with Herpes Zoster
      Ophthalmicus involving the left eye. He had a positive history of pulmonary
      tuberculosis, repeated hospital admissions and blood transfusion. He was
      confirmed to have Acquired Immune Deficiency Syndrome. During the course of his
      followup, he developed cotton-wool spots and perivasculitis in the right eye. The
      mother was found to be seropositive while the father was seronegative.

PMID- 2226232
TI  - Conjunctival Kaposi's sarcoma in a patient with acquired immune deficiency
      syndrome.
AB  - A patient with confirmed acquired immune deficiency syndrome (AIDS) and
      disseminated Kaposi's sarcoma was seen in the Eye Clinic, Kenyatta National
      Hospital, and was found to have involvement of the conjunctiva and lids,
      confirmed by biopsy. He also had retinal haemorrhages and cotton-wool spots.
      Kaposi's sarcoma of the conjunctiva may be confused with a subconjunctival
      haemorrhage.

PMID- 2226234
TI  - The history of interferon and its use in animal therapy.
AB  - The history of the discovery and development of knowledge on interferon is
      reviewed in some depth. Although interferons have been considered a very exciting
      group of proteins for many years during which they were initially shown to have
      antiviral effects and lately immunomodulatory and immunoregulatory effects,
      attempts to use them in the therapy of animal and human disease have been
      disappointing. The initial problem was to obtain sufficient quantities of
      purified interferons for use in clinical trials. This was overcome in the 1980's
      by the use of biotechnological techniques which resulted in the synthesis of
      adequate amounts of interferons. While beneficial aspects of interferon therapy
      have been shown in a variety of experiments, both in animals and humans, the
      great potential for interferon treatment has yet to be achieved. In the body,
      interferon is produced in such small quantities as compared to the large
      quantities which have been normally used in therapy and it is well recognized
      that these proteins, the interferons, are particularly potent. A small group of
      scientists working from biological principles, originating from U.S.A. and are
      now being developed in Kenya, have found powerful beneficial effects when
      relatively low dose of IFN-alpha is applied orally to animals and humans,
      particularly for the treatment of AIDS and East Coast fever. It is now known that
      interferons are only a part of the cytokine network and indirect and direct
      effects of interferon can occur on cells to change their behaviour. Many of these
      effects are non-specific and have a general effect on the course of diseases
      which, hopefully, can be translated into effective broad spectrum therapy, for
      man and animals.

PMID- 2226235
TI  - Efficacy of Kemron (low dose oral natural human interferon alpha) in the
      management of HIV-1 infection and acquired immune deficiency syndrome (AIDS).
AB  - One hundred and ninety nine symptomatic and 5 asymptomatic patients seropositive
      for the human immunodeficiency virus type 1 (HIV-1) were treated with KEMRON, a
      natural human interferon alpha (nHIF alpha) stabilized in a complex
      polysacchariche carrier. Treatment was given for at least 10 weeks at a daily
      oral dose of approximately 2.0 IU of nHIF alpha per kg body weight. Karnofsky
      performance score increased from an average of 60.5 on entry into the study to
      100 by the 10th week after treatment. Similarly, common clinical complaints
      associated with HIV-1 infection rapidly reduced per patient from an average of
      3.8 to 0.05 and 0 by week 8 and 10 of treatment. Eighteen of the patients
      serodeconverted by both ELISA and western blot assays during the study period.
      These observations suggest that KEMRON used as recommended is beneficial in HIV-1
      seropositive individuals.

PMID- 2226237
TI  - Kemron. Low dose natural human interferon alpha for oral administration (general
      information and technical details).

PMID- 2226236
TI  - Treatment of HIV infections and AIDS: new horizons.
AB  - Treatment of HIV infections has involved the use of antiviral drugs as well as
      those drugs that act against opportunistic infections. Immune modulators have
      also been used. A review of these drugs is reported emphasizing on those which
      have great promise in the clinical management of HIV infections in the light of
      our present knowledge on immunopathology of the disease.

PMID- 2226238
TI  - Response of Pleurotus ostreatus to cadmium exposure.
AB  - The possibility of utilizing agroindustrial wastes in the production of edible,
      high-quality products (e.g., mushrooms) implies the risk of bringing toxic
      substances, such as heavy metals, into the human food chain. Thus, growth in the
      presence of cadmium and cadmium accumulation limits have been studied in the
      industrially cultivated fungus P. ostreatus. Fruit body production is
      substantially unaffected in the presence of 25, 139, and 285 mg Cd/kg of dried
      substrate. Cadmium concentration in fruit bodies is related to cadmium substrate
      level, the metal being present at higher levels in caps (22-56 mg/kg dry wt) than
      in stems (13-36 mg/kg dry wt). Concentration factor (CF), very low in the
      controls (about 2), further decreases in treated specimens. The presence of a
      cadmium control mechanism in this fungi species is suggested. Fruit body cadmium
      levels could, however, represent a risk for P. ostreatus consumers, according to
      FAO/WHO limits related to weekly cadmium intake.

PMID- 2226239
TI  - Metabolic effects of kraft mill effluents on the eel Anguilla anguilla L.
AB  - Yellow eels (Anguilla anguilla L.) with an average weight of 60 g were used in
      this experiment. The fish were caught in June/July at the Aveiro Lagoon on the
      Portuguese West Coast, transported to the Department of Biology, Aveiro
      University, and kept in aerated aquaria for 1 week before the experiment started.
      The eels were then exposed for 1 and 3 weeks to 75 and 50% of the kraft pulp mill
      effluent. The eels exposed to the kraft pulp mill effluent developed an increase
      in red blood cell number per cubic millimeter and several biochemical changes,
      such as an increase in plasma lactate and sodium and a decrease in plasma
      pyruvate and potassium. Histological examination of the experimental eels exposed
      to the 50% kraft pulp mill effluent revealed deep alteration of the tissue
      structure, such as disruption of the skin and edematous hypertrophy of covering
      epithelial cells in secondary gill lamellae. The kidney had damage of the renal
      tubules. The liver developed necrosis supported by a significant decrease in GOT
      and GPT activity. The spleen had an increase in blood content as well as in
      pigment centers. Previous results indicated the kraft pulp mill effluent causes
      tissue damage and consequent metabolic changes in the eel Anguilla anguilla L.

PMID- 2226240
TI  - In vivo recovery of glycogen metabolism in hemolymph and tissues of a freshwater
      field crab Barytelphusa guerini on exposure to hexavalent chromium.
AB  - The in vivo toxic effects of hexavalent chromium (20 mg/liter) on hemolymph
      glucose, tissue glycogen, total free sugars, and active and total phosphorylases
      of an edible, freshwater crab Barytelphusa guerini were studied. In a 15-day
      exposure span followed by a 15-day postexposure recovery, the time-course
      alterations in these constituent segments of the glycogen metabolism indicate an
      inconsistent depletion in metabolite levels and elevated enzyme activities during
      exposure period as well as hyperglycemia. An insignificant recovery was observed
      in these parameters on the 15th day of the postexposure phase.

PMID- 2226241
TI  - Effect of copper sulfate on hematology, blood chemistry, and hepato-somatic index
      of an Indian catfish, Heteropneustes fossilis (Bloch), and its recovery.
AB  - The present communication deals with the effect of copper sulfate (0.25 ppm) on
      hematology, blood chemistry, and hepato-somatic indices of an Indian catfish,
      Heteropneustes fossilis (Bloch) and its recovery from intoxication. Analysis of
      various parameters was made after 24 hr, and 5, 10, 20, and 30 days of CuSO4
      exposure. Subsequently, the fish were allowed recovery periods of 24 hr and 5
      days in normal water. Changes in various parameters from normal values during
      exposure and recovery were recorded and probable reasons for alterations have
      been discussed in detail.

PMID- 2226242
TI  - Fish embryos as teratogenicity screens: a comparison of embryotoxicity between
      fish and birds.
AB  - Early life stage (ELS) toxicity experiments were carried out with zebra fish
      (Brachydanio rerio) and rainbow trout (Salmo gairdneri) and 10 chemicals used in
      the rubber industry. Several of these chemicals appeared to be teratogenic. A
      good correlation (r = 0.95) was found between the 7-day EC50 for zebra fish and
      the 60-day EC50 for rainbow trout for total embryotoxicity (embryolethality and
      malformations). The S. gairdneri test appeared to be slightly more sensitive than
      the test with B. rerio. It is therefore concluded that this short-term test is a
      good alternative for the long-term test with S. gairdneri. A remarkably good
      correlation (r = 0.90) was found between the ED50 for chicken embryotoxicity
      reported in the literature and the EC50 for embryotoxicity for both zebra fish
      and rainbow trout. This may, among other things, be explained by similarities in
      embryonic development and the absence of maternal and placental metabolism of the
      toxicants in tests with eggs of both fish and birds. It may therefore be
      concluded that both the short-term ELS test with B. rerio and the chicken egg
      test have the same predictive power for mammalian teratogenicity; i.e., both are
      suitable screening tests for direct-acting teratogens.

PMID- 2226243
TI  - Effect of 3,4-dichloroaniline and metavanadate on Daphnia populations.
AB  - Fourteen continuously fed populations of Daphnia magna were exposed to 3,4
      dichloroaniline (3,4-DCA) or metavanadate and monitored for 20 (two controls), 14
      (six with metavanadate), and 8 (six with 3,4-DCA) weeks. The controls showed a
      damped oscillation. Low concentrations of either 3,4-DCA or metavanadate
      stimulated the first population peak. High concentrations of metavanadate
      rendered population peaks less regular, and at the highest metavanadate
      concentration, one population perished. High concentrations of 3,4-DCA slightly
      reduced population size. Four periodically fed populations of D. magna were also
      monitored. The more they were fed, the larger they grew. In the continuously fed
      populations, ephippia were formed at and just after the population peaks. No
      ephippia were noted in the periodically fed populations. Metavanadate promoted
      the formation of ephippia (NOEC 0.56 mg/liter), and 3,4-DCA depressed sexual
      reproduction at all concentrations tested (6, 12, and 24 micrograms/liter). The
      population dynamics of the controls were compared with those predicted by
      Kooijman's model (1986a, in The Dynamics of Physiologically Structured
      Populations (J.A.J. Metz and O. Diekmann, Eds.), pp. 266-297, Springer Lecture
      Notes in Biomathematics; 1986b, J. Math. Biol. 23, 163-185) for growth and
      reproduction of individual daphnids. In general, there is reasonable agreement
      between model predictions and observations, but some adjustments to the model may
      be necessary.

PMID- 2226244
TI  - Influence of inorganic lead on the biochemical blood composition of the eel,
      Anguilla anguilla L.
AB  - Yellow eels (Anguilla anguilla L.) with an average weight of 50 g were caught in
      September in the Aveiro Lagoon on the Portuguese West Coast and kept in aerated
      aquaria for 1 week before the experiment started. The eels were exposed to an
      inorganic lead concentration of 300 micrograms Pb/liter for 30 days. Differential
      white blood cell count showed an increase in the number of lymphocytes in exposed
      fish. Blood hemoglobin and number of red blood cells per cubic millimeter showed
      no differences between the control and the exposed fish. Biochemical analyses of
      blood composition, such as plasma glucose, total plasma protein, total plasma
      cholesterol, and sodium and potassium plasma, showed no differences between
      treated and control animals. Plasma lactate levels increased in treated animals
      compared with those in controls.

PMID- 2226245
TI  - Retention of cadmium in cadmium-naive normal and iron-deficient rats as well as
      in cadmium-induced iron-deficient animals.
AB  - The retention of cadmium was investigated in cadmium-naive normal and iron
      deficient rats in comparison to rats with cadmium-induced iron deficiency. Rats
      subchronically (4 weeks) exposed to dietary cadmium (28, 56, 112 ppm Cd and 28
      ppm Fe) received a radioactively labeled dose of 2 mumol Cd/kg body wt; acutely
      (no cadmium exposure with diet) treated rats received doses between 1 and 8 mumol
      Cd/kg body wt. Two animals of each group received iron (1 mumol/kg as 59FeSO4 in
      order to monitor iron absorption in parallel. After a period of 4 weeks of
      feeding a cadmium-fortified diet, the test dose was administered and after a 2
      weeks period 109Cd and of 59Fe retention was determined. The results showed in
      part an unexpected pattern of cadmium retention: subchronic feeding of cadmium
      induced iron deficiency. This implies an immediate interaction between the two
      metals with regard to intestinal transfer of iron. The retention of iron was
      increased in the Cd-induced anemia to the same extent as that in iron deficiency
      induced by iron restriction. Cadmium retention in iron deficiency induced by iron
      withdrawal also showed a marked increase, which implies that iron deficiency
      stimulates the intestinal transfer system for both metals in a similar way.
      Contrary to this effect, the cadmium retention in cadmium-induced iron deficiency
      was reduced to about 30% of control values. A self-induced aggravation of the
      body cadmium burden, as a consequence of the iron deficiency which is known to
      result from subchronic exposure to feeding of dietary cadmium, was thus excluded.

PMID- 2226246
TI  - Incorporation of a subacute test with zebra fish into a hierarchical system for
      evaluating the effect of toxicants in the aquatic environment.
AB  - Single-species laboratory tests were used to assess the acute toxicity of
      halogenated phenolic compounds. No single test system was most sensitive to all
      of the compounds examined, substantial variations in the sensitivity of the
      various organisms were noted, and there was no correlation between the toxicities
      assayed with different test systems. The zebra fish (Brachydanio rerio)
      embryo/larvae system was used to examine subacute effects using two of the
      compounds, and a protocol was developed with 6 weeks preexposure to the toxicant.
      Preexposure decreased the lowest observable effect concentration by a factor of
      about 4, and the effect was completely reversible during a 6-week postexposure
      period in the absence of the toxicant. An enclosed system for carrying out the
      zebra fish embryo/larvae test was developed and evaluated with three neutral
      volatile compounds: the median survival time and the frequency of occurrence of
      deformation were examined as end points. The effect of pH on toxicity was
      evaluated in buffered media for four of the test systems: toxicity increased
      markedly at the lower pH values, and it could be shown that the ionized forms of
      the phenols were not the only contributors to toxicity. It is proposed that the
      zebra fish system incorporating preexposure could be incorporated into a
      hierarchical system using a range of organisms for assessing acute toxicity in
      single species under laboratory conditions and multicomponent systems simulating
      natural ecosystems.

PMID- 2226247
TI  - Evaluation of the isobologram method for the assessment of mixtures of chemicals.
      Combination effect studies with pesticides in algal biotests.
AB  - The aim of this paper is an evaluation of isobolograms, a method proposed for the
      assessment of combined effects of chemicals. In order to examine potentials and
      shortcomings of this approach for ecotoxicological purposes, algal biotests with
      selected pesticidal compounds were performed. Additivity, as defined by the
      model, is demonstrated for the combination of atrazine and metribuzin for
      different combination ratios, response levels, and parameters. Subadditivity is
      shown for amitrole and glufosinate-ammonium. The results and inherent biometrical
      features are discussed in terms of criteria considered suitable for comparative
      evaluation of biometrical models for the assessment of mixtures of chemicals.

PMID- 2226248
TI  - [Biosocial orientation of education and health in society].

PMID- 2226249
TI  - [Local health systems and the medical job market: results of a study on
      preferences as to geographic location].

PMID- 2226250
TI  - [The process of work and permanent education of health personnel: reorientation
      and trends in Latin America].

PMID- 2226251
TI  - [Variables related to the academic success of the medical students at the
      Universidad Autonoma de Nuevo Leon, Mexico].

PMID- 2226252
TI  - [Changes in the epidermal growth factor receptors in the liver cells of rats in N
      nitrosodiethylamine-induced hepatic carcinogenesis].
AB  - A sharp decrease in the number of epidermal growth factor receptors (EGF-R) in
      the rat liver plasma membranes had been found at different stages of
      diethylnitrosamine-induced carcinogenesis. The complete loss of high-affinity
      binding sites for EGF did not prevent EGF-dependent autophosphorylation of EGF-R.
      Hepatocytes from the rat liver tumors in the primary culture had two classes of
      EGF-R: high and low affinity ones, though their number had been twice less than
      in the normal hepatocytes. The dynamics of internalization and down-regulation of
      EGF-R was very similar in the primary culture of transformed and normal
      hepatocytes. It testifies that there are some factors of microenvironment in the
      liver during carcinogenesis which cause the loss of EGF-R (down-regulation) and a
      decrease of their affinity (activation of protein kinase C). A possible autocrine
      or paracrine nature of these factors is discussed.

PMID- 2226253
TI  - [The modifying effect of ortho-cresol on benzo(a)pyrene-induced carcinogenesis in
      mice].
AB  - A modifying influence of ortho-cresol (o-cresol) on the carcinogenic effect of
      benzo(a)pyrene (B(a)P) in their combined peroral administration to CC57Br mice
      has been revealed. During the simultaneous administration of the o-cresol (1 mg)
      and B(a)P (1 mg) the rate of tumours, their multiplicity index, the degree of
      malignancy increased and the latent period shortened. In case of o-cresol
      administration before or after B(a)P (in the same doses) the decrease of
      carcinogenic effect has been revealed. In case of simultaneous administration of
      10 mg of the o-cresol and 5 mg of the B(a)P the tumor incidence did not change in
      comparison with the animals of the control group which received only B(a)P. But
      their progression was hampered which was confirmed by a decrease of the
      malignancy rate, frequent occurrence and prolongation of the period of the
      malignization beginning.

PMID- 2226255
TI  - [The rate of macrophage inclusion in the elimination of tumor cells when
      administered to syngeneic animals].
AB  - A degree of destruction of tumour cells after their inoculation to a syngenic
      recipient correlates positively with sensitivity to the lytic effect of
      macrophages. A clear-cut participation of macrophages in elimination of tumours
      cells can be detected 8 h after their inoculation.

PMID- 2226254
TI  - [The role of nitrites in carcinogenesis].
AB  - Data from literature as well as the results of the author's investigations on the
      genotoxic and carcinogenic effects of sodium nitrite (SN) are presented.
      Carcinogenicity of SN detected in animal experiments proved to be connected with
      the formation of nitroso compounds from endogenous nitrosable precursors. Sodium
      nitrite possessed the transforming and promoting effects in the cell cultures as
      well as the mutagenic effects in the bacterial systems where predominant effect
      of SN as compared with N-nitrosodimethylamine (NDMA) was registered. The
      prolonged pretreatment with SN amplified the liver DNA damage in rats in case of
      NDMA endogenous synthesis.

PMID- 2226256
TI  - [The effect of biocarbazine on the indices of humoral and cellular immunity in
      mice].
AB  - Biocarbazin (5-3,3-dimethyl-1-triazeno)-imidazole-4-carboxamide) when
      administered in different doses and schedules depressed the primary immune
      response of mice to erythrocytes (SE). A dose-dependent effect on the
      immunosuppression degree is revealed. Both the inductive and productive stages of
      antibody formation are sensitive to the immunosuppressive action of the agent.
      Under certain conditions biocarbazin induced a sharp suppression of humoral
      immune response. At the same time, it enhanced significantly the delayed-type
      hypersensitivity (DTH) response to SE.

PMID- 2226257
TI  - [The expression of an antigen interacting with monoclonal antibody IB4 on the
      surface membranes of normal human leukocytes and in lymphoproliferative
      diseases].
AB  - Monoclonal antibody (MAb) 1B4 of IgG3 isotype reacting with 55 +/- 10% peripheral
      blood lymphocytes was obtained. MAb 1B4 is bound with 100% of B and NK cells and
      50-70% of T cells in blood. The most part of CD8+ cells (60-100%) and
      approximately 50% of CD4+ cells belong to 1B4+ population. T-ALL cells do not
      express 1B4 antigen. Analysis of reactivity of MAb 1B4 with transformed malignant
      cells has shown that 1B4 antigen appeared in the process of differentiation of B
      lymphocytes at the state of pre-B cells and disappeared with activation of B
      lymphocytes and transition to plasma cells.

PMID- 2226259
TI  - [The effect of the bone marrow fibroblasts from patients with malignant diseases
      of the blood system on the colony-forming capacity of granulomonocytic precursor
      cells].
AB  - The inhibiting activity of bone marrow fibroblasts and their ability to sustain
      survival of granulocytic cell precursors have been studied in patients with
      chronic myelocytic leukemia, chronic lymphoproliferative disorders, acute
      leukemia, myelodysplastic syndrome. Fibroblast conditioned medium inhibits
      proliferation of granulomonocytic precursors stimulated by leucocyte feeder layer
      or leucocyte conditioned medium. The effect depends both on the presence of
      monocytes and the specificity of the disease. The inhibitory effect is related
      with long-ranged factors. Bone marrow fibroblasts are able to sustain survival of
      hemopoietic precursors via humoral and cell-cell mechanisms. The regulatory role
      of bone marrow fibroblasts in hemopoietic disorders is discussed.

PMID- 2226258
TI  - [Lymphocyte proliferation and differentiation in chronic lympholeukemia].
AB  - Proliferative activity and differentiation levels of lymphocytes of lymph nodes
      and peripheral blood of practically healthy people and patients with chronic
      lymphocytic leukemia have been studied using the present physicochemical methods
      (autoradiography with labelled DNA and RNA precursors, microspectrocytometry, NMR
      spectroscopy, kinetic formaldehyde method, etc.). The following points have been
      stated: stage character of changes in normal and leukemic cells, differences in
      synthesis of nucleic acids in different periods of the cell cycle in norm and
      under chronic lymphocytic leukemia, proliferation peculiarities of lymphocytes in
      lymph nodes and in blood, presence of DNA defects in the process development,
      changes in lipids of lymphocytes and blood plasma at early stages of the disease
      and in the process of its development.

PMID- 2226260
TI  - [Tumor-induced immunosuppression in breast cancer patients].
AB  - A comparative study of immunological reactivity of healthy volunteers and cancer
      patients with different stages of the disease was carried out. The study of 8
      types of suppressor cells, chemoreceptor sensitivity and blast transformation of
      lymphocytes, natural killer cells, the level of immunoglobulins, regulatory
      subpopulation of lymphocytes, etc., has revealed several alterations in
      regulatory and effector links of immunity in the patients with late stages of the
      disease. The detailed immunological monitoring in the course of varying schemes
      of treatment is emphasized.

PMID- 2226261
TI  - [The induction of tolerance in mice for a human melanoma graft].
AB  - Mouse skin allografts and intramuscular BRO human melanoma xenografts were
      successfully established in phenotypically normal mice after inducing
      immunological tolerance in the recipients. Tolerance was achieved by inoculating
      allogenic embryonic liver cells after the whole-body irradiation. No
      immunological rejection was evident in BRO xenografts for 34 days after
      transplantation. During this period the BRO cells invaded neighboring tissues and
      formed distant micrometastases in the lungs.

PMID- 2226262
TI  - [The hormonal sensitivity of a transplantable adenocarcinoma of the large
      intestine].
AB  - It was found that repeated transplantation of ACATOL strain cells resulted in a
      loss of their sensitivity to growth-stimulating effect of pentagastrin. The
      effect of gastrin receptor antagonist proglumide, on ACATOL cells growth was
      inconstant. ACATOL tumor was sensitive to VIP and glucagon in vitro (as shown by
      adenylate cyclase activity assay), that makes the model promising for selecting
      potent hormone drugs against colorectal cancer.

PMID- 2226264
TI  - [The characteristics of the incorporation of the 14C-glucose label into the total
      lipids of the organs and tissues of Wistar rats with Guerin's carcinoma under
      differing nutritional conditions].
AB  - Peculiarities of 14C-glucose label incorporation into total lipids (TL) of
      organs, tissues, blood serum and tumors in rats with the Guerin carcinoma under
      different nutrition conditions have been studied. It is determined that after
      recycling 14C-glucose is used in TL synthesis of organs, tissues, tumor which may
      be again involved in the process of metabolism, that evidences for the function
      of the synthesis mechanism and mobilization of TL. With an increase of tumor mass
      the specific activity of label in TL of organs and tissues decreases. In contrast
      to organs and tissues, the tumor involves 14C-glucose into synthesis of own TL
      independent of nutrition conditions, their level does not decrease in starvation.

PMID- 2226263
TI  - [The proliferative kinetics and acid-soluble proteins of the nuclear chromatin in
      tumor cells with a modified polyamine level].
AB  - The inhibition of polyamine synthesis by DFMO (2.7 x 10(-3) M) resulted in a
      decrease of proliferation rate of L and OH-1 cells. The patterns of acid-soluble
      nuclear proteins were studied by the SDS electrophoresis. The content of protein
      fraction with molecular weight 25 kD was shown to correlate with the rate of
      proliferation of cell cultures.

PMID- 2226265
TI  - [The mutagenicity of animal carcinogenic agents of natural origin].
AB  - The current data from literature on the mutagenicity of carcinogens of natural
      origin are reviewed. A high correlation between carcinogenicity and mutagenicity
      of this group of agents is established.

PMID- 2226266
TI  - [Dextran-ferrite distribution in the body of animals in a nonuniform permanent
      magnetic field].
AB  - Dextran-ferrite (DF) was injected via the femoral artery to the dogs and followed
      by local magnetization (induction 0.3 T, grade 0.024 T/cm). It has been shown
      that the local retention of the iron in some tissues of the leg was 3-5 times as
      high as the control. The magnetization did not increase the local retention of
      the iron after intravenous injection of DF to mice and rabbits.

PMID- 2226267
TI  - [A chronobiological analysis of the lymphocyte dehydrogenase activity in the
      peripheral blood of rats with Walker 256 carcinosarcoma].
AB  - In a series of experiments the alpha-glycerophosphate dehydrogenase and succinate
      dehydrogenase (SDH) activities were daily determined simultaneously by the
      cytochemical method in peripheral blood lymphocytes of normal rats and those with
      the Walker carcinosarcoma. Using an original algorithm a hierarchy of biorhythms
      was singled out by a computer according to individual changes in the
      dehydrogenase activity for each rat. The mean level of succinate dehydrogenase
      activity was higher than that of alpha-glycerophosphate dehydrogenase. A set of
      discovered biorhythms and their representation were identical in the both
      enzymes. The tumor transplantation caused changes in the phase coordination of
      investigated dehydrogenases in all rhythms and promoted an increase of the
      succinate dehydrogenase amplitude as compared with the alpha-glycerophosphate
      dehydrogenase amplitude in certain rhythms. It is concluded that
      biorhythmological parameters of these enzymes may be used for characterization of
      the tumor-bearing host.

PMID- 2226268
TI  - [The enhancement under the action of a limited diet of the antimetastatic effect
      due to macrophage activation in mice with Lewis carcinoma].
AB  - An antimetastatic effect associated with macrophage activation by liposome
      encapsulated glucosaminylmuramyldipeptide was found to enhance in malnourished
      mice with the Lewis lung carcinoma. These changes were not matched by further
      increase in the functional activity of macrophages. It has been suggested that
      enhancement of the antimetastatic effect in malnourished animals is due to the
      inhibition of neovascularization necessary for the beginning of metastatic
      exponential growth. The induction of neovascularization may be caused by the
      tumor necrosis factor, main product of activated macrophages.

PMID- 2226269
TI  - Post-contraction variations in motor pool excitability.
AB  - Previous evidence has shown a marked increase in motoneuronal excitability during
      muscle contraction and decreased post-contraction excitability. This post
      contraction inhibition has been shown to persist up to 800 msec following the end
      of contraction (Gottlieb and Agarwal, 1973) and apparently continues with gradual
      recovery up to one minute (Enoka, Hutton and Eldred, 1980). These effects have
      been attributed in part to influences of muscle receptors on the homonymous motor
      pool. The purpose of the present study was to observe the time course of short
      term post-contraction effects, following a maximum isometric contraction, on
      excitability of the homonymous motoneuronal pool as measured by the Hoffmann
      reflex. Each of five subjects lay supine on a table with shoulder blocks to
      prevent movement during resisted plantar flexion. The subject's preferred foot
      was placed in a stirrup attached to a force gauge which measured tension.
      Recording electrodes were applied over the soleus muscle, and M- and H-responses
      were evoked by percutaneous electrical stimulation of the tibial nerve at the
      popliteal fossa. The stimulus strength was set to elicit a control H-reflex at
      rest of half the magnitude of the maximum H-reflex value. For each trial the
      subject performed a 6 s maximum contraction of the triceps surae muscle group,
      beginning on one visual signal and ending on a second visual signal. The H-reflex
      was elicited at semi-random intervals prior to and after the visual signal to
      relax. Increased H-reflex excitability was observed during muscle contraction
      followed by a marked decrease in evoked amplitudes with gradual recovery
      following the end of contraction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226270
TI  - Electrophysiologic signs of sensory fiber lesion in spinal amyotrophies and the
      role of physiologic variations of sensory finger innervation pattern.
AB  - In 33 patients, 30 to 64 years old, with spinal amyotrophy and brachial paresis,
      the sensory symptoms and electrophysiologic signs were analyzed. The paresthesias
      were felt most often in the ulnar nerve innervation region. The motor conduction
      velocities, terminal latency quotient, sensory conduction on direct nerve
      stimulation were within the limits of normal in both median and ulnar nerve. On
      percutaneous stimulation normal values were obtained for median nerve, and
      significantly slower for ulnar nerve innervation region. In four cases no nerve
      potential was obtained over the ulnar nerve with stimulation of the fifth finger.
      The nerve potential over the ulnar nerve was elicited mostly by stimulation of
      median nerve innervated fingers. Congenital variations of sensory innervation
      pattern were considered, which may increase the liability to destruction.

PMID- 2226271
TI  - Radiation-induced brachial plexopathy: clinical and electromyographical (EMG)
      considerations in 13 cases.
AB  - The purpose of this study was to determine the clinical and electromyographical
      characteristics of the initial picture, and the subsequent course of the
      radiation-induced brachial plexopathy. The AA. studied 13 females affected by
      infiltrating carcinoma of the breast, who underwent a radical mastectomy with
      removal of the axillary cavity, followed by radiotherapy (total dose was 50 Gy
      per cycle). The symptom-free interval between the end of radiotherapy and the
      appearance of symptoms varied considerably (from one month to 15 years). The
      initial clinical picture presented pain (5 cases), paresthesia (6 cases) and
      motor deficit (8 cases). EMG examination showed a pluriradicular denervation in
      10 cases (with a very frequent damage of the lower roots of the plexus) and a
      monoradicular denervation in 3 cases. In 6 cases it was possible to carry out a
      follow-up with repeated tests for 3-17 years after radiotherapy. The role of the
      EMG in the diagnosis and prognosis of this plexopathy is then discussed.

PMID- 2226272
TI  - Surface EMG and motor unit activity of partially denervated human muscle during
      fatiguing submaximal isometric contraction.
AB  - The extent to which the normal fatigue compensatory mechanisms are disturbed in
      partially denervated muscles was investigated in human patients. Surface EMG, as
      well as motor unit electrical and mechanical activity, were analyzed from the
      partially denervated first interosseous muscle, during fatiguing isometric
      submaximal contraction. The EMG power and frequency changes which reveal the
      local fatigue process of healthy muscle have not been systematically found. Motor
      unit firing rate changes were rather normal and twitch contraction time did not
      increase during the fatiguing exercise. Differences between normal and partially
      denervated muscles could be explain by the occurrence of a central fatigue
      process more or less important in neurogenic lesions.

PMID- 2226273
TI  - Aging and quantitative sensory thresholds.
AB  - Cutaneous thresholds for vibration and thermal sensitivity were quantitated at
      the index finger and great toe in 54 subjects without obvious neurological
      disease. Twelve patients over sixty years of age also consented to standard nerve
      conduction studies which proved normal. Vibration thresholds progressively
      increased with age to a significant degree at the finger (p less than 0.05), and
      especially at the toe (p less than 0.001). Thermal sensitivity thresholds showed
      no significant relationship with age. These findings confirm the clinical notion
      that vibration discrimination decreases with normal aging, especially in the
      toes.

PMID- 2226274
TI  - Forearm median nerve conduction velocity in carpal tunnel syndrome.
AB  - Reduced velocity of median nerve conduction in the forearm of patients with
      carpal tunnel syndrome (CTS) has been attributed to an artifact of the
      electrodiagnostic method rather than pathophysiologic changes in the forearm
      segment. Standard nerve conduction velocity (NCV) tests measure the forearm
      segment in combination with the distal latency and this may not represent an
      accurate assessment of conduction in the proximal portion of the nerve. A new
      technique of direct evaluation of the forearm median nerve was developed by the
      stimulation and recording of the forearm nerve action potential (FNAP) proximal
      to the wrist. The FNAP measurement was compared to the usual NCV in persons with
      CTS and control subjects. Forearm median nerve conduction velocities in the CTS
      group were significantly slower (p less than 0.05) than normal subjects using
      both FNAP and standard NCV techniques. The finding of decreased conduction speeds
      by the direct measurement of the forearm segment confirms that the reduced speeds
      derived from NCV are valid and suggests that retrograde degeneration of the nerve
      axons may result from entrapment in the carpal tunnel.

PMID- 2226275
TI  - Transmission of acoustic or vibratory signals from a contracting muscle to
      relatively distant tissues.
AB  - In 20 normal subjects, acoustic or vibratory signals generated during sustained
      voluntary isometric contraction of the biceps brachii muscle were recorded
      directly over the muscle belly. The signals were also recorded simultaneously at
      a distance from the contracting biceps muscle over the posterior upper arm near
      the triceps muscle. Frequency amplitude spectra (FAS) of the recordings were
      determined. The amount of transmission of the most dominant vibratory signal from
      the biceps muscle to the posterior arm was estimated from the amplitude ratio of
      similar frequency peaks in the FAS obtained from recordings in these two separate
      regions. The mean amplitude ratio was 0.46. This finding suggests that when
      several groups of muscles are contracting simultaneously, there may be
      significant transmissions of acoustic signals from one muscle to the other. These
      transmissions could potentially interfere with the selective recording of sounds
      produced by a specific muscle.

PMID- 2226276
TI  - Refractory studies in early detection of carpal tunnel syndrome.
AB  - We studied refractory periods of the median sensory nerves in 10 patients with
      mild carpal tunnel syndrome (CTS), and compared them with the median sensory
      refractory studies on normal subjects. Our data showed that relative refractory
      period (RRP) studies are useful in diagnosing early CTS.

PMID- 2226277
TI  - Technical approaches to hemisphere-selective transcranial magnetic brain
      stimulation.
AB  - Clinical application of transcranial magnetic brain stimulation is mainly used to
      determine central motor conduction times. With the stimulation coil (Magstim 200,
      Novametrix) centered conventionally over the midline of the skull convexity and
      using high stimulus intensities, which are often required in pathological states,
      the motor cortices of both hemispheres are usually activated simultaneously.
      Under this condition it is not possible to determine from which hemisphere the
      descending excitatory volleys to a particular motoneurone pool originate and how
      the input to the lower motoneurons is organized (uni-/bilateral, ipsi
      /contralateral). This limitation can be overcome by two different techniques for
      selective stimulation of the motor cortex of one hemisphere without coactivation
      of the other even when using maximal stimulus intensities: 1. A large 12 cm
      (outer diameter) stimulation coil could be used for selective stimulation when a)
      the magnetic field radiated over the non-stimulated hemisphere is modified by
      using a prototype coil shield covering the half of the coil over the
      nonstimulated hemisphere in combination with b) placing the coil away from the
      midline towards the preferentially excited hemisphere. The coil shield consists
      of a sheet of a nickel iron alloy which alters the time course of the induced
      currents by reducing the initial rate of current intensity change (dI/dt). 2. The
      use of a smaller 6.5 cm (outer diameter) coil also provided a useful tool for
      selective stimulation of one hemisphere but was restricted to subjects with low
      excitation thresholds. In subjects with high excitation thresholds the described
      use of the large stimulation coil is advisable.

PMID- 2226278
TI  - Effect of corticosterone and dexamethasone on glucocorticoid receptor in
      lactating rat mammary gland.
AB  - The effects of either a single dose or long-term administration of corticosterone
      or dexamethasone 21-acetate (Dex Ac) on glucocorticoid receptor concentration in
      mammary gland cytosol of lactating adrenalectomized rats were investigated.
      Adrenalectomy on lactation day 7 failed to affect the glucocorticoid receptors
      significantly. Both the natural and synthetic steroid caused a rapid decrease of
      receptor binding in the cytosol but the time course of glucocorticoid receptor
      depletion was different. Complete depletion of cytosol receptor was observed
      after both a single s.c. Dex Ac dose (20 micrograms/100 g) and after long-term
      oral treatment (10 micrograms/ml saline as drinking solution for 6 days)
      immediately after the last steroid dose. In the first case the depletion was
      still observable at 24 h after the injection without any change in Kd. In
      contrast, prolonged administration of Dex Ac maintained the receptor binding low
      even for 48 h after steroid withdrawal and resulted in an increased Kd. Even
      after an additional day the binding did not exceed the level of 50% of controls.
      By that time, however, Kd has returned to normal values. On the other hand, a
      single dose of corticosterone (100 micrograms/100 g) as well as long-term
      corticosterone treatment (100 micrograms/ml saline as drinking solution for 6
      days) reduced the glucocorticoid receptor concentration only to 60% and 25%,
      respectively. Twenty four hours after the hormone administration the receptor
      binding returned to control level, no change in Kd being observed. It was
      concluded that Dex Ac, but not corticosterone, down-regulates the glucocorticoid
      receptors in mammary gland cytosol of lactating rats.

PMID- 2226279
TI  - Influence of melatonin on thyroid secretion in pinealectomized rats.
AB  - The influence of a single dose of melatonin administered to pinealectomized and
      sham operated rats at different times of day on serum T3, T4 concentrations was
      investigated. It was found that such melatonin influence depends upon a time of
      day. Both pinealectomy and exogenous melatonin did not influence the thyroid
      activity in the morning. The most remarkable pineal effect on the thyroid
      appeared during the night.

PMID- 2226280
TI  - Effect of pinealectomy on mitotic activity of adrenal cortex in rats subjected to
      unilateral adrenalectomy.
AB  - The effect of pinealectomy on the adrenal growth in unilaterally adrenalectomized
      rats was studied by evaluation of the mitotic activity of adrenocortical cells on
      the fifth and tenth day after operation. It was found that pinealectomy resulted
      in an about double increase of mitotic index on the 5th day after unilateral
      adrenalectomy, and on the 10th day the stimulatory effect of pinealectomy became
      less significant.

PMID- 2226281
TI  - Thyrotropin receptors, thyroid hormones and thyroglobulin in patients with
      Hashimoto's thyroiditis.
AB  - TSH receptors in plasma membranes of thyroid nodular and perinodular tissue and
      the concentration of thyroid hormones and thyroglobulin in serum were estimated
      in patients with Hashimoto's thyroiditis (HT) and in six persons with
      scintigraphically cold thyroid nodules (AFN). In perinodular tissue of HT
      patients specific binding of 125I-bTSH was found to be significantly decreased
      (1.50 +/- 0.13%; mean +/- S.E.) as compared with AFN patients (2.79 +/- 0.53%),
      whereas any significant difference in hormone binding to nodular tissues between
      both examined groups was not detected. Scatchard analysis of TSH binding revealed
      two kinds of binding sites for both thyroid tissues of all examined patients. The
      capacity of high affinity binding sites in both thyroid tissues of HT patients
      was found to be decreased (3.92 +/- 0.86 fmol/mg protein in nodular tissue and
      5.93 +/- 1.16 fmol/mg protein in perinodular tissue) in comparison with these
      tissues of AFN patients (18.80 +/- 18.36 and 32.24 +/- 33.38, respectively). Any
      differences in dissociation constant and capacity of low affinity binding sites
      between analysed groups were not observed. Serum TSH levels of HT patients were
      higher than these in AFN patients and were not significantly changed after
      surgical treatment. Any difference in triiodothyronine (T3) levels between
      analysed groups was not detected, while the concentration of thyroxine (T4) was
      lower in HT than in AFN and significantly decreased after the excision of thyroid
      gland. Thyroglobulin levels were significantly changed after surgical treatment
      in both analysed groups.

PMID- 2226282
TI  - Failure to demonstrate the effect of glucose on insulin removal by perfused rat
      liver.
AB  - The effect of glucose on insulin removal by perfused liver of fed and fasted rats
      has been studied. The perfusion medium contained glucose at a concentration of
      300 mg/dl or no glucose. It has been found that glucose has no effect on insulin
      removal in either group and that fasting had no effect on this process. It is
      concluded that blood glucose concentration does no influence insulin removal by
      the liver.

PMID- 2226283
TI  - Emergency aspects of alcoholism.

PMID- 2226284
TI  - Alcoholic ketoacidosis.
AB  - Alcoholic ketoacidosis is characterized by a metabolic acidosis with an elevated
      anion gap. It generally is seen in the chronic alcoholic patient who has recently
      gone on a "binge" that was terminated because of complaints such as nausea,
      vomiting or abdominal pain. Caloric intake is diminished. Treatment includes
      volume repletion and glucose administration. Morbidity and mortality usually
      result from intercurrent illness.

PMID- 2226285
TI  - Electrolyte abnormalities in the alcoholic patient.
AB  - The acute effect of ethyl alcohol ingestion is to induce diuresis with excretion
      of free water and preservation of electrolytes. This occurs as the blood alcohol
      concentration is increasing and is due to the suppression by alcohol of the
      endogenous release of ADH. During a steady blood alcohol concentration, alcohol
      acts as an antidiuretic, causing retention of water and electrolytes. While at
      steady state, additional doses of alcohol will produce progressively smaller and
      eventually absent diuretic responses. The chronic effect of alcohol is to promote
      isosmotic retention of water and electrolytes due to increased ADH levels. Excess
      water and electrolytes are acutely excreted in response to additional alcohol
      ingestion. With the cessation of alcohol intake, this excess will be excreted
      over several days. Routine parenteral fluid administration to chronic and
      withdrawing alcoholics should be avoided. The role of potassium and magnesium in
      the genesis of specific manifestations of the alcohol withdrawal syndrome is not
      clear. Alcoholic patients may have electrolyte abnormalities due to alcohol
      induced diseases, poor nutrition, or vomiting and diarrhea. Each case must be
      individually evaluated.

PMID- 2226286
TI  - Cardiac disease in the alcoholic patient.
AB  - Ethanol in acute low doses is believed to be relatively nontoxic to the normal
      myocardium, despite data indicating low-level contractility impairment. In
      patients with myocardial disease, or as the serum ethanol concentration is
      increased to high levels, angina, myocardial infarction, and arrhythmia may be
      potentiated. Chronic ethanol use, at moderate doses, may be protective against
      coronary artery disease, despite increased rates of hypertension. Alcohol
      consumption at high doses may result in dilated cardiomyopathy and a dismal
      prognosis. Alcohol abuse is associated with increased mortality.

PMID- 2226287
TI  - Infections in alcoholic patients.
AB  - Alcoholic patients have an increased susceptibility to certain bacterial
      infections. Among the more important of these infections are pneumonia,
      tuberculosis, spontaneous peritonitis, and bacteremia. This susceptibility is
      caused by alteration of immune function and mechanical defenses and are the
      sequel of chronic alcoholism, most notably cirrhosis. In many infections,
      morbidity is increased in alcoholics, with the course of the illness being more
      severe and complications more frequent. Assessment of the alcoholic patient with
      suspected infection should, therefore, be thorough and treatment prompt.

PMID- 2226288
TI  - Alcohol withdrawal syndromes.
AB  - Current studies have begun to elucidate the pathophysiology of alcoholism and its
      withdrawal syndrome. Newer benzodiazepines, beta-blockers, alpha-agonists,
      butyrophenones and calcium channel blocking agents, alone and in combination,
      have been studied recently in alcohol withdrawal. This article discusses
      evaluation and therapy for delirium tremens, major alcohol withdrawal, mild
      alcohol withdrawal, adjunct therapy, and admission criteria.

PMID- 2226289
TI  - Seizures in the alcoholic patient.
AB  - The First International Symposium on Alcohol and Seizures (September 1988,
      Washington, DC) convened experts from North America and Europe to discuss the
      basic and clinical research findings in this field. Most of the observations
      communicated at this symposium are included in this article. Emergency physicians
      are familiar with the alcoholic patient who presents during or after a
      seizure(s). This familiarity must not obscure the fact that a significant
      minority of these patients will have an underlying process that can cause
      morbidity or mortality if the unsuspecting physician does not have an organized
      and methodic approach to the evaluation and management of the seizing alcoholic
      patient. Status epilepticus should be evaluated and treated in a similar fashion,
      whether or not the patient is an alcoholic. Otherwise, almost without exception,
      there are nuances and controversies with respect to the evaluation and management
      of the alcoholic patient with a seizure(s), from the indications for CT scan, to
      the proper role of sedatives and anticonvulsants, and the need for admission. The
      emergency physician must remain a patient advocate. The great majority of
      alcoholic patients with seizures who require admission can be treated
      satisfactorily at the hospital of presentation.

PMID- 2226290
TI  - Neurologic complications of alcoholism.
AB  - Neurologic and myopathic complications of alcoholism are multiple and diverse,
      affecting both the central and peripheral nervous systems. In the ED, initial
      concern is for diagnosing readily reversible causes and ruling out possible life-
      or limb-threatening etiologies. A rapid assessment of the ABCs, a fingerstick
      blood glucose determination, and, in cases of AMS, the administration of
      intravenous naloxone is indicated. In almost every instance of a potential
      neurologic complication, intravenous thiamine replacement is indicated initially,
      along with the parenteral administration of folic acid and the other B vitamins,
      including nicotinic acid and pyridoxine. Metabolic screening with electrolytes,
      glucose, blood urea nitrogen, creatinine, calcium, magnesium, liver enzymes (AST,
      alkaline phosphatase), bilirubin, arterial blood gases with carboxyhemoglobin
      determination, and a complete blood count are often warranted. Special tests such
      as CT scan, CK, ammonia, or toxicologic screens are indicated in specific
      instances. In terms of physical examination, attention to the presence of focal
      neurologic findings is paramount because of the possibility of a subdural or
      epidural hematoma. It is important not to miss meningitis and a low threshold for
      treatment or lumbar puncture should be maintained. Specialized consultation and
      referral are needed only after stabilization and appropriate tests are performed.
      If an organized approach to the evaluation of an alcoholic with neurologic
      symptoms is undertaken, occult disease will not be missed and outcomes will be
      improved.

PMID- 2226291
TI  - Alcohol and gastrointestinal bleeding.
AB  - Ethanol has experimentally been shown to be "ulcerogenic," independent of gastric
      intraluminal pH. Ethanol remains ulcerogenic despite antisecretory doses of H2
      receptor antagonists. Low-dose alcohol stimulates acid secretion in man, an
      effect possibly mediated by histamine or gastrin. High-dose alcohol reduces
      intraluminal acid by damaging mucosa, thereby enhancing back diffusion of
      hydrogen ion, and also by direct damage to oxyntic (parietal) cells. Ethanol is
      capable of increasing gastric mucosal permeability as evidenced by the increase
      in back diffusion (increases intraluminal pH) and by the characteristic fall in
      transmucosal potential difference which reflects surface cell layer exfoliation.
      This exfoliation may offer an explanation for the potentiating effect of alcohol
      on gastric mucosal injury when it is ingested simultaneously with other gastric
      irritants. Ethanol of greater than 20% concentration can rapidly destroy the
      gastric mucus-bicarbonate layer, which may be a defense layer for both the
      inhibition of back diffusion and bicarbonate neutralization of existing acid.
      Ethanol depletes sulfhydryl compounds in gastric mucosa. These sulfhydryls may be
      necessary for stabilization of cell membranes as well as for binding free
      radicals. Ethanol is damaging to the mucosal microcirculation. The rapidity of
      ethanol-induced damage makes it unlikely that the process is purely ischemic. The
      cytoprotective phenomenon, as this brief literature review suggests, is a
      multifactorial, dynamic process. The complex interplay of mucosal defense
      factors, endogenous and exogenous stimuli, induction of humoral responses, and
      ultimately the success or failure of cellular repair, is unlikely to be solely
      mediated by endogenous prostaglandins. Although prostaglandins are unquestionably
      significant to cytoprotection, the supporting and, perhaps, major roles of
      leukotrienes, sulfhydryls, histamines, and like substances cannot be ignored.
      Several innovative therapeutic agents directly derived from these research
      efforts have already entered the clinician's formulary. The significance of the
      concept of cytoprotection is only now being realized in clinical applications.
      Alcoholic hemorrhagic gastritis, although a significant clinical entity, remains
      a rather elusive diagnosis for the emergency physician. As a diagnosis of
      suspicion, therapeutic trials of antacids, sucralfate, or perhaps synthetic
      prostaglandin analogues are acceptable, pending endoscopic verification or short
      term resolution of symptoms. All patients presenting with true hemorrhage or with
      persistent symptoms should undergo gastroenterologic referral and endoscopic
      evaluation. The Mallory-Weiss syndrome has long been associated with acute and
      chronic alcohol abuse.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2226292
TI  - Pancreatitis.
AB  - Pancreatitis is a common but rather poorly understood entity most often
      associated with alcohol abuse or biliary tract disease. Despite the availability
      of a variety of diagnostic tests and imaging techniques, the diagnosis of
      pancreatitis continues to be primarily a clinical one. Of major concern to the
      emergency physician is distinguishing pancreatitis from other, potentially
      lethal, causes of abdominal pain, and identifying those patients with severe
      pancreatitis who are at risk for a complicated course secondary to the remote
      systemic effects of the disease.

PMID- 2226293
TI  - Alcoholic liver disease.
AB  - Alcoholic liver disease presents a wide spectrum of clinical manifestations
      ranging from mild asymptomatic fatty liver to alcoholic hepatitis and severe life
      threatening liver failure with ascites, hemorrhaging esophageal varices, and
      encephalopathy. Although still poorly understood, the mechanism of this injury is
      probably the result of numerous direct toxic and metabolic effects of alcohol on
      the hepatocyte. Therapy consists primarily of abstinence and supportive care.
      However, several newer treatments are actively being studied. These include
      prednisolone, anabolic steroids, glucagon and insulin, propylthiouracil, and
      cyanidanol. Colchicine is promising as an agent to inhibit fibrosis.
      Complications of cirrhosis, including ascites and variceal hemorrhage, are the
      result of end stage disease. A return to old techniques of ascitic fluid
      management suggests that therapeutic large-volume paracentesis with albumin
      infusion is a safe and effective form of therapy. Variceal hemorrhage is best
      treated with sclerotherapy, vasoconstrictors, and balloon tamponade. Little has
      been done to alter the ultimately dismal prognosis and long-term survival of
      alcoholic liver disease.

PMID- 2226294
TI  - Alcoholism and society.
AB  - The problems of alcohol abuse are rampant in society and permeate the Emergency
      Department experience. The cost to society as measured by social, medical,
      occupational, and legal effects is exceedingly high and probably underestimated.
      Emergency physicians have the opportunity to intervene in this vicious cycle and
      must learn their role in the process.

PMID- 2226295
TI  - The other alcohols. Methanol, ethylene glycol, and isopropanol.
AB  - The alcoholic patient, in an attempt to maintain an altered mental status, may
      ingest ethanol substitutes containing methanol, ethylene glycol, or isopropanol.
      The subsequent clinical presentation in the Emergency Department is highly
      variable and depends on the ethanol substitute ingested, the time since
      ingestion, and concomitant ethanol abuse. This article describes the clinical
      features of intoxication by the ethanol substitutes. Early diagnosis and
      therapeutic intervention may prevent irreversible sequelae. The rationale for
      treatment interventions is discussed.

PMID- 2226296
TI  - Alcohol and trauma.
AB  - Countermeasures to alcohol-related trauma are essential. The public perception
      that there is low risk of detection and punishment for alcohol-precipitated
      violence is being addressed. Current legislation is aimed at decreasing the
      availability of alcohol (e.g., adjusting legal drinking age, decreasing the serum
      alcohol intoxication limit, restricting the sale of alcoholic beverages at public
      events), increasing detection (e.g., greater driver surveillance, increased
      number of dedicated personnel), strengthening legal penalties for alcohol-related
      offenses, and mandating rehabilitative therapy. Physicians can intervene in the
      alcohol-trauma cycle. Unfortunately, they are notably poor in detecting the
      patient with alcohol-related injury. Moreover, physicians infrequently refer
      these patients to facilities and personnel that are expert in alcohol
      detoxification and rehabilitation. Recidivism can be positively impacted by
      physicians who are sensitive to and versed in the medical and social patterns of
      alcohol abuse.

PMID- 2226297
TI  - RU486 and the early nineties.

PMID- 2226298
TI  - Sources of cholesterol for testosterone biosynthesis in murine Leydig cells.
AB  - The sources of cholesterol for testosterone production were investigated in
      freshly isolated murine Leydig cells. In vitro stimulation with human CG (hCG)
      (0.2 IU/ml) caused a 75-fold increase in testosterone production. Leydig cells
      contained approximately equal amounts of free and esterified cholesterol (7.8 vs.
      8.7 micrograms/mg protein). The total cholesterol content of cells stimulated for
      4 h with hCG was significantly decreased compared with unstimulated cells (8.4
      vs. 17.6 micrograms/mg protein); both free and esterified cholesterol decreased
      by about 50%. In unstimulated Leydig cells incubated with [14C]acetate for 12 h,
      the majority of incorporated [14C] was found in free and esterified cholesterol,
      whereas, in the hCG-stimulated cells, 80% of incorporated 14C was in
      testosterone. The activity of hydroxymethylglutaryl-coenzyme A (HMG-CoA)
      reductase after 4 h in hCG-stimulated cells was 20% higher than in unstimulated
      cells (115.5 vs. 84.4 pmol/mg protein.min). However, by 6 h, HMG-CoA reductase
      activity doubled in the hCG-stimulated compared with unstimulated cells. By 12 h,
      HMG-CoA reductase activity in hCG-stimulated cells was 4 times the preincubation
      level and 8 times the 12-h level in unstimulated cells. HMG-CoA reductase
      activity induced by hCG was blocked by aminoglutethimide, an inhibitor of the
      cholesterol side-chain cleavage enzyme. Lovastatin, a potent inhibitor of HMG-CoA
      reductase, had no effect on unstimulated or hCG-stimulated testosterone
      production during a 12-h incubation. Murine high density lipoproteins (mHDL)
      increased HMG-CoA reductase activity in both unstimulated (29%) and hCG
      stimulated (20%) cells. During a 6 h incubation, mHDL increased hCG-stimulated
      testosterone production by 20%, but had no effect on unstimulated testosterone
      production. These results suggest that murine Leydig cells store enough
      cholesterol and cholesteryl esters to support testosterone production for at
      least 12 h in vitro. Although mHDL does not have a major stimulatory effect on
      testosterone biosynthesis, it may be involved in the regulation of de novo
      cholesterol synthesis.

PMID- 2226299
TI  - Anionic complex-carbohydrate units of human thyroglobulin.
AB  - Human thyroglobulin (hTG) contains sulfate in chondroitin 6-sulfate chains and in
      complex carbohydrates. In this study the sulfate-containing complex carbohydrates
      were characterized by the number of sulfate and sialic acid residues that they
      contain. Samples of normal and nodular thyroid tissue were incubated for 16 h in
      [35S]sulfate-containing medium, and hTG was purified from the tissues and the
      media. Complex carbohydrates were enzymatically removed from hTG. Subsequent
      analysis on an HPLC anion exchange column at pH 2.2 separated the carbohydrate
      units according to their number of negative charges. Sulfate-containing peaks
      were monitored by radioactivity, and sialic acid-containing peaks were identified
      by their shift to lower charge after treatment with neuraminidase. Peaks
      corresponding to sialic acid-free carbohydrate units with one to four sulfates
      were identified. Also, carbohydrate units with two and three negative charges
      containing both sulfate and sialic acid were present. In the nodular tissue of
      one patient there were more sulfated units with higher charge, especially units
      containing sialic acid. In this patient the proportion of sulfated polyvalent
      units with sialic acid was 22.4% for normal and 64.6% for nodular tissue. No
      difference in the composition of the charged units between the tissues and their
      corresponding media was seen, making it unlikely that the sulfate-containing
      carbohydrates play a role in hTG release. It is concluded that hTG contains
      complex carbohydrate units with up to four sulfate groups and units with both
      sulfate and sialic acid. In some patients, the sulfate-containing anionic
      carbohydrate units of hTG from normal and nodular thyroid tissue are different.

PMID- 2226300
TI  - Insulin-like growth factor II is a potent inhibitor of the aromatase activity of
      human placental cytotrophoblasts.
AB  - The placenta is the primary source of estrogens and progesterone during
      pregnancy. Because pregnant diabetic women are reported to have lower serum
      estrogen and higher progesterone levels than nondiabetic pregnant women, and
      placental insulin-like growth factor II (IGF-II) production may be elevated
      during diabetic pregnancy, the role of IGF-II in the regulation of human
      cytotrophoblastic aromatase, 3 beta-hydroxysteroid dehydrogenase (3 beta HSD),
      and P450 cholesterol side-chain cleavage (P450scc) enzyme activities was studied.
      Incubation of cytotrophoblasts with IGF-II for 24 h significantly diminished the
      ability of these cells to convert androstenedione to estrogens by 92.3 +/- 6.6
      (SE)%. IGF-II could suppress aromatase activity at a concentration as low as 2.0
      ng/ml. Preincubation of cells with either insulin, IGF-I, or a monoclonal anti
      IGF-I receptor antibody did not alter IGF-II's potent inhibitory effect.
      Treatment with mannose 6-phosphate alone also resulted in significant suppression
      of aromatase activity, and concurrent treatment with both mannose 6-phosphate and
      IGF-II resulted in greater inhibition than with either agent alone. These
      observations suggest that IGF-II suppresses aromatase activity by activation of
      its own specific receptor. In contrast, incubation of cytotrophoblasts with IGF
      II for 24 h significantly increased the 3 beta HSD activity (as determined by the
      conversion of pregnenolone to progesterone) and P450scc activity (as determined
      by the conversion of 25-hydroxycholesterol to progesterone) of these cells. IGF
      II's ability to stimulate these enzymatic processes was found to be comparable in
      magnitude to that of IGF-I. IGF-II-stimulated 3 beta HSD activity was completely
      inhibited by concurrent treatment with either actinomycin D or cycloheximide,
      suggesting that new mRNA and protein synthesis are required for IGF-II to exert
      its stimulatory effect. These studies indicate that IGF-II is a potent inhibitor
      of human cytotrophoblastic aromatase activity in vitro. In addition, IGF-II can
      stimulate cytotrophoblastic 3 beta HSD and P450scc activities. Since placental
      IGF-II production in pregnant diabetic women may be augmented, these observations
      may help explain the lower serum estrogen and higher progesterone levels
      associated with pregnancy in the diabetic patient.

PMID- 2226301
TI  - Suckling increases the proportions of mammotropes responsive to various prolactin
      releasing stimuli.
AB  - It is well established that the suckling stimulus sensitizes or primes the
      anterior pituitary to PRL-releasing stimuli. It is also recognized that PRL
      secreting cells from a given animal are not all alike but instead exhibit a
      considerable degree of functional heterogeneity. The goal of the present study
      was to determine whether the suckling-induced priming phenomenon is manifest at
      the cellular level by shifts in the relative abundance of various mammotrope
      subpopulations. This was accomplished by using reverse hemolytic plaque assays to
      evaluate the secretory characteristics of individual PRL secretors derived from
      lactating rats either before or after the transient application of a suckling
      stimulus. Groups of day 10 lactating rats separated from their litters for 4 h
      were either killed immediately or were reunited briefly (10 min) with their pups
      before death. Adenohypophyseal cells obtained after trypsin dispersion were then
      subjected to plaque assays for PRL. Mammotropes derived from suckled rats were,
      on average, considerably more responsive to the stimulatory actions of TRH and
      angiotensin II and less susceptible to inhibition by dopamine. Mammotropes from
      nonsuckled rats exhibited a bimodal frequency distribution in which plaques from
      the second mode were roughly 6-8 times larger (released considerably more PRL)
      than those from the first. Superimposition of suckling (or in vitro treatment
      with dopamine) caused the second mode to disappear. Suckling also enhanced
      greatly the fraction of PRL cells that shifted from the first to the second mode
      (i.e. released more hormone) after treatment with TRH or angiotensin II. Taken
      together, our results demonstrate that the suckling-induced sensitization of
      pituitary tissue to PRL-releasing stimuli is manifest at the cellular level as
      proportional shifts toward those cells most responsive to stimulatory
      secretagogues and away from those most susceptible to inhibition by dopamine.

PMID- 2226302
TI  - Arginine vasopressin and corticotropin releasing factor: binding to ovine
      anterior pituitary membranes.
AB  - In the sheep, in contrast to the rat, arginine vasopressin (AVP) is a more potent
      stimulus to ACTH secretion from the anterior pituitary (AP) than CRF. To further
      explore this difference, we have compared [3H]AVP and [125I]-[Nle21 Tyr32]ovine
      CRF binding in membranes prepared from rat and sheep AP. Between species, no
      difference in affinity of binding was found for either ligand. In contrast, the
      concentration of AVP receptors in sheep AP was twice that in rat, whereas that of
      CRF receptors was only one tenth. AVP receptor concentration in sheep AP was not
      altered by chronic (10 day) dexamethasone administration, but fell to 60% of
      control after chronic (60 day) hypothalamo-pituitary-disconnection. The increased
      level of AVP receptors and the much lower level of CRF receptors in sheep
      compared with rat may thus provide an explanation for our previous findings of
      increased sensitivity to AVP and a very poor response to CRF in stimulating ACTH
      release from the sheep AP. In addition the finding that AVP receptor numbers are
      reduced in the hypothalamo-pituitary-disconnected sheep suggests that
      hypothalamic factors may play a role in regulating AVP receptor concentration in
      the ovine AP gland.

PMID- 2226303
TI  - Monoclonal antibodies against luteinizing hormone receptor. Immunochemical
      characterization of the receptor.
AB  - Human CG (hCG)-receptor complexes were solubilized from porcine testicular
      membranes. They were chromatographed on an immunomatrix of Affi-Gel 10-D1E8 anti
      beta-hCG monoclonal antibody (this antibody has been shown not to interfere with
      hCG binding to receptor). Elution was performed at alkaline pH, a condition in
      which hCG-receptor complexes are relatively stable. Immunization of a mouse with
      these partially (approximately 15%) purified hormone-receptor complexes allowed
      the preparation of 20 different hybridomas, each secreting antireceptor
      antibodies. The latter were used for receptor characterization. Immunoblot of
      testicular membrane extracts or of purified receptor preparations showed the
      presence of a major band at approximately 85,000 mol wt and minor bands at
      approximately 68,000 mol wt and approximately 48-45,000 mol wt. The width of all
      these bands suggested some microheterogeneity possibly due to glycosylation. The
      same approximately 85,000 mol wt receptor was seen in ovarian membranes, but no
      detectable antigen was observed in liver, muscle, and kidney membranes. An
      immunoaffinity method (using antibody LHR 38) was devised to purify the receptor
      in a single step. This demonstrated that the purified receptor preparation did
      not contain any protein component other than those detected by immunoblot.
      Comparison of receptors purified by immunoaffinity chromatography using either
      antireceptor or antihormone monoclonal antibodies showed in both cases the
      presence of the 85,000 mol wt and 48-45,000 mol wt species, but the absence, in
      the latter case, of the 68,000 mol wt species. This suggests that the 68,000 mol
      wt receptor cannot bind hormone and does not form oligomers with other receptor
      species.

PMID- 2226304
TI  - Intercellular propagation of individually programmed growth bursts in FRTL-5
      cells. Implications for interpreting growth factor actions.
AB  - Five methods are commonly used to quantify FRTL-5 cells' and other thyrocytes'
      growth in vitro and the impact of growth inhibiting or stimulating maneuvers:
      Total cell count, mitotic index, DNA measurement, total [3H]thymidine
      incorporation, and the fraction of [3H]thymidine labeled cells. All of them
      assess cell growth as though all cells were homogeneous with an identical
      response to growth factors. We demonstrate here that this assumption is not
      valid. Rather, some intrinsically growth-prone cells appear to pass a growth
      signal to neighboring cells so that variably sized colonies of synchronized cells
      within each cluster growing from monodispersed cells are formed. This is true for
      FRTL-5 cells growing in vitro in monolayers and in three-dimensional, collagen
      embedded spheroids. The pattern is the same when cell suspensions or collagen
      embedded spheroids are implanted onto nude mice. Patches with alternating high
      and low growth become particularly prominent in the large tumor-like organoids
      grown from monodispersed cells in nude mice. The pattern much reminds of similar
      observations in growing intact thyroids. Since there is no significant
      correlation between the fraction of [3H]thymidine labeled cells and the size of
      two- or three-dimensional clusters in any experiment, growth of signal-spreading
      cells is assumed to occur in leaps and bounds. Growth velocity in each subclone
      of a cell population depends on the mean interval between bursts of replications
      and on the number of cells synchronized by cell-to-cell diffusion of the growth
      signal emanating from one dividing cell. Thus, growth-promoting and growth
      inhibiting factors may not only act on the mean interval between successive
      growth bursts, but they may also change cell-to-cell spreading of growth signals.

PMID- 2226305
TI  - Expression of the pregnancy-specific beta 1-glycoprotein gene in cultured human
      trophoblasts.
AB  - Human pregnancy-specific beta 1-glycoprotein (PS beta G), the major placental
      glycoprotein, shares strong sequence similarity with carcinoembryonic antigen and
      is a member of the immunoglobulin superfamily. To understand the role of PS beta
      G in placental ontogeny during pregnancy, we examined its synthesis and
      regulation in primary cultures of trophoblast cells. Freshly plated (12 h)
      cytotrophoblasts expressed little PS beta G transcripts; however, within 24 h of
      culture, PS beta G mRNAs became detectable. PS beta G synthesis and mRNA
      expression increased with time in culture, and maximal synthesis was achieved at
      4 days, indicating that primary trophoblasts continue differentiating in vitro.
      Molecular cloning revealed that PS beta G is an extremely polymorphic protein.
      Most PS beta G cDNAs identified to date, including the three cDNAs (PSG16, PSG93,
      and PSG95) isolated in this laboratory, share strong sequence similarity in the
      5' (designated PSG-5') and coding regions, but differ in sequences at the 3'
      region. The PSG-5', PSG93-specific, PSG16/PSG93-3', and PSG95-3' probes, which
      identify the majority of PS beta G mRNAs, hybridized with three mRNAs of 2.3,
      2.2, and 1.7 kilobases in primary trophoblasts and human term placental tissue.
      Ribonuclease protection analysis demonstrated that primary trophoblasts expressed
      most of the placental PS beta G transcripts. However, culturing in vitro altered
      PS beta G gene expression, and the level of PS beta G transcripts containing a
      PSG95-3' sequence was preferentially increased in primary trophoblasts. Moreover,
      primary trophoblasts synthesized a 64K PS beta G polypeptide in variable amounts
      and three PS beta Gs of 72K, 62K, and 54K in roughly equal amounts, whereas
      purified human term placental PS beta G consists of a major polypeptide of 72K
      and two minor ones of 64K and 54K. PS beta G gene expression in primary
      trophoblasts was slightly reduced by 8-bromo-cAMP, but was markedly inhibited by
      sodium butyrate.

PMID- 2226306
TI  - Changes in 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4 isomerase
      messenger ribonucleic acid, activity and protein levels during the estrous cycle
      in the bovine ovary.
AB  - A 1169 base pair fragment of bovine 3 beta-hydroxysteroid dehydrogenase/delta 5
      delta 4 isomerase (3 beta-HSD) cDNA was used to quantitate 3 beta-HSD messenger
      RNA (mRNA) levels in the bovine ovary during the estrous cycle. The content of 3
      beta-HSD protein was measured by immunoblot analysis using an antiserum developed
      in rabbits against human 3 beta-HSD, whereas 3 beta-HSD activity was measured
      using [3H]pregnenolone, [3H] dehydroepiandrosterone, and [3H]androst-5-ene-3
      beta,17 beta-diol as substrates. There was a parallel increase in 3 beta-HSD
      mRNA, protein content, and enzymatic activity levels from days 1-3 after estrus
      to maximal values at 50-100% above control on days 8-11 after estrus. Thereafter,
      all values decreased progressively until days 16-17 before a dramatic fall to 5%
      or less than maximal values on days 18-20 after estrus. Almost superimposable
      results of enzymatic activity were obtained with the three substrates, thus
      suggesting a unique 3 beta-HSD or parallel changes in the activity of multiple 3
      beta-HSDs. The above-described changes observed during the luteal phase are
      almost exclusively due to variations in corpora lutea. In fact, 3 beta-HSD
      activity in ovarian follicles was approximately 10,000 lower than that measured
      in corpora lutea. The close correlation observed over a wide range of 3 beta-HSD
      mRNA, protein content, and activity levels suggests that changes of ovarian 3
      beta-HSD activity are controlled at the level of 3 beta-HSD gene expression
      and/or 3 beta-HSD mRNA stability.

PMID- 2226307
TI  - Tissue distribution and molecular heterogeneity of human growth hormone-releasing
      factor in the transgenic mouse.
AB  - Transgenic mice expressing the human growth hormone-releasing factor (hGRF) gene
      linked to the metallothionein promoter exhibit high circulating levels of hGRF
      and GH and increased growth. We have described the distribution of GRF
      immunoreactivity (GRF-IR) in various tissues and characterized its molecular
      heterogeneity using gel filtration and high performance liquid chromatography
      (HPLC) and two separate RIAs that recognized mid-molecule and carboxyl-terminal
      epitopes of hGRF. The highest levels of GRF-IR were in the pituitary, followed by
      the pancreas. Intermediate levels were present in hypothalamus and liver, and
      lower levels in visceral organs, heart, and gonads. The pituitary and brain
      revealed evidence of the two mature hormone forms [hGRF(1-44)-NH2 and hGRF(1-40)
      OH and in addition a more hydrophobic form that is believed to represent the hGRF
      precursor (proGRF) on the basis of its estimated molecular size (approximately
      9,000) and selective recognition by the mid-molecule RIA. The profiles of GRF in
      pancreas and gut were similar except that only minimal amounts of hGRF(1-40)-OH
      were detected. In contrast, neither mature hormonal form was present in the liver
      and plasma contained primarily hGRF(3-44)-NH2, the major circulating metabolite
      of hGRF. The results provide evidence for variable processing of the hGRF
      precursor that is tissue specific and indicate that several extrahypothalamic
      tissues possess the necessary complement of enzymes to generate the mature
      hormonal forms.

PMID- 2226308
TI  - Inhibitory effects of a tumor-promoting phorbol ester on luteinizing hormone
      stimulated renin and prorenin production by cultured bovine theca cells.
AB  - In this report, we have described a serum free culture method for culturing
      bovine theca cells in vitro. These cultured cells could be stimulated with LH to
      produce renin and prorenin. Though intracellular prorenin as well as renin was
      increased by LH, no renin was found to be released into the extracellular medium.
      The extracellular medium contained prorenin exclusively. The stimulatory effect
      of LH could be mimicked by 8-bromo-cAMP (8-Br-cAMP) and forskolin, suggesting
      cAMP to be the second messenger involved. Induction of renin and prorenin
      production by LH in cultured theca cells was dependent upon de novo protein
      synthesis, since the action of LH could be completely blocked by the protein
      synthesis inhibitor, cycloheximide. The stimulatory effects of LH, 8-Br-cAMP, or
      forskolin were also blocked by 4 beta-phorbol 12-myristate 13-acetate (PMA), via
      putative activation of protein kinase C. However, to completely block the
      stimulatory effect of LH or 8-Br-cAMP, it was necessary to add PMA either before
      LH/8-Br-cAMP was added or simultaneously with the agonists. With progressive
      delay in addition of PMA after LH/8-Br-cAMP was added, the extent of inhibition
      decreased gradually and if PMA was added anytime after 4 h of LH/8-Br-cAMP
      addition, no inhibitory effect could be observed. Thus we have shown that
      renin/prorenin production by theca cells in vitro can be directly regulated by LH
      in a cAMP-dependent manner. Prorenin is preferentially released from the cells.
      Activation of protein kinase C appears to inhibit some very early steps in the
      induction of prorenin/renin production which however is distal to cAMP formation.

PMID- 2226309
TI  - Progesterone action in normal mouse mammary gland.
AB  - Previously it has been shown that progesterone, as well as estrogen, plays an
      important role in the growth of the mammary gland. Eighty percent of mammary
      progesterone receptors (PgR) are estrogen-inducible and are localized in the
      epithelium; the remaining 20% of PgR are estrogen-independent and appear to be
      localized in the mammary stroma. The purpose of the present study was to
      investigate how progestins promote mammary growth in relation to their
      interactions with epithelial and stromal components of the gland and to assess
      the role of estrogen in these interactions. Progestins [progesterone, [17 beta
      methyl-3H]promogestone (R5020), and medroxy progesterone acetate] alone or in
      combination with estrogen were combined with Elvax 40P and implanted directly
      into mammary glands. The effect of hormones on cell proliferation was determined
      by observing changes in mammary gland morphology and by quantitating DNA
      synthesis in both epithelial and stromal cells by DNA histoautoradiography. The
      results demonstrate that in mammary epithelial cells the effects of progestins on
      mammary gland morphology and DNA synthesis are locally mediated such that
      proliferative changes in the hormone-implanted glands were greater than in
      contralateral control glands. Dose-response studies with estrogen and R5020
      revealed that the extent of progestin activity was only partially dependent upon
      the R5020 dose with the major determining factor being the dose of estrogen.
      Analysis of the effect of estrogen on mammary PgR concentration indicates that
      the degree and pattern of the morphological response of ductal sidebranching and
      increases in DNA synthesis are largely due to the increase in estrogen-dependent
      PgR. The antiprogestin, 11 beta-(4-dimethylamino-phenyl)1-17 beta-hydroxy-17
      alpha-(prop-1ynyl)-estra-4,9-diene-3-one (RU486), blocks the proliferation in the
      epithelium that is mediated through estrogen-dependent PgR. In contrast, in
      stromal cells progestin activity is not estrogen-dependent, and stimulation of
      DNA synthesis was not confined to the hormone-implanted glands. Furthermore,
      RU486 stimulates stromal cell DNA synthesis, and this response is augmented by
      estrogen. While progestin effects in epithelial cells appear to be mediated by
      estrogen-dependent PgR, the mechanism operative in stromal cells appears to be
      different and remains to be elucidated.

PMID- 2226310
TI  - Developmental and tissue-specific regulation of proglucagon gene expression.
AB  - The pattern of glucagon gene expression and the posttranslational processing of
      proglucagon was studied in the fetal and neonatal rat. Pancreatic immunoreactive
      glucagon (IRG) and glucagon-like immunoreactivity (GLI) were low in both fetal
      pancreas and intestine, respectively. Immediately after birth, pancreatic IRG
      rose markedly and reached a peak concentration at postnatal day 7, followed by a
      gradual return to its adult level. Intestinal GLI was low until postnatal day 7
      and rose steadily thereafter to adult levels. The levels of GLI in the
      hypothalamus were much lower than in intestine, yet the developmental
      accumulation of hypothalamic GLI resembled the pattern observed in intestine. In
      contrast, the levels of GLI and IRG in the brain stem were higher in the fetus
      and neonate, and decreased to adult levels. Proglucagon mRNA transcripts, uniform
      in size, were detected in RNA isolated from fetal or adult brainstem, pancreas,
      and intestine. However, fetal proglucagon mRNA transcripts were larger than adult
      proglucagon mRNA transcripts in pancreas and intestine, but not brainstem. The
      results of RNAse mapping studies, including analysis of both the 5'- and 3'-ends
      of the mRNA transcripts, demonstrated that the larger fetal mRNA transcripts
      could be accounted for by an increase in the length of the polyadenylate tail in
      the fetal tissues. These observations demonstrate that the developing rat
      exhibits tissue-specific differences in both proglucagon gene expression and the
      pattern of posttranslational processing of the prohormone.

PMID- 2226311
TI  - Altered glucagon- and catecholamine hormone-sensitive adenylyl cyclase
      responsiveness in rat liver membranes induced by manipulation of dietary fatty
      acid intake.
AB  - Glucagon-stimulated adenylyl cyclase activity has been shown to change in liver
      membranes manipulated to alter either their fatty acid composition or fluidity.
      We examined whether membrane alterations induced by dietary manipulation affected
      receptor function. Glucagon- and beta-adrenergic-stimulated receptor-adenylyl
      cyclase systems were examined in liver membranes of rats fed diets containing 10%
      corn oil, 10% coconut oil (essential FFA deficient), or 8.5% coconut oil with
      1.5% corn oil (essential FFA repleat). Basal and maximal nonreceptor-mediated
      adenylyl cyclase activity (stimulated by NaF, guanylylimidodiphosphate, and
      forskolin) was the same in membranes of each of the dietary groups, suggesting
      that Gs-protein and the catalytic unit activity per se were unaltered by the
      manipulations. Glucagon-stimulated adenylyl cyclase activity increased with
      increasing unsaturation of dietary fatty acids; activity in coconut oil-fed rats
      was 527 +/- 30 (mean +/- SEM) pmol/mg.10 min, that in coconut/corn oil-fed rats
      was 752 +/- 74 pmol/mg.10 min, and that in corn oil-fed rats was 981 +/- 94 pmol
      cAMP/mg.10 min. [125I]Monoiodoglucagon binding did not increase in parallel to
      the adenylyl cyclase alterations; coconut oil-fed animals (614 fmol/mg) differed
      from the other groups (450 and 430 fmol/mg). Isoproterenol (beta-adrenergic)
      stimulated adenylyl cyclase activity was also highest in the corn oil-fed
      animals, but was similar in the other dietary groups, with no difference in other
      characteristics of [125I]iodopindolol binding between the groups. The results
      demonstrate that alterations in the glucagon-stimulated adenylyl cyclase response
      are different from those in the beta-adrenergic adenylyl cyclase response.
      Further, they suggest that although direct activations of the catalytic unit or
      its interaction with the guanine nucleotide-sensitive protein are apparently not
      affected, hormone receptor-mediated adenylyl cyclase activity may be altered by
      these dietary manipulations.

PMID- 2226312
TI  - Localization of the thyroxine binding sites in apolipoprotein B-100 of human low
      density lipoproteins.
AB  - By photoaffinity labeling human low density lipoproteins (LDL) with [125I]T4 we
      confirmed our previous observation that of the three T4 binding sites of
      apolipoprotein B-100 (apoB-100) one is in its 26% NH2-terminal portion [apoB-26,
      the 140 kDa fragment, residues 1-1297] and two in the remaining 74% COOH portion
      (apoB-74, 410 kDa, residues 1298-4536). We now show that of these two sites one
      is in the NH2 portion of apoB-74 (apoB-44, 240 kDa, residues 1298-3249) and the
      other in the nonoverlapping COOH portion (apoB-30, 170 kDa, residues 3250-4536).
      ApoB-100 contains 13 binding sites for heparin, a known inhibitor of T4 binding
      to the major T4 carrier plasma proteins; however, heparin failed to inhibit T4
      binding to apoB-100 and fragments thereof. The same failure was seen with three
      monoclonal antibodies (MAbs), 4G3, 5E11, and 43 that block totally or partially
      LDL binding to the LDL receptor [respective epitopes at residues 2980-3084 (apoB
      44), 3441-3569, and 4027-4081 (apoB-30)]. Of the other 3 MAbs, all without effect
      on LDL binding to the LDL receptor, [1D1, 2D8, and 16, respective epitopes at
      residues 474-539 (apoB-26), 1438-1481 (apoB-44), and 4154-4189 (apoB-30)], only
      two (MAbs 1D1 and 2D8) inhibited T4 binding (21 to 39%). We conclude that the
      three T4-binding sites of apoB-100 are outside the LDL receptor binding domain,
      distant from the heparin binding sites and, assuming no allosteric effects, in
      the vicinity of residues 474-539 (T4 site of apoB-26), 1438-1481 (T4 site of apoB
      44), and in the C terminal quarter of apoB-30.

PMID- 2226313
TI  - Small intestinal fatty acid synthesis is increased in diabetic rats.
AB  - Several studies have demonstrated that intestinal triglyceride production and
      secretion are increased in diabetic animals and may contribute to the
      hypertriglyceridemia that accompanies diabetes. There are three potential sources
      of fatty acids for intestinally derived triglycerides; de novo fatty acid
      synthesis, circulating free fatty acids, or dietarily derived fatty acids. Prior
      data have demonstrated that de novo cholesterol synthesis is increased in the
      small intestine of diabetic animals. The primary aim of the present study was to
      determine the effect of diabetes on small intestinal de novo fatty acid
      synthesis. We found that de novo fatty acid synthesis in the small intestine is
      increased approximately 2-fold in streptozotocin-induced diabetic rats. In
      contrast, hepatic fatty acid synthesis is decreased in the diabetic animals. The
      increase in intestinal fatty acid synthesis is observed in both the fed and
      fasting states. Limiting food intake by pair feeding prevents the diabetic
      induced increase in small intestinal fatty acid synthesis, a finding similar to
      previous data on cholesterol synthesis. Thus, the increase in both small
      intestinal cholesterol and fatty acid synthesis is dependent on the increased
      food intake that accompanies poorly controlled diabetes. The present study
      indicates that increases in small intestinal de novo fatty acid synthesis in
      diabetic animals could play an important role in providing fatty acids for
      increased small intestinal triglyceride synthesis and secretion.

PMID- 2226314
TI  - Nongenomic activation of the calcium message system by vitamin D metabolites in
      osteoblast-like cells.
AB  - 1,25-dihydroxycholecalciferol (1,25(OH)2D3) rapidly affects calcium (Ca2+)
      transport in several cell systems, suggesting physiological actions independent
      of genomic activation. To test this hypothesis, we studied immediate to early
      effects (0.5-300 sec) of 1,25(OH)2D3 on cytosolic Ca2+ [Ca2+]i in single
      osteogenic sarcoma ROS 17/2.8 cells loaded with fura-2. An acute rise in [Ca2+]i
      was observed in 40% of the cells following addition of 1,25(OH)2D3, with a
      threshold concentration of 10(-11) M. In most cases, the [Ca2+]i rise was
      transient, with return to baseline within 1 min; less frequently a more prolonged
      effect was observed, with variable recovery times. 25-hydroxycholecalciferol
      (25(OH)D3) reproduced the effect of 1,25(OH)2D3 on [Ca2+]i, with equal potency
      and similar responses, whereas 24,25-dihydroxycholecalciferol, 1 alpha
      hydroxycholecalciferol, and 22 oxa-1,25(OH)2D3 were not effective. 1,25(OH)2D3
      also increased [Ca2+]i in ROS 24/1 cells, which are defective of receptors for
      the vitamin D metabolites. At high doses (10(-8)-10(-7) M) of 1,25(OH)2D3 the
      [Ca2+]i rise in ROS 17/2.8 cells was due to both influx of extracellular Ca2+ and
      release of Ca2+ from intracellular stores, as the effect was only partially
      inhibited by Ca2(+)-channel blockade by nifedipine. At low doses (10(-9)-10(-10)
      M), the effect was entirely dependent on extracellular Ca2+. 1,25(OH)2D3 also
      increased the production of inositol 1,4,5 trisphosphate (Ins(1, 4, 5)P3) and
      diacylglycerol, at a threshold dose of 10(-9) M, indicating activation of
      phospholipase C (PLC). In two thirds of the cells studied, a second addition of
      1,25(OH)2D3 within 5 min to cells prestimulated with equimolar doses of the
      vitamin D metabolite resulted in a [Ca2+]i transient of higher amplitude than the
      first, a phenomenon occurring at all doses of the hormone, and associated with
      production of Ins(1, 4, 5)P3. This response amplification was not produced by
      25(OH)D3, and pretreatment with 1 alpha(OH)D3 did not significantly enhance
      1,25(OH)2D3-induced production of Ins(1, 4, 5)P3. In conclusion, activation of
      the Ca2+ message system by vitamin D metabolites is a rapid, nongenomic effect;
      1,25(OH)2D3 specifically activates both PLC and dihydropyridine-sensitive Ca2+
      channels, and "primes" the cells to respond with an enhanced [Ca2+]i rise to a
      subsequent homologous stimulation; the presence of both the 1 alpha and 25
      hydroxyl groups is necessary to express the full hormonal action of vitamin D on
      [Ca2+]i.

PMID- 2226316
TI  - Functional heterogeneity in neuropeptide-Y-producing cells in the rat brain as
      revealed by testosterone action.
AB  - Despite the widespread distribution of neuropeptide-Y (NPY) in various
      hypothalamic sites, castration reduced and testosterone (T) replacement restored
      NPY levels selectively in the median eminence (ME), arcuate nucleus (ARC), and
      ventromedial nucleus (VMN). Since androgen-concentrating cells and NPY-producing
      cells display overlapping distribution in the ARC and brain stem (BS), we
      assessed the participation of BS NPY cells in the steroid-dependent site-specific
      effects on NPY levels. The BS projections to the hypothalamus were severed by
      bilateral neural transection (BNT) with a knife lowered on either side of the
      sagittal sinus to the depth of the dorsal tegmentum in the mesencephalon in
      intact, castrated, or castrated rats that additionally received sc T implants to
      maintain physiological T levels. Two weeks later, NPY concentrations in
      microdissected hypothalamic sites and serum LH and T levels were quantitated by
      RIA. Castration decreased and T replacement increased NPY concentrations in only
      three sites, such as the VMN, ARC, and ME. In response to BNT in gonadally intact
      rats, a different site-specific response of NPY levels was observed; NPY levels
      decreased in the ME, as seen after castration, and, additionally, decreased in
      the medial preoptic area, paraventricular nucleus, and dorsomedial nucleus,
      suggesting that BS NPY neurons innervate these four sites. When castration and
      BNT were performed simultaneously, a combined regional response was evident. NPY
      levels decreased in six sites, including two sites (ARC and VMN) that normally
      respond to castration alone, three sites (medial preoptic area, paraventricular
      nucleus, and dorsomedial nucleus) that normally respond to BNT alone, and the ME,
      the only site that showed reduction of NPY levels of similar magnitude after
      either castration or BNT, but the response of combined surgery was not additive.
      This observation suggested that gonadal steroids act outside the hypothalamus to
      raise ME NPY levels, and therefore, BNT in intact rats impaired the effectiveness
      of steroids. To test this hypothesis, the effects of physiological T replacement
      in the castrate plus BNT group were studied. We observed that whereas T
      replacement readily raised NPY levels in the VMN and ARC, it was completely
      ineffective in the third T-dependent site, the ME. Collectively, these findings
      revealed a functional heterogeneity among NPY-producing cells in response to T.
      Apparently, there are two distinct neural sites in the rat brain where T acts to
      exert a site-specific stimulatory effect on NPY in the hypothalamus.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2226315
TI  - Effect of thyroxine administration on the expression of epidermal growth factor
      in the kidney and submandibular gland of neonatal mice. An immunocytochemical and
      in situ hybridization study.
AB  - The effect of T4 administration on epidermal growth factor (EGF) expression in
      kidney and submandibular glands (SMG) was studied in newborn mice. EGF messenger
      RNA (mRNA) abundance and EGF immunoreactivity were assessed by in situ
      hybridization and immunohistochemical techniques, respectively. T4 treatment on
      days 0-6 augmented both the in situ hybridization and immunocytochemical signals
      in kidney but not in SMG on day 7. By contrast, T4 injections on days 7-14 did
      not alter the in situ hybridization or immunocytochemical signals in kidney but
      increased both signals in SMG on day 15. Thus, neonatal T4 treatment augments the
      levels of EGF mRNA as well as EGF immunoreactivity in both kidney and SMG. The T4
      effect is manifested during the first week in kidney whereas the SMG responds to
      T4 treatment only during the second week of life.

PMID- 2226317
TI  - Cell surface vitamin D-binding protein (GC-globulin) is acquired from plasma.
AB  - Vitamin D-binding protein (DBP) is an abundant plasma protein. The observation of
      immunodetectable, cell-associated DBP on peripheral blood mononuclear cells and
      placental cytotrophoblasts had presented the question of the origin, function,
      and precise subcellular localization of cell-associated DBP. Using anti-human DBP
      F(ab')2 with fluorescence-activated cytometric analysis and immunogold electron
      microscopy, we detected DBP on the plasmalemma of U937 cells, a monoblastic,
      histiocytic cell line grown in media supplemented with fetal calf serum (FCS).
      DBP was then removed from FCS by actin affinity chromatography followed by anti
      DBP immunoaffinity chromatography. U937 cells in this DBP-free medium exhibited
      nearly identical growth rates to cells grown in medium containing native FCS.
      However, in contrast to cells grown with native FCS, those grown for seven to
      eight generations with DBP-free FCS exhibited less cell-surface DBP as quantified
      by fluorescence-activated cytometric analysis (73% decrease) and immunoelectron
      microscopy (88% decrease). DBP mRNA could not be detected in U937 cells,
      placental tissues, freshly prepared resting and stimulated B and T lymphocytes,
      or lymphocyte-derived cell lines by Northern analysis. In addition, using the
      sensitive reverse transcriptase/polymerase chain reaction assay no DBP fragments
      were detectable in U937 cells. We conclude that U937 cell-associated DBP is
      exogenously derived from plasma and is located on the plasmalemma. Based upon
      this conclusion, we postulate that specific binding sites for DBP may exist on
      the plasma membranes of certain cell types.

PMID- 2226318
TI  - Prolonged effects of recombinant human interleukin-1 alpha on mouse thyroid
      function.
AB  - Rapid and prolonged effects of recombinant human interleukin-1 alpha (IL-1 alpha)
      on mouse thyroid were studied. After daily administration of 15 micrograms or 1
      microgram IL-1 for 7 consecutive days, serum T4 concentrations rapidly fell to
      undetectable levels but returned to near control level after the cessation of IL
      1. On the 31st day, 3 weeks after the drug cessation, a significant depression of
      serum T4 was observed again. In addition, the IL-1-treated mouse thyroid showed
      an in vitro unresponsiveness to TSH, with an increase of pituitary TSH (2.24-fold
      by 15 micrograms IL-1). To understand underlying mechanisms further, serial
      observations were performed. Thyroidal T4 contents increased initially, decreased
      to a low level at day 14, and returned to approximately the control level. IL-1
      administration induced an increase in the basal thyroidal cAMP level for a
      prolonged period. Its response to TSH showed a gradual decline to a level
      approximately 30% of the control by the 31st day. Pituitary TSH contents on the
      22nd and 31st days showed significant elevations. Slight decreases in thyroidal
      TSH binding and T4 contents also were seen concomitantly. These studies indicate
      that an administration of a large dose of IL-1 results in a dramatic decrease in
      serum T4 primarily through the inhibition of T4 release from the thyroid. The
      results also indicate the induction of a prolonged hypothyroid state due to the
      unresponsiveness to TSH via a postreceptor mechanism.

PMID- 2226319
TI  - Effect of bilateral splanchnic nerve section on adrenal function in the ovine
      fetus.
AB  - The effect of bilateral splanchnic nerve (SPLX) section in fetal sheep [116-121
      days gestational age (dGA)] on subsequent adrenocortical function was
      investigated. Fetal cortisol release was stimulated by 1) ACTH-(1-24)
      administration (100 ng/min for 15 min) at 126-129 and at 132-135 dGA, and 2)
      nitroprusside-induced hypotension (50% reduction in fetal arterial blood pressure
      for 10 min) at 129-132 and 136-139 dGA. No differences were observed between SPLX
      and control fetuses (CONT) in basal arterial plasma concentrations of cortisol
      from 126-141 dGA. A significant effect of fetal age on basal cortisol was
      observed in both SPLX and CONT fetuses from 126-141 dGA. A significant (P less
      than or equal to 0.05) increase in fetal arterial concentrations of cortisol was
      achieved by ACTH-(1-24) infusion in SPLX and CONT and did not differ between
      groups at either 126-129 or 132-135 dGA. Hypotension induced a significant
      increase in fetal plasma cortisol concentrations in SPLX and CONT fetuses (P less
      than or equal to 0.05). SPLX fetuses secreted significantly less cortisol in
      response to hypotension than CONT fetuses at both 129-132 and 136-139 dGA (P less
      than 0.05). Fetal arterial plasma concentrations of immunoreactive ACTH in
      response to hypotension were not different between CONT and SPLX fetuses. We
      estimated the half-life of endogenous fetal plasma cortisol after both
      hypotension and infusion of ACTH-(1-24). There were no differences between either
      method of inducing cortisol release on the endogenous cortisol half-life, nor
      were any differences in cortisol half-life observed between SPLX and CONT. At 136
      139 dGA the adrenomedullary response to hypotension was abolished in SPLX,
      confirming completeness of denervation. In conclusion, the splanchnic nerves do
      not appear to be involved in the normal increase in basal fetal plasma cortisol
      observed in late gestation in fetal sheep. However, splanchnic nerve modulation
      of secretion of cortisol in response to stress may be involved in the increased
      fetal adrenal sensitivity to stress observed late in gestation.

PMID- 2226320
TI  - Localization and growth hormone (GH)-releasing activity of rat testicular GH
      releasing hormone-like peptide.
AB  - The testis contains many peptides originally described as originating in the
      central nervous system. The physiological function of these factors in the testis
      is generally unknown. We previously reported that the rat testis contains both a
      peptide with GH-releasing hormone-like immunoactivity (tGHRH-LI) and a mRNA
      species that cross-hybridizes with a hypothalamic cDNA for rat GHRH (rGHRH). The
      current study was designed to further characterize tGHRH-LI by determining its
      location within rat testis, and to evaluate whether tGHRH-LI and hypothalamic
      GHRH share similar biological and electrophoretic properties. Partially purified
      tGHRH is capable of stimulating GH secretion from cultured anterior pituitary
      cells in a dose-dependent manner. Testicular GHRH and rGHRH have different HPLC
      retention times and significantly different electrophoretic properties by Western
      gel analysis. The estimated size of tGHRH-LI is approximately 3.7 times that of
      synthetic rGHRH. Using immunohistochemistry, tGHRH-LI is localized to mature
      sperm forms in rat testis. We conclude that rat tGHRH-LI and rGHRH share some
      structural and functional properties and are probably related peptides. However,
      the difference in electrophoretic mobility and HPLC retention time indicates that
      they are not identical. The presence of tGHRH-LI in rat sperm, within the
      confines of the blood-testis barrier, which is generally impermeable to peptides,
      leads us to speculate that tGHRH serves a paracrine or autocrine role in
      testicular physiology.

PMID- 2226321
TI  - Expression of gonadotropin-releasing hormone and prothymosin-alpha messenger
      ribonucleic acid in the ovary.
AB  - GnRH exerts paradoxical effects on ovarian cells through specific receptors.
      Based on observed direct effects of GnRH and its antagonists on ovarian
      functions, the presence of endogenous ovarian GnRH-like peptide(s) has been
      postulated. In an attempt to detect the ovarian expression of GnRH or related
      genes at the RNA level, we used the reverse transcription-polymerase chain
      reaction (RT-PCR) to amplify GnRH mRNA levels. Total RNA from rat ovaries was
      converted to first strand cDNA using reverse transcriptase and amplified in PCR
      using a pair of primers complementary to the rat GnRH cDNA. The DNA products
      obtained were subcloned into plasmid vectors, and their sequences were
      determined. The most prominent PCR product of 462 basepairs (bp) was unexpectedly
      identified as a fragment of prothymosin-alpha cDNA previously found in the
      spleen. This cDNA was obtained because of an identical 10 bp match with the 3'
      end of one of the GnRH primers. Northern blot analyses using the cloned
      prothymosin-alpha cDNA as probe revealed the presence of mRNA for this factor in
      ovary, thymus, testis, placenta, and hypothalamus. RT-PCR amplification of
      hypothalamus and granulosa cell messages indicated the presence of a 244-bp
      product with a sequence identical to that of GnRH. To further confirm the
      presence of GnRH messages in the ovary, a second set of GnRH primers was used.
      PCR amplification of cDNA from hypothalamus, granulosa cells, and whole ovary
      yielded a 241-bp product identical to the authentic GnRH sequence based on
      analysis on both strands. In contrast, no PCR product was evident after
      amplification of thyroid cDNA. Our data demonstrated the expression of mRNA for
      GnRH and prothymosin-alpha in the ovary. Although the exact ovarian role of the
      immune hormone awaits further study, the detection of GnRH transcript in the
      ovary suggests potential intragonadal roles of this decapeptide.

PMID- 2226322
TI  - The production of transforming growth factor-beta in the porcine ovary and its
      secretion in vitro.
AB  - Porcine granulosa cells isolated from small (1-3 mm in diameter) follicles
      proliferate rapidly in culture in response to 10% fetal bovine serum (FBS) and
      epidermal growth factor (EGF) (10 ng/ml). Transforming growth factor-beta (TGF
      beta) inhibits FBS/EGF-stimulated proliferation in a dose-dependent manner. We
      have used this proliferation inhibitory property of TGF beta to assay
      qualitatively, the presence of this growth factor in conditioned medium from
      cultured follicle cells as well as in partially purified preparations from
      porcine ovarian compartments. In addition, the concentration of TGF beta in the
      theca cell conditioned medium was quantitatively estimated by generating a TGF
      beta-dose-response curve (inhibition of FBS/EGF-stimulated proliferation of
      granulosa cells in monolayer culture) using authentic human TGF beta-1. Ovarian
      thecal cells isolated from small and large size follicles in the pig ovary
      secrete TGF beta-like activity in vitro. Medium conditioned by thecal cells in
      primary monolayer culture contains a latent form of TGF beta which can be
      activated by heat or acid treatment. In contrast, and unlike rat granulosa cells,
      porcine granulosa cells in primary monolayer culture do not secrete detectable
      levels of TGF beta-like activity in the medium. Incubation of heat-activated
      thecal cell conditioned medium with a TGF beta-neutralizing antibody (which
      recognizes TGF beta-1 and 2) but not nonimmune serum attenuated the TGF beta-like
      activity in thecal cell conditioned medium suggesting that this activity is due
      to authentic TGF beta. Since many cell types secrete latent TGF beta in the
      medium when cultured in vitro, we next investigated whether thecal cell secretion
      of latent TGF beta was a function of cell culture or whether the ovarian thecal
      compartment actually contained detectable levels of TGF beta-like activity. To
      this end, we used an acid-ethanol extraction procedure to isolate thecal proteins
      from fresh-frozen tissue. The acid-ethanol extracted protein fraction was mixed
      with trace amounts of 125I-TGF beta for detection and chromatographed on Bio-Gel
      P-60 column under acidic conditions. Elution of TGF beta bioactivity from the Bio
      Gel P-60 column as measured by inhibition of granulosa cell proliferation
      correlated with the elution of radioiodinated authentic TGF beta. Preincubation
      of TGF beta-like activity-containing fractions with TGF beta-neutralizing
      antibody attenuated the proliferation-inhibitory activity in these fractions. TGF
      beta activity was also observed in fractions extracted from porcine corpora
      lutea.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2226323
TI  - Endogenous opioid peptides mediate the interleukin-1-induced inhibition of the
      release of luteinizing hormone (LH)-releasing hormone and LH.
AB  - We have reported recently that central administration of both the alpha- and beta
      subtypes of the cytokine interleukin-1 (IL-1) inhibited the estrogen-progesterone
      induced LH surge in ovariectomized (ovx) rats. This inhibition was probably due
      to a central effect, since IL-1 alpha and IL-1 beta also suppressed the in vitro
      LHRH output from the hypothalami of steroid-primed ovx rats. Whether IL-1
      inhibits LHRH release by a direct action or via some other neuronal system is not
      known. Since IL-1 reportedly stimulates the release of POMC peptides, which are
      known to be inhibitory to the LHRH-LH axis, we have tested the hypothesis that
      the inhibitory influence of IL-1 may be mediated via activation of hypothalamic
      opioid peptides. Ovx rats, preimplanted with cannulae in the third ventricle of
      the brain, were injected with 30 micrograms estradiol benzoate, followed by 2 mg
      progesterone 48 h later. Three hours after P injection, IL-1 alpha, IL-1 beta, or
      saline (SAL) was injected intracerebroventricularly (30 ng/3 microliters) at 1300
      h, followed immediately by iv infusion of SAL or the opiate antagonist naloxone
      hydrochloride (NAL; 2 mg/0.6 ml.h) for 2 h. Plasma LH levels were measured in
      blood samples withdrawn hourly until 1800 h. Both IL-1 alpha and IL-1 beta
      blocked the afternoon LH surge. NAL infusion into control SAL-injected rats did
      not alter the LH surge; however, it reversed the IL-1 alpha- and IL-1 beta
      induced suppression of the LH surge. To determine whether this reversal of IL-1
      suppression of the LH surge was due to NAL action at the hypothalamic level, the
      preoptic area-medial basal hypothalamus of similarly primed ovx rats was obtained
      at 1300 h and incubated in vitro in the presence of 10 nM IL-1 alpha or IL-1 beta
      with or without 100 micrograms/ml NAL. Both subtypes of IL-1 suppressed LHRH
      output significantly. NAL alone did not affect LHRH release, but it completely
      reversed the inhibitory effects of the cytokine on LHRH release. These results
      suggest that IL-1 alpha and IL-1 beta inhibit LHRH-LH release by stimulating the
      activity of hypothalamic endogenous opioid peptide systems.

PMID- 2226324
TI  - Influence of the fetus and estrogen on serum concentrations and placental
      formation of insulin-like growth factor I during baboon pregnancy.
AB  - In the present study, we used an in vivo approach to determine whether the fetus
      and estrogen have direct effects on placental production and serum concentrations
      of insulin-like growth factor I (IGF-I) in baboons. On day 100 of gestation,
      fetuses were removed and placentas left in situ (fetectomy). On days 100-155 of
      gestation after fetectomy, baboons received 50 mg androstenedione pellets sc in
      increasing numbers (1-3 every 10 days, n = 8), were injected sc with estradiol
      (E2) benzoate (0.50-2.5 mg/day, n = 8), or were not further treated (n = 6).
      Placentas were obtained on day 160, and cells were dispersed in 0.1% collagenase,
      isolated on 50% Percoll, then incubated for 24 h at 37 C in medium 199. Mean (+/-
      SE) peripheral serum E2 (nanograms per ml) in untreated baboons (n = 5) was 1.33
      +/- 0.06 on days 101-160. Fetectomy decreased (P less than 0.001) E2 to 0.28 +/-
      0.04, and androstenedione and E2 after fetectomy increased serum E2 to 0.75 +/-
      0.08 and 2.51 +/- 0.23, respectively. Serum IGF-I (nanograms per ml) determined
      by RIA was 182 +/- 6 on days 101-160 in controls. Serum IGF-I increased (P less
      than 0.001) rapidly after fetectomy to 403 +/- 22 on days 101-160 and fell
      precipitously to 185 +/- 8 after placental delivery. Androstenedione and E2
      treatment after fetectomy decreased IGF-I to 291 +/- 16 and 239 +/- 6,
      respectively, values similar to those before fetectomy. Uterine vein
      concentrations of IGF-I were similar to those in peripheral maternal serum, and
      the same relative treatment effects were observed. IGF-I secretion (picograms per
      ml/24 h) by placental trophoblasts of fetectomized baboons (80.1 +/- 9.8) was
      242% greater (P less than 0.001) than controls (23.4 +/- 4.7) and decreased after
      fetectomy by androstenedione (56.7 +/- 15.1) and E2 (62.3 +/- 12.8). Thus,
      removal of the fetus decreased serum E2 and markedly elevated placental
      production and maternal serum levels of IGF-I, and these effects were largely
      reversed by androstenedione or E2. We suggest that the fetus, via secretion of
      estrogen precursors, regulates placental IGF-I production and consequently
      maternal serum concentrations of IGF-I during primate pregnancy.

PMID- 2226325
TI  - Hypoglycemic potency and metabolic clearance rate of intravenously administered
      human proinsulin and metabolites.
AB  - Since circulating proinsulin has been suggested to be important in the
      pathogenesis of noninsulin-dependent diabetes, and biosynthetic human proinsulin
      (HPI) may have a therapeutic role in patients with diabetes mellitus, the
      biological activity of proinsulin metabolites is of potential significance.
      Moreover, recent studies have suggested that the majority of circulating
      proinsulin immunoreactivity consists of metabolites. We, therefore, compared the
      blood glucose-lowering ability and MCR of the two proinsulin metabolites des
      (31,32)HPI and des-(64,65)HPI with intact HPI in seven anesthetized dogs after an
      overnight fast. Intravenous bolus injections of 12.5 micrograms HPI/kg BW and
      equimolar amounts of des-(31,32)HPI and des-(64,65)HPI were given on three
      separate occasions. In addition to blood glucose, des-(31,33)HPI, des-(64,65)HPI,
      and HPI were measured using an insulin RIA and peptide-specific standard curves.
      Kinetic parameters were derived by fitting two exponentials to the respective
      decay curves. The MCR of HPI (3.3 +/- 0.1 ml/kg.min) was significantly lower (P
      less than 0.05) than that of des-(64,65)HPI (6.4 +/- 0.6 ml/kg.min), but was not
      significantly different from that of des-(31,32)HPI (3.8 +/- 0.4 ml/kg.min). The
      MCR of biosynthetic insulin (17.2 +/- 1.8 ml/kg.min), as measured in three of the
      dogs, was higher than that of HPI or the two metabolites. The blood glucose
      lowering ability (defined as nadir glucose/fasting glucose, expressed as a
      percentage) of des-(64,65)HPI (49.3 +/- 5.0%) was significantly greater (P less
      than 0.05) than that of intact HPI (87 +/- 2.2%), and the glucose-lowering
      ability of des-(31,32)HPI (75.2 +/- 3.8%) was intermediate. In conclusion, HPI
      metabolites are more biologically active than intact HPI. The extent of in vivo
      conversion of proinsulin to metabolites may enhance the biological activity of
      proinsulin and, thus, have physiological, pathophysiological, and therapeutic
      significance.

PMID- 2226326
TI  - Third-ventricular infusion of neuropeptide Y suppresses luteinizing hormone
      secretion in ovariectomized rhesus macaques.
AB  - Neuropeptide Y (NPY) has been shown to modulate gonadotropin secretion in an
      estrogen-dependent manner in the rat and rabbit, and to act centrally in these
      species to alter GnRH release. The present study examined the ability of
      centrally administered NPY to affect LH secretion in the primate. Human NPY
      (hNPY) was administered into the third cerebroventricle of unanesthetized, freely
      moving, ovariectomized (OVX), or estradiol (E2)-treated OVX rhesus monkeys. LH
      was measured in blood samples collected remotely at 10-min intervals throughout
      the experiments. An extensive range of NPY doses was tested in a preliminary
      study in which OVX monkeys received a 3-h control infusion of Krebs Ringer
      phosphate buffer (KRP) followed immediately by a 3-h infusion of hNPY (0.1-50
      micrograms/h). Only doses greater than or equal to 5 micrograms/h produced a
      consistent and marked suppression of LH (5 micrograms/h; 35.1 +/- 7.2% reduction,
      P less than 0.05, n = 4). A longer duration study was performed to better
      characterize changes in LH pulse frequency and amplitude produced by hNPY
      treatment. We administered 5 micrograms/h and 15 micrograms/h to OVX (n = 5) and
      E2-treated OVX (n = 4) monkeys according to the following protocol: 8 h control
      KRP/8-h hNPY/6-h recovery KRP. In OVX monkeys, LH was suppressed after 2 to 3 h
      of peptide infusion (P less than 0.01); LH secretion returned to normal after
      treatment. Both doses of hNPY suppressed mean LH by approximately 55% (P less
      than 0.05) and LH pulse frequency by approximately 69% (P less than 0.025). LH
      pulse amplitude was unaffected. In E2-treated OVX monkeys, neither dose of hNPY
      affected mean LH or LH pulse amplitude. LH pulse frequency was suppressed by
      approximately 65% (P less than 0.05) during 15-micrograms/h treatment. Because
      centrally administered hNPY reduced LH pulse frequency and thereby mean LH
      levels, our results support a central, neural action of NPY to affect the GnRH/LH
      secretory system. The ability of estrogen feedback to alter the response to NPY
      treatment supports a physiological role for NPY in controlling reproduction in
      the primate.

PMID- 2226327
TI  - Alterations in phospholipase A2 activity during luteal regression in
      pseudopregnant and pregnant rats.
AB  - The activity of phospholipase A2 was measured in microsomes prepared from ovaries
      of superovulated pseudopregnant rats during spontaneous and prostaglandin F2
      alpha-induced regression and during regression in pregnant rats. Microsome
      samples were incubated at 40 C for 90 min in Tris buffer (pH 8.3) with 1.0 mM
      CaCl2 added. The substrate, radiolabeled phosphatidylcholine, was incorporated
      into liposomes. During spontaneous regression, there was a significant 2- to 4
      fold increase in phospholipase A2 activity, when compared with levels at mid
      pseudopregnancy (days 8-9). This elevation was correlated with a significant
      decrease in plasma progesterone concentration. On day 6 or 7 of pseudopregnancy,
      treatment of rats with luteolytic doses of prostaglandin F2 alpha also caused a
      significant increase in phospholipase A2 activity, which remained elevated
      throughout the 72-h sampling period. In pregnant rats there was a small but
      significant rise in phospholipase A2 activity after parturition. These results
      indicate that the activity of phospholipase A2 increases during luteal regression
      in pregnant and pseudopregnant rats and that it could be involved in the
      mechanism that causes the loss in progesterone secretion.

PMID- 2226328
TI  - Differential response of luteinizing hormone receptor and steroidogenic enzyme
      gene expression to human chorionic gonadotropin stimulation in the neonatal and
      adult rat testis.
AB  - To study further the functional differences of the fetal-neonatal and adult
      growth phases of Leydig cells, neonatal (5-day-old) and adult (60-day-old) male
      rats were challenged with a 600 IU/kg injection of human CG (hCG). Certain Leydig
      cell responses were monitored 1, 2, and 3 days after the hCG injection. The down
      regulation of LH receptors and blockage of the 17-hydroxylase/C17-20 lyase step
      in adult testis, and the absence of these responses in neonatal testis were
      confirmed. Novel data were obtained on concomitant responses of LH receptor and
      steroidogenic enzyme messenger RNAs (mRNAs). The LH receptor mRNA was increased 4
      5-fold by 2 days after hCG injection in the neonatal testis (P less than 0.05),
      but in the adult was decreased during all 3 days by 50% (P less than 0.05). The
      mRNA level of the cytochrome P450 for cholesterol side chain cleavage responded
      similarly at both ages, with a 180-260% increase during 2 and 3 days (P less than
      0.05-0.01). In contrast, the 17-hydroxylase/17,20-lyase cytochrome P450 mRNAs
      displayed opposite responses, increasing 4.5-fold in 2 days (P less than 0.01) in
      the neonates, but decreasing by 80% in 1 day in the adults (P less than 0.01). No
      response of the aromatase cytochrome P450 mRNA to hCG stimulation was found at
      either age studied. These results demonstrate that the functional differences of
      the neonatal and adult Leydig cells to high gonadotropic stimulation occur at the
      level of expression of specific genes, including those of the LH receptor and the
      17-hydroxylase/17,20-lyase cytochrome P450. Although aromatization of testicular
      androgens has been suggested to mediate the blockade of the 17-hydroxylase/C17-20
      lyase step in adult testes, altered steady state levels of aromatase mRNA are not
      involved in this response. LH receptor mRNA decreases in adult rat testis in
      response to treatment with high levels of hCG. Thus, this phenomenon of down
      regulation of membrane receptors includes a decreased LH receptor mRNA as well as
      cellular internalization of the existing receptors.

PMID- 2226330
TI  - Parathyroid hormone messenger ribonucleic acid in the rat hypothalamus.
AB  - Polyadenylated RNA, extracted from rat hypothalami, cross-hybridized with a RNA
      probe complementary in sequence to rat PTH (rPTH) messenger RNA (mRNA).
      Amplification of complementary DNA (cDNA) by the polymerase chain reaction also
      demonstrated the presence of rPTH mRNA in the rat hypothalamus and parathyroid
      gland. rPTH mRNA was localized by in situ hybridization in the paraventricular
      and supraoptic nuclei of the rat hypothalamus. These results demonstrate the
      expression of the PTH gene in the central nervous system of the rat in areas
      which suggest roles for PTH in neuroendocrine function.

PMID- 2226329
TI  - Insulin-like growth factor type I increases concentrations of messenger
      ribonucleic acid encoding cytochrome P450 cholesterol side-chain cleavage enzyme
      in primary cultures of porcine granulosa cells.
AB  - Insulin-like growth factor type I (IGF-I) is an important intraovarian peptide
      that stimulates granulosa cell steroidogenesis during follicular development. The
      cytochrome P450 cholesterol side-chain cleavage enzyme (P450scc) that converts
      cholesterol to pregnenolone is the rate-limiting step in progesterone
      biosynthesis. Since treatment of primary cultures of immature porcine granulosa
      cells with IGF-I will increase progesterone production as well as the synthesis
      of immunoprecipitable P450scc enzyme, we examined possible molecular mechanisms
      subserving these inductive effects of IGF-I. To this end, cultures of porcine
      granulosa cells were maintained in serum-free medium with or without IGF-I under
      various treatment paradigms. Cellular concentrations of specific P450scc mRNA
      were measured by Northern blot hybridization using a 32P-labeled 1-kilobase
      porcine cDNA clone. Northern blot autoradiogram densitometry data were normalized
      with a constitutively expressed 1.2-kilobase chicken glyceraldehyde-3-phosphate
      dehydrogenase cDNA clone. Steroidogenesis was monitored by measuring concomitant
      progesterone accumulation in the culture medium. Treatment with pure recombinant
      human IGF-I (100 ng/ml) significantly increased P450scc mRNA concentrations after
      18 h, and maximal stimulation (10- to 20-fold) occurred by 48 h for both P450scc
      mRNA and progesterone accumulation. The IGF-I dose-response curve studied at 48 h
      showed a significant increase in P450scc mRNA levels at a minimal IGF-I
      concentration of 1 ng/ml (although progesterone production was not increased).
      Treatment with equimolar concentrations of epidermal growth factor, IGF-I, or
      insulin significantly increased P450scc mRNA concentrations, whereas fibroblast
      growth factor did not. To examine possible mechanisms underlying stimulation of
      P450scc by IGF-I, immature granulosa cells were treated with aminoglutethimide (a
      P450scc enzyme inhibitor), low density lipoprotein (to increase cholesterol
      delivery to granulosa cells), or estradiol in the presence or absence of IGF-I.
      Aminoglutethimide had no effect, alone or with IGF-I, on P450scc mRNA
      concentrations, but suppressed progesterone production. Low density lipoprotein
      alone also did not stimulate P450scc mRNA levels and only slightly increased
      progesterone accumulation, but acted synergistically with IGF-I to augment
      P450scc mRNA concentrations and progesterone accumulation. Estradiol alone did
      not stimulate P450scc mRNA concentrations, but did significantly increase
      progesterone production. Estradiol cotreatment with IGF-I synergistically
      enhanced progesterone production, but did not alter IGF-I-stimulated P450scc mRNA
      concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2226331
TI  - Gonadotropin-releasing hormone (GnRH) agonists and GnRH antagonists do not alter
      endogenous GnRH secretion in short-term castrated rams.
AB  - The administration of GnRH agonists and antagonists suppresses pituitary LH
      secretion. However little is known about their effects on endogenous GnRH
      secretion. To determine if GnRH analogs act on GnRH secretion through a short or
      ultrashort loop feedback mechanism, experiments were performed to analyze GnRH
      secretion in hypophyseal portal blood of conscious short-term castrated rams
      under both agonist or antagonist treatment. In Study 1, six rams were castrated
      and surgically prepared for portal blood collection on day -7. Portal and
      peripheral blood were collected simultaneously every 10 min for 14-15 h on day 0.
      Five hours after the beginning of the portal blood collection, animals were
      injected im with 5 mg potent GnRH antagonist (Nal-Glu). In Study 2, six rams were
      treated daily from day -11 to day 0 with the GnRH agonist D-Trp6 GnRH (0.5 mg
      im). Castration and surgical preparation for portal blood collection were
      performed on day -7. On day 0 portal and peripheral blood were collected
      simultaneously every 10 min for 10-11 h. In both studies, to determine whether an
      increase in GnRH concentration in hypophyseal portal blood can overcome the
      inhibitory effect of the GnRH analogs, between 5 and 5.5 h after the injection of
      the analogs, endogenous GnRH secretion was stimulated by Naloxone administration
      (3 x 100 mg, iv, at 30-min intervals) followed by a bolus of exogenous GnRH (2 x
      10 micrograms, iv at 30-min intervals). In Study 1, Nal-Glu administration led to
      a rapid cessation of pulsatile LH secretion for the duration of blood collection
      while GnRH pulse frequency and amplitude were not affected. GnRH and LH pulse
      frequency before and after Nal-Glu administration were, 6.2 +/- 0.6 vs. 5.7 +/-
      0.8 (NS) and 5.3 +/- 0.3 vs. 0.3 +/- 0.2 pulses/6 h (P less than 0.001)
      respectively. In Study 2, peripheral LH secretion was completely suppressed while
      GnRH secretion (portal blood) remained pulsatile. GnRH pulses frequency and pulse
      amplitude were 4.3 +/- 0.3 pulses/6 h and 43.0 +/- 4.7 pg/ml, respectively. In
      both experiments, neither stimulation of endogenous GnRH secretion by naloxone
      nor administration of exogenous GnRH allowed reinitiation of LH secretion.
      However, additional studies in two animals of each treatment group (study-III)
      showed that this was clearly a dose related effect in antagonist treated but not
      in agonist-treated animals since higher doses of exogenous GnRH (i.e. 100
      micrograms or 1000 micrograms) can increase significantly LH levels.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2226332
TI  - Localization of the vicinal dithiols involved in steroid binding to the rat
      glucocorticoid receptor.
AB  - Our previous studies with the thiol-specific reagent methyl methanethiolsulfonate
      (MMTS) and the vicinal dithiol-specific reagent sodium arsenite have established
      that 2 spatially close thiols (i.e. vicinal dithiols) are involved in steroid
      binding to the intact 98 K rat glucocorticoid receptor. These 2 thiols form an
      intramolecular disulfide after treatment with low concentrations of MMTS. One of
      these thiols was proposed to by Cys-656. In an effort to identify both thiols, we
      have examined the effects of MMTS and arsenite on proteolytic fragments of the
      receptor, which contain progressively fewer cysteines. MMTS and arsenite are now
      found to cause the same dithiothreitol-reversible inhibition of steroid binding
      and affinity labeling of both the 42 K chymotrypsin fragment and the 16 K steroid
      binding core fragment of the receptor as was seen for the intact receptor.
      Characteristic responses include a bimodal inhibition curve for steroid binding
      after preincubation with MMTS and an inhibition of binding by very low
      concentrations of arsenite. Low concentrations of MMTS could block steroid
      binding by forming a disulfide bond between the receptor and a tightly
      associated, nonreceptor protein. However, no evidence for such cross-linking was
      observed when intact 98 K receptors, 42 K chymotrypsin fragments, or 16 K trypsin
      fragments were treated with various concentrations of MMTS, separated on
      nonreducing sodium dodecyl sulfate-polyacrylamide gels, and visualized by Western
      blotting with antiheat shock protein 90 or antireceptor antibodies. One of the
      antireceptor antibodies (aP1) that had been raised against the rat receptor
      sequence 440-795 was now found to recognize at least 1 epitope in the 16 K core
      fragment. We conclude that the vicinal dithiols involved in steroid binding are 2
      of the 3 cysteines in the sequence of Thr537-Arg673.

PMID- 2226333
TI  - Further studies on the involvement of protein kinase C in human sperm flagellar
      motility.
AB  - Addition of the phorbol ester 12-O-tetradecanoyl phorbol-13-acetate (TPA) or the
      membrane-permeable diacylglycerol analog, 1-oleoyl-2-acetylglycerol to human
      sperm resulted in increased motility. The biologically inactive 4 alpha-phorbol
      12,13 didecanoate had no effect on flagellar motility. Basal motility was
      markedly reduced in the absence of Ca2+ in the incubation medium, but TPA-induced
      sperm motility persisted even in the absence of Ca2+. Sperm motility was also
      enhanced by the Ca2+ ionophore ionomycin in a Ca2(+)-dependent, protein kinase c
      (PKC)-independent fashion. Although all stimulants examined here reached maximal
      response at about 15 min of incubation, nevertheless whereas the effect of TPA
      and 1-oleoyl-2-acetylglycerol declined at 60 min of incubation, that of ionomycin
      still persisted. Human sperm PKC activity is extremely low and represents only
      about 20% and 25% of the specific activity recovered from PC-12 and rat pituitary
      cells, respectively. Immunohistochemical analysis using various type-specific PKC
      antibodies revealed staining only in the equatorial segment and the principal
      piece of the tail. Thus, PKC is present in human ejaculated sperm and is involved
      in flagellar motility.

PMID- 2226334
TI  - Opposing effects of ethanol on pig ovarian adenylyl cyclase desensitized by human
      choriogonadotropin or isoproterenol.
AB  - Pig ovarian follicular membranes contain a gonadotropin-responsive adenylyl
      cyclase, which becomes partially desensitized (approximately 40%) upon a 40-min
      incubation with a saturating concentration of human (h) CG. This in vitro
      desensitization is time and hormone dependent and also requires the presence of
      micromolar concentrations of GTP. In this report we show that 10% ethanol present
      during the desensitization phase of the incubation increases the extent of hCG
      induced desensitization of adenylyl cyclase by 2-fold. Ethanol shortened the time
      necessary to reach maximal hCG-induced desensitization from 20 to 10 min, but had
      no effect on the dose dependency for GTP. In addition, ethanol had no effect on
      the affinity of the LH/hCG receptor for 125I-hCG but did cause an increase in the
      ED50 of hCG for inducing desensitization from 0.25 to 0.75 nM. Interestingly,
      ethanol decreased the apparent number of LH/hCG-receptor sites by 55%, yet the
      control hCG-sensitive adenylyl cyclase activity was not reduced. The
      "hyperdesensitized" state achieved in the presence of ethanol could not be
      reversed by washing the membranes and incubating them in ethanol-free medium. NaF
      sensitive adenylyl cyclase was also not impaired in hCG-desensitized membranes
      from control or ethanol-treated samples. Thus, hCG-induced desensitization was
      not due to a defect in the functioning of the stimulatory guanine nucleotide
      binding regulatory protein (G8) or catalytic subunits, but rather was caused by
      an impairment of the coupling of the lutropin (LH)/hCG receptor with G8, which
      was exacerbated further by ethanol. In spite of the effect of ethanol on hCG
      induced desensitization, this agent had an inhibitory effect on isoproterenol
      induced desensitization of isoproterenol-responsive luteal adenylyl cyclase.
      These results indicate that membrane fluidity is important in modulating the
      structure and functional interaction of the LH/hCG receptor with G8 because
      ethanol is a well known lipid-fluidizing agent. The resistance to ethanol
      potentiation of desensitization of the isoproterenol-sensitive adenylyl cyclase
      suggests that there are differences between the LH/hCG- and beta-adrenergic
      receptors in factors controlling their structures and or interactions with G
      proteins, and that there is a fundamental difference in their mechanisms of
      desensitization.

PMID- 2226335
TI  - Identification of prolactin-like proteins synthesized by normal murine
      lymphocytes.
AB  - Cultured murine lymphoid cells release a PRL-like immunoreactive (IR) protein
      which may be important in immunity, as anti-PRL antisera inhibit lymphocyte
      proliferation in vitro. We examined culture supernatants (SNs) and cell lysates
      from concanavalin A (Con A) activated murine thymocytes to identify these
      proteins. Western blot analysis of cell lysates revealed three specifically
      stained PRL-IRs. A doublet of bands at 35.6 and 33.6 kDa was associated with the
      particulate fraction of the cell. These PRL-IRs were present in lymphocytes
      independently of mitogen stimulation. In contrast, a 22 kDa PRL-IR was only
      produced in mitogen stimulated cells, and was specifically immunoprecipitated
      with anti-PRL antiserum. In addition, all three PRL-like IRs incorporated 35S
      methionine in vitro, indicating that they are synthesized by these cells. Only
      the 22 kDa PRL-like protein was present in culture medium from stimulated cells,
      suggesting that this may be the PRL bioactivity previously demonstrated in SNs
      from murine lymphocytes.

PMID- 2226336
TI  - Triphasic AVP secretion in encephalopathy.
AB  - A patient with encephalopathy developed triphasic changes in the clinical course,
      starting with diabetes insipidus (DI), then the syndrome of inappropriate ADH
      secretion (SIADH), and followed by the final phase of DI. The clinical course of
      encephalopathy was very rapid. The patient lost consciousness completely within
      only one day after the onset. During the early phase, he lapsed into a condition
      of "brain death". We could not identify the etiology of the encephalopathy. The
      triphasic change referred to above is similar to previous reports of cats model
      after stereotactic destruction of the supraopticohypophyseal tract. We speculate
      that our case may have been associated with neurohypophyseal dysfunction caused
      by supraopticohypophyseal tract damage.

PMID- 2226337
TI  - Epidermal growth factor stimulate cell proliferation and inhibits prolactin
      secretion of the human decidual cells in culture.
AB  - Epidermal growth factor (EGF) has been found to be mitogenic in a variety of
      tissues. We investigated the biological effect of EGF on early pregnant human
      decidua and the non-pregnant decidualized human endometrium in the primary cell
      culture. EGF had a stimulatory action on cell proliferation in the early pregnant
      decidual cells and an inhibitory effect on prolactin (PRL) secretion from the
      decidual cells. The addition of progesterone into culture medium suppressed cell
      proliferation of decidual cells, whereas it enhanced PRL secretion from decidua.
      The analysis of the specific receptor for EGF in the early pregnant decidua and
      non-pregnant decidualized endometrium revealed that both tissues had a single
      component EGF receptor with a dissociation constant of nM order. These results
      suggest that EGF may play a role in the growth and function of endometrial
      stromal cells.

PMID- 2226338
TI  - DNA replication in uterine cells of adult and prepubertal mice under normal and
      hormonally stimulated conditions detected by bromodeoxyuridine labeling method.
AB  - To confirm the utility of the bromodeoxyuridine (BrdU) labeling method in the
      study of cell proliferation in mouse uterine tissues, changes in the labeling
      index in the luminal and glandular epithelia, the periluminal, periglandular and
      deep stromal regions and the myometrium were surveyed in normal adult mice during
      the estrous cycle and early pregnancy, in prepubertal mice and in ovariectomized
      adult and young animals treated with estrogen and/or progesterone. All results
      obtained were consistent with those obtained in previous histometric and
      autoradiographic studies and proved the effectiveness of the BrdU labeling method
      in the study of the uterus as well as many other organs. A marked rise in the
      labeling index was found in the luminal epithelium at metestrus, as well as on
      the proestrous morning, indicating the occurrence of extensive cell proliferation
      in the absence of estrogen stimulation. The change in the labeling index in adult
      mice was much more evident in the luminal epithelium than in the glandular
      epithelium in all conditions examined. On the other hand, the change in the
      stroma was more eminent in the periglandular region than in the periluminal and
      deep regions in most conditions. In immature mice, a great increase in labeling
      incidence occurred not only in luminal epithelium but also in muscle layers along
      with the process of puberty and at the time of estrogen stimulation. A moderate
      increase in the incidence also occurred in all other areas of the uterus
      including the perimetrium. Again, the increase was more prominent in the
      periglandular area than in other stromal regions.

PMID- 2226340
TI  - Hypothalamic luteinizing hormone-releasing hormone (LHRH) and LH secretion in
      aging female rats.
AB  - Age-related changes in hypothalamic luteinizing hormone-releasing hormone (LHRH)
      and luteinizing hormone (LH) secretion were studied in young (6 months), middle
      aged (12 months) and old (18 months) female rats. The LHRH levels in the mid
      hypothalamic area were higher in intact middle-aged and old females than in young
      ones. Additionally, there was no age difference in the hypothalamic LHRH levels
      in male rats. In order to clarify the significance of this age-related increase
      in female rats, we examined the effects of progesterone treatment in estrogen
      primed ovariectomized young and old rats on the LHRH levels in the median
      eminence (ME) and on plasma LH levels. We found phasic changes in ME-LHRH and
      plasma LH levels in estrogen-primed rats following progesterone treatment in rats
      of both ages, but the progesterone-induced change in ME-LHRH levels tended to be
      delayed in old rats compared with young females. This delay may correspond to the
      delayed onset, slow and low magnitude of plasma LH increase in old females. The
      ME-LHRH levels were generally higher in old rats than in young rats.
      Nevertheless, we found that the increase in plasma LH in response to progesterone
      treatment in estrogen-primed ovariectomized females was smaller in old rats than
      young rats. These results suggest that the LHRH secretory mechanism changes with
      age in female rats. Such alterations may result in the accumulation of LHRH in
      the mid-hypothalamic area and an increase in ME-LHRH.

PMID- 2226339
TI  - In vivo regulation of hepatic insulin-like growth factor-1 messenger ribonucleic
      acids with thyroid hormone.
AB  - Insulin-like growth factor-1 (IGF-1) is synthesized primarily by the liver in
      response to growth hormone (GH). Thyroid hormone plays a major role in mediating
      pituitary GH secretion. In order to clarify the effect of thyroid hormone on IGF
      1 gene expression, we measured hepatic IGF-1 mRNA levels in rats with thyroid
      dysfunction. Female Wistar rats were rendered hypothyroid by surgical
      thyroidectomy or hyperthyroid by daily injections of thyroxine (12
      micrograms/day) for 2 weeks. Northern gel analysis of hepatic poly (A) RNA
      revealed the multiple sizes of the RNA transcripts ranging from 1.6 to 9.0 kb.
      After 4 weeks, hepatic IGF-1 mRNA levels were suppressed in hypothyroid rats, to
      less than 20% of control euthyroid animals. These suppressed mRNA levels were
      restored to euthyroid levels by thyroid hormone replacement for 2 weeks.
      Hyperthyroid rats, however, did not contain altered levels of hepatic IGF-1 mRNA
      as compared to euthyroid rats. The gamma-actin mRNA hybridization signal was not
      altered in hypothyroid or hyperthyroid rats. These results suggest that thyroid
      hormone regulates the in vivo expression of hepatic IGF-1 mRNA, probably through
      the mechanism of GH regulation.

PMID- 2226341
TI  - cDNA cloning of androgen-stimulated mRNAs in rat seminal vesicles: partial
      characterization of newly isolated cDNA clones, pSv-1 and pSv-2.
AB  - As the first step in surveying the molecular mechanism of androgen-responsive
      gene expression in rat seminal vesicles, the effect of androgen on the mRNAs was
      examined by in vitro translation assay. When the in vitro translation products of
      mRNAs from castrated animals (48 h) were compared with those from castrated and
      testosterone-treated animals (48 h) by SDS-PAGE, several discrete bands which
      were stimulated or repressed in response to androgen were observed in addition to
      major peptide bands of SVS IV and SVS V. From these findings, we constructed a
      partial cDNA library from the seminal vesicle poly(A +)RNAs of androgen-treated
      rats and screened by differential colony hybridization. Two distinct cDNA clones,
      pSv-1 and pSv-2, whose mRNAs were differentially stimulated in response to
      androgen and seemed to be expressed specifically in the seminal vesicles, were
      isolated. pSv-1 and pSv-2 hybridized to mRNAs of 1,600 and 3,500 nucleotides in
      length, respectively. These cDNA sequences, newly isolated in the present study,
      may provide useful probes for the study of molecular mechanism of androgen
      responsive gene expression.

PMID- 2226342
TI  - cDNA cloning of androgen-repressed mRNA in rat seminal vesicles: partial
      characterization of a cDNA clone, pSvr-1.
AB  - When the in vitro translation products of mRNAs from castrated animals (48 h)
      were compared with those from androgen-treated animals (48 h) to survey the
      molecular mechanism of androgen-responsive gene expressions in the rat seminal
      vesicles, some peptide bands which were repressed in response to androgen were
      observed. From these findings, we constructed a partial cDNA library of
      poly(A+)RNAs which had been isolated from the seminal vesicles of castrated rats
      (48 h) and modestly enriched with respect to the concentration of androgen
      repressed mRNAs by sucrose density gradient centrifugation, and screened by
      differential colony hybridization. One cDNA clone, pSvr-1, whose mRNA is markedly
      induced within 24 h after castration of the animal in the seminal vesicles as
      well as in the ventral prostate, was isolated. pSvr-1 hybridized to a mRNA of
      1,700 nucleotides in length. Partial sequence analysis showed that this clone had
      highly homologous but not identical sequences to those reported for rat sulfated
      glycoprotein-2. This cDNA clone may provide a useful probe for the study of the
      negative regulation mechanism of gene expression by androgens.

PMID- 2226343
TI  - Change in the growth hormone (GH) response to GH-releasing factor (GRF) caused by
      exogenous GH in short children.
AB  - To determine whether exogenous GH induces feedback of GH release in children,
      growth hormone-releasing factor (GRP) tests were performed before and after 10
      day GH administration. Sixteen non-obese short boys, aged 5-14 yr, with normal GH
      response to pharmacological tests were studied. Mean basal and peak serum GH
      levels in GRF tests before and after exogenous GH were not significantly
      different. The subjects were divided into two groups, A and B, according to the
      percent change in integrated areas under the GH curves in GRF tests (GH AUC)
      before and after 10-day GH administration. Group A consisted of 6 boys with
      decreased GH AUC and group B consisted of 10 boys with increased GH AUC. Mean
      peak GH in GRF tests and mean GH AUC were significantly higher before exogenous
      GH in group A than in group B. The boys in group A were all prepubertal, while 4
      boys in group B had begun their early pubertal change. The mean age in group A
      (7.8 +/- 1.8 yr) was significantly lower than that of group B (11.9 +/- 2.4 yr).
      GH AUC before exogenous GH showed a significant correlation with the percent
      change in AUC (= -0.742, p less than 0.01). These data demonstrated that the
      exogenous GH suppressed the GH response to GRF in prepubertal children with good
      response to GRF before exogenous GH, while it exaggerated the GH response to GRF
      in older children with relatively poor response before GH.

PMID- 2226344
TI  - Hyperparathyroidism associated with Cushing's syndrome due to an adrenal cortical
      adenoma.
AB  - Two patients with the rare association of Cushing's syndrome and primary
      hyperparathyroidism are reported. Initially, both patients suffered from
      Cushing's syndrome due to adrenal cortical adenomas with typical features and
      laboratory findings. Five years after treatment of the Cushing's syndrome by
      removal of the tumor, asymptomatic mild hypercalcemia was incidentally noticed in
      both patients, which suggested the occurrence of primary hyperparathyroidism. An
      enlarged parathyroid gland was removed surgically in both cases and was
      histologically shown to be a parathyroid adenoma. The levels of serum calcium
      returned to normal after parathyroidectomy. Papillary adenocarcinoma of the
      thyroid in one patient and adenomatous goiter in the other were also incidentally
      detected at operation. These findings suggest that Cushing's syndrome resulting
      from an adrenal cortical adenoma may be another presentation of multiple
      endocrine neoplasia type I.

PMID- 2226345
TI  - Plasma growth hormone, insulin-like growth factor-I, and milk production
      responses to exogenous human growth hormone-releasing factor analogs in dairy
      cows.
AB  - Responses of plasma growth hormone (GH) and insulin-like growth factor-I (IGF-I),
      and milk production to subcutaneous (sc) injection(s) of two synthetic human
      growth hormone-releasing factor (hGRF) analogs were studied in dairy cows. Two mg
      of each hGRF analog dissolved in 5 ml saline per cow were injected into the
      shoulder area of each experimental animal, and jugular venous blood samples were
      collected via an indwelling catheter or by venipuncture. Plasma GH and IGF-I
      concentrations were measured by radioimmunoassay methods. In dry cows, the mean
      concentration of plasma GH after a single sc injection of hGRF analogs rose to
      22.0-28.3 ng/ml at about 5 h from 1.4-1.7 ng/ml at 0 h (just before injection),
      and returned to the level before injection after 10-12 h. On the other hand, the
      plasma IGF-I began to increase after a lag of 4-6 h following a single injection
      of hGRF analogs, and reached maximum values of 71.1-89.4 ng/ml at 20 h from 43.7
      46.4 ng/ml at 0 h. The IGF-I concentration at 24 h after a single injection of
      hGRF analogs was still higher than the value for the dry cows given saline. In
      lactating cows, the plasma concentration of GH at 2 h after daily sc injections
      of hGRF analogs during 14 consecutive days (an injection period) was higher than
      those for the lactating cows which received saline. Also, during the injection
      period, the concentration of IGF-I was higher in the lactating cows which
      received hGRF analog injections than in the cows which received saline
      injections. During the last 7 days of the injection period, the administration of
      hGRF analogs increased the mean milk yield by 11-19% in comparison with those for
      the saline injected cows. A positive correlation was observed between the mean
      plasma IGF-I concentration and the mean milk yield in the lactating cows treated
      with hGRF analogs throughout the injection and a postinjection (11 consecutive
      days after cessation of hGRF analog injection) periods. The results demonstrate
      that a single sc injection of hGRF analogs stimulates both GH release and the
      circulating level of IGF-I in dry cows, and that daily sc injections of hGRF
      analogs over 14 days enhance milk production, and plasma GH and IGF-I levels in
      lactating cows.

PMID- 2226346
TI  - The participation of sterol carrier protein2 in cholesterol esterification in rat
      adrenal microsomes.
AB  - The effect of sterol carrier protein2 (SCP2) purified from rat liver on the
      formation of cholesterol esters by acyl-CoA: cholesterol acyl-transferase (ACAT:
      EC 2.3.1.26) in rat adrenal microsomes was studied. The rate of incorporation of
      [1-14C]oleoyl-CoA into cholesteryl oleate was determined in the presence or
      absence of exogenously added cholesterol or SCP2, or both. The addition of SCP2
      had no effect on the formation of cholesterol esters from endogenous cholesterol
      by ACAT in rat adrenal microsomes. In contrast, the formation of cholesterol
      esters from exogenous cholesterol by ACAT was dose-dependently increased by the
      addition of SCP2. These experiments showed that SCP2 had an enhancing effect on
      cholesterol esterification by ACAT in rat adrenal microsomes most likely by
      modulating the availability of exogenous cholesterol and that SCP2 may
      participate in the formation of cholesterol esters in the rat adrenal gland.

PMID- 2226347
TI  - Effects of sc administration of recombinant human insulin-like growth factor I
      (IGF-I) on normal human subjects.
AB  - Recombinant human insulin-like growth factor I (IGF-I) was administered
      subcutaneously to each of 5 normal human subjects at doses of 0 mg/kg (control),
      0.06 mg/kg, or 0.12 mg/kg successively at one week intervals. After 0.06 mg/kg or
      0.12 mg/kg IGF-I injections, plasma IGF-I levels increased from 185 +/- 17 ng/ml
      (mean +/- SEM) to maximal levels of 396 +/- 21 ng/ml at 3 hours and from 169 +/-
      14 ng/ml to 480 +/- 27 ng/ml at 4 hours, respectively. These two peak values were
      statistically different (p less than 0.05). After 0.06 mg/kg and 0.12 mg/kg IGF-I
      administration, blood glucose levels decreased from 85 +/- 2 mg/dl to minimal
      levels of 73 +/- 3 mg/dl at 3 hours and from 83 +/- 1 mg/dl to 50 +/- 4 mg/dl at
      2 hours, respectively. These two minimal values were statistically different (p
      less than 0.001). Serum insulin and C-peptide levels were decreased in a dose
      dependent manner after IGF-I administration. There were no changes between blood
      urea nitrogen levels before and 4 hours after IGF-I administration. The urinary
      GH concentration decreased after 0.06 mg/kg IGF-I administration, but increased
      and maintained normal values after 0.12 mg/kg IGF-I administration.

PMID- 2226348
TI  - The tissue matrix: cell dynamics and hormone action.

PMID- 2226349
TI  - Metabolism and effects of epidermal growth factor and related growth factors in
      mammals.
AB  - The initial observations of Stanley Cohen in the 1960s established that EGF
      induced in vivo effects such as precocious eyelid opening and tooth eruption.
      Subsequently the actions of EGF have been extensively explored in cell culture
      systems. The receptor for EGF was characterized as a prototype model for other
      growth factors and the now extensive in vitro data indicate multiple functions
      for EGF. Moreover, EGF and EGF receptors have been characterized in many tissues,
      and EGF has been identified in most body fluids of several mammalian species.
      Interestingly, neither EGF antibody administration to newborn animals nor passive
      immunization of pregnant rodents against EGF has caused major deleterious effects
      (except the delay in epidermal maturation events), as might be expected from the
      in vitro studies. This is in contrast to the effects of nerve growth factor
      antiserum in developing rodents. Also, to date, no pathological EGF deficiency
      disorder has been characterized. However, the EGF family of growth factors
      appears to be important in mammalian development and function, although the
      precise roles and significance are not yet clear. Members of the family may have
      a role in embryogenesis and fetal growth since receptors have been identified in
      fetal tissues. Available evidence suggests that TGF alpha subserves the growth
      factor family roles in fetal development. In the developing postnatal animal pro
      EGF mRNA, immunoreactive EGF, immunoreactive TGF alpha, and EGF receptors are
      present in many tissues. EGF also is produced and secreted by the maternal
      mammary gland, and mammary derived EGF appears to be important in gut development
      in the neonatal rodent. There is now extensive data to indicate important hormone
      EGF interactions. In the postnatal period, thyroid and steroid hormones including
      retinoic acid have been shown to modulate EGF and/or EGF receptors in several
      tissues. GH increases EGF binding in liver and increases urine EGF
      concentrations. Moreover, EGF stimulates secretion of several hypothalamic and
      pituitary hormones, increases placental production of hCG and human chorionic
      somatomammotropin, increases adrenal cortisol production, and inhibits
      testicular, ovarian, and thyroid hormone secretions. As summarized in this review
      EGF has been implicated in a number of developmental events including palate and
      skin differentiation, growth of hair follicles, eye opening and tooth eruption,
      lung maturation, gut and liver growth, and differentiation of neurons. These EGF
      actions probably are mediated via autocrine, paracrine, and endocrine routes. A
      role for salivary and urine EGF in the maintenance of adult stomal, gut, and
      urinary epithelial surface integrity seems likely, although not yet
      proven.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2226350
TI  - Uterine insulin-like growth factor-1: regulation of expression and its role in
      estrogen-induced uterine proliferation.

PMID- 2226351
TI  - The potential relevance of cytokines to ovarian physiology: the emerging role of
      resident ovarian cells of the white blood cell series.

PMID- 2226352
TI  - Effect of transforming growth factor beta on synthesis of glycosaminoglycans by
      human lung fibroblasts.
AB  - The processes of lung growth, injury, and repair are characterized by alterations
      in fibroblast synthesis and interstitial distribution of extracellular matrix
      components. Transforming growth factor beta (TGF-beta), which is postulated to
      play a role in modulating lung repair, alters the distribution of several matrix
      components such as collagen and fibronectin. We studied the effect of TGF-beta on
      the synthesis and distribution of the various glycosaminoglycans (GAGs) and
      whether these effects may explain its role in lung repair. Human diploid lung
      fibroblasts (IMR-90) were exposed to various concentrations of TGF-beta (0-5 nM)
      for variable periods of time (0-18 h). Newly synthesized GAGs were labeled with
      either [3H]glucosamine or [35S]sulfate. Individual GAGs were separated by size
      exclusion chromatography after serial enzymatic and chemical digestions and
      quantitated using scintillation counting. There was a dose-dependent increase in
      total GAG synthesis with maximal levels detected after 6 h of exposure. This
      increase was noted in all individual GAG types measured and was observed in both
      the cell associated GAGs (cell-matrix fraction) as well as the GAGs released into
      the medium (medium fraction). In the cell-matrix fraction, TGF-beta increased the
      proportion of heparan sulfate that was membrane bound as well as the proportion
      of dermatan sulfate in the intracellular compartment. In the medium fraction, TGF
      beta increased the proportion of hyaluronic acid, chondroitin sulfate and
      dermatan sulfate released. We conclude that the role of TGF-beta in lung growth
      and repair may be related to increased synthesis of GAGs by human lung
      fibroblasts as well as alterations in the distribution of individual GAGs.

PMID- 2226353
TI  - Conditioned medium from irradiated bovine pulmonary artery endothelial cells
      stimulates increased protein synthesis by irradiated bovine lung fibroblasts in
      vitro.
AB  - Pulmonary fibrosis, a potentially fatal consequence of radiation exposure, occurs
      by unknown mechanisms. The hypothesis that endothelial cells, injured by
      radiation, could alter the biochemical function of lung fibroblasts, was tested
      by exposing cultures of bovine pulmonary artery endothelial cells to 0 or 5 Gy
      radiation and then incubating them in fresh medium for 48 h. This endothelial
      cell conditioned medium (ECCM) was then applied to irradiated or nonirradiated
      cultures of bovine lung fibroblasts. Forty-eight hours later the fibroblasts were
      analyzed for their ability to synthesize DNA and protein. The ECCM from injured
      cells stimulated fibroblast protein synthesis twofold to threefold in irradiated
      fibroblasts without increasing DNA synthesis. It also stimulated a significant
      but less marked increase in protein synthesis in nonirradiated fibroblasts. Two
      dimensional gel electrophoresis revealed this increased synthesis to be expressed
      in less than 10% of the 1100 separable fibroblast proteins. This study shows that
      endothelial cells injured by radiation produce factors that stimulate injured
      fibroblasts to markedly increase their synthesis of certain intracellular
      proteins, while not stimulating fibroblast replication.

PMID- 2226354
TI  - Body temperature alters the lipid composition of pulmonary surfactant in the
      lizard Ctenophorus nuchalis.
AB  - In any 24-h period the body temperature (Tb) of the central Australian agamid
      lizard, Ctenophorus nuchalis, may vary from 13 to 45 degrees C; the mean
      preferred Tb is 37 degrees C. We have analyzed surfactant-type lipids in lizards
      that underwent rapid changes in Tb from 37 degrees C to 14, 19, 27, or 44 degrees
      C. Lipids were extracted from lung lavage and lamellar body fractions, and
      phospholipids and cholesterol components were measured. There was no change in
      either the total amount or relative proportions of the different classes of
      phospholipids, but cooling increased the cholesterol content of lavage. An
      increase in the cholesterol: phospholipid ratio was evident within 2 h of cooling
      to 19 degrees C and was maintained for at least 48 h. The ratio increased from 8%
      at 37 degrees C, to 15% after 4 h at 19 degrees C, and 18% after 4 h at 14
      degrees C. Possibly the increase in cholesterol promotes fluidity and absorption
      of surfactant within the alveoli of lizards with low Tb. Cold lizards collapse
      their lungs during prolonged periods of apnea and the surfactant may prevent the
      epithelial walls from adhering.

PMID- 2226356
TI  - Gestational variation of glycerophosphate acyltransferase activity in maternal
      guinea pig lung and possible role of thyroid hormone in its de novo synthesis.
AB  - We have observed earlier that the pattern of gestational variation of microsomal
      glycerophosphate acyltransferase (GAT) activity is similar in maternal and fetal
      guinea pig lung. Furthermore, there is a close resemblance between these patterns
      and that of the gestational variation of fetal plasma thyroid hormone. It is
      known that triiodothyronine (T3) injected to pregnant rats can cross the placenta
      to some extent and cause an increase in phosphatidylcholine synthesis in fetal
      lung. It is possible, therefore, that the gestational increase of GAT activity in
      maternal and fetal lung is associated with an increase in maternal plasma thyroid
      hormone. The objective of this study was to investigate whether intramuscular
      injection of T3 to adult guinea pig causes any change in the activity of GAT in
      lung and, if so, to determine the mechanistic basis. The results indicated that
      T3 significantly increased the GAT activity in the microsomes but not in the
      mitochondria. Actinomycin D or cycloheximide abolished the hormone-mediated
      stimulation of the enzyme in the microsomes, suggesting that T3 is involved in
      both transcriptional and translational pathways of GAT synthesis. We also
      confirmed our previous preliminary finding that there is a gestational variation
      of GAT activity in maternal guinea pig lung and furthermore the increase in GAT
      activity during pregnancy is predominantly in the microsomes.

PMID- 2226355
TI  - Migratory behaviors of alveolar macrophages during the alveolar clearance of
      light to heavy burdens of particles.
AB  - We investigated the unstimulated and stimulated migratory activities of lavaged
      alveolar macrophages (AMs) in vitro over the course of alveolar clearance of
      three different mass lung burdens of microspheres. Our intent was to uncover
      potentially important relationships between the migratory behaviors of the AM and
      the retention kinetics of particles. Groups of adult, male Fischer-344 rats were
      intratracheally instilled with approximately 86 micrograms (low burden, LB),
      approximately 1 mg (medium burden, MB), or approximately 3.7 mg (high burden, HB)
      of polystyrene microspheres (2.13 microns diameter), or with carrier vehicle
      (phosphate buffered saline, PBS) alone. The lung retention kinetics of the
      particles were determined over an approximately 170 day period. On days 14,
      approximately 57, and approximately 85, lavaged AMs were assessed for their
      abilities to migrate through 5-microns pore membranes in response to inactivated
      rat serum (unstimulated condition) and yeast-activated rat serum (stimulated
      condition). The retention characteristics of the three burdens could be
      satisfactorily described by two-component, negative exponential equations. The
      kinetics of retention of the LB and MB were similar, although some evidence
      indicated the MB slightly retarded the lung clearance process. Deposition of the
      HB resulted in more marked prolongations of both the early, more rapid, and the
      slower, longer term components of alveolar clearance. The unstimulated migration
      indices of AMs from the particle-instilled lungs were generally not significantly
      different from those of AMs from PBS-instilled lungs except for a significant
      increase in the migration indices of LB AMs at the last assay time. The
      stimulated migration indices of MB and HB AMs were significantly decreased on
      assay days 14 and approximately 57. On day approximately 85, however, the
      migration indices of LB, MB, and HB AMs were all increased above the PBS AMs.
      Comparisons of the frequency distributions of particles in the unstimulated and
      stimulated AM that migrated to those in corresponding parent AM populations
      consistently indicated a preferential migration of particle-free AMs and of AMs
      with lesser loads of microspheres. The overall results of this study suggest that
      the unstimulated and stimulated migratory activities of particle-laden AMs are
      depressed in vitro. Our results also suggest that the migratory activities of
      generally particle-free AMs may be enhanced over a prolonged period of time
      following the deposition of particles in the lung.

PMID- 2226357
TI  - Fluorescence polarization changes with gestational age in amniotic fluid of
      rabbit and guinea pig.
AB  - The variation of amniotic fluid microviscosity with gestational age was measured
      in rat, rabbit, and guinea pig. In rat, the changes followed the same pattern as
      known for women, microviscosity being high during early and mid-gestation and
      markedly lowering 12 h before delivery. Surprisingly, an opposite trend was
      observed in rabbit and guinea pig amniotic fluid. Moreover, the lecithin to
      sphingomyelin ratio markedly rose in late gestation in all species considered.
      Qualitative and quantitative analysis of lipids and phospholipids were performed
      in woman and rabbit amniotic fluids at early and late gestational ages. Among all
      the parameters measured, the most important differences that can influence the
      amniotic fluid microviscosity are the presence of very high levels of
      lysophosphatidylcholine both in early and late gestation in rabbit (much higher
      than in woman) and the cholesterol to total phospholipid ratio which decreased
      with gestational age in woman but remained stable in rabbit. The Arrhenius plot
      of the logarithm of microviscosity against the reciprocal of absolute temperature
      of mature and immature amniotic fluids from woman and rabbit was also determined.
      The temperature profiles confirmed the differences in lipid profile between woman
      and rabbit in early and late gestation which could be quantified on a
      physicochemical basis by determining the activation energy (delta E) at 25
      degrees and 37 degrees C for each curve. This confirmed the opposite patterns in
      woman and rabbit and showed that amniotic fluid from the immature rabbit was the
      most fluid.

PMID- 2226358
TI  - Uptake and metabolism of endothelin in the isolated perfused rat lung.
AB  - The uptake and metabolism of endothelin was studied in the isolated perfused rat
      lung. 125I-Labeled endothelin (4 x 10(-12) M) was rapidly removed from the lung
      perfusate. More than 90% of the label was removed by 5 min, and only 4-5%
      remained in the perfusate after 30 min. In the presence of 10(-9) or 5 x 10(-9) M
      unlabeled endothelin added 6 min before 125I-labeled endothelin, the radiolabel
      was more slowly removed, so that after 30 min 19 or 73% of the label,
      respectively, remained in the perfusate. Although a high level of unlabeled
      endothelin in the perfusate reduced the uptake of 125I-labeled endothelin, it did
      not displace radiolabel previously taken up by the lung. Analysis of radiolabel
      composition showed that endothelin metabolism was less than 15% in both the lung
      and the perfusate after 30 min of lung perfusion. Autoradiography of the lung
      indicated that the radiolabel was located primarily within the alveolar wall.
      These results suggest that circulating endothelin is readily but finitely taken
      up in the pulmonary microvasculature where it is avidly bound but slowly
      metabolized.

PMID- 2226359
TI  - Inhibition of porcine pancreatic elastase-induced emphysema by eglin-c.
AB  - Eglin-c, a compound that inhibits rat elastase but has little effect on porcine
      pancreatic elastase (PPE), was employed to examine the role of endogenous
      elastase in PPE-induced emphysema. Twenty-four female Long-Evans rats were
      divided into three groups: control (n = 8), PPE (n = 9), and PPE + eglin-c (n =
      7). Eglin-c (9 mg/rat) was intratracheally instilled 3 days after PPE treatment,
      twice weekly, until 3 days before pulmonary function testing. Function tests and
      lung fixation for morphometric analysis were carried out 15-34 days after PPE
      treatment. Intratracheal instillation of PPE (400 IU/kg) produced significant
      increases in functional residual capacity, dynamic and quasi-static compliances,
      total lung capacity (TLC), and mean linear intercept (MLI), as well as a
      significant decrease in carbon monoxide diffusion coefficient. However, no
      significant alterations in quasi-static compliance, TLC, or MLI were found in
      animals treated with PPE and eglin-c. Three additional groups were used to
      examine the effects of intratracheal instillation of saline or eglin-c: control
      (n = 9), saline (n = 8), and eglin-c (n = 10). No significant change in any
      respiratory parameter was found in either the saline or the eglin-c group,
      indicating no detectable alteration in pulmonary function caused by either the
      intratracheal procedure or eglin-c. These data suggest that endogenous elastase
      is an important contributing factor in the development of PPE-induced emphysema
      in the rat.

PMID- 2226361
TI  - Vagus nerve stimulation for the control of epilepsy. Proceedings of a symposium
      held in conjunction with the American Epilepsy Society annual meeting. Boston,
      Massachusetts, December 2, 1989.

PMID- 2226360
TI  - Anatomical, physiological, and theoretical basis for the antiepileptic effect of
      vagus nerve stimulation.
AB  - The vagus is a mixed nerve carrying somatic and visceral afferents and efferents.
      The majority of vagal nerve fibers are visceral afferents and have a wide
      distribution throughout the central nervous system (CNS) either monosynaptically
      or via the nucleus of the solitary tract. Besides activation of well-defined
      reflexes, vagal stimulation produces evoked potentials recorded from the cerebral
      cortex, the hippocampus, the thalamus, and the cerebellum. Activation of vagal
      afferents can depress monosynaptic reflexes, decrease the activity of
      spinothalamic neurons, and increase pain threshold. Depending on the stimulation
      parameters, vagal afferent stimulation in experimental animals can produce
      electroencephalographic (EEG) synchronization or desynchronization and has been
      shown to affect sleep states. The desychronization of the EEG appears to depend
      on activation of afferent fibers that have conduction velocities of less than or
      equal to 15 m/s. Vagal afferent stimulation can also influence the activity of
      interictal cortical spikes produced by topical strychnine application, and either
      attenuate or stop seizures produced by pentylenetetrazol, 3-mercaptoproprionic
      acid, maximal electroshock, and topical alumina gel. The mechanisms for the
      antiepileptic effects of vagal stimulation are not fully understood but probably
      relate to effects on the reticular activating system. The vagus provides an
      easily accessible, peripheral route to modulate CNS function.

PMID- 2226362
TI  - Feasibility and safety of vagal stimulation in monkey model.
AB  - The feasibility, safety, and preliminary effects of chronic vagal stimulation
      were studied in an aluminagel monkey model. Pilot studies to perfect the
      equipment, determine stimulation thresholds, and insure the comfort and safety of
      the animals preceded this study. Four monkeys were equipped with an indwelling, 2
      electrode cuff (titanium bands spaced 7 mm apart; silicone encased; 1.5 cm total
      length) in contact around the right vagus nerve; avoidance of the cardiac branch
      was confirmed by electrocardiograms. After postsurgical recovery, the intact and
      awake animals received constant-current stimulation (5 mA; 83 Hz, 143 Hz, or 50
      250 Hz randomly; 0.5-ms pulse width) at the onset of every spontaneous seizure
      for the duration of the seizure or every 3 h for 40 s if stimulation had not
      occurred in the preceding hour. Stimulation periods of 2-6 weeks, with differing
      levels of stimulation, were preceded and followed by at least a 2-week baseline
      period of no stimulation. During the stimulation periods, the seizure rate
      decreased to zero in two monkeys and the interseizure intervals became invariable
      in the remaining two monkeys. These effects carried over temporarily into the
      poststimulation baseline periods. Vagal stimulation had no consistent effects on
      seizure severity or EEG interictal spikes. Histological studies of six vagus
      nerves were unable to separate electrode cuff damage from any direct effects
      stimulation may have had on the nerves. Although it appears that chronic vagal
      stimulation is feasible and that epileptogenic processes are influenced, the
      safety and efficacy of the procedure are still in question.

PMID- 2226363
TI  - Considerations for safety with chronically implanted nerve electrodes.
AB  - Electrical stimulation of cranial and peripheral nerves has been used to
      ameliorate a variety of neurologic disease states and neural injuries over the
      past 20 years. In this review, clinical applications and the histopathologic
      results of chronic implants in animals and humans are discussed, and the results
      of neural damage models developed at Huntington Medical Research Institutes are
      summarized. Chronically implanted electrode arrays may produce neural injury by
      either mechanical factors or by continuous, high-frequency electrical
      stimulation. The margin of safety to avoid electrically induced injury may be
      increased by minimizing the frequency or total stimulation time, and by the use
      of an intermittent duty cycle. The protocols presently being used for the
      stimulation of the vagus nerve to effect inhibition of seizures appear to have an
      adequate margin of safety.

PMID- 2226364
TI  - An implantable neurocybernetic prosthesis system.
AB  - The neurocybernetic prosthesis (Cyberonics, Inc.) is an implantable,
      multiprogrammable pulse generator that delivers constant current electrical
      signals to the vagus nerve for the purpose of reducing the frequency and/or
      severity of epileptic seizures. The device is implanted in a subcutaneous chest
      pocket just below the clavicle, similar to cardiac pacemaker placement. The
      stimulation signal is transmitted from the prosthesis to the vagus nerve through
      a stimulation lead. The prosthesis can be programmed using any IBM-compatible
      personal computer with programming software and a programming wand. The
      electrodes used in the first group of patients were found to break at an
      unacceptable rate. Design modifications appear to have resolved this problem.

PMID- 2226365
TI  - Surgical technique for implantation of the neurocybernetic prosthesis.
AB  - The surgical technique for the implantation of the neurocybernetic prosthesis is
      described in detail. This procedure is straightforward and is easily carried out
      by surgeons familiar with carotid surgery.

PMID- 2226366
TI  - Efficacy and safety of vagus nerve stimulation in patients with complex partial
      seizures.
AB  - A clinical trial of chronic intermittent vagal stimulation in five patients
      suggests that the procedure may be safe and effective as adjunctive treatment of
      medically intractable seizures of partial onset. Patients tolerated well the
      implantation of the neurocybernetic prosthesis and the vagal stimulation without
      serious physiological or lifestyle changes. Stimulation of the vagus nerve either
      reduced the seizure frequency or decreased the duration or intensity of seizures.
      Adverse side effects were limited to a tingling sensation in the throat and
      hoarseness during stimulation. A major complication was mechanical interruption
      of the wire-electrode circuitry, with consequent cessation of stimulation. The
      small number of patients and the relatively short follow-up period make this a
      pilot study, but the results are promising.

PMID- 2226367
TI  - Vagus nerve stimulation in humans: neurophysiological studies and
      electrophysiological monitoring.
AB  - Evidence from studies of experimental animals indicates that electrical
      stimulation of the vagus nerve alters behavioral and electrographic seizure
      activity. We report on effects of electrical stimulation of the vagus nerve in
      five patients with medically intractable seizures as part of a clinical trial of
      chronic vagal stimulation for control of epilepsy. The mechanism of action of the
      vagal antiepileptic effect is unknown, and it is hoped that analysis of
      electrophysiological effects of vagal nerve stimulation will help elucidate which
      brain areas are affected. Stimulation of the left vagus nerve in the neck was
      accomplished with a programmable implanted stimulator. Effects of stimulus
      amplitude, duration, and rate were studied. Noncephalic reference recording of
      the vagus-nerve-evoked potential showed some unusual properties: a scalp negative
      component occurred with latency of 12 ms, very high amplitude (up to 60 microV),
      and widespread scalp distribution. Field distribution studies indicate that this
      potential is generated in the neck, in the region of the stimulating electrodes.
      Muscle paralysis confirms this observation. Stimulation at various frequencies
      had no noticeable effect on electroencephalographic (EEG) activity regardless of
      whether the patient was under general anesthesia, awake, or asleep.

PMID- 2226368
TI  - Effects of vagal stimulation on experimentally induced seizures in rats.
AB  - Repetitive stimulation of the vagus nerve inhibits chemically induced seizures in
      dogs. We report here the results and conclusions from studies designed to answer
      some of the immediate questions raised by this finding. (1) Maximal stimulation
      of vagal C fibers at frequencies greater than 4 Hz prevents or reduces chemically
      and electrically induced seizures in young male rats. (2) Antiepileptic potency
      is directly related to the fraction of vagal C fibers stimulated. (3) Vagal
      stimulation shortens but does not shut down a chemical seizure once it has begun.
      (4) In rats, optimal stimulus frequency is approximately 10-20 Hz; duration of
      stimulus, 0.5-1 ms; and stimulus strength, 0.2-0.5 mA/mm2 of nerve cross-section.
      These results, when taken together with similar results obtained from dogs,
      monkeys, and humans, strongly suggest that periodic stimulation of the vagus
      nerve using appropriate stimulation parameters is a powerful method for
      preventing seizures. The data from the literature suggest that the antiepileptic
      actions of vagal stimulation are largely mediated by widespread release of GABA
      and glycine in the brainstem and cerebral cortex. The probable pathway is via
      projections from the nucleus of the solitary tract to the reticular formation and
      thence by diffuse projections to the cortex and other areas. Intermittent vagal
      stimulation has the potentiality of reducing the number and/or the intensity of
      seizures in patients with intractable epilepsy. These results indicate that
      feasibility studies in humans should be continued and expanded.

PMID- 2226369
TI  - Epileptic syndromes: genetic, diagnostic, and therapeutic aspects. Ninth annual
      Merritt-Putnam Symposium. December 7, 1989, Boston, Massachusetts. Proceedings.

PMID- 2226370
TI  - The epilepsies: clinical implications of the international classification.
AB  - From the earliest days of neurology, the classification of epileptic seizures
      into those generalized from the beginning and those with a definable localization
      in the cortex from the onset has added to knowledge about the function of the
      nervous system. Further elaboration of the classification of seizures into those
      localized to the six-layered isocortex and those whose elaboration involves
      regions of the brain involved with consciousness and memory has provided the
      basic focus for the burgeoning subspecialty of epilepsy surgery. It is
      increasingly apparent that the etiology of a seizure disorder is of at least
      equal or of greater significance than the nature of the seizures it spawns and is
      the product not only of localization in the nervous system but also of causative
      factors with implications reaching into areas of genetics, higher cortical
      function, and intelligence. The prognosis concerning the outcome of the epilepsy
      under consideration is based on all of these facets. This pathophysiological
      substratum, of which the seizure is only the presenting symptom, constitutes the
      epilepsy or epileptic syndrome on which the formulation of a rational treatment
      plan is based.

PMID- 2226371
TI  - Experimental models of temporal lobe epilepsy: new insights from the study of
      kindling and synaptic reorganization.
AB  - Temporal lobe epilepsy is a common localization-related epileptic syndrome
      characterized by complex partial seizures, ictal and interictal epileptic
      discharges arising from limbic structures of the temporal lobe, and association
      with hippocampal sclerosis. Temporal lobe epilepsy may follow perinatal injury
      and febrile convulsions, may be progressive, and frequently becomes refractory to
      standard antiepileptic therapy. The neurobiology that underlies these features of
      temporal lobe epilepsy is not known. Recent studies in experimental models have
      provided new insights that may help clarify the relationship of seizures,
      hippocampal sclerosis, and temporal lobe epilepsy. Observations from the study of
      the hippocampus with kainic acid-induced lesions, the kindling model, and other
      experimental models of epilepsy have demonstrated that seizures induce structural
      and electrophysiologic alterations in hippocampal pathways that may lead to
      increased excitability and could play a role in the development and progression
      of temporal lobe epilepsy. These alterations include mossy fiber synaptic
      reorganization, induction of NMDA-mediated synaptic transmission, and progressive
      hippocampal neuronal loss induced by brief kindled seizures. Some of the
      structural alterations induced by kindling have also been observed in the human
      epileptic temporal lobe, raising the possibility that mechanisms operative in
      kindling may play a role in the pathogenesis of hippocampal sclerosis and in the
      syndrome of human temporal lobe epilepsy.

PMID- 2226372
TI  - Mesial temporal sclerosis: pathogenesis, diagnosis, and management.
AB  - Mesial temporal sclerosis (MTS) is probably the most common symptomatic
      pathologic entity--alone or mixed with other pathologic features--for seizures of
      temporal lobe origin. The pathophysiology of MTS, including any genetic
      influence, needs clarification. A characteristic ictal expression for seizures of
      MTS origin appears not to exist. The majority of patients (78%) with
      postresection MTS who are seizure-free have tightly localized interictal
      abnormalities restricted to F7/F8, Sp1/Sp2, T3/T4, and T5/T6 more than 96% of the
      time. MRI abnormalities may be seen in 55% of patients with MTS if both "hard"
      and "soft" criteria are used or in 20% when only "hard" criteria are used. The
      neuropsychologic evaluation of patients with MTS, which includes intracarotid
      amobarbital test (IAT), may prove to be increasingly useful in identifying
      patterns of cognitive deficit that correlate with enhancement of both
      lateralizing and localizing preoperative information.

PMID- 2226373
TI  - Post-traumatic epilepsy: cellular mechanisms and implications for treatment.
AB  - Epilepsy complicates severe head trauma. Development of persistent seizures
      appears to correlate with the extent of trauma. Although early reports suggested
      that prophylactic administration of antiepileptic drugs would prevent
      epileptogenesis, controlled studies have failed to corroborate this assumption.
      Head trauma initiates a sequence of responses that includes altered blood flow
      and vasoregulation, disruption of the blood-brain barrier, increases in
      intracranial pressure, focal or diffuse ischemia, hemorrhage, inflammation,
      necrosis, and disruption of fiber tracts. The presence of an intracranial
      hematoma has a robust association with the development of post-traumatic
      epilepsy. Extravasation of blood is followed by hemolysis and deposition of heme
      containing compounds into the neuropil, initiating a sequence of univalent redox
      reactions and generating various free radical species, including superoxides,
      hydroxyl radicals, peroxides, and perferryl ions. Free radicals initiate
      peroxidation reactions by hydrogen abstraction from methylene groups adjacent to
      double bonds of fatty acids and lipids within cellular membranes. Intrinsic
      enzymatic mechanisms for control of free radical reactions include activation of
      catalase, peroxidase, and superoxide dismutase. Steroids, proteins, and
      tocopherol also terminate peroxidative reactions. Tocopherol and selenium are
      effective in preventing tissue injury initiated by ferrous chloride and heme
      compounds. Treatment strategies for prevention or prophylaxis of post-traumatic
      epilepsy must await absolute knowledge of mechanisms. Antioxidants and chelators
      may be useful, given the speculation that peroxidative reactions may be an
      important component of brain injury responses. However, potential treatment
      strategies involving gamma-aminobutyric acid (GABA) agonists, NMDA receptor
      antagonists, and barbiturates need further scientific assessment.

PMID- 2226374
TI  - The case for a National Association of Physicians for the Environment.

PMID- 2226375
TI  - In memoriam Norton Nelson.

PMID- 2226376
TI  - Basic mechanisms leading to focal emphysema in coal workers' pneumoconiosis.
AB  - Coal miners develop focal emphysema characterized by dilatation of second- and
      third-order respiratory bronchioles with coal mine dust-laden macrophages
      infiltrating the wall. A reticulin network with small amounts of collagen and
      atrophy of smooth muscle occurs. To evaluate the mechanisms of lung injury
      associated with this lesion, 17 long-term non- or ex-smoking West Virginia
      underground coal miners underwent bronchoalveolar lavage (BAL) and were compared
      to healthy nonsmoker and smoker controls. The coal miners had evidence of an
      alveolar macrophage-neutrophil alveolitis with a significant increase in
      neutrophils/microliter of epithelial lining fluid and an increased gallium lung
      scan index (206 +/- 26 units). Alveolar macrophages lavaged from coal miners
      spontaneously released exaggerated amounts of superoxide anion and hydrogen
      peroxide in vitro compared to nonsmoking controls. Coal workers had significantly
      elevated levels of neutrophil elastase in BAL fluid complexed with alpha 1
      antitrypsin (P less than 0.01) and normal levels of alpha 1-antitrypsin. An
      accumulation of activated, dust-laden inflammatory cells with increased release
      of oxidants and elastase may contribute to the development of focal emphysema
      identified at postmortem in miners with coal workers' pneumoconiosis.

PMID- 2226377
TI  - Pathways of human exposure to arsenic in a community surrounding a copper
      smelter.
AB  - Several studies have found elevated levels of urinary arsenic among residents
      living near a copper smelter in Tacoma, Washington. To assess pathways of
      exposure to arsenic from the smelter, biological and environmental samples were
      collected longitudinally from 121 households up to 8 miles from the smelter. The
      concentration of inorganic and methylated arsenic compounds in spot urine samples
      was used as the primary measure of exposure to environmental arsenic. Urinary
      concentration of arsenic dropped off to a constant background level within one
      half mile of the smelter in contrast to environmental concentrations, which
      decreased more steadily with increasing distance. Among all age-sex-specific
      groups in all areas, only children ages 0-6 living within one-half mile of the
      smelter had elevated levels of arsenic in urine. A separate analysis of data for
      these children suggests that hand-to-mouth activity was the primary source of
      exposure. Inhalation of ambient air and resuspension of contaminated soil were
      not important sources of exposure for children or adults.

PMID- 2226378
TI  - Retention of lead and cadmium in prehistoric and modern human teeth.
AB  - In 5000-year-old premolars from Nubia and in 500-year-old teeth from Greenland,
      the lead concentrations were very low; modern teeth contained 10-100 times more
      lead. In contrast, cadmium concentrations varied by 30-fold in the two
      prehistorical populations; modern-day cadmium levels were in the lower range of
      this interval. These data suggest that, when compared to preindustrial exposures,
      the impact of current environmental lead pollution is considerable, while that of
      cadmium pollution is much less.

PMID- 2226379
TI  - Effects of the organophosphorus pesticide fenitrothion on behavior and
      reproduction in zebra finches.
AB  - Activity was significantly altered in zebra finch pairs orally dosed with
      fenitrothion insecticide at rates of 1.04 and 3.80 mg/kg. Both the level and the
      dirunal pattern of activity were affected. Recovery of normal activity required 1
      2 days, depending on the dosage administered. Fenitrothion had only a slight
      effect on reproduction when parents were dosed at the egg-laying stage of the
      breeding cycle. The implications of these results for the interpretation of field
      monitoring studies are discussed.

PMID- 2226380
TI  - Tetrachloroethene air pollution originating from coin-operated dry cleaning
      establishments.
AB  - In 15 coin-operated dry cleaning establishments (CODC), in one building where a
      CODC had been run and in a private car transporting a dry-cleaned down jacket
      tetrachloroethene (TCE) indoor concentrations were investigated by air sampling
      with activated carbon tubes, elution of the carbon with toluene, and subsequent
      gas chromatographic analysis of the eluate. TCE concentrations in the car
      transporting the garment were up to 24.8 mg/m3. Within CODC air concentrations
      between 3.1 and 331 mg/m3 were measured. In the building where a CODC had once
      been run the TCE concentrations were slowly decreasing after removal of dry
      cleaning machines. In the basement below the CODC the TCE air concentration was
      155 mg/m3 immediately after removal of the machines and 4.5 mg/m3 7.5 months
      later. TCE migrated from the basement via the staircase to the flats of the
      second floor where TCE air concentrations were about 1% of the concentrations in
      the basement. TCE-contaminated building material is shown to be a reservoir
      causing increased TCE air concentrations for a long time, which is serious
      considering the carcinogenic and reproductive risks from TCE exposure.

PMID- 2226381
TI  - Environmental stress and blood glucose change in insulin-dependent diabetes
      mellitus.
AB  - Blood glucose (BG) response to psychological stress in insulin-dependent diabetes
      mellitus (IDDM) patients has not been firmly established. We report a study
      designed to address the gaps and methodological difficulties reviewed. Subjects
      with IDDM were exposed to two sessions (12 weeks apart) of two 20-min
      standardized stressors (active and passive) and a control condition administered
      in counterbalanced order. To measure BG response, subjects were connected to a
      glucose/insulin infusion system providing continuous BG measurement. Mood
      checklist measures were obtained at prestressor, poststressor, and recovery
      periods. During the first session of testing, the active stressor was associated
      with significantly more absolute change in BG response than the passive stressor.
      Results also indicate that IDDM subjects' BG response to this active stressor was
      idiosyncratic but significantly reliable over time.

PMID- 2226382
TI  - Psychological stress and blood glucose regulation in type I diabetic patients.
AB  - Fifteen Type I diabetic patients self-monitored daily mean blood glucose levels
      (BGL), psychological stress, diet, exercise, and insulin injections for a period
      of 8 weeks. Separate multiple-regression analyses were conducted for each subject
      to assess the predictability of BGL from stress reports, independent of the
      effects of diet, exercise, and insulin self-administration. Considerable
      individual variability in findings was evident, with stress predicting BGL in a
      statistically significant manner in 7 of the 15 subjects. Stress had a
      significant effect on BGL independent of diet, exercise, and insulin
      administration for each of these 7 subjects. Discussion focused on the problems
      of measuring the key self-management behaviors influencing BGL and on the
      possibility that a subgroup of diabetic patients may be BGL stress responders.

PMID- 2226383
TI  - Impact of stress on objectively recorded menopausal hot flushes and on flush
      report bias.
AB  - The hot flush (or flash) is the most widely reported menopausal symptom.
      Anecdotal reports suggest that women experience more hot flushes when stressed.
      Although stress may actually trigger hot flushes, another possibility is that
      women under stress may be more aware of the physiological changes associated with
      flushes and, therefore, more likely to report them. The goal of this study was to
      test these hypotheses by investigating the association between stress and both
      objective (i.e., physiologically recorded) and subjective hot flushes. Twenty-one
      postmenopausal women who reported having frequent hot flushes each underwent
      psychophysiological monitoring during stressful and nonstressful laboratory
      sessions. Significantly more objective flushes were recorded during the stress
      session than during the nonstress session. The stress manipulation, however, did
      not affect subjects' propensity to report flushes. These results suggest that the
      observed association between reported hot flushes and stress is not due to
      changes in report bias. The physiological mechanisms through which stress may
      stimulate hot flushes are discussed.

PMID- 2226384
TI  - Dentists' voice control: effects on children's disruptive and affective behavior.
AB  - Voice control, a punishment technique based on loud commands, has been used
      widely in pediatric dentistry. This study examined whether (a) loudness is a
      necessary component of the technique, (b) voice control actually reduces
      children's disruptive behavior, and (c) after treatment, children's negative
      affect increases. Subjects were forty 3 1/2- to 7-year-olds who posed potential
      behavior problems and who were scheduled for cavity restoration. Children were
      assigned randomly to either loud- or normal-voice groups. Children who were
      assigned to either group but who were not disruptive formed a nonexperimental
      control group. Prior to and after treatment, children reported their feelings
      using the Self-Assessment Mannequin. Disruptive behavior was scored using the
      Behavior Profile Rating Scale. Results indicated that, following loud, but not
      normal voice commands, children reduced their disruptive behavior (p less than
      .004) and self-reported lower arousal (p less than .09) and greater pleasure (p
      less than .10). Theoretical and practical implications of these findings are
      discussed.

PMID- 2226385
TI  - Analysis of child and parent behavior during painful medical procedures.
AB  - Examined (a) the impact of demographic, medical, and psychological factors on
      overall child distress during an invasive medical procedure required for
      pediatric cancer treatment and (b) the relationship of individual parent
      behaviors to child distress across phases of the procedure. Seventy 3- to 10-year
      old pediatric cancer patients receiving outpatient venipuncture and their parents
      participated. Overall distress was greater in younger children who had fewer
      previous venipunctures and poorer venous access and whose parents rated them
      prior to the procedure as less likely to be cooperative. Providing explanations
      regarding the procedure was the parent behavior most clearly associated with
      child distress. The impact of parent explanation depended on when the explanation
      was given and on the child's level of distress at the time.

PMID- 2226386
TI  - Differential effects of avoidant and attentional coping strategies on adaptation
      to chronic and recent-onset pain.
AB  - Examined the effectiveness of attentional and avoidant coping strategies for
      somatic, behavioral, and psychological adaptation to clinical pain. Subjects were
      30 chronic and 30 recent-onset pain patients who used either attentional or
      avoidant coping strategies in response to their pain. Based on a review of the
      coping literature, it was hypothesized that subjects with recent-onset pain would
      demonstrate greater adaptation (lower anxiety, depression, lower pain severity
      and somatization ratings, and higher levels of social activity) when employing
      avoidant rather than attentional strategies. Chronic pain subjects using
      attentional strategies were predicted to demonstrate greater adaptation than
      chronic pain subjects using avoidant strategies. The results supported this "time
      x strategy" hypothesis. Implications for pain treatment programs are discussed,
      and suggestions are made for matching pain duration with patient coping style.

PMID- 2226387
TI  - Correspondence programs for smoking cessation and weight control: a comparison of
      two strategies in the Minnesota Heart Health Program.
AB  - Mailed invitations to participate in weight loss and/or smoking cessation
      correspondence programs to 31,400 households in a suburban community. Two
      programs were offered to randomized subsets of households, a 6-month
      correspondence program costing +5 and the same program for free but requiring a
      +60 deposit to be refunded based on success in weight loss or smoking cessation.
      Overall, sign-up included 1,304 people for weight loss and 142 for smoking
      cessation. The +5 program was about 5 times as popular as the incentive program.
      Validated weight change after 6 months averaged about 4 lb for the +5 program and
      8 lb for the incentive program. Corresponding rates of smoking cessation were
      about 9% and 20%, respectively. We conclude that correspondence programs for the
      promotion of weight control and smoking cessation are potentially cost-effective
      methods for reaching individuals in the community at large, many of whom would
      not be interested in clinic-based programs. Issues meriting further research
      include recruitment, especially of smokers, and evaluation of the relative trade
      offs in recruitment success versus efficacy of differing treatment approaches.

PMID- 2226388
TI  - Effects of weight cycling on metabolic control in male outpatients with non
      insulin-dependent diabetes mellitus.
AB  - Examined the effects of weight cycling (i.e., losing and regaining or gaining and
      relosing body weight) versus weight maintenance on metabolic control in 327
      adult, male, outpatient veterans with non-insulin-dependent diabetes mellitus
      (NIDDM) who were followed over an average of 3.4 years. When compared with weight
      maintenance, weight cycling, whether defined as a categorical or as a continuous
      variable, was not found to be associated with deficits in metabolic control or
      increased need for hypoglycemic medication. Patients who weight cycled had
      fasting serum glucose and hemoglobin A1c levels comparable to those who remained
      within 10% of their initial body weights, and these levels of metabolic control
      were obtained with similar classes and dosages of hypoglycemic medication.

PMID- 2226389
TI  - Adherence-health status relationships in childhood diabetes.
AB  - Used 24-hr recall interviews to assess adherence in a sample of seventy-eight 6-
      to 19-year-olds with insulin-dependent diabetes mellitus over a 3-month period.
      Thirteen adherence measures were quantified and grouped into six adherence
      factors (Injection, Exercise, Diet Type, Testing/Eating Frequency, Calories
      Consumed, and Concentrated Sweets). Prevailing glucose levels over a 2- to 3
      month interval were indexed by glycosylated hemoglobin A1c (HA1c) and
      glycosylated serum protein (GSP) assays. Fasting triglycerides (TRIG) and total
      cholesterol (CHOL) assays were used to estimate lipid metabolism. Adolescents
      were generally less adherent than their young counterparts. Using hierarchical
      multiple-regression techniques, HA1c and GSP were not reliably predicted by most
      of the adherence factors; only Calories Consumed showed any predictive power. No
      significant regression equations emerged for CHOL. In contrast, TRIG was
      significantly associated with five of the six adherence factors; in all cases,
      adherence interacted with the patients' metabolic status (as defined by HA1c) at
      study entry, suggesting that adherence had different effects for youngsters in
      good versus poor diabetes control.

PMID- 2226390
TI  - Personal models of diabetes and their relations to self-care activities.
AB  - Investigated the personal models of diabetes held by 46 female outpatients with
      non-insulin-dependent diabetes mellitus. The subjects' mean age was 64 years
      (range = 46 to 79 years), and 24 subjects were taking insulin. Their personal
      models were explored by using a comprehensive interview including questions on
      beliefs and emotions about cause, symptoms, course, treatment, and consequences
      of their diabetes. Two weeks after their interview, patients provided information
      about their levels of self-care activities, including exercise, diet, and glucose
      testing. The interview provided multiple indicators of the personal-model
      constructs from which four composites were formed assessing cause, symptoms,
      treatment, and seriousness (a combination of course and consequences). In
      hierarchical multiple-regression analyses, these dimensions significantly
      improved the prediction of diet level and marginally improved the prediction of
      exercise after accounting for the effects of age and insulin taking. The results
      are discussed in terms of variations in personal models across different patient
      groups and diseases and the role of personal models in determining self-care
      behaviors.

PMID- 2226391
TI  - Effects of 24-hour ambulatory blood pressure monitoring on daily activities.
AB  - Compared the self-monitored activities, locations, and postural positions of 28
      hypertensives while they wore an alarm watch and then while they wore a 24-hr
      ambulatory blood pressure monitor (ABPM) to see if wearing the ABPM led to
      alterations in behavior. Within the limitations of the study (no counterbalancing
      of order and twice as many ABPM measures as watch measures), we found significant
      differences in frequency of being at home or in miscellaneous settings, in
      standing and reclining positions, and in mental, physical and miscellaneous
      activities between the two occasions.

PMID- 2226392
TI  - The equine stress response to anaesthesia.

PMID- 2226393
TI  - The human stress response to surgical trauma and anaesthesia.

PMID- 2226394
TI  - New insights into the equine respiratory tract.

PMID- 2226395
TI  - Atelectasis causes gas exchange impairment in the anaesthetised horse.
AB  - The anatomical basis of gas exchange impairment in the anaesthetised horse was
      studied by computerised tomography (CT; three shetland ponies) and morphological
      analysis (one pony and three horses). By means of CT, densities were seen in
      dependent lung regions early during anaesthesia, both with spontaneous breathing
      and with mechanical ventilation. The densities remained for some time where they
      had initially been created when the animal was turned from dorsal to sternal
      recumbency. Deep insufflation of the lungs reduced the dense area. Gas exchange
      was impaired roughly in proportion to the dense area. On histological analysis,
      the densities were atelectatic and congested with blood. Gravimetry showed no
      more extravascular water per unit lung tissue in the atelectatic than in the
      'normal' regions, and the blood content was increased only slightly. It is
      concluded that the horse develops atelectasis in dependent lung regions early
      during anaesthesia in dorsal recumbency, and that atelectasis is the most likely
      explanation for the large shunt and impaired arterial oxygenation regularly seen
      during anaesthesia.

PMID- 2226396
TI  - Agenesis of the corpus callosum with cerebellar vermian hypoplasia in a foal
      resembling the Dandy-Walker syndrome: pre-mortem diagnosis by clinical evaluation
      and CT scanning.

PMID- 2226397
TI  - A scanning electron microscopic study of the equine upper respiratory tract.
AB  - The surface features of the upper respiratory tract of 20 clinically normal
      horses of various ages and types were studied with scanning electron microscopy.
      In the rostral part of the nasal cavity, there was a wide zone of non-ciliated
      epithelium whereas, caudally, the surface was well ciliated. This latter type of
      epithelium extended into the nasopharynx and guttural pouches although scattered
      areas of non-ciliated microvillous cells were also found.

PMID- 2226398
TI  - An ultrastructural study of the equine lower respiratory tract.
AB  - The surface features of the lower respiratory tract of 20 clinically normal
      horses of different ages and types were studied with scanning electron
      microscopy. Parallel light microscopical and transmission electron microscopical
      studies were also carried out. The ciliary carpet was virtually complete from the
      trachea to the lobar bronchi. In small bronchi, ciliation was less complete
      allowing numerous non-ciliated mucous cells to become obvious. The terminal
      bronchioles, populated mainly by non-ciliated bronchiolar epithelial cells, had
      an abrupt junction with alveolar ducts. Interalveolar pores were common
      particularly in older horses.

PMID- 2226399
TI  - Ultrastructural findings in horses with chronic obstructive pulmonary disease
      (COPD). I: Alterations of the larger conducting airways.
AB  - Extensive light and electron microscope studies of the conducting airways were
      carried out in 28 horses with varying degrees of clinically manifested chronic
      obstructive pulmonary disease (COPD) and in 8 horses with normal lungs. The
      principal ultrastructural changes were found in the ciliated cells. There was
      focal loss of ciliated cells, which were replaced by undifferentiated cells in a
      largely hyperplastic epithelium, and some horses, independent of the degree of
      severity of the disease, showed various types of ciliary malformation. The
      finding of dilated intercellular clefts and accumulations of mast cells was
      interpreted as morphological evidence of non-specific mucosal hyperreactivity.
      Interstitial cells with intracytoplasmal crystal inclusions, the cause of which
      is not clear, were seen in many horses. Comparison between the clinical diagnosis
      and the morphological findings showed partial correlation. The ciliary loss, the
      appearance of peribronchial inflammatory processes and the occurrence of
      intracytoplasmic crystalline inclusions showed a positive correlation. In 12 of
      28 cases, the severity of clinical diagnosis agreed with the degree of the
      morphological findings. The changes in the conducting airways were interpreted
      pathogenetically as reactive processes to changes in the small airways in the
      course of equine COPD.

PMID- 2226400
TI  - Ultrastructural findings in horses with chronic obstructive pulmonary disease
      (COPD). II: Pathomorphological changes of the terminal airways and the alveolar
      region.
AB  - Extensive light and electron microscope studies (transmission and scanning
      electron microscopy) of the bronchioles and alveolar region, in 28 horses
      suffering chronic obstructive pulmonary disease (COPD) and eight control horses,
      revealed good correlation between clinical severity and morphological changes. In
      the bronchiolar epithelium the non-ciliated bronchiolar epithelial (Clara) cells,
      in particular, showed ultrastructural alterations and, even in the mild stages of
      disease, these presented degenerative changes and lack of differentiation.
      Together with loss of granulation in the Clara cells and metaplasia of the goblet
      cells, cells were seen with unusual intracytoplasmic lamellar inclusion, the
      number of which increased sharply with clinical severity. The focal changes in
      the alveolar region were necrosis of type I epithelial cells, alveolar fibrosis
      of varying degrees with type II epithelial transformation and emphysema or
      hyperinflation, with an increase in Kohn's pores. Some horse also showed
      morphological signs of interference with the surfactant system, in the form of
      marked cysts with lamellar structure. The alveolar changes were mostly in the
      peribronchiolar region and were, therefore, interpreted as reactive processes. No
      conclusions as to the aetiology of equine COPD can be derived from these
      morphological investigations.

PMID- 2226401
TI  - The influence of photoperiod on gonadotrophin-releasing hormone stimulated
      luteinising hormone release in the anoestrous mare.
AB  - The transition from anoestrus to oestrus in mares is controlled by photoperiod.
      The present study examined whether additional daylength would accelerate the
      mares' response to gonadotrophin-releasing-hormone (GnRH). Nine anoestrous mares
      were placed under ambient or artificial long lighting on 7th January. The four
      month experimental period was divided into a three-day sequence which was
      repeated at 21 day intervals. Ovaries were palpated rectally on Day 1; saline was
      injected (1 ml intravenously [iv]) on Day 2; GnRH was administered (0.59
      microgram/kg bodyweight iv) on Day 3. Blood was taken at -60, 0, 15, 30, 60 and
      120 mins relative to saline or GnRH treatment. Serum luteinising hormone (LH) was
      determined by a homologous equine radioimmunoassay (RIA). Several criteria were
      employed to define a positive response to GnRH and the results were analysed by
      Fisher's exact probability test. Treatment with artificial light allowed a
      response to GnRH within six weeks whereas the mares in ambient lighting took 12
      weeks to respond to GnRH. The advancement in the time of response to GnRH under
      the long photoperiod could be related to changes in pituitary LH content,
      accelerated follicular activity or alterations in other brain-pituitary hormone
      levels.

PMID- 2226402
TI  - Peritoneal fluid values from healthy foals.
AB  - Peritoneal fluid was analysed from 17 foals, aged 13 to 134 days with a mean age
      of 68 days. Cytologically, the peritoneal fluid was characterised by a mean total
      cell count of 0.45 x 10(9)/litre (range 0.06 to 1.42 x 10(9)/litre), rare
      eosinophils, rare cytophagia and variable percentages of neutrophils and
      mononuclear cells. These data indicate that peritoneal fluid nucleated cell
      counts over 1.50 x 10(9)/litre in the foal should be interpreted as elevated.
      Biochemical evaluation revealed a mean biuret protein level of 12 g/litre, mean
      refractive index protein level of 16 g/litre and urea nitrogen concentration of
      1.96 mmol/litre. There was no correlation between the foals' white blood cell and
      peritoneal fluid nucleated cell counts. Results of this study indicate that adult
      horse reference values for evaluation of peritoneal fluid are of questionable
      validity for foals. Diagnostically, the most important observation was that
      maximum peritoneal fluid nucleated cell counts in healthy foals were much lower
      than reported maximal reference values for adult horses (1.5 x 10(9)/litre versus
      5.0 x 10(9)/litre or 10.0 x 10(9)/litre).

PMID- 2226403
TI  - Plasma histamine levels during exploratory laparotomies in suspected equine grass
      sickness cases.

PMID- 2226404
TI  - The crystalline composition of normal equine urine deposits.

PMID- 2226405
TI  - An autoradiographic study of equine hoof growth.

PMID- 2226406
TI  - Soft palate cysts as a cause of pharyngeal dysfunction in two horses.

PMID- 2226407
TI  - Serum protein changes in four horses with monoclonal gammopathy.

PMID- 2226408
TI  - Sequence analysis of proteins separated by polyacrylamide gel electrophoresis:
      towards an integrated protein database.
AB  - Improved technologies or the synergistic use of complementary methods enhance the
      efficiency of research and permit the exploration of new approaches for the
      investigation of complex problems. High sensitivity protein sequence analysis and
      polyacrylamide gel electrophoresis are such complementary methods. Here we
      summarize the current status of high sensitivity sequence analysis of proteins
      separated in polyacrylamide gels and discuss strategies by which this technology
      can enhance biological research by generating new approaches for the solution of
      complex, multifacetted problems. Finally, we outline imminent technological
      advances in the area of high sensitivity protein sequence analysis and argue that
      further technological developments will ultimately lead to the generation of an
      integrated protein database (containing structural and functional as well as
      physiological information in an easily accessible form) of all the proteins
      separated by high resolution two-dimensional gel electrophoresis.

PMID- 2226409
TI  - Internal sequence analysis of proteins separated on polyacrylamide gels at the
      submicrogram level: improved methods, applications and gene cloning strategies.
AB  - The fields of protein chemistry and molecular biology are currently merging for
      study of biologically relevant events and conditions. To obtain partial sequences
      of microamounts of protein, efficient integration of high resolution separation
      and sequencing technologies is required. We report here on improved methods that
      allow extensive internal sequencing of 10 to 20 picomoles protein recovered from
      one- or two-dimensional gels. Each step of the standard protocol of Aebersold et
      al. (Proc. Natl. Acad. Sci. USA 1987, 84, 6970-6974) and the required
      instrumentation were examined and specifically adapted for use with submicrogram
      amounts of protein. Optimizations of in situ microdigests and liquid
      chromatography were needed for improved peptide recovery. Subsequent automated
      sequencing required subpicomole analysis. New methods for S-alkylation of gel
      separated proteins and accurate identification of tryptophan-containing peptides
      were introduced to insure overall higher efficiencies. The acquired internal
      sequences facilitated cloning of the genes and several strategies are discussed.
      Applying our method, several proteins of unknown structure were sequenced and
      successfully identified or cloned. Internal sequences of submicrogram protein
      amounts, recovered from a single two-dimensional gel of Escherichia coli total
      protein (120 micrograms), allowed unambiguous identification of the spots but pre
      gel enrichment will be required for analysis of most (90-95%) other spots.
      Integration of comprehensive two-dimensional gel protein databases with methods
      and strategies outlined here could potentially be an abundant source of DNA
      probes and markers useful for guidance of the human genome sequencing project and
      for analysis of the emerging vast amounts of data.

PMID- 2226410
TI  - Combination of two-dimensional gel electrophoresis with microsequencing and amino
      acid composition analysis: improvement of speed and sensitivity in protein
      characterization.
AB  - High-resolution two-dimensional polyacrylamide electrophoresis (2-DE) is commonly
      used as an analytical approach to resolve and detect most of the numerous protein
      species of an organism. However, the isolation of microgram amounts of protein in
      a 2-DE spot in a form suitable for microsequence analysis and amino acid
      composition analysis is a key step in the chemical characterization of these
      proteins. With the development of chemically inert membranes it is now possible
      to retain proteins present in low quantities from the polyacrylamide matrix with
      high yields. The immobilized proteins are suitable for direct sequence analysis
      and amino acid composition analysis. The combination of protein chemical and
      electrophoretic techniques makes it possible to obtain chemical information from
      subpicomole quantities of protein, resulting in the availability of a new set of
      biologically important proteins for structural analysis. This paper summarizes
      the methods and strategies for the chemical protein analysis of 2-DE spots in our
      laboratory.

PMID- 2226411
TI  - Protein blotting followed by microsequencing.
AB  - The use of new membranes such as activated or derivatized glass fibers as well as
      synthetic membranes, which are compatible with the hazardous sequencing reagents,
      are described. Precautions to be taken in order to prevent N-terminal blockage of
      the proteins during electrophoresis and blotting are described, as well as the
      conditions for protein detection after blotting and protein treatment for in situ
      amino acid analysis, fragmentation and microsequencing. For a number of standard
      proteins and bacterial ribosomal proteins microsequence analysis is reported for
      two commercially available sequencers (Applied Biosystems and Knauer).

PMID- 2226412
TI  - Electroblotting of polypeptides onto glass fiber filters for direct sequence
      analysis after sodium dodecyl sulfate-polyacrylamide gel electrophoresis.
AB  - The technique of electroblotting polypeptides onto Polybrene-treated glass fiber
      filter discs after protein detection with potassium chloride is evaluated further
      with different proteins in separate applications. The number of proteins analyzed
      with this method is now more than double that previously reported. Reproducible
      results in good yield are obtained. Average overall yield--including the
      electrophoretic step before blotting--is 26%, with maximal recoveries through all
      steps up to 60%. High sensitivity radiosequence analysis is also applicable.
      Recent modifications of the previously described procedure include use of Whatman
      glass fiber filters, removal of air in the Polybrene-impregnated filters by
      buffer penetration under reduced pressure, and use of widely different times for
      electrotransfer. Special advantages with this method are low extent of protein
      alpha-amino group destruction, direct use of the entire filter in the sequencer,
      and insensitivity to variations in electroblotting time. Gas-phase hydrolysis in
      situ of blotted proteins followed by amino acid analysis is known to give a low
      yield of polar amino acids, and often artifacts, but can still give an estimate
      of the amount of polypeptide immobilized on the filter. A wash with n-butyl
      chloride is now shown to reduce the Polybrene-associated artifacts, and an
      addition of sodium chloride to increase the recovery of polar amino acids. These
      two steps therefore appear interesting in schemes for compositional analyses of
      electroblotted proteins.

PMID- 2226413
TI  - Microsequencing of proteins electrotransferred onto immobilizing matrices from
      polyacrylamide gel electrophoresis: application to an insoluble protein.
AB  - Semidry electroblotting is convenient and allows a rapid and efficient protein
      transfer from one- or two-dimensional polyacrylamide gels onto sequencer stable
      supports for protein microsequence analysis in a gas-phase sequencer. Using this
      technique, we determined the amino acid sequences of the basic 7S globulin (Bg),
      an insoluble protein present in soybean seeds. Based on sequence determination,
      the cDNA-encoding Bg could be easily cloned and characterized.

PMID- 2226414
TI  - Blotting efficiency investigated by using two-dimensional electrophoresis,
      hydrophobic membranes and proteins from different sources.
AB  - Purification and chemical characterization of proteins may be achieved by
      combining two-dimensional electrophoresis (2-DE) and microsequencing or amino
      acid analysis. To enable this combination, the protein has to be transferred as
      completely as possible from the gel into the sequencer. In this study hydrophobic
      membranes were used as support for the transfer and proteins were transferred
      from the gels onto the membranes by semidry blotting. Blotting conditions were
      optimized to obtain high blotting efficiencies for as many proteins of a complex
      2-DE pattern as possible. Under optimized conditions, blotting efficiencies
      between 60% and 100% were obtained for five marker proteins; the mean values from
      four regions of a 2-DE pattern from 29 unknown proteins of a complex protein
      mixture from mouse brain were between 60% and 79%. The four commercially
      available hydrophobic membranes that were compared showed only slight differences
      in protein amount on the membranes after blotting for whole protein patterns,
      whereas single proteins occurred with higher amounts on either one or the other
      membrane. The results of the blotting optimization allowed us to suggest a
      blotting mechanism with which systematic improvement of the blotting conditions
      is possible for problematic proteins.

PMID- 2226415
TI  - Identification of rat liver glutathione S-transferase Yb subunits by partial N
      terminal sequencing after electroblotting of proteins onto a polyvinylidene
      difluoride membrane from an analytical isoelectric focusing gel.
AB  - Rat liver glutathione S-transferases were partially purified using S-hexyl
      glutathione affinity chromatography, followed by native isoelectric focusing
      employing a pH 7-11 or pH 3-10 gradient. Proteins were excised and eluted from
      the gel for determination of subunit composition using sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. In separate experiments, isoelectric focusing
      gels were equilibrated with a sodium dodecyl sulfate-containing buffer at high
      pH, and proteins on the gel were electroblotted onto a polyvinylidene difluoride
      membrane, utilizing graphite plates as electrodes. The membrane-bound proteins
      were visualized by Coomassie Brilliant Blue staining. The protein bands were then
      excised from the membrane and inserted into a gas phase sequenator for direct
      sequencing. N-Terminal sequences thus determined were compared with published
      cDNA sequences. The isoelectric points (pIs) and positions on the isoelectric
      focusing gel of Yb1Yb1, Yb1Yb2 and Yb2Yb2 subunits were determined. We have also
      located on the pH 3-10 focusing gel an N-terminal blocked glutathione S
      transferase which has a molecular weight similar to Yb subunits.

PMID- 2226416
TI  - Ergonomic aspects of the health and safety of VDT work in Japan: a review.

PMID- 2226417
TI  - New electronic media and the human interface.
AB  - Discussion is focused on the relationship between the new media and the human
      visual system. First, the process of information transmission in the human visual
      system is shown as a hierarchically structured model. Second, examples of the
      human interface in the development of a Japanese teletext system are shown, such
      as desired luminance and contrast, or favourable colour combination, or how to
      make superimposed sentences on screen easy to read. Third, examples of the human
      interface in the development of Hi-Vision, or High Definition Television (HDTV),
      are discussed, namely the conditions required for Hi-Vision from the standpoint
      of visual characteristics, the visual effects of Hi-Vision, and an objective
      evaluation of psychological effects of Hi-Vision.

PMID- 2226418
TI  - CRT display visibility in automobiles.
AB  - Three experiments were carried out into aspects of CRT display in the context of
      driving automobiles. The first focused on the combination of colours which
      renders information 'easy-to-read', and determined the relationship between
      luminance contrast and chromaticity difference. In the second a background
      luminance which was not dazzling at night was expressed in a chromaticity
      diagram. In the third the amount of information which can be read 'at-a-glance'
      was investigated.

PMID- 2226419
TI  - The ergonomic evaluation of eye movement and mental workload in aircraft pilots.
AB  - This paper presents an experiment which examines characteristics of pilots'
      scanning behaviour when using integrated CRT displays, and the changes in
      characteristics when pilots face abnormal situations. The subjects were five
      experienced pilots. They performed two modes of flight tasks, under normal and
      abnormal situations, in flight simulators with standard settings. The flight
      simulators were for a Boeing 747-300 (B747), which made use of electromechanical
      displays, and for a Boeing 767 (B767), equipped with integrated CRT displays. The
      results showed that the B767 pilots tended to gaze at the attitude director
      indicator which was displayed in the integrated CRT display. It was assumed that
      'gaze-type scanning' might be one of the characteristics of pilots' scanning
      behaviour in cockpits which use the integrated display. By employing subjective
      ratings and heart rate variability to measure mental workload, no differences in
      mental workload between the B767 pilots and the B747 pilots were observed.
      However, in abnormal situations, the changes in scanning pattern for B767 pilots
      were found to be smaller than those of the B747 pilots. It is concluded that the
      application of integrated displays helps pilots to obtain sufficient information
      more easily than electromechanical displays do, even under abnormal situations.

PMID- 2226420
TI  - Examination of the near triad in VDU operators.
AB  - It has recently been demonstrated that the tonic level of accommodation is
      related to the loading of accommodative work. The aim of the present study was to
      investigate the effect of a sustained accommodative stimulus on the tonic level
      of accommodation, pupil, and convergence, i.e., the near triad, in three
      different groups of young (20-39 years) subjects, viz., 1. 19 professional visual
      display unit (VDU) workers; 2. 12 ordinary hard copy (non-VDU) workers; and 3. 19
      control subjects doing different jobs from the two former groups. All had worked
      25-30 h per week for over two years. Only Groups 1 and 2 had eyestrain after
      office work. Except for mild myopia, subjects had no eye or systemic disease upon
      routine examination. Accommodation was measured with an objective infrared
      optometer, the pupil was measured by an infrared video pupillography, and
      convergence was measured from the contralateral eye by photoelectronic
      oculography. In order to elicit tonic responses, the velocity of the target
      stimulus was 0.2 D (diopters) per second. Based on the data obtained from the
      controls, the near triad was analysed. Asymmetric response of the near triad in
      the right and the left eye and the existence of a hysteresis curve, especially in
      the pupil and in convergence, were the major findings. No abnormality was found
      in the control group. In the VDU group, 34.6% showed an abnormal near triad, but
      this also occurred in 18.5% of the non-VDU group. Even with the same complaint of
      eyestrain, it was concluded that VDU work produced abnormalities 1.8 times higher
      in the near triad produced by tonic stimulus.

PMID- 2226421
TI  - Study of the relationship between lacrimation and blink in VDT work.
AB  - VDT (Visual Display Terminal) work generates various symptoms in operators' eyes
      such as strain, a sensation of dryness, the presence of a foreign body, and so
      on. Research suggests that lacrimal abnormality may be related causally to such
      symptoms. In this paper, the relationship between lacrimation (the secretion of
      tears) and the frequency of blink due to VDT work in health subjects and VDT
      workers with such symptoms, and consequent therapeutic methods, were studied.
      When lacrimation, BUT (Break-UP Time), and the frequency of blink before and
      after VDT work compared in the control subjects and VDT-operators, an essential
      difference was noted in experiment 1 the frequency of blink decreased only during
      VDT operation, and a decreasing tendency of lacrimation was also noted while
      lacrimation before operation was already less in the VDT group; no large
      variation was noted before or after VDT operation. The frequency of blink was
      relatively high during operation, and a decreasing tendency of BUT was noted,
      compared with that for control subjects. In experiment 2, lacrimation increased
      remarkably in four eyes (of two operators), and relief from the subjective
      symptoms was noted. However, BUT intactly reduced similarly before the use of a
      gelatin rod during the whole process. The insertion of a gelatin rod was
      consecutively carried out every two weeks for approximately eight months; the
      development of complications such as dacryosolenitis, etc., was not noted. From
      these results, it is considered that the insertion of a gelatin rod is clinically
      useful for VDT operators with decreasing lacrimation.

PMID- 2226422
TI  - An ergonomic evaluation of lens accommodation related to visual circumstances.
AB  - This study is intended to make clear the relationships between a number of
      external conditions (target luminance, size, etc.), dynamic responsiveness of the
      lens accommodation, and microfluctuation. Further, the effects of ageing and the
      difference between monocular and binocular observations are examined. These
      studies established that age factors have a large bearing on the ability of the
      lens to focus on an object, as well as affecting such abilities as the
      responsiveness of the lens accommodation, amplitude of lens accommodation
      response, microfluctuation, and contraction and relaxation time. Of these
      accommodation functions, such factors as contraction and relaxation time clearly
      reflect the ease of seeing an object. Clear relationships between the amount of
      diopter and the ease of seeing an object were also observed. Further, it was
      established that a binocular observation is more responsive (velocity of
      contraction) than a monocular one. As to the microfluctuation, on the other hand,
      clear effects of age on its spectrum distribution were recognized but no definite
      correlations concerning the ease of seeing an object were observed.

PMID- 2226424
TI  - The acceptable load while marching at a speed of 5 km h-1 for young Chinese
      males.
AB  - Ninety-three young Chinese men selected at random were involved in the load
      carrying experiments. They marched at 5 km h-1 carrying loads of 0, 15, 20, 25
      and 31 kg for 7 h per day. At this speed the acceptable load to be carried was 20
      kg. Under this load 95% of the men had heart rates below 120 bt min-1 while
      marching and energy metabolism was in balance. Nevertheless, 10-15% of the men
      were fatigued and felt tired.

PMID- 2226423
TI  - Maximum acceptable repetitive lifting workload by Chinese subjects.
AB  - This study used psychophysical methods to determine the acceptable mean maximum
      lifting workload for eight Chinese young male subjects, and examined the effects
      of lifting technique (including freestyle, stoop and squat), lifting frequency
      (including 2, 3, 4, 5 and 6 lifts/min) and physical characteristics on the
      maximum acceptable workload. The results are described as follows: (1) The
      maximum acceptable weights selected by subjects varied from 11.34 to 18.33 kg
      with changes in lifting technique and frequency. These data were lower than those
      previously obtained; (2) The upper limit of physiological tolerance over an 8 h
      workday was also generally lower than previously suggested. However, this upper
      limit varied with changes in lifting technique and frequency, and in some
      circumstances it was the same as or even higher than previous limit; (3) Lifting
      efficiency was affected significantly by technique and frequency. The rank order
      of efficiency for three lifting techniques were freestyle, stoop and squat.
      Efficiency was greatest when lifting frequency was between 5 and 6 lifts/min; and
      (4) The correlations between the maximum acceptable workloads selected by
      subjects and anthropometric sizes were significant, but those between maximum
      acceptable workload and isometric strength were not.

PMID- 2226425
TI  - The effects of VDT data entry work on operators.
AB  - The before/after study of physiological and biochemical parameters was used to
      delineate the effects of VDT data entry work on operators. Twenty-nine healthy
      Chinese students were chosen and divided at random into the simple and the
      complicated data entry group. The subjects were instructed to work as quickly and
      correctly as possible according to the 'Data Entry Work Programme' for 150 min.
      Work performance (correct entry) was automatically recorded once every 10 min.
      The before/after parameters were tested respectively. The results showed that
      performance fluctuated over time. It decreased obviously after 50-60 min of work,
      followed by a rebound, and there was a terminal motivation phenomenon at the end
      of the test, which was associated with the auto-arousal and cerebral compensatory
      effort. Changes in physiological parameters revealed that operators were fatigued
      after data entry work. The adrenaline excretion in urine showed a tendency to
      increase after simple data entry work. The noradrenaline excretion showed a
      tendency to decrease after complicated data entry work. The differences in
      performance, diastolic blood pressure in a standing position and neurobehaviour
      between two groups indicated that much stress was experienced when performing
      complicated data entry work.

PMID- 2226426
TI  - A three-dimensional ultrasonic system for posture measurement.
AB  - A time-efficient, cost-effective, and accurate system has been developed for
      measuring static three-dimensional joint coordinates in the laboratory. This
      system uses a personal computer interface to determine the distance between
      transmitters positioned at body joints and receivers positioned near the subject
      by measuring the travel time of ultrasound. Distance data are then converted to
      spatial coordinates and joint angles. The system can determine the location of 14
      joints at one time. An experiment using three distances and five orientations
      between a transmitter and a receiver was performed to investigate the
      significance of measurement errors for the new system. The results showed that
      the standard deviation of the distance measurement was about 0.2 cm for single
      orientation conditions and was about 1 cm for all conditions tested. A second
      experiment using 11 transmitters and four receivers was performed to investigate
      the significance of measurement errors when determining three-dimensional
      coordinates. The results showed no significant difference between actual and
      measured coordinates. The system was then used to study the posture of a
      subject's upper extremity. Eight postures representing a variety of typical
      reaching tasks were examined. The results showed that the system was suitable for
      three-dimensional posture measurement.

PMID- 2226427
TI  - Physical work and strain involved in manual sorting of postal parcels.
AB  - A field study was conducted to assess cardiorespiratory and musculoskeletal
      stress and strain and work output during manual sorting of postal parcels, and to
      detect the effects of parcel sorting on the maximal muscle strength and
      endurance. The volunteer subjects comprised 32 healthy male sorters with mean (+/
      s.d.) age of 34 +/- 7 years at five different sorting sites. Each subject was
      studied during one evening work shift. During the shift of 391 +/- 46 min the
      subjects manually sorted 1173 +/- 630 parcels and walked 4.7 +/- 2.3 km with and
      without the load. While sorting, heart rate was 101 +/- 18 beats min-1. In the
      heaviest tasks the oxygen consumption was 1.2 +/- 0.41 min-1, and no elevated
      blood lactate concentrations were found. Work postures in which the back was bent
      forward averaged 24% of the time for sorting. The overall cardiorespiratory
      rating and local ratings of perceived exertion for arms, back, and legs did not
      exceed the 'somewhat strong' level during the work shift. The maximal static
      strength both for the right and left hand-grip muscles was, on average, 3% lower
      (p less than 0.05) after the work shift than before the shift. No significant
      differences were found in the static or dynamic endurance times for the hand-grip
      muscles when the results obtained after the work shift were compared to the
      baseline values. At sorting centres the stress and strain on the
      cardiorespiratory and musculoskeletal system was evaluated to remain within
      acceptable limits for healthy male sorters.

PMID- 2226428
TI  - Influence of simultaneous bilateral exertion on muscle strength during voluntary
      submaximal isometric contraction.
AB  - The influence of simultaneous bilateral exertion on muscle strength was tested
      under the conditions in which the same or different levels of strength were
      exerted by the right and left arm (or hand). Isometric muscle strength of elbow
      flexion, elbow extension and hand grip was studied. Subjects voluntarily exerted
      25%, 50%, and 75% of maximal strength based on their subjective judgement without
      the feedback of the strength actually exerted. Involuntary decrements of muscle
      strength were caused by the bilateral exertion. Muscle strength of both sides
      decreased under the condition where the same level of strength was exerted by the
      right and the left arm (or hand). When different levels of strength were exerted
      by each arm (or hand), the strength of the weaker side considerably decreased,
      while the strength of the stronger side did not decrease.

PMID- 2226429
TI  - Musculo-skeletal symptoms and signs and isometric strength among fishermen.
AB  - Previous studies have shown that subjective symptoms from the musculo-skeletal
      system are common among fishermen. In the present study, physical signs of
      malfunction were also found to be common in this profession. The co-existence of
      physical signs and subjective symptoms differed greatly between different joint
      systems, and the correlation was in some locations very low. The prevalence of
      physical health problems other than orthopaedic problems was low. Isometric
      lifting strength was high compared to results reported on other vocational
      groups.

PMID- 2226430
TI  - A multinuclear magnetic resonance study of a cls11 mutant showing the Pet-
      phenotype of Saccharomyces cerevisiae.
AB  - Energetic and intermediary metabolism was studied in a Pet- mutant of
      Saccharomyces cerevisiae with a calcium-sensitive phenotype that shows an
      inability to grow when cultured in a medium containing non-fermentable
      substrates. The perchloric acid extracts were prepared from suspensions of cls11
      mutant and wild-type cells incubated with [1,3-13C]glycerol or [2-13]acetate, and
      analyzed by 31P, 13C and 1H NMR. 31P- and 1H-NMR spectra showed significant
      differences between cls11 and wild-type cells at the level of amino acids, the
      storage carbohydrate trehalose (higher in mutant cells), and sugar phosphates
      (higher in wild-type cells). 13C-NMR spectra revealed major differences in the
      steady-state labelling of glutamate carbons. For incubations with [1,3
      13C]glycerol, we estimated from the relative 13C enrichment of glutamate carbons
      that acetyl-CoA C2 is 43% C13 labelled in wild-type and 10% 13C labelled in
      mutant cells, respectively. For incubations with [2-13C]acetate, we calculated
      that the ratio of the relative flux through the glyoxylate shunt versus oxidative
      reactions is 58% in wild-type cells and 44% in the cls11 mutant cells. Again, a
      dilution of the relative enrichment of C2 of acetyl-CoA was observed in the
      mutant cells (89%) compared to the wild-type cells (97%). These results are
      discussed in terms of pleiotropic defects in non-fermentable carbon metabolism in
      mutant cells.

PMID- 2226431
TI  - A natural-abundance 13C-NMR study of Dictyostelium discoideum metabolism.
      Monitoring of the spore germination process.
AB  - Amoebae and spores of the cellular slime mold Dictyostelium discoideum have been
      investigated by natural-abundance proton-decoupled 13C-NMR spectroscopy.
      Axenically grown vegetative amoebae have been found to contain, as prominent
      metabolites, the polyamines 1,3-diaminopropane (3.2 mM), putrescine (9.4 mM) and
      spermidine (1.7 mM). We also detected lactic acid (4.4 mM) and the following
      amino acids as free metabolites in concentrations ranging over 1-3 mM: glycine,
      alanine, glutamine and glutamate. The glycogen level is highly dependent upon
      growth state, being below the level of NMR detection in early-exponential cells
      and reaching about 110 mM glucose equivalents in plateau-phase cells. Dormant
      spores contained high amounts of trehalose (50 mM), glutamine (73 mM) and
      glutamate (20 mM). The latter two compounds were not reported previously to be
      present in such high concentrations in Dictyostelium spores. Germination induced
      by heat-shock activation was monitored by 13C NMR. No change in the major
      components occurred during the activation step. The progressive disappearance of
      trehalose during germination correlated with the decrease of glutamine and
      glutamate. In general, the data suggest that germinated spores contain a
      composition of free metabolites very similar to that of starved vegetative
      amoebae.

PMID- 2226432
TI  - Muscle-specific response to thyroid hormone of myosin isoform transitions during
      rat postnatal development.
AB  - Transitions from embryonic and neonatal to adult-type-II isomyosins are known to
      be related to the increase in the thyroid hormone plasma concentration during
      postnatal development. These transitions have been shown, however, to occur at
      different times, depending on the muscle, suggesting that each muscle responds
      differently to the thyroid hormone. We have investigated quantitatively the
      effects of experimental hypothyroidism and hyperthyroidism on isomyosin
      transitions from birth until the 45th postnatal day in eight rat muscles:
      diaphragm, intercostals, gastrocnemius medialis, soleus, plantar muscles of the
      foot, tongue muscle, levator ani and bulbocavernosus complex, and masseter.
      Hypothyroidism delayed the isomyosin transitions in all the muscles examined,
      particularly in the sexually dimorphic muscles (levator ani and bulbocavernosus
      complex and masseter). However, it did not eventually inhibit isomyosin
      transitions, indicating that the thyroid hormone was not an absolute requirement
      for these to occur. Hyperthyroidism had only a slight effect on isomyosin
      transition in the diaphragm, and accelerated such transitions in the other
      muscles. The transition curves of all the muscles investigated, except those of
      the sexually dimorphic muscles, became similar to that of the diaphragm,
      demonstrating that the various muscles did not display the same sensitivity to
      the thyroid hormone but were regulated by it in the same way. The isomyosin
      transitions in the sexually dimorphic muscles remained late in comparison to that
      in the diaphragm, which suggests a more complex regulation. The effect of
      hyperthyroidism was not permanent and could be reversed, by interruption of the
      treatment, to a greater or lesser extent depending on the muscle. In all muscles
      containing slow-type-I isomyosin, hypothyroidism had no effect on this isomyosin
      synthesis, whereas hyperthyroidism inhibited it. This inhibition ceased rapidly
      after the interruption of the treatment.

PMID- 2226433
TI  - Hormone binding to natural mutants of human serum albumin.
AB  - High-affinity binding of progesterone, testosterone, prostaglandin F2 alpha and L
      thyroxine to five genetic variants of human serum albumin with defined point
      mutations was investigated by equilibrium dialysis (pH 7.4). Endogenous albumin A
      (Alb A) from each individual and commercial human serum albumin were used as
      controls in each case. The association constant for binding of progesterone to
      Alb Canterbury (Lys313----Asn) was 1.5 times that calculated for binding to the
      corresponding, endogenous Alb A. In contrast, the variants Alb Niigata (Asp269---
      Gly), Alb Roma (Glu321----Lys), Alb Parklands (Asp365----His) and Alb Verona
      (Glu570----Lys) all had normal progesterone binding properties. Specificity with
      respect to the type of mutation was also found for the binding of testosterone
      and prostaglandin F 2 alpha. Testosterone binding to Alb Roma was only 0.7 of
      that determined for endogenous Alb A, whereas prostaglandin F 2 alpha binding to
      Alb Niigata was increased by a factor 2.4. In the case of L-thyroxine normal
      binding properties were found for all the variants. Steric effects and/or
      conformational changes of the protein, introduced by the amino acid
      substitutions, probably account for the altered hormone binding. However, in the
      case of the increased binding of prostaglandin F2 alpha to Alb Niigata
      electrostatic effects could also be involved. The experimental findings suggest
      different high-affinity sites for the four hormones. Progesterone, testosterone
      and prostaglandin F2 alpha are apparently bound within the middle third (domain
      II) of the protein molecule. The possible position of the primary L-thyroxine
      site is discussed.

PMID- 2226435
TI  - A glycoprotein inhibitor of pectin methylesterase in kiwi fruit (Actinidia
      chinensis).
AB  - The finding of a powerful inhibitor of pectin methylesterase in ripe kiwi fruit
      is reported. The inhibitor was revealed to be a glycoprotein. It was purified to
      homogeneity and found to have a molecular mass of about 28 kDa, as estimated by
      gel filtration chromatography, SDS/PAGE and analytical ultracentrifugation. The
      sugar portion is composed of galactose, arabinose and rhamnose, the latter being
      much less represented. The amino acid composition showed a very high content of
      acidic residues compared to basic ones, which is the reason for the very low
      isoelectric point of the protein (less than 3.5). The kind of inhibition on kiwi
      pectin methylesterase was found to be competitive with an apparent Ki of 0.22
      microM, using citrus pectin as a substrate. Moreover, the inhibitor is effective
      in inhibiting pectin methylesterase in the pH range 3.5-7.5. Kiwi inhibitor
      appears to be specific for pectin methylesterase, inasmuch as it was found to be
      ineffective against other polysaccharide-degrading enzymes, such as
      polygalacturonase and amylase. Conversely, it appears to be completely aspecific
      as far as the pectin methylesterase source is concerned. In fact, it was found to
      inhibit this enzyme effectively from all the sources we assayed, i.e. orange,
      tomato, apple, banana, potato.

PMID- 2226434
TI  - Geometry of binding of the benzamidine- and arginine-based inhibitors N alpha-(2
      naphthyl-sulphonyl-glycyl)-DL-p-amidinophenylalanyl-pipe ridine (NAPAP) and
      (2R,4R)-4-methyl-1-[N alpha-(3-methyl-1,2,3,4-tetrahydro-8- quinolinesulphonyl)-L
      arginyl]-2-piperidine carboxylic acid (MQPA) to human alpha-thrombin. X-ray
      crystallographic determination of the NAPAP-trypsin complex and modeling of NAPAP
      thrombin and MQPA-thrombin.
AB  - The X-ray crystal structure of the trypsin complex formed with N alpha-(2
      naphthyl-sulphonyl-glycyl)-DL-p-amidinophenylalanyl-piper idine (NAPAP) was
      determined with X-ray data to 0.18-nm resolution and crystallographically
      refined. NAPAP binds into the active site of trypsin in a quite compact form: the
      p-amidinophenylalanine moiety of the D-stereoisomer binds into the specificity
      pocket; the glycyl group is hydrogen bonded with Gly216; the naphthyl group
      stands perpendicular to the indole moiety of Trp215; the piperidine ring is
      tightly packed between this naphthyl moiety and His57; in consequence the carboxy
      terminal amido bond of NAPAP is located in such a way that it is not susceptible
      to the active-site Ser195. NAPAP and (2R,4R)-4-methyl-1-[N alpha-(3-methyl
      1,2,3,4-tetrahydro-8- quinolinesulphonyl)-L-arginyl]-2-piperidine carboxylic acid
      (MQPA) [Matzusaki, T., Sasaki, C., Okumura, C. & Umeyama (1989) J. Biochem.
      (Tokyo) 105, 949-952] were transferred in their trypsin-binding conformations to
      human alpha-thrombin [Bode, W., Mayr, I., Baumann, U., Huber, R., Stone, S. R. &
      Hofsteenge, J. (1989) EMBO J. 8. 3467 - 3475] and energy minimized. Both
      synthetic inhibitors fit perfectly into the much more restricted active site of
      thrombin. The accommodation of the S-aryl moieties in the 'aryl-binding site' and
      of the piperidine rings in the S2 subsite of thrombin are particularly favorable.
      The preference of thrombin for distinctly substituted piperidine derivatives and
      its generally higher (compared with trypsin) affinity for benzamidine and
      arginine-based inhibitors can be accounted for by these thrombin inhibitor
      models.

PMID- 2226436
TI  - Casein kinase II phosphorylates DNA-polymerase-alpha--DNA-primase without
      affecting its basic enzymic properties.
AB  - Immunoaffinity-purified DNA-polymerase-alpha--DNA-primase complex from calf
      thymus was phosphorylated in vitro by highly purified casein kinase II from the
      same tissue. Specific phosphorylation of the DNA-polymerizing alpha subunit and
      the primase-associated gamma subunit was observed. About 1 mol phosphate/mol
      polymerase--primase was incorporated. Despite this effect, neither the DNA
      polymerase nor the DNA primase activity were changed after phosphorylation by
      casein kinase II. Furthermore, dephosphorylation of polymerase--primase with
      alkaline phosphatase did not change the polymerase or the primase activity to a
      significant extent. Moreover, both alkaline phosphatase and casein kinase II had
      no effect on the processivity of DNA synthesis and on the lengths and amounts of
      primers formed by the DNA primase. Because DNA polymerase alpha maintained all
      its basic properties even after extensive treatment with alkaline phosphatase, it
      is unlikely that phosphorylation has a direct influence on the activities of the
      DNA-polymerase-alpha--DNA-primase complex. The possible influence of post
      translational phosphorylation on the formation of a complex of polymerase alpha
      and its accessory proteins is discussed.

PMID- 2226437
TI  - Coamplification of mu class glutathione S-transferase genes and an adenylate
      deaminase gene in coformycin-resistant Chinese hamster fibroblasts.
AB  - In Chinese hamster fibroblasts, we previously detected an expressed gene located
      near the AMP deaminase gene. This gene was named Y1. Upon selection for
      resistance to coformycin, an inhibitor of AMP deaminase activity, both genes were
      amplified in several mutants. We have determined the complete nucleotide sequence
      of Y1 cDNA and identified the Y1 gene as a mu class glutathione S-transferase
      gene by comparison with sequences present in a data bank. Accordingly, Y1
      amplified mutants express an increased glutathione S-transferase activity toward
      1-chloro-2,4-dinitrobenzene; this activity, as well as the abundance of the
      corresponding RNA, appears, however, to reach a limit despite further increase in
      the Y1 gene copy number during successive amplification steps. Southern blot
      experiments showed that Y1 belongs to a multigene family, all or part of which
      has been amplified in mutant lines. These data provide a method to amplify and to
      overexpress the mu class of the glutathione S-transferase gene family on the
      basis of its linkage with the AMP deaminase gene.

PMID- 2226438
TI  - Two glyceraldehyde-3-phosphate dehydrogenase isozymes from the koningic acid
      (heptelidic acid) producer Trichoderma koningii.
AB  - The sesquiterpene lactone koningic acid (heptelidic acid) irreversibly
      inactivated glyceraldehyde-3-phosphate dehydrogenase [D-glyceraldehyde 3
      phosphate: NAD+ oxidoreductase (phosphorylating)] (EC 1.2.1.12) (GAPDH) and thus
      inhibits glycolysis. The koningic-acid-producing strain of Trichoderma koningii
      M3947 was shown to contain the koningic-acid-resistant GAPDH isozyme (GAPDH I)
      under conditions of koningic acid production. In peptone-rich medium, however, no
      koningic acid production was observed, and the koningic-acid-sensitive GAPDH
      isozyme (GAPDH II), in addition to the resistant enzyme, was produced. Both
      enzymes were tetramer with a molecular mass of 152 kDa (4 x 38 kDa) and lost
      enzyme activity when two of the four cysteine residues reacted with koningic
      acid. The apparent Km values of GAPDH I and II for glyceraldehyde 3-phosphate
      were 0.54 mM and 0.33 mM, respectively. The former isozyme was inhibited 50% by 1
      mM koningic acid but not affected at 0.1 mM, while the latter isozyme was
      inhibited 50% at 0.01 mM. The immunochemical properties and partial amino acid
      sequences suggested that the two isozymes have different molecular structures.
      These results suggest that GAPDH I is responsible for the glycolysis in T.
      koningii when koningic acid is produced.

PMID- 2226439
TI  - Purification and characterization of a cysteine proteinase from silkworm eggs.
AB  - Eggs of the silkworm, Bombyx mori, contain a high level of a proteinase which is
      most active in acidic pH region. The proteinase was purified from an extract of
      eggs by a six-step procedure which included conventional chromatographic
      fractionations. The molecular mass of the proteinase was estimated to be 350 kDa
      by gel filtration and 47 kDa by electrophoresis on sodium dodecyl
      sulfate/polyacrylamide gels, suggesting an octameric structure. The amino acid
      composition was found to resemble that of mammalian lysosomal cysteine
      proteinases, in particular cathepsin L. The NH2-terminal 10-residue sequence is
      Val-Gln-Phe-Phe-Asp-Leu-Val-Lys-Glu-Glu-. The enzyme appears to be a member of
      the class of cysteine proteinases since it was strongly inhibited by sulfhydryl
      reactive compounds and N-[N-(1,3-trans-carboxyoxiran-2-carbonyl)-L-leucyl]
      agmatine (E-64). The enzyme hydrolyzed various protein substrates, such as
      hemoglobin, vitellogenin, vitellin, and lipophorin, with maximal activity around
      pH 3-3.5. The specificity of the cleavage sites in the oxidized B chain of
      insulin was rather well defined and there was high affinity for hydrophobic
      residues at the P2 and P3 positions. The cysteine proteinase is thought to be
      involved in protein degradation during embryonic development of silkworm eggs.

PMID- 2226440
TI  - Cooperative homotropic interaction of L-noradrenaline with the catalytic site of
      phenylalanine 4-monooxygenase.
AB  - Catecholamines (adrenaline, noradrenaline and dopamine) are potent inhibitors of
      phenylalanine 4-monooxygenase (phenylalanine hydroxylase, EC 1.14.16.1). The
      amines bind to the enzyme by a direct coordination to the high-spin (S = 5/2)
      Fe(III) at the active site (charge transfer interaction), as seen by resonance
      Raman and EPR spectroscopy. Experimental evidence is presented that a group with
      an apparent pKa value of about 5.1 (20 degrees C) is involved in the interaction
      between the catecholamine and the enzyme. The high-affinity binding of L
      noradrenaline to phenylalanine hydroxylase, as studied by equilibrium
      microdialysis (anaerobically) and ultrafiltration (aerobically), shows positive
      cooperativity (h = 1.9); at pH 7.2 and 20 degrees C the rat enzyme binds about
      0.5 mol L-noradrenaline/mol subunit with a half-maximal binding (S50) at 0.25
      microM L-noradrenaline. No binding to the ferrous form of the enzyme was
      observed. The affinity decreases with decreasing pH, by phosphorylation and by
      preincubation of the enzyme with the substrate L-phenylalanine, while it
      increases after alkylation of the enzyme with the activator N-ethylmaleimide.
      Preincubation of the enzyme with L-phenylalanine also leads to a complete loss of
      the cooperativity of L-noradrenaline binding (h = 1.0). The many similarities in
      binding properties of the inhibitor L-noradrenaline and the activator/substrate L
      phenylalanine makes it likely that the cooperative interactions of these
      effectors are due to their binding to the same site. The high-affinity of
      catecholamines to phenylalanine hydroxylase is a valuable probe to study the
      active site of this enzyme and is also relevant for the homologous enzyme
      tyrosine hydroxylase, which is purified as a stable catecholamine-Fe(III)
      complex.

PMID- 2226441
TI  - Ornithine/phosphate antiport in rat kidney mitochondria. Some characteristics of
      the process.
AB  - [14C]Ornithine uptake by rat kidney mitochondria has been investigated according
      to the stop inhibitor method by using praseodimium chloride as an inhibitor. The
      existence of an ornithine/Pi exchange was found occurring with 1:1 stoichiometry.
      Both uptake and efflux follow first-order kinetics with a k of 2.4 min-1. Uptake
      increases with increasing pH. The activation energy for the process is 58.6
      kJ/mol and Q10 is 2.6. Ornithine/Pi exchange is electrical and energy-dependent,
      as suggested by the sensitivity of the process to the ionophores valinomycin and
      nigericin. Measurements both of proton movement across the mitochondrial membrane
      and of membrane potential strongly suggest that ornithine uptake into
      mitochondria is driven by the electrochemical proton gradient via the dependent
      ornithine/Pi translocator and delta pH-dependent Pi carrier.

PMID- 2226443
TI  - Two of the three genetic variants of goat alpha s1-casein which are synthesized
      at a reduced level have an internal deletion possibly due to altered RNA
      splicing.
AB  - This paper describes the elucidation of the primary structure of the three
      genetic variants of goat alpha s1-casein, alpha s1-Cn D, E and F, which have been
      found to be associated with reduced amounts of alpha s1-casein in milk. Variant E
      has the same electrophoretic mobility as variant B, but differs from the latter
      by the substitutions of Arg for Lys and of Thr for Ala at positions 100 and 195.
      A genetically controlled event which does not affect the amino acid sequence of
      this variant might be responsible for its lower rate of synthesis compared to
      that of alpha s1-casein B. The deletion of 11 amino acids at positions 59-69 and
      of 37 amino acids at positions 59-95 in variant B leads to variants D and F. In
      both cases the deletions, which start at the same position of the polypeptide
      chain, include the major phosphorylation site of the protein. On the basis of
      sequence data for casein genes and cDNAs, it was concluded that the deletions
      occurring in the D and F variants are due to the exclusion of one and several
      exons, respectively. The observed deletions in the proteins could thus be the
      consequence of splice site mutations which would induce altered RNA processing
      and hence reduce the rate of synthesis of the casein.

PMID- 2226442
TI  - Developmental regulation of metallothionein mRNA, zinc and copper levels in
      rainbow trout, Salmo gairdneri.
AB  - The metallothionein (MT) gene expression profile was followed in rainbow trout
      during early embryo development and in liver and gonads during the period of
      sexual maturation. The hepatic MT mRNA levels increase at the end of sexual
      maturation in both male and female rainbow trout. Although both isoforms of MT
      mRNA accumulate in the liver, there is a preferential increase in MT-A in the
      female liver. Concomitantly with this increase in MT there is a redistribution of
      zinc and copper to MT. In the juvenile female there is an abundance of MT mRNA in
      the ovaries. This is correlated to high levels of zinc in the MT fraction upon
      Sephadex G-75 chromatography. During ovary development the MT mRNA levels and the
      MT-bound zinc levels drop, with an increase in zinc being bound to high-molecular
      mass proteins. At ovulation most of the zinc is found in the membrane portion
      upon centrifugation. In contrast to the ovaries, there are no apparent changes in
      either trace metal distribution or MT mRNA levels during testis development. In
      the developing embryo there is an increase in MT-bound copper at gastrulation.
      This is accompanied by an increase in both isoforms of MT mRNA. At hatch both the
      copper and zinc levels increase in the MT fraction, with a concomitant increase
      in mainly MT-A mRNA. These findings indicate that the variations in MT mRNA
      levels during development are closely associated with metal regulation.

PMID- 2226444
TI  - Lipases catalyse hydrolysis of fatty acid anhydrides.
AB  - Regio-specific and non-regio-specific lipases from mammals and microorganisms
      catalyse the hydrolysis of short, medium and long-chain fatty acid anhydrides.
      All the lipases tested in the present study can catalyse the hydrolysis of pure
      fatty acid anhydrides more efficiently than that of glycerol tributyrate.
      Molecular turnovers more than four times higher than that measured using glycerol
      tributyrate were calculated. The presence of 0.5% (by mass) anhydride in a
      triacylglyceride can double the initial rate of proton release during enzymatic
      hydrolysis. This should be taken into account when testing the chain specificity
      of a lipase for various synthetic substrates. Lipase inhibition was found to be
      associated very often with anhydride hydrolysis. The inhibition rates depended on
      the anhydride and the origin of the lipase. Inhibition of lipase activity is
      probably due to the formation of a poorly reversible acyl-lipase complex which
      differs from the classical fully reversible acyl-lipase complex at the catalytic
      centre.

PMID- 2226445
TI  - In vivo 13C-NMR studies on the metabolism of the lugworm Arenicola marina.
AB  - 13C-NMR natural-abundance spectra of specimens of Arenicola marina obtained,
      showed seasonal changes in the concentration of some metabolites, with the
      osmolite alanine as well as triacylglyceride storage compounds present at high
      concentrations. Glycogen was sometimes only barely detectable due to the low
      natural abundance level of 13C. Glycogenic metabolism of the lugworm A. marina
      was studied in vivo by 13C-NMR spectroscopy using 13C-labelled glucose. During
      recovery from a hypoxic period [1-13C]glucose was incorporated into glycogen. [1
      13C]Glucose was injected 5 h after the end of hypoxia to guarantee sufficient and
      reliable 13C labelling of glycogen. An earlier injection of [1-13C]glucose led to
      considerably diminished incorporation of 13C-labelled glucosyl units into
      glycogen, probably due to the consumption of the available glucose as fuel for
      ATP production. No scrambling of 13C into the C6 position of glycogen was
      observed, indicating a lack of gluconeogenic activity. 13C was also incorporated
      into the C3 positions of alanine and alanopine. To assign correctly this last 13C
      NMR resonance, the compound was synthesized biochemically. No labelling of
      glycogen was observed when [3-13C]alanine was injected into the coelomic cavity
      with similar incubation conditions being used. The 13C of [1-13C]glucose,
      incorporated into glycogen, showed a very low turnover rate in normoxic lugworms
      as shown by two 13C(1H)-NMR spectra, one obtained 48 h after the other. On the
      other hand, in hypoxia lugworms the signal due to 13C-labelled glycogen decreased
      very rapidly proving a high turnover rate. The disappearance of 13C from glycogen
      during the first 24 h of hypoxia indicates that the last glycosyl units to be
      synthesized are the first to be utilized. Lugworms were quite sensitive to the 1H
      decoupling field used for obtaining the 13C(1H)-NMR spectra, especially at 11.7
      T. Using bi-level composite-pulse decoupling and long relaxation delays, no
      tissue damage or stress-dependent phosphagen mobilization, as judged by 31P-NMR
      spectroscopy, was observed.

PMID- 2226447
TI  - Amino acid sequence and disulfide bridges of an antifungal protein isolated from
      Aspergillus giganteus.
AB  - A very basic secreted protein which displays antifungal activity was isolated
      from the medium of the mold Aspergillus giganteus. The protein consists of 51
      amino acid residues whose sequence was determined as Ala-Thr-Tyr-Asn-Gly-Lys-Cys
      Tyr-Lys-Lys-Asp-Asn- Ile-Cys-Lys-Tyr-Lys-Ala-Gln-Ser-Gly-Lys-Thr-Ala-Ile-Cys-Lys
      Cys-Tyr-Val- Lys- Lys-Cys-Pro-Arg-Asp-Gly-Ala-Lys-Cys-Glu-Phe-Asp-Ser-Tyr-Lys-Gly
      Lys-Cys- Tyr-Cys . Disulfide bonds were formed between Cys7-Cys33, Cys14-Cys40,
      Cys26-Cys28 and Cys49-Cys51. These results suggest that the antifungal protein
      forms a loop structure and is similar to phospholipase A2.

PMID- 2226446
TI  - A 31P-NMR study of bovine adrenocortical mitochondrial metabolic activities.
AB  - High-field 31P-NMR spectroscopy has been used to study the metabolic activities
      of coupled bovine adrenocortical mitochondria in vitro. These differentiated
      organelles use oxygen as a substrate to support both oxidative phosphorylation
      and specific steroid hydroxylation reactions. The NMR technique allowed the
      resolution of two inorganic phosphate signals, attributed to the matrix and
      external medium phosphate pools, at low and high field, respectively. These
      signals were used to calculate the respective Pi concentrations and to obtain the
      pH of the two corresponding compartments. In addition, the NMR spectra displayed
      resonance signals corresponding to ADP added to the medium and to ATP synthesized
      during oxidative phosphorylation. NMR analysis of the mitochondrial perchloric
      acid extracts identified the major phosphate-containing metabolites, namely
      NADP+, NAD+, phosphocholine, phosphoethanolamine, sn-glycero-(3)phosphocholine,
      AMP, ADP, ATP and Pi. Upon addition of ADP and malate to the oxygenated
      suspension, the kinetics of mitochondrial external Pi consumption and of ATP
      synthesis, along with the intra- and extraorganelle pH variations could be
      monitored over time periods of approximately 30 min, in the absence and presence
      of different steroid hydroxylation substrates. A major observation was that
      oxidative phosphorylation, which takes place in the absence of steroid, was
      markedly inhibited as soon as steroid hydroxylation was operating. These
      observations show the potential of 31P-NMR spectroscopy in the study of metabolic
      activities of isolated intact mitochondrial organelles. Such an approach appears
      promising for further determination of the underlying mechanisms in the balance
      between vital oxidative phosphorylation and differentiated steroid hydroxylation
      which are under hormonal control in adrenocortical mitochondria as well as in
      other steroidogenic cell systems.

PMID- 2226448
TI  - Protozoan myoglobin from Paramecium caudatum. Its autoxidation reaction and
      hemichrome formation.
AB  - Native oxymyoglobin (MbO2) was isolated directly from the cells of Paramecium
      caudatum with complete separation from metmyoglobin (metMb) on a DEAE-cellulose
      column. It was examined for its spectral and stability properties. When compared
      with sperm whale MbO2 used as a reference, Paramecium MbO2 was found to be much
      more susceptible to autoxidation over a wide range of pH (4-11) in 0.1 M buffer
      at 25 degrees C. Kinetic analysis has revealed that a proton-catalyzed
      displacement of O2- from MbO2 by an entering water molecule can play a dominant
      role in the autoxidation reaction of Paramecium MbO2 to metMb, as in the case of
      sperm whale MbO2 involving the distal histidine as its catalytic residue. At pH
      values higher than 9.5, however, Paramecium MbO2 was found to be oxidized to
      yield a hemichrome. The spontaneous formation of hemichromes is at variance with
      the other known myoglobins and is therefore discussed in relation to the unusual
      amino acid sequence of Paramecium myoglobin having a large number of deletion.

PMID- 2226449
TI  - Carbonyl reductases from rat testis and vas deferens. Purification, properties
      and localization.
AB  - Three enzyme forms (T1, T2, T3) from rat testis and two from rat vas deferens
      (V1, V2) of carbonyl reductase have been highly purified to apparent homogeneity.
      These carbonyl reductases from rat reproductive organs have several similarities
      in terms of molecular mass (32-33 kDa), isoelectric point (pI 5.9-6.4),
      immunochemical properties, cofactor requirement (NADPH dependency) and
      sensitivity to sulfhydryl reagents. The isoenzymes from the vas deferens (V1, V2)
      have similar catalytic activities, whereas those from the testis (T1, T2, T3)
      showed different catalytic activities from each other. All enzymes, however,
      reduced quinones, aromatic aldehydes and ketones, while T3, V1 and V2 were
      characterized as possessing high affinity towards prostaglandins. An
      immunoinhibition study using a specific antibody indicated that these enzymes
      were solely responsible for the overall catalytic activities of 13, 14-dihydro-15
      oxo-prostaglandin F2 alpha, 4-benzoylpyridine, and 4-nitroacetophenone reduction
      and prostaglandin F2 alpha oxidation in both testis and vas deferens cytosol. The
      immunohistochemical staining revealed a positive immunoreactivity to antibody
      only in the Leydig cells of the testis, but neither the germ cells nor Sertoli
      cells in the seminiferous tubule. The staining also showed that the enzymes in
      the vas deferens were primarily localized in mucosal epithelium cells.

PMID- 2226450
TI  - Kinetic analysis of the human erythrocyte glyoxalase system using 1H NMR and a
      computer model.
AB  - 1H NMR was used with methylglyoxal, purified by an HPLC technique, to study the
      kinetics of the human erythrocyte glyoxalase system. 1H NMR enabled the direct
      measurement of the time-dependent changes in concentrations of the two hydrates
      of methylglyoxal, which have not previously been directly measurable, as well as
      measurement of substrates and products of the glyoxalase enzyme system in the
      human red blood cell. A computer model of the reaction scheme was developed and
      NMR data numerically analyzed, thus allowing a complete kinetic description of
      the reactions. The rate constants describing the chemical equilibria between the
      hydrated species of methylglyoxal were determined by this numerical analysis or
      by a saturation-transfer technique, and found to be much slower (by several
      orders of magnitude) than previously determined by other methods. The kinetic
      parameters describing the enzyme-catalyzed reactions were also determined from
      experiments using a dilute haemolysate that was added to solutions of
      methylglyoxal and reduced glutathione (GSH). The maximal velocity of glyoxalase 1
      is threefold greater (Vmax = 70.4 +/- 4.7 mmol.min-1.1 packed cells-1) than
      glyoxalase 2(Vmax = 24 +/- 5 mmol.min-1.1 packed cells-1) and it exhibits
      threefold-greater affinity for its substrate (Km = 0.46 +/- 0.04 mM) than the
      second enzyme (Km = 1.5 +/- 0.4 mM). Both enzymes are subject to competitive
      inhibition; glyoxalase 1 by reduced glutathione (KiGSH = 7.88 +/- 0.16 mM) and
      glyoxalase 2 by the hemithioacetal (HTA) of methylglyoxal and GSH (KiHTA = 0.29
      +/- 0.04 mM).

PMID- 2226451
TI  - Subcellular localisation of dihydrolipoamide dehydrogenase and detection of
      lipoic acid in bloodstream forms of Trypanosoma brucei.
AB  - In the long-slender bloodstream form of Trypanosoma brucei, the enzyme
      dihydrolipoamide dehydrogenase exists in the absence of the 2-oxo-acid
      dehydrogenase complexes of which it is normally a component, and appears to be
      associated with the plasma membrane of the organism [Danson, M. J., Conroy, K.,
      McQuattie, A. & Stevenson, K. J. (1987) Biochem. J. 243, 661-665]. In the present
      paper, a complete subcellular fractionation of T. brucei has been carried out
      and, by comparison with marker enzymes, it is confirmed that the dihydrolipoamide
      dehydrogenase is indeed associated with the plasma membrane. In addition, we now
      provide evidence that the distribution of the enzyme is over the whole surface of
      the membrane, including the flagellar pocket region, and that the enzyme is not
      found in any other cellular fraction. A study of the latency of the enzyme
      suggests that it is located on the cytoplasmic surface of the plasma membrane.
      The discovery of the presumed substrate of dihydrolipoamide dehydrogenase, lipoic
      acid, is reported for T. brucei. Using a biological assay involving a strain of
      Escherichia coli that requires lipoic acid for growth, we have found that acid
      hydrolysed extracts of T. brucei contain 1.7 (+/- 0.2) ng of the cofactor/mg
      protein. The chemical nature of the lipoic acid was confirmed by gas
      chromatography/mass spectrometry.

PMID- 2226453
TI  - Comparison of three classes of human liver alcohol dehydrogenase. Emphasis on
      different substrate binding pockets.
AB  - Conformational models of the three characterized classes of mammalian liver
      alcohol dehydrogenase were constructed using computer graphics based on the known
      three-dimensional structure of the E subunit of the horse enzyme (class I) and
      the primary structures of the three human enzyme classes. This correlates the
      substrate-binding pockets of the class I subunits (alpha, beta and gamma in the
      human enzyme) with those of the class II and III subunits (pi and chi,
      respectively) for three enzymes that differ in substrate specificity, inhibition
      pattern and many other properties. The substrate-binding sites exhibit pronounced
      differences in both shape and properties. Comparing human class I subunits with
      those of class II and III subunits there are no less than 8 and 10 replacements,
      respectively, out of 11 residues in the substrate pocket, while in the human
      class I isozyme variants, only 1-3 of these 11 positions differ. A single
      residue, Val294, is conserved throughout. The liver alcohol dehydrogenases, with
      different substrate-specificity pockets, resemble the patterns of other enzyme
      families such as the pancreatic serine proteases. The inner part of the substrate
      cleft in the class II and III enzymes is smaller than in the horse class I
      enzyme, because both Ser48 and Phe93 are replaced by larger residues, Thr and
      Tyr, respectively. In class II, the residues in the substrate pocket are larger
      in about half of the positions. It is rich in aromatic residues, four Phe and one
      Tyr, making the substrate site distinctly smaller than in the class I subunits.
      In class III, the inner part of the substrate cleft is narrow but the outer part
      considerably wider and more polar than in the class I and II enzymes. In
      addition, Ser (or Thr) and Tyr in class II and III instead of His51 may influence
      proton abstraction/donation at the active site.

PMID- 2226452
TI  - The three cysteine residues of cytoplasmic aspartyl-tRNA synthetase from
      Saccharomyces cerevisiae are not essential for its activity.
AB  - Cytoplasmic aspartyl-tRNA synthetase from Saccharomyces cerevisiae is a dimer
      made up of identical subunits (Mr 63,000) each of these containing three
      cysteines (residues 255, 512 and 519 in the amino acid sequence). Thiol-specific
      probes were used to label these cysteines and study the resulting effect of the
      modification on the kinetic parameters of both the ATP/PPi exchange and tRNA
      aminoacylation reactions. Using the classical techniques of protein chemistry it
      was shown that none of the three cysteines was labelled with iodoacetic acid,
      whilst N-ethylmaleimide and 5,5'-dithiobis(2-nitrobenzoate) reacted with Cys512
      and Cys255, respectively. Only the latter modification was accompanied by a
      decrease in the rates of both enzyme activities whilst the Km values for the
      various substrates remained unaffected. Site-directed mutagenesis was also used
      to replace each of the three cysteines by other residues, either individually or
      simultaneously. For these experiments the enzyme was expressed in Escherichia
      coli using an expression vector bearing the structural gene in which the first 13
      codons were replaced by the first 14 of the CII lambda gene. The resulting
      substitution in the amino-terminal part of the expressed enzyme had no effect on
      the kinetic parameters, compared to those of the enzyme purified from S.
      cerevisiae. Taking into account the consequences of such substitutions, as well
      as those of chemical modifications on the two reactions catalysed by the enzyme.
      ATP/PPi exchange and tRNA aminoacylation, it could be concluded that none of
      these three cysteines plays any essential role in either substrate binding or
      catalysis.

PMID- 2226454
TI  - The tissue-specific expression of the thyroglobulin gene requires interaction
      between thyroid-specific and ubiquitous factors.
AB  - Thyroid-specific expression of the rat thyroglobulin gene is mediated by
      transcriptional control. Sufficient DNA sequence information to confer thyroid
      specific expression to a heterologous gene is contained between positions -168
      and +39. DNA-binding studies have demonstrated that this region interacts with
      two thyroid-specific factors (TTF-1 and TTF-2), and a ubiquitous factor (UFA).
      Here we have characterized three elements within the promoter, A, K, and C, which
      are important for promoter activity in thyroid cells. We have shown by mutational
      analysis that the interaction of TTF-1 with the A and C regions. UFA with the A
      region, and TTF-2 with the K region are required for full promoter activity. The
      complex interactions in the A region can be replaced by the substitution of the
      UFA/TTF-1-binding site with a high-affinity TTF-1 binding site. There is a
      correlation between the presence of TTF-1 and TTF-2 DNA-binding activities and
      the expression of thyroglobulin, which implies that the mechanism restricting
      thyroglobulin expression to thyroid cells is mediated through the control of the
      expression, or the activity, of TTF-1 and TTF-2.

PMID- 2226455
TI  - Export and purification of a cytoplasmic dimeric protein by fusion to the maltose
      binding protein of Escherichia coli.
AB  - A hybrid between the maltose-binding protein (MalE) of Escherichia coli and the
      gene 5 protein (G5P) of phage M13 was constructed at the genetic level. MalE is a
      monomeric and periplasmic protein while G5P is dimeric and cytoplasmic. The
      hybrid (MalE-G5P) was synthesized in large amounts from a multicopy plasmid and
      efficiently exported into the periplasmic space of E. coli. The export was
      dependent on the integrity of the signal peptide. MalE-G5P was purified from a
      periplasmic extract by affinity chromatography on cross-linked amylose, with a
      yield larger than 50,000 molecules/E. coli cell. The hybrid specifically bound
      denatured but not double-stranded DNA cellulose, as native G5P. Sedimentation
      velocity and gel-filtration experiments showed that MalE-G5P exists as a dimer.
      Thus, it was possible to efficiently translocate through the membrane a normally
      cytoplasmic and dimeric protein, by fusion to MalE. Moreover, the passenger
      protein kept its activity, specificity and quaternary structure in the purified
      hybrid. MalE-G5P will enable the study of mutant G5P that no longer binds single
      stranded DNA and therefore cannot be purified by DNA-cellulose chromatography.

PMID- 2226456
TI  - Bovine hemoglobin pseudo-crosslinked with mono(3,5-dibromosalicyl)-fumarate.
AB  - Under oxygenated conditions bovine hemoglobin reacts with mono(3,5
      dibromosalicyl)-fumarate which specifically acylates the EF5 lysines in the beta
      cleft of the protein. The chemical modification introduces in the molecule a
      pseudo-crosslink which hinders the dissociation of the hemoglobin molecule into
      dimers. Retention time in circulation of the chemically modified bovine
      hemoglobin, measured in the rat, is increased fivefold with respect to untreated
      bovine hemoglobin. The oxygen affinity at 37 degrees C and at pH 7.4, has a P50 =
      5.4 kPa and a value of n = 1.9. Under the same experimental conditions the oxygen
      affinity is not sensitive to anions and polyanions whereas it is sensitive to
      CO2. The Bohr effect is shifted toward the alkaline pH range by 0.5-1: the
      maximum number of protons released is 1.5/tetramer, similar to normal bovine
      hemoglobin (1.8 protons/tetramer). Analysis of the binding isotherms, using the
      two-state Monod-Wyman-Changeux model and fixing the value of the allosteric
      constant L = 10(5), shows that the oxygen affinity of the T structure is not
      modified, and that the low oxygen affinity of the system is due to a decrease of
      the oxygen affinity of the R structure. Analysis using the sequential Adair model
      shows a modification of the overall binding constants and suggests a
      redistribution of the intermediate species of oxygenation.

PMID- 2226458
TI  - Distribution of the early light-inducible protein in the thylakoids of developing
      pea chloroplasts.
AB  - The distribution of the early light-inducible protein (ELIP) of pea (Pisum
      sativum) between grana and stroma thylakoids was studied. An antibody raised
      against a bacterial-expressed fusion protein containing ELIP sequences was used.
      Illumination of dark-grown pea seedlings causes an accumulation of the ELIP in
      the thylakoid membranes with a maximum level at 16 h. During continuous
      illumination exceeding 16 h the level decreases again. The fractionation of
      thylakoid membranes of 48-h-illuminated pea seedlings in grana and stroma
      thylakoids reveals that there is no uniform distribution of ELIP in the
      thylakoids. Rather 60-70% of ELIP was found in the stroma thylakoids and 30-40%
      in the grana thylakoids. This distribution is in accordance with that of
      photosystem I but not with that of photosystem II. After Triton-X-100
      solubilization almost all ELIP is found in the photosystem-I-containing fraction.
      This also supports an association of ELIP with photosystem I.

PMID- 2226457
TI  - Physicochemical studies of human O6-methylguanine-DNA methyltransferase.
AB  - O6-Methylguanine-DNA methyltransferase, present in most organisms, removes
      mutagenic and carcinogenic O6-alkylguanine from DNA by accepting the alkyl group
      in a stoichiometric reaction. The protein has been partially purified from human
      placenta. It reacts with second-order rate constants of 2.20 x 10(8) and 0.067 x
      10(8) lmol-1 min-1 at 37 degrees C for duplex and single-stranded DNA substrates,
      respectively. The corresponding value for the alkylated base in synthetic
      poly(dC, dG, m6dG) is 0.02 x 10(8) l mol-1 min-1. The native protein is monomeric
      with a molecular mass of 22-24 kDa. Methylation of the protein does not lead to a
      gross change in its conformation but causes a slight reduction in its isoelectric
      point of 6.2. Although DNA protects the protein from heat inactivation, both
      duplex and single-stranded DNAs inhibit its activity in a concentration-dependent
      manner. The transferase reaction rate is also strongly inhibited by salt with
      about 20% of the maximum rate observed in physiological ionic strength. This
      inhibition is nonspecific with respect to the ions of univalent salts.

PMID- 2226459
TI  - Effect of the tyrosine 96 hydrogen bond on the inactivation of cytochrome P
      450cam induced by hydrostatic pressure.
AB  - The effects of removal of the tyrosine 96 hydrogen bond on the stability and
      conformational events of cytochrome P-450cam are presented in this communication.
      Hydrostatic pressure has been used as a tool to perturbe the structure leading to
      the formation of cytochrome P-420, an inactivated but soluble and undenatured
      form of the enzyme. We show that the spin transition of cytochrome P-450cam,
      which is known to be influenced by hydrostatic pressure, is affected by this
      single mutation. The free energy of stabilisation of native substrate-free
      cytochrome P-450cam is not affected by the removal of the tyrosine 96 hydrogen
      bond via mutagenesis to phenylalanine, whereas the substrate-bound protein shows
      a difference of 21 kJ/mol. These results, as well as an observed 110 ml/mol
      difference for the volume of the inactivation reaction between substrate-bound
      native and mutant proteins, have been interpreted in terms of a more hydrated
      heme pocket for the site-directed mutant at position 96 compared to the wild-type
      protein where camphor is tightly bound via the tyrosine 96 hydrogen bond and
      water excluded from the active site.

PMID- 2226460
TI  - Dual effects of the ricin A chain on protein synthesis in rabbit reticulocyte
      lysate. Inhibition of initiation and translocation.
AB  - Ricin A chain caused inhibition of protein synthesis by reticulocyte lysate with
      concomitant depurination of 28S rRNA. The partial reaction(s) of protein
      synthesis inhibited was investigated by following the appearance of
      [35S]methionine from initiator [35S]Met-tRNA into 40S ribosomal subunits, 80S
      monosomes and polysomes. Ricin A chain caused an accumulation of [35S]Met in
      monosomes which did not enter polysomes. In these respects the effects of the
      ricin A chain resembled those of diphtheria toxin, an inhibitor of elongation
      factor-2-catalyzed translocation. This is consistent with the previously proposed
      site of action of ricin as an inhibitor of elongation. However, the inhibitory
      effects of the ricin A chain and diphtheria toxin are not equivalent because we
      observed that the rate of formation of the 80S initiation complex was reduced
      approximately sixfold with the ricin A chain relative to diphtheria toxin.
      Analysis of methionine-containing peptides bound to 80S monosomes in ricin-A
      chain-inhibited and diphtheria-toxin-inhibited lysates, programmed with globin
      mRNA, revealed a predominance of Met-Val, suggesting that the elongation cycle is
      inhibited at the translocation step. Translocation was also implicated as the
      step blocked in both the ricin-A-chain-inhibited and diphtheria-toxin-inhibited
      lysates, by the finding that nascent peptide chains were unreactive towards
      puromycin. It is concluded that ricin-A-chain-modified ribosomes are deficient in
      two protein synthesis partial reactions: the formation of the 80S initiation
      complex during initiation and the translocation step of the elongation cycle.

PMID- 2226461
TI  - Secondary structure and dosage of soluble and membrane proteins by attenuated
      total reflection Fourier-transform infrared spectroscopy on hydrated films.
AB  - Attenuated total reflection Fourier-transform infrared spectroscopy of thin
      hydrated films of soluble and membrane protein included in a phospholipid bilayer
      is shown to provide useful information as to the secondary structure of the
      protein. The analysis of the amide I band of deuterated samples by Fourier self
      deconvolution followed by a curve fitting was performed by a new procedure in
      which all the input parameters are generated by the computer rather than by the
      investigator. The results of this analysis provide a correct estimation of the
      alpha-helix and beta-sheet structure content with a standard deviation of 8.6%
      when X-ray structures are taken as a reference. We also show that the orientation
      of the different secondary structures resolved by the Fourier self
      deconvolution/curve-fitting procedure and of the phospholipid acyl chains can be
      simultaneously evaluated for membrane proteins reconstituted in a lipid bilayer.
      Of special interest for reconstitution of membrane proteins, the lipid/protein
      ratio can be accurately and quickly determined from the infrared spectrum.

PMID- 2226462
TI  - myo-inositol oxygenase from rat kidneys. Substrate-dependent oligomerization.
AB  - myo-Inositol from rat kidneys, an oligomeric protein with apparent molecular mass
      of about 270 kDa can be dissociated under mild conditions to structured 16.8-kDa
      monomers. This dissociation can be reversed at high protein concentrations at
      room temperature. The corresponding apparent dimerization constant K2app = 1.38 x
      10(5) M-1, the corresponding rate constant k2 = 350 s-1.M-1, and the apparent
      constant for the association of dimers, K4app = 2.7 x 10(6) M-1. Reassociation is
      significantly enhanced in the presence of the substrate and iron(II) (K2app = 9.8
      x 10(5) M-1; K4app = 3.75 x 10(6) M-1, k2 = 1750 s-1.M-1, at 20 mM myo-inositol
      and 0.5 mM FeSO4). Under these conditions almost 100% of the original enzymatic
      activity was reconstituted. Monomers, with or without bound ligands, lack
      catalytic activity, whereas the dimer is likely to be the elementary active
      enzyme-building unit. The effects of myo-inositol on the dimerization lead to the
      conclusion that this step is both mediated and facilitated by the substrate.

PMID- 2226463
TI  - A novel testis-specific 105-kDa protein related to the 90-kDa heat-shock protein.
AB  - Brain 90- and 100-kDa heat-shock proteins (HSP90 and HSP100) were purified and
      antibodies against them prepared. The two antibodies were very specific and did
      not cross-react with each other. In rat, immunoblotting with the anti-HSP90
      antibody showed the most abundant presence of HSP90 in testis as well as brain,
      compared with lung, liver, spleen, kidney, cardiac muscle, ovarium and uterus.
      The anti-HSP90 antibody showed the presence of a new 105-kDa protein in rat
      testis. This novel 105-kDa protein was also detected in brain at a very low
      concentration but not in HeLa cells or other organs including the uterus and
      ovarium. The testis 105-kDa protein was purified from rat testis; although it was
      clearly separable from HSP90 by two-dimensional gel electrophoresis, Q-Sepharose
      and hydroxyapatite column chromatographies, the properties of this protein were
      very similar to HSP90. The similarity was higher than 60% on peptide mapping with
      trypsin digestion, the 105-kDa protein cross-reacted with anti-HSP90 antibody,
      both were bound similarly to heparin-Sepharose gel and both are located in the
      cytosol fraction. When the 105-kDa protein was fractionated by HPLC, a molecular
      mass of 195 kDa was calculated, indicating that it is composed of two identical
      subunits, similarly to HSP90. The 105-kDa protein did not react with the anti
      HSP100 antibody. There was a slight similarity between the 105-kDa protein and
      HSP100 on the peptide mapping. HSP100 was present in the microsomal fraction as
      well as in the cytosol. It is concluded that the 105-kDa protein is a testis
      specific and HSP90-related protein.

PMID- 2226464
TI  - Analysis of the binding of glyceraldehyde-3-phosphate dehydrogenase to
      microtubules, the mechanism of bundle formation and the linkage effect.
AB  - The binding of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) to microtubules
      was analysed by the determination of the concentration of the free enzyme in
      equilibrium with the complex. At low ionic strength (0.03 M) the binding data are
      best described by a sum of high (Kd = 0.28 microM) and low affinity (Kd = 7.14
      microM) sites, showing positive cooperativity. Addition of 1 mM adenosine 5'
      [beta,gamma-imido]triphosphate (p[NH]ppA) or increasing the ionic strength to 0.1
      M reduces the binding constant of the high-affinity sites considerably. Adding
      microtubule-associated proteins (at I = 0.1 M) does not appreciably influence the
      affinities. Total stoichiometries vary over 2.1-1.2 tubulin dimers involved in a
      binding site for GAPDH. Bundling is reduced concomitantly with the reduction of
      the affinities and the increase of the stoichiometry to close to 1 mol GAPDH/mol
      tubulin dimer. The critical concentration of tubulin is practically not
      influenced by the binding of the enzyme. This behaviour is discussed in terms of
      the concept of linked functions. p[NH]ppA dissociates the bundles very rapidly.
      Analytical sedimentation studies showed that the dissociation of the bundles by
      p[NH]ppA is not due to the dissociation of the tetrameric enzyme. Bundling slows
      down association and dissociation of microtubules. The rate of bundle formation,
      after addition of GAPDH to preformed microtubules, is not dependent on the GAPDH
      concentration.

PMID- 2226465
TI  - Binding of a photoaffinity analogue of pyridoxal to pyridoxal kinase.
AB  - The binding of pyridoxal analogues to the structural domains of pyridoxal kinase
      was studied by fluorescence spectroscopy and chromatographic techniques. Two
      fragments of 24 and 16 kDa, arising from limited proteolysis of the native
      enzyme, were separated by ion-exchange chromatography and used for binding
      studies with pyridoxal oxime. Fluorometric titrations yielded dissociation
      constants of 6 and 12.4 MicroM for pyridoxal oxime bound to the native enzyme and
      24-kDa fragment, respectively. 4-(4-Azido-2-nitrophenyl)-pyridoxamine, a new
      photolabeling reagent, binds irreversibly to the kinase with concomitant loss of
      catalytic activity. The modified kinase (2.1 mol label/mol dimer) yields two
      fragments upon limited proteolysis with chymotrypsin. The two fragments were
      separated by reverse-phase HPLC and SDS/polyacrylamide gel electrophoresis.
      Radiolabeled ligand was detected only in the 24-kDa fragment. It is postulated
      that the pyridoxal binding site is located in the 24-kDa structural domain.

PMID- 2226466
TI  - Inhibition of factor X and factor V activation by dermatan sulfate and a
      pentasaccharide with high affinity for antithrombin III in human plasma.
AB  - There is evidence that by catalyzing thrombin inhibition, several
      glycosaminoglycans can inhibit the thrombin-mediated amplification reactions of
      coagulation and thereby delay prothrombin activation. The two amplification
      reactions can apparently be catalysed by endogenously generated factor Xa and
      thrombin. This study provides evidence which suggests that on a molar basis, an
      agent which can only catalyse thrombin inhibition is approximately 10 times more
      effective than an agent which can only catalyse factor Xa inhibition in their
      ability to inhibit intrinsic prothrombin activation. We determined the
      concentrations of each of heparin, dermatan sulfate and a pentasaccharide with
      high affinity for antithrombin III, to delay intrinsic prothrombin activation for
      at least 15s. Heparin catalyses both thrombin and factor Xa inhibition; dermatan
      sulfate catalyses only thrombin inhibition, while the pentasaccharide only
      catalyses factor Xa inhibition. Efficient prothrombin activation, which coincided
      with both factor X activation and factor V proteolysis, was first observed 45s
      after CaC12 was added to contact-activated plasma. Heparin (approximately 0.1
      microM) prolonged by at least 30 s the time required for the activation of the
      three clotting factors to begin. The minimum concentrations of the
      pentasaccharide and dermatan sulfate to delay the activation of prothrombin,
      factors X and V were approximately 50 microM and approximately 5 microM,
      respectively. Thus, each anticoagulant could inhibit intrinsic prothrombin
      activation only when it inhibited activation of both factors X and V. A
      combination of approximately 5 microM pentasaccharide and approximately 0.05
      microM dermatan sulfate similarly delayed the activation of all three clotting
      factors. Thus, while catalysis of thrombin inhibition is a more effective pathway
      than catalysis of factor Xa inhibition for delaying prothrombin activation, the
      simultaneous catalysis of thrombin and factor Xa inhibition can synergistically
      improve the ability of a sulfated polysaccharide to delay prothrombin activation.

PMID- 2226467
TI  - The inositol-phospholipid-accelerated activation of prekallikrein by activated
      factor XII at physiological ionic strength requires zinc ions and high-Mr
      kininogen.
AB  - In a system consisting of purified proteins inositol-phospholipid-accelerated
      activation of prekallikrein by alpha-factor XIIa was determined by measuring the
      appearance of kallikrein amidolytic activity towards the chromogenic substrate, H
      D-Pro-Phe-Arg-NH-PhNO2 (PhNO2, 4-nitrophenyl). The activation reaction was ionic
      strength dependent. In the absence of high-Mr kininogen optimal activity was
      recorded at I = 50 mM. Searching for conditions, which could change this optimum
      towards physiological values, high-Mr kininogen was added. This resulted in an
      inhibition of the activity, with no change in ionic strength optimum. If,
      however, Zn2+ were added concomitant with high-Mr kininogen, the inhibition was
      abolished and optimal activity recorded at physiological ionic strength. The
      optimal Zn2+ concentration was found to be 0.1 mM. Kinetic analysis of the
      reaction demonstrated that the kcat/Km was 1.2 x 10(5) M-1 s-1 in the absence and
      1.1 x 10(6) M-1 s-1 in the presence of Zn2+. Zn2+ were also required for inositol
      phospholipid-accelerated initiation of the contact activation in whole plasma.

PMID- 2226468
TI  - Activation of a serine/threonine kinase that phosphorylates microtubule
      associated protein 1B in vitro by growth factors and phorbol esters in quiescent
      rat fibroblastic cells.
AB  - We have previously found and characterized a mitogen-activated, serine/threonine
      specific protein kinase that specifically phosphorylates microtubule-associated
      protein 2 (MAP2) in vitro, which we call here MAP2 kinase [Hoshi, M., Nishida, E.
      & Sakai, H. (1988) J. Biol. Chem. 263, 5396-5401; Hoshi, M., Nishida, E. & Sakai,
      H. (1989) Eur. J. Biochem. 184, 477-486]. In this study, we have found another
      serine/threonine-specific protein kinase that is activated by various mitogens.
      The activated kinase utilized microtubule-associated protein 1B (MAP1B) as the
      major substrate in vitro, so we tentatively call it MAP1B kinase (M1BK). M1BK was
      maximally activated 20-30 min after treatment of quiescent rat fibroblastic 3Y1
      cells with epidermal growth factor (EGF), while MAP2 kinase was maximally
      activated within 5-10 min of EGF treatment. The EGF-activated M1BK was eluted at
      about 0.15 M NaCl on a DEAE-cellulose column, while the activated MAP2 kinase was
      eluted at about 0.1 M NaCl under the conditions used. The EGF-activated M1BK was
      eluted as a single peak just after the activated MAP2 kinase on an HPLC gel
      filtration column. Histone, casein and ribosomal protein S6 were very poor
      substrates for the M1BK, while MAP2 and myelin basic protein were moderate
      substrates. The M1BK activity in cell extracts was inhibited by Ca2+, glycerol 2
      phosphate and Zn2+, and slightly enhanced by heparin. These data suggested that
      M1BK is distinct from previously described mitogen-activated kinases such as MAP2
      kinase, casein kinase II and S6 kinase. Pretreatment with cycloheximide or
      puromycin did not block the M1BK activation by EGF. Furthermore, incubation of
      the EGF-activated M1BK with acid phosphatase inactivated the kinase activity.
      Therefore, M1BK may be activated by phosphorylation in EGF-treated cells. In
      addition to EGF, 12-O-tetradecanoylphorbol 13-acetate, platelet-derived growth
      factor and insulin-like growth factor-I also induced the activation of M1BK in
      quiescent cells.

PMID- 2226469
TI  - M-phase-specific cdc2 protein kinase phosphorylates the beta subunit of casein
      kinase II and increases casein kinase II activity.
AB  - The M-phase-specific cdc2 (cell division control) protein kinase (a component of
      the M-phase-promoting factor) was found to activate casein kinase II in vitro.
      The increase in casein kinase II activity ranged over 1.5-5-fold. Increase in
      activity was prevented if ATP was replaced during the activation reaction by a
      non-hydrolysable analogue. Alkaline phosphatase treatment of the activated enzyme
      decreased the activity to the basal level. The beta subunit of casein kinase II
      was phosphorylated by cdc2 protein kinase at site(s) different from the
      autophosphorylation sites of the enzyme. Phosphoamino acid analysis showed that
      the beta subunit was phosphorylated by cdc2 protein kinase at threonine residues
      while autophosphorylation involved serine residues. Casein kinase II may be part
      of the cascade which leads to increased phosphorylation of many proteins at M
      phase and therefore be involved in the pleiotropic effects of M-phase-promoting
      factor.

PMID- 2226470
TI  - The role of an invariant tryptophan residue in alpha-bungarotoxin and cobrotoxin.
      Investigation of active derivatives with the invariant tryptophan replaced by
      kynurenine.
AB  - Ozone oxidation converted the single, invariant, tryptophan residue to N2
      formylkynurenine in alpha-bungarotoxin and cobrotoxin. Upon this modification,
      the lethal toxicity was significantly reduced in cobrotoxin but mostly retained
      in alpha-bungarotoxin. Each neurotoxin containing kynurenine instead of
      tryptophan retained the same antigenicity as the native toxin. Fluorescence and
      CD spectroscopy revealed that, although the environment and state of the
      kynurenine residue were similar, [Kyn29]cobrotoxin was much more sensitive to pH
      change than alpha-[Kyn28]bungarotoxin. In terms of lethal toxicity and
      conformational stability, the invariant tryptophan residue appears to play a more
      important role in cobrotoxin, imparting a higher lethal toxicity than that in
      alpha-bungarotoxin, which has a disulfide bond at Cys29-Cys33.

PMID- 2226471
TI  - Nuclear-magnetic-resonance investigations of the biliverdin-apomyoglobin complex.
AB  - The recently described biliverdin-apomyoglobin complex has been investigated by
      two-dimensional NMR methods and molecular modeling with respect to the geometry
      of the chromophore and its position within the myoglobin pocket. Nuclear
      Overhauser effect correlations between the ligand and apoprotein amino acid
      residues prove that the bile pigment assumes a cyclic helical conformation and a
      position similar to heme in native myoglobin.

PMID- 2226472
TI  - Screening of natural products for antimicrobial agents.
AB  - Antimicrobial research is geared toward the discovery and development of novel
      chemical structures such as therapeutic antimicrobial agents. The continuing
      problem of development of resistance to existing antibacterial agents and the
      dearth of good antifungal agents motivates this effort toward innovation.
      Selection of possible new enzyme targets for antibiotic inhibition may be made on
      theoretical grounds, but it appears premature to select any single, previously
      unvalidated target for the intensive study required for rational drug design.
      Instead, a broad screen of chemical entities can be undertaken, dedicated to the
      discovery of novel antimicrobial inhibitors. A number of target areas are under
      investigation, including fungal mRNA splicing and bacterial DNA synthesis. A
      major part of the endeavor is in the historically productive area of natural
      product screening. To make the best use of natural product resources for the
      discovery of novel antibiotics, a balance is struct between screening for
      inhibitors of rationally chosen targets for which clinically useful inhibitors
      are not yet available, and screening more broadly to ensure that rare activities
      of unanticipated mode-of-action are not missed.

PMID- 2226473
TI  - Remarks on the screening of antibiotics for antibacterial activity.
AB  - The general principles of screening antibiotics for antimicrobial activity are
      similar to those for screening for other pharmacological effects. The system
      should be adapted to the specific character of the test substance and the
      objectives of the program. In the screening of beta-lactams, standard tests, such
      as determination of the MICs, effects of inoculum size or activity against
      systemic infection in mice, should be supplemented by less conventional studies
      on for instance activity against dormant bacteria or, in the case of penems or
      carbapenems, stability in the presence of kidney and lung dehydropeptidases.

PMID- 2226474
TI  - Screening for new agents.
AB  - Screening for new antiviral drugs is concentrated on a search for inhibitors of
      the human immunodeficiency virus, herpesviruses, influenza virus, hepatitis B
      virus and rhinovirus. The first step in the process is usually the screening of
      virus-infected cell cultures followed by secondary screening in infected animals.
      The relevance of the different screening methods for predicting clinical efficacy
      is at present uncertain due to the low number of compounds evaluated in double
      blind placebo-controlled clinical trials. As a consequence of the con-siderable
      activity in ongoing research on antiviral drugs the predictive value of the
      screening systems is expected to improve.

PMID- 2226475
TI  - Animal models as predictors of the safety and efficacy of antibiotics.
AB  - As opposed to the testing of safety, the testing of the efficacy of antibiotics
      in animals is not specified in any directives or guidelines and not explicitly
      required by regulatory authorities. There exists, however, no doubt that in the
      evaluation of new compounds testing of both safety and efficacy forms an
      essential link between in vitro tests and clinical trials. It is inconceivable
      that clinicians would be prepared to conduct a trial in patients without evidence
      of the efficacy of the antibiotic in question in an appropriate animal model of
      infection. Both the models for testing safety and those for testing efficacy
      suffer from a number of shortcomings. If investigators are aware of these
      deficiencies and take them into account when interpreting the results, the
      predictive value of the models can be significantly enhanced.

PMID- 2226476
TI  - Correlation between pharmacokinetics, pharmacodynamics and efficacy of
      antibacterial agents in animal models.
AB  - On the basis of a review of published literature it is demonstrated that
      pharmacokinetic parameters of antibacterial agents correlate well with
      therapeutic efficacy in animal models, provided pharmacodynamic parameters are
      taken into account. The time that serum levels exceed the MIC is the most
      significant parameter determining efficacy of beta-lactams, whereas the efficacy
      of aminoglycosides is dependent on serum concentrations and the area under the
      curve. The efficacy of quinolones tends to be correlated to the doses
      administered or drug levels achieved. However, specific pharmacodynamic
      properties contribute significantly to the therapeutic efficacy of a few
      quinolones only whereas other quinolones lack these specific pharmacodynamic
      attributes. Thus, the correlation of pharmacokinetic parameters with therapeutic
      efficacy provides important basic concepts for the design of preclinical and
      clinical studies in the course of which additional pharmacodynamic properties
      will become apparent.

PMID- 2226477
TI  - Basic requirements for the toxicity testing of antimicrobial agents.
AB  - The regulations in different countries on the toxicological testing of
      antimicrobial agents are similar and harmonized on an international basis.
      Existing requirements cover both the standard investigations performed with any
      other new class of therapeutic drug and investigations necessary due to the
      specific features of anti-infective agents. Such features are the therapeutic
      target (the microorganisms), the need to provide adequate treatment of patients
      even during clinical trials, and the potential of the drug to induce certain
      adverse reactions. The combination of toxicity tests used will be determined by
      the drug, its class and current knowledge.

PMID- 2226478
TI  - European standards for antibiotic susceptibility testing: towards a theoretical
      consensus.
AB  - Six different systems for antimicrobial susceptibility testing are used in Europe
      (BSAC, DIN, SFM, SIR, NCCLS and WRG). Breakpoints defining susceptibility or
      resistance of bacteria to antimicrobial agents remain the subject of discussion.
      Nevertheless, it is possible to establish a theoretical consensus standard list
      of breakpoints such that more than 95% of the breakpoints proposed by the
      different systems differ from the consensus standard by no more than one
      dilution. In general, the BSAC and DIN systems recommend lower breakpoints, and
      the SFM and NCCLS systems higher breakpoints than the consensus standard. Two
      thirds of the discrepancies are related to the breakpoints defining
      susceptibility. The breakpoint for susceptibility should reflect the intrinsic
      susceptibility of the isolate (absence of mechanisms of resistance), and the
      breakpoint for resistance the pharmacological potential of the drug. The
      scientific validation of breakpoints requires clinical verification.

PMID- 2226479
TI  - Prospects for standardisation of methods and guidelines for disc susceptibility
      testing.
AB  - The disc diffusion method of susceptibility testing is widely used in diagnostic
      laboratories throughout the world. It is simple to perform and very suited to the
      clinical laboratory where a single isolate can be tested with a series of
      antibiotics in one experiment. For these two reasons the test is by far the
      commonest type of susceptibility method used. Other methods such as determination
      of the minimum inhibitory concentration or "breakpoint" methods are used in only
      a small number of laboratories. If standardisation of methods is to be achieved
      in order to agree on uniform reporting and guidelines, methods using disc tests
      are of the highest priority.

PMID- 2226480
TI  - The regulation of biological products.
AB  - The purpose of regulations for biological products is the same as that for any
      other medicinal or related products: the protection of recipients of the
      products. The entry into the age of molecular biology with its attendant
      development and manufacturing technology has placed new demands on regulatory
      agencies and related industry personnel. While the general goals of regulations
      remain the same, the scientific bases by which biological products must be
      reviewed and registered vary from those traditionally used for drugs or even
      older vaccines produced by conventional methods of growth, harvesting and
      purification. New regulations must be developed which take into account the new
      science involved in molecular biology and recombinant technology; new definitions
      must be provided and widely understood. The regulation of biologic products on an
      international basis is complicated by issues such as national interests
      superceding individual patient needs, bureaucracies being driven primarily by
      regulation and secondarily by science, industry expecting priority treatment for
      innovative products while having to absorb costs related to lost regulatory
      review time, and agencies or industry relying upon outdated regulations and/or
      archaic tests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226481
TI  - Requirements for the documentation of pharmacokinetic properties of antimicrobial
      agents.
AB  - Proper documentation of new antimicrobial drugs for governmental registration
      authorities includes extensive pharmacokinetic studies. Pharmacokinetics
      represents the bridge between the in vitro and in vivo phases of drug
      development. Both healthy human volunteers and patients must be studied, the
      former during the initial stages of the pharmacokinetic studies. The
      documentation should give information on the following: absorption from the
      gastrointestinal tract, bioavailability, pharmacokinetic model, impact of
      increasing doses (oral and intravenous), metabolism, routes and degree of
      elimination, interaction with food and other drugs, impact of the steady state,
      and serum protein binding. Basic pharmacokinetic parameters used are the serum
      half-life, clearance, distribution volume and dose dependence. The
      bioavailability of oral doses must be determined using the same dose sizes and
      subjects. Data on extravascular penetration should also be included in complete
      documentation. Key diseases in which the pharmacokinetics should be studied are
      reduced renal and liver function, heart failure, pregnancy, cystic fibrosis and
      intestinal diseases. The consequences of low age (e.g. newborns) and old age also
      require some attention.

PMID- 2226483
TI  - Studies on the ecological impact of antibiotics.
AB  - The presence of an antibiotic in the intestinal tract as a result of oral
      administration or intestinal excretion can have a pronounced impact of the
      microflora. Studies of the effect on the intestinal microflora and faecal
      excretion should therefore be carried out in volunteers and patients when new
      antibacterial agents are evaluated. These two analyses should be combined in the
      evaluation.

PMID- 2226482
TI  - Significance of tissue levels for prediction of antibiotic efficacy and
      determination of dosage.
AB  - Determination of tissue levels is widely thought to provide useful information in
      the investigation of a new antibiotic, however this assumption is not fully
      justified. In this paper the following questions are covered. Firstly, the
      methodological problems encountered in the measurement of antibiotic levels in
      solid tissues and extravascular fluids are described. Secondly, the difficulties
      encountered in interpreting tissue concentrations are discussed, given the
      heterogeneity of distribution of drugs, potential intracellular penetration,
      binding to tissue proteins and local factors reducing antibacterial activity.
      Thirdly, the respective importance of animal and human data on tissue levels for
      prediction of efficacy is analysed. In some animal models it is possible to study
      the conditions affecting antibacterial activity and to obtain data relevant to
      the clinical situation. However, the inoculum effect, the metabolism of bacteria,
      the mechanism of the bactericidal action of drugs and the type of infected tissue
      are important factors to be taken into account. In humans, data obtained from
      infected tissue is sparse and contributes little to knowledge. Knowledge of
      tissue levels may be important for establishing whether data obtained in animals
      can be applied to humans or not. Fourthly, the importance of tissue levels in
      determining antibiotic dosages is evaluated. In humans, tissue levels are of
      limited value in the determination of unitary dose and dosage intervals in
      relation to the clinical response. Trough serum levels of free drug, half-life at
      the beta-phase and rate of in vitro killing are the most important parameters to
      be considered. Their relative importance depends mainly on the mode of action of
      the drug.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226484
TI  - Good clinical practice.
AB  - Good Clinical Practice (GCP) is a quality assurance system dealing with all
      stages of clinical trials which is progressively being adopted by European
      countries. European GCP guidelines are in preparation and will be issued soon.
      However, implementation of the guidelines poses major and costly problems. The
      training of investigators, the proper functioning of research ethics committees,
      the practice of obtaining written informed consent, source data verification, and
      quality control with internal audit and official inspections are among the most
      difficult issues. The obvious benefits of GCP are the improved quality of
      clinical trials and of data generated by such trials, as well as mutual
      recognition of studies conducted abroad.

PMID- 2226485
TI  - The design of clinical trials with antibiotics.
AB  - Clinical trials to test antibiotics are normally of a less than satisfactory
      quality. Examples of common errors in the design and execution of trials with
      antibiotics are inclusion of too few patients to allow conclusions to be drawn,
      open uncontrolled design leading to a risk of considerable investigator bias, and
      inclusion of heterogeneous patient samples. This article suggests minimum
      requirements for antibiotic studies. Guidelines for such trials are needed and
      should have the widest possible international application in order to permit
      studies involving centres in various countries and to reduce the costs for
      development of new drugs.

PMID- 2226487
TI  - Evaluation of methods for recording adverse drug reactions in clinical trials.
AB  - Four methods used for obtaining information from patients on adverse drug
      reactions are reviewed on the basis of personal experience. In the development of
      new therapeutic drugs the method which records all events experienced by a
      patient during drug treatment is to be preferred as it increases the possibility
      of detecting unanticipated or previously unreported adverse reactions.
      Disadvantage of this method is that a high number of events not related to drug
      treatment may be recorded, causing problems in analysis of the data.

PMID- 2226486
TI  - Evaluation of safety and tolerance in clinical trials with antimicrobial agents.
AB  - In this review the general and specific difficulties encountered in the
      evaluation of safety and tolerance of antimicrobial agents in clinical trials are
      discussed. In addition to the usual pharmacological and toxicological effects
      (adverse drug reactions) occurring in individual patients, microbiologically
      induced side-effects also have to be considered. The different methods for
      registration of side-effects and their limitations are discussed. A system is
      proposed for evaluation of the cause/effect relationships of adverse drug
      reactions. A system is also discussed for the evaluation of the severity of
      adverse drug reactions, and different classifications are presented.

PMID- 2226488
TI  - Regulatory requirements for clinical evaluation of antimicrobial agents.
AB  - Evaluation of antimicrobial agents in governed mainly by interaction between the
      pharmaceutical industry and regulatory authorities. The 1977 FDA guidelines have
      been setting the standards for more than a decade now. Basic principles of the
      1977 guidelines remain valid, however changes in the definition of end-points of
      response, as measured by both clinical and microbiological criteria, have
      occurred. The new (draft) FDA guidelines and the 1989 guidelines of the British
      Society of Antimicrobial Chemotherapy are more consistent with contemporary
      concepts of treatment. In general, the differences in the requirements are
      minimal with a few exceptions, namely the requirements concerning blinding and
      assessment of clinical efficacy by site of infection and by organism in the FDA
      guidelines.

PMID- 2226489
TI  - The clinical evaluation of antibacterial drugs: guidelines of the British Society
      for Antimicrobial Chemotherapy.
AB  - Anti-infective agents differ in several respects from other classes of
      therapeutic drugs. They are aimed at the treatment or prevention of infection
      which can occur at several body sites and be caused by a wide range of
      microorganisms. The infectious process frequently modifies metabolic behaviour
      which in turn may affect the pharmacology of an agent. In addition, the issue of
      drug resistance raises concerns in individual patients, hospital units and the
      broader community. The difficulties in scientifically validating the clinical
      efficacy and safety of anti-infective drugs led to the Report on the Clinical
      Evaluation of Antibacterial Drugs of the British Society for Antimicrobial
      Chemotherapy. The report identifies general principles relevant to the study of
      these drugs in man and identifies the major microbiological and clinical
      considerations. Detailed comments on the conduct of pharmacokinetic studies and
      therapeutic trials are provided with particular emphasis on design, definitions,
      execution and analysis. Adverse event monitoring, assessment of severity and
      determination of causality are also reviewed. Pharmaco-economic considerations
      are identified as a significant issue for the future. The revision of the 1977
      FDA guidelines on anti-infective drug development provides the opportunity to
      harmonise these issues, particularly within the major markets of North America,
      Europe and Japan.

PMID- 2226490
TI  - Guidelines of the World Health Organization for clinical trials with
      antimicrobial agents.
AB  - The WHO Consensus Documents Series on Clinical Investigation covers many
      different therapeutic drug groups including the antibacterial drugs. The
      documents have been produced by the WHO Regional Office for Europe in
      collaboration with a wide group of clinicians and other experts in order to
      define and promote agreement on current and emerging standards for the clinical
      investigation of drugs.

PMID- 2226491
TI  - The implications for Europe of revised FDA guidelines for clinical trials with
      anti-infective agents.
AB  - This article summarizes the current collaborative effort between the US Food und
      Drug Administration and the Infectious Diseases Society of America for the
      purpose of generating new General and Disease/Organism Specific Guidelines for
      the evaluation of anti-infective agents. Examples of proposed changes from draft
      documents are presented. The final documents may assist European colleagues in
      their efforts to establish a standardized new drug registration process by 1992.
      An area of mutual interest is the acceptability of safety and efficacy data from
      international clinical trials. In the interest of human and financial economies,
      both US and European Guidelines need to clarify the conditions, or criteria, for
      the conduct of valid 'off-shore' clinical trials.

PMID- 2226492
TI  - Use of a ribosomal RNA gene probe for the epidemiological study of methicillin
      and ciprofloxacin resistant Staphylococcus aureus.
AB  - Conventional bacteriophage typing was combined with ribotyping in the analysis of
      methicillin and ciprofloxacin resistant Staphylococcus aureus strains isolated in
      increasing frequency since the introduction of the new 4-quinolones as
      therapeutic agents in the Tel-Aviv Medical Center. Whole-cell DNA was digested
      with EcoRI and HindIII restriction endonucleases. Agarose gel electrophoresis,
      Southern blotting, and hybridization by biotinylated probe DNA coding for
      ribosomal RNA revealed 7 to 14 bands. Analysis of the patterns established a
      single DNA type in EcoRI as well as in HindIII digests for all strains except
      one. Control strains from other sources differed in their band patterns.
      Bacteriophage typing confirmed the results of DNA typing. Thus, the frequent
      occurrence of staphylococcal isolates resistant to 4-quinolones in the hospital
      was not due to mutational development of resistance in many strains, but to the
      spread of a resistant strain.

PMID- 2226493
TI  - Blood culture techniques for the diagnosis of melioidosis.
AB  - The effects of variations in laboratory technique on the speed and sensitivity of
      isolation of Pseudomonas pseudomallei from blood were evaluated prospectively.
      Pseudomonas pseudomallei was isolated from 154 of 546 cultures from 325 patients
      with suspected or confirmed melioidosis. Subcultures after 12 to 24 and 36 to 48
      hours of incubation were positive in 52.3% and 80.8% respectively. The yields
      from 20 ml (blood to broth ratio 1:4) and 50 ml (blood to broth ratio 1:10) brain
      heart infusion broth bottles were equivalent in patients not receiving treatment
      for melioidosis. During therapy, the 50 ml bottles grew Pseudomonas pseudomallei
      significantly faster than the 20 ml bottles (p less than 0.01), and gave a higher
      overall yield for cultures processed in antimicrobial removal devices (p less
      than 0.05). These devices themselves increased the speed of isolation of the
      organism from treated patients (p less than 0.01). In most cases, all bottles
      collected from a patient before treatment were positive, and a single 20 ml
      bottle had an estimated relative sensitivity of 85.7% (95% confidence interval
      77.1-94.3%). Early subculture should be employed routinely for the laboratory
      diagnosis of septicaemic melioidosis. However, blood culture techniques do not
      need to be sophisticated. Culture of 5 ml blood in 20 ml broth is a simple and
      sensitive procedure suitable for regions where melioidosis is currently under
      diagnosed.

PMID- 2226494
TI  - Histopathological method for diagnosis of cryptosporidiosis using monoclonal
      antibodies.
AB  - A monoclonal antibody directed against the oocyst wall of Cryptosporidium parvum
      was produced which strongly reacted with 25 strains of the parasite. This
      antibody was assessed for use in a diagnostic immunoperoxidase assay performed on
      tissue sections. It permitted an intense and specific staining of the parasite in
      five biopsies positive for Cryptosporidium parvum fixed with routine techniques.
      The procedure described may be useful in screening mucosal biopsies from
      immunosuppressed patients.

PMID- 2226495
TI  - Evaluation of two media for antibiotic susceptibility testing of anaerobic
      bacteria using the receiver operating characteristic procedure.
AB  - Wilkins-Chalgren agar and Meat-Yeast agar were evaluated as media for antibiotic
      susceptibility testing using 112 anaerobic bacterial strains. The results
      obtained with the two media using the diffusion method were compared with those
      obtained by the dilution method as reference method. The results were analyzed by
      the receiver operating characteristic (ROC) procedure allowing a graphic
      representation of sensitivity and specificity of the technique for each cut-off
      value. The area under the ROC curves was calculated to compare the accuracy of
      the two methods. Six antibiotics were tested including amoxicillin, cefoxitin,
      piperacillin, doxycycline and clindamycin. For amoxicillin and clindamycin, the
      two methods showed a high and identical discriminative power for distinguishing
      susceptible bacteria from the others. Diffusion in Wilkins-Chalgren agar appeared
      better than diffusion in Meat-Yeast agar for separating resistant bacteria from
      bacteria of intermediate susceptibility (amoxicillin p less than 0.005;
      clindamycin p less than 0.04). For other drugs, diffusion in Wilkins-Chalgren
      agar always had a discriminative power higher than that obtained with diffusion
      in Meat-Yeast agar for separating susceptible bacteria from the others (cefoxitin
      p less than 0.0005; piperacillin p less than 0.02; doxycycline p less than 0.05).
      The Wilkins-Chalgren agar medium thus appeared superior to the Meat-Yeast agar
      medium using the ROC evaluation method, which would deserve wider utilization in
      the field of microbiology.

PMID- 2226496
TI  - Onset of ocular complications in congenital toxoplasmosis associated with
      immunoglobulin M antibodies to Toxoplasma gondii.
AB  - Four patients with congenital toxoplasmosis serologically diagnosed by the Sabin
      Feldman test (SFT) and the IgM-indirect fluorescent antibody test (IgM-IFAT) in
      the first year of life presented with eye disease between the age of 21 months
      and ten years. Repeated serological testing revealed increasing levels of
      specific antibodies as measured by the SFT. IgM antibodies to Toxoplasma gondii
      were detected in all four patients by the immunosorbent agglutination assay, in
      two by the IgM-IFAT and in three by the IgM-indirect haemagglutination test.
      Findings suggest that specific IgM antibodies reappear at the time of
      reactivation of congenital toxoplasmosis later in life, or possibly persist for
      an extraordinary long period (up to ten years).

PMID- 2226497
TI  - Evaluation of a line immunoassay for the differential detection of antibodies to
      human immunodeficiency virus.
AB  - A newly introduced single strip line immunoassay was evaluated as a possible
      alternative to Western blot for the differential detection of antibodies to
      multiple HIV-1 and HIV-2 antigens in human serum. In a panel of 153 sera found to
      be positive twice in currently used screening tests, the line immunoassay and the
      Western blot detected 44 true positive results. Using Western blot as reference
      method, the line immunoassay gave 100% specificity and sensitivity. These results
      suggest that the line immunoassay may be a viable alternative to Western blot.

PMID- 2226498
TI  - Comparative in vitro activity of cefpirome and cefepime, two new cephalosporins.
AB  - In in vitro tests the broad-spectrum cephalosporins cefpirome and cefepime were
      highly active against Enterobacteriaceae, although often less so against strains
      resistant to amoxicillin-clavulanate and ticarcillin-clavulanate, and against
      most strains of Acinetobacter spp. and Aeromonas hydrophila. They were also
      active against Pseudomonas aeruginosa, although strains with non-plasmid mediated
      beta-lactam resistance were sometimes less sensitive. Other Pseudomonas spp.
      varied in their sensitivity. Both agents were highly active against Haemophilus
      influenzae, but beta-lactamase-producing Branhamella catarrhalis were somewhat
      less sensitive. Neisseria gonorrhoeae were susceptible, although non-beta
      lactamase producing penicillin-resistant strains had higher MICs. Gardnerella
      vaginalis was also susceptible and Campylobacter coli/jejuni usually susceptible.
      Both antibiotics had good activity against Staphylococcus aureus and coagulase
      negative staphylococci except for methicillin-resistant strains and
      Staphylococcus haemolyticus which were of borderline sensitivity. All
      streptococci were sensitive, with the exception of highly penicillin-resistant
      pneumococci and enterococci against which cefpirome had greater activity than
      cefepime. Both antibiotics had little useful activity against the Bacteroides
      fragilis group or Bacteroides oralis group but were active against most other
      anaerobes. Clostridium difficile and some other Clostridium species were
      resistant.

PMID- 2226500
TI  - In vitro susceptibility of Helicobacter pylori to the new oral cephalosporins
      cefpodoxime, ceftibuten and cefixime.
AB  - The in vitro activity against 30 Helicobacter pylori strains of three new third
      generation cephalosporins, cefpodoxime, ceftibuten and cefixime, which can be
      administered orally, was determined using an agar dilution technique under
      microaerophilic conditions. The MIC50 and MIC90 of cefpodoxime was 0.5 and 4.0
      micrograms/ml respectively, of ceftibuten 2.0 and 8.0 micrograms/ml, and of
      cefixime 0.06 and 0.5 microgram/ml. All antibiotics showed good activity against
      Helicobacter pylori, cefixime having the highest activity of the three agents.

PMID- 2226499
TI  - In vitro activity and beta-lactamase stability of the new oral cephalosporin Bay
      v 3522.
AB  - The activity of the new oral cephalosporin Bay v 3522 was compared to that of six
      other beta-lactam agents. Bay v 3522 inhibited methicillin-susceptible
      Staphylococcus aureus and Staphylococcus epidermidis at less than or equal to 2
      micrograms/ml, compared to MICs of greater than or equal to 8 micrograms/ml for
      the other cephalosporins tested. It was more active against Streptococcus
      pyogenes (MIC less than or equal to 0.06 microgram/ml) than cefuroxime, cefixime,
      cephalexin and cefaclor. Groups B, C and G streptococci were inhibited at less
      than or equal to 0.12 microgram/ml, while the MI"90 for Streptococcus bovis and
      viridans streptococci was 0.5 and 2 micrograms/ml, respectively. The MIC90 for
      enterococci and Listeria monocytogenes was 8 micrograms/ml. Clostridium
      perfringens was inhibited by 0.12 microgram/ml, but most Bacteroides spp. were
      resistant. The MIC90 for beta-lactamase positive Escherichia coli (producing
      primarily TEM-1) was greater than 64 micrograms/ml and for beta-lactamase
      negative strains 16 micrograms/ml. The MIC90 for high-level beta-lactamase
      producing Klebsiella pneumoniae was greater than 64 micrograms/ml versus 4
      micrograms/ml for other isolates. The MIC90 for Moraxella catarrhalis was 2
      micrograms/ml, for Haemophilus influenzae 1 micrograms/ml, and for Neisseria
      gonorrhoeae 4 micrograms/ml. Enterobacter cloacae, Citrobacter freundii, Proteus
      mirabilis, Providencia spp. and Pseudomonas aeruginosa were resistant. Bay v 3522
      was destroyed by TEM-1, SHV-1, TEM-3 and P99 beta-lactamases.

PMID- 2226501
TI  - In vitro activity of the new semi-synthetic polypeptide cilofungin (LY121019)
      against Aspergillus and Candida species.
AB  - The in vitro activity of cilofungin (LY121019), a new semi-synthetic antifungal
      agent was evaluated. Potent activity was seen against Candida albicans and
      Candida tropicalis, with almost identical MIC and MFC results, whereas no
      activity was seen against any isolates of Candida parapsilosis or three
      Aspergillus spp. However, MICs were dependent on medium and test conditions
      chosen. It is concluded that cilofungin has good activity against some medically
      important yeasts in vitro, and that its in vitro activity depends on the method
      used.

PMID- 2226502
TI  - Peritonitis caused by Actinomadura madurae in a patient on CAPD.

PMID- 2226503
TI  - Reactivation of hepatitis B virus in a previously immune patient with human
      immunodeficiency virus infection.

PMID- 2226504
TI  - Reentry revisited.

PMID- 2226505
TI  - Early appearance of 2,3-butanediol in acute myocardial infarction. A new marker
      for ischaemia?
AB  - In 28 patients with acute myocardial infarction, the release pattern of 2,3
      butanediol (BD), a product of intermediary metabolism, and creatine kinase
      activity (CK) in blood were compared. Whereas CK at entry was low in all
      patients, the BD level was elevated in 18 (64%). However, BD returned to normal
      levels during the next 24 h whereas CK increased. The BD level at entry did not
      allow differentiation between patients with transmural or non-transmural
      infarction; it was independent of clinical findings and biochemical parameters.
      We suggest that, in patients with acute myocardial infarction, elevated levels of
      BD originates from myocardial metabolism. Whether it reflects ongoing ischaemia
      or reperfusion of the infarcted area remains unresolved.

PMID- 2226506
TI  - Polymorphonuclear leucocytes as potential source of free radicals in the
      ischaemic-reperfused myocardium.
AB  - The feasibility of polymorphonuclear leucocytes as a potential source of free
      radicals during reperfusion of ischaemic myocardium was evaluated. Isolated rat
      heart was perfused in the presence of f-Met-Leu-Phe-activated and normal
      polymorphonuclear leucocytes for 30 min. To judge the degree of cellular injury
      which might result from activated polymorphonuclear leucocytes during perfusion,
      isolated hearts were also perfused with superoxide anions, hydroxyl radicals, and
      hypochlorous acid-generating systems in the absence or presence of their
      corresponding scavengers, superoxide dismutase plus catalase, dimethylthiourea,
      and allopurinol, respectively. Activated polymorphonuclear leucocytes stimulated
      the release of lactate dehydrogenase, a biological marker of cellular injury, and
      malondialdehyde, a presumptive marker for lipid peroxidation; increased tissue
      injury, as evidenced by morphologic examinations using light and electron
      microscopy; decreased dry/wet ratios of heart, signifying oedema formation; and
      reduced myocardial adenosine triphosphate and creatine phosphate content as well
      as coronary flow, indicating decreased myocardial performance. These biological,
      physiological, and morphologic parameters were reversed significantly, but not
      completely, by treating the heart with scavengers, superoxide dismutase plus
      catalase or allopurinol, but were reversed completely by simultaneous treatment
      with superoxide dismutase, catalase, and allopurinol. Comparable results were
      obtained when the hearts were treated with each of these free radical-generating
      systems and their corresponding scavengers. Generation of free radicals was
      confirmed either by cytochrome c reduction or by examining the chemiluminescence
      response using a luminometer. These results indicate that activated
      polymorphonuclear leucocytes can cause myocardial cellular injury equivalent to
      the damage caused by free radicals and oxidants which are present in an ischaemic
      reperfused heart, suggesting that polymorphonuclear leucocytes may be a potential
      source of free radicals in the reperfused heart.

PMID- 2226507
TI  - Increased neutrophil aggregability in coronary artery disease.
AB  - The purpose of this investigation was to study neutrophil (PMN) aggregation in
      the aorta and coronary sinus of 20 patients with angiographically documented
      coronary artery disease (group I) compared with eight patients with normal
      coronary arteries (group II). PMNs were separated from the other blood components
      and their aggregation response to Ca2+ ionophore A 23187 l x 10(-5) M (final
      concentration) was measured. Group I patients had higher aggregating activity in
      the coronary sinus than in the aorta (24.9 +/- 3.7 vs 18.7 +/- 3.4 average
      maximum delta T, P less than 0.01), while no difference was found in group II
      (coronary sinus 16.7 +/- 3.5; aorta 16.3 +/- 2.4 average maximum delta T P = NS).
      Among group I patients, smokers had a significantly higher aggregating activity
      than non-smokers, whereas no correlation was found between aggregation response
      and blood cholesterol values. These data suggest that the presence of
      atherosclerotic plaques in coronary vessels may prime PMNs so that they show
      greater aggregating response to subsequent stimulation.

PMID- 2226508
TI  - Factors predicting mortality in idiopathic dilated cardiomyopathy.
AB  - A study of factors predicting mortality was performed in 201 patients with
      dilated cardiomyopathy (163 men, 38 women, mean age: 48 +/- 11 years) by
      multivariate analysis (Cox Model) of 51 clinical, electrocardiographic,
      echocardiographic and haemodynamic parameters, 56 patients died during follow-up
      (mean follow-up: 57.1 +/- 29.9 months). 5 year survival was 77 +/- 3%. The
      following parameters were independent predictors of mortality: first symptom:
      pulmonary oedema, peripheral oedema, syncope; duration of symptoms at the time of
      inclusion; end systolic left ventricular volume; end diastolic left ventricular
      diameter; pulmonary artery systolic pressure; and their combination had the most
      accurate predictive value for death. A quantitative score (s) was calculated and
      used to define three subgroups: A:s less than or equal to 4.5; B: 4.5 less than s
      less than 6; C:s greater than or equal to 6. Five-year survival was 90 +/- 5% in
      group A; 84 +/- 4% in B and only 53 +/- 7% in C. In conclusion, overall survival
      was good in this population of all stage dilated cardiomyopathy; factors related
      to clinical severity, left ventricular dilation, systolic pulmonary artery
      pressure and duration of symptoms defined a subgroup of patients with poor
      prognosis.

PMID- 2226509
TI  - Cardiac evaluation of candidates for kidney transplantation: value of exercise
      radionuclide angiocardiography.
AB  - In view of the high incidence and mortality of coronary artery disease (CAD) in
      patients with kidney transplantation, a systematic cardiac evaluation was
      prospectively performed in 103 uraemic patients eligible for transplantation.
      After clinical examination, 28 patients with symptoms of CAD or diabetes mellitus
      were referred directly for coronary angiography, whereas the remaining 75
      patients had rest and exercise radionuclide angiocardiography for evaluation of
      possible asymptomatic CAD. Among them, left ventricular ejection fraction was
      below 40% at rest or fell during exercise by at least 5 EF% in 12 patients;
      coronary angiography in nine showed CAD in four and hypertensive heart disease in
      five. In the remaining 63 (of 75) patients without severe resting left
      ventricular dysfunction or exercise ischaemia, the follow-up of 28 +/- 7 months
      revealed no clinical manifestation of CAD. Overall incidence of CAD in
      symptomatic and asymptomatic patients during a follow-up of 27 months after
      cardiac evaluation was 20 and 25% in nondiabetic and diabetic candidates for
      kidney transplantation, respectively (P = n.s.). Thus, clinical examination
      combined with exercise radionuclide angiocardiography in patients without signs
      or symptoms of heart disease had a high predictive accuracy for presence or
      absence of late manifestations of CAD. Exercise radionuclide angiocardiography is
      therefore a useful method for screening kidney transplantation candidates for
      asymptomatic CAD.

PMID- 2226510
TI  - Doppler evaluation of left ventricular filling: effect of verapamil on non
      obstructive hypertrophic cardiomyopathy.
AB  - Impaired left ventricular (LV) filling is known to be a major determinant of non
      obstructive hypertrophic cardiomyopathy (HCM). Seventeen patients with non
      obstructive HCM (mean age 71 years) were investigated by Doppler
      echocardiography, before and after oral treatment with verapamil (mean daily
      doses: 335 mg). Diagnosis was based on clinical and echocardiographic data.
      Mitral regurgitation was absent or mild. Heart rate, PQ interval and mitral
      regurgitation did not change after treatment. All calculated values of Doppler LV
      filling improved significantly: corrected relaxation time, ratio of atrial to
      early velocity, EF slope and pressure half-time (P less than 0.005) showed more
      significant differences than more sophisticated indices using time-velocity
      integrals of Doppler LV filling flow (P less than 0.005). Results appear to
      reflect an effect of verapamil on LV relaxation; a slight effect of a modified
      load was nevertheless not excluded. We conclude that all parameters of Doppler LV
      filling show marked improvement in this elderly group with non-obstructive HCM,
      after oral verapamil. Doppler echocardiography is an easy and useful clinical
      method to assess the effect of a drug on ventricular relaxation of non
      obstructive HCM.

PMID- 2226511
TI  - Hepatic venous connection to a persistent inferior caval vein in left isomerism.
AB  - In 22 cases of left atrial isomerism studied at the Brompton Hospital, four cases
      were found to have an unusual arrangement of the abdominal vessels. There was
      persistence of an inferior caval vein, partially anomalous hepatic venous
      connection and additional continuation of part of the venous return from the
      lower body through the azygos venous system. This venous pattern had surgical
      implications in our index case, since redirection of the inferior caval venous
      return was necessary.

PMID- 2226512
TI  - Giant intrapericardial aneurysm of the left atrial appendage.
AB  - A young patient is reported with an aneurysm of the left atrial appendage having
      supraventricular arrhythmias and a period of chest pain accompanied by a rise in
      cardiac enzymes. Compression of the left anterior descending coronary artery by
      the aneurysm was felt to be responsible for the myocardial injury.

PMID- 2226513
TI  - Malignant thymoma causing tricuspid valve obstruction.
AB  - A 57-year-old man presenting with a retrosternal mass was found to have a
      malignant thymoma. This was treated with surgery and radiotherapy. It recurred 5
      years later as an intra-cardiac mass causing tricuspid valve obstruction.

PMID- 2226514
TI  - AV nodal reentrant tachycardia using three different AV nodal pathways.
AB  - In a patient with frequent paroxysmal supraventricular tachycardia, an
      electrophysiologic study was performed. Although by programmed atrial stimulation
      only double AV nodal pathways could be documented, three distinct forms of AV
      nodal reentrant tachycardia could be induced. By programmed atrial stimulation a
      typical AV nodal reentrant tachycardia was initiated, by programmed ventricular
      stimulation, an AV nodal reentrant tachycardia was induced with an antegrade
      conduction time of 215 ms and a retrograde conduction time of 160 ms.
      Furthermore, a third form of tachycardia was induced with alternating cycle
      length due to two different antegrade conduction times, whereas retrograde
      conduction time was almost identical, irrespective of the antegrade conduction
      time. The patient received betaxolol (20 mg day-1); during a second
      electrophysiologic study, the tachycardia could not be induced, and it did not
      occur spontaneously during a follow-up period of 14 months.

PMID- 2226515
TI  - Transthoracic and transoesophageal echocardiographic documentation of
      disappearance of massive right atrial and pulmonary artery thromboemboli after
      fibrinolytic therapy and normalization of left ventricular dimensions and
      function.
AB  - In this paper, we report a case of dilated cardiomyopathy with right atrial
      thrombi and pulmonary artery thromboemboli, in which regression of thromboemboli
      followed fibrinolytic therapy, and normalization of left ventricular dimensions
      and function were documented at echocardiographic follow-up. The important role
      of transoesophageal echocardiography in diagnosis and follow-up of right
      intracavitary masses and thromboemboli in the main pulmonary arteries is
      discussed, as is the role of echocardiography in follow-up of cardiomyopathy.

PMID- 2226516
TI  - Lipoproteins and the pathobiology of the arterial intima. The ninth Paavo Nurmi
      symposium. 7-9 September 1989, Porvoo, Finland. Proceedings.

PMID- 2226517
TI  - Malondialdehyde, modified lipoproteins, and atherosclerosis.

PMID- 2226518
TI  - Macrophage uptake of cholesterol-containing particles derived from LDL and
      isolated from atherosclerotic lesions.
AB  - A variety of different cholesterol-rich particles with different physical and
      chemical structures can be isolated from human atherosclerotic lesions. Many of
      these particles are internalized in an unregulated fashion by macrophages in
      culture, leading to lipid loading of these cells. However, the in vivo relevance
      of this uptake is still uncertain. In this overview, we have summarized data
      obtained primarily in our laboratory on low density lipoprotein (LDL)-like
      particles (A-LDL) and large cholesterol-rich droplets isolated from human
      atherosclerotic lesions. Based on our studies, we propose a variety of different
      mechanisms of uptake. A-LDL can be internalized by the LDL receptor or the
      scavenger receptor on macrophages in culture; the latter uptake mechanism can
      lead to lipid loading. In addition, at high concentrations A-LDL can undergo
      aggregation, possibly due to intermolecular cross-bridging by aldehydes released
      during oxidation of these particles. The aggregates are subsequently internalized
      by macrophages by phagocytosis, a process which appears to be independent of the
      LDL or scavenger receptor. By contrast, arterial smooth muscle cells do not take
      up these aggregates. Large cholesteryl ester-rich particles isolated from human
      lesions, and derived from LDL that had been degraded by hydrolytic enzymes in the
      extracellular space of the arterial wall, or from inclusions released from lysed
      foam cells, are also internalized via phagocytosis by macrophages in culture.
      Since some of these particles contain apoliproteins and/or proteins that are
      ligands for receptors on macrophages, initial receptor-mediated binding may
      precede and facilitate subsequent phagocytosis in some cases. Uptake of the
      diverse group of cholesteryl ester-rich particles in plaques can induce lipid
      loading of macrophages and therefore may lead to further growth of the
      atherosclerotic plaque.

PMID- 2226519
TI  - Macrophages and ceroid in human atherosclerosis.
AB  - It is proposed that atherosclerosis is a chronic inflammatory disease in which
      monocyte-derived macrophages are doing harm and smooth muscle cells are
      essentially reparative. Activities of macrophages that might be contributory to
      the development of atherosclerosis are tabulated. Observations and experiments
      are described that suggest macrophages may be contributing to lipoprotein
      oxidation within the plaque and that individual humans vary in their macrophage
      oxidative capacity. The possibility of intervention with antioxidants is
      discussed.

PMID- 2226520
TI  - The role of oxidized low density lipoprotein in the pathogenesis of
      atherosclerosis.
AB  - Recently, it has been suggested that oxidized low density lipoprotein (LDL) plays
      an important role in atherogenesis by facilitating the accumulation of lipids in
      macrophages. In vitro studies from our laboratory have shown that oxidized LDL is
      recognized not only by a specific receptor, but also by a receptor which
      recognizes both oxidized LDL and acetyl LDL. Probucol, originally developed as an
      antioxidant, prevents the oxidative modification of LDL in vitro. Our recent
      studies show that probucol prevents the progression of atherosclerosis in
      homozygous WHHL rabbits in vivo without any changes in plasma LDL cholesterol
      levels. These results strongly suggest that oxidative modification of LDL could
      occur in vivo and probucol could slow the progression of atherosclerosis,
      especially the foam cell-rich fatty streak lesions, without changing plasma
      cholesterol levels.

PMID- 2226521
TI  - Lipoprotein metabolism of human and rabbit arterial cells in primary culture.
AB  - The early atherosclerotic lesion, the fatty streak, consists of cholesteryl ester
      containing foam cells originating mainly from monocyte-macrophages and to a
      lesser extent from smooth muscle cells. In this study, we describe lipoprotein
      uptake and cholesterol accumulation into enzyme-dispersed primary cell cultures
      from cholesterol-fed rabbit aortas and human aortic fatty streaks. Uptake of
      fluorescently labelled acetylated low density lipoprotein (acetyl-LDL) was
      demonstrable in macrophage-derived foam cells and in many smooth muscle cells in
      early primary cultures. The uptake of acetyl-LDL led to significantly enhanced
      cellular esterification of cholesterol. Fluorescent beta-migrating very low
      density lipoprotein (beta-VLDL) was internalized by a considerable number of
      lesion macrophages and also by smooth muscle cells. Also beta-VLDL uptake
      stimulated cholesterol esterification, although the effect was milder than that
      of acetyl-LDL. These findings lend support to the assumption that, during
      atherogenesis, arterial macrophages are capable of accumulating cholesteryl
      esters by receptor-mediated uptake of beta-VLDL and modified LDL. The
      internalization of modified LDL by smooth muscle cells represents a mechanism
      potentially contributing to the formation of foam cells in the atherosclerotic
      lesion.

PMID- 2226522
TI  - The metabolism of low density lipoproteins by rat serosal mast cells.
AB  - Rat serosal mast cells contain secretory granules composed of a heparin
      proteoglycan matrix in which neutral proteases are embedded. Stimulation of the
      mast cells leads to granule exocytosis and formation of two pools of granules
      located extracellularly, firstly, granules expelled into the 'free' extracellular
      space and ultimately phagocytosed by the scavenging cells in the vicinity of mast
      cells and, secondly, granules which remain associated with their parent mast
      cells, and become internalized by them during recovery from stimulation. If mast
      cells are stimulated in the presence of macrophages in a low density lipoprotein
      (LDL)-containing medium, LDL is bound to the heparin proteoglycan component of
      the exocytosed granules whether they are expelled into the 'free' extracellular
      space or remain associated with the mast cells. The granules located in the
      'free' extracellular space degrade, by the action of their neutral proteases, the
      apolipoprotein B component of the bound LDL. The proteolytic degradation of the
      granule-bound LDL results in its modification such that large fused LDL particles
      are formed on the granule surface. Phagocytosis, by macrophages, of the granules
      containing fused LDL particles leads to lysosomal degradation of LDL and
      cholesterol accumulation in macrophages as non-membrane-bound cholesteryl ester
      droplets, typical of foam cells. In contrast, the rapid internalization of the
      LDL-bearing, mast-cell-associated granules by recovering mast cells is not
      followed by lysosomal processing of LDL. Instead, it leads to cholesterol
      accumulation in mast cells, in the form of large, partially degraded, modified
      LDL particles, in the granule compartment.

PMID- 2226523
TI  - Arterial wall proteoglycans--biological properties related to pathogenesis of
      atherosclerosis.
AB  - The arterial wall is a complex organ system with respect to carbohydrate-protein
      macromolecules, particularly proteoglycans. Proteoglycans in the arterial wall
      display polydispersity and heterogeneity even in the same family. At least two
      major types are known: chondroitin sulphate-dermatan sulphate type and heparan
      sulphate type. These proteoglycans have varied biological properties, and some of
      these properties are implicated in the development of atherosclerosis. The
      chondroitin sulphate-dermatan sulphate proteoglycans are capable of forming
      complexes with serum low-density lipoproteins, a process conductive to lipid
      accumulation in the extracellular space of the arterial wall. Also, such
      reactions render low-density lipoprotein particles electronegative aggregates.
      These altered low-density lipoproteins are taken up by macrophages (and possibly
      by proliferative smooth muscle cells) through a high-affinity receptor pathway
      devoid of feedback regulation, which results in intracellular lipid accumulation
      and foam-cell formation, a hallmark of atherosclerosis. On the other hand,
      heparan sulphate proteoglycan located on the cell surface and internal elastic
      lamina is antithrombogenic, and facilitates binding of the lipid-clearing enzyme,
      lipoprotein lipase, to endothelium. Thus, chondroitin sulphate and heparan
      sulphate proteoglycans with divergent biological properties play a crucial role
      in the pathogenesis of atherosclerosis.

PMID- 2226524
TI  - Transfer of lipoproteins from plasma to the cell populations of the normal and
      atherosclerotic arterial tissue.
AB  - It appears that retention of lipoproteins rather than increased influx is the
      basis for lipoprotein deposition in arterial tissue during atherogenesis. Binding
      of lipoproteins to arterial proteoglycans is mediated by a peptide sequence
      considered to be involved in the interaction between the lipoproteins and the
      lipoprotein receptor. Consequently, in the presence of an excess of arterial
      proteoglycan, receptor-mediated cellular uptake of LDL is inhibited. However, LDL
      which has been precipitated by proteoglycan and subsequently resolubilized is
      taken up more avidly than native LDL, both in macrophages and in smooth muscle
      cells. This appears to be due to selection by the proteoglycans of a more
      reactive fraction of LDL. This fraction has a smaller molecular size and less
      surface phospholipids. As smaller LDL particles also have a higher transfer rate
      into the arterial tissue they may be particularly atherogenic. Low density
      lipoproteins appear to be taken up with higher affinity by arterial macrophages
      than by smooth muscle cells. The selective transfer of the LDL to macrophages can
      be inhibited by alpha-tocopherol, suggesting that oxidative modification may be
      involved in this process. The role of foam cells in atherogenesis is discussed in
      the context of the energy requirements of the arterial wall.

PMID- 2226525
TI  - Molecular basis of the association of arterial proteoglycans with low density
      lipoproteins: its effect on the structure of the lipoprotein particle.
AB  - Modifications of low density lipoproteins (LDL) that enter the arterial intima
      appear to be responsible for their eventual extracellular and intracellular
      accumulation during atherogenesis. Some of these modifications seem to be the
      result of LDL association with intimal chondroitin sulphate-rich proteoglycans
      (CSPG). We have used frontal elution affinity chromatography, binding and
      competition experiments with synthetic segments of apoB-100 to better define the
      ligand regions for the LDL-CSPG complexes. The minimum structural requirement for
      recognition by the CSPG appears to be a hydrophilic nine-residue amino-acid
      segment with five lysine and arginine residues. Analysis of other similar regions
      in apoB-100 and other glycosaminoglycan-binding proteins suggest that besides a
      cluster of positively charged amino-acids, the presence of hydroxyl-containing
      residues favours the association with sulphated proteoglycans. With controlled
      proteolytic hydrolysis, we found that the interaction of LDL with CSPG modifies
      the surface accessibility of a apoB-100 segments containing arginine and lysine.
      Because these apoB-100 domains may also be involved in cell-receptor binding, the
      CSPG-induced modifications could be the structural explanation for the observed
      increase in cellular uptake of proteoglycan-modified LDL.

PMID- 2226527
TI  - Extracellular lipid deposition in atherosclerosis.
AB  - Atherosclerotic lipid deposits found in the core region of fibrous plaques are
      almost entirely extracellular, but it is not known whether they are derived from
      necrosis of cells containing accumulated lipid or from direct extracellular lipid
      accumulation. New evidence pertaining to this question has been obtained through
      the use of recently developed techniques for preserving and staining lipids in
      electron microscopy, and through a detailed morphologic and chemical examination
      of human aortic fibrolipid lesions, which are progenitor lesions for fibrous
      plaques. The evidence favours a substantial role, perhaps a dominant role, for
      extracellular lipid accumulation in the formation of the fibrous plaque core
      region.

PMID- 2226526
TI  - The role of HDL in reverse cholesterol transport and its disturbances in Tangier
      disease and HDL deficiency with xanthomas.

PMID- 2226528
TI  - Initial steps in reverse cholesterol transport: the role of short-lived
      cholesterol acceptors.
AB  - The early metabolism of cell-derived cholesterol was followed during the
      interaction of normolipaemic native plasma with cultured cell monolayers labelled
      to high specific activity with 3H-cholesterol. Kinetic analysis indicated that
      initial processing involved several prebeta-migrating high-density lipoprotein
      (HDL) species. A small prebeta species, the initial acceptor, was first converted
      to a lipoprotein whose composition predicts a discoidal structure. The free
      cholesterol content of this was then esterified by lecithin: cholesterol
      acyltransferase, and its cholesterol converted to the alpha mobility of
      spheroidal mature HDL the binding of apolipoprotein A-II. These studies follow
      the genesis of HDL in plasma from peripheral cell membrane cholesterol.

PMID- 2226529
TI  - Lipoproteins in interstitial fluid of dogs: implications for a role in reverse
      cholesterol transport.

PMID- 2226530
TI  - Lipoproteins of human peripheral lymph.
AB  - The concentration of cholesterol in peripheral lymph is roughly one tenth of that
      in the blood plasma of the same subject. In lymph, there is virtually no very low
      density lipoprotein (VLDL), probably due to low permeability of the vascular
      endothelium for particles of this size. More than 95% of apo B-containing
      lipoproteins of lymph have the density of plasma low density lipoproteins (LDL).
      The concentration of apo A-I and apo A-II in lymph is about 15% of that in
      plasma; yet about 50% of the total mass of both these main HDL apoproteins is
      present extravascularly. High density lipoproteins (HDL) of lymph appear square
      packing, and the presence of such large HDL particles is the most conspicuous
      difference between lipoproteins in plasma and in the extravascular fluids. It
      remains to be seen whether raising plasma apo A-I concentration per se will
      increase the initial stages of reverse cholesterol transport and also be
      clinically beneficial.

PMID- 2226531
TI  - Atheroma formation: defective control in the intimal round-trip of cholesterol.
AB  - This article is based on the concluding remarks by the author at the Ninth Paavo
      Nurmi Symposium on 'Lipoproteins and the Pathobiology of the Arterial Intima'. .
      . . Circulating cholesterol is carried into the arterial intima, the site of
      atherogenesis, in low-density lipoprotein (LDL) particles, and from the intima
      back into the circulation in high-density lipoprotein (HDL) particles. At
      affected sites in the intima, cholesterol accumulates in deposits known as
      atheromas. These local accumulations are due to disturbances in the cholesterol
      flow through the intima, resulting in imbalance between inflow and outflow of
      cholesterol. The rate of cholesterol accumulation depends ultimately on the
      severity of the imbalance. The factor primarily responsible for this cholesterol
      imbalance appears to be local modification of LDL particles. Hence, to prevent
      accumulation of cholesterol in the intima, the production of modified LDL
      particles must be prevented. This can best be achieved by reducing the inflow of
      LDL particles into the intima. This, in turn, can be achieved by lowering the
      concentration of circulating LDL particles. In addition, increasing the
      concentration of circulating HDL particles should accelerate the rate of removal
      of cholesterol from the intima, so further improving the disturbed cholesterol
      balance at the atheromatous sites.

PMID- 2226532
TI  - Mapping of proteoglycans in atherosclerotic lesions.
AB  - The involvement of sulphated glycosaminoglycans in atherosclerotic changes have
      been studied in human and rat arteries, and biochemical experiments have revealed
      that a significant increase in the contents of chondroitin sulphate/dermatan
      sulphate and cholesterol, but loss of heparan sulphate, occurs in human
      atherosclerotic arterial tissues. Electron micrographs have revealed that
      extracellular deposits of lipid are predominantly present in areas rich in
      chondroitin sulphate proteoglycans but not in areas rich in collagen bundles and
      dermatan sulphate proteoglycans. The different types of proteoglycans have been
      distinguished in situ by the cuprolinic blue staining method and enzymatic
      degradation experiments, and their topohistochemical distribution patterns
      analysed by morphometry of proteoglycan/cuprolinic blue precipitates. The
      ultracytochemical investigations indicate changes in size and pattern of
      chondroitin sulphate-rich proteoglycan-cuprolinic blue precipitates in human
      atherosclerosis. In plaque tissue, these precipitates are significantly enlarged.
      In addition, they accumulate around smooth muscle cells in the medial tissue. An
      increase in the size of proteoglycan-cuprolinic blue precipitates has also been
      observed in balloon catheter-induced lesions in rat carotid arteries. The large
      chondroitin sulphate as well as the small dermatan sulphate proteoglycan
      cuprolinic blue precipitates show this alteration 2 weeks after balloon injury.
      We suggest that quantitative and qualitative alterations in the arterial
      proteoglycans occur in the pathogenesis of atherosclerosis in addition to the
      cell proliferation and lipid accumulation.

PMID- 2226533
TI  - Pathobiology of human familial hypercholesterolaemia and a related animal model,
      the Watanabe heritable hyperlipidaemic rabbit.
AB  - Defective expression of low density lipoprotein (LDL) receptors is the basic
      genetic defect in human familial hypercholesterolaemia (FH) and its animal
      counterpart, the Watanabe heritable hyperlipidaemic (WHHL) rabbit. The pathologic
      manifestations of human FH were evaluated based on the study of material from six
      subjects with homozygous FH and a review of the literature. This analysis
      indicated that homozygous FH is characterized by accelerated atherosclerosis and
      prominent lipid accumulation in macrophages and other stromal cells of the aortic
      and mitral valves, skin, tendon, and, variably, in other extravascular sites.
      Disease progression was studied in the WHHL rabbit. From birth to 1 year, WHHL
      rabbits show evidence of progressive disease of the aorta with accumulation of
      birefringent lipid in intimal lesions, including fatty streaks, raised foam cell
      lesions, and plaques (atheromas), as well as in the media. At 1-2 years, WHHL
      rabbits develop coronary atherosclerosis and focal extravascular lipid deposits,
      including subcutaneous and tendinous xanthomas. Vascular lesion development is
      associated with adhesion of monocytes and other leucocytes to the endothelium.
      The cells of the intimal lesions are lipid-containing macrophages, smooth muscle
      cells and foam cells. Most of the intracellular lipid is in the form of non
      membrane-bound neutral lipid droplets indicating that the cytoplasm is the major
      site of lipid storage. Similar ultrastructural features are shown by human FH
      lesions. Observations are reviewed regarding therapeutic approaches aimed at
      altering the pathologic expression of familial hypercholesterolaemia, including
      the negative results of treatment of WHHL rabbits with the calcium-channel
      antagonist, verapamil, and omega-3 fatty acids.

PMID- 2226534
TI  - Intimal thickening in the coronary arteries of infants and children as an
      indicator of risk factors for coronary heart disease.
AB  - Narrowings of the coronary arteries were measured in 94 infants aged less than 1
      year who died in hospital and 102 1- to 16-year-old children who died
      accidentally. The arteries were transformed mathematically to circles. The degree
      of narrowing caused by intimal thickening was determined as the ratio of intimal
      area to the original luminal area. This ratio was further transformed to
      percentage. The degree of narrowing varied between 0 and 58% (mean 20%). The mean
      degree of narrowing in the left coronary artery during the first year of life was
      17% and, between 12 and 15 years, 34%. Narrowing was greater in males (P = 0.02),
      when all the 333 coronary samples were included in the analysis. The birthplaces
      of the subjects' grandparents were traced from population registers and it was
      found that narrowing in the left coronary artery of infants was greater in those
      descended from grandparents from eastern Finland, an area of high mortality from
      coronary heart disease (CHD). Intimal thickening in infants and children seems to
      be a morphological manifestation of hereditary predisposition to CHD.

PMID- 2226535
TI  - Transport of low density lipoproteins across endothelial monolayers.

PMID- 2226536
TI  - Transport, interactions and retention of plasma proteins in the intima: the
      barrier function of the internal elastic lamina.
AB  - This paper presents a brief overview of our current understanding of the relation
      between plasma macromolecules and atherogenesis. Plasma proteins enter normal
      intima by vesicular transport across normal endothelium, and convective transport
      within the intima; accumulation depends mainly on molecular size and the
      molecular sieve properties of the internal elastic lamina. Within the intima the
      proteins may be modified; particularly striking changes occur in high density
      lipoprotein (HDL) and in fibrinogen. Fibrinogen appears to be converted to fibrin
      which is then lysed, providing a continuing source of fibrin degradation products
      (FDP). Fibrin also seems to be associated with a tightly bound, plasmin
      releasable apo-B-containing lipoprotein; work in progress suggests that much of
      this fraction is accounted for by lipoprotein(a).

PMID- 2226537
TI  - Lipoproteins in normal and atherosclerotic aorta.
AB  - Each method used for the extraction and isolation of intimal lipoproteins has
      advantages and disadvantages. Gentle extraction methods are needed to
      characterize subtle modifications in the structure and biologic properties of the
      lipoproteins, whereas more aggressive methods are needed if the goal is to
      maximize the yield of lipoproteins from atherosclerotic arteries. The present
      paper evaluates different methods used for the isolation of intimal lipoproteins.
      Normal intima contains remnant-like and low density lipoprotein (LDL)-like
      particles that more strongly stimulate cholesterol esterification in macrophages
      than do control plasma LDL. Both fractions contain apolipoprotein (apo) E but
      neither shows clear signs of oxidative modification. LDL-like particles from
      atherosclerotic lesions, on the other hand, contain malondialdehyde- and 4
      hydroxynonenal-lysine adducts in apo B, are chemotactic for monocytes and show
      increased degradation in macrophages, a process that oxidized LDL prepared in
      vitro can compete with. The findings support the conclusion that at least a
      portion of the LDL isolated from atherosclerotic lesions is similar, if not
      identical, to oxidatively modified LDL.

PMID- 2226538
TI  - Controversial indications. Rationale for thrombolysis: later than 4-6 h from
      symptom onset, and in patients with smaller myocardial infarctions. The ISAM
      Study Group.
AB  - To evaluate the effect of late reperfusion of an infarct-related coronary artery
      on left ventricular (LV) function in the month after myocardial infarction (MI),
      findings from 386 patients in the Intravenous Streptokinase in Acute Myocardial
      Infarction (ISAM) trial were studied. All patients had a late peaking in the
      creatine kinase-MB serum time-activity curve, suggesting absence of early
      reperfusion. Significantly better LV function associated with patency of the
      infarct artery at angiography 1 month after the acute event confirmed the
      beneficial effect of reperfusion even if achieved beyond the time window for
      myocardial salvage. Thrombolysis commenced later than 4-6 h after symptom onset
      will be of benefit as long at it reopens infarct arteries more often and earlier
      than occurs spontaneously or from anticoagulation. The value of the size of the
      sum of ST-segment elevation (sigma ST increases) on admission ECG was evaluated
      from the total ISAM study population. The relation between sigma ST increases and
      final infarct size as well as mortality risk was highly significant. However,
      weak correlations largely limit the value of sigma ST increases to predict the
      outcome in an individual patient. Thus, whatever the relative beneficial effect
      in patients with smaller or larger MI may be, it would be unwarranted to withhold
      thrombolytic therapy from patients with smaller sigma ST increases on admission
      ECG.

PMID- 2226539
TI  - Thrombolysis: adjuvant therapy and the role of complement.
AB  - A possible role for adjuvant therapy following thrombolysis exists in the context
      of reperfusion injury and post-ischaemic dysfunction, or so-called 'stunned
      myocardium'. The question that arises is whether the extent of myocardial
      stunning, or the ultimate extent of necrosis, can be reduced by preventing
      reperfusion injury and the impairment of reflow. Essential to any attempted
      intervention is an understanding of the mechanisms underlying myocardial damage
      following ischaemia and reperfusion. Certain mediators responsible for injury and
      repair have been identified, and their effects modified in experimental
      preparations; the role of complement, in particular, is central to these
      phenomena. Lysis of coronary artery thrombus is only the initiator of a sequence
      of events involving vascular endothelium and an intravascular response to tissue
      injury. The challenge is whether reperfusion injury may be modified and whether
      such intervention will favourably alter clinical outcome.

PMID- 2226540
TI  - Pre-hospital thrombolysis, is it useful?
AB  - Thrombolytic treatment efficacy is greater when the delay between onset of pain
      and treatment is short. One way to shorten this delay is to give treatment at
      home, but one cannot recommend this technique if it has not been demonstrated
      first, that pre-hospital thrombolysis is feasible and safe, and second, that it
      is useful. We have been able to demonstrate that pre-hospital thrombolysis with
      APSAC is feasible and safe. Our findings are similar to those of other teams
      using other drugs. Whether pre-hospital thrombolysis is useful has not been
      adequately assessed; and we consider that first, the benefit of pre-hospital vs
      in-hospital thrombolysis must be determined, and second, the results of a study
      involving many centres, with various levels of training, practicing pre-hospital
      thrombolysis must be examined. Two large scale studies are currently being
      performed. One in Seattle, uses left ventricular ejection fraction as the major
      end-point, whereas the other, the European Myocardial Infarction Project, (EMIP)
      is using total mortality. Data currently available indicate that pre-hospital
      thrombolysis with APSAC is feasible, easy and safe. We hope that we will very
      soon be able to answer the last question: is it useful?

PMID- 2226542
TI  - Time as a factor in thrombolytic therapy.
AB  - There is abundant evidence from angiographic studies that reperfusion and/or
      patency rates are greater when thrombolysis is initiated earlier. Evidence of a
      reduction in infarct size has been provided by a number of studies, which have
      also suggested that earlier therapy preserves left ventricular function. The
      major intravenous thrombolytic mortality trials appear to confirm the importance
      of delivering therapy soon after the onset of symptoms e.g. GISSI and ISIS-2.
      However, the benefit reported in the first hour in GISSI may be questioned.
      Furthermore, it seems probable that those coming in late to trials are patients
      who did not have a sudden onset of symptoms, but whose symptoms persisted,
      perhaps with recurrent pain, or with heart failure symptoms. This may account for
      the fact that the benefit seen relatively late, particularly in ISIS-2, does not
      seem to accord with reperfusion, infarct size and LVEF findings. The true
      benefits of earlier therapy will be established only when patients are randomized
      to active therapy or placebo at one point in time and then switched to
      alternative therapy at a specified later time. This has been done in a small
      trial with alteplase in Belfast. The findings were suggestive but not conclusive
      of an improvement in LVEF in those treated earlier. The European Myocardial
      Infarction Project (EMIP) should go far towards answering the question. In most
      European cities the time between onset of symptoms and the initiation of skilled
      treatment for myocardial infarction is of the order of 5-6 h.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2226541
TI  - Reduction in hospital time to thrombolytic therapy by audit of policy guidelines.
AB  - Despite the importance of early thrombolysis in the treatment of acute myocardial
      infarction, unacceptable delays in drug administration still occur in hospital.
      From March 1989 we decided to monitor our performance, and thereby to reduce
      avoidable in-hospital delay to a minimum. Potential candidates for thrombolytic
      therapy were identified by paramedic ambulancemen whenever this was feasible.
      Rapid check-lists were used for inclusion and exclusion criteria in the Accident
      and Emergency Department. A target of 15 min was set for time to treatment, and
      reasons for any gross deviation (greater than 30 min) were explored in each
      instance. As a result of these strategies, we achieved a median time from
      admission to initiation of thrombolysis in 50 consecutive patients of 17 min. The
      39 patients treated with injections of APSAC as opposed to infusions of
      streptokinase had a median in-hospital delay to treatment of only 13 min.

PMID- 2226543
TI  - The role of intervention following thrombolysis for acute myocardial infarction.

PMID- 2226545
TI  - Birth weight of children with congenital heart disease.
AB  - Birth weights of 843 children with congenital heart disease (CHD) were compared
      to the respective data of a normal West German population. On average, the CHD
      group had significantly lower birth weights, but the weight deficit was far less
      pronounced than in previous studies. The decrease in birth weight was distinct
      only in children with tetralogy of Fallot and atrial septal defect. Compared to
      normal newborns, patients with CHD were more often small for gestational age
      (15.0%) or had a low (less than 2500 g) birth weight (8.6%). The prevalence of
      prematurity was not increased. Extracardiac malformations were not significantly
      more common in CHD patients, who were small for gestational age, than in CHD
      patients with normal birth weight.

PMID- 2226546
TI  - Diagnosis, therapy, and outcome of ventricular septal defects in the 1st year of
      life: a two-dimensional colour-Doppler echocardiography study.
AB  - Between January 1987 and July 1989 a ventricular septal defect (VSD) as a single
      cardiac lesion was detected in 269 small infants aged less than 1 year. The
      diagnosis was achieved by two-dimensional echocardiography and Doppler colour
      flow mapping using subcostal, parasternal, apical, and suprasternal views. VSDs
      were divided into perimembraneous, muscular, malalignment, and subpulmonary
      defects. Septal defects in complex lesions and atrioventricular defects were
      excluded. In group 1 (174 infants up to 4 weeks of age, mean 10 days) 125
      muscular (71.8%), 35 (20.1%) perimembraneous, 12 (6.9%) malalignment, and 2
      (1.1%) subpulmonary defects were diagnosed. One baby had a combined
      perimembraneous and muscular defect. In another baby a malalignment defect was
      associated with an av-canal. In group 2 (95 infants aged 4 weeks to 1 year, mean
      4.0 months), 57 (60%) muscular, 32 (33.6%) perimembraneous and 6 (6.3%)
      malalignment defects were found. Within the maximum observation period of 13
      months, spontaneous closure occurred in 72 (42.6%) of 169 infants who had a
      sufficient follow up. Sixty-four had a muscular (88.9%) and 8 (11.1%) a
      perimembraneous defect. Surgical intervention was required in 11 patients: five
      perimembraneous defects were closed, one was palliated. Five infants with a
      malalignment defect were palliated. The malalignment defect frequently needed
      surgical intervention even in newborns; it never closed spontaneously. About 10%
      of patients with perimembraneous septal defect required surgery. Spontaneous
      closure rarely occurred in early infancy. Muscular VSDs were most frequent but
      virtually never required therapy. Spontaneous closure rate was about 50% during
      the 1st year of life.

PMID- 2226544
TI  - Cystic fibrosis, pathophysiological and clinical aspects.
AB  - Cystic fibrosis is a lethal, hereditary, until recently little understood
      disease, which leads to progressive functional disturbances in various organs,
      including the lungs, liver and pancreas. Knowledge of the genetic and cellular
      abnormalities is rapidly progressing, but therapy is still symptomatic and based
      on insufficiently controlled and short-term studies. At present the therapeutic
      approach aims to combat respiratory infections by optimal antibiotic therapy,
      combined with techniques to promote sputum evacuation. Additional measures
      attempt to optimise both nutritional state and physical condition. Median
      survival has improved from approximately 1 year to about 25 years during the past
      3 decades. This article summarises present information on disease mechanisms and
      treatment.

PMID- 2226547
TI  - A new device to measure short-term growth of head circumference in newborn
      infants.
AB  - We have developed and tested a new instrument to measure the occipitofrontal head
      circumference of newborn infants more accurately. The intra- and interobserver
      variability was determined. The results indicate that the head circumference of
      newborn infants can be measured with an accuracy of 1 mm.

PMID- 2226548
TI  - Maximal steady state blood lactate levels in 11-year-old boys.
AB  - To evaluate whether anaerobic threshold criteria evaluated in adults are
      pertinent to children, ten boys with a mean age of 11.2 years were investigated
      during treadmill running. Maximal running velocity was determined at stepwise
      increasing load, with determination of blood lactate following exercise. On the
      following days four runs each lasting 16 min were performed at a constant speed
      starting with a speed corresponding to about 70% of the maximal speed and
      increasing it during the next run in order to determine maximal steady state
      levels of blood lactate. Blood lactate was measured at the end of every 4 min
      period. From this date the anaerobic threshold was calculated. The correlation
      between anaerobic threshold values and maximal steady state levels of blood
      lactate was poor, however, a steady state of blood lactate was present at 4.6
      mmol/l, whereas the mean anaerobic threshold value was determined at 2.6 mmol/l.
      In view of our results, the anaerobic threshold during increasing work does not
      correspond to the true anaerobic threshold, which can be assumed to occur at much
      higher lactate values. The meaning of the term anaerobic threshold is therefore
      to be questioned.

PMID- 2226549
TI  - Protein C activity and antigen levels in childhood.
AB  - Hereditary protein C deficiency is an important risk factor for thrombosis. To
      enable its diagnosis shortly after birth, we determined reference values of
      protein C antigen and activity levels for the first 3 months of life. To
      establish an age-related range of protein C levels we also determined median
      values for individuals up to 18 years of age. A good correlation between the two
      levels was seen from the 3rd/4th month of life onwards, whereas in the first 2
      months the activity levels were significantly lower than the antigen levels. This
      was not due to interference by the increased plasma citrate concentration at high
      haematocrit values, and may suggest a dysfunctional protein C molecule in the
      neonatal period. We found a rapid rise in protein C activity and antigen levels
      until the age of 7-9 months, followed by a slower progression toward adolescence.
      In contrast to previous reports, our results indicate that adult values are
      probably not achieved until sometime during the 2nd decade of life.

PMID- 2226550
TI  - Intravenous immunoglobulin in Diamond-Blackfan anaemia.
AB  - Since immunological disorders have been demonstrated in patients with Diamond
      Blackfan anaemia (DBA), intravenous immunoglobulins (IVIG) were administered to a
      14-year-old girl with DBA and congenital malformations, previously treated with
      corticosteroids and blood transfusions. No therapeutic effect was observed.

PMID- 2226551
TI  - Simultaneous palsy of facial and vestibular nerve in a child with Lyme
      borreliosis.
AB  - We describe a boy with borreliosis characterized by lymphocytic meningitis and
      simultaneous palsy of facial and vestibular nerves on the left side. A mild
      sensoneural affection was also confirmed by brainstem evoked response audiometry.
      While symptoms of vestibular dysfunction quickly decreased during antibiotic
      treatment, facial palsy improved only slowly.

PMID- 2226552
TI  - A patient with features of both Bardet-Biedl and Alstrom syndromes.
AB  - We describe a 30-year-old patient with acanthosis nigricans, diabetes mellitus
      with insulin resistance, hypogonadotropic hypogonadism, pigmentary degeneration
      of the retina and cerebellar, pyramidal and posterior columnar involvement. He
      had normal mental function, normal hearing and no hexadactyly. The patient had
      symptoms of both Bardet-Biedl and Alstrom syndromes, but did not manifest all the
      main features of either syndrome. This suggests either that the Bardet-Biedl,
      Alstrom, Laurence-Moon syndromes (including the variant described by Edwards)
      have a highly variable expression or that our case is a new variant within this
      group of syndromes.

PMID- 2226553
TI  - Thoraco-abdominal enteric duplication with meningocele, skeletal anomalies and
      dextrocardia.
AB  - We describe an infant with an enteric thoraco-abdominal duplication arising in
      the proximal jejunum and associated with a dorsal meningocele, dextrocardia,
      agenesis of ribs and hypoplasia of the left arm. Diagnosis was reached post
      operatively and the infant died of cytomegalovirus pneumonitis. Results of the
      postmortem examination are presented. Awareness of this rare malformation is
      required in order to reach a timely diagnosis and to plan a suitable operative
      approach.

PMID- 2226554
TI  - Variation of alpha 1-antitrypsin glycoprotein microheterogeneity in hepatic
      postresuscitation disease.
AB  - Microheterogeneity of the glycoprotein alpha 1-antitrypsin has been investigated
      sequentially by high resolution isoelectric focusing in a child with the
      proteinase inhibitor MS phenotype after near-drowning. A band-splitting with
      additional cathodal fractions exhibited migration from the most cathodic to the
      anodic positions of the glycoprotein isoforms in the course of post-resuscitation
      disease. The pattern may reflect the time- and stage-dependent hypoxic and post
      hypoxic effects on hepatocellular metabolic zonation.

PMID- 2226555
TI  - The use of metronidazole in management of methylmalonic and propionic acidaemias.
AB  - Gut bacteria have been implicated as an important source of propionate in
      children with inborn errors of propionate metabolism. We have investigated the
      value of oral metronidazole (10-20 mg/kg per day) in five children with
      methylmalonic acidaemia (MMA) and four with propionic acidaemia (PA). Urinary
      excretion of propionate metabolites fell significantly during the treatment in
      all subjects, the mean decrease being 41% (range 12-76, P less than 0.01), while
      mean plasma propionate was reduced from 45.0 mumol/l to 25.1 mumol/l (P less than
      0.05). Substantial reduction of the gut bacterial population was confirmed by
      lactulose breath hydrogen tests and by stool culture, and stool propionate
      concentration was reduced in most subjects. Clinical improvement was noted in
      three children. These results suggest that long-term antimicrobial therapy may
      offer significant clinical benefit to children with inborn errors of propionate
      metabolism.

PMID- 2226556
TI  - Routine lumbar punctures in the newborn--are they justified?
AB  - The records of 62,107 neonates cared for at three neonatal referral units between
      1979 and 1985 were analysed with regard to the number of lumbar punctures (LP)
      performed and the results obtained. The mean perinatal mortality rate was
      9.3/1000 live births and the neonatal mortality rate was 5.9/1000. The units were
      comparible in this respect. Two hundred and sixty three (0.4%) babies weighed
      less than 1.0 kg at birth and 510 (0.8%) babies weighed 1.0-1.5 kg. A total of
      1554 LPs were performed on 1084 babies, 1.7% of the whole population. Seventeen
      babies were diagnosed as having meningitis following CSF examination; 5 weighed
      less than 1.5 kg (VLBW) (incidence of meningitis 6.5/1000 births) and 12 weighed
      more than 1.5 kg (incidence 0.2/1000 live births). An LP was performed on 44% of
      VLBW babies and 1.2% of babies weighing more than 1.5 kg. In both groups
      approximately 1.5% of CSF samples were positive. Eight of the 17 positive results
      were obtained during the first 3 postnatal days. Only one VLBW baby had
      meningitis on the 1st day of life (1.3/1000). In view of the low incidence of
      meningitis and the risk factors associated with an LP it is questionable whether
      this procedure should be a routine investigation in the VLBW newborn.

PMID- 2226557
TI  - Relationship between mode of delivery and neonatal calcium homeostasis.
AB  - Serum levels of calcium (Ca), calcitonin (CT) and parathyroid hormone (PTH) were
      determined in cord blood of 229 newborns. In 136 newborns the tests were repeated
      24 h later. The probands were divided into four groups according to mode of
      delivery: (1) spontaneous; (2) elective caesarean section without labour; (3)
      elective caesarean section in labour; (4) emergency caesarean section with fetal
      distress. Newborns in group 2 had significantly lower Ca and CT levels and
      significantly higher PTH concentrations in cord blood than the other three
      groups. In all groups Ca and PTH concentrations were negatively correlated. At 24
      h, mean Ca levels had decreased and mean CT and PTH concentrations had increased
      in all four groups. Newborns in group 2 still had lower Ca levels but higher CT
      and PTH concentrations. At that time there were negative correlations between Ca
      and CT levels in groups 1 and 2 and between Ca and PTH concentrations in group 1.
      These data demonstrate that without labour, cord blood Ca and CT levels are lower
      and PTH concentrations are higher. The low 24 h calcium in newborns delivered
      without labour is explained by the lower Ca levels at birth and a tremendous
      increase of CT. The PTH secretion in full-term newborns is very substantial and
      negatively correlated with Ca levels.

PMID- 2226558
TI  - Neonatal hepatic haemangioendothelioma: presentation with jaundice and
      microangiopathic haemolytic anaemia.
AB  - A neonate with multicentric hepatic haemangioendothelioma complicated by jaundice
      and microangiopathic haemolytic anaemia is presented. To our knowledge such a
      constellation has not been previously reported.

PMID- 2226560
TI  - VACTERL-association: an unusual case of fetus detected by ultrasound screening at
      19 weeks of gestation.

PMID- 2226559
TI  - Biochemical evidence for the need of long-term mineral supplementation in an
      extremely low birth weight infant fed own mother's milk exclusively during the
      first 6 months of life.
AB  - In an extremely low birth weight infant fed expressed own mother's milk
      exclusively during the first 6 months of life, introduction of a human milk
      fortifier resulted in improvement of biochemical alterations consistent with
      metabolic bone disease of prematurity. Attempts to discontinue fortification at 9
      weeks (discharge) and 21 weeks of age induced deterioration of biochemical
      parameters, demonstrating a persistent need for mineral supplementation during
      the whole period of breast-feeding. The effects of long-term human milk
      fortification are discussed.

PMID- 2226561
TI  - Transfontanellar ultrasonography in HIV-positive children.

PMID- 2226562
TI  - Varicella-associated pancytopenia.

PMID- 2226563
TI  - Immunization against cow's milk in infants with cleft lip and/or palate.

PMID- 2226565
TI  - Thoughts of a reviewer.

PMID- 2226564
TI  - Childhood Lyme borreliosis in Europe.
AB  - Lyme borreliosis is a multisystem disorder common in childhood. It is an acute
      and persistent anthropozoonotic infection caused by the spirochete Borrelia
      burgdorferi (Bb) which is transmitted by Ixodes ticks. After the tick bite in
      summer, erythema migrans, meningoradiculoneuritis, or carditis may develop within
      the same season. Later manifestations may be oligo-arthritis, progressive
      encephalomyelitis, or acrodermatitis chronica atrophicans. The most common course
      is probably asymptomatic. Connatal infection is possible. Diagnosis is
      established mainly by history and clinical manifestations. The antibody response
      to Bb can be measured in serum and cerebrospinal fluid. Tests may be false
      negative early in the course of the disease or after early treatment. False
      positive results may be caused by cross-reactions. Interpretation of test results
      must also consider unrelated anamnestic titres or asymptomatic infection.
      Treatment with appropriate antibiotics cures the disease in most patients,
      however some patients may not respond. The optimal drug has not yet been found.
      Best prophylaxis is by early removal of the tick from the skin.

PMID- 2226566
TI  - Growth and endocrine disorders in optic glioma.
AB  - Hypothalamo-pituitary function in children with optic glioma may be impaired by
      the tumour itself and by the high cranial radiation doses used in treatment. This
      study evaluates the effect of optic glioma and its treatment on patient growth
      and pubertal development. Twenty-one patients (13 boys, 8 girls), treated for
      optic glioma by cranial irradiation (45-55 Grays) at a mean age of 5.4 years,
      were evaluated before (n = 10) and/or after (n = 21) irradiation. Growth hormone
      (GH) deficiency was present in only 1 patient tested before irradiation and in
      all patients after irradiation. Precocious puberty occurred in 7/21 cases, before
      irradiation in 5 patients and after irradiation in 2 patients. The cumulative
      height loss during the 2 years after irradiation was 0.2 +/- 0.2 SD (m +/- SEM)
      in 7 patients with precocious puberty and 1.1 +/- 0.2 SD in 14 prepubertal
      patients (P less than 0.01). The corresponding bone age advance over
      chronological age, evaluated 1-3 years after irradiation, was 1.1 +/- 0.5 and 
      0.7 +/- 0.3 year in the two groups (P less than 0.01). The mean height loss
      between time of irradiation and the final height was 2.3 +/- 0.6 SD (n = 6).
      Primary amenorrhoea, associated with low oestradiol levels, occurred in two of
      the three girls of pubertal age. These data indicate that the high dose of
      cranial radiation used to treat optic glioma invariably results in GH deficiency
      within 2 years and that hGH therapy is required when GH deficiency is
      documented.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226567
TI  - Cellular cytotoxicity against autologous hepatocytes in children with different
      forms of chronic hepatitis B.
AB  - Cell-mediated immune reactions play the most important role in the pathogenesis
      of chronic viral and auto-immune hepatitis. Cellular cytotoxicity (CC) of
      peripheral blood lymphocytes against autologous hepatocytes isolated from liver
      biopsies was studied in 29 children with different types of hepatitis B surface
      antigen (HBsAg)-positive hepatitis. Children with chronic hepatitis B showed
      higher cytotoxicity than control patients. However, a correlation of cytotoxicity
      to serum amino-transferases, HBeAg-/Anti-HBe-status, and hepatitis B virus DNA in
      serum could not be found. Children with a higher percentage of hepatitis B core
      antigen (HBcAg) expression in their liver tissue presented lower CC values, and
      vice versa. This supports the hypothesis that virus elimination occurs via T-cell
      attack against HBcAg expressing hepatocytes. Furthermore, children with a longer
      duration of chronic hepatitis B had considerably higher cytotoxicity values.
      Possibly, CC plays a role in perpetuating liver damage after infection with
      hepatitis B virus.

PMID- 2226568
TI  - Neurological outcome in high risk weight appropriate for gestational age preterm
      children at early school age.
AB  - Neurological development in preterm children with birth weight appropriate for
      gestational age is reported in two separate groups: a longitudinal study of 97
      preterm children and 93 term children as a control group and a cross-sectional
      study of 249 preterm children. Both preterm groups were regarded as high risk
      with respect to number of outborns, distribution of gestational age and perinatal
      risk factors. Neurological outcome at 5-6 years of age in the majority of the
      preterm children was comparable to that of the term children. However, 15% of
      boys and 9% of girls in the preterm group were diagnosed as having cerebral
      palsy. Mild diplegia was most frequently observed; 4% of the children were
      severely impaired. Fourteen percent of the preterm vs 2% of the term boys and 6
      9% of the preterm vs none of the term girls received motor therapy during early
      school age. There was a small but consistent sex difference in neurological
      outcome in favour of the term and preterm girls. Effects of drop out rate and of
      incompleteness of ascertainment are reported in detail.

PMID- 2226569
TI  - Intellectual outcome, speech and school performance in high risk preterm children
      with birth weight appropriate for gestational age.
AB  - Intellectual development, speech and school performance of preterm infants with
      birth weight appropriate for gestational age are reported in two separate
      investigations: a longitudinal study of 97 preterm children and 93 term children
      as a control group, and a cross-sectional study of 249 preterm children. Both
      preterm groups were regarded as high risk groups with respect to number of
      outborns, distribution of gestational age and perinatal risk factors.
      Intellectual outcome at 5 and 7 years of age in the majority of the preterm
      children was comparable to that of the term children. However, 8% of the preterm
      boys and 2% of the preterm girls achieved lower IQ scores than any of the term
      children. Between 15% and 17% of the preterm boys and 9%-12% of the preterm girls
      did not attend school at grade level, compared to 4% and 2% in the term group,
      respectively. Intellectual and neurological development and school performance
      were higher interrelated in the preterm than in the term children. Articulation
      defects, stuttering and dysgrammatism occurred more frequently in the preterm
      than in the term children and in boys more so than in girls.

PMID- 2226570
TI  - Pulse oximetry used for documenting oxygen saturation and right-to-left shunting
      immediately after birth.
AB  - The objective of this study was to investigate the clinical applicability of
      pulse oximetry to measure haemoglobin oxygen saturation and heart rate in the
      first 20 min of life and to analyse the effect of pre- or post-ductal (hand,
      respectively, foot) fixation of sensors on oxygen saturation. Measurements were
      carried out on 53 newborn infants selected at random after delivery by caesarean
      section. Signal detection occurred significantly faster from the hand (50% after
      1.3 min, 90% after 4 min) than from the foot (50% after 3.1 min, 90% after 9
      min). Both fixation sites showed equally great sensitivity to motion. The heart
      rates from pulse oximetry recordings were up to 30% lower than those from ECG
      recordings. Saturation values from the hand were nearly always higher than those
      from the foot (median difference in the 5th min was 10%; between the 5th and 10th
      min it was 7%; no significant difference occurred after the 17th min). We
      conclude that pulse oximetry can be used for documenting oxygenation and right-to
      left shunting in newborn infants during the first minutes of life in spite of
      limitations due to incomplete pulse wave detection and artifacts.

PMID- 2226571
TI  - Cardiomyopathy and multicore myopathy with accumulation of intermediate
      filaments.
AB  - A girl affected by a restrictive cardiomyopathy with neuromuscular involvement is
      described. Morphological examination showed a pattern of multicore myopathy and
      with electron microscopy a sarcoplasmic accumulation of electron dense granular
      and filamentous material was demonstrated both in skeletal muscle and heart. This
      peculiar electron dense material corresponded to increased desmin in muscle and
      cardiac fibres and was demonstrated immunohistochemically.

PMID- 2226572
TI  - Fluctuation in the concentrations of vanillylmandelic acid and homovanillic acid
      in mass screening for neuroblastoma.
AB  - Fluctuations in the amount of vanillylmandelic acid (VMA) and homovanillic acid
      (HVA) were studied in random urine samples from 13 infants with neuroblastoma. In
      patients with a small tumour, many samples contained amounts below the cut off
      values, suggesting that detection of a patient with neuroblastoma depended on
      mathematical probability. Using high performance liquid chromatography a patient
      with a tumour of about 10 g may well be overlooked, whereas a patient whose
      tumour weighs over 30 g would probably be detected. With qualitative screening,
      although more likely to miss a patient with low VMA excretion, a patient with a
      tumour weighing over 50 g would be detected. In a thorough hospital examination
      care should be exercised in interpreting borderline values of VMA and HVA;
      excretion information suggesting the existence of a tumour may aid localization
      by radiological imaging procedures.

PMID- 2226573
TI  - Lung volumes following resection of pulmonary metastases in paediatric patients-
      a retrospective study.
AB  - Pulmonary function was evaluated before and after 15 operations for resection of
      pulmonary metastases from osteogenic sarcoma. In the whole study group (ten
      patients, aged 13-18 years) preoperative vital capacity (VC) ranged from 62% to
      122% (mean 83%) of predicted normal values for height. The operations were
      performed via median sternotomy. One-28 metastases were removed per session. Six
      months after the operations VC averaged nearly 95% of the preoperative values.
      Signs of bronchial obstruction or persistent pulmonary hyperinflation were only
      present in one patient with repeated operations. We conclude that resection of
      pulmonary metastases with limited loss of parenchyma leads to an almost complete
      recovery of preoperative pulmonary function parameters.

PMID- 2226574
TI  - Pelvic lipomatosis in the Proteus syndrome: a further diagnostic sign.

PMID- 2226575
TI  - Clinical implications of cartilage metabolism in arthritis.
AB  - The ability of articular cartilage to withstand repeated mechanical loading with
      relatively little wear over a lifetime results from the properties of the
      extracellular matrix (ECM) and the optimal function of the chondrocytes which are
      responsible for the synthesis and presumably maintenance of this ECM. The
      properties of the ECM are accounted for by the relationship of the major
      aggregating, polyanionic, negatively charged proteoglycans with their potent
      viscoelastic properties to the network of collagens and several noncollagenous
      proteins. The major collagen (type II) interacts with type IX collagen in a
      highly specific manner. Type IX collagen has a chondroitin sulfate side chain and
      can also bind to the aggregating proteoglycans through a basic amino terminal
      domain. In inflammation, injury and probably repeated wear, function of the
      chondrocytes is disturbed, mediated by the action of potent cytokines, which
      results in release of degradative enzymes and alterations in the pattern of
      synthesis of the ECM. Identification of the critical cytokines and the sequence
      of events that result from their action should provide the basis for rational
      prophylaxis and therapy of disorders such as osteoarthritis and rheumatoid
      arthritis. Articular cartilage has unique mechanical properties which permit
      repeated mechanical loading with relatively little wear over a lifetime. These
      properties result from the special character of the extracellular matrix (ECM)
      and optimal functioning of the component cells (chondrocytes) which are
      responsible for the synthesis and presumably, maintenance of this matrix.
      Articular chondrocytes survive and perform these critical functions in an
      anaerobic environment remote from the vasculature and must derive their nutrition
      from the synovial fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226577
TI  - Symposium on cell movement. Belgian and Dutch Societies for Cell Biology.
      Antwerpen, 22-23, November 1990. Abstracts.

PMID- 2226576
TI  - Annual meeting of the Dutch Society for Cell Biology, Nijmegen. 29-30 January
      1990. Abstracts.

PMID- 2226578
TI  - 'Solitary' Ta-T1 G1 bladder tumour--history and long-term prognosis.
AB  - Natural history of 'solitary', histological grade 1, stage Ta-T1 transitional
      cell carcinoma of the bladder was studied in 198 patients retrospectively over a
      period from 1975 to 1987. Three patterns of tumour behaviour were evident. In 56%
      of patients the tumour did not recur following the initial resection. Twenty-one
      percent developed recurrences localised to the site of the original tumour. This
      group became tumour-free by 5 years and remained so thereafter. The remaining 23%
      continued to produce recurrent tumours up to 10 years at different sites in the
      bladder. The actuarial percentage of patients who remained continuously free of
      tumour after the initial resection was 53% at 5 years and 51% at 10 years. The
      results of this study suggest that cytoscopic follow-up may be discontinued in
      patients who remain continuously tumour-free for 5 years.

PMID- 2226579
TI  - External-beam radiation for carcinoma of the prostate.
AB  - Over 14 years 111 patients with prostatic cancer underwent attempted curative
      radiotherapy; full data was obtained on 105 patients. The 5-year actuarial
      survival rate was 62%, with 54 patients still alive at the time of review. The
      toxicity rate was 94%, and serious late complications occurred in 4%. 40% of the
      patients developed symptomatic recurrence, and only 4% of the patients had local
      recurrence.

PMID- 2226580
TI  - Maximal electrical stimulation in the treatment of unstable detrusor and urge
      incontinence.
AB  - Ninety-one patients with unstable detrusor and urge incontinence were treated
      with maximal electrical stimulation. There were 17 dropouts. From the remaining
      74 patients 51 were subjectively cured or significantly improved, this effect
      lasted for more than 6 weeks in 40. Objectively a significant decrease in
      frequency was found, also a significant increase in bladder volume. No effect on
      detrusor pressure at bladder contraction was noted.

PMID- 2226581
TI  - The role of abdominal and transrectal ultrasound and cytology in the detection of
      recurrent bladder tumours.
AB  - Transrectal and transabdominal ultrasound combined with cytology were compared
      with conventional cystoscopy as a mean of detecting recurrences of bladder
      tumours. One hundred and twenty-five patients underwent combination ultrasound in
      the outpatient department 1 week before cystoscopy. Combination ultrasound
      identified 90% of recurrent tumours and tumour identification with the results of
      ultrasound and cytology combined was 93%. The false positive rate was 2%. The
      ultrasonographer would have referred 97% of patients with recurrent tumour for
      cystoscopy. Combination ultrasound and cytology may be a satisfactory alternative
      to check cystoscopy in certain categories of bladder tumours.

PMID- 2226582
TI  - Comparison of the incidence of Ureaplasma urealyticum in infertile men and in
      donors of semen.
AB  - 569 infertile patients and 75 fertile men (donors of semen) were included in our
      study from 1985 to 1987. We compared the frequency of Ureaplasma urealyticum in
      semen specimens in these two groups: 40 infertile men (7%) and 4 donors of semen
      (5.3%) had U. urealyticum in semen cultures. This difference was not
      statistically significant. We concluded that U. urealyticum was not more frequent
      in infertile than in fertile men. We also report the results of semen cultures
      for other bacteria and the parameters of routine semen analysis in these two
      groups. All infertile patients infected by U. urealyticum were treated with
      doxycycline: the infection was eradicated in 77.5% of them.

PMID- 2226583
TI  - Quantitative analysis of trace elements in human clear cell carcinoma of the
      kidney by energy-dispersive X-ray fluorescence.
AB  - In a case-control study, 20 cases of renal cell carcinoma (RCC) were analyzed by
      energy-dispersive X-ray fluorescence in order to establish the concentration of
      Fe, Cu, Zn and Cd. Patients with RCC were examined and compared with 7 controls
      from selected autopsies. A significant decrease in Cd and Zn concentration was
      found in the neoplastic tissue in all cases. In contrast, no significant decrease
      in Cu concentration was detected in our cases.

PMID- 2226584
TI  - Flow cytometry analysis of urothelial cell DNA content according to pathological
      and clinical data on 100 bladder tumors.
AB  - DNA content of 100 bladder tumors (34 grade I, 42 grade II and 24 grade III, WHO
      classification) were studied by flow cytometry. Ten normal bladder samples were
      used as control. The 100 bladder tumors could then be separated into two groups.
      A first group of 60 tumors (60%) had a unimodal distribution with a diploid peak
      and a DNA index close to 1.0, 32 grade I, 22 grade II and 6 grade III tumors
      displayed this pattern as did the 10 normal bladders. The second group (40%) had
      a bimodal distribution with two peaks, the first one (diploid peak) with a DNA
      index of 1.0, the second (aneuploid peak) with a DNA index greater than 1.0. Two
      grade I, 20 grade II and 18 grade III tumors belonged to this group. Frequency of
      the aneuploid peak increased with tumor grade and infiltration progression. Hence
      6% of grade I, 48% of grade II and 75% of grade III tumors showed an aneuploid
      peak as well as 8% of Pa, 46% of P1, 73% of P2 and 87.5% of P3 stage tumors. This
      study showed that a good correlation exists between flow-cytometric, pathological
      and clinical data.

PMID- 2226585
TI  - Leiomyosarcoma of the renal vein: a report of two cases.
AB  - We report 2 cases of leiomyosarcoma of the renal vein. The diagnosis, assessment,
      treatment and prognosis of this uncommon tumour are discussed with reference to
      15 other cases reported in the literature.

PMID- 2226586
TI  - Carcinoma of the penis in lichen sclerosus atrophicus. A case report.
AB  - Three cases of glans penis epidermoid carcinoma after lichen sclerosus et
      atrophicus (LSA) or balanitis xerotica obliterans are discussed. Relationships
      between both diseases are analyzed but remain unclear. Balanitis xerotica
      obliterans causes foreskin and urethral meatus stenosis that requires
      circumcision. Glans penis carcinoma can be observed many years later even after
      circumcision. The knowledge of LSA is important to do circumcision at the
      beginning of the disease with a long-term follow-up of these patients to realize
      a glans penis biopsy if necessary. Most cases of LSA are not recognized, and the
      frequency is higher than reported.

PMID- 2226587
TI  - Early 'invasive' malignant melanoma of the glans penis and the male urethra.
      Report of a case and review of the literature.
AB  - A 40-year-old male with early 'invasive' malignant melanoma of the glans penis
      and meatus urethrae externus is presented. Early stages of primary melanoma of
      the glans penis and the male urethra are distinctly rare and are often clinically
      indistinguishable from penile lentigo, melanosis and melanocytic nevus on the
      genitalia. In order to avoid large and useless surgery on such a delicate
      location we propose a punch biopsy with subsequent histological examination prior
      to definitive surgical procedure. Whereas malignant melanoma of the penis with a
      thick Breslow index is treated with extended surgical management, only local
      excision of the tumor without groin dissection was performed in our patient.

PMID- 2226588
TI  - Use of Biopty gun for corpus cavernosum biopsies.
AB  - Needle biopsy of the corpus cavernosum with the Biopty gun system has been
      performed in impotent patients. This technique is cost-effective, rapid, safe,
      relatively harmless and effective in obtaining erectile tissue to identify the
      presence of intracavernous structures (smooth muscle cells, collagen, arteries
      and nerves). It can certainly replace the open method, but we have to determine
      its place in the assessment of impotent patients.

PMID- 2226589
TI  - Results after organ-preserving surgery for renal cell carcinoma. An Austrian
      multicenter study.
AB  - Data from 120 patients diagnosed as having renal cell carcinoma (RCC), and
      treated in an organ-preserving surgical manner were analyzed from 11
      participating Austrian urological centers. The male to female ratio was 66:54.
      The subjects age ranged from 27 to 75 years with mean age of 59 years. The
      indication for conservative tissue-saving surgery was a solitary kidney in 48
      instances, a bilateral RCC in 18 cases and, in 2 patients, a horseshoe kidney
      tumor. In 52 cases the indication for conservative surgery was a peripheral,
      easily resectable, low-stage tumor (elective indication). Results were comparable
      to radical nephrectomy of low-stage tumors especially relating to survival rates.
      Ninety-nine patients survived and were tumor free at the point of check up
      (December 1988). Thirteen patients had either local tumor recurrence and/or
      metastases and 5 patients died from the disease. The operative mortality and the
      morbidity rate was very low.

PMID- 2226590
TI  - Regional lymph node metastasis in renal cell carcinoma: incidence, distribution
      and its relation to other pathological findings.
AB  - Extended ipsilateral lymphadenectomy performed on 102 patients with renal cell
      carcinoma revealed 21 patients (21%) having regional lymph node metastasis. Of
      the 21 patients, 6 (6%) had single-node metastasis and 15 (15%) multiple-node
      metastasis. PT, pV, pM, cell type and grade were all correlated with regional
      node metastasis. The metastatic lymph node foci were distributed along the
      pathways of normal lymphatic drainage. The recurrence of the disease was
      correlated with lymph node metastasis, indicating that metastasis is one of the
      prognostic factors. The very close correlation of node metastasis with vein
      invasion suggests that removal at least of the ipsilateral lymph node might be
      necessary when removal of a thrombus in the renal vein or vena cava is indicated.

PMID- 2226591
TI  - Incidental detection of renal tumours by abdominal ultrasonography.
AB  - One hundred and twenty-six patients with renal cell carcinoma were treated by
      nephrectomy between 1985 and 1988. They were classified into three groups: group
      A: 47 patients in whom ultrasonography revealed the renal cancer in the absence
      of any suggestive clinical signs of tumour; group B: 63 patients who presented
      with clinical urological signs suggestive of the tumour; group C: 16 patients who
      presented with general signs leading to the diagnosis. In group A, 50% of the
      tumours measured between 5 and 10 cm, 51% were located at the lower pole of the
      kidney and 83% were stage T2. Sixty-six percent of cancers in this group were
      situated on the right side, indicating that left renal cancers are missed in 16%
      of cases. In group B, 60% of the tumours measured between 5 and 10 cm, 44% were
      located at the lower pole and 56% were stage T2. In group C, 60% of the tumours
      measured between 5 and 10 cm, 50% were located at the upper pole of the kidney
      and only 38% of the tumours were still stage T2. We can conclude that incidental
      detection reveals renal tumours at a relatively limited stage (83% of T2), with
      dimensions smaller than those of the other groups. It is therefore essential for
      radiologists, ultrasonographists and urologists to investigate the left lumbar
      fossa and the upper pole of both kidneys very carefully during abdominal or
      vesico-prostatic ultrasound examinations.

PMID- 2226593
TI  - The operable renal cell carcinoma. Progress in basic research, diagnosis,
      surgical and medical therapy. 3rd symposium. Hamburg, November 3-4, 1989.
      Proceedings.

PMID- 2226592
TI  - Influence of blood group type on prognosis of transitional cell carcinoma of the
      urinary bladder.
AB  - The correlation of blood group to grade, stage and tumor markers at diagnosis and
      to the subsequent clinical course was investigated in a consecutive retrospective
      series of 230 patients with primary transitional cell carcinoma of the urinary
      bladder. The follow-up period was 5-9 years. There were no significant
      differences in grade, stage or DNA ploidy between patients of blood groups A and
      O. However, the deletion of ABH blood group isoantigen was found more frequently
      in tumors from patients of blood group O. Concerning progression of superficial
      bladder tumors, this was found earlier among patients of blood group O, and in a
      multivariate analysis this emerged as an independent prognostic factor. The crude
      and corrected mortality was not significantly higher among patients of group O
      than among those of other blood groups.

PMID- 2226594
TI  - Monoclonal antibodies to renal cancer antigens.

PMID- 2226595
TI  - Implications of insulin-like growth factors in renal cell carcinoma.

PMID- 2226596
TI  - Immunohistology of renal carcinomas.

PMID- 2226597
TI  - Renal oncocytoma: prognosis and treatment.

PMID- 2226598
TI  - Clinically unrecognized renal cell carcinoma. Diagnostic and pathological
      aspects.

PMID- 2226599
TI  - Pros and cons of retroperitoneal lymphadenectomy in operable renal cell
      carcinoma.

PMID- 2226600
TI  - The role of nephron-sparing surgery for renal cell carcinoma.

PMID- 2226601
TI  - Operative management of renal cell carcinoma with suprahepatic intracaval
      neoplastic extension.

PMID- 2226602
TI  - DNA content in renal cell carcinoma and its clinical significance.

PMID- 2226603
TI  - Value of DNA analysis for treatment of renal cell carcinoma.

PMID- 2226605
TI  - Prognostic parameters of renal cell carcinoma.

PMID- 2226604
TI  - New approaches to the evaluation of the metastatic ability of renal cancer and
      new approaches to chemotherapy.

PMID- 2226606
TI  - Tumor heterogeneity of renal cell carcinoma.

PMID- 2226607
TI  - Antigen expression in renal cell carcinoma. Correlation with histological grade,
      pathological stage and development of distant metastasis.

PMID- 2226608
TI  - The biology of renal cancer: the influence of nephrectomy.

PMID- 2226609
TI  - Immunotherapy for advanced renal cell cancer: the role of radical nephrectomy.

PMID- 2226610
TI  - Immunotherapy of advanced renal cancer.

PMID- 2226611
TI  - The operable renal cell carcinoma: summary and conclusions.

PMID- 2226612
TI  - The Heinrich Warner Prize 1989: the use of differential hybridization analysis to
      identify markers for diagnosis of urogenital cancer.

PMID- 2226613
TI  - Cytomorphological typing of renal cell carcinoma--a new approach.

PMID- 2226614
TI  - Story composition skills of middle-grade students with learning disabilities.
AB  - This study examined the story composition abilities of learning disabled (LD) and
      normally achieving young adolescents as indicated by measures of writing
      category, cohesion, and fluency. Findings suggest that although adolescents with
      learning disabilities have a rudimentary knowledge of story form, this knowledge
      is less well developed than that of their nondisabled peers. Students with
      learning disabilities also had greater coherence problems in their writing and
      were less fluent writers. Several important age trends were noted when results of
      this investigation were compared with outcomes from a similar investigation
      involving younger students.

PMID- 2226616
TI  - Prediction is not the only measure of a plan: a response to Marston.

PMID- 2226615
TI  - Nonaversive treatment of high-rate disruption: child and provider effects.
AB  - A multiple baseline across three providers showed that each provider, using only
      differential reinforcement of incompatible behavior (DRI), substantially reduced
      high-rate out-of-seat behavior in a highly disruptive 4-year-old boy with severe
      disabilities. During the experiment, duration of the boy's in-seat behavior
      expanded from less than 1 min to 20 min. Furthermore, during the intervention,
      the providers' use of physical restraint decreased to near-zero levels, even
      though restraint and DRI could be used together. Although not specifically
      targeted, the boy's appropriate toy play also increased during DRI.

PMID- 2226617
TI  - Effects of corticotropin-releasing factor on central respiratory activity.
AB  - Effects of corticotropin-releasing factor (CRF) on central regulation of
      respiration were studied in urethane-anaesthetized, vagotomized, paralyzed and
      artificially ventilated rabbits. Injections of CRF into the IVth cerebral
      ventrile (i.c.v.) resulted in an increase of the neuronal tidal volume (nVt), but
      had only minor effects on the duration of respiratory phases. Microinjection of
      CRF into the ventral parabrachial region of the pons (pneumotaxic center)
      resulted in a reduction of nVt and of the respiration rate. Respiratory effects
      of CRF administered i.c.v. or into the pontine parabrachial region were
      antagonized by alpha-helical-CRF, indicating a receptor-mediated action of CRF.
      Respiratory effects of CRF were not significantly affected after blocking
      ganglionic transmission with chlorisondamine. Neither mean arterial blood
      pressure nor heart rate were significantly affected by the injection of CRF into
      the IVth ventricle or the rostral pons. Results suggest an involvement of CRF in
      the central regulation of respiratory movements. CRF may be involved in the
      adaptation of respiration to stress.

PMID- 2226618
TI  - High-affinity binding of mequitamium iodide (LG 30435) to muscarinic and
      histamine H1 receptors.
AB  - Mequitamium iodide (LG 30435) is a novel quaternary ammonium phenothiazine with
      potential as an anti-asthmatic agent. In vitro binding experiments were performed
      in order to clarify the molecular mechanisms underlying its biological activity.
      Mequitamium iodide was found to bind with high affinity only to histamine H1
      receptors in rat brain membranes (Ki = 9 nM) and to muscarinic acetylcholine
      receptors in various tissues homogenates (Ki = 12-77 nM) with no clearcut
      selectivity for any of the known subtypes. The interaction with muscarinic
      receptors in rat cerebral cortex and lung parenchyma was competitive, as showed
      by saturation studies. Lower affinity values (Ki = 1-10 microM) were found for
      serotonin 5-HT2, platelet-activating factor (PAF), verapamil and beta-adrenergic
      agents. These results indicate that both the potent antimuscarinic and
      antihistamine and the relatively weak anti-PAF pharmacological effects of
      mequitamium iodide may be explained by the direct interaction of the substance
      with the respective receptors.

PMID- 2226619
TI  - Pharmacological and functional analysis of a novel serotonin receptor in the rat
      hippocampus.
AB  - Administration of serotonin (5-hydroxytryptamine, 5-HT) to pyramidal cells of the
      CA1 region of the hippocampus results in a hyperpolarizing response which is
      followed by a rebound depolarization and a decrease in the calcium-activated
      afterhyperpolarization (AHP). While the hyperpolarizing response has been
      previously shown to be mediated by receptors of the 5-HT1A subtype, the identity
      of the receptor(s) involved in the depolarizing response and decrease of the AHP
      have not been identified. In the present study the effectiveness of a series of 5
      HT receptor antagonists in blocking the membrane depolarization and reduction of
      the AHP was assessed. While a variety of 5-HT1 and 5-HT2 antagonists were found
      to be ineffective, the substituted benzamide BRL 24924 was found to be a potent
      and selective antagonist of the 5-HT-induced depolarization and decrease in the
      AHP in this region. This effect however appeared unrelated to the ability of this
      compound to block 5-HT3 receptors, as ICS 205-930 and MDL 72222 were markedly
      less efficacious in blocking these effects of 5-HT. Upon blockade of 5-HT1A
      receptors, 5-HT elicits a depolarization which is accompanied by a marked
      increase in excitability. These effects were also dose-dependently antagonized by
      BRL 24924. The present results thus suggest the presence in the CA1 region of the
      hippocampus of a novel 5-HT receptor at which BRL 24924 functions as a selective
      antagonist and which is capable of mediating slow excitatory responses in central
      neurons.

PMID- 2226620
TI  - Identification and pharmacological properties of binding sites for the atypical
      thiazide diuretic, indapamide.
AB  - [3H]Indapamide bound to a single class of binding sites in pig renal cortex
      membranes with a dissociation constant Kd = 35 +/- 13 nM and a binding site
      density Bmax = 40 +/- 9 pmol/mg of protein. [3H]Indapamide binding was inhibited
      by the carbonic anhydrase inhibitor, acetazolamide, and by thiazide diuretics
      with the following rank order of potency: chlorothiazide greater than
      hydrochlorothiazide approximately metolazone greater than hydroflumethiazide. The
      effect of the latter drugs to inhibit [3H]indapamide binding was not related to
      their activity as thiazide diuretics, but was significantly correlated with their
      inhibitory effect on carbonic anhydrase II. These results suggest that the major
      renal binding site of [3H]indapamide is a membrane form of carbonic anhydrase.
      Inhibition of carbonic anhydrase may play a role in the antihypertensive effect
      of indapamide.

PMID- 2226621
TI  - Beneficial hemodynamic effects of two weeks' milrinone treatment in conscious
      rats with heart failure.
AB  - Milrinone is a phosphodiesterase inhibitor which combines vasodilating effects
      with inotropic effects. Hemodynamic improvement after acute administration and
      increased survival with chronic milrinone therapy in rats with heart failure have
      been reported before, and suggest long-term hemodynamic improvement. However, no
      detailed hemodynamic studies are available on prolonged milrinone therapy in rats
      with heart failure. Therefore, the hemodynamic effects of 2 weeks' milrinone
      therapy were now investigated in conscious rats with heart failure due to
      myocardial infarction. The effects were compared to hemodynamic changes after
      acute administration. Acute milrinone increased the baseline cardiac output in
      infarcted rats by increasing heart rate rather than stroke volume. However, the
      maximal cardiac output achieved when the heart was stimulated through a volume
      load was improved due to increased stroke volume as well as increased heart rate.
      The increase in maximally stimulated cardiac output after acute milrinone was
      found to be related to infarct size. Two weeks' milrinone therapy in chronically
      infarcted rats dose dependently restored the hemodynamic changes which were
      caused by infarction. In contrast to acute administration, two weeks' milrinone
      restored cardiac function without an increase in heart rate. The effects were
      achieved at a rate of administration which presumably has no acute inotropic
      effects. The data indicate that acute milrinone in infarcted rats has
      vasodilating effects. Positive inotropic effects, possibly masked by concomitant
      venodilatation at baseline conditions, became overt after stimulation by volume
      loading. Long-term milrinone dose dependently restored cardiac function in
      infarcted rats without effects on heart rate or mean arterial pressure,
      suggesting that different mechanisms may be involved.

PMID- 2226622
TI  - The hypotensive and negative chronotropic effects of dehydroevodiamine.
AB  - The cardiovascular effects of dehydroevodiamine, an alkaloid isolated from Evodia
      rutaecarpa Jussieu, were studied in both in vivo and in vitro experiments. The in
      vivo experiments revealed that i.v. administration of dehydroevodiamine elicited
      a slight but significant reduction in blood pressure and a marked decrease in
      heart rate which was confirmed by an increased cycle length of the
      electrocardiogram. However, a hemodynamic experiment with microspheres showed
      that the total peripheral resistance was not altered by dehydroevodiamine. The
      blood flows of various organs were not significantly changed except those of
      kidney and skin, in which blood flow was decreased. In vitro, the spontaneously
      beating atria were significantly suppressed by dehydroevodiamine in a dose
      dependent manner. These findings suggested an important effect of
      dehydroevodiamine in suppressing the heart, which may largely contribute to the
      hypotensive effect of this alkaloid. However, its vasodilator effect on
      hindquarter muscles cannot be neglected.

PMID- 2226624
TI  - Cultured endothelial cells maintain their L-arginine level despite the continuous
      release of EDRF.
AB  - Endothelial cells cultured from bovine aorta and grown on microcarrier beads
      contain 107 +/- 9 microM L-arginine (Arg; n = 11). When packed into a jacketed
      chromatography column and perfused with Krebs solution, the cells showed a
      substantial and sustained release of endothelium-derived relaxing factor (EDRF)
      for up to 2 h, which was further enhanced by infusions of adenosine diphosphate
      (4 microM). In contrast to other amino acids, such as L-alanine, L-aspartate, L
      glutamine, L-glutamate or L-serine, which showed a time-dependent decrease to
      less than 30% of their original level within 2 h, Arg remained at control levels
      for 30 min and decreased only by 25% after 2 h. Thus endothelial cells can
      generate Arg from an intracellular source to maintain their Arg level despite the
      continuous formation of EDRF.

PMID- 2226623
TI  - Content and contractile effect of arginine vasopressin in rat urinary bladder.
AB  - The contractile response of normal male rat urinary bladders to exogenous
      arginine vasopressin (AVP) and the AVP content of normal and denervated bladders
      were investigated. In isolated detrusor strips, the maximal response to AVP was
      about 12% of the contraction elicited by KCl (124 mM), and the EC50 value was
      1.03 +/- 0.13 x 10(-8) M. The response to transmural nerve stimulation was not
      affected by the presence of AVP. Addition of an AVP receptor antagonist strongly
      reduced the response to exogenous AVP, but did not affect contractions in
      response to nerve stimulation. In normal bladders, the concentration of
      immunoreactive (ir) AVP was 29 +/- 6.0 x 10(-15) mol/g. Three days after
      denervation the bladders had increased 2.4-fold in weight. At this time, the
      concentration of irAVP was not different from the control value, but the total
      content had increased significantly. Characterization of bladder irAVP by reverse
      phase HPLC revealed that 66.5% of the total immunoreactivity eluted in the
      position of synthetic AVP. The results suggest a non-neuronal localization of
      bladder irAVP.

PMID- 2226625
TI  - Stereospecific inhibition of non-opioid defeat analgesia in male mice by MDL
      72832, a selective 5-HT1A receptor agonist.
AB  - The effects of MDL 72832, a potent and stereoselective ligand for 5-HT1A sites,
      on basal nociception and non-opioid defeat analgesia in male mice were examined.
      Neither (+)- nor (-)-MDL 72832 significantly altered basal tail-flick latencies.
      In contrast, (-)-MDL 72832 potently inhibited defeat analgesia (0.1-0.5 mg/kg
      i.p.), with similar effects produced by (+)-MDL 72832 only at substantially
      higher doses (3.0-5.0 mg/kg i.p.). These data clearly demonstrate a
      stereoselective action of this 5-HT1A ligand on non-opioid defeat analgesia.

PMID- 2226626
TI  - Inhibition of nitric oxide synthesis reduces the hypotension induced by bacterial
      lipopolysaccharides in the rat in vivo.
AB  - E. coli lipopolysaccharide (LPS; 15 mg kg-1 i.v.) produced a long-lasting
      reduction in mean arterial blood pressure (MAP) in the anaesthetized rat.
      Inhibition of nitric oxide endothelium-derived relaxing factor (EDRF) synthesis
      with NG-monomethyl-L-arginine (MeArg, 1 mg kg-1 min-1 i.v. for 30 min) produced
      an increase in MAP and largely attenuated the LPS-induced hypotension; both
      effects were significantly reversed with L-arginine (6 mg kg-1 min-1 i.v.). When
      compared to MeArg, phenylephrine (300 mg kg-1 h-1 i.v.) produced a similar
      pressor response, but much less attenuation of the hypotensive response to LPS.
      Thus, a stimulation of EDRF release contributes to the LPS-induced hypotension in
      the anaesthetized rat.

PMID- 2226627
TI  - Opposite effects of endothelin-1 and Big-endothelin-(1-39) on renal function in
      rats.
AB  - Bolus injections of Big-endothelin-(1-39) (Big-ET; 0.1-3.0 nmol/kg) induced a
      dose-dependent diuretic and natriuretic response in conscious Sprague-Dawley
      rats. Endothelin-1-(1-21) (ET-1; 1 nmol/kg) induced an opposite effect with
      almost complete renal shut down. Renal blood flow did not change with Big-ET but
      was reduced by half with ET-1. Although the maximal pressor responses of the two
      peptides were comparable the renal resistance did not change with Big-ET but
      increased 4-fold with ET-1. These data suggest that Big-ET may have a different
      mechanism of action than ET-1.

PMID- 2226628
TI  - The polyamine synthesis inhibitor alpha-difluoromethylornithine blocks NMDA
      induced neurotoxicity.

PMID- 2226629
TI  - Phosphoramidon, a metalloproteinase inhibitor, suppresses the hypertensive effect
      of big endothelin-1.
AB  - Intravenous (i.v.) injection of big endothelin-1 (1-39, 0.05-1.0 nmol/kg) to
      anaesthetized rats produced a dose-dependent and long-lasting hypertensive
      effect, the magnitude of which was similar to that evoked by ET-1 (1-21). In
      animals given phosphoramidon (0.25 mg/kg per min i.v.), a metalloproteinase
      inhibitor, the hypertensive effect of big endothelin-1 was markedly attenuated.
      The same dose of phosphoramidon did not influence the endothelin-1-induced
      hypertensive effect. The possibility that big endothelin-1 is converted to
      endothelin-1 by a phosphoramidon-sensitive metalloproteinase in vivo warrants
      further attention.

PMID- 2226630
TI  - Temperature dependence of angiotensin II-mediated depolarisation of the rat
      isolated nodose ganglion.
AB  - The ability of angiotensin II (A II) and 5-hydroxytryptamine (5-HT) to depolarise
      the rat isolated nodose ganglion preparation was examined. 5-HT depolarised the
      nodose ganglion, both at room temperature (20-24 degrees C) and at 35-37 degrees
      C. However, A II depolarised the nodose ganglion only under the latter condition,
      and these responses were blocked by the A II receptor antagonist saralasin. This
      study extends previous findings which have demonstrated A II binding sites on the
      nodose ganglion and axon, and identifies the rat nodose ganglion as a sensitive
      preparation in which to study the interactions between neuronal A II receptor
      activation and its blockade by A II receptor antagonists.

PMID- 2226631
TI  - Modulatory role of endogenous nitric oxide in pulmonary circulation in vivo.

PMID- 2226632
TI  - Neuroprotective effect of memantine demonstrated in vivo and in vitro.
AB  - The purpose of the present study was to test whether the anticonvulsant,
      memantine (1-amino-3,5-dimethyladamantane), can protect neurons against hypoxic
      or ischemic damage. To this end, we used a rat model of transient forebrain
      ischemia and cultured neurons from chick embryo cerebral hemispheres. Ischemia
      was induced for 10 min by clamping both carotid arteries and lowering the mean
      arterial blood pressure to 40 mm Hg; the rats were allowed to recover for 7 days.
      Cultured neurons were made hypoxic with 1 mmol/l NaCN added to the incubation
      medium for 30 min followed by a recovery period of 3 days. The possible effects
      of memantine were compared with those produced by a typical non-competitive NMDA
      antagonist, dizocilpine. Similar effects were obtained with both drugs. The drugs
      reduced the damage caused by transient ischemia to neurons of the hippocampal CA1
      subfield. Memantine (10 and 20 mg/kg) had a dose-dependent effect when
      administered intraperitoneally to the rats 1 h before ischemia. Dizocilpine was
      active in this model at a dosage of 1 mg/kg. When administered after ischemia, 10
      mg/kg memantine significantly protected CA1 neurons against ischemic damage.
      Furthermore, the drugs protected cultured neurons against hypoxic damage. The
      lowest effective concentration was 0.1 mumol/l for dizocilpine and 1 mumol/l for
      memantine. Thus, memantine possesses neuroprotective activity but is less potent
      than dizocilpine.

PMID- 2226633
TI  - A comparison of the haemodynamic profiles of Ro 31-6930, cromakalim and
      nifedipine in anaesthetised normotensive rats.
AB  - The regional haemodynamic profiles of Ro 31-6930, cromakalim and nifedipine were
      compared using pulsed Doppler flowmetry in the anaesthetised rat. In order of
      potency, Ro 31-6930 (0.1-300 micrograms/kg), cromakalim (1-300 micrograms/kg) and
      nifedipine (1-1000 micrograms/kg) produced dose related falls in mean arterial
      pressure. The hypotensive effects of Ro 31-6930 and cromakalim were accompanied
      by reflex tachycardia. All three agents reduced renal vascular resistance by 30
      50%. Cromakalim exerted a selective action on this vascular bed. Similar maximal
      reductions in mesenteric vascular resistance (37-50%) were observed; however,
      cromakalim was the least potent on this vascular bed. Maximal reductions in iliac
      vascular resistance (65-78%) were observed, with an order of potency as observed
      on mean arterial pressure. Qualitative differences in the regional haemodynamic
      profiles of Ro 31-6930, cromakalim and nifedipine are evident from this study.
      The different profiles of Ro 31-6930 and cromakalim may reflect structural
      differences between the pharmacophores of these compounds.

PMID- 2226634
TI  - Distinct stimulatory effect of platelet-activating factor on prostaglandin I2 and
      thromboxane A2 biosynthesis by rat dental pulp.
AB  - Platelet-activating factor (PAF-acether), but not lyso PAF, stimulated the
      production of both PGI2 and TXA2 by rat dental pulp tissue in vitro. However,
      there were differences in the dose- and time-dependence of the stimulatory
      effects. PAF-acether antagonists, Bn 52021, CV 3988 and kadsurenone, dose
      dependently inhibited PAF-acether-induced PG production. BN 52021, CV 3988 also
      dose dependently inhibited TX production, but kadsurenone was almost without
      effect on TX production. Pretreatment of the tissues with PAF-acether or phorbol
      12-myristate 13-acetate completely abolished the effect of the second challenge
      with PAF-acether. The stimulatory effects of PAF-acether and the calcium
      ionophore A23187 on PGI2 production were completely blocked by removal of
      extracellular calcium, whereas the effects on TXA2 production were not. TMB-8, an
      intracellular calcium antagonist, completely inhibited PAF-acether-induced PG
      production, whereas it slightly inhibited TX production. H-7, a protein kinase C
      inhibitor, and neomycin, a phospholipase C inhibitor, completely inhibited PAF
      acether-induced PG and TX production, whereas W-7, a calmodulin inhibitor, did
      not. These results suggest that PAF-acether stimulates PGI2 and TXA2 production
      in rat dental pulp by interacting with distinct PAF-acether receptors, and that
      these receptors are coupled to independent signal transduction pathways which
      have a different dependence on extra- and intracellular calcium.

PMID- 2226635
TI  - Inositol hexakisphosphate stimulates 45Ca2+ uptake in anterior pituitary cells in
      culture.
AB  - Inositol hexakisphosphate (InsP6) is thought to act as an intracellular signal
      molecule in the central nervous system. We report that InsP6 stimulates 45Ca2+
      uptake in cultured anterior pituitary cells. This effect is concentration
      dependent, is mimicked by inositol-pentakis phosphate (InsP5) but not by inositol
      tetrakis phosphate (InsP4), is present after 2 min of incubation, is independent
      of extracellular Na+ and insensitive to nifedipine and verapamil. These results
      suggest that InsP6, a putative metabolite of the inositol cycle, may regulate
      transmembrane mechanism in the pituitary.

PMID- 2226636
TI  - Inhibitory effects of a novel antiatheromatous agent, E5050, on aortic smooth
      muscle cell proliferation, in vitro.
AB  - The effect of a novel antiatheromatous agent, N-(3-[4'-(2'',6''
      dimethylheptyl)phenyl]butanoyl)ethanolamin e (E5050), on the proliferation of
      porcine aortic smooth muscle cells was studied in vitro. E5050 dose-dependently
      inhibited DNA synthesis as well as proliferation of cells stimulated with 10%
      fetal calf serum with no cytotoxic effects. An inhibitory effect of E5050 on DNA
      synthesis was also confirmed in cells stimulated with human platelet extract and
      with a combination of platelet-derived growth factor and human plasma-derived
      serum. DNA synthesis in smooth muscle cells stimulated with other mitogens, such
      as fibroblast growth factor and insulin, was inhibited by E5050 and this
      inhibitory effect was positively correlated with the E5050 uptake into smooth
      muscle cells. These results indicate that E5050 inhibits smooth muscle cell
      proliferation stimulated by various mitogenic factors. It is suggested that E5050
      prevents atherogenesis and inhibits the progression of fibromuscular lesions by
      interfering with the proliferation of arterial smooth muscle cells.

PMID- 2226637
TI  - P2 purinoceptor-mediated inositol phosphate formation in relation to cytoplasmic
      calcium in DDT1 MF-2 smooth muscle cells.
AB  - The effect of P2 purinoceptor stimulation on inositol phosphate (InsP) formation
      in relation to the intracellular Ca2+ concentration was measured in vas deferens
      DDT1 MF-2 smooth muscle cells. The different [3H]myo-inositol-labelled InsP
      fractions were analyzed by high performance liquid chromatography and
      intracellular Ca2+ was determined by measuring fluorescence using Indo-1 as
      indicator. Stimulation with ATP (10(-4) M) resulted in an enhanced formation of
      inositol mono-, bis-, tris- and tetrakisphosphate (InsP1, InsP2, InsP3 and
      InsP4), but no changes occurred in the formation of inositol pentakis- and
      hexakisphosphate (InsP5 and InsP6). The putative second messenger Ins(1,3,4,5)P4
      rapidly increased after addition of the agonist, reaching a maximum after about 2
      min. The isomer Ins(1,4,5)P3 showed a delayed rise starting after about 2 min.
      The formation of Ins(1,3,4,5)P4 in the presence of ATP (2 min) was concentration
      dependent, reaching a half maximal value at about 50 microM of the agonist. The
      intracellular Ca2+ concentration showed an initial increase after P2 purinoceptor
      stimulation, reaching a plateau after 2 min. Both the top of the initial phase
      and the plateau value of the response reached a half maximal value at an ATP
      concentration of about 7 microM. This Ca2+ response could be evoked repeatedly by
      ATP and was not affected by diltiazem (10(-5) M). In the absence of external
      Ca2+, the internal Ca2+ concentration increased transiently in the presence of
      ATP without showing the plateau phase. This response could be evoked only once
      under Ca2(+)-free conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226638
TI  - Identification and initial characterization of high-affinity [3H]dextrorphan
      binding sites in rat brain.
AB  - We have identified specific high-affinity [3H]dextrorphan binding sites in rat
      forebrain. [3H]Dextrorphan binds saturably and reversibly to an apparently
      homogenous class of sites characterized by a Bmax of 2.62 +/- 0.06 pmol/mg
      protein and KD of 60 +/- 4 nM. Glycine and glutamate independently increase
      [3H]dextrorphan binding in a concentration-dependent manner. The pharmacological
      profiles of [3H]dextrorphan binding characterized by equilibrium competition
      experiments together with these data suggest that [3H]dextrorphan labels a site
      at or near the N-methyl-D-aspartate receptor.

PMID- 2226639
TI  - GTP modulates [125I]iodomelatonin binding to a picomolar-affinity site in the
      Syrian hamster hypothalamus.
AB  - Saturation binding experiments conducted with [125I]iodomelatonin at 0-4 degrees
      C in the Syrian hamster hypothalamus, revealed a single nanomolar-affinity site
      which was not affected by GTP. In contrast, incubation at 30 degrees C revealed
      two distinct binding sites with picomolar and nanomolar affinities, respectively.
      GTP caused a significant decrease in the affinity of only the picomolar site but
      did not alter its density; control: Kd = 43 +/- 6 pM, Bmax = 1.7 +/- 0.3 fmol/mg
      protein; GTP (1 mM): Kd = 250 +/- 52, Bmax = 3.9 +/- 2.6 fmol/mg protein. The
      foregoing indicates that the affinity of the putative melatonin receptor in the
      hamster hypothalamus is modulated by a regulatory G protein.

PMID- 2226640
TI  - Immortalization of primary cells by DNA tumor viruses.
AB  - Cellular senescence is characterized by a decline in sensitivity to growth
      factors resulting in cessation of cellular growth. The expression of cellular or
      viral oncogenes may result in the establishment of cell lines with unlimited
      proliferative potential ("immortalization"). A variety of viral and cellular
      oncogenes have been reported to immortalize cells, suggesting that multiple
      mechanisms may lead to an escape from senescence. Immortalization has been
      reported to occur as a result of an interaction of viral proteins with cellular
      suppressor gene products or may result from the elevated expression of
      "transforming" oncoproteins (such as the polyomavirus middle-t antigen). Here we
      speculate that a selection for cells with a further decreased probability of cell
      cycle withdrawal can occur during the growth of cells expressing viral early
      genes, resulting in a process of tumor progression. Explaining immortalization in
      terms of mitogenic stimulation due to the expression of viral oncogenes followed
      by genetic/epigenetic changes may help to explain why lytic DNA viruses have a
      biological activity which may not be necessary for their life cycle.

PMID- 2226641
TI  - Interleukin-1-induced suppression of type II collagen gene transcription involves
      DNA regulatory elements.
AB  - Interleukin-1 is a proinflammatory polypeptide that influences cartilage
      macromolecular degradation and synthesis. Since previous studies have suggested
      that interleukin-1 may inhibit type II collagen synthesis, we have studied the
      mechanism of inhibition of type II collagen synthesis by interleukin-1. When
      rabbit articular chondrocytes were treated with purified recombinant interleukin
      1 beta or macrophage-conditioned medium, the synthesis and assembly of type II
      collagen into the extracellular matrix were greatly reduced. The inhibition was
      concentration-dependent and occurred within 10 h of treatment with interleukin-1,
      with greater inhibition occurring at 30 h. The reduced level of collagen
      synthesis correlated with a reduction in the steady-state mRNA levels coding for
      type II collagen, as measured by a Northern blot analysis. This further
      correlated with a reduction in the transcription of type II collagen gene, as
      determined by nuclear run-on experiments. Finally, transfection studies using
      plasmid constructs containing DNA regulatory sequences from the type II gene,
      coupled to a reporter gene (CAT), revealed that in comparison to control
      chondrocytes, interleukin-1 treated cells showed a reduced level of CAT activity.
      These studies demonstrate that the inhibition of collagen type II synthesis by
      interleukin-1 is due to a reduction in the transcription of the type II collagen
      gene and that the reduction in gene transcription involves DNA regulatory
      sequences that determine type II collagen gene expression.

PMID- 2226642
TI  - Growth inhibition of mitogen-stimulated fibroblasts induced by double-stranded
      RNA depends on cell density.
AB  - Polyinosinic-polycytidylic acid [poly(I:C)], a synthetic double-stranded RNA, is
      an inhibitor of mitogen-induced proliferation of normal fibroblasts. We show that
      this inhibition depends strongly on cell density. While cultures with densities
      at or above confluence are completely inhibited by poly(I:C) in their
      proliferative response to epidermal growth factor (EGF), the proliferation of
      sparse (subconfluent) cultures is only delayed. Conditioned medium from dense
      fibroblasts exposed to poly(I:C) inhibits EGF stimulation of sparse cells,
      indicating that the inhibition is, at least in part, mediated by a factor
      released from the cells. Preincubation of quiescent cultures with poly(I:C)
      renders the cells refractory to the inhibitory effects of poly(I:C). This
      desensitization correlates with a decreased production of the inhibitor. Since
      the inhibition of mitogenic stimulation by poly(I:C) is completely overcome by
      antisera recognizing interferon-beta (IFN-beta) and interleukin-6 (IL-6), we
      tested the effect of IL-6 and IFN-beta on EGF mitogenicity. None of the available
      IL-6 preparations had any effect on cell cycle entry. IFN-beta caused a dose
      dependent delay of cell division but did not affect the density-dependent
      proportion of cells entering the cell cycle in response to EGF. Thus, IFN-beta
      cannot be the sole mediator of the poly(I:C)-induced inhibition. In the presence
      of dexamethasone, poly(I:C) did not inhibit EGF mitogenis. Indeed, the combined
      presence of poly(I:C) and dexamethasone did more than just restore the density
      dependent control levels of EGF stimulation; most cells entered the cell cycle
      even at extremely high cell densities. Thus, poly(I:C) in combination with
      dexamethasone could deactivate the cell density-dependent negative control of
      proliferation.

PMID- 2226643
TI  - Different effects of TPA on two skin-derived cell lines: murine (HEL-30) and
      human (NCTC) epidermal cells.
AB  - 12-O-tetradecanoylphorbol-13-acetate (TPA) caused a rapid activation of protein
      kinase C in a murine (HEL-30) and in a human (NCTC) epidermal cell line. In HEL
      30 cells, protein kinase C activation is followed by ornithine decarboxylase
      stimulation and cell proliferation, events inhibited by H-7, a specific inhibitor
      of protein kinase C. TPA in NCTC cells inhibited the basal ornithine
      decarboxylase activity and cell growth, whereas H-7 did not modify TPA effect.
      The response of NCTC cells was not due to direct toxicity of TPA. These data
      confirm that in murine epidermal cells, the proliferation induced by TPA is
      mediated by protein kinase C, whereas in a human skin-derived cell line these
      events are not or inversely associated.

PMID- 2226644
TI  - Differentiation of newborn rat preadipocytes in culture: effects of insulin and
      dexamethasone.
AB  - A preadipocyte cell population isolated from the inguinal tissue of 3-day-old
      rats converts at confluence into mature adipocytes when cultured with insulin
      (10(-9) M). Insulin is necessary only from Day 4 postplating. If the addition of
      insulin is further delayed, the proportion of cells which will undergo adipose
      conversion decreases. A loss of the differentiation competence is also observed
      when the cells are allowed to proliferate (seeding at a low density in a serum
      containing medium). A preexposure of the primary cells to dexamethasone during
      the insulin-insensitive period (Days 0-4) accelerates the subsequent "insulin
      dependent" adipose conversion. In order to produce its effect, dexamethasone
      needs only to be present for 4 h on Day 2 postplating. The effect of
      dexamethasone is probably due neither to inhibition of cell proliferation nor to
      induction of the cell content of insulin receptors. The evolution of G3PDH enzyme
      activity as well as of G3PDH protein and mRNA was used as an indicator of the
      differentiation process. The enzyme accumulates to a low extent during culture in
      the absence of insulin. When insulin is present, the enzyme level is dramatically
      increased (maximum on Day 11). Dexamethasone pretreatment (Days 0-4, or 4 h on
      Day 2) accelerated the G3PDH enzyme activity increase as well as protein and mRNA
      accumulation. This was also true in cells maintained in insulin-free medium;
      however, in this case, the increase in the enzyme activity was limited to the
      first 8 days of culture and full differentiation did not take place. We conclude
      that: (1) the rat preadipocytes are committed to differentiate, requiring insulin
      as a sufficient physiological stimulus; (2) the differentiation program is
      progressively lost after greater than 4 days of culture without insulin and more
      rapidly if the cells are allowed to undergo divisions; and (3) dexamethasone
      accelerates the insulin-dependent adipose conversion but alone does not ensure
      the complete differentiation process.

PMID- 2226645
TI  - Membrane fatty acid changes during the cell cycle of CV-1 cells.
AB  - Monolayers of CV-1 cells were synchronized at the G1/S boundary of the cell cycle
      by a 24-h 2 mM thymidine blockade. Uptake of tritiated thymidine indicated that
      the peak DNA synthesis occurred 6-8 h after release from the block and that cell
      cycle time was 18-20 h. The fatty acid composition of phospholipids extracted
      from cells at 0, 7, and 18 h postblockade was measured by gas chromatography. The
      results indicate cyclic changes in membrane fatty acids with a significant
      increase in long-chain polyunsaturated fatty acids during the DNA synthesis phase
      (S phase) of the cell cycle.

PMID- 2226646
TI  - Effect of TGF-beta 1, TGF-beta 2, and bFGF on chick cartilage and muscle cell
      differentiation.
AB  - In insulin containing defined medium TGF-beta 1, TGF-beta 2, and bFGF all
      stimulate chondrogenic differentiation in high-density micromass cultures of
      distal limb bud mesenchyme cells of chick embryos. In addition bFGF inhibits
      myogenic differentiation, while TGF-beta 1 and TGF-beta 2 appear to have no
      effect. TGF-beta 1 and bFGF together act additively to enhance chondrogenesis,
      while TGF-beta blocks the bFGF inhibitory action on myoblasts, thus allowing them
      to differentiate. In the absence of insulin, the inhibitory effect of bFGF on
      muscle cell differentiation is reduced; cartilage differentiation in the presence
      of the above growth factors is also slightly reduced.

PMID- 2226647
TI  - Nucleolar transcriptional activity in mouse Sertoli cells is dependent on
      centromere arrangement.
AB  - Experimental evidence suggests that centromere arrangement is relevant to the
      expression of ribosomal genes in murine Sertoli cells. Nuclei endowed with a
      nucleolus inactive in rRNA synthesis presented several clusters, each containing
      a bunch of individual centromeres. RNA polymerase I was not cytochemically
      detected in the nucleolar structure, which contained only small amounts of
      fibrillarin. In the course of nucleolar activation, the centromeres within the
      separate clusters became fused into larger centromeric bodies. Synthesis of
      precursor rRNAs and their processing were visualized by strong nucleolar
      fluorescence signals using antibodies to RNA polymerase I and fibrillarin.

PMID- 2226648
TI  - Serum-induced cytosolic calcium movements and mitogenesis in cultured preosseous
      chondrocytes.
AB  - The differentiation of preosseous chondrocytes begins with the proliferation of
      resting cells and results in the expression of the hypertrophic phenotype. The
      effect of fetal calf serum on chondrocyte mitogenesis and intracellular Ca2+
      concentration was studied in resting and hypertrophic cells in primary culture.
      Resting chondrocytes respond to the growth stimulus with immediate release of
      Ca2+ from intracellular stores and with opening of the plasma membrane Ca2+
      channels. These events may be related to the elevated [3H]thymidine incorporation
      observed after serum exposure. In contrast, in hypertrophic chondrocytes the
      lower rate of DNA synthesis seems to be coupled with a lower activity of the Ca2+
      signaling mechanism and, probably, with reduced intracellular calcium stores. It
      is proposed that expression of the Ca2+ signaling mechanism may be modulated
      during the differentiation of preosseous chondrocytes.

PMID- 2226649
TI  - Effect of long-term hypoxia on cultured aortic and pulmonary arterial endothelial
      cells.
AB  - In a previous study, we found a marked difference in the release of a cytokine,
      neutrophil chemoattractant activity (NCA), from cultured endothelial cells
      exposed to acute decreases in ambient oxygen, depending on the vascular bed of
      origin. In the current study, we used this cytokine to evaluate the effect of
      long-term exposure to decreased oxygen on endothelial cell function. We found
      that, in aortic and pulmonary arterial endothelial cells maintained for months in
      decreased ambient oxygen (10 or 3% oxygen), exposure to acute decreases in
      ambient oxygen caused a change in the pattern of NCA release; however, the
      differential response between the two cell types persisted. Aortic endothelial
      cells release NCA when exposed acutely to a level of oxygen below that in which
      they have been chronically maintained. In contrast, pulmonary arterial
      endothelial cells release NCA only when exposed to 0% oxygen acutely, but only if
      grown chronically in 10% oxygen; otherwise there was no release of NCA. As
      another indicator of endothelial cell function, we evaluated the effects of acute
      hypoxic exposure on prostacyclin production by endothelial cells maintained in 21
      or 3% oxygen. If grown in 21% oxygen, both cell types decreased prostacyclin
      production upon exposure to 0% oxygen. However, when grown in 3% oxygen, only
      aortic endothelial cells decreased prostacyclin production when exposed acutely
      to 0% oxygen; pulmonary arterial endothelial cell prostacyclin production did not
      change. This study demonstrating the persistence of a differential pattern of NCA
      release and the appearance of a differential pattern of prostacyclin production
      after a long-term decrease in environmental oxygen suggests that the capacity of
      certain vascular endothelial cells to respond to decreases in oxygen
      concentration is carried by the cell throughout its existence. Thus, in certain
      situations, vascular endothelial cells may be important in sensing acute
      decreases in ambient oxygen.

PMID- 2226650
TI  - Changes in the DNA polymerase beta gene expression during development of lung,
      brain, and testis suggest an involvement of the enzyme in DNA recombination.
AB  - Changes in the expression pattern of DNA polymerase beta gene during rat lung,
      brain, and testis development have been investigated. A decrease in the level of
      beta-pol mRNA was observed during postnatal development of lung and brain. By
      contrast, an almost 20-fold increase in the level of beta-pol mRNA was observed
      during spermatogenesis. For most adult rat tissues the abundance of beta-pol mRNA
      was low compared with that of beta-actin mRNA. Northern blot analysis revealed
      four distinct transcripts hybridizing to beta-pol probes. At least two of them,
      1.4 kb and 4.0 kb, were products of a beta-polymerase gene. The changes in the
      expression pattern during lung and brain development, and during spermatogenesis,
      suggest involvement of DNA polymerase beta in gap-filling DNA synthesis during
      recombination.

PMID- 2226651
TI  - Correlation between chemotactic peptide-induced changes in chlorotetracycline
      fluorescence and F-actin content in human neutrophils: a role for membrane
      associated calcium in the regulation of actin polymerization?
AB  - Several observations indicate that the triggering event for receptor-mediated
      actin polymerization takes place in or close to the plasma membrane. Stimulation
      of human neutrophils with the chemotactic peptide formylmethionyl-leucyl
      phenylalanine (fMet-Leu-Phe) causes rapid and transient changes in both
      chlorotetracycline (CTC) fluorescence and the cellular content of filamentous
      actin (F-actin), thus suggesting a regulatory role for membrane-bound calcium in
      actin polymerization. In the present study, tetracaine, a proposed antagonist to
      membrane-bound calcium, totally inhibited the rebinding of the membrane calcium
      released by fMet-Leu-Phe. This was accompanied by a magnified and sustained
      increase in the cellular content of F-actin. In agreement, N-ethylmaleimide, an
      inhibitor of motile functions, completely abolished the fMet-Leu-Phe-triggered
      changes in both CTC fluorescence and F-actin content and rapidly reversed the
      responses when added after the peptide. The tumor promoter phorbol-12-myristate
      13-acetate, caused only small changes in CTC fluorescence and F-actin content,
      and reduced a subsequent fMet-Leu-Phe-induced CTC response and actin
      polymerization. Inhibition of the breakdown of phosphatidylinositol 4,5
      bisphosphate, by calcium depletion, had no significant effects on the fMet-Leu
      Phe-induced CTC response and alterations in F-actin content, whereas pretreatment
      with pertussis toxin totally inhibited both these responses. Consequently, the
      strong correlation between changes in CTC fluorescence and F-actin content, found
      in this study, suggests a triggering or modulating role of membrane-associated
      calcium on actin polymerization in human neutrophils.

PMID- 2226652
TI  - Expression of human chromosomal proteins HMG-14 and HMG-17 in Saccharomyces
      cerevisiae.
AB  - The cDNAs coding for human chromosomal proteins HMG-14 and HMG-17 were cloned
      into yeast expression vector pBM150, under the control of the Gal10 promoter.
      Northern analysis of transformed yeast cells revealed that both cDNAs were
      efficiently transcribed. Western analysis indicated that the mRNAs were
      translated into authentic proteins. Expression of human HMG proteins in yeast
      cell did not produce detectable phenotypic changes, as measured by the growth
      rate of the yeast cells under a variety of conditions. The antibiotic resistance
      of the transfected cells was similar to that of control cells, suggesting that
      the presence of HMG did not affect the expression of actively transcribed genes.
      However, examination of the protein profile on two-dimensional polyacrylamide gel
      electrophoresis revealed differences between control and HMG-transfected cells.

PMID- 2226653
TI  - Fibronectin and collagen gene expression during in vitro ageing of pig skin
      fibroblasts.
AB  - The fibronectin, collagen type I, and collagen type III genes code for three
      major proteins of the cell matrix. The age-related alterations in their
      expression were measured during the in vitro lifespan of pig skin fibroblasts. We
      observed changes in the transcription rate of these specific genes during ageing.
      The levels of fibronectin and type III collagen mRNA rose markedly during the
      senescence phase. The level of collagen type I mRNA decreased during cell ageing,
      while that of beta-actin did not change. As regards proteins, we observed a sharp
      increase in the secreted noncollagenous proteins and in the total proteins of the
      cell layer during senescence. On the contrary, the secretion of the collagenous
      proteins decreased during senescence. Moreover, most of the newly synthesized
      molecules of collagen were immediately degraded in the cells, before their
      extracellular secretion. The terminal phenotype of pig senescent cells was
      therefore characterized by overexpression of fibronectin and type III collagen
      genes and reduced expression of the type I collagen gene. Surprisingly, for
      fibronectin and type III collagen, that terminal phenotype resembled the one
      normally found in the fibroblasts during the processes of tissue repair,
      cicatrization, and development.

PMID- 2226654
TI  - Agents which modify colonial morphology of tumor cells also affect acid vesicle
      function and fibronectin deposition in the extracellular matrix.
AB  - The tumor cell line U937A is motile, weakly plastic-adherent and forms large,
      loosely packed colonies in vitro and is invasive and metastatic in vivo. U937A/R,
      a mutant selected for resistance to killing by tumor necrosis factor (TNF), is
      less motile, more adherent and forms small, tightly packed colonies and is not
      invasive or metastatic. U937A and U937A/R also have differing cytoplasmic
      distributions of acid vesicles, and unlike U937A, U937A/R fails to deposit
      fibronectin into its extracellular matrix. In this study we have sought reagents
      that could convert "loose" U937A cells into the nonmetastatic, "tight" colonial
      phenotype. Six effective reagents were found: wheat germ agglutinin,
      phytohemagglutinin-L, dexamethasone, chloroquine, promethazine, and monensin. All
      6 reagents caused swelling and/or redistribution of acid vesicles but
      phytohemagglutinin-L, dexamethasone, and monensin also reduced fibronectin
      deposition in the extracellular matrix. Therefore, these agents probably reduce
      motility by interference with recycling of cell surface receptors through acid
      vesicles and also in some cases by altering the extracellular matrix.

PMID- 2226655
TI  - Fibroblast behavior on gels of type I, III, and IV human placental collagens.
AB  - Various collagens were extracted and purified from human placenta after partial
      pepsin digestion. We prepared type III + I (57:43), enriched type I, type III,
      and type IV collagens on an industrial level, and studied their biological
      properties with MRC5 fibroblast cells. Using the process of contraction of a
      hydrated collagen lattice described by Bell, we found tha the contraction rate
      was dependent on collagen type composition. The contraction was faster and more
      pronounced with pepsinized type I collagen than with pepsinized type III + I
      (57:43) collagen; the lowest rate was obtained with the pepsinized type III
      collagen. Using a new technique of collagen cross-linking, a gel was made with
      type IV collagen. This cross-linking procedure, based on partial oxidation of
      sugar residues and hydroxylysine by periodic acid, followed by neutralization,
      resulted in an increased number of natural cross-link bridges between oxidized
      and nonoxidized collagen molecules, without internal toxic residues. The
      fibroblasts were unable to contract type IV/IVox collagen gels. The type IV/IVox
      collagen gel was transparent and its amorphous ultrastructure lacked any visible
      striated fibrils. Fibroblast cells exhibited atypical behavior in these type
      IV/IVox collagen gels as evidenced by optical and electron microscopy. The
      penetration of fibroblasts could be measured. Fibroblasts penetrated faster in
      type IV/IVox collagen gels than in untreated type III + I collagen gels. The
      lowest rate of penetration was obtained with cross-linked type III + I gels.
      Fibroblast proliferation was similar on untreated or cross-linked type III + I
      collagen gels and slightly increased on type IV/IVox collagen gels, suggesting
      that this cross-linking procedure was not toxic.

PMID- 2226656
TI  - Nathan Shock 1906-1989.

PMID- 2226657
TI  - Cellular activity, matrix proteins, and aging bone.
AB  - The extracellular matrix of bone is composed of proteins from both local and
      exogenous sources. Many of these are known growth factors (e.g., transforming
      growth factors-beta; insulin-like growth factors; and fibroblast growth factors)
      which concentrate in mineralized bone and probably contribute to the ability of
      bone to regenerate itself on injury. With advancing age, human osteoblasts have
      reduced bone formative properties and in vitro, osteoblasts from fetuses
      generally have greatly increased proliferative and biosynthetic capacities
      compared to cells from adult donors. Aside from type I collagen, many noncollagen
      components are synthesized by osteoblasts and secreted to the bone matrix space.
      Several of these are cell attachment proteins (e.g., fibronectin, thrombospondin,
      osteopontin) which greatly influence cytodevelopment and differentiation. They
      are degraded to lower molecular weight fragments with advancing age, probably
      deactivating their true bioactivities. It is not know whether the age-related
      degradation of these proteins affects bone cell function in aged individuals.
      Several of the bone matrix proteins are also found in platelets and have been
      implicated in the wound-repair process. One of these, osteonectin, is found in a
      wide variety of nonbone cell systems, but only in periods of rapid growth and
      proliferation. Osteonectin production is the highest and is maintained the
      longest in bone compared to all other tissues of the body. Thus, reduced
      osteonectin production in aged bone cells may be an important parameter for
      further study.

PMID- 2226658
TI  - 1,25-Dihydroxyvitamin D3 increases the toxicity of hydrogen peroxide: the role of
      calcium and heat shock.
AB  - 1,25-Dihydroxyvitamin D3 [1,25-(OH)2D3] increases synthesis of heat shock
      proteins in monocytes and U937 cells and protects these cells from thermal
      injury. We therefore examined whether 1,25-(OH)2D3 would also modulate the
      susceptibility to H2O2-induced oxidative stress. Prior incubation for 24 h with
      1,25-(OH)2D3 (25 pM or higher) produced unexpected increased H2O2 toxicity. Since
      cellular Ca2+ may be a mediator of cell injury, we investigated the effects of
      altering extracellular Ca2+ ([Ca2+]e) on 1,25-(OH)2D3-enhanced H2O2 toxicity, as
      well as the effects of 1,25-(OH)2D3 and H2O2 on cytosolic-free Ca2+ concentration
      ([Ca2+]f). Basal [Ca2+]f in medium containing 1.5 mM Ca2+ as determined by fura-2
      fluorescence was higher in 1,25-(OH)2D3-pretreated cells than control cells (137
      versus 112 nM, p less than 0.005). H2O2 induced a rapid increase in [Ca2+]f (to
      greater than 300 nM) in both 1,25-(OH)2D3-treated and control cells, which was
      prevented by a reduction in [Ca2+]e to less than basal [Ca2+]f. The 1,25-(OH)2D3
      induced increase in H2O2 toxicity was also prevented by preincubation with 1,25
      (OH)2D3 in Ca2(+)-free medium or by exposing the cells to H2O2 in the presence of
      EGTA. Preexposure of cells to 45 degrees C for 20 min, 4 h earlier, partially
      prevented the toxic effects of H2O2 particularly in 1,25-(OH)2D3-treated cells,
      even in the presence of physiological levels of [Ca2+]e. Thus, 1,25-(OH)2D3
      potentiates H2O2-induced injury probably by increasing cellular Ca2+ stores. The
      protective effects of heat shock are probably exerted at a site distal to the
      toxic effects of Ca2+. The 1,25-(OH)2D3-induced amplification of the heat shock
      response likely represents a mechanism for counteracting the Ca2(+)-associated
      enhanced susceptibility of oxidative injury due to 1,25-(OH)2D3.

PMID- 2226659
TI  - Calcium antagonists and intimal cell proliferation in atherogenesis.
AB  - Smooth muscle cell (SMC) migration and intimal proliferation are major events in
      the formation of the atherosclerotic lesions. Among other processes, calcium may
      participate in atherogenesis by affecting SMC proliferation. Calcium antagonists,
      which possess antiatherosclerotic properties in animal models, are effective in
      inhibiting SMC proliferation. This effect has been demonstrated both in vitro in
      cell culture and in vivo in balloon-catheterised rats and rabbits. Such an
      effect, indicates a possible mechanism involved in the antiatherosclerotic
      activity elicited by this category of drugs.

PMID- 2226660
TI  - Cardiac aging, calcium overload, and arrhythmias.
AB  - The effect of aging was tested on experimental ventricular arrhythmias in
      isolated heart preparations from normal Wistar rats (NWR), Wistar Kyoto rats
      (WKY), and spontaneously hypertensive rats (SHR). Delayed afterdepolarizations
      and triggered activity induced by high-calcium perfusion (16 mM) in isolated
      papillary muscles were more frequent in the 24-month-old than in 6-month-old NWR.
      Reperfusion-VA were more severe in 14-month-old SHR than in WKY. The authors have
      previously shown that: (1) reperfusion- and reoxygenation-induced VA, in the
      isolated Langendorff perfused heart, were significantly more severe and frequent
      in 24-month-old than in 6-month-old NWR; (2) no age-related difference in the
      incidence of programmed electrical stimulation (PES, train of stimuli + 1 or 2
      extrastimuli)-induced VA was observed in isolated NWR hearts during control
      perfusion, after coronary artery ligation or during hypoxia; (3) on the contrary,
      the incidence of PES-induced VA was significantly higher in isolated hearts from
      14-month-old SHR than from 3-month-old SHR, and 3-month-old and 14-month-old WKY.
      It was concluded that "physiological" aging is associated with a higher
      propensity to calcium-related VA, while "pathological" aging characterized by
      hypertension of long duration increases the incidence of PES-induced VA, probably
      caused by myocardial fibrosis, which could facilitate reentry.

PMID- 2226661
TI  - Parathyroid origin of a new hypertensive factor.
AB  - Many physiological abnormalities have been described in essential hypertension,
      yet the cause of this condition remains unknown. Included among the reported
      abnormalities are alterations in serum and tissue calcium levels, abnormalities
      in calcium regulating hormones, and the involvement of the parathyroid gland in
      some forms of hypertension. In the current study, the authors review evidence
      suggesting that a newly described hypertensive factor may explain a number of
      these abnormalities. This factor was first described in spontaneously
      hypertensive rat (SHR) plasma and is characterized by its ability to raise blood
      pressure in a delayed manner in normotensive rats, as well as by its ability to
      increase calcium uptake in vascular smooth muscle. The factor seems to be
      produced by the parathyroid gland, yet it is distinct from parathyroid hormone.
      Histological studies suggest that the factor may be produced by a specific cell
      type in the parathyroid glands. Given the parathyroid gland dependency of this
      factor, the authors have tentatively named it "parathyroid hypertensive factor,"
      or "PHF."

PMID- 2226662
TI  - Red cell aging and active calcium transport.
AB  - The authors have investigated the relationships between the active calcium
      transport across the human red blood cell (RBC) membrane and the RBC aging
      processes in vivo and in vitro. For the study of this biological system, the
      authors have determined the active calcium uptake by inside-out membrane vesicles
      obtained from selected RBC populations. This model provided an optimal way to
      assess the biochemical and functional responses of the human cell to the
      oxidative stimulus triggered by the cellular aging processes. The activity of the
      calcium pump is indeed strictly correlated to the oxidative damage suffered by
      the RBC, being higher in the aged RBC. It appears that the main controller of the
      active calcium transport is the age-dependent protein inhibitor of the calcium
      pump.

PMID- 2226663
TI  - Bone loss and age-related fractures.
AB  - The aging of the skeleton represents an important cause of both morbidity and
      mortality in the Western World. A great deal is known about the epidemiology,
      pathogenesis, and structural alterations which occur during the osteoporotic
      process to increase the risk of fracture with age. Whereas osteoporosis is
      associated with a decrease in bone mass, factors other than bone mass are clearly
      important. These include the turnover of bone and the destruction of trabecular
      elements, the repair of fatigue damage, as well as extraskeletal factors. An
      improved understanding of the aging of bones will form a basis for improved
      strategies for its prevention and treatment.

PMID- 2226664
TI  - Non-invasive methods for quantitating bone loss of aging.
AB  - The clinical utility of bone mass measurements has been the subject of
      considerable debate. The determination of whether a measurement has utility in
      clinical practice is difficult, but several elements must be present. First, the
      measurement must be predictive of clinical outcomes. Two recent studies have
      shown that bone mass measurements predict the incidence of both nonspine and
      vertebral body fractures. A second necessary element is the availability of
      therapeutic options which would be based on these measurements. The effectiveness
      of estrogen replacement therapy in preventing bone loss and subsequent fractures
      is well documented. It is also possible that alterations in glucocorticoid
      therapy or treatment of hyperparathyroidism might be based on bone measurements.
      Finally, it should be clear that the information available through bone mass
      measurements would not be otherwise obtainable. Researchers have yet to
      demonstrate that other risk fractures are adequate substitutes either in the
      prediction of bone mass or in the estimations of fracture risk. Although it is
      not yet clear that bone mass measurements should be used in screening, their
      clinical utility in specific circumstances is becoming established.

PMID- 2226665
TI  - Vertebral bone loss in menopause.
AB  - A direct correlation between loss of ovarian function and reduction of bone mass
      is well established. The incidence of fractures sharply increases with age
      starting from the menopause. Therefore, it is very important to know the rate of
      bone loss occurring after menopause, at both trabecular and cortical levels.
      Several factors may contribute to the reduction of bone mass in menopause.
      Reduced estrogen secretion results in reduced intestinal calcium absorption,
      increased bone resorption, and probably a deficient production of calcitonin.
      Furthermore, in vivo and in vitro experimental data confirm that estrogen failure
      is associated with histologic changes, mirroring the biochemical changes
      described in postmenopausal osteoporosis.

PMID- 2226666
TI  - The role of interleukin-1 in postmenopausal bone loss.
AB  - Interleukin-1 (IL-1), a cytokine best known for its ability to stimulate
      lymphocyte proliferation, has recently been shown to stimulate bone resorption
      and modulate bone formation in vivo. Consequently, the authors have devised a
      series of studies to investigate the relationship between bone remodeling,
      menopause, and monocyte IL-1-secretion. In a first study, monocytes from
      osteoporotic patients were found to produce more IL-1 than monocytes from control
      subjects. IL-1 activity was also found to reflect histomorphometric indices of
      bone formation, but not of bone resorption. In a second study, devised to assess
      the effect of menopause on the relationship between IL-1 and bone turnover, a
      significant correlation was found between IL-1 and BGP in premenopausal
      osteoporotic women and osteoporotic men, but not in both postmenopausal
      osteoporotic subjects and normal subjects of either sex. In a third study, IL-1
      from untreated postmenopausal women was found to be higher than in either
      untreated premenopausal or estrogen/progesterone-treated postmenopausal women. A
      significant negative correlation was found between IL-1 and years since menopause
      in both the healthy and osteoporotic postmenopausal women. Premenopausal IL-1
      levels were achieved within eight years of menopause in the healthy but not in
      the osteoporotic subjects. In osteoporotic women, high IL-1 levels were evident
      as long as 15 years after menopause. IL-1 also correlated inversely with mineral
      density as measured by quantitative computer tomography. In prospective study,
      treatment with estrogen/progesterone caused a significant increase in IL-1
      activity. This data indicates that monocyte IL-1 production mirrors the rate of
      bone turnover in both the healthy and osteoporotic patient, and that alteration
      in IL-1 production may underlie the postmenopausal acceleration of bone loss and
      its inhibition by ovarian steroids.

PMID- 2226667
TI  - Biological effects of aging on bone and the central nervous system.
AB  - The skeletal and nervous systems express conspicuous signs of aging in humans in
      the form of osteoporosis and senile dementia, the most common diseases affecting
      the elderly population. Although the prevalence of these diseases progressively
      rises with advancing age, especially in females, the interrelationship between
      the degenerative changes of the skeletal and nervous systems has not been studied
      in detail. Defective 1,25(OH)2D synthesis in chronic renal failure is known to
      cause renal osteodystrophy and is also associated with the appearance of dialysis
      encephalopathy and a decrease of the conduction velocity of peripheral nerves.
      Calcium content of the nervous system is increased in this condition, suggesting
      the existence of generalized abnormalities of calcium metabolism, which affect
      both the skeletal and nervous system. The mild, chronic renal failure of aging,
      and the consequent secondary hyperparathyroidism, might therefore contribute to
      the development of nervous degenerative diseases.

PMID- 2226668
TI  - Calciotropic hormones and the aging bone.
AB  - The aging of bone is conditioned by intrinsic and extrinsic factors. The decrease
      of bone density, of cortical and of trabecular bone volume with age goes along
      with an increase of interstitial trabecular bone (Courpron, 1981), in addition to
      other intrinsic structural changes. Interstitial bone has a lower cellularity and
      a lower metabolic activity than the bone tissue which is closer to the trabecular
      surface. This increase of interstitial bone serves as an example for the supposed
      decrease of bone cellularity, cellular activity, and hormonal receptors with age
      in bone. Therefore, the "playground" for calciotropic hormones is reduced in
      advanced age, independently from the hormonal changes which will be discussed
      thereafter. The relative role of this decrease of the target organ with age is
      not yet fully understood. The process of aging can interfere with each step of
      calcium metabolism from calcium intake and absorption, vitamin D intake and
      absorption to vitamin D production, hydrolysation and action, as well as to
      secretion and action of calciotropic hormones such as PTH, calcitonine, and
      gonadal steroids.

PMID- 2226669
TI  - Biological activity of calcitonin and its assessment.
AB  - Radioimmunoassay has been the method of choice for the routine determination of
      calcitonin (CT) in biological fluids, mainly due to its precision, sensitivity,
      and ability to handle large numbers of samples. However, spuriously high results
      are often obtained due to undefined cross-reactivities of polyclonal antisera to
      precursors, polymers, metabolites, or fragments of CT, or to other physiological
      and pathological variants of the hormone. In routine practice, radioimmunoassays
      of CT are being replaced by immunometric two-site 'sandwich' assays utilizing
      monoclonal antibodies against defined antigenic epitopes. Hormone activity is,
      however, accurately quantifiable by biological assays based on the exquisite
      hormonal sensitivity of isolated osteoclasts. The assays are highly specific and
      remarkably sensitive. Their use in routine laboratories is nevertheless limited
      only to specific situations.

PMID- 2226670
TI  - Calcitonin and postmenopausal bone loss.
AB  - In order to establish the role of calcitonin (CT) in postmenopausal bone loss, we
      studied CT metabolism in 25 pre- and postmenopausal women. Postmenopausal women
      presented a highly significant reduction of CT basal levels compared to
      premenopausal females (p less than 0.01). Also, production rates of CT in
      osteoporotics were significantly lower than in either young premenopausal (18-25
      years old), older premenopausal (35-40 years old), or postmenopausal healthy
      subjects. In a study in rabbits, we found that injection of CT, along with
      equimolar amounts of anti-SCT antibodies extracted from serum of pagetic
      patients, did not inhibit the hypocalcemic response to the hormone, thus
      demonstrating that resistance to CT treatment cannot be accounted for by antibody
      production. In a subsequent clinical study in patients with Paget's disease of
      bone, we found that 200 IU/day of salmon CT (SCT), given by nasal spray, improved
      both clinically and biochemically the activity of the disease, as demonstrated by
      37 +/- 4% decrease of serum alkaline phosphatase and 35 +/- 5% fall of urinary
      excretion of hydroxyproline after six months of therapy. The effectiveness of CT
      as nasal spray was further tested in healthy women at an early stage of
      menopause. A 12-month course of intranasal SCT counteracted early postmenopausal
      bone loss, presumably by inhibiting bone resorption. In conclusion, intranasal CT
      seems to be a very attractive alternative to be considered for the prevention of
      postmenopausal osteoporosis.

PMID- 2226671
TI  - The concept and treatment of osteoporosis.
AB  - Osteoporosis is a dynamic process, thought to be caused by an uncoupling between
      osteoblast and osteoclast activity. Altered pulsatile secretion of growth hormone
      and parathyroid hormone (PTH) have been proposed as pathogenetic factors for this
      unbalanced coupling. The anatomical lesions are believed to be reversible until
      trabecular perforations develop, if fractures already occurred the anatomical
      defect is permanent. It is helpful to classify osteoporosis in stages of
      increasing severity depending on bone density and the presence of fractures.
      Theoretically, if the bone density is above the fracture threshold, then the only
      therapeutic goal is to maintain the bone mass. If instead the mineral density is
      below the threshold, an active therapy is needed with drugs that can possibly
      increase the skeletal mass. Osteoporosis with multiple fractures cannot be
      reversed. The authors propose a promising pharmacologic treatment for
      osteoporosis, based on the combination of human PTH-(1-38) and intranasal salmon
      calcitonin. If started in the early stages of the osteoporotic process, this
      regimen may restore the initial bone mass. In more advanced stages, only a
      correction of the metabolic defect is possible, but the irreversible vertebral
      deformities are not affected. On the basis of the results, cyclic therapy with
      human PTH-(1-38) and salmon calcitonin represents a good treatment choice for
      osteoporosis.

PMID- 2226672
TI  - Receptor sites involved in the action of calcium blocking agents.
AB  - The affinities of calcium blocking agents (CBAs) for membrane binding sites and
      for calmodulin were compared to their potencies at inhibiting contraction of
      various isolated arteries. Two allosterically linked binding sites, the
      dihydropyridine (DHPS) and benzothiazepine-phenylakylamine (BS) one, were
      characterized. In spite of a correlation between the affinities of a number of
      hydrophobic CBAs and calmodulin antagonists for DHPS and for calmodulin, these
      drugs displayed higher affinities for BS. Furthermore, their potency at
      inhibiting calcium-induced contraction in depolarized rat aorta rings was
      correlated to their affinity for the latter site. These results suggest that
      binding to membrane sites was the basis of the inhibition of depolarization
      elicited contraction by all CBAs, including calmodulin antagonists. Differences
      in sensitivity to CBAs depending on the artery and whether they were depolarized
      or stimulated by noradrenaline were shown in further experiments on rat cerebral
      artery and resistance arterioles. These differences in sensitivity did not
      correspond to differences in the apparent affinity of the drugs. This suggests
      that the receptors of CBAs (and therefore the associated calcium channels)
      involved in the responses to depolarization and to the agonist were identical.

PMID- 2226673
TI  - Factors influencing the responses to calcium antagonists in elderly patients with
      hypertension and ischaemic heart disease.
AB  - The results of a variety of studies that have investigated the effect of age on
      the pharmacokinetics and pharmacodynamics of calcium antagonist drugs have
      produced the following conclusions. Primarily, as a result of an age-dependent
      decline in plasma drug clearance, there is a tendency for elderly patients to
      have higher plasma drug concentrations than young patients. In terms of
      pharmacological response, there is good evidence of therapeutic efficacy in both
      hypertension and ischaemic heart disease, but there is no convincing evidence of
      any preferential age-related effect, particularly in relation to blood pressure
      reduction. Similarly and conversely, there is no convincing evidence that the
      elderly are at greater risk from the adverse effects of calcium antagonist drugs,
      particularly those which reflect the negative effects on cardiac conduction. An
      integrated mathematical method for describing antihypertensive response, which
      incorporates both pharmacokinetic and pharmacodynamic information, has been used
      to investigate the variability in antihypertensive effect with nifedipine and
      verapamil. There was no relationship between responsiveness (in mmHg/ng/mL) and
      patient age and plasma renin activity; however, responsiveness during chronic
      treatment was directly correlated with the height of the starting blood pressure
      and the response to the first dose.

PMID- 2226674
TI  - Adenosine system and cell calcium translocation: interference of calcium channel
      blockers.
AB  - Adenosine is able to inhibit in vitro neutrophil functions induced by formyl
      methionyl-leucyl-phenylalanine (FMLP) and A23187, but not phorbol 12-myristate 13
      acetate (PMA). The inhibiting activity on A23187 is reversed by increasing
      extracellular Ca2++ concentration. The calcium entry blocker flunarizine shows an
      activity very similar to that of adenosine. Both adenosine and flunarizine
      prevent Ca++ influx into activated neutrophils as detected by the fluorescent
      Ca++ chelator Quin-2. Finally, flunarizine binds to the neutrophil membrane and
      adenosine competitively inhibits flunarizine binding as assessed by 1H-Nuclear
      Magnetic Resonance (1H-NMR) technique, thus indicating that the two agents share
      a common binding site on the cell membrane.

PMID- 2226675
TI  - Smoking, calcium, calcium antagonists, and aging.
AB  - Aging is characterized, besides other changes, by a progressive increase in
      calcium content in the arterial wall, which is enhanced by diabetes mellitus,
      osteoporosis, arterial hypertension, and tabagism. As to tabagism, experiments in
      animals have shown that nicotine can increase calcium content of the arterial
      wall, and clinical studies have demonstrated that cigarette smoking induces
      peripheral vasoconstriction, with consequent increase in blood pressure levels.
      In order to study the role of calcium ions in the pathogenesis of the
      vasoconstrictive lesions caused by "acute" smoking, the author has studied the
      peripheral vascular effects of the calcium-channel antagonist nifedipine, a
      dihydropyridine derivative, and calcitonin, a hypocalcemizing hormone which
      possess vasoactive actions on 12 elderly regular smokers (mean age 65.8 years).
      The results demonstrated that both nifedipine (10 mg sublingually 20 min before
      smoking) and salmon calcitonin (100 MRC U/daily intramuscularly for three days)
      are able to prevent peripheral vasoconstriction evaluated by Doppler velocimetry,
      as well as the increase of blood pressure induced by smoking. On the basis of our
      results, the author proposes that cigarette smoking-induced vasoconstriction is a
      calcium-mediated process, which can be hindered by drugs with calcium antagonist
      action.

PMID- 2226676
TI  - 1,25-Dihydroxyvitamin D3 enhances cytosolic free calcium in HL-60 cells.
AB  - 1,25-Dihydroxyvitamin D3 (1,25[OH]2D3) caused a rise in the concentration of
      intracellular free calcium ions ([Ca2+]i) in HL-60 cells. This effect of
      1,25(OH)2D3 parallels its suppression of cell proliferation and its induction of
      cell differentiation into monocyte-like cells. The changes in [Ca2+]i are dose
      and time dependent. The concentration of 1,25(OH)2D3 (10(-7) M) that induced
      maximal differentiation also caused the maximal increase in intracellular Ca2+.
      The rise in cytoplasmic free Ca2+ concentration was not immediate and reached
      statistical significance only after 24 h. The [Ca2+]i reached its peak at 48 h
      (134 +/- 4 nM vs 101 +/- 3 nM in controls) and remained stable at this level. The
      increase in intracellular Ca2+ was found to be related to new protein synthesis,
      because it was inhibited in the presence of specific RNA and protein synthesis
      inhibitors. The rise in [Ca2+]i was not observed during incubation of HL-60 cells
      with 24,25-dihydroxyvitamin D3 (24,25[OH]2D3), a vitamin D metabolite that does
      not induce the differentiation of HL-60 cells. In contrast, 25-hydroxyvitamin D3
      (25-OH-D3) and phorbol 12-myristate 13-acetate (TPA), both of which induce
      differentiation in this cell line, also increase [Ca2+]i. In conclusion, the
      present study emphasizes that a significant increase in intracellular free Ca2+
      occurs in the effect of 1,25(OH)2D3 on HL-60 cells.

PMID- 2226677
TI  - Evidence for the existence of circulating monoclonal B-lymphocytes in multiple
      myeloma patients.
AB  - Multiple myeloma is characterized by the proliferation of a single clone of
      plasma cells producing a homogeneous immunoglobulin fraction. In this disease,
      plasma cells home essentially in the bone marrow. However, controversy exists
      whether peripheral blood B-lymphocytes in patients with multiple myeloma (MM) are
      part of the malignant clone. We investigated clonal immunoglobulin gene
      rearrangement (IgGR) in T-cell-depleted peripheral blood mononuclear cells as
      well as in bone marrow of these patients. Seven out of 17 MM patients
      demonstrated an identical IgGR in bone marrow and peripheral mononuclear cells,
      these patients were in an active stage of the disease. In nine patients in
      plateau phase, clonal IgGR could not be detected in peripheral blood. Peripheral
      mononuclear cells from ten patients with monoclonal gammopathies of undetermined
      significance (MGUS) were also examined and no IgGR was detected. The existence of
      monoclonal B-lymphocytes in the circulation of patients with MM suggests a
      mechanism whereby the malignant clone homes in the bone marrow through peripheral
      blood. These findings may also be used for the evaluation of patients with active
      myeloma and the determination of plateau phase.

PMID- 2226678
TI  - Effects of mixed chimeric bone marrow repopulation on platelet storage pool
      associated bleeding defects in mouse mutants.
AB  - We have previously shown mouse platelet storage pool deficiency (SPD) to be
      associated with lesions at eight different genetic loci, each of which is
      sufficient to produce murine SPD. We have also shown that normal bleeding times
      and normal platelet functions are restored when mice with SPD are transplanted
      with marrow from normal mice. Conversely, when normal mice are transplanted with
      mutant marrow, they present symptoms of SPD. In order to determine the amount of
      normal platelets needed to prevent the prolonged bleeding times associated with
      SPD, we established stable mixed chimeric mice by transplanting various ratios of
      normal and mutant marrow into lethally irradiated host animals. The proportion of
      normal input marrow correlated well with the proportion of normal peripheral red
      blood cells and platelets determined in chimerae 100 days after transplantation
      using direct morphology and electrophoretic variants of glucose phosphate
      isomerase to identify normal and mutant cell populations. The proportions of
      normal input marrow were also reflected in the proportions of platelets with
      normal and mutant platelet morphology in the chimerae. This confirms that the
      platelet abnormality in SPD is intrinsic to the stem cell population from which
      the platelets are derived. When bleeding times were determined in the mixed
      chimeric mice, a surprisingly high percentage of normal platelets (greater than
      50% and sometimes greater than 75%) were needed to stop bleeding. These results
      suggest that the mutant platelets in the mixed chimeric mice may interfere with
      normal platelet aggregation patterns. They also raise some important
      considerations in devising treatment for SPD. Bleeding episodes in human SPD are
      normally treated by platelet transfusion. The results suggest that, at least in
      some cases, transfusions may not be effective. Also, in future gene therapy of
      this disease, it is like that a functional gene will have to be present in
      greater than 50% of stem cells for therapy to be effective.

PMID- 2226679
TI  - Modulation of etoposide (VP-16) cytotoxicity by verapamil or cyclosporine in
      multidrug-resistant human leukemic cell lines and normal bone marrow.
AB  - We studied the effects of two modulators of multidrug resistance (MDR),
      cyclosporine and verapamil, on the cytotoxicity of etoposide (VP-16) in normal
      human bone marrow; two human leukemia cell lines, K562 and CEM; their MDR
      variants, K562/DOX and CEM/VLB; and mixtures of normal marrow and leukemic cells.
      VP-16 was selectivity toxic to the parental leukemic cells, with IC-50 values of
      2 microM for CEM cells, 1.5 microM for K562 cells, and 12 microM for normal
      marrow CFU-GM. This selectivity was lost in the MDR variant leukemia cells, with
      IC-50s of 20 microM in K562/DOX and 8 microMs in CEM/VLB. Cyclosporine, 6
      microMs, and verapamil, 20 microM, alone were nontoxic to bone marrow CFU-GM, and
      did not significantly increase the toxicity of VP-16 to normal marrow cells or to
      the two drug-sensitive leukemic cell lines. However, cyclosporine specifically
      enhanced the cytotoxicity of VP-16 in the MDR leukemia cells, reducing the IC-50
      to the same level as the parental sensitive cells. Verapamil was considerably
      less effective. In a mixing experiment that included K562/DOX cells and normal
      bone marrow, cyclosporine increased the toxicity of VP-16 to the resistant
      leukemic cells by nearly 20-fold. Because the cytotoxic effect of cyclosporine is
      additive for resistant tumor cells, its combination with VP-16 may be useful in
      the purging of contaminating tumor cells prior to autologous bone marrow
      transplantation.

PMID- 2226680
TI  - High-dose recombinant human erythropoietin for treatment of anemia in
      myelodysplastic syndromes and paroxysmal nocturnal hemoglobinuria: a pilot study.
AB  - In a dose escalation study we tested the feasibility and tolerance of high-dose
      recombinant human erythropoietin (r-HuEPO) therapy in four patients with
      ineffective erythropoiesis due to myelodysplastic syndromes (MDS) or paroxysmal
      nocturnal hemoglobinuria (PNH). Recombinant human EPO was administered i.v. with
      an initial dose of 50 U/kg body weight (BW) three times per week. The dose was
      increased by steps of 25 or 50 U/kg bW with intervals of 1-4 weeks up to a
      maximum dose of 500 U/kg BW three times per week. All patients were treated as
      outpatients. Pre-study treatment with cyclosporin A and/or Danazol was continued
      in three patients. In one patient r-HuEPO was discontinued after 20 weeks because
      of relapse of severe aplastic anemia. No major side effects were observed even at
      the maximum dose. One patient with PNH showed an increase of hemoglobin from 89
      to 139 g/liter that permitted monthly phlebotomies to reduce his iron overload.
      In one patient with MDS the reticulocyte count increased from 2.5 to 50 x
      10(9)/liter, and the transfusion requirement decreased to 2 U every 3-4 weeks
      instead of every 2 weeks. Two patients did not complete the whole treatment
      period and showed no rise in reticulocyte count. We conclude that high dose r
      HuEPO therapy is feasible in patients with anemia due to MDS or PNH. High-dose r
      HuEPO appears to have some effect on anemia due to ineffective erythropoiesis in
      a subgroup of patients. Further studies are needed to identify potential
      responders and to define the optimal administration of r-HuEPO.

PMID- 2226681
TI  - Integration in descending motor pathways controlling the forelimb in the cat. 17.
      Axonal projection and termination of C3-C4 propriospinal neurones in the C6-Th1
      segments.
AB  - Collateralization and termination of single C3-C4 propriospinal neurones (PNs)
      have been studied in the C6-Th1 segments of the cat using two methods: threshold
      mapping for antidromic activation of C3-C4 PNs and intra-axonal injection of
      horseradish peroxidase. Low threshold points for antidromic activation of C3-C4
      PNs were found in the region of different motor nuclei in lamina IX both at one
      level and at different segmental levels, in all parts of lamina VII, in the
      lateral part of lamina VI and in the dorsal and ventral parts of lamina VIII.
      Collaterals were found from C6 to Th1. A marked decrease of conduction velocity
      of the stem axon occurred in the caudal region of termination, while it was
      almost constant in the rostral region of termination. HRP was injected
      iontophoretically in C6-Th1 into stem axons of neurones, which were activated
      antidromically from the ventral part of the lateral funiculus in C5/C6, from the
      lateral reticular nucleus (LRN) and monosynaptically from the corticospinal
      fibres (stimulated in the contralateral pyramid) which were transected in C5/C6.
      Reconstruction of successfully stained stem axons, revealed collaterals with
      terminals on presumed motoneurones in different parts of lamina IX and on
      interneurones in laminae IV-VIII. These findings confirm previous results which
      showed monosynaptic projections from C3-C4 PNs to forelimb motoneurones and Ia
      inhibitory interneurones. With respect to termination in the region of the
      motoneurones in lamina IX and in the region of Ia inhibitory interneurones in
      lamina VII, three patterns were found: 1) termination mainly in lamina IX (n = 1)
      2) termination in laminae IX and VII (n = 15) and 3) termination mainly in lamina
      VII (n = 2). However, in some cases the same stem axon gave off collaterals which
      terminated either on motoneurones in lamina IX or on presumed Ia inhibitory
      interneurones in lamina VII. Furthermore, when the stem axons had collaterals
      which terminated in different motor nuclei only some of these collaterals had
      additional terminations on presumed Ia inhibitory interneurones. This result
      suggest that C3-C4 PNs do not follow a strict Ia pattern of reciprocal
      innervation. It is tentatively proposed that the difference of innervation may be
      related to the type of multi-joint movement, such as target-reaching with the
      forelimb, which has been shown to be controlled by the C3-C4 PNs. Termination in
      laminae VI, VIII and different parts of lamina VII indicates that C3-C4 PNs also
      project to other types of neurones than motoneurones and Ia inhibitory
      interneurones.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2226683
TI  - The human horizontal vestibulo-ocular reflex in response to high-acceleration
      stimulation before and after unilateral vestibular neurectomy.
AB  - The normal horizontal vestibulo-ocular reflex (HVOR) is largely generated by
      simultaneous stimulation of the two horizontal semicircular canals (HSCCs). To
      determine the dynamics of the HVOR when it is generated by only one HSCC,
      compensatory eye movements in response to a novel vestibular stimulus were
      measured using magnetic search coils. The vestibular stimulus consisted of low
      amplitude, high-acceleration, passive, unpredictable, horizontal rotations of the
      head with respect to the trunk. While these so called head "impuses" had
      amplitudes of only 15-20 degrees with peak velocities up to 250 deg/s, they had
      peak accelerations up to 3000 deg/s/s. Fourteen humans were studied in this way
      before and after therapeutic unilateral vestibular neurectomy; 10 were studied 1
      week or 1 year afterwards; 4 were studied 1 week and 1 year afterwards. The
      results from these 14 patients were compared with the results from 30 normal
      control subjects and with the results from one subject with absent vestibular
      function following bilateral vestibular neurectomy. Compensatory eye rotation in
      normal subjects closely mirrored head rotation. In contrast there was no
      compensatory eye rotation in the first 170 ms after the onset of head rotation in
      the subject without vestibular function. Before unilateral vestibular neurectomy
      all the patients' eye movement responses were within the normal control range.
      One week after unilateral vestibular neurectomy however there was a asymmetrical
      bilateral HVOR deficit. The asymmetry was much more profound than has been shown
      in any previous studies. The HVOR generated in response to head impulses directed
      away from the intact side largely by ampullofugal disfacilitation from the single
      intact HSCC (ignoring for the moment the small contribution to the HVOR from
      stimulation of the vertical SCCs), was severely deficient with an average gain
      (eye velocity/head velocity) of 0.25 at 122.5 deg/sec head velocity (normal gain
      = 0.94 +/- 0.08). In contrast the HVOR generated in response to head impulses
      directed toward the intact side, largely by ampullopetal excitation from the
      single intact HSCC, was only mildly (but nonetheless significantly) deficient,
      with an average gain of 0.80 at 122.5 deg/sec head velocity. At these
      accelerations there was no significant improvement in the average HVOR velocity
      gain in either direction over the following year. These results indicate that
      ampullopetal excitation from one HSCC can, even in the absence of ampullofugal
      disfacilitation from the opposite HSCC, generate a near normal HVOR in response
      to high-acceleration stimulation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2226682
TI  - Spatial properties of second-order vestibulo-ocular relay neurons in the alert
      cat.
AB  - Second-order vestibular nucleus neurons which were antidromically activated from
      the region of the oculomotor nucleus (second-order vestibuloocular relay neurons)
      were studied in alert cats during whole-body rotations in many horizontal and
      vertical planes. Sinusoidal rotation elicited sinusoidal modulation of firing
      rates except during rotation in a clearly defined null plane. Response gain
      (spike/s/deg/s) varied as a cosine function of the orientation of the cat with
      respect to a horizontal rotation axis, and phases were near that of head
      velocity, suggesting linear summation of canal inputs. A maximum activation
      direction (MAD) was calculated for each cell to represent the axis of rotation in
      three-dimensional space for which the cell responded maximally. Second-order
      vestibuloocular neurons divided into 3 non-overlapping populations of MADs,
      indicating primary canal input from either anterior, posterior or horizontal
      semicircular canal (AC, PC, HC cells). 80/84 neurons received primary canal input
      from ipsilateral vertical canals. Of these, at least 6 received input from more
      than one vertical canal, suggested by MAD azimuths which were sufficiently
      misaligned with their primary canal. In addition, 21/80 received convergent input
      from a horizontal canal, with about equal number of type I and type II yaw
      responses. 4/84 neurons were HC cells; all of them received convergent input from
      at least one vertical canal. Activity of many vertical second-order
      vestibuloocular neurons was also related to vertical and/or horizontal eye
      position. All AC and PC cells that had vertical eye position sensitivity had
      upward and downward on-directions, respectively. A number of PC cells had MADs
      centered around the MAD of the superior oblique muscle, and 2/3 AC cells recorded
      in the superior vestibular nucleus had MADs near that of the inferior oblique.
      Thus, signals with spatial properties appropriate to activate oblique eye muscles
      are present at the second-order vestibular neuron level. In contrast, none of the
      second-order vestibuloocular neurons had MADs near those of the superior or
      inferior rectus muscles. Signals appropriate to activate these eye muscles might
      be produced by combining signals from ipsilateral and contralateral AC neurons
      (for superior rectus) or PC neurons (for inferior rectus). Alternatively, less
      direct pathways such as those involving third or higher order vestibular or
      interstitial nucleus of Cajal neurons might play a crucial role in the spatial
      transformations between semicircular canals and vertical rectus eye muscles.

PMID- 2226684
TI  - New method to identify nociceptor units innervating glabrous skin of the human
      hand.
AB  - A new technique is described for detecting nociceptor activity in microelectrode
      recordings from cutaneous fascicles of the human median nerve. The search
      strategy involves combined intraneural microstimulation and microneurographic
      recording in intrafascicular sites, where a critically low electrical stimulus
      amplitude evokes a threshold sensation of pain. From the subject's projection of
      pain to a small area of skin, the experimenter is guided to receptive fields of
      recordable nociceptor units. This technique has allowed, for the first time, to
      identify and study receptive properties of very high threshold nociceptors with A
      and C fibers in the glabrous skin of the human hand.

PMID- 2226685
TI  - GABAergic mechanisms in the cat red nucleus: effects of intracerebral
      microinjections of muscimol or bicuculline on a conditioned motor task.
AB  - Interneurons in the Red Nucleus (RN) are known to be under cortical control and
      to exert an inhibitory action, mediated by GABAergic mechanisms, on the main
      output towards the spinal cord. The effects of discrete injections of a GABA
      receptor agonist (muscimol) or an antagonist (bicuculline) in the Red Nucleus
      were tested on a motor task performed by seven cats. The subjects were trained to
      release a lever with a flexion movement of the forelimb controlled by a reaction
      time (RT) paradigm. Muscimol as well as bicuculline increased RTs in a dose
      dependent manner at doses below 100 ng. However the parameters of the force
      exerted on the lever were differentially altered by the two drugs. Muscimol
      increased RTs by slowing down the force change preceding movement as well as
      slightly delaying its latency. While bicuculline increased drastically the force
      change latency. It could also speed up the force change velocity for low doses.
      At higher doses (up to 500 ng) both drugs produced an arrest of the performance
      either associated with anxiety signs (bicuculline) or dystonic movements of the
      head followed by body rotations (muscimol). The strong motor impairments as well
      as the disruption of the conditioned performances following muscimol or
      bicuculline microinjection in the RN suggest an important functional role for
      GABAergic interneurons. Under the control of cortical afferences they can
      modulate rubrospinal activity and participate in the triggering of a conditioned
      movement.

PMID- 2226686
TI  - Brainstem genesis of reserpine-induced ponto-geniculo-occipital waves: an
      electrophysiological and morphological investigation.
AB  - Several experimental results indicate that the peribrachial (PB) cholinergic area
      of the pedunculopontine nucleus is the final relay for the transfer of brainstem
      generated pontogeniculo-occipital (PGO) waves to the thalamus. However, the
      mechanisms underlying the PGO-related activity of PB neurons remain unknown. In
      order to study these mechanisms, single unit recordings in the PB area were
      performed in reserpinized cats. Because PGO waves are closely related to rapid
      eye movements, our microelectrode explorations were also aimed to some structures
      of the preoculomotor network, namely, the superior colliculus (SC) and parts of
      the central tegmental field (FTC). We have found several classes of PGO-on cells
      in the PB area, most of them descharging 80 ms or less before the peak of PGO
      waves. These cell-classes comprised high-frequency bursting cells, slow-frequency
      bursting cells, and neurons discharging single spikes or doublets. Intracellular
      recordings showed that PGO-on single spikes arise from conventional excitatory
      postsynaptic potentials. Among PGO-related cells in structures outside the PB
      limits, it was found that most SC cells discharge during or after the PGO,
      whereas FTC cells increase their discharge rate several hundreds of ms before PGO
      waves, thus indicating that PGO waves are elaborated long before the activation
      of PB neurons. Massive retrograde labeling was found in FTC following horseradish
      peroxidase injections into the PB area. We suggest that long-lead FTC neurons
      provide an excitatory input to PGO-on PB neurons.

PMID- 2226687
TI  - Axotomized, adult basal forebrain neurons can innervate fetal frontal cortex
      grafts: a double fluorescent tracer study in the rat.
AB  - The ability of axonal regeneration of identified adult basal forebrain (BFB)
      neurons was examined after homotopic grafting of fetal neocortical tissue to a
      lesion cavity in the frontal neocortex. Using a four step experimental procedure,
      adult rats first received an injection of the fluorescent dye Fluoro-Gold (FG)
      into the sensorimotor cortex in order to label those neurons with projections to
      the area by retrograde axonal transport. After one week the injection area was
      removed by aspiration, leaving a cavity in the neocortex. One week later a block
      of fetal (E14) frontal cortical tissue was placed in the cavity. The animals were
      then allowed to survive for 6 weeks before a second fluorescent tracer, Nuclear
      Yellow (NY), was injected into the transplant. The animals were sacrificed 24 h
      later and analyzed by fluorescence microscopy. Both single labeled, FG and NY
      containing neurons and double labeled neurons containing both tracers were found
      in the BFB. The results demonstrate that adult BFB neurons can reestablish
      cortical projections into fetal cortical grafts (double labeled neurons), and
      they suggest that other BFB neurons, not initially innervating the lesioned
      cortical area, have sprouted into the transplant (NY labeled neurons).

PMID- 2226689
TI  - Differences in coordination of elbow flexor muscles in force tasks and in
      movement tasks.
AB  - Motor-unit activity in m. biceps brachii, m. brachialis and m. brachioradialis
      during isometric contractions has been compared with motor-unit activity during
      slow voluntary (extension and flexion) movements made against external loads.
      During these slow movements the recruitment threshold of m. biceps motor units is
      considerably lower than it is during isometric contractions but the recruitment
      threshold of both m. brachialis and m. brachioradialis motor units is
      considerably higher. For all three elbow flexor muscles the motor-unit firing
      frequency seems to depend on the direction of movement: the firing frequency is
      higher during flexion movements (3 deg/s) and lower during extension movements (
      3 deg/s) than during isometric contractions. The relative contribution of the
      biceps to the total exerted flexion torque during slow voluntary movements is
      estimated to increase from 36% to about 48% and that of the
      brachialis/brachioradialis is estimated to decrease from 57% to about 45%
      compared to the relative contribution of these muscles during isometric
      contractions. This difference in the relative contribution of the three major
      elbow flexor muscles is shown to be caused by differences in the central
      activation in force tasks and movement tasks.

PMID- 2226688
TI  - Stimulation of cranial vessels excites nociceptive neurones in several thalamic
      nuclei of the cat.
AB  - Extracellular recordings were made in the thalamus of cats anaesthetized with
      chloralose and urethane following electrical, mechanical and chemical stimulation
      of the superior sagittal sinus or middle meningeal artery. Facial receptive
      fields were looked for using electrical and mechanical stimuli. The locations of
      fifty-six cells were verified histologically. Twenty six cells were located in
      the ventroposteromedial nucleus (VPM) and six in its ventral periphery (VPMvp).
      All units in VPM had facial receptive fields, usually involving the first
      trigeminal division. Cells with nociceptive receptive fields or responding to the
      craniovascular application of bradykinin were often found in the periphery or
      "shell" region of VPM. Other craniovascular nociceptive cells were found in
      VPMvp, in the posterior group and in the intralaminar complex. This study shows
      that craniovascular afferents in the cat project to several thalamic nuclei and
      implicate VPM especially in craniovascular nociception.

PMID- 2226690
TI  - The effect of agonist/antagonist muscle vibration on human position sense.
AB  - During voluntary movement, muscle spindles of both the agonist and antagonist
      muscles potentially can supply information about position of the limb. Muscle
      vibration is known to increase muscle spindle discharge and cause systematic
      distortions of limb position sense in humans. The following two experiments
      attempted to examine these contributions by separately vibrating over the triceps
      and biceps muscles during forearm positioning. In the first experiment, subjects
      performed a horizontal flexion or extension of the right arm to a mechanical stop
      randomly positioned at 20, 40 or 60 degrees. Vision was occluded and vibration
      was applied to the right arm. The perceived position of the right limb was
      assessed by instructing subjects to simultaneously match the right arm position
      with the left limb. Vibration of the shortening, agonist muscle had no effect on
      limb matching accuracy. However, antagonist muscle vibration resulted in a
      significant overestimation of the vibrated limb position by 6-13 degrees. The
      procedures for the second experiment were similar to the first, except that
      movements of the right limb were self-terminated and only flexion movements were
      performed. A screen was mounted over the arms and subjects were instructed to
      move the right arm until it was positioned beneath a marker on the screen.
      Vibration of the shortening agonist muscle had no effect on either the
      positioning accuracy of the right limb or matching accuracy of the left limb.
      However, antagonist muscle vibration resulted in significantly shorter movements
      (6-10 degrees) by the right limb and an overestimation of right limb position by
      the left, matching limb.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226691
TI  - Representation of braille characters in human nerve fibres.
AB  - We have used microneurographic techniques in human subjects to record
      mechanoreceptive afferent responses to standard Braille characters scanned across
      the finger pads. Responses from all four mechanoreceptor classes (FA I, FA II, SA
      I and SA II) have been reconstructed to form two-dimensional Spatial Event Plots
      (raster plots) of the Braille alphabet. Both the SA I and FA I responses resolve
      the dot patterns of Braille characters with sufficient fidelity that the
      representations of the individual characters can be recognized visually.
      Responses from SA II and FA II afferents do not resolve the Braille characters.
      We believe that the Spatial Event Plots derived from SA I and FA I responses
      closely approximate the images that are transmitted within a human nerve during
      Braille reading.

PMID- 2226692
TI  - Relations between identified tendon organs and motor units in the medial
      gastrocnemius muscle of the cat.
AB  - In one medial gastrocnemius muscle of each of several cats, the response was
      recorded of a single tendon organ to the contraction of a single motor unit which
      strongly excited the receptor. The motor unit was depleted of its glycogen and
      the depleted muscle fibres identified in PAS-stained transverse sections. The
      site of maximum tendon organ sensitivity was marked and the tendon organ
      identified in the same sections. Five pairs of tendon organs and motor units were
      studied completely. Each tendon organ was found to have one or two (mean 1.6)
      depleted muscle fibres attached to it, included in the bundle of fibres attached
      to the end (mean no. 14.4) and side (mean no. 5.6) of the tendon organ. A
      correlation was found between tendon organ discharge rate and the tension
      calculated from cross-sectional area measurements of the depleted muscle fibres
      attached to the tendon organ, with variation between individual pairs of tendon
      organs and motor units. One estimate of the average sensitivity of the sample was
      28 imp/s/mN. A nearly linear discharge rate vs. tension relation was found for
      single tendon organ and motor unit pairs when tension was graded during a series
      of fatiguing contractions. Under these conditions the sensitivity, measured as
      the slope of the relation between discharge rate and motor unit tension recorded
      at the common tendon, varied between 0.11 and 0.30 imp/s/mN for 6 pairs.

PMID- 2226693
TI  - Vomeronasal activation by urine in the primate Microcebus murinus: a 2 DG study.
AB  - The vomeronasal system (VNS) seems to be functional in some primates and involved
      in the detection of urinary signals. Anterograde tracing (WGA-HRP) and evoked
      metabolic activity (2-DG method) were used in order to clarify the conditions
      under which the VNS is activated in the prosimian mouse lemur. After WGA-HRP
      deposition at one of the oral entries of the nasopalatine duct, reaction product
      was observed within the accessory bulb (AOB). 2-DG experiments show that urine in
      the volatile phase stimulates the main but not the accessory bulb (AOB). Liquid
      urine produced bilateral or unilateral activation of AOB depending on whether the
      stimulation was exclusively unilateral or not; under the same conditions
      distilled water could not produce 2-DG labelling. It is concluded that VNS is
      activated by urine in the liquid but not the volatile phase. The biological
      implications of these results are discussed.

PMID- 2226694
TI  - Output pathways from the rat superior colliculus mediating approach and avoidance
      have different sensory properties.
AB  - Neuroanatomical studies have demonstrated that the two major descending pathways
      from the superior colliculus arise from regionally segregated, distinct, cells of
      origin. Stimulation and lesion studies have implicated the crossed descending
      tecto-reticulo-spinal projection in approach movements towards novel stimuli
      whereas the ipsilateral pathway appears to be involved in the control of
      avoidance and escape-like behaviours. The present electrophysiological study
      attempted to characterise the sensory properties of antidromically identified
      cells of origin of these pathways in anaesthetised rats. We found that the
      contralaterally projecting predorsal bundle (PDB) efferents were primarily
      somatosensory while the ipsilateral cuneiform (CNF) projection was primarily
      visual. PDB cells, mainly found in the intermediate layers, responded principally
      to vibrissal stimulation with their overlying visual fields optimally stimulated
      by small dark moving objects in the lower rostral and lateral field. In contrast,
      most CNF cells were located rostromedially, with the greatest contribution from
      visual cells responsive to stimuli in the upper rostral field. A significant
      proportion of these showed no response to small moving dark discs but fired
      vigorously to 'looming' stimuli. Ethological considerations suggest that these
      are appropriate stimulus characteristics for a system controlling approach and
      avoidance behaviour in an animal such as the rat where predators generally appear
      from above and prey is found on the ground.

PMID- 2226695
TI  - Extensive monosynaptic inhibition of ventral respiratory group neurons by
      augmenting neurons in the Botzinger complex in the cat.
AB  - Axonal projections and synaptic connectivity of expiratory Botzinger neurons with
      an augmenting firing pattern (Bot-Aug neurons) to neurons in the ipsilateral
      ventral respiratory group (VRG) were studied in anaesthetized cats. Antidromic
      mapping revealed extensive axonal arborizations of Bot-Aug neurons (24 of 45) to
      the rostral or caudal VRG, with some having arbors in both regions. Of 234 pairs
      of neurons studied with intracellular recording and spike-triggered averaging,
      monosynaptic inhibitory postsynaptic potentials (IPSPs) were evoked in 49/221 VRG
      neurons by 38/98 Bot-Aug neurons. The highest incidence of monosynaptic
      inhibition was found in inspiratory bulbospinal neurons (10 of 23 tested).
      Evidence was also found for monosynaptic inhibition, by a separate group of Bot
      Aug neurons, of expiratory bulbospinal neurons (12/58), while excitatory
      postsynaptic potentials (EPSPs) were identified in another two of these neurons.
      In addition, monosynaptic IPSPs were recorded from 13 of 53 identified laryngeal
      motoneurons, and from 14 of 100 respiratory propriobulbar neurons. Presumptive
      disynaptic IPSPs were recorded from 11 of the 221 VRG neurons. We conclude that
      Bot-Aug neurons exert widespread inhibition on all major neuron categories in the
      ipsilateral VRG, and should be regarded as an important element in shaping the
      spatiotemporal output pattern of both respiratory motoneurons and premotor
      neurons.

PMID- 2226696
TI  - Topography of the facial musculature within the facial (VII) motor nucleus of the
      neonatal rat.
AB  - WGA-HRP, HRP and fluorescent tracers were used to determine the representation of
      the facial muscles in the facial motor nuclear complex (FMNC) of the newborn rat.
      Tracer injections of the superficial cervical and anterior mandibular portions of
      platysma, the orbicularis oculi muscle, the nasolabial musculature and the
      posterior auricular musculature revealed an adult-like topographic organization
      across FMNC subnuclei. Tracer delivery to individual vibrissa follicle loci of
      the whiskerpad also demonstrated an adult-like musculotopic organization within
      the lateral subnucleus.

PMID- 2226697
TI  - Direction-selective saccadic-burst neurons in the fastigial oculomotor region of
      the macaque.
AB  - Discharges of 68 neurons, recorded from the oculomotor region of the fastigial
      nucleus (FN) of the macaque, were characterized by a burst which started
      approximately 20 msec prior to the onset of a saccade in a direction
      contralateral to the recording site. These fastigial neurons also paused before
      saccades in their nonpreferred direction and then discharged with a subsequent
      burst. All units were spontaneously active but the tonic level of activity did
      not reflect eye position. They aggregated within the oculomotor region and the
      firing of 57 units (83.8%) was suppressed by stimulation of vermal lobule VII.
      Tonic discharges of six other units were closely related to eye position and
      located rostral to the burst units. Discharges of 16 units increased during the
      ipsilateral phase of sinusoidal head rotation and those of 50 units increased
      during contralateral head rotation. These neurons did not show saccade-related
      activity. They were widely scattered in the rostral and central portions of the
      FN. None of these units was inhibited by stimulation of vermal lobule VII.

PMID- 2226698
TI  - Methodology of microdialysis of neostriatum in hemiparkinsonian nonhuman
      primates.
AB  - In vivo biochemical microdialysis in primate brain would greatly expand our
      understanding of functional neuronal systems. This work describes our efforts to
      establish a microdialysis system in primate brain. Seven anesthetized rhesus
      monkeys underwent magnetic resonance imaging (MRI) with the head fixed in a
      compatible stereotaxic frame. This allowed stereotaxic localization of the
      caudate nucleus and putamen. Guide cannulae were implanted and fixed to the
      skull. Microdialysis probes made from polyethylene and fused silica were inserted
      into the caudate and putamen through the guide cannulae and perfused at the rate
      of 1.3 microliters/min. The putamens were approached horizontally, while the
      caudate nuclei were reached via a 30 degrees-45 degrees angle from the vertical.
      Postdialysis MRI and histologic evaluation proved that all probes accurately
      arrived at the predetermined region. Our data show that MRI guided stereotaxis
      allows accurate placement of dialysis probes and that implantation of guide
      cannulae is a reliable and convenient way to perform repeated brain microdialysis
      procedures.

PMID- 2226700
TI  - Delayed visual feedback and movement control in Parkinson's disease.
AB  - The dependence of movement on visual information was compared for healthy
      individuals and Stage II-III patients with Parkinson's disease (PD). A time delay
      (0-1400 ms) was introduced into a visually guided motor tracking task which
      required the subject to maintain constant index finger position relative to a
      stationary baseline on an oscilloscope. For healthy individuals, delayed visual
      feedback induced complex oscillations in finger displacement. Similar results
      were obtained for four of eight patients with PD. However, oscillations were not
      induced in four of eight patients with PD because of reduced gain and/or a higher
      tremor amplitude at zero delay which obscured the tracking error. These results
      suggest that some patients with PD are able to utilize visual information for
      controlling tracking in this motor task in the same manner as healthy
      individuals.

PMID- 2226699
TI  - Chronic levodopa impairs morphological development of grafted embryonic dopamine
      neurons.
AB  - Degeneration and plasticity of dopamine (DA) neurons may be influenced by their
      own neurotransmitter and/or metabolic by-products. Substances with known
      neurotoxic properties, such as hydrogen peroxide and 6-hydroxydopamine, are
      produced during oxidation of DA. Additionally, DA can directly regulate neurite
      outgrowth in both invertebrate and vertebrate species. We have begun to
      investigate the influence of increased local transmitter concentrations on the
      morphological plasticity of neurons by examining the effect of chronic levodopa,
      a drug that increases DA synthesis, on grafted embryonic nigral DA neurons in a
      rat model of experimental parkinsonism and in monolayer cell cultures. Results
      from our in vivo investigation show that although chronic levodopa does not
      significantly affect the number of surviving grafted cells, morphological
      development of these embryonic DA neurons appears impaired. Levodopa administered
      chronically to fetal DA neurons in culture results in a decreased number of
      surviving neurons as well as a reduction in neurite outgrowth with increasing
      concentration of levodopa ranging from 10(-8) to 10(-4) M. This information
      provides further evidence to support the hypothesis that excess DA or its
      metabolites can influence the survival and growth of DA neurons. These results
      may be important in the design of pharmacotherapy for Parkinson's disease and the
      combination of drug and neural grafting therapies in this disorder.

PMID- 2226701
TI  - Brugia pahangi: effects of duration of infection and parasite burden on lymphatic
      lesion severity, granulomatous hypersensitivity, and immune responses in jirds
      (Meriones unguiculatus).
AB  - The effects of Brugia pahangi infection duration and parasite burden on parasite
      associated inflammatory and immune responses were determined over a 181-day
      period in jirds receiving from one to eight inoculations of infective larvae.
      Multiple infections did not produce a protective resistance to reinfection as
      determined by adult worm recovery at necropsy. Intralymphatic granulomatous
      lesions, lymph thrombi, were first seen at 48 days post initial inoculation
      (DPI). The numbers of lymph thrombi reached peak levels in singly inoculated
      jirds at 90 DPI and significantly decreased to low levels by 160 DPI. The ratio
      of lymph thrombi to adult worms recovered from the spermatic cord lymphatics
      followed a similar pattern. Sizes of renal lymph nodes, which drain lymphatics
      containing parasites, followed a temporal pattern of increase and decrease
      similar to that of lymph thrombi numbers. Peak granuloma areas around antigen
      coated beads embolized in lungs were seen at 27 DPI. Granuloma areas around
      antigen-coated beads began to decrease after 69 DPI and reached sizes not
      significantly different from uninfected controls by 118 DPI. Multiple
      inoculations of infective larvae and increasing worm burdens did not affect the
      pattern of granulomatous response to antigen-coated beads. Eosinophilia of singly
      and multiply infected jirds peaked at 26 DPI. Eosinophilia of singly infected
      jirds returned to normal levels by 103 DPI but those of multiply infected jirds
      remained elevated until 160 DPI. Lymph node cell blastogenic responses to antigen
      were greater than those of splenocytes at all time intervals measured. However,
      significant differences in stimulation indexes between groups with different
      infection durations were not seen with either cell type. Antibody responses to
      somatic adult worm antigen as measured by ELISA reached near peak levels by 48
      DPI and remained elevated for the course of the study in all infected jirds. The
      decrease in lymphatic lesion severity seen in chronically infected jirds
      temporally corresponds to the decrease in granulomatous reactivity measured
      around antigen-coated beads embolized in the lungs. This observation suggests
      that host and/or parasite factors associated with these two phenomena may be
      similar. Although these decreases may be the result of down-regulated immune
      responses, corresponding decreases in antibody levels and blastogenesis of
      lymphocytes stimulated by crude worm extracts were not observed in chronic
      infections.

PMID- 2226702
TI  - Dirofilaria immitis: effect on hemolymph polypeptide synthesis in Aedes aegypti
      during melanotic encapsulation reactions against microfilariae.
AB  - [35S]Methionine-labeled hemolymph polypeptides from adult, female Aedes aegypti
      Liverpool strain mosquitoes inoculated with the microfilariae of the filarial
      nematode Dirofilaria immitis were compared with those from saline-inoculated and
      uninoculated controls by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) followed by fluorography. SDS-PAGE analysis of cell
      free hemolymph collected via perfusion at 6, 12, 24, 48, 72, and 96 hr
      postinoculation (PI) detected the enhanced expression of an 84-kDa polypeptide.
      This polypeptide, expressed constitutively in the hemolymph of all three groups
      of mosquitoes, increased considerably in inoculated mosquitoes as time progressed
      as compared with uninoculated controls. Moreover, the 84-kDa polypeptide was
      expressed at higher levels in D. immitis-inoculated mosquitoes than in saline
      inoculated controls. This stimulation of de novo biosynthesis of the 84-kDa
      polypeptide in inoculated mosquitoes may play a role in the immune response of
      mosquitoes. Since it is likely that the wound healing response in insects
      involves many of the same chemical processes as occur in melanotic encapsulation
      reactions of mosquitoes against filarial worms, the preferential expression of
      the 84-kDa polypeptide in saline-inoculated mosquitoes seen in this study may
      reflect a wound healing response. The greater increase in synthesis of this
      protein in D. immitis-inoculated mosquitoes may reflect production of melanotic
      material required for parasite destruction as well as for wound healing.

PMID- 2226703
TI  - Opisthorchis viverrini: finding and recognition of the fish host by the
      cercariae.
AB  - The cercaria of Opisthorchis viverrini finds and recognizes its fish host by
      using at least four steps of behavioral patterns. (1) Dispersal and selection of
      plant-free water microhabitat are achieved by intermittent swimming behavior with
      positive phototactic orientation. (2) Attachment to the host is stimulated by
      water currents and a hydrophilic component of fish skin surface which has a
      molecular weight of more than 30,000. This component is sensitive to digestion
      with hyaluronidase and seems to be a glycosaminoglycan other than hyaluronic acid
      and chondroitin sulfate. (3) Remaining on the host's surface is induced by an
      unknown chemical component of fish skin surface mucus. (4) Penetration into the
      host is triggered by a hydrophilic component of fish skin surface of a molecular
      weight of more than 30,000. This host signal has a proteinaceus character as it
      is sensitive to proteinase digestion but not to hyaluronidase and glycosidases.
      The requirement of O. viverrini cercariae for complete glycosaminoglycans and
      proteins as signals in host identification may have the advantage that the
      numerous small molecules in mud and decaying materials in the water cannot
      interfere with host-finding.

PMID- 2226704
TI  - Trypanosoma brucei: calcium-dependent endoribonuclease is associated with
      inhibitor protein.
AB  - T. brucei cytoplasmic calcium-dependent alkaline ribonuclease activity from DEAE
      cellulose fractionation was separated into endoribonuclease and exoribonuclease
      activities by hydroxyapatite chromatography. T. brucei cytoplasmic extract
      markedly decreased the endoribonuclease activity, but slightly potentiated the
      activities of the exoribonuclease and bovine ribonuclease A. While the
      endoribonuclease was activated by trypsin, the exoribonuclease and bovine
      ribonuclease A were partially inactivated by trypsin. The endoribonuclease was
      activated by p-chloromercuribenzoate or N-ethylmaleimide; the exoribonuclease was
      not affected by these sulfhydryl group reagents. Free ribonuclease was separated
      from the latent endoribonuclease by 1 M NaCl-Sephadex G-100 gel filtration. The
      results demonstrate that T. brucei cytoplasm contains a latent endoribonuclease
      consisting of ribonuclease and inhibitor protein.

PMID- 2226705
TI  - Toxoplasma gondii: immunocytochemistry of four immunodominant antigens with
      monoclonal antibodies.
AB  - Four monoclonal antibodies in which diagnostic usefulness has been observed,
      concerning congenital, acquired, and reactivated toxoplasmosis, were raised
      against Toxoplasma gondii tachyzoites in order to localize immunodominant
      antigens. On immunoblots, it appears that McAb IV47, McAB GII9, McAb II38, and
      McAb IE10 identify families of proteins with estimated molecular weights of 28-30
      kDa, 30 kDa, 45-50 kDa, and 66-70 kDa, respectively. By immunogold preembedding
      techniques one can observe an homogeneous labeling of the outer pellicle of the
      tachyzoites with the McAb GII9 and IV47 and a light labeling with the McAb II38
      and IE10. The three-dimensional observation of cell surface antigens is performed
      by applying a modified metal extraction replica method, i.e., A plasma
      polymerization method of glow discharge by Tanaka (1979). By immunogold
      preembedding techniques [with saponin permeabilization (0.1%)], and by immunogold
      postembedding techniques, a labeling of the rhoptries is observed with McAb GII9
      and McAb IV47 but essentially all label is found with McAb II38 and IE10. With
      McAb GII9 a uniform labeling is observed on the cell surface. By immunoenzymatic
      techniques (peroxidase) a cell surface labeling is observed with the four McAb.
      Intracellular Toxoplasma, the outer pellicle, and the vesicles of the network
      (elaborated by Toxoplasma in parasitophorous vacuole) are also labeled with McAb
      IE10. These results indicate that McAb GII9 recognizes antigens of the antigen
      family (P 30) located on the cell surface and in the rhoptries. The antigen
      recognized by McAb IV47 is essentially located on and beneath the Toxoplasma cell
      surface membrane, and McAb II38 and IE10 identify preferentially rhoptry
      proteins.

PMID- 2226706
TI  - Plasmodium falciparum: ATP/ADP transport across the parasitophorous vacuolar and
      plasma membranes.
AB  - Previous studies have shown that ATP is required for the growth of the
      intracellular parasite, Plasmodium, outside its host cell, the erythrocyte, and
      that bongkrekic acid, an inhibitor of mitochondrial ATP/ADP transporter, inhibits
      intraerythrocytic Plasmodium maturation. We have characterized ATP/ADP transport
      of Plasmodium falciparum, isolated by either immune lysis or N2-cavitation.
      [3H]ATP uptake was due to ATP/ADP exchange since ADP efflux was dependent on
      exogenous ATP in an approximate 1:1 stoichiometry and both ATP influx and ADP
      efflux were equally inhibited by atractyloside (Ki = 100 nM). ATP uptake was not
      inhibited by the nucleoside transport inhibitor, nitrobenzylthioinosine.
      Conversely, adenosine and hypoxanthine transport were insensitive to
      atractyloside. ATP influx was characterized by a Km = 0.14 mM and Vmax = 1.2 nmol
      ATP/min/10(6) cells. Substrate specificity studies for nucleotide-induced ADP
      efflux indicated a preference for an adenosine ring and triphosphate, but
      transport did not require a hydrolyzable phosphate bond. Protein synthesis was
      measured with free parasites starved of glucose. Addition of 1.0 mM ATP resulted
      in a 40% recovery of total protein synthetic capacity in a process inhibited by
      500 nM atractyloside, suggesting that uptake of erythrocyte-derived ATP by P.
      falciparum may be essential for maintaining maximal rates of protein synthesis
      during specific stages of intra-erythrocytic parasite maturation.

PMID- 2226707
TI  - Giardia sp.: comparison of electrophoretic karyotypes.
AB  - Species in the genus Giardia have been named on the basis of host specificity,
      cell dimensions, and median body morphology. Despite these criteria, the species
      taxonomy of Giardia is still in question. To investigate Giardia taxonomy on a
      molecular level, Giardia chromosomal DNA was analyzed by orthogonal-field
      alternation gel electrophoresis (OFAGE) and transverse alternating field
      electrophoresis (TAFE). Chromosomal DNA of G. duodenalis isolates (human,
      muskrat, sheep, dog, beaver), G. muris (mouse), and G. ardeae (great blue heron)
      were subjected to OFAGE and TAFE analyses. Comparable DNA patterns were obtained
      by both electrophoretic methods, but OFAGE required 8 days while TAFE required
      only 3 days. DNA patterns among all G. duodenalis isolates, although quite
      similar to each other, were distinctly different from those of G. muris and G.
      ardeae; G. muris and G. ardeae DNA patterns were distinctly different from each
      other. A G. duodenalis (Portland 1) total DNA probe hybridized to the DNA of all
      G. duodenalis isolates on Southern blots, but not detectably to G. muris and G.
      ardeae DNA. Similarly, G. muris and G. ardeae total DNA probes only hybridized
      detectably to their respective DNA. One probe that appears to hybridize to the
      DNA of all G. duodenalis and to G. ardeae DNA rather than G. muris DNA has been
      developed. Another probe that hybridizes only to G. muris and G. ardeae DNA has
      been developed. These data suggest that the differentiation of Giardia isolated
      from host and environmental samples may eventually be accomplished by DNA probes.
      Additionally, these techniques perhaps combined with other criteria may lead to
      the establishment of a sound taxonomic scheme for this genus.

PMID- 2226708
TI  - Panagrellus redivivus and Caenorhabditis elegans: evidence for the absence of
      sialic acids.
AB  - Complementary experiments were performed to indicate the presence or absence of
      sialic acids in axenically cultured Panagrellus redivivus and Caenorhabditis
      elegans. Competitive displacement experiments with radiolabeled Limax flavus
      agglutinin demonstrated the presence of sialic acid in nematodes grown in medium
      which contained liver extract as a growth factor but the absence of sialic acid
      when heme was substituted for liver extract. This finding suggested that sialic
      acid present in the liver medium was responsible for conflicting results of other
      studies. Transmission electron microscopy of thin sections from nematodes labeled
      with an LFA-ferritin conjugate revealed no label to the surface area of the
      cephalic chemosensilla. Fluorometric analysis with a modification of the
      thiobarbituric acid assay was negative for sialic acid. Analyses by gas
      chromatography-mass spectrometry, sensitive to the high picomole range, were also
      negative for sialic acid. Taken together the results provide evidence for the
      absence of sialic acid in P. redivivus and C. elegans using the most sensitive
      and diagnostic technique currently available.

PMID- 2226709
TI  - Onchocerca volvulus: biochemical and morphological characteristics of the surface
      of third- and fourth-stage larvae.
AB  - The annulated cuticles of third- and fourth-stage larvae of Onchocerca volvulus
      have the typical structure of other nematodes but the cuticle of fourth-stage
      larvae was thinner. The surface of the third-stage larva was wrinkled and fuzzy,
      while that of the fourth-stage was smooth. Intermediate stages in the formation
      of the new cuticle and epicuticle beneath the old basal layer and of the
      separation of the cuticles are shown. Monoclonal antibodies specific to the
      surface of third-stage larvae did not react with the surface of the fourth-stage
      larvae. Binding of the monoclonal antibodies to the third-stage larvae was
      abrogated by treatment of the worms with trypsin and proteinase K, but was
      unaffected by treatment with periodate or the detergents sodium deoxycholate and
      SDS. The lectins RCA120 and WGA, but not any of the other lectins tested, bound
      only to the surface of fourth-stage larvae, and not to that of third-stage
      larvae. The surfaces of third- and fourth-stage larvae were shown to be different
      and contained stage-specific surface epitopes.

PMID- 2226710
TI  - Arachidonic acid metabolism in filarial parasites.

PMID- 2226711
TI  - Intercellular dye-coupling in intestinal smooth muscle. Are gap junctions
      required for intercellular coupling?
AB  - The dye Lucifer Yellow was injected into single smooth muscle cells in the guinea
      pig small intestine in order to study intercellular coupling. Dye-coupling was
      observed in both the circular and longitudinal muscle layers and was markedly
      reduced when the intercellular pH was lowered. These results suggest the presence
      of gap junctions among intestinal muscle cells, but are inconsistent with
      previous ultrastructural studies that failed to demonstrate such junctions in the
      longitudinal muscle.

PMID- 2226712
TI  - Aging and endothelin-1 induced vascular contractions.
AB  - Contractions produced by endothelin-1 (0.3-30 nM) have been investigated in
      aorta, renal arteries and mesenteric arteries from 2- and 24-month-old Sprague
      Dawley rats. In senescent rats the EC50 values of endothelin-1 for aorta and
      renal artery were significantly increased (aorta: from 6.2 to 12 nM; renal
      artery: from 5.2 to 7.8 nM). For mesenteric artery the EC50 value (4.3 nM) was
      unchanged by aging, whereas the maximal contractile response to endothelin-1 was
      enhanced (from 8.3 to 11.7 mN). In contrast, there was no significant age-related
      difference in the maximal endothelin-1 response of aorta and renal artery. The
      present data demonstrate a reduced sensitivity for aorta and renal artery and an
      enhanced maximal response to endothelin-1 in the mesenteric artery in senescent
      rats.

PMID- 2226713
TI  - Lack of pyrogenic tolerance transmission between brain and periphery in the
      rabbit.
AB  - Successive injections of lipopolysaccharide (LPS) either intravenously (i.v.) or
      intracerebroventricularly (i.c.v.) induced pyrogenic tolerance to LPS in rabbits.
      Tolerance was shown by a decrease of the magnitude of the fever response to
      repeated doses of LPS, irrespective of the route of pyrogen administration. A
      significantly greater and more dramatic decrease of the fever index, however, was
      observed in rabbits made tolerant to pyrogen given i.v. than when the pyrogen was
      given i.c.v. Transmission of the pyrogenic tolerance between brain and peripheral
      tissues, however, has not been ascertained.

PMID- 2226714
TI  - Effect of feeding cereal-legume diets to rats on in vitro absorption of 45Ca.

PMID- 2226716
TI  - Pentobarbital-induced phase shifts of circadian rhythms of locomotor activity are
      not mediated through stimulated activity in mice.
AB  - The possibility that phase shifts of circadian rhythms of locomotor activity
      induced by pentobarbital injections are mediated through hyperactivity after
      recovery from the sedative condition was tested in DBA/2 mice. The mice were
      restrained for 3 h in a tube immediately after injections of pentobarbital at
      either CT 9 or CT 0. The results indicated that immobilization did not block the
      phase shifts, suggesting that pentobarbital-induced phase shifts are not due to
      increasing the level of activity.

PMID- 2226715
TI  - Irradiation of the head by 60Co opens the blood-brain barrier for drugs in rats.
AB  - The passage of 6 model drugs; acetylsalicylic acid, chloramphenicol, ethimizol,
      carbisocaine, heptacaine, and diazepam, through the blood-brain barrier, was
      determined in unirradiated control rats and in animals 1, 3, and 7 days after
      irradiation of the head only with a dose of 25 Gy from a 60Co source. The brain
      uptake index (BUI), which compares the uptake of the test substance with that of
      3H2O 5 s after their injection into the common carotid artery, was significantly
      increased in comparison with unirradiated controls 7 days after irradiation, for
      all substances tested except for ethimizol. For acetylsalicylic acid and
      chloramphenicol it was also significantly increased in the other time intervals.
      The less lipophilic substances showed a greater relative increase of BUI than the
      more lipophilic ones.

PMID- 2226717
TI  - Effects of selective dopamine D1 and D2 antagonists on male rat sexual behavior.
AB  - The effects of selective dopamine (DA) D1 and D2 antagonists on male rat sexual
      behavior were investigated. The D1 antagonist (+)SCH-23390, 25-100 micrograms kg
      1 s.c. -20 min, and the D2 antagonist raclopride, 0.1-1.6 mg kg-1 s.c., -20 min,
      decreased both the number of mounts and intromissions preceding ejaculation. No
      statistically significant effects in the time up to ejaculation or in the time up
      to the first intromission were noted, whereas both compounds produced a
      statistically significant increase in the post-ejaculatory interval. The effect
      can generally be characterized as psychomotor inhibition, and no evidence was
      obtained for a specific role of DA D1 or D2 receptors in the mediation of male
      rat sexual behavior.

PMID- 2226718
TI  - Fatty acid modulation of antiestrogen action and antiestrogen-binding protein in
      cultured lymphoid cells.
AB  - Nonsteroidal antiestrogens reversibly and specifically inhibited the
      proliferation of two estrogen receptor-negative lymphoid cell lines (EL4 and
      Raji) in a dose-dependent manner. [3H]Thymidine incorporation of concanavalin A
      stimulated primary splenocytes was also inhibited by 10(-6) M clomiphene (1-[4-(2
      diethylaminoethoxy)phenyl]-1,2-diphenyl-2-chloroethylene). The antiproliferative
      effect could be prevented by the simultaneous presence in the growth medium of
      10(-5) M linoleic acid or 10(-5) M arachidonic acid but not by 10(-6) M
      estradiol. Both lymphoid cell lines had high affinity antiestrogen-binding sites
      whose affinity could be altered by conditions of growth. Growth of EL4 cells in
      RPMI 1640 medium supplemented with charcoal-pretreated 5% fetal calf serum
      (charcoal-stripped medium) resulted in significantly higher affinity (Kd 0.54 nM
      +/- 0.11 nM; n = 6) than growth in medium supplemented with untreated serum
      (complete medium) (Kd = 1.68 nM +/- 0.48 nM; n = 6) (p less than 0.001). This
      change in affinity was partly due to removal of fatty acids from the growth
      medium by charcoal pretreatment, since addition of 10(-5) M linoleic acid or 10(
      5) M gamma-linolenic to charcoal-stripped medium decreased the affinity of the
      antiestrogen-binding protein. In contrast, growth in 10(-5) M stearic acid or 10(
      5) M oleic acid did not significantly alter the affinity of the antiestrogen
      binding protein, whereas 10(-5) M palmitic acid significantly increased its
      affinity. The same fatty acids were also tested for their intrinsic effects on
      EL4 cell proliferation. Oleic, linoleic and gamma-linolenic acids were growth
      stimulatory while stearic and palmitic acids were not. Thus linoleic and gamma
      linolenic acids whose presence in the growth medium was associated with decreased
      affinity of [3H]tamoxifen (1-[4-(2-dimethylaminoethoxy)phenyl]-1,2-diphenylbut
      1(Z)-ene) binding to the intracellular antiestrogen-binding protein were also
      growth stimulatory. Unsaturated fatty acids have previously been shown to inhibit
      binding of [3H]tamoxifen to the antiestrogen-binding protein in a cell-free
      system. The present observations demonstrate that unsaturated fatty acids also
      modify the affinity of the antiestrogen-binding protein in intact cells.

PMID- 2226719
TI  - Effects of a new cholecystokinin antagonist (GE 410) on the smooth muscle of the
      guinea pig ileum.
AB  - Suc-Tyr-(SE)-Met-Gly-Trp-Met-Asp-beta-phenethylamide (GE 410) competitively
      antagonized the contractions of smooth muscle strips from guinea pig ileum (pA2 =
      7.6, n = 0.95) induced by cholecystokinin-octapeptide (CCK8). GE 410 inhibited
      the electrically-induced cholinergically mediated contractile responses and the
      [3H]ACh release in the ileum, as well as the CCK-stimulated electrical
      contractile responses and the [3H]ACh release in the cholinergic nerve terminals.
      The results suggest the existence of CCK-receptors not only in the smooth muscles
      but also on the neurons.

PMID- 2226720
TI  - Studies on the thyroid in transgenic mice expressing the genes for human and
      bovine growth hormone.
AB  - The thyroid glands of transgenic mice (TM) expressing the genes for human (h) and
      bovine (b) growth hormone (GH) were studied. The percentages of larger follicles
      in hGH TM of either sex were significantly greater than in the corresponding
      normal littermates, and follicles ranging up to 350 microns in diameter were
      present in male hGH TM. In contrast, thyroid follicles were only slightly
      enlarged in male bGH TM, and were unchanged in female bGH TM. The serum
      concentrations of T4 were significantly decreased in male bGH TM and not altered
      in the other groups. Serum concentrations of T3 were slightly, but significantly
      increased in female hGH TM and female bGH TM, but were unaffected in male TM of
      either type. Since the principal difference between these foreign GHs in rodents
      is the additional lactogenic activity of human GH, these results may indicate
      that the effects of prolactin can influence the development of the thyroid.

PMID- 2226721
TI  - In vitro culture of chick down feather bulbi: a tool to obtain proliferating and
      differentiating keratinocytes in an organotypic structure.
AB  - Chick down feather bulbi can be cultured in different culture systems.
      Morphological analysis and 3H-thymidine incorporation measurements prove that the
      majority of cells are viable epithelial cells.

PMID- 2226722
TI  - Cytogenetic and biochemical comparison of Mus musculus and Mus hortulanus.
AB  - Two chromosome markers of Mus hortulanus are described: a dotted Y chromosome
      exceeding half of the length of autosome 19, and the 'domesticus' type of C
      banding in the X chromosome. In Mus musculus from distant regions of the USSR
      (more than 200 specimens of various subspecies), the Y chromosome is equal to
      autosome 19, and the X chromosome is of the 'molossinus' type. Specific
      biochemical characteristics of house mice of the USSR are shown.

PMID- 2226723
TI  - Transdifferentiation of larval Xenopus laevis iris under the influence of the
      pituitary.
AB  - Fragments of larval Xenopus laevis dorsal iris implanted together with the
      pituitary into the tail fin transdifferentiate into neural retina. On the
      contrary, in the control experiments the implanted tissues, dorsal iris alone,
      pituitary, or dorsal iris with liver fragments, do not undergo any retinal
      transformation.

PMID- 2226724
TI  - A novel reaction time task for investigating force and time parameters of
      locomotor initiation in rats.
AB  - A novel simple reaction-time task for rats is described in the present study.
      Food-deprived rats were trained in a modified runway for rapid locomotor
      initiation, in response to a combined optical/acoustic stimulus, to receive a
      food reward. Rats rapidly learned this task with small variability, and movement
      patterns of locomotor initiation are congruent under these conditions. Reaction
      time, movement time and accelerative forces were recorded from each initiation of
      locomotion by means of video equipment and a force platform. The quantification
      modes yielded consistent results and a quantitative description of measured force
      and time parameters is given. The task may be especially appropriate for
      investigating basal ganglia functions. The present results will be the basis for
      investigating initiation of locomotion in animal models of neurological diseases.

PMID- 2226725
TI  - Diagnostic value of glycosylated hemoglobin in intravascular hemolysis after
      cardiac surgery.
AB  - Glycosylated hemoglobin (GH), hemoglobin (Hb), hematocrit, LDH and serum
      bilirubin were measured pre-operatively, and 1-10 days and 11-42 d post
      operatively in 42 patients undergoing cardiac surgery. Their mean age was 39.90
      years, ranging from 4 to 68 yr. In the early post-operation days, Hb and
      hematocrit, but not GH percentage, were significantly decreased. This
      demonstrates that, at this stage, acute blood loss rather than hemolysis is more
      prominent. In the later post-operative days, GH, but not Hb or hematocrit,
      decreased significantly. This indicates the presence of chronic hemolysis with
      bone marrow compensation. In our study, the incidence of chronic mild hemolysis
      after cardiac surgery was very high (68.8%). We conclude that GH determination is
      a simple, easy and sensitive method to detect chronic hemolysis and we suggest
      measuring it in every case with suspicion of hemolysis.

PMID- 2226726
TI  - Serum homocysteine in routine evaluation of potential vitamin B12 and folate
      deficiency.
AB  - Total serum homocysteine (Hcy) was measured in patients with either low serum
      folate, low serum vitamin B12 (B12), or potential metabolic defects, in order to
      evaluate Hcy as an indicator of the tissue status of the two vitamins. An
      increased Hcy supported the diagnosis of frank tissue deficiency in those
      patients in whom tissue deficiency was evident by other means. A Hcy within the
      reference interval enabled the clinician to identify those patients whose low
      serum vitamin level and symptoms did not reflect a tissue deficiency of B12 or
      folate of clinical consequence. Children with inherited disturbances of B12
      metabolism, and whose serum B12 was within the reference interval, were correctly
      identified by an increased Hcy. A declining Hcy was evidence of correction of a
      deficiency even when other laboratory or clinical measurements of a response were
      obscured.

PMID- 2226727
TI  - Structural chromosomal abnormalities of 3q in myelodysplastic syndrome/acute
      myeloid leukaemia with Sweet's syndrome.
AB  - Structural rearrangements in the long arm of chromosome 3, del(3)(q12q25) and
      t(3;5)(q21-25;q31-33), were observed in bone marrow cells from 2 patients with
      myeloid neoplastic disorders (myelodysplastic syndrome and acute myeloid
      leukaemia) and acute febrile neutrophil dermatosis (Sweet's syndrome). 3 of the 4
      patients with leukaemia-associated Sweet's syndrome and acquired chromosome
      abnormalities known from the literature also had 3q changes, in 2 involving band
      3q21.

PMID- 2226728
TI  - Tumor-necrosis factor induces cell cycle arrest in multipotential hematopoietic
      stem cells: a possible radioprotective mechanism.
AB  - Tumor-necrosis factor (TNF) and interleukin-1 (IL-1) have been shown to confer
      protection of hematopoiesis in mice challenged with radiation. Herein, a series
      of experiments designed to elucidate the underlying mechanism is presented. After
      TNF administration, colony-stimulating activity, but no IL-1 activity, was
      detectable in mouse plasma. In endogenous CFU-S assays, TNF enhanced the survival
      of multipotential progenitors when administered before, but not after,
      irradiation. In experiments with fractionated irradiation, the radioprotective
      effect of TNF was distinctly different from that of IL-1. In vivo and in vitro
      thymidine suicide assays demonstrated that TNF wholly or partially abolished cell
      cycling of the CFU-S hematopoietic compartment. These data imply that TNF may
      inhibit the cell cycle in hematopoietic progenitor cell populations.

PMID- 2226729
TI  - High-dose cytosine arabinoside and amsacrine or mitoxantrone in relapsed and
      refractory acute myeloid leukaemia: a prospective randomized study.
AB  - 52 patients with refractory or relapsed acute myeloid leukaemia (AML) were
      randomly assigned to receive a combination of high-dose cytosine arabinoside (HD
      Ara-C), 3 g/m2/d and either mitoxantrone (MTX), 7 mg/m2/d (5 mg if older than 60
      yr) or m-amsacrine (AMSA), 120 mg/m2/d (90 mg if older than 60 yr) for 5 d. The
      overall response rate was 50% and did not differ significantly in the two groups
      (46% for AMSA and 56% for MTX, p = 0.415). The median survival was 11 months (8
      months for AMSA and 12 months for MTX, p = 0.326) and the median duration of
      complete remission (CR) was 11 months for AMSA and 12 months for MTX (p = 0.643).
      In relapsed patients, the only significant predictive factor for obtaining a
      complete response was the length of first complete remission. Patients with a
      first CR shorter than 6 months had a CR rate of 36% while it was 65% if the first
      CR lasted more than 6 months (p = 0.03). Severe (WHO grade III-IV) gastro
      intestinal toxicity was more frequent in the AMSA group (27% vs 4%, p = 0.021).
      Treatment-related death occurred in 4 patients in the AMSA group and in 2
      patients in the MTX group (p = 0.097). We conclude that neither of these two
      treatment modalities was shown to be superior in terms of CR rate and survival,
      with a better tolerance for MTX.

PMID- 2226730
TI  - Immunophenotype of hairy-cell leukemia.
AB  - 15 cases of HCL were studied with a panel of monoclonal antibodies against
      different leukocyte antigens. A B-cell phenotype different from that of B-CLL was
      observed (CD10-, CD19+, CD20+, CD21-, CD22+, CD37+, CD38-, FMC7+, LN1+, PCA-1+,
      BLy7+ and CD5-). As expected, CD11c and CD25 were positive and, in addition, a
      My7 and My9 positivity in varying degree was noted. 3 weeks of in vitro
      incubation did not significantly alter the phenotype. We conclude that HCL
      exhibits a unique phenotype among chronic B-cell leukemias, which is closer to
      the plasma cell stage of differentiation than that of B-CLL. The BLy7 monoclonal
      antibody seems to be a promising marker for HCL.

PMID- 2226731
TI  - Chronic granulocytic leukaemia in asplenic patients.

PMID- 2226732
TI  - Effects of a mixed physical activity (biathlon) on haematologic parameters, red
      cell 2,3-DPG and creatine, serum erythropoietin, urinary enzymes and
      microalbumin.

PMID- 2226733
TI  - Idarubicin plus attenuated high-dose cytosine arabinoside in the treatment of
      relapsed and refractory acute leukemia.

PMID- 2226734
TI  - GM-CSF in busulfan overdosage.

PMID- 2226735
TI  - Sweet's syndrome in association with myelodysplastic syndrome.

PMID- 2226736
TI  - Effect of 52 monoclonal antibodies against platelet membrane on platelet
      aggregation and release reaction.

PMID- 2226737
TI  - Prognostic factors in multiple myeloma in a population-based trial.
AB  - Prognostic factors have been tested in patients with multiple myeloma treated
      according to a randomized trial of standard therapy versus 5-drug combination
      therapy. The following population-based study included 92 patients with a median
      age of 70 yr. The median survival was 31 months. The Cox regression model was
      used to search for predictors of survival. The cut-off levels for blood analyses
      derived in earlier studies tended to select few patients in the high-risk groups,
      for example only 8% of the patients had hemoglobin (Hb) less than or equal to 7.5
      g/dl. Lytic bone lesions in the pelvis or in the long bones, or spontaneous
      fractures and age greater than 70 yr gave prognostic information in addition to
      anemia and impaired renal function. The MRC staging system was a better
      prognostic tool than the Durie & Salmon stages. Palliative treatment regimens
      which take quality of life into account should be considered carefully in
      multiple myeloma patients greater than 70 yr.

PMID- 2226738
TI  - Bone marrow stromal elements in murine leukemia: decreased CSF-producing
      fibroblasts and normal IL-1 expression by macrophages.
AB  - A study of bone marrow stromal elements in murine acute myeloid leukemia (AML)
      was carried out. Our previous studies had indicated marrow stromal deficiency in
      murine AML. In the current investigation, separate stromal cells were cultured
      and the results obtained have shown that, while marrow stromal macrophages are
      normal in leukemia and express adequate amounts of IL-1, the fibroblasts are
      markedly reduced. However, if sufficient fibroblasts are pooled in vitro, they
      produce adequate amounts of CSF. Test of TNF alpha in leukemic cells CM, as
      possible cause of marrow stromal inhibition in leukemia, had not disclosed this
      cytokine. Further, it was observed that total body lethal irradiation of leukemic
      mice aggravates the stromal deficiency, confirming results of our previous
      investigations. It is concluded that bone marrow stromal deficiency in murine AML
      is due to decreased fibroblasts and, implicitly, reduced CSF production.

PMID- 2226739
TI  - Abnormal chromatin clumping in leucocytes: a clue to a new subtype of
      myelodysplastic syndrome.
AB  - We report 6 patients with myelodysplastic syndrome, all of whom showed a bizarre
      nuclear anomaly within the neutrophils that was characterized by extensive
      clumping of chromatin into large blocks separated by clear zones, generally
      associated with a lack of segmentation. Anaemia, thrombocytopenia, variable
      leucocyte counts with leucoerythroblastic picture, marrow hypercellularity with
      granulocytic hyperplasia and moderate dysplastic changes in erythroblastic and
      megakaryocytic lines were present at diagnosis. 2 patients had normal karyotypes
      and a 3 showed a deletion of chromosome 14. 5 out of 6 patients had pneumonia at
      diagnosis. The median survival was short (5 months) and haemorrhagic
      complications were the cause of death in 4 patients. The clinical features and
      the evolution of these and other reported cases suggest that the presence of
      abnormal chromatin clumping in leucocytes might be a clue to a new subtype of
      myelodysplastic syndrome.

PMID- 2226741
TI  - Acute myelofibrosis. Case report and review of the literature.

PMID- 2226740
TI  - Labelling autologous platelets with 111In tropolonate for platelet kinetic
      studies: limitations imposed by thrombocytopenia.
AB  - An in vitro method of radiolabelling platelets with 111In tropolonate in plasma
      has been devised enabling imaging and cell kinetic studies to be performed in
      patients with thrombocytopenia (TP) using autologous, rather than donor,
      platelets. Platelets from 10 TP patients, with platelet counts ranging from 4-91
      x 10(9)/l, were labelled in 50% plasma with 111In tropolonate, containing the
      optimum tropolone concentration of 2 x 10(-4) mol/l, at platelet concentrations
      ranging from 0.08-4.5 x 10(9)/ml resulting in labelling efficiencies (LE) between
      51 and 86%. In 4 patients, red cells contaminated the platelets but this was
      corrected for by measuring the proportion of 111In on the platelets prior to
      injection and in the post-injection blood samples. Platelet recovery (PR), mean
      platelet life-span (MPLS) and platelet production rate (PPR) were calculated and
      splenic and hepatic images were taken. The results clearly show that useful
      clinical data can be obtained by this method even in patients with severe TP.

PMID- 2226742
TI  - Autoantibody occurrence in hairy-cell leukemia during prolonged interferon
      treatment.

PMID- 2226744
TI  - Cytogenetics in multiple myeloma: are we studying the 'right' cells?

PMID- 2226743
TI  - Differential expression of LFA-1 alpha molecule in clinical stages of chronic B
      lymphocytic leukemia patients.

PMID- 2226745
TI  - Low-income women's perceptions of family planning service alternatives.
AB  - A sample of 665 low-income women from a predominantly rural area of north central
      Florida rated the value of 25 features of family planning providers and reported
      their perceptions of how characteristic each feature was of different types of
      providers. A well-trained, trustworthy and friendly staff, the presence of a
      doctor if you need one and a staff that is gentle with the examination were the
      most desirable features of family planning services. The respondents' perceptions
      of public health clinics suggest that the strongest qualities of such facilities
      are that they treat people from different backgrounds, accept Medicaid, are easy
      to find and teach you how to avoid pregnancy and how to take care of yourself and
      stay healthy. Features thought most characteristic of private physician services
      were a well-trained staff, privacy and the presence of a doctor if you need one.
      Voluntary organizations were seen as providing services for people of different
      backgrounds, having a friendly staff, serving as a referral agency and teaching
      about staying healthy and avoiding pregnancy. However, voluntary organizations
      were rated lower than public health clinics or private physicians on nearly all
      features. The total scores for public health clinics and private physicians were
      not significantly different from each other, but both were noticeably higher than
      the score for voluntary organizations. Ethnicity affected ratings dramatically,
      with black respondents clearly more favorable toward public health clinics and
      private physicians than white respondents; conversely, whites were more positive
      toward voluntary organizations than were blacks. For many of these low-income
      respondents, the high ratings of private physicians may have represented their
      expectations rather than their actual experience.

PMID- 2226746
TI  - Factors associated with the use of court bypass by minors to obtain abortions.
AB  - Interviews with minors at four Minnesota abortion clinics revealed that 43
      percent used the court bypass option that is part of that state's parental
      notification statute. The proportion who did so increased with age and was most
      common among lower socioeconomic groups. A discriminant function analysis showed
      that perceived maternal supportiveness was a key difference between those who
      went to court and those who notified their parents. Young women who attended
      religious services frequently were less likely than those who did not tell their
      parents of their abortion plans. Minors who notified only one parent--and still
      had to go to court under Minnesota law, which requires notification of both
      parents--were more likely than those who told neither to come from a single
      parent household and to have good communication with their mother.

PMID- 2226747
TI  - Trends in use of oral contraceptives--data from the 1987 National Health
      Interview Survey.
AB  - Despite fluctuations in current use rates for oral contraceptives, ever-use of
      the pill has remained remarkably stable for all cohorts of U.S. women born since
      1945. Approximately 80 percent of these women report having used the pill at some
      time. Average duration of use is about five years among cohorts who had access to
      the pill from their earliest reproductive years. Among women born before 1940,
      whites are more likely than blacks to have ever used the pill, but no racial
      difference is evident among women in later cohorts. Age at first use of the pill
      has declined with each succeeding five-year birth cohort. Black women are more
      likely than white women to have used oral contraceptives before age 18, but by
      age 25, about three-fourths of blacks and whites have used the pill. Among ever
      users born before 1945, the majority began taking the pill after their first full
      term pregnancy; this pattern is reversed among more recent cohorts.

PMID- 2226749
TI  - The Supreme Court upholds parental notice requirements.

PMID- 2226748
TI  - At pill's 30th birthday, breast cancer question is unresolved.

PMID- 2226750
TI  - The Supreme Court retreats another step on abortion.

PMID- 2226751
TI  - [Attenuation of the effect of imizin on the dynamics of forced swimming and the
      circadian rhythm of mobility in rats chronically administered melatonin].
AB  - Imizine (10 mg/kg, 14 days) was shown to change the temporal dynamics of forced
      swimming in rats and to decrease the biorhythmical index of depression. The
      antidepressant also produced reorganization of the circadian rest-activity rhythm
      with the acrophase shift for the late night hours. A pineal hormone melatonin (1
      and 10 mg/kg, 7 days) administered in combination with imizine attenuated the
      main rhythmic indices of its action and precipitated the occurrence of tolerance.

PMID- 2226752
TI  - [The effect of antidepressants on the experimental anticonvulsant activity and
      acute toxicity of anticonvulsants].
AB  - In the experiments on white mice there was studied the anticonvulsant activity by
      the test of the maximal electric shock and acute toxicity of anticonvulsants and
      antidepressants at separate and combined administration. The combined use of
      anticonvulsants and antidepressants showed the increase of the anticonvulsant
      activity of phenobarbital with amitriptyline, levomepromazine and lithium
      oxybutyrate; diphenine and carbamazepine with amitriptyline as well as hexamidine
      with all antidepressants. The combination of phenobarbital with amitriptyline,
      levomepromazine and lithium oxybutyrate, diphenine with amitriptyline, hexamidine
      with amitriptyline and imizine proved to be the safest.

PMID- 2226753
TI  - [The analgesic activity of coordination compounds of methionine enkephalin with
      divalent metals].
AB  - Coordination compounds of methenkephalin with transition metals: copper, cobalt,
      nickel and zinc were shown to be superior to morphine by the analgesic activity
      and to morphine and methenkephalin by the duration of the analgesic effect. A
      more stable relationship between opiate receptors and copper-containing
      methenkephalin was shown in the experiments on the isolated neuronal membrane.

PMID- 2226754
TI  - [The effect of anti-arrhythmia agents on ventricular arrhythmias arising as a
      consequence of disorders in the myocardial blood supply].
AB  - The protective and therapeutic effects of some antiarrhythmic drugs of classes I
      IV were studied in the experiments on 103 cats and 75 dogs. The antiarrhythmic
      drugs of classes 1a (N-propylaimaline bromide, aimaline, ethacizine), 1b
      (trimecaine) and IV (finoptine) were shown to prevent with various effectiveness
      the occurrence of early occlusion and reperfusion ventricular arrhythmias. The
      antiarrhythmic drugs of classes II (anapriline) and III (cordaron) proved to be
      ineffective in these cases. Ventricular arrhythmia in dogs occurring at the late
      stage of experimental infarction is reliably relieved in all cases with the
      antiarrhythmic drugs of class 1a, in most cases--those of classes 1b and III. The
      antiarrhythmic drugs of classes II and III are ineffective on this model. The
      experimental results analysed with regard to modern concepts of the genesis of
      modelled arrhythmias may be used as the experimental basis for a rational choice
      of antiarrhythmic drugs.

PMID- 2226755
TI  - [The effect on gastric secretion and the anti-ulcer action of imidazo[1,2
      A]benzimidazole derivatives].
AB  - The experiments on rats showed that of 16 studied imidazo [1,2-a]benzimidazole
      derivatives only the compounds with phenyl at the second carbon atom and nitrogen
      containing radical of the ninth nitrogen atom inhibit the gastric acid secretion.
      The binding of oxymethyl group to phenyl, its substitution through adamantyl,
      displacement of nitrogen-containing substitute to the first nitrogen atom or its
      substitution were found to decrease or stop the inhibiting action of these
      substances on the gastric parietal cells. Dihydrochloride 2-phenyl-9 (beta
      diethyl-aminoethyl)imidazo [1,2-a]denzimidazole was more potent than cimetidine
      and omeprazole in inhibiting the gastric acid secretion, pepsin output and
      antiulcer action.

PMID- 2226756
TI  - [The liver-protective properties of D-glucosamine].
AB  - The antioxidant and membrane-stabilizing activities of D-glucosamine were studied
      on two models of toxic liver damage. When administered in a dose of 50 mg/kg, D
      glucosamine was found to prevent the development of the hepatocyte cytolysis
      syndrome, to normalize the cholate- and glycogen-synthetic functions of the
      liver. D-glucosamine exhibited a significant anabolic effect that also
      supplemented its hepatoprotective activity.

PMID- 2226757
TI  - [The effect of cholagogic preparations and Essentiale on the natriuretic hormone
      content of the blood plasma and on kidney function in patients with liver
      pathology].
AB  - The effect of cholagogic drugs on blood plasma content of natriuretic hormone
      (NH) in 41 patients with chronic opisthorchiasis was studied. The drugs were
      found to exert no effect on NH content and the kidney function in this pathology.
      The use of essentiale in patients with persistent hepatitis and cirrhosis of the
      liver was shown to increase sodium excretion due to an increase of NH content.

PMID- 2226758
TI  - [The effect of tefestrol on the secretion of luteinizing hormone from the
      hypophysis].
AB  - The effect of tefestrol on the content of luteinising hormone in blood and
      hypophysis in female and male rats was studied on the basis of the
      radioimmunological assays. It was shown that administration of tefestrol to the
      female rats depending on the preparation dose and the time of administration
      during the estrous cycle can produce an increase and a decrease of luteinising
      hormone content in the material under study. In the male rats tefestrol induced a
      stable elevation of blood gonadotropine level. The results obtained suggest that
      tefestrol may be used as a stimulant of the reproductive function and also as a
      contraceptive depending on the dose and the functional state of the reproductive
      system during the treatment.

PMID- 2226759
TI  - [The content of a heparin-like anticoagulant in the flowers of the meadowsweet
      (Filipendula ulmaria)].
AB  - The flowers of Filipendula ulmaria were found to contain heparin bound to the
      plant proteins in the form of a complex. This complex enhances the anticoagulant
      and fibrinolytic properties of the nonenzymatic nature at its administration to
      animals both intramuscularly and intravenously. The neutralizing effect of
      protaminesulphate on the anticoagulant activity of the plant heparin was shown.
      The identity of the action on the hemostasis system of heparin of animal and
      plant origin was found.

PMID- 2226760
TI  - [The similarity of the pathogenetic mechanisms of alcoholism and drug dependence
      and the means of searching for agents for treating these diseases].
AB  - The concept of the principal unity of the pivotal mechanisms underlying the
      formation of the syndrome of dependence on alcohol and various narcotic agents is
      presented. The central link of the mechanisms is the totality of the specific
      disturbances of neurochemical processes among which of particular importance are
      the specific changes in the functional state of catecholamine system. The
      theoretical approaches to the development of medicinal agents for treating
      alcoholism and drug addictions are considered. As an example there are discussed
      the results of using small doses of dopamine receptor stimulants (apomorphine and
      bromocriptine) and a neuropeptide cholecystokinin.

PMID- 2226761
TI  - [A pharmacological analysis of the cholinergic system in animals with alloxan
      diabetes].
AB  - In the animal experiment the sensitivity to acetylcholine was shown to increase
      in alloxan-induced hypoinsulinemia. The blockade of M-cholinoreactive structure
      produced by administration of amizil caused a deterioration of the condition of
      the animals with alloxan-induced diabetes. The increased sensitivity to
      acetylcholine was accompanied by changes in the activity of acetylcholine
      esterase in the hypothalamus nuclei.

PMID- 2226762
TI  - [An analysis of the structure of the metabolic products of methandrostenolone in
      the body of white rats].
AB  - The products of biotransformation of an anabolic steroidal drug
      methandrostenolone in the Wistar albino rat organism were studied. By using the
      developed methods of HPLC the products of a complete reduction of
      methandrostenolone were isolated and their chemical structures were determined.
      It was found that at the reduction of the system of methandrostenolone double
      bonds were formed all four possible isomers.

PMID- 2226763
TI  - [The effect of x-ray contrast agents on the concentration and size of immune
      complexes in the blood].
AB  - Bilignost, iodamide and triombrast were shown to increase the concentration and
      to decrease the size of the rat blood serum immune complexes in vivo and in
      vitro. A decrease of the size of immune complexes was also observed during
      angiography with the use of triombrast in humans. According to the relation to
      the action of roentgen contrast media on the concentration and size of immune
      complexes humans and rats can be divided in "sensitive" and "tolerant" ones.

PMID- 2226765
TI  - [The effect of dopamine on diuresis in newborn infants with the hypodynamic
      syndrome of pulmonary heart failure].
AB  - The effects of three dosages of dopamine (0.2-3.0, 3.1-8.0, 8.1-22.0 mg/kg/min)
      on diuresis were studied in 28 neonates with cardiopulmonary insufficiency. The
      relationship between the ability of dopamine to increase diuresis and an
      elevation of the lowered arterial blood pressure as well as the degree of acid
      base condition compensation was revealed.

PMID- 2226764
TI  - [The effect of parmidine on the lipid peroxidation processes in coronary
      atherosclerosis].
AB  - During the formation and development of atherosclerosis the intensity of lipid
      peroxidation and the activity of antioxidant defence system significantly change.
      The use of parmidine decreases the contents of primary and secondary products of
      lipid peroxidation, reduces peroxide hemolysis of erythrocytes and increases the
      content of reduced glutathione in erythrocytes of patients with atherosclerosis.
      This shows that parmidine possessing the antioxidant properties stabilizes lipid
      peroxidation processes and normalizes the physiological antioxidant system.

PMID- 2226767
TI  - [Free amino acids of the liver and the characteristics of the amino acid
      metabolism in the liver and brain after cyanamide administration to rats].
AB  - A single administration to rats of cyanamide (60 mg/kg, for 1 hour) was found to
      decrease the contents of cysteate, serine, glutamate, glycine, alanine, valine,
      methionine, isoleucine, tyrosine, ethanolamine, ornithine and histidine that may
      be considered as a manifestation on the drug hepatotoxicity. The activities of
      transaminases, glutamate dehydrogenase, pyruvate dehydrogenase remained
      unchanged. Cyanamide effects were considerably abolished by the supplementary
      ethanol administration (0.5 g/kg). Cyanamide failed to affect vitamin-dependent
      enzymes reflecting thiamine pyrophosphate, pyridoxal phosphate and flavine
      adenine dinucleotide status of the rat organism.

PMID- 2226766
TI  - [The effect of a fluorocarbon emulsion--an enzyme inducer of the cytochrome P-450
      dependent monooxygenase system of the liver--on the acute toxicity of CCl4 and on
      the efficacy of the prophylactic use of antidotes in organophosphate pesticide
      poisoning].
AB  - The effect of intraperitoneal administration of perfluorocarbon emulsion, an
      inducer of cytochrome P-450-dependent monoxygenase system of the liver, on the
      resistance of rodents to the action of CCl4 and organophosphorus pesticides was
      studied. Perfluorocarbon emulsion potentiated CCl4 toxicity decreasing LD50 from
      4.5 to 3.7 mg/kg mouse body weight without changing susceptibility of rats to
      organophosphorus pesticides. A preliminary administration of perfluorocarbon
      emulsion effectively increased the protective action of antidotes (atropine +
      dipyroxime) providing the resistance of the animals to 12-fold, 20-fold and 20
      fold LD50 of dichlophos, methaphos and butiphos, respectively.

PMID- 2226768
TI  - [The antiedematous activity of a table salt substitute, veroshpiron and
      furosemide in experimental circulatory failure].
AB  - On the model of circulatory insufficiency and secondary aldosteronism in rats it
      was shown that a new table salt substitute normalizes like spironolactone the
      extracellular fluid volume whereas furosemide exerts a less marked dehydrating
      action. The antiedema effect of the substitute of table salt is due to a decrease
      in drinking activity, an increase in natriuresis, normalization of aldosteronism.

PMID- 2226769
TI  - [Psychomotor stimulants as agents for enhancing work capacity].
AB  - Amphetamine, methamphetamine, pemoline, sydnocarb and other psychomotor
      stimulants derived from phenylethylamine are referred as the most effective
      agents for an urgent increase of performance. Their positive effect is however
      reduced or even transformed in a nonbeneficial one if the work is of the complex
      nature or is performed under emotional stress, overfatigue, hypoxia, overheating.
      The psychomotor stimulants, in particular amphetamine and methamphetamine, can
      cause attacks of angina pectoris, arrhythmias, an elevation of arterial blood
      pressure, drug addiction, anxiety or aggressive behavior, psychotic reactions.

PMID- 2226770
TI  - [Modern concepts of neurotoxicity].
AB  - A systematic analysis of the main literature published in the recent five years
      which reflects a variety of aspects of research on specifics of the nervous
      system reactions in humans and animals to effects of neurotropic chemical
      products was performed. The further insight into the essence of neurotoxicity
      would contribute to the development of necessary measures for prevention and
      therapy of exogenous neurointoxications.

PMID- 2226771
TI  - [The undesirable action of drugs on the embryo, fetus and newborn infant].
AB  - The up-to-date data on the negative influence of various drugs on the
      intrauterine development and postnatal condition of the human fetus and neonate
      are presented. The embryotoxic, teratogenic and fetotoxic effects of drugs are
      considered. The data on the teratogenic action of drugs taken not only by the
      mother but by the father as well, the behavioral teratology, disturbances in the
      condition of the neonate whose mother received some drugs during labour are
      given.

PMID- 2226772
TI  - [The problems of the experimental and clinical pharmacology of vein-tonicizing
      agents].
AB  - General regularities of changes in the regional venous and systemic hemodynamics
      under the influence of venotropic drugs are considered. Particular emphasis is
      given to problems of pharmacodynamics of venotropic agents. The mechanisms of
      their action, similarity and differences in phlebohemodynamic effects, problems
      of clinical use and also prospects of the further research on pharmacology of
      venotropic agents are discussed.

PMID- 2226773
TI  - Overexpression of glucose transporter modulates insulin biosynthesis in insulin
      producing cell line.
AB  - Glucose transporter (GT) has been suggested to be involved in the insulin
      biosynthesis. However, the functional relationship between GT and insulin
      biosynthesis is not well understood. In this report, we have generated rat
      pancreatic B cell lines (RINr) that stably overexpress a cDNA encoding the brain
      type GT. These cell lines showed 3- to 4-fold increase in insulin mRNA and
      protein. These results suggest that GT might have some relationship to the
      insulin biosynthesis in the pancreatic B cells.

PMID- 2226774
TI  - A single cell observation of staurosporine effect on the Ca2+ signals in rat
      basophilic leukemia cells.
AB  - A digital imaging fluorescence microscope was used to study the effect of a
      protein kinase inhibitor staurosporine on the antigen-dependent calcium signals
      in an individual rat basophilic leukemia cell (RBL-2H3). Although dose dependency
      of staurosporine was different from one cell to another, staurosporine inhibited,
      at low concentration, the calcium influx from the external medium into RBL-2H3
      cells. At high concentration, however, it inhibited both the removal of calcium
      ion from internal stores and the calcium influx from the external medium. These
      results indicated that staurosporine is necessary for the inhibition of the
      calcium influx from the external medium and that a protein kinase (possibly
      protein kinase C) is involved in the calcium influx from the external medium into
      the cytoplasm.

PMID- 2226775
TI  - In vivo and in vitro mutants of FNR the anaerobic transcriptional regulator of E.
      coli.
AB  - FNR regulates the expression of target genes in response to anaerobiosis. It
      resembles the catabolite gene activator or cAMP-receptor protein (CRP) except for
      the presence of an N-terminal cysteine cluster, which may form a redox-sensing
      iron-binding site. Site-directed mutagenesis has shown that 3 of the 4 cysteine
      residues in the N-terminal cluster (Cys-20, -23 and -29, but not Cys-16) and the
      only other cysteine residue (Cys-122), are essential for the normal activation
      and repression of FNR-dependent promoters. Deletion of residues Pro-3-Arg-9
      (inclusive) had no effect, but FNR was inactivated by a frameshift extending
      through the C-terminal DNA-binding domain. Four independent in vivo mutants
      contained identical Gly-96----Asp substitutions, which may inactivate FNR by
      distorting a sharp turn between beta-strands in the predicted structure.

PMID- 2226776
TI  - Revised structure of the peptide lactone antibiotic, TL-119 and/or A-3302-B.
AB  - The peptide lactone antibiotic TL-119 and/or A-3302-B was chemically synthesized
      in order to confirm the proposed structure. The synthetic compound was different
      from both natural TL-119 and A-3302-B in their physicochemical properties and in
      biological activity. Re-examination of the configuration of the constituent amino
      acid residues in natural TL-119 and/or A-3302-B indicated that natural TL-119 and
      A-3302-B contains D-aThr instead of the original L-Thr. We tentatively propose a
      revised structure for TL-119 and/or A-3302-B.

PMID- 2226777
TI  - N-myc suppression and cell cycle arrest at G1 phase by prostaglandins.
AB  - Effects of cyclopentenone prostaglandins, delta 12-prostaglandin (PG) J2 and PGA2
      on the expression of N-myc in relation to the effects on cell cycle progression
      were investigated using human neuroblastoma cell line GOTO. Both PGs suppressed N
      myc expression within several hours prior to inducing G1 arrest. The N-myc
      suppression with delta 12-PGJ2 was continued but with PGA2 it was gradually
      released, followed by the release of G1 arrest. These results suggest that delta
      12-PGJ2 and PGA2 inhibit cell cycle progression in strong association with N-myc
      suppression and delta 12-PGJ2 is more potent and has a longer effect than PGA2.

PMID- 2226778
TI  - Differential regulation of interleukin-6 expression in human fibroblasts by tumor
      necrosis factor-alpha and lymphotoxin.
AB  - The treatment of human diploid fibroblasts with tumor necrosis factor (TNF)-alpha
      and with lymphotoxin (LT) is associated with induction of interleukin-6 (IL-6)
      transcripts with TNF-alpha being 10-fold more potent than LT. Here we report on
      the TNF-alpha/LT-induced signaling mechanisms responsible for the regulation of
      IL-6 gene expression in these cells. Run-on assays demonstrated that both TNF
      alpha and LT increase IL-6 mRNA levels by transcriptional activation of this
      gene. Stability studies of IL-6 transcripts in fibroblasts showed that TNF-alpha
      delayed IL-6 mRNA decay but not LT. The induction of IL-6 transcripts by TNF
      alpha and LT was not inhibited by the isoquinoline sulfonamide derivative H7.
      Similarly, depletion of protein kinase C (PKC) by 12-O-tetradecanoyl-phorbol 13
      acetate (TPA) did not change the ability of TNF-alpha and LT to induce IL-6
      transcripts, demonstrating that stimulation by these agents may not be mediated
      by activation of PKC. Stimulation of IL-6 transcripts in fibroblasts did also not
      require new protein synthesis as exposure to the protein synthesis inhibitor
      cycloheximide (CHX) enhanced accumulation of IL-6 mRNA in the presence or absence
      of TNF-alpha or LT.

PMID- 2226779
TI  - Flight and heat dissipation in birds. A possible molecular mechanism.
AB  - Birds during normal sustained flight must be able to dissipate more than 8 times
      as much heat as during rest in order not to be overheated. The experiments
      reported in this note on the hemoglobin systems from two different birds indicate
      the existence of a molecular mechanism by which hemoglobin is used simultaneously
      for oxygen transport and heat dissipation.

PMID- 2226780
TI  - Clear cell carcinoma of the human ovary synthesizes and secretes a transferrin
      with microheterogeneity of lectin affinity.
AB  - Human ovarian clear cell carcinoma cell line (transferrin (Tf)-non-producer), HAC
      2, cells were adapted to grow in chemically defined synthetic medium when the
      cells were cultured with medium containing 10 micrograms/ml of insulin at least
      for 6 months. They synthesized and secreted constantly the 80 kDa protein
      immunologically similar to human serum Tf (15 +/- 12 ng/ml/10(7) cells/3 days).
      By sensitive lectin-affinity electrophoresis followed by antibody-affinity
      blotting technique, a concanavalin A weakly bound or unbound, lentil lectin, a
      strongly reactive abnormal band, which was rarely found in human serum Tf, was
      detectable in the Tf synthesized by HAC 2 cells (HACTf). These findings suggest
      that the HACTf may act as one of the autocrine growth factors and that this
      heterogeneity of HACTf for lectin affinity is ascribed to differences in the
      carbohydrate moiety of the Tf.

PMID- 2226781
TI  - gamma-Purothionins: amino acid sequence of two polypeptides of a new family of
      thionins from wheat endosperm.
AB  - Two homologous sulfur-rich basic polypeptides form wheat endosperm, so-called
      gamma 1-purothionin and gamma 2-purothionin, are described. Purification involves
      extraction with volatile solvents and ammonium bicarbonate fractionation followed
      by reversed-phase high-performance liquid chromatography. The complete primary
      structure of these two polypeptides has been determined by automatic degradation
      of the intact, S-carboxymethylated gamma-purothionins and peptides obtained by
      enzymatic cleavage. gamma 1-Purothionin and gamma 2-purothionnin consist of 47
      amino acids with an molecular weight of 5239 and 5151 Da, respectively and 8
      cysteines organized in 4 disulfide bridges. They present a high degree of
      homology among themselves (89% of identity) and are the first two thionin-like
      polypeptides, so-called gamma-thionins, described from wheat endosperm.

PMID- 2226782
TI  - Sodium-activated potassium current in mouse diaphragm.
AB  - The mouse diaphragm muscle fiber was studied using the loose patch clamp
      technique. The voltage gated sodium currents were evoked by step pulses from a
      holding potential of about - 70 mV. Following the activation of the sodium
      current, a very large and fast outward current was evoked. The sensitivity of
      this current to 4-aminopyridine and tetraethylammonium indicates the potassium
      ion as the possible carrier for the channel. Furthermore, the sensitivity to
      tetrodotoxin and extracellular sodium demonstrated the sodium dependence of this
      current.

PMID- 2226783
TI  - Amino acid sequence elucidation of human acrosin-trypsin inhibitor (HUSI-II)
      reveals that Kazal-type proteinase inhibitors are structurally related to beta
      subunits of glycoprotein hormones.
AB  - The amino acid sequence of the acrosin-trypsin inhibitor HUSI-II from human
      seminal plasma is presented which unequivocally identifies HUSI-II as being of
      Kazal-type. In addition, the HUSI-II sequence shows a striking similarity to the
      middle part of glycoprotein hormone beta-subunits thus revealing a hitherto
      unknown structural and evolutionary relationship between Kazal-type inhibitors
      and glycoprotein hormones.

PMID- 2226785
TI  - Efficient aminoacylation of a yeast tRNA(Asp) transcript with a 5' extension.
AB  - A yeast aspartic acid tRNA with a 5' extension of 14 nucleotides was obtained by
      in vitro transcription with T7 DNA dependent RNA polymerase. This transcript,
      called extended tRNA(Asp) transcript, retains its aspartylation capacity with the
      same Km and only three times reduced kcat values as compared to those measured
      for canonical tRNA(Asp). This result indicates that the 5' extension of the amino
      acid acceptor stem of tRNA(Asp) does not interfere with recognition by aspartyl
      tRNA synthetase. However, in contrast to the wild-type tRNA(Asp) transcript, the
      5' extended molecule presents a reduced capacity to be mischarged by arginyl-tRNA
      synthetase, suggesting the existence of different structural requirements in
      aspartyl- and arginyl-tRNA synthetases for tRNA(Asp) recognition.

PMID- 2226784
TI  - Characterization of muscarinic acetylcholine receptors on the rat pancreatic
      gastrin-producing cell line B6 RIN.
AB  - The mechanisms of cholinergic stimulation of gastrin cells were studied in the
      rat pancreatic cell line B6 RIN. Carbachol induced an increase in intracellular
      Ca2+ and stimulated gastrin release in a dose-dependent manner over the range 10(
      5)-10(-3) M. These effects were completely abolished by atropine, suggesting the
      implication of muscarinic cholinergic receptors. The binding properties of these
      receptors were investigated. [N-Methyl-3H]scopolamine [( 3H]NMS) binding on cell
      homogenates was time-dependent, saturable and consistent with a single high
      affinity binding class (Kd = 39.5 pM, and Bmax = 7.9 fmol/mg DNA). Carbachol
      competitively inhibited [3H]NMS binding. The potency of inhibition of [3H]NMS
      binding by subtype selective antagonists was hexahydrodifenidol greater than
      pirenzepine greater than AF-DX 116. These results suggest the M3 muscarinic
      receptors may be involved in the carbachol-induced gastrin release from B6 RIN
      cells.

PMID- 2226786
TI  - Purification and site-specific immobilization of genetically engineered glucose
      dehydrogenase on thiopropyl-Sepharose.
AB  - The gene encoding glucose dehydrogenase (EC 1.1.1.47) from Bacillus subtilis was
      inserted in a plasmid 1.0 kb downstream from a lac promoter, resulting in a 70
      fold higher production of the enzyme when expressed in Escherichia coli. A
      glucose dehydrogenase mutant containing a cysteine residue at position 44 could
      also be expressed at the same high level. This single cysteine residue was used
      as an 'affinity tag' to simplify the purification procedure as well as for site
      specific immobilization of glucose dehydrogenase on Thiopropyl-Sepharose. This
      enzyme was purified to homogeneity with a final recovery of 65% and a specific
      activity of 240 U/mg. The oriented immobilization resulted in increased thermal
      stability.

PMID- 2226787
TI  - Methyllycaconitine: a selective probe for neuronal alpha-bungarotoxin binding
      sites.
AB  - The ability of methyllycaconitine (MLA) to inhibit the binding of [125I]alpha
      bungarotoxin to rat brain membranes, frog and human muscle extracts and the human
      muscle cell line TE671 has been measured. MLA showed a markedly higher affinity
      for the rat brain site (Ki 1.4 x 10(-9) M) than for the muscle receptors (Ki 10(
      5)-10(-6) M). Structure modelling techniques were used to fit the structure of
      MLA to a nicotinic pharmacophore model. MLA is the first low molecular weight
      ligand to be shown to discriminate between muscle nicotinic receptors and their
      alpha-bungarotoxin-binding counterpart in the brain, and as such may be a useful
      structural probe for pursuing the structural and functional properties of the
      neuronal protein.

PMID- 2226789
TI  - The functional properties of full length and mutant chicken gizzard smooth muscle
      caldesmon expressed in Escherichia coli.
AB  - Wild type chicken gizzard caldesmon (756 amino acids) was expressed in a T7 RNA
      polymerase-based bacterial expression system at a yield of 1 mg pure caldesmon
      per litre bacterial culture. A mutant composed of amino acids 1-578 was also
      constructed and expressed. The wild type and mutant caldesmon were purified and
      compared with native chicken gizzard caldesmon. Native and wild type expressed
      caldesmon were indistinguishable in assays for inhibition of actin-tropomyosin
      activation of myosin ATPase, reversal of inhibition by Ca2(+)-calmodulin and
      binding to actin, actin-tropomyosin, Ca2(+)-calmodulin, tropomyosin and myosin.
      The mutant missing the C-terminal 178 amino acids had no inhibitory effect and
      did not bind to actin or Ca2(+)-calmodulin. It bound to tropomyosin with a 5-fold
      reduced affinity and to myosin with a greater than 10-fold reduced affinity.

PMID- 2226788
TI  - Adherence of human neutrophils changes Ca2+ signaling during activation with
      opsonized particles.
AB  - Changes in the cytosolic free Ca2+ concentration ([Ca2+]i) upon activation of
      human neutrophils by opsonized particles (serum-treated zymosan; STZ) were
      evaluated by three different methods: (i) measurement of total fluorescence
      changes in indo-1 loaded neutrophils activated in suspension; (ii) measurement of
      fluorescence changes in individual indo-1 loaded neutrophils in a flow cytometer
      and (iii) measurement of fluorescence changes in individual fura-2 loaded
      neutrophils adherent to serum-coated coverslips. Our study shows that the
      opsonized particle-induced change in [Ca2+]i in neutrophils is altered during
      adherence of the cells to a serum-coated surface. These observations might be of
      importance for neutrophil function in vivo, since adherence is a prerequisite for
      diapedesis and chemotaxis.

PMID- 2226790
TI  - Molecular cloning of human cardiac troponin I using polymerase chain reaction.
AB  - We have used the polymerase chain reaction (PCR) to synthesise a cDNA encoding
      part of human cardiac troponin I. Amplification was achieved using fully
      degenerate sets of oligonucleotides corresponding to conserved regions of amino
      acid sequence identified in other troponin I isoforms. The cloned PCR fragment
      was subsequently used to isolate full-length cDNAs from a cardiac cDNA library.
      We describe the approach, as a general cloning strategy starting from limited
      amino-acid sequence data and report the cloning, and complete amino acid sequence
      of human cardiac troponin I. Analysis of human development using these clones
      demonstrates early expression of this gene in the heart.

PMID- 2226791
TI  - Site directed mutagenesis of subunit 8 of yeast mitochondrial ATP synthase.
      Functional and import properties of a series of C-terminally truncated forms.
AB  - The function of the positively charged C-terminal region of mitochondrially
      encoded subunit 8 of yeast mitochondrial ATP synthase was investigated using
      derivatives truncated at each of the 3 positively charged residues (Arg37, Arg42
      and Lys47). Each construct, allotopically expressed in the nucleus, was tested
      for its ability to import and assemble functionally into ATP synthase in yeast
      cells unable to synthesize mitochondrial subunit 8. The efficiency of import of
      each construct into isolated wild-type yeast mitochondria was also determined.
      One construct truncated at the penultimate residue of subunit 8 (Lys47) functions
      in vivo and shows efficient import in vitro. Thus subunit 8 can function with
      only two positively charged residues. The remainder of the subunit 8 variants
      failed to rescue in vivo. Since they all show greatly reduced or undetectable
      import in vitro, presumably because of the increased hydrophobic character of the
      subunit 8 moiety in the chimaeric precursors, the status of these variants as
      regards assembly and function is not clear.

PMID- 2226792
TI  - Rat lactate dehydrogenase A and B subunit concentrations are not regulated by
      mRNA abundance in liver and heart.
AB  - RNA was isolated from rat liver and heart tissues at various times up to 12 weeks
      after birth, and probed on slot blots with lactate dehydrogenase A and B cDNA
      probes. Although the relative abundances of LDH A in liver and LDH B in heart
      increased substantially in the 12 weeks after birth, mRNAs for both isoenzymes
      remained remarkably stable in both tissues over the same period. The implications
      of these observations for the regulation of constitutive gene expression are
      discussed.

PMID- 2226793
TI  - Inhibition of thrombin by synthetic hirudin peptides.
AB  - To investigate the role of different regions of hirudin in the interaction with
      the proteinase thrombin, segments of hirudin containing 15-51 residues were
      synthesized. The C-terminal segment 40-65 inhibited the fibrinogen clotting
      activity of thrombin but not amidolysis of tosyl-Gly-Pro-Arg-p-nitroanilide.
      Central peptide 15-42 was insoluble at pH 7, but peptide 15-65 inhibited
      fibrinogen clotting and amidolysis to an equal extent. The N-terminal loop
      peptide 1-15 had no inhibitory activity and did not affect the potency of peptide
      15-65. These data suggest that the central region inhibits catalysis.

PMID- 2226794
TI  - Analysis of beta-tubulin sequences reveals highly conserved, coordinated amino
      acid substitutions. Evidence that these 'hot spots' are directly involved in the
      conformational change required for dynamic instability.
AB  - Vertebrate beta-tubulins have been classified into six classes on the basis of
      their C-terminal sequences [(1987) J. Cell Biol. 105, 1707-1720]. In particular,
      the sequences starting at residue 430 differ between isotypes of the same animal
      but are conserved between species. We extend this analysis and show that there
      are three 'hot spots', at residues 35, 55-57 and 124 which exhibit intra-species
      heterogeneity but inter-species conservation. There is a remarkable correlation
      between the identity of these residues and the C-terminal sequences, and suggests
      that the vertebrate beta-tubulins fall into three broad types. This correlation
      extends to those non-vertebrate organisms which have the Type 1 C-terminal
      sequence. We propose that these three 'hot spots' and the C-terminal peptide
      interact in the tertiary structure. We have also noted that the C-terminal
      peptide almost always contains a single phenylalanine or tyrosine residue, and
      that there is a strong correlation between this residue and the amino acids at
      positions 217/218, in both the vertebrate and non-vertebrate sequences. We
      propose that the C-terminal aromatic amino acid interacts with residues 217/218
      in the tertiary structure. Analysis of conditions which stabilise microtubules
      and/or lower the steady state critical concentration strongly suggests that these
      two sets of coordinated amino acid substitutions are directly involved in
      effecting the conformational change associated with GTP hydrolysis which results
      in dynamic instability. We propose that there is an interaction between the
      highly acidic sequence between residue 430 and the aromatic amino acid (termed
      peptide A) and conserved basic amino acids located close to the 'hot spots'. We
      suggest that this interaction is altered in response to the assembly-dependent
      GTP hydrolysis, with the consequential increase in the subunit dissociation rate
      constant.

PMID- 2226795
TI  - Cloning and nucleotide sequence of cDNA for retinochrome, retinal photoisomerase
      from the squid retina.
AB  - The Rhodopsin-retinochrome system is essential for the visual photoreception of
      molluscs. cDNA coding for retinochrome of the squid (Todarodes pacificus) was
      cloned and the nucleotide sequence has been determined. The sequence (2.1 kb)
      covers the whole coding region of 903 bp. The deduced primary sequence suggests
      that retinochrome contains seven transmembrane spanning domains. The homology
      with bovine rhodopsin and the possible retinal binding site are also discussed.

PMID- 2226796
TI  - Uni-site ATP synthesis in thylakoids.
AB  - Uni-site ATP synthesis was measured with thylakoids. The membrane-bound ATP
      synthase, CF0F1, was brought into the active, reduced state by illumination in
      the presence of thioredoxin, dithiothreitol and phosphate. This enzyme contains
      two tightly bound ATP per CF0F1. ATP was released from the enzyme when ADP was
      added in substoichiometric amounts during illumination. Experiments with [14C]ADP
      indicated that after binding the same nucleotide was phosphorylated and released
      as [14C]ATP, i.e. only one site is involved in ATP-synthesis ('uni-site ATP
      synthesis'). The two tightly bound ATP are not involved in the catalytic
      turnover. The rate constant for ADP binding was (4 +/- 2) x 10(6) M-1s-1.
      Compared to deenergized conditions the rate constant for ADP binding and that for
      ATP-release were drastically increased, i.e. membrane energization increased the
      rate constants for the ATP-synthesis direction.

PMID- 2226798
TI  - Analysis of the stop codon context in plant nuclear genes.
AB  - A region of 18 nucleotides surrounding the stop codon (the stop codon context) in
      748 plant nuclear genes was analyzed. Non-randomness was found both upstream and
      downstream from the stop codon, suggesting that these sequences may help in
      ensuring efficient termination of translation. The UAG amber codon is the least
      used stop codon and the bias in the nucleotide distribution 5' and 3' to the stop
      codon was more pronounced for the amber codon than for the other stop codons.
      This might indicate that the codon context affects termination more at UAG than
      at UGA or UAA stop codons.

PMID- 2226797
TI  - Carbohydrate structures of a human tissue plasminogen activator variant expressed
      in recombinant Chinese hamster ovary cells.
AB  - The carbohydrate structures of a genetically engineered human tissue plasminogen
      activator variant bearing a single N-glycosylation site at Asn 448 are reported.
      After isolation of the tryptic glycopeptide and liberation of the N-linked
      carbohydrates by polypeptide:N-glycosidase F, 6 major oligosaccharide fractions
      were separated by HPLC on NH2-bonded phase. Their structures were determined by
      compositional and methylation analyses combined with fast atom bombardment mass
      spectrometry. Seventy percent of the carbohydrates were of the biantennary
      complex type with fucose at the proximal GlcNAc and zero, one or two alpha 2-3
      linked NeuAc. The remainder were triantennary structures with one, two or three
      NeuAc.

PMID- 2226799
TI  - Nonthermal 60 Hz sinusoidal magnetic-field exposure enhances 45Ca2+ uptake in rat
      thymocytes: dependence on mitogen activation.
AB  - The effect of a 60 Hz sinusoidal magnetic field of nonthermal intensity on Ca2+
      metabolism in rat thymic lymphocytes (thymocytes) was assessed in resting cells
      and in cells activated with the mitogen Concanavalin A (Con A). A 60 min exposure
      at 37 degrees C to an induced electric field of 1.0 mV/cm produced an average 2.7
      fold increase in Con A-dependent 45Ca2(+)-uptake compared to non-exposed,
      isothermal control cells. In contrast, 45Ca2+ uptake remained unaltered during
      exposure of resting thymocytes. It was also found that thymocytes with a
      diminished ability to mobilize Ca2+ in response to Con A were most sensitive to
      the 60 Hz magnetic field. Although the precise mechanism of field interaction is
      at present unknown, modulation of Ca2+ metabolism during cell activation may
      represent a common pathway for field coupling to cellular systems.

PMID- 2226800
TI  - Membrane lateral pressure as a modulator of glycerol-3-phosphate dehydrogenase
      activity.
AB  - Michaelis-Menten kinetics of glycerol-3-phosphate dehydrogenase activity in
      proteoliposomes from brown adipose tissue mitochondria with exogenously added
      phospholipids or cholesterol was measured. It was shown that changes in membrane
      lipid composition affected the membrane lateral pressure and therefore modulated
      the enzyme activity, namely Vmax value. Contrarily, changes in surface charge
      caused by minute amounts of phosphatidylserine or charged organic substances
      influenced only the apparent Km value. The role of bulk phospholipids in
      regulation of glycerol-3-phosphate dehydrogenase is discussed.

PMID- 2226801
TI  - Primary structure and functional expression from cDNA of the cardiac ryanodine
      receptor/calcium release channel.
AB  - The sequence of 4968 (or 4976 with an insertion) amino acids composing the
      ryanodine receptor from rabbit cardiac sarcoplasmic reticulum has been deduced by
      cloning and sequencing the cDNA. This protein is homologous in amino acid
      sequence and shares characteristic structural features with the skeletal muscle
      ryanodine receptor. Xenopus oocytes injected with mRNA derived from the cardiac
      ryanodine receptor cDNA exhibit Ca2(+)-dependent Cl- current in response to
      caffeine, which indicates the formation of functional calcium release channels.
      RNA blot hybridization analysis with a probe specific for the cardiac ryanodine
      receptor mRNA shows that the stomach and brain contain a hybridizable RNA species
      with a size similar to that of the cardiac mRNA. This result, in conjunction with
      cloning and analysis of partial cDNA sequences, suggests that the brain contains
      a cardiac type of ryanodine receptor mRNA.

PMID- 2226802
TI  - Protective role of CaCl2 against Pb2+ inhibition in Photosystem II.
AB  - The Pb2+ treatment of Photosystem II (PS II) membrane fragments, either intact or
      depleted in 17 and 23 kDa extrinsic polypeptides, inhibits PS II activity. When
      CaCl2 was present in the assay, the Pb2+ inhibition was significantly reduced in
      both types of PS II membranes, suggesting a protective role of CaCl2 against Pb2+
      inhibition. However, in either case, the degree of PS II inhibition by Pb2+ was
      higher in the protein depleted than in intact PS II. It showed that the loss of
      endogenous Ca2+ induced by polypeptide depletion causes the PS II to be more
      susceptible to Pb2+. The interaction of Pb2+ with CaCl2 in protein-depleted PS II
      was competitive. Our results suggest that Pb2+ competes for binding to the Ca2(+)
      and Cl- active sites in the water-splitting complex. Since Pb2+ inhibition of PS
      II activity cannot be reversed by CaCl2 but can be reversed by diphenylcarbazide,
      we conclude that Pb2+ induced inhibition of PS II activity was mediated via the
      water-splitting system.

PMID- 2226803
TI  - The RNA component of RNase P in Schizosaccharomyces species.
AB  - In the fission yeast Schizosaccharomyces pombe, the enzyme RNAse P copurifies
      with two RNAs, K1- and K2-RNA, which are identical except for their termini [1]
      and which are encoded by a single gene [2]. We have undertaken the cloning of the
      K-RNA genes in related organisms in order to gain comparative structural
      information. Because the K-RNA sequence is poorly conserved across species, we
      have cloned the K-RNA genes in the Schizosaccharomyces species S. malidevorans,
      S. japonicus, S. versatilis, and S. octosporus. Of the 4 species, only S.
      octosporus contains a K-RNA gene different from that in S. pombe; the gene
      diverges by 20%. Based on the two sequences, nuclease protection data and
      computer analysis, we have proposed a secondary structure model for the K-RNA.
      Northern analysis shows the K-RNA genes in all four Schizosaccharomyces species
      to be expressed as two RNAs, as in S. pombe.

PMID- 2226804
TI  - Structural features of the McPC603 Fab fragment not defined in the X-ray
      structure.
AB  - The proteolytic Fab fragment of the well characterized antibody McPC603 was
      compared to the recombinant Fab fragment, which was obtained in functional form
      from an Escherichia coli expression system [(1989) Methods Enzymol. 178, 497
      515]. We found evidence that the proteolytic fragment is glycosylated at Asn H160
      in the CH1 domain, where additional electron density had been observed in the
      crystal structure [J. Mol. Biol. 190, 593-604]. In addition, its heavy chain is
      about 30 amino acids longer than visible in the electron density and thus
      contains the complete hinge region. These structural differences between the
      recombinant Fab fragment, which had been designed exactly according to the
      defined electron density, and the proteolytic Fab fragment of McPC603 had no
      effect on the hapten binding properties of these antigen binding fragments. Yet,
      it may be important to be aware of these structural features of McPC603 in
      folding studies and some comparative analyses of antibody structures.

PMID- 2226805
TI  - Reaction mechanism of oxidative rearrangement of flavanone in isoflavone
      biosynthesis.
AB  - Microsomes that were prepared from elicitor-treated Pueraria lobata cell cultures
      catalyzed the conversion of liquiritigenin, a flavanone, into daidzein, an
      isoflavone. The reaction was resolved into two steps. 2, 7, 4'
      Trihydroxyisoflavonone was formed as a major product when liquiritigenin was
      incubated with carefully washed microsomes in the presence of NADPH. The
      structure of 2, 7, 4'-trihydroxyisoflavanone was confirmed by mass and 1H NMR
      spectroscopies. The enzyme responsible for this rearrangement reaction is a
      cytochrome P-450-dependent monooxygenase. Upon treatment with a soluble enzyme
      fraction 2, 7, 4'-trihydroxyisoflavone yielded daidzein quantitatively. The
      incorporation of 18O from 18O2 into the 2-hydroxy group of 2, 7, 4'
      trihydroxyisoflavanone was demonstrated by the shift of molecular ion in its mass
      spectrum. Based on these observations a new reaction mechanism, hydroxylation
      associated with 1,2-migration, is proposed for the oxidative rearrangement
      reaction catalyzed by the cytochrome P-450 enzyme of Pueraria lobata.

PMID- 2226806
TI  - High-affinity binding of a synthetic heptaglucoside and fungal glucan phytoalexin
      elicitors to soybean membranes.
AB  - Soybean membranes possess high-affinity binding sites for fungal beta-glucans
      that elicit phytoalexin synthesis. The ability of 1,3-1,6-beta-glucans, released
      by acid hydrolysis from mycelial walls of Phytophthora megasperma f.sp. glycinea,
      to compete for the putative phytoalexin elicitor receptors increases with their
      average degree of polymerization (DP). The results suggest a function where the
      probability for glucan fragments of containing a structural determinant that is
      optimal for binding approaches 1 as the DP tends to infinity. Ligand displacement
      data obtained against a 125I-labeled glucan elicitor (average DP = 18) provided a
      theoretical minimum IC50 (50% inhibitory concentration) for 1,3-1,6-beta-glucans
      of 3 nM. The IC50 value obtained for a synthetic hepta-beta-glucoside having a
      known elicitor-active structure was 8 nM, remarkably close to the predicted
      value. Displacement of the 125I-glucan of large DP was uniform and complete
      showing that the heptaglucoside had access, with similar affinity, to all sites
      available to the radioligand. Further analysis using a 125I-labeled
      aminophenethylamine derivative of the heptaglucoside suggested that the putative
      glucan-elicitor receptors bind a basic structural determinant present in all
      elicitor-active glucans from the soybean pathogen P. megasperma.

PMID- 2226807
TI  - Newly identified type of beta actin reduces invasiveness of mouse B16-melanoma.
AB  - Low metastatic parent B16 melanoma and isolated B16-F1 cell lines have a third
      actin designated as beta m(Ax:previously). beta m actin is scantily or not at all
      detected in highly metastatic cell lines, such as B16-F10 and BL6. To directly
      assess the physiological role of beta m in phenotypic changes of B16 melanoma, we
      transfected expression plasmids of beta m into B16-F10 cells. The actin expressed
      in the transfectants is located largely in cytoskeletal fractions. The
      transfectants exhibited a larger number of stress fibers and a lower invasiveness
      than did the recipient cells. Thus, beta m actin plays an important role in the
      organization of actin stress fibers, the result being a decrease in invasiveness
      of B16 melanoma.

PMID- 2226808
TI  - Prenyltransferase compartmentation in cells of Vitis vinifera cultivated in
      vitro.
AB  - Two prenyltransferases were located in cell cultures of Vitis vinifera. A geranyl
      pyrophosphate synthase (EC 2.5.1.1) was associated with plastid-like membranes
      whereas a farnesyl pyrophosphate synthase (EC 2.5.1.10) was found to be soluble.

PMID- 2226809
TI  - A stereospecific enzyme of the putative biosynthetic pathway of cardenolides.
      Characterization of a progesterone 5 beta-reductase from leaves of Digitalis
      purpurea L.
AB  - Leaves of Digitalis purpurea contain an enzyme activity which catalyzes the
      conversion of progesterone to 5 beta-pregnane-3,20-dione. Since cardenolides
      without exception possess a 5 beta-configuration, 5 beta-pregnane-3,20-dione can
      serve as a precursor for this class of secondary metabolites. It is assumed that
      the enzyme is part of the putative biosynthetic pathway of cardenolides. This
      enzyme activity was spotted in the soluble fraction of a crude homogenate.
      Product formation was detected by gas chromatography and by gas
      chromatography/mass spectroscopy (g.c./m.s.). The enzyme had a pH optimum at 8.0
      and an apparent Km value of 6 microM for progesterone. It required NADPH as a co
      substrate with an apparent Km value of 22 microM. The optimum temperature in
      vitro was 30 degrees C. The activity was not dependent on monovalent and bivalent
      cations.

PMID- 2226811
TI  - Characterization of the virA gene of the agropine-type plasmid pRiA4 of
      Agrobacterium rhizogenes.
AB  - We sequenced a 4.2-kb DNA region encompassing the vir A locus of the hairy-root
      inducing plasmid pRiA4, and compared its sequence with the published vir A region
      sequences of four tumor-inducing plasmids. An open reading frame capable of
      coding for 829 amino acids was identified for vir A. Deletion mutants of vir A
      constructed by fusing to lacZ, but not the wild-type game itself, were
      efficiently expressed in Escherichia coli when they were put downstream front the
      lac promoter. These fused gene products became soluble or insoluble depending on
      the length of their lacZ moieties.

PMID- 2226810
TI  - Function of the conserved triad residues in the class C beta-lactamase from
      Citrobacter freundii GN346.
AB  - The conserved KTG triad in the class C beta-lactamase from Citrobacter freundii
      GN346 was examined as to its function by means of site-directed mutagenesis. The
      following conversions were performed; Lys-315 to arginine, alanine or glutamic
      acid, Thr-316 to valine, and Gly-317 to alanine, proline or isoleucine. The
      resultant mutant enzymes revealed that a basic amino acid at position 315 and a
      small uncharged residue at position 317 are essential for the enzyme activity,
      but a hydroxyl group at residue 316 is not required for the enzymatic catalysis.
      The kinetic properties of the purified Arg-315 and Val-316 enzymes provided
      information on the function of these residues.

PMID- 2226812
TI  - Possible mechanism of nuclear translocation of proteasomes.
AB  - Proteasomes (multicatalytic proteinase complexes), which are identical to the
      ubiquitous eukaryotic 20S particles, are localized in both the cytoplasm and the
      nucleus, but the mechanism of their co-localization in the two compartments is
      unknown. On examination of the primary structures of subunits of proteasomes, a
      consensus sequence for nuclear translocation of proteins, X-X-K-K(R)-X-K(R)
      (where X is any residue), was found to be present in some subunits and to be
      highly conserved in the subunits of a wide range of eukaryotes. In addition,
      proteasomal subunits were found to bear a cluster of acidic amino acid residues
      and also a potential tyrosine phosphorylation site that was located in the same
      polypeptide chain as the nuclear location signal. These structural properties
      suggest that two sets of clusters with positive and negative charges serve to
      regulate the translocation of proteasomes from the cytoplasm to the nucleus, and
      that phosphorylation of tyrosine in certain subunits may play an additional role
      in transfer of proteasomes into the nucleus.

PMID- 2226813
TI  - The primary structure of rat ribosomal protein S7.
AB  - The amino acid sequence of the rat 40S ribosomal subunit protein S7 was deduced
      from the sequence of nucleotides in two recombinant cDNAs and confirmed from the
      amino acid sequence of a cyanogen bromide peptide obtained from the protein.
      Ribosomal protein S7 has 194 amino acids and has a molecular mass of 22,113.
      Hybridization of the cDNA to digest of nuclear DNA suggests that there are 14-16
      copies of the S7 gene. The mRNA for the protein is about 725 nucleotides in
      length. Rat S7 is homologous with Xenopus laevis S8. The protein contains a
      possible internal duplication of 10 residues.

PMID- 2226814
TI  - Multiple mechanisms of protein kinase C inhibition by triphenylacrylonitrile
      antiestrogens.
AB  - The activation of type I (gamma), II (beta) and III (alpha) protein kinase C
      (PKC) subspecies by phosphatidylserine (PS) and diacylglycerol (DAG) is inhibited
      by micromolar concentrations of triphenylacrylonitrile (TPE) antiestrogens. TPE A
      (with p-hydroxy and p-diethylaminoethoxy groups on the 3- and 3'-phenyl rings,
      respectively) interacts with PS-vesicles as well as with the regulatory domain of
      PKC, probably at a site different from the Ca2+ and DAG binding sites. The
      interaction of TPE A with the regulatory domain of enzyme is very slow.
      Apparently, TPE A does not interact with the catalytic domain of PKC. In
      contrast, another TPE derivative, TPE B (with a p-hydroxy group on each of the
      three phenyl rings) inhibits the enzyme activity in a competitive manner with
      respect to ATP, suggesting that this TPE interacts with the catalytically active
      site of the enzyme. It seems likely that various TPE antiestrogen derivatives may
      exert their inhibitory action on PKC by multiple different mechanisms.

PMID- 2226815
TI  - Transcriptional and post-transcriptional suppression of P450IIC11 and P450IIC12
      by inflammation.
AB  - Induction of inflammation in rats by treatment with endotoxin or turpentine is
      known to suppress levels of hepatic mRNAs for P450IIC11 and P450IIC12. We report
      that transcription of CYP2C12 in female rats is not significantly reduced from
      control levels; suppression of this gene during inflammation appears to be
      mediated post-transcriptionally. In contrast, transcription of CYP2C11 in male
      rats is reduced to 23% and to 5% of control levels by turpentine and by
      endotoxin, respectively. Sex-specificity of CYP2C11 expression is also regulated
      transcriptionally, whereas sex-specificity of CYP2C12 expression appears to be
      regulated by a post-transcriptional mechanism.

PMID- 2226816
TI  - Purification and characterization of a tartrate-sensitive acid phosphatase of
      Trypanosoma brucei.
AB  - In search for invariant surface proteins in Trypanosoma brucei bloodstream forms,
      acid phosphatase was investigated. Earlier work had shown that part of the
      cellular phosphatase activity is associated with the flagellar pocket of the
      parasite. It is demonstrated that T. brucei contains at least two membrane-bound
      enzymes, one is sensitive to the inhibitor L-(+)-tartrate while the other is
      resistant. The tartrate-sensitive phosphatase was purified to homogeneity by
      monoclonal antibody affinity chromatography and shown to be a glycoprotein of low
      abundance (13,000 molecules/cell). It has an apparent molecular weight of 70,000
      Da. The usefulness of acid phosphatase as a marker for characterizing the
      membrane lining the flagellar pocket is discussed.

PMID- 2226818
TI  - Hydrodynamic data show that C1- inhibitor of complement forms compact complexes
      with C1-r and C1-s.
AB  - The C1- inhibitor of the complement cascade forms stoichiometric complexes with
      C1-r and C1-s and controls the activation of first component C1 of complement.
      Literature sedimentation coefficients s degrees 20,w for the complexes formed
      between C1- inhibitor, C1-r and C1-s were analysed using frictional ratios and
      the hydrodynamic sphere approach. A head-and-tail two-domain model for C1-
      inhibitor was combined with cylindrical hydrodynamic models for the six-domain
      structures of C1-r and C1-s. The hydrodynamic data show that the heavily
      glycosylated N-terminal domain of C1- inhibitor is positioned close to the two
      complement 'short consensus repeat' domains found in the centre of C1-r and C1-s.

PMID- 2226817
TI  - Synthetic sialyl glycolipids (sialo-cholesterol and sialo-diglyceride) induce
      granulocytic differentiation of human myelogenous leukemia cell line HL-60.
AB  - When HL-60 cells were cultivated with synthetic sialyl glycolipids, sialo
      cholesterol and sialo-diglyceride, the cells were found to be differentiated into
      mature granulocytes on morphological and functional criteria. The differentiation
      of cells was accompanied by inhibition of cell proliferation. The differentiation
      inducing activity of sialo-cholesterol was greater than that of sialo-diglyceride
      on a molar basis, and the alpha-anomer of each compound was more potent than the
      beta-anomer, suggesting that the stereospecific structure of the compounds is
      important for the differentiation-inducing activity.

PMID- 2226819
TI  - Could domain movements be involved in the mechanism of trypsin-like serine
      proteases?
AB  - It is hypothesised that the characteristic twin domain structure of serine
      proteases permits important allosteric responses in the molecule when peptide and
      protein substrates bind. Such movement would be ideal for stressing the scissile
      bond in the substrate, thereby making the task of hydrolysis substantially
      easier. The control of the domain movement can be closely associated with
      substrate binding, via the N- and C-terminal regions of the enzyme. The
      hypothesis also suggests that certain inhibitory peptides exert their effect by
      binding without inducing the domain movement.

PMID- 2226820
TI  - The N intermediate of bacteriorhodopsin at low temperatures: stabilization and
      photoconversion.
AB  - In aqueous suspensions of purple membranes (pH 10.2, 0.4 M KCl) an intermediate
      having an absorption maximum at 570-575 nm (at -196 degrees C) was produced by
      first heating the M intermediate up to -30 degrees C and then stabilizing it by
      subsequent cooling to -60 degrees C. We suggest that this species is the
      intermediate N (or P or R) found and characterized earlier near room temperature.
      Upon illumination at -196 degrees C N is transformed into a bathochromically
      absorbing species KN which has an absorption maximum near 605 nm and an
      extinction 1.35 times that of N. This light reaction is photoreversible. The
      quantum yield ratio for the forward and back reaction is 0.18 +/- 0.02. The
      maximum photo steady state concentration of KN is about 0.24. The N intermediate
      was also trapped in water suspensions of purple membranes at neutral pH and low
      salt concentration by illumination at lambda greater than 620 nm during cooling.
      In addition to N another intermediate absorbing in the red (maximum at 610-620
      nm) was accumulated in smaller amounts. It is not photoactive at -196 degrees C
      and apparently is the O intermediate or a photoproduct of N.

PMID- 2226821
TI  - Conformational changes in human fibrinogen after in vitro phosphorylation and
      their relation to fibrinogen behaviour.
AB  - The far-ultraviolet circular dichroism spectra of fibrinogens phosphorylated by
      protein kinase C or casein kinase II indicated a conformational change
      corresponding to an increase in ordered secondary structure. The spectra of
      protein kinase A- or casein kinase I-phosphorylated fibrinogens did not differ
      substantially from the control. Fluorescence studies indicated changes in the
      tertiary structure around tryptophan residues for protein kinase A- or C
      phosphorylated fibrinogens, but failed to show any such change for fibrinogen
      phosphorylated by either of the casein kinases. This latter result was also
      confirmed by circular dichroism measurements in the near-ultraviolet region. The
      apparent increase in ordered structure was proposed as an explanation for the
      slower rate of plasmin degradation seen in fibrinogens after phosphorylation by
      protein kinase C [6], and casein kinase II, especially as both spectral changes
      and plasmin degradation rate were unaffected by alkaline phosphatase.

PMID- 2226822
TI  - Synthesis of a trihexacontapeptide corresponding to the sequence 8-70 of eglin c
      and studies on the relationship between the structure and the inhibitory activity
      against human leukocyte elastase, cathepsin G and alpha-chymotrypsin.
AB  - A trihexacontapeptide corresponding to the sequence 8-70 of eglin c and its
      related peptides were synthesized by the conventional solution method and their
      inhibitory activity against human leukocyte elastase, cathepsin G and alpha
      chymotrypsin was examined. Although synthetic eglin c (41-49) inhibited cathepsin
      G and alpha-chymotrypsin (Ki = 4.0 x 10(-5) M and 2.0 x 10(-5) M, respectively)
      but not leukocyte elastase, the synthetic trihexacontapeptide potently inhibited
      cathepsin G, alpha-chymotrypsin and leukocyte elastase (Ki = 1.8 x 10(-9) M, 1.4
      x 10(-9) M and 2.2 x 10(-9) M, respectively). The relationship between the
      structure of eglin c and the inhibitory activity against the above enzymes is
      also described.

PMID- 2226823
TI  - Luminol enhanced chemiluminescence of the perfused rat heart during ischemia and
      reperfusion.
AB  - We show that the production of Luminol reactive oxygen radicals in the perfused
      rat heart under ischemia and reperfusion can be monitored continuously by
      measuring the chemiluminescence of Luminol-perfused hearts. Luminol did not
      affect the monitored physiological parameters of the hearts. Chemiluminescence
      increased during ischemia and reperfusion. Superoxide dismutase treatment of the
      heart before ischemia, but not catalase, abolished these increases.

PMID- 2226824
TI  - The primary structure of iodopsin, a chicken red-sensitive cone pigment.
AB  - A purified iodopsin was digested by CNBr or several proteolytic enzymes into
      fragments, the amino acid sequences of which were determined. A partial sequence
      of the C-terminal fragment was utilized for synthesizing an oligonucleotide probe
      which identified the iodopsin cDNA (1339 bases). The deduced amino acid sequence
      (362 residues) had 80%, 42%, or 43% homology to that of human red-sensitive cone
      pigment, cattle or chicken rhodospin, respectively. Although the hydropathy
      profile implies that iodopsin, like rhodopsin, has 7 transmembrane alpha-helical
      segments, iodopsin may have a hydrophilic pocket near the seventh segment on the
      basis of the unexpected cleavages in the middle of the segment VII by
      chymotrypsin under nondenaturing conditions.

PMID- 2226825
TI  - The actin gelling activity of chicken gizzard alpha-actinin at physiological
      temperature is triggered by water sequestration.
AB  - At 37 degrees C, in the presence of 6% (w/v) polyethylene glycol 6000, 30 nM
      alpha-actinin from chicken gizzard induces the gelation of 12 microM actin.
      Static measurement shows that the addition of 30 nM alpha-actinin increases the
      rigidity of the system from 23.5 to 54 dynes/cm2. According to the theory of
      osmoelastic coupling, also large additives, such as the proteins of the cell sap,
      are able to cause an osmotic stress equivalent to that caused by polyethylene
      glycol. We thus conclude that, in vivo, alpha-actinin acts as an actin gelling
      protein.

PMID- 2226826
TI  - Heterogeneity of metabolic response to muscular exercise in humans. New criteria
      of invariance defined by in vivo phosphorus-31 NMR spectroscopy.
AB  - 31P NMR spectroscopy at 4.7 T has been used in vivo to follow metabolic changes
      associated with exercise and subsequent recovery in the forearm flexor digitorum
      superficialis muscle of 14 healthy volunteers. The muscle content in
      phosphomonoesters at rest provides an index of glycogenolytic activity.
      Quantitative linear correlations have been shown to link end-of-exercise acidosis
      to recovery kinetics of phosphocreatine and phosphocreatine/organic phosphate
      ratio. These linear relationships constitute new metabolic invariants to be used
      in the study of myopathies and muscle adaptation to exercise.

PMID- 2226827
TI  - Spin-spin relaxation of the phosphodiester resonance in the 31P NMR spectrum of
      human brain. The determination of the concentrations of phosphodiester
      components.
AB  - The phosphodiester peak in 31P nuclear magnetic resonance spectra of human brain
      in vivo is often the most prominent feature of the spectrum. We have demonstrated
      that this resonance exhibits bi-exponential spin-spin relaxation, giving
      relaxation times of 2 and 10 ms. We interpret this in terms of the two components
      which make up the peak, bilayer lipids and the small cytosolic phosphates
      glycerophosphoethanolamine and glycerophosphocholine. Using the relaxation times
      and the relative peak heights of the two components we have also been able to
      quantitate the concentration of the bilayer lipids as 20-40 times that of ATP.

PMID- 2226829
TI  - Transient versus steady state NOE in paramagnetic molecules Cu2Co2SOD as an
      example.
AB  - Truncated, steady state and transient NOE experiments have been performed on
      bovine Cu2Co2 superoxide dismutase. The effectiveness of the different NOE
      experiments in the general case of paramagnetic macromolecules is discussed. It
      is concluded that steady state NOEs give superior results. The validity of the
      two spins approximation is discussed, and NOE values for a fully coupled set of
      nuclei have been calculated. Transient NOE experiments, when properly performed,
      confirm the previous assignment of the hyperfine shifted signals in Cu2Co2SOD
      based on steady state NOE measurements [(1989) Inorg. Chem. 28, 4650] and
      eliminate any further reason for controversy on an important issue as the
      assignment of the 1H NMR signals of protons of metal-coordinated imidazoles.

PMID- 2226828
TI  - Hoogsteen versus Watson-Crick A-T basepairing in DNA complexes of a new group of
      'quinomycin-like' antibiotics.
AB  - The interaction of a new group of 'quinomycin-like' antibiotics with the DNA
      duplexes d(ACGT)2 and d(GACGTC)2 has been investigated in solution by 1H NMR
      spectroscopy. By monitoring the intensity of intranucleotide base H6/H8 to
      deoxyribose H1'NOE cross-peaks we conclude that the terminal A-T basepairs
      flanking the CG bisintercalation site in the d(ACGT)2 complex adopt the Hoogsteen
      bonding scheme, with the purine base in a syn conformation. By comparison in the
      d(GACGTC)2 complex all glycosidic bond angles are anti, consistent with a
      preferred Watson-Crick basepairing scheme. Both DNA duplexes appear to be
      significantly unwound compared with the ligand-free DNAs. The data illustrate the
      influence of helical constraints on the stability of the Hoogsteen bonding scheme
      adjacent to the drug binding sites.

PMID- 2226830
TI  - Highly selective affinity labeling of the primer-binding site of E. coli DNA
      polymerase I.
AB  - Highly selective affinity labeling of the primer site of E. coli DNA polymerase I
      was performed with the 5'-reactive derivatives of oligothymidylate in the
      presence of poly(dA) template. Subtilysine cleavage proved that the site of
      affinity modification belonged to the 'Klenow' part of DNA polymerase I. If taken
      separately, Klenow fragment was not labeled by these oligonucleotide derivatives.
      The site of affinity labeling were tested in the structure of DNA polymerase I by
      hydroxylamine cleavage. At least two sites of labeling were revealed. The main
      one was localized between Gly-833 and His-928.

PMID- 2226831
TI  - Carboxyatractylate-sensitive uncoupling in liver mitochondria from ground
      squirrels during hibernation and arousal.
AB  - Energy coupling parameters of liver mitochondria from hibernating and arousing
      ground squirrels have been studied. In the oligomycin-treated mitochondria,
      carboxyatractylate, an inhibitor of the ATP/ADP-antiporter, is shown to decrease
      the respiration rate, to increase the membrane potential and to lower the rate of
      the membrane-potential discharge after the addition of cyanide to liver
      mitochondria from hibernating and arousing animals. BSA effectively substitutes
      for carboxyactactylate so that carboxyactactylate, added after BSA, has no
      effect. In mitochondria from hibernating animals, the maximal respiration rate in
      the presence of DNP and the rate of the membrane potential discharge in its
      absence are much lower than in those from arousing animals. It has been concluded
      that upon arousal of the animals from hibernation, the uncoupling of oxidative
      phosphorylation, mediated by free fatty acids and ATP/ADP-antiporter, parallels
      the respiratory chain activation.

PMID- 2226833
TI  - The primary structure of superoxide dismutase purified from anaerobically
      maintained Bacteroides gingivalis.
AB  - The superoxide dismutase (SOD) of Bacteroides gingivalis can use either iron or
      manganese as a cofactor in its catalytic activity. In this study, the complete
      amino acid sequence of this SOD purified from anaerobically maintained B.
      gingivalis cells was determined. The proteins consisted of 191 amino acid
      residues and had a molecular mass of 21,500. The sequence of B. gingivalis SOD
      showed 44-51% homology with those for iron-specific SODs (Fe-SODs) and 40-45%
      homology with manganese-specific SODs (Mn-SODs) from several bacteria. However,
      this sequence homology was considerably less than that seen among the Fe-SOD (65
      74%) or Mn-SOD family (42-60%). This indicates that B. gingivalis SOD, which
      accepts either iron or manganese as metal cofactor, is a structural intermediate
      between the Fe-SOD and Mn-SOD families.

PMID- 2226832
TI  - Amino acid sequence of CAP37, a human neutrophil granule-derived antibacterial
      and monocyte-specific chemotactic glycoprotein structurally similar to neutrophil
      elastase.
AB  - We report the amino acid sequence of CAP37, a human neutrophil granule protein
      with antibacterial and monocyte-specific chemotactic activity. CAP37 is a single
      chain protein consisting of 222 amino acid residues. It has three N-glycosylation
      sites, at Asn residues 100, 114 and 145. Some species of CAP37 are glycosylated
      at all three sites; some at Asn-114 alone, others at Asn-114 and Asn-110 or Asn
      145. CAP37 has 45% sequence identity to human neutrophil elastase, and 30-37%
      identity to several other granule serine proteinases. Despite these similarities,
      CAP37 is not a serine proteinase because the active site residues serine and
      histidine are replaced.

PMID- 2226834
TI  - Characterization of the beta-chain N-terminus heterogeneity and the alpha-chain C
      terminus of human platelet GPIIb. Posttranslational cleavage sites.
AB  - Human platelet glycoprotein IIb (GPIIb) and IIIa (GPIIIa) form a Ca2(+)-dependent
      heterodimer, the integrin GPIIb/IIIa, which functions as the fibrinogen receptor
      at the surface of activated platelets. GPIIB and GPIIIa are synthesized as single
      polypeptides from single messages and their amino acid sequences were derived
      from their cDNAs. The GPIIb precursor is proteolytically processed to yield the
      known disulphide-bonded two-chain (GPIIb alpha and GPIIb beta) covalent structure
      found in mature GPIIb. Our present protein chemical and mass spectrometric
      analyses indicate that the GPIIb precursor is proteolytically cleaved at two or
      three sites, to give rise to an homogeneous alpha-chain (GPIIb 1-856) single
      disulphide-bonded to one of the two beta-chains, which are present in a nearly
      1:1 ratio: GPIIb beta 1 (860-1008), with pyroglutamic acid as its blocked N
      terminal residue: and GPIIb beta 2 (872-1008), with the already known N-terminal
      sequence. These results satisfy the previously observed electrophoretic size
      residue: and GPIIb beta 2 (872-1008), with the already known N-terminal sequence.
      These results satisfy the previously observed electrophoretic size-heterogeneity
      of the beta-chain, confirmed the potential cleavage sites in the junction region,
      and indicate a probable dual proteolytic processing of GPIIb, which may be
      relevant to the rest of the two-chain alpha-subunits of the integrin family.

PMID- 2226835
TI  - Importance of the G27-A43 mismatch at the anticodon stem of Escherichia coli
      tRNA(Thr2).
AB  - The tRNA(Thr2) isoacceptor of E. coli has a G-A mismatch at positions 27-43. When
      the anticodon of this tRNA was converted to an amber anticodon (CUA), this tRNA
      showed suppressor activity in E. coli. Moreover, introduction of the base pair (G
      C or U-A) at positions 27-43 of this suppressor tRNA reduced its suppressor
      activity. These results indicate that the G27-A43 mismatch is necessary for full
      function of tRNA(Thr2).

PMID- 2226836
TI  - The carboxyl terminus heptapeptide of the R2 subunit of mammalian ribonucleotide
      reductase inhibits enzyme activity and can be used to purify the R1 subunit.
AB  - The heptapeptide, FTLDADF, identical in sequence to the last seven amino acid
      residues of the carboxyl terminus of the R2 subunit of mouse ribonucleotide
      reductase (RR), and its N alpha-acetyl derivative both inhibit calf thymus RR.
      The N alpha-acetyl derivative is considerably more potent, displaying a K1 of 20
      microM. The same K1 was found for N-AcFTLDADF inhibition of a reconstituted
      ribonucleotide reductase from calf thymus R1 and mouse R2, indicating that the C
      termini of calf R2 and mouse R2 might be identical. Our results, taken together
      with previous results of others on inhibition of viral RR, suggest that
      inhibition of RRs by peptides mimicking the C-terminus of R2 may be a general
      phenomenon. In addition, we have shown that an affinity column, FTLDADF-Sepharose
      4B, can be used to prepare approximately 95% pure calf thymus R1, devoid of
      contamination with R2, in a very simple procedure that should be generally
      applicable to R1 purification from many sources.

PMID- 2226837
TI  - Isolation and characterization of human reg protein produced in Saccharomyces
      cerevisiae.
AB  - reg was originally identified as a gene expressed during the regeneration of
      insulin-producing pancreatic beta-cells of the rat. We built an expression vector
      containing human reg cDNA to drive Saccharomyces cerevisiae to synthesize the reg
      protein, and purified it from the culture medium. The 144-amino acid sequence of
      the recombinant protein was consistent with that deduced from the cDNA and
      genomic DNA sequence except that the signal sequence of 22 amino acids was
      eliminated, and the amino-terminal residue of the protein was pyroglutamic acid.
      The secondary structure of the reg protein was predicted by determination of the
      intramolecular cystine linkage and of alpha-helix and beta-sheet contents.

PMID- 2226839
TI  - Depression of prothymosin alpha production in murine thymus correlates with
      staphylococcal enterotoxin-B-induced immunosuppression [corrected].
AB  - Prothymosin alpha [corrected] (ProT alpha) and thymosin beta 4 [corrected] (T
      beta 4) were isolated from murine thymus and characterized by microsequence
      analysis. Murine T beta 4 has an identical sequence to bovine T beta 4, whereas
      murine ProT alpha is highly homologous to rat Pro T alpha. Murine Pro T alpha
      differs from rat Pro T alpha at two positions, Glu100 and Asp108 of the rat
      sequence are substituted by aspartic and glutamic acid, respectively, in murine
      Pro T alpha. The amount of Pro T alpha in murine thymus was found to be reduced
      after in vivo treatment with staphylococcal enterotoxin B [corrected] (SEB), a
      superantigen which stimulates T cells bearing specific V beta receptors. Results
      from the anti-SRBC (sheep erythrocyte) plaque-forming cell assay showed that the
      antibody response of the spleen cells from these animals was also suppressed. On
      the other hand, the amount of T beta 4 was not changed significantly. Our studies
      suggest that the suppression of SEB on antibody response correlates with the
      depression of Pro T alpha production in the thymus.

PMID- 2226838
TI  - Biosynthesis of cyclic 2,3-diphosphoglycerate. Isolation and characterization of
      2-phosphoglycerate kinase and cyclic 2,3-diphosphoglycerate synthetase from
      Methanothermus fervidus.
AB  - Starting from 2-phosphoglycerate the biosynthesis of cDPG comprises two steps:
      (i) the phosphorylation of 2-phosphoglycerate to 2,3-diphosphoglycerate and (ii)
      the intramolecular cyclization to cyclic 2,3-diphosphoglycerate. The involved
      enzymes, 2-phosphoglycerate kinase and cyclic 2,3-diphosphoglycerate synthetase,
      were purified form Methanothermus fervidus. Their molecular and catalytic
      properties were characterized.

PMID- 2226841
TI  - Primary structure of NADP-dependent malic enzyme in the dicotyledonous C4 plant
      Flaveria trinervia.
AB  - The primary structure of NADP-dependent malic enzyme (NADP-ME) of the
      dicotyledonous C4 plant Flaveria trinervia was determined from sequence analysis
      of a cDNA clone containing the complete coding region. Comparison of the mature
      F. trinervia NADP-ME with the maize enzyme reveals extensive sequence similarity.
      In contrast, no significant similarity can be detected between the putative
      transit peptides of the two enzymes. This suggests that the corresponding parts
      of the genes arose independently from each other during evolution of mono- and
      dicotyledonous C4 plants.

PMID- 2226842
TI  - Molecular cloning, nucleotide sequence and expression of the gene encoding prepro
      polygalacturonaseII of Aspergillus niger.
AB  - PolygalacturonaseII of Aspergillus niger was fragmented using CNBr and the NH2
      terminal fragment and another fragment were partially sequenced. The
      polygalacturonaseII (pgaII) gene was then isolated by using an oligonucleotide
      mixture based on the internal amino acid sequence as a probe. The nucleotide
      sequence of the pgaII structural gene was determined. It was found that
      polygalacturonaseII is synthesized as a precursor having an NH2-terminal prepro
      sequence of 27 amino acids. The cloned gene was used to construct
      polygalacturonaseII over-producing A. niger strains. PolygalacturonaseII was
      isolated from one such strain and was determined to be correctly processed and to
      be fully active.

PMID- 2226840
TI  - The predicted molecular structure suggests that CTF/NF-I may function as a
      histone acetylase.
AB  - The primary structure of nuclear factor-I (CTF/NF-I), a eukaryotic regulatory DNA
      binding protein involved in both DNA replication and gene transcription, and the
      secondary structure predictable from it, are compared here with those of a number
      of prokaryotic acetylases. Hydropathy and Chou-Fasman analyses reveal that the
      polypeptide chain of CTF/NF-I is likely to fold to higher order structures
      similar to those of the acetylases, and significant conservation of functionally
      important regions of the acetylases is observed in CTF/NF-I. It is therefore
      suggested that CTF/NF-I may function as a histone acetylase.

PMID- 2226843
TI  - Synergy between zinc and phorbol ester in translocation of protein kinase C to
      cytoskeleton.
AB  - Protein kinase C was measured in the cytoskeletal fraction of lymphocytes,
      platelets and HL60 cells, by specific binding of [3H]phorbol dibutyrate and by
      immunoblotting with antibody to a consensus sequence in the regulatory domain of
      alpha-, beta- and gamma-isozymes of protein kinase C. Treatment of cells for 40
      min with a combination of zinc (2-50 microM), zinc ionophore pyrithione and
      unlabelled phorbol dibutyrate (200 nM) caused up to a ten-fold increase in
      cytoskeletal protein kinase C and a corresponding decrease in other cellular
      compartments. Omission of any of the reagents resulted in much less or no
      translocation. These effects were inhibited by 1,10-phenanthroline, which
      chelates zinc, and were not seen with calcium. Increase in cytoskeletal protein
      kinase C persisted for several hours and appeared to involve attachment of the
      enzyme to actin microfilaments. We propose that zinc, like calcium, regulates the
      distribution of PKC in cells. However, unlike calcium which controls the binding
      of PKC to the lipid component on cell membranes, zinc controls the distribution
      of PKC to membrane cytoskeleton, possibly actin.

PMID- 2226844
TI  - ATP binding site of mitochondrial creatine kinase. Affinity labelling of Asp-335
      with C1RATP.
AB  - The ATP binding site of mitochondrial creatine kinase from chicken heart has been
      studied by modifying the purified enzyme with a 14C-labelled ATP analogue,
      C1RATP, in which the reactive label was covalently bound to the gamma-phosphate
      group of ATP. The modified enzyme was digested by pepsin, and a single
      radioactive nonapeptide was isolated by HPLC. Amino acid analysis and direct
      sequence determination revealed that the isolated peptide corresponds to amino
      acids 335-343 within the C-terminal region of Mi-CK, this peptide being highly
      preserved throughout evolution. Asp-335 is very likely the site of modification
      by C1RATP. The specificity of the ATP analogue for the active site of creatine
      kinase was demonstrated by the inhibition of the enzymatic activity of Mi-CK by
      C1RATP and by the prevention of this inhibition bij ADP.

PMID- 2226845
TI  - Depurination of plant ribosomes by pokeweed antiviral protein.
AB  - Mammalian ribosomes have been shown to be enzymatically modified by ribosomal
      inactivating protein (RIPs) via specific depurination of rRNA. Here we report
      that ribosomes isolated from wheat germ contain intact and undepurinated rRNA and
      are depurinated by pokeweed antiviral protein (PAP). Pokeweed ribosomes isolated
      under the same conditions are depurinated. Total RNA isolated from pokeweed in
      the presence of strong denaturants was found to pbe partially depurinated. We
      conclude that wheat germ ribosomes are resistant to the endogenous RIP, tritin,
      but are sensitive to PAP and that pokeweed ribosomes can be depurinated by the N
      glycosidase activity of endogenous PAP during isolation.

PMID- 2226846
TI  - A one-variable topographical descriptor for the beta-turns of peptides and
      proteins.
AB  - The beta-turn is a common secondary structure in biologically active peptides and
      globular proteins, where it is widely thought to serve as a molecular recognition
      site for many biological processes. Although the primary beta-turn recognition
      requirements are thought to be straightforward, relating mainly to the relative
      positions of the peptide sidechains, current classifications of beta-turns are
      complex and are based solely upon the very variable geometry of the peptide
      backbone. We demonstrate here that beta-turns can be described in terms of a
      single dihedral angle, which we have called beta, which provides a complete
      description of the spatial relationship between the entry and exit peptide bonds
      as well as the relative orientations of the intervening sidechains for any beta
      turn. This description should prove particularly useful in the development and
      application of novel peptide mimetic drugs, compounds for which a classification
      based on a peptide backbone geometry may be entirely irrelevant.

PMID- 2226847
TI  - Isolation of allophycocyanin B from Rhodella violacea results in a model of the
      core from hemidiscoidal phycobilisomes of rhodophyceae.
AB  - Two 'trimeric' allophycocyanin complexes could be isolated from the hemidiscoidal
      phycobilisomes of Rhodella violacea. AP = (alpha *AP alpha 2AP beta 2AP beta *AP)
      and APB = (alpha *AP alpha AP alpha APB beta 2AP beta *AP). Lc13.5APB. The
      isolation was performed by combined methods of gradient centrifugation,
      hydroxylapatite chromatography and 'native' polyacrylamide gel electrophoresis.
      AP showed the well-known spectral characteristics of allophycocyanin without
      linker polypeptide. APB is characterized by its long wavelength absorbing
      shoulder (675 nm) and fluorescence emission (682 nm), respectively. The existence
      of two low molecular linker polypeptides Lc12.5 and Lc13.5APB in the
      phycobilisomes of Rhodella violacea, their stoichiometric calculations and the
      localization of Lc13.5APB in allophycocyanin B facilitated the construction of a
      model of the phycobilisome core.

PMID- 2226848
TI  - A new protein inhibitor of trypsin and activated Hageman factor from pumpkin
      (Cucurbita maxima) seeds.
AB  - A protein inhibitor (CMTI-V; Mr 7106) of trypsin and activated Hageman factor
      (Factor XIIa), a serine protease involved in blood coagulation, has been isolated
      for the first time from pumpkin (Cucurbita maxima) seeds by means of trypsin
      affinity chromatography and reverse phase high performance liquid chromatography
      (HPLC). The dissociation constants of the inhibitor complexes with trypsin and
      Factor XIIa have been determined to be 1.6 x 10(-8) and 4.1 x 10(-8) M,
      respectively. The primary structure of CMTI-V is reported. The protein has 68
      amino acid residues and one disulfide bridge and shows a high level of sequence
      homology to the Potato I inhibitor family. Furthermore, its amino terminus
      consists of an N-acetylates Ser. The reactive site has been established to be the
      peptide bond between Lys44-Asp45. The modified inhibitor which has the reactive
      site peptide bond hydrolyzed inhibits trypsin but not the Hageman factor.

PMID- 2226849
TI  - The primary structure of a triple-helical domain of collagen type VIII from
      bovine Descemet's membrane.
AB  - We have isolated and sequenced a fragment of 469 amino acid residues from bovine
      type VIII collagen. The sequence was composed of a series of Gly-X-Y repeats
      which was interrupted 8 times by short imperfections. The number and relative
      location of these interruptions were similar to those of chicken alpha 1(X) and
      rabbit alpha 1(VIII) chain triple-helical domains. Comparison to published N
      terminal sequences to two triple-helical fragments of bovine type VIII collagen
      and to the cDNA derived sequence of the rabbit alpha 1(VIII) chain showed that
      this fragment was the triple-helical domain of a second type VIII collagen chain
      which we designate alpha 2(VIII).

PMID- 2226850
TI  - Codon reading properties of an unmodified transfer RNA.
AB  - We have previously shown that the Mycoplasma mycoides glycine tRNA (anticodon
      UCC) effectively reads the codons GGU and GGC in violation of the classic codon
      reading rules. We have attempted to elucidate what structural elements in this
      tRNA molecule confer this translational property and in the course of this
      investigation T7 RNA polymerase transcription of the corresponding gene was used
      to produce a tRNA devoid of modified nucleosides. Using an in vitro translation
      system the ability of this tRNA to read the 4 glycine codons (GGU, GGC, and GGG)
      was tested and it was shown to be as efficient as its normal, fully modified
      counterpart in the reading of all four codons. This result demonstrates that a
      tRNA devoid of modified nucleosides is able to efficiently sustain protein
      synthesis in vitro and, furthermore, that the normal modification pattern of the
      Mycoplasma glycine tRNA is not essential for the ability of this tRNA to read the
      glycine codons GGU and GGC effectively.

PMID- 2226851
TI  - Glucose-stimulated efflux of indo-1 from pancreatic beta-cells is reduced by
      probenecid.
AB  - Indo-1 loaded pancreatic beta-cells, isolated from obese hyperglycaemic mice,
      were studied with respect to cytoplasmic free Ca2+ concentration ([Ca2+]i),
      efflux of indicator and insulin release. In the absence of glucose there was a
      continuous efflux of indo-1 which increased upon stimulation with 20 mM of the
      sugar. The anion exchange inhibitor probenecid reduced both basal efflux of indo
      1 and prevented that promoted by glucose. Measurements of [Ca2+]i and insulin
      release revealed similar results as previously reported with quin-2 and fura-2.
      Furthermore, probenecid did not influence the [Ca2+]i responses. It is thus
      possible to reduce efflux of indo-1 probenecid and thereby improve the
      measurements of [Ca2+]i in pancreatic beta-cells.

PMID- 2226852
TI  - Heme-CO as a probe of the conformational state of calmodulin.
AB  - The interaction of heme-CO with calmodulin, in the presence of calcium, leads to
      a complex of four heme-CO molecules per protein. No interaction was observed in
      the absence of calcium. The binding of heme-CO to calmodulin was monitored by the
      shift in the Soret absorption band from 407 to 420 nm (bound form); the four
      sites are not spectrally identical. The ligand CO can be photodissociated from
      the calmodulin-heme-CO complex and the biomolecular recombination kinetics also
      indicate a heterogeneous mixture. The complex does not bind oxygen reversibly. As
      calmodulin has only one histidine, the hemes are apparently not bound by the iron
      atom as in hemoglobin, but are probably loosely associated (Kd = 0.5 microM) in
      hydrophobic pockets which apparently open when the protein is activated by
      calcium.

PMID- 2226853
TI  - A genomic clone encoding a cryptophyte phycoerythrin alpha-subunit. Evidence for
      three alpha-subunits and an N-terminal membrane transit sequence.
AB  - A genomic library of Chroomonas (Cryptophyceae) DNA has been constructed in
      lambda EMBL4. Using a synthetic oligomer as a hybridization probe, a clone
      containing a phycoerythrin alpha-subunit has been obtained and sequenced. The
      principal alpha 1- and alpha 2-subunits of the holoprotein have been partially
      sequenced by sequential Edman degradation and differ from the DNA derived
      sequence, providing evidence for at least 3 alpha-subunit genes. The nucleotide
      sequence of the alpha-subunit gene is GC rich and encodes an N-terminal extension
      which is putatively thylakoid-lumen directing.

PMID- 2226855
TI  - Influence of the aminoacyl-tRNA synthetase inhibitors and the diadenosine-5'
      tetraphosphate phosphonate analogues on the catalysis of diadenosyl
      oligophosphates formation.
AB  - Well-known aminoacyl-tRNA synthetase (ARSase) inhibitors, namely the analogues of
      amino acids and aminoacyl adenylates (aminoalkyl- and aminophosphonyl adenylates
      with Ki congruent to 0.1 microM) as well as the diadenosine 5',5'''-p1,p4
      tetraphosphate (Ap4A) phosphonoanalogues, were for the first time used for the
      Ap4A biosynthesis regulation. Effects of a set of such compounds on lysyl-,
      phenylalanyl- and alanyl-tRNA synthetases from E. coli, capable of synthesizing
      Ap4A in the presence of Zn2+ ions and pyrophosphatase, have been studied. The
      adenylate analogues were found to inhibit the Ap4A and Ap3A formation (I50
      congruent to 6 mM). Aminophosphonic and aminophosphonous acids are not involved
      in Ap3A and Ap4A biosynthesis and inhibited it at high concentrations. The Ap4A
      phosphoanalogues slightly inhibited the major reactions of ARSases, as well as
      the biosynthesis of Ap3A and Ap4A, at a concentration of 5 mM.

PMID- 2226854
TI  - Gene structure of mouse cathepsin B.
AB  - The structure of a genomic DNA fragment encoding mouse cathepsin B was
      characterized. The genomic insert spans 15 kbp and contains 9 exons encoding the
      339 amino acid residues of mouse preprocathepsin B. Intron break-points are not
      found at the junctions of the pre-peptide, pro-peptide and mature enzyme. Like
      other cysteine proteinase genes, the region around the cysteinyl active site is
      split by an intron, but in contrast with cathepsins L and H the intron break
      point is located immediately after the active site.

PMID- 2226856
TI  - A comparative study of ribosomal and DNA binding protein II from two thermophilic
      bacteria, Bacillus caldolyticus strain EP 00275 and Bacillus stearothermophilus.
AB  - Ribosomal and DNA binding proteins (DNA bp II) from an extreme thermophilic
      bacterium, B. caldolyticus strain EP 00275, were investigated for stability and
      crystallization and compared to the homologous proteins from B.
      stearothermophilus. Two-dimensional gel electrophoresis of both types of
      proteins, the amino acid composition and the sequences of some of the peptides of
      DNA bp II revealed a close relationship between each other. The physico-chemical
      characteristics of DNA bp II were similar but different from homologous proteins
      from T. thermophilus and C. pasteurineum. From our results we conclude: B.
      stearothermophilus and B. caldolyticus strain EP 00275 are similar organisms with
      regard to their ribosomal and DNA binding proteins.

PMID- 2226857
TI  - Enhanced expression of group II phospholipase A2 gene in the tissues of endotoxin
      shock rats and its suppression by glucocorticoid.
AB  - We studied the regulation of group II phospholipase A2 (PLA2-II) gene in vivo,
      using endotoxin shock rat as a model for systemic inflammation. Administration of
      endotoxin into rats increased PLA2 activity in the plasma, as described by Vadas
      and Hay, using endotoxin-challenged rabbit. Specific absorption of this activity
      by anti-PLA2-II antibody indicated that the released PLA2 was PLA2-II. The levels
      of PLA2-II mRNA were elevated in the aorta, spleen, lung, and thymus but not in
      the liver and kidney. The tissues with high PLA2-II mRNA contents released a
      greater amount of PLA2-II than the tissues of control rats. These results suggest
      that in endotoxin shock rats, PLA2-II is synthesized de novo in the above tissues
      and released into circulation. Furthermore, our present study demonstrates that
      glucocorticoid suppresses the enhanced expression of the PLA2-II gene in the
      tissues of endotoxin shock rats.

PMID- 2226858
TI  - GTP gamma S inhibits early c-myc protein accumulation but not DNA synthesis in
      Swiss 3T3 fibroblasts.
AB  - Quiescent Swiss 3T3 fibroblasts stimulated with epidermal growth factor and
      insulin showed large transient increases in c-myc mRNA and c-myc protein
      accumulation which were maximal at about 2 h after addition of the co-mitogens.
      When the cells were loaded with 0.1 mM of guanosine 5'-O-(3-thiotriphosphate)
      (GTP gamma S) by transient permeabilisation immediately before mitogenic
      stimulation, the increase in c-myc mRNA was similar to that observed in unloaded
      cells but the corresponding c-myc protein peak was reduced by at least 95%. The
      GTP gamma S completely blocked incorporation of [35S]methionine into cell
      proteins for 3-4 h after addition of the mitogens, but not thereafter, and caused
      a delay in the subsequent onset of DNA synthesis by the same period. The data
      show that less than 5% of the early increase in c-myc protein normally observed
      after mitogenic stimulation is required for its obligatory role in the
      progression of cells to S phase implied by other evidence.

PMID- 2226859
TI  - D1-D2 complex of the photosystem II reaction center from spinach. Isolation and
      partial characterization.
AB  - A pigment-protein complex consisting of D1 and D2 proteins, but depleted in the
      two lower molecular mass components of photosystem II, i.e. cytochrome b-559 and
      psbI gene product, has been isolated by octyl-beta-D-glucopyranoside treatment of
      the purified photosystem II reaction center complex from spinach [(1987) Proc.
      Natl. Acad. Sci. USA 84, 109-112], followed by separation by high performance
      liquid chromatography using a gel-permeation column (TSK G3000 SW). The isolated
      complex is photochemically active in the photoreduction of intrinsic pheophytin a
      under steady-state illumination, in the presence of dithionite and methyl
      viologen, and exhibits pigment stoichiometries similar to those in the untreated
      reaction center, indicating that the D1-D2 complex provides the site of primary
      photochemistry in photosystem II, as well as the principal binding sites of
      pigments in the reaction center.

PMID- 2226860
TI  - Purification and characterization of mouse DNA polymerase alpha devoid of primase
      activity.
AB  - A simple method was developed for the isolation of primase-free DNA polymerase
      alpha from the DNA polymerase-alpha-primase complex of mouse FM3A cells. The
      polymerase was separated from primase subunits by chromatography on a single
      stranded DNA-cellulose column in the presence of 50% etylene glycol. The primase
      free DNA polymerase-alpha contained two polypeptides with molecular masses of
      180,000 and 68,000. Analysis of the DNA products with poly(dA)-oligo(dT)10 as
      template-primer revealed that both primase-free DNA polymerase-alpha and the DNA
      polymerase-alpha-primase complex predominantly synthesized short DNA with less
      than 30 nucleotides, but that the DNA polymerase-alpha-primase complex also
      synthesized some longer DNA with more than 300-400 nucleotides.

PMID- 2226861
TI  - Identification of phosphopeptides by mass spectrometry.
AB  - Phosphopeptides can be identified by ion spray mass spectrometry. The method was
      tested with phosphokemptide and with a proteolytic digest of one subunit (delta
      subunit) of the nicotinic acetylcholine receptor. In the latter one peptide
      containing tyrosine phosphate, one with two serine phosphates, and two different
      peptides each containing one serine phosphate were unambiguously identified. Thus
      it is proven that ion spray mass spectrometry can be applied for the localization
      of phosphorylation sites in a known primary structure.

PMID- 2226862
TI  - The domain organization of the plant thylakoid membrane.
AB  - A model of the photosynthetic membrane from higher plants is presented. The
      different photosystems, PSI alpha, PSI beta, PSII alpha and PSII beta, are
      located in separate domains. The photosystems with the largest antenna systems,
      the alpha systems, are in the grana and the other in the stroma lamellae. In each
      grana disc PSI alpha is located in a flat annulus surrounding a circular PSII
      alpha domain. In this the PSII alpha units with the largest antennae are found in
      the center. The model is consistent with results from recent membrane
      fractionation experiments.

PMID- 2226863
TI  - A common motif of two adjacent phosphoserines in bovine, rabbit and human cardiac
      troponin I.
AB  - From rabbit and human cardiac troponin I N-terminal mono and bisphosphorylated
      peptides were isolated which were obtained from Lys-C proteinase digests. Two
      adjacent phosphoserine residues could be localized in each phosphopeptide
      following further tryptic digestion. The previously published sequence of rabbit
      cardiac troponin I had to be corrected. Two adjacent phosphoserine residues are a
      common motif in the very similar sequences of bovine, rabbit and human cardiac
      troponin I. The N-terminal sequences are: AcADRSGGSTAG DTVPAPPPVR
      RRS(P)S(P)ANYRAY ATEPHAK (bovine), AcADESTDA-AG EARPAPAPVR RRS(P)S(P)ANYRAY
      ATEPHAK (rabbit), (Ac,A,D/N,G,S,S,D/N,A,A,R) EPRPAPAPIR RRS(P)S(P)-NYRAY ATEPHAK
      (human).

PMID- 2226864
TI  - Time-resolved fluorescence studies on mutants of the dihydrolipoyl transacetylase
      (E2) component of the pyruvate dehydrogenase complex from Azotobacter vinelandii.
AB  - Fluorescence anisotropy decays were measured for the wild-type dihydrolipoyl
      transacetylase (E2) component of pyruvate dehydrogenase complex from Azotobacter
      vinelandii and E. coli and for E2-mutants from A. vinelandii in which the alanine
      proline-rich sequence between the binding domain and the catalytic domain is
      partially or completely deleted. In both E2-mutants the rotational mobility of
      the lipoyl domain and the overall activity after reconstitution of the complex
      are significantly decreased indicating the important role of the deleted sequence
      for the movement of the lipoyl domain and the transfer of substrates between the
      different active sites within the complex.

PMID- 2226865
TI  - The primary structure of DNA binding protein II from the extreme thermophilic
      bacterium Thermus thermophilus.
AB  - The primary structure of DNA binding protein II (DNA bp II) from the extreme
      thermophilic bacterium Thermus thermophilus has been established by combination
      of manual and automated techniques. The protein has 95 residues and a molecular
      mass of 11,843. Comparison of the primary structure with the known sequence data
      of DNA bp II from Clostridium pasteurineum, Baccillus stearothermophilus,
      Escherichia coli, Rhizobium meliloti, Anabena, Thermoplasma acidophilum,
      Pseudomonas aeruginosa and Bacillus caldolyticus reveals a clear homology among
      these small basic proteins. In particular, two short sequences in the middle and
      C-terminal part of the proteins (residues N-Gly-Phe-Gly-X-Phe and Pro-X-Thr at
      positions 46-51 and 63-65, respectively) are completely conserved.

PMID- 2226866
TI  - Transforming growth factor beta and a mesoderm inducing factor from human blood
      platelets are different proteins.

PMID- 2226867
TI  - A CD study of interactions of ellipticine derivatives with DNA. Relations with
      the in vitro cytotoxicity.
AB  - UV-absorption and circular dichroism (CD) experiments showed that ellipticine
      derivatives may interact with DNA according to 3 possible binding modes depending
      on their structure and concentration. The first mode concerned intercalation of 1
      methyl-9-hydroxyellipticine (1-Me-HE) with its long axis perpendicular to the
      long axis of base pairs. The same drug was able to bind to external sites (second
      mode) once the intercalation sites were saturated at high concentration. The
      third mode illustrated by 1,2-dimethyl-9-hydroxyisoellipticinium (1-Me-isoNMHE),
      concerned self-stacked molecules interacting at the surface of DNA. Biological
      significance of these different binding modes was then discussed in connection
      with in vitro cytotoxic activity of compounds.

PMID- 2226868
TI  - Partial hepatectomy and mediators of inflammation decrease the expression of
      liver alpha 2-HS glycoprotein gene in rats.
AB  - Liver mRNA levels of two acute phase reactant (APR) proteins, alpha 2-HS
      glycoprotein (a major negative APR) and alpha 1-acid glycoprotein (a major
      positive APR) were measured in male rats at different times after the
      administration of turpentine, of tumor necrosis factor, or following partial
      hepatectomy. In every case, a marked decrease in mRNA levels of alpha 2-HS
      glycoprotein was observed which reached a maximum at 24 h. A concomitant increase
      of alpha 1-acid glycoprotein mRNA levels was observed under the same conditions.
      These results indicate that the decreased levels of alpha 2-HS glycoprotein
      induced by the acute-phase response following inflammatory mediators and partial
      hepatectomy are due to a down-regulation of the gene expression of this protein
      in rat liver.

PMID- 2226869
TI  - Biosynthesis of bisbenzylisoquinoline alkaloids in cultured roots of Stephania
      cepharantha.
AB  - Cultured roots of Stephania cepharantha, which are rich sources of
      bisbenzylisoquinoline alkaloids, were fed 14C-labelled tyrosine, tyramine or
      dopamine. While tyrosine was well incorporated into the bisbenzylisoquinolines,
      tyramine and dopamine were poorly incorporated. Incorporated tyrosine was shown
      to be decarboxylated and stored as tyramine in the roots, then gradually
      converted to the bisbenzylisoquinolines. Tracer experiments using [3-13C]tyrosine
      demonstrated that tyrosine was specifically incorporated into the corresponding
      sites of aromoline, which verified that aromoline was composed of four molecules
      of tyrosine. The ratio of 13C-enrichments of C-4 and C-alpha in (R) and (S)
      halves of aromoline was the same within experimental limits. This indicated that
      the two coclaurine units must have one and the same biogenetic origin.

PMID- 2226870
TI  - Long term culture of rat soleus muscle in vitro. Its effects on glucose
      utilization and insulin sensitivity.
AB  - Rat soleus muscle strips cultured for 24 h in medium 199 were well preserved in
      terms of electron microscopy; ATP and creatine phosphate concentrations; rates of
      glucose utilization, glycogen and protein synthesis, and effects of insulin
      thereon. Culture led to modest changes in fluid spaces and intracellular (K+);
      increased basal glucose utilization up to two-fold; had no effect on the maximum
      response to insulin; and had no effect on sensitivity to insulin except in the
      presence of adenosine deaminase. Thus in vitro neither denervation nor absence of
      insulin had any marked effects in 24 h to decrease responses to insulin.

PMID- 2226871
TI  - The three carboxy-terminal amino acids of human interleukin-6 are essential for
      its biological activity.
AB  - We have constructed on the cDNA level deletion mutants of human interleukin-6
      lacking one, two, three or four amino acids from the carboxy-terminus of the
      molecule. After in vitro transcription and translation the biological activity of
      these deletion mutants was determined by two independent bioassays. Both, the
      mouse B9 cell proliferation assay and the fibrinogen induction assay with the
      human hepatoma cell line HepG2 led to the following result: already the removal
      of the last amino acid resulted in a five-fold loss of biological activity. An
      additional slight reduction was seen when two amino acids were removed from the
      carboxy-terminus. Interleukin-6 lacking three or four C-terminal amino acids were
      completely inactive. The presented results emphasize the extreme importance of
      the carboxy-terminus of interleukin-6 for its biological function.

PMID- 2226872
TI  - Generation of human endothelin by cathepsin E.
AB  - Highly-purified cathepsin D processed human big endothelin1-38 into endothelin
      like fragments but did not appear to generate endothelin1-21 under the conditions
      employed. By contrast, human cathepsin E specifically cleaved human big
      endothelin into endothelin1-21 and the C-terminal fragment under identical
      conditions but did not degrade either product further.

PMID- 2226873
TI  - Duplex scanning: the second sight of the vascular surgeon.

PMID- 2226874
TI  - Non-surgical treatment of critical limb ischaemia.

PMID- 2226876
TI  - Intra-operative arteriography in arterial embolectomy.
AB  - In a retrospective study, 154 embolectomies in 135 patients with acute arterial
      occlusion were reviewed and the value of intraoperative arteriography studied.
      Included in the study were 69 embolectomies of the femoro-popliteal artery in 64
      patients, and in 40 (58%) intra-operative arteriography was performed. Of these,
      20 were done because of difficulty in passing the Fogarty catheter and/or absent
      backflow and 20 as a routine procedure where there was easy passage of the
      catheter and good backflow. In 29 embolectomies (42%) intra-operative
      arteriography was not performed because some surgeons, doubting the benefit of
      routine arteriography, did not use it. In 23 cases (58%) intra-operative
      arteriography led to an extension of the operation. Six out of 20 routine
      arteriograms (30%) showed incomplete clearance of the arterial tree, resulting in
      further embolectomy. The amputation rate was 17%, however in the group where
      routine arteriography was performed it was zero and significantly less than in
      the non-arteriogram group (23%). The use of intra-operative arteriography in
      arterial embolectomy surgery is recommended.

PMID- 2226875
TI  - The natural history of small abdominal aortic aneurysms: an ultrasound study.
AB  - A retrospective study was undertaken to assess whether, using serial ultrasound
      examinations, the behaviour of small abdominal aortic aneurysms could be
      predicted. The average increase in size was found to be 0.3 cm/year. The pattern
      of increase in size was not affected by age, sex or the presence of hypertension.
      A proposed course of management of patients with small aneurysms is suggested,
      particularly if they have other significant medical problems.

PMID- 2226877
TI  - Real-time B-mode ultrasonography in the diagnosis of postoperative deep vein
      thrombosis in non-symptomatic high-risk patients. The Venous Thrombosis Group.
AB  - In a prospective study of 61 patients who were undergoing elective total hip
      replacement, the accuracy of real-time B-mode ultrasonography (B-US) in the
      diagnosis of postoperative deep vein thrombosis (DVT) was compared with blindly
      assessed bilateral ascending phlebography. The overall sensitivity and
      specificity of ultrasound was 71 and 94%, and the positive and negative
      predictive values were 77 and 92%, respectively. The sensitivity and specificity
      for diagnosis of proximal DVT was 73 and 96%, respectively. Thrombi smaller than
      1 cm were not detected. It is concluded that B-US may be used as a screening test
      for postoperative DVT after elective hip surgery.

PMID- 2226878
TI  - Results of surgical treatment for atherosclerotic renovascular occlusive disease.
AB  - In this study we retrospectively examined the results of surgery for
      atherosclerotic renal artery lesions and analysed the factors that may affect
      postoperative blood pressure response, changes in renal function and late
      mortality. A total of 326 patients were operated on over a 15 year period and
      were followed up for periods from 4 to 165 months (mean follow-up time: 37.2
      months). An extra renal vascular area was also involved in 91.4% of cases and in
      187 (57.3%) a significant involvement of both renal arteries was found and
      simultaneously treated. Combined revascularisation of other arteries was
      performed in 50.3% of patients. The indications for surgery were the treatment of
      extreme hypertension in 243 patients (74.5%), the improvement of renal function
      in 45 with renal insufficiency, and preservation of the kidney in 38 (11.7%). The
      preferred method of reconstruction was transaortic endarterectomy (236 cases,
      i.e. 72.4%) and postoperative angiography demonstrated a normal patent renal
      artery in 319 of 338 studied renal arteries (94.4%). There were no deaths in the
      early postoperative period after isolated renal artery reconstruction. Of the 164
      patients with simultaneous renal and aortic reconstruction however 14 died during
      the early postoperative phase. The overall early mortality was thus 4.3% (14 out
      of 326 patients) and correlated significantly with the extent of the
      atherosclerotic disease, the age of the patients, the operative technique used
      and the different intra- and postoperative management during the two different
      periods of our experience (1974-1980 v. 1981-1989).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2226879
TI  - Long-term results of venous thrombectomy combined with a temporary arterio-venous
      fistula.
AB  - Forty-one patients with acute iliofemoral venous thrombosis were randomised to
      conventional anticoagulation or acute thrombectomy combined with a temporary
      arterio-venous fistula (AVF) and anti-coagulation. Follow-up after 5 years in 22
      medical and 19 surgical patients revealed slightly more asymptomatic patients (37
      vs. 18%) and less frequent severe post-thrombotic sequelae (16 vs. 27%) in the
      surgical group (N.S.). The iliac vein was more frequently (P less than 0.05)
      normal following thrombectomy (71 vs. 30%) as demonstrated by radionuclide
      angiography, but occlusion plethysmography showed an outflow capacity (61 vs. 45
      ml/min/100 ml) that was not significantly better. There was no obvious difference
      in muscle pump function (EVrel) and reflux (Q/EVrel) assessed by foot volumetry.
      Still, the ambulatory venous pressure was significantly (P less than 0.05) lower
      in the surgical group. There was a tendency towards better results following
      thrombectomy in patients with fresh thrombosis and a successful initial
      procedure. Although the numbers of observations in many cases were too small to
      provide statistical evidence of benefit with venous thrombectomy + AVF, this
      procedure seems to improve the long-term outcome following acute iliofemoral
      venous thrombosis. Since the difference in outcome is not very striking,
      anticoagulation treatment is still an acceptable alternative.

PMID- 2226880
TI  - Vein marking through ultrasound coupling gel.
AB  - It is now common practice to mark the course of the long saphenous vein by duplex
      scanning prior to in situ or reversed vein bypass grafting. This poses the
      problem of how best to mark its course durably in the presence of the ultrasound
      coupling gel on the skin. Blind to two observers, 11 commonly available marking
      pens were applied to the skin through ultrasound coupling gel, the gel was
      removed and the skin cleaned using a spirit-based antiseptic solution. The
      observers then rated the pens in order of performance. We recommend "Pilot Super
      Color Marker", "Artline 70" and "Edding 3020 Surgical Skin Marker" for
      preoperative vein mapping. These pens allow rapid marking of the saphenous or
      other veins through ultrasound coupling gel at the time of duplex scanning, and
      the marks persist after surgical preparation of the skin.

PMID- 2226881
TI  - The "isolated" popliteal segment: a comparative evaluation of its vascular
      resistance.
AB  - During femoro-popliteal and femoro-distal bypass, measurement of vascular
      resistance (VR) at the site of graft outflow may be used to quantify "run off".
      Intra-operative measurements were made in 51 lower limbs to compare VR in
      different categories of outflow; the "isolated" popliteal segment (IPS group, n =
      11), the popliteal artery in continuity with patent vessels to the pedal arch
      (PIC group, n = 26) and the single calf vessel (SCV group, n = 14). VR was
      measured both before and after intra-arterial papaverine. The values in the 37
      popliteal arteries were correlated with two different methods of arteriographic
      scoring. Vascular resistance in the IPS group (median 1149 mPRU, P = 0.003) but
      not significantly different from VR in the SCV group (median 1014 mPRU, range 743
      1541 mPRU). VR in the SCV group was significantly greater than that in the PIC
      group (P = 0.006). After papaverine administration, the same relationships were
      observed between the IPS, PIC and SCV groups. Both before and after papaverine,
      VR in the popliteal artery correlated significantly with both arteriographic
      scores. In terms of VR, the isolated popliteal segment provides an outflow
      comparable to that of a single calf artery but less favourable than a popliteal
      artery wtih patent run off.

PMID- 2226882
TI  - Survival in patients with abdominal aortic aneurysms. Comparison between
      operative and nonoperative management.
AB  - This study evaluates the risk benefit relationship in the surgical treatment of
      abdominal aortic aneurysm (AAA). Two hundred and thirteen patients with AAA
      diagnosed by CT were selectively managed depending upon the size of the aneurysm,
      and were followed with a mean follow-up time of 5 years and 4 months. Aneurysms
      greater than 5 cm were generally operated on if no serious contraindication
      existed. Aneurysms less than 5 cm were followed by repeated examinations and
      operated on if an increase in size occurred. Some small aneurysms were operated
      on for other reasons. Elective surgical management of 134 patients resulted in a
      thirty day mortality of 7.5%. Later, seven additional patients died from causes
      related to the surgery. Survival of electively operated patients by life table
      analysis was 68% at 5 years. A significantly higher mortality was noted among
      those who had evidence of coronary heart disease at the time of operation. Forty
      two patients with AAA less than 5 cm at the initial examination were not operated
      on and three ruptured, but all had grown to a size greater than 5 cm at the time
      of rupture. Patients with AAA less than 5 cm that were not operated on had a
      slightly but not significantly higher mortality than those who were operated on
      electively. This difference was mainly attributable to deaths from cardiac causes
      and not to ruptures. Patients with aneurysms greater than 5 cm who were not
      operated on had a significantly higher mortality than those that were, only 14%
      in the former group survived.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2226883
TI  - Selective low-dose thrombolysis in patients with an axillary-subclavian vein
      thrombosis.
AB  - The treatment of axillary-subclavian vein thrombosis is still controversial.
      Development of a post-phlebitic syndrome in patients treated conservatively
      occurs in many patients. Therefore more aggressive treatment is advocated. We
      report six patients treated with selective low-dose streptokinase infusion with
      excellent short-term results. Major complications did not occur. Recanalisation
      was observed in all patients. Long-term results are not yet available.

PMID- 2226884
TI  - Prospective randomised evaluation of a new cell saving device in elective aortic
      reconstruction.
AB  - In order to evaluate the clinical and haematological implications of salvage
      autotransfusion using the Haemolite device (Haemonetics, Leeds, UK), 67 aortic
      reconstructions were studied. Bank blood transfused during the operation fell
      from a median of four units in the control group to zero using the cell saver (P
      less than 0.0001), and wound drainage decreased from 250 to 200 ml (P = 0.12).
      Evidence of fibrinolytic and platelet activation was found during salvage, but no
      bleeding diathesis was encountered. There was no morbidity or mortality related
      to the technique, and median hospital stay was reduced in autotransfused
      patients. The Haemolite is a safe effective device for autotransfusion in
      elective aortic surgery, and can substantially reduce exposure of both patients
      and staff to the dangers of homologous blood.

PMID- 2226885
TI  - Markers of disease severity in peripheral atherosclerosis.
AB  - Many studies have attempted to define haematological markers of disease severity
      in patients with coronary artery disease but there are few similar analyses in
      peripheral arterial disease. We have determined haematological correlates of
      disease severity in 51 patients with angiographically documented occlusive
      arterial disease. Transfemoral arteriograms performed within the previous 12
      months were visually scored for disease severity using a reproducible method.
      Fasting venous blood samples were withdrawn on two separate occasions from each
      patient and a complete lipoprotein and haematological profile obtained. These
      determinations included total cholesterol and triglycerides, lipoproteins with
      their respective apoproteins, plasma lipid peroxides, fibrinogen, factors VII and
      VIII and rheological indices (haematocrit, whole blood and plasma viscosity).
      Mean values for each parameter were correlated with the angiographic score. Of
      the significant correlations, total cholesterol, triglycerides, low density
      lipoprotein and apoprotein B were all significantly inversely related to disease
      severity, in contrast to plasma lipid peroxides which showed a weak positive
      correlation (r = 0.27, P = 0.06). The best index of disease severity was the
      lipid peroxide/total lipid ratio (r = 0.41, P less than 0.005). This data
      strengthens the hypothesis that lipid peroxides are involved in atherogenesis and
      also suggests that they are the best available plasma marker of disease severity
      in patients with peripheral arterial disease.

PMID- 2226886
TI  - The warm knee sign--an evaluation.
AB  - The presence of an area of warmth at the knee has been described in cases of
      arterial occlusion at the popliteal fossa. A study was carried out to evaluate
      the significance of this sign by comparing clinical and thermographic findings
      with arteriographic results in a group of 30 patients. The clinical and
      thermographic findings were described with reference to the symptomatic limb.
      Clinically, 14/30 (47%) and thermographically, 16/30 (53%) had "positive" warm
      knee signs. The overall agreement between clinical impressions and thermographic
      findings was 28/30 (93%). The commonest arteriographic finding in patients with a
      positive warm knee sign was that the occlusion or stenosis ended at the adductor
      hiatus. Comparing this arteriographic finding with a positive warm knee sign,
      sensitivity, specificity, positive and negative predictive values of 73%, 75%,
      79% and 69% respectively were obtained suggesting that this is a useful sign, is
      of proven value and deserves its place in the initial screening of patients with
      peripheral vascular disease.

PMID- 2226887
TI  - Urethral strictures and aortic surgery. Suprapubic rather than urethral
      catheters.
AB  - Urethral strictures associated with the use of a urethral catheter may be more
      common after cardiac and aortic surgery when compared with other surgical
      procedures. The reasons for this are obscure. Fifty-two aortic procedures in
      males from 1980-1983 were reviewed with an incidence of urethral stricture of
      21%. Forty anterior resections of the rectum in which a urethral catheter was
      used were also reviewed with an incidence of urethral stricture of only 5%. Since
      1985 supra-pubic catheters have been used now in over 200 aortic procedures with
      no morbidity and no urethral stricture. Bacteriuria has been significantly
      reduced by the use of supra-pubic catheters and there would appear to be
      considerable advantages in the use of this technique.

PMID- 2226888
TI  - Vascular tumours in occlusive disease of the iliac-femoral vessels.
AB  - Two cases of intraluminal tumours of the iliac-femoral vessels are presented. One
      was a benign haemangioendothelioma of the common femoral vein and the other a
      leiomyosarcoma of the iliac artery. Their clinical features were similar to those
      of patients having venous thrombosis and atherosclerotic occlusive disease
      respectively. Consequently every physician specialized in vascular disease should
      be aware of intraluminal tumours as an uncommon explanation of these common
      clinical pictures.

PMID- 2226889
TI  - Episodic intermittent claudication associated with a Baker's cyst.
AB  - Baker first described synovial cysts in the leg in connection with diseases of
      the knee joint. Whilst the majority are asymptomatic, some present as a localised
      swelling behind the knee, and others either compress the popliteal vein or
      rupture and can be misdiagnosed as deep vein thrombosis; transmitted pulsation
      through the cyst can suggest the presence of a popliteal aneurysm. This paper
      documents a case of intermittent claudication of the lower limb secondary to
      compression of the popliteal artery by a Baker's cyst.

PMID- 2226890
TI  - Pseudomembranous colitis after abdominal aortic aneurysm repair.
AB  - We report three patients who developed pseudomembranous colitis following aortic
      aneurysm resection. Colonic ischaemia can occur after such surgery and ischaemic
      colonic mucosa is known to be more susceptible to damage by bacteria and their
      toxins. This colonic ischaemia together with the antibiotic prophylaxis used may
      render aortic aneurysm patients susceptible to pseudomembranous colitis. It is
      important to distinguish pseudomembranous from ischaemic colitis in these
      patients as specific and effective drug therapy can be given to those with the
      pseudomembranous type.

PMID- 2226891
TI  - [The anatomicophysiological characteristics of the genitalia of girls].

PMID- 2226892
TI  - [The prevention of myopia and its complications].

PMID- 2226893
TI  - [Erythremia].

PMID- 2226894
TI  - [Chronic bronchitis in the miners of deep coal mines].

PMID- 2226895
TI  - [Ultrasound in the treatment of surgical wounds].

PMID- 2226896
TI  - [Arthrosis of the I metatarsophalangeal joint].

PMID- 2226898
TI  - [The extra sense without mysticism].

PMID- 2226897
TI  - [The aspects of contraception (the experience of sociological research)].

PMID- 2226899
TI  - [The basic principles of resuscitation in severe combined trauma].

PMID- 2226900
TI  - [Physical methods for treating the sequelae of the crush syndrome].

PMID- 2226901
TI  - [The history of medical first aid in Petersburg].

PMID- 2226902
TI  - [Pregnancy and labor following cesarean section].

PMID- 2226903
TI  - [The preclinical diagnosis of late toxicosis at the prehospital stage].

PMID- 2226904
TI  - [Stenocardia of effort].

PMID- 2226905
TI  - [The polycystic ovary syndrome].

PMID- 2226906
TI  - [The work experience of the student study circle at Moscow Medical College No.
      17].

PMID- 2226907
TI  - [Pregnancy and labor in women with a large fetus].

PMID- 2226909
TI  - When is enough enough?

PMID- 2226908
TI  - Current concepts of beta-endorphin physiology in female reproductive dysfunction.
AB  - beta-Endorphin has a role in the regulation of the normal menstrual cycle and
      possibly in the onset of puberty. We have reviewed the evidence pointing to an
      alteration in this neuropeptide that may contribute to the pathogenesis of
      various reproductive dysfunctions. Elevated or high levels of beta-endorphin have
      been associated with exercise-associated amenorrhea, stress-associated
      amenorrhea, and polycystic ovarian syndrome. Depressed or low levels of beta
      endorphin have been associated with PMS and menopause. Alterations in the levels
      of beta-endorphin may change the pulsatile release of GnRH via noradrenergic
      and/or dopaminergic pathways. We have primarily focused on beta-endorphin as
      representative of the endogenous opioid peptides, but other opioid peptides may
      also contribute to the pathogenesis of various types of reproductive dysfunction.
      Perhaps it will become possible to characterize and hone our understanding of the
      function of beta-endorphin and the other substances composing the endogenous
      opioid peptides. A better understanding of their role in physiological as well as
      pathophysiological processes may allow for the development of rational approaches
      to the treatment of specific disorders pertaining to reproduction. Many questions
      remain unanswered. Among the most relevant are: what is the precise mechanism of
      action by which beta-endorphin exerts its influence on pulsatile GnRH release? Is
      there a functional relationship between CNS and peripheral (serum) levels of beta
      endorphin? Are the detected changes in beta-endorphin levels merely associated,
      or are they a cause of a particular disorder? Since it took almost 40 years
      between the time prostaglandins were first discovered and eventual realization of
      their clinical application, it may take some time before the beta-endorphin story
      is complete.

PMID- 2226910
TI  - Hormonal treatment of functional ovarian cysts: a randomized, prospective study.
AB  - Estrogen (E)/progestin therapy for functional ovarian cysts is widely used in
      clinical practice, but the efficacy of this treatment has not been determined in
      controlled trials. In this study, we examined the effect of E/progestin
      administration in a group of infertility patients enrolled in a program of
      ovulation induction who had cysts identified by transvaginal sonography. Patients
      were randomized to receive either norethindrone 1 mg/mestranol 0.05 mg/d (group
      A, n = 24) or no treatment (group B, n = 24) for up to 6 weeks. Patients were re
      evaluated by sonography at 3, 6, and 9 weeks after entry into the protocol. The
      ages, mean cyst diameters, and proportions of patients having received
      gonadotropins in the previous menstrual cycle were not significantly different
      among the two groups. All patients who had a sonographic abnormality persisting
      for 9 weeks were surgically explored and found to have pathological cysts. The
      rate of disappearance of functional ovarian cysts was not affected by E/progestin
      treatment.

PMID- 2226911
TI  - Serum lipids and lipoproteins in continuous or cyclic medroxyprogesterone acetate
      treatment in postmenopausal women treated with conjugated estrogens.
AB  - This study evaluates effects on serum lipids of continuous or sequential
      progestogens for hormonal replacement in women. Subjects received either a cyclic
      regimen of replacement (0.625 mg/d of conjugated equine estrogens (Es) for 25
      days/month and 10 mg medroxyprogesterone acetate [MPA] for the last 13 days of E)
      or 0.625 mg/d E along with either 5 or 10 mg MPA (Provera, Upjohn Company,
      Kalamazoo, MI). Study parameters were measured over a 24-week period. No
      differences in total cholesterol, high-density lipoprotein (HDL) cholesterol,
      triglycerides, apolipoproteins I and II, sex hormone-binding globulin, or serum
      MPA levels were noted between the sequential and 5 mg continuous group. The 10 mg
      MPA group did not have an increase in HDL or decrease in low-density lipoprotein
      as did the other groups.

PMID- 2226912
TI  - Further observations on the doubling time of human chorionic gonadotropin in
      early asymptomatic pregnancies.
AB  - The doubling time (DT) of human chorionic gonadotropin (hCG) in serum was
      investigated retrospectively using serial serum hCG values that had been obtained
      from asymptomatic pregnant women with a prior history of infertility. The DT of
      hCG did not increase significantly as pregnancy advanced during the period in
      gestation when the serum hCG concentration was less than 10,000 mIU/mL
      (International Reference Preparation). Serum hCG concentrations increased
      subnormally in 2 of 60 women with normal intrauterine pregnancies, 5 of 8 women
      with asymptomatic ectopic pregnancies (EPs), and in 2 of 8 asymptomatic women who
      subsequently aborted their pregnancies. Neither the sensitivity nor the
      specificity of serial hCG testing for EP was enhanced by adopting different test
      criteria at different serum hCG concentrations.

PMID- 2226913
TI  - Oocyte retention after follicle luteinization.
AB  - Indirect evidence supports the existence of the luteinized unruptured follicle
      syndrome in infertile women. To seek direct evidence of oocyte retention,
      infertile and normal women were studied in the early and midluteal phase by
      visual documentation of ovulation stigma, needle aspiration of ovarian follicles,
      and peritoneal fluid collection for estradiol and progesterone assay. Luteal
      phase was confirmed by endometrial biopsy (postovulation day 2 to 8). In normal
      control subjects (n = 16), 25% of test cycles were stigma-negative and no oocytes
      were recovered. In infertile group (n = 23), 43% of test cycles were stigma
      negative. Five oocytes were recovered including one from a stigma-bearing
      follicle. Peritoneal fluid steroid levels failed to discriminate stigma-positive
      from stigma-negative cycles in either group. Oocyte retention after luteinization
      occurs in infertile women.

PMID- 2226914
TI  - Accelerated dissolution of luteal-endometrial integrity by the administration of
      antagonists of gonadotropin-releasing hormone and progesterone to late-luteal
      phase women.
AB  - Sequential blockade of gonadotropin-releasing hormone (GnRH) and progesterone (P)
      receptors by potent antagonists (Nal-Glu GnRH antagonist and RU486) was conducted
      in late-luteal phase women to develop a once-a-month birth control method by
      timed advancement of ongoing luteolysis and endometriolysis. Hormonal dynamics
      and timing of uterine bleeding during the antagonists' imposed luteal-follicular
      transition were compared with spontaneous (1st to 2nd) and recovery (2nd to 3rd)
      cycles in 10 normally cycling women. Serum luteinizing hormone (LH) and follicle
      stimulating hormone levels declined (47 +/- 4.3% and 24 +/- 3.0%, respectively)
      by 24 hours after Nal-Glu injection, which accelerated the ongoing luteolytic
      process, as evidenced by more rapid declines of serum concentrations of
      estradiol, P, and ir-inhibin, as compared with the corresponding control cycle.
      This was accompanied by the prompt (16 +/- 3.2 hours after RU486) onset of a
      single episode of uterine bleeding, which was advanced by 2 days. Whereas the
      luteal phase length was foreshortened by 2 days, the subsequent follicular phase
      duration was prolonged by 2 days with a normal sequence of follicular maturation,
      LH surge, and luteal function during the recovery cycle. We conclude that the
      late-luteal sequential administration of antagonists of GnRH and P resulted in
      acceleration of the ongoing luteolytic and endometriolytic processes without
      functional alterations of the subsequent cycle.

PMID- 2226915
TI  - Endocervical chlamydial deoxyribonucleic acid in infertile women.
AB  - The presence of chlamydial deoxyribonucleic acid (DNA) was evaluated by DNA
      hybridization in endocervical cells of infertile and normal fertile women.
      Chlamydial DNA was detected in 49 of 186 (26.3%) infertile patients, which is
      significantly more common than in fertile control individuals (12.5%, or 8 of 64
      individuals). Among infertile patients, 49.3% (33 of 67) of those with tubal
      factors as cause of infertility and 13.4% (16 of 119) of those with nontubal
      factors were found to contain chlamydial DNA in their endocervical cells. The
      results show that chlamydial DNA could be found significantly more frequently in
      endocervical cells of infertile patients with tubal factor than those without
      tubal factors or in normal controls.

PMID- 2226916
TI  - Late onset adrenal hyperplasia: mutation at codon 282 of the functional 21
      hydroxylase gene is not ubiquitous.
AB  - Ten patients affected with 21-hydroxylase (21-OH) deficient late-onset adrenal
      hyperplasia were studied to determine the prevalence of a mutation at codon 281
      of the functional 21-OH gene (CYP21B) that results in a valine to leucine amino
      acid shift. This mutation has been reported in eight unrelated late-onset adrenal
      hyperplasia patients of Ashkenazi Jewish descent possessing the human leukocyte
      antigen-B14,DR1 haplotype. Normally, there are two 21-OH genes; a pseudogene
      (CYP21A) and a functional gene (CYP21B). The aberrant codon 281 sequence is
      normally present only in CYP21A. In all of our late-onset adrenal hyperplasia
      patients, hybridization of an oligonucleotide probe specific for this mutation
      was demonstrated to CYP21A but not to CYP21B. The mutation at codon 281 of CYP21B
      does not appear to be a ubiquitous genetic marker for 21-OH deficient late-onset
      adrenal hyperplasia, suggesting that this disorder may demonstrate the same
      molecular heterogeneity as congenital adrenal hyperplasia.

PMID- 2226917
TI  - The interaction of parameters of male and female fertility in couples with
      previously unexplained infertility.
AB  - A prospective study was undertaken of the relationship between semen variables,
      serial endocrine and follicular ultrasound measurements in one complete menstrual
      cycle, and the treatment-independent chance of conception for couples who were
      referred with unexplained infertility. For the 91 couples studied, the mean
      length of infertility was 70 months. A 100% follow-up rate was achieved. When a
      stepwise analysis was performed examining semen variables and ultrasonographic
      and endocrine variables, the mean ratio of salivary progesterone/plasma estradiol
      between days +1 and +3, with respect to the luteinizing hormone surge and the
      Grade 2 motile sperm density, were the only variables that achieved the 5% level
      of significance. There was a highly significant relationship between the product
      of these two variables and the chance of conception. This study clearly
      demonstrates an interaction between parameters of male and female fertility.

PMID- 2226918
TI  - Subzonal insemination for the alleviation of infertility.
AB  - Methods were developed to facilitate the use of subzonal insemination to achieve
      fertilization in vitro. A clinical trial was undertaken in those patients having
      previously failed to achieve fertilization by in vitro fertilization, and in
      those presenting with severe oligospermia/oligoasthenospermia. From 85 patients,
      585 oocytes were obtained. Of these, 0.3% had been "activated"
      parthenogenetically in vivo, 369 (72%) at metaphase II underwent subzonal
      insemination, 15% were fertilized, and 0.5% had three pronuclei. Thirty-eight
      percent of the patients had fertilization with 36% having a replacement. One
      conceptus was replaced in 19 patients, two conceptus in 8 patients, and three in
      4 patients. A twin and two singleton pregnancies were established.

PMID- 2226919
TI  - The role of tubal pathology and other parameters in ectopic pregnancies occurring
      in in vitro fertilization and embryo transfer.
AB  - Contradictory findings were reported concerning the role of tubal disease in the
      genesis of ectopic pregnancy in in vitro fertilization and embryo transfer (IVF
      ET). We report on six ectopics that occurred in 141 IVF-ET pregnancies (4.3%).
      All of the six cases were among 84 patients with tubal disease, and none occurred
      in the remaining 57 patients with other etiological factors. No correlation was
      found in other parameters including: ovulation induction, number of embryos
      transferred, and luteal support. A comparison between the ectopics and six
      matched controls demonstrated similar estradiol levels, but beta-hCG levels on
      day 15 to 17 after ET were lower. Homolateral salpingectomy was performed in all
      six cases, but a contralateral resection was carried out in three of them. More
      comprehensive studies are needed to clarify whether tubal pathology really
      increases the risk for ectopic gestation in IVF-ET.

PMID- 2226920
TI  - Binovular human ovarian follicles associated with in vitro fertilization:
      incidence and outcome.
AB  - Binovular follicles were found in 15 (0.3%) of 4,695 follicles containing
      oocytes. These binovular follicles were either with adjacent cumulus complexes (9
      cases), or separate corona radiata and common cumulus mass (1 case), or two
      oocytes within a single zona pellucida (5 cases). In each of the latter form,
      there was a smaller and a larger oocyte. All the smaller oocytes and two larger
      ones possessed a germinal vesicle, whereas the remaining three larger oocytes
      were mature and developed normally. Though being exposed to the same
      intrafollicular milieu, there can be a difference in the maturity of the nucleus
      and characteristics of the cytoplasm of both oocytes.

PMID- 2226921
TI  - Psychological assessment and follow-up after in vitro fertilization: assessing
      the impact of failure.
AB  - The present study was conducted to assess the immediate psychological impact of
      failed in vitro fertilization (IVF). Emotional status and marital functioning
      were also examined pre-IVF, and both demographic information and psychological
      test scores were evaluated as predictors of reaction to treatment failure. After
      a failed first cycle, both males and females showed significant increases in
      anxiety and depressive symptoms. Although group means were not clinically
      elevated and most participants were coping adequately, the prevalence of both
      mild and moderate depression increased substantially, particularly among women.
      In addition, women without children were a subgroup particularly vulnerable to
      the stress of failure. Predisposition towards anxiety, pre-IVF depressive
      symptoms, and fertility history were the most important predictors of emotional
      response. Treatment implications of these findings were discussed.

PMID- 2226922
TI  - Effects of incubation time in serum and capacitation on spermatozoal reactivity
      with antisperm antibodies.
AB  - Sperm reside within the female reproductive tract before the occurrence of
      fertilization. During this time they undergo surface modifications associated
      with changes in their functional state. To study their antigenic expression,
      capacitated and acrosome-reacted sperm were incubated with sera that had
      previously been tested for antisperm antibodies against fresh washed sperm, as
      detected by indirect immunobead binding. Forty-eight percent of previously
      positive and 20% of previously negative sera reacted differently with sperm after
      an extended time (18 hours) of incubation in serum or after sperm capacitation.
      These results suggest that current techniques of antisperm antibodies detection
      be modified to include testing sera after prolonged incubation times with both
      capacitated as well as fresh sperm.

PMID- 2226924
TI  - Protein differences between normal and oligospermic human sperm demonstrated by
      two-dimensional gel electrophoresis.
AB  - Protein expression by sperm obtained from men with normal semen analysis and men
      with oligospermia were evaluated by two-dimensional gel electrophoresis. Proteins
      were solubilized in a 9.5 M urea/2% Nonidet-P40 (LKB, Bromma, Sweden) lysis
      buffer and underwent second dimension separation on 10 to 16% polyacrylamide
      gradient gels. A set of 36 invariant proteins was identified in all normospermic
      samples, whereas 8 of 10 evaluable oligospermic samples lacked 1 or more of the
      invariant proteins. Proteins absent in oligospermic samples may be critical to
      normal sperm function and may serve as markers for infertility.

PMID- 2226923
TI  - A reverse (antibody capture) enzyme-linked immunosorbent assay for detection of
      antisperm antibodies in sera and genital tract secretions.
AB  - A reverse (antibody capture) enzyme-linked immunosorbent assay (ELISA) for
      detection of antisperm antibodies has been developed. The assay enables detection
      of immunoglobulin (Ig) M, IgG, IgA, or IgM, IgG, and IgA--antisperm antibodies in
      serum, cervical mucus, and seminal plasma samples. The reverse ELISA is more
      specific and sensitive than conventional ELISA in detecting human antisperm
      antibodies of different isotypes. Using this assay, statistically significant
      differences in levels of antibodies between infertile and fertile individuals
      were demonstrated in sera and in genital tract secretions. Studies with 143
      infertile couples revealed that the presence of antibodies in sera was not
      necessarily reflected in individual's genital tract secretion and vice versa.
      These data emphasize the importance of detecting antisperm antibodies in sera as
      well as in genital tract secretions for correct evaluation of sperm immunity.

PMID- 2226925
TI  - Pooled sequential ejaculates: a way to increase the total number of motile sperm
      from oligozoospermic men.
AB  - We investigated the yield of total number of motile spermatozoa from
      oligozoospermic men by pooling two closely spaced sequential ejaculates. Semen
      characteristics were compared between sequential ejaculates (within a period of 1
      to 4 hours) of 18 oligozoospermic males (sperm concentration less than 20 X
      10(6)/mL and total sperm count less than 40 X 10(6) in the ejaculate) and a
      control group of 16 normozoospermic men. Whereas the median total number of
      motile sperm of normozoospermic males significantly decreased from 70 X 10(6) in
      the first ejaculate to 23 X 10(6) in the second sequential ejaculate, such a
      decrease was not detected in oligozoospermic males, 3.6 X 10(6) and 3.1 X 10(6),
      respectively. The percent of normozoospermic and oligozoospermic men who
      demonstrated a decreased (less than 50%), a comparable (50% to 150%), or an
      increased (greater than 150%) total motile sperm count in the second ejaculate in
      comparison with the first ejaculate were 69%, 31%, and 0 versus 39%, 28%, and
      33%, respectively. Consequently, pooling of two sequential ejaculates
      significantly increased the median total number of motile sperm from
      normozoospermic males by 144% and from oligozoospermic males by 329%, (to 10.2 X
      10(6]. We suggest that pooling of two sequential ejaculates from oligozoospermic
      males is a simple and cost effective method to increase significantly the total
      number of motile sperm for intrauterine insemination, in vitro fertilization,
      gamete intrafallopian transfer, or semen cryopreservation.

PMID- 2226926
TI  - Studies on requirements for trackpoints in CellSoft automated semen analysis.
AB  - The CellSoft (CRYO Resources, Ltd., New York, NY) system for computer-assisted
      sperm analysis was evaluated as to the appropriate settings for trackpoints.
      Fifty-eight human spermatozoa exhibiting complex swimming modes were chosen for
      analysis at room temperature. The accumulated measures for curvilinear velocity,
      linearity, mean and maximum amplitude of lateral head displacement, and beat
      cross frequency were determined over a range of trackpoints from 2 to 37. Stable
      measures (within the 95% confidence interval at 37 frames) were observed at 4
      frames for curvilinear velocity and at 20 frames for linearity. The corresponding
      figure for mean amplitude of lateral head displacement and beat cross frequency
      was 8 frames. We conclude that the frame requirements concerning measures for
      curvilinear velocity/linearity and mean amplitude of lateral head
      displacement/beat cross frequency should be 20 and 8, respectively. Thus, 20
      consecutive frames to analyze will suffice.

PMID- 2226927
TI  - Effect of serum from patients with minimal to mild endometriosis on mouse embryo
      development in vitro.
AB  - Two-cell mouse embryos were cultured at 37 degrees C in 5% CO2, 95% air with a
      7.5% serum supplement from patients with minimal to mild endometriosis, (group I,
      n = 31), tubal factor (group II, n = 33), male factor (group III, n = 17), fetal
      cord samples (group IV, n = 37), and Ham's F-10 medium (Gibco, Grand Island, NY)
      without a serum supplement (group V, n = 30). The progression to blastocyst stage
      (mean percent +/- SE) at 96 hours in groups I, II, III, IV, and V was 29.9% +/-
      3.7%, 60.6% +/- 4.9%, 56.2% +/- 5.2%, 61.7% +/- 5.8%, and 63.2% +/- 6.9%,
      respectively. Serum factors appear to be associated with an inhibition of early
      embryogenesis, which may explain the decreased fertility rates observed in
      patients with minimal to mild endometriosis.

PMID- 2226928
TI  - The effect of cocaine on oocyte development and the follicular microenvironment
      in the rabbit.
AB  - We examined the effects of cocaine exposure in the rabbit on in vitro oocyte
      development and on steroidal content of follicular fluid (FF) and serum
      progesterone (P). Cocaine hydrochloride (0, 10, 20, 40, or 80 mg/kg) was
      administered daily subcutaneously for 5 days to New Zealand White female rabbits
      before superovulation. On the last day of cocaine administration, animals were
      given human chorionic gonadotropin intravenously, and laparotomy was performed 6
      to 8 hours later. During laparotomy, ovaries were removed, the number of
      follicles recorded, oocytes retrieved, and FF was obtained. In vitro
      fertilization (IVF) was then performed on the oocytes and the rate of cleavage
      observed. For all cocaine dosage groups, no differences were observed in the
      number of follicles present, number of oocytes retrieved, or IVF and cleavage
      rates. Cocaine did, however, decrease periovulatory serum P, and FF P, whereas FF
      estradiol concentrations increased. This suggests that short-term cocaine
      exposure affects the follicular steroid milieu, possibly by delaying granulosa
      cell luteinization.

PMID- 2226929
TI  - Peritoneal fluid fractions from patients with endometriosis do not promote two
      cell mouse embryo growth.
AB  - Peritoneal fluid (PF) from 10 infertile patients with endometriosis, obtained
      during the follicular phase of the cycle during laparoscopy, did not promote two
      cell mouse embryo growth to the extent observed by fluid obtained from seven
      normal controls. Five molecular weight (MW) fractions were obtained by
      ultrafiltration, and each was used as media supplement in the assay and compared
      with PF fractions from normal controls. All fractions of PF from patients with
      endometriosis inhibited mouse embryo growth to a greater extent than did normal
      controls. However, the MW fractions greater than 100,000 daltons showed greater
      inhibition of embryo development than did fractions less than 100,000 daltons.
      This study of cell-free PF suggests the presence of a humoral factor greater than
      100,000 daltons that is inhibitory on mouse embryo growth.

PMID- 2226930
TI  - Retroperitoneal mobilization of the vas deferens in the complex vasovasostomy.
AB  - Anatomic distances along retroperitoneal, inguinal, and infrainguinal segments of
      the vas deferens were measured in 14 formalin fixed cadavers and in 15 recently
      postmortem males. There were no significant differences in segment lengths
      between the two groups nor between the right and left vasa. Data from the recent
      postmortem group reveals a mean length of 5.83 +/- .65 cm to be gained from
      retroperitoneal mobilization of the vas deferens. This information is important
      to surgical decisions in cases of microsurgical repair of obstructive azoospermia
      resulting from damage to the inguinal segment of the vas deferens. Data on other
      vasal segment lengths is beneficial for planning repair in other complex cases of
      obstructive azoospermia as well.

PMID- 2226931
TI  - Transient hyperprolactinemia is associated with a midcycle luteinizing hormone
      surge.
AB  - This study demonstrates that LH surge cycles in IVF patients were associated with
      significantly higher serum PRL concentrations than cycles in which a spontaneous
      LH surge did not occur. Our findings support the hypothesis of concomitant LH and
      PRL release at the time of the midcycle gonadotropin surge, as well as that of
      estrogen sensitization of pituitary lactotropes, and suggest a possible mechanism
      for transient midcycle hyperprolactinemia.

PMID- 2226932
TI  - Effect of sperm preincubation with follicular fluid on the fertilization rate in
      human in vitro fertilization.
AB  - The study investigates the effect of sperm preincubation with FF on the
      fertilization rate in an IVF program. The oocytes inseminated with FF pretreated
      semen showed a significantly higher rate of fertilization. The percentage of
      cleavage and polypronuclear occurrence did not differ from the controls.

PMID- 2226933
TI  - In vitro fertilization and development of one of two human oocytes with fused
      zonae pellucidae: case report.
AB  - This report describes a pair of human oocytes of differing maturities but fused
      at the zona pellucida, believed to have originated from a binovular follicle.
      After insemination in vitro, one oocyte fertilized and developed into an expanded
      blastocyst, whereas the other, which contained a germinal vesicle, degenerated. A
      biopsy was aspirated from the blastocyst, which subsequently re-expanded but did
      not hatch.

PMID- 2226934
TI  - The use of electroejaculation and zygote intrafallopian transfer to achieve a
      pregnancy after a major gunshot wound to the abdomen: a unique application.

PMID- 2226935
TI  - Deletion of chromosome 4: 46,XY, del(4) (q31.3) after gamete intrafallopian
      transfer and in vitro fertilization-embryo transfer.
AB  - It seems that assisted reproduction technology does not increase the rate of
      chromosome abnormalities, and up to now, a few cases have been reported. The case
      we describe here is the first one of monosomy 4q31 in a full-term liveborn after
      a combined GIFT-IVF procedure. Once more, this case raises the question of
      whether pregnancies resulting from IVF should be monitored for chromosome
      abnormalities or not.

PMID- 2226936
TI  - Hazards of electromagnetic fields to human reproduction: what information is in
      the scientific literature?

PMID- 2226937
TI  - Recent editorial--a lightning rod for discussion.

PMID- 2226938
TI  - Variations of the human sex ratio at birth.

PMID- 2226939
TI  - [The demonstration of potential-dependent potassium channels in the plasma
      membrane of secretory cells].
AB  - Outward current of the salivary gland cells membrane of chironomus larva
      activated by the displacement of the membrane potential to the region of positive
      values has been registered by the voltage-clamp method under conditions of
      intracellular dialysis in the presence of only the potassium transmembrane
      gradient. Activation threshold of the current is about +10 mV. Subsequent
      displacement of the membrane potential to the region of positive values causes an
      increase of the current. Time constant of the current activation is (652 +/- 57)
      ms. The current decreases with the intracellular potassium concentration, under
      the influence of tetraethyl-ammonium and 4-aminopyridine. Thus, high threshold
      potential-dependent potassium channels are presented in the secretory cells
      membrane.

PMID- 2226941
TI  - [The basic patterns in the development of lymph circulatory failure in the
      heart].
AB  - 63 adult rabbits were used to stimulate single physical exercise, acute and
      relapsing coronary insufficiency, alimentary atherosclerosis and to study
      adaptive and pathologic changes in the lymphatic channel (LC) of the heart. LC of
      the heart in animals with alimentary atherosclerosis after cholesterol exclusion
      from their diet was studied to determine reversibility of these changes. LC of
      the heart was injected by differently coloured masses and was investigated by the
      stereoangioscopic method on clarified preparations, on semithin sections and by
      the electron-microscopic method. Changes in different elements of a lymphatic net
      were of the stereotype character, as a whole. Morphofunctional reactions
      determining the development of the chronic insufficiency of the lymph flow in the
      heart form as successively following phases which change both due to exposition
      of the pathological process-initiated effect and due to certain endogenic factors
      arising during arrangement of LC of the heart.

PMID- 2226940
TI  - [The hypothesis of acupuncture points as polymodal receptors of the ecoceptive
      sensitivity system].
AB  - Hypothesis is proposed that the human brain has the sensory system (ecoceptive
      sensory system) which responds to changes of the Earth electromagnetic fields
      (EEFs) and meteorologic factors (MFs). Acupuncture points which are activated
      easily by adequate somatosensory stimuli (mechanical, temperature) and
      electromagnetic fields (electropuncture, magnetopuncture) can be polymodal
      receptors of the ecoceptive sensory system. It is supposed that the sensory
      endings of acupuncture points are excited by sharp changes ef EEFs and MFs.
      Through the neuronal brain stem structures, especially through hypothalamus,
      acupuncture points excitation starts the adaptive mechanisms intended to
      compensate the brain functional systems deviations, provoked by prolonged EEFs
      and unsettled weather environmental influences.

PMID- 2226942
TI  - [The nature of the hypermetabolism and tachycardia in cold adaptation and
      experimental hyperthyroidism].
AB  - The cross circulation method has been used to study contribution of humoral and
      nonhumoral components to the origin of hypermetabolism (increased level of basal
      metabolism) and tachycardia under adaptation to cold and experimental
      hyperthyroidism. Consumption of oxygen, heart rate and rectal temperature have
      been studied in periods prior to and during the cross circulation. It is shown
      that under experimental hyperthyroidism contribution of humoral and nonhumoral
      factors to the origin of hypermetabolism equals 22 and 78%, while that to genesis
      of tachycardia--44 and 56%, respectively. Under cold adaptation an increase of
      the basal metabolism level depends on humoral agents by 77% and on changes of the
      stationary character only by 23%. The nature of adaptation tachycardia is mainly,
      of the humoral origin (65%).

PMID- 2226943
TI  - [The protective effect of energy substrates, vitamins, coenzymes and their
      complexes in the action on the body of the factors of an enclosed space].
AB  - Experiments on mice were performed to study a protective action of amino acids
      and other oxidation substrates (L-aspartic acid, pyruvate, succinate, GABA, alpha
      ketoglutarate), metabolites (pyridoxal-5'-phosphate) as well as vitamin-coenzyme
      complexes in combination with oxidation substrate while being under closed space
      conditions. GABA, aspartate, glutamate possessed the highest protective effect as
      against alpha-ketoglutarate and succinate.

PMID- 2226944
TI  - [The effect of hypoxia on the glucose-6-phosphate dehydrogenase activity of the
      erythrocytes in rats].
AB  - Biochemical methods have shown, that adaptation of rats to the conditions of the
      middle mountains (2100 m above sea level) as well as with subsequent affecting
      acute hypoxia in the hypobaric chamber (7500 m, 2-5 h and 9000 m, 1-3 h) is
      accompanied by the increase of the activity of glucose-6-phosphate dehydrogenase.
      Its level also increases in experiment with nitrite methemoglobinemia and
      phenylhydrazine anemia, as well as with ionol introduction.

PMID- 2226945
TI  - [The effect of the antigen-induced splenic suppressor factor on the immune
      response to different antigens].
AB  - Quick-frozen spleen of mice immunized with sheep red blood cells was homogenized
      and centrifuged. Supernatant was used as a source of suppressor factor (SF). It
      was shown that SF inhibited antibody immune response to thymus-dependent antigens
      and delayed hypersensitivity reaction. SF did not inhibit antibody formation to
      thymus-independent antigen. SF activity disappeared after its treatment with anti
      Ig immunosorbent.

PMID- 2226946
TI  - [A comparative analysis of the effect of clofelin on gastric secretory function
      in man and dog].
AB  - It is established that clofelin suppresses the human and dog insulin gastric
      secretion as well as human basal and histamine secretion. Clofelin has no effect
      on the secretory function of the dog stomach, stimulated by pentagastrin,
      carbachol histamine. It is supposed that clofelin-induced suppression of the
      human histamine gastric secretion takes place due to the inhibition of basal
      secretory component being a part of the common secretory effect on histamine.
      Clofelin may be promising drug in the treatment of patients with hypertension and
      duodenum ulcer.

PMID- 2226947
TI  - [The role of the duodenojejunal junction in regulating the evacuatory function of
      the duodenum].
AB  - Chronic experiment on dogs was performed to study the effect of duodenojejunal
      junction exclusion from the evacuatory process on dynamics of gastric and
      duodenal emptying of the carbohydrate and fatty food. It is established that in
      the case of exclusion of the duodenojejunal junction, the degree of coordination
      of gastric and duodenal emptying decreases, dynamics of chyme evacuation from the
      duodenum considerably changes. It is concluded that the duodenum is not a mere
      transporter of food coming from the stomach, but has its own regulation
      mechanisms represented by the duodenojejunal junction and the Treitz ligament.

PMID- 2226948
TI  - [The effect of ethonium on the fatty acid composition of the lipids in the
      hepatic and muscular tissues of hypotrophic piglets].
AB  - Relative content of unsaturated, in particular polyene fatty acids, being a part
      of total lipids and lipase activity in the liver tissue and muscular tissue in
      the hypotrophic pigs is much lower than those parameters in normotrophic ones.
      Ethonium induces an increase in the percentage of irreplaceable polyene acids in
      total lipids, activity of lipase and CME in tissues as well as average diurnal
      increments and preservation percent of youngs.

PMID- 2226949
TI  - [The protective action of the organic substances in naftusia water on erosive
      ulcerative lesions of the gastric mucosa in rats undergoing immobilization-cold
      stress].
AB  - It is shown that 7-11-day long consumption (by rats) of water naftusia or organic
      matters isolated from it which contain carbonic acids and catecholamines
      possessing paramagnetic activity exerts a preventive effect on stress injuries of
      the mucous membrane of the stomach. Gastric protective action of naftusia goes
      with hyperplasia and hypertrophy of argyrophil endocrinocytes and antral mucosa,
      with an increase of gastrin content in it as well as in blood serum, shortening
      of the nembutal sleep duration.

PMID- 2226950
TI  - [The cytological and hormonal characteristics of cell cultures from the testes of
      newborn piglets].
AB  - A cell culture of neonatal pig testes has been studied. Leydig cells, Sertoli
      cells, sex cells and fibroblasts have been identified by cytologic and
      cytochemical research methods, Gonadotropin concentration (0.1 U/ml) of
      nutritional medium, increases proliferation of the Leydig cells and increases
      their 3-beta-ol-steroiddehydrogenase activity as well as increases amount of
      lipid inclusions and stimulates testosterone production. The cell culture can be
      used to treat some forms of hypogonadism.

PMID- 2226952
TI  - [The dependence of the achievement of students on the individual typological
      properties of their nervous systems].
AB  - A reliable correlation (r = 0.47) between cognitive ability and educational
      achievement has been determined in 195 students (men and women) aged 21-25.
      Progress in studies depends also on such individual-typological properties as
      "strength" of the excitation process (r = 0.46), work reliability (r = 0.49) and
      functional "mobility" of the nervous brain process (r = 0.38). On the whole,
      teaching efficiency is determined by a complex of psychophysiological state
      indices rather than by one of these indices.

PMID- 2226951
TI  - [The pathomorphological characteristics of the action on the body of the
      antitumor antibiotic asterin under stress conditions].
AB  - The action (on the organism) of antitumour antibiotic asterine isolated from
      plant of family Asteraceae under stress conditions at D. K. Zabolotnyi Institute
      of Microbiology and Virology has been pathomorphologically characterized.
      Asterine is stated to be able to decrease the harmful effect of stressor,
      preventing the expression of structural alterations in adrenal glands, cortex and
      lungs of stress-subjected organism. Adaptogenic effect of antitumour antibiotic
      is confirmed.

PMID- 2226953
TI  - [The action of reserpine on cholinergic processes in the heart].
AB  - Experiments on white rats show that reserpine creates conditions for
      acetylcholine accumulation in the heart. In early periods after reserpine
      administration (within 8 hours) this process depends on restriction of mediator
      hydrolysis. In more distant periods (within 24 hours) synthesis activation adds
      to the mentioned mechanism.

PMID- 2226954
TI  - [The dynamics of the autoimmune process in guinea pigs during their acquisition
      of an experimental neurosis].
AB  - Pathogenetic role of the neuroautoimmune reactions in dynamics of the
      experimental neurosis development has been investigated. Application of the
      dynamic approach in estimation of the pathological process has permitted
      analyzing changes in the immunological indices in dynamics of the experimental
      neurosis development. The results obtained testify to that maximum content of
      autoantibodies to the nervous tissue, circulating immune complexes and changes in
      the reaction of neutrophilic injury are observed in the beginning of the
      experimental neurosis development.

PMID- 2226955
TI  - [History of the Dental (Stomatologic) Clinic through 1920 (Jozsef Arkovy)].
AB  - The Dental Clinic of the Budapest University was established 100 years ago. The
      prehistory and the history of the first three decades of the clinic is closely
      attached to the course of life of Professor Jozsef Arkovy (1952 to 1922). Arkovy
      acquired a medical and dental master certificate in 1876. Between 1881 and 1890
      he directs a private dental clinic. This became the basis of the University
      Dental Clinic opened in 1890 which disposed of a treating hall with 10 dental
      chairs, a narcosis chamber and a class room. In 1908, the clinic moves into a new
      building planned for such purpose and its name becomes Clinic of Stomatology. In
      the new clinic the departments of surgery, conserving dentistry and prosthetic
      dentistry became separated and there was a bedpatient department as well. Arkovy
      retired in 1920.

PMID- 2226956
TI  - [History of the Stomatologic Clinic between 1920 and 1959].
AB  - Since 1919 the clinic was directed and developed by Professor Jozsef Szabo (1874
      to 1937). His book entitled The Practical Dentistry appeared also in Italian and
      Spanish. His collaborator was Professor Henrik Salamon (1865 to 1944)
      distinguished prosthetic, orthodontist and dental historian. The professorate was
      taken over in spring of 1944 by Professor Karoly Balogh (1895 to 1973) who
      organized the independent training of dentists. The Clinic of Stomatology became
      the basis of the Faculty of Dental Science of the Budapest Medical University and
      of the four dental clinics operating since 1959. Today the building of the Clinic
      of Stomatology serves for the operating of the Oral Surgery and Dental Clinic.

PMID- 2226957
TI  - [The significance of the styloid process syndrome in the differential diagnosis
      of temporomandibular dysfunction].
AB  - Two cases are reported on, both patients came to the clinic on the suspicion of
      temporo mandibular joint disfunction. Their complaints was caused by
      overdeveloped processus styloideus. After surgical removal of the processus
      styloideus the complaints ceased. In cases of seemingly temporo mandibular joint
      disfunction not improving on conventional treatment the possibility of the
      processus styloideus syndroma has to be considered.

PMID- 2226958
TI  - [Dental education in the past century, its current status and future trends].
AB  - Since the second half of the nineteenth century, two ways of dentist-formation co
      existed: medically based-, and independent dental education. Medically based
      dental education,--present until the last decade in four countries of Europe-,
      favoured the development of oral medicine and surgery. Independent dental
      education,--specially in Western Europe and USA--realized through prevention a
      decline in caries and associated dental diseases. According to these changes,
      treatment needs in future will require low-, and high technology skills, an
      integration of the dentist into the Primary Health Care Team, as an "Oral
      Physician". In education a closer relationship between medical and dental
      subjects, as well as between basic and dental clinical subjects will be
      necessary. On the basis of E.E.C. decision an agreement on dental curricula in
      Europe should be attained in the near future.

PMID- 2226959
TI  - [Xerostomia as a side effect of drugs].
AB  - After a definition of xerostomia and a description of it's diagnostics and
      consequences the most important etiological factors are reviewed with special
      emphasis on drugs inducing xerostomia as an adverse effect. The most important
      drugs concerned are summarized in a table indicating generic names as well as
      proprietary names of preparations marketed in Hungary. Possible therapeutic
      approaches are also described.

PMID- 2226960
TI  - [Effect of partial dentures on the residual dentition and the periodontium].
AB  - The data of 969 dental arches replaced by partial denture, and 1282 dental arches
      of the same edentulousness but unreplaced, examined in an unselected population,
      have been analyzed from the point of view of the occurrence frequency of the
      gingivitis, the pocket, the movability and the caries. It has been stated that
      the effect of the prosthesis of the remaining teeth may be evaluated only by
      comparison with a suitable control group with no dentures. Furthermore, it has
      been stated that the remaining teeth are not damaged by well planned partial
      dentures (with metal base plates) while the wrongly planned dentures (with
      plastic base plates) develop a significant damaging effect.

PMID- 2226961
TI  - [Stomatologic developmental abnormalities causing speech defects, their incidence
      in hereditary syndromes].
AB  - Inherited disturbances of development of the mouth and the surrounding oral
      environment: lips, tongue, teeth palate as well as lesion of the central motoric
      kernels of certain brain nerves may cause grave speech defects. In the report a
      number of hereditary syndromes are listed among the symptoms of which the speech
      defect has dominant significance. Short description is given of dental methods by
      means of which the defects can be eliminated or, at least, are curable.

PMID- 2226962
TI  - [Malocclusion of the front teeth in wearers of complete upper and lower
      dentures].

PMID- 2226964
TI  - [Experience with amalgams manufactured by Southern Dental Industries
      (Australia)].
AB  - The gamma 2 phaseless amalgam of the firm Southern Dental Industries (SDI) was
      tested. None of the 205 fillings showed level deviations, unevenness, secondary
      caries and breakage. A minimum size gap was found in 2 cases.

PMID- 2226963
TI  - [Development and therapeutic possibilities in pathological bone changes in the
      alveolar ridge].
AB  - For preventing pathological leison its healing as well as slowing down of the
      progress of the already formed course the employment of prosthetic therapy is
      suggested. Various solutions are presented which, on basis of their clinical
      experiences, are deemed successful therapeutics. Finally, in case of the above
      mentioned statuses attention is called to the possibilities of error in the
      course of individual stages of work in making denture as well as to the
      possibility to their elimination.

PMID- 2226965
TI  - [ Aligning of retained and impacted teeth using and orthodontic device].

PMID- 2226966
TI  - [Use of a finger sucking prevention device (report of a case)].

PMID- 2226967
TI  - Patient outcomes: the time is right.

PMID- 2226968
TI  - Heparin therapy.

PMID- 2226969
TI  - Preventing increased ICP.

PMID- 2226970
TI  - From Florence Nightingale to critical care nursing: a visit to Istanbul.

PMID- 2226971
TI  - Air emboli: a potentially lethal complication of central venous lines.

PMID- 2226972
TI  - A regional approach to entry-level critical care education.
AB  - The education and training of the novice critical care nurse place a constant
      financial demand on many Puget Sound area hospitals. Critical care educators from
      this area, committed to cost-effective, high-quality education, enhanced through
      precepted clinical experience, assessed the need for a collaborative approach
      among institutions. Jointly we have successfully planned, implemented, and
      evaluated a cooperative educational program. To date, the program has served to
      reduce the costs of preparing the RN entering critical care in the Puget Sound
      area. Application of principles of adult education, timely application of theory
      to practice, and expansion of the professional role of critical care clinical
      nurse specialists and educators have also been recognized as outcomes of the
      CCEC.

PMID- 2226973
TI  - Esophageal perforation. A case study.

PMID- 2226974
TI  - A clinical practice journal club: bridging the gap between research and practice.
AB  - The value of applying the findings of research to nursing practice is obvious. A
      clinical practice journal club may assist in this process. Monthly in our
      clinical settings. Our journal club helped to bridge the gap between research and
      our professional practice.

PMID- 2226975
TI  - Understanding cardiovascular drug interactions.

PMID- 2226976
TI  - Trust: a critical element in critical care nursing.
AB  - All nurses, regardless of specialty, should strive to develop a trusting
      relationship with their patients. This relationship paves the way for obtaining
      the accurate and pertinent information necessary to form correct nursing
      diagnoses. In a critical care unit, this accuracy and trust is essential caused
      by the intensity of the environment. Support systems are weakened with family
      members being separated and allowed to visit for only short periods of time.
      Family members may see a loved one as never seen before, appearing absolutely
      helpless. A trusting relationship with the critical care nurse could help
      reinforce and strengthen the weakened support system. Professional nurses spend
      the greatest amount of time with consumers of health care. This situation places
      them in a position to influence life-styles. Seeking further assistance or
      following advice may depend on the quality of the nurse-patient relationship.
      Specifically for critical care and long-term situations, trusting relationships
      may make a long, intensive illness less traumatic. Trust built in the critical
      care area may provide the basis for positive nurse-patient relationships
      developing throughout the hospitalization and during future interactions with
      professional nurses.

PMID- 2226977
TI  - HIV therapy update.

PMID- 2226978
TI  - Thyroid eye disease.

PMID- 2226979
TI  - Epikeratophakia for keratoconus.
AB  - Results of the author's first 15 cases of epikeratophakia for keratoconus are
      presented. All patients were intolerant of contact lens correction and could not
      achieve satisfactory acuity with spectacle correction due to corneal ectasia and
      irregular astigmatism. The average follow-up was 13 months. Seventy-three per
      cent of eyes treated had a pre-operative spectacle acuity of 6/60 or worse. One
      eye had a preexisting amblyopia that limited final acuity, but every other eye
      achieved a post-operative spectacle acuity of 6/12 or better and 50% achieved
      6/6. One eye had 11 dioptres of post-operative astigmatism and required
      penetrating keratoplasty; the remaining eyes had an average astigmatism of 1.9
      dioptres. Epikeratophakia appears to be a safe alternative to penetrating
      keratoplasty in selected cases.

PMID- 2226980
TI  - Management of diplopia on down-gaze following orbital trauma.
AB  - Diplopia in the inferior field due to orbital trauma is a notoriously difficult
      and disabling problem. Even if a blow-out fracture is repaired by current
      methods, patients may still have diplopia. There also exists another group in
      whom no demonstrable radiological fracture can be found, and yet there is a
      severe down gaze deficit. The possible mechanisms of this phenomenon are
      discussed and the results of horizontal muscle transposition surgery in a series
      of nine patients is reported. The authors conclude that this procedure is a
      valuable method of increasing the useful field of binocular single version in
      these patients.

PMID- 2226981
TI  - Botulinum toxin therapy in dysthyroid strabismus.
AB  - We report our experience with the use of Botulinum toxin injection in 38 patients
      (64 injections) with severe dysthyroid strabismus. Three quarters of the
      injections led to a decrease in the angle of the squint by a mean 75% of the
      initial deviation. The average duration of effect was two months. Twenty six
      patients went on to surgery after stabilisation of their squint and endocrine
      status. Six patients achieved a stable long-term result with Botulinum toxin
      only. We suggest these results of treatment of early dysthyroid myopathy are more
      consistent with the characteristics of inflammatory spasm than contracture. The
      value of Botulinum toxin as a temporary means of maintaining binocularity in
      these young patients is discussed.

PMID- 2226982
TI  - Cataract surgery with intraocular lens implantation in Fuchs' heterochromic
      cyclitis.
AB  - The results of cataract extraction with posterior chamber lens implantation in
      twenty eyes with Fuchs' Heterochromic Cyclitis are reported. No serious operative
      complications were experienced. The visual outcome has been excellent in all but
      those eyes with coexistent glaucoma. The postoperative complications seem no more
      frequent than would be expected for the underlying condition.

PMID- 2226983
TI  - Secondary intraocular lens implantation: eight year experience.
AB  - OBJECTIVE: To investigate the outcome of secondary intra-ocular lens
      implantation. Neither a requirement for vitreous surgery nor previous complicated
      eye surgery/trauma was considered necessarily to be a contra-indication. DESIGN:
      Retrospective Study. Recruitment was achieved by examination of operating theatre
      records. SETTING: Teaching Hospital. PATIENTS: 52 out of 54 consecutive cases in
      whom a secondary lens had been implanted from 1982-1989 under the care of one
      consultant (BAN). INTERVENTIONS: The medical records of all patients were
      reviewed and data collected for 52 of the total of 54 patients. MAIN OUTCOME
      MEASURES: Visual acuity and major complications. RESULTS: 77% of eyes retained
      the same Snellen visual acuity or better than that pre-operatively and 88% were
      within one line or better. The Mann Whitney U-test showed that neither vitreous
      manipulation at the time of secondary lens implantation nor a previous history of
      trauma had a significant effect on the change between pre- and post-operative
      Snellen visual acuity. Only one patient developed a retinal detachment and eight
      had cystoid macula oedema although in only one patient did this account for a
      final decrease in post-operative visual acuity of more than one line. The most
      common complication was an intense post-operative uveitis (35%) leading in some
      cases to indefinite low dose topical steroid treatment (21%). CONCLUSIONS: This
      technique gives good visual results, even in the disorganised eye, providing the
      vitreous is adequately managed. However there is a significant complication rate
      which should be discussed with the patient before undertaking surgery.

PMID- 2226984
TI  - The visual field in chronic open angle glaucoma: the rate of change in different
      regions of the field.
AB  - Using automated perimetry the distribution of visual field loss in 40 chronic
      open angle glaucoma eyes (40 patients) was found to be predominantly in the
      nasal, supranasal, and superotemporal regions. The rate of change of visual field
      threshold values in seven regions of the field was measured by trend analysis
      over 44.9 +/- 17.9 months. Seventeen eyes had a significant rate of field loss in
      one or more regions of the field with the remaining eyes either showing
      improvement or stability. Seven of the 17 eyes with significant regional field
      loss had stable overall fields. The greatest rate of field loss occurred in the
      temporal and superotemporal regions. The correlation between the mean threshold
      value of the initial field test and the rate of change of field over time was
      significant in the temporal region and of borderline significance in the
      superotemporal region. The relationship was such that the greater the initial
      threshold value, the greater the subsequent rate of field loss.

PMID- 2226985
TI  - The progress of the visual field in chronic simple glaucoma and ocular
      hypertension treated topically with pilocarpine or with timolol.
AB  - It is theoretically possible that the vascular effects of topical sympathetic
      beta-blocking therapy in chronic simple glaucoma (CSG) might tend to neutralise
      the beneficial effect of a reduced intraocular pressure on the preservation of
      the visual field. We therefore followed the progress of 422 right eyes and 420
      left eyes of 483 patients with CSG and 119 right eyes and 132 left eyes of 151
      patients with an original diagnosis of ocular hypertension (OH). These patients
      were observed for a minimum of one year and up to 13 years, being followed for an
      average of 5.1 years in the case of CSG and of 4.5 years in OH. The majority of
      eyes with CSG were treated topically with a miotic and 38% of these received beta
      blocking therapy in the form of topical timolol. It was concluded that despite
      suggestions that beta blockers might reduce vascular perfusion of the optic nerve
      head, which might in turn cause an adverse effect on the visual field progress,
      the results of this analysis showed that there was less mean deterioration of
      visual field in eyes treated with beta blocker plus miotic treatment compared
      with those on miotic therapy alone.

PMID- 2226986
TI  - Screening for hydroxychloroquine retinal toxicity: is it necessary?
AB  - All the patients (73) in the Rheumatology Department five year study of second
      line therapy who have taken hydroxychloroquine (Plaquenil) for rheumatoid
      arthritis for longer than 18 months were reviewed. These patients have their
      treatment dosage carefully monitored and have been receiving regular ophthalmic
      examinations. Most patients still taking the drug were assessed with a battery of
      tests for evidence of retinal toxicity. No retinal toxicity causing visual loss
      was found. On the basis of these results and a review of the recent literature we
      no longer routinely screen patients for hydroxychloroquine retinal toxicity in
      Cardiff.

PMID- 2226987
TI  - The development of cataract following trabeculectomy.
AB  - OBJECTIVE: To determine the risk of cataract development following
      trabeculectomy. DESIGN: A prospective follow-up study of patients seen pre
      operatively and at one, three, six and 12 months following surgery and
      subsequently at yearly intervals. SETTING: Ophthalmology Department of Nottingham
      University Hospital. PATIENTS: Fifty-seven patients with primary open angle
      glaucoma, including pseudoexfoliation, undergoing trabeculectomy. MAIN OUTCOME
      MEASURES: Increases in lens opacity measured by the Lens Opacity Meter 701, the
      Keeler Projectoscopy and clinical grading. RESULTS: Of 35 patients seen at six
      months post-operatively, none had lost two Snellen lines of visual acuity due to
      lens opacity, although three patients showed evidence of increasing lens opacity
      on all three parameters. CONCLUSION: There is no evidence of visually significant
      lens opacity occurring at six months post-operative follow-up.

PMID- 2226988
TI  - Light scatter from the central human cornea.
AB  - Light scatter from the central human cornea was measured in 60 eyes of 60
      patients using computerised image analysis of Scheimpflug slit image photographs.
      There was no correlation between the amount of scatter and the age of the
      patients (correlation 0.035, p = 0.79). In addition it was found that light was
      scattered more at the anterior and at the posterior surfaces of the cornea than
      from the stroma.

PMID- 2226989
TI  - Acanthamoeba adherence to contact lenses and removal by cleaning agents.
AB  - The quantitative adherence of a keratitis isolate of Acanthamoeba polyphaga to
      low- and high-water content non-ionic soft contact lenses and one type of rigid
      gas-permeable lens was investigated. Adherence of trophozoite and cyst forms of
      the organism was observed in vitro, and adherent amoebae counted by a plaque
      assay method following detachment. Trophozoites adhered to all lens types with
      adherence being statistically significantly greater to high water content soft
      lenses. Cyst attachment occurred only to the soft lenses but not to gas-permeable
      lenses, and was significantly higher for the high water content lenses.
      Attachment of cysts was significantly lower than that of trophozoites to each
      lens tested. Recommended cleaning procedures using two commercial solutions
      removed all adherent trophozoites and cysts from lenses. These studies
      demonstrate (i) that lenses may act as a vector in Acanthamoeba keratitis,
      particularly for high-water content lenses and trophozoite amoebae, (ii) that
      lens cleaning agents may prevent keratitis by removing adherent Acanthamoeba.

PMID- 2226990
TI  - Precorneal residence times of sodium hyaluronate solutions studied by
      quantitative gamma scintigraphy.
AB  - Sodium hyaluronate solutions have been advocated in the management of a variety
      of dry-eye states. By virtue of their non-Newtonian rheological properties,
      formulations exhibiting high zero-shear viscosities may be used as an artificial
      tear with the expectation of prolonged precorneal residence times and improved
      tolerance. Quantitative gamma scintigraphy was used to evaluate the residence
      times of 0.2% and 0.3% sodium hyaluronate solutions and a polymer-free solution
      of buffered saline in 12 patients with keratoconjunctivitis sicca and a group of
      six normal volunteers. Using several indices of residence time, mean values for
      the sodium hyaluronate solutions were significantly longer than those for
      buffered saline. Parallel changes in tear film thickness were also demonstrated
      using a technique based on laser interferometry.

PMID- 2226991
TI  - Penetration of topically applied betamethasone sodium phosphate into human
      aqueous humour.
AB  - Gas Chromatography combined with Negative Chemical Ionisation Mass Spectrometry
      (GCMS) was used to determine the absorption of topically applied beta-methasone
      sodium phosphate into the aqueous humour of human subjects undergoing routine
      intraocular surgery. The Betamethasone concentration was greatest in the interval
      91-120 minutes following topical administration (mean peak concentration = 7.7
      ng/ml). At twelve hours post instillation the mean concentration of Betamethasone
      was 2.5 ng/ml and detectable levels were recorded in the aqueous humour 24 hours
      after application (mean concentration 0.4 ng/ml).

PMID- 2226993
TI  - Macrophages related to Bruch's membrane in age-related macular degeneration.
AB  - This report describes focal thinning of Bruch's membrane in age-related macular
      degeneration and suggests a role for macrophages in this process. Electron
      microscopy was performed on four eyes ranging from normal ageing to age-related
      macular degeneration with early subretinal neovascularisation. As degeneration
      progressed multiple segments of thinning of Bruch's membrane were observed and
      macrophages appeared to engulf fragments of the outer collagenous zone. An
      associated finding at this stage was the shedding of membranous debris by the
      retinal pigment epithelium and its deposition within Bruch's membrane. This
      debris forms the basis of soft drusen but in the presence of this material
      thinning of Bruch's membrane was also observed beneath hard drusen. It is
      suggested that the widespread accumulation of phospholipid-containing membranes
      together with the focal concentration of lipid in hard drusen attract
      macrophages.

PMID- 2226992
TI  - Autonomic function in Holmes Adie syndrome.
AB  - Autonomic function was studied in a group of 11 patients with Holmes Adie
      Syndrome. Autonomic function was assessed by the measurement of cardiovascular
      reflexes. Heart rate responses to respiration, valsalva manoeuvre and standing
      were studied. The change in systolic blood pressure on moving from the lying to
      the standing position was measured. Abnormalities of parasympathetic function
      were found in three patients, compared with matched controls. Autonomic
      dysfunction in Holmes Adie Syndrome may be more widespread than previously
      suspected.

PMID- 2226994
TI  - Cell culture.

PMID- 2226995
TI  - A hand-held OKP chart for the screening of glaucoma: preliminary evaluation.
AB  - Oculo-kinetic perimetry (OKP) uses controlled movements of the patient's eye to
      position a static test stimulus in the visual field. The test chart consists of a
      white tangent screen with 23 numbered fixation points located eccentrically at
      strategic points in relation to a central black spot, which is the test stimulus.
      As the patient looks at each number in turn, the spot stimulates the retinal
      areas that are most likely to show early glaucomatous damage. The result is
      positive if one or more numbers make the spot disappear. Ninety-eight eyes of 54
      patients attending a hospital glaucoma clinic were tested with a prototype OKP
      glaucoma screener and by conventional perimetry. Visual fields plotted
      conventionally were independently categorised as normal, equivocal and
      glaucomatous by the perimetrist and the ophthalmologist and these results were
      further categorised as normal, equivocal or glaucomatous according to whether
      they were considered abnormal by none, one or both of the observers respectively.
      The OKP test was positive in (i) 93% of 27 eyes with glaucomatous defects, (ii)
      69% of 32 eyes with equivocal loss, (iii) 41% of 39 eyes without previously
      recognised field loss but having ocular hypertension, a suspicious disc, or
      contralateral glaucoma, (iv) 9% of 116 eyes from 60 age matched persons
      accompanying the patients to hospital. If the results were considered in terms of
      patients not eyes, the OKP test was positive in 85% individuals with glaucomatous
      field loss in their worse eye and in 12% of the controls. A hand-held OKP chart
      testing a small set of points and using a constantly exposed stimulus could be a
      useful tool for the detection of glaucoma in the community.

PMID- 2226996
TI  - The Oxford modular cataract image analysis system.
AB  - A modular system of acquisition and analysis of Scheimpflug, retro-illumination
      and fluorescence images of the in vivo human crystalline lens is described. Image
      analysis is directed towards the following goals: Scheimpflug slit-images are
      analysed for: (1) The optical density of nuclear cataract present; (2) The
      dimensions of the lens and the lenticular zones; (3) The curvatures of the lens
      and lenticular zones. Retro-illumination images are analysed for: (1) The
      percentage area which is occupied by cataract; (2) A combined measure (weighted
      integral) describing both the amount of cataract present and its optical density.
      Lenticular auto-fluorescence images are analysed for the mean density
      (fluorescence) of the lens as a whole. A pilot study of the repeatability of the
      methods is presented.

PMID- 2226997
TI  - Ocular injury from external rear view mirrors.

PMID- 2226998
TI  - Headache and sudden collapse in a young man.

PMID- 2226999
TI  - Response of tumors to thermodynamic stimulation of the immune system.
AB  - Cytokines such as interferon, interleukin and tumor necrosis factor are natural
      body defense proteins which have been used individually in recent years to
      produce a few complete responses of some tumors in a few patients but their
      overall effect has been limited. The hypotheses is that a biologic stimulus such
      as endotoxin will stimulate the immune system in a more natural way and hence
      will be more likely to have an effect especially in the presence of a naturally
      produced fever than treatment from just one lymphokine. One of the side effects
      of current lymphokine studies has been fever usually spiking in nature but there
      has been no obvious effort to relate the extent of the fever to any tumor
      responses. Clinical experience has shown that increased temperature can enhance
      the results of radiotherapy and chemotherapy in some situations. Therefore it is
      logical to put this hypothesis to a test clinically. It is surprising that the
      combined effect of fever and lymphokine stimulation has not been reported aside
      from Coley's work, and it is only in retrospect that fever has been suggested to
      be essential to the tumor control noted. Most of the literature, animal and
      human, has focused on the destructive effect of temperature on tumor cells and
      not as part of an immune response to control tumor growth. Endotoxin is the
      pyrogen on which most current information is available. More effective and more
      available pyrogens may be developed later.

PMID- 2227001
TI  - Genetics.

PMID- 2227000
TI  - Current concerns in the genetics of pregnancy losses.

PMID- 2227002
TI  - [Response to environmental conditions of extreme driving by the human organism
      and the stomatognathic apparatus].

PMID- 2227003
TI  - [White areas of reticular appearance of the vestibular mucosa].

PMID- 2227004
TI  - [Polygraphic examination of dysgnathic subjects undergoing physico-psychic
      stress. Methodological basis].

PMID- 2227005
TI  - [Occlusal analysis of dysgnathic subjects during off road driving. Statement of
      research and results].

PMID- 2227006
TI  - [Monitoring of masticatory muscles with surface EMG before and after off road
      driving].

PMID- 2227007
TI  - [Electromyographic evaluation (EMG) of postural muscles of the neck during off
      road driving].

PMID- 2227008
TI  - [Spectral analysis of electroencephalograms (EEG) before and after off road
      driving].

PMID- 2227009
TI  - [Variations in cardiac rate and arterial pressure during off road driving].

PMID- 2227010
TI  - [Fixed prosthetic reconstruction. Restoration of upper incisors. 2].

PMID- 2227011
TI  - [Muscular flow and resistance in dentists during work].
AB  - In the present paper the advantage of muscular flux and resistance determination
      in the limb over the traditional cardiovascular parameter about operative stress
      in dentistry has been discussed.

PMID- 2227012
TI  - [Training and professional profile of dentistry in the EEC. 5].

PMID- 2227013
TI  - [Esthetic dentistry. Perspectives for dental technology].

PMID- 2227014
TI  - [Dental technology in Australia. High standard in porcelain technic].

PMID- 2227015
TI  - [Development of a process. Pouring titanium in the dental laboratory].

PMID- 2227016
TI  - [Soft denture lining material].

PMID- 2227018
TI  - [Groove-shoulder-pin attachment. Fourth to ninth milling step].

PMID- 2227017
TI  - [Inlays and onlays today. Laboratory completed composite inlay].

PMID- 2227019
TI  - [More on the theme comparison and selection of tooth color].

PMID- 2227020
TI  - [Total restoration from casting to installation].

PMID- 2227021
TI  - [Heratec-system. Layering technic for greater stability].

PMID- 2227022
TI  - [Silicoater-MD-process in 2-year clinical test].

PMID- 2227023
TI  - [Compatibility of Impresept disinfectant with impression materials].

PMID- 2227024
TI  - [New model and duplication system. High tech finishing for greater precision].

PMID- 2227025
TI  - [Sensible alternative in preparation of a complete denture?].

PMID- 2227026
TI  - [Conceptual preparation of an inlay and onlay partial denture].

PMID- 2227027
TI  - [Chewing movements, foundations and basic relations of occlusal arrangements in
      practice].

PMID- 2227028
TI  - [Experimental method of judging heat fast porcelain restorations].

PMID- 2227029
TI  - [Curiosities and amusements. Laboratory applications and their results].

PMID- 2227030
TI  - [Better quality in poured alloy models by supplementary seed crystals].

PMID- 2227031
TI  - [Cyclarc-system. Titanium pouring in dentistry].

PMID- 2227032
TI  - Removable partial overdentures.

PMID- 2227033
TI  - Philosophies and principles of removable partial overdentures.
AB  - Retention of remaining teeth for use as overdenture abutments has been widely
      used in the discipline of complete denture therapy, but has frequently been
      overlooked as a means of enhancing removable partial denture therapy. There are
      considerable advantages in retaining even severely compromised teeth that can be
      included in a treatment plan for providing removable partial overdentures. The
      value of such teeth in providing aesthetic improvement, residual bone retention,
      denture base support, primary or secondary retention, and improved stability
      should be of primary importance in treatment planning.

PMID- 2227034
TI  - The overdenture concept.
AB  - The biomechanical rationale for the treatment of patients with overdentures, and
      their advantages and disadvantages are presented. The indications and
      contraindications for the treatment of partially edentulous patients with
      removable partial overdentures are discussed. The patient's and dentist's
      responsibilities for the success of therapy are enumerated.

PMID- 2227035
TI  - Classification of removable partial overdentures.

PMID- 2227036
TI  - Removable partial overdentures. Clinical considerations.
AB  - Removable partial overdentures have the potential for salvaging teeth with poor
      prognoses and using them for prosthesis support and retention. Careful case
      selection and creative treatment planning can lead to aesthetic, well-supported
      restorations for a variety of patients with compromised dentitions.

PMID- 2227037
TI  - Design, preparation, and maintenance of overdenture abutments.

PMID- 2227038
TI  - Endodontic considerations in restoration of partial overdenture abutments.
AB  - Overdenture abutment teeth often require endodontic treatment. Various factors,
      such as status of the pulp, periodontal state of the tooth, and the sequence of
      overdenture treatment, influence endodontic management of the patient. After
      completion of endodontic treatment, the coronal part of the root filling is
      removed, leaving an adequate amount of the root filling in the apical part of the
      root canal undisturbed. The abutment tooth is then permanently restored with a
      filling material, or is prepared for a cast restoration.

PMID- 2227039
TI  - Periodontal considerations of the removable partial overdenture.
AB  - 1. An overdenture, whether complete or partial, is an excellent mode of treatment
      in the mutilated dentition for the preservation of the residual ridge. 2.
      Selection of patients for an overdenture should be based on past history of
      dental neglect, the status of the teeth and their periodontium, including present
      oral hygiene status, and patient motivation. The patients with a history of
      dental neglect, poor oral hygiene, and lack of motivation in having the teeth and
      the periodontium restored to health as well as strict compliance to a home-care
      regimen and recall schedule are not good candidates for treatment with an
      overdenture. 3. The choice of teeth or roots to serve as overdenture abutments
      must include their periodontal evaluation, which should consist of a detailed
      periodontal examination, diagnosis, prognosis, and treatment when this is
      indicated, including chemical protection (fluoride gel) and an oral hygiene
      regimen tailored to individual needs. 4. The knowledge and expertise in the
      selection and implementation of appropriate periodontal treatment modalities is
      of paramount importance in restoring optimum periodontal health to the
      overdenture abutments before overdenture fabrication. 5. The maintenance phase of
      the overdenture abutments as well as of the existing natural teeth is of critical
      importance in the preservation of health of these abutments and teeth. This
      maintenance phase should consist of periodic recalls based on individual needs; a
      detailed periodontal evaluation, including patient's motivation and status of
      oral hygiene and denture hygiene; and detection of caries. If necessary,
      appropriate periodontal and/or restorative therapy should be performed, and oral
      hygiene measures reinforced. This will ensure longevity of both abutment teeth or
      roots and of the existing natural teeth resulting in a long-term success of an
      overdenture. 6. Because there is evidence of high incidence of periodontal
      disease and dental caries in overdenture wearers, and because this evidence is
      attributed mainly to lack of motivation and compliance of adequate oral hygiene
      as well as to frequency of recall visits, patients should be made aware of the
      importance of their role in the maintenance phase of treatment and in the factors
      that lead to ultimate success of overdenture therapy. 7. With (a) proper
      selection of the patient and the abutment teeth, (b) adequate periodontal and
      restorative health and treatment to ensure optimum health prior to RPOD
      construction, (c) a well-designed home-care regimen and frequency of recalls, and
      (d) proper execution of maintenance care, changes for long-term success of
      overdenture therapy will be much improved.

PMID- 2227040
TI  - Removable partial overdentures with mechanical (precision) attachments.
AB  - Mechanical attachments for overdentures have been available in various forms for
      over a century. The explosive interest in osseointegration and the effort on the
      part of the profession to avoid the complete denture as a treatment modality has
      stirred the interest in positive retentive elements for overdentures represented
      by the mechanical stud and bar attachments. The cited references provide a
      resource as a trouble-free guide in the selection and use of the various stud and
      bar attachment systems. The clinical examples show a pattern of application not
      generally discussed by the manufacturers, illustrating the simplicity of use with
      the options for all attachments including magnets. The discussion on magnets
      comes from 9 years of clinical experience. Rare earth magnets provide excellent
      adjunct retention, and their assembly follows the same protocol and complexity as
      stud attachment systems. All magnets, at the present state of the art, have a
      corrosion potential with the exception of the Laser Sealed Units (Golden Dental,
      Golden, CO). Finally, the mechanics of the attachment overdenture serves as an
      excellent training field for the osseointegrated prosthesis, be it the classic
      Branemark (Nobelpharma USA, Chicago, IL) restorative or the implant overdenture
      concept.

PMID- 2227041
TI  - Overdentures with magnetic attachments.
AB  - Magnets were used only occasionally for dental purposes several decades ago.
      Since the advent of rare earth magnet alloys, however, intraoral magnets are
      shaping the course of aesthetics and retention for both complete and removable
      partial overdentures. Their benefits include simplicity, low cost, self
      adjustment, inherent stress breaking, automatic reseating after denture
      displacement, comparative freedom of lateral denture movement, a low potential
      for trauma to the retained roots, and elimination of the need for adjustment in
      service. The clinical procedures involved in their application do not require any
      special skills, and the options offered by the various manufacturers give the
      dentist a wide variety of choices in selecting an appropriate treatment plan.
      Clinical experience has shown that magnetic retention offers an economical
      alternative for teeth that would otherwise require expensive or extensive
      restorative treatment, and can be used as an effective and often superior
      replacement for failed bridgework. Finally, it is clear that overdenture
      treatment per se is a valuable option for the dentist, and the use of magnets
      expands this option to the retention of tooth roots that might otherwise be
      scheduled for extraction. The natural tooth root, even if periodontally involved,
      can serve as a useful aid in denture support and retention, and should be
      regarded as at least as good as, and in most cases superior to, an implant. It is
      also much less expensive.

PMID- 2227042
TI  - Removable partial overdentures with natural root structure and osseointegrated
      fixtures.
AB  - The development and refinement of osseointegration have had primary impetus in
      treatment of the totally edentulous patient. The same principles, however, may be
      applied to the partially edentulous patient. Osseointegrated fixtures used in
      conjunction with mechanical or magnetic attachments may be used to construct
      partial or full overdentures. This allows treatment with removable prosthodontics
      in many cases in which it is not practical to achieve anchorage for a fixed
      prosthesis.

PMID- 2227043
TI  - Overdentures and osseointegration. Case studies in treatment planning.
AB  - Prosthodontic considerations in the treatment planning and treatment of the
      overdenture patient have been described within the context of osseointegration.
      The rehabilitation of patients with a minimal number of teeth remaining
      represents an increasingly interesting challenge because of the introduction of
      osseointegration into the clinical armamentarium. As demonstrated through case
      reviews, a clinician cannot be limited to osseointegration procedures alone.
      Conservative tooth-supported complete and partial overdentures represent not only
      viable alternatives, but in some instances will be the treatment of choice.
      Expertise in both modalities will be required to treat the patient with limited
      dentition.

PMID- 2227044
TI  - Removable partial overdentures for special patients.
AB  - Removable partial overdentures are an option that should be considered by every
      dentist who is involved with cosmetic dentistry or dentistry for the older adult.
      The rationale, indications, and technique have been described for providing an
      aesthetic, functional prosthesis that is also conservative in nature. The
      reversibility of the procedure allows the patient the opportunity to pursue other
      forms of treatment should the result not meet his or her expectations. For
      appropriately selected special patients, the results can be extremely gratifying
      for both the patient and dentist.

PMID- 2227045
TI  - Removable partial overdentures for the irradiated patient.
AB  - Patients who have received radiotherapy to the head and neck area must avoid
      dental extractions and seek simplicity in treatment and home care follow-up. For
      partially edentulous patients, removable partial overdenture therapy can fulfill
      these goals while maintaining the high level of function and aesthetics desired
      by patients.

PMID- 2227046
TI  - [Mechanism of action and therapeutic use of cyclosporin A. Experimental and
      clinical experiences in dermatology].
AB  - The clinical application of cyclosporine A caused many success in transplantation
      surgery as well as in the treatment of (auto-) immune disorders. The biological
      highly active substance differs from conventional immunosuppressive drugs (i.e.
      steroids, azathioprine) by it's selective action on T-lymphocytes. However,
      current experimental findings indicate a direct influence on epidermal
      keratinocytes, too. First therapeutical experiences, concerning systemic and
      topical application in different skin diseases are summarized.

PMID- 2227047
TI  - [The cytotoxic effect of anti-Ro- (SS-A) antibodies and UVA light on human
      endothelial cells in vitro].
AB  - There is in photosensitive lupus erythematosus a strong association of high
      titers of anti-Ro(SS-A) antibodies in the serum of the patient with the
      development of special skin reactions depending on UV-light. The aim of our
      experiments was to detect a cytotoxic effect of anti-Ro(SS-A) antibodies and UVA
      light on human endothelial cells in vitro (standard trypan blue exclusion test,
      SEM). After UVA-doses of 1 to 100 J/cm2, which were tested, and influence of
      serum containing anti-Ro(SS-A) antibodies (62 E, ELISA) membrane destructions of
      endothelial cells depending on the UVA-dose can be seen, irrespective of the fact
      whether the antibodies are present throughout the irradiation or added
      afterwards. This cytotoxic reaction depends on complement. A UVA-dose of 100
      J/cm2 causes lethal damage of 40% of the cells. These results were confirmed by
      scanning electron microscopy.

PMID- 2227048
TI  - [8-MOP serum level profile following administration of Geroxalen to patients with
      psoriasis and a control group].
AB  - After 8-MOP application (Geroxalen) the mean serum levels with 11 single values
      over 8 hours from 21 psoriatics with squamous infiltrative plaques do not differ
      from serum level curves of 46 healthy volunteers (Psoriatics: maximum plasma
      level cmax 189 nm 8 MOP/ml serum at the time tmax 1,2h; area under the curve AUC0
      8 284 ng.ml-1.h. CONTROL GROUP: cmax 193 ng 8 MOP/ml serum; tmax 0.9h; AUC0-8 290
      ng.ml-1.h). A malabsorption of 8-MOP in psoriatic patients could not be found in
      our study, although this is described for fat among other.

PMID- 2227049
TI  - [8-methoxypsoralen serum content of problem patients in PUVA therapy].
AB  - Beside the stage, expression and course of psoriasis as well as the compliance of
      patients low or abnormal 8-MOP levels are the cause of the ineffectiveness of the
      PUVA-therapy, as we could demonstrate in 7 of 11 problem cases. Thus, we
      determined only a maximal 8-MOP concentration of 47 ng/ml serum as an extreme
      value in one patient and on other patient had his maximal serum peak 3-4 hours
      after 8-MOP-application and only a value of 8-MOP of 18 ng/ml serum at the
      recommended time of irradiation. In this connection a first pass mechanism for 8
      MOP by a limited biotransformation capacity in the liver is significant and one
      basic reason for the interindividual variation. Therefore in these cases the
      knowledge of the individual serum profiles of 8-MOP is helpful to adapt the time
      of irradiation to the individual necessities and/or to increase the 8-MOP doses.

PMID- 2227050
TI  - [Multiple daily ultrasound treatment of patients with progressive systemic
      scleroderma].
AB  - Inpatients with progressive systemic scleroderma were submitted to ultrasound
      application several times every day. This type of ultrasonic therapy is
      practicable. Pain decreased in 18 of 24 patients. At the end of therapy, pain had
      not increased in any of the patients. The strength of the hands was significantly
      improved in all patients.

PMID- 2227051
TI  - [Results of treatment of malignant melanoma--a computer analysis of 772
      patients].
AB  - The data of 772 patients with malignant melanoma, treated from 1.1.1972 to
      30.6.1988 in the Regional Hospital Dresden-Friedrichstadt were analysed by
      computer. The probability of survival was estimated separately by the method of
      Kaplan and Meier in dependence on clinical stage in the time of the first
      treatment, pT and sex. The 10-year survival rate in clinical stage I amounts to
      pT1 = 100%; pT2 = 82.9% +/- 4.0%; pT3 = 67.1 +/- 4.3% and pT4 = 58.0 +/- 4.7%.
      There are significantly differences between women and men with melanomas of the
      category pT2 and pT3 in favour of women (pT2: 88.6%:70.0%; pT3: 75.8%: 53.4%). In
      the cases of pT4 melanoma there are no differences (61%:53%). The average time of
      survival from these patients who have died from melanoma shows also marked
      differences according to pT (pT2 = 46.6 month, pT3 = 36.6 month, pT4 = 30.2
      month).

PMID- 2227052
TI  - [Histology of UV-induced epidermis reactions. 1. A contribution to the
      differentiation of sunburn cells].
AB  - The UV-induced reaction of the epidermis is marked be extra- and intracellular
      edema and intraepidermal vesicles. Characteristical is the appearance of sunburn
      cells. In semithin section they can be differentiated in two cell types: "fried
      egg cells" prevail as early type in the exsudative phase (type I), "dark cells"
      as late type in the degenerative phase (type II) of the UV-reaction.

PMID- 2227053
TI  - [Initial results of the long-term effect of PUVA therapy in lichen ruber of the
      mouth].
AB  - In a study involving 77 patients affected by lichen ruber lenticularis oralis,
      the relative clinical long-term healing rate was determined after application of
      a "Systemic Mouthmucosal Photochemotherapy" (SMPT). The results obtained showed
      that 78.5 percent of the patients were cured while the disease recurred in 21.5
      percent of the patients. Against of 12 patients with erosive Lichen ruber oralis
      have had 9 patients an recidive post Re-SMPT.

PMID- 2227054
TI  - Lichen ruber and bullous pemphigoid.
AB  - The authors describe the case of a male patient, 20 years old, with a rapidly
      developing picture of disseminated lichen ruber planus together with the
      formation of vesicles and blisters. Immunofluorescent examination demonstrated
      lichen ruber associated with bullous pemphigoid. A good therapeutic effect was
      obtained with a combination of Triamcinolon and Tigason.

PMID- 2227055
TI  - [Photo-photochemotherapy with the "Theralum" UV whole body therapy equipment].

PMID- 2227056
TI  - [Modification of various cell functions of lymphocytes and granulocytes in vitro
      by 8-MOP without activating UVA irradiation].

PMID- 2227057
TI  - [Keratolytic therapy].

PMID- 2227058
TI  - [Commentary on the new AIDS guideline and on the 4th regulation of
      implementation].

PMID- 2227059
TI  - [Hyde's nodular prurigo--preference for creases of the skin].
AB  - The arrangement of papules in prurigo nodularis Hyde along the cleavage lines of
      the skin, but not Blaschko's lines, supports the classification of prurigo
      nodularis Hyde as a traumatic chronic papulosis with cutaneous neural hyperplasia
      of xerodermal skin.

PMID- 2227060
TI  - [The effect of monochromatic and polychromatic UV irradiation and of 8-MOP on
      phagocytosis of neutrophilic granulocytes].
AB  - We investigated the inhibition of granulocyte phagocytosis by 8-MOP and
      monochromatic or polychromatic UV light. After application of 8-MOP and UV there
      was an additional inactivation compared with UV alone, as expected from studies
      on other cell species. This additional inhibition of phagocytosis was found to be
      increasing with 8-MOP level. The action spectra of granulocyte inactivation by 8
      MOP and UV involves the investigated UVB range (until 300 nm). A marked
      inactivation of granulocytes was seen after erythemogenic fluences only.
      Therefore we assume that inactivation of granulocytes by direct UV action does
      not play an essential role in UV therapy in vivo.

PMID- 2227061
TI  - [Kinship studies in Gorlin-Goltz syndrome (basal cell nevus syndrome)].
AB  - By means of an investigation on 7 patients from 3 families views are expressed on
      the problems of the basal cell-naevus-syndrome. The typical clinical signs appear
      preferentially and as first-symptoms in the jaw-bone as solitary and later
      developing multiple cysts. Because these first symptoms of the syndrome cause
      secondary, dentitio tarda (belated dentition) and displacement of the teeth, the
      dentist or the maxillo-facial-surgeon has a special responsibility for early
      diagnosis of this disease. Reference is made to the necessity of
      interdisciplinary cooperation and the ambulatory-care of the patients in the
      sense of a family registration and observation.

PMID- 2227062
TI  - [Leukoplakia-like epidermal nevus of the mouth mucosa. Case report].
AB  - We report on a nevus of the oral mucosa, which became present in the age of 30 of
      a male patient. By microscopic examination we did not find any vacuolation of the
      spinous layer of the epithelium. So this nevus has been considered quite
      different from the typical white sponge nevus, and we prefer to name it
      leucoplakial nevus of the oral mucosa.

PMID- 2227063
TI  - [Pamphlet on the treatment of psoriasis with 8-methoxypsoralen tablets and UV
      light (PUVA therapy)].

PMID- 2227064
TI  - The use of calcium channel blockers in obstetrics and gynecology; a review.
AB  - Since their introduction, calcium channel blockers gained wide use in the
      treatment in various fields of medicine. Calcium channel blockers were shown to
      inhibit contractions of the pregnant and nonpregnant uterus, and lately their
      properties have made it, theoretically, an ideal candidate for the use in severe
      pregnancy-induced hypertension: it is effective in lowering blood pressure, has a
      fast and long-standing action, may be conveniently administered via the oral
      route, and it is not associated with serious side effects.

PMID- 2227065
TI  - Influence of pregnancy on human immunodeficiency virus disease.
AB  - Over a period of 3 years (mean 16, extremes 3 and 36 months), we compared
      clinical and laboratory parameters of 128 female, human immunodeficiency virus
      (HIV)-infected patients, all in clinical stage II or III (CDC classification). 34
      patients were pregnant and delivered a viable infant after at least 28 weeks of
      amenorrhea (group I), 29 patients were pregnant and had a spontaneous or induced
      abortion during the first or second trimester (group II), and 64 were non
      pregnant female control patients (group III). The changes in the clinical stages
      over time were not statistically significant between the groups. The only
      laboratory parameters that were significantly higher in group I at the time of
      the delivery were: leucocyte count (p less than 0.001), lymphocyte count (p less
      than 0.05), and sedimentation rate (p less than 0.001). These changes are known
      to be related to pregnancy and not to HIV disease. All other laboratory
      parameters showed no significant differences within and between the groups. We
      conclude, that pregnancy--carried to term or interrupted--does not aggravate the
      natural evolution of HIV infection in clinical stage II and III patients.

PMID- 2227066
TI  - Female sterilization failure after bipolar electrocoagulation: a 6 year
      retrospective study.
AB  - A 6 year retrospective study was conducted from January 1983 till December 1988.
      During this period there were 13,014 births, 1,776 registered spontaneous
      abortions and 200 tubal pregnancies. 1,437 sterilizations were performed in the
      same period via bipolar electrocoagulation. 11.5% of the ectopic pregnancies were
      in patients who had previously undergone a tubal sterilization. The failure ratio
      following bipolar coagulation was 1.18%, and all failures were extra-uterine
      pregnancies, with an average interval between sterilization and ectopic pregnancy
      of 28.8 months. This reflects the importance of previous sterilizations as an
      etiologic agent in ectopic gestations. We will discuss the possible etiological
      factors for our sterilization failures and how these failures can be avoided or
      minimized. Also diagnostic difficulties and management of an extra-uterine
      pregnancy (EUP) following sterilization will be presented.

PMID- 2227067
TI  - The pin-hole cervical os; a small fertility problem.
AB  - 24 women with a so-called pin-hole cervical os during the pre-ovulatory phase of
      the menstrual cycle were detected in a group of 850 infertile couples. This
      cervical condition is rarely seen and is often combined with extreme
      oligomucorrhea and poor cervical mucus qualities. Sperm quality was so poor in
      four couples that they were excluded. Nine women were likely to have been exposed
      to diethylstilbestrol (DES) in utero. The pregnancy rate in this group was poor,
      only two pregnancies by coitus and none by intra-uterine AIH. In the other eleven
      women there was a strong correlation between a good result of the post-coital
      test (PCT) and the chance to achieve pregnancy. Four of the eight women with a
      good result of the PCT became pregnant by coitus. The three women with a poor
      result of the PCT became pregnant by intra-uterine AIH. It is possible that the
      fertility prognosis of a woman with a pin-hole cervical os during the pre
      ovulatory phase of the menstrual cycle is unfavourably influenced by DES exposure
      in utero. A pin-hole cervical os in the pre-ovulatory phase of the menstrual
      cycle, without DES exposure, has probably no influence on fertility.

PMID- 2227069
TI  - Predictive values of CA 125 antigen levels and CT scan in second-look procedures
      for ovarian cancer.
AB  - 23 patients with ovarian cancer were investigated 10 days after their last
      regimen of chemotherapy by CT scan and CA 125 in comparison with 'second-look'
      findings. In 17 out of 23 cases the CT scan results correlated with the operative
      ones. There were 6 false-negative findings but no false-positives. In all cases
      serum CA 125 levels correlated with the second-look operation. Our data suggest
      that the upper limit of CA 125, especially for patients, with negative findings,
      is less than or equal to 20 U/ml which is much lower than that of 35 U/ml, which
      is generally accepted. They also indicate the value of CA 125 in the detection of
      persistent ovarian cancer and the value of the CT scan in the detection of liver
      metastases. According to the above findings we question the value of the second
      look operation in certain cases of ovarian cancer.

PMID- 2227068
TI  - Hormonal postcoital contraception with an ethinylestradiol-norgestrel combination
      and two danazol regimens.
AB  - The ethinylestradiol-norgestrel combination (EE-NG) for postcoital contraception,
      as described by Yuzpe, has been shown to be an effective method but with frequent
      side effects. To overcome the problem of adverse effects a new approach using
      danazol was proposed, but the efficacy and acceptability of this treatment have
      not yet been tested in large studies. In a 5-year period at the AIECS Family
      Planning Centre in Milan we treated 2448 women requesting postcoital
      contraception using Yuzpe's regimen and two danazol regimens (800 mg/1200 mg).
      The patients' acceptability for danazol treatment was higher than for Yuzpe's
      regimen due to fewer, milder and shorter side effects. Nine pregnancies occurred
      in the EE-NG group (2.21%), 17 in the 800 mg group (1.71%) and 6 in the 1200 mg
      group (0.82%). Our study shows a statistically significant efficacy against
      expected pregnancy rates both with Yuzpe's regimen and with danazol. The 1200 mg
      danazol treatment seems to be more effective and can be considered a valid
      alternative to the EE-NG combination for hormonal postcoital contraception.

PMID- 2227070
TI  - Comparative study of RIS with the 131I-OC 125 F(ab')2 Mab and CT scan prior to
      second look operation for ovarian cancer.
AB  - A tumour-associated radiolabelled monoclonal antibody (Mab) 131I-OC 125 F(ab')2
      was used to investigate 27 patients 2 weeks after their last chemotherapy regimen
      and prior to second-look surgery for ovarian cancer. We did compare the
      radioimmunoscintigraphy (RIS) findings with the CT scan results and the second
      look operation data. In 23 out of 27 cases the RIS results correlated with the
      operation findings, while there were four false-negative results. Computed
      tomography (CT) scans correlated in 17 out of 23 cases with the operative
      findings, while there were six false-negative results. We concluded that RIS is
      more specific in detecting the tumour site within the pelvis, while CT scan is
      superior in detecting liver metastases.

PMID- 2227071
TI  - Female urinary incontinence: comparative value of history and urodynamic
      investigations.
AB  - In order to identify the role of urodynamic investigation in relation to urinary
      symptoms, the authors assessed the diagnostic value of history and of urodynamic
      investigation in female urinary incontinence. 154 patients presenting with
      urinary incontinence were investigated prospectively, by standardised history and
      investigation of bladder stability and investigation of bladder stability and of
      cervico-urethral closure function. Clinical and urodynamic diagnostic conclusions
      were compared. Urodynamic results were highly discordant in the presence of
      clinical 'erethism', whilst agreement was more marked in the case of stress
      incontinence. Urodynamic investigation may be indicated after failure of medical
      treatment in the case of 'dysfunction'. By contrast, it is essential in stress
      incontinence in order to identify the mechanism or detect subclinical
      'dysfunction'.

PMID- 2227072
TI  - Advanced combined intra-uterine and ovarian gestations: case report.
AB  - Combined intra-uterine and ectopic gestations are uncommon. Heterotopic
      gestations in which the ectopic pregnancy is located in the ovary are
      exceptional. We are reporting a 22 week heterotopic gestation with two live
      fetuses, one fetus was developing in the uterus and one in the ovary. Surgical
      excision of the ovarian pregnancy was conducted without disturbing the intra
      uterine live fetus who was ultimately delivered uneventfully at term.

PMID- 2227073
TI  - Determination of plasma concentrations of cyclandelate and mandelic acid in
      patients with generalized atherosclerotic vasculopathy treated with oral
      cyclandelate.
AB  - Cyclandelate, a vasoactive substance consisting of the mandelic acid ester of
      3,3,5-trimethylcyclohexanol, was administered to 10 patients with cerebrovascular
      and/or peripheral vascular disease. Blood specimens were collected at 1-6 h after
      oral administration of 1600 mg cyclandelate, and the ester and acid were
      extracted from plasma in acid medium using n-hexane/isopropyl alcohol. The
      concentrations were determined by a high-performance liquid chromatography
      isocratic system. The highest plasma cyclandelate concentrations were detected at
      the third hour, whereas plasma mandelic acid concentrations were still increasing
      6 h after administration.

PMID- 2227074
TI  - Controlled-release theophylline in the treatment of nocturnal asthma.
AB  - A total of 104 asthmatic patients with symptoms of asthma and/or a 'morning dip'
      in the peak expiratory flow rate (PEFR) who were receiving multiple therapies,
      including inhaled or oral steroids, were treated in addition once nightly with
      controlled-release theophylline in an 8-week double-blind, placebo-controlled
      cross-over study. Theophylline produced an improvement in symptoms of cough,
      wheeze, sleep disturbance and PEFR in the 73 completing patients compared to run
      in and placebo treatment. Theophylline also produced an improvement in the forced
      expiratory volume in 1 s and forced vital capacity relative to baseline, and in
      the difference between actual and predicted PEFR values. Nausea was the most
      frequent side-effect but both patients' and investigator's global impressions of
      the effect of study medication were in favour of theophylline.

PMID- 2227075
TI  - Oral and intravenous pharmacokinetic profiles of doxofylline in patients with
      chronic bronchitis.
AB  - Serum doxofylline concentrations were evaluated after solid-phase extraction by
      high-performance liquid chromatography following administration of 100 mg
      doxofylline given as a single intravenous dose over 10 min or 400 mg doxofylline
      given orally twice daily for 5 days in six and eight non-smoking, fasting,
      chronic bronchitic patients, respectively. Doxofylline possessed a very short
      distribution phase following intravenous administration, with a sustained
      elimination phase (half-life 1.83 +/- 0.37 h). After oral administration, the
      peak serum doxofylline concentration was 15.21 +/- 1.73 micrograms/ml and the
      mean elimination half-life was 7.01 +/- 0.80 h; there was a large inter-subject
      variability. No side-effects were experienced by the patients during the study.

PMID- 2227076
TI  - Steatorrhoea in cirrhosis: effect of ursodeoxycholic acid administration.
AB  - In a double-blind, crossover study, 10 cirrhotic patients (Child B rating) with
      steatorrhoea (daily output of faecal fat greater than 8 g) and dyspepsia were
      placed on a controlled diet for 14 days. Patients then received 150 mg
      ursodeoxycholic acid (UDCA) or placebo twice daily for 14 days. Faecal fat
      excretion was reduced from 14.7 to 10.6 g/day by UDCA and dyspepsia symptom
      scores were also reduced. Serum aspartate aminotransferase concentrations
      declined significantly (P less than 0.02) following UDCA treatment, whereas serum
      bile acid levels increased from 35 to 40.5 microM and the percentage of UDCA
      increased to 22%. It is concluded that UDCA may be useful for many of the
      symptoms present in patients with liver cirrhosis.

PMID- 2227077
TI  - Ketorolac, a new non-opioid analgesic: a double-blind trial versus pentazocine in
      cancer pain.
AB  - A randomized double-blind trial was performed to evaluate the efficacy of a new
      non-steroidal anti-inflammatory analgesic drug, ketorolac, in the treatment of
      cancer pain compared with the opioid pentazocine. A total of 40 patients with
      moderate to severe cancer pain were studied, 20 patients being treated with 10 mg
      ketorolac given orally every 6 h and 20 receiving 50 mg pentazocine given orally
      every 6 h for up to 7 days. A reduction in the severity of the pain was recorded
      in both treatment groups with no significant difference in efficacy being found
      between the two therapies, although withdrawals due to adverse reactions were
      significantly less in the ketorolac-treated group (p less than 0.005). It is
      concluded that ketorolac may be a useful and more acceptable alternative to
      opioids in the treatment of cancer pain.

PMID- 2227079
TI  - Pharmacokinetics and therapeutic study with nimesulide suppositories in children
      with post-operative pain and inflammation.
AB  - The pharmacokinetic pattern of 100 mg nimesulide administered rectally at
      different times prior to undergoing minor surgery was studied in 45 children.
      Absorption of nimesulide was relatively fast, a peak plasma concentration of 75
      mg/l being reached 3 h after administration, and the elimination half-life was
      3.15 h. The efficacy and tolerability of the nimesulide suppositories were
      assessed in a randomized, double-blind, dipyrone-controlled study of 50 children
      suffering from moderate to severe post-operative pain, the drugs being
      administered one to three times daily as required; 26 patients received
      nimesulide and 24 dipyrone. A consistent reduction in pain was recorded during
      nimesulide therapy given for a mean period of 2.5 days, with a mean consumption
      of 3.5 suppositories. Similar results were obtained in dipyrone-treated patients.
      The efficacy of both drugs was judged by the physicians to be good or very good
      in 70% of cases and there were no statistically significant differences between
      the two treatment groups in the dosage required or the pain relief. Tolerability
      of both drugs was excellent, with only one patient in each treatment group
      complaining of nausea.

PMID- 2227080
TI  - Treatment of respiratory tract infections in children: a study of a combination
      of amoxycillin and clavulanic acid.
AB  - In an open study, 70 in-patients and 23 out-patients aged between 1 and 14 years
      with sinusitis (n = 1), perforated otitis media (n = 4), pharyngotonsillitis (n =
      25), tracheobronchitis (n = 30) or broncho-pneumonia (n = 33) were treated daily
      with a combination of 40 mg/kg amoxycillin and 10 mg/kg clavulanic acid in three
      equal doses for between 6 and 15 days. Purulent specimens were cultured when
      obtainable and pathogenic organisms identified were Staphylococcus aureus, beta
      haemolytic streptococcal group A, Pseudomonas aeruginosa, Pseudococcus species
      and Klebsiella pneumoniae infections, of which 45.7% were beta-lactamase
      producing and 54.3% were ampicillin-susceptible. After treatment, only one beta
      lactamase-producing Streptococcus and one Staphylococcus infection persisted.
      Side-effects (vomiting, nausea, diarrhoea, maculopapular exanthema, rash)
      occurred in 16 patients and treatment was withdrawn in eight. It is concluded
      that the amoxycillin--clavulanic acid combination is a suitable first choice for
      the treatment of respiratory tract infections in children in whom the pathogenic
      organism may not have been established.

PMID- 2227078
TI  - Placebo-controlled comparison of single intramuscular doses of ketorolac
      tromethamine and pethidine for post-operative analgesia.
AB  - The analgesic efficacy and safety of single doses of 10 mg and 30 mg ketorolac
      tromethamine and 100 mg pethidine were evaluated in a double-blind, parallel
      group study. The drugs were administered intramuscularly to patients experiencing
      moderate, severe or very severe pain immediately following major abdominal
      surgery. A total of 129 patients were randomly assigned to receive either active
      drug (n = 32 for each treatment group) or placebo (n = 33), and the patients
      assessed pain intensity and pain relief on a visual analogue scale at regular
      intervals over the following 8 h. During the first 2 h, pethidine had a more
      rapid onset of action than ketorolac or placebo, and thereafter 100 mg pethidine
      and 30 mg ketorolac were equally effective. Ketorolac, at a dose of 10 or 30 mg,
      and 100 mg pethidine were clinically and statistically more effective than
      placebo, with 30 mg ketorolac having a similar efficacy to 100 mg pethidine over
      the 8-h study period and 10 mg ketorolac being slightly less effective than 30 mg
      ketorolac. No serious adverse events were reported.

PMID- 2227082
TI  - Photodamaged skin: clinical management with topical tretinoin. Proceedings of a
      satellite symposium to the 1st congress of the European Academy of Dermatology
      and Venereology. Florence, 26 September 1989.

PMID- 2227081
TI  - Short- and long-term effect of nifedipine on the visual field in patients with
      presumed vasospasm.
AB  - It is assumed that the ocular circulation may be involved in the vasospastic
      syndrome and patients with vasospasm have visual field defects that are neither
      ophthalmologically nor neurologically explainable. A retrospective study showed
      that 20 mg sustained-release nifedipine treatment given orally may be helpful in
      these cases. There was a marked short-term effect in cases with proven peripheral
      vasospasms but not in similar cases without such vasospasms. The study also
      showed that the effect could last for up to 12 months when 20 mg nifedipine was
      given twice daily but the long-term effect was slightly less than the short-term
      effect. A number of patients had to discontinue nifedipine treatment due to side
      effects.

PMID- 2227083
TI  - Topical tretinoin research: an historical perspective.
AB  - The topical tretinoin epoch began almost 30 years ago in the laboratories of
      Stuttgen where he first recognized that a vitamin A derivative, tretinoin, had
      the potential to be a truly significant form of dermatological therapy. His early
      clinical trials in a variety of skin disorders provided the first indication of
      topical activity for the retinoids. Kligman evaluated further the utility of
      topical tretinoin; focusing his attention on acne. Through these initial studies,
      topical tretinoin became a fundamental treatment modality for acne. Soon after
      topical tretinoin was made available, elderly patients using it to treat acne
      noted a general improvement in the quality of their skin. Kligman began open
      clinical trials to investigate the effects of topical tretinoin on treatment of
      photodamaged skin. Positive findings from these trials led to double-blind,
      vehicle-controlled pilot studies which supported the concept that topical
      tretinoin could improve the fine wrinkling, mottled hyperpigmentation and tactile
      roughness which are characteristic of photodamaged skin. These results were
      verified in two large double-blind, multicentre studies of approximately 700
      patients that used not only clinical and patient evaluations but also biopsies
      and skin surface replicas.

PMID- 2227084
TI  - Photodamaged skin: a medical or a cosmetic concern?
AB  - A well-tanned skin is currently regarded as a sign of fitness, youth and health,
      with people increasingly exposing their skin to the sun and using tanning
      accelerators, such as psoralens, but exposure to ultraviolet B (UVB) radiation
      from the sun causes extrinsic ageing of the skin. The minimal erythema dose is
      rarely exceeded but the UVB dose that brings about irrepairable DNA damage
      leading to photodamage is lower. Growing numbers of patients, therefore, have
      prematurely aged skin with pigmented spots, dryness, itchiness and wrinkles.
      These symptoms are more than just of cosmetic concern. It is known that
      epitheliomas frequently develop in photodamaged skin; consequently, this skin
      requires medical treatment. Prophylactic measures should be taken from childhood,
      but an effective treatment for already damaged skin is topically applied
      tretinoin, which should be used with a mild skin cleansing and skin care
      programme.

PMID- 2227085
TI  - Clinical effects of long-term therapy with topical tretinoin and cellular mode of
      action.
AB  - In a double-blind, placebo-controlled study, 0.1% topical tretinoin reduced the
      effects of photo-ageing maximally after 10 months, with no further improvements
      if treatment was continued until 22 months. Topical tretinoin induced epidermal
      hyperplasia, compaction of the stratum corneum and the deposition of
      ultrastructurally visible collagen fibrils in the papillary dermis. It also
      reduced the number and activity of melanocytes, and possibly induced
      angiogenesis. An Alcian Blue-positive glycosaminoglycan-like substance was
      detected in the stratum corneum of tretinoin-treated skin and mitoses were
      significantly increased. The cellular changes brought about by tretinoin may, in
      part, be the basis for the clinical improvement in photo-aged skin brought about
      by tretinoin.

PMID- 2227086
TI  - Methods for the assessment of the effects of topical retinoic acid in photo
      ageing and actinic keratoses.
AB  - Quantitative techniques for assessing the effects of tretinoin on photo-aged skin
      mainly involve humans, although hairless mice were used in initial studies.
      Ideally techniques should be non-invasive but occasionally biopsies have to be
      taken, especially when studying the effects of tretinoin on different skin
      compartments. Characteristic features of photo-aged skin, including the
      development of fine and coarse wrinkles, skin discoloration, rosy cheeks and
      telangiectasis, have been assessed subjectively using a visual analogue scale.
      Effects of tretinoin on wrinkle depth have been measured non-invasively by
      quantifying contours of silicone rubber replicas using either a mechanical
      tracking device or an optical technique employing an image-analysing computer.
      Changes in skin colour have been measured using an erythema meter and the
      stimulatory effect of tretinoin on blood flow has been established by laser
      doppler flowmetry. Skin thickness has been measured non-invasively using pulsed A
      scan ultrasound which showed that tropical tretinoin increased thickness.
      Biopsies have also been used but no changes in the thickness of the dermal repair
      zone have been noted in humans, in contrast to the situation in hairless mice.
      Epidermal dysplasia has been measured by a visual analogue scale or by objective
      image analysis.

PMID- 2227087
TI  - Clinical efficacy and patient tolerance of topical tretinoin therapy in photo
      ageing.
AB  - A total of 89 patients (mean age 42 years) with clinical signs of photo-ageing
      were evaluated in an open study to determine the clinical efficacy and tolerance
      of topical tretinoin therapy. Each evening for 6 months about 1 cm of cream
      containing tretinoin was applied to the face. Patient compliance and tolerance
      were maximized by gradually increasing the tretinoin concentration in the cream
      over the treatment period: 0.01% tretinoin for 1 month, then 0.025% for 1 month
      and finally 0.05% for 4 months. By the end of the 6 months' treatment period,
      95.8% of patients showed improvement in the clinical symptoms of photo-ageing
      (coarse and fine wrinkling, skin thinning, mottled hyperpigmentation and laxity),
      except for xerosis. During treatment, 17 (19.1%) patients withdrew from the
      study, in five (5.6%) this was due to treatment-related side-effects. Patient
      compliance was rated as excellent in 47.0% of cases, good in 48.5% and fair in
      4.5%; tolerability was excellent in 51.4% of cases, good in 44.4% and fair in
      4.2%. Improvements were confirmed by scanning electron microscopy, computerized
      profilometry and computerized image analysis of skin replicas of the same areas
      taken before and after treatment, with a reduction in width and depth of
      wrinkles, improved skin texture and increased follicle density.

PMID- 2227088
TI  - Tretinoin therapy: practical aspects of evaluation and treatment.
AB  - Tretinoin has previously been used for the treatment of acne. Recent studies,
      however, demonstrating the efficacy of topical tretinoin in the treatment of
      photodamaged skin have led to its widespread use for this entirely new
      indication. When prescribing tretinoin for photodamaged skin rather than acne,
      physicians must take into consideration a new set of issues. Patients must be
      selected based on their commitment to a total sun-avoidance regimen. Evaluation
      of photodamage must be careful and thorough prior to initiating topical tretinoin
      therapy. Global assessment of a patient's photodamaged skin should be made before
      therapy and at all follow-up visits. The patient population treated for
      photodamage tends to be older than that using topical tretinoin for acne;
      therefore, the treatment regimen must account for the different clinical and
      physiological characteristics of older patients' skin.

PMID- 2227089
TI  - The effects of ultraviolet exposure on skin melanin pigmentation.
AB  - The main clinical, histological, ultrastructural and biochemical changes to the
      pigmentary system following photo-exposure are reviewed. Acute exposure to
      ultraviolet (UV) radiation induces an immediate pigment-darkening reaction, due
      to photo-oxidation of preformed melanin, followed by delayed tanning, the
      mechanism of which is unknown. Chronic exposure to UV induces photo-ageing with
      uneven pigment distribution. The most common pigmented lesions on chronically sun
      exposed skin include ephelides, solar lentigines and pigmented solar keratoses.
      Idiopathic guttate hypomelanosis is also common in sun-exposed skin and may be
      considered as a manifestation of photo-ageing. Chronic UV also appears to induce
      cutaneous melanomas. Psolaren UVA lentigines and sunbed lentigines provide good
      arguments for the fact that UV exposure can induce melanocyte dysplasia. In
      addition, various tumours involving the keratinocyte population are associated
      with increased pigmentation, suggesting a concomitant alteration in melanocyte
      function, as in the case of pigmented epitheliomas and pigmented actinic
      keratoses. The exact nature of the interactions between photo-exposure and
      melanocytes has yet to be fully established.

PMID- 2227090
TI  - A dual function of the Notch gene in Drosophila sensillum development.
AB  - We have investigated the function of the neurogenic gene Notch (N) during
      development of the adult sensilla of Drosophila. Heat pulses were applied to
      flies carrying the temperature-sensitive Notch allele Nts1 at different larval
      and pupal stages. We can show that the reduction of Notch+ function during a
      short interval prior to the onset of sensillum precursor division, resulting from
      a heat pulse between 0 and 14 hr after puparium formation (apf), leads to an
      increase in microchaete precursors at the expense of epidermal cells. The
      structure and cellular composition of the sensilla produced by these
      supernumerary precursors are normal. Later heat pulses which include the interval
      immediately after sensillum precursor division (14-20 hr apf) lead, among the
      progeny of the sensillum precursors, to a hyperplasia of sensory neurons, at the
      expense of accessory cells. The resulting "sensilla" consist of neurons only and
      lack the external cuticular structures (i.e., shaft, socket). These results
      demonstrate that similar mechanisms both of which involve the function of the
      Notch gene may be operating to sort out (premitotic) sensillum precursors from
      epidermal precursors and (postmitotic) sensory neurons from accessory cells. They
      further show that in postmitotic sensillum cells the differentiative fate is not
      yet irreversibly fixed, but presumably requires cell-cell interaction to become
      established.

PMID- 2227091
TI  - Adult expression of the Drosophila Lsp-2 gene.
AB  - Previous work has demonstrated expression of the larval serum protein-2 gene, Lsp
      2, uniquely during the late larval and pupal stages of development in Drosophila
      melanogaster. Here we report that the LSP-2 polypeptide accumulates in the
      hemolymph throughout adult life as well. Western blot analysis using an LSP-2
      antiserum reveals notable differences in the molecular weight of the larval and
      adult polypeptides. Lsp-2 transcription results in a unique mRNA of 2.3 kb,
      exhibiting the same 5' end in both larvae and adults. However, adult Lsp-2 mRNa
      is only expressed at 1% of the high level detectable in late third-instar larvae.
      Whereas Lsp-2 mRNA accumulates uniformly in all fat body cells of third-instar
      larvae, over 80% of the adult Lsp-2 transcript is expressed in the adipose tissue
      of the head. These results suggest a differential regulation for expression of
      the Drosophila Lsp-2 gene in adults and larvae.

PMID- 2227092
TI  - Mesodermal cell migration during Xenopus gastrulation.
AB  - The adhesive glycoprotein fibronectin (FN), which is a component of the network
      of extracellular matrix fibrils on the inner surface of the blastocoel roof
      (BCR), has been proposed to play a major role in directing mesodermal cell
      migration during amphibian gastrulation. In the first part of this paper, the
      adhesion of Xenopus mesodermal cells to FN in vitro is examined. Cells from
      several mesoderm regions, which differ in developmental fate and morphogenetic
      activity, are able to bind specifically to the RGD cell-binding site of FN.
      Dorsal mesodermal cell adhesion to FN varies along the anterior-posterior (a-p)
      axis: adhesion is strongest in the anterior head mesoderm, and gradually
      decreases posteriorly. This a-p gradient of mesodermal adhesiveness to FN does
      not change during mesodermal involution, and is reflected in the morphology of
      mesodermal explants on FN. An a-p strip of mesoderm develops a spreading, leading
      anterior margin and a compact, retracting posterior end, thus moving slowly and
      directionally over the FN substrate at about 0.8 micron/min. Although dissociated
      cells from all levels of the dorsal mesodermal axis adhere to FN, only the
      anterior, leading prospective head mesoderm cells migrate as single cells on a FN
      substrate in vitro. Locomotion by means of lamelliform protrusions occurs at an
      average rate of about 1.5 micron/min. Cells of the more posterior axial mesoderm
      merely shift position at random without substantial net translocation, and
      preinvolution mesoderm cells are completely stationary. On the BCR, the in vivo
      substrate for mesodermal cell migration, dissociated prospective head mesoderm
      cells spread and migrate as on FN in vitro, at 2.2 microns/min. In the presence
      of an RGD peptide which inhibits cell-FN interaction, cells remain globular and
      do not spread. They are still motile, but change direction frequently, which
      leads to less efficient net translocation. Apparently, interaction with the RGD
      cell-binding site of FN and concomitant spreading of head mesoderm cells is
      required for the stabilization of cell locomotion. In contrast to the directional
      migration of the mesoderm cell population toward the animal pole in the embryo,
      the pathways of dissociated cells on the BCR are randomly oriented. Coherent
      explants of migratory mesoderm do not move at all on the BCR, although they
      translocate on FN in vitro.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2227093
TI  - Identification and developmental expression of a chicken calsequestrin homolog.
AB  - Calsequestrin (CAL) is a calcium-binding protein whose primary function is
      thought to involve sequestration of calcium in the muscle sarcoplasmic reticulum
      (SR). Little is known about the mechanisms regulating CAL expression, or about
      the role of this protein in muscle development. In addition, CAL may regulate
      calcium localization in some nonmuscle cells. We have identified an avian
      calsequestrin homolog. The predicted amino acid sequence of the avian CAL, first
      described as a laminin binding protein, and named aspartactin, is 70-80%
      identical to mammalian CAL sequences. We have used affinity-purified antibodies
      and cDNA probes to investigate expression in developing and adult chicken
      tissues. In adult chickens, the avian CAL homolog was expressed in slow and fast
      twitch skeletal muscle as well as in cardiac muscle. Surprisingly high levels of
      CAL protein were also detected in cerebellum. During development, CAL mRNA and
      protein were detected in Embryonic Day 5 (E-5) limb primordia, well before the
      initiation of myoblast fusion. In leg skeletal muscle, CAL protein and mRNA
      increase approximately 10-fold from E-8 to E-18 with a time course that just
      precedes myoblast fusion. This early expression pattern was also observed in
      cultured chicken pectoral myoblasts, and appears to be regulated at the level of
      mRNA abundance. The developmental profile of CAL expression is compared to that
      of other muscle proteins and possible additional functions of CAL are discussed.

PMID- 2227094
TI  - Transport of cationic and zwitterionic amino acids in preimplantation rat
      conceptuses.
AB  - The ability of preimplantation rat conceptuses to take up several amino acids was
      examined under a variety of conditions, and the characteristics of uptake were
      compared to those determined previously for mouse conceptuses. Mediated leucine
      transport in two-cell rat conceptuses is Na(+)-independent and inhibited almost
      completely by 2-amino-endobicyclo[2.2.1]heptane-2-carboxylic acid (BCH), so it
      resembles system L which predominates in two-cell mouse conceptuses. System L
      becomes less conspicuous than homoarginine-sensitive, Na(+)-independent leucine
      transport (provisionally designated system bo,+) by the time rat conceptuses
      develop into blastocysts, as is also the case for mouse conceptuses. In contrast
      to leucine transport, system bo,+ appears to be the most conspicuous transporter
      of cationic amino acids throughout preimplantation development of both species. A
      Na(+)-independent cation-preferring amino acid transport process also appears to
      be present in rat as well as in mouse conceptuses. Moreover, rat conceptuses
      resemble mouse conceptuses because Na(+)-dependent transport system Gly activity
      virtually disappears from them by the time they form blastocysts. Unlike mouse
      conceptuses, however, Na(+)-dependent system Bo,+ activity appears to be present
      throughout preimplantation development of rat conceptuses, whereas it has not
      been detected until at least the two-cell stage in the mouse. Although system
      Bo,+ becomes more conspicuous in mouse than in rat conceptuses by the time they
      form blastocysts, system Bo,+ activity appears to increase when blastocysts of
      both species are removed from the uterus just prior to implantation. The latter
      observation is consistent with the possibility that system Bo,+ activity is
      controlled, in part, by the uterus near the time of implantation, although
      further studies are needed to verify this possibility. Similarities as well as
      differences in the amino acid transport processes present in conceptuses of rats
      and mice may eventually be understood best in relation to the environments in
      which they develop in vitro and in situ.

PMID- 2227095
TI  - Developmental profiles of gangliosides in trisomy 19 mice.
AB  - The ganglioside composition of the cerebrum, cerebellum, brainstem, liver, heart,
      and spleen was analyzed quantitatively in trisomy 19 (Ts19) mice aged 4 to 12
      days postpartum. The developmental profiles of cerebral gangliosides were similar
      in Ts19 mice and control littermates: Total ganglioside-sialic acid as well as
      the proportions of the individual gangliosides GD1a and GM1 increased with age,
      while the percentages of GQ1b and GT1b decreased during development. Both the
      accretion of the total ganglioside content and the development of the individual
      ganglioside fractions were delayed by 2-3 days in the Ts19 telencephalon.
      Likewise, the shift from the b- to the a-pathway of ganglioside synthesis was
      retarded. Ganglioside development was equally delayed in the cerebellum and the
      brainstem of Ts19 mice. Since in Ts19 mice, morphogenesis of several brain
      regions is similarly delayed by 2 days, these results confirm the usefulness of
      gangliosides as biochemical markers for brain maturation. In contrast to brain
      gangliosides, the ganglioside composition of the Ts19 livers was clearly
      distinguished from that of control livers. Total ganglioside-bound sialic acid
      was increased by 35-50% in Ts19 livers. This elevation in ganglioside content not
      explicable by a simple delay in development was mainly due to an increase in GD3
      and fraction 2, which is likely to contain GD1a and GD1b. In contrast, GM2 which
      increased considerably with age in control mice persisted on a low level in Ts19
      livers. Comparable alterations of the ganglioside pattern were neither observed
      in the spleen nor in the heart of Ts19 mice. The data presented give additional
      evidence that ganglioside synthesis in the liver is under a different regulation
      mechanism than that in the brain, heart, and spleen.

PMID- 2227096
TI  - Mutations in the par genes of Caenorhabditis elegans affect cytoplasmic
      reorganization during the first cell cycle.
AB  - A dramatic reorganization of cytoplasm occurs during the first cell cycle in
      embryos of the nematode, Caenorhabditis elegans. We present here the results of a
      quantitative study of some of the events during this reorganization in wild-type
      embryos and in par mutant embryos. The par mutations define a set of genes
      required for cytoplasmic localization in early embryos. We show that par
      mutations lead to defects in several events of the reorganization. Mutations in
      all four of the par genes we studied lead to defects in pseudocleavage and
      asymmetric redistribution of cortical microfilaments. In addition, some of the
      par mutations affect streaming of cytoplasm, migration of the pronuclei, and
      asymmetric shortening of the embryo. We propose that the major function of the
      par genes might be to orchestrate this initial reorganization of cytoplasm.

PMID- 2227098
TI  - Periodic calcium waves cross ascidian eggs after fertilization.
AB  - Ascidian eggs respond to fertilization with one to two dozen periodic calcium
      pulses (J.E. Speksnijder, D.W. Corson, C. Sardet, and L.F. Jaffe, 1989a, Dev.
      Biol. 135, 182-190). We examined the spatial pattern of these pulses and found
      that they are initiated in discrete regions from which they propagate as waves.
      The first few pulses start in the animal hemisphere, whereas the later ones are
      mostly initiated near the vegetal pole. Such vegetal waves are often followed by
      a contraction of the egg surface. Since these waves are attenuated as they
      spread, they repeatedly expose the vegetal pole region to more calcium. The
      mechanism of these repetitive calcium waves and their possible role in
      establishing pattern or completing meiosis is discussed.

PMID- 2227097
TI  - Protein kinase C activates the respiratory burst of fertilization, but not
      cortical granule exocytosis, in ionophore-stimulated sea urchin eggs.
AB  - In a "respiratory burst", fertilized sea urchin eggs consume oxygen to produce
      H2O2 as an extracellular oxidant to crosslink their protective surface envelopes.
      The egg generates H2O2 via a NADPH-specific oxidase that requires protein kinase
      C for activation. To further study the physiological regulation of the
      respiratory burst and cortical granule exocytosis, we have measured azide
      insensitive oxygen uptake and fertilization envelope assembly in ionophore
      stimulated eggs. Procaine, trifluoperazine, staurosporine, and H-7, which inhibit
      protein kinase C by different mechanisms, suppressed egg oxygen consumption
      without affecting fertilization envelope assembly. In contrast, both exocytosis
      and oxygen uptake were blocked in N-ethylmaleimide-treated eggs. When the eggs
      were stimulated with ionophore in Na-free artificial seawater, which prevents the
      increase in pHi, oxidase activity was inhibited. This effect was reversed by
      elevation of cytoplasmic pH with the membrane-permeant base NH4Cl. We conclude
      that protein kinase C was not involved in the events downstream from the
      ionophore-dependent elevation of Ca2+ which induced cortical granule exocytosis.
      However, the respiratory burst was inhibited despite the increase in Ca2+ that
      triggered exocytosis. The likely target for inhibition of the burst was protein
      kinase C. Cytoplasmic alkalinization was necessary for optimal rates of H2O2
      synthesis, further implicating pHi as a regulator of the egg oxidase.

PMID- 2227099
TI  - Junctional acetylcholine receptor channel open time is not presynaptically
      regulated in developing muscle.
AB  - The role of motor innervation in controlling the development of acetylcholine
      receptor (AChR) channel open time was tested by examining synaptic current
      durations in transplanted muscles of Xenopus tadpoles. The presumptive lower jaw
      region, which gives rise to the interhyoideus muscle, was transplanted to the
      tail, overlying the myotomal muscle cells. The transplanted muscles became
      innervated, presumably by spinal nerves which normally innervate myotomal muscle.
      Despite development in the presence of foreign innervation, synaptic currents in
      the transplanted interhyoideus were predominantly long in duration and resembled
      those in the normally innervated interhyoideus. They did not resemble those in
      the myotomal muscle, where synaptic currents are brief. The apparent lack of
      neural influence on development of AChR function in muscle contrasts with the
      evidence for presynaptic control of AChR open time in frog sympathetic ganglia.
      This may reflect a fundamental difference between nerve and muscle in the
      regulation of postsynaptic function.

PMID- 2227100
TI  - Locale and level of bindin mRNA in maturing testis of the sea urchin,
      Strongylocentrotus purpuratus.
AB  - This first study of the onset of spermatogenesis in the sea urchin,
      Strongylocentrotus purpuratus, was undertaken using individuals reared in the
      laboratory. Spermatogenesis commences about 11-12 months after metamorphosis in
      these animals. Bindin message accumulates in late spermatocytes and early
      spermatids which lie in the luminal germinal layer. Bindin message accumulates
      later than does the testis-specific histone, H2b-1, suggesting that different
      classes of genes are sequentially activated during the differentiation of sperm.
      We correlate the number of bindin mRNA molecules with morphological structure and
      with quantitative aspects of gonad maturation including the number of nuclei and
      of sperm. The results suggest that the bindin mRNA concentration in total RNA
      from testis at different stages of maturation reflects the change in the
      proportion of expressing cells in the total cell population of the testis.

PMID- 2227101
TI  - Rapid induction of acetylcholine receptor aggregates by a neural factor and
      extracellular Ca2+.
AB  - A soluble fetal brain extract (EBX) induces acetylcholine receptor (AChR)
      aggregation in cultured rat myotubes within 4 hr at 36 degrees C in a defined
      medium containing 1.8 mM (normal) extracellular Ca2+ (Olek et al., 1983). The
      activity of EBX was Ca2+ dependent; reducing extracellular Ca2+ significantly
      inhibited EBX-induced AChR aggregation and a 15-50% increase in extracellular
      Ca2+ synergistically enhanced the activity of EBX. Synergism was specific for
      Ca2+ as increases in other divalent cations (Ba2+, Co2+, Mg2+, Mn2+, Sr2+) had no
      effect. A large increase (300-500%) in extracellular Ca2+ alone also induced AChR
      aggregation within 4 hr at 36 degrees C. An equivalent increase in other cations
      (Ba2+, Co2+, Mg2+, Mn2+, Sr2+) did not promote AChR aggregation. An initial 15
      min pulse of increased extracellular Ca2+ alone or with EBX was adequate to
      induce AChR aggregation. Aggregates induced by EBX, Ca2+ alone, or EBX/Ca2+ were
      found predominantly on the top surface of the myotube. These treatments did not
      detectably alter preexisting aggregates present at substrate contact sites on the
      bottom surface of myotubes. AChR aggregation induced by any treatment was not
      inhibited by cycloheximide, Ca2+ channel blockers, or protease inhibitors but was
      blocked by Co2+ and sodium azide.

PMID- 2227102
TI  - The cortical cytoskeleton and its role in sperm penetration of the mammalian egg.
AB  - In this study isolated cortical regions of both penetrated and nonpenetrated
      Syrian hamster eggs were examined in whole mounts and platinum replicas of
      detergent-extracted cortical patches. Two types of cytoskeletal organization were
      observed in the egg cortex: Loose networks (LN regions) with integrated localized
      dense networks (LDN regions). Decoration with heavy meromyosin and labeling with
      antiactin/protein G gold both indicate that the cortical cytoskeleton consists
      mainly of a LN of actin microfilaments and several types of nonactin filaments,
      whereas LDN regions dispersed within the LN were comprised of nonactin filaments.
      Cortical patches and replicas of eggs incubated with sperm for 10-15 min provide
      evidence that cortical microfilaments may be intimately associated with
      penetrating spermatozoa. The results of this investigation provide the first high
      resolution view of the cortical cytoskeletal domain of a mammalian egg and
      suggest that actin microfilaments might play a role in sperm penetration of the
      egg cortex.

PMID- 2227103
TI  - Epidermal growth factor binding and receptor distribution in the mouse
      reproductive tract during development.
AB  - The ontogeny of the epidermal growth factor (EGF) receptor in the different cell
      types in the neonatal and immature mouse uterus and vagina was examined.
      Immunohistochemical examination of prenatal and neonatal reproductive tracts with
      a polyclonal antibody to the EGF receptor shows immunoreactive EGF receptors as
      early as Day 13 of gestation. Autoradiographic analysis of tissue sections at 3
      to 17 days of age (the day of birth is Day 1) demonstrates that both uterine and
      vaginal epithelial and stromal cells are capable of binding 125I-labeled EGF.
      Both the 125I-labeled EGF autoradiography and immunohistochemistry in whole
      tissue show higher EGF receptor levels in the uterine epithelium than the uterine
      stroma. The presence of EGF receptors was also confirmed by affinity labeling and
      Scatchard analysis of isolated uterine cell types at 7 and/or 17 days of age.
      However, in contrast to the autoradiography and immunohistochemistry data of
      intact tissue, the affinity labeling and Scatchard data of isolated cells
      indicate that the uterine stroma contains higher levels of EGF receptor than that
      of the uterine epithelium. The reason for this discrepancy between the different
      techniques is, as yet, unknown. Regardless of the differences in the actual
      numbers of EGF receptors obtained, our data demonstrate that the developing mouse
      reproductive tract contains immunoreactive EGF receptors that are capable of
      binding 125I-labeled EGF.

PMID- 2227104
TI  - Target recognition by the archenteron during sea urchin gastrulation.
AB  - During sea urchin gastrulation filopodia are sent out by secondary mesenchyme
      cells (SMCs) at the tip of the archenteron in continual cycles of extension,
      attachment, and retraction. Eventually the archenteron ceases its elongation and
      its tip localizes to the animal pole region of the embryo (Gustafson and
      Kinnander, 1956, Exp. Cell Res. 11, 36-57; Dan and Okazaki, 1956, Biol. Bull.
      110, 29-42). We have investigated the mechanisms and specificity of this
      localization by analyzing filopodial behavior and by experimental manipulation of
      the interaction of the archenteron with the animal pole region. When the tip of
      the archenteron nears the animal pole, some filopodia make contact with a well
      defined locus within this region. Filopodia that make contact with the locus
      remain attached 20-50 times longer than attachments observed at any other site
      along the blastocoel wall. The SMCs bearing the long-lived filopodia eventually
      change their phenotype by flattening and spreading onto this region. Several
      lines of experimental evidence indicate that contact with the animal pole locus,
      or "target" region, is crucial for the change in phenotype of the SMCs: (1) the
      phenotypic change can be induced precociously by bringing the animal pole region
      within reach of the tip of the archenteron early in gastrulation. Precocious
      contact with other regions of the blastocoel wall does not induce a similar
      change. (2) The phenotypic change can be delayed by placing the animal pole out
      of reach late in gastrulation, resulting in artificial prolongation of
      exploratory behavior by filopodia. (3) Ectopic combinations of animal pole
      ectoderm and archenterons in fused multiple embryos and chimaeras result in
      attachment of archenterons to the nearest available target, and (4) freely
      migrating SMCs are observed to migrate randomly within the blastocoel, then stop
      at the animal pole and undergo the change in phenotype. Filopodia rapidly attach
      to the animal pole when the shape of early gastrulae is altered such that the
      animal pole is less than 35 microns from the tip of the archenteron, even though
      such attachments only occur in normal embryos at the 2/3-3/4 gastrula stage.
      Since it has previously been shown that the archenteron elongates autonomously to
      2/3 of its final length (Hardin, 1988, Development 103, 317-324), it appears that
      autonomous extension of the archenteron is required to place filopodia close
      enough to the animal pole to allow them to interact with it.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2227105
TI  - Mapping genes in diabetes. Genetic epidemiological perspective.
AB  - Research on mapping diabetes-susceptibility genes is dependent on several
      factors, including the existence of a single major gene for susceptibility,
      genetic homogeneity, and the existence of appropriate clinical material. The
      power to detect susceptibility genes is dependent on the risks in relatives and
      the distance of genetic markers from the susceptibility genes. For insulin
      dependent diabetes mellitus (IDDM), the best-fitting risk models are those with a
      single major locus with residual polygenic factors. The major locus effect is
      likely represented by genes in the HLA complex, because specific genotypes have
      been found to affect IDDM risk significantly. Thus, mapping the remaining
      polygenic IDDM susceptibility factors--each of small effect--is a difficult and
      long task. For non-insulin-dependent diabetes mellitus (NIDDM), the likely risk
      models result in few genes with moderate effect. Models of NIDDM have significant
      residual polygenic variation remaining, reflecting the importance of multiple
      loci with small effect, environmental effects, or genetic heterogeneity; however,
      the prospects for mapping genes that provide at least moderate susceptibility for
      NIDDM now appear promising.

PMID- 2227106
TI  - Marked improvement of glucose homeostasis in diabetic ob/ob mice given oral
      vanadate.
AB  - The trace element vanadium exerts insulinlike effects in vitro and decreases
      hyperglycemia in insulin-deficient animals. This study examined whether vanadate
      can improve glucose homeostasis in genetically obese hyperglycemic insulin
      resistant ob/ob mice, which present metabolic abnormalities similar to those of
      human non-insulin-dependent diabetes. Sodium orthovanadate (0.3 mg/ml) was
      administered for 7 wk in H2O. Vanadate treatment induced a fall in fed and fasted
      plasma glucose and insulin levels and improved tolerance to oral glucose; the
      stimulated glucose area was decreased by 65%, and an early peak of insulin
      secretion was restored. During an intravenous glucose tolerance test, the glucose
      disappearance rate was twofold higher in vanadate-treated mice, and the
      reappearance of a significant insulin response was also observed. Moreover,
      vanadate produced a twofold increase in hepatic glycogen content and prevented
      the exhaustion of pancreatic insulin stores. The hypoglycemic response to
      exogenous insulin was similar in control and treated mice. In vitro experiments
      showed that basal glucose oxidation by hemidiaphragms was 32% higher in vanadate
      treated mice than in controls, although stimulation by insulin was similar in
      both groups. In conclusion, oral vanadate caused a marked and sustained
      improvement of glucose homeostasis in diabetic insulin-resistant mice by exerting
      an insulinlike effect on peripheral tissues and apparently preventing the
      exhaustion of pancreatic insulin stores.

PMID- 2227107
TI  - Short-term administration of captopril and nifedipine and exercise-induced
      albuminuria in normotensive diabetic patients with early-stage nephropathy.
AB  - Recent studies have demonstrated that short-term angiotensin converting enzyme
      (ACE) inhibition with captopril can reduce urinary albumin excretion rate (UAER)
      after exercise in normotensive diabetic patients with early-stage nephropathy.
      The aim of this study was to investigate whether this effect of ACE inhibition
      was due to a systemic hypotensive action or a specific action at the intrarenal
      level. Thus, we compared the acute effects of captopril and the Ca2(+)-channel
      blocker nifedipine on exercise-induced UAER in normotensive (blood pressure less
      than 165/95 mmHg) diabetic patients who were normoalbuminuric or microalbuminuric
      at rest (stage 2 or 3 of diabetic nephropathy). Twenty-five stage 2 diabetic
      nephropathy patients, 39 stage 3 diabetic nephropathy patients, and 12
      nondiabetic subjects performed five submaximal cycloergometric exercises (90% of
      theoretical heart rate) on nonconsecutive days. The first two exercises were
      performed in basal conditions; the next three exercises were performed 24 h after
      administration of captopril (25 mg twice daily) or nifedipine AR (20 mg twice
      daily) or placebo (1 tablet twice daily) according to a randomized double-blind
      crossover trial. After placebo, blood pressure and UAER did not change at rest or
      1 h after exercise. After captopril, blood pressure at rest and during exercise
      was similar to that observed after placebo. UAER at rest was not modified,
      whereas 1 h after exercise, it was significantly decreased both in stage 2 and
      stage 3 diabetic nephropathy patients (P less than 0.001). After nifedipine,
      blood pressure decreased significantly at rest and during exercise in respect to
      placebo and captopril. UAER at rest did not change significantly.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2227108
TI  - Effect of bacitracin on retroendocytosis and degradation of insulin in cultured
      kidney epithelial cell line.
AB  - In an earlier study, we described the presence of a retroendocytotic pathway for
      insulin in a cultured kidney epithelial cell line. Derived from the opossum
      kidney (OK), these cells possess many features of proximal tubule epithelium,
      which is the major site of kidney insulin metabolism. We studied the interaction
      between the retroendocytotic and the degradative pathways with bacitracin as a
      pharmacological probe. Monolayers of OK cells were loaded with 125I-labeled
      insulin over 30 min, acid washed to remove membrane-bound insulin, then incubated
      in fresh medium for 60 min while the release of intracellular radioactivity was
      monitored. In experiments carried out in the presence of bacitracin (2 mM), there
      was a two-thirds increase in intracellular radioactivity at the end of the
      loading phase. Measurements made during the subsequent release phase showed that
      bacitracin reduced the release of degradation products. Thus, although controls
      released 72.1 +/- 8.1% of the internalized radioactivity as trichloroacetic acid
      (TCA)-soluble products, bacitracin-treated cells released 59.2 +/- 9.4% (P less
      than 0.02). In contrast, release of TCA-precipitable insulin increased from 15.2
      +/- 4.6% in controls to 25.8 +/- 3.7% in bacitracin-treated cells (P less than
      0.01). In separate experiments analyzed by gel-exclusion chromatography, 6.4 +/-
      0.6% of radioactivity released from preloaded control cells into medium over 60
      min was insulin sized compared to 29.7 +/- 1.4% in bacitracin-treated cells. High
      performance liquid chromatography revealed that 61.5 +/- 3.5% of this insulin
      sized material released from control cells preloaded with A14-insulin eluted as
      intact insulin and the remainder as unidentified intermediate degradation
      products.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227109
TI  - Abnormal redox status without increased lipid peroxidation in sugar cataract.
AB  - In conflict with a previous report, we find that phenolic inhibitors of lipid
      peroxidation (butylated hydroxytoluene [BHT] and butylated hydroxyanisole [BHA])
      do not have significant inhibitory effect on galactosemic cataract formation.
      This is consistent with the lack of enhancement of stable products of lipid
      peroxidation (measured by the thiobarbituric acid assay) in the lenses of
      galactosemic rats. This does not imply that oxidative stress plays no role in
      galactosemic cataract formation (indeed, we find that galactosemic lens
      homogenates contain increased amounts of an Fe2+ oxidant, possibly a peroxide),
      but rather that BHT- and BHA-inhibitable lipid peroxidation specifically has no
      role to play. In instances where drugs appear to inhibit galactosemic cataract
      formation, other effects caused by the drugs, e.g., inhibition of feeding or
      induction of general detoxification pathways, must be considered.

PMID- 2227110
TI  - Determination of portal insulin absorption from peritoneum via novel nonisotopic
      method.
AB  - The absorption mechanism of insulin administered in the peritoneal cavity (IP) is
      of current interest because of the near availability of implantable insulin
      infusion devices for the treatment of diabetes. To determine the fraction of
      insulin absorbed by the portal circulation after IP administration, a novel
      nonisotopic method is described. Conscious fasting diabetic dogs were studied at
      normoglycemia via the euglycemic insulin-clamp method. Posthepatic appearance of
      insulin and C-peptide were measured in peripheral blood during IP or intravenous
      (IV) equimolar infusion of insulin and C-peptide at two sequential 3-h infusion
      rates of 3.2 and 12.8 pmol.kg-1.min-1. Prior studies have shown that 40-60% of
      portal insulin is extracted at first pass by the liver, whereas C-peptide is not
      extracted. Thus, the fraction (F) of IP insulin not taken up by liver at first
      pass and consequently the fraction absorbed by the portal circulation can be
      derived from insulin (I) and C-peptide (C) plasma concentration values at steady
      state with a monocompartmental model where F = (IIP/IIV)(CIV/CIP). The mean +/-
      SE value of F was 49.7 +/- 8.8%. Glucose disappearance rates were lower with IP
      than IV infusion but similar when peripheral insulin levels were matched. We
      conclude that IP insulin is almost entirely absorbed by the portal circulation
      and induces lower glucose disappearance rates than IV insulin because of lower
      peripheral circulating insulin levels. Whether these properties make the IP route
      a more appropriate route for insulin therapy than the subcutaneous or IV routes
      remains to be established.

PMID- 2227111
TI  - Anti-islet cell antibodies from NOD mice.
AB  - We produced a panel of monoclonal autoantibodies from the spleen cells of
      prediabetic nonobese diabetic mice. The antibodies were selected on the basis of
      their ability to bind to the surface of nondiabetic mouse islet cells, and from
      greater than 4000 hybridomas screened, 35 islet-reactive antibodies were
      isolated. Most of these reagents also bind to nondiabetic rat and human islet
      cells and beta-cell tumor lines. A few of the antibodies were found to be
      reactive with insulin. When tested for cross-reactivity with other cell types,
      most of the antibodies were found to be islet specific.

PMID- 2227112
TI  - Inhibition of hepatic glucose production by SDZ 51641.
AB  - The new oral hypoglycemic agent SDZ 51641 was evaluated in nondiabetic rats and a
      rat model of human non-insulin-dependent diabetes mellitus. Diabetes was induced
      with a single injection of 37.5 mg/kg streptozocin, and the rats exhibited
      hyperglycemia in the fed state with normal insulin levels. Treatment of
      nondiabetic animals with 100 mg/kg SDZ 51641 given orally significantly decreased
      serum glucose and ketone levels within 4 h without affecting insulin levels.
      Nonesterified fatty acids increased more than twofold during the same period. Its
      effect on ketone and fatty acid levels suggests that SDZ 51641 acts as an
      inhibitor of fatty acid oxidation. Diabetic rats treated with SDZ 51641 exhibited
      a significant acute hypoglycemic response, which was more pronounced after 3 days
      of treatment. The compound also significantly decreased serum cholesterol and
      triglyceride levels 27 and 53%, respectively. When endogenous hepatic glucose
      production was assessed in nondiabetic and diabetic animals via continuous
      infusion of [3-3H]glucose, we found that hepatic glucose production was elevated
      43% in diabetic compared with control animals. When diabetic rats were treated
      with 100 mg/kg SDZ 51641, hepatic glucose production decreased to normal levels
      within 6 h. Hyperinsulinemic-euglycemic clamp studies indicated that SDZ 51641
      had no effect on insulin-stimulated glucose utilization. Measurement of [1
      14C]oleate oxidation in isolated hepatocytes demonstrated that SDZ 51641
      inhibited long-chain fatty acid oxidation in a concentration-dependent manner.
      The compound was ineffective at inhibiting long-chain fatty acid oxidation in
      epitrochlearis or soleus muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227113
TI  - Insulinlike activity of new antidiabetic agent CP 68722 in 3T3-L1 adipocytes.
AB  - We examined the in vitro effects of CP 68722, a novel antidiabetic agent, in 3T3
      L1 adipocytes. CP 68722 stimulated 2-deoxyglucose uptake in the absence of
      insulin. At least 30 min of incubation were required for stimulation of uptake.
      This effect increased over 5 h and was sustained up to 72 h. The stimulation of 2
      deoxyglucose uptake by CP 68722 could be inhibited approximately 60% by
      inhibition of protein synthesis with cycloheximide. Half-maximal and maximal
      responses to CP 68722 at 72 h of incubation were observed at 10 and 100 microM of
      drug, respectively, with a threefold stimulation of uptake at 100 microM
      approximating the maximal response of these cells to acute insulin stimulation.
      CP 68722 was able to overcome insulin resistance induced by dexamethasone in 3T3
      L1 cells. The effect of drug, like that of insulin, was primarily to increase the
      Vmax of 2-deoxyglucose uptake. The stimulation of uptake by CP 68722 or insulin
      could be prevented by incubating the cells at 10 degrees C, a temperature that
      impedes translocation of glucose transporters to the plasma membrane. Therefore,
      it appears that CP 68722, like insulin, stimulates glucose uptake by a mechanism
      that involves translocation of intracellular glucose transporters to the plasma
      membrane and de novo protein synthesis. We compared the effect of CP 68722 with
      the sulfonylureas, the primary drugs used in the treatment of non-insulin
      dependent diabetes mellitus (NIDDM). CP 68722 was a more potent and effective
      stimulator of 2-deoxyglucose uptake in 3T3-L1 cells than either first- or second
      generation sulfonylureas.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227114
TI  - Autoxidative glycosylation and possible involvement of peroxides and free
      radicals in LDL modification by glucose.
AB  - It has been postulated that the etiology of the complications of diabetes
      involves oxidative stress, perhaps as a result of hyperglycemia. Consistent with
      this hypothesis, it has been shown that glucose, under physiological conditions,
      produces oxidants that possess reactivity similar to the hydroxyl free radical.
      These oxidants hydroxylate benzoic acid, fragment protein, and induce
      peroxidation in phosphatidylcholine liposomes and low-density lipoprotein (LDL)
      when LDL is incubated with hyperglycemic levels of glucose in vitro. These
      reactions are accelerated by transition metals and inhibited by a metal-chelating
      agent. The atherosclerotic potential of LDL in diabetes mellitus is often
      discussed in terms of protein glycosylation, which may affect cellular
      interactions. Our studies demonstrate, however, that peroxidative reactions also
      accompany LDL glycosylation in vitro. Peroxidative modification of LDL has also
      been implicated in LDL atherogenicity. Our studies indicate that glycosylation
      and peroxidation occur concomitantly in LDL modified by glucose in vitro and may
      both contribute to the behavioral changes of this lipoprotein.

PMID- 2227115
TI  - Effects of exercise training on insulin-regulatable glucose-transporter protein
      levels in rat skeletal muscle.
AB  - Exercise training has been shown to enhance the ability of insulin to stimulate
      glucose uptake in responsive tissues. The purpose of this study was to determine
      the effects of exercise training on the levels of the insulin-regulatable glucose
      transporter (IRGT) in rat skeletal muscle. After 6 wk of voluntary running in
      exercise-wheel cages, male Sprague-Dawley rats were rested for approximately 27 h
      and fasted overnight before removal of plantaris and soleus muscles. The
      concentration of glucose transporters per unit of muscle protein or DNA was
      quantitated by immunoblotting with an anti-IRGT polyclonal antibody raised
      against a synthetic peptide. The IRGT protein was increased by 60% (141 +/- 14
      vs. 229 +/- 24 counts/min [cpm]/25 micrograms protein, P less than 0.01) in
      plantaris muscle from exercise-trained rats compared with controls. Total protein
      yield, DNA content, and 5'-nucleotidase activity were not different in plantaris
      muscle from control and exercise-trained rats. In contrast, there was no
      significant increase in the IRGT protein in soleus muscle after training when
      data were expressed per unit of muscle protein (292 +/- 22 vs. 346 +/- 16 cpm/25
      micrograms protein). These data indicate that the increase in the IRGT in
      plantaris muscle is a selective response to exercise training that does not
      reflect an overall increase in muscle protein. The changes in IRGT for these
      muscles with exercise training parallel changes observed in insulin-mediated
      glucose uptake. We propose that this increase in the total number of glucose
      transporters may be a major component of the increase in insulin-mediated glucose
      uptake that is observed with exercise training.

PMID- 2227116
TI  - Insulin and hypertension. Relationship to obesity and glucose intolerance in Pima
      Indians.
AB  - The relationships among blood pressure, obesity, glucose tolerance, and serum
      insulin concentration were studied in 2873 Pima Indians aged 18-92 yr (mean 37
      yr). Age- and sex-adjusted to the Pima population, the prevalence of hypertension
      (systolic blood pressure greater than or equal to 160 mmHg, diastolic blood
      pressure greater than or equal to 95 mmHg, or receiving drug treatment) was 7.1%
      for subjects with normal glucose tolerance compared with 13.0% for subjects with
      impaired glucose tolerance (IGT) and 19.8% for those with non-insulin-dependent
      diabetes mellitus (NIDDM) (P less than 0.001). The prevalence ratio of
      hypertension was 1.8 (95% confidence interval [CI] 1.2-2.5) for IGT and 2.6 (95%
      CI 2.0-3.2) for NIDDM compared with normal glucose tolerance, controlled for age,
      sex, and body mass index (BMI). In logistic regression analysis, hypertension was
      positively related to age, male sex, BMI, glucose tolerance, and fasting but not
      2-h postload serum insulin concentration. Among subjects not taking
      antihypertensive drugs, however, neither fasting nor 2-h postload serum insulin
      was significantly related to hypertension. Furthermore, in 2033 subjects
      receiving neither antihypertensive nor antidiabetic drugs, blood pressure was not
      significantly correlated to fasting insulin concentration, and 2-h postload serum
      insulin was negatively correlated with diastolic blood pressure. In conclusion,
      insulin is not significantly related to blood pressure in Pima Indians not
      receiving antihypertensive drugs. Higher insulin concentrations in drug-treated
      hypertensive patients might result from the treatment rather than contribute to
      the pathogenesis of hypertension. Thus, these data do not support a major role
      for insulin in determining the occurrence of hypertension or regulation of blood
      pressure in Pima Indians.

PMID- 2227117
TI  - Structural abnormality in LDL from diabetic patients as revealed by resonance
      Raman spectroscopy.
AB  - Resonance Raman spectra of low-density lipoprotein (LDL) isolated from the plasma
      of diabetic patients (age range 13-77 yr, mean age 37 yr) and age- and sex
      matched control subjects were recorded in the 1000- to 1600-cm-1 region as a
      function of temperature (0-50 degrees C). Both nondiabetic and diabetic LDL yield
      spectra characterized by two major bands near 1160 and 1530 cm-1 due to the
      carotenoid component of lipoproteins. The relative intensity of 1530- and 1160-cm
      1 bands, assigned to -C = C- and = C-C = stretchings, respectively, i.e., I1530
      I1160 ratio, was plotted against temperature. For nondiabetic control subjects,
      the plots showed an inflection in the temperature range of 30-39 degrees C, which
      corresponded to the thermal transition of LDL. This transition was abolished in
      the LDL of diabetic patients (P less than 0.001), suggesting an altered lipid
      structure. The transition (30-39 degrees C) was also abolished in the in vitro
      glycosylated nondiabetic LDL. Lipid analysis did not show any appreciable change
      between nondiabetic control subjects and diabetic patients. The change in the
      thermal transition properties of diabetic LDL has been attributed to the
      organizational change in the LDL protein.

PMID- 2227118
TI  - Glucose-induced electrical activity in beta-cells. Feedback control of ATP
      sensitive K+ channels by Ca2+? [corrected].
AB  - Glucose regulates Ca2+ influx in beta-cells by controlling a rhythmic electrical
      activity (slow waves with spikes). However, the glucose-sensitive feedback system
      that triggers repolarization at the end of the slow waves, and thus stops Ca2+
      influx, is unknown. Raising extracellular Ca2+ to 10 mM shortened slow waves in
      mouse beta-cells perifused with medium containing 15 mM glucose and restored slow
      waves when persistent depolarization and continuous spike activity were induced
      by 30 mM glucose. The effects of high Ca2+ were reversed or prevented by
      tolbutamide, whereas 1 mM tetraethylammonium only increased spike amplitude. This
      suggests that a feedback action of Ca2+ on ATP-sensitive K+ channels rather than
      on voltage- and Ca2(+)-activated K+ channels may be involved in slow wave
      generation. Metabolic modulation of this feedback could be central in the
      regulation of electrical activity and, hence, insulin release.

PMID- 2227119
TI  - Human insulin-receptor gene.
AB  - The human insulin-receptor (hINSR) gene spans a region of greater than 120,000
      base pairs (bp) on the short arm of chromosome 19. It is comprised of 22 exons or
      coding regions that vary in size from 36 to greater than 2500 bp. To a large
      degree, the introns appear to divide the hINSR gene into segments that encode
      structural and/or functional elements of the hINSR protein. The exon-intron
      organization of the hINSR gene provides a clue to the evolutionary history of
      this gene and suggests that it is a mosaic constructed from protein-coding
      regions recruited from other genes. Eight mutations in the hINSR gene that result
      in expression of structurally abnormal proteins have been described. These
      mutations are associated with insulin resistance and provide insight into the
      role of the hINSR gene in the development of diabetes mellitus.

PMID- 2227120
TI  - Defective free-fatty acid and oxidative glucose metabolism in IDDM during
      hypoglycemia. Influence of glycemic control.
AB  - To examine the impact of diabetes and its treatment on plasma free-fatty acid
      (FFA) and oxidative fuel metabolism during hypoglycemia, we combined indirect
      calorimetry with [3-3H]glucose during a 4-h low-dose insulin infusion (plasma
      insulin approximately 2-fold above basal) in six poorly controlled and nine well
      controlled insulin-dependent diabetes mellitus (IDDM) patients and in six healthy
      subjects. Diabetic subjects received insulin overnight to maintain euglycemia
      before study. Although free-insulin levels and counterregulatory hormone
      responses were similar, the plasma glucose fall was more pronounced in well
      controlled diabetic subjects. In well-controlled diabetic and healthy subjects,
      the small increment in insulin rapidly suppressed plasma FFA and fat oxidation by
      approximately 50% and stimulated carbohydrate oxidation by approximately 80%. In
      contrast, plasma FFA levels did not fall in poorly controlled diabetic subjects,
      and glucose oxidation was not stimulated. To determine whether this resistance to
      the antilipolytic effect of insulin occurs in the absence of hypoglycemic
      counterregulation, we used a sequential low-dose euglycemic insulin clamp (0.2,
      0.3, and 0.5 mU.kg-1.min-1). In healthy subjects, plasma FFA was nearly maximally
      suppressed at the lowest insulin dose. In contrast, plasma FFA remained
      persistently elevated in poorly controlled diabetic subjects at each insulin
      dose. However, the insulin dose-response curve for suppression of plasma FFA was
      near normal in well-controlled subjects. We conclude that poorly controlled IDDM
      diabetic patients are resistant to the antilipolytic effects of insulin and show
      impaired stimulation of glucose oxidation during insulin-induced hypoglycemia.
      Amelioration of these defects in well-controlled patients may be another factor
      contributing to the higher risk of hypoglycemia during intensified insulin
      therapy.

PMID- 2227121
TI  - Pattern of postprandial carbohydrate metabolism and effects of portal and
      peripheral insulin delivery.
AB  - The importance of portal insulin delivery in the regulation of postprandial
      carbohydrate metabolism is uncertain. To address this question, three groups of
      dogs were studied: one group in which pancreatic venous drainage was transected
      and reanastomosed (portal insulin delivery), one in which the pancreatic drainage
      was transected and anastomosed to the inferior vena cava (peripheral insulin
      delivery), and one that received only a sham operation. Plasma insulin was
      greater (P less than 0.05) during peripheral insulin delivery than in either the
      portal or sham groups, respectively, before and after meal ingestion. On the
      other hand, C-peptide concentrations did not differ between groups, resulting in
      a higher (P less than 0.001) insulin to C-peptide ratio in the peripheral group.
      This indicated that the hyperinsulinemia in the peripheral group was due to
      decreased insulin clearance rather than increased insulin secretion. Isotopically
      determined splanchnic uptake of ingested glucose, postprandial suppression of
      hepatic glucose release, incorporation of CO2 into glucose (a qualitative measure
      of gluconeogenesis), and total-body glucose uptake were virtually identical in
      all groups. Similarly, plasma lipid, beta-hydroxybutyrate, and lactate
      concentrations did not differ between groups. Our data indicate that, despite
      differences in systemic insulin concentration, portal and peripheral insulin
      delivery comparably regulate hepatic and extrahepatic carbohydrate metabolism
      after meal ingestion.

PMID- 2227122
TI  - Metabolic effects of hyperglycemia and hyperinsulinemia on fate of intracellular
      glucose in NIDDM.
AB  - Hyperglycemia in non-insulin-dependent diabetes mellitus (NIDDM) stimulates
      peripheral glucose uptake, which tends to compensate for impaired insulin
      mediated glucose uptake. The metabolic fate of glucose and suppression of fat
      oxidation may differ, however, when glucose uptake is stimulated primarily by
      insulin or hyperglycemia. To address this issue, three hyperinsulinemic glucose
      clamp studies were performed in combination with indirect calorimetry in seven
      nonobese subjects with NIDDM. In the first two experiments, when glucose uptake
      was matched at approximately 8 mg.kg-1 fat-free mass (FFM).min-1 with primarily
      hyperinsulinemia (1350 +/- 445 pM) or hyperglycemia (20.8 +/- 1.8 mM), identical
      rates of glucose oxidation (3.21 +/- 0.29 and 3.10 +/- 0.23 mg.kg-1 FFM.min-1,
      NS) and nonoxidative glucose metabolism (5.19 +/- 0.75 and 5.46 +/- 0.61 mg.kg-1
      FFM.min-1, NS) were achieved. When glucose uptake was increased further to 11.11
      +/- 0.36 mg.kg-1 FFM.min-1 with less insulin (625 +/- 70 pM) and hyperglycemia,
      glucose oxidation (3.85 +/- 0.26 mg.kg-1 FFM.min-1) and nonoxidative glucose
      metabolism (7.26 +/- 0.51 mg.kg-1 FFM.min-1) rose significantly (both P less than
      0.05 from matched studies at lower rates of glucose uptake). During all glucose
      clamp studies, free fatty acids were comparably suppressed by 40-46% (all P less
      than 0.005 vs. basal values), whereas fat oxidation was suppressed by 70-80% (all
      P less than 0.005 vs. basal values). A strong negative correlation was observed
      between rates of glucose and fat oxidation (r = -0.88, P less than 0.001) when
      all studies were combined.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227123
TI  - Calcitonin gene-related peptide and induction of hyperglycemia in conscious rats
      in vivo.
AB  - The effect of calcitonin gene-related peptide (CGRP) on glucose metabolism was
      investigated in conscious and unrestrained rats in vivo. Intravenous injection of
      rat CGRP (5.67 and 0.567 nmol/kg) caused a significant, dose-dependent increase
      in plasma glucose concentration and a simultaneous dose-dependent increase in
      plasma insulin level. In contrast, plasma glucagon level was not changed. On the
      other hand, intravenous infusion of CGRP (46.6 pmol.kg-1.min-1) decreased
      tolerance to intragastric administration of glucose (IGGTT). Plasma insulin
      response to IGGTT, however, was not affected by CGRP infusion. Moreover, although
      intravenous injection of CGRP (5.67 nmol/kg) elicited a significant increase in
      plasma epinephrine and norepinephrine concentrations, concomitant administration
      of epinephrine and norepinephrine, inducing a more prominent rise in plasma
      catecholamines than those induced by CGRP, affected neither plasma glucose nor
      insulin levels. Finally, plasma insulin levels obtained by simulating CGRP
      induced changes in plasma glucose or glucose plus catecholamine levels by
      infusion of glucose or glucose plus catecholamines were not different from those
      induced by CGRP injection. These results suggest that CGRP has a hyperglycemic
      action that is not mediated by sympathetic outflow in conscious rats, and
      inhibition of insulin secretion, if any, does not play a major role in this
      hyperglycemic action of CGRP. We have demonstrated specific CGRP receptors linked
      to adenylate cyclase activation in rat liver plasma membranes; this hyperglycemic
      effect of CGRP in vivo may be partly due to its direct action on the liver.

PMID- 2227124
TI  - Change in hexose distribution volume and fractional utilization of [18F]-2-deoxy
      2-fluoro-D-glucose in brain during acute hypoglycemia in humans.
AB  - We used positron emission tomography (PET) to study the effects of mild
      hypoglycemia on cerebral glucose uptake and metabolism. Nine healthy men were
      studied under basal saline-infusion conditions, and during euglycemic and
      hypoglycemic clamp studies. Insulin was infused at the same rate (1 mU.kg-1.min
      1) in both clamp studies. In euglycemic clamp studies, glucose was infused at a
      rate sufficient to maintain the basal plasma glucose concentration, whereas in
      hypoglycemic clamp studies, the glucose infusion rate was reduced to maintain the
      plasma glucose at 3.1 mM. Each study lasted 3 h and included a 30-min baseline
      period and a subsequent 150-min period in which insulin or glucose was
      administered. Blood samples for measurement of insulin, glucose, cortisol, growth
      hormone, and glucagon were obtained at 20- to 30-min intervals. A bolus injection
      of 5-10 mCi [18F]-2-deoxy-2-fluoro-D-glucose (2-DFG) was administered 120 min
      after initiation of the study, and plasma radioactivity and dynamic PET scans
      were obtained at frequent intervals for the remaining 40-60 min of the study.
      Cerebral regions of interest were defined, and concentrations of radioactivity
      were calculated and used in the three-compartment model of 2-DFG distribution
      described by Sokoloff. Glucose levels were similar during saline-infusion (4.9 +/
      0.1 mM) and euglycemic clamp (4.8 +/- 0.1 mM) studies, whereas the desired
      degree of mild hypoglycemia was achieved during the hypoglycemic clamp study (3.1
      +/- 0.1 mM, P less than 0.05). The insulin level during saline infusion was 41 +/
      7 pM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227125
TI  - Effects of insulin on diacylglycerol-protein kinase C signaling in rat diaphragm
      and soleus muscles and relationship to glucose transport.
AB  - Insulin was found to provoke rapid increases in diacylglycerol (DAG) content and
      [3H]glycerol incorporation into DAG and other lipids during incubations of rat
      hemidiaphragms and soleus muscles. Insulin also rapidly increased phosphatidic
      acid and total glycerolipid labeling by [3H]glycerol, suggesting that insulin
      increases DAG production at least partly through stimulation of the de novo
      pathway. Increased DAG production may activate protein kinase C (PKC) as reported
      previously in the rat diaphragm. We also observed apparent insulin-induced
      translocation of PKC from cytosol to membrane in the rat soleus muscle. The
      importance of insulin-induced increases in DAG-PKC signaling in the stimulation
      of glucose transport in rat diaphragm and soleus muscles was suggested by 1) PKC
      activators phorbol esters and phospholipase C stimulation of [3H]-2-deoxyglucose
      (DOG) uptake and 2) PKC inhibitors staurosporine and polymixin B inhibition of
      insulin effects on [3H]-2-DOG uptake. Although phorbol ester was much less
      effective than insulin in the diaphragm, phospholipase C provoked increases in
      [3H]-2-DOG uptake that equaled or exceeded those of insulin. In the soleus
      muscle, phorbol ester, like phospholipase C, was only slightly but not
      significantly less effective than insulin. Similar variability in effectiveness
      of phorbol ester has also been noted previously in rat adipocytes (weak) and
      BC3H1 myocytes (strong), whereas DAG, added exogenously or generated by
      phospholipase C treatment, stimulates glucose transport to a degree that is
      quantitatively more comparable to that of insulin in each of the four tissues.
      Differences in effectiveness of phorbol ester and DAG could not be readily
      explained by postulating that the latter acts independently of PKC, because DAG
      provoked the apparent translocation of the enzyme from cytosol to membranes in
      rat adipocytes, and effects of DAG on [3H]-2-DOG uptake were blocked by
      inhibitors of PKC in both rat adipocytes and BC3H1 myocytes. Collectively, our
      findings provide further support for the hypothesis that insulin increases DAG
      production and PKC activity, and these processes are important in the stimulation
      of glucose transport in rat skeletal muscle and other tissues.

PMID- 2227126
TI  - Is insulinlike growth factor I associated with diabetic retinopathy?
AB  - Insulinlike growth factor I (IGF-I) is the mediator of the growth-promoting
      effects of growth hormone and has been suspected of playing a role in the
      pathogenesis of proliferative diabetic retinopathy (PDR). However, previous
      attempts to correlate IGF-I levels with PDR have yielded conflicting results. We
      determined IGF-I levels in a large population-based study of 682 early-onset
      (diagnosed before 30 yr of age) adult (greater than or equal to 18 yr old)
      insulin-taking diabetic subjects. PDR was found in 25% of the population. IGF-I
      levels were measured by radioimmunoassay. The mean serum level of IGF-I was 277
      +/- 108 micrograms/L (mean +/- SD). Spearman rank correlations showed
      statistically significant negative correlations between IGF-I levels and age (r =
      -0.51, P less than 0.0001), duration of disease (r = -0.36, P less than 0.0001),
      and glycosylated hemoglobin (r = -0.09, P less than 0.05). There was a
      significant trend (P less than 0.001) toward decreasing risk of PDR with
      increasing IGF-I. However, after controlling for duration of diabetes,
      glycosylated hemoglobin, diastolic blood pressure, and the presence of
      proteinuria and/or creatinine greater than or equal to 265 microM in a multiple
      logistic regression model, IGF-I was not significantly associated with PDR. These
      data suggest that IGF-I may not be a risk factor for the development of PDR.

PMID- 2227127
TI  - Altered steady-state mRNA levels of basement membrane proteins in diabetic mouse
      kidneys and thromboxane synthase inhibition.
AB  - We examined steady-state levels of mRNA encoding type IV collagen, B1 chain of
      laminin, and the basement membrane heparan sulfate proteoglycan in the kidney
      cortex of a mouse model (KKAy) of non-insulin-dependent diabetes. mRNAs encoding
      laminin B1 and the proteoglycan were unchanged in kidneys taken from diabetic
      mice with demonstrable basement membrane thickening. mRNA levels for type IV
      collagen, in contrast, were significantly elevated (2-fold) in diabetic mice
      concurrent with but not preceding morphologically thickened basement membranes.
      There was a negative correlation between a ratio of proteoglycan/type IV collagen
      and levels of albuminuria in the diabetic mice. No correlation was noted with
      laminin. We also examined the effects of inhibiting the synthesis of thromboxane,
      a potent vasoconstrictor, on the steady-state levels of type IV collagen in the
      diabetic mice. Inhibition of thromboxane stopped the progression of albuminuria
      and prevented an increase in type IV collagen mRNA levels. We conclude that
      basement membrane thickening in diabetes, a hallmark of diabetic nephropathy, is
      partly a consequence of an unbalanced increase in the production of type IV
      collagen. The relative decrease in proteoglycan production may contribute to
      chronic albuminuria.

PMID- 2227128
TI  - Lack of predictive value of islet cell antibodies, insulin antibodies, and HLA-DR
      phenotype for remission in cyclosporin-treated IDDM patients. The Canadian
      European Randomized Control Trial Group.
AB  - The effect of immunosuppression on the humoral immune response to islet
      autoantigens and exogenously administered insulin and the predictive value of
      islet cell cytoplasmic antibodies (ICAs), insulin antibodies (IAs), and HLA-DR
      phenotype for remission during immunosuppression were studied in a prospective
      randomized double-blind trial of cyclosporin administration in 98 newly diagnosed
      insulin-dependent diabetes mellitus (IDDM) patients. HLA-DR phenotype and
      glycosylated hemoglobin were determined at study entry, and insulin requirement,
      glucagon-stimulated C-peptide, ICAs, and IAs were measured at entry and after 1,
      3, 6, 9, and 12 mo of follow-up. Cyclosporin therapy caused significant
      suppression of the prevalence and serum concentrations of ICAs and IAs.
      Cyclosporin-treated IDDM patients ICA+ at study entry had higher levels of
      stimulated C-peptide after 1 mo of study, but the increased beta-cell function
      was not associated with a higher frequency of insulin-free remission at 1 mo. ICA
      and IA status at entry did not predict cyclosporin-insulin-free remission as
      assessed by the prevalence of insulin-free remission or beta-cell function at 3
      12 mo of study, and significant decrements in the titers or total disappearance
      of ICAs were not associated with an increased prevalence or duration of non
      insulin-requiring remission or higher stimulated C-peptide values. There was no
      correlation between the serum levels of ICAs and IAs at entry and beta-cell
      function at 12 mo of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227129
TI  - Contribution of impaired muscle glucose clearance to reduced postabsorptive
      systemic glucose clearance in NIDDM.
AB  - The reduced postabsorptive rates of systemic glucose clearance in non-insulin
      dependent diabetes mellitus (NIDDM) are thought to be the consequence of insulin
      resistance in peripheral tissues. Although the peripheral tissues involved have
      not been identified, it is generally assumed to be primarily muscle, the major
      site of insulin-mediated glucose disposal. To test this hypothesis, we measured
      postabsorptive systemic and forearm glucose utilization and clearance in 15
      volunteers with NIDDM and 15 age- and weight-matched nondiabetic volunteers.
      Although systemic glucose utilization was increased in NIDDM subjects (14.5 +/-
      0.5 vs. 11.2 +/- 0.2 mumol.kg-1.min-1, P less than 0.001), systemic glucose
      clearance was reduced 1.40 +/- 0.06 vs. 2.13 +/- 0.05 ml.kg-1.min-1, P less than
      0.01). Although forearm glucose utilization was increased in NIDDM subjects
      (0.663 +/- 0.058 vs. 0.411 +/- 0.019 mumol.dl-1.min-1, P less than 0.001),
      forearm glucose dl-1 clearance was reduced (0.628 +/- 0.044 vs. 0.774 +/- 0.037
      ml.L-1.min-1, P less than 0.01). However, extrapolation of forearm data to total
      body muscle indicated that impaired clearance reduced muscle glucose disposal by
      only 61 +/- 21 mumol/min, whereas impaired systemic clearance reduced systemic
      glucose disposal by 662 +/- 82 mumol/min. Thus, impaired muscle glucose clearance
      accounted for less than 10% of the reduced systemic glucose clearance in NIDDM
      subjects. Therefore, we conclude that muscle insulin resistance plays only a
      minor role in the reduced systemic glucose clearance found in NIDDM in the
      postabsorptive state and propose that reduced brain glucose clearance is largely
      responsible.

PMID- 2227130
TI  - Hepatic and extrahepatic responses to insulin in NIDDM and nondiabetic humans.
      Assessment in absence of artifact introduced by tritiated nonglucose
      contaminants.
AB  - It is well established that patients with non-insulin-dependent diabetes mellitus
      (NIDDM) are resistant to insulin. However, the contribution of hepatic and
      extrahepatic tissues to insulin resistance remains controversial. The uncertainty
      may be at least in part due to errors introduced by the unknowing use in previous
      studies of impure isotopes to measure glucose turnover. To determine hepatic and
      extrahepatic responses to insulin in the absence of these errors, steady-state
      glucose turnover was measured simultaneously with [6-3H]- and [6-14C]glucose
      during sequential 5- and 4-h infusions of insulin at rates of 0.4 and 10 mU.kg
      1.min-1 in diabetic and nondiabetic subjects. At low insulin concentrations, [6
      3H]- and [6-14C]glucose gave similar estimates of glucose turnover. Hepatic
      glucose release was equal to but not below zero in the nondiabetic subjects, but
      persistent glucose release (P less than 0.001) and decreased glucose uptake (P
      less than 0.001) was observed in the diabetic patients. At high insulin
      concentrations, both isotopes underestimated glucose turnover during the 1st h
      after initiation of the high-dose insulin infusion. More time (P less than 0.05)
      was required to reachieve steady state in NIDDM than nondiabetic subjects. At
      steady state, [6-3H]- but not [6-14C]glucose systematically underestimated (P
      less than 0.05) glucose turnover in both groups due to the presence of a
      tritiated nonglucose contaminant. The percentage of radioactivity in plasma due
      to tritiated contaminants was linearly related to turnover.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2227131
TI  - Metabolic effects of 1200-kcal diet in obese pregnant women with gestational
      diabetes.
AB  - Calorie restriction is widely used as a primary therapy for obese pregnant women
      with gestational diabetes. To better understand the metabolic consequences of
      marked calorie restriction, we performed a randomized prospective trial under
      metabolic ward conditions. Obese gestationally diabetic women were randomized to
      control (n = 5) and calorie-restricted (n = 7) groups. All patients consumed an
      approximately 2400-kcal/day diet during the 1st wk of the study, and at the end
      of the 1st wk, metabolic features of the two groups were statistically
      indistinguishable. During the 2nd wk, the control group continued to consume
      approximately 2400 kcal/day, whereas the calorie-restricted group consumed
      approximately 1200 kcal/day. Twenty-four-hour mean glucose levels remained
      unchanged in the control group (6.7 +/- 0.8 mM wk 1 vs. 6.8 +/- 0.8 mM wk 2),
      although they dropped dramatically in the calorie-restricted group (6.7 +/- 1.0
      mM wk 1 vs. 5.4 +/- 0.5 mM wk 2, P less than 0.01). Fasting plasma insulin also
      declined in the calorie-restricted group (265 +/- 165 pM wk 1 vs. 145 +/- 130 pM
      wk 2), resulting in a significant change between groups (P less than 0.02).
      Surprisingly, fasting plasma glucose and glucose tolerance measured by the 3-h
      oral glucose tolerance test did not change within or between groups. Fasting
      levels of beta-hydroxybutyrate rose in the calorie-restricted group (290 +/- 240
      microM wk 1 vs. 780 +/- 30 microM wk 2) but not in the control group (P less than
      0.01). Finally, urine ketones increased significantly (P less than 0.02) in the
      calorie-restricted group, whereas they remained absent in the control
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227132
TI  - Reduced membrane fluidity in platelets from diabetic patients.
AB  - Platelets from diabetic patients are hypersensitive to agonists in vitro.
      Membrane fluidity modulates cell function, and reduced membrane fluidity in
      cholesterol-enriched platelets is associated with platelet hypersensitivity to
      agonists, including thrombin. Decreased membrane fluidity of these platelets is
      attributed to an increased cholesterol-phospholipid molar ratio in platelet
      membranes. We examined the response of platelets from diabetic subjects to
      thrombin, platelet membrane fluidity, and platelet cholesterol-phospholipid molar
      ratio. Twelve poorly controlled diabetic subjects were compared with 12 age- and
      sex-matched control subjects. In response to a low concentration of thrombin,
      mean values for release of [14C]serotonin from washed prelabeled platelets were
      not significantly different between diabetic and control subjects, but in 8 of 12
      diabetic subjects, the release response was greater than in their paired control
      subjects. Mean steady-state fluorescence polarization values in 1,6-diphenyl
      1,3,5-hexatriene-labeled platelets prepared from diabetic subjects were
      significantly greater than in control subjects; this indicates a decreased
      membrane fluidity in platelets from diabetic subjects. Total or very-low-density
      (VLDL), low-density (LDL), or high-density (HDL2, HDL3) lipoprotein cholesterol
      concentrations in plasma were not significantly different between groups;
      however, the ratio of VLDL + LDL to HDL2 + HDL3 was significantly greater in
      diabetic than in control subjects. There was no difference in the total platelet
      cholesterol-phospholipid molar ratio between groups.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2227133
TI  - Relationship between blood pressure and urinary albumin excretion in development
      of microalbuminuria.
AB  - Two hundred nine consecutive normotensive insulin-dependent diabetic (IDDM)
      patients were followed prospectively from November 1982 to January 1988. Patient
      urinary albumin excretion rate (UAE) had to be normal (less than 30 mg/24 h) on
      at least two occasions before inclusion in the study. Patients were aged 18-50 yr
      with a duration of diabetes of 10-30 yr. UAE was measured every 4 mo, and supine
      blood pressure was measured annually. Two hundred five patients completed the
      study. Five years later, 15 patients had developed persistent microalbuminuria
      with median UAE greater than 30 mg/24 h for at least 2 yr (group 2), and 190
      patients stayed normoalbuminuric (group 1). Although within normal range, initial
      UAE was significantly elevated in group 2 compared with group 1 (mean 19 mg/24 h
      [range 15-23 mg/24 h] vs. 11 mg/24 h [10-12], 95% confidence interval [CI], P
      less than 0.001). Initially, there was no difference in blood pressure between
      group 2 (mean systolic 122 mmHg [117-127], diastolic 80 mmHg [76-84]) and group 1
      (mean 126 mmHg [124-128], 79 mmHg [78-80], 95% CI), and a significant increase in
      diastolic blood pressure could first be detected during the 3rd yr of persistent
      microalbuminuria (mean systolic 132 mmHg [124-140], diastolic 85 mmHg [81-89] vs.
      128 mmHg [126-130], 79 mmHg [78-80], P less than 0.05). Initial hemoglobin A1c
      was significantly elevated in group 2 compared with group 1 (9.6% [8.8-10.4] vs.
      8.5% [8.3-8.7], P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227134
TI  - Insulin-receptor autophosphorylation and endogenous substrate phosphorylation in
      human adipocytes from control, obese, and NIDDM subjects.
AB  - We identified a possible endogenous substrate (pp185) of the insulin-receptor
      kinase in human adipocytes by treating intact cells with insulin and
      immunoblotting the cellular extracts with polyclonal antiphosphotyrosine
      antibody. This 185,000-Mr protein was phosphorylated on tyrosine residues in
      response to insulin in both rat and human adipocytes. The time course of pp185
      phosphorylation at 37 degrees C was rapid and corresponded closely to insulin
      receptor autophosphorylation but preceded insulin-stimulated glucose transport.
      Unlike many growth factor receptors, including the insulin receptor, pp185 was
      not adsorbed to wheat-germ agglutinin. We found that pp185 phosphorylation
      occurred at 12 degrees C and that the phosphoprotein was associated with both
      cytoplasmic and membrane fractions at this temperature. Furthermore, pp185
      phosphorylation was induced to the same extent as insulin by vanadate and
      hydrogen peroxide, compounds previously shown to mimic the biologic effects of
      insulin. In addition, dose-response analysis of insulin-stimulated glucose
      transport, receptor autophosphorylation, and pp185 phosphorylation resulted in
      ED50 values of 0.3, 12, and 12 ng/ml, respectively. These results demonstrate the
      magnitude of "spare" autophosphorylation and pp185 phosphorylation with respect
      to glucose transport stimulation in human adipocytes. To determine whether the
      insulin resistance characteristic of non-insulin-dependent diabetes mellitus
      (NIDDM) and obesity is associated with a defect in receptor autophosphorylation
      and/or endogenous substrate phosphorylation, we estimated the extent of beta
      subunit and pp185 phosphorylation in adipocytes from NIDDM, obese, and healthy
      subjects. Although the efficiency of coupling between receptor activation and
      pp185 phosphorylation was normal in obesity and NIDDM, the capacity for insulin
      receptor autophosphorylation was approximately 50% lower in NIDDM subjects
      compared with nondiabetic obese or lean subjects.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2227135
TI  - Induction of insulin resistance in vivo by amylin and calcitonin gene-related
      peptide.
AB  - During hyperinsulinemic glucose-clamp studies, intravenous infusion of calcitonin
      gene-related peptide (CGRP) in rats antagonized the ability of insulin to
      stimulate peripheral glucose disposal by 52% (196 +/- 7.2 vs. 105 +/- 10.5
      mumol.kg-1.min-1, P less than 0.05) and to inhibit hepatic glucose output by 54%
      (P less than 0.01). CGRP also inhibited the in vitro effects of insulin to
      stimulate hexose uptake in cultured BC3H1 myocytes at all insulin concentrations
      studied. Amylin is a peptide isolated from amyloid deposits in pancreatic islets
      of type II (non-insulin-dependent) diabetic subjects, is present in normal beta
      cells, and bears a striking homology to CGRP. When synthetic human amylin was
      infused during clamp studies, it inhibited the ability of insulin to stimulate
      glucose disposal by 56% (96.9 +/- 9.4 vs. 42.4 +/- 5.0 mumol.kg-1.min-1, P less
      than 0.05) and to suppress hepatic glucose output by 64%. Therefore, amylin and
      CGRP can cause insulin resistance in vivo and may be implicated in insulin
      resistant states such as type II diabetes mellitus.

PMID- 2227137
TI  - 'Future directions in research and prevention'.

PMID- 2227136
TI  - High frequency of aspartic acid at position 57 of HLA-DQ beta-chain in Japanese
      IDDM patients and nondiabetic subjects.
AB  - The HLA-DQ beta-chain (DQB1) genes of 72 Japanese patients with insulin-dependent
      diabetes mellitus (IDDM) and 85 control subjects were studied with polymerase
      chain-reaction (PCR) amplification and allele-specific oligonucleotide
      hybridization. DQW4 (DQBBlank) and DQw9 (DQB3.3) were increased in IDDM patients
      compared with the control subjects, and DQB1.2, DQB1.9, and DQw7 (DQB3.1) were
      decreased. Thirty-five (48.6%) IDDM patients had both alleles carrying an
      aspartic acid at position 57 of the DQ beta-chain (Asp 57), 35 (48.6%) were Asp
      57/non-Asp 57 heterozygous, and 2 (2.8%) had non-Asp 57 alleles only. Of 85
      control subjects, the respective values for these three genotypes were 49
      (57.6%), 29 (34.1%), and 7 (8.2%), respectively. The high frequency of Asp 57
      alleles in both IDDM and control subjects contrasts with data for Whites.
      Therefore, the Asp 57 hypothesis that the presence of an aspartic acid at
      position 57 of DQ beta-chain provides protection against developing IDDM is not
      tenable for Japanese IDDM patients. The DRB1 gene, particularly position 57 of
      the DR beta-chain, may contribute to IDDM susceptibility in Japanese.

PMID- 2227138
TI  - Light-gazing by visually impaired children.
AB  - This study assessed the prevalence and characteristics of light-gazing by all
      visually impaired children referred during a 2 1/2-year period. Light-gazing
      (compulsive staring into lights) is one of the many clinical signs of cortical
      visual impairment (CVI), and in the present study it occurred in 60 per cent of
      children with CVI. The authors believe that light-gazing by any child with ocular
      lesions indicates some degree of CNS involvement. Visually impaired children who
      flicker their fingers in front of their eyes against a light source demonstrate
      an extension of this compulsive behaviour. This and other studies suggest that
      blind mannerisms have specific neuropathological substrata and therefore are
      useful clinical signs.

PMID- 2227139
TI  - Cervical auscultation of suckle feeding in newborn infants.
AB  - The authors recorded the sound signals during suckle feeding of six normal
      infants within the first two postnatal days. The sounds were recorded onto a
      cassette tape-recorder from a small microphone attached to the infant's neck,
      then displayed on an oscilloscope and analysed by digital signal processing
      techniques. These displays demonstrated acoustic patterns and temporal
      relationships which are not otherwise audible. The method and findings are
      described in detail, and the method should be useful in the clinical
      investigation of feeding and swallowing problems associated with more subtle
      neurological impairment and preterm birth.

PMID- 2227140
TI  - Multiple sclerosis in childhood: contribution of serial MRI to earlier diagnosis.
AB  - The authors report six children (five girls, one boy) aged 11 to 13 years, of
      whom four had clinically definite multiple sclerosis (MS) and two had laboratory
      supported definite MS. All had brain white matter abnormalities indicative of MS.
      In three cases, positive findings on the first MRI contributed significantly to
      their early diagnosis. Follow-up MRI studies over an average period of five
      months detected morphological changes in three of the children, although there
      was no concomitant clinical evidence. This raises the question of whether changes
      in clinically 'silent' lesions on follow-up MRI are antecedents of the essential
      MS criterion of dissemination over time, which could lead to earlier diagnosis of
      childhood MS. With cranial computerized tomography (CT) during the first clinical
      attack, a large focus with a lamellar structure mimicked a brain tumour in two
      patients. As CT also misses additional small lesions, it should no longer be used
      as the primary diagnostic method.

PMID- 2227141
TI  - Control of isometric muscle activity in cerebral palsy.
AB  - Voluntary control of muscle contraction was examined in five adults with cerebral
      palsy, who were required to track a moving target by continuously varying the
      level of isometric contraction of elbow flexor muscles (measured by EMG). First
      performance varied from minimal control to almost normal control, depending on
      the severity of disability. Practice over 12 weeks reduced inappropriate muscle
      activity in the most disabled patients, but there was no increase in appropriate
      muscle activity for any patient beyond that observed after the first few minutes
      of tracking. Thus their ability to translate a visual response into the
      appropriate motor activity was impaired, and there was no evidence of potential
      to overcome this. This supports the authors' earlier proposal that impairment of
      sensory-motor learning is the primary cause of functional disability in cerebral
      palsy. The EMG tracking task may provide a technique for assessing the ability of
      individuals with cerebral palsy to control muscle contraction.

PMID- 2227142
TI  - Postoperative electromyographic function of tendon transfers in patients with
      cerebral palsy.
AB  - Electromyographic studies were performed on 13 patients with cerebral palsy
      before and after flexor carpi ulnaris transfers. No changes in activity of the
      extensor digit communis were noted in the transferred muscles. This further
      validates the rationale of pre-operative planning based on such studies.

PMID- 2227143
TI  - Rapid anti-epileptic drug assay.
AB  - The usefulness of rapid anti-epileptic drug assay in a paediatric neurology
      clinic was assessed. Compared with a method in which results were not available
      for seven to 10 days, there was an increased likelihood that levels would be
      within the target range, particularly for carbamazepine. Increased parental
      discussion, and therefore involvement with dosage, was possible. Management of
      children receiving phenytoin was more efficient and non-compliance could be dealt
      with immediately. When anti-epileptic drug levels are measured, rapid assay, with
      results available while the patient is still in the clinic, should be a standard
      facility.

PMID- 2227144
TI  - Fukuyama congenital muscular dystrophy in two Australian female siblings.
AB  - The clinical course of two female siblings with congenital muscular dystrophy is
      briefly described, and includes congenital cerebral malformations consisting of
      pachygyria, polymicrogyria and white matter abnormalities. The first sibling died
      in infancy; the second is now 18 years of age. The changes found at autopsy in
      the first sibling are identical to MRI changes in the surviving sibling.

PMID- 2227145
TI  - Old syndromes and new cytogenetics.
AB  - This annotation has been confined to well-established clinical syndromes with
      recently discovered chromosomal etiologies. It deliberately omits retinoblastoma,
      the oft-cited paradigm of a contiguous gene syndrome, since it is usually
      inherited as a Mendelian single gene disorder. However, it was recognition of
      both the deletion of band q14 of chromosome 13 in mentally retarded children with
      retinoblastoma, and the linkage of retinoblastoma with the genetic marker
      esterase D, which resulted in the eventual cloning of the gene. Also omitted are
      microdeletions of the X chromosome. These disorders are seen primarily in males,
      who manifest the phenotypic effects of the deletion of the loci of various
      combinations of adjacent genes: Duchenne muscular dystrophy, glycerol kinase
      deficiency, adrenal hypoplasia, optic albinism, hypogonadotropic hypogonadism and
      anosmia (Kallman syndrome), chondrodysplasia punctata and ichthyosis. Many are
      also mentally retarded. The third group omitted are Mendelian disorders occurring
      with atypical mental retardation (not usually part of the disorder), the
      presumption being that they include small deletions. It is expected that other
      contiguous gene syndromes will be recognized eventually; Rubinstein-Taybi and
      Cornelia de Lange syndromes are prime candidates. Why do deletions have such
      dramatic consequences when a normal homologue of the region is present? If their
      effects were due to the uncovering of recessive genes, we would expect to see
      greater variations in phenotype among carriers, including normal individuals
      whose deletions were masked by the protective effects of dominant alleles in the
      homologous regions. Imprinting--the 'stamping' of a gene as it passes through the
      germ line--provides a more satisfactory explanation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2227146
TI  - Further thoughts on autistic tendencies.

PMID- 2227147
TI  - Correlation between temperature and infants' gross motor development.

PMID- 2227148
TI  - EPC European Pancreatic Club. XXIInd meeting. Basel, October 15-17, 1990.
      Abstracts.

PMID- 2227149
TI  - Toxicological information series, IV. Information resources for chemical
      emergency response.
AB  - The need for rapidly available information by community agencies responding to
      chemical emergencies (leaks, spills, releases, fires, explosions, etc.) can be
      met by a number of resources. These resources include local poison control
      centers, the Toxicology Data Network (National Library of Medicine), the Agency
      for Toxic Substances and Disease Registry, ATSDR/NLM's ANSWER, the National
      Chemical Response and Information Center, the National Pesticide
      Telecommunications Network, The National Response Center (U.S. Coast Guard), the
      Federal Emergency Management Agency, the U.S. Environmental Protection Agency,
      the National Safety Council, private-sector database vendors, and textbooks
      addressing hazardous substances.

PMID- 2227150
TI  - Aldicarb immunotoxicity: functional analysis of cell-mediated immunity and
      quantitation of lymphocyte subpopulations.
AB  - Adult female B6C3F1 mice received distilled water only or water containing 1.0,
      10, or 100 ppb of aldicarb daily for 34 days. The target concentration of
      aldicarb present in the 100 ppb dosing solution was analytically verified. To
      further develop an immune profile of this compound, following aldicarb exposure,
      the ability of splenic natural killer cells and specifically sensitized cytotoxic
      T-lymphocytes to lyse YAC-1 lymphoma and P815 tumor cells, respectively, was
      evaluated. To supplement the functional assays, the impact of aldicarb exposure
      on the percentages and absolute numbers of total T-cells, T-suppressor, T-helper,
      and B-cells was evaluated. The absence of statistically significant effects on
      any of these parameters supports earlier reports that aldicarb does not result in
      adverse effects on the immune system of mice.

PMID- 2227152
TI  - Variability of a mouse ear swelling test (MEST) in predicting weak and moderate
      contact sensitization.
AB  - An investigation was conducted at two independent laboratories for the purpose of
      evaluating the ability of a mouse ear swelling test (MEST), previously developed
      and validated by S.C. Gad. B.J. Dunn, D. W. Dobbs, C. Reilly, and R.D. Walsh
      (1986, Toxicol. Appl. Pharmacol. 84, 93-114), to predict contact sensitization
      induced by weak to moderate contact sensitizers. Twenty-six coded chemicals, 23
      with weak to strong potential to induce sensitization in animals and/or humans
      and 3 negative controls, were investigated. Each laboratory tested 18 materials:
      10 chemicals were common to both labs and 16 chemicals were divided so that 8
      were unique to each of the two labs. The methods and chemicals utilized were the
      same as those used and reported by Gad et al. (1986) and, therefore, data
      generated from this investigation were compared to results from their research.
      Contrary to results reported by Gad and co-workers, findings from the present
      study suggest that this MEST is a useful model for identifying strong contact
      sensitizers, but is not reliable for detecting weak to moderate allergens.

PMID- 2227151
TI  - Clearance, translocation, and excretion of beryllium following acute inhalation
      of beryllium oxide by beagle dogs.
AB  - Beagle dogs inhaled radiolabeled beryllium oxide (7BeO) particles that were
      calcined at either 500 or 1000 degrees C, resulting in either high (mean of 50
      micrograms/kg body wt) or low (mean of 17 micrograms/kg body wt) initial lung
      burdens (ILBs) of both preparations of BeO. Levels of beryllium in whole body,
      tissue, and excreta were measured by external gamma-ray counting. Dogs were
      euthanized in pairs at 8, 32, 64, and 180 days after exposure to determine
      beryllium distribution in tissues. Beryllium oxide calcined at 1000 degrees C was
      retained more tenaciously in the lungs (62% of the ILB retained at 180 days after
      exposure) than BeO calcined at 500 degrees C (14% of the ILB retained at 180 days
      after exposure). Most of the beryllium that was cleared from the lungs and not
      excreted was translocated to the tracheobronchial lymph nodes, skeleton, liver,
      and blood. More beryllium was translocated to the skeleton and liver at 180 days
      after inhalation of BeO prepared at 500 degrees C than at 1000 degrees C. The
      predominant mode of excretion at early times after exposure was through the
      feces, with urinary excretion assuming predominance at later times. These data
      are important for interpreting the toxic effects of beryllium in the exposed
      dogs. Furthermore, because little is known concerning the retention and clearance
      of inhaled beryllium in man, these results provide information that may be used
      to understand the disposition of beryllium in accidentally exposed humans.

PMID- 2227153
TI  - Taurine failed to protect against the embryotoxic effects of isotretinoin in the
      rat.
AB  - Experimental evidence exists to indicate that retinoids may act as detergents to
      disrupt biological membranes. Taurine, an amino sulfonic acid, has been shown to
      possess membrane-stabilizing and cytoprotective properties. This study was
      undertaken to test whether taurine coadministered with isotretinoin might be able
      to protect against the teratogenic effects of the retinoid. Our study failed to
      find any support for this speculation. Whether challenged against a 75 (mildly
      teratogenic) or 150 (very teratogenic) mg/kg/day dose of isotretinoin, taurine
      for the most part worsened the retinoid embryotoxicity. While in a few
      combinations taurine decreased the resorption or malformation rate associated
      with isotretinoin, the decrease was, at best, marginal. In no case was taurine
      able to decrease these rates to those noted in the controls.

PMID- 2227154
TI  - Preclinical toxicological evaluation of fostriecin, a novel anticancer
      antibiotic, in rats.
AB  - Fostriecin, a novel anticancer antibiotic produced by Streptomyces pulveraecus,
      is believed to act via inhibition of topoisomerase II. Single-dose intravenous
      administration to rats at dose levels of 8.8 to 48 mg/kg resulted in lethality at
      dose levels of 35 mg/kg and higher. Major toxic effects were observed primarily
      at 17.5 mg/kg and higher, were reversible, and consisted of bone marrow
      hypocellularity, leukopenia, neutropenia, thrombocytopenia, and diffuse necrosis
      of various lymphoid tissues. The kidney was also identified as a target organ.
      Renal effects were observed primarily at 20 mg/kg, were reversible, and included
      increases in serum BUN, creatinine, and 24-hr glucose excretion. Twenty-four-hour
      excretion of Na+, K+ and urine osmolality were decreased postdosing at 10 and 20
      mg/kg. Renal lesions, observed primarily at 20 mg/kg, consisted of vacuolization
      and necrosis of proximal and distal tubular epithelium at the corticomedullary
      junction extending into the medulla. Repeated daily intravenous administration of
      fostriecin for 5 days to rats at dose levels of 2.5 to 26.5 mg/kg resulted in
      death at 10 mg/kg and above and similar hematologic, bone marrow, lymphoid
      tissue, and renal changes as observed in the single-dose study. Hematological,
      bone marrow, lymphoid, and renal changes observed in rats were consistent with
      the cytotoxic mechanism of action of the compound.

PMID- 2227155
TI  - Modulation of glucose metabolism in isolated rat hepatocytes by 1,1,1,2
      tetrafluoroethane.
AB  - The thermodynamic behavior and lack of ozone-depleting potential of 1,1,1,2
      tetrafluoroethane (R-134a) suggest it as a likely replacement for
      dichlorodifluoromethane (R-12), now used as the refrigerant in many air
      conditioning systems. To further the presently incomplete toxicological analysis
      of R-134a, the effects of R-134a on cell viability and functional competence of
      glucose metabolism were evaluated in suspension cultures of hepatocytes derived
      from fed or fasted rats. R-134a concentrations up to and including 75% (750,000
      ppm) in the gas phase of sealed culture flasks did not produce evidence of
      cytolethality (LDH leakage) following 2 hr of exposure; in contrast, halothane
      (1,1,1-trifluoro-2-bromo-2-chloroethane) caused cell death at a gas phase
      concentration of only 1250 ppm. In hepatocytes isolated from fed rats. R-134a at
      concentrations of 12.5 to 75% increased glycolysis (production of lactate +
      pyruvate) in a concentration-dependent manner; no effect was observed at 5%. At
      25%, R-12 and 1,1,2,2-tetrafluoro-1,2-dichloroethane (R-114) were of equal
      potency to R-134a in stimulating glycolysis: 1,1,1,2,2-pentafluoro-2-chloroethane
      (R-115) depressed glycolysis slightly. Halothane, at concentrations as low as 300
      ppm, markedly increased rates of glycolysis. Glucose production by hepatocytes of
      fed rats was decreased by R-134, R-12, and R-114 only at concentrations of 25% or
      more. On the other hand, halothane (greater than or equal to 300 ppm) potently
      decreased glucose production by hepatocytes. In cells isolated from livers of
      fasted rats, R-134a exposure inhibited gluconeogenesis in a concentration
      dependent manner although this effect was not significant until R-134a
      concentrations reached 12.5%. Comparative potency studies showed that R-134a, R
      12, or R-114 (25% gas phase) inhibited gluconeogenesis about equally while as
      little as 300 ppm halothane was effective and R-115 (25%) was without effect.
      Considering that the threshold for alteration of the rate of glucose metabolism
      in this in vitro paradigm is about 12.5% R-134a, we conclude that toxicologically
      significant alteration of glucose-linked bioenergetics is unlikely at the levels
      of R-134a exposure anticipated in workplace or environment.

PMID- 2227157
TI  - The structure-dependent effects of heptachlorodibenzofuran isomers in male
      C57BL/6 mice: immunotoxicity and monooxygenase enzyme induction.
AB  - The dose-response effects of the 1,2,3,4,6,7,8-, 1,2,3,4,7,8,9-, 1,2,3,4,6,8,9-,
      and 1,2,3,4,6,7,9-heptachlorodibenzofurans (HpCDFs) on the splenic plaque-forming
      cell (PFC) response to sheep erythrocytes and on the induction of hepatic
      microsomal aryl hydrocarbon hydroxylase (AHH) and ethoxyresorufin-O-deethylase
      (EROD) activities were determined in male C57BL/6 mice. The ED50 values for the
      decrease in the PFCs/spleen, the number of PFCs/10(6) viable cells, and the
      induction of AHH and EROD activities were 1,2,3,4,6,7,8-HpCDF, 0.011, 0.018,
      0.11, and 0.315 mumol/kg, respectively; 1,2,3,4,7,8,9-HpCDF, 0.012, 0.054, 0.70,
      and 0.20 mumol/kg, respectively; 1,2,3,4,6,7,9-HpCDF, 1.2, 1.3, greater than 43,
      and greater than 43 mumol/kg, respectively; 1,2,3,4,6,8,9-HpCDF, 1.5, 3.4, 22,
      and 22 mumol/kg, respectively. It was apparent from these studies that the
      2,3,7,8-substituted HpCDF isomers (1,2,3,4,6,7,8- and 1,2,3,4,7,8,9-) were
      significantly more potent than the compounds which contained only three lateral
      C1 groups. These results were obtained using a multiple dosing regimen in which
      10 separate doses of the HpCDF isomers were administered to the mice by
      intraperitoneal injection over a period of 12 days. However, when the mice were
      treated with a single dose of an HpCDF congener, which was equivalent to the
      total dose used in the multiple dose study, the responses were comparable. A
      comparison of the relative immunotoxic potencies of the 2,3,7,8-substituted
      HpCDFs and 2,3,7,8-tetrachlorodibenzo-p-dioxin showed that the latter compound
      was approximately 10 times more active than the HpCDFs.

PMID- 2227156
TI  - Carbendazim-induced alterations of reproductive development and function in the
      rat and hamster.
AB  - We are developing a data base that will allow us to select endpoints that would
      be useful in the detection of reproductive toxicity in a multigenerational test.
      In this effort, carbendazim (MBC), a known reproductive toxicant, was
      administered to male and female rats from weaning, through puberty, gestation,
      and lactation. A similar study was conducted with hamsters. In rats, MBC was
      administered at 0, 50, 100, 200, or 400 mg/kg/day. Hamsters were dosed at 0 or
      400 mg/kg/day. In the parent (P0) generation, landmarks of puberty were measured.
      In females, estrous cyclicity, litter size, the number of implants, organ
      weights, and histology were assessed. Our assessment of the male rat included
      organ weights, testicular and epididymal sperm counts, a quantitative measure of
      sperm motility, sperm morphology, testicular histology, and endocrine measures.
      The growth, viability, and reproductive function of the offspring (F1) were
      observed during a 4-month period of continuous breeding. In the P0 of both
      species. MBC did not alter pubertal development, growth, or viability. The
      reproductive potential of the rats treated with MBC at 200 and 400 mg/kg/day was
      reduced due to effects on sperm production and fetal viability. In the male rat,
      MBC treatment markedly altered sperm morphology, testicular and epididymal
      weights, and sperm numbers and testicular histology. Fertility, sperm motility,
      and hormonal levels were altered, primarily in the males with very low sperm
      counts. The ability to conceive did not appear to involve a female factor. In P0
      female rats, MBC administration caused postimplantation losses in the high-dosage
      groups and a few malformed rat pups were found in the litters from the 100 and
      200 treatment groups. MBC was less toxic to the hamster than the rat. The only
      reproductive effects induced by MBC treatment were on sperm measures. Fertility
      of the P0 generation and fetal and neonatal (F1) viability were not decreased by
      MBC administration. In the male rat, testis weight, sperm numbers in the cauda
      epididymis and testis and sperm morphology were sensitive to the effects of MBC.
      In females, counting implantation scars at necropsy was useful, as this
      information allowed us to confirm pregnancy and identify postimplantation losses
      induced by MBC administration.

PMID- 2227158
TI  - Effect of inhaled azodicarbonamide on F344/N rats and B6C3F1 mice with 2-week and
      13-week inhalation exposures.
AB  - Azodicarbonamide (ADA), a compound used in the baking and plastics industries,
      has been reported to cause pulmonary sensitization and dermatitis in people. Two
      week repeated and 13-week subchronic inhalation exposures of F344/N rats and
      B6C3F1 mice to ADA were conducted to determine the toxicity of inhaled ADA. The
      mean air concentrations of ADA in the 2-week studies were 207, 102, 52, 9.4, or
      2.0 mg/m3. No exposure-related mortality nor abnormal clinical signs were
      observed in rats or mice during or after exposure. The terminal body weights were
      slightly depressed in the highest exposure group. Liver weights were lower in
      male rats exposed to 200 mg ADA/m3. No significant lesions were noted on either
      gross or histologic evaluation of rats or mice. In the 13-week subchronic study,
      the mean air concentrations of ADA were 204, 100, or 50 mg/m3. No mortality or
      clinical signs related to exposure were observed. The terminal body weights of
      exposed rats were not significantly different from those of control rats but were
      significantly depressed in mice exposed to 100 or 200 mg ADA/m3. No
      histopathological lesions were noted in mice. Lung weights were increased and
      enlarged mediastinal and/or tracheobronchial lymph nodes were noted in rats
      exposed to 50 mg ADA/m3. No exposure-related lesions were observed
      microscopically in rats exposed to 100 or 200 mg ADA/m3. All rats in the 50 mg
      ADA/m3 exposure group only had lung lesions that consisted of perivascular
      cuffing with lymphocytes and a multifocal type II cell hyperplasia, suggesting a
      possible immune reaction to an antigen in the lung. Viral titers for rats exposed
      to 50 mg ADA/m3 were negative for Sendai virus and pneumonia virus of mice, which
      produce similar lesions. The possibility of an unknown viral antigen causing this
      lesion cannot be eliminated. Lung tissue from male rats was analyzed for ADA and
      biurea, the major metabolite of ADA. No ADA was detected. The amount of biurea in
      the lungs increased nonlinearly with increasing exposure concentration,
      suggesting that clearance was somewhat impaired with repeated exposures. However,
      even at the highest exposure concentration, this amount of biurea was less than
      1% of the estimated total ADA deposited over the exposure period. In summary, ADA
      is rapidly cleared from the lungs, even when inhaled at concentrations up to 200
      mg/m3. Exposure to ADA for up to 13 weeks did not appear to be toxic to rodents.

PMID- 2227159
TI  - Estimation of epidermal carcinogenic potency.
AB  - This report compared two statistical methods of estimating tumor latency, the
      Weibull distribution model and the Kaplan-Meier method. Parallelism of dose
      response curves of different materials and quantitative reproducibility of dermal
      carcinogenesis data were also examined. The Weibull method has the advantage of
      producing parameter estimates, even when tumor yield is low. The Kaplan-Meier
      method, on the other hand, is free of distribution assumptions. Overall, since
      the comparisons of potency are made on the basis of parameters from the same
      assumed distribution on the same strain of animal, the Weibull estimates are
      favored. A comparison of dose-response data for benzo[a]pyrene and catalytically
      cracked clarified oil indicated that the slopes of the two dose-response curves
      were significantly different. Thus the relative carcinogenic potencies of
      different materials vary with dose, and potency comparisons must necessarily be
      dose-specific. The quantitative reproducibility of dermal carcinogenesis
      bioassays was also assessed. The dose-response curves from the three studies of
      one material had significantly different slopes. Thus the results suggested that
      there were sources of biological variability which could contribute to
      experimental error.

PMID- 2227160
TI  - Arsine: absence of developmental toxicity in rats and mice.
AB  - Arsine gas is a potent hemolytic agent but the effects of exposure to tolerated
      concentrations on pregnancy and prenatal development have not been reported. In
      the present evaluation, groups of bred mice and rats were exposed to arsine at
      concentrations of 0.025, 0.5, or 2.5 ppm on Gestation Days (gd) 6 through 15.
      Animals were killed on gd 17 (mice) or on gd 20 (rats) and endpoints of maternal
      and developmental toxicity were evaluated. In rats, maternal spleens were
      enlarged in the 2.5 ppm group and there was a decrease in packed red cell volume
      in pregnant rats. Fetuses weighed more than in the control group but other
      endpoints of developmental toxicity were not affected by arsine exposure. In
      another experiment involving separate groups of rats, the arsenic content of
      maternal blood and fetal livers increased with increasing atmospheric arsine
      concentrations, as assessed on gd 20. In mice, maternal spleen size was
      significantly increased in the 2.5 ppm group. The number of live fetuses, mean
      fetal body weight, and percentages of resorptions or malformations per litter
      were not affected by arsine exposure. In conclusion, arsine at atmospheric
      concentrations that caused increases in maternal spleen size and measurable
      levels of arsenic in maternal blood and fetal livers did not adversely affect
      endpoints of developmental toxicity.

PMID- 2227161
TI  - Inhalation toxicity studies of cobalt sulfate in F344/N rats and B6C3F1 mice.
AB  - Groups of 10 F344/N rats and B6C3F1 mice of each sex were exposed to cobalt
      sulfate heptahydrate aerosols of 0, 0.3, 1.0, 3.0, 10, or 30 mg/m3, 6 hr per day,
      5 days per week, for 13 weeks. All rats and female mice and all but 2/10 male
      mice exposed at the top concentration survived to the end of the studies.
      Polycythemia was observed in exposed rats but not in mice. Sperm motility was
      decreased in mice exposed at 3 mg/m3 (the lowest concentration evaluated) and at
      higher concentrations, and increased numbers of abnormal sperm and decreased
      testis and epididymal weights occurred in mice exposed to 30 mg/m3. Cobalt
      content in the urine of rats increased with increasing atmospheric cobalt
      exposure. Primary histopathologic effects were limited to the respiratory tract.
      Lesions in rats and mice included degeneration of the olfactory epithelium,
      squamous metaplasia of the respiratory epithelium, and inflammation in the nose;
      inflammation, necrosis, squamous metaplasia, ulcers (rats), and inflammatory
      polyps (rats) of the larynx; metaplasia of the trachea (mice); and fibrosis,
      histiocytic infiltrates, bronchiolar epithelial regeneration, and epithelial
      hyperplasia in the alveoli of the lung. The most sensitive tissue was the larynx,
      with squamous metaplasia observed in rats and mice at the lowest exposure
      concentration of 0.3 mg/m3. Thus, a no-observed-adverse-effect level was not
      reached in these studies.

PMID- 2227162
TI  - Toxic interactions of the munitions compounds TNT and RDX in F344 rats.
AB  - The potential toxic interactions in F344 rats of the munitions compounds
      trinitrotoluene (TNT) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) were
      examined following their coadministration in the diet. Groups of 10 rats per sex
      received TNT at doses of 5 or 125 mg/kg/day, RDX at doses of 30, 100, or 300
      mg/kg/day, and combinations thereof for 13 weeks. Thirty rats per sex served as
      controls. Toxicologic endpoints included clinical observations, body weight, food
      consumption, hematology, clinical chemistry, organ weights, and tissue
      morphology. The major toxic effects following dietary administration of TNT to
      rats included anemia, hypercholesterolemia, and hepatomegaly, splenomegaly, and
      testicular atrophy with their accompanying histologic lesions. RDX intoxication
      in rats included hypotriglyceridemia, behavioral changes, and mortality. Most of
      the toxic effects of these chemicals were partially antagonized following their
      coadministration.

PMID- 2227163
TI  - Degeneration and recovery of rat olfactory epithelium following inhalation of
      dibasic esters.
AB  - Dibasic esters (DBE) are solvent mixtures used in the paint and coating industry.
      To evaluate the potential subchronic toxicity of DBE, groups of male and female
      rats were exposed for periods of up to 13 weeks to DBE concentrations of 0, 20,
      76, or 390 mg/m3. After approximately 7 and 13 weeks of exposure, 10 rats per sex
      per group were subjected to clinical chemical, hematological, and urine analyses.
      Following 7 or 13 weeks of exposure, 10 or 20 rats per sex per group,
      respectively, were euthanized. An additional 10 rats were euthanized following a
      6-week recovery period. A standard profile of tissues, including four levels of
      nasal cavity, was evaluated histopathologically. After 7 weeks of exposure,
      slight degeneration of the olfactory epithelium was observed in both male and
      female rats at 76 and 390 mg/m3. After 13 weeks, degeneration of the olfactory
      epithelium was present at all DBE concentrations in female rats, but only at the
      mid and high concentrations in male rats. The severity and incidence of the
      lesions were concentration related for both sexes with female rats being more
      sensitive than males. Following the recovery period, histological changes
      compatible with repair in the olfactory mucosa included an absence of
      degeneration, focal disorganization of the olfactory epithelium, and respiratory
      metaplasia. All other tissues were macroscopically normal. No other signs of
      toxicity were indicated by the other parameters evaluated. Inhalation studies of
      other esters demonstrate similar pathology in the olfactory epithelium. Since
      olfactory mucosa is rich in carboxylesterase activity, acids may be the toxic
      metabolites of these compounds. This hypothetical mechanism may explain the
      sensitivity of olfactory tissue to the effects of DBE.

PMID- 2227165
TI  - Statistical analyses for the carcinogenesis bioassay.

PMID- 2227164
TI  - Subchronic inhalation study with vinyl fluoride: effects on hepatic cell
      proliferation and urinary fluoride excretion.
AB  - Vinyl fluoride is used widely in the manufacture of fluoropolymers. Based in part
      on the structural similarity of vinyl fluoride to the hepatocarcinogens vinyl
      chloride and vinyl bromide, a TSCA Section 4 test rule mandated the testing of
      vinyl fluoride for oncogenicity. This report presents the results of a 90-day
      inhalation study in rats and mice with vinyl fluoride designed to set test
      concentrations for a subsequent oncogenicity study. Groups of 15 male and female
      rats and mice were exposed 6 hr per day, 5 days per week for approximately 90
      days to target concentrations of 0, 200, 2000, or 20,000 ppm vinyl fluoride.
      Clinical chemical, hematological, and urine analyses were performed on rats after
      45 and 90 days of exposure. A hematological evaluation was performed on mice
      following 45 and 90 days of exposure. A complete gross and microscopic evaluation
      was conducted at the end of the study. After 93 days on test, groups of five rats
      and five mice per sex were implanted with osmotic minipumps containing
      [3H]thymidine and were exposed for an additional 5 days to measure cell
      proliferation in liver, kidney, lung, and nasal cavity tissues. Results of the
      histopathological, clinical chemical, and hematological evaluations showed no
      significant effects of vinyl fluoride exposure at any concentration following
      either 45 or 90 days of exposure. A concentration-related increase in fluoride
      ion in urine was observed in rats at 45 and 90 days of exposure. A plateau in
      urinary fluoride excretion was observed at approximately 2000 ppm, suggesting
      saturation of vinyl fluoride metabolism. Vinyl fluoride-related cell
      proliferation effects were largely restricted to liver. Hepatic cell
      proliferation in male and female rats and mice was elevated at all
      concentrations. The response was similar at concentrations of either 2000 or
      20,000 ppm and was consistent with concentration-response relationships for other
      haloethylenes. Taken together, the urinary fluoride excretion and hepatic cell
      proliferation data suggest a mechanistic link between the two effects. On the
      basis of these findings and experience with other haloethylenes, concentrations
      of vinyl fluoride to be tested for oncogenicity should be chosen such that the
      full linear range of the concentration-response curve is evaluated. The present
      study demonstrates through example the value of incorporating cell proliferation
      studies in standard testing protocols.

PMID- 2227166
TI  - New ideas for geriatric fellowships.

PMID- 2227167
TI  - The nutritional content of pharmaceutical company sponsored promotions.

PMID- 2227168
TI  - Assessment of the Federal Grant Program for the Establishment of Departments of
      Family Medicine.
AB  - As part of an evaluation of the Federal Establishment of Departments of Family
      Medicine Grant Program, nine departments of family medicine were visited from
      March to May 1988 to assess their development in the academic setting and to
      evaluate the role of the federal program in that developmental process. The study
      found that grant support has been useful in enhancing the status of family
      medicine by aiding research and curriculum development, supporting administrative
      infrastructure, and fostering other topics specific to individual departments.
      The flexibility with which departments can seek funds for specific needs makes
      broad measures of success impractical; however, it appears that funds from this
      grant program have been reasonably effective in advancing the academic stature of
      departments of family medicine. It is concluded from the study that the program
      should be continued and that its inherent flexibility should be preserved.

PMID- 2227169
TI  - The Upper Peninsula Program: a successful model for increasing primary care
      physicians in rural areas.
AB  - In 1974, Michigan State University established the Upper Peninsula Medical
      Education Program (UP) to improve the physician supply in rural areas of Michigan
      by training students in a rural, practice-based setting. Practicing graduates of
      the program (N = 28) were surveyed by mail and their responses compared to a
      random sample of downstate MSU graduates (N = 57) with regard to practice
      location, specialty choice, hometown, and medical education and training. UP
      Program graduates showed a tendency to rural origin and chose rural practice and
      primary care specialties, especially family practice, more often than did their
      downstate colleagues. Responses of UP graduates suggested that rural residency
      locations would lead to increased numbers of rural practitioners. The rural UP
      Program has been successful to date in training medical students who ultimately
      pursue careers in rural primary medicine.

PMID- 2227170
TI  - Qualitative and quantitative methods for the assessment of clinical preceptors.
AB  - The improvement of clinical teaching skills has consistently been an important
      focus of faculty development in family medicine. Successful faculty development
      programs depend on an understanding of the components of clinical teaching and a
      profile of the strengths and weaknesses of each faculty member with respect to
      these components. In this study a system was developed to identify and measure
      specific faculty characteristics of inpatient preceptors. Complementary
      quantitative and qualitative approaches were employed. An analysis and comparison
      of the two approaches suggest that the measures result in a similar ranking of
      faculty, but that the qualitative approach identifies individual faculty
      strengths and weaknesses, which are more useful for providing feedback to
      stimulate and guide change.

PMID- 2227171
TI  - Ideology and reality of continuity of care.
AB  - The concept of continuity of care is part of the framework on which the ideology
      and teaching of family practice is based. The purpose of the present study was to
      evaluate the ideals and reality of continuity of care as perceived by Norwegian
      family physicians. A representative sample of 207 physicians answered a mailed
      questionnaire related to continuity of care. Eighty percent of the physicians
      found the concept of continuity important or very important to the ideology of
      family practice. There were, however, significant statistical and clinically
      important discrepancies between ideals and reality. If standards are too
      ambitious or unrealistic to achieve, they often become counterproductive. Two
      basic ways to correct this discrepancy are discussed: improving reality by
      increasing chronological care and lowering the ideals by de-emphasizing
      comprehensive care. The ideals of continuity of care in family practice were set
      more than 20 years ago. As the field of family practice matures, more realistic
      goals may be indicated to prevent individual professional burnout and loss of
      credibility as a specialty.

PMID- 2227172
TI  - A randomized controlled evaluation of a psychosocial intervention in adults with
      chronic lung disease.
AB  - The effect of a stress management program on morbidity and psychosocial and
      physical function in patients with chronic lung disease was assessed. Adults
      attending either a VA pulmonary clinic or university hospital pulmonary
      rehabilitation clinic who met criteria for obstructive or restrictive pulmonary
      disease were randomly assigned to receive the intervention or to a control group.
      The intervention was provided by a nurse and included one to three teaching
      sessions, reading material, audiotapes, and telephone follow-up. The program
      focused on stress management techniques such as cognitive restructuring,
      progressive relaxation, breathing exercises, and visual imagery. The 45
      experimental subjects were similar to the 49 controls with respect to baseline
      characteristics. Experimental and control subjects had similar rates of
      mortality, hospital days, bed-disability days, restricted-activity days, and
      physician visits during the 12-month follow-up. There were no differences between
      the two groups in physical or psychosocial function at six months or in levels of
      stressful life changes, social supports, and self-esteem at six and 12 months.
      Intervention recipients had better function at 12 months, suggesting a possible
      benefit of the intervention.

PMID- 2227173
TI  - Local anesthesia for neonatal circumcisions: are family practice residents likely
      to use it?
AB  - Dorsal penile nerve block with lidocaine (DPNB) is a local anesthetic technique
      for neonatal circumcision which is both effective and consistent with ethical
      concerns for infant welfare. As such, it should be included in training programs
      that prepare residents to care for newborns. To assess the current level of DPNB
      use by residents in a family practice training program and to identify attitudes
      and other factors that relate to use, a survey was sent to 127 residents in the
      Department of Family Practice and Community Health, University of Minnesota. Of
      the 101 respondents, 55% had used DPNB, and 17% could be characterized as high
      users, employing the technique for over one half of the circumcisions they
      performed. Residents with comprehensive understanding of the newborn's capacity
      to feel pain were more likely to be using DPNB than their less well-informed
      counterparts. Four factors were identified as predicting use: cooperation of
      nursery staff for the procedure, accessibility of instruction in PNB technique,
      belief that PNB is effective in reducing infant pain, and likelihood of parents
      giving consent for PNB. These results suggest strategies which may be implemented
      by family practice educators who wish to promote the principles and techniques of
      DPNB.

PMID- 2227174
TI  - Interpreting office radiographs: a research-based curricular prototype for
      training family practice residents.
AB  - Radiographic film interpretation is one area of the family practice residency
      training curriculum that has been given little focused emphasis. Starting with a
      series of studies into the office practice of radiology by family physicians to
      define need, content, and interpretation skill level, and following a systematic
      curriculum design process, the authors developed a comprehensive curriculum for
      teaching office X-ray interpretation to family practice residents. The final
      curricular prototype consists of: 1) a complete set of curriculum objectives; 2)
      a written monograph; 3) a set of instructional X-rays; and 4) a set of evaluation
      films. This research-based curriculum development process may serve as a model
      for developing other educational components for family practice residency
      training.

PMID- 2227175
TI  - Predicting elderly patients' mobility using fall history and physician
      assessment.
AB  - This study tested whether a patient's history of falls or an office clinician's
      general assessment can predict which ambulatory elderly patients will do poorly
      on mobility testing. Ambulatory patients making routine visits who were age 65 or
      older, mentally competent, and not acutely ill were eligible. Fifty-two (91%) of
      these patients participated by completing a fall history questionnaire and
      undergoing mobility testing. After the visit, the attending physician estimated
      how the patient would score on the mobility test. Twelve (23%) of the patients
      reported falls and seven (13.5%) reported fall injuries in the preceding year.
      Both fall history and physician estimate of mobility score significantly
      correlated with the measured mobility score. Only the physician estimate of
      mobility score, however, had adequate sensitivity (94.4%) and specificity (82.4%)
      to be clinically useful. This estimate will allow the clinician to selectively
      apply mobility testing to those patients likely to score poorly.

PMID- 2227176
TI  - Family practice residents and the elderly: fostering positive attitudes.
AB  - The population of elderly patients is steadily growing. Because physician
      attitudes toward caring for elderly patients are often negative, it is important
      to identify aspects of training that lead to favorable attitudes toward the
      practice of geriatrics. This study investigated the relationships among past
      casual experiences, educational experiences, level of training, faculty
      attitudes, and current resident attitudes. All Louisiana family practice
      residents (72) and program faculty members (35) were surveyed, with response
      rates of 69% and 86%, respectively. Residents generally held positive attitudes
      toward the elderly. Variables associated with positive resident attitudes were
      the amount of didactic training and faculty attitudes. No differences were found
      among the attitudes of residents at different levels of training. These findings
      highlight the importance of cognitive training and role modeling in geriatrics.
      Educational settings in which training occurs--classrooms, ambulatory care
      facilities, hospitals, and nursing homes--deserve careful consideration.

PMID- 2227178
TI  - Risks and benefits of a family systems approach to medical care.
AB  - The "art of medicine" is struggling for survival in medical education, practice,
      and research. The authors embrace the biopsychosocial model as an ideal new
      paradigm for medicine and propose that the family systems approach provides the
      best available vehicle for applying the biopsychosocial model to everyday medical
      practice and research. Such an approach would require major changes in the way
      health care is delivered and offers both benefits and risks for family physicians
      to consider. One important change would involve the sharing of physicians' power
      in a health care system that emphasizes collaboration among individuals,
      families, and a variety of professionals. Such revolutionary changes should be
      approached with caution.

PMID- 2227177
TI  - Computerized health information networks: house calls of the future?
AB  - The Cleveland Free-Net is the nation's first free open-access computer system
      providing health information to the public. An online survey was developed for
      the family medicine clinic housed within the Free-Net to study the
      characteristics of the users of the system and the reason they selected the Free
      Net as a source of health information. Three areas were addressed: 1) user
      demographics; 2) content analysis of questions; and 3) reasons Free-Net was used
      instead of the person's own health care provider. An analysis of the initial
      system done in 1985 revealed that early users of the system were known to be
      predominantly white male professionals, generally in the 25-35 age range. In
      comparison to that profile, more of the users in this study were women, but the
      majority of users continued to be white male professionals. Questions asked can
      be classified in six categories: diagnosis, symptoms, treatment, medications,
      laboratory tests, and prevention. The main categories of medical concerns were
      cardiovascular, gastrointestinal, obstetrical, and gynecologic problems. Users
      tended to use the Free-Net for health information rather than their physician
      because the traditional means was not always appropriate for the life-style of
      this population.

PMID- 2227179
TI  - Reprint requests for family medicine literature: how do we respond?
AB  - Requesting and sending reprints of articles published in the medical literature
      is an established tradition. This survey of authors of family medicine literature
      found that 54% believed the tradition should be continued, and 43% felt reprints
      meet a real need. The authors responded to 90% of the requests. Those authors who
      paid the cost out of their own pockets were significantly more likely to view
      reprints as useful and more likely to respond to requests. Support for innovative
      ways of disseminating information, ways that may meet needs that reprints do not,
      is potentially available.

PMID- 2227180
TI  - [Voluntary hypoventilation changes in the breathing pattern of the bradypnea type
      in healthy nonpregnant women and in normal and complicated pregnancies].

PMID- 2227181
TI  - [Spontaneous temperature fluctuations of human hands].

PMID- 2227182
TI  - [The characteristics of the kidney functions and water-electrolyte metabolism in
      children in the Far North].

PMID- 2227183
TI  - [Changes in human heat exchange and nutritional status after moving to a region
      with a hot climate].

PMID- 2227184
TI  - [The stability characteristics of the spatial-temporal organization parameters of
      the EEG in patients with craniocerebral trauma].

PMID- 2227186
TI  - [The determination of the structure and significance of the physical status of
      mine rescuers of different ages and qualifications].

PMID- 2227185
TI  - [The hormonal reaction of the healthy subject to combined exposure to the insulin
      test and physical loading].

PMID- 2227187
TI  - [Functional adaptive regulation in operators in gas-chemical production].

PMID- 2227188
TI  - [The self-organization of proliferating cellular systems: the basic patterns of
      interaction, functioning and evolution].

PMID- 2227189
TI  - [The dynamic analysis of the functional status of a test subject after 1.5-hour
      monotonous operator activity].

PMID- 2227190
TI  - [Profiles of the neuronal reactions of the human brain during visual testing for
      orientational sensitivity].

PMID- 2227191
TI  - [The correlation between the amount of slow fibers in the musculus vastus
      externus of the thigh and sports results].

PMID- 2227192
TI  - [Shifts in the body thermal status during electrical stimulation of the skeletal
      muscles].

PMID- 2227194
TI  - [A standardized psychophysiological conflict-game test].

PMID- 2227193
TI  - [A method for determining the level of information loading in subjects in
      operator jobs].

PMID- 2227195
TI  - [Superslow fluctuations in the indices of the CNS functional status and the rate
      characteristics of the process of problem solving].

PMID- 2227196
TI  - [Electrophysiological research on the functional organization of the human brain
      during directed attention. III. 11- to 12-year-old children with retarded mental
      development].

PMID- 2227198
TI  - [The functional status of the cardiovascular system in healthy subjects and
      hypertension patients based on vector electrocardiographic data
      (biorhythmological research)].

PMID- 2227197
TI  - [The dynamic cardiovascular responses to varying levels of loading in patients
      with ischemic heart disease].

PMID- 2227199
TI  - [The effect of information loading and physical activity of differing intensities
      on the organization of the heart rhythm in children].

PMID- 2227200
TI  - [An evaluation of the statistical characteristics of the spatial coherence of
      bioelectrical processes in the human brain. I. Multiple electroneurographic
      studies of parkinsonism patients].

PMID- 2227201
TI  - [The effect of a local static load on left ventricular contractile function in 6-
      to 7-year-old children].

PMID- 2227203
TI  - [The characteristics of the function of the cardiovascular system in 6- to 7-year
      old children compared with the type of manual asymmetry].

PMID- 2227202
TI  - [The dynamics of the central and cerebral circulations during the head-down tilt
      test taking into account the individual characteristics of 7- to 10-year-old
      children].

PMID- 2227204
TI  - [A comparison of the ventricular myocardial contractility of newborns and adults
      by using a noninvasive echocardiographic method].

PMID- 2227205
TI  - [The relationships between orthostatic hemodynamic stability and the blood
      circulatory indices at rest and during physical loading].

PMID- 2227206
TI  - [The dynamics of the phase and amplitude indices of the rheopolycardiogram
      depending on the directed changes in contractility and the load parameters].

PMID- 2227207
TI  - [The circadian dynamics of the indices of the human cardiorespiratory system
      under physical loading and in an altered gaseous environment].

PMID- 2227208
TI  - [Seasonal changes in the pulmonary ventilation function and respiratory tract
      reactivity in healthy subjects].

PMID- 2227209
TI  - Qui tam suits: scientific misconduct goes to the jury.

PMID- 2227210
TI  - Theoretical studies of protein conformation by means of energy computations.
AB  - In this review we describe fundamental concepts and applications of
      conformational energy computations, with emphasis on some recent advances and
      problems being investigated. The formulation of potential energy functions is
      described, including the nature of the intramolecular force field, the
      representation of interactions with the solvent, and considerations of entropy
      contributions. Approaches to the search for the optimal potential energy are
      summarized. Examples cited among applications of conformational energy
      computations include refinement of X-ray crystallographic structures, the use of
      computations in conjunction with NMR data, prediction of the structures of
      proteins based on either homology or on other procedures that surmount the
      multiple-minima problem, the analysis of hierarchical levels of structure and
      assembly, and interactions in enzyme-substrate complexes.

PMID- 2227211
TI  - Legume lectins--a large family of homologous proteins.
AB  - More than 70 lectins from leguminous plants belonging to different suborders and
      tribes have been isolated, mostly from seeds, and characterized to varying
      degrees. Although they differ in their carbohydrate specificities, they resemble
      each other in their physicochemical properties. They usually consist of two or
      four subunits (25-30 kDa), each with one carbohydrate binding site. Interaction
      with carbohydrates requires tightly bound Ca2+ and Mn2+ (or another transition
      metal). The primary sequences of more than 15 legume lectins have been
      established by chemical or molecular genetic techniques. They exhibit remarkable
      homologies, with a significant number of invariant amino acid residues, among
      them most of those involved in metal binding. The 3-dimensional structures of the
      legume lectins are similar, too, and are characterized by a high content of beta
      sheets and a lack of alpha-helix. The location of the metal and carbohydrate
      binding sites, established unequivocally in concanavalin A by high resolution X
      ray crystallography, appears to be the same in the other legume lectins. Several
      of the lectin genes have been cloned and expressed in heterologous systems. This
      opens the way for the application of molecular genetics to the investigation of
      the atomic structure of the carbohydrate binding sites of the lectins, and of the
      relationship between their structure and biological activity. The new approaches
      may also provide information on the mechanisms that control gene expression in
      plants and on the role of lectins in nature.

PMID- 2227212
TI  - Oncogenes in growth and development.
AB  - Oncogenes play a major role in the control of proliferation in animal cells.
      Because the growth of cell populations is regulated by the stimulatory and
      inhibitory growth factors in the environment, we have attempted in this review to
      relate the function of oncogenes to the mechanism of action of growth factors.
      This correlation allows a description of the cell cycle that rests on a molecular
      basis and in which protooncogenes figure prominently as the cellular messengers
      of the environmental growth stimuli.

PMID- 2227213
TI  - Molecular biology and biochemistry of pyruvate dehydrogenase complexes.
AB  - In most organisms, the pyruvate dehydrogenase complex catalyzes the pivotal
      irreversible reaction that leads to the consumption of glucose in the aerobic,
      energy-generating pathways. A combination of biochemical and molecular biology
      studies have greatly expanded our understanding of the overall structural
      organization of this multicomponent system, delineated the locations and
      elucidated the functions of structural domains of the catalytic components, and
      revealed significant evolutionary changes. Important to this progress was the
      deduction of the primary amino acid sequences from cDNA clones for each of the
      catalytic components from several species. The greatest detail is available for
      the FAD-containing dihydrolipoamide dehydrogenase component, which is the only
      component for which tertiary structure information has recently emerged. For the
      dihydrolipoamide acetyltransferase core component, a similar but species-variable
      multidomain structure is established that is responsible for the distinct
      architectures of the inner cores, the peripheral binding of the other components,
      and the conveyance of reaction intermediates between distantly separated active
      sites. A second lipoyl-bearing component, protein X, has been shown to play a
      critical role in the organization and function of the complex from many higher
      organisms. Although much is known about the means of effector modulation of
      mammalian complex activity, identification of the signal eliciting its regulation
      by insulin still poses an exciting challenge.

PMID- 2227214
TI  - Human growth hormone in the blood of athymic mice grafted with cultures of
      hormone-secreting human keratinocytes.
AB  - An established line of human epidermal keratinocytes was permanently transformed
      by transfection with plasmid vectors bearing the human growth hormone gene under
      the control of two different promoters. Suitable selection permitted the
      isolation of clones secreting abundant growth hormone in culture. When such
      cultures were grafted to athymic mice, human growth hormone could be detected in
      the blood of the mice at concentrations in the physiological range for more than
      4 weeks. Retrograde transfer from epithelial cells should be studied further as a
      possible means of introducing exogenous gene products into the circulation of
      humans.

PMID- 2227215
TI  - Protection against cisplatin toxicity by administration of glutathione ester.
AB  - The role of cellular glutathione in the prevention of toxicity due to the anti
      cancer drug cisplatin (cis-diamminedichloroplatinum) was explored in mice treated
      with buthionine sulfoximine (BSO), a selective inhibitor of gamma
      glutamylcysteine synthetase (and therefore of glutathione synthesis), and with
      glutathione and glutathione monoisopropyl ester. Pretreatment of mice with BSO
      enhanced the lethal toxicity of cisplatin by about twofold. Administration of
      glutathione ester (dose, 2.5-7.5 mmol/kg) protected against lethal cisplatin
      toxicity; glutathione was also effective, but much less so. Glutathione ester, in
      contrast to glutathione, is effectively transported into cells and split to
      glutathione intracellularly. The previous findings that administered glutathione
      does not protect against lethal toxicity due to cadmium ions and mercuric ions,
      whereas glutathione ester does, suggest that intracellular glutathione is
      required for protection against these heavy metal ions. That administration of
      glutathione has a protective effect on cisplatin toxicity suggests that the toxic
      effects of cisplatin may be exerted both intracellularly and extracellularly, and
      that extracellular glutathione (or its degradation products) may form a complex
      with cisplatin extracellularly. The finding that glutathione ester is more
      effective than glutathione in protecting against the toxicity of cisplatin
      suggests that use of glutathione ester may be therapeutically advantageous.

PMID- 2227216
TI  - Whole-body imaging of the distribution of mercury released from dental fillings
      into monkey tissues.
AB  - The fate of mercury (Hg) released from dental "silver" amalgam tooth fillings
      into human mouth air is uncertain. A previous report about sheep revealed uptake
      routes and distribution of amalgam Hg among body tissues. The present
      investigation demonstrates the bodily distribution of amalgam Hg in a monkey
      whose dentition, diet, feeding regimen, and chewing pattern closely resemble
      those of humans. When amalgam fillings, which normally contain 50% Hg, are made
      with a tracer of radioactive 203Hg and then placed into monkey teeth, the isotope
      appears in high concentration in various organs and tissues within 4 wk. Whole
      body images of the monkey revealed that the highest levels of Hg were located in
      the kidney, gastrointestinal tract, and jaw. The dental profession's advocacy of
      silver amalgam as a stable tooth restorative material is not supported by these
      findings.

PMID- 2227217
TI  - The Human Genome Project: answers closer than you think?

PMID- 2227218
TI  - [Coronary surgery: technical progress in the last decade].

PMID- 2227220
TI  - [Analysis of the recovery phase after the ergometric test].

PMID- 2227219
TI  - [Myocardial ischemia induced by exercise. Analysis of the recovery phase.
      Behavior of the rate-pressure normalization product in patients with fixed
      ischemic threshold and patients with variable ischemic threshold].
AB  - Traditionally, in patients with exercise-induced myocardial ischemia we analyze
      the stress-test by studying the behaviour of double product at ischemia. We
      recognize the presence of a functional component in the reduction of coronary
      flow reserve if the double product at ischemia (DPI) varies in 3 stress-tests
      i.e. more than 20% or more than 3200 mmHg b m'-1. Any analysis that relies
      exclusively on double product at ischemia is, of necessity, limited to the
      beginning of the ischemic phenomenon. To better understand the development of the
      whole event, we also considered the double product calculated when the ischemic
      electrocardiographic signal regressed (double product of normalization: DPN).
      More specifically, we set out to determine whether or not double product at
      ischemia behaviour in patients with variable ischemic threshold (i.e. double
      product at ischemia variation greater than 3200 mmHg b m'-1) differs from that of
      patients with fixed ischemic threshold (i.e. double product at ischemia variation
      less than b m'-1). We performed four multistage bicycle ergometer tests, without
      drugs, on 19 patients with chronic exertional anginal and exercise-induced ST
      depression. Patients were tested at the same time of day, within a 10 day period.
      In the second, third and fourth stress test double product at ischemia was
      calculated. On the basis of double product at ischemia values in three stress
      tests, we distinguished two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227221
TI  - [Nisoldipine in the therapy of stable exercise angina: evaluation of its efficacy
      in ergometric tests compared with propranolol].
AB  - The safety and efficacy of a new dihydropyridine calcium antagonist, nisoldipine,
      were studied in comparison with propranolol, in patients with stable angina.
      Following 2 weeks of wash-out of the current therapy and 1 week of placebo, 26
      patients underwent two cycloergometer tests, before and 2 hours after placebo
      administration. Subsequently, 10 mg of nisoldipine twice daily or 40 mg of
      propranolol three times daily were administered over a 4 week period, in a
      randomized single-blind fashion. Cycloergometer tests were performed after 2 and
      4 weeks, before and two hours after drug administration. Two patients, one out of
      the nisoldipine group and one out of the propranolol, were considered drop outs.
      Statistical analysis of the results was performed using two-way variance
      analysis. With both drugs, time to 1 mm exercise induced ST-segment depression (p
      less than 0.01), time to angina (p less than 0.01), and exercise tolerance (p
      less than 0.01) improved furthermore, ST-segment and heart rate recovery time
      decreased (p less than 0.01). Rate-pressure product values at ischemic threshold
      and at peak exercise remained unchanged with nisoldipine, while significant
      reductions were observed with propranolol (p less than 0.01). Maximum ST-segment
      depression was reduced (p less than 0.01) with both drugs and a further
      improvement was observed two hours after drug administration (p less than 0.05).
      At submaximum work-load, rate pressure product values and ST-segment depression
      were improved with both drugs (p less than 0.01); this improvement was more
      evident two hours after drug administration. No significant side effects were
      observed with either drug.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227222
TI  - [Efficacy and duration of effect of two delayed-action preparations of gallopamil
      in patients with exercise angina].
AB  - In 15 subjects (13 male, 2 female) with reproducible threshold ischaemic effort
      angina, the efficacy and the duration of the effect of two different formulations
      of gallopamil in equal doses were evaluated. One of these was gallopamil slow
      release administered twice daily (at 7.00 a.m. and 6.00 p.m.) in doses of 100 mg.
      The other was action gallopamil immediate release administered four times daily
      (at 7.00 a.m., 1.00 p.m., 6.00 p.m., 11.00 p.m.) in doses of 50 mg. The double
      blind study followed the cross-over model. After one week of run-in with placebo
      and two-weeks of treatment with active preparations, the patients underwent a
      clinical examination, an ambulatory electrocardiogram monitoring for 24 hours and
      two cycloergometric effort tests. The ergometric tests were carried out at 10.00
      a.m. and at 5.00 p.m. on the same day so that there was a three-hour interval
      between the administration of both preparations (slow release and immediate
      release) and the morning test. The ergometric test which was carried out at 5.00
      p.m. was at a ten-hour interval from the administration of slow release and at a
      four-hour interval from the administration of immediate release. For each period
      of treatment the gallopamil plasma concentrations were dosed during the
      ergometric test. In both these tests, the two preparations significantly
      increased the duration of the exercise compared to the basal values with placebo
      (7.9 +/- 2.3 minutes with placebo, 9.2 +/- 2.0 minutes with slow
      release.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227223
TI  - [Clinical and prognostic value of evaluation of atrial vulnerability in an
      electrophysiological endocavitary and transesophageal study].
AB  - Atrial fibrillation or flutter is frequently inducible during endocavitary or
      transesophageal electrophysiologic study. However, its clinic and prognostic
      significance has not yet been clarified. We studied 443 patients: 276 underwent
      endocavitary electrophysiologic study, 228 underwent transesophageal
      electrophysiologic study and 61 underwent both methods. In 343 of them a
      satisfactory echocardiogram was obtained. Patients were divided in three groups:
      gr. I, 93 patients with documented episodes of paroxysmal atrial fibrillation or
      flutter; gr. II, 257 patients with or without heart disease without clinical
      atrial fibrillation or flutter; gr. III, 93 symptomatic or asymptomatic Wolff
      Parkinson-White patients without clinical atrial fibrillation or flutter. Gr. I
      included patients without overt heart disease (20), with WPW (11), mitral valve
      prolapse (4), and miscellaneous (58). Gr. II included patients without overt
      heart disease (49), with concealed Kent bundles (7), Mahaim (1) or James fibers
      (1) mitral valve prolapse (6), sick sinus syndrome (40), miscellaneous (91), or
      syncope of an unknown origin (62). Atrial vulnerability was evaluated both by
      endocavitary and transesophageal electrophysiologic study using two different
      protocols; the first protocol was moderately aggressive (prot. A), while the
      second was aggressive (prot. B). Endocavitary electrophysiologic study. Prot. A:
      single and double extrastimuli at the three heart rates (sinus, 100 and 150/m'),
      10/m' incremental atrial pacing from 160 to 250/m; prot. B: prot. A + incremental
      atrial pacing from 260/m' up to 2:1 St-A block. Transesophageal
      electrophysiologic study. Prot. A: 10" atrial burst at 100-600/m' prot. B: prot.
      A + 6-9" increasing rate bursts from 200 to 800/m'. End point of all protocols:
      initiation of greater than 1' atrial fibrillation or atrial flutter. RESULTS:
      Endocavitary electrophysiologic study. A greater than 1' atrial fibrillation or
      atrial flutter was induced with the two protocols respectively in 67% (52/78) and
      85% (51/60) of gr. I, in 17% (26/150) and 36% (38/105) of gr. II and in 35%
      (17/48) and 44% (21/48) of gr. III (gr. I vs gr. II p less than 0.001 for prot. A
      and p less than 0.01 for prot. B; gr. II vs gr. III p less than 0.001 for prot. A
      and NS for prot. B). Induced atrial fibrillation or atrial flutter using the two
      protocols had a greater than 5' duration respectively in 83 and 78% of gr. I, 62
      and 42% of gr. II and in 41 and 38% of gr. III.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2227224
TI  - Electropharmacological test with pentisomide (CM 7857) in patients with sustained
      ventricular tachycardia.
AB  - Pentisomide (CM 7857) is a new class I antiarrhythmic drug whose effect on
      sustained ventricular tachycardia has only been slightly investigated to date.
      The aim of this paper is to examine the pentisomide action on selected patients
      with ventricular tachycardia inducible during intracavitary electrophysiological
      study. Thus, 12 patients (9 M, 3 F, mean age: 45.2 years, range: 24-78), all but
      two with detectable heart disease, underwent electropharmacological tests with
      pentisomide after they had resulted "non responders" (8 patients) or had had a
      proarrhythmic worsening effect (3 patients) to electropharmacological tests with
      amiodarone or flecainide or propafenone or mexiletine. After the inducibility and
      the reproducibility of ventricular tachycardia has been assessed in the basal
      state, all patients underwent several attempts to reinduce ventricular
      tachycardia, during the i.v. infusion of pentisomide 1.5 mg/kg/5 min followed by
      continuous infusion of 1 mg/kg/h, at the same time drug plasma level was
      assessed. Ventricular tachycardia inducibility was still inducible after
      pentisomide, but with a longer cycle length (446 +/- 88 versus 337 +/- 82 msec)
      than in the basal state (p less than 0.0025). No patients had proarrhythmic
      worsening effects. The pentisomide plasma level (available in 5 patients) ranged
      from 3.4 to 22.3 (mean 8.9 micrograms/ml). Four patients underwent chronic oral
      treatment (in 1 pt in association with amiodarone) with a good clinical outcome
      (mean follow-up 6.25 months, range 1-12). We stress the absence of proarrhythmic
      worsening effects and the powerful effect of the drug on ventricular tachycardia
      cycle length.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227225
TI  - Late potentials in idiopathic dilated cardiomyopathy.
AB  - Twenty-five patients with idiopathic dilated cardiomiopathy were investigated in
      order to evaluate the role of late ventricular potentials as possible markers of
      ventricular tachycardia or sudden cardiac death. Holter monitoring showed
      ventricular tachycardia in 9 patients (group A) all of whom had late ventricular
      potentials, (mean +/- SD length 37.22 +/- 15.83 ms and mean +/- SD voltage 5.62
      +/- 2.78 microV). Mean +/- SD ejection fraction in this group was 20 +/- 9.39%.
      In 16 patients (group B), without ventricular tachycardia, means +/- SD ejection
      fraction 27.5 +/- 8.17%; late ventricular potentials were recorded in 2 patients.
      During the follow-up period (means +/- SD 11.53 +/- 7.19 months), 3 patients
      underwent heart transplantation, 2 patients underwent pace-maker implantation and
      2 patients from the ventricular tachycardia group died one from sudden cardiac
      death and the other from progressive heart failure. No significant differences
      were found in the ejection fraction either between the ventricular tachycardia
      and the non-ventricular tachycardia group, or between the late ventricular
      potentials and the non-late ventricular potential groups. Negative data were also
      obtained when we tried to find a correlation between the ejection fraction and
      late ventricular potential length and/or voltage. Good results were observed with
      regard to sensitivity (100%), specificity (87%) and predictive accuracy (81%) but
      follow-up data did not specify a definite prognostic value for late ventricular
      potentials. The Authors conclude that late ventricular potentials are markers of
      patients with idiopathic dilated cardiomyopathy who are prone to ventricular
      tachycardia. However, the role of late ventricular potentials in sudden cardiac
      death is still uncertain.

PMID- 2227226
TI  - [Right ventricular dysplasia and sudden death in young people].
AB  - In this study two autoptic cases of right ventricular dysplasia, observed in
      young and asymptomatic subjects who died suddenly are reported. In these
      patients, the "primary" myocardial atrophy involved the right ventricle, the
      right atrium and the conduction system: the sinoatrial node and the internodal
      pathways (in both cases) and the hisian bifurcation (only in the second case).
      The primary ventricular dysplasia was always associated with "secondary"
      transmural hyperplasia of the sub-epicardial fat tissue except for the anterior
      wall of the pulmonary infundibulum. According to the findings observed, we think
      that: 1) in all cases of right ventricular dysplasia a careful examination of the
      conduction system must be performed due to the fact that the lethal arrhythmias
      can be not only "hyperkinetic" but also "hypokinetic" arrhythmias; 2) right
      ventricular dysplasia is a dysplastic-congenital disease and transmural fatty
      hyperplasia depends both on "primary" myocardial atrophy and on the presence of
      sub-epicardial fat tissue; the latter is related to the age of the patient.

PMID- 2227227
TI  - [Arrhythmogenic dysplasia or cardiomyopathy?].

PMID- 2227228
TI  - [Mexiletine in patients with progressive infarction and reduced ventricular
      function: anti-arrhythmic efficacy and hemodynamic effects].
AB  - Reduced left ventricular function and ventricular arrhythmias are the main risk
      factors associated with sudden death in patients with previous acute myocardial
      infarction. Antiarrhythmic therapy may have side-effects on myocardial
      contractility and sometimes makes the arrhythmia itself worse, especially when
      the pump function is seriously compromised. The aim of this study was to evaluate
      the efficacy of oral mexiletine as well as any modifications in left ventricular
      function by means of ambulatory ECG monitoring and angiocardiography with Tc 99m,
      at rest and after the handgrip test, in 20 patients with previous myocardial
      infarction and ventricular arrhythmias who were grouped into NYHA class II and
      class III. The mexiletine therapy lasted three weeks. Both classes showed a
      significant decrease in the number of ventricular extrasystoles/hour and in the
      number of couples (p less than 0.01). The decrease in the number of the
      ventricular runs proved to be higher in the general analysis (p less than 0.01)
      than in each NYHA class (p less than 0.05). At the end of the study, significant
      modifications were not observed either in the end-diastolic and end-systolic
      volumes, or in the ventricular ejection fraction.

PMID- 2227229
TI  - [The role of surgery and percutaneous valvuloplasty in conservative treatment of
      post-rheumatic mitral stenosis].

PMID- 2227230
TI  - [The conclusion of the trial of the Italian group in Second International Study
      of Infarct Survival].

PMID- 2227231
TI  - The autopsy registry of congenital heart disease at the University of Padua.

PMID- 2227232
TI  - [Incidence of inflammatory bowel disease in the Nord-Pas-de-Calais region and the
      Somme area of France in 1988].
AB  - No epidemiological data on inflammatory bowel disease (IBD) are available in
      France. We therefore conducted a prospective epidemiologic study of IBD in the
      Nord-Pas de Calais region and the Somme department of France (4.5 million
      inhabitants). Each suspected new case was reported by all (private and public)
      gastroenterologists (n = 120) and a questionnaire was filled out at the
      gastroenterologist office by an epidemiologist. The final diagnosis of Crohn's
      disease (CD), ulcerative colitis (UC), or proctitis (UP) was made in a blind
      manner by two gastroenterologists. During 1988, 576 IBD patients were identified;
      281 (49 percent) had CD, 207 (36 percent) had UC including 75 UP; and 88 (15
      percent) had unclassified colitis. The incidence rate per 10(5) was 6.3 for CD
      and 4.6 for UC. The female/male ratio was 1.4 for CD and 0.9 for UC. The mean age
      at the time of diagnosis was 31 years for CD and 40.5 years for UC. The mean time
      between onset of symptoms and diagnosis was longer for CD (15 months) than for UC
      (6.8 months). These preliminary data suggest that the incidence of IBD is high in
      Northwestern France and comparable, for CD, to the highest incidence of Northern
      Europe.

PMID- 2227233
TI  - [Local recurrence of rectal cancers. Multidimensional analysis by anatomoclinical
      factors and role of irradiation].
AB  - Pre- or postoperative radiation therapy reduces the incidence of local recurrence
      after surgical treatment of rectal carcinoma. Factors related to local recurrence
      were analyzed retrospectively by uni- and multivariate analysis. One hundred and
      fifty-five patients (mean age: 65 years) were operated on with curative intent
      between 1967 and 1984. Ninety-four patients (46 patients having abdominoperineal
      resections (APR), and 48 having anterior resections) did not receive radiation
      therapy. Sixty-one patients had preoperative radiation therapy followed by APR in
      59 cases. Univariate analysis showed that the risk of local recurrence increased
      significantly with male sex (p less than 0.006), positive lymph nodes (p less
      than 0.01), vascular invasion (p less than 0.02), and Astler-Coller
      classification (p less than 0.05). Tumor located at less than 5 cm from the anal
      verge was significantly related to recurrence only in patients not receiving
      radiation therapy (p less than 0.02). Multivariate analysis including therapeutic
      modalities showed that local recurrence was significantly related with male sex
      (p less than 0.02), positive lymph nodes (p less than 0.01), and distance to anal
      verge (p less than 0.01). The beneficial role of radiation therapy appeared only
      for tumors located 5 cm or less from the anal verge. Prognostic scores were
      established using these variables and the effect of irradiation was evaluated
      according to these scores. Radiation therapy significatively reduced the risk of
      local recurrence in low-risk patients, i.e., female with low-lying tumor and with
      negative lymph nodes (p less than 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227234
TI  - [Primitive digestive localizations of malignant non-Hodgkin's lymphoma.
      Prognostic factors of locally advanced disease: stage II. Report of 67 cases].
AB  - Sixty-seven patients with non-Hodgkin's lymphoma of the digestive tract with
      locally advanced disease (stage II) were analyzed to determine the main factors
      influencing survival. There were 19 patients with stage II E1 and 48 with stage
      II E2 disease (Musshoff classification). According to the Kiel classification, 46
      percent were low grade, 46 percent were high grade, and 8 percent were
      unclassified. The principal sites involved included the stomach: 11 cases, small
      intestine: 21 cases, colon: 12 cases, and mesentery: 11 cases. Lymphoma was
      unique in 45 cases (67 percent). Treatment consisted of laparotomy in 61 of 67
      cases: partial resection was achieved in 21 cases, complete resection in 27
      cases, and exploration only in 13 cases. Chemotherapy, according to
      histopathological subtypes, was employed in 90 percent of cases. Radiation
      therapy was applied in 25 patients (37 percent), essentially when there was
      residual disease after surgery (17 patients). Therapeutic indications were
      dependent on histological subtype, extension, and the therapy regimen in use at
      the time of treatment. Five patients were treated by surgery only, 2 by surgery
      and radiation therapy, 37 by surgery followed by chemotherapy, and 23 by all
      three treatment modalities. Overall survival was 62 percent at 5 years.
      Univariate analysis showed that 5-year survival rates were not influenced by sex,
      age, histopathological subtype (low grade: 69 percent; high grade: 59 percent;
      NS) or local extension (stage II E1: 76 percent vs stage II E2: 59 percent; NS).
      In contrast, complete surgical excision (p = 0.06) and radiation therapy in case
      of local residual disease (p = 0.02) seemed to improve survival. The main
      prognostic factor was the achievement of a complete therapeutic response (CR) (p
      = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227236
TI  - [Should we still prescribe intravenous cholangiography?].

PMID- 2227237
TI  - [Intravenous cholangiography is not indicated before cholecystectomy for
      uncomplicated lithiasis].
AB  - The purpose of this prospective study was to assess the usefulness of intravenous
      cholangiograms before elective cholecystectomy for lithiasis. The accuracy of
      preoperative intravenous cholangiography to detect choledocolithiasis was
      compared with that of routine operative cholangiography. All patients had
      preoperative intravenous cholangiography provided that they did not have known
      common bile duct gallstones or a previous history of adverse reaction to iodine.
      As well, patients presenting with cholestasis, cholecystitis or cholangitis were
      excluded. A choledocotomy was performed when the operative cholangiography
      disclosed choledocolithiasis; the preoperative intravenous cholangiograms were
      shown to the surgeon only after the operation. One hundred patients were selected
      among 206 consecutive operations for biliary lithiasis. A choledocolithiasis was
      detected in 3 preoperative and in 9 operative cholangiographies. Twelve
      choledocotomies were performed: one or more stones (1 to 12) were found in 9
      patients; operative cholangiography was accurate in all these cases whereas
      preoperative cholangiography was accurate in only 2 (sensitivity = 22 percent).
      We conclude that preoperative cholangiography is useless before elective
      cholecystectomy for lithiasis and is unreliable to select patients in which
      operative cholangiography could be omitted.

PMID- 2227235
TI  - [Digestive gas: pathophysiology and therapeutic approach in functional bowel
      disorders].

PMID- 2227239
TI  - [Family screening strategy for genetic hemochromatosis].

PMID- 2227238
TI  - [Thermic and metabolic effects of meals in liver cirrhosis assessment of
      oxidation and storage rates of nutrients].
AB  - The thermic effect of food was evaluated in 10 cirrhotic patients and 7 normal
      controls by indirect calorimetry during 6 hours following intake of a mixed meal
      supplying 15 kcal/kg of body weight and containing 30, 15 and 55 percent as
      lipid, protein and carbohydrate calories respectively. The rates of storage and
      oxidation of nutriments, as well as variations of blood glucose, insulin, plasma
      lactates, free fatty acids, glycerol, and ketonic corps were also evaluated. The
      thermogenic response to food was lower (p less than 0.025) and delayed in
      cirrhotic patients. In cirrhotic patients the rate of glucose oxidation was
      significantly increased (70.2 +/- 3.9 vs 50.4 +/- 3.9 percent of the glucose
      load; p less than 0.01) suggesting a defect in glycogen storage. These results
      can be related to insulin resistance as attested by a larger increase of glucose
      and insulin levels in cirrhotics than in controls (p less than 0.001 and p less
      than 0.001, respectively). Compared with controls, lipolysis in cirrhotic
      patients was more suppressed as shown by a sharper decrease of free fatty acids
      and glycerol levels (p less than 0.001 and p less than 0.02, respectively).
      Furthermore, the rate of lipid oxidation decreased more in cirrhotic as compared
      with controls (p less than 0.001) before becoming completely suppressed. De novo
      lipogenesis appeared between the 2nd and 4th hours. Consequently, the rate of
      lipid oxidation was significantly reduced in cirrhotic vs controls (14.3 +/- 5.0
      vs 30.5 +/- 3.7 percent of the lipid load; p less than 0.02) showing an increased
      rate of lipid storage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227240
TI  - [Salmonella pancreatic abscess. Treatment by drainage without cholecystectomy].
AB  - We report a case of necrotic collection in the head of the pancreas infected by
      Salmonella typhimurium. Treatment associated necrosectomy and antibiotic therapy
      without cholecystectomy. The course of pancreatic disease was uneventful.
      Complete sterilization was obtained with quinolone antibiotic therapy.

PMID- 2227241
TI  - [Primary adenocarcinoma of the ileostomy after total proctocolectomy for
      ulcerative colitis].
AB  - A 61-year-old man developed primary adenocarcinoma with skin invasion, at the
      ileostomy site 33 years after a proctocolectomy for ulcerative colitis. A total
      of eleven patients with ileostomy adenocarcinoma have been reported in the
      literature. Ten patients were treated surgically for ulcerative colitis and the
      other for adenomatous polyposis coli. The diagnosis of stomal malignancy was made
      9 to 36 years after the ileostomy (mean interval, 22 years). The pathogenesis of
      the malignant growth is uncertain and several possibilities are discussed:
      stasis, severe chronic inflammation, colonic metaplasia and severe dysplasia of
      the ileal mucosa. When an ileostomy requires late revision for inflammatory
      changes, careful pathologic examination of the entire stoma and surrounding skin
      is essential.

PMID- 2227243
TI  - Production of paf-acether by various bacterial strains.

PMID- 2227242
TI  - [Unusual cause of ascites: the POEMS syndrome].
AB  - A 39-year-old woman presented with polyneuropathy, hepatomegaly, splenomegaly,
      endocrinopathy, monoclonal protein and skin changes, several of the many clinical
      features of the recently described POEMS syndrome. In addition, she had a
      Castleman's disease (angiofollicular lymph node hyperplasia). In this case
      ascites was a main presenting feature. Thus, the POEMS syndrome must be added to
      the list of rare causes of ascites. Electron microscopy of the liver showed
      perisinusoidal fibrosis.

PMID- 2227244
TI  - [Possibility of prednisone-omeprazole interference in bullous pemphigoid].

PMID- 2227245
TI  - [Serum piperacillin pharmacokinetics in ascitic cirrhosis].

PMID- 2227246
TI  - [Tumoral seeding after percutaneous liver biopsy of colonic metastasis].

PMID- 2227247
TI  - Effects of endoscopic variceal sclerotherapy using GT XIII on blood coagulation
      tests and the renal kallikrein-kinin system.
AB  - Forty-six sclerotherapy sessions were performed on liver cirrhotics with high
      risk esophageal varices using GT XIII, a sclerosant composed of gelatin, thrombin
      and coagulation factor XIII. GT XIII was effective for the prevention of
      temporary symptoms and transient hypotension observed in 55 sclerotherapy
      sessions using thrombin. In 42 (91%) sessions, patients underwent sclerotherapy
      with no symptoms, and in the other four (9%) sessions, only slight symptoms of
      general fatigue and headache were observed. Changes in the mean arterial pressure
      were significantly smaller in sessions using GT XIII than in those using thrombin
      (-12.3 +/- 13.6 vs. -26.8 +/- 20.7 mmHg, P less than 0.01). Changes in
      coagulation tests, similar to those of disseminated intravascular coagulation
      (DIC), were also reduced in sessions using GT XIII. Urinary kallikrein and kinin
      excretion significantly increased after the procedure (P less than 0.01),
      indicating activation of the renal kallikrein-kinin system. Increases in urinary
      kallikrein and kinin excretion showed a significant relationship with the
      consumed plasma fibrinogen levels (r = -0.51, P less than 0.01 and r = -0.58, P
      less than 0.01, respectively), and it was suggested that activation of the
      glandular kallikrein-kinin system caused by abrupt DIC-like changes in the
      hemostatic system might play a role in manifestations of temporary complications
      occurring with the use of hemostatic agents containing thrombin.

PMID- 2227248
TI  - The relationship between interdigestive gallbladder and gastroduodenal motility
      in man.
AB  - The relationship between interdigestive gallbladder and gastroduodenal motility
      simultaneously with the behavior of plasma motilin and CCK levels in 20 subjects
      was investigated. We used an infusion catheter method for the measurement of
      gastroduodenal motility, and real-time ultrasonography for the measurement of
      gallbladder size. In gastric phase II, the gallbladder contracted with extension
      of the major axis and shrinking of the minor axis, with its minimum volume being
      84% of the volume in phase I. The gallbladder then filled rapidly assuming a
      sphere-like shape with extension of the minor axis and shrinking of the major
      axis in gastric phase I. This motility was recognized only during the
      gastrointestinal interdigestive migrating complex (GI-IMC) cycle, originating in
      the stomach, and was associated with an increase of motilin levels, it was not
      seen before or after the intestinal IMC (I-IMC), which originated in the duodenum
      without contraction of the stomach or an increase of motilin levels. Furthermore
      no apparent relationship was recognized between CCK and gastric or gallbladder
      motility. Our findings suggest that gallbladder motility in the interdigestive
      period has a close relationship with gastroduodenal motility and is related to
      the appearance of the GI-IMC.

PMID- 2227249
TI  - Class II (HLA-DR, -DP, and -DO) antigens on intestinal epithelia in ulcerative
      colitis, Crohn's disease, colorectal cancer and normal small intestine.
AB  - Class II antigens in involved colonic epithelia of ulcerative colitis (UC),
      Crohn's disease (CD), colorectal cancer, and epithelia of normal small intestine
      were investigated using an immunoperoxidase method. Ten normal colonic mucosa
      served as normal controls. Ten specimens were studied for each group. Normal
      colonic epithelia did not express class II antigens. In colonic diseases; (1)
      with regard to the frequency and extent of class II antigens on epithelia. HLA-DR
      antigens were the most highly and greatly expressed, followed by HLA-DP and then
      HLA-DQ antigens. (2) The extent of HLA-DR and -DP, but not HLA-DQ, expression on
      epithelia of UC and colorectal cancer seemed to be positively correlated with the
      degree of mononuclear cell infiltration in the lesion. (3) The extent of class II
      antigen expression on colonic epithelia in CD was not related to the degree of
      mononuclear cell infiltration in the lesion. (4) The extent of HLA-DR and -DP
      expression on epithelia of colorectal cancer seemed to be positively correlated
      with increasing undifferentiation. In the normal small intestine, where HLA-DR
      antigens were physiologically expressed on epithelia. HLA-DQ antigens were not
      expressed. The heterogeneity among colonic diseases, and between the
      physiological and pathological status, may reflect differences in
      immunoregulation.

PMID- 2227250
TI  - Frequency of concurrence of hepatitis B surface antigen and antibody in a large
      number of carriers in Okinawa, Japan.
AB  - A large number of chronic hepatitis B surface antigen (HBsAg) carriers in
      Okinawa, Japan were tested for antibody to HBsAg (anti-HBs), by both
      radioimmunoassay and enzyme immunoassay methods. Concurrence of HBsAg and anti
      HBs was found in 166 (26.1%). We found no clear predominance of either liver
      damage or hepatitis B e antigen (HBeAg) in the concurrent carriers studied.
      Antibody to pre-S2 antigen (anti-pre-S2) was detected in 16 (9.6%) of 166
      subjects with concurrent markers, 15 of these 16 carriers were positive for
      antibody to HBeAg (anti-HBe). Anti-pre-S2 was correlated with anti-HBe rather
      than with anti-HBs. The distribution of HBsAg subtypes among carriers determined
      to have subtypes was 76.7% adw, 22.0% adr, 0.2% ayr, 0.9% adwr, and 0.2% adyr.
      The distribution of anti-HBs subtypes among concurrent carriers was 51.5% anti-r,
      21.4% anti-w, 15.5% anti-d, and 10.7% anti-y. Concurrent carriers had HBsAg of
      one subtype and heterotypic anti-HBs. Because the HBsAg subtype ay is rare in
      this area, it is hard to believe that the concurrent carriers with anti-y were
      infected with hepatitis B virus of which the HBsAg subtype was ay. A dual
      infection was highly unlikely. It seems that some of the concurrent carriers
      correlate with compound subtypes adwr and adyr.

PMID- 2227251
TI  - Serous cystadenoma of the pancreas: radiologic and clinicopathologic features in
      seven cases.
AB  - Clinical charts, radiologic features, macroscopic and microscopic findings, and
      clinical follow-up data in seven patients with serous cystadenoma of the pancreas
      (SCAP) were retrospectively reviewed. The seven patients with SCAP consisted of
      six women and one man, and their ages ranged from 52 to 76 years with a mean age
      of 64.9. The most common symptoms were abdominal mass or pain. The greatest
      diameter of the seven tumors ranged from 2cm to 10cm with a mean diameter of
      6.6cm. On ultrasonograms and/or computed tomograms, the tumors were visualized as
      lobulated masses containing numerous small cysts. Three tumors angiographically
      examined were all characteristic hypervascular masses with neovascularity.
      Macroscopically, the tumors were well-defined lobulated masses containing many
      cysts with a central scar. Microscopically the cysts were lined with a layer of
      cuboidal epithelium with centrally placed round nuclei and clear cytoplasms
      containing abundant glycogen. One patient had undergone a cystojejunostomy five
      years before the complete resection and the tumor increased in size necessitating
      a pancreatoduodenectomy. The seven patients with SCAP were doing well without any
      signs of local recurrence or distant metastasis during the period from 2 months
      to 120 months after a complete resection. Despite its enormous size at the time
      of diagnosis, SCAP should be resected with aggressive intent because the complete
      resection produces a favorable clinical course.

PMID- 2227252
TI  - Effect of dimethadione derived from repeated oral administration of trimethadione
      on pancreatic secretion in dogs.
AB  - The effect of the weak organic acid of dimethadione (DMO) on secretin-stimulated
      pancreatic secretion was studied with repeated oral administration of
      trimethadione (TMO), the precursor of DMO, to dogs at a dose of 10 to
      160mg/kg/day for a period of 14 days. The bicarbonate concentration in pancreatic
      juice at a steady state decreased significantly, reflecting a close correlation
      with the dose of TMO and DMO concentrations in plasma and pancreatic juice. The
      maximal decrement from the control of cases of no TMO administration was 18.8
      mEq/l (12.1% of the control level). The chloride concentration in pancreatic
      juice showed a reciprocal relation to the bicarbonate concentration. The sum of
      both anion concentration was constant, irrespective of the dose of TMO. The
      average carbon dioxide tension of pancreatic juice in all doses of TMO was lower
      than that of the control, but differences were not statistically significant. The
      pH, flow rate, sodium and potassium concentrations in pancreatic juice at a
      steady state did not differ significantly in relation to the dose of TMO. These
      findings suggest that repeated oral administration of TMO cause a significant
      decrease in bicarbonate concentration in pancreatic juice, resulting probably
      from the buffer action of bicarbonate on protons provided from the undissociated
      form of DMO.

PMID- 2227253
TI  - Clear and colorless fluid observed during percutaneous transhepatic gallbladder
      drainage.
AB  - Twelve patients with discharge of clear colorless fluid during percutaneous
      transhepatic gallbladder drainage (PTGBD) were encountered during a period of 4.5
      years. On the average, the fluid appeared on the 12th day after PTGBD and
      continued to flow until the completion of observation. The volume was usually
      less than 60ml per day. It flowed in an alternating pattern with normal yellow
      color bile each day. The fluid was observed in patients in whom satisfactory
      patency of the biliary system was confirmed by cholangiography and/or cholangio
      fiberscopy. Biochemical examinations of the fluid revealed lower biliary lipids
      but a similar electrolyte composition compared to bile of normal color. It was
      alkaline. These observations indicate that the clear colorless fluid is different
      from what is known as "white bile", which is produced when there is an
      obstruction of the biliary tree. The fluid may be secreted from the gallbladder
      epithelium or the bile duct epithelium. The significance was not clarified in
      this study. Further investigation is necessary to elucidate the clinical
      implications of the clear and colorless fluid secretion.

PMID- 2227254
TI  - A case of coexisting malignant carcinoid tumor and adenocarcinoma in the papilla
      of Vater.
AB  - A 47-year-old Japanese woman in whom obstructive jaundice had already been
      diagnosed, was found to have a dome-shaped elevated tumor approximately 3 cm in
      diameter located in the area very close to the papilla of Vater on endoscopical
      and radiographical investigations. Histopathologically, the resected tumor was
      composed mainly of solid nests of atypical argyrophilic cells, and partially of
      an area of well differentiated tubular adenocarcinoma, showing mutual transition
      in the mucosal layer. Both immunohistochemical and ultrastructural analyses
      confirmed the difference in character of tumor cells between these two areas:
      neuroendocrine cell carcinoma and tubular adenocarcinoma of common type in the
      intestine. To the best of our knowledge, this is only the third case reported to
      be a coexisting malignant carcinoid tumor and adenocarcinoma arising in the
      periampullary region.

PMID- 2227255
TI  - A clinicopathological study of asymptomatic primary biliary cirrhosis in three
      aged patients.
AB  - The 3 cases suffering from asymptomatic primary biliary cirrhosis (aPBC) were all
      older than 70 and female. Case 1, 2 and 3 were respectively 77, 72 and 70 years
      old. The final diagnosis was made on the basis of clinical observation and liver
      biopsy. Case 1 was diagnosed as CAH-PBC mixed type from histological findings and
      classified as stage II-III according to Scheuer's classification. Case 2 was
      stage I and exhibited morphological features of PBC with arteriosclerotic change.
      Case 3 was stage I and had dysplasia-like large nuclei in some hepatic cells.
      Clinically, all cases were AMA positive. Elevation of serum ALP and IgM values
      was recognized in 2 cases, but serum transaminase and ALP values were not
      elevated in Case 2 for 1 year. In the follow-up observation during 5 years. Case
      1 remained asymptomatic except for gradual elevation of serum ALP value. AMA,
      which was positive at the time of diagnosis, is now negative after 5 years, but
      now produces high potency ANA. The incidence of PBC in those aged older than 70
      in Japan accounts for only 2-3% of all PBC cases. According to some reports, the
      prognosis of PBC deteriorates with age. In 3 cases reported here, however, the
      clinical course did not deteriorate even in untreated cases. This suggests the
      possibility that some aPBC cases diagnosed at an age older than 70 may have a
      favorable prognosis.

PMID- 2227256
TI  - A case of idiopathic portal hypertension after renal transplantation.
AB  - A case of idiopathic portal hypertension (IPH) developing after renal
      transplantation is reported. A 33-year-old Japanese male who had undergone renal
      transplantation 8 years previously was transferred to our hospital because of
      hematemesis from ruptured esophageal varices. He had no history of any liver
      disease before the renal transplantation, but had a history of receiving blood
      transfusion. Abdominal computed tomography (CT) and ultrasonography revealed
      marked splenomegaly and collateral channels, but no obliteration which might
      cause portal hypertension in the hepatic or portal vein. No findings suggestive
      of hepatitis or liver cirrhosis were found either macroscopically on laparoscopy
      or by liver biopsy. Light microscopic study of the liver biopsy specimen showed
      mild periportal fibrosis, inconspicuous portal branches in the most peripheral
      tracts, but no pseudolobule formation or piecemeal necrosis. However collagen
      deposition was found in the perisinusoidal space and partly in intercellular
      space on electron microscopy. We consider that the development of portal
      hypertension in this case is responsible for the collagen deposition, which may
      be related to the administration of azathioprine after renal transplantation.
      There are few reports on IPH after renal transplantation, and it is stressed that
      a lower amount of azathioprine than previously reported may induce IPH under such
      conditions.

PMID- 2227257
TI  - An ultrastructural analysis of changes in surface architecture of intestinal
      mucosa following Giardia lamblia infection in mice.
AB  - The oral inoculation of Giardia lamblia trophozoites (Portland 1 strain) resulted
      in the establishment of infection by day 3-5 in NMRI mice. By 9-11 days
      postinfection, the trophozoites load reached maximum (acute phase) and later
      declined by day 17-21. The tissue sections from infected animals during the
      establishment phase of infection indicated limited changes in surface epithelium
      with normal villous length. Although trophozoites of G. lamblia were seen in all
      sections lying free in the lumen as discrete parasite, the active invasion by the
      parasite could not be demonstrated. During the acute phase of infection, fuzzy
      appearance of brush border, marked reduction in villous height and infiltration
      of intraepithelial lymphocytes were commonly seen in all tissues. Electron
      microscopic observation demonstrated large numbers of trophozoites of G. lamblia
      preferentially aggregated at the base of the villi. At some sites, adhesive marks
      indicating attachment of Giardia trophozoites were also seen by scanning electron
      microscopy. In addition, severe flattening and blunting of microvilli and
      occasional loss of basic morphology of intracellular organelles of columnar cells
      were noticed at the site of parasite colonization under electron microscopy. The
      brush border microvilli were noted to be damaged in areas where parasites were
      attached to surface epithelium with the help of suction discs. The morphological
      changes associated with Giardia infection tended to reverse as the parasite load
      declined by day 17-21. Thus we feel that malabsorption in giardiasis with total
      or varying degrees of morphological alterations of surface mucosa can be
      explained on the basis of reduced absorptive surface area.

PMID- 2227258
TI  - Transendoscopic projectile drug delivery.

PMID- 2227259
TI  - Prostaglandin production by isolated Kupffer cells.

PMID- 2227260
TI  - Changes of bile bilirubin composition after intravenous bilirubin injection in
      dogs.

PMID- 2227261
TI  - Organization of the X gene region of the hepatitis B virus genome.
AB  - In the hepatitis B virus (HBV) genome four long open reading frames (ORFs) have
      been found that encode the virus core, surface and polymerase proteins as well as
      a protein that appears to be involved in virus gene expression (X). However, all
      HBV genomes examined contain two addition ORFs designated ORF5 and ORF6. ORF5 is
      located on the same strand as the four known viral genes and is 70-100 codons in
      size. ORF6 is located on the DNA strand complementary to the one that encodes the
      other virus genes, and is approximately 210 codons in length. Both ORFs are
      located in the X gene region which corresponds to the 3' terminus of the linear
      RNA genome. Northern blot analysis identified an X region specific transcript of
      approximately 0.7 kb. Although this transcript may be the template for the
      translation of the X gene protein it may also be involved in the expression of
      the protein encoded by ORF5. The promoter for this transcript may consist, in
      part, of the 15 residue sequence GCYTGYYTTGCYCGC because this sequence is near
      the 5' end of the transcript, it is highly conserved among hepadnaviruses, and it
      contains sequences involved in RNA polymerase binding. Also, the nucleotides
      within this region of the hepadnavirus genome are capable of forming a stable (G
      = -18 kcal/mole) hairpin structure. Understanding the organization and gene
      expression of the X region may be crucial in expanding our knowledge on the
      biology of HBV.

PMID- 2227262
TI  - Hepadnavirus enhancer and its binding proteins.
AB  - In the hepadnavirus enhancer region, a 33 bp DNA sequence is strongly conserved
      among mammalian hepadnavirus genomes. To elucidate the role of the sequence, we
      tested enhancer activities and capability to form DNA-protein complex of several
      synthetic DNAs. Not only two tandem copies of a 46 bp DNA covering the sequence
      but also two tandem copies of a 23 bp in the sequence exhibit enhancer activity.
      Also the activity was augmented by treatment of a tumor promoter, TPA. DNA
      binding proteins complexes with the 23 bp DNA were augmented in extracts of HepG2
      or HeLa cells stimulated with TPA. These results imply that the conserved
      sequence of hepadnavirus enhancer is a TPA-inducible enhancer which is
      transactivated by ubiquitous DNA-binding proteins. We presented results showing
      that DNA-protein complexes with a 23 bp DNA are similar to but distinct from
      those with a TPA-responsive element DNA, the recognition site for c-jun/fos
      products. We also presented results suggesting that hepadnavirus X protein may
      not directly or indirectly affect DNA-protein complex formation with the
      conserved sequence in the hepadnavirus enhancer.

PMID- 2227263
TI  - Open reading frames on plus strand genome of duck hepatitis B virus.
AB  - Hepadnaviruses have open reading frames of surface, core, polymerase and X
      protein on the minus strand of the genome. We analyzed a plus strand of duck
      hepatitis B virus (DHBV) for the presence of open reading frame with a computer
      program. We found one frame on the area that is complement to 3' end of
      polymerase gene and 5' end of precore gene. That open reading frame is conserved
      in three strains of DHBV, and the predicted protein is about 80 amino acids.

PMID- 2227264
TI  - Experimental WHV infection of woodchucks: an animal model of hepadnavirus-induced
      liver cancer.
AB  - Woodchuck hepatitis virus (WHV), a member of the Hepadnaviridae, is closely
      related to HBV in its virus structure, genetic organization and mechanism of
      replication. Natural infection of woodchucks is associated with chronic liver
      disease and primary hepatocellular carcinoma (HCC). A concerted effort to develop
      the woodchuck as an experimental animal model of hepadnavirus-induced disease was
      initiated in 1980. The experimental studies have established the following: (1)
      Chronic WHV carriage as an outcome of infection is a function of age of exposure,
      virus dose and, possibly, virus strain. As in humans, animals infected as
      newborns develop chronic antigenemia at high rates compared to young adults. (2)
      WHV causes primary hepatocellular carcinoma (HCC) in woodchucks. Hundred percent
      of experimentally-induced chronic WHsAg carriers developed HCC within three
      years; no HCC has occurred in concurrent uninfected control animals born and held
      in the same laboratory environment. The predictable course of experimental WHV
      infection leading to liver disease in woodchucks makes this an ideal model in
      which to study the natural history of hepadnavirus and to develop effective
      prophylactic and therapeutic strategies.

PMID- 2227265
TI  - HBV production in transgenic mice.
AB  - We produced transgenic mice by microinjecting a partially duplicated copies of
      hepatitis B virus (HBV) gene into fertilized eggs of C57BL/6 mice. One mouse was
      a high producer of HBV surface antigen (HBsAg) and HBV e antigen (HBeAg) in the
      serum. All offspring carrying HBV DNA were positive for both antigens in the
      serum. The HBV DNA was expressed in liver- and kidney-specific manner. The normal
      process of HBV replication, including the packaging of the pregenome 3.5-kb RNA
      into a nucleocapsid, the reverse-transcription of the complete minus strand DNA,
      and the release of Dane particles into the serum before the completion of
      synthesis of plus strand, occurred in the liver of these transgenic mice. These
      results suggest that the species specificity of HBV infection is not due to the
      inability to replicate in nonnatural host but to the lack of receptors or factors
      needed for virus adsorption and internalization. The founder mouse is now 19
      months of age but shows no clinical or pathological change, suggesting that HBV
      itself is not cytopathic.

PMID- 2227266
TI  - Development of transgenic mice containing woodchuck hepatitis virus DNA.
AB  - We produced transgenic mice containing woodchuck hepatitis virus DNA with tandem
      repeat structure capable of producing virus and viral antigens. Poly(A)+ RNAs
      probably corresponding to pregenome and viral antigens were detected in their
      liver. These mice have now been healthy for one year. However, there is the
      possibility of inducing immunologically mediated hepatitis. We anticipate these
      transgenic mice may present a useful model system for studying the significance
      of chronic hepatitis in hepatocellular carcinoma development.

PMID- 2227267
TI  - Hepatitis B virus DNA detection and comparison with hepatitis B surface antigen.
AB  - Hepatitis B surface antigen (HBsAg) has been used for the detection of hepatitis
      B virus (HBV). Recently, HBV detection using the polymerase chain reaction (PCR)
      has been shown to be a direct measure of complete virions and to be potentially a
      very sensitive method. Therefore, we attempted to analyze the relationship
      between HBsAg detection and HBV DNA assay by PCR. We tested HBV DNA by a
      modification of the PCR technique in serial sera from five chimpanzees
      experimentally infected with HBV and 29 human sera. Our new method of PCR
      analysis is as sensitive as former methods but is more simple and rapid than
      existing procedures. In chimpanzee studies, HBV DNA was detected 2-3 weeks before
      the appearance of HBsAg, and continued to be detectable 2 weeks after the
      production of antibody to HBsAg. Also, 3 of 11 chronic hepatitis B patients who
      lost HBsAg were positive for HBV DNA in serum, while all of patients who
      recovered from acute viral infection were negative for HBV DNA in serum. These
      results indicate that HBV DNA detection by PCR analysis is the most sensitive
      method currently available to detect the presence of complete virions in serum.

PMID- 2227268
TI  - Complementation analysis of mutants defective in different steps of HBV reverse
      transcription.
AB  - The HBV P gene encodes a multifunctional polyprotein which contains the major
      enzymatic activities required for hepadnaviral reverse transcription (protein
      primer, DNA polymerase, and RNase H). Mutant HBV genomes unable to synthesize
      fully functional P gene products were analysed for their potential to be rescued
      by a second mutant HBV genome that either contained a wild type P gene
      (intergenic complementation) or a mutation in a functionally different P gene
      domain (intragenic complementation). This analysis was carried out by
      cotransfecting two mutants at a time into HepG2 cells and assaying for the
      production of core particles containing DNA polymerase activity. The results
      obtained demonstrate the existence of intergenic, but not of intragenic
      complementation. This indicates that the primary P gene product is not processed
      before core assembly, and furthermore that there is a rather free mixing of all
      HBV gene products in the HBV infected cell which can lead to the efficient
      propagation of defective viral genomes.

PMID- 2227269
TI  - Hepatitis A, B, C, D and E viruses: structure of their genomes and general
      properties.
AB  - Hepatitis A virus is an enteric picornavirus. Its genome is a single stranded RNA
      molecule of positive-strand polarity of 7478 bases. This sequence codes for a
      polyprotein which is processed to give rise to viral proteins VP-1, VP-2, VP-3
      and others. Hepatitis B virus, a major worldwide infectious and cancer promoting
      agent contains a DNA genome of 3226 base pairs that replicates by a reverse
      transcriptase via an RNA intermediate. Extensive sequencing and expression
      experiments have revealed four major genes named surface, core, polymerase and X
      which are coded in more than one reading frame. Furthermore, within a frame,
      proteins are expressed from multiple initiation codons resulting in several
      related products. The viral genome of hepatitis C virus (nonA-nonB), an elusive
      major infectious agent, has recently been cloned. This genome is a single
      positive-stranded RNA of at least 10,000 bases which codes for several antigens,
      some of them associated specifically with nonA-nonB hepatitis infections. The
      hepatitis D (delta) viral agent, an infectious agent requiring a hepadnarious for
      propagation, contains a covalently closed circular single-stranded RNA genome of
      1167 nucleotides. This genome encodes the protein p24 and p27 that bind
      specifically to antisera from patients with chronic hepatitis D infections.

PMID- 2227270
TI  - Presentation of the Julius Friedenwald Medal to Rudi Schmid, M.D., Ph.D.

PMID- 2227271
TI  - Natural history of congestive gastropathy in cirrhosis. The Liver Study Group of
      V. Cervello Hospital.
AB  - In a prospective study of the natural history of congestive gastropathy, 212
      consecutive cirrhotic patients (75 treated with sclerotherapy) were included.
      Mean follow-up was 46 months. Mild gastropathy (mosaiclike pattern) was found in
      110 patients and severe gastropathy (granular mucosa with cherry spots) was found
      in 20. Prevalence of Helicobacter pylori, formerly Campylobacter pylori, was 50%
      in patients without, 43% in those with mild, and 28% in those with severe
      gastropathy. Congestive gastropathy was significantly more frequent in patients
      treated with sclerotherapy (83% vs. 50%, P less than 10(-5)). Sixty-month
      actuarial proportions of patients free of anemia (in the absence of hematemesis
      or melena), were 17% with severe, 62% with mild, and 93% without gastropathy (P
      less than 10(-8]. Corresponding figures for overt bleeding were 25%, 73%, and 87%
      (P less than 10(-7], whereas those for survival were 46%, 72%, and 85% (P =
      0.0005), respectively. A multivariate regression analysis supported the following
      conclusions: (a) sclerotherapy and the presence of large esophageal varices
      significantly increase the risk of congestive gastropathy, which (b) is a
      significant risk indicator of both chronic and overt bleeding but does not
      independently affect survival.

PMID- 2227272
TI  - Multiple hormone elevations in Zollinger-Ellison syndrome. Prospective study of
      clinical significance and of the development of a second symptomatic pancreatic
      endocrine tumor syndrome.
AB  - In the present study of 45 patients with Zollinger-Ellison syndrome, the
      frequency and clinical importance of the release of multiple gastrointestinal
      peptides were assessed prospectively. During an initial evaluation, extent of
      gastrinoma, clinical symptoms, disease duration, and presence or absence of
      multiple endocrine neoplasia, type I (MEN-I) were assessed. All patients had
      determinations of fasting plasma gastrin, human pancreatic polypeptide, motilin,
      neurotensin, and somatostatin; 35 had determinations of insulin and gastrin
      releasing peptide and 21 had determinations of glucagon. A plasma elevation of
      additional peptides besides gastrin was detected in 62%, with 44% having one, 18%
      having two, and 0% having three additional peptides elevated. Motilin was
      elevated in 29%, human pancreatic polypeptide in 27%, neurotensin in 20%, and
      gastrin-releasing peptide in 10%, whereas insulin, glucagon, and somatostatin
      were not elevated in any patient. The presence or absence of elevation of any
      peptide did not differ in patients with or without MEN-I, with gastrinoma size,
      with the presence or absence of metastatic disease, or with various clinical
      symptoms. Patients were assessed yearly for clinical evidence of a secondary
      symptomatic pancreatic endocrine tumor syndrome with a median follow-up of 146
      and 84 months from onset or diagnosis, respectively. Only one patient (2% of
      patients) developed a second syndrome (rate, 2 patients per 100 patients observed
      for 10 years). These results demonstrate that the plasma elevation of multiple
      gastrointestinal peptides is common in patients with Zollinger-Ellison syndrome;
      however, the rate of developing a second symptomatic pancreatic endocrine tumor
      syndrome is much lower than generally believed. Furthermore, no evidence is found
      to support the conclusions that the detection of the plasma elevation of these
      peptides is clinically important in assessing MEN-I status, disease extent, or
      presence of metastatic disease or that elevated levels of motilin, neurotensin,
      gastrin-releasing peptide, or human pancreatic peptide are associated with any
      distinct clinical symptoms. Therefore, we recommend that plasma concentrations of
      these additional gastrointestinal peptides should not be assessed routinely but
      rather only if new symptoms develop.

PMID- 2227273
TI  - Human pepsinogen A isozymogen patterns in serum and gastric mucosa.
AB  - The pepsinogen A isozymogen pattern in gastric mucosa is genetically determined
      and can be visualized in nondenaturating polyacrylamide gel electrophoresis of
      supernatants of sonified gastric mucosal biopsies by demonstrating proteolytic
      activity after converting pepsinogen into pepsin by acid. Pepsinogen isozymogens
      are present in very low concentrations in the blood but can now be demonstrated
      in serum by a newly developed immunoblotting procedure. This study investigated
      whether the serum pepsinogen A isozymogen pattern adequately reflects the
      pepsinogen A phenotype. Serum and gastric mucosal pepsinogen A isozymogen
      patterns were compared in 72 subjects from the routine endoscopy program. A close
      correlation was found between the relative intensities of the pepsinogen A
      isozymogens in the serum and the gastric mucosal patterns. Increasing the
      pepsinogen A release into the circulation by oral omeprazole did not affect the
      pepsinogen A patterns in the blood. It is concluded that the serum pepsinogen A
      pattern reflects the pepsinogen A phenotype in humans. In addition, no
      preferential release of a pepsinogen A isozymogen into the circulation was
      observed. Thus, immunoblotting of serum provides a new and reliable tool to study
      pepsinogen genetics in humans. Because a relationship was previously shown
      between specific pepsinogen A phenotypes and gastric malignancies in humans,
      serum pepsinogen A patterns may provide a tool to detect subjects who are at risk
      of gastric cancers.

PMID- 2227274
TI  - Effect of truncal vagotomy on parietal cell mass and antral gastrin cell mass in
      dogs.
AB  - Vagotomy is known to reduce acid secretion and to increase serum gastrin
      concentrations. However, there is minimal information on the effect of vagotomy
      on parietal cell mass or gastrin cell mass. Basal and maximal acid secretions and
      fasting serum gastrin concentrations were measured in 22 gastric fistula dogs
      with pyloromyotomy before and up to 56 days following complete bilateral truncal
      vagotomy (n = 11) or sham vagotomy (n = 11). Dogs underwent total gastrectomy on
      postoperative days 9 (n = 5 per group) or day 56 (n = 6 per group). Parietal
      cells were stained with Luxol fast blue and parietal cell mass determined with
      computer-assisted histomorphometry. Parietal cell mass averaged 10.68 +/- 0.90
      billion in control dogs and correlated significantly with maximal acid output (r
      = 0.76; P less than 0.01). Vagotomy reduced maximal acid output by 40%-50% (P
      less than 0.001) but had no significant effect on parietal cell mass (8.99 +/-
      1.00 billion). Vagotomy increased serum gastrin concentrations significantly, but
      antral gastrin cell mass in vagotomized dogs (5.66 +/- 1.00 million) was not
      significantly different than that in control dogs (4.74 +/- 0.50 million). Thus,
      vagotomy did not lead to parietal cell hypoplasia or gastrin cell hyperplasia
      despite profound alterations in parietal cell and gastrin cell function.

PMID- 2227275
TI  - 24-hour intragastric acidity and plasma gastrin after omeprazole treatment and
      after proximal gastric vagotomy in duodenal ulcer patients.
AB  - The relationship between suppressed gastric acidity and the increase in plasma
      gastrin levels after pharmacological and surgical treatment of peptic ulcer
      disease were compared in this study. Eight patients with chronic duodenal ulcer
      and referred for proximal gastric vagotomy were studied. 24-hour intragastric
      acidity and plasma gastrin levels were investigated in the same patients on three
      consecutive occasions: preentry without any treatment; after 4 weeks of
      administration of 20 mg of omeprazole daily, and 4-6 months after proximal
      gastric vagotomy. Intragastric acidity was slightly more reduced by omeprazole
      (94%) than after proximal gastric vagotomy (78%), with no difference found during
      the day or night with either. Plasma gastrin levels increased slightly more after
      proximal gastric vagotomy [284% (median, 2120 pmol.h/L; range, 733-2831
      pmol.h/L)] than after omeprazole administration [186% (median, 1586 pmol.h/L;
      range, 495-2573 pmol.h/L)]. There is strong evidence that the increased plasma
      gastrin concentration following omeprazole treatment is caused by the reduced
      intragastric acidity. The slight increase in plasma gastrin concentration
      following proximal gastric vagotomy despite a lesser reduction in intragastric
      acidity may be the result of additional effects on gastrin release by the
      vagotomy. Both treatments resulted in a modest increase in plasma levels of
      gastrin that were far below the gastrin levels observed in achlorhydric patients,
      e.g., patients with pernicious anemia.

PMID- 2227276
TI  - Role of epidermal growth factor, prostaglandin, and sulfhydryls in stress-induced
      gastric lesions.
AB  - Epidermal growth factor promotes the growth of and protects gastric mucosa
      against various ulcerogens, including stress, but little is known about its role
      in the pathogenesis of stress ulcerations. In this study, Wistar rats with intact
      and resected salivary glands were exposed to water-immersion and restraint
      stress. During 2-14 hours of water-immersion restraint stress, the formation of
      gastric ulcerations increased progressively and the duration of stress was
      accompanied by a decrease in DNA synthesis in the gastric mucosa. Following
      sialoadenectomy, a significant increase in the number of stress ulcerations and
      further reduction in DNA synthesis were observed. Exogenous epidermal growth
      factor and dimethyl prostaglandin E2 significantly reduced the ulcerations in the
      stressed rats with intact salivary glands, but this reduction was significantly
      less pronounced after sialoadenectomy. Water-immersion restraint stress also
      resulted in about 50% reduction in mucosal prostaglandin E2 generation, and the
      pretreatment with indomethacin, which suppressed prostaglandin E2 by about 90%,
      almost doubled the number of stress ulcerations and abolished the gastro
      protective effect of exogenous epidermal growth factor (but not dimethyl
      prostaglandin E2) against the stress lesions. An inhibition of ornithine
      decarboxylase activity by difluoromethyl ornithine also augmented stress-induced
      ulcerogenesis and abolished the protective action of epidermal growth factor
      while the administration of spermine almost completely prevented stress
      ulcerations in rats both without and with pretreatment with
      difluoromethylornithine. Water-immersion restraint stress also significantly
      reduced mucosal content of glutathione. Cysteamine increased tissue glutathione
      and reduced stress ulcerations but N-ethylmaleimide, an sulfhydryl blocker,
      decreased mucosal content of glutathione without affecting the stress
      ulcerations. This study indicates that the stress ulcers are accompanied by the
      reduction in mucosal synthesis of DNA, prostaglandin, and glutathione and that
      the presence of salivary glands attenuates the stress ulcerogenesis probably by
      releasing epidermal growth factor which acts, in part, by enhancing ornithine
      decarboxylase activity, mucosal growth, and prostaglandin and glutathione
      formation.

PMID- 2227277
TI  - Comparison of salsalate and aspirin on mucosal injury and gastroduodenal mucosal
      prostaglandins.
AB  - The effects of a 7.5-day course of orally administered salsalate (3.0 g/day),
      aspirin (3.9 g/day), or placebo on gastroduodenal mucosal injury, mucosal
      prostaglandin content, and plasma prostaglandin concentrations in healthy,
      asymptomatic human volunteers were examined. Mean serum salicylate concentrations
      after these doses of salsalate and aspirin were nearly identical (approximately
      15 mg/dL). When the gastroduodenal mucosa was assessed endoscopically 1 hour
      after the final dose of medication, there was minimal mucosal injury in placebo
      treated or salsalate-treated subjects and considerable injury in the stomach and
      duodenum of aspirin-treated subjects (P less than 0.001, aspirin vs. salsalate or
      placebo). In both the stomach and duodenum, aspirin lowered mucosal prostaglandin
      F2a and E2 content by greater than 90% (P less than 0.001), whereas salsalate
      produced no significant change. Aspirin also lowered plasma prostaglandin F2a
      concentrations by 58% +/- 6%, whereas salsalate lowered them by only 11% +/- 9%
      (P less than 0.001). Thus, the nonacetylated salicylate, salsalate, produced much
      less gastroduodenal mucosal damage than aspirin at equivalent serum salicylate
      concentrations, possibly because salsalate did not inhibit mucosal prostaglandin
      synthesis.

PMID- 2227278
TI  - Detection of duodenal gastrinomas by operative endoscopic transillumination. A
      prospective study.
AB  - The ability of operative endoscopic transillumination of the bowel wall to detect
      duodenal gastrinoma was evaluated prospectively in 26 patients with the Zollinger
      Ellison syndrome. The results were assessed by exploratory laparotomy and
      compared with the results of other localization techniques. Twelve duodenal
      gastrinomas were resected from 10 patients. Operative endoscopic
      transillumination detected 10 of the 12 gastrinomas, a sensitivity of 83%, which
      was significantly greater (P less than 0.05) than that for either preoperative
      imaging (25%) or intraoperative ultrasonography and palpation (42%). The
      sensitivity of operative endoscopic transillumination was a result of the ability
      to detect focal areas that did not transilluminate on the serosal side of the
      duodenum, and not the mucosal appearances seen through the endoscope, which were
      not helpful. Operative endoscopic transillumination detected gastrinomas less
      than 1 cm in diameter throughout the duodenum. Of the patients in this study, 39%
      had duodenal gastrinomas, a greater frequency than previously reported. These
      results indicate that operative endoscopic transillumination is the most
      sensitive technique yet described for detecting duodenal gastrinomas and should
      be performed routinely in all patients with the Zollinger-Ellison syndrome who
      undergo exploratory laparotomy for cure.

PMID- 2227279
TI  - Acute and chronic stress in duodenal ulcer disease.
AB  - Acute and chronic life event stressors were objectively assessed in a sample of
      duodenal ulcer patients and community controls. Stress was assessed on two
      dimensions, "personal threat" and "goal frustration." Chronic stressors (those of
      6 months' duration or more) involving high goal frustration were significantly
      and independently associated with the onset and relapse of duodenal ulcers, as
      were acute events of high immediate but transient personal threat.

PMID- 2227280
TI  - Choledochoduodenal flow: effect of the sphincter of Oddi in opossums and cats.
AB  - The aim of this study was to test in vivo (a) whether the sphincter of Oddi acts
      as a resistor or also as a pump, (b) the effect of an IV infusion of
      cholecystokinin (CCK) on choledochoduodenal flow, and (c) the ability of the
      choledochoduodenal junction to prevent duodenobiliary reflux in two animal
      species, opossums (n = 11) and cats (n = 8). Opossums were implanted with bipolar
      electrodes on the sphincter of Oddi and the adjacent duodenum. Cats were not.
      Experiments were performed in vivo using a propulsion evaluation system to test
      whether the Sphincter of Oddi was able to pump fluid from the bile duct to the
      duodenum against pressure gradients. In 5 opossums and 4 cats, choledochoduodenal
      flow was evaluated during the IV infusion of CCK (20 ng.kg-1.min-1). The opossum
      sphincter of Oddi moved fluid against duodenal pressure gradients of 6-45 cm H2O.
      The spike-burst frequency (6.4 +/- 1.7 min-1) was maximal at peak bile duct
      pressures and decreased as bile duct pressure decreased (4.9 +/- 1.6 min-1; P
      less than 0.001). Pressure pulses in the bile duct were observed at a frequency
      that correlated with sphincter of Oddi spike-burst frequency (r = 0.84; P less
      than 0.001). In cats, choledochoduodenal flow occurred only along a hydrostatic
      gradient; the sphincter of Oddi never acted as a pump but only as a resistor.
      Infusion of CCk significantly increased the frequency of sphincter of Oddi
      contractions in opossums, but the transfer of fluid from bile duct to duodenum
      was significantly reduced. In cats, the rate of fluid flow from the bile duct to
      the duodenum during CCK infusion did not differ from control values. Reflux of
      duodenal fluid into the biliary tree was never observed, even at duodenal
      pressures as high as 100 cm H2O. In conclusion, in vivo, the sphincter of Oddi is
      able to pump fluid from the bile duct to the duodenum against a pressure gradient
      in opossums, but, in cats, choledochoduodenal flow requires a bilioduodenal
      pressure gradient. The increase in sphincter of Oddi contraction frequency
      induced by CCK in opossums resulted in a decrease in active transsphincteric
      flow. Duodenobiliary reflux could not be elicited in opossums and cats under the
      conditions of these experiments.

PMID- 2227281
TI  - Amines protect in vitro the celiac small intestine from the damaging activity of
      gliadin peptides.
AB  - Proteins and peptides responsible for the celiac small intestinal lesion inhibit
      both the enterocyte recovery of in vitro cultured flat celiac mucosa and the in
      vitro development of fetal rat intestine. They also agglutinate K 562 (S) cells.
      Using these three in vitro systems (cultured human celiac and rat fetal intestine
      and cell agglutination), it is shown that several small-molecular-weight amines,
      mostly the polyamines spermidine and spermine, prevent and reverse K 562 (S) cell
      agglutination induced by gliadin peptides, whereas they do not prevent cell
      agglutination induced by concanavalin A and wheat germ agglutinin. Some of these
      amines also protected in vitro developing fetal rat intestine and flat celiac
      mucosa from the damaging effect of gliadin peptides. This protective effect may
      be related to the trophic activity exerted by amines on the intestine and/or the
      effect of amines on the functions of intestinal brush border or intracellular
      membranes involved in the intestinal handling of gliadins.

PMID- 2227282
TI  - Role of visceral afferent mechanisms in functional bowel disorders.
AB  - This report analyzes the clinical and physiological evidence supporting a role
      for altered visceral afferent mechanisms in the pathogenesis of two functional
      bowel syndromes: noncardiac chest pain and the irritable bowel syndrome.
      Considerable recent evidence indicates that increased contractility is present
      only in a minority of patients and that hypercontractile episodes are not
      temporally related to abdominal pain. In contrast, altered sensation and motor
      reflexes in response to physiological stimuli, such as mechanical distention or
      acid, is common when appropriately investigated. The vagal and spinal afferent
      innervation mediates visceral sensation and is involved in multiple reflex loops
      regulating gastrointestinal effector function, such as motility and secretion.
      Sensory input can be modulated peripherally at the afferent nerve terminal, at
      the level of prevertebral ganglia, the spinal cord, and the brainstem. An up
      regulation of afferent mechanisms would result both in altered conscious
      perception of physiological stimuli and in altered motor reflexes. Current
      evidence is consistent with an alteration in the peripheral functioning of
      visceral afferents and/or in the central processing of afferent information in
      the etiology of altered somatovisceral sensation and motor function observed in
      patients with functional bowel disease.

PMID- 2227284
TI  - Intravenous but not intracolonic epidermal growth factor maintains colonocyte
      proliferation in defunctioned rat colorectum.
AB  - The role of epidermal growth factor in the proliferation of normal and
      premalignant colonocytes in vivo is not fully understood. In particular, the
      relative importance of its possible systemic and intraluminal routes of action
      has not been fully clarified. Rats with surgically defunctioned distal
      colorectums were used, and mini osmotic pumps were implanted to study the effects
      of intraluminal and IV administration of epidermal growth factor on colonocyte
      proliferation. Within 2 weeks of bypass, colonocyte proliferation in defunctioned
      colorectum has decreased to about one third the rate in normal colorectum or in
      colorectum proximal to the defunctioning colostomy. Intraluminal epidermal growth
      factor, infused from the time of operation did not reverse this hypoplasia,
      whereas IV epidermal growth factor maintained colonocyte proliferation at
      approximately the normal rate in bypassed colorectum. This model is suitable for
      testing other putative colonic mitogens for possible intraluminal and systemic
      effects.

PMID- 2227283
TI  - Excremental studies in human neonates. Identification of zinc coproporphyrin as a
      marker for meconium.
AB  - Zinc coproporphyrin, isomers I and III (I:III ratio, approximately 8:1), was
      identified in human meconium using high-performance liquid chromatography,
      ultraviolet-visible absorbance spectroscopy, and emission fluorescence
      spectroscopy. The high levels of zinc coproporphyrin in the first stools of life
      decrease steadily as meconium is evacuated and reach a plateau at comparatively
      negligible levels after complete evacuation of meconium. Zinc coproporphyrin can
      be used as a marker for human meconium.

PMID- 2227285
TI  - Glucose disposal, beta-cell secretion, and hepatic insulin extraction in
      cirrhosis: a minimal model assessment.
AB  - Factors controlling glucose metabolism after IV load were studied in nine
      patients with compensated cirrhosis and in six age-matched controls. The time
      courses of glucose, insulin, and C peptide were analyzed by means of the minimal
      model technique. In cirrhosis, insulin sensitivity was reduced by approximately
      70% and glucose-dependent glucose uptake (glucose effectiveness) by 45%.
      Decreased glucose effectiveness explained 65% of the variance of glucose
      disappearance and correlated with the ratio of urinary creatinine to height, an
      independent measure of muscle mass (r = 0.839). beta-cell responsiveness to
      glucose, measured on C-peptide kinetics, was variable and increased on average by
      170% and 107% (first-phase and second-phase, respectively). The total amount of
      insulin secreted by beta-cells in the course of the study was nearly doubled,
      whereas the basal insulin secretion rate was in the normal range. The time
      courses of hepatic extraction of insulin did not differ between groups, and basal
      extraction was on average 58% in controls and 56% in patients with cirrhosis. It
      was reduced to 30% in a single patient who had severe hepatocellular failure and
      large spontaneous portosystemic shunting. We conclude that the alterations in
      glucose metabolism of cirrhosis include a decreased insulin sensitivity, a
      reduced glucose effectiveness, and an increased pancreatic responsiveness to
      glucose, leading to hyperinsulinemia. The hepatic extraction of insulin is
      reduced only in the very advanced stages of the disease, possibly because of a
      large reserve capacity of the hepatic parenchyma.

PMID- 2227286
TI  - Host response to mycobacterial infection in the alcoholic rat.
AB  - Animals, chronically treated with alcohol, were inoculated with mycobacteria
      (bacillus Calmette-Guerin, 10.2 x 10(6) organisms) into the spleen to produce a
      granulomatous hepatitis. Before infection, chronic alcohol ingestion was
      associated with a depressed skin test response to phytohemagglutinin, 71.7% of
      baseline (P = 0.009). Mycobacterial (bacillus Calmette-Guerin) infection
      stimulated phytohemagglutinin skin test response to 417% of baseline in controls
      and 299% in alcoholics (P less than 0.001). The hepatic granuloma response was
      altered with smaller but more numerous granulomas (mean +/- SEM, 81.2 +/- 1.5
      microns2 of area with a frequency of 1.8 granulomas per field in alcoholics vs.
      129.8 +/- 5.71 microns2 and 1.2 granulomas per field in controls; P less than
      0.001). These changes were associated with a 10-fold increase in colony-forming
      units per gram of liver (54.5 +/- 18.2 in alcoholics vs. 5.6 +/- 1.83 in
      controls; P = 0.0006). This model offers precise parameters for host response to
      infection and indicates that alcohol significantly impairs the clearing capacity
      for mycobacteria from the liver.

PMID- 2227287
TI  - Hepatitis B virus DNA in liver and peripheral blood mononuclear cells during
      reduction in virus replication.
AB  - Changes in hepatitis B virus DNA in blood cells and liver were studied in 34
      patients (12 controls, 22 under therapy). There were no basal differences in the
      presence of the viral genome in blood cells between treated and control patients.
      A significant decrease in the percentage of patients with viral genome in blood
      cells was observed in patients who lost this marker in serum. Replicative
      intermediates of the viral genome were observed in the basal liver samples from
      all patients. In patients who lost the viral DNA in serum, hepatitis B virus
      genome became undetectable in the second liver sample in all but two patients who
      had viral sequences integrated in the host genome. Replicative intermediates were
      found in all patients with serum viral DNA. The results of this study suggest
      that there may be a relation between the disappearance of hepatitis B virus DNA
      in liver and blood cells.

PMID- 2227288
TI  - Effect of loxiglumide, a cholecystokinin antagonist, on pancreatic polypeptide
      release in humans.
AB  - The purpose of this study was to determine the role of cholecystokinin in the
      regulation of postprandial pancreatic polypeptide secretion in humans. The
      pancreatic polypeptide responses to modified sham feeding and gastric
      instillation of a test meal were first compared with the response to oral
      ingestion of the same meal. The experiments were repeated under cholinergic
      (atropine) and cholecystokinin (loxiglumide) blockade. Atropine completely
      abolished the pancreatic polypeptide response to sham feeding and caused
      significant reductions after gastric and oral food intake. Loxiglumide, on the
      other hand, significantly reduced pancreatic polypeptide release to oral food
      (51% inhibition) without affecting the response to sham feeding. In separate
      experiments using a duodenal perfusion system, the effects of atropine and
      loxiglumide on intestinal phase-stimulated pancreatic polypeptide release were
      examined, and both cholinergic and cholecystokinin blockade induced complete
      suppression. It was concluded (a) that cholecystokinin is involved in
      postprandial pancreatic polypeptide response, especially during the intestinal
      phase stimulation, and (b) that the cholinergic system is crucial and
      superimposed on cholecystokinin in stimulating pancreatic polypeptide release.

PMID- 2227289
TI  - Are diets associated with different rates of human interdigestive and
      postprandial pancreatic enzyme secretion?
AB  - To determine if diets are associated with different rates of interdigestive and
      postprandial enzyme secretion and how quickly enzyme secretion is modulated by
      nutrients, 27 healthy humans were randomly selected to follow one of five diets.
      The calorie proportions of carbohydrate, fat, and protein in each diet was
      assigned by a mixture design. After the subjects followed a diet for 2 weeks,
      they were intubated with an oroduodenal tube, and enzyme outputs were measured
      during the interdigestive period and after eating a meal identical to meals eaten
      during the previous 2 weeks. For the next 24 hours subjects either followed the
      same diet or a diet that contained the same amount of fat, but the percent of
      carbohydrate and protein was changed by 30%. Then interdigestive and postprandial
      pancreatic enzyme outputs were remeasured. After 2 weeks, diets containing the
      most carbohydrate (50%-80%) were associated with the lowest interdigestive and
      postprandial amylase and lipase (P less than 0.05) and trypsin outputs (P less
      than or equal to 0.05). In contrast, diets containing the most fat (40%) were
      associated with the highest interdigestive and postprandial outputs of amylase (P
      less than 0.05) and trypsin (P less than 0.05). Maintaining or altering diets for
      24 hours did not change interdigestive pancreatic enzyme outputs, but
      postprandial amylase output was significantly increased (P less than 0.05) by
      increasing protein and decreasing carbohydrate content of the diets by 30% for 24
      hours. We conclude that diets containing a high proportion of calories as
      carbohydrate for 2 weeks are associated with lower interdigestive and
      postprandial pancreatic secretion than diets that have a high fat content. In
      response to diets, changes in postprandial pancreatic enzyme secretion occur
      within 24 hours whereas changes in interdigestive secretion (no nutrients in the
      lumen) occur after 24 hours.

PMID- 2227290
TI  - Pathogenesis of ceftriaxone-associated biliary sludge. In vitro studies of
      calcium-ceftriaxone binding and solubility.
AB  - Ceftriaxone, a semisynthetic third-generation cephalosporin, has recently been
      associated with biliary sludge formation. Analysis of the biliary concretions
      induced by this agent shows a calcium salt of ceftriaxone. The present in vitro
      studies were undertaken to provide insight into the pathogenesis of ceftriaxone
      associated biliary sludge formation by evaluating possible interactions that may
      exist between calcium, bile salts, and ceftriaxone. Ceftriaxone possessed high
      calcium-binding affinity. The formation constant for the calcium ceftriaxone salt
      at 37 degrees C was about 157.3 L/mol; stoichiometry of the salt was 1:1, i.e.,
      calcium ceftriaxone. The calcium-binding property of ceftriaxone was observed to
      be additive to that of taurocholate in mixed taurocholate-ceftriaxone solutions.
      Although the solubility product constant for calcium ceftriaxone was only 1.62 x
      10(-6) mol/L2, marked metastability was observed; neither visible nor microscopic
      precipitates developed until the [Ca2+] x [ceftriaxone] ion product exceeded the
      solubility product constant by a factor of 10.4. Metastability of the calcium
      ceftriaxone salt was also observed in human gallbladder bile in vitro. Estimates
      of human biliary calcium ceftriaxone solubility in vivo were than calculated from
      previously-reported values for biliary [Ca2+], [ceftriaxone], and from the
      solubility product constant as defined in this study. Calculated saturation
      indices for calcium-ceftriaxone in human bile generally increased (corresponding
      to a decrease in solubility) with increasing ceftriaxone dose. At doses less than
      or equal to 1 g, saturation index was well within the metastable range of this
      calcium-salt. However, at doses greater than or equal to 2 g, the saturation
      index surpassed the metastable limit. Under these conditions, precipitation of
      ceftriaxone could occur. It was concluded that the development of ceftriaxone
      induced biliary sludge is a solubility problem that occurs in patients receiving
      high-dose treatment (greater than or equal to 2 g). This study proposes that the
      risk of developing ceftriaxone-associated biliary "pseudolithiasis" increases
      with increasing ceftriaxone dose and in patients with impaired gallbladder
      emptying.

PMID- 2227291
TI  - Gallbladder motility in cholesterol gallstone disease. Effect of ursodeoxycholic
      acid administration and gallstone dissolution.
AB  - Gallbladder motility was evaluated by ultrasonography in 75 cholesterol gallstone
      patients and in 77 matched control subjects. All 75 gallstone patients were
      candidates for oral bile acid therapy (radiolucent gallstones, less than 2 cm in
      diameter, in well-opacified gallbladder), and 38 of them were also studied during
      ursodeoxycholic acid administration. An additional 20 gallstone patients were
      studied 1 year after confirmed gallstone dissolution with oral bile acids.
      Gallstone patients showed significantly greater fasting and residual volumes, a
      decreased percent of gallbladder emptying, but a similar absolute emptying and
      emptying rate compared with the control subjects. Greater fasting volumes and
      reduced percents of gallbladder emptying were also found in gallstone-free
      patients who achieved complete dissolution with oral bile acids. After
      ursodeoxycholic acid administration, fasting gallbladder volumes were greater,
      and percents of gallbladder emptying were further decreased than in untreated
      gallstone patients. In conclusion, greater fasting volumes, and not reduced
      gallbladder contractility, account for the defective gallbladder function in
      radiolucent (cholesterol-rich) gallstone patients. This condition is likely to
      precede, and possibly to promote, gallstone formation because it persists after
      gallstone dissolution. Ursodeoxycholic acid administration worsens the defect
      observed in gallstone patients. This finding also suggests, although indirectly,
      that the expected normalization of cholesterol saturation during oral bile acid
      administration is not paralleled by an improvement in gallbladder function.

PMID- 2227293
TI  - Long-term outcome after surgery for biliary atresia. Study of 40 patients
      surviving for more than 10 years.
AB  - To define long-term prognosis of children who underwent surgery for biliary
      atresia, a retrospective study was undertaken in 122 children who underwent one
      of the Kasai procedures between 1968 and 1977. Forty of the 122 children (32.7%)
      were alive after 10 years. Firm hepatomegaly was present in 31 and splenomegaly
      in 29 children. Serum bilirubin or all liver function tests were normal in 21 and
      11 children, respectively; survival rate decreased with the age at operation, but
      no significant difference was observed in the rate of children surviving with
      normal serum bilirubin whether they underwent surgery before age 2 months or
      between 2 and 3 months. Twenty-four had esophageal varices and 15 experienced
      gastrointestinal bleeding. Normal liver-function tests and absence of portal
      hypertension were observed in 11 of 122 children. These results indicate that
      Kasai's procedures were helpful in a significant proportion of children with
      biliary atresia who underwent surgery during this period. However, 80% of
      children who initially underwent surgery with Kasai's procedures should
      eventually undergo liver transplantation.

PMID- 2227292
TI  - Primary biliary cirrhosis. Quantitation of autoantibodies to purified
      mitochondrial enzymes and correlation with disease progression.
AB  - Primary biliary cirrhosis is characterized by the presence of antimitochondrial
      antibodies. Recently, six of the autoantigens have been identified as components
      of the 2-oxo acid dehydrogenase multienzyme complexes located within mammalian
      mitochondria. Immunoblotting studies have shown that two of these components,
      namely E2 and protein X of pyruvate dehydrogenase complex, are the major
      antigenic polypeptides recognized by autoantibodies. This study shows the
      development of an enzyme-linked immunosorbent assay to detect and quantitate
      antibodies to these two purified antigens. Coded serum samples from 166 patients
      with primary biliary cirrhosis, 140 patients with other liver and/or autoimmune
      disease, and 52 normal women were analyzed for reactivity using this immunoassay.
      These results indicate that this rapid, simple method has a 93% sensitivity and
      96% specificity in the diagnosis of primary biliary cirrhosis. The titer of
      immunoglobulin G autoantibodies correlated not only with antimitochondrial
      antibody titer measured by indirect immunofluorescence (P less than 0.0001) but
      also with histological stage of disease (P less than 0.04) and prognostic
      biochemical variables such as higher serum bilirubin and lower serum albumin
      levels (P = 0.038 and 0.028, respectively). There was no significant correlation
      between titer of autoantibodies and serum globulin or immunoglobulin G levels,
      indicating that the positive correlation with disease progression was not
      secondary to hypergammaglobulinemia.

PMID- 2227294
TI  - Phospholipase C and diacylglycerol lipase in human gallbladder and hepatic bile.
AB  - A phospholipase C in bile, free of bacterial infection, has recently been
      identified from cholesterol gallstone patients. Because of the importance of
      phosphatidylcholine in solubilizing cholesterol in bile, this study further
      investigates the metabolism of phosphatidylcholine in delipidated gallbladder and
      common bile duct biles. Phospholipase C activity, as measured by the release of
      phosphoryl[3H]choline from the substrate 1,2-dipalmitoyl-sn-glycero-3-phospho [N
      methyl-3H]choline, was identified in both hepatic and gallbladder biles. Similar
      levels of activity (nmol.h-1.mg-1 of delipidated protein) were found in common
      bile duct (11.25 +/- 14.23) and gallbladder bile (19.07 +/- 22.24), although per
      milliliter of bile, the mean gallbaldder levels were 6.4 times greater than those
      found in common duct bile. With the tow substrates, 1-palmitoyl-2[9,10-3H]
      palmitoyl-sn-glycero-3-phosphocholine and 1,2(1-14C) dipalmitoyl-sn-glycero-3
      phosphocholine, the majority of organically extracted label, after thin-layer
      chromatography, was recovered as radiolabeled diglyceride, confirming the
      presence of phospholipase C. Diglyceride levels were found to be closely
      correlated with [3H]choline (slope, 0.9820; r = 0.9844). In addition to
      diglyceride, both radiolabeled free fatty acid and monoglyceride were identified
      in common bile duct and gallbladder biles, although their levels were an order of
      magnitude less than measurable phospholipase C activity. To determine whether the
      free fatty acid release was due to either a diacylglycerol-lipase or a
      phospholipase A2, the effect of adding unlabeled diglyceride on free fatty acid
      formation from the substrate [14C]DPPC was examined. As the concentration of
      unlabeled diglyceride was increased, the amount of free fatty acid and
      monoglyceride released were both reduced in parallel. Direct measurement of
      diacylglycerol-lipase activity by incubating the diglyceride, sn
      2[3H]dipalmitoyl, resulted in release of both products in a ratio similar to that
      found with sn-2[3H]DPPC. Finally, no radiolabeled lysolecithin was identified
      with [3H]choline-DPPC or [14C]DPPC as substrate indicating the free fatty acid
      was the product of a diacylglycerol-lipase rather than a phospholipase A2.
      Phospholipase C and diacyl-glycerol-lipase activities were significantly
      correlated (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2227295
TI  - Microprocessor-assisted solvent-transfer system for gallstone dissolution. In
      vitro and in vivo validation.
AB  - To improve the efficacy, safety, and convenience of contact dissolution of
      gallbladder stones, a microprocessor-assisted solvent transfer system was
      developed. The system's two pumps simultaneously infuse and aspirate solvent into
      and from the gallbladder at a high flow rate through a multilumen catheter. The
      microprocessor controls the pumps using a closed feedback loop control algorithm
      to regulate intragallbladder pressure to prevent solvent escape into the
      duodenum. Turbulent solvent flow at the catheter end in the gallbladder is
      designed to induce rapid stone dissolution and to suspend insoluble residue, thus
      promoting its aspiration. The system's response and gallbladder emptying capacity
      was 160-fold faster than the natural gallbladder emptying rate. The rate at which
      gallstones were dissolved by methyl tert-butyl ether using the system was
      compared with that achieved with a syringe pump. For 6 of 11 pairs of stones that
      totally dissolved, the mean dissolution time with the system was 10 +/- 6 minutes
      compared with 112 +/- 81 minutes for the syringe pump. In the 5 of 11 stone pairs
      which dissolved incompletely, insoluble residue was completely eliminated by the
      system in 21 +/- 9 minutes but not by the syringe pump even at 360 minutes. When
      the system was used in gallstone patients, solvent recovery was 99% +/- 1%, and
      the concentration of a nonabsorbable marker did not change, confirming the lack
      of appreciable absorption of methyl tert-butyl ether. These studies suggest that
      the microprocessor-assisted solvent transfer system is a device capable of safe,
      complete, and fully automatic contact dissolution of cholesterol gallbladder
      stones using methyl tert-butyl ether or similar solvents.

PMID- 2227296
TI  - Adaptive hyperphagia in patients with postsurgical malabsorption.
AB  - The specific nutritional consequences of malabsorption after small-bowel surgery
      were studied in a consecutive series of 48 ambulatory patients who had had small
      bowel resection (n = 43) or bypass (n = 5) and in 10 patients who had an ileal
      pouch (n = 10). The patients received a 3-day standardized oral regimen providing
      daily 30 kcal/kg of ideal body weight (IBW). Throughout the study, 41 patients
      had malabsorption (fecal fat greater than 5%); 17 had fecal fat less than 5% and
      served as controls. The malabsorption patients absorbed 70% of protein and 71% of
      fat. Twenty-one were normonourished and 20 had features of mild energy
      malnutrition, vs. 15 and 2 controls, respectively. Compared with controls,
      malabsorption patients had decreased body weight and triceps skin-fold but no
      features of protein malnutrition. their mean daily food intake at home was
      significantly enhanced (39.6 +/- 13.1 kcal/IBW kg) vs. controls (28.8 +/- 5.8
      kcal/IBW kg, P less than 0.001). In the malabsorption group, caloric intake was
      higher in the normonourished patients than in those with mild malnutrition. This
      study shows that a chronic malabsorption has limited nutritional consequences.
      The patients compensate for their absorptive handicap by increasing their oral
      intake.

PMID- 2227297
TI  - Esophageal obstruction after ingestion of a fiber-containing diet pill.
AB  - Foreign bodies of the esophagus in adults may be the result of a food bolus that
      becomes lodged proximal to a structural abnormality of the distal esophagus. A
      case of peptic stricture of the esophagus in a patient who presented with acute
      dysphagia after ingesting an over-the-counter diet pill composed of guar gum is
      discussed. It is recommended that anorectics composed of dietary fiber should not
      be used in patients with a history of esophageal stricture.

PMID- 2227298
TI  - Idiopathic biliary ductopenia in adults: a report of five cases.
AB  - The clinical and pathological findings of five adult cases of idiopathic
      nonsyndromatic paucity of interlobular bile ducts are reported. Patients were 18
      32 years old at the onset of the disease; four presented with pruritus and/or
      jaundice and one with bleeding of the esophageal varices. Two patients were
      siblings. Serum alkaline phosphatase counts ranged from 1 to 16 times the upper
      normal value, and total bilirubin counts ranged from 0.6 to 8.8 mg/dL (10 to 150
      mumol/L). Initial liver biopsy showed portal and periportal fibrosis with
      cholangiolar proliferation and reduction in the number of interlobular bile
      ducts. Antimitochondrial antibodies were absent, and bile ducts were normal after
      opacification. The patients were observed for 3-11 years. Repeated liver biopsies
      in the five patients showed progression of the lesions, with development of
      biliary type cirrhosis in four. Two of the four patients with cirrhosis died of
      hepatic failure 3 and 11 years after onset of the disease. In the two other
      cases, liver transplantation was performed successfully. These cases suggest that
      chronic cholestasis with marked ductopenia resembling the nonsyndromatic paucity
      described in infancy and childhood may reveal itself at an adult age. This
      disorder, possibly familial, may rapidly progress to severe and even fatal liver
      disease and could be a new indication for liver transplantation.

PMID- 2227300
TI  - Heterotopic liver transplantation for fulminant Wilson's disease.
AB  - Wilson's disease may present with severe acute hepatocellular failure. The only
      effective treatment for fulminant Wilson's disease is liver transplantation,
      which may lead to reversal of the underlying disease. Some patients with
      cirrhosis who are too ill to undergo orthotopic liver transplantation have been
      treated with heterotopic liver transplantation. However, use of heterotopic liver
      transplantation for fulminant hepatocellular failure has not been successful.
      This case study involves a patient in whom a heterotopic liver transplant was
      successfully used for treatment of Wilson's disease presenting with fulminant
      hepatocellular failure.

PMID- 2227299
TI  - Omeprazole in the management of intractable esophageal ulceration following
      injection sclerotherapy.
AB  - Transient esophageal ulceration is a common finding after sclerotherapy of
      varices. A small proportion of these ulcers become chronic and resistant to
      conventional therapy. Such chronic ulcers have been associated with pain,
      stricture formation, and recurrent hemorrhage. The use of omeprazole, a proton
      pump inhibitor, was examined in the current study in the treatment of 10 patients
      (6 women, 4 men; age range, 27-86 years) with cirrhosis (PBC, 4; sclerosing
      cholangitis, 2; chronic active liver disease, 2; alcohol, 1; and cryptogenic, 1)
      who developed an esophageal ulcer after a mean of 13 (range, 8-21) sessions of
      sclerotherapy. The ulcers had been present for 3-54 months despite prolonged
      treatment with high-dose H2-receptor antagonists and sucralfate. In each case one
      or more complications had occurred: severe pain in 3, stricture formation in 4,
      and recurrent hemorrhage in 7 cases. After an 8-week course of omeprazole, 40 mg
      daily, endoscopy confirmed complete healing of the ulceration in all 10 cases
      with symptom resolution. In 2 cases the ulcer recurred, with associated bleeding
      within 6 weeks of discontinuing the treatment in 1 patient. Both cases responded
      to repeat therapy. These results confirm the efficacy of omeprazole for
      postsclerotherapy ulceration and imply that acid-pepsin has a role in
      perpetuating such ulcers.

PMID- 2227301
TI  - Caseating hepatic granulomas in Hodgkin's lymphoma.
AB  - A 68-year-old man presented with recurrent Hodgkin's lymphoma after a 9-year
      disease-free interval induced by chemotherapy. In addition to histological
      evidence of recurrent Hodgkin's disease, the liver biopsy specimen showed
      extensive caseating granulomas. Cultures of bone marrow and liver tissue tested
      negative for Mycobacterium tuberculosis. No antituberculous treatment was
      administered, and the patient had an excellent clinical response to additional
      chemotherapy for lymphoma. Hodgkin's lymphoma should be added to the list of
      disease entities associated with caseating granulomas in the liver.

PMID- 2227302
TI  - An immunohistological study of the human enteric nervous system with microtubule
      associated proteins.
AB  - Immunohistochemical study of normal intestines from six infants and children with
      monoclonal antibodies against microtubule-associated proteins showed that
      microtubule-associated proteins 5 and tau were excellent markers of the enteric
      nervous system. Compared with neuron-specific enolase, microtubule-associated
      proteins 5 and tau had similar distribution but gave more cellular details
      showing a cytoskeleton of microtubules in neuroplasm. Unlike S100 protein,
      microtubule-associated proteins 5 and tau were neuron specific and were absent
      from glial cells. More enteric neurons contained microtubule-associated proteins
      5 and tau than neurofilament proteins. Of the other microtubule-associated
      proteins, microtubule-associated protein 2 was present in only a few enteric
      neurons and microtubule-associated protein 1 was entirely absent.

PMID- 2227303
TI  - Esophageal tests for all seasons and all reasons but ... how do they help the
      patient???

PMID- 2227304
TI  - What is functional disease and how do you measure it?

PMID- 2227305
TI  - Surveillance after colon cancer: is it worthwhile?

PMID- 2227306
TI  - Delayed measurement of bicarbonate secretion in vitro.

PMID- 2227307
TI  - Abnormal drug metabolism in chronic pancreatitis: treatment with antioxidants.

PMID- 2227308
TI  - The prevalence of hemorrhoids and chronic constipation.

PMID- 2227309
TI  - Eicosanoids in amebiasis.

PMID- 2227310
TI  - Reflux esophagitis in Zollinger-Ellison syndrome.

PMID- 2227311
TI  - Ulcer healing: does omeprazole efficacy depend on daytime or 24-hour acid
      inhibition?

PMID- 2227312
TI  - Colonic lipomas: outcome of endoscopic removal.
AB  - Colonic lipomas are benign adipose tumors which are usually submucosal. With the
      increase in the number of endoscopic procedures being performed, these tumors are
      often detected incidentally at colonoscopy. Although the risks of removing these
      tumors have been recognized, numerous reports have documented safe removal by
      snare electrocautery. We have reviewed the clinical outcome and the endoscopic
      and histopathologic features of seven lipomas that were endoscopically removed
      over a 5-year period. Four patients recovered uneventfully, while three patients
      (42.8%) developed colonic perforation after the polypectomy. In the latter group,
      the lipomas were significantly larger than they were in the patients who did not
      develop colonic perforation (1.9 +/- 0.4 and 4.2 +/- 0.7 cm, respectively; p =
      0.048). Furthermore, the polypectomy specimens from those patients who developed
      perforation all contained significant muscularis propria. Lipomatous polyps that
      are identified at endoscopy to be greater than or equal to 2 cm in diameter and
      to have a limited pedicle are at the greatest risk for endoscopic perforation.

PMID- 2227313
TI  - A laser-induced scar at the cardia increases the yield pressure of the lower
      esophageal sphincter.
AB  - Low yield pressure of the lower esophageal sphincter is associated with
      esophageal reflux, and fundoplication must increase yield pressure if it is to
      prevent reflux. We attempted to increase yield pressure endoscopically in the dog
      by using the Nd:YAG laser to produce a fibrous scar at the cardia in the
      approximate line of the gastric sling fibers. Ten beagle dogs were studied. In a
      pilot study with two dogs, 15 watts for 4.2 sec were found to produce a scar deep
      into the muscle coat of the stomach. Three configurations of scar were used. One
      produced significant rises in yield pressure in all four of the dogs treated, the
      second produced a significant rise in one of the two dogs treated, and the third
      caused a significant drop in yield pressure in the one dog treated. One dog died
      of gastric perforation 10 days after lasering, but no other animal experienced
      any ill effects. These findings may have therapeutic implications for the
      management of esophageal reflux.

PMID- 2227314
TI  - Endoscopic retrograde cannulation of the gallbladder: direct dissolution of
      gallstones.
AB  - Percutaneous transhepatic catheterization of the gallbladder for dissolution of
      cholesterol stones by instillation of methyl tert-butyl ether (MTBE) is an
      invasive therapeutic procedure. The only non-invasive alternative available to
      now, endoscopic retrograde cannulation of the cystic duct, was difficult because
      of the cystic duct's tortuosity and spiral valves. We therefore developed a
      catheter system which, using conventional duodenoscopes during a routine
      endoscopic retrograde cholangiography (ERC) procedure, permits reliable and safe
      catheterization of the gallbladder without the need for endoscopic
      sphincterotomy. In 18 of 22 patients (82%) we were able to place a cysto-nasal
      catheter, and in 14 patients MTBE dissolution therapy was then performed. Eight
      patients (57%) were completely free of stones after treatment; the other six
      (43%) had residual debris. In 4 of 22 patients (18%) cannulation attempts failed,
      in 3 patients due to cystic duct blockage by a calculus. Endoscopic retrograde
      cannulation of the gallbladder (ERCG) represents a promising alternative to the
      invasive percutaneous transhepatic catheterization procedure.

PMID- 2227315
TI  - Pain on common bile duct injection during ERCP: does it indicate sphincter of
      Oddi dysfunction?
AB  - The reproduction of a patient's biliary-type pain upon initial injection of
      contrast material into the common bile duct during diagnostic ERCP is a dramatic
      experience for both patient and physician. The significance of this phenomenon is
      not clear, but it is touted by some to be a provocative test for sphincter of
      Oddi dysfunction. Sphincter of Oddi manometry was performed on 224 consecutive
      patients referred over a 2-year period for evaluation of post-cholecystectomy
      syndrome and suspected sphincter of Oddi dysfunction. All patients received only
      intravenous diazepam as premedication for ERCP. Delayed drainage time (greater
      than 45 min), bile duct dilation (greater than or equal to 12 mm), and a basal
      sphincter of Oddi pressure of greater than 40 mm Hg (mean +/- 3 SD) were
      considered elevated. We observed a reproduction of pain in 15 of 224 patients
      (6.7%) immediately following contrast injection. There was no correlation between
      pain on contrast injection and elevated basal sphincter of Oddi pressure, delayed
      common bile duct drainage, bile duct dilation, or abnormal liver enzymes.
      Therefore, we feel that reproduction of the patient's biliary-type pain
      associated with contrast injection of ERCP is not a provocative test for
      sphincter of Oddi dysfunction.

PMID- 2227317
TI  - The role of endoscopic injection sclerotherapy in the management of bleeding
      peristomal varices.
AB  - Peristomal varices usually occur in patients with enterostomies who develop
      portal hypertension, and represent a cause of recurrent or intractable
      gastrointestinal bleeding. Treatment options for such bleeding include surgical
      ligation of varices, stoma revision with devascularization, injection
      sclerotherapy, portacaval shunt, or liver transplantation. We reviewed the
      records of seven patients with peristomal varices, who were followed for a mean
      of 17 months after diagnosis. Fourteen episodes of clinically significant
      peristomal bleeding occurred in six patients. Surgical ligation of varices was
      ineffective in controlling bleeding in two of three patients, although stoma
      revision with devascularization was temporarily effective in two other patients.
      Injection sclerotherapy, used in three patients, effectively controlled acute
      bleeding without serious complications or need for surgery. Definitive treatment
      for peristomal bleeding (portacaval shunt or liver transplantation) has prevented
      any further bleeding in three patients for a mean of 8 months after surgery.

PMID- 2227316
TI  - Sincalide-aided ultrasonography of the common bile duct as a predictor of biliary
      obstruction determined by ERCP and biliary manometry.
AB  - Sonographically observed changes in common bile duct caliber following
      intravenous sincalide injection were correlated with distal common duct pathology
      as defined by endoscopic retrograde cholangiopancreatography and biliary
      manometry. Thirty-two patients, 17 with prior cholecystectomies, were studied. In
      post-cholecystectomy patients, a 1-mm or greater diminution of duct caliber
      within 5 min represented a normal response. When gallbladder contraction occurred
      in normal patients with an intact gallbladder, no change or a diminution in duct
      caliber was observed. When gallbladder contraction was not observed, a normal
      response was considered to be the same as that in post-cholecystectomy patients
      with a diminution in duct caliber occurring. By using these criteria two false
      negatives, both with hypertensive sphincters of Oddi that responded normally to
      sincalide injection, were encountered. This technique was valuable in defining
      non-obstructed post-cholecystectomy dilated bile ducts which demonstrated a
      prompt diminution in caliber following sincalide injection.

PMID- 2227318
TI  - Variceal sclerosis in schistosomotic patients: a 5-year follow-up study.
AB  - To assess the therapeutic possibilities of injection sclerosis in schistosomotic
      portal hypertension, a 5-year prospective study was conducted in northeast
      Brazil, where this parasitosis is endemic. Fifty patients undergoing endoscopy
      for upper gastrointestinal hemorrhage from rupture of esophageal varices from
      July through December 1981 were chosen for the study. The 32 consenting patients
      were submitted to injection sclerotherapy paravariceally, using ethanolamine
      oleate; the 18 refusing to participate were assigned to the control group. The
      incidence of rebleeding was 28.1% in the former and 44.5% in the latter, a
      difference which was not statistically significant (Fisher's test, p = 0.375).
      Mortality from rupture of esophageal varices was 3.1% in the sclerotherapy group
      and 27.7% in the control group, a statistically significant difference (Fischer's
      test, p = 0.017). Since sclerotherapy markedly improved the long-term survival
      rate of the patients, this procedure is advocated for the treatment of esophageal
      varices in cases of portal hypertension due to schistosomiasis.

PMID- 2227319
TI  - Schatzki's ring: long-term results following dilation.
AB  - The purpose of this study is to report long-term results of 61 patients with
      Schatzki's ring who were dilated for relief of dysphagia. The severity of
      Schatzki's ring was mild in 28 patients (46%), moderate in 26 (43%), severe in 5
      (8%), and indeterminate in 2 (3%). Follow-up information was available in 56 of
      61 patients (mean, 75 months). During follow-up, 35 patients (63%) developed
      recurrent dysphagia and required repeated dilations: 19 patients (34%) had one to
      two dilations, 9 patients (16%) had three to seven dilations, 6 patients (11%)
      had more than seven dilations; 1 patient underwent surgery for resection of the
      Schatzki's ring (2%). The mean (range) dilation-free interval was 50.1 months
      (11.8 to 100 months) in mild cases, 44.5 months (8.9 to 82 months) in moderate
      cases, and 28.6 months (9 to 76 months) in severe cases. There was no significant
      correlation between the severity of Schatzki's ring on initial presentation and
      the subsequent dilation-free interval. Our data indicate that recurrent dysphagia
      is common among patients with Schatzki's ring after a successful dilation, and
      that the severity of Schatzki's ring is not a good prognostic indicator of the
      need for subsequent dilation.

PMID- 2227320
TI  - Witzel pneumatic dilation for achalasia: safety and long-term efficacy.
AB  - Forceful dilation of the lower esophageal sphincter is considered primary therapy
      for achalasia. The Witzel pneumatic balloon dilator, unlike fluoroscopically
      placed dilators, is placed over a standard gastroscope allowing positioning and
      dilation under direct vision. We report our experience with the Witzel dilator in
      45 patients with achalasia over a 5-year period. All patients had at least one
      major symptom score of 8 out of 10 for dysphagia and/or regurgitation before
      dilation. After Witzel dilation, symptomatic response was graded as excellent
      (score 0 to 2), good (score 3 to 5), fair (score 6 to 8), and poor (no
      improvement). Symptom response was assessed after 1 week, 1 month, 6 month, 1
      year, and present. The mean period of follow-up was 25 months (range, 3 to 85
      months). Passage of the balloon across the gastroesophageal junction was
      technically unsuccessful in three patients. Esophageal perforation occurred in
      two patients (4%) and transient chest pain greater than 2 days in three patients
      (7%). There was no bleeding or death. Symptomatic long-term improvement was
      excellent in 25 patients (63%), good in 6 patients (15%), fair in 4 patients
      (10%), and poor in 5 patients (12%). A repeat Witzel dilation was performed in
      five patients but resulted in good/excellent improvement in only one patient. We
      conclude that pneumatic dilation with the Witzel balloon is a safe, effective
      procedure for achalasia.

PMID- 2227321
TI  - Performing screening flexible sigmoidoscopy using colonoscopes: experience in 500
      subjects.
AB  - There is still controversy regarding the optimal length of flexible
      sigmoidoscopes. We performed screening distal colon examinations using 168-cm
      colonoscopes in 500 asymptomatic subjects who were unsedated and had
      sigmoidoscopy cleansing preparation. The mean depth of penetration was 66 cm and
      was similar in persons in whom the examination was discontinued because of poor
      preparation versus those with discomfort. Polyps were detected in 87 patients,
      but only 5 subjects had polyps detected above 60 cm. We conclude that in a group
      of unsedated subjects scheduled for flexible sigmoidoscopy after a sigmoidoscopy
      prep, the use of instruments longer than 60 cm gives very little additional
      yield.

PMID- 2227322
TI  - Arterial blood oxygen desaturation in infants and children during upper
      gastrointestinal endoscopy.
AB  - Arterial blood oxygen desaturation and abnormal electrocardiographic changes have
      been reported in adults undergoing upper gastrointestinal endoscopy. We studied
      32 infants and children less than 12 years of age using pulse oximetry and
      continuous electrocardiography before, during, and after upper gastrointestinal
      endoscopy performed under intravenous sedation. Sinus tachycardia was the most
      common electrocardiographic change, and no clinically significant
      electrocardiographic abnormalities were induced by the procedure. Desaturation to
      less than or equal to 90% was found in 37.5% of the patients and was most
      commonly noted during the endoscopy procedure and in patients with
      cardiopulmonary disease. The desaturation was unpredictable because there was no
      correlation between desaturation and medication, tolerance to the procedure,
      weight, or age of the child. Some patients who subjectively appeared to tolerate
      the procedure well had significant desaturation. The use of pulse oximetry should
      be considered for all children undergoing upper gastrointestinal endoscopy.

PMID- 2227323
TI  - First clinical evaluation and experimental study of a new mechanical suture
      device for endoscopic hemostasis.

PMID- 2227324
TI  - A method to correlate common bile duct pressure and the migrating motor complex
      of the duodenum.

PMID- 2227325
TI  - Does continuous aspiration from an end and side port in a sphincter of Oddi
      manometry catheter alter recorded pressures?

PMID- 2227326
TI  - Endoscopic biliary decompression aided by a different technique of percutaneous
      transhepatic access.

PMID- 2227327
TI  - Submucosal tumors of the terminal ileum managed by endoscopic polypectomy.

PMID- 2227328
TI  - Endoscopic correction of intussusception and removal of a colonic lipoma.

PMID- 2227329
TI  - Endoscopic diagnosis and treatment of duodenal gastrinoma.

PMID- 2227330
TI  - An unusual vascular lesion in a patient with hereditary hemorrhagic
      telangiectasia.

PMID- 2227331
TI  - The honeycomb stomach: coalesced gastric angiodysplasia.

PMID- 2227333
TI  - Endoscopic transpapillary drainage of gallbladder empyema.

PMID- 2227332
TI  - ERCP documentation of obstructive jaundice caused by a solitary, centrally
      located, benign hepatic cyst.

PMID- 2227334
TI  - Endoscopic removal of an intact anti-reflux prosthesis 6 years after
      implantation.

PMID- 2227335
TI  - Endoscopic removal of toothbrushes.

PMID- 2227336
TI  - Use of endoscopic laser therapy to prevent reflux.

PMID- 2227337
TI  - The cystic artery: borderline between internal medicine and surgery?

PMID- 2227338
TI  - Delayed hemorrhage after hot biopsy.

PMID- 2227339
TI  - Modify technique for wire-guided papillotomy.

PMID- 2227340
TI  - Endoscopic extraction of a proximally migrated Amsterdam-type biliary
      endoprosthesis.

PMID- 2227341
TI  - Malignant obstructive jaundice.

PMID- 2227342
TI  - Sclerotherapy and corticosteroids: a word of caution.

PMID- 2227343
TI  - More on the tip of the therapeutic video duodenoscope.

PMID- 2227344
TI  - Seeing red.

PMID- 2227345
TI  - Monitoring during endoscopy.

PMID- 2227346
TI  - Endoscopic diagnosis of intestinal metaplasia.

PMID- 2227347
TI  - Infective endocarditis and infections of orthopedic and vascular prostheses
      following gastrointestinal endoscopy and dilation.

PMID- 2227348
TI  - Nucleotide sequence of the G6-amylase gene from alkalophilic Bacillus sp. H-167.
AB  - The nucleotide sequence of the G6-amylase gene from alkalophilic Bacillus sp. H
      167 was determined. The open reading frame of the gene consisted of 2865 base
      pairs, encoding 955 amino acids. The NH2-terminal amino acid sequence analysis of
      the G6-amylase indicated that the enzyme had a single peptide of 33 amino acid
      residues and the mature enzyme was composed of 922 amino acids, giving a
      molecular mass of 102,598. Identity of the NH2-terminal amino acid sequences
      among each component of the multiform G6-amylase suggested the proteolytic
      processing of the COOH-terminal side of the enzyme. The DNA sequence and the
      deduced amino acid sequence of the G6-amylase gene showed no homology with those
      of other bacterial alpha-amylases although the consensus amino acid sequences of
      the active center were well conserved.

PMID- 2227349
TI  - Isolation of zidovudine resistant Escherichia coli from AIDS patients.
AB  - Zidovudine-resistant Escherichia coli were isolated from faecal samples from 6
      out of 11 AIDS patients receiving zidovudine. Resistance appeared to be due to
      the loss of thymidine kinase activity which is required for the phosphorylation
      of zidovudine to its active form. No zidovudine resistant enterobacteria were
      isolated from 30 control faecal samples. Hence, clinically, there appeared to be
      a high correlation between the development of zidovudine-resistance in E. coli
      and exposure to zidovudine (chi 2: 11.77, P less than 0.001). However the
      development of zidovudine resistance does not appear to be associated with cross
      resistance to other antimicrobial agents as the zidovudine-resistant E. coli did
      not display a high degree of resistance to other antibacterials.

PMID- 2227350
TI  - Effect of coumarin on glucose uptake by anaerobic rumen fungi in the presence and
      absence of Methanobrevibacter smithii.
AB  - The effect of coumarin (1,2 benzopyrone) on glucose utilisation by the anaerobic
      rumen fungi Neocallimastix frontalis and N. patriciarum has been compared with
      the effect of p-coumaric acid. Both compounds largely inhibited glucose
      utilisation by N. patriciarum strain Cx when present in the medium at a
      concentration of 2.5 mM, and had a similar effect on N. frontalis strain RE1 at 5
      mM. Although in earlier studies co-culturing rumen fungi with Methanobrevibacter
      smithii enhanced resistance to ionophores, no comparable protective effect of M.
      smithii was found in the present study.

PMID- 2227351
TI  - Evidence that the capsule around mycobacteria grown in axenic media contains
      mycobacterial antigens: implications at the level of cell envelope architecture.
AB  - The intracellular growth of pathogenic mycobacteria has been linked to the
      presence of an electron transparent zone (ETZ or capsule), which surrounds the
      phagocytized bacteria and prevents the diffusion of lysosomal enzymes in infected
      macrophages. Recently, it was suggested that this capsule may be a bacterial
      structures, even being present in test tube-grown pathogenic mycobacteria (FEMS
      Microbiol. Lett. 1988, 56, 225-230). In the present paper, we show that under
      special fixation and embedding conditions, this capsule was clearly observed
      among 7 strains of mycobacteria grown in axenic media and also in M. leprae
      extracted and purified from experimentally infected armadillo or nude mice. In
      the case of bacteria treated likewise but subject to a prior dehydration step,
      this capsular structure disappeared suggesting its lipidic nature. Ultrathin
      sections of M. intracellular after immunolabelling showed for the first time that
      this capsule obtained mycobacterial antigens confirming its mycobacterial origin.
      It is suggested that the mycobacterial capsule may be formed of inert lipids, in
      which surface antigens are embedded.

PMID- 2227352
TI  - Induction of vancomycin resistance in Enterococcus faecium by inhibition of
      transglycosylation.
AB  - Vancomycin resistance has recently been recognized among clinical isolates of
      enterococci. Resistance is inducible, and associated with production of a novel
      39 kDa membrane protein. The mechanism by which exposure to vancomycin, which
      does not penetrate the cell membrane, induces resistance is unknown. In the
      vancomycin resistant strain Enterococcus faecium 228, resistance was also
      inducible by moenomycin, suggesting that inhibition of the transglycosylation
      step in peptidoglycan synthesis may be required for induction of resistance.
      Cytoplasmic pools of peptidoglycan precursors were increased after exposure to
      vancomycin or moenomycin, representing a potential means for regulation of
      induction.

PMID- 2227353
TI  - Anaeromyces mucronatus nov. gen., nov. sp. A new strictly anaerobic rumen fungus
      with polycentric thallus.
AB  - A new species of strictly anaerobic fungus was isolated from the cow rumen. It is
      characterized by a polycentric thallus, a polynuclear rhizomycelium, mucronate
      zoosporangia and uniflagellated zoospores. It is also singular in that the
      sporocysts do not react to the specific lectins of L-fucose, N-acetyl-D
      galactosamine and diacetyl chitobiose. These characteristics justify the creation
      of a new genus.

PMID- 2227354
TI  - Evidence for two fatty alcohol oxidases in the biosurfactant-producing yeast
      Candida (Torulopsis) bombicola.
AB  - Fatty alcohol oxidase activities in Candida (Torulopsis) bombicola ATCC 22214,
      which produces large amounts of glycolipids consisting of omega- and (omega-1)
      hydroxyfatty acids and a sugar moiety, occurred only in the microsomal fraction
      whether the cells had grown on n-alkanes, carbohydrates or a mixture of the two.
      High activities occurred in glucose-grown cells. Aliphatic alcohols from octanol
      to hexadecanol were oxidized with two maxima in activities for decanol and for
      tetradecanol. Differences in their pH optima and in temperature stability suggest
      two separate enzymes are present. Long chain diols, but not omega-hydroxyfatty
      acids, were also oxidized.

PMID- 2227355
TI  - Assay of 4-hydroxybutyryl-CoA dehydratase from Clostridium aminobutyricum.
AB  - It has been proposed that Clostridium aminobutyricum contains an enzyme
      catalyzing an unusual reaction: the dehydration of 4-hydroxybutyryl-CoA to
      vinylacetyl-CoA. 4-Hydroxy-[3-3H]butyric acid has been prepared which allows the
      activity of this enzyme to be assayed in the presence of acetyl-CoA under
      anaerobic conditions by the release of tritiated water. Initial characterization
      of the enzyme from C. aminobutyricum has shown it to be largely membrane or
      particle bound in the crude lysates. It can be solubilized in detergent. It is
      inactivated by oxygen, but stable under anaerobic conditions. Only 49 +/- 2% of
      the label is removed after enzyme-catalyzed equilibration with water. This
      stereospecific release is consistent with the formation of vinylacetyl-CoA and
      excludes a vitamin B12 coenzyme-dependent rearrangement to 3-hydroxybutyryl-CoA
      followed by dehydration to crotonyl-CoA.

PMID- 2227356
TI  - The invasiveness of different strains of Salmonella enteritidis phage type 4 for
      young chickens.
AB  - Five strains of Salmonella enteritidis phage type 4 (PT4) isolated in 1978, 1984
      and 1988 were examined for their ability to colonise the caecum and invade the
      liver of day-old chickens. All strains were capable of caecal colonisation and
      there were no differences in their colonisation ability in this respect. In
      contrast there was a gradation in the ability of strains to invade the liver,
      with strains isolated in 1988 proving the most invasive. Absence of a 38
      megadalton (Md) plasmid, which has been shown to be involved in the virulence of
      S. enteritidis PT4 for BALBc mice, had little effect on the ability of strains of
      this phage type to colonise the caecum or invade the liver of day-old chickens.
      These results suggest that recent isolates of PT4 may have enhanced virulence for
      chickens which is not necessarily associated with the carriage of a 38 Md
      plasmid.

PMID- 2227357
TI  - Starvation-induced modulations in binding protein-dependent glucose transport by
      the marine Vibrio sp. S14.
AB  - The uptake kinetics of D-glucose were examined in the marine Vibrio sp. S14
      during a period of 168 h of complete energy and nutrient starvation. Two glucose
      transport systems were distinguished in Vibrio sp. S14: a low affinity system (Km
      = 4.6 +/- 0.9 microM) at the onset of starvation, and a high affinity system (Km
      = 0.55 +/- 0.15 microM) after 168 h of starvation. Both systems had a narrow
      substrate specificity, and both were osmotic shock-sensitive.

PMID- 2227358
TI  - Factors involved in the electroporation-induced transformation of Clostridium
      perfringens.
AB  - The following factors were found to improve the efficiency of transformation of
      Clostridium perfringens 3624A Rifr Strr: (1) a reduction in cuvette sample volume
      (DNA and cell suspension) to 0.8 ml, (2) use of a 1 microgram/ml concentration of
      transforming DNA, (3) use of late-logarithmic phase cells, (4) 3-fold
      concentration of cell density (3.0 x 10(8) CFU/ml), and (5) a reduction in the pH
      of the expression and selective plating medium to 6.4. Application of the
      improved conditions resulted in transformation efficiencies for C. perfringens
      3624A Rifr Strr ranging from 7.1 transformants/microgram DNA for plasmic pIP401
      to 9.2 x 10(4) transformants per microgram DNA for plasmid pAK201. The greatest
      transformation efficiency obtained using pAK201 was 9.8 x 10(6)
      transformants/micrograms DNA for C. perfringens strain 13. Using the improved
      protocol, pAM beta 1 was transformed at a 42-fold greater level when compared
      with the values reported earlier [1]. In addition to C. perfringens 3624A Rifr
      Strr, strains 13, 10543A, 3628C, NTG-4, and 3624A were successfully transformed.
      Nuclease does not appear to be a factor in the C. perfringens strain-specific
      electro-transformation protocol.

PMID- 2227359
TI  - Cloning and expression of the carbon monoxide dehydrogenase genes from
      Pseudomonas thermocarboxydovorans strain C2.
AB  - Carbon monoxide dehydrogenase (CODH) from Pseudomonas thermocarboxydovorans
      strain C2 is composed of three non-identical subunits. A gene library of C2 DNA
      in lambda vector L47.1 was generated and screened using anti-CODH serum. Western
      blotting experiments revealed a protein which co-migrated with and had the same
      immunological reaction as the large subunit of CODH in some of the clones
      isolated from the library. The coding region was pinpointed to a 4 kb fragment
      which was subcloned into plasmid. Western blotting experiments showed that all
      three subunits of CODH were coded for by the subclone. However, no CODH activity
      was detected.

PMID- 2227360
TI  - The phylogeny of Aerococcus and Pediococcus as determined by 16S rRNA sequence
      analysis: description of Tetragenococcus gen. nov.
AB  - The phylogenetic interrelationships of the genera Pediococcus and Aerococcus were
      investigated using reverse transcriptase sequencing of 16S rRNA. The genus
      Pediococcus was found to be phylogenetically heterogeneous. The four species P.
      acidilactici, P. damnosus, P. parvulus and P. pentosaceus formed a
      phylogenetically distinct group. Within this pediococcal cluster, P. acidilactici
      was closely related to P. pentosaceus whereas P. damnosus showed a specific
      relationship with P. parvulus. The species P. dextrinicus, although showing
      significant sequence relatedness with these pediococcal species, was peripheral
      to the genus. Pediococcus halophilus exhibited low sequence homology with all of
      the species examined and formed a distinct line of descent. Pediococcus
      halophilus exhibited a closer affinity with enterococci and carnobacteria than
      with the other lactic acid bacteria. Pediococcus urinae-equi was phylogenetically
      very closely related to Aerococcus viridans. The 16S rRNA sequences of the type
      strains of these species differed by only two nucleotides (99.9% sequence
      homology) and clearly demonstrate that P. urinae-equi is a member of the genus
      Aerococcus.

PMID- 2227361
TI  - Analysis of immune response: comparison of immunoblots after isoelectric focusing
      and sodium dodecyl sulfate-polyacrylamide gel electrophoresis using cytoplasmic
      protein extract from Brucella.
AB  - Analysis of the immune response towards the facultative intracellular bacterium,
      Brucella melitensis, was studied by immunoblotting after either isoelectric
      focusing (IEF) or sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS
      PAGE). A cytoplasmic extract (CPE) of Brucella melitensis was used as antigen to
      analyse the response in 17 sera from naturally infected goats. CPE analysed by
      IEF exhibited 25 proteins within the pH range of 4.35 to 6. Immunoblotting
      revealed most of the stained bands around pH 4.5-5.4. CPE analysed by SDS-PAGE
      showed more than 20 silver stained proteins in the molecular range of 16-18 kDa
      to 70 kDa but immunoblotting revealed only 1 to 6 bands according to the sera
      tested. Because proteins are preserved in their native state with IEF, in
      contrast to SDS-PAGE treatment, this technique may be best suited for analysis of
      the overall response to natural infection.

PMID- 2227362
TI  - Antimicrobial effect of human milk on Bordetella pertussis.
AB  - It has been demonstrated that human milk, unlike bovine milk, can reduce the
      viability of Bordetella pertussis. This antibacterial activity was not due to the
      presence of antibiotics or antibodies in the human milk. Reducing the level of
      available iron or increasing the concentration of lysozyme in bovine milk did not
      induce anti-B. pertussis activity. Analysis of total fatty acids revealed that
      human milk contained significantly more linoleic acid than bovine milk. However,
      the addition of linoleic acid to bovine milk did not inhibit the growth of B.
      pertussis.

PMID- 2227363
TI  - Factors and markers of virulence in Escherichia coli from human septicemia.
AB  - One hundred Escherichia coli isolates from human septicemia were characterized
      with respect to O serogroups 1, 2, 4, 6, 7, 8, 15, 18, 75 and 78, alpha
      hemolysin, carboxylesterase B typing, cytotoxic necrotizing factor, F165 and
      CS31A fimbrial antigens, aerobactin production, colicins, and antibiotic
      sensitivity. A factorial analysis of correspondence and chi 2 tests indicated
      that most of E. coli isolates belonging to the studied O serogroups were positive
      for the virulence factors or markers alpha-haemolysin, carboxylesterase B2 type,
      cytotoxic necrotizing factor, F165 fimbrial antigen and were antibiotic-sensitive
      (Group I). These characteristics differentiated them from E. coli isolates from
      other O serogroups which were generally antibiotic resistant and negative for the
      cited virulence factors and markers (Group II). Aerobactin and colicin production
      did not differentiate the two E. coli groups. E. coli O serogroups 4 and 6 were
      highly represented in group I and were responsible for most of the differences
      between the two groups.

PMID- 2227364
TI  - Nucleotide sequence of the Serratia marcescens SR50 chromosomal ampC beta
      lactamase gene.
AB  - The Serratia marcescens SR50 chromosomal beta-lactamase gene (ampC) was cloned
      and sequenced. It contains 1128 nucleotides encoding a protein of 355 amino acids
      preceded by 21 amino acids which probably constitutes the signal peptide. The
      mature protein has a predicted molecular mass of 38,901 Da. About 40% of the
      amino acid sequence was identical among AmpC beta-lactamases resided in S.
      marcescens, Citrobacter freundii OS60, Escherichia coli K12 and Enterobacter
      cloacae P99. All of these enzymes are highly similar around the active site
      serine at the position 59 of the mature enzyme.

PMID- 2227365
TI  - Evaluation of cytotoxic activity in fecal filtrates from patients with
      Campylobacter jejuni or Campylobacter coli enteritis.
AB  - We sought to determine the prevalence of cytotoxic activity in fecal filtrates
      from persons with C. jejuni or C. coli enteritis. Stool specimens were collected
      from 20 persons with C. jejuni or C. coli enteritis, 20 persons with acute
      diarrheal illnesses of other causes, and 9 healthy, asymptomatic persons. Fecal
      filtrates were then incubated with Chinese hamster ovary (CHO) or HeLa cells. The
      fecal filtrate from 1 of the 20 (5%) persons with Campylobacter enteritis was
      cytotoxic for HeLa cells at a titer of 1:40, and 10 (50%) were cytotoxic for CHO
      cells at maximum titers of 1:20. Cytotoxic activity for CHO cells at a median
      titer of 1:20 was also present in 40% of the fecal filtrates from persons with
      diarrhea due to causes other than Campylobacter enteritis, and in 33% of
      filtrates from healthy, asymptomatic persons. The observed low level of
      cytotoxicity in fecal filtrates from all patient groups studied likely resulted
      from non-specific factors, unrelated to the pathogenesis of Campylobacter
      enteritis.

PMID- 2227367
TI  - Stability of soluble and extracellular vesicle-associated trypsin-like protease
      (TLP) activity of Bacteroides gingivalis W50.
AB  - Comparison was made of the specific activities of whole extracellular soluble
      protein (EP) and extracellular vesicle (ECV)-associated trypsin-like protease
      (TLP) activity from batch cultures of Bacteroides gingivalis W50. Rapid loss of
      activity occurred when these fractions were maintained at 37 degrees C in the
      presence of DTT. Residual levels of activity were detected after incubation of
      ECV and EP for up to 8 days under non-reducing conditions. Rates of activity loss
      in EP and ECV were similar. Mixtures of EP and ECV, in the same proportions as
      found in the culture supernatant showed neither depression nor elevation of total
      activity from the expected compound activities of the two separate fractions.

PMID- 2227366
TI  - Simultaneous exploitation of different peptide permeases by combinations of
      synthetic peptide smugglins can lead to enhanced antibacterial activity.
AB  - Various synthetic, peptide prodrugs (smugglins) were tested alone and in
      combination for activity against Escherichia coli. The smugglins may be
      transported through any of three peptide permeases, and once inside the bacteria
      are activated by intracellular peptidase action to release their intrinsically
      impermeant, antibacterial moieties. When each such antibiotic peptide present in
      a mixture was accumulated via a different permease, synergistic effects could be
      observed. Synergy was also found when smugglins were combined with other non
      peptide antibiotics. The principle of using smugglin combinations could extend
      the scope of their application, and should minimise the potential problem that
      can arise from the occurrence of resistant, transport mutants. The smugglin
      interactions were studied using a modified microtitre plate assay.

PMID- 2227368
TI  - Determination of taxonomic resolution capacity of conventional one-dimensional
      SDS-polyacrylamide gel electrophoresis of whole-cell proteins using
      Enterobacteriaceae.
AB  - The capacity of one-dimensional SDS-PAGE of whole bacterial cells to both
      separate and cluster taxonomic units is studied using members of
      Enterobacteriaceae as test material. The results show that intraspecies variation
      can be detected and on the other hand the degree of taxonomic divergence which
      still can be grouped together is determined. In addition the system has high
      tolerance to changes in cell culture conditions making the usage of SDS-PAGE
      suitable for applications where rapid and reliable bacterial identification is
      needed.

PMID- 2227370
TI  - Measuring the inflation of the lod score due to its maximization over model
      parameter values in human linkage analysis.
AB  - A computer-simulation method is presented for determining and correcting for the
      effect of maximizing the lod score over disease definitions, penetrance values,
      and perhaps other model parameters. The method consists of simulating the
      complete analysis using marker genotypes randomly generated under the assumption
      of free recombination. It is applicable as a "post-treatment" to linkage analyses
      of any trait with an uncertain mode of inheritance and/or disease definition.
      When the method is applied to a linkage analysis of schizophrenia versus
      chromosome 5 markers, we find that, in this specific case, the P-value associated
      with a maximum lod score of 3 is equal to 0.0003. We also find that a lod score
      of 3.0 should be "deflated" by approximately 0.3 to 1 units, and, by tentative
      extrapolation, the observed lod score of 6.5 should be "deflated" by 0.7 to 1.5
      units.

PMID- 2227369
TI  - Digestion of human immunoglobulin G by the major cysteine proteinase (cruzipain)
      from Trypanosoma cruzi.
AB  - The major cysteine proteinase (cruzipain) from Trypanosoma cruzi was able to
      digest human IgG, as shown by polyacrylamide gel electrophoresis in the presence
      of SDS, and by gel filtration on a Superose 12 column, in a FPLC system. The Fab
      fragment of IgG was only slightly degraded, but Fc was extensively hydrolyzed to
      small peptides. The results suggest that cruzipain might be involved in the
      defense mechanisms of the parasite against the immune response of the host.

PMID- 2227371
TI  - Assessing the effect of multiple linkage tests in complex diseases.
AB  - The significance of a lod score value of 3 is very difficult to assess in linkage
      studies between a genetic marker and a complex disease. One reason is that
      multiple tests may have been performed, voluntarily or otherwise. For the same
      disease, linkage may be tested by different laboratories with several markers
      under various genetic models and diagnostic schemes for the disease. In such a
      case, we show that the probability of getting a lod score value of 3 under
      independent transmission of the disease and the marker may be not negligible.

PMID- 2227372
TI  - Structure of ischemic heart disease risk factors in the North Khanty population
      of western Siberia.
AB  - The relationships between serum lipids, blood pressures, anthropometric traits,
      age, and ischemic changes of the electrocardiogram (ECG) in the North Khanty
      population were studied. To this end, eight morphophysiological variables-
      presumably risk factors for ischemic heart disease--have been subjected to a
      principal components analysis. Two principal components were extracted. The first
      revealed age dependency of the traits not associated with ischemic changes of
      myocardium in both sexes. A comparative analysis of the second component has
      shown that the chosen traits correlated with ischemic heart disease in males but
      not in females. Interpretation is given of the components obtained.

PMID- 2227373
TI  - Twin concordance for a binary trait: III. A bivariate analysis of hay fever and
      asthma.
AB  - Self-reported histories of hay fever and asthma were obtained from 3,808 pairs of
      adult twins 18 years and over registered with the Australian National Health
      Medical Research Council Twin Registry (1232 MZF, 567 MZM, 751 DZF, 352 DZM, 906
      DZO). The prevalence of hay fever and asthma was 0.32 and 0.13, respectively,
      with little variation with zygosity, sex, and age. The associations between twin
      pairs for these two traits were analysed, under the assumption of constant
      prevalences, as a special case of a log-linear model for binary traits in
      pedigrees using the statistical package GLIM. The model assumption that there are
      no second- or higher-order interactions was tested in the 2 X 2 X 2 X 2 table of
      twin by disease outcomes without revealing strong evidence of departure, even in
      this large data set. The log-linear modelling showed that only three first-order
      interactions, namely 1) between hay fever in a twin pair, 2) asthma in a twin
      pair, and 3) hay fever and asthma in the same twin, were necessary to describe
      the data. The first two interaction terms were significantly larger in identical
      pairs; the third was independent of zygosity. Under this parsimonious model,
      there was a significant difference between identical and fraternal pairs in
      marginal correlation, both in asthma and hay fever, and in the cross-correlation
      between hay fever in one twin and asthma in the other. This suggests that genetic
      factors are implicated in both hay fever and asthma and that some of these
      genetic factors are common (at least among a subgroup of individuals) to both
      traits.

PMID- 2227374
TI  - Familial factors associated with malignant gliomas.
AB  - Family histories of male patients with histologically confirmed malignant gliomas
      were compared to family histories of controls (wives). Included were 77 case
      families with 892 relatives and 77 control families with 719 relatives. Cases had
      significantly more siblings than controls (P = 0.02), although cases were not
      preferentially the oldest or the youngest sibs. Odds ratios of two or more were
      found for mental retardation, Parkinson's disease, and meningitis for the
      relatives of cases versus controls, but none were statistically significant. The
      excesses of Parkinson's disease and meningitis were explained by the family of
      one particularly interesting case containing three relatives with meningitis and
      two relatives with Parkinson's disease. Noteworthy age-adjusted odds ratios for
      cancer among relatives of cases compared to relatives of controls were 1.6 (95%
      confidence interval (CI) = 1.0-2.3) for cancer of any site, 2.4 (95% CI = 0.8
      6.1) for breast cancer, and 4.0 (95% CI = 0.6-10.7) for lung cancer. Only the
      odds ratio for cancer of any site was statistically significant. Overall, 6 of 77
      (8%) of cases came from families that included two or more relatives with breast
      or lung cancer in addition to the proband with malignant glioma. These three
      cancer sites may form familial clusters worthy of further evaluation in future
      studies by pedigree and genetic linkage analyses.

PMID- 2227375
TI  - Association of Duffy blood group with schizophrenia in Chinese.

PMID- 2227376
TI  - Information theory and collative motivation: incentive value of uncertainty,
      variety, and novelty for children.
AB  - We tested the applicability of concepts and measures from information theory to
      studies of the development and operation of collative motivation. Three variables
      nominated by Berlyne as potential motivators of information seeking--uncertainty,
      variety, and novelty--were put into correspondence with three informational
      theoretic measures--average uncertainty in bits, number of possible outcomes, and
      outcome probability--to investigate the incentive properties of each variable for
      first and fourth graders. Increasing bit levels of uncertainty by adding
      alternatives to the set of possible outcomes was generally positively related to
      cover choices; however, increasing bit values by varying outcome probabilities
      from unequal to equal had no effect on choice. Without uncertainty, variety
      provided a weak source of collative motivation, systematically related to the
      choice of the transparent cover only for the older children when rewards occurred
      equally frequently. In contrast, the transparent cover was chosen significantly
      more frequently when the outcome probability of the associated reward was low. We
      obtained developmental stability in motivational effects except for variety
      operating in the absence of uncertainty.

PMID- 2227377
TI  - Factor structures and validity of the Child-Related Values Survey.
AB  - The Child-Related Values Survey (CRVS) is being developed for assessment of
      various values that affect the nature of our regard for the psychological and
      physical welfare of children in general. Factor analysis of the CRVS resulted in
      six subscales. A confirmatory factor analysis on these subscales showed that the
      Affective Valence, Empathic Caring, Self-Sacrifice, and Societies' Duties
      subscales each reflect a humanitarian concern for children and that the
      Instrumentality and Authoritarian Attitude subscales tap values involving a
      moralistic expectation of children. Data on the validity of the CRVS include the
      humanitarian cluster of subscales predicting subjects' perceived satisfaction in
      pursuing child-related careers, relating the CRVS to various social issues, and
      the demonstration of several group differences with respect to CRVS subscales.

PMID- 2227378
TI  - Herschel L. Roman (1914-1989).

PMID- 2227380
TI  - Major effects on teratogen-induced facial clefting in mice determined by a single
      genetic region.
AB  - A major correlation has been found between the incidence of glucocorticoid
      induced cleft palate and the chromosome 8 segment identified by N-acetyl
      transferase in mice. The resistant strain became fully susceptible while the
      susceptible strain became resistant when this chromosomal region, representing
      less than 0.7% of the genome, was transferred from one strain to the other by the
      construction of congenic strains. 6-Aminonicotinamide-induced cleft palate and
      phenytoin-induced cleft lip with or without cleft palate are also influenced by
      this genetic region but not as strongly. In both cases the susceptible strain
      became quite resistant to the teratogen-induced clefting when the N-acetyl
      transferase region of chromosome 8 was transferred. However, this chromosomal
      region does not make the resistant strain susceptible to these two teratogens.

PMID- 2227379
TI  - Context effects in the formation of deletions in Escherichia coli.
AB  - We have examined the frequency with which identical deletions are formed in
      different chromosomal contexts. A panel of six mutant bla genes containing
      palindrome/direct repeat structures were moved from pBR322 to three locations: at
      lambda att, at chromosomal lac, and at F'lac. Deletion of the palindromes and one
      of the direct repeats results in reversion to Ampr. The frequency of deletion for
      all alleles declines beyond the reduction in copy number when they are moved from
      the multicopy plasmid environment to a single-copy chromosome. The magnitude of
      the declines varies in an allele-specific and location-specific manner. Our data
      support the hypothesis that context can influence the frequency of mutation
      independent of the immediate DNA sequence.

PMID- 2227381
TI  - Theoretical study of near neutrality. I. Heterozygosity and rate of mutant
      substitution.
AB  - In order to clarify the nature of "near neutrality" in molecular evolution and
      polymorphism, extensive simulation studies were performed. Selection coefficients
      of new mutations are assumed to be small so that both random genetic drift and
      selection contribute to determining the behavior of mutants. The model also
      incorporates normally distributed spatial fluctuation of selection coefficients.
      If the system starts from "average neutrality," it will move to a better adapted
      state, and most new mutations will become "slightly deleterious." Monte Carlo
      simulations have indicated that such adaptation is attained, but that the rate of
      such "progress" is very low for weak selection. In general, the larger the
      population size, the more effective the selection becomes. Also, as selection
      becomes weaker, the behavior of the mutants approaches that of completely neutral
      genes. Thus, the weaker the selection, the smaller is the effect of population
      size on mutant dynamics. Increase of heterozygosity with population size is very
      pronounced for subdivided populations. The significance of these results is
      discussed in relation to various observed facts on molecular evolution and
      polymorphism, such as generation-time dependency and overdispersion of the
      molecular clock, or contrasting patterns of DNA and protein polymorphism among
      some closely related species.

PMID- 2227382
TI  - Relationship between migration and DNA polymorphism in a local population.
AB  - The expected amount of DNA polymorphism, measured in terms of the number of
      nucleotide differences between the two DNA sequences randomly sampled from
      subpopulations, was studied by using the stepping-stone model and the finite
      island model, under the assumption that the migration rate is not the same among
      different subpopulations. The results obtained indicate that the expected amount
      of DNA polymorphism in the subpopulation with lower migration rate is smaller
      than that of higher migration rate. This suggests that marginal populations tend
      to have lower level of DNA polymorphism than central populations if the migration
      rate in the marginal populations is lower than that of the central populations.

PMID- 2227384
TI  - Detecting isolation by distance using phylogenies of genes.
AB  - We introduce a method for analyzing phylogenies of genes sampled from a
      geographically structured population. A parsimony method can be used to compute
      s, the minimum number of migration events between pairs of populations sampled,
      and the value of s can be used to estimate the effective migration rate M, the
      value of Nm in an island model with local populations of size N and a migration
      rate m that would yield the same value of s. Extensive simulations show that
      there is a simple relationship between M and the geographic distance between
      pairs of samples in one- and two-dimensional models of isolation by distance.
      Both stepping-stone and lattice models were simulated. If two demes k steps apart
      are sampled, then, s, the average value of s, is a function only of k/(Nm) in a
      one-dimensional model and is a function only of k/(Nm)2 in a two-dimensional
      model. Furthermore, log(M) is approximately a linear function of log(k). In a one
      dimensional model, the regression coefficient is approximately -1 and in a two
      dimensional model the regression coefficient is approximately -0.5. Using data
      from several locations, the regression of log(M) on log(distance) may indicate
      whether there is isolation by distance in a population at equilibrium and may
      allow an estimate of the effective migration rate between adjacent sampling
      locations. Alternative methods for analyzing DNA sequence data from a
      geographically structured population are discussed. An application of our method
      to the data of R. L. Cann, M. Stoneking and A. C. Wilson on human mitochondrial
      DNA is presented.

PMID- 2227383
TI  - How informative is Wright's estimator of the number of genes affecting a
      quantitative character?
AB  - S. Wright suggested an estimator, m, of the number of loci, m, contributing to
      the difference in a quantitative character between two differentiated
      populations, which is calculated from the phenotypic means and variances in the
      two parental populations and their F1 and F2 hybrids. The same method can also be
      used to estimate m contributing to the genetic variance within a single
      population, by using divergent selection to create differentiated lines from the
      base population. In this paper we systematically examine the utility and problems
      of this technique under the influences of unequal allelic effects and initial
      allele frequencies, and linkage, which are known to lead m to underestimate m. In
      addition, we examine the effects of population size and selection intensity
      during the generations of selection. During selection, the estimator m rapidly
      approaches its expected value at the selection limit. With reasonable assumptions
      about unequal allelic effects and initial allele frequencies, the expected value
      of m without linkage is likely to be on the order of one-third of the number of
      genes. The estimates suffer most seriously from linkage. The practical maximum
      expectation of m is just about the number of chromosomes, considerably less than
      the "recombination index" which has been assumed to be the upper limit. The
      estimates are also associated with large sampling variances. An estimator of the
      variance of m derived by R. Lande substantially underestimates the actual
      variance. Modifications to the method can ameliorate some of the problems. These
      include using F3 or later generation variances or the genetic variance in the
      base population, and replicating the experiments and estimation procedure.
      However, even in the best of circumstances, information from m is very limited
      and can be misleading.

PMID- 2227385
TI  - Gene conversion, linkage, and the evolution of repeated genes dispersed among
      multiple chromosomes.
AB  - The evolution of the probabilities of genetic identity within and between the
      loci of a multigene family dispersed among multiple chromosomes is investigated.
      Unbiased gene conversion, equal crossing over, random genetic drift, and mutation
      to new alleles are incorporated. Generations are discrete and nonoverlapping; the
      diploid, monoecious population mates at random. The linkage map is arbitrary, but
      the same for every chromosome; the dependence of the probabilities of identity on
      the location on each chromosome is formulated exactly. The greatest of the rates
      of gene conversion, random drift, and mutation is epsilon much less than 1. Under
      the assumption of loose linkage (i.e., all the crossover rates greatly exceed
      epsilon, though they may still be much less than 1/2), explicit approximations
      are obtained for the equilibrium values of the probabilities of identity and of
      the linkage of disequilibria. The probabilities of identity are of order one
      [i.e., O(1)] and do not depend on location; the linkage disequilibria are of
      O(epsilon) and, within each chromosome, depend on location through the crossover
      rates. It is demonstrated also that the ultimate rate and pattern of convergence
      to equilibrium are close to that of a much simpler, location-independent model.
      If intrachromosomal conversion is absent, the above results hold even without the
      assumption of loose linkage. In all cases, the relative errors are of O(epsilon).
      Even if the conversion rate between genes on nonhomologous chromosomes is
      considerably less than between genes on the same chromosome or homologous
      chromosomes, the probabilities of identity between the former genes are still
      almost as high as those between the latter, and the rate of convergence is still
      not much less than with equal conversion rates. If the crossover rates are much
      less than 1/2, then most of the linkage disequilibrium is due to intrachromosomal
      conversion. If linkage is loose, the reduction of the linkage disequilibria to
      O(epsilon) requires only O(-ln epsilon) generations.

PMID- 2227386
TI  - Two-locus linkage analysis using recombinant inbred strains and Bayes' theorem.
AB  - Recombinant inbred (RI) strains are useful in linkage analysis and gene mapping.
      The currently available statistical tests of linkage using data derived from the
      study of RI strains, including a previous Bayesian analysis, have not been
      stringent enough guides for conclusions about linkage. In this paper, the
      probability of linkage was estimated using Bayes' theorem. Tables are presented
      that give the probability of linkage in sets of up to 30 RI strains and the
      critical values of i (the number of recombinants) in sets of up to 100 RI
      strains. Several means of increasing the power of RI strains in linkage analysis
      are discussed.

PMID- 2227387
TI  - Genetic control of RNA polymerase I-stimulated recombination in yeast.
AB  - We examined the genetic control of the activity of HOT1, a cis-acting
      recombination-stimulatory sequence of Saccharomyces cerevisiae. Mutations in RAD1
      and RAD52 decrease the ability of HOT1 to stimulate intrachromosomal
      recombination while mutations in RAD4 and RAD50 do not affect HOT1 activity. In
      rad1 delta strains, the stimulation of excisive recombination by HOT1 is
      decreased while the rate of gene replacement is not affected. In rad52-8 strains
      the ability of HOT1 to stimulate both excisive recombination and gene replacement
      is decreased. All of the recombinants in the rad52-8 strains that would be
      categorized as gene replacements based on their phenotype are diploids apparently
      derived by endomitosis and excisive recombination. Studies on rad1 delta rad52-8
      strains show that these mutations interact synergistically in the presence or
      absence of HOT1, resulting in low levels of recombination. The rate of gene
      replacement but not excisive recombination is stimulated by HOT1 in rad1 delta
      rad52-8 strains. Taken together, the results show that HOT1 stimulates exchange
      using multiple recombination pathways. Some of the activity of HOT1 is RAD1
      dependent, some is RAD52-dependent, and some requires either RAD1 or RAD52 as
      suggested by the synergistic interaction found in double mutant strains. There is
      also a component of HOT1 activity that is independent of both RAD1 and RAD52.

PMID- 2227388
TI  - Spontaneous point mutations that occur more often when advantageous than when
      neutral.
AB  - Recent reports have called into question the widespread belief "that mutations
      arise continuously and without any consideration for their utility" (in the words
      of J. Cairns) and have suggested that some mutations (which Cairns called
      "directed" mutations) may occur as specific responses to environmental
      challenges, i.e., they may occur more often when advantageous than when neutral.
      In this paper it is shown that point mutations in the trp operon reverted to trp+
      more frequently under conditions of prolonged tryptophan deprivation when the
      reversions were advantageous, than in the presence of tryptophan when the
      reversions were neutral. The overall mutation rate, as determined from the rates
      of mutation to valine resistance and to constitutive expression of the lac
      operon, did not increase during tryptophan starvation. The trp reversion rate did
      not increase when the cells were starved for cysteine for a similar period,
      indicating that the increased reversion rate was specific to conditions where the
      reversions were advantageous. Two artifactual explanations for the observations,
      delayed growth of some preexisting revertants and cryptic growth by some cells at
      the expense of dying cells within aged colonies, were tested and rejected as
      unlikely. The trp+ reversions that occurred while trp- colonies aged in the
      absence of tryptophan were shown to be time-dependent rather than replication
      dependent, and it is suggested that they occur by mechanisms different from those
      that have been studied in growing cells. A heuristic model for the molecular
      basis of such mutations is proposed and evidence consistent with that model is
      discussed. It is suggested that the results in this and previous studies can be
      explained on the basis of underlying random mechanisms that act during prolonged
      periods of physiological stress, and that "directed" mutations are not
      necessarily the basis of those observations.

PMID- 2227389
TI  - Mobility of two optional G + C-rich clusters of the var1 gene of yeast
      mitochondrial DNA.
AB  - Yeast mtDNA contains two different kinds of mobile optional sequences, two group
      I introns and a short G + C-rich insertion to some var1 genes. Movement of each
      element in crosses has been called gene conversion though little is known about
      the mechanism of G + C cluster conversion. A new allele of the var1 gene found in
      mtDNA of Saccharomyces capensis is described that permitted a more detailed
      comparison between intron mobility and G + C cluster conversion. The S. capensis
      var1 gene lacks the cc+ element present in all S. cerevisiae var 1 genes and the
      previously described optional a+ element. In crosses with cc+ a- and cc+ a+ S.
      cerevisiae strains, both clusters were found to be mobile and, in the latter
      cross, appear to convert independently and only to homologous insertion sites. No
      evidence for flanking marker coconversion (a hallmark feature of intron
      conversion) was obtained despite the availability of nearby physical markers on
      both sides of cluster conversion sites. These data indicate that G + C cluster
      conversion has only a superficial resemblance to intron mobility; analogies to
      procaryotic transposition mechanisms are considered.

PMID- 2227390
TI  - Isolation and molecular characterization of the Aspergillus nidulans wA gene.
AB  - The walls of Aspergillus nidulans conidia contain a green pigment that protects
      the spores from damage by ultraviolet light. At least two genes, wA and yA, are
      required for pigment synthesis: yA mutants produce yellow spores, wA mutants
      produce white spores, and wA mutations are epistatic to yA mutations. We cloned
      wA by genetic complementation of the wA3 mutation with a cosmid library
      containing nuclear DNA inserts from the wild-type strain. The wA locus was mapped
      to an 8.5-10.5-kilobase region by gene disruption analysis. DNA fragments from
      this region hybridized to a 7500 nucleotide polyadenylated transcript that is
      absent from hyphae and mature conidia but accumulates during conidiation
      beginning when pigmented spores first appear. Mutations in the developmental
      regulatory loci brlA, abaA, wetA and apsA prevent wA mRNA accumulation. By
      contrast, yA mRNA fails to accumulate only in the brlA- and apsA- mutants. Thus,
      the level of wA transcript is regulated during conidiophore development and wA
      activation requires genes within the central pathway regulating conidiation.

PMID- 2227391
TI  - [Genetic determination of spontaneous and induced dominant lethality in
      Drosophila].
AB  - Estimation of heritability ha2 index in experiments on spontaneous and induced
      dominant lethality gives the possibility to evaluate with sufficient accuracy
      genetic determination of the effect and its dependence on casual reasons.
      Besides, the individual breeding method gave quite stable data both on late
      embryonic lethality index and on heritability value. Directed selection of
      different test-objects (species or stocks of Drosophila) should be carried out
      using heritability index, since selection efficiency mostly depends on this value
      degree. Making stocks resistant and sensitive to certain mutagen classes, their
      comparison from the point of view of their pharmacogenetic features, on the basis
      of the indices used, may be taken as the start of studies aimed at further
      identification of certain biochemical factors or system taking part in
      manifestation of mutagenic effect. The data obtained permit us to suggest an idea
      of advisability of studying the genetic control of mutagenesis in humans using
      the method described.

PMID- 2227392
TI  - [Polymorphism of the HLA genetic system in Khanty population].
AB  - Serological polymorphism of HLA 1 class genes and antigens (A, B, C) was studied
      in native West-Siberian population of Khants. Genes HLA-A2, A23, A24, B7, B35,
      B49, Cw4 and Cw7 appeared to be most frequent in this population. HLA-A23/B49 was
      the most wide-spread haplotype with strong linkage disequilibrium. The main
      features of the HLA polymorphism indicate profound mongoloid roots of Khants,
      whereas strong linkage disequilibrium of some HLA alleles confirms the idea of
      the origin of Khants as a result of ancient mixing of mongoloids and caucasoids.

PMID- 2227393
TI  - [Gametic disequilibrium in populations of reindeer Chukchi and Asian Eskimos].
AB  - Ten local populations of Reindeer Chukchi and four local populations of Asiatic
      Eskimos were surveyed for variation of nine polymorphic loci (MN, Ss, Cc, Ee,
      Duffy, AcP, PGM1, Hp, G3M). Pairwise linkage disequilibria were estimated from
      multilocus genotype frequencies using the Hill's method. Large amounts of linkage
      disequilibrium were found for the two pairs of linked genes MNSs and CcEe. The
      same pattern of non-random association between unlinked loci PGM1 and AcP was
      found in all subpopulations of both tribes that is induced by natural selection.

PMID- 2227394
TI  - [uvrD-like sequences in the genome of Agrobacterium tumefaciens].

PMID- 2227395
TI  - [Cloning of Shigella flexneri 2a genes coding for restriction- modification
      system Sfl2aI].
AB  - The Sfl2aI system of restriction-modification (RM) was revealed in the cells of
      Shigella flexneri encoded by pKMR114 plasmid belonging to the IncN
      incompatibility group. The genes for Sfl2aI RM system were cloned. The system was
      ascribed to the enzymes of the EcoRII specificity, as shown by in vivo and in
      vitro experiments. Restriction analysis of these genes' region and antigenic
      properties of the Sfl2aI endonuclease pointed to significant differences between
      this and EcoRII RM systems.

PMID- 2227397
TI  - [Development of a system of intragenic mapping for molecular genetic analysis of
      mutations in the gene LYS2 of Saccharomyces yeasts].
AB  - The collection of overlapping lys2 deletions (five in the chromosomal and seven
      in the plasmid LYS2 gene) is constructed in this work. The deletions overlap the
      whole coding region of the gene and provide the system for intragenic
      recombinational mapping of lys2 mutations in one of 14 controlled regions. A
      portion of these regions can be correlated with the regions on the physical map
      of LYS2. Mutations in two regions can be easily cloned. The system constructed
      gives the possibility for the study of intragenic and molecular specificity of
      mutagenesis.

PMID- 2227396
TI  - [Cloning and expression of the gene for diphtheria toxin and its subunits in
      Escherichia coli].
AB  - The results of cloning Corynebacterium diphtheriae phi 984 tox gene and its A and
      B subunits in Escherichia coli are presented. Regulatory sequences of tox gene
      are capable to promote effective expression in E. coli cells. A set of
      recombinant plasmids has been obtained which can determine the synthesis of A and
      B individual subunits and are suitable for constructing immunotoxins by gene
      engineering. The diphtheria toxin of 62 kDa synthesized in E. coli has enzymatic
      activity and reacts with antitoxin sera. Some sites for E. coli proteases are
      present in tox-specific polypeptides.

PMID- 2227398
TI  - [Genetic analysis of spontaneous and 6-N-hydroxylaminopurine and propiolactone
      induced Adp+ mutants in Saccharomyces yeasts].
AB  - 652 spontaneous and 6-N-hydroxylaminopurine and propiolactone-induced mutants
      were obtained in yeast. 598 of them were LYS2 mutants. Detailed genetic analysis
      of the mutants was performed, including analysis of growth pattern on lysineless
      medium, suppressibility by nonsense suppressors of three types and localization
      on the recombination map of the LYS2 gene. Mutants induced by different agents
      were different for all these criteria, except for distribution among the map
      regions.

PMID- 2227399
TI  - [Cytogenetic study of synapsis and crossing-over in male mice heterozygous for
      reciprocal translocation T(14; 15)6Ca].
AB  - Synapsis and crossing over in male mice heterozygous for reciprocal translocation
      T (14; 15)6Ca were studied. The translocated multivalent undergoes the synaptic
      adjustment in the course of meiotic prophase. Translocated distal region of the
      14th chromosome forms inproportionally long lateral element of synaptonemal
      complex. The number of chiasmata in the 14th chromosome increases from 1.02 0.02
      in normal karyotype to 1.41 0.03 in heterozygous mice. The density of chiasmata
      in translocated, distal region is ten times higher than in the other part of the
      14th chromosome.

PMID- 2227400
TI  - [The role of genetic and ecological factors in development of resistant phenotype
      in mice during experimental trichinelliasis].
AB  - The role of genetic (genes for wool, eyes colour, X and Y chromosomes, H-2
      haplotype) and ecological (contamination intensity leading to strengthening of
      illness) factors in forming phenotype of resistance in mice under experimental
      trichinelliasis is studied. The experiments have been performed on male and
      female mice CBA/Ca, BALB/c, C57/BL/6J, DBA/2J, C3HA/Mv, CC57BR/Mv, CC577W/Mv and
      hybrids /C57BL/6J x CBA/Ca/F having 19-25 g mass each, which were infected with
      trichinella larvae of Byelorussian laboratory "strains" in dosage of 5, 20, 35
      and 70 units per 1 g body mass. The intensity of intestine invasion, the level of
      free histamine in the liver, the index of inhibition of spleen leucocyte
      migration on the 7th day and intensity of muscle invasion on the 30th day after
      contamination were defined. The analysis of the results of the study allowed to
      formulate the following points of regularity of trichinella resistance phenotype
      formation in mice: 1. The phenotype is formed as the result of interaction of
      genetic and ecological factors. 2. Mice of different genotypes form different
      phenotypes of resistance to trichinella. 3. Mice of the same genotypes form
      different phenotypes of resistance to intestine and muscle trichinella. The
      problems of inheritance and mechanisms of resistance are discussed.

PMID- 2227401
TI  - [Synapsis in single and double heterozygotes for partially overlapping inversions
      in chromosome 1 of the house mouse].
AB  - Electron microscopic analysis of synaptonemal complexes (SC) in single and double
      heterozygotes for the partially overlapping inversions In(1)1Icg, In(1)1Rk and
      In(1)12Rk in the Chromosome 1 of the house mouse reveals a dependence of synapsis
      and synaptic adjustment on the size and location of the inversions and their
      interaction. In(1)1Icg contains the insertions of inverted repeats Is(HSR:
      1C5)1Icg and Is(HSR: 1I)2Icg as well as inverted euchromatic region. The synaptic
      adjustment of the D loops by shortening of asynapsed parts of the lateral
      elements of SC belonging to the insertions occurs at late zygotene-early
      pachytene stage. After that the synaptic adjustment of the inversion loops takes
      place. A delay in adjustment was found in diheterozygotes In(1)1Icg/In(1)1Rk and
      In(1)1Icg/In(1)12Rk. Morphological alterations of the asynapted terminal segments
      of lateral elements preventing synaptic adjustment were found in single and
      double heterozygotes for In(1)1Rk and In(1)12Rk. Correspondence between the size
      of asynapted regions and the probability of association of XY and heteromorphic
      bivalents was revealed.

PMID- 2227402
TI  - [Hereditary polymorphism of glutathione-S-transferase in the human liver in
      normal conditions and in alcoholic hepatitis].
AB  - A total of 100 autopsy liver extracts from Russian individuals were examined for
      glutathione-S-transferase I (GST1) isozymes by means of starch gel
      electrophoresis. The gene frequencies of GST1* 1, GST1* 2 and GST1* 0 were 0.051,
      0.251 and 0.697, respectively. Analysis of data obtained and those in literature
      for other populations revealed the difference between European and Mongoloid
      groups. The GST1 0 phenotype was found in samples of liver from individuals with
      alcoholic hepatitis at frequency 77.3%. The gene frequencies for GST1* 1, GST1* 2
      and GST1* 0 were 0.020, 0.100 and 0.879, respectively.

PMID- 2227403
TI  - Evolutionary implications of duplications and Balbiani rings in Drosophila. A
      study of Drosophila serrata.
AB  - Drosophila serrata, a species of subgroup montium, exhibits in its salivary-gland
      chromosomes a high number of inverted tandem duplications and a well-formed
      Balbiani ring. A photographic map, the duplications, and the Balbiani ring of
      this species are presented. Also presented are the most prominent puffs during
      normal larval development and after ecdysone treatment, as well as intercalary
      heterochromatin regions of the above chromosomes. These data are discussed and
      compared with those of Drosophila auraria, another species of subgroup montium.
      All the inverted tandem duplications found in both species are homozygous and are
      not accompanied by other types of chromosomal rearrangements. These results argue
      in favor of the relatively old origin of these structures. The similarity of the
      structure and the developmental profile of the Balbiani ring 1 in both species
      may indicate a necessary role served by the Balbiani ring 1 and hence its
      selection during evolution.

PMID- 2227404
TI  - Organization of the 5S rRNA genes in the soybean Glycine max (L.) Merrill and
      conservation of the 5S rDNA repeat structure in higher plants.
AB  - The 5S rRNA gene of the soybean Glycine max (L.) Merr. has been cloned on a 556
      bp fragment of DNA and sequenced. This fragment contains two copies of the
      soybean 5S rDNA sequence, one intact and one truncated, separated by noncoding
      DNA. We have used this clone to investigate the organization of the 5S genes
      within the soybean genome and the extent of their methylation. Our results
      demonstrate that soybean 5S genes are clustered, organized into tandem repeats of
      330 bp, and extensively methylated. Hybridization of the 5S sequence to Southern
      transfers of soybean DNA digested with BamHI reveals a striking ladderlike
      pattern. Hybridization of the soybean 5S sequence to a wide variety of plant DNAs
      results in similar patterns, suggesting that the 5S rDNA sequence, gene
      organization, and methylation pattern are conserved in many higher plants.

PMID- 2227405
TI  - Lack of correlation between crossing-over and chromosome distance between
      inversions in Drosophila ananassae.
AB  - Two linked inversions, AL and ZE, located in the opposite limbs of the second
      chromosome of Drosophila ananassae are separated from each other by nearly 32% of
      the total length of the second chromosome. Crossing-over between these inversions
      when heterozygous was studied in females and males by the salivary-gland smear
      technique using karyotypically homozygous stocks. The results of recombination
      experiments show that there is a strong suppression of recombination between
      inversions when heterozygous, in spite of a large euchromatic distance available
      for crossing-over between them. Thus there is no correlation between chromosome
      distance and crossing-over between heterozygous inversions in the second
      chromosome of D. ananassae when studied cytologically.

PMID- 2227406
TI  - Branched chain amino acid regulation of the ILV2 locus in Saccharomyces
      cerevisiae.
AB  - Mutant regulatory loci of the branched pathway for the biosynthesis of isoleucine
      valine and leucine were identified with the unusual phenotype of an amino acid
      dependent auxotrophy. Two mutant loci, bcs1 and bcs2, conferred branched chain
      amino acid sensitivity and showed independent segregation. Linkage studies
      defined bcs1 as a cis-acting regulatory site of ILV2 (SMR1). ILV2 upstream
      deletion analyses and high-copy transformation of the positive regulatory locus
      LEU3 ruled out the possibility of LEU3 protein binding palindromes mediating the
      branched chain amino acid dependent auxotrophy. In the presence of leucine and
      valine, the general amino acid control system (GCN4) was epistatic to bcs1 and
      bcs2, and under nonstarvation conditions GCN4 strains showed an increased
      acetolactate synthase activity over gcn4 strains. Thus in addition to general
      regulation of ILV2, GCN4 functions in basal level expression when the locus is
      subject to specific repression by pathway end product.

PMID- 2227407
TI  - An XXY mouse, the result of a rearrangement between one X and a Y chromosome.
AB  - A male mouse with irregular white spotting, typical of piebald, s, arose during
      an experiment designed to search for mutations induced in spermatogonial cells by
      ethylnitrosourea (ENU). On being examined cytologically it was found to carry 40
      chromosomes but was effectively XXY since one of the two X chromosomes present
      was distally fused to a Y chromosome. In common with the previously described XXY
      mice, all of which carried 41 chromosomes, the mouse was sterile with a total
      absence of germ cells. Because of this, it was not possible to determine if the
      white spotting was inherited. The spotting could not be related to any observable
      abnormality of chromosomes known to carry spotting genes, nor could it be linked
      in any way with the X and Y fusion. It was concluded from the cytological
      considerations and the time interval (6 months) that had elapsed between mutagen
      treatment and birth of the offspring, that whereas the spotting was probably the
      result of ENU damage in a spermatogonial stem cell, the XY fusion was probably a
      later and spontaneous event.

PMID- 2227408
TI  - Relative growth of the skull and postcranium in giant transgenic mice.
AB  - Cross-sectional allometric growth patterns of the cranial and postcranial
      skeleton were compared between giant transgenic (MT-rGH) mice and their normal
      littermate controls. Body weights, external body dimensions, and a series of
      cranial and postcranial linear dimensions of the skeleton were determined for
      samples of known age. Comparative bivariate and multivariate allometric analyses
      were completed in order to determine whether (1) the larger transgenic mice
      differed significantly from the normal controls in aspects of body and skeletal
      proportions, and (2) any such proportion differences resulted from general
      allometric effects of overall weight or skeletal size increase. Results
      demonstrate that the transgenic mice do exhibit significantly different body and
      skeletal proportions than normal control adults. Allometric comparisons of the
      skeletal dimensions relative to body weight reveal similar coefficients of growth
      allometry but several differences in gamma-intercept values in the transgenic vs.
      control groups. The comparisons among the skeletal dimensions of the skull and
      postcranium generally reveal the sharing and differential extension of common
      growth allometries in the two groups. Thus, the elevated levels of growth hormone
      (GH) and insulin-like growth factor I (IGF-I) in the transgenic mice appear to
      result in increased overall growth for the various skeletal elements, but in the
      relative proportions determined by intrinsic growth controls within that system.

PMID- 2227409
TI  - In vivo footprint and methylation analysis by PCR-aided genomic sequencing:
      comparison of active and inactive X chromosomal DNA at the CpG island and
      promoter of human PGK-1.
AB  - The promoter region of the X-linked human phosphoglycerate kinase-1 (PGK-1) gene
      is a CpG island, similar to those often found near autosomal genes. We used
      ligation-mediated polymerase chain reaction (PCR) for a genomic sequencing study
      in which 450 bp of the human PGK-1 promoter region was analyzed for the presence
      of in vivo protein footprints and cytosine methylation at all CpG sites. A
      technique was devised to selectively visualize the DNA of the inactive X
      chromosome (Xi), even in the presence of the active X chromosome (Xa). We found
      that the human Xa in both normal male lymphocytes and hamster-human hybrids is
      completely unmethylated at all 120 CpG sites. In contrast, 118 of the CpG sites
      are methylated on the human Xi in hamster-human hybrids. The Xi in normal female
      lymphocytes is also highly methylated, but some GCG or CGC trinucleotides
      partially escape methylation; all other CpGs are fully methylated. In vivo
      footprinting studies with dimethylsulfate (DMS) revealed eight regions of
      apparent protein-DNA contacts on the Xa. Four of the footprints contained the
      consensus sequence of the binding site for transcription factor Sp1. The other
      regions include potential binding sites for transcription factors ATF, NF1, and a
      CCAAT-binding protein. The Xi did not show any specifically protected sequences,
      and with the exception of four hyperreactive sites, the in vivo DMS reactivity
      profile of Xi DNA was very similar to that of purified, linear Xi DNA. The
      implications of these findings with regard to the maintenance of methylation-free
      islands, X chromosome inactivation, and the chromatin structure of facultative
      heterochromatin are discussed.

PMID- 2227410
TI  - Developmentally regulated fetal thymic and extrathymic T-cell receptor gamma
      delta gene expression.
AB  - The gamma delta T-cell receptor (TCR) is the first TCR to be expressed in
      ontogeny in all vertebrates in which it has been examined thoroughly. Murine
      gamma delta cell-surface protein is detected by the fourteenth day of gestation.
      In this work, the activation of gamma delta RNA has been studied. Data indicate
      that the first TCR protein to appear in the thymus is encoded by gamma genes that
      are activated after cells colonize the thymus. However, the sequential appearance
      of different gamma delta TCR proteins during thymic ontogeny cannot be readily
      explained by differential temporal activation of V gamma genes in the thymus.
      There are distinct patterns of gamma and delta gene expression during fetal liver
      development and in the fetal gut (or tissue associated with it). Cells apparent
      in the liver of mice at birth express gamma delta cell-surface protein, but they
      disappear from the liver very soon afterward. One V gamma gene is rearranged and
      expressed prethymically. In addition, gamma gene expression is detectable in the
      livers of newborn athymic mice. Together, these observations indicate a thymic
      independent pathway of activation of TCR genes.

PMID- 2227411
TI  - Human cDNAs encoding homologs of the small p34Cdc28/Cdc2-associated protein of
      Saccharomyces cerevisiae and Schizosaccharomyces pombe.
AB  - The Cks1 protein is a component of the Cdc28 protein kinase in the budding yeast
      Saccharomyces cerevisiae. This paper reports the cloning of two homologs of the
      S. cerevisiae CKS1 gene from human cells. These homologs, CKShs1 and CKShs2, both
      encode proteins of 79 amino acids that share considerable homology at the amino
      acid level with the products of CKS1 from S. cerevisiae and suc1+ from the
      fission yeast Schizosaccharomyces pombe. Both human homologs are capable of
      rescuing a null mutation of the S. cerevisiae CKS1 gene when expressed from the
      S. cerevisiae GAL1 promoter. S. pombe suc1+ expressed from the GAL1 promoter is
      also capable of rescuing a S. cerevisiae cks1 null mutation. Ckshs1 or Ckshs2
      protein linked to Sepharose beads can bind the Cdc28/Cdc2 protein kinase from
      both S. cerevisiae and human cells. The CKShs1 and CKShs2 mRNAs are expressed in
      different patterns through the cell cycle in HeLa cells, which may reflect
      specialized roles for the encoded proteins.

PMID- 2227412
TI  - Transcription of a yeast U6 snRNA gene requires a polymerase III promoter element
      in a novel position.
AB  - Vertebrate genes coding for U6 small nuclear RNA are transcribed by RNA
      polymerase III (pol III), using only upstream promoter elements rather than the A
      and B block internal control regions typical of most pol III transcription units.
      We show that expression of the U6 gene from the yeast Saccharomyces cerevisiae
      has two unexpected features: it requires a B block promoter element, and this
      element is located in a novel position, 120 bp downstream of the coding region.
      In tRNA genes, the B block is the primary binding site for transcription factor
      (TF) IIIC, whose function is to promote the subsequent binding of TFIIIB. Both
      factors are thus implicated in yeast U6 gene transcription. We present a model of
      the U6 transcription complex based on the structure of yeast and vertebrate U6
      promoters.

PMID- 2227413
TI  - Interaction of the human immunodeficiency virus type 1 Rev protein with a
      structured region in env mRNA is dependent on multimer formation mediated through
      a basic stretch of amino acids.
AB  - Interaction of the human immunodeficiency virus type 1 (HIV-1) Rev protein with a
      structured region within env mRNA (termed RRE) mediates the export of virus
      structural mRNAs from the nucleus to the cytoplasm. We show that the region
      encompassing the basic stretch of amino acids is essential for the ability of Rev
      to bind to RRE RNA and function in vivo. By use of a functional truncated Rev
      protein in conjunction with authentic Rev, effects on gel mobilities of the Rev
      RRE RNA complex attributable to multimerization of Rev protein were observed. Rev
      proteins, unable to multimerize, failed to bind RRE RNA. Identification of Rev
      mutants capable of forming multimers, but unable to bind RRE RNA, suggests that
      the multimerization and RNA-binding domains can be distinguished and that
      multimerization is likely a prerequisite for formation of the RRE RNA-binding
      site. A mutant Rev protein, shown previously to function as a trans-dominant
      inhibitor of Rev function, bound to RRE RNA as a multimer to a similar extent as
      wild-type Rev. This observation is consistent with the hypothesis that regulation
      of HIV gene expression by Rev involves the interaction with cellular factors and
      that the trans-dominant Rev is probably defective in this function.

PMID- 2227414
TI  - A bulge structure in HIV-1 TAR RNA is required for Tat binding and Tat-mediated
      trans-activation.
AB  - The Tat protein of human immunodeficiency virus type 1 (HIV-1) trans-activates
      viral gene expression and is obligatory for virus replication. Tat function is
      mediated through a sequence termed TAR that comprises part of the 5'-noncoding
      region of all HIV-1 mRNAs. This region forms a stable stem-loop structure in
      vitro. Recent evidence indicates that Tat binds directly to the TAR RNA sequence,
      and this binding is independent of the nucleotide sequence in the loop but
      dependent on the integrity of the upper stem. We used the electrophoretic
      mobility-shift assay to identify the sequence and structure specificity of this
      interaction and its correlation with Tat trans-activation. We show that a 3
      nucleotide bulge structure (positions +23 to +25) in TAR RNA is important for
      both Tat interaction with TAR RNA and Tat-mediated trans-activation of gene
      expression. Single base substitutions at position +23 that impair Tat-mediated
      trans-activation in vivo also reduce binding of Tat to TAR in vitro, suggesting
      that the first uridine residue in the bulge is the critical base for both
      functions. In contrast, mutations in the loop (positions +31 to +34) and the stem
      (positions +9 to +12 and +49 to +52), which reduce Tat-mediated trans-activation,
      had no effect on Tat binding. We also show that a Tat peptide that includes the
      basic region required for nucleolar localization binds to TAR RNA with the same
      specificity as the full-length protein. We conclude that Tat binding to TAR is
      necessary but not sufficient by itself to account for trans-activation.

PMID- 2227415
TI  - Trypanosome variable surface glycoproteins: composite genes and order of
      expression.
AB  - Combinatorial processes increase the diversity of variable surface glycoproteins
      (VSGs) expressed by Trypanosoma equiperdum. We show here that a single telomeric
      pseudogene provides the 3' portion of three distinct T. equiperdum VSG genes by
      recombination with different 5' donor pseudogenes. Regions of sequence homology
      among the pseudogenes determine the sites of recombination in the formation of
      the expressed copies. This suggests that the recombination between any given
      basic copy (BC) and the expression-linked copy (ELC) depends on their sharing
      homology. We present evidence that this is the case and propose that such rules
      account for the order of expression of the VSGs. These results demonstrate how
      homologous recombination can generate an ordered sequence of gene expression.

PMID- 2227416
TI  - The b mating-type locus of Ustilago maydis contains variable and constant
      regions.
AB  - The b locus of the phytopathogenic fungus Ustilago maydis encodes a multiallelic
      recognition function that controls the ability of the fungus to form a dikaryon
      and complete the sexual stage of the life cycle. The b locus has at least 25
      alleles and any combination of two different alleles, brought together by mating
      between haploid cells, allows the fungus to cause disease and undergo sexual
      development within the plant. An open reading frame of 410 amino acids has been
      shown to specify a polypeptide responsible for the activity of the b1 allele, and
      comparisons of the predicted amino acid sequences for 6 b alleles allowed
      identification of variable and constant regions within the coding region of the
      gene. Haploid strains carrying a null mutation at the b locus, created by gene
      disruption, are viable but fail to interact with formerly compatible strains to
      give an infectious dikaryon. Analysis of mutants carrying a null allele indicated
      that the products of different alleles of the b locus combine to form a new
      regulatory activity and that this activity directly or indirectly turns on the
      pathway leading to sexual development and pathogenesis.

PMID- 2227417
TI  - Identification of two polypeptide segments of CCAAT/enhancer-binding protein
      required for transcriptional activation of the serum albumin gene.
AB  - We used molecular genetic methods to generate systematically altered forms of
      CCAAT/enhancer-binding protein (C/EBP). The aim of our experiments was to
      identify regions of C/EBP that contribute to its capacity to activate
      transcription from the promoter of the serum albumin gene in cultured hepatoma
      cells. Earlier experiments had shown that the DNA-binding domain must remain
      intact for C/EBP to activate albumin transcription. We now provide evidence of
      two additional elements of C/EBP that are required for its gene-activating role.
      One such element occurs within a 28-residue region located close to the amino
      terminus of the protein. The other maps to a broader, more internal region of the
      protein and appears to exhibit functional redundancy. These newly defined
      elements of C/EBP exhibit two characteristics of "activation" domains delineated
      in studies of other gene regulatory proteins. First, they play no obvious role in
      the capacity of C/EBP to bind to its DNA substrate. Second, they retain function
      after being appended onto the DNA-binding domain of a different protein. Neither
      of these putative activating elements is characterized by overt distinction in
      either charge or preponderance of any particular amino acid. The more amino
      terminal element does, however, exhibit several features suggesting that it may
      assume an alpha-helical structure. These studies offer observations and reagents
      that will be valuable for future studies concerning the physiologic function of
      C/EBP.

PMID- 2227418
TI  - HNF-3A, a hepatocyte-enriched transcription factor of novel structure is
      regulated transcriptionally.
AB  - Hepatocyte-specific gene expression requires the interaction of many proteins
      with multiple binding sites in the regulatory regions. HNF-3 is a site found to
      be important in the maximal hepatocyte-specific expression of several genes. We
      find that liver nuclear extracts contain three major binding activities for this
      site, which we call HNF-3A, HNF-3B, and HNF-3C. Purification from rat liver
      nuclear extracts of HNF-3A and HNF-3C reveals that each activity corresponds to a
      distinct polypeptide, as determined by SDS-PAGE. Peptide sequence derived from
      the most abundant species, HNF-3A, was used for synthesizing probes with which to
      isolate a cDNA clone of this protein. The encoded protein contains 466 amino
      acids (48.7 kD) and has binding properties identical to those of the purified
      protein. A 160-amino-acid region that does not resemble the binding domain of any
      known transcription factor is essential for DNA binding. The mRNA for HNF-3A is
      present in the rat liver but not in brain, kidney, intestine, or spleen, and the
      basis for this difference is cell-specific regulation of HNF-3A gene
      transcription.

PMID- 2227419
TI  - Isolation and characterization of a Ustilago maydis glyceraldehyde-3-phosphate
      dehydrogenase-encoding gene.
AB  - The complete nucleotide sequence of the glyceraldehyde-3-phosphate dehydrogenase
      gene from the corn smut fungus Ustilago maydis is reported. The gene encodes a
      337-amino acid protein, parts of which show sequence identity to corresponding
      regions of GAPDH-encoding genes from other organisms. A single, putative 407-bp
      intron interrupts the tenth codon. Codon usage is highly biased for codons ending
      in cytosine.

PMID- 2227420
TI  - Characterization of a gene encoding a manganese peroxidase from Phanerochaete
      chrysosporium.
AB  - The complete nucleotide (nt) sequence of a gene (mnp-1) encoding manganese
      peroxidase isozyme 1 (MnP-1) (pI = 4.9) from Phanerochaete chrysosporium has been
      determined. The sequence of 2539 bp includes 526 bp of 5'-flanking sequence and
      368 bp 3' to the poly(A) site. Comparison of cDNA and genomic sequences indicates
      six introns varying in size from 57-72 bp. Intron splice-junction sequences all
      adhere to the GT---AG rule. The positions of the introns show little similarity
      to the intron positions in the closely related lignin peroxidase-encoding genes.
      The 5' upstream region of the mnp-1 gene contains a TATAA element and three
      inverted CCAAT elements (ATTGG) at nt positions -81, -181, -195, and -304,
      respectively, relative to the start codon. In addition, the mnp-1 gene contains
      three putative heat-shock (HS) elements similar to the consensus C--GAA--TTC--G
      sequence, and two consensus metal response elements located within 500 bp
      upstream from the start codon. Furthermore, Northern-blot analysis demonstrates
      that mnp gene transcription is regulated by HS.

PMID- 2227421
TI  - Use of uracil DNA glycosylase to control carry-over contamination in polymerase
      chain reactions.
AB  - Polymerase chain reactions (PCRs) synthesize abundant amplification products.
      Contamination of new PCRs with trace amounts of these products, called carry-over
      contamination, yields false positive results. Carry-over contamination from some
      previous PCR can be a significant problem, due both to the abundance of PCR
      products, and to the ideal structure of the contaminant material for re
      amplification. We report that carry-over contamination can be controlled by the
      following two steps: (i) incorporating dUTP in all PCR products (by substituting
      dUPT for dTTP, or by incorporating uracil during synthesis of the
      oligodeoxyribonucleotide primers; and (ii) treating all subsequent fully
      preassembled starting reactions with uracil DNA glycosylase (UDG), followed by
      thermal inactivation of UDG. UDG cleaves the uracil base from the phosphodiester
      backbone of uracil-containing DNA, but has no effect on natural (i.e., thymine
      containing) DNA. The resulting apyrimidinic sites block replication by DNA
      polymerases, and are very labile to acid/base hydrolysis. Because UDG does not
      react with dUTP, and is also inactivated by heat denaturation prior to the actual
      PCR, carry-over contamination of PCRs can be controlled effectively if the
      contaminants contain uracils in place of thymines.

PMID- 2227422
TI  - The pAX plasmids: new gene-fusion vectors for sequencing, mutagenesis and
      expression of proteins in Escherichia coli.
AB  - A family of plasmid cloning vectors have been constructed, allowing both the
      sequencing and mutagenesis of foreign genes and the easy isolation of their
      expression products via fusion proteins in Escherichia coli. Fusion proteins can
      be inducibly expressed and isolated by affinity chromatography on APTG-Sepharose.
      The fusion protein consists of beta-galactosidase at the N-terminus, linked by a
      collagen 'hinge' region containing blood coagulation factor Xa cleavage site to
      the foreign protein at the C terminus. The factor Xa cleavage site at the N
      terminal side of the foreign protein allows the release of the desired amino acid
      sequence under mild conditions. A multiple cloning site in all three reading
      frames and stop codons followed by the strong lambda t0 terminator facilitate
      simple gene insertions and manipulations. The intergenic region of the phage f1
      inserted in both orientations allows the isolation of single-stranded DNA from
      either plasmid-strand for sequencing and mutagenesis. This vector family has been
      successfully used for the expression and purification of the isoleucyl-tRNA
      synthetase from Saccharomyces cerevisiae and the histidyl-tRNA synthetase from E.
      coli.

PMID- 2227423
TI  - Construction of mobilizable vectors derived from plasmids RP4, pUC18 and pUC19.
AB  - Mobilizable narrow-host-range plasmids were constructed from pUC18 and pUC19 by
      addition of a segment of pSUP2021 bearing the basis of mobilization (bom) site
      and origin of transfer (oriT) of RP4. One pair of expression vectors, pARO180 and
      pARO190, retains the beta-lactamase (bla) gene and twelve of the 13 restriction
      enzyme multiple cloning sites (MCS) of pUC18/19. Another pair was created by
      replacing the bla gene with the gene encoding kanamycin resistance (kan) from
      Tn5. The molecules replicate to high copy number in Escherichia coli and
      Enterobacter aerogenes. They can be transferred efficiently to other Gram-
      bacteria from the mobilizing strain, E. coli S17-1. In non-enteric strains, the
      new plasmids can be used as suicide vectors in site-specific insertional
      mutagenesis.

PMID- 2227424
TI  - Construction of cloning vectors using the Vibrio harveyi luminescence genes luxA
      and luxB as markers.
AB  - A synthetic oligodeoxyribonucleotide harboring four new restriction sites was
      inserted into the luxB gene of Vibrio harveyi. This insertion did not disrupt the
      reading frame. An active beta-subunit was synthesized since a plasmid with both
      the luxA and mutated luxB genes conferred upon Escherichia coli the bacterial
      luciferase (Lux) phenotype in the presence of an aldehyde. Ligation of a piece of
      foreign DNA at these new cloning sites in the vector extinguish the Lux phenotype
      of the transformed bacteria. Therefore, the plasmid was used as a cloning vector,
      and recombinant DNA-containing bacteria were detected by the loss of
      bioluminescence. To create more versatile plasmids, the intergenic region of
      phage f1 was inserted outside of the lux genes. The selection by loss of
      bioluminescence presents several advantages over the white/blue selection of the
      lacZ gene on indicator plates.

PMID- 2227425
TI  - Nucleotide sequence of mkaD, a virulence-associated gene of Salmonella
      typhimurium containing variable and constant regions.
AB  - We have identified the nucleotide (nt) sequence of mkaD, a virulence-associated
      gene of the Salmonella typhimurium virulence plasmid, pEX102. The gene shows 98%
      homology on nt sequence level to mkfA, a corresponding gene of the S. typhimurium
      virulence plasmid pIP1350. The few nt changes, however, caused more extensive
      changes on the amino-acid level. The differences between mkaD and mkfA were
      clustered in distinct variable regions rather than being randomly scattered along
      the sequence. A third salmonellar virulence plasmid, pLT2, contained an mkaD gene
      identical to that of pEX102. Our observation suggests that the conserved
      virulence determinant on the plasmids of Salmonellae may contain different
      alleles of the same gene.

PMID- 2227426
TI  - Multiple endo-beta-1,4-glucanase-encoding genes from Bacillus lautus PL236 and
      characterization of the celB gene.
AB  - A Bacillus lautus strain was isolated from compost by its ability to degrade
      microcrystalline Avicel cellulose and acid-swollen cellulose. Three DNA fragments
      cloned in Escherichia coli encoded at least four endo-beta-1,4-glucanases (EG),
      of which at least two were contained on one DNA fragment. Another fragment, of
      2.5 kb and carrying celB, was cloned in the shuttle-vector plasmid, pJKK3-1, and
      expressed in E. coli and Bacillus subtilis. The fragment was sequenced and shown
      to encode a 62-kDa protein, which was found as a 56-kDa mature and active EG in
      extracts of E. coli and in the supernatant of B. subtilis. The deduced amino acid
      (aa) sequence has a homology of 37% identical aa on a stretch of 295 aa to EG-E
      of Clostridium thermocellum. A low level of homology is detected with the
      Bacillus-type EG.

PMID- 2227428
TI  - Resistance to pactamycin in clones of Streptomyces lividans containing DNA from
      pactamycin-producing Streptomyces pactum.
AB  - A pactamycin (Pc)-resistance determinant (pct) from Streptomyces pactum has been
      isolated on a 4.9-kb KpnI fragment. The original construct involving plasmid
      pIJ702 was highly unstable in Streptomyces lividans, leading to deletion of the
      pct gene from the vector. Subcloning of pct into an alternative vector (pOJ160)
      led to the generation of a more stable clone which possessed Pc-resistant
      ribosomes, and reconstitution analysis established that 16S rRNA was responsible
      for such resistance. Post-transcriptional modification of rRNA is probably the
      mechanism of resistance since the cloned DNA fragment did not appear to encode
      16S rRNA.

PMID- 2227427
TI  - Development of a cloning system in Mycoplasma pulmonis.
AB  - A system suitable for recombinant DNA manipulation in mycoplasmas was developed
      using the cloned antibiotic-resistance genes of Tn4001 and Tn916. An integrative
      plasmid containing one of the resistance markers was inserted into the genome of
      Mycoplasma pulmonis to form a recipient strain. This was accomplished by
      transformation and homologous recombination between chromosomal DNA sequences
      cloned onto the integrative plasmid. A second vector, the cloning vector,
      containing the same plasmid replicon and alternate resistance marker, carried
      cloned foreign DNA. When transformed into mycoplasmal recipients, homologous
      recombination between plasmid sequences resulted in integration of the cloning
      vector and foreign DNA. A Brucella abortus gene coding for a 31-kDa protein and
      the P1 structural gene and operon from Mycoplasma pneumoniae were introduced to
      examine the feasibility of developing mycoplasma as cloning hosts. Recombinant
      plasmids as large as 20 kb were inserted into M. pulmonis, and the integrated
      foreign DNA was stably maintained. The maximum size of clonable DNA was not
      determined, but plasmids larger than 22 kb have not been transformed into
      mycoplasmas using polyethylene glycol. Also the size of genome (800-1200 kb) may
      affect the stability of larger inserts of foreign DNA. This system is applicable
      to any mycoplasma capable of transformation, homologous recombination and
      expression of these resistance markers. Because of their lack of a cell wall,
      mycoplasmas may be useful cloning hosts for membrane or excreted protein genes
      from other sources.

PMID- 2227429
TI  - Cloning and expression of two genes encoding highly homologous hemolysins from a
      Kanagawa phenomenon-positive Vibrio parahaemolyticus T4750 strain.
AB  - We have cloned and sequenced the gene encoding thermostable direct hemolysin
      (TDH), a possible virulence factor in Vibrio parahaemolyticus gastroenteritis,
      from a Kanagawa-phenomenon-positive strain, T4750. This strain was found to
      contain two sequences (tdhA and tdhS) homologous to the tdh gene previously
      reported by Nishibuchi and Kaper [J. Bacteriol 162 (1985) 558-564] and Taniguchi
      et al. [Microb. Pathog. 1 (1986) 425-432]. Sequence homology of the coding regior
      between tdhA and tdhS was 97.2%. The deduced amino acid (aa) sequence of TdhA,
      excluding the putative signal peptide was identical to that of TDH protein
      purified from V. parahaemolyticus [Tsunasawa et al., J. Biochem. 101 (1987) 111
      121] except for Glu118 instead of Gln118. Although the aa sequence deduced from
      the second gene, tdhS, differed in eight residues from the TDH protein, it agreed
      with the sequence of Tdh deduced from the previously cloned tdh gene. Both tdhA
      and tdhS expressed biologically active hemolysins in Escherichia coli. While the
      apparent molecular size of TDH purified from a culture supernatant of V.
      parahaemolyticus T4750 was identical to TdhA protein synthesized in E. coli, it
      was larger than TdhS. Only one band was detected in the culture supernatant of V.
      parahaemolyticus T4750 by Western blotting; its mobility was indistinguishable
      from that of purified TDH. These data suggest that tdhA is the structural gene
      for TDH found in the culture supernatant of V. parahaemolyticus T4750, and that
      there was only partial, if any, tdhS expression in the strain T4750 under the
      test conditions employed.

PMID- 2227430
TI  - Cloning and expression in a heterologous host of the complete set of genes for
      biosynthesis of the Streptomyces coelicolor antibiotic undecylprodigiosin.
AB  - A fragment of DNA carrying the hitherto unisolated members of the cluster of
      genes (red) for biosynthesis of the red-pigmented antibiotic undecylprodigiosin
      of Streptomyces coelicolor A3(2) was isolated. This was done by cloning random
      fragments of S. coelicolor DNA into the closely related Streptomyces lividans 66
      and recovering a clone that caused overproduction of undecylprodigiosin. The
      effect was probably due to the presence of the cloned redD gene, which functions
      as a positive regulator of the expression of the red cluster, activating the
      normally poorly expressed red genes of S. lividans. Two fragments from either end
      of the red cluster were cloned adjacent to each other on a low-copy-number
      Streptomyces vector. Double crossing-over occurring between these plasmid-borne
      sequences and the chromosomal copy of the same DNA in S. coelicolor led to
      isolation of the entire red cluster as a single cloned fragment. Isolation of
      antibiotic biosynthetic genes by the effects of an activator in a self-cloning
      experiment, and in vivo reconstitution of a large cluster of genes by homologous
      recombination, may turn out to be usefully generalizable procedures.

PMID- 2227431
TI  - Organization and transcription of Volvox histone-encoding genes: similarities
      between algal and animal genes.
AB  - The nucleotide sequences of two non-allelic histone H2A-H2B gene loci of the
      green alga Volvox carteri have been determined. Each locus contains a divergently
      arranged H2A-H2B gene pair. The encoded proteins differ in one (H2A) and 16
      positions (H2B), respectively. The coding regions are separated by short
      intercistronic segments (256 bp and 298 bp) containing TATA boxes and a central
      tandem repeat of a conserved 20-bp element as the putative histone-specific
      transcription signals. The 3'-untranslated regions exhibit a characteristic 3'
      palindrome and weakly conserved spacer elements. Transcription in one gene locus
      was shown to initiate 48 bp upstream from H2A and 59 bp upstream from H2B.
      Contrary to higher plants, V. carteri histone mRNAs are nonpolyadenylated. S1
      mapping and Northern-blotting experiments indicated that V. carteri histone mRNAs
      are terminated at the 3'-palindrome by the same mechanism that operates in
      vertebrates and sea urchins.

PMID- 2227432
TI  - Two evolutionarily divergent genes encode a cytoplasmic ribosomal protein of
      Arabidopsis thaliana.
AB  - Two clones of Arabidopsis thaliana possessing high sequence identity to the yeast
      gene encoding ribosomal (r) protein L3 were isolated by heterologous DNA
      hybridization. The coding regions of these two clones have approx. 63% amino acid
      (aa) sequence identity to the yeast L3 r-protein and 85% aa sequence identity to
      each other. Both genes are expressed in shoots. The presence of two divergent
      genes in A. thaliana raises the possibility that the gene products participate in
      the formation of functionally distinct ribosomes.

PMID- 2227433
TI  - Biologically active A-chain of the plant toxin ricin expressed from a synthetic
      gene in Escherichia coli.
AB  - To assess the biological activity and pharmacokinetic properties of
      nonglycosylated ricin A-chain (RA), we have obtained the polypeptide following
      expression of a synthetic 842-bp RA gene in Escherichia coli. Expression of the
      gene was carried out using the phage T5 PN25 promoter fused to the E. coli lac
      operator. The RA polypeptide was synthesized in a completely soluble form and was
      purified in one step by immunoabsorption. It was shown to be as cytotoxic for a
      human cell line as both native RA and chemically deglycosylated native RA.
      Reconstituted whole ricin and an immunotoxin containing the recombinant RA were
      also biologically active. Immunotoxins made with recombinant and deglycosylated
      RA had similar clearance rates in vivo showing, after a short period of rapid
      elimination, stabilities far higher than that of an immunotoxin made with native
      RA. Our results show that the complete elimination of sugar side chains from the
      RA is not sufficient to entirely eradicate the rapid initial in vivo clearance of
      RA-based biologicals.

PMID- 2227434
TI  - Two highly reiterated nucleotide sequences in the low C-value genome of
      Panagrellus redivivus.
AB  - Two families of highly reiterated satellite nucleotide (nt) sequences have been
      found in the genome of the sexually separated nematode Panagrellus redivivus. The
      repeats are arranged in tandem arrays but the different satellites are not
      intermingled. Monomeric lengths are of 155 bp for one kind and 167 bp for the
      other; they were named E155 and E167. The A + T content is elevated in both
      families (i.e., 59.5%, and 65.3%, respectively). No similarity was found between
      the two satellites nor to other known highly repetitive elements. Furthermore, nt
      methylation as well as transcriptional activity were negative. An internal
      subrepeating unit, about 30 bp long, was observed in E167, implying that it could
      have evolved from a shorter sequence. Reiteration frequencies are approx. 30,000
      and 40,000 copies per haploid genome, for E155 and E167, respectively,
      constituting together about 17% of the total DNA. This figure is astonishingly
      high, considering a C-value of 70,000 kb in P. redivivus, which is thought to be
      the lower limit for metazoans. Hence, the genome complexity is approx. 58,000 kb.
      In contrast to the nematodes Ascaris lumbricoides and Parascaris equorum,
      however, P. redivivus does not seem to eliminate large blocks of satellite DNA in
      the presomatic cells during early development.

PMID- 2227435
TI  - Isolation and characterization of the gene encoding bovine adenylate kinase
      isozyme 2.
AB  - Mitochondrial adenylate kinase isozyme 2 (AK2) exists in two isoforms, AK2A and
      AK2B, which have the same amino-acid sequence except for the C-terminal portion.
      We have isolated the gene encoding AK2 from a bovine genomic library. The gene
      covers about 25 kb and consists of seven exons and six introns. The nucleotide
      sequences from exon 1 to the 5' half of exon 6 encode the portion common to AK2A
      and AK2B, while the sequences of the 3' half of exon 6 and exon 7 direct the
      unique portions of AK2A and AK2B, respectively. Therefore, an alternative
      splicing mechanism is suggested in generating two types of mRNA encoding AK2A and
      AK2B. The 5'-flanking region of the gene lacks a TATA box, but contains three
      CAAT boxes. The G + C content of this region is high and eight copies of GC box
      are found. These features of the promoter region resemble those of 'housekeeping'
      genes. S1 mapping and primer extension analyses revealed multiple transcription
      start points. The 581-bp region just upstream from the start codon functions as a
      promoter in the expression of the cat gene in Chinese hamster ovary cells.

PMID- 2227436
TI  - A novel expression vector for high-level synthesis and secretion of foreign
      proteins in Escherichia coli: overproduction of bovine pancreatic phospholipase
      A2.
AB  - A novel expression plasmid (pTO-N) has been constructed that allows for the
      production of large quantities of foreign proteins (or fragments thereof) in an
      unfused state. The vector has a strong and tightly regulated T7 gene 10 promoter
      and the ompA Shine-Dalgarno (SD) sequence, followed by the ompA sequence and a
      cloning linker region. The mRNAs produced by the vector are protected by
      secondary structures at both ends of the mRNAs. The OmpA signal peptide directed
      the synthesized proteins into the periplasmic space of Escherichia coli.
      Phospholipase A2 and prophospholipase A2 from bovine pancreas have been produced
      to a high level by using this expression vector. One additional feature, which is
      essential for the stable maintenance of the plasmid in the E. coli expression
      host, BL21 (DE3)[pLysS], is the shortened distance between the 5' secondary
      structure sequence (immediately following the gene 10 promoter) and the SD
      sequence. This vector could be particularly useful for synthesis of toxins in E.
      coli.

PMID- 2227437
TI  - Molecular cloning and characterization of rat liver catechol-O-methyltransferase.
AB  - The coding sequence of rat liver catechol-O-methyl-transferase (COMT; EC 2.1.1.6)
      was determined from rat cDNA and genomic libraries were screened with DNA probes
      and specific antiserum. The open reading frame consisted of 663 nucleotides
      coding for a 221-amino acid (aa) polypeptide with a deduced Mr of 24,747. No
      obvious hydrophobic signal sequence, membrane-spanning domains, or potential N
      glycosylation sites were found in this sequence. The identity of the clone and
      the accuracy of the sequence was verified by direct aa sequencing of the tryptic
      peptides derived from the purified rat liver enzyme. Primer extension analysis
      showed that the transcription start point of the rat liver COMT mRNA was 450 bp
      upstream from the translation start codon. A putative polyadenylation signal
      (ATTAAA) was found in the 3'-noncoding region. The predicted size of the COMT
      transcript was 1.8-2.0 kb, which could be confirmed from Northern hybridization
      analyses of the isolated rat liver mRNA. One polypeptide of 25 kDa, could be
      immunoprecipitated with anti-COMT antibody from in vitro translation of rat liver
      mRNA. Employing the DNA blot analysis only one COMT-encoding gene was found in
      the rat genome.

PMID- 2227438
TI  - Cloning and functional analysis of the rat ornithine decarboxylase-encoding gene.
AB  - We have isolated a functional gene (ODC) encoding rat ornithine decarboxylase
      (ODC; EC 4.1.1.17) from a partial rat liver genomic DNA bank. The entire gene is
      located on a 7776-bp BamHI fragment and was shown to comprise twelve exons, of
      which ten encode the ODC protein (exons III-XII). Introduction of the BamHI
      fragment into an ODC-deficient hamster cell line restores ODC activity,
      indicating that the gene is functional. Comparison of the structure and
      nucleotide (nt) sequence of the rat ODC gene with recently reported mouse ODC
      genes, reveals that the gene is highly conserved. Primer extension analysis and
      RNA sequencing demonstrates that the transcription start point of rat ODC mRNA is
      located 303 nt upstream from the A residue in the start codon. Compared with our
      previously published sequence of the rat ODC cDNA, this indicates that a short
      sequence at the extreme 5' end of our cDNA clone represents a cloning artefact.
      The correct 5' leader of ODC mRNA, which is very G + C rich (62%), can be folded
      into a highly stable secondary structure, which may play a role in the
      translational control of ODC activity. Like in mouse, the promoter region of rat
      ODC is also extremely rich in G + C, and contains a TATA box and several putative
      SP1-binding sites. Possible binding sites for other transcription factors, like
      AP-1, AP-2 and CREB, can also be observed in the promoter region and, moreover,
      in the first intron.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227440
TI  - Rapid two-stage polymerase chain reaction amplification of chromosomal DNA
      segments in lysates made from monolayer cultures attached to microcarrier beads.
AB  - We describe a method for the rapid two-stage amplification and detection by
      ethidium bromide staining of chromosomal nucleotide (nt) sequences in lysates
      made directly from anchorage-dependent cells attached to microcarrier beads. The
      procedure circumvents the need for cell detachment steps prior to analysis,
      facilitates the collection, transfer, and manipulation of the cells being
      studied, and makes unnecessary the use of Southern-blot hybridization for
      identification of specific nt sequences present in a small fraction of cells
      within a heterogeneous population.

PMID- 2227439
TI  - Human ornithine decarboxylase-encoding loci: nucleotide sequence of the expressed
      gene and characterization of a pseudogene.
AB  - Previous studies have shown that human ornithine decarboxylase (ODC)-encoding
      sequences map to two chromosome regions: 2pter-p23 and 7cen-qter. In the present
      work we have cloned the expressed human ODC gene from a genomic library of
      myeloma cells that overproduce ODC protein due to selective gene amplification
      and determined its entire nucleotide sequence. The gene comprises 12 exons and 11
      introns and spans about 8 kb of chromosome 2 DNA. The organization of the human
      gene is very similar to that of the mouse and rat, with the major difference
      being the presence of longer intronic sequences in the human gene. Some of these
      differences can be accounted for by the insertion of four Alu sequences in the
      human gene. Several potential regulatory elements are present in the promoter
      region and in 5'-proximal introns, including a TATA box; GC boses; AP-1-, AP-2-
      and NF-1-binding sites; and a cAMP-responsive element. The 5'-untranslated
      sequence of ODC mRNA is extremely GC-rich, and computer predictions suggest a
      very stable secondary structure for this region, with an overall free energy of
      formation of -225.4 kcal/mol. In addition to the active ODC gene on chromosome 2,
      ODC gene-related sequences were isolated from human chromosome 7-specific
      libraries and shown to represent a processed ODC pseudogene.

PMID- 2227442
TI  - Evolutionary conservation of target sequences for cis-acting regulation in c-myc
      exon 1 and its upstream region.
AB  - Transcriptional control of the c-myc proto-oncogene, an important factor in
      cellular growth, differentiation and in the genesis of various neoplasms, is
      mediated by multiple positive and negative regulators in the 5' end region of the
      gene. Here, we report the nucleotide sequence of the first c-myc exon and its
      upstream region from woodchuck, a rodent which can develop liver tumors
      associated with c-myc activation [Moroy et al., Nature 324 (1986) 276-279].
      Alignment of these sequences with the corresponding human and murine regions
      shows a surprisingly high homology between woodchuck and human, and suggests the
      absence of species-specificity in the fundamental regulatory elements which
      govern c-myc expression.

PMID- 2227441
TI  - The primary structure of rat ribosomal protein L9.
AB  - The amino acid (aa) sequence of rat ribosomal (r) protein L9 was deduced from the
      nucleotide (nt) sequence in a recombinant cDNA and confirmed from the N-terminal
      aa sequence of the protein. L9 contains 192 aa and has an Mr of 21879.
      Hybridization of the cDNA to digests of nuclear DNA suggests that there are 20-23
      copies of the L9 gene. The mRNA for the protein is about 800 nt in length. Rat L9
      is related to Saccharomyces cerevisiae YL11, Methanococcus vannielii L6,
      Escherichia coli L6 and other members of the prokaryotic L6 family. The protein
      contains a possible internal duplication of 11 aa.

PMID- 2227443
TI  - Characterization and nucleotide sequence of the gene encoding the human pyruvate
      dehydrogenase alpha-subunit.
AB  - Genomic clones encompassing the entire gene (PDH alpha) encoding the human
      pyruvate dehydrogenase alpha-subunit (PDH alpha) have been isolated by screening
      a leukocyte genomic library in the cloning vector, lambda EMBL4. The PDH alpha
      gene spans 17082 bp and is composed of eleven exons and ten introns. All
      intron/exon splice junctions follow the GT/AG rule. A total of seven Alu repeats
      were found in five introns. The entire nucleotide (nt) sequence of the PDH alpha
      gene has been determined and typical consensus promoter sequences in the 5'
      flanking region were found. The results of primer extension analysis imply that
      the PDH alpha gene transcription start point (tsp) is a thymine residue 124 bp
      upstream from the ATG start codon in exon 1. The structural organization and the
      tsp were compared with the recent report [Maragos et al., J. Biol. Chem. 264
      (1989) 12294-12298]. Analysis of the PDH alpha gene resolves existing
      discrepancies among four published sequences of PDH alpha cDNAs. A 93-bp sequence
      that was missing in our sequence of cultured foreskin fibroblast PDH alpha cDNA
      [Koike et al., Proc. Natl. Acad. Sci. USA 85 (1988) 41-45] was identified in the
      gene as exon 6.

PMID- 2227444
TI  - The proximal 5'-flanking region of the gene encoding human growth hormone
      releasing factor contains an inserted Alu sequence.

PMID- 2227445
TI  - A totally synthetic plasmid for general cloning, gene expression and mutagenesis
      in Escherichia coli.
AB  - A first totally synthetic Escherichia coli plasmid has been designed, constructed
      and shown to be a functional, stable, high-copy cloning vector. The FokI method
      of gene synthesis [Mandecki and Bolling, Gene 68 (1988) 101-107] was used to
      assemble the plasmid from 30 oligodeoxyribonucleotides. The plasmid contains
      synthetic modules for the beta-lactamase-encoding gene (bla), replication origin,
      lacZ gene fragment and multicloning site. The plasmid is patterned after the pUC
      type plasmids and has a copy number similar to that of pUC plasmids. The major
      changes introduced include the removal of nearly 50% of the restriction sites
      present in pUC plasmids, reduction of plasmid size to 2050 bp, and introduction
      of transcription terminators downstream from both the bla gene and lacZ fragment.
      The changes facilitate a number of techniques, such as cloning, mutagenesis,
      expression and restriction analysis.

PMID- 2227446
TI  - Sequence comparison of mecA genes isolated from methicillin-resistant
      Staphylococcus aureus and Staphylococcus epidermidis.

PMID- 2227447
TI  - The structure of the trpE, trpD and 5' trpC genes of Bacillus pumilus.

PMID- 2227448
TI  - Nucleotide sequences of genes encoding heat-stable and heat-labile glyceraldehyde
      3-phosphate dehydrogenases; amino acid sequence and protein thermostability.

PMID- 2227449
TI  - Chloramphenicol resistance in Campylobacter coli: nucleotide sequence,
      expression, and cloning vector construction.
AB  - A chloramphenicol-resistance determinant (CmR), originally cloned from
      Campylobacter coli plasmid pNR9589 in Japan, was isolated and the nucleotide
      sequence determined, which contained an open reading frame of 621 bp. The gene
      product was identified as Cm acetyltransferase (CAT), which had a putative amino
      acid sequence that showed 43% to 57% identity with other CAT proteins of both
      Gram+ and Gram- origin. Although expression of the cat gene was constitutive in
      both C. coli and Escherichia coli, results of primer extension experiments
      indicated that transcription was initiated at different sites in these two
      species. A kanamycin-resistance determinant, identified as the aphA-3 gene, was
      located downstream from the cat gene. The codon usage of the cat gene is very
      different from that used in E. coli, however, the CAT polypeptide was synthesized
      in large amounts in E. coli maxicells. Therefore, the codon usage bias is not one
      of the obstacles which affects Campylobacter spp. gene expression in E. coli. New
      Campylobacter cloning vectors were constructed in this study.

PMID- 2227450
TI  - Cloning and characterization of the asd gene of Salmonella typhimurium: use in
      stable maintenance of recombinant plasmids in Salmonella vaccine strains.
AB  - The asd mutants of Salmonella typhimurium have an obligate requirement for
      diaminopimelic acid (DAP) and will undergo lysis in environments deprived of DAP.
      This has allowed the development of a balanced-lethal system for the expression
      of heterologous antigens in vaccine strains using vectors containing the wild
      type asd gene from Streptococcus mutans and asd mutant Salmonella hosts [Nakayama
      et al., Biotechnology 6 (1988) 693-697]. We have cloned the asd gene from S.
      typhimurium, characterized the gene product and used this gene to construct Asd+
      expression cloning vectors. In addition we have constructed an asd cassette and a
      transposon derived from Tn5 that allow the rapid modification of other vectors
      for use with delta asd vaccine strains of S. typhimurium adding versatility to
      the Asd+ vector/delta asd host system of plasmid maintenance.

PMID- 2227451
TI  - Cloning, expression and characterization of the Sau3AI restriction and
      modification genes in Staphylococcus carnosus TM300.
AB  - The genes encoding the restriction enzyme (ENase) and modification enzyme (MTase)
      of Staphylococcus aureus 3A (recognition sequence 5'-GATC-3') have been cloned in
      Staphylococcus carnosus TM300 using the vector pCA44. Clones carrying both genes
      were isolated from DNA libraries prepared with MboI + BamHI. The DNA region
      encoding M.Sau3AI was subcloned on a 3.66-kb EcoRV fragment in vector pT181mcs.
      Plasmids purified from the clones were resistant to digestion with Sau3AI,
      indicating that the sau3AIM gene was expressed and the product was functional in
      S. carnosus. Cell lysates of clones with both activities encoded on plasmid
      pSEM7, cut DNA with the same pattern as Sau3AI, showing that the sau3AIR gene was
      also expressed and the ENase was functional in S. carnosus. Sequence analysis
      shows that both genes are transcribed in the same direction and encode
      polypeptides with calculated Mrs of 56,477 for R.Sau3AI and 47,300 for M.Sau3AI.
      Efforts to clone one or both genes in Escherichia coli have so far failed.

PMID- 2227452
TI  - Construction of a series of pSAM2-based integrative vectors for use in
      actinomycetes.
AB  - We have developed vectors which allowed integration of cloned DNA at a single
      site in the chromosome of Streptomyces lividans 66. These vectors made use of (1)
      an Escherichia coli replicon, (2) a thiostrepton (Th)- and a
      streptomycin/spectinomycin-resistance gene for selection in Streptomyces, (3) a
      3.5-kb fragment of the Streptomyces integrative plasmid pSAM2 containing its xis
      and int genes as well as its attachment site, attP, to direct the integration of
      the vectors at the chromosomal pSAM2 attachment site attB, (4) the origin of
      transfer of the IncP broad-host-range plasmid RK2 which allowed the mobilization
      of the vectors from E. coli to S. lividans, and (5) the Th-inducible tipA
      promoter to permit regulated transcription of cloned genes. We demonstrated that
      pPM927, a plasmid which contained all of these elements, was able to transfer
      cloned fragments from E. coli to S. lividans by conjugation, stably integrate
      into the chromosome, and express cloned genes from the tipA promoter.
      Furthermore, since pPM927 contained the pBR322 replicon, cloned fragments could
      be conveniently recovered from the S. lividans chromosome for analysis in E. coli
      by cleavage of genomic DNA isolated from transformed strains, intramolecular
      ligation and transformation. Since we have shown that the pSAM2 attB site forms
      part of a conserved prokaryotic tRNA gene, these integrative vectors are
      potentially useful tools for analysis and expression of genes in diverse
      bacteria.

PMID- 2227453
TI  - Cloning, expression and sequence analysis of an endolysin-encoding gene of
      Lactobacillus bulgaricus bacteriophage mv1.
AB  - The lysA gene specifying an endolysin of Lactobacillus delbrueckii subsp.
      bulgaricus bacteriophage mv1, was cloned and expressed in Escherichia coli. The
      4.05-kb restriction fragment containing this gene was analysed by restriction and
      deletion mapping, and by subcloning. The nucleotide sequence of a 1150-bp
      fragment coding for an active lysin was determined. The lysA gene consists of 585
      bp and codes for a protein of a deduced Mr of 21,120, which agrees with the size
      based on in vivo transcription/translation studies. The deduced amino acid
      sequence of the mv1 lysin (LysA) was compared to that of other known lytic
      enzymes. Significant homology was observed with the N-terminal portion of the
      muramidase of the fungus Chalaropsis and that of the muramidase of the
      Streptococcus pneumoniae phage Cp-1, suggesting that LysA might be a muramidase.
      In E. coli, the cloned lysA gene was able to complement the muramidase-defective
      bacteriophage lambda Ram5, proving that the products of these two genes are
      interchangeable. The lysA gene is preceded by an open reading frame with unknown
      function and no characteristic prokaryotic promoter sequences could be detected
      upstream from lysA, suggesting that this gene is part of an operon.

PMID- 2227454
TI  - Cloning, sequence and expression in Escherichia coli of the Methylobacillus
      flagellatum recA gene.
AB  - By means of interspecific complementation of an Escherichia coli recA- mutation
      with phasmids containing a gene bank from an obligate methylotroph,
      Methylobacillus flagellatum (Mf), the recA+ gene from this bacterium was
      identified. When expressed in an E. coli recA- host, it can function in
      recombination, DNA repair, and prophage induction. The nucleotide sequence of the
      gene has been determined. The coding region consists of 1032 bp specifying 344
      amino acids. The deduced RecA protein structure shows a striking homology with
      RecA from other bacteria, except for the C-terminal region and some residues
      which were proposed to be responsible for the coprotease ability of RecA
      proteins. The region preceding the recA-Mf gene start codon has no SOS box--the
      LexA repressor binding site. Expression of the recA-Mf gene in E. coli proved to
      be DNA-damage independent.

PMID- 2227455
TI  - Molecular analysis of the Bacteroides fragilis recA gene.
AB  - The nucleotide sequence of a 2.5-kb DNA segment containing the Bacteroides
      fragilis recA gene was determined. The coding region of the recA gene specifies a
      protein of 318 amino acids. The RecA protein of B. fragilis shows significant
      homology with that of Escherichia coli, Thiobacillus ferrooxidans, Pseudomonas
      aeruginosa and Proteus mirabilis. No SOS box characteristic of LexA-regulated
      promoters could be identified in the 5'-noncoding region of the B. fragilis recA
      gene. Promoter activity of the cloned recA gene in E. coli was located within a
      113-bp fragment of the B. fragilis DNA by in vitro construction of operon fusions
      with a promoterless lacZ gene. The transcription start point for this gene in B.
      fragilis was determined by primer extension analysis.

PMID- 2227456
TI  - Cloning, sequencing, and transcriptional analysis of the recA gene of Pseudomonas
      cepacia.
AB  - A recombinant plasmid carrying the recA gene of Pseudomonas cepacia complements a
      recA mutation of Escherichia coli and restores UV and methylmethane sulfonate
      resistance, as well as recombinational proficiency. The predicted amino acid (aa)
      sequence of P. cepacia RecA (347 aa; Mr, 37256) is highly homologous to the RecA
      proteins from Thiobacillus ferrooxidans (74% aa homology), Pseudomonas aeruginosa
      (72%), E. coli (71%), Anabaena variabilis (61%), and Synechococcus sp. strains
      PCC7002 (59%). The transcription of the recA gene in P. cepacia and E. coli,
      which starts at almost the same site, was enhanced slightly by UV irradiation in
      the former and markedly in the latter bacteria. An SOS box characteristic to LexA
      regulated promoters, along with the -10 and -35 consensus sequences, was found in
      the 5' upstream region of the P. cepacia recA gene.

PMID- 2227458
TI  - Never too old to teach.

PMID- 2227457
TI  - Cloning and sequencing of the locus encoding the large and small subunit genes of
      the periplasmic [NiFe]hydrogenase from Desulfovibrio fructosovorans.
AB  - The genetic locus encoding the periplasmic [NiFe]hydrogenase (Hyd) from
      Desulfovibrio fructosovorans was cloned and sequenced. The genes of this two
      subunit enzyme have an operon organization in which the 0.94-kb gene encoding the
      small subunit precedes the 1.69-kb gene encoding the large subunit. A Shine
      Dalgarno sequence is centered at -9 bp from the ATG of both subunits. The
      possible presence of another open reading frame downstream from the large-subunit
      encoding gene is considered. The N-terminal sequence of the large 61-kDa subunit
      deduced from the nucleotide sequence is in perfect agreement with the results of
      the amino acid (aa) sequence determined by Edman degradation. A 50-aa leader
      peptide precedes the small 28-kDa subunit. The aa sequence of the enzyme shows
      nearly 65% homology with the [NiFe]Hyd aa sequence of Desulfovibrio gigas.
      Comparisons with a large range of Hyds from various bacterial species indicate
      the presence of highly conserved Cys residues, the implications of which are
      discussed from the point of view of nickel atom and cluster accommodation.

PMID- 2227459
TI  - Atrial fibrillation in the elderly: management update.
AB  - Non-valvular atrial fibrillation is associated with a markedly increased risk of
      embolic stroke in elderly persons. Evidence is accumulating that anticoagulation
      with warfarin or aspirin may be effective in reducing this risk.

PMID- 2227460
TI  - Soft tissue rheumatism of the upper extremities: diagnosis and management.
AB  - Upper extremity tendinitis and bursitis are usually the result of repetitive
      microtrauma, probably resulting in disruption of fibers. A focus of inflammation
      often occurs, producing pain, spasm, and disability. With a careful history and
      physical exam, the diagnosis can be made, distinguishing soft tissue rheumatism
      from arthritis. Treatment consists of rest, heat or ice, and frequently, the use
      of non-steroidal anti-inflammatory drugs or injections to control the
      inflammatory response. Protection from repeated trauma may be beneficial in
      preventing recurrence.

PMID- 2227461
TI  - Practical nutritional advice for the elderly, Part II: Modification and
      motivation. A Geriatrics panel discussion.

PMID- 2227462
TI  - Infection control in the nursing home: the physician's role.
AB  - Infection control in the nursing home or long-term care facility is an
      increasingly complex activity. The high rates (approximately 15%) and special
      risks (group activities, crowding) for nosocomial infection demand special
      attention by attending physicians. Some specific responsibilities include:
      recognition of infection; knowledge and use of basic infection control
      principles; appropriate antibiotic use; review of immunizations; facilitation of
      communications among office, hospital, and long-term care facility; and
      involvement with infection control program(s).

PMID- 2227463
TI  - E. D. Vaughan, Jr., MD: newer options in managing prostate disease. Interview by
      Richard L Peck.

PMID- 2227465
TI  - Variations in the life span, enzymes and lipid peroxide levels in ageing Caryedon
      serratus (Coleoptera: Bruchidae).
AB  - In the bruchid Caryedon serratus, life span of males was longer than that of
      females. Catalase showed an increasing trend with age in both the sexes but the
      increase was higher in males. However, an opposite trend was observed for lipid
      peroxide levels. A rapid decline of NADH and succinate dehydrogenases in females
      is indicative of early depletion of food reserves due to the higher metabolic
      rate. Thus, in C. serratus, the factors contributing to relatively higher life
      span of males are efficient homeostatic defence mechanisms and low oxidative
      damage in males, early maturity and more reproductive demands in females.

PMID- 2227464
TI  - Geriatric autopsies: it's time to get involved.
AB  - As calls for physician accountability mount up, physicians who request autopsies
      may be deemed more professional. This will be particularly true if they
      understand the terminology.

PMID- 2227466
TI  - On the strategy of directed assembly and its relevance to ageing.
AB  - The strategy which Nature has chosen to generate complex, asymmetric structures
      has been to build on previously established structures and to render the internal
      chemistry asymmetric by a close association with asymmetrically distributed,
      stable topological organizers. This is what we call the strategy of directed
      assembly. Ageing and the strategy of directed assembly seem to be general for
      biological systems displaying history-dependent development. We believe that it
      is this strategy which imposes severe limitations on topological organizer
      turnover rates and, therefore plays a major role in initiating the ageing
      process.

PMID- 2227467
TI  - Labyrinth learning impairment in patients with early symptoms of presenile
      dementia.
AB  - 21 patients (54 +/- 7 years old) with early cognitive deficit (ECD) during the
      presenile stage of presumptive primary degenerative dementia (mild stage) and 14
      patients (54 +/- 4 years old) with early cognitive deficit with a background of
      cardiovascular disease (CVD) were examined in a labyrinth learning test of Milner
      (modified by Roth). 15 patients in the ECD group made 3 times more errors to
      negative fields (p less than 0.01), about 10 times more errors to positive fields
      (p less than 0.01) and needed treble the amount of time for passing through the
      labyrinth (p less than 0.01) compared with a healthy control group (51 +/- 4
      years). A further 6 patients of the ECD group had no success in performing the
      labyrinth test. The CVD group was not different from the control group in making
      errors, but slower (p less than 0.05). The labyrinth test is found suitable for a
      more precise diagnosis of early cognitive deficit in the early stage of a primary
      degenerative dementia of the Alzheimer type.

PMID- 2227468
TI  - Medical correlates of agitation in nursing home residents.
AB  - This paper examines the relationship between agitation and medical and
      psychiatric diagnoses. Agitation marked by aggressive behaviors (e.g., hit, kick)
      was related to dementia and impairments in activities of daily living. Physically
      nonaggressive behaviors (e.g., pacing, disrobing inappropriately) correlated with
      cognitive impairment, fewer medical diagnoses, and absence of a hearing loss.
      Verbally agitated behaviors (e.g., constant complaints) were manifested by
      residents with more physical diagnoses, mental disease (other than schizophrenia
      and affective disorders), more reported pain, and higher cognitive functioning
      than the population as a whole.

PMID- 2227469
TI  - Features of multiple sclerosis in older patients in South Wales.
AB  - Multiple sclerosis (MS) may occur outside the commonly accepted age range. Data
      relating to features of MS in a population in South Wales have been analysed to
      find features which characterise older patients. The older patients are more
      severely disabled due to the accumulation of visual defects and motor signs and
      symptoms. The course of the disease is marked by single localised attacks with
      long remissions. Those with onset over 50 years deteriorate more rapidly, but in
      those who were over 50 at the time of interview, this did not occur. It is
      suggested that there is no essential difference in MS in older patients, but
      there may be features which reflect normal ageing and diseases commoner in old
      age.

PMID- 2227470
TI  - Monokine production by malnourished nursing home patients.
AB  - Protein malnutrition is associated with a decreased febrile and acute phase
      response to infection and increased mortality. To elucidate a cause for this poor
      response, we assessed the effect of chronic protein malnutrition on monocyte
      production of the pyrogens interleukin-1 (IL-1) and tumor necrosis factor (TNF).
      Thirteen malnourished nursing home residents, 11 age-matched controls, and 9
      young controls were studied. Production of IL-1 and TNF in vitro was not
      diminished in the malnourished group when compared with the age-matched and young
      controls. Causes other than diminished IL-1 or TNF production should be sought to
      explain decreased resistance to infection in the malnourished nursing home
      resident.

PMID- 2227471
TI  - Hypernatraemia in the elderly patient.
AB  - The elderly are at risk of developing hypernatraemia because of age-related
      changes in renal function and body composition. The pathophysiology and aetiology
      of hypernatraemia are reviewed with emphasis on iatrogenic factors. A rational
      approach to management is discussed and clear guidelines for treatment described.

PMID- 2227472
TI  - Consideration of spatial orientation mechanisms as related to elderly fallers.

PMID- 2227473
TI  - Behavioral training for stress and urge incontinence in the community.
AB  - Behavioral training procedures provide an effective, low-risk approach to the
      treatment of persistent urinary incontinence. This paper describes the use of
      biofeedback techniques for the operant conditioning of physiological responses,
      such as selective contraction of pelvic floor muscles and voluntary inhibition of
      detrusor contraction, that mediate bladder control. The effectiveness of
      biofeedback-assisted behavioral training for most independent-living older adults
      is documented in several research studies. The data indicate that behavioral
      treatment of stress or urge incontinence results in improvement rates which range
      from 78 to 94%. The role of biofeedback in behavioral training and its
      practicality for use in office practice are also discussed.

PMID- 2227474
TI  - Urinary incontinence in old age: helping the general practitioner to make a
      diagnosis.
AB  - Since urinary incontinence is one of the major presenting symptoms of illness in
      old age, all those who deal with this professionally should have a clear plan in
      mind as to how to proceed with diagnosis and management. Such a plan is outlined
      here based first of all on history and examination and easily performed tests and
      followed, if the problem still remains, by an empirical approach based on the
      major presenting symptom--urge incontinence, stress incontinence or incontinence
      of which the patient is unaware.

PMID- 2227475
TI  - Noninvasive diagnosis of the patient with complex incontinence.
AB  - Even in complex cases, the cause of incontinence can usually be discerned
      noninvasively. The author outlines one such approach, focusing on helpful
      diagnostic points that can be elicited without sophisticated urodynamic
      techniques.

PMID- 2227476
TI  - [From Helmholtz' eye mirror to the fundus camera. Ophthalmoscope and related
      instruments of the Museum of Medical History of the Zurich University].

PMID- 2227477
TI  - Rapid assessment of the visual field in glaucoma using an analysis based on
      multiple correlations.
AB  - We wished to determine which areas of the visual field contribute most strongly
      and most frequently to the deterioration of the visual fields in patients with
      high ocular pressure. The computerized analysis, using linear and multiple
      regressions of the findings in 382 visual fields, allowed us to select four test
      points sensitive enough to estimate the actual global sensitivity of the central
      visual field (correlation coefficient, 0.98). This system also allowed us to
      estimate the number of pathological points and even to classify accurately over
      75% of the cases in terms of their normal or pathological condition, as well as
      to determine the depth of the defect. The remaining cases show that the
      deterioration, if it exists, is not significant. Requiring less than 1 min a
      threshold examination at these four test points enables us to acquire greater
      insight into the glaucomatous defect.

PMID- 2227478
TI  - Congenital nonpigmented epithelial iris cyst removed by block-excision.
AB  - A 1-month-old white girl developed a rapidly progressing congenital nonpigmented
      iris cyst covering the pupil and displacing the lens and ciliary body. The cyst
      was completely removed using a modified block excision (9 x 3.5 mm). The tumor
      consisted of partially keratinizing cuboidal epithelium with goblet cells, which
      was covered by proliferating corneal endothelium on the outside.
      Histopathological, and scanning and transmission electron microscopic findings
      are described. The postoperative course is unremarkable for 1 year. To our
      knowledge this case is the first case of a congenital iris cyst successfully
      treated with block-excision.

PMID- 2227479
TI  - Presence and distribution of fibronectin on the surface of implanted intraocular
      lenses in rabbits.
AB  - An immunohistochemical study was performed to observe cellular proliferation on
      the surface of implanted intraocular lenses (IOLs) in rabbit eyes. Rabbits were
      killed at intervals of 3 days and 1, 2, and 4 weeks after the operation. The IOLs
      were removed and examined by an immunoperoxidase staining method using
      antifibronectin (anti-FN) antibodies. The FN immunoreactivity was detected in
      macrophages and giant cells attached to the IOL surface. Prominent staining was
      observed in these cells 1 week after the operation, and staining for FN was less
      intense in the specimens obtained 2 and 4 weeks after implantation. These
      findings suggest that FN is produced by macrophages and giant cells on the IOL
      surface and may play an important role in cellular adhesion and motility. FN
      immunoreactivity decreased with time, which might be related to cellular
      activity.

PMID- 2227480
TI  - Vertical rectus muscle transposition with intraoperative botulinum injection for
      treatment of chronic sixth nerve palsy.
AB  - Six adult patients with acquired, chronic, complete sixth nerve palsy had
      vertical rectus muscle transposition to the lateral rectus muscle insertion with
      intraoperative injection of botulinum toxin into the ipsilateral medial rectus
      muscle. Five of six patients were orthophoric in primary gaze, and the remaining
      patient achieved single binocular vision with a small head turn. This method
      compares favorably with previously described transposition procedures for sixth
      nerve palsy in terms of amount of correction and size of the window of single
      binocular vision with a lower risk of anterior segment ischemia.

PMID- 2227481
TI  - Intraocular pressure in patients with Cushing's disease.
AB  - Externally applied corticosteroids increase the intraocular pressure in one-third
      of the general population. We evaluated the intraocular pressure in 62 patients
      with endogenously elevated serum cortisol levels due to hypothalamic pituitary
      dependent Cushing's disease. All patients underwent transphenoidal microsurgical
      sella exploration within 4 years after the onset of subjective symptoms. The
      intraocular pressure (preoperative mean, 14.9 +/- 3.5 mm Hg) exceeded 21 mm Hg in
      four eyes before surgery and in one eye after surgery (postoperative mean, 14.3
      +/- 2.8 mm Hg). In patients attaining postoperative remission and whose pressure
      readings were taken at least 3 months after surgery, the postoperative
      intraocular pressure was significantly (P = 0.04) lower than that measured
      preoperatively (14.2 +/- 2.7 vs 13.0 +/- 2.0 mm Hg). Biomorphometry of the optic
      disc topography and the retinal nerve-fiber layer in 19 patients revealed no
      glaucomatous changes. In contrast to topically applied corticosteroids,
      endogenously elevated serum cortisol levels in patients with hypothalamic
      pituitary-dependent Cushing's disease increased intraocular pressure only
      slightly, with no great risk of glaucomatous optic nerve damage.

PMID- 2227482
TI  - Pattern electroretinograms in optic neuritis during the acute stage and after
      remission.
AB  - A total of 20 patients with unilateral acute optic neuritis were studied. Each
      patient had experienced the recent onset of a decrease in visual acuity, a
      relative afferent pupillary defect, a relative or absolute central scotoma and a
      colour-vision defect. The pattern-reversal electroretinogram (PERG) of each
      patient was analysed with regard to the amplitude of the positive and negative
      components. During the acute stage the amplitude of the positive component was
      reduced in all patients and that of the negative, in 18 of 20 cases. Parallel to
      clinical recovery, a steady increase was observed in the amplitude of the
      positive component to normal values; no statistical differences between affected
      and fellow eyes was found. In contrast, the amplitude of the negative component
      remained significantly reduced after clinical recovery.

PMID- 2227483
TI  - Temporary silicone oil tamponade in the treatment of complicated diabetic retinal
      detachments.
AB  - A retrospective study is reported on 132 eyes with retinal detachment, resulting
      from advanced proliferative diabetic retinopathy, treated using vitrectomy
      techniques and silicone oil tamponade. Epiretinal surgery was performed using a
      bimanual technique. Silicone oil was removed in 64 eyes (49%) which regained an
      improved final vision of 5/200 or better. In 17 eyes (13%), vision was improved
      but silicone oil could not be removed. It is expected that the function of
      several of these eyes will eventually deteriorate because of progressive silicone
      induced glaucoma. The remaining 51 eyes (38%) were surgical and functional
      failures.

PMID- 2227484
TI  - Retinal break type and proliferative vitreoretinopathy in nontraumatic retinal
      detachment.
AB  - In a retrospective study of 1180 consecutive eyes operated for retinal
      detachment, vitreous traction on the rent was the determining factor for the
      development of proliferative vitreoretinopathy (PVR). Round, multiple, small
      holes in equatorial degeneration (retinogenic) and macular holes in which no
      vitreous traction on the rent was found did not complicate with PVR. Retinal
      detachment caused by horseshoe or crescent-shaped tears with evidence of vitreous
      traction (vitreogenic) developed PVR to a variable degree: in 171 (25.8%) senile
      myopic, 19 (44.2%) senile-myopic aphakic, 23 (20.2%) typical aphakic, and 32
      (78.1%) patients with giant tears. We also found that retinogenic retinal
      detachments affected younger age groups more than did vitreogenic retinal
      detachments.

PMID- 2227485
TI  - New and recurrent tumor foci following local treatment as well as external beam
      radiation in eyes of patients with hereditary retinoblastoma.
AB  - The study is based on a retrospective analysis of data from 200 patients with
      hereditary retinoblastoma. Apart from four unilateral cases with a positive
      family history all patients had bilateral disease; 229 appeared suitable for
      conservative treatment while 167 eyes had to be enucleated. Primary local
      treatment was performed in 102 eyes, while 127 eyes received primary external
      beam radiation using a linear accelerator. Follow-up was adjusted by life tables,
      with 75% of the patients being observed longer than 2 years. Using life-table
      statistics new and recurrent tumors were found in 41% of all patients and in 95%
      of these cases they were noted within 26 months after initiation of therapy.
      Among eyes treated with primary external beam radiation new and recurrent tumors
      were observed significantly less frequently when 50 Gy (22% compared with 49%
      after 40 Gy) and a highly accurate beam alignment technique (22% compared with
      48% after alignment to the outer bony canthus) were applied. The incidence of
      recurrent tumors following primary local treatment did not differ significantly
      with regard to the application of either photo- or cryocoagulation (28% vs 33%),
      while no recurrence was observed among tumors that were suitable for primary
      treatment using ruthenium or cobalt plaques.

PMID- 2227486
TI  - X-linked congenital retinoschisis.
AB  - The natural history and electrophysiological findings of 52 patients with X
      linked congenital retinoschisis with a follow-up of up to 26 years are described.
      The mean visual acuity was reduced to 0.24 +/- 0.2 and remained unchanged in most
      patients during this time. If visual loss occurred, it usually happened in the
      first decennium. The complications were retinal detachments in 11% and vitreous
      hemorrhages in 4% of the eyes. In general, the vitreous hemorrhages resolved
      spontaneously. Retinal detachments were treated successfully with conventional
      buckling procedures. Redetachments occurred in about 40%. Prophylactic laser
      coagulation was of no use because it was complicated by detachment in 43% of our
      series. The electro-oculogram was usually normal. In addition to the known
      electrorentinographic findings of normal a-wave and reduced b-wave amplitudes, we
      found prolonged b-wave latencies and implicit times, as well as a reduced 30 Hz
      flicker response.

PMID- 2227487
TI  - Macular detachment following laser treatment for proliferative diabetic
      retinopathy.
AB  - Case records of patients who had macular detachment following argon laser
      photocoagulation for proliferative diabetic retinopathy were reviewed. Thirteen
      eyes of 11 patients out of a total of 480 patients treated had this complication,
      and in 12 eyes of 10 patients the short latency suggested a true precipitating
      effect. This represents 2.1% of patients receiving panretinal photocoagulation.
      Patients with detachment were younger and developed diabetes earlier than the
      controls (P less than 0.025), and the detached eyes had received more numerous
      laser burns on average per session than the controls (P less than 0.001). In 5
      eyes the last photocoagulation dose exceeded 1000 burns delivered in the presence
      of traction membranes in an attempt to arrest continuing neovascular
      proliferation not responding to earlier more moderate treatment. Only 1 eye had
      received early, extensive and repeated photocoagulation. Vigorous treatment at an
      early stage of the proliferation may prevent this complication, although the
      advantages or disadvantages of fractionation of photocoagulation will only be
      shown by a prospective trial.

PMID- 2227488
TI  - Retinal circulation times in quantitative fluorescein angiography.
AB  - We tried to obtain an overview of the quantitative state of the retinal
      circulation. Optical density measurements by an image analyzer were performed on
      video fluorescein angiograms for the determination of dyedilution curves. To
      ensure that curves with a sharp peak were obtained, 1 ml sodium fluorescein 10%
      was flushed with 20 ml physiological saline. From dilution curves of a retinal
      circulation times, T(x) (x = 1, 25, 50, 75, and 100) and Tm, were calculated.
      T(1) corresponds to the difference in the time of initial dye appearance; T(50),
      to the so-called half-maxim time difference; T(100), to the difference in the
      time to peak intensity; and Tm, to the mean circulation time. T(50) showed the
      best reproducibility when it was examined at 49 retinal regions of 10 healthy
      volunteers with a double video-fluorescein angiogram that was obtained within 1
      min. Normal values (mean +/- SD) at the temporal superior region of 37 healthy
      volunteers were as follows: T(1) = 0.87 +/- 0.66 s, T(25) = 1.52 +/- 0.48 s,
      T(50) = 1.83 +/- 0.50 s, T(75) = 2.12 +/- 0.56 s, T(100) = 2.73 +/- 0.76 s, and
      Tm = 2.69 +/- 1.25 s. We believe that these values give a general overview of the
      quantitative state of normal retinal circulation.

PMID- 2227489
TI  - Evaluation of the 701 interzeag lens opacity meter.
AB  - The Interzeag 701 Lens Opacity Meter was used to study the lenses of 122 cataract
      eyes and 73 healthy eyes with clear lenses. The readings taken separately in 67
      eyes by two different operators did not significantly differ. Statistically
      significant differences were found between the readings taken by the same
      operator when the pupil size was different in all types of cataract and also in
      eyes with transparent lenses. Opacity Meter readings correlate well with the
      visual acuity of eyes with nuclear and mixed cataracts, but no correlation was
      found in eyes with cortical or posterior subcapsular cataracts. In healthy eyes
      with clear lens, a correlation was found between the instrument readings and age.

PMID- 2227490
TI  - Hemianopic offsets in the visual field of patients with glaucoma.
AB  - In 359 glaucoma patients (600 eyes), we measured the peripheral field with
      kinetic targets and the central 30 degrees field of vision with static testing,
      using the Field-master-5000 automated perimeter to evaluate the prevalence and
      significance of step-like visual-field defects along the vertical midline (a
      hemianopic offset). In all, 129 eyes of 121 patients had a hemianopic offset. In
      108 eyes the offsets (involving either the peripheral or the central field or
      both) were associated with other glaucomatous field changes, whereas 21 eyes
      showed a peripheral offset as an isolated finding. Of the 8 cases of offsets
      found in both eyes, 7 were binasal and 1 occurred bitemporally but in separate
      hemifields. This study suggest that hemianopic offsets occur commonly in glaucoma
      patients but have limited diagnostic value because most are associated with other
      glaucomatous field changes. However, these findings help in distinguishing
      glaucomatous offsets from those caused by neurological lesions.

PMID- 2227491
TI  - Static threshold variability in the peripheral visual field in normal subjects.
AB  - We assessed the variability of point-wise static threshold values and the
      components of fluctuation outside the central 30 degrees field in 20 normal
      individuals tested on the Humphrey field analyzer. We found a mean short-term
      fluctuation of 2.37 dB, a long-term heterogeneous fluctuation of 5.28 dB, and a
      long-term homogeneous fluctuation of 1.10 dB. All components of fluctuation were
      greatest superiorly. Point-wise variation was highest superiorly and nasally and
      increased with greater eccentricity from fixation in all but the temporal
      quadrant. Also, point-wise variation was greater between individuals than between
      tests in a single individual. This study suggests that outside the central 30
      degrees field, changes in individual threshold measurements in the superior and
      nasal quadrants should be greater than those in the temporal or inferior
      quadrants before they can be distinguished from normal variation.

PMID- 2227492
TI  - External eye flora as a nutrient source for Acanthamoeba.
AB  - Certain bacteria cause excystment of Acanthamoeba from cyst to trophozoite form
      and are then ingested by migrating trophozoites. We studied the response of
      Acanthamoeba cysts to inoculation on agar seeded with three types of commensal
      eye bacteria and Escherichia coli. Amoebae excysted on all bacteria tested, and
      the migration rate of Acanthamoeba trophozoites on each was compared.
      Acanthamoeba migrated with equal speed on E. coli and Staphylococcus epidermidis.
      Migration was observed, but was more slow on Micrococcus and Corynebacterium.
      Commensal bacteria on the eyelids, conjunctiva and tear film may have a role in
      pathogenesis of Acanthamoeba keratitis.

PMID- 2227493
TI  - Panretinal photocoagulation aggravates experimental proliferative
      vitreoretinopathy.
AB  - The effects of panretinal photocoagulation (PRP) on intravitreal proliferation
      were evaluated in an experimental model for proliferative vitreoretinopathy
      (PVR). Thirty-three pigmented rabbits underwent argon laser PRP in one eye.
      Cultured fibroblasts (2 x 10(5) or 4 x 10(5) cells) were implanted into the
      intact vitreous of both eyes of each animal either 3 days after PRP (when acute
      laser lesions were present) or 4 weeks after PRP (scarred laser lesions). PVR was
      assessed by indirect ophthalmoscopy for 4-8 weeks. Histological examination
      included staining with monoclonal antibodies against glial fibrillary acidic
      protein (GFAP). In both groups significantly more severe stages of PVR developed
      after PRP than in the controls. Total retinal detachments ensued in 13
      photocoagulated eyes versus five controls. PRP induced invasion of macrophages,
      proliferation of retinal pigment epithelium and a conspicuous Muller cell
      response, enhancing intraocular inflammation, which stimulated intravitreal
      proliferation and aggravated PVR.

PMID- 2227494
TI  - Muller cells in detached human retina express glial fibrillary acidic protein and
      vimentin.
AB  - We investigated the expression of vimentin and glial fibrillary acidic protein
      (GFAP) within Muller cells in normal human retinas and in detached human retinas
      of proliferative vitreoretinopathy (PVR) cases using the immunogold method.
      Muller cells in normal retinas showed vimentin immunoreactivity and faint GFAP
      immunoreactivity; however, in detached retinas they showed distinct GFAP
      immunoreactivity as well as vimentin immunoreactivity. Immunoelectron microscopic
      observation revealed that intermediate filaments (IF) within Muller cells in
      normal retinas showed vimentin immunoreactivity and that those within Muller
      cells in detached retinas showed both vimentin and GFAP immunoreactivity. Double
      staining for vimentin and GFAP showed that in detached retinas, these two protein
      immunoreactivities were observed in the same filaments. These results indicate
      that IF of human Muller cells consist of vimentin under normal conditions and
      that Muller cells in detached retinas contain different IF, which consist of
      vimentin and GFAP.

PMID- 2227495
TI  - Toxicity and clearance of intravitreal cefotetan.
AB  - Direct intravitreal injection of antibiotics plays an important role in the
      management of bacterial endophthalmitis. In the present study we investigated the
      toxicity and clearance of intravitreally injected cefotetan in a rabbit model. No
      toxic ocular side effects could be detected by electroretinography (ERG) or light
      and electron microscopy up to and including a single intravitreal dose of 1000
      micrograms. Intravitreal injection of 2000 micrograms cefotetan resulted in mild
      degeneration of photoreceptor outer segments and, sporadically, in cataract
      formation. After intravitreal injection of 4000 micrograms, moderate toxic
      degeneration of photoreceptors occurred, with displacement and mitochondrial
      swelling of inner segments. In addition, lysosomal lamellar inclusion bodies
      could be detected in pigment epithelial cells. After a single intravitreal
      injection of 1000 micrograms cefotetan, concentrations greater than the minimum
      necessary for the inhibition of most commonly occurring intraocular pathogens
      (except Pseudomonas aeruginosa and Staphylococcus epidermidis) were maintained in
      the vitreous humor for greater than 48 h. Cefotetan may be a potentially
      important drug for intravitreal injection, especially in cases of gram-negative
      and suspected anaerobic endophthalmitis.

PMID- 2227496
TI  - Clinicopathological findings 11 months after implantation of a functioning
      aqueous-drainage silicone implant.
AB  - An aqueous-drainage silicone device was implanted in a 57-year-old diabetic
      patient with neovascular glaucoma after failure of conventional therapy.
      Postoperative intraocular pressure (IOP) was well controlled, ranging between 10
      and 20 mm Hg without the use of supplemental agents. Despite the normal IOP, the
      eye became painful and amaurotic 11 months after implantation due to progression
      of the retinopathy accompanied by the development of severe tractional retinal
      detachment. Enucleation was performed and the eye underwent histopathological
      examination. The filtering bleb around the silicone plate of the implant on the
      equatorial sclera was lined with a thick layer of collagenous connective tissue.
      Numerous microcystic spaces could be seen in the bleb wall by light microscopy.
      Electron microscopy confirmed this finding; in addition, only a meshwork of
      collagen fibre-like bundles was visible at some areas of the innermost bleb wall.
      Control of IOP in spite of bleb fibrosis in this particular case may have been
      due to a loss of matrix components and to the formation of microcystic spaces in
      the bleb wall, which seem likely to be channels for the passage of aqueous humor.

PMID- 2227497
TI  - Ultrastructural pathology of anterior persistent hyperplastic primary vitreous.
AB  - Using transmission electron microscopy, the fine structure of anterior persistent
      hyperplastic primary vitreous (PHPV) removed from the eyes of four infants was
      studied. The tissue mass was composed of vessels derived from or representing the
      tunica vasculosa lentis posterior and the vasa hyaloidea propria. They were
      embedded in a loose connective-tissue matrix containing many fibroblasts and
      mature collagen fibrils. Toward the posterior surface, the fibroblasts became
      more numerous, elongated and densely packed. At the point of its entry into the
      posterior pole of the mass, the hyaloid artery was found to be surrounded by
      glial cells, probably representing an extension of the wall cells of the hyaloid
      canal. Venous drainage of the PHPV nodules seemed to occur via the ciliary body
      to which they were connected by tiny vessels bridging the distance from the PHPV
      lump to elongated ciliary processes. The anterior surface of the tissue lump was
      covered with lens fragments. These remnants showed signs of very early
      disturbance of lens development, with a failure to form posterior lens fibers.
      Based on these findings, the authors suggest that PHPV may be secondary to a
      primary defect in lens development.

PMID- 2227498
TI  - Evaluation of the functional results after different techniques for treatment of
      retinal detachment due to macular holes.

PMID- 2227499
TI  - [Ecological and hygienic concepts of human nutrition].
AB  - The paper presents data on the development of eco-hygienic concept of human
      nutrition. The scheme of migration of various xenobiotics and biological
      contaminants along the food chain is given. The necessity for the substantiation
      of unified MACs of alien substances for all eco-systems is indicated. The ++eco
      hygienic concept of nutrition should be directed at the protection (purity) of
      the inner human environment and normalization of the processes of its activity in
      interrelations with the environment.

PMID- 2227500
TI  - [Changes in biological activity of turf-podzolic soil of different mechanical
      composition contaminated with heavy metals].
AB  - It has been shown that soil pollution with heavy metals (copper, nickel) lead to
      negative changes in parameters characterizing potential biological activity of
      soil (nitrogen-fixation, breath, invertase activity, bacteria and fungi count).
      More profound changes were observed in sandy soil compared to loamy soil. A
      direct relationship of these effects with the content of mobile forms of heavy
      metals in soil has been established. For the comparative and prognostic
      investigation of the danger of soil pollution with heavy metals it has been
      suggested to use a coefficient of differences in the content of mobile forms and
      a coefficient of biological effect.

PMID- 2227501
TI  - [Monitoring of xenobiotics in food products and daily diets (review of the
      literature)].

PMID- 2227502
TI  - [Hygienic examination of oranges subjected to electro-ion treatment for the
      prolongation of preservation time].
AB  - On the basis of large experimental material (study of organoleptic properties,
      chemical composition of electro-antiseptic + oranges, microbiological studies of
      microbic cenosis during their storage, biological experiments to find out the
      possible general toxic effect of the pretreated fruit on animal organism) safety
      of oranges subjected to electro-ion++ treatment to prolong the term of
      preservation has been stated. The possibility to use electro-atiseptic oranges by
      the people in their nutrition has been proved.

PMID- 2227503
TI  - [Psychological adaptation of older workers to occupational conditions].
AB  - As a result of ergometric investigation of labour activity of 187 workers of mass
      professions (machine-operators, metal craftsmen, fitters), involved in physical
      labour of medium heaviness, the following age patterns in behavioral self
      regulation of activity were detected in people of 20-79 years of age: reduction
      of the occupation in the major jobs and increase in the occupation in the
      auxiliary, less tense jobs, decrease in the density of work time, changing in the
      activity strategy, reduction of the duration of continuous work and increase of
      the duration of the subsequent rest, dividing of the alloted volume of work into
      parts. Physiological rationalization of labour of older workers based on the
      established patterns of their behavioral adaptation to labour is a sufficiently
      effective measure for labour rehabilitation and lengthening of the period of
      active life.

PMID- 2227504
TI  - [Ways of increasing the operational and protective properties of anti-mercury
      respirators].
AB  - The major results of studies on the assessment of the dynamic activity of
      sorption--filtering respirators relative to mercury vapours are presented. It has
      been shown that the term for the storage of the respirator "Lepestok-G" can be
      increased from 6 months, starting from the date of production--according to the
      established technical rules, --up to 2 years. The surface density of the sorbent
      can be reduced from 3.5 down to 1.5 mg/sm2, which will make it possible to
      significantly reduce the initial resistance to breathing and to improve the
      operational and protective properties of the respirator.

PMID- 2227505
TI  - [Interrelations between functional changes and health status and climatic factors
      of Extreme North (review)].

PMID- 2227506
TI  - [Mobility of cesium-137, sodium and potassium in different types of soil and
      prediction of cesium-137 accumulation in agricultural plants].
AB  - Mobility of caesium-137, sodium and potassium in the natural environment in
      podzolic gray and chernozem medium-loamy, sward podzolic sandy soils and
      chernozem has been studied. Durability of fixation of caesium-137 increases in a
      number of soils: sward-podzolic sandy, podzolic loamy soils, chernozem. Caesium
      137 concentration in agricultural plants is reduced along with the increase of
      caesium-137 fixation in soils and increase of the level of metabolic potassium.
      Coefficients of transition of metabolic caesium-137 by potassium and sodium, and
      of sodium by potassium. The mentioned above coefficients can be used for the
      prediction of caesium-137 cumulation in plants.

PMID- 2227507
TI  - [Effect of inhalation of trichlorobenzene and normal paraffins on the behavior of
      plutonium-239 in the rat body].

PMID- 2227508
TI  - [Sanitary-protective and limitation areas for antennae of the decameter range].
AB  - A detailed overview of a transmitting antenna of the decameter range is provided.
      It is shown that the field near such antennas has rather a complex structure. A
      comparative analysis of the existing design techniques for the determination of
      electromagnetic field intensity has been undertaken. On the basis of numerical
      design techniques the procedure of automated prediction of the electromagnetic
      situation is proposed. The basic components of the procedure are set forth. As
      illustrated by some antennas the dependence of sanitary and limitation zones on
      the wavelength, radiated power and the type of soil has been studied.

PMID- 2227509
TI  - [Hygienic regulation of static electric field generated by devices with electron
      ray tube].
AB  - When detecting and hygienically assessing the static electric field generated by
      the devices with a half-tone storage tube it is necessary to take account of the
      impact of a number of characteristics of field intensity ranging on the obtained
      results. Taking into consideration the above characteristics during the research
      permits to lower error in the derived values and approximate them to the
      characteristics affecting the organisms of those using devices with a half-tone
      storage tube.

PMID- 2227510
TI  - [Substantiation of the tactics of short-wave ultraviolet irradiation of the air
      in hospital premises].
AB  - It has been found out, that the level of microbic dissemination of the air of
      premises for the treatment of children increases 3-10 times following carrying
      out various functional activities in them. To reduce air contamination it is
      reasonable to use irradiation of bactericidal lamps of DB 30-1 type with specific
      power of 1.5 W/m3 for the first 20 min. after the work has been fulfilled in the
      premises.

PMID- 2227511
TI  - [Toxicokinetics of croneton].

PMID- 2227512
TI  - [Relation between the inhibition of respiration of isolated liver mitochondria
      and the structure of copper and vanadium phthalocyanines].

PMID- 2227513
TI  - [Evaluation of environmental effects of sewage water from sugar-processing
      factories used for irrigation of agricultural fields].

PMID- 2227514
TI  - [A device for elimination of microorganisms from the air].

PMID- 2227515
TI  - [Determining the levels of chloride ions in water solutions using a chloride
      selective electrode].

PMID- 2227516
TI  - [Determining the activity of large radiation sources of arbitrary form].

PMID- 2227517
TI  - [Threshold signaler of the gammaphone TIK-87].

PMID- 2227518
TI  - [Various methodological approaches to evaluation of the cardiotoxic effect of
      pesticides in relation to the age factor].

PMID- 2227519
TI  - [A method of preparing standardized gas mixtures of sulfur dioxide].

PMID- 2227520
TI  - [Use of a new reagent azopyram for quality control of pre-sterilization of
      medical equipment].

PMID- 2227521
TI  - [Problem of sorption of hydrofluoric acid with fibrous materials used for
      hemosorption].

PMID- 2227523
TI  - [Problem of increasing the qualifications and special training of public health
      physicians and other specialists working in radiological subdivisions in
      Ukraine].

PMID- 2227522
TI  - [Use of the method of the study of erythrocyte membrane permeability for urea for
      detecting the toxic effect of cyclohexylnitrate].

PMID- 2227524
TI  - [Ways of improving the personnel organizational structure of the system of
      radiological subdivisions of the sanitary-epidemiological centers in Ukraine].

PMID- 2227525
TI  - [Hygienic aspects and methodological basis for producing bioinert polymer
      materials with the properties for individual protection].

PMID- 2227526
TI  - [V.I. Tatishchev on medicine].

PMID- 2227527
TI  - Antioxidant enzymes and lipoperoxide in blood in uremic children and adolescents.
AB  - To determine whether oxidant-antioxidant balance is altered in chronic renal
      failure, antioxidant enzymes and lipid peroxide in peripheral blood cells and
      lipid peroxide in plasma were measured. Nine children and adolescents maintained
      on hemodialysis (HD), 9 on continuous ambulatory peritoneal dialysis (CAPD), and
      14 controls were studied. Lipid peroxide was assayed fluorimetrically as
      thiobarbituric acid-reactive substances, superoxide dismutases by
      radioimmunoassays. Both manganese and copper-zinc superoxide dismutases in
      lymphocytes and monocytes in the HD and CAPD patients, and manganese superoxide
      dismutase in polymorphs in the HD patients were higher than in the controls.
      Copper-zinc superoxide dismutase, glutathione peroxidase, and catalase in
      erythrocytes were unaltered. The lipid peroxide level in plasma in the dialyzed
      patients was increased, whereas those in polymorphs and lymphocytes were
      unaltered. Triglyceride and total cholesterol in plasma in the dialyzed patients
      were also increased. The plasma lipid peroxide in the patients correlated with
      the triglyceride and total cholesterol level. This is the first study in which
      manganese superoxide dismutase is measured in nucleated cells of the patients
      with chronic renal failure. The present results suggest that increased superoxide
      dismutases protect against oxidative stress induced by chronic renal failure in
      nucleated cells but in neither erythrocytes nor plasma.

PMID- 2227528
TI  - Antioxidant action of ubiquinol homologues with different isoprenoid chain length
      in biomembranes.
AB  - Ubiquinones (CoQn) are intrinsic lipid components of many membranes. Besides
      their role in electron-transfer reactions they may act as free radical
      scavengers, yet their antioxidant function has received relatively little study.
      The efficiency of ubiquinols of varying isoprenoid chain length (from Q0 to Q10)
      in preventing (Fe2+ + ascorbate)-dependent or (Fe2+ + NADPH)-dependent lipid
      peroxidation was investigated in rat liver microsomes and brain synaptosomes and
      mitochondria. Ubiquinols, the reduced forms of CoQn, possess much greater
      antioxidant activity than the oxidized ubiquinone forms. In homogenous solution
      the radical scavenging activity of ubiquinol homologues does not depend on the
      length of their isoprenoid chain. However in membranes ubiquinols with short
      isoprenoid chains (Q1-Q4) are much more potent inhibitors of lipid peroxidation
      than the longer chain homologues (Q5-Q10). It is found that: i) the inhibitory
      action, that is, antioxidant efficiency of short-chain ubiquinols decreases in
      order Q1 greater than Q2 greater than Q3 greater than Q4; ii) the antioxidant
      efficiency of long-chain ubiquinols is only slightly dependent on their
      concentrations in the order Q5 greater than Q6 greater than Q7 greater than Q8
      greater than Q9 greater than Q10 and iii) the antioxidant efficiency of Q0 is
      markedly less than that of other homologues. Interaction of ubiquinols with
      oxygen radicals was followed by their effects on luminol-activated
      chemiluminescence. Ubiquinols Q1-Q4 at 0.1 mM completely inhibit the luminol
      activated NADPH-dependent chemiluminescent response of microsomes, while
      homologues Q6-Q10 exert no effect. In contrast to ubiquinol Q10 (ubiquinone Q10)
      ubiquinone Q1 synergistically enhances NADPH-dependent regeneration of endogenous
      vitamin E in microsomes thus providing for higher antioxidant protection against
      lipid peroxidation. The differences in the antioxidant potency of ubiquinols in
      membranes are suggested to result from differences in partitioning into
      membranes, intramembrane mobility and non-uniform distribution of ubiquinols
      resulting in differing efficiency of interaction with oxygen and lipid radicals
      as well as different efficiency of ubiquinols in regeneration of endogenous
      vitamin E.

PMID- 2227529
TI  - Multiple actions of superoxide dismutase: why can it both inhibit and stimulate
      reduction of oxygen by hydroquinones?
AB  - Superoxide dismutase can either inhibit or stimulate autoxidation of different
      hydroquinones, suggesting multiple roles for O2.-. Inhibitory actions of
      superoxide dismutase include termination of O2.(-)-propagated reaction chains and
      metal chelation by the apoprotein. Together, chelation of metals and termination
      of O2.(-)-propagated chains can effectively prevent reduction of oxygen. Chain
      termination by superoxide dismutase can thus account for negligible accumulation
      of H2O2 without invoking a superoxide:semiquinone oxidoreductase activity for
      this enzyme. One stimulatory action of superoxide dismutase is to decrease
      thermodynamic limitations to reduction of oxygen. Whether superoxide dismutase
      inhibits or accelerates an autoxidation depends on the reduction potentials of
      the quinone and the availability of metal coordination for inner sphere electron
      transfers.

PMID- 2227530
TI  - Role of oxidatively modified LDL in atherosclerosis.
AB  - Oxidative modification of LDL is accompanied by a number of compositional and
      structural changes, including increased electrophoretic mobility, increased
      density, fragmentation of apolipoprotein B, hydrolysis of phosphatidylcholine,
      derivatization of lysine amino groups, and generation of fluorescent adducts due
      to covalent binding of lipid oxidation products to apo B. In addition, oxidation
      of LDL has been shown to result in numerous changes in its biologic properties
      that could have pathogenetic importance, including accelerated uptake in
      macrophages, cytotoxicity, and chemotactic activity for monocytes. The present
      article summarizes very recent developments related to the mechanism of oxidation
      of LDL by cells, receptor-mediated uptake of oxidized LDL in macrophages, the
      mechanism of phosphatidylcholine hydrolysis during LDL oxidation, and other
      biologic actions of oxidized LDL including cytotoxicity, altered eicosanoid
      metabolism, and effects on the secretion of growth factors and chemotactic
      factors. In addition, this review will examine the evidence for the presence of
      oxidized LDL in vivo and the evidence that oxidized LDL plays a pathogenetic role
      in atherosclerosis.

PMID- 2227531
TI  - HPLC procedure for the pharmacokinetic study of the spin-trapping agent, alpha
      phenyl-N-tert-butyl nitrone (PBN).
AB  - Considerable progress has been made in the use of spin-trapping agents for the
      trapping of free radicals in biological systems. Radicals have been detected in
      both in vitro and in vivo systems using this methodology. Free radicals have not
      only been identified by this procedure, but also the intensity of radical
      generation and the duration of their production has been assessed as well. One of
      the most widely used spin-trapping agents in biological systems is PBN. This spin
      trap appears to be relatively nontoxic at the levels required for successful
      trapping experiments, but there is no information concerning the possible fate of
      PBN in such biological systems. Metabolism of PBN could alter the concentration
      of PBN at the site of trapping which may affect the efficiency of radical
      capture, especially in in vivo systems. In this study, PBN was administered
      intraperitoneally to rats and the concentration of the spin trap in various
      organs was determined by high pressure liquid chromatography as a function of
      time (15 min to 12 h). The concentration of PBN in plasma peaked at 15 min while
      the maximum in all organs tested occurred at 30 min. The time course of PBN
      concentrations in all tissues followed similar curves, and declined rather
      steeply after the 30-min maximum with a biological half-life of 134 min. However,
      the amount of PBN per gram of tissue was always higher in liver and kidney than
      in the brain, heart, and lung. PBN was detected in the urine for as long as 24 h
      after injection of the compound.

PMID- 2227532
TI  - Oxidative damage and repair. The 5th biennial meeting of the International
      Society for Free Radical Research. November 14-20, 1990, Pasadena, California.
      Abstracts.

PMID- 2227533
TI  - [Personal view of the use of disposable syringes for analgesia in dentistry].
AB  - After a synthetis of the main infectious illness transmittable through the oral
      cavity, the authors describe the experimental use of a new disposable syringe in
      dentistry. On the basis of a total of 160 local injections for dental
      interventions, the authors can say that this instrument allows to operate with a
      maximum of safety for the absolute absence of a direct infection, also by the
      simple salivary mean, between patients. More advantage come from the risk drop of
      needle puncture for the dentist and the assistants and for the automatic
      autoaspiration the syringe is provided which.

PMID- 2227534
TI  - [Emergencies in ambulatory dentistry].
AB  - The most frequent critical situations that could happen in outpatient dental
      practice are analyzed and emergency treatment is proposed. Further, a full
      emergency set (both drugs and devices) is proposed as standard dotation.

PMID- 2227535
TI  - Age migraine and achievement motivation related? A psychophysiological study of
      responses to real-life achievement stress in young headache sufferers.
AB  - Achievement motivation and its physiological correlates were studied in 37 young
      migrainous headache sufferers (30 females and 7 males) and in 37 matched
      controls. Temporal and digital pulse amplitude, the EMGs of the m. frontalis,
      anterior temporalis and corrugator supercilii, heart and respiration rate, head
      temperature and electrodermal activity were measured during an adaptation
      session, an examination and an intelligence test. An abnormal response in the
      temporal artery, which was present in the migrainous headache sufferers, was not
      associated with achievement motivation. But the latter was positively associated
      with a high skin conductance level, a greater number of spontaneous skin
      conductance responses (SCRs) during the examination and a lower digital pulse
      amplitude in both the migrainous headache and control groups. Higher sympathetic
      activity in subjects with high achievement motivation was interpreted as an
      indication of greater mental effort and is a possible contributory factor to an
      attack in those with migraine.

PMID- 2227537
TI  - Diagnostics of cervicogenic headache.
AB  - Cervicogenic headache (CH) is a clearly defined headache syndrome and can usually
      be differentiated from other unilateral headaches like cluster headache, chronic
      paroxysmal hemicrania (CPH) and hemicrania continua by a thorough history and
      neurological examination. Combinations of CH with other headaches like migraine,
      tension headache, combination headache and drug induced headache, that occur
      quite frequently, can complicate the diagnosis. In our own material of 5520
      headache patients the prevalence of CH was 13.8% (763). Four hundred and thirty
      of these patients suffered from CH in combination with one or more other
      headaches.

PMID- 2227536
TI  - The headache of challenge in our time: cervicogenic headache.
AB  - Cervicogenic headache is a unilateral headache without sideshift, beginning in
      the posterior of the head but ultimately spreading to the front. It is
      characterized by rather mild and protracted pain episodes, the pain in many
      instances eventually becoming chronic, but with an undulating course. There is a
      marked female preponderance. The special features indicating neck involvement
      include: whiplash trauma by history, reduction of range of movement in the neck,
      ipsilateral shoulder and--occasionally--arm pain, and, further, the fact that
      attacks can be precipitated mechanically by the patients (by neck movements) or
      by the physician (by external pressure towards circumscribed points in the neck).
      An important theoretical--and diagnostic--feature is the fact that the
      anaesthetic blockade of the major occipital nerve results in discontinuation of
      pain in an area (the oculo-frontal area) where anaesthesia has not been obtained.

PMID- 2227539
TI  - Proceedings of the 21st annual meeting of the Society of Gynecologic Oncologists.
      San Francisco, California, February 1990.

PMID- 2227538
TI  - The challenge of the 1990s.

PMID- 2227540
TI  - Adjuvant chemotherapy with cisplatin, doxorubicin, and cyclophosphamide (PAC) for
      early-stage high-risk endometrial cancer: a preliminary analysis.
AB  - Between October 1985 and January 1989, 33 patients with stage I (31) or
      clinically occult stage II (2) endometrial cancer at a high risk for recurrence
      were entered in a prospective study evaluating adjuvant cisplatin, doxorubicin,
      and cyclophosphamide (PAC) chemotherapy. Eligibility criteria included grade 2
      tumors with middle- or outer-third myometrial invasion (16), grade 3 tumors with
      any degree of myometrial invasion (17), presence of extrauterine disease with no
      gross residual (17), or a high-risk histologic subtype including papillary serous
      (4), adenosquamous (5), or clear cell (1) tumors. Patients received PAC
      (50/50/500 mg/m2) at 4-week intervals for six cycles. Thirty patients (90%)
      completed therapy. Toxicity included severe neutropenia in 14 patients,
      neutropenic sepsis in 2 patients, and doxorubicin-related cardiomyopathy in 1
      patient. There were no treatment deaths. Current median follow-up is 25 months.
      Nine patients (27%) have developed a recurrence, 7 of whom died, after a median
      interval of 14 months. Eight of the 9 with recurrence initially had extrauterine
      disease (P = 0.02). The resulting 2-year actuarial progression-free and overall
      survival rates were 79 and 83%, respectively. The median progression-free
      interval was 29 months for patients with extrauterine disease and 45+ months for
      those with no extrauterine disease (P = 0.02). These results suggest that a phase
      3 randomized trial comparing adjuvant PAC with radiation therapy is warranted.

PMID- 2227541
TI  - Surgical-pathologic variables predictive of local recurrence in squamous cell
      carcinoma of the vulva.
AB  - One hundred and thirty-five patients with squamous carcinoma of the vulva were
      treated at UCLA and City of Hope Medical Centers between 1957 and 1985. Sixty-two
      cases were stage I, 48 stage II, 18 stage III, and 7 stage IV. Twenty-one
      patients developed a local vulvar recurrence after primary radical resection.
      Ninety-one patients had a surgical tumor-free margin greater than or equal to 8
      mm on tissue section and none had a local vulvar recurrence. Forty-four patients
      had a margin less than 8 mm; 21 had a local recurrence and 23 did not (P less
      than 0.0001). Of the 23 patients with a margin less than 8 mm who did not recur
      locally, 14 remained free of disease, and 9 had either advanced disease,
      declining health, or short follow-up. Depth of invasion is associated with local
      recurrence, with a 9.1-mm reference value correctly predicting outcome in 81.5%
      of cases. Increasing tumor thickness is associated with local recurrence, with a
      10-mm reference value predictive of 90% non-recurrence and 33% recurrences. A
      pushing border pattern is less likely to recur than an infiltrative growth
      pattern. Lymph-vascular space invasion has a combined predictive accuracy of
      81.5%. Increasing keratin and greater than 10 mitoses per 10 high-power fields
      correlate with local recurrence. Neither clinical tumor size nor coexisting
      benign vulvar pathology correlates with local recurrence. Fourteen of twenty-one
      patients with vulvar recurrence died of metastatic disease, four died of
      intercurrent disease, and three were alive at 32, 68, and 157 months, with 16
      recurring in less than 1 year. Surgical margin is the most powerful predictor of
      local vulvar recurrence. Combining factors in a stepwise logistical regression
      does not significantly improve this predictive value. Accounting for specimen
      preparation and fixation, a 1-cm tumor-free surgical margin on the vulva results
      in a high rate of local control, whereas a margin less than 8 mm is associated
      with a 50% chance of recurrence.

PMID- 2227543
TI  - Radical wide excision and selective inguinal node dissection for squamous cell
      carcinoma of the vulva.
AB  - Limited resection of some vulvar cancers may provide cure rates equivalent to
      those obtained with radical vulvectomy and bilateral inguinal node dissection.
      Rapid recovery, fewer complications, and better functional result have been
      described as advantages to less extensive procedures. Since 1978, 32 patients
      with invasive squamous cell cancer of the vulva (depth greater than 1 mm) and
      clinically negative inguinal lymph nodes underwent radical wide excisions as
      primary therapy. Mean age at diagnosis was 61 years. Seventeen patients had T1
      and 15 had T2 tumors. Resection of the primary lesion was tailored to lesion
      location and size, and dissection was carried to the deep perineal fascia. Twenty
      two patients had unilateral superficial inguinal lymph node dissections, five
      with midline lesions had bilateral superficial dissections, and five had node
      samplings which included deep inguinal nodes. Depth of invasion ranged from 1.5
      to 13.0 mm. Mean largest lesion dimension was 23 mm. Five-year lifetable survival
      for the entire group was 84%. Univariate analysis of potential prognostic
      variables showed no significant recurrence or survival differences for patient
      age (P = 0.56), symptom duration (P = 0.57), FIGO stage (P = 0.67), tumor grade
      (P = 0.20), tumor location (P = 0.26), depth of invasion (P = 0.56), or resection
      margin status (P = 0.63). Thirty-one percent of patients had perioperative
      complications, and 16% developed delayed complications. Mean hospital stay was 10
      days. Three patients (10%) developed new or recurrent vulvar disease and
      underwent additional therapy. None have died of disease, although one is alive
      with persistent tumor. Radical wide excision and selective inguinal
      lymphadenectomy constitute a reasonable alternative to radical vulvectomy with
      bilateral inguinal node dissections for squamous tumors clinically limited to the
      vulva. Outcome may not be strongly influenced by lesion size or depth of
      invasion.

PMID- 2227542
TI  - Treatment of 29 patients with bulky squamous cell carcinoma of the cervix with
      simultaneous cisplatin, 5-fluorouracil, and split-course hyperfractionated
      radiation therapy.
AB  - Attempting to improve local disease control in bulky (greater than 8 cm) primary
      or recurrent pelvic tumors, 29 patients with squamous cell carcinoma of the
      cervix (stage II, 4; III, 10; IV, 6; recurrent, 9) were treated with concomitant
      chemotherapy and split-course hyperfractionated radiation therapy between April
      1983 and August 1988. Cisplatin (CDDP) and 5-fluorouracil (5-FU) have been shown
      to be radiation enhancers; furthermore, CDDP, radiation therapy, and continuous
      infusion 5-FU have elicited high local response rates in head and neck squamous
      cell carcinoma. A pilot study of cyclical week on/week off CDDP, continuous
      infusion 5-FU, and hyperfractionated radiation therapy was developed. Radiation
      was administered at 116 cGy twice daily, Days 1-5, every other week for a median
      dose of 4600 cGy to a pelvic field, with paraaortic extension if indicated.
      Concomitant chemotherapy included CDDP 60 mg/m2 IV Day 1 and 5-FU 600 mg/m2 IV
      continuous infusion for 96 hr following CDDP infusion. Patients received a median
      of four cycles of combined treatment, and intracavitary or interstitial
      brachytherapy followed in 21 patients. Local pelvic response was achieved in 29
      of 29 (100%): complete response (CR) in 19 of 29 (66%), partial response (PR) in
      10 of 29 (34%). Among CR patients 10 of 19 (53%) were without evidence of disease
      at a mean follow-up of 29 (range 12-76) months. Five-year actuarial disease-free
      survival among complete responders was 65%. Of the 10 CR patients 2 failed in the
      pelvis, for a local control rate of 17/19 (89%). Chemotherapy-related and acute
      radiation morbidity was minimal but 2 patients required surgical correction of
      radiation injury. Aggressive combination of split-course hyperfractionated
      radiation therapy with radiation enhancers resulted in promising local control of
      bulky pelvic tumor, with an acceptable complication rate, in this otherwise very
      poor prognostic group of patients.

PMID- 2227544
TI  - Synergy is documented in vitro with low-dose recombinant tumor necrosis factor,
      cisplatin, and doxorubicin in ovarian cancer cells.
AB  - Ovarian carcinomas have been shown to be sensitive or insensitive to the in vitro
      exposure of several cytotoxic drugs and cytokines. Because of the potential for
      cytokines to enhance the efficacy of chemotherapeutic agents and to improve their
      therapeutic index, the optimal dose and schedule of the combination of these
      agents have been studied. We examined the cytotoxic effect of a combined modality
      using a variety of concentrations of recombinant tumor necrosis factor (rTNF) (a
      cytotoxic cytokine) with Adriamycin (ADR) and cisplatin (CDDP) on human ovarian
      carcinoma cell lines. Cytotoxicity was determined in a 24-hr 51Cr-release assay
      and confirmed in a 5-day viability culture assay. Five cell lines were used: PA
      1, 222, OVCAR-3, SKOV-3, and OVCAR-8. Doses of rTNF that were minimally cytotoxic
      resulted in significant cytotoxicity and synergy when used with optimal or
      suboptimal concentrations of ADR or CDDP. This synergy was observed in four cell
      lines. Interestingly, the rTNF- and drug resistant SKOV-3 cell line was sensitive
      to the synergistic effect of Adriamycin and rTNF. The synergistic effect that was
      obtained was specific to rTNF, while the combined use of ADR and CDDP or
      recombinant interleukin-2 and cytotoxic drugs had no synergistic effect on tumor
      cell lysis. Further, the addition of anti-TNF antibody abrogated the synergistic
      effect seen with rTNF and the cytotoxic drugs. These studies demonstrate clearly
      that significant synergistic antitumor cytotoxic activity against human ovarian
      carcinoma cell lines can be achieved with combinations of low doses of rTNF and
      ADR or CDDP, suggesting their possible adaptation in vivo for cancer therapy.
      Further, the studies suggest that rTNF and the cytotoxic drugs tested may share a
      common lytic pathway. Since rTNF used alone has been relatively inactive in
      clinical trials, its potential activity may be apparent only when combined with
      conventional cytotoxic chemotherapeutic agents and when administered in
      relatively low concentration.

PMID- 2227545
TI  - c-myc amplification in ovarian cancer.
AB  - The c-myc oncogene codes for a DNA binding protein that appears to play an
      important role in the regulation of cell growth. c-myc gene amplification has
      been documented to occur in both hematopoietic and solid neoplasms and often
      indicates more biologically aggressive tumors. Southern hybridization analysis
      was performed on high-molecular-weight DNA isolated from primary ovarian
      carcinomas. Major structural rearrangements of c-myc were not detected. Five of
      seventeen (29.4%) tumor samples demonstrated amplification of the myc oncogene.
      The 5 patients with ovarian carcinomas associated with c-myc amplification
      exhibited a median survival of 17 months. Of the 12 patients without evidence of
      tumor-associated c-myc amplification, 5 have exhibited disease-free survival for
      an average of 36.8 months and are currently alive. The remaining 7 patients, the
      majority of whom had advanced-stage, poorly differentiated lesions with a normal
      c-myc copy number, exhibited a median survival of 9 months. There was no apparent
      relationship between c-myc amplification, grade of tumor differentiation, and
      response to platinol-based chemotherapy. These data do not suggest a prognostic
      role for c-myc amplification in primary ovarian cancer. However, c-myc
      amplification is a common finding in advanced-stage ovarian cancer.

PMID- 2227546
TI  - Diagnosis and treatment of pulmonary metastases from cervical carcinoma.
AB  - The records of 2116 patients treated for cervical malignancy from 1969 to 1984 at
      the University of Alabama at Birmingham were reviewed and 88 (4.16%) had
      pulmonary lesions consistent with metastatic cervical cancer. The data were
      analyzed to characterize risk factors for developing lung metastases, to
      determine radiographic patterns, to assess methods of documentation, and to
      determine response to chemotherapy. Platinum-type chemotherapy has a 67.7%
      response rate on chest X ray, with one-third of the responses being complete. The
      prognosis is poor with a median survival of 0.69 year (8.3 months); only 2 of
      these 88 patients were long-term survivors. Although the survival is poor, a few
      statistically significant factors could be identified as prognostic. Our data do
      not support use of surveillance chest X rays, as there is no statistically
      significant survival difference in symptomatic versus asymptomatic patients. The
      development of more effective salvage therapy may alter this recommendation.

PMID- 2227547
TI  - Prospective surgical-pathological study of disease-free interval in patients with
      stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group
      study.
AB  - There were 732 evaluable patients with primary, previously untreated,
      histologically confirmed stage I squamous carcinoma of the cervix with greater
      than or equal to 3-mm invasion. Of these, 645 had no gross disease beyond the
      cervix/uterus, had negative paraaortic lymph nodes, and had undergone a radical
      hysterectomy with pelvic lymphadenectomy. The 3-year disease-free interval (DFIs)
      for the 545 patients with negative pelvic nodes was 85.6%, and for the 100 with
      positive pelvic nodes, 74.4%. A large number of pelvic nodes involved with tumor
      was not correlated with a poorer prognosis; the DFIs were 72.1, 86.4, and 64.6%
      for one, two, and three or more positive pelvic nodes, respectively. DFI
      correlated strongly with depth of tumor invasion, both in absolute terms (mm) and
      infractional thirds. The DFI was 94.6% for less than or equal to 5 mm, 86.0% for
      6-10 mm, 75.2% for 11-15 mm, 71.5% for 16-20 mm, and 59.5% greater than or equal
      to 21 mm. In fractional terms, the DFI was 94.1% for superficial third, 84.5% for
      middle third, and 73.6% for deep third invasion. With respect to clinical tumor
      size, the DFIs were 94.8, 88.1, and 67.6% for occult, less than or equal to 3 cm,
      and greater than 3 cm, respectively. The DFI was 77.0% for those with positive
      capillary-lymphatic spaces (CLS) and 88.9% for those with negative CLS. Tumor
      grade and parametrial status correlated with DFI. DFI was not significantly
      different for age, disease status of the surgical margins, tumor description
      (e.g., exophytic), quadrant involved with tumor, uterine extension, and
      keratinizing status of tumor cells. Clinical tumor size, CLS, and depth of tumor
      invasion were independent prognostic factors.

PMID- 2227548
TI  - Aggressive chemosurgical debulking in patients with advanced ovarian cancer.
AB  - From July 1986 to June 1989, 43 evaluable patients with advanced ovarian cancer
      were treated on protocol with initial cytoreductive surgery, two courses of high
      intensity intravenous Cytoxan (1000 mg/m2) and cisplatin (120-200 mg/m2)
      chemotherapy, and repeat debulking laparotomy in an effort to maximize response
      to a subsequent four cycles of intraperitoneal platinum-based chemotherapy. Two
      patients were stage IIIA, 2 stage IIIB, 28 stage IIIC, and 11 stage IV. Five
      tumors were grade 1, 9 grade 2, and 29 grade 3. Thirty-eight (88%) patients had
      bulky tumor (5-25 cm) found at first laparotomy; 25 of these had greater than 1
      cm residual after initial debulking. Following two cycles of intensive
      intravenous chemotherapy 18 of these 25 had greater than 1-cm disease found at
      second laparotomy; 12 of 18 underwent secondary cytoreduction to less than 1 cm.
      Thus, 30 of these 38 (79%) patients entered the intraperitoneal phase of the
      protocol with less than 1-cm disease. Four patients had 2- to 5-cm tumor at
      initial laparotomy; two of four were debulked to less than 1-cm residual. All
      four were found to have less than 1-cm disease at second laparotomy. This
      combination regimen was well tolerated. There was one treatment-related death. In
      sum, 42 of 43 patients had tumor greater than 2 cm at staging laparotomy and 38
      (88%) had large, bulky disease (5-25 cm); 34 of 43 (79%) entered the
      intraperitoneal phase of the protocol with optimal (less than 1-cm) disease.
      Aggressive chemosurgical cytoreduction in patients with bulky advanced ovarian
      cancer can leave a large proportion of patients with minimal residual disease and
      maximize their chances of responding to subsequent intraperitoneal chemotherapy.

PMID- 2227549
TI  - Oncogene alterations in endometrial carcinoma.
AB  - The neu oncogene codes for a cell surface protein that has a high degree of
      homology with the epidermal growth factor receptor. Amplification of this
      oncogene in breast carcinoma and ovarian carcinoma is correlated with a poorer
      prognosis. The c-myc oncogene codes for a DNA binding protein and is believed to
      regulate cellular proliferation. Sixteen primary endometrial adenocarcinomas were
      analyzed for c-myc and c-neu amplification. Eleven of sixteen tumor samples
      exhibited amplification of the neu gene. Four of these eleven patients died of
      disease an average of 16 months after diagnosis. The five patients without tumor
      amplification of the c-neu gene have been followed an average of 31.2 months
      without evidence of recurrent disease. Ten of fifteen tumor samples exhibited
      amplification of the c-myc gene. Five of the ten patients died of disease an
      average of 13.4 months after diagnosis. The remaining five patients have been
      followed for an average of 31.2 months and are free of disease. Six of the
      sixteen tumor specimens exhibited amplification of the both c-neu and c-myc
      genes, and four of these patients died of recurrent disease. Amplification of the
      c-neu or c-myc oncogene correlated with advanced-stage disease and poorly
      differentiated lesions, suggesting that oncogene amplification may predict
      biologically aggressive adenocarcinomas of the endometrium.

PMID- 2227550
TI  - Ovarian intraepithelial neoplasia demonstrated in patients with stage I ovarian
      carcinoma.
AB  - Retrospective review of sections of ovary from 50 patients with stage I, grade 1
      3, epithelial ovarian carcinoma was performed to assess presence of cellular and
      nuclear atypia in noncancerous tissue adjacent to the primary tumor; ovarian
      tissue from 50 patients undergoing incidental oophorectomy was reviewed as well.
      Atypia was more common in cancer patients, and finding the combination of nuclear
      atypia, defined as presence of pleomorphism or irregular chromatin distribution,
      with cellular atypia, defined as presence of stratification or loss of polarity,
      allowed separation of cancer and control groups with 98% sensitivity and 100%
      specificity. Presence of nuclear and cellular atypia was used to define ovarian
      intraepithelial neoplasia (OIN). If OIN is demonstrated to precede ovarian
      carcinoma, then it may offer insights into the development of ovarian cancer and
      may eventually increase the feasibility of screening for this disease.

PMID- 2227551
TI  - Does serum CA-125 level prior to second-look laparotomy for invasive ovarian
      adenocarcinoma predict size of residual disease?
AB  - The records of 125 patients with nonmucinous invasive ovarian adenocarcinoma who
      underwent cytoreductive surgery, cisplatin-based combination chemotherapy, and
      second-look laparotomy were analyzed to correlate pre-second-look serum CA-125
      levels with the size of residual ovarian cancer. The majority of patients with
      negative second-look laparotomy had normal serum CA-125 levels (46/50 or 92%). Of
      the 75 patients with positive second-look, 56 (75%) had normal CA-125 levels
      preoperatively. Twenty-three of twenty-four (96%) patients with residual disease
      less than or equal to 1 cm had normal CA-125 levels as did 20 of 28 (71%)
      patients with disease 1.1-2.0 cm. Although elevated serum CA-125 levels were
      invariably associated with visible/gross disease and increasing size of residual
      disease tended to be associated with increasing elevations of CA-125, normal CA
      125 levels often occurred in the presence of large-volume (greater than 2 cm)
      disease (13/23, 57% of patients). The considerable overlap of serum CA-125 levels
      for all sizes of residual disease precluded precise prediction of residual
      disease size based on serum CA-125 level alone.

PMID- 2227552
TI  - Human immunodeficiency virus infection and cervical neoplasia.
AB  - To determine the relationship between human immunodeficiency virus (HIV)
      infection and cervical neoplasia, the characteristics of invasive and preinvasive
      cervical disease in 114 patients of known HIV status were assessed. Seven of
      thirty-seven patients (19%) under age 50 with invasive cervical carcinoma were
      HIV-positive, including a 16-year-old with stage IIIB disease. HIV-positive
      patients had more advanced invasive cancer than HIV-negative patients. Disease
      persisted or recurred in all HIV-positive patients compared to 37% of HIV
      negative patients. In HIV-positive patients, the median times to recurrence and
      death were 1 and 10 months, respectively. No HIV-positive patient had HIV-related
      symptoms. The mean T4:T8 cell ratio in HIV-positive patients was 0.49, compared
      to 1.86 in HIV-negative patients. The mean T4 cell count was 362/mm3 in HIV
      positive and 775/mm3 in HIV-negative patients. Colposcopic evaluations of the
      lower genital tract of 77 patients with abnormal smears revealed higher-grade
      cytology and histology in 25 HIV-positive than in 52 HIV-negative patients. HIV
      positive patients had significantly more multifocal/extensive lesions, multisite
      involvement, perianal involvement, evidence of human papillomavirus (HPV)
      infection, and associated gynecologic infections than HIV-negative patients. In
      areas at high risk for HIV infection, we must anticipate a high prevalence of HIV
      seropositivity in women with invasive cervical cancer. In the HIV-infected,
      cervical cancer is of advanced stage and responds poorly to therapy.
      Intraepithelial neoplasia in HIV-positive patients may be of higher grade than in
      HIV-negative patients, with more extensive involvement of the lower genital
      tract.

PMID- 2227554
TI  - Flow cytometric versus immunohistochemical analysis of ovarian cancer class I
      antigen expression: differences may represent a defect in antigen expression.
AB  - Class I antigen expression by ovarian epithelial neoplasms was determined by flow
      cytometric analysis and an immunoperoxidase technique for each specimen. The
      numbers of class I positive tumors determined by the methods were compared. The
      more subjective immunohistochemical analysis and the more objective flow
      cytometric technique revealed similar results as long as strict criteria for the
      interpretation of results was applied. Most of the tumor specimens revealed a
      homogeneous Gaussian distribution of green fluorescence, class I antigen
      expression, by flow cytometry. There were two specimens that exhibited a less
      than characteristic type of membrane staining. The antigen-antibody reaction
      product was expressed in the extracellular matrix, as well as on the cell
      membrane of certain cells. This may represent a defect in antigen expression and,
      if so, might alter the immune response to these tumors.

PMID- 2227553
TI  - Chemotherapy versus radiotherapy in the management of ovarian cancer patients
      with pathological complete response or minimal residual disease at second look.
AB  - The management of patients with epithelial ovarian cancer with no or minimal
      residual disease at second-look laparotomy after aggressive surgery and platinum
      based chemotherapy has not been definitively established. We report the results
      of a randomized study comparing three more courses of the same chemotherapy
      inducing the response (21 patients) with whole-abdomen radiotherapy (20
      patients). Thirty-eight patients responded to first-line chemotherapy and three
      had stabilization of disease. In eight patients tumor debulking was performed at
      second-look laparotomy. No severe toxic effects were noted in both arms. Bowel
      obstruction occurred in one patient treated with radiotherapy. At a median follow
      up of 22 months, 11 of 20 patients in the radiotherapy arm and 6 of 21 in the
      chemotherapy arm progressed and 9 and 3 patients died, respectively. Although the
      number of randomized patients is small we stopped the trial because of the
      survival and progression-free survival advantage of chemotherapy-treated
      patients.

PMID- 2227555
TI  - Gynecologic radiotherapy fields defined by intraoperative measurements.
AB  - Whole-pelvis radiation therapy has been traditionally delivered through fields,
      the dimensions of which have been determined by convention and based largely on
      textbook anatomic landmarks. Since July 1986, 100 patients have had
      intraoperative retroperitoneal measurements carried out at the time of radical
      surgery in an effort to examine this anatomic basis for field dimensions.
      Structural measurements of the pelvic and paraaortic arterial branches were made
      in reference to the lumbosacral prominence to correlate with lymphatic pathways.
      The mean level of the aortic bifurcation was found to be 6.7 cm above the
      lumbosacral prominence. The mean level of the bifurcation of the common iliac
      artery was 1.7 cm above this reference point on the right and 1.4 cm above on the
      left. Both common iliac bifurcations were cephalad to the level of the
      lumbosacral prominence in 87% of patients. In only three patients were both
      bifurcations located below this level. Transverse pelvic dimension measurements
      demonstrated a width of 12.3 cm at the level of the obturator fossa and of 13.0
      cm at the most inferior outside width of the external iliac arteries. To
      establish a simple external reference which could assist in defining radiotherapy
      field widths, the maximal separation of the femoral arteries at the level of
      inguinal ligaments was measured and averaged 14.6 cm. These data suggest that
      conventional fields frequently fail to correspond to true anatomic landmarks and
      that to optimally cover the lymphatics in radiotherapy, fields should, ideally,
      be based on intraoperative measurements. If such surgical guides are not
      available, we would suggest that standard whole-pelvis radiotherapy for cervical
      cancers should employ anterior and posterior fields with widths of at least 16 cm
      which will fully include the bifemoral separation. A superior border at the L4-L5
      interspace is required to cover lymphatic pathways to the mid-common iliac nodal
      level. It may also be convincingly pointed out that the attachments of the
      uterosacral and cardinal ligaments are clearly posterior to the rectosigmoid,
      mandating lateral fields that should encompass the entire anterior sacral
      silhouette.

PMID- 2227557
TI  - Database management for a gynecologic oncology service.
AB  - With the ready availability of powerful desktop computers, the ability to manage
      large clinical databases has become practical. A computer can enhance the
      capability of a gynecologic oncology service to catalog, recall, and analyze data
      about patients, tumors, and therapies. While commercially available database
      packages can be used for this purpose, we have developed a custom database for
      tracking the clinical activity of a busy gynecologic oncology service. The system
      catalogs data about patients, admissions, tumors, and therapeutic modalities and
      uses this information to generate several useful reports. The reports are used
      for daily patient care, fellow and resident case statistics, and clinical
      research. What is unique about the system is that it is optimized for ease of
      use. The development of this tumor registry, its user friendliness, and
      advantages over a manual recordkeeping system are described. Unlike other tumor
      registries, our system is utilized on a daily basis for patient care. Therefore,
      the data being entered have an immediate usefulness in addition to being
      simultaneously added to the tumor register for retrospective clinical research.
      One may hypothesize that it would be useful if all gynecologic oncology services
      used a common computerized tumor registry that could allow for the sharing of
      information on a national or global scale.

PMID- 2227556
TI  - Clinical-pathologic study of stage IIB, III, and IVA carcinoma of the cervix:
      extended diagnostic evaluation for paraaortic node metastasis--a Gynecologic
      Oncology Group study.
AB  - Three hundred twenty patients were entered into GOG Protocol 63, a clinical
      pathologic study of stage IIB, III, and IVA cervical carcinoma. Following the
      completion of FIGO staging prerequisites, patients had computerized tomography
      (CT), a lymph-angiogram (LAG), and an ultrasound (US) of the aortic area. If any
      study was positive, a cytologic or histologic evaluation by fine-needle
      aspiration or selective paraaortic lymphadenectomy was performed. Paraaortic node
      dissection was mandated for patients with negative extended staging studies.
      Results of extended staging evaluations were compared with histologic or
      cytologic results. Two hundred sixty-four patients were eligible and evaluable.
      One hundred sixty-seven patients (63%) were stage IIB, 89 (34%) were stage III,
      and 8 (3%) were stage IVA. Positive paraaortic nodes occurred in 21% of stage
      IIB, 31% of stage III, and 13% of stage IVA. LAG sensitivity was 79% with a
      specificity of 73%. Sensitivity of CT and US was 34 and 19%, respectively, with
      specificities of 96 and 99%, respectively. The frequency of false-negative
      results with LAG for patients with stage IIB disease was 6%. This decrease is
      consistent with a stable sensitivity and specificity. These findings suggest that
      a negative LAG may be adequate to eliminate surgical staging in subgroups with
      low risk of metastasis to the aortic nodes. Until new noninvasive testing methods
      are developed, LAG appears to be the most reliable noninvasive examination to
      evaluate spread of cervical cancer to aortic nodes.

PMID- 2227558
TI  - Heterogeneity in hormone receptor status in primary and metastatic endometrial
      cancer.
AB  - The rationale for endocrine therapy in patients with advanced endometrial
      carcinoma may be based on the presence of estrogen or progesterone receptors in
      the primary tumor. A study was designed to evaluate tumor cell heterogeneity of
      steroid hormone receptors in the primary and metastatic sites in endometrial
      cancer. Primary endometrial cancer tissue samples from 10 patients and 16
      metastatic tumor sites were simultaneously analyzed for estrogen and progesterone
      receptors, using a radioligand biochemical assay. The primary tumor was estrogen
      receptor (ER) and progesterone receptor (PR) positive in 70 and 60% of the
      patients, respectively. The metastatic sites were ER positive in 63% and PR
      positive in 25%. The primary tumor tissue and the metastatic disease showed an
      identical ER and PR status in only 25 and 19%, respectively. Four patients had
      multiple metastatic sites analyzed. In two of four patients the PR values, and in
      three of four patients the ER values, in these metastatic sites were discordant.
      These data support the concept of tumor cell heterogeneity for steroid hormone
      receptors in endometrial cancer. To optimize treatment planning, it may be
      important to biopsy primary, metastatic, and recurrent tumor sites for individual
      analysis of receptor activity.

PMID- 2227559
TI  - Bone marrow involvement in epithelial ovarian cancer by immunocytochemical
      assessment.
AB  - The incidence of bone marrow involvement with epithelial ovarian cancer has been
      evaluated as a continuation of interest in autologous bone marrow support. Fifty
      eight aspirates were obtained on 50 patients and 53 aspirates were evaluable.
      Immunocytochemistry with the monoclonal cytokeratin antibodies 35 beta H11 and 34
      beta E12 was performed. There have been no complications. Twelve (23%) were
      positive and three were indeterminate. Stage, grade, and CA-125 level were not
      different in the two groups. No patient had a positive biopsy at the time of
      initial diagnosis. The majority of patients were drawn from second-look
      procedures; of these, 7 of 19 were positive. Five of twelve with positive
      aspirates died from disease versus 5 of 38 with negative aspirates, and patients
      with a positive aspirate had a longer overall survival time until death from
      disease. We can confirm the presence of epithelial ovarian cancer in 23% of
      patients at varying times in the course of their disease. We cannot identify risk
      factors for the development of this finding nor the viability of those cells when
      found in this data set.

PMID- 2227560
TI  - Concurrent chemoradiation in advanced cervical cancer.
AB  - The pelvis is the predominant site of failure following radical radiotherapy (RT)
      for locally advanced cervical cancer. We report the results of phase I-II studies
      on 200 patients with bulky (greater than or equal to 5 cm) carcinoma of the
      cervix. Patients were treated between 1981 and 1988 on sequential protocols of
      concurrent chemoradiation to establish an acceptable treatment regimen. RT with
      daily or partially hyperfractionated pelvic (n = 154) or pelvic plus paraaortic
      (n = 46) fields was given by continuous (n = 154) or split course (n = 46)
      regimens. Infusional fluorouracil (5-FU) in a dose of 1 g/m2/day was given on the
      first and last 4 days of a 5-week course of continuous RT, or with both halves of
      split course RT. Seventy-eight patients received bolus mitomycin C (Mit-C), 6
      mg/m2, once or twice with the start of the 5-FU infusion. The median external RT
      dose was 46 Gy (range 40 to 65 Gy) followed in 90% (n = 181) by a single
      intracavitary application of 40 Gy using a linear source of cesium-137. Median
      follow up is 2.5 years (range 0.6 to 6.9 years) and is sufficient to reliably
      estimate late toxicities. Acute toxicities were transient oral mucositis (13), RT
      interruption for enteritis (7), febrile neutropenia (3), and thrombocytopenic
      tumor bleed (1). Serious late toxicities resulted in death in 3 patients and
      occurred in bladder in 6 and in bowel in 25, including 8 patients with tumor
      recurrence. The incidence of late bowel toxicity correlated with the specific
      therapy given and decreased with each successive protocol. On logistic regression
      the only treatment variable showing a statistically significant effect on
      complications was the use of Mit-C (P = 0.0053). Pelvic RT and 5-FU alone
      produced fewer complications, only 4/105, than historically seen with standard
      pelvic RT alone. Three-year pelvic control and survival rates were 85 and 71%
      respectively in stage Ib/II (n = 100) and 50 and 42% in stage III/IV (n = 100).
      Encouraged by these results and decreased toxicity, we have begun a phase III
      study to determine whether the addition of concurrent 5-FU to continuous
      partially hyperfractionated pelvic RT improves local control and survival.

PMID- 2227561
TI  - Class I histocompatibility antigen expression: a prognostic factor for aneuploid
      ovarian cancers.
AB  - Epithelial ovarian cancers with aneuploid DNA content are associated with a
      poorer clinical course than diploid tumors. Flow cytometric analysis may further
      categorize aneuploid tumors based on the relative expression of cell surface
      histocompatibility (HLA) antigens. Surgical specimens from 20 patients with
      aneuploid tumors were stained using an indirect immunofluorescence method with
      primary murine monoclonal antibodies W36/22 (class I HLA surface antigens) and
      L5.1 (irrelevant antibody), counterstained with propidium iodide (DNA stain), and
      analyzed with the flow cytometer using a computer program to correct staining
      intensity for cell size. Patients with high or low class I expression were
      similar with respect to age, stage, histology, grade, and residual disease
      following surgical debulking; all patients were treated with cisplatin-based
      chemotherapy. Women with low class I HLA antigen expression had higher
      progression rates and death rates than patients with high class I HLA expression.
      Low class I HLA antigen expression is a poor prognostic factor among patients
      with aneuploid ovarian cancers.

PMID- 2227562
TI  - Pelvic exenteration with low rectal anastomosis: survival, complications, and
      prognostic factors.
AB  - Between July 1979 and January 1989 there were 31 patients who underwent pelvic
      exenteration with low rectal anastomosis (PE and LRA) at the University of
      Alabama at Birmingham (UAB). There were no operative deaths; however, 32% of the
      patients experienced significant postoperative morbidity. Survival (Kaplan-Meier)
      at 1 year is 86%. Overall survival is 68% with follow-up ranging from 10 months
      to greater than 9 years. For those patients with disease confined to the cervix
      and/or vagina (n = 18) the survival is 89% while it is 38% for patients with
      spread to the bladder, rectum, or parametrium (n = 13). Survival was not
      influenced by tumor differentiation, time from irradiation to exenteration, or
      initial stage. Complete healing of the LRA was achieved in 16 patients (52%).
      However, in the subset of patients with an omental wrap (n = 13) the complete
      healing rate is 85%. Protective colostomies were utilized in 12 patients;
      however, this was not shown to improve the healing rate of the LRA. This group of
      patients is compared to similar patients who had anterior pelvic exenteration at
      UAB for morbidity and survival. LRA at the time of pelvic exenteration for
      recurrent cervical cancer is associated with acceptable morbidity and survival
      and should be attempted in those patients who are appropriate candidates.

PMID- 2227563
TI  - Radioimmunoscintigraphy of ovarian tumors using a new monoclonal antibody, SM-3.
AB  - Radioimmunoscintigraphy with SM-3 monoclonal antibody produces results similar to
      those obtained with 123I-labeled HMFG-2. The tumor specificity of SM-3 in vitro
      is not as marked as that in vivo. SM-3 is, however, much easier to produce in
      tissue culture and, with the availability of 99mTc labelling, has allowed
      radioimmunoscintigraphy to be done as an outpatient procedure. This technique has
      important implications for the continuing management of patients with ovarian
      cancer.

PMID- 2227564
TI  - Chromosome abnormalities in human epithelial ovarian malignancies.
AB  - Karyotypic analysis of tumor specimens from 29 patients with untreated epithelial
      ovarian carcinoma was performed at the University of Kentucky Medical Center.
      Twenty-three of the twenty-nine tumors had adequate cells for analysis. Seventeen
      of these tumors exhibited chromosome abnormalities. Chromosome alterations were
      complex, with an average of seven different abnormal chromosomal patterns per
      tumor (range 2-14). Chromosomes 1 and 11 were the most commonly involved, being
      abnormal in 89 and 83% of tumors, respectively. Chromosomes 3 and 7 were also
      frequently abnormal. In contrast to invasive tumors, alterations in chromosomes 1
      and 11 were not seen in the two tumors of borderline malignant potential.
      Evidence for DNA amplification of IGF2, Ha-ras-1, and c-ets was not observed.
      Amplification of the c-erbB-2 oncogene was present in two tumors. These findings
      indicate that multiple karyotypic abnormalities occur in untreated epithelial
      ovarian malignancies, with chromosomes 1 and 11 being the most frequently
      abnormal. These data also suggest that alterations of these chromosomes may be
      associated with the biologically aggressive behavior of frankly invasive ovarian
      tumors.

PMID- 2227565
TI  - Estimates of dose to intraperitoneal micrometastases from alpha and beta emitters
      in radioimmunotherapy.
AB  - Intraperitoneal metastases from ovarian and other gynecologic tumors are a
      significant source of treatment failure. In recent years, investigators have used
      radiolabeled monoclonal antibodies to treat this disease with encouraging
      results. We have developed a dose calculational technique which generates isodose
      distributions from intraperitoneally administered alpha and beta particle
      emitters. In this study we apply the calculations to tissue biopsy samples to
      determine the adequacy of dose to ovarian micrometastases. Tissue samples from
      staging biopsies at the time of surgical debulking are scanned to identify small
      metastases. The patient population studied comprised those with ovarian disease
      who based on clinical criteria would be considered good candidates for
      intraperitoneal radioimmunotherapy. The regions of interest (which include the
      tumor and surface of the peritoneum) are digitized and tumor volumes are
      contoured. Dose calculations based on the modeling of intraperitoneally
      administered antibodies radiolabeled with various isotopes is performed and the
      minimum dose to tumor and normal tissue is assessed. For example, with tumor
      uptake of 0.1% injected dose per gram of tissue, the surface tumor dose from
      alpha emitters is up to 45,000 rads. The dose falls to 6000 rads at approximately
      40 microns from the peritoneal surface. The surface dose from 20 mCi 90Y
      administered in 1500 ml saline is up to 10,000 rads, and at a 2-mm depth,
      approximately 2000 rads. From our calculation dose distribution from
      radioimmunotherapy varies as a function of physical characteristics of the
      isotope, absorption of activity, and amount of disease being treated.

PMID- 2227566
TI  - Tumor markers in gynecologic oncology.

PMID- 2227567
TI  - Debridement of vaginal radiation ulcers using the surgical Ultrasonic Aspirator.
AB  - The surgical Ultrasonic Aspirator (USA) is a fairly new surgical instrument used
      for an increasingly wide range of procedures. This paper introduces a new
      application: debridement of vulvovaginal necrotic ulcers resulting from
      intracavitary radiation therapy. The ultrasonic aspirator allowed removal of the
      soft, necrotic tissue while preserving underlying healthy, firm tissue and blood
      vessels.

PMID- 2227568
TI  - Usefulness of endocervical curettage (ECC)

PMID- 2227569
TI  - Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide
      antigen, and placental alkaline phosphatase, in patients with ovarian carcinoma,
      borderline tumors, or benign adnexal masses: relevance for differential
      diagnosis.
AB  - Pretreatment serum levels of the antigens CA-125, tissue polypeptide Antigen
      (TPA), carcinoembryonic antigen (CEA), and placental alkaline phosphatase (PLAP)
      were determined in samples from 295 women with adnexal masses. At laparotomy 48%
      of patients had epithelial ovarian carcinoma, 9% had tumors of low malignant
      potential, and 8% suffered from malignancies of other kinds. The sensitivity of
      CA-125 with 35 U/ml as the cutoff was 88% in women with ovarian carcinoma, but
      74% among those with limited disease and 58% in borderline malignancy. Only 6 of
      17 mucinous ovarian carcinomas were detected. Specificity was 83%. CEA was
      elevated above 5.0 micrograms/liter in 15 of 17 patients with mucinous ovarian
      cancer. TPA detected advanced stages of malignancy, but the sensitivity was low,
      53%, in cases with limited disease. PLAP was elevated in 46% of ovarian carcinoma
      patients. For detecting malignancy overall, the use of a parallel combination of
      the CA-125 and CEA assays was more sensitive than use of CA-125 as a single
      marker. This test combination may be of value in the diagnosis of adnexal masses.
      The predictive value of a positive result was 90%, and that of a negative result,
      76%.

PMID- 2227570
TI  - Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide
      antigen, and placental alkaline phosphatase in patients with ovarian carcinoma:
      influence of histological type, grade of differentiation, and clinical stage of
      disease.
AB  - Pretreatment serum levels of the tumor-associated antigens CA-125, tissue
      polypeptide antigen (TPA), carcinoembryonic antigen (CEA), and placental alkaline
      phosphatase (PLAP) were analyzed in 142 patients with epithelial ovarian
      carcinoma, and related to clinical and histopathological parameters. In a linear
      multiple regression model CA-125 serum levels were profoundly influenced by the
      type of tumor, i.e., mucinous or nonmucinous. Clinical stage also had significant
      impact, whereas grade of differentiation did not, when the other two factors were
      taken into account. CEA levels were also dependent mainly on histological type.
      Mucinous tumor cases had high levels. Only clinical stage or tumor burden had a
      significant impact on TPA levels. PLAP levels were significantly influenced by
      histological type of tumor and by grade of differentiation but not by clinical
      stage. The dependence of CA-125 levels upon clinical stage was evident only in
      nonmucinous tumors. Furthermore, size of the primary tumor was not important for
      the CA-125 value, in contrast to FIGO stage. Thus CA-125 is primarily a sensitive
      indicator of disseminated disease in ovarian carcinoma patients. On the basis of
      the CA-125 level it was possible to predict the extent of disease with an overall
      accuracy of 55%. If TPA and CEA levels were also considered, the predictive
      accuracy was 63%.

PMID- 2227571
TI  - Epidemiology of adenocarcinoma of the cervix.
AB  - There is general evidence that the incidence of adenocarcinoma of the cervix has
      been rising, particularly among younger women. The determinants of these trends,
      however, remain largely unknown. We have reviewed the epidemiology of
      adenocarcinoma of the cervix using descriptive data from cancer registration and
      clinical series and two main sources of analytical data: clinical studies
      comparing cervical adenocarcinoma (AC) and squamous carcinoma (SC) and formal
      case-control and cohort epidemiological studies. In both the United States and
      northern Europe there is evidence of the rising frequency of AC in absolute and
      relative terms as compared to SC. These trends are generally restricted to
      younger women: under-age-35 AC incidence approximately doubled from the early
      1970s to the early 1980s. Available data, although scanty, consistently show that
      the frequency of cervical adenocarcinoma rises with the number of partners and
      with decreasing age at first intercourse, suggesting a potential role for
      sexually transmitted (viral) factors. In clinical series, nulliparity was
      reported more frequently in AC than in SC cases but an inconsistent association
      was found in three formal epidemiological studies. Similarities with the
      epidemiology of endometrial cancer are also suggested from the association with
      overweight, while a possible relation with hypertension and diabetes is based on
      clinical series only and hence more difficult to interpret. Thus, adenocarcinoma
      of the cervix appears to share epidemiological characteristics with both
      adenosquamous cancer of the cervix and adenocarcinoma of the endometrium,
      although uncertainties in classification and registration leave several questions
      unanswered.

PMID- 2227572
TI  - Radiation therapy in stage III ovarian cancer following surgery and chemotherapy:
      prognostic factors, patterns of relapse, and toxicity: a preliminary report.
AB  - Twenty patients with FIGO stage III epithelial ovarian cancer who had undergone
      maximum cytoreductive surgery (including pelvic and paraaortic lymph node
      dissection) and combination chemotherapy (4-10 cycles, median 6) were treated
      with irradiation to the abdomen and pelvis with 30 Gy followed by
      diaphragmatic/paraaortic and pelvis boost fields to 42 and 51.6 Gy, respectively.
      Second-look laparotomy was not performed. Seventeen of 20 patients completed the
      planned course of radiation. In 2 cases, failure to complete treatment was
      related to acute hematologic toxicity, and 1 patient refused further treatment.
      Five patients (29%) required treatment breaks ranging from 8 to 16 days (median,
      12 days) due to pancytopenia. Actuarial overall survival and relapse-free
      survival at 3 years for the 17 patients who completed radiation was 69 and 47%,
      respectively, with follow-up ranging from 19 to 53 months (median: 24, mean: 27.6
      months). Seven patients (41%) relapsed within the abdomen alone and 2 patients
      developed extraabdominal lymph node metastasis as their sole site of failure. The
      prognostic factors evaluated for correlation with relapse-free survival included
      histologic subtype, grade, amount of residual disease at the time of surgery, and
      nodal involvement; only residual tumor at surgery (none vs less than or equal to
      2 cm or greater than 2 cm) was found to be statistically significant (P less than
      0.01). Three-year overall survival correlated with amount of residual disease
      following the initial cytoreductive surgery. It was 100% for patients with no
      residual disease, 66.7% for less than or equal to 2 cm, and 26.7% for those with
      greater than 2 cm residual disease, respectively. Radiation treatment was well
      tolerated, with only one patient developing treatment-related bowel obstruction 7
      months after radiation therapy. The results of this planned trimodality treatment
      approach compare favorably with those reported following surgery and
      chemotherapy, particularly in patients who have been maximally cytoreduced.

PMID- 2227573
TI  - Human ovarian cancers specifically bind daunorubicin-OC-125 conjugate: an
      immunofluorescence study.
AB  - This study was designed to test the specific binding to human ovarian serous
      adenocarcinomas of a drug-antibody conjugate [daunorubicin (DNR-OC-125], made
      from a new analog (PIPP-DNR) of daunorubicin that chemically links the drug to
      monoclonal antibodies. We recently reported that the DNR-OC-125 conjugate is
      selectively toxic in vitro to dividing cell populations of the human ovarian
      cancer cell lines SK-OV-3 and OVCAR-3 that express the CA-125 antigen [F. Sweet,
      L. O. Rosik, G. M. Sommers, and J. L. Collins, Gynecol. Oncol. 34, 305-311
      (1989)]. In the present study, immunofluorescence data show that the DNR-OC-125
      conjugate has high affinity and specificity for proliferating malignant cells
      from human ovarian tumors. The results demonstrate that the DNR-OC-125 conjugate
      retains the specific binding to CA-125 antigenic sites characteristic of the OC
      125 monoclonal antibody moiety. The DNR-OC-125 conjugate selectively binds to CA
      125 antigen-positive ovarian cancerous tissue in both cryostat and paraffin
      embedded tissue sections. This is consistent with the earlier in vitro data from
      dividing populations of two human ovarian cancer cell lines that revealed
      retention by the DNR-OC-125 conjugate of both the specificity due to OC-125 and
      the cytotoxicity of daunorubicin. The present immunofluorescence studies in the
      DNR-OC-125 conjugate is tested on human ovarian serous tumors indicate that the
      OC-125 monoclonal antibody can indeed serve as a cancer-targeting carrier for
      daunorubicin and its analogs.

PMID- 2227574
TI  - Recurrent carcinoma of the vulva after conservative treatment for "microinvasive"
      disease.
AB  - Although the standard therapy of vulvar carcinoma remains radical surgery, this
      approach is accompanied by significant postoperative morbidity and psychological
      adjustment. Radical hemi-vulvectomy and ipsilateral superficial groin node
      dissection are increasingly used for patients with "early" or "microinvasive"
      disease. Two patients with an "early" vulvar carcinoma were treated
      conservatively and later developed recurrent disease. Despite further surgery and
      radiotherapy, both patients eventually died of disease. The case histories are
      described and the pertinent literature is discussed.

PMID- 2227575
TI  - Interobserver variation in ovarian measurements using transvaginal sonography.
AB  - Ultrasound examination of ovarian size and morphology has been proposed as a
      screening method for ovarian carcinoma. A screening test must give consistent
      results when performed by different examiners to reliably determine the
      sensitivity and specificity of the test. This study was designed to evaluate
      interobserver variation in ovarian size measurements using transvaginal
      sonography. Two examiners independently measured 86 ovaries in three planes and
      ovarian volumes were calculated using the prolate ellipsoid formula. The
      correlation coefficient between the ovarian volume measurements made by each
      examiner was 0.960. These results indicate that interobserver variation in
      ovarian volume measurements is extremely low as determined by transvaginal
      sonography.

PMID- 2227576
TI  - Study of the selective cytotoxic properties of cationic, lipophilic mitochondrial
      specific compounds in gynecologic malignancies.
AB  - Cationic lipophilic compounds have a unique cytotoxic mechanism of action which
      is dependent on mitochondrial-specific localization of these fluorescent dyes. We
      have demonstrated in vitro that carcinoma cells, which have a higher negative
      mitochondrial membrane potential than normal cells, have an increased
      accumulation and retention of two of these compounds. The compounds tested were
      rhodamine 123 and dequalinium (DECA). After the development of a reproducible
      murine intraperitoneal (ip) human ovarian cancer model, which maintained the
      biologic characteristics of the parent cell line, we undertook in vivo evaluation
      of DECA. Mice with intraperitoneal tumor inoculations were treated with
      cisplatin, and/or DECA. When compared to cisplatin, a chemotherapeutic agent
      known to be effective in the treatment of clinical ovarian cancer, DECA was
      significantly more efficacious and seemed less toxic in the murine model.
      Cisplatin and DECA used together were possibly synergistic. Cationic lipophilic
      compounds may prove to be an exciting new class of antineoplastic agents which
      exploit intracellular, mitochondrial differences between normal cells and cancer
      cells.

PMID- 2227577
TI  - Is radical hysterectomy always necessary in early cervical cancer?
AB  - A semiquantitative histopathologic grading system was used in combination with
      flow cytometric measurements of tumor cell DNA content to predict the risk of
      lymph node metastases in early cervical cancer. A retrospective study of 126
      stage IB patients showed that a group with no risk of lymph node involvement
      could be identified by the use of both the histopathologic score and the DNA
      index. The results were confirmed in a prospective investigation of 59 new
      patients. Simple hysterectomy may be advised in low-risk patients.

PMID- 2227578
TI  - Serous carcinoma of the ovary: value of computed tomography in detection of
      calcified pleural and pulmonary metastatic implants.
AB  - Reported are three cases of serous papillary cystoadenocarcinoma of the ovary
      with pleural and pulmonary calcified metastatic implants detected by computed
      tomography (CT), but not by chest X-ray. CT patterns of metastatic calcifications
      were considered because of the unexpected frequency of this finding (15.7%) and
      in view of a possible clinical use of CT in monitoring extraabdominal disease.

PMID- 2227579
TI  - Gallstone ileus masquerading as recurrent carcinoma of the ovary.
AB  - A case of gallstone ileus in a patient with carcinoma of the ovary is presented.
      A 78-year-old female with stage III carcinoma of the ovary underwent optimal
      debulking surgery followed by six courses of chemotherapy and a microscopically
      positive second-look laparotomy. She was treated by whole-abdomen pelvic
      radiation. She then developed progressive nausea, vomiting, abdominal distension,
      and eventually complete small bowel obstruction. The diagnosis of gallstone ileus
      was made preoperatively based on the radiological findings. The pathophysiology
      of gallstone ileus is discussed in the differential diagnosis of patients treated
      for carcinoma of the ovary.

PMID- 2227580
TI  - Advanced vulvar carcinoma treated with internal iliac arterial embolization
      therapy after radiotherapy.
AB  - Two patients with vulvar carcinoma are reported who were treated with internal
      iliac transcatheter arterial embolization and radiotherapy. Patient 1 had T3N3M0
      vulvar carcinoma. The lesion remaining after radiotherapy was treated by
      bilateral internal iliac arterial embolization. Vulvectomy was then performed,
      and the resected specimen showed no residual malignant cells. This patient is
      alive without recurrence 4 years 7 months after operation. Patient 2 (T3N0M0
      vulvar carcinoma) underwent radiotherapy, and the remaining malignant tumor
      disappeared after bilateral internal iliac artery embolization. This patient has
      remained disease free without vulvectomy for 3 years after treatment.

PMID- 2227581
TI  - Breast carcinoma metastatic to endometrial polyp.
AB  - An elderly woman presented with an enlarged uterus without uterine bleeding. The
      hysterectomy specimen contained a large, solitary intrauterine mass. Microscopic
      examination revealed metastatic poorly differentiated adenocarcinoma infiltrating
      an endometrial polyp. This metastatic tumor appeared histologically identical to
      the patient's ductal carcinoma of the breast removed by modified radical
      mastectomy 6 years earlier. An extrapelvic primary carcinoma metastatic to tan
      endometrial polyp is a very rare event but should be included in the differential
      diagnosis of endometrial carcinomas.

PMID- 2227582
TI  - Bone metastasis from gynecologic carcinomas: a clinicopathologic study.
AB  - Between 1948 and 1984, autopsies were performed on 305 patients with primary
      carcinomas of the cervix, endometrium, ovaries, fallopian tubes, vulva, and
      vagina. Skeletal metastases were detected premortem and at autopsy in 49 cases
      (16.1%): cervix, 20 (40.8%); endometrium, 17 (34.7%); ovary, 7 (14.3%); vulva, 4
      (8.2%); fallopian tube, 1 (2%). There were no cases of osseous metastasis from
      vaginal carcinoma. The incidence and sites of metastasis from these gynecologic
      carcinomas were correlated with their clinical and histopathologic
      classifications. This clinicopathologic study, based on autopsy data,
      demonstrates that osseous metastases are not uncommon, are significantly greater
      than clinically appreciated, and correlate with advanced anatomic stage and
      histopathologic type and grade.

PMID- 2227583
TI  - Electrosurgical debulking of ovarian cancer: a new technique using the argon beam
      coagulator.
AB  - Survival of ovarian adenocarcinoma patients depends on the size of the largest
      residual nodule at the end of debulking surgery. The argon beam coagulator (ABC)
      delivers radiofrequency current traveling in a beam of argon gas which
      facilitates tumor destruction and hemostasis. We used the ABC as an aid to
      cytoreduction in seven consecutive patients with stage III/IV ovarian cancer.
      Despite extensive disease, optimal debulking was achieved in all seven patients:
      four (57%) had no gross residual cancer; three had residual nodules of 2-3 mm.
      The ABC facilitated tumor destruction on the diaphragm, bowel wall and mesentery,
      presacral space, ureters, vagina, and iliac vessels. In addition, the ABC was
      used to "sterilize" surgical margins such as the vaginal cuff and rectosigmoid
      colon anastomoses. Five patients are currently alive, four disease free, with
      mean survival of 33 months since diagnosis. The ABC enables debulking of ovarian
      cancer in sites inaccessible to conventional resection.

PMID- 2227584
TI  - Etoposide combination chemotherapy in refractory ovarian malignant germ cell
      tumor.
AB  - Thirty-three patients with malignant germ cell tumor of the ovary received
      postoperative vincristine, dactinomycin, and cyclosphosphamide (VAC) treatment.
      Eight failed VAC treatment and received etoposide, bleomycin, and cisplatin (PEB)
      combination chemotherapy. Three were cured and remained disease free 24-79 months
      after completion of PEB therapy.

PMID- 2227585
TI  - Influence of histological features and treatment on the prognosis of patients
      with cervical cancer metastatic to pelvic lymph nodes.
AB  - Ninety-seven patients with stage IB through IIB cervical cancer metastatic to
      pelvic lymph nodes treated at Magee-Womens Hospital, Pittsburgh, Pennsylvania,
      between 1955 and 1979 were analyzed retrospectively to determine histological
      factors which might predict treatment failure. All patients were treated by
      radical hysterectomy with a pelvic lymphadenectomy (S) or in combination with
      radiation therapy (S + RT) (27 and 73%, respectively) and were followed for a
      minimum of 5 years or until death. There were no significant differences between
      the two treatment groups when compared for patient age at diagnosis, distribution
      of disease stages, cell type, and tumor differentiation. The groups were
      dissimilar only with respect to the number of lymph nodes found to contain
      metastatic carcinoma. Significantly more patients treated by S + RT than by S
      alone were found to have metastasis to more than one node. Of patients treated
      with S alone, 65% recurred within 5 years compared with 51% with the addition of
      RT (P less than 0.16). The extent of both lymphocytic and polymorphonuclear
      infiltration of the tumor did not influence the probability of recurrence
      following treatment; however, tumors with a marked eosinophilic infiltration
      recurred significantly more frequently than those without (P less than 0.05).

PMID- 2227586
TI  - Clinical significance of hyperkeratosis and parakeratosis in otherwise negative
      Papanicolaou smears.
AB  - To ascertain the clinical significance of hyperkeratosis and parakeratosis in
      otherwise negative Papanicolaou smears, we retrospectively reviewed 96 patients
      with these findings seen during a 32-month period. Evaluation included repeating
      the smear and performing colposcopy in all patients. Colposcopically directed
      biopsy and endocervical curettage were performed when appropriate. Only one
      patient had human papillomavirus (HPV) infection. The isolated finding of
      hyperkeratosis or parakeratosis was not associated with an increased incidence of
      cervical intraepithelial neoplasia or HPV and, clinically, was not associated
      with uterine descensus or vaginal prolapse.

PMID- 2227587
TI  - Occult pleural involvement in stage III ovarian carcinoma: role of diaphragm
      resection.
AB  - In a 2-year period 12 diaphragmatic resections were performed on 11 patients with
      invasive metastases from ovarian carcinoma without significant complications, via
      transabdominal approach in 10 instances and thoracoabdominal incision in 1. Full
      thickness penetration of the diaphragm by tumor occurred in all instances without
      prior evidence of pleural involvement (occult Stage IV). Six patients had primary
      disease (Group A) and 5 had recurrent disease (Group B). Ten patients who
      underwent excision of nonpenetrating diaphragmatic metastases were analyzed for
      comparison (Group C). Mean diameters of the metastases were as follows: Group A,
      7.84 +/- 1.60 cm; Group B, 7.00 +/- 2.24 cm; Group C, 2.51 +/- 1.08 cm. The
      difference in mean diameter between the penetrating (Groups A and B) and
      nonpenetrating (Group C) tumors was highly significant (P less than 0.01).
      Penetrating tumors were 5.0 cm or greater; nonpenetrating tumors were 4.0 cm or
      less. Invasiveness of diaphragmatic metastases was inversely related to survival
      in patients with primary but not recurrent disease. Group A patients had a marked
      survival disadvantage (median survival time of 8 months; range 7-25 months)
      compared to Group C (median survival time of 26 months; range 13-96+ months; P
      less than .05). In contrast, Group B patients appeared to gain salutory
      palliation despite large diaphragmatic masses involving the pleural surface (4/5
      alive at 16(+)-33+ months following surgery). Previous reports of response and
      survival in patients with Stage III Ovarian cancer may have included patients
      with "occult Stage IV" disease.

PMID- 2227588
TI  - Crossover study with cisplatin or carboplatin in advanced ovarian cancer.
AB  - Fifty-seven patients who had progressed during or relapsed after randomized first
      line combination chemotherapy containing cisplatin or carboplatin were entered
      into a crossover study in which the analog not previously assigned was
      administered alone as salvage treatment. Carboplatin and cisplatin were
      administered at doses of 400 and 100 mg/m2, respectively, every 28 days. Among
      the 24 patients enrolled in the cisplatin arm, 6 (25%) objective responses (ORs)
      (3 complete, 3 partial) were observed, whereas 3 partial responses were obtained
      in the 33 carboplatin-treated patient (9%). Analysis of results, according to
      response to first-line chemotherapy, demonstrated that the patients who
      progressed were sensitive only to cisplatin second-line treatment (OR: 3/12),
      with no responders among carboplatin-treated patients (OR: 0/11). All patients
      were treated on an outpatient basis and therapy-related toxic effects were mild,
      consisting chiefly of myelosuppression, and more frequent in the carboplatin
      group. In our opinion, carboplatin 400 mg/m2 per cycle is scarcely effective in
      patients with refractory or relapsed ovarian cancer pretreated with cisplatin
      regimens, whereas cisplatin 100 mg/m2 per cycle appears to be an effective
      salvage therapy even in patients not responding to carboplatin. The dose of
      carboplatin should be further escalated especially in refractory patients.

PMID- 2227589
TI  - The impact of whole-abdomen radiotherapy on survival in advanced ovarian cancer
      patients with minimal residual disease after chemotherapy.
AB  - Between March 1982 and March 1987, 26 patients with minimal residual epithelial
      ovarian cancer after cisplatin-based chemotherapy were treated with whole-abdomen
      irradiation [moving-strip technique (MST)] with or without pelvic boost. Prior to
      radiation residual disease was macroscopic (less than or equal to 0.5 cm) in 8
      cases and microscopic (positive random biopsies) in 18 cases (8 diffuse, 10
      localized). Eighty percent of patients completed the planned therapy, 34% with
      interruptions secondary to hematologic or gastrointestinal toxicity. With a
      median follow-up time from completion of radiotherapy of 24 months, 34.6% of
      patients remain alive. The 3-year survival rates (from the second-look procedure)
      are 50% for the patients with microscopic tumor and 25% for those with
      macroscopic residual disease. Progression-free intervals are statistically
      different in the two groups: 16.9 months for microscopic residuals and 6.16
      months for macroscopic tumors (P = 0.037). All but two of the recurrences were in
      the irradiated field (pelvis and/or abdomen); one was distant (pleural) and one
      only retroperitoneal. Small bowel injury was the most limiting complication: 3.8%
      was registered as fatal acute enteritis and 19% as late obstruction or
      malabsorption syndrome, necessitating surgical intervention in 10% of treated
      cases.

PMID- 2227590
TI  - Studies on the distribution of abnormal cells in cytological smears. VII.
      Cervical brush versus plastic and wooden spatulas.
AB  - A model system of exfoliated normal human cervicovaginal squamous cells,
      exfoliated rodent tumor cells, and acellular, viscous, mucuslike material was
      used to investigate cell deposition on smear preparations made with three
      different instruments: plastic spatulas, wooden spatulas, and brush-tipped
      collectors. The total number of exfoliated cells and the total number of tumor
      cells present within the randomly distributed holes were then recorded for 41
      smear preparations. For smears done with the brush, a total of 47,146 exfoliated
      cells were recorded; with wooden spatulas, 4517 cells; and with plastic spatulas,
      7648 cells. When the brush was used, 6905 tumor cells were recorded. When wooden
      or plastic spatulas were applied, 563 and 1132 tumor cells were found,
      respectively. Thus, the brush yielded 12.2 and 6.1 times more tumor cells than
      plastic and wooden spatulas, respectively.

PMID- 2227591
TI  - Surgical complications of obese patients with endometrial carcinoma.
AB  - Sixty-seven patients had exploratory laparotomy for stage I and II (occult)
      adenocarcinoma of the endometrium. Acute surgical complications were analyzed in
      obese and in normal-weight patients. Compared to normal-weight patients, obese
      patients had significantly higher rates of wound infection and wound dehiscence,
      longer operating time, greater blood loss, and longer hospital stay. Wound
      infection and wound dehiscence were significantly related to postoperative
      anemia.

PMID- 2227592
TI  - Prognostic significance of single versus multiple lymph node metastases in
      cervical carcinoma stage IB.
AB  - From January 1, 1970, to December 31, 1985, 51 patients with stage IB (FIGO)
      carcinoma of the cervix with lymph node metastases were treated at the University
      Hospital, Groningen, The Netherlands. The survival rate was 54% and the average
      duration of follow-up was 78 months (range 47-132). Important clinical variables
      for survival were investigated retrospectively: the survival rate in patients
      with a single lymph node metastasis (with tumor confined to the node itself) (n =
      23) appeared to be much better than that of patients with multiple node
      involvement and/or single nodes with extranodular tumor infiltration (n = 28);
      survival was 85 and 24%, respectively (P less than 0.001). The same applied to
      patients with only occult lymph node involvement: the survival rate in patients
      with occult involvement of the hypogastric, external iliac, or obturator nodes
      was 87% in 19 patients with a single metastasis and 53% in 15 patients with
      multiple node involvement (P less than 0.02). The survival rate in 8 patients
      with adenomatous histological components was 42%. In 42 patients with squamous
      cell carcinoma, the survival rate was 56%. This difference was not statistically
      significant. Treatment complications and the effect of treatment on the site of
      recurrence were investigated.

PMID- 2227593
TI  - DNA ploidy level as prognostic factor in low stage carcinoma of the uterine
      cervix.
AB  - Flow cytometry was used to measure DNA content of tumor cells in paraffin
      embedded archival material from 89 patients with squamous cell carcinoma of the
      cervix uteri stages IB and IIA. Patients were all treated with radical
      hysterectomy and transperitoneal lymphadenectomy. Twenty-four percent received
      radiotherapy postoperatively because of tumor spread into parametria or positive
      lymph nodes. Ploidy grade was compared to other prognostic factors. DNA
      aneuploidy was seen in 44 (49%), DNA-diploidy in 16 (18%) and 29 (33%) of the
      tumors were DNA-periploid. Sixty-nine (78%) patients were in FIGO stage IB, 20
      (22%) in IIA. In 19 (21%) lymph node metastases were found, vasoinvasion in 25
      (28%). Overall disease-specific 5-year survival was 80%. There was a significant
      effect of positive lymph nodes (90% vs 47%) and vasoinvasion (87% vs 64%) on the
      5-year survival (resp. P less than 0.01 and P = 0.02). No correlation was found
      between stage (81% for IB vs 80% for IIA) or DNA-ploidy grade (81% for
      aneuploidy, 82% for periploidy, 79% for diploidy) and survival (resp. P = 0.9 and
      P = 0.8). Ploidy grade was equally divided over other prognostic factors. In
      stepwise Cox regression analysis DNA-ploidy grade showed no independent effect on
      survival. We conclude that DNA flow cytometry in this material was of no
      additional prognostic value.

PMID- 2227595
TI  - Epithelial ovarian tumors of borderline malignancy.
AB  - Between January 1975 and January 1987, 80 patients underwent primary surgery at
      Brigham and Women's Hospital for epithelial ovarian tumors of borderline
      malignancy. Surgical staging revealed 52 (65%) patients with stage IA, 2 (2.5%)
      with stage IB, 10 (12.5%) with stage IC, 4 (5%) with stage II, 11 (13.8%) with
      stage III, and 1 (1.2%) with stage IV. All 37 patients with mucinous tumors had
      stage I disease, whereas 13 (33%) of 39 patients with serous tumors had stage II
      IV disease. The mean sizes of mucinous and serous ovarian tumors were 18.7 and 10
      cm, respectively. At initial surgery, 48 (60%) patients had a total abdominal
      hysterectomy with bilateral salpingo-oophorectomy and 16 (20%) had an
      oophorectomy. Sixteen (20%) patients underwent cystectomy, 6 (37.5%) of whom
      subsequently had an oophorectomy. All 10 patients treated by cystectomy alone
      have remained disease free. CA-125 levels were normal in 5 patients with stage I
      disease, but were elevated in 6 of 8 patients with more advanced tumors. Current
      disease status was determined in 72 patients (90%); 69 (95.8%) are alive and
      disease free, 1 (1.4%) patient is alive with tumor, and 2 (2.8%) patients died,
      free of disease.

PMID- 2227596
TI  - Restorative effects of calmodulin antagonists on reduced cisplatin uptake by
      cisplatin-resistant human ovarian cancer cells.
AB  - In the present study, we attempted to determine effects of calmodulin antagonists
      (W-7 and W-5) on cisplatin uptake by human ovarian cancer cells, using KF cells
      derived from serous cystadenocarcinoma of the ovary and cisplatin-resistant cells
      (KFr). The degree of cisplatin resistance of the KFr cells was about 3.7-fold
      higher than that of the parent KF cells, with regard to the concentration of
      cisplatin required for 50% inhibition of cell proliferation (IC50). When KF and
      KFr cells were incubated with 10 micrograms/ml cisplatin for 4 hr, cisplatin
      content in the KF cells was significantly higher than that in the KFr cells. When
      KF cells were incubated in the presence of W-7 (but not W-5), cisplatin uptake
      significantly increased, compared to cells treated with cisplatin alone. On the
      other hand, when KFr cells were incubated in the presence of 5 micrograms/ml W-7
      or W-5, cisplatin uptake was significantly higher than uptake by KFr cells
      treated with cisplatin alone, being comparable to that by KF cells treated with
      cisplatin alone. Such an increase in cisplatin uptake seemed to bring about
      adjuvant effects to cisplatin of KFr cell proliferation in vitro. The KF tumor
      grown in nude mice took up 24.8 ng/g dry wt of cisplatin 4 hr after
      intraperitoneal administration. When cisplatin was administered with calmodulin
      antagonists, cisplatin uptake by the KF and KFr tumors was significantly
      increased, compared to that after treatment with cisplatin alone. In particular,
      the cisplatin uptake by the KFr tumor was about 2.5-fold higher than that by the
      KFr tumor treated with cisplatin alone. These results suggest that
      coadministration of calmodulin antagonists and cisplatin may be of use in
      patients with refractory ovarian cancer.

PMID- 2227597
TI  - Benign teratoma of the omentum and ovary coexistent with an ovarian neoplasm.
AB  - Benign cystic teratoma of the omentum is a rare abdominal tumor. Review of the
      literature describes seven reported cases of omental teratomas in association
      with ovarian teratomas. Our patient is a 68-year-old woman who presented with an
      asymptomatic abdominal mass and uterine prolapse. Ultrasound revealed a right
      sided, cystic and solid pelvic mass. CT scan revealed a second mass with
      calcifications situated along the right iliac crest. This is the first
      description of an omental teratoma in association with a benign ovarian cystic
      teratoma coexistent with a malignant neoplasm. Possible etiologies of the present
      case are discussed and additional literature investigated.

PMID- 2227594
TI  - Cancer of the uterine cervix: sensitivity and specificity of serum squamous cell
      carcinoma antigen determinations.
AB  - Between 1978 and 1989, 451 patients with cervical squamous cell carcinoma were
      referred to our department, of whom 143 experienced persistent or recurrent
      disease. Serial serum samples of the patients were analyzed for the presence of
      squamous cell carcinoma antigen (SCC). The incidence of elevated pretreatment
      serum SCC levels ranged from 37% in stage IB (N = 173) to 90% in stage IV (N =
      19). Multivariate analysis showed that deep stromal infiltration and lymph node
      metastases were associated with significantly higher serum SCC levels. Serum SCC
      trends correlated with the course of disease: after treatment the sensitivity
      (percentage positive results in patients with persistent disease) was 79% and the
      specificity (percentage negative results in patients with no evidence of disease)
      was 91%. During follow-up, the sensitivity of the assay was 85.5% in patients
      with recurrent disease. However, the positive predictive value of a single serum
      SCC value greater than 2.5 ng/ml for tumor recurrence was only 49%. This figure
      rose to 76% when two consecutive elevations were determined. Stage and
      pretreatment serum SCC level were the only factors found to influence survival,
      using Cox's regression analysis with five pretreatment variables.

PMID- 2227598
TI  - Malignant hemangiopericytoma of the omentum presenting as an ovarian tumor.
AB  - Malignant hemangiopericytomas are usually found in the musculature of the
      extremities, the retroperitoneum, and the pelvis. Malignant hemangiopericytoma
      arising in the omentum is extremely rare. We recently experienced such a case, in
      which a malignant ovarian tumor was suspected preoperatively on the basis of the
      sonogram, CT scan, magnetic resonance image, and increased CA-125 value.
      Microscopically, the tumor showed many mitoses, increased cellularity, and
      cytologic atypia. The patient was treated with CAP combination therapy following
      resection of the tumor; however, an intraperitoneal recurrence probably due to
      implantation was recognized 11 months later.

PMID- 2227599
TI  - An unusual presentation of metastatic squamous cell carcinoma of the vulva.
AB  - Recurrent squamous cell cancer of the vulva metastasized via regional lymphatics.
      Hematogenous spread is late and unusual. A patient with metastatic disease
      presented with soft tissue mass in her thigh musculature. We believe this to be
      the first reported case of noncontiguous skeletal metastasis for this tumor.

PMID- 2227600
TI  - Papillary villoglandular carcinoma of the cervix.
AB  - Three cases of papillary villoglandular carcinoma of the cervix are presented.
      Each patient was multiparous and presented with abnormal vaginal bleeding. The
      mean age at presentation was 35 years (range 28-42 years). All patients were
      staged as FIGO IB and underwent radical Wertheim hysterectomy and bilateral
      pelvic lymphadenectomy. Disease was limited to the cervix in two patients and
      extended to involve the lower uterine segment in one patient. There was no
      evidence of microscopic spread to the lymph nodes. Previous reports that examined
      patients with papillary villoglandular carcinoma of the cervix found them to have
      a favorable prognosis. Treatment implications are discussed.

PMID- 2227601
TI  - Successful treatment of small intestine fistula with somatostatin analog.
AB  - A patient who developed an entero-neovagina fistula after total pelvic
      exeneteration is presented. When traditional conservative therapy appeared to be
      failing, addition of somatostatin analog resulted in a successful outcome.

PMID- 2227602
TI  - Incisional recurrence of squamous cell cervical carcinoma following operative
      staging.
AB  - A patient with FIGO Stage IIB cervical carcinoma underwent an extraperitoneal
      lymphadenectomy with exploratory laparotomy and washings for surgical staging.
      Intraperitoneal tumor was found. Seven months later, the tumor recurred as a
      subcutaneous nodule in the surgical incision. The implications of this recurrence
      are discussed.

PMID- 2227603
TI  - Retention of endometrial sensitivity to hormones after radiation therapy (RT) for
      cervical cancer in premenopausal patients.

PMID- 2227604
TI  - Growth hormone levels in maternal serum during pregnancy.
AB  - Maternal growth hormone (GH) levels during pregnancy have been variously reported
      to be suppressed or, more lately, to be increased. In an attempt to clarify this
      point, maternal GH levels were estimated with two modern GH polyclonal radio
      immunoassays (RIAs) and a new monoclonal enzyme-linked immunoassay (ELISA). The
      Cambridge Medical Diagnostics RIA and the more specific bioMerieux RIA gave
      similar results in control non-pregnant patients with raised GH levels, while the
      monoclonal ELISA gave slightly lower values. The bioMerieux assay gave results
      about 10 times higher than the Cambridge assay during pregnancy, at 12-61 ng/ml
      at 16-20 weeks and 47-153 ng/ml at 28-39 weeks (total n = 27). These high 'GH'
      levels did not correlate with maternal levels of prolactin or human placental
      lactogen. It is presumed that some unknown GH-like molecule(s) are being
      estimated in this assay, possibly the recently discovered human chorionic GH.
      That this is not pituitary GH was confirmed by the monoclonal ELISA, by which GH
      levels were almost undetectable during pregnancy.

PMID- 2227605
TI  - Perinatal outcome in HIV-infected pregnant women.
AB  - We have observed 74 HIV-seropositive and 48 HIV-seronegative drug-addicted women
      and 22 HIV-seropositive nondrug-addicted pregnant women during pregnancy and we
      report their perinatal outcome. 8 out of 96 HIV-seropositive patients had
      hematological signs of immunodeficiency and 2 of these patients were symptomatic
      belonging to CDC class III. We recorded 2 early and 3 late spontaneous abortions,
      no intrauterine fetal death and 3 neonatal deaths. Seropositive patients had 3
      malformed babies, seronegative patients had 1. All these women had a high
      incidence of premature delivery and intrauterine fetal growth retardation:
      seropositive patients had a higher incidence of fetuses small for gestational age
      and a lower incidence of preterm delivery compared to seronegative patients, but
      the difference was not statistically significant. The incidence of malformation
      was comparable to the general population: 3 malformed babies were born to HIV
      positive drug-addicted mothers, and 1 to a seronegative drug-addicted mother.
      These findings do not support the hypothesis of a direct detrimental effect of
      HIV on perinatal outcome. Consequences of fetal exposure to maternal HIV
      infection involve mostly postnatal life and development of acquired
      immunodeficiency.

PMID- 2227606
TI  - First trimester live pregnancy and subsequent fetal loss. Impact of transcervical
      CVS and colonization of the cervix.
AB  - A consecutive series of 224 women undergoing transcervical chorionic villi
      sampling (CVS) were analyzed for the presence of cervical microbes. The outcome
      of pregnancy was related to age, number of aspirations and to the presence or not
      of microbes. The CVS group was compared to a group of 200 women with live fetuses
      at 8-11 weeks of gestation not undergoing CVS (ultrasound, US group). In the US
      group the miscarriage rate was 8.5% with 5.9% occurring after the 16th week of
      gestation. In the CVS group 20.3% ended as a miscarriage, 28.9% of these after
      the 16th week. There was no correlation between miscarriage rate and maternal age
      in the US group. In the CVS group younger women had a prominent rate of fetal
      loss. In the present study the risk of fetal loss after CVS was associated with a
      previous history of spontaneous abortions, with several aspirations performed,
      and with bacterial colonization of the cervix--candida and gardnerella excluded.

PMID- 2227607
TI  - Amniotic fluid findings in women with high levels of chlamydial antibody.
AB  - A study was undertaken to examine possible transplacental passage of Chlamydia
      trachomatis from pregnant women who were seropositive for chlamydia, but with no
      cervical C. trachomatis infection. Forty asymptomatic pregnant women, scheduled
      for diagnostic amniocentesis at 15-19 weeks of gestation, were tested for the
      presence of high serum IgA and IgG chlamydial specific antibodies and for
      cervical chlamydia infection. Five (12.5%) had both high serum IgA and IgG
      antibody levels and 10 (25%) had high serum IgG antibody levels. Overall, 15
      (37.5%) had high serum chlamydia specific antibody levels (all were free of
      cervical chlamydial infection). The evaluation of the amniotic fluid specimens of
      these 15 seropositive pregnant women, who were free of cervical chlamydial
      infection, proved negative for direct C. trachomatis antigen detection and for
      chlamydial IgA and IgG specific antibodies. These negative results could be
      attributed to the lack of transplacental passage of C. trachomatis or to the
      antimicrobial activity of amniotic fluid against C. trachomatis, which has been
      previously described. The discrepancy between maternal infection and maternal
      serum antibody levels may suggest that the serologic test does not predict the
      presence of an antigen in the cervix.

PMID- 2227608
TI  - Steroid hormone receptors in pelvic muscles and ligaments in women.
AB  - Using monoclonal antibody assay techniques estrogen receptors (ER) and
      progesterone receptors (PgR) were quantitated in female pelvic floor muscles,
      urogenital ligaments and uterus (myometrium). Receptors were detected in all
      these structures. In addition qualitative assessment showed distinct nuclear
      staining in the same structures. ER and PgR were not found in the musculus rectus
      abdominis with either method. The findings provide a rationale for estrogen
      treatment in women with urogenital disorders.

PMID- 2227609
TI  - Ovarian pathology in chronic pelvic inflammatory disease.
AB  - One hundred and sixty-six ovaries of the women of childbearing age suffering from
      chronic pelvic inflammatory disease (PID) were studied histologically and
      compared with normal ovaries. The number of mature follicles, cystic atretic
      follicles, follicular cysts, corpora lutea of menstruation, regressing corpora
      lutea, and corpus luteum cysts were calculated for each ovary. The main
      difference between ovaries in chronic PID and normal controls was increase in the
      number of cystic follicles and follicular and corpus luteum cysts in PID. This
      phenomenon is explained by the altered blood supply in PID-involved ovaries
      covered by adhesions containing numerous blood vessels. Chronic PID did not
      influence the growth of follicles, and their ability to ovulate.

PMID- 2227610
TI  - Transvaginal ultrasound is an effective method for screening in polycystic
      ovarian disease: preliminary study.
AB  - To assess the usefulness of transvaginal ultrasound scanning (TVS) for screening
      in polycystic ovarian (PCO) disease, we symptomatically and endocrinologically
      compared 9 cases (group A) with PCO noted by transabdominal ultrasound scanning
      (TAS) with 8 cases (group B) with PCO noted by TVS only. No difference in the
      mean value of LH/FSH ratio, E1/E2 ratio and testosterone was observed between the
      two groups. However, the frequency of endocrine abnormalities, menstrual
      disorders and hypertrichosis in group A was significantly more than in group B.
      Therefore, we suggest that the stage of PCO noted by TAS is more progressive than
      that noted by TVS only and TVS is useful for screening of PCO disease.

PMID- 2227611
TI  - Effect of combined treatment with phenylpropanolamine and estriol, compared with
      estriol treatment alone, in postmenopausal women with stress urinary
      incontinence.
AB  - Twenty-nine postmenopausal women with slight to severe stress urinary
      incontinence and estrogen deficiency symptoms in the urogenital tract were
      treated with estriol, p.o. 4 mg once daily, and either phenylpropanolamine (PPA),
      p.o. 50 mg twice daily, or placebo for periods of 6 weeks according to a
      randomized double-blind crossover schedule. At urodynamic recordings the maximum
      urethral closure pressure increased by 22% with combined treatment (p less than
      0.001) and an additional effect of PPA to estriol was shown (p = 0.022). The
      pressure transmission ratio increased, by about 15%, with both treatments (p less
      than 0.07). The number of leakage episodes was reduced by 28% with combined
      treatment (p = 0.007), but not with estriol alone (p = 0.08). Both combined
      treatment and estriol alone reduced significantly (p less than 0.01) the urinary
      incontinence complaints. Twelve women (43%) preferred combined treatment, while 7
      (25%) preferred estriol alone. In women with initially slight to very severe
      urine loss, combined treatment reduced also (p = 0.02) the amount of urine loss,
      measured at a standardized physical stress test. Signs of estrogen deficiency in
      vulva, vagina and urethra were reduced, 75% (p less than 0.001) or 65% (p =
      0.001) with estriol given in combination with PPA or alone. Maturation index of
      both urethral and vaginal epithelium displayed significant changes. It is
      concluded that the combined treatment, PPA + estriol, by affecting both the
      muscular and mucosal factor of the urethra, is more effective than estriol alone
      for treatment of female stress urinary incontinence in the postmenopausal ages.

PMID- 2227612
TI  - Treatment of large fibroids with high doses of gestrinone.
AB  - Twenty-four women with large, myomatous uteri, measuring between 218.7 and 2,920
      cm3 were treated with gestrinone, a tri-enic steroid with antiestrogen and
      antiprogesterone properties. In order to saturate the receptors of the large
      myomata, the doses used to treat these women were twice the recommended dosage of
      2.5 mg, 3 times weekly, used to treat smaller tumors. The treatment lasted 6
      months to 1 year. In all cases there was a reduction in uterine volume. In the 24
      patients, the mean uterine volume of 724.9 cm3 on admission decreased to 450.73
      cm3 at 6 months. For 14 patients treated for a full year, the mean uterine volume
      of 689.73 cm3 decreased to 329.22 cm3. Menstruation was suppressed in all
      patients by the end of the 2nd month of treatment. Episodic bleeding occurred in
      6 patients but in only 1 did this last longer than 1 week. Other symptoms such as
      pelvic discomfort and dysuria disappeared or were significantly alleviated by the
      2nd month of treatment. Side effects included seborrhea, acne, nervousness,
      myalgia and arthraglia, hoarseness and mild hirsutism but all these symptoms were
      promptly reversed following discontinuation. The mean increase in weight was 3.4
      kg in 6 months. No menopausal symptoms such as hot flushes and depression
      developed during this trial. Six patients complained of excessive sweating. Blood
      glucose creatinine, blood urea nitrogen, alkaline phosphatase, pyruvic and
      glutamic transaminases remained within the normal range.

PMID- 2227613
TI  - Measurements of ascorbic acid and glutathione in exfoliated cervicovaginal
      epithelial cells of smokers and women with cervical dysplasias.
AB  - This report emphasizes the ability to quantify ascorbic acid (AA) and reduced
      glutathione (GSH) levels in exfoliated cervicovaginal epithelial cells obtained
      by a lavage technique. Sixty-two women with abnormal Papanicolaou smears
      underwent colposcopic examinations. Colposcopic lesions were biopsied and
      histopathologically graded. Marked variations in the number of cells and in the
      levels of AA and GSH were observed. In cigarette smokers, the number of
      exfoliated cells retrieved was significantly higher (p less than 0.05, by
      Student's t test). The simultaneous investigation of biochemical and virologic
      parameters in exfoliated cervicovaginal epithelial cells, in conjunction with the
      known cytopathologic and epidemiologic risk variables, provides a novel approach
      to elucidate factor(s) that may inhibit or promote cervical carcinogenesis in
      designed prospective studies.

PMID- 2227614
TI  - Fetal and uteroplacental flow velocity waveforms in the expectant management of
      placental abruption.
AB  - The change in flow velocity waveforms was assessed by Doppler ultrasound in the
      course of evolution of placental separation. The velocity changes reflected a
      high response to blood flow in the placental circulation along with decreased
      cerebral vascular resistance.

PMID- 2227615
TI  - Post-remission treatment in acute myeloid leukemia: chemotherapy or autologous or
      allogeneic bone marrow transplantation.

PMID- 2227617
TI  - Transferrin receptor expression in the human placenta.
AB  - Iron transport from the mother to the fetus is mediated by transferrin receptors
      located at the maternofetal interface of the placenta. Transferrin receptors bind
      iron-loaded transferrin molecules from the maternal plasma, thus allowing iron
      uptake by trophoblastic cells which then deliver the metal to the fetal plasma.
      We have measured the transferrin receptor content in the placentas from 16 normal
      term pregnancies and investigated the relationships between transferrin receptor
      expression and non-haem iron content, as well as maternal and fetal iron status.
      Transferrin receptor content was evaluated indirectly by determining the
      transferrin binding capacity of a placenta extract. Transferrin receptor content
      of the placenta ranged from 20 to 154 micrograms/g of tissue, with a mean value
      of 96 +/- 37 micrograms/g. The mean non-haem iron content was 78 +/- 11
      micrograms/g of tissue, corresponding to 47 +/- 10 mg for the whole placentas.
      The amount of transferrin receptors in the placenta was found to be inversely
      related to the amount of non-haem iron (r = 0.64; p less than 0.025). No
      significant relationship was observed between each of these two parameters and
      the iron status of either the mother or the fetus. We conclude that placental non
      haem iron, which represents a storage form of this element, is likely to play a
      regulatory role in the expression of transferrin receptors, and consequently in
      the process of iron uptake by the placenta.

PMID- 2227616
TI  - High expression of multinucleated giant cells in cultures of peripheral blood
      cells from HIV infected patients.
AB  - Multinucleated giant cells (MGCs) were detected in cell lines established from
      peripheral blood lymphocytes of patients with: (a) acquired immunodeficiency
      syndrome (AIDS) and lymphadenopathy syndrome (LAS), (b) chronic active hepatitis
      (CAH), (c) papular acrodermatitis (PA) negative for hepatitis B virus antigens
      but positive for EBV, and (d) epidermolysis bullosa acquisita positive for EBV.
      All the cell lines established, including those established from AIDS and LAS
      patients, were examined for the presence of human immunodeficiency virus (HIV) by
      indirect immunofluorescence with monoclonal antibodies directed against the HIV
      antigens p17 and p24 and for the presence of reverse transcriptase. All the cell
      lines were found to be negative for HIV. While the cell lines obtained from AIDS
      patients still express MGCs after more than two years in culture, their
      supernatants are negative for reverse transcriptase activity and carry phenotypic
      markers characteristic of B cells. From the LAS and chronic active hepatitis
      patients we obtained a monolayer of adherent cells almost completely represented
      by MGCs that lasted for six and four months, respectively. After this period of
      time a proliferation process took place. Both the cell lines obtained carry B
      cell phenotypic markers, but MGCs are still a characteristic only for the LAS
      derived cell culture. Non infected patients or normal subjects express MGCs only
      during the early stage of the cultue. The correlation between the presence of
      MGCs and a retrovirus infection is discussed in the light of the role of MGCs in
      the pathogenesis of AIDS.

PMID- 2227618
TI  - Average life expectancy of heterozygous beta thalassemic subjects.
AB  - In order to define the lifespan of heterozygous beta thalassemic subjects as
      compared to non thalassemic subjects, the authors prospectively studied all
      patients deceased during a period of 76 months at St. Camillo Hospital of
      Comacchio (Ferrara), located in the Po delta, a region with high prevalence of
      thalassemia minor. No statistically significant differences were found in the
      average life expectancy between the thalassemic and non thalassemic groups.

PMID- 2227619
TI  - Idiopathic myelofibrosis: a retrospective study of 103 patients.
AB  - The clinical course of 103 patients (50 males, 53 females; median age 59 years)
      with idiopathic myelofibrosis (IMF) seen at our hospital between 1967 and 1986
      was analyzed retrospectively. Common symptoms and signs at the time of diagnosis
      were: myelofibrosis (96%), splenomegaly (84%), anemia (81%), osteosclerosis
      (45%), malaise (41%) and leukocytosis (41%). It was possible to follow the
      majority of patients without treatment or with transfusion therapy only for
      prolonged periods of time. The use of cytostatic drugs and radiotherapy was
      restricted as much as possible. Probably due to this treatment strategy the
      incidence of acute leukemia was low (5%). Major thromboembolic complications were
      seen in 19% of the patients. Median survival of the patients was 4.3 years. The
      prognostic influence of several disease parameters determined at the time of
      diagnosis was tested: age, sex, leukocytes, platelets, hemoglobin, reticulocytes,
      LDH, ANP-score, spleen size and percentage of peripheral blood blasts +
      promyelocytes had no significant influence on the length of survival.
      Osteosclerosis, a presumed sign of advanced disease, was not correlated with
      survival either.

PMID- 2227620
TI  - Incidence and clinicopathological heterogeneity of HIV-related non-Hodgkin's
      lymphoma.
AB  - The characteristics of 14 HIV-seropositive patients with NHL consecutively
      observed between 1984 and 1988 at our Institution are described. Patients
      belonged to a known population of 1242 HIV-seropositive individuals in whom the
      incidence of NHL was 1.13%, significantly higher than in age-matched controls (P
      less than .0001). Within this population, a previous diagnosis of ARC or AIDS,
      but not of LAS, was the only significant risk factor for the development of NHL
      (P less than .0001). According to the status of HIV infection at the time of NHL
      diagnosis, two groups of patients could be clearly identified with different
      clinicopathological features and prognosis. In fact, NHL developing in 7 patients
      previously affected by ARC or AIDS, presented as localized, extranodal disease,
      predominantly in the CNS; large cell histology, peripheral blood cytopenia,
      severe immunodeficiency and poor prognosis further distinguished this subgroup.
      Conversely, NHL developing in 7 patients with either asymptomatic HIV
      seropositivity or LAS, more often presented as disseminated disease both in nodal
      and extranodal sites, with Burkitt's-type histology. Cytopenia was uncommon and
      immunodeficiency was significantly less severe. In this subgroup complete
      remission (CR) was achieved with aggressive treatment in 6 of 7 patients. No
      relapses occurred but two opportunistic infection-related deaths were observed.
      Four patients are alive 6-34 months after CR, two of whom show newly developed
      opportunistic infections.

PMID- 2227621
TI  - Chronic B-cell lymphoproliferative disease: relationship between immunophenotype
      and clinical stage.
AB  - We analyzed the immunophenotype in 34 cases of B-CLD referred to our observation
      over a 13-month period. In 25 patients the classical phenotypic pattern of B-CLL
      was observed; in 9 cases clinical, morphocytochemical, and histologic findings
      were consistent with CLL but differed in phenotype. The results indicate that
      four immunophenotypic subgroups related to CD5 and FMC7 expression may be
      identified within B-CLL. Clinical correlations in these cases suggest that B-CLL
      with anomalous phenotypes are more frequently diagnosed at a later stage than
      classical B-CLL. Furthermore, while the percentage of CD3+ cells did not vary
      among the subgroups, a comparison of the CD4/CD8 ratio disclosed marked
      differences.

PMID- 2227622
TI  - High doses of ara-C and m-AMSA in the treatment of refractory acute non
      lymphocytic leukemia.
AB  - From November, '85 to March, '87, 17 patients (12 males and 5 females, median 28
      years) with resistant or relapsed ANLL received HiDAC (3 g/m2 c.i. 3 hs every 12
      hs, day 1-4) + m-AMSA (100 mg/m2 i.v. day 5-7) as salvage therapy: 8/17 patients
      (47.1%) achieved CR, 7/17 (41.1%) were resistant and 2/17 (11.8%) died during
      induction; 8/10 relapsed patients achieved a 2nd CR, while all 7 primary
      resistant patients failed to. Median period of PMN less than 0.5 x 10(9)/l was 28
      days, median period of PLTS less than 30 x 10(9)/l was 25 days. All patients had
      infections during aplasia. Median CR duration was 6.6 months, while median
      survival of responders was 10.6 months. Two patients with severe induction
      related complications relapsed after 2 and 5 months, respectively: 1 patient
      underwent BMT and relapsed after 21 months; 5 patients, 4 of whom had received a
      prior ABMT during 1st CR, underwent ABMT: 3 died from ABMT related toxicity and 2
      relapsed after 8 and 18 months, respectively. We conclude that HiDAC + m-AMSA is
      highly effective in relapsed, but not in resistant patients with acceptable
      hematologic and extra-hematologic toxicity. The role and modalities of ABMT in
      prolonging a 2nd CR are at present controversial.

PMID- 2227623
TI  - Automatic differential blood counting in plasma cell leukemia.
AB  - The authors report a case of primary plasma cell leukemia and two cases of
      multiple myeloma with a large number of circulating plasma cells. The display of
      Technicon H-1 shows a very high "cloud" in the area of large unstained cells. A
      massive invasion of the basophil area was not found. Differences between these
      results and those found in different lymphoid leukemias are discussed.

PMID- 2227624
TI  - Combined factor VIII and factor XI congenital deficiency: a case report.
AB  - Combined congenital defect involving both Factor VIII and XI is a very rare
      disorder. We describe a case of combined Factor VIII and XI deficiency in which
      the propositus has a mild hemophilia A and inherited a Factor XI deficiency from
      the father. Moreover, we report on the benefit of DDAVP administration to the
      patient during a bleeding episode.

PMID- 2227625
TI  - Ticlopidine in the treatment of thrombotic thrombocytopenic purpura: report of
      two cases.
AB  - The observation of two clinical cases make possible an evaluation of the
      potential therapeutic activity of platelet function inhibitors in thrombotic
      thrombocytopenic purpura (TTP). In particular, the clinical and hematological
      effects of ticlopidine (TC), employed alone in two TTP patients, are reported.
      The mechanism of action of this peculiar antiplatelet drug is mainly represented
      by the inhibition of fibrinogen binding on the platelet surface. In the first
      patient, a 45-year-old female in whom plasma-exchange (PE) and corticosteroids
      (C) led to a partial remission (platelets 80 x 10(9)/l), treatment with TC at a
      dose of 750 mg/day was carried out, and after 6 weeks a normal platelet count was
      observed. A complete remission was maintained for 31+ months, even after
      reduction of the TC dose to 250 mg/day. In the second patient, an 18-year-old
      female affected by relapsing TTP, a complete remission obtained with PE and C was
      maintained for 19 months in concomitance with TC treatment, started at a dose of
      750 mg/day and lowered to 250 mg/day. After 11 months of treatment at this low
      dosage there was a relapse (platelets 20 x 10(9)/l), but the increase of the TC
      dose to 750 mg/day in a few weeks induced a complete remission again. These data,
      in accord with a few other recent preliminary reports, suggest that TC, even
      alone, may play an interesting role in the management of TTP patients.

PMID- 2227626
TI  - Fine needle aspiration biopsy of a splenic hemangioma. A case report with review
      of the literature.
AB  - A 33-year-old man was hospitalized for hyperpyrexia and pain in the left upper
      quadrant of his abdomen. Abdominal ultrasound showed a mass in the inferior pole
      of the spleen. A computed axial tomography of the abdomen and a liver and spleen
      scintigraphy confirmed a space-occupying lesion in the spleen but were not able
      to define its nature. A FNAB performed during abdominal ultrasound showed cells
      with elliptic nuclei and elongated pale blue cytoplasm, separated from each other
      by empty spaces of varying width. The presence of a hemangioma or lymphangioma of
      the spleen was suspected. A splenectomy was performed. The histologic findings
      were compatible with a cavernous hemangioma. After a review of the literature,
      the role of FNAB of the spleen is discussed as a reasonable diagnostic approach
      that assists the clinician in making therapeutic decisions in the management of
      the space-occupying lesions in the spleen. The possibility of differentiating
      benign from malignant lesions is pointed out, particularly those of endothelial
      nature. Finally, the differential diagnosis between hamartoma and hemangioma of
      the spleen is discussed. The two words, in times past, were often used for the
      same lesion, producing a confusion of names in literature.

PMID- 2227627
TI  - Wernicke-like encephalopathy after autologous bone marrow transplantation.
AB  - A 15-year-old boy with non-T ALL in early 2nd remission was autografted using a
      regimen with busulphan 4 mg/kg/day, po, from day -9 to -6, and cyclophosphamide
      50 mg/kg/day, iv, from day -5 to -2. During busulphan administration he
      experienced a few generalized seizures, and starting on day 25 post ABMT he
      developed a progressively severe neurological symptomatology characterized by
      nystagmus, right VIth cranial nerve palsy, truncal ataxia and, finally, confusion
      and coma. MRI showed lesions in the periaqueductal gray matter, thalamus,
      mammillary bodies and putamen. Within 24 hours of treatment with thiamine he
      improved dramatically, but during the following weeks permanent neurologic damage
      with memory deficit, truncal ataxia and nystagmus became evident. To our
      knowledge this is the first case of Wernicke's encephalopathy reported after BMT.
      We suspect in this case a contribution of busulphan to the development of the
      syndrome.

PMID- 2227628
TI  - Bone marrow transplantation in an HIV positive thalassemic child following
      therapy with azidothymidine.
AB  - The authors report their experience on allogeneic bone marrow transplant in an
      HIV seropositive thalassemic child. Before transplant a treatment with
      Azidothymidine was performed with the aim of reducing the viral load. Engraftment
      took place but, later, an explosive upsurge of viral disease occurred with
      encephalitis, positivation of the P24 antigen, proliferation of opportunistic
      infections and an increase of the IgG level. Furthermore the failure of CD4+ cell
      recovery was also observed. This case underlines that bone marrow transplantation
      can have a successful engraftment in HIV seropositive patients, but this doesn't
      modify the course of the infection.

PMID- 2227629
TI  - Thrombotic thrombocytopenic purpura. Clinical course and response to therapy in
      seven patients.
AB  - The clinical characteristics, treatment and outcome are reported in 7 patients
      with 8 episodes of thrombotic thrombocytopenic purpura (TTP). In all episodes a
      complete remission was reached. Plasma exchange therapy was successful as single
      treatment in two episodes. Combination with other treatment modalities, however,
      was necessary in six episodes, in which a complete hematologic and clinical
      remission was obtained with antiplatelet therapy (4 X), and with antiplatelet
      therapy and corticosteroids (2 X).

PMID- 2227630
TI  - 1,25-Dihydroxyvitamin D3 in the treatment of idiopathic thrombocythemia and
      myelofibrosis.
AB  - The effect of treatment with 1,25-dihydroxyvitamin D3 administered at the dose of
      1.50-3.00 ug/day for at least 12 months was evaluated in three patients with
      idiopathic myelofibrosis and in five patients with idiopathic thrombocythemia.
      This treatment did not cause any significant change in the hematological values
      or the clinical course of the myeloproliferative diseases in any of the patients.
      Based on these data, treatment with 1,25-dihydroxyvitamin D3 in non toxic doses
      seems to be of doubtful benefit in patients with these disorders.

PMID- 2227632
TI  - T cell defect in a case of sinus histiocytosis with massive lymphadenopathy and
      extranodal involvement.

PMID- 2227631
TI  - Norfloxacin versus cotrimoxazole for infection prophylaxis in granulocytopenic
      patients with acute leukemia. A prospective randomized study.
AB  - Norfloxacin (NOR) or cotrimoxazole (TMP/SMX) were randomly administered to 59
      granulocytopenic patients with acute leukemia for prevention of bacterial
      infections. Nineteen NOR patients (65%) and 22 TMP/SMX patients (73%) complained
      of febrile or infectious episodes during the study. The mean incidence of febrile
      complications per patient was higher in the TMP/SMX group: 1.05 vs 0.68 (p less
      than 0.05). Eleven of 16 microbiologically documented infections in the TMP/SMX
      group and 7 of 11 in the NOR group were caused by gram negative bacilli (GNB).
      NOR recipients had fewer days of fever, fewer days on parenteral antibiotics and
      a lower proportion of time spent febrile. Fecal surveillance cultures showed
      intestinal GNB colonization in 42/80 specimens in the TMP/SMX group (resistant
      strains: 93%) and in 8/75 specimens in the NOR group (1 resistant strain).
      Overall, NOR seems to be effective in eradicating GNB from the digestive tract
      without selection of resistant strains and in preventing febrile episodes in
      neutropenic patients.

PMID- 2227634
TI  - Analysis of factors affecting acute transformation in chronic myelomonocytic
      leukemia.

PMID- 2227633
TI  - Kinetics of serum TK and LDH during therapy for AML.

PMID- 2227635
TI  - Central indwelling catheter to prevent phlebosclerosis by peptichemio in patients
      with multiple myeloma.

PMID- 2227636
TI  - Fungal infection and haematological malignancies: a report about association
      therapy with amphotericin B and 5-flucytosine in primary lung involvement.

PMID- 2227638
TI  - [Primary tensile strength of newer and modified tendon sutures. A comparative in
      vitro study].
AB  - Modified with new methods of flexor tendon sutures compared with the Kessler
      technique on cadaveric tendons are reported. The authors offer some suturing
      methods which allow active movement of the reconstructed flexor tendons.

PMID- 2227637
TI  - [Primary and secondary covering of defects of the hand using pedicled and free
      forearm flaps].
AB  - Our experiences in eight radial forearm flaps as free flaps or island flaps are
      shown. Indications for the use of these flaps in the hand are shown and
      advantages and disadvantages mentioned. Since 1980, when Muhlbauer and others
      brought the idea of this flap from China to Europe, its use as an island or as a
      free flap has been mentioned repeatedly. Generally the safety of this flap and
      the ease of harvesting are stressed. Other advantages are the long vascular
      pedicle and the large size of the vessels. These advantages are a temptation to
      use this flap for indications where it is not really suitable and where other
      methods are better. It has to be stressed that the donor site is not without
      problems from an esthetic and functional point of view. The removal of the radial
      artery, even when replaced by a venous graft may have some drawbacks.

PMID- 2227639
TI  - [Measurement of the tensile force exerted on the flexor tendons of the hand].
AB  - Immediate postoperative active motion after flexor tendon repair is a recurring
      theme in hand surgery. In the present study the authors determined the tensile
      stress of the sutured tendon subjected to active motion by the use of cadaveric
      hands and a tensiometer. The force necessary to draw forth the proximal stump was
      also measured. A tendon suture which can resist two kilo-ponds tensile force
      seems to allow active motion of the reconstructed flexor tendon.

PMID- 2227640
TI  - [Controlling and supporting apparatus of the deep finger flexor tendon and the
      long extensor tendon of the thumb. Clinico-anatomical analysis].
AB  - Full function of finger flexion requires an intact pulley system. After
      destruction of the pulleys, reconstruction over the metacarpal head (A1) and over
      the center of the proximal and middle phalanges (A2, A4) should be carried out.
      Calculations on a computer model suggest that the reconstructed pulley must hold
      the tendon close to the underlying bone. Width of the pulley and distance from
      the next proximal or distal joint of the inserted pulley are of minor functional
      importance. The amount of maximum load on the pulley, exceeding the tension of
      the tendon, must be considered in operation and postoperative treatment. The
      extensor pollicis longus tendon lies at the dorsal tubercle (tubercle of Lister)
      within an osseous gliding surface, where it changes direction. The deviation
      angle depends on the radiocarpal position and causes, in addition to the usual
      tension, a pressure stress to that part of the tendon. A graphical analysis of
      statics, based on X-rays, demonstrates maximum loads on the gliding surface. They
      can increase in relation to the tension force of the tendon to about 50% in the
      antero-posterior and to 100% in the radioulnar projection. Densitography of the
      distal radius shows a maximum of density where the dorsal tubercle is most
      prominent. Nutritional problems of that tendon are predisposed by that particular
      mechanical stress. Therefore spontaneous rupture of the extensor pollicis longus
      tendon in patients with rheumatoid arthritis or after fracture of the distal
      radius occurs, though infrequently. In the case of immobilization, slight ulnar
      abduction within the radiocarpal joint remarkably reduces the tension and
      pressure stresses on the tendon.

PMID- 2227641
TI  - [Monitoring of an acute compartment syndrome of unusual etiology using MRI
      (magnetic resonance tomography) and MRS (magnetic resonance spectroscopy)].
AB  - The authors report on an acute compartment syndrome occurring symmetrically in
      the extensors of both forearms. The etiology of this unique compartment syndrome,
      not previously described, could be attributed to the inhalation of a propane
      butane gas mixture, low in oxygen, while sleeping, in combination with external
      compression of both forearms, due to the patient's head lying on both forearms
      while sleeping. Ischemic damage to muscles was precisely located using non
      invasive MRI (Magnetic Resonance Imaging). The extent of cellular damage due to
      ischemia after fasciotomy and healing by secondary intention was quantitatively
      assessed using non-invasive 31P-MRS (Phosphorus Magnetic Resonance Spectroscopy).
      The results correlate with the clinical and histological findings and indicate a
      bioenergetic regeneration of the ischemic skeletal muscle's cells.

PMID- 2227642
TI  - [Acute carpal tunnel syndrome and tendon rupture of the long flexor muscle of the
      thumb as a rare complication of a scaphoid pseudoarthrosis. Case report].
AB  - The authors demonstrate a case of a scaphoid pseudarthrosis leading to an
      attrition rupture of the flexor pollicis longus tendon, tenosynovitis and
      haemorrhage into the carpal tunnel causing recurrent symptoms of an acute carpal
      tunnel syndrome. Every acute carpal tunnel syndrome is an emergency requiring
      instant decompression of the carpal tunnel. If success with conservative
      treatment of acute carpal tunnel syndrome is questionable, early operative relief
      of the median nerve is the safest procedure.

PMID- 2227643
TI  - [Reposition instrument for Bennett's fracture-dislocation].
AB  - A special hook and plate can be used to adapt small central fragments in the open
      reduction of Bennett's fracture-dislocation. The hook is positioned behind the
      small central fragment and compression exerted between the hook and a plate
      attached to the opposite side of the base of the first metacarpal bone using an
      adjustable nut, thus holding the fragments together. The reduction device
      simplifies X-ray controls and internal fixation with Kirschner wires.

PMID- 2227644
TI  - [Apparatus for the cooling and preparation of extremity parts in vitro.
      Application in replantation surgery].

PMID- 2227645
TI  - [Long-term results following implantation of breast prosthesis with a
      polyurethane coating].
AB  - 42 of 63 cases of bilateral augmentation mammaplasty using polyurethane-covered
      prostheses, so-called Ashley "Natural-Y" prostheses were seen 15 to 17 years
      after the primary operation. Two implants had previously been replaced by Cronin
      gel type prostheses for various reasons. The 84 breasts which were examined in
      follow-up compared well with breasts augmented with other devices as far as
      capsular contracture was concerned. The extreme difficulty of removing these
      implants because of the deterioration of the polyurethane cover makes any further
      use of these implants unjustifiable.

PMID- 2227646
TI  - [Construction of a neo-clitoris in male-to-female transsexuals].
AB  - To preserve the ability of orgasm in male-to-female transsexuals we retain the
      glans-penis and the corpus cavernosum urethrae as a unit. The glans-penis will be
      placed into the anterior wall of the neo-vagina under the symphysis as the neo
      clitoris.

PMID- 2227647
TI  - [Strategic planning in the hospital today--a mandatory process].
AB  - Since the beginning of this decade strategic planning has become a common
      analytical method in nonprofit organizations, as well as in the business sector.
      In the nonprofit sector it has been implemented mainly in hospitals and
      universities. From experience, it is clear that strategic planning has
      contributed to the hospital's survival, improved performance, implementation and
      control. However, such good results have only followed correct planning and
      implementation, with emphasis on the business elements of an economic firm, such
      as marketing and budgetary planning, a control system and funding with increasing
      integration of "mathematical business" models. Recent studies have proved that
      strategic planning is a necessary condition for the survival of nonprofit
      organizations in a competitive environment. Experience demonstrates that
      modification of the business model of strategic planning in the nonprofit sector
      has significant advantages for both public and private sectors. We describe the
      way strategic planning is performed in hospitals, as well as relevant
      modification and limitation of the process. Our message to Israeli hospitals is
      that those which do not prepare themselves systematically for change, may find
      survival impossible.

PMID- 2227648
TI  - [Multiple enteral fistulas in peritoneal tuberculosis].
AB  - A 40-year-old Ethiopian man had abdominal pain for a year and a half, diarrhea
      and weight loss. Multiple enteral fistulas were diagnosed by X-ray and
      colonoscopy. During investigation, the differential diagnosis was between Crohn's
      disease, intestinal lymphoma and intestinal tuberculosis. Therapeutic trial with
      corticosteroids was unsuccessful. At operation peritoneal tuberculosis was
      diagnosed and several entero-enteric fistulas were found, but there were no other
      intestinal lesions nor other foci of tuberculosis. Intestinal fistulas
      complicating peritoneal tuberculosis are rare in comparison with enteral
      tuberculosis, lymphoma or Crohn's disease. After the fistulas were closed
      surgically and antitubercular treatment given, the patient recovered, returned to
      his normal weight, and had no complaints.

PMID- 2227650
TI  - [Statewide system approach to the organization of trauma care services--a way to
      improve the quality of care to the injured].

PMID- 2227649
TI  - [A thermostable toxin-producing E. coli and infantile diarrhea].
AB  - An E. coli strain producing only a thermostable toxin (ST) and belonging to
      serogroup 0153 (ETEC 0153; ST) was isolated from the stools of 9 infants with
      diarrhea, 4 of them premature, during the last half of August, 1988. All the 4
      prematures passed frequent fluid stools. In 5 of the 9 infants, other pathogens
      were found in addition to the ETEC strain, including rotavirus, Plesiomonas and
      Shigella sonnei. Until recently, ETEC strains like that described were considered
      rare all over the world. During the past 2 years ETEC strains belonging to that
      serogroup and toxin type were reported as a major cause for infantile diarrhea in
      Spain in 5 outbreaks. Infantile diarrhea caused by an ETEC strain in Israel is
      reported here for the first time.

PMID- 2227651
TI  - [Immune neutropenias of infancy and childhood--update on diagnosis and
      treatment].

PMID- 2227652
TI  - [Idiopathic atrial fibrillation and occult thyrotoxicosis].

PMID- 2227653
TI  - [Extracorporeal renovascular surgery].

PMID- 2227655
TI  - [Non-convulsive status epilepticus and the importance of emergency EEG].

PMID- 2227654
TI  - [Chest pain: cardiac or esophageal?].

PMID- 2227656
TI  - [Routine breast examination and early detection of hypertension and diabetes
      mellitus by primary care physicians ].
AB  - Breast cancer is the leading cause of cancer mortality among women is Israel. On
      average, 1 in every 12 women develops the disease. While breast self-examination
      has not proved effective, and routine mass mammography is at present unavailable
      to the population at large, regular routine breast examination by primary care
      physicians can effectively screen a large fraction of this country's population.
      In order to do so, full acceptance of the procedure by women and their physicians
      is required. This study examines the attitudes and practice of primary care
      physicians with regard to routine breast examination, and compares them with
      routine detection of hypertension and diabetes mellitus. A structured
      questionnaire was distributed to all 97 Kupat Holim (workers' federation sick
      fund) primary care physicians in the Negev. They included 40 family physicians
      (FP), board-certified or completing specialization, and 57 general practitioners
      (GP), not board-certified. There was no difference in response rate between the 2
      groups (47%). Nearly all physicians perform routine examinations for detection of
      hypertension (100% of the FP and 96% of the GP) and diabetes mellitus (91% and
      74%, respectively). Of the FP, 96% consider routine breast examination as the
      task of the primary care physician, versus only 68% of the GP. Accordingly, 92%
      of the FP stated that they routinely perform the procedure, but only 52% of the
      GP. Being an FP was positively related with the performance of breast
      examination, while seeing a large number of patients per clinic session and low
      job satisfaction were negatively associated with it.

PMID- 2227658
TI  - [Early detection of diseases in primary care].

PMID- 2227657
TI  - [Leukergy 1990].

PMID- 2227659
TI  - [Meningitis, shock and rash in a 16-year-old girl].

PMID- 2227660
TI  - [Polymorphous ventricular tachycardia in acute myocarditis ].
AB  - Myocarditis may present with a variety of electrocardiographic patterns. However,
      polymorphous ventricular tachycardia (PVT), potentially a highly malignant
      ventricular arrhythmia, has not been described in acute myocarditis. As far as we
      know, this is the first report of this arrhythmia in that condition. It is
      characterized by unusual resistance to both the common pharmacological and
      nonpharmacological approaches. This report of a 28-year-old woman demonstrates
      the role of PVT as a potential cause for sudden death among patients with
      subclinical myocarditis.

PMID- 2227661
TI  - [Laryngeal neuroendocrine carcinoma (carcinoid)].
AB  - Neuroendocrine carcinoma (carcinoid), is a rare laryngeal malignancy with
      aggressive behavior. The 5-year survival rate is only about 10%, mainly because
      of distant metastases. We describe a patient with neuroendocrine carcinoma of the
      larynx, large cell type, without evidence of regional or distant metastases.
      Treatment included total laryngectomy and adjuvant radiotherapy to the neck.
      There was no evidence of disease at 6-month follow-up.

PMID- 2227662
TI  - [Patient status evaluation using severity scores in the general intensive care
      unit].

PMID- 2227663
TI  - [Human values and medical ethics].

PMID- 2227664
TI  - [Hemoptysis].

PMID- 2227665
TI  - [Policy with regard to laxatives].

PMID- 2227666
TI  - [Extracorporeal shock wave lithotripsy for gallstones].
AB  - Biliary stone disease is common in most western societies, among whom gallstones
      are present in approximately 15-20% of adults. 40-60% of all persons with
      gallstones are asymptomatic, but 30-50% of them develop symptoms over a period of
      2-5 years. For decades, cholecystectomy was the only solution. In the past decade
      new options, such as oral dissolution, direct dissolution, invasive endoscopy and
      lately lithotripsy and adjuvant treatment with oral dissolution agents, have
      become available. This paper summarizes the rationale of lithotripsy, its
      indications and complications, the impressive results of its use abroad and the
      authors' year of experience with 110 patients. Immediate fragmentation was
      achieved in 90.3%. Complete dissolution after 1 month was seen in 20%, after 3
      months in 38.5% and after 6 months in 61.6%. After 1 year of treatment 85.8% of
      our patients were stone-free. Experience abroad, as well as our own, shows that
      lithotripsy and oral dissolution can be the treatment of choice in a selected
      group of patients with symptomatic gall stones.

PMID- 2227667
TI  - [Effect of hemodialysis on hemodynamic assessment and cardiac flows determined by
      Doppler echocardiography].
AB  - 25 patients with end-stage renal failure were studied by different
      echocardiographic techniques before and immediately after hemodialysis using M
      mode, 2-dimensional and Doppler echocardiography. Preload reduction after
      dialysis was manifested by a decrease in body weight, in left atrial diameter and
      in the left ventricular end-diastolic dimension. Doppler flow patterns
      immediately after dialysis showed reduction in early diastolic velocities across
      the atrioventricular valves and increase in the flow velocities across the
      semilunar valves and the peripheral A-V fistula. The flow velocity integral,
      calculated by Doppler echocardiography, was lower after dialysis. Significant
      improvement in left ventricular myocardial function after dialysis was correlated
      with reduction in afterload and increase in myocardial contractility.

PMID- 2227668
TI  - [Diabetic hand syndrome in juvenile diabetics].
AB  - 247 patients with juvenile diabetes mellitus, aged 3-37 years, were examined for
      diabetic hand syndrome. 68 (27%) had 1 or more of the manifestations of diabetic
      hand syndrome. In 45 (18%) flexion contractures were found, 41 (17%) had skin
      changes resembling those of scleroderma and digital sclerosis, and 12 (5%)
      suffered from trigger finger. We found an association between diabetic hand
      syndrome and diabetes control as evaluated by serial levels of hemoglobin A1c
      measured during the years of follow-up. A high relative risk for microvascular
      complications was found in those who had diabetic hand syndrome, compared to the
      others. The relative risk for retinopathy was 2.5 times greater in patients with
      diabetic hand syndrome (p less than 0.001). These results show that diabetic hand
      syndrome is a common presentation of juvenile diabetes mellitus and can be
      utilized as a marker for some of its complications.

PMID- 2227669
TI  - [Intracavernous pharmacotherapy for organic impotence in the elderly].
AB  - Vasoactive intracavernous pharmacotherapy (VIP) has become an important tool for
      the treatment of erectile impotence. The average age of patients treated has been
      only 59 years and the oldest, 79. We describe the results of VIP in the oldest
      group of patients described. 28 men, 65-84 years old (average 70), were treated
      for organic impotence with intracavernous injections of a mixture containing 25
      mg/ml papaverine HCl and 0.83 mg/ml phentolamine. Treatment was started with an
      injection of 0.25 ml of the mixture, with increments of 0.25 ml until there was
      functional erection, or untip a total of 1.5 ml was injected. Full erection was
      obtained in 46.5%, while in 40.0% there was a mild nonfunctional erection and in
      13.4% no reaction to treatment. The response to the injection was similar in the
      different etiologic groups. There were no complications, such as prolonged
      erections or adverse reactions to the drugs injected. We conclude that elderly
      men seek help in order to have normal sexual function. We therefore think that
      VIP has a definite place in the treatment of impotence of the elderly.

PMID- 2227671
TI  - [Posterior approach for excision of sacral chordoma].
AB  - Chordoma is considered to be a malignant, fatal tumor. According to most authors
      it constitutes between 1-4% of all malignant bone tumors. In 50% of the cases it
      is located in the sacrum, in 35% in the cervical spine and skull, and in 15% in
      the thoracic spine and elsewhere. It is an aggressive, locally invasive, slowly
      growing tumor. Although metastases are rare, when they occur they are of an
      anaplastic type, especially in the lungs, liver, regional lymph nodes, skin and
      muscles. Chordoma is a rare tumor, and its location and slow growth often result
      in delayed diagnosis. Complete excision of the chordoma was formerly considered
      impossible. There is often local recurrence, and often, by its very nature,
      excision results in neurological defects. Lately, there is more optimism
      regarding complete cure, due to more advanced surgical methods. We present a 66
      year-old man in whom a tumor developed in the sacrococcygeal area and the right
      buttock. The tumor was diagnosed by CT, MRI and biopsy as a chordoma of the
      sacrum, without intra-abdominal infiltration. He was operated through a posterior
      approach, with complete resection of the tumor, including almost the whole sacrum
      and the coccyx. We consider this approach simpler than the abdominal-dorsal
      approach, which in cases of intra-abdominal infiltration is necessary. We regard
      this simple incision as a significant advance in the treatment of this
      condition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227670
TI  - [Delayed spontaneous rupture of the bladder following augmentation
      enterocystoplasty].
AB  - Delayed spontaneous rupture of the urinary bladder following augmentation
      enterocystoplasty is a serious life-threatening complication of uncertain
      etiology. Multiple factors are believed to contribute to the mechanism of bladder
      perforation. Ruptured augmented bladders share a common urodynamic pattern of
      high leak point pressure of the urethra, with sensory and mechanical tolerance of
      high filling pressure. This combination seems to be the main predisposing factor
      for spontaneous perforation. Other risk factors, including catheter trauma during
      intermittent self-catheterization, urinary retention due to mucus retention or
      noncompliance with the catheterization protocol, chronic infection, and decreased
      sensation of bladder filling, may play roles in the mechanism of rupture.
      Clinically, patients present with sepsis, abdominal pain and distension, ileus,
      fever, oliguria and peritoneal irritation. The diagnosis is made on low pressure
      cystography, although failure of cystography to demonstrate extravasation is not
      unusual. Aggressive surgical treatment consists of immediate exploration, primary
      repair of the perforation, drainage of the perivesical space, suprapubic
      cystostomy and broad-spectrum antibiotics. Longterm management includes a strict
      intermittent catheterization schedule, anticholinergic therapy and urodynamic
      evaluation. Failure to achieve a low pressure storage reservoir by conservative
      means entails an increased risk of recurrent perforation. In such cases further
      surgical intervention should be considered. We present a 21-year-old paraplegic
      man 5 months after augmentation enterocystoplasty who required operation because
      of spontaneous rupture of the augmented bladder. Spontaneous delayed rupture of
      the bladder should be considered in the differential diagnosis of acute abdomen
      in patients after augmentation enterocystoplasty. Early surgical treatment and
      subsequent monitoring of the low pressure reservoir are recommended.

PMID- 2227672
TI  - [Toxocariasis in Emek Israel].
AB  - Toxocariasis is a rare zoonotic disease in Israel. It usually affects children
      under the age of 10. Toxocara canis and Toxocara catis are common parasites among
      dogs and cats which affect man when he ingests the eggs of these helminths. We
      describe 3 children with different clinical presentations of the infestation. A 6
      year-old boy had pain in the muscles of the limbs and diffuse patches in the
      right lower lobes on X-ray; a 7-year-old girl presented with a limp; and a 3-year
      old boy had abdominal pain and a maculopapular rash covering the whole body. All
      3 had eosinophilia. They illustrate the importance of toxocariasis in the
      differential diagnosis of eosinophilia.

PMID- 2227673
TI  - [Metastatic Serratia marcescens endophthalmitis].
AB  - A case of metastatic Serratia marcescens (SM) endophthalmitis is described in a
      57-year-old diabetic woman, after amputation of her leg above the knee because of
      peripheral vascular disease. SM cultured from the infected surgical stump was the
      source of septic emboli to her right eye and lungs, causing endophthalmitis and
      pneumonia. The ocular infection did not respond to appropriate antibiotic therapy
      and evisceration was required. SM infection can cause endophthalmitis refractory
      to antibiotics, and it should be aggressively treated when SM is cultured from
      any infected site.

PMID- 2227674
TI  - [Increased use of drugs in sports].

PMID- 2227675
TI  - [Autoantibodies as specific markers for autoimmune diseases].

PMID- 2227676
TI  - [Transfusion-associated graft-versus-host disease and its prevention].

PMID- 2227677
TI  - [Clinical and pathophysiological aspects of thromboembolic phenomena in cancer].

PMID- 2227678
TI  - [Intestinal obstruction in cancer patients].

PMID- 2227679
TI  - [Continuous monitoring of mixed venous oxygen saturation: physiology, clinical
      utility, indications].

PMID- 2227680
TI  - [Communicating with families of children with cerebral palsy].

PMID- 2227681
TI  - [Epidemiology of basketball injuries].
AB  - The players of an elite basketball team were followed during the course of a
      season which included 71 games and 250 training sessions. All injuries were noted
      and were correlated with age, height and other physical parameters of the
      players, as well as with degree of fatigue during games and during training
      sessions. The lower extremity was the most common site of injury. Ligamentous
      injuries of the knee are more common in basketball than in soccer players, but
      they have fewer meniscal injuries than the latter. However, the upper extremity,
      especially the hand, is more frequently injured in basketball than in other
      sports. The age, height and personality of the player affect the injury pattern.

PMID- 2227682
TI  - [The diagnostic value of CT and MRI studies in brain-stem tumors].
AB  - The combination of lower cranial nerve palsy and contralateral motor impairment,
      presenting subacutely and following a progressive course in a child or young
      adult, suggests the possibility of brain-stem tumor. However, if the CT scan is
      normal, the diagnosis of multiple sclerosis or a vasculitis is frequently
      considered. Since CT scans may miss lower brain-stem tumors, MRI is recommended
      as the definitive diagnostic test in such cases.

PMID- 2227683
TI  - [Extreme bilirubinemia in hepatitis A associated with G6PD-deficiency].
AB  - In patients with G6PD-deficiency and hepatitis A infection, the clinical picture
      can resemble fulminant hepatitis. We describe 2 patients with this association.
      Bilirubin concentrations were over 50 mg/dl in both, but they recovered
      completely.

PMID- 2227684
TI  - [Epiglottitis in adults].
AB  - Acute epiglottitis in the child is an emergency, well known to pediatricians,
      that requires rapid diagnosis and treatment. Aggressive treatment in recent years
      has markedly decreased mortality (17). Acute epiglottitis in adults has been
      thought to be rare, but lately numerous studies have shown an increase in the
      disease. We present 19 older patients, aged 13-72 (mean 44.7 years), with acute
      epiglottitis. A most important finding was the relatively long time from onset of
      symptoms until diagnosis, averaging 2.5 days. All the blood and throat cultures
      were negative, except for a single throat culture which yielded Pseudomonas
      aeruginosa. The most common presenting symptoms were severe sore-throat and
      dysphagia; half presented with some respiratory distress. Diagnosis was usually
      made on indirect laryngoscopy, but lateral X-ray of the soft tissues of the neck
      was found to be highly reliable. Treatment was usually conservative, including
      antibiotics, rehydration and steroids to alleviate edema. All patients were under
      strict observation for the first 48 hours, but only 1 required intubation. There
      were no deaths.

PMID- 2227686
TI  - [The seton in the treatment of trans-sphincteric anal fistulas].
AB  - In most patients anal fistulas are of the intersphincteric type (Parks'
      classification). Treatment consists of simple fistulotomy. 10% of those with an
      anal fistula have the more complicated trans-sphincteric type. The treatment of
      such a fistula by primary fistulotomy is associated with a high rate of
      incontinence. A technique to avoid this complication is the use of the seton for
      gradual transection of the sphincteric fibers. 21 of 53 patients with anal
      fistula had a trans-sphincteric fistula, and all of them were treated with
      setons. Hospital stay was 2 days and was followed by 2-4 outpatient visits. 17
      patients (85%) underwent the procedure without any complications and were cured.
      3 (15%) had minor problems with continence, of whom 2 required emergency
      operation. In no case did the fistula recur. We find that the use of the seton
      after partial fistulotomy for complicated anal fistulas reduces the rate of
      incontinence caused by sphincteric transection and has a very low recurrence
      rate.

PMID- 2227685
TI  - [A respiratory health questionnaire for occupational screening].
AB  - A Hebrew pulmonary health questionnaire was designed for occupational screening,
      based on the American Thoracic Society questionnaire but adjusted to conditions
      in Israel. It was designed for assisted completion using a computer, but can
      easily be modified to become self-administered. We propose that it be used here
      as the standard, occupational, pulmonary health questionnaire and as the basis
      for a standard, general purpose, respiratory health questionnaire.

PMID- 2227687
TI  - [Brown spider bite].
AB  - The diagnosis of bite by the brown recluse spider, Loxosceles reclusus, is rarely
      based on absolute identification of the insect because the victims are usually
      bitten while sleeping or dressing. More often, the history, clinical findings and
      course of the bite lead to the diagnosis. For early confirmation up to 24 hours
      after the bite, the passive hemagglutination test can be used. For older lesions,
      the in-vitro lymphocyte transformation test is useful, but is available in only a
      few medical centers. Treatment of the bite of the brown recluse spider varies
      from conservative to more active approaches. Resting, local cooling, systemic
      antibiotics to prevent infection and mild anti-inflammatory drugs may be given.
      In the more active approach oral corticosteroids are added in the first 72 hours
      to the antibiotics, especially in massive bites with necrotic centers greater
      than 2 cm in diameter, or when there is systemic loxoscelism. Recently, good
      results have been reported with Avlosulfon (dapsone), which is claimed to cure
      necrotic cutaneous ulcerations, presumably by reducing the activity of
      polymorphonuclear leukocytes. Other treatments include specific antivenin, (of
      limited use because it must be administered shortly after the bite), and surgery
      to prevent spreading of the venom. We describe 3 cases of brown spider bite with
      typical clinical presentations in adults aged 20-40 years. 2 were treated with
      corticosteroids and antibiotics and 1 with Avlosulfon and prednisone, all within
      72 hours of the bite. 2 recovered completely within a few days, but the third
      treated with prednisone and antibiotics, developed an ulcer which healed only
      after several months of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227688
TI  - [Late pneumothorax: a complication of subclavian vein catheterization].
AB  - Subclavian vein catheterization is safe as long as proper indications and
      contraindications are observed. In the hands of highly qualified personnel,
      subclavian vein catheterization has a minimum rate of complications. Pneumothorax
      is by far the most common complication of the procedure. We describe a 64-year
      old man who developed pneumothorax late after left subclavian vein
      catheterization.

PMID- 2227689
TI  - [The emergency room as a setting for clinical training].
AB  - The undergraduate medical curriculum does not include supervised training in
      emergency services. Medical students and residents are expected to acquire skills
      and experience related to emergency medicine during their clerkships in the
      clinical wards. Consequently, Israeli medical graduates often have difficulty in
      coping with common situations in primary care and emergency medicine. In response
      to the perceived need of emergency training, we modified the undergraduate
      teaching program of the clinical clerkship. During their medical clerkship,
      students spent several weeks in the emergency ward. Residents were similarly
      assigned to the emergency ward on a rotating basis for 3-month periods. Both the
      positive feedback of the trainees and the practical relevance of the program and
      its feasibility, suggest that it may be a worthwhile addition to the
      undergraduate and graduate clinical curriculum. However, we have no data for
      evaluating the outcome. We feel that all aspects of emergency medicine should be
      included in the teaching programs of the various clinical specialties, and
      suggest that the emergency room should be used as a teaching setting during the
      clinical clerkship, the internship and residency training.

PMID- 2227690
TI  - [Selection of fetal sex: facts and myths].

PMID- 2227691
TI  - [Malignant ovarian tumors in pregnancy].

PMID- 2227692
TI  - [New antibiotics for gynecologic infections].

PMID- 2227694
TI  - [Medical aspects of boxing].

PMID- 2227693
TI  - [Chlamydial salpingitis--diagnosis and treatment].

PMID- 2227695
TI  - [Mental aspects of physical activity].

PMID- 2227697
TI  - [Balneological (Spa) therapy for rheumatic diseases].

PMID- 2227696
TI  - [Immunotherapy for stinging insect allergy--update].

PMID- 2227699
TI  - [Pitfalls in the diagnosis of brain-stem tumors].

PMID- 2227698
TI  - [Chemical drug dependency and the medical community: a short circuit].

PMID- 2227700
TI  - [Nephrotic syndrome, amyloidosis].

PMID- 2227701
TI  - Pathogenicity and ultrastructural pathology of Eimeria debliecki (Douwes, 1921)
      in experimentally infected pigs.
AB  - It was confirmed, after experimental infection of 24 weaned pigs with different
      doses (200,000 and 4 mil.) of Eimeria debliecki oocysts that the developmental
      cycle of E. debliecki occurs in the anterior jejunum and after a high dose of
      oocysts also in the duodenum and anterior parts of the middle jejunum.
      Pathological changes characterized by a light atrophy of the villi, scarcely
      dispersed minute erosions of the epithelium in upper parts of the mucosa and an
      inflammatory response in the propria of the anterior jejunum were found in the
      area of the largest occurrence of developmental stages of E. debliecki (from 50
      cm to 100 cm from the pylorus). An inflammatory infiltrate in the propria of the
      anterior jejunum from 3 DPI to 5 DPI contained a conspicuously large number of
      plasma cells with Russell bodies. Cellular changes were detected only in
      enterocytes with developmental stages of E. debliecki. Changes of the
      microvillous zone were observed in infected enterocytes; dilated mitochondria,
      free ribosomes and an increased number of residual bodies were found in the
      cytoplasm of enterocytes. The degree of the cellular changes of enterocytes was
      dependent on the maturity of the developmental stage of E. debliecki. Based on
      pathological changes observed by the use of light and electron microscopy, the
      coccidium E. debliecki is considered to be pathogenic for weaned pigs in spite it
      does not provoke a clinical infection.

PMID- 2227702
TI  - Laboratory diagnosis of acute toxoplasmosis by immunosorbent agglutination assay
      (IgM ISA).
AB  - A group of 401 patients suspected for toxoplasmosis was examined by the indirect
      immunofluorescent antibody test (IFAT). All patients positive in IFAT (176) were
      examined by the immunosorbent agglutination assay (IgM ISA). In the IgM ISA 154
      of them were negative, 10 temporarily and 12 high-positive. Some of high-positive
      patients were examined repeatedly; decrease of high levels of specific IgM
      antibodies occurred 2-9 months after the first examination. For the IgM ISA
      antigen prepared from peritoneal exudate of experimentally infected mice was
      used. The antigen was stable at 4 degrees C or in liquid nitrogen at least 1
      year. The IgM ISA combined with IFAT and IgM IFAT was proved satisfactory for the
      diagnosis of acquired acute toxoplasmosis and can be recommended for laboratories
      with lower capacity.

PMID- 2227704
TI  - Synopsis of type specimens deposited in the helminthological collection of the
      Institute of Parasitology, Czechoslovak Academy of Sciences, in Ceske Budejovice.
      II. Cestoda, Trematoda and Acanthocephala.
AB  - The paper comprises a list of the cestode, trematode and acanthocephalan type
      specimens deposited in the helminthological collection of the Institute of
      Parasitology, Czechoslovak Academy of Sciences, in Ceske Budejovice. These
      materials include a total of 7 species of cestodes, 16 species of trematodes, and
      5 species of acanthocephalans.

PMID- 2227703
TI  - Effect of cortisone on Toxoplasma gondii infection studied by electron
      microscopy.
AB  - The ultrastructural features of cortisone effect on the early development and
      formation of Toxoplasma gondii tissue cysts were examined in the brains of
      experimental mice on days 8-47 post inoculation. The cortisone was injected
      subcutaneously into mice twice a week: 1) at the early acute phase, 5 days post
      infection, and 2) at the transition phase of development, 12 days post infection.
      The disturbed regulation of the host-parasite relationship due to the effect of
      cortisone showed itself in an increase of T. gondii tachyzoites, cystozoites, and
      cysts not only by intracellular but also by as yet not described extracellular
      division. The persisting parasitaemia induced by tachyzoites and the earlier
      development and differentiation of cysts resulted in the cyst rupture releasing a
      highly resistant antigen of cystozoite type. The toxoplasmic encephalitis had a
      lethal effect in all mice. The tachyzoites penetrated into many types of cells,
      but a predilection of development into cysts was detected in neurons and
      astrocytes. According to the character of host cells, two types of cysts arose:
      less resistant electron-transparent cysts in neurons often rupturing or budding
      and more resistant electron-dense cysts in astrocytes.

PMID- 2227705
TI  - Environment and host-parasite relationships in Monogenea.
AB  - The interest of a new approach in taking up the problems of host-parasite
      relationships with environment is proposed in terms of population biology. Two
      different integrating levels are considered: a microenvironment that corresponds
      particularly to the host and a macroenvironment corresponding to the whole host
      parasite system. Some examples are given that provide significant reasons in
      perceiving the biology of Monogenea under these aspects. To conclude we emphasize
      the importance of developing this new way for the study of hybrids models in
      relation to parental host systems.

PMID- 2227706
TI  - The systematical composition of the family Heteraxinidae and other allied
      families of Monogenea.
AB  - This paper briefly presents a system of Heteraxinidae and other allied small
      monogenean families of suborder Microcotylinea Lebedev, 1972 with the indication
      of specific composition of all taxa and diagnoses of some taxa; new families
      Megamicrocotylidae, Paramonoxinidae and Monaxinoididae are proposed.

PMID- 2227707
TI  - Caryophyllaeides ergensi sp. n. (Cestoda: Caryophyllidea) from Leuciscus
      Leuciscus baicalensis from Mongolia.
AB  - The tapeworm Caryophyllaeides ergensi sp. n. (Cestoda: Caryophyllidea) is
      described from Leuciscus leuciscus baicalensis from the River Selenga basin in
      Mongolia. It differs from the only hitherto recognized species of the genus C.
      fennica (Schneider, 1902), mainly in its extremely long uterus with coils
      extending anteriorly to anterior half, sometimes up to anterior third of the body
      of gravid specimens.

PMID- 2227709
TI  - Immunodiagnostics of Toxocara canis in suspected ocular and visceral
      manifestations.
AB  - Sera from patients with ocular and visceral manifestations of toxocariasis were
      tested by precipitin absorption (PAT), counter-immunoelectrophoresis (CIEP),
      indirect fluorescent antibody (IFAT) and ELISA. The ocular cases revealed a
      percentage of positivity of 36% by PAT, 0% by CIEP, 32% and 28% by IFAT with
      embryonated egg (EE) and frozen section antigens (FS) respectively and 40% by
      ELISA. The visceral cases revealed 44% positively by PAT, 24% by CIEP 52% and 48%
      by IFAT with EE and FS respectively and 52% by ELISA. Statistical evaluation was
      done to interpret the results.

PMID- 2227708
TI  - A new genus of capillariids from birds, Ornithocapillaria gen. n. (Nematoda:
      Capillariidae).
AB  - A new genus, Ornithocapillaria gen. n., belonging to the family Capillariidae and
      subfamily Baruscapillariinae is described and its diagnosis is given. The type
      species of the genus is Ornithocapillaria ovopunctata (Linstow, 1873) comb. n.,
      other species are O. cylindrica (Eberth, 1863) comb. n., O. quiscali (Read, 1949)
      comb. n., and O. picorum (Rudolphi, 1819) comb. n. The new genus is characterized
      by a relatively large membranous pseudobursa, shape of processes supporting
      pseudobursa, and presence of a vulval appendage in female. It includes only
      species parasitic in the intestine of birds of the orders Passeriformes,
      Falconiformes, Strigiformes, and Piciformes.

PMID- 2227710
TI  - Francisella tularensis from ixodid ticks in Czechoslovakia.
AB  - A total of 26,478 ixodid ticks (935 pools) were examined by intracerebral
      inoculation of suckling mice. Six species of ticks were tested: Ixodes ricinus
      (23,470 individuals), I. trianguliceps (12), Haemaphysalis punctata (831), H.
      concinna (39), Dermacentor reticulatus (69) and D. marginatus (2,057). The ticks
      were collected largely by flagging vegetation, a substantial minority (4%) from
      animals. Three strains of Francisella tularensis were isolated, one each from I.
      ricinus (males, district Breclav, southern Moravia), D. reticulatus (males,
      district Breclav) and D. marginatus (engorged females collected from sheep in
      Roznava district, eastern Slovakia). D. marginatus and D. reticulatus represent
      new vector species for Czechoslovakia.

PMID- 2227711
TI  - Susceptibility of Mastomys natalensis to Brugia malayi following pretreatment
      with antifilarials.
AB  - Mastomys natalensis pretreated with diethylcarbamazine (DEC), levamisole or
      centperazine were exposed to the standard inoculum of infective larvae of Brugia
      malayi. Percentage 'take' of infection, duration of prepatent period, course of
      microfilaraemia and number of adult worms recovered were compared with those of
      untreated infected Mastomys (control). DEC and centperazine did not alter the
      'take' (DEC/centperazine: 100%; control: 88.24%) and the average prepatent period
      (DEC: 105.44 days; centperazine: 105.18 days, control: 109.20 days). In
      levamisole pretreated animals on the other hand, the 'take' was much lower
      (68.18%) with extended prepatent period (125.87 days). However, unlike
      centperazine and control, the course of microfilaraemia was identical in DEC and
      levamisole pretreated animals. The average adult worm recovery was significantly
      high in centperazine pretreated animals being 14.09 as against 8.12, 7.46 and
      8.42 in DEC, levamisole pretreated and control animals, respectively.

PMID- 2227712
TI  - Remarkable records of Anoplura from Czechoslovakia.

PMID- 2227713
TI  - A new species of the genus Chauhanellus Bychowsky et Nagibina, 1969 (Monogenea)
      from the gills of a sea fish Tachysurus dussumieri (Val.) from Andhra Pradesh,
      India.
AB  - Chauhanellus chauhani sp. n., collected from the gills of a sea cat-fish,
      Tachysurus dussumieri (Valenciennes) from the Bay of Bengal, off the coast of
      Kakinada, Andhra Pradesh, India is described and illustrated. It differs from the
      related species of the genus--C. oculatus, C. flexiosus, C. australis, C.
      nagibinae, and C. pedunculatus--in the shape and articulation of accessory piece
      with cirrus and in having a crescentic posteromedian process on its dorsal bar.
      It has five transverse hard structures on the ventral surface of peduncular
      region, by which it differs from C. oculatus and C. australis the latter have 10
      11 and 3 such hard structures, respectively.

PMID- 2227714
TI  - A new Monogenean species, Bicotyle lucknowensis sp. n. (Monogenea:
      Heteraxinidae), from the Indian fish, Gudusia chapra (Ham.).
AB  - A new monogenean species, Bicotyle lucknowensis sp. n. of the family
      Heteraxinidae, has been described from the fish, Gudusia chapra (Ham.), from
      Lucknow, India. The new species is characterized by the number and shape of
      cirral spines, presence of an unarmed vagina and details of copulatory complex
      and haptoral armature.

PMID- 2227715
TI  - Antigenic characterization of rat louse Polyplax spinulosa.
AB  - Number and relative molecular weights of proteins in whole body homogenates of
      the louse, Polyplax spinulosa were determined using SDS-PAGE. 13 protein
      components from the total of 28 bands were defined as Con A binding
      glycoproteins. In immunoblotting sera of lice infested laboratory rats of BN
      strain specifically recognized 3 major protein components with r.m.w. of 77,000,
      105,000 and 230,000 Da and from 6 to 8 minor protein components with r.m.w. of
      31,000-180,000 Da.

PMID- 2227716
TI  - Experimental infection of ticks Ixodes ricinus with tick-borne encephalitis virus
      under different microclimatic conditions.
AB  - The influence of environmental temperature and relative air humidity on the
      development of ticks Ixodes ricinus and their infection rate with tick-borne
      encephalitis virus was studied. It was found that the temperature influenced
      significantly the development of ticks, but it did not influence their infection
      rate. To the contrary, the relative air humidity influenced the infection rate.
      It is assumed that the intrinsic factors play a primary role in the infection of
      ticks, while extrinsic factors have a secondary role; they are probably important
      at border values only.

PMID- 2227717
TI  - A record of gravid cestodes Bothriocephalus claviceps (Goeze, 1782) from the
      newts Triturus vulgaris (L.) (Amphibia).

PMID- 2227718
TI  - Occurrence of Coxiella burnetii, Rickettsia slovaca, and organisms resembling
      bacillary rickettsiae in their natural foci in Slovakia 20 years after their
      first detection.

PMID- 2227719
TI  - [Second messengers and protein phosphorylation in cellular signal transduction].
AB  - Protein phosphorylation has been recognized as a major mechanism by which
      cellular functions are controlled by neurotransmitters and hormones. In this
      review, applications of molecular biological techniques to the analyses of
      regulatory mechanisms of protein phosphorylation by four major second messengers,
      cAMP, cGMP, diacylglycerol, and Ca2+, are described. 1) Complementary DNA of the
      regulatory subunit of the cAMP-dependent protein kinase was cloned and expressed
      in E. coli. Point mutations were introduced in order to analyze functional
      domains of the subunit. 2) The soluble isoform of guanylate cyclase was purified,
      and a cDNA of its 70-KD subunit was cloned. Cyclic GMP binding to purified cGMP
      dependent protein kinase was characterized using a rapid filtration assay. 3)
      Primary structure of the catalytic subunit of calmodulin-dependent protein
      phosphatase (calcineurin A) was determined and the presence of the second isoform
      of the enzyme was shown by the cDNA cloning technique. 4) The regulatory domain
      of the protein kinase C was expressed in E. coli. Analysis using site-directed
      mutagenesis revealed that a "zinc finger"-like structure is responsible for the
      binding of phorbol esters. In these studies, the molecular biological approach
      has proven to be useful for clarifying the molecular mechanisms of cellular
      signal transduction related to second messengers and protein phosphorylation.

PMID- 2227720
TI  - [Effect of Y-516 on the hyperactivity induced by dopamine injected bilaterally
      into the nucleus accumbens].
AB  - The effect of Y-516 on the hyperactivity induced by dopamine injected bilaterally
      into the nucleus accumbens was compared with those of clocapramine (CCP),
      haloperidol (HPD) and chlorpromazine (CPZ). Dopamine (5-50 micrograms) injected
      into the nucleus accumbens induced a dose-dependent hyperactivity following
      pretreatment with nialamide (100 mg/kg, i.p., 2 hr). The hyperactivity induced by
      10 micrograms of dopamine was antagonized by the i.p. administration of Y-516
      (0.5-1.0 mg/kg), CCP (5-25 mg/kg), HPD (0.05-0.5 mg/kg) and CPZ (1-5 mg/kg) in a
      dose-dependent manner. The ED50 values of Y-516, CCP, HPD and CPZ were 0.85,
      16.5, 0.098 and 2.53 mg/kg, respectively. These results suggest that Y-516 has a
      potential inhibitory effect on the mesolimbic dopaminergic system and may be a
      beneficial neuroleptic drugs.

PMID- 2227721
TI  - Changes in the behaviour of wild long-tailed macaques (Macaca fascicularis) after
      encounters with a model python.

PMID- 2227722
TI  - Obituary. Norman Creel.

PMID- 2227724
TI  - Incisor microwear and diet in three species of Colobus.
AB  - Examination of incisor microwear in three species of Colobus revealed that the
      predominantly folivorous C. badius more closely resembles C. satanas, a seed
      predator/folivore, than C. guereza, another predominantly folivorous species.
      This demonstrates that species of the same broad dietary category can have very
      different patterns of incisor microwear, indicative of differences in food
      procurement behavior and/or the physical properties of dietary items for some
      portion of the diet. Conversely, species of different categories can have
      microwear patterns that, superficially at least, are quite similar. The
      dissimilarity in incisor microwear between C. badius and C. guereza is mirrored
      to a certain extent in molar microwear, although the differences are not nearly
      so great on the molars. The differences between C. badius and C. guereza may
      involve different food items in the major, folivorous portions of their diets, or
      they may relate to differences in the very minor fruit and bark components. The
      similar microwear patterns of C. badius and C. satanas demonstrate that incisor
      microwear by itself is unreliable for assigning fossil species to broad dietary
      categories. Incisor microwear can be used to infer finer dietary distinctions in
      fossil species for which dietary category has been determined by other means.

PMID- 2227723
TI  - Comparison of auditory functions in the chimpanzee and human.
AB  - Absolute thresholds for pure tones, loudness, frequency and intensity difference
      thresholds and the resonance of the external auditory meatus were measured in
      chimpanzees and compared with those in humans. Chimpanzees were more sensitive
      than humans to frequencies higher than 8 kHz but less sensitive to frequencies
      lower than 250 Hz and 2- to 4-kHz tones. Difference thresholds for frequency and
      intensity were greater in chimpanzees than in humans. The resonance of the
      external ear was about the same in the two species. The effects of differences in
      hearing between species upon speech perception are discussed.

PMID- 2227725
TI  - Social climber: independent rise in rank by a female Barbary macaque (Macaca
      sylvanus).

PMID- 2227726
TI  - Female dominance in Lemur catta: more than just female feeding priority?

PMID- 2227727
TI  - Female dominance does not characterize all of the Lemuridae.

PMID- 2227728
TI  - Fourier analysis of the forehead shape of skull and sex determination by use of
      computer.
AB  - The forehead shape of the skull was quantified with the Fourier analysis method
      by using 100 male and 100 female radiographic lateral views of the skull, and sex
      difference in the forehead shape was studied. Furthermore to predict the sex of
      cranial specimens, an automated sexing computer system based on the
      quantification was created. The effectiveness of the system was evaluated by
      checking 56 male and 56 female specimens of skulls. This system was proved to
      discriminate male and female skulls from forehead shapes with 85% accuracy.

PMID- 2227729
TI  - Evaluation of a commercial radioimmunoassay kit for the detection of lysergide
      (LSD) in serum, whole blood, urine and stomach contents.
AB  - The Diagnostic Products Corporation Coat-A-Count radioimmunoassay kit for LSD in
      urine has been evaluated for use in forensic toxicology with a variety of sample
      types. The cut-offs (defined as the mean response of blank samples plus three
      standard deviation) for LSD in serum, haemolysed whole blood, urine and stomach
      contents were 0.06, 0.050-0.055, 0.18 and 0.18 ng/ml, respectively. Preliminary
      extraction of LSD from the samples is not usually necessary. The precision of the
      analysis and the recoveries from spiked samples were satisfactory. The cross
      reactivities of 2-oxo-LSD, lysergic acid methyl propylamide, lysergic acid
      monoethylamide and nor-LSD were estimated to be 11,6,2 and 1% respectively
      relative to LSD (100%).

PMID- 2227730
TI  - Avian vitreous humor concentrations of inosine, hypoxanthine, xanthine, uric
      acid, uracil and uridine as influenced by age and sex: their relevance as
      indicators of ante-mortem hypoxia.
AB  - An investigation was made to determine the effects of age and sex on postmortem
      concentrations (mumol/l) of inosine, hypoxanthine, xanthine, uric acid, uracil
      and uridine in the vitreous humor of chickens (Gallus domesticus). Five male and
      5 female chickens were sampled each week from 0-10 weeks of age. Samples were
      collected at 0 and 24 h postmortem and analysed by HPLC. Hypoxanthine, uric acid
      and uridine were detected at both 0 and 24 h postmortem whereas inosine, xanthine
      and uracil were detected only at 24 h postmortem. Neither sex nor the sex X age
      interaction influenced the concentrations of the compounds investigated (P
      greater than 0.01). Age had a significant influence on the concentrations of all
      compounds at 24 h postmortem (P less than 0.0001). At 0 h postmortem, age
      significantly affected the levels of hypoxanthine and uridine (P less than
      0.0001) but not uric acid (P = 0.014). All compounds occurred at higher
      concentrations at 24 than 0 h postmortem with the exception of uridine at 0 and 1
      week of age. Previous studies using data confounded by age and postmortem
      sampling time have concluded that postmortem vitreous humor hypoxanthine
      concentration is a useful indicator of antemortem hypoxia. The results of this
      study cast doubt on that conclusion. Age and postmortem sampling time should be
      rigorously controlled when conducting quantitative analyses of these compounds in
      vitreous humor.

PMID- 2227731
TI  - Immunofluorescence demonstration of digoxin in human myocardial tissue and
      isolated rat cardiac myocytes with monoclonal antibodies.
AB  - The aim of the present investigation was to identify the morphological correlates
      of digoxin binding sites in human heart muscle tissue and isolated viable rat
      heart myocytes. Cardiac glycoside linked to myocardial cells was demonstrated by
      monoclonal digoxin specific antibody and by FITC-conjugated anti-mouse
      immunoglobin serum. This versatile immunofluorescence method can be used in
      diagnostic and experimental studies of cardiac glycoside binding.

PMID- 2227732
TI  - Routine phenotyping of native and desialyzed alpha 2HS-glycoprotein from blood
      stains.
AB  - The application of a polyacrylamide gel isoelectric focusing (PAGIEF) and
      immunoblotting procedure for the identification of native alpha 2HS-glycoprotein
      (AHSG) in routine casework blood stains has produced reportable results on 57.2%
      of samples. This reporting rate is lower than that for group specific component
      (GC) (83.8%) and phosphoglucomutase (PGM 1) (72.8%) phenotyping of the same
      samples. Blood stain samples were desialyzed with 1 U/ml neuraminidase, overnight
      at room temperature prior to PAGIEF in gels containing pharmalyte pH 5-6 and 2.5
      M urea. Simple AHSG patterns were developed by immunoblotting. This procedure was
      five times as sensitive as the native AHSG method and desialyzation was
      reproducible over a range of incubation times and neuraminidase concentrations.
      The application of the desialyzed AHSG analysis to routine casework samples has
      resulted in a significant increase in the number of reportable results (762
      reported out of 1027 samples). This reporting rate (74.2%) compares favourably
      with that for GC (79.1%) and PGH 1 (69.6%) phenotyping of the same samples. The
      three AHSG alleles (AHSG*1, 2 and 3) are clearly resolved after sample
      desialyzation and separation in gels containing pharmalyte pH 5-6 and 2.5 M urea.
      The sensitivity of desialyzed AHSG phenotyping approaches that of GC and this
      technique is worthy of inclusion in blood stain screening protocols of forensic
      laboratories in regions where the population has a limited range of rare AHSG
      alleles.

PMID- 2227733
TI  - Cocaine and fetal death.
AB  - Toxicologic screening for cocaine and its metabolites was performed on 103 cases
      of fetal death autopsied in the Office of Chief Medical Examiner, City of New
      York. In 64 cases cocaine or its metabolites were found in the blood or in the
      brain. Some malformations were also found. The study indicates that maternal use
      of cocaine may lead to abruptio placentae, abortion and fetal death. The
      importance of toxicologic examination in these deaths is emphasized.

PMID- 2227734
TI  - [The effect of the vertical bracket position on the orthodontic finish].
AB  - As during orthodontic treatment and in particular during the phase of the precise
      adjustment of occlusion by applying the "straight-wire technique" problems arise
      as far as the vertical dimensions are concerned, the usual distances between the
      bracket slots and the edges of the incisors respectively the top of the cusps
      have been verified. Measurements were done on models at the end of treatment of
      ten patients treated with fixed attachments who may represent ideal occlusion as
      far as profile radiographs and gnathology were concerned. After regulation of the
      plane of occlusion the vertical distances between the slot base plane (parallel
      to the plane of occlusion) and the edge of the incisors respectively tops of
      cusps were measured by means of a modified parallelometer in connection with a
      special slot and tube support as well as a specially developed dial test
      indicator, while a maximum fit between bracket base and buccal crown surface was
      given. In case of the upper front brackets (torque + 22 degrees) large vertical
      measurement to the edge of the incisors were recorded, 8.25 respectively 8.33
      mm). This may be attributable to excessive torque of the applied brackets. Only
      approximate figures for the vertical positioning for other teeth could be given,
      as anatomical variations have to be considered.

PMID- 2227735
TI  - [Glass ionomer cements as orthodontic bracket adhesives. An in vitro study with 4
      glass ionomer cements (GIC) and 2 conventional orthodontic bracket adhesives as
      the comparative group].
AB  - 240 orthodontic brackets were bonded to buccal surfaces of bovine teeth. As
      bonding material we used four glass ionomer cements without etching and two
      normal orthodontic bracket bonding materials with etching of enamel. Brackets of
      group 1 were tested with a material testing machine for shear and tensile
      strength after ten minutes. Brackets of group 2, 3 and 4 were tested after one
      day, 28 days and 98 days, respectively. In the average the bonding strength of
      glass ionomer cements was 50% less than the bonding strength of the comparison
      group with etching. The fracture of the bonding took place to 80% between the
      mesh base and the glass ionomer cements. Defects of the enamel surface were never
      observed. The bonding between mesh-base and glass ionomer cements has to be
      improved before the use of this bonding material can be recommended for the use
      in a busy practice.

PMID- 2227736
TI  - [Growth and therapy in Angle class II/2--a longitudinal cephalometric study].
AB  - The influence of both growth and functional therapy with the U-Bow-Activator Type
      I on Angle class II subdivision 2 malocclusion is analysed in a cephalometric
      long term study. Findings concerning skeletal problems: 1. Therapeutically
      intended clockwise rotation of the mandible with vertically and sagittally
      controlled maxillary position, 2. achieving normal sagittal mandibular growth
      rates. Dental problems are improved significantly. The results obtained by
      functional therapy and growth proved to be stable in the post-treatment check
      ups.

PMID- 2227737
TI  - [Individual overbite behavior between the deciduous and permanent dentition].
AB  - Manuals and relevant publications give rise to the impression that the formation
      of the overbite in the incisor region throughout its development is a process
      easy to overlook. Impressions of 108 cases were taken, one of the deciduous
      dentition and one of the permanent dentition 13 years later. A mathematic
      statistical analysis of objective measurable morphological dentition criteria
      were made and discussed. This shows that neither from the degree of overbite nor
      from any other feature of the deciduous dentition a prognosis concerning the
      extent of the final overbite of the permanent dentition can be derived. Changes
      throughout the development of the overbite are predominant. There are only little
      correlative coherencies among the morphological symptoms that can be applied
      quickly and easily for the prognosis in the clinical inspection. For estimating
      the development tendency longterm individualized observations are necessary.

PMID- 2227738
TI  - [The early treatment of children with cheilognathopalatoschisis--the orthodontic
      aspects].
AB  - Maxillary alveolar arch morphology and growth was studied in 15 children with
      complete unilateral cleft lip and palate treated with passive orthopaedic plates.
      Nine patients were treated to the "Zurich concept" and compared to six children
      who had lip surgery and primary bone-grafting at about six months of age and
      complete palate closure at 18 months. Maxillary alveolar arch morphology was
      described at birth, at six months, at 18 months and at 4.5 years. After early
      orthopaedic treatment the alveolar and palatal cleft width decreased
      significantly, the major segment was relocated into a more normal position and
      the midline deviation was reduced, whereas the minor segment rotated towards the
      palate.

PMID- 2227740
TI  - [Fluorine and the dentition].
AB  - In order to estimate the influence of fluorine (in drinking-water and air) on the
      occlusion 372 twelve-year-old children have been examined in four different
      localities with differing fluorine concentrations of drinking water and air.
      Apart from the determination of the fluorosis frequency and of the DMFt index,
      the number of children who do not require any orthodontic treatment according to
      the WHO recommendation has been determined. The degree of malocclusion has been
      defined by means of the Eismann-Masztalerz's method. There was observed that the
      optimal fluorine concentration in drinking water (0.7-0.9 mg/l) decreases the
      degree of malocclusion except for the crowding of the teeth whereas its
      concentration above the optimum (4.0-7.0 mg/l) as well as fluorine polluted air
      are one of the causes of crowding.

PMID- 2227739
TI  - [Initial attitudes to orthodontic treatment--the results of a practical and
      clinical questionnaire study (I)].
AB  - 312 patients from one clinic and nine offices, between eight and 15 years of age
      treated with bionators, their parents and a control group were questioned on
      various aspects of their treatment. Findings regarding opinions about dentofacial
      appearance, initial motives and expectations are presented. Aesthetic motives
      proved preponderant by seeking treatment though the children's ability to
      verbally differentiate aesthetic concepts was poor. Above all, they expected
      visible treatment progress, absence of appliance-caused psychosomatic impairment
      and rather factual information than personal communication with the orthodontist.

PMID- 2227741
TI  - [The computer simulation of orthodontic tooth movements].
AB  - A personal computer programme is presented which allows the prediction of
      orthodontic tooth movement under the influence of any given force and moment. The
      changes in position of the front teeth caused by the chosen forces appear on the
      monitor as a three-dimensional diagram and as a movie-like picture sequence.

PMID- 2227742
TI  - [The realization of a wear-timing device for clarifying the scientific questions
      presented in orthodontics].
AB  - A timing device for removable orthodontic appliances is described. The
      measurement system includes a quartz digital clock at the timer. A reed switch
      serves as a sensor and is activated by a magnetic device fastened directly or by
      an orthodontic band to a molar tooth. A changeover reedswitch prevents
      manipulation by the patient. As a timing device the system provides great
      accuracy. The high-speed capability of the device permits further scientific
      application: Installation of two timing devices in a single Bionator permits
      selective timing (e.g. biting contact during wear of the appliance).

PMID- 2227743
TI  - [NMR-microscopic studies of the condylar cartilage of the temporomandibular
      joint].
AB  - The objectifying of growth mechanisms of the TMJ is very important for
      orthodontic diagnosis, treatment as well as clinical research. Condylar cartilage
      of the TMJ from neonatal pigs was investigated on in vivo preparations by NMR
      microscopy. NMR-micro-pictures and histologic slide preparations of condylar
      cartilage were compared and discussed in connection with its implications for
      treatment with functional appliances.

PMID- 2227744
TI  - [Incidence and risk factors of malignant diseases].

PMID- 2227745
TI  - [Body-packer syndrome. Psychotropic drug smuggle in the human body--discussion
      from the legal and medical viewpoint based on own patients].
AB  - Body packing is the term used to describe the smuggling of drugs, usually cocaine
      or heroin, in special containers introduced within the body. Rupture of the
      containers leads to acute intoxication that often ends fatally. The possibility
      of drug poisoning should always be considered by the emergency or hospital
      physician confronted with an unconscious patient. If representatives of the law
      suspect anyone of drug smuggling and refer him/her to hospital, a knowledge of
      the legal position as laid down in particular in paragraph 81a and d of the StPO
      is of great importance.

PMID- 2227746
TI  - [Venous constriction by local administration of ruscus extract].
AB  - The venoconstrictive action of the topical application of Ruscus extract was
      evaluated in a randomized, double-blind study involving 18 healthy volunteers,
      using duplex B-scan ultrasonography. Within 2 1/2 hours of the application of 4
      to 6 g of a cream containing 64 to 96 mg Ruscus extract, the diameter of the
      femoral vein decreased by an average (median) of 1.25 mm, while placebo (base of
      the cream) was associated with a diameter increase of 0.5 mm (means) (p = 0.014).
      The decrease in venous diameter reflects good percutaneous absorption of the
      active substance. To date, venoconstrictive action has been demonstrable only
      indirectly with the aid of plethysmographic methods; it has now been measured
      directly under orthostatic conditions.

PMID- 2227747
TI  - [Growth of knowledge in immunology. From congenital immune deficiencies to common
      infection susceptibility].

PMID- 2227748
TI  - [Congenital combined disorders of immune defense. Survival possibilities with
      early bone marrow transplantation].
AB  - Congenital combined immunodeficiencies involving both T-cell- and B-cell
      dependent functions, are characterized by the early onset of life-threatening
      complications, usually of infections. Major clinical and laboratory findings in
      these disorders are presented, as well as therapeutic strategies involving bone
      marrow transplantation.

PMID- 2227749
TI  - [Acquired immunodeficiency].
AB  - Secondary immunodeficiencies are much more frequent than primary immunological
      disorders. There are many etiologies, such as malnutrition, cytostatic drug
      therapy, burns, protein-losing conditions and infections. This review briefly
      considers the history of virus-induced immunosuppression. Today, measles and AIDS
      are the most important virus-induced immunodeficiency diseases. In rate
      instances, infections with Epstein-Barr virus can lead to hypogammaglobulinemia
      and B cell lymphomas. A viral etiology should always be considered in all cases
      of congenital and postnatally acquired immunological disorders.

PMID- 2227750
TI  - [Primary antibody deficiency syndrome. Improved life expectancy and
      immunoglobulin G substitution].
AB  - Recurrent pyogenic infections are the leading clinical symptom in patients with
      antibody deficiency syndromes. In accordance with the WHO-classification at least
      nine different diseases are differentiated. In some cases diagnosis can be made
      simply by determining the immunoglobulin serum levels. Some diseases, such as Ig
      heavy chain gene deletions, are clearly characterized by molecular biological
      methods, while other terms, such as common variable immunodeficiency, cover a
      collection of different diseases with changes predominantly of B-cell functions.
      The main features of the antibody deficiency syndromes are described. In most
      cases adequate therapy can be achieved by IgG replacement therapy.

PMID- 2227751
TI  - [Erroneous methods in the care of children with immunodeficiencies. How can they
      be avoided?].
AB  - Immunodeficiencies are often suspected, but altogether rarely diagnosed in time.
      A fatalistic attitude should not be allowed to justify inconsequential diagnosis
      and treatment, since nowadays, in a considerable percentage of these patients,
      life can be prolonged, or even a cure can be achieved, for example, by bone
      marrow transplantation. In order to meet the demands of modern pediatric
      immunology, structural improvements in the care of children with immunological
      disorders, as well as in the mediation of knowledge, are discussed.

PMID- 2227752
TI  - [Delayed-release verapamil hydrochloride in chronic atrial fibrillation. Reducing
      the heart rate].
AB  - In an open clinical trial, the therapeutic effect of sustained-release verapamil
      hydrochloride was investigated in 40 patients with chronic atrial fibrillation.
      As required, the daily dose was increased from 240 mg to 480 mg. A clinically
      relevant, statistically significant decrease in the heart rate was observed in
      almost all the patients. Since only four patients experienced mild side effects,
      with no major clinical significance, the preparation has a positive benefit/risk
      ratio for the indication investigated.

PMID- 2227753
TI  - [Acute abdomen in anorexia nervosa. A case report].
AB  - Anorexia is a common psychiatric condition of childhood and adolescence in which,
      apart from the striking psychopathology, somatic complications are frequently
      seen. The secondary somatic findings, however, are sometimes overlooked. This
      case report describes a 17-year-old girl in whom, during an episode of bulimia
      dilatation of the stomach occurred, which presented clinically as perforation.

PMID- 2227754
TI  - [Improvement in diabetes therapy. Interview by Heike E. Nahtke].

PMID- 2227755
TI  - [Report on treatment with captopril and hydrochlorothiazide combination.
      Comprehensive therapy of hypertension].

PMID- 2227757
TI  - [Do ambulatory patients complain more often?].

PMID- 2227756
TI  - [Report of the 6th annual meeting of the European League Against Rheumatism,
      Athens, May 17, 1990. Naproxen--standard in rheumatism therapy. Confirmation of a
      tried and tested non-steroidal anti-rheumatic drug (NSAR)].

PMID- 2227758
TI  - [NSAID indicated in all rheumatic diseases].

PMID- 2227759
TI  - [Heart diseases as a cause of cerebral symptoms and syndromes].
AB  - The causes, clinical indications and diagnosis and differential diagnosis of
      cardiac disorders which may lead to cerebral symptoms are illustrated on the
      basis of a review of the present day level of scientific research. Principally
      involved are cerebral ischaemias arising from cerebral embolisms or from
      reduction of cardiac output in cardiovalvular and myocardial disorders. The
      incidence of all embolisms of cardiac origin makes up 10% of all ischaemic
      cerebral infarcts, with auricular fibrillation, irrespective of its origin,
      mitral stenosis, myocardial infarct, mitral insufficiency and combined mitral
      valve defects, and, in younger patients, mitral valve prolapse, being, in this
      order of frequency, of primary clinical significance. The other cardiovalvular
      and myocardial disorders have, in comparison, a relatively low incidence of
      cerebral embolisms. Haemodynamically induced cerebral ischaemias frequently occur
      in the form of complications following acute cardiac arrest, in myocarditis and
      in case of primary cardiomyopathies resulting from cardiac insufficiency or
      complicating bradyarrhythmia. They are clinically apparent in the form of
      syncope, and other impairments of consciousness of various levels of seriousness
      with and without indications of cerebral origin, extending up to coma. In view of
      the high incidence of 25% of acute cerebral ischaemias in cases of cardiac
      disease, not only neurological but also detailed cardiological investigation is
      vital in all cases for a correct diagnosis and for the selection of a suitable
      course of treatment. Cerebral complications in bradyarrhythmia and endocarditis
      are discussed in the context of a review of the relevant literature together with
      consideration of their epidemiology, aetiology, pathophysiology and clinical
      profile. Pathological sinus-bradycardia, bradyarrhythmia absoluta, sinu-atrial
      and atrio-ventricular blockages, carotid-sinus and sick-sinus node syndrome,
      paroxysmal atrial tachycardia, AV-node tachycardias, and auricular fibrillation
      and flutter, taken as a whole, lead to cerebral complications affected patients
      in 5 to 10% of afflictions of the central nervous system occur in 50% of patients
      suffering from complete AV blockage and, at a not precisely definable frequency,
      in patients suffering from other bradyarrhythmias. In addition to transitory,
      uncharacteristic symptoms such as dizziness, vertigo, impairment of vision and
      balance, presyncope, syncope and Adams-Stokes syndrome dominate the clinical
      profile. Endocarditis, with an incidence of 0.01 to 0.05% in the overall
      population, results in central nervous system complications in 12 to 25% of cases
      on average.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2227760
TI  - [Psychopathology of person misidentification--a multidimensional concept].
AB  - The misidentification of person or Personenverkennung (PV) is provisionally
      redefined in this paper by focusing on four important points of view offered by
      German-speaking authors, all more or less based on an analysis of content. These
      deal with the extent of "craziness" of a PV (Leonhard), the degree of personal
      relationship of the person misidentified with respect to the patient
      (Kahlbaum/Pauleikhoff), the extent of the incorrect identification (Jaspers),
      and, lastly, the stage of stability shown by a PV at a particular point in time
      (Conrad). On this basis it is suggested that it may be best to initially call the
      PV simply a "delusion" with all further differentiation of types of PV carried
      out in light of a multidimensional psychopathological model utilizing various
      combinations of these four aspects of content.

PMID- 2227761
TI  - [Bone marrow transplantation].

PMID- 2227762
TI  - [Solid and cystic tumor of the pancreas with prominent calcification].
AB  - A case of a solid and cystic tumor of the pancreas is presented. The
      immunohistochemical study of the resected tumor revealed alpha 1-antitrypsin and
      neuron specific enolase positive malignant cells proliferating pseudopapillary
      around fibrovascular stroma. Prominent calcification was characteristic in the
      present case.

PMID- 2227763
TI  - [A case of acute potassium bromate intoxication].
AB  - We experienced a case of a 44 year old man who had ingested potassium bromate
      solution for suicide attempt. Soon after the ingestion, nausea, vomiting,
      abdominal pain and diarrhea developed in him. Several hours later, he began to
      complain of auditory disturbance and, in addition, anuric acute renal failure
      occurred. Direct hemoperfusion and hemodialysis was performed on the patient for
      the treatment purpose. Five weeks later, he was released from hemodialysis
      procedure. Gradually, on the other hand, progressing anemia was observed until
      90th hospital day, which slowly improved thereafter. Further, pruritus, lower leg
      pain, headache, tinnitus and loss of sense of taste, etc. were observed in the
      clinical course. Renal biopsy was performed on the 119th hospital day and the
      specimen showed the regenerative stage of acute tubular necrosis. In our case,
      acute renal failure was reversible and, many other clinical manifestations were
      observed. However slight anemia and irreversible severe auditory disturbance
      remained unimproved.

PMID- 2227765
TI  - Laser balloon angioplasty: potential clinical applications.
AB  - Coronary laser balloon angioplasty (LBA) is a new technique which permits
      application of heat (generated by the laser source) and pressure (by balloon
      inflation) to thermally weld tissue during coronary angioplasty (PTCA). The goal
      of LBA is to achieve a large, smooth arterial lumen, by thermal welding of
      dissection flaps, elimination of elastic recoil, elimination of vasospasm,
      reduction in platelet activation, desiccation of thrombus, and inhibition of
      smooth muscle cell proliferation (Table 1). The LBA system consists of a 50 watt
      continuous wave Nd:YAG laser with a wavelength of 1060 nm, and a modified
      coronary balloon angioplasty catheter with a 4.3 French shaft and a PET balloon
      measuring 20 mm in length and 2.5, 3.0 and 3.5 mm in diameter. For clinical use,
      laser doses ranging from 250 to 450 joules each are delivered over 20 seconds, to
      achieve adventitial tissue temperatures of 90 to 110 degrees C. The LBA technique
      is quite similar to that of conventional PTCA. The LBA catheter is usually
      positioned over a 0.014" guidewire through an 8 French guiding catheter. Once the
      laser balloon is in position, the balloon is inflated to a pressure of 4
      atmospheres and the programmed laser dose is delivered over 20 seconds, followed
      by continued balloon inflation for an additional 20 to 40 seconds while the
      temperature of the arterial wall returns to normal. Conventional PTCA is
      virtually never necessary to improve lumen appearance and dimensions after LBA.
      LBA has been shown to be effective in the management of acute failure of PTCA,
      due to abrupt closure or severe dissection with impaired flow ("impending
      closure").(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227764
TI  - [Rotation angioplasty of chronic coronary artery stenosis].
AB  - Coronary artery occlusion of more than six months duration can only rarely be
      recanalized with conventional techniques. For this reason, rotational
      angioplasty, which has been successfully applied for occlusion of peripheral
      arteries, has been employed in modified form for recanalization of chronic
      coronary artery occlusion. Rotational angioplasty is based on the concept that
      the slowly revolving, dull and relatively thick head of the flexible rotation
      catheter will seek the path of least resistance which, even in the case of
      relatively old arterial occlusions, mostly represents thrombotic material. The
      elastic, high-torque rotational catheter constructed of several V2A spiral steel
      wires has an interior lumen for insertion of exchange guidewires up to 0.014" and
      injection of contrast medium and an olive-shaped head of V2A steel with a
      diameter of 1.3 to 1.6 mm. A protection catheter made of polyethylene with metal
      markers and conically-tapered tip provides variable stiffness of the rotating
      catheter and protection of the endothelium in the proximal vascular segment. The
      slow rotation of 200 r.p.m. is performed with a small electric motor. Between
      April 1987 and February 1988, rotation angioplasty was performed in 20 patients,
      17 with occlusion of the right coronary artery, two with occlusion of the left
      anterior descending artery and one with bypass graft occlusion to the left
      anterior descending artery in whom a conventional guidewire through the chronic
      occlusion could not be advanced. The duration of occlusion, based on previous
      angiograms anginal complaints or myocardial infarction, ranged from one month to
      twelve years, in twelve patients more than six months. In all patients, the
      indication for revascularization was clearly established.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2227766
TI  - Intracoronary stents: clinical and angiographic results.
AB  - Limitations of current forms of coronary angioplasty including abrupt vessel
      closure and delayed restenosis have led to the development of alternative
      nonsurgical methods of coronary revascularization. By scaffolding the arterial
      dissection and smoothing the endoluminal surface, intracoronary stenting may
      obviate the need for emergency coronary bypass surgery in patients who develop
      abrupt vessel closure following coronary angioplasty. As primary therapy, its use
      may prevent or delay restenosis in high-risk patients; however, due to potential
      patient selection bias, controlled studies are needed. Currently available
      intracoronary stents are limited by varying degrees of inflexibility,
      radiolucency, and thrombogenicity. These limitations have resulted in the
      development of innovative stent designs using radioopaque tantalum filaments and
      aggressive pharmacologic treatment with antiplatelet and anti-thrombotic therapy
      following stent deployment. Current experimental investigation into the
      feasibility of intracoronary stent coating with genetically engineered
      endothelial cells or slow release antiproliferative agents, such as colchicine or
      methotrexate, may further serve to lessen the frequency of late restenosis. The
      optimal patient selection criteria for the use of the intracoronary stent is
      currently the subject of intense clinical investigation.

PMID- 2227767
TI  - [Coronary endoprostheses (stents)].
AB  - Even before the introduction of transluminal balloon dilatation of coronary
      arteries, Dotter had conceived intravascular endoprostheses and, in 1969,
      published a report of his observations after implantation of a spiral-shaped
      support of surgical steel and nickel-titanium ligation in peripheral arteries of
      the dog. Interest in intravascular supports developed especially in consideration
      of frequent unsatisfactory long-term results after coronary angioplasty. Coronary
      artery occlusion is observed in about 5% of balloon dilatations due to
      dissection, thrombosis, spasm or a combination of these phenomena. The rate of
      recurrent stenosis after uncomplicated balloon dilatation is about 30%, that of
      recanalization of chronic occlusion or dilatation of stenosed bypass grafts about
      50%. Stent technology: In order to provide a meaningful solution to unresolved
      problems of balloon dilatation, the ideal endoprosthesis must be rapidly and
      reliably implantable as well as sufficiently flexible to conform to vascular
      curvatures. It should have a low profile, must be biocompatible and not
      thrombogenic; it should be rapidly endothelialized with no excessive
      proliferatory stimulus. Rigid stents are limited in length; elastic stents
      display a better transition to normal coronary arteries. Negatively-charged
      metallic surfaces appear less thrombogenic than those positively charged, the
      former, however, are usually not free of corrosion. The generally positive charge
      of stainless steel, the most commonly used material, is tempered with a special
      surface treatment. Currently, materials under investigation are nickel-titanium,
      tantalum and biodegradable plastic. Of importance for endothelialization are the
      wall thickness of the stent and the relationship of material to pore size.
      Filaments of stainless steel measuring 0.09 mm in diameter are completely covered
      by neoendothelium within three weeks. In laboratory animals, within minutes after
      implantation, all three stents currently in clinical use are covered with a thin
      layer of thrombocytes and fibrin; after one day, endothelial-like and
      pseudoendothelial cells develop along the metal structures. After one week, there
      is a flow-oriented behaviour of the surface cell formation embedding the stent
      between neoendothelial and lamina elastica interna, a process which is complete
      in three months. The thickness of the neointimal proliferation may be dependent
      on the stent geometry and may vary between 0.09 and 0.4 mm.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 2227768
TI  - [Sinus node inhibitors in coronary surgery].
AB  - In patients with coronary artery disease, rapid ventricular rates require
      adequate treatment since disturbed oxygen balance and ischemia may be incurred.
      By virtue of their isolated action on the sinus node, "specific bradycardic
      substances" have only negligible hemodynamic side effects and, accordingly,
      represent an alternative to other available rate-slowing drugs. The clonidine
      derivative, alinidine (N-allyl-clonidine) was used primarily as the specific
      bradycardic substance in our studies in patients at the time of aortocoronary
      bypass surgery. In addition to its rate-slowing properties, this substance also
      elicits an analgetic and anti-ischemic effect and, in a small percentage, it is
      metabolized to clonidine. The purpose of this study was to assess the
      effectiveness and hemodynamic actions of alinidine in the treatment of
      intraoperative heart rate acceleration and, in combination with the calcium
      channel blocker nifedipine, to evaluate its use for postoperative hypertension.
      The first study was performed in nine patients in whom, during aortocoronary
      bypass surgery, there was a heart rate increase in excess of 20% above the
      preoperative control value. Patients were excluded with impaired ventricular
      function, absence of sinus rhythm, concomitant increase in arterial mean pressure
      greater than 30%, hypovolemia, pulmonary capillary wedge pressure in excess of 15
      mmHg as well as those with ECG changes precluding exact assessment of myocardial
      ischemia. In addition to the ECG, the following parameters were registered: heart
      rate, arterial pressure, central venous pressure and, with a semi-floating
      balloon-tipped catheter, pulmonary artery pressure as well as pulmonary wedge
      pressure. Cardiac output was determined with thermodilution.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2227770
TI  - A prescription for high drug prices.

PMID- 2227769
TI  - Surgical treatment for chronic pulmonary thromboembolism.

PMID- 2227771
TI  - New drug legislation: a response from the pharmaceutical industry.

PMID- 2227772
TI  - Adverse drug reactions and the elderly.

PMID- 2227773
TI  - Drug approval and AIDS: benefits for the elderly.

PMID- 2227774
TI  - Geriatric medications in the pipeline.

PMID- 2227775
TI  - Employer-sponsored health insurance, 1989.

PMID- 2227776
TI  - Foundations' role in improving medication use by older persons.

PMID- 2227777
TI  - Prescription drugs, practicing physicians, and the elderly.

PMID- 2227778
TI  - Health promotion: continuing the national debate.

PMID- 2227779
TI  - Measuring progress in health promotion.

PMID- 2227780
TI  - The health of industrialized nations.

PMID- 2227781
TI  - Understanding the nature of addiction.

PMID- 2227782
TI  - Value of Medicare risk contracts.

PMID- 2227783
TI  - Experience of state drug benefit programs.

PMID- 2227784
TI  - Prescription drugs and the elderly.

PMID- 2227785
TI  - Managed care and a changing pharmaceutical industry.

PMID- 2227786
TI  - The role of mail service pharmacies.

PMID- 2227787
TI  - The Medicare Catastrophic Coverage Act: a post-mortem.

PMID- 2227788
TI  - Understanding the cost of a catastrophic drug benefit.

PMID- 2227789
TI  - [Repression of rearranged c-myc expression in murine cell hybrids].
AB  - In hybrids SBW I and SBW II between S194 mouse plasmacytoma and BW5147 mouse T
      cell lymphoma, enhanced expression of the rearranged c-myc mRNA of heterogeneous
      sizes (1.8-2.4 kb) in S194 was markedly downregulated but expression of the non
      rearranged c-myc of 2.4 kb in BW5147 was not. Treatment of SBW I hybrid cells
      with cycloheximide augmented non-rearranged c-myc expression 2-4-fold but did not
      release the downregulated expression of the rearranged c-myc. Nuclear run-on
      assay showed that the high level of c-myc transcripts in S194 cells declined in
      SBW I cells comparable to the level in BW5147 cells. The results suggest that the
      downregulation of the rearranged c-myc in SBW I hybrid cells was at a
      transcriptional level rather than a posttranscriptional level. Methylation
      patterns of the rearranged c-myc in SBW I cells was the same as S194 cells.
      Treatment of the SBW I cells with 5-azacytidine, TPA or forskolin did not release
      the downregulated expression of the rearranged c-myc, suggesting no causative
      involvement of DNA methylation or protein phosphorylation in the downregulation.
      Higher DNase I sensitivity of the rearranged c-myc in S194 cells decreased to a
      similar extent to that of the non-rearranged c-myc after cell fusion with BW5147
      cells. All these results suggest that expression of the rearranged c-myc was
      downregulated at the level of transcription in murine cell hybrids between a
      plasmacytoma and a T-cell lymphoma probably by changing the chromatin
      configuration around the gene from the open to the closed state.

PMID- 2227790
TI  - [Mechanism of reduction in proteinuria by cyclosporine A: effects on the
      glomerular anionic sites].
AB  - To consider the mechanism of reduction of proteinuria by cyclosporine A (CYA) in
      the patient with intractable nephrotic syndrome, the effect of CYA on proteinuria
      and anionic sites (AS) of the glomerular basement membrane (GBM) was studied in
      puromycin aminonucleoside (PA) nephrotic rats. In addition the rats exogenously
      given human recombinant interleukin-2 (hrIL-2) every day repeated the same
      proteinuria were used. The PA nephrotic rats were made by single injection of PA
      150 mg/kg excrete of urinary protein as compared 10 mg/day of urinary protein in
      the controls. The increase of urinary protein in the PA rats was inhibited by
      CYA10-20 mg/kg administrated orally from the day of PA injection for 15 days. To
      evaluate AS, the kidney were treated with a polyethyleneimine (PEI) staining
      method and the deposits in the lamina rara externa (LRE) of the GBM were counted
      on the electron micrographs. On the 15th day, in the PA rats, AS decreased
      greatly but were normal in the CYA-treated rats. On one hand, rats injected of hr
      IL-2 2.5 X 10(5)U/rat intraperitoneally for 14 days showed slight proteinuria on
      the 14th day, and the proteinuria was also inhibited by oral administration of
      CYA 25 mg/kg. As reduced in the rats treated with hrIL-2 as well as PA. The
      findings indicate that the proteinuria in the PA nephrotic rats and rats treated
      with hrIL-2 might result from reduction of AS and that the improvement of
      proteinuria in these rats by CYA might be due to the recovery of AS in the GBM.

PMID- 2227791
TI  - [Effects of volatile anesthetics on the cervical sympathetic nerve activity
      during acute hypoxemia or hypercarbia in dogs].
AB  - Either hypoxemia or hypercarbia produces a significant change in the autonomic
      nervous system activity. Responses of the cervical sympathetic nerve activity
      (CSA) to acute hypoxemia and/or hypercarbia were studied in the absence and the
      presence of either halothane (H), enflurane (E), isoflurane (I) or sevoflurane
      (S). Multifiber potentials of CSA, EEG, ECG, heart rate, arterial blood pressure,
      arterial oxygen saturation (SaO2) and endtidal carbon dioxide concentration
      (FETCO2) were continuously monitored. CSA increased responding to acutely induced
      hypoxemia at a speed of -6-9% (SaO2)/min. The response of CSA was estimated in
      two ways as a function of SaO2; the threshold was determined at which CSA
      increased by 3% over the base level and the gain was determined by the slope of
      CSA increase divided by the SaO2 span. They were 92% and -1. 88 (Mean) in the
      absence of volatile anesthetics, respectively. The threshold and the gain
      decreased markedly in the presence of volatile anesthetics in a dose dependent
      fashion. They were 89.2% and -1.16; 81% and -0.74; 84.2% and -1.16 and 86.2% and 
      0.94 with 1MAC of H, E, I and S. At 1MAC, E and S suppressed CSA response
      significantly compared to equipotential H and I. CSA also increased responding to
      acutely induced hypercarbia at FETCO2 of 10%. The peak level increased 34% above
      the control value responding to hypercarbia in the absence of volatile
      anesthetics, though it was less than a half value of that induced by hypoxemia.
      The tonic levels of CSA were suppressed with increasing concentrations of
      volatile anesthetics. The base level and the peak level were 68.3% and 75%; 50.7%
      and 51.8%; 70.3% and 76.7%, and 55.5% and 63.2% with 1MAC of H, E, I and S. The
      inhibitory effects of 1MAC E on the CSA was significantly stronger than that of
      equipotential H or I. CSA did not respond against hypoxemia following bilateral
      sinus nerve block with 2% lidocaine 4 ml. Since EEG was silent while SaO2 was
      lower than 30%, vigorous CSA at these levels of hypoxemia should be maintained by
      strong afferent activity of the chemoreceptor site. These combined stimulation of
      both acute hypoxemia and hypercarbia seem to suggest that CSA response are
      additive each other. In conclusion, it is indicated that the depressant effects
      of volatile anesthetics on the CSA responses to acutely induced hypoxemia and
      hypercarbia can cause depression of the control activity on the autonomic nervous
      system against hypoxemia and hypercarbia, and conceal the manifestation of
      clinical signs of hypoxemia and hypercarbia, per se.

PMID- 2227792
TI  - [Plasma prostaglandin E2 and skin graft rejection in the rat].
AB  - The aim of this study is to make it clear whether plasma prostaglandin E2 (PGE2)
      is a useful parameter or not for prediction and judgement of the graft rejection.
      We studied the plasma levels of PGE2 in skin graft recipients; a control group of
      isogeneic grafts with LEW rats, a group of allografts with ACI to LEW and a group
      of allogeneic graftings with intramuscular administrations of cyclosporin A (CyA)
      with 20 mg/kg/day from day-2 to day 14. Rejection was judged to be complete when
      the grafts got dried or appeared graft necrosis. During the first interval after
      grafting (from 6 hours to the 5th day), significantly high levels of plasma PGE2
      with a peak at 12 hours after transplantation (7.8 days prior to 50% skin
      survival time (ST50), and with 60 times higher value than normal control, can be
      seen in the allogeneic group. On the other hand, we found no peaks of plasma PGE2
      in the immunosuppressed group while using CyA, but a slight elevation was
      recognized on the 4th day after stopping CyA treatment (7.7 days prior to ST50)
      with 10 times higher than the normal value. In conclusion, the plasma PGE2 level
      elevates about 1 week prior to the graft rejection and the serial monitoring may
      be useful for prediction and judgement of the graft rejection.

PMID- 2227793
TI  - [DNA sequence analysis of HLA-DQB genes associated with insulin-dependent
      diabetes mellitus in Japanese].
AB  - Recently it has been reported that 57th amino acid of DQ beta antigen was a non
      aspartic acid in the most Caucasian patients with insulin-dependent diabetes
      mellitus (IDDM). Using serological analysis, HLA-DQ antigens show a strong
      association with IDDM rather than the HLA-DR antigens. In the Caucasian
      population, IDDM is associated with DQw2 and DQw3 antigens. However, in the
      Japanese population, DQw4 and DQw9 antigens are strongly associated with IDDM. In
      order to determine the possible significance of the 57th amino acid of DQ beta
      chain for the susceptibility to IDDM in Japanese, we performed DNA Sequence
      analysis of HLA-DQB from Japanese IDDM patient, its same HLA genotyped healthy
      sibling and B cell line with Japanese IDDM associated haplotype. The results
      revealed that all of the 57th amino acid are aspartic acid which is thought to
      contribute to develop IDDM resistance in Caucasian. Furthermore we could not find
      any other amino acid sequence of DQ beta chain which might contribute to the
      susceptibility of the Japanese IDDM.

PMID- 2227794
TI  - Estimation of permeability in blood-retinal barrier.
AB  - Permeability of the blood-retinal barrier (BRB) can be determined by vitreous
      fluorophotometry and computer analysis. In this study, we characterize our eye
      model and apply it to normal human subjects. In this investigation of BRB
      permeability, we employed four parameters for the eye model: the inward
      permeability (Pin) and outward permeability (Pout) of the BRB; the diffusion
      coefficient in the posterior vitreous gel (D-p); and the plasma fluorescein
      concentration. The values of Pin, D-p, and plasma fluorescein concentration
      significantly affected the fluorescein concentration in the posterior vitreous 60
      minutes after intravenous fluorescein injection. The value of Pout had little
      influence on the fluorescein kinetics in the posterior vitreous 60 minutes after
      injection. The results of experiments on humans indicate that the estimated
      values obtained by simulation fit satisfactorily the measured values. It is
      suggested that our computer simulation method in conjunction with vitreous
      fluorophotometry can effectively estimate permeability of BRB in normal and
      pathological eyes.

PMID- 2227795
TI  - [2',5'-oligoadenylate synthetase activity in peripheral blood mononuclear cells
      obtained from patients with chronic hepatitis B during interferon therapy].
AB  - The activities of 2',5'-oligoadenylate synthetase (2-5AS) in spleen and liver
      extracts obtained from mice treated with recombinant mouse interferon-beta
      (rMuIFN-beta) were investigated. The levels of the enzyme activity increased
      significantly in both spleen and liver extracts for 72 hours after the treatment
      with rMuIFN-beta (5 X 10(4)IU). The levels of the enzyme activity in spleen
      extracts correlated well with those in liver extracts. Therefore it is suggested
      that the assay of 2-5AS activity in peripheral blood mononuclear cells (PBMC) of
      patients infected with hepatitis B virus (HBV) is useful for monitoring the
      antiviral state of liver during IFN therapy. The activities of 2-5AS in PBMC
      obtained from patients with chronic hepatitis B (CHB) were significantly higher
      than those of healthy controls, resulting from the endogenous IFNs detected in
      the patients with CHB. Furthermore, the enzyme activities of PBMC in the patients
      with CHB increased significantly during IFN therapy as compared with IFN
      untreated patients. This increase in the enzyme levels during IFN therapy
      correlated well with the decrease of DNA-polymerase (DNA-P) activities associated
      with HBV. These results indicate that the assay of 2-5AS detected in PBMC from
      the patients is valuable to determine the optimal IFN therapy for CHB.

PMID- 2227796
TI  - Binding of low density lipoprotein (LDL) to C-reactive protein (CRP): a possible
      binding through apolipoprotein B in LDL at phosphorylcholine-binding site of CRP.
AB  - Healthy human serum reacted with C-reactive protein of human (hCRP) or rat (rCRP)
      immobilized on Sepharose 4B in the presence of Ca2+. The bound serum proteins
      were eluted with 0.1 M ethylenediaminetetraacetic acid, trisodium salt (EDTA)
      dissolved in 10 mM Tris-HCl buffer, pH 8.0, containing 140 mM NaCl. The eluted
      proteins from the hCRP column was found to be low density lipoprotein (LDL), 90%
      of its protein being apo B. The one from the rCRP column contained also apo B by
      36.7%. The effect of phosphorylcholine (PC), phosphorylethanolamine,
      phosphorylserine, galactose and high density lipoprotein (HDL) on the binding of
      LDL and apo B to CRP was investigated by enzyme-linked immunosorbent assay. Among
      them, only PC strongly inhibited the binding. One of the two available mouse
      monoclonal antibodies to hCRP (#19), which interferes with the binding of PC to
      CRP molecule, prevented CRP from binding LDL or apo B. In contrast, the other
      antibody (#17), which does not affect the binding of PC to CRP, did not inhibit
      the binding of LDL or apo B to CRP. It was therefore concluded that LDL binds to
      CRP by apo B moiety at the PC-binding site of CRP molecule.

PMID- 2227797
TI  - [A new approach to the quantitative analysis of the vascular architecture and its
      application to the cerebral cortex of the reeler mouse].
AB  - (1) A new method for morphometric studies on the vascular architecture of the
      mouse brain was developed. The method was as follows: the cerebral vascular
      images of the arteries, capillaries and veins, which were visualized by injection
      with gelatinized India-ink, were entirely entered into a personal computer system
      from a digitizer through light-microscopic photographs (X250). Thus the vessels
      were transformed into consecutive lines composed of short straight "line
      segments". The parameters obtained from these "line segments" were the total
      vascular length per unit area and volume ("length density"), the direction of the
      "orientation axis" and the "intensity of orientation" of the blood vessels. The
      three-dimensional properties of the vascular vessels were calculated from these
      data. The frontal and sagittal vascular patterns of the occipital cortex,
      thalamus, hippocampus, piriform cortex, internal capsule and corpus callosum were
      entered and the parameters described above were calculated. The calculated three
      dimensional "length densities" of the blood vessels in the occipital cortex and
      thalamus were about twice as great as those of the corpus callosum and internal
      capsule, and those of the hippocampus and piriform cortex had intermediate
      values. The "orientation axis" of the occipital cortex was approximately
      perpendicular to the cerebral surface, while those of the corpus callosum and
      internal capsule were parallel to the course of the nerve fibers. The axis of the
      thalamus was parallel to the horizontal plane, and that of the hippocampus was
      perpendicular to its surface. The "intensity of orientation" of the piriform
      cortex, however, was very small. (2) In order to investigate the factors defining
      the vascular pattern in the cerebral cortex, the reeler mutant mouse, in which
      the lamination of the cortex is reversed and the neurons distributed more
      homogeneously than in normal mice, was investigated by the above-mentioned
      method. The vascular pattern of the reeler mutant mouse revealed a difference
      from that of the normal mouse in that the "length density" of the reeler mouse
      was apparently equal in different layers, and the degree of vascular orientation
      was not as intensive as that of the normal cortex, in which the blood vessels
      tended to be perpendicular to the pial surface.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2227798
TI  - [Light microscopic observations on intrapineal neurons and myelinated fibers
      distributed in the pineal gland and its capsule in cotton rats (Sigmodon
      hispidus) at various postnatal ages].
AB  - From birth to 300 days, neurons are mainly encountered in the distal third of the
      pineal gland. Neurons are scarce in the middle or proximal third; their number is
      fewer in the proximal third. Nuclear size of neurons in all pineal regions
      increases until 100-200 day. Since there are regional differences in size of
      nuclei of intrapineal neurons in cotton rats until 200 days, intrapineal neurons
      of this animal may be composed of different populations of cells. The observation
      that age changes in size of nuclei of intrapineal neurons are similar to those of
      pinealocytes suggests that such neuronal changes may be related to the functional
      differentiation of the organ. In all pineal regions, the number of neurons
      reduces to half from birth to 100 days. The enlargement of neuronal nuclei and
      the decrease in neuronal numbers proceed simultaneously with advancing age. Half
      the number of neurons may degenerate and disappear until 100 days. Myelinated
      fibers in the pineal gland and its capsule appear first at 20 days and their
      density increases with age. Myelinated fibers are mainly distributed in the
      distal pineal region and the capsule covering its posteroventral area. Since
      neurons are mainly located in the posteroventral area of the distal pineal
      region, a close topographical relation exists between myelinated fibers and
      intrapineal neurons. The myelinated fibers in the capsule may usually run from
      distal to proximal regions of the pineal gland; some of these fibers may enter
      the organ.

PMID- 2227799
TI  - Spontaneous diabetes in BB rats: evidence for insulin dependent liver microsomal
      delta 6 and delta 5 desaturase activities.
AB  - We studied linoleic acid delta 5 and dihomo-gamma-linolenic acid delta 5
      desaturations, and fatty acid composition, of liver microsomes in the insulin
      dependent spontaneously diabetic adult female BB rat. These desaturations were
      defective along the normo- and hyper-glycemic period and restored during the
      hypoglycemic period which followed the insulin injection to the diabetic rats.
      The fatty acid composition of BB rats microsomes was not consistent with the
      desaturase activities at the different periods of glycemia, probably because
      other factors than desaturation impairments were involved in the evolution of
      fatty acid composition.

PMID- 2227800
TI  - Effect of triiodothyronine and thyroxine on mitochondrial alpha-glycerophosphate
      dehydrogenase activity and mitochondrial protein content of liver, muscle and
      brain of toad, Bufo melanostictus.
AB  - The responsiveness of the adult toad to triiodothyronine (T3) and thyroxine (T4)
      was studied by measuring the mitochondrial alpha-glycerophosphate dehydrogenase
      activity and mitochondrial protein content of liver, muscle and brain of toad.
      Both T3 and T4 increased the alpha-GPD activity and mitochondrial protein content
      of liver and muscle of toad. The extent of increase in the alpha-GPD activity and
      mitochondrial protein content were more pronounced with T3 than with T4. Further
      that the muscle exhibited more alpha-GPD activity than liver, whenever liver
      showed greater mitochondrial protein content than that of muscle. Brain showed no
      significant change in the alpha-GPD activity and mitochondrial protein content.
      Injections of cycloheximide showed inhibition of T3 induced changes in liver and
      muscle. Injection of propylthiouracil also counteracted the T4 induced effects of
      liver and muscle.

PMID- 2227801
TI  - Effects of fetal intravenous glucose challenge in normal and growth retarded
      fetuses.
AB  - Fetal intravenous glucose challenge test (0.75 g/kg of estimated fetal weight)
      was performed at 26-33 weeks gestation in 9 patients undergoing fetal blood
      sampling (FBS) by ultrasound guided needling from the umbilical vein. The
      indication for FBS was rapid karyotyping for fetal malformations in 5 (control
      group) and severe intrauterine growth retardation in the remaining 4 (IUGR
      group). Fetal blood samples were taken before the glucose infusion and after 1,
      3, 5, 10 and 15 min; glucose and insulin were assayed on each occasion and acid
      base balance at 0 and 5 min. Basal fetal pO2, pH, glucose and insulin were lower
      in the IUGR group than in controls. Following the glucose challenge, fetal
      glucose levels were similar in the two groups, but in the IUGR group the latter
      part of the glucose curve was characterized by a slower and delayed return to
      basal levels. In control fetuses the insulin response following the glucose
      challenge peaked at 3 min while in IUGR no change in insulin concentration was
      detected. Fetal pO2 did not change in either group; the median change in fetal pH
      was significantly different between the two groups (controls: +0.01; IUGR: -0.04;
      P less than 0.05) and there was a significant correlation between basal pO2 and
      the change in fetal pH (r = 0.79) (P less than 0.02). These results support the
      concept of a low energy state in IUGR. Fetal glucose supplementation in IUGR is
      unlikely to be of benefit and may even exacerbate underlying acidosis.

PMID- 2227802
TI  - Effects of low molecular weight peptides and divalent cations on degradation and
      binding of angiotensin II.
AB  - The effects of peptide inhibitors (bestatin and amastatin) and divalent cations
      (Ca2+ and Co2+) on the velocity of Asp1 liberation from angiotensin II (A-II) by
      human placental membrane fractions and binding of 125I A-II to human placental
      membranes were tested at 22 degrees C and 4 degrees C. Asp1 liberation was
      measured by high performance liquid chromatography. As expected, the degradation
      and binding of A-II were temperature sensitive, with both being at 4 degrees C
      than at 22 degrees C. While amastatin (10(-4) M) and bestatin 10(-6) M)
      significantly reduced the velocity of Asp1 liberation from A-II to about 45%,
      amastatin (10(-4) M) and bestatin (10(-4) M) increased 125I A-II binding to 125%
      and 130%, respectively. Ca2+ (10 mM) and Co2+ (10 mM) activated the velocity of
      Asp1 liberation from A-II to 140% and 120%, respectively at 22 degrees C. Ca2+
      (10(-1) M) and Co2+ (10 mM) also enhanced 125I A-II binding about 130%.
      Previously we showed that the A-II degrading activity found in human placental
      membrane fractions is mainly due to aminopeptidases A and M. Since amastatin and
      bestatin are the specific inhibitors for aminopeptidases A and M, and since Ca2+
      and Co2+ are the activators for aminopeptidase A and aminopeptidase M,
      respectively, it is conceivable that the enzymes regulate the levels of A-II and,
      therefore, that they may play an important role in the binding of A-II to human
      placental membrane fractions.

PMID- 2227803
TI  - Food intake and diurnal testosterone variation in the Caerphilly Heart Disease
      Study.

PMID- 2227804
TI  - Chronic ethanol administration impairs receptor-mediated endocytosis of epidermal
      growth factor by rat hepatocytes.
AB  - The effects of chronic ethanol administration on the receptor-mediated
      endocytosis of epidermal growth factor were studied in isolated rat hepatocytes.
      In initial experiments, it was demonstrated that significantly less ligand was
      bound by hepatocytes isolated from rats fed an ethanol liquid diet for 5 to 7 wk
      than by cells isolated from chow-fed or pair-fed controls. Reduced binding was
      shown to be primarily caused by a decreased number of surface receptors rather
      than by changes in receptor affinity. When hepatocytes were incubated at 37
      degrees C in the presence of a large saturating concentration of epidermal growth
      factor (80 nmol/L), intracellular levels of the ligand were significantly lower
      in cells from the ethanol-fed animals. However, no effect on degradation of the
      ligand was observed under those conditions. A defect in the initial stages of
      receptor-ligand internalization was also indicated because less surface-bound
      ligand was internalized and subsequently degraded in cells from the ethanol
      treated rats. When the endocytosis of a lower, more physiological concentration
      of the growth factor (0.5 nmol/L) was studied, both the uptake of ligand and its
      degradation were markedly impaired in hepatocytes from the ethanol-fed animals.
      These results indicate that chronic ethanol administration impairs the receptor
      mediated endocytosis of epidermal growth factor by the liver. The major
      impairment appears to be a reduction of cell surface receptors; however, other
      steps of the endocytotic pathway also appear to be affected. These altered steps
      include defective receptor-ligand internalization and changes in intracellular
      processing of the ligand leading to decreased degradation.

PMID- 2227805
TI  - Role of ethanol-inducible cytochrome P-450 IIE1 in carbon tetrachloride-induced
      damage to centrilobular hepatocytes from ethanol-treated rats.
AB  - The ethanol-inducible form of cytochrome P-450 (IIE1) is expressed and induced by
      ethanol, predominantly in the centrilobular region. Because this isoenzyme has a
      particularly high capacity to convert carbon tetrachloride and several other
      hepatotoxins into reactive intermediates, its role in producing damage was
      studied by comparing the effect of carbon tetrachloride exposure on hepatocytes
      isolated from either the periportal or the perivenous region by digitonin
      collagenase perfusion. After exposure for 18 hr of primary culture to 600 mumol/L
      of carbon tetrachloride, periportal cells were only slightly damaged, as
      estimated from dye exclusion and lactate dehydrogenase leakage. In marked
      contrast, perivenous cells, which contained a several-fold higher amount of
      immunoreactive P-450 IIE1 apoprotein, were partly damaged after exposure to 60 to
      150 mumol/L of carbon tetrachloride and severely damaged after 600 mumol/L.
      Similarly, lipid peroxidation after carbon tetrachloride was much more prominent
      in perivenous cells. The differences between perivenous and periportal cells in
      carbon tetrachloride-induced injury were larger when cells were isolated from
      chronically ethanol-treated rats. Isoniazid, an efficient inhibitor of P-450
      IIE1, protected against damage by carbon tetrachloride more efficiently than the
      general P-450 inhibitor cimetidine. Our results suggest that the greater
      susceptibility of the perivenous hepatocytes to carbon tetrachloride-induced
      damage is associated with the high expression of P-450 IIE1 in these cells. This
      enzyme may also be involved in damage elicited by several other typical
      centrilobular hepatotoxins.

PMID- 2227807
TI  - Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with
      analysis of risk factors.
AB  - Steatohepatitis (fatty liver hepatitis), histologically identical to alcoholic
      disease, occurs in some obese patients after jejunoileal bypass. A similar lesion
      occurs rarely in obese patients without bypass surgery, but the risk factors are
      poorly understood. Hepatic steatosis, steatohepatitis and fibrosis were sought in
      351 apparently nonalcoholic patients at autopsy and various risk factors were
      evaluated. Incidence of steatosis and steatohepatitis correlated with the degree
      of obesity. Steatohepatitis was found in 18.5% of markedly obese patients and
      2.7% of lean patients. Additional risk factors for steatohepatitis were type II
      diabetes, weight loss in the preterminal period shortly before death and
      intravenous glucose therapy in the last week of life. Severe fibrosis was found
      in 13.8% of markedly obese patients and in 6.6% of lean patients; this difference
      was largely explained by the higher prevalence of diabetes in obese groups. The
      risk factors defined in this study are known to be associated with abnormalities
      of free fatty acid metabolism. Obesity, type II diabetes and intravenous glucose
      therapy are associated with hyperinsulinemia, which may inhibit fatty acid
      oxidation. Obesity and weight loss increase the presentation of fatty acids to
      the liver. Similar metabolic changes may occur in obese patients after
      jejunoileal bypass surgery. Thus this study supports the hypothesis that fatty
      acids have a role in the hepatocellular necrosis found in some obese individuals.

PMID- 2227806
TI  - Zonal heterogeneity of the effects of chronic ethanol feeding on hepatic fatty
      acid metabolism.
AB  - Periportal and perivenous hepatocytes were isolated from rats fed a high-fat,
      ethanol-containing diet to investigate the acinar heterogeneity of the effects of
      prolonged ethanol administration on lipid metabolism. Chronic feeding of ethanol
      caused a rather selective accumulation of triacylglycerols in the perivenous zone
      of the liver. In control animals the rate of lipogenesis and the activity of
      acetyl-CoA carboxylase were higher in perivenous than in periportal hepatocytes,
      whereas the rate of fatty acid oxidation and the activity of carnitine
      palmitoyltransferase I were higher in periportal than in perivenous cells;
      however, no zonation was evident for very-low-density-lipoprotein-lipid
      secretion. Prolonged ethanol administration abolished the zonal asymmetry of the
      lipogenic process and inverted the acinar distribution of the fatty acid
      oxidative process (i.e., in ethanol-fed animals the rate of fatty acid oxidation
      and the activity of carnitine palmitoyltransferase I were higher in perivenous
      than in periportal hepatocytes). Moreover, chronic feeding of ethanol led to a
      marked and selective inhibition of very-low-density-lipoprotein-triacylglycerol
      secretion by the perivenous zone of the liver. Nevertheless, no zonal differences
      were observed between control and ethanol-fed animals with respect to the effects
      of acute doses of ethanol and acetaldehyde on lipid metabolism. In conclusion,
      our results show that chronic ethanol intake produces important alterations in
      the acinar distribution of the different fatty acid-metabolizing pathways.

PMID- 2227809
TI  - Antibodies to nuclear lamin C in chronic hepatitis delta virus infection.
AB  - Sera of patients with chronic hepatitis delta virus infection stained the nuclear
      periphery in indirect immunofluorescence. Using proteins of isolated nuclei,
      isolated nuclear matrices, the nuclear pore complex-lamina fraction and purified
      lamins A and C as antigen source in immunoblotting experiments, nuclear lamin C
      was identified as the reactive antigen. Most sera tested (8 of 10) recognized
      nuclear lamin C exclusively, but not the nuclear lamins A and B. Antibodies
      reacting with both nuclear lamins A and C, which share extensive sequence
      homologies, have been reported to occur in autoimmune hepatitis and primary
      biliary cirrhosis. The present findings suggest that the novel autoantibody
      associated with chronic hepatitis delta virus infection recognizes an epitope
      localized in the short carboxyterminal region of nuclear lamin C.

PMID- 2227808
TI  - Immunization of woodchucks with recombinant hepatitis delta antigen does not
      protect against hepatitis delta virus infection.
AB  - To assess the role of immunization against hepatitis delta antigen in the
      prevention of hepatitis delta virus infection, woodchuck carriers of woodchuck
      hepatitis virus were immunized with a 64 amino acid portion of hepatitis delta
      antigen from its N-terminal region. The protein was expressed in Escherichia coli
      and contained a major immunogenic epitope. A significant anti-hepatitis delta
      response was observed that did not, however, protect the animals from hepatitis
      delta virus superinfection. Unexpectedly, the period of detectable viremia was
      longer in the immunized than in the control animals. We conclude that
      immunization with this recombinant hepatitis delta antigen does not afford
      protection against subsequent hepatitis delta virus exposure.

PMID- 2227810
TI  - Hormonal and enzymatic parameters of hepatic regeneration in patients undergoing
      major liver resections.
AB  - Thirteen patients who underwent 40% to 80% removal of their livers had blood
      samples drawn initially and daily on postoperative days 1 to 7. The enzyme marker
      of heightened polyamine metabolism, ornithine decarboxylase, and the indicator of
      DNA synthesis, thymidine kinase, were measured. In addition, the hormones
      (insulin, glucagon, estradiol and androgen), which in animals are known to
      reflect and possibly modulate regeneration, were measured. Changes in all these
      indices followed the same pattern as in rats, dogs and swine but at a slower
      rate. Ornithine decarboxylase and estradiol increased within 24 hr, but thymidine
      kinase and insulin rises did not become statistically significant until 3 to 5
      days. Using these plasma or serum indices as surrogate measures of biochemical
      events in the liver itself, regeneration reached a maximum after 4 or 5 days. By
      computed tomography scan analysis, restoration of hepatic cell mass was not
      complete until 3 wk.

PMID- 2227811
TI  - Metabolic actions of insulin-like growth factor-I in cultured hepatocytes from
      adult rats.
AB  - Short-term and long-term regulation of hepatic carbohydrate metabolism by
      insulinlike growth factor-I was studied in primary cultures of adult rat
      hepatocytes and compared with the metabolic potency of insulin. Insulinlike
      growth factor-I stimulated the formation of [14C]lactate from [14C]glucose up to
      three-fold with a half-maximally effective concentration of approximately 50
      nmol/L. Basal glycogenolysis was inhibited by about 20%, and glucagon-activated
      glycogenolysis was blocked completely by insulinlike growth factor-I with half
      maximally effective concentrations of about 1.5 to 2 nmol/L. The activity of the
      key glycolytic enzymes glucokinase and pyruvate kinase were induced twofold. The
      glucagon-dependent induction of phosphoenolpyruvate carboxykinase--the key
      gluconeogenic enzyme--was antagonized with a half-maximally effective
      concentration of about 5 nmol/L. This inhibition of the glucagon-dependent
      induction of the enzyme was accompanied by a similar reduction of the increase in
      phosphoenolpyruvate carboxykinase-mRNA level as assessed by Northern blot
      analysis. The potency of insulinlike growth factor-I at half-maximally effective
      concentrations was approximately 2% to 4% that of insulin. Because binding
      studies demonstrated a comparably low affinity of insulinlike growth factor-I to
      the insulin receptor, it is suggested that in adult liver--in contrast to fetal
      and regenerating liver--insulinlike growth factor-I could exert short-term and
      long-term metabolic effects on parenchymal cells only through interaction with
      the insulin receptor.

PMID- 2227812
TI  - Human hepatic regenerative stimulator substance: partial purification and
      biological characterization of hepatic stimulator substance from human fetal
      liver cells.
AB  - Current support or replacement therapies for fulminant acute hepatic failure are
      frequently very disappointing. In this study, human hepatic stimulator substance-
      a liver-specific growth factor--was partially purified from human fetal liver
      cells and characterized by its biological effects. Almost 70-fold protein content
      was purified with an approximately 80-fold increase in specific growth stimulator
      activity. Human hepatic stimulator substance proved to be heat-stable, protease
      sensitive, organ-specific and species-nonspecific. Human hepatic stimulator
      substance produced a two- to threefold increase of 3H-thymidine incorporation
      into hepatic DNA when injected intraperitoneally into growing weanling mice
      (nonhepatectomized) or regenerating rats (34% hepatectomy). The effects of hHSS
      in reversing the lethality of D-galactosamine (1.6 gm/kg body weight)-induced
      hepatic necrosis in rats were further evaluated. A survival rate of 4% (n = 24),
      41% (n = 12, p less than 0.05), 33% (n = 12, p less than 0.05), 31% (n = 13, p
      less than 0.05) and 18% (n = 11, p greater than 0.05) was observed when the rats
      were injected with 4 ml of saline intraperitoneally, 4 ml of human intact fetal
      hepatocytes (2.4 x 10(8] intraperitoneally, 4 ml of human hepatic stimulator
      substance intraperitoneally, 2 ml of twofold concentrated human hepatic
      stimulator substance intravenously and 1 ml of fourfold human hepatic stimulator
      substance intramuscularly, respectively, 20 hr after poisoning.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2227813
TI  - Endotoxin and the hyperdynamic circulation of portal vein-ligated rats.
AB  - Humoral factors may be responsible for the hyperdynamic circulation seen in
      portal hypertension. Endotoxin, a peripheral arteriolar vasodilator, has been
      proposed to mediate this hemodynamic picture. We examined the pathogenic role of
      endotoxin in portal vein-ligated rats, a prehepatic portal hypertensive model
      with a well-developed hyperdynamic circulation. To this end, we (a) administered
      oral neomycin, a poorly absorbable antibiotic, at doses of 50 and 100 mg/day for
      7 days and found no evident splanchnic hemodynamic effects of a 2-log-fold
      reduction of cecal aerobic bacterial flora as assessed by the radioactive
      microsphere technique in portal vein-ligated rats studied in the postanesthesia
      awake state; (b) assayed endotoxin in arterial samples using a quantitative
      limulus assay and found no evidence of endotoxinemia in PVL rats; (c) induced a
      state of endotoxin tolerance by repeated daily intraperitoneal injections of low
      dose endotoxin and found no amelioration of the hyperdynamic state in portal vein
      ligated rats. Our results do not support the hypothesis that endotoxin plays a
      major pathogenic role in the hyperdynamic circulation of this experimental model.

PMID- 2227814
TI  - A study of the inhibition of adrenaline-induced vasoconstriction in the isolated
      perfused liver of rabbit.
AB  - We have studied the action of a series of vasoactive and antispasmodic agents on
      the intrahepatic vasoconstriction induced by adrenaline in the isolated perfused
      liver of rabbits. The arterial and portal venous resistance, oxygen consumption,
      liver weight and bile flow were investigated. The drugs used were as follows:
      nonspecific alpha-adrenergic antagonists (DH-ergocristine, dibenamine,
      phenoxybenzamine), vasodilators with a direct miscellaneous action (theophylline,
      papaverine, dipyridamole, glucagon, Aiu-cor by Instituto Gentilli, Italy
      [inosine, ATP, IPI, UTP]) and antispasmodics (piperylone, tropenziline,
      noraminophenazone). Adrenaline increased arterial and portal venous resistance
      followed by a diminution of oxygen consumption, liver weight and bile flow. alpha
      Adrenergic antagonists inhibited the effects of adrenaline on portal venous
      resistance and oxygen consumption and especially the effects on hepatic arterial
      resistance. The most potent agent was phenoxybenzamine. In contrast to alpha
      adrenoceptor blockade, the effects of other vasoactive agents were without a
      sustained influence on hepatic arterial resistance (excepting those of glucagon
      and dipyridamole). Some of them were effective as antagonists on responses in the
      portal venous bed (papaverine, Aiu-cor). Moreover, there were drugs exerting an
      enhancement of the vasoconstrictor responses of hepatic artery to low
      concentrations of adrenaline with no effect on the portal venous bed (piperylone,
      tropenziline). Theophylline and noraminophenazone exerted no effect either on the
      arterial or portal venous bed. No vasodilator agent antagonized the changes of
      the bile flow after adrenaline administration.

PMID- 2227815
TI  - Hepatic vascular disease and portal hypertension in polycythemia vera and
      agnogenic myeloid metaplasia: a clinicopathological study of 145 patients
      examined at autopsy.
AB  - The pathogenesis of portal hypertension arising in patients with
      myeloproliferative disorders has been difficult to understand because liver
      biopsy findings often show minimal changes. It has been suggested that increased
      splenic blood flow, hepatic infiltration with hematopoietic cells or sinusoidal
      fibrosis may be important. We have reviewed the autopsy findings and clinical
      histories of 97 patients with polycythemia vera and 48 patients with agnogenic
      myeloid metaplasia collected from three institutions and from the Polycythemia
      Vera Study Group. Cirrhosis was present in seven patients, one of whom had
      bleeding varices. Esophageal varices were present clinically in 10 patients
      without cirrhosis (seven polycythemia and three agnogenic myeloid metaplasia).
      All of these patients had lesions in small or medium-sized portal veins and four
      had stenosis of the extrahepatic portal vein with histology compatible with
      organized thrombi. Nodular regenerative hyperplasia occurred in 14.6% and
      correlated closely with the presence of portal vein lesions. Thirty patients had
      greater than 500 ml of ascites, seven of these patients also had varices and six
      of them had hepatic vein thrombosis. Ascites also correlated with hepatic vein
      disease confined to small intrahepatic branches. No correlation was seen between
      hepatic hematopoietic infiltration and signs of portal hypertension. We conclude
      that esophageal varices are common and are almost always associated with portal
      vein lesions visible by light microscopy. These portal vein lesions, and the
      secondary effects of nodular regenerative hyperplasia and portal hypertension,
      are most likely a result of portal vein thrombosis in patients with
      myeloproliferative disorders.

PMID- 2227816
TI  - Selective intestinal decontamination increases serum and ascitic fluid C3 levels
      in cirrhosis.
AB  - Selective intestinal decontamination for 7 days with norfloxacin was performed in
      14 cirrhotic patients with ascites and low ascitic fluid total protein.
      Variations in serum and ascitic fluid of C3 and C4 and ascitic fluid total
      protein after therapy were compared with those of a control group of 14 untreated
      patients with similar characteristics. After oral norfloxacin administration, we
      saw a significant increase of C3 in serum (p less than 0.05) and ascitic fluid (p
      = 0.01). A significant increase was also observed in ascitic fluid total protein
      (p less than 0.05) but not in serum and ascitic fluid C4. There were no changes
      in serum C3, ascitic fluid C3, ascitic fluid C4 or in ascitic fluid total protein
      in group 2. These data demonstrate that selective intestinal decontamination
      increases serum and ascitic fluid C3 levels and, therefore, might be useful in
      preventing spontaneous infections in cirrhotic patients at high risk of
      infection.

PMID- 2227817
TI  - Involvement of tumor necrosis factor-alpha in development of hepatic injury in
      galactosamine-sensitized mice.
AB  - Intravenous injection of lipopolysaccharide and D-galactosamine, at doses of 0.2
      micrograms/kg and 800 mg/kg, respectively, elicited massive hepatic necrosis
      within 24 hr in C3H/HeN mice. The plasma L-alanine aminotransferase (ALT, E.C.
      2.6.1.2) or L-aspartate aminotransferase (AST, E.C. 2.6.1.1) activities at this
      point reached more than 2,000 IU/L. However, overt hepatic injury as evaluated by
      the plasma aminotransferase activities did not develop in mice in which only
      lipopolysaccharide or only D-galactosamine was injected. No tumor necrosis factor
      like activities could be detected in the plasma of galactosamine- and
      lipopolysaccharide-injected mice as determined by the assay of cytotoxicity to
      highly tumor necrosis factor-sensitive L-P3 cells through the experimental period
      of 24 hr. However, passive immunization against mouse tumor necrosis factor-alpha
      with polyvalent rabbit anti-mouse tumor necrosis factor-alpha antiserum, which
      was able to neutralize the cytotoxic effects of recombinant mouse tumor necrosis
      factor-alpha on L-P3 cells, could protect the mice from the development of
      hepatic injury in a dose-dependent manner. Simultaneous injection of recombinant
      human tumor necrosis factor-alpha, instead of lipopolysaccharide, with 800 mg/kg
      of D-galactosamine in lipopolysaccharide-resistant C3H/HeJ mice sensitized the
      animals more than one thousand-fold to the development of hepatic injury. The
      livers appeared to be morphologically similar to those of galactosamine- and
      lipopolysaccharide-injected C3H/HeN mice.

PMID- 2227818
TI  - Calcium absorption in bone disease associated with chronic cholestasis during
      childhood.
AB  - Fractional absorption of calcium was determined in 9 children aged 4.9 to 16.9 yr
      with chronic cholestatic liver disease to determine the role of calcium
      malabsorption in the development of metabolic bone disease. Radiological evidence
      of rickets was absent in all patients, but bone density, measured by single beam
      photon absorptiometry of the distal radius, was reduced in eight of nine
      subjects. Serum calcium and phosphorus concentrations were normal in all except
      one subject. Serum 25-hydroxyvitamin D concentration was decreased compared with
      controls in only one of nine patients, but serum 1,25-dihydroxyvitamin D
      concentrations were diminished in seven of nine subjects. In all subjects,
      dietary calcium and phosphorus intakes were greater than 80% of the RDA.
      Fractional absorption of calcium, determined by oral and intravenous
      administration of stable calcium isotopes, was similar in cholestatic compared
      with control subjects (37.1% +/- 12.5% vs. 34.0% +/- 16.4%). In the cholestatic
      subjects, calcium absorption correlated with serum 1,25-dihydroxyvitamin D (r =
      0.871, p less than 0.002) but not 25-hydroxyvitamin D concentrations. Calcium
      balance, assessed by the duplicate diet method, was positive in four of five
      subjects. Anthropometric measurements were performed to examine the relationship
      between nutritional status and bone mineral content. Heights of all subjects were
      less than or equal to the 10th percentile and fat stores and somatic protein
      stores were less than the 25th percentile in six of nine subjects. We conclude
      that factors other than calcium malabsorption and decreased serum 25
      hydroxyvitamin D concentration contribute to diminished bone mass in children
      with cholestatic liver disease.

PMID- 2227819
TI  - Effect of chronic administration of ursodeoxycholic acid on the ileal absorption
      of endogenous bile acids in man.
AB  - The effect of long-term administration of ursodeoxycholic acid on the ileal
      absorption of endogenous bile acids was determined using the tauro 23 (75Se)
      selena-25 homotaurocholic acid test in a controlled double-blind study involving
      healthy subjects (n = 15). Subjects received placebo or 13 to 15 mg/kg/day
      ursodeoxycholic acid for 5 wk. In the placebo group (n = 7) there was no change
      in the composition of serum bile acids or in the mean percentage of retention of
      tauro 23(75Se) selena-25 homotaurocholic acid (36.1% +/- 6.0% vs. 38.7% +/-
      6.7%). In contrast, in the ursodeoxycholic acid group, serum ursodeoxycholic acid
      conjugates increased and the percentage of retention of tauro 23 (75Se) selena-25
      homotaurocholic acid fell from 45.8% +/- 6.8% to 20.5% +/- 5.7% (p less than
      0.01). We conclude that ursodeoxycholic acid administration reduces ileal
      absorption of endogenous bile acids. These findings provide a rational
      explanation for the changes in the composition of the bile acid pool during
      ursodeoxycholic acid therapy and could have important therapeutic implications.

PMID- 2227820
TI  - Bile acids exert negative feedback control on bile acid synthesis in cultured pig
      hepatocytes by suppression of cholesterol 7 alpha-hydroxylase activity.
AB  - Feedback regulation of bile acid synthesis by its end products was studied in
      cultured hepatocytes of young weaned pigs. We previously showed that conversion
      of exogenous [14C] cholesterol into bile acids was suppressed by addition of bile
      acids to the culture medium. In the present study, the effects of bile acids on
      bile acid mass production and cholesterol 7 alpha-hydroxylase activity were
      examined. Mass production of bile acids was strongly inhibited by addition of
      taurocholic acid (50 and 100 mumol/L) to the culture medium. The inhibitory
      action was exerted specifically on activity of cholesterol 7 alpha-hydroxylase
      because conversion of [14C] 7 alpha-hydroxycholesterol to bile acids by pig
      hepatocytes was not affected. Suppression of cholesterol 7 alpha-hydroxylase
      activity after incubation of the hepatocytes with taurocholic acid was
      concentration- and time-dependent. Maximum suppression (-80%) was achieved after
      a 20 to 30 hr incubation of hepatocytes with 100 mumol/L of this bile acid.
      Decline of enzyme activity caused by 100 mumol/L taurocholic acid followed first
      order kinetics with a half-life of 10 hr. Taurocholic acid had no direct effect
      on cholesterol 7 alpha-hydroxylase activity in homogenates of hepatocytes as
      assessed by addition of the bile acid to the assay mixture. The effects of
      several other bile acids in a concentration of 100 mumol/L on cholesterol 7 alpha
      hydroxylase activity were examined in 48 hr incubations. Glycochenodeoxycholic
      and glycohyodeoxycholic acids, which are the major bile acids in pig bile, their
      unconjugated forms and also deoxycholic and cholic acid pronouncedly inhibited
      activity of the enzyme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227821
TI  - Hepatic injury induced by bile salts: correlation between biochemical and
      morphological events.
AB  - Continuous intravenous infusion of taurochenodeoxycholate at a rate of 0.4
      mumol.min-1.100 gm-1 for only 30 min in rats caused threefold to tenfold greater
      release of proteins (alkaline phosphatase, lactate dehydrogenase and albumin)
      into bile in comparison with animals infused with tauroursodeoxycholate at much
      higher rates (1.8 mumol.min-1.100 gm-1) for 2 hr. The simultaneous infusion of
      tauroursodeoxycholate and taurochenodeoxycholate (0.6 and 0.4 mumol.min-1.100 gm
      1, respectively) for 2 hr prevented the marked biochemical changes in the bile
      induced by taurochenodeoxycholate for 15 to 60 min exhibited significantly more
      necrotic hepatocytes, especially in zone 1, in comparison with animals infused
      with tauroursodeoxycholate or a combination of taurochenodeoxycholate and
      tauroursodeoxycholate. A good correlation was observed between biochemical and
      morphological indices of bile acid-induced hepatocyte injury. These data suggest
      that (a) primary events induced by the acute infusion of toxic bile salts
      responsible for cholestasis include zone 1 hepatocellular necrosis and (b) this
      can be prevented by the simultaneous infusion of tauroursodeoxycholate.

PMID- 2227822
TI  - Characteristics of biliary lipid metabolism after liver transplantation.
AB  - Biliary lipid metabolism was studied after 10 liver transplantations with
      continuous drainage of bile. Within 3 wk after transplantation, the new liver
      produced bile with concentrations of biliary lipids in agreement with those
      reported for T-tube bile in cholecystectolized nontransplanted subjects. Although
      changes in biliary lipid composition occurred swiftly in response to various
      forms of disturbed liver function, they did not provide substantially more
      information than did standard serum tests or simple measurements of bile flow in
      most patients. Secretion rates of phospholipids and cholesterol were found to be
      completely bile acid dependent. For each micromole of bile acids, 0.22 and 0.08
      mumol of phospholipids and cholesterol were secreted, respectively. When bile
      flow was related to bile acid output, a linear relationship was found (r = 0.89),
      with a positive intercept indicating a bile acid-independent bile flow of
      approximately 44 microliters/min. Analysis of individual bile acids showed almost
      exclusively primary bile acids. The relative proportion of chenodeoxycholic acid
      was more prominent during the first days after transplantation. Different
      explanations for this are discussed.

PMID- 2227824
TI  - 31Phosphorus nuclear magnetic resonance spectroscopy: what does it tell us about
      alcohol-induced liver disease?

PMID- 2227823
TI  - Perspectives on Wilson's disease.

PMID- 2227825
TI  - Mechanism of cholate uptake: Na(+)-cotransport, but not cholate/OH- exchange.

PMID- 2227826
TI  - Effect of lactulose on the metabolism of short-chain fatty acids.

PMID- 2227828
TI  - Decrease of growth hormone binding in hepatomas.

PMID- 2227827
TI  - Alcohol content of various beverages: all booze is created equal.

PMID- 2227829
TI  - Chronic hepatitis in liver allografts.

PMID- 2227830
TI  - Current problems in the pathology of intra-epithelial lesions of the uterine
      cervix.
AB  - Problems in the interpretation and diagnosis of intraepithelial lesions of the
      uterine cervix include interobserver differences in respect of grading,
      uncertainty as to the significance of human papillomavirus infection and debate
      about the current terminology. The role of human papillomaviruses in cervical
      intra-epithelial neoplasia (CIN) remains unclear and the specific type of virus
      present does not correlate closely with the behaviour of these lesions. There are
      defects in the current terminology and in proposed new terminology for CIN; it is
      suggested that the term 'borderline CIN' should be introduced in cases where
      there is uncertainty as to whether or not CIN 1 is superimposed on a flat
      condyloma.

PMID- 2227831
TI  - An immunohistological study of condylomata acuminata.
AB  - Using an indirect immunoperoxidase method and a panel of monoclonal antibodies,
      anogenital warts removed from 86 individuals (28 heterosexual men, 47 homosexual
      men and 11 women) were studied. A constant feature was the presence of a stromal
      infiltrate of lymphocytes, in which CD4+ and CD8+ cells appeared in a ratio of
      about 5:1. Cells expressing interleukin-2 receptors were found in the stroma,
      amounting to 10% of the CD3+ cells. Leu 6+ epidermal dendritic cells (Langerhans'
      cells) were present in each wart; their density and morphology were similar to
      that in adjacent, apparently normal, skin. The mean number of Langerhans' cells
      that expressed HLA-DQ was lower than that of HLA-DR + cells. In 40 warts, HLA-DR
      was expressed on the surface of keratinocytes. Leu 7+ and Leu 11b+ cells were
      found in the epidermis of 17 and five warts, respectively. B-cells were noted in
      only five warts. These results are discussed in relation to persistence of wart
      virus infection.

PMID- 2227832
TI  - A combination of cytological and architectural morphometry in assessing
      regenerative hyperplasia and dysplasia in ulcerative colitis.
AB  - Morphometry and stereology were used to assess the cytological and architectural
      characteristics of regenerative and dysplastic colorectal mucosal abnormalities
      in ulcerative colitis. Reproducibility of measurements was assessed and found to
      be good, confirming the objective and reproducible nature of morphometric
      analysis. Discriminant analysis between the morphometric features of regenerative
      mucosal change and low-grade dysplasia revealed the significant cytological and
      architectural variables from which a cytological and architectural score were
      derived. The architectural score was capable of classifying all of the cases into
      their correct diagnostic category, although a combination of the two scores
      provided better separation of cases. Probability density analysis was carried out
      so that probabilities of group membership could be allocated to cases, given
      their cytological and architectural scores. Discriminant analysis was also
      applied to low- and high-grade dysplasia. Important cytological and architectural
      variables were identified and used separately to derive scoring systems. In
      combination, the dual scoring of lesions was capable of separating low- from high
      grade dysplasia, although overlap was still evident. Again, probability density
      analysis allowed the allocation of cases into one or other category, although a
      closer examination showed that such a rule could not successfully classify a new
      set of low- and high-grade dysplasia cases. Quantitative histological analysis of
      mucosal abnormalities is shown to be of use in the objective diagnosis of
      reactive and dysplastic change in patients with ulcerative colitis. The use of
      simple scoring systems and probability based allocation of cases promotes the
      future role of morphometric techniques in the diagnostic laboratory.

PMID- 2227833
TI  - Immunoproliferative small intestinal disease: a study of 13 cases with alpha
      heavy-chain disease.
AB  - The pathology of 13 cases of immunoproliferative small intestinal disease (IPSID)
      associated with alpha-heavy-chain disease--one an apparent non-secretor and
      another with localized infiltration--is described. Four cases exhibited
      immunohistological light-chain monotypia. In one of these, evolution of a light
      chain negative cell population was observed over a 7-year period. In the
      intestine, centrocyte-like cells produced lympho-epithelial lesions in 11 cases
      and enlarged lymphoid follicles in three. In lymph nodes, perifollicular
      infiltration was observed in 11 cases and abnormal follicles in six. Of three
      patients with high-grade lymphoma at presentation, one died untreated at 2
      months, and two are alive at 34 and 91 months. Of 10 patients with low-grade
      disease at presentation, two died--one at 76 months, the other after transforming
      to high-grade lymphoma at 73 months. Eight patients with low-grade disease are
      alive, an average of 67 months after presentation. Four of five conservatively
      treated low-grade cases (including three in remission) showed evidence of
      monoclonality at presentation (light-chain monotypia in two and gene
      rearrangement in two), while two of the five exhibited DNA aneuploidy. It is
      concluded that IPSID with alpha-heavy-chain disease is neoplastic in all its
      stages and is a variant of mucosa-associated lymphoma. The role of centrocyte
      like cells and the response to conservative therapy are discussed.

PMID- 2227834
TI  - Gastric lymphoma associated with mucosal and nodal granulomas: a new differential
      diagnosis in granulomatous gastritis.

PMID- 2227835
TI  - Intramammary tuberculous lymphadenitis.

PMID- 2227836
TI  - Combined immunohistochemical study of tissue polypeptide antigen and cancer
      antigen 125 in human ovarian tumours.
AB  - An indirect immunoperoxidase method was used to study the expression of tissue
      polypeptide antigen (TPA) and cancer antigen 125 (CA 125) in 47 benign and
      malignant ovarian tumours. Tissue polypeptide antigen and CA 125 antigen were
      expressed respectively in 22 (73%) and 16 (53%) of the 30 adenocarcinomas and in
      five (29%) and four (23%) of the 17 benign tumours. Co-expression of TPA and CA
      125 antigen occurred in 12 (40%) malignant and four (23%) benign tumours.
      Ultrastructurally, TPA and CA 125 antigens were located at the cell surface and
      microvillous surfaces. Evaluation of combined TPA and CA 125 antigen results
      revealed a remarkable improvement in the positivity rate and a significant
      decrease (P less than 0.05) in the negativity rate of ovarian carcinomas as
      compared with the result of each one separately. These findings provide
      complementary evidence for the previous results on the plasma levels of TPA and
      CA 125 antigen and suggest that specific combinations of tumour markers may be
      more effective for the diagnosis and monitoring of ovarian carcinomas, than the
      use of any single marker.

PMID- 2227837
TI  - 'Diamond-shaped' crypts and mucosal elastin: helpful diagnostic features in
      biopsies of rectal prolapse.
AB  - The biopsy diagnosis of prolapsing rectal mucosa syndrome can be difficult. We
      present two newly described features--'diamond-shaped' crypts and mucosal elastin
      -which appear to be helpful in histological diagnosis. Of 32 biopsies of
      prolapsing rectal mucosa syndrome, all showed diamond-shaped crypts or mucosal
      elastin, and 28 contained both. Control biopsies comprised cases of normal or
      irritable bowel syndrome (46), irradiation colitis and ischaemic colitis (16),
      inflammatory bowel disease (26), and adenomas (30). Mucosal elastin and 'diamond
      shaped' crypts with distinctive scalloped edges, which were never seen in
      prolapse, were observed in half the cases of irradiation and ischaemic colitis.
      Diamond-shaped crypts were seen in one case of inflammatory bowel disease.
      Diamond-shaped crypts and elastin were seen in the base of adenomas large enough
      to cause localized prolapse, and in four biopsies from patients with irritable
      bowel syndrome, all of whom had given a history of straining at stool.

PMID- 2227839
TI  - An aggressive lipoblastic tumour in the orbit of a child.
AB  - The case is described of a locally aggressive lipoblastic tumour presenting in
      the orbit of an 8-year-old boy. There do not appear to be any previous reports of
      a comparable tumour in this situation.

PMID- 2227838
TI  - Multicentric Castleman's disease in association with a solitary plasmacytoma: a
      case report.
AB  - Multicentric Castleman's disease with aggressive systemic symptomatology is
      usually associated with the plasma cell variant. We report a case in which the
      clinical presentation was typical of multicentric Castleman's disease but which
      was associated with the hyaline vascular subtype histologically. Plasma cells
      were absent from all biopsies until, at autopsy, a solitary plasmacytoma was
      found in the vertebral column. This case supports the view that plasma cells are
      of primary importance in the clinical and pathological manifestations of
      multicentric Castleman's disease.

PMID- 2227840
TI  - Cystadenocarcinoma of the appendix testis.
AB  - We report an example of what we believe to be an adenocarcinoma of the appendix
      testis. This very rare neoplasm arose in a patient on long term treatment with
      oestrogens which may be implicated as an aetiological factor.

PMID- 2227841
TI  - Bilateral virilizing sclerosing stromal tumours of the ovary in a pregnant woman
      with Gorlin's syndrome: implications for pathogenesis of ovarian stromal
      neoplasms.
AB  - A woman with Gorlin's syndrome who had become pregnant following clomiphene
      therapy presented in early pregnancy with bilateral ovarian sclerosing stromal
      tumours which were associated with profound virilization. Pre- and post-operative
      hormone profiles indicated androgen production by the tumours. Ovarian sclerosing
      stromal tumours have not previously been reported as occurring bilaterally or in
      association with Gorlin's syndrome. We discuss the questions raised by this
      unusual case regarding the pathogenesis of ovarian stromal neoplasms.

PMID- 2227842
TI  - Plasmacellular Castleman's disease and POEMS syndrome.

PMID- 2227843
TI  - Squamous cell carcinoma arising in a chronic hydrocoele.

PMID- 2227844
TI  - Plexogenic pulmonary arteriopathy.

PMID- 2227845
TI  - Facilitation of receptive behavior in estrogen-primed female rats by the anti
      progestin, RU 486.
AB  - The progestin receptor antagonist RU 38486 (henceforth referred to as RU 486) was
      tested for facilitative effects on female receptive behavior in ovariectomized
      Long-Evans rats primed with 2 micrograms estradiol benzoate (EB). RU 486 (0, 0.5,
      1.6, or 5.0 mg) was administered 48 hr after estrogen priming. The lordosis
      quotient (LQ) and lordosis score (LS) were assessed 4 hr after RU 486
      administration in a standardized test consisting of a 10-mount test by a stimulus
      male. A significant dose effect was found by both LQ and LS, with those subjects
      receiving 5 mg of RU 486 being significantly more receptive than vehicle control
      animals. Thus RU 486 acted as a weak progestin agonist under testing conditions
      typical for assessment of progestin facilitation of female sexual behavior in
      rats. Low levels of proceptive behavior (hops and darts) were seen in a minority
      of the tests, and did not vary systematically as a function of the dose of RU 486
      administered. We also examined the effects of RU 486 given before progesterone
      (P) on receptivity in a blocking paradigm and confirmed previous reports that the
      antagonist significantly attenuates facilitation of sexual behavior when given in
      combination with P. A progestin receptor assay of the cytosols of the
      hypothalamus-preoptic area in estrogen-primed female rats treated with 5 mg RU
      486 revealed a significantly greater depletion of available cytosolic P receptors
      than when rats were treated with a similarly facilitating dose of P (100
      micrograms). The results suggest a possible dual mode of action for RU 486--a
      weak, receptor-mediated agonistic effect on sexual behavior when given alone to
      estrogen-primed rats, and a competitive blocking effect on receptivity when
      administered with P.

PMID- 2227846
TI  - Gonadal hormones during puberty organize environment-related social interaction
      in the male rat.
AB  - This study examined the role of gonadal androgens during puberty on the
      development of environment-related social interaction (SI) in male rats. SI in an
      unfamiliar environment versus SI in a familiar environment was evaluated in young
      adult rats as a function of sex and gonadal status. Intact male rats at 60 days
      of age exhibited a differential response to the two environments, whereas SI in
      intact female rats at 60 days was equivalent in the two environments.
      Furthermore, male rats castrated as juveniles and tested for SI at 60 days
      displayed a pattern of environment-related SI similar to SI in intact adult
      female rats. This effect of juvenile castration on SI in male rats was prevented
      by chronic exposure to testosterone propionate (TP) over Days 30 through 60. SI
      in male rats castrated in adulthood, on the other hand, was not altered either 2
      or 4 weeks postcastration. The results from this study indicate that pubertal
      secretions of gonadal androgen(s) are necessary for the development of
      environment-related SI in male rats. In contrast, secretions of gonadal androgens
      in adulthood do not appear to be critical for the continued expression of
      environment-related SI, as suggested by the observation that environment-related
      SI in male rats remains unchanged by castration in adulthood.

PMID- 2227847
TI  - Effects of restraint stress on plasma LH and testosterone concentrations, Leydig
      cell LH/hCG receptors, and in vitro testicular steroidogenesis in adult rats.
AB  - We examined the effect of restraint stress (3 hr) on plasma LH and testosterone
      levels, on the Leydig cell LH/hCG receptor, and on the activity of enzymes in the
      testicular steroidogenic pathway of the adult rat. Restraint stress caused a 47%
      reduction in plasma testosterone concentrations, but had no effect on plasma LH
      levels. The binding capacity and affinity of Leydig cell LH/hCG receptors were
      not affected by restraint. Stress did not affect the testicular activity of 20,22
      desmolase or 3 beta-hydroxysteroid dehydrogenase, but testicular interstitial
      cells of stressed rats incubated in vitro with progesterone as a substrate
      produced more 17 alpha-hydroxyprogesterone but less testosterone than control
      cells, and when incubated with 17 alpha-hydroxypregnenolone, produced 39% less
      androstenedione and 40% less testosterone than control cells. These results
      suggest that restraint stress inhibited 17,20 desmolase but not 17 alpha
      hydroxylase activity. When the delta 4 pathway was blocked with cyanoketone (3
      beta-HSD inhibitor), stress did not alter the production of pregnenolone or 17
      alpha-hydroxypregnenolone, but the production of dehydroepiandrosterone by cells
      from stressed rats was subnormal, suggesting again a reduction of 17,20 desmolase
      activity. The data suggest that a major site of the inhibitory action of
      restraint stress on testicular steroidogenesis is the 17,20 desmolase step. The
      disruption of androgen production by restraint appears to be LH independent since
      stress did not affect plasma LH levels, the binding capacity or affinity of
      LH/hCG receptors, or the activity of 20,22 desmolase.

PMID- 2227848
TI  - Prolonged estrogen-progesterone treatment of nonpregnant ovariectomized rats:
      factors stimulating home-cage and maternal aggression and short-latency maternal
      behavior.
AB  - A 16-day treatment of nonpregnant, ovariectomized rats using 5-mm Silastic
      implants of estradiol (E), daily injections of 4 mg of progesterone (P), and
      terminal injections of 5 micrograms/kg of estradiol benzoate (EB) to provide a
      pregnancy-like pattern of hormone exposure, stimulates (a) home-cage aggression
      toward unfamiliar intruder rats, (b) short-latency maternal behavior when the
      females are exposed continuously to pups, and (c) maternal aggression after
      maternal care has been initiated. Preliminary experiments examined the
      persistence of stimulation of aggression by the 16-day treatment in the absence
      of exposure to pups eliciting maternal care, and whether an abbreviated, 1-week
      treatment stimulates aggression equally. Subsequent experiments examined the
      importance of the elements of the treatment (E implants, P injections, EB
      injection), and whether prolonging exposure to P or E would alter its behavioral
      effects. The full 16-day E/P/EB treatment stimulated higher levels of home-cage
      and maternal aggression, and shorter maternal behavior latencies than abbreviated
      and partial treatments. E in combination with P or EB significantly raised home
      cage aggression, whereas P alone was without effect. Administering P for 2
      additional days attenuated reductions in maternal behavior latencies by E/P/EB,
      but did not reduce home-cage or maternal aggressiveness. Continuous exposure to E
      throughout testing did not affect any dependent variable. Comparing these
      findings to earlier data and reports suggests that hormone exposure for 2 weeks
      or more, and provision of P levels approaching those of pregnancy are important
      to the effects of the E/P/EB treatment on aggression.

PMID- 2227849
TI  - Oxytocin inhibits infanticide in female house mice (Mus domesticus).
AB  - Between 60 and 90% of female house mice spontaneously kill unrelated young. A
      previous report indicated that subcutaneous administration of oxytocin
      significantly reduced the frequency of infanticide by virgin and pregnant
      females. However, in this study a distinction could not be made between an action
      of oxytocin on the CNS versus a secondary effect such as an enhanced release of
      prolactin by oxytocin. In the current experiment, oxytocin administered
      intracerebroventricularly was equally as effective at inhibiting infanticide as
      sc oxytocin. There was no difference in the effectiveness of oxytocin between
      groups of infanticidal females that were gonadally intact, ovariectomized, or
      estrogen treated. Pretreatment of infanticidal females with the prolactin
      inhibitors, bromocriptine and cysteamine, was also without effect on the ability
      of oxytocin to inhibit infanticide. Last, prolactin-inhibiting drugs had no
      significant effect on spontaneous parenting behavior by female mice. These data
      suggest that oxytocin acts directly on the CNS to alter behavior toward pups and
      that prolactin may not play a role in the maternal behavior of the house mouse.

PMID- 2227850
TI  - Effects of estrogen treatment on dominance relationships in cows.
AB  - The effects of prolonged estrogen treatment were studied in two groups of eight
      ovariectomized heifers. In Group I, four animals were treated with increasing
      doses of estradiol benzoate (300 micrograms/day to 1.5 mg/day) for 180 days. In
      Group II, four animals were treated with 1.5 mg/day for 90 days. In each group
      the other four animals received the vehicle only. Ninety percent of the dominance
      relationships between treated and control animals was reversed. The delay was,
      nevertheless, longer than those observed previously following androgen treatment.
      As is the case following androgen treatment, changes in social rank could not be
      explained by an increase in aggressiveness by treated animals, but rather could
      be explained by a lowered reactivity to aggressions and perhaps by a decrease in
      fear reactions.

PMID- 2227851
TI  - Testosterone and sexual behavior in oral contraceptive users and nonusers: a
      prospective study.
AB  - The relationship between plasma testosterone (T) secretion and patterns of sexual
      behavior was examined in 18 women using oral contraceptives (OCs) and 13 nonusers
      matched for partner availability. Retrospective assessments of perimenstrual
      symptoms, sexual attitudes, and sexual experience were obtained and women
      completed daily ratings of the frequency of sexual activities and the level of
      well-being for 1 month. Plasma levels of sex hormone binding globulin (SHBG),
      progesterone, Total T, Free T, and non-SHBG bound T were determined by
      radioimmunoassay at four phases of the pill or menstrual cycle. Overall, women
      not using OCs had higher plasma levels of Total, Free, and non-SHBG bound T and
      lower plasma levels of SHBG than those of OC users. Further, only nonusers had
      perimenstrual decreases in plasma levels of Total and Free T. The two groups were
      comparable on most retrospective measures. However, OC users reported more
      satisfaction with their sexual partners than did nonusers and prospective
      monitoring revealed that they engaged in sexual interactions more frequently than
      did nonusers across the cycle. In contrast, both groups reported a similar
      frequency of autosexual activities across the cycle. There were no correlations
      between average levels of T and levels of sexual desire, sexual interactions, or
      autosexuality. Moreover, only nonusers reported a decrease in levels of sexual
      desire during the perimenstrual period that was associated with the changes in
      Free T over the menstrual cycle.

PMID- 2227852
TI  - Sex differences in the play behavior of immature spotted hyenas, Crocuta crocuta.
AB  - Social, locomotor, and object play were studied in a colony of five male and five
      female peer-reared spotted hyenas during 12 1-hr tests while the animals were 13
      19 months of age. Animals were tested in both same-sex and mixed-sex groups and
      were stimulated to play by the introduction of fresh straw and sawdust bedding.
      Each test was videotaped and the frequency of each type of play was determined by
      a time sampling procedure. Females played more frequently than males, however,
      the category of play which was elevated depended upon the social context during
      testing. In same-sex tests the frequency of vigorous social play displayed by
      females markedly exceeded that by males, but no comparable sex difference
      appeared in mixed-sex tests. Females engaged in locomotor play more frequently
      than males in mixed-sex tests, but no comparable sex difference appeared in same
      sex tests. No sex difference in object play was observed. Two male and two female
      hyenas were gonadectomized prior to the initiation of the present sequence of
      tests. The results suggest that gonadectomy during the prepubertal period does
      not affect the frequency of play behavior. However, the small sample sizes
      preclude any conclusive determination of the effects of these gonadectomies on
      play.

PMID- 2227853
TI  - Role of septum and preoptic area in regulating masculine and feminine sexual
      behavior in male rats.
AB  - The effects of septal or preoptic lesions on both masculine and feminine sexual
      behaviors were examined in castrated adult male rats. Three weeks after brain
      surgery, animals were implanted with Silastic tubes containing testosterone (T)
      and observations of masculine sexual behavior were carried out four times every 5
      days. T tubes were removed immediately after the end of the masculine behavioral
      tests. Two weeks later, animals implanted with Silastic tubes containing
      estradiol-17 beta(E2) were subjected to three feminine sexual behavioral tests at
      5-day intervals. The bilateral lateral septal lesion (LSL) and the medial
      preoptic lesion (MPOL) effectively suppressed the performance of mounts,
      intromissions, and ejaculations, whereas the medial septal lesion (MSL), the
      dorsolateral preoptic lesion (DPOL), and the sham operation did not show any
      significant suppression of these behaviors. In the feminine sexual behavioral
      tests, intact and sham-operated control males showed only a low lordotic
      activity. However, the performance of the lordosis reflex was markedly
      facilitated by LSL or DPOL, while the lordotic activity of MSL and MPOL males was
      not significantly different from that of control males. These results suggest
      that the lateral septum exerts not only a facilitatory influence on masculine
      sexual behavior but also an inhibitory influence on feminine sexual behavior in
      male rats. On the other hand, the medial preoptic area may play a critical role
      in regulating masculine sexual behavior in male rats.

PMID- 2227854
TI  - The effects of testosterone administration and visual erotic stimuli on nocturnal
      penile tumescence in normal men.
AB  - Nocturnal penile tumescence (NPT), as circumference change and rigidity, and REM
      sleep were measured in eight normal eugonadal men in two controlled experiments.
      In the first, exposure to erotic film prior to sleep had no effect on frequency
      of REM or on NPT. In the second placebo controlled experiment 150 mg im
      testosterone enanthate administration was associated with enhanced rigidity of
      NPT but with no effect on frequency or circumference change of NPT and no effect
      on frequency of REM.

PMID- 2227855
TI  - How hospital CEOs plan to control costs.

PMID- 2227856
TI  - Not-for-profit hospitals fight tax-exempt challenges.
AB  - The message being sent by local tax boards, state agencies, and the Internal
      Revenue Service is clear: Not-for-profit hospitals will have to justify their tax
      exempt status. But complying with this demand can be a costly administrative
      burden. Just ask the executives who have been through the experience. CEO Richard
      Anderson, of St. Luke's Hospital, Bethlehem, PA, is luckier than some executives
      who have faced tax-exempt challenges. He won his hospital's case. But he still
      faces a yearly battle: The hospital must prove its compliance annually to the
      county board of assessors. Other executives report similar experiences. Our cover
      story takes an in-depth look at how administrators faced challenges to their
      hospital's tax status and what they learned about their relationship with their
      communities, as well as a complete state and federal legislative outlook for
      future developments.

PMID- 2227857
TI  - Congress measures hospitals' community benefit.

PMID- 2227858
TI  - The IRS is set to turn up the heat on not-for-profits.

PMID- 2227859
TI  - Survey lets physicians diagnose deficits in hospital operations.

PMID- 2227860
TI  - Catholic hospitals join forces with non-Catholic competitors.
AB  - Many Catholic hospitals are teaming up with nearby non-Catholic providers to
      develop stronger regional systems of care. Like all collaboration arrangements,
      these deals must survive state regulatory scrutiny as well as monitoring for
      antitrust violations by federal agencies. Unlike other arrangements, however,
      religious and philosophical issues must also be reconciled.

PMID- 2227861
TI  - Effective employee surveys require commitment to change.
AB  - Some hospital administrators have turned to employee opinion surveys for guidance
      on employee relations. That's because there is an emerging consensus that
      employee opinion surveys can help hospitals stay competitive. Yet up to now, the
      hospital field's record for making use of such surveys is poor, say
      organizational development specialists.

PMID- 2227862
TI  - Occupational health programs reap profits and referrals.
AB  - Hospitals with occupational health programs can build profitable bridges with
      employers. Programs that offer comprehensive, client-driven services are most
      likely to succeed, experts say.

PMID- 2227863
TI  - Overcoming MD resistance to occupational programs.

PMID- 2227864
TI  - As cardiology market matures, technology's impact is clearer.
AB  - What's the likelihood that magnetic resonance imaging will become a more
      important diagnostic tool for cardiologists? Are electrophysiology services the
      "wave of the future" in cardiology? These were among several issues discussed at
      a recent conference on cardiac services.

PMID- 2227865
TI  - CEO ups admissions by making hospital physician-friendly.

PMID- 2227866
TI  - Nurse attorneys can educate lawmakers, attorney says.

PMID- 2227867
TI  - Behavior is the most effective communicator.
AB  - Actions speak louder than words. This is one of the most important strategies for
      successful organizational communications. Managers can best communicate their
      organization's vision, values, and concern for customers and employees through
      their own behavior.

PMID- 2227869
TI  - Exclusive physician contracts can be a win/win situation.

PMID- 2227868
TI  - Employees key to hospitals' future survival.
AB  - Hospitals that don't invest in their employees may be endangering their own
      survival, hospital CEOs say. Almost 87 percent of 250 hospital CEOs recently
      polled by Hospitals magazine say that the declining skill level of workers will
      adversely affect quality of care.

PMID- 2227870
TI  - Hospitals provide written payment policies for patients.

PMID- 2227871
TI  - Quality is not a problem for CA recovery centers.

PMID- 2227872
TI  - CEOs who negotiate get top retirement plans.

PMID- 2227873
TI  - Cancer patients fly with 'corporate angels'.

PMID- 2227874
TI  - What consumers look for in an internist.
AB  - Consumers are looking for a high level of physician/patient interaction with
      their internists regarding treatment options, but their demand for extended
      appointment hours varies widely by location. Look to Data Watch for insights into
      what will attract consumers to members of your medical staff.

PMID- 2227875
TI  - Imaging.
AB  - Medical imaging has been--for decades--a highly profitable business for hospitals
      and imaging equipment manufacturers. But new circumstances are having an impact
      on the industry: Profits are no longer pouring in, and decision-makers are
      adjusting their strategies in response. Hospitals are discovering that they must
      closely monitor their radiology departments' financial performance to compete
      effectively in this tougher environment. At the same time, they're developing new
      business arrangements to help claim and protect their share of the medical
      imaging market. Meanwhile, clinical researchers are expanding the boundaries of
      imaging technology, leading to competition among modalities for market share.
      Changed technology and new financial considerations are combining to make
      hospitals' medical imaging investment decisions increasingly complex.

PMID- 2227876
TI  - Financial measures key to surviving pricing squeeze.

PMID- 2227877
TI  - Imaging devices' shifting uses affect market.

PMID- 2227878
TI  - Hospitals and MDs vie for imaging business.

PMID- 2227879
TI  - Hospitals voice objections to HCFA's proposed lab regulations.
AB  - HCFA is poring over 50,000 letters commenting on the proposed new clinical lab
      regulations. Health care providers say the regulations are unreasonably complex.
      As a result, "It's very likely the standards will be changed," says Thomas
      Morford, HCFA's health standards director.

PMID- 2227880
TI  - Patient-centered care: can your hospital afford not to have it?
AB  - A new survey tool to measure the personalization of patient care is helping
      hospitals look beyond the quantifiable and the clinical and zero in on the
      patient's perception of care. "Assuming good technology and good doctors, more
      patients are basing their choice [of a hospital] on ... differences in personal
      service," says one of the survey's managers.

PMID- 2227881
TI  - The delivery challenges posed by Canada: a bilateral view.
AB  - The Canadian health care system continues to appeal to Americans looking for
      alternatives to our own system. But, according to administrators who have worked
      in both, there are pluses and minuses to consider in each system.

PMID- 2227882
TI  - AHA data: net patient margins fall below one percent.

PMID- 2227883
TI  - Why hospitals lose services to their physicians.
AB  - Financial considerations are driving physicians to set up shop for themselves,
      say hospital CEOs. In fact, two-thirds of respondents say that their hospitals
      have lost services to competition from physicians. Other CEOs contend that
      physicians end up competing with their hospital because neither side is able to
      find common ground for joint ventures.

PMID- 2227885
TI  - Can CEOs survive medical staff opposition?
AB  - The odds are stacked against CEOs who hope their jobs will survive embattled
      relations with their medical staffs. An estimated 50 to 75 percent of CEOs who
      are fired lose their jobs as a direct result of medical staff conflicts. Some
      CEOs who have survived such conflicts say that the key is finding unusual
      solutions to conventional problems.

PMID- 2227884
TI  - PRRB ruling alters bond refunding outlook.
AB  - A recent ruling by the Provider Reimbursement Review Board on an accounting
      change for hospital bond refinancing may compel some CEOs to reconsider
      refinancing now. Hospitals may not be able to claim this loss once capital
      reimbursement is folded into the prospective pricing system, experts warn.
      Hospitals should accelerate their refundings--assuming, of course, that market
      conditions are favorable.

PMID- 2227886
TI  - The NLRB: its many faces can be deceiving.
AB  - Unions are gearing up for a hospital-organizing blitz, say three attorneys.
      Consequently, hospitals will have to learn to deal with the National Labor
      Relations Board and its "multiple personalities." The NLRB acts as investigator,
      grand jury, prosecutor, judge, and executioner, the attorneys warn. In the world
      of the NLRB, you stand charged without knowing the charges.

PMID- 2227887
TI  - Second quarter Monitrend II data from AHA.

PMID- 2227888
TI  - CEOs as risk takers--from vision to reality.
AB  - Health care management today is inherently risky. And because of the environment
      of high CEO turnover and bottom-line responsibility in which executives work,
      some CEOs become enmeshed in a crisis-management mode on a day-to-day basis. But
      there are some administrators with broader visions of what their institutions
      should be and what they should achieve, and who are willing to risk their
      reputations--and more--to bring those visions to reality. From a Massachusetts'
      hospital system's downsizing to a California medical center's pioneering advances
      in technology to a Nebraska hospital system's new marketing approach to an Ohio
      CEO's creativity mandate, here's how six CEOs in very different situations took
      risks.

PMID- 2227889
TI  - CEO closes a hospital, yet retains support of physicians and patients.

PMID- 2227890
TI  - 'Yes we can' creativity spurs system to new successes.

PMID- 2227891
TI  - Proton beam accelerator: investing in unconventional medicine.

PMID- 2227892
TI  - CEO gives local corporations a new guide to measure quality.

PMID- 2227893
TI  - Clarkson rewrites the book on hospital marketing.

PMID- 2227894
TI  - Medical society campaigns to reduce red tape for physicians.
AB  - The American Society of Internal Medicine is launching a campaign to attack the
      "hassle factor" in medicine, which, physicians say, damages patient care and
      undermines their decisionmaking process. In a white paper titled The Hassle
      Factor: America's Health Care System Strangling in Red Tape, the society outlines
      how government and private payer regulations are increasing costs, reducing
      access, and hurting patient care. The degree to which these regulations are
      driving physicians out of practice directly affects hospitals.

PMID- 2227895
TI  - Avoiding unions: supervisors are the first line of defense.
AB  - Hospital employees voting in union elections are swayed by their feelings about
      their individual supervisors, labor experts say. If supervisors are to be
      effective in helping to avert unionization of hospital employees, they must be
      trained, says Diane Iorfida, senior vice-president of human resources at
      University Hospitals of Cleveland (OH) and president of the Chicago-based
      American Society for Health Care Human Resources Administration of the American
      Hospital Association. Supervisor training, according to Iorfida, should be an
      ongoing process and not a one-time response to the immediate possibility of
      unionization.

PMID- 2227896
TI  - Hospital exec helps shape ProPAC policy.

PMID- 2227897
TI  - Patient relations director promotes customer loyalty.

PMID- 2227898
TI  - Sports medicine attracts a young, healthy market.

PMID- 2227899
TI  - Targeting teens as future employees.

PMID- 2227900
TI  - Survey: executives expect increases in purchasing budgets.

PMID- 2227901
TI  - Nursing homes seek advance directives.

PMID- 2227902
TI  - Medical staff changes reflect external pressure.

PMID- 2227903
TI  - Teambuilding: it starts at the top--of a tree?
AB  - Management experts say that teamwork begins at the top--with senior executives.
      For senior executives at the Saddleback Memorial Medical Center, Laguna Hills,
      CA, teamwork improvement started last March at the top of a tall pine tree. The
      Saddleback team's deeds of daring were part of a sophisticated four-and-a-half
      day training session at a special camp in the California mountains. The program
      challenged the hospital group to move beyond its current levels of teamwork.

PMID- 2227904
TI  - Corporate culture must foster innovation.

PMID- 2227905
TI  - Flexible schedules are vital to CEO success.

PMID- 2227906
TI  - Recruiting must adapt to MD payment changes.
AB  - In summary, the adverse effects of reimbursement reform on physician recruiting
      can be overcome by proper planning--starting now. Hospital administrators who
      respond appropriately to this challenge can preserve income levels for both
      physicians and hospitals in the years ahead.

PMID- 2227907
TI  - Variation and classification of human age patterns of mortality: analysis using
      competing hazards models.
AB  - The structure of variation in human mortality patterns is explored using a five
      parameter competing hazards model and standard multivariate taxonomic procedures.
      The data consist of 281 national life tables representing a wide range of
      environmental and cultural regions of the world. A general or average age pattern
      of mortality was generated for the entire sample using multiple regression
      procedures. A K mean cluster analysis conducted on the residuals of the
      regression analysis identified seven distinct models of mortality that differ in
      characteristic ways from the general pattern. Four of the seven clusters have age
      patterns of mortality similar to the north, east, south, and west regions of the
      Coale and Demeny model life tables. The remaining three clusters represent
      regions of the world and age patterns of mortality that are not represented in
      the Coale and Demeny model life tables.

PMID- 2227909
TI  - Patterned selection of mates in St. Ouen, Jersey, and the Scilly Isles examined
      by isonymy.
AB  - Within-lineage repeated-pair isonymy is calculated as RPW = sigma [Sij(Sij -
      1)]/sigma [Si(Si - 1)], in which Sij is the number of a combination of two
      surnames in marriages (for total RPW, in both orders, brides first and also
      grooms first) and Si is the corresponding number of individuals of each surname
      (for total RPW of both sexes). In St. Ouen the 3479 native Jersey marriages
      between 1634 and 1914 yield a mean total RPW of 0.03314, which can be compared
      with a random isonymy (Ir) of 0.02205 and a marital isonymy (Im) of 0.04942. In
      the most recent time periods (1830-1914) there was an increase in RPW, but the
      increase is small if all marriages are considered rather than only native Jersey
      ones. In the Scilly Isles 2827 marriages between 1725 and 1975 yield a mean total
      RPW of 0.05127, which compares with a mean Ir of 0.01960 and an Im of 0.05238. In
      each kind of isonymy there is a decline over 1850-1975 caused by increased
      migration to the Scilly Isles. In the Scilly Isles RPW consistently approximately
      equals Im, so the nonrandom component of inbreeding is fully accounted for by
      factors that affect marital choice in the whole lineage. In St. Ouen, however,
      RPW is intermediate in value between Ir and Im, so the nonrandom component of
      inbreeding is only partly a lineage phenomenon and is also affected by other
      (individual) factors in choice of spouses.

PMID- 2227908
TI  - Reconstructing history: the Amazonian Mura Indians.
AB  - We studied demographic characteristics of two Mura Indian villages. Two-hundred
      six inhabitants of these villages and another population were tested in relation
      to 30 blood and 4 saliva genetic systems. These groups exhibit high mobility and
      exogamy rates and high fertility but relatively low mortality and variance in
      number of children per woman. Hb J Oxford and albumin Maku were observed, and
      they show high prevalences of GPT*1 and RH*R1 but low of HP*1 compared to other
      South American Indians. Four electrophoretic saliva systems are reported here for
      the first time in a predominantly Amerindian group. The amount of polymorphism
      was more limited than that found in Caucasian, black, and Oriental populations.
      The Mura are still predominantly Indian (82%) but have African (11%) and
      Caucasoid (7%) admixture. Using these values, the putative ancestral Mura gene
      frequencies were assessed. Problems related to quantitative estimations of
      admixture and the factors that influence the process are discussed.

PMID- 2227910
TI  - Relationships estimated by isonymy among the Italo-Greco villages of southern
      Italy.
AB  - Surnames of parents and grandparents were collected from 1993 children in the
      primary schools of the thirteen Italo-Greco communes that lie in two areas, four
      communes in Reggio Calabria in the "toe" of Italy and nine in Lecce in the
      "heel." The coefficients of relationship by isonymy show almost no relationship
      between the two areas. The smaller area in Reggio Calabria Province has
      consistently larger coefficients of relationship between communes than the larger
      area in Lecce Province. The difference can be ascribed to greater accumulated
      random isonymy in the smaller area. These populations are not genetic isolates,
      but each area shows a degree of cohesiveness with respect to surnames that
      suggests that they are genetically somewhat distinct. Contiguous pairs of
      communes tend to have higher coefficients of relationship than pairs of communes
      separated by intervening communes.

PMID- 2227911
TI  - Hand locomotor functions, body structure, and epidermal ridge patterns:
      preliminary study.
AB  - The purpose of this study was to determine whether any relationships exist
      between hand locomotor functions and dermatoglyphic characteristics and body
      structure. The pilot sample consisted of 71 adult normal individuals (30 males
      and 41 females). The locomotor function tests included a power grip and two
      precision grips; dermatoglyphic features were represented by finger and palmar
      pattern intensities and ridge counts, and body structure by 35 head, face, trunk,
      and limb anthropometric measurements. Univariate and multivariate correlation
      analyses reveal that on average half of the variance in the locomotor hand
      function tests can be accounted for by a set of body and/or dermatoglyphic
      variables in males; this contribution is appreciably lower in females. Body
      longitudinal measurements and some facial measures, such as jaw length, were
      found to be the main correlates of either a power grip or a simple thumb-index
      squeeze, especially in males; head and face measurements and the size and
      intensity of patterns on fingers 1 and 2 were the main correlates of more complex
      precision tests involving complicated manipulation of objects using the thumb and
      index finger. These preliminary results identify some previously unknown sources
      of variation in dermatoglyphic patterns and contribute to a better understanding
      of the evolutionary aspects of the relationships between specific functional and
      morphologic traits in humans.

PMID- 2227912
TI  - Age effects and secular trend in a cross-sectional sample: application to four
      head dimensions in Belgian adults.
AB  - If longitudinal studies represent the more direct way to analyze modifications
      resulting from aging, often for obvious reasons cross-sectional samples can also
      be used for this purpose. But in this case differences between age groups cannot
      be identified with the effects of age only; they can also be attributed to the
      effects of a secular trend. It is the aim of this study to show, using four
      cephalic dimensions and a cross-sectional sample, the need to take into account
      the effect of a secular trend when the age effect is studied. In 1985 a study of
      head and facial measurements of 182 Belgian men, aged 25-54 years, was carried
      out. A simple comparison between different age groups (F tests) revealed
      significant differences for head breadth and facial breadths. However, no
      difference for head length was observed. The amplitude of the secular trend in
      the Belgian population is already known; thus an easy calculation is proposed to
      define the effects of the age factor. For head breadth the whole difference seems
      to be the result of the important decrease of secular trend, whereas the global
      increase observed for the bizygomatic and bigonial breadths results in part from
      the decrease resulting from the secular trend and in part from the increase
      resulting from the age effect.

PMID- 2227914
TI  - Effects of maternal birth season on birth seasonality in the Canadian population
      during the seventeenth and eighteenth centuries.
AB  - Birth records of the French-Canadian population for the period 1621-1765 were
      analyzed retrospectively to examine the effect of maternal birth season on the
      seasonal distribution of births. Preliminary examination indicated that there was
      a bimodal pattern in birth seasonality: a major peak in early spring, a trough in
      early summer, a minor peak in autumn, and a trough around December. Because this
      seasonality was strongly biased at the level of the first birth by the month of
      marriage, which was concentrated in November, the seasonality of nonfirst births
      (n = 32,926) was examined in relation to the four seasons of maternal birth.
      Mothers born in May-July showed a flatter monthly distribution of nonfirst births
      at a maternal age of 28 years or more. Analysis of marriage-first birth intervals
      indicated that mothers who married in August-October showed a lower percentage of
      immediate conception (intervals of 8-10 months), whereas those mothers born in
      May-July had a higher percentage of immediate conception. This difference in
      birth seasonality shown by mothers born in May-July is similar to results from
      early twentieth-century Japan. Some seasonal infertility factors could have
      affected the embryos at the earliest stage of pregnancy, modifying a part of the
      seasonal variation in birth rate.

PMID- 2227913
TI  - High fertility of Old Colony Mennonites in Mexico.
AB  - Old Colony Mennonites in Mexico appear to demonstrate natural fertility, using no
      form of artificial birth control and apparently not attempting to limit family
      size. The resulting fertility is nearly as high as that of the Hutterites,
      although the Mennonites lack the communal economic system of the latter. Most
      Mennonites in Mexico migrated from Canada in the 1920s, and the largest single
      settlement, called the Manitoba Colony, is one of four in the state of Chihuahua.
      A 1967 partial census obtained data from 38% of the Mennonite households. Family
      size in the sample was close to that in a local survey taken in the same year.
      Available church records matched with census forms permitted verification of and
      corrections to 560 female reproductive histories. The median number of live
      births to women over age 45 years was 9.5, compared with 10.4 in the Hutterites.
      Age-specific marital fertility rates and birth intervals closely resembled those
      of the Hutterites.

PMID- 2227915
TI  - Birth weight in an African-American population living under moderate ecologic
      stress.
AB  - The African-American population of McNary, Arizona, resides at an altitude of
      2200 m. The lengthy winters are typically quite cold; the monthly mean
      temperature from November to April is 1.8 degrees C. Data from 318 singleton full
      term births of African-American babies from 1949 to 1972 show a mean weight of
      3095 g (s.d. = 427 g). At birth 1.9% of the babies weighed at least 4 kg; 9.7%
      weighed less than 2.5 kg. These data suggest that altitude may have influenced
      birth weight in this sample. Significant patterns in birth weight exist for sex,
      parity, mother's age, and severity of the winter preceding the year of birth. The
      birth weight of female babies born following warm winters is significantly
      lighter than those born during years following cold winters. There are relatively
      fewer high-birth-weight babies, in comparison to other African-American
      populations. Birth weight is also significantly lighter than three other African
      American samples, even though African-American mothers of McNary had full-term
      professional care. Birth weight of African-American babies born in McNary is
      consistent with the overwhelming African ancestry of the African-American
      population of McNary. Sex differences in birth weight of babies born following
      cold winters can be ascribed to gender-related hereditary or physiologic factors
      at the level of the fetus. Maternal inactivity during particularly cold winters
      may be a contributing factor.

PMID- 2227916
TI  - Collagenous, "microscopic," lymphocytic, and other gentler and more subtle forms
      of colitis.

PMID- 2227917
TI  - Colonic lymphocytosis in patients with celiac sprue.
AB  - We examined colonic biopsies from 39 patients with clinical and small bowel
      biopsy changes of celiac sprue. In 12 of 39 patients (31%), striking lymphocytic
      infiltration of the superficial colonic epithelium and chronic inflammation of
      the lamina propria were identified. These 12 cases had a mean of 30.4 lymphocytes
      per 100 superficial colonic epithelial cells, compared with means of 8.4 in sprue
      cases without colonic epithelial lymphocytosis, 4.8 in normal controls, and 32.4
      in nine cases of lymphocytic colitis without concurrent celiac sprue. No case
      showed subepithelial collagen layer thickening. Four patients with celiac sprue
      and colonic lymphocytosis also had gastric biopsies; two showed gastric
      lymphocytosis. Intraepithelial lymphocytes at all sites were positive for the T
      cell marker MT-1. These findings indicate that sprue-associated colonic
      lymphocytosis and lymphocytic colitis are histologically, quantitatively, and
      immunohistochemically indistinguishable, that the epithelial T-cell infiltration
      of celiac sprue occurs in glandular mucosa at all levels of the gastrointestinal
      tract, and that colonic subepithelial collagen deposition in patients with celiac
      sprue is an infrequent occurrence. These findings also suggest that
      gastrointestinal epithelial T-cell infiltration may be an immunologic response
      that is common in individuals sensitized to absorbed lumenal antigens, and that
      colonic lymphocytosis may occur as a response to a number of antigens, including
      gluten.

PMID- 2227918
TI  - Nuclear DNA measurements of metastatic melanoma by a computerized digital imaging
      system.
AB  - To determine the extent of nuclear DNA abnormalities and their relationship with
      prognosis of stage II malignant melanoma, metastatic melanomas in lymphadenectomy
      specimens of 22 patients were studied by a computerized digital imaging system.
      The DNA ploidy pattern was aneuploid in 86% of the cases and tetraploid in the
      remaining 14%. In metastatic melanomas, there was a single clone in one third of
      patients and multiple clones in the remaining two thirds. Poor survival rate was
      associated with multiple clones and greater than 30% of mean coefficient of
      variation of DNA content. With tumor progression stem-cell lines often became
      heterogeneous with the development of multiple clones and widespread DNA values.
      These abnormalities, determined by nuclear DNA ploidy analysis, provide useful
      prognostic information.

PMID- 2227919
TI  - Peripheral T-cell lymphomas: a clinicopathologic study of 75 cases.
AB  - Seventy-five peripheral T-cell lymphomas (PTLs) were classified according to the
      recently proposed "Updated Kiel Classification of Non-Hodgkin's Lymphomas"
      (mycosis fungoides and Sezary's syndrome excluded). Thirty-seven PTLs belonged to
      the low-grade category (T-cell chronic lymphocytic leukemia [T-CLL], 3;
      lymphoepithelioid, 4; angioimmunoblastic, 22; T-zone, 6; pleomorphic small cell,
      2) and 38 belonged to the high-grade category (pleomorphic medium and large cell,
      24; immunoblastic, 1; large-cell anaplastic Ki-1-positive, 13). Loss of pan-T
      antigens occurred exclusively in high-grade PTLs; on paraffin sections UCHL 1 was
      slightly more sensitive than MT 1. Sixty patients presented with lymphadenopathy
      and 15 patients (20%) presented with extranodal disease most frequently affecting
      the skin and upper aerodigestive tract. B-cell lymphoma symptoms were found in 43
      cases (57%) and bone marrow involvement (T-CLL excluded) was found in 12 cases
      (17%). Staging (T-CLL excluded) revealed stage I in 13%, stage II in 15%, and
      stages III and IV in 72% of the cases. Among the intensively treated patients,
      37% achieved complete remission and 15 are still in complete remission after 4 to
      79 months (median: 24 months). The overall median survival (MS) rate was 23
      months. Peripheral T-cell lymphoma of pleomorphic medium and large-cell type was
      the most aggressive lymphoma (MS: 8 months). B-cell lymphoma symptoms, bone
      marrow involvement, and Ki-67 positivity 60% or greater significantly shortened
      survival times, whereas age (under 60 versus over 60 years), stage (I and II
      versus III and IV), and grade had no significant influence. Ki-67 reactivity was
      found to be a prognostic factor which allows prediction of probable poor outcome,
      especially in cases with limited stage of disease.

PMID- 2227920
TI  - Immunohistologic analysis of small lymphocytic infiltrates of the orbit and
      conjunctiva.
AB  - In a prior study we reported that monotypic immunoglobulin expression
      significantly correlated with an increased risk of dissemination by small
      lymphocytic infiltrates (SLIs) of the orbit and conjunctiva. However, less than
      half of all monotypic SLIs disseminated. In this study, we applied a large panel
      of monoclonal antibodies to cryostat sections of orbital and conjunctival SLIs to
      address two questions. First, might immunohistologic results other than
      immunoglobulin staining predict which patients with monotypic SLIs will develop
      disseminated lymphoma? Second, what is the usefulness of these findings in the
      diagnosis of orbital and conjunctival SLIs? We found that immunohistologic
      results did not significantly predict or correlate with disseminated lymphoma in
      patients with monotypic SLIs, either at time of presentation (ie, staging
      evaluation positive) and/or subsequently. However, three monotypic infiltrates
      (10%) had a proliferative rate (Ki-67-positive) of 20% or greater, and all three
      cases disseminated. Regarding the usefulness of the antibody panel, a B to T cell
      ratio of 4 or greater (76%), anomalous pan-T cell antigen expression by B cells
      (38%), and pan-B cell antigen loss (15%) were found exclusively in monotypic
      SLIs. Combining these results, 80% of monotypic SLIs had additional
      immunophenotypic criteria of lymphoma. Thus, these findings appear to be useful,
      although less helpful than immunoglobulin staining, and provide another means of
      immunophenotypic diagnosis when the results of immunoglobulin staining are
      technically unsatisfactory or difficult to interpret. We were unable to detect
      anomalous antigen expression or antigen loss in polytypic infiltrates, including
      one lesion which locally recurred 30 months later as a histologically
      indistinguishable, clearly monotypic SLI. We attribute the absence of these
      findings in polytypic SLIs to their relatively infrequent occurrence in monotypic
      infiltrates and/or to our inability to detect small clones of malignant cells (if
      present) by our immunohistologic methods.

PMID- 2227921
TI  - Genotype and phenotype: a practical approach to the immunogenetic analysis of
      lymphoproliferative disorders.
AB  - Determination of cell lineage and clonality in lymphoproliferative disorders
      (LPD) is greatly enhanced by molecular genetic analysis in conjunction with
      morphologic and immunologic techniques. We now report on a technique in which we
      used cryostat-cut, fresh-frozen sections (CCFFS) prepared from tissues in a
      manner that allows DNA hybridization studies to be coordinated readily with
      routine morphologic and immunohistologic studies. Thirty-seven cases representing
      a broad spectrum of reactive and malignant LPD were examined with this method.
      Samples of DNA were extracted from frozen sections, subjected to Southern blot
      hybridization, and probed for rearrangements of the immunoglobulin (Ig) heavy
      chain and the kappa and lambda light-chain genes, as well as for the T-cell
      receptor beta-chain gene. We also evaluated the effects of (1) diagnostic
      category of LPD, (2) volume of the tissue sample, and (3) fibrosis, necrosis, and
      ice crystal artifacts in the sample on the recovery of DNA. Ice artifact and
      sample size had the greatest negative impacts on the quantity and condition of
      DNA recovered. Of 19 samples involved by B-cell LPD, the results of immunogenetic
      studies were consistent with the immunophenotypes in all but one case. Of the T
      cell lymphomas from which sufficient DNA was available (three out of five of the
      T-cell cases), all showed rearrangements of the T-cell beta-chain gene. In order
      to reduce sample processing time, we evaluated alternate blot hybridization
      methods, rapid alkaline transfers, and direct hybridization of synthetic
      oligonucleotides in dried agarose gels, and found that they decreased the time
      required for hybridization studies. In summary, the use of CCFFS as the source of
      DNA allows study of gene rearrangements and, at the same time, preserves frozen
      tissue blocks in tumor banks for further immunologic studies. The development of
      time-effective methods will make the routine use of molecular-genetic analysis
      more practical in the diagnostic hematopathology laboratory.

PMID- 2227922
TI  - Metaplastic carcinomas of the breast: V. Metaplastic carcinoma with osteoclastic
      giant cells.
AB  - The clinical and pathologic features of 29 examples of mammary metaplastic
      carcinoma with osteoclastic giant cells (OGC) in the stroma are reported. A bland
      spindle cell or sarcomatous component dominated these neoplasms, although
      infiltrating duct carcinoma was present in 23 cases, and intraductal carcinoma
      was present in six cases. In all 29 neoplasms, the carcinoma was admixed or
      contiguous with the stroma. Osteoclastic giant cells were admixed within the
      cellular stroma, and were intimately associated with prominent thin-walled
      vessels. Hemorrhage and hemosiderin deposition were common. Osteoclastic giant
      cells were immunoreactive for vimentin and, to a lesser extent, actin, and
      uniformly not immunoreactive for keratins, confirming their mesenchymal nature.
      The stromal component of 63% of neoplasms tested was immunoreactive for keratin,
      33% was immunoreactive for epithelial membrane antigen, 54% reacted for S-100
      protein, 84% reacted for actin, and 100% was immunoreactive for vimentin.
      Nineteen neoplasms had osteoid, bone, or cartilage, but these were a prominent
      component in only five neoplasms and OGC were not limited to these areas. The
      disease-specific cumulative 5-year survival rate for patients with metaplastic
      carcinoma with OGC was 68%, similar to rates for patients with matrix-producing
      carcinoma (68%), spindle cell carcinoma (64%), and squamous carcinoma of ductal
      origin (63%), but notably different from that of patients with carcinosarcoma
      (49%). Of 17 women with axillary node dissection, only two had metastases. Eleven
      women developed distant metastases, most commonly to the lungs. Metastasis
      present at or following initial surgery was an ominous sign, as all 11 women with
      metastases died from tumor. Size and microscopic circumscription were significant
      factors in predicting disease progression.

PMID- 2227924
TI  - Sequestrated meningoceles of scalp: extracranial meningeal heterotopia.
AB  - Sequestrated meningocele of the scalp has seldom been reported and is difficult
      to diagnose. Clinically it resembles dermoid cyst, hemangioma, or alopecia;
      radiographs and computed tomographic scans reveal no cranial bone defect, and
      surgery discloses no communication with the cranial cavity. Histologically, the
      lesion is characterized by a loose arrangement of connective tissue in dermis and
      subcutis, associated with flattened cells around collagen fibers (meningothelial
      cells). Most examples are very vascular, sometimes mimicking angioma, and about
      one third contain small necrotic foci. The meningothelial nature of the lesion is
      shown by its architectural similarity to communicating meningocele, and its
      identical immunoperoxidase reactions with vimentin and epithelial membrane
      antigen. In the 12 cases reported herein, most lesions were small (1 to 1.5 cm),
      and all but one were noted at birth but usually not resected until the patient
      had reached age 1 to 4, and one not until the patient was 31 years of age. Five
      lesions were not midline. We have been unable on histologic grounds to determine
      whether meningoceles are communicating or sequestrated. Compared with 20
      communicating meningoceles, the sequestrated lesions were usually smaller, found
      in slightly older patients, and much less likely to be associated with
      hydrocephalus. The local excision of scalp lesions in children should include a
      search for a small intracranial connection.

PMID- 2227923
TI  - Mixed medullary-papillary carcinoma of the thyroid: a previously unrecognized
      variant of thyroid carcinoma.
AB  - Two unusual medullary carcinomas of the thyroid gland and their metastases
      contained a population of cells (20% to 25%) with the characteristic clear nuclei
      of papillary carcinoma. The predominant component of the tumors exhibited the
      typical growth pattern and cytologic features of medullary carcinoma with
      abundant amyloid deposits. The cells with clear nuclei lined follicle-like or
      tubular structures. In both the primary and the metastatic lesions,
      immunoreactive thyroglobulin was demonstrated only in the cells with clear
      nuclei, while calcitonin, carcinoembryonic antigen, and neuron-specific enolase
      were present only in cells of the predominant medullary carcinomatous component.
      Moreover, intense and diffuse staining for cytokeratin was seen only in the cells
      with clear nuclei, but not in those of the major medullary carcinomatous
      component. These findings suggest the existence of a distinctive variant of mixed
      medullary-papillary carcinoma that can be recognized with routine stains.

PMID- 2227925
TI  - Corneal and conjunctival crystals in paraproteinemia.
AB  - A 64-year-old woman with bilateral corneal and conjunctival crystal deposition
      was evaluated. A biopsy of her conjunctiva showed intracytoplasmic inclusions of
      immunoglobulin crystals in fibrocytes, macrophages, and endothelial cells. Serum
      protein electrophoresis showed elevated kappa and IgA light and heavy chains
      which corresponded with immunoperoxidase staining results of the conjunctival
      biopsy. Conjunctival and corneal crystal deposition may be indicative of
      paraproteinemia, and histopathologic examination of a conjunctival biopsy may be
      useful in diagnosing this condition.

PMID- 2227926
TI  - Giant cell tumor of the pancreas of mixed osteoclastic and pleomorphic cell type:
      evidence for a histogenetic relationship and mesenchymal differentiation.
AB  - We describe a giant cell tumor of the pancreas composed of a mixture of
      osteoclastic and pleomorphic cell types. This rare tumor had a unique
      immunohistochemical profile. Both types of tumor giant cells stained for
      vimentin, alpha-1-antitrypsin, alpha-1-antichymotrypsin, synaptophysin, muscle
      actin, and neuron-specific enolase, but not for epithelial markers. Electron
      microscopy showed cells which resembled primitive fibroblasts and osteoclast with
      no epithelial features. These findings are most consistent with mesenchymal
      differentiation. The extensive homologies in immunohistochemical staining of both
      osteoclastic and pleomorphic giant cells in this case indicates that these cells
      are histogenetically related.

PMID- 2227927
TI  - Composite carcinoid-adenocarcinoma of ampulla of Vater.

PMID- 2227928
TI  - Use of energy-dispersive X-ray analysis for detection of Teflon in tissue
      sections.

PMID- 2227930
TI  - Variability in expression of common fragile sites: in search of a new criterion.
AB  - Fragile sites are nonrandom, heritable sites on chromosomes that can be induced
      to form gaps, breaks, and rearrangements under specific conditions. There is
      currently no established criterion to define a common fragile site. We applied
      seven published criteria to our data from three groups of subjects: (1) three
      pairs of like-sexed twins, (2) four unaffected von Hippel-Lindau (VHL) family
      members, and (3) six patients affected with VHL disease. Substantial differences
      were present in the numbers of sites considered positive by these criteria. While
      some of this variability can be attributed to technical factors, our data
      illustrate the problems in comparing results from different studies to assess the
      significance of fragile sites. A recently published criterion is based upon the
      Poisson distribution. We found this criterion to be flawed in its presentation,
      and furthermore, the Poisson distribution did not provide an adequate
      approximation to our data. We propose here an alternative approach based upon the
      negative binomial distribution.

PMID- 2227931
TI  - Y isochromosome associated with a mosaic karyotype and inactivation of the
      centromere.
AB  - A patient with azoospermia and a Y isochromosome is described. The breakpoint
      producing this i(Y) was within the terminal short arm of the Y chromosome.
      Lymphocyte cultures from peripheral blood contained a high proportion of 45,X
      cells and cells with different Y-chromosome rearrangements. The i(Y) had either a
      monocentric or dicentric appearance. In dicentrics, anti-kinetochore
      immunofluorescence was present at both centromeres. However, this was also true
      for most of the functional monocentrics (pseudodicentrics). Kinetochore staining
      was generally positive at the site of the inactive centromeres; only a minority
      of the suppressed centromeres had lost their antigenic properties. Permanently
      growing lymphoblasts consistently showed a monocentric i(Y) with only one
      fluorescing kinetochore; the immunonegative Y centromere did not recover
      antigenicity.

PMID- 2227929
TI  - The critical region on the human Xq.
AB  - Adult female carriers of balanced X; autosome translocations (118 cases) and of
      balanced X inversions (31 cases) have been collected from the literature. Forty
      five of the 118 translocation carriers in whom the break was in the critical
      region (Xq13-q22, Xq22-q26, separated by a narrow region within Xq22) showed
      gonadal dysgenesis. Seven of the 31 inversion carriers in whom the break was in
      the same region also had gonadal dysgenesis, whereas the remaining 24 were normal
      in this respect. The critical region consists mainly of Q-bright material, and is
      the fifth brightest segment in the human genome. The region contains relatively
      few genes. It is possible that meiotic crossing-over, rarely, if ever, takes
      place in it. The critical region may therefore consist of two "supergenes" whose
      integrity must be maintained to allow normal ovarian development. The effect
      exerted by this region differs from other known position effects, in that it is
      independent of the breakpoint within the region and of the chromosome bands to
      which the broken ends are attached. One possible mechanism causing this effect
      might be a change in the replication order of the chromosome bands, which, in
      turn, might affect their function.

PMID- 2227933
TI  - Significance of structural chromosome aberrations in human sperm: analysis of
      induced aberrations.
AB  - A significant increase in the incidence of structural chromosome anomalies has
      been observed in the sperm of patients treated with radio and/or chemotherapy for
      different types of cancer when analyzed by the interspecific fertilization of
      hamster eggs. The analysis of these aberrations shows that while in controls only
      9.4% of structural abnormalities are of the stable type, in treated patients this
      figure increases to 39.3%, thus indicating that the anomalies have not been
      produced during the fertilization of the hamster egg. However, it is possible
      that part, or even most, of the breaks appear as a result of a reduced repair
      capacity of sperm chromosomes in the cytoplasm of the hamster egg.

PMID- 2227932
TI  - Deletion of specific sequences or modification of centromeric chromatin are
      responsible for Y chromosome centromere inactivation.
AB  - Stable dicentric chromosomes behave as monocentrics because one of the
      centromeres is inactive. The cause of centromere inactivation is unknown; changes
      in centromere chromatin conformation and loss of centromeric DNA elements have
      been proposed as possible mechanisms. We studied the phenomenon of inactivation
      in two Y centromeres, having as a control genetically identical active Y
      centromeres. The two cases have the following karyotypes: 45, X/46,X,i(Y)(q12)
      and 46,XY/47,XY,+t(X;Y) (p22.3;p11.3). The analysis of the behavior of the active
      and inactive Y chromosome centromeres after Da-Dapi staining, CREST
      immunofluorescence, and in situ hybridization with centromeric probes leads us to
      conclude that, in the case of the isochromosome, a true deletion of centromeric
      chromatin is responsible for its stability, whereas in the second case, stability
      for its stability, whereas in the second case, stability of the dicentric (X;Y)
      is the result of centromere chromatin modification.

PMID- 2227934
TI  - Identification of a compound heterozygote for adenine phosphoribosyltransferase
      deficiency (APRT*J/APART*Q0) leading to 2,8-dihydroxyadenine urolithiasis.
AB  - Homozygous deficiency of a purine salvage enzyme, adenine
      phosphoribosyltransferase (APRT), causes urolithiasis and renal failure. There
      are two known types of homozygous APRT deficiencies; type I patients completely
      lack APRT activity while type II patients only partially lack such activity. All
      type II patients possess at least one APRT*J allele with a substitution from ATG
      (Met) to ACG (Thr) at codon 136. Type I patients are considered to possess two
      alleles (APRT*Q0) both of which code for complete deficiencies. Thus, some
      patients with type II APRT deficiencies may have a genotype of APRT*J/APRT*Q0. As
      no individuals with such a genotype have previously been identified, we performed
      extensive analysis on four members of a family by (1) the T-cell method for the
      identification of a homozygote, (2) the B-cell method for the identification of
      heterozygotes, and (3) oligonucleotide hybridization after in vitro amplification
      of a part of genomic APRT sequence for the identification of APRT*J and non
      APRT*J alleles. We report here the first evidence that 2,8-dihydroxyadenine
      urolithiasis developed in a boy aged 2 years with a genotype of APRT*J/APRT*Q0.

PMID- 2227935
TI  - Locus assignment of human alpha-globin structural mutants by selective enzymatic
      amplification of alpha 1 and alpha 2-globin cDNAs.
AB  - We have used the powerful methodology of DNA enzymatic amplification in order to
      assign human alpha-globin structural mutants to one of the two highly homologous
      alpha-globin genes. Selectively amplified alpha 1 and alpha 2-globin cDNAs were
      dot-blotted and further hybridized to synthetic oligonucleotides encompassing
      either the normal or the mutated sequences. The generated signals corresponded
      specifically to one of the two alpha-globin genes. Using this approach the alpha
      globin structural mutants J-Buda and G-Pest were found to be encoded by the alpha
      2 and the alpha 1-globin genes, respectively. Furthermore, the exact nucleotide
      changes were determined. We propose this technique to serve as a simple and
      definitive method for assigning alpha-globin structural mutants.

PMID- 2227936
TI  - Involvement of the region 13q14 in a patient with adamantinoma of the long bones.
AB  - A cytogenetic analysis of a lung metastasis of an adamantinoma of the tibia, a
      rare tumor of the long bones, revealed a karyotype 52, XY, t(7;13)(q32;q14), +7,
      +12, +13, +19, +der(7) t(7;13), +der(13) t(7;13). The t(7;13) was found to be
      constitutional in the patient and was also present in peripheral blood
      lymphocytes of his unaffected father. However, both subjects displayed normal
      levels of esterase D enzyme activity.

PMID- 2227937
TI  - Investigation of three patients with the "ring syndrome", including familial
      transmission of ring 5, and estimation of reproductive risks.
AB  - We report three cases of ring chromosome 5 [r(5)], two familial (mother and
      daughter) and one sporadic. The phenotype resembled that of the "ring syndrome"
      with prenatal onset of short stature, growth retardation, mild facial dysmorphism
      and normal psychomotor development. Extended metaphase and prometaphase
      chromosome preparations using G-, R- and Q-banding and scanning electron
      microscopy (SEM) failed to demonstrate deletion in the ring 5. Flow karyotype
      using the FACS cell sorter and peak area analysis showed the r(5) to be in the
      same position as the normal chromosome 5. The deletion that is presumably
      associated with ring formation appears to involve less that one megabase of DNA.
      In the "complex" rings, high resolution SEM showed fragile sites at the 5q34 and
      5q35 region with frequent deletions at that site. A literature survey suggests
      that when a parent carries a ring chromosome about 80% of recognised pregnancies
      result in live birth. Of these, about half have a normal phenotype and karyotype,
      and half inherit the parental ring; about half of those acquiring the ring (20%)
      show significant mental retardation.

PMID- 2227938
TI  - The human QARS locus: assignment of the human gene for glutaminyl-tRNA synthetase
      to chromosome 1q32-42.
AB  - We have used a cDNA encoding the core region of the human glutaminyl-tRNA
      synthetase to determine the chromosomal localization of the corresponding gene.
      Southern blots of restricted DNA from a panel of rodent-human cell lines and in
      situ chromosome hybridization gave identical results showing that the human gene
      locus for glutaminyl-tRNA synthetase resides on the distal long arm of chromosome
      1. There are now nine mapped aminoacyl-tRNA synthetase genes in the human genome.

PMID- 2227939
TI  - Molecular analysis of the human MHC class I region in hereditary
      haemochromatosis. A study by pulsed-field gel electrophoresis.
AB  - The unknown allele that predisposes to the development of haemochromatosis in man
      has been localized to the HLA class I region on the short arm of chromosome 6. We
      have utilized pulsed-field gel electrophoresis in conjunction with probes that
      map within, or in the vicinity of, this region to search for structural lesions
      that may further define the disease locus. Using the enzyme Mlu I, fragments that
      associated specifically with the HLA-A23, A31 and B8 alleles were identified.
      However, in members of three pedigrees affected by haemochromatosis, and in six
      unrelated patients with the disorder, no disease-specific differences were
      detected in the DNA fragments with four restriction enzymes and eight probes when
      compared with healthy individuals. These data suggest that the lesion responsible
      for hereditary haemochromatosis lies beyond the resolution of this technique and
      does not involve large structural deletions or extensive re-arrangements in this
      highly polymorphic region of the genome.

PMID- 2227940
TI  - Molecular characterisation of two alpha-1-antitrypsin deficiency variants:
      proteinase inhibitor (Pi) Null(Newport) (Gly115----Ser) and (Pi) Z Wrexham (Ser
      19----Leu).
AB  - Two single point mutations in the alpha-1-antitrypsin gene, resulting in AAT
      deficiency, have been characterised in heterozygotes by DNA amplification and
      direct sequencing. The mutations result in amino acid substitutions, Gly115---
      Ser and Ser-19----Leu, in the leader sequence, respectively, and have been
      designated Pi Null(Newport) and Pi Z Wrexham. In the two families studied the
      mutations occur on chromosomes which also carry the common mutation causing Z
      deficiency. Individuals with such a deficiency are, therefore, compound
      heterozygotes. It is not known if these particular mutations would only cause a
      mild form of AAT deficiency in the absence of the Z mutation as they do not
      appear to cause predictable folding abnormalities. They do, however, result in
      severe deficiency when the Z mutation occurs in the same gene.

PMID- 2227941
TI  - In situ chromosome preparation technique for simultaneous cytogenetic and
      immunocytochemical studies on cell cultures of solid tumors.
AB  - Immunophenotyping of cultured cancer cells requires intact antigenic structures;
      these are mostly destroyed by conventional chromosome preparation techniques.
      Thus, the simultaneous cytogenetic and immunocytochemical characterization of
      solid tumor cells appears unfeasible. Here, we describe a novel method that
      allows in situ chromosome preparation from monolayer cultures of solid tumor
      cells without affecting their immunological features. Using this technique, it is
      possible to achieve detailed cytogenetic data including chromosome banding
      together with the demonstration of cytoplasmic and nuclear antigens within the
      same tumor cells.

PMID- 2227942
TI  - Rapid diagnosis of Miller-Dieker syndrome and isolated lissencephaly sequence by
      the polymerase chain reaction.
AB  - Probe YNZ22 (D17S5) is a highly polymorphic, variable number tandem repeat (VNTR)
      marker previously shown to be deleted in all patients with the Miller-Dieker
      syndrome (MDS) but not in patients with isolated lissencephaly sequence (ILS).
      Primers were constructed to the unique sequence flanking the polymorphic,
      repetitive region of YNZ22 for amplification by the polymerase chain reaction
      (PCR). Analysis of 118 normal individuals revealed 12 alleles (differing in copy
      number of a 70-bp repeat unit) ranging in size from 168 to 938 bp. A
      retrospective study of eight MDS and six ILS patients was consistent with
      Southern blot analysis in all cases except one. In the latter, a very large
      allele (12 copies of the repeat unit) in a patient and her mother failed to
      amplify on initial attempts, but was successfully amplified by reducing the
      concentration of genomic DNA used in the reaction. Prospective studies on two MDS
      and five ILS patients were successfully performed and confirmed in all cases by
      Southern blot analysis. From the total sample, restriction fragment length
      polymorphism (RFLP) analysis was fully informative in four of ten MDS patients
      and showed a deletion in all four cases. Nine of eleven ILS patients were
      heterozygous and therefore not deleted for YNZ22. Development of primers for
      additional polymorphic markers in the Miller-Dieker region will lead to a rapid
      PCR-based diagnostic approach for all MDS and ILS patients. PCR typing of YNZ22
      will also facilitate use of this marker in other applications, including genetic
      linkage, paternity and forensic studies, and analysis of loss of heterozygosity
      in tumors.

PMID- 2227943
TI  - Close linkage of the Wilson's disease locus to D13S12 in the chromosomal region
      13q21 and not to ESD in 13q14.
AB  - Wilson's disease (WD) is an autosomal recessive disorder resulting in copper
      accumulation notably in liver and brain tissue. Linkage of the WD locus (WND) to
      ESD at 13q14 was first shown by studies in families of Middle Eastern origin
      using the isozymic polymorphism of esterase D. Using RFLPs detected by the ESD
      cDNA we could not confirm this reported close linkage in an analysis of 17 WD
      families of northwest European origin. A tight linkage was detected, however, to
      the marker D13S12, located more distally at 13q21. No obligate cross-overs were
      detected in 63 gametes informative for this marker. Our data confirm an
      assignment of WND to 13q14-21. Its localization, however, seems to be more distal
      to ESD than previously reported. Although genetic heterogeneity cannot be
      excluded, the observed differences between the two populations are probably due
      to random variation.

PMID- 2227944
TI  - Deletion 3q27----3qter associated with a new skin disorder?

PMID- 2227945
TI  - Complex translocations, simple variant translocations and Ph-negative cases in
      chronic myelogenous leukaemia.
AB  - A proportion of cases of chronic myelogenous leukaemia (CML) has been described
      either (1) with a variant translocation, or (2) without the apparent involvement
      of both 9q34 and 22q11 (Ph-negative CML). All variant translocations have been
      further demonstrated to be complex implicating 9q34,22q11, plus another
      breakpoint on a variable chromosome. Complex translocations may be due to two
      successive events. Some of the breakpoints on the variable chromosome appear to
      be recurrent, and these remain to be studied for prognostic significance. Ph
      negative CML comprises (1) cases of submicroscopic (hidden) insertion of 9q34-ABL
      within 22q11-BCR, and (2) cases without BCR-ABL rearrangement. We propose this
      last category to be called "CML-like disease", not to be confused anymore with
      true CML, and consequently to be studied as a separate entity.

PMID- 2227947
TI  - Regional assignment of the human thymidylate synthase (TS) gene to chromosome
      band 18p11.32 by nonisotopic in situ hybridization.
AB  - The human thymidylate synthase (TS) gene was regionally assigned to chromosome
      band 18p11.32 by nonisotopic in situ hybridization using biotinylated cDNA (1.1
      kb insert) and genomic DNA (6.8 kb insert) probes of the human gene. There have
      been two provisional assignments for the TS gene to 18pter-q12 and 18q21-qter.
      The present result confirmed the first of these and further localized the TS gene
      to the telomeric region of the short arm of chromosome 18. The TS gene appears to
      be a novel telomeric anchor point for the construction of both physical and
      genetic linkage maps of human chromosome 18.

PMID- 2227946
TI  - Identification and characterization of normal length nonfluorescent Y
      chromosomes: cytogenetic analysis, southern hybridization and non-isotopic in
      situ hybridization.
AB  - In two female patients with a 45,X/46,X, +mar karyotype the marker chromosomes
      were identified as normal length nonfluorescent Y chromosomes (nlYnf) using non
      isotopic in situ hybridization (NISH) complementary to routine cytogenetic
      analysis and Southern hybridization. The recognition of the nlYnf as isodicentric
      in both patients illustrates and confirms the usefulness and importance of NISH
      in the identification and characterization of this and many other types of
      complex chromosome rearrangements.

PMID- 2227948
TI  - Direct carrier detection by in situ suppression hybridization with cosmid clones
      of the Duchenne/Becker muscular dystrophy locus.
AB  - A basic problem in genetic counseling of families with Duchenne/Becker muscular
      dystrophy (DMD/BMD) concerns the carrier status of female relatives of an
      affected male. In about 60% of these patients, deletions of one or more exons of
      the dystrophin gene can be identified. These deletions preferentially include
      exon 45, which can be detected by multiplex polymerase chain reaction (PCR) and
      Southern blot analysis of genomic cosmid clones that map to this critical region.
      As a new approach for definitive carrier detection, we have performed chromosomal
      in situ suppression (CISS) hybridization with these cosmid clones in female
      relatives of four unrelated patients. In normal females, most metaphases showed
      signals on both X chromosomes, whereas only one X chromosome was labeled in
      carriers. Our results demonstrate that CISS hybridization can define the carrier
      status in female relatives of DMD patients exhibiting a deletion in the
      dystrophin gene.

PMID- 2227949
TI  - Localization of the gene for amiloride binding protein on chromosome 7 and RFLP
      analysis in cystic fibrosis families.
AB  - The apical sodium channel is essential for sodium reabsorption by the kidney. Its
      activity is blocked by the diuretic amiloride. Using a human cDNA coding for the
      amiloride binding protein (ABP), the corresponding structural gene was mapped to
      human chromosome 7q34-q36 by in situ hybridization. This region flanks the region
      implicated in cystic fibrosis (7q32). Because an alteration of the amiloride
      sensitive sodium channel function has been suggested in cystic fibrosis, a
      possible link between the ABP gene and this disease was analyzed by restriction
      fragments length polymorphism (RFLP) analyses. From this study, it appears that
      the gene coding for ABP is not directly modified by mutations causing cystic
      fibrosis.

PMID- 2227950
TI  - X chromosome imprinting in fragile X syndrome.
AB  - Laird et al. (1987) hypothesized that there are at least four cis-acting alleles
      or 'chromosome states' at Xq27 that increasingly delay replication at this
      chromosomal area resulting in its increasing fragility in vitro. When on the
      inactive X chromosome, the proposed third ('mutated') allele can permanently
      block reactivation of its cis Xq27 area as the chromosome passes through female
      meiosis. Males and some females who inherit such an 'imprinted' fragile X
      chromosome (the fourth proposed allele) will be clinically affected due to
      impaired transcription of genes in the 'imprinted' Xq27 area. To test this
      hypothesis, late replication reverse banding patterns at Xq27 were evaluated in
      cultured lymphoblastoid cell lines from 25 subjects. Our data suggest that DNA
      replication of the presumed 'imprinted' Xq27 region in affected fragile X
      patients is indeed later relative to Xq27 on the active X chromosome in other
      subjects. These results support in part Laird's hypothesis of chromosomal
      imprinting in fragile X syndrome.

PMID- 2227951
TI  - Crossovers within a short DNA sequence indicate a long evolutionary history of
      the APRT*J mutation.
AB  - Adenine phosphoribosyltransferase (APRT) deficiency causing 2,8-dihydroxyadenine
      urolithiasis and renal failure is present at a high frequency among the Japanese
      but not other ethnic groups. A special type of mutant allele, designated APRT*J,
      with a nucleotide substitution at codon 136 from ATG (Met) to ACG (Thr) is
      carried by approximately 79% of all Japanese 2,8-dihydroxyadenine urolithiasis
      patients. We analyzed mutant alleles of 39 APRT deficient patients using a
      specific oligonucleotide hybridization method after in vitro amplification of a
      part of the genomic APRT sequence. We found that 24 had only APRT*J alleles.
      Determination of the haplotypes of 194 APRT alleles from control Japanese
      subjects and of the 48 different APRT*J alleles indicated that normal alleles
      occur in four major haplotypes, whereas all APRT*J alleles occur in only two.
      These results suggest that all APRT*J alleles have a single origin and that this
      mutant sequence has been maintained for a long period, as calculated from the
      frequency of the recombinant alleles.

PMID- 2227952
TI  - Characteristic chromosome abnormalities, including rearrangements of 6p, del(7q),
      +12, and t(12;14), in 44 uterine leiomyomas.
AB  - The cytogenetic analysis of 224 leiomyomas from 138 patients is presented. An
      insufficient number of mitoses was found in 35 tumors, normal karyotypes in 145,
      and clonal chromosome aberrations were detected in 44. The three previously
      identified cytogenetic subgroups were all represented in this series: del(7)
      (q21.2q31.2) was found in 11, trisomy 12 in five, and t(12;14)(q14-15;q23-24) in
      one leiomyoma. Rearrangements of 6p, including deletions, inversions, and various
      translocations, were found in eight tumors, thus delineating a new cytogenetic
      subgroup of uterine leiomyoma. The remaining 21 karyotypically abnormal tumors
      had nonrecurrent changes. One leiomyoma had two cytogenetically unrelated clones
      characterized by del(7)(q21.2q31.2) and +12. Karyotypic changes in two separate
      leiomyomas from the same uterus were identified in five patients; in three of
      them, different anomalies were found in the two tumors, whereas cytogenetically
      identical aberrations - del(7q) and dic(21;22) - were detected in two
      macroscopically discrete tumors. These findings suggest that whereas some
      multiple leiomyomas originate independently, others may be derived from the same
      neoplastic clone.

PMID- 2227953
TI  - Distal trisomy 14q. I. Clinical and cytogenetical studies.
AB  - Two cases of de novo duplication of the distal part of the long arm of chromosome
      14 are reported. In one case, the partial trisomy of 14q is due to translocation
      of a segment (14q24 to 14qter) at the end of the satellite stalk of chromosome
      14. The clinical picture is very severe. In the second case, a tandem duplication
      in 14 (q23----q32) is present with only minor malformations and mild mental
      retardation.

PMID- 2227954
TI  - Evidence that expression of Sp alpha I/65 hereditary elliptocytosis is compounded
      by a genetic factor that is linked to the homologous alpha-spectrin allele.
AB  - Many cases of hereditary elliptocytosis (HE) result from mutated spectrin alpha
      chains. It has repeatedly been observed that the amount of a mutant alpha-chain
      is different in various affected individuals, resulting in clinical pictures of
      variable severity. The different levels are thought to result from different
      percentages of the alpha-spectrin allele in trans. Such percentages, in turn,
      could be under genetic control. We tested this hypothesis in a large Algerian
      family with Sp alpha I/65 HE. In an informative sibship, we found three persons
      with a distinctly high level of expression of the Sp alpha I/65 variant,
      suggesting the existence, in trans, of a low percentage alpha-allele. The alpha
      spectrin gene haplotype associated with the latter was constantly - + -, based on
      the XbaI, PvuII, and MspI polymorphic sites. In contrast, a basal level of
      expression of the Sp alpha I/65 variant in the same sibship indicated, in trans,
      the existence of a normal percentage alpha-allele. The haplotype corresponding to
      this other alpha-allele was + - +. Study of another generation of the family
      showed, however, that the - + - haplotype could also be linked to a normal
      percentage alpha-allele. These results are consistent with the view that the
      expression level of alpha I/65 spectrin (and of other types of alpha-variants) is
      compounded by a genetic factor that is linked to the normal alpha-allele in
      trans. The low percentage allele itself remains silent in the simple heterozygous
      state.

PMID- 2227955
TI  - Acute intermittent porphyria caused by a C----T mutation that produces a stop
      codon in the porphobilinogen deaminase gene.
AB  - A mutation of the porphobilinogen (PBG) deaminase gene that produces the cross
      reacting immunological material (CRIM)-negative type of acute intermittent
      porphyria (AIP) has been identified in one of 43 unrelated patients with this
      form of the disorder. The mutation is a C----T transition that abolishes a PstI
      recognition site in exon 9 of the gene and converts a codon for glutamine to a
      stop codon.

PMID- 2227956
TI  - Clinical and genetic heterogeneity in retinitis pigmentosa.
AB  - The clinical course of defective vision and blindness has been investigated in
      relation to different modes of genetic transmission in a large series of 93
      families with retinitis pigmentosa (RP). For autosomal dominant RP, two clinical
      subtypes could be distinguished according to the delay in macular involvement. In
      the severe form, macular involvement occurred within 10 years, while in the mild
      form, macular involvement occurred after 20 years. Interestingly, a significant
      increase of mean paternal age (38.8 years, mean controls in France = 29.1 years,
      P less than 0.001) was found in this form of RP, a feature which is suggestive of
      new mutations. For autosomal recessive RP, four significantly different clinical
      subtypes could be recognized, according to both age of onset and the pattern of
      development (P less than 0.001), namely cone-rod dystrophy and early-onset severe
      forms on the one hand (mean age of onset = 7.6 years), late-onset mild forms and
      senile forms on the other. Similarly, two significantly different clinical
      subtypes could be recognized in X-linked RP, according to both mode and age of
      onset, which were either myopia (mean age = 3.5 +/- 0.5 years) or night blindness
      (mean age = 10.6 +/- 4.1 years. P less than 0.001). By contrast, no difference
      was noted regarding the clinical course of the disease, which was remarkably
      severe whatever the clinical subtype (blindness before 25 years). In addition,
      all obligate carriers in our series were found to have either severe myopia or
      pigment deposits in their peripheral retina. Finally, sporadic RP represented the
      majority of cases in our series (42%). There was a considerable heterogeneity in
      this group, and at least three clinical forms could be recognized, namely cone
      rod dystrophy, early onset-severe forms and late onset moderate forms. At the
      beginning of the disease, the hereditary nature of the sporadic forms was very
      difficult to ascertain (especially between 7-10 years) and only the clinical
      course could possibly provide information regarding the mode of inheritance.
      However, the high level of consanguinity, and the high sex ratio in early onset
      and severe sporadic forms (including cone-rod dystrophy), was suggestive of an
      autosomal or X-linked recessive inheritance, while increased paternal age in late
      onset forms was suggestive of autosomal dominant mutations.

PMID- 2227957
TI  - Fragile X expression and X inactivation. I. The expression of the fragile site at
      Xq27.3 is not suppressed on inactive X chromosomes separated from the active
      homologue.
AB  - The inactive fragile X chromosomes of a 47,fra(X),fra(X),Y male with a typical
      fragile X phenotype were successfully separated from the active homologues by
      means of somatic cell hybridization. It was shown by FUdR-induction and caffein
      posttreatment that the separated inactive X chromosomes expressed their fragile
      sites and that the presence of an active mutated X chromosome was not a
      prerequisite for fragile X expression. The fragility seems to be an intrinsic
      property of the individual fragile site. This result is in favour of the
      classical concept that the fragile site at Xq27.3 has a primary pathogenetic
      function in this syndrome, although the fragility itself could represent a
      secondary phenomenon related to an unknown alteration of the DNA in this
      chromosome region. It is also concluded that inactivation of the fragile X
      chromosome in females is not responsible for either false negative fragile X
      findings or the observation of fragile X negative colonies isolated from fragile
      X positive fibroblasts in heterozygotes.

PMID- 2227959
TI  - An informative polymorphism detectable by polymerase chain reaction at the 3' end
      of dystrophin gene.

PMID- 2227960
TI  - Applying health promotion to seniors' dental health: the Toronto experience.

PMID- 2227958
TI  - A ZFY-negative 46,XX true hermaphrodite is positive for the Y pseudoautosomal
      boundary.
AB  - Two loci on the short arm of the human Y chromosome have recently been described
      as candidates for the testis determining factor (TDF); namely, ZFY, and a locus
      distal to ZFY, near the pseudoautosomal boundary. We have previously reported on
      seven 46,XX true hermaphrodites and one 45,X mixed gonadal dysgenesis case all
      presenting with testicular tissue in their gonads in the apparent absence of Y
      specific DNA sequences. A reanalysis of these cases shows them all to lack ZFY,
      but one 46,XX true hermaphrodite carries sequences next to the Y pseudoautosomal
      boundary. This case provides further evidence for assigning the TDF locus very
      close to the pseudoautosomal region on Yp.

PMID- 2227961
TI  - [In Tunisia: description of a health education program based on socio-cultural
      realities].
AB  - Structured within the framework of the National Programme for the Fight Against
      Diarrhoea in Tunisia, (PNLAD) the goal of the LAD Project is to improve the
      understanding and in-home treatment of diarrhoea by mothers. The programme
      consists of three elements: education of the mothers through health centers and
      preschool institutions, training of health care and social workers, and a mass
      media campaign. This article discusses the education programme for mothers
      through preschool institutions. Before embarking on its education programme, the
      project team conducted a preliminary study in order to establish what level of
      knowledge of diarrhoea existed among the general population and what current
      treatment methods were used. The study consisted of small discussion groups
      composed of mothers, grandmothers, and fathers. In evaluating current notions
      regarding diarrhoea, the study noted the various vocabulary used and its meaning
      for both diarrhoea and dehydration. It also examined the general beliefs of what
      caused diarrhoea and what people believed would cure and/or prevent the disease.
      As far as treatment methods were concerned, it was important to understand the
      origins of the various remedies, the level of awareness of the formal and
      informal health channels that existed and the different kinds of treatment based
      on diet, mother's milk, liquids, saline/sugar solutions and medication. The
      second key aspect of the programme concerned the kind of educational materials
      and teaching methods used. Both had to be geared towards the teaching of adults
      while insuring a real exchange of knowledge and experience between the population
      and the development personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2227963
TI  - The IUHE: "Vision 2000" a draft strategy.

PMID- 2227962
TI  - Strengthening the effects of schooling on health practices in Kenya.

PMID- 2227965
TI  - Health coverage in Indian English newspapers.

PMID- 2227964
TI  - Bottle-feeding: an already entrenched practice that needs active discouragement
      in developing communities.

PMID- 2227966
TI  - Media consultation on AIDS.

PMID- 2227967
TI  - Health for all by the year 2000: a challenge to behavioural sciences and health
      education.

PMID- 2227968
TI  - Vector quantization for compression of multichannel ECG.
AB  - We propose a scheme based on vector quantization (VQ) for the data-compression of
      multichannel ECG waveforms. N-channel ECG is first coded using m-AZTEC, a new,
      multichannel extension of the AZTEC algorithm. As in AZTEC, the waveform is
      approximated using only lines and slopes; however, in m-AZTEC, the N-channels are
      coded simultaneously into a sequence of N + 1 dimensional vectors, thus
      exploiting the correlation that exists across channels in the AZTEC duration
      parameter. Classified vector quantization (CVQ) of the m-AZTEC output is next
      performed to exploit the correlation in the other AZTEC parameter, namely, the
      value-parameter. CVQ preserves the waveform morphology by treating the lines and
      slopes as two perceptually-distinct classes. Both m-AZTEC and CVQ provide data
      compression and their performance improves as the number of channels increases.
      Moreover, the final output differs little from the AZTEC output and hence ought
      to enjoy the same acceptability.

PMID- 2227969
TI  - An approach to cardiac arrhythmia analysis using hidden Markov models.
AB  - This paper describes a new approach to ECG arrhythmia analysis based on "hidden
      Markov modeling" (HMM), a technique successfully used since the mid-1970's to
      model speech waveforms for automatic speech recognition. Many ventricular
      arrhythmias can be classified by detecting and analyzing QRS complexes and
      determining R-R intervals. Classification of supraventricular arrhythmias,
      however, often requires detection of the P wave in addition to the QRS complex.
      The hidden Markov modeling approach combines structural and statistical knowledge
      of the ECG signal in a single parametric model. Model parameters are estimated
      from training data using an iterative, maximum likelihood reestimation algorithm.
      Initial results suggest that this approach may provide improved supraventricular
      arrhythmia analysis through accurate representation of the entire beat including
      the P wave.

PMID- 2227970
TI  - Ventricular tachycardia and fibrillation detection by a sequential hypothesis
      testing algorithm.
AB  - An algorithm for detecting ventricular fibrillation (VF) and ventricular
      tachycardia (VT) by the method of sequential hypothesis testing is presented. The
      algorithm first generates a binary sequence by comparing the signal to a
      threshold. The probability distribution of the time intervals of the binary
      sequence is obtained, and Wald's sequential hypothesis testing procedure is next
      employed to discriminate the arrhythmias. Sequential hypothesis testing of 85
      cases resulted in identification of 1) 97.64% VF and 97.65% VT episodes after 5
      s, and 2) 100% identification of both VF and VT after 7 s. The desired false
      positive and false negative error probabilities can be preprogrammed into the
      algorithm. An important feature of the sequential method is that extra time for
      detection can be traded off for improved accuracy, and vice versa.

PMID- 2227971
TI  - Standardized evaluation of techniques for measuring the spectral compression of
      the myoelectric signal.
AB  - A digital algorithm was designed to produce band-limited noise with adjustable
      median frequency and amplitude. This algorithm produces test signals with
      spectral characteristics typical of those of the surface myoelectric signals
      encountered in muscle fatigue studies. These synthesized signals provide the
      basis for standardized evaluation of the performance of various techniques which
      monitor the spectral compression of the myoelectric signal during muscle fatigue.

PMID- 2227972
TI  - Simulation of propagation along a cylindrical bundle of cardiac tissue--I:
      Mathematical formulation.
AB  - This paper presents a mathematical description based on a three-dimensional model
      for studying propagation in cardiac muscle. The model makes use of the bidomain
      concept to construct a representation of a cylindrical, multicellular bundle
      lying in an extensive volume conductor. The equations for the cylindrical
      bidomain are derived here for different combinations of boundary conditions and
      simplifying assumptions. The analysis shows that an analytic model for
      propagation can be set up if one assumes that the ratio of the intracellular and
      interstitial bidomain conductivities in the radial and axial direction are the
      same (i.e., equal anisotropy) and the intracellular radial current density
      vanishes at the surface. The simulation of this model will be discussed in a
      subsequent paper. As a point of reference, the classical one-dimensional cable
      model is also examined and the expressions governing propagation are reformulated
      to account for the extracellular medium, a factor ignored in most simulation
      studies.

PMID- 2227973
TI  - Simulation of propagation along a cylindrical bundle of cardiac tissue--II:
      Results of simulation.
AB  - Previous evaluations of the cylindrical bidomain model of a bundle of cardiac
      tissue, have been obtained by using an analytic function for the transmembrane
      potential and assuming the activating wavefront through the bundle cross section
      is planar. In this paper, nonlinear membrane kinetics are introduced into the
      bidomain membrane and equal anisotropy ratios are assumed, permitting the
      transmembrane potential to be computed and its behavior examined at different
      depths in the bundle and for different values of conductivity and bundle
      diameters. In contrast with single fiber models, the bundle model reveals that
      the shape of the action potential is influenced by tissue resistivities. In
      addition, the steady-state activation wavefront through the cross-section
      perpendicular to the long axis of the bundle is not planar and propagates with a
      velocity that lies between that of a single fiber in an unbounded volume and a
      single fiber in a restricted extracellular space. In general, the bundle model is
      shown to be significantly better than the classical single fiber model in
      describing the behavior of real cardiac tissue.

PMID- 2227974
TI  - Evaluation of shoulder movement as a command control source.
AB  - The purpose of this study was to evaluate the use of scapular shoulder movement
      as a command control source. The focus of this study was on the evaluation of
      movement signals from quadriplegic subjects as well as on the processing of these
      signals for use as command inputs to a functional neuromuscular stimulation (FNS)
      hand-grasp system. The shoulder movement of three C5-level quadriplegic and nine
      normal subjects was studied using externally mounted two-degree-of-freedom
      transducers overlying the sternum and clavicles. The C5-level quadriplegic
      subjects tested had a considerably poorer range of motion than the normal
      subjects. The range of motion was greatest in elevation but was coupled with a
      significant component of retraction. The vertical command resolution of the
      quadriplegic subjects ranged from eight to 13 command levels, whereas the
      horizontal range contained four or fewer command levels. Normal subjects were
      able to produce 26 to 79 command levels along the vertical axis and 18 to 85
      along the horizontal axis. Subjects were able to maintain a static command level
      to within several percent of their range in trials lasting from 10 to 30 s. The
      quadriplegic subjects performed poorly in tasks where they were required to move
      to a point along the horizontal or vertical central axis and then along the
      opposite axis. The normal subjects were readily able to perform these tasks. The
      interference with the command signal due to movement of the opposite extremity
      was significant, with a maximum error ranging between 25 and 86% along the
      vertical axis and between 38 and 105% along the horizontal axis. Rise time and
      normalized velocity (velocity divided by the size of the movement) were found to
      be suitable for distinguishing different types of shoulder movements independent
      of the size of the movement. Shoulder movement in quadriplegics is suitable as a
      command control source for a FNS hand-grasp system requiring one proportional
      command signal and at least one logical command signal with appropriate
      processing of the signals. The available transducers are cosmetically acceptable
      and are easy to don and doff. Use of shoulder movement as a command control
      source does not interfere with other activities of the user such as eating or
      talking. Shoulder movement also provides a command control source that is easy
      for the user to learn and provides some feedback to the user through shoulder
      proprioception.

PMID- 2227975
TI  - Restoring unassisted natural gait to paraplegics via functional neuromuscular
      stimulation: a computer simulation study.
AB  - Functional neuromuscular stimulation (FNS) of paralyzed muscles has enabled
      spinal-cord-injured patients to regain a semblance of lower-extremity control,
      for example to ambulate while relying heavily on the use of walkers. Given the
      limitations of FNS, specifically low muscle strengths, high rates of fatigue, and
      a limited ability to modulate muscle excitations, it remains unclear, however,
      whether FNS can be developed as a practical means to control the lower extremity
      musculature to restore aesthetic, unsupported gait to paraplegics. A computer
      simulation of FNS-assisted bipedal gait shows that it is difficult, but possible
      to attain undisturbed, level gait at normal speeds provided the electrically
      stimulated ankle plantarflexors exhibit either near-normal strengths or are
      augmented by an orthosis, and at least seven muscle-groups in each leg are
      stimulated. A combination of dynamic programming and an open-loop, trial-and
      error adjustment process was used to find a suboptimal set of discretely-varying
      muscle stimulation patterns needed for a 3-D, 8 degree-of-freedom dynamic model
      to sustain a step. An ankle-foot orthosis was found to be especially useful, as
      it helped to stabilize the stance leg and simplified the task of controlling the
      foot during swing. It is believed that the process of simulating natural gait
      with this model will serve to highlight difficulties to be expected during
      laboratory and clinical trials.

PMID- 2227976
TI  - An improved video-based computer tracking system for soft biomaterials testing.
AB  - We present an improved video-based computer system for on-line tracking of small
      markers moving in a plane. The system consists of a CCD camera, a video monitor,
      a dedicated 80386/20 microcomputer, a video frame grabber, and custom software.
      Up to four markers can be tracked at the 30-Hz video frame rate using a two-step,
      correlation-based search procedure. We discuss the requisite hardware and
      software requirements and illustrate how this tracking system can be used to
      collect strain data during biaxial stretching tests on planar soft tissues.
      Operating at 30 Hz, this system is an improvement over those previously reported,
      which are either slower or yield less information.

PMID- 2227978
TI  - Two requirements for job contentment: autonomy and social integration.
AB  - The interaction of autonomy (control over work activities) and social integration
      (relationships with co-workers) was investigated in a sample of newly employed
      nurses in the 6th and 12th month of work. Those nurses with low autonomy and low
      social integration reported low job satisfaction and work motivation, poor
      commitment to the organization and less intent to stay on the job. They were
      older, with more experience and more education and tended to work on medical
      units. This study supports the notion of feminist psychologists that what women
      nurses want is "autonomy with connectedness".

PMID- 2227977
TI  - An umbilical data-acquisition system for measuring pressures between the foot and
      shoe.
AB  - We have developed an umbilical data-acquisition system for measuring pressures
      between the foot and shoe during walking. It consists of pressure sensors in the
      insoles of shoes, amplifier circuits, umbilical cables, an analog-to-digital
      converter, and a graphics display card in an IBM PC for real-time data collection
      and display. The applied pressure on a sensor decreases its resistance, which
      causes the output voltage of the amplifier circuit to increase. We attach seven
      sensors to the surface of each insole of a pair of extra-depth shoes and
      calibrate all the sensors in the insole before and after each test using a load
      cell as a reference. The IBM PC samples the outputs from the sensor and the load
      cell and stores a piecewise linear lookup table for use in compensation for the
      nonlinearity of the sensor. On the PC's graphics display, two programs provide
      displays of foot pressures as real-time bar graphs or as analog pressure versus
      time curves.

PMID- 2227979
TI  - Wife rape in a sample of psychiatric patients.
AB  - A descriptive study of 53 ever-married women currently being treated for primary
      depression or anxiety documented that wife rape is a significant negative factor
      in the lives of these women and is positively correlated with a history of
      childhood sexual abuse. The study identified the incidence of wife rape in this
      sample and described co-variables of the wife rape experience. The findings from
      this research may be used by nurses to increase the effectiveness of their care.

PMID- 2227981
TI  - Passage through infertility treatment: a stage theory.
AB  - This grounded theory study explored the perceptions of 25 couples as they
      underwent infertility assessment and treatment. A substantive theory of passage
      through infertility treatment explains the psychosocial responses of couples to
      their infertility from prediagnosis to posttreatment. The theory consists of
      three concepts--engagement, immersion and disengagement. Eight stages were
      identified within these concepts: experiencing a dawning of awareness, facing a
      new reality, having hope and determination, intensifying treatment, spiralling
      down, letting go, quitting and moving out, and shifting the focus.

PMID- 2227980
TI  - Overadherence with breast self-examination recommendations.
AB  - Overadherence with breast self-examination (BSE) was studied to seek explanations
      for this phenomenon and to suggest individualized interventions for the
      performance of BSE. In a descriptive study, women attending BSE instruction (N =
      264) were interviewed regarding their beliefs as well as peer and professional
      interactions about breast self-examination. Of these women, 29 (11%) were
      overadherent; they had the highest rates of breast disease and the least
      professional instruction and encouragement for BSE. Ironically, some women
      perform BSE repeatedly because they lack sufficient knowledge and confidence.
      Clinicians should assess women's knowledge of BSE as well as their skill to
      provide individualized clarification.

PMID- 2227982
TI  - Impact of work stress on female nurse educators.
AB  - Factors predictive of work-related stress in 287 female nurse educators were
      studied in a randomly selected sample of 18 U.S. (NLN) accredited schools of
      nursing. The Maslach Burnout Inventory-Form Ed, the Hardiness of Personality
      Inventory, the Blair Exercise Activity Index, a demographic tool and an
      administrator-completed questionnaire were used. Moderate levels of stress were
      found to exist, with five individual variables (hardiness, age, education, years
      in nursing education and exercise) and five organizational variables (student
      contact hours for part-time faculty, task complexity, economic environment of
      school, number of full-time faculty and percentage of tenured faculty) combining
      to best predict the occurrence of work-related stress.

PMID- 2227983
TI  - Critical multiplism: a research strategy for nursing science.
AB  - This paper describes critical multiplism from the perspective of the world views
      and models of scientific inquiry that frequently guide the work of nurse
      scientists. Nurse scientists may wish to consider critical multiplism as a
      research strategy within a dialectical model of scientific inquiry to study the
      multiple realities of interest to nurses. This approach to nursing knowledge
      development may enhance the usefulness of nursing research findings in nursing
      practice.

PMID- 2227984
TI  - The metalanguage of menopause research.
AB  - Nurse scholars often debate such technical issues as when to use quantitative or
      qualitative methods or some combination of methods. The proper focus of a
      discussion on nursing science should be the basic assumptions and values of
      various approaches to research. Unless we gain an awareness and appreciation of
      the human process of knowledge generation, our research questions will remain
      limited, and nursing practice will be shaped in ways that may be neither coherent
      nor consistent with our philosophies of nursing. Used to demonstrate this
      position, is the knowledge of menopause gleaned through a philosophical inquiry
      of the biomedical and sociocultural approaches to menopause research.

PMID- 2227985
TI  - Preventive intervention following accidental death of a child.
AB  - This paper describes the development and pilot testing of an empirically and
      theoretically based preventive intervention program for bereaved parents whose
      adolescent and young adult children died suddenly following an accident. The
      parents were assigned to either an early (2-6 months postloss) or a later (7-13
      months postloss) transition group (N = 15) in which they received two-dimensional
      preventive intervention: informational support and emotional support. A
      comparison group (N = 19) received no intervention. Weekly and summative
      evaluations completed by bereaved parents and group leaders showed the
      therapeutic benefits of the preventive intervention for both treated groups.
      However, the two groups responded differently to the interventions, suggesting
      that timing and type of support might both be important factors to consider.

PMID- 2227986
TI  - Openness: a qualitative analysis of nurses' and patients' experiences of
      therapeutic touch.
AB  - The constant comparative method was used to generate a grounded theory explaining
      the process of therapeutic touch for seven nurses and seven patients. Interviews
      and observations of one treatment session each indicate that the primary
      experience of therapeutic touch is opening to the flow of the universal life
      energy. This includes three major categories of experience: (a) opening intent-
      allowing oneself to focus on getting the universal life energy moving again; (b)
      opening sensitivity--assessing the quality of its flow; and (c) opening
      communication--participating in a healing relationship that unblocks, engages and
      enlivens its movement. Further research on therapeutic touch using qualitative
      methodology may deepen our understanding of the inner experiences of both
      patients and nurses to experiences that facilitate the healing process.

PMID- 2227987
TI  - Subjectively perceived quality of life.
AB  - Subjectively perceived quality of life is a priority concern in planning,
      implementing and evaluating health policy and treatment decisions. The lack of a
      universally accepted definition of this multivariate concept is a barrier to
      sound research. This article analyzes the concept of subjectively perceived
      quality of life to determine its critical attributes, antecedents and
      consequences to establish a basis for an operational definition for use in
      research.

PMID- 2227988
TI  - Functional status during pregnancy and the postpartum: a framework for research.

PMID- 2227990
TI  - A nursing model for homeless families.

PMID- 2227989
TI  - Nightingale, nursing and harassment.

PMID- 2227991
TI  - Presence of host-reactive and MHC-restricted T cells in a transplanted severe
      combined immunodeficient (SCID) patient suggest positive selection and absence of
      clonal deletion.

PMID- 2227992
TI  - Tolerance in vivo and in vitro.

PMID- 2227993
TI  - Imprint of thymic selection on autoreactive repertoires.
AB  - We have focussed on the differences in origin and physiological properties of two
      classes of self-reactive T cells. Autoreactive T cells described in many
      laboratories are activated in the course of normal immune responses to foreign
      antigen. These T cells can be shown under well-defined conditions to be the
      direct progeny of antigen-stimulated precursors. This, together with evidence
      that their activation requirements can be distinguished from those of antigen
      specific, MHC-restricted T cells, leads us to suggest that they represent a
      particular physiological state that recapitulates the conditions of thymic
      selection and is induced in many antigen-specific, MHC-restricted peripheral T
      cells as a result of normal antigen-dependent activation. Although it appears
      that the associated physiological properties can be stable in some in vitro
      maintained lines, it is possible that this is normally a transient state in vivo.
      Available evidence concerning the specificity of these T cells indicates only
      that they can be activated in the absence of any identifiable foreign antigen by
      class II MHC-syngeneic but not MHC-allogeneic stimulators. We have suggested that
      such T cells are specific for the same elements, possibly an association of MHC
      and other self-peptides (Singer et al. 1987), that are the basis for positive
      selection in the thymus. The properties of these autoreactive T cells need to be
      distinguished from those of T cells associated with autoimmune pathology. It is
      presumed that autoimmune T cells are directly activated in a resting state by
      specific self-peptides. Our interest in distinguishing these self-reactive T-cell
      populations has focussed on different predictions concerning the diversity of
      their associated self-reactive repertoires. The relative complexity of the immune
      repertoire expressed in autoreactive T cells expanded by positive selection and
      restimulated in the course of normal antigen-specific immune responses should be
      considerably greater than that of autoimmune T cells constrained by negative
      selection and a narrow window of escape from self-tolerance. We were greatly
      hindered in our initial efforts in this analysis by the considerable effort
      required to characterize any specific immune repertoire. A published technique
      employing poly(A) tailing (Frohman et al. 1988) did not work efficiently in our
      hands, although others (Loh et al. 1989) have apparently had some success. We
      describe above an alternative approach, linker-facilitated PCR, which we have
      employed for efficient repertoire analysis. Using this method we have been able
      to identify dominant utilization of the Va4 family in T cells specific for the
      synthetic peptide YYEELLKYYEELLK.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2227995
TI  - Images of caring. My day with Helen.

PMID- 2227994
TI  - Autoreactive HLA-DR-specific autoreactive T-cell clones: possible regulatory
      function for B lymphocytes and hematopoietic precursors.
AB  - The physiological significance of autoreactive T cells derived from normal
      individuals and activated in the absence of any identifiable foreign antigen by
      class II MHC-syngeneic molecules remains unexplained. Here we report that
      autoreactive T-cell clones (Tilkin et al. 1987) proliferate and are able to kill
      autologous or syngeneic EBV-cell lines but not autologous or syngeneic HLA-Class
      II-positive PHA-activated T-cell blasts. Furthermore, they are able to
      efficiently inhibit in vitro the differentiation of CFU-GM and BFU-E colonies, in
      agreement with the well-known observation that hematopoietic precursors express
      HLA-DR molecules (Cannistra et al. 1986). The reasons why the autoreactive clones
      do not recognize T-cell blasts, as well as their possible implications in
      regulatory mechanisms involving HLA-class II molecules are discussed.

PMID- 2227996
TI  - ECMO therapy.

PMID- 2227997
TI  - Your personal business. Planning for your retirement.

PMID- 2227998
TI  - Orthopaedic nursing: nursing is the operative word.

PMID- 2227999
TI  - The use of physical restraints for the elderly.

PMID- 2228000
TI  - The future of gerontic nursing.

PMID- 2228001
TI  - How did this happen to your little boy?

PMID- 2228004
TI  - The future of pediatric nursing: anticipating the health care needs of children.

PMID- 2228002
TI  - Perceptions from the nursing home: how we can make a difference.

PMID- 2228003
TI  - Understanding the psychosocial challenges of older adulthood.

PMID- 2228005
TI  - The arts: helping children cope with hospitalization.

PMID- 2228006
TI  - What do I say when a baby is born with a birth defect?

PMID- 2228008
TI  - Ethics in nursing education: reexamining the need.

PMID- 2228007
TI  - Solutions to the nursing shortage. Second place winner--NSNA/Johnson & Johnson
      Consumer Products Essay Contest.

PMID- 2228009
TI  - A case control study of cancer cervix patients attending Command Hospital, Pune.
AB  - A case control study was undertaken with the objective to determine the
      association of certain host factors like marital status, age at first marriage,
      duration of married life, parity, literary status and genital hygiene, in the
      subsequent development of cancer cervix. A total number of ninety-two cases and
      an equal number of control subjects, under matched case control design, were
      studied at Command Hospital, Pune over a period of nine months. Salient findings
      of this epidemiological study have been highlighted in this communication. Few of
      the risk factors viz early age at first marriage, longer duration of married
      life, increased and early parity, low educational status and poor genital hygiene
      were found to have played significant role in the subsequent development of
      carcinoma cervix.

PMID- 2228010
TI  - Histopathological changes following anterior chemotherapy in advanced breast
      cancer.
AB  - Twenty five patients of advanced breast cancer (Stage IIIb and IV) were studied
      and the histological changes following chemotherapy were looked. All the tumours
      showed varying degree of histological changes. Twenty eight percent tumours
      showed Grade I changes, 28 percent had Grade II changes and 28 percent had Grade
      III changes. Residual tumour was present in all the cases. The tumour showing
      higher grade of cancer cell degeneration following chemotherapy had better
      response. Seven tumours showing Grade III changes had 85.7 percent partial
      response. No complete response was achieved.

PMID- 2228011
TI  - Adenolymphoma of lacrimal sac. A case report.

PMID- 2228012
TI  - Calcified hypernephroma. A case report.
AB  - Pattern of classification in an renal neoplasm is variable. If calcium is located
      nonperipherally (within the mass) it is more likely to be a renal cell carcinoma.
      But peripheral calcification does not rule out malignancy.

PMID- 2228013
TI  - Non functioning kidney in renal cell carcinoma. Case report of an unusual cause.

PMID- 2228014
TI  - Coagulant and fibrinolytic activities of a metastasising and non-metastasising
      tumour line.
AB  - The two types of transplantable methyl cholanthrene induced fibrosarcoma in rats
      was used to find out the possible relationship between the fibrinolytic,
      procoagulant activities and the metastasizing capacity of the tumours. The highly
      metastatic tumour seems to possess high fibrinolytic activity as compared to the
      low metastatic one. Interestingly enough, it was found that the procoagulant and
      fibrinolytic activities in the highly metastasising tumour bear inverse
      relationship with each other in relation to time of tumour growth. The
      procoagulant activity of the tumour bypasses factor VII and acts at factor X
      level. The plasminogen activator present in the tumour tissue has been
      characterized by sephadex G-200 column chromatography and PAGE.

PMID- 2228015
TI  - Cancer projection by the turn of century-Indian science.
AB  - This is an attempt to understand the magnitude of cancer problem in India. The
      incidence data generated by the three population based cancer registries at
      Bangalore, Bombay and Madras and the population projections of country have been
      utilised for estimating the present and future load of new cancer cases. It is
      estimated that the total number of incident cases in males increased from 0.29
      million to 0.43 million by the turn of the century as a result of change in size
      and composition of population and when adjusted for tobacco habits the estimates
      increased to 0.49 million. In females the incident cases of cancer for three
      registries increased from 0.32 to 0.42 million by 2001, with cancer of uterine
      cervix and breast being the major problems. The above results show an urgent need
      for strengthening and augmenting the existing diagnostic/treatment facilities
      which are vow fully inadequate to tackle even the present load.

PMID- 2228016
TI  - Secondary carcinoma of testis--a clinicopathologic study of 10 cases.
AB  - Ten cases of metastatic carcinomas to the testis are recorded in the last 17
      years from Tata Memorial Hospital (TMH). There were two from kidney and four each
      from prostate and gastrointestinal tract carcinomas. The age of the patients
      ranged from 40 to 82 years with a mean of 57 years. The disease was unilateral in
      eight cases and bilateral in two. The testicular mass preceded the symptomatology
      of the primary lesion in a single case. The disease was an incidental finding in
      three prostatic carcinomas, where bilateral orchidectomy was performed as a
      therapeutic procedure. Hydrocele was associated in three cases. Grossly the
      tumour deposits were nodular or diffuse. Microscopically involvement of the
      interstitial parenchyma, with sparing of the tubular structures of the testis,
      epididymis and retetestis and special stains for mucin were helpful in the
      diagnosis. Lymphatic emboli were present in six cases and vascular emboli in
      three. The spermatic cord was involved in two cases.

PMID- 2228017
TI  - Pediatric cancer care in India. A national survey.
AB  - A national survey of institutions treating children with cancer was undertaken in
      April 1988. The 21-item questionnaire included questions on personnel, treatment
      facilities, support services, attitudes and opinions regarding pediatric cancer
      care. 73 institutions responded. From the survey, it emerged that pediatricians
      did not see all pediatric patients with cancer at one-third of the respondent
      institutions. 50 percent of cancer centres did not have pediatricians. Cancer
      centres were better staffed with specialist personnel and better support
      services. Respondents felt that pediatric oncologists and specialist support
      personnel were necessary for optimal pediatric cancer care and facilities at
      medical colleges needed to be improved because of the large number of children
      with cancer treated at these institutions.

PMID- 2228018
TI  - Activation of idiotype-specific CD4+ T-cell line: cellular processing of
      exogenous self-immunoglobulin.
AB  - An idiotype (Id)-specific long-term cultured T-cell line has been generated from
      BALB/c mice immunized with M315 (alpha, lambda 2). The cell line comprises both
      CD3+ and CD4+ but CD8- cells. The T-cell line is stimulated in a class II major
      histocompatibility complex (MHC)-restricted manner, and is capable of producing
      interleukin-2 (IL-2) in response to the Id along with Iad-bearing antigen
      presenting cells (APC). Fine Id specificity analysis has shown that changes in
      amino acid residues, Phe-94, Arg-95 and Asn-96, located on the VL-315, resulting
      from a somatic mutation mechanism of the mouse V lambda 2 gene, contribute to the
      T-cell activation. Pretreatment of APC with either glutaraldehyde or
      paraformaldehyde prevented both Fv-315 and VL-315 from triggering the T cells.
      This suggested that further processing of VL is required for T-cell activation.
      To clarify this point, we have generated a synthetic peptide, designated P18,
      which spans residues 91-108 of VL-315. In sharp contrast to VL, prefixed APC were
      capable of presenting P18 to stimulate the T-cell line to induce IL-2.

PMID- 2228019
TI  - Effects of cyclosporin A on T-cell development in organ-cultured foetal thymus.
AB  - The effects of cyclosporin A (CsA) on T-cell development were assessed in an
      organ culture of murine foetal thymus. Applying three-colour flow cytometric
      analysis, we showed that the agent inhibits the development of mature CD3/T-cell
      receptor alpha beta (TcR alpha beta)+ cells both in CD4+8- and CD4-8+
      populations. CD4-8- cells appeared to be accumulated by CsA. We examined the
      heterogeneity of CD4-8- cells generated in the organ culture, and defined five
      subpopulations by the expression of the cell-surface molecules CD3/TcR, J11d and
      CD25. It has been demonstrated that only the CD3/TcR alpha beta+ J11d- CD25-
      subpopulation is susceptible to the suppressive effects of CsA among CD4-8-
      cells, whereas all the other four subpopulations, including CD3/TcR gamma delta+
      cells, are resistant. Thus, all of the TcR alpha beta-bearing cells, including
      CD4-8- cells but none of the TcR alpha beta- cells, are CsA sensitive. Because it
      is known that CsA inhibits the TcR-mediated signalling events in mature T cells
      and that signallings mediated via the interaction of TcR with major
      histocompatibility complex (MHC) molecules on thymic stroma cells are crucial for
      thymic selection of T cells, these results indicate that TcR alpha beta-bearing
      CD4-8- cells but not TcR gamma delta-bearing CD4-8- cells undergo thymic positive
      selection.

PMID- 2228020
TI  - Mechanisms of inhibition of mononuclear cell activation by the iron-chelating
      agent desferrioxamine.
AB  - Iron-withholding by the chelating agent desferrioxamine abrogates the
      proliferative response of human peripheral blood mononuclear cells (PBMC) to
      phytohaemagglutinin (PHA). The present study investigated whether desferrioxamine
      operates late in the activation process or, as recently suggested, at an early
      stage, by inhibiting the appearance of the interleukin-2 (IL-2) receptor. Human
      PBMC were stimulated with PHA (10 micrograms/ml) and [3H]thymidine ([3H]TdR)
      incorporation determined after 66 hr of culture. Greater than 90% inhibition was
      achieved by concentrations of desferrioxamine as low as 5 mumol/l present
      throughout culture, while IL-2 receptor expression (anti-Tac), analysed by FACS,
      was maintained at up to 75% of control levels. 300 mumol/l desferrioxamine
      present throughout culture abrogated [3H]TdR incorporation and additionally
      suppressed IL-2 receptor to 10-15% of control levels. In contrast, the same high
      dose of desferrioxamine when added for 2 hr to cells previously cultured for 66
      hr produced 80% inhibition of [3H]TdR incorporation but failed to inhibit
      expression of the IL-2 receptor. Desferrioxamine rapidly achieved equilibrium
      across the cell membrane (within 60 min) and chelated 59Fe delivered to activated
      cells by the transferrin endocytic cycle. These results indicate that
      desferrioxamine can inhibit T-cell activation either early or late in the process
      by chelating iron and independently of an effect on the IL-2 receptor. In support
      of a dual effect of the drug is the finding that at 50 mumol/l, desferrioxamine
      enhanced expression of the transferrin receptor occurred, an adaptive response
      made to intracellular iron depletion, while IL-2 receptor expression was
      inhibited.

PMID- 2228021
TI  - Evidence of a role for TNF-alpha in cytolysis by CD4+, class II MHC-restricted
      cytotoxic T cells.
AB  - Variants of the tumour necrosis factor (TNF)-sensitive cell lines BALB/c 3T3 and
      WEHI-164/13 were generated by selection in high concentrations of recombinant TNF
      alpha. The selected cells were highly resistant to cytolysis by both TNF-alpha
      and TNF-beta (lymphotoxin); however, there was no significant difference in
      sensitivity to killing by class I major histocompatibility complex (MHC)
      restricted cytotoxic T lymphocytes (CTL). Resistance to TNF-mediated lysis was,
      however, accompanied by increased resistance to cytolysis by CD4+ class II
      restricted CTL. Furthermore, cytolysis of WEHI-164/13 cells by CD4+ was
      completely inhibited by anti-TNF antiserum. These data strongly suggest a role
      for TNF in killing by CD4+ class II MHC-restricted CTL but not in class I MHC
      restricted killing.

PMID- 2228023
TI  - The distribution of immunoreactive interferon-alpha in formalin-fixed paraffin
      embedded normal human foetal and infant tissues.
AB  - Human foetal and infant tissues were studied to test the hypothesis that microbes
      have a role in switching on interferon-alpha (IFN-alpha) synthesis. Foetal
      tissues were essentially 'germ free', while the infants had been exposed to a
      normal microbial environment in life. IFN-alpha was first seen at 9 weeks
      gestation in macrophages in the liver and thereafter was seen in macrophages in
      most other organs. When infant lungs were compared with foetal lungs, a
      statistically significant increase in the number of macrophages and the
      percentage of these cells expressing IFN-alpha was noted in the infant lungs. No
      such change was observed in spleen, liver and thymus following birth. These
      findings suggest that there is a basal production of IFN-alpha by macrophages
      that is not dependent on microbial products, but that such products can enhance
      synthesis of this cytokine.

PMID- 2228022
TI  - Generation and characterization of a neutralizing rat anti-rmTNF-alpha monoclonal
      antibody.
AB  - A rat anti-recombinant mouse tumour necrosis factor-alpha (rmTNF-alpha)
      monoclonal IgM antibody (1F3F3) with high specific binding activity for rmTNF
      alpha was generated. The 1F3F3 monoclonal antibody (mAb) neutralizes the
      cytotoxic activity in vitro of rmTNF-alpha on L929 cells and inhibits the binding
      of radiolabelled rmTNF-alpha to its putative receptor on L929 cells. The 1F3F3
      mAb binds to monomeric, dimeric and trimeric rmTNF-alpha and does not bind to
      reduced rmTNF-alpha, indicating that the recognized epitope is sensitive to
      denaturation. Using the 1F3F3 mAb as a capturing antibody and a biotinylated anti
      rTNF-alpha as a detecting antibody, we have developed a sandwich ELISA that can
      specifically detect biologically active mTNF-alpha with a detection limit of 10
      pg mTNF-alpha/well. This assay correlates well with the classical L929 cristal
      violet assay for the detection of bioactive rmTNF-alpha in biological fluids. The
      1F3F3 mAb inhibits various in vitro biological activities of the rmTNF-alpha,
      such as the TNF-alpha-mediated tumoricidal activity of activated macrophages, the
      rmTNF-alpha-dependent stimulation of neutrophil degranulation and the growth
      promoting effect of rmTNF-alpha. In vivo the 1F3F3 mAb inhibits
      lipopolysaccharide (LPS)-induced endotoxic shock. In conclusion, the 1F3F3 mAb is
      a useful tool to probe rmTNF-alpha activity both in vitro and in vivo.

PMID- 2228024
TI  - Thrombin and factor Xa enhance the production of interleukin-1.
AB  - Interleukin-1 (IL-1) plays a major role in inflammatory responses. Activation of
      coagulation and fibrin deposition typical of these reactions is mediated by
      macrophage procoagulants induced on stimulated macrophages. IL-1 activity in the
      supernatant of lipopolysaccharide (LPS)-stimulated guinea-pig macrophages was
      markedly enhanced by the presence of thrombin during macrophage activation.
      Although thrombin alone had no effect, inclusion of 1 mU/ml of thrombin with
      suboptimal levels of LPS produced a 200-fold increase in IL-1 activity, and
      further enhancement was observed with increasing doses of thrombin. The active
      site of thrombin was necessary for enhancement, as the serine esterase inhibitor
      di-isopropyl-fluorophosphate (DIP) and hirudin inhibited the synergy observed
      with LPS and thrombin. Prothrombin and Factor Xa also enhanced IL-1 production,
      although not to the same extent as thrombin. Factor Xa-like activity was
      demonstrated on the surface of LPS-stimulated macrophages. Both the Xa-like
      activity and IL-1 generated by LPS-stimulated cells were inhibited by heparin.
      Heparin with a high affinity for antithrombin III (anti-coagulant heparin; HAH)
      inhibited IL-1 generation, whereas low-affinity heparin (non-anticoagulant; LAH)
      had no effect. We show that proteases of the extrinsic coagulation cascade
      enhance IL-1 generation and propose that a Factor Xa-like activity present in
      activated macrophages, together with thrombin, may be important in IL-1
      processing.

PMID- 2228025
TI  - A limited role of IL-1 in immune-enhancement by adjuvants.
AB  - Generation of interleukin-1 (IL-1) in the draining lymph nodes after injection of
      complete Freund's adjuvant (CFA), incomplete Freund's adjuvant (IFA) and alum was
      studied in line with IL-1 mRNA expression (cytoplasmic slot blot analysis) and IL
      1 beta antigen detection (ELISA and immunohistochemistry) in rabbits. The
      expression of IL-1 beta mRNA was marked from 6 to 96 hr, with a maximum at around
      24 hr post-injection of CFA, while injection of the other two adjuvants elicited
      only a moderate or negligible response. On the other hand, IL-1 alpha mRNA
      expression was almost negligible during the entire 8-week observation period
      after injection of the above three adjuvants. Generation of IL-1 beta antigen in
      the draining lymph nodes after CFA injection paralleled the expression of IL-1
      beta mRNA. Immunohistochemistry revealed that cells containing IL-1 beta resided
      in the medullary sinuses, marginal sinuses and para-cortical area, but not in the
      follicles. Despite marked generation of IL-1 beta in CFA-treated draining lymph
      nodes, the primary antibody response (IgG) to ovalbumin differed only slightly
      between the three animal groups that were immunized with the antigen incorporated
      in CFA, IFA and alum. Further, rIL-1 beta did not significantly enhance the
      immune response when it was entrapped together with the antigen in IFA and alum.
      IL-1 beta enhanced the immune response only when it was injected with antigen
      without adjuvant. Thus, IL-1 seemed to play only a limited role, if any, in the
      augmentation of the primary immune response by the above-mentioned adjuvants.

PMID- 2228026
TI  - IL-5 enhances the in vitro adhesion of human eosinophils, but not neutrophils, in
      a leucocyte integrin (CD11/18)-dependent manner.
AB  - In an attempt to explain the preferential accumulation of eosinophils at sites of
      allergic tissue reactions, we have studied the effects of interleukin-5 (IL-5) on
      the adherence of human eosinophils and neutrophils to plasma-coated glass (PCG)
      or human microvascular endothelial cells (HMVEC). IL-5 was compared with IL-3,
      granulocyte-macrophage colony-stimulating factor (GM-CSF) and platelet-activating
      factor (PAF), since all these agents have biological properties associated with
      eosinophil activation and/or survival in vitro. IL-5, IL-3 and GM-CSF induced a
      time-dependent increase in adherence of normal density eosinophils to PCG optimal
      at 60 min, whereas the effect of PAF was greater at 15 min. Similar results were
      obtained with neutrophils, with the exception that IL-5 had minimal and non
      significant effects on this cell type. Unstimulated eosinophils and neutrophils
      also adhered to PCG or HMVEC, but in low numbers. Preincubation of eosinophils
      with IL-5, GM-CSF or PAF resulted in dose-dependent increases in the numbers of
      adherent cells to PCG. IL-3 had a smaller but significant effect on enhanced
      eosinophil adhesion to PCG, while IL-2 and lyso-PAF were ineffective. Neutrophils
      gave similar levels of baseline and stimulated adhesion to PCG as eosinophils, IL
      5 again had no significant stimulatory effect. IL-5 also increased eosinophil,
      but not neutrophil, adherence to HMVEC in a concentration-dependent manner.
      Preincubation with the protein synthesis inhibitor cycloheximide had no effect on
      IL-5-, GM-CSF- or PAF-stimulated eosinophil adhesion. The contribution of the
      CD11/18 leucocyte integrins to IL-5- and PAF-induced eosinophil hyperadherence
      was investigated by inhibition experiments utilizing monoclonal antibodies (mAb).
      Enhanced adhesion to PCG (by PAF) or HMVEC (by IL-5) was inhibited by (ranked in
      order of potency) anti-CR3 alpha = common beta-chain greater than LFA-1 alpha.
      Anti-p150,95 alpha had no measurable effect. Baseline adhesion by unstimulated
      eosinophils was not significantly influenced by prior incubation with these mAb.
      Using flow cytometry, IL-5 and IL-3 were found to up-regulate cosinophil but not
      neutrophil CR3 expression. These findings demonstrate that IL-5 enhances
      cosinophil, but not neutrophil, adherence reactions, by a mechanism dependent, at
      least in part, on the CD11/18 family of adhesion glycoproteins.

PMID- 2228027
TI  - Production of bovine immunoregulatory molecules by xenogeneic hybrids.
AB  - The study of bovine cytokines and lymphocyte surface markers has been restricted
      by the lack of stable, long-lived, easily maintained cell lines. To address this
      problem, bovine mononuclear leucocytes were fused with the mouse thymoma cell
      line BW5147 to produce interspecies hybrid cell lines and clones. Hybridomas were
      produced which contained more than 40 chromosomes and expressed one or more
      bovine leucocyte surface markers, they grew well and were cloned without the use
      of exogenous factors. Fusion rates were improved when exogenous factors,
      including recombinant human interleukin-2 (rhIL-2), were added. Some hybrids
      secreted immunoregulatory factors able to maintain the growth of either an IL-2
      dependent bovine T-cell line (C625) and/or preactivated normal bovine B cells.
      Anti-human IL-2 partially blocked the T-cell growth factor (TCGF) activity
      produced by these hybrids. The release of growth factors by the hybrid clones
      5/AA6/16 and 5/AA6/19 was augmented by concanavalin A stimulation.

PMID- 2228029
TI  - Biochemical manifestations of a rat mammary adenocarcinoma-producing cachexia: in
      vivo and in vitro studies.
AB  - The physical and metabolic characteristics of a Dark Agouti rat mammary
      adenocarcinoma and its effects on host metabolism are described. The tumour was
      characterized by a lack of glandular differentiation, tetraploidy, a rapid
      mitotic index and a high rate of glycolysis. The adenocarcinoma was readily
      maintained in tissue culture and could be passaged through the host by
      inoculating either cell suspensions or tissue explants. In the rat, tumour growth
      resulted in a loss of adipose tissue at a tumour mass of less than 5% body weight
      indicating that increased energy expenditure was already present at that stage.
      In addition the tumour caused anaemia, hypercalcaemia and hypoglycaemia.
      Hyperketonaemia was also observed in fasted tumour-bearing rats. Methotrexate
      arrested tumour growth in vivo. These aspects of the tumour model make it useful
      for investigations into host-tumour competition and mechanisms of cachexia.

PMID- 2228030
TI  - Lymphocyte activation as measured by interleukin-2 receptor expression to gluten
      fraction 111 in coeliac disease.
AB  - Lymphocyte activation was examined by interleukin-2 (IL-2) receptor expression on
      peripheral blood mononuclear cells from coeliac and control subjects. Purified T
      cells were incubated with gluten fraction 111 (a known toxic peptide for coeliac
      subjects), soyabean hydrolysate (an unrelated hydrolysed food antigen), and
      Concanavalin-A (Con-A, a non-specific mitogen). After 1-5 days incubation,
      expression of IL-2 receptors was assessed using a cellular enzyme-linked
      immunosorbent assay (ELISA). Gluten fraction 111 induced expression of IL-2
      receptors on T lymphocytes from coeliac but not from normal subjects (P =
      0.0005), whereas soyabean hydrolysate did not induce IL-2 receptor expression.
      Lymphocytes from both coeliac and normal subjects had similar increased IL-2
      receptor expression after incubation with Con-A. Flow cytometry was also used to
      confirm specific expression of IL-2 receptor expression of lymphocytes from
      coeliac subjects. Interleukin-2 receptor expression increased from 0 to 5.4% of
      cultured mononuclear cells after 7 days incubation with gluten fraction III.
      These cells were CD3-positive and CD4-positive. We conclude that peripheral blood
      lymphocytes from coeliac subjects are sensitized specifically to gluten fraction
      III.

PMID- 2228028
TI  - Complement gene expression in hepatic and extrahepatic tissues of NZB and NZB x W
      (F1) mouse strains.
AB  - To study the role of local production of complement proteins during the evolution
      of a naturally occurring immune complex disease, C3, C4, C2 and Factor B mRNA
      expression was assessed in several tissues of the inbred mouse strains NZB and
      (NZB x W) F1 hybrid. In the NZB/W F1 hybrid strain, coincident with the
      development of glomerulonephritis a marked increase in kidney C3 and C4 mRNA was
      observed; Factor B mRNA, which is expressed as a doublet in kidney and intestine,
      showed an increase in expression of the smaller transcript. This alteration of
      kidney C3, C4 and Factor B mRNA is identical to that noted in association with
      lupus nephritis in the MRL lpr/lpr strain and following in vivo administration of
      endotoxin to the BALB/c strain. The development of systemic lupus erythematosis
      (SLE) in the NZB/W F1 was not associated with a marked change in hepatic
      complement gene expression. These findings support the hypothesis that local
      production of complement may play a role in the pathogenesis of
      glomerulonephritis and other tissue injury in SLE.

PMID- 2228031
TI  - Presentation of Salmonella antigens by peritoneal cells of normal and Salmonella
      infected mice.
AB  - A comparison of the ability of normal peritoneal cells (PC) and those harvested
      from mice 1-3 days after intraperitoneal immunization with live Salmonella
      enteritidis 11RX (11RX) to present antigen to 11RX-primed T cells was made using
      formalin-killed 11RX and a soluble 11RX antigen extract as antigens.
      Unfractionated PC and the adherent and non-adherent PC populations were analysed
      separately and the effects of the lysosomal function-impairing drug chloroquine
      and the fixative paraformaldehyde, used before or after antigen-pulsing, were
      also determined. The results presented indicate that immunization with live 11RX
      did not induce any detectable modulation of APC function which could account for
      the ability of live 11RX to induce cell-mediated immune responses involving Lyt
      2+ T cells.

PMID- 2228032
TI  - An immunodominant antigen of Candida albicans shows homology to the enzyme
      enolase.
AB  - Antibody to an immunodominant antigen of approximately 48 kDa is found in a high
      proportion of patients with mucocutaneous or systemic infections of the yeast
      Candida albicans. A cDNA encoding part of the 48 kDa antigen has been isolated.
      From the deduced amino acid sequence of the cDNA clone, the 48 kDa antigen shows
      homology to the enzyme enolase.

PMID- 2228033
TI  - Murine candidiasis: susceptibility is associated with the induction of T cell
      mediated, strain-specific autoreactivity.
AB  - Inbred mice can be classified as susceptible or resistant to systemic infection
      with the yeast Candida albicans by histopathological evaluation of tissue
      lesions. Candida-specific memory T cell responses generated by resistant BALB/c
      mice are vigorous and sustained, whereas those displayed by susceptible CBA/H
      mice are weak. When spleen cells from immune mice were activated by culture with
      candida antigens in vitro, and injected into syngeneic and allogeneic recipients
      in the absence of further antigenic stimulation, cells from CBA/H mice induced a
      specific inflammatory response only in CBA/H recipients. In contrast, cells from
      immune BALB/c mice showed no specific activity. The effector cells were
      identified as T cells of the cytotoxic/suppressor subclass (CD4-, CD8+); and
      analysis in various F1 hybrid mice showed that reactivity was expressed only in
      animals carrying CBA/H genes. The data thus indicate that susceptibility to C.
      albicans infection is associated with the induction of a T cell subpopulation
      that has the potential to react specifically against unmodified self antigens
      expressed by the susceptible strain.

PMID- 2228034
TI  - [A critical review of the results of clinical experimentation with topical
      minoxidil 2%].
AB  - The results of clinical double-blind trials using minoxidil 2% demonstrate the
      real efficacy of the drug in producing satisfactory esthetical results in some
      30% of treated patients. One aspect of the results of this research which is not
      yet clear is the significant increase in the number of hairs, also found in
      voluntary subjects treated with placebo. In the present study is hypothesised
      that this increase may be partially explained by the failure to take into account
      the physiological seasonal variations in hair density, and by the confusion
      caused by the use of the "non-vello" category which is used to describe terminal
      (thick) and indeterminate (thin) hairs. In our study placebo failed to produce a
      significant increase in the number of terminal hairs, thus explaining why, even
      in the presence of an increased number of "non-vello" hairs, on average there was
      no real cosmetic benefit in these subjects.

PMID- 2228035
TI  - [Results of a preliminary study of 50 patients treated with a new corticosteroid:
      tipredane cream 0.1%].

PMID- 2228036
TI  - [A clinical study on the use of norfloxacin in the therapy of urethritis caused
      by Chlamydia trachomatis].
AB  - Norfloxacin (NOR) was given to 37 patients affected by urethritis due to
      Chlamydia trachomatis (CT), as demonstrated by clinical findings and fluorescent
      monoclonal antibody in urethral swab. The patients were divided into two groups
      according to a randomization list, and given either: NOR 400 mg t.i.d. or NOR 800
      mg b.i.d. for 10 days. The 2 groups were comparable in terms of age, clinical
      presentation and duration of symptoms. Six out of 18 patients treated by regimen
      2 had persistence of CT at the end of treatment (2 cases were clinically
      improved), while 4 out of 19 patients in group 1 dit not respond to the
      treatment. Overall 12 patients in group 2 (66.6%) and 15 patients in group 1
      (79%) were asymptomatic and negative for fluorescent antibody at the end of the
      treatment. Both regimens were well tolerated. Our data show that NOR given at
      dosage higher than those usually recommended (e.g. 400 mg b.i.d.), may be of
      value for the treatment of urethritis due to Chlamydia trachomatis.

PMID- 2228038
TI  - [Determination of circulating antibodies in cutaneous leishmaniasis by
      immunofluorescence test].
AB  - Using a gradient purified leishmania donovani infantum antigen, the sensitivity
      and specificity of the IIF test in detecting anti-leishmania antibodies are
      investigated. The "purified" antigen increases the specificity and sensitivity of
      the IIF test, at the same time, eliminating false positiviness caused by
      connective diseases, tuberculosis, etc.

PMID- 2228037
TI  - [Blood deficiency values of polyunsaturated fatty acids of phospholipids, vitamin
      E and glutathione peroxidase as possible risk factors in the onset and
      development of acquired immunodeficiency syndrome].
AB  - Plasma levels of vitamin E (vit E) and polyunsatured fatty acids of phospholipids
      (PUFA-PL) as well as erythrocyte glutathione peroxidase (GSH-Px) activity are
      significantly lower (p less than 0.001) in patients HIV sero-positive (AIDS and
      ARC cases) both affected and not affected with seborrheic dermatitis and in 32%
      of HIV sero-negative intravenous drug abusers (IVDA, A subgroup) than in
      controls. The deficiency of PUFA-PL (mainly C20:3 n-6, C20:4 n-6 and C22:6 n-3)
      which is associated with a significant increase (p less than 0.001) of saturated
      palmitic and stearic acids and monounsaturated oleic acid, cannot be correlated
      to an active lipoperoxidative process. In fact the levels of thiobarbituric acid
      reactive materials (TBA-RM) are not increased in the plasma of HIV sero-positive
      patients and A subgroup of IVDA. It is likely that the reduction of PUFA-PL is
      due to an inhibition of hepatic microsomal desaturase enzymes (delta 6
      desaturase, delta 5 desaturase, delta 4 desaturase) which are involved in both n
      6 and n-3 pathways. Since IVDA represent, and not only in Italy, a major risk
      category for HIV infection, we suggest that reduced blood levels of vit E, GSH-Px
      and particularly PUFA-PL may be added to the list of risk factors favouring the
      onset and the development of AIDS.

PMID- 2228039
TI  - [Preliminary experiences with chemotactic activity of CGRP using the skin window
      test].
AB  - The neuropeptide CGRP (Calcitonin Gene-Related Peptide) develops in sensory
      fibers of the human skin a series of well proven biological effects and seems
      particularly correlated with the neurogenic inflammation. In the site of
      intradermic injection of 50 pmol of CGRP, neutrophilic inflammation was
      documented. For this reason we have studied using the skin window test the
      chemotactic actions of this neuropeptide in vivo. The apposition of CGRP (12.5
      pmol) on the abraded skin modifies neutrophilic egress, increasing that effect in
      a significant way in comparison with controls. The action on neutrophils of CGRP
      helps to explain the importance of this neuropeptide in the genesis of the
      "Neurogenic inflammation".

PMID- 2228040
TI  - [Histological simulators of Kaposi's sarcoma in the initial phase].
AB  - Early Kaposi's sarcoma might be simulated by many different conditions,
      especially when the vascular component is prominent. the criteria suggested to
      differentiate early Kaposi's simulators are discussed. We found that these
      criteria are high in sensibility but low in specificity, therefore, we suggest
      using these criteria only when they are found in clusters.

PMID- 2228041
TI  - [Atypical mycobacteriosis caused by Mycobacterium marinum].
AB  - Granulomatous lesions located on the hand and on the right forearm have been
      described in a 67-year-old housewife. They appeared after a small lesion caused
      by a fish bone, from a piece of frozen fish. Clinical aspect and history together
      with histological examination are typical of an infection by Mycobacterium
      marinum.

PMID- 2228042
TI  - [Reticular erythematous mucinosis (REM). A report of 2 cases].
AB  - Cases of reticular erythematous mucinosis have not been frequently observed since
      Steinglender discovered the disease in 1971. The two patients with a dermatosis
      having the clinical and histologic characteristics of REM came to our clinic. The
      biopsies then taken underwent elective colouring for the mucin and was observed
      under an electron microscope.

PMID- 2228043
TI  - [Cultured epidermis in the treatment of leg ulcer: "edge effect" and correlation
      with keratinocyte proliferation index].
AB  - Cultured keratinocyte grafting (KG) of chronic leg ulcers produces an impressive
      stimulation of host epithelization by an effect on the edge of the ulcer, which
      starts to grow in rapidly ("edge effect"). In 5 patients with chronic leg ulcers
      treated by KG, we have studied the proliferation index of the epidermis of the
      edge and of the graft area and that of secondary culture keratinocytes. The aim
      of the study was to correlate this parameter with the clinical evolution of the
      treated lesions. We found a significant correlation between the proliferation
      index of the edge epidermis and the clinical evidence of "edge effect".

PMID- 2228044
TI  - Revised nomenclature of mouse H-2 genes.

PMID- 2228046
TI  - The B144-H-2Db interval and the location of a mouse homologue of the human D6S81E
      locus.

PMID- 2228047
TI  - Promoter region of HLA-C genes: regulatory elements common to and different from
      those of HLA-A and HLA-B genes.

PMID- 2228045
TI  - DNA typing for HLA-DPB1*02 and -DPB1*04 in multiple sclerosis and juvenile
      rheumatoid arthritis.
AB  - DP gene typing using in vitro DNA amplification combined with sequence-specific
      oligonucleotide probes (SSOP) has recently been reported. The amplification step
      may be specific for the HLA-DPB locus, or it may be specific for one or a group
      of HLA-DPB alleles, thus increasing the discriminatory power of the system. We
      report the combined use of group-specific DNA in vitro amplification followed by
      SSOP in typing for DPB1*02 and DPB1*04 variants. The method was used to type for
      these variants in 96 randomly selected, healthy Danes, in 37 patients with
      pauciarticular juvenile rheumatoid arthritis (PJRA), and in 38 patients with
      multiple sclerosis (MS). Increased frequencies of the cellularly defined HLA-DPw2
      in PJRA and of HLA-DPw4 in MS have previously been reported. In the patient
      groups, the frequencies of the DPB1*02 and DPB1*04 variants did not differ
      significantly from those expected based on the cellularly defined HLA-DP types of
      the patients and the frequencies of the DPB1*02 and DPB1*04 variants among
      healthy Danes.

PMID- 2228048
TI  - DRB1*LY10--a new DRB1 allele and its haplotypic association.

PMID- 2228049
TI  - HIV seropositivity among patients with sexually transmitted diseases in Vellore.
AB  - In a prospective, systematic investigation, 2215 new patients with sexually
      transmitted diseases (STD) were screened for human immuno deficiency virus (HIV)
      infection during April 1986 to December 1988. Among them 9 were positive for HIV
      antibody giving a rate of 4/1000. In addition, 5 patients had been referred to
      our clinic with a diagnosis of HIV infection and STD. Among these 14, there was
      one married couple. Of the remaining 5 married individuals, 4 were men; the wives
      of 3 of them were infected but asymptomatic, and were not included in this
      report. The rate of conjugal infection was 71 per cent. Most (57%) patients
      belonged to poor socio-economic background; 78 per cent of patients were young,
      in the age group 15-25 yr. The presenting STD were syphilis, venereal warts,
      gonorrhoea, chancroid, genital herpes, non-gonococcal urethritis and candidiasis.
      It appeared that the course of associated STD had not been altered in these HIV
      infected individuals.

PMID- 2228051
TI  - Acute rubella infection in pregnant women in Delhi.
AB  - Serum samples of 17 pregnant women with suspected rubella who presented at the
      Department of Microbiology, AIIMS, New Delhi, from March to May 1988 for
      confirmation of diagnosis were tested for rubella haemagglutination inhibiting
      (HAI) antibodies and rubella specific IgM antibodies by mu-capture ELISA. Ten of
      the 17 women were diagnosed to have acute rubella infection as they showed the
      presence of rubella specific IgM antibodies. Nine of these gave history of fever
      and rash whereas one woman remained asymptomatic. These observations suggest an
      increase in the incidence of rubella infection in pregnant women from March to
      May 1988 in Delhi.

PMID- 2228053
TI  - Seasonal fluctuations in the occurrence of enteroinvasive Escherichia coli
      diarrhoea.
AB  - Enteroinvasive Esch. coli (EIEC) was implicated in 2.1 per cent (57 out of 2661)
      diarrhoeal patients investigated at Ludhiana (Punjab). The predominant serogroups
      isolated were 028, 0147, 0124 and 0112. High prevalence of EIEC infection was
      noticed among infants (50.6%) followed by children up to 10 yr (19.3%). The peak
      incidence (24.5%) occurred during the hot and dry month of May as compared to 1.7
      per cent in February. The disease incidence was positively correlated with mean
      minimum temperature and mean maximum temperature. All strains gave Sereny's test
      positive and were mostly susceptible to cephalothin, gentamicin, nalidixic acid,
      furazolidine and neomycin.

PMID- 2228050
TI  - Comparison of immunofluorescence & culture for the diagnosis of respiratory
      syncytial virus infection.
AB  - In 809 infants and children with acute respiratory infection, HEp-2 cells were
      used for the isolation of respiratory syncytial virus (RSV) and an indirect
      immunofluorescence technique (IIF) was used for the detection of RSV antigen in
      the epithelial cells of nasopharyngeal secretions. While RSV was detected in
      culture in only 87 subjects, IIF was positive for viral antigen in 158 subjects.
      In children with bronchiolitis and in those with pneumonia 57 and 19 per cent
      respectively, had evidence of RSV infection by culture or IIF. The frequency of
      virus antigen detection by IIF was above 90 per cent irrespective of the duration
      of symptoms before specimen collection. The frequency of virus isolation in
      culture was 86 per cent in children with less than 2 days duration of symptoms
      and 42 to 69 per cent in those with duration of symptoms of 2 days or more.
      However, this difference was not statistically significant. In conclusion, the
      IIF test was not only rapid, but also more sensitive for the detection of RSV
      infection than culture.

PMID- 2228054
TI  - Phage typing of Vibrio cholerae 01 biotype ElT or strains.
AB  - Data accumulated over the past 20 yr (1969-88) on the phage typing of V. cholerae
      01 biotype ElT or strains received at the Vibrio Phage Reference Laboratory, were
      retrospectively analysed to ascertain the frequency of occurrence of the
      different phage types of Basu and Mukerjee typing scheme. The analysis revealed
      that phage types 2 and 4 were the most common types not only at the time when the
      Basu and Mukerjee typing scheme (of 1968) was introduced but also at present. The
      existing phage typing scheme needs to be improved with the addition of more new
      phages to obtain more type distinction and better discrimination within biotype
      ElT or strains for epidemiological studies.

PMID- 2228055
TI  - Effect of drug treatment on the prevalence of intestinal parasites amongst school
      children in a sub-urban community.
AB  - The prevalence of intestinal protozoal and helminthic infection was studied over
      a period of one year amongst 297 school children, aged 5-20 yr in a sub-urban
      area. The overall prevalence rate of various protozoal infection, 15.82 per cent
      had only helminthic infection and 14.47 per cent had combined helminthic and
      protozoal infection. Ascaris lumbricoides infestation was found to be the
      commonest helminthic infection (61.70%) while giardiasis was the commonest
      protozoal infection (59.80%). The prevalence rates, one year after effective anti
      protozoal and antihelminthic treatment was administered, were overall parasitic
      infection 25.92 per cent; only protozoal infection 17.50 per cent, only
      helminthic infection 5.72 per cent and combined infection 2.69 per cent. The
      reinfection rate was found to be 7.40 per cent and the fresh infection rate was
      found to be 11.4 and 39.8 per cent at the end of six months and one year
      respectively.

PMID- 2228052
TI  - Immune response to hepatitis B viral antigens in chronic infection & its
      relationship with liver necrosis.
AB  - Markers of hepatitis B virus (HBV) and immune response against them were studied
      in 18 chronic asymptomatic carriers, 8 patients of the virus induced chronic
      liver disease (CLD), and 7 patients of chronic alcoholic liver cirrhosis, who
      were also chronic HBV carriers (CALC). The LMI responses to HBeAg were elevated
      in HBeAg and/or HBV-DNA positive chronic asymptomatic carriers, (median response
      31.5%), along with elevation of serum alanine aminotransferase (sALT) levels (59
      150 IU/l). On the other hand the LMI responses to this antigen, in HBeAg and HBV
      DNA negative chronic carriers were in the normal range (median response 12%) and
      their sALT levels were also normal (7-50 IU/l). The CLD and CALC patients did not
      show any relation between their LMI to HBeAg and sALT levels. In contrast no
      relation between LMI to HBsAg and sALT levels was observed in any group. The LMI
      responses to HBsAg in CLD patients were elevated (median response 38%) and the
      responses of chronic asymptomatic carriers and CALC patients were either in the
      normal range or poor (median responses, 18 and 7% respectively), irrespective of
      their sALT levels. These results suggest that T cell responses to both the
      antigens may be involved in liver cell damage.

PMID- 2228056
TI  - Antibiotic resistance, haemagglutination type & haemolysin production in relation
      to serogroups of uropathogenic Escherichia coli.
AB  - A total of 56 urinary isolates of Esch. coli were characterised according to
      serotype, haemagglutination (HA) type, production of beta haemolysin and
      antibiotic resistance pattern. Forty five strains were serotyped with prevalence
      of 057 followed by other serotypes. Eleven different Esch. coli serotypes were
      found to have mannose resistant haemagglutinating property (MRHA) and just five
      strains showed haemolysin production (Hly+). Multidrug resistance was common with
      preponderance of ampicillin, co-trimoxazole and tetracycline resistance. No
      correlation between serogroup, HA type, haemolysin production and antibiotic
      resistance was found.

PMID- 2228057
TI  - Enzyme linked immunosorbent assay for immunoglobulins G to Mycoplasma hominis.
AB  - Sera (187) from women patients attending the STD, Obstetrics and Gynaecology, and
      Family Planning Clinics were screened for the presence of the IgG class of
      immunoglobulins against M. hominis, using the ELISA technique. Sonicates of
      locally isolated M. hominis serotype (CS1) and standard PG 21 strain were used as
      antigens. The test was standardized using penicillinase as an enzyme. The ELISA
      showed 90.48 per cent sensitivity and 84.8 per cent specificity, and was also
      rapid (as compared to culture) and reproducible.

PMID- 2228058
TI  - Double blind clinical trial on centperazine & DEC in bancroftian filariasis.
AB  - Centperazine, an analogue of DEC, was subjected to a double blind controlled
      trial, to evaluate its efficacy as a newer antifilarial agent. Centperazine (300
      mg/day) along with equivalent quantities of DEC and placebo were administered to
      different types of filariasis patients. DEC was found to be significantly
      effective in reducing peripheral microfilaraemia, in different weeks and months
      of follow-up, except at the end of 6th month, as compared to Centperazine. There
      was no significant difference between the placebo and Centperazine treated
      patients, in this respect, revealing that the drugs had no efficacy in
      eliminating peripheral microfilaraemia. Recurrence of acute attack within 6
      months was nearly equal with both Centperazine and DEC, being 28.2 and 24 per
      cent respectively, whereas in the placebo group the recurrence rate was 48.9 per
      cent. Centperazine treated patients showed significantly less side effects
      (8.9%), as compared to DEC treated patients (34%). Giddiness, nausea and vomiting
      were the common adverse effects observed.

PMID- 2228060
TI  - A mathematical analysis of various factors involved in transmission of
      bancroftian filariasis in Pondicherry.
AB  - The variation of clumping factor in microfilaraemia among different age groups
      was observed in Pondicherry for 1981 and 1986. The clumping factor was minimum in
      the age group 0-5 yr and it was maximum in 16-20 yr group in 1981 and 21-25 yr in
      1986. The variation in clumping factor resembled the changes in microfilaria (mf)
      rate. Multiple linear regression analysis showed that the multiple correlation
      between mf rate and the other parameters i.e., median microfilarial density
      (MFD50), clumping factor in human population, and, infection rate and infectivity
      rate in vector population was highly significant. The relationship between
      filariometric indices in human host and vector population may provide the basis
      on which a mathematical model on transmission of filariasis could be developed.

PMID- 2228059
TI  - Choice & integration of different approaches to case detection with special
      reference to brugian filariasis in south India.
AB  - Treatment following rapid case detection in population, particularly the target
      age classes, which record high prevalence, is necessary for effective control of
      lymphatic filariasis. Conventional door-to-door surveys resulted in delay in
      detection of parasite carriers and patients with clinical filariasis,
      particularly in rural areas. An integration with other approaches like school
      surveys, health camps, filariasis clinics and microfilaria detection camps (MDC)
      was found effective in covering a much larger population in brugian filariasis
      case detection in an endemic area in south India. The MDCs organized through
      Integrated Child Development Scheme (ICDS MDC) yielded a good coverage of pre
      school children. School surveys were ideal in covering children en masse.
      Community MDCs and health camps arranged with active community participation were
      useful in covering adolescents and young adults in large numbers. The filariasis
      clinic was effective in screening older adults above 30 yr. The relative
      efficiency of these approaches in terms of time and manpower utilization has been
      discussed.

PMID- 2228061
TI  - Estimation of fecundic life span of Wuchereria bancrofti from longitudinal study
      of human infection in an endemic area of Pondicherry (south India).
AB  - The fecundic life span of adult female W. bancrofti was estimated by longitudinal
      study of microfilaraemia in a cohort of population (7,525) in Pondicherry. The
      estimation was based on a deterministic model, using the rate of loss in
      infection. The life span of the parasite was 10.2 yr without chemotherapy, while
      it was reduced to 5.3 yr following diethyl-carbamazine therapy. The analysis of
      mean microfilarial counts in microfilaraemic persons without chemotherapy
      indicates that the rate of production of microfilaria by the adult female is
      stable at least for a period of five years.

PMID- 2228063
TI  - Plasma levels of estradiol & progesterone at different gestational ages in Indian
      women.
AB  - Plasma levels of estradiol and progesterone were determined at different
      gestational ages in Indian pregnant women from the low socio-economic group. The
      levels of estradiol and progesterone progressively increased with gestation and
      reached maximum values (14.35 +/- 1.092 and 145.9 +/- 7.69 ng/ml, respectively)
      by term. Though the estradiol values were comparable to those reported in
      literature, the term values of progesterone were found to be lower (145.9 +/-
      7.69 ng/ml) than those reported from Western countries (160 +/- 7.5 ng/ml) at 34
      38 wk of gestation. These low progesterone values may have physiological
      implication in placental function.

PMID- 2228062
TI  - An improved method of mass culturing of Romanomermis iyengari, a mermithid
      nematode parasite of mosquito larvae.
AB  - An attempt was made to develop an alternative method of mass culturing for R.
      iyengari instead of the usual sand culture method. Fifty pairs each of post
      parasitic juveniles were seeded in moist sandbed and beakers containing tap water
      and distilled water and examined for exsheathing, egg-laying and egg-hatching.
      All post-parasitic juveniles in the moist sandbed had moulted by 7th day whereas
      in tap water and distilled water it lasted up to 11th day. Maximum numbers of
      eggs were observed on day 14 in sandbed (15/ml), day 16 in tap water (24/ml) and
      day 29 in distilled water (28/ml). The preparasites obtained from moist sandbed,
      tap water and distilled water did not exhibit any difference in their infectivity
      to mosquito larvae. The eggs of the nematode obtained from a culture in distilled
      water maintained at 30 +/- 2 degrees C for 60 days, when treated with CO2 (18 to
      556 ppm) showed enhanced rate of egg hatching (73-98% compared with 11.5% in the
      untreated ones). CO2 treatment did not affect the infectivity of the preparasites
      that hatched from the CO2-treated eggs.

PMID- 2228064
TI  - Perinatal outcome in relation to maternal glycaemic control in diabetic mothers.
AB  - The relationship between glycaemic control and perinatal outcome was assessed in
      60 pregnant diabetic women, divided into three groups on the basis of the mean
      plasma glucose level. Group I, had mean plasma glucose less than 120 mg/dl (32
      patients); group II, mean plasma glucose 121-140 mg/dl (13 patients); and group
      III, mean plasma glucose exceeding 140 mg/dl (15 patients). The degree of
      maternal glycaemic control appeared to affect the perinatal outcome. Neonatal
      morbidity was minimum in group I (31.25%) followed by group II infants (46.15%)
      and maximum in group III infants (66.6%). Maintenance of maternal plasma glucose
      level at or below 120 mg/dl was thus associated with minimum neonatal morbidity.

PMID- 2228065
TI  - Prevalence & clinical associations of anticardiolipin antibodies in patients with
      systemic lupus erythematosus in India.
AB  - Anticardiolipin antibody (aCL) screening using an ELISA technique, in 76 patients
      of Indian origin with systemic lupus erythematosus (SLE), showed aCL in 27.63 per
      cent of patients. This prevalence was much lower than that reported in the
      Western population. The presence of aCL showed positive correlations with
      recurrent abortions and organic neurological lesions seen in SLE.

PMID- 2228066
TI  - Non-organ specific & organ specific antibodies in rheumatoid arthritis.
AB  - Fifty patients of rheumatoid arthritis clinically diagnosed (by ARA criteria)
      were studied for both non-organ specific [rheumatoid factor (RF), anti-nuclear
      antibodies (ANA), extractable nuclear antibody (ENA), granulocyte specific anti
      nuclear antibody (GS-ANA), anti-smooth muscle antibody (SMA) and anti
      mitochondrial antibody (AMA)] and organ specific, [anti-adrenal (AAA), anti-islet
      cell (ICA), antithyroid antibody (ATA) and anti-parietal cell (PCA)] auto
      antibodies. RF was positive in 80 per cent of patients. ANA was positive in 44
      per cent of patients, ENA in 62 per cent, SMA in 20 per cent, AMA in 18 per cent
      and GS-ANA in 68 per cent. Of the organ specific antibodies, PCA was demonstrable
      in 28 per cent of the patients and none of the other antibodies were present.
      Circumstantial evidence indicates that ANA and GS-ANA are not synonymous but
      independent, cross-reacting entities and the presence of both increase the
      sensitivity (94%) of diagnosis of RA.

PMID- 2228067
TI  - Prevalence, awareness & treatment status of hypertension in urban population of
      Delhi.
AB  - A community based survey for the prevalence of hypertension was carried out on a
      random urban sample of 13,723 adults in the age group 25-64 yr from the Union
      Territory of Delhi (India). Hypertension was defined as systolic pressure greater
      than 160 mm Hg and/or a diastolic pressure greater than 90 mm Hg or a history of
      current antihypertensive medication. The overall prevalence rate/1000 adults was
      127.5 (116.6 in males and 136.8 in females). Mild hypertension (diastolic
      pressure between 91-104 mm Hg) predominated in the whole group, the proportion
      decreasing with increasing age in both sexes. Fifty per cent of the hypertensives
      were aware of their problem, the awareness being slightly higher in females
      (51.8% versus 46.5%). Approximately 30 per cent of the hypertensives were on
      medication for high blood pressure. The status control of blood pressure was low
      in the population, being only 9 per cent, with little difference between the two
      sexes. The study emphasises the enormity of the problem of hypertension in an
      urban population in India and poor control of blood pressure achieved in the
      community.

PMID- 2228068
TI  - Alterations in immunoglobulin & complement levels in chronic obstructive
      pulmonary disease.
AB  - Thirty patients of chronic obstructive pulmonary disease (COPD; all smokers) and
      an equal number of controls (15 smokers) were studied. The COPD patients were
      further divided into group A (predominantly emphysema) and group B (predominantly
      bronchitis) of 15 patients each. Serum and sputum IgG, IgA and IgM and serum C3
      and C4 were estimated. IgG, IgA, IgM and C3 and C4 were similar in smoker and non
      smoker controls. Mean (+/- SD) serum IgG (IU/ml) was significantly higher in COPD
      patients (207.78 +/- 62.73) than in control (177.25 +/- 43.5; P less than 0.05),
      serum IgA (IU/ml) was also significantly higher in COPD (205.04 +/- 46.56) than
      in control (108.21 +/- 33.3; P less than 0.01). IgM was similar in the 2 groups.
      Sputum IgA (IU/ml) was higher in COPD (4.68 +/- 3.51) than in control (2.25 +/-
      1.03; P less than 0.05). IgG and IgM were similar in the 2 groups. Both serum C3
      (IU) and C4 (IU) were lower in COPD patients (C3 = 95.9 +/- 33.11, C4 = 113.6 +/-
      62.4) than in control (C3 = 167.3 +/- 25.42, C4 = 205 +/- 76.5; P less than
      0.05). Serum IgA in type B COPD (212.25 +/- 50.06) was higher than in type A
      (197.52 +/- 43.3; P less than 0.05) IgG and IgM were similar in these 2 groups.
      In COPD patients, immunoglobulins were either normal or higher indicating that
      deficiency of immunoglobulin is not a predisposing factor in development of COPD.
      Similar immunoglobulin values in smoker and nonsmoker controls indicated that
      smoking was not the cause of rise of immunoglobulins in COPD.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2228071
TI  - Circadian variation of serum urea concentration in north Indian subjects.
AB  - Circadian rhythm of serum urea concentration was studied in 25 clinically
      healthy, diurnally active, nocturnally resting young male Indians. The mean urea
      concentration was observed to be 22.32 mg/dl at 0800 h which increased gradually
      reaching maximum at 0000 h with a mean of 31.00 mg/dl. A marked circadian
      variation in serum urea was recorded with a statistically significant amplitude
      and acrophase at 2232 h (Cosinor analysis). The observation that serum urea
      concentration oscillates physiologically in the peripheral blood according to a
      circadian rhythm may prove to be of importance in the clinical interpretation of
      values at different times along the 24 h light-dark period.

PMID- 2228069
TI  - Simplified technique for recording human cortical & spinal evoked muscle
      potentials.
AB  - Muscle responses evoked on transcranial stimulation of the motor cortex
      (corticomotor) and motor roots (spinal) were studied in 20 healthy volunteers
      using a simplification of Rossini's technique and conventional EMG equipment.
      Cortical motor responses were consistently obtained from the contralateral upper
      limb with tolerable stimuli. Lower limb motor responses were inconsistent and
      sometimes required uncomfortably high stimulus strengths. In the upper limbs,
      peripheral conduction time (PCT) was estimated by the latency of the response to
      spinal stimulation. A comparable measure of PCT was obtained for the abductor
      pollicis brevis (APB) from the F-responses. The difference between the latency of
      the corticomotor response and the PCT was considered to represent central motor
      conduction time (CMCT). Corticomotor latencies were: APB 18.51 +/- 1.1 msec,
      biceps 9.77 +/- 0.46 msec and tibialis anterior 26.5 +/- 2.9 msec. CMCT from
      cortex to C8/T1 segments (APB) was 4.68 +/- 0.6 msec and between cortex and C5/C6
      (biceps) 4.24 +/- 0.42 msec.

PMID- 2228070
TI  - Auditory brainstem evoked responses in healthy north Indians.
AB  - Auditory brainstem evoked potential responses (ABR) were recorded from CZ-A1 and
      A2 scalp regions in 132 healthy normal subjects in four age groups (in yr; less
      than 15, 16-25, 26-45 and greater than 46). The normative data for absolute,
      interpeak latencies and amplitude of waves V and I in each group are being
      reported. A mean value of 2.09, 1.85 and 3.97 msec for IPLs I-III, III-V and I-V
      respectively is worked out representing a normal baseline, irrespective of age.
      As significant sex related differences are seen in IPLs, two separate values for
      male and females are given along with 99 per cent tolerance limit. The values of
      IPLs for males are 2.13 (2.58 TL) for I-III, 1.88 (2.30 TL) for III-V, 4.03 (4.48
      TL) for I-V and for females 2.05 (2.44 TL) for I-III, 1.80 (2.25 TL) for III-V,
      3.89 (4.42 TL) for I-V in msec. These values in Indian subjects are comparable to
      those reported in the West.

PMID- 2228072
TI  - Coitus induced changes in oviductal motility & effect of progesterone.
AB  - Motility of different oviductal segments of conscious rabbits was recorded
      through permanently implanted sensors using the technique of impedance
      plethysmography. The implants were around the oviductal wall and therefore did
      not obstruct its lumen. Pre-ovulatory ampullary motility was always less than the
      isthmic motility. Coitus induced ovulation produced a characteristic oviductal
      motility pattern consisting of (i) initial relaxation of both isthmus and ampulla
      (4-12 h) followed by (ii) increased isthmic motility in the face of a continually
      relaxed ampulla (36-48 h), and finally phase (iii) leading to restitution of both
      ampullary and isthmic motility to the base-line at 72-96 h. Estimation of ova
      positions indicated the presence of fertilized eggs in the ampulla and ampullo
      isthmic junction at 48 h and the ova could come to the end of the isthmic segment
      only at 72 h or after. Increased isthmic motility thus served to counter the
      transportation of ova and their retention in the ampulla. Rabbits in which
      oviducts were not taken out for ova positioning achieved normal pregnancy.
      Administration of progesterone (im, 2.5 mg) produced complete relaxation of both
      isthmus and ampulla, did not produce increased isthmic contractility on coitus,
      accelerated the ovum transport rate and inhibited pregnancy, again emphasising
      the ova retentive role of oviductal motility.

PMID- 2228073
TI  - Immune response to syngeneic spermatozoa & its effect on target organs in mice.
AB  - Two groups of adult Swiss mice were immunised with washed syngeneic spermatozoa
      without any adjuvant for a period of two months or four months respectively. The
      presence of antibodies to spermatozoa was measured by micro sperm-agglutination
      and micro sperm-immobilization tests. The development of cell mediated immune
      response (CMIR) was measured by leucocyte migration inhibition test (LMIT) using
      spermatozoal antigens solubilized by 3M KCl, Nonidet P-40 or by subjecting the
      cells to ultrasonication. SDS-PAGE analysis of these proteins indicated that
      extraction of spermatozoa with 3 M KCl was a better method for solubilization of
      antigens present on sperm membrane. Almost all immunized mice had varying titers
      of sperm agglutinating antibodies. Nearly 40-50 per cent of the mice had a titre
      of 1:128 in both groups whereas only 33 per cent had sperm immobilizing
      antibodies. CMIR, as assessed by LMIT, was detected in immunized mice. However,
      this had not resulted in the infiltration of immune cells into the target organs
      perhaps due to the lower magnitude of immune response.

PMID- 2228074
TI  - Hepatoprotective activity of andrographolide from Andrographis paniculata against
      carbontetrachloride.
AB  - Andrographolide, a diterpenoid lactone, was isolated (yield 0.78% w/w) from A.
      paniculata (whole plant). Its LD50 in male mice was 11.46 g/kg, ip.
      Antihepatotoxic activity of andrographolide (100 mg/kg, ip) was compared with
      861.33 mg/kg, ip, of the methanolic extract (equivalent to 100 mg/kg of
      andrographolide) and 761.33 mg/kg ip, of the andrographolide-free methanolic
      extract (equivalent to 861.33 mg/kg of the methanolic extract) of the plant,
      using CCl4-intoxicated rats. Biochemical parameters like serum transaminases--GOT
      and GPT, serum alkaline phosphatase, serum bilirubin and hepatic triglycerides
      were estimated to assess the liver function. Overall inhibition of CCl4-induced
      increase in the five biochemical parameters was found to be 48.6 per cent
      (andrographolide), 32.0 per cent (methanolic extract) and 15.0 per cent
      (andrographolide-free methanolic extract). These biochemical observations were
      supplemented by histopathological examination of the liver slices. Further,
      andrographolide (100 mg/kg, ip) was found to normalize completely the CCl4
      induced increase in the pentobarbitone induced sleep time of mice. The results
      suggest that andrographolide is the major active antihepatotoxic principle
      present in A. paniculata.

PMID- 2228075
TI  - Hepatoprotective activity of andrographolide against galactosamine & paracetamol
      intoxication in rats.
AB  - Hepatoprotective effect of andrographolide (the major active diterpenoid lactone
      of the plant Andrographis paniculata) was studied on acute hepatitis induced in
      rats by single dose of galactosamine (800 mg/kg, ip)/paracetamol (3g/kg, po).
      Hepatoprotective activity was monitored by estimating the serum transaminases
      (GOT and GPT), alkaline phosphatase and bilirubin in serum, hepatic
      triglycerides, and by histopathological changes in the livers of experimental
      rats. Pre-treatment and/or post-treatment of rats at different time intervals
      with different doses of andrographolide in the two experimental models of
      hepatotoxicity showed that treatment of rats with 400 mg/kg, ip or 800 mg/kg, po,
      48, 24 and 2 h before galactosamine administration or with 200 mg/kg, ip, 1, 4
      and 7 h after paracetamol challenge leads to complete normalisation of toxin
      induced increase in the levels of all the five biochemical parameters, and
      significantly ameliorates toxin-induced histopathological changes in the livers
      of experimental rats. The results confirmed the in vivo hepatoprotective effect
      of andrographolide against galactosamine or paracetamol-induced hepatotoxicity in
      rats. Since the protective effect of andrographolide was observed in two types of
      intoxication, which are very different in their primary mechanism of inducing
      hepatotoxicity, it is suggested that protective mechanisms of andrographolide
      which are not specific to galactosamine or paracetamol toxicity may be
      responsible for the hepatoprotective activity of the compound.

PMID- 2228077
TI  - Efficacy of indomethacin suppository in primary dysmenorrhoea.
AB  - The efficacy of indomethacin suppositories (100 mg 1-3 times a day) in the
      treatment of primary dysmenorrhoea was investigated in a double-blind, crossover
      study involving 40 patients, in comparison to placebo. The patients were treated
      for four menstrual periods-two periods with placebo and two periods with
      indomethacin suppositories. A dysmenorrhoeic score based on subjective
      estimations of nine symptoms was used, the symptoms including pelvic pain,
      backache, headache, dizziness, nausea, vomiting, diarrhoea, nervousness and
      incapacitation. As compared to placebo, indomethacin suppositories led to a
      insignificant decrease in the frequency and severity of the associated symptoms,
      as evaluated by subjective rating (P less than 0.05). Indomethacin suppositories
      were well tolerated and there was no drop-out. No side effects were reported
      except for a mild burning sensation in the rectal region experienced by 3
      patients on indomethacin suppositories.

PMID- 2228076
TI  - Changes in the sensitivities of dopamine receptors to chronic treatment with
      imipramine & haloperidol in rats.
AB  - Apomorphine induced locomotor activity was studied in Wistar rats treated with
      imipramine and haloperidol with the help of automated measuring devices. The
      control rats showed a biphasic response of hypomotility and sedation to low dose
      apomorphine, and hypermotility to high dose apomorphine. In chronic imipramine
      treated rats, the hypomotility and sedative response to low dose apomorphine
      challenge was significantly attenuated (P less than 0.05), as compared to saline
      treated controls. A similar response was observed in the chronically haloperidol
      treated rats (P less than 0.01). However, there were no significant differences
      in motility responses to high dose apomorphine challenge between the control and
      experimental groups. These results suggest that presynaptic dopamine auto
      receptors may not be involved in mediating the loss of response to low dose
      apomorphine by chronic imipramine treatment. Imipramine being predominantly a
      monoamine uptake inhibitor and haloperidol a potent postsynaptic D-2 blocker,
      some indirect mechanisms may be involved in the loss of response to low dose
      apomorphine challenge.

PMID- 2228078
TI  - Children and environment: A UNICEF Strategy for Sustainable Development.

PMID- 2228079
TI  - The painful hip.

PMID- 2228081
TI  - Care of the uncircumcised penis.

PMID- 2228080
TI  - Circumcision in children.

PMID- 2228082
TI  - Pediatric neurology.

PMID- 2228083
TI  - Approach to epilepsy in children.

PMID- 2228084
TI  - Subependymal-intraventricular hemorrhage in the newborn.

PMID- 2228085
TI  - Acute hemiplegia in infancy.

PMID- 2228086
TI  - Muscular dystrophies.

PMID- 2228087
TI  - Headaches in childhood.
AB  - The diagnosis and management of headache in children is a challenge to the
      clinician, covering as it does a wide range of diagnostic possibilities and
      enlisting a range of skills from neurosurgery and infectious disease to the
      psychological. The task is best undertaken, as in so many medical problems, by
      taking careful history and physical examination, including the past history,
      family history, and life circumstance of the child. After this is done, only in a
      minority of cases will it be necessary to request a specific special test, such
      as a CT scan, lumbar puncture or EEG. In those cases where doubt remains after
      initial careful evaluation or even after special studies have not resolved the
      question, careful follow up of the child over time, with re-examination as
      necessary, will allow definitive diagnosis and prevent the physician from missing
      obscure or in apparent disease.

PMID- 2228088
TI  - Attention deficits and hyperactivity.
AB  - The precise nature of the relationship among attention deficit, hyperkinesis, and
      specific learning disabilities remains a mystery. They are encountered in one
      another's company with far greater than chance frequency. It is clear, on the one
      hand, that attention deficit and learning disability aggravate one another; that
      is, that what is difficult to learn is difficult to attend to, and vice versa.
      Furthermore, in children at least, attending ability and activity level have a
      reciprocal relationship; that is, improvement of attention tends to reduce
      activity level, and vice versa. On the other hand, each of these disorders is
      seen in isolation with sufficient frequency to assure us that none of the three
      is simply a by-product of one or both of the other two. It is unlikely that a
      single etiology will be identified to account for a significant number of cases
      of hyperactivity or attention deficit, and thus unlikely that a "cure" or even a
      mode of prevention will be found. A change in the attitude of the culture toward
      formal education would reduce the morbidity of the syndrome, but this is also
      unlikely in the foreseeable future. What further research does promise to yield
      are medications that improve attention span with fewer side effects, and perhaps
      more important, more workable technologies for changing behaviour and engineering
      environments to encourage academic productivity in the face of this important
      aptitude deficit.

PMID- 2228090
TI  - Experiences with milk banking in Bombay.

PMID- 2228091
TI  - G6PD deficiency in neonates: a prospective study.
AB  - One thousand consecutively born babies were screened for G6PD deficiency and
      observed for seven days for development of jaundice. Frequency of the deficiency
      was 3.9%, being 5% in males and 2.8% in females. Religion did not have any
      bearing on the frequency. Parental screening in cases of babies deficient in G6PD
      enzyme revealed deficiency of the enzyme in majority of the mothers.
      Hyperbilirubinemia developed in 48.7% of babies having G6PD deficiency : It is
      recommended that any neonate presenting with jaundice must be screened for G6PD
      deficiency not only to define the etiology of hyperbilirubinemia but also to
      prevent future hemolytic episodes.

PMID- 2228089
TI  - Human milk banking: current concepts.

PMID- 2228092
TI  - Standard curves for mid arm circumference and mid-arm/head circumference ratio in
      newborns.
AB  - One Thousand singleton neonates, between 28 and 44 weeks of estimated gestational
      age (EGA) were measured within 48 hours of their birth for upper mid-arm
      circumference (MAC), head circumference (HC) and birth weight (BW). Regression
      analysis was used to draw standard curves for MAC versus EGA and mid-arm
      circumference/head circumference ratio (MAC/HC) versus EGA. Correlation
      coefficients were 0.961 for MAC versus EGA and 0.889 for MAC/HC versus EGA (p
      less than 0.001). MAC, MAC/HC and HC were also highly correlated with birth
      weight (p less than 0.001). These standard curves make available a discriminating
      method for evaluation of intra-uterine growth and a non-invasive technique for
      following somatic protein status in growing preterm infants.

PMID- 2228093
TI  - Maternal knowledge regarding breast feeding and weaning practices.
AB  - The study assessed the knowledge of mothers of the high income group of urban
      Baroda, related to breast feeding and weaning. Forty mothers with children aged 4
      to 18 months were studied. Knowledge and practices regarding breast feeding and
      weaning were assessed using pretested questionnaires. Results indicated that only
      half the mothers breast fed their babies on the first day. Breast feeding was
      stopped when the child was 3-6 months; top feeding and solid supplements were
      initiated at 4-6 months. Mainly commercial baby foods were used for weaning. Most
      mothers avoided 'dals' for the child because these were believed to be difficult
      to digest and produced gas in the child's stomach. Fifty percent of the mothers
      were not in favour of feeding the sick child with small frequent meals.

PMID- 2228094
TI  - Knowledge and attitude towards breast feeding among adolescent girls.
AB  - Majority of the urban adolescent girl students (n = 76) from middle socioeconomic
      group correctly reported that breast milk is the best food for infants (95%), and
      it has protective antibodies (98%). However, most of them (92%) had incorrect
      knowledge about the role of diet in breast milk secretion and continuation of
      breastfeeding while mother is suffering from tuberculosis (92%), malaria (84%).

PMID- 2228095
TI  - Sister chromatid exchanges in congenital cataracts.
AB  - A total of 25 patients with bilateral congenital cataracts, from three
      aetiological groups i.e. rubella (6 patients) hereditary (6 patients) and
      undetected aetiology (13 patients) were studied for sister chromatid exchanges
      (SCE). SCEs were markedly raised in the rubella groups as compared with age sex
      matched controls. The other two groups also showed raised SCE, more so in
      hereditary group.

PMID- 2228096
TI  - Dermatoglyphic profile in congenital cataracts.
AB  - Forty-five children with congenital cataract cases were studied for patterns and
      compared with age sex matched controls. The patients showed marked differences in
      different dermatoglyphic traits. The intra uterine aetiological groups i.e.
      rubella, hereditary and undetected aetiology, showed variations in mainline
      terminations. Rubella group showed increased angle atd.

PMID- 2228097
TI  - Pediatric emergency news letter no. 11.

PMID- 2228099
TI  - Vein of Galen aneurysm.

PMID- 2228100
TI  - Glycosylated hemoglobin level: an indicator of fetal birth weight and perinatal
      outcome.

PMID- 2228098
TI  - Congenital leukemia.

PMID- 2228101
TI  - Cryptosporidiosis in children with diarrhea.

PMID- 2228102
TI  - Renal amyloidosis.

PMID- 2228105
TI  - Complex mixtures and cancer risk.

PMID- 2228104
TI  - Complex mixtures and cancer risk.

PMID- 2228103
TI  - Cancer: causes, occurrence and control.

PMID- 2228106
TI  - Use of bacterial assay system for monitoring genotoxic complex mixtures in the
      occupational setting.
AB  - Workplace environmental genotoxicity assessments, which may be carried out either
      by laboratory analysis or using an in-situ assay system, are potentially useful
      for health hazard evaluations, for industrial hygiene and biological (genetic)
      monitoring. Whenever possible, genotoxicity assays should be performed in
      conjunction with industrial hygiene studies to assess the biological activity of
      workplace contaminants. Efforts should continue to be made to establish a simple
      and reliable in-situ assay system for the detection and monitoring of genotoxic
      complex mixtures in the occupational setting.

PMID- 2228108
TI  - Approaches to detecting individual exposure to carcinogens.
AB  - Specific and sensitive methods are now available to detect DNA and protein
      adducts induced by a variety of carcinogens. These measurements of individual
      exposures are now starting to be used in cancer epidemiological studies. In this
      paper the requirements and the problems in implementation of the studies are
      discussed, as well as aspects of interpretation of the results in relation to
      assessments of past exposure and biological relevance to the disease process.

PMID- 2228107
TI  - Chemical mixtures and interactive carcinogenesis: in vitro studies.
AB  - Interactive effects in carcinogenesis have been described for a certain number of
      combinations of agents. They are described in terms of inhibition or enhancement
      of carcinogenesis, and the latter can involve either synergistic, cocarcinogenic
      or promotional action. Such effects constitute an important consideration to be
      borne in mind in assessment of the risks due to complex exposures.

PMID- 2228109
TI  - Approaches used by the US National Toxicology Program in assessing the toxicity
      of chemical mixtures.
AB  - The US National Toxicology Program has made a definite commitment towards
      improving the understanding and predictability of the toxicity of chemical
      mixtures. The commitment has consisted of a thorough review by the National
      Research Council of the state of the art of complex mixture testing and strategy
      for in vivo tests as well as a series of laboratory studies to better
      characterize the toxicity of selected chemical mixtures and research programmes
      to improve our ability to predict the toxicological properties of other mixtures.

PMID- 2228110
TI  - Analytical tools and biomonitoring for carcinogens in complex mixtures.
AB  - Two approaches are described for the analysis and biomonitoring of complex
      mixtures: (a) activity-guided fractionation of pyrolysed opium followed by
      spectroscopic determination of molecular structure and (b) trapping of possibly
      genotoxic metabolites by a series of microencapsulated, recoverable, synthetic
      macromolecular targets within the milieu of the gastrointestinal tract. Opium
      pyrolysis was shown to produce (principally from morphine) a series of
      hydroxyphenanthrenes of novel structure having activity not only in the S.
      typhimurium used as a guide, but also in a variety of in vitro and in vivo test
      systems. Many analytical tools were used together for separation, structure
      determination and activity monitoring, and their relative merits and overall
      strategy are discussed. The microcapsules have been shown to trap carcinogens,
      nitrosating agents, cross-linking agents and aldehydes. Their trapping of a model
      carcinogen in vivo is modulated by components of human diets. Development of
      these microcapsules for detecting endogenous carcinogens and their sources is
      discussed with reference to the type of target and analytical tools that may be
      appropriate.

PMID- 2228111
TI  - Cytogenetic markers in detecting the effects of exposure to complex mixtures of
      chemicals.
AB  - A significant proportion of the mutations responsible for both inherited and
      acquired human disease are a consequence of chromosome structural changes and of
      losses or gains of whole chromosomes. Some of these changes are readily
      detectable by the cytogeneticist and their frequencies are increased following
      exposure of individuals to mutagens. Techniques to visualize human sperm
      chromosomes and to detect micronuclei in spermatids now allow the cytogeneticist
      to detect induced chromosomal mutations in human germ cells. Rapid advances in
      our understanding of the molecular organization of the human genome, in the
      application of recombinant DNA probes and in situ hybridization with isotopic and
      non-isotopic probes, now enable chromosome organelles and specific chromosomal
      regions to be uniquely identified. These approaches are being applied to analyse
      chromosomal changes in somatic cells and, coupled with the development of
      machines to rapidly analyse chromosomes and nuclei, provide a powerful means to
      utilize cytogenetic markers to detect the effects of exposure of people to
      complex mixtures of chemical mutagens.

PMID- 2228112
TI  - The effect of background variables on human peripheral lymphocyte micronuclei.
AB  - Application of biological methods for assessment of occupational and
      environmental exposure to single agents or complex mixtures is optimized by
      determination of the possible influence of background factors on the biological
      endpoint of interest. Analysis of micronuclei in peripheral blood lymphocytes
      using the cytokinesis-block method was performed on healthy volunteers up to
      three times for each individual at intervals of approximately four months.
      Questionnaires were administered to ascertain recent health history and lifestyle
      factors such as smoking and drinking habits. Results to date indicate that age (r
      = 0.45, p = 0.001) and estimated number of diagnostic X-rays during the past year
      (r = 0.35, p = 0.01) contribute significantly to increased frequency of
      micronuclei. Information on the potential influence of background factors is
      critical for appropriate statistical analysis of data from occupational and
      population monitoring studies that utilize the cytokinesis block lymphocyte
      micronucleus assay to assess exposure to genotoxic agents.

PMID- 2228113
TI  - Quantitation of chromatin patterns by image analysis as a predictive tool in
      chemopreventive trials with vitamin A.
AB  - Nuclear textures of oral mucosal cells were quantitated by image analysis, and
      their suitability as markers in a chemopreventive trial explored. Subjects were
      chewers of tobacco-containing betel quids with well established oral
      leukoplakias. Treatment consisted of a weekly oral administration of vitamin A
      (200,000 IU/week) for six months. Leukoplakias regressed in 57.1% of the 21 trial
      participants. The original leukoplakias did not redevelop within four months
      after termination of treatment. For image analysis, biopsies were taken from
      leukoplakias of five chewers before administration of vitamin A, at the end of
      the administration, and four months after termination of treatment. Sections of
      paraffin-embedded biopsies were stained with the Feulgen reaction and submitted
      to quantitative image analysis of two parameters: variance of intensity and
      entropy. Both these parameters were significantly reduced in all five trial
      participants as a result of the six-month vitamin A treatment. During the post
      treatment period, nuclei with condensed chromatin, as measured by the variance of
      intensity, reappeared in the mucosa of four of the five chewers examined,
      although no leukoplakias were detectable on visual examination of the oral
      cavity. The results indicate that the quantitation of nuclear textures in a small
      subpopulation of a chemopreventive trial could conceivably be a simple marker
      with a predictive value.

PMID- 2228116
TI  - Polycyclic aromatic hydrocarbon-DNA adducts in coke-oven workers.
AB  - Different approaches for measuring occupational exposure to polycyclic aromatic
      hydrocarbons (PAHs) are presented, (i) determination of PAHs in the workplace by
      personal sampling, (ii) determination of urinary PAHs and PAH metabolites, and
      (iii) measurements of aromatic DNA adducts in white blood cells by ultra
      sensitive enzyme radioimmunoassay (USERIA) and 32P-postlabelling. Large amounts
      of PAHs, including benzo[a]pyrene (BP), are released from the coke ovens. Mean
      PAH exposure levels were reduced by 60% when the workers used masks during work.
      However, low PAH concentrations were found in the urine of the exposed workers.
      Approximately 40% of the coke-oven workers had detectable levels of
      benzo[a]pyrene diol epoxide (BPDE)-DNA adducts in the white blood cells measured
      by USERIA and 90% had levels of aromatic adducts detectable by the 32P
      postlabelling assay. In this study there was a correlation between DNA adduct
      levels and estimated exposure.

PMID- 2228115
TI  - DNA adducts in humans related to occupational and environmental exposure to
      aromatic compounds.
AB  - White blood cell DNA adducts were measured in coke workers, local controls and
      countryside controls using the 32P-postlabelling technique and immunoassay. The
      methods detected aromatic adducts, including those formed by polycyclic aromatic
      hydrocarbons. Coke workers are heavily exposed to aromatic compounds, which are
      also emitted in large amounts into the environment. The two techniques detected a
      large difference in adduct levels between the coke workers and the countryside
      controls. The adduct levels in the local controls were substantially higher than
      those in the countryside controls. As occupational exposure did not account for
      such a difference, the data suggest that the source of aromatic adducts in local
      controls is environmental pollution.

PMID- 2228117
TI  - Biologically based models for risk assessment.
AB  - The modelling problems associated with the estimation of risks from long-term
      chemical exposures at low dose levels represent a statistical and mathematical
      challenge with special relevance to environmental research. Determining an
      adequate model for estimating the relationship between dose and response is
      critical to reducing potential bias in the risk estimation process. This paper
      discusses the various assumptions and models used in carcinogenic risk
      assessment. The emphasis is on our ability to accurately determine the magnitude
      of the carcinogenic risk, the shape of the dose-response relationship and the
      overall variability of the risk estimates.

PMID- 2228114
TI  - Macromolecular adducts and related biomarkers in biomonitoring and epidemiology
      of complex exposures.
AB  - In order to evaluate the potential of biological markers in epidemiology and risk
      assessment of complex exposures, we review recent studies of macromolecular
      adducts and oncogene activation in human populations. Results are discussed in
      terms of the strengths and weaknesses of various study designs in order to
      identify the most promising approaches for future research.

PMID- 2228119
TI  - Biological monitoring of human exposure to coal tar. Urinary mutagenicity assays
      and analytical determination of polycyclic aromatic hydrocarbon metabolites in
      urine.
AB  - The mutagenicity of urine extracts from anode plant workers exposed to coal tar
      pitch volatiles and non-smoking psoriatic patients treated with coal tar
      applications and UV light (Goeckermann regimen), was determined by the plate
      incorporation assay and the fluctuation test employing Salmonella typhimurium
      strain TA98 in the presence of rat liver post-mitochondrial fractions and
      deconjugating enzymes. The levels of total polycyclic aromatic hydrocarbons
      (PAHs) and of a marker metabolite of pyrene (1-hydroxypyrene) were determined in
      the urine of the same subjects. Both the occupational and in particular the
      therapeutic exposure to coal tar resulted in clear increases in urinary levels of
      PAH metabolites as compared to unexposed subjects. The level of 1-hydroxypyrene
      in the urine samples was comparable to or even greater than the corresponding
      level of total PAHs, indicating a poor recovery of PAH metabolites for this
      method. Following treatment with coal tar, most of the psoriatic patients
      excreted clearly increased levels of mutagens in their urine, while non-smoking
      anode plant workers showed no increase in urinary mutagenicity. The minimum
      levels of PAH metabolites corresponding to a significant increase in urinary
      mutagenicity varied from sample to sample, presumably depending on interfering
      factors present in different amounts in the extracts. Nonetheless the urine
      samples which were clearly mutagenic presented elevated levels of PAH
      metabolites, suggesting that the mutagenicity assays lack sufficient sensitivity
      to allow their application in the biological monitoring of most occupational
      exposures to coal tar.

PMID- 2228120
TI  - DNA adduct formation in human and mouse skin by mixtures of polycyclic aromatic
      hydrocarbons.
AB  - 32P-Postlabelling analysis has been used to detect the formation in vivo of DNA
      adducts by components of complex mixtures of polycyclic aromatic hydrocarbons
      (PAHs) in coal-tar, creosote, bitumen, juniper tar, used engine oils and fuel
      exhaust condensates. The presence of DNA adducts derived from these agents has
      been investigated in mouse skin, in human skin explants maintained in short-term
      organ culture and in human skin in vivo, and the formation of many different PAH
      DNA adducts was observed. Similar levels and patterns of adducts were found in
      DNA from human skin to those in mouse skin, which is known to be susceptible to
      the carcinogenic activity of PAH mixtures, thus demonstrating the potential
      hazard to man of epidermal contact with these materials.

PMID- 2228121
TI  - Carcinogens in our environment.

PMID- 2228122
TI  - Air pollution and cancer.
AB  - Epidemiological studies have shown increased lung cancer risks in urban areas and
      in communities near some types of industries, such as non-ferrous smelters. The
      excess relative risks are generally of the order of 50% or lower, which implies
      that uncontrolled confounding has to be considered in the evaluation.
      Extrapolations of risks associated with occupational exposures provide some
      support for the findings. For cancer of other sites, the data are less
      consistent. An increased precision in exposure estimation is desirable in future
      epidemiological studies on cancer related to ambient air pollution.

PMID- 2228118
TI  - A pilot study of detection of DNA adducts in white blood cells of roofers by 32P
      postlabelling.
AB  - To assess the utility of DNA adducts as biomarkers of exposure to carcinogens in
      an industrial population, a pilot study of roofers occupationally exposed to a
      mixture of polycyclic aromatic hydrocarbons was conducted. DNA was isolated from
      peripheral white blood cells of roofers and non-occupationally exposed subjects
      matched for age, sex and smoking status. Occupational exposures to anthracene,
      fluoranthene, pyrene, benzanthracene, benzo[a]pyrene, benzo[b]fluoranthene,
      benzo[g,h,i]perylene and benzo[k]fluoranthene were assessed by personal breathing
      zone air sampling and skin wipes. Exposures to benzo[a]pyrene in air of exposed
      subjects ranged from 0.60 microgram/m3 to 1.39 micrograms/m3, and exposures to
      total polycyclic aromatic hydrocarbon (the sum of eight hydrocarbons) ranged from
      6.0 micrograms/m3 to 13.8 micrograms/m3 on the day before blood collection. In
      the biomarker studies 10 of 12 roofers, but only 2 of 12 comparison subjects, had
      detectable levels of aromatic DNA adducts by 32P-postlabelling assay (p less than
      0.01). The two non-roofers with detectable adducts had levels at or near the
      detection limit of 2 adducts per 10(9) nucleotides. In two roofer samples which
      were studied in a mixing experiment, the major adduct spots did not co-migrate
      with the guanosine N2 adduct of benzo[a]pyrene diol epoxide. These results
      suggest that the 32P-postlabelling assay may be useful for monitoring exposures
      to complex mixtures of aromatic hydrocarbons in industrial populations.

PMID- 2228123
TI  - Complex mixtures of urban air pollutants: identification and comparative
      assessment of mutagenic and tumorigenic chemicals and emission sources.
AB  - Current research on the cancer risks of complex mixtures of urban air pollutants
      addresses the identification and comparative assessment of mutagenic and
      carcinogenic chemicals and emission sources. To identify genotoxic compounds in
      urban air, micromutagenesis methods are coupled to analytical fractionation and
      new chemical characterization methods. Among polar mutagenic compounds, many
      appeared to be nitrated and or oxygenated aromatic compounds. Source
      apportionment of the mutagenic activity observed in urban air shows that vehicles
      and residential heating are major contributors to the ambient mutagenicity of the
      aerosol fraction. Comparative tumorigenesis and DNA adduct dosimetry studies are
      also being conducted with these same combustion emission sources and urban
      aerosols. The potential hazard and sources of the gaseous emissions have not been
      determined, but appear to be significantly increased by atmospheric
      transformation by ozone and nitrogen oxides.

PMID- 2228124
TI  - Mutagenic activity of complex air pollutants in Silesia.
AB  - Continuous monitoring of air over the highly industrialized region of Silesia,
      Poland, shows high pollution with free sedimenting particulate matter, gaseous
      compounds and metals. Partial chemical analysis of extracts from airborne
      particulate material revealed over a hundred polycyclic aromatic hydrocarbons
      (PAHs); 15 major PAHs were evaluated quantitatively at 20 measuring points during
      summer and winter periods. Both direct and indirect mutagenic activity in
      extracts of particulate material was observed, with seasonal variations in
      activity. The direct mutagenic activity was higher in winter samples than in
      summer ones. Summer samples exhibited high mutagenic activity after metabolic
      activation of extracts.

PMID- 2228125
TI  - Mutagenicity of emission and immission samples around industrial areas.
AB  - Urban air particulates (suspended particles and settling dusts), as well as dusts
      emitted by a Soderberg aluminium production plant and a coal-burning power plant,
      in the industrial town of Ajka were analysed for polycyclic aromatic hydrocarbon
      (PAH) content (liquid chromatography) and mutagenicity (Salmonella microsome
      test). The same parameters for air particulates from Papa (a town of similar size
      without much heavy industry) were analysed and compared to those from Ajka. The
      dust content, PAH concentration and the mutagenic potency of the air in Ajka were
      higher than in Papa. Mutagenicity of airborne particulates showed a clear
      seasonality with a winter maximum and a summer minimum in both towns. The
      mutagenic potency of air correlated well with the benzo[a]pyrene (BP) and PAH
      content in Ajka but not in Papa. The amounts of extractable organic material and
      mutagenic potency, as calculated for unit quantity of airborne particulate
      matter, were higher in the Papa samples. Similar differences between the two
      towns were observed in the case of deposited dust. As regards the emission dusts,
      the aluminium plant emissions are responsible for much more of the mutagenicity
      of the urban air than the power plant emission, which is the main component of
      air dust pollution in Ajka.

PMID- 2228126
TI  - Statistical aspects of experimental studies with complex mixtures.
AB  - Some formal concepts are introduced relating to the statistical design and
      analysis of experiments with complex mixtures. Aspects relating to the chemical
      analysis of complex mixtures, identification of their major components,
      continuous monitoring of samples or related issues are not addressed. As a
      surrogate for experimental studies in general, the discussion is oriented towards
      the situation of long-term animal experiments. When complex mixtures of unknown
      components are to be tested, samples collected under a standardized protocol must
      be applied to the different exposure groups in such a way that the experimental
      groups differ only in the dose of the exposure they receive. If the composition
      of a mixture is known, selected components may be combined in experimental
      testing in order to study the nature of their joint effect. Careful consideration
      guided by a priori knowledge about the individual compounds' dose-response
      relationships is required to design and analyse such experiments. There is an
      apparent need to avoid confusion by unifying the terminology in this field.

PMID- 2228128
TI  - Genotoxicity of drinking waters.
AB  - Drinking waters in many countries have been shown to contain non-volatile polar
      mutagenic compounds as well as trihalomethanes. Their nature is uncertain, but
      one compound, a chlorinated furanone (3-chloro-4-(dichloro-methyl)-5-hydroxy
      2(5H)-furanone;MX) seems to be responsible for one third to over one half of the
      mutagenicity. Its concentration seems to correlate rather well also with the
      total bacterial mutagenicity. Animal toxicity studies are being used to evaluate
      the possible carcinogenicity risk of this compound as a first stage in complete
      risk assessment of the whole complex mixture. Epidemiological risk assessment is
      also possible, since mutagenicity values can be predicted on the basis of organic
      material in the raw water and the amount of chlorine used. This information has
      been collected in Finland retrospectively from waterworks, and will be correlated
      with the Finnish Cancer Registry data.

PMID- 2228127
TI  - Drinking water and human cancer.
AB  - The relatively low concentrations of the various natural and man-made
      contaminants of drinking water, together with the methodological problems of
      obtaining valid and complete exposure histories for individuals and of
      controlling for confounding factors, have made it difficult for epidemiological
      studies to detect and estimate risks of cancer. Nearly all studies to date, with
      some exceptions for the halogenated hydrocarbons, have been at the ecological
      level. For these and other reasons, quantitative risk assessment of the cancer
      risks due to this complex environmental exposure remains rudimentary. If,
      eventually, risks are assessed to be non-trivial, primary prevention could be
      sought by alternative choices of either methods of water treatment or of water
      sources. However, since we cannot eliminate all trace carcinogens from our
      environment, we need simultaneously to minimize both the exposures and the
      biological impact of such exposures. The latter will require studies of cancer
      chemoprevention, using biochemical and molecular epidemiological approaches.

PMID- 2228130
TI  - Mutagenic compounds in chlorinated pulp bleaching waters and drinking waters.
AB  - A review is given of the isolation and identification of the extremely strong
      bacterial mutagen 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone, coded MX,
      in wood pulp chlorination waters in 1980. This compound is one of the most potent
      known mutagens, as determined by the Ames test. In 1986 this compound was found
      also in chlorinated drinking water. MX accounts for a substantial portion of the
      mutagenicity of chlorinated drinking waters. Several other compounds related to
      MX have recently been identified in chlorinated waters, such as the geometric
      isomer (E-MX), the oxidized and reduced forms of MX and the oxidized form of E
      MX. Brominated analogues of MX may be formed by chlorination in the presence of
      bromide ions. Unanswered questions pertaining to the chemistry and genotoxicity
      of MX and related chlorinated mutagens are examined.

PMID- 2228129
TI  - Toxicity and mutagenicity of a mixture of 25 chemicals found in contaminated
      groundwater.
AB  - A defined mixture of 25 chemicals that are often found in contaminated
      groundwater was prepared as an aqueous solution and studied for mutagenicity in
      bacteria, for prophage induction in bacteria, for palatability and effect on
      weight-gain in rats and mice, and for cytogenetic effects in bone marrow cells of
      rats and mice. The bacterial mutation and prophage induction tests were negative.
      Exposure to the mixture in drinking water for two weeks resulted in a
      concentration-related decrease in water consumption in male and female rats and
      mice. Concentration-related decreases in weight gain were observed in male and
      female mice; in rats, only the high-dose groups showed decreased weight gains. A
      small but significant increase in sister chromatid exchanges was seen in male
      mice and a similar weak effect on micronucleated polychromatic erythrocytes (PCE)
      in the bone marrow of males and females. Also in bone marrow of male and female
      mice, an increase in mitotic index and a decrease in average cell generation time
      was observed. The %PCE in bone marrow was decreased in female mice only, while
      the %PCE in peripheral blood was increased in both sexes. In rats, the only
      effects observed in the cytogenetic studies were increased PCE frequencies in the
      peripheral blood of males and in the bone marrow of males and females. These
      results indicate that the 25-chemical mixture studied is not genotoxic in
      bacteria and that a concentration-dependent effect on its palatability to rodents
      leads to reduced water consumption, food consumption and weight gain. Although
      the bone marrow effects may be associated with disruptions of normal
      erythropoiesis that, in turn, alter the cytogenetic end-points reported,
      elevations of SCE and MN-PCE in mice suggest the 25-chemical mixture, under the
      conditions of administration, leads to cytogenetic damage in the bone marrow.
      Such damage may indicate a potential health hazard.

PMID- 2228132
TI  - Interaction between human carcinogens.
AB  - In the absence of direct information on the carcinogenicity of a complex mixture,
      assessment of its risk requires not only knowledge of the risks due to the
      separate components, but also assumptions about the interaction between the
      components. A formal definition of interaction is given, followed by a discussion
      of the theoretical basis for different kinds of interactions. Epidemiological
      studies which have considered the simultaneous effect of two chemical carcinogens
      are reviewed, and shown to provide examples of additivity, multiplicativity and
      interaction both intermediate between the two and greater than multiplicative.
      Finally, implications for the risk assessment of mixtures are discussed.

PMID- 2228131
TI  - Environmentally stable chlorinated contaminants from the pulp and paper industry.
AB  - Toxic polychlorinated dioxins and dibenzofurans have been identified in effluents
      and products from pulp and paper mills using chlorine bleaching. The amounts and
      levels depend on the bleaching technique used and the product quality. The same
      compounds have also been identified in sediment samples and aquatic organisms
      collected in the vicinity of pulp mills. The highest levels were found in
      hepatopancreas from crustaceans. Much higher levels of alkyl-substituted
      polychlorodibenzofurans have been found in sediment and sludge samples.

PMID- 2228133
TI  - Carcinogenicity and mutagenicity of the shale-oil produced in the Estonian
      Kiviter retort.
AB  - Skin painting experiments in CC57Bl mice showed that the total oil (TO) obtained
      by thermal processing of lump oil shale in the high capacity 'Kiviter' retort
      containing 56 ppm benzo[a]pyrene (BP) and diluted with benzene (66.6%) induced
      skin tumours in five out of 60 effective mice--in three mice squamous-cell
      papillomas and in two mice carcinomas. The light fraction (230-350 degrees C) of
      this oil and the laboratory residue (82 ppm BP) of the latter failed to induce
      skin tumours. An industrial residue of a blend of shale oils containing 590 ppm
      BP induced in 10 mice papillomas and in three mice carcinomas, gave a positive
      response in the Ames assay and also induced chromosome aberrations and sister
      chromatid exchanges. The laboratory residue and light fraction were clearly
      mutagenic in the Ames assay and positive responses were also obtained with the
      basic and neutral fractions and a polynuclear aromatics fraction.

PMID- 2228134
TI  - Estimated risk of lung cancer attributable to occupational exposures in iron and
      steel foundries.
AB  - Elevated risks of lung cancer have been observed in foundry workers in a number
      of studies. When the levels of exposure were compared with other industries, the
      most probable causes of the lung cancer excess were polynuclear aromatic
      compounds (PACs) and silica in iron foundries and PACs, silica, as well as
      chromium and nickel fumes in steel foundries.

PMID- 2228136
TI  - Assessment of exposure to genotoxicants in a foundry.
AB  - The mutagenicity of acetone extracts of airborne particles sampled during two
      seasons at different work sites in a foundry and of foundry workers' urine
      concentrates was determined by the Salmonella plate incorporation assay. In
      general, the ambient concentration of particles did not correlate with the air
      mutagenicity at different work sites. The considerable seasonal variation in the
      mass concentration of fumes and/or dust and in the airborne particles and air
      mutagenicity, was apparently related to changes in the intensity of work at some
      work sites. Because of confounding with smoking, urine mutagenicity was not found
      suitable for assessment of individual exposure, even though at a group level some
      correlation in mutagenicity was observed between the air at specific work sites
      and the workers' urine.

PMID- 2228135
TI  - Definition of exposure in epidemiological studies on foundry workers.
AB  - Epidemiological analytical studies investigating lung cancer risk among foundry
      workers are reviewed in relation to the available information on exposure. Nine
      studies (eight historical cohorts and one case-control) have been included.
      Overall, the information on exposure was poor. In none of the studies were there
      industrial hygiene measurements for investigating dose-response relationships,
      while duration of employment was the most common proxy of exposure utilized. None
      of the studies made an attempt to construct job-exposure matrices. The
      interpretation of the evidence in causal terms appears mainly based on the
      consistency across studies of the increased lung cancer mortality rather than on
      the relationship between the exposure in the working environment and the excess
      mortality reported.

PMID- 2228137
TI  - Cancer epidemiology in the paper and pulp industry.
AB  - Several studies of pulp and paper workers have demonstrated increased risks for
      certain cancer sites, e.g. tumours of the lymphatic and haematopoietic system as
      well as stomach cancer. An impressive lung cancer excess was found among paper
      and board mill workers in Finland, but not in studies elsewhere. Individual
      exposures have not been estimated, neither has a job-exposure matrix been applied
      in any of the studies. Therefore, it is impossible to link any of the excesses to
      specific single compounds or mixtures, of which there are a multitude in the pulp
      and paper industries. Although there are high quantities of organic chlorine
      compounds in the process mixtures and waste, the compounds have low volatility
      and occupational exposures are not necessarily high. Estimations of individual
      occupational exposure should be mandatory in future epidemiological studies in
      this industry.

PMID- 2228139
TI  - Food as source of complex mixtures of mutagens and carcinogens.

PMID- 2228140
TI  - Chemistry and biological activity of volatile and nonvolatile mutagenic compounds
      from cooked food.
AB  - Cooking fumes constitute a major part of the mutagenic activity detected in
      indoor air samples. The chemical nature of the smoke mutagens has not been
      determined, but existing data indicate the presence of carcinogenic heterocyclic
      amines, previously identified in crust and pan residue from fried meat. Reports
      on the chemical nature and biological activity of these compounds are reviewed.

PMID- 2228138
TI  - Complex chlorinated hydrocarbons: occupational exposure in the sawmill industry.
AB  - Exposure to chlorophenols occurs in the vicinity of the lumber treatment area in
      sawmills and in subsequent work phases where treated lumber is handled.
      Measurements from several countries indicate that the concentration of
      chlorophenols in the workroom air is generally below 0.5 mg/m3, the occupational
      exposure limit of chlorophenols in many countries. Inhalation usually leads to
      relatively low concentrations of chlorophenols in urine of exposed workers.
      Frequent skin contact with chlorophenol solution or with freshly treated lumber
      can produce urine concentrations 10-100 times higher than among those with
      inhalatory exposure only. In addition to chlorophenols, exposure to toxic
      polychlorinated dibenzodioxins and dibenzofurans may occur in some tasks carried
      out in sawmills. Jobs with potentially heavy exposure include the treatment of
      dipping-vat sludge and processes involving heating of chlorophenols, such as
      burning of treated waste wood and welding of metal structures contaminated by
      chlorophenols.

PMID- 2228141
TI  - Dietary influences on urinary excretion of hydroxyphenanthrenes, thioethers and
      mutagenicity in man.
AB  - Our study indicates that large differences in dietary polycyclic aromatic
      hydrocarbon (PAH) content in humans are not reflected by urinary and faecal
      excretion of hydroxyphenanthrenes, although significant increases in 3
      hydroxybenzo[a]pyrene and 3-hydroxychrysene in faeces were observed after
      consumption of a diet rich in PAHs. The question therefore arises whether urinary
      hydroxyphenanthrenes are a reliable marker for exposure to PAHs. As expected, the
      elevated mutagenicity of the diet rich in PAHs led to increased mutagenic
      activity in urine. The increased urinary excretion of thioethers after this diet
      was probably due to its higher thioether content. Therefore, an elevated
      thioether excretion does not always indicate exposure to electrophilic compounds.

PMID- 2228142
TI  - Linear relationship between DNA adducts in human lung and cigarette smoking.
AB  - Human lung and bladder DNA has been isolated and purified from either surgical or
      autopsy specimens. Smoking history details were obtained from patients or their
      close relatives. Each DNA sample was investigated using the nuclease P1 digestion
      modification of the 32P-postlabelling procedure. Data are presented for 48 lung
      and 19 bladder specimens. The samples were subdivided into three groups for data
      analysis, viz. smokers, former smokers and nonsmokers. The mean adduct levels
      (adducts per 10(8) nucleotides) in lung samples were: [see text] The
      chromatographic pattern of bladder DNA adducts for smokers was similar to that
      for smokers' lung DNA, although less intense. Adduct levels in former smokers
      tended to be lower than in smokers, although loss of adducts appeared to require
      several years after cessation of smoking. These findings support a link between
      DNA adduct levels and cigarette smoking, for both the lung and the bladder. For
      the former tissue there was a strong linear correlation between adduct levels and
      the number of cigarettes smoked.

PMID- 2228143
TI  - Mouse skin tumours and human lung cancer: relationships with complex
      environmental emissions.
AB  - Mouse skin tumorigenesis has often been used to evaluate the tumorigenic effects
      of complex mixtures, including human respiratory carcinogens. This study examines
      the quantitative relationships between tumour induction in SENCAR mouse skin and
      the induction of respiratory cancer in man using four well established human
      respiratory carcinogens: emissions from coke ovens, roofing tar pots, diesel
      engines, and cigarettes. The tumour multiplicity data from mouse skin studies
      using extracts of particulates from each of the four emission sources are
      compared and their relative potencies to the coke oven sample are: coke
      oven:roofing tar:diesel:cigarette smoke condensate; 1.0:0.20:0.15:0.0011. Using
      the unit risk (the lifetime probability of respiratory cancer death due to a
      constant lifetime exposure of 1 microgram/m3 emissions in the inhaled air) to
      compare the potencies of the four emissions to human respiratory cancer, the
      relative potencies are: coke oven:roofing tar:diesel:cigarette smoke:
      1.0:0.39:0.075:0.0024. When fitted to a linear regression, the mouse skin tumour
      data and human lung cancer risks were highly associated, with a correlation
      constant of 0.95 and a slope value of 0.89. The close association suggests that
      this comparative potency approach can be used in prospective analyses of human
      respiratory cancer risk to complex emissions, and several examples are proposed.
      In addition, the similarity of the chemical and toxicological characteristics of
      complex mixtures is discussed with regard to the prospective use of the
      comparative potency approach.

PMID- 2228144
TI  - Screening assays for carcinogenic agents and mixtures: an appraisal based on data
      in the IARC Monograph series.
AB  - To determine whether genotoxic and non-genotoxic carcinogens contribute similarly
      to the cancer burden in humans and which types of short-term test are more
      relevant for predicting human hazards, an analysis was performed on agents that
      were evaluated in IARC Monographs Supplements 6 and 7 for their carcinogenic
      effects in humans and animals and for activity in short-term genotoxicity tests.
      The prevalence of genotoxicity among four groups of agents, consisting of
      established human carcinogens (group 1, n = 30), probable human carcinogens
      (group 2A, n = 37), possible human carcinogens (group 2B, n = 113) and agents
      with limited evidence of carcinogenicity in animals (a subset of group 3, n = 66)
      was determined. Each of the groups 1, 2A and 2B contained a high proportion (80
      90%) of genotoxic carcinogens, which were also multi-species or multi-tissue
      carcinogens. The distribution of carcinogenic potency in rodents did not reveal
      any specific characteristic of the human carcinogens in group 1 that would
      differentiate them from agents in groups 2A, 2B and many in group 3. Although
      limited by the data-base available through the Monographs series, this analysis
      implies that genotoxic carcinogens add more to the human cancer burden than non
      genotoxic carcinogens. Thus, the continued use of in vitro/in vivo short-term
      tests, involving as endpoints DNA chromosomal or mutational damage, to identify
      genotoxic carcinogens or in the isolation of carcinogenic components in complex
      mixtures is fully justified. It is concluded that (a) an agent or complex mixture
      with unknown carcinogenic potential showing sufficient evidence of activity in
      genotoxicity assays in vitro or in vivo is likely to represent a hazard to humans
      and (b) an agent or complex mixture showing lack of activity in this spectrum of
      genotoxicity assays should undergo evaluation for carcinogenicity for rodent
      bioassay, in view of the present lack of validated short-term tests for non
      genotoxic carcinogens.

PMID- 2228146
TI  - The use of short-term tests in detecting carcinogenicity of complex mixtures.
AB  - Since it is not feasible to test all substances in long-term animal studies,
      short-term tests for DNA damage, gene mutation, aneuploidy, chromosomal damage
      and cell transformation performed in prokaryotes and eukaryotes in vitro and in
      vivo are used to test pure chemicals and mixtures. Understanding the contribution
      of mutagens in air, water and food is important to our way of life; methods of
      sampling and testing such mutagens are discussed in this review.

PMID- 2228145
TI  - Genetic activity profiles--application in assessing potential carcinogenicity of
      complex environmental mixtures.
AB  - Some knowledge of the potential genetic activity of a complex environmental
      mixture may be gained from an assessment of the genetic activity of its component
      chemicals. The expanded genetic activity profile (GAP) data-base provides a
      computer-generated graphic representation of genetic bioassay data as a function
      of dose of the substance tested. In addition, the atmospheric chemical compound
      (ACC) data-base contains information on chemical structures, properties,
      detection methods and sources of chemicals found in ambient air. Using the
      combined data-bases, information on the quantity of an individual chemical
      present within a mixture or fraction of a mixture may be related to the quantity
      (lowest effective dose; LED) of the chemical required to demonstrate a positive
      response in one or more genetic bioassays. Alternatively, quantitative
      information on the carcinogenic potency of each individual compound (TD50 value)
      may be related to the quantity present in the mixture or mixture fraction and
      used to calculate the percent human exposure dose/rodent potency dose (HERP) for
      the chemical. Using an additivity assumption, a conservative estimate of
      potential carcinogenic hazard for the mixture may be calculated based on the HERP
      indices for its chemical components. This conceptual approach is limited by the
      relatively small number of chemicals identified in complex mixtures for which
      genetic toxicology and animal cancer data exist.

PMID- 2228147
TI  - Close correlation of intra-abdominal fat accumulation to hypertension in obese
      women.
AB  - The relation between intra-abdominal visceral fat accumulation and blood pressure
      was investigated in 67 obese women (mean body mass index, 33.6 +/- 3.1; average
      age, 50 +/- 11 years). As an index of intra-abdominal fat accumulation, the ratio
      of the intra-abdominal visceral fat area to subcutaneous fat area was determined
      using a computed tomographic section at the level of the umbilicus. When the
      obese subjects were divided into a hypertensive group and a normotensive group,
      the ratio of the intra-abdominal visceral fat area to subcutaneous fat area in
      the hypertensive group was significantly higher (0.53 +/- 0.33 versus 0.29 +/-
      0.12, p less than 0.01). Significant correlations between the ratio of intra
      abdominal visceral fat area to subcutaneous fat area and systolic blood pressure
      (r = 0.62, p less than 0.001) and diastolic blood pressure (r = 0.53, p less than
      0.001) also were found. However, no significant difference existed in either the
      body mass index or the waist-to-hip circumference ratio between the hypertensive
      and normotensive groups. Plasma renin activity, aldosterone, epinephrine, and
      norepinephrine levels were not significantly different between the two groups.
      Moreover, the correlation between the ratio of the intra-abdominal visceral fat
      area to subcutaneous fat area ratio and blood pressure was found independent of
      age and body mass index by multiple regression analyses. We conclude that intra
      abdominal fat accumulation itself may play an important role in the pathogenesis
      of hypertension in obesity.

PMID- 2228148
TI  - Early 24-hour blood pressure elevation in normotensive subjects with parental
      hypertension.
AB  - Subjects with a family history of parental hypertension are reported to have a
      slightly higher office blood pressure in the prehypertensive stage. Whether this
      reflects a hyperreactivity to blood pressure measurement or a more permanent
      blood pressure elevation, however, is not known. In the present study, blood
      pressure was measured in 15 normotensive subjects whose parents are both
      hypertensive (FH++), 15 normotensive subjects with one hypertensive parent (FH(+)
      ), and 15 normotensive subjects whose parents are not hypertensive (FH--); among
      the three groups, subjects were matched for age, sex, and body mass index. The
      measurements were made in the office during a variety of laboratory stressors and
      during a prolonged resting period, and for a 24-hour period (ambulatory blood
      pressure monitoring). Office blood pressure was higher in the FH++ group than in
      the FH-- group (p less than 0.05). The pressor responses to laboratory stressors
      were similar in the two groups, but the FH++ group had higher prolonged resting
      and 24-hour blood pressure than the FH-- group; the difference was always
      significant (p less than 0.05) for systolic blood pressure. The FH++ group also
      had a greater left ventricular mass index (on echocardiographic examination) than
      the FH-- group (p less than 0.01). The blood pressure values and
      echocardiographic values of the FH(+)- group tended to be between those of the
      other two groups. Thus, the higher blood pressure shown by individuals in the
      prehypertensive stage with a family history of parental hypertension does not
      reflect a hyperreactivity to stress but an early permanent blood pressure
      elevation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228149
TI  - Inheritance of hypertension and blood pressure reactivity.

PMID- 2228150
TI  - Exercise tolerance and alcohol intake. Blood pressure relation.
AB  - The relations of systolic and diastolic blood pressures to alcohol intake and
      exercise tolerance levels in 15,612 men and 3,855 women were investigated.
      Alcohol intake was assessed by questionnaire and stratified into seven levels for
      men and six for women according to the ounces of ethanol consumed per week.
      Exercise tolerance was determined by maximal treadmill exercise testing and was
      categorized into six age-specific by sex-specific levels. Both systolic and
      diastolic blood pressure were significantly related to both alcohol intake and
      exercise tolerance levels in both men and women. These relations, which were
      positive for alcohol and negative for exercise tolerance, remained after
      covariance adjustment for age, body mass index, and cigarette smoking. Alcohol
      intake was not significantly correlated with exercise tolerance. The relation of
      blood pressure to alcohol was not linear because the blood pressure of moderate
      consumers of alcohol tended to be slightly lower than that of nondrinkers. Higher
      blood pressure was found only in drinkers whose ethanol intake exceeded 9.5
      ounces (approximately 285 ml or 19 drinks) per week. However, heavy drinkers in
      high exercise tolerance categories had no higher blood pressure than nondrinkers
      in low exercise tolerance groups. Exercise tolerance or physiological fitness
      appears to be important in quantifying the relation between alcohol intake and
      blood pressure and should be considered in describing this relation.

PMID- 2228151
TI  - Red blood cell Na+ transport as a predictor of blood pressure response to Na+
      load in young blacks and whites.
AB  - The present study was designed to investigate the role of abnormalities in red
      blood cell sodium-potassium-chloride (Na-K-Cl) cotransport and Na+ pump as
      predictors of the pressor response to chronic oral Na+ loading in young whites
      and blacks. Subjects were healthy adults from 18 to 23 years of age and included
      normotensive whites (n = 24) and normotensive blacks (n = 35). Red blood cell
      transport studies were performed before Na+ loading. The Na+ load consisted of 10
      g NaCl daily added to the usual diet. A sodium-sensitive response was defined as
      an increase of 5 mm Hg or more in mean arterial pressure after the Na+ load; a
      sodium-insensitive response was a less than 5 mm Hg increase in mean arterial
      pressure. A sodium-sensitive response occurred in 16% of whites and 57% of
      blacks. Black subjects have a significantly lower (p less than 0.005) maximal
      rate of furosemide-sensitive Na+ efflux and a higher Km for cellular Na+ (p less
      than 0.05) to activate Na-K-Cl cotransport than white subjects. Normotensive
      blacks with sodium-sensitive blood pressure response had a higher Km (14.4 +/- 6
      mmol/l cell, n = 17, mean +/- SD) to activate the cotransport than sodium
      insensitive blacks (9.9 +/- 3.7 mmol/l cell, n = 13, p less than 0.001).
      Normotensive whites had a significantly lower red blood cell Na+ content (p less
      than 0.05) and a higher maximal rate of cotransport (p less than 0.005) than
      young normotensive blacks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228152
TI  - Calcitropic hormones, platelet calcium, and blood pressure in essential
      hypertension.
AB  - Plasma ionized calcium, platelet cytosolic calcium (using the fura-2 method in
      gel-filtered platelets), parathyroid hormone (both the intact hormone and a
      midmolecule portion), calcitriol, and calcidiol were measured in 19 untreated
      male patients with essential hypertension and 19 age-matched normotensive male
      research subjects. Mean levels of platelet cytosolic calcium, parathyroid
      hormone, calcitriol, and calcidiol were all significantly higher, whereas plasma
      ionized calcium was significantly lower, in the hypertensive group compared with
      the normotensive group. Both platelet cytosolic calcium and intact parathyroid
      hormone were positively correlated with mean arterial pressure (r = 0.58, p less
      than 0.001; r = 0.54, p less than 0.001, respectively), whereas plasma ionized
      calcium was inversely correlated with mean arterial pressure (r = -0.60, p less
      than 0.001) in the combined group of all study subjects. All three of these
      correlations were significant in the hypertensive group alone but not in the
      normotensive group alone. When analyzed with plasma ionized calcium, body mass
      index, serum calcitriol, and calcidiol in a multivariable regression model, the
      significance of the partial regressions of platelet cytosolic calcium and
      parathyroid hormone with mean arterial pressure persisted. Intact parathyroid
      hormone was positively correlated to platelet cytosolic calcium (r = 0.43, p less
      than 0.01) and plasma ionized calcium was inversely correlated to platelet
      cytosolic calcium (r = -0.44, p less than 0.01). These results confirm previous
      reports of disturbances of calcium metabolism in essential hypertension and
      suggest that the elevated platelet cytosolic calcium observed in essential
      hypertension may be linked to one or more of these alterations of calcium
      metabolism.

PMID- 2228153
TI  - Injection of 1,25-(OH)2 vitamin D3 enhances resistance artery contractile
      properties.
AB  - The hypothesis that 1,25-dihydroxyvitamin D3 [1,25-(OH)2 vitamin D3] modulates
      vascular smooth muscle contractile function was tested. 1,25-(OH)2 vitamin D3 (50
      ng/day) was administered by intraperitoneal injection over a 3-day period to 13
      15-week-old male spontaneously hypertensive and Wistar-Kyoto normotensive rats.
      On the fourth day, serum was prepared and contractile force generation of
      isolated mesenteric resistance arteries was examined. Treatment with 1,25-(OH)2
      vitamin D3 approximately doubled serum levels of the hormone and increased
      ionized and total serum Ca2+ and phosphate by 5-10%. No effect on blood pressure
      was detected. 1,25-(OH)2 vitamin D3 injection in both strains enhanced maximal
      stress generation to norepinephrine and serotonin by 30-40%, with no effect on
      apparent sensitivity of the vessels to the agonists. To assess the effect of a
      maneuver that elevates serum ionized Ca2+ without the addition of exogenous
      hormone, maximal stress generation was examined in resistance arteries isolated
      from rats fed diets containing 0.5% or 2% calcium over a 6-7-week period. Maximal
      stress generation in response to norepinephrine was greater in vessels from rats
      of both strains maintained on 0.5% calcium. It is concluded that 72-hour in vivo
      treatment with 1,25-(OH)2 vitamin D3 increases contractile force-generating
      capacity of resistance arteries without affecting blood pressure. It is proposed
      that this action of 1,25-(OH)2 vitamin D3 is the result of a direct action of the
      hormone on the vascular wall.

PMID- 2228154
TI  - Does antihypertensive therapy improve the function of the vascular endothelium?

PMID- 2228155
TI  - Enalapril and renal injury in spontaneously hypertensive rats.
AB  - Rats of the spontaneously hypertensive strain develop kidney damage that
      resembles the nephropathy seen in some cases of human essential hypertension.
      Previous studies with a triple drug antihypertensive regimen indicated that
      proteinuria and glomerular histopathology in spontaneously hypertensive rats
      might develop despite long-term effective control of systemic blood pressure. To
      investigate further the relation between hypertension and kidney disease, a group
      of spontaneously hypertensive rats were treated with enalapril at 15 weeks of
      age. Blood pressure, protein excretion, and kidney function were measured in
      those rats at regular intervals during the next year and a half and were compared
      with untreated spontaneously hypertensive rats and the normotensive Wistar-Kyoto
      parent strain. Kidney tissue samples from all three groups, collected at autopsy,
      were stained by immunohistochemical and conventional methods to assess the
      relative severity and nature of kidney damage. Although enalapril therapy was
      completely effective in controlling the blood pressure of spontaneously
      hypertensive rats, it only postponed the onset of kidney disease. Enalapril
      treated spontaneously hypertensive rats eventually exhibited albuminuria as
      severe as that found in hypertensive rats. Kidney vessel pathology was completely
      prevented with enalapril, but the abnormal accumulation of mononuclear cells in
      tubulointerstitial and periglomerular sites was the same as in untreated
      spontaneously hypertensive rats. We have concluded that elevated protein
      excretion in rats of the spontaneously hypertensive rat strain is not a secondary
      consequence of systemic hypertension. Structural abnormalities of renal vessels
      also do not appear to contribute significantly to the pathogenesis of albuminuria
      in spontaneously hypertensive rats. Other explanations must be sought to account
      for the close link between spontaneous hypertension and kidney damage in this
      animal model. The clear dissociation of kidney disease from systemic hypertension
      exhibited by spontaneously hypertensive rats may also be relevant for human
      disease.

PMID- 2228156
TI  - Intrarenal de novo production of angiotensin I in subjects with renal artery
      stenosis.
AB  - To estimate the renal extraction and de novo production of angiotensin I and to
      assess the contribution of blood-borne renin to renal angiotensin I production,
      the aortic and renal venous plasma levels of renin and intact [125I]angiotensin I
      and endogenous angiotensin I during continuous systemic intravenous infusion of
      monoiodinated [125I]angiotensin I were measured in subjects with unilateral renal
      artery stenosis (n = 8) who were treated with captopril (50 mg b.i.d.). Results
      demonstrated that 80% of angiotensin I delivered by the renal artery was
      extracted both by the affected and the unaffected kidney and that on both sides a
      major part of angiotensin I in the renal vein was derived from intrarenal de novo
      production. Production of plasma angiotensin I was in excess over extraction (p
      less than 0.01) on the affected side, whereas extraction was in excess over
      production (p less than 0.01) on the contralateral side. The plasma level of de
      novo intrarenally produced angiotensin I in the renal vein was seven times higher
      on the affected side than the contralateral side. This difference was by far too
      big to be explained by a difference in the transit time of blood between the two
      kidneys, by an augmented production of angiotensin I in the circulating blood
      passing through the affected kidney due to the higher level of venous plasma
      renin activity in that kidney, or by the combination of both.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2228157
TI  - Effects of salt, race, and hypertension on reactivity to stressors.
AB  - Blood pressure and heart rate reactivity to a psychological stressor and to a
      cold pressor test were examined in a group of 51 normotensive and 37 unmedicated
      hypertensive men. All were studied twice, once while the participants were
      maintained on a moderately high salt (200 meq sodium/day) diet and once while the
      participants were maintained on an extremely low salt (10 meq sodium/day) diet.
      Dietary salt had no effect on blood pressure or heart rate responses to the two
      stressors. The systolic and diastolic responses of the white participants to the
      psychological stressor were greater than those of the black participants (both p
      less than 0.05); however, there was no difference between blacks and whites in
      reactivity to the cold pressor challenge. As compared with the normotensive
      group, the hypertensive group reacted to the psychological stressor with
      increased responses in systolic blood pressure, diastolic blood pressure, and
      heart rate (all p less than 0.05). The hypertensive group also hyperresponded in
      terms of the systolic pressure response to the cold pressor task (p less than
      0.05). Plasma norepinephrine and epinephrine responses were not significantly
      different across the two diets, races, or diagnoses.

PMID- 2228159
TI  - Update: Recommendations for human blood pressure determination by
      sphygmomanometers.

PMID- 2228158
TI  - Pressor systems in hypertension and congestive heart failure. Role of
      vasopressin.
AB  - Elevated peripheral vascular resistance, which characterizes hypertension and
      congestive heart failure (the latter regardless of absolute blood pressure level)
      is maintained to a large extent by the combined effects of three major
      neurohormonal pressor mechanisms: the renin-angiotensin system, the
      sympathoadrenal system, and arginine vasopressin. Blockade of one of these
      mechanisms may lead to compensatory stimulation of the others, thus offsetting in
      part the hemodynamic benefits of a specific intervention. Combination therapy,
      designed to attack all three systems (with use of an angiotensin converting
      enzyme inhibitor, a sympathetic blocker such as clonidine, and an antagonist of
      the vasopressor action of vasopressin), may help in the treatment of such cases.
      To illustrate this strategy, two experimental studies, one case of malignant
      hypertension, and one case of congestive heart failure are presented.

PMID- 2228161
TI  - Gastroesophageal reflux disease.

PMID- 2228162
TI  - Pathophysiology of gastroesophageal reflux. Lower esophageal sphincter
      dysfunction in gastroesophageal reflux disease.
AB  - LES dysfunction is the principal mechanism responsible for GER disease. Two main
      patterns of sphincter dysfunction have been identified: an abnormally high rate
      of transient LES relaxations, and defective basal LES pressure. Overpowering of a
      weak LES by pressure transients induced by straining is less common than
      previously thought, at least under conditions tested thus far. Current evidence
      suggests that LES dysfunction results primarily from defective neural control,
      although smooth muscle function may also be impaired. Extrinsic mechanisms,
      particularly the diaphragmatic crura, also appear to be important during
      straining. The role of hiatus hernia remains unclear but seems likely to
      contribute to the pathogenesis of reflux disease by impairing LES function.

PMID- 2228163
TI  - Esophageal motor activity and acid clearance.
AB  - Esophageal acid clearance normally occurs as a two-step process. The initial step
      of emptying most of the fluid volume contained within the esophagus occurs
      quickly by gravity or by one or two peristaltic sequences. However, volume
      clearance is distinct from acid clearance, and esophageal pH is restored to
      normal after volume clearance as the 1 mL or so of residual acid is neutralized
      by swallowed saliva in a stepwise fashion. A considerable body of evidence has
      accumulated suggesting that about half of patients with reflux disease have
      markedly prolonged acid clearance times. Within this group abnormalities or both
      volume clearance and salivation have been demonstrated. Volume clearance may be
      impaired as a result of a breakdown of the peristaltic mechanism commonly seen
      with severe esophagitis or by "re-reflux" of cleared fluid from within a hiatal
      hernia. Either way, the result is increased residual acidic fluid within the
      esophagus. The increased residual acid must be titrated with saliva that has so
      slight a neutralizing capacity that it takes about 7 minutes for the average
      person to secrete enough saliva to titrate 1 mL of 0.1 N HCl. Salivation itself
      is reduced in cigarette smokers and in patients using anticholinergic
      medications, thereby prolonging the process of mucosal neutralization in such
      persons. Whatever the mechanism of prolonged acid clearance for a particular
      individual, the overall result is of prolonged esophageal mucosal acid exposure,
      which makes the development of peptic esophagitis more likely.

PMID- 2228160
TI  - Current concepts of the antireflux barrier.
AB  - The lower esophageal sphincter, crural diaphragm, and phrenoesophageal ligament
      are the anatomic structures that constitute the antireflux barrier. The
      intraluminal pressure at the esophagogastric junction (EGJ) reflects the strength
      of the antireflux barrier. The end-expiratory pressure is a result of the tonic
      activity of the smooth muscles of the lower esophageal sphincter. The EGJ
      pressure increases during inspiration owing to the effect of the crural
      diaphragm. There is a reflex increase in the EGJ pressure during periods of
      increased intra-abdominal pressure, and the crural diaphragm contributes to this
      reflex contraction of the EGJ. Based on the contribution of the lower esophageal
      sphincter and crural diaphragm to the EGJ pressure, a two sphincter hypothesis of
      the antireflux barrier competence is suggested.

PMID- 2228164
TI  - Esophageal mucosal resistance. A factor in esophagitis.
AB  - The development of esophageal damage depends on a number of factors. The
      components in the refluxate, including H+ ion, pepsin, bile salts, and pancreatic
      enzymes, are able to permeate the mucosa and cause injury. These agents may act
      individually or in combination. Balancing the effects of these damaging agents is
      the "esophageal mucosal barrier." This barrier is an integrated complex of
      anatomic and physiologic components that acts to maintain the integrity of the
      mucosa. Although the relative efficacy of the various components in developing an
      effective barrier is not understood completely, their physiologic and clinical
      importance in the face of "noxious" luminal contents remains critical.
      Understanding the interplay between the injurious agents in the refluxate and the
      esophageal mucosal barrier may allow for the development of new therapeutic
      measures in the treatment and prevention of gastroesophageal reflux disease.

PMID- 2228167
TI  - Pediatric gastroesophageal reflux disease.
AB  - Gastroesophageal reflux is a recognized clinical problem in infancy. To a great
      extent it represents a normal behavior that improves with maturation. The
      identification of appropriate candidates for medical and surgical therapy of GER
      during infancy is difficult and deserves further study. There are few well
      conducted clinical trials of therapy for infantile GER that compare the usual
      drugs used for adults with GER. Moreover, medications currently licensed for
      adults are often not approved for pediatric use in the United States. Surgical
      therapy for GER should be reserved for infants with severe disease that does not
      respond to medical therapy.

PMID- 2228165
TI  - Medical and surgical conditions predisposing to gastroesophageal reflux disease.
AB  - Esophageal disease has been reported in 70% to 90% of patients with scleroderma,
      of whom nearly 50% will have reflux esophagitis. The combined motility disorder
      of low LES pressure and aperistalsis of the esophageal body makes scleroderma
      patients especially susceptible to severe gastroesophageal reflux disease (GERD).
      Symptomatic GERD is a common problem in pregnancy, affecting 30% to 50% of women.
      Hormonal effects of estrogen and progesterone likely promote GERD by compromising
      LES function. Fortunately, the problem is usually relieved with delivery of the
      baby. Although difficult to quantitate, the reflux of both acid and especially
      alkaline material may be a common sequela of many types of gastric surgery.
      Medical therapy binding bile salts usually does not bring relief. The Rouxen-Y
      biliary diversion operation is the best solution for this problem. GERD
      complicates the treatment of achalasia after 10% of Heller myotomies and 2% of
      pneumatic dilatations. Nearly 50% of patients with the Zollinger-Ellison syndrome
      have esophagitis, which may be more difficult to treat than their ulcer disease.

PMID- 2228166
TI  - The spectrum of the symptoms and presentations of gastroesophageal reflux
      disease.
AB  - The symptoms and presentations of gastroesophageal reflux disease are rather
      numerous. These include the typical symptoms, such as heartburn, regurgitation,
      water brash, or dysphagia. However, reflux may also be responsible for such
      symptoms as hoarseness, pulmonary aspiration, or asthma. It may also be an
      important cause of noncardiac chest pain. Thus, gastroesophageal reflux disease
      may be considered a disease with more than just "esophageal" symptoms.

PMID- 2228168
TI  - Esophageal pH monitoring.
AB  - In the 25 years since it was first described, prolonged esophageal pH monitoring
      has gained increasing acceptance and popularity as a diagnostic and research
      technique in GER disease. Some recent developments that have contributed to its
      attraction include compact portable recorders, computerized analysis, short
      monitoring periods, the good discriminant value of the simple measurement of
      percent monitoring time that pH is less than 4, and the symptom index, allowing
      correlation of symptoms with reflux events. Nevertheless, there remain areas of
      uncertainty with regard to reproducibility and the conditions of monitoring, in
      particular whether strict dietary control and controlled activity and posture are
      necessary. There is no universally accepted normal range of values, but it is now
      apparent that normal and abnormal GER are not appropriately differentiated by
      simply defining the upper limit of normal using a formula of the mean plus two
      standard deviations, so other statistical techniques have emerged. Indications
      for the technique include atypical symptoms, particularly noncardiac chest pain,
      respiratory symptoms, and, in young children, apneic attacks and recurrent
      vomiting associated with failure to thrive. The technique is having an impact on
      the assessment prior to, during, and after medical and surgical therapy for GER,
      as well as in helping to unravel the complexities of the pathogenesis of
      esophagitis.

PMID- 2228169
TI  - Ancillary tests in the diagnosis of gastroesophageal reflux disease.
AB  - This article reviews some of the diagnostic procedures for gastroesophageal
      reflux disease other than the procedures of choice, endoscopy and prolonged
      intraesophageal pH monitoring. The author discusses the roles of the acid
      perfusion (Bernstein) test, radiology, manometry, and radionuclide scintigraphy
      in the diagnosis and management of gastroesophageal reflux disease.

PMID- 2228170
TI  - Complications of reflux esophagitis and their medical management.
AB  - It is shortsighted to consider only the esophageal manifestations and
      complications of esophageal reflux. That such reflux can directly affect not only
      the lung but also the oropharynx and larynx, both by direct acid contact and
      reflex neurologic mechanisms, has been demonstrated repeatedly. The task of the
      future will be to place such reflux into perspective as it remains only one of
      many genetic and environmental factors associated with disparate and often
      confusing disease processes.

PMID- 2228173
TI  - [Focus on esthetic prototypes adopted for Branemark implants].

PMID- 2228171
TI  - Barrett's esophagus. Current assessment and future perspectives.
AB  - Barrett's esophagus is a premalignant condition and must be suspected in any
      patient with signs and symptoms of chronic reflux esophagitis. This condition
      itself is asymptomatic, so maintaining a high index of suspicion is the key to
      diagnosis. This article reviews natural history, pathogenesis, prevalence, and
      clinical symptoms of Barrett's esophagus. Diagnosis, dysplasia, adenocarcinoma,
      and treatment are discussed.

PMID- 2228175
TI  - [New applications of echography in maxillo-facial pathology].

PMID- 2228174
TI  - [Protection of donor sites].

PMID- 2228172
TI  - Antireflux surgery. A surgeon's look.
AB  - With a reassessment of the antireflux barrier, we are gaining a better
      appreciation of the components of the barrier and their importance in preventing
      reflux. The GE valve in particular appears to play a key role in preventing
      reflux. With better understanding of the anatomy and function of the GE barrier,
      we should do a better job, both medically and surgically. The knowledge and new
      technology that are available should allow the surgeon to perform antireflux
      surgery with 95% good to excellent results with a minimum of morbidity. As our 15
      to 20 year follow-up with a mean of 17.8 years shows, these good results will
      last over the long term. These observations should give the gastroenterologist
      confidence that antireflux surgery is highly effective for those patients who
      fail medical management.

PMID- 2228176
TI  - [Physiological techniques of complete denture design for musicians, wind
      instrument players].

PMID- 2228177
TI  - [Marketing for dentists].

PMID- 2228180
TI  - [Root recovering. Lateral sliding flap].

PMID- 2228178
TI  - [Forced eruption, a clinical procedure: apropos of 2 clinical cases].

PMID- 2228179
TI  - [Dental prevention. 10 years experience at the University of Montreal School of
      Dental Medicine].

PMID- 2228181
TI  - [A socioeconomic strategy in orthodontic treatment].

PMID- 2228182
TI  - [Guillaume van den Bossche. His "Historia Medica"--1639--and dental
      organotherapy].

PMID- 2228183
TI  - [Diagnosis of risk in periodontology].

PMID- 2228185
TI  - [Appointment management. Fundamental factors].

PMID- 2228184
TI  - [Cervico-facial cutaneous lesions of dental origin].

PMID- 2228186
TI  - [What is your diagnosis? Maxillary sinus neoplasm].

PMID- 2228187
TI  - Medical teams, flying squads--the arguments revisited.

PMID- 2228189
TI  - Closed percutaneous K-wire stabilization for displaced fractures of the surgical
      neck of the humerus.
AB  - We report a series of 22 displaced fractures of the proximal humerus treated by
      percutaneous Kirschner wire stabilization. Poor results (69 per cent) in the
      older age group of patients is a reflection of the severity of the fracture and
      the difficulties of closed reduction. Reduction in a poor position in this series
      has led to a poor range of movement. Good functional results can only be expected
      with a good reduction. Experience of migration with smooth K-wires has resulted
      in a strong recommendation for the use of threaded pins.

PMID- 2228188
TI  - Medical teams for accidents and major disasters.
AB  - Recent major disasters within the United Kingdom have highlighted the role of
      mobile medical teams. A prospective study of 244 call-outs demonstrated that an
      experienced medical team can be mobilized rapidly and effectively in response to
      accidents and potential disasters. An accident flying squad reduced mortality in
      the severely multiply-injured patient by providing treatment at the scene of the
      accident in 234 patients. The argument supporting the development of flying
      squads for accidents and major disasters can be based on the objective evidence
      of their value rather than on their empirical and emotional appeal.

PMID- 2228190
TI  - Pugh nail system as a form of treatment for fractures of the proximal femur.
AB  - A retrospective study of the results of treatment of 177 patients who had
      sustained a fracture of the proximal femur was undertaken. The social background,
      type of injury, operation performed, duration of stay after operation, mortality
      and morbidity were recorded and compared with the results published by other
      workers. It is concluded that the Pugh sliding nail system adequately fixes most
      fractures of the proximal femur. It allows early postoperative mobilization and
      discharge to the home environment for most patients. The overall mortality and
      morbidity compares favourably with results published for the dynamic compression
      screw. Treatment of the elderly patient with a displaced subcapital fracture of
      the femoral neck remains a problem, due to the high incidence of failure of
      fixation. It may be that for this group of patients a primary hemiarthroplasty is
      the treatment of choice. A prospective study to resolve this issue is required.
      The cost of a Pugh nail is considerably less than that of a dynamic compression
      screw.

PMID- 2228192
TI  - Radial nerve lesions associated with fractures of the humeral shaft.
AB  - Radial nerve palsy associated with a fracture of the shaft of the humerus is a
      relatively common injury. Out of 91 radial nerve injuries, operated upon in the
      Neurosurgical University Clinic in Belgrade from 1979 to 1988, 37 were associated
      with fractures of the humeral shaft or their surgical treatment. These fractures
      were previously treated in other medical units. In all cases a microsurgical
      reconstruction of the radial nerve was done: an interfascicular neurolysis in 24
      cases and interfascicular grafting in 13 cases. A useful functional recovery was
      obtained in 91.9 per cent of the cases. Timing of nerve exploration and repair,
      as a main problem, is discussed.

PMID- 2228191
TI  - Closed nailing of tibial shaft fractures.
AB  - A total of 98 tibial shaft fractures were internally fixed by closed
      intramedullary nailing. Twenty-seven of the fractures were open and 71 were
      closed. In 62 patients (67 per cent) the fracture was the consequence of road
      traffic accidents; 32 patients (35 per cent) had other skeletal and soft tissue
      injuries. All the fractures united with a good range of knee and ankle movements;
      no disuse atrophy was encountered. Most patients returned to work early. In 14
      patients comminution of the fracture resulted in up to 2 cm of shortening. Eight
      tibial fractures had delayed union. It is concluded that tibial nailing is a safe
      method of treatment for unstable fractures and for patients with multiple
      injuries.

PMID- 2228193
TI  - Internal fixation of pubic symphysis diastasis with a tension banding technique.
AB  - We present the details of a method of internally fixing diastasis of the pubic
      symphysis with stout wires and a tension band which can be employed with speed
      and ease, through a minimal exposure or minimally extended laparotomy wound. The
      technique is suitable for those with little experience of internal fixation of
      the pelvis. Our initial cases are presented.

PMID- 2228194
TI  - Management of unreduced traumatic posterior dislocation of the hip: heavy
      traction and abduction method.
AB  - Eight cases of unreduced traumatic posterior dislocation of the hip were treated
      by heavy traction and abduction. In four out of eight cases a concentric
      reduction was obtained. In two patients where a concentric reduction was not
      obtained, open reduction was performed. In these patients, there was an excellent
      or good result. In the remaining two patients a non-concentric reduction was
      accepted, and they had poor clinical results.

PMID- 2228195
TI  - Motorcycle injuries in Bermuda.
AB  - Tourists who hire mopeds or motorcycles for personal use have a risk for
      accident. The incidence of tourist accidents in Bermuda was 1.57 accidents/1000
      tourists evaluated over a 6-month period. The accident incidence increased as the
      tourist population got larger. Tourists of more than 40 years of age had the
      greatest increase in incidence for accident during this period. The risk of an
      injury requiring hospital stay was one patient for every 16,000 tourists visiting
      the island, and usually involved the fracture of an extremity. All accidents,
      major or minor, resulted in some form of skin injury.

PMID- 2228196
TI  - Pilot study of injured patients seen in the University of Port Harcourt Teaching
      Hospital, Nigeria.
AB  - A 12-month pilot study of injured patients seen in the Emergency Department of
      the University of Port Harcourt Teaching Hospital was carried out. Trauma (28.8
      per cent) was the main reason for emergency visits; 82.1 per cent of the patients
      were under 31 years of age. Domestic accidents were the commonest cause of trauma
      (42.5 per cent), followed by criminally motivated injuries (30.4 per cent), road
      traffic accidents (26.0 per cent), industrial (0.5 per cent) and other accidents
      (0.6 per cent). The overall mortality rate due to trauma was 5.4 per cent and
      within the period of study, trauma was the most common cause of deaths in
      hospital (10.1 per cent). Road traffic accidents were responsible for 67.9 per
      cent of these deaths, followed by criminally motivated injuries (16.1 per cent).
      Domestic, industrial and boat accidents caused 7.6 per cent, 5.4 per cent and 3.1
      per cent deaths, respectively. Injury Severity Scores (ISS) among 419 patients
      showed a 100 per cent mortality for those with scores above 35. There were 48
      prehospital, 19 emergency room and 14 in-hospital deaths among patients with an
      ISS below 35. The deaths resulted largely from delayed transportation of victims
      to the hospital and partly from inadequate emergency medical services. To reduce
      the current high rate of preventable deaths from injury, we recommend (i)
      ambulance services for early transportation of victims to the hospital and (ii)
      improved emergency medical care.

PMID- 2228198
TI  - Tetanus complicating frostbite.

PMID- 2228197
TI  - Locked intramedullary nailing for recent lower limb fractures.
AB  - This paper reports the results in a prospective series of recent fractures of
      both the femur and tibia treated by the Grosse and Kempf locking system of
      intramedullary nailing. Although the technique requires some attention to detail,
      it has been possible to treat a wide range of relatively severe injuries with a
      short hospital stay and rapid rehabilitation, with benefit to both the patient
      and hospital services.

PMID- 2228202
TI  - Simultaneous avulsion of the long flexor and extensor tendons of a finger.

PMID- 2228200
TI  - Acute compression of the cervical spinal cord: a complication of preganglionic
      injury to the brachial plexus.

PMID- 2228203
TI  - Delayed small intestinal obstruction following blunt trauma to a Meckel's
      diverticulum.

PMID- 2228199
TI  - Thoracic disc protrusion in a patient with preganglionic injury of the brachial
      plexus: differential diagnosis of cord compression.

PMID- 2228201
TI  - A rare complication of a preganglionic brachial plexus injury.

PMID- 2228204
TI  - Spontaneous dislocation of the lunate in a weight lifter.

PMID- 2228205
TI  - Bilateral anterior glenohumeral dislocation in a weight lifter.
AB  - A case of bilateral anterior dislocation of the shoulder joint is described. The
      patient was a recreational weight lifter who sustained the injury while
      performing the 'pull-over' bench movement using free weights. Probably, the
      shoulders dislocated when the force developed by the periarticular muscles was
      less than the actual weight that the patient was trying to lift. The need for
      stricter safety rules and better supervision in health clubs is stressed.

PMID- 2228206
TI  - Dorsal subtalar dislocation of the foot.

PMID- 2228207
TI  - [Method of preparation of an individually programmed bracket system].
AB  - Described is a method how brackets can be provided with individual bases by the
      means of a diagnostic set-up. Such a bracket system matches fully the individual
      tooth anatomies and the individually defined treatment objective, which is built
      into the appliance from the very beginning.

PMID- 2228208
TI  - [Modern functional and esthetic aspects of orthodontic surgery].

PMID- 2228210
TI  - [Mandibular activation with rigid and elastic activators].

PMID- 2228209
TI  - [Tooth mobility following treatment with removable appliances].
AB  - After a therapy with removable appliances all the teeth showed an increased
      loosening degree, that means tooth mobility, in comparison to an untreated
      control group. All the measured patients had been in the retention phase after an
      average treatment time of 4 years in cases of male patients and 3.8 years in
      cases of female patients.

PMID- 2228212
TI  - [Adult treatment as therapy of dysfunction].
AB  - Adult orthodontics often is to be considered as the prophylactic treatment for
      the disordered stomatognathic system. The enlarged facilities of diagnosis enable
      the orthodontist to investigate the reasons of the functional disorders, like
      neglected or insufficient orthodontic treatment in the growing patient or
      inconsiderate extractions. For many functional disorders with different reasons
      adult orthodontics is the causal therapy. Orthodontic treatment is also able to
      reduce the prosthetic therapy and to improve the prognosis for preserving the
      natural structures. Enlarged, continuous diagnosis and a high degree of
      postgraduate education must be required for successful adult treatment.

PMID- 2228211
TI  - [Growth of the facial skeleton and biomechanics of the stomatognathic system].
AB  - Biomechanical analysis of the stomatognathic system yields that the linkage
      between posterior and anterior guidance can be modelled by a link quadrangle
      (throttle crank) with closed linkage. Within this gear system the biochemical
      ideal position of the couple-line (functional length of the mandible) possesses a
      special meaning in centric occlusion: Along this line the gear system can be
      stretched without altering its essential mechanical properties. Interindividual
      comparison of the arrangement of mandibulary and maxillary structures related to
      the ideal initial position of the couple-line presents interindividual constants
      of arrangement and of growth. It is possible to define an individual, non
      orthogonal system of coordinates. Its origin represents the individual center of
      growth. During growth special skeletally defined points run along radius vectors
      of this center. The rate of growth can depend on the angle between radius vector
      and couple-line.

PMID- 2228213
TI  - [Development of standard Edgewise apparatus for a pre-torqued and pre-angulated
      bracket system].

PMID- 2228216
TI  - [Gaps in anterior region].

PMID- 2228215
TI  - [PG-Universal retraction system. Theoretical aspects and clinical application. 1.
      Controlled cuspid retraction].

PMID- 2228214
TI  - [Space closure with straight-wire apparatus].

PMID- 2228217
TI  - [Long way of a third molar].

PMID- 2228218
TI  - Regulation of magnitude of antibody response to bacterial polysaccharide antigens
      by thymus-derived lymphocytes.

PMID- 2228219
TI  - Partial biochemical characterization of cell surface hydrophobicity and
      hydrophilicity of Candida albicans.
AB  - Hydrophobic yeast cells of Candida albicans are more virulent than hydrophilic
      yeast cells in mice. Results of experiments performed in vitro suggest that
      surface hydrophobicity contributes to virulence in multiple ways. Before
      definitive studies in vivo concerning the contribution of fungal surface
      hydrophobicity to pathogenesis can be performed, biochemical, physiological, and
      immunochemical characterization of the macromolecules responsible for surface
      hydrophobicity must be accomplished. This report describes our initial progress
      toward this goal. When hydrophobic and hydrophilic yeast cells of C. albicans
      were exposed to various enzymes, only proteases caused any change in surface
      hydrophobicity. Hydrophobic cell surfaces were sensitive to trypsin,
      chymotrypsin, pronase E, and pepsin. This indicates that surface hydrophobicity
      is due to protein. Papain, however, had no significant effect. The hydrophobicity
      of hydrophilic cells was altered only by papain. The proteins responsible for
      surface hydrophobicity could be removed by exposure to lyticase, a beta 1-3
      glucanase, for 30 to 60 min. When 60-min lyticase digests of hydrophobic and
      hydrophilic cell walls were analyzed by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) with a 12.5% resolving gel, each protein population
      contained a single unique protein that was not evident in the other protein
      population. However, when the cell wall surface proteins of hydrophobic and
      hydrophilic cells were first labeled with 125I and then removed by lyticase and
      analyzed by SDS-PAGE, at least four low-molecular-mass (less than 65 kilodaltons)
      proteins associated with hydrophobic cells were either absent or much less
      abundant in the hydrophilic cell digests. This result was seen for both C.
      albicans strains that we tested. When late-exponential-phase hydrophilic cells
      were treated with tunicamycin, high levels of surface hydrophobicity were
      obtained by stationary phase. These results indicate that the surface
      hydrophobicity of C. albicans reflects changes in external surface protein
      exposure and that protein mannosylation may influence exposure of hydrophobic
      surface proteins.

PMID- 2228220
TI  - Hyperoxia potentiates Ureaplasma urealyticum pneumonia in newborn mice.
AB  - The effect of continuous exposure to 80% oxygen on newborn mice with Ureaplasma
      urealyticum pneumonia was determined. Mice were inoculated intranasally with
      either U. urealyticum or sterile broth and then housed in either 80% oxygen or
      room air (21% oxygen). The mice were sacrificed at either 7 or 14 days after
      inoculation. Significantly more mice in the U. urealyticum group housed in 80% O2
      than in the room air-exposed group were culture positive 14 days after
      inoculation (P = 0.042), but no difference was found at 7 days. The presence of
      alveolar macrophages, neutrophils, and lymphocytes and alveolar wall thickness
      were determined. Overall, the group housed in 80% O2 and inoculated with U.
      urealyticum had severe pulmonary lesions at both time points, while the lesion
      severity in the room air-exposed group inoculated with U. urealyticum and the
      group housed in 80% O2 and inoculated with sterile broth was dependent on the
      time point. Mortality was significantly higher in the group housed in 80% O2 and
      inoculated with U. urealyticum than it was in all other groups (P less than
      0.001). Our results indicate that hyperoxia causes the persistence of U.
      urealyticum in the lungs of newborn mice, acutely potentiates the inflammatory
      response, and turns an otherwise self-limited pneumonia into a lethal disease.

PMID- 2228221
TI  - Aspergillus fumigatus complement inhibitor: production, characterization, and
      purification by hydrophobic interaction and thin-layer chromatography.
AB  - Aspergillus fumigatus has previously been shown to produce a soluble
      extracellular inhibitor of the alternative complement pathway, called Aspergillus
      complement inhibitor, or CI. We now report an efficient method for production of
      CI which relies on the fact that poorly conidiating cultures yielded CI activity
      with approximately sevenfold-higher potency than CI produced by conidiating
      cultures. CI from poorly conidiating cultures provided 50% inhibition of
      alternative pathway-mediated binding of 125I-labeled complement component C3 to
      cryptococcal blastoconidia at a mean concentration of 60 micrograms/ml. The
      ability of crude CI to inhibit the alternative complement pathway seemed to be
      independent of intact protein or polysaccharide structure, as evidenced by
      resistance of inhibitory activity to digestion by proteases, including
      subtilisin, alpha-chymotrypsin, papain, and pepsin as well as endoglycosidases F
      and H. Separation of the active inhibitory component of CI from contaminating
      materials contained in crude CI preparations was achieved by using Phenylsuperose
      hydrophobic interaction chromatography in a fast protein liquid chromatography
      system. The active material proved to be extremely hydrophobic, desorbing from
      the column only during elution with ethanol; it contained only 15% protein and 5%
      polysaccharide. Furthermore, results from preparative thin-layer chromatography
      indicated that lipids which comigrated with
      phosphatidylserine/phosphatidylinositol and phosphatidylethanolamine possessed
      significant complement-inhibitory activity. Taken together, these data suggested
      that phospholipids from A. fumigatus contributed to the functional activity of
      CI.

PMID- 2228222
TI  - Excystation of in vitro-derived Giardia lamblia cysts.
AB  - This is the first in-depth analysis of the excystation of Giardia lamblia cysts
      prepared in vitro. Its goals were both to achieve efficient excystation and to
      gain insights into this crucial but poorly understood process. To identify the
      critical elements of excystation, we tested the sequential low-pH induction and
      protease treatments which had been reported to be important for excystation of
      fecal cysts. The optimal pH for induction of excystation was 4.0. Emergence was
      greatly (approximately 10-fold) stimulated by subsequent exposure of in vitro
      derived cysts to chymotrypsin, trypsin, or human pancreatic fluid. The
      stimulatory activity of each was abolished by soybean trypsin inhibitor,
      demonstrating that the activity of pancreatic fluid was due to these proteases.
      Excystation of in vitro-derived cysts was approximately 10 to 38%. Although the
      walls of in vitro-derived cysts were partially digested by protease treatment,
      trophozoites emerged only from one pole, as observed with fecal cysts. The
      conditions of encystation also determined the efficiency of excystation.
      Specifically, encystation in the presence of lactic acid, a major metabolite of
      colonic bacteria, stimulated excystation approximately fourfold, although it did
      not increase the total numbers of cysts. These experiments have shown that
      excystation of in vitro-derived cysts reflects that of cysts purified from human
      feces in that it is dependent upon conditions which simulate the passage of cysts
      through the human stomach (low pH) and into the small intestine (pancreatic
      proteases).

PMID- 2228223
TI  - Role of lipopolysaccharides in adherence of Actinobacillus pleuropneumoniae to
      porcine tracheal rings.
AB  - The ability of 17 Actinobacillus pleuropneumoniae isolates, representing
      serotypes 1, 2, 5, and 7, to adhere to tracheal rings maintained in culture was
      examined. Porcine tracheal rings were infected, and 8 h after inoculation,
      adherent bacterial cells were evaluated. A. pleuropneumoniae adhered to tracheal
      rings, and marked variations were observed between and even within serotypes,
      suggesting that adherence of this microorganism is not primarily related to the
      serotype of the isolate. No relationship was found between adherence to porcine
      tracheal rings and plasmid profiles, virulence in mice, hemagglutination,
      capsular material thickness, or whole-cell protein profiles. On the other hand,
      we observed that all isolates of serotypes 1 and 5 had a semirough-type
      lipopolysaccharide (LPS), whereas isolates of serotypes 2 and 7 had a smooth-type
      LPS (75%) or a semirough-type LPS (25%). Results showed that 83% of isolates with
      a smooth-type LPS adhered in large numbers to tracheal rings, whereas 80% of
      isolates with a semirough-type LPS adhered poorly (P less than 0.007). Our data
      indicated that the degree of adherence of A. pleuropneumoniae to porcine tracheal
      rings appeared to be related, at least in part, to LPS profiles. Furthermore, LPS
      seemed to be the adhesin of A. pleuropneumoniae, since purified LPS blocked
      adherence of this microorganism to porcine tracheal rings.

PMID- 2228226
TI  - Reduced lymphocyte responses to mitogens in natural and experimental
      trichomoniasis.
AB  - Proliferative responses to mitogens were determined by using peripheral blood
      mononuclear cells from women with active trichomoniasis, with serological
      evidence of past infection with Trichomonas vaginalis, and with no evidence of
      current or past infection. Even after the human immunodeficiency virus antibody
      status of the patients was taken into account, cells from women with active
      trichomoniasis showed reduced responses to phytohemagglutinin, concanavalin A,
      pokeweed mitogen, and bacterial lipopolysaccharide. Similar findings were
      obtained by using spleen cells from mice inoculated subcutaneously with live
      trichomonads. Reduction in proliferative responses by these cells could be
      detected 3 days after inoculation. There was some evidence to suggest that more
      pathogenic strains of the parasite induced a greater degree of immunosuppression.
      The responses of spleen cells from mice inoculated with trichomonad-free culture
      supernatants were within normal limits, indicating that live trichomonads were
      needed to induce suppression. Support for this was gained from studies with cells
      from women who were treated successfully. Cells from these women rapidly regained
      normal lymphoproliferative function. Interleukin-2 (IL-2) production by spleen
      cells from infected mice was determined from measurements of mitochondrial
      activity in an IL-2-dependent T-cell line following incubation with stimulated
      spleen cell culture supernatants. These tests demonstrated lower IL-2 activity in
      supernatants from cell cultures from infected mice than in those from uninfected
      mice. The reduction in IL-2 activity did not, however, appear to correlate with
      the degree of reduction of mitogen-induced lymphoproliferation. Suppression of T
      cell-mediated immunity may be one of the mechanisms by which T. vaginalis is able
      to evade host responses to infection.

PMID- 2228225
TI  - Immunological cross-reactivity between Streptococcus mutans and human heart
      tissue examined by cross-immunization experiments.
AB  - Hyperimmunization of rabbits with Streptococcus mutans or other related
      cariogenic streptococci sometimes induces serum antibodies that react with human
      heart muscle. To determine whether antigen I/II (AgI/II), a major surface protein
      antigen present in most human isolates of these organisms, was responsible for
      inducing cross-reactive antibodies, we tested it for antigenic similarity to
      heart components, exploiting the ability of immune systems to mount anamnestic
      responses to antigens previously encountered. Mice immunized with a strain of
      Streptococcus pyogenes type M6, known to be heart cross-reactive, or with intact
      S. mutans cells developed antibodies that could be detected on a human heart
      sarcolemmal preparation. However, mice immunized with AgI/II and boosted with
      sarcolemma were unable to develop significant antisarcolemmal antibodies
      attributable to prior sensitization by AgI/II. Similarly, AgI/II was unable to
      recall antisarcolemmal responses in mice previously immunized with sarcolemma.
      Nevertheless, strong immunoglobulin G antibody responses to AgI/II were detected
      at the single-cell level in spleens and as circulating antibodies in all mice
      immunized with AgI/II or AgI/II-bearing S. mutans. We conclude that the ability
      of S. mutans to induce heart-reactive antibodies is not due to antigenic
      similarity between AgI/II and components of human heart but may be caused by
      other cross-reactive antigens in the bacterial cells or by nonspecific
      stimulation of the immune system.

PMID- 2228224
TI  - Immunoreactivity of neoglycolipids constructed from oligomannosidic residues of
      the Candida albicans cell wall.
AB  - To establish a model to study the immunoreactivity of oligosaccharidic structures
      from the Candida albicans cell wall, we attempted to construct neoglycolipids
      with these residues by using oligomannosides released after mild acid hydrolysis
      of the phosphopeptidomannans isolated from yeast forms. From a mixture of manno
      oligosaccharides ranging from mannobiose to mannononaose, the structure of a
      quantitatively major component (mannotriose) was determined to be Man (beta 1-2)
      Man (beta 1-2) Man alpha by 1H nuclear magnetic resonance analysis. After
      coupling of the pool of oligosaccharides to a lipid (4-hexadecylaniline), the
      synthesized molecules were injected into mice and rats. Antibody responses were
      detected on enzyme-linked immunosorbent assay plates coated with either
      phosphopeptidomannans or neoglycolipids. The hybrid molecules exhibited both
      immunogenicity and antigenicity. The kinetics of antibody responses as well as
      immunofluorescence patterns observed on whole C. albicans cells strongly mimicked
      results from the immunization of animals with natural antigens. Construction of
      neoglycolipids could therefore provide an interesting approach to the study of
      specific oligosaccharides of C. albicans and their recognition by the host immune
      system.

PMID- 2228227
TI  - Differential induction of bone marrow macrophage proliferation by mycoplasmas
      involves granulocyte-macrophage colony-stimulating factor.
AB  - We have studied the ability of three different Mycoplasma species to induce
      proliferation of bone marrow-derived macrophages (BMM). We observed a significant
      mitogenic effect when BMM cells from BALB/c, DBA/2J, SJL, and C57BL/6 mice were
      incubated with membranes derived from Mycoplasma arginini or M. arthritidis but
      not when they were incubated with an equivalent amount of M. pulmonis membrane.
      We also determined that pretreatment of mycoplasma membrane preparations with
      papain eliminated the ability of these preparations to induce BMM proliferation.
      To determine whether these membrane fractions acted indirectly by stimulating the
      production of soluble factors known to stimulate proliferation of BMM cells, we
      performed blocking studies with antibodies directed against colony-stimulating
      factor 1 (CSF-1), interleukin-3 (IL-3), and granulocyte-macrophage colony
      stimulating factor. Our results indicate that antibodies directed against either
      CSF-1 or IL-3 failed to block mycoplasma-initiated proliferation of BMM cells.
      However, when anti-GM-CSF was added to proliferative cultures at the time of
      initiation, we saw a dose-dependent reduction of mycoplasma-initiated
      proliferation. We conclude that the ability of mycoplasma membranes to initiate
      the proliferation of BMM is not shared by all species of mycoplasma and that it
      involves the production of GM-CSF by an as yet undetermined cell.

PMID- 2228228
TI  - Mycoplasmas induce transcription and production of tumor necrosis factor in a
      monocytic cell line, THP-1, by a protein kinase C-independent pathway.
AB  - We demonstrated that mycoplasmas (MP), previously shown to augment the antitumor
      activity of murine peritoneal macrophages, also induce cytotoxic activity in a
      human monocytic cell line, THP-1. THP-1 cells were induced to produce cytotoxic
      activity by MP in a time- and dose-dependent manner. By using neutralization by
      antibody against tumor necrosis factor (TNF), the cytotoxic activity was shown to
      be due to TNF released from the MP-stimulated cells. Studies with inhibitors of
      second-messenger pathways and Northern RNA blot analysis indicated that a Ca2(+)
      dependent, but not protein kinase C-dependent, biochemical pathway is involved in
      MP-induced TNF production by THP-1 cells and that MP induce TNF production in the
      cells at the level of transcription. MP, unlike other bacteria, lack cell walls
      and lipopolysaccharide. The possible involvement of a TNF production mechanism
      distinct from that triggered by lipopolysaccharide is discussed.

PMID- 2228229
TI  - Molecular epidemiologic evidence for association of thermostable direct hemolysin
      (TDH) and TDH-related hemolysin of Vibrio parahaemolyticus with gastroenteritis.
AB  - The Kanagawa phenomenon induced by the thermostable direct hemolysin (TDH) of
      Vibrio parahaemolyticus is almost exclusively associated with clinical strains,
      and TDH has been considered an important virulence factor. However, Kanagawa
      phenomenon-negative strains isolated from patients with diarrhea have recently
      been shown to produce TDH-related hemolysin (TRH). We studied the distribution of
      the tdh gene encoding TDH and the trh gene encoding TRH in vibrios by
      hybridization analyses. The presence or absence of the tdh gene and the trh gene
      in 285 strains of V. parahaemolyticus was examined by the DNA colony
      hybridization test with a tdh gene-specific probe and a newly constructed trh
      gene-specific probe. For assessment of the importance of TRH, many Kanagawa
      phenomenon-negative clinical strains (35.4% of all strains) were included. Of 214
      clinical strains of V. parahaemolyticus, 112 strains (52.3%) had the tdh gene
      only, 52 strains (24.3%) had the trh gene only, and 24 strains (11.2%) carried
      both the tdh and the trh gene. The coexistence of the tdh and trh genes in these
      24 strains was confirmed by Southern blot hybridization analysis. Of 71
      environmental strains, 5 strains (7.0%) hybridized very weakly with the trh gene
      probe and none hybridized with the tdh gene probe. These results suggest that TRH
      as well as TDH is an important virulence factor of V. parahaemolyticus. Among 118
      strains of other Vibrio species examined for the trh gene, only 1 strain of
      Vibrio furnissii gave a very weak hybridization signal. Among 48 representative
      trh gene-positive strains of V. parahaemolyticus, only 18 strains (37.5%) were
      found to produce TRH in culture medium when examined by a sensitive enzyme-linked
      immunosorbent assay method.

PMID- 2228231
TI  - Genetic relationships among strains of avian Escherichia coli associated with
      swollen-head syndrome.
AB  - Genetic diversity among 22 Escherichia coli strains isolated from chickens with
      swollen-head syndrome (SHS), an acute respiratory disease of domestic poultry,
      and 93 strains isolated from birds with colibacillosis was assessed on the basis
      of allelic variation at 20 enzyme-encoding loci detected by multilocus enzyme
      electrophoresis. SHS isolates from Spain and Canada were polymorphic at 14 loci
      and were classified into 19 multilocus genotypes, defining clones that differed
      on average at 34% of the loci. In most cases, SHS isolates of different clonal
      genotypes were distinct in O:H serotype and expressed different fimbrial
      antigens. Comparisons with 93 isolates obtained from birds with colibacillosis
      revealed enzyme polymorphisms at 17 of 20 loci, with an average of 3.5 alleles
      per locus. In the total sample, 56 clonal genotypes were distinguished, with 27
      (23%) of the isolates belonging to one of three common clones. Both SHS and
      colibacillosis isolates were genetically diverse, with an average single-locus
      diversity of 0.36, indicating that a wide variety of naturally occurring
      bacterial clones is associated with these acute avian infections. Six previously
      defined groups of clones identified in diseased birds from the United States were
      represented in isolates from Spain, indicating that similar clones occur in
      widely separated geographic areas. In addition, one group of SHS isolates was
      closely related to a recognized widespread clone complex incriminated in human
      septicemia and meningitis. The results suggest that certain strains implicated in
      SHS infections belong to a clone complex whose members have special attributes
      that promote involvement in invasive diseases in humans and animals.

PMID- 2228232
TI  - Adenylate cyclase toxin of Bordetella pertussis: production, purification, and
      partial characterization.
AB  - Bordetella pertussis produces a number of virulence determinants which contribute
      to its pathogenicity. One factor, the adenylate cyclase toxin (ACT), has been
      suggested to directly penetrate human phagocytes and disrupt their normal
      function by direct production of intracellular cyclic AMP (cAMP). Experiments
      evaluating the production of cell-associated ACT in liquid cultures of B.
      pertussis 504 demonstrated that the greatest activity was observed during mid-log
      phase growth. Urea extracts of cells harvested during the time of maximal ACT
      production have been used to purify the toxin with both biological and enzymatic
      activities. ACT is a protein with an apparent molecular mass of 220 kDa and an
      isoelectric point of 7.0. The specific activity of purified ACT is 17,000 mumol
      of cAMP formed per mg per min. The the biological specific activity of purified
      ACT is 6,250 nmol of intracellular cAMP formed per mg per min in 2 x 10(6) S49
      lymphoma cells per ml. Preparations containing 8 micrograms of ACT completely
      abrogated the chemiluminescence response of 2 x 10(6) human neutrophils per ml.

PMID- 2228233
TI  - Cytotoxic and hemolytic effects of Tritrichomonas foetus on mammalian cells.
AB  - Geographically distinct lines of Tritrichomonas foetus were assayed for their
      ability to cause cytotoxicity in nucleated mammalian cells and lysis of bovine
      erythrocytes. T. foetus was highly cytotoxic toward a human cervical cell line
      (HeLa) and early bovine lymphosarcoma (BL-3) but displayed low levels of
      cytotoxicity against African green monkey kidney (Vero) cells. In addition to
      variation in the extent of cytotoxicity toward different targets, differences in
      the levels of cytotoxicity in the same nucleated target occurred with different
      parasite lines. Whole T. foetus, unfractionated whole-cell extracts, and parasite
      conditioned medium (RPMI 1640 without serum) all caused lysis of bovine
      erythrocytes. Lytic activity in the conditioned medium was substantially reduced
      by repeated freezing and thawing or heating to 90 degrees C for 30 min. Damage of
      mammalian target cells by live T. foetus could be reduced by the presence of
      protease inhibitors; however, such inhibitors did not diminish the lytic effects
      of conditioned medium. These results suggested that proteolytic enzymes were
      necessary for the lytic mechanism of the live parasites but were not required
      once lytic factors were released into the parasite-conditioned medium. They
      further suggested that the lytic molecules were either proteins or had
      proteinaceous components.

PMID- 2228234
TI  - High-frequency spontaneous mutation of classical Vibrio cholerae to a nonmotile
      phenotype.
AB  - The species Vibrio cholerae contains within it two biotypes, classical and El
      Tor, both of which are motile. Phenotypic expression of motility was unaffected
      by type of growth medium, salt concentration, pH, or temperature of incubation.
      However, seven strains of classical V. cholerae produced spontaneous nonmotile
      mutants at an unusually high frequency (ca. 10(-4)), while no mutants were
      detected for all three El Tor strains examined. No revertants of these nonmotile
      mutants were detected. Four independent mutants of classical strain 395 were
      isolated to characterize this phenomenon. By transmission electron microscopy,
      one of the nonmotile mutants was found to be flagellated, while the other three
      were found to be aflagellate. Chromosomal DNA from the mutants and parental wild
      type strain 395 was examined by Southern blot analysis with, as probes, V.
      cholerae mutagenic prophages VcA-1 and VcA-2 and six cloned motility gene regions
      isolated from transposon insertion motility mutants of strains 395 and N16961 (El
      Tor, Inaba). The parental wild-type strain and all of the mutants exhibited the
      same pattern of bands when probed with VcA-1 and VcA-2 DNAs. Four of the cloned
      motility gene regions hybridized to the same fragments of DNA in both the wild
      type and mutant isolates. However, two other probes detected a new fragment for a
      single aflagellate mutant. The observations that spontaneous nonmotile mutants
      occurred at a high frequency and that these mutants did not revert at a
      detectable frequency suggested that a genetic event is involved. The phenomenon
      appears to be limited to classical V. cholerae and may explain why classical V.
      cholerae is only sporadically associated with disease in the current pandemic.

PMID- 2228230
TI  - Immunopathology of experimental Chagas' disease: binding of T cells to
      Trypanosoma cruzi-infected heart tissue.
AB  - The immunopathology of Chagas' disease was studied in the experimental model of
      chronic infection in C57BL/10JT or mice. Sublethal infection with Trypanosoma
      cruzi, Y strain, induced specific antibodies and a delayed hypersensitivity
      response to parasite antigens. Mice developed chronic chagasic myocarditis but
      not skeletal muscle myositis. Binding of T cells to infected heart tissue was
      investigated during short-term cocultivation of lymphocytes with heart cryostat
      sections. T cells from infected mice and from normal controls bound equally to
      myocardium and liver sections from both infected and normal mice. A search in
      depth was attempted with cells heavily tagged with 99mTc. Labeled T cells from
      chagasic mice bound to both normal and infected myocardium slices. 99mTc-labeled
      T cells from controls gave the same binding values. Glass-adherent spleen cells
      behaved identically to T cells. Prior treatment of the tissue with serum from
      chronically infected mice did not increase the number of binding cells.
      Peritoneal macrophages tagged with 99mTc-sulfur colloid also bound to infected
      myocardium slices. The binding of macrophages was not changed by pretreatment of
      infected tissue with anti-T, cruzi antibodies. In short, this work did not detect
      any population of T cells or macrophages which could bind specifically to
      infected heart tissue to initiate an autoreactive process.

PMID- 2228235
TI  - Chlamydicidal activity of human alveolar macrophages.
AB  - Pneumonia due to Chlamydia trachomatis is a disease limited mainly to infants
      under 6 months of age. Rare cases have been reported in immunocompromised adults.
      One possible reason for the propensity of the pneumonia to occur in the very
      young may be related to differences in the phagocytic and bactericidal capacity
      of alveolar macrophages (AMs) in young infants and adults. At birth a function of
      AMs is clearance of surfactant-related material from the alveolar surface.
      Studies in animals have suggested that engorgement of AMs with surfactant-related
      lipids may reduce the microbicidal capacity of these cells. In the present study
      we determined that AMs obtained from healthy, nonsmoking adults were capable of
      killing both human biovars of C. trachomatis, with complete killing observed by
      48 h after inoculation. Preincubation of AMs from adults with surfactant did not
      reduce the capacity of the cells to kill C. trachomatis.

PMID- 2228237
TI  - Engineering of genetically detoxified pertussis toxin analogs for development of
      a recombinant whooping cough vaccine.
AB  - Pertussis toxin (PT) is an important protective antigen in vaccines against
      whooping cough, and a genetically detoxified PT analog is the preferred form of
      the immunogen. Several amino acids of the S1 subunit were identified as
      functionally critical residues by site-directed mutagenesis, specifically, those
      at positions 9, 13, 26, 35, 41, 58, and 129. Eighty-three mutated PT operons were
      introduced into Bordetella parapertussis, and the resultant toxin analogs were
      screened for expression levels, enzymatic activity, residual toxicity, and
      antigenicity. While more than half of the mutants were found to be poorly
      secreted or assembled, the rest were fully assembled and most were highly
      detoxified. Single mutations resulted in up to a 1,000-fold reduction in both
      toxic and enzymatic activities, while PT analogs with multiple mutations (Lys-9
      Gly-129, Glu-58 Gly-129, and Lys-9 Glu-58 Gly-129) were 10(6)-fold detoxified.
      Operons coding for stable and nontoxic mutants shown to express a critical
      immunodominant protective epitope were returned to the chromosome of Bordetella
      pertussis by allelic exchange. In vivo analysis of the toxin analogs showed a
      dramatic reduction in histamine sensitization and lymphocytosis-promoting
      activities, paralleling the reduction in toxic activities. All mutants were
      protective in an intracerebral challenge test, and the Lys-9 Gly-129 analog was
      found to be significantly more immunogenic than the toxoid. PT analogs such as
      those described represent suitable components for the design of a recombinant
      whooping cough vaccine.

PMID- 2228238
TI  - Opsonic effect of jacalin and human immunoglobulin A on type II group B
      streptococci.
AB  - This study examined the effect of immunoglobulin A (IgA) and the IgA-binding
      lectin jacalin on the phagocytosis of type II group B streptococci (GBS). Strains
      possessing the trypsin-sensitive and trypsin-resistant components of the c
      protein (II/c) and type II GBS lacking the c protein (II) were examined by
      radiolabeled bacterial uptake, bactericidal assays, and electron microscopy. Type
      II/c GBS resisted phagocytosis by monocytes (4.9% +/- 0.8% uptake, mean +/- SE, n
      = 25) compared with type II GBS (8.5% +/- 1.4% uptake, n = 14, P = 0.03).
      Phagocytic killing by polymorphonuclear leukocytes was also less for the type
      II/c strain 78-471 than for the type II strain 79-176 (68% +/- 5% versus 86% +/-
      4% reduction in CFU at 45 min, P = 0.03). IgA binding did not explain the
      resistance of type II/c GBS to phagocytosis. The uptake of type II/c GBS was not
      significantly different after opsonization in cord sera lacking endogenous IgA
      (5.93% +/- 1.4%) than in the same cord sera after addition of exogenous IgA
      (5.48% +/- 1.4%, P = 0.69, n = 9). Attempts to remove serum IgA with the IgA
      binding lectin jacalin resulted in the binding of IgA-jacalin complexes to II/c
      GBS. This combination of nonspecific IgA and jacalin increased uptake of II/c GBS
      from 4.9% +/- 0.8% to 11.8% +/- 1.9% (P = 0.002). Jacalin also combined with
      specific, immune, monoclonal IgA bound to the surface of Haemophilus influenzae
      and promoted the uptake of these bacteria. Jacalin and IgA mediated phagocytosis
      of II/c GBS via receptors that were not dependent on divalent cations and that
      were not modulated by plating monocytes on antigen-antibody complexes.

PMID- 2228236
TI  - Construction of a bifunctional Escherichia coli heat-stable enterotoxin (STb)
      alkaline phosphatase fusion protein.
AB  - A fusion between the genes encoding the Escherichia coli STb heat-stable
      enterotoxin (estB) and alkaline phosphatase (phoA) was constructed, and the
      expressed protein product was characterized. The STb-alkaline phosphatase protein
      (STb-PhoA) had an apparent molecular mass of 50,000 daltons and was detected with
      both monoclonal anti-alkaline phosphatase and polyclonal anti-STb antibodies.
      Expression of the gene fusion resulted in high-level production of alkaline
      phosphatase activity, indicating that STb-PhoA was processed and exported into
      the periplasm of the E. coli host strain. Amino acid sequence analysis of the
      hybrid protein yielded the sequence Ser-Thr-Gln-Ser-Asn-Lys-Lys, indicating that
      STb-PhoA was processed during export in a fashion identical to that of native STb
      (Y. M. Kupersztoch, K. Tachias, C. R. Moomaw, L. A. Dreyfus, R. G. Urban, C.
      Slaughter, and S. Whipp, J. Bacteriol. 172: 2427-2432, 1990). STb-PhoA was
      purified from an expressed bacterial lysate by preparative isoelectric focusing.
      In a rat ligated intestinal loop model, purified STb-PhoA induced highly
      significant (P less than 0.002) fluid secretion. In addition, the specific
      activity of STb-PhoA was nearly identical to that of purified STb. Thus, the STb
      PhoA hybrid protein represents a readily obtainable source of biologically active
      (STb) enterotoxin that may prove useful in studies to determine the mode of toxin
      action.

PMID- 2228239
TI  - Insertional inactivation of the gene encoding a 76-kilodalton cell surface
      polypeptide in Streptococcus gordonii Challis has a pleiotropic effect on cell
      surface composition and properties.
AB  - A library of Streptococcus gordonii DL1-Challis DNA was constructed in lambda
      gt11. Phage plaques were screened for production of antigens that reacted with
      antiserum to S. gordonii cell surface proteins. A recombinant phage denoted
      lambda gt11-cp2 was isolated that carried 1.85 kb of S. gordonii DNA and that
      expressed an antigen with a molecular mass of 29 kDa in Escherichia coli.
      Antibodies that reacted with the expression product were affinity purified and
      were shown to react with a single polypeptide antigen with a molecular mass of 76
      kDa in S. gordonii DL1-Challis. A segment (0.85 kb) of the cloned DNA within the
      transcription unit was ligated into a nonreplicative plasmid carrying an
      erythromycin resistance determinant and transformed into S. gordonii DL1-Challis.
      The plasmid integrated onto the chromosome, and expression of the 76-kDa
      polypeptide antigen was abolished. The gene inactivation had no obvious effect on
      bacterial growth or on a number of phenotypic properties, including
      hydrophobicity and adherence. However, it abolished serum-induced cell
      aggregation, mutant cells had reduced aggregation titers in saliva and in
      colostrum immunoglobulin A, and it also reduced coaggregation with some
      Actinomyces species. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      profiles of cell envelope proteins from wild-type and mutant strains showed that
      as well as lacking the surface-exposed 76-kDa polypeptide, mutant cell envelopes
      were deficient in several other polypeptides, including those that bound to
      immunoglobulin A. Expression of the gene encoding the 76-kDa polypeptide in S.
      gordonii appeared to be critical for functional conformation of the cell surface.

PMID- 2228240
TI  - Purification and characterization of a novel hemagglutinin from Vibrio cholerae.
AB  - A lectin with strong hemagglutinating activity toward erythrocytes of several
      animal species was isolated from an 18-h culture supernatant of a diarrheagenic
      strain, V2, of non-O1 Vibrio cholerae. The hemagglutinin (HA) was purified free
      of lipopolysaccharide by salt fractionation followed by gel filtration,
      hydrophobic interaction chromatography, and, finally, gel filtration in the
      presence of urea and deoxycholate. The purification procedure resulted in an HA
      preparation with 80-fold enhancement of specific activity. The HA consisted of
      noncovalently bound subunits of Mr 62,000 and behaved essentially as a single
      component with pI 6.0. Nonpolar and acidic amino acids contributed 46 and 24%,
      respectively, to the total amino acid residues. Electron micrographs of the HA
      showed it to consist of large, nonstoichiometric aggregates' of disklike
      molecules of 10-nm diameter. Inhibition of the HA by the glycoproteins fetuin,
      asialofetuin, and mucin, but not by ovalbumin and simple sugars, suggested the
      specific requirement of complex carbohydrates for binding. Rabbit antisera to the
      purified HA inhibited the hemagglutinating activities of the crude cell-free HA
      preparations, but not cell-associated HA activities of the parent (V2) or of
      other O1 and non-O1 V. cholerae strains. This suggested that the released and
      cell-associated HA activities were mediated by antigenically distinct components.
      Immunoblotting experiments showed that the antisera recognized a polypeptide
      component of Mr 62,000 in the cell envelope preparations of the parent and
      several other V. cholerae O1 and non-O1 strains. These data suggested that the HA
      was a nonfimbrial lectin of somatic origin with no protease activity and was
      apparently distinct from V. cholerae HAs described so far.

PMID- 2228241
TI  - Activation of cholera toxin-specific T cells in vitro.
AB  - Cholera toxin (CT) and its B subunit (CT-B) are potent oral immunogens in vivo,
      although both strongly inhibit polyclonal lymphocyte activation in vitro. In
      order to help understand this paradox, we have studied the activation and
      proliferation of CT-specific T cells in vitro, by using CT-B-primed lymph node T
      cells as responders, concanavalin A-stimulated peritoneal macrophages as antigen
      presenting cells (APCs), and various forms of CT-B as antigen. The results
      indicate that in many ways CT-specific T cells respond in a manner similar to
      that of T cells specific for other protein antigens: the degree of proliferation
      was proportional to the dose of antigen and APCs in the cultures, was antigen
      specific, and was H-2 restricted. APCs from genetic high-responder strains to CT
      stimulated significantly more proliferation in F1 (high x low) responder T cells
      than did APCs from low responder strains. However, there was a marked difference
      in the activation of CT-specific T cells when different forms of CT-B were used.
      Native CT-B stimulated little or no T-cell proliferation, whereas denatured CT-B
      or CT-B blocked by its ligand, GM1 ganglioside, stimulated T cells well. Addition
      of native CT-B to cocultures of primed T cells, APCs, and these latter
      stimulatory forms of CT-B inhibited the specific proliferative response to CT-B
      to varying degrees, depending on the ratio of the two forms in culture. We
      conclude that the ability of CT-B to inhibit T cells extends even to T cells
      specific for CT itself. Because of these inhibitory properties, processing of CT
      to nonbinding molecular forms or fragments must be an important prerequisite for
      the immune response to CT to occur in vivo, and such processing is likely to be
      important in the immune response to a variety of other enterotoxins as well.

PMID- 2228242
TI  - Enterotoxin and cytotoxin production by enteroinvasive Escherichia coli.
AB  - It has long been suspected that besides their ability to invade enterocytes,
      enteroinvasive Escherichia coli (EIEC) strains have the ability to elaborate an
      enterotoxin. We tested 35 EIEC strains for cytotoxins and 9 (1 per serogroup) for
      enterotoxins. All 35 strains exhibited low levels of Vero cell cytotoxins that
      are immunologically and genetically distinct from Shiga-like toxin I or II of
      enterohemorrhagic E. coli. Sterile supernatants and cell lysates of two EIEC
      strains were tested in rabbit ileal loops, and both stimulated moderate fluid
      accumulation (circa 0.5 ml/cm) without tissue damage; secretory activity was
      confirmed in Ussing chambers, where these two strains and the seven others tested
      significantly increased short circuit current without altering tissue
      conductance. Curing the 140-MDa invasiveness plasmid from an EIEC strain did not
      diminish enterotoxin production. Culture in minimal Fe2+ medium is necessary to
      detect expression of the enterotoxin which is circa 68 to 80 kDa in size and is
      distinct from the EIEC cytotoxin.

PMID- 2228243
TI  - Rapid membrane permeabilization and inhibition of vital functions of gram
      negative bacteria by bactenecins.
AB  - Bactenecins are a class of arginine-rich antibacterial peptides of bovine
      neutrophil granules. Two bactenecins with approximate molecular weights of 5,000
      and 7,000 designated Bac5 and Bac7, respectively, exert in vitro a potent
      bactericidal activity toward several gram-negative bacteria (R. Gennaro, B.
      Skerlavaj, and D. Romeo, Infect. Immun. 57:3142-3146, 1989). We have now found
      that this activity shows an inverse relationship to the ionic strength of the
      medium and is inhibited by divalent cations and greatly potentiated by
      lactoferrin. Under conditions supporting marked bactericidal activity, the two
      peptides cause a rapid increase in the permeability of both the outer and inner
      membranes of Escherichia coli, as shown by unmasking of periplasmic beta
      lactamase and of cytoplasmic beta-galactosidase. In addition, the two bactenecins
      inhibit the respiration of E. coli and Klebsiella pneumoniae but not of Bac5- and
      Bac7-resistant Staphylococcus aureus. Furthermore, they induce a drop in ATP
      content in E. coli, K. pneumoniae, and Salmonella typhimurium and a marked
      decrease in the rates of transport and incorporation of [3H]leucine and
      [3H]uridine into E. coli protein and RNA, respectively. In general, all these
      effects become evident within 1 to 2 min and reach their maximal expression
      within about 5 min. Overall, these data strongly suggest that the decrease in
      bacterial viability is causally related to the increase in membrane permeability
      and the subsequent fall in respiration-linked proton motive force, with the
      attendant loss of cellular metabolites and macromolecular biosynthesis ability.

PMID- 2228244
TI  - Identification and characterization of a zinc metalloprotease associated with
      invasion by the fish pathogen Vibrio anguillarum.
AB  - An invasiveness-defective mutant of the fish-pathogenic bacterium Vibrio
      anguillarum was isolated. Compared with the wild type, this mutant had a 1,000
      fold higher 50% lethal dose after immersion infection of rainbow trout,
      Oncorhynchus mykiss, while after intraperitoneal infection, the mutant had only a
      10-fold higher 50% lethal dose. In addition, the mutant showed a lower level of
      protease activity. Two forms of the protease (Pa and Pb) were found after sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis of nonheated samples. Pa was
      found predominantly in protease preparations of the wild type, while Pb was the
      predominant form in the mutant. Conversion of Pb to Pa was observed in protease
      preparations after incubation at 4 degrees C. Characterization of the protease
      showed that it was an elastolytic enzyme which required Zn2+ for activity and
      Ca2+ for stability. The molecular mass of the protease was 36 kilodaltons. N
      terminal amino acid sequence analysis of the protease of V. anguillarum revealed
      homology to the elastase of Pseudomonas aeruginosa and the protease of Legionella
      pneumophila.

PMID- 2228245
TI  - Cytokine induction by lipopolysaccharide (LPS) corresponds to lethal toxicity and
      is inhibited by nontoxic Rhodobacter capsulatus LPS.
AB  - Many pathological effects of gram-negative bacteria are produced by their cell
      wall-derived lipopolysaccharides (LPSs). Differing pathogenicity of gram-negative
      LPSs, however, may depend on their capacities to induce cytokines. Thus, we
      studied the lethal toxicity of four nonenterobacterial LPSs and compared it with
      their capacity to induce mononuclear cell (MNC)-derived interleukin-1 (IL-1),
      interleukin-6 (IL-6), and tumor necrosis factor (TNF). Unstimulated MNC did not
      release these cytokines. LPS from the phototrophic strain Rhodobacter capsulatus
      37b4 elaborated little toxicity in galactosamine-treated mice (10 micrograms of
      LPS per mouse was the 100% lethal dose [LD100]) and induced IL-1 and IL-6 release
      only at high concentrations (10 to 50 micrograms of LPS per ml). R. capsulatus
      LPS failed to induce TNF activity even at the highest concentration tested (100
      micrograms of LPS per ml). In contrast, LPS derived from Pseudomonas diminuta
      NCTC 8545 or the nodulating species Bradyrhizobium lupini DSM 30140 and Rhizobium
      meliloti 10406 expressed lethal toxicity (LD100, 1,000, 100, and 10 ng per mouse,
      respectively) and induced IL-1 or IL-6 (10 to 100, 10, and 1 ng of LPS per ml,
      respectively) at concentrations 1,000- to 10,000-fold lower than effective levels
      of R. capsulatus LPS. LPSs from P. diminuta, B. lupini, and R. meliloti also
      stimulated TNF production and release. MNC accumulated cell-associated IL-1
      activities under circumstances in which released activity was readily detected.
      The cells contained only scant IL-6 activity, indicating release of this mediator
      rather than intracellular accumulation. Antisera to the respective cytokines
      inactivated biological activities of the samples selectively. The R. capsulatus
      LPS inhibited cytokine induction by LPS from P. diminuta, B. lupini, and R.
      meliloti in coincubation experiments. These results show that the in vivo
      lethality of the LPSs tested correlates with the induction of monocyte-derived
      cytokines in vitro. The results of this study suggest that the different
      lethality of various LPSs from gram-negative bacteria may be due to the
      differential ability of these LPSs to induce cytokine production.

PMID- 2228246
TI  - Identification and partial characterization of a cytolytic toxin produced by
      Gardnerella vaginalis.
AB  - Generation and release into the culture medium of a cytolytic toxin by
      Gardnerella vaginalis has been demonstrated. Addition of starch and of the
      nonionic detergent Tween 80 to the culture medium was essential to recover
      cytolytic activity. A protein with an apparent molecular mass of 61 to 63 kDa was
      purified from the culture supernatants showing lytic activity towards
      erythrocytes and nucleated cells, such as human endothelial cells and human
      neutrophils. The protein had marked selectivity for human erythrocytes, while
      erythrocytes from other species were not lysed or were lysed at much higher
      concentrations of the protein than those needed for human erythrocytes. The
      cytolytic activity was remarkably unstable in polar media, but was stabilized by
      nonionic detergents, by binding, or by insertion into the target cell membrane,
      suggesting its amphiphilic nature.

PMID- 2228248
TI  - Cloning and nucleotide sequence of the gene encoding arginine deiminase of
      Mycoplasma arginini.
AB  - The existence of a mycoplasmal arginine deiminase which catalyzes the conversion
      of L-arginine to L-citrulline has been postulated. Here we show the partial amino
      acid sequence of arginine deiminase of Mycoplasma arginini and the complete
      nucleotide sequence of the arginine deiminase gene of M. arginini. The open
      reading frame deduced from this sequence consists of 1,230 bp encoding 410 amino
      acids. The mature form of this enzyme contains 409 amino acids after the deletion
      of the first methionine. In this open reading frame, TGA nonsense codons are used
      as tryptophan codons; this usage was verified by determination of the amino acid
      sequence. The molecular weight of the enzyme calculated from the deduced amino
      acid sequence is 46,372. Recently, the nucleotide sequence of the arginine
      deiminase gene of M. arginini was reported by Kondo et al. (K. Kondo, H. Sone, H.
      Yoshida, T. Toida, K. Kanatani, Y.-M. Hong N. Nishino, and J. Tanaka, Mol. Gen.
      Genet. 221:81-86, 1990). However, their sequence differed from ours in several
      places and especially at the C terminus.

PMID- 2228247
TI  - Streptococcus pyogenes clinical isolates and lipoteichoic acid.
AB  - Minimally subcultured clinical isolates of virulent nephritogenic and
      nonnephritogenic Streptococcus pyogenes of the same serotype showed major
      differences in lipoteichoic acid (LTA) production, secretion, and structure.
      These were related to changes in coccal adherence to and destruction of growing
      human skin cell monolayers in vitro. A possible relationship between cellular LTA
      content and group A streptococcal surface hydrophobicity was also investigated.
      Nephritogenic S. pyogenes M18 produced twice as much total (i.e., cellular and
      secretory) LTA as did the virulent, serologically identical, but nonnephritogenic
      isolate. Also, the LTAs from these organisms differed markedly. The polyglycerol
      phosphate chain of LTA from the nephritogenic isolate was longer (1.6 times) than
      was that from the nonnephritogenic isolate. Likewise, both LTAs indicated the
      presence of alanine and the absence of glucose. Amino sugars were found in LTA
      from only nephritogenic S. pyogenes. Teichoic acid, as a cellular component or
      secretory product, was not detected. The adherence of two different nephritogenic
      group A streptococcal serotypes (M18 and M2) exceeded that of the serologically
      identical but nonnephritogenic isolates (by about five times), indicating a
      correlation between virulent strains causing acute glomerulonephritis and
      adherence to human skin cell monolayers. Likewise, LTA from nephritogenic S.
      pyogenes M18 was more cytotoxic (1.5 times) than was that from the
      nonnephritogenic isolate for human skin cells, as determined by protein release.
      This difference was not perceptible by the more sensitive dye exclusion method
      (i.e., requiring less LTA), which emphasizes changes in host cell morphology and
      death. Also, the secretion of LTA by only virulent nephritogenic S. pyogenes M18
      was exacerbated by penicillin (a maximum of four times). Finally, while the
      adherence of nephritogenic S. pyogenes M18 decreased markedly after continued
      subculturing in vitro, the surface hydrophobicity did not.

PMID- 2228249
TI  - Binding of viridans group streptococci to human platelets: a quantitative
      analysis.
AB  - The binding of viridans group streptococci with human platelets was analyzed by
      two-color flow cytometry. Binding was detected within 15 s of mixing bacteria and
      platelets. At ratios of bacteria to platelets of 1:1, 10:1, 100:1, and 1,000:1,
      the percentages of bound streptococci (mean +/- standard deviation) were 93.2% +/
      5.4%, 80.0% +/- 8.6%, 39.8% +/- 11.1%, and 12.5% +/- 2.0%, respectively. Binding
      of labeled bacteria was reversed by adding a 500-fold excess of unlabeled
      streptococci. These results demonstrate that streptococcus-platelet binding is
      rapid, reversible, and saturable, which suggests a specific receptor-ligand
      interaction.

PMID- 2228250
TI  - Fab fragments from a monoclonal antibody against a germ tube mannoprotein block
      the yeast-to-mycelium transition in Candida albicans.
AB  - Fab fragments prepared from the immunoglobulin G monoclonal antibody (MAb) 4C12,
      which reacts with a determinant expressed on the hyphal extension of germ tubes
      of Candida albicans, inhibited germ tube formation, but intact MAb 4C12 did not.
      Indirect immunofluorescence showed a punctate binding pattern on cells incubated
      with Fab fragments but a confluent binding on cells incubated with intact MAb
      4C12.

PMID- 2228251
TI  - Resistance of congenitally immunodeficient gnotobiotic mice to vaginal
      candidiasis.
AB  - Congenitally immunodeficient beige, athymic, and beige athymic mice whose
      orogastric mucosal tissues were chronically colonized and infected with a pure
      culture of Candida albicans were found to be resistant to naturally occurring
      vulvovaginal candidiasis.

PMID- 2228252
TI  - Growth of Chlamydia trachomatis in enucleated cells.
AB  - Chlamydia trachomatis is an obligate intracellular parasite of eucaryotic cells.
      Little is known about the role of the host in supporting chlamydial replication
      beyond the facts that host cells provide ATP and that de novo host protein
      synthesis is not required for bacterial growth. To further explore potential
      contributions of host nuclear function to chlamydial development, we questioned
      whether murine C. trachomatis could grow in mouse L cells that had been
      enucleated with cytochalasin B. Following enucleation, cells were infected with
      chlamydiae and analyzed morphologically and biochemically. Late in infection,
      substantial numbers of chlamydiae of all developmental stages were seen within
      large cytoplasmic inclusions that were indistinguishable from those seen in
      infected intact cells. Normal numbers of infectious progeny particles were
      produced from enucleated cultures. We conclude that active host cell nuclear
      function is not required to support the growth of chlamydiae.

PMID- 2228253
TI  - Does asbestosis increase the risk of lung cancer?
AB  - The question of whether asbestos workers with or without asbestosis have the same
      risk of lung cancer has not been adequately addressed in the literature. Studies
      of asbestos workers indicate that clinical symptoms and abnormal lung X-rays are
      more frequent among smokers than non-smokers, and some studies show that workers
      with asbestosis compared to those without asbestosis are more likely to be
      smokers or ex-smokers. Since smoking has a large affect on the risks of lung
      cancer, smoking habits should be considered when evaluating the risk of lung
      cancer among persons with and without asbestosis. Some studies show that the risk
      of lung cancer is higher for persons with asbestosis compared to persons without
      asbestosis, but none of these studies also considered the combined effects of
      smoking and asbestos exposure on the risk of lung cancer. It is unlikely that the
      higher risk of lung cancer to persons with asbestosis is only due to their higher
      prevalence of smoking. Some studies have suggested that asbestos workers with
      asbestosis may have a higher risk of lung cancer, but no definite conclusions can
      be drawn since dose-response relations were not evaluated. Further studies are
      needed to evaluate the interrelationships of smoking, asbestosis and the risk of
      lung cancer.

PMID- 2228254
TI  - The relationship between occupational classification and low birth weight in a
      national sample of white married mothers.
AB  - The relationship between occupational classification and Low Birth Weight
      singletons (LBW; less than 2500 g) was studied in a sample of white married
      mothers employed in the National Natality Survey 1980 (N = 3300). Univariate
      analyses included relationship between birth weight and occupation, smoking,
      alcohol, parity, age, education, prenatal care, weight gain during pregnancy,
      gestation and sex of the singleton. Occupation was significantly associated with
      LBW (P less than 0.05). The LBW rate was higher among blue collar workers (162
      per 1000) compared to white collar workers (132 per 1000). The mean birth weight
      of singletons among blue collar workers was also significantly lower compared to
      those among white collar workers (P less than 0.057). However, after adjusting
      simultaneously for the effect of the confounding variables in multiple regression
      analysis, occupation was no longer a significant predictor of LBW. The extent to
      which the validity problems may limit the interpretation of the study are
      discussed.

PMID- 2228255
TI  - Annoyance and health risk caused by military low-altitude flight noise.
AB  - Effects of noise of low-flying military jet aircraft were investigated from
      demoscopic and epidemiological points of view. Areas with different low-altitude
      flight noise exposure were compared with one another as to subjective annoyance,
      casual blood pressure and ear symptoms. With the same energy equivalent sound
      pressure level (Leq), the subjective disturbance caused by military low-altitude
      flight noise was essentially greater than that due to ordinary flight noise (in
      the neighbourhood of civil airports). A comparison of several areas revealed that
      frequencies of ear symptoms (tinnitus lasting more than one hour and permanent
      hearing threshold shifts of greater than 30 dB) were higher only in areas where
      maximal flight noise levels considerably exceeded 115 dB (A) accompanied by rapid
      noise level increases. Blood pressure measurements yielded significantly higher
      values (group difference 9 mm Hg systolic) in girls living in these highly
      exposed areas. Acoustic limits are proposed with respect to public health.

PMID- 2228256
TI  - Acute circulatory effects of military low-altitude flight noise.
AB  - Volunteers aged 70 to 89 years living in a senior citizen's home in Haifa were
      exposed to flight noise via earphones while watching video films. Their blood
      pressure and heart rates were measured simultaneously. A high-quality recording
      and reproduction technique was employed. They were exposed to the noise of two to
      three overflights with Lmax = 99-114 dB(A) and slow sound pressure level increase
      (aircraft take off) or with Lmax = 95-112 dB(A) and a fast sound pressure level
      increase (low-altitude flight at high subsonic speed) at intervals of 10 to 15
      min. The systolic and diastolic blood pressure was raised at Lmax = 112 dB(A) and
      high speed level increase at the average of 23 and 13 mmHg, respectively with
      individual maximal values of about 40 mm Hg (systolic). In order to prevent risks
      to the subjects' health, the noise exposure was not raised to levels above 112
      dB(A) and fast level increase, although Lmax = 125 dB(A) has been measured in 75
      m-low-altitude flight areas. The blood pressure response to a repeated single
      exposure increased in proportion to the preceding noise exposure. At high
      intensities and fast level increase an up to fourfold reaction intensification
      was detected in the majority of subjects. This change in reactivity is regarded
      as the result of sensitization toward the special type of noise and the
      implications of these observations for the long-term effects of chronic exposure
      to low-altitude flight noise are considered. On the basis of these results,
      proposals are made for limiting values for Lmax and for the speed of sound
      pressure level increase, the implementation of which would lead to a marked
      reduction in health risks from low-altitude flight noise.

PMID- 2228257
TI  - Cadmium in human lung tissue.
AB  - In 101 unselected autopsies, cadmium (Cd) in lung tissue was analyzed by means of
      flameless atomic absorption spectrometry (AAS). The subjects originated from
      Bochum (BO), Dortmund (DO), and neighbouring cities in the Ruhr District (BO/DO)
      as well as from Muenster (MS) and vicinity. The sample included eight persons who
      had died from bronchial carcinoma. The Cd concentration in lung tissue (CdL) did
      not show a significant age-dependency. There was only a slight increase of CdL in
      the age around 50. For males, the median CdL value was found to be 1.32
      micrograms/g dry wt in the age group from 20-45, 1.48 micrograms/g dry wt from 45
      65, and 0.64 micrograms/g dry wt greater than 65 (the corresponding means and
      standard deviations were 1.48 +/- 1.22, 1.73 +/- 1.42, and 1.18 +/- 1.27
      micrograms/g dry wt). CdL in men was twice that in women. There were no
      differences between the two regions (BO/DO:MS) examined. CdL of the bronchial
      carcinoma cases were mostly clearly above the expected level, often similar to
      the Cr and Ni concentration of the same specimens. Besides the amount of inhaled
      metal aerosols, insufficient lung clearance may play a leading role for their
      retention in lung parenchyma. However, with regard to the determination of
      causality between uptake and disease the data are difficult to interpret, in our
      study due to a lack of enough consistent and reliable data on occupation,
      environment, and smoking habits, and in general due to a lot of variables which,
      until now, cannot be sufficiently quantified.

PMID- 2228258
TI  - Identification of cis- and trans-verbenol in human urine after occupational
      exposure to terpenes.
AB  - Urine from sawmill workers exposed to alpha-pinene, beta-pinene and delta-3
      carene was collected and hydrolyzed with beta-glucuronidase at pH 5.0 for 24 h at
      37 degrees C. After hydrolysis the urine was cleaned on a SEP-PAK C18 cartridge.
      The cartridge was eluted with n-heptane. The eluate was injected onto a gas
      chromatograph equipped with a 25-m (0.32-mm ID) SP-1000 capillary column. The
      major peak in the chromatogram was identified by GC-MS as trans-verbenol by
      electron impact at 70 eV. cis-Verbenol was also identified. These metabolites
      could not be detected in non-hydrolyzed urine from the exposed workers or in
      hydrolyzed urine from an unexposed individual. The recoveries of the verbenols
      from hydrolyzed urine were in the range of 85 to 94% and the metabolites were
      stable both in urine and in n-heptane after sample cleaning at -20 degrees C for
      at least 12 weeks. We suggest that these metabolites are formed from alpha-pinene
      by hydroxylation.

PMID- 2228259
TI  - Biological monitoring of isocyanates and related amines. II. Test chamber
      exposure of humans to 1,6-hexamethylene diisocyanate (HDI).
AB  - Five male subjects were exposed to 1,6-hexamethylene diisocyanate (HDI)
      atmospheres for 7.5 h. The exposures were performed in an 8 m3 stainless steel
      test chamber, and the HDI atmospheres were generated by a gas-phase permeation
      method. HDI in air was determined by an HPLC method utilizing the 9-(N
      methylaminomethyl)-anthracene reagent, and by a continuous monitoring device (MDA
      7100). The average air concentration was ca 25 micrograms/m3, and the inhaled
      dose of HDI for the different subjects was estimated at ca 100 micrograms. The
      related amine 1,6-hexamethylene diamine (HDA) was after acid hydrolysis of urine
      and plasma, determined as a heptafluorobutyric derivative, by glass capillary gas
      chromatography and selected ion monitoring (SIM), in a chemical ionization mode
      using ammonia as reagent gas. The cumulated urinary excretion of HDA during 28 h
      was 8.0 to 14 micrograms, which corresponds to ca 11 to 21% of the inhaled dose
      of HDI. The urinary level of HDA, in samples collected immediately after the end
      of the exposures, was on average 0.02 mmol/mol creatinine (range 0.01-0.03
      mmol/mol creatinine). The urinary elimination was rapid, and half-time (t 1/2),
      for the concentration of HDA in urine, showed an average of 1.2 h (range 1.1-1.4
      h). No specific IgE and IgG antibodies to HDI were detected before and after
      provocation; nor were spirometry or bronchial reactivity changed immediately and
      15 h after provocation. Analysis of HDA in hydrolysed urine, as a marker of short
      time exposure to HDI, is proposed.

PMID- 2228260
TI  - Blood biochemical and cellular changes during decompression and simulated
      extravehicular activity.
AB  - Blood biochemical and cellular parameters were measured in human subjects before
      and after exposure to a decompression schedule involving 6 h of oxygen
      prebreathing. The exposure was designed to simulate extravehicular activity for 6
      h (subjects performed exercise while exposed to 29.6 kPa). There were no
      significant differences between blood samples from subjects who were susceptible
      (n = 11) versus those who were resistant (n = 27) to formation of venous gas
      emboli. Although several statistically significant (P less than 0.05) changes in
      blood parameters were observed following the exposure (increases in white blood
      cell count, prothrombin time, and total bilirubin, and decreases in
      triglycerides, very-low-density lipoprotein cholesterol, and blood urea
      nitrogen), the changes were small in magnitude and blood factor levels remained
      within normal clinical ranges. Thus, the decompression schedule used in this
      study is not likely to result in blood changes that would pose a threat to
      astronauts during extravehicular activity.

PMID- 2228261
TI  - Modelling of environmental lead contributors to blood lead in human.
AB  - The Second National Health and Nutrition Examination Survey (NHANES II) is the
      only representative national study of body burden of lead where detailed
      concurrent information is available on a number of geographic and socio-economic
      factors. To date, however, reliable information on concurrent local environmental
      lead exposure for the sample has been lacking. In this study, we have identified
      and utilized previously unused concurrent lead exposure data. Our exposure data
      include time and region specific information on sales of lead from gasoline and
      ambient air-lead measurements from the United States Environmental Protection
      Agency (EPA). In addition, we have included information on lead consumed in food
      from the United States Food and Drug Administration (FDA). Our results indicate
      weak but significant associations between state sales of lead from gasoline and
      blood lead. In addition, we found a significant association between ambient air
      lead measurements and blood-lead concentrations. Socio-economic factors and life
      style factors were significantly related to blood lead, controlling for other
      possible confounders. Overall, our model explained 34% of the variance in blood
      lead levels, which is a significant improvement compared to the maximum of 25%
      from other studies using the NHANES II data. The study substantiates prior
      findings that the majority of the variance in overall blood lead is significantly
      related to lead sources other than gasoline. From a public health perspective, it
      is therefore imperative that lead screening programs be continued and focused on
      multiple sources of lead, including lead in gasoline. The study supports prior
      findings of a continuous decrease in blood lead, independent of decreases of lead
      from gasoline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228262
TI  - The method of choice for the determination of 2,5-hexanedione as an indicator of
      occupational exposure to n-hexane.
AB  - To identify the method of choice for analysis of urine for 2,5-hexanedione (2,5
      HD) as an indicator of occupational exposure to n-hexane, the end-of-shift urine
      samples of 36 n-hexane exposed male workers and 30 non-exposed male workers were
      analyzed for 2,5-HD under three conditions of hydrolysis, i.e. enzymic hydrolysis
      at pH 4.8, acid hydrolysis at pH 0.5, and without hydrolysis. The 2,5-HD
      concentrations thus determined were examined for correlation with 8-h, time
      weighted average exposure concentrations of n-hexane measured by diffusive
      sampling. The regression analysis showed that the 2,5-HD concentrations without
      any hydrolysis correlated best with the intensity of exposure to n-hexane. No 2,5
      HD was detected in the urine of the non-exposed subjects under the analytical
      conditions with no hydrolysis. Thus, the analysis without hydrolysis was
      considered to be the method of choice from the viewpoint of simplicity in
      analytical procedures, sensitive separation of the exposed from the non-exposed,
      and quantitative increase in the amount of 2,5-HD after n-hexane exposure.

PMID- 2228263
TI  - Biological monitoring of occupational exposure to isopropyl alcohol vapor by
      urinalysis for acetone.
AB  - The relationship of the intensity of occupational vapor exposure to isopropyl
      alcohol (IPA) with urinary excretion of acetone and unmetabolized IPA was studied
      in 99 printers of both sexes, who were exposed to up to 66 ppm IPA (as time
      weighted average), together with toluene, xylenes, methyl ethyl ketone and/or
      ethyl acetate. Acetone and IPA concentrations in urine were studied also in 34
      non-exposed subjects. Acetone was detectable in the urine of most of the non
      exposed, and the urinary acetone concentration increased in proportion to the IPA
      exposure intensity (r = 0.84 for observed, non-corrected values), whereas the
      correction for creatinine concentration or specific gravity of urine did not give
      a larger correlation coefficient. IPA itself was not found in the urine of the
      non-exposed, and was detectable in urine of only those who were exposed to IPA
      above a certain level, e.g. 5 ppm. The present study results suggest that urinary
      acetone is a valuable index for biological monitoring of occupational exposure to
      IPA as low as 70 ppm.

PMID- 2228264
TI  - Preventive restorative dentistry.
AB  - Greater use of conservative tooth restorations is advocated to encourage optimum
      tooth strength and restoration longevity. Improvements in tooth preparation
      instruments, and restorative materials, accompanied by use of magnification and
      meticulous care, afford optimum patient care for minimally sized carious lesions.

PMID- 2228265
TI  - Edentulism and preventive goals in the treatment of mutilated dentition.
AB  - The percentage of edentulous people is expected to decrease in the coming decades
      as a result of improved oral health, whereas the number of edentulous people will
      increase as a result of the strong increase in the ageing population. If the
      preservation of the natural dentition is no longer possible, the remaining teeth
      of a multilated dentition have to be extracted according to specific principles.
      Within the framework of the so-called 'preventive-prosthetic-treatment strategy',
      preservation of the alveolar ridge is the main goal.

PMID- 2228266
TI  - Restoring the ageing dentition: repair or replacement?
AB  - An old tooth does not exist on its own; therefore, any decision about a tooth
      demands knowledge about the elderly patient to whom the tooth belongs. If it is
      available, one can then evaluate the oral cavity in which the tooth resides. When
      all this information has been gathered, decisions about the individual tooth can
      be made. This paper discusses three specific issues: when does one 'patch' an
      amalgam restoration; when should one crown this restored tooth; and when does one
      'patch' the crown, and when does one replace it? A review of the literature
      indicated that reliable and generally applicable data on these issues do not
      exist, so that these decisions are still made by clinical judgement based upon
      experience. In view of the known changes in caries rates, fluoridation of water
      supplies, and patient attitudes, dentists' judgements of appropriate restorative
      treatment for older adults based upon past experience may be inappropriate.
      Longitudinal clinical research is required to develop clinically usable
      guidelines, especially for the elderly.

PMID- 2228267
TI  - Root lesions.
AB  - In the elderly, but increasingly also in middle-aged patients, root lesions are a
      major problem in everyday practice. Formerly, the cause of these root
      destructions was usually caries attack due to a failure of patients to practise
      adequate oral hygiene measures. However, with increasing dental motivation and
      health consciousness, patients--for example in the USA, Scandinavian countries
      and Switzerland--cause such lesions by vigorous, badly controlled brushing, often
      in combination with the consumption of 'healthy' vegetarian, erosive diets. The
      former problem of carious root destruction due to neglect thus seems to be
      gradually being replaced by the problem that self-care is not yet thoroughly
      understood, is exaggerated and is technically inadequate. Faulty brushing may
      result in severe damage to those gingival sites that require attention
      cariologically as well as periodontologically. To exploit all possibilities of
      (secondary) preventive management of patients, careful investigation and analysis
      of the clinical signs is required to identify the aetiology of the lesions in
      each case. Fortunately, therapeutic management of root lesions, regardless of
      their aetiology, is facilitated by modern restorative techniques and materials.

PMID- 2228268
TI  - Palladium alloys in prosthodontics: selected aspects.
AB  - The high costs of gold and platinum have caused other alloys to be considered in
      the construction of prosthetic appliances. This paper reports on the grain
      structure, corrosion resistance and microstructure of palladium alloys. Also
      discussed are the properties of these alloys and how these affect their technical
      manipulation.

PMID- 2228269
TI  - Mandibular atrophy and metabolic bone loss.
AB  - Radiological studies were performed on edentulous patients with and without
      atrophy of the mandible. Radiological, histomorphometrical and endocrinological
      studies were performed in edentulous patients with a severe atrophy of the
      mandible treated by ridge augmentation. The results of these studies showed that
      metabolic bone loss, histologically and endocrinologically characterized as a
      secondary hyperfunction of the parathyroid glands, is a causal factor in the
      pathogenesis of mandibular atrophy.

PMID- 2228271
TI  - Politics, education and curriculum.

PMID- 2228270
TI  - Correlation between caries prevalence (DMFS) and periodontal condition (CPITN) in
      more than 2000 patients.
AB  - The CPITN (Community Periodontal Index of Treatment Needs) and DMFS (Decayed
      Missing-Filled Surfaces) index were evaluated simultaneously to provide
      information on the mutual influences of periodontal disease and caries. With the
      aid of an electronic database system the data of the caries index and periodontal
      index of more than 2000 patients aged between 18 and 80 years were stored and
      calculated. As expected, the CPITN and DMFS values increased with age. When the
      CPITN was selected as a reference the DMFS was found to change with increasing
      CPITN. With the examination method used in this study no correlation could be
      established between the prevalence of caries and periodontal condition, although
      both conditions have a common aetiological factor: microbial plaque.

PMID- 2228272
TI  - Transfusion risks.
AB  - Hepatitis remains the most serious transfusion risk, in terms of incidence and
      severity. Transfusion-associated AIDS, hemolytic reactions, TRALI, and
      anaphylaxis are severe problems that occur relatively rarely, while febrile
      reactions and mild allergic reactions are common but not serious. The key to
      avoiding all these complications is autotransfusion (see the article "Autologous
      Transfusion" in this issue). Although intraoperative scavenging became available
      in many centers in the United States in the 1980s, it is hoped that pre-deposit
      autotransfusion will also become widely utilized in the next decade.

PMID- 2228273
TI  - Autologous transfusion.
AB  - Autologous transfusion is but one component of the comprehensive blood
      conservation program. It is often appropriate to employ more than one method of
      autologous transfusion. In addition, use of pharmacological measures to decrease
      blood loss, meticulous attention to surgical hemostasis, acceptance of lower
      hemoglobin levels during the perioperative period, and seeking the advice of
      transfusion medicine experts in assessing the need for administration of blood
      components are also important. Finally, the risks of homologous blood transfusion
      should not overshadow the life-saving benefits of transfusion.

PMID- 2228274
TI  - Safe limits of isovolemic hemodilution and recommendations for erythrocyte
      transfusion.

PMID- 2228275
TI  - The role of colloids in blood conservation.

PMID- 2228276
TI  - Perioperative considerations in Jehovah's Witnesses.

PMID- 2228277
TI  - Optimal use of blood components.

PMID- 2228278
TI  - Induced hypotension.

PMID- 2228279
TI  - Desmopressin and antifibrinolytics.
AB  - Desmopressin appears to be a safe and effective hemostatic agent for use during
      surgery in patients with mild to moderate hemophilia or von Willebrand disease.
      Uremic patients also benefit from substitution of desmopressin for
      cryoprecipitate to control bleeding. The highly variable response to desmopressin
      by individual patients with hemophilia or von Willebrand disease dictates that
      each patient receive a trial administration prior to surgery; surgery should
      proceed only following verification of a therapeutically effective increase in
      Factor VIII and vWF after desmopressin. Use of desmopressin in patients with
      normal baseline hemostatic function is not clearly advantageous, although certain
      patient subgroups might benefit, and prospective studies have documented the
      drug's safety in these cases. Data are lacking to clarify a role for desmopressin
      during surgery in patients taking aspirin. Antifibrinolytic therapy appears to
      decrease bleeding without increased risk after cardiac surgery. In addition,
      specific use after urological surgery may be beneficial in the absence of upper
      urinary tract bleeding. In the last ten years, other applications for
      antifibrinolytic therapy have been found--both surgical (intracranial aneurysms,
      oral and lacrimal surgery) and nonsurgical (in cancer patients and for
      gastrointestinal bleeding). Although anecdotal reports have fueled fears of
      increased thrombosis with antifibrinolytics, controlled studies indicate no
      increased risk.

PMID- 2228281
TI  - Electromyography of rapid forearm flexion and extension and aging.
AB  - This investigation examined several parameters of agonist- and antagonist-muscle
      activity and movement time in young and old males during rapid, forearm flexion
      and extension tasks. Maximal isometric strength of the forearm flexors and
      extensors and limb-volume measurements were also procured. The subject sample
      included sixteen males in each of the following groups: 1) thirty to forty year
      olds, 2) fifty to sixty year olds, and 3) sixty-one to seventy year olds. The
      averaged, electromyographic patterns (AEMG) of the biceps brachii and triceps
      brachii muscles were recorded during unloaded and loaded trials of forearm
      flexion and extension to a predetermined target. Sixteen temporal and ten
      quantitative parameters were examined. Significant differences between age groups
      were observed for only the quantitative-parameter accuracy. The conclusions were
      that an individual's agonist- and antagonist-muscle-activity parameters are
      maintained into the seventh decade. Flexion and extension strengths decrease
      progressively with age. Analysis of the limb-volume measures revealed that the
      oldest group had the greatest amount of fat in each of the segments evaluated.

PMID- 2228280
TI  - A comparative acoustic analysis of the Laugh responses of 20- and 70-year-old
      males.
AB  - Several studies have documented age-related changes in speech or voice
      characteristics, but no study has reported differences across age groups in human
      laughter. The purpose of this investigation was to identify, describe, and
      compare the measurements of five acoustic correlates of elicited, spontaneous
      laughter in twenty- and seventy-year-old males. Five acoustic characteristics of
      laugh responses including Initial Laugh Fundamental Frequency (ILFo), Mean Laugh
      Fundamental Frequency (MLFo), Peak Laugh Fundamental Frequency (PLFo), Duration
      Laugh Response (DLR), and Laugh Bursts (LB) as well as Speech Fundamental
      Frequency (SFF) were analyzed across groups. Statistically significant
      differences were found between twenty- and seventy-year-old males in ILFo, MLFo,
      PLFo, and in the number of laughs per minute. Older respondents produced a
      relatively compressed fundamental frequency range of laugh behavior and fewer
      laugh responses per minute. These differences are congruent with age-related
      changes in speech and voice but also might be explained by other physiological or
      sociological variables.

PMID- 2228282
TI  - Hobbies of retired people in the People's Republic of China: a preliminary study.
AB  - This study describes and analyzes the hobbies of over 500 retired individuals
      (ages fifty to eighty-eight in the People's Republic of China. Data were obtained
      through questionnaires and compared with the responses of 100 younger people
      (twenty to thirty-nine years of age). Hobbies of the retired people were
      classified into five categories: reading, physical exercise, productive, visual
      auditory, and recreational. This classification is at variance with the one
      proposed by some Western writers. The following conclusions were reached: 1)
      there are significant differences between the hobbies of retired people and those
      of younger people; 2) reading is the hobby most preferred by the retired person
      in China; and 3) gender, age, education, and previous occupation are the factors
      that most influence the retired person's choice of hobbies.

PMID- 2228283
TI  - Leisure activities of retired persons in the United States: comparisons with
      retired persons in the People's Republic of China.
AB  - This study was undertaken in view of the large and growing numbers of retired
      persons in the People's Republic of China; the dearth of information about how
      they spend their time; and the importance of such knowledge in guiding city
      reform and accomplishing the Four Modernizations and the future cause. The
      discretionary-activity patterns and rates, the importance of these activities,
      and their perceived impact upon the health of 551 retired persons and 100
      employed workers in Shanghai were compared in order to investigate the role of
      retirement in China. To assess similarities and differences between retired
      persons in China and in the West, the activity patterns and rates of retired
      Chinese adults were compared with retired adults in two samples from the United
      States (352 from San Antonio and 899 from San Francisco).

PMID- 2228284
TI  - Attitudes toward retirement in an Israeli cohort.
AB  - The three-fold purpose of this study was 1) to clarify the concept of "attitudes
      toward retirement" and its multidimensional structure; 2) to test hypotheses
      about the relationship between attitudes and gender and SES; and 3) to analyze
      the relationship between attitudes and the Sense of Coherence concept in terms of
      the functional consequences of different attitudes. A sample of 805 (432 men and
      373 women) Israeli "on-time" people on the verge of retirement were interviewed.
      Results point to the importance of distinguishing between perceptions of gains
      and losses in the retirement developmental transition; identification of blue
      collar workers, with ambivalent attitudes, as a high-risk group; and the
      importance of a strong Sense of Coherence in adopting attitudes presumably
      functional in coping with the developmental transition.

PMID- 2228285
TI  - Gonadotropin secretion in chronic renal failure.

PMID- 2228286
TI  - End stage renal disease in diabetes.

PMID- 2228287
TI  - Materials or biomaterials?

PMID- 2228288
TI  - Reflection on EPO.

PMID- 2228289
TI  - On the need for erythropoietin treatment in dialysis patients. A Copenhagen City
      Dialysis Unit study.
AB  - We evaluated the need for erythropoietin (EPO) treatment in 134 end-stage renal
      disease patients assuming a level of hemoglobin below 6 mmol/l (9.6 g/dl) as
      indication for treatment. 91 patients (68%) fulfilled this criterion. Absolute
      contraindications in 2 patients were previous thrombotic encephalopathy and
      refusal of treatment. Relative contraindications due to cardiac disease were
      found in 3 patients. In 15 patients additional treatment was required because of
      hypertension (5) or deficiency states (10). The implications of elevated serum
      PTH and aluminum overload are discussed.

PMID- 2228290
TI  - Magnetic resonance imaging of the bone marrow following treatment with
      recombinant human erythropoietin in patients with end-stage renal disease.
AB  - We used magnetic resonance imaging (MRI) to study vertebral bone marrow in
      hemodialysis patients during treatment with recombinant human erythropoietin
      (rHuEPO). We found changes in T1 relaxation times and image contrast within 14
      days after starting treatment, before any response was seen in the hemoglobin
      concentration in peripheral blood. The increase in T1 relaxation times, together
      with earlier reported changes observed with localized magnetic resonance
      spectroscopy, indicate an alteration in cellular composition of the hemopoietic
      bone marrow with an increase in the amount of hemopoietic active tissue. MRI may
      be a useful, non-invasive way of evaluating bone marrow response to different
      modes of rHuEPO administration and dosage.

PMID- 2228291
TI  - Hemodialysis-associated febrile episodes: surveillance before and after major
      alteration in the water treatment system.
AB  - Surveillance for bacteremic or pyrogenic episodes associated with hemodialysis
      was undertaken before and after the reconstruction of the water treatment system
      at our University medical center. The new water system included a holding tank
      with iodination treatment. The water delivered to individual dialysis stations
      had only occasional positive bacterial cultures (3 of 21 samples before
      completion of construction, 2 of 16 samples afterwards) and intermittent
      detection of endotoxin (6 of 21 samples before completion of construction, 9 of
      16 samples afterwards) at monthly sampling. Among 51 individual dialysis
      treatments (25 patients) before reconstruction and 56 treatments (29 patients),
      after, only 2 and 3 febrile events were identified, respectively. All of these
      were associated with underlying infectious illness and not with the hemodialysis
      procedure itself. Overall, we conclude that pyrogenic episodes associated
      directly with hemodialysis treatment are infrequent, and that the addition of a
      water storage tank with iodination treatment does not appear to increase the risk
      of bacteremia or pyrogenic episodes.

PMID- 2228292
TI  - Mineralization of polyurethane membranes in the total artificial heart (TAH): a
      retrospective study from long-term animal experiments.
AB  - The degree of mineralization of TAH membranes in animals is directly related to
      the survival time of animals with a TAH. Large differences in mineralization of
      the membranes among individual animals have been observed. These differences can
      be explained by the simultaneous presence of infection on biomaterials
      (polyurethane) as well as by different levels of natural inhibitors of
      mineralization. No positive influence of applying sodium warfarin for the
      inhibition of the mineralization was observed.

PMID- 2228293
TI  - Development of a new inflow valve for a 20cc semisoft ventricle: preliminary
      results.
AB  - We remodeled and tested our semisoft 20cc ventricle and made a new bileaflet flap
      inflow valve. Housings, bases, outflow valve, and a newly designed diaphragm were
      all made by vacuum forming and put together by radiofrequency welding or glue. In
      vitro, the ventricle produced a cardiac output of 2.5 to 3.0 L/min and showed
      reliable durability results. Hematological testing showed no important
      thrombogenicity of the new valve. Cardiac output was higher than expected for the
      volume of the ventricle, perhaps because of stretching or flow through. Animal
      experiments with the left ventricular assist device (LVAD) version was done at
      Ohio State University. Earlier in Utah, we did 20 cc total artificial heart (TAH)
      implantations and LVAD experiments in lambs and recently in calves with the 60cc
      TAH version. A soft ventricle is easy to implant and low in production costs.

PMID- 2228294
TI  - In vivo effects of stroma-free hemoglobin and polyhemoglobin on coagulation
      factors in rats.
AB  - We studied the effects of rat stroma-free hemoglobin (rSFH), human stroma-free
      hemoglobin (hSFH), rat polyhemoglobin (rPoly), and human polyhemoglobin (hPoly)
      on coagulation factors in rats. Albumin and saline infused rats were controls.
      The infusion volume was 10% of the rat's blood volume. The concentrations of
      hemoglobin in this study were 7 g/dl. Measurements for prothrombin time (PT) and
      activated partial thromboplastin time (PTT) were at 5 minutes, 2, 6, 24 and 72
      hours after infusion. Factor X, fibrinogen, plasminogen, antithrombin III, and
      antiplasmin were followed at 24 and 72 hours after infusion. Compared with saline
      infused rats PT and PTT did not change significantly in those rats infused with
      Hb preparations. There was a transient increase of PTT from 2 to 24 hours after
      infusion in albumin infused rats. Factor X, fibrinogen, antithrombin III and
      antiplasmin showed no significant differences between Hb infused groups and
      saline infused group. Twenty-four hours and 72 hours after infusion plasminogen
      decreased in all groups except the albumin infused rats at 24 hours after
      infusion when compared with normal rat plasma pool. However, there were no
      significant differences in plasminogen levels between the hemoglobin infused
      groups and the control saline group. Stroma-free and polyHb solutions (rSFH,
      hSFH, rPoly and hPoly) did not cause significant changes in prothrombin time and
      activated partial thromboplastin time in rats. The rats infused with hemoglobin
      solutions (rSFH, hSFH, rPoly, and hPoly) did not show significant differences in
      Factor X, fibrinogen, antithrombin III and antiplasmin levels compared with the
      control group.

PMID- 2228295
TI  - New approaches for biocompatibility testing using cell culture.
AB  - We are proposing two modified assays for biocompatibility testing which analyze
      the effects of cytotoxic substances leached from a biomaterial in cell culture.
      The biocompatibility of two vascular prostheses made of polytetrafluoroethylene
      was analyzed using the modified assays. One test, the "fluid medium assay" was
      modified by using small pieces of graft glued to a screening lid, thereby
      reducing the possibility of mechanical injury to cultured cells by free fragments
      of the tested biomaterial. Another test, the "cell inhibition assay" was modified
      in that the biomaterial to be tested was ground into small pieces while at very
      low temperature. The measure of cell toxicity used was the effect on DNA
      replication. Our results suggest that these modified assay methods can be used to
      evaluate the biocompatibility of biomaterials.

PMID- 2228296
TI  - Connectology problems with swan neck peritoneal dialysis catheters.

PMID- 2228297
TI  - Spectral resolution of cardio-circulatory variations in men measured by
      autorhythmometry over 2 years.
AB  - An analogue of the periodogram method for unequally spaced data is presented with
      a view to resolving the frequency structure of the observations. The algorithm is
      explicitly based on the sequential least squares procedure. In particular, the
      key concept is that the within-plot spectral analysis can be augmented by the
      between-plot information to make inferences about common characteristics. It is
      also shown how the between-plot random variations can be incorporated into the
      multiple harmonic regression model. A detailed spectral analysis investigates the
      periodic fluctuations in four cardio-circulatory variables, measured by
      autorhythmometric observation by eight men at rest and extending over a time span
      of 2 years. The spectral curves show the existence of circadian and circaseptan
      rhythmicities. The amplitude modulation of the dian rhythm by circaseptan
      variation is assimilated with the rhythmicity of work during the week. The blood
      pressure variables situate their maximum annual peak in the winter period. These
      quasi-periodic fluctuations appear to be related to the amount of physical
      activity performed in time by the subjects.

PMID- 2228299
TI  - Forecasting spore concentrations: a time series approach.
AB  - Fungal basidiospores and Cladosporium spores are the two most numerous spore
      types in the air of Dublin and its surroundings. They are known to have
      allergenic components, and the aim of the study described here is to develop a
      predictive model for these spores. A very simple model, which combines an
      estimated diurnal rhythm with a simple, one-parameter time series model, provided
      good short-term forecasts. The one-step prediction error variance was reduced by
      88% for Cladosporium spores and by 98% for basidiospores.

PMID- 2228298
TI  - Rheological modelling of physiological variables during temperature variations at
      rest.
AB  - The evolution with time of cardio-respiratory variables, blood pressure and body
      temperature has been studied on six males, resting in semi-nude conditions during
      short (30 min) cold stress exposure (0 degree C) and during passive recovery (60
      min) at 20 degrees C. Passive cold exposure does not induce a change in HR but
      increases VO2, VCO2, Ve and core temperature Tre, whereas peripheral temperature
      is significantly lowered. The kinetic evolution of the studied variables was
      investigated using a Kelvin-Voigt rheological model. The results suggest that the
      human body, and by extension the measured physiological variables of its
      functioning, does not react as a perfect viscoelastic system. Cold exposure
      induces a more rapid adaptation for heart rate, blood pressure and skin
      temperatures than that observed during the rewarming period (20 degrees C),
      whereas respiratory adjustments show an opposite evolution. During the cooling
      period of the experiment the adaptative mechanisms, taking effect to preserve
      core homeothermy and to obtain a higher oxygen supply, increase the energy loss
      of the body.

PMID- 2228300
TI  - Studies on organ weights in naproxen treated rats after intermittent exposure to
      simulated high altitude.
AB  - Rats were exposed intermittently for 8 h per day over 6 days at simulated high
      altitude of 20,000 feet. One group of altitude-exposed animals was treated with
      naproxen, a prostaglandin inhibiting drug. Significant reduction in body weight
      gain was observed in both altitude-exposed and drug-treated altitude-exposed
      animals compared to the control group. Right and left ventricular weights and
      weights of the adrenal glands were increased significantly in altitude-exposed
      and altitude-exposed drug-treated animals. The weight of the spleen was increased
      significantly in altitude-exposed animals whereas no such increase of splenic
      weight was observed in drug-treated altitude-exposed group of animals. On the
      other hand, the weight of the liver was decreased significantly in both cases. In
      drug-treated altitude-exposed animals, the unaltered splenic weight was thought
      to be due to inhibition of the erythropoietic activity.

PMID- 2228301
TI  - Body fluid status on induction, reinduction and prolonged stay at high altitude
      of human volunteers.
AB  - Studies on adaptation to high altitude (HA) of 3500 m in the Himalayas were
      conducted in three phases, each including 10 normal and healthy males normally
      resident at sea-level. Phase I subjects had no previous experience of HA, phase
      II subjects after 4-6 months at HA were airlifted to sea-level and phase III
      subjects stayed continuously for 6 months at 3500 m. Body fluid compartments and
      blood gases were determined in all three groups. Plasma volume was highly
      elevated in the phase II subjects on reinduction to sea-level from HA. In
      comparison to phase I subjects, the retention of fluid in extracellular
      compartment was increased at HA leading to increased susceptibility to high
      altitude illness. Phase III subjects were hyperhydrated with decreased plasma
      volume and increased PO2 in comparison to the other two groups.

PMID- 2228302
TI  - Too hot for comfort: the heatwaves in Greece in 1987 and 1988.
AB  - The heatwaves that affected Greece in July 1987 and July 1988 are considered in
      terms of (i) the relative strain index. For different types of activity, and (ii)
      the discomfort index. Hourly values of air temperature and humidity for
      Thessaloniki and Athens were used as the data base. Both indices show that in
      terms of physiological strain and general discomfort, Thessaloniki suffered a
      little more and a little longer than Athens. We conclude that the relative strain
      index is probably a useful tool in studies of the adverse effects of humid
      heatwaves on different sections of a population.

PMID- 2228303
TI  - Report on a Workshop of the UICC Project on Evaluation of Screening for Cancer.

PMID- 2228304
TI  - Total energy intake and nutrient composition: dietary recommendations for
      epidemiologists.

PMID- 2228305
TI  - Dietary factors and breast-cancer risk in Denmark.
AB  - The influence of dietary factors, in particular the intake of fat and beta
      carotene, on breast-cancer risk was evaluated in a case-control study including
      1,486 breast cancer cases diagnosed over a 1 year period in Denmark. The control
      group was an age-stratified random sample of 1,336 women from the general
      population. Data on usual diet prior to the breast cancer diagnosis were
      collected by self-administered questionnaires of the semi-quantitative food
      frequency type. A highly significant trend (p less than 0.001) of increasing risk
      was observed with increasing fat intake, the RR for the highest quartile being
      1.45 (95% Cl 1.17-1.80) compared with the lowest. However, information was not
      available to allow adjustment for the possible confounding effect of energy
      intake. The risk of breast cancer was not associated with consumption of
      vegetables rich in beta-carotene, multi-vitamin tablets or other dietary
      supplements, coffee, tea, sugar or artificial sweeteners.

PMID- 2228306
TI  - Humoral modulation of lymphokine-activated killer (LAK)-cell induction in humans:
      IgG-related and non-IgG inhibitors in sera from cancer patients.
AB  - Soluble inhibitors of lymphokine-activated killer (LAK) cell induction were
      characterized and purified from serous fluids from healthy donors or from
      patients with advanced cancer. Inhibitory activity in sera from cancer patients
      was partially absorbed with protein A agarose or anti-human IgG agarose.
      Following absorption, residual inhibition varied with individual sera, suggesting
      the presence of IgG-related and non-IgG inhibitory factors, and the proportions
      varied in the patient population. IgG, purified by affinity chromatography from
      ascitic fluids, from plasma of cancer patients, and from plasma of healthy
      donors, significantly inhibited IL-2 induction of LAK cells in a dose-dependent
      manner. Irrespective of the sources, inhibitory activity resided in the high
      molecular-weight IgG fraction composed of IgG aggregates and immune complexes,
      but not monomeric IgG. Commercially prepared human IgG in aggregated form, but
      not in monomeric form, inhibited LAK cell induction in a dose-dependent manner.
      In contrast, neither bovine IgG nor human albumin affected LAK cell induction,
      even at higher concentrations. Aggregated human IgG inhibited LAK cell induction
      in unfractionated peripheral blood mononuclear cells (PBMC) but not in monocyte
      depleted peripheral blood lymphocytes (PBL). Despite extensive (greater than 99%)
      depletion of IgG by protein-G affinity chromatography, the serous fluid from
      cancer patients displayed significant inhibitory activity. Fractionation of the
      IgG-depleted inhibitory materials by Sephacryl S-300, high-pressure ion-exchange
      column (HPIEC) or gel-permeation chromatography (HPGPC) demonstrated a 65-kDa
      inhibitor, distinct from IgG. Affigel-blue affinity chromatography of the 65-kDa
      fraction depleted albumin but did not remove the inhibitory activity, suggesting
      that the 65-kDa inhibitor is not serum albumin nor an albumin-bound component.
      These results suggest that serous fluids from patients with advanced-stage cancer
      contain 2 distinct regulators for LAK cell induction: (I) aggregated IgG and (2)
      a 65-kDa inhibitor, distinct from albumin.

PMID- 2228307
TI  - Occurrence of non-gastric cancer in the digestive tract after remote partial
      gastrectomy: analysis of an Amsterdam cohort.
AB  - If peptic ulcer surgery favors the formation of carcinogenic N-nitroso compounds
      in the gastric remnant, an increased risk of cancer at sites in the
      gastrointestinal tract distant from the stomach might be predicted. To estimate
      the risk of carcinomas in the digestive tract, other than the stomach, occurring
      after partial gastrectomy, we analyzed an Amsterdam cohort of 2,633 post
      gastrectomy patients operated on for benign disease between 1931 and 1960.
      Mortality in the study population was compared with the general Dutch population
      through person-year analysis. An excess mortality of biliary tract cancer
      (O/E:2.64; CL:1.32-4.72; p less than 0.01) and pancreatic cancer (O/E:1.65;
      CL:1.06-2.44; p less than 0.05) was found in males more than 5 years after
      surgery; females showed only an increased risk of pancreatic cancer in the first
      5 years postoperatively (O/E:15.33; CL:1.85-55.43; p less than 0.01), probably
      due to misdiagnosis. All other non-gastric sites of the digestive tract carried
      no increased risk for cancer. In males, mortality due to colorectal cancer more
      than 5 years post-operatively was significantly decreased (O/E:0.58; CL 0.34
      0.92; p less than 0.01). The excess mortality of biliary-tract and pancreatic
      cancer in males, which increases with the duration of post-operative interval, is
      consistent with a dose-response phenomenon. This study therefore supports the
      hypothesis that carcinogens are not only locally activated in the gastric
      remnant, but are hepatically excreted and initiate cancer in the biliary tree and
      pancreatic duct. Further exploration of this mechanism of carcinogenesis is
      warranted, since it may also explain the pathogenesis of pancreatic and biliary
      cancers in patients without gastrectomy.

PMID- 2228308
TI  - Age at menarche, age at menopause, height and obesity as risk factors for breast
      cancer: associations and interactions in an international case-control study.
AB  - The importance of age at menarche, age at menopause, height, and obesity as risk
      factors for breast cancer, and the possible interactions among these factors in
      breast cancer causation were investigated in a data set collected in the late
      1960's, in an international multicenter case-control study. Multiple logistic
      regression procedures were used to model data from 3,993 breast cancer cases and
      11,783 controls from 7 study centers representing the range of international
      variation of breast cancer incidence. Height and obesity (measured through the
      weight/height2 index) were independent risk factors for breast cancer among post
      menopausal but not pre-menopausal women; post-menopausal women taller by 10 cm
      had a 12% higher risk of breast cancer (95% confidence interval, CI, 3-21%) and
      post-menopausal women of average height (say 158 cm) had an 11% higher risk of
      breast cancer (CI 7-16%) when they were heavier by 10 kg (and, therefore, more
      obese by 4 kg/m2). Age at menarche was a risk factor among both pre-menopausal
      and post-menopausal women, a delay of 2 years corresponding to a 10% reduction in
      breast cancer risk (CI 6-15%). Age at menopause was also a breast cancer risk
      factor, women with menopause at each 5 year age difference having a 17% higher
      risk of breast cancer (CI 11-22%). There is evidence of an interaction (deviation
      from the logistic regression-postulated multiplicativity) between obesity and age
      at menarche, implying that the protective effect of late menarche may not apply
      to overweight women or that late menarche may become detrimental in obese women.
      The estimated relative risk coefficients, when applied to average risk factor
      levels observed among control women, can explain only a small fraction of the
      difference in breast cancer incidence between Boston and Tokyo.

PMID- 2228309
TI  - Chromosome aberrations induced by etoposide (VP-16) are not random.
AB  - The clastogenic effect of etoposide, an anti-cancer chemotherapeutic drug, was
      investigated in vitro on lymphocytes of 5 healthy donors. The analysis of the
      first division metaphases arising after mutagenesis in G1 phase shows that
      chromosome-type aberrations are much more frequent than chromatid-type lesions.
      The distribution in relation to chromosome lengths of the 439 breakpoints that
      were accurately identified is not random: chromosomes 1, 11 and 17 are most
      frequently involved, while chromosomes 4, 5 and X are seldom affected. This non
      random distribution may be related to chromosome structure, since R-band-rich
      chromosomes are significantly more affected than G-band-rich chromosomes.

PMID- 2228311
TI  - Survival of breast-cancer patients and body size indicators.
AB  - The association of breast-cancer survival with various risk factors was
      investigated using data of 213 breast-cancer patients who underwent surgical
      operation between 1975 and 1978. They were followed-up until 1987, and a total of
      64 deaths including 47 breast-cancer deaths were certified. The 5-year and 10
      year relative survival rates were 78.5% and 75.3% respectively. Of the various
      factors investigated, some anthropometric indicators revealed interesting
      results; i.e., body weight, Quetelet index, and body surface area at the time of
      operation turned out to be strong predictors of survival with a statistically
      significant trend towards lower survival with larger body structure even after
      adjustment for confounding factors (e.g., clinical stage) using a proportional
      hazard model. The estimated survival probability for women with Quetelet index of
      20 was about 12% higher than that with Quetelet index of 24 over a 10-year or
      more follow-up period. Other variables exhibiting prognostic importance were
      clinical stage, TNM classification, and some histological findings, while height
      and reproductive life indicators were, as a rule, not significantly related to
      survival.

PMID- 2228310
TI  - Expression of HLA-A,B,C, beta 2-microglobulin (beta 2m), HLA-DR, -DP, -DQ and of
      HLA-D-associated invariant chain (Ii) in soft-tissue tumors.
AB  - Non-neoplastic mesenchymal cells, along with 33 benign and 87 malignant soft
      tissue tumors (STT) were examined for expression of HLA-A,B,C, beta 2
      microglobulin (beta 2m), HLA-DR, -DP, and -DQ molecules and the HLA-D associated
      invariant chain (Ii). Serial frozen sections were immunostained using monoclonal
      antibodies (MAbs) to monomorphic framework determinants of HLA sublocus products,
      beta 2m and Ii, and to CD53, a recently defined broadly distributed pan-leucocyte
      molecule. Compared with the normal state, an induction/neo-expression of HLA
      A,B,C/beta 2m was found in a considerable number of tumors of muscle, peripheral
      nerve, cartilage-forming, adipose, and vascular tissues. Conversely, some tumors
      of fibrous origin and of autonomic ganglia showed an abnormal abrogation/loss of
      HLA-A,B,C/beta 2m with respect to their cells of origin. Small, round tumor cells
      present in various types of STT exhibited a heterogenous pattern of expression of
      these molecules with a preponderance of HLA-A, B,C/beta 2m-negativity. HLA-D/Ii
      determinants were rarely detectable in STT. Besides their expression in some
      fibrohistiocytic tumors, they were only occasionally found in tumors of smooth
      muscle, peripheral-nerve and vascular origin as well as in one clear-cell
      sarcoma. In all tumors but one, there was no microtopographic association between
      HLA-D/Ii-positive tumor cells and inflammatory cells. CD53 allowed discrimination
      between dendritic interstitial cells (DIC) and neoplastic cells and additionally
      revealed that, in contrast to other solid tumors, STT are generally characterized
      by an extreme scarcity of lymphohistiocytic infiltrates. Our data indicate that,
      aside from very rare exceptions, aberrant induction or abrogation of MHC
      molecules in STT occurs in the absence of lymphohistiocytic stromal infiltrates,
      suggesting that these alterations might not be a consequence of local cytokine
      effects.

PMID- 2228312
TI  - Patterns of expression of the p53 tumour suppressor in human breast tissues and
      tumours in situ and in vitro.
AB  - An extensive series of histological sections reflecting the various states of
      normal breast tissue, and a range of benign and malignant lesions, were examined
      for the expression of the p53 protein using a panel of anti-p53 antibodies. In 2
      separate series the results of using frozen or methacarn-fixed, paraffin-embedded
      sections were compared. Strong positive staining for p53 was detected in over 50%
      of the malignant lesions when frozen sections were used. This number fell to just
      over 20% when methacarn-fixed sections were examined. In neither series was any
      p53 staining seen in normal breast or in the benign lesions. Studies by Western
      blotting on breast cell lines confirmed that this histological signal is due to a
      pronounced over-expression of the p53 protein. Earlier studies show that this
      over-expression is associated with mutation of the p53 gene. Mutation of the p53
      gene with over-expression of the mutant protein is therefore one of the most
      frequent specific genetic changes in malignant breast cancer.

PMID- 2228313
TI  - Abelson murine leukemia virus transforms preneoplastic Emu-myc transgene-carrying
      cells of the B-lymphocyte lineage into plasmablastic tumors.
AB  - E mu-myc transgenic mice were back-crossed to BALB/c mice up to back-cross
      generation 3. The offspring that included transgene-carrying and -negative mice
      in approximately equal proportions were randomly divided into 2 groups. Thirty
      four mice (group I) were treated with pristane, followed by A-MuLV, and 40 (group
      II) were injected with A-MuLV alone. Altogether, 16 lymphoid tumors developed in
      group I and 17 in group II. Nine of the tumors in group I and 4 in group II
      appeared as ascitic tumors. The ascites contained lymphoblasts and 10 to 45%
      plasmacytoid cells. These tumors were designated as plasmablastic lymphomas
      (PLs). All tumors except one were transgene-positive and did not carry
      translocations. An exceptional tumor in group I carried a variant 6;15
      translocation but not the transgene. It obviously corresponds to the regular
      Abelson + pristane-induced plasmacytoma. Among 11 tested PLs, 10 had a single
      retroviral insertion site, while one tumor showed 3. Among 18 untreated
      transgenic descendants (group III), chosen randomly during serial back-crosses,
      15 (83%) developed lymphomas, with no sign of plasmacytoid differentiation. The
      incidence was comparable in all 3 groups, assuming 50% of the mice in groups I
      and II to be transgenic. The time distribution of tumor development was also
      similar. Spleen cells from transgene-carrying mice with no clinical sign of
      lymphoma were infected in vitro with A-MuLV and transplanted i.p. into BALB/c
      recipients. PLs developed in 26 of 31 pristane-treated recipients, but in only
      one of 18 untreated recipients. One of 6 PLs tested was monoclonal, whereas the
      remaining 5 were oligoclonal. They all expressed v-abl. These results show that
      some of the preneoplastic B-cells that expressed constitutively active myc
      transgene turned into plasmablasts after infection with A-MuLV. Full development
      of their neoplastic potential was facilitated by the presence of pristane
      granuloma.

PMID- 2228314
TI  - Detection of colonic growth factors using a human colonic carcinoma cell line
      (LIM1215).
AB  - Although the colonic mucosa is one of the most rapidly proliferating epithelial
      tissues in the body, little is known about the factors that direct this
      proliferation. In this report we have studied the parameters of both a mitogenic
      and a clonogenic assay for detecting potential colonic growth factors (CGF).
      Using a colon carcinoma cell line (LIM1215), which has retained a number of the
      properties of normal colonic mucosa, we have assayed a range of mitogenic factors
      for CGF activity. 3H-thymidine incorporation by the LIM1215 cell line was
      stimulated by low concentrations of epidermal growth factor and basic fibroblast
      growth factor and, to a lesser extent, by higher concentrations of interleukin-1
      and insulin-like growth factor 1. The cells did not respond to a range of other
      mitogens and lymphokines. Optimal clonogenic response in a soft-agar assay was
      obtained using a primary pituitary extract.

PMID- 2228315
TI  - Immunochemical comparison of transformation-associated protein and secreted
      phosphoprotein.
AB  - Transformation-associated protein (TAP) has been detected in MSV-M-transformed
      rat cell lines as glycosylated, weakly phosphorylated protein of molecular weight
      (Mr) 66,000 and 68,000. In the ts-MSV-M-transformed rat kidney cell line (6m2),
      the synthesis of TAP and the v-mos gene product is temperature-sensitive and
      accompanies the expression of transformation phenotypes. Therefore, TAP
      potentially plays a role in cellular transformation. On the other hand, SPP
      represents a family of glycosylated phosphoprotein with apparent Mr ranging from
      42,000 to 69,000. SPP has been detected in osteoblasts and in avian and murine
      retrovirus-transformed rat and mouse epithelial cells. Therefore, the potential
      relatedness of TAP and SPP was studied. Using the 6m2 cells, we found that SPP
      was strongly phosphorylated and was synthesized at both the permissive (33
      degrees C) and non-permissive (39 degrees C) temperatures. By contrast, TAP was
      weakly phosphorylated, and was synthesized, as we found previously, only at the
      permissive temperature of 33 degrees C. Furthermore, in 35S-methionine
      incorporation studies, TAP became heavily labelled whereas SPP was not
      (consistent with its amino acid composition having few methionine residues).
      Using 125I-TAP in both immunoprecipitation and radioimmunoassays, it was found
      that an antiserum raised against SPP did not cross-react with 125I-TAP.
      Additionally, SPP has now been found in many human and rodent cells, while TAP
      thus far has only been detected in MSV-transformed rat cells. These data suggest
      that structurally, TAP and SPP are not closely related phosphoproteins.

PMID- 2228316
TI  - Evidence for the role of 34-kDa galactoside-binding lectin in transformation and
      metastasis.
AB  - The endogenous Mr 34,000 galactoside-binding lectin (L-34) is found at elevated
      levels in a wide variety of neoplastic cells and correlative evidence suggests
      that it is involved in tumor metastasis in vivo and in transformation in vitro.
      We demonstrate here that introduction of recombinant L-34 into tumorigenic,
      weakly metastatic UV-2237-cl-15 fibrosarcoma cells results in an increased
      incidence of experimental lung metastases in syngeneic and nude mice.
      Transfection of normal BALB/c-A31 cloned fibroblasts with functional L-34 results
      in acquisition of anchorage-independent growth and in morphological
      transformation in vitro but not in tumorigenicity in vivo. These results provide
      direct evidence that the cellular expression of L-34 is associated with some
      aspects of transformation and with metastasis, but not with tumorigenicity per
      se.

PMID- 2228317
TI  - Tumor necrosis factor-alpha and interleukin-1 alpha production in cachectic,
      tumor-bearing mice.
AB  - Weight-stable mice bearing a syngeneic, methylcholanthrene-induced, rapidly
      growing tumor lost approximately 22% of their lean tissue, became significantly
      hypoalbuminemic and had a marked increase in serum amyloid P concentrations
      during progressive tumor growth. Tumors from cachectic mice were producing both
      TNF-alpha and IL-1 alpha in vivo as documented by the presence of TNF-alpha and
      IL-1 alpha mRNA and immune-reactive protein for IL-1 alpha. Only spleens from
      tumor-bearing mice had statistically significantly elevated quantities of IL-1
      mRNA. In general, alterations in tissue concentrations of IL-1 mRNA in tumor
      bearing animals agreed qualitatively with those found in endotoxin-stimulated,
      non-tumor-bearing control mice. However, endotoxin-stimulated mice had
      significantly elevated tissue concentrations of TNF mRNA in spleen and livers,
      while TNF mRNA levels were not significantly increased in any host tissues.
      Cytokine mRNA levels in tumor tissue were not higher than those found
      constitutively in various tissues from non-tumor-bearing control animals. Plasma
      from tumor-bearing mice and endotoxin-stimulated controls contained high levels
      of IL-6 but low (endotoxin-stim.) or no measurable levels (tumor-bearing) of
      either IL-1 or TNF. When tumor cells from cachectic mice were placed into long
      term cell culture, immune reactive TNF-alpha and IL-1 alpha were produced, but IL
      6 bioactivity ws not produced in measurable amounts.

PMID- 2228318
TI  - Progestin induction of 17 beta-hydroxysteroid dehydrogenase enzyme protein in the
      T-47D human breast-cancer cell line.
AB  - Steroid regulation of 17 beta-hydroxysteroid dehydrogenase (17-HSD) was studied
      in the T-47D human breast-cancer cell line, using a radioimmunoassay. In
      addition, 3 mRNA species (2.4, 1.4, and 0.9 kb) specific for the enzyme were
      shown to be present in these cells. All the synthetic progestins tested (ORG
      2058, R5020, medroxyprogesterone acetate) significantly increased the
      immunoreactive enzyme protein concentration, while other types of steroids, such
      as testosterone, oestradiol and dexamethasone, were ineffective. The progestin
      specific induction of 17-HSD was dose-related and was maximum in about 5 days. An
      antiprogestin, RU 486, when used in combination with synthetic progestins,
      blocked the progestin-induced increase of 17-HSD concentration very effectively.
      A good correlation was observed in the different experiments between the enzyme
      activity and the immunoreactive 17-HSD concentration. We conclude that progestins
      induce 17-HSD in T-47D cells and that the induction occurs via an increased
      accumulation of enzyme protein.

PMID- 2228319
TI  - Oncogene expression of FANFT- or BBN-induced rat urothelial cells.
AB  - Proto-oncogene expression by cultured urothelial cells prepared from the bladders
      of male F344 rats that had been treated with N-[4-(5-nitro-2-furyl)-2-thiazolyl]
      formamide (FANFT) or N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) were examined.
      Although all of the cultured cells showed varying degrees of anchorage
      independent growth, only 9 of them were transplantable into nude mice. A Northern
      blot technique was employed for the detection of proto-oncogene transcripts. The
      c-Ha-ras transcripts were detected in all the cultured urothelial cells prepared
      from the carcinogen-treated rats and in normal urothelial cells. However, the
      transcript levels were several-fold higher in the former than in normal cells.
      Increased expression of p21, as determined by immunohistochemical techniques, was
      also observed in all the original bladder tissues from which the cultures were
      derived. c-myc transcripts were detected in the cells from carcinogen-treated
      rats but not in the normal cells. The presence of myc product in hyperplastic
      urothelial lesions and carcinomas of original bladder tissues was confirmed by
      immunohistochemical methods. Transcripts of mos, erb B, Ki-ras, abl and src were
      not detected. Since increased expression of c-myc and c-Ha-ras were present in
      both transplantable and non-transplantable cell lines, and the expression of p21
      occurs in preneoplastic cells, this suggests that elevated expression of these 2
      genes may be an early genetic event during bladder carcinogenesis in the rat and
      further alteration of these 2 genes or mutation of additional genes may be
      required for the completion of malignant transformation.

PMID- 2228320
TI  - Retardation of metastatic tumor growth after immunization with metastasis
      specific monoclonal antibodies.
AB  - The influence of 4 murine monoclonal antibodies (MAbs) directed against surface
      determinants of a metastasizing rat adenocarcinoma (BSp73ASML) on metastatic
      spread was evaluated and compared to their in vivo binding as well as to the
      induction of a humoral anti-MAb response, especially with respect to the
      development of anti-idiotypic (ID) antibodies of the internal image type. In a
      protocol of explicit immunization, all 4 MAbs transiently inhibited metastatic
      growth. Survival was prolonged only with one MAb (4.4ASML). With another MAb
      (1.1ASML), directed against a new variant form of CD44, metastatic growth was
      accelerated after transient retardation. Retardation of metastatic growth
      correlated with the humoral anti-MAb response. This accounted for the isotype- as
      well as for the idiotype-specific response. An exception was noted after
      immunization with MAb 1.1ASML. Rats with high levels of anti-1.1ASML antibodies,
      which inhibited binding to the tumor cells (internal image-type antibodies)
      showed accelerated metastatic spread. Data are interpreted to mean that MAb
      induced inhibition of metastatic spread may be based on 2 independent mechanisms:
      blockade of metastasis-associated epitopes (i.e., with MAb 1.1ASML) and induction
      of an anti-mouse Ig response. In the latter case it was irrelevant whether the
      response was isotype- or idiotype-specific.

PMID- 2228321
TI  - Epidermal growth factor receptors and EGF-responsiveness of the human breast
      carcinoma cell line PMC42.
AB  - PMC42 is an early-passage, well-differentiated, pleiomorphic human breast-cancer
      cell line. It expresses an average of 2.4 x 10(5) EGF receptor (EGFR) sites per
      cell when cultures are assayed using a radioreceptor assay. This is a relatively
      high figure for breast-carcinoma cell lines. Its responses to epidermal growth
      factor (EGF) were analyzed morphologically and by flow cytometry and
      immunocytochemistry. PMC42 responded in vitro to EGF with morphological changes,
      inhibition of "doming" and an increase in DNA synthesis in serum-containing
      medium in confluent or near-confluent cultures. When EGF receptor sites were
      localized immunocytochemically in PMC42, they were found to be variably expressed
      on the membrane of cells grown in the absence of EGF, with discrete areas of
      strong and weak cells of different morphological appearances; flow cytometry
      indicated a 10-fold range in EGFR levels between individual cells. Cultures
      maintained in the presence of EGF were less heterogeneous in their morphology and
      had a predominantly cytoplasmic, relatively uniform localization of EGFR with
      down-regulation of membrane EGFR levels. EGF-stimulated cultures were stained
      simultaneously for the presence of EGFR and the proliferation-related antigen Ki
      67 and analyzed by both flow cytometry and immunocytochemistry. No correlation
      was observed between Ki-67 positivity and level of EGFR expression by individual
      cells. Electron microscopic localization of receptor sites demonstrated that the
      receptors were concentrated predominantly on the lateral and basal membranes.
      These results show that the PMC42 line reflects a number of the properties of
      heterogeneous breast tumours in situ. It may also continue to express growth
      factor receptors in a manner that reflects their topographical distribution on
      normal luminal breast epithelial cells.

PMID- 2228322
TI  - A multicenter double-blind study of sulglycotide versus sucralfate in nonulcer
      dyspepsia.
AB  - Nonulcer dyspepsia remains to this date a clinical disease entity that is
      diagnosed and treated empirically by considering such patients potential ulcer
      carriers and treating them accordingly with H2 antagonists. The purpose of this
      study was to assess the therapeutic effectiveness of sulglycotide in patients
      with nonulcer dyspepsia in a random double-blind trial vs sucralfate. One hundred
      and eighty-seven consecutive patients with nonulcer dyspepsia were treated with
      sulglycotide (oral, 200 mg t.i.d. for 6 weeks, n = 93) or with sucralfate (oral,
      1 g t.i.d. for the same length of time, n = 94). Drug effectiveness was evaluated
      in terms of apparent clinical symptom modifications, fiberoptic endoscopy
      findings and histological aspects of biopsy specimens. Both treatments resulted
      in prompt abatement of the clinical complaints of nonulcer dyspepsia and the
      improvement of macroscopic gastritis at endoscopy. These results confirm the
      usefulness of cytoprotective drugs in nonulcer dyspepsia characterized by
      gastroduodenal inflammation.

PMID- 2228323
TI  - Drug trials on healthy volunteers in Yugoslavia.
AB  - Ninety-seven healthy volunteers who participated in different clinical trials
      (phases III and IV) in a clinical pharmacology unit were interviewed over the
      period December 1988-February 1990 using questionnaire method. The aim of the
      investigation was to analyze the examinees' occupational distribution, the degree
      of insight in the trials they participated in, their opinion about the
      remuneration they get and their estimate of the importance or inconveniences of
      numerous trial elements. Only 39 volunteers (40.2%) were members of medical
      staff: 17 (17.5%) physicians, 17 (17.5%) medical students and 5 (5.2%) nurses.
      The volunteers assessed the importance of different elements related to the trial
      marking them from 1-5. They were more afraid of possible adverse drug reactions
      (ADR) occurring during the trial (median 3.87) than of those that might occur
      afterwards (2.94). Significant was their concern about the kind of investigated
      drug (3.49). "Potential contribution of the trial to the medicine and society"
      (3.30) and "length of time spent in the laboratory" (3.17) followed. The conduct
      of clinical trials on healthy volunteers in Yugoslavia and legal regulations are
      discussed at the end of the paper.

PMID- 2228324
TI  - Measuring the bronchial effects of bronchodilating drugs in healthy subjects with
      methacholine provocations: theophylline protects against induced
      bronchoconstriction in a dose-dependent manner.
AB  - To assess whether it would be possible to use methacholine (MCH) provocation
      tests with healthy subjects in the evaluation of bronchodilatory drugs, an
      intravenous infusion of theophylline ethylenediamine in increasing doses of 2.5,
      5.0 and 7.5 mg/kg was given in random order to nine healthy non-smoking
      volunteers in a single-blind, placebo-controlled study. Dose response slope (DRS
      = maximal decline [%] in pulmonary function/the maximum dose of MCH [mumol]) was
      used to estimate airway reactivity. DRS was calculated to FEV1 (DRSFEV1) and to
      area under the flow-volume curve (AEFV, DRSAEFV). The bronchial reactivity was
      first tested with a standard MCH provocation method. An abbreviated, single-dose,
      method was used in the measurement of the effects of theophylline. The DRS-values
      obtained from the short method did not differ from those obtained from the
      standard one (p = 0.86, for DRSFEV1 and DRSAEFV), and correlation between these
      two methods was good (r = 0.93 and 0.98 for DRSFEV1 and DRSAEFV, respectively [p
      less than 0.001]). Serum theophylline concentrations achieved were (mean +/- SEM)
      32.4 +/- 0.9, 63.7 +/- 3.3 and 93.4 +/- 3.3 mumol/l, which differed significantly
      from each other (p much less than 0.001). An inverse linear relationship between
      the serum theophylline concentration and the airway reactivity was observed with
      both indexes (r = -0.54, p less than 0.01 for DRSFEV1 and r = -0.65, p less than
      0.001 for DRSAEFV). Even the lowest dose, which produced serum concentrations
      well under the therapeutic range, protected significantly (p less than 0.05)
      against MCH induced bronchoconstriction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228325
TI  - Comparative effects of rifampin and/or probenecid on the pharmacokinetics of
      temazepam and nitrazepam.
AB  - The pharmacokinetics of nitrazepam and temazepam were investigated in 16 healthy
      volunteers before and after seven days of the administration of rifampin 600 mg/d
      and/or probenecid 500 mg/d. In order to determine the endoplasmatic reticulum
      enzyme function, 6-beta-hydroxycortisol excretion and antipyrine pharmacokinetic
      parameters were evaluated. After the administration of rifampin, the total body
      clearance of antipyrine and nitrazepam increased by 87% and 83%, respectively.
      After the combined treatment with rifampin and probenecid, the elimination of the
      two drugs was also increased, even though to a lesser extent (33%, 31%). After
      the administration of probenecid only, the total clearances of antipyrine and
      nitrazepam were decreased by 22% and 25%, respectively. The urinary clearance of
      the antipyrine metabolites also decreased. In norantipyrine and 4-OH-antipyrine,
      this was due to a significant reduction of glucuronide fraction (211 +/- 32 to
      159 +/- 26 mg, and 259 +/- 39 to 191 +/- 25 mg). The sulphate fraction of
      norantipyrine increased by 18% and that of 4-OH-antipyrine by 21%. Apart from a
      reduced excretion of the glucuronide fraction, the pharmacokinetics of temazepam
      were neither altered significantly by probenecid nor by rifampin. According to
      the outcome of this investigation, probenecid seems to bring about not merely an
      inhibition of phase II but also an inhibition of phase I metabolization.

PMID- 2228326
TI  - Lithium treatment and the geriatric population.
AB  - The present review attempts to highlight selective concerns with regard to the
      use of lithium in the geriatric population. Several points as pharmacokinetics,
      prophylaxis, side-effects, intoxication deserve particular emphasis in relation
      to the elderly patient and are discussed. Furthermore, since the potential for
      drug interactions is greatly increased because of the greater number of drugs
      these patients take, the clinical significance of some drug interactions is also
      reported.

PMID- 2228327
TI  - Intramuscular atropine in healthy volunteers: a pharmacokinetic and
      pharmacodynamic study.
AB  - In a randomized, double-blind, placebo controlled crossover study, the
      pharmacokinetics and some clinically important pharmacodynamic effects of
      intramuscular atropine (dl-hyoscyamine) were studied in 6 healthy male
      volunteers. The plasma concentrations of l-hyoscyamine were analyzed by
      radioreceptor assay (RRA) and the plasma concentrations of dl-hyoscyamine by
      radioimmunoassay (RIA). The absorption rate and the elimination rate of dl
      hyoscyamine and l-hyoscyamine were comparable (tmax = 8.40 vs 8.67 min, t1/2el =
      2.95 vs 2.43 h, dose 0.02 mg/kg) but the mean maximum plasma concentration of dl
      hyoscyamine was 2.9 times and the mean AUC value 6.0 times higher than that of l
      hyoscyamine which indicates a kinetic difference between the enantiomers. The
      concentrations of d-hyoscyamine calculated from the dl- and l-hyoscyamine
      concentrations reached maximum between 1 and 2 h after drug injection. The renal
      excretion of l-hyoscyamine occurred mostly in 6 h (34% of the dose) and no
      conjugated drug forms were detected. The increase in heart rate was observed only
      after the higher dose (0.02 mg/kg) and it was significant between 30 min and 2 h.
      The plasma concentrations of l-hyoscyamine and the change in heart rate expressed
      as percentages showed a linear correlation: concentrations under 0.5 micrograms/l
      caused slowing of rate, higher concentrations caused acceleration. Also, the
      antisialagogue effect (30 min-3 h) correlated with plasma concentrations.

PMID- 2228328
TI  - The College Drinking Attitude Scale: a tool for alcohol education program
      assessment.
AB  - The development and validation of the College Drinking Attitude Scale (CDAS) are
      described. Based on a sample of over 4,000 college students, an item analysis,
      internal consistency analysis, and criterion validity analysis procedures were
      performed. The author concludes that the CDAS is a valid and reliable instrument
      that could be used to assess responsible attitudes toward the use of alcohol
      among college students.

PMID- 2228329
TI  - Ketamine--can chronic use impair memory?
AB  - Ketamine, a congener of phencyclidine (PCP), can produce a range of psychological
      effects which have led to its nonmedical use. Recent discoveries concerning the
      effects of ketamine and similar substances in the brain suggest that they may
      interfere with memory processes when given acutely and may affect synaptic
      plasticity when given chronically in high doses in certain animal models. It is
      thus of interest to examine the consequences, if any, of chronic use in humans. A
      case is here presented of long-term, high-dose ketamine use, in which the user
      described impaired recall and attention, and a subtle visual anomaly persisting
      after cessation of the habit. This history is considered in the context of other
      relevant studies.

PMID- 2228331
TI  - Existence, effectance, esteem: from gambling to a new theory of human motivation.
AB  - A study of gamblers' motives leads to the formulation of a new theory of human
      motivation. The theory states that humans have three basic interrelated needs:
      (1) a need to confirm their existence, (2) a need to affirm their worth, and (3)
      a need to produce effects (be a causal agent). The theory further states: (4)
      When they produce desired (intended) effects, they experience pleasure (e.g.,
      joy); and when they fail to produce desired effects, they experience displeasure
      (e.g., disappointment). (5) The principle of least effort and (6) mental,
      emotional, and bodily blocks act as impediments to the confirmation of existence,
      to the affirmation of worth, and to the production of effects.

PMID- 2228330
TI  - Instrument for the measurement of individual and societal attitudes toward drugs.
AB  - Due to the importance of the relation between attitudes and the experimentation
      with and use of drugs among adolescents, an instrument was developed composed of
      individual and societal attitudes toward drugs. A pilot study was carried out on
      the basis of which a questionnaire containing 63 items was constructed. This
      questionnaire was given to the research sample of 566 Israeli high school
      students aged 15-17. Three criteria were used to determine the final version of
      the instrument, which contains 55 items. Factor analysis revealed seven factors:
      curiosity and willingness to use drugs, social concern, individual freedom,
      attribution of positive characteristics to drugs, perceived harmfulness of drugs,
      perceived characteristics of drug users, and legalization of drugs. Reliability
      of the factors ranges from alpha = 0.64 to alpha = 0.88; reliability of the
      entire questionnaire is alpha = 0.89. A short version of the questionnaire
      consisting of 27 items (alpha = 0.80) was developed for special populations.
      These findings suggest that the Green Individual and Societal Attitudes Toward
      Drugs Questionnaire can be employed as a diagnostic tool to identify potential
      drug experimenters, and as a planning and evaluation measure to preventive drug
      educational programs.

PMID- 2228332
TI  - The Addiction Severity Index: predicting relationship to a hospital and a
      professional.
AB  - The Addiction Severity Index was developed to be a useful instrument in treatment
      planning for the substance abuser. Multivariate statistical tests were conducted
      on the questionnaire for a clinical sample of 190 males at a Veterans
      Administration hospital. When the desire for psychological treatment with a
      specific person was taken into consideration, the overall predictive validity of
      the instrument in designating discharge accounted for 69% of the variance rather
      than 24% of the variance. This finding could challenge the myth that substance
      abusers and patients from lower socioeconomic levels are not psychologically
      minded and not capable of being engaged in psychological process treatment. This
      finding is also relevant to governmental concerns for quality assurance and cost
      effectiveness, since it can be utilized to both improve treatment planning and
      delete irrelevant documentation and assessment procedures.

PMID- 2228333
TI  - From theory to practice: the planned treatment of drug users. Interview by
      Stanley Einstein.

PMID- 2228334
TI  - Personality and alcohol and marijuana use: patterns of convergence in young
      adulthood.
AB  - This study looks at similarities and differences between users of alcohol only
      and users of both alcohol and marijuana ranging in age from 18 to 24. Assessment
      of use included measures of use intensity, use context, use functions, and use
      problems. Personality variables included measures of temperamental/affective
      tendencies, evaluative appraisals of self, and stress associated with negative
      appraisals of one's self and one's environment. The two strongest patterns of
      convergence were found to be similar across groups and to be consistent with mean
      differences between both groups. It is concluded that the two patterns
      characterize different segments of the population of users.

PMID- 2228335
TI  - Perception of intoxication and blood alcohol concentration of drinkers in social
      settings.
AB  - This study examined associations among perception of intoxication, blood alcohol
      concentration (BAC), discriminability of internal physiological sensations, and
      awareness of external stimuli related to the number of drinks consumed of
      subjects in social drinking settings. A total of 156 randomly selected
      individuals consented to be interviewed as they walked by preselected drinking
      establishments, and afterward provided a breath sample to determine BAC. This
      study found that drinkers in social settings can make at least crude estimates of
      their level of intoxication, and that the accuracy of these estimates decreases
      as BAC increases.

PMID- 2228336
TI  - The relationship between child and adult psychopathology in children of
      alcoholics.
AB  - Children of alcoholics (COA) and adult children of alcoholics (ACA) are
      identified as a group with recognizable characteristics resulting from their
      childhood situation. The major conclusions in the literature regarding the
      psychosocial consequences of being a COA are reviewed. Two lists, one for
      children and one for adults, are provided which summarize these consequences.
      Variables which influence these effects are discussed, as well as the development
      of adult psychopathology from child psychopathology. Treatment strategies
      designed to prevent this development are reviewed briefly and a resource table
      for COAs is presented.

PMID- 2228337
TI  - AIDS-related risk behaviors among substance abusers.
AB  - Ninety-two substance abusers were surveyed about AIDS-related risk behaviors. The
      questionnaire administered elicited information on demographics, sexual
      practices, substance abuse, and risk behaviors involving the use of needles.
      Results indicated an appropriate base of prevention knowledge and patients'
      efforts to modify vulnerability to HIV exposure. Nevertheless, patients continue
      to engage in behaviors resulting in HIV exposure and transmission.

PMID- 2228338
TI  - Drug abuse prevalence in western Canada and the North West Territories: a survey
      of students in grades 6-12.

PMID- 2228339
TI  - From theory to practice: the planned treatment of drug users. Interview by
      Stanley Einstein.

PMID- 2228340
TI  - Role of digoxin in right ventricular failure due to chronic cor pulmonale.
AB  - The effect of digoxin in the treatment of decompensated chronic cor pulmonale was
      investigated in a randomized double-blind, cross-over, placebo-controlled trial.
      A total of 34 successive patients with evident right heart failure were included
      in the study. The mean maintenance daily dose of digoxin was 0.30 +/- 0.03 mg
      with the mean serum level of 1.7 +/- 0.7 nmol/L. The severity of heart failure
      was assessed according to a clinicoradiographic scoring system (Heart Failure
      Score). The heart failure worsened during the placebo-period in eight (23.5%)
      patients (four with atrial fibrillation, two with a third heart sound (S3), one
      with a cardiothoracic ratio of more than 0.5 and one with sinus rhythm). By
      regression analysis, the heart failure significantly worsened only in the
      subgroup of patients with atrial fibrillation. Digoxin was successfully (without
      worsening of the heart failure) discontinued in 26 (76.5%) patients. No
      significant improvement was observed in the patients with S3 gallop. It was
      concluded that digoxin had no beneficial effect in chronic cor pulmonale patients
      with heart failure, except in those with atrial fibrillation.

PMID- 2228341
TI  - Lack of interaction between famotidine and warfarin.
AB  - In eight healthy male volunteers taking daily subtherapeutic doses of warfarin
      (mean daily dose = 4.0 mg), the addition of famotidine 40 mg once-a-day for seven
      days did not alter the prothrombin time profile, thrombotest coagulation time or
      total warfarin steady-state plasma concentration. Plasma peak concentration, time
      to peak concentration and area under curve for famotidine were not affected by
      the co-administration of warfarin. However the plasma half-life of famotidine was
      slightly, but statistically significantly longer (p less than 0.05) during
      maintenance treatment with warfarin (mean +/- s.e.m.: 2.58 +/- 0.14 h versus 2.96
      +/- 0.16 h respectively).

PMID- 2228342
TI  - Protection of the upper gastrointestinal mucosa: the role of antacids.
AB  - Experiments performed in animals and in healthy human subjects suggest that
      antacids increase prostaglandin synthesis and have a cytoprotective effect on
      gastroduodenal mucosa. To investigate this hypothesis, the ability was evaluated
      of an antacid containing an aluminium/magnesium hydroxide combination (Maalox TC)
      to modify prostanoid production at the gastric level in 28 patients with gastric
      antral ulcer of various sizes in different stages of activity with or without
      erosive gastritis. After the antacid treatment, a significant prostaglandin E2
      reduction was observed, together with a significant 6-keto-prostaglandin F1 alpha
      increase, but there was no thromboxane B2 variation at antrum level, nor any
      significant modification of prostanoid production at body level. The decreased
      prostaglandin E2 levels, detected after treatment with the antacid combination,
      may be due to lesion improvement, decreased synthesis or increased catabolism by
      mucosal cells, to a drop in this prostaglandin production by inflammatory cells.
      As far as 6-keto-prostaglandin F1 alpha is concerned, the obtained data confirm
      the results reported by other authors in healthy human subjects. The increase of
      this prostaglandin could enhance blood flow, resulting in a protective effect.

PMID- 2228343
TI  - Ranitidine in children with peptic ulcer and patients with pancreatic cystic
      fibrosis.
AB  - This article describes experience of the use of ranitidine in children with
      peptic ulcer and patients with pancreatic cystic fibrosis. Ranitidine proved to
      be efficacious and well tolerated, the percentage of healing being 89.4%.
      Ranitidine was also used in subjects with gastritis from Campylobacter pylori,
      obtaining rapid regression of subjective symptoms. Administration of ranitidine
      to cystic fibrosis patients improved the efficacy of the pancreatic extract, with
      consequent enhancement of digestive compensation.

PMID- 2228344
TI  - Imipramine pharmacokinetics in depressed geriatric patients.
AB  - Pharmacokinetics of single dose (25 mg i.m.) of imipramine was studied in
      geriatric and young adult patients with mood disorders requiring antidepressant
      treatment. Imipramine and its principal metabolites were determined by means of a
      high performance liquid chromatography method with electrochemical detection.
      Serum concentrations analysis was performed according to a bicompartmental open
      model. A relationship between age and kinetic parameters such as area under the
      curve, elimination phase constant, half-life and total body clearance was
      observed. Significant differences were demonstrated between elderly and young
      adult patients when comparing these parameters. It is concluded that geriatric
      patients treated with imipramine should receive doses of about 60% of those of
      young adults.

PMID- 2228345
TI  - Metabolic effects induced by L-carnitine and propionyl-L-carnitine in human
      hypoxic muscle tissue during exercise.
AB  - An experimental model was developed to investigate some metabolic effects of
      strenuous exercise in hypoxic muscle tissue of human volunteers. The incidence of
      carnitine supplementation was studied, assuming as marker the thiobarbituric acid
      reaction products analysed in plasma samples collected during the course of the
      protocol programme. Propionyl-L-carnitine appears to antagonize in a significant
      degree the damaging effects of muscle fatigue combined with hypoxic status. Under
      these conditions the detoxifying role played by propionyl-L-carnitine, previously
      reported in various tissues and in other pathological conditions, appears to be
      relevant, although further studies are needed to elucidate the pharmacodynamics
      of this molecule.

PMID- 2228346
TI  - Towards an integrated model of group psychotherapy with the elderly.
AB  - Three current approaches to the group therapy of the cognitively intact,
      depressed elderly are reviewed. Examination of the strengths and limitations of
      these three models--self psychology, developmental considerations such as
      reminiscing and life review, and cognitive-behavioral therapies--points in the
      direction of the usefulness of an integrated model. The main objectives of an
      integrated approach include: stabilization of the individual's sense of self,
      establishment of interpersonal competence, and enhanced mastery over the affects
      of depression and demoralization. Clinical illustrations are provided to
      demonstrate the practical considerations in this model of group therapy.

PMID- 2228347
TI  - Group therapy with sexually abused boys: leadership, projective identification,
      and countertransference issues.
AB  - Group therapy is an essential component of the treatment of sexually abused
      children. Since the painful effects associated with the abuse are often
      dissociated or acted out, the group leaders learn of the affective experience of
      the abuse through the process of projective identification. The leaders must be
      aware of this process, set limits on the abusive acting out in the group, and
      help moderate, label, and empathize with the affect. It is through this difficult
      process that the children have a chance to reintegrate and work through their
      abuse experiences so they no longer feel compelled to act them out through
      repetitive abusive relationships. Specific leadership, countertransference, and
      projective identification issues in group therapy with sexually abused boys are
      discussed.

PMID- 2228348
TI  - Activities and games for group psychotherapy with sexually abused children.
AB  - As increasing attention is given to the practice of group psychotherapy with
      sexually abused children, clinicians are using games and activities designed to
      address issues related to sexual abuse and its prevention. This paper describes
      how specific games and activities can be used in group therapy with child
      victims. These games and activities include: prevention films, role plays, and
      communication board games. Benefits and risks associated with the use of these
      resources are also discussed.

PMID- 2228350
TI  - Brief group psychotherapy in relapse prevention for alcohol dependent patients.
AB  - The effects of brief group psychotherapy in relapse prevention were tested. The
      groups focused on the clients' capacity to formulate their own treatment goals,
      including controlled drinking, programmed relapse, and total abstinence. Twelve
      months after completion of the eight-week outpatient group treatment, thirty-five
      clients were followed up. There appeared to be no harmful effects as a result of
      the treatment. Nobody in the follow-up group had a deteriorated drinking pattern
      as compared to pretreatment data. The follow-up results were significantly better
      than before treatment and also than in a comparison group of alcohol dependent
      patients. It seemed as if those patients who could benefit from the treatment had
      a shorter duration of abuse and had a later onset of uncontrolled drinking
      compared to those who continued with a negative drinking pattern and the
      dropouts. The clients assigned the positive treatment effects to course leaders'
      encouragement of personal decision making, increased awareness of risk
      situations, and improved coping skills. The group situation in itself seemed to
      be of special importance for this result. The degree of structure implemented by
      course leaders allowed a free and respectful openness to develop between group
      members.

PMID- 2228349
TI  - A controlled study of effectiveness and patient suitability for short-term group
      psychotherapy.
AB  - A controlled, clinical trial investigation of short-term psychoanalytically
      oriented group psychotherapy (STG) was conducted which included eight
      psychotherapy groups led by experienced therapists. Patient psychological
      mindedness (PM) was investigated as a selection criterion and prognostic
      variable. Seventy-nine psychiatric outpatients experiencing prolonged or delayed
      grief reactions were matched for level of PM and then randomly assigned to STG or
      a wait list. There was repeated measurement of several areas and sources of
      outcome. Results indicated a strong main effect for STG but not for PM on
      outcome, and minimal evidence for an interaction effect. Benefits were maintained
      at six-month follow-up. Psychological mindedness emerged as highly predictive of
      attrition. A clinical discussion is presented wherein the efficacy of STG is
      considered as reflecting a good patient-treatment match.

PMID- 2228351
TI  - The different patterns of group climate critical incidents in high and low
      cohesion sessions of group psychotherapy.
AB  - The total data set for this study consisted of 958 critical incidents from high
      and low cohesion sessions in person-centered group psychotherapy. These incidents
      were typically noted on a group climate questionnaire at the end of each session.
      Altogether 211 clients and students participated in twenty-six groups. The high
      cohesion sessions were dominated by the following cohesion dimensions in rank
      order: self-disclosure and feedback (24.0%); attraction and bonding (20.2%);
      listening and empathy (20.0%); process performance and goal attainment (15.0%);
      and support and caring (10.6%). The corresponding rank order for the low cohesion
      sessions was strikingly different: avoidance and defensiveness (43.5%); conflict
      and rebellion (22.2%); and self-disclosure and feedback (8.9%). Apparently then,
      there are very different patterns of critical incidents in high and low cohesion
      sessions of group psychotherapy.

PMID- 2228352
TI  - Eating problems and calorie intake levels in Swiss adolescent athletes.
AB  - The purpose of this study was to investigate the incidence of eating disorders
      (ED), calorie intake levels and body fat measures in Swiss female athletes.
      Thirty athletic and 34 non-athletic adolescent Swiss females were assessed for
      tendencies toward eating disorders and weight preoccupation using the Eating
      Disorders Inventory (EDI). Calorie intakes were calculated from 7-day intake
      records. Body compositions were determined using skin-fold measures. The athletes
      were divided into two groups: Those whose activities emphasize leanness (12
      gymnasts, means age = 12.5 +/- 1.1 yrs), and those whose activities do not
      emphasize leanness (18 swimmers, mean age = 12.8 +/- 0.9 yrs). The non-athletic
      school-girls (mean age = 13.4 +/- 1.2 yrs) served as controls. ANOVA indicated
      that the gymnasts had lower body fat levels (p less than 0.01) and consumed fewer
      total calories (p less than 0.05) than swimmers or controls, but all groups
      consumed similar calories per kg/body weight. Chi square analysis indicated that
      similar numbers of swimmers (11%), gymnasts (1%) and controls (6%) were
      exceptionally preoccupied with weight (p greater than 0.05). However, more
      swimmers (38%) scored high on the body dissatisfaction subscale of the EDI than
      the gymnasts (1%) or control (9%) (p less than 0.01). In fact, more swimmers
      scored high on 3 subscales of the EDI compared to the other groups (p less than
      0.05). It appears that disturbances in eating behaviors are not limited to sports
      that emphasize leanness.

PMID- 2228353
TI  - Oxidation of exogenous carbohydrate during prolonged exercise in fed and fasted
      conditions.
AB  - The oxidation of glucose and fructose ingested during moderate exercise performed
      on a cycle ergometer (120 min, 52% VO2max) was compared in ten young males fasted
      (n = 5) or fed (n = 5) before exercise. The subjects ingested randomly 1.33 g/kg
      body weight (approximately 96 +/- 9 g) of either enriched 13C-glucose (G), 13C
      fructose (F), or water only (W); the solutions were evenly distributed over the
      exercise period. The fasted subjects began the three exercises with a lower blood
      glucose (P less than or equal to 0.05 for F only) and insulin (P less than or
      equal to 0.05) levels and a higher free fatty acid (FFA) concentration (P less
      than or equal to 0.05) than the fed ones. Throughout the exercise period, blood
      glucose level was maintained in fasted as well as in fed group for G and F
      ingestions, while it decreased (P less than or equal to 0.05 at the 100th min in
      fasted subjects) with water ingestion. Insulin level was similar in both fed and
      fasted conditions with F and W ingestions and lower than G trials for the fed
      subjects. For the three ingestions, FFA was lower (P less than or equal to 0.05)
      in the fasted than in the fed group over the exercise period. Over the 2-h period
      of exercise, a greater (P less than or equal to 0.05) amount of exogenous F was
      oxidized in the fasted (49 +/- 6 g) than in the fed (36 +/- 5 g) group, which
      represent 31% and 20% of the total carbohydrate energy supply,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228354
TI  - Zinc metabolism in the athlete: influence of training, nutrition and other
      factors.
AB  - Serum zinc was measured four times (October, January, March and May) in six young
      male athletes during a nine-month sporting season in relation to eleven other
      parameters. A significant decrease in serum zinc was observed after five months
      of intensive training (all values remaining in the normal range). This cannot be
      explained by changes in dietary habits, plasma protein concentrations, hormonal
      changes nor by the existence of minor infectious or inflammatory pathologies. The
      dietary intakes seemed adequate. These results support the hypothesis that zinc
      status may be slightly altered in the high-level athlete.

PMID- 2228355
TI  - Effects of training specificity on the lactate threshold and VO2 peak.
AB  - We examined the effects of training specificity on the lactate threshold (LT) and
      VO2peak. Sixteen male subjects completed VO2peak/LT protocols on the cycle
      ergometer (CE) and treadmill (TM) before and after a training program. The
      subjects were assigned to run training (N = 5), cycle training (N = 6), and
      control groups (N = 5). Subjects trained 4 day/week for 10 weeks at approximately
      89% of pre-training VO2peak. Results indicated that run training increased VO2 at
      LT (VO2LT) within both the CE and TM protocols (17.9 to 22.5 ml/kg.min-1 for CE,
      22.7 to 36.0 ml/kg.min-1 for TM, p less than 0.05) with the 58.5% increase in
      VO2LT for TM being greater than the 30.3% increase for CE (p less than 0.05).
      Cycle training resulted in a 38.7% increase in CE VO2LT (19.7 to 27.4 ml/kg.min
      1, p less than 0.05) with no significant improvement in TM VO2LT (23.6 to 24.0
      ml/kg.min-1). Similar increases in VO2peak were observed for CE and TM protocols
      for both cycle and run training groups (VO2peak increased by 11.9 to 20.7% in
      both CE and TM regardless of training mode). No changes were observed in the
      control group for any variable. The present data suggest that increases in LT
      resulting from training may be specific to the mode of exercise.

PMID- 2228356
TI  - Prediction of oxygen uptake on a bicycle wind-loaded simulator.
AB  - The primary purpose of this study was to determine the accuracy of estimating
      oxygen uptake (VO2) from the flywheel revolution rate of a bicycle wind-loaded
      simulator. VO2 at four different flywheel revolution rates was measured on a
      Findlay Road Machine (FRM). Ten male trained cyclists, 10 male untrained
      cyclists, 10 female trained cyclists and 10 female untrained cyclists served as
      subjects. Significant curvilinear relationships (P less than 0.01) were found
      between road speed estimated from flywheel revolution rate and VO2 expressed as
      1.min-1, ml.kg-1.min-1, 1.min-1.m-2 (r = 0.97, 0.96, 0.98, respectively). The
      absolute standard error of the mean VO2 was 0.21 l.min-1 (9.6%), 3.71 ml.kg-1.min
      1 (11.5%) and 0.10 l.min-1.m-2 (7.9%), respectively. The relationship between VO2
      and speed was similar to that reported during road cycling. To determine the
      magnitude of between-machine differences in VO2, six subjects randomly performed
      cycling using two different FMR. Significant (P less than 0.05) differences
      between machines were found at only the highest speed. The present study
      indicates that it is possible to accurately predict VO2 from flywheel revolution
      rate using a FRM. Since the FRM appears to approximate the resistance a cyclist
      experiences on the road and allows cyclists to use their own bicycle, it provides
      a good alternative to traditional laboratory ergometers.

PMID- 2228357
TI  - Comparative lactate kinetics after short and prolonged submaximal exercise.
AB  - Arterial blood lactate concentrations were determined in two groups of eleven
      males before, during and after near 2 W.kg body mass-1 bicycle exercise. One
      group of subjects cycled for 3 min, whereas the second group exercised for 60
      min. All the lactate curves during recovery could be fitted to a bi-exponential
      time function consisting of a rapidly increasing and a slowly decreasing
      component. This typical evolution pattern indicates that the two-compartment
      model which has been proposed to represent the movements of lactate after short
      exercise applies also to recovery from prolonged exercise. Lengthening exercise
      duration decreased (respectively 10% and 28%) the value of both velocity
      constants of the fits to the lactate recovery curves, with the difference (28%)
      being statistically significant for the velocity constant describing the slowly
      decreasing part of the curves. This result indicates that extending exercise from
      3 to 60 min impairs the ability to remove lactate after the exercise.

PMID- 2228358
TI  - Proprioceptive facilitation of muscle tension during unilateral and bilateral
      knee extension.
AB  - The effects of double neuromuscular facilitation (DNF) in unilateral movements
      and of quadruple neuromuscular facilitation (QNF) in bilateral movements were
      studied in 42 physically active college-age male subjects. Results showed a 10.4%
      significant increase of maximal knee extension torque output when unilateral
      extension was preceded by a knee flexion on an isokinetic exerciser and a 16.7%
      increase of maximal torque in the bilateral condition of simultaneous alternating
      flexion-extension when compared to the simultaneous extension movement.
      Consequently, the increased peak torque observed in the unilateral and bilateral
      experimental conditions in which knee extension was preceded by a knee flexion
      appears to be the result of a combination of neuromuscular influences and stored
      elastic energy.

PMID- 2228359
TI  - Resistance exercise effects on plasma cortisol, testosterone and creatine kinase
      activity in anabolic-androgenic steroid users.
AB  - Anabolic-androgenic steroids (AS) users have been reported to have an improved
      ability to withstand exhaustive resistance workouts and to recover more rapidly.
      The purpose of this investigation was to study the effects of AS usage on the
      cortisol (C), testosterone (T) and creatine kinase (CK) response to a resistance
      training session. Eleven trained body builders and power lifters (5.0 +/- 1.6
      training years, mean +/- SD), 5 AS users (SU) and 6 nonusers (NU), completed a
      standardized resistance training session consisting of 10 sets of back squats at
      preset percentages of the subject's 1 RM max. Blood samples were obtained at
      rest, immediately post exercise and 24 hours after the exercise session. SU had
      significantly lower T at rest. Neither group exhibited a significant change in T
      at 1 min or at 24 h post exercise. Both the NU and SU exhibited a significant
      increase in CK at 1 min post exercise (129 +/- 23.3 U.l-1, 81 +/- 15.3 U.l-1,
      respectively), with the NU response significantly greater than the SU. After 24
      h, CK for NU was significantly elevated (171.9 +/- 54.5 U.l-1) above resting
      level. In contrast, CK for SU had returned to resting level. NU had a significant
      increase in cortisol (C) (p less than 0.05) at 1 min post exercise (156.8 +/-
      10.9 nmol.l-1), while the SU cortisol was not significantly changed. By 24 h C
      for the NU returned to resting level. The results of this investigation support
      the concept that AS users have a diminished CK response and an altered stress
      response to a single bout of resistance exercise.

PMID- 2228360
TI  - Hypothalamic-pituitary-testicular axis function in endurance-trained males.
AB  - The hypothalamic-pituitary-testicular (H-P-T) axis was evaluated in groups of
      endurance-trained (TRG) and untrained (UNT) males. Each group was subjected to:
      1) a 4-h resting hormonal profile [testosterone (T), free-testosterone (FT),
      estradiol (E2), luteinizing hormone (LH), prolactin (PRL), and cortisol (C)], 2)
      a dopamine antagonist (DA; 10 micrograms.kg-1 body weight) challenge to the
      pituitary-testes, and 3) a gonadotropin-releasing hormone (GnRH; 120
      micrograms.kg-1 body weight) challenge to the pituitary-testes. Compared to UNT,
      the TRG resting T (4.8 +/- 0.7 vs 7.1 +/- 1.2 ng.ml-1, p = 0.05) and PRL (3.3 +/-
      1.4 vs 7.0 +/- 2.3 ng.ml-1, p = 0.09) were lower while LH was elevated (15.0 +/-
      1.8 vs 11.8 +/- 1.5 mIU.ml-1, p = 0.06). The DA challenge produced a greater
      integrated PRL response in the TRG (2962.7 +/- 265.1 ng +/- ml-1.min) than in the
      UNT (1735.3 +/- 282.0 ng.ml-1.min; p = 0.01). No significant changes were
      observed in T following the DA-induced PRL rise. The TRG had a blunted LH
      response (817.2 +/- 111.6 mIU.ml-1.min) following the GnRH injection as compared
      to the UNT (1493.7 +/- 213.4 mIU.ml-1.min; P less than 0.02). T levels were
      significantly (p less than 0.03) increased in both groups by the LH rise after
      the GnRH challenge (TRG = 9.9 +/- 5.0%; UNT = 8.6 +/- 9.9%, respectively), but no
      significant between group differences were observed. Results suggest endurance
      training produces an enhanced PRL and attenuated LH release by the
      pituitary.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228361
TI  - Exercise cardiac contractility in men and boys: a recovery echocardiographic
      study.
AB  - Previous reports have suggested that children possess limited cardiac functional
      reserve during exercise compared to young adults. In this study, echocardiography
      was performed immediately after maximal treadmill exercise to measure left
      ventricular dimensions and shortening fraction (SF) in college men, and these
      values were compared to previous results in a post-exercise echocardiographic
      study of prepubertal boys. Post-exercise SF, change in SF from rest, and percent
      change in SF from rest were all significantly greater in the post-pubertal
      subjects. In both men and boys changes in SF following exercise were related to
      reductions in left ventricular end-systolic dimension, with only minor reductions
      observed in end-diastolic dimension. These findings support the concept that
      prepubertal subjects may have inferior myocardial function with exercise when
      compared to young adults.

PMID- 2228362
TI  - Isolated fractures of the capitate: use of nuclear medicine as an aid to
      diagnosis.
AB  - Fractures of the capitate are considered to be uncommon injuries of the wrist,
      however, delay in diagnosis may result in prolonged disability and avascular
      necrosis. Two cases are reported in which an isolated fracture of the capitate
      was diagnosed with a 99mTc-MDP nuclear medicine bone scan and confirmed with CT
      scan or repeated conventional x-rays. These two cases illustrate that an isolated
      fracture of the capitate should be considered in an individual presenting with
      persistent wrist pain of traumatic origin, even when conventional x-ray views are
      negative. The nuclear medicine bone scan can be a useful investigative tool and
      serve to guide further radiological investigations.

PMID- 2228363
TI  - Care or convenience? On the medical-bureaucratic model of commitment of the
      mentally ill.

PMID- 2228364
TI  - The future of homicide offenders. Results from a homicide project in Copenhagen.
AB  - As a part of a Copenhagen homicide project, 52 released homicide offenders were
      followed during a mean period of 9 years. Pessimistic expectations were confirmed
      as post-release rates of criminality, psychiatric admission, and suicide were all
      very high. By logistic regression analyses, young age by release, and long stay
      in prison were found to increase the risk of further criminality, and previous
      psychiatric admission was found predictive of future admission. The problems in
      using logistic regression analysis on variables--all of whom may be viewed as
      "parallel" indicators of a common tendency to adverse behaviors--are discussed.
      In conclusion, the results have been used for a tentative division of homicide
      according to the offender-victim relationship into intra-family homicide and
      extra-family homicide. In intra-family homicide the most important dimension
      seems to be the psychic state of the offender, in extra-family homicide more
      impact should be attributed to the social dimension.

PMID- 2228365
TI  - Accounting for predictions of dangerousness.

PMID- 2228366
TI  - The predictors of insanity acquittal.

PMID- 2228367
TI  - Effects of ultimate opinions on juror perceptions of insanity.

PMID- 2228368
TI  - The prevalence of depression, alcohol abuse, and cocaine abuse among United
      States lawyers.

PMID- 2228369
TI  - Erysipelas.

PMID- 2228370
TI  - A dermatologic gazetteer.

PMID- 2228371
TI  - Chondrodysplasia punctata (Conradi disease).

PMID- 2228373
TI  - Action in international dermatology.

PMID- 2228372
TI  - Geographic dermatology.

PMID- 2228374
TI  - Familial pityriasis rotunda.
AB  - Pityriasis rotunda is a rare dermatosis characterized by circular, dusty scaling,
      dyschromic patches, quite asymptomatic and mostly described in Japanese and
      blacks. The authors have seen three cases of pityriasis rotunda in a Sardinian
      family that are to be added to two other similar reports. The patients were all
      in good health. An interesting feature was the association with favism. On
      inquiry it was discovered that many more members of the family were affected by
      either or both pathologies. The authors believe this condition to be a form of
      minor acquired ichthyosis of which Sardinia could be an ethnic center.

PMID- 2228375
TI  - Morphea coexisting with lichen sclerosus et atrophicus.
AB  - A 65-year-old woman presented with four autoimmune diseases. These include
      morphea, lichen sclerosus et atrophicus, insulin-dependent diabetes mellitus, and
      autoimmune thyroid disease. The relationship between morphea and lichen sclerosus
      et A is discussed, as is the link between these conditions and autoimmunity.

PMID- 2228376
TI  - Reactions in leprosy. A study of 250 patients in a multidrug therapy project,
      Baroda District, Gujarat, India.

PMID- 2228377
TI  - Histoid lepromas of lepromatous leprosy.
AB  - Histoid lepromas are a rare eruption in patients with lepromatous leprosy. A 59
      year-old man from India with lepromatous leprosy who developed histoid lepromas
      and who was dapsone resistant was studied. These tumors resembled cutaneous
      metastases. This Indian man is to our knowledge the first patient to be reported
      with this rare disorder in the continental United States.

PMID- 2228378
TI  - Nodularity of nerves in treated leprosy.
AB  - Ten patients with fully treated paucibacillary leprosy, mainly tuberculoid, had
      asymptomatic nodules present along the peripheral nerves that persisted even
      after the skin lesions had completely subsided and treatment was stopped.
      Histopathology of the nodules revealed no signs of activity of the disease. The
      evolution, follow-up care, and significance of these nodules are discussed.

PMID- 2228379
TI  - Outbreak of Paederus dermatitis in southern Nigeria. Epidemiology and
      dermatology.

PMID- 2228380
TI  - Epidemiological studies on head lice infestation in Israel. I. Parasitological
      examination of children.
AB  - Of 3,079 children in a medium-sized community near Jerusalem, 11.2% were found to
      be infested with living lice and eggs and another 23.4% had only nits. Boys and
      girls were equally infested. The incidence of infestation was highest among
      children 4-11 years of age. About 78% of the infested children had from one to
      ten lice. Approximately 80% of the infested children had nits that were 2-5 cm
      away from the scalp. Boys with medium length hair and girls with short hair
      showed the highest incidence of lice infestation. Children with brown and red
      hair were more infested than those with black and blond hair. Boys and girls with
      straight and wavy hair were more infested than those with curly and frizzy hair.

PMID- 2228381
TI  - Insect bite lesions in Kuwait possibly due to Leptodemus minutus.

PMID- 2228382
TI  - Conditions for dermatological treatment in a developing country.
AB  - Malaria is the most common disease in the world, with 100 million new cases a
      year. Statistics, however, seem to show that skin diseases are next on the list
      of most common diseases in developing countries.

PMID- 2228383
TI  - Acroangiodermatitis. A clinical variant of stasis dermatitis.

PMID- 2228384
TI  - Erosive pustular dermatosis of the scalp.

PMID- 2228385
TI  - Hyperkeratosis of the nipple and areola in a patient with cutaneous T-cell
      lymphoma.

PMID- 2228386
TI  - Naftifine cream 1% compared with miconazole cream 2% in dermatophytosis.

PMID- 2228387
TI  - "Zoological classification" of skin diseases.

PMID- 2228388
TI  - First report of leprosy and psoriasis occurring together.

PMID- 2228389
TI  - Systemic sclerosis: scleroderma.

PMID- 2228390
TI  - Resting metabolic rate and postprandial thermogenesis in polycystic ovarian
      syndrome.
AB  - To determine whether the high frequency of obesity in women with polycystic ovary
      syndrome (PCO) is related to a defect in energy expenditure, resting metabolic
      rate (RMR) and the thermic response to a standard meal were compared in 10 obese
      PCO women, nine obese but otherwise normal women, and 11 lean women. All groups
      were matched with respect to age and fat-free mass and the two obese groups were
      matched for degree of obesity. RMR was measured by indirect calorimetry for 3 h
      on two days: (1) in the postabsorptive state; and (2) after a 720 kcal (3014 kJ)
      liquid mixed meal. The thermic effect of food, calculated as 3 h postprandial
      minus fasting RMR, was significantly greater for the lean [52.9 +/- 5.5 kcal/3 h
      (221 +/- 23 kJ/3 h)] than the obese [17.2 +/- 5.1 kcal/3 h (72 +/- 21 kJ/3 h)]
      and the PCO women [22.8 +/- 5.2 kcal/3 h (95 +/- 22 kJ/3)], P less than 0.001).
      The thermic effect of food was negatively related to percent body fat (r = 
      0.694, P less than 0.001). Resting metabolic rate did not differ significantly
      among the three groups, and was strongly related to fat-free mass (r = 0.687, P
      less than 0.001). These results confirm previous reports of blunted thermogenesis
      in obese individuals, but provide no evidence of altered resting metabolic rate
      or postprandial thermogenesis in women with PCO compared with normal women of
      similar degree of obesity.

PMID- 2228391
TI  - Invited commentary: phenylpropanolamine and the medical literature: a thorough
      reading is required.

PMID- 2228392
TI  - Phenylpropanolamine and caffeine use among diet center clients.
AB  - We surveyed phenylpropanolamine (PPA) use and overuse among 309 diet center
      clients. Fifty-one percent of all subjects surveyed reported using PPA drugs: 44
      percent used cold medicines and 16 percent used diet aids. Twenty-two percent of
      diet aid users and 7 percent of cold medicine users reported that they
      deliberately used more than the dosage recommended to improve efficacy. Among
      diet aid users, 59 percent also regularly consumed caffeine. Despite package
      warnings, individuals who had been told by their doctors that they were
      hypertensive used PPA products as often as normotensive individuals. PPA, the
      fifth most frequently used drug in the USA, is contained in over-the-counter
      (OTC) diet aids as well as OTC and prescription cold medicines. Severe adverse
      drug reactions (ADRs) including hypertensive crisis, stroke and death have been
      attributed to PPA products. Clinical studies have shown that using greater than
      recommended doses of PPA and using PPA in combination with caffeine may increase
      the risk of ADRs. Overweight patients may be particularly at risk for ADRs to PPA
      because they are likely to be hypertensive and to use diet aids. We recommend
      informing diet center clients of the potential dangers of consuming PPA products,
      especially more than the recommended dose, in the presence of hypertension, and
      when other sympathomimetic drugs are being taken.

PMID- 2228393
TI  - The association of body fat distribution with lifestyle and reproductive factors
      in a population study of postmenopausal women.
AB  - We examined the cross-sectional association of fat distribution with a number of
      lifestyle and reproductive factors in a random sample of 40,980 postmenopausal
      women, aged 55 to 69 years. The relationship of weight history with current fat
      distribution was also explored. Body fat distribution, defined by the ratio of
      waist-to-hip circumferences (WHR), was most strongly related to body mass index
      (BMI). WHR was also significantly and negatively associated with physical
      activity, alcohol consumption, and education, and was significantly positively
      associated with age, cigarette smoking, and a number of reproductive factors,
      such as history of infertility, number of live births, age at first live birth,
      and replacement estrogen use. WHR was not related to past BMIs, after adjusting
      for current body mass. The best-fit final regression model included (beta +/-
      s.e.) age (0.003 +/- 0.0001), BMI (0.02 +/- 0.0005), a curvilinear term for BMI (
      0.0002 +/- 0.00001), greater than high school education (-0.007 +/- 0.001),
      cigarette smoking (0.02 +/- 0.001), alcohol drinker (-0.005 +/- 0.001), and
      number of live births (0.001 +/- 0.0002). The model R2 was 0.21. BMI (R2 = 0.18)
      and age (R2 = 0.02) accounted for most of the variation in WHR. The association
      of these lifestyle and reproductive factors with WHR suggests that the deposition
      of fat in the abdominal versus the gluteal region may be influenced somewhat by
      factors other than overall adiposity and genetics.

PMID- 2228394
TI  - Genetic and behavioral influences on body fat distribution.
AB  - Genetic and environmental influences on four measures of body fat distribution -
      subscapular/triceps ratio (STR), waist/hip ratio (WHR), and regression-adjusted
      subscapular skinfold and waist circumference indices - were examined in 265 pairs
      of white male twins, ages 59 to 70 years, who participated in the third
      examination of the National Heart, Lung, and Blood Institute's Twin Study.
      Skinfold indices of fat distribution were not highly correlated with indices
      based on body circumferences (r = 0.26-0.37 for the four possible correlations).
      After adjustment for overall obesity, the heritability of the adjusted
      subscapular skinfold index was substantial (h2 = 0.60, P less than 0.001), as
      were estimates for both subscapular and tricep skinfolds individually. By
      contrast, heritability of the STR was low and of borderline statistical
      significance (h2 = 0.24, P = 0.06). Heritability for the WHR (h2 = 0.31, P =
      0.07) was also low. Although higher estimates were observed for the adjusted
      waist circumference index (h2 = 0.46, P = 0.02) and for the component
      circumferences, these were not clearly due to genetic influences. Among
      behavioral influences, cigarette smoking was strongly related to the WHR and
      adjusted waist circumference index (P less than 0.0001). A crude measure of total
      physical activity was weakly, inversely related to WHR (P = 0.06), and slightly
      more strongly related to the adjusted waist circumference index (P = 0.01).
      Skinfold indices were unrelated to either behavior. We conclude that: (1)
      skinfold indices measure a different dimension of fat distribution than
      circumference indices; (2) there is evidence for a genetic influence on
      subcutaneous fat distribution, but less evidence for such an influence on the
      WHR; (3) behavioral factors appear to be more important in determining the WHR
      than subcutaneous fat patterning.

PMID- 2228395
TI  - Direct measurement of abdominal fat by dual photon absorptiometry.
AB  - We have assessed photon absorptiometry as a new technique for direct measurement
      of the abdominal fat percentage (AF%). The accuracy of the method was assessed in
      vitro with phantoms consisting of ox muscle, lard, and a mixture of both. The
      results showed good linearity (r = 0.999). The in vitro reproducibility and the
      in vivo reproducibility were s.d. = 2.0 and s.d. = 2.8 (AF%), respectively. The
      AF% was measured in 148 healthy post-menopausal women and found to correlate with
      other measurements of fatness, such as total body fat per cent (r = 0.82, P less
      than 0.001), body mass index (r = 0.79, P less than 0.001) and the ratio of waist
      to-hip circumference (r = 0.59, P less than 0.001). The waist-to-hip ratio, an
      important predictor of cardiovascular disease, was more tightly correlated with
      AF% than with body mass index. We conclude that this method may be a useful new
      research tool for direct measurements of abdominal fat, a possible cardiovascular
      risk factor.

PMID- 2228396
TI  - The effect of long-term dexfenfluramine treatment on 24-hour energy expenditure
      in man. A double-blind placebo controlled study.
AB  - In order to investigate the effect of long-term treatment with dexfenfluramine
      (dF) on 24-hour energy expenditure (EE), 10 obese females were studied in a
      double-blind design. Shortly before and 4 weeks after cessation of a 13 months
      treatment period with either dF (30 mg/day) or placebo (PL) the 24-hour EE was
      measured. The measurements were performed using a 24 m3 direct heat sink
      calorimeter with continuous real time measurements of evaporative and sensible
      heat losses. The patients performed a standardized program of exercise, rest and
      meals. The measurements were performed at 24 degrees C and at a humidity between
      3 and 11 g/m3. Discontinuation of dF treatment did not change energy expenditure
      significantly from placebo, neither when expressed in kJ/kg lean body mass nor in
      kJ/kg body weight. After cessation of treatment total 24-hour EE decreased
      likewise nonsignificantly by 2.9 percent in the dF group and by 4.0 percent in
      the PL group. EE measured over 24 hours was subdivided into day and night periods
      and into resting energy expenditure as well as a measurement of the heat losses
      over a period of 3 hours after a meal. This subdivision of the EE showed similar
      nonsignificant differences. The conclusion is therefore that dF possesses no
      significant thermogenic effect during long-term administration in human obese
      subjects.

PMID- 2228397
TI  - Overweight and mortality in Mexican Americans.
AB  - The Geriatric Research Center (GRC) table of desirable weights is based on the
      mortality experience of holders of 4.2 million policies issued by 25 life
      insurance companies in the USA and Canada. The GRC table defines optimum weight
      for-height as the weight range which is associated with below average mortality
      for a given age and height group. People who fall outside this range, i.e.
      overweight or underweight, experience above average mortality for their age and
      height group. We classified 3176 Mexican Americans and 1841 non-Hispanic whites
      who participated in the San Antonio Heart Study according to the GRC table and
      found that Mexican Americans were less likely than non-Hispanic whites to be
      underweight and more likely to be overweight. The two effects did not offset one
      another, however, and fewer Mexican Americans were found to be in the 'just
      right' range. If the mortality experience of the population which generated the
      GRC table (largely non-Hispanic) applied to Mexican Americans, these results
      imply that Mexican Americans should have higher mortality rates than non-Hispanic
      whites. Vital statistics data from the state of Texas for the years 1979-81,
      however, fail to corroborate this prediction. Beyond age 45 years, an age range
      in which obesity and obesity-related disorders would be expected to exert an
      important influence on mortality, age-specific and age-adjusted all cause
      mortality was at last as good if not better in Mexican Americans than in non
      Hispanic whites. These results could not be explained by ethnic differences in
      body fat distribution, since fat was less favorably distributed in Mexican
      Americans.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228398
TI  - Nutrient oxidation patterns and protein metabolism in lean and obese subjects.
AB  - The immediate metabolic response to eating has been compared in a group of
      grossly obese subjects (W/H2 = 45) with that in lean controls (W/H2 = 22).
      Dietary intake of energy for obese subjects was based on their estimated basal
      energy expenditure for ideal body weight (given at an hourly rate of 3 X BMR over
      a 4-h period). Lean subjects were measured twice: control 1 with the same intake
      of energy as the obese in terms of ideal body weight and control 2 with the same
      energy intake in relation to each subject's measured resting energy expenditure
      (2.2 X REE). The changes in energy expenditure and nutrient disposal with the
      onset of eating have been assessed by a method of combined respiratory gas
      analysis and intravenous infusion of 13C-labelled leucine. Leucine kinetics were
      used to quantitate rapid changes in protein oxidation and to assess protein
      synthesis and degradation. 1) Total energy expenditure was 20-30 per cent greater
      in obese subjects than lean subjects in fasting and feeding. Energy expenditure
      expressed per kg fat-free mass, from D2O dilution, was similar in obese and lean
      subjects in both fasting (5.8 v. 5.5 kJ/kg FFM/h) and feeding [6.7 v. 6.3
      (Control 2) kJ/kg FFM/h]. 2) The onset of eating was associated with increased
      carbohydrate and protein oxidation with decreased fat oxidation in both lean and
      obese individuals. In obese subjects, however, both the decrease in fat oxidation
      and the increase in protein oxidation were significantly smaller (P less than
      0.05) than the corresponding increments in lean subjects (Control 2). 3) The rate
      of protein synthesis was significantly (P less than 0.05) higher in obese
      subjects both in the fasting state (99 v. 84 mumols leucine/kg FFM/h) and in the
      fed state [94 v. 67 (Control 2) mumols leucine/kg FFM/h]. The rate of protein
      degradation was also higher in obese individuals in fasting (117 +/- 6 v. 106 +/-
      4 mumol leucine/kg FFM/h) and feeding [65 +/- 4 v. 54 +/- 6 (Control 2) mumol
      leucine/kg FFM/h] though these differences are not statistically significant (P
      greater than 0.05). 4) The observed differences between obese and lean
      individuals in protein and energy metabolism in the fasted state and in the
      immediate response to eating do not support a hypothesis of greater metabolic
      efficiency in obesity.

PMID- 2228399
TI  - Effect of dl-fenfluramine on thermic effect of food in humans.
AB  - To determine whether dl-fenfluramine increased metabolic rate in humans, hourly
      indirect calorimetry measurements were made on 16 nonobese males over a 5 h
      period under each of four conditions: placebo/no meal, placebo/meal, 60 mg dl
      fenfluramine/no meal, and 60 mg dl-fenfluramine/meal. Drug administration was
      double-blind and a Latin square design was used with treatments separated by 7
      days. To confirm that active drug was administered when assigned, subjective
      sensations were measured by questionnaires administered three times during each
      treatment. Metabolic rate (kcal/min) during the four treatments was compared by
      analysis of variance over the entire 5 h and at the end of the measurement
      period. The 750 kcal (3140 kJ) meal increased metabolic rate over the fasting
      conditions (0.160 +/- 0.035 kcal/min, P less than 0.0005) and the combination of
      fenfluramine and meal caused a further significant increase beyond that found
      with placebo and meal (0.072 +/- 0.035 kcal/min, P less than 0.025). At the end
      of the measurement period, metabolic rate during the placebo/meal treatment had
      returned to the level of the fasting treatments. In contrast, during the
      fenfluramine/meal condition, metabolic rate was still elevated (0.173 +/- 0.04
      kcal/min, P less than 0.003). The results of this study suggested that
      fenfluramine increased metabolic rate by potentiating the thermic effect of food.

PMID- 2228400
TI  - The association of waist hip ratio and angiographically determined coronary
      artery disease.
AB  - Body fat distribution as measured by the ratio of waist circumference to hip
      circumference (WHR) is now accepted as an important risk factor for a number of
      diseases. This study evaluated the association of WHR and coronary artery disease
      (CAD). Measurements included the subjects' height, weight, waist girth, hip
      girth, significant CAD on coronary angiography, and cholesterol levels. A history
      of myocardial infarction, angina, diabetes or hypertension was obtained from
      subject interviews. The subjects were analyzed in two age groups: younger than
      age 60 (88 men and 39 women) and age 60 or older (85 men and 63 women). For older
      women the relative odds of CAD comparing women at the 75th percentile of WHR to
      women at the 25th percentile was 3.67 (P = 0.003), with a 95 percent confidence
      interval of 1.57-8.57. The relative odds was reduced to 2.80 after adjusting for
      all other risk factors. WHR was significantly associated with angiographic
      evidence of CAD in all women combined after adjusting for age (P = 0.0004), but
      it was not significantly associated with CAD in younger women or in men. The
      results suggest that in older women the risk of CAD increases with a greater
      percentage of body fat in the abdomen.

PMID- 2228401
TI  - Nutrient intake of obese children in a family-based behavioral weight control
      program.
AB  - The caloric and nutrient intakes, weight, percent overweight and growth of obese
      and lean children aged 8-12 were compared at baseline and after the obese
      children participated in a six month family-based behavioral weight control
      program. At baseline there were no significant differences in the caloric, fat,
      calcium, iron, vitamin A, vitamin C, thiamin, and riboflavin intakes, or height
      percentiles of the obese and lean children. After six months the obese children
      significantly decreased their calorie, protein, fat, and carbohydrate intake,
      while the lean children significantly increased their protein intake. The percent
      overweight of the obese children decreased significantly (-18.3 percent), with no
      changes in percent overweight of the lean children (-0.1 percent). Both the obese
      (+4.3 cm) and lean (+3.8 cm) children grew significantly over six months, with no
      significant changes in height percentiles. At baseline and six months both groups
      exceeded at least two-thirds of the RDA for all nutrients studied.

PMID- 2228402
TI  - Hunger/craving responses and reactivity to food stimuli during fasting and
      dieting.
AB  - One group of fasting obese patients and one group of dieting obese patients were
      instructed to report their feelings of hunger and craving on a continuous basis
      before and during a three-week treatment period. Once a week they were also
      exposed to food slides to measure their reactivity to food stimuli. The frequency
      of hunger/craving responses and reactivity to food stimuli showed radically
      different changes over time in the fasting and dieting groups. During the last
      week of fasting, reactivity to food slides was completely abolished, and the
      frequency of hunger/craving responses was close to zero. Only slight changes of
      frequency of hunger/craving responses and reactivity to food stimuli were
      observed in the dieting group. The results suggest that the frequency of
      hunger/craving responses and reactivity to food stimuli show parallel decreases
      during fasting, but no changes during dieting.

PMID- 2228403
TI  - Body composition, muscle and fat pad changes following two levels of dietary
      restriction and/or exercise training in male rats.
AB  - This study examined the effects of exercise training on conservation of lean mass
      during moderate and severe dietary restriction in male Sprague-Dawley rats. Eight
      rats each (48 total) were assigned to one of three levels of dietary restriction
      (ad lib., AL; moderate, MR; severe, SR) and to one of two activity levels (cage
      confined, CC; or treadmill exercised, E) for a 10-week period. Post-intervention,
      the AL-E (91 percent), MR-CC (84 percent), MR-E (86 percent), SR-CC (66 percent)
      and SR-E (68 percent) groups all weighed less than the AL-CC group (427 +/- 4.3
      g). Exercise training resulted in conservation of lean mass (protein + water +
      ash) at the moderate but not severe levels of dietary restriction. Further
      examination showed that this was mostly water since no between-group differences
      existed at any given diet level for protein or ash mass. Exercise training did
      elicit conservation of left ventricular heart muscle mass at both the moderate
      and severe levels of dietary restriction. In contrast, gastrocnemius muscle mass
      was conserved or maintained only at the moderate dietary restriction level. Thus,
      the level of dietary restriction appears to affect the ability of exercise
      training to elicit conservation of both total lean mass and the mass of
      individual muscles during diet-induced body mass reduction.

PMID- 2228404
TI  - The effect of dietary restriction on gastrin secretion in the obese Zucker rat.
AB  - It has been hypothesized that G-cell hyperplasia secondary to increased food
      consumption in the obese Zucker rat was responsible for the hypergastrinemia
      observed in vivo and from the isolated perfused stomach preparation. This
      possibility was investigated in pair-feeding experiments wherein the food intake
      of obese animals was restricted to match that of lean littermates from 5 to 8
      weeks of age. Dietary restriction reduced the antral G-cell population of the
      obese rat to a similar level as that seen in lean animals, supporting the view
      that hyperphagia is the trigger for G-cell hyperplasia. However, basal gastrin
      levels measured in vivo and in vitro from the stomach preparation of the pair-fed
      obese animals were not significantly lower than those of obese animals fed ad
      libitum. Thus, abnormal feeding behavior in the obese phenotype cannot be
      directly related to gastrin hypersecretion and G-cell hyperplasia is not the
      primary cause of hypergastrinemia.

PMID- 2228405
TI  - The doubling of prolactin levels after a dry Finnish sauna may increase body fat
      stores.

PMID- 2228406
TI  - B cell secretion and insulin sensitivity in hypertensive and normotensive obese
      subjects.
AB  - To test the hypothesis that in obesity hypertension is associated with more
      pronounced hyperinsulinaemia and insulin resistance we compared plasma insulin
      levels and insulin sensitivity in a group of 6 obese subjects with untreated
      hypertension and in a group of 6 obese subjects with normal blood pressure. The
      two groups were similar for sex, age, body mass index and glucose tolerance. Six
      nonobese subjects served as controls. The study consisted of a 2-h hyperglycaemic
      clamp (steady-state plasma glucose = 11 mmol/l) and a 15-min insulin tolerance
      test (0.1 U/kg body wt). During hyperglycaemic clamp, insulin and C-peptide
      plasma levels were similar in normotensive and hypertensive obese subjects: the
      area under the plasma insulin curve was 36,000 +/- 3000 pmol/l X 120 min in the
      former and 34,000 +/- 1000 pmol/l X 120 min in the latter; the area under the
      plasma C-peptide curve was 298,000 +/- 26,000 pmol/l X 120 min in the former and
      246,000 +/- 26,000 pmol/l X 120 min in the latter (P = n.s.). The ratio M/I
      between the amount of glucose metabolized (M) and the mean plasma insulin levels
      (I) during hyperglycaemic clamp was similar in the two groups: 0.59 +/- 0.09 in
      normotensive and 0.58 +/- 0.08 mg/min X m2 per pmol/l in hypertensive obese
      subjects (P = n.s.). Also the rate coefficient of glucose disappearance from
      plasma (K(itt)) after i.v. insulin injection was similar in the two groups (4.08
      +/- 0.51 vs. 3.87 +/- 0.53 per cent/min).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228407
TI  - Effects of a high-protein meal (meat) and a high-carbohydrate meal (vegetarian)
      on satiety measured by automated computerized monitoring of subsequent food
      intake, motivation to eat and food preferences.
AB  - We have examined the effects on satiety of equicaloric meals with different
      protein and carbohydrate content. Twenty normal weight healthy women were served
      cooked lunch meals made of commonly used natural food items with either a high
      protein (43 energy %) (a meat casserole) or a high-carbohydrate (69 energy %) (a
      vegetarian casserole) content in a counterbalanced repeated measures design. The
      subsequent ad libitum evening meal intake (4 h after lunch) was measured by a
      'universal eating monitor' and subjective feelings of motivation to eat and food
      preferences were assessed repeatedly. At the subsequent evening meal subjects ate
      12 per cent less (P less than 0.05) after the high-protein meal compared to the
      high-carbohydrate meal. There was no difference in motivation to eat between
      meals. This could partly be explained by a difference in palatability between the
      meals. The food-preference lists showed that before lunch there was relative
      preference for high-protein foods in favour of high-carbohydrate foods. After
      lunch either meal produced instead a relative 'aversion' for high-protein foods.
      This 'aversion' was greater after the high-protein lunch meal than after the high
      carbohydrate lunch meal.

PMID- 2228408
TI  - Fat distribution in relation to age, degree of obesity, smoking habits, parity
      and estrogen use: a cross-sectional study in 11,825 Dutch women participating in
      the DOM-project.
AB  - Fat distribution (waist/hip ratio) was assessed in a population of 11,825 women,
      aged 40-73 years, presenting for routine breast cancer screening (the DOM project
      in Utrecht) in the period 1984 to 1986. Waist/hip ratio increased with increasing
      Quetelet's index and age. Postmenopausal women did not have higher waist/hip
      ratios compared to premenopausal women after adjustment for Quetelet's index and
      age. In pre- and postmenopausal women, waist/hip ratio increased with increasing
      number of cigarettes smoked per day (while Quetelet's index decreased) and a
      positive linear relationship was found between parity and waist/hip ratio (also
      after adjustment for Quetelet's index and age). Age at menarche was strongly
      inversely related to Quetelet's index but was not related to waist/hip ratio. In
      postmenopausal women, waist/hip ratio was lower in women who reported to use
      oestrogens for menopausal complaints in comparison with similar women who did
      not, but this difference disappeared after adjustment for age and degree of
      obesity. This study emphasizes the role of some variables that are associated
      with fat distribution and are potential confounders of risk estimates of
      abdominal obesity.

PMID- 2228409
TI  - Genetic effects in the response of adipose tissue lipoprotein lipase activity to
      prolonged exercise. A twin study.
AB  - Our laboratory has reported large inter-individual differences in the metabolic
      response of adipose tissue to prolonged exercise in humans. The present study
      investigated the contribution of heredity in the metabolic changes of adipose
      tissue to prolonged exercise in 11 monozygotic and 10 dizygotic pairs of male
      twins, 18 to 27 years of age, studied immediately before and after a 90 min bout
      of exercise. The sum of 7 skinfold thicknesses and percent of fat from underwater
      weighing were used as body fat indicators (BFI). Subcutaneous adipose tissue was
      excised and fat cell weight (FCW) determined. The activity of adipose tissue
      lipoprotein lipase (LPL) released with heparin was also measured. BFI and FCW
      were identical in both types of twins. As previously reported, LPL activity was
      increased by exercise (P less than 0.01) in both type of twins. The changes
      observed for LPL activity were more similar in monozygotic twins than in
      dizygotic twins resulting in a significant level of inheritance (P less than
      0.05). A genetic component for LPL activity supports the hypothesis that adipose
      tissue LPL could be genetically determined not only in its basal activity but
      also in response to stresses such as exercise.

PMID- 2228410
TI  - Prediction of body water and fat in adult Danes from measurement of electrical
      impedance. A validation study.
AB  - The purpose of the present study was to test the validity of the electrical
      impedance method for estimation of total body water and lean body mass in adult
      Danes with large differences of obesity and fat distribution, and to develop
      algorithms for estimation of body water, lean body mass and fat from measurement
      of impedance. The results of the electrical impedance method were compared in 139
      Danes aged 35-65 years, to those of a four-compartment-model based on
      measurements of both total body potassium (whole body counting) and total body
      water (dilutometry). The comparison confirmed the validity of the impedance
      method. Equations for predicting body water and lean body mass in Danes are
      given. A significant difference was found between two instruments of the same
      model. In spite of the fact that the test resistance supplied by the manufacturer
      gave identical measurements, measurements on humans diverged on average by 31
      ohm. A cross-validation study showed that most of the algorithms found in the
      literature for predicting lean body mass from impedance yield reliable results.

PMID- 2228411
TI  - Sex-specific vs. unisex body mass indices as predictors of non-insulin dependent
      diabetes mellitus in older adults.
AB  - In order to examine sex differences in the association of obesity with the risk
      of non-insulin dependent diabetes mellitus (NIDDM) when using the body mass index
      (BMI), we compared unisex body mass index classifications with sex-specific
      categories, as defined by the Metropolitan Life Tables, based on their utility in
      predicting the 12-year incidence of NIDDM in men and women. The present analysis
      included all 747 men and 969 women from a defined older caucasian population in
      Rancho Bernardo, California, who were 40 years of age or older at the baseline
      examination in 1972-1974 and who had complete diabetes-related data available
      then and between 1984-1987. The 12-year age-adjusted incidence rates for NIDDM
      increased with increasing BMI among women (all steps significant), but was
      significantly increased only in the most obese category of men (relative risk
      (RR) = 2.3, P less than 0.05 for men; RR = 3.8, P less than 0.001 for women). Men
      and women had nearly identical rates of NIDDM in this obese category. When
      identical (unisex) BMI cutpoints were used, results were the same; (RR = 2.4, P
      less than 0.05 for men; RR = 3.1, P less than 0.01 for women). These data
      indicate that unisex and sex-specific cutpoints for BMI identify the same sex
      specific patterns of association between obesity and risk of NIDDM.

PMID- 2228412
TI  - Adrenalectomy reverses the impaired pyrogenic responses to interleukin-beta in
      obese Zucker rats.
AB  - Interleukin-1 is an important endogenous pyrogen which stimulates thermogenesis
      in normal animals by a central action which is dependent on release of
      corticotrophin releasing factor (CRF). Central injection of murine recombinant
      interleukin-1 beta (IL-1 beta, 5 ng) in conscious lean (+/?) Zucker rats produced
      significant increases in resting oxygen consumption (VO2, 26 per cent), colonic
      temperature (1.3 degrees C) and thermogenic activity (mitochondrial GDP binding)
      of brown adipose tissue (BAT, 24 per cent). In contrast, genetically obese
      (fa/fa) Zucker rats showed nonsignificant changes in VO2 (4 per cent),
      temperature (0.5 degrees C) and BAT activity (0 per cent). Bilateral surgical
      adrenalectomy (ADX) dramatically enhanced the effects of IL-1 beta on VO2 (45 per
      cent) body temperature (1.8 degrees C) and BAT activity (44 per cent) in obese
      mutants, but only slightly increased responses in lean rats. These data suggest
      that impaired responses to IL-1 beta in obese mutants may be due to inhibitory
      actions of glucocorticoids on either prostaglandin synthesis or CRF release
      within the hypothalamus.

PMID- 2228413
TI  - Obesity: a biogenetic or biobehavioral problem.
AB  - A great deal of effort is being expended to investigate the biogenetic basis of
      the development and maintenance of obesity and the regulation of food intake. The
      task of developing and validating theoretical models of the regulation of food
      intake and its relationship to body weight is hampered by a lack of basic
      descriptive data. This study investigated the eating behavior of 96 obese women
      by conducting a microanalysis of 2-week baseline behavioral eating diaries.
      Subjects were in approximate energy balance consuming a high-fat diet (41 percent
      of kcal from fats) averaging 1978 kcal/day. Self-reported episodes of overeating
      and impulsive eating occurred frequently and were associated with situational
      antecedents such as eating in the car, snacking alone, friends, restaurants,
      availability of forbidden foods, craving sweets, tired, irritable, bored,
      depressed, and skipping meals. Markov chain analysis showed that overeating and
      impulsive eating were positively autocorrelated, suggesting the presence of an
      abstinence violation effect. These data suggest that eating behavior is often
      controlled by environmental, cognitive, and affective variables and that a
      complete understanding of obesity will require an integrated biobehavioral
      approach.

PMID- 2228414
TI  - Introduction to the symposium on energy expenditure and obesity.

PMID- 2228415
TI  - Energy expenditure and thermogenesis: animal studies on brown adipose tissue.
AB  - Thermogenesis in brown adipose tissue is now regarded as being a major component
      in the normal energy expenditure of laboratory rodents, and variations in the
      level of thermogenesis in the tissue are important in the regulation of energy
      balance. Defective thermogenic responses to diet or to cold have been shown to be
      central to the development of obesity in various rodent models. The quantitative
      importance of brown adipose tissue thermogenesis to energy expenditure in species
      other than rodents has not been established, but it is clear that the tissue is
      present in a wide range of mammals. In particular, active brown adipose tissue
      has now been identified in adult humans, as well as in newborn infants.

PMID- 2228416
TI  - Body weight regulation in obese and obese-reduced rats.
AB  - We previously developed a model of dietary obesity in adult male rats where
      duration of feeding a high fat diet (HFD; 60 percent of calories from fat)
      influences reversibility of the obesity following a reduction in dietary fat. In
      the model, rats fed the HFD for 4 months show an apparent complete reversal of
      obesity when switched to a low fat diet (LFD; 14 percent of calories from fat),
      but rats fed the HFD for 7 months show persistent obesity even when switched to
      the LFD. This model of dietary obesity is useful for studies of energy balance
      and energy requirements during obesity development and reversal. In the present
      study, rats fed the HFD for 4 or 7 months were switched to the LFD and, after
      weights stabilized, were subjected to food restriction followed by ad libitum
      refeeding. Food restriction (15 g/day of the LFD, or about 60 percent of usual
      control food intake) continued until body weights of the groups stabilized at
      new, reduced levels (about 2-2.5 months). This was followed by ad libitum
      refeeding of the LFD for 3--4.5 months. Rats fed the HFD for 4 months showed
      complete obesity reversal after 2 months of eating the LFD. They showed a similar
      response to food restriction to LFD controls, but surprisingly regained
      significantly more body weight, body fat and total body energy during refeeding
      than LFD controls. Rats fed the HFD for 7 months remained heavier and fatter than
      LFD controls after 2 months of eating the LFD. Despite losing more carcass energy
      than controls during food restriction, their body weights and body energy content
      stabilized at higher levels than LFD controls. During refeeding, they regained
      their obese state relative to controls. These results demonstrate that: (1) the
      duration of HFD feeding is an important factor in the reversibility of the obese
      state; (2) sustained HFD feeding produces an obese state that is defended more by
      a greater restoration of carcass energy during refeeding than by a preservation
      of carcass energy during food restriction; (3) sustained obesity appears to
      produce some reductions in energy requirements; (4) even a brief period of
      obesity may leave the rats prone to reattain an obese state when body weight is
      challenged.

PMID- 2228417
TI  - Genetic effects in human energy expenditure components.
AB  - It is increasingly recognized that variations in human energy expenditure are
      partly due to an influence of the genotype, even after control for the well
      established concomitants of energy expenditure. Using the technique of genetic
      epidemiology, we have found that about 40 percent of the variance in resting
      metabolic rate, thermic effect of food and energy cost of low to moderate
      intensity exercise (less than or equal to 5 times the resting metabolic rate) is
      explained by inherited characteristics. A significant genetic effect has also
      been reported for the level of habitual physical activity. The existence of a
      genotype-environment interaction has also been investigated. Thus, we have
      demonstrated that in response to chronic overfeeding, as well as negative energy
      balance, changes in the components of energy expenditure are partly determined by
      one's genotype. Taken as a whole, these observations consistently support the
      hypothesis that heredity plays a significant role on the variations in the
      various components of energy expenditure in humans. Further research should now
      be focused more on the identification of biochemical and molecular markers of
      these energy expenditure characteristics.

PMID- 2228418
TI  - The pathogenesis of obesity in man: results of studies on Pima Indians.

PMID- 2228419
TI  - Energy metabolism in obese patients before and after weight loss, and in patients
      who have relapsed.

PMID- 2228420
TI  - Assessment of energy expenditure in ambulatory reduced-obese subjects by the
      techniques of weight stabilization and exogenous weight replacement.
AB  - A technique based on a completely metabolizable liquid diet was developed rapidly
      to achieve weight stability (+/- 50 g/day) in experimental subjects. Weight
      stabilizing caloric intake was then used as an estimate of total daily energy
      expenditure (24 h EE) in a study of 10 ambulatory obese subjects before and after
      weight loss. In five control subjects 24 h EE fell by 928 +/- 121 kcal/day (3885
      +/- 507 kJ/day) or 29 +/- 3 percent after a 22.6 +/- 1.2 percent weight loss
      achieved on a three month 700 kcal/day (2930 kJ/day) diet. To determine how much
      of this decrease was due to the reduced thermic effect of exercise (TEE) at the
      lower body weight, the remaining five subjects underwent progressive exogenous
      weight replacement during dieting to compensate exactly for their 21.0 +/- 5.2
      percent weight loss. In the latter group 24 h EE fell by only 392 +/- 192
      kcal/day (1641 +/- 804 kJ/day) or 12 +/- 5 percent (P less than 0.001). These
      data, along with indirect calorimetric measurements of resting metabolic rate
      (RMR), permitted the decrease in 24 h EE with weight loss to be divided into its
      component parts. Decreases in RMR, TEE and the thermic effect of food accounted
      for 30 percent, 52 percent and 18 percent respectively of the fall in 24 h EE. A
      reduction in TEE appears to make a greater contribution to the enhanced energy
      efficiency of ambulatory reduced-obese subjects than has been suggested by
      studies based on methods requiring greater subject confinement.

PMID- 2228421
TI  - Sphingomyelin synthesis in Fasciola hepatica.
AB  - Whole worms and/or homogenates of F. hepatica incorporate label from cytidine-5
      diphospho[methyl-14C]choline,[1-14C]palmitoylCoA,[U- 14C]serine,[2
      14C]methionine, [U-14C]glycine, [U-14C]threonine and [U-14C]aspartate into the
      various intermediates of sphingomyelin synthesis (ketosphinganine, sphinganine,
      sphingosine, ceramide and sphingomyelin). This suggests that sphingomyelin
      synthesis in F. hepatica occurs by a pathway similar to that found in mammals.
      However, there is some evidence that in F. hepatica 3-ketosphinganine may be N
      acylated prior to reduction and dehydrogenation.

PMID- 2228422
TI  - Taenia taeniaeformis: evasion of complement-mediated lysis by early larval stages
      following activation of the alternative pathway.
AB  - Activation of the alternative pathway of complement by T. taeniaeformis
      oncospheres and early stage metacestodes, although a factor in host defense
      against primary infection, does not directly lead to the killing of the parasite
      larvae observed prior to day 6 post-infection in innately resistant BALB/cByJ
      inbred mice. Immunogold labelling techniques clearly demonstrated tegument
      associated C3 on in vitro-activated oncospheres incubated with non-immune mouse
      sera. However, C5, a protease necessary for the assembly of the membrane attack
      complex, was not detected. Early stage larvae cultured from in vitro-activated
      oncospheres escaped membrane damage and survived incubation in non-immune sera
      from both BALB/cByJ and taeniid-susceptible C3H/HeDub mice. Comparisons of cobra
      venom factor-treated and untreated C5-deficient B10.D2osn mice revealed no
      significant differences in parasite burden and local eosinophil infiltration at 6
      days post-infection, suggesting that the terminal arm of the complement system is
      necessary for the previously reported role of complement in resistance to primary
      infection in BALB/cByJ and C3H/HeDub mice. An in vivo test of chemotaxis
      indicated that although both complement-intact mouse strains examined responded
      to intraperitoneal injections of inulin, there were lower numbers of eosinophils
      in C3H/HeDub mice than in BALB/cByJ mice, perhaps pointing to possible mouse
      strain differences in C5a generation/catabolism or eosinophil ability to respond
      to C5a. Lectin-binding studies showed an affinity of PNA for the exposed surface
      of taeniid oncospheres and 4-day post-infection metacestodes; however, binding of
      lectin to the carbohydrate moiety did not inhibit complement activation.

PMID- 2228423
TI  - The in vitro adherence of murine eosinophils, neutrophils and non-induced and
      induced macrophages to infective larvae of Toxocara canis (Nematoda,
      Ascarididae).
AB  - Infective larvae of the parasite nematode Toxocara canis were incubated in vitro
      with murine eosinophils, neutrophils and non-induced and induced macrophages. The
      interactions between the different types of cells and the worms were observed in
      the presence or absence of immune mouse serum and/or complement. Cells showed
      considerable differences in the manner, duration and outcome of this interaction.
      Despite the adhesion of cells to the larvae of T. canis, there was no evidence of
      damage to the worms. Scanning and transmission electron microscopic observations
      suggest that the cells adhere to the cuticular surface via an electron-dense
      material. This material might play a protective role against the helmintotoxic
      capacity of the inflammatory cells.

PMID- 2228424
TI  - Gametocytogenesis induction by ammonium compounds in cultured Plasmodium
      falciparum.
AB  - Asexual parasites of a strain that seldom or never produce gametocytes in in
      vitro culture began gametocytogenesis after 24 h treatment with RPMI 1640 medium
      containing concanavalin A (final concentration, 10 micrograms ml-1) and ammonium
      carbonate (final concentration, 15 mM ml-1) or ammonium bicarbonate (final
      concentration, 15 mM ml-1). Gametocytogenesis was consistently observed from the
      3rd day after the treatment. Concanavalin A enhanced gametocytogenesis induction
      by ammonium carbonate or ammonium bicarbonate, although concanavalin A does not
      itself have gametocytogenesis induction activity. Whereas no gametocytogenesis
      was observed after addition of concanavalin A and ammonium acetate (final
      concentration, 5-25 mM ml-1) or ammonium chloride (final concentration, 5-15 mM
      1). Addition of ammonium compounds resulted in decrease of parasitemia,
      regardless of gametocytogenesis.

PMID- 2228425
TI  - Eimeria apsheronica in the goat: endogenous development and host cellular
      response.
AB  - Most first generation schizonts of Eimeria apsheronica developed in the jejunum;
      others were distributed throughout the small intestine and occasionally in the
      caecum. Some were also found in the mesenteric lymph nodes, which were oedematous
      and haemorrhagic. In the intestine, haemorrhage and congestion were seen before
      parasites were detected, and continued throughout all later stages. Schizonts
      occurred in the lamina propria and occasionally in the submucosa, where they
      sometimes caused a cellular inflammatory response. Schizonts were first seen at 8
      days post-infection (DPI); they had poorly defined nuclei and were enclosed in a
      capsule-like wall. At 16 DPI, many had matured, had a mean size of 125 x 82
      microns, and were filled with numerous spindle-shaped merozoites, which were in
      ranks and loops. At 18 and 20 DPI, when small white lesions (1-3 mm in diameter)
      were observed in the jejunum and elsewhere in the small intestine, a second
      generation of schizonts, macrogametes, microgametocytes and maturing oocysts were
      seen, in the epithelial cells of the small intestine and caecum. Their mean
      sizes, respectively, were: 26.2 x 18.9, 24.7 x 18.5, 30.2 x 21.7 and 26.6 x 19.3
      microns. Macrogametes contained basophilic central and eosinophilic peripheral
      granules. The sexual stages were associated with a generalized cellular
      inflammatory response.

PMID- 2228426
TI  - Basophils in skin reactions of mast cell-deficient mice infested with Dermacentor
      variabilis.
AB  - Acquired resistance to ticks in guinea pigs has been found to be associated with
      basophil-rich skin reactions. Mice, which are generally believed to possess few,
      if any basophils, also acquire resistance following repeated tick infestations
      and this has been found to be associated with increased numbers of dermal mast
      cells. Mast cell-deficient W/Wv mice have, however, also been shown capable of
      acquiring resistance after two infestations with Dermacentor variabilis larvae.
      In the studies described here, we have examined, with the electron microscope,
      skin reactions in W/Wv and +/+ mice undergoing their third infestation with
      Dermacentor variabilis. Basophils, along with neutrophils and eosinophils, were
      identified using established criteria. The possibility that basophils contribute
      to various pathogenetic mechanisms in these and other strains of mice is
      discussed.

PMID- 2228427
TI  - Intestinal mucosal mast cells in Nippostrongylus-infected mice: lack of
      sensitivity to corticosteroids.
AB  - Immune reactions to enteric nematodes, in which mast cells are thought to play an
      important role, are abrogated following corticosteroid treatment of host animals.
      This is probably due, at least in part, to inhibition of cytokine production by T
      cells. It has proved difficult to block worm expulsion in mice with
      corticosteroids. We have therefore examined the effects of corticosteroids on
      mast cell numbers and concentrations of the mast cell granule-specific serine
      protease Mouse Intestinal Mast Cell Protease (MIMCP) in the intestines of mice
      infected with Nippostrongylus brasiliensis. Mucosal mast cell (MMC) numbers and
      concentrations of MIMCP were unaltered by steroid treatment. This is in marked
      contrast to Nippostrongylus-infected rats which showed decreases in both mast
      cell numbers and concentrations of the rat mucosal mast cell protease RMCP II
      after steroid treatment. This suggests that differentiated murine MMC are less
      dependent on T cells than those of the rat.

PMID- 2228428
TI  - Trypanosoma cruzi: calcium ion movement during internalization in host HeLa
      cells.
AB  - The role of cytosolic Ca2+ and cytoplasmic calcium movement during the
      parasitization of HeLa cells by T. cruzi were studied. The level of calcium in
      parasitized cells increased compared to the control cells. Our experiments
      demonstrate that this cytosolic calcium originates from the release of the
      intracellular calcium deposits, especially from the mitochondria of the host
      cell. The parasitization rates decreased after the cells were treated with drugs
      to increase the cytosolic Ca2+ levels to inhibit the host-cell calmodulin.

PMID- 2228429
TI  - Alteration in density of eosinophils in the cerebrospinal fluid of mice infected
      with Angiostrongylus cantonensis.
AB  - The density of eosinophils in the cerebrospinal fluid (CSF) and blood of male ddY
      mice infected with Angiostrongylus cantonensis was examined on days 14, 20 and 27
      post-infection (p.i.) with discontinuous Percoll gradient centrifugation. Normal
      blood eosinophils had a density of between 1.070 and 1.080 g ml-1. No significant
      changes in density in blood eosinophils were noted during the course of the
      observations. CSF eosinophils began to become hypodense (defined as density less
      than 1.070 g ml-1) on day 20 p.i., and 88% of eosinophils were hypodense on day
      27. Our results suggest therefore that eosinophils probably become hypodense in
      the CSF and brain tissues, but not in the blood.

PMID- 2228431
TI  - Extraintestinal strobilar development of immature Echinococcus multilocularis in
      laboratory rodents following intratracheal inoculation of the protoscoleces.
AB  - Intratracheal inoculation of Echinococcus multilocularis protoscoleces was
      performed in prednisolone tertiary-butylacetate(PTBA)-treated and untreated
      golden hamsters and AKR/J mice. Repeated PTBA treatments prior to the day of
      inoculation prevented the influx of neutrophils against the cestode. More than 1
      month after infection, living immature adult forms of E. multilocularis, showing
      some somatic prolongation, were recovered from the pulmonary alveolar space of
      PTBA-treated golden hamsters, in the absence of any cystic development.

PMID- 2228430
TI  - Babesia bovis: immunity induced by vaccination with a lipid enriched fraction.
AB  - A chloroform extract from Babesia bovis-infected erythrocytes was used to
      vaccinate a group of five naive cattle. Following vaccination, the vaccinates,
      along with a group of control cattle, were challenged with a virulent
      heterologous strain of B. bovis. The vaccinates, comparative to the controls,
      showed delayed as well as decreased parasitaemias. The serological and initial
      biochemical studies suggested that the immune response was elicited by lipid of
      babesial origin.

PMID- 2228432
TI  - Seasonal transmission of Fasciola hepatica in north central Florida (U.S.A.).
AB  - To assess seasonal transmission of Fasciola hepatica 37 groups of fluke-free
      tracer sheep, one group of four sheep each month in succession, grazed an
      infected pasture in north central Florida (U.S.A.) from June 1984 to June 1987.
      At the end of each month, tracers were moved to a fluke-free barn for 2 months,
      then necropsied and flukes counted. Fluke transmission mostly occurred during the
      first half of the year, with peak transmission from February to April. No
      transmission occurred during the warm summer months, having ceased in either May
      or June of each year to begin again in late autumn or early winter (November
      January).

PMID- 2228433
TI  - The arginine dihydrolase pathway is present in Giardia intestinalis.
AB  - Growth of Giardia intestinalis in Diamond's TYI-S-33 medium is characterized by a
      rapid depletion of the arginine in the medium, and concurrent production of
      ornithine and ammonia. [Guanidino-14C] arginine was converted to 14CO2 by
      extracts of G. intestinalis suggesting the presence of the arginine dihydrolase
      pathway. This was confirmed by the detection of arginine deiminase, catabolic
      ornithine transcarbamylase, carbamate kinase and ornithine decarboxylase in
      giardial extracts. The findings demonstrate for the first time the existence of
      the arginine dihydrolase pathway in Giardia, and suggest that arginine metabolism
      via this pathway plays a significant role in energy metabolism by providing a
      site for anaerobic substrate level phosphorylation.

PMID- 2228434
TI  - Does Giardia intestinalis need glucose as an energy source?
AB  - Giardia intestinalis was grown in Diamond's TYI-S-33 medium containing either 50
      mM-glucose or no added glucose to assess its dependence on glucose availability
      as an energy source. The parameters monitored included cell growth, glucose
      utilization and the accumulation of end products in the medium. In the medium
      containing no added glucose, G. intestinalis trophozoites achieved a cell density
      of about half that of the control, and produced the same end products, alanine,
      ethanol and acetate. Decreased amounts of both ethanol and alanine were observed
      (10 and 33% of controls, respectively after 4 days) while there was no change in
      acetate production. These observations indicate that G. intestinalis can utilize
      carbon sources other than glucose, and is not absolutely dependent upon glucose
      as an energy source.

PMID- 2228435
TI  - Eosinophil responses to Fasciola hepatica in rodents.
AB  - Qualitative and quantitative cellular changes in the peripheral blood and bone
      marrow of resistant (rat) and susceptible (mouse) hosts of Fasciola hepatica have
      been examined. Eosinophil numbers in the peripheral blood and bone marrow of both
      hosts increased almost immediately following infection. Rats responded more
      rapidly than mice. Bone marrow colony formation in both rats and mice was greatly
      enhanced following F. hepatica infection. Injection of excretory/secretory (E/S)
      antigens of the fluke into rats and mice caused peripheral eosinophilia.
      Eosinophil levels in mice dropped by day 7 post-injection, but those in rats
      remained high. Eosinophil precursors in the bone marrow of injected animals also
      rose. Bone marrow colony formation in antigen-injected mice peaked sharply at day
      7 but then fell rapidly. Rats injected with E/S antigens had about twice the
      level of bone marrow colonies as controls, 12 days post-injection. For most
      parameters measured, the magnitude of the responses of rats was greater than
      mice, which may be significant in the context of the rat's ability to acquire
      resistance to reinfection.

PMID- 2228436
TI  - The use of computer-aided learning for teaching parasite life cycles.
AB  - The difficulty of presenting parasite life cycles in a textual or diagrammatic
      form is discussed and the use of computer-aided learning to solve this is
      described. The design and use of a Hypercard stack for teaching parasite life
      cycles on an Apple Macintosh microcomputer are outlined.

PMID- 2228437
TI  - The concept of truth in psychoanalysis.
AB  - A philosophical controversy concerning the nature of truth has begun to play an
      important part in psychoanalytic theorizing. The two major philosophical notions,
      the coherence and the correspondence theories and their use in psychoanalytic
      theory making, are examined. It is argued that although coherence is part of the
      criteria of truth, correspondence is the more essential and fundamental
      criterion. It was in this way that Freud used these concepts in creating
      psychoanalysis. Psychoanalytic discoveries concerning the psychogenesis of
      objectivity in perception and thought support the correspondence theory of truth
      and provide, in addition, an answer to the third party critique of
      correspondence. The correspondence theory as a basic attitude of mind is a
      necessary element in the respect for the patient upon which psychoanalytic
      therapy depends.

PMID- 2228438
TI  - As-if: the phenomenon of not learning.
AB  - In this paper I discuss a clinical problem presented by those patients who,
      instead of using analysis as an emotional learning experience, invest all their
      energies in keeping it in a static condition. Using the material of four
      patients, I illustrate how they have an underlying state of disintegration which
      is contained in a precarious enclosure. The patients experience great difficulty
      in facing this situation and preventing further disintegration. I describe a
      particular type of splitting, which I call 'slicing', by which they achieve an
      arrest of further disintegrative processes, and for which they need the
      continuous existence of a useless analysis. I link this situation with Bion's
      concept of 'minus K'.

PMID- 2228439
TI  - A hypothesis about the determining process of autistic states.
AB  - First, the author observes that in the case of autistic children there exists a
      lack of links with other human beings as such. Instead, intense relationships
      with objects take place due to the sensory stimuli that they produce. These
      observations were correlated with ethological studies according to which certain
      animals, reared far from their fellow-creatures, establish links with other types
      of objects within their environment, most frequently with the individuals that
      take care of them or, in the absence of such a person, with a material object.
      After this link is established, they can stop relating to creatures of the same
      species. On this basis a hypothesis is elaborated meaning that autistic people
      would have the instinctive precognition of the creatures of the same species
      fulfilled not by such creatures (imprinting), but by partial aspects of them,
      regarding sensory stimuli that they produce.

PMID- 2228440
TI  - Analysis of a little girl with an autistic syndrome.
AB  - This paper is a clinical one, relating to a four-year analysis of a 28-month-old
      girl who developed an autistic syndrome as a reaction to the violent abduction of
      her parents which she had seen. The reality of the violence of the political
      situation in the country helped blur the distinction between fantasy and reality
      for both analyst and patient. The author introduced melodic singing (after the
      failure of singing with lyrics) as a means of communication with the little girl.
      Her eventual recovery seems to have been possible because of the soundness of her
      upbringing during the first two years of her life.

PMID- 2228441
TI  - Repetition and surprise: a clinical approach to the necessity of construction and
      its validation.
AB  - The analysis of a dream revealed, to the surprise of both patient and analyst,
      identifications corresponding to different times and places. The (re)construction
      led to the discovery of conflicts involving three generations. We explore the
      clinical conditions for this discovery, and we develop the links between the
      concepts of 'historicity' and '(re)construction'. The concept of
      (re)construction, in its very structure, implies a very fertile paradox: being by
      definition retroactive, it is at the same time anticipatory, in the sense that it
      establishes a pre-condition for access to psychical truths. The revelation of
      unconscious identifications (telescoping of generations) through construction
      enables the analyst to gain a retroactive understanding of how the patient has
      understood the interpretations. The analyst obtains thus the means to understand
      (also in a retroactive way) the value and the limits of his interpretations.

PMID- 2228442
TI  - On the formulation of interpretations.
AB  - The author analyses several interpretations published by different authors from
      the point of view of their linguistic form and the type of language used, in
      order to determine the therapeutic effect and the manner of working of each. Two
      types can be distinguished: literal-explanatory language and metaphorical
      language. Each performs a different function. Metaphorical language is proper to
      the primary process; it is related to displacement and condensation; it
      reactivates the most primitive levels of the mind; it serves the purpose of
      expressing affects and emotions. Literal-explanatory language is proper to the
      secondary process; it is related to logical-formal thought; it reactivates the
      most highly developed levels of the mind; it serves a referential, informative
      and explanatory purpose. A knowledge of the function of each of these forms of
      language allows the psychoanalyst to direct the interpretations he formulates to
      either the primary or the secondary process as befits the clinical requirements.

PMID- 2228443
TI  - Gender and identity issues in the analytic process.
AB  - The influence of gender--of analyst and analysand--in the unfolding of the
      analytic process is being addressed. A brief discussion of the reasons why such
      influence was either dismissed or denied in the analytic literature until
      recently, is followed by an overview of possible analyst-analysand interactions
      in the four gender-related dyads. Finally two specific developments, not uncommon
      in the transference of female patients in analysis with female analysts (and
      their countertransference implications) are presented. The first refers to the
      issues around closeness and distance with the maternal object (usually expressed
      as issues over control and as a sado-masochistic struggle with the analyst in the
      transference), while the second to the erotization of the transference.

PMID- 2228444
TI  - The containing function and the analyst's projective identification.
AB  - The concept of the container and the contained in psychoanalysis describes a
      process whereby the patient's projective identifications are internalized by the
      analyst, transformed, given meaning, and returned to the patient in a useful
      fashion. In this paper, it is suggested that what the analyst gives back, and
      what the patient receives, is the analyst's projective identification. The
      containing function itself can be transmitted to the patient via this mechanism.
      All interpretation, from whatever theoretical viewpoint, has an element of
      containing and therefore projective identification on the part of the analyst.
      Paradoxically, neutrality itself can be considered a vehicle for projective
      identification. Previously, the role of the therapist's projective identification
      in the containing process has been implied, but not discussed.

PMID- 2228445
TI  - Catastrophic illness in the analyst and the analyst's emotional reactions to it.
AB  - The author reviews the fact that there is very little literature available on
      catastrophic illness in the analyst and the analyst's emotional reactions to it,
      compared with other topics of interest. Some of the factors suggested to account
      for this are exhibitionistic concerns, concerns about one's privacy (including
      psychic privacy), embarrassment related to countertransference, and concerns
      about losses of referrals if colleagues perceive the analyst to be impaired. The
      author then draws a distinction between the emotional life of analysts and
      countertransference, and discusses how and why he defines them differently. The
      major part of the paper then goes on to discuss two major technical questions in
      considerable detail: (a) whether or not to give factual information to patients
      about one's condition, and (b) the manner in which the material is introduced
      into the analysis. A number of case examples are cited. The author closes with a
      discussion of the question of the pros and cons of reporting on the experience
      immediately versus waiting for the passage of time.

PMID- 2228447
TI  - The investigation of psychoanalytic theory by means of the experimental method.
AB  - Psychoanalysis has been criticized for its lack of a quantitative research
      tradition and its resulting reliance on the case history method for its data.
      While the in-depth observation of a small group of cases has an important place
      in the development of science, particularly in the hypothesis generating phase,
      it is argued that the testing of psychoanalytic hypotheses must depend on
      research methods that allow for more stringent control and replication. Five
      studies that utilize a true experimental design and that examine
      psychoanalytically significant topics are described. Special problems confronting
      the psychoanalytic experimenter are discussed. It is hoped that this article will
      stimulate those investigators who have an interest in testing psychoanalytic
      principles to design future studies that are rigorous in their methodology.

PMID- 2228446
TI  - Post-termination patient-analyst contact: I. Analysts' attitudes and experience;
      II. Impact on patients.
AB  - Post-termination patient-analyst review, due to the increased psychological
      distance from the patient provided by the passage of time, generates an
      advantaged perspective of the gains and limitations of analytic work than was
      possible at treatment termination. Despite analysts' widespread belief that such
      analyst-initiated contact is deleterious to the patient, assessment of clinical
      experience with such contacts by Luborsky, Martin and Schlessinger, as well as by
      re-evaluated data of Wallerstein, indicates little or no damage to patients, and
      in some cases distinct benefits. Analysts generally make post-termination contact
      with their patients conditional upon the patient's need for additional help,
      although their personal experience is of unconditional extensive contacts with
      their own training analyst. Whether expectation of and experience of substantial
      post-termination contact with the patient's analyst impacts on either the degree
      of mourning or of resolution of residual transference requires evaluation.

PMID- 2228448
TI  - A new look at the theory of Melanie Klein.
AB  - This paper tried to show that Melanie Klein's theory can very profitably be
      viewed as a descriptive theory of strong emotions rather than an instinct or
      developmental theory. Furthermore, since in Klein's thinking feelings 'create'
      objects, the primacy of feelings in this theory is central. The paper contains a
      short chronological study of Klein's formulations of psychic phenomena in terms
      of affects. It is also maintained that the paranoid-schizoid and the depressive
      positions are constellations of affects and of reactions to them; that psychic
      development is essentially in terms of the capacity to tolerate feelings, and
      that the basic conflict in mental life is between feelings of love and hate and
      associated feelings. Such a view solves many of the conceptual difficulties of
      Kleinian theory and in addition promises rewarding insights into the world of
      feelings.

PMID- 2228449
TI  - "A dream is the fulfillment of a wish': traumatic dream, repetition compulsion,
      and the pleasure principle.
AB  - This paper describes the case of a battle veteran who suffered from a repetitive
      traumatic dream and symptoms of a traumatic stress disorder. Psychodynamic
      exploration revealed the basic wish-fulfilling aspects of both the dream and the
      fact of its repetition. The patient's obsessional preoccupation with his war
      experiences was also in significant part determined by unconscious wishes to
      repeat the infantile experience it represented. It is suggested that the
      repression of pleasure according to the classic psychoanalytic model is as
      important a dynamic in the dreams and symptoms associated with specific traumata
      as with any other neuroses. The question is raised as to whether a repetition
      compulsion, of normal or pathological intensity, may reflect the wish to repeat a
      descriptively unconscious pleasurable component of a disturbing experience, as
      well as to master it.

PMID- 2228450
TI  - Need for technology assessment in oral health care.

PMID- 2228451
TI  - Value of technology assessment in developing countries.
AB  - The contrasting cycles of changing caries prevalence in developing and
      industrialized countries are described, as they relate to differing needs in
      technology. Using this contrast as a background, the selective needs for
      technology in measurement, adequate quality of treatment and materials,
      appropriate personnel, and simplicity and mobility in equipment are discussed.

PMID- 2228452
TI  - On amalgam toxicity.

PMID- 2228453
TI  - Present and future value of dental composite materials and sealants.
AB  - This article reviews the development, composition, chemistry, recent
      technological advances, and extent of use of composite resin restorative
      materials, adhesives, and pit and fissure sealants. The problems related to the
      clinical behavior of these materials in the oral environment are dealt with, and
      methods of minimizing their present deficiencies are suggested. Future directions
      that might be taken to improve these materials and solve some of the inadequacies
      that these materials exhibit are also discussed.

PMID- 2228454
TI  - Pit and fissure sealants. An underutilized preventive technology.

PMID- 2228455
TI  - Long-term assessment of periodontal surgery versus curettage or scaling and root
      planing.
AB  - The various treatments for periodontal disease must be assessed in light of the
      recently articulated goals of periodontal therapy to preserve teeth for a
      lifetime and to enhance esthetics and comfort as well as oral health. This
      article examines the long-term comparisons of periodontal surgery, curettage, and
      scaling and root planing in improving attachment levels instead of the more
      traditional pocket depth.

PMID- 2228456
TI  - Rationale for the use of antimicrobial agents in periodontal disease.
AB  - The traditional approach to treating dental decay and periodontal disease has
      often focused on caries, neglecting periodontal infection. The past 15 years have
      seen significant advances in the treatment of periodontal disease with
      antimicrobial therapy, both with and without more traditional debridement or
      surgery. This article presents an overview of the use of antimicrobials,
      including an examination of treatment philosophies and the diagnosis of
      periodontal infection.

PMID- 2228457
TI  - Psychological safety of a multiple channel cochlear implant device. Psychological
      aspects of a clinical trial.
AB  - Fifty-three deaf patients were screened psychologically and medically for
      suitability to receive an intracochlear implant. After initial screening for
      psychological normalcy, candidates were assessed again 1 year postimplant.
      Isolated deleterious psychological effects were found, and certain aspects of
      psychological functioning were enhanced. Overall evidence suggests that the
      implant is not psychologically damaging.

PMID- 2228458
TI  - Searching for consensus through multi-criteria decision analysis. Assessment of
      screening strategies for hemoglobinopathies in southeastern France.
AB  - Until now, no systematic strategy for the prevention of major hemoglobinopathies
      has been implemented in southeastern France, in spite of frequencies of beta
      thalassemia trait and HbS trait as high as 2.5-8% in some ethnic populations. The
      purpose of the study was to help a group of experts, brought together by the
      Regional Center for Disease Control, to reach a consensus about screening for
      carriers of heterozygote hemoglobinopathies. A multicriteria decision-analysis
      model was used to take into account not only the costs and effectiveness of
      potential screening strategies, but also five other qualitative criteria:
      technical and practical feasibilities, ethical acceptability, information follow
      up in time, and global impact on health education. Conclusions differ
      significantly from those of a pure cost-effectiveness analysis, but a
      multicriteria approach seems best suited to medical experts' preferences.

PMID- 2228459
TI  - Format and conduct of consensus development conferences. Multi-nation comparison.
AB  - The consensus development conference method developed by the National Institutes
      of Health in the United States has been adopted and modified by a number of
      countries. Based on published articles and communication with representatives
      from each country, we examined whether the organization and conduct of these
      conferences in nine countries (United States, Canada, Denmark, Finland, the
      Netherlands, Norway, Sweden, Switzerland, and the United Kingdom) enhanced or
      detracted from achieving the stated conference goals and objectives. We conclude
      that improvements in the process by which consensus conferences are conducted may
      be warranted. More scientific methods for synthesizing literature, such as meta
      analysis, should be used in developing inputs for the conference panel.
      Formalizing the decision-making processes through polling or other methods that
      allow for structured disagreement with parts of a consensus statement would
      potentially expand the range and type of issues that can be addressed in such
      conferences. Finally, countries should consider having the consensus statement
      written over a longer period of time than the traditional overnight session,
      which seems unlikely to promote clear thinking.

PMID- 2228460
TI  - Analysis of the National Institutes of Health Medicare coverage assessment.
AB  - The National Institutes of Health (NIH) is periodically asked to conduct
      assessments of new medical technologies to assist in coverage decisions made at
      the Office of Health Technology Assessment (OHTA) for the Health Care Financing
      Administration coverage policy. Analysis of NIH assessments indicates that even
      though most NIH assessments rely only on expert opinion, OHTA agreed with NIH
      recommendations in over 90%.

PMID- 2228461
TI  - Assessment of two oxygen treatment alternatives in the home.

PMID- 2228462
TI  - Screening with mammography.

PMID- 2228463
TI  - How ICN is promoting research.
AB  - "No Health Without Research." That's the conclusion of the 43rd World Health
      Assembly technical discussions in May and ICN's warning since the early '70s when
      it began to promote nursing research in earnest. But ICN's commitment to research
      is not recent. It is deeply embedded in its first constitution in 1900. Below, a
      review of ICN's special role in supporting research, excerpted from Taka
      Oguisso's introductory speech to the Task Force on International Research meeting
      in May (page 287).

PMID- 2228464
TI  - A survey of nursing research in Nigeria.
AB  - In Nigeria, nurses are not considered to be sufficiently educated to understand
      the abc's of research methodology much less to participate in or conduct
      research. This lamentable fact was made at a conference on "The Role of Research
      in Nursing" in Nigeria. This was in 1973. Has the situation changed since? For
      lack of any study or documentation on the topic, and to be able to report on the
      status of nursing research in Nigeria for the ICN-sponsored Task Force on
      International Research meeting at end April-May, Rosaline Olade decided to
      conduct her own exploratory study. While the responses shed light on the
      situation in both Nigeria and the African region, they also sound only too
      familiar in countries where nursing is beginning to be recognized at the
      university level.

PMID- 2228465
TI  - Nursing in the 21st century in Latin America: Part III--Policies.
AB  - The following is the last of a three-part analysis of nursing in Latin America.
      The first two installments dealt with education and practice. Below, a look at
      current policies and their repercussions for nursing.

PMID- 2228466
TI  - Nursing regulation moves ahead.
AB  - Since its creation in 1899, ICN has had a major and legitimate interest in the
      regulation of the profession. It has supported the passage of appropriate nursing
      legislation and, through studies, seminars and publications, has consistently
      sought appropriate and effective regulation. Its strongest effort in this area to
      date has been "The Nursing Regulation: Moving Ahead" project launched in 1988
      with the support of W.K. Kellogg Foundation and other development agencies. And
      now after 11 workshops involving 77 countries around the world, the project team
      takes a recapitulating look at the project's evolution and promising outcomes.

PMID- 2228467
TI  - Nursing in Canada: a profession.
AB  - The headlines scream out: "Hospitals alarmed as disgruntled nurses flee
      profession". "Living with death; the strains of daily tragedy feed chronic
      shortage of nurses". "Ministry should encourage alternative health care". "BC
      nurses set to withdraw services". As the provincial health care system falters
      and nurses, the very core of health care, flee the profession, politicians
      scramble to find answers. And so is Janice Kopinak, who takes a deep look at the
      current nurses' revolution and sees a glimmer of hope for change.

PMID- 2228468
TI  - Synthesis: the BSN's preparation for practice.
AB  - Entry-level competencies and successful role transition have become a major
      concern of employers, who often complain that new graduates (particularly with
      baccalaureate degrees) lack preparation for staff nursing. To aid in this
      transition to the workplace, a clinical course has been developed for the last
      semester of a BS programme that increases students' confidence and ability to
      function as competent professional nurses and that could be used by other
      countries as a role model. Below, a description of the "Synthesis in Nursing
      Practice" course and its benefits to both students and future employers.

PMID- 2228469
TI  - Selection and interpretation of laboratory tests for patients with uveitis.

PMID- 2228470
TI  - Anterior and intermediate uveitis.

PMID- 2228471
TI  - Fuchs' heterochromic iridocyclitis.

PMID- 2228473
TI  - Ocular toxoplasmosis.

PMID- 2228472
TI  - Ocular sarcoidosis.

PMID- 2228474
TI  - Behcet's disease.

PMID- 2228475
TI  - Sympathetic ophthalmia and Vogt-Koyanagi-Harada syndrome.

PMID- 2228476
TI  - Multifocal choroiditis.

PMID- 2228478
TI  - Brucellosis and nonsyphilitic treponemal uveitis.

PMID- 2228477
TI  - Lyme uveitis.

PMID- 2228479
TI  - Fluorescein angiography in patients with posterior uveitis.

PMID- 2228480
TI  - Immunosuppressive treatment of uveitis.

PMID- 2228481
TI  - Surgical approaches to uveitis.

PMID- 2228482
TI  - Peripheral uveitis: an infectious etiology?

PMID- 2228483
TI  - Group environment and group interaction in psychiatric assessment meetings.
AB  - This study examines two aspects of psychiatric assessment meetings: staff
      perceptions of group social climate, and staff verbal interaction. An
      Experimental group using a novel format was compared with two groups using a
      Traditional format. Group environment was measured by the Group Environment Scale
      (GES). Staff verbal interaction was rated both in terms of discussion content and
      distribution of discussion time among the categories of Chair, Keyworker, and
      Others. Changes in group environment were found on four out of ten GES subscales:
      in the Experimental meetings Expressiveness and Independence both increased,
      while Leader Control, and Anger & Aggression decreased. Content of discussion
      remained largely unchanged, but there was a marked shift in the distribution of
      discussion time towards Keyworkers and away from the Chair.

PMID- 2228484
TI  - Depression and loneliness in overseas students.
AB  - This paper compared the effect of life change in adjustment of overseas students
      with those of Australian students. 342 students were divided into 4 experimental
      groups. There were: Overseas students with residence of less than one year (OV1
      group, N = 44), overseas students with residence of more than one year (OV2
      group, N = 81), Australian students raised in Brisbane (A3, N = 105) and
      Australian students raised outside Brisbane (A4, N = 112). The result of
      discriminate analysis showed that overseas students (OV2) were significantly more
      likely to experience moderate to severe clinical depression and loneliness than
      the Australian students. Age and expectation of difficulty in study were the best
      predictors for depression in overseas students.

PMID- 2228485
TI  - Evaluation of psychiatric morbidity following an earthquake.
AB  - Greece has been characterized by high earthquake activity in comparison not only
      with Mediterranean countries, but also with many parts of Eurasia. In the present
      study an assessment of the psychiatric morbidity was carried out in the city of
      Kalamata, Greece, two weeks after the earthquake in September, 1986. A random
      sample of residents divided into three categories was assessed. The participating
      groups consisted of 205 adults, 172 high school students and 69 adult outpatients
      who suffered from minor pathological problems or proceeded for a check-up without
      being necessarily ill. The Langner and CES-D scales were administered for the
      population assessment. Detailed statistical analysis revealed that the earthquake
      had significant psychological effects and caused a considerable degree of
      depression in all groups. According to the Langner Scale, 31.3% of the general
      population, 11.6% of the students and 40.6% of the patients exhibited 10 or more
      symptoms on the Langner scale indicating severe disturbance. Also 50.9% of the
      whole sample exhibited 6 or more symptoms indicating serious disturbance. In the
      CES-D scale, 79% of the general population, 69.2% of students and 75% of the
      outpatients exhibited 16 or more symptoms, or 74.6% of the whole sample. The
      observed difference between general population and students is significant on
      Langner scale (p less than 0.001) and on CES-D scale (p less than 0.025). The
      major symptoms in all groups were prevalence of severe psychiatric
      symptomatology, anxiety, psychosomatic disorders and depression.

PMID- 2228486
TI  - Is day hospital treatment effective, and can success be predicted?
AB  - Clinical improvement is demonstrated in a group of 41 day patients of mixed
      diagnosis by changes in measures of depression, self-esteem, loquacity and
      sociability over a period of six weeks. Staff predictions of success, made after
      2 weeks, correlated positively (Spearman's rho = 0.53) with an overall assessment
      of success after 6 weeks, which itself was positively correlated with
      improvements in scores on depression (rho = 0.58) and sociability (rho = 0.66 and
      0.60). The patients for whom staff predicted least success were in 6 cases out of
      7 men aged 20-51.

PMID- 2228488
TI  - Towards culture- and population-specific norms for self-reported depressive
      symptomatology.
AB  - This paper: (1) reviewed and integrated the small body of cross-cultural
      literature on Zung SDS scores among college students and (2) reported new SDS
      data on students in four countries. Its purpose was to facilitate the development
      of population- and culture-specific norms for the measurement of depression and
      to identify patterns in the data available at this time. The results indicated
      considerable culture and gender specificity. Females had higher SDS scores in all
      but one group. There was a slight tendency for scores to increase over time. The
      pattern of mean scores across cultural groups was somewhat inconsistent. Korean
      and Philippine students had the highest scores, Caucasian Americans the lowest.
      There was moderate concordance of ranked symptoms across eleven samples. This
      concordance increased within cultural groups and especially within nations.
      Finally, two specific methodological problems were discussed. First, nine of ten
      of the highest ranked symptoms were stated in negative form, which suggests that
      negative wording biases symptom means. Second, there appear to be additional
      problems in the specific wording of the libido and diurnal variation items as
      applied to college students.

PMID- 2228487
TI  - Problems of meaning in psychiatric screening scales: a critique and possible
      solutions.
AB  - It is argued that there are problems in the way that psychiatric screening scales
      are constructed. The normal procedure is to collect a group of symptom items and
      sum them creating a single score. While researchers generally assign an equal
      weight to each symptom, this is not warranted. Using data from two psychiatric
      screening scales from large representative samples, it is shown that symptoms
      vary tremendously in the degree to which they are experienced in the population;
      the more rare symptoms appear to measure depression while the more common
      symptoms sound much like stress. Summing these items and assigning them equal
      weights makes little sense, given these differences. Examining case profiles
      shows that individuals with quite different symptom patterns receive identical
      scores. Several alternative methods of creating psychiatric screening scales are
      suggested, including eliminating some items, and devising systems of symptom
      weights; factor analysis is ruled out, however.

PMID- 2228489
TI  - Emotional changes in pregnancy and early puerperium among the Yoruba women of
      Nigeria.
AB  - A randomly selected clinic population of 400 pregnant women in Ile-Ife, Nigeria,
      were interviewed for complaints of psychological disorders during the last
      trimester of pregnancy and the post-partum period. The study shows a considerable
      degree of psychological disturbances during pregnancy which later decreased
      significantly during the post-partum. While the complaints of worrying, guilt
      feeling, nausea and vomiting and "heat in-the-head", were significantly more
      common in younger women, insomnia and anorexia were more common in older women.
      The incidence of psychological complaints among the women decreased with
      increasing parity. There was no significant difference in the incidence between
      women with monogamous and polygamous marriages.

PMID- 2228490
TI  - Interaction in health education.
AB  - The usefulness of the application of the psychodynamic frame of reference in
      person-to-person health education is examined in the present study. The health
      educator's proper understanding of his client through an integrative use of his
      own cognitive and emotional responses to the client is first discussed. Depending
      on the level of maturity of their personalities, and on the nature of their
      formative relations, the clients will develop different modes of interaction in
      their relationships with the health educator. Learning to adequately recognize
      and meet clients showing different interactional modes is considered to
      substantially increase the prospects of the health educator helping his clients
      to accomplish a change in health behaviour. Four levels of interaction and their
      proper encountering are described and discussed. It is concluded that health
      education and individual health educators would benefit from an increased
      familiarity with, and use of, the psychodynamic body of knowledge.

PMID- 2228491
TI  - Renal cell carcinoma presenting as spontaneous retroperitoneal haemorrhage.
AB  - On the basis of a spontaneous retroperitoneal haematoma in a 55-year-old female
      patient the diagnostic and therapeutical problems of such an emergency situation
      will be discussed. Due to the high incidence of malignant tumours as the bleeding
      source, radical surgery becomes the necessary treatment, which may be needlessly
      burdened by high operative risk in the acute phase. For that reason the mode of
      treatment chosen in this particular case was immediate embolization subsequent to
      arteriography along with consecutive extracapsular nephrectomy and removal of the
      haematoma.

PMID- 2228492
TI  - Universal papillary necrosis: report of a case of widespread sloughed and
      calcified papillae mimicking multicomponent staghorn calculi.
AB  - A case of florid papillary necrosis is presented demonstrating the unusual and
      graphic feature of universal sloughed and calcified papillae, resulting in
      recurrent obstruction. Recognizing this entity from plain radiographs is
      important in not overlooking this potentially treatable cause of progressive
      renal failure.

PMID- 2228494
TI  - A decade of experience in the surgical treatment of vesicoureteral reflux.
AB  - Our ten years of experience in the treatment of vesicoureteral reflux is
      presented. The results have been presented with respect to the grade and the
      antireflux technique employed, with special emphasis on grade IV and V cases.

PMID- 2228493
TI  - Treatment of radiolucent renal calculi using ESWL combined with urine
      alkalinization.
AB  - During the last 16 months, out of a total of 50 patients with renal urate stones
      30 were treated by ESWL alone (Group A) and 20 by ESWL combined with urine
      alkalinization (Group B) as an adjuvant treatment. The stones were single in 14
      cases, multiple in 25 and branching in 11 cases. The average long axis of the
      stones was 3.6 cm. In Group A 76.6% of the patients were stone-free 3 months
      after ESWL, in comparison with 90% in Group B patients who underwent the combined
      treatment.

PMID- 2228495
TI  - Follow-up of patients treated for urinary bladder calculi.
AB  - Fifty patients were followed-up for an average of 3 years after treatment for
      urinary bladder calculi. In 10 of these (20%) altogether 20 metabolic or
      endocrine diagnoses were revealed at follow-up: hypercalcaemia, 8;
      hyperuricosaemia, 4; high parathormone, 3; hyperuricosuria, 2; hypercalciuria, 2:
      hyperoxaluria, 1. About half of the patients also had other diagnoses, dominated
      by outflow obstruction at the prostatic level, followed by neurogenic bladder
      disorder. Fifteen had developed new bladder calculi. Urography revealed upper
      tract calculi in 12 patients, but 11 of these were free from metabolic disorder.
      Significant bacteriuria was common (24%). Our conclusion is that a follow-up is
      to be recommended after treatment of bladder calculi. It should include
      cystoscopy and screening for endocrine/metabolic disorders.

PMID- 2228497
TI  - Radical prostatectomy and complications.
AB  - Radical prostatectomy has been successfully applied in the treatment of
      intracapsular prostatic tumour. A few modifications of the surgical technique are
      suggested to prevent complications. Initial results confirm that the method
      works, as all patients have remained continent. One of them died of pulmonary
      embolism right in the postoperative phase.

PMID- 2228496
TI  - Combined cisplatin and radiation therapy in patients with invasive bladder
      cancer.
AB  - Thirty-five patients with T2-T4 invasive bladder cancer were treated with
      combined cisplatin and radiation therapy. In 18 patients radical cystectomy was
      performed after the combined therapy. In the other 17 patients radical cystectomy
      could not be performed for various reasons. Pathological examination of the
      cystectomy specimens showed down-staging in 66.7% and no residual tumour in
      33.3%. These results suggest a synergistic action of cisplatin and radiation.
      Side effects were not severe and were well tolerated. This combined therapy of
      cisplatin and radiation is very effective for invasive bladder cancer.

PMID- 2228498
TI  - Traumatic rupture of the corpus cavernosum.
AB  - Penile fracture is a rare entity. Twelve patients with penile fractures were
      treated surgically with a very low complication rate. Our results were compared
      with those reported in the literature.

PMID- 2228499
TI  - Intralbugineous testicular prosthesis, a new technique. Summary of 30 implants.
AB  - A study of 16 patients who underwent intralbugineous testicular implants during
      the practice of orchiectomy is presented. In 14 cases of prostatic carcinoma,
      after bilateral subcapsular orchiectomy intralbugineous prostheses were implanted
      and in 2 other cases of testicular torsion unilateral prosthesis was implanted.
      With this new, easily executed technique the size, mobility and testicular
      sensibility are maintained.

PMID- 2228500
TI  - Silicon transfer during haemodialysis.
AB  - Silicon transfers were examined during haemodialysis (HD) in 120 chronic HD
      patients who received 5-hour dialyses 3 times a week. Si levels were measured by
      flameless atomic absorption spectrophotometry. Ultrafiltrable Si levels
      approximately equalled dialysate Si levels. Serum Si levels before HD
      significantly increased in all patients and total protein values were also high.
      It is concluded that serum Si levels increasing with time during HD with
      cellulose acetate or cuprophan is due to haemoconcentration and liberation from
      the silicon rubber tube.

PMID- 2228501
TI  - Combined peritoneal and haemodialysis therapy for chronic renal insufficiency.
AB  - Twenty-three patients with chronic uraemia were treated for an average of 8.5
      months with intermittent peritoneal dialysis. When hypervolaemia developed and/or
      the volume of low-molecular weight substances increased, the therapy was
      complemented by one or two sessions of haemodialysis per week. The combined
      treatment was carried on for 4.1 months on average, in consequence of which the
      general condition improved, body weight reached the optimum, blood pressure
      diminished, turned normal and could be controlled by drugs. In the wake of the
      therapy carbamide nitrogen and creatinine levels dropped significantly, serum
      total protein and albumin values increased. At the close of the observation
      period 3 patients remained under combined therapy, 2 had undergone cadaveric
      kidney transplantation, 18 were transferred to chronic haemodialysis. Thoughts
      are evolved about the advisability of intermittent peritoneal dialysis and
      combined therapy in the care for uraemic patients.

PMID- 2228502
TI  - Urinary tract infections in post-renal transplant patients.
AB  - The overall incidence of urinary tract infections (UTIs) in our renal transplant
      population was 30.9%, i.e. 0.15 episode per patient-year. UTIs occurred more
      often within the first 3 months (60%) of transplantation. Fifty per cent of UTIs
      were asymptomatic. Recurrences were common. Acute tubular necrosis and cellular
      rejections were important associations. UTIs had little effect on graft function
      and survival up to 3 years post-transplant.

PMID- 2228503
TI  - Serum selenium levels in healthy adults and its changes in chronic renal failure.
AB  - In this study the serum selenium levels of 500 healthy Greeks and 225 patients
      with chronic renal failure (CRF) were measured using Watkinson's method. The
      patients were treated either conservatively or by peritoneal dialysis or
      haemodialysis. We found that the levels were in an intermediate position compared
      to those of other Europeans. Selenium levels were also found to increase
      significantly with age. No difference was detected between male and female
      patients. A statistically significant drop was observed in CRF patients compared
      to age matched controls. This drop was smaller in patients treated conservatively
      than in those treated by peritoneal dialysis. A further drop was observed in
      patients under haemodialysis.

PMID- 2228504
TI  - [Continuing education. Changes in late ventricular potentials in the ECG].

PMID- 2228506
TI  - [Paraneoplastic syndromes in dermatology. Cutaneous paraneoplasias].

PMID- 2228505
TI  - [Paraneoplastic endocrinopathies].

PMID- 2228507
TI  - [Paraneoplastic myopathies].

PMID- 2228508
TI  - [Paraneoplastic syndromes of the hematopoietic cell system].

PMID- 2228509
TI  - [Paraneoplastic disorders of hemostasis].

PMID- 2228510
TI  - [Fever, weight loss and rare paraneoplasias].

PMID- 2228511
TI  - [Fatigue, pulmonary coin lesions and liver tumor].

PMID- 2228512
TI  - [Bronchial asthma, eosinophilia and vasculitis].

PMID- 2228513
TI  - [Nicotine patch for smoking cessation?].

PMID- 2228514
TI  - Characterization of the tumorigenic and metastatic potential of a poorly
      differentiated human colon cancer cell line.
AB  - We characterized the tumorigenic and metastatic potential of a poorly
      differentiated, non-CEA-producing colon cancer cell line, MIP-101, after
      injection at different sites in athymic mice. After subcutaneous and intrasplenic
      injection tumor grew locally in 100 and 50%, respectively, but no metastases were
      found, even after intravenous injection. Intraperitoneal implantation, however,
      resulted in a high tumor take (10/10) and subsequent liver colonization (8/10
      mice). Exogenous CEA prior to intrasplenic injection induced metastasis in 7/8
      mice (in 2 mice to the liver and in 5 mice to the lung). Intrasplenic injection
      of CX-1, a good CEA producer, resulted in hepatic metastases in 100% of the
      animals. These data suggest a direct or indirect role of CEA in the metastatic
      process. We conclude that MIP-101 has a high tumorigenic and invasive potential
      but a low metastatic proclivity, except when grown in the peritoneum, and that
      pretreatment of tumor-bearing animals with CEA affects the metastatic proclivity.

PMID- 2228515
TI  - Intrapulmonary spread of established B16 melanoma lung metastases and lung
      colonies.
AB  - Spontaneous metastasis of subcutaneous B16 melanoma transplants proceeds in two
      distinct stages: initially to the lungs, and secondarily, following tumor
      removal, from established lung metastases to extrapulmonary systemic sites.
      Coincident with extrapulmonary metastasis, there is a dramatic amplification of
      visible lung metastases, with death generally resulting from extensive lung
      metastasis. The progression of lung metastasis, and lung colonization initiated
      by intravenous injection of tumor cells, was investigated using B16 melanoma
      clone G3.12. Analysis of the growth of invisible metastases in organ culture
      explants of lung revealed that tumors continually disseminated relatively small
      numbers of lung metastases after reaching a size of about 6 mm in diameter.
      However, most terminal-stage lung metastases, along with all extrapulmonary
      metastases, apparently arise from a secondary spread of tumor cells from tumor
      derived lung metastases 1-2 mm in size. Individual lung colonies, initiated with
      G3.12 cells bound to single microbeads, also disseminated large numbers of
      secondary lung colonies, as well as extrapulmonary colonies, at a 1- to 2-mm
      size. The mechanism for intrapulmonary spread of secondary metastases and
      colonies is unclear, but the consequence appears to be a secondary stage of
      intrapulmonary and extrapulmonary metastasis with selection for tumor cells with
      rapid growth rates.

PMID- 2228517
TI  - Change in the role of the spleen from protective to harmful following tumor
      progression in AKR lymphoma.
AB  - Tumor progression has been reported to be often accompanied by a loss of
      sensitivity to various elements of the immune system. In the present study, three
      variants of malignancy of AKR lymphoma were compared as to the host reaction they
      elicit. Splenectomy caused an acceleration of growth of the low-metastasizing
      tumor, slightly inhibited the growth of the tumor of intermediate malignancy and
      significantly inhibited the development of the high-metastasizing lymphoma. These
      results suggest that splenic elements exert an inhibitory effect on the low
      metastasizing tumor and a growth-stimulatory effect on the more malignant ones.
      While decreased sensitivity to various host defense mechanisms following tumor
      progression has been amply documented, the present study shows a more severe
      phenomenon: increased malignancy can be accompanied by a deviation of the host
      immune reaction from tumor growth inhibition to growth stimulation.

PMID- 2228516
TI  - Lymphatic metastases from the peritoneal cavity are increased in the
      postinflammatory state.
AB  - Cell suspensions of chemically induced tumors (rhabdomyosarcoma) were
      transplanted into the peritoneal cavities of Lewis rats. In normal animals, the
      greater omentum was the main site of tumor growth, and transdiaphragmatic
      metastases to regional lymph nodes in the mediastinum were few and small. In
      animals during the healing phase of a chemical peritonitis, the greater omentum
      was fibrotic, shrunken, and inactivated. The loss of the scavenging function of
      the omentum was associated with wide dissemination of the tumor in the peritoneal
      cavity and increased access of the tumor to the lymphatic stomata on the
      peritoneal surface of the diaphragm. Number and size of transdiaphragmatic
      metastases in draining lymph nodes were greatly increased in this
      postinflammatory state.

PMID- 2228518
TI  - Interactions of exogenous heparan sulfate with tumor cells of different
      metastatic phenotype.
AB  - Heparan sulfate (HS) enhanced the growth of the highly metastatic (HM) 3LL cell
      line, but not that of the low metastatic (LM) counterpart, in a dose-dependent
      way. Heparin, chondroitin sulfate, hyaluronate did not produce this effect. At 4
      degrees C both cell lines exhibited high affinity binding sites (Kd 10(-8) M) for
      exogenous HS. Unlike LM cells, the HM ones lost half of the surface-bound HS
      during the 24-hour incubation at 37 degrees C. HM cells in the exponential growth
      phase took up the bound HS at lower rate than the LM counterparts. Both cell
      lines fragmented the exogenous HS intracellularly, but only the HM cells were
      able to degrade it at the cell surface. The HM cells contained much more heparin
      binding proteins--especially in the cell membrane and nuclear fraction--than the
      LM ones. These results clearly demonstrate that the interactions of tumor cells
      with exogenous HS are influenced by the invasive phenotype. We suggest also that
      there could be a correlation between the surface degradation, the slow uptake and
      the growth-promoting effect of the exogenous HS.

PMID- 2228519
TI  - Substance abuse: a problem that won't go away.

PMID- 2228520
TI  - The price of addiction.

PMID- 2228521
TI  - Babies at risk: drug abuse and pregnancy.

PMID- 2228522
TI  - The case of the pained hypertensive.

PMID- 2228523
TI  - Medicus, physicus, doctore.

PMID- 2228524
TI  - IFMC case notes. Private review.

PMID- 2228525
TI  - Governor's alliance on substance abuse.

PMID- 2228526
TI  - Molecular biology of cancer.

PMID- 2228527
TI  - The use of cyclosporin A in adult nephrotic syndrome: nine cases and literature
      review.
AB  - Nine adult patients with resistant nephrotic syndrome were treated with
      cyclosporin A (CyA). All had failed to respond to high dose corticosteroids with
      or without cyclophosphamide. Three patients had minimal change disease, 3 had
      focal sclerosing glomerulosclerosis (FSGS), 2 had mesangiocapillary GN, and one
      had membranous nephropathy. The mean age of the patients was 26.4 years (range 16
      to 39 years). CyA was given orally twice daily at a mean dose of 6.7 mg/kg/24
      hours (range 6-10 mg/kg/24 hours). Four patients achieved full remission, two
      patients went into partial remission and three failed to respond. Two patients
      developed clinical nephrotoxicity, which reversed on dose reduction or cessation
      of CyA. All 3 patients with minimal change disease who responded subsequently
      relapsed after stopping CyA, but remitted rapidly on reintroduction of the drug.
      We suggest that the mode of action of CyA in nephrotic syndrome may be related to
      intra-renal vasoconstriction in addition to its direct immunosuppressive effect.
      In this limited series, we found that CyA can be an effective therapy for
      otherwise refractory nephrotic syndrome, although relapse on withdrawal of CyA
      may well be a significant clinical problem.

PMID- 2228528
TI  - The use of the laryngeal mask airway in day case and short stay surgery.
AB  - An increase in day case surgery has followed a reduction in the number of
      hospital beds available. Anaesthetic methods and techniques must be modified so
      that patients can be safely discharged as soon as possible following surgery. The
      use of Brain's laryngeal mask airway (L.M.A.) can play a part in achieving this
      objective.

PMID- 2228529
TI  - Regular planned respite admissions to a geriatric unit.
AB  - A programme of regular planned respite admissions to the geriatric unit in Cork
      was established in 1984, for dependent elderly being cared for at home.
      Retrospective analysis of the respite programme sought to establish its bed
      utilisation, type of patients admitted, factors in their selection process, their
      outcome and any associated hospital morbidity. Twenty-four patients have used the
      scheme during the four years since its commencement, with an efficiency of bed
      utilisation in 1987 of 14 patients occupying a mean of 4.33 beds per month. The
      median number of medical problems per patients was five; their median age 77
      years and the percentage over 80 years was 46%. Twenty-two patients were already
      receiving intensive rehabilitation before being placed on the programme, mobility
      problems dominated. Nine patients continue on the programme with a mean of 23.9
      months of respites to date, eight were discharged and seven died. There was no
      significant difference between the number of respite stays in hospital and "at
      home" stays complicated by morbidity. The results suggest that even for a highly
      selected group of dependent elderly, a planned programme of respite admissions is
      an effective form of care, uses hospital beds efficiently without associated
      morbidity and may provide an alternative to long stay institutional care.

PMID- 2228530
TI  - Surgical management of gastric cancer.
AB  - The presentation and surgical management of gastric cancer is changing as a
      result of advances in endoscopy and preoperative imaging techniques. One
      surgeon's experience with 44 cases operated on between 1982 and 1988 is reviewed.
      Endoscopy was performed in 93% of cases. A sub-total gastrectomy was performed in
      23 cases, a total gastrectomy in 13, and a proximal gastrectomy in eight. Of the
      cancers, 13 involved local or distant structures (d+), 18 had lymph node
      involvement (+) and 13 were node free (-). Of the first 22 patients, only four
      had a node (-) lesion compared to nine of the second 22 patients (p = ns). There
      were two postoperative deaths (4.5%) and eight postoperative complications (20%).
      Mean hospital stay for (d+) patients (36.2 +/- 22.8 days) was significantly
      longer than that of the node (-) group (18.3 +/- 5.7 days) (p less than 0.02).
      Over half the (d+) group died within six months and survival was significantly
      worse than in the node (-) group for the following three years. No patient in the
      node (-) group has developed recurrent carcinoma after a mean follow up of 21
      months (6 months - 4 years). Early results suggest that subtotal gastrectomy is
      curative in node (-) patients. Extensive gastrectomies may not be justified in
      patients with advanced gastric cancer if symptoms do not warrant it, as hospital
      stay is likely to be prolonged and long term survival is poor.

PMID- 2228531
TI  - Lung pathology in HIV positive patients.
AB  - We describe the results of 43 bronchoscopic examinations carried out on 35
      patients who were HIV positive. Of these, 13 were intravenous drug abusers, 13
      were homosexual or bisexual, six were haemophiliacs, two were homosexual
      intravenous drug abusers and one was a heterosexual contact of a drug abuser. All
      underwent investigation because of respiratory symptoms. Aetiological diagnosis
      could not be made from physical examination, x-ray or routine laboratory tests
      but, was usually made using bronchoscopy and its associated investigations. Using
      these techniques, Pneumocystis carinii pneumonia was the commonest diagnosis (19
      cases) followed by bacterial infection. Mycobacterial infection accounted for two
      cases and non-specific interstitial pneumonitis accounted for three. Kaposi's
      sarcoma was found in one instance and eight investigations were non-diagnostic.

PMID- 2228532
TI  - Raised PPD antibodies in active pulmonary tuberculosis.
AB  - Antibodies to purified protein derivative of tuberculin (PPD) were measured in 47
      patients with active pulmonary tuberculosis and in various control subjects using
      an enzyme linked immunosorbent assay. Raised IgG anti PPD antibodies were found
      in 30 patients with active tuberculosis, in one of 28 patients with miscellaneous
      non tuberculous diseases and in one of 49 healthy control subjects. This gave the
      assay a sensitivity of 65% and a specificity of 98%. Antibodies were also
      measured in a further 20 patients with suspected tuberculosis but in whom
      microbiological evidence was absent. In eight of these patients active
      tuberculous disease was subsequently validated on the basis of clinical response
      to chemotherapy: raised PPD antibodies were found in six of this group but in
      none of the remaining 12 patients in whom the diagnosis of tuberculosis was
      considered doubtful. Further studies showed that patients' PPD antibody level
      fell over a one year period of successful therapy and that tuberculin skin
      testing and BCG vaccination did not cause a rise in antibodies in healthy
      subjects. These results suggest that the measurement of PPD antibodies is a
      useful adjunctive test in the diagnosis of tuberculosis.

PMID- 2228533
TI  - Metastatic malignant melanoma in pregnancy.
AB  - A 29 year old expectant mother was critically ill at 27 weeks gestation with
      disseminated metastatic malignant melanoma and was treated with dacarbazine. A
      dramatic remission was induced and at 38 weeks gestation she went into labour
      spontaneously and delivered a healthy infant. She relapsed and died eight weeks
      post partum. This is the first reported use of dacarbazine in pregnancy.

PMID- 2228534
TI  - Seal finger in a wildlife ranger.
AB  - We describe a case of septic arthritis of the interphalangeal joint of the thumb
      in a man following a seal bite. Early and continued treatment with antibiotics of
      the penicillin family failed to control the infection. Empirical treatment with
      tetracycline resolved the infection, but the patient has permanent joint damage.
      In apparently ordinary infective conditions, which fail to respond to therapy,
      the history may suggest that an unusual organism is responsible.

PMID- 2228536
TI  - Septicaemia and the prevention of multiorgan failure--the intensive care
      perspective.
AB  - Septicaemia frequently presents without "classic" signs of infection--tachypnoea,
      hypotension and confusion are the commonest features. The mortality rate is 40 to
      80% and in intensive care units, septicaemia accounts for 70% of all deaths.
      Despite the use of antimicrobial drugs to which the offending organism is
      sensitive, patients are still dying. Effects on distant organ systems are due to
      "Mediators". "Microvascular Failure" resulting in tissue hypoxia is the unifying
      hypothesis of multiple organ failure in septicaemia. Mortality is correlated with
      the number of organ system failures. Supportive management is aimed at prevention
      of organ failure--manipulation of the circulation being the central key.
      Intravascular volume expansion, vasoactive drugs, mechanical ventilation and
      invasive monitoring are the means. Antimicrobial therapy must be guided by 'best
      guess' approach with multiple agents until isolation of the offending organism
      can recommend specific therapy. Aggressive surgical drainage or excision, is
      particularly applicable in abdominal sepsis. Several adjunctive therapies aimed
      at mediators of sepsis, are as yet experimental.

PMID- 2228535
TI  - Resuscitation skills among the general public in Dublin.
AB  - Evidence exists that many of the victims of cardiac arrest due to ischemic heart
      disease can be resuscitated if cardiopulmonary resuscitation (CPR) and
      defibrillation are made available in the minutes following collapse. In order to
      evaluate the ability of the general public in Dublin to perform CPR
      appropriately, 225 people were asked when CPR was indicated and how cardiac
      arrest was diagnosed and then asked to perform CPR on a mannequin. In the
      knowledge sections, 45% gave an appropriate indication for CPR and 34% gave
      appropriate criteria for diagnosing cardiac arrest. However, only eight
      participants were able to perform CPR correctly and only six (2.6%) had both the
      correct skills and knowledge. There is an urgent need to improve the public's
      knowledge of and ability to perform CPR as part of an overall strategy to
      decrease mortality from ischemic heart disease in Ireland.

PMID- 2228538
TI  - Current management of gall stones.

PMID- 2228537
TI  - Exercised induced migraine.

PMID- 2228540
TI  - Epilepsy and the European dimension.

PMID- 2228539
TI  - Ulcerative colitis relapse: a continuing enigma.

PMID- 2228541
TI  - Breast enlargement in infants and children.

PMID- 2228542
TI  - The Ugandan AIDS epidemic--a personal comment.

PMID- 2228543
TI  - Blood pressure levels among primary school children.
AB  - Blood pressure, height, weight and body mass index were measured in 1,280 Irish
      children aged 5-12 years (640 boys and 640 girls). Mean systolic and diastolic
      pressures accurate to within +/- 3 mmHg for each one year age-sex-group are
      presented. Blood pressure levels were found to correlate positively and
      significantly with height, weight and body mass index in both sexes. Forty nine
      (8%) boys and 58 (9%) girls were found to have a mean systolic blood pressure
      level above the 95th percentile value recommended by the 1987 Task Force of the
      National Heart Lung and Blood Institute of America. Sixty eight (11%) boys and 71
      (11%) girls had elevated diastolic levels above 95th percentile values, while 19
      (3%) boys and 20 (3%) girls had an elevation of both systolic and diastolic
      pressure. The implications of these findings for Irish children are discussed.

PMID- 2228544
TI  - An evaluation of an anticoagulant clinic.
AB  - Patient comprehension of the risks of anticoagulation, tablet recognition skills
      and knowledge of complications of warfarin therapy were evaluated in 160 patients
      attending the anticoagulant clinic in a central Dublin teaching hospital group.
      Potential complications from over- and under- dosage with warfarin were unknown
      to 119 (74%) and 97 (60%) patients respectively. 1, 3 and 5 mg tablets could not
      be identified by 40 (25%), 55 (34%) and 60 (37%) patients respectively. The
      current prescribed dose could not be recollected by 31 (19%) patients.
      Haemorrhagic complications occurred in 23 (14%) subjects over one year, four of
      whom required hospital admission and two blood transfusions. No thromboembolic
      episodes were noted. This study reveals a widespread lack of understanding of
      anticoagulation and its potential complications in patients receiving warfarin
      therapy and has led to a critical reappraisal of patient education, patterns of
      referral and supervision of such individuals in our clinic.

PMID- 2228545
TI  - Physical signs: papilloedema.

PMID- 2228546
TI  - Contact sports and injury.
AB  - A year long survey of sports injuries in the accident and emergency department of
      St. Luke's Hospital, Kilkenny revealed 864 injuries, with hurling and soccer
      accounting for 41% and 23% respectively. In hurling, lacerations to face and
      scalp, and fractures of the wrist and hand, accounted for a large number of the
      injuries seen, while in soccer bruising and sprains of the lower limbs accounted
      for the majority of the injuries. We make some recommendations for avoidance of
      these injuries. We show clearly that non-accidental or deliberately inflicted
      injury forms a significant proportion of sport injuries and recommended steps to
      curb non-accidental injuries.

PMID- 2228547
TI  - Abuse versus neglect: a model to understand the causes of and treatment
      strategies for mistreatment of older persons.

PMID- 2228548
TI  - How can we best care for persons who are medically indigent in a world of limited
      resources?

PMID- 2228549
TI  - Johnson v. Gross.

PMID- 2228550
TI  - In re Gannon ex rel. Coons.

PMID- 2228551
TI  - Couture v. Couture.

PMID- 2228553
TI  - The hormonal regulation of purine nucleotide turnover. Influence of testosterone
      in rat liver.
AB  - An influence of testosterone on de novo purine nucleotide synthesis has been
      demonstrated in rat liver of adult and prepubertal castrated rats, showing that
      the action of the hormone is not limited to sexual organs. Castration accelerated
      the turnover of purine nucleotides in adults rats and reduced it in prepubertal
      castrated rats. Administration of testosterone tended to restore normality in
      both cases with opposite mechanisms, lowering the reaction rates in the first
      group, enhancing them in the second one. An action of the hormone on the inosinic
      branch-point and specifically on GMP synthesis, was evident, which was again
      different according to the age of the animal. The observed changes in purine
      nucleotide metabolism could be responsible for variations in RNA and DNA
      metabolism, in cellular size and number--which probably occur in the liver--after
      orchiectomy and following androgen administration.

PMID- 2228552
TI  - Tryptophan, copper and zinc in hair of healthy subjects. Correlation with
      differences in hair pigmentation.
AB  - Tryptophan, copper and zinc levels were determined in the hair of 300 healthy
      subjects divided by sex, age and hair colour. Sex influences tryptophan content
      in hair, the levels of this amino acid being higher in males than in females.
      Tryptophan is also higher in infancy (2-5 years) and in both males and females
      aging around 80 years and over. Hair colour also influences tryptophan levels,
      which increase from fair to black hair. Copper levels are similar in hair of both
      males and females, while those of zinc are higher in women. Age influences the
      distribution of these two metals in human hair. Copper contents in hair of males
      are higher at the age 20-40 years. In females, values decrease over the age of 60
      years. Instead, zinc levels are higher between 20 and 60 years in males, and
      between 13 and 19 years in females. As regards hair colour, copper is slightly
      higher in black hair in males and in fair hair in females, and lower in white
      hair in both sexes. Zinc values appear to be higher in red and lower in white
      hair in males. In females they are higher in black hair.

PMID- 2228554
TI  - Primary structure of rat liver L-threonine deaminase.
AB  - The primary structure of rat liver L-threonine deaminase has been studied
      utilizing a highly purified preparation (S.A. = 940 U/mg protein) obtained from
      Wistar male rats. These data have been compared with the predicted sequences
      obtained by other Authors, showing a considerable concordance with the Noda's
      prediction and difference with the Ogawa's results. The FAB-MS analysis has
      demonstrated the presence of an acetyl group as blocking agent on the N-terminal
      alanine.

PMID- 2228556
TI  - The antitumor action of seminal ribonuclease tested with the plasmacytoma spleen
      colonization assay.
AB  - The antitumor action of bovine seminal ribonuclease was evaluated with a
      quantitative assay based on the production of tumor foci in the spleens of mice
      injected with plasmacytoma cells. The antitumor action depended on the integrity
      of the catalytic site, and on the dimeric structure of the enzyme. A working
      hypothesis is proposed, based on these results, and on previous results obtained
      studying the antitumor action of seminal RNAase in vitro on cell cultures.
      According to this hypothesis, the antitumor action is based on the ability of
      seminal RNAase to interact at specific receptor sites on the tumor cell membrane,
      as well as on its RNA degrading ability.

PMID- 2228555
TI  - Amino acid sequence around the pyridoxal 5'-phosphate binding site of rat liver L
      threonine deaminase.
AB  - Rat liver L-threonine deaminase is a pyridoxal 5'-phosphate dependent enzyme. In
      the present study we have studied the amino acid sequence composition of the
      peptide surrounding the coenzyme binding lysine at the active site of the native
      enzyme. We have also examined the homology between this peptide and the analogue
      forms of L-threonine deaminase from different sources.

PMID- 2228557
TI  - Family medicine--an overview.

PMID- 2228558
TI  - Cutaneous leishmaniasis serodiagnosis by immunoperoxidase assay.
AB  - Immunoperoxidase assay was used for the determination of serum-specific anti
      leishmanial IgG antibodies in 65 patients with cutaneous leishmaniasis (CL), in 5
      with visceral leishmaniasis (VL) and in 84 controls. A significant difference was
      observed between CL and VL sera and the control sera when either Leishmania
      major, L. donovani or L. aethiopica intact promastigotes were used as antigens.
      CL patients showed similar activity against L. major and L. donovani antigen
      (titers 4-64 and less than 2-64 respectively), whereas VL patients showed a
      higher activity with the homologous antigen L. donovani (titers 128-2,048). A
      high and significant correlation was demonstrated between immunoperoxidase assay,
      immunofluorescent assay and radioimmunoassay. No cross-reactivity was found with
      sera from malaria patients.

PMID- 2228559
TI  - Oxygen free radical scavenger system intermediates in essential hypertensive
      patients before and immediately after sublingual captopril administration.
AB  - Oxygen-free radical intermediates/scavengers were measured in 43 patients with
      essential hypertension who, although under antihypertensive therapy (without
      angiotensin-converting enzyme inhibitors), still had high blood pressure values.
      Measurements were taken before and 30, 60 and 120 min after sublingual
      administration of 25 mg captopril. Both systolic and diastolic blood pressures
      were reduced significantly. Twenty normotensive healthy volunteers were used as
      controls. The hypertensive patients had lower glutathione peroxide activity
      (GSHPx), higher superoxide dismutase (SOD) and serum glutathione reductase
      activity (GSHRx) compared with the controls. After captopril (30, 60 min) the
      glutathione and GSHPx increased compared with the pretreatment values. SOD and
      GSHRx remained high compared with the controls, while whole blood glucose-6
      phosphate dehydrogenase remained low. Another group of 19 essential hypertensive
      patients, free of any antihypertensive medication (for at least 3 weeks), had
      lower GSHPx, SOD and higher GSHRx than the normal control group. Our results show
      significant differences in the oxygen free radical scavenger system of
      hypertensives compared with the normal subjects. It may be that captopril has a
      concomitant scavenging action together with its antihypertensive effect. Our
      study raises the question whether cell/organ damage will occur in hypertensive
      patients exposed to oxidative stress during periods of low antioxidative
      capacity.

PMID- 2228560
TI  - Prevalence of thyroid disorders among the elderly in Israel.
AB  - The prevalence of thyroid disorders was investigated in 698 elderly people (443
      women and 255 men), registered in special family health clinics of the Israel
      Ministry of Health and in two homes for the aged. The first screening was done by
      serum thyroxine (total T4) examination, and those with values greater than 150
      nmol/l or less than 64 nomol/l underwent further laboratory and clinical
      evaluation in our endocrinological service. Hypothyroidism was diagnosed in 12
      women and 5 men (2.5% of the cohort) and hyperthyroidism in 10 women and 1 man
      (1.5% of the cohort); thus the prevalence of thyroid disorders among the elderly
      was 4% in this population.

PMID- 2228561
TI  - Aquagenic pruritus: prevalence and clinical characteristics.
AB  - We conducted a study of the prevalence and clinical characteristics of aquagenic
      pruritus (AP) in 996 employees at a general hospital. Forty-five of them claimed
      that they had AP, thus giving a reported prevalence of 4.5%; 12 were excluded for
      various reasons and a detailed workup was carried out in 33 people. In more than
      75% of the cases AP had started before age 30 and lasted for over 10 years in
      42%. The onset of AP occurred within 5 min of exposure in 76% of the cases and
      usually lasted between 10 and 30 min. In most cases no association could be
      demonstrated between AP and each of the following factors: place, season, time of
      day, water temperature, type of soap, towelling or mental stress. AP in at least
      one other family member was found in 33% of the cases.

PMID- 2228562
TI  - Carnitine palmitoyltransferase deficiency: a common cause of recurrent
      myoglobinuria.
AB  - Six patients with carnitine palmitoyltransferase (CPT) deficiency were diagnosed.
      Five were males aged 12-48 years and one was a 7-year-old girl. Severe
      myoglobinuria with renal shut-down led to the diagnosis in four, the main cause
      of myoglobinuria being prolonged exertion. Other precipitating factors included
      febrile illnesses, fasting and sleep deprivation. Between attacks, EMG, serum
      creatine kinase (CK) activity and the response of serum lactate to ischemic
      exercise were normal in all patients. The diagnosis of CPT deficiency was based
      on assay of the enzyme by the isotope exchange assay in leukocyte, muscle or
      cultured skin fibroblast homogenates. CPT activity assayed by the forward assay
      under standard conditions was normal. CPT deficiency seems to be a common cause
      of exercise-induced myoglobinuria. Prompt diagnosis can lead to avoidance of risk
      factors and prevention of rhabdomyolysis and its consequences.

PMID- 2228563
TI  - Screening for thyroid disease.

PMID- 2228564
TI  - Acquired von Willebrand's disease, plasma cell dyscrasia, and angiodysplasia:
      more than a coincidence?

PMID- 2228565
TI  - Pregnancy and cavernous sinus involvement in a patient with primary non-Hodgkin's
      lymphoma of bone.

PMID- 2228566
TI  - Electrocardiographic classification of acute myocardial ischemia.

PMID- 2228567
TI  - Inhibition of polyamine synthesis suppresses human lymphocyte proliferation
      without decreasing cytokine production or interleukin 2 receptor expression.
AB  - Difluoromethylornithine (DFMO) irreversibly inhibits ornithine decarboxylase
      (ODC), a crucial enzyme in polyamine synthesis, and impairs mitogen-induced
      lymphocyte proliferation. To examine the mechanism of action of DFMO, we studied
      the effect of this ODC inhibitor on lymphokine production and interleukin 2 (IL
      2) receptor expression. DFMO decreased thymidine uptake of peripheral blood
      mononuclear cells stimulated by the mitogens phytohemagglutinin, concanavalin A,
      phorbol myristate acetate and ionomycin 60-70% compared with untreated cells, and
      the inhibition could be completely reversed by 10 mM spermidine. DFMO had no
      effect on IL 1 production by monocytes exposed to silica particles.
      Concentrations of IL 2 increased 7-fold in DFMO-treated, PHA-stimulated PBMC
      cultures, compared with untreated cells; whereas IL 2 receptor expression as
      measured by the anti-Tac monoclonal antibody was not affected by the inhibition
      of ODC. Mixing experiments using cells cultured with or without DFMO indicated
      that the inhibition by DFMO was not mediated by suppressor cells. Our results
      strongly support the concept that polyamines are required for a relatively late
      event in lymphocyte activation occurring after the interaction of IL 2 and its
      receptor.

PMID- 2228569
TI  - Matching client and therapist ethnicity, language, and gender: a review of
      research.
AB  - The purpose of this article is to examine whether therapy process and outcome are
      influenced by a client-therapist ethnicity, language, or gender match. A review
      of research in this area does not demonstrate support for a client-therapist
      match on any of these variables. The methodological problems and unresolved
      conceptual issues involved in this research may limit the findings. The ethical
      and political context of the research and the implications for mental health
      nursing are explored.

PMID- 2228568
TI  - Alleviation of experimental cyclosporin A toxicity by substitution of fish muscle
      oil as drug vehicle.
AB  - The toxicity of cyclosporin A (CsA) formulated in either olive oil (OO) or fish
      muscle oil (FO) was investigated in groups of normal Sprague-Dawley rats or in
      animals which had undergone laparotomy or unilateral nephrectomy. CsA (25
      mg/kg/day for 14 days) was administered by gavage from the time of operation, and
      indices of renal and hepatic function were determined at regular intervals.
      Urinary thromboxane B2 (TxB2) excretion and whole blood CsA concentrations were
      determined on day 14, when renal histology was also examined. Compared to CsA/OO
      treatment, and observed only in normal animals, body weight was significantly
      increased following administration of CsA/FO, to values similar to those observed
      following treatment with FO alone. Although there was evidence of renal
      dysfunction in all CsA-treated animals, irrespective of drug vehicle, elevations
      in plasma urea and urinary N-acetyl-beta-D-glucosaminidase activity were
      significantly more pronounced in rats given CsA/OO compared with CsA/FO. Indeed,
      compared with pretreatment values, no significant changes in these parameters
      were observed in CsA/FO-treated nephrectomized animals. Whilst there were no
      great differences in plasma creatinine or creatinine clearance rates between
      CsA/OO- and CsA/FO-treated groups, animals given CsA/FO showed less evidence of
      renal structural change as assessed by proximal tubular cell vacuolation,
      basophilia and microcalcification. The extent of hepatic impairment was also
      significantly less pronounced when FO was used as drug vehicle. Groups of CsA/FO
      treated animals also demonstrated significantly lower whole blood CsA levels
      compared with CsA/OO groups; moreover, TxB2 excretion was significantly lower in
      the former group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228571
TI  - Retirement: what happens to the marriage.
AB  - The focus of this descriptive study was to examine what happens to the marriage
      at retirement. The data were to serve as a basis for further investigation toward
      the creation of a marital enhancement program at retirement. Purposeful sampling
      was used to identify the 10 couples who were involved in the study. Findings from
      this study indicated that an effective marital enhancement program at retirement
      would consider the following factors: changes in roles and identity were
      significant stressors during this time; the communication of thoughts was more
      frequent than the communication of feelings; spouses became increasingly aware of
      their partners' faults during retirement; men appeared to be more satisfied in
      retirement than their wives; hobbies and time spent together did not change
      following retirement; children served as important topics of conversation and
      sources of pride and thought; time spent with children following retirement did
      not increase; and children were often unaware of the challenges and changes faced
      by their parents at retirement.

PMID- 2228570
TI  - Enhancing the self-esteem of inpatient alcoholics.
AB  - This study examined the effect of pairing inpatient alcoholics with nursing home
      residents (NHRs) on the alcoholics' self-esteem. In this PALS program, the
      alcoholic inpatients assumed a helping-companion relationship with the NHRs for 2
      hr per day during their last 2 weeks of treatment. Fifty alcoholic inpatients
      were randomly assigned to the PALS program (n = 25) or to the library for free
      reading time (n = 25). The Tennessee Self-Concept Scale (TSCS) was administered
      to all subjects in both groups before and after the interventions. Of the nine
      TSCS scales, the improvement on the Moral-Ethical scale was significantly greater
      in the PALS group. Because the alcoholic inpatients in the PALS group engaged in
      altruistic (moral) behavior, this study provides a logical link between the
      intervention and the outcome, which has been a prevalent weakness in previous
      studies of self-esteem in alcoholics.

PMID- 2228572
TI  - Behavioral competence as a predictor of perceived control in nursing home elders.
AB  - The purpose of this study was to describe the relationship between behavioral
      competence and perceived control in nursing home elders. The literature strongly
      supports perceived control as a primary determinant of psychological well-being
      in nursing home residents. Identifying predictors of this salient variable will
      enhance the development of interventions to increase and maintain control in
      nursing home elders. A nonrandom sample of 134 cognitively intact nursing home
      elders with poor to excellent self-rated physical health was selected from 13
      nursing homes in four counties of a southeastern state. Instruments used included
      the Desired Control Measure and the Philadelphia Geriatric Center Multilevel
      Assessment Instrument. Regression analysis demonstrated that components of
      behavioral competence, time use and self-rated health, explained 34% of the
      variance of perceived control. Additional research questions were identified.

PMID- 2228573
TI  - Facilitating growth and development: a paradigm case for modeling and role
      modeling.
AB  - This article describes an example of a paradigm case for the nursing theory of
      modeling and role-modeling. A synthesis of the mid-range theoretical linkages of
      basic need satisfaction, object attachment, and growth and developmental
      processes derived from the theory and paradigm are described. These theoretical
      linkages guide the assessment, implementation, and evaluation of the nursing care
      and provide the basis for describing the dynamic nurse-client relationship.

PMID- 2228574
TI  - Reorganization of community psychiatric services by professional nurses.
AB  - This article describes the reorganization of one part of an individual, home
      visiting service for mentally dysfunctional women into a group intervention.
      Deinstitutionalization has been followed by escalating health care costs, cost
      containment, and restructuring of services, affecting the already constrained
      resources for community psychiatric services. Faced with these challenges, a
      nursing staff, under the administration of a clinical specialist psychiatric
      nurse, began reorganization of a home visiting service with one trial group. The
      model group used the prior success reports of groups that were adapted
      prospectively with a focus on immediate needs and led by nurses for women. The
      aims were to enhance social supports of the clients while reducing their relapse
      rates and to reduce the personnel time and cost. Evaluation found that these
      objectives were met. Thus, the involvement of nurses in the assessment, planning,
      implementation, and evaluation of its services demonstrates success in the
      redesign and reorganization of community psychiatric services.

PMID- 2228575
TI  - A methodological approach to enhance external validity in simulation based
      research.
AB  - Simulation methodology, as exemplified by use of vignettes, has many advantages,
      such as standardization of data collection procedure, control of extraneous
      variables, and manipulation of variables of interest. The main shortcoming is its
      artificiality and therefore its limited external validity. To determine the
      degree to which findings from simulation research are transferable to the real
      world, a comparison can be made using the same measure on artificial and real
      situations, or the researcher can determine the degree to which a score on the
      simulation compares with a score in the field. The predictive validity approach
      was used in a study that used an artificial method to study patient assault. In
      this study, the intent was to determine the degree of accuracy that the subjects'
      causal attribution scores on an assault vignette were predictive of causal
      attribution scores in the actual assault situation.

PMID- 2228576
TI  - Cruzan and caring for others.

PMID- 2228577
TI  - An alternative to property rights in human tissue.
AB  - A three-tiered legal structure of the substances constitutive of human beings can
      accommodate property rights in new products created by the investment of labor in
      human tissue.

PMID- 2228578
TI  - Community values in Vermont health planning.

PMID- 2228579
TI  - Giving voice to the pragmatic majority in New Jersey.

PMID- 2228580
TI  - Public input into health care policy: controversy and contribution in California.

PMID- 2228581
TI  - A vision of the health decisions movement.

PMID- 2228582
TI  - Democracy and justice in health policy.

PMID- 2228583
TI  - Noncompliance in AIDS research.
AB  - Participants in AIDS research may justify non-compliance with protocols by a
      "coercion defense." While this defense may not be philosophically successful, a
      prudent social policy can enhance compliance by encouraging community
      participation and providing greater access to non-validated therapies.

PMID- 2228584
TI  - The Patient Self-Determination Act: yes.

PMID- 2228585
TI  - The Patient Self-Determination Act: not now.

PMID- 2228586
TI  - Ethics committees as corporate and public policy advocates.

PMID- 2228587
TI  - Business ethics in ethics committees?

PMID- 2228588
TI  - Nancy Cruzan in China.

PMID- 2228589
TI  - "Make me live": autonomy and terminal illness.

PMID- 2228590
TI  - Deciding for others.

PMID- 2228591
TI  - Ethics and objectivity.

PMID- 2228592
TI  - Cruzan: clear and convincing? How can they?

PMID- 2228593
TI  - Cruzan: On taking substituted judgment seriously.

PMID- 2228594
TI  - Cruzan: no rights violated.

PMID- 2228595
TI  - Cruzan:A hostage to technology.

PMID- 2228596
TI  - Serious migraine: a study of some epidemiological aspects.
AB  - Data are scant concerning some epidemiological aspects of those severe headaches
      which cause serious personal and economic morbidity. Our purpose was to study the
      incidence and other epidemiological features of patients suffering from severe
      migraine exacerbations, in an unselected population. The 64 patients who suffered
      from severe migraine bouts represented 10.5% of all the new walk-in neurological
      consultations in the area covered in this study. 70% of these patients were
      between 10 and 39 years old. Although females clearly predominated in all ages
      after fifteen, below this age there was a slight male predominance. The
      calculated incidence of serious migraine exacerbations was 90 per 100,000 people
      per year, the corrected incidence for females being 143/100,000 and for males
      37/100,000. The highest incidence for females was in 15-19 year-olds
      (377/100,000) and for males in 10-14 year-olds (166/100,000). Our data seem to
      confirm the periodic nature of this condition since in 80% of patients the
      migraine bouts (ie: groups of attacks) lasted between two and nine months. Also
      they support the reported existence of genetic and hormonal factors in the
      susceptibility to migraine exacerbations. Our results may help in planning the
      public health aspect of migraine and add some light to the natural history of
      this common condition.

PMID- 2228597
TI  - Swimmer's migraine.
AB  - Three cases of sudden, severe headache occurring during swimming are described. A
      51-year-old female had been engaging in a swimming exercise for about 20 minutes
      when she suddenly experienced a pulsating headache in the parietotemporal region,
      accompanied by nausea. A few days later, she experienced a similar episode, again
      during swimming practice. A 45-year-old male developed a pulsating headache with
      nausea immediately after diving into a swimming pool, and had a similar attack
      during diving practice 1 week later. A 32-year-old male developed a pulsating
      headache accompanied by nausea while swimming in the sea. In all three cases,
      blood pressure, pulse rate, neurological findings, cervical spinal x-rays, brain
      CT scans, and hematological findings were normal and the outcome was good.
      Although these patients' headaches were diagnosed as benign exertional headache,
      pathophysiologically they appeared to resemble the headache associated with
      sexual activity.

PMID- 2228598
TI  - Platelet monoamine oxidase activity in female migraine patients.
AB  - Platelet monoamine oxidase activity (MAO) in a group (n = 17) of white, female
      migraineurs during an acute migraine attack was similar to both the values
      obtained for the same group of patients two to three weeks after the headache
      episode (pain-free period) and to the results obtained for a group (n = 18) of
      sex and race-matched, age-comparable, drug-free healthy volunteers (blind study;
      substrate p-tyramine, 38.7 +/- 5.7, 41.9 +/- 8.8 and 43.0 +/- 3.4 or p
      methoxybenzylamine, 178.9 +/- 11.3, 177.2 +/- 6.9 and 181.0 +/- 9.7
      nmole/hr/10(9) platelets +/- SD respectively). With each patient serving as its
      own control, MAO activity during the migraine episode and when pain-free failed
      to show a significant trend. Neither a number of other medical conditions nor the
      use of several medications appeared to significantly influence our results. The
      present work, while dealing only with a small but well defined patient
      population, argues against the possible usefulness of platelet MAO activity as a
      biological marker for migraine headaches.

PMID- 2228599
TI  - A protocol for butalbital, aspirin and caffeine (BAC) detoxification in headache
      patients.
AB  - The abuse of the combination drug containing butalbital 50 mg, aspirin 325 mg and
      caffeine 40 mg (or BAC), is commonly recognized by headache specialists as
      causing headaches. Despite this widespread problem, there is not a published
      treatment regimen for the BAC detoxification of patients. I describe such a
      protocol which was used four times in three patients. These patients fulfilled
      the diagnostic criteria of the IHS Headache Classification for headaches induced
      by chronic substance abuse (8.2) and analgesics abuse headache (8.2.2). These
      patients took between 150 and 420 BAC/month for 2-15 years. Two patients had
      previously undergone inpatient detoxification. One patient unsuccessfully tried
      detoxification twice as an outpatient. All patients were required to have
      psychological support prior to hospitalization for this protocol. BAC was
      discontinued. A pentobarbital challenge test corroborated butalbital dosage. The
      patients were given phenobarbital and caffeine which were tapered over several
      days. Dihydroergotamine (DHE) with metoclopramide was used (Raskin). Propranolol
      60 mg bid was started. No narcotics were permitted. After hospital discharge,
      patients were allowed to continue subcutaneous DHE, as needed. One patient
      restarted BAC use after 8 months without it. The other two patients were still
      BAC free 18 and 14 months after detoxification.

PMID- 2228600
TI  - Thermographic findings in cranio-facial pain.
AB  - This work assesses the differences in the thermographic findings in the
      craniofacial and neck areas between normal individuals and patients with
      craniofacial pain or headache, and investigates the influence of muscle
      contraction on such findings. Thermographic records were taken in 10 healthy
      subjects and 47 patients suffering from craniofacial pain or headache of
      different kinds. In the patients with painful episodes the record was taken
      between attacks. In all the normal subjects and in 19 patients lateral
      thermograms were also taken during and after maximal tooth clenching for three
      minutes. The majority of the patients, as compared to the normal group, showed
      some thermal alterations and asymmetry. Such alterations seem to be due both to
      vascular instability and muscle contraction: these two factors may be variably
      superimposed in the different conditions. In patients with cluster headache or
      chronic paroxysmal hemicrania the presence on the symptomatic side of a cold spot
      along the supraorbital area and/or the inner orbital canthus, was a constant
      finding. We conclude that thermography is useful as an additional diagnostic
      means in patients with head and face pain, and that the clenching test may
      increase the amount of information provided.

PMID- 2228601
TI  - Dissociation between pain and autonomic disturbances in cluster headache.
AB  - The relationship between pain and autonomic disturbances in cluster headache was
      studied in 54 patients whose attack always recurred on the same side, and in 7
      others whose attack had affected either side on different occasions. In one of
      these seven patients, facial flushing and ocular sympathetic deficit was observed
      on the original side of headaches. In most patients, the orbital region was
      warmer on the painful side but in three cases this region was cooler during and
      between attacks. Lacrimation and rhinorrhoea were more common in severe attacks,
      and the temperature difference between the orbits increased with increasing
      severity of pain. These findings support the view that certain autonomic
      disturbances in cluster headache are provoked by pain. Residual autonomic
      dysfunction could influence autonomic activity during cluster headache. If so,
      residual dysfunction on the pain-free side could explain the dissociation between
      autonomic disturbances and pain observed in a few cases.

PMID- 2228602
TI  - Sinus bradycardia, junctional rhythm and blood pressure increase during repeated
      cluster headache attacks.

PMID- 2228603
TI  - A study of the seasonal variation of migraine.
AB  - Available evidence supports the contention that migraine involves a disturbance
      in serotonin function. Several parameters of serotonin function in humans have
      been found to vary seasonally and may underlie the seasonal fluctuations observed
      in many clinical neuropsychiatric phenomena that are thought to involve serotonin
      dysfunction. We therefore postulated that migraine headaches might also vary
      seasonally and examined the admissions to our hospital over a 20-year period with
      a primary diagnosis of migraine. Peak admissions were found to occur most
      frequently in the spring for females in comparison to males (p less than or equal
      to 0.04, chi-square). The implications of these findings are discussed.

PMID- 2228604
TI  - Clinical characteristics of migraine and episodic tension-type headache in
      relation to old and new diagnostic criteria.
AB  - Eighty-one patients were diagnosed as having migraine, tension headache or both
      according to previously used criteria. Then we performed a standardized interview
      to determine the frequency and severity of headache characteristics used in the
      new operational diagnostic criteria of the International Headache Society (IHS).
      In every patient the original diagnosis fulfilled also the IHS criteria, but in 9
      patients the criteria were only fulfilled in half or less of the attacks, and
      applying the IHS criteria they also achieved an additional diagnosis. In one
      patient these attacks did not fulfill the pain criteria and in 8 (4 migraine, 4
      tension headache) they did not fulfill the criteria for accompanying symptoms.
      Overall the IHS criteria are sensitive and specific, but they may possibly be
      improved with regard to accompanying symptoms. The present study suggests that
      recording of frequency and graded severity of characteristics using a headache
      diary may further improve the distinction between the different types of
      headache.

PMID- 2228605
TI  - Radiation phobia as a culturally mediated reflex.

PMID- 2228606
TI  - Bomb survivor selection and consequences for estimates of population cancer
      risks.
AB  - Health records of the Japanese bomb survivor population [with the 1965 (T65D) and
      1986 (DS86) dosimetry systems] have been analyzed and some evidence found for the
      selection effect hypothesized by Stewart and Kneale. This is found to be
      significant in only the first of the periods examined (1950-1958), and the effect
      diminishes in magnitude thereafter. There are indications that the effect might
      be an artifact of the T65D dosimetry, in which it is observed more strongly than
      in the DS86 data. There is no evidence to suggest that selection on this basis
      might confer correspondingly reduced susceptibility to radiation-induced cancer.
      If, however, one makes this assumption, as suggested by Stewart and Kneale, then
      current estimates of population cancer risks might need to be inflated by between
      5% and 35% (for excess cancer deaths, Gy-1) or between 8% and 40% (for years of
      life lost, Gy-1) to account for this. It is likely that these figures, even
      assuming them not to be simply an artifact of the T65D dosimetry, overestimate
      the degree of adjustment required to the risk estimates.

PMID- 2228607
TI  - Predicted and observed early effects of combined alpha and beta lung irradiation.
AB  - The nonstochastic radiobiological effects of combined alpha and beta irradiation
      of the lungs of rats from inhaled radionuclides were studied. Both respiratory
      functional morbidity at 18 mo and mortality from radiation pneumonitis within 18
      mo after exposure were examined for rats exposed to the beta-emitter 147Pm, the
      alpha-emitter 238Pu, or both combined. The results were used to validate hazard
      function models that were developed (1) for respiratory functional morbidity at
      18 mo and (2) for lethality from radiation pneumonitis within 18 mo. Both models
      were found to adequately predict the experimental observations for chronic alpha
      plus beta irradiation of the lung. Based on this 18-mo study, a relative
      biological effectiveness of approximately seven was obtained for 238Pu alpha
      radiation compared to 147Pm beta radiation for both respiratory functional
      morbidity and lethality from radiation pneumonitis. However, the relative
      biological effectiveness for the alpha radiation is likely to increase with
      longer follow-up.

PMID- 2228608
TI  - Design issues in epidemiologic studies of indoor exposure to Rn and risk of lung
      cancer.
AB  - Recent data on indoor air quality have indicated that Rn (222Rn) and its decay
      products are frequently present in domestic environments. Since studies of Rn
      exposed miners have established that Rn decay products are a lung carcinogen,
      their presence in indoor air raises concerns about an increase in lung cancer
      risk for the general population. To directly evaluate lung cancer risk from
      domestic exposure to Rn and its decay products, as well as to evaluate risk
      assessments derived from studies of Rn-exposed underground miners, several
      epidemiologic studies of indoor Rn exposure have been initiated or are planned.
      This paper calculates sample sizes required for a hypothetical case-control study
      to address several important hypotheses and shows the impact of several difficult
      problems associated with estimating a subject's Rn exposure. We consider the
      effects of subject mobility, choice of the exposure response trend which is used
      to characterize an alternative hypothesis, and errors in the estimation of
      exposure. Imprecise estimation of Rn exposure arises from errors in the
      measurement device, exposure to Rn decay products from sources outside the home,
      inability to measure exposures over time in current as well as previous
      residences, and the unknown relationship between measured concentration and lung
      dose of alpha energy from the decay of Rn and its progeny. These methodological
      problems can result in large discrepancies between computed and actual study
      power. Failure to anticipate these problems in the design of a study can result
      in inaccurate estimates of power. We conclude that case-control studies of indoor
      Rn and lung cancer may require substantial numbers of subjects in order to
      address the many questions of importance that burden current risk assessments
      with uncertainty. We suggest pooling data from studies with the largest numbers
      of cases and with the most precise estimates of Rn exposure as the best approach
      for meeting present research needs.

PMID- 2228609
TI  - Energy deposition at the bone-tissue interface from nuclear fragments produced by
      high-energy nucleons.
AB  - The transport of nuclear fragmentation recoils produced by high-energy nucleons
      in the region of the bone-tissue interface is considered. Results for the
      differential flux and absorbed dose for recoils produced by 1-GeV protons are
      presented in a bidirectional transport model. The energy deposition in marrow
      cavities is seen to be enhanced by recoils produced in bone. Approximate analytic
      formulae for absorbed dose near the interface region are also presented for a
      simplified range-energy model.

PMID- 2228610
TI  - Evaluation of two thermoluminescent detection systems for medical imaging
      environments.
AB  - Thermoluminescent detectors (TLDs) can provide accurate and precise measurements
      for both patient and personnel dosimetry in the medical imaging environment. They
      have the advantages of tissue equivalency, an excellent dynamic range, and dose
      rate independence. In the work reported here, experiments with planar x-ray,
      fluoroscopy, and a 57Co source were conducted to test the repeatability and
      energy dependence of an LiF TL ribbon/automatic reader system and a four-element
      CaSO2 and Li2B4O7 badge/automatic reader system for diagnostic radiology and
      nuclear medicine dosimetry. The results indicate the usefulness and
      appropriateness of the TLD systems tested for both personnel and patient
      dosimetry in the medical diagnostic environment.

PMID- 2228611
TI  - Estimation of neutron dose equivalent at the mezzanine of the Advanced Light
      Source and the laboratory boundary using the ORNL program MORSE.
AB  - To investigate the radiation effect of neutrons near the Advanced Light Source
      (ALS) at Lawrence Berkeley Laboratory (LBL) with respect to the neutron dose
      equivalents in nearby occupied areas and at the site boundary, the neutron
      transport code MORSE, from Oak Ridge National Laboratory (ORNL), was used. These
      dose equivalents result from both skyshine neutrons transported by air scattering
      and direct neutrons penetrating the shielding. The ALS neutron sources are a 50
      MeV linear accelerator and its transfer line, a 1.5-GeV booster, a beam
      extraction line, and a 1.9-GeV storage ring. The most conservative total
      occupational-dose-equivalent rate in the center of the ALS mezzanine, 39 m from
      the ALS center, was found to be 1.14 X 10(-3) Sv y-1 per 2000-h "occupational"
      year, and the total environmental-dose-equivalent rate at the ALS boundary, 125 m
      from the ALS center, was found to be 3.02 X 10(-4) Sv y-1 per 8760-h calendar
      year. More realistic dose-equivalent rates, using the nominal (expected) storage
      ring current, were calculated to be 1.0 X 10(-4) Sv y-1 and 2.65 X 10(-5) Sv y-1
      occupational year and calendar year, respectively, which are much lower than the
      DOE reporting levels.

PMID- 2228612
TI  - Effectiveness of three natural biobarriers in reducing root intrusion by four
      semi-arid plant species.
AB  - Plant root depth, relative density, and an Intrusion Index were determined for
      three grass and one shrub species growing above three different natural
      biobarriers. High-clay content soil was the least effective barrier. Scoria
      (volcanic cinder) was most effective in excluding roots of crested wheatgrass and
      streambank wheatgrass. Root parameters for sagebrush and Great Basin wildrye were
      least growing over a biobarrier mixture of gravel and cobble.

PMID- 2228613
TI  - Atmospheric deposition, resuspension, and root uptake of Pu in corn and other
      grain-producing agroecosystems near a nuclear fuel facility.
AB  - Plutonium released to the environment may contribute to dose to humans through
      inhalation or ingestion of contaminated foodstuffs. Plutonium contamination of
      agricultural plants may result from interception and retention of atmospheric
      deposition, resuspension of Pu-bearing soil particles to plant surfaces, and root
      uptake. Plutonium on vegetation surfaces may be transferred to grain surfaces
      during mechanical harvesting. Data obtained from corn grown near the U.S.
      Department of Energy's H-Area nuclear fuel chemical separations facility on the
      Savannah River Site were used to estimate parameters of a simple model of Pu
      transport in agroecosystems. The parameter estimates for corn were compared to
      those previously obtained for wheat and soybeans. Despite some differences in
      parameter estimates among crops, the relative importances of atmospheric
      deposition, resuspension, and root uptake were similar among crops. For even
      small deposition rates, the relative importances of processes for Pu
      contamination of corn grain should be: transfer of atmospheric deposition from
      vegetation surfaces to grain surfaces during combining greater than resuspension
      of soil to grain surfaces greater than root uptake. Approximately 3.9 X 10(-5) of
      a year's atmospheric deposition is transferred to grain. Approximately 6.2 X 10(
      9) of the Pu inventory in the soil is resuspended to corn grain, and a further
      7.3 X 10(-10) of the soil Pu inventory is absorbed and translocated to grains.

PMID- 2228614
TI  - Short-term bioconcentration studies of Np in freshwater biota.
AB  - Short-term laboratory exposures were conducted to determine the potential
      accumulation of Np in aquatic organisms. Concentration factors were highest in
      green algae. Daphnia magna, a filter-feeding crustacean, accumulated Np at levels
      one order of magnitude greater than the amphipod Gammarus sp., an omnivorous
      substrate feeder. Accumulation of Np in juvenile rainbow trout (Oncorhynchus
      mykiss) was highest in carcass (generally greater than 78% of the total body
      burden) and lowest in fillets. Recommended concentration factors for Np, based on
      fresh weight, were 300 for green algae, 100 for filter-feeding invertebrates, for
      nonfilter-feeding invertebrates, 10 for whole fish, and one for fish flesh.

PMID- 2228615
TI  - Desorption kinetics and mobility of some radionuclides in sediments.
AB  - The desorption kinetics of five radionuclides, 85Sr, 137Cs, 60Co, 54Mn, and 65Zn,
      were studied for several coastal sediments, a few limnetic sediments, and one
      subsoil, using various aqueous solutions for extraction in batch systems. In a 2
      wk desorption experiment, greater than 90% of most radionuclides sorbed were
      extracted by 6N-HCl, whereas in 1N-HCl approximately 30% of the 137Cs was
      retained within the sediments and a soil due to its fixation following
      intraparticle diffusion. For longer desorption periods (6 wk), reversible
      sorption with sediments could be seen for the 137Cs compared with the other four
      radionuclides in seawater. The EDTA-2Na solution extracted greater than 70% of
      65Zn, 54Mn, and 60Co, and the ammonium oxalate extracted greater than 60% of 54Mn
      and 60Co. Readily exchangeable cations extracted by ammonium acetate were greater
      than 80% for 85Sr, approximately 50% for 137Cs, and 40% for 60Co and 54Mn. Many
      of the distribution coefficients for these radionuclides in coastal sediments
      obtained by desorption experiments were one order of magnitude or more larger
      than those obtained by the adsorption experiments. For 85Sr, larger-than-expected
      distribution coefficients were obtained in the desorption experiments, an
      indication of the irreversible formation of metal-oxyhydroxides during a slow
      reaction. Using batch and column diffusion experiments, it was recognized that
      60Co and 54Mn are less strongly associated with coastal sediments under suboxic
      conditions, and their migration rates are greater in deeper layers of sediment
      than in the top layer, an indication that a single Kd model is inappropriate to
      forecast the behavior of radionuclides near sediment surface layers.

PMID- 2228616
TI  - Transmission of a Gaussian scanning beam through circular, square, and slit
      apertures: Part I. Theory.
AB  - Energy and power values for Gaussian profile scanning laser beams through
      circular, square, and slit apertures may be required for hazard analysis in laser
      safety programs. Equations describing the transmitted power for a Gaussian beam
      concentric and eccentric with circular, square, and slit apertures are given.
      Simple expressions of transmitted power and energy with a scanning laser beam
      across the square and slit apertures are derived. For the circular aperture, the
      transmitted power and energy can be calculated conveniently by using the
      correction factors from the graphic values or from the computer programs.

PMID- 2228617
TI  - Transmission of a Gaussian scanning beam through circular, square, and slit
      apertures: Part II. Experimental results for transmission through a circular
      aperture.
AB  - To perform an analysis of the hazards associated with scanned laser radiation to
      determine compliance with either federal or user standards, it is usually
      necessary to determine the amount of energy entering a specified aperture. A
      mathematical model has recently been developed that may simplify the hazard
      analysis. Experimental data and the mathematical model were compared for
      stationary and scanning Gaussian laser beams transmitted through a stationary 7
      mm-diameter circular aperture, representing the dilated pupil of the human eye.
      Data were obtained for three values of laser beam diameter. The data and the
      mathematical model were found to agree within the estimated experimental error
      when the laser beam was concentric with the aperture, the situation typically
      encountered in compliance measurements. For two of the three laser beam diameters
      studied, as the eccentricity of the laser beam with respect to the center of the
      aperture was increased, the difference between the data and the mathematical
      model was found to increase. At the higher degrees of eccentricity, the
      percentage errors were shown to be highly sensitive to the errors in the
      determination of relative position.

PMID- 2228618
TI  - Retention and subsequent release of radioactivity from the incineration of wastes
      containing microspheres.

PMID- 2228619
TI  - Chemical risks from nuclear waste repositories: review of the literature.

PMID- 2228620
TI  - Radon in the human body from drinking water.

PMID- 2228621
TI  - Optimizing radiation worker protection: the practical application of risk
      analysis.
AB  - This paper presents the concepts of equivalent risk and risk minimization in
      optimizing radiation worker protection. When prescribing worker protection
      requirements and identifying work restrictions, all significant contributions to
      worker risk should be considered, not just the risk associated with radiation
      dose. This approach requires a practical application of risk analysis that allows
      comparison of a variety of risks. Examples of the types of worker risks that must
      be evaluated are given, and the author proposes that the scientific community
      develops a methodology for risk comparison that can be implemented via an expert
      system to facilitate risk analysis and decision making.

PMID- 2228622
TI  - Source inventory limits.
AB  - A new set of values has been developed for exempting sealed sources of
      radioactive materials from inventory. The criteria for exemption are: (a) the
      annual occupational dose from external radiation at 1 m from the source is
      approximately 100 microSv (10 mrem) or less; and (b) the source activity is
      approximately equal to the annual limit on intake by inhalation or less than 4 X
      10(7) Bq (1000 microCi). These criteria were selected to correspond to an annual
      occupational dose of approximately 50 to 500 microSv (5 to 50 mrem) and a small
      potential annual risk of approximately 1 X 10(-6) to 1 X 10(-5) fatal cancers or
      less.

PMID- 2228624
TI  - EURADOS-CENDOS discusses ICRP draft recommendations.

PMID- 2228623
TI  - Sex discrimination in prenatal radiation exposure policies of U.S. NRC licensees:
      U.S. NRC staff position.

PMID- 2228626
TI  - Annual per caput effective dose equivalent of Beijing inhabitants from diagnostic
      x-ray procedures.

PMID- 2228625
TI  - Temperature and humidity effects of 222Rn adsorption on activated charcoal
      monitors.

PMID- 2228627
TI  - Certification and its discontents: a history of the moratorium.

PMID- 2228628
TI  - Health education credentialing--an idea whose time has come.

PMID- 2228629
TI  - A patient education program to improve adherence rates with antituberculosis drug
      regimens.
AB  - The design, logic, and results of a two-year health education study directed at
      improving rates of patient adherence to antituberculosis medical regimens are
      presented. An incentive scheme to reward positive health behaviors plus targeted
      educational counseling sessions was implemented in a randomized clinical
      controlled trial. The 205 subjects who participated in the study are categorized
      according to patients with active tuberculosis (n = 88) or preventive patients
      with no evidence of active disease (n = 117). Patients in each of these groups
      were randomly assigned to a special intervention (SI) group or a usual care (UC)
      control group and were followed monthly throughout their treatment program. While
      SI patients with active tuberculosis demonstrated higher levels of appointment
      keeping behavior and mean percent of medication taken compared to UC patients, no
      statistically significant differences between the two groups were found.
      Preventive therapy patients assigned to the SI group, however, were significantly
      more likely than UC patients to remain in care during their 12-month regimen (64%
      vs 47%; p = .003). Furthermore, SI patients had significantly higher levels of
      adherence to their medical regimen compared to UC patients (68% vs 38%; p less
      than .001). These results demonstrate the positive effects of a structured health
      education program on the improvement of continuity of care and adherence behavior
      among patients with tuberculosis.

PMID- 2228630
TI  - Identifying strategies for increasing employee physical activity levels: findings
      from the Stanford/Lockheed Exercise Survey.
AB  - While worksite exercise programs offer a number of potential advantages with
      respect to increasing physical activity levels in American adults, typical
      participation rates remain relatively low. The purpose of this study was to
      explore employee preferences and needs related to physical activity programming
      in a major work setting in northern California. Two-thirds (399) of a randomly
      selected sample of employees responded to a mailed survey. Male and female
      employees reporting no regular aerobic activity over the past two years more
      strongly endorsed a number of erroneous beliefs concerning exercise, reported
      less support for engaging in exercise both at home and at work, and avoided even
      routine types of activity to a greater extent than more active individuals (p
      values less than 0.001). Current exercisers reported use of a greater number and
      variety of motivational strategies as part of their exercise program than past
      exercisers who were not currently active (p less than 0.001). Respondents,
      regardless of exercise status and age, reported preferences for moderate
      intensity activity occurring away from the workplace which could be performed on
      one's own rather than in a group or class. Implications of the findings with
      respect to development of educational and behavioral programs for the current
      employee population are discussed.

PMID- 2228632
TI  - A validity problem in measuring exposure to mass media campaigns.
AB  - Recognition of radio and television messages included in three mass media
      campaigns designed to keep adolescents from starting to smoke cigarettes was
      measured in six treatment and four control cities (Standard Metropolitan
      Statistical Areas) in the southeastern United States. The telephone survey of 574
      randomly selected adolescents found high recognition of campaign messages even in
      the areas where the campaigns had not been broadcast. Campaign messages that
      differed significantly from other anti-smoking messages were less likely to be
      falsely recognized. These results reinforce the need to include true control
      groups in mass media evaluations and to construct distinctive messages if
      exposure is an important aspect of campaign evaluation.

PMID- 2228631
TI  - Attitudes and behaviors of Hispanic smokers: implications for cessation
      interventions.
AB  - The smoking behavior of Hispanics, especially Mexican Americans, has been
      reported to differ from that of non-Hispanic whites, in both large gender
      differences in prevalence as well as a lower self-reported number of cigarettes
      smoked per day. This study compared the responses of a convenience sample of 263
      Hispanic (44% Mexican American and 38% Central American) and 150 non-Hispanic
      white smokers, in order to identify other ethnic; gender, and acculturation
      differences in smoking behaviors. Hispanic women smoked fewer cigarettes and
      initiated smoking at a comparatively later age than Hispanic men; they were also
      less likely to smoke during pregnancy than non-Hispanic white women. Hispanics
      smoked more cigarettes on Saturday than other days, but this was not true for non
      Hispanic whites. Will power (voluntad propia) and knowing the negative effects of
      smoking were considered the most helpful techniques for quitting by Hispanics.
      Considering that light smokers are able to quit with less intensive cessation
      techniques, these data suggest that a properly developed health education
      community intervention may have an impact on smoking rates among Hispanics.

PMID- 2228633
TI  - Planning and implementing health promotion in the workplace: a case study of the
      Du Pont Company experience.
AB  - This case study describes the needs assessment, design, implementation, and
      preliminary evaluation of a comprehensive workplace health promotion program. The
      company had 110,000 U.S. employees at more than 100 locations engaged in a
      variety of manufacturing, research, sales, and support occupations in 1980. The
      PRECEDE framework was used to focus program planning and evaluation on key areas
      of health knowledge, attitudes, and behavior. The needs assessment included use
      of company morbidity and mortality data, a survey of medical and human resources
      staff, and a survey of employees, spouses, and pensioners. An in-house network of
      lay committees, site medical personnel, and corporate health education, nutrition
      and fitness specialists was used to staff critical program functions.
      Interventions included: public health approaches to program kick-off and health
      risk assessment; group and self-directed lifestyle change activities; recognition
      and awards; and workplace climate changes such as smoking policies that favor
      nonsmokers. One pilot location experienced a 47.5% decline in hourly employee
      absenteeism over six years versus a 12.5% decline in the total Du Pont hourly
      workforce. A number of lessons are discussed on how to improve the planning,
      implementation, institutionalization, and evaluation of health promotion programs
      in large industrial companies. Four areas where future research and practice
      should be focused include: reaching spouses, sales personnel, shiftworkers, and
      employees at small sites; balancing what is popular with what reduces risks over
      the long-term; documenting program impacts when research resources are scarce;
      and integrating health promotion programs with workplace medical, safety,
      employee assistance and benefits programs.

PMID- 2228634
TI  - Essential elements of self-help/minimal intervention strategies for smoking
      cessation.
AB  - Two decades of research suggest that self-help/minimal intervention strategies
      for smoking cessation may be the preferred means by which smokers stop and can
      produce success rates approximating those of more formal programs, at lower cost
      and with greater access to relevant populations. In order to make the best
      possible use of these self-help/minimal intervention approaches, the National
      Cancer Institute (NCI) supported a series of randomized, controlled intervention
      trials and, in June of 1988, convened an Expert Advisory Panel to address the
      question "What are the essential elements of self-help/minimal intervention
      strategies for smoking cessation?". The panel's recommendations were that: (1)
      Intervention efforts should focus on increasing smokers' motivations to make
      serious quit attempts; (2) Delivery of programs be broadened to include all
      smokers; (3) Programs be targeted to stages of cessation and specific
      populations; (4) All programs include (a) elements focused on health and social
      consequences of smoking, and (b) strategies and exercises aimed at quitting,
      maintenance of nonsmoking, relapse prevention, and recycling; (5) Materials and
      programs be made widely available rather than "fine tuning" existing programs or
      developing new ones; and (6) Programs make use of specific adjunctive strategies.
      In this way, a reacceleration of the decline in smoking prevalence may be
      realized in the 1990s and significantly contribute to the NCI's Year 2000 goals
      and the Surgeon General's aim of a smoke-free society.

PMID- 2228635
TI  - Virginia Bottomley: the caring face of the marketplace. Interview by Nick Robin.

PMID- 2228637
TI  - Public health: back to the future.

PMID- 2228636
TI  - Looking to a green tomorrow's world.

PMID- 2228638
TI  - Sense and science.

PMID- 2228639
TI  - Antenatal classes: becoming a mother.

PMID- 2228640
TI  - Maternal perceptions of child health care.

PMID- 2228641
TI  - Health visitors and health promotion.

PMID- 2228642
TI  - Community involvement: health mornings in the inner city.

PMID- 2228643
TI  - Infant feeding practices in Britain.

PMID- 2228645
TI  - Your rights at work. Contracts--beyond the bounds.

PMID- 2228644
TI  - Health promotion: running a health information desk.

PMID- 2228646
TI  - Race and benefits. 1.

PMID- 2228647
TI  - Pivotal role of early and sustained infarct vessel patency in patients with acute
      myocardial infarction.
AB  - Thrombolytic therapy in acute myocardial infarction unequivocally has improved
      short- and long-term mortality. The fundamental goal of therapy for evolving
      myocardial infarction is early and sustained infarct vessel recanalization. The
      mechanisms linking an open artery with improved long-term survival and other
      clinical outcomes are presented with use of data from extensive clinical trials.

PMID- 2228648
TI  - Clinical controversies surrounding thrombolytic therapy in acute myocardial
      infarction.
AB  - The treatment of acute myocardial infarction has changed tremendously in the past
      decade because thrombolytic therapy has become the treatment of choice for the
      patient with acute myocardial infarction. Although many issues have been
      resolved, several controversial issues remain unresolved. This article addresses
      thrombolytic agents in terms of their superiority in achieving infarct vessel
      patency and mortality reduction as well as the role of thrombolysis in patients
      who present with chest pain of greater than 6 hours' duration, who are elderly,
      and who have an inferior infarction.

PMID- 2228649
TI  - Role of angioplasty in myocardial infarction management strategies: a review.
AB  - The role of angioplasty in acute myocardial infarction has been extensively
      studied in the past few years. Although angioplasty in some circumstances can be
      the primary reperfusion intervention, logistic problems and the excellent results
      of intravenous thrombolytic therapy have resulted in postlytic angioplasty being
      the preferred use of this interventional strategy. Clinical trials of this
      strategy have not supported its routine use, however, and a much more selective
      application of postthrombolytic coronary artery dilation is advocated at this
      time.

PMID- 2228650
TI  - Effects of heparin versus saline solution on intermittent infusion device
      irrigation.
AB  - The purpose of this study was to compare the effectiveness of 1 ml of 0.9% sodium
      chloride with 10 units of heparin in 1 ml sodium chloride solution, both
      containing benzyl alcohol, in maintaining patency and reducing the incidence of
      phlebitis in patients with intermittent infusion devices. The subjects (N = 32)
      were randomly assigned in a double-blind experimental design. Repeated-measures
      analysis of variance revealed no significant difference between the groups in
      phlebitis or patency variables. The results from this controlled study would
      suggest that 0.9% sodium chloride is as effective as 10 units of heparin in
      sodium chloride solution in maintaining intermittent infusion device patency and
      preventing phlebitis.

PMID- 2228651
TI  - Obtaining reliable plasma sodium and glucose determinations from pulmonary artery
      catheters.
AB  - In critically ill patients, blood specimens are frequently withdrawn from
      intravascular catheters without consideration of possible infusate contamination,
      of test accuracy, or of undue blood loss. The reliability of sodium (Na+) and
      glucose determinations withdrawn from the venous infusion port of a pulmonary
      artery catheter was studied in 30 patients after cardiac surgery. Catheter
      patency was maintained by a saline and heparin infusate. Venipuncture samples for
      Na+ and glucose served as controls. A sample containing the dwell volume of the
      catheter and the stopcock (1 ml) was withdrawn and discarded, followed by fifteen
      1 ml samples being taken for analysis. It was concluded that Na+ values are
      stable after discard of the catheter dwell volume and an additional milliliter of
      blood. Minimal clinical differences were found in the glucose values after
      discard of the catheter dwell volume and two additional milliliters of blood.

PMID- 2228652
TI  - Evaluation of manometer use in manual ventilation of infants in neonatal
      intensive care units.
AB  - Variations exist in the techniques used to perform manual ventilation in neonates
      and in the proficiency levels of nurses in neonatal intensive care units (NICU)
      who perform the procedure. This study was undertaken to determine (1) whether
      significant differences exist in nurses' ability to control prescribed peak
      inspiratory pressure (PIP) accurately when mamometers are used, as compared with
      when they are not used, during manual ventilation in NICU infants; and (2)
      whether the number of years of work experience nurses have in the NICU is related
      to manometer use and success in controlling prescribed PIP. The sample included
      60 professional nurses whose experience ranged from 1 to 26 years. A
      statistically significant difference was found in nurses' ability to control PIP
      successfully when manometers were used as compared with when they were not used
      (t = 12.04, p = 0.001). Nurses with more experience tended to rely less on
      manometers to guide their manual ventilation techniques, but were also less
      accurate in controlling the delivery of PIP without the devices. We provide
      recommendations for clinical practice based on these findings.

PMID- 2228653
TI  - Effects of supplemental oxygen administration in an infant with pulmonary artery
      hypertension.
AB  - In patients with pulmonary disease, pulmonary artery hypertension often occurs as
      a result of pulmonary artery vasoconstriction, primarily from hypoxia and
      alveolar hypotension. In this report we describe the hemodynamic effects of
      breathing supplemental oxygen in a child with bronchopulmonary dysplasia and
      pulmonary artery hypertension. These hemodynamic effects include an improvement
      in oxygenation, an increase in systemic vascular resistance, and a decrease in
      the pulmonary vascular resistance. As a direct result of these changes in
      vascular resistances, alterations of heart rate, cardiac index, stroke volume,
      aortic pressure, oxygen consumption, and pulmonary artery pressure have been
      shown to occur. Oxygen is widely used to treat many physiologic conditions.
      However, during the administration of supplemental oxygen, rarely do we recognize
      the hemodynamic changes associated with its use. These hemodynamic effects must
      be clearly understood and appreciated before oxygen administration in any
      clinical situation.

PMID- 2228654
TI  - Impact of cardiac transplantation on the spouse's life.
AB  - The purpose of this research was to explore the effect of waiting for heart
      transplantation and the effect of the transplantation on the life, relationship,
      and reported stress of the patient's spouse. A cross-sectional descriptive design
      was used. The impact of both the pretransplant (waiting) and posttransplant
      periods was measured by using the Perception of Heart Transplantation
      Questionnaire (PHTQ) and the Subjective Stress Scale (SSS). Thirty spouses of
      patients who had undergone cardiac transplantation completed the mailed
      questionnaires. Results indicated that spouses perceived the pretransplant period
      to have a greater overall influence on their lives and relationships (p less than
      0.001) than did the posttransplant period. Their impression of the posttransplant
      period was significantly more positive than of the pretransplant period (p less
      than 0.001). However, no significant differences between pretransplant and
      posttransplant stress scores were found. These results demonstrate the great
      impact of the waiting period on the spouse's quality of life. Additional research
      is needed.

PMID- 2228655
TI  - Improving family functioning after cardiac surgery: a randomized trial.
AB  - As part of a randomized clinical trial of in-hospital and postdischarge nursing
      interventions designed to facilitate the individual patient's recovery and
      improve the family's functioning after cardiac surgery, we followed 67 patient
      spouse pairs for 6 months after surgery. Family health was appraised by using
      three pencil and paper measurements: the Family APGAR, the Locke-Wallace Marital
      Adjustment Scale, and the Family Inventory of Resources for Management. Mixed
      effects analysis of variance did not detect differences for the main effect of
      intervention group; however, the main effect of time was significant for both
      patients' and spouses' APGAR scores and for patients' Marital Adjustment Scale
      scores, suggesting a pattern of response during recovery from cardiac surgery.

PMID- 2228656
TI  - Critical care family needs: nurse-family member confederate pairs.
AB  - In this study we explored the relationship between critical care family members'
      perceived needs and the assessment of these needs by a confederate sample of
      intensive care unit (ICU) nurses. Family needs were measured by using Molter's
      revised Critical Care Family Needs Inventory. Data consisted of 92 confederate
      pairs of Critical Care Family Needs Inventory responses obtained from 92 family
      members of adult patients hospitalized in a variety of ICUs and 49 ICU nurses
      providing direct care for these patients. Paired t tests (two tailed) were
      calculated to detect significant differences between confederate pairs of family
      members' perceptions and ICU nurses' assessments of the importance of the needs
      studied. Family members' perceptions and ICU nurses' assessments of the most and
      least important critical care family needs were identified. Significant (p less
      than 0.001 to p less than 0.05) differences were detected between confederate
      pairs of family members' perceptions and ICU nurses' assessments of the
      importance of 15 (50%) of the critical care family needs studied. Therefore, it
      appears that these nurses were only moderately accurate in their assessments of
      critical care family needs. Implications for nursing practice, education, and
      research were identified and discussed.

PMID- 2228657
TI  - Effects of anxiety on family members of patients with cardiac disease learning
      cardiopulmonary resuscitation.
AB  - The effects of anxiety on learning cardiopulmonary resuscitation (CPR) by family
      members of patients with cardiac disease was examined. Family members of
      hospitalized patients (n = 17), family members of nonhospitalized patients (n =
      12), and a control group (n = 21) all took one of nine Heart Saver programs in
      which CPR was taught and performance evaluated. Subjects took the State Anxiety
      Inventory three times: immediately before the program, immediately after the
      performance test, and 2 months after completion of the program. Family members of
      hospitalized patients had significantly higher before-program anxiety scores than
      the other groups. This difference was not present immediately after the program
      or 2 months later. Family members of hospitalized patients showed a significant
      decline in anxiety over the three testing times. These outcomes support the
      benefit of teaching CPR to this group.

PMID- 2228658
TI  - Effect of activity on supraventricular tachyarrhythmias after coronary artery
      bypass surgery.
AB  - The purpose of this study was to evaluate patient activities, professional staff
      activities, backrest position, and diurnal variations as factors that may
      contribute to the onset of supraventricular tachyarrhythmias (SVT) after coronary
      artery bypass surgery (CABG). The activities surrounding the recognition of first
      onset SVT, as well as preoperative and postoperative data and patient
      characteristics were examined in 249 patients having CABG. One hundred seventy
      three patients qualified for the study; 28% of these patients (n = 49) had SVT.
      No statistical difference was found between the subjects with SVT and those
      without SVT when sex, cross-clamp time, creatine kinase peak, hemoglobin and
      hematocrit levels, and number of bypasses were examined. Patients who had SVT
      were older than those who did not: 64.8 years for the SVT group versus 60.7 years
      for the non-SVT group (p less than 0.01). SVT was rare in the first 24 hours
      after surgery, whereas 60% of the cases occurred during the next 48 hours,
      without significant diurnal variation: mean time of onset was 11:50 AM. No
      particular activity of the patient or nurse influenced the onset of SVT during
      the postoperative period in this group.

PMID- 2228659
TI  - Trapped-lung syndrome after cardiac surgery: a potentially preventable
      complication of pleural injury.
AB  - A case of trapped-lung syndrome after coronary artery bypass grafting (CABG) is
      presented. A significant pleural injury occurred during the bypass operation
      resulting in intrapleural hemorrhage, pleural fibrosis, and trapped-lung
      syndrome. The physicians caring for the patient when she was first seen with the
      trapped-lung syndrome were unaware of the potential relationship between the two
      prior bypass surgeries to this pulmonary complication. Recognition of the
      potential for pleural injury to occur after cardiac operations is important and
      may allow for earlier diagnosis and institution of appropriate therapeutic
      interventions. Early recognition and treatment with pleural fluid drainage and
      reexpansion of the collapsed lung may help prevent this potentially serious
      pleuropulmonary complication from occurring. In addition, the presentation of
      this pleuropulmonary complication may be delayed after the cardiac surgery,
      making early diagnosis more problematic.

PMID- 2228660
TI  - Semiventricular tachycardia.

PMID- 2228661
TI  - Chronic encephalitis caused by leukoencephalopathy.
AB  - As mentioned previously, both MS and PML are demyelinating conditions of the CNS
      and pose diagnostic difficulties in their differentiation because of similarities
      in their clinical findings. However, certain features unique to each of these
      diseases are helpful in clinical diagnosis. MS, unlike PML, is a disease of
      unknown cause. Polygenetic influences in combination with exposure to an
      environmental agent and immune-mediated factors may be operative in the
      pathogenesis of MS. Age of onset peaks in the third to fourth decades with a
      predominance in women, as contrasted with PML, which peaks in the fifth to sixth
      decades in most non-AIDS-associated cases with a slight predominance in men. MS
      is more prevalent in areas farther from the equator: North America, Europe,
      Australia, and New Zealand. Common initial symptoms seen in MS include bilateral
      limb weakness (with the legs being affected twice as often as the arms),
      hyperreflexia, spasticity, optic neuritis, diplopia, incoordination, and
      paresthesias. (Paresthesias are typically found in the lower limbs in a symmetric
      pattern, but may follow no obvious anatomic distribution and often do not
      correspond to the distribution of sensory symptoms. Vibration and position sense
      are more frequently disturbed than pain and temperature.) Intellectual impairment
      and mental deterioration are uncommon early in MS, whereas they are a more
      frequent initial presentation in PML. In addition, the presence of speech
      impairment and monoparesis or hemiparesis with homonymous hemianopsia is more
      suggestive of PML. Brain stem involvement is infrequent.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2228662
TI  - Required request: why it has not significantly improved the donor shortage.

PMID- 2228663
TI  - Ethical issues in critical care. Who should decide?

PMID- 2228664
TI  - Wolff-Parkinson-White syndrome.

PMID- 2228665
TI  - The standard of care for the nursing diagnosis of ineffective airway clearance.

PMID- 2228666
TI  - Ethics of the 'doctor-nurse' game.

PMID- 2228667
TI  - [Callus distraction by an internal bone transport system in unilateral fixation].
AB  - The problem of the treatment of bone defects can be solved by distraction
      osteogenesis as developed by ILIZAROV. This study shows how the bone transport
      technique can be adapted to every common external fixator while using a new
      internal distraction system. In 20 dogs a bone defect of 6 cm was performed at
      the femur. The femur was stabilized with an unilateral frame. A proximal or
      distal corticostomized bone fragment (length 2.5 cm) was descended through the
      bone defect (1 mm day). In 15 dogs a new regeneration of bone was observed. The
      quality of the regenerated bone depends upon stability of the fixation. In 5 dogs
      with osteotomy and rapid dislocation of the transported fragment no bone bridging
      was found.

PMID- 2228668
TI  - [Interlocking intramedullary nailing. A solid aiming device for distal locking].
AB  - An additional aiming-device to the original Hielekes intramedullar locking nail
      system is presented and described. It simplifies greatly the difficult
      performance of distal locking of a tibial nail. The principle is a firm
      connection between the intramedullar nail and the aiming-device as well as
      between the aiming-device and the tibia.

PMID- 2228669
TI  - [Pedicled muscle flap in secondarily exposed plate of the lower leg].

PMID- 2228670
TI  - [Recurrent carpal tunnel syndrome--caused by an inadequate surgical technique?].
AB  - The carpal tunnel syndrome (CTS) is a common disease, and the decompression of
      the median nerve is one of the most often performed procedures in surgery. Within
      our patients from the 1. 12. 1987 to the 1. 12. 1988 we found 16 cases of
      recurrent CTS. Intraoperatively in more than 60% of the cases we could detect
      some sort of subluxation or even luxation of the median nerve and severe scarring
      involving the median nerve and the regenerated transverse carpal ligament in all
      cases. Considering the anatomy of the transverse carpal ligament, to guide the
      median nerve and the flexor tendon within the carpal tunnel, as well as serving
      as origin for the thenar musculature, especially for the opposition, one
      concludes that the simple dissection of the carpal ligament should be avoided.
      For the past 4 years we therefore have been performing a widening Z-plasty and
      reconstruction of the transverse carpal ligament, for the primary CTS as well as
      for revisions. The favorable postoperative results seem to confirm our theory. We
      discuss our operative technique as well as the results in CTS revision cases.

PMID- 2228671
TI  - [Ultrasonic diagnosis of meniscus lesions].
AB  - Controversy exists about the value of ultrasonography of meniscal tears. We
      therefore examined 101 knee joints of 99 patients in a prospective study. Prior
      to the arthroscopy the menisci were scanned from an independent team by using 7.5
      and 10.0 MHz ultrasound waves. 81 meniscal tears were seen at arthroscopy; 36% of
      these tears could not be detected with the scanner (? false negative results)
      while 20% of intact menisci showed positive echogenic structures, which were
      analysed as meniscal tears. It seems that ultrasonography of the menisci is still
      of experimental use without any clinical importance.

PMID- 2228672
TI  - [Clinical aspects, diagnosis and therapy of genuine bile duct cysts].
AB  - During an eight-year period eight patients with intra- or extrahepatic bile duct
      cysts were treated at our institution. One patient belonged to Type I, four to
      Type IV and three to Type V according to the classification by Alonso-Lej/Todani.
      The main symptom among the Type IV patients was jaundice, among the Type V
      patients abdominal pain. The correct diagnosis could be established by ERCP in
      seven of eight cases. Two type V patients with disease mainly confined to one
      lobe of the liver could be resected, one patient was treated endoscopically, the
      others underwent biliary drainage procedures.

PMID- 2228673
TI  - [Traumatology and emergency medicine: helicopter evacuation in the Basel area].
AB  - 999 patients were treated and evacuated by medical helicopter in the region of
      Basel between 1986 and 1988. 687 were trauma patients (70.5%) and among them
      53.9% were directly treated on the accident scene. Mortality during the
      stabilization prior to transport (2.6%) and during transport (0.3%) was low. The
      presence of a physician in the helicopter allows fast and intensive in-field
      care. All life-saving procedures like endotracheal tubes (36.3%), closed
      intercostal drainage (7.4% of trauma patients) and cardiovascular reanimation
      (1.9), even hemostasis, or fixation of fractures are performed. Early in-field
      intensive care by medical helicopter decreases lethality and mortality and must
      be recommended by severe trauma.

PMID- 2228674
TI  - [Technique of bile duct revision].
AB  - In view of the progress of endoscopic treatment of common bile duct pathologies
      the management of retained common duct stones following simple cholecystectomy
      has become a minor problem. Nevertheless duct stones should be recognized and
      removed during the cholecystectomy procedure. High risk patients or extreme forms
      of acute inflammation are an exception. For this purpose a standardized technique
      of revision of the common bile duct is recommended. We describe such a technique
      of the exploration of the common bile duct by means of manual extraction, Fogarty
      catheter, irrigation, distension--irrigation and flexible choledochoscopy.

PMID- 2228676
TI  - [Use of photoplethysmography with calibration in vivo for assessing venous
      hemodynamics of the lower extremity and particularly ambulatory venous pressure
      and refilling time after exercise].
AB  - Several invasive and non-invasive methods are used actually for the appreciation
      of the morphology and the function of the venous system of the lower extremity.
      Hemodynamic parameters like the ambulatory venous pressure and the venous
      refilling time can not be determined without invasive measurements. This report
      describes the results of a prospective comparison of the ambulatory venous
      pressure and the venous refilling time with the in vivo calibrated
      photoplethysmography and with invasive measurements. Postural changes of
      hydrostatic pressure permitted in vivo calibration of the photoplethysmograph. We
      recorded quantitative photoplethysmography (PPG) ambulatory venous pressure and
      venous refilling time in 20 normal subjects, 20 patients with superficial
      varicosis and in 20 patients with chronic venous insufficiency. Quantitative
      photoplethysmography correlated closely with invasive measurements of ambulatory
      venous pressure with respect to estimated drop in superficial venous pressure and
      recovery time. PPG estimates of intravenous pressure in normal patients (24 +/- 9
      mm Hg), in patients with varicosis (42 +/- 7 mm Hg) and post-thrombosis patients
      (63 +/- 9 mm Hg) agreed with ambulatory venous pressure measurements 22 +/- 9 mm
      Hg, 40 +/- 6 mm Hg and 61 +/- 6 mm Hg, respectively. Non invasive, quantitative
      photoplethysmography may prove to be an accurate estimate of ambulatory venous
      pressure in patients with superficial varicosis and in patients with chronic
      venous insufficiency.

PMID- 2228675
TI  - [Extracorporeal piezoelectric gallstone lithotripsy: initial surgical experience
      with a new treatment. Technique and indications].
AB  - The extracorporeal piezoelectric lithotripsy (EPL) is a new method for non
      operative therapy of symptomatic gallbladder and problematic bile duct stones.
      The rare intrahepatic calculi were similarly disintegrated. Best results were
      reached with EPL as adjuvant measure or combined with oral cheno- and
      ursodeoxycholic acid therapy. EPL compared to other lithotripsy techniques is
      performed without any analgesia. That means advantage and patient's benefit.

PMID- 2228677
TI  - [Drug-induced acute arterial occlusion].
AB  - An acute ischemia has almost its origin in a mechanical obstruction of the vessel
      caused by embolus, thrombose or dissection. An ischemia caused by medicament,
      excepted the erronated intraarterial injection of vasoconstrictive medicament, is
      very seldom encountered in the clinic. We describe the case of a young woman who
      was referred to our clinic for investigation and treatment of an acute ischemia
      of both limbs. In her past medical history she was treated because of a liver
      insufficiency occurring after a spontaneous abortion and received
      methylergometrine (Methergin) for uterine stimulation. Because of this unusual
      manifestation in a young patient with a complicated past medical history we
      considered the possibility of a drug induced ischemia caused by ergotamine
      derivate. The rapid recovering after treatment with chlorpromazine and nifedipine
      confirmed the suspected diagnosis. A well defined therapy of this rare
      complication has not been described; vasodilatators, nitroglycerin, calcium
      antagonists and even streptokinase and balloon dilatation are proposed.

PMID- 2228679
TI  - [Does the surgeon have to master sonography? Results of a survey in Swiss
      clinics].
AB  - The range of applications for sonography in medicine is widening rapidly. More
      and more specialists are doing their particular sonographic examinations
      themselves. In other countries ultrasound is already part of the postgraduate
      surgical training. A questionnaire was sent to 142 surgical clinics in
      Switzerland to assess the present situation of ultrasound in surgery and to find
      out if changes are desirable. 112 questionnaires were returned. In 107 hospitals
      ultrasound equipment was available. Only 31 clinics had a surgeon trained in
      sonography amongst their staff, although 71 would like to start sonography in
      their clinic. Courses in sonography were considered necessary 87 times and most
      important, 83 clinics (74%) agreed to the introduction of ultrasound into the
      postgraduate training of Swiss surgeons.

PMID- 2228678
TI  - Experimental porcine orthotopic liver transplantation: a training protocol for
      transplantation in humans.
AB  - The authors suggest that, prior to human liver transplantations, exhaustive
      training be undertaken on an animal model in order to acquire the expertise
      required for this delicate procedure. The pig has considerable anatomic
      similarities to man, as well as a comparable physiological and hemodynamic
      sensitivity, and has been used as a model by our experimental team to perfect our
      clinical liver transplantation technique. In particular, a surgical model
      representing the adult donor/child recipient situation has been developed.
      Anesthesia, extracorporeal bypass procedure and the full surgical protocol are
      described. This operative protocol was elaborated to mimic as closely as possible
      the clinical situation. Our model also allowed us to undertake several relevant
      physiological and pharmacological studies during the transplantation procedure.

PMID- 2228680
TI  - [Surgical treatment of cholelithiasis and its complications. Comparison of 2
      treatment periods].
AB  - We have realized a retrospective analysis of all cholecystectomies performed
      during two five-year periods (period I: 1970 to 1974, period II: 1984 to 1988)
      for stone disease. We were especially interested in the development concerning
      the type of intervention, the diagnostic procedures, the morbidity and mortality.
      Our analysis showed in the second period the substitution of the preoperative
      diagnostic procedure away from the cholangiography up to the ultrasound, a
      significant decrease of interventions, a marked decrease of surgically performed
      papillotomies and a reduction of mortality.

PMID- 2228681
TI  - [Rupture of a subcapsular liver hematoma in the postpartum period associated with
      HELLP syndrome].
AB  - We describe the case of a 31-year-old woman who underwent a section caesarean and
      24 hours later a laparotomy for treatment of a ruptured subcapsular liver
      hematoma due to a HELLP syndrome. The HELLP syndrome (hemolysis, elevated liver
      enzymes, low platelets count) is a serious complication of the pregnancy with or
      without eclampsia. This complication has a high mortality and morbidity and can
      occur during the pregnancy or after delivery. The diagnosis of a subcapsular
      hematoma of the liver should be considered in patients with acute abdominal pain
      in the last trimenon or just after delivery. Laparotomy must be performed at the
      first signs of hemodynamic instability.

PMID- 2228682
TI  - [Acute appendicitis: avoiding unnecessary laparotomy in young women].
AB  - Eighty-eight consecutive patients undergoing surgery for clinical diagnosis of
      appendicitis are reviewed. The diagnosis was correct in 71 (85%), incorrect in 17
      (15%). Of these 17 patients 5 suffered from other diseases demanding surgical
      treatment (diverticulitis, cholecystitis, torsion of ovarian cyst, pyosalpinx).
      Pain migration, local tenderness and WBC greater than 10,000/mm3 were
      significantly associated with appendicitis, whereas duration of pain, defense
      musculaire and body temperature did not allow any discrimination. In men, the
      diagnosis was correct in 42 out of 43, whereas in women only in 34 out of 45. All
      11 women with incorrect diagnosis were less than 35 years old. We conclude that
      the diagnosis of appendicitis is particularly difficult in women younger than 35
      years.

PMID- 2228683
TI  - [Emergency diagnosis of cecal volvulus].
AB  - Twelve cases of coecal volvulus have been analysed. Given typical signs, plain
      radiography of the abdomen should assure diagnosis. Chronic volvulus requires a
      colon contrast enema for confirmation of diagnosis.. Immediate laparotomy is
      mandatory.

PMID- 2228684
TI  - [Clinical aspects and therapy of intestinal non-rotation in adults].
AB  - The intestinal non-rotation is a rare fetal disorder of the gut torsion. Its
      manifestation is very rarely seen in the adult, either in form of a volvulus of
      the midgut or ileocecal with an acute onset, or as chronic recurrent abdominal
      pain. Each diagnostic or therapeutic delay increases the risk of strangulation
      and may end as an abdominal disaster. We describe three own cases and we try to
      elucidate the diagnostic and therapeutic problems. Our proceeding: In the acute
      symptomatic form the explorative laparotomy with a consequent staging of the
      abdominal situs is the safest way to get an exact diagnosis. Therapeutically the
      procedure described by LADD is the best torsion prophylaxis; the ascending colon
      is sawn to the descending colon. Due to a paratopia, the appendectomy is
      recommended. In the chronic forms the contrast enema and the gastrointestinal
      barium study are the main diagnostic procedures. In the operation described by
      Fitzgerald and the ascending colon and the mesentery of the small bowel are-
      after incision of the common mesentery--fixed at their anatomical site.

PMID- 2228685
TI  - [Choice of technique in "difficult" inguinal hernias. Personal experience].
AB  - The authors refer on their positive results in the treatment of so-called
      difficult inguinal hernias (relapsing or multiple hernias) with the use of
      prosthetic prolene mesh according to Stoppa's procedure (partly modified) through
      a preperitoneal approach after a Pfannenstiel's incision. On the other hand
      recurrent hernias in risky patients as well as gross hernias are treated by
      Rives' method which consists in a prolene mesh placement through the inguinal
      approach.

PMID- 2228686
TI  - [Surgical treatment of acute portal vein thrombosis].
AB  - A concept of the surgical treatment of acute portal vein obstruction is
      presented: thrombectomy, small bowel resection and placing of a portal vein
      catheter for local application of heparin, allowing also angiographic control.
      Two cases are reported. With early diagnosis and surgical therapy acute portal
      vein obstruction seems to have a favorable prognosis.

PMID- 2228687
TI  - [Undifferentiated thyroid cancer: improved therapeutic results following initial
      radical intervention and early postoperative radiotherapy].
AB  - During a 16-year period (1972-1988), 40 out of 477 thyroid cancer patients
      underwent thyroidectomy for undifferentiated thyroid carcinoma. To analyse the
      significance of "radical" versus "palliative" surgical procedures with regard to
      early postoperative course, operative complications and survival, all patients
      records were reviewed and actually followed up. A significant better survival was
      correlated with radical (n = 17) versus palliative tumor resection (n = 23) (p
      less than 0.001), and total thyroidectomy (n = 22) versus subtotal thyroidectomy
      (n = 18) (p less than 0.006). Radical surgery with early postoperative external
      irradiation revealed no postoperative mortality and only one symptomatic cervical
      tumor recurrence. In contrast, palliative surgery, particularly in the case of
      synchronous tracheotomy, was attended with a relatively high mortality (30%) and
      symptomatic local recurrences. The results of this study suggest that in
      undifferentiated thyroid carcinoma without infiltration of the esophageal or
      tracheal mucosa an attempt of radical tumor resection should be undertaken, since
      palliative surgical procedures revealed a significantly lower survival due to
      complications of persistent or recurrent cervical tumor infiltration and
      frequently were accompanied by local complications during the postoperative
      course.

PMID- 2228688
TI  - [Cystadenoma of the pancreas].
AB  - We report on a patient with a microcystic adenoma of the head of the pancreas.
      Cystic neoplasms of the pancreas comprise only about 2% of all exocrine tumours.
      They can be divided into two distinct groups with different prognoses: the
      microcystic glycogen containing tumours, which are always benign and the mucinous
      cystic tumours, the majority of which shows malignant dysplasia. Clinically they
      manifest as a palpable abdominal mass with unspecific upper abdominal pain.
      Preoperative diagnosis is difficult to achieve. Computer-tomography and
      ultrasound are the main radiological facilities that allow some degree of
      differentiation. During operation a frozen section is mandatory to differentiate
      between a pseudocyst and a real cyst with epithelial wall. Resection of the
      tumour is the therapy of choice. The prognosis of the microcystic adenoma is
      good, the prognosis of the mucinous cystadenoma-cystadenocarcinoma is much better
      than the prognosis of the adenocarcinoma of the pancreas.

PMID- 2228689
TI  - [Desmoid tumor and Gardner syndrome: a little known surgical dilemma.
      Presentation of 2 cases].
AB  - Two patients affected with Gardner's syndrome and desmoid tumour are presented: a
      35-year-old man without polyposis coli who developed a clavicular posttraumatic
      desmoid tumour, and a 52-year-old woman with polyposis coli who died of an intra
      abdominal desmoid tumour 3 years after prophylactic colectomy. A close follow-up
      of patients with Gardner's syndrome for early detection of desmoid tumours after
      surgery is recommended.

PMID- 2228690
TI  - [IODIDA scanning for functional and morphologic assessment of the liver and bile
      ducts before and following surgical interventions in bile duct obstruction].
AB  - PROBLEM: Full pre- and postoperative assessment is mandatory in the management of
      complex cases of incomplete biliary obstruction. Investigations should not only
      define the level of extrahepatic bile duct obstruction but also detect
      intrahepatic obstruction, give some index of liver function and of the dynamics
      of biliary flow. Computed tomography, ultrasonography and direct cholangiography
      are very valuable. IODIDA-scanning provides a non-invasive method which not only
      complements other studies but also gives information otherwise unobtainable.
      CLINICAL MATERIAL: In an initial retrospective study 36 patients, 12 of whom had
      previously undergone operation for biliary obstruction, were fully investigated
      with particular reference to the use of IODIDA-scanning. PROCEDURE: 2-5 mCi of
      99mTc labelled IODIDA were injected intravenously and the liver and upper abdomen
      scanned at 1 minute intervals and displayed at 5 minute intervals during the
      first hour. RESULTS: All patients were studied on admission and then
      postoperatively at intervals. In 31 of 36 patients IODIDA-scanning gave reliable
      evidence of the level of obstruction of biliary flow and of the patency of
      biliodigestive anastomosis. Assessment of liver function before and after biliary
      reconstruction was also possible. CONCLUSION: IODIDA-scanning has proved a
      valuable non-invasive method for the assessment of liver parenchymal function,
      intrahepatic abnormalities and of bile flow in cases of complex biliary
      obstruction. This is particularly valuable with the Roux-Y biliary reconstruction
      since ERCP is impossible and PTC an invasive method which, although supplying an
      accurate picture of major biliary obstruction, fails to characterize hepatic
      function and bile flow.

PMID- 2228691
TI  - [Hemostasis in tumors of the pelvis by transarterial embolization].

PMID- 2228692
TI  - [Bone and joint transplantation. Alternatives to bridging segmental bone defects
      and a model for allogenic bone transplantation].
AB  - Fresh allogeneic diaphyseal bone segments were transplanted into 12 dogs. We
      attempted to improve the immunogenity and incorporation of the bone segments
      through "graft manipulation" with and without immunosuppression. Through clinical
      and radiological study during the 20-week experimental period, we observed
      transplant healing with differing structural phenomena. After autologous knee
      joint replantation in 4 dogs and allogeneic transplantation in 2 dogs (with and
      without revascularization and immunomodulation with Cyclosporin A) we present a
      canine model to investigate all open questions about the transplantation of
      allogeneic, fresh joints (i.e. transplant biology, immunology, and vitality).

PMID- 2228693
TI  - [Bile duct reconstruction in liver transplantation].
AB  - Complications of the biliary anatomosis are common after liver transplantation.
      Even with improved techniques the frequency of biliary complications is
      approximately ten percent. Main reason for this high morbidity rate is the
      unfavourable blood supply to the biliary tract. A variant of reconstructions has
      been described and recommended. The end-to-end-choledochocholedochostomy over a T
      tube turned out to be the preferred technique in most centers. In cases of
      different diameter of donor and recipient biliary tract, the side-to-side
      choledochocholedochostomy provides a relayable alternative method. When the
      length of the bile duct doesn't allow direct anastomosis, the gallbladder-conduit
      may help to overcome this problem. The choledochojejunostomy with Roux-en-Y loop
      has become a frequently used biliary anastomosis, especially when the recipients
      bile duct is absent or otherwise destroyed. - Our own experience with fourteen
      liver transplantations shows biliary tract complications in three cases: a
      leakage and a stenosis of the anastomosis after choledochocholedochostomy were
      successfully transformed to a hepaticojejunostomy. In the third case,
      intrahepatic biliary stenosis were treated by percutaneous transhepatic
      dilatation.

PMID- 2228694
TI  - [The University of Wisconsin-solution and elective human liver transplantation].

PMID- 2228695
TI  - [Organ donation for transplantation. Survey of opinions of physicians and
      paramedics in the province of Vaud].
AB  - In 1987, two media campaigns were organized in Switzerland to promote donor
      cards. The purpose of this study was to test their impact on the medical
      community. Questionnaires were sent to qualified practitioners, doctors in
      training and intensive care nurses. It is concluded that the campaigns for organ
      donation must be repeated and that their quality can be improved. It is however
      more urgent to improve the level of knowledge among doctors and other health
      professionals.

PMID- 2228696
TI  - [Text, archiving, coding--integration with electronic data processing].
AB  - For a successful computer-installation in the medical area you need a staff,
      which is used to work with computers in the daily routine. We tried with this
      project to establish the computer in a medical office by doing the whole patient
      related writings on a specially tailored software. Most of the daily routine can
      now be done with the help of the computer. A certain time-saving effect could be
      achieved, although this was not our first aim. On this base we are now able to
      solve other problems such as coding, statistics or archiving routines by using
      our established computer environment.

PMID- 2228697
TI  - [Electronic organization of patient records as a component of integrated medical
      informatics].
AB  - Conventional patient records are not only inconvenient to store, their structure
      is often not consistent and faulty, research is difficult and quality control is
      not possible. One solution to this problem is the computerized patient record. It
      contains all necessary data beginning with the first medical statements and
      ending with the final results of treatment. At any time and from any with the
      system connected computer terminal it allows immediate access to all medical
      records. In addition to medical information also administrative data are stored.
      The here presented system of a computerized medical record has proven to be an
      effective tool in the daily work as well for clinical, administrative and
      research tasks.

PMID- 2228698
TI  - Beta-globin gene cluster haplotypes in Hb C heterozygotes.
AB  - Previous work has suggested that the beta C mutation arose on a relatively rare
      beta A chromosome with a unique haplotype, and these data have been used to
      postulate a single origin of the beta C allele. Most characteristic of this
      haplotype has been the absence of a Hpa I recognition site 3' to the beta-globin
      gene. We studied 40 patients with Hb SC, 11 with Hb AC, and one with Hb CC.
      Complete haplotyping was possible on 44 beta C alleles and 3' haplotyping was
      possible on an additional four beta C alleles. Our results support the
      predominence of a unique beta C haplotype which is characterized by the absence
      of the Hpa I site. However, one patient who was homozygous for Hb C had one beta
      C allele with an atypical haplotype which contained the Hpa I site. It is unclear
      at this time whether or not this represents a second origin of the beta C
      mutation.

PMID- 2228700
TI  - International Hemoglobin Information Center variants list.

PMID- 2228699
TI  - Hb Lepore-Baltimore in a north Sardinian family.

PMID- 2228701
TI  - International Hemoglobin Information Center. Alphabetical hemoglobin variant
      list.

PMID- 2228702
TI  - Entry of the hearing impaired into the health care system.
AB  - The current system of referral of patients complaining of hearing loss usually
      requires a dual appointment with otolaryngology and audiology. Most of these
      patients have sensorineural hearing loss for which there is rarely surgical or
      medical treatment. This study tests the hypothesis that these patients would
      receive appropriate treatment and that health care dollars would be saved if an
      audiological assessment could identify those patients who require medical or
      surgical care. One hundred consecutive patients whose sole complaint was hearing
      loss were evaluated using audiograms and "hearing abilities questionnaires" by
      five audiologists using subjective and objective criteria to determine the need
      for referral to otolaryngology. Audiologists determined the need for referral
      with an accuracy of 55% and 72% utilizing subjective and objective criteria,
      respectively. The questionnaire was found to be of little value. Audiologists may
      be able to function as the entry point into the health care system for patients
      complaining of hearing loss. We are encouraged by the results of this preliminary
      study, but improvement in the system by which audiologists detect disease is
      necessary.

PMID- 2228703
TI  - Management of chronic staphylococcal osteomyelitis of the temporal bone: the use
      of hyperbaric oxygen.
AB  - Hyperbaric oxygen (HBO) is an effective adjunct in the management of selected
      otolaryngologic problems including radiation-induced necrosis of the temporal
      bone, malignant external otitis, mandibular osteoradionecrosis and refractory
      osteomyelitis, soft tissue head and necrotizing fasciitis, compromised skin flaps
      and grafts, acute air or gas embolism, and otologic barotrauma. We describe the
      management of a patient with insidious Staphylococcus aureus osteomyelitis of the
      temporal bone by the use of HBO preoperatively and postoperatively in conjunction
      with surgical debridement. The possible application of angiogenic agents and
      tetracycline bone-labeling in combination with HBO therapy in the management of
      refractory neurotologic disease is discussed.

PMID- 2228704
TI  - Denker rhinotomy for inverted papilloma of the nose and paranasal sinuses.
AB  - Inverted papilloma of the nose and paranasal sinuses is an unusual benign
      neoplasm that has the propensity for local tissue destruction and an association
      with malignant degeneration. The tumor represents an inverted growth of
      epithelium rather than outward proliferation. It most commonly arises from the
      lateral nasal wall with growth into the nose and paranasal sinuses and only
      rarely originates from the septum. Presenting symptoms are usually unilateral
      nasal obstruction and clear rhinorrhea. Surgical excision is the recommended
      treatment though the aggressiveness of the approach has varied. Transnasal local
      excision has been associated with a high recurrence rate. Lateral rhinotomy with
      removal of the lateral nasal wall and wide local excision has a low recurrence
      rate and has been the recommended treatment by most authors since 1980. However,
      the poor cosmetic results in some patients due to the visible external scar is
      especially undesirable in young females. We present a series of 23 patients
      treated over a ten-year period. Fifteen underwent a Denker rhinotomy and medial
      maxillectomy through a sublabial approach without an external incision. The
      recurrence rate in our group is 27% with a mean 4.7 year follow-up. This
      recurrence rate lies between that reported for lateral rhinotomy and local
      transnasal excision.

PMID- 2228705
TI  - Hemangiomas of the nasal septum and paranasal sinuses.
AB  - Hemangiomas of the nasal septum and paranasal sinuses are rare; only 62 cases of
      septal hemangiomas and 32 cases of maxillary sinus/maxilla hemangiomas have been
      reported in the English literature. Hemangiomas should be considered in the
      differential diagnosis of any nasal mass lesion because biopsy may result in
      profuse bleeding and even death. We report the clinical presentation,
      differential diagnosis, etiology, and histologic appearance of paranasal sinus
      hemangiomas occurring in four of our patients.

PMID- 2228706
TI  - Cervicofacial actinomycosis in children.
AB  - Actinomycotic infections, once common in humans and cattle, are now rare causes
      of disease in man. This general group of organisms belongs taxonomically between
      the true bacteria and the fungi; however, the organisms behave clinically like
      true anaerobes. The organism, although phagocytized by the host cells, is not
      killed. Therefore, it is defined as a facultative intracellular parasite of the
      host. The protean manifestations of actinomycotic infections often mimic
      infectious processes, such as osteomyelitis or granulomatous disease, as well as
      neoplasia. It is therefore important for the surgeon to include actinomycosis in
      the differential diagnosis of cervicofacial masses in children as well as in
      adults. Being an anaerobe, the organism is difficult to culture and the diagnosis
      must be considered at the time of biopsy of a cervicofacial mass or when
      culturing a sinus tract. A case of a 12-year-old girl seen at Children's Hospital
      of Los Angeles prompted the review of our experience with this disease. In this
      child, actinomycosis presented as an expansile mass in the mandible. From 1956 to
      1986, five children were treated for cervicofacial actinomycosis. Detailed case
      analysis, pathophysiology, clinical characteristics, and current treatment
      recommendations are presented.

PMID- 2228707
TI  - Abnormal coagulation profiles in tonsillectomy and adenoidectomy patients.
AB  - Preoperative coagulation profile screening is routinely performed in
      otolaryngology before tonsillectomy and adenoidectomy surgery in the United
      States. Recently there has been controversy as to whether this routine testing is
      necessary. To evaluate the need for this testing, we reviewed a series of
      patients with particular attention to abnormal coagulation profiles. Of 91
      consecutive patients undergoing tonsillectomy, adenoidectomy, or both, four had
      abnormal preoperative coagulation profiles. Of these patients, one had von
      Willebrand disease, one had hypofibrinoginemia, and two had a transient acquired
      lupus-like anticoagulant. The latter condition, which causes a temporary
      prolongation of the activated partial thromboplastin time, is discussed in detail
      along with a review of the pertinent literature. We conclude that coagulopathies
      occur frequently enough to justify preoperative screening even in the absence of
      a positive history.

PMID- 2228708
TI  - Metastatic carcinoma of the jaws: report of a case.
AB  - Primary malignant tumors of the mouth and jaws usually do not present a
      diagnostic challenge to oral surgeons or otolaryngologists. However, recognition
      of metastatic tumors in the mouth and jaws is much more difficult. A case is
      presented of metastatic carcinoma from the lung to the soft tissue of the oral
      cavity. Histopathology of the lesions in the lung and oral cavity as well as the
      chest x-ray and the Panorex x-ray are presented. The patient refused palliative
      treatment, became malnourished, and died. A review of the pertinent literature is
      also presented.

PMID- 2228709
TI  - Infant hearing screening 1984 to 1989: the Henry Ford Hospital experience.
AB  - From 1984 to 1989 the Infant Hearing Screening (IHS) program at Henry Ford
      Hospital identified 1,300 infants as being "at risk" for hearing loss. The
      prevalence of significant sensorineural hearing loss in this sample was 1.4%.
      Additionally, 80 infants who passed the IHS program and reached 3 years of age
      were found to have normal hearing sensitivity by conventional audiometric
      techniques (ie, no false-negative predictions). There were three false-positive
      predictions. It was discovered that infants of low birthweight (ie, less than
      1,500 g) were three times more likely to fail IHS than those whose weight
      exceeded 1,500 g. A higher return rate was found for infants failing an initial
      hearing screening conducted in the neonatal intensive care unit in comparison to
      those screened as outpatients one week postdischarge. The sensitivity and
      specificity of behavioral observation audiometry were 43% and 92%, respectively,
      when brainstem auditory-evoked potentials was used as the criterion validity
      measure.

PMID- 2228710
TI  - Management of voice disorders.
AB  - Voice disorders are commonly seen in general medical practice. In some cases
      voice disorders represent the presenting symptom for serious underlying disease.
      It is important for clinicians from internal medicine, pediatrics, and family
      practice to be able to identify those factors in the history or observed vocal
      symptoms which suggest need for referral for comprehensive voice evaluation as
      well as to understand the distinct but complementary roles of the specific
      disciplines (otolaryngology and speech-language pathology) involved in diagnosis
      and treatment of patients with voice disorders.

PMID- 2228711
TI  - Functional endoscopic sinus surgery: morbidity and early results.
AB  - Functional endoscopic sinus surgery is a new alternative to conventional sinus
      surgery as a means of managing recalcitrant sinus disease. This approach to sinus
      pathology focuses on the importance of the functional ostiomeatal complex and
      anterior ethmoid sinuses in the pathogenesis of sinus disease. In an effort to
      assess the morbidity and initial results of this procedure, 85 cases were
      reviewed. A total of 82% of the patients had bilateral maxillary and ethmoid
      sinusitis, and 45% had pansinusitis, frequently associated with allergic rhinitis
      (56%) and nasal polyps (58%). A total of 82% of the patients were operated on as
      outpatients under local anesthesia. There were no major complications associated
      with the surgery and minor complications were rare. Disease control was achieved
      in 88% of patients with short-term follow-up.

PMID- 2228712
TI  - The Bouveret syndrome: an unusual cause of hematemesis.
AB  - Gallstones are usually silent. Less commonly, patients with cholelithiasis
      develop symptoms and/or complications; biliary fistula occurs in 3% to 5% of the
      cases. When a large stone is passed and occludes the duodenum, gastric outlet
      obstruction (the Bouveret syndrome) may result. In reported cases, the stones are
      usually larger than 2.5 cm. The usual presenting symptoms are those of bowel
      obstruction: abdominal pain, nausea, and vomiting. Less commonly, the patients
      experience melena and, rarely, hematemesis. We describe a patient who had the
      largest stone reported to cause hematemesis rather than bowel obstruction and to
      be diagnosed endoscopically. The 5 X 4 X 3 cm stone was extracted surgically.
      Endoscopic diagnosis and extraction of stones up to 3 cm in size has been
      reported, avoiding the need for surgery.

PMID- 2228713
TI  - Cocaine-induced hepatonephrotoxicity: a case report.
AB  - Hepatotoxicity due to cocaine has been well described in animal models. There are
      few reports on cocaine-induced hepatic injury in humans; however, its link to
      rhabdomyolysis and renal failure is better known. We report a case of reversible
      acute hepatonephrotoxicity associated with recreational cocaine use. The proposed
      mechanisms responsible for its hepatic and renal toxicity are reviewed.

PMID- 2228714
TI  - Computerized literature searching in the ambulatory setting using PaperChase.
AB  - PaperChase, a self-service computerized literature search (SSCLS) service, was
      compared to conventional resources for accessing recent medical information by
      assessing user attitudes, search costs, and number of searches performed. The
      study was designed as a randomized controlled trial using survey instruments
      before and after the intervention. Accounting of PaperChase searches was
      monitored electronically, and costs of librarian searches were provided by the
      hospital library. Participants included 57 physicians in several specialties who
      were members of a group practice located in a suburban ambulatory care center.
      Responses were received from 67%. The experimental group received free, unlimited
      access to PaperChase over a one-year period, while the control group used
      conventional resources (manually self-performed searches and computerized MEDLINE
      searches performed free-of-charge by hospital librarians). The study disclosed no
      change in attitude of either those employing computers or SSCLS. Attitude scores
      in the experimental group showed statistically significant worsening in
      preference for SSCLS over textbook use and the estimation of SSCLS utility in the
      outpatient setting. The cost of PaperChase compared favorably to literature
      searches done by librarians. The self-reported numbers of literature searches of
      all types increased in the experimental group. PaperChase searches changed
      physicians' perceptions of patient treatment and outcome in some cases. While
      computerized literature searches may have a role in the outpatient setting, other
      resources remain important. Although only certain physicians are interested in
      using this method, this study shows that PaperChase can be a cost-effective
      alternative to MEDLINE searches performed by hospital librarians.

PMID- 2228715
TI  - Variability of quantitative sensory testing: implications for clinical practice.
AB  - The conventional estimation of motor, sensory, and mixed nerve conduction
      velocities reflects activity in the fastest conducting, heavily myelinated nerve
      fibers that are only a small proportion of the total. Unmyelinated and thinly
      myelinated fibers are not evaluated by this technique and numerically represent
      the largest group of fibers in human cutaneous nerves. The availability of new
      quantitative techniques to study this aspect of sensory function is an important
      addition to standard electrodiagnosis. Patient understanding and cooperation is
      essential because subjective responses are evaluated. We evaluated a reference
      range for 20 healthy subjects as well as variability on repeated testing.
      Vibration and thermal thresholds were measured bilaterally at several sites.
      Measurements were repeated at intervals ranging from two days to three months.
      There was no side difference but substantial site differences were noted for all
      measurements. Intraindividual variation was substantial but within the expected
      range for a psychophysiologic test. Close correlation was noted between various
      measurements at same and different sites, indicating a great degree of
      interindividual variation. The Marstock method is recommended for routine
      clinical use.

PMID- 2228716
TI  - Systemic dissemination of Pneumocystis carinii in a patient with acquired
      immunodeficiency syndrome.
AB  - Pneumocystis carinii is usually considered a respiratory tract pathogen; however,
      there are reported cases of limited and generalized dissemination of the organism
      from the lungs of immunocompromised patients. We present the autopsy findings of
      a 29-year-old male with acquired immunodeficiency syndrome (AIDS) and recurrent
      Pneumocystis carinii pneumonia who developed abnormal liver function tests. The
      patient had received aerosolized pentamidine because of toxic reactions to other
      modes of therapy. The postmortem examination revealed Pneumocystis in the lungs,
      liver, spleen, kidney, myocardium, thymus, pancreas, thyroid gland, bilateral
      parathyroid and adrenal glands, gastrointestinal mucosa, perihilar and mesenteric
      lymph nodes, and bone marrow. A high index of suspicion, especially in patients
      treated with aerosolized pentamidine, may lead to an increased recognition of
      disseminated pneumocystosis. Dissemination of the infection may be due to failure
      of the aerosolized drug to achieve adequate blood levels. As AIDS patients
      survive longer because of the developing therapeutic arsenal, disseminated
      pneumocystosis may be encountered with increasing frequency in these
      immunocompromised patients.

PMID- 2228717
TI  - Surgical removal of metastatic renal adenocarcinoma to the midbrain tectum: a
      case report.
AB  - A patient with adenocarcinoma of the kidney metastatic to the quadrigeminal plate
      of the midbrain presented with acute obstructive hydrocephalus and early
      tonsillar herniation. Because the majority of these carcinomas are resistant to
      radiation therapy, only limited treatment choices were available. Initially, a
      ventriculoperitoneal shunt relieved the hydrocephalus and neurologic symptoms.
      After a short course of improvement, with decompressed ventricles demonstrated by
      postoperative computed tomography, the patient developed additional neurologic
      signs, leading to the decision to excise the metastatic tumor. Convalescence was
      complicated but the patient survived for six months, succumbing to respiratory
      failure presumably caused by lung metastases.

PMID- 2228718
TI  - Management of advanced endodermal sinus tumor of the ovary with preservation of
      reproductive function.
AB  - Endodermal sinus tumor of the ovary occurs primarily in children and young
      adults. This tumor is classified as a germ cell tumor which comprises
      approximately 5% of all ovarian tumors. In the past, patients with this highly
      malignant tumor had low survival. However, with the evolution of effective
      adjunctive chemotherapeutic regimens, specifically vincristine, actinomycin D,
      and cyclophosphamide, survival rates have improved. In an attempt to continuously
      improve survival rates, other combination chemotherapeutic regimens are currently
      under investigation. Unlike epithelial ovarian malignancies, endodermal sinus
      tumor can be monitored by a specific tumor marker, alpha-fetoprotein (AFP). Serum
      levels of AFP can be followed from the preoperative period through the course of
      chemotherapy. When elevated, AFP has excellent predictability that persistent
      disease is present. Because this disease presents primarily in young females,
      preservation of reproductive function is of utmost importance. We report a case
      of advanced endodermal sinus tumor which was managed with conservative surgery
      only, followed by radical combination chemotherapy, resulting in preservation of
      normal reproductive function and total resolution of disease documented by second
      look laparotomy.

PMID- 2228719
TI  - Evaluation of the predictive power of progesterone receptor levels in primary
      breast cancer: a comparison with other criteria in 559 cases with a mean follow
      up of 74.8 months. The Breast Cancer Prognostic Study Associates.
AB  - A total of 559 women with primary breast cancer treated by modified radical
      mastectomy were followed for a mean of 74.8 months to evaluate the relationship
      of sex hormone receptor content in the tumor with time to first recurrence and to
      death due to breast cancer. The prognostic significance of progesterone receptor
      (PgR) status was evaluated in terms of estrogen receptor (ER) status, age (less
      than or equal to 49 years, greater than or equal to 50 years), extent of lymph
      node involvement, tumor size, and morphologic characteristics. Overall, patients
      with PgR positive (greater than 9 femtomoles/10 mg wet weight tissue) tumors
      experienced a significantly longer period to both first recurrence and death due
      to breast cancer, but this advantage was restricted to those whose cancer had
      metastasized to their axillary lymph nodes. For women with nodal involvement, the
      extent of this involvement and the size of the primary lesion had the greatest
      predictive value followed by nuclear grade and PgR status. In these node-positive
      patients, PgR positivity, although strongly associated with ER positivity, had a
      greater predictive value than that of the estrogen receptor per se.

PMID- 2228720
TI  - Single coronary artery.

PMID- 2228721
TI  - Practical value of echo Doppler evaluation of aortic and mitral stenosis: a
      comparative study with cardiac catheterization.
AB  - This retrospective analysis compares data derived by echocardiography and cardiac
      catheterization in the evaluation of aortic and mitral valve stenosis. Sixty
      seven patients, aged 69 +/- 12 years, underwent 76 catheterization procedures. In
      all studies the Doppler recording was technically adequate. In 64 studies of
      patients with aortic stenosis, correlation was good between the gradient obtained
      at catheterization (peak 51 +/- 28 mm Hg, mean 48 +/- 24 mm Hg) and the Doppler
      gradient (peak 73 +/- 29 mm Hg, mean 41 +/- 17 mm Hg) (R = 0.78 peak, 0.77 mean).
      In 15 studies the aortic valve area, 0.8 +/- 0.2 cm2, calculated by the
      simplified continuity equation, correlated well with the catheterization valve
      area, 0.7 +/- 0.3 cm2, calculated by the Gorlin equation (R = 0.80). In 14
      studies in mitral stenosis patients, the mean gradient at catheterization was 11
      +/- 5 mm Hg compared to the Doppler gradient of 8 +/- 4 mm Hg (R = 0.58). The
      mitral valve area was 1.1 +/- 0.3 cm2 by the Gorlin equation and 1.2 +/- 0.3 cm2
      by echo Doppler, using pressure half-time. When cardiac rhythm, the presence and
      severity of regurgitation, and the cardiac index were analyzed, none was shown to
      have demonstrable influence on the accuracy of the Doppler study. Doppler
      echocardiography can be used reliably to assess valvular stenosis in a clinical,
      noninvasive laboratory where routine tests are performed and interpreted by more
      than one individual.

PMID- 2228722
TI  - Sensorineural hearing loss and the diagnosis of acoustic neuroma.
AB  - Sensorineural hearing loss and tinnitus are gradually receiving more attention in
      medicine due to advances in diagnosis and treatment. Acoustic neuromas can now be
      detected when they are small, and early microsurgical removal results in the
      lowest overall morbidity. We examine the historical development of acoustic
      neuroma management, discuss current diagnosis and treatment, and present
      illustrative cases from our recent experience. Complaints of tinnitus and hearing
      loss, especially when unilateral, require appropriate medical evaluation.

PMID- 2228723
TI  - A tribute to Henry Ford Hospital.

PMID- 2228724
TI  - Lymphocyte subpopulations in peripheral blood and the spleen from gastric cancer
      patients.
AB  - Lymphocyte subpopulations in peripheral blood and the spleen from gastric cancer
      patients were identified by either single or two color analysis with fluorescence
      activated cell sorter-IV (FACS-IV) using monoclonal antibodies. The absolute and
      percentages of CD3+ (mature T) cells and CD4+ (helper/inducer T) cells in
      peripheral blood from the advanced cancer patients were significantly lower than
      those from normal healthy controls. In peripheral blood, a significant decrease
      of CD4+ cells was due to the decrease of CD4+ CD45RA+ (suppressor inducer T)
      cells, while CD8+ CD11b+ (suppressor T) cells tended to increase with progress of
      the disease. CD4+ CD45RA+ cells located more predominantly in peripheral blood
      and spleen than in the splenic vein, while CD8+ CD11b+ cells were more
      predominant in the splenic vein.

PMID- 2228725
TI  - Gastric carcinoma with lymphoid stroma: pathological and immunohistochemical
      analysis.
AB  - Nineteen gastric carcinomas with lymphoid stroma were selected from 554 surgical
      cases and examined pathologically and immunohistochemically using formaldehyde
      fixed, paraffin embedded materials. Most showed ulcerative lesion and 15 cases
      located in fundic and cardiac gland regions. They were subdivided histologically
      into three groups, early (group I), localized (group II) and infiltrative tumors
      (group III), the number of cases being 2, 10 and 7, respectively. Lymph node
      metastases occurred in 3 cases in group II and 6 in group III, the latter showing
      a significantly higher incidence. The number of carcinoembryonic antigen and CA19
      9 immunoreactive tumor cells was apparently smaller in gastric carcinomas with
      lymphoid stroma than in ordinary gastric carcinomas. Frequent presence of alpha 1
      antichymotrypsin immunoreactivity characterized the tumor cells of gastric
      carcinoma with lymphoid cells. Stroma cells consisted of lymphocytes, plasma
      cells, granulocytes and histiocytes. Of these, the greatest number examined
      immunohistochemically was B cells and IgG cells, followed in descending order by
      T cells, IgA cells and IgM cells in the order given. A variable number of
      lysozyme immunoreactive histiocytes were also detected in all the cases. Gastric
      carcinoma with lymphoid stroma might be subclassified as a separate entity,
      although short term follow-up study did not demonstrate a favorable prognosis for
      this type of gastric cancer.

PMID- 2228726
TI  - A clinical and cytogenetic study of institutionalized mental retardates.
AB  - One hundred and four out of 110 patients in a residential institution for mental
      retardates were examined clinically and cytogenetically. Both conventional and
      folate deficient media were employed in order to detect both conventional
      chromosomal abnormalities and rare fragile sites. Conventional abnormalities were
      detected in 18 cases (17%). Rare folate sensitive fragile site at 2q13 was
      detected in one female patient. The same chromosomal aberration was also detected
      in the patient's mother who had a normal phenotype. Spontaneous expression of the
      rare fragile site at 2q13 was also observed.

PMID- 2228727
TI  - Microalbuminuria in subjects with no history of diabetes mellitus and
      hypertension: the relationship with hyperglycemia and high blood pressure at non
      diagnostic level.
AB  - 1969 subjects underwent albumin index [A.I., urine microalbumin
      (mg/liter)/creatinine (g/liter)] in early morning urine, 75 g oral glucose
      tolerance test (OGTT), determination of plasma lipids (total cholesterol,
      triglyceride and high density lipoprotein-cholesterol) and a resting
      electrocardiogram. There was no history of treatment for diabetes mellitus and
      hypertension. The relationship between microalbuminuria, and hyperglycemia or
      high blood pressure at non-diagnostic level was examined. Then, plasma lipid
      levels or changes in electrocardiogram were correlated with the degree of
      microalbuminuria. Subjects were divided into 4 groups according to 75 gOGTT and
      into 3 groups according to blood pressure based on WHO definition, and A.I. was
      divided into 4 categories (0-9.9, 10.0-19.9, 20.0-49.9, and 50.0-199.9 mg/gCr).
      Mildly or moderately enhanced microalbuminuria (A.I.) was found in subjects with
      hyperglycemia or high blood pressure at non-diagnostic level. In normotensive
      subjects, neither hyperglycemia in fasting nor after glucose challenge increased
      urine microalbumin above normal range, while in borderline hypertensives,
      diabetic glucose intolerance produced 2 and 3 fold increases respectively
      compared with normotensives. There was a linear increase in urine microalbumin in
      relation to the glucose intolerance in newly diagnosed hypertensives. No
      correlation could be found between microalbuminuria and plasma lipid levels,
      while the prevalence of electrocardiographic changes increased 3 folds in group
      with the heaviest microalbuminuria compared with the other 3 groups excreting
      less microalbumin.

PMID- 2228728
TI  - The circadian rhythm of intra-acinar profiles of alcohol dehydrogenase activity
      in rat liver: a microquantitative study.
AB  - Using microquantitative measurements of alcohol dehydrogenase activity in
      microdissected samples of liver tissue along the sinusoidal length, the intra
      acinar distribution profiles were studied in seven groups of female rats at
      different times during 24 h with a light phase from 6:30 h to 18:30 h. The mean
      values of alcohol dehydrogenase activity showed a circadian rhythm with a minimum
      at 13.30 h and a maximum at 17.30 h (p less than 0.001). However, the intra
      acinar gradients remained almost unchanged, indicating that increase and decrease
      in enzyme activity takes place simultaneously in all parts of the liver acinus.
      This observation, together with data from the literature, suggests that the
      circadian rhythm of alcohol dehydrogenase activity reflects variations in
      different liver cell constituents, rather than enzyme protein synthesis or
      proteolysis.

PMID- 2228730
TI  - An efficient histochemical method for deoxyribonucleic acids using a silver
      enhancement procedure.
AB  - An efficient histochemical method has been worked out for the demonstration of
      deoxyribonucleic acids (DNA) with light microscopy. This involves a hot
      hydrochloric acid-thiocarbohydrazide-silver proteinate sequence followed by a
      physical development procedure. When applied to tissue sections from rabbit
      organs such as the spleen, cerebellum and testis, the new method has given
      excellent discrimination of nuclear DNA in all cells examined. Thus, the method
      is higher in efficiency and visibility of reaction products than the traditional
      hot HCl-Schiff (Feulgen) method used hitherto. Its specificity is also high.

PMID- 2228729
TI  - Validation of bromodeoxyuridine immunohistochemistry for localization of S-phase
      cells in decalcified tissues. A comparative study with tritiated thymidine
      autoradiography.
AB  - Immunohistochemical detection of the thymidine analogue 5-bromo-2'-deoxyuridine
      (BrdUrd), which is incorporated by S-phase cells, offers a convenient way of
      studying the proliferation kinetics of cells in normal skeletal tissues and in
      bone containing/derived tumours. To assess the validity of using this approach on
      decalcified, paraffin embedded tissues, the BrdUrd method was compared with
      tritiated thymidine (3H-TdR) autoradiography, using rat tibiae labelled with both
      3H-TdR and BrdUrd, fixed in Carnoy's fluid and decalcified in EDTA, prior to
      routine paraffin embedding. The distribution of BrdUrd-labelled cells correlated
      with the sites of cell proliferation in the growing rat tibia. Independent
      studies with each method on paired serial sections of double-labelled tissue,
      showed a highly significant correlation (r = 0.81, p less than 0.0003) in the
      numbers of labelled cells seen in autoradiographs and immunostained sections from
      the proximal tibial growth plate. Combined BrdUrd immunohistochemistry and 3H-TdR
      autoradiography showed that the majority of labelled cells in cartilage, bone
      marrow, and fibrous perichondrium and periosteum had incorporated both labels.
      These results show that BrdUrd immunohistochemistry is a valid technique for the
      study of dividing cells in mineralized tissues after decalcification.

PMID- 2228731
TI  - Biotinylated epidermal growth factor: a useful tool for the histochemical
      analysis of specific binding sites.
AB  - Epidermal growth factor (EGF) was labelled with biotin via modification of either
      the amino or carboxyl groups, using suitable reagents, namely biotinyl-N
      hydroxysuccinimide ester or biotinamidocaproyl hydrazide. To assure that the
      specific binding capacity of EGF is retained despite its chemical modification,
      displacement of the EGF by biotinylated derivatives in a routine binding assay
      was performed. The inhibitory potency compared to unmodified EGF was only
      slightly reduced. This result is the prerequisite for testing the usefulness of
      biotinylated EGF in histochemistry. The biotinylated probes were applied to
      sections of human tumour tissue and of monkey organs (liver, kidney, uterus of
      Cynomolgus and Rhesus monkey) to localize the specific binding sites for EGF.
      Formalin-fixed, paraffin-embedded tissue sections were deparaffinized and
      incubated with the probes at a concentration of 10 micrograms ml-1 at room
      temperature for 60 min. Specific binding of the EGF was visualized by the avidin
      biotin techniques (ABC). A positive reaction in conjunction with appropriate
      controls by competitive inhibition was seen for all monkey tissue sections and
      for the following number of cancer cases: breast carcinoma: 7/10; mesothelioma:
      2/4; lung carcinoma: 1/3; colon carcinoma: 1/3. The staining properties were
      similar for both types of probes that differed in the functional group that is
      involved in modification by biotin attachment. However, the batches with
      modification of the amino groups stained more intensely and more distinctly than
      the carboxyl modified EGF. Overall, the data indicate that the ligand properties
      of the EGF are not impaired by biotinylation of the two types of functional
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228732
TI  - Localization of adhesive proteins in two newly subdivided zones in electron
      lucent matrix of human platelet alpha-granules.
AB  - Platelet alpha-granules have been reported to consist of two zones, nucleoid and
      electron-lucent matrix, with different densities under electron microscopy. When
      washed human platelets were prepared by a rapid freeze-substitution method using
      liquid helium, we found that the electron-lucent matrix could be further
      subclassified into two zones having different densities: the intermediate and the
      light zones. The light zone was located at the periphery opposite the most dense
      nucleoid and contained several tubular structures with diameters of about 20 nm.
      The intermediate zone often laid between the nucleoid and light zone. By careful
      inspection, intermediate and light zones could even be identified in the
      platelets embedded in Lowicryl K4M, which where then used to localize several
      adhesive proteins in these two zone by immunocytochemical studies using the
      respective polyclonal antibodies. Fibrinogen, thrombospondin, and fibronectin
      were detected only in the intermediate zone. In contrast, von Willebrand factor
      (vWF) was localized only in the light zone, suggesting an association between vWF
      and the tubular structures in the light zone. In the nucleoid, none of these
      adhesive proteins were detected. Glycoprotein IIb/IIIa, a receptor for these
      adhesive proteins on the platelet surface, was detected not only on the outer
      surface of the cell membranes but also on the inner surface of the alpha-granule
      membrane. These data indicate that two zones with different densities in electron
      lucent matrix and functions exist in the platelet alpha-granules.

PMID- 2228734
TI  - Stage-dependent appearance of sulfhydryl oxidase during spermatogenesis in the
      testis of rat and hamster. An immunohistochemical study.
AB  - Sulfhydryl oxidase (SOx), an enzyme that catalyzes the oxidation of sulfhydryl
      compounds, appears in the spermatogenic cells of rat and hamster testes in a
      stage-dependent manner. It first appears in pachytene spermatocytes at stage I in
      both the animal species studied. SOx immunoreactivity is associated with
      mitochondria of these cells. The fate of such mitochondria is species-dependent.
      In rat, the immunoreactive mitochondria aggregate during maturation phase and are
      retained in the residual bodies. Spermatozoa free of SOx are released into the
      lumen. On the other hand, in hamster, the immunoreactive mitochondria arrange
      themselves around the midpiece of spermatozoa. In such a case, residual bodies
      lack SOx. The appearance of SOx coincides with the appearance of LDH-X in the
      spermatogenic cells. Like many other proteins such as LDH-X, RSA-1 and cytochrome
      ct, SOx provides yet another example of differential gene activation associated
      with a developmental process of gametes.

PMID- 2228733
TI  - Demonstration of distinct corticotropin releasing factor--containing neuron
      populations in the bed nucleus of the stria terminalis. A light and electron
      microscopic immunocytochemical study in the rat.
AB  - Immunocytochemical light and electron microscopic studies revealed two distinct
      populations of corticotropin releasing factor (CRF) - containing neurons, a
      dorsolateral and ventrolateral group, located in the bed nucleus of the stria
      terminalis (BST) of the rat brain. CRF neurons of the dorsolateral group had a
      smaller diameter and more primary dendrites than those of the ventrolateral
      group. CRF neurons in the dorsolateral BST had both somatic and dendritic spines,
      smooth contoured nuclei, and many dense and alveolate vesicles in their
      cytoplasm. Whereas, CRF neurons in the ventrolateral BST had only dendritic
      spines, irregularly-shaped indented nuclei and contained only alveolate vesicles
      in their cytoplasm. The only obvious difference in the type of unidentified
      afferents that synapsed on the CRF neurons of the BST could be attributed to the
      presence of the somatic spines on the CRF neurons of the dorsolateral population.
      Otherwise, the CRF neurons of the BST had a profuse innervation that included
      axosomatic, axospinous and axodendritic synapses. CRF-containing axons were
      distributed unevenly throughout the BST. The density of CRF axons was greatest in
      the lateral subdivisions of the BST, but the ventromedial BST contained many more
      CRF axons than the dorsomedial BST. The presence of these two CRF neuron
      populations in the BST suggests functional subdivision beyond previous proposals
      of a medial and lateral separation of function. Now there is additional
      morphological evidence to support the proposal of a dorsal and ventral separation
      of function within the BST.

PMID- 2228735
TI  - Bile duct ligation-induced redistribution of canalicular antigen in rat
      hepatocyte plasma membranes demonstrated by immunogold quantitation.
AB  - Extrahepatic obstructive cholestasis has been demonstrated to induce a
      redistribution of domain specific membrane proteins in rat hepatocytes reflecting
      loss or even reversal of cell polarity. In order to further characterize the
      redistribution of canalicular antigens, we used the Lowicryl K4M immunogold
      technique for examination of the effects of bile duct ligation (50 h) on the
      distribution of antigen in rat hepatocytes at the ultrastructural level and
      quantitated immuno-gold density in the three domains of the plasma membrane. In
      normal hepatocytes, antigen was localized almost exclusively in the canalicular
      domain while the sinusoidal and lateral membranes showed only weak
      immunoreactivity. Other localizations included organelles compatible with known
      pathways of biosynthesis and degradation. Bile duct ligation markedly reduced
      immunolabel in the canalicular and increased it slightly in the sinusoidal
      domain. The number and staining intensity of immunoreactive subcanalicular
      lysosomes and vesicles probably representing endosomes was augmented. Number of
      immunogold particles per micron of plasma membrane were 7.86 vs 2.46 (P less than
      0.005) in the canalicular, 1.16 vs 1.38 (n.s.) in the sinusoidal, and 1.23 vs
      1.08 (n.s.) in the lateral domain resulting in a canalicular decrease by 68.7%
      and a sinusoidal increase of 19.0%. Overall decrease in total plasma membranes
      was by 29.7% (P less than 0.05). Thus, our data show that the sinusoidal and
      lateral domains behave differently. Furthermore, quantitative immunocytochemistry
      demonstrates a decrease in the canalicular antigen density and suggests a
      sinusoidal increase. The present data agree with the concept that bile duct
      ligation results in a loss or even reversal of cell polarity in hepatocytes.

PMID- 2228736
TI  - Helix pomatia agglutinin binds specifically to the Golgi apparatus in cultured
      human fibroblasts and reveals two Golgi apparatus-specific glycoproteins.
AB  - Fluorochrome-coupled Helix pomatia agglutinin (HPA), but not other lectin
      conjugates with the same nominal specificity, bound specifically to the Golgi
      apparatus in cultured human fibroblasts, revealing a cytoplasmic juxtanuclear
      reticular structure. Unlike other Golgi-binding lectins the HPA-conjugates did
      not bind to the cell surface membrane or pericellular matrix. Experiments with
      35S-methionine-labeled cells showed that HPA recognized two glycoproteins of Mr
      170,000 and 400,000 among the secreted products of fibroblasts and two major
      cellular glycoproteins of Mr 40,000 and Mr 180,000 in Triton X-100 extracts of
      the cells. The two cellular HPA-binding polypeptides were also found in cells
      depleted of secretory products and in cells pulse-labeled shortly with 35S
      methionine and then chased with methionine containing medium up to 12 h. These
      findings suggest that the two cellular glycoproteins recognized by HPA are
      retained in the Golgi apparatus and are therefore not precursors of secretory
      proteins. The results suggest that there are two endogenous, Golgi apparatus
      specific glycoproteins in cultured human fibroblasts with terminal non-reducing O
      glycosidic N-acetyl galactosaminyl residues.

PMID- 2228737
TI  - The sheep pars tuberalis: an immunohistochemical study. Demonstration of the
      presence of glycoprotein and lipotropin hormones.
AB  - Using indirect immunofluorescence with fourteen different antisera raised against
      pituitary hormones and peptides, we characterized immunochemically the cells of
      the sheep pars tuberalis. The presence of LH- and FSH-containing cells, shown in
      previous studies, was also observed in the present investigation. In addition, we
      found TSH-containing cells, never observed in sheep, and beta LPH-containing
      cells. The latter hormone has never been found in any studied species. It
      appeared that a small amount of perikarya (less than 20%) were immunolabelled
      and, that the sheep pars tuberalis contained a majority of immunonegative cells
      as in the guinea-pig rabbit and rhesus monkey. This study may contribute to a
      better knowledge of the function of the sheep pars tuberalis.

PMID- 2228738
TI  - Glutamate producing aspartate aminotransferase in glutamatergic perforant path
      terminals of the rat hippocampus. Cytochemical and lesion studies.
AB  - The enzyme aspartate aminotransferase was demonstrated cytochemically in the rat
      hippocampus 4, 7, and 14 days after unilateral entorhinal cortex lesion. At the
      light microscopic level the enzyme showed a significant activity decrease in the
      ipsilateral entorhinal terminal field which was similar at all postlesion times
      investigated. Non-denervated areas, i.e. the inner one-third of the dentate gyrus
      molecular layer and the radiatum layer of CA2/3, showed an increase of
      aminotransferase activities. At the electron microscopic level in the entorhinal
      terminal field of the control (unoperated) side aspartate aminotransferase was
      localized preferentially in a great number of boutons, containing the cytoplasmic
      and mitochondrial isoenzymes. Following entorhinal lesion a significant loss of
      these positively reacting boutons was seen. Most of the degenerating boutons
      contained reaction product but a small number was negative for aspartate
      aminotransferase. From 4 to 14 postlesion days the positively reacting boutons of
      the non-denervated supragranular zone expanded outward into the denervated area
      according to the known terminal proliferation of the commissural and
      associational systems. The remaining denervated entorhinal terminal field was
      reinnervated predominantly by negatively reacting boutons (probably terminal
      proliferations of septal afferents) and by a small number of positively reacting
      boutons (probably terminal proliferations of the crossed temporo-dentate
      pathway). The presence of cytoplasmic aspartate aminotransferase in the terminals
      of a well-known glutamatergic system is discussed in relation to the possible
      importance of this enzyme for the production of releasable glutamate.

PMID- 2228739
TI  - Early replication signals in nuclei of Chinese hamster ovary cells.
AB  - DNA replication sites generally known as replicon domains were resolved as
      individual replication signals in interphase nuclei of permeabilized Chinese
      hamster ovary cells by immunofluorescent microscopy. Biotin-11-dUTP was utilized
      as a tool to label newly replicated DNA in permeable cells and to study the
      distribution of nascent DNA in pulselabel and in pulsechase experiments. Active
      sites of DNA replication were visualized in exponentially growing cells and in
      synchronized cultures throughout the S phase. Fluorescent images of replication
      sites were analyzed by standard fluorescence microscopy and in three dimensions
      by confocal laser scanning microscopy. The rapid increase in number of discrete
      foci of newly replicated DNA is an indication that DNA synthesis starts at
      limited number of sites in mammalian nuclei rather than at thousands of foci at
      the same time.

PMID- 2228740
TI  - [Occupation and cancer of the oral cavity, pharynx and larynx].
AB  - There is increasing evidence of an association between occupational factors and
      head and neck cancer. The present paper reviews the most relevant epidemiological
      studies published within the last 30 years. Generally these studies indicate an
      increased cancer risk for "blue collar workers" exposed to dust or inhaled
      organic and inorganic agents. Moreover, the increased risk of head and neck
      cancer in most studies persists after adjustment for alcohol and tobacco
      consumption. More detailed, clinically orientated studies are necessary to
      provide a better understanding of the role of occupational factors in head and
      neck cancer.

PMID- 2228741
TI  - [History of surgical interventions in the paranasal sinuses].
AB  - Hippocratices was the first to describe lesions that obstruct the nasal passages.
      Andreas Vesalius described the maxillary, frontal, and sphenoid sinuses.
      Mikulicz, Lothrop and Claoue are considered to have been the first to perform
      inferior meatal antrostomy of the maxillary sinus. Siebenmann was apparently the
      first to recommend suprameatal antrostomy in the middle meatus, which is now
      fashionable again. Grunwald, Hajek, Killian, Halle and Uffenorde developed
      endonasal ethmoid surgery to an established procedure.

PMID- 2228742
TI  - [Ultrasound-controlled fine needle biopsy of pathologic space occupying lesions
      in the head and neck area].
AB  - We report 121 fine-needle aspiration biopsies of tumours and lymph nodes of the
      head and neck guided by ultrasound. The average minimal diameter of the lesions
      was 1.2 cm; the smallest lymph node was adjacent to the carotid artery and had a
      diameter of 0.4 cm. There were no complications. Of the cytological results 96%
      were confirmed by histology or by the subsequent clinical course.

PMID- 2228744
TI  - [Botulinum toxin treatment of synkinesia following facial paralysis].
AB  - We report ten patients with unilateral synkinesias after facial palsy treated
      with botulinum toxin injections. All patients suffered from extensive mass
      movements around the eye. After periocular injections all patients showed much
      improvement: a period of 11 weeks free of symptoms was followed by a 9-week
      period of minimal symptoms. There were no important complications. The use of
      botulinum toxin injections is an effective therapy for mass movements after
      defect healing of facial palsy.

PMID- 2228743
TI  - [Squamous cell carcinoma in the area of the parotid gland. Metastasis or primary
      tumor?].
AB  - A total of 61 patients with a histological diagnosis of squamous cell carcinoma
      of the parotid gland were studied. The patients were classified into three
      categories. There were 34 patients with a metastasis to the parotid gland from a
      squamous cell carcinoma elsewhere within the head and neck who presented on
      average 2.1 years (range 3 months to 7 years) after diagnosis of the primary
      tumour; in one case a salivary gland tumor presented 32 years after irradiation
      of a squamous cell carcinoma of the temple. Six patients had histological
      evidence of a metastasis within the parotid gland, but no evidence of a primary
      tumour. Twenty-one patients presented with a primary epidermoid carcinoma of the
      parotid gland. Two patients showed a primary squamous cell carcinoma of the
      parotid arising in myoepithelial sialadenitis.

PMID- 2228745
TI  - Subcortical gating in the human visual system during spatial selective attention.
AB  - The question of whether subcortical gating occurs as a function of spatial
      selective attention remains unsettled. This issue was investigated, using the
      paradigm of Eason et al. (1969) wherein subjects are instructed to attend to a
      specified location in a given visual field while attempting to ignore stimuli
      presented in the opposite field. Visual evoked responses falling within the 40-70
      ms range were found to be significantly more negative when the location at which
      the evoking stimulus appeared was being attended to than when it was not. Also,
      later deflections (100-200 ms) were enhanced in amplitude and negatively biased.
      The very early effect provides further evidence for spatial attention-induced
      precortical gating. The later effects provide additional evidence for the
      amplitude enhancement of 'exogenous' components, along with the possible
      involvement of glial cell activity in the generation of slow wave negativity.

PMID- 2228746
TI  - Relations between slow (4 cps) EEG activity, sensorimotor speed, and
      psychopathology.
AB  - Slow rhythmic activity (SRA) in the frequency range from 2.5 to 5.0 cps was
      studied in 20 subjects (Ss) in order to examine its effect upon sensorimotor
      reactions and its possible relationship to psychological findings. With monopolar
      EEG derivations, maximal power density of SRA is found in frontal regions,
      whereas bipolar leads reveal maximum occurrence of SRA over posterior areas.
      Reaction times (RT) to visual and auditory stimuli increase significantly during
      the occurrence of SRA; the amount of this prolongation (ca. 74 ms) is independent
      of stimulus modality but significantly correlates with SRA frequency: the lower
      the frequency, the higher the RT increment. In psychological tests, most Ss with
      SRA displayed disturbances of emotionality as well as 'pathological' values in
      the subscales hysteria, hypochondria, psychasthenia, and paranoia, but none of
      our Ss was diagnosed as psychotic. There is a high correlation between the SRA
      frequency and the extent of psychological deviations: Ss with low SRA frequency
      values are more likely to reveal psychological disturbances than Ss with high SRA
      frequency. The possible origin and physiological impact of SRA is discussed and
      the desirability of further neurophysiological studies is emphasized.

PMID- 2228747
TI  - Effects of habituation and classical conditioning on reflex modification.
AB  - Reflex modification is the inhibition or facilitation of a reflex by a stimulus
      (S1) occurring prior to a reflex-eliciting stimulus (S2). Two experiments were
      conducted that investigated the effects of habituation of the orienting response
      (OR) and classical conditioning on reflex modification of skin conductance
      responses (SCRs). During the first phase of Expt. 1 two groups (Group S1 and the
      Control group) received pre-presentations of S1 (200 Hz). Another group (Group
      S3) received pre-presentations of a different tone (S3, 3000 Hz). During the
      second phase, Groups S1 and S3 received pairings of S1 with S2 (white noise),
      whereas the Control group received pairings of S2 with S1. The predictions were:
      if the OR to S1 produces reflex modification of the response to S2, then Group S1
      and the Control group will display larger SCRs on the first trial of the second
      phase of the experiment compared to Group S3, in which the OR to S1 will produce
      reflex modification. However, if conditioned diminution of the unconditioned
      response (UR) elicited by S1 produces reflex modification of the response to S2,
      then there should be no initial differences between the groups in the second
      phase of the experiment. The results showed that SCRs in Group S1 were
      significantly larger in the second phase compared to Group S3. This result favors
      an OR explanation of reflex modification. In Expt. 2, the effect of conditioned
      diminution of the UR on reflex modification was further investigated.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2228748
TI  - Early cognitive components of somatosensory event-related potentials.
AB  - Somatosensory event-related potentials (ERPs) were recorded during a selective
      attention task involving electrical stimuli delivered to index fingers or the
      left and right median nerves at the wrist. In 11 healthy, young subjects, ERPs
      were recorded from 6 scalp locations while they mentally counted the electrical
      stimuli designated as target. Sequential ERP events measured included N20
      (negativity at 20 ms), P30, P45, N60, P100, N140, P180, and P400. Analysis of
      amplitude data indicated modifications of both early and late ERP events with
      selective attention. While electrical stimulation at the wrist yielded early ERP
      amplitudes that were larger overall and latencies that were generally shorter,
      the selection attention effects did not differ on the basis of site of
      stimulation. The early ERP selective attention effects had differing scalp
      topography, with the P30/P45 effect of maximal over postcentral gyrus and N60
      effect maximal over prerolandic gyrus. The data further elucidate the temporal
      features and spatial distribution of somatosensory ERP processes involved in
      attentional activity.

PMID- 2228749
TI  - Biofeedback-produced hemispheric asymmetry of slow cortical potentials and its
      behavioural effects.
AB  - Two studies served to examine behavioural effects of slow cortical potentials
      (SPs). SPs were manipulated by means of a biofeedback procedure. The ability of
      human subjects to alter SPs differentially between the two hemispheres-
      specifically over the lateral aspects of the central sulcus--was tested by
      providing feedback of the SP difference between C3 and C4. In Expt. I, 21 of the
      45 subjects produced hemispheric asymmetries of more than 2 microV between C3 and
      C4 on an average after 80 trials of analogue, continuous and immediate feedback.
      In Expt. II, SP changes were fed back digitally at the end of each trial. Within
      120 trials, 20 of the 48 subjects reached the criterion of a minimum 2-microV
      difference in SPs between C3 and C4 on the average. Average differentiation
      remained significantly below the SP differentiations achieved for continuous
      feedback. Trials with feedback were followed by 'task' trials without feedback,
      during which subjects were still requested to produce SP changes but also had to
      complete a task: Either sensorimotor tasks (Expt. I) or forced choice handedness
      tasks (Expt. II) were presented to evaluate behavioural consequences of
      hemispheric SP differences. In subjects achieving the required SP differentiation
      it affected the behavioural output in agreement with the known functions of the
      respective cortical area.

PMID- 2228750
TI  - Occurrence of infraslow potential oscillations in relation to task, ability to
      concentrate and intelligence.
AB  - The occurrence of infraslow potential oscillations (ISPOs) of the brain was
      investigated during a listening and a resting condition in 44 subjects (Ss) with
      high (HAC) and low ability to concentrate (LAC). The occurrence of ISPOs was
      found in 36% of the Ss. While in the HAC group the occurrence of ISPOs did not
      change from listening to resting, in the LAC group Ss with ISPOs were affected by
      experimental conditions, showing ISPOs during the listening condition. For Ss
      with ISPOs only during listening a lower score was found for ability to
      concentrate, suggesting ISPOs as a possible underlying mechanism. For Ss with
      stable ISPOs a higher I.Q. was found compared to Ss without ISPOs.

PMID- 2228751
TI  - Ontogeny of the endorphinergic and dopaminergic modulation on the immobility
      reflex elicited by clamping in rats.
AB  - The effects of some dopaminergic and endorphinergic agonists and antagonists on
      the immobility reflex (IR) elicited by clamping the neck of the rat were
      investigated. We found that both morphine and haloperidol produce a significant
      increase in the duration of this IR at all ages tested (10, 20 and 300 days). The
      effect of apomorphine depends on the age of the rat, showing an increase in the
      duration of the immobility reflex only at the age of 10 days which was not
      counteracted by haloperidol. Naloxone alone showed a slight non-significant
      tendency to increase the duration of the IR but blocked morphine effects at all
      ages tested. When naloxone was added to apomorphine there was a peculiar effect:
      the duration of the immobility reflex was increased significantly in rats of 20
      days and adults, but not in 10-day-old rats. The combination of morphine plus
      haloperidol showed the most marked potentiation of the immobility reflex at all
      ages tested. These results are discussed with respect to the development of
      dopaminergic and endorphinergic systems to control posture and movement during
      the IR, and its possible relation to the catatonia of schizophrenics. A
      hypothetical model explaining an interaction between the dopaminergic and
      endorphinergic systems in developing and adult rats is presented.

PMID- 2228752
TI  - Sensation-seeking: electrodermal and behavioral effects of stimulus content and
      intensity.
AB  - Although a number of studies support an arousal theory interpretation of
      differential sensation-seeking behavior, the conditions under which arousal
      correlates of this personality dimension are manifest is as yet unclear. Both
      theory and research suggest that among the external factors affecting the
      differential arousal response are stimulus relevance and stimulus intensity. The
      present study assessed the impact of these factors on both psychophysiological
      and behavioral responses. Subjects were preselected to represent the extremes of
      the sensation-seeking dimension, then exposed to auditory and visual
      presentations of a series of sexual and aggressive stimuli of systematically
      varied intensity. High sensation seekers gave larger amplitude SCRs to violent
      stimuli and larger initial responses to sexual stimuli presented visually, while
      verbal response intensities showed an opposite pattern. Overall, results provided
      support for an arousal theory interpretation of sensation-seeking, but suggested
      that the probability and magnitude of group differences is a somewhat complex
      function of stimulus intensity, stimulus modality, and perhaps other factors not
      yet assessed.

PMID- 2228753
TI  - Stability of resonance EEG reactions to flickering light in humans.
AB  - In order to study resonance phenomena in the EEG response to flickering light, 10
      subjects were exposed to intermittent photic stimulation with the frequency of
      flashes linearly changing from 1 to 15 Hz and vice versa. Spectral analysis of
      occipital electrical activity revealed the occurrence of peaks of spectral
      density in those frequency components which coincide with the frequency of
      flashes. Such resonance peaks were observed at individually specific frequencies
      of stimulation. To assess the stability of the characteristics of the resonance
      phenomena, a repeated trial with 4-fold higher rate of changing the flash
      frequency was performed 3 months later. In a repeated trial the resonance
      phenomena were less pronounced, but were registered at the same frequencies as in
      the initial trial, showing significant test-retest reliability. The data obtained
      are interpreted in terms of provoking the activity of multiple brain oscillators
      having a narrow tuning to individually specific frequencies of photic stimulation
      by flickering light with the changing frequency of flashes.

PMID- 2228754
TI  - Initially high plasma prolactin levels are depressed by prolonged psychological
      stress in males.
AB  - Plasma levels of prolactin were determined by radioimmunoassay in medical
      students before and after an academic examination and corresponding control
      periods. Before the academic examination, both the males' and the females'
      prolactin values were higher than their control values; they were statistically
      significant, however, only in the males. After the examination, the prolactin
      values were lower than the control values in the males, but not in the females.
      The results partly explain the diverging opinions in the literature regarding the
      effect of psychological stress on plasma prolactin.

PMID- 2228755
TI  - Nasopharyngeally and vertex recorded P300's in normal subjects.
AB  - The P300 waveform has been associated with cognitive activity during information
      processing, and the hippocampus has been discussed as a possible generator of
      this waveform. This being the case some would argue that it should be possible to
      record the P300 with a shorter latency and greater amplitude from an electrode
      placed as near the hippocampus as possible. Under local anaesthesia we inserted a
      specially constructed needle electrode through the left nostril in the recessus
      pharyngeus close to the hippocampus. The results did not support the hippocampal
      hypothesis. Nasopharyngeally recorded P300's were found to have significantly
      decreased amplitudes and extended latencies when compared to vertex recordings.

PMID- 2228756
TI  - Aggression in dogs.

PMID- 2228757
TI  - Uveitis as a manifestation of Borrelia burgdorferi infection in dogs.

PMID- 2228758
TI  - "Steal phenomenon" proposed as the cause of blindness after arterial occlusion
      for treatment of guttural pouch mycosis in horses.

PMID- 2228759
TI  - Feedlot consultant shares insights on FDA investigations.

PMID- 2228761
TI  - Pricing a veterinary practice.

PMID- 2228760
TI  - Safe levels of antimicrobial residues in milk announced by FDA.

PMID- 2228762
TI  - Punitive damages.

PMID- 2228763
TI  - Power and sample size.

PMID- 2228764
TI  - Satisfying an itch to treat itching pets.

PMID- 2228765
TI  - ECG of the month.

PMID- 2228766
TI  - Repeated transplacental transmission of Neospora caninum in dogs.
AB  - Four litters of German Shorthaired Pointers from one owner developed a
      toxoplasmosis-like illness. According to the records, 29 of 39 dogs had hind limb
      paralysis. Six dogs from 2 litters were necropsied and had generalized
      encephalomyelitis. Tachyzoites and tissue cysts of Neospora caninum were found in
      the brain and spinal cord of each dog. Lesions were found in the eyes,
      extraocular muscles, or both in all of the dogs, and N caninum was detected
      microscopically in the eyes (retina and choroid in 1 dog), extraocular muscles,
      or both in 5 of the 6 dogs. Ocular lesions consisted of focal retinitis,
      choroiditis, mild nonspecific iridocyclitis, and myositis of extraocular muscles.
      Organisms stained with anti-N caninum serum, but not with anti-Toxoplasma gondii
      serum in an immunohistochemical test, except in 1 dog. In one dog, aged thick
      walled N caninum tissue cysts reacted mildly with anti-T gondii serum.

PMID- 2228767
TI  - Effects of sedation on intradermal skin testing in flea-allergic dogs.
AB  - Effects of 4 commonly used sedatives on the wheal-and-flare response to histamine
      and flea antigen were evaluated in 8 flea-allergic Beagles. Skin testing was
      performed in 12 separate occasions, 3 to 4 days apart. Twelve intradermal
      injections were given during each skin test: 5 doubling dilutions of histamine
      phosphate, 6 doubling dilutions of flea antigen, and a phosphate-buffered saline
      solution (negative control). Of the 12 intradermal skin tests, 8 were control
      tests performed on nonsedated dogs. The remaining 4 tests were performed on dogs
      sedated with xylazine, ketamine and valium combination, acepromazine, or
      oxymorphone. Oxymorphone had the most profound effect on skin test results,
      significantly (P less than 0.05) decreasing skin responsiveness in 8 of 11 test
      sites (by objective evaluation) and in 5 of 11 test sites (by subjective
      evaluation). Xylazine sedation enhanced skin test results in 4 of 11 test sites
      (by objective evaluation) and in 1 of 11 test sites (by subjective evaluation).
      In non instance did xylazine significantly decrease skin responsiveness to
      histamine or flea antigen. Xylazine is the recommended sedative in dogs when
      sedation is necessary for intradermal skin testing.

PMID- 2228769
TI  - Use of external coaptation for the treatment of avascular necrosis of the femoral
      head in a dog.
AB  - Avascular necrosis of the femoral head was diagnosed in a 5-month-old Schipperke,
      before the development of femoral head and neck collapse and resultant
      degenerative joint disease. External coaptation, consisting of an Ehmer sling,
      was used to prevent the bearing of weight during revascularization and
      reossification of the subchondral bone. Results of pelvic radiography (at 10 and
      24 weeks) indicated that the early use of conservative treatment was successful
      in promoting resolution of the aseptic necrosis and in maintaining normal
      coxofemoral anatomic features and function.

PMID- 2228768
TI  - Comparison of two doses of aqueous bovine thyrotropin for thyroid function
      testing in dogs.
AB  - Thyroid function was evaluated in 20 healthy dogs by thyrotropin (TSH) response
      testing. Two dose regimens were used: 5 IU of TSH given IV and 1 IU of TSH given
      IV. Blood samples were collected prior to and at 4 and 6 hours after TSH
      administration. Serum was obtained and analyzed for total 3,5,3'-tri
      iodothyronine and thyroxine (T4) concentrations by radioimmunoassay. All dogs
      were classified as euthyroid on the basis of response to 5 IU of TSH at 4 and 6
      hours. The 1-IU dose of TSH failed to induce adequate increase in T4
      concentration in 7 dogs at 4 and 6 hours when the criteria for normal response
      were post-TSH serum concentration T4 greater than or equal to 3.0 micrograms/dl
      and serum T4 increase by greater than or equal to 100% over baseline serum T4
      concentration. One IU of TSH induced increase in serum T4 concentration over
      baseline; however, the increase was significantly (P less than 0.05) less than
      that in response to a 5-IU dose at 6 hours after administration of TSH.

PMID- 2228770
TI  - Disseminated aspergillosis attributable to Aspergillus deflectus in a springer
      spaniel.
AB  - Disseminated aspergillosis attributable to Aspergillus deflectus was diagnosed in
      a Springer Spaniel with lethargy, lameness, anorexia, weight loss, pyrexia,
      lymphadenopathy, hematuria, and urinary incontinence. Necropsy revealed
      granulomatous inflammation and numerous fungal hyphae in many organs. The
      conidial heads of the fungus have a characteristic briar-pipe appearance in
      culture.

PMID- 2228771
TI  - Isolation of Microsporum vanbreuseghemii from skin lesions of a dog.
AB  - Routine examination of a 12-week-old Labrador Retriever revealed circular scaly
      lesions, with alopecia, on the lateral aspect of the left carpus and left upper
      eyelid. The geophilic fungus Microsporum vanbreuseghemii was isolated from the
      lesions. Topical treatment with chlorhexidine ointment resulted in resolution,
      with hair regrowth.

PMID- 2228772
TI  - Pigmented villonodular synovitis and plasmacytoid lymphoma in a dog.
AB  - A 4-year-old Labrador Retriever was examined because of progressive left hind
      limb lameness involving the stifle. A villous synovial mass was evacuated by
      synovectomy. Initially, the macroscopic and histopathologic features suggested a
      malignant fibrosarcomatous process; however, further histologic studies revealed
      lesions consistent with pigmented villonodular synovitis. Nine months later, the
      dog developed a large retroperitoneal tumor, with metastasis to the lungs and
      liver. The dog was then euthanatized. By histologic and electron microscopic
      examinations, the tumor was found to be a primitive plasmacytoid lymphoma.

PMID- 2228773
TI  - Congenital obstruction of the caudal vena cava in a dog.
AB  - A 16-week-old female Rottweiler was examined because of labored breathing and
      abdominal distention. Ascites, hepatomegaly, and pleural effusion were detected
      during physical and radiographic examinations. Selective angiography revealed a
      stenotic lesion at the junction of the caudal vena cava and the right atrium. A
      fibrous diaphragm with a pin-hole orifice was observed at surgery. Clinical signs
      of disease resolved after successful removal of the membranous obstruction.

PMID- 2228774
TI  - Giant cell tumor of the accessory carpal bone in a dog.
AB  - A 4-year-old Springer Spaniel was referred because of a 6-week history of
      progressive left forelimb lameness. A marked pain response was elicited by
      palpation over the left accessory carpal bone. Radiography revealed a lytic,
      markedly expansile lesion of the accessory carpal bone. The bone was excised, and
      pancarpal arthrodesis was performed. Histologic examination of the excised bone
      revealed giant cell tumor. At 14 months after surgery, the dog was using the limb
      normally. Radiography of the carpus revealed satisfactory progression of the
      arthrodesis, and thoracic radiographs were negative for metastases.

PMID- 2228775
TI  - Bronchial dysgenesis and lobar emphysema in an adult cat.
AB  - An adult male cat was examined because of chronic respiratory tract disease.
      Results of thoracic radiography indicated overinflation of the right lung, and
      atelectasis or agenesis of the left lung. Notable aerosol deposition
      (ventilation) to the right caudal lung lobe was seen by use of pulmonary
      ventilation scintigraphy. Postmortem findings suggested the primary pathoanatomic
      lesion was bronchial dysgenesis involving all but the right caudal lung lobe.

PMID- 2228776
TI  - Wound infection rates in dogs and cats after use of cotton muslin or disposable
      impermeable fabric as barrier material: 720 cases (1983-1989).
AB  - A retrospective study involving 720 dogs and cats that underwent a variety of
      elective surgical procedures was done to compare the effectiveness of reusable
      cotton barrier materials with that of a commercially available disposable barrier
      system for prevention of wound infection. The overall wound infection rate, using
      cotton barrier materials, was 3.1% and for disposable materials, was 4.4%. The
      difference between groups was not significant.

PMID- 2228777
TI  - Clinical and epizootiologic characteristics of dogs seropositive for Borrelia
      burgdorferi in Texas: 110 cases (1988).
AB  - Of 2,409 canine serum samples submitted to the Texas Veterinary Medical
      Diagnostic Laboratory between Jan 1, 1988 and Dec 31, 1988 and tested by
      immunofluorescent antibody technique for antibody to Borrelia borgdorferi, 132
      (5.5%) had positive results. Clinical and epizootiologic characteristics of
      seropositive dogs from Texas (n = 110) were examined. Male dogs were more likely
      than female dogs to be seropositive for B burgdorferi. The most frequent clinical
      sign of disease described in seropositive dogs was lameness; neurologic,
      ophthalmologic, dermatologic, renal, and hepatic signs also were reported by
      referring veterinarians.

PMID- 2228778
TI  - Adverse drug reactions in cattle.

PMID- 2228779
TI  - What is your diagnosis? Agenesis of the left sixth rib.

PMID- 2228780
TI  - What is your diagnosis? Diffuse mineralization throughout the lungs and the
      stomach.

PMID- 2228781
TI  - Instruction on health care malpractice issues in entry-level physical therapy
      curricula.
AB  - In the face of an ongoing health care malpractice crisis, instruction on
      malpractice issues in entry-level health care professional education programs is
      vital for the legal well-being of prospective clinicians. A 1978 survey of US
      medical schools revealed that less than 40% required instruction in medical law.
      By 1989, 76% of US medical schools required medicolegal instruction. This article
      summarizes the results of a survey of entry-level physical therapy educational
      programs to determine whether a majority currently offer required malpractice
      instruction. The study found that the majority do offer such instruction. Half of
      the physical therapy programs with instruction in malpractice employ attorney
      instructors, essential for improving relations between health care and legal
      professionals. Graduate entry-level programs offer 11 or more hours of
      medicolegal instruction with greater frequency than undergraduate programs.
      Additional surveys of other allied health disciplines are recommended to
      ascertain other standards for entry-level malpractice-related instruction.

PMID- 2228782
TI  - An investigation of managed health care case managers.
AB  - Managed care case management is a relatively new concept within health and
      rehabilitation. As such, it lacks both definition and profiles of those providing
      services. This paper constructs a definition of managed care case management and
      presents the detailed results of a survey that identified the characteristics of
      case managers in the Midwest. The survey was mailed to 250 subjects. The
      respondents of the survey (N = 56) were relatively young (the largest number of
      respondents were 30 to 39 years of age), relatively new to their jobs (means =
      2.2 years), and were typically employed full-time. They primarily served mental
      health (n = 43) and physically impaired (n = 30) clients. The highest number of
      their service referrals were made to vocational rehabilitation specialists,
      social workers, occupational therapists, nurses, and physical therapists.

PMID- 2228783
TI  - Profile of an allied health dean.
AB  - This study sought to gather baseline data about allied health deans in academic
      health centers in the US, their backgrounds, career patterns, role
      characteristics, and perceptions of professional development. The study also
      examined relationships that existed between a profile of allied health deans
      established in this study and other selected career variables. Allied health
      deans in 63 academic health centers were surveyed using a 55-item, self
      administered questionnaire, "Today's Allied Health Deans." The results revealed
      that the characteristics of allied health deans did not depart significantly from
      those of other academic deans. All deans had fairly uniform experiences in their
      roles as academic officers across the country. A review of their career patterns
      showed that they departed slightly from the traditional career ladder models
      established for other academic deans.

PMID- 2228784
TI  - Looking to the 21st century in schools of allied health.
AB  - During 1989, the members of the College of Health Deans participated in a Delphi
      study to identify objectives for schools of allied health professions now
      planning to meet the health care needs in the year 2000. There was consensus
      among the participating deans that 21 potential developments in health and health
      care are likely to occur by the year 2000 and that 16 objectives related to these
      developments are important for schools of allied health.

PMID- 2228785
TI  - The relationship between choice of college major and prevalence of adult children
      of alcoholics.
AB  - This study was designed to clarify the possible relationship between choice of
      college major and prevalence of parental alcoholism. A total of 190 occupational
      and physical therapy (OT/PT) students were surveyed using the Children of
      Alcoholics Screening Test. Results were compared to those from a group of 211
      marketing, mixed, and undecided majors. The allied health OT/PT group reflected a
      33% prevalence of parental alcoholism. Furthermore, a significant difference was
      found between the allied health and nonallied health groups. Awareness of this
      prevalence can help faculty identify students who are adult children of
      alcoholics and refer them for help before potential problems arise when they
      become helping professionals.

PMID- 2228786
TI  - A view from Washington. Allied health and the federal budget process.

PMID- 2228787
TI  - Where have all the graduates gone?

PMID- 2228788
TI  - Intermediate filaments in the inner ear of normal and experimentally damaged
      guinea pigs.
AB  - The hypothesis that proteins known to occur in glial cells in the central nervous
      system may be present in inner-ear supporting cells was investigated.
      Immunocytochemical techniques were used to look for the existence of two classes
      of intermediate filaments, vimentin and glial fibrillary acidic protein (GFAP),
      in cellular elements of the inner-ear epithelium in normal and experimentally
      damaged guinea-pig cochleas. Vimentin is present in two types of supporting cells
      in the normal organ of Corti: Deiters' cells and inner pillar cells. Differences
      in intensity and distribution of vimentin immunostaining are observed across the
      three rows of Deiters' cells. GFAP immunoreactivity was not detected in any
      supporting-cell type in the organ. Cochlear hair cells were not labeled for
      either GFAP or vimentin. Following hair-cell destruction by exposure to noise or
      the administration of aminoglycosides, GFAP and vimentin are not present in
      phalangeal scars replacing lost hair cells.

PMID- 2228789
TI  - Derivation of auditory filter shapes from notched-noise data.
AB  - A well established method for estimating the shape of the auditory filter is
      based on the measurement of the threshold of a sinusoidal signal in a notched
      noise masker, as a function of notch width. To measure the asymmetry of the
      filter, the notch has to be placed both symmetrically and asymmetrically about
      the signal frequency. In previous work several simplifying assumptions and
      approximations were made in deriving auditory filter shapes from the data. In
      this paper we describe modifications to the fitting procedure which allow more
      accurate derivations. These include: 1) taking into account changes in filter
      bandwidth with centre frequency when allowing for the effects of off-frequency
      listening; 2) correcting for the non-flat frequency response of the earphone; 3)
      correcting for the transmission characteristics of the outer and middle ear; 4)
      limiting the amount by which the centre frequency of the filter can shift in
      order to maximise the signal-to-masker ratio. In many cases, these modifications
      result in only small changes to the derived filter shape. However, at very high
      and very low centre frequencies and for hearing-impaired subjects the differences
      can be substantial. It is also shown that filter shapes derived from data where
      the notch is always placed symmetrically about the signal frequency can be
      seriously in error when the underlying filter is markedly asymmetric. New
      formulae are suggested describing the variation of the auditory filter with
      frequency and level. The implication of the results for the calculation of
      excitation patterns are discussed and a modified procedure is proposed. The
      appendix list FORTRAN computer programs for deriving auditory filter shapes from
      notched-noise data and for calculating excitation patterns. The first program can
      readily be modified so as to derive auditory filter shapes from data obtained
      with other types of maskers, such as rippled noise.

PMID- 2228790
TI  - S-100 immunoreactivity identifies a subset of hair cells in the utricle and
      saccule of a fish.
AB  - Certain hair cells of fish exhibit strong immunoreactivity to an S-100 antibody.
      By their spatial locations in the utricle and saccule, these hair cells appear to
      possess a relatively short kinocilium and a roughly ovoid cell shape. In the
      utricle, these cells are predominantly located in the striola. In the saccule,
      these cells are found within the central area of the epithelium. In both of these
      epithelia the strongly immunoreactive hair cells coincide with the locations of
      hair cells possessing F1 ciliary bundles.

PMID- 2228791
TI  - SEM analysis of the developing tectorial membrane in the chick cochlea.
AB  - The development of the tectorial membrane in the embryonic chick cochlea was
      studied using scanning electron microscopy. Chick embryos ranged in age from
      embryonic day 7 (E7) to post-hatching day 15. Our studies revealed that a fine
      filamentous matrix arose on the apical surface of the basilar papilla at
      approximately E7. This matrix was secreted by the supporting cells which
      encircled the hair cells. By E9, the early matrix had increased in volume but
      remained filamentous in structure, except at the inferior edge of the basilar
      papilla where it was condensed into a layer of laterally-oriented columns. At E9
      the TM exhibited an additional layer of matrix, called the amorphous component.
      It appeared to originate from the homogene cell population, and attached to the
      early columnar matrix at the inferior edge of the basilar papilla. The two
      components of the TM were separated by a longitudinal ridge, called the 'track',
      which marked the inferior edge of the amorphous component. As the cochlea
      developed, the basilar papilla increased in width, the columnar component
      elongated and the track appeared to recede. These morphological findings point to
      separate developmental origins for the two components of the tectorial membrane.

PMID- 2228792
TI  - Psychophysical measures from electrical stimulation of the human cochlear
      nucleus.
AB  - Auditory performance on basic psychophysical tasks was measured in ten deaf
      patients with electrodes positioned near their cochlear nucleus. The device is
      called the auditory brainstem implant (ABI). Electrodes were placed during
      surgery to remove an acoustic neuroma, which results in the removal of the VIII
      nerve and, thus deafness. In patients who received auditory sensation from
      electrical stimulation we measured auditory performance on standard
      psychophysical tasks: thresholds, loudness growth, intensity discrimination,
      temporal integration, temporal modulation detection, gap detection, and forward
      masking. Plots of threshold as a function of frequency or biphasic pulse duration
      were markedly different from those of patients with cochlear implants. The
      difference in threshold functions is probably partly due to the biophysical
      difference in the neural elements stimulated. Another possibility is that part of
      the difference is due to the highly abnormal spatial pattern of activation in the
      cochlear nucleus from electrical stimulation, which prevents normal spatial
      integration of activity. The usable range of electrical amplitudes above
      threshold is comparable with that of cochlear implants, typically 10-15 dB.
      Little temporal integration occurs over a range of stimulus durations from 2-1000
      ms. When compared at equivalent loudness levels, gap detection thresholds are
      similar to, or a bit longer than, gap thresholds in normal-hearing listeners and
      cochlear implant patients. Forward masking recovery functions are similar to
      those of normal listeners and cochlear implant patients. Patients' ability to
      detect amplitude modulation as a function of modulation frequency is similar to
      that of cochlear implant patients and normal listeners. Thus, direct electrical
      stimulation of the brainstem produces temporal resolution that does not
      significantly differ from that of normal listeners when compared in equivalent
      amplitude units. This implies that the limiting factors for these tasks are more
      centrally located, and not directly related to threshold mechanisms. Thus, a
      properly designed speech processor could preserve the important temporal features
      of speech for these patients.

PMID- 2228794
TI  - The effect of a low-frequency masker on loudness.
AB  - Intense low-frequency tones produce masking-period patterns in which the masking
      of a higher-frequency tone burst varies by up to 25 dB over the period of the
      masker. In this experiment, observers were asked to match the loudness of
      partially masked test-tone bursts in one ear by adjusting the level of unmasked
      bursts presented to the other ear. It was found that the variation in masked
      threshold over the period of the masker also affects loudness matches. This
      effect on loudness, although it decreases in size with increasing level above
      masked threshold, persists even 25 dB above masked threshold.

PMID- 2228793
TI  - Pentoxifylline increases cochlear blood flow while decreasing blood pressure in
      guinea pigs.
AB  - The effects of pentoxifylline on cochlear blood flow (CoBF) were investigated in
      anesthetized guinea pigs by laser Doppler flowmetry and intravital microscopy red
      blood cell velocity measurement. Intra-arterial infusion of pentoxifylline (3, 4,
      and 5 mg/kg/min) produced dose-dependent reductions in blood pressure,
      accompanied by significant elevations in CoBF that were not dose-dependent. These
      results are in general agreement with previous findings from our laboratory
      utilizing normotensive and spontaneously hypertensive rats, however, in contrast
      with rats, guinea pigs revealed an initial decrease in CoBF followed by an
      increase. Also, pentoxifylline produced relatively smaller elevations in CoBF in
      guinea pigs as compared with those previously reported in rats. Taken together
      these results support the hypothesis that pentoxifylline increases vascular
      perfusion by decreasing blood viscosity and increasing the plasticity of red
      blood cells.

PMID- 2228795
TI  - Evoked response narrow-band noise masking patterns in the chinchilla.
AB  - Narrow-band noise masking patterns were measured at 0.5, 1, 2 and 4 kHz in the
      chinchilla using the auditory evoked response from the inferior colliculus. At
      low masker levels, the masking profiles were symmetrical and centered on the
      masker. However, as masker level increased, the masking profiles spread
      predominantly toward the high frequencies. The masking profiles obtained at 0.5
      and 1 kHz, exhibited a broad plateau extending 1-2 octaves above the masker at
      the highest masker level (70 dB SPL) whereas those obtained at 2 and 4 kHz showed
      a peak. In contrast to tone-on-tone masking profiles, none of the narrow-band
      noise masking profiles contained a low-threshold notch on the high frequency side
      of the masker. The evoked response masking profiles obtained in the chinchilla
      were slightly wider, but qualitatively similar to those measured psychophysically
      in humans. Thus, the evoked response narrow-band noise masking profiles may
      provide a convenient way of evaluating the spread of masking in difficult-to-test
      subjects.

PMID- 2228796
TI  - Acetylcholinesterase-positive innervation in cochleas from two strains of shaker
      1 mice.
AB  - Shaker-1 is a recessive gene mutation on chromosome 7 in mice, causing both
      deafness and neurosensory degeneration in the inner ear. A failure of efferent
      innervation to the outer hair cells is being implicated in the cause of deafness
      (Green, 1981). To investigate the efferent innervation, we examined the cochleas
      of two strains of shaker-1 mutants: Sh1/Le (25 and 45 days old) and FS/Ei (28 and
      68 days old), using enzymatic staining of acetylcholinesterase (AChE) for the
      light and electron microscopes, and also by measuring the activities of AChE and
      of AChE molecular forms. The enzyme levels in the SH1/Le and FS/Ei homozygotes
      (sh-1/sh-1) were within the range of those in SH1/Le heterozygotes (+/sh-1) and
      in normal mouse strains (C3H/HeJ, 129/SvJ, ICR). The picture of AChE-positive
      innervation in both strains differed. In the SH1/Le mutants at 25 days, the
      innervation appeared normal, but by 45 days it showed a marked atrophy. In the
      FS/Ei mutants, the degeneration was already evident by the 28th day. In the
      younger animals of both mutants, large differentiated vesiculated nerve endings
      were ultrastructurally detected in synaptic contact with outer hair cells. The
      preservation of AChE activity and of the expression of AChE molecular forms up to
      68 days indicate that the shaker-1 cochlea may initially possess a normal input
      of AChE-positive efferent innervation. The late onset and the slow course of the
      degeneration of AChE-positive innervation seen in the SH1/Le mutants suggest that
      the loss of efferent endings may be, contrary to previous suggestions, the
      consequence rather than the cause of the shaker-1 pathology.

PMID- 2228797
TI  - Acetylcholine, carbachol, and GABA induce no detectable change in the length of
      isolated outer hair cells.
AB  - The mechanical and electrical properties of cochlear outer hair cells (OHCs) are
      suggested to modulate transduction by inner hair cells. These properties of OHCs
      are presumably regulated by efferent neurons which use several transmitters
      including acetylcholine (Ach) and gamma aminobutyric acid (GABA). Since it had
      been suggested that Ach causes isolated OHCs to shorten visibly, this study was
      designed to investigate whether GABA also alters the length of OHCs. OHCs were
      isolated from the guinea pig cochlea by mechanical dispersion after collagenase
      treatment. Cells were initially selected by strict morphological criteria. In
      addition they were only included in further studies if they attained a constant
      length during 10 min of superfusion with buffer solution. Neither GABA (20
      microM: 100 microM), Ach (5 mM; 10 microM with 10 microM eserine) or carbachol
      (10 microM; 100 microM) altered OHC length when applied in iso-osmotic Hank's
      balanced salt solution (total number of cells tested, 72). If a change in length
      occurred it must have been smaller than 0.3 microns, our detection ability. In
      contrast, high potassium and variations in osmolarity changed hair cell length by
      3-10% in agreement with other reports.

PMID- 2228798
TI  - Insulin stimulates protein synthesis and phospholipid signaling systems but does
      not regulate glucose uptake in the inner ear.
AB  - High-affinity insulin receptors exist in the organ of Corti (Kd = 1.1 +/- 0.5 nM)
      and in the lateral wall (stria vascularis and ligamentum spirale; Kd = 1.1 +/-
      0.4 nM) of the inner ear of the guinea pig as determined by the binding of
      radiolabeled porcine or bovine insulin in vitro. Carrier-mediated transport of
      glucose (defined as the cytochalasin B-sensitive part of total uptake) was
      measured in vitro with 2-deoxy-D-glucose as the substrate. Its Km was 188 microM
      in the lateral wall (r = 0.99 and 0.94, respectively). Neither the Km nor the
      rates of transport (0.20 +/- 0.10 pmol/micrograms protein/hr in the organ of
      Corti, and 0.56 +/- 0.34 pmol/micrograms protein/hr in the lateral was) were
      affected by insulin. In contrast, 0.1 mM ouabain decreased deoxyglucose uptake in
      the organ or Corti by 37% and in the lateral wall tissues by 45% indicating the
      presence of an active, Na(+)-dependent transporter in these tissues. Insulin
      influenced both protein and lipid metabolism in the inner ear. Proteins and
      lipids were labeled in situ by perfusion of the perilymphatic space of the
      cochlea with [3]-leucine or [32P]-orthophosphate and [3H]-glycerol, respectively.
      Thirty nM insulin stimulated the incorporation of [3H]-leucine into protein of
      the organ of Corti from 39 to 56 pmol/mg protein but was ineffective in the
      tissues of the lateral wall. In the organ of Corti, [32P]-orthophosphate was
      incorporated into the phosphoinositides and phosphatidate, and 30 nM insulin
      increased this incorporation by 101 to 149%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228799
TI  - Basic properties of auditory-nerve responses from a "simple' ear: the basilar
      papilla of the frog.
AB  - Spike discharges initiated by mammalian inner hair cells are produced by a
      complicated system involving both mechanical and neural components that normally
      operate in a bi-directional configuration involving multiple feedback loops. In
      contrast, the frog basilar papilla has the equivalent of inner hair cells, but
      lacks outer hair cells; it has no efferent system, and no basilar membrane. This
      suggests that the frog basilar papilla lacks some of the mechanical and neural
      feedback paths characteristic of the mammalian system. Detailed measurements of
      tuning curves, spontaneous activity and responses to tones an clicks reveal large
      parametric differences between frog and mammals in spontaneous rate, absolute
      refractory time, long-term adaptation and phase locking. Responses to tone bursts
      are qualitatively similar, but parametrically quite different. More focused
      examinations of these effects will be able to exploit the differences in
      adaptation to long- versus short-duration stimuli could be caused by depletion of
      afferent neurotransmitter or by activation of feedback loops involving the
      efferent system. In the basilar papilla, any differences in adaptation must
      result from changes in the afferent pathway alone.

PMID- 2228800
TI  - Potassium-induced release of an endogenous toxic activity for outer hair cells
      and auditory neurons in the cochlea: a new pathophysiological mechanism in
      Meniere's disease?
AB  - In Meniere's disease, the increase of extracellular potassium concentration in
      the perilymph is thought to play a key role in determining the progressive loss
      of cochlear hair cells. In this paper, we describe a serum-free culture
      preparation of hair cells from 5 day-old rat and report the release by the
      cochlea, in response to an increase of extracellular potassium concentration, of
      a cytotoxic activity active on hair cells and auditory neurons. The toxic
      activity is associated with low molecular weight (less than 10,000 Dalton)
      molecule(s) as revealed by ultrafiltration. Morphological studies performed on
      the organ of Corti incubated during 24 h in the presence of the cochlea-derived
      toxic activity (CTA), show that this factor is toxic for hair cells and not for
      supporting or surrounding cells. The release of CTA occurs both in the spiral
      ganglion and in the organ of Corti. We suggest that this cochlea-derived toxic
      activity may play an important role in the pathophysiology of the hearing loss
      that occurs during the progression of Meniere's disease.

PMID- 2228801
TI  - Quantitative assessment of the rat stria vascularis.
AB  - Stria vascularis tissues from standardized regions in the basal, middle and
      apical turns of the rat cochlear duct were assessed quantitatively. Strial width,
      number of marginal cells across the strial width, radial area, as well as the
      volume density of the different components of the stria vascularis were
      determined for each standardized region. Strial width, number of marginal cells
      across the strial width and the radial area were greatest in the basal region and
      least in the apical region of the cochlea. The volume density of intermediate
      cells and capillary space was statistically unchanged in the three examined
      regions of the stria vascularis. However, the volume density of marginal cells
      and that of basal cells were different between regions. The volume density of
      marginal cells was highest in the basal turn while the volume density of basal
      cells was greatest in the apical turn. An objective assessment of the response of
      the stria vascularis to environmental conditions can be made by kant of its
      cellular architecture, providing a means to compare the effects of various agents
      between animal models used to study human inner ear dysfunction.

PMID- 2228802
TI  - On the influence of acoustical probe impedance on evoked otoacoustic emissions.
AB  - Using two different probes representing different acoustical impedances,
      simultaneously evoked otoacoustic emissions, thresholds in quiet, and delayed
      evoked emissions were measured in the frequency region of 900 to 1100 Hz for one
      subject who has extremely large emissions at these frequencies. All data show
      that the sound pressure produced in the closed ear canal clearly depends on two
      contributions, that of the activity of the inner ear, and that of the acoustical
      impedance of the probe. These effects can be simulated in an analog model of
      peripheral preprocessing.

PMID- 2228803
TI  - The ototoxic mechanism of cisplatin.
AB  - The ototoxic mechanism of cisplatin was investigated. Potentiation of cisplatin
      ototoxicity by furosemide and amino-oxyacetic acid (AOAA) was observed.
      Substantial hearing loss in cisplatin-deafened animals was accompanied by normal
      values of the endocochlear potential and a reduction in the sensitivity of the
      2f1-f2 distortion products. The loss in dB of the sensitivity of the distortion
      products correlated extremely well with the loss of the neural sensitivity in dB.
      There was also a relationship between the fractional reduction of the low
      frequency (1000 Hz) microphonic potential and hearing loss in dB. Iontophoresis
      of cisplatin into scala media resulting in the immediate loss of neural
      thresholds at the site of iontophoresis. It is concluded that cisplatin caused
      the hearing loss by blocking OHC transduction channels.

PMID- 2228804
TI  - Heterodyne interferometer measurements of the frequency response of the manubrium
      tip in cat.
AB  - A heterodyne interferometer proved to be a very accurate tool to measure
      amplitude and phase of the malleus response during acoustical stimulation. It was
      shown that to obtain equal accuracy in the acoustical pressure measurements,
      pressure response must be remeasured at short time intervals. At frequencies
      above 4 kHz various gross resonances are apparent on the frequency response
      curves. The resonances are, depending on the animal, more or less pronounced. As
      a result of the improved accuracy changes of the malleus vibration response with
      time could clearly be discriminated. These changes can be related to shifts in
      frequency of the position of these resonances. Comparison of experimental
      frequency response and lumped parameter model predictions from literature shows
      that these resonances are not present in the model responses.

PMID- 2228806
TI  - Carbachol-induced inositol phosphate formation during rat cochlea development.
AB  - The age related-intensity developmental pattern of the phosphoinositide
      breakdown, which leads to the formation of intracellular second messengers, was
      investigated in rat cochleas by measuring the accumulation of inositol phosphates
      induced by carbachol in the presence of LiCl. The accumulation of the
      phosphoinositide metabolites elicited by this muscarinic agonist is very low at
      post-natal day 1 and particularly large during the period between post-natal days
      8 and 14 with a peak around day 12. In the 25-day-old rat cochlea, carbachol
      induced a 2-fold increase in inositol phosphates (IPs) accumulation, with respect
      to the basal control level. The apparent affinities of the carbachol-induced IPs
      responses are 49.6, 31.6 and 36.7 microM in cochleas of 12-, 16- and 25-day-old
      rats, respectively, thus suggesting that the specific developmental changes are
      rather due to a modification in the number of muscarinic cholinergic receptors
      than to alterations of the apparent affinity of carbachol for its receptors. This
      developmental pattern of carbachol-elicited IPs accumulation reveals a striking
      time coincidence with both the efferent synaptogenesis at the outer hair cells
      (OHCs) level and the period of increased sensitivity of OHCs to aminoglycoside
      toxicity. Phosphoinositide breakdown may, consequently, play a role in the
      maturation of OHCs and their efferent supply. In addition, the remaining IPs
      response measured at 25 post-natal days indicates that muscarinic agonist
      mediated IPs metabolism also occurs in mature cochlea, and might be involved in
      the regulation of OHCs motility.

PMID- 2228805
TI  - Periaqueductal gray influence on anteroventral cochlear nucleus unitary activity
      and naloxone effects.
AB  - The effect of periaqueductal gray (PAG) electrical stimulation on the response
      properties of auditory and 'spontaneously' firing units (abolished when the
      cochlea is destroyed) in the anteroventral cochlear nucleus (AVCN) was explored
      using extracellular recordings in acute guinea-pigs. Significant increases and
      decreases in firing rate were detected in both neuronal groups: only 4% of the
      sound-responding units were insensitive to PAG stimulation while the
      'spontaneous' units showed significantly smaller changes in firing rate in
      response to PAG stimulation. The auditory AVCN neurons were categorized both by
      their sound post stimulus time (PST) histograms at their characteristic frequency
      (CF) and the changes in the probability of discharge after PAG stimulation while
      the tone burst was maintained constant. PAG was implicated in pain input
      modulation through enkephalin actions. Because enkephalins have been also
      observed at the CN level, a pharmacological approach administering naloxone was
      carried out. We observed that 1) naloxone abolished the unit discharge shifts
      observed after PAG stimulation and 2) when the drug was injected without PAG
      stimulation, it produced changes in the firing, increasing or decreasing, and
      shifts in the probability of discharge versus time, even in cases in which the
      firing rate was not altered. An involvement of the auditory efferent pathways to
      CN is postulated and a possible enkephalinergic factor is suggested as a
      modulator of the auditory input at this level. The probability of discharge
      observed in the PSTH at the AVCN is dependent on the auditory input plus the
      central efferent action to its neurons.

PMID- 2228807
TI  - Sensitivity for interaural time and intensity difference of auditory midbrain
      neurons in the grassfrog.
AB  - The sensitivity for interaural time (ITD) and intensity (IID) difference was
      investigated for single units in the auditory midbrain of the grassfrog. A
      temporally structured stimulus was used which was presented by means of a closed
      sound system. At best frequency (BF) the majority of units was selective for ITD
      as indicated by an asymmetrically (73%) or symmetrically (7%) shaped ITD-rate
      histogram. About 20% appeared to be nonselective. Units with a symmetrical rate
      histogram had BFs well above 0.9 kHz, whereas for the other categories no
      relationship with BF was observed. Most units had a selectivity for ITD which was
      rather independent from frequency and absolute intensity level. In 62% of the
      units interaural time difference could be traded by interaural intensity
      difference. In most cases this so-called time-intensity trading could be
      explained by the intensity-latency characteristics of auditory nerve fibres.
      About 20% was sensitive to IID only and 5% to ITD only. A binaural model is
      proposed which is based on the intensity-rate and intensity-latency
      characteristics of auditory nerve fibres, the linear summation of excitatory and
      inhibitory post synaptic potentials in second order neurons, and spatiotemporal
      integration at the level of third order neurons. By variation of only a small
      number of parameters, namely strengths and time constants of the connectivities,
      the range of experimentally observed response patterns could be reproduced.

PMID- 2228808
TI  - Reversible blockade of vestibular evoked activity in the chick.
AB  - Vestibular evoked potentials (VsEP) were recorded from young chickens following
      bilateral intralabyrinthine injections of Tetrodotoxin (TTX). The purpose of this
      study was to document the long term effects of TTX on the electrophysiological
      activity of the vestibular system. VsEP components were eliminated within 30 min
      of TTX injections. Twelve hours post-treatment the early waves of the response
      began to emerge from the background noise. Recordings completed 24 h after the
      manipulation were not different from baseline responses. Our results indicate
      that TTX is a useful substance for reversibly blocking vestibular afferent
      pathways without permanently damaging the labyrinth or neural components. In
      addition, VsEP is an appropriate tool to objectively evaluate vestibular system
      function. Their combination can be applied to study the significance of afferent
      influences on the development and function of vestibular nuclei.

PMID- 2228809
TI  - Women of Denmark.

PMID- 2228810
TI  - Maternal role of women in clerical jobs in southern Brazil: stress and
      satisfaction.
AB  - The number of women in the work force in Brazil is increasing, and a pattern of
      early work participation and a later decline continues to be manifested. The
      maternal role is a central role for these women. We investigated the quality of
      the maternal role as perceived by women who hold clerical jobs in a southern
      Brazilian city. Qualitative and quantitative data were collected from a random
      sample of 60 women. Thirty-three of these women were mothers with one or more
      children. Maternal role likes, dislikes, and stresses were obtained through
      questionnaires. Coping strategies and resources to cope with the maternal role
      needs were also obtained. Analytical categories were developed for each of these
      variables and the analysis was completed through the use of a qualitative
      computer program.

PMID- 2228811
TI  - Trying it on for size: mutual support in role transition for pregnant teens and
      student nurses.
AB  - Pregnant adolescents and student nurses are both undergoing role transition when
      student nurses teach prenatal classes to single adolescents. Through participant
      observation and the constant comparative analysis of grounded theory, I
      determined that both groups engage in the process of "trying it on for size". As
      learners teach learners, an environment of mutual support is created that allows
      for experimentation with roles. In this article, the process of trying it on for
      size is discussed from the perspective of a faculty advisor with emphasis on the
      benefits to both students and clients.

PMID- 2228812
TI  - Dimensions of nurse and patient roles in labor.
AB  - Nurses, as the principal caregivers during labor, play a major role in
      structuring the social context of childbirth. The influence of nurse-patient
      verbal interaction on the social construction of the childbirth experience was
      investigated. Verbatim records of nurse-patient interaction during labor were
      analyzed using Stiles's (1978a) Taxonomy of Verbal Response Modes. Nurse and
      patient scores on three dimensions of interpersonal roles, attentiveness,
      acquiescence, and presumptuousness, were determined. The results indicated that
      nurses established and maintained control over the definition of the childbirth
      experience. The viewpoint of the laboring woman was seldom acknowledged as
      relevant. Presumption of knowledge of the laboring woman's experience and failure
      to determine her perception of the situation can have a negative impact on
      individualization of care and the creation of a patient-centered birthing
      environment.

PMID- 2228813
TI  - Sleep and the reproductive cycle: a review.
AB  - Women of all ages have been found to have a higher rate of sleep disturbances
      than men. Attempts to determine whether hormonal changes marking their
      reproductive lives render women more vulnerable to emotional stress and to
      concomitant sleep disturbances are the focus of this article. Investigations of
      sleep patterns and sleep-related experiences that occur in connection with the
      menstrual cycle (normal menstrual cycle and premenstrual syndrome) and are
      associated with hormonal abnormalities (amenorrhea) and changes in hormonal
      status (pregnancy and menopause) are reviewed. Methodological problems are
      discussed and areas of future research are proposed. It is suggested that the
      triad of sleep, endocrine changes, and mood should be more systematically
      investigated.

PMID- 2228815
TI  - Early patterns of maternal attachment.
AB  - The relationship between maternal-fetal attachment and maternal-child interaction
      was examined. The Maternal Fetal Attachment Scale (Cranley, 1981) was
      administered to 32 women between their 35th and 40th weeks of pregnancy. These
      mothers were observed again while they fed their infants once on the second and
      once on the third postpartum days. Their interactive behaviors were then rated on
      the Nursing Child Assessment Feeding Scale (University of Washington) and the
      Funke Mother-Infant Interaction Assessment. The findings indicated a positive and
      significant relationship between maternal fetal attachment behaviors and mother
      infant interaction. Qualitative data collected during the research process gave
      meaning and interpretation to observed behaviors. Implications for nursing
      practice are discussed.

PMID- 2228814
TI  - Drug therapy in pregnancy: the lessons of diethylstilbestrol, thalidomide, and
      bendectin.
AB  - A pregnant woman and the fetus she carries face health risks from many sources.
      One risk that requires ongoing vigilance is the use of prescription drugs during
      pregnancy. The international health care community has been sensitized to the
      risks of drug use during pregnancy because of three pharmaceuticals that have
      caused widespread crises for mothers and their offspring. The crises that
      diethylstilbestrol, thalidomide, and, to a lesser extent, Bendectin have created
      in the past four decades are reviewed in this article. The lessons these drug
      crises can teach us are articulated in the belief that similar crises may be
      averted in the future.

PMID- 2228816
TI  - Enhancing the adolescent reproductive process: efforts to implement a program for
      black adolescent fathers.
AB  - The importance of adolescent fathers participating more fully in pregnancy and
      childrearing has been emphasized increasingly in the literature. This article
      describes the development and evaluation of childbearing clinical services
      designed for adolescent fathers. This multidisciplinary effort used an action
      research model that integrates empirical research into ongoing programs,
      continuously monitoring progress. It is comprised of five elements: population
      description, determination of clients' health needs, assessment and development
      of resources, evaluation of program services, and monitoring of outcomes.
      Although the study was not designed exclusively for black adolescents, 95% of the
      individuals who participated were black. The cultural composition of the study
      population suggests and impact on the findings. Suggestions are made for future
      program efforts with adolescent parents.

PMID- 2228817
TI  - Frequency of illness in mother-infant dyads.
AB  - The purpose of this study was to identify the frequency and types of illnesses
      experienced by mothers and their infants who were in the second half of the first
      year of life, the actions taken concerning these illnesses, the number of days
      the mother was hospitalized or in bed because of illness, and the subjective
      health status of both as rated by the mothers. During home visits mothers (N =
      182) completed the Health Status Interview. They were asked about infant and
      maternal illness in the previous month and the actions taken in response to them.
      The number and types of illnesses reported indicate that mothers of full-term
      infants who were healthy at birth must deal with a number of minor illnesses in
      themselves and in their infants. The possible relationship of maternal illness to
      stress is discussed and suggestions are given for interventions by health
      professionals.

PMID- 2228818
TI  - Self-attitudes and behavioral characteristics of Type A and B female registered
      nurses.
AB  - Type A behavior in nurses has received little attention from researchers despite
      its assumed prevalence. What attitudes and behaviors distinguish Type A from Type
      B nurses? In this descriptive study, locus of control and selected self-attitudes
      of female RNs who exhibited the Type A pattern (n = 40) were compared with
      attitudes of Type B nurses (n = 40). The participants were selected from a larger
      sample of 178 RNs on the basis of extremely high and extremely low Type A scale
      scores. Type A nurses were more likely to term themselves "perfectionistic" or
      "compulsive" and to construe time as an enemy, in contrast to Type B nurses, who
      often referred to themselves as "easy-going." Self-aggrandizement characterized
      73% of Type A nurses, as opposed to only 23% of Type Bs. As expected, Type A and
      B nurses differed significantly in terms of job involvement, speed/impatience,
      and hard-driving behaviors. Although it is widely recognized that the daily work
      of nurses subjects them to considerable physical and psychosocial stress,
      findings of this study suggest that a segment of RNs (Type As) may be at
      particular risk for coronary heart disease, burnout, and other health problems
      due to a constellation of attitudes and behaviors that they bring with them to
      the stressful work environment. Future research investigating the relationship of
      Type A/B characteristics and nursing turnover or burnout is recommended.

PMID- 2228819
TI  - Effects of a premenstrual syndrome education program on premenstrual
      symptomatology.
AB  - This exploratory study was conducted to determine the effects of an educational
      program on the number and severity of premenstrual symptoms as well as the number
      of premenstrual days with symptoms. Participants were a convenience sample of 47
      employed women, whose scores on Abraham's Menstrual Symptomatology Questionnaire
      were in the moderate to severe range. Women were randomly divided into control
      and experimental groups, and those in the experimental groups participated in an
      education program. Both groups recorded daily on Abraham's Menstrual Symptom
      Diary for 19 anxiety, appetite, edema, and depression symptoms. Participants in
      the education program had fewer occurrences of anxiety and appetite symptoms and
      fewer severe edema and depression symptoms, as well as fewer days with symptoms,
      than women who did not participate in the educational program. The findings
      support the idea that client education can promote self-care and improve health
      status.

PMID- 2228820
TI  - Rural U.S. women: traditions and transitions affecting health care.
AB  - Warren (1972) proposed a means for determining differences between rural and
      urban social contexts that expands on the population definitions. Essentially,
      these differences are geographical, social, and economic in nature, and the
      health status of individuals in either setting may be affected by these
      variations. The health issues of women that evolve from these rural factors are
      the focus of this article.

PMID- 2228822
TI  - Local chemotherapy of selected bacterial infections of the ear.

PMID- 2228821
TI  - Epidemiology of antibiotic-inactivating enzymes and DNA probes: the problem of
      quantity.

PMID- 2228823
TI  - A comparative study on the inhibitory actions of chloramphenicol, thiamphenicol
      and some fluorinated derivatives.
AB  - Chloramphenicol, thiamphenicol and three fluorinated derivatives, Sch 24893, Sch
      25298 and Sch 25393, were studied with respect to inhibition of the growth of
      selected bacterial strains and cell-free translation systems. Thiamphenicol was
      the least potent inhibitor in the former experiments, but behaved similarly to
      chloramphenicol and Sch 25298 in the latter, thereby displaying selective
      inhibition of prokaryotic protein synthesis. Thiamphenicol and Sch 25298 were
      shown to be like chloramphenicol in inhibiting peptidyl transferase activity
      specifically on 70 S ribosomes, but the antibiotics bound to their common
      ribosomal-receptor site with different efficiencies in the order chloramphenicol
      greater than thiamphenicol greater than Sch 25298. Selected bacterial strains
      highly resistant to chloramphenicol and thiamphenicol because of chloramphenicol
      acetyltransferase production were, in contrast, highly sensitive to inhibition by
      the fluorinated antibiotics. Thus Sch 24893, Sch 25298 and Sch 25393 may have
      important uses in veterinary and clinical medicine.

PMID- 2228824
TI  - In-vitro antibacterial activity of DQ-2556 and its stability to various beta
      lactamases.
AB  - DQ-2556, a new cephalosporin, showed a broad antibacterial spectrum over Gram
      positive and -negative organisms. The activity of DQ-2556 against recent clinical
      isolates of Gram-positive cocci and Enterobacteriaceae was comparable with that
      of cefpirome, and superior to that of ceftazidime. DQ-2556 was almost as active
      as cefpirome against Pseudomonas aeruginosa, but was less active than
      ceftazidime. With the exception of Ps. aeruginosa, DQ-2556 was bactericidal
      against various organisms at either the MIC or twice the MIC. DQ-2556 bound
      preferentially to penicillin-binding proteins (PBPs) 2, 1 and 3 of Staphylococcus
      aureus, PBPs 3, 1A and 1B of Escherichia coli and PBPs 1A, 3 and 4 of Ps.
      aeruginosa. DQ-2556 was stable to various penicillinases and cephalosporinases,
      but was unstable to oxyiminocephalosporinases. The Km values of DQ-2556 for the
      cephalosporinases of Citrobacter freundii and Enterobacter cloacae were only two-
      or three-fold higher than those of ceftazidime, indicating that DQ-2556 had a
      relatively high affinity for these enzymes compared with other recently developed
      cephalosporins. The MIC of DQ-2556 for Esch. coli increased four-fold in an OmpF
      deficient mutant, indicating that the OmpF porin was one of the major routes for
      penetration of DQ-2556 into Esch. coli cells.

PMID- 2228825
TI  - The effect of sodium salicylate on antibiotic susceptibility and synergy in
      Klebsiella pneumoniae.
AB  - Sodium salicylate was combined with the antibiotics amikacin, aztreonam,
      cefazolin, cefonicid, cefoperazone, ceftizoxime, norfloxacin, doxycycline,
      clindamycin, imipenem, mezlocillin and trimethoprim-sulphamethoxazole. The
      activity of the combinations was tested against encapsulated strains of
      Klebsiella pneumoniae, which differed markedly in their antibiotic
      susceptibility. The addition of salicylate (from 2 to 350 mg/l) to cultures
      increased the MIC of most antimicrobial agents from two- to four-fold, with the
      exception of imipenem and amikacin. Inhibition by imipenem was largely unchanged,
      and that of amikacin was increased in the presence of salicylate. The synergy of
      the combination of cefazolin and amikacin was abolished by salicylate, while the
      synergistic activity of imipenem and amikacin was significantly increased by
      salicylate. Doxycycline activity was most severely affected by salicylate as
      antimicrobial activity was significantly diminished at salicylate levels as low
      as 5 mg/l. In contrast, significant loss of inhibitory activity with other
      antimicrobials required at least 100 mg/l of salicylate. The clinical
      implications of salicylate on the sensitivity of K. pneumoniae to antimicrobials
      are discussed.

PMID- 2228826
TI  - In-vitro study of the susceptibility of cefoxitin/cefotetan resistant Bacteroides
      fragilis group strains to various other antimicrobial agents.
AB  - The in-vitro activity of various beta-lactam antibiotics, beta-lactam/beta
      lactamase inhibitor combinations, clindamycin, and metronidazole was determined
      against Bacteroides fragilis group isolates that were resistant to both cefoxitin
      and cefotetan. Among the cephalosporins tested ceftizoxime was the most active
      with 80% of the strains susceptible, followed by cefotaxime (65% susceptible),
      and cefoperazone (47% susceptible). Piperacillin and clindamycin showed
      comparable activity to ceftizoxime with 80% and 81% susceptible, respectively.
      The addition of a beta-lactamase inhibitor (sulbactam, clavulanate, or
      tazobactam) enhanced the activity of the various beta-lactam agents from 4-fold
      to 16-fold overall. One strain of B. fragilis was found that was resistant to all
      beta-lactam agents either alone or in combination. All strains in this study were
      susceptible to less than or equal to 4 mg/l of metronidazole.

PMID- 2228827
TI  - Beta-lactamase production, beta-lactam sensitivity and resistance to synergy with
      clavulanate of 737 Bacteroides fragilis group organisms from thirty-three US
      centres.
AB  - Beta-Lactamase production and agar dilution sensitivities to amoxycillin,
      amoxycillin/clavulanate, ticarcillin, ticarcillin/clavulanate, cefoxitin,
      imipenem and metronidazole were determined for 737 Bacteroides fragilis group
      strains isolated between 1986 and 1988 from 33 US centres. The strains comprised
      441 B. fragilis, 114 B. thetaiotaomicron, 35 B. ovatus, 58 B. distasonis, 58 B.
      vulgatus, 26 B. uniformis and five B. caccae. Overall, addition of clavulanate
      lowered the geometric mean MICs of of amoxycillin from 46.7 to 0.6 mg/l, and of
      ticarcillin from 37.2 to 1.3 mg/l. Addition of clavulanate increased the number
      of strains sensitive to amoxycillin from 9.5% to 90.0%, and to ticarcillin from
      68.0% to 98.6%. However, synergy was not observed following addition of
      clavulanate to amoxycillin and ticarcillin for 48 strains (6.5%). These comprised
      15 B. fragilis, two B. ovatus, 21 B. distasonis, six B. vulgatus and four B.
      uniformis strains. Ten of the 15 non-synergic B. fragilis isolates had the
      features of B. fragilis homology group II and were susceptible to amoxycillin
      alone; the other five strains were resistant to amoxycillin and ticarcillin.
      Geometric mean MICs (% susceptibility) of the non-synergic strains were as
      follows: amoxycillin, 6.2 mg/l (68.8); amoxycillin/clavulanate, 4.8 mg/l (72.9);
      ticarcillin, 11.8 mg/l (75.0); ticarcillin/clavulanate, 9.4 mg/l (77.1). Twenty
      six strains (3.5% were resistant (greater than 32 mg/l) to cefoxitin, and two
      strains (0.3%) were resistant (4 mg/l) to imipenem. All were susceptible to
      metronidazole. Thus, on the basis of in-vitro activity, metronidazole, imipenem,
      ticarcillin/clavulanate, cefoxitin and amoxycillin/clavulanate are indicated for
      treatment of infections with B. fragilis strains. The clinical significance of
      the lack of synergy with clavulanate in the B. fragilis group is unclear;
      relatively low beta-lactam MICs for most of these strains suggests that they may
      be amenable to therapy with high doses of beta-lactams. Results of this study
      indicate that it cannot be assumed that clavulanate will uniformly inhibit beta
      lactamases in the B. fragilis group (especially B. distasonis) and indicate the
      need for identification and susceptibility testing, especially in cases of
      serious infections with these strains.

PMID- 2228828
TI  - Comparative in-vitro activities of ten fluoroquinolones and fusidic acid against
      Mycobacterium spp.
AB  - The in-vitro activities of eight new quinolones (A-56620, amifloxacin,
      difloxacin, CI-934, enoxacin, irloxacin, pefloxacin, temafloxacin), two reference
      fluoroquinolones (ciprofloxacin and ofloxacin) and fusidic acid against 147
      mycobacterial strains, belonging to seven different species, were compared.
      Temafloxacin, ofloxacin and ciprofloxacin were the most active compounds. They
      only showed consistent activity against Mycobacterium tuberculosis, M. malmoense
      and M. fortuitum, but not against M. chelonei, M. avium, M. intracellulare and M.
      scrofulaceum. However, individual strains of these species were sometimes
      susceptible. The best overall in-vitro activity was obtained with temafloxacin,
      which often showed activity where other products were inactive. Fusidic acid
      merely displayed good activity against M. tuberculosis (MIC90 16 mg/l).

PMID- 2228829
TI  - The contribution of Escherichia coli to microbial colonization resistance.
AB  - The contribution of Escherichia coli to the microbial colonization resistance
      (CR) of the bowel was investigated in six healthy volunteers. Esch. coli was
      eliminated from faeces by the administration of a low dose (20 mg daily) of
      pefloxacin. This did not cause an increase in the faecal concentration of aerobic
      Gram-positive cocci or yeasts, nor did it facilitate colonization of the bowel by
      a pefloxacin-resistant challenge strain of Klebsiella pneumoniae. Therefore,
      Esch. coli does not appear to contribute to the microbial CR. After ten days of
      pefloxacin, clindamycin 300 mg was administered twice daily for 18 days.
      Clindamycin caused a significant increase in the faecal concentration of
      enterococci, yeasts and the K. pneumoniae challenge strain, indicating that the
      study design was suitable to demonstrate disturbance of microbial CR if it
      occurred.

PMID- 2228830
TI  - Effect of ceftazidime and gentamicin on the oropharyngeal and faecal flora of
      patients with haematological malignancies.
AB  - Thirty-four patients with haematological malignancies were studied to investigate
      the effect of empirical broad-spectrum antibiotic therapy (ceftazidime and
      gentamicin) on the gastro-intestinal flora. Twenty-five patients with acute
      myeloid leukaemia or post-autologous bone-marrow transplantation were given
      framycetin, nystatin and colistin (Fracon), and two patients with non-Hodgkin's
      Lymphoma were on co-trimoxazole, as long-term gut prophylaxis. Semi-quantitative
      microbiology was carried out on oropharyngeal swabs and quantitative microbiology
      on faecal specimens. The oropharyngeal flora consisted mainly of streptococci,
      coagulase-negative staphylococci and coryneforms, and was little affected by
      ceftazidime/gentamicin. A strain of Enterobacter cloacae resistant to ceftazidime
      and gentamicin colonized one patient, who later developed septicaemia. The faecal
      flora of patients on Fracon was dominated by enterococci; the few enterobacteria
      present were eliminated by ceftazidime/gentamicin. The anaerobic flora was absent
      in 15% of patients; in the remainder, it consisted mainly of Bacteroides spp.,
      and was little affected by ceftazidime/gentamicin. The faecal flora of patients
      not on Fracon always contained anaerobes, and some strains of enterobacteria
      persisted throughout antibiotic treatment. None of the patients was colonized by
      Clostridium difficile or Pseudomonas aeruginosa. Broad-spectrum therapy with
      ceftazidime and gentamicin appeared to have little effect on the gastro
      intestinal flora, except to encourage the overgrowth of enterococci and reduce
      the numbers of enterobacteria.

PMID- 2228831
TI  - A three year survey of clinical isolates in the United Kingdom and their
      antimicrobial susceptibility.
AB  - A United Kingdom national survey of clinical isolates and their antimicrobial
      susceptibility was performed, with 61 participating hospital laboratories,
      between 1986 and 1989. Each centre used Microbe Base, a commercial suite of micro
      computer programs which can record and analyse antimicrobial susceptibility data
      Informative on 366,853 bacterial isolates and their antimicrobial susceptibility
      was received from hospital and domiciliary specimens; Candida spp. accounted for
      a further 9121 isolates. The sites of origin were urine 51%, skin and soft tissue
      21%, lower respiratory tract 8%, genital tract 7%, ear, nose and throat 6%, eye
      3%, blood 1.5% and faeces 1%. Gram-negative bacteria accounted for 242,307
      isolates, the main species were Escherichia coli 48%, Proteus spp. 9%,
      Pseudomonas spp. 7%, Haemophilus influenzae 6% and Klebsiella spp. 4%. Gram
      positive bacteria numbered 124,546 with a predominance of Staphylococcus aureus
      42%, beta-haemolytic streptococci 20%, Enterococcus spp. 12%, coagulase negative
      staphylococci 10% and Streptococcus pneumoniae 5%. All pneumococci were sensitive
      to penicillin, and methicillin resistant in Staph. aureus was only 2%. Twelve per
      cent of H. influenzae strains were resistant to ampicillin. There were no
      significant levels of gentamicin resistance in Gram-negative bacilli.

PMID- 2228832
TI  - 4-Quinolone resistant staphylococci.

PMID- 2228833
TI  - Susceptibility of enteropathogenic bacteria to furazolidone.

PMID- 2228834
TI  - Tetracycline resistance in Gardnerella vaginalis.

PMID- 2228835
TI  - Disc sensitivity testing to ofloxacin.

PMID- 2228836
TI  - Cefaclor in the treatment of chronic bronchitis.

PMID- 2228837
TI  - Successful treatment with chloramphenicol of Pseudomonas mesophilica peritonitis
      not responding to aztreonam and gentamicin.

PMID- 2228838
TI  - Serum protein binding and extravascular diffusion of methoxyimino cephalosporins.
      Time courses of free and total concentrations of cefotaxime and ceftriaxone in
      serum and pleural exudate.
AB  - A new approach to the study of the distribution pharmacokinetics of variably
      bound beta-lactams is to plot the concentration time course of their free
      (dialysable) and total (free and bound) forms. In the present study, the 6-h
      concentration time course was plotted of the total and free concentrations of
      cefotaxime and ceftriaxone in serum and pleural exudate in 12 patients per group,
      after iv dosing with 1 g of either cefotaxime or ceftriaxone. Samples were taken
      at 0.5, 1, 1.5, 2, 3, 4 and 6h after dosing. The results of a study of similar
      design, but conducted over 24 h in ten patients per group, following iv dosing
      with either cefotaxime 1 g 12-hourly or ceftriaxone 1 g daily are also reported.
      Samples were taken at 0.5, 1, 1.5, 2, 4, 6, 8, 12, 14, 16 and 24 h after dosing.
      Areas under the curve of free cefotaxime in pleural fluid were greater than those
      of free ceftriaxone, in both the 6 h (+54.6%) and 24 h studies (+29.8% after 12 h
      and +71.0% after 24 h). The free cefotaxime/free ceftriaxone Cmax ratio was 1.75
      in the 6 h study. Cefotaxime was superior to ceftriaxone in terms of the
      diffusion of the free (antibacterially active) fraction into a typical
      inflammatory exudate. Assessment of the effects of protein binding must be taken
      into account in antibiotic pharmacokinetic profiles.

PMID- 2228839
TI  - Tissue penetration of cefotaxime in normal pigs and pigs with haemorrhagic
      pancreatitis.
AB  - This study was designed to evaluate the tissue penetration of cefotaxime in
      normal pigs and pigs with haemorrhagic pancreatitis. Serum, peritoneal fluid,
      bile, gallbladder wall and pancreatic tissue concentrations of cefotaxime in
      these groups of pigs exceeded the MIC90 for susceptible species of Gram-negative
      aerobic bacteria. Cefotaxime penetration into pancreatic tissue and peritoneal
      fluid was increased from 2% to 2.6% and 73% to 89%, respectively, in pigs with
      pancreatitis in comparison with normal pigs. These increases however, were not
      statistically significant.

PMID- 2228840
TI  - An experimental model of chronic osteomyelitis caused by Escherichia coli treated
      with cefotaxime.
AB  - An experimental model in Wistar rats, of osteomyelitis caused by Escherichia
      coli, was used to evaluate the efficacy of cefotaxime in two treatment regimens
      of different durations. Four groups of rats were set up: a group of rats
      receiving short-term treatment (14 days) with subcutaneous cefotaxime (100 mg
      bd), killed after 56 days; a control group receiving no treatment, killed after
      56 days; a group of rats undergoing long-term treatment (28 days) with
      subcutaneous cefotaxime as above, killed after 70 days and a control group of
      rats receiving no treatment, killed after 70 days. Analysis of histopathological
      and microbiological findings revealed significantly better results in the long
      term treatment group. No side-effects were observed during treatment or
      afterwards.

PMID- 2228841
TI  - Treatment of gonococcal conjunctivitis with a single intramuscular injection of
      cefotaxime.
AB  - Between 25% and 50% of children in African countries are exposed to Neisseria
      gonorrhoeae at birth and are at risk of developing gonococcal ophthalmia
      neonatorum. The problem is aggravated by the emergence of penicillinase-producing
      strains of N. gonorrhoeae (PPNG). Twenty-one children (9 boys, 12 girls, mean age
      13 days) presenting with gonococcal conjunctivitis were identified during a 47
      month period. Nineteen children received a single im injection of 100 mg/kg
      cefotaxime (maximum dose 1 g) without topical antibiotic therapy. One neonate
      with concurrent otitis media was treated with cefotaxime for five days and a 17
      month old girl received two im injections because of the severity of her
      symptoms. Eight patients (38%) had received previous antibiotic therapy
      (penicillin im and/or tetracycline eye ointment). Twelve isolates of N.
      gonorrhoeae were found to be PPNG strains. At three to seven day follow-up
      examination all 21 patients were clinically cured without residual eye damage.
      Cefotaxime offers an effective first line treatment for gonococcal ophthalmia
      neonatorum in areas where there is a high prevalence of PPNG strains. The
      advantages of a single-dose treatment over multidose regimens in terms of
      compliance and cost are discussed.

PMID- 2228842
TI  - Short-course cefotaxime compared with five-day co-amoxyclav in acute otitis media
      in children.
AB  - This randomized, multicentre prospective study was undertaken to compare the
      efficacy and tolerance of a one day course of injectable cefotaxime with a five
      day oral course of co-amoxyclav (amoxycillin plus clavulanic acid) in the
      treatment of acute otitis media in children. The study was conducted in 116
      patients between the ages of three months and 12 years. No significant difference
      in efficacy was observed between the two treatment groups, but tolerance to the
      treatments differed significantly. There were no unwanted side-effects in the
      cefotaxime group whereas 22% of children in the amoxycillin plus clavulanic acid
      group suffered side-effects (P 0.0007). Short-course antibiotic therapy with
      cefotaxime appears to be a valuable alternative to conventional treatment
      regimens for acute otitis media in children.

PMID- 2228844
TI  - Cefotaxime in the treatment of chronic osteomyelitis caused by gram-negative
      bacilli.
AB  - Fifty patients with chronic osteomyelitis due to aerobic or facultative Gram
      negative bacilli, alone or in mixed infections with Gram-positive cocci, were
      treated with cefotaxime. The diagnosis of osteomyelitis was made on the basis of
      clinical, roentgenographical, isotopic, microbiological and histopathological
      evidence of infection. Only those patients with infection sensitive to cefotaxime
      were treated. Most patients received 2 g cefotaxime qid iv for 30-60 days (mean
      40 days). Some patients received metronidazole in addition. The following results
      were obtained at the six month follow-up: 40 patients cured, six improved, no
      failures and four relapses. The surgical technique had an impact on these
      results. No clinically important side-effects were encountered, nor were any
      cefotaxime resistant strains found.

PMID- 2228843
TI  - Comparison of cefotaxime, cefoxitin and clindamycin plus gentamicin in the
      treatment of uncomplicated and complicated pelvic inflammatory disease.
AB  - Patients with uncomplicated pelvic inflammatory disease (PID) (acute salpingitis
      and no pelvic masses) were randomly assigned for treatment with either cefotaxime
      or cefoxitin. A clinical cure was achieved in 17 of 20 cases (82%) and 19 of 22
      cases (84%), respectively. Within the complicated PID group, patients were
      assigned to two subgroups: those with a tubo-ovarian complex (26 patients), and
      those with a tubo-ovarian abscess (32 patients), as confirmed by ultrasonography
      or surgery. Patients within each of these two subgroups were then randomly
      assigned for treatment with either cefotaxime or clindamycin plus gentamicin.
      Within the tubo-ovarian complex subgroup, a clinical cure was achieved in 11 of
      13 cases (85%) treated with cefotaxime and 10 of 13 cases (77%) treated with
      clindamycin plus gentamicin. Within the tubo-ovarian abscess subgroup, a clinical
      cure was achieved in 12 of 16 cases (75%) treated with cefotaxime and 11 of 16
      cases (69%) treated with clindamycin plus gentamicin. No differences in any
      category were statistically significant. Specimens for culture were obtained from
      the endocervix, endometrium, and when possible, the cul-de-sac, fallopian tubes,
      and abscess. Neisseria gonorrhoeae (33%) was isolated more frequently than
      Chlamydia trachomatis (12%) in patients with PID, and neither of these organisms
      was isolated with any increased frequency in patients with complicated PID. The
      majority of the patients were considered to have polymicrobial infection.
      Cefotaxime was as efficacious as cefoxitin and clindamycin plus gentamicin for
      the treatment of acute salpingitis, tubo-ovarian complex and tubo-ovarian
      abscess.

PMID- 2228845
TI  - Multiresistant Salmonella typhimurium systemic infection in Rwanda. Clinical
      features and treatment with cefotaxime.
AB  - Children with multiresistant Salmonella typhimurium (MRST) systemic infections,
      in total 246, were diagnosed during the study period. Of these, 220 had MRST
      without metastatic focal infections and 26 had metastatic focal infections
      (including 12 patients with meningitis). The median age of the children was 10
      months. Diarrhoeal disease, measles and severe malnutrition were the most
      frequent causes of admission. Fever was found in 99% and diarrhoea in 72% of the
      patients, with respiratory symptoms in 72%. In 199 (81%) of the patients, the
      MRST infection was considered to be hospital-acquired. Of the 246 children, 159
      were treated with cefotaxime. In this group, 16 of 152 patients died (10.5%).
      However, of the 87 children who did not receive cefotaxime, 64 died (74%).
      Relapses occurred in 4% of the patients with bacteraemia treated with cefotaxime.
      Our study confirms the high efficiency of cefotaxime in treating severe systemic
      infections with MRST.

PMID- 2228846
TI  - Prevention of bacterial colonization of the respiratory tract and stomach of
      mechanically ventilated patients by a novel regimen of selective decontamination
      in combination with initial systemic cefotaxime.
AB  - A novel regimen of selective decontamination (SDD) with initial systemic
      cefotaxime prevented bacterial colonization of the oropharynx and stomach in
      mechanically ventilated patients. In a three-group study of all patients
      receiving prolonged mechanical ventilation, patients in control groups A and B
      received antibiotics only when infection was present. In group A, antibiotics
      that disturb colonization resistance (CR) were used. In group B, antibiotics use
      was restricted to antibiotics not affecting CR. Patients in group C received SDD,
      consisting of norfloxacin, polymyxin E and amphotericin B, administered via a
      gastric tube and applied to the oropharynx. Group C patients further received an
      initial five day course of cefotaxime, 500 mg tid. The lower respiratory tract
      was colonized with microorganisms on admission in about half of the patients, and
      this persisted in both control groups. In group C, lower respiratory tract
      colonization was eliminated in all patients after five days. In both control
      groups about 90% of the patients acquired microbial colonization of the
      oropharynx and stomach, mostly with Gram-negative bacilli. In group C, only 12%
      and 24% of the patients acquired colonization of the oropharynx and stomach
      respectively (P less than 0.001). The oropharynx and stomach were the major
      sources of microorganisms causing lower respiratory tract infection in both
      control groups. In group C, elimination of oropharyngeal and gastric colonization
      completely prevented lower respiratory tract infection from these sources.

PMID- 2228847
TI  - Antibiotic prophylaxis with cefotaxime in endoscopic extraction of upper urinary
      tract stones: a randomized study. The Cefotaxime Cooperative Group.
AB  - This French multicentre, placebo-controlled, double-blind study investigated the
      efficacy of a single dose of cefotaxime 1 g iv in the prophylaxis of patients
      undergoing endoscopic extraction of urinary tract stones. Postoperative fever
      occurred in 12 patients in the placebo group and in nine in the cefotaxime group
      (no significant difference). The incidence of postoperative bacteriuria, between
      the first and third postoperative day, was significantly higher in the placebo
      group (15/60, 25%) than in the cefotaxime group (5/60, 8.5%). This controlled
      study clearly demonstrates the efficacy of antibiotic prophylaxis in
      endourological procedures. Cefotaxime significantly reduced the incidence of
      early postoperative bacteriuria without causing any significant side effects.

PMID- 2228848
TI  - Reflex control of the circulation during exercise: chemoreflexes and
      mechanoreflexes.
AB  - The overall scheme for control is as follows: central command sets basic patterns
      of cardiovascular effector activity, which is modulated via muscle chemo- and
      mechanoreflexes and arterial mechanoreflexes (baroreflexes) as appropriate error
      signals develop. A key question is whether the primary error corrected is a
      mismatch between blood flow and metabolism (a flow error that accumulates muscle
      metabolites that activate group III and IV chemosensitive muscle afferents) or a
      mismatch between cardiac output (CO) and vascular conductance [a blood pressure
      (BP) error] that activates the arterial baroreflex and raises BP. Reduction in
      muscle blood flow to a threshold for the muscle chemoreflex raises muscle
      metabolite concentration and reflexly raises BP by activating chemosensitive
      muscle afferents. In isometric exercise, sympathetic nervous activity (SNA) is
      increased mainly by muscle chemoreflex whereas central command raises heart rate
      (HR) and CO by vagal withdrawal. Cardiovascular control changes for dynamic
      exercise with large muscles. At exercise onset, central command increases HR by
      vagal withdrawal and "resets" the baroreflex to a higher BP. As long as vagal
      withdrawal can raise HR and CO rapidly so that BP rises quickly to its higher
      operating point, there is no mismatch between CO and vascular conductance (no BP
      error) and SNA does not increase. Increased SNA occurs at whatever HR (depending
      on species) exceeds the range of vagal withdrawal; the additional sympathetically
      mediated rise in CO needed to raise BP to its new operating point is slower and
      leads to a BP error. Sympathetic vasoconstriction is needed to complete the rise
      in BP. The baroreflex is essential for BP elevation at onset of exercise and for
      BP stabilization during mild exercise (subthreshold for chemoreflex), and it can
      oppose or magnify the chemoreflex when it is activated at higher work rates.
      Ultimately, when vascular conductance exceeds cardiac pumping capacity in the
      most severe exercise both chemoreflex and baroreflex must maintain BP by
      vasoconstricting active muscle.

PMID- 2228849
TI  - Effects of tracheal irritation and hypercapnia on tracheal smooth muscle in
      humans.
AB  - Both hypercapnia and tracheal irritation are known to constrict the airways in
      animals. To see whether similar responses occur in humans, we investigated
      tracheal smooth muscle (TSM) responses to hypercapnia and tracheal irritation
      with water in 14 paralyzed and anesthetized humans. TSM tone was monitored by
      measuring the pressure in the saline-filled cuff of the endotracheal tube.
      Although, tracheal irritation caused TSM constriction in 10 of 14 patients, 4
      patients showed no TSM response. Administration of intravenous atropine
      attenuated the TSM constriction response. Hypercapnia did not cause any change in
      TSM tone in any of the 14 patients. These results indicate that in paralyzed and
      anesthetized humans, there exist interindividual differences in the TSM responses
      to tracheal irritation and that hypercapnia cannot be an effective stimulus for
      the TSM constriction.

PMID- 2228850
TI  - Mucus-depleted frog palate as a model for the study of mucociliary clearance.
AB  - To better understand the frog palate model of mucociliary transport, we measured
      the transport rate of mucus (MTR) from the leopard frog, Rana pipiens, and from
      the bullfrog, R. catesbeiana, recorded the stability of the MTR over a period of
      hours and days and over the course of 1 yr, and measured the viscoelasticity,
      percent solid composition, and spinnability (filance) of mucus from both species.
      Bullfrog mucus was less rigid than leopard frog mucus (log G* at 1 rad/s 2.09 vs.
      2.61; P less than 0.01) and had a higher viscosity-to-elasticity ratio (tan delta
      at 1 rad/s 0.36 vs. 0.26; P less than 0.05). It also had a lower solids content
      (8.71 vs. 13.72%; P = 0.02), and there was a trend to lower spinnability for
      bullfrog mucus (filance 26.7 vs. 33.5 mm). These data suggest that bullfrog mucus
      has viscoelastic properties similar to normal mammalian respiratory mucus and
      leopard frog mucus has viscoelasticity similar to sputum samples. MTR was
      significantly slower in the winter than in the summer months (17 vs. 30 mm/min; P
      less than 0.0001). Although the leopard frog palate could be used for at least 7
      consecutive days without exhaustion, bullfrog palates could be used for only 5
      days. Palates of either species could generally be tested for 6 h/day without a
      significant decrease in MTR. These data clarify some of the sources of
      variability in the use of this system and suggest methods of standardization.

PMID- 2228851
TI  - Cerebral blood flow in acute mountain sickness.
AB  - Changes in cerebral blood flow (CBF) were measured using the radioactive xenon
      technique and were related to the development of acute mountain sickness (AMS).
      In 12 subjects, ascending from 150 to 3,475 m, CBF was 24% increased at 24 h
      [45.1 to 55.9 initial slope index (ISI) units] and 4% increased at 6 days (47.1
      ISI units). Four subjects had similar increases of CBF when ascending to 3,200 m
      3 mo later, indicating the reproducibility of the measurements. In nine subjects,
      ascending from 3,200 to 4,785-5,430 m, CBF increased to 76.4 ISI units, 53% above
      estimated sea-level values. CBF and increases in CBF were similar in subjects
      with or without AMS. In six subjects, CBF was measured before and after
      therapeutic intervention. At 2 h CBF increased 22% (71.3 to 87.3 ISI units) above
      pretreatment values in three subjects given 1.5 g acetazolamide, while three
      subjects given placebo showed no change. Symptoms remained unaltered in all
      subjects during the 2 h of the study. Overall, the results indicated that
      increases in CBF were similar in subjects with or without AMS while acetazolamide
      provoked increases of CBF in AMS subjects caused no acute change in symptoms.
      Alterations in CBF cannot be directly implicated in the pathogenesis of AMS.

PMID- 2228852
TI  - Hydraulic conductivity of canine parietal pleura in vivo.
AB  - The hydraulic conductivity (Lp) of the parietal pleura was measured in vivo in
      spontaneously breathing anesthetized dogs in either the supine (n = 8) or the
      prone (n = 7) position and in an excised portion of the chest wall in which the
      pleura and its adjacent tissue were intact (n = 3). A capsule was glued to the
      exposed parietal pleura after the intercostal muscles were removed. The capsule
      was filled with either autologous plasma or isotonic saline. Transpleural fluid
      flow (V) was measured at several transpleural hydrostatic pressures (delta P)
      from the rate of meniscus movement within a graduated pipette connected to the
      capsule. Delta P was defined as the measured difference between capsule and
      pleural liquid pressures. The Lp of the parietal pleura was calculated from the
      slope of the line relating V to delta P by use of linear regression analysis. Lp
      in vivo averaged 1.36 X 10(-3) +/- 0.45 X 10(-3) (SD) ml.h-1.cmH2O-1.cm-2,
      regardless of whether the capsule was filled with plasma or saline and
      irrespective of body position. This value was not significantly different from
      that measured in the excised chest wall preparation (1.43 X 10(-3) +/- 1.1 X 10(
      3) ml.h-1.cmH2O-1.cm-2). The parietal pleura offers little resistance to
      transpleural protein movement, because there was no observed difference between
      plasma and saline. We conclude that because the Lp for intact parietal pleura and
      extrapleural interstitium is approximately 100 times smaller than that previously
      measured in isolated stripped pleural preparations, removal of parietal pleural
      results in a damaged preparation.

PMID- 2228853
TI  - Fluctuation in timing of upper airway and chest wall inspiratory muscle activity
      in obstructive sleep apnea.
AB  - An imbalance in the amplitude of electrical activity of the upper airway and
      chest wall inspiratory muscles is associated with both collapse and reopening of
      the upper airway in obstructive sleep apnea (OSA). The purpose of this study was
      to examine whether timing of the phasic activity of these inspiratory muscles
      also was associated with changes in upper airway caliber in OSA. We hypothesized
      that activation of upper airway muscle phasic electrical activity before
      activation of the chest wall pump muscles would help preserve upper airway
      patency. In contrast, we anticipated that the reversal of this pattern with
      delayed activation of upper airway inspiratory muscles would be associated with
      upper airway narrowing or collapse. Therefore the timing and amplitude of midline
      transmandibular and costal margin moving time average (MTA) electromyogram (EMG)
      signals were analyzed from 58 apnea cycles in stage 2 sleep in six OSA patients.
      In 86% of the postapnea breaths analyzed the upper airway MTA peak activity
      preceded the chest wall peak activity. In 86% of the obstructed respiratory
      efforts the upper airway MTA peak activity followed the chest wall peak activity.
      The onset of phasic electrical activity followed this same pattern. During
      inspiratory efforts when phasic inspiratory EMG amplitude did not change from
      preapnea to apnea, the timing changes noted above occurred. Even within breaths
      the relative timing of the upper airway and chest wall electrical activities was
      closely associated with changes in the pressure-flow relationship. We conclude
      that the relative timing of inspiratory activity of the upper airway and chest
      wall inspiratory muscles fluctuates during sleep in OSA.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2228854
TI  - Prior running reduces hypertrophic growth of skeletal muscle grafts.
AB  - Run training can increase the mass of soleus muscle grafts, yet values remain
      lower than nongrafted muscle even with continued training. Thus we tested the
      hypothesis that nerve-implant soleus grafts of rats previously run trained would
      be refractory to the hypertrophic stimulus of ablation of synergistic muscle. We
      also compared the magnitude of growth of the nerve-implant soleus graft after
      ablation with that reported by others for the nerve-intact soleus graft. We
      studied eight groups that differed relative to the combination and order of
      treatments (running and ablation of synergistic muscle) and the graft age at the
      time of the ablation operation and study. Graft mass, protein concentration, and
      histochemical fiber composition were measured. Compared with grafts from cage
      sedentary rats, the mass and protein content of the nerve-implant soleus grafts
      were higher (16-63%) at all times after ablation. When the ablation operation was
      performed at 56 days postgrafting, there was a 33% increase in protein content of
      the soleus graft by 84 days for cage-sedentary animals. This increase was twofold
      greater (P less than or equal to 0.02) than the 15% increase that followed
      ablation for the grafts from the animals that had been run trained before the
      ablation operation. Four weeks of run training before the ablation operation
      impaired the adaptive response of muscle grafts to the ablation of synergistic
      muscles, which may reflect alterations in motor unit recruitment and/or satellite
      cell activity. Ablation of synergistic muscles resulted in an absolute growth of
      the nerve-implant soleus grafts that was comparable with that reported for nerve
      intact soleus grafts.

PMID- 2228855
TI  - Slow phase of transvascular fluid flux reviewed.
AB  - In six circuit experiments using a clinical hemofiltration device, we validated a
      colorimetric technique to measure transvascular volume exchange (VE). In 12
      isolated excised canine left lower lobes, continuous colorimetric measurements of
      VE correlated well with calculations of VE from changes in microhematocrit
      obtained simultaneously. We introduced step increases in microvascular
      hydrostatic pressure (Pc) of 9 +/- 4.8 (SD) cmH2O and followed the time course of
      weight and continuous hematocrit changes measured colorimetrically for 40 min,
      after which Pc was returned to base line, while measurements were continuously
      obtained. This procedure was repeated for an additional 30 min. VE was calculated
      from the hematocrit signals and compared with the time course of the weight
      signal. After increases in Pc, followed by a rapid weight gain, weight signals
      followed a slow exponential time course, whereas the calculated VE changed
      linearly. VE reflected approximately 60% of the slow weight gain. When Pc was
      decreased, weight signals decreased exponentially, whereas VE continued to
      increase linearly at a slower rate. These results suggest that a significant
      component of the slow weight signal represents slow vascular volume changes.
      Contrary to what the weight signal suggested, edema was never reabsorbed over the
      range of Pc measured.

PMID- 2228856
TI  - Distribution of pulmonary capillary transit times in recruited networks.
AB  - When pulmonary blood flow is elevated, hypoxemia can occur in the fastest-moving
      erythrocytes if their transit times through the capillaries fall below the
      minimum time for complete oxygenation. This desaturation is more likely to occur
      if the distribution of capillary transit times about the mean is large.
      Increasing cardiac output is known to decrease mean pulmonary capillary transit
      time, but the effect on the distribution of transit times has not been reported.
      We measured the mean and variance of transit times in single pulmonary capillary
      networks in the dependent lung of anesthetized dogs by in vivo videofluorescence
      microscopy of a fluorescein dye bolus passing from an arteriole to a venule. When
      cardiac output increased from 2.9 to 9.9 l/min, mean capillary transit time
      decreased from 2.0 to 0.8 s. Because transit time variance decreased
      proportionately (relative dispersion remained constant), increasing cardiac
      output did not alter the heterogeneity of local capillary transit times in the
      lower lung where the capillary bed was nearly fully recruited.

PMID- 2228857
TI  - Catecholamines, circulation, and the kidney during water immersion in humans.
AB  - Because results in literature are discrepant with regard to the effects of water
      immersion (WI) on the release of norepinephrine (NE) in humans, the following
      study was performed. Simultaneous measurements of plasma NE, central
      cardiovascular variables, and renal sodium excretion were conducted in eight
      normal male subjects on 2 study days; 6 h of thermoneutral (35.0 degrees C) WI to
      the neck were preceded and followed by 1 h in the seated posture outside the
      water and 8 h of a seated control period. During the control period, the subjects
      wore a water-perfused garment (water temperature 34.6 degrees C) to obtain the
      same skin temperature as during WI. The subjects were fluid restricted overnight
      and kept in this condition throughout the study. Compared with the prestudy, post
      study, and control periods, plasma NE decreased significantly by 61% during WI.
      Simultaneously, central venous pressure, cardiac output, stroke volume, systolic
      arterial pressure, and arterial pulse pressure increased, whereas heart rate
      decreased. Renal sodium excretion and urine flow rate increased. In conclusion,
      the release of NE is suppressed in humans during immersion. This decrease
      probably reflects a decrease in sympathetic nervous activity initiated by
      stimulation of low- and high-pressure baroreceptors. It is possible that the
      decrease in NE acts as one of several mechanisms of the natriuresis and diuresis
      of immersion in humans.

PMID- 2228858
TI  - Effect of sleep and sleep deprivation on ventilatory response to
      bronchoconstriction.
AB  - To characterize ventilatory responses to bronchoconstriction during sleep and to
      assess the effect of prior sleep deprivation on ventilatory and arousal responses
      to bronchoconstriction, bronchoconstriction was induced in eight asthmatic
      subjects while they were awake, during normal sleep, and during sleep after a 36
      h period of sleep deprivation. Each subject was bronchoconstricted with
      increasing concentrations of aerosolized methacholine while ventilatory patterns
      and lower airway resistance (Rla) were continually monitored. The asthmatic
      patients maintained their minute ventilation as Rla increased under all
      conditions, demonstrating a stable tidal volume with a mild increase in
      respiratory frequency. Inspiratory drive, as measured by occlusion pressure
      (P0.1), increased progressively and significantly as Rla increased under all
      conditions (slopes of P0.1 vs. Rla = 0.249, 0.112, and 0.154 for awake, normal
      sleep, and sleep after sleep deprivation, respectively, P less than 0.0006).
      Chemostimuli did not appear to contribute significantly to the observed increases
      in P0.1. Prior sleep deprivation had no effect on ventilatory and P0.1 responses
      to bronchoconstriction but did significantly raise the arousal threshold to
      induced bronchoconstriction. We conclude that ventilatory responses to
      bronchoconstriction, unlike extrinsic loading, are not imparied by the presence
      of sleep, nor are they chemically mediated. However, prior sleep deprivation does
      increase the subsequent arousal threshold.

PMID- 2228859
TI  - Rat soleus muscle ultrastructure after hindlimb suspension.
AB  - The aim of the present investigation was to determine, by quantitative electron
      microscopy, the effects of a 5-wk tail-suspension period on rat soleus muscle
      ultrastructure. A marked decline (-60%) in muscle mass occurred. The mean fiber
      cross-sectional area decreased to a greater extent (-75%) than the capillary-to
      fiber ratio (-37%), leading to a higher capillary density (+148%) after
      hypokinesia. The total mitochondrial volume density remained unchanged, whereas
      the volume density of myofibrils was slightly but significantly reduced (-6%). A
      shift from subsarcolemmal to interfibrillar mitochondria occurred. Interfibrillar
      mitochondrial volume density was highest near the fiber border and decreased
      toward the fiber center. An increase in volume density of satellite cells
      suggested muscle regenerative events. Soleus atrophy with tail suspension greatly
      decreases the muscular volume but leaves the ultrastructural composition of
      muscle fibers relatively unaffected.

PMID- 2228860
TI  - Linkage between parasternals and external intercostals during resting breathing.
AB  - To assess the mechanical coupling between the parasternal and external
      intercostals in the cranial portion of the rib cage, we measured the respiratory
      changes in length and the electromyograms of the two muscles in the same third or
      fourth intercostal space in 24 spontaneously breathing dogs. We found that 1) the
      amount of inspiratory shortening of the external intercostal was considerably
      smaller than the amount of shortening of the parasternal; 2) after selective
      denervation of the parasternal, the inspiratory shortening of both the
      parasternal and the external intercostal was almost abolished; 3) on the other
      hand, after selective denervation of the external intercostal, the inspiratory
      shortening of the parasternal was unchanged, and the inspiratory shortening of
      the external intercostal was reduced but not suppressed; and 4) this persistent
      shortening of the external intercostal was reversed into a clear-cut inspiratory
      lengthening when the parasternal was subsequently denervated. We conclude that in
      the dog 1) the inspiratory contraction of the external intercostals in the
      cranial portion of the rib cage is agonistic in nature as is the contraction of
      the parasternals; 2) during resting breathing, however, the changes in length of
      these external intercostals are largely determined by the action of the
      parasternals. These observations are consistent with the idea that in the dog,
      the parasternals play a larger role than the external intercostals in elevating
      the ribs during resting inspiration.

PMID- 2228861
TI  - Left ventricular asynchrony in patients with pulmonary hypertension.
AB  - Left ventricular regional wall motion was evaluated in 11 patients with pulmonary
      hypertension and 18 control subjects. All 11 patients had secondary pulmonary
      hypertension and less than 20% measured diameter stenosis in any vessel. This
      study utilizes a video-intensity-based frame-by-frame computerized technique. All
      pulmonary hypertensive patients showed early diastolic asynchrony in the anterior
      or apical regions that lasted 100-200 ms. The size of the abnormal area varied
      from 2 to 20% of the ventricular silhouette. Four patients also showed systolic
      abnormalities. No abnormalities were detected in the control group. The cause of
      the asynchrony detected in pulmonary hypertension is probably due to
      interventricular interaction caused by pressure gradients across the septum.

PMID- 2228862
TI  - Reactive absorption of nitrogen dioxide by pulmonary epithelial lining fluid.
AB  - In a previous study (J. Appl. Physiol. 68: 594-603, 1990) in isolated rat lungs,
      we suggested that the rate of pulmonary air space absorption of inhaled NO2 is
      limited, in part, by chemical reaction(s) rather than by physical solubility.
      Because the initial site of primary absorption interactions involves the
      epithelial lining fluid (ELF), we investigated whether ELF-NO2 interactions could
      account for pulmonary NO2 reactive absorption. Rat ELF, obtained by
      bronchoalveolar lavage (BAL), was compared with a model chemical system (reduced
      glutathione, GSH). In vitro exposures (NO2-air) used constant gas flow and planar
      gas-liquid interfaces. 1) Solvent pH notably altered NO2 uptake by GSH but to a
      lesser extent by BAL. 2) Uptake displayed [GSH]-dependent saturation. [ELF] in
      BAL was augmented by sequential lavage (lavagate reuse) of multiple lungs. Uptake
      was proportional to [ELF] but did not saturate under these exposure conditions.
      3) The uptake rate exhibited [NO2] dependence. However, relative to increasing
      [NO2], fractional uptakes decreased for BAL and 1 mM GSH but not for 10 mM GSH.
      4) Altered convective gas flow produced nonlinear increments in uptake (10 mM
      GSH) and substantial decrements in fractional uptake. 5) Arrhenius plots [ln(r)
      vs. 1/T, where r is reaction rate and T is absolute temperature (degree K)] for
      BAL and 1 mM GSH yielded respective activation energies of 4,952 and 4,149 kcal.g
      1.mol-1 and degree of change in the rate of NO2 uptake per 10 degrees C (Q10) of
      1.32 and 1.25. These results imply that the rate of NO2 uptake into rat ELF, like
      intact lung, is limited, in part, by chemical reaction(s).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2228863
TI  - Fractal properties of pulmonary blood flow: characterization of spatial
      heterogeneity.
AB  - The heterogeneity of pulmonary blood flow was examined using a fractal analytic
      procedure, and the results were compared with the traditional gravitational model
      of flow distribution. 99mTc-labeled macroaggregate was injected intravenously at
      functional residual capacity in six supine anesthetized dogs. The lungs were
      fixed in situ and sliced in transverse sections. The slices were imaged on a
      planar gamma camera, and a three-dimensional array of blood flow measurements was
      reconstructed for each lung. Fractal analysis was used to examine the spatial
      heterogeneity or RDs (relative dispersion = SD/mean) as a function of the number
      of pieces into which the flow array was subdivided. RDs was fractal and could be
      characterized by a fractal dimension (Ds) of 1.09 +/- 0.02, where a Ds of 1.0
      reflects homogeneous flow and 1.5 indicates a random flow distribution. The data
      fit the fractal model exceptionally well with an average r = 0.98. RDs was
      examined in gravitational and isogravitational planes and as expected was
      greatest in the gravitational direction. However, the difference was small,
      suggesting that gravitation plays a secondary role to an underlying process
      producing heterogeneity. Within the limits of resolution attained by this study
      (piece volumes greater than 0.25 cm3), the heterogeneity of pulmonary blood flow
      is well characterized by a fractal model.

PMID- 2228864
TI  - Periodic flow at airway bifurcations. I. Development of steady pressure
      differences.
AB  - In studies of large-amplitude periodic flows at an airway bifurcation, we found
      an appreciable steady-state pressure difference between the terminal units. To
      elucidate the fluid dynamic origins of such steady-state pressure differences, we
      studied single asymmetric bifurcation models with various area ratios and
      branching angles. The daughter ducts were identical in size and were terminated
      into identical elastic loads. Sinusoidal flow oscillations were applied at the
      parent duct so that the upstream Reynolds number ranged from 30 to 77,000 and the
      Womersley parameter from 2 to 30. The steady-state component (time averaged) of
      the pressure measured at the terminal with the smaller branching angle was found
      to be consistently higher than that at the other terminal. This steady-state
      pressure difference scaled approximately as a fixed fraction of the parent duct
      dynamic head. Guided by the results of flow-visualization studies, we modeled
      such behavior based on the temporal and spatial differences of head loss between
      the two branches of the bifurcation. Our results suggest that interlobar
      heterogeneity of mean alveolar-pressure observed in excised canine lungs during
      high frequency oscillation (Allen et al., J. Appl. Physiol. 62: 223-228, 1987)
      arises solely from fluid dynamic origins: differential head loss due to asymmetry
      of central airway branching structure.

PMID- 2228865
TI  - Periodic flow at airway bifurcations. II. Flow partitioning.
AB  - The distribution of flow among parallel pathways is believed to be determined by
      the balance of downstream mechanical loads or time constants. We studied the
      influence of upstream flow conditions and airway geometry vs. downstream
      mechanical impedances in determining flow partitioning at airway bifurcations.
      Each model consisted of a single rigid bifurcation with various branching angles
      and area ratios but having identical pathway impedances. Sinusoidal volumetric
      oscillations were applied at the parent duct with various frequencies and tidal
      volumes. Measuring the terminal pressures continuously, we calculated the flow
      distribution. When flow amplitude was small, flow partitioning was homogeneous
      and synchronous, as expected in a system possessing homogeneous pathway
      impedances and time constants. But when flow amplitude was large and frequency
      was high, appreciable heterogeneity and asynchrony of flow partitioning arose;
      during midinspiration the high-velocity flow stream preferentially favored the
      axial pathway. This effect vanished in the absence of a net area change at the
      bifurcation. For a given bifurcation geometry, these observations could be
      organized using only two nondimensional parameters, neither of which incorporated
      consideration of fluid friction. The description of temporal events required, in
      addition, a nondimensional time. Therefore these flow-dependent phenomena and
      their underlying mechanisms differ fundamentally from those described in
      classical impedance models. The complex pattern of nonuniform interregional
      behaviors apparent in whole lungs when tidal volume and frequency are large
      (Allen et al., J. Clin. Invest. 76: 620-629, 1985) is reiterated faithfully in
      models consisting of only two compartments with homogeneous time constants. As
      such, the behaviors observed in lungs would appear to be attributable in large
      part to fluid dynamic factors in central airways.

PMID- 2228866
TI  - Periodic flow at airway bifurcations. III. Energy dissipation.
AB  - We measured the energy dissipation associated with large-amplitude periodic flow
      through airway bifurcation models. Each model consisted of a single asymmetric
      bifurcation with a different branching angle and area ratio, with each branch
      terminated into an identical elastic load. Sinusoidal volumetric oscillations
      were applied at the parent duct so that the upstream Reynolds number (Re) varied
      from 30 to 77,000 and the Womersley parameter (alpha) from 4 to 30. Pressures
      were measured continuously at the parent duct and at both terminals, and
      instantaneous branch flow rates were calculated. Time-averaged energy dissipation
      in the bifurcation was computed from an energy budget over a control volume
      integrated over a cycle and was expressed as a friction factor, F. We found that
      when tidal volume was small [ratio of tidal volume to resident (dead space)
      volume, VT/VD less than 1], F was independent of branching angle and fell with
      increasing alpha and VT/VD. When tidal volume was large (VT/VD greater than 1), F
      increased with increasing branching angle and varied less strongly with alpha and
      VT/VD. No simple benchmark flow represented the data well over the entire
      experimental range. This study demonstrates that only two nondimensional
      parameters, alpha and VT/VD, are necessary and are sufficient to describe time
      averaged energy dissipation in a given bifurcation geometry during sinusoidal
      flow.

PMID- 2228867
TI  - Maximal O2 uptake of in situ dog muscle during acute hypoxemia with constant
      perfusion.
AB  - We investigated the relationships among maximal O2 uptake (VO2max), effluent
      venous PO2 (PvO2), and calculated mean capillary PO2 (PCO2) in isolated dog
      gastrocnemius in situ as arterial PO2 (PaO2) was progressively reduced with
      muscle blood flow held constant. The hypothesis that VO2max is determined in part
      by peripheral tissue O2 diffusion predicts proportional declines in VO2max and
      PCO2 if the diffusing capacity of the muscle remains constant. The inspired O2
      fraction was altered in each of six dogs to produce four different levels of PaO2
      [22 +/- 2, 29 +/- 1, 38 +/- 1, and 79 +/- 4 (SE) Torr]. Muscle blood flow, with
      the circulation isolated, was held constant at 122 +/- 15 ml.100 g-1.min-1 while
      the muscle worked maximally (isometric twitches at 5-7 Hz) at each of the four
      different values of PaO2. Arterial and venous samples were taken to measure
      lactate, pH, PO2, PCO2, and muscle VO2. PCO2 was calculated using Fick's law of
      diffusion and a Bohr integration procedure. VO2max fell progressively (P less
      than 0.01) with decreasing PaO2. The decline in VO2max was proportional (R =
      0.99) to the fall in both muscle PvO2 and calculated PCO2 while the calculated
      muscle diffusing capacity was not different among the four conditions. Fatigue
      developed more rapidly with lower PaO2, although lactate output from the muscle
      was not different among conditions. These results are consistent with the
      hypothesis that resistance to O2 diffusion in the peripheral tissue may be a
      principal determinant of VO2max.

PMID- 2228868
TI  - Lung overexpansion increases pulmonary microvascular protein permeability in
      young lambs.
AB  - To study the effects of inflation pressure and tidal volume (VT) on protein
      permeability in the neonatal pulmonary microcirculation, we measured lung
      vascular pressures, blood flow, lymph flow (QL), and concentrations of protein in
      lymph (L) and plasma (P) of 22 chronically catheterized lambs that received
      mechanical ventilation at various peak inflation pressures (PIP) and VT. Nine
      lambs were ventilated initially with a PIP of 19 +/- 1 cmH2O and a VT of 10 +/- 1
      ml/kg for 2-4 h (base line), after which we overexpanded their lungs with a PIP
      of 58 +/- 3 cmH2O and a VT of 48 +/- 4 ml/kg for 4-8 h. QL increased from 2.1 +/-
      0.4 to 13.9 +/- 5.0 ml/h. L/P did not change, but the ratio of albumin to
      globulin in lymph relative to the same ratio in plasma decreased, indicating
      altered protein sieving in the pulmonary microcirculation. Seven other lambs were
      mechanically ventilated for 2-4 h at a PIP of 34 +/- 1 cmH2O and a VT of 23 +/- 2
      ml/kg (base line), after which their chest and abdomen were bound so that PIP
      increased to 54 +/- 1 cmH2O for 4-6 h without a change in VT. QL decreased on
      average from 2.8 +/- 0.6 to 1.9 +/- 0.3 ml/h (P = 0.08), and L/P was
      unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228869
TI  - Late-phase bronchial vascular responses in allergic sheep.
AB  - Sheep were classified on the basis of their airway response to Ascaris suum
      antigen aerosols as allergic or nonsensitive. Allergic sheep were classed as
      acute or dual responders. Acute responders had only an immediate increase in mean
      airflow resistance after antigen, whereas dual responders had an immediate and
      late-phase (6-8 h after antigen challenge) increase in mean airflow resistance;
      nonsensitive sheep had minimal airway responses to antigen (less than 30%
      increase from base line). The sheep were anesthetized 2 wk later and, after a
      left thoracotomy, were challenged with antigen to determine bronchial vascular
      responses; bronchial artery blood flow was measured with an electromagnetic flow
      probe. Airway responses to antigen aerosol challenge were similar in the
      anesthetized and conscious animals. The mean fall in bronchial vascular
      resistance (BVR) immediately after antigen challenge was similar in acute and
      dual responders (41 +/- 7 and 47 +/- 9% of base line, respectively). In dual
      responders, late-phase airway responses were preceded by a significant increase
      from base line in Qbr and a fall in bronchovascular resistance (BVR). The mean
      fall in BVR 6-8 h after antigen challenge in documented dual responders was
      significantly different from bronchial vascular responses in acute responders (59
      +/- 3 vs. 89 +/- 10%, respectively). Sheep without airway responses to A. suum
      had no significant changes in bronchial hemodynamics or airways mechanics. Late
      phase-associated changes in BVR are a specific response to antigen challenge and
      may be a sensitive index of mediators being released.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2228870
TI  - Urinary N tau-methylimidazole acetic acid excretion in respiratory disease.
AB  - N tau-methylimidazole acetic acid (N tau-MIAA) is the principal urinary
      metabolite of histamine. The basal urinary excretion rate of N tau-MIAA was
      determined as 0.117 +/- 0.008 (SE) mg/h, with a renal clearance for N tau-MIAA of
      273 +/- 27 ml/min implying active secretion. After subpharmacological infusion of
      histamine (50 ng.kg-1.min-1 over 2 h) in five volunteers that increased plasma
      histamine from 0.28 +/- 0.04 to 0.71 +/- 0.15 ng/ml, urinary excretion of N tau
      MIAA over 8 h was increased by less than 17% compared with a control saline
      infusion. Urinary N tau-MIAA excretion in normal controls (273 +/- 14
      micrograms/mmol creatinine) was similar to that observed in patients with severe
      acute asthma (253 +/- 22 micrograms/mmol), antigen-induced bronchoconstriction
      (269 +/- 21 micrograms/mmol), seasonal allergic rhinitis (304 +/- 31
      micrograms/mmol), and clinically stable bronchiectasis (270 +/- 22
      micrograms/mmol). In contrast, large increases in metabolite excretion (greater
      than 7,000 micrograms/mmol creatinine) were observed in a patient with systemic
      mastocytosis where very high plasma histamine levels were recorded (greater than
      500 ng/ml) and marked systemic hemodynamic effects occurred. We conclude that
      urinary N tau-MIAA will only be increased in pathologies where sustained
      hyperhistaminemia occurs and that increased local histamine production in the
      lung or the upper airway does not cause a measurable change in the basal urinary
      excretion of this metabolite.

PMID- 2228871
TI  - Effect of ischemia reperfusion or hypoxia reoxygenation on lung vascular
      permeability and resistance.
AB  - The effect of ischemia reperfusion or hypoxia reoxygenation on pulmonary vascular
      permeability and resistance was studied in 25 isolated blood-perfused dog lungs.
      Vascular permeability, assessed by determining filtration coefficient (Kf), and
      vascular resistances were measured at the beginning and end of the experiment.
      Ischemia reperfusion was produced by occluding blood flow to the lung for 3 h and
      reperfusing for 1 h, whereas hypoxia reoxygenation was obtained by ventilating
      the lung with 95% N2-5% CO2 for 3 h and then ventilating with 95% O2-5% CO2 for 1
      h with no interruption of perfusion. There was a significant increase in Kf in
      both ischemia reperfusion and hypoxia reoxygenation groups (51 and 85%,
      respectively), and total vascular resistance increased greatly in both groups
      (386 and 532%, respectively). Two additional groups were also studied in which
      the ischemia reperfusion or hypoxia reoxygenation lungs were pretreated with
      allopurinol (20 micrograms/ml). The Kf did not significantly increase in either
      the allopurinol ischemia reperfusion or the allopurinol hypoxia reoxygenation
      groups (22 and 6%, respectively). However, total vascular resistance
      significantly increased in both groups (239 and 224%, respectively). Although
      vascular permeability is modestly increased by both ischemia reperfusion and
      hypoxia reoxygenation, the predominant change in these conditions is the
      increased vascular resistance, which predominantly affects the postcapillary
      resistance and would result in a greater tendency for edema to develop in these
      slightly damaged lungs. Allopurinol, which inhibits xanthine oxidase, attenuated
      the permeability changes in both groups and may be useful in preventing ischemia
      reperfusion injury in certain conditions.

PMID- 2228872
TI  - Plasma catecholamines in the aorta and the phrenicoabdominal vein in exercising
      dogs.
AB  - Plasma epinephrine and norepinephrine concentrations were measured in the aorta
      and phrenicoabdominal vein in five dogs at rest and during short-duration mild-
      and moderate-intensity exercise and during prolonged mild-intensity exercise.
      Plasma epinephrine and norepinephrine concentrations increased with exercise in
      both the aorta and the phrenicoabdominal vein. Plasma epinephrine concentration
      was much higher in the phrenicoabdominal vein than in the aorta (24-43 times).
      Plasma epinephrine concentrations in the aorta and phrenicoabdominal vein were
      significantly correlated (r = 0.88). This confirms that peripheral epinephrine
      concentration is a reliable index of the activity of the adrenal medulla during
      exercise. The epinephrine-to-norepinephrine ratio in the phrenicoabdominal vein
      was stable (4:1) throughout the experimental protocol, suggesting that the
      proportion of the two amines released by the adrenal medulla did not vary through
      this range of adrenal activity in dogs.

PMID- 2228873
TI  - Effect of saline infusion during exercise on thermal and circulatory regulations.
AB  - To quantify the effect of an acute increase in plasma volume (PV) on forearm
      blood flow (FBF), heart rate (HR), and esophageal temperature (Tes) during
      exercise, we studied six male volunteers who exercised on a cycle ergometer at
      60% of maximal aerobic power for 50 min in a warm [(W), 30 degrees C, less than
      30% relative humidity (rh)] or cool environment [(C), 22 degrees C, less than 30%
      rh] with isotonic saline infusion [Inf(+)] or without infusion [Inf(-)]. The
      infusion was performed at a constant rate of 0.29 ml.kg body wt-1.min-1 for 20-50
      min of exercise to mimic fluid intake during exercise. PV decreased by
      approximately 5 ml/kg body wt within the first 10 min of exercise in all
      protocols. Therefore, PV in Inf(-) was maintained at the same reduced level by 50
      min of exercise in both ambient temperatures, whereas PV in Inf(+) increased
      toward the preexercise level and recovered approximately 4.5 ml/kg body wt by 50
      min in both temperatures. The restoration of PV during exercise suppressed the HR
      increase by 6 beats/min at 50 min of exercise in W; however, infusion had no
      effect on HR in C. In W, FBF in Inf(+) continued to increase linearly as Tes rose
      to 38.1 degrees C by the end of exercise, whereas FBF in Inf(-) plateaued when
      Tes reached approximately 37.7 degrees C. The infusion in C had only a minor
      effect on FBF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228874
TI  - Transperitoneal fluid dynamics in rabbit liver.
AB  - The peritoneal cavity of 18 anesthetized spontaneously breathing supine rabbits
      was opened through a midline section. One or two hollow capsules (surface area
      0.8 cm2) were glued to the exposed liver surface, filled with whole or 25%
      diluted plasma, and connected to a transducer and a graduated pipette. Various
      hydraulic pressures (Pcap) were set in the capsule; at each Pcap the liquid flow
      per unit surface area (V/S) between the Disse's interstitial space and the
      capsule was measured from the rate of liquid displacement in the pipette. The
      slope of the V/S vs. Pcap linear regression was utilized to estimate the
      hydraulic conductivity of the Glissonian-peritoneal membrane and averaged 5.1 x
      10(-3) +/- 4.7 x 10(-3) (SD) ml.h-1.cmH2O-1.cm-2 (n = 25). Hydraulic pressure in
      the Disse's space (Pd) was measured by closing the capsule against the transducer
      disconnected from the pipette. At portal and hepatic venous pressures of 7.6 +/-
      2.9 and 2.6 +/- 1 cmH2O, respectively, Pd was 2.05 +/- 2 cmH2O. Physiologically,
      Starling pressure gradients cause fluid transfer from the sinusoids to the
      Disse's space; transperitoneal fluid filtration only occurs through the liver
      surface that faces the diaphragm, which corresponds to one-fifth of the total
      hepatic surface.

PMID- 2228875
TI  - Nonrandom variability in respiratory cycle parameters of humans during stage 2
      sleep.
AB  - We analyzed breath-to-breath inspiratory time (TI), expiratory time (TE),
      inspiratory volume (VI), and minute ventilation (Vm) from 11 normal subjects
      during stage 2 sleep. The analysis consisted of 1) fitting first- and second
      order autoregressive models (AR1 and AR2) and 2) obtaining the power spectra of
      the data by fast-Fourier transform. For the AR2 model, the only coefficients that
      were statistically different from zero were the average alpha 1 (a1) for TI, VI,
      and Vm (a1 = 0.19, 0.29, and 0.15, respectively). However, the power spectra of
      all parameters often exhibited peaks at low frequency (less than 0.2
      cycles/breath) and/or at high frequency (greater than 0.2 cycles/breath),
      indicative of periodic oscillations. After accounting for the corrupting effects
      of added oscillations on the a1 estimates, we conclude that 1) breath-to-breath
      fluctuations of VI, and to a lesser extent TI and Vm, exhibit a first-order
      autoregressive structure such that fluctuations of each breath are positively
      correlated with those of immediately preceding breaths and 2) the correlated
      components of variability in TE are mostly due to discrete high- and/or low
      frequency oscillations with no underlying autoregressive structure. We propose
      that the autoregressive structure of VI, TI, and Vm during spontaneous breathing
      in stage 2 sleep may reflect either a central neural mechanism or the effects of
      noise in respiratory chemical feedback loops; the presence of low-frequency
      oscillations, seen more often in Vm, suggests possible instability in the
      chemical feedback loops. Mechanisms of high-frequency periodicities, seen more
      often in TE, are unknown.

PMID- 2228876
TI  - Phrenic afferent contribution to reflexes elicited by changes in diaphragm
      length.
AB  - Recent evidence from several laboratories suggests that activation of afferents
      in the diaphragm can reflexly affect inspiratory muscle activation. This study
      determined whether afferents in the diaphragm contribute to compensatory changes
      in phrenic motor drive when the operating length of the diaphragm is suddenly
      increased. Experiments were performed in six closed-chest pentothal-anesthetized
      cats. Length changes were measured using a pair of piezoelectric crystals
      implanted in the left crural diaphragm. The crural electromyogram (EMGdi) was
      measured by electrodes fixed to each crystal. The animal was suspended in a
      spinal frame, and a Plexiglas tube was fitted around the cat's abdomen. A balloon
      placed inside the tube was inflated during the expiratory phase to produce a mean
      increase of 17% in diaphragm length at functional residual capacity. Ten trials
      were performed in succession under the following conditions: intact, after
      bilateral vagotomy, after spinal section at C7, and after cervical dorsal
      rhizotomy. Peak integrated EMGdi (integral of EMGdi) and neural inspiratory time
      (nTI) were measured for the last control inspiration and the first after
      inflation. There was a significant reduction in the peak integral of EMGdi when
      the length of the diaphragm was increased for all conditions except after
      rhizotomy. Although not measured, it is likely that the tension developed by the
      diaphragm was also increased during abdominal compression. Results suggest that
      afferents sensitive to changes in the operating length and/or tension in the
      diaphragm contribute to compensatory alterations in phrenic motor drive.

PMID- 2228877
TI  - Regional metabolic differences in the rat diaphragm.
AB  - This study characterized the biochemical properties of the rat diaphragm by
      measuring the activities of selected citric acid cycle and glycolytic enzymes.
      The diaphragm was removed from 10 female Sprague-Dawley rats (180 days old) and
      dissected into five discrete anatomic regions: crural (region 1), left posterior
      costal (region 2), left anterior costal (region 3), right anterior costal (region
      4), and right posterior costal (region 5). Sections were assayed for total
      protein concentration and the activities of succinate dehydrogenase (SDH) and
      lactate dehydrogenase (LDH). The SDH activity in the crural region was
      approximately 18% lower (P less than 0.05) than that in any costal region.
      Furthermore, protein concentration was significantly lower (P less than 0.05) in
      the crural region compared with all costal regions. In contrast, costal regions 2
      5 did not significantly differ from each other in protein concentration or SDH
      activity. LDH activity did not differ significantly (P greater than 0.05) between
      regions. Finally, the LDH-to-SDH activity ratio was significantly higher (P less
      than 0.05) in the crural diaphragm compared with all costal regions. We conclude
      that the crural region of the rat diaphragm is significantly lower in oxidative
      capacity than all the costal regions. Investigators who use a rodent model to
      study diaphragmatic function and plasticity should consider the oxidative
      heterogeneity of the diaphragm when designing experiments.

PMID- 2228879
TI  - Cardiovascular regulation during head-out water immersion exercise.
AB  - Head-out water immersion is known to increase cardiac filling pressure and volume
      in humans at rest. The purpose of the present study was to assess whether these
      alterations persist during dynamic exercise. Ten men performed upright cycling
      exercise on land and in water to the suprasternal notch at work loads
      corresponding to 40, 60, 80, and 100% maximal O2 consumption (VO2max). A Swan
      Ganz catheter was used to measure right atrial pressure (PAP), pulmonary arterial
      pressure (PAP), and cardiac index (CI). Left ventricular end-diastolic (LVED) and
      end-systolic (LVES) volume indexes were assessed with echocardiography. VO2max
      did not differ between land and water. RAP, PAP, CI, stroke index, and LVED and
      LVES volume indexes were significantly greater (P less than 0.05) during exercise
      in water than on land. Stroke index did not change significantly from rest to
      exercise in water but increased (P less than 0.05) on land. Arterial systolic
      blood pressure did not differ between land and water at rest or during exercise.
      Heart rates were significantly lower (P less than 0.05) in water only during the
      two highest work intensities. The results indicate that indexes of cardiac
      preload are greater during exercise in water than on land.

PMID- 2228878
TI  - Effect of increased central blood volume with water immersion on plasma
      catecholamines during exercise.
AB  - To examine the influence of an increase in central blood volume with head-out
      water immersion (WI) on the sympathoadrenal response to graded dynamic exercise,
      nine healthy men underwent upright leg cycle exercise on land and with WI. Plasma
      norepinephrine and epinephrine concentrations were used as indexes of overall
      sympathoadrenal activity. Oxygen consumption (VO2), heart rate, systolic blood
      pressure, and plasma concentrations of norepinephrine, epinephrine, and lactate
      were determined at work loads corresponding to approximately 40, 60, 80, and 100%
      peak VO2. Peak VO2 did not differ on land and with WI. Plasma norepinephrine
      concentration was reduced (P less than 0.05) at 80 and 100% peak VO2 with WI and
      on land, respectively. Plasma epinephrine and lactate concentrations were similar
      on land and with WI at the three submaximal work stages, but both were reduced (P
      less than 0.05) at peak exertion with WI. Heart rate was lower (P less than 0.05)
      at the three highest work intensities with WI. These results suggest that the
      central shift in blood volume with WI reduces the sympathoadrenal response to
      high-intensity dynamic exercise.

PMID- 2228880
TI  - Pharmacological differentiation of epithelium-derived relaxing factor from nitric
      oxide.
AB  - We examined the possibility that nitric oxide is one of the epithelium-derived
      relaxing factors in guinea pig airways. First we studied whether nitric oxide
      could relax isolated tracheal strips, and then we examined the effects of known
      inhibitors of endothelium-dependent relaxation (EDR) in the vascular system
      [hemoglobin, methylene blue, and NG-monomethyl-L-arginine (L-NMMA)] on epithelium
      dependent relaxation (EpDR) induced by hyperosmotic stimuli in perfused whole
      tracheal preparations. Mannitol (160 mM in Krebs-Henseleit solution) applied to
      the epithelial surface was used as an osmotic stimulus to induce EpDR after
      carbachol-induced contraction (2 microM, serosal side). Nitric oxide produced
      concentration-dependent and complete relaxation of epithelium-denuded tracheal
      strips. Preincubation of the whole trachea with hemoglobin significantly
      inhibited osmotic-induced EpDR (P less than 0.05), but preincubation with
      methylene blue and L-NMMA did not. Hemoglobin introduced into the epithelial side
      after EpDR induced by hyperosmotic stimuli reversed relaxation, but methylene
      blue and L-NMMA did not. These results suggest that, although EpDR and vascular
      EDR have some pharmacological similarities and nitric oxide can relax airway
      smooth muscle, nitric oxide is not responsible for osmotic-induced EpDR.

PMID- 2228881
TI  - Cardiovascular responses to arm cranking and FNS-induced leg exercise in
      paraplegics.
AB  - Twelve spinal cord-injured males performed arm-crank exercise (ACE) with and
      without concurrent functional neuromuscular stimulation (FNS) of paralyzed leg
      muscles to investigate the hypothesis that FNS would augment cardiovascular
      performance during submaximal ACE. Six men who exhibited vigorous isometric
      contractions of thigh and calf muscles were classed as "responders" to FNS (R),
      and the remaining subjects with poor or nonexistent contractions served as
      "nonresponder controls" (C). Steady-state heart rate and oxygen uptake during ACE
      at 30, 60, and 90 W were not appreciably different from the ACE + FNS condition.
      However, cardiac outputs in R were augmented by 30% during FNS at rest (from 4.9
      to 6.4 l/min), by 18% during 30-W ACE + FNS (from 8.6 to 10.1 l/min), and by 28%
      during 90-W ACE + FNS (from 12.1 to 15.6 l/min). Similarly, resting stroke
      volumes were increased by 18% (9 ml) and by 23% (19 ml) at 60 W during FNS in the
      R group. Calculated total peripheral resistance was reduced at rest and during 90
      W ACE + FNS by approximately 24%. In contrast, no alterations of circulatory
      hemodynamics were observed for C subjects. These data indicate that FNS-induced
      contractions of paralyzed leg muscles augment venous return to aid central
      cardiovascular control during upper-body submaximal exercise in paraplegics.

PMID- 2228882
TI  - Ventilatory control during exercise with increased respiratory dead space in
      goats.
AB  - Our objectives were to determine 1) the effects of increased respiratory dead
      space (VD) on the ventilatory response to exercise and 2) whether changes in the
      ventilatory response are due to changes in chemoreceptor feedback (rest to
      exercise) vs. changes in the feedforward exercise stimulus. Steady-state
      ventilation (VI) and arterial blood gas responses to mild or moderate hyperoxic
      exercise in goats were compared with and without increased VD. Responses were
      compared using a simple mathematical model with the following assumptions: 1)
      steady state, 2) linear CO2 chemoreceptor feedback, 3) linear feedforward
      exercise stimulus proportional to CO2 production (VCO2) and characterized by an
      exercise gain (Gex), and 4) additive exercise stimulus and CO2 feedback producing
      the system gain (Gsys = delta VI/delta VCO2). Model predictions at constant Gex
      [assuming VD-to-tidal volume (VT) ratio independent of VCO2] are that increased
      VD/VT will 1) increase arterial PCO2 (PaCO2) and VI at rest and 2) increase Gsys
      via changes in chemoreceptor feedback due to a small increase in the PaCO2 vs.
      VCO2 slope. Experimental results indicate that increased VD increased VD/VT,
      PaCO2, and VI at rest and increased Gsys during exercise. However, measurable
      changes in the PaCO2 vs. VCO2 slope occurred only at high VD/VT or running
      speeds. Gex was estimated at each VD for each goat by using the model in
      conjunction with experimental measurements. With 0.2 liter VD, Gex increased 40%
      (P less than 0.01); with 0.6 liter VD, Gex increased 110% between 0 and 2.4 km/h
      and 5% grade (P less than 0.01) but not between 2.4 and 4.8 km/h. Thus, Gex is
      increased by VD through a limited range. In goats, increases in Gsys with
      increased VD result from increases in both Gex and CO2 chemoreceptor feedback.
      These results are consistent with other experimental treatments that increase the
      exercise ventilatory response, maintaining constant relative PaCO2 regulation,
      and suggest that a common mechanism linked to resting ventilatory drive modulates
      Gex.

PMID- 2228883
TI  - Two discharge patterns of carotid body chemoreceptors in the goat.
AB  - Twenty-nine single carotid body chemoreceptor units recorded during normocapnic
      normoxia from 20 anesthetized goats were classified into two groups by discharge
      pattern. Thirteen fibers, which had interspike interval distributions with a
      prominent peak [24.0 +/- 9.8% (SD)] at 0- to 20-ms bin, were termed bursting
      fibers (BF). The 16 remaining fibers were termed nonbursting fibers (NBF); these
      had no notable peak in the interval distributions. During hypoxia and
      hypercapnia, the chemoreceptor fibers continued to discharge in their established
      patterns. The interval distribution of most NBF spike trains could be described
      with the Poisson process, but none of the BF could be. However, except for the
      intervals in the range of 0-20 ms, the interval distribution of the BF could be
      described as exponential. This study suggests that 1) there are two distinct
      populations of the goat chemoreceptor fiber, each with an inherent discharge
      pattern; 2) the chemoreceptor did not code information about arterial PO2 and
      PCO2 in different patterns; and 3) the basic chemotransduction mechanism is
      likely the same in BF and NBF, and the difference in discharge pattern is more
      likely to reflect processes downstream from the transducer.

PMID- 2228884
TI  - Increased fatigue of isovelocity vs. isometric contractions of canine diaphragm.
AB  - A comparison of fatigue as a loss of force with repeated contractions over time
      was performed in canine respiratory muscle by isometric (nonshortening) and
      isovelocity (shortening) contractions. In situ diaphragm muscle strips were
      attached to a linear ergometer and electrically stimulated (30 or 40 Hz) via the
      left phrenic nerve to produce either isometric (n = 12) or isovelocity (n = 12)
      contractions (1.5 s) from optimal muscle length (Lo = 8.8 cm). Similar velocities
      of shortening between isovelocity experiments [0.19 +/- 0.02 (SD) Lo/S] were
      produced by maximizing the mean power output (Wmax = 210 +/- 27 mW/cm2) that
      could be developed over 1.5 s when displacement was approximately 0.30 Lo.
      Initial peak isometric tension was 1.98 kg/cm2, whereas initial peak isovelocity
      tension was 1.84 kg/mc2 (P less than 0.01) or 93% of initial isometric tension.
      Fatigue trials of 5 min were conducted on muscles contracting at a constant duty
      cycle (0.43). At the end of the trials, peak isovelocity tension had fallen to
      50% of initial isometric tension (P less than 0.01), whereas peak isometric
      tension had only fallen by 27%. These results indicate that muscle shortening
      during force production has a significant influence on diaphragm muscle fatigue.
      We conclude that the effects of shortening on fatigue must be considered in
      models of respiratory muscle function, because these muscles typically shorten
      during breathing.

PMID- 2228885
TI  - Measurement of phase I volume breath by breath in spontaneously breathing guinea
      pigs.
AB  - A new method to determine phase I volume in tracheotomized spontaneously
      breathing guinea pigs is presented. Measurements were performed in three animals
      weighing 567-896 g. In simultaneous tracings of tidal volume (VT) and expiratory
      profiles of endogenous gases (PO2 or PCO2), the phase I volume of each breath was
      determined graphically as the volume expired up to the end of phase I of the
      expirogram. The mean phase I volume of different animals ranged from 0.29 to 0.43
      ml with an arithmetic dispersion between 0.014 and 0.021 ml. Spontaneous sighs
      sometimes with doubling of the VT caused a significant rise of phase I volume up
      to 50% of the normal values. The linear regression curve was calculated for
      corresponding VT's and phase I volumes. The VT gradient of the phase I volume as
      the slope of this curve ranged from 0.108 to 0.217 ml/ml VT. The results of the
      new procedure, which works also with humans and rabbits, are discussed in respect
      to improvement of the characterization of the bronchial system. Compared with the
      human system, the VT gradient of the guinea pig is four times greater. By not
      being affected by disorders in pulmonary gas exchange, the phase I volume
      determined as described is a new suitable quantity to specifically assess actions
      and reactions of the bronchial system.

PMID- 2228887
TI  - Sensitivity analysis of respiratory parameter uncertainties: impact of criterion
      function form and constraints.
AB  - A sensitivity analysis based on weighted least-squares regression is presented to
      evaluate alternative methods for fitting lumped-parameter models to respiratory
      impedance data. The goal is to maintain parameter accuracy simultaneously with
      practical experiment design. The analysis focuses on predicting parameter
      uncertainties using a linearized approximation for joint confidence regions.
      Applications are with four-element parallel and viscoelastic models for 0.125- to
      4-Hz data and a six-element model with separate tissue and airway properties for
      input and transfer impedance data from 2-64 Hz. The criterion function form was
      evaluated by comparing parameter uncertainties when data are fit as magnitude and
      phase, dynamic resistance and compliance, or real and imaginary parts of input
      impedance. The proper choice of weighting can make all three criterion variables
      comparable. For the six-element model, parameter uncertainties were predicted
      when both input impedance and transfer impedance are acquired and fit
      simultaneously. A fit to both data sets from 4 to 64 Hz could reduce parameter
      estimate uncertainties considerably from those achievable by fitting either
      alone. For the four-element models, use of an independent, but noisy, measure of
      static compliance was assessed as a constraint on model parameters. This may
      allow acceptable parameter uncertainties for a minimum frequency of 0.275-0.375
      Hz rather than 0.125 Hz. This reduces data acquisition requirements from a 16- to
      a 5.33- to 8-s breath holding period. These results are approximations, and the
      impact of using the linearized approximation for the confidence regions is
      discussed.

PMID- 2228886
TI  - Spatial distribution of collagen and elastin fibers in the lungs.
AB  - Surface tension forces acting on the thin-wall alveolar septa and the collagen
      elastin fiber network are major factors in lung parenchymal micromechanics.
      Quantitative serial section analysis and morphometric evaluations of planar
      sections were used to determine the spatial location of collagen and elastin
      fibers in Sprague-Dawley rat and normal human lung samples. A large concentration
      of connective tissue fibers was located in the alveolar duct wall in both
      species. For rats, the tissue densities of collagen and elastin fibers located
      within 10 microns of an alveolar duct were 13 and 9%, respectively. In human lung
      samples, the tissue densities of collagen and elastin fibers within 20 microns of
      an alveolar duct were 18 and 16%, respectively. In both species, bands of elastin
      fibers formed a continuous ring around each alveolar mouth. In human lungs,
      elastin fibers were found to penetrate significantly deeper into alveolar septal
      walls than they did in rat lungs. The concentration of connective tissue elements
      in the alveolar duct walls of both species is consistent with their proposed
      roles as the principal load-bearing elements of the lung parenchyma.

PMID- 2228888
TI  - Errors in heat flux measurements due to the thermal resistance of heat flux
      disks.
AB  - Questions have been raised regarding the effect of the thermal resistance of heat
      flux transducers (HFTs) on the thermal flux from the skin. A model capable of
      simulating a large range of "tissue" insulation (variable-R model) was used to
      study the effect of the underlying tissue insulation on the relative error in
      heat flux due to the thermal resistance of the HFTs. The data show that the
      deviation from the true value of heat flux increases as the insulation of the
      underlying tissue decreases (r = 0.99, P less than 0.001). The underestimation of
      the heat flux through the skin measured by an HFT is minimal when the device is
      used on vasoconstricted skin in cool subjects (3-13% error) but becomes important
      when used during vasodilation in warm subjects (29-35% error) and even more
      important on metallic-skin mannequins (greater than 60% error).

PMID- 2228889
TI  - Central nervous effects of CRF and angiotensin II on cardiac output in conscious
      rats.
AB  - Studies were performed to determine whether the central nervous system actions of
      corticotropin-releasing factor (CRF) and angiotensin II (ANG II) on systemic
      arterial pressure are mediated, in part, through changes in cardiac output (CO).
      Changes in CO after intracerebroventricular administration of ANG II and CRF were
      assessed in conscious unrestrained rats bearing pulsed Doppler flow probes on the
      ascending aorta. Intracerebroventricular injection of CRF (0.15 nmol) increased
      arterial pressure (15-20 mmHg), heart rate (70-100 beats/min), and CO (25-35%)
      without significantly affecting total peripheral resistance.
      Intracerebroventricular injection of ANG II (0.1 nmol) produced similar
      elevations of arterial pressure (15-20 mmHg). However, the ANG II-induced pressor
      response was attended by significant decreases in heart rate (20 beats/min) and
      CO (10-15%) and significant increases in total peripheral resistance (30-40%).
      The results of these studies demonstrate that CO, as assessed by pulsed Doppler
      flow probe methodology, may be influenced significantly and differentially by
      central nervous system administration of CRF and ANG II.

PMID- 2228890
TI  - Coping, negative affectivity, and the work environment: additive and interactive
      predictors of mental health.
AB  - The present study tested the hypothesis that direct coping would moderate
      relations between work stress and mental health outcome, whereas suppression (a
      form of emotion-focused coping) would show an overall effect on outcome. Data on
      coping, perceived work demand and support, and affective symptoms were obtained
      from trainee teachers (N = 157). The results supported the hypothesis. Gender
      differences also were observed; men reported more use of suppression than did
      women. In addition, negative affectivity (NA) was examined as a confounding
      variable and as an index of reactivity in stress-outcome relations. NA acted to
      inflate associations between work perceptions and affective symptoms, but it was
      also a significant moderator variable; high NA subjects showed greater reactivity
      to work demand than did low NA subjects.

PMID- 2228891
TI  - Some methodological considerations for the behavioral genetic analysis of work
      attitudes.
AB  - In a recent article, Arvey, Bouchard, Segal, and Abraham (1989) argued that about
      30% of the variance in job satisfaction was accounted for by workers' genetic
      make-ups. To demonstrate this, they examined a group of monozygotic twins who had
      been reared apart. Although this method has been used widely in behavioral
      genetic research, it contains many hidden threats to validity, which could render
      suspect numerical estimates of either environmental or genetic effects. We
      examine some of the threats associated with this type of twin research,
      emphasizing the problems involved in quantifying the heritability of job
      satisfaction.

PMID- 2228892
TI  - Examining the relationships among self-report measures of the Type A behavior
      pattern: the effects of dimensionality, measurement error, and differences in
      underlying constructs.
AB  - The most widely used self-report measures of the Type A behavior pattern (TABP)
      are the Bortner scale, the Framingham scale, and the Jenkins Activity Survey
      (JAS). Though high scores on each of these measures have been linked to the
      development of coronary heart disease, their intercorrelations are rather low,
      suggesting that they may reflect different aspects of TABP. This study indicates
      that the low correlations among the Bortner scale, the Framingham scale, and the
      JAS are due not only to differences in underlying constructs but also to
      measurement error and multidimensionality. These results also identify several
      psychometric problems, which raise serious questions regarding the use of these
      measures in TABP research. Suggestions for the development of new measures of
      TABP are offered.

PMID- 2228894
TI  - Childhood acute lymphoblastic leukemia--Part I. Biology of the lymphoblast.

PMID- 2228893
TI  - Morphologic and cytochemical characteristics of childhood lymphoblastic leukemia.
AB  - The majority of childhood acute leukemias can be classified as acute
      lymphoblastic leukemia and acute nonlymphocytic leukemia with light microscopy
      and cytochemical stains alone. However, myeloperoxidase-negative myeloblastic
      leukemias and megakaryoblastic leukemias, as well as some metastatic tumors, can
      mimic lymphoblastic leukemia when these cytologic examinations are used.
      Conversely, occasional cases of Sudan black B-positive ALL can be confused with
      myeloblastic leukemia. Thus, additional immunologic and sometimes further
      ultrastructural studies should complement the morphologic diagnosis of ALL. The
      significance of L1 and L2 subtypes of ALL is still controversial. Modern
      chemotherapy may have obscured any significance of this division. Future studies
      of lymphoblast morphology should center on biologic correlates of the L2
      cytology. Little prognostic significance has been found for the morphologic
      variants of ALL, such as the granular and hand-mirror cell types. It is important
      not to confuse granular ALL with acute myeloblastic leukemia. Functional
      immunologic studies may help in delineating the cause of uropod formation in hand
      mirror variant ALL.

PMID- 2228895
TI  - Immunologic markers in childhood acute lymphoblastic leukemia.
AB  - This article details the immunologic diversity of acute lymphoblastic leukemia in
      children. A historical review of developments in immunophenotyping is followed by
      a discussion of how major subgroups of leukemia are best defined today. The
      relationship of immunologic subtypes to stages of normal lymphoid development is
      explored, and the clinical impact of immunophenotyping is discussed.

PMID- 2228896
TI  - Mixed-lineage leukemia and asynchronous antigen expression.
AB  - Considerable confusion exists regarding the definition of acute mixed-lineage
      leukemia. We have proposed a list of strict criteria, limiting the term acute
      mixed-lineage leukemia to those patients whose blast cells co-express lymphoid
      and myeloid characteristics. This system includes cytochemical, immunologic,
      molecular, and cytogenetic characteristics that are strongly associated with
      either lymphoid or myeloid lineages. As more information becomes available, the
      criteria for mixed-lineage leukemia will undoubtedly change. Identification of
      patients with mixed-lineage leukemia and metachronous leukemia (lineage switch)
      is important for determining the prognostic implications of these findings. Care
      must be taken in identifying cases of metachronous leukemia because of the
      increased incidence of second malignancies following aggressive therapy. Evidence
      of a recurrence of the original clone must be obtained before metachronous
      leukemia can be diagnosed. As with mixed-lineage and metachronous leukemias, the
      potential clinical and prognostic implications of lymphoid leukemias with
      antigenic asynchrony should be identified. The asynchronous antigen expression in
      leukemic lymphoblasts may provide a means for detecting minimal residual disease.
      Detection of minimal residual leukemia is possible because these blasts differ
      from the predominant population of normal lymphoid cells in their expression of
      cell surface markers. Study of the mechanisms that lead to these unusual
      leukemias may result in better understanding of the processes that underlie both
      normal hematopoietic differentiation and leukemogenesis. An understanding of
      these leukemias may also permit identification of cases that are destined to fail
      current therapies so that more intensive or selective therapy can be instituted
      for such children. Curing the 30% of children with ALL that relapse despite our
      best efforts should be one of the top priorities for pediatric oncologists.

PMID- 2228897
TI  - Cytogenetic abnormalities and molecular markers of acute lymphoblastic leukemia.
AB  - The chromosomal abnormalities that occur in acute lymphoblastic leukemia have
      greatly elucidated the biologic causes (leukemogenesis) of this disease. ALL is
      extremely heterogeneous; different cell types at differing stages of
      differentiation may become leukemic. Although not yet completely understood, the
      chromosomal abnormalities occurring in this disease are not random. Rather, the
      abnormalities are highly specific, with specific abnormalities occurring in
      specific cell phenotypes. Early chromosomal investigations were concerned with
      identification of heterogeneous cytogenetic "groups," with independent prognostic
      indications, among patients with ALL. These studies progressed to the
      identification of specific chromosomal translocations, many of which can be
      correlated with specific cell phenotypes. Molecular studies of these cytogenetic
      aberrations have defined specific chromosomal breakpoints, and specific genes,
      which have been implicated in the oncogenic process. As a result of these
      translocations, the involved genes either produce abnormal products or are
      deregulated. The products of these genes vary, but all are concerned with cell
      growth and differentiation. Much remains to be determined regarding cytogenetic
      abnormalities in acute lymphoblastic leukemia and their clinical and biologic
      significance. The molecular bases of all of the recurring abnormalities in ALL
      have not been determined. The biologic causes for the chromosomal abnormalities
      are not known, nor is it known why specific chromosomal aberrations correlate
      with prognosis.

PMID- 2228898
TI  - Ontogeny of normal human B-cell and T-cell precursors and its relation to
      leukemogenesis.
AB  - The concept that a pluripotent stem cell exists and has the capacity eventually
      to give rise to mature B and T cells is uncontestable. However, the precise
      developmental relationship between pluripotent stem cells and the earliest stages
      of B-cell and T-cell development are still obscure. Patterns of gene expression
      are being identified that characterize normal B-cell and T-cell precursors, and
      the regulatory variables that influence self-renewal and differentiation of these
      cells. These are important studies because childhood lymphoblastic leukemia
      almost always manifests a cellular phenotype consonant with an immature lymphoid
      cell. A comprehensive understanding of the etiology of acute lymphoblastic
      leukemia will likely be hastened by a more thorough understanding of normal
      lymphopoiesis. This knowledge will complement the large data base that currently
      characterizes lymphoblastic leukemia in children.

PMID- 2228899
TI  - Lymphohematopoiesis: role of growth factors in leukemogenesis and therapy.
AB  - The interrelationship between proliferation, differentiation, and activation
      responses of hematopoietic progenitor cells and mature blood cells is complex.
      Therefore, we are only now learning what role colony-stimulating factors play in
      the regulation of normal hematopoiesis in vivo and in the dysregulation of
      hematopoiesis in leukemia. Recent advantages in molecular hematology have opened
      the door to the therapeutic administration of recombinant growth factors. Through
      continued preclinical trials in animals and by clinical trials in humans, a
      better understanding of the precise target cells and mechanisms of action of
      hematopoietic growth factors will improve the therapeutic index of administering
      colony-stimulating factors. Better understanding of hematopoietic growth factors
      will, in turn, suggest novel approaches to therapy of acute lymphoblastic
      leukemia.

PMID- 2228900
TI  - A novel assay system for quality control testing of surfaces for mammalian cell
      culture.

PMID- 2228901
TI  - Hypoxanthine increases basal and FGF-stimulated growth of porcine aortic
      endothelial cells in media with calf or newborn bovine serum.

PMID- 2228902
TI  - Growth of the malignant and nonmalignant human squamous cells in a protein-free
      defined medium.
AB  - A novel protein-free synthetic medium has been developed for the culture of human
      squamous cell carcinoma cells. This medium, designated PF86-1, supports the
      serial subcultivation of six out of nine human squamous cell carcinoma cell lines
      in a protein-free, chemically defined condition without the adapting culture from
      serum-containing conditions. These cell lines growing in PF86-1 exhibited nearly
      equal potency to grow in massive culture without noticeable changes in morphology
      but presented a significantly decreased level of colony forming efficiency when
      compared with the cells cultured in serum-containing media, suggesting the
      implication of some autocrine mechanism. Interestingly, this medium supported the
      growth of normal human squamous cells of oral mucosa and skin for more than 2 mo.
      in the primary explant culture in spite of high levels of calcium ion
      concentration, where the overgrowth of fibroblasts as contaminant was not
      observed. These results suggest that PF86-1 supports the growth of cells derived
      from epidermal tissues selectively and provides the same defined condition for
      growth of malignant and nonmalignant human squamous cells. It seems, therefore,
      that PF86-1 allows investigations on the products of squamous cell carcinoma
      cells or on the differences of growth mechanisms between normal and neoplastic
      human squamous cells.

PMID- 2228903
TI  - A serum-free system for culturing human placental trophoblasts.
AB  - We have compared hormone production by early gestation and term human placental
      trophoblasts cultured in Ham's F10 medium containing 10% fetal bovine serum with
      that by cells cultured in serum-free HB102 medium. Mean daily production of
      progesterone on Days 3 to 7 was approximately 25% less by both early gestation
      and term cells cultured in HB102 as compared to Ham's F10, but production was
      maintained at a stable level for at least 7 d longer than the cells in Ham's.
      Estradiol production from 10(-6) M dehydroepiandrosterone by both early gestation
      and term cells was comparable in both media. Human placental lactogen production
      on Days 3 to 7 was 40% less by cells cultured in HB102. Human chorionic
      gonadotropin (hCG) output by early gestation cells was also 50% less in HB102 but
      term cells in HB102 produced twice as much hCG as those in Ham's F10. 3B
      Hydroxysteroid dehydrogenase (3BHSD) activity in early gestation and term cells
      and 11B-hydroxysteroid dehydrogenase (11BHSD) activity of early gestation
      cultures was comparable in the two media. 11BHSD activity was decreased in the
      term cultures, and this decrease was more marked in Ham's than in HB102.
      Sulfatase and aromatase activities in the early gestation cultures were
      comparable in both media; sulfatase activity was comparable and aromatase
      activity only 20% less in the term cells cultured in HB102. These results
      indicate that serum-free HB102 supports differentiated function of human
      trophoblast cells and is useful for studies of placental activity for as long as
      14 d in culture.

PMID- 2228904
TI  - Growth-promoting effects of gastrin on mouse colon cancer cells in vitro: absence
      of autocrine effects.
AB  - We have previously demonstrated trophic effects of gastrin on mouse colon cancer
      (MC-26) cells, in vivo, and demonstrated the presence of gastrin receptors (GR)
      on these cells. The cellular and intracellular mechanism by which gastrin
      expresses trophic effects on colon cancer cells is, however, as yet unknown. For
      us to start investigating the possible mechanisms involved, it was important that
      we first develop an in vitro model, in which gastrin expresses its trophic
      effects directly on the MC-26 cells. The growth-promoting effects of gastrin on
      the MC-26 cells were examined in various in vitro culture models, in terms of
      [3H]thymidine incorporation and cell number. A significant trophic effect of
      gastrin could be demonstrated on quiescent cells in culture, in the absence of
      serum. The optimal cell-culture conditions for observing trophic effects of
      gastrin were defined and included a 24-h period of rapid growth of MC-26 cells in
      serum-supplemented normal growth medium, followed by a 24-h period of culture in
      serum-free medium containing an optimal dose (1.0 mM) of thymidine, to achieve
      growth-arrest of the cells. Addition of gastrin (0.5 to 25 nM) to the quiescent,
      growth-arrested cells resulted in significant dose-dependent increases in both
      the incorporation of [3H]thymidine uptake by the cells, and a significant
      increase in cell number. The concentration of GR on the growth-arrested quiescent
      MC-26 cells in culture was significantly increased compared to the GR
      concentration on the control, asynchronized cells. The increased presence of GR
      on the growth-arrested, synchronized MC-26 cells may have allowed us to observe a
      significant trophic effect of gastrin on the MC-26 cells, in vitro itself. To
      determine if gastrin was functioning as an autocrine growth factor for MC-26
      cells, we examined the effect of gastrin antibodies on the growth of MC-26 cells;
      no significant effect of the antigastrin IgG on the growth of MC-26 cells was
      observed.

PMID- 2228906
TI  - Ultrastructural and immunohistological characterization of the SIRC corneal cell
      line.
AB  - A widely utilized rabbit corneal cell line, SIRC, was characterized
      ultrastructurally and immunohistologically. Although SIRC cells are often
      described as being of epithelial origin, important ultrastructural and antigenic
      characteristics indicate that these cells are fibroblastic and not epithelial.
      SIRC cells lack desmosomes, cytoplasmic filaments, and cytokeratin-structures
      that are characteristic of corneal epithelial cells. By contrast, the dendritic
      morphology, presence of vimentin, and the extensive dense accumulations of
      ribosomes and rough endoplasmic reticulum are consistent with a fibroblastic
      phenotype. Collectively, the morphology, ultrastructural features, and antigenic
      composition favor the hypothesis that SIRC cells are fibroblastic cells
      (keratocytes) and not corneal epithelial cells.

PMID- 2228907
TI  - The detection of technical failures in perfused heart with ischemia and
      reperfusion by epicardial NADH fluorescence.
AB  - This study documents the value of continuous observation of nicotinamide adenine
      dinucleotide (NADH) fluorescence (NADH-F). NADH-F monitoring is used to identify
      ischemic regions for the recognition of minor technical failures associated with
      ischemia and reperfusion experiments in the isolated perfused heart system. The
      visualization of NADH-F is possible by simply irradiating the heart with
      ultraviolet light. Rat hearts, in the working-heart mode, were subjected to
      occlusion/reperfusion of the left coronary artery, and analyzed. The perfusate
      was filtered through a 5 micron pore membrane. Out of 281 hearts which were
      judged to be free of technical failures by conventional physiological indices
      (heart rate greater than 200/min, cardiac output greater than 34 ml/min, and
      coronary flow 9-14 ml/min), 43 (15%) disclosed an abnormal NADH-F area prior to
      the coronary intervention. During coronary intervention, 29 technical failures
      were detected as indicated by sparse NADH-F distribution with occlusion, delayed
      disappearance of NADH-F upon reperfusion, or the exhibition of an abnormal NADH-F
      region unassociated with the coronary artery supply area. These technical
      failures are not detectable without the use of NADH-F, although the actual number
      of failures detected may depend on the skill of the operator. We recommend NADH-F
      monitoring for any preparations which do not contain hemoglobin, since NADH-F is
      an intrinsic probe for ischemia and is easily applicable to a variety of
      experiments.

PMID- 2228905
TI  - Monolayer culture of rat parotid acinar cells without basement membrane
      substrates.
AB  - Acinar cells have been difficult to maintain in primary or secondary cultures
      over extended periods of time. The most successful monolayer culture system
      reported to date requires basement membrane substrates. We report here a
      technique for culture of rat parotid acinar cells which does not rely upon
      basement membrane supports for maintenance and growth. The procedure involves
      gland excision, treatment to chelate metal ions, enzymatic digestion with
      collagenases and hyaluronidase, removal of fat and red blood cells by gravimetric
      separation, and nylon mesh filtration to yield a homogeneous suspension of small
      aggregates and single cells. The cells were examined for: a) morphology,
      identity, and growth; b) macromolecular synthesis; and c) secretory output. They
      were healthy, peroxidase positive, and growing for up to 10 d. Protein synthesis
      increased from the point of cell layer formation at 3 to 4 d, through 10 d, while
      DNA synthesis decreased. As in other studies, amylase secretion fell sharply
      between 2 and 4 d in culture and remained low. Although previous studies
      indicated that the initial isolation protocol left these acinar cells unable to
      thrive in monolayer culture except in the presence of basement membrane
      substrates, the modified technique reported herein allows these cells to attach,
      spread, and grow on a wide variety of commercially available plasticware. This
      method lends itself readily to long-term analysis of rat parotid acinar cell
      metabolism without the complications of dedifferentiation, cell loss through
      culture manipulation common in suspension cultures, or complex interactions
      between bioactive supports and cell surfaces.

PMID- 2228908
TI  - Endothelin-1-induced constriction in the coronary resistance vessels and
      abdominal aorta of the guinea pig.
AB  - The purpose of this study was to examine contractile properties of endothelin-1,
      a newly discovered vasoactive peptide, in guinea pig coronary resistance vessels
      and abdominal aorta. Changes in perfusion pressure after injections of endothelin
      1 were measured using a constant-flow modified Langendorff preparation. The ED10
      values of coronary perfusion pressure were about 100-fold less for endothelin-1
      than for prostaglandin F2 alpha. After the endothelium was damaged by exposure to
      free radicals, maximal coronary constriction in response to endothelin-1 (10(-9)
      moles) was not altered, whereas dilator responses to low doses of endothelin-1
      were converted to constrictor responses. Removal of the endothelium from aortic
      rings significantly increased responsiveness to endothelin-1 and the maximal
      response to the peptide. In calcium-free medium, endothelin-1 induced small
      increases both in perfusion pressure in coronary vessels and in tension in the
      aorta. Reintroduction of calcium in the coronary and aortic preparations produced
      a rapid increase in perfusion pressure and tension, respectively. Further,
      endothelin-1-induced coronary constriction was inhibited 59% +/- 7% by nifedipine
      (10(-7) moles). We conclude that endothelin-1 is a more potent constrictor than
      prostaglandin F2 alpha in the coronary vasculature. Endothelin-1-induced
      constriction in the coronary vasculature of the guinea pig is not mediated
      through an endogenous constricting factor released from the endothelium or a
      constrictor prostaglandin. Further, endothelin-1-induced dilation in the coronary
      vasculature and attenuation of endothelin-1-induced contraction in the abdominal
      aorta of the guinea pig are mediated through the release of a factor from the
      endothelium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228909
TI  - Interstitial cell infiltrate and myocardial fibrosis in dilated cardiomyopathy: a
      special type of cardiomegaly corresponding to sequelae of myocarditis.
AB  - We examined the relationship between interstitial cell infiltration and
      myocardial fibrosis in patients with clinically diagnosed dilated cardiomyopathy
      (DCM). Forty-two cases of DCM were divided into two groups, according to the mean
      number of the interstitial round cells per 10.2 x 10(4) square microns (Nic): the
      inflammatory group (Nic greater than or equal to 5) and noninflammatory group
      (Nic less than 5). The 12 cases in the inflammatory group were clinically similar
      to the 30 cases in the non-inflammatory group, but the inflammatory group
      exhibited a significantly (P less than 0.001) larger area of myocardial fibrosis
      (34.8% +/- 12.8% vs 17.5% +/- 8.2%), a significantly (P less than 0.01) higher
      frequency of diffuse perimyocytic-type fibrosis (83% vs 23%), fewer myocardial
      cells in the left ventricular wall (170 +/- 70 fibers vs 216 +/- 81 fibers), and
      significantly (P less than 0.01) greater hypertrophy of the myocytes (18.3 +/-
      3.4 vs 15.3 +/- 2.7 microns). In addition, cases exhibiting marked fibrosis
      (fibrosis area greater than or equal to 25% of the myocardium) had a
      significantly higher Nic score (8.3 +/- 6.8) compared to cases with the less
      fibrotic type of DCM (4.0 +/- 5.7). We speculate that persistent or preceding
      inflammatory cell infiltration induces the myocardial fibrosis, especially the
      diffuse perimyocytic type, in the fibrosis-predominant type of DCM. Therefore,
      most of these cases may be a sequela of myocarditis, and more correctly termed
      post-myocarditic cardiomegaly.

PMID- 2228910
TI  - Immunological features in a case of hypereosinophilic syndrome and myocarditis.
AB  - The clinical and immunological follow-up of a 38-year-old female patient with
      hypereosinophilic syndrome and classical cardiac involvement, but without
      demonstrable degranulation of eosinophils and lacking binding of a specific
      antibody for activated eosinophils, is presented. Instead, the patient
      demonstrated all the immunological features of autoreactive myocarditis:
      cytolytic, complement-fixing antimyolemmal antibodies and increased
      concentrations of circulating immune complexes were present over 3 years.

PMID- 2228911
TI  - Chronic dissecting aneurysm of the isolated coronary artery with hemorrhagic
      myocardial infarction: a rare complication of cardiac operation in a female with
      Marfan's syndrome.
AB  - A 37-year-old female with Marfan's syndrome developed myocardial infarction
      during a cardiac operation for annuloaortic ectasia and chronic dissecting
      aneurysm of the aorta. At autopsy, a chronic dissecting aneurysm of the left
      coronary arterial system (the left main stem, anterior descending branch, first
      diagonal branch, and circumflex branch) showing a true lumen and a pseudo lumen,
      which were patent, was found. There was also a hemorrhagic myocardial infarction
      of the anteroseptal wall and apical portion of the left ventricle.

PMID- 2228912
TI  - A case of tuberculous pericarditis--use of adenosine deaminase activity (ADA) in
      early diagnosis.
AB  - Pericardial tuberculosis is rare, and because of the difficulty in isolating the
      causative organism, the diagnosis is often missed. Adenosine deaminase, an enzyme
      associated with purine metabolism, shows markedly high levels of activity in
      tuberculous effusion. We report a case of tuberculous pericarditis diagnosed by
      high levels of adenosine deaminase activity, and where the pericardial fluid
      cultures revealed acid-fast organisms.

PMID- 2228914
TI  - Bittersweet farms.
AB  - Bittersweet Farms, a rural Ohio farm community for autistic adults, is presented.
      The land and facility are described, and the importance of certain elements of
      location, physical plant, and layout to the program model are discussed. The
      Bittersweet Farms program model is presented in detail as it applies to each
      aspect of rural, group living, and the contribution of each of its main features
      to the success of the Bittersweet Farms community is discussed.

PMID- 2228913
TI  - The relationship between existing residential services and the needs of autistic
      adults.
AB  - Existing residential services for adults with autism vary in size, location, and
      source of funding. Most service options have been designed for individuals with
      handicaps other than autism and therefore have difficulty addressing the needs of
      all but the highest functioning autistic adults. This paper provides a review of
      the characteristics of autism that affect adaptation to residential settings. A
      description of existing residential options based on the combined experiences of
      Great Britain and North Carolina is presented, and directions for future research
      are then discussed.

PMID- 2228915
TI  - Benhaven's residential program.
AB  - Benhaven, a residential program of group homes providing intensive programming
      for autistic and neurologically impaired children, is described. Its major
      program factors of administration and management, treatment, support services,
      and family and community involvement are presented in detail. Benhaven's mission
      as an educational placement for preparing residents to function in the least
      restrictive environment on their way to future living situations is stressed.

PMID- 2228916
TI  - Community-based services for children and adults with autism: the Eden Family of
      Programs.
AB  - The service needs of those with autism and the response to those needs by the
      Eden Family of Programs are described. The Eden Family of Programs is described
      in detail, giving its history and discussing its participants, staff, schedules,
      programs, normalization, human rights, administration, and trustees.

PMID- 2228917
TI  - Group homes in North Carolina for children and adults with autism.
AB  - Autistic people not living with their families live in 11 group homes throughout
      North Carolina. These homes, funded by both state and federal sources, are
      affiliated with TEACCH, the state agency for the identification and treatment of
      autism. This article looks at several aspects of group homes including cost
      effectiveness, staff selection and training, level of structure and programming,
      composition of the client group, adherence to a central philosophy, and the role
      of administration. Evidence suggests that group homes are a viable and cost
      effective residential option for autistic people. While more group homes are
      needed, development of other residential options is encouraged.

PMID- 2228918
TI  - Critical issues in the residential care of people with autism.
AB  - There is an ever-growing need to expand both the number and range of residential
      services for individuals with autism while developing strategies for assuring the
      quality of these programs. Future program development will be facilitated by an
      empirical approach to the critical elements that have been identified throughout
      the articles in this issue.

PMID- 2228919
TI  - Treatment of attentional and hyperactivity problems in children with
      sympathomimetic drugs: a comprehensive review.
AB  - Issues concerning sympathomimetic drug treatment of children with attentional
      problems and hyperactivity are considered in light of cumulative and current
      research. These issues concern the atypical or "paradoxical" drug response of
      such children, predictability of drug response from neurological or biochemical
      assessments, and, especially, long-term outcome or effectiveness of
      sympathomimetic medication. Short-term drug effects on behavior and performance
      are well documented. However, follow-up studies that exist presently suggest
      little long-term impact of sympathomimetic drugs on school achievement, peer
      relationships, or behavior problems in adolescence. Questions remain concerning
      development of tolerance in children, ways to define subgroups of disordered
      children who may respond uniquely to stimulants, the efficacy of medication in
      combination with other treatments, and possible long-term negative consequences
      of medication.

PMID- 2228920
TI  - The DSM-III-R field trial of disruptive behavior disorders.
AB  - The members of the DSM-III-R Advisory Committee responsible for the diagnostic
      criteria for the disruptive behavior disorders (attention deficit hyperactivity
      disorder, oppositional defiant disorder, and conduct disorder) were able to reach
      agreement on potential items to be included in the final diagnostic criteria.
      However, there was considerable disagreement about the relative utility of
      different items for the three disorders and no agreement on how many items should
      be required from a final list of discriminating items to establish each of the
      diagnoses. This article describes the method and results of a national field
      trial of the proposed criteria. Using as a standard the diagnosis of these
      disorders made by expert clinicians with experience with these disorders, the
      diagnostic criteria that were finally included in DSM-III-R demonstrated high
      sensitivity, specificity, and internal consistency.

PMID- 2228921
TI  - Parent-based diagnosis of attention deficit disorder predicts a diagnosis based
      on teacher report.
AB  - The literature evaluating agreement between parent and teacher reports on
      symptoms of attention deficit disorder (ADD) has repeatedly shown only modest
      correlations between these two sources of information. A more relevant statistic
      to this clinical issue, however, is the positive predictive power, the
      conditional probability that diagnostic criteria will be met by teacher's report
      if that diagnosis has been made based on parental report. In a population of 43
      children (ages 4 to 17) satisfying clinical criteria for DSM-III ADD, parents and
      teachers independently completed them module on ADD derived from the Diagnostic
      Interview for Children and Adolescents. Although correlations for individual
      symptoms were low to moderate, there was a 90% probability that the teacher
      report would result in a positive diagnosis given a positive parent diagnosis,
      indicating a very high probability that, in clinically referred children, a
      clinical diagnosis of ADD based on parent report will be corroborated by a
      teacher report.

PMID- 2228922
TI  - Clinical effects of a controlled trial of methylphenidate on adolescents with
      attention deficit disorder.
AB  - Forty-eight attention deficit disorder patients, 12 to 18 years old and without
      previous stimulant therapy, received a double-blind trial of methylphenidate and
      placebo for 3 weeks each. Stimulant treatment produced mild side effects and
      weight reduction. Methylphenidate significantly reduced teachers' and parents'
      ratings of hyperactivity, inattention, and oppositionality. In addition, patients
      rated themselves as clinically improved and reported elevated subjective mood
      during stimulant therapy. Treatment benefits were comparable for patients with
      and without concurrent conduct or oppositional disorder as well as those with and
      without past or present depressive disorders. These results support the continued
      effectiveness of stimulant therapy for attention deficit disorder in adolescence.
      However, the magnitude of clinical effectiveness reported was smaller than
      previously found in younger patients.

PMID- 2228923
TI  - Methylphenidate in aggressive-hyperactive boys: I. Effects on peer aggression in
      public school settings.
AB  - One of the least documented "known" effects of methylphenidate in hyperactive
      children is the suppression of peer aggression. In this study, 11 aggressive
      hyperactive children received a low (0.3 mg/kg) and moderate (0.6 mg/kg) dose of
      methylphenidate and placebo for 2 weeks each under double-blind conditions.
      Children were observed in public school settings during classroom seatwork
      activities, lunch, and recess. Results showed that methylphenidate suppressed
      nonphysical aggression (p = 0.06) in the classroom, and a moderate dose decreased
      physical aggression (p less than 0.01) and verbal aggression (p = 0.07) on the
      playground. The effect on the rate of appropriate social interaction was
      variable. The majority of subjects exhibited either the same or higher levels of
      appropriate social interaction on the 0.6 mg/kg dose compared with placebo. In
      the classroom, both doses of methylphenidate also resulted in reduced levels of
      motor movement, off-task behavior, noncompliance, and disruptiveness. Teacher
      ratings of hyperactivity and conduct problem symptoms revealed drug effects,
      whereas parallel parent instruments did not.

PMID- 2228924
TI  - Effects of methylphenidate on adolescents with aggressive conduct disorder and
      ADDH: a preliminary report.
AB  - The effect of methylphenidate on aggression in adolescents diagnosed with both
      aggressive conduct disorder and attention deficit disorder with hyperactivity was
      assessed in nine male adolescents. After three open trials, a placebo controlled
      double-blind design was used. During methylphenidate treatment of the six double
      blind subjects, there was a significant reduction of aggressivity (p's less than
      0.05), as measured by the Adolescent Antisocial Behavior Checklist. Conners
      Teacher Rating Scale Hyperactivity and Aggression scores were in the predicted
      directions, but the differences were not statistically significant.

PMID- 2228925
TI  - The prevalence of psychotic symptoms in homeless adolescents.
AB  - This study was designed to gather data on psychotic symptoms in a sample of
      homeless adolescents. The sample included adolescents who were located in street
      sites as well as adolescents who were currently using shelter services. Ninety
      six adolescents participated in this study (mean age = 16.1 years). The results
      indicated that 29% of the sample reported the experience of four or more
      psychotic symptoms on the Diagnostic Interview Schedule psychotic symptom index.
      These results suggested that the endorsement of psychotic symptoms is a
      relatively prominent feature of the self-report of psychopathology among homeless
      adolescents. These symptoms did not only include reports of paranoid ideation,
      which may be generally elevated as part of the stress of street life, but also
      included reports of ideas of reference and auditory hallucinations. Moreover,
      these symptoms were correlated with reports of affective disturbance, abusive
      life experience, and a particular type of substance use.

PMID- 2228926
TI  - Sexualized doll play among young children: implications for the use of anatomical
      dolls in sexual abuse evaluations.
AB  - The use of anatomical dolls in sexual abuse evaluations remains controversial
      because of concerns that the dolls induce normal, nonabused children to act out
      in sexual ways that are likely to be misinterpreted as evidence of sexual abuse.
      This study examines the incidence of explicit sexual doll play in a large,
      demographically diverse sample of 2- to 5-year-olds. The 6% incidence of
      demonstrations of apparent sexual intercourse found in this sample compared
      favorably with the rate of less than 2% across prior studies of anatomical doll
      play among presumably nonabused children. However, higher rates of explicit
      sexual play were associated with being older, poor, black, and somewhat with
      being male, with over 20% of some subgroups of children displaying such behavior.
      These results are interpreted as evidence that anatomical dolls are not overly
      suggestive to young, sexually naive children, but are useful in assessing sexual
      knowledge and exposure to sexual intercourse.

PMID- 2228927
TI  - Specificity and sensitivity of sexually anatomically correct dolls in
      substantiating abuse: a pilot study.
AB  - Sexually anatomically correct dolls are often used to verify or refute
      allegations of sexual abuse in young children. As a test of their effectiveness
      in facilitating decisions about the abuse status of young children, the authors
      conducted blind interviews with six abused subjects, five nonclinic controls and
      four psychiatric controls. The child psychiatrist interviewer followed a
      standardized protocol and was able to correctly categorize 33% of the abused and
      67% of the nonabused children. Proper classification was 53% for the sample using
      this protocol. The authors' preliminary conclusion is that, without other
      information available to the interviewer, sexually anatomically correct dolls are
      a poor source of information to decide the abuse status of a young child. The
      authors recommend that professionals should be cautious when basing decisions on
      a single instrument, such as sexually anatomically correct dolls. Mental health
      professionals are encouraged to maintain quality standards in evaluation of
      children by conducting a comprehensive examination in child sexual abuse cases.

PMID- 2228928
TI  - Cognitive behavioral treatment for sexually abused children suffering post
      traumatic stress: preliminary findings.
AB  - The present investigation examined the effectiveness of a cognitive behavioral
      treatment program designed for sexually abused children suffering post-traumatic
      stress disorder. Nineteen girls who suffered contact sexual abuse and met DSM-III
      R criteria for post-traumatic stress disorder were included in the study.
      Subjects ranged in age from 3 to 16 years old. Structured interviews were
      conducted to assess the presence or absence of post-traumatic stress disorder
      symptoms before, during, and following the abuse. Additionally, parents completed
      the Child Behavior Checklist, and subjects at least 6 years of age were
      administered the Child Depression Inventory and the Spielberger State-Trait
      Anxiety Inventory at the initial evaluation and again approximately 2 to 3 weeks
      later before the initiation of treatment. The baseline data collected at these
      two points were compared, and no significant changes were found over time. The
      above measures were readministered following 12 treatment sessions. The results
      revealed significant improvements at post-treatment on all measures.

PMID- 2228929
TI  - The prevalence of overanxious disorder and separation anxiety disorder: results
      from the Ontario Child Health Study.
AB  - Data from a community epidemiological study of 1,869 families (Ontario Child
      Health Study) was used to evaluate the effect of different ways of
      operationalizing DSM-III-R criteria for overanxious disorder (OAD) and separation
      anxiety disorder (SAD) among adolescents aged 12 to 16. The authors determined
      that a high threshold for symptoms to qualify as present, the presence of one or
      both of the essential symptoms, and the presence of four or more auxiliary
      symptoms for OAD and three or more for SAD gave prevalence of OAD of 3.6% and SAD
      of 2.4%. There was high overlap between the presence of OAD and SAD and
      externalizing disorder and depression, but one-half of youth with OAD and SAD had
      pure anxiety disorder. Youth with OAD and SAD were just as impaired as youth with
      externalizing disorder and depression, except that they admitted to less social
      isolation and their schoolwork was less affected.

PMID- 2228930
TI  - Symptoms of anxiety disorders in normal children.
AB  - The present study examined prevalence, expression, and developmental patterns of
      DSM-III-R anxiety disorder symptoms in 62 never-psychiatrically-ill children.
      Subclinical phobias and overanxious disorder symptoms were fairly common, while
      symptoms of other anxiety disorders were less common. Direction of sex and age
      differences was generally consistent with previous literature, but few reached
      statistical significance. Nonanxious and subclinically anxious subsamples of
      never-psychiatrically-ill subjects were compared on individual and family
      psychopathology. Subclinically anxious children showed greater individual and
      family psychopathology than nonanxious children, though differences decreased at
      12-month follow-up. Anxiety as a normal developmental phenomenon is discussed.

PMID- 2228931
TI  - Obsessive compulsive disorder in children and adolescents: phenomenology and
      family history.
AB  - Phenomenology and family history in 21 clinically referred children and
      adolescents with obsessive compulsive disorder are described. Each child and
      family participated in a standard clinical psychiatric assessment. The most
      frequently reported symptoms were repeating rituals, washing, ordering and
      arranging, checking, and contamination concerns. Controlling behaviors involving
      other family members were seen in 57% of the patients. Associated psychopathology
      was common: 38% received an anxiety disorder diagnosis; 29% received a mood
      disorder diagnosis; tics were observed in 24%. Fifteen (71%) of the children had
      a parent with either obsessive compulsive disorder (N = 4) or obsessive
      compulsive symptoms (N = 11). The clinical and research implications of these
      findings are discussed.

PMID- 2228932
TI  - Comparative studies of pharmacotherapy for school refusal.
AB  - Two studies compared alprazolam and imipramine in the treatment of school
      refusal. In an open label study (N = 17), two-thirds of the subjects completing a
      trial in both the alprazolam and imipramine groups showed moderate to marked
      global improvement in symptoms of anxiety and depression. In the double-blind,
      placebo-controlled study (N = 24), posttreatment scores calculated as change from
      baseline on the Anxiety Rating for Children were significantly different (p =
      .03) among the three treatment groups, with the active medication groups showing
      the most improvement. Additionally, on all depression rating scales, similar
      trends were evident with the alprazolam and imipramine groups demonstrating
      greater improvement than the placebo group. However, analyses of covariance (with
      pretreatment scores as the covariates) showed no significant differences among
      the three treatment groups on change in anxiety and depression scales. Thus,
      additional research is needed to determine whether trends in this study are
      explained by drug effect or baseline differences on rating scales.

PMID- 2228933
TI  - Diagnosis of panic disorder in prepubertal children.
AB  - Few reports on panic disorder in children are available, despite the
      retrospectively documented onset in childhood of about 20% of the cases of adult
      panic disorder. The authors report on six prepubertal children, aged 8 to 13
      years, who met DSM-III-R criteria for adult-type panic disorder. Hyperthyroidism,
      cardiologic, and respiratory problems were excluded as well as abuse of caffeine
      or other drugs. The first panic attack occurred between 5 to 11 years of age,
      with an average interval of 3 years between onset of the disorder and diagnosis.
      Mitral valve prolapse was documented in two cases. Family history was always
      positive for panic disorder. Although not common, panic disorder should be
      considered in children with school phobia and positive family history. As it is
      in adults, mitral valve prolapse may be associated with panic disorder in
      children.

PMID- 2228934
TI  - Panic disorder on a child psychiatric consultation service.
AB  - In a review of all cases seen from 1984 to 1988 by the psychiatric consultation
      liaison service of a tertiary referral pediatric hospital, four cases of definite
      panic disorder meeting DSM-III-R criteria were identified. Three of these
      children were referred to the consultation service after intensive investigation
      of physical complaints had failed to yield a diagnosis. These cases of panic
      disorder differed from those previously reported in child psychiatric populations
      by their relative absence of psychiatric comorbidity. This suggests that
      uncomplicated panic disorder may present with primarily somatic symptoms in
      pediatric subspecialty clinics, while panic disorder, complicated by behavioral
      or emotional disturbance, is more likely to present directly to child psychiatric
      services. Children presenting with somatic symptoms are at risk for receiving
      nonproductive investigations while having delayed diagnosis and treatment of the
      panic disorder.

PMID- 2228935
TI  - Applying impairment criteria to children's psychiatric diagnosis.
AB  - This paper examines the effect of applying impairment criteria using the
      Children's Global Assessment Scale on rates, agreement between informants, and
      recall of diagnosis over 2 years in a sample of 220 offspring of depressed and
      nondepressed parents. The findings show that the offspring of depressed parents,
      compared with nondepressed parents, were more impaired overall. The rates of most
      psychiatric disorders in both groups of children were markedly reduced when
      impairment criteria were applied. The application of impairment criteria improved
      agreement between mother and child on many of the children's diagnoses and also
      improved stability of recall of child's diagnosis at 2-year follow-up. Long-term
      follow-up studies are needed to determine the clinical consequences for children
      who meet diagnostic criteria for psychiatric disorder but who have minimal
      functional impairment.

PMID- 2228936
TI  - Impairment in the epidemiological measurement of childhood psychopathology in the
      community.
AB  - The desirability of incorporating a measure of impairment to the categorization
      of childhood psychopathology in the community is examined. The use of the
      Children's Global Assessment Scale (CGAS) for this purpose is recommended. The
      choice of 61 (definite case) and 71 (probable case) as cutpoints on the
      Children's Global Assessment Scale is supported empirically by the data on
      service utilization, parental perceived need, and behavior problem scores
      obtained in the Puerto Rico Child Psychiatry Epidemiological Study.

PMID- 2228937
TI  - Children at risk: II. Risk factors and clinic utilization.
AB  - Using a strategy involving multiple raters and instruments, the authors compared
      134 clinic subjects with controls matched on sex, age, and socioeconomic status
      to determine how various risk factors are related to clinic utilization apart
      from their effects on children's symptomatology. Parental psychopathology, family
      size, and marital status were most predictive of children's symptom levels, while
      stress levels, family size, and marital status were most predictive of clinic
      utilization. Although children's total symptom levels explained 27.6% of the
      variance in clinic utilization, other factors (family size, family history of
      divorce, stress, and parental psychopathology) explained an additional 13.2% of
      the variance. Findings indicate that clinicians and health care planners must
      carefully assess variables other than children's symptom levels in order to
      better understand children's mental health services utilization, develop more
      robust models of risk, and increase the effectiveness of our efforts directed
      towards prevention and intervention.

PMID- 2228938
TI  - Alcoholism and substance abuse teaching in child psychiatry residency programs.
AB  - In order to determine the needs and goals of substance abuse teaching, vis-a-vis
      child psychiatry training, a questionnaire was sent to the training directors at
      every child psychiatry program accredited by the Accreditation Council of
      Graduate Medical Examination. The results demonstrated that most child psychiatry
      programs schedule at least some didactic time specifically for substance abuse
      topics. However, only 59% of the training directors felt that their fellows were
      adequately educated to identify and at least initially manage a drug abusing
      adolescent.

PMID- 2228939
TI  - A model curriculum for substance abuse education in child and adolescent
      psychiatry training programs.
AB  - Child psychiatry training recognizes substance abuse as a problem requiring an
      educational effort to provide fellows with adequate clinical skills to manage
      these patients. The components of a substance abuse educational module which may
      be integrated into existing child psychiatry fellowships are presented, with a
      discussion of practical problems raised by the expansion of child psychiatry into
      this neglected area.

PMID- 2228940
TI  - A study of the Board Certification Examination in Child and Adolescent
      Psychiatry.
AB  - In 1977, training directors of 55 child psychiatry training programs agreed to
      provide the Committee on Certification in Child Psychiatry of the American Board
      of Psychiatry and Neurology, Inc. with confidential data about the clinical
      performance of each of their graduates in 1978, 1979, and 1980. Information about
      267 graduates from 37 programs was received. Almost all programs were university
      affiliated and located in medical centers. By 1986, 112 of these graduates had
      taken the child aboard examination. Training director ratings were found to be
      statistically correlated to a significant degree with actual pass or fail results
      on the written and on the overall examination.

PMID- 2228941
TI  - Resolved: children should be told of their adoption before they ask.

PMID- 2228942
TI  - Does panic disorder exist in childhood?

PMID- 2228943
TI  - From DSM-III-R to DSM-IV.

PMID- 2228944
TI  - Subtypes of conduct disorder.

PMID- 2228945
TI  - Psychological screening for the pediatrician.

PMID- 2228946
TI  - Pharmacotherapy of aggression.

PMID- 2228947
TI  - Antistuttering medication?

PMID- 2228948
TI  - More on ECT.

PMID- 2228949
TI  - Ultrasonographic findings in peptic ulcer: a report on 24 cases proven
      endoscopically.
AB  - A series of 24 patients is presented who had routine upper abdominal sonography
      for reason of atypical abdominal pain; in all cases the sonographically suggested
      diagnosis of a mucosal ulceration was proved by a following endoscopy. The
      ultrasonic findings were localized thickening of the gastric wall in combination
      with presence of liquid intragastrically in a fasting patient.

PMID- 2228950
TI  - [Left adrenal gland hemorrhage as isolated lesions following blunt trauma].
AB  - Posttraumatic hemorrhage of the adrenals usually occurs in the right or in both
      glands. This report describes one case of isolated, posttraumatic hemorrhage of
      the left adrenal in a 56-year-old woman. US examination shows a mass, almost
      isoreflective with the spleen, with central bright echoes, which are
      characteristic of fresh hematoma. CT examination displays a dense, relatively
      well-defined mass lesion causing a spread of the adrenal limbs. Density
      measurements are typical for hematoma. Follow-up examination one week later
      demonstrates partial regression of the lesion in volume and density.

PMID- 2228951
TI  - [Diagnosis and percutaneous treatment of pulmonary hydatid cyst. State of the
      problem apropos of a case].
AB  - A pulmonary hydatid cyst was diagnosed and cured by percutaneous CT guided
      aspiration. Pleural effusion related to incomplete aspiration of the loculated
      cyst was observed. No deleterious effect occurred, after a follow-up of 22
      months.

PMID- 2228952
TI  - [Prenatal bowing of the long bones].
AB  - A case of congenital angulation and bowing of the long bones is reported. The
      condition belongs to a group of bone pathologies which have as a common feature
      an abnormal bowing of the diaphysis. The cortex at the concave side shows a
      thickening while the convex side shows a cortical thinning, corresponding to a
      structural adaptation to external compressing forces at the site of the bowing of
      the bone. The angulation is a consequence of bowing of long bones over other
      foetal parts.

PMID- 2228953
TI  - The role of CT in the diagnosis of adenocarcinoma of the ethmoid.
AB  - A retrospective study of 26 patients with ethmoid adenocarcinoma is presented. CT
      proves to be of great diagnostic value in demonstrating the location and
      extension of these tumors. The only interpretation problem that may exist is the
      overestimation of the tumor extension due to the occurrence of retro-obstructive
      sinusitis.

PMID- 2228954
TI  - MRI of intraparenchymal hematoma: responsible mechanisms.
AB  - The MRI appearance and evolution of hemorrhage remains a difficult entity. A
      typical example of the MR visualization of an intracerebral bleeding in the basal
      ganglia and the internal capsule at 1.5 T is presented. The sequential
      biochemical and physical changes in an hemorrhage are described.

PMID- 2228955
TI  - Agrobacterium rhizogenes mutants that fail to bind to plant cells.
AB  - Transposon insertion mutants of Agrobacterium rhizogenes were screened to obtain
      mutant bacteria that failed to bind to carrot suspension culture cells. A light
      microscope binding assay was used. The bacterial isolates that were reduced in
      binding to carrot cells were all avirulent on Bryophyllum diagremontiana leaves
      and on carrot root disks. The mutants did not appear to be altered in cellulose
      production. The composition of the medium affected the ability of the parent and
      mutant bacteria to bind to carrot cells. The parent strain bound to carrot cells
      in greatest numbers in low-ionic-strength media such as 4% sucrose but still
      showed significant binding in Murashige-Skoog tissue culture medium. All of the
      mutants showed reduced binding in 4% sucrose after 2 h of incubation with carrot
      cells. One mutant was delayed in binding in 4% sucrose. This mutant and one other
      mutant also showed reduced binding to carrot cells in Murashige-Skoog medium. To
      determine whether the Tn5 insertion was responsible for the mutant phenotype, DNA
      containing the Tn5 insertion was cloned from the mutant bacteria and used to
      introduce Tn5 into the parent strain in the same location as in the original
      mutant by marker exchange. The resulting transconjugants had the same avirulent,
      nonattaching phenotype as the original mutants, suggesting that the mutant
      phenotype was due to the Tn5 insertion. The cloned DNA containing the Tn5
      insertion was also tested for homology to DNA of known genes that affect
      attachment of Agrobacterium tumefaciens to plant cells by DNA hybridization. No
      homology to chv, att, or pscA clones was observed. In addition, cloned chv, att,
      and pscA genes from A. tumefaciens were unable to complement the attachment-minus
      A. rhizogenes mutants. Thus, the A. rhizogenes nonattaching mutants appear to be
      different from the previously described A. tumefaciens mutants.

PMID- 2228956
TI  - The level of a transcript required for production of a Streptomyces coelicolor
      antibiotic is conditionally dependent on a tRNA gene.
AB  - In Streptomyces coelicolor A3(2), bldA mutants are conditionally defective in
      aerial mycelium formation and fail to synthesize all four antibiotics produced by
      bldA+ strains. Previous studies showed that bldA specifies the tRNA for the
      rarely used leucine codon UUA. Here we describe experiments examining the
      abundance in a bldA mutant of a transcript involved in antibiotic production.
      With use of a bacteriophage-based integrative vector, a promotorless xylE
      reporter gene was inserted into a previously undescribed gene for an early step
      in biosynthesis of the red antibiotic undecylprodigiosin, located in the red gene
      cluster. With this transcriptional fusion present at unit copy number in the
      chromosome, xylE expression in a bldA+ strain was maximal late in growth in a
      liquid production medium and was virtually absent in a bldA mutant. On plates of
      a different medium, the bldA mutant was able to produce undecylprodigiosin and to
      express the red::xylE fusion, but both abilities were repressed by increasing the
      concentration of phosphate in the medium. These experiments showed that the
      undecylprodigiosin deficiency of bldA mutants cannot be accounted for by the
      presence of TTA codons in the red structural genes, but rather that bldA
      influences red gene mRNA abundance. In low-phosphate conditions, an alternative
      regulatory pathway can lead to red gene expression.

PMID- 2228957
TI  - LexA-independent expression of a mutant mucAB operon.
AB  - pKM101 is a naturally occurring plasmid that carries mucAB, an analog of the
      umuDC operon, the gene products of which are required for the SOS-dependent
      processing of damaged DNA necessary for most mutagenesis. Genetic studies have
      indicated that mucAB expression is controlled by the SOS regulatory circuit, with
      LexA acting as a direct repressor. pGW16 is a pKM101 derivative obtained by N
      methyl-N'-nitro-N-nitrosoguanidine mutagenesis that was originally identified on
      the basis of its ability to cause a modest increase in spontaneous mutation rate.
      In this report, we show that pGW16 differs from pKM101 in being able to enhance
      methyl methanesulfonate mutagenesis and to confer substantial resistance to UV
      killing in a lexA3 host. The mutation carried by pGW16 is dominant and was
      localized to a 2.4-kb region of pGW16 that includes the mucAB coding region and
      approximately 0.6 kb of the 5'-flanking region. We determined the sequence of a
      119-bp fragment containing the region upstream of mucAB and identified a single
      base-pair change in that region, a G.C-to-A.T transition that alters a sequence
      homologous to known LexA-binding sites. DNA gel shift experiments indicate that
      LexA protein binds poorly to a 125-bp fragment containing this mutation, whereas
      a fragment containing the wild-type sequence is efficiently bound by LexA. This
      mutation also alters an overlapping sequence that is homologous to the -10 region
      of Escherichia coli promoters, moving it closer to the consensus sequence. The
      observation that the synthesis of pGW16-encoded mucAB proteins in maxicells is
      increased relative to that of pKM101-encoded mucAB proteins even in the absence
      of a lexA+ plasmid suggests that this mutation also increases the activity of the
      mucAB promoter.

PMID- 2228958
TI  - Analysis of the Erwinia chrysanthemi arb genes, which mediate metabolism of
      aromatic beta-glucosides.
AB  - Erwinia chrysanthemi is one of the few members of the family Enterobacteriaceae
      that is capable of metabolizing most of the naturally occurring beta-glucosides.
      We previously isolated the clb genes, which allow the use of the disaccharide
      cellobiose as well as the aromatic beta-glucosides arbutin and salicin. We report
      here the isolation of the arb genes, which permit fermentation of the aromatic
      beta-glucosides only. Establishment of a functional Arb system in Escherichia
      coli depended on the presence of the phosphotransferase system and on the
      activation by the cyclic AMP-cyclic AMP receptor protein complex. Strains
      carrying mini-Mu-induced LacZ fusions to the arb genes were used to analyze arb
      genes organization and function. Three arb genes (arbG, arbF, and arbB) were
      identified and organized in this order. Genetic and structural evidence allowed
      us to assign a phospho-beta-glucosidase and a permease activity to the ArbB and
      ArbF proteins, respectively. Several Lac+ arb-lacZ insertions were introduced
      into the E. chrysanthemi chromosome. Both ArbG- and ArbF- strains were unable to
      ferment the aromatic beta-glucosides, whereas ArbB- strains were impaired only in
      salicin fermentation. None of the mutations in the arb genes affected cellobiose
      metabolism. The expression of the arb genes was substrate inducible and required
      the ArbF permease and, possibly, the ArbG protein. Collectively, our results
      underline the resemblance between the naturally expressed E. chrysanthemi arbGFB
      and the cryptic E. coli bglGFB operons, yet the arbG gene product seemed unable
      to activate E. coli bgl operon expression.

PMID- 2228959
TI  - The Escherichia coli polB gene, which encodes DNA polymerase II, is regulated by
      the SOS system.
AB  - The dinA (damage inducible) gene was previously identified as one of the SOS
      genes with no known function; it was mapped near the leuB gene, where the polB
      gene encoding DNA polymerase II was also mapped. We cloned the chromosomal
      fragment carrying the dinA region from the ordered Escherichia coli genomic
      library and mapped the dinA promoter precisely on the physical map of the
      chromosome. The cells that harbored multicopy plasmids with the dinA region
      expressed very high levels of DNA polymerase activity, which was sensitive to N
      ethylmaleimide, an inhibitor of DNA polymerase II. Expression of the polymerase
      activity encoded by the dinA locus was regulated by SOS system, and the dinA
      promoter was the promoter of the gene encoding the DNA polymerase. From these
      data we conclude that the polB gene is identical to the dinA gene and is
      regulated by the SOS system. The product of the polB (dinA) gene was identified
      as an 80-kDa protein by the maxicell method.

PMID- 2228961
TI  - Cross talk to the phosphate regulon of Escherichia coli by PhoM protein: PhoM is
      a histidine protein kinase and catalyzes phosphorylation of PhoB and PhoM-open
      reading frame 2.
AB  - Transcription of the genes in the phosphate regulon in Escherichia coli is
      activated by PhoB protein, which is phosphorylated by PhoR protein under
      phosphate-limiting conditions. In the absence of the phoR function, the genes in
      the phosphate regulon are expressed constitutively and the expression is
      dependent on the function of phoM and phoB. We constructed a plasmid with a lacZ'
      'phoM fusion gene, which encoded a hybrid protein (PhoM1206) in which the
      hydrophobic amino-terminal half of the native PhoM was replaced by beta
      galactosidase. The phoM1206 gene could complement the phoM mutation in vivo. We
      purified PhoM1206 from the overproducing strain carrying the plasmid; it was
      autophosphorylated at a histidine residue in the presence of ATP, and the phospho
      PhoM1206 phosphorylated PhoB. PhoM1206 could also transphosphorylate the product
      of phoM-orf2, which is structurally homologous to phoB and located immediately
      upstream of phoM. Although PhoR1084 that lacked the hydrophobic amino-terminal
      region of the native PhoR protein transphosphorylated PhoB, it could not
      phosphorylate PhoM-open reading frame 2. Therefore, cross talk by protein
      phosphorylation appears to occur from PhoM to PhoB but not from PhoR to PhoM-open
      reading frame 2.

PMID- 2228960
TI  - Purification and preliminary characterization of the Escherichia coli K-12 recF
      protein.
AB  - The recF gene of Escherichia coli is known to encode an Mr-40,000 protein that is
      involved in DNA recombinationa nd postreplication DNA repair. To characterize the
      role of the recF gene product in these processes, the recF gene was cloned
      downstream of a tac promoter to facilitate overproduction of the recF gene
      product. The RecF protein was overproduced and purified to apparent homogeneity.
      N-terminal protein sequence analysis demonstrated that the purified protein had
      the sequence that was predicted from the DNA sequence of the recF gene, except
      that the predicted N-terminal Met was not present. The RecF protein bound to
      single-stranded oligonucleotides in filter binding and gel filtration assays.
      Maximal binding required 2 to 3 min of incubation at 37 degrees C; the binding
      reaction had a pH optimum of 7.0, did not require divalent cations, and was
      inhibited by NaCl concentrations of greater than 250 mM. The Kd of RecF protein
      binding to a 59-base single-stranded oligonucleotide was on the order of 1.3 X
      10(-7) M, and the reaction did not show cooperativity. Experiments measuring the
      binding to various DNA substrates and competition binding experiments with
      different DNA molecules demonstrated that RecF protein binds preferentially to
      single-stranded, linear DNA molecules.

PMID- 2228962
TI  - Cloning, mapping, and sequencing of the gene encoding Escherichia coli
      quinoprotein glucose dehydrogenase.
AB  - Escherichia coli contains pyrroloquinoline quinone-dependent glucose
      dehydrogenase. We cloned and sequenced the gene (gcd) encoding this enzyme and
      showed that the derived amino acid sequence is highly homologous to that of the
      gdhA gene product of Acinetobacter calcoaceticus. Stretches of homology also
      exist between the amino acid sequence of E. coli glucose dehydrogenase and other
      pyrroloquinoline quinone-dependent dehydrogenases from several bacterial species.
      The position of gcd on the chromosomal map of E. coli was determined to be at 3.1
      min.

PMID- 2228963
TI  - Bacteriophage T4 nrdA and nrdB genes, encoding ribonucleotide reductase, are
      expressed both separately and coordinately: characterization of the nrdB
      promoter.
AB  - We examined the expression of the bacteriophage T4 nrdA and nrdB genes, which
      encode the alpha 2 and beta 2 subunits, respectively, of ribonucleoside
      diphosphate reductase, the first committed enzyme in the pathway of synthesis of
      the deoxyribonucleoside triphosphates. T4 nrdA, located 700 bp upstream from
      nrdB, has been shown previously to be transcribed by two major transcripts: a
      prereplicative, polycistronic message, TU, orginating at an immediate-early
      promoter, PE, that is 3.5 kb upstream from nrdA, and a postreplicative message
      commencing from a late promoter in its 5' flank. We have found a third promoter
      initiating a transcript at 159 nucleotides upstream from the reading frame of
      nrdB. PnrdB functions only in the presence of the T4 motA gene product, which is
      required for middle (time) promoters, and therefore the onset of nrdB
      transcription is delayed more than 2 min after infection. Because of the distance
      of nrdA from PE, the inception of nrdA transcription (delayed early) coincides
      closely with that of nrdB. An apparent termination site, tA, occurs about 80 bp
      downstream from nrdA. Some of the polycistronic mRNA reading through the site
      after 5 min contributes to nrdB transcription. nrdA and nrdB genes in an
      uninfected host have been reported to be transcribed only coordinately. In
      contrast, T4 nrdA and nrdB are initially transcribed separately onto the PE and
      PnrdB transcripts, respectively, but at about 5 min after infection are
      transcribed both coordinately and on separate transcripts. Evidence is presented
      that TU coordinately transcribes a deoxyribonucleotide operon in the order: frd,
      td, gene 'Y,' nrdA, nrdB. Since the beta 2 subunit is known to be formed after
      the alpha 2 subunit, the expression of the nrdB gene determines the onset of
      deoxyribonucleoside triphosphate synthesis and thus of T4 DNA replication.

PMID- 2228964
TI  - Cloning, expression, and nucleotide sequence of the Lactobacillus helveticus 481
      gene encoding the bacteriocin helveticin J.
AB  - Lactobacillus helveticus 481 produces a 37-kDa bacteriocin called helveticin J.
      Libraries of chromosomal DNA from L. helveticus were prepared in lambda gt11 and
      probed for phage-producing fusion proteins that could react with polyclonal
      helveticin J antibody. Two recombinant phage, HJ1 and HJ4, containing homologous
      inserts of 350 and 600 bp, respectively, produced proteins that reacted with
      antibody. These two phage clones specifically hybridized to L. helveticus 481
      total genomic DNA but not to DNA from strains that did not produce helveticin J
      or strains producing unrelated bacteriocins. HJ1 and HJ4 lysogens produced beta
      galactosidase fusion proteins that shared similar epitopes with each other and
      helveticin J. The intact helveticin J gene (hlv) was isolated by screening a
      library of L. helveticus chromosomal DNA in lambda EMBL3 with the insert DNA from
      phage HJ4 as a probe. The DNA sequence of a contiguous 3,364-bp region was
      determined. Two complete open reading frames (ORF), designated ORF2 and ORF3,
      were identified within the sequenced fragment. The 3' end of another open reading
      frame, ORF1, was located upstream of ORF2. A noncoding region and a putative
      promoter were located between ORF1 and ORF2. ORF2 could encode an 11,808-Da
      protein. The L. helveticus DNA inserts of the HJ1 and HJ4 clones reside within
      ORF3, which begins 30 bp downstream from the termination codon of ORF2. ORF3
      could encode a 37,511-Da protein. Downstream from ORF3, the 5' end of another ORF
      (ORF4) was found. A Bg/II fragment containing ORF2 and ORF3 was cloned into
      pGK12, and the recombinant plasmid, pTRK135, was transformed into Lactobacillus
      acidophilus via electroporation. Transformants carrying pTRK135 produced a
      bacteriocin that was heat labile and exhibited an acitivity spectrum that was the
      same as that of helveticin J.

PMID- 2228965
TI  - Transcription of the Shiga-like toxin type II and Shiga-like toxin type II
      variant operons of Escherichia coli.
AB  - Shiga-like toxin type II (SLT-II) and Shiga-like toxin type II variant (SLT-IIv)
      are cytotoxins produced by certain strains of Escherichia coli. Nucleotide
      sequence analyses had revealed that the structural genes for the A subunit and B
      subunit of SLT-II or SLT-IIv are arranged in an operon. Primer extension and S1
      nuclease protection analyses identified a promoter for the slt-II operon 118
      bases upstream of the slt-IIA gene. The slt-IIv promoter was demonstrated to be
      identical to the slt-II promoter. The slt-II and slt-IIv promoters differed
      significantly from the previously characterized Shiga toxin (stx) and Shiga-like
      toxin type 1 (slt-I) promoters. The transcriptional efficiencies of the stx and
      slt-II promoters were compared in fusions to the chloramphenicol
      acetyltransferase gene, and constitutive expression of the slt-II promoter was
      found to be equivalent to derepressed expression of the stx promoter. In contrast
      to the stx and slt-I promoters, the slt-II and slt-IIv promoters did not contain
      sequences for binding of the Fur repressor protein, and SLT-II production was not
      determined by iron levels in the media in various E. coli strains with wild-type
      or mutant ferric uptake regulation (fur) alleles. Northern (RNA) blot analysis
      demonstrated a single mRNA transcript for the slt-II operon, and further analysis
      of the slt-II operon by primer extension did not reveal an independent promoter
      for the B subunit gene. A putative rho-independent transcription terminator was
      identified 274 bases downstream of slt-IIB. These data indicated that the slt-II
      and slt-IIv operons differ from the stx/slt-I operon in regulation of their
      transcription by iron. Whether these regulatory differences enable the type I and
      type II groups of Shiga-like toxins to perform different roles in the
      pathogenesis of infectious diseases remains to be established.

PMID- 2228966
TI  - Beta-lactamase expression in Streptomyces cacaoi.
AB  - Plasmids were prepared by inserting genomic DNA fragments from Streptomyces
      cacaoi within the mel gene of plasmid pIJ702. The inserted DNA fragments contain
      the beta-lactamase-encoding bla gene and upstream nucleotide sequences of various
      lengths. The transcription start point of bla was identified by nuclease S1
      mapping. Upstream nucleotide sequences of sufficient lengths had an enhancing
      effect on beta-lactamase production by the Streptomyces host. The dot blot
      hybridization assay revealed that this effect was exerted at the transcriptional
      level. Experimental evidence strongly suggests that the underlying mechanism
      involves, at least in part, one or several trans-acting elements. In one of the
      constructs, in which the upstream nucleotide sequence was reduced to 0.3 kb, the
      bla promoter was present but the bla gene was expressed by readthrough from a
      promoter, possibly the mel promoter, of the pIJ702 vector.

PMID- 2228967
TI  - Purification and characterization of the reduced-nicotinamide-dependent 2,2'
      dithiodiethanesulfonate reductase from Methanobacterium thermoautotrophicum delta
      H.
AB  - A novel reduced nicotinamide-dependent disulfide reductase, the 2,2'
      dithiodiethanesulfonate [(S-CoM)2] reductase (CoMDSR) of Methanobacterium
      thermoautotrophicum was purified 405-fold to electrophoretic homogeneity. Both
      NADPH and NADH functioned as electron donors, although rates with NADPH were
      three times higher. Reduced factor F420, the deazaflavin electron carrier
      characteristic of methanogenic bacteria, was not a substrate for the enzyme. The
      enzyme was most active with (S-CoM)2 but could also reduce L-cystine at 23% the
      (S-CoM)2 rate. Results of sodium dodecyl sulfate polyacrylamide gel
      electrophoresis indicated that the enzyme was monomeric with an Mr of about
      64,000; spectral analysis showed that it was a flavoprotein with an estimated
      composition of one molecule of flavin per polypeptide. Maximal activity occurred
      at 64 degrees C, and the pH optimum was 8.5. The apparent Km for both NADPH and
      (S-CoM)2 was 80 microM. The enzyme was completely inactivated by oxygen in crude
      cell extracts but was oxygen stable in the homogeneous state. The low activity of
      the CoMDSR in cell extracts as well as its relatively low rate of reducing CoM-S
      S-HTP (the heterodisulfide of the two thiol cofactors involved in the last step
      of methanogenesis) make it unlikely that it plays a role in the methylreductase
      system. It may be involved in the redox balance of the cell, such as the NADPH
      dependent bis-gamma-glutamylcystine reductase with which it shows physical
      similarity in another archaebacterium, Halobacterium halobium (A. R. Sundquist
      and R. C. Fahey, J. Bacteriol. 170:3459-3467, 1988). The CoMDSR might also be
      involved in regenerating the coenzyme M trapped as its homodisulfide, a
      nonutilizable form of the cofactor.

PMID- 2228968
TI  - Control of diauxic growth of Azotobacter vinelandii on acetate and glucose.
AB  - Batch cultures of Azotobacter vinelandii were inoculated with cells pregrown on
      either acetate or glucose. When they were subsequently grown on a mixture of
      acetate and glucose, typical diauxic growth was observed, with preferential
      uptake of acetate in the first and glucose in the second phase of growth.
      Extracts from acetate-pregrown cells exhibited high acetate kinase activity in
      the first phase of growth. This activity decreased and activities of the two
      glucose enzymes glucose 6-phosphate dehydrogenase and glyceraldehyde 3-phosphate
      dehydrogenase increased in the second phase. Extracts from glucose-pregrown cells
      exhibited high initial activities of the two glucose enzymes, which decreased
      while acetate kinase activity increased in the first phase of growth. Again, in
      the second phase, activities of the two glucose enzymes increased and acetate
      kinase activity decreased. In any case, isocitrate dehydrogenase activity varied
      only slightly and unspecifically. The differences in enzyme activity and the
      constancy of isocitrate dehydrogenase were confirmed by experiments with either
      acetate- or glucose-limited chemostats. In chemostats in which both of the
      substrates were limiting, all of the enzymes displayed significant activities.
      Glucose 6-phosphate dehydrogenase activity was inhibited by acetyl coenzyme A and
      acetyl phosphate but not by acetate. It is proposed that diauxic growth is based
      on the control of enzymes involved in acetate or glucose dissimilation by which
      acetate or its metabolites control the expression and activity of glucose
      enzymes.

PMID- 2228969
TI  - Interaction of RecA protein with acidic phospholipids inhibits DNA-binding
      activity of RecA.
AB  - The RecA protein of Escherichia coli binds specifically to acidic phospholipids
      such as cardiolipin and phosphatidylglycerol. This binding appears to be affected
      by the presence of divalent cations such as Ca2+ and Mg2+. The interaction leads
      to the inhibition of RecA binding to at least two different conformations of DNA,
      single-stranded DNA and left-handed Z-DNA, thus suggesting that the phospholipids
      interact at the DNA-binding site of the RecA protein. Inclusion of a nucleotide
      cofactor [adenosine 5'-O-(gamma-thiotriphosphate)] in the reactions did not
      prevent the inhibition of DNA-binding activities of RecA protein by the
      phospholipids. The interaction of RecA protein with cardiolipin and
      phosphatidylglycerol, which represent two of the three major phospholipids of the
      E. coli membrane, may be physiologically important, as it provides a possible
      mechanism for the RecA-membrane association during the SOS response. These
      observations raise the possibility that the Z-DNA-binding activity of RecA
      protein is merely a manifestation of its phospholipid-binding property.

PMID- 2228970
TI  - Enterohemolysin production is associated with a temperate bacteriophage in
      Escherichia coli serogroup O26 strains.
AB  - A temperate bacteriophage that determines the expression of enterohemolysin was
      isolated from Escherichia coli O26 strain C3888. The genetic determinant
      associated with enterohemolysin production (E-Hly determinant) was cloned from
      EcoRI-digested bacteriophage DNA in vector plasmid pUC8. pUC8 recombinant plasmid
      pEO19 carries a 3.7-kb EcoRI insert of phage DNA, and enterohemolysin was
      expressed in E. coli K-12 after transformation. Hemolysin-negative derivatives of
      pEO19 were generated by transposon mutagenesis with Tn1725. By subcloning, the
      phage E-Hly determinant was assigned to a 2,150-bp piece of DNA which is flanked
      by EcoRI and AccI restriction sites. The enterohemolysin-producing recombinant
      strains and wild-type strain C3888 express a 60-kDa protein which was detected in
      the bacterial outer membrane by Western immunoblotting. Biologically active
      enterohemolysin was detected only in bacteria grown to the stationary phase, and
      the hemolysin was not released into the culture medium. Lysis of erythrocytes was
      inhibited by 30 mM dextran 4, which functions as an osmotic protectant without
      destroying the enterohemolysin itself.

PMID- 2228971
TI  - Characterization of sodium dodecyl sulfate-stable Staphylococcus aureus
      bacteriolytic enzymes by polyacrylamide gel electrophoresis.
AB  - Profiles of the bacteriolytic activities of Staphylococcus aureus culture
      supernatants, sodium dodecyl sulfate cell extracts, LiCl cell extracts, cell wall
      extracts, and cell membranes were analyzed in sodium dodecyl sulfate
      polyacrylamide gels containing Micrococcus luteus or S. aureus. A total of 20
      distinct bands of bacteriolytic activity could be detected in gels containing M.
      luteus, 8 of these bands were found in culture supernatants. The sodium dodecyl
      sulfate cell extracts, the LiCl cell extracts, and the cell membranes each
      contained 20 bands (P1 to P20), but no activity was found in cell wall extracts.
      Less bacteriolytic activity could be detected in gels containing S. aureus,
      although three bands were found in culture supernatants and LiCl extracts and
      cell membranes contained one major band, P13. Crude cell extracts showed five
      bacteriolytic bands of which the major bacteriolytic bands were distributed in an
      identical manner in all 10 strains of S. aureus studied. The effects of chemical
      and physical factors were determined, and it was shown that iodoacetic acid,
      Hg2+, and Cibacron Blue 3G-A reduced activity, and an optimum pH for enzyme
      detection was between 7 and 8. Preincubation at 100 degrees C for 30 min reduced
      the activity of P1 and P2 bands.

PMID- 2228972
TI  - Unusual septum formation in Streptococcus pneumoniae mutants with an alteration
      in the D,D-carboxypeptidase penicillin-binding protein 3.
AB  - An internal 630-bp DNA fragment of the gene encoding penicillin-binding protein 3
      (PBP 3) (dacA) of Streptococcus pneumoniae was identified in a lambda gt11 gene
      bank screened with anti-PBP 3 antiserum. The deduced 210-amino-acid sequence
      showed a high degree of homology to the low-molecular-weight PBPs 5 and 6 of
      Escherichia coli and Bacillus subtilis PBP 5. Viable mutants lacking a C-terminal
      part of PBP 3 were obtained after a plasmid containing the dacA fragment was
      integrated into the PBP 3 gene by homologous recombination. The truncated PBP 3*
      was still active in terms of beta-lactam binding. Most PBP 3 was found in the
      growth medium, indicating that membrane anchoring of PBP 3 is provided by the C
      terminus, as has been shown for other D,D-carboxypeptidases. The mutant cells
      grew with a slower generation time than the wild type in the shape of irregular
      enlarged spheres. In addition, as revealed by electron microscopy, cell
      separation was severely affected, septa were found unevenly distributed at
      multiple sites within the cells, and the murein layer appeared variable in
      thickness.

PMID- 2228973
TI  - Molecular cloning and nucleotide sequence of the beta-lytic protease gene from
      Achromobacter lyticus.
AB  - Two bacteriolytic enzymes secreted by Achromobacter lyticus M497-1 were purified
      and identified as being very similar (considering their amino acid composition
      and N-terminal sequence) to alpha- and beta-lytic proteases from Lysobacter
      enzymogenes. A 1.8-kb EcoRI fragment containing the structural gene for beta
      lytic protease was cloned from A. lyticus chromosomal DNA. The protein sequence
      deduced from the nucleotide sequence was identical to the known sequence of beta
      lytic protease, except for six residues. The nucleotide sequence revealed that
      the mature enzyme is composed of 179 amino acid residues with an additional 195
      amino acids at the amino-terminal end of the enzyme, which includes the signal
      peptide, thus indicating that the enzyme is synthesized as a precursor protein.

PMID- 2228974
TI  - Biosynthesis of a membrane adhesion zone fraction throughout the cell cycle of
      Escherichia coli.
AB  - Synchronized cells of Escherichia coli were pulse-labeled with [3H]leucine and
      subjected to membrane fractionation to determine whether a fraction that is
      enriched for membrane-murein adhesion zones (fraction OML) was preferentially
      generated at specific times during the cell cycle, as previously suggested from
      studies of lkyD and cha mutants. Contrary to this prediction, the experiments
      showed that OML was formed continuously during the division cycle.

PMID- 2228975
TI  - Microcin H47, a chromosome-encoded microcin antibiotic of Escherichia coli.
AB  - Microcin H47 (MccH47) is a novel microcin antibiotic produced by a natural
      Escherichia coli isolate. In contrast to all the other colicins and microcins
      examined to date, which are plasmid encoded, the genes for MccH47 synthesis and
      immunity are located on the chromosome. These genetic determinants were cloned
      and shown to extend over a continuous DNA region of ca. 10 kb.

PMID- 2228976
TI  - Rhizobium meliloti chromosomal loci required for suppression of exopolysaccharide
      mutations by lipopolysaccharide.
AB  - Mutants of alfalfa symbiont Rhizobium meliloti SU47 that fail to make
      extracellular polysaccharide (exo mutants) induce the formation of nodules that
      are devoid of bacteria and consequently do not fix nitrogen. This Fix- phenotype
      can be suppressed by an R. meliloti Rm41 gene that affects lipopolysaccharide
      structure. Here we describe mutations preventing suppression that map at two new
      chromosomal loci, lpsY and lpsX, present in both strains. Two other lps mutations
      isolated previously from SU47 also prevented suppression.

PMID- 2228977
TI  - Methylated DNA in Borrelia species.
AB  - The DNA of Borrelia species was examined for the presence of methylated GATC
      sequences. The relapsing-fever Borrelia sp., B. coriaceae, and only 3 of 22
      strains of B. burgdorferi contained adenine methylation systems. B. anserina
      lacked an adenine methylation system. Fundamental differences in DNA methylation
      exist among members of the genus Borrelia.

PMID- 2228979
TI  - Regulation of expression of the ftsA cell division gene by sequences in upstream
      genes.
AB  - The essential cell division genes ftsQ and ftsA overlap by 1 bp (A. C. Robinson,
      D. J. Kenan, G. F. Hatfull, N. F. Sullivan, R. Spiegelberg, and W. D. Donachie.
      J. Bacteriol. 160:546-555, 1984; Q.-M. Yi, S. Rockenbach, J. E. Ward, and J. F.
      Lutkenhaus. J. Mol. Biol. 184:399-412, 1985). We have previously shown that ftsA
      can be expressed from a weak promoter located within the ftsQ gene (Robinson et
      al., J. Bacteriol. 160:546-555, 1984). We report here the effects on ftsA
      expression of a series of deletions within ftsQ. We find that two regions
      upstream of the promoter are important in its expression. When both are present,
      ftsA is expressed, as is also the case when both are absent. The two regulatory
      elements (O1 and O2) have 9-bp sequences, of which 8 bp are identical.

PMID- 2228978
TI  - Phenotypic suppression by aminoglycoside antibiotics of mutations blocking
      erythromycin biosynthesis in Saccharopolyspora erythraea.
AB  - The presence of a sublethal amount of apramycin, the aminoglycoside antibiotic
      used as a selectable marker in transformations of Saccharopolyspora erythraea
      with pKC505 and related plasmids, was found to suppress phenotypically the S.
      erythraea eryB25 and eryB26 mutations blocking erythromycin biosynthesis in this
      organism, probably by the effect of mistranslation.

PMID- 2228980
TI  - Panic and phobic disorders in patients with obsessive compulsive disorder.
AB  - Obsessive compulsive disorder shares numerous clinical features with other
      anxiety disorders. To study the relationship between OCD and other anxiety
      disorders, the authors administered the Structured Clinical Interview for DSM-III
      to 36 OCD patients. Thirty-nine percent (14) of patients reported a lifetime
      history of panic attacks, and 14% (5) met DSM-III-R criteria for panic disorder
      at the time of interview. Fourteen percent (5) met criteria for social phobias,
      and 19% (7) met criteria for simple phobias. Eighteen patients were treated with
      clomipramine in doses of at least 100 mg/day for 3 months. Patients with a
      history of other anxiety disorders responded significantly better to
      clomipramine.

PMID- 2228981
TI  - An epidemiologic study of Tourette's syndrome in a single school district.
AB  - To evaluate the frequency of Gilles de la Tourette's syndrome (TS) in children,
      3034 students in three schools in a single school district in greater Los Angeles
      were monitored frequently over a 2-year period by a school psychologist
      thoroughly familiar with the symptoms of the disorder. A portion of the cases
      were also evaluated in a TS clinic. A total of 14 males fulfilled the Tourette
      Syndrome Association research criteria for definite TS. When corrected for the
      number of students in special education classes in the monitored schools, the
      frequency of definite TS in males was 1 in 152. An additional 7 males who
      differed only in that they were not observed for a full year were termed definite
      TS less than 1 year. When the two groups were combined, the frequency of definite
      TS was 1 in 95 for males and 1 in 759 for females. These figures do not include
      an additional 10 males diagnosed as having definite transient tic disorder, 2
      males diagnosed as having probable TS, and 10 males diagnosed as having possible
      TS. In addition to tics, most of these children had problems with attention span,
      obsessive compulsive behavior, and learning and/or conduct disorders. Seventy
      percent of the students with definite TS or definite TS less than 1 year were in
      special education classes. Twelve percent of the children in special education
      classes had definite TS or definite TS less than 1 year, and 28% were in one of
      the diagnostic categories of definite, probable, or possible. All of the 10
      definite TS patients that were seen in the clinic had attention-deficit
      hyperactivity disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228982
TI  - Clonazepam for the treatment of social phobia.
AB  - Nine of 11 patients with social phobia of both the generalized and performance
      type responded to treatment with clonazepam in total daily doses ranging from
      0.75 to 3 mg. Only 2 of these 9 had comorbid panic disorder; the benefit for
      social phobic symptoms appears independent of clonazepam's putative efficacy for
      panic disorder.

PMID- 2228983
TI  - An efficacy study of single- versus double-seizure induction with ECT in major
      depression.
AB  - Twenty-nine patients with major depression, with and without psychosis, were
      randomly assigned to bilateral conventional electroconvulsive therapy (ECT) or
      modified multiple monitored ECT (MMECT) limited to two seizure inductions in a
      session. From pretreatment to after the fourth treatment session, modified MMECT
      was associated with more rapid amelioration of depressive symptoms on the basis
      of blindly rated Hamilton Rating Scale for Depression scores. No medical
      complications occurred. Sixty-two percent of patients in the modified MMECT group
      had posttreatment confusion, whereas 15% of patients treated with conventional
      ECT were confused. Modified MMECT appears to confer some clinical advantage over
      conventional ECT in the treatment of major depression while carrying an increased
      risk of treatment-related reversible confusion.

PMID- 2228984
TI  - Imipramine treatment of panic disorder during pregnancy.
AB  - Two women with panic disorder who continued to be symptomatic during pregnancy
      were successfully treated with low doses of imipramine. Plasma drug
      concentrations were lower than usually required for antidepressant response and
      remained relatively stable during gestation. Each woman delivered a healthy
      infant with minimal discomfort from panic symptoms during pregnancy. These cases
      are illustrative of two women who had a need of and benefited from
      pharmacotherapy for panic disorder during pregnancy.

PMID- 2228985
TI  - Selective response to carbamazepine in a case of organic mood disorder.

PMID- 2228986
TI  - Is maintenance ECT effective?

PMID- 2228988
TI  - Anxiety: the burden of illness. A symposium held at the annual meeting of the
      American Psychiatric Association. May 13-16, 1990, New York City. Proceedings.

PMID- 2228987
TI  - Acute dystonia and fluoxetine.

PMID- 2228989
TI  - Psychosocial stressors and adjustment disorder: van Gogh's life chart illustrates
      stress and disease.
AB  - The life of Vincent van Gogh is illustrative of the natural history of
      psychosocial stressors and their relationship to a person's states of health and
      disease. In the author's opinion, there is a lack of such understanding in the
      current, established criteria for psychosocial stressors in the diagnosis of
      adjustment disorder. By use of a life chart, which chronologically documents a
      person's major life events and concomitant health status over his or her life
      span, a fuller understanding can be reached regarding why an individual becomes
      ill at a particular time.

PMID- 2228990
TI  - Anxiety and adjustment disorder: a treatment approach.
AB  - Adjustment disorder with anxious mood can be difficult to differentiate from
      other anxiety disorders or personality disorders. Particular care must be taken
      to distinguish between the reasonable, expected response to psychosocial
      stressors and the inordinate response that may indicate the diagnosis of
      adjustment disorder. Once the diagnosis has been established, options for the
      management of these patients include nonpharmacologic approaches,
      pharmacotherapy, and combinations of both. The ultimate goals of treatment are to
      mobilize the patient's stress-coping mechanisms and to prevent the adjustment
      disorder from developing into another, more chronic condition, such as
      generalized anxiety disorder.

PMID- 2228991
TI  - The waking nightmare: an overview of obsessive compulsive disorder.
AB  - Symptoms of obsessive compulsive disorder (OCD) have been recognized for
      centuries. Only recently, however, has this disorder been the focus of
      significant research. OCD remains one of the least understood, least diagnosed,
      and most disabling of the anxiety disorders. Patients are imprisoned in senseless
      rituals that siphon off energy that could otherwise contribute to their
      socioeconomic functioning or personal development. OCD often begins in
      adolescence and persists in some form throughout adulthood. Recent findings shed
      light on the epidemiology of OCD and its association with other disorders, and
      point to a neurophysiologic model involving serotonin.

PMID- 2228992
TI  - The comorbidity factor: establishing the primary diagnosis in patients with mixed
      symptoms of anxiety and depression.
AB  - Accurate diagnosis is the key to effective treatment and long-term management of
      anxiety and depressive disorders. Numerous studies, however, have established a
      high incidence of depressive symptoms among patients with anxiety disorders and
      likewise a significant incidence of anxiety symptoms among patients with unipolar
      or bipolar disorders. These patients with mixed symptoms will experience a more
      severe illness, with generally poorer outcome. Careful assessment of the
      patient's predominant mood, sleep patterns, psychomotor signs, age of onset,
      family history, pattern of substance use, response to exercise, and extent of
      psychosocial contact can assist the clinician in making an accurate primary
      diagnosis.

PMID- 2228993
TI  - The hidden patient: unrecognized panic disorder.
AB  - The lifetime prevalence of panic disorder in the United States is 1.5%; nearly 3
      times that many Americans experience recurrent panic attacks. Both conditions are
      associated with diminished well-being, increased alcohol and drug abuse, suicide
      attempts, and financial dependency, at rates often exceeding those for other
      psychiatric disorders, including major depression. In spite of these considerable
      social consequences, panic disorder and panic attacks often go unrecognized.
      Because their symptoms can present as other medical disorders, including
      myocardial infarction, temporal lobe epilepsy, Cushing's disease, anemia,
      hypoglycemia, and lupus, these patients are instead often seen in emergency
      departments and cardiac and other medical clinics. General practitioners, and
      especially physicians working in emergency departments, should be alert to the
      possibility of panic disorder, especially if the patient has a first-degree
      family member suffering from panic disorder.

PMID- 2228994
TI  - Managing long-term therapy for panic disorder.
AB  - Diagnostic criteria for panic disorder have been well defined; but treatment
      modalities, less so. Combined psychotherapy and pharmacotherapy is the most
      effective treatment for these disorders. Benzodiazepines, tricyclic
      antidepressants, monoamine oxidase inhibitors, and other medications have been
      found effective in clinical studies. Alprazolam, a triazolo analog of the 1,4
      benzodiazepine class, recently was proved effective in a cross-national study
      involving approximately 1700 patients, with minimal side effects. Therapy with
      the medication is advised for at least 6 months. Medications should be tapered
      over a prolonged period, at least 8 weeks, especially where high doses are
      employed.

PMID- 2228995
TI  - Alpha- and gamma-tocopherol in plasma, red blood cells, and platelets during
      plasma exchange.
AB  - The effect of a rapid reduction of plasma lipoproteins on the alpha- and gamma
      tocopherol levels in plasma, erythrocytes, and platelets was studied. Sixteen
      successive plasma exchange procedures performed weekly in an adult with
      heterozygous familial hypercholesterolemia were evaluated. Plasma exchange was
      done by intermittent flow centrifugation, exchanging one plasma volume against a
      4% human albumin solution. Plasma exchange reduced in plasma alpha-tocopherol
      from 41.5 +/- 8.9 to 23.6 +/- 4.8 mumol/L and gamma-tocopherol from 4.9 +/- 4.1
      to 2.4 +/- 2.1 mumol/L, without changing their ratios to total lipids. It
      diminished alpha-tocopherol in platelets from 12.97 +/- 4.37 to 10.03 +/- 1.78
      mumol/10(13) cells and gamma-tocopherol from 1.43 +/- 0.55 to 1.06 +/- 0.41
      mumol/10(13) cells, but did not affect erythrocyte tocopherols. The total amount
      removed per procedure was 47.57 +/- 13.65 mumol for alpha-tocopherol and 4.70 +/-
      3.59 mumol for gamma-tocopherol. Plasma exchange increased the number of
      erythrocytes from 3.67 +/- 0.10.10(12) to 4.05 +/- 0.13.10(12) cells/L, without
      affecting their volume. Platelet count did not change, but mean platelet volume
      decreased from 7.7 +/- 0.5 to 6.9 +/- 0.5 fl and platelet distribution width from
      15.1 +/- 0.4 to 14.9 +/- 0.5. Thus, plasma exchange reduces plasma alpha- and
      gamma-tocopherol to the same extent as total lipids, and decreases these
      tocopherols in circulating platelets, along with a reduction in platelet size
      and, compared to the change in erythrocyte count, a fall of platelet
      number.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2228996
TI  - Modified method of exchange transfusion in sickle cell disease.
AB  - The treatment of various complications of sickle cell disease has included red
      cell exchange in the past, and the development of automated pheresis equipment
      has greatly simplified such exchanges. Traditionally, the patient's red cells
      have been exchanged while their plasma was returned to them. Recently, plasma
      factors have been thought to play a role in the pathogenesis of vasoocclusive
      events. Therefore, we performed whole blood exchange, which consisted of
      replacement of the patient's plasma with albumin and saline in addition to the
      usual replacement of erythrocytes. A total of 32 whole blood exchanges were
      performed on 12 patients with a variety of complications of their disease. The
      procedure was done using standard pheresis equipment and was relatively simple to
      perform. There were no serious complications and the clinical outcome was good
      with 10 out of 12 patients experiencing improvement.

PMID- 2228997
TI  - Thrombotic complications of subclavian apheresis catheters in cancer patients:
      prevention with heparin infusion.
AB  - Twenty-two silicone rubber apheresis catheters were placed into the subclavian
      veins of 18 cancer patients to allow serial leukapheresis for collection of
      circulating hematopoietic stem cells. The tips of the catheters were placed in
      the innominate vein to avoid reinfusion of citrate into the right atrium and the
      resulting tendency to cardiac arrhythmias. Sixteen catheters were placed without
      prophylactic anticoagulation. Anticoagulation was prematurely discontinued in one
      patient because of the inconvenience of the portable heparin infusion pump. Six
      of these 17 catheters developed venographically proven thrombotic complications
      and five others had presumed thrombosis-related access failure or caused symptoms
      of venous obstruction, but confirmation of the presence of a thrombus with
      venography was not obtained. Three catheters spontaneously withdrew from the
      vein, one during urokinase infusion for thrombosis. Only three catheters had
      uncomplicated apheresis courses. Prophylactic heparin infusions via portable
      infusion pumps were given after placement of six catheters. As long as the
      heparin infusions were continued all patients had uncomplicated apheresis
      courses. One patient's heparin was prematurely discontinued. Within 3 days of its
      discontinuance, radiographically proven thrombotic catheter occlusion occurred.
      Patients given heparin were less likely to develop complications (P less than
      0.001). No unexpected complications of apheresis were encountered as a result of
      the use of these catheters. Silicone rubber subclavian catheters can be used for
      peripheral stem cell collection but have a high frequency of thrombotic
      complications. Systemic anticoagulation with heparin can minimize the likelihood
      of these complications.

PMID- 2228998
TI  - Plasma exchange in endocrine ophthalmopathy.
AB  - We studied the effects of intensive plasma exchange on endocrine ophthalmopathy
      in 12 patients with Graves' disease and one with Hashimoto's thyroiditis. All
      patients were euthyroid at the time of plasma exchange. All but five had
      concomitant treatment with azathioprine. Each patient had a treatment period
      consisting of six plasma exchanges performed in 2-3 weeks; two patients were
      treated in two periods. Each time a mean of 2.4 liters plasma was exchanged.
      There was a prompt reduction in the concentration of circulating immune complexes
      and/or thyrotropin receptor antibodies following plasma exchange. Six of the 13
      patients improved their proptosis; their median duration of eye symptoms before
      treatment was less than 8 months. In patients suffering from eye symptoms for
      more than 1 year improvement was rare. Overall the Hertel values were 24.1 +/-
      4.4 (SD) before and 22.8 +/- 3.4 after plasma exchange for the left eyes (P =
      0.07) and 23.8 +/- 4.0 before and 23.0 +/- 3.8 after for the right eyes (P =
      0.09). Nine patients altogether improved their ophthalmopathy index and
      periorbital oedema. In patients with disabling endocrine ophthalmopathy plasma
      exchange may sometimes be of value to induce a relief of the ophthalmopathy; when
      it is used it should be instituted before fibrotic changes occur. We suggest that
      concomitant immunosuppressive drugs should be given to prevent rebound phenomenon
      induced by plasma exchange. To establish the role of plasma exchange in the
      treatment of endocrine ophthalmopathy controlled studies should be performed.

PMID- 2228999
TI  - Clinical studies on adequate dosage of heparin during immunoadsorption with
      membrane plasmapheresis.
AB  - Heparin has been used as an anticoagulant during hemodialysis and plasmapheresis.
      Recently, immunoadsorption with membrane plasmapheresis (IAP) has been used for
      treatment of myasthenia gravis and multiple sclerosis. Ten patients were
      examined. Plasma heparin levels were studied before IAP, 30 minutes, 60 minutes,
      90 minutes, and 120 minutes after the start of IAP, and at the end of IAP.
      Prothrombin time, activated partial thromboplastin time (APTT), bleeding time,
      plasma fibrinogen levels, fibrin degradation products, and complete blood count
      were measured pre- and post-IAP. In general, plasma heparin levels lower than 1
      IU/ml during plasmapheresis are adequate. The dosage of 40 IU/kg/hr of heparin
      administered during IAP resulted in plasma heparin levels lower than 1 IU/ml.
      APTT pre-IAP (36.8 +/- 3.4 sec) were nearly one-half values of APTT post-IAP (6.2
      +/- 9.70 sec). In conclusion, 40 IU per kg of the body weight per hour is an
      acceptable dose of heparin during IAP.

PMID- 2229000
TI  - Computerization of plateletpheresis quality control records with a commercially
      available spreadsheet program.
AB  - Many apheresis units lack the resources to acquire customized computer software
      for record keeping. We have adapted a commercially available "spreadsheet"
      program (Lotus 1-2-3) to aid in quality control activities for plateletpheresis.
      Data are entered in a grid pattern wherein each donation occupies one row and
      successive columns contain numerical data derived from the donation. The last two
      columns contain formulas that calculate yield and collection efficiency from
      values entered in preceding columns. The program runs on an IBM PC or equivalent
      with 512 K RAM; the combined cost of a computer and software is currently under
      $2,000.00. Data entry requires fewer keystrokes per record than computation of
      yield and efficiency with a calculator, and creates an inclusive permanent record
      for future analysis. Data sorting and statistical functions allow rapid
      identification of incomplete records, and derivation of average platelet yield
      and/or collection efficiency for any time period of interest. The program also
      facilitates determining the proportion of donations that fall below any chosen
      cutoff. Performance characteristics of a particular instrument or operator can be
      assessed easily by isolating the pertinent records and analyzing them separately.
      The system will thus accomplish a variety of quality control activities,
      including those mandated by licensing agencies. It can be implemented by
      apheresis personnel with limited "computer literacy" and is superior to manual
      tabulation of quality control data in both ease of data entry and facility of
      analysis.

PMID- 2229001
TI  - Therapeutic plasmapheresis and protein A immunoadsorption in malignancy: a brief
      review.
AB  - Plasmapheresis is being used with considerable frequency in the management of
      malignant and non-malignant disorders. More recently, staphylococcal Protein A
      immunoadsorption has been employed in similar clinical situations. In patients
      with malignancy, plasmapheresis has been shown to produce alterations in plasma
      proteins, decrease circulating immune complexes, remove "specific" and "non
      specific" blocking factors, change immune reactivity, and affect monocyte
      function. Partial responses have been reported in a small number of patients with
      carcinoma of lung, colon, and breast following plasmapheresis. In addition, there
      are reports of favorable responses in patients with melanoma, head and neck
      tumors, lymphomas, leukemias, and Kaposi's sarcoma in acquired immune deficiency.
      All these responses were partial and brief, and the treatment did not alter the
      course of the disease. Plasmapheresis has been useful in the management of
      hyperviscosity and occasionally of paraneoplastic syndromes. It may also have a
      role in the treatment of thrombotic thrombocytopenic purpura associated with
      mitomycin-C therapy. Protein A immunoadsorption, by which circulating immune
      complexes are selectively removed, can activate the complement system, increase
      blastogenic responses, and increase the natural killer cell activity. It has been
      shown to produce partial responses in breast and colon cancer, as well as
      Kaposi's sarcoma in acquired immune deficiency. It may have a useful role to play
      in the management of mitomycin-C-associated thrombotic thrombocytopenic purpura.
      Both plasmapheresis and Protein A immunoadsorption should be considered
      investigational interventions at this time. Toxicity of plasmapheresis, though
      uncommon, can be serious and may rarely be fatal. Toxicity of Protein A
      immunoadsorption is mild, consisting mainly of influenza-like symptoms and rash.

PMID- 2229002
TI  - The cAMP-dependent protein kinase in sea urchin sperm tails: association of the
      enzyme with the flagellar axonemes.
AB  - When sea urchin spermatozoa were treated with a Triton X-100 solution, cAMP
      dependent protein kinase (cA-kinase) activity was extracted. Further extraction
      with Triton X-100 of axonemes isolated from the Triton-extracted sperm again
      released a considerable amount of the cA-kinase activity. The activity which
      remained after extraction three times with Triton X-100 was released by treatment
      with a low salt solution. These activities found in the various extracts were
      likely to be due to the same cA-kinase, which was a mammalian type II-like
      enzyme. The cA-kinase activity that remained in the axonemes after the first
      Triton X-100 extraction may be involved in the regulation of flagellar movement
      in the Triton-extracted sperm.

PMID- 2229003
TI  - Steroid transhydrogenase activity of 3-ketosteroid-delta 1-dehydrogenase from
      Nocardia corallina.
AB  - 3-Ketosteroid-delta 1-dehydrogenase from Nocardia corallina catalyzes
      transhydrogenation of 3-keto-4-ene-steroid to 3-keto-1,4-diene-steroid e.g.,
      progesterone to 1,4-androstadiene-3,17-dione. The reaction proceeded linearly at
      first and then soon slowed down owing to equilibration. The turnover number of
      this reaction was of the same magnitude as that of the dehydrogenation of 3-keto
      4-ene-steroid. The pH optimum was 8.4, which is lower than that of the
      dehydrogenase reaction. The enzyme has a wide specificity for hydrogen acceptor
      steroids. The Km' and Kmax' values for these steroids and the values of the
      corresponding 3-keto-4-ene-steroids were compared. Kinetic studies of the steroid
      transhydrogenase reaction demonstrated a typical ping-pong mechanism. The enzyme
      oxidized 1,2-tritiated progesterone and transferred the tritium atoms to the
      reaction product, 4-androstene-3,17-dione, and water. Transhydrogenation in D2O
      resulted in the incorporation of a deuterium atom into the C2-position of 4
      androstene-3,17-dione. The results indicate that the enzyme catalyzes C1, C2
      trans axial abstraction of hydrogen atoms from progesterone, transfer of the 1
      alpha-hydrogen to the C1-position of 1,4-androstadiene-3, 17-dione and release of
      the 2 beta-hydrogen to water. Reaction schemes based on the experimental results
      are proposed. The enzyme also catalyzes the reduction of 3-keto-1,4-diene
      steroids with reduced benzyl viologen.

PMID- 2229004
TI  - Complete amino acid sequence of rat kidney ornithine aminotransferase: identity
      with liver ornithine aminotransferase.
AB  - The complete amino acid sequence of rat kidney ornithine aminotransferase [EC
      2.6.1.13] is presented. The 404-residue sequence was determined by analysis of
      peptides generated by digestion of the S-carboxyamidomethylated protein with
      CNBr, Achromobacter protease I, arginylendopeptidase, or Staphylococcus aureus V8
      protease. Mueckler and Pitot have reported the amino acid sequence of the rat
      liver enzyme (440 residues) as predicted from the nucleotide sequence of the cDNA
      [Mueckler, M.M. & Pitot, H.C. (1985) J. Biol. Chem. 260, 12993-12997]. The amino
      acid sequence of the rat kidney enzyme presented herein coincides with residue 36
      (Gly) through 440 (Phe) of the predicted precursor protein, indicating that the
      liver and kidney enzymes are identical, and that the enzyme is processed at the
      amino-terminal region after translation.

PMID- 2229005
TI  - Amino acid sequence of a lectin from Japanese frog (Rana japonica) eggs.
AB  - The complete amino acid sequence and the location of disulfide bonds of a lectin
      from Japanese frog (Rana japonica) eggs, which specifically agglutinates
      transformed cells, are presented. The sequence was determined by analysis of
      peptides generated by digestion of the S-carboxyamidomethylated protein with
      Achromobacter protease I, or chymotrypsin, and by chemical cleavage with BNPS
      skatole or cyanogen bromide. The lectin is a single-chain protein consisting of
      111 residues, with a pyroglutamyl residue at the amino terminus. Four disulfide
      bonds link half-cystinyl residue 19 to 72, 34 to 82, 52 to 97, and 94 to 111. The
      sequence and the location of the disulfide bonds are highly homologous to those
      of bull frog (Rana catesbeiana) egg S-lectin. They are also homologous to human
      angiogenin, a tumor angiogenesis factor, and a family of pancreatic
      ribonucleases.

PMID- 2229006
TI  - Kinetics of the hydrolysis of mixed micelles of dipalmitoyllecithin with triton X
      100 catalyzed by a phospholipase A2 from the venom of Agkistrodon halys
      blomhoffii.
AB  - The pH dependence of kinetic parameters for the hydrolysis of mixed micelles of
      1,2-dipalmitoyl-sn-glycero-3-phosphorylcholine (diC16PC) with Triton X-100,
      catalyzed by the intact and the N-terminal alpha-NH2-modified phospholipases A2
      (PLA2s) of Agkistrodon halys blomhoffii, was studied at 25 degrees C and ionic
      strength 0.1 in the presence of saturating amounts of Ca2+. The pH dependence of
      the kinetic parameters for the hydrolysis of monodispersed diC6PC, catalyzed by
      the modified enzyme, was also studied under the same conditions, and the data
      were compared with the previous results for the intact enzyme [Teshima, K. et al.
      (1986) J. Biochem. 100, 1655-1662]. The pK values of the catalytic group, His 48,
      and Tyr 52 were found to shift from 5.55 to 7.00 and from 10.50 to 11.50,
      respectively, on binding of the micellar substrates to the enzyme. On the other
      hand, no participation of these ionizable groups was observed for the binding of
      the monodispersed substrate. On the basis of the present finding and the X-ray
      crystallographic studies on bovine pancreatic PLA2 [Dijkstra, B.W. et. al. (1981)
      J. Mol. Biol. 147, 97-123] and on a PLA2 of Crotalus atrox venom [Brunie, S. et
      al. (1985) J. Biol. Chem. 260, 9742-9749], the hydrogen-bonding of Tyr 73, which
      is involved in the lipid-water interface recognition site, to His 48 and Tyr 52
      in the active center was strongly suggested to be important for the hydrolysis of
      micellar substrates.

PMID- 2229007
TI  - Induction in mouse peritoneal macrophages of 34 kDa stress protein and heme
      oxygenase by sulfhydryl-reactive agents.
AB  - The synthesis of 34-kDa stress protein was enhanced, with a simultaneous increase
      in heme oxygenase activity, when mouse macrophages were exposed to diethylmaleate
      or sodium arsenite. After 7 h of exposure to the sulfhydryl agents, the 34-kDa
      protein was the most actively synthesized protein. Immunoblot analysis showed
      that the induced 34-kDa protein reacted with an antibody raised against bovine
      heme oxygenase. Cadmium ions or 1-chloro-2,4-dinitrobenzene also induced the 34
      kDa protein which reacted with the antibody. Treatments of the cells with
      buthionine sulfoximine or hydrogen peroxide weakly induced the protein, while
      diamide treatment or heat shock was without effect. These results are consistent
      with our previous findings that heavy metal ions including arsenite and cadmium
      ions induce heme oxygenase (32-kDa stress protein) in human cell lines [Taketani,
      S., Kohno, H., Yoshinaga, T., & Tokunaga, R. (1989) FEBS Lett. 245, 173-176], and
      also suggest that the formation of glutathione conjugate with sulfhydryl-reactive
      agents may mediate the induction of the stress protein in mouse peritoneal
      macrophages.

PMID- 2229008
TI  - Purification and characterization of rat pulmonary cytochrome P-450.
AB  - The pulmonary cytochrome P-450, P450 L-2, was purified 460-fold from pulmonary
      microsomes of untreated male rats. Its specific content was 10.6 nmol/mg of
      protein. The monomeric molecular weight was 54,000 on SDS-polyacrylamide gel
      electrophoresis. The CO-reduced absorption maximum of P450 L-2 was at 451 nm, and
      the oxidized heme iron appeared to be in the low-spin state, as deduced from the
      Soret maximum at 421 nm. P450 L-2 had high lauric acid omega- and (omega-1)
      hydroxylation activities, but low prostaglandin A1 omega- and (omega-1)
      hydroxylation activities. It catalyzed the O-dealkylation of 7-ethoxycoumarin,
      but was not efficient in the hydroxylation of testosterone or the N-demethylation
      of aminopyrine. The NH2-terminal amino acid sequence of P450 L-2 was V-L-N-F-L-X
      P-X-L (X being an unidentified residue). The catalytic properties of P450 L-2
      resembled those of P450 K-5, the major rat renal cytochrome P-450. However, anti
      P450 K-5 antibody did not cross-react with P450 L-2, and these forms had
      different NH2-terminal sequences. To judge from the results of NH2-terminal
      sequence analysis, P450 L-2 seems to be placed in the IVB gene family. Also, P
      450 IIB1 was detected by immunoblotting in one of the peaks on ion-exchange HPLC
      during the purification of P450 L-2, suggesting the presence of P-450 IIB1 in rat
      pulmonary microsomes.

PMID- 2229009
TI  - Sexual response of Saccharomyces cerevisiae: phosphorylation of yeast glyoxalase
      I by a cell extract of mating factor-treated cells.
AB  - The phosphorylation of glyoxalase I was observed when the phosphatase-treated
      enzyme was incubated in the presence of [gamma-32P]ATP and a cell extract
      prepared from alpha-type yeast cells which had been treated with the culture
      supernatant of a-type yeast cells. The phosphorylated protein was identified as
      glyoxalase I by using anti-glyoxalase I rabbit immunoglobulin G.

PMID- 2229010
TI  - Inhibitory effect of pseudo-aminosugars on oligosaccharide glucosidases I and II
      and on lysosomal alpha-glucosidase from rat liver.
AB  - We examined the inhibitory effect of three pseudo-aminosugars (validamine,
      valienamine, and valiolamine), which were isolated from the broth of Streptomyces
      hygroscopicus, on the oligosaccharide-processing glucosidases I and II involved
      in glycoprotein biosynthesis in rat liver. Both glucosidases I and II were
      inhibited to the same extent by the pseudoaminosugars, and valiolamine had a more
      potent inhibitory activity than validamine or valienamine. A 50% inhibition of
      valiolamine was observed at 12 microM for glucosidase I and glucosidase II
      activities acting respectively on the substrates Glc3Man9GlcNAc2 and p
      nitrophenyl alpha-D-glucopyranoside. Further, in order to investigate further the
      ability of valiolamine to inhibit glucosidase I, reaction products were analyzed
      by gel filtration on a Bio-Gel P-4 column. We also compared the inhibitory action
      of these pseudo-aminosugars on the acid alpha-glucosidase of rat liver lysosomes.
      They competitively inhibited the hydrolysis of both substrates, maltose and
      glycogen. Valiolamine again had a more potent lysosomal alpha-glucosidase
      inhibitory activity than the other two. The Ki values of valiolamine for the
      hydrolysis of maltose and glycogen were 8.1 and 11 microM, respectively.
      Valiolamine is a particularly effective inhibitor of oligosaccharide glucosidases
      I and II and of lysosomal alpha-glucosidase. Hence valiolamine might be useful as
      a research tool in investigations of carbohydrate metabolism.

PMID- 2229012
TI  - Tissue specificity of tropomyosin from the crayfish, Cambarus clarki.
AB  - The molecular heterogeneity and tissue specificity of crustacean tropomyosin were
      investigated, using muscle and nonmuscle tissues from the crayfish, Cambarus
      clarki. In muscle, three types of tropomyosin isoforms were found on two
      dimensional gel electrophoresis. One of them was specific to cardiac muscle, and
      the other two were shared by skeletal and visceral muscles. In nonmuscle tissues,
      four types of isoforms were found on two-dimensional gel electrophoresis and in
      immunoreplica tests using an antiserum against crayfish skeletal muscle
      tropomyosin. Two of them were common to the muscle isoforms, but the other two
      were not detected in muscles. Furthermore, nonmuscle tissues contained several
      peculiar isoforms, the electrophoretic mobilities of which were considerably
      higher than those of the other isoforms mentioned above. When tropomyosin was
      purified from the mid-gut gland, these isoforms with high mobilities were found
      in the crude tropomyosin preparation. These results showed that the crayfish
      tropomyosin was heterogeneous and that the isoforms were distributed in a tissue
      specific manner, like vertebrate tropomyosin. However, the results did not
      coincide with those of our previous study on horseshoe crab tropomyosin, which
      showed molecular heterogeneity but no tissue specificity. In view of the
      difference in the isoform distributions between the two major groups (Crustacea
      and Merostomata) of Arthropoda, the significance of the tissue specificity of
      tropomyosin isoforms was discussed.

PMID- 2229011
TI  - Structure of an allergenic pentasaccharitol, Gp-1 beta-b6, isolated from a sea
      squirt antigen, Gi-rep, as a minimum structural unit responsible for its
      allergenicity.
AB  - An allergenic pentasaccharitol, Gp-1 beta-b6, was isolated as a minimum
      structural unit responsible for the allergic reaction in skin of patients with
      sea squirt allergy from a saccharitol fraction, Gp-1 beta-b, that had been
      liberated by beta-elimination from a glycopeptide in a Pronase digest of a sea
      squirt antigen, Gi-rep. Methylation/GC-MS and FAB-MS analyses indicated the sugar
      sequence of Gp-1 beta-b6 to be GalNAcl----2Fucl----(GalNAc1----) 3,4GlcNAc1---
      3GalNAc-ol. To analyze the structure in more detail, Gp-1 beta-b6 was labeled
      with p-aminobenzoic acid ethyl ester (ABEE), i.e., the reducing terminal 3-O
      substituted GalNAc-ol of the saccharitol was oxidized to 2-O-substituted L-ThrNAc
      with equimolar periodate, and the resultant aldehyde was labeled with ABEE by
      reductive amination. The ABEE-labeled Gp-1 beta-b6 was subjected to sequential
      exoglycosidase digestion with beta-N-acetylhexosaminidase, alpha-N
      acetylgalactosaminidase, and alpha-fucosidase, and the digests were
      chromatographed on an HPLC column of TSK gel Amide 80. From the results of the
      HPLC, methylation/GC-MS, and FAB-MS analyses of the digests of the labeled
      substrate, the structure of Gp-1 beta-b6 was determined to be GalNAc alpha 1---
      2Fuc alpha 1----3(GalNAc beta 1----4)GlcNAc beta 1----3GalNAc-ol. Enzymatic
      elimination of either the non-reducing terminal beta-GalNAc or the non-reducing
      terminal alpha-GalNAc led to inactivation of the allergenic pentasaccharitol.
      Accordingly, it is possible that the allergenic saccharitol contains two
      disaccharide units as the allergy-specific epitopes, one GalNAc alpha 1----2Fuc
      alpha 1---- and the other GlcNAc beta 1----4GLcNAc beta 1----.

PMID- 2229013
TI  - Characterization of the Fc receptor for IgG2 on guinea pig polymorphonuclear
      leukocytes by the use of a monoclonal antibody.
AB  - Guinea pig polymorphonuclear leukocytes (PMNs) possess two distinct types of Fc
      gamma receptor (Fc gamma R): Fc gamma 1/gamma 2R for both IgG1 and IgG2, and Fc
      gamma 2R for IgG2 alone. The Fc gamma 2R was previously shown to differ
      antigenically from homologous macrophage (M phi) Fc gamma 2R by the use of a
      monoclonal antibody to M phi Fc gamma 2R (VIIAI IgG1), though the Fc gamma
      1/gamma 2R cross-reacts with a monoclonal antibody to homologous M phi Fc gamma
      1/gamma 2R (VIA2 IgG1). Recently, we obtained a monoclonal antibody (MP-2)
      secreted by a hybridoma prepared by fusion of the splenic cells of mice immunized
      with guinea pig PMNs with a myeloma cell line. This antibody completely inhibited
      both the Fc gamma 2R-mediated rosette formation of PMNs with IgG2 antibody
      sensitized sheep erythrocytes and the Fc gamma 2R-mediated binding of ovalbumin
      (OA)-complexed IgG2 antibody to PMNs. When the antigen of MP-2 was isolated by
      affinity chromatography with the antibody-Sepharose, it gave a single band with a
      molecular weight of 120,000 on SDS-PAGE. The number of antigen molecules per PMN
      was estimated to be 9 X 10(4) by measuring the binding of 125I-MP-2 Fab. This
      value was essentially the same as that obtained by measuring the binding of OA
      complexed IgG2 antibody to the PMNs treated with the Fab' of VIA2 IgG1. These
      results strongly suggest that MP-2 is a monoclonal antibody to PMN Fc gamma 2R.

PMID- 2229014
TI  - Amino acid sequence at the reactive site of rabbit alpha-1-antiproteinases.
AB  - Rabbit alpha-1-antiproteinases S and F were treated with trypsin, chymotrypsin,
      Staphylococcus aureus protease V8, and thermolysin, and the liberated peptides
      encompassing the reactive region of the respective inhibitors were separated and
      sequenced. The reactive center of the F form was methionine, and the residues
      from P3 to P'1 (Ile-Pro-Met-Ser) were the same as those of human alpha-1
      antiproteinase. The S form, on the other hand, was found to be a mixture of two
      distinct proteins (S-1 and S-2), and their reactive centers (P1-P'1) were Ser-Ser
      and Tyr-Ser, respectively. Seven out of 17 amino acids in the F form and 7 out of
      16 in the S-1 form were the same as the corresponding residues of human alpha-1
      antiproteinase, while 5 of 10 residues in the S-2 form were the same as those of
      the human inhibitor. Ten out of 16 residues were the same between the F and the S
      1 forms, whereas the sequence P1 to P'3 of the S-2 form (Tyr-Ser-Met-Pro) was the
      same as the corresponding residues of mouse alpha-1-antiproteinase.

PMID- 2229015
TI  - Kinetics of hydroperoxide degradation by NADP-glutathione system in mitochondria.
AB  - Hydroperoxide decomposition by the NADP-glutathione system in rat liver
      mitochondria was analyzed. Mitochondria were found to contain high concentrations
      of the reduced form of glutathione (GSH) (4.32 +/- 0.50 nmol/mg) and NADPH (4.74
      +/- 0.64 nmol/mg), and high activities of glutathione peroxidase and reductase.
      In the initial phase of the reaction, the rate of hydroperoxide decomposition was
      proportional to both the GSH level and the activity of GSH peroxidase. However,
      in the later steady state, the step of NADP reduction was rate-limiting, and the
      overall reaction rate was independent of the initial concentration of GSH, and
      activities of glutathione peroxidase and reductase. Some GSH was released from
      mitochondria during incubation, but the rate of the decomposition could be simply
      expressed as kappa [GSH]/2, where kappa is the first-order rate constant of the
      peroxidase and [GSH] is the intramitochondrial level of GSH in the steady state.
      The rate of the reaction in the steady state was also dependent on the NADPH
      level, its reciprocal being linearly correlated with [NADPH]-1. The rate of
      decomposition of hydroperoxide was influenced by the respiratory state. During
      state 3 respiration, the rate was greatly depressed, but was still considered to
      exceed by far the rate of physiological generation of hydroperoxide.

PMID- 2229016
TI  - High-performance liquid chromatography-mass spectrometry of glycosphingolipids:
      II. Application to neutral glycolipids and monosialogangliosides.
AB  - We previously reported a method of high-performance liquid chromatography-fast
      atom bombardment mass spectrometry (HPLC/FAB/MS) for the structural
      characterization of molecular species of GlcCer and IV3 beta Gal-Gb4Cer [M.
      Suzuki et al. (1989) J. Biochem. 105, 829-833]. In this paper, we report a
      modification of this HPLC/FAB/MS method, which was used for the separation and
      characterization of neutral glycosphingolipids (GlcCer, LacCer, Gb3Cer, Gb4Cer,
      and IV3 alpha GalNAc-Gb4Cer) and monosialogangliosides [GM3(NeuAc or NeuGc), GM2
      (NeuAc or NeuGc), and GM1 (NeuAc or NeuGc)]. Mixtures of the purified neutral
      glycolipids and monosialogangliosides were subjected to HPLC on a silica gel
      column, with programmed elution with isopropanol-n-hexane-water, with or without
      ammonium hydroxide. In order to obtain mass spectra and mass chromatograms of
      individual components, effluent from the HPLC column was mixed with a methanol
      solution of triethanolamine, which was used as the matrix for the FAB ionization,
      and one-thirtieth of the effluent mixture was introduced into a mass spectrometer
      through a frit interface. A mixture of the five neutral glycolipids, 5 micrograms
      of each, gave five peaks on a mass chromatogram obtained by monitoring of the
      corresponding major pseudo-molecular ions. A mixture of the six
      monosialogangliosides, 5 micrograms of each, gave six peaks on a mass
      chromatogram obtained by monitoring of the major pseudo-molecular ions,
      indicating that GM3, GM2, and GM1 were clearly separated, and that separation due
      to differences in sialic acid species was also achieved. In the mass spectra of
      the neutral glycolipids and monosialogangliosides, pseudo-molecular ions and
      fragment ions due to the elimination of sugar moieties were clearly
      detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229017
TI  - Primary structure of human plasma glutathione peroxidase deduced from cDNA
      sequences.
AB  - Human plasma glutathione peroxidase (GSHPx) has been shown to be a selenium
      containing enzyme immunologically distinct from cellular GSHPx. Oligonucleotide
      probes, based on the partial amino acid sequence of plasma GSHPx, were
      synthesized and used to screen a human placenta cDNA library. Nucleotide sequence
      analysis of the obtained clones revealed that GSHPx consisted of a 678-base pair
      open reading frame coding for a 226-amino acid polypeptide with a Mr of 25,389.
      About 50% of the deduced amino acid sequence was confirmed by partial amino acid
      sequencing of the peptides in a lysine endopeptidase-digest of the purified
      enzyme. The amino acid sequence exhibited only 44% homology with that of human
      cellular GSHPx. Northern blot analysis revealed a single transcript of 2.2
      kilobases in the poly(A)+ RNA fractions of human placenta and HepG2 (a human
      hepatic cell line), but not that of human liver and endothelial cells.

PMID- 2229018
TI  - Human aldolase A of a hemolytic anemia patient with Asp-128----Gly substitution:
      characteristics of an enzyme generated in E. coli transfected with the expression
      plasmid pHAAD128G.
AB  - Aldolase A derived from a hemolytic anemia patient with aldolase A deficiency was
      shown to have an amino acid substitution of glycine for aspartic acid at the
      128th position (Asp-128) in the enzyme [Kishi et al. (1987) Proc. Natl. Acad.
      Sci. U.S.A. 84, 8623-8627]. We constructed an Escherichia coli expression
      plasmid, pHAAD128G, which carries the mutant aldolase A [aldolase A(D-G)] cDNA,
      and the enzyme generated in E. coli transfected with the expression plasmid was
      purified and characterized. Conversion of Asp to Gly at the 128th position in the
      enzyme rendered the enzyme thermolabile and susceptible to tryptic digestion. CD
      spectra analysis also revealed that the mutant enzyme had a remarkable
      conformation change with a decrease of regular form in the molecule. Addition of
      glycerol or some other polyalcohols during thermal treatment protected this
      altered enzyme (but not the normal enzyme) against denaturation and activity
      decrease. In order to determine the function of the amino acid residue at the
      128th position, two artificial mutant enzymes with the substitutions of Glu for
      Asp [aldolase A(D-E)] and Ser for Asp [aldolase A(D-S)], respectively, at the
      position were constructed by site-directed mutagenesis and characterized. These
      analyses demonstrated the necessity for Asp to be present at the 128th residue in
      order for this enzyme to be thermally stable.

PMID- 2229019
TI  - Three-dimensional structure of an alpha-amylase inhibitor HAIM as determined by
      nuclear magnetic resonance methods.
AB  - The three-dimensional structure of an alpha-amylase inhibitor, HAIM, composed of
      78 amino acids, was analyzed by two-dimensional NMR techniques. Sequence-specific
      assignments were made for the amino acid residues from Ile-6 to Cys-72. Distance
      geometry analysis of the interresidue NOEs revealed that the HAIM molecule
      consists of two beta-sheets, as is the case in a homologous alpha-amylase
      inhibitor, Tendamistat, though one of its beta-strands is much shorter than that
      of Tendamistat. The combination of molecular modeling from Tendamistat and
      distance geometry analysis was confirmed to be useful for our purpose.

PMID- 2229020
TI  - Characterization of cyanide-resistant respiration and appearance of a 36 kDa
      protein in mitochondria isolated from antimycin A-treated Hansenula anomala.
AB  - Mitochondria exhibiting cyanide-resistant respiration were isolated from
      Hansenula anomala which had been incubated in the presence of antimycin A to
      induce cyanide-resistant respiration. The cyanide-resistant respiration in
      isolated mitochondria was not inhibited by antimycin A or myxothiazol, suggesting
      that the branching of the pathway from the normal cyanide-sensitive pathway takes
      place at the coenzyme Q level. Analysis of mitochondrial proteins by sodium
      dodecyl sulfate gel electrophoresis indicated that a 36 kDa protein was induced
      by antimycin A treatment of the yeast. It is suggested that this protein is a
      component of the cyanide-resistant respiratory pathway.

PMID- 2229021
TI  - Gangliosides from the eggs of the sea urchin, Anthocidaris crassispina.
AB  - NeuGc alpha 2-6Glc beta 1-1Cer (M5 ganglioside) and HSO3-8NeuGc alpha 2-6Glc beta
      1-1Cer (T1 ganglioside) were purified by column chromatographies with DEAE
      Sephadex A-25 and silicic acid from the eggs of the sea urchin, Anthocidaris
      crassispina. Their chemical structures were determined by gas-liquid
      chromatography, methylation analysis, enzymatic hydrolysis, negative-ion fast
      atom bombardment mass spectrometry, and proton nuclear magnetic resonance
      spectroscopy. Long-chain base compositions of both gangliosides were almost
      identical: all the long-chain bases were phytosphingosines, and C18
      phytosphingosine accounted for more than 95% of them. Fatty acid compositions
      were also very similar: the main fatty acids were 22:1, 23:1, 24:1, and their 2
      hydroxylated forms, and the 2-hydroxy fatty acids amounted to 65.3 and 74.3% of
      the fatty acids in M5 and T1 gangliosides, respectively. Proton nuclear magnetic
      resonance spectroscopic study revealed a downfield-shifted H8 proton signal of
      NeuGc residue in T1 ganglioside, in agreement with the presence of sulfate ester
      at the C8 position.

PMID- 2229022
TI  - Characterization of gene organization and generation of heterogeneous mRNA
      species of rat ISK protein.
AB  - The ISK protein is a novel, probably epithelial potassium channel which differs
      from conventional potassium channels in its structure, electrophysiology, and
      tissue distribution. In this investigation, we isolated and analyzed genomic and
      cDNA clones coding for the rat ISK protein to characterize the structural
      organization and expression pattern of the ISK protein gene. This analysis,
      together with primer extension and RNase protection experiments, indicated that
      the ISK protein mRNA is initiated from two different upstream exons and then
      encoded by an uninterrupted downstream exon covering the protein-coding and the
      3'-untranslated regions of the mRNA. RNA blot hybridization analysis showed
      additional generation of several large species of mRNAs which result from
      inclusion of a part of the intron sequence and the 3'-flanking region of the ISK
      protein gene. Thus, the single ISK protein gene is involved in the production of
      multiple species of mRNAs through a variety of cellular mechanisms including
      transcription initiation at different sites, alternative RNA splicing, and
      polyadenylation at different sites. The heterogeneity of the ISK protein mRNAs
      may be associated with the emergence of the functional and regulatory diversity
      observed for potassium ion permeation in epithelial cells.

PMID- 2229023
TI  - Presequence does not prevent folding of a purified mitochondrial precursor
      protein and is essential for association with a reticulocyte cytosolic factor(s).
AB  - Ornithine carbamoyltransferase (OTC; subunit, 36,000 Da) [EC 2.1.3.3] is
      initially synthesized as a precursor (pOTC) with a transient NH2-terminal
      presequence of 32 amino acid residues, then is imported posttranslationally nto
      the mitochondrial matrix. We expressed rat pOTC in Escherichia coli, purified it
      in a denatured form, and showed that could be transported into isolated
      mitochondria in the presence of rabbit reticulocyte lysate [Murakami et al.
      (1988) J. Biol. Chem. 263, 18437-18442]. In order to compare the properties of
      the precursor and mature form of OTC, the rat mature OTC was synthesized in E.
      coli and purified. The recombinant OTC represented about 5% of the total
      bacterial protein and was present in both the supernatant and precipitate of the
      disrupted bacteria. The OTC, extracted from the precipitate with 8 M urea or 6 M
      guanidine.HCl, was essentially homogeneous, as judged by SDS-PAGE. When
      guanidine.HCl-denatured mature OTC was diluted and incubated at 0 degrees C for
      40-60 h, it was reactivated to a specific activity of 170 mumol/min/mg protein at
      37 degrees C (18% of that of the purified mature enzyme). Guanidine.HCl-denatured
      pOTC was activated to a specific activity of 125 mumol/min/mg protein under
      similar conditions. The native and reactivated OTC sedimented with an s20.w value
      of 6.2S, whereas the activated pOTC sedimented with an s20.w of 5.2S. The
      activated pOTC was more unstable than the reactivated OTC at 50 degrees C. These
      observations indicate that the presequence does not prevent pOTC from folding
      into an enzymatically active trimeric form, although the pOTC trimer appears to
      be less compact than the mature trimer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229024
TI  - Molecular cloning and sequencing of the cDNA of rat alpha 1-protease inhibitor
      and its expression in COS-1 cells.
AB  - A cDNA clone for alpha 1-protease inhibitor (pc alpha 1P1212) was isolated from a
      lambda ZAP rat liver cDNA library. The 1.4 kb cDNA insert of pc alpha 1P1212
      contained an open reading frame that encodes a 411-residue polypeptide (46,125
      Da), in which a signal peptide of 24 residues was identified by comparison with
      the NH2-terminal sequence of the purified protein. Three potential sites for N
      linked glycosylation were found in the molecule, accounting for the difference in
      molecular mass between the predicted form and the purified protein (56 kDa). The
      deduced primary structure of rat alpha 1-protease inhibitor showed 68.5% homology
      to that of the human inhibitor. We then constructed the expression plasmid pSV2
      alpha 1PI from pSV2-gpt and pc alpha 1P1212, and transfected it into COS-1 cells.
      The transfected cells synthesized a molecule which was precipitated with anti
      (rat alpha 1-protease inhibitor)-IgG and had the same molecular size as that of
      the inhibitor produced by rat hepatocytes.

PMID- 2229025
TI  - Tachyplesins isolated from hemocytes of Southeast Asian horseshoe crabs
      (Carcinoscorpius rotundicauda and Tachypleus gigas): identification of a new
      tachyplesin, tachyplesin III, and a processing intermediate of its precursor.
AB  - Tachyplesins and their analogs are antimicrobial peptides composed of 17 or 18
      amino acid residues present abundantly in acid extracts of hemocyte debris of
      horseshoe crabs. We purified here tachyplesin isopeptides from hemocytes of two
      species of Southeast Asian horseshoe crabs, Carcinoscorpius rotundicauda and
      Tachypleus gigas, and determined their amino acid sequences. The major
      tachyplesin isolated from both species was identified, respectively, as
      tachyplesin I, which had previously been found in hemocytes of the Japanese
      horseshoe crab (Tachypleus tridentatus). The yield from both species was very
      high (more than 70 mg per 100 g wet weight of hemocytes), i.e., comparable with
      that from T. tridentatus. In addition to tachyplesin I, a new tachyplesin
      isopeptide, named tachyplesin III, was also isolated from T. gigas hemocytes, in
      which an arginine replaced the 15th lysine of tachyplesin I. The carboxyl
      terminal residue of the isolated tachyplesins I and III was confirmed,
      respectively, to be an arginine alpha-amide by chemical analysis. Furthermore, a
      tachyplesin peptide derivative with a carboxyl-terminal extension of glycine
      lysine was newly found in the hemocytes of C. rotundicauda. It appeared to be an
      intermediate derived from a tachyplesin precursor during processing to the mature
      form.

PMID- 2229026
TI  - Evidence for in vivo synthesis of thiamin triphosphate by cytosolic adenylate
      kinase in chicken skeletal muscle.
AB  - We showed previously that cytosolic adenylate kinase (AK1) purified from pig
      skeletal muscle catalyzes in vitro formation of thiamin triphosphate (TTP) from
      thiamin diphosphate (TDP) and ADP in addition to ATP formation from ADP [Shikata,
      H. et al. (1989) Biochem. Int. 18, 933-942]. To obtain evidence for in vivo
      synthesis of TTP by AK1, changes in TTP content and AK1 activity were determined
      in chicken skeletal muscle during development after hatching. Thiamin phosphate
      metabolism in chicken skeletal muscle was also studied. i) An extremely high TTP
      content, 81% of total thiamin (thiamin plus thiamin phosphates), was detected in
      the white (fast-twitch) muscle of adult normal chicken (5th to 9th month)
      compared with a relatively high TTP content of 31% in the red (slow-tonic)
      muscle. Since approximately equivalent amounts of total thiamin were present in
      the two types of muscle, the ratio of TTP to TDP was high (5.0) in the white
      muscle and low (0.41) in the red muscle. ii) Rabbit anti-chicken AK1 antiserum
      against the purified chicken cytosolic AK1 preparation was obtained. Both AK1
      activity and TTP-synthesizing activity in crude cytosol fraction of adult chicken
      white muscle were inhibited in parallel by the antiserum. iii) In the white
      muscle of normal chicken, the TTP content and AK1 activity responsible for
      forming either ATP or TTP were increased in a parallel manner up to day 16 after
      hatching, after which both remained constant. In the red muscle, on the other
      hand, both the TTP content and the AK1 activity were low in comparison with those
      in the white muscle, and were almost constant after hatching.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2229027
TI  - Phosphorylated and dephosphorylated types of non-activated glucocorticoid
      receptor.
AB  - We purified glucocorticoid receptors quickly but very partially using DEAE-resin.
      [3H]-Triamcinolone acetonide-labeled and non-activated receptors in the quickly
      purified fraction were found to be separated into two fractions (P-2 and P-3) by
      hydroxyapatite column chromatography. The P-2 receptor was the main component,
      and the ratio of P-2/P-3 was around 2. The molecular weights of the two receptors
      were calculated to be the same, 242,000: Rs = 6.2 nm and s20,w = 9.0. Treatment
      of the receptor with catalytic subunits of phosphoprotein phosphatase 2A1 reduced
      the P-2/P-3 ratio from 2 to 0.5, while treatment with catalytic subunits of cAMP
      dependent protein kinase and ATP increased it to 2.5. The isolated P-3 receptor
      could be converted into the P-2 type by the kinase treatment. Tungstate, a
      phosphatase inhibitor, stabilized the P-2 receptor, and the P-2/P-3 ratio was
      larger than 3 when the DEAE-fraction was prepared in the presence of tungstate.
      However, the tungstate effect was not very strong, and the P-2 type tended to
      change into the P-3. [3H]-Triamcinolone acetonide-labeled and non-activated
      receptors were purified very highly by using an affinity gel; the procedure
      required more than 10 h. Only the P-3 form was observed in the preparation of
      highly purified receptors. Hormone-free receptors were affected by neither the
      phosphatase nor the kinase. The results indicate that the hormone binding makes
      the receptor sensitive to phosphatase. The reversibly dephosphorylated receptor
      is more stable than the non-dephosphorylated one, and can be activated.

PMID- 2229028
TI  - A heparin binding protein whose expression increases during differentiation of
      embryonal carcinoma cells to parietal endoderm cells: cDNA cloning and sequence
      analysis.
AB  - A cDNA clone isolated from a lambda gt11 expression library of teratocarcinoma
      OTT6050 specifies for a glycoprotein with a molecular weight of about 44,000. The
      new glycoprotein was termed heparin binding protein-44 (HBP-44), since it was
      absorbed to a heparin-agarose column and was eluted from it by a buffer
      containing 1.5 M NaCl. HBP-44 mRNA was intensely expressed in PYS-2 parietal
      endoderm cells and in the kidney, and the RNA level increased about 10-fold
      during differentiation of F9 embryonal carcinoma cells to parietal endoderm
      cells. From the cDNA sequence, HBP-44 was concluded to be rich in charged amino
      acids, and large segments of the protein appeared to form alpha-helixes. The
      protein was considered to be anchored to the membrane by a cluster of hydrophobic
      amino acids present in the N-terminal region. Indeed, the N-terminal sequence of
      HBP-44 was homologous to asialoglycoprotein receptor, which is anchored to the
      membrane by the N-terminal region. Furthermore, a portion of the N-terminal
      region of HBP-44 was homologous to the leucine zipper domain. Except for the N
      terminal region, HBP-44 had over-all homology with structural proteins such as
      myosin heavy chain. We propose that HBP-44 is extruded from plasma membranes and
      interacts with heparin and related molecules and that it is involved in the
      interactions of plasma membranes with basement membranes.

PMID- 2229029
TI  - Primary structure of a base non-specific and adenylic acid preferential
      ribonuclease from Aspergillus saitoi.
AB  - The complete primary structure of a base non-specific and adenylic acid
      preferential RNase (RNase M) from Aspergillus saitoi was determined. The sequence
      was determined by analysis of the peptides generated by digestion of heat
      denatured RNase M with lysylendopeptidase, and the peptides generated from RCM
      RNase M by digestion with staphylococcal V8 protease or chemical cleavage with
      BrCN. It consisted of 238 amino acid residues and carbohydrate moiety attached to
      the 74th asparagine residue. The molecular weight of the protein moiety deduced
      from the sequence was 26,596. The locations of 10 half cystine residues are
      almost superimposable on those of RNase Rh from Rhizopus niveus and RNase T2 from
      Aspergillus oryzae which have similar base specificity. The homology between
      RNase M and RNase Rh and RNase T2 amounted to 97 and 160 amino acid residues,
      respectively. The amino acid sequences conserved in the three RNases are
      concentrated around the three histidine residues, which are supposed to form part
      of the active sites of these RNases.

PMID- 2229030
TI  - Repression of serotonin secretion by an endogenous Ca2(+)-activated protease in
      electropermeabilized bovine platelets.
AB  - Micromolar levels of free calcium ions added to the extracellular medium elicit
      secretion of serotonin from electropermeabilized bovine platelets in the presence
      of millimolar levels of Mg-ATP. Such Ca2(+)-dependent secretion of serotonin was
      almost completely impaired when the permeabilized platelets were preincubated for
      1 min at 35 degrees C in 100 microM Ca2+ without Mg-ATP. The half-maximal effect
      was observed with about 45 microM Ca2+ in the preincubation medium. Inhibitors of
      serine-thiol protease, such as leupeptin and antipain, suppressed the impairment
      of the secretion of serotonin by the preincubation with Ca2+. Electron
      microscopic observation revealed that disorganization of the cytoskeletal
      structures, in particular of the membrane undercoat and the network of
      microfilaments, accompanied the impairment of secretion of serotonin.
      Microfilaments were also found to be dissociated from dense granules that
      contained serotonin. These morphological changes were also suppressed when
      antipain was included in the Ca2(+)-preincubation medium. Coincident with these
      morphological changes, the following biochemical changes were observed in 100
      microM Ca2+ but not in the presence of Ca2+ and antipain. The amount of Triton
      insoluble cytoskeleton and the acto-myosin content of the dense-granule fraction
      were markedly decreased. The decrease in Triton-insoluble cytoskeletons was
      quantitatively correlated with the degree of impairment of secretion of
      serotonin. Immunoblot analysis of EGTA extracts of the cells showed that the 240
      kDa spectrin in platelets was degraded to a 235-kDa fragment, and a 260-kDa actin
      binding protein (ABP) in platelets was partially degraded to 190- and 110-kDa
      components.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229031
TI  - UDP-glucose pyrophosphorylase from potato tuber: cDNA cloning and sequencing.
AB  - We have isolated a cDNA encoding UDP-glucose pyrophosphorylase from a cDNA
      library of immature potato tuber using oligonucleotide probes synthesized on the
      basis of partial amino acid sequences of the enzyme. The cDNA clone contained a
      1,758-base-pair insert including the complete message for UDP-glucose
      pyrophosphorylase with 1,431 base pairs. The amino acid sequence of the enzyme
      inferred from the nucleotide sequence consists of 477 amino acid residues. All
      the partial amino acid sequences determined protein-chemically [Nakano et al.
      (1989) J. Biochem. 106, 528-532] confirmed the primary structure of the enzyme.
      An N-terminal-blocked peptide was isolated from the proteolytic digest of the
      enzyme protein, and the blocking group was deduced to be an acetyl group by fast
      atom bombardment-mass spectrometry. On the basis of the predicted amino acid
      sequence (477 residues minus the N-terminal Met plus an acetyl group), the
      molecular weight of the enzyme monomer is calculated to be 51,783, which agrees
      well with the value determined by polyacrylamide gel electrophoresis. In the cDNA
      structure, the open-reading frame is preceded by a 125-base-pair noncoding
      region, which contains a sequence being homologous with the consensus sequence
      for plant genes, and is followed by a 174-base-pair noncoding sequence including
      a polyadenylation signal. Amino acid sequence comparisons revealed that the
      potato UDP-glucose pyrophosphorylase is homologous to the enzyme from slime mold,
      Dictyostelium discoideum, but not to ADP-glucose pyrophosphorylases from rice
      seed and Escherichia coli.

PMID- 2229032
TI  - Purification and properties of 4-hydroxy-4-methyl-2-oxoglutarate aldolase from
      Pseudomonas ochraceae grown on phthalate.
AB  - 4-Hydroxy-4-methyl-2-oxoglutarate aldolase [4-hydroxy-4-methyl-2-oxoglutarate
      pyruvate-lyase: EC 4.1.3.17] has been purified to homogeneity (about 770-fold
      purification, yield 11.4%) from Pseudomonas ochraceae grown on phthalate. The
      enzyme has a molecular weight of 160,000 (gel filtration on Bio-Gel A-1.5m), a
      subunit molecular weight of 26,000 (SDS-PAGE) and an isoelectric point of 5.0
      (isoelectric focusing). The enzyme requires divalent metal ions such as Mg2+,
      Mn2+, Co2+, Zn2+, and Cd2+ for activity. The enzyme actively cleaves 4-carboxy-4
      hydroxy-2-oxoadipate, a physiological substrate of the enzyme, to give pyruvate
      and oxaloacetate, but shows much lower affinity for 4-hydroxy-4-methyl-2
      oxoglutarate. 4-Hydroxy-2-oxoglutarate is cleaved at a low rate to pyruvate and
      glyoxylate. The l-isomers of the substrates are preferentially cleaved rather
      than the d-isomers as determined polarimetrically. The enzyme reactions are
      reversible: the equilibrium constants (pH 8.0, 25 C) for the HMG and HG cleavage
      reactions are about 0.07 and 0.03 M, respectively, whereas no equilibrium is
      observed with CHA due to oxaloacetate beta-decarboxylase activity associated with
      the enzyme. The enzyme activity is hardly affected by thiols and thiol reagents.
      The non-enzymatic cleavage reaction caused by various metal ions has also been
      studied to examine the mechanistic similarity to the enzymatic reaction.

PMID- 2229033
TI  - Activation of Pseudomonas ochraceae 4-hydroxy-4-methyl-2-oxoglutarate aldolase by
      inorganic phosphate.
AB  - Pseudomonas ochraceae 4-hydroxy-4-methyl-2-oxoglutarate aldolase [4-hydroxy-4
      methyl-2-oxoglutarate pyruvate-lyase: EC 4.1.3.17], one of the metal ion
      requiring aldolases, is markedly activated by Pi. The activation is reversible
      and can be observed in every step of enzyme purification. The extent of
      activation is almost independent of the metal ion used, but varies with each
      substrate. The cleavage of l-4-carboxy-4-hydroxy-2-oxoadipate, a physiological
      substrate of the enzyme, is most strongly activated: Pi gives a hyperbolic
      activation curve with an activation constant of 0.36 mM and a maximum activation
      of about 65-fold. Arsenate, phosphorous acid, bicarbonate, acetyl phosphate,
      thiamine diphosphate, ADP, PPi, and ATP are also effective to various extents.
      These anions appear to be effective in the free form but not in the metal ion
      complex. Many organic and inorganic anions are ineffective. Pi causes parallel
      increases in Vmax and in Km for substrate or metal ion with a concomitant shift
      of the optimum pH toward the alkaline side, and the enhancement of activity is
      closely correlated with the shift of optimum pH. Pi induces no gross change of
      molecular form of the enzyme protein as evaluated from gel filtration, PAGE, UV,
      fluorescence, and CD spectral data. Based on these findings, the mechanism and
      the physiological meaning of the observed activation are discussed.

PMID- 2229035
TI  - Anion exchange reactions in bacteria.
AB  - Bacterial anion exchange now includes both "carboxylate-linked" reactions in
      which there is an antiport of mono- and dicarboxylic acids, and "Pi-linked"
      reactions that build on phosphate (Pi) and organic phosphates. To illustrate the
      general features of this expanding class, this article discussed the
      biochemistry, physiology, and molecular biology of Pi-linked antiporters that
      accept glucose 6-phosphate (G6P) as their primary substrate. Kinetic and
      biochemical analysis suggests that Pi-linked exchangers have a bifunctional
      active site that accepts a pair of negative charges. For this reason, exchange
      stoichiometry moves between the limits of 2:1 and 2:2 to reflect the ratio of
      mono- and divalent substrates at either membrane surface. This results in a
      particularly interesting reaction sequence in vivo, where, because cytosolic pH
      is relatively alkaline, one can expect the asymmetric exchange of two monovalent
      G6P anions against a single divalent G6P. In this way, an otherwise futile self
      exchange of G6P gives a net flux driven (indirectly) by the pH gradient. Despite
      this biochemical and physiological complexity, Pi-linked carriers resemble all
      other secondary carriers at a molecular level. Indeed, sequence analysis leads
      one to infer a common (albeit low resolution) structural theme in which each
      functional unit has two sets of six trans-membrane alpha helices separated by a
      central hydrophilic loop. Present examples show that this topology can derive
      from either a single protein, as is typical in bacteria, or from pairs of
      identical subunits, as found in mitochondria and chloroplasts. The finding of
      this common structure should make it possible to build detailed structural models
      that have implications for all membrane carrier proteins.

PMID- 2229034
TI  - Transport systems encoded by bacterial plasmids.
AB  - A variety of bacterial functions are encoded on plasmids, extrachromosomal
      elements. Examples of plasmid-borne functions are antibiotic production and
      resistance, degradation of recalcitrant chemicals, virulence factors, and plant
      symbiotic properties. Several transport systems with diverse functions have
      recently been found to be carried on plasmids. These systems serve to either
      accumulate or extrude a compound from a cell. The focus of this review is to
      present a survey on several of these novel plasmid-borne transport systems
      emphasizing functions, components, and molecular genetics.

PMID- 2229037
TI  - Bifunctional role of glycosphingolipids. Modulators for transmembrane signaling
      and mediators for cellular interactions.
AB  - Glycosphingolipids (GSLs), or their modified catabolites, at the cell surface
      modulate transmembrane signal transduction by influencing protein kinases
      associated with growth factor receptors and protein kinase C. On the other hand,
      the same or different GSLs at the cell surface interact in highly specific
      fashion with other GSLs or with binding proteins, possibly at the surface of
      adjacent interacting cells or in the extracellular matrix. The GSL-GSL
      interaction apparently provides the basis for a specific cell recognition system
      independent of the fibronectin/integrin or surface lectin systems, occurring
      earlier during a cell recognition event.

PMID- 2229038
TI  - Mutations in fnr that alter anaerobic regulation of electron transport-associated
      genes in Escherichia coli.
AB  - The fnr gene product, FNR, is a global regulator of anaerobic gene expression in
      Escherichia coli. When E. coli is switched from aerobic to anaerobic growth
      conditions, cytochrome o (cyoABCDE) and d oxidase (cydAB) genes are repressed and
      the anaerobic terminal reductase genes, including nitrate (narGHJI), dimethyl
      sulfoxide/trimethylamine (dmsABC), and fumarate (frdABCD) reductase, are induced.
      To determine if certain amino acid residues are essential for FNR to function in
      this regulatory process, site-directed mutations were introduced into the fnr
      gene. The resulting mutant proteins were assayed in vivo for their ability to
      either activate dmsA'-'lacZ and frdA'-'lacZ gene expression, or repress
      expression of a cyoA'-'lacZ gene fusion. The fnr mutants were grouped into four
      classes. Class I exhibited a severe decrease in the ability to either activate or
      repress fnr-dependent gene expression. Mutations in four of the five cysteine
      residues in the FNR protein were in this class. The sole exception was an FNR
      Cys16----Ser "mutant" that exhibited normal activity. Class II mutations caused a
      mild reduction in FNR-dependent activation or repression while Class III
      mutations conferred a modest increase in the ability of the FNR protein to
      activate gene expression under aerobic conditions (i.e. FNR*). Finally, Class IV
      mutations lowered the modest aerobic FNR transcriptional activation function
      proportionally more than the anaerobic FNR activity. These findings identify an
      essential role for the NH2 terminus of the FNR protein in its various activities
      in anaerobic gene regulation.

PMID- 2229036
TI  - Binding protein-dependent transport systems.
AB  - Bacterial binding protein-dependent transport systems are the best characterized
      members of a superfamily of transporters which are structurally, functionally,
      and evolutionary related to each other. These transporters are not only found in
      bacteria but also in yeasts, plants, and animals including man, and include both
      import and export systems. Although any single system is relatively specific,
      different systems handle very different substrates which can be inorganic ions,
      amino acids, sugars, large polysaccharides, or even proteins. Some are of
      considerable medical importance, including Mdr, the protein responsible for
      multidrug resistance in human tumors, and the product of the cystic fibrosis
      locus. In this article we review the current state of knowledge on the structure
      and function of the protein components of these transporters, the mechanism by
      which transport is mediated, and the role of ATP in the transport process.

PMID- 2229039
TI  - Amino acid sequence and characterization of a heparin-binding neurite-promoting
      factor (p18) from bovine brain.
AB  - A neurite-promoting factor (p18) was isolated from bovine brain using ammonium
      sulfate fractionation, sulfated Sephadex G-50 chromatography, heparin-Sepharose
      gel chromatography, and reverse phase high performance liquid chromatography. The
      complete amino acid sequence of p18 was determined by automated Edman degradation
      of S-pyridylethylated p18, and its peptide fragments produced by cyanogen bromide
      cleavage and by digestion with specific endoproteinases. Alignment of the amino
      acid sequences of these peptides revealed that p18 consists of 119 amino acid
      residues with a calculated molecular weight of 14,200. p18 appears to possess
      five disulfide bonds per molecule. A region of amino acid sequence at the C
      terminus of p18 shows a structural feature homologous to that around the reactive
      sites of Kazal-type protease inhibitors. However, p18 did not exhibit anti
      trypsin activity. p18 showed very little, if any, mitogenic activity toward NIH
      3T3 cells and Swiss mouse 3T3 cells. p18 was found to bind to a specific receptor
      with an apparent Kd of approximately 8 nM and receptor numbers 1.7 x 10(5) and
      1.0 x 10(4) for NIH 3T3 cells and PC12 cells (rat pheochromocytoma cells),
      respectively.

PMID- 2229040
TI  - Saturation site-directed mutagenesis of thymidylate synthase.
AB  - We have subjected 12 different codons of a synthetic Lactobacillus casei
      thymidylate synthase (TS) gene to saturation site-directed mutagenesis to create
      amino acid "replacement sets" at each of those positions. The target residues
      were chosen because they are highly conserved and because they are important for
      the structure and function of the protein as indicated by solution and structural
      studies. The mutagenesis procedure involved excision of a fragment of the
      synthetic gene containing the target codon, followed by its replacement with a
      mixture of oligonucleotides which code for all 20 amino acids and the amber stop
      codon. TS mutants were identified by DNA sequencing, and catalytically active
      mutants were identified by genetic complementation using a Thy- strain of
      Escherichia coli. Only 3 of the 12 target amino acids examined were essential for
      TS activity; and of the 125 total mutants identified, 57 were catalytically
      active. These results point to a high degree of plasticity of TS in accommodating
      function with structural change.

PMID- 2229041
TI  - Cleavage of disulfide bonds in endocytosed macromolecules. A processing not
      associated with lysosomes or endosomes.
AB  - Whereas there is biological evidence that the reductive cleavage of disulfide
      bonds is critical for the activation of endocytosed macromolecules such as
      toxins, immunotoxins, and other drug carriers, virtually nothing is known about
      the specifics of this cleavage. To study this process, a model compound was
      synthesized in which a radioiodinated tyramine was linked through a disulfide
      bond to an undegradable carrier, poly(D-lysine), known to be efficiently
      endocytosed. Cultured Chinese hamster ovary cells were pulse-labeled with this
      probe, and the disulfide cleavage was measured as released acid-soluble
      radioactivity at different times of chase. Pulse-labeled cells were also
      subjected to subcellular fractionation to identify intracellular structures
      associated with disulfide cleavage. Cleavage began without lag, amounted to about
      approximately 7% of the initial cell-bound radioactivity in the first hour and
      continued for more than 6 h. It was abolished in the presence of N
      ethylmaleimide. When sulfhydryl groups present at the cell surface were blocked
      with cell-impermeant sulfhydryl reagent, the initial phase of disulfide cleavage
      was inhibited, indicating that cleavage began at the cell surface. A long-lasting
      intracellular phase of disulfide cleavage began after about approximately 30 min
      of chase. Subcellular fractionation and kinetic analysis indicated that neither
      lysosomes nor endosomes were participating in that phase, leaving the Golgi
      apparatus as the most probable site of endocytic disulfide cleavage.

PMID- 2229042
TI  - Transmission of ADP.vanadate-induced conformational changes to three peptide
      segments of myosin subfragment-1.
AB  - In order to study the conformational changes associated with formation of the
      stable ternary complex of myosin subfragment-1 (S-1) with ADP and orthovanadate
      (Vi), S-1 was fluorescently labeled with 9-anthroylnitrile, 4-fluoro-7-nitrobenz
      2-oxa-1,3-diazole, and 5-(iodoacetamido) fluorescein at the 23-, 50-, and 20-kDa
      peptide segments of S-1, respectively (Hiratsuka, T. (1989) J. Biol. Chem. 264,
      18188-18194; Hiratsuka, T. (1986) J. Biol. Chem. 261, 7294-7299; Takashi, R.
      (1979) Biochemistry 18, 5164-5169). The extrinsic fluorescence of these S-1
      derivatives was sensitive not only to binding of ADP but to formation of the
      stable ternary complex with ADP and Vi. By using these fluorescent properties,
      the kinetics of formation of the stable ternary complexes of these S-1
      derivatives with ADP and Vi, M. ADP.Vi, were analyzed according to the scheme
      proposed by Goodno (Goodno, C. C. (1979) Proc. Natl. Acad. Sci. U. S. A. 76, 2620
      2624). [Formula; see text] The values obtained for KVi )0.2-0.4 mM) and k (0.03
      0.05 s-1) of these S-1 derivatives were similar regardless of the peptide
      segments of S-1 where the fluorophore had been covalently labeled. These results
      suggest that the conformational changes, which are induced by formation of the
      stable ternary complex of S-1 with ADP and Vi, are transmitted to all three
      peptide segments of S-1 at a similar rate. The present results also encourage us
      to confirm that the ATPase site of S-1 resides at or near the region where all
      three peptide segments of S-1 are contiguous.

PMID- 2229043
TI  - Kinetics of conformational changes in Nereis sarcoplasmic calcium-binding protein
      upon binding of divalent ions.
AB  - The sarcoplasmic calcium-binding protein (SCP) of the sandworm Nereis possesses
      three Ca2(+)-Mg2+ sites but no Ca2(+)-specific site. Binding of Mg2+, but not of
      Ca2+, displays a marked positive cooperativity. The apparent cooperativity of
      Ca2+ binding in the presence of Mg2+ results from the allostery in Mg2+
      dissociation. Binding of the first Ca2+ or Mg2+ induces all the conformational
      change, monitored by Trp fluorescence. In displacement reactions the
      conformational changes occur in the step SCP.Mg3----SCP.Ca1Mg2. Stopped-flow
      experiments indicate that Trp fluorescence changes upon Ca2(+)-binding are
      instantaneous whereas Mg2(+)-binding involves a fast pre-equilibrium (Keq = 28 M
      1), followed by two slow consecutive conformational changes with k1 = 13.5 s-1
      and k2 = 0.21 s-1. The fluorescence change after dissociation of Ca2+ from SCP is
      monophasic with k = 0.02 s-1; that after Mg2+ dissociation is biphasic with k1 =
      0.8 s-1 and k2 = 0.1 s-1. Trp life time measurements also indicate that Ca2(+)-
      and Mg2(+)-induced conformational changes are completely different. Displacement
      of bound Ca2+ by Mg2+ can be described by two consecutive reactions in which the
      first (without fluorescence change) corresponds to the dissociation of the last
      Ca2+ (k1 = 2.4 s-1) and the second (k2 = 0.45 s-1) to the final conformational
      change observed upon direct Mg2+ binding. Displacement of bound Mg2+ by Ca2+
      follows the kinetic scheme of simple competition; the conformational rate
      constant approaches asymptotically (up to the limit of 129 s-1) the dissociation
      rate of Mg2+ as the concentration of Ca2+ increases. In summary, after fast
      dissociation of Ca2+ or Mg2+, Nereis SCP slowly converts to the metal-free
      configuration, but in Ca2(+)-Mg2+ exchange reactions, the conformational changes
      are nearly as fast as the cation dissociation reactions.

PMID- 2229044
TI  - Thermodynamic study of protein dynamic structure in the oxygen binding reaction
      of myoglobin.
AB  - We examined the flash photolysis of oxy complexes of sperm whale myoglobin (Mb)
      on the nanosecond time scale at ambient temperatures. In this time range, we can
      observe the geminate reaction of Mb with the O2 ligand existing in the protein
      matrix after the photodissociation from the heme iron. We found that the fraction
      of the geminate component to the total O2 photodissociation exhibited temperature
      dependences. The geminate fraction decreased with rising temperature, indicating
      that the protein fluctuation is enhanced at high temperature because of thermal
      agitation. However, the temperature-dependent behavior showed a break at 20
      degrees C. Concerning the geminate O2 escaping reaction from the protein matrix
      to the solvent region, the activation energy above 20 degrees C (0.4 +/- 0.4
      kcal/mol) is significantly lower than that below 20 degrees C (5.1 +/- 0.4
      kcal/mol). Thermodynamic analysis on the basis of the transition state theory
      indicated that the O2 escaping reaction above 20 degrees C is entropy dominated
      whereas that below 20 degrees C is enthalpy dominated. The results were
      qualitatively compatible with the theoretical prediction by J. Kottalam and D. A.
      Case [1988) J. Am. Chem. Soc. 110, 7690-7697). Comparing the kinetic and
      thermodynamic process of the O2 geminate reaction among several Mbs, we concluded
      that the geminate O2 reaction with Mb is governed by the dynamic motion of the
      protein which is sensitively controlled by the static interaction of the heme
      moiety with the surroundings.

PMID- 2229045
TI  - The proton motive force lowers the level of ATP required for the in vitro
      translocation of a secretory protein in Escherichia coli.
AB  - The role of the electrochemical potential difference of proton (delta mu H+) in
      protein translocation across the membrane of Escherichia coli was examined in
      detail using an efficient in vitro assay system (Yamada, H., Tokuda, H., and
      Mizushima, S. (1989) J. Biol. Chem. 264, 1723-1728). Delta mu H+ reduced the
      level of ATP necessary for the efficient translocation of OmpF-Lpp, a chimeric
      model secretory protein. The apparent Km value of the translocation reaction for
      ATP was lower by 2 orders of magnitude in the presence of delta mu H+ than in its
      absence. The membrane potential and delta pH, both of which are components of
      delta mu H+, independently lowered the apparent Km value of the translocation
      reaction for ATP. An ATP-generating system also lowered the level of ATP required
      for translocation in the absence of delta mu H+ but not in its presence. It is
      proposed that ADP formed during protein translocation lowers the affinity of the
      putative translocation machinery for ATP and that the removal of ADP from the
      secretory machinery, a possible critical step in the translocation reaction, is
      stimulated in the presence of either delta mu H+, an ATP-generating system, or a
      higher concentration of ATP.

PMID- 2229046
TI  - Caldesmon-binding sites on tropomyosin.
AB  - The interaction of chicken gizzard caldesmon with fragments of tropomyosin,
      generated by chemical, enzymatic, and mutational means, was studied to determine
      the caldesmon-binding site(s) on tropomyosin. Binding was examined by
      fluorescence spectroscopy and affinity chromatography. Removal of residues 1-141
      and 228-284, respectively, from the NH2 and COOH ends of tropomyosin did not
      affect its binding to caldesmon significantly, indicating that the major,
      caldesmon-binding region lies between residues 142-227. The Escherichia coli
      produced chicken gizzard beta-tropomyosin mutant, CSM-beta (1/8/12-227), bound
      caldesmon about 2-fold stronger than a similar mutant of residues 8-200. This
      further focused the primary caldesmon-binding site to residues 201-227. Cleavage
      of tropomyosin at CYS-190 weakened markedly the binding of the two resulting
      fragments, residues 1-189 and 190-284, to caldesmon suggesting the requirement
      for the integrity of the caldesmon-binding region between residues 142227 of
      tropomyosin for strong interaction with caldesmon. Based on data from this study
      and others, we have proposed models for the interaction of tropomyosin with
      caldesmon in vitro, as well as the possible arrangement of the smooth muscle thin
      filament proteins in vivo.

PMID- 2229047
TI  - Relationship of cholesterol content to spatial distribution and age of disc
      membranes in retinal rod outer segments.
AB  - The initial events of visual transduction occur on disc membranes which are
      sequestered within the photoreceptor outer segment. In rod cells, the discs are
      stacked in the outer segment. Discs are formed at the base of the rod outer
      segment (ROS) from evaginations of the plasma membrane. As new discs form, older
      discs move toward the apical tip of the rod, from which they are eventually shed
      and subsequently phagocytosed by the adjacent pigment epithelium. Thus, disc
      membranes within a given rod cell are not of uniform age. We have recently shown
      that disc membranes are not homogeneous with respect to cholesterol content
      (Boesze-Battaglia, K., Hennessey, T., and Albert, A. D. (1989) J. Biol. Chem.
      264, 8151-8155). In the present study, freshly isolated bovine retinas were
      incubated with [3H]leucine for 4 h in order to allow sufficient time for the
      radiolabeled proteins to become incorporated into the basal-most (newest) discs.
      Osmotically intact discs were then isolated. After the addition of digitonin, the
      discs were fractionated based on cholesterol content, and radioactivity
      (indicative of newly synthesized protein) was measured. Discs which exhibited
      high cholesterol content also exhibited high radio-activity. These results
      demonstrate that the cholesterol heterogeneity of ROS disc membranes is related
      to the age, and thus the position, of the discs in the ROS.

PMID- 2229048
TI  - Amino acid sequences of two proline-rich bactenecins. Antimicrobial peptides of
      bovine neutrophils.
AB  - Bactenecins are highly cationic polypeptides of the large granules of bovine
      neutrophils, exerting in vitro a potent antimicrobial activity. Two bactenecins,
      with an approximate molecular weight of 7000 and 5000, called Bac7 and Bac5, are
      characterized by a high content of proline (greater than 45%) and arginine
      (greater than 23%) residues. Their complete amino acid sequences were determined
      by automated Edman degradation combined, in the case of Bac5, with plasma
      desorption mass spectrometry. Bac7 comprises 59 residues and includes three
      tandem repeats of a tetradecamer characterized by several Pro-Arg-Pro triplets
      spaced by single hydrophobic amino acids. Resolution of the primary structure of
      Bac5 required fragmentation with N-bromosuccinimide as well as digestion of the
      obtained C-terminal fragment with carboxypeptidases P and Y directly in the mass
      spectrometer. Bac5 comprises 42 amino acid residues with a repeated motif of Arg
      Pro-Pro triplets also alternating with single apolar residues.

PMID- 2229049
TI  - Glucose regulation of insulin receptor affinity in primary cultured adipocytes.
AB  - Treatment of primary cultured adipocytes with 20 mM glucose resulted in a
      progressive increase in specific 125I-insulin binding that began almost
      immediately (no lag period) and culminated in a 60% increase by 24 h. This effect
      was dose-dependent (glucose ED50 of 4.6 mM) and mediated by an increase in
      insulin receptor affinity. Moreover, it appears that glucose modulates insulin
      receptor affinity through de novo protein synthesis rather than through covalent
      modification of receptors, since cycloheximide selectively inhibited the glucose
      induced increase in insulin binding capacity (ED50 of 360 ng/ml) and restored
      receptor affinity to control values. Importantly, insulin sensitivity of the
      glucose transport system was increased by glucose treatment (63%) to an extent
      comparable with the enhancement in receptor affinity, thus indicating a
      functional coupling between insulin binding and insulin action. When the long
      term effects of insulin were assessed (24 h), we found that insulin treatment
      reduced 125I-insulin binding by greater than 60% by down-regulating the number of
      cell surface receptors in a dose-dependent manner (insulin ED50 of 7.4 ng/ml). On
      the basis of these studies, we conclude that 1) insulin binding is subject to
      dual regulation (glucose controls insulin action by enhancing receptor affinity,
      whereas insulin controls the number of cell surface receptors); and 2) glucose
      appears to modulate insulin receptor affinity through the rapid biosynthesis of
      an affinity regulatory protein.

PMID- 2229050
TI  - Growth inhibition by vaccinia virus growth factor.
AB  - Vaccinia virus growth factor (VGF), a highly glycosylated 77-residue epidermal
      growth factor (EGF)-like polypeptide encoded in vaccinia poxvirus, is reported to
      play an important role in stimulating growth of uninfected cells to facilitate
      virus infection. We have chemically synthesized the unglycosylated forms of VGF
      and VGF19-69, a shortened VGF analog consisting of 51 residues and comprising the
      EGF-homologous region (position 19-69) of VGF. Both synthetic forms of VGFs were
      purified to homogeneity and vigorously characterized by various criteria,
      including the Cf-252 ion fission fragment mass spectrometry, amino acid
      sequencing, and enzymatic digestion to confirm the disulfide linkages. Synthetic
      VGFs exhibited high affinity binding to the EGF receptors in A431, NRK 49F, NRK
      clone 3, and NIH 3T3 cells, but, unlike the glycosylated form, showed contrasting
      mitogenic activities in various cells in vitro. Synthetic VGFs showed low levels
      of mitogenic and colonogenic activities in NRK clone 49F cells and NIH 3T3 cells,
      full agonist activities in human keratinocytes and Swiss 3T3 cells, and partial
      agonist activities in NRK clone 3 cells. Our results suggest that the
      unglycosylated form of VGF is an EGF antagonist to selected cells and that the
      production of unglycosylated form of VGF by the cytolytic vaccinia virus may
      serve as a mechanism whereby inhibition of growth and metabolism of selected host
      cells may be used to facilitate the propagation of the virus infection.

PMID- 2229051
TI  - Stoichiometry, base orientation, and nuclease accessibility of RecA.DNA complexes
      seen by polarized light in flow-oriented solution. Implications for the mechanism
      of genetic recombination.
AB  - By using flow linear dichroism, in combination with nuclease digestion and two
      spectroscopically distinguishable DNAs, we demonstrate the existence of two
      internal and one external DNA-binding sites in the RecA fiber. A number of
      different complexes between RecA and single- and double-stranded DNAs are
      characterized with respect to stoichiometry, location, and base orientation of
      each of the associated DNAs. Based on these results, we discuss important steps
      of the mechanism of general genetic recombination.

PMID- 2229052
TI  - Transient spectroscopy of the reaction of cyanide with ferrous myoglobin. Effect
      of distal side residues.
AB  - The reaction of cyanide metmyoglobin with dithionite conforms to a two-step
      sequential mechanism with formation of an unstable intermediate, identified as
      cyanide bound ferrous myoglobin. This reaction was investigated by stopped-flow
      time resolved spectroscopy using different myoglobins, i.e. those from horse
      heart, Aplysia limacina buccal muscle, and three recombinant derivatives of sperm
      whale skeletal muscle myoglobin (Mb) (the wild type and two mutants). The
      myoglobins from horse and sperm whale (wild type) have in the distal position
      (E7) a histidyl residue, which is missing in A. limacina Mb as well as the two
      sperm whale mutants (E7 His----Gly and E7 His----Val). All these proteins in the
      reduced form display an extremely low affinity for cyanide at pH less than 10.
      The differences in spectroscopy and kinetics of the ferrous cyanide complex of
      these myoglobins indicate a role of the distal pocket on the properties of the
      complex. The two mutants of sperm whale Mb are characterized by a rate constant
      for the decay of the unstable intermediate much faster than that of the wild
      type, at all pH values explored. Therefore, we envisage a specific role of the
      distal His (E7) in controlling the rate of cyanide dissociation and also find
      that this effect depends on the protonation of a single ionizable group, with pK
      = 7.2, attributed to the E7 imidazole ring. The results on A. limacina Mb, which
      displays the slowest rate of cyanide dissociation, suggests that a considerable
      stabilizing effect can be exerted by Arg E10 which, according to Bolognesi et al.
      (Bolognesi, M., Coda, A., Frigerio, F., Gatti, C., Ascenzi, P., and Brunori, M.
      (1990) J. Mol. Biol. 213, 621-625), interacts inside the pocket with fluoride
      bound to the ferric heme iron. A mechanism of control for the rate of
      dissociation of cyanide from ferrous myoglobin, involving protonation of the
      bound anion, is discussed.

PMID- 2229053
TI  - Refolding of an integral membrane protein. OmpA of Escherichia coli.
AB  - OmpA is an integral membrane protein from the outer membrane of Escherichia coli.
      Purified, lipopolysaccharide-free OmpA was denatured by boiling in sodium dodecyl
      sulfate (SDS). Refolding was then induced by replacement of SDS with the nonionic
      detergent octylglucoside. The structure of both the denatured and refolded
      protein were investigated by SDS-gel electrophoresis, protease digestion, Raman
      and fluorescence spectroscopy. Refolded OmpA could be reconstituted into
      membranes of the synthetic lipid dimyristoylphosphatidylcholine. Thus,
      lipopolysaccharide is neither necessary for proper folding of OmpA nor for its
      insertion into lipid membranes. Based on this result, models for sorting of OmpA
      into the outer membrane of E. coli are discussed.

PMID- 2229054
TI  - Displacement of rhodopsin by GDP from three-loop interaction with transducin
      depends critically on the diphosphate beta-position.
AB  - We have studied the effect of GDP and its analog guanyl-5'-yl thiophosphate (GDP
      beta S) on the interaction between rhodopsin and transducin (Gt). Stabilization
      of the light-induced active intermediate, metarhodopsin II (MII), by bound Gt
      (extra-MII effect) monitored the catalytic interaction between the proteins.
      Extra-MII can be completely abolished by GDP, with a half-suppression at 10
      microM under the conditions (4 degrees C, pH 8, 7.5 nM photoactivated rhodopsin).
      The effect of GDP did not depend on divalent cations, in contrast to GTP-induced
      dissociation of the complex. The GDP analog GDP beta S did not affect extra-MII
      although it binds to the MII-Gt complex with only three times lower affinity
      (reversal of the GDP effect by GDP beta S). However, GDP beta S enhanced
      considerably the efficiency of synthetic rhodopsin peptide competition against
      the formation of extra-MII. GDP and GDP beta S slow the Gt activation rate
      (monitored by kinetic light scattering), with the same relative efficiencies. We
      therefore assume that GDP, GDP beta S, and GTP bind at the same site. We discuss
      a generalized induced fit mechanism, where MII induces opening of the Gt
      nucleotide site and release of GDP which in turn is obligatory to establish the
      MII-stabilizing rhodopsin-Gt three-loop interaction (Konig, B., Arendt, A.,
      McDowell, J.H., Kahlert, M., Hargrave, P.A., and Hofmann, K.P. (1989) Proc. Natl.
      Acad. Sci. U.S.A. 86, 6878-6882). The GDP beta S/GDP difference is discussed in
      terms of bound GDP disturbing the interaction with two and GDP beta S with only
      one of the rhodopsin binding sites. Mechanistically, our results indicate a
      critical role of the beta-phosphate interaction with the nucleotide binding site
      in the GDP-induced transformation of Gt.

PMID- 2229055
TI  - Evidence for direct interaction between cysteine 138 and the flavin in
      thioredoxin reductase. A study using flavin analogs.
AB  - The flavoenzyme thioredoxin reductase from Escherichia coli contains an oxidation
      reduction active disulfide made up of Cys135 and Cys138. Mutations changing each
      Cys residue to a Ser residue have been effected (Prongay, A. J., engelke, D. R.,
      and Williams, C. H., Jr. (1989) J. Biol. Chem. 264, 2656-2664). The FAD
      prosthetic group of each altered thioredoxin reductase has been replaced with 1
      deaza-FAD (a flavin analog with carbon substituted for nitrogen at position 1), 4
      thio-FAD (a flavin analog with sulfur substituted for oxygen at position 4), and
      6-thiocyanato-FAD. 1-Deaza-FAD-TRR(Cys135,Ser138) has absorbance and fluorescence
      spectral properties similar to the oxidized form of wild type apothioredoxin
      reductase reconstituted with 1-deaza-FAD. The absorbance spectrum of 1-deaza-FAD
      TRR(Ser135,Cys138) is similar to the spectrum of the two-electron reduced form of
      wild type apothioredoxin reductase reconstituted with 1-deaza-FAD, indicating
      that it is a mixture of two species (O'Donnell, M. E., and Williams, C. H., Jr.
      (1984) J. Biol. Chem. 259, 2243-2251). The spectrum of one of these species of 1
      deaza-FAD-TRR(Ser135,Cys138) resembles the spectrum of oxidized 1-deaza-FAD bound
      to wild type apothioredoxin reductase. The other species has an absorbance
      spectrum with a single peak at 400 nm (epsilon 400 = 11,100 M-1 cm-1) and
      resembles the spectrum of a thiolate adduct at the C4a position of the 1-deaza
      FAD. The equilibrium between these species is pH-dependent, with a maximum of 50%
      C4a-adduct formation at low pH, and is linked to pK alpha values at 8.2 and 9.3.
      The absorbance spectrum of 4-thio-FAD-TRR(Cys135,Ser138) resembles the spectrum
      of the unbound 4-thio-FAD, whereas 4-thio-FAD-TRR(Ser135,Cys138) has a spectrum
      indicative of a mixture of 4-thio-FAD and FAD, suggesting a reaction between the
      4-position of the flavin and Cys138. The binding of 6-thiocyanato-FAD to the
      apoprotein of the mutated enzymes showed no evidence for a reaction between the
      thiols and the group at the 6-position of the flavin.

PMID- 2229056
TI  - Growth pattern of the murein sacculus of Escherichia coli.
AB  - The mechanism by which the murein sacculus of Escherichia coli is being enlarged
      during growth was investigated by pulse and pulse-chase labeling with
      [3H]diaminopimelic acid. Changes in the composition of the sacculus during aging
      were analyzed in detail by high performance liquid chromatography separation of
      the muropeptide subunits released after complete muramidase digestion. After
      pulses as short as 10 s, a group of novel phosphorylated muropeptides was
      detected. The kinetics of their appearance is consistent with these structures
      being derived from the undecaprenylphosphate-linked growing points of murein. A
      complex maturation process of murein took place including a rapid decay of
      pentapeptide side chains and a 10-fold increase in tripeptidyl moieties. In
      addition, the total degree of cross-linkage increased from 16 to 25%, partly due
      to a 3-fold increase in the formation of LD-A2pm-A2pm cross-links. In pulse-chase
      experiments the cross-linkage started to decrease after a maximum at about 35 min
      of chase. The kinetics in the distribution of the radioactivity among acceptor
      and donor part in the major cross-bridges Tetra-Tetra and Tetra-Tri differed from
      each other substantially, indicating that the latter structure is completely
      cleaved within three generations, whereas only 40% of Tetra-Tetra is cleaved
      during the same time. Furthermore, the attachment of the lipoprotein to murein
      was delayed by about one generation. It is proposed that these findings reflect
      an inside-to-outside growth mechanism of the murein sacculus of E. coli.

PMID- 2229057
TI  - Important role of arginine 129 in heparin-binding site of antithrombin III.
      Identification of a novel mutation arginine 129 to glutamine.
AB  - An hereditary abnormal antithrombin III (ATIII Geneva) with defective heparin
      cofactor activity was characterized by DNA single strand amplification and
      subsequent direct sequencing. ATIII Geneva was found to have a G to A transition
      in Exon IIIa leading to an Arg-129 to Gln mutation. This amino acid is part of
      the ATIII region comprising residues 114-154, which contains the highest
      proportion of basic residues (Arg or Lys), and is known from chemical
      modification studies to be involved in heparin binding. The variant protein did
      not bind heparin-Sepharose and was isolated from the propositus plasma by
      immunoaffinity chromatography. High affinity (for ATIII) heparin had only a
      minimal effect on thrombin and activated factor X inhibition by the purified
      abnormal ATIII. Taken together, these results demonstrate an important role for
      Arg-129 in the binding and interaction of ATIII with heparin of high affinity. We
      propose that a cooperation between Lys-125, Arg-129, Lys-136, and Arg-47 exposed
      at the surface of the inhibitor allows the binding of the essential
      pentasaccharide domain of heparin which is specific for the ATIII interaction.

PMID- 2229058
TI  - Characterization of bacteriophage T4 regA protein-nucleic acid interactions.
AB  - The bacteriophage T4 regA protein is a translational repressor of a group of T4
      early mRNAs. We have characterized the binding of regA protein to polynucleotides
      and to specific RNAs. Binding to nucleic acids was monitored by the quenching of
      the intrinsic tryptophan fluorescence of regA protein. regA protein exhibited
      differential affinities for the polynucleotides examined, with the order of
      affinity being poly(rU) greater than poly(dT) greater than poly(dU) = poly(rG)
      greater than poly(rC) = poly(rA). The binding site size calculated for regA
      protein binding to poly(rU) was n = 9 +/- 1 nucleotides. Cooperativity was
      observed in binding to multiple-site oligonucleotides, with a cooperativity
      parameter (omega) value of 10-22. To study the specific interaction between regA
      protein and T4 gene 44 mRNA, the affinity of regA protein for synthetic gene 44
      RNA fragments was measured. The association constant (Ka) for regA protein
      binding to gene 44 RNA fragments was 100-fold higher than for binding to
      nontarget RNA. Study of variant gene 44 RNA fragments indicated that the
      nucleotides required for specific binding are contained within a 12-nucleotide
      sequence spanning -12 to -1, relative to the AUG codon. The bases of five
      nucleotides (indicated in upper case type) are critical for specific regA protein
      interaction with the gene 44 recognition element, 5'-aaUGAGgAaauu-3'. These
      studies further showed that formation of a regA protein-RNA complex involves a
      maximum of 2-3 ionic interactions and is primarily an enthalpy-driven process.

PMID- 2229059
TI  - Translation of c-myc mRNA is required for its post-transcriptional regulation
      during myogenesis.
AB  - During the differentiation of C2 myoblasts into differentiated myotubes, there is
      a marked decrease in the abundance of c-myc mRNA. c-myc transcription initiation
      and elongation do not change significantly, but the turnover of c-myc transcripts
      appears to be accelerated during differentiation. We examined the expression of
      several recombinant c-myc genes introduced into C2 cells by stable transfection
      and found that mRNAs containing the c-myc protein-coding region of exons 2 and 3
      are appropriately regulated; the upstream c-myc sequences, the long leader
      sequence encoded by c-myc exon 1, and the 3' untranslated region are dispensible
      for proper regulation. Regulation appears to affect c-myc transcripts that are
      bound to polyribosomes, and the mRNA from a gene with a point mutation in the
      translation initiation codon is no longer properly regulated. We conclude that
      down-regulation of c-myc expression during myogenesis is post-transcriptional and
      requires the presence of sequences encoding the c-myc protein in a form that can
      be translated.

PMID- 2229060
TI  - Murine complement C2 and factor B genomic and cDNA cloning reveals different
      mechanisms for multiple transcripts of C2 and B.
AB  - Murine genomic and cDNA clones were isolated to ascertain the mechanisms
      accounting for previously recognized multiple forms of complement C2 and factor B
      mRNA and to analyze structural similarities with the corresponding human gene
      products (C2, 74% and B, 85%, amino acid identity). Like the human Bf gene,
      murine Bf and C2 each consist of 18 exons with similar intron-exon organizations.
      The murine C2 gene (20 kilobases) is more than three times the size of Bf (6
      kilobases) due to the presence of large intronic segments separating the exons
      encoding the NH2-terminal binding and central (von Willebrand factor) domains.
      Evidence from cDNA clones shows that the two C2 transcripts are generated by an
      alternative splice at the donor site of exon 14 producing long and short C2 mRNA
      species that differ by 21 base pairs encoding a region within the binding pocket
      (amino acids 636-642 (GSTCKDH)) of the serine proteinase domain. Tissue-specific
      multiple factor B transcripts are generated by alternative transcriptional
      initiation. From the structure of these transcripts the predicted regulation of
      expression and rates of translation of B programmed by the short and long mRNA
      species may differ, but the polypeptides are identical. These data indicate that
      different molecular mechanisms account for the multiple forms of C2 and factor B
      mRNA and that the structure of the different transcripts predicts differences in
      function and expression of the respective gene products.

PMID- 2229061
TI  - Regulation of transcriptional initiation in yeast mitochondria.
AB  - We have investigated in vitro transcriptional initiation by purified yeast
      mitochondrial RNA polymerase using a variety of previously described promoter
      variants and dinucleotides corresponding to the first two transcript nucleotides.
      Regardless of the actual nucleotides that occupy the first two transcript
      positions, the rate of initiation increases with increasing concentrations of the
      first two ribonucleoside triphosphates up to 125 microM whereas elongation is
      carried out optimally with less than 10 microM. Under normal in vitro
      transcription conditions, mitochondrial RNA polymerase only employs the in vitro
      start site (+1 position), again without regard to the nucleotide at the position.
      Even with initiator dinucleotide monophosphates as primers, the polymerase is
      only capable of initiating transcription at this position and one other, i.e. 1
      base upstream (-1). Dinucleotides enhance transcription from partially active
      variant promoters (mutations around the initiation sites -3, -1, +1, +2),
      suggesting that these mutations reduce transcription by their effects on
      initiation. In contrast, inactive promoters (-7C, -6G, -4A, and -2A) are not
      active in the presence of initiating dinucleotide. We suggest that dinucleotides
      may function in one of three ways: (i) bypassing the energy barrier in forming
      the first internucleotide bond; (ii) stabilizing the initiation complex; or (iii)
      accelerating promoter clearance.

PMID- 2229062
TI  - The Ch21 protein, developmentally regulated in chick embryo, belongs to the
      superfamily of lipophilic molecule carrier proteins.
AB  - Ch21, a developmentally regulated low molecular weight protein observed in chick
      embryo skeletal tissues, is expressed "in vitro" by differentiating chondrocytes
      at a late stage of development. Here we report the complete amino acid sequence
      of the protein. 86% of the total amino acid sequence was deduced by sequences of
      17 high performance liquid chromatography-separated proteolytic fragments and 33
      amino acid residues at the amino-terminal end of protein purified from spent
      culture medium of hypertrophic chondrocytes. Furthermore we isolated by molecular
      cloning the corresponding cDNA and determined its nucleotide sequence. By
      combining protein and nucleotide sequence data we determined the primary
      structure of the entire Ch21. It consists of 158 amino acids and has a molecular
      mass of 18.065 kDa. Computer-assisted analysis showed that the Ch21 belongs to
      the superfamily of low molecular weight proteins sharing a basic framework for
      binding and transport of small hydrophobic molecules.

PMID- 2229063
TI  - Serum transferrin receptor is a truncated form of tissue receptor.
AB  - Recent studies have provided immunological evidence for the existence of
      transferrin receptor in human serum and have revealed that its concentration is a
      sensitive measure of erythropoiesis and iron deficiency. The present study was
      undertaken to establish the molecular identity of this immunoreactive component.
      Purification from human serum was accomplished by immunoaffinity chromatography
      using, as the ligand, monoclonal antitransferrin receptor antibody. The receptor
      preparation contained two major components with Mr of 75,000 and 85,000, which
      were identified as transferrin and transferrin receptor, respectively. The
      physicochemical and immunochemical properties of the 85,000 serum receptor were
      compared with those established for intact placental transferrin receptor. The
      serum receptor exhibited an apparent Mr = 85,000 on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis under non-reducing conditions, as compared
      with 190,000 for placental transferrin receptor. Upon reduction, the Mr of serum
      receptor was unaltered, whereas, the 190,000 placental receptor dimer decreased
      to the expected monomer value of 95,000. Amino-terminal amino acid sequence
      analysis revealed that residues 1-19 of serum receptor were identical to residues
      101-119 of intact receptor. These findings provide physicochemical evidence for
      the existence of transferrin receptor in human serum, establish its molecular
      identity as a truncated form lacking the cytoplasmic and transmembrane domains
      (residues 1-100) of intact receptor, and demonstrate that it exists as a
      transferrin-receptor complex in serum.

PMID- 2229064
TI  - Catalytic mechanism of xylose (glucose) isomerase from Clostridium
      thermosulfurogenes. Characterization of the structural gene and function of
      active site histidine.
AB  - The gene coding for thermophilic xylose (glucose) isomerase of Clostridium
      thermosulfurogenes was isolated and its complete nucleotide sequence was
      determined. The structural gene (xylA) for xylose isomerase encodes a polypeptide
      of 439 amino acids with an estimated molecular weight of 50,474. The deduced
      amino acid sequence of thermophilic C. thermosulfurogenes xylose isomerase
      displayed higher homology with those of thermolabile xylose isomerases from
      Bacillus subtilis (70%) and Escherichia coli (50%) than with those of
      thermostable xylose isomerases from Ampullariella (22%), Arthrobacter (23%), and
      Streptomyces violaceoniger (24%). Several discrete regions were highly conserved
      throughout the amino acid sequences of all these enzymes. To identify the
      histidine residue of the active site and to elucidate its function during
      enzymatic xylose or glucose isomerization, histidine residues at four different
      positions in the C. thermosulfurogenes enzyme were individually modified by site
      directed mutagenesis. Substitution of His101 by phenylalanine completely
      abolished enzyme activity whereas substitution of other histidine residues by
      phenylalanine had no effect on enzyme activity. When His101 was changed to
      glutamine, glutamic acid, asparagine, or aspartic acid, approximately 10-16% of
      wild-type enzyme activity was retained by the mutant enzymes. The Gln101 mutant
      enzyme was resistant to diethylpyrocarbonate inhibition which completely
      inactivated the wild-type enzyme, indicating that His101 is the only essential
      histidine residue involved directly in enzyme catalysis. The constant Vmax values
      of the Gln101, Glu101, Asn101, and Asp101 mutant enzymes over the pH range of 5.0
      8.5 indicate that protonation of His101 is responsible for the reduced Vmax
      values of the wild-type enzyme at pH below 6.5. Deuterium isotope effects by D-[2
      2H]glucose on the rate of glucose isomerization indicated that hydrogen transfer
      and not substrate ring opening is the rate-determining step for both the wild
      type and Gln101 mutant enzymes. These results suggest that the enzymatic sugar
      isomerization does not involve a histidine-catalyzed proton transfer mechanism.
      Rather, essential histidine functions to stabilize the transition state by
      hydrogen bonding to the C5 hydroxyl group of the substrate and this enables a
      metal-catalyzed hydride shift from C2 to C1.

PMID- 2229065
TI  - Interaction of lipoproteins with isolated ovary plasma membranes.
AB  - Plasma membranes of ovarian luteal and adrenal cortical cells from "microvillar
      channels," a unique extracellular compartment formed by the close apposition of
      flattened microvillar surfaces. Microvillar channels have unusual affinity for
      cholesterol-rich lipoproteins, and, in vivo, may provide an increased surface
      area for these particles. In this research, we have isolated a plasma membrane
      enriched fraction from rat luteinized ovaries, in which closely apposed membrane
      (i.e. microvillar channels) comprise about 30% of the preparation. Following in
      vitro incubations (approximately 1 h) of this plasma membrane fraction with
      different plasma lipoproteins, the closely apposed plasma membrane surfaces widen
      and become filled with lipoprotein particles (up to about 30 nm), whereas other
      membranes of the fraction show little binding. Competition experiments show that
      rat high density lipoproteins have the highest affinity for binding to the plasma
      membrane fraction. Radiolabeled plasma lipoprotein and the tissue-specific
      hormone, human chorionic gonadotropin, showed specific and saturable binding to
      the plasma membrane fraction, whereas other macromolecules used as controls did
      not. Radioautographic analyses of 125I-labeled lipoproteins and human chorionic
      gonadotropin indicate that binding occurs predominantly to the closely apposed
      plasma membranes (i.e. microvillar channels of the fraction). These studies show
      that microvillar channels of steroid-secreting cells entrap large numbers of
      plasma lipoproteins, particularly high density lipoproteins particles, presumably
      functioning in the delivery of cholesterol to these cells.

PMID- 2229066
TI  - Mechanisms involved in the transcriptional activation of proenkephalin gene
      expression in bovine chromaffin cells.
AB  - Stimulation of cultured bovine chromaffin cells with histamine (10(-5) M),
      nicotine (10(-6) M), and veratridine (2 x 10(-6) M) results in a time-dependent
      up to 5-fold increase in proenkephalin (Penk) mRNA levels. After an initial lag
      phase (with no major alterations) Penk mRNA increased markedly between 6 and 12 h
      followed by a slower, steady increase up to 48 h. The nicotinic receptor
      antagonist tubocurarine (4 x 10(-7) M) and the Ca2+ channel blocker D600 (10(-5)
      M) prevent the subsequent rise of Penk mRNA levels after challenge with nicotine,
      when given within the lag phase (0-6 h), suggesting the need of continuous
      receptor occupation and Ca2+ entry for induction of gene expression. Similarly,
      incubation of chromaffin cells with cycloheximide (10(-6) M), given at 0-6 h,
      blocks the increase in Penk mRNA after stimulation with histamine and nicotine
      indicating that ongoing protein synthesis is necessary for the delayed rise of
      Penk mRNA. Nuclear run-off experiments revealed high transcription levels of the
      Penk gene (3-fold at 2 h) and the tyrosine hydroxylase gene (7-fold at 20 min)
      following stimulation with histamine, which was not observed in the presence of
      cycloheximide (10(-5) M). A more rapid induction of transcription was measured
      for the c-fos gene after histamine stimulation (high levels after 12 min)
      followed by c-fos mRNA accumulation (about 20-fold after a 1-h stimulation),
      which was superinduced when cells were pretreated with cycloheximide. The half
      life of Penk mRNA levels (about 12 h), however, seems not to be affected by
      histamine as suggested by measurement of the subsequent decay of Penk mRNA levels
      after addition of alpha-amanitin or alpha-amanitin and cycloheximide. Thus,
      activation of Penk gene expression upon neurotransmitter challenge is suggested
      to be due to an enhanced transcriptional activity of the gene mediated by de novo
      synthesized protein (-like) factors.

PMID- 2229067
TI  - Characterization of U6 small nuclear RNA cap-specific antibodies. Identification
      of gamma-monomethyl-GTP cap structure in 7SK and several other human small RNAs.
AB  - The cap structure in human U6 small nuclear (sn)RNA, gamma-monomethylguanosine
      triphosphate (meGTP), was conjugated to human serum albumin and used as antigen
      to raise polyclonal antibodies in rabbits. The resulting antibodies reacted
      specifically with meGTP but not with GTP, GDP, GMP, meGMP, meATP, meCTP, meUTP,
      or with methyl phosphate in enzyme-linked immunosorbent assay and/or in
      radioimmunoassays. Although less efficiently, meGDP was also recognized by these
      antibodies. Indirect immunofluorescence studies with anti-meGTP antibodies showed
      predominantly nuclear immunofluorescence. Anti-meGTP antibodies
      immunoprecipitated intact U6 snRNA from a mixture of HeLa cell RNAs. In addition
      to the U6 snRNA, anti-meGTP antibodies immunoprecipitated several additional
      small RNAs that varied in length from approximately 50 to 330 nucleotides. These
      RNAs contained the meGTP cap structure and are structurally distinct from U6
      snRNA. One of these meGTP-containing RNAs was found to be previously
      characterized 7SK RNA; human 7SK RNA synthesized in vitro also contained the same
      cap structure. Results obtained in this study provide evidence for the presence
      of gamma-monomethyl-GTP cap structure in a wide spectrum of human cellular RNAs.
      These antibodies will be useful in studying the structure and function of this
      new family of small RNAs.

PMID- 2229068
TI  - Expression of human immunodeficiency virus 1 (HIV-1) envelope gene products
      transcribed from a heterologous promoter. Kinetics of HIV-1 envelope processing
      in transfected cells.
AB  - The expression of human immunodeficiency virus 1 (HIV-1) envelope glycoprotein
      products was studied in cells transfected with env gene constructs transcribed
      from an SV40 promoter. Gene constructs possessing the complete tat, rev (tat+
      rev+) and env genes were transiently expressed in COS-1 cells as precursor SU-TM
      (gp160), SU.TM (gp120 x 41), and nucleolar rev protein. In addition, envelope
      glycoprotein was detected on the surface of those transfected COS-1 cells
      expressing abundant levels of env protein. Transfected constructs possessing a
      mutated tat translational initiation codon (tat-rev+) were expressed in COS-1
      cells with at least a 10-fold increase in the level of envelope glycoprotein
      expression compared to the analogous constructs with an intact tat AUG codon
      (tat+ rev+). Mutation of the rev initiation codon (tat+ rev-) and (tat-rev-)
      resulted in no detectable expression of env products but expression of these
      proteins could be rescued by co-transfection of a cDNA encoding the rev gene.
      Subgenomic tat/rev transcripts were detected following transfection of all of the
      gene constructs indicating splicing of the env mRNAs transcribed from a
      heterologous promoter. Unspliced env transcripts were only detected in the
      cytoplasm of cells transfected with (rev+) constructs or with the (tat- rev-)
      construct in the presence of the rev cDNA supplied in trans. In contrast,
      unspliced transcripts were detected in the nuclear and total cellular RNA of all
      transfected cells. Expression of rev protein was localized to the nucleolus of
      transfected COS-1 cells. These results indicate that the export of unspliced env
      mRNA to the cytoplasm is facilitated by the expression of rev. Following env
      synthesis, the conversion of SU-TM (gp160) to SU.TM (gp120 x 41) was not
      quantitative. After a 20-h pulse-chase, only 40% of the SU-TM (gp160) present at
      the start of the chase period was subsequently accountable as mature SU (gp120),
      and approximately 30% of the detectable SU (gp120) was found in the culture
      medium of transfected COS-1 cells. The findings indicate that the surface
      expression of SU.TM (gp120 x 41) derived from heterologous gene transcripts is
      modulated (i) the co-expression of rev, (ii) the efficiency of proteolytic
      processing of SU-TM (gp160), and (iii) the degree of SU (gp120) shedding and/or
      secretion from the cell.

PMID- 2229069
TI  - Retinoylation of HL-60 proteins. Comparison to labeling by palmitic and myristic
      acids.
AB  - Recent studies suggest that a retinoic acid (RA) nuclear receptor or a
      retinoylated nuclear protein may be involved in the action of RA. We showed
      previously (Takahashi, N., and Breitman, T. R. (1989) J. Biol. Chem. 264, 5159
      5163) that retinoylation involves the formation of a thioester bond and occurs on
      protein in newly formed cells and in pre-existing cells. In this study, we saw at
      least 14 retinoylated proteins in HL-60 cells. Greater than 90% of the
      retinoylation was associated with the nuclear protein described previously. This
      protein, partially purified from isolated nuclei, bound to DNA-cellulose and was
      eluted with NaCl. Retinoylation occurred in HL-60 cells exposed to cycloheximide.
      Thus, retinoylation resembled palmitoylation, both in the covalent bond and the
      exchangeable reaction involving preformed protein. These similarities prompted us
      to compare retinoylation with two other fatty acylations in growing HL-60 cells.
      We found that the major retinoylated protein was labeled by either radioactive
      palmitic acid or myristic acid. The extent of [3H]palmitic acid labeling of this
      protein was not reduced by growth in the presence of RA. The extent of
      retinoylation of this protein was not reduced by growth in the presence of
      increasing concentrations of palmitic acid. These results raise the possibility
      that the same protein is a substrate for retinoylation, palmitoylation, and
      myristoylation.

PMID- 2229070
TI  - Large scale purification and immunolocalization of bovine uroplakins I, II, and
      III. Molecular markers of urothelial differentiation.
AB  - The differentiation of mammalian urothelium culminates in the formation of
      asymmetrical unit membrane (AUM). Using gradient centrifugation and detergent
      wash, we purified milligram quantities of AUMs which, interestingly, contained
      three major proteins (15, 27, and 47 kDa) that appeared to be identical to the
      three immunoaffinity purified, putatively AUM-associated proteins that we
      described earlier (Yu, J., Manabe, M., Wu, X.-R., Xu, C., Surya, B., and Sun, T.
      T. (1990) J. Cell Biol., 111, 1207-1216). Peptide mapping and immunoblotting
      established that these three proteins were distinct molecules. Using monospecific
      antibodies to these three proteins, we showed that they were all restricted to
      the superficial urothelial cells and were AUM-associated. The 27- and 15-kDa
      proteins were detected exclusively on the luminal side of mature, apical AUMs. In
      contrast, epitopes of the 47-kDa protein were detected on both sides of apical
      AUMs suggesting a transmembranous configuration. These results (i) provide the
      strongest evidence thus far that AUM contains three major proteins (the 27-kDa
      uroplakin I, 15-kDa uroplakin II, and 47-kDa uroplakin III) which form an
      extremely insoluble complex, (ii) suggest that uroplakin II, like uroplakin I
      (Yu, J., Manabe, M., Wu, X.-R., Xu, C., Surya, B., and Sun, T.-T. (1990) J. Cell.
      Biol. 111, 1207-1216), translocates from one side of the membrane to another
      during AUM maturation, (iii) indicate that uroplakin III may play a different
      structural role than uroplakins I and II in AUM formation, and (iv) establish the
      three uroplakins as markers for an advanced stage of urothelial differentiation.

PMID- 2229071
TI  - The mitochondrial tRNAs of Trypanosoma brucei are nuclear encoded.
AB  - The mitochondrial DNA of Trypanosoma brucei is organized as a catenated network
      of maxicircles and minicircles. The maxicircles are equivalent to the typical
      mitochondrial genome except that the genes for the mitochondrial tRNAs have not
      been identified by sequence analysis of the maxicircle DNA. The apparent absence
      of tRNA genes in the maxicircle DNA suggests that the mitochondrial tRNAs are
      encoded by either the minicircle or the nuclear DNA. In order to determine their
      genomic origin, we isolated and identified the mitochondrial tRNAs of T. brucei.
      We show that these mitochondrial tRNAs are truly mitochondrially located in vivo
      and that they are free from detectable contamination by cytosolic RNAs. By
      hybridization analysis, using mitochondrial tRNAs as the probe, we determined
      that the mitochondrial tRNAs are encoded by nuclear DNA. This implies that RNAs,
      like proteins, are imported into the mitochondria. We investigated the
      relationship between the cytosolic and the mitochondrial tRNA genes and show that
      there are unique cytosolic tRNA genes, unique mitochondrial tRNA genes, and tRNA
      genes which appear to be shared and whose products are therefore targeted to both
      the cytosol and the mitochondrion.

PMID- 2229072
TI  - The MAS-encoded processing protease of yeast mitochondria. Overproduction and
      characterization of its two nonidentical subunits.
AB  - The amino-terminal presequences of proteins imported from the cytoplasm across
      the mitochondrial inner membrane are cleaved off by a soluble matrix-localized
      protease composed of two nonidentical homologous subunits. In the yeast
      Saccharomyces cerevisiae, these are encoded by the nuclear MAS1 and MAS2 genes.
      We have now constructed yeast strains in which either one or both of the genomic
      MAS genes are controlled by a galactose-inducible strong promoter. In these
      strains, the intramitochondrial concentration of each MAS-encoded subunit as well
      as of the holo-protease can be varied over a wide range. When overproduced, the
      MAS1 protein precipitates in the matrix whereas the MAS2 protein remains soluble.
      The MAS2 protein was obtained at a purity of 98% in milligram amounts. The
      purified MAS2 subunit exists largely as a soluble 52-kDa monomer. Its cleavage
      activity is very low and might well reflect the 2% contamination by holoprotease.
      Activity is restored by adding the solubilized purified MAS1 subunit. Yeast cells
      depleted of one or both MAS subunits continue to import precursor proteins into
      mitochondria, but fail to cleave them; eventually the deficient cells stop
      growing. This growth arrest is partly suppressed on minimal medium or under
      conditions in which the cells are less dependent on mitochondrial metabolism.
      Depletion of the MAS1 subunit causes overproduction of the MAS2 subunit.

PMID- 2229073
TI  - A second fibronectin-binding region is present in collagen alpha chains.
AB  - The interactions of plasma fibronectin with alpha chains or cyanogen bromide
      fragments of collagen types I and II have been studied using a variety of
      techniques. Affinity chromatography of cyanogen bromide-cleaved type II collagen
      on immobilized fibronectin revealed the binding of cyanogen bromide fragment CB12
      in addition to the previously characterized CB10. Using fluorescence
      polarization, we analyzed the interaction between the collagen peptides and
      fluorescein isothiocyanate-labeled 42-kDa gelatin-binding fragment of fibronectin
      in solution. Dissociation constants for the binding of CB10 and CB12 to the
      fibronectin fragment were calculated as 0.38 and 0.94 microM, respectively,
      indicating a lower affinity for the uncharacterized site. However, as with CB10,
      CB12 was able to compete effectively with the intact alpha chain for bindinng to
      fibronectin. Additionally, both CB10 and CB12 absorbed to tissue culture surfaces
      were each able to support fibronectin-dependent cell adhesion. Finally, the
      regions of alpha 2(I) homologous to CB12 and CB10 were found to be active in
      fibronectin binding, demonstrating the presence of two fibronectin-binding
      regions in this collagen chain.

PMID- 2229074
TI  - Aggregated dnaA protein is dissociated and activated for DNA replication by
      phospholipase or dnaK protein.
AB  - dnaA protein isolated from Escherichia coli is equally distributed between a
      monomeric form, which is active for initiation of DNA replication, and an
      inactive, aggregated form which contains phospholipids. Replication activity of
      the aggregated form can be restored by treatments with either dnaK protein or
      phospholipase A2. Dissociation of the aggregate by dnaK protein is driven by ATP
      hydrolysis; action by phospholipase A2 requires a minute concentration of ATP
      only to stabilize the dissociated protein. Conversion of inactive dnaA
      phospholipid complexes to the active form may contribute to the regulation of the
      initiation of chromosomal replication in E. coli.

PMID- 2229075
TI  - Apolipoprotein B messenger RNA editing in the rat liver. Modulation by fasting
      and refeeding a high carbohydrate diet.
AB  - Apolipoprotein B (apoB) mRNA is modified by a posttranscriptional editing
      reaction in which a single base (C to U) change in apoB100 mRNA modifies a
      glutamine (CAA) to a translational stop codon (UAA), producing apoB48 mRNA in
      mammalian intestine. Rat liver normally contains both edited and unedited apoB
      mRNAs and previous work (Davidson, N. O., Powell, L. M., Wallis, S. C., and
      Scott, J. (1988) J. Biol. Chem. 263, 13482-13485) has demonstrated that the
      introduction of a translational stop codon can be modulated by thyroid hormone.
      In the current study, hepatic lipogenesis was modulated in vivo by fasting and
      refeeding a high carbohydrate diet, a maneuver which produced a 30-fold increase
      in hepatic triglyceride content. In this setting, hepatic apoB100 synthesis
      became undetectable in animals subjected to 48 h fasting and subsequently refed a
      high carbohydrate diet for either 24 or 48 h. This change was accountable for by
      an increase in the proportion of edited apoB mRNA, as determined by primer
      extension analysis, from 37% UAA in fasted animals to 79 and 91% UAA at 24 and 48
      h of refeeding, respectively. The effect of this regimen on the expression of
      other hepatic apolipoprotein genes was less dramatic. ApoA-I and apoA-IV gene
      expression was modulated over a 2-fold range, in contrast to the (6-14-fold)
      pretranslational changes induced by thyroid hormone administration. ApoCIII mRNA
      abundance was unaltered in the setting of either fasting and refeeding or thyroid
      hormone administration, while apoE gene expression demonstrated a
      pretranslational increase following prolonged fasting. Taken together the data
      provide evidence that apoB mRNA editing is modulated by alterations in hepatic
      lipogenesis which additionally produce effects on the expression of other hepatic
      apolipoprotein genes suggesting that they are not coordinately regulated in vivo.

PMID- 2229076
TI  - Reconstitution of the uncoupling protein of brown adipose tissue mitochondria.
      Demonstration of GDP-sensitive halide anion uniport.
AB  - The fluorescent anion indicator 6-methoxy-N-(3-sulfopropyl)quinolinium was
      trapped in proteoliposomes reconstituted with purified 32-kDa uncoupling protein
      and used to detect GDP-sensitive uniports of Cl-, Br-, and I-. Transport of these
      halide anions was rapid and potential-dependent. F- and nitrate were found to
      inhibit Cl- uptake competitively, suggesting that these anions are also
      substrates for transport. This preparation also exhibited H+(OH-) transport,
      showing that the reconstituted uncoupling protein possesses both halide and H+
      transport functions, as is observed in intact brown adipose tissue mitochondria.
      Cl- transport was inhibited to the residual level observed in liposomes without
      protein when GDP was present on both sides of the membrane. Cl- transport was
      inhibited by about 50% when GDP was present only on one side of the membrane. We
      infer that uncoupling protein reconstitutes into proteoliposomes with a 1:1 ratio
      of sidedness orientation. The Km values for Cl- uniport were 100 and 65 mM,
      respectively, in GDP-loaded and non-GDP-loaded vesicles. Participation of the
      inner membrane anion channel in the observed transport is rendered unlikely by
      the fact that this carrier is insensitive to GDP. A variety of additional
      experiments probing for inner membrane anion channel yielded uniformly negative
      results, confirming the absence of contamination by this protein. Our results
      therefore demonstrate that the uncoupling protein mediates anion translocation, a
      function previously reported as lacking in the reconstituted system.

PMID- 2229077
TI  - New substrates and competitive inhibitors of the Cl- translocating pathway of the
      uncoupling protein of brown adipose tissue mitochondria.
AB  - A large number of new substrates for anion uniport by the uncoupling protein of
      brown adipose tissue mitochondria have been found. These include alkylsulfonates,
      alkylsulfates and their derivatives, benzenesulfonate, oxohalogenides,
      hypophosphate, hexafluorophosphate, and pyruvate. Although the spectrum of anion
      selectivity is far wider than had previously been suspected, there are strong
      structural requirements for transport. The anion must be monovalent, and polar
      groups must not be attached to alkyl or aryl chains. The most striking finding is
      that transport increases dramatically with anion hydrophobicity. Anions that are
      transported are shown to compete with Cl- for transport by the reconstituted
      uncoupling protein. For each anion, the Ki for GDP inhibition of transport
      increases with its rate of transport and correlates inversely with its Ki for
      competitive inhibition of Cl- transport. For alkylsulfonates, transport rate, Ki
      for GDP inhibition, and Ki for inhibition of Cl- transport each depend
      monotonically on alkyl chain length. These findings suggest several new
      hypotheses relating to the molecular mechanism of transport through uncoupling
      protein and suggest explanations for observed functional differences among
      porters belonging to the same gene family.

PMID- 2229078
TI  - Purification and characterization of sea urchin initiation factor 2. The
      requirement of guanine nucleotide exchange factor for the release of eukaryotic
      polypeptide chain initiation factor 2-bound GDP.
AB  - Protein synthesis in sea urchin eggs is stimulated dramatically upon
      fertilization. We previously demonstrated that this stimulation is primarily due
      to an increase in the rate of polypeptide chain initiation which in turn may be
      regulated at the level of recycling of eukaryotic initiation factor 2 (eIF-2)
      (Colin, A. M., Brown, B. D., Dholakia, J. N., Woodley, C. L., Wahba, A. J., and
      Hille, M. B. (1987) Dev. Biol. 123, 354-363). We have now purified eIF-2 from sea
      urchin Strongylocentrotus purpuratus blastulae to apparent homogeneity by
      chromatography on DEAE-cellulose, phosphocellulose, Mono Q, Mono P, and Mono S
      columns. The factor, which differs from mammalian eIF-2, is composed of three non
      identical subunits with apparent molecular weights of 40,000-alpha; 47,000-beta,
      and 58,000-gamma as estimated by sodium dodecyl-polyacrylamide gel
      electrophoresis. Antibodies raised against rabbit reticulocyte eIF-2 do not cross
      react with sea urchin eIF-2. The binding of Met-tRNA(f) to sea urchin eIF-2 is
      totally dependent on GTP. A 4-fold stimulation in the rate of protein synthesis
      in unfertilized sea urchin egg extracts is observed by the addition of 1
      micrograms of purified eIF-2. The factor also binds GDP to form a binary (eIF
      2.GDP) complex which is stable in the presence of Mg2+. GDP binding to sea urchin
      eIF-2 inhibits ternary (eIF-2-GTP.[35S]Met-tRNA(f) complex formation. The rabbit
      reticulocyte guanine nucleotide exchange factor (GEF) catalyzes the exchange of
      GDP bound to sea urchin eIF-2 for GTP and stimulates ternary complex formation.
      The requirement of GEF for the recycling of eIF-2 suggests that protein synthesis
      in sea urchins is similar to that in mammalian systems and may also be regulated
      at the level of GEF activity. The reticulocyte heme-controlled repressor
      phosphorylates the alpha-subunit of eIF-2 from both sea urchins and rabbit
      reticulocytes. However, casein kinase II which phosphorylates the beta-subunit of
      the reticulocyte factor specifically phosphorylates the alpha-subunit of sea
      urchin eIF-2. In this respect, the sea urchin factor is similar to eIF-2 isolated
      from other nonmammalian sources. Since both heme controlled repressor and casein
      kinase II phosphorylate the alpha-subunit of sea urchin eIF-2 caution should be
      exercised when interpreting the significance of eIF-2(alpha) phosphorylation in
      sea urchins.

PMID- 2229079
TI  - Thyrotropin modulates low density lipoprotein binding activity in FRTL-5 thyroid
      cells.
AB  - FRTL-5 cells possess high affinity low density lipoprotein (LDL) receptors which
      bind, internalize, and degrade LDL. When FRTL-5 cells are deprived of thyrotropin
      (TSH) the binding of LDL increases more than 2-fold. Upon addition of TSH, at a
      concentration of 1 x 10(-10) M or greater, LDL binding decreases rapidly and
      within 24 h reaches the level which is typical of FRTL-5 cells chronically
      stimulated by TSH. The data available suggest that TSH-dependent down-regulation
      of LDL receptor activity is exerted through a reduction of the number of active
      LDL receptors, with no change in affinity. It is unlikely that the synthesis of
      LDL receptors is impaired, since LDL receptor messenger RNA is not decreased by
      TSH. The effect of the hormone on LDL receptor activity can be mimicked by 8-Br
      cAMP and is completely abolished by the protein synthesis inhibitor cycloheximide
      but not by actinomycin D. TSH regulation of LDL receptor activity is lost in v
      ras Ki-transformed FRTL-5 cells (Ki Mol) which also have lost TSH dependence for
      adenylate cyclase activation and growth. However, 8-Br-cAMP decreases LDL binding
      in Ki Mol FRTL-5 cells. The reduced availability of LDL receptor in TSH
      stimulated FRTL-5 cells may be related to the increased membrane fluidity
      (Beguinot, F., Beguinot, L., Tramontano, D., Duilio, C., Formisano, S., Bifulco,
      M., Ambesi-Impiombato, F. S., and Aloj, S. M. (1987) J. Biol. Chem. 262, 1575
      1582) or may reflect increased degradation of LDL receptors. We propose that a
      lower cholesterol uptake is needed in an actively proliferating cell population,
      to increase the production of isoprenoids whether it be for cholesterol
      biosynthesis or for the synthesis of other compounds requiring isoprenoid
      precursors.

PMID- 2229080
TI  - Cell cycle progression and 3-hydroxy-3-methylglutaryl coenzyme A reductase are
      regulated by thyrotropin in FRTL-5 rat thyroid cells.
AB  - The incorporation of [14C]acetate into cholesterol shows that FRTL-5 cells
      possess an active cholesterol biosynthetic pathway. When these cells were made
      quiescent, and synchronized by thyrotropin (TSH) starvation, in the presence of
      low serum (0.2%), addition of this hormone increased acetate conversion into
      cholesterol up to a maximum of 8-fold. Feedback inhibition of sterol synthesis by
      exogenous cholesterol occurs in FRTL-5 cells since, in the presence of higher
      serum concentration (5%), acetate conversion into cholesterol was significantly
      depressed. Even in high serum TSH increased sterol synthesis, albeit to a lesser
      extent. The time course of the TSH effect on cholesterol synthesis, strongly
      suggests that this process is necessary for quiescent FRTL-5 cells to enter the
      cell cycle. Thus, the rate of cholesterol synthesis was maximal 12-16 h after TSH
      challenge and declined thereafter, returning to levels slightly above the basal
      at 48 h. Thymidine incorporation into DNA, measured under identical conditions of
      TSH starvation/challenge, increased after 20 h, was maximal at 36 h, and returned
      to pre-TSH level at 70 h. The effect of TSH on cholesterol synthesis is not a
      general feature of lipid synthesis in FRTL-5 since [14C]acetate incorporation
      into triglycerides after TSH treatment has a different magnitude and time course.
      TSH increases cholesterol synthesis through the induction of the enzyme 3-hydroxy
      3-methylglutaryl coenzyme A reductase. This is due to an increase in the level of
      3-hydroxy-3-methylglutaryl-CoA reductase messenger RNA up to 8-fold caused by a
      proportional increase in the rate of gene transcription, as assessed by nuclear
      "run on" experiments. The effect of TSH on cholesterol synthesis and reductase
      gene expression is likely to be mediated by cAMP since 8-bromo-cAMP mimicked the
      effect of the hormone. The data presented suggest that an active cholesterol
      biosynthetic pathway is required for DNA synthesis to occur.

PMID- 2229081
TI  - A human ubiquitin carboxyl extension protein functions in yeast.
AB  - The ability of the human ubiquitin carboxyl extension protein (HUBCEP80) to
      functionally replace its yeast homolog was determined in a ubi3 mutant of
      Saccharomyces cerevisiae. Expression of HUBCEP80 in ubi3 mutants resulted in
      processing of the fusion protein to produce free ubiquitin and extension protein,
      the latter of which localized specifically with the 40 S ribosomal subunit.
      Furthermore, expression of the human fusion protein completely alleviated the
      phenotypic deficiencies found in ubi3 mutants, including slow growth, abnormal
      ribosomal RNA processing, and correspondingly low levels of 40 S ribosomal
      subunits. Finally, expression of the extension protein alone was much less
      efficient in complementing the ubi3 mutant phenotype as compared with expression
      of the normal ubiquitin-fused extension protein. In the latter case, cells were
      found to contain at least 5-fold more extension protein, suggesting that
      ubiquitin either increased translational efficiency of the HUBCEP80 transcript or
      increased the stability of the processed extension protein.

PMID- 2229082
TI  - Surface array protein of Campylobacter fetus. Cloning and gene structure.

PMID- 2229083
TI  - Wrist loading patterns during pommel horse exercises.
AB  - Gymnastics is a sport which involves substantial periods of upper extremity
      support as well as frequent impacts to the wrist. Not surprisingly, wrist pain is
      a common finding in gymnasts. Of all events, the pommel horse is the most
      painful. In order to study the forces of wrist impact, a standard pommel horse
      was instrumented with a specially designed load cell to record the resultant
      force of the hand on the pommel during a series of basic skills performed by a
      group of seventeen elite male gymnasts. The highest mean peak forces were
      recorded during the front scissors and flair exercises (1.5 BW) with peaks of up
      to 2.0 BW for some gymnasts. The mean peak force for hip circles at the center or
      end of the horse was 1.1 BW. The mean overall loading rate (initial contact to
      first loading peak) ranged from 5.2 BWs-1 (hip circles) to 10.6 BW s-1 (flairs).
      However, many recordings displayed localized initial loading spikes which
      occurred during 'hard' landings on the pommel. When front scissors were performed
      in an aggressive manner, the initial loading spikes averaged 1.0 BW in magnitude
      (maximum 1.8 BW) with an average rise time of 8.2 ms; calculated localized
      loading rates averaged 129 BW s-1 (maximum 219 BW s-1). These loading parameters
      are comparable to those encountered at heel strike during running. These impact
      forces and loading rates are remarkably high for an upper extremity joint not
      normally exposed to weight-bearing loads, and may contribute to the pathogenesis
      of wrist injuries in gymnastics.

PMID- 2229084
TI  - Pressure distribution on articular surfaces: application to joint stability
      evaluation.

PMID- 2229085
TI  - Effects of simulated weightlessness on bone properties in rats.

PMID- 2229086
TI  - Pulsatile two-dimensional flow and plaque formation in a carotid artery
      bifurcation.
AB  - Velocity and pressure fields, streamlines and wall shear stress distributions
      were numerically obtained for two-dimensional, steady and pulsatile flow in a
      carotid artery segment. Distinct regions of reverse flow near the bifurcation and
      wavy flow patterns in the branching channels were observed during portions of the
      pulse. These phenomena disappear at the end of the systolic phase of the cardiac
      cycle. A previously validated plaque formation model predicts that plaque sites
      and the local extent of atherosclerotic lesions are similar for those present on
      human angiograms.

PMID- 2229087
TI  - Estimating segment inertial properties: comparison of magnetic resonance imaging
      with existing methods.
AB  - To explore magnetic resonance imaging (MRI) as the basis of a technique for
      estimating body segment inertial properties directly on subjects, MRI-based
      estimates were compared with those generated with more traditional methods. The
      sensitivity of mass, center of mass location, and moment of inertia estimates to
      the estimation methods and the distribution of muscle, bone, and fat tissues in
      the lower leg were also evaluated. A series of transverse plane images spaced 2.5
      cm apart on the right lower leg of 12 adult males were taken, using MRI. Cross
      sectional area data determined from the images served as the basis of the
      inertial calculations. MRI-based estimates for mass, center of mass location, and
      moment of inertia about a transverse axis through the center of mass all fell
      within the range of values obtained with other methods. While the center of mass
      position was similar for all estimation methods, MRI-based estimates of lower leg
      mass and moment of inertia showed considerable variability among methods. In
      addition, MRI mass and moment of inertia values were higher than those from most
      of the other prediction methods. It is suggested that the higher MRI-based
      estimates for these descriptors may be reasonable when age and structural
      differences between young adult runners and cadaver specimens for the comparison
      studies are considered. These results provide further support for MRI as a means
      of generating valid inertial property estimates.

PMID- 2229088
TI  - The decomposition of apparent stresses in disturbed pulsatile flow in the
      presence of large scale organized structures.
AB  - Flow disturbance phenomena that occur in unsteady-in-the-mean flows (i.e.
      pulsatile or oscillating) at moderate Reynolds numbers are analyzed in both the
      time domain and the frequency domain. The analysis utilizes variable
      decomposition into a time-varying underlying waveform and flow disturbances which
      are composed of large scale organized structures and random fluctuations. A
      practical technique which incorporates time domain phase conditioning, trend
      removal, and frequency domain matched filtering, is presented and examined using
      simulated data of known statistical behavior. The applicability of the method is
      shown by the decomposition of the simulated data and the technique is then
      applied to experimental data obtained in pulsatile flow through a constricted
      tube by means of a laser Doppler anemometer. The cross-sectional area reduction
      at the constriction throat was 90%. The Womersley parameter in the experiments
      was 5.3 and the Reynolds number based on the average flow rate per cycle was 300
      with a minimum/maximum value of 55/600 based on the instantaneous flow rate.
      Measurements were taken in the flow region downstream of the constriction throat
      which included several interesting flow disturbance phenomena. The results of the
      decomposed flow phenomena demonstrate the significant role of large scale
      organized structures in such flows. This is particularly important when analyzing
      blood flow in the large arteries in the presence of severe stenosis or behind
      prosthetic devices in an attempt to estimate the 'turbulent' stress which act on
      cellular elements. Estimation of the apparent stress tensor is of importance in
      an effort to elucidate the mechanical factors which influence the durability of
      red blood cells under abnormal conditions.

PMID- 2229089
TI  - Three-dimensional determination of an oblique osteotomy in the hip by
      mathematical optimization fulfilling some anatomical demands.
AB  - The present paper describes a nonlinear optimization process to estimate the
      single cutting plane of an oblique osteotomy in the hip. This kind of osteotomy
      was introduced and practised by Charit (Research report 81, University of
      Witwaters brand, Johannesburg, 1981). We calculate the cutting plane in such a
      way that the postoperative coverage of the resulting two parts of the femur are
      as great as possible whereby some anatomical constraint conditions are fulfilled.
      Additionally a simplified preoperative planning is described by using a sphere
      lying on the femoral head and determined by a least-squares method.

PMID- 2229090
TI  - Optimal design parameters of the bicycle-rider system for maximal muscle power
      output.
AB  - The purpose of this study was to find the optimal values of design parameters for
      a bicycle-rider system (crank length, pelvic inclination, seat height, and rate
      of crank rotation) which maximize the power output from muscles of the human
      lower limb during bicycling. The human lower limb was modelled as a planar system
      of five rigid bodies connected by four smooth pin joints and driven by seven
      functional muscle groups. The muscles were assumed to behave according to an
      adapted form of Hill's equation. The dependence of the average power on the
      design parameters was examined. The instantaneous power of each muscle group was
      studied and simultaneous activity of two seemingly antagonistic muscle groups was
      analyzed. Average peak power for one full pedal revolution was found to be around
      1100 W. The upper body position corresponding to this peak power output was
      slightly reclined, and the pedalling rate was 155 rpm for a nominal crank length
      of 170 mm.

PMID- 2229091
TI  - The importance of internal load in contractile models of muscles.

PMID- 2229092
TI  - Comment on 'stiffness and strain energy criteria to evaluate the threshold of
      injury to an intervertebral joint'.

PMID- 2229093
TI  - Niels Stensen's geometrical theory of muscle contraction (1667): a reappraisal.
AB  - From reading the Elementorum Myologiae Specimen of 1667 by Niels Stensen (Steno),
      I assert that the text and illustrations contain an observation-based theory on
      the mechanics of muscle contraction: (1) Based on the study of the structure and
      motion of several muscles in different animals and in man, Stensen described the
      contraction of parallel equally long motor fibers formated as uni- or
      multipennate structures, each forming a parallelepipedon between parallel tendon
      plates. The parallelepipedon was used as a model allowing Stensen to apply
      mathematical methods in the argumentation. When the motor fibers contract, the
      tendons move in parallel planes, the muscle shortens, but the distance between
      the tendon planes does not change. There will appear a swelling, even if the
      volume of the model remains the same. Therefore, the swelling observed during
      contraction, according to Stensen, is no argument for an increase in muscle bulk
      and no argument against contraction without any change of muscle volume. (2) In
      the first century after its proposal, different arguments were published against
      Stensen's theory: in 1680 by Borelli (De Motu Animalium), 1694 by Bernoulli (De
      Motu Musculorum), 1743 by Boerhaave (Praelectiones), and 1762 by Haller (Elementa
      Physiologiae). When read today, these arguments are irrelevant, erroneous, or
      without scientific documentation. However, by the end of the 18th century,
      Stensen's theory all but disappeared from the science literature. (3) Anatomical
      and biomechanical studies published after 1980 show that the foundation and
      applicability of Stensen's theory are still valid. (4) While earlier considered
      to be perhaps Stensen's weakest work, arguments are presented to reappraise
      Elementorum as one of Stensen's significant publications and as a significant
      work in the biomechanical sciences.

PMID- 2229094
TI  - Fracture mechanics of bone with short cracks.
AB  - Tensile fracture experiments were performed upon specimens of wet mature bovine
      Haversian bone, with short, controlled notches. Stress concentration factors were
      found to be significantly less than values predicted using a maximum stress
      criterion in the theory of elasticity. Results were also modeled with the aid of
      linear elastic fracture mechanics. Agreement of experiment with theory was better
      in this case, however deviations were seen for short notches. Two mechanisms were
      evaluated for the behavior: plasticity near the crack tip, and effects of the
      Haversian microstructure, modelled by Cosserat elasticity, a generalized
      continuum theory. Plastic zone effects were found to be insignificant. Cosserat
      elasticity, by contrast, predicted stress concentration factors which better
      approximated observed values. To explore strain redistribution processes, further
      experiments were conducted upon notched specimens in torsion at small strain.
      They disclosed a strain redistribution effect consistent with Cosserat
      elasticity. These microelastic effects were attributed to the Haversian
      architecture of bone. The implications of the results are that bone resists the
      effect of stress raisers such as fatigue microcracks and surgical sawcuts to a
      much greater extent than anticipated on the basis of its elastic or elastoplastic
      properties.

PMID- 2229095
TI  - Joint reaction forces at the first MTP joint in a normal elderly population.
AB  - The calculation of net ankle, knee, and hip joint reaction forces is an often
      applied procedure in the analysis of gait. Except for very few studies, joint
      reaction forces have not been measured in other joints such as the fingers,
      wrist, elbow, shoulder and toes. In this study the joint reaction forces between
      the metatarsal head and the proximal phalanx and the metatarsal head and the
      sesamoids are calculated for the push off phase during gait. The results of ten
      normal elderly subjects show that the maximum resultant loads of the two
      articulations lie close to the longitudinal axis of the metatarsal. The knowledge
      of the magnitude and direction of the joint reaction forces of a normal elderly
      population will be essential for the design of an optimal fixation of an
      artificial anatomical first MTP joint.

PMID- 2229096
TI  - Biomechanics of the venous wall under simulated arterial conditions.
AB  - The failure of vein graft conduits implanted in the arterial circulation has been
      hypothesized to occur in part due to the exposure of the graft to altered
      biomechanical and fluid shearing forces. In the present study, these forces are
      characterized for canine internal jugular veins (IJV) exposed to realistic
      arterial flow dynamics. Freshly excised vein segments were mounted into a
      pulsatile perfusion apparatus and exposed to arterial flow conditions (P = 115/75
      mmHg and Q = 110 ml min-1) for 2 h. Dynamic measurements of intraluminal pressure
      and flow rate and vessel wall radial distension were acquired to accurately
      quantitate the incremental modulus of elasticity; hoop, axial and radial wall
      stresses; and fluid shearing forces within the vessel. Identical measurements
      were performed on canine carotid arteries (CCA) to serve as a comparison. Under
      arterial conditions, IJV segments demonstrated a significant elevation (p less
      than 0.05) over the CCA in the incremental elasticity modulus, along with a
      corresponding elevation in hoop and axial wall stresses. Additionally the average
      wall shearing rate to which the IJV endothelial surface was exposed was a factor
      of six less than that observed in the CCA. These results are discussed in
      relationship to the clinical situation of vein graft adaptation to arterial
      hemodynamics.

PMID- 2229097
TI  - Trends of mechanical consequences and modeling of a fibrous membrane around
      femoral hip prostheses.
AB  - In the present study, the effects of a fibrous membrane between cement and bone
      in a femoral total hip replacement were investigated. The study involved the
      problem of modeling this fibrous membrane in finite-element analyses, and its
      global consequences for the load-transfer mechanism and its resulting stress
      patterns. A finite-element model was developed, suitable to describe nonlinear
      contact conditions in combination with nonlinear material properties of the
      fibrous membrane. The fibrous tissue layer was described as a highly compliant
      material with little resistance against tension and shear. The analysis showed
      that the load transfer mechanism from stem to bone changes drastically when such
      a membrane is present. These effects are predominantly caused by tensile
      loosening and slip at the interface, and are enhanced by the nonlinear membrane
      characteristics. Using parametric analysis, it was shown that these effects on
      the load-transfer mechanism cannot be described satisfactorily with linear
      elastic models. Most importantly, the fibrous tissue interposition causes
      excessive stress concentrations in bone and cement, and relatively high relative
      displacements between these materials.

PMID- 2229099
TI  - Steady state plasma [3H]-noradrenaline kinetics in quadriplegic chronic spinal
      cord injury patients.
AB  - 1. Steady state plasma noradrenaline kinetics were measured in eight male
      quadriplegic patients and in eight age and sex matched controls. 2. Plasma
      noradrenaline levels were significantly lower in quadriplegic patients compared
      to controls. Noradrenaline spillover rate was markedly reduced in quadriplegics
      compared to controls while noradrenaline clearance was similar in both groups. 3.
      Noradrenaline kinetics in quadriplegic patients differ from peripheral autonomic
      neuropathy patients where reductions in both the spillover and clearance of
      noradrenaline are present.

PMID- 2229100
TI  - Heterogeneity of vascular muscarinic receptors.
AB  - Muscarinic receptors mediate diverse effects on the vasculature. Recently, a
      consensus has been arrived at with regard to muscarinic receptor classification
      (Levine & Birdsall, 1989). As a result, it may now be possible to clarify the
      role of each subtype in the responses of vascular tissues to muscarinic agonists.
      It is apparent that vascular muscarinic receptors form a heterogeneous
      population. M1 receptors contract canine venous tissue, whilst M3 receptors
      contract porcine and bovine coronary arteries. M3 receptors also mediate EDRF
      dependent relaxant responses in the majority of tissues studied to date. M2
      receptors elicit relaxations by a decrease in sympathetic outflow in canine
      femoral vein, rabbit ear artery and rat portal vein. These conclusions are
      primarily derived from functional estimations of equilibrium dissociation
      constants, since comparable radioligand binding data are both scarce and
      contradictory. It is concluded that all three major subtypes of receptors are
      present in the vasculature. However, the limited selectivity of the available
      antagonists, the lack of extensive use of such compounds and the unavailability
      of selective agonists clearly indicate the need for more definitive studies to be
      undertaken.

PMID- 2229098
TI  - Cholecystokinin and cholinergic agents on periodic gallbladder contraction in
      dogs.
AB  - 1. The effect of cholecystokinin octapeptide (CCK-OP), methacholine, 2-deoxy-D
      glucose (2DG) and gastric distension on gallbladder contraction in relation to
      interdigestive activity was studied in four conscious dogs with chronic biliary
      fistulae. 2. The gallbladder contraction in response to CCK-OP was inhibited by
      atropine and by a ganglionic blocking agent, the characteristics suggesting
      competitive inhibition. 3. Spontaneous contraction of the gallbladder was still
      observed after the administration of CCK-OP, methacholine or 2DG. With ganglionic
      blockade, CCK(-)-OP or methacholine initiated gallbladder contraction, but the
      spontaneous peak was no longer observed. 4. CCK-OP (100 ng kg-1), methacholine or
      2DG advanced the spontaneous contraction of the gallbladder, but did not alter
      the duration of the cycle. 5. Gastric distension initiated gallbladder
      contraction. This was abolished by ganglionic blockade. The contraction did not
      continue in spite of continuous gastric distension, and the spontaneous
      contraction reappeared 100 min following the pre-distension control.

PMID- 2229101
TI  - Results of treatment of displaced patellar fractures by partial patellectomy.
AB  - The results of partial patellectomy as a treatment for displaced patellar
      fractures were assessed retrospectively with use of clinical, radiographic, and
      isokinetic strength-testing criteria. Forty patients who had been followed for an
      average of 8.4 years were studied. In the extremity that had been operated on,
      the mean active range of motion was 94 per cent, the circumference of the thigh
      was 100 per cent, and the strength of the quadriceps was 85 per cent of these
      measurements in the contralateral extremity. The over-all result was rated as
      excellent in twenty patients, good in eleven, fair in six, and poor in three.
      There was a significant statistical correlation between the type of fracture and
      the outcome. The results of this study indicate that partial patellectomy can be
      an effective treatment for selected patellar fractures.

PMID- 2229102
TI  - Dealing with geographic variations in the use of hospitals. The experience of the
      Maine Medical Assessment Foundation Orthopaedic Study Group.
AB  - Orthopaedists and other physicians in Maine organized the Maine Medical
      Assessment Foundation to deal with the problem of variations in the rates of
      hospitalization for orthopaedic conditions. Five musculoskeletal injuries and
      five orthopaedic procedures were selected for study. The variation in decision
      making by orthopaedists was least for fractures of the ankle and fractures of the
      hip and was greatest for fractures of the forearm, derangement of the knee, and
      lumbosacral sprain. The rates in an area tended to be consistently high or low
      for the same treatments. The major reasons for the variations appeared to be
      related to lack of agreement about optimum treatment. Feedback of data to
      physicians on variations in patterns of practice reduced the variations.

PMID- 2229103
TI  - Unexpected geographic variation in rates of hospitalization for patients who have
      fracture of the hip. Medicare enrollees in the United States.
AB  - With the use of data from hospitals for fiscal year 1985, we calculated the rates
      of hospitalization for fracture of the hip, by state of residence, for all
      enrollees in Medicare who were sixty-five years old or older; we adjusted for age
      and race. The rate of fracture of the hip was highest in the South and lowest in
      the Northeast, especially in women. The cause of this difference is not known.

PMID- 2229104
TI  - Arthrometric evaluation of knees that have a torn anterior cruciate ligament.
AB  - We used the KT-1000 arthrometer to test the knees of 107 patients who had an
      acute tear of the anterior cruciate ligament, 153 patients who had a chronic
      tear, and 141 control subjects, for a total of 401 individuals. The three testing
      parameters were the extent of anterior translation at eighty-nine newtons of
      force and at maximum manual force, and the compliance index. The differences
      between the involved and the uninvolved knees were calculated. At eighty-nine
      newtons, all but one of the control subjects had anterior translation of ten
      millimeters or less, compared with 58 per cent of the patients who had a chronic
      tear. At maximum manual force, all but two of the control subjects had
      translation of ten millimeters or less, compared with 20 per cent of the patients
      who had an acute or a chronic tear. Analysis of variance showed that the clinical
      diagnosis correlated well with the results for all tests (p less than 0.001).
      However, when the uninjured knees of patients who had an acute or a chronic tear
      were compared with the knees of the control subjects, significant differences
      were noted (p less than 0.001 to 0.006). In the patients who had a chronic tear,
      there was no relationship between the time from injury to operation and the
      extent of anterior translation. The arthrometric test at maximum manual force was
      the strongest discriminant; it differentiated normal from abnormal knees (p less
      than 0.001) with high sensitivity (92 per cent), high specificity (95 per cent),
      and high positive predictive accuracy; the cut-off point was eleven millimeters
      or less.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229105
TI  - Measurement of anterior-posterior displacement of the knee. A comparison of the
      results with instrumented devices and with clinical examination.
AB  - Thirteen subjects who had normal knees and fifteen patients who had a chronic
      rupture of the anterior cruciate ligament were tested in order to compare the
      measurements of tibiofemoral displacement as recorded by four commercial devices:
      the Acufex knee-signature system, the Genucom knee-analysis system, the Medmetric
      KT-1000 arthrometer, and the Stryker knee-laxity tester. Anterior and posterior
      displacement were measured at forces of eighty-nine newtons (twenty pounds) and
      133 newtons (thirty pounds). We found significant differences in reproducibility
      of measurement among the devices. The Acufex, Medmetric, and Stryker devices had
      more reproducible measurements, and they could be used to identify 80 to 90 per
      cent of the normal subjects and anterior cruciate-deficient patients. The Genucom
      device had poorer reproducibility of measurement, and it tended to register
      greater differences in displacement between the right and left knees of normal
      subjects.

PMID- 2229106
TI  - Evaluation of an electrogoniometric instrument for measurement of laxity of the
      knee.
AB  - Eight lower extremities from cadavera were tested for anterior-posterior laxity
      in two positions before and after transection of the anterior cruciate ligament.
      At critical points in the tests, electrogoniometric and radiographic measurements
      of tibiofemoral translation were compared. By direct measurement, we determined
      the accuracy of the radiographic method to +/- 0.4 millimeter (95 per cent) in
      measuring anterior-posterior translations of the tibia with respect to the femur.
      The electrogoniometer estimated displacement of the tibia with respect to the
      femur during the anterior drawer test to be 3.5 +/- 8.2 millimeters at 90 degrees
      of flexion of the knee and 11.1 +/- 16.1 millimeters at 30 degrees of flexion.
      Direct comparison of these measurements with those obtained by means of the
      radiographic technique showed that the electrogoniometer tended, on average, to
      overestimate the tibial translation. The amount of overestimation was 0.7
      millimeter for intact knees and 1.9 millimeters after sacrifice of the anterior
      cruciate ligament. Despite this small average error in measurement of tibial
      translation, the difference between individual electrogoniometric and
      radiographic measurements varied greatly, with a 95 per cent confidence limit of
      +/- 5.5 millimeters. The error of the electrogoniometric measurements varied with
      the angle of flexion of the knee during testing, both the accuracy and the
      reliability of the electrogoniometric measurements being greatly diminished at 30
      degrees of flexion. The electrogoniometric method also tended to overestimate
      tibial internal rotation (by an average of 10.5 degrees) and external rotation
      (by an average of 9.3 degrees); the reliability of these measurements was +/- 6.9
      degrees.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229107
TI  - Use of a knee-brace for control of tibial translation and rotation. A comparison,
      in cadavera, of available models.
AB  - We assessed the relative restraints that are provided by fourteen currently
      available functional knee-braces, using six limbs in cadavera. The tests were
      made at 30 and 60 degrees of flexion of the knee, and a mechanical loading system
      applied loads that caused anterior-posterior translation and internal-external
      rotation. The braces limited abnormal tibiofemoral displacements by 10 to 75 per
      cent in translation; there was more variation in rotation. This study
      demonstrated that functional knee-braces provide a restraining influence that may
      be beneficial in the control of abnormal displacements of the knee, but that the
      degree of restraint varies considerably.

PMID- 2229108
TI  - Hypertension after operative correction of club-foot deformity.
AB  - Severe hypertension occurred as a postoperative complication after correction of
      a club-foot deformity in four children (seven feet) who were between the ages of
      two and three years and had no history of hypertension. The hypertension subsided
      slowly after administration of antihypertensive medications or more rapidly after
      release of the correction that had been obtained operatively.

PMID- 2229109
TI  - Translation of the humeral head on the glenoid with passive glenohumeral motion.
AB  - We have demonstrated that certain passive motions of the glenohumeral joint are
      reproducibly accompanied by translation of the head of the humerus on the
      glenoid. We investigated the relationship of these translations to the position
      of the glenohumeral joint and to applied torques and forces in seven isolated
      glenohumeral joints from fresh cadavera, using a six-degrees-of-freedom position
      sensor and a six-axis force and torque transducer. Reproducible and significant
      translation occurred in an anterior direction with glenohumeral flexion and in a
      posterior direction with extension. We also observed translation with cross-body
      movement. The translation occurring with flexion was obligate in that it could
      not be prevented by the application of an oppositely directed force of thirty to
      forty newtons. Operative tightening of the posterior portion of the capsule
      increased the anterior translation on flexion and cross-body movement and caused
      it to occur earlier in the arc of motion compared with the intact glenohumeral
      joint. Operative tightening of the posterior part of the capsule also resulted in
      significant superior translation with flexion of the glenohumeral joint.

PMID- 2229110
TI  - Histological studies of the glenoid labrum from fetal life to old age.
AB  - To help to resolve the controversy regarding the composition of the glenoid
      labrum, thirty-eight shoulders from cadavera were examined grossly and
      histologically. We used specimens for individuals of different ages so that we
      could determine what changes occur as a result of aging. In children and adults,
      the labrum appeared to be fibrocartilaginous tissue. The labrum was a separate
      anatomical structure that could be distinguished from the fibrous capsule of the
      shoulder. Neonatal labra were composed of primitive mesenchymal tissue containing
      only few chondrocytes that modulated into fibrocartilage in the first few years
      of life. Neonatal labra contained no elastin, whereas specimens from adults had
      rare elastin fibers. The labrum was sparsely vascularized throughout its
      substance, with no particular pattern of distribution. Vascularity decreased with
      increasing age of the individual.

PMID- 2229111
TI  - Comparison of a hybrid with an uncemented total hip replacement. A retrospective
      matched-pair study.
AB  - The efficacy of a type of uncemented total hip replacement was compared with that
      of a hybrid total hip replacement in which an uncemented acetabular and a
      cemented femoral component were used. Twenty-five patients who had had a hybrid
      total hip replacement were matched, by age, weight, sex, and diagnosis, with
      twenty-five patients who had had an uncemented total hip replacement. All of the
      operations were done by one surgeon, who used the same operative approach and the
      same regimen of postoperative rehabilitation. All of the patients were followed
      for at least two years. The mean postoperative hip score was 96 points for the
      hybrid group and 84 points for the cementless group (p less than 0.02). Twenty
      four (96 per cent) of the patients who had a hybrid prosthesis reported no or
      only slight pain postoperatively. In the uncemented group, of the six patients
      (24 per cent) who reported mild to severe pain, five had pain in the thigh, a
      limp occurred more frequently, five femoral components had migrated, and four
      hips needed reoperation. The results with the hybrid replacement that had a
      cemented femoral component were superior to those with the uncemented femoral
      component over the relatively brief period for which these patients were
      followed.

PMID- 2229112
TI  - The lateral approach for operative release of post-traumatic contracture of the
      elbow.
AB  - A lateral approach was used to release a post-traumatic contracture of the elbow
      in seven patients, and the results were evaluated an average of thirty-eight
      months postoperatively. Extension improved from an average flexion contracture of
      45 degrees preoperatively to one of 12 degrees postoperatively, and the average
      point of maximum flexion increased from 116 degrees preoperatively to 129 degrees
      postoperatively. The average arc of motion increased 46 degrees. All patients
      began using a continuous-passive-motion device immediately after the operation.
      There were no problems with wound-healing or formation of heterotopic bone.

PMID- 2229113
TI  - Arthrodesis of the ankle with cancellous-bone screws and fibular strut graft.
      Biomechanical analysis.
AB  - The stability of an arthrodesis with two cancellous-bone screws across the ankle
      joint was evaluated in eighteen ankles from fresh-frozen cadavera. Tibiotalar
      motion was recorded in response to the following loading modes: medial-lateral
      moment, plantar flexion-dorsiflexion moment, and internal-external tibial torque.
      The series of loading tests was performed with two cancellous-bone screws through
      the tibia into the talus and a lateral fibular strut graft fixed with a proximal
      and a distal screw. The tests were repeated after the strut graft was removed,
      and again after it had been reapplied. The amount of motion at the site of the
      arthrodesis was greatest with tibial torque and was least with medial-lateral
      bending; this was true for specimens with or without a fibular strut graft.
      Removal of the strut graft allowed increased tibiotalar motion for all modes of
      loading; increases in motion were far greater for specimens of poor bone quality.

PMID- 2229114
TI  - Spondyloepiphyseal dysplasia of Maroteaux.
AB  - The cases of four patients who had an unusual clinical entity of
      disproportionately short stature, referred to as spondyloepiphyseal dysplasia of
      Maroteaux, are described. In patients who have this syndrome, the abnormalities
      are confined to the musculoskeletal system. The patients do not have corneal
      opacities or increased excretion of keratosulphate. The mode of transmission
      appears to be autosomal dominant. Platyspondylysis is present but there are no
      anterior tongue-like deformities of the vertebral bodies. Because of the presence
      of spondyloepiphyseal dysplasia and normal intelligence, and the lack of
      abnormalities at birth, this entity seems to mimic Morquio syndrome. However,
      unlike Morquio syndrome, the disorder involves no biochemical abnormalities.
      Thus, the entity may be classified as new.

PMID- 2229115
TI  - Replantation of the distal part of the leg.
AB  - We successfully replanted five amputated legs in five patients and followed the
      patients for two years or more (average, six years and three months). Although
      some patients found it impossible to squat and to run because of joint
      contractures, muscle weakness, or deformities of the foot, all patients could
      perform other activities without difficulty. None had important pain or any
      intolerance to cold, and all were satisfied with the results of the replantation.

PMID- 2229116
TI  - The osteogenic response to distant skeletal injury.
AB  - We tested the hypothesis that when one bone of the skeleton is injured, others
      experience an osteogenic response. Although similar or related phenomena have
      been observed previously, the purposes of the study were to determine if this
      response was reproducible, to characterize it in terms of its magnitude and
      duration, and to show how it is related to the type of injury sustained. To
      obtain this information, a model was used in which an intramedullary nail was
      implanted in the femur and a standard closed fracture was subsequently produced.
      The osteogenic response was measured by histomorphometry. Eight-four nine-week
      old male Sprague-Dawley rats were divided into seven groups of twelve animals
      each. Groups I and II consisted of control animals in which no injury was
      produced. In Group-III rats, cortical drilling of the intercondylar notch and
      piriformis fossa of the right femur was performed, without intramedullary
      nailing. In Groups IV through VII, half of each group received intramedullary
      nails only, and in the other half intramedullary nailing was done and a closed
      transverse diaphyseal fracture was produced. With two different fluorochrome
      labels, rates of mineral apposition were measured in the left and right tibiae of
      all animals. The labeling periods differed in each group and were designed to
      determine when the peak response occurred, how long it lasted, and whether aging
      during the course of the experiment affected the response.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2229117
TI  - The patellofemoral joint after total knee arthroplasty without patellar
      resurfacing.
AB  - One hundred total knee replacements with a total condylar prosthesis and without
      patellar resurfacing were followed for a minimum of two years. Eighty-four per
      cent of the knees were affected by osteoarthrosis. Graded according to the knee
      rating system of the Hospital for Special Surgery, there were eighteen excellent,
      fifty-three good, eighteen fair, and eleven poor results. At the most recent
      follow-up, twenty-nine knees (29 per cent), nine of which were affected by
      rheumatoid arthritis, were still painful in the patellofemoral area. The height
      and weight of the patient definitely influenced the amount of patellofemoral pain
      postoperatively. Small patients who had osteoarthrosis were exceptionally free of
      pain, regardless of sex, age, or level of activity. It seems that the best
      approach to patellofemoral replacement includes resurfacing of the patella in all
      patients who have rheumatoid arthritis and in patients who have osteoarthrosis if
      they have preoperative patellofemoral pain, are more than 160 centimeters tall,
      weigh more than sixty kilograms, and have advanced changes in the patella at the
      time of the operation.

PMID- 2229118
TI  - Treatment of infection after total knee arthroplasty by debridement with
      retention of the components.
AB  - Thirty-one total knee arthroplasties were followed by infection in twenty-seven
      patients who were subsequently treated with debridement, retention of the
      components, and intravenous administration of antibiotics. The results were
      reviewed retrospectively in an effort to evaluate the function of the prostheses
      that had been salvaged successfully and to identify the causes of failure of
      those around which an infection had recurred. At the most recent follow-up
      (average duration, 8.8 years), infection had recurred around twenty-four (77 per
      cent) of the thirty-one arthroplasties. Seven knees (23 per cent) remained free
      of infection. Function remained satisfactory, although revision was subsequently
      needed in two knees for reasons other than infection. One cause of failure was
      the duration of the infection before debridement. This averaged twenty-one days
      for the seven knees in which the prosthetic arthroplasty had been salvaged and
      thirty-six days for the twenty-four knees in which treatment had failed. Another
      cause of failure was the type of organism: Staphylococcus aureus had caused the
      infection in fourteen (58 per cent) of the twenty-four knees in which the
      treatment failed but in only two of the seven knees in which the prosthetic
      arthroplasty was salvaged. In addition, eight infections in the first group were
      resistant to penicillin, whereas both infections in the second group were
      sensitive to penicillin. The four infections with gram-negative organisms in the
      series were all in knees in which the treatment failed. All six hinged prostheses
      that were used failed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229119
TI  - Amputation or limb-lengthening for partial or total absence of the fibula.
AB  - Thirty-two patients who had ablation of the foot by the Syme or Boyd technique
      for partial or total absence of the fibula, with subsequent fitting of a
      prosthesis, were compared with eleven patients who had lengthening of the lower
      limb by the Wagner method, to assess the long-term results of each procedure. The
      final results were evaluated on the basis of pain, limp, limb-length discrepancy,
      level of physical activity, and satisfaction of the patient. Of the thirty-two
      patients who had an amputation, twenty-eight (88 per cent) had a satisfactory
      result, compared with only six (55 per cent) of the eleven patients who had limb
      lengthening. The amount of inequality between the lower limbs was classified as
      follows: Group I--the foot of the shorter extremity was at the distal third of
      the contralateral, normal limb, and the percentage of shortening was 15 per cent
      or less; Group II--the foot of the shorter extremity was at the level of the
      middle third of the contralateral, normal limb, and the percentage of shortening
      was between 16 and 25 per cent; and Group III--the foot of the shorter extremity
      was at the level of the proximal third of the contralateral, normal limb, and the
      percentage of shortening was greater than 26 per cent. Lengthening was best
      suited for patients in Group I who had stable hips, knees, and ankles and a
      plantigrade foot. Patients in Groups II and III were best served by ablation of
      the foot and fitting of a prosthesis.

PMID- 2229120
TI  - Total knee arthroplasty in obese patients.
AB  - We examined 182 patients (257 knees) who had had a total knee arthroplasty two to
      five six years earlier. The patients were grouped into five weight classes.
      Eighteen patients (twenty-seven knees) were considered moderately obese and
      twelve patients (twenty-seven knees), severely obese. The results in all but four
      knees were rated excellent or good. One patient needed a revision procedure for
      late infection, and the result was rated poor. Three results were rated fair.
      There was no discernible difference in the over-all scores among the five weight
      groups. However, 30 per cent of the knees of the moderately and severely obese
      patients had patellofemoral symptoms, whereas the incidence was 14 per cent in
      the other groups (p less than 0.03). No clear-cut association was found between
      obesity and either thrombophlebitis or complications related to the wound.

PMID- 2229121
TI  - Tourniquet-induced rhabdomyolysis. A case report.

PMID- 2229122
TI  - Non-infectious pyogenic arthritis after a blind-loop intestinal-bypass operation.
      A case report.

PMID- 2229123
TI  - Avulsion fracture of the tibial tubercle with avulsion of the patellar ligament.
      Report of two cases.

PMID- 2229124
TI  - Idiopathic osteonecrosis of the patella: an unusual cause of pain in the knee. A
      case report.

PMID- 2229125
TI  - Use of a soft-tissue cap in endoprosthetic reconstruction of the proximal part of
      the humerus after excision of a neoplasm. A case report.

PMID- 2229126
TI  - Disorders of patellofemoral alignment.

PMID- 2229127
TI  - Comparative assessment of gait after limb-salvage procedures.

PMID- 2229128
TI  - Development of a reconstituted collagen tendon prosthesis.

PMID- 2229129
TI  - Dietrich Schmahl on the occasion of his 65th birthday.

PMID- 2229130
TI  - Basic principles in preclinical cancer chemotherapy.

PMID- 2229131
TI  - Potentiation of cisplatin cytotoxicity by methylxanthines in vitro.
AB  - The ability of two supposed DNA-repair inhibitors to modulate cisplatin-induced
      cytotoxicity in a human ovarian cancer cell line (CAOV-3) and a human cervical
      cancer cell line (Me-180) was investigated using a short-term chemosensitivity
      assay based on bioluminescence of cellular adenosine triphosphate (ATP).
      Cisplatin concentrations bracketing the reported peak plasma concentration (2.5
      micrograms/ml) were used and the 50% inhibitory concentrations were determined by
      linear regression of log-transformed survival data. At 2.5 mM, the methylxanthine
      caffeine enhanced cisplatin sensitivity 2.9-fold in CAOV-3 cells and 2.7-fold in
      Me-180 cells. At 2.5 mM, pentoxifylline, a closely related methylxanthine,
      increased cisplatin sensitivity 2.9-fold in CAOV-3 cells and 3.4-fold in Me-180
      cells. Chemical modification of cisplatin-induced cytotoxicity by assumed
      inhibition of DNA-repair mechanisms may hold promise for clinical application in
      the treatment of gynecological cancer.

PMID- 2229133
TI  - D-19466, a new cyclobutane-platinum complex with antitumor activity.
AB  - D-19466, a new platinum complex, was characterized. It showed no nephrotoxic side
      effects as determined by the measurement of blood urea. It was cytotoxic in vitro
      for tumor cells in concentrations comparable to or lower than cytotoxic
      concentrations of cisplatin. It had excellent anticancer activity in vivo against
      a number of murine experimental tumors, including a cisplatin-resistant P388
      line. Clinical evaluation of this compound has therefore been initiated.

PMID- 2229132
TI  - Tumor-inhibiting [1,2-bis(fluorophenyl)ethylenediamine]platinum(II) complexes. V.
      Synthesis and evaluation of enantiomeric [1,2-bis-(4
      fluorophenyl)ethylenediamine]dichloroplatinum(II) complexes.
AB  - The enantiomeric [1,2-bis(4-fluorophenyl)ethylenediamine]dichloroplatinum(II)
      complexes were synthesized and tested on the hormone-sensitive human MCF7 breast
      cancer cell line and on the P388 leukemia of the mouse. They showed a strong and
      comparable activity on both tumor models.

PMID- 2229135
TI  - The pharmacokinetic model and distribution pattern of new sexual-steroid-hormone
      linked anticancer agents.
AB  - Sexual-steroid-hormone-linked anticancer agents are a new group of cytotoxic
      drugs designed for a site-directed chemotherapy of tumors containing sexual
      steroid hormone receptors. The hormone (e.g. estradiol or testosterone) should
      act as a carrier that leads to a preferential receptor-mediated drug accumulation
      in hormone-receptor-positive tumors (such as mammary carcinomas and prostatic
      cancer). In several preclinical therapeutic studies of sexual-hormone-receptor
      positive breast cancer, for instance, conjugates of 2-chloroethyl-carbamoyl-L
      alanine linked to estradiol or dihydrotestosterone showed, in comparison to the
      unlinked single agent, a significantly higher antineoplastic activity and a
      clearly lower systemic toxicity. But there is still only limited knowledge about
      the pharmacokinetic properties and the mode of action of these new drugs. For
      this reason in the present article a more comprehensive pharmacokinetic model and
      the pattern of distribution of new sexual-steroid-hormone-linked anticancer
      agents have been described.

PMID- 2229134
TI  - Sensitivity of rodent osteosarcoma clones to platinum-containing phosphonic acid
      complexes in vitro.
AB  - Osteosarcoma treatment still is unsatisfactory owing to the development of
      metastases. This situation causes many problems for the patients as well as the
      clinicians. Tumor heterogeneity is made responsible for the development of cell
      lines resistant to chemotherapy. As the transplantable osteosarcoma of the rat
      resembles the human metastasizing osteosarcoma, studies on clones of this tumor
      were started. The following compounds were investigated: AMDP, cis
      diammine[nitrilotris-(methylphosphonato)(2-)-O1,N1]plati num II; DADP, cis
      cyclohexane-1,2-diamine[nitrilotris(methylphosphonato)(2 -)-O1,N1]- platinum II;
      IMD, cis-diammine[imino-bis(methylphosphonato)(2-)-O1,N1]platinum II; DIMD, cis
      cyclohexane-1,2-diamine[iminobis(methylphosphonato) (2-)-O1,N1]platinum II. In
      vitro assays were performed with cell lines derived from a lung metastasis with
      the limited-dilution method. The clones varied in modal chromosome number, growth
      kinetics and tumorigenicity. AMDP was the most potent compound in all three
      clones resulting in a concentration- and time-dependent effect while IMD was
      somewhat less active. The diamminocyclohexane derivatives were considerably less
      effective, inhibiting cell growth especially in clone C10. In contrast, clone C36
      was more sensitive than C25 and did not recover within the observation period of
      5 days. Viability was reduced significantly only in C10, when treated with AMDP.
      Differences between the clones and the various compounds in inhibiting cell
      growth could be observed. Therefore, further experiments on the heterogeneity and
      sensitivity of these cell lines seem promising.

PMID- 2229136
TI  - Differential relationship of vitamin A and E levels in methylnitrosourea-induced
      Sprague-Dawley rats following prolonged feeding of fatty diets enriched with the
      vitamins.
AB  - Prolonged supplementation of vitamins A and E (2500 IU and 11.3 IU/rat daily) in
      10.3% and 21.6% fatty diets administered to methylnitrosourea-induced Sprague
      Dawley rats caused alterations in plasma and liver levels of both vitamins as
      well as of the total lipids. Liver vitamin A levels increased steadily (more than
      fourfold) until termination of the experiment, whereas plasma vitamin A levels
      only showed a minor increase at the end of the study in comparison to rats fed a
      standard diet. Liver vitamin E levels initially showed no difference from those
      of rats treated with a standard diet, and were decreased at the end of the
      experiment, whereas the respective plasma levels were increased throughout the
      study, only showing a decrease relative to initial values at termination of the
      experiment. Plasma total lipids increased with age and following supplementation
      of the vitamins in the high-fat diet, whereas liver total lipids were influenced
      less by aging than by the fat and vitamin contents of the respective diets. The
      observed alterations were, however, not related to significant chemopreventive
      activity of the vitamins A and E contained in high-fat diets.

PMID- 2229137
TI  - Mutagenic and genotoxic activities of extracts derived from the cooked and raw
      edible mushroom Agaricus bisporus.
AB  - A. bisporus has been reported to be carcinogenic to mice [Toth et al. (1986)
      Cancer Res 38:177-180] and mutagenic in Salmonella typhimurium [Sterner et al.
      (1982) Mutat Res 101:269-281]. The effects of different heat treatments on the
      mutagenicity of raw, cooked (boiled) and fried A. bisporus extracts in the S.
      typhimurium test is reported. The spectrum of potential mutagenic activity of A.
      bisporus extracts was tested in vitro in Syrian hamster embryo cells for
      selective DNA amplification and in primary rat hepatocytes for DNA single-strand
      breaks. DNA single-strand breaks were also determined in liver cells of rats and
      micronuclei were measured in bone marrow cells of mice in vivo following oral
      application of A. bisporus extracts. It was shown that the complex A. bisporus
      extracts per se are not detectably mutagenic in S. typhimurium and that the
      previously observed increase in number of colonies per plate is probably due to a
      histidine artefact. No indication of genotoxicity was seen in the two in vitro
      assays with primary mammalian cells with two different end points. No evidence of
      in vivo genotoxic effects was observed in the rat liver cells. Finally, A.
      bisporus was not genotoxic in the micronucleus assay of mouse bone marrow cells
      in contrast to its previously reported carcinogenicity in mice.

PMID- 2229138
TI  - Assessment of nucleolar organizer regions by automatic image analysis in breast
      cancer: correlation with DNA content, proliferation rate, receptor status and
      histopathological grading.
AB  - The value of automatic image analysis in the investigation of nucleolus regions
      (AgNOR) has been examined in tissue sections of 52 malignant and 30 benign breast
      lesions. Determination of the AgNOR number per cell alone revealed a considerable
      overlap between benign (range 1.2-3.8) and malignant specimens (range 1.5-16.2).
      They differed however, highly significantly (P less than 0.001) in their AgNOR
      sizes. In benign breast disorders the mean AgNOR area per tumour ranged from 0.22
      microns2 to 1.07 microns2 (mean 0.39 microns2), whereas in carcinomas AgNOR sites
      ranged from 0.05 microns2 to 0.22 microns2 (mean 0.09 microns2). AgNOR counts
      showed a good correlation with histopathological grade (P less than 0.05),
      aneuploidy (P less than 0.01), proliferation rate as determined by Ki67
      immunostaining (P less than 0.01), as well as oestrogen and progesterone receptor
      content (P less than 0.01). Image analysis proved to be advantageous over AgNOR
      counting alone as it facilitated the standardization of the AgNOR technique
      itself and thus, significantly improved its diagnostic specifity.

PMID- 2229139
TI  - Value of bone scanning in the follow-up of breast cancer patients. A study of
      1000 cases.
AB  - The aim of the study was to assess the value of routine bone scintigrams,
      independent of the primary tumor stage or the presence of symptoms, in the
      postsurgical follow-up of breast cancer patients for the early detection of bone
      metastases. For this purpose 1,000 patients with postsurgical breast cancer
      without previous documentation of metastatic disease, who were admitted to the
      special oncology hospital, Onkologische Klinik Bad Trissl, entered a prospective
      study in 1987-1988. The parameters followed were the TNM stage of the primary
      tumor, the presence of pain, bone pain as revealed by a thorough physical
      examination, and the patient's history for the assessment of risk factors. In
      addition, a whole-body skeletal scintigram, supplementary X-rays, and additional
      diagnostic measures were performed, if necessary, to detect bone metastases. It
      was shown that in 856 of 894 patients (groups 1-6) without clinical symptoms, the
      clinical examination and radiological and scintigraphic diagnostic measurements,
      demonstrating the absence of bone metastases, gave matching results, but in 12 of
      the 894 patients the results of all examinations remained questionable. In
      another 12 of the 894 patients (groups 1-3) radiological and/or scintigraphical
      evidence for the presence of bone metastases was found. In 14 of 79 cases (groups
      7-10) with clinically suspicious symptoms these were proven to be signs of
      metastases by subsequent scintigrams, supplementary X-rays, and additional
      diagnostic measures. In 65 of the 79 patients with clinically suspicious
      symptoms, bone metastases could not be confirmed by obtaining bone scintigrams or
      X-rays while in the other 14 patients (groups 9 and 10) evidence for the presence
      of bone metastases was found in the scintigrams and/or X-rays. However, 10 of
      these 14 patients were high-risk patients for developing bone metastases as they
      had axillary lymph node infiltration. The other 4 patients were of the low-risk
      group as they had positive receptor status or no axillary lymph node infiltration
      at the time of primary diagnosis. In 13 of 27 patients (groups 11-14) with
      clinical symptoms indicating the presence of bone metastases this diagnosis was
      confirmed by scintigrams and/or X-rays (groups 11 and 12), while it was possible
      to exclude the presence of bone metastases in spite of the symptoms in 11 of the
      27 patients. In the other 3 patients the results of the additional examinations
      remained questionable.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2229141
TI  - The mutagenic activity of human breast secretions.
AB  - Human breast secretions, as obtained by nipple aspiration, were analysed for the
      presence of mutagenic activity by means of the Ames test. The overall incidence
      of women with secretions giving positive tests against Salmonella typhimurium,
      either strain TA98 or TA100, was 7.64%. No significant association was identified
      between the incidence of mutagen-positive breast secretions and age, menopausal
      status or the presence of breast abnormality in these women. Furthermore, there
      was no obvious environmental characteristic common to women with mutagen-positive
      fluids.

PMID- 2229140
TI  - Down-regulation of androgen receptor by progestins and interference with
      estrogenic or androgenic stimulation of mammary carcinoma cell growth.
AB  - The regulatory influence of medroxyprogesterone acetate (MPA) on estrogen and
      androgen receptors of the human breast cancer cell lines MCF-7 and EFM-19 was
      explored in conjunction with the growth-promoting properties of these steroids.
      In the absence of steroidal stimulation, up to 1 microM MPA had no effect on the
      proliferation of the MCF-7 cell strain used and of EFM-19 cells. Under
      stimulation with 10 nM 17 beta-estradiol or 1 microM dihydrotestosterone, dose
      dependent inhibition of the cell proliferation rates by 0.1-1 microM MPA was
      observed. Binding of MPA to the androgen receptor (Kd = 2.1 nM) but not to the
      estrogen receptor was demonstrable. During incubation of MCF-7 or EFM-19 cells
      with 1 microM MPA for 7 days, the estrogen and androgen receptor contents were
      down-regulated by approximately 50% and 60%, respectively. Likewise, the number
      of androgen-binding sites was reduced to 35% of the untreated controls after
      incubation of MCF-7 cells with 1 microM synthetic progestin R5020 for 7 days. The
      results indicate down-regulation of estrogen and androgen receptors by progestins
      in the absence of stimulatory effects on the proliferation of mammary carcinoma
      cells.

PMID- 2229142
TI  - Phase II study of tamoxifen and high-dose retinyl acetate in patients with
      advanced breast cancer.
AB  - Retinoids have shown a tumor growth inhibition and a synergistic activity with
      hormonal manipulations in human breast cancer cell lines and rat mammary
      carcinoma. To investigate the potential usefulness of this synergistic activity
      in human breast cancer, 33 postmenopausal patients with advanced disease were
      treated with the combination of tamoxifen (10 mg p.o. three times a day) and
      retinyl acetate (300,000 IU p.o. daily). Out of 31 evaluable patients, 3 achieved
      complete response, 9 partial response (overall response rate: 38.5%, 95%
      confidence interval = 21%-56%) and 16 (52%) showed no change. The median duration
      of response was 11.5 months (range: 3-19+ months), while the 2-year overall
      survival rate for the entire group of patients was 63%. Toxicity was generally
      mild, hot flushes, nausea (and/or vomiting), headache and cutaneous itching being
      the most frequent side-effects. Only 1 patient discontinued treatment for severe
      toxicity. These preliminary results suggest that the combination of tamoxifen and
      high-dose retinyl acetate is a safe and effective regimen for breast cancer
      patients. However, the study design does not allow us to establish whether the
      very low rate of early disease progression we observed might be related to a
      possible synergistic effect between retinoids and antiestrogens or rather to the
      quite indolent disease of the patients who have been selected for entry into this
      trial.

PMID- 2229143
TI  - Prognostic grouping: the next step in tumor classification.
AB  - At present, staging of malignant tumors is based on the anatomical extent of
      disease defined by the T(umor) N(odes) M(etastasis) classification. The main
      objective of further efforts in classifying tumors is to identify additional
      independent prognostic factors and to create mathematical models that may predict
      disease progression by prognostic grouping. This article summarizes problems,
      methods and the design of coordinated studies on prognostic grouping.

PMID- 2229144
TI  - The vascular architecture of human xenotransplanted tumors: histological,
      morphometrical, and ultrastructural studies.
AB  - This study was designed to examine the vascular system of human xenotransplanted
      tumors on nude mice with different complementary morphometrical and morphological
      methods. The vascular system shows a chaotic arrangement. There is an extreme
      heterogeneity in the vascular distribution and density. Large avascular regions
      could be identified in several non-necrotic tumors. There was no clear difference
      in the vascular density between the center and the periphery of the tumors, nor
      was there any zonal correlation for the distribution of the necrosis. With three
      dimensional corrosion casts it could be demonstrated that clusters of vessels
      were directly beneath areas almost free of vessels. In the center, vessels often
      form a sinusoidal system with numerous blind ends without clearly discernible
      endothelial cells. Numerous irregular tumor-cell-lined sinusoids are visible next
      to endothelial-lined vessels with transmission electron microscopy. With scanning
      electron microscopy it could be demonstrated that large-calibre endotheliazed
      vessels were found in the direct vicinity or in the center of non-viable zones.
      Even large-calibre vessels have a capillary wall structure. Sometimes, a basement
      membrane cannot be observed at all or only incompletely. There are numerous
      indications of vascular discontinuities and leaks with a widespread intercellular
      occurrence of blood cells.

PMID- 2229145
TI  - Histocompatibility locus antigens (HLA) in the epidermoid type of lung carcinoma.
AB  - HLA-A and B antigens were determined in a study of 162 patients (93 epidermoid
      type, 20 adenocarcinoma, 26 small-cell carcinoma and 23 undifferentiated types)
      with lung cancer. Differences between antigen frequencies in cancer and control
      populations were studied by chi 2Y analysis or Fisher's exact test. Survival data
      were analyzed using Cox's model for censored data. Cancer patients had a
      decreased frequency of the antigen HLA-B40 (chi 2Y = 14.15, P = 0.00018, Pc =
      0.003, relative risk = 0.21). Patients with HLA-A10, A 11 and B27 had a shortened
      mean survival time. Patients with HLA-B12 had a prolonged survival time.

PMID- 2229146
TI  - Recent advance in treatment of Stanford type A aortic dissection.
AB  - During the period between November 1986 and November 1988, 13 consecutive
      patients with Stanford type A aortic dissection (8 acute and 5 chronic) were
      treated as follows: (1) urgent operation for cases with pericardial tamponade or
      severe heart failure, (2) initial medical treatment followed by elective
      operation for acute but stable cases or chronic cases, and (3) routine use of
      open distal anastomosis or selective cerebral perfusion. One patient died during
      medical treatment: 5 patients were operated on emergently. The remaining 2 acute
      and 5 chronic cases were operated on electively. There were no operative deaths,
      neurological disturbances, or late deaths. It is suggested that acute dissection
      of the ascending aorta requires immediate surgical intervention, especially when
      the entry is in the ascending aorta. On the other hand, it is also suggested that
      one could avoid emergency operations in selected cases with retrograde extension
      of the aortic dissection.

PMID- 2229147
TI  - Surgical treatment of aneurysm or dissection involving the ascending aorta and
      aortic arch, utilizing circulatory arrest and retrograde cerebral perfusion.
AB  - Recently we replaced the ascending aorta and aortic arch in 8 patients with
      aneurysm or dissection, using profound hypothermic circulatory arrest with
      retrograde cerebral perfusion. There were no operative deaths. Open aortic
      anastomosis facilitated repair of the aortic arch without clamping the arch
      tributaries, and embolism due to particulate debris from clamping of the arch
      vessels was eliminated. Retrograde cerebral perfusion during profound hypothermic
      circulatory arrest is a simplified technique that may protect the brain. This
      method offers advantages over previously described methods, particularly in
      obviating dissection of the arch tributaries and the clamping thereof, and in
      protecting the central nervous system.

PMID- 2229148
TI  - Aggressive blood conservation in coronary artery surgery: impact on patient care.
AB  - Data on 100 consecutive non-emergency coronary artery bypass (CABG) patients were
      analyzed retrospectively. Sixty-nine patients received no homologous blood (Group
      I). Thirty-one patients received a total of 118 units of blood products averaging
      2.23 units of red cells (Group II). The average red cell transfusion rate for all
      patients was 0.7 units per patient. The median age for Group I was 61 and Group
      II was 68 years (p less than 0.05). The average number of grafts was the same for
      both (3 per patient) with 75% of Group I and 58% of Group II receiving internal
      mammary artery (IMA) grafts (p less than 0.05). Twelve of the Group II patients
      who received intraoperative transfusions on cardiopulmonary bypass to maintain
      adequate hemoglobin levels were older and had lower admission hematocrits: 36 +/-
      0.8% compared to 41 +/- 0.5% for all other patients (p less than 0.05). Average
      postoperative blood loss was 889 +/- 38 ml for Group I and 1077 +/- 104 ml for
      Group II (p less than 0.05). Increased hemorrhage was correlated with bypass time
      and IMA use but not with preoperative heparin administration, pre-existing risk
      factors (diabetes, hypertension, etc.), bleeding time, post-bypass clotting time,
      age or number of grafts. Two patients in Group II and none in Group I required
      exploration for excessive postoperative hemorrhage. Mortality rate was 2% (both
      in Group II, neither transfusion related). Discharge hematocrits were the same
      for all at 29.4 +/- 0.4%. Among anemia-related postoperative symptoms, only sinus
      tachycardia was significantly higher in Group I (20%) compared to Group II
      (6.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229149
TI  - Efficacy of transesophageal echocardiography as a perioperative monitor in
      patients undergoing cardiovascular surgery. Analysis of 149 consecutive studies.
AB  - To evaluate the usefulness of transesophageal echocardiography as a perioperative
      monitor in patients undergoing cardiovascular surgery, 149 consecutive patients
      were studied since 1985. Left ventricular function was assessed by measurement of
      left ventricular dimension and ejection fraction in patients with valvular
      disease. This monitoring was useful in detecting the changes in left ventricular
      performance in patients with volume overload and in managing patients in the
      early postoperative period. Cardiac tamponade was clearly demonstrated before
      changes in electrocardiogram and hemodynamic data. In 27 patients,
      transesophageal color Doppler echocardiography was used to confirm that there was
      no residual regurgitation immediately after valvular reconstructive surgery.
      Transesophageal color Doppler echocardiography was also useful in detecting the
      entry of false lumen before surgery in 7 patients with dissecting aortic
      aneurysm. There were no unsuccessful introductions, no traumatic or thermal
      injuries, 18 patients (12.1%) with hoarseness and 5 patients (3.4%) with
      transient arrhythmia. In conclusion, transesophageal echocardiography provides a
      good imaging window to the heart and great vessels perioperatively. This
      expedient, safe informative imaging method can be used more routinely in patients
      during surgery.

PMID- 2229150
TI  - Measurement of resistance versus flow in assessing efficiency of aortocoronary
      bypass grafts.
AB  - Measurement of flow in saphenous bypass grafts with an electromagnetic flowmeter
      is complicated and poorly reproducible. Since coronary flow is largely dependent
      on variable factors the stable value of resistance seems more appropriate for
      comparison. A simple method has been developed for intraoperative measurement of
      resistance in the respective coronary bed. Pressure is recorded in the saphenous
      graft by an electromanometer during continuous flushing with known amounts of
      blood, and resistance is calculated instantaneously. The procedure is very simple
      and takes less than one minute. The quality of the saphenous vein itself can be
      assessed simultaneously by the same method. Resistances were measured during
      coronary surgery in over 500 saphenous grafts. The results were highly
      reproducible and comparable. Excellent flows can be expected if resistance is
      below 200 Peripheral Resistance Units (PRU); if this is over 800 PRU flow is very
      poor.

PMID- 2229151
TI  - Submammary median sternotomy.
AB  - A vertical skin incision is used as routine approach for sternotomy. The
      resulting scar is often disappointing and the top is visible and unpleasant,
      especially for young women. In 35 women ranging from 10 to 48 years (mean 29.2
      years), median sternotomy was performed via a submammary skin incision. In all
      cases an open heart surgical procedure was performed. Adequate exposure of the
      heart was achieved in every case and there were no technical problems related to
      this approach, no hospital mortality or major complications. The cosmetic result
      is excellent and this approach is certainly justified in open heart surgery for
      young women.

PMID- 2229152
TI  - Valvular and coronary surgery in renal transplant patients.
AB  - The Authors report aortic valvular replacement (AVR) and coronary artery bypass
      graft surgery (CABG) successfully performed in two renal transplant patients. The
      postoperative blood urea and creatinine levels were comparable to the
      preoperative values. The first patient underwent isolated AVR. The second patient
      had an initial AVR combined with CABG followed two years later by a further AVR
      for prosthetic dysfunction. For many reasons, coronary artery (CAD) and valvular
      diseases are not uncommon in renal transplant patients. Cardiac surgery is
      feasible without impairment of the renal function provided some precautions are
      taken, ie good mean perfusion pressure during cardiopulmonary bypass (CPB),
      adequate volume replacement, and selected use of mannitol and dopamine.

PMID- 2229153
TI  - Successful surgical treatment of subaortic stenosis caused by an accessory mitral
      valve.
AB  - A 22-month-old boy with subaortic stenosis was found to have relatively mature
      mitral valve tissue beneath the aortic valve, associated with a hypertrophic and
      prominent interventricular septum. This tissue caused obstruction of the left
      ventricular outflow tract and resulted in a pressure gradient of 70 mmHg between
      the aorta and the left ventricle. Surgical treatment was successfully performed
      to excise the tissue and part of the hypertrophic ventricular septum. Results of
      microscopic examination of the resected specimen are shown and discussed.

PMID- 2229154
TI  - An unusual late complication following surgical repair of tetralogy of Fallot.
AB  - A case is presented of extrusion of right ventricular outflow tract patch
      material through a mediastino-cutaneous fistula occurring five years after repair
      of tetralogy of Fallot. The focus of the mediastinal infection was an infected
      epicardial pacemaker electrode placed at the time of initial surgery. Subsequent
      echocardiographic studies showed minimal right ventricular outflow tract or
      pulmonary arterial dilatation, and, with no further surgery, the child is well
      after two and a half years follow-up.

PMID- 2229155
TI  - Acute dissection of the internal mammary artery: a fatal complication of coronary
      artery bypass grafting.
AB  - A case of acute traumatic dissection of the right internal mammary artery is
      presented in a patient who had both IMAs grafted for recurrent angina 10 years
      after initial vein coronary revascularisation. The event was mistaken for spasm,
      but because of severe circulatory collapse no time was available to treat the
      patient appropriately. The purpose of this report is to facilitate the early
      recognition and avoidance of this potentially fatal complication.

PMID- 2229156
TI  - Traction injury in the internal mammary artery. Report of a case and review of
      the literature.
AB  - The internal mammary artery (IMA) is now used routinely along with saphenous vein
      for myocardial revascularization procedures. We have documented a particular form
      of non-perforating injury which may reduce blood flow during operation or may
      lead to early closure of the IMA bypass graft. Traction injury to the intima is
      well documented in other vessles but has not been previously reported in the IMA.
      We present a potentially disastrous example of traction injury to the IMA.

PMID- 2229157
TI  - Three staged approach to the surgical management of renal cell carcinoma
      extending into the right atrium. Case report.
AB  - Left renal cell carcinoma extending into the right atrium was treated by
      angioinfarction, removal of right atrial tumour using cardiopulmonary bypass and
      ten days later abdominal radical nephrectomy and inferior vena cava thrombectomy.
      Twenty four months later the patient remains well with no evidence of tumour
      recurrence.

PMID- 2229158
TI  - Intraoperative assessment of cerebral ischemia during carotid surgery.
AB  - One of the problems in carotid surgery is the intraoperative detection of brain
      ischemia. None of the methods (EEG; stump pressure) applied so far have been
      successful. Branston et al. (1974) found a threshold relationship between
      cortical cerebral blood flow and cortical somatosensory evoked potential (SEP).
      As the local blood flow fell below about 16 ml/100 g/min a progressive reduction
      occurred in the amplitude of the cortical evoked potential (N20/P25), implying a
      fundamental failure of neuronal function in the somatosensory cortex. We have
      monitored cortical SEP (somatosensory evoked potential) during 734 CEA's (carotid
      endarterectomies) in order to find an index of risk of incipient cerebral
      ischemia during carotid cross-clamping, to determine the need for shunting and
      the causes of early irreversible neurologic deficits. In 59 cases evaluation of
      SEP was not possible because of technical difficulties. During 586 CEA's no
      alteration of SEP occurred. However, 4 patients had an immediate postoperative
      neurologic deficit, while the SEP remained normal. Abnormal SEP occurred in 89
      cases and in 6 of these an irreversible loss of SEP was seen. These patients
      awoke with a new neurologic deficit. We found a reversible abnormal SEP in 83
      cases. Reversible changes of SEP occurred mainly during carotid clamping. The
      diagnostic sensitivity of intraoperative SEP monitoring in predicting neurologic
      outcome was 60% with a specificity of 100%.

PMID- 2229159
TI  - Reappraisal of surgical treatment of traumatic transection of the thoracic aorta.
AB  - Since Crawford's report in 1973, repair of traumatic transection of the thoracic
      aorta without shunt or bypass has emerged as a popular technique which simplifies
      the operation and avoids use of heparin. Growing evidence, however, indicates
      that the incidence of paraplegia is higher with this method and may outweigh its
      advantages. With this in mind, we have examined our experience with 40 patients
      who underwent repair of aortic transection from 1975-1988. The operated patients
      in our series all survived. Fourteen were repaired using some type of bypass or
      shunt, none of whom developed paraplegia. The remaining 26 patients were repaired
      without a shunt and 9 (34.6%) developed paraplegia or paraparesis (p less than
      0.02). Paraplegia was related to aortic occlusion time (p less than 0.002). It
      did not occur in 11 patients with times less than 27 minutes, but happened in 2
      of 8 patients with times between 28 and 35 minutes and in all 7 patients with
      clamp times over 35 minutes. These data suggest that shunt or bypass should be
      used in most cases of aortic transection.

PMID- 2229160
TI  - Inflammatory abdominal aortic aneurysms.
AB  - In a series of 517 operations for abdominal aortic aneurysm from 1971 to 1988
      there were 45 cases (8.7%) with an inflammatory aneurysm with a typical thick
      glistening whitish fibrous layer. Almost two-third of the patients had rather
      severe chronic or acute progressive pain in the abdomen, the back or the flank.
      Unilateral (7) or bilateral (2) hydronephrosis due to ureteral compression
      occurred in 9 patients (20%). A diagnosis of inflammatory aneurysm was made
      preoperatively only in 10 patients. In 8 of the 9 patients with hydronephrosis
      ureterolysis was done, unilaterally (6) or bilaterally (2). After ureterolysis
      all had complete resolution of the hydronephrosis. Preoperative diagnostic
      methods are excretory urography, showing medial deviation, ultrasonography and CT
      scanning of the abdominal aorta. All patients with an inflammatory aneurysm
      should undergo aortic replacement to prevent rupture and achieve pain relief.
      Ureterolysis in cases of hydronephrosis is strongly recommended and may be
      performed safely and with excellent results.

PMID- 2229161
TI  - Thrombectomy for late graft limb occlusion: our experience in 182 consecutive
      cases.
AB  - Late occlusion of an aortofemoral bypass graft is usually caused by fibrointimal
      hyperplasia or progressive atherosclerosis. Several surgical approaches have been
      advocated in order to minimize the operative risk, to correct the impaired inflow
      and to provide a satisfactory outflow. In the last 16 years, in the Institute of
      Vascular Surgery and Angiology of the University of Milan, we have operated upon
      182 consecutive thrombosed grafts. Inflow was restored by performing a graft limb
      thrombectomy using a Fogarty balloon catheter and simultaneously employing an
      endarterectomy ring stripper to dislodge tenaciously adherent fibrinous material
      and thrombotic plug. As the superficial femoral artery was generally occluded,
      usually a good outflow was achieved by profundaplasty in 101 cases (55.5%) or
      direct bypass (interposition graft), to a more distal segment of the profunda
      femoris artery in 55 cases (30.2%). Concomitant popliteal or tibial
      revascularization was done in the remaining 26 cases (14.3%) when pre-operative
      or intra-operative findings suggested an inadequate collateral network through
      the profunda femoris artery. Early re-occlusion, which occurred in 14 cases
      (7.6%), generally due to insufficient outflow, was corrected by additional
      intervention in 7 cases (3.8%), while 7 legs were amputated for extensive
      atherosclerotic disease. Six patients died giving a mortality rate of 3.3%. This
      low rate in a high risk population is probably related to our policy of operating
      under loco-regional anaesthesia. Long term results, with a patency rate of 62.0%
      at 3 years and 60.2% at 5 years (life table method), prove that this operation is
      a durable procedure for correction of graft limb thrombosis.

PMID- 2229162
TI  - Assessment of major venous anomalies by computerized tomography.
AB  - Congenital anomalies of major venous structures are not common but their
      identification and relative position, particularly in relation to an abdominal
      aortic aneurysm, are of significant value in planning and conducting aortic
      operations. Computed tomography (CT) has become a common method of preoperative
      evaluation of aortic disease. Its reliability in providing accurate information
      regarding aneurysmal size, configuration, and extension, as well as the presence
      of intraluminal thrombus and involvement of the renal and iliac arteries, has
      been demonstrated. Simultaneous visualization of the major adjacent venous
      structures with the use of contrast enhancement is obtained, but anatomic
      variants can be overlooked because they are commonly subtle and considered
      incidental. The preoperative diagnosis of these venous abnormalities is
      significant to the vascular surgeon. Such information can be accurately and
      reliably acquired with the present CT techniques without the need for further
      diagnostic studies.

PMID- 2229163
TI  - Left retroperitoneal exposure for distal mesenteric artery repair.
AB  - Distal disease in the mesenteric arteries has usually been repaired
      transabdominally since it is believed that only the proximal centimeter of each
      vessel is accessible through the retroperitoneum. We treated five patients with
      chronic visceral ischemia and lesions extending beyond the orifice using a
      retroperitoneal approach. Exposure was obtained with a left flank incision
      through the tenth interspace. The left crus of the diaphragm was divided in order
      to control the supraceliac aorta. The mesenteric vessels were identified and
      dissected until their entrance into the peritoneum. There were no difficulties in
      exposing the superior mesenteric artery (SMA) as it coursed under the pancreas
      and over the duodenum for an approximate length of 5 to 10 cm. The uncinate
      process of the pancreas was not a limiting factor for exposure of the SMA in this
      region and further distal exposure could be obtained by incising the peritoneum.
      The trifurcation of the celiac artery and the splenic artery were accessible
      through this exposure; however, only the first centimeter of the hepatic and
      gastric branches could be reached. Revascularization was performed with
      endarterectomy (2 patients) and bypass (3 patients). Bowel viability was assessed
      at the conclusion of the procedure by incising the peritoneum. There were no
      complications from this exposure and no patient required reoperation for ischemic
      bowel. We conclude that the left retroperitoneal approach is not only acceptable
      for orifice lesions but is also applicable for distal disease.

PMID- 2229164
TI  - Stimulation of adenylate cyclase activity in cultured endothelial cells subjected
      to cyclic stretch.
AB  - While vascular endothelial cells are repeatedly stretched by the pulsatile nature
      of cardiac output, in vitro models traditionally used to study vascular biology
      involve static culture techniques. We have recently shown that pulsatile
      stretching of endothelial cells in culture will increase their rates of
      proliferation and regulate their secretion of macromolecules. The aim of this
      study was to determine whether membrane adenylate cyclase is involved in
      intracellular signalling during pulsatile stress. Bovine aortic endothelial cells
      were seeded on flexible-bottomed culture wells (3 x 10(5) cells/25 mm well) and
      allowed to attach for 48 hours. The culture wells were placed in a vacuum
      operated stress providing instrument and subjected to 0.5 s of 24% strain, 0.5 s
      relaxation (60 cycles/min) for 0, 1, 3, 5, 7, 10 and 15 minutes (N = 24
      wells/time point). Cells were homogenized and a crude membrane preparation
      (27,000 x g) was assayed for adenylate cyclase under basal and forskolin (100
      microM) stimulated conditions. The results indicate that there is a time
      dependent increase in both basal and stimulated adenylate cyclase with cyclic
      deformation and suggest that there may be a "stretch receptor" coupled to
      adenylate cyclase which can modulate endothelial cell function with hemodynamic
      changes.

PMID- 2229165
TI  - The effect of adjunctive arteriovenous fistula on prosthetic graft patency: a
      controlled study in a canine model.
AB  - Bilateral 6 mm PTFE grafts were placed from the external iliac artery to the
      femoral artery with ligation of the intervening segment of the iliofemoral artery
      in 14 dogs. An arteriovenous fistula was constructed at the distal anastomosis on
      one randomly selected side in each animal while the contralateral graft served as
      a control. Graft follow-up ranged between 8 and 12 months in all animals. Serial
      arteriography was performed to confirm graft and fistula patency and demonstrated
      persistence of antegrade flow into the arterial tree distal to all patent
      bypasses. Femoral intraarterial pressures distal to patent grafts were identical
      on both sides in each animal throughout the study. Cumulative life-table patency
      rates showed higher patency for the arteriovenous fistula bypasses than the
      control grafts at all time intervals: 71% vs. 57% at 3 months, 48% vs. 25% at 6
      months, and 40% vs. 22% at 12 months, respectively. This is the first controlled
      study that provides experimental evidence suggesting that these bypasses may
      produce increased patency of prosthetic arterial grafts and lends support to
      their use in a clinical, prospective, randomized study.

PMID- 2229166
TI  - Effect of antiplatelet and anticoagulant therapy on patency of femorotibial
      bypass grafts.
AB  - In a retrospective study, 210 autogenous femorotibial saphenous vein grafts
      inserted during the 15 years from 1967 to 1982 were followed-up for a mean period
      of 62.3 +/- 5.7 months. Seven patients, who had had eight grafts died in
      hospital. The remaining 202 grafts fell into three groups: (1) Sixty grafts in
      patients who received 325 mg of dipyridamole and 1.0 g of acetylsalicylic acid
      daily, starting on the second postoperative day and continuing for six months.
      (2) One hundred and two grafts in patients on no antithrombotic therapy. (3)
      Forty grafts in patients on warfarin therapy to maintain the prothrombin time
      (prothrombin-proconvertin method) within the therapeutic range (0.10 to 0.20).
      Medication was continued for six months. This group included more high-risk
      patients than the other two groups. The mean ages and the incidence of risk
      factors did not vary significantly between the groups. The patency rates in three
      groups at five years were 62.5%, 44.0% and 26.0% and at ten years 48.5%, 25.0%
      and 21.5% for the dipyridamole and acetylsalicylic acid, no therapy and warfarin
      groups, respectively. The limb salvage rates were 100%, 96% and 85% in the
      dipyridamole and acetylsalicylic acid, no therapy and warfarin groups
      respectively. Thus, the best results were seen in the aspirin/dipyridamole group.

PMID- 2229167
TI  - Balloon dilatation versus surgical revision of infra-inguinal autogenous vein
      graft stenoses: long-term follow-up.
AB  - Although infra-inguinal autogenous vein graft stenoses may be treated by balloon
      dilatation (PTA) or surgical revision, the optimal approach is undefined. Over
      the last 7 years 24 PTA procedures were performed on 37 vein graft stenoses in 19
      grafts. Graft stenoses were diagnosed from 2 to 72 (mean = 17.3) months after
      implantation. PTA was successfully completed in 23 (96%) of the 24 procedures
      including 18 (95%) of the primary, and 5 (100%) of the secondary procedures.
      Recurrent vein graft stenosis or graft thrombosis developed in 12 (67%) grafts
      from 3 to 47 (mean = 12.5) months after primary PTA. Long-term patency after
      primary PTA was 69% at 6, 29% at 12, and 22% at 36 months; secondary patency was
      81% at 6, 45% at 12, and 27% at 36 months. During the same period vein graft
      stenosis in 7 fem-pop and 2 fem-tib grafts were surgically revised with an
      initial success rate of 100%, and 2 (22%) complications. Four (44%) of these
      grafts occluded from 1-17 (mean 6.2) months after repair, yielding a primary 5
      year patency of 62%. Although vein graft stenosis may be safely, effectively, and
      repeatedly treated with PTA, long-term durability appears to be superior after
      surgical revision.

PMID- 2229168
TI  - Surveillance of in situ infrainguinal bypass grafts: conventional vs. color flow
      duplex ultrasonography.
AB  - Surveillance of in situ saphenous vein bypass grafts with duplex scanning detects
      graft abnormalities which may lead to graft thrombosis. Correction of these
      defects, while grafts are still patent, potentially improves overall graft
      patency. In this study we compared color flow and conventional duplex to
      determine whether color flow provided additional information not obtainable by
      conventional duplex examination. The primary patency rate (patency maintained
      without intervention) for all 51 cases was 76% (39/51). The secondary patency
      rate (patency maintained by identification and correction of graft defects before
      failure) was 88% (45/51). Duplex scanning reduced the graft failure rate by 50%.
      Color flow and conventional duplex examination provided the same information
      regarding incipient graft failure. In 20 patients monitored with both techniques,
      the same number of proximal (100%) and distal (90%) anastomoses were imaged. The
      same number of graft defects (three vein graft stenoses, one proximal femoral
      artery stenosis) were identified. Velocity data obtained using the two techniques
      (peak systolic velocity in an area of stenosis and the duplex velocity ratio)
      were not always the same, making calculation of percent stenosis from this data
      inaccurate. Color flow duplex is useful in monitoring graft patency, but provides
      no additional information over that provided by conventional scanning.

PMID- 2229169
TI  - Aneurysmal dilatation in saphenous vein bypass grafts.
AB  - Three patients are reported who developed aneurysmal degeneration of a saphenous
      vein arterial bypass graft. All three had hypercholesterolemia and two had marked
      elevation of triglycerides. One bypass was for occlusive disease and two for
      popliteal aneurysm. There was a long lag, 3 to 7 years between graft implantation
      and aneurysmal degeneration. The pathology was similar for all three cases with
      lipid laden macrophages, loss of elastic lamina, and other atherosclerotic
      changes in the vein wall. While atheromatous changes and aneurysm formation in
      saphenous vein bypass grafts are rare, this may occur especially in patients with
      hypercholesterolemia and hypertriglyceridemia. Careful and prolonged follow-up
      plus vigorous management of the hyperlipidemic state is mandatory in these
      patients.

PMID- 2229170
TI  - Primary varicose veins: topographic and hemodynamic correlations.
AB  - This study was conducted to correlate the clinical presentations of uncomplicated
      primary varicose veins with the topographic and anatomic source of reflux (escape
      points). One-hundred sixty-three patients with primary varicose veins (144
      females, 19 males; 96 unilateral, 67 bilateral) in 230 involved limbs were
      examined. The origin and extent of venous reflux was traced with Doppler
      ultrasound. Three distinct groups were recognized. Group I. Typical saphenous
      varicosities with junctional escapes occurred in 164 (71.3%). Sapheno-femoral
      junction (SFJ) incompetence in 147, and sapheno-popliteal junction (SPJ)
      incompetence in 17 limbs. Group II. Atypical saphenous varicosities with non
      junctional escapes occurred in 51 (22.17%) limbs. In 5 limbs, no escape was
      detected. Twenty-two limbs had escapes localized in the main perforators: mid
      thigh perforator 17, upper calf 2, distal ankle in 3. Twenty-four limbs had their
      escapes in the auxiliary perforators: abdomino-pelvic 17, and circumflex
      iliac/external epigastric, 7 limbs. Group III. Non saphenous (lateral venous
      system) varicosities occurred in 15 (6.52%) limbs. Based on physical examination
      alone, 55 limbs would possibly have undergone unnecessary ankle to groin
      stripping and 83 limbs an unnecessary SFJ ligation. Doppler US is an essential
      diagnostic tool that can accurately map the origin and extent of the venous
      reflux. The obtained hemodynamic information will permit more selective,
      multimodal therapy and avoid the indiscriminate, often unnecessary stripping of
      the entire saphenous system in all cases of primary varicose veins.

PMID- 2229171
TI  - Management of deep venous thrombosis in the pregnant female.
AB  - Deep venous thrombosis of the lower extremities is an uncommon but dreaded
      complication of pregnancy which can present diagnostic and therapeutic problems
      to the treating physician. From January 1, 1985, to December 31, 1988, 7867
      deliveries were performed at St. Luke's Hospital. Five of these patients were
      pregnant women who were treated for deep venous thrombosis of the lower
      extremities. The women were either in their second or third trimester of
      pregnancy. The clinical diagnosis in each case was confirmed with duplex
      ultrasonography. Each patient was treated with 7 to 10 days of intravenous
      heparin therapy and then discharged on subcutaneous heparin therapy. There were
      no bleeding complications related to the heparin therapy. No patient developed a
      pulmonary embolism. Each patient delivered a normal child. The only complication
      was a heparin induced rash in one patient which resolved when a different
      preparation of heparin was used. The management of deep venous thrombosis in
      pregnancy is discussed.

PMID- 2229172
TI  - Multifunctional Ca2+/calmodulin-dependent protein kinase is necessary for nuclear
      envelope breakdown.
AB  - The role of multifunctional Ca2+/calmodulin-dependent protein kinase (CaM kinase)
      in nuclear envelope breakdown (NEB) was investigated in sea urchin eggs. The eggs
      contain a 56-kD polypeptide which appears to be a homologue of neuronal CaM
      kinase. For example, it undergoes Ca2+/calmodulin-dependent autophosphorylation
      that converts it to a Ca2(+)-independent species, a hallmark of multifunctional
      CaM kinase. It is homologous to the alpha subunit of rat brain CaM kinase.
      Autophosphorylation and substrate phosphorylation by the sea urchin egg kinase
      are inhibited in vitro by CaMK(273-302), a synthetic peptide corresponding to the
      autoinhibitory domain of the neuronal CaM kinase. This peptide inhibited NEB when
      microinjected into sea urchin eggs. Only one mAb to the neuronal enzyme
      immunoprecipitated the 56-kD polypeptide. Only this antibody blocked or
      significantly delayed NEB when microinjected into sea urchin eggs. These results
      suggest that sea urchin eggs contain multifunctional CaM kinase, and that this
      enzyme is involved in the control of NEB during mitotic division.

PMID- 2229173
TI  - Identification of two HSP70-related Xenopus oocyte proteins that are capable of
      recycling across the nuclear envelope.
AB  - Two 70-kD polypeptides, B3 and B4, are present in equivalent concentrations in
      the nucleus and cytoplasm of Xenopus oocytes. The objectives of this study were
      to determine if they (a) are members of the 70-kD family of heat shock proteins,
      and (b) recycle between the nuclear and cytoplasmic compartments. Evidence based
      on high-affinity binding to ATP, cross-reactivity of B3/B4-specific antibodies
      with rat hsc70, and a comparison of cyanogen bromide cleavage peptide maps with
      hsc70, verified that B3 and B4 are members of the 70-kD family of heat-shock
      proteins. Nuclear uptake studies were performed by microinjecting 125I-labeled
      B3/B4, rat hsc70, and BSA into the cytoplasm of oocytes, and examining their
      subsequent intracellular distributions. By 6 h postinjection, the nuclear
      concentration of B3/B4 and hsc70 were approximately 24-fold greater than BSA
      controls. It was also found that B3/B4-coated gold particles as large as 120A in
      diameter were able to enter the nucleus by passing through the pores. Nuclear
      efflux was analyzed by microinjecting the iodinated proteins directly into the
      oocyte nuclei. 2 h after nuclear injection, at least 46% of the B3/B4 and 60% of
      the hsc70 were found in the cytoplasmic fractions, compared with less than 10%
      for the BSA controls. Cell fusion experiments, in which labeled, anucleate oocyte
      vegetal hemispheres were fused, under oil, with nucleate unlabeled animal
      hemispheres, demonstrated that cytoplasmic B3 and B4 could enter the nucleus
      after equilibration was reached, arguing against the existence of separate
      nuclear and cytoplasmic populations. Collectively, these results show that B3,
      B4, and rat hsc70 are transported across the nuclear envelope and recycle between
      the nucleus and cytoplasm.

PMID- 2229174
TI  - Characterization and inducibility of hsp 70 proteins in the male mouse germ line.
AB  - The properties and inducibility of the heat shock protein 70 (hsp 70) gene
      products were examined during differentiation of mouse testicular cells by one
      and two-dimensional gel electrophoresis and immunoblotting. Low levels of the 72-
      and 73-kD heat shock proteins normally found in mouse cell lines were detected in
      the mouse testis. A novel isoform with a relative molecular mass of 73 kD (called
      73T) was also observed, in the presence or absence of heat shock. 73T was shown
      to be produced by germ cells since it was not detected in testes from mutant mice
      devoid of germ cells. Furthermore, 73T was found only in adult mouse testicular
      cells, not in testes from animals that lack meiotic germ cells. 73T was
      synthesized in enriched cell populations of both meiotic prophase and postmeiotic
      cells, but was not inducible by in vitro heat shock. In the adult testis, low
      levels of the bona fide 72-kD heat-inducible (hsp72) were induced in response to
      elevated temperatures. In contrast, in testes from animals in which only somatic
      cells and premeiotic germ cells were present, there was a substantial induction
      of hsp 72. It is suggested that hsp 72 is inducible in the somatic compartment
      and possibly in the premeiotic germ cells, but not in germ cells which have
      entered meiosis and which are expressing members of the hsp 70 gene family in a
      developmentally regulated fashion.

PMID- 2229175
TI  - Evidence that proteolysis of the surface is an initial step in the mechanism of
      formation of sperm cell surface domains.
AB  - On terminally differentiated sperm cells, surface proteins are segregated into
      distinct surface domains that include the anterior and posterior head domains. We
      have analyzed the formation of the anterior and posterior head domains of guinea
      pig sperm in terms of both the timing of protein localization and the
      mechanism(s) responsible. On testicular sperm, the surface proteins PH-20, PH-30
      and AH-50 were found to be present on the whole cell (PH-20) or whole head
      surface (PH-30, AH-50). On sperm that have completed differentiation (cauda
      epididymal sperm), PH-20 and PH-30 proteins were restricted to the posterior head
      domain and AH-50 was restricted to the anterior head domain. Thus these proteins
      become restricted in their distribution late in sperm differentiation, after
      sperm leave the testis. We discovered that the differentiation process that
      localizes these proteins can be mimicked in vitro by treating testicular sperm
      with trypsin. After testicular sperm were treated with 20 micrograms/ml trypsin
      for 5 min at room temperature, PH-20, PH-30, and AH-50 were found localized to
      the same domains to which they are restricted during in vivo differentiation. The
      in vitro trypsin-induced localization of PH-20 to the posterior head mimicked the
      in vivo differentiation process quantitatively as well as qualitatively. The
      quantitative analysis showed the process of PH-20 localization involves the
      migration of surface PH-20 from other regions to the posterior head domain.
      Immunoprecipitation experiments confirmed that there is protease action in vivo
      on the sperm surface during the late stages of sperm differentiation. Both the PH
      20 and PH-30 proteins were shown to be proteolytically cleaved late in sperm
      differentiation. These findings strongly implicate proteolysis of surface
      molecules as an initial step in the mechanism of formation of sperm head surface
      domains.

PMID- 2229176
TI  - A beta-spectrin isoform from Drosophila (beta H) is similar in size to vertebrate
      dystrophin.
AB  - Spectrins are a major component of the membrane skeleton in many cell types where
      they are thought to contribute to cell form and membrane organization. Diversity
      among spectrin isoforms, especially their beta subunits, is associated with
      diversity in cell shape and membrane architecture. Here we describe a spectrin
      isoform from Drosophila that consists of a conventional alpha spectrin subunit
      complexed with a novel high molecular weight beta subunit (430 kD) that we term
      beta H. The native alpha beta H molecule binds actin filaments with high affinity
      and has a typical spectrin morphology except that it is longer than most other
      spectrin isoforms and includes two knoblike structures that are attributed to a
      unique domain of the beta H subunit. Beta H is encoded by a different gene than
      the previously described Drosophila beta-spectrin subunit but shows sequence
      similarity to beta-spectrin as well as vertebrate dystrophin, a component of the
      membrane skeleton in muscle. By size and sequence similarity, dystrophin is more
      similar to this newly described beta-spectrin isoform (beta H) than to other
      members of the spectrin gene family such as alpha-spectrin and alpha-actinin.

PMID- 2229178
TI  - Myosin mRNA accumulation and myofibrillogenesis at the myotendinous junction of
      stretched muscle fibers.
AB  - Myofiber growth and myofibril assembly at the myotendinous junction (MTJ) of
      stretch-hypertrophied rabbit skeletal muscle was studied by in situ
      hybridization, immunofluorescence, and electron microscopy. In situ hybridization
      identified higher levels of myosin heavy chain (MHC) mRNA at the MTJ of fibers
      stretched for 4 d. Electron microscopy at the MTJ of these lengthening fibers
      revealed a large cytoplasmic space devoid of myofibrils, but containing
      polysomes, sarcoplasmic reticulum and T-membranes, mitochondria, Golgi complexes,
      and nascent filament assemblies. Tallies from electron micrographs indicate that
      myofibril assembly in stretched fibers followed a set sequence of events. (a) In
      stretched fiber ends almost the entire sarcolemmal membrane was electron dense
      but only a portion had attached myofibrils. Vinculin, detected by
      immunofluorescence, was greatly increased at the MTJ membrane of stretched
      muscles. (b) Thin filaments were anchored to the sarcolemma at the electron dense
      sites. (c) Thick filaments associated with these thin filaments in an
      unregistered manner. (d) Z-bodies splice into thin filaments and subsequently
      thin and thick filaments fall into sarcomeric register. Thus, the MTJ is a site
      of mRNA accumulation which sets up regional protein synthesis and myofibril
      assembly. Stretched muscles also lengthen by the addition of myotubes at their
      ends. After 6 d of stretch these myotubes make up the majority of fibers at the
      muscle ends. Essentially all these myotubes repeat the developmental program of
      primary myotubes and express slow MHC. MHC mRNA distribution in myotubes is
      disorganized as is the distribution of their myofibrils.

PMID- 2229177
TI  - Primary structure of the 175K Plasmodium falciparum erythrocyte binding antigen
      and identification of a peptide which elicits antibodies that inhibit malaria
      merozoite invasion.
AB  - The Plasmodium falciparum gene encoding erythrocyte binding antigen-175 (EBA
      175), a putative receptor for red cell invasion (Camus, D., and T. J. Hadley.
      1985. Science (Wash. DC). 230:553-556.), has been isolated and characterized. DNA
      sequencing demonstrated a single open reading frame encoding a translation
      product of 1,435 amino acid residues. Peptides corresponding to regions on the
      deduced amino acid sequence predicted to be B cell epitopes were assessed for
      immunogenicity. Immunization of mice and rabbits with EBA-peptide 4, a synthetic
      peptide encompassing amino acid residues 1,062-1,103, produced antibodies that
      recognized P. falciparum merozoites in an indirect fluorescent antibody assay.
      When compared to sera from rabbits immunized with the same adjuvant and carrier
      protein, sera from rabbits immunized with EBA-peptide 4 inhibited merozoite
      invasion of erythrocytes in vitro by 80% at a 1:5 dilution. Furthermore, these
      sera inhibited the binding of purified, authentic EBA-175 to erythrocytes,
      suggesting that their activity in inhibiting merozoite invasion of erythrocytes
      is mediated by blocking the binding of EBA-175 to erythrocytes. Since the
      nucleotide sequence of EBA-peptide 4 is conserved among seven strains of P.
      falciparum from throughout the world (Sim, B. K. L. 1990. Mol. Biochem.
      Parasitol. 41:293-296.), these data identify a region of the protein that should
      be a focus of vaccine development efforts.

PMID- 2229179
TI  - Localization of myosin IC and myosin II in Acanthamoeba castellanii by indirect
      immunofluorescence and immunogold electron microscopy.
AB  - Polyclonal antisera have been raised against purified Acanthamoeba myosin II and
      to a synthetic 26 amino acid peptide that corresponds in sequence to the
      phosphorylation site of Acanthamoeba myosin IC. These antisera are specific for
      their respective antigens as determined by immunoblotting after SDS-PAGE of total
      cell lysates. By using the antisera, localization studies were performed by
      indirect immunofluorescence and by immunogold electron microscopy. Myosin II
      occurred in the cell cytoplasm and appeared to be concentrated in the cortex.
      Immunogold cytochemistry revealed at high resolution that myosin II is organized
      into rodlike filaments approximately 200 nm long. The antibody raised against the
      myosin IC synthetic peptide recognized both the plasma membrane and the membrane
      of the contractile vacuole. The plasma membrane staining was labile to treatment
      with saponin suggesting an intimate association of the myosin IC with membrane
      phospholipids. Immunogold cytochemistry with the antimyosin IC synthetic peptide
      showed that the myosin IC is closely associated with the membrane bilayer.

PMID- 2229180
TI  - Mechanism of the formation of contractile ring in dividing cultured animal cells.
      II. Cortical movement of microinjected actin filaments.
AB  - The contractile ring in dividing animal cells is formed primarily through the
      reorganization of existing actin filaments (Cao, L.-G., and Y.-L. Wang. 1990. J.
      Cell Biol. 110:1089-1096), but it is not clear whether the process involves a
      random recruitment of diffusible actin filaments from the cytoplasm, or a
      directional movement of cortically associated filaments toward the equator. We
      have studied this question by observing the distribution of actin filaments that
      have been labeled with fluorescent phalloidin and microinjected into dividing
      normal rat kidney (NRK) cells. The labeled filaments are present primarily in the
      cytoplasm during prometaphase and early metaphase, but become associated
      extensively with the cell cortex 10-15 min before the onset of anaphase. This
      process is manifested both as an increase in cortical fluorescence intensity and
      as movements of discrete aggregates of actin filaments toward the cortex. The
      concentration of actin fluorescence in the equatorial region, accompanied by a
      decrease of fluorescence in polar regions, is detected 2-3 min after the onset of
      anaphase. By directly tracing the distribution of aggregates of labeled actin
      filaments, we are able to detect, during anaphase and telophase, movements of
      cortical actin filaments toward the equator at an average rate of 1.0 micron/min.
      Our results, combined with previous observations, suggest that the organization
      of actin filaments during cytokinesis probably involves an association of
      cytoplasmic filaments with the cortex, a movement of cortical filaments toward
      the cleavage furrow, and a dissociation of filaments from the equatorial cortex.

PMID- 2229181
TI  - Components of the yeast spindle and spindle pole body.
AB  - Yeast spindle pole bodies (SPBs) with attached nuclear microtubles were enriched
      approximately 600-fold from yeast cell extracts. 14 mAbs prepared against this
      enriched SPB fraction define at least three components of the SPB and spindle.
      Immunofluorescent staining of yeast cells showed that throughout the cell cycle
      two of the components (110 and 90 kD) were localized exclusively to the SPB
      region, and the other (80 kD) was localized both to the SPB region and to
      particulate dots in short spindles. Immunoelectron microscopy confirmed and
      extended most of these findings. Thus the 110-kD component was localized to a
      layer in the SPB just to the nuclear side of the plane of the inner nuclear
      membrane. The 90-kD component was localized in a layer across the cytoplasmic
      face of intact SPBs, and, in SPBs where nuclear microtubules were removed by
      extraction with DEAE-dextran, the 90-kD component was also found in an inner
      nuclear layer close to where spindle microtubules emerge. In intact SPBs with
      attached nuclear microtubules the anit-80-kD mAb labels microtubules,
      particularly those close to the SPB. These results begin to provide a preliminary
      molecular map of the SPB and should also enable the corresponding genes to be
      isolated.

PMID- 2229182
TI  - Spatial and temporal colocalization of the Golgi apparatus and microtubules rich
      in detyrosinated tubulin.
AB  - The integrity and intracellular distribution of the Golgi apparatus appear to
      depend upon microtubules. We have found that the microtubules rich in
      detyrosinated tubulin are located preferentially in the vicinity of the Golgi.
      Cells were double-stained with antibodies specific for either tyrosinated or
      detyrosinated tubulin and an antibody to prolactin or wheat germ agglutinin
      (Golgi markers). Microtubules rich in detyrosinated tubulin showed a close
      codistribution with the Golgi in three different cultured cell lines GH3, BS-C-1,
      and AtT20. Disruption of microtubules with nocodazole in GH3 cells resulted in
      fragmentation and dispersal of the Golgi apparatus as reported previously. During
      recovery of the microtubules and the Golgi complex after removal of the
      nocodazole, there was a spatial and temporal colocalization of the Golgi
      apparatus and microtubules rich in detyrosinated tubulin. Our results suggest
      that a functional relationship may exist between the structure and organization
      of the Golgi complex and the detyrosination of alpha-tubulin in microtubules.

PMID- 2229183
TI  - Growth cone behavior and production of traction force.
AB  - The growth cone must push its substrate rearward via some traction force in order
      to propel itself forward. To determine which growth cone behaviors produce
      traction force, we observed chick sensory growth cones under conditions in which
      force production was accommodated by movement of obstacles in the environment,
      namely, neurites of other sensory neurons or glass fibers. The movements of these
      obstacles occurred via three, different, stereotyped growth cone behaviors: (a)
      filopodial contractions, (b) smooth rearward movement on the dorsal surface of
      the growth cone, and (c) interactions with ruffling lamellipodia. More than 70%
      of the obstacle movements were caused by filopodial contractions in which the
      obstacle attached at the extreme distal end of a filopodium and moved only as the
      filopodium changed its extension. Filopodial contractions were characterized by
      frequent changes of obstacle velocity and direction. Contraction of a single
      filopodium is estimated to exert 50-90 microdyn of force, which can account for
      the pull exerted by chick sensory growth cones. Importantly, all five cases of
      growth cones growing over the top of obstacle neurites (i.e., geometry that
      mimics the usual growth cone/substrate interaction), were of the filopodial
      contraction type. Some 25% of obstacle movements occurred by a smooth backward
      movement along the top surface of growth cones. Both the appearance and rate of
      movements were similar to that reported for retrograde flow of cortical actin
      near the dorsal growth cone surface. Although these retrograde flow movements
      also exerted enough force to account for growth cone pulling, we did not observe
      such movements on ventral growth cone surfaces. Occasionally obstacles were moved
      by interaction with ruffling lamellipodia. However, we obtained no evidence for
      attachment of the obstacles to ruffling lamellipodia or for directed obstacle
      movements by this mechanism. These data suggest that chick sensory growth cones
      move forward by contractile activity of filopodia, i.e., isometric contraction on
      a rigid substrate. Our data argue against retrograde flow of actin producing
      traction force.

PMID- 2229184
TI  - Antisense inhibition of glial S100 beta production results in alterations in cell
      morphology, cytoskeletal organization, and cell proliferation.
AB  - The phenotypic effects of selectively decreasing the levels of S100 beta in
      cultured glial cells were analyzed. Two separate antisense approaches were
      utilized for inhibition of S100 beta production: analysis of clonal isolates of
      rat C6 glioma cells containing an S100 beta antisense gene under the control of a
      dexamethasone-inducible promoter, and analysis of C6 cells treated with S100 beta
      antisense oligodeoxynucleotides. Both antisense methods resulted in a decrease in
      S100 beta levels in the cell, as measured by RIA. The inhibition of S100 beta
      production correlated with three alterations in cellular phenotype: (a) a
      flattened cell morphology; (b) a more organized microfilament network; and (c) a
      decrease in cell growth rate. The studies describe here provide direct evidence
      for an involvement of S100 beta in glial cell structure and function, and suggest
      potential in vivo roles for S100 beta in regulation of glial cell morphology,
      cytoskeletal organization, and cell proliferation.

PMID- 2229185
TI  - Acetylcholine receptor clustering is triggered by a change in the density of a
      nonreceptor molecule.
AB  - Acetylcholine receptors become clustered at the neuromuscular junction during
      synaptogenesis, at least in part via lateral migration of diffusely expressed
      receptors. We have shown previously that electric fields initiate a specific
      receptor clustering event which is dependent on lateral migration in aneural
      muscle cell cultures (Stollberg, J., and S. E. Fraser. 1988. J. Cell Biol.
      107:1397-1408). Subsequent work with this model system ruled out the possibility
      that the clustering event was triggered by increasing the receptor density beyond
      a critical threshold (Stollberg, J., and S. E. Fraser. 1990. J. Neurosci. 10:247
      255). This leaves two possibilities: the clustering event could be triggered by
      the field-induced change in the density of some other molecule, or by a membrane
      voltage-sensitive mechanism (e.g., a voltage-gated calcium signal).
      Electromigration is a slow, linear process, while voltage-sensitive mechanisms
      respond in a rapid, nonlinear fashion. Because of this the two possibilities make
      different predictions about receptor clustering behavior in response to pulsed or
      alternating electric fields. In the present work we have studied subcellular
      calcium distributions, as well as receptor clustering, in response to such
      fields. Subcellular calcium distributions were quantified and found to be
      consistent with the predicted nonlinear response. Receptor clustering, however,
      behaves in accordance with the predictions of a linear response, consistent with
      the electromigration hypothesis. The experiments demonstrate that a local
      increase in calcium, or, more generally, a voltage-sensitive mechanism, is not
      sufficient and probably not necessary to trigger receptor clustering. Experiments
      with slowly alternating electric fields confirm the view that the clustering of
      acetylcholine receptors is initiated by a local change in the density of some non
      receptor molecule.

PMID- 2229186
TI  - Properties of the desmin tail domain: studies using synthetic peptides and
      antipeptide antibodies.
AB  - Intermediate filament (IF) proteins have a common structural motif consisting of
      an alpha-helical rod domain flanked by non-alpha-helical amino-terminal head and
      carboxy-terminal tail domains. Coiled-coil interaction between neighboring rod
      domains is though to generate the backbone of the 10-nm filament. There must also
      be other interactions between subunits to bring them into alignment and to effect
      elongation of the filament, but these are poorly understood. To examine the
      involvement of the tail domain in filament structure and stabilization, we have
      studied the interaction between a synthetic peptide corresponding to residues 442
      450 of avian desmin, and authentic desmin protein. The potential importance of
      this region lies in its hydrophilic nature and its high degree of homology among
      the Type III IF proteins and cytokeratins 8 and 18. The peptide, D442-450, binds
      to a 27-residue region between lys-436 and leu-463, the carboxy terminus. The
      presence of the peptide during assembly causes the filaments to appear much more
      loosely packed than normal desmin IF. We have also generated polyclonal
      antibodies against this peptide and attempted to localize this portion of the
      tailpiece along desmin IFs by immunological procedures. By immunoblotting, we
      found that anti-D442-450 antibodies recognize desmin and only those proteolytic
      fragments that contain the tailpiece. In contrast, the antibodies do not label
      any structure in adult gizzard smooth muscle and skeletal muscle myofibrils in
      immunofluorescence experiments during which conventional antidesmin antibodies
      do. At the ultrastructural level, anti-D442-450 antibodies label free desmin
      tetramers but not desmin IFs. These results show that, as part of an assembled
      IF, the epitope of anti-D442-450 is inaccessible to the antibodies, and suggest
      that either the tailpiece of an IF protein may not be entirely peripheral to the
      filament backbone, or the interaction between end domains during assembly masks
      this particular region of the IF molecule.

PMID- 2229187
TI  - Epithelial origin of cutaneous anchoring fibrils.
AB  - Anchoring fibrils are essential structural elements of the dermoepidermal
      junction and are crucial to its functional integrity. They are composed largely
      of type VII collagen, but their cellular origin has not yet been confirmed. In
      this study, we demonstrate that the anchoring fibrils are primarily a product of
      epidermal keratinocytes. Human keratinocyte sheets were transplanted to a
      nondermal connective tissue graft bed in athymic mice. De novo anchoring fibril
      formation was studied ultrastructurally by immunogold techniques using an
      antiserum specific for human type VII procollagen. At 2 d after grafting, type
      VII procollagen/collagen was localized both intracellularly within basal
      keratinocytes and extracellularly beneath the discontinuous basal lamina. Within
      6 d, a subconfluent basal lamina had developed, and newly formed anchoring
      fibrils and anchoring plaques subjacent to the xenografts were labeled.
      Throughout the observation period of the experiment, the maturity, population
      density, and architectural complexity of anchoring fibrils beneath the human
      epidermal graft continuously increased. Identical findings were obtained using
      xenografts cultivated from cloned human keratinocytes, eliminating the
      possibility of contributions to anchoring fibril regeneration from residual human
      fibroblasts. Immunolabeling was not observed at the mouse dermoepidermal junction
      at any time. These results demonstrate that the type VII collagen of human
      cutaneous anchoring fibrils and plaques is secreted by keratinocytes and can
      traverse the epidermal basal lamina and that the fibril formation can occur in
      the absence of cells of human dermal origin.

PMID- 2229188
TI  - Identification of a novel glycoprotein (AGp110) involved in interactions of rat
      liver parenchymal cells with fibronectin.
AB  - We have identified an integral membrane glycoprotein in rat liver that mediates
      adhesion of cultured hepatocytes on fibronectin substrata. The protein was
      isolated by affinity chromatography of detergent extracts on wheat germ lectin
      Agarose followed by chromatography of the WGA binding fraction on fibronectin
      Sepharose. The glycoprotein (AGp110), eluted at high salt concentrations from the
      fibronectin column, has a molecular mass of 110 kD and a pI of 4.2. Binding of
      immobilized AGp110 to soluble rat plasma fibronectin required Ca2+ ions but was
      not inhibited by RGD peptides. Fab' fragments of immunoglobulins raised in
      rabbits against AGp110 reversed the spreading of primary hepatocytes attached
      onto fibronectin-coated substrata, but had no effect on cells spread on type IV
      collagen or laminin substrata. The effect of the antiserum on cell spreading was
      reversible. AGp110 was detected by immunofluorescence around the periphery of the
      ventral surface of substratum attached hepatocytes, and scattered on the dorsal
      surface. Immunohistochemical evidence and Western blotting of fractionated liver
      plasma membranes indicated a bile canalicular (apical) localization of AGp110 in
      the liver parenchyma. Expression of AGp110 is tissue specific: it was found
      mainly in liver, kidney, pancreas, and small intestine but was not detected in
      stomach, skeletal muscle, heart, and large intestine. AGp110 could be labeled by
      lactoperoxidase-catalyzed surface iodination of intact liver cells and, after
      phase partitioning of liver plasma membranes with the detergent Triton X-114, it
      was preferentially distributed in the hydrophobic phase. Treatment with
      glycosidases indicated extensive sialic acid substitution in at least 10 O-linked
      carbohydrate chains and 1-2 N-linked glycans. Immunological comparisons suggest
      that AGp110, the integrin fibronectin receptor and dipeptidyl peptidase IV, an
      enzyme involved in fibronectin-mediated adhesion of hepatocytes on collagen, are
      distinct proteins.

PMID- 2229190
TI  - Mapping MAP-2.

PMID- 2229189
TI  - Human smooth muscle VLA-1 integrin: purification, substrate specificity,
      localization in aorta, and expression during development.
AB  - A membrane glycoprotein complex was isolated and purified from human smooth
      muscle by detergent solubilization and affinity chromatography on collagen
      Sepharose. The complex was identified as VLA-1 integrin and consisted of two
      subunits of 195 and 130 kD in SDS-PAGE. Liposomes containing the VLA-1 integrin
      adhered to surfaces coated with type I, II, III, and IV collagens, Clq
      subcomponent of the first component of the complement, and laminin. The liposomes
      specifically adhered to these proteins in a Ca2+, Mg2(+)-dependent manner, but
      did not bind to gelatin, fibronectin, and thrombospondin substrates. The
      expression of VLA-1 integrin in different human tissues and cell types, and
      during aorta smooth muscle development was studied by SDS-PAGE, and subsequent
      quantitative immunoblotting was performed with antibodies recognizing alpha 1 and
      beta 1 subunits of the VLA-1 integrin. A high level of VLA-1 integrin expression
      was an exceptional feature of smooth muscles. Fibroblasts, endothelial cells,
      keratinocytes, striated muscles, and platelets contained trace amounts of VLA-1
      integrin. In the 10-wk-old human fetal aorta, VLA-1 integrin was found only in
      smooth muscle cells whereas mesenchymal cells, surrounding aortic smooth muscle
      cells, were VLA-1 integrin negative. By the 24th wk of gestation, the amount of
      VLA-1 integrin was significantly reduced in the aortic media (4.3-fold for alpha
      1 subunit and 2.5-fold for beta 1 subunit) compared with that in the 10-wk-old
      aortic smooth muscle cells. After birth, the expression of VLA-1 integrin
      increased and in the 1.5-yr-old child aorta the VLA-1 integrin level was almost
      the same as in adult aortic media. Smooth muscle cells from intimal thickening of
      adult aorta express five times less alpha 1 subunit of VLA integrin that smooth
      muscle cells from adult aortic media. In primary culture of aortic smooth muscle
      cells, the content of the VLA-1 integrin was dramatically reduced and subcultured
      cells did not contain VLA-1 integrin at all.

PMID- 2229191
TI  - Localization of human growth hormone to a sub-set of cytoplasmic vesicles in
      transfected PC12 cells.
AB  - Two distinct population of vesicles can be identified in PC12 cells by
      subcellular fractionation and immunofluorescence. Density gradient separation
      reveals one population of dense vesicles that contains the transgenic regulated
      secretory protein hGH (human growth hormone) along with the endogenous
      neurotransmitter norepinephrine. Some of the neuronal vesicle marker
      synaptophysin (P38) is also associated with these vesicles. A second population
      of low-density vesicles contains synaptophysin but not hGH or norepinephrine.
      Immunofluorescence localization of hGH revealed a pattern consistent with
      packaging into catecholaminergic vesicles: the staining is punctate and most
      concentrated in the tips of the neuritic processes, with secondary accumulation
      in the perinuclear region. Double-staining of cells for hGH and synaptophysin
      confirms that these proteins do not co-localize but rather are spatially
      segregated within the cell. The observed distribution of vesicle markers is
      inconsistent with simple models for the generation of one type of vesicle from
      the other, suggesting that the vesicles are products of two divergent
      biosynthetic pathways. While the hGH is clearly contained in regulated secretory
      vesicles, the function of the second population of vesicles remains uncertain.

PMID- 2229192
TI  - Variable pathways for developmental changes in composition and organization of
      microtubules in Physarum polycephalum.
AB  - The development of uninucleate amoebae into multinucleate plasmodia in
      myxomycetes is called the amoebal-plasmodial transition (APT). During the APT in
      Physarum polycephalum the ability to form flagellar axonemes is lost; the astral,
      open mitosis is replaced by the anastral, closed mitosis; and cytoskeletal
      microtubules disappear. These changes are accompanied by alterations in the
      repertoire of expressed tubulins. Using immunofluorescence microscopy we have
      studied the timing of loss and accumulation of developmentally regulated tubulin
      isotypes in relation to other cellular events during the APT. We specifically
      asked whether changes in the composition of microtubules are correlated with
      changes in their organization. The plasmodium-specific beta 2-tubulin can first
      be detected in microtubules of uninucleate cells after they become committed to
      plasmodium formation. However, rare cells are observed that exhibit beta 2
      tubulin at earlier or only at later stages of development. Amoeba-specific
      acetylated alpha 3-tubulin disappears gradually during development. Individual
      cells differ in the timing of loss of this isotype: alpha 3-tubulin is present in
      the majority of uninucleate cells, in a fraction of binucleate and quadrinucleate
      cells, and is absent from larger multinucleate cells. Cytoplasmic microtubules in
      uninucleate cells are organized by a single microtubule-organizing center (MTOC)
      juxtaposed to the nucleus. Binucleate cells and quadrinucleate cells exhibit
      variable numbers of MTOCs. Cytoplasmic microtubules persist during the APT until
      the stage of plasmodia containing at least 100 nuclei. The lack of a strict
      correlation between the changes in tubulin composition and changes in
      organization of microtubular structures indicates that accumulation of beta 2
      tubulin and disappearance of alpha 3-tubulin isotypes are not sufficient to bring
      about reorganization of microtubules during development. Individual cells in a
      developing population differ not only in the succession of accumulation and loss
      of developmentally regulated tubulins, but also in the sequences of other
      cellular changes occurring during the APT.

PMID- 2229193
TI  - Phosphorylation of algal centrin is rapidly responsive to changes in the external
      milieu.
AB  - Centrin, a calcium-sensitive contractile phosphoprotein, is the major component
      of the striated flagellar roots of the flagellate green alga, Tetraselmis
      striata. Flagellar roots contract in response to elevated calcium levels. Data
      presented here indicate that the level of centrin phosphorylation is rapidly
      responsive to changes in the cell's external environment. Centrin is
      dephosphorylated in response to elevated calcium or to heat shock. An increase in
      centrin phosphorylation accompanies pH shock or ethanol treatment. These changes
      are compared with flagellar excision, flagellar root contraction, and protein
      synthesis under the same treatments. We conclude that under certain conditions
      phosphorylation/dephosphorylation of centrin and extension/contraction of the
      flagellar root are uncoupled. Possible role(s) of centrin phosphorylation
      independent of force generation in the flagellar root are discussed.

PMID- 2229194
TI  - The monovalent ionophore monensin maintains the nuclear localization of the human
      stress protein hsp28 during heat shock recovery.
AB  - In HeLa cells exposed to supra-optimal temperatures, the alpha-crystallin-related
      stress protein hsp28 is reversibly redistributed inside the nucleus and increases
      its level of phosphorylation and aggregation. Here, I show that, at normal
      temperature after a heat stress, the sodium ionophore monensin maintains the
      nuclear localization of hsp28 without impairing the dephosphorylation of this
      protein. This phenomenon is not due to a prolongation, by monensin, of the
      synthesis of the heat-shock proteins after the heat stress. In contrast, the
      potassium ionophore nonactin induces only a weak alteration in the hsp28 locale,
      while the calcium ionophore A23187 and the uncoupler of oxidative phosphorylation
      FCCP have no effect. Following the removal of monensin 15 h after the heat
      stress, a further incubation of the cells for at least 36 h is necessary in order
      to observe a redistribution of hsp28 into the cytoplasm. A large fraction of
      hsp28 is then observed as dense excretion granules. In control cells kept at
      normal temperature, monensin, like nonactin, A23187 and FCCP, does not induce the
      redistribution of hsp28 inside the nucleus. Taken together, these results suggest
      that the disruption of the Na+ active transport by monensin probably inhibits the
      redistribution of hsp28 in the cytoplasm after heat shock.

PMID- 2229195
TI  - Continued DNA synthesis after a mitotic block in the double mutant cut1 cdc11 of
      the fission yeast Schizosaccharomyces pombe.
AB  - DNA synthesis is normally dependent on a cell having previously gone through
      mitosis. Hirano et al. (1986), however, found that DNA synthesis continued at the
      restrictive temperature in the double mutant cut1 cdc11 of Schizosaccharomyces
      pombe even though mitosis was blocked in some of the cells. We have confirmed
      this result with bulk DNA assays of asynchronous cultures. Synchronous cultures
      of a diploid double mutant at the restrictive temperature showed two peaks of
      incorporation with an interval between them that was approximately the same as
      the doubling time in cell length. Flow cytometry showed that the cells had
      increased their DNA content from 4C (the diploid value) to about 16C after 7h.
      The cytological appearance at this time was mixed, with uninucleate, binucleate
      and dead cells, but fluorescence measurements on single cells indicated that
      about half the population had single nuclei with about the 16C value and had
      therefore gone through two rounds of DNA synthesis without mitosis.

PMID- 2229196
TI  - Cytoplasmic pool of histone H1 in mammalian cells.
AB  - Two types of cell populations, nondividing mouse liver cells and exponentially
      growing Friend erythroleukemia cells, were studied for the presence of a histone
      H1 pool in the cytoplasm. Purified cytoplasmic fractions were extracted with 5%
      perchloric acid and the resulting protein preparation was characterized by two
      types of electrophoresis, gel filtration, peptide mapping, ELISA and
      immunoblotting. The occurrence of significant quantities of H1 in isolated
      cytoplasmic fractions was confirmed by indirect immunofluorescence on whole
      cells. The existence of a cytoplasmic pool of H1 contrasts with the lack of
      detectable amounts of core histones in the cytoplasm. This indicates that the
      observed H1 pool is not just a reflection of its cytoplasmic synthesis but
      probably has some functional significance.

PMID- 2229197
TI  - Monoclonal antibody study of the decorated spongiome of contractile vacuole
      complexes of Paramecium.
AB  - A monoclonal antibody (mAb) has been developed and selected by immunofluorescence
      for the radial canals of the contractile vacuole complex (CVC) of Paramecium
      multimicronucleatum. By applying indirect immunogold labeling to thin frozen
      sections this mAb has been shown at the electron microscopic level to be specific
      for the decorated spongiome. We have used the mAb to study the normal
      interfission appearance as well as developmental stages of the decorated
      spongiomes. Two decorated spongiomes, presumably involved in water sequestration,
      radiate as 5-10 bands from unlabeled, circular, 25 microns diameter centers. Two
      new CVCs arise just anterior to the space occupied by the old spongiomes, the new
      anterior CVC appearing slightly before the posterior one. Development of the new
      spongiomes around a 10 microns unlabeled central zone is accompanied by a
      regression of old spongiome bands until the lengths of these bands in both old
      and new CVCs are equal just before cell division. After division both old and new
      spongiome bands grow at equal rates to the same length. Exceptions to the above
      general scheme, both in number of CVCs in interfission, as well as in position of
      the new relative to the old CVCs, are also observed.

PMID- 2229198
TI  - Fodrin in the human polymorphonuclear leucocyte: redistribution induced by the
      chemotactic peptide.
AB  - Fodrin, a membrane skeletal protein, was found to accumulate in the posterior
      portion of human neutrophils polarized morphologically after stimulation by the
      chemotactic peptide, N-formylmethionyl-leucylphenylalanine (FMLP). In most
      (greater than 90%) unstimulated neutrophils, the distribution of fodrin was found
      to be uniform by immunofluorescence microscopy. When FMLP (10(-8)M) was applied
      at 25 degrees C, fodrin became polarized in about 40% of cells by 1 min, about
      70% by 2 min, and about 80% by 10 min. The cells with polarized distribution
      decreased thereafter to about 60% of the cells at 20 min and about 20% at 60 min.
      Using the under-agarose system, it was confirmed that the concentration of fodrin
      occurred in the region opposite to the direction of chemoattraction in moving
      cells. By immunoelectron microscopy, most of the labeling for fodrin was observed
      in the filamentous cell cortex and not associated with the plasma membrane
      itself. In cells polarized morphologically by FMLP, the fodrin labeling became
      concentrated in the posterior portion of the cell; the labeling was found most
      densely in the granule-rich cytoplasm, while the filamentous tail region was not
      labeled intensely. The lamellipodium in the head region was also labeled only
      sparsely. The results indicate that in human neutrophils fodrin exists as a
      cytoskeletal protein rather than as a membrane protein and that the protein
      accumulates in the endoplasm of the posterior portion in migrating cells. The
      rearrangement is likely to modulate the organization of the actin-rich cell
      cortex for cell locomotion.

PMID- 2229199
TI  - Cysteine proteinase in Trypanosoma cruzi: immunocytochemical localization and
      involvement in parasite-host cell interaction.
AB  - A monospecific polyclonal antibody obtained against a cysteine proteinase
      isolated from epimastigotes of Trypanosoma cruzi was used for the
      immunocytochemical localization of the protein by electron microscopy and to
      analyse the role played by cysteine proteinase in the process of T. cruzi-host
      cell interaction. Cytoplasmic structures that correspond to elements of the
      endosomal-lysosomal (reservosome) system found in epimastigote, amastigote and
      trypomastigote forms reacted intensely with colloidal gold-labelled antibodies
      using on-section indirect labelling. The surface of most of the tissue culture
      derived trypomastigotes was not labelled. However, the flagellar pocket of this
      form was labelled. All epimastigotes obtained from axenic cultures and amastigote
      like forms found in the supernatant of vertebrate cells heavily infected with T.
      cruzi had their surface intensely labelled, indicating also the surface
      localization of the protein. Incubation of the parasites in the presence of a sub
      agglutinating concentration of the anti-cysteine proteinase antibody led to a
      marked increase in their uptake by macrophages. In contrast, addition of the
      F(ab')2 portion of the same antibody significantly reduced the uptake of the
      parasites by the macrophages. The results obtained strongly suggest an important
      participation of cysteine proteinase in the process of T. cruzi-macrophage
      interaction.

PMID- 2229200
TI  - Lysosomal enzyme secretory mutants of Dictyostelium discoideum.
AB  - Dictyostelium discoideum secretes a number of lysosomal enzymes during axenic
      growth and upon suspension in a low ionic strength, non-nutrient buffer (standard
      secretion conditions). These secretory characteristics have allowed us to
      identify 74 lysosomal enzyme secretory mutants generated by N-methyl-N'-nitro-N
      nitrosoguanidine mutagenesis. The majority of these mutants fell into one of four
      classes, on the basis of their secretory characteristics in non-nutrient buffer.
      The four mutant classes indicate that a minimum of three distinct sets of genes
      are necessary for proper secretion of lysosomal enzymes from D. discoideum cells
      under standard secretion conditions: one set of genes that is involved in general
      lysosomal enzyme secretion, one that is involved in glycosidase type secretion,
      and a third that is involved in acid phosphatase type secretion. These three
      classes likely reflect heterogeneity in the intracellular destination of
      lysosomal enzymes, the secretory mechanism, or both. A fourth set of genes may be
      necessary for proper secretion during growth, but plays no role under standard
      secretion conditions. These are likely altered in the regulation of secretion or
      in lysosomal enzyme targeting. Of the 74 secretory mutants, 36 were also
      modification mutants resulting in decreased pI, thermolability, or in vivo
      instability of lysosomal enzyme activities. The high frequency of modification
      mutants indicates an integral relationship between lysosomal enzyme modification,
      and lysosomal enzyme targeting and secretion in D. discoideum.

PMID- 2229201
TI  - Regulation by calcium of proliferation and morphology of normal human
      tracheobronchial epithelial cell cultures.
AB  - Human tracheobronchial epithelial cells have been serially passaged in serum-free
      medium. This serum-free model was employed to investigate the effects of
      different concentrations of Ca2+ (0.1, 1.0 and 2.0 mM) on multiplication and
      morphology of the cells. The responses were analysed in terms of growth kinetics,
      histochemical and ultrastructural alterations. Culturing of the cells in high
      Ca2+ (1.0-2.0 mM) medium stimulated cell multiplication characterized by
      increased colony forming efficiency, greater number of cells per colony and cell
      population doublings per day. Additionally, the high Ca2+ concentrations induced
      proliferation in cultures grown to confluency in low Ca2+ (0.1 mM) medium. Cells
      propagated in low Ca2+ medium consisted of relatively heterogeneous cell
      populations, with most cells staining positive with periodic acid-Schiff (PAS)
      reagent. Ultrastructurally the cells exhibited secretory vesicles and microvilli
      on their surfaces, small desmosomes and intercellular interdigitation between
      cells and numerous large secretory vesicles in the cytoplasm. The cells grown in
      high Ca2+ medium acquired characteristics of a highly proliferative phenotype.
      The cultures consisted of closely packed, relatively homogeneous cells that did
      not stain with PAS reagent. Their characteristic features were: absence of
      surface secretory vesicles, reductions of microvilli and intercellular
      interdigitations, and increases in size and number of desmosomal junctions. The
      results show that low Ca2+ in the culture medium inhibits cell multiplication and
      favors the secretory cell phenotype, while high Ca2+ levels stimulate cell
      multiplication and inhibit the secretory cell phenotype.

PMID- 2229202
TI  - An analysis of chick limb bud intercellular adhesion underlying the establishment
      of cartilage aggregates in suspension culture.
AB  - To examine the mechanism of intercellular adhesion in the establishment of limb
      skeletal elements we have investigated the process of limb bud cell aggregation
      in vitro. Limb bud cells are aggregation-competent immediately after their
      trypsin:collagenase dissociation in the absence of calcium. This aggregation is
      largely Ca2(+)-independent (CI) and is completely and reversibly inhibited by
      cycloheximide. In contrast, when limb bud cells are first allowed to recover from
      Ca2(+)-free trypsin:collagenase dissociation, aggregation of the surviving
      population is exclusively Ca2(+)-dependent (CD) and completely and reversibly
      inhibited by cycloheximide. The presence of exogenous calcium during initial cell
      dissociation retains a functional CD aggregation mechanism. However, incubation
      of such cells with EGTA releases the CD component and converts the cells to a
      predominantly CI aggregation. Rabbits were immunized with limb bud cells
      exhibiting the recovered CD aggregation mechanism and the resulting immune sera
      were screened for their effect on cell aggregation. Relative to pre-immune sera,
      intact immune IgG agglutinated dissociated limb bud cells whilst immune Fab
      fragments inhibited their aggregation. The aggregation-inhibiting antiserum
      recognizes five major limb bud cell surface components with apparent molecular
      weights of 72K, 50K, 23K, 14.5K and 8.5K (K = 10(3) Mr), respectively. Limb bud
      cell surface plasma membranes were isolated by sucrose gradient density
      centrifugation and detergent-solubilized proteins coupled to Sepharose 4B with
      cyanogen bromide. Equivalent cell surface plasma membrane proteins were 125I
      iodinated and applied to the affinity column. Limb bud cell surface protein
      affinity chromatography in the presence of exogenous calcium yields a single
      protein with an apparent molecular weight of approximately 8.5 K. This protein
      molecule elutes at 0.6 M NaCl, indicating a high affinity, is recognized by the
      aggregation-inhibiting antiserum, and is itself capable of inhibiting CD limb bud
      cell aggregation. Fab fragments prepared from rabbit antisera specifically
      directed against the affinity-purified material also inhibit CD limb bud cell
      aggregation and this inhibition is neutralized by the 8.5 K protein. Our data
      thus demonstrate that CD limb bud cell aggregation is not mediated by fibronectin
      and/or collagen type I and indicate that this process is governed by a novel 8.5
      K cell adhesion molecule.

PMID- 2229203
TI  - The therapeutic role of gangliosides.

PMID- 2229204
TI  - Factors influencing pharmacists' participation in third-party programmes.

PMID- 2229205
TI  - High-performance liquid chromatographic analysis of indomethacin in serum.
AB  - A rapid high-performance liquid chromatographic (HPLC) method for quantitative
      determination of indomethacin in serum is described. The assay was performed
      after single extraction of indomethacin and itraconazole (internal standard) from
      serum using diethyl ether and eluted from a 4 micron C-18 reversed-phase column
      at ambient temperature. The mobile phase consisted of ethanol:water:glacial
      acetic acid (65:34:1, v/v) pumped isocratically at a flow rate of 1.3 ml/min. The
      effluent was monitored at 254 nm. Quantification was achieved by the measurement
      of the peak area ratio, and the absolute recoveries ranged from 94 to 97%. Within
      day coefficients of variation (CV) ranged from 2.72 to 5.70% and between-day CV
      varied from 3.61 to 6.1%. Stability testing indicated that indomethacin is stable
      for at least 30 days in serum at -20 degrees C. The method was used to study
      indomethacin pharmacokinetics in rabbits.

PMID- 2229206
TI  - Patterns of out-patients non-steroidal anti-inflammatory drug prescribing in two
      teaching hospital rheumatology units--implications for post-marketing
      surveillance.
AB  - Patterns of prescriptions or recommendations for non-steroidal anti-inflammatory
      drugs (NSAIDs) were examined in the out-patient departments of two teaching
      hospital rheumatology units [The General Infirmary, Leeds (n = 140), and Musgrave
      Park Hospital, Belfast (n = 77)]. In both units four drugs accounted for over 80%
      of prescriptions/recommendations (diclofenac, indomethacin, ibuprofen and
      naproxen in Leeds and flurbiprofen, nabumetone, ibuprofen and diclofenac in
      Belfast). In Leeds patients with pre-existing upper gastrointestinal problems
      were more likely to receive diclofenac whereas in Belfast they were more likely
      to receive nabumetone or ibuprofen. In Leeds, patients who received indomethacin
      tended to be young males with seronegative arthritis. These differences between
      drugs and between centres could have important implications for cost, design and
      interpretation of studies of post-marketing surveillance.

PMID- 2229207
TI  - Stability of doxorubicin, daunorubicin and epirubicin in plastic syringes and
      minibags.
AB  - The shelf lives of doxorubicin, daunorubicin and epirubicin in infusion fluids
      were studied using high-performance liquid chromatographic (HPLC) methods.
      Doxorubicin and epirubicin were stable (loss in potency of less than 10%) for 24
      and 20 days respectively, when dissolved in sodium chloride solution (0.9%; pH,
      6.47) at 25 degrees C and stored in polyvinyl chloride (PVC) minibags, while
      daunorubicin was stable for at least 43 days. All three drugs were stable for at
      least 43 days in sodium chloride (0.9%; pH 6.47 and 5.20) and dextrose (5%; pH
      4.36) at 4 and -20 degrees C. Repeated thawing and re-freezing of these solutions
      at ambient temperature did not cause degradation. All three drugs were stable for
      at least 43 days when reconstituted with Water-for-Injections BP and stored in
      polypropylene syringes at 4 degrees C.

PMID- 2229208
TI  - Photodegradation of doxorubicin, daunorubicin and epirubicin measured by high
      performance liquid chromatography.
AB  - The degradation kinetics of doxorubicin, daunorubicin and epirubicin in aqueous
      solution under fluorescent light and sunlight were studied using high-performance
      liquid chromatographic (HPLC) methods. The rates of photodegradation of all three
      drugs were similar, they were inversely proportional to the drug concentration
      and were accelerated by an increase in the pH of the vehicle. Photodegradation
      followed first-order kinetics. At concentrations greater than or equal to 500
      micrograms/ml no special precautions appeared to be necessary to protect freshly
      prepared solutions of these agents from light. Photolysis was very rapid,
      however, at concentrations in the low microgram range therefore, when these
      solutions are used for in-vitro work or stability studies, they should be
      protected from light at all times. In addition, adsorptive losses, which may also
      be pronounced in low concentration solutions, should be prevented by storage in
      polypropylene containers.

PMID- 2229209
TI  - Gastrointestinal symptoms. I.

PMID- 2229210
TI  - [Hydatid cysts of the liver appearing late (10 to 22 years) after surgical
      treatment of pulmonary hydatidosis. Physiopathologic problems].
AB  - The very late observation of an hydatid cyst of the liver, after clinical or
      fortuitous signs (intraoperative, ultrasound, CT) is a highly underestimated
      possibility. From 4 cases of hydatid cysts of the liver which were removed 10 to
      22 year after a pulmonary hydatidosis, any possibility of parasitic reinfestation
      during this time being excluded, the authors propose a physiopathological
      explanation to an often very long clinical latency period of the liver
      hydatidosis. Indeed the pulmonary location of the hydatid disease means that the
      hepatic filter did not properly operate or was bypassed, but it does not exclude
      a simultaneous intrahepatic graft. The literature study shows a 4 to 8.4% rate of
      concomitant liver-lung location according to the statistical data provided by
      thoracic and digestive surgery departments. The percentage reaches 25% when
      ultrasounds and abdominal computed tomography are systematically used. The rapid
      growth of the hydatid cyst in the lung can be explained by the low resistance of
      the lung parenchyma and vasculo-bronchial structure to the intracystic pressure,
      whereas in the liver, the hydatid cyst growing is stopped by a dense parenchyma
      and the hepatobiliary capsules. When fissuring or large opening in the biliary
      tract occurs the intracystic pressure drops, the pericyst becomes sclerotic,
      calcified. The combination of these different factors all the more contributes to
      the cyst involution since it presents a central topography.

PMID- 2229211
TI  - [A.L.J. external fixation. Indications and results in 59 cases].
AB  - The authors report their results in 59 cases of external fixation with A.L.J.
      type devices inserted from November, 1984, to November, 1988, in 57 patients (2
      cases of bilateral injuries). These included 49 cases of "recent" traumatology, 4
      cases of "second-hand" traumatology, and 6 orthopaedic cases (tibiotarsal
      arthrodesis for degenerative lesions). Among the recent traumatic injuries, 38
      were fractures, most often compound fractures (stages II and III), and 11 serious
      soft tissue lesions, for which the external fixation was used temporarily for
      stabilization until the wound was healed. The older traumatological lesions were
      4 infected pseudarthroses. The results based on 52 cases (6 were lost to follow
      up and 1 is a peculiar case) include 45 healed injuries (ie. 86.5%) and 7
      failures. The soft-tissue lesions have all healed within 2 to 4 months. Among the
      bony lesions, some knit primarily without an additional graft (20 of 37 cases, ie
      54 percent), the others after 1, 2 or 3 grafts (10 of 37 cases, ie. 27 percent).
      The union also occurred without any problem for all 6 tibiotarsal arthrodeses.
      The 7 failures occurred in cases where no additional bone graft had been
      performed. The discussion evidences the advantages and drawbacks of the A.L.J.

PMID- 2229212
TI  - [Predictive factors of mortality and morbidity in colectomy patients over 75
      years of age. Report of 69 cases].
AB  - Sixty nine patients over 75 years old who had a colectomy were retrospectively
      studied. The carcinoma of the colon represented the main indication for 42 cases
      (60.9%) and 22 patients (31.9%) were immediately operated. The influence of
      parameters such as age, sex, visceral defects, emergency, performance of a
      colostomy or associated intervention, type of colic pathology, was statistically
      studied. The age (p less than 0.05), emergency (p less than 0.03) and the number
      of defects greater than or equal to 3 (p less than 0.04) contribute to mortality.
      The number of defects greater than or equal to 3 (p less than 0.006) contributes
      to general morbidity. Only complications connected with the operation by itself
      significantly prolong the duration of hospitalization (p less than 0.02). The
      authors draw the conclusion that the age by itself is not a contra-indication for
      operation except in case of associated polyvisceral failure. In addition, it is
      required to carry out an early detection of colic lesions in elderly subjects in
      order to contemplate surgery before complications whose prognosis is fearsome
      (54.5% of death in emergency operation).

PMID- 2229213
TI  - [Alcoholic pancreatitis and pseudocysts. Prospective study of 20 cases in Reunion
      Island].
AB  - In the french indian ocean's island whose name is Reunion, between 1984 and 1986,
      20 pancreatic pseudocysts, exclusively encountered in alcoholic patients, were
      submitted to a prospective study. Most of the lesion were very symptomatic, large
      and extrapancreatic. Accordingly to Marseille's classification, most of the
      patients were suffering from acute or chronic relapsing pancreatitis. 18 patients
      were submitted to a therapeutic procedure. Internal drainage was performed in 9
      patients, and external drainage was performed in 5. In addition, pancreatic
      resection was carried out in 2 patients, and needle aspiration in 2. Comments
      concern potential specificities of the population which was studied. Special
      emphasis concern the necessity of preoperative computerized tomographic scanning,
      the indications of percutaneous external drainage and the long-term survival of
      patients.

PMID- 2229214
TI  - [Indications for arteriography in penetrating wounds of the lower limbs].
AB  - One hundred arteriographies were performed in emergency in 87 patients with
      penetrating trauma of the lower limbs caused by high- or medium-velocity
      projectiles (bullet or shell fragment). Thirteen patients had bilateral wounds.
      In 79 cases, the arteriogram was abnormal and led to surgical exploration. In 76
      cases, an arterial lesion was found and treated (positive predictive value =
      76/79 = 96%). In three cases, no arterial lesion was detected (3 false-positive
      findings). Among the 21 patients with normal arteriograms, 10 had surgical
      exploration because of clinical suspicion. An arterial lesion was found in 2
      cases (2 false-negative findings). In the other 11 cases, the clinical and
      Doppler sonographic observations were normal (negative predictive value = 19/21 =
      90%). The sensitivity rate was 97%, specificity 86% and accuracy 95%. In 8 cases,
      arteriography led to modifying the surgical procedure. These results show that
      preoperative arteriography, performed as an emergent examination in
      hemodynamically stable patients, allows avoiding surgery in some cases, and
      modifying the procedure in others.

PMID- 2229215
TI  - [Gallbladder volvulus].
AB  - We report two new cases of gallbladder volvulus. This rare condition principally
      affects elderly patients but is due to a congenital malformation related to the
      presence of a long mesocyst. Various factors such as kyphoscoliosis, multiparity
      and peristalsis of neighbouring organs favorise the occurrence of volvulus, the
      role of lithiasis is debatable. The diagnosis may be suggested on ultrasound but
      is most often confirmed at laparotomy. Diagnosis should be made rapidly in order
      to avoid progression towards a potentially fatal secondary peritonitis. Certain
      clinical elements such as the presence of a "floating mass" on palpation may
      suggest the diagnosis.

PMID- 2229216
TI  - [Adenocarcinoma at an ileostomy site after colectomy for ulcerative colitis].
AB  - In this article we present the tenth case, according to the literature, of
      adenocarcinoma occurring at a long standing ileostomy originally performed for
      ulcerative colitis. Study of this and previous cases demonstrates common factors
      such as a previous history of ulcerative colitis, a long interval until the
      appearance of symptoms, together with a similar clinical and pathological
      characterisation with invasion of neighbouring skin layers close to the
      ileostomy. Several pathogenic hypotheses are considered. We believe that local
      excision in oder to obtain the diagnosis is a better option than a sampling
      biopsy and that surgery should include a wide resection of the abdominal wall and
      intestine in order to comply with therapeutic criteria in malignant disease.

PMID- 2229217
TI  - [Encapsulating peritonitis. Report of 2 cases].
AB  - Walled-off peritonitis which is a frequent occurrence in patients treated by
      continuous ambulatory peritoneal dialysis may also occur in cases where there is
      no obvious pathological factor. This was the case in the two patients reported.
      Both were male patients aged 28 and 32 years hospitalised and operated on for
      acute intestinal obstruction. Positive diagnosis was made at the time of
      operation. Decortication with total enterolysis was performed in the two cases.
      However, a jejunal fistula with a favorable outcome occurred in one case,
      investigation for acid fast bacilli was negative and histological examination was
      non specific.

PMID- 2229218
TI  - [Digestive malacoplakia; observations on a colonic site].

PMID- 2229219
TI  - [Malignant cutaneous melanoma with metastases in the small intestine].

PMID- 2229220
TI  - [A rare cause of intestinal occlusion in the elderly].

PMID- 2229221
TI  - [Cystic pneumatosis of the small intestine. A case report].

PMID- 2229222
TI  - High-performance liquid chromatography of amino acids, peptides and proteins.
      CIII. Mass transfer resistances in ion-exchange and dye-affinity chromatography
      of proteins.
AB  - Adsorption equilibria and rate kinetics have been investigated for the binding of
      several proteins, with different molecular geometries, to several ion-exchange
      and dye-affinity chromatographic resins with varying pore size and protein
      accessibilities. The pore geometry was shown to play a significant role in the
      protein capacity and loadability of both the ion-exchange and dye-affinity
      resins. For example the Fractogel HW75-Cibacron Blue F3GA affinity sorbent had
      the greatest capacity for the small protein, lysozyme, compared to the other
      Fractogel HW-Cibacron Blue F3GA sorbents, and similarly, the ion-exchange resins,
      such as DEAE-Fractogel 65, bound more human serum albumin (HSA), as opposed to
      the larger protein, ferritin. The apparent diffusion of protein from the bulk
      phase to the ligands/ionic sites was calculated to be considerably restricted
      when the pore to protein size ratio was small, as is the case of DEAE Fractogel
      65/ferritin system, and the dye-affinity Fractogel HW55/HSA system. In these
      circumstances, pore diffusivity was calculated to be up to 100-fold smaller than
      bulk diffusivity.

PMID- 2229223
TI  - High-performance liquid chromatographic approach to the separation of antiviral
      and immunostimulant fractions in Neuramide.
AB  - Neuramide, a tissue extract having antiviral action against influenza A virus and
      immunostimulant action, was analyzed by preparative size-exclusion high
      performance liquid chromatography (HPLC) and a low-molecular-weight fraction
      responsible for the antiviral action was isolated after reversed-phase HPLC. Four
      fractions having immunostimulant activity were also isolated, as evidenced by
      their potentiating action in the human lymphocyte proliferation induced by
      phytohaemagglutinin.

PMID- 2229224
TI  - Purification of immunomodulatory factors in human peripheral blood leukocytes.
AB  - Procedure is described for purifying low-molecular-weight factors with antigen
      aspecific properties from a dialysate of human leukocyte extract. It includes gel
      chromatography on Sephadex G-25 and G-15, ion-exchange chromatography, reversed
      phase high-performance liquid chromatography (HPLC) on a C18 hydrophobic column
      and gel permeation HPLC. The immunosuppressive factor (mol.wt. 800-1000) was
      purified to near homogeneity. It is probably of peptidic nature, although it is
      pronase resistant. The enhancer factor (mol.wt. 300-600) is eluted from
      chromatographic columns together with a hypoxanthine-like substance.
      Nevertheless, the biological activity cannot be attributed to the purine
      derivative. Identification of this amplifier activity is still lacking.

PMID- 2229225
TI  - Isolation of isoproteins from monoclonal antibodies and recombinant proteins by
      chromatofocusing.
AB  - A fast protein liquid chromatographic method for the preparative separation of
      the various isoproteins is described. Highly purified human monoclonal
      antibodies, recombinant human superoxide dismutase and human superoxide dismutase
      from erythrocytes were used as starting material. The isoproteins were separated
      by chromatofocusing on Mono P columns. A very narrow pH gradient was applied to
      achieve complete separation of the isoproteins. The prepurification steps and the
      pretreatment of the samples to achieve optimum resolution are described in
      detail. The method is also applicable to extremely basic monoclonal antibodies
      (pI = 9). The successful separation was checked by isoelectric focusing in
      immobilized pH gradients (Immobilines). The future of these methods is discussed,
      because for many different biochemical and biophysical investigations pure and
      homogeneous isoproteins are necessary.

PMID- 2229226
TI  - Separation of fragments from human serum albumin and its charged variants by
      reversed-phase and cation-exchange high-performance liquid chromatography.
AB  - Reversed-phase high-performance liquid chromatography (RP-HPLC) and ion-exchange
      chromatography on poly(2-sulphoethylaspartamide)-silica (SCX) were compared as
      alternative approaches in characterizing charged genetic variants of human serum
      albumin. The chromatographic behaviour of cyanogen bromide (CNBr), tryptic and V8
      protease digests from normal and mutant albumins were examined. The results
      showed that substituted site-containing CNBr fragments are successfully resolved
      by RP-HPLC; in most instances SCX and RP-HPLC are equally adequate in identifying
      the modified tryptic peptides from CNBr fragments; although generally useful, SCX
      chromatography is specifically needed in all instances where amino acid
      replacement is occurring in a small hydrophilic tryptic fragment and choosing
      Staphylococcus aureus V8 protease instead of tryptic digestion is advantageous.

PMID- 2229227
TI  - Chromatography and generation of specific antisera to synthetic peptides from a
      protective Boophilus microplus antigen.
AB  - Four oligopeptides corresponding to predicted antigenic regions of the protective
      Bm86 glycoprotein of the cattle tick Boophilus microplus were synthesized and
      purified. Three were conjugated to carrier proteins and antisera raised in
      rabbits and cows. All elicited antipeptide antibodies that recognized Bm86 and
      recombinant derived products in Western blots; however, only one produced
      antiserum capable of recognizing native Bm86 in an indirect immunofluorescence
      assay. Ticks fed in vitro on this antiserum showed no obvious gut damage.

PMID- 2229228
TI  - Characterization of apolipoproteins from chicken plasma.
AB  - Although functionally similar, the lipoprotein systems of birds and mammals
      differ in composition. The major apolipoproteins, apo A-I and apo B, are common
      to all vertebrates; however apo A-II and apo E, functionally important components
      of mammalian lipoproteins, are absent from chicken plasma. Chicken apo A-I and
      apo B have been characterized, and several minor apolipoprotein components have
      been observed in electrophoretic patterns of chicken lipoproteins. In this study
      a single density gradient ultracentrifugation was used to isolate and
      subfractionate chicken lipoproteins into density classes. Isolated lipoproteins
      were delipidated with hexane-isopropanol (3:2). Apolipoproteins were then
      solubilized at pH 8.5 in 3 M guanidine hydrochloride and chromatographed on a 25
      X 0.4 cm C4 reversed-phase column using 0.1% trifluoroacetic acid in a gradient
      of acetonitrile in water. Molecular weights estimated by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and amino acid compositions were compared with
      those of apolipoproteins from other species in a search for functional
      similarities. Similarities in composition between the major chicken
      apolipoprotein and several human apolipoproteins were observed.

PMID- 2229229
TI  - Evaluation of factors which affect column performance with immobilized monoclonal
      antibodies. Model studies with a lysozyme-antilysozyme system.
AB  - Methods are described for the automated evaluation of affinity columns by frontal
      boundary analysis. These methods were used to evaluate the performance of
      immunoaffinity columns based on antilysozyme monoclonal antibody-lysozyme
      immunoaffinity system. This model system enabled the effects of (i) matrix
      activation and (ii) the density of immobilized antibody on the change in specific
      activity of immobilized antibody to be quantitatively assessed. Experimental data
      were accumulated with carbonyldiimidazole-activated Fractogel HW65F and Trisacryl
      GF2000 resins and cyanogen bromide-activated Sepharose 4B. An increase in the
      molar ratio between the concentration of the active groups on the activated
      matrix and the concentration of immobilized antibody ligands did not result in
      significant change in the specific activity of the immobilized antibody in the
      immunochromatographic system. However, increased antibody density with the
      Fractogel HW65F resin resulted in an increase in the apparent heterogeneity of
      antibody binding sites for lysozyme and a significant decrease in the specific
      activity of the immobilized antibody. Furthermore, data from size-exclusion
      studies with these immunoaffinity matrices demonstrated that at high antibody
      densities, the accessibility of the immobilized antibody was further decreased
      due to steric resistance as the antigen size increased.

PMID- 2229230
TI  - Reversed-phase high-performance liquid chromatographic separation of synthetic
      phosphopeptide isomers.
AB  - Selectively phosphorylated synthetic peptides corresponding to the human
      neurofilament protein middle-sized subunit, H-Lys-Ser-Pro-Val-Pro-Lys-Ser-Pro-Val
      Glu-Glu-Lys-Gly-OH, and its analogues were separated by reversed-phase high
      performance liquid chromatography of mixtures consisting of the non
      phosphorylated, the diphosphorylated and the two different monophosphorylated
      isomers. Application of the algorithm for the expected retention times to 4-9
      amino acid-long peptide fragments revealed the correct elution order of the
      monophosphorylated isomers. According to circular dichroism studies, this elution
      order is also compatible with the possibility of induced conformational
      orientation on the surface of the bonded phase. Chromatographic analysis of the
      synthetic phosphorylation reaction indicates that the reaction rates of the two
      structurally different monophosphorylated peptides are similar, which is in
      contrast to the in vivo site-directed reaction.

PMID- 2229231
TI  - High-performance displacement chromatography-mass spectrometry of tryptic
      peptides of recombinant human growth hormone.
AB  - The combination of high-performance displacement chromatography with continuous
      flow fast atom bombardment (FAB)-mass spectrometry (MS) offers a means of
      overcoming the sample capacity limitations imposed by the low flow-rates
      tolerated in microbore systems employed for directly coupled liquid
      chromatography-MS. Displacement chromatography is performed at high
      concentrations with the same equipment and columns as typically used in
      chromatography at low concentrations. By using this mode of chromatography with a
      solution of cetyltrimethylammonium bromide as the displacer, the capacity of a
      reversed-phase column can be increased 50- to 100-fold for separation of a
      tryptic digest of biosynthetic human growth hormone. Despite the high load, the
      use of displacement chromatography allowed high-resolution separation of the
      complex mixture of eighteen major components. On-line analysis by continuous flow
      FAB-MS yielded high-quality spectra of these peptides and demonstrated that
      sharp, single-component bands can be obtained in this separation. Along with the
      major fragments, the chromatogram showed other peptides originating from protein
      variants in the sample, from non-specific cleavage in the enzymatic digest or
      from autolysis of trypsin. On-line analysis also allowed selective ion monitoring
      of the column effluent for individual peptides and confirmed the high efficiency
      and resolution obtained by preparative displacement separations on HPLC columns
      and equipment.

PMID- 2229232
TI  - Binding of sodium dodecyl sulphate to an integral membrane protein and to a water
      soluble enzyme. Determination by molecular-sieve chromatography with flow
      scintillation detection.
AB  - We have determined the binding of sodium dodecyl sulphate (SDS) to the human red
      cell glucose transporter (polypeptide, Mr 54,117) and to a water-soluble enzyme,
      N-5'-phosphoribosylanthranilate isomerase-indole-3-glycerol-phosphate synthase
      (PRAI-IGPS) from Escherichia coli (Mr 49,484). [35S]SDS was equilibrated with
      each protein on molecular-sieve chromatography at a series of SDS concentrations.
      The binding ratios of SDS to protein were determined by flow scintillation
      detection and automated amino acid analyses. Unexpectedly the glucose
      transporter, which is a transmembrane protein, bound about the same amount of SDS
      per gram of protein as did the enzyme. At 1.6 mM SDS, slightly below the critical
      micelle concentration (CMC) (1.8 mM) in the eluent, the binding ratio was 1.6 g
      SDS/g protein for both the glucose transporter and PRAI-IGPS. At 2.0 mM SDS
      (above the CMC) the glucose transporter showed a binding ratio of 1.7 g SDS/g
      protein. The corresponding value for the enzyme was about 1.5 g/g. The SDS
      glucose transporter complex seems to be more compact than the SDS-enzyme complex
      as judged by molecular-sieve chromatography and by SDS-polyacrylamide gel
      electrophoresis. Recent neutron scattering results have shown a protein-decorated
      triple-micelle structure for the SDS-PRAI-IGPS complex. Hypothetically, the more
      compact SDS-glucose transporter complex may therefore consist of a dual-micelle
      structure. The molecular-sieve gel beads bound considerable amounts of SDS. The
      SDS binding to the gel matrix and to the proteins increased with increasing SDS
      concentration up to at least 1.6-2.0 mM SDS. In the case of the water-soluble
      enzyme a shoulder was observed in the binding curve at 1 mM SDS, probably
      reflecting a change in the conformation of the complex.

PMID- 2229233
TI  - Synthetic antibody fragment as ligand in immunoaffinity chromatography.
AB  - The possibility that a fragment of an antibody molecule may interact with a
      protein antigen was tested by studying the binding properties of a thirteen
      residue synthetic peptide with an amino acid sequence similar to part of a
      hypervariable segment of a monoclonal antibody directed against lysozyme.
      Affinity adsorbents were prepared with this peptide and with non-related peptides
      as ligand. Non-specific interactions could be abolished by washing the column
      with 0.05 M sodium thiocyanate in 20 mM tris-HCl (pH 7.4). Lysozyme was only
      bound to the antilysozyme adsorbent and could be eluted with 1 M sodium
      thiocyanate. The results show that immunoaffinity chromatography with synthetic
      peptide ligands which mimic the antigen-binding site may be a useful tool in the
      selective purification of proteins.

PMID- 2229234
TI  - Isolation of anti-idiotypic antibodies by immunoaffinity chromatography on
      Affinichrom beads.
AB  - Anti-idiotypic antibodies are important regulators of the immune system but they
      are difficult to isolate and monitor. We have developed a technique for isolating
      specific auto-anti-idiotypic antibodies by high-performance immunoaffinity
      chromatography using immobilized autologous anti-tumor antibodies as the affinity
      ligand. The isolated anti-idiotypes demonstrated the ability to react with the
      original antitumor antibodies and inhibit their reactivity against autologous
      tumor cells. This technique can be used to monitor regulatory antibodies in
      cancer patients receiving immune modulation therapy.

PMID- 2229235
TI  - Characterization of temperature-sensitive cytidine triphosphate synthase
      mutations in bacteria by high-performance liquid chromatography.
AB  - Cytidine triphosphate (CTP) synthase catalyzes the last step in pyrimidine
      ribonucleotide synthesis, namely the formation of CTP from UTP, ATP, and
      glutamine. Mutants devoid of CTP synthase activity require cytidine for growth
      and have been designated pyrG in an obligate cdd background. Using a ts mutation
      blocked in the conversion of UTP to CTP at 43 degrees C, it was demonstrated that
      the conversion occurs by growing cells at 33 degrees C or below where UTP and CTP
      pools are normal. Growth at 43 degrees C shuts off the enzyme, while UTP
      accumulates and CTP is decreased significantly. By now feeding exogenous cytidine
      the CTP pool can be restored to the level found at the permissive temperature.
      Intracellular nucleoside triphosphates (CTP and UTP) were separated on a Partisil
      SAX10 cartridge, using a linear gradient of low buffer (7 mM ammonium
      dihydrogenphosphate, pH 3.8) to high buffer (250 mM ammonium dihydrogenphosphate,
      pH 4.5 with 500 mM potassium chloride). Nucleoside triphosphates were also
      separated after enzymatic conversion of UTP to CTP in solution by cell extracts
      using ion-pair reversed-phase chromatography on a C18 cartridge eluted with a
      mixture of 95% buffer A (25 mM ammonium dihydrogenphosphate with 1 mM
      tetrabutylammonium phosphate, pH 7.0) and 5% buffer B (15% aqueous acetonitrile).
      Using the two different separation techniques, it was possible to monitor the
      level of UTP and CTP inside cells as well as the enzymatic conversion of UTP to
      CTP by the enzyme CTP synthase.

PMID- 2229236
TI  - Convenient purification of tritylated and detritylated oligonucleotides up to 100
      mer.
AB  - Oligomers from crude phosphoramidite synthesis mixtures have been purified by
      reversed-phased high-performance liquid chromatography by exploiting the
      chromatographic variables of stationary phase pore size, chain length, and
      gradient shape. Chromatography was performed on oligomers up to 100-mer with
      mobile phases containing triethylammonium acetate/acetonitrile mixtures.
      Convenient guidelines are offered to enrich or purify synthetic oligomers.
      Tritylated oligomers up to 25 bases in length are best purified on C8 or C18, 80
      A columns with moderate strength mobile phases using a combination of isocratic
      delays and shallow gradients. For oligomers longer than 25-mer, C3, 300 A columns
      provide adequate fast purification in as little as 5 min, while 300 A, C8 columns
      with long, slow gradients gave substantially increased purity. Chromatography of
      detritylated oligomers requires a modified approach. Up to 25-mer they are best
      purified on 80 A, C18 columns with much lower organic concentrations and
      shallower gradients than those used for tritylated oligomers. Detrytilated
      oligomers greater than 25-mer can be enriched on both C3 and C8, 300 A columns
      using the same conditions described for shorter detritylated oligomers.

PMID- 2229237
TI  - Rapid separation, quantitation and purification of products of polymerase chain
      reaction by liquid chromatography.
AB  - The polymerase chain reaction (PCR), a new, powerful method for rapid enzymatic
      amplification of specific DNA fragments, has gained tremendous popularity in
      molecular biology. This paper describes the successful application of liquid
      chromatography to the analysis of products of the PCR. Efficient separation of
      both DNA restriction fragments and amplified PCR products were achieved in 10-12
      min on a new ion-exchange column, DEAE-NPR, packed with 2.5-microns non-porous
      particles. The PCR products were quantitated with a reproducibility within 10%.
      Use of liquid chromatography was demonstrated for separation and quantitation of
      PCR products in amounts below those required for direct analysis by ethidium
      bromide gel electrophoresis or a Hoechst 33258 dye-based fluorescence assay.
      Liquid chromatography was also demonstrated to be effective for quick
      optimization of PCR procedures.

PMID- 2229238
TI  - High-performance liquid chromatography of amino acids, peptides and proteins.
      XCIX. Comparative study of the equilibrium refolding of bovine, porcine and human
      growth hormone by size-exclusion chromatography.
AB  - The equilibrium refolding of bovine, porcine and human growth hormone and ovine
      prolactin in guanidine hydrochloride has been investigated using high-performance
      size-exclusion chromatography (HPSEC). It was found that bovine and porcine
      growth hormones exhibited very similar refolding behaviour. However, the
      renaturation of human growth hormone followed a different pathway. In particular,
      the folding transition of human growth hormone occurred at 4.7 M guanidine
      hydrochloride compared to 3.8 and 3.5 M for the bovine and porcine molecules,
      respectively, and 3.5 M for ovine prolactin. The refolding mechanism of an
      internally clipped fragment derived from partial tryptic digestion, exhibited
      similar folding properties to the corresponding intact molecule. The internally
      clipped analogue existed as a relatively larger molecule under fully denaturing
      conditions. Reduction followed by carboxymethylation resulted in growth hormone
      molecules with significantly reduced stability and altered folding properties.
      The results have been correlated with differences in structure to further
      demonstrate the utility of HPSEC in the study of protein folding and stability.

PMID- 2229239
TI  - (S)-2-hydroxypropyl-beta-cyclodextrin, a new chiral stationary phase for reversed
      phase liquid chromatography.
AB  - (S)-2- and (R,S)-2-hydroxypropyl-beta-cyclodextrin have been bonded to silica gel
      and evaluated as stationary phases for reversed-phase liquid chromatography.
      Stationary phases also were prepared on two silicas having different pore sizes
      and surface areas. Dissimilarities were observed in enantiomeric selectivities
      between these columns and also between these and the native beta-cyclodextrin
      columns. With the exception of compounds 5 and 10, all other racemates reported
      here which have been successfully resolved on the new phases are enantiomers
      which have not been previously reported as separated on the beta-cyclodextrin
      stationary phase. In some cases, there were also differences in
      enantioselectivities observed between the (S)- and the (R,S)-hydroxypropyl-beta
      cyclodextrin phases on the same silica. The results are discussed in terms of the
      retention mechanism and compared to results reported earlier for beta
      cyclodextrin columns.

PMID- 2229240
TI  - Applications of high-performance liquid chromatography to quantitation of
      metabolites and enzymes of the patulin pathway from Penicillium patulum.
AB  - Conditions for extraction and high-performance liquid chromatographic (HPLC)
      analysis for fourteen of the patulin pathway metabolites from Penicillium patulum
      are described which allow quantitation of the metabolite content of cultures at
      hourly intervals. The HPLC analysis is more sensitive than gas-liquid
      chromatographic analysis and is more quantitative than thin-layer chromatographic
      analysis. Separations on a preparative column allow for the collection and
      identification of new metabolites. The column elution program can be varied to
      optimize analysis time for individual metabolites, allowing individual enzymes of
      the pathway to be assayed by following the conversion of substrate to product.
      Analysis of product formation in crude enzyme mixtures can be used to assay an
      enzyme in the presence of subsequent enzymes of the pathway and to establish the
      pathway reaction sequence.

PMID- 2229241
TI  - High-performance liquid chromatographic method for the comparison of tanning
      capacity of tannic acid batches used in the manufacture of pregnancy testing
      kits.
AB  - A high-performance liquid chromatographic (HPLC) method was developed for the
      quantitative comparison of various batches of tannic acid from the same
      manufacturer used to aid the binding of human chorionic gonadotropin to sheep
      erythrocytes in the manufacture of pregnancy testing kits. The tannic acids were
      separated by reversed-phase HPLC on a C18 column using gradient elution with
      aqueous methanolic eluents at low pH. A portion of the chromatogram corresponding
      to the compounds involved in the tanninisation process was integrated and a
      linear relationship was established between this peak area and tannic acid
      concentration. The correlation coefficient was greater than 0.993 even in the
      absence of an internal standard. Tanning capacity was evaluated on the basis of
      the amount of tannic acid which remained following incubation with a known
      quantity of erythrocytes. The application of this procedure to three batches of
      tannic acid is demonstrated.

PMID- 2229242
TI  - Separation and determination of lipophilic corticosteroids and benzothiazepin
      analogues by micellar electrokinetic chromatography using bile salts.
AB  - The separation of corticosteroids and benzothiazepin analogues by micellar
      electrokinetic chromatography (micellar EKC) was studied in comparison with
      capillary zone electrophoresis. The separation of these substances was not
      successful under neutral and alkaline conditions because they migrated with the
      same velocity as that of the electroosmotic flow. Micellar EKC with sodium
      dodecyl sulphate (SDS) solutions was also not successful because these substances
      migrated with almost the same velocity as that of the SDS micelle, owing to their
      high lipophilicity. The use of bile salts, which have a similar skeleton to
      corticosteroids, as the micellar phase permitted the separation of these
      substances with high theoretical plate numbers (150,000-350,000) within a short
      time (ca. 15 min). Sodium cholate was particularly useful. The effects of bile
      salt concentration, pH and the addition of methanol were investigated. Micellar
      EKC was also applied to the determination of the drug substances in tablets and
      cream using the internal standard method and to purity testing of drug substances
      and tablets.

PMID- 2229243
TI  - Use of M-series retention index standards in the identification of trichothecenes
      by electron impact mass spectrometry.
AB  - A method for the reliable identification of a series of trichothecenes as their
      trifluoroacetate esters in porridge flake samples is described. The esters were
      separated by gas chromatography and identified from their retention times
      relative to n-alkyl-bis(trifluoromethyl)phosphine sulphide (M-series) retention
      index standards and their electron impact mass spectra. The relative retention
      times offer an independent identification method by which the reliability of the
      identification can be improved. The mass spectra and the relative retention times
      were obtained from the same gas chromatographic-mass spectrometric run. Detection
      limits were of the order to 0.005-0.05 mg/kg. All the flake samples including
      oats (ten of fourteen samples studied) contained deoxynivalenol (0.01-0.2 mg/kg)
      and one oat flake sample contained HT-2 toxin (0.008 mg/kg). The other
      trichothecenes monitored were not found.

PMID- 2229244
TI  - Use of thin-layer chromatography for the testing of avermectins produced by
      Streptomyces avermitilis strains.

PMID- 2229245
TI  - Comparison of quarter-hourly on-line dynamic headspace analysis to purge-and-trap
      analysis of varying volatile organic compounds in drinking water sources.
AB  - On-line dynamic headspace analysis was refined for the quarter-hourly monitoring
      of select volatile organic compounds (VOCs) in ground and surface waters, for
      extended periods of time. Hourly comparisons were made to on-line purge-and-trap
      analysis, and to purge-and-trap analysis after sample preservation and storage.
      Variations in VOC concentrations of 6047% biweekly, 222% daily, 97% hourly, and
      35% quarter-hourly were observable, with the 15-min cycle of the dynamic
      headspace analysis. The headspace analyzer had superior retention time stability,
      required less maintenance, and had 1/4 the analysis time as a typical purge-and
      trap-gas chromatograph system used for hourly comparisons.

PMID- 2229246
TI  - Simultaneous determination of neutral and amino sugars in biological materials.
AB  - A method is described for the simultaneous analysis of nine neutral and three
      amino sugars. Mixtures of standard sugars and biological samples were acid
      hydrolyzed with a two step Saeman procedure, neutralized with BaCO3, reduced with
      sodium borohydride, acidified, evaporated and alditol acetates prepared. Baseline
      resolution was achieved on a glass-capillary SP-2340 column in ca. 52 min.
      Reproducibility, response factors and hydrolysis losses were determined.
      Quantitation was linear over the range of 10-20 micrograms/ml to 2000
      micrograms/ml. Conditions were defined for the reproducible quantitation of
      muramic acid.

PMID- 2229247
TI  - Molecular mass distribution of water-soluble crystallins from the human foetal
      lens during development.
AB  - The water-soluble crystallins of twenty human foetal lenses with gestational ages
      of 112-231 days were analysed by size-exclusion chromatography. The crystallin
      distribution showed similar patterns for all foetal lenses, but clear changes in
      the proportions of different crystallins were evident. The distribution showed
      that the water-soluble part of all the lenses already contained high-molecular
      mass material. Also beta-crystallins of high molecular mass (beta H), formed by
      post-translational changes, were detected in all stages. During gestation, the
      percentage of high-molecular-mass crystallins and of alpha-crystallins of low
      molecular mass (alpha L) decreased significantly. The total beta-crystallins
      (beta T) and the total gamma-crystallins (gamma T) increased significantly. The
      low Mr crystallins were resolved into three peaks, designated beta s-, gamma H-
      and gamma L-crystallins. They increased significantly during development. These
      significant increases of the low Mr crystallins took place exclusively in the
      developing lens. The rate of protein synthesis of the low Mr crystallins was 23%
      of the total water-soluble crystallin synthesis rate.

PMID- 2229248
TI  - High-performance liquid chromatographic analysis of bile pigments as their native
      tetrapyrroles and as their dipyrrolic azosulfanilate derivatives.
AB  - A reversed-phase high-performance liquid chromatographic (HPLC) analysis of bile
      pigments is described that provides baseline separation of the major bilirubin
      conjugates found in bile. The advantage of the technique is that the bile
      pigments can be analyzed directly as their native tetrapyrroles without prior
      solvent extractions or derivatization. The use of ammonium acetate in place of
      sodium salts permits preparative isolation and lyophilization of the pigments for
      mass spectroscopy. The derivatization of the pigments as their dipyrrolic
      azosulfanilates with subsequent HPLC analysis demonstrates baseline separation of
      the endo- and exovinyl azodipyrroles and allows identification of that half of
      the tetrapyrrole which contains the conjugate in the instances of monoglycosides.

PMID- 2229249
TI  - Determination of captopril in human blood by gas chromatography-negative-ion
      chemical ionization mass spectrometry with [18O4]captopril as internal standard.
AB  - A method for the quantitative measurement of captopril in human blood is
      described. Blood was immediately treated with N-ethylmaleimide to prevent
      oxidative degradation. The carboxyl moiety was derivatized to the
      pentafluorobenzyl ester, which shows excellent properties for negative-ion
      chemical ionization mass spectrometry. A stable isotope-labelled standard was
      prepared from the intact target molecule in quantitative yield by exchanging the
      oxygen atoms of the free carboxylic acid and the imide moiety against 18O. The
      detection limit under negative-ion chemical ionization conditions is ca. 100
      times lower than under electron-impact or positive-ion chemical ionization
      conditions, therefore only very small amounts of the original sample have to be
      analysed. The method was applied to be quantitative determination of unchanged
      captopril in human plasma after oral administration of a 25-mg dose.

PMID- 2229250
TI  - Determination of metrifonate and dichlorvos in whole blood using gas
      chromatography and gas chromatography-mass spectrometry.
AB  - Analytical methods for determining metrifonate and dichlorvos in whole blood and
      a sampling procedure suitable for pharmacokinetic studies in man are described.
      Metrifonate concentrations were determined after chloroform extraction using gas
      chromatography-nitrogen-phosphorus detection. The within-assay coefficients of
      variation were 4 and 9% at 19.4 and 0.8 mumol/l (limits of determination),
      respectively. Dichlorvos was determined using gas chromatography-mass
      spectrometry of toluene extracts. The within-assay coefficients of variation were
      2 and 5% at 225 and 50 nmol/l (limits of determination), respectively. Since both
      substances are chemically unstable, the blood was collected by dripping it
      directly from the vein into 0.74 M phosphoric acid.

PMID- 2229251
TI  - Determination of atracurium and laudanosine in human plasma by high-performance
      liquid chromatography.
AB  - A high-performance liquid chromatographic method coupled with fluorometric
      detection has been developed for the determination of atracurium and its major
      end-product laudanosine in human plasma. The method enables good separation of
      atracurium from its metabolites after direct precipitation of plasma proteins.
      The assay is sensitive, reproducible and linear for atracurium concentrations
      ranging from 31.25 to 8000 ng/ml. In a clinical setting, drugs commonly
      administered during anesthesia did not interfere with the assay. This method
      provides a simple and time-saving alternative to existing methods.

PMID- 2229252
TI  - High-performance liquid chromatographic bio-analysis and preliminary
      pharmacokinetics of the experimental antitumour drug vintriptol.
AB  - A high-performance liquid chromatographic procedure, including sample
      pretreatment, is presented for the analysis of the experimental antitumour drug
      vintriptol in plasma. The sample pretreatment involved liquid-liquid extraction
      of the buffered (pH 3) sample with chloroform. Vinblastine was used as internal
      standard. Separation was achieved on a Hypersil ODS (5 microns) column with a
      mobile phase of acetonitrile-phosphate buffer. Electrochemical detection (at
      +0.70 V) was used, giving a detection limit of 2 micrograms/l. The applicability
      of the assay was demonstrated in a pharmacokinetic study with eight cancer
      patients who received 45 or 50 mg/m2 vintriptol in a phase I study. A three
      compartment model was used to fit the plasma concentration-time curves.
      Pharmacokinetic parameters are presented.

PMID- 2229253
TI  - Determination of the enantiomers of mefloquine in plasma and whole blood using a
      coupled achiral-chiral high-performance liquid chromatographic system.
AB  - A coupled achiral-chiral high-performance liquid chromatographic system has been
      developed for the determination of the enantiomers of mefloquine, (+)-MFQ and (-)
      MFQ, in plasma and whole blood. The MFQ was separated from the interfering
      components in the biological matrix and quantified on a cyano-bonded phase, and
      the enantiomeric composition was determined on an (S)-naphthylurea chiral
      stationary phase. The two columns were connected by a switching valve equipped
      with a silica precolumn. The precolumn was used to concentrate the MFQ in the
      eluent from the achiral column before backflushing onto the chiral phase. The
      coupled-column system was validated and applied to the analysis of a pilot study
      of the pharmacokinetics of (+)- and (-)-MFQ in plasma and whole blood.

PMID- 2229254
TI  - Simultaneous determination of disopyramide and its mono-N-dealkylated metabolite
      enantiomers in human plasma and urine by enantioselective high-performance liquid
      chromatography.
AB  - Enantiomers of disopyramide (DP) and its mono-N-dealkylated metabolite (MND) were
      determined in human plasma and urine by enantioselective high-performance liquid
      chromatography using a chiral stationary-phase column. This method was precise
      and sensitive: the mean recoveries from plasma at a concentration of 0.5
      microgram/ml were 101.1% for (+)-DP, 98.0% for (-)-DP, 94.4% for (+)-MND and
      82.9% for (-)-MND; the within- and between-day coefficients of variation at the
      same concentration were 4.4 and 3.3% for (+)-DP, 4.7 and 4.1% for (-)-DP, 6.5 and
      4.1% for (+)-MND and 7.8 and 2.4% for (-)-MND for plasma; the lower detection
      limits were 40 ng/ml for (+)-DP, 80 ng/ml for (-)-DP, 100 ng/ml for (-)-MND and
      200 ng/ml for (+)-MND, for 0.5 ml of plasma and 0.2 ml of urine. The
      ultrafiltration technique was used for determination of the unbound concentration
      of DP enantiomers in plasma. A preliminary study of the determination of DP and
      MND enantiomers in plasma and urine samples from a healthy subject given racemic
      DP demonstrated the clinical applicability of the present method for therapeutic
      monitoring and pharmacokinetic studies.

PMID- 2229255
TI  - Sensitive method for the determination of daunorubicin and all its known
      metabolites in plasma and heart by high-performance liquid chromatography with
      fluorescence detection.
AB  - The cytostatic agent daunorubicin is effective against leukaemia. An important
      side-effect is cardiomyopathy, common to all anthracyclines. Since anthracycline
      metabolites are thought to contribute to the observed cardiotoxicity, a method
      for the quantitative determination of all metabolites in plasma as well as in
      tissues is needed as a basis for the further investigation of the correlation
      between toxicity and the amount of each metabolite formed. Using Sep-Pak C18
      cartridges we were able to extract daunorubicin and its five metabolites,
      including the aglycones, with recoveries in the range 50-90%. Depending on the
      chemical properties of each metabolite, fluorescence detection following high
      performance liquid chromatographic separation permitted detection limits as low
      as 0.2-0.9 nM in plasma and 0.8-3.10(-11) mol/g in tissue, at a signal-to-noise
      ratio of 2, which compare favourably with literature data. The method showed
      linearity in the ranges 1-250 nM in plasma and 0.04-4.0 nmol/g in tissue (r
      greater than or equal to 0.998). The accuracy determined at 10 and 100 nM for
      plasma and at 0.1 and 1.0 nmol/g for tissue, was in the range 86-103 and 85-110%
      for plasma and tissue, respectively. The within-day and between-day repeatability
      values were acceptable (between 2 and 12%). Because of large inter-compound
      differences, separate calibration curves were used for each anthracycline.
      Application of the assay to the analysis of plasma and tissue samples of mice
      after intravenous injection of daunorubicin proved successful.

PMID- 2229257
TI  - Rapid determination of urinary oxalate by high-performance liquid chromatography.

PMID- 2229256
TI  - Determination of a potential antiasthmatic compound, tibenelast, and its
      application to phase I clinical trials.
AB  - A sensitive and selective high-performance liquid chromatographic (HPLC) assay
      was developed for the determination of tibenelast, 5,6-diethoxybenzo[b]thiophene
      2- carboxylic acid, in plasma and urine. The plasma assay involves protein
      precipitation with 4% trichloroacetic acid, while the urine assay is an automated
      solid-phase extraction procedure that utilizes the Waters Millilab workstation.
      The analysis was achieved by reversed-phase HPLC with ultraviolet detection at
      313 nm. The quantitation limit of the assay was 50 ng/ml in plasma and 100 ng/ml
      in urine. The intra-day coefficient of variation for the plasma analysis was
      between 2.2 and 8.4%, while the overall inter-day coefficient of variation was
      5.5 and 6.0% for the high and low calibration curves, respectively. The intra-day
      coefficient of variation for the urine analysis was between 0.3 and 3.0%, while
      the inter-day coefficient of variation was 2.1% for both the low and high
      validation samples. The assay methodology has been used in the evaluation of
      samples from pharmacokinetic and clinical safety studies.

PMID- 2229258
TI  - Measurement of acetylcholine and choline in cerebrospinal fluid by high
      performance liquid chromatography: failure to detect acetylcholine in normal
      human cerebrospinal fluid.

PMID- 2229259
TI  - Determination of gamma-aminobutyric acid in human cerebrospinal fluid by
      isocratic high-performance liquid chromatography.

PMID- 2229260
TI  - Separation of albumin-binding ligands present in uremic serum by high-performance
      affinity chromatography.

PMID- 2229261
TI  - New high-performance liquid chromatographic method for the determination of low
      activities of dihydropyrimidine dehydrogenase.

PMID- 2229263
TI  - Determination of alcuronium in plasma and urine by high-performance liquid
      chromatography.

PMID- 2229262
TI  - New assay method for the determination of vinpocetine in human plasma with gas
      chromatography-mass spectrometry without transesterification caused by solvents.

PMID- 2229264
TI  - High-performance liquid chromatographic analysis of unchanged cis
      diamminedichloroplatinum (cisplatin) in plasma and urine with post-column
      derivatization.

PMID- 2229265
TI  - Determination of the plasma protein binding of the coumarin anticoagulants
      phenprocoumon and its metabolites, warfarin and acenocoumarol, by ultrafiltration
      and high-performance liquid chromatography.

PMID- 2229266
TI  - Determination of tenilsetam in human plasma and urine by high-performance liquid
      chromatography.

PMID- 2229267
TI  - Sensitive one-step extraction procedure for high-performance liquid
      chromatographic determination of viloxazine in human plasma.

PMID- 2229268
TI  - Determination of denopamine in human and dog plasma by high-performance liquid
      chromatography with electrochemical detection.

PMID- 2229269
TI  - Quantitative determination of selected compounds in a Kentucky 1R4F reference
      cigarette smoke by multidimensional gas chromatography and selected ion
      monitoring-mass spectrometry.
AB  - Eight compounds from a Kentucky 1R4F reference cigarette smoke condensate have
      been determined by selected ion monitoring-mass spectrometry (SIM-MS) to confirm
      the validity of multidimensional gas chromatography (MDGC) as a quantitative tool
      in complex mixture analyses. Four electrostatically precipitated smoke condensate
      samples of 100 cigarettes each are dissolved individually in 25 mL of 2-propanol.
      The 2-propanol contains two methyl esters (C8 and C14) and seven deuterium
      labeled compounds used as internal standards (IS). Analysis of the compounds of
      interest, pyridine; acetamide; acrylamide; phenol; o-, m-, and p-cresol; and
      quinoline, is accomplished by using two heartcuts. Heartcut times of the MDGC
      analysis are selected such that at least one IS is transferred with each group of
      compounds being analyzed. This study shows that the MDGC technique previously
      developed and described can be used for quantitative analyses. A comparison is
      made between the two types of internal standards. The results obtained for both
      types of internal standards agree within 20% of each other, on the average, with
      higher standard deviations for approximately 60% of the compounds where methyl
      esters are used as internal standards.

PMID- 2229270
TI  - Separation and quantitation of monovalent anionic and cationic species in
      mainstream cigarette smoke aerosols by high-performance ion chromatography.
AB  - A simple method has been developed to separate and quantitate monovalent ionic
      species in mainstream cigarette smoke aerosols based on ion chromatography (IC)
      with conductivity detection. The method entails collecting the smoke aerosol
      particulate phase by electrostatic precipitation, dissolving the smoke condensate
      in methanol (MeOH), and separating the ionic species on either a cation- or anion
      exchange column. The method has been applied to the analysis of smoke aerosols
      from two cigarettes, 1R4F Kentucky Reference cigarettes and a new cigarette that
      heats but does not burn tobacco. The predominant cations in smoke aerosols from
      1R4F Kentucky Reference and the new cigarettes are sodium (Na+), ammonium (NH4+),
      and potassium (K+) ions; the predominant anions are acetate (AcO-) and formate
      (HCOO-). Trace amounts of chloride (Cl-), nitrite (NO2-), and nitrate (NO3-) ions
      are also present.

PMID- 2229271
TI  - Clinical review 15: Management of ovulatory disorders with pulsatile gonadotropin
      releasing hormone.
AB  - Pulsatile GnRH therapy has yet to achieve widespread acceptance as an alternative
      to exogenous gonadotropin therapy in women with hypothalamic amenorrhea and
      complete GnRH deficiency. However, when a physiologically based replacement
      regimen of pulsatile GnRH is used, a high rate of ovulation and conception can be
      anticipated in patients with complete GnRH deficiency and hypothalamic
      amenorrhea. Women with polycystic ovarian syndrome may also benefit from
      pulsatile GnRH, although rates of ovulation are lower. Pretreatment with a GnRH
      agonist may improve these rates considerably, but experience is limited. Whether
      an iv or sc route of administration is chosen, a simplified clinical monitoring
      protocol can be created which requires a minimum of patient monitoring while
      assuring maximum safety. Seventy five nanograms per kg appears to be a reasonable
      initiating dose, with subsequent increases in those who do not respond. The
      frequency of GnRH administration is best based on the GnRH pulse frequency in
      normal women. However, further information is needed to determine whether such a
      variable frequency is clearly superior to a fixed frequency regimen. When used
      appropriately, pulsatile GnRH is safe, effective, and offers an excellent
      alternative to conventional gonadotropin therapy for women with disordered
      endogenous GnRH secretion. Most importantly, and as opposed to exogenous
      gonadotropin therapy, pulsatile GnRH can be administered by most physicians in
      the office setting without the necessity of on-line E2 monitoring. This feature
      will enable more patients to receive treatment by their local physicians, whereas
      exogenous gonadotropin therapy should be administered by appropriately equipped
      referral centers. In the future, further studies will be required to determine
      which other categories of patients might benefit from pulsatile GnRH.

PMID- 2229272
TI  - Attainment of peak bone mass.

PMID- 2229273
TI  - Effects of hormonal status on bone density in adolescent girls.
AB  - Few data are available on bone density in late adolescence. We studied factors
      affecting peak bone density in females. Forty-three white girls, aged 13-20 yr,
      were studied. Integrated estrogen exposure over the pubertal years was obtained
      by a score based on physiological events known to reflect circulation estrogen
      levels. The subjects were selected to provide great variation in estrogen
      exposure. Bone mineral density (BMD) was measured by single photon absorptiometry
      (midradius) and dual photon absorptiometry (spine and first metatarsal of the
      foot). Weight, estrogen score, and testosterone levels were highly correlated
      with BMD of the spine, wrist, and foot (P less than 0.05). Age correlated
      positively only with the BMD of the wrist. Twenty-four girls reaching ages 18-20
      yr in the 2 yr of observation were divided into groups reflecting low (less than
      24), medium (25-48), and high (greater than or equal to 49) estrogen exposure.
      The lowest scoring groups had the lowest spine and wrist BMD (P less than 0.05).
      This group weighed less and had lower weight to height ratio (P less than 0.05),
      the lowest weight (P less than 0.05) during adolescence, the highest age of
      menarche, and the highest amount of fiber in the diet (P less than 0.05). These
      subjects were separated into low and high BMD groups. Those subjects with the
      lowest values for spine, wrist, and foot were found to have significantly lower
      estrogen exposure scores and lower weight/height ratios; in addition, low BMD of
      the foot was associated with higher activity levels. Thus, wrist and spine BMD
      are affected by estrogen exposure during adolescence and weight; foot BMD, in
      addition, was negatively affected by activity, suggesting that bone mass in the
      active adolescent is affected by the absence of estrogen exposure.

PMID- 2229274
TI  - Immunological evidence for a human ovarian tumor necrosis factor-alpha.
AB  - Tumor necrosis factor-alpha (TNF alpha) was localized to follicular and luteal
      compartments of the human ovary using a biotin strept-avidin immunocytochemical
      technique with polyclonal antibodies to human recombinant TNF alpha.
      Immunoreactive TNF alpha (I-TNF) was observed in granulosa cells of healthy
      antral and atretic follicles and appeared to be secreted by the granulosa cells,
      since it was present in the follicular fluid surrounding antral and degenerating
      granulosa. Preantral follicles did not exhibit I-TNF. I-TNF was in the cytoplasm
      of large granulosa-lutein cells and small paraluteal cells. Granulosa cells
      cultured on an Immobilon membrane exhibited I-TNF in the cytoplasm and I-TNF
      released onto the membrane, which appeared as a dark-red stain after
      immunolocalization. Granulosa cells cultured on plastic slides exhibited I-TNF
      throughout the cytoplasm. To determine if I-TNF was secreted by granulosa cells,
      granulosa cell-conditioned medium was examined for the presence of TNF by a
      double sandwich enzyme-linked immunosorbant assay using both monoclonal and
      polyclonal antibodies to human recombinant TNF alpha. Conditioned medium
      contained up to 800 pg TNF/500,000 cells after 24 h of culture. I-TNF was also
      found (100-170 pg/mL) in human follicular fluid. Immunoblot assay of I-TNF in
      cultured granulosa revealed approximately 240 pg TNF/250,000 cells. The results
      indicate that the human ovary contains I-TNF, and thus, a paracrine and/or
      autocrine role of TNF in human ovarian follicular function seems likely.

PMID- 2229275
TI  - Parathyroid hormone-like peptide in normal and neoplastic human endocrine
      tissues.
AB  - PTH-like peptide (PLP) is produced by tumors commonly associated with
      hypercalcemia as well as nonneoplastic tissues and several endocrine glands and
      tumors. To characterize the distribution of PLP in human endocrine tissues and
      tumors, we localized PLP in formalin-fixed paraffin-embedded material using the
      avidin-biotin-peroxidase technique with polyclonal antisera. Among peptide
      hormone-producing tissues, PLP was identified in nontumorous adenohypophysis and
      pituitary adenomas; medullary thyroid carcinomas; normal, hyperplastic, and
      adenomatous parathyroids; adrenal medulla and pheochromocytomas; normal
      pancreatic islets; and endocrine tumors of pancreas, gut, and lung, including
      small cell carcinomas. In other endocrine tissues PLP was identified in
      nontumorous thyroid follicular epithelium, colloid nodules, and follicular
      neoplasms; normal adrenal cortex, adrenocortical adenomas, and carcinomas;
      nontumorous testicular Leydig cells; normal ovarian granulosa and thecal cells;
      an ovarian thecoma and a granulosa cell tumor; placental trophoblast; and
      decidua. These results demonstrate that PLP is localized in many normal and
      neoplastic endocrine cells, including those not known to influence extracellular
      calcium homeostasis. The presence of PLP in a variety of endocrine tissues
      suggests that it may play a local physiological role in the growth or function of
      endocrine cells.

PMID- 2229276
TI  - Reproducibility of growth hormone testing procedures: a comparison between 24
      hour integrated concentration and pharmacological stimulation.
AB  - The purpose of this study was to compare the reproducibility of two approaches to
      the evaluation of GH secretion: the integrated concentration of GH (IC-GH), a
      physiological test of GH secretion, and pharmacological stimulation tests. IC-GH
      was determined in 40 poorly growing children twice within 4 weeks. The first and
      second IC-GH were highly correlated r = 0.859, P less than 0.001. One hundred and
      thirteen poorly growing children underwent pharmacological GH stimulation tests
      twice within 6 weeks. A moderate correlation was found between the first and
      second pharmacological test r = 0.524, P less than 0.01. Among the three
      pharmacological stimuli studied, clonidine (n = 81) had the highest
      reproducibility followed by arginine (n = 20), and insulin (n = 12). We conclude
      that IC-GH is more consistently reproducible than the GH response to repeated
      pharmacological stimulation.

PMID- 2229277
TI  - Thyroid hormones influences sex steroid binding protein levels in infancy: study
      in congenital hypothyroidism.
AB  - In order to test the hypothesis of a role of thyroid hormones on the circulating
      levels of sex steroid binding protein (SHBG) in children, SHBG levels were
      determined in 15 infants with congenital hypothyroidism at diagnosis and during
      the first 18 months of T4 therapy and in a separate group of 13 children with
      congenital hypothyroidism (7.1 +/- 0.5 yr, mean +/- SD), treated before 1 month
      of age, both during adequate L-T4 therapy and 4 weeks after withdrawing therapy.
      SHBG levels were significantly lower in hypothyroid infants than in controls
      (48.2 +/- 6.5 vs. 77.8 +/- 7.9 nmol/L; P less than 0.01), and significantly lower
      in infants with athyreosis compared to those with ectopic or eutopic glands (P
      less than 0.05). In patients with low values at diagnosis, SHBG increased rapidly
      and remained normal during LT4 therapy. After 1.5-18 months of treatment, a
      positive correlation (P less than 0.01) was found between SHBG, FT4, and FT3
      levels. In older hypothyroid children, 4 weeks after withdrawal of therapy a
      significant (P less than 0.05) decrease in SHBG concentrations was observed.
      Analysis of these results as well as previous reports in adults, indicates that
      thyroid hormones influence SHBG concentrations in infants and children. This
      study also indicates that thyroid hormones may play a role in the physiological
      postnatal increase of SHBG.

PMID- 2229278
TI  - Short term treatment of acromegaly with the somatostatin analog octreotide: the
      first double-blind randomized placebo-controlled study on its effects.
AB  - Several studies suggest that the somatostatin analog octreotide, or SMS 201-995,
      may effectively reduce GH hypersecretion. However, no double blind, placebo
      controlled study has substantiated these findings. We present the results of a
      randomized double blind 14-day clinical trial with octreotide in 20 patients with
      acromegaly. The drug was given sc every 8 h and to the initial dose (50
      micrograms) was added another 50 micrograms every other day up to 200 micrograms.
      GH levels, calculated as the mean values of 12 observations at hourly intervals
      during 0700-1800 h, and insulin-like growth factor-I (IGF-I) levels were
      significantly reduced during octreotide treatment. Responses varied from a
      reduction of 97% of the basal mean GH level to no significant reduction in 2 of
      10 patients. There was a good correlation between the reduction of GH and IGF-I
      levels. The main side-effects were gastrointestinal and well tolerated. We found
      a spontaneous variation of daily mean GH and IGF-I levels (at 0700 h) in the
      placebo group, ranging from approximately 150% to 50% of the GH and 120% to 80%
      of the IGF-I levels noted on day 0. In patients treated with octreotide, the
      occurrence of GH rises between administration times suggests that it may be
      desirable to give octreotide every 6 h in some patients.

PMID- 2229279
TI  - Evaluation of the growth hormone-binding proteins in human plasma using high
      pressure liquid chromatography gel filtration.
AB  - A technique using high pressure liquid chromatography gel filtration was used to
      evaluate GH-binding proteins (BP) in human plasma; eluate was monitored for
      radioactivity in a gamma-detection system connected to a computer. Plasma (200
      microL) was incubated with [125I]human (h) GH (200,000 cpm) at 4 C for 20 h. The
      main GH-BP (peak II) was well separated from free [125I]hGH (peak III) and from a
      higher mol wt complex (peak I), which was minor. In our control plasma, the
      specific binding of [125I]hGH to peak II BP (II-BP) was 32.2 +/- 0.6% of the
      radioactivity. Scatchard analyses indicate an association constant of 3.6-7.4 X
      10(8) M-1 and a binding capacity ranging from 24-86 ng/mL for peak II-BP in five
      normal adult plasma samples. Peak I material, separated from plasma of boys with
      pubertal delay, bound hGH with a low affinity (3 x 10(6) M-1) and a very high
      capacity (2 micrograms/mL). In cross-linking experiments, peak I appeared as two
      proteins of 165 and 174 kD; these mol wt were much higher than that of peak II
      BP, previously estimated at 53,000. hGH complexed to peak II-BP remained fully
      immunoreactive with use of the anti-hGH antibodies of our assay. In plasma
      containing 10-20 micrograms/L hGH, the proportion of bound hormone (peak II) was
      44.5 +/- 2.3%, whereas the amount of hGH in peak I was very low or undetectable.
      Specific binding of hGH to II-BP was lowest during the first year of life and
      highest in adulthood. No sex difference was found. I-BP is differentially
      regulated, since its binding activity was significantly lower in adults than in
      prepubertal children. Normal values for age should be taken into account to
      interpret GH-binding activity, particularly in children 2 yr of age or younger.
      Our GH binding assay offers important gains in terms of rapidity and resolution;
      it has permitted a clear separation and characterization of the two GH-binding
      components present in human plasma.

PMID- 2229280
TI  - Steroid hormone receptors in human adipose tissues.
AB  - Administration of glucocorticoid, estrogen, and progesterone is followed by
      changes in human adipose tissue distribution, morphology, and function.
      Therefore, specific receptors for these hormones were determined in different
      regions of human adipose tissue using ligand techniques, with separation of bound
      and free hormone by chromatography, absorption techniques, or isoelectric
      focusing, as well as protein quantitation with monoclonal antibodies against
      human estrogen and progesterone receptors. Furthermore, mRNAs were measured by
      solubilization hybridization technique with glucocorticoid, estrogen, and
      progesterone receptor cRNA probes for human receptors. Saturable specific
      cytosolic glucocorticoid binding was found. Quantitative analyses indicated more
      binding sites and mRNAs in intraabdominal than sc adipose tissue samples. In
      contrast, neither specific estrogen or progesterone binding, cytosolic or nuclear
      receptor protein, nor mRNAs for these receptors could be identified in abdominal,
      femoral, or omental adipose tissues. Parallel control experiments confirmed the
      presence of both estrogen and progesterone receptors in rat adipose tissues. It
      was concluded that while glucocorticoid receptors are clearly present in human
      adipose tissues, female sex hormone receptors are not present in quantities
      detectable with presently available methods. Effects of these hormones on human
      adipose tissue might, therefore, be mediated via a minute nondetectable quantity
      of receptors, the glucocorticoid receptor, or indirect mechanisms.

PMID- 2229281
TI  - Glucose and gluconeogenic substrate exchange by the forearm skeletal muscle in
      hyperglycemic and insulin-treated type II diabetic patients.
AB  - To determine the contribution of skeletal muscle to fasting hyperglycemia in
      noninsulin dependent type II diabetes (NIDDM), the forearm balance of glucose,
      lactate, and alanine was quantified in 25 control subjects, 21 hyperglycemic
      (blood glucose: 11.6 mmol/L), and 19 insulin-treated patients with NIDDM (blood
      glucose: 5.8 mmol/L). Forearm glucose uptake was similar in controls (4.6 +/- 0.6
      mumol L-1 min-1) and in hyperglycemic diabetic patients (4.5 +/- 0.9 mumol L-1
      min-1). In spite of this, in the diabetic patients lactate (5.1 +/- 0.8 mumol L-1
      min-1) and alanine (2.6 +/- 0.4) release by the forearm was 3- and 2-fold higher
      than in the control group (lactate: 1.7 +/- 0.8, P less than 0.005; and alanine:
      1.3 +/- 0.2, P less than 0.05, respectively). The ratio of lactate release to
      glucose uptake was 57% and 18% in diabetic and control subjects, respectively.
      Insulin administration did not affect either glucose uptake or the release of
      gluconeogenic substrates by the forearm. It is concluded that: 1) in fasting
      patients with NIDDM, glucose is taken up by the skeletal muscle in normal amounts
      but preferentially used nonoxidatively with lactate formation. This suggests
      that, although the muscle does not contribute directly to fasting hyperglycemia,
      it may play an indirect role through an increased delivery of glucose precursors;
      and 2) insulin-induced normoglycemia is maintained by mechanisms that do not
      involve the exchange of glucose and gluconeogenic substrates by the skeletal
      muscle.

PMID- 2229282
TI  - Decreased serum triiodothyronine is associated with increased concentrations of
      tumor necrosis factor.
AB  - Previous studies in laboratory animals have shown that tumor necrosis factor
      alpha (TNF) may alter thyroid function tests. To determine whether elevated serum
      TNF levels are associated with altered serum concentrations of T4, T3, free T4,
      rT3, and TSH, we measured these parameters in 29 nursing home residents with
      detectable serum TNF levels and compared the levels to those found in 36 patients
      with undetectable serum TNF levels. The 2 groups were matched for age, sex,
      clinical problems, use of medications, and nutritional status. Patients with
      detectable serum TNF levels had significantly lower serum T3 concentrations
      compared to those with undetectable levels [1.072 +/- 0.588 vs. 1.621 +/- 0.594
      nmol/L (mean +/- SD); P less than 0.01]. Differences in other tests did not
      achieve statistical significance. Thyroid function tests were not significantly
      different when patients with detectable interleukin-1 alpha levels, another
      cytokine secreted during endotoxemia, were compared to those with undetectable
      levels. These observations taken together with the previous findings in
      laboratory animals suggest that some of the alterations in thyroid hormone levels
      seen in nonthyroidal illness are associated with elevated serum concentrations of
      TNF.

PMID- 2229283
TI  - Regulation of intracellular free calcium in human myometrial cells by
      prostaglandin F2 alpha: comparison with oxytocin.
AB  - The effects of prostaglandin F2 alpha (PGF2 alpha) on intracellular Ca2+
      concentration ([Ca2+]i) and inositol phosphate (IP) generation in human
      myometrial cells were evaluated and compared to the effects of oxytocin. Basal
      [Ca2+]i levels were 146 and 153 nM in the absence and presence of 1 mM
      extracellular Ca, respectively. In Ca-containing medium, both PGF2 alpha and
      oxytocin significantly (P less than 0.01) increased [Ca2+]i over control values,
      eliciting half-maximal stimulation (ED50) at 4 and 1 nM, respectively. In Ca-free
      medium the potency of PGF2 alpha to raise [Ca2+]i was drastically reduced (ED50,
      2 microM), whereas that of oxytocin remained the same, although maximal responses
      were markedly decreased. PGF2 alpha had no effect on total IP production in the
      concentration range that significantly raised [Ca2+]i. However, at a 100 times
      higher concentration (10 microM), PGF2 alpha produced a maximum 48% increase in
      total IP, with a rapid (15-30 s) rise in IP3 and IP2, followed by IP1. A similar
      increase in IP production was obtained when [Ca2+]i levels were raised by A23187
      to the same level as that obtained with 10-50 microM PGF2 alpha. The effect of
      PGF2 alpha was dependent on extracellular Ca and could be suppressed by
      verapamil, but not by pertussis toxin, or phorbol ester. In contrast, the
      potencies of oxytocin to raise IP and [Ca2+]i were similar and independent of
      extracellular Ca2+, and could be suppressed by pertussis toxin and phorbol ester,
      but not by verapamil. These data provide evidence that in isolated human
      myometrial cells, PGF2 alpha and oxytocin trigger an increase in [Ca2+]i by
      different mechanisms. The action of PGF2 alpha depends on extracellular Ca2+,
      whereas oxytocin activates the G-protein-dependent phospholipase-C-IP3-Ca2+
      signal-transducing pathway, complemented by the influx of extracellular Ca2+.

PMID- 2229284
TI  - Vasopressin and oxytocin responses to illusory self-motion and nausea in man.
AB  - Vasopressin and oxytocin are nonapeptides secreted from the neurohypophysis;
      increases in vasopressin are associated with nausea and vomiting in some, but not
      all, species. Our aim was to determine whether plasma vasopressin and oxytocin
      levels were altered in healthy volunteers who did or did not develop nausea
      during vection, an optokinetic stimulus which produces the illusion of self
      motion. Vection was produced by rotating a drum with an inner surface of black
      and white vertical stripes around the seated stationary subject. Gastric
      myoelectrical activity was recorded continuously throughout the experiment with
      electrodes positioned on the abdominal surface. Plasma samples were obtained
      before vection and after drum rotation stopped when nausea and tachygastria were
      present. Vasopressin and oxytocin were extracted from plasma and quantified by
      RIA. During vection six subjects reported nausea and developed gastric
      dysrhythmias; six other subjects had no nausea and remained in normal 3-cpm
      myoelectrical rhythms. Vasopressin and oxytocin values before vection were
      similar in each group of subjects. One minute after vection stopped, plasma
      vasopressin levels were significantly greater (P less than 0.05) in subjects
      experiencing nausea and tachygastrias (35.4 +/- 26.7 pmol/L) than in those
      without symptoms (2.7 +/- 0.47 pmol/L). Oxytocin levels were unchanged by either
      vection or nausea. It is concluded that 1) vasopressin, not oxytocin, neurons in
      the magnocellular-neurohypophyseal system are activated during vection-induced
      nausea and gastric dysrhythmias; and 2) illusory self-motion may be used safely
      to study the neuroendocrine responses to brain-gut interactions and nausea in
      man.

PMID- 2229285
TI  - Effects of transdermal estrogen replacement on parathyroid hormone secretion.
AB  - The effect of transdermal 17 beta-estradiol replacement on ionized calcium and
      PTH levels was examined in 15 postmenopausal women. After baseline studies in the
      fasting state, the effect of a calcium infusion on PTH levels was studied.
      Estrogen replacement resulted in a fall in fasting resting ionized calcium and a
      rise in PTH levels. After calcium infusion there was no change in the shape of
      the relationship between plasma calcium and PTH. The level of nonsuppressible PTH
      secretion was not altered. Transdermal estrogen did not alter basal vitamin D
      binding protein levels, 25-hydroxyvitamin D levels, or calcitriol levels. We
      conclude that the effect of transdermal estrogen replacement on PTH secretion is
      completely explained by the lowering of ionized calcium, causing a rise in PTH
      secretion. Thus, with this route of estrogen replacement, there is no necessity
      to postulate a direct effect of 17 beta-estradiol on the parathyroid gland.

PMID- 2229286
TI  - Estrogen preserves a normal intestinal responsiveness to 1,25-dihydroxyvitamin D3
      in oophorectomized women.
AB  - Estrogen treatment improves calcium malabsorption induced by surgical or natural
      menopause, but the mechanisms involved are still under debate, with both
      increased production of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] and improved
      peripheral responsiveness to the steroid having been proposed. To address this
      issue, we studied the effect of short term administration of 1,25-(OH)2D3 (1
      microgram/day for 7 days) on intestinal fractional absorption of 47Ca (47Ca FA)
      and vertebral bone density, measured by dual photon absorptiometry, in 14
      premenopausal women (aged 31-50 yr) before and 6 months after oophorectomy. After
      surgery, patients were randomly allocated to a 6-month treatment with either
      conjugated estrogens (0.625 mg/day; n = 7) or placebo (n = 7). Oophorectomy
      caused a decrease in both basal 47Ca FA (-40.8 +/- 23.4%; P = 0.004) and
      vertebral bone density (-7.21 +/- 1.20%; P less than 0.001) in the placebo group.
      Estrogen replacement prevented these changes and increased basal serum 1,25
      (OH)2D3 (+10.3 +/- 10.9%; P = 0.047), whereas a detectable but not significant
      decrease was observed in the control group (-8.8 +/- 10.5%; P = 0.07). Assessment
      of 47Ca FA before and after 1,25-(OH)2D3 administration revealed a similar degree
      of responsiveness to the steroid in the estrogen-treated women before and at the
      end of the study period (45.8 +/- 6.9% vs. 42.9% +/- 14.9% from basal,
      respectively; P = 0.142), but a blunted response to 1,25-(OH)2D3 was observed in
      the placebo group at 6 months (27.9 +/- 17.7%) compared to the result obtained
      before surgery (36.7 +/- 9.1%; P = 0.032). Multifactor analysis of variance
      revealed that the effects of estrogen and 1,25-(OH)2D3 on 47Ca FA were
      independent of basal serum 1,25-(OH)2D3 levels. On the other hand, calcitriol
      administration increased serum 1,25-(OH)2D3 to a similar extent before and 6
      months after surgery in the placebo group (24.2 +/- 18.3% vs. 34.7 +/- 16.7% from
      basal, respectively; P = 0.484) as well as in the estrogen-treated women (34.2 +/
      17.2% vs. 26.6 +/- 15.45%; P = 0.302). The significant impairment of 1,25
      (OH)2D3 stimulation of 47Ca FA in spite of increased levels of circulating 1,25
      (OH)2D3 in the untreated women is suggestive of an end-organ resistance to the
      vitamin D metabolite in a hypoestrogenic condition, which can be prevented by
      hormone replacement, and supports the hypothesis of a vitamin D-independent
      action of estrogen on intestinal calcium absorption.

PMID- 2229287
TI  - Effect of central obesity on regulation of carbohydrate metabolism in obese
      patients with varying degrees of glucose tolerance.
AB  - It has been proposed that central obesity, by virtue of the enhanced lipolytic
      activity of abdominal adipose tissue, leads to higher plasma FFA concentrations,
      which, in turn, decrease both hepatic removal of insulin and insulin-stimulated
      glucose uptake by peripheral tissues. In short, the predicted consequences of
      abdominal obesity are elevations in circulating FFA and insulin levels as well as
      insulin resistance. The goal of this study was to evaluate the relationships
      predicted by the overall hypothesis; this study was carried out in 31 obese
      females, defined as having normal glucose tolerance (n = 12), impaired glucose
      tolerance (n = 8), or noninsulin-dependent diabetes mellitus (n = 11). Abdominal
      obesity was estimated by determining the ratio of waist to hip girth, fasting and
      postprandial plasma FFA and insulin concentrations were measured at hourly
      intervals from 0800-1600 h, and insulin-stimulated glucose disposal was
      quantified by the euglycemic hyperinsulinemic clamp technique. The first step in
      the postulated sequence of events to be tested was that the greater the WHR, the
      higher the total integrated plasma FFA response. The correlation coefficient
      between these two variables was 0.29, indicating that the results did not support
      the prediction. Furthermore, we could not demonstrate any relationship between
      the magnitude of the plasma FFA and insulin responses (r = 0.20; P = NS).
      However, there was a modest inverse relationship between height of circulating
      plasma insulin concentration and a decrease in insulin-stimulated glucose uptake
      (r = -0.43; P less than 0.03) in the group as a whole. On the other hand, when
      the three groups were analyzed individually, a significant inverse relationship
      was only seen in the control group (r = -0.67), and a direct relationship was
      actually seen in patients with impaired glucose tolerance (r = 0.88).
      Furthermore, when the mean responses for the variables in each of the three
      groups were compared, it was apparent that the postulated relationships between
      abdominal obesity, plasma FFA concentration, and insulin secretion and action
      were not present. Thus, the data presented do not support the hypothesis that
      differences in the degree of central obesity play an important role in regulation
      of plasma concentrations of either FFA or insulin or in modulation of insulin
      stimulated glucose uptake in the patients we studied.

PMID- 2229288
TI  - Primary hyperparathyroidism and severe hypercalcemia with low circulating 1,25
      dihydroxyvitamin D.
AB  - We report a postmenopausal woman with primary hyperparathyroidism (PHPT) and
      severe hypercalcemia while her total calcium intake was more than 2 g daily.
      Despite a markedly elevated intact PTH level, her serum 1,25-dihydroxyvitamin D
      [1,25-(OH)2D] level was low (17 pmol/L; 7 pg/mL). With reduced calcium intake,
      her serum calcium normalized, and 1,25-(OH)2D increased to 122 pmol/L (51 pg/mL).
      At the same time, intact PTH decreased to 32% of the initial value. PHPT may be
      associated with low circulating 1,25-(OH)2D levels. Furthermore, low 1,25-(OH)2D
      levels in PHPT may be due to a direct effect of severe hypercalcemia and be
      reversible with correction of hypercalcemia.

PMID- 2229289
TI  - Secretion of chorionic gonadotropin by cultured human pituitary cells.
AB  - To investigate the possibility that the human pituitary gland secretes CG, we
      used a highly specific, two-site, double monoclonal immunoradiometric assay to
      measure CG in the medium in which the dispersed cells of pituitary glands from
      human fetuses of 20-24 weeks gestation were cultured. The cross-reactivity of
      immunopurified human LH in the CG assay was less than 0.03%. LH was also measured
      by a double monoclonal immunoradiometric assay. Secretion of CG by the cultured
      fetal pituitary cells was readily detectable, although in gradually decreasing
      amounts, for the 11 days of culture. LH secretion paralleled CG secretion and was
      much greater in magnitude. Pituitary cells from female fetuses generally secreted
      more CG as well as more LH than those from male fetuses. Dilutions of the medium
      showed that the secreted CG exhibited parallelism with the CG standard.
      Chromatofocusing of the medium across a pH 6-9 gradient yielded several peaks of
      LH immunoreactivity between pH 6.5 and 8.5, but no peaks of CG. Chromatofocusing
      of the medium across a pH 3-7 gradient yielded peaks of CG, but not LH, between
      pH 4.0-5.5. These data indicate that CG immunoreactivity, distinct and separable
      from LH immunoreactivity, is secreted by the dispersed cells of fetal human
      pituitary glands.

PMID- 2229290
TI  - Studies of the mechanism by which androgens enhance mitogenesis and
      differentiation in bone cells.
AB  - Recently, we reported a direct effect of androgens on murine and human bone cells
      to stimulate bone cell proliferation and differentiation. To test whether this
      effect of androgenic steroids might be mediated by growth factors, we measured
      relative concentrations of insulin-like growth factor-I and -II (IGF-I and IGF
      II) and transforming growth factor-beta (TGF beta) in the conditioned medium from
      androgen-treated murine calvarial cell cultures. Only the concentration of TGF
      beta was increased. Consistent with the increased secretion of TGF beta in the
      mouse calvarial cell system, we observed an increased expression of TGF beta mRNA
      in a normal human osteoblastic cell system. We also determined whether androgens
      alter the response to growth factors. We found that dihydrotestosterone (DHT)
      treatment enhanced the mitogenic effects of fibroblast growth factor (FGF) and
      IGF-II but not those of IGF-I. The enhanced effect of FGF and IGF-II after DHT
      pretreatment was not affected by addition of TGF beta-blocking antibodies or by
      changing the culture medium. This indicated that in addition to increased release
      of TGF beta, another mechanism might be involved in the action of DHT on human
      and murine bone cells. Thus, we investigated the binding of human IGF-II to human
      osteoblastic cells and observed an increase in IGF-II binding after DHT
      treatment. Our results are consistent with a mechanism of action of androgens on
      bone cells that involves the induction of TGF beta and, in addition, may
      sensitize the cells to show an enhanced response to FGF and IGF-II, possibly by
      changing the receptor binding of mitogenic growth factors.

PMID- 2229291
TI  - Sex differences in serum luteinizing hormone and testosterone in the human
      neonate during the first few hours after birth.
AB  - Blood was obtained from human male and female neonates within a few minutes after
      birth, and at intervals thereafter for up to 21 h. Serum LH was substantially
      higher at birth for boys than girls. For most boys, serum LH fell precipitously
      during the next hour; serum LH remained low for the remainder of the period
      sampled in both boys and girls. In girls, serum testosterone was low at birth and
      remained low for at least 21 h. At birth, serum testosterone in boys was higher
      than for girls, increased dramatically during the first 3 h after birth, and
      remained elevated (2 to 3 times higher than for girls) between 3 and 12 h after
      birth. In newborn human males, a sudden discharge of hypophyseal LH appears to
      stimulate neonatal secretion of testosterone by the testes. The functional
      significance of this phenomenon remains to be determined.

PMID- 2229292
TI  - Increased overnight growth hormone concentrations in diabetic compared with
      normal adolescents.
AB  - To determine the extent to which spontaneous plasma GH concentrations are
      abnormal in adolescents with insulin-dependent diabetes mellitus we performed 12
      h overnight plasma GH profiles in 21 diabetic adolescents (11 males and 10
      females; aged 9.8-16.5 yr; median, 13.6 yr) and 34 healthy adolescent controls
      (17 males and 17 females; aged 9.1-20.9 yr; median, 13.1 yr). Data were analyzed
      using the pulse detection program Pulsar and time series analysis, and are
      presented with respect to age and puberty stage. Mean and maximum GH
      concentrations, sum of the peak amplitudes, and mean calculated baseline
      concentrations in the normal children were higher during puberty; highest levels
      were seen in girls at puberty stages 2-3, and in boys at stages 4-5. A similar
      pattern was observed in the diabetic adolescents, but all measures of pulse
      height and mean calculated baseline concentrations were significantly greater
      than those in the normal subjects (multivariate analysis, P less than 0.001).
      Pulse frequency did not change during puberty in the normal or diabetic subjects,
      and the dominant pulse periodicity in both groups was about 180 min. We conclude
      that the predominant change in GH release during puberty is in pulse amplitude,
      and that this is increased in diabetes, whereas pulse frequency remains constant
      in both normal and diabetic adolescents.

PMID- 2229294
TI  - Corticotropin-releasing hormone inhibition of growth hormone-releasing hormone
      induced growth hormone release in man.
AB  - Recent studies in the rat have shown that intracerebroventricular administration
      of CRH inhibited spontaneous pulsatile GH secretion and prevented GH-releasing
      hormone (GHRH)-induced GH release. We have studied the effect of CRH on GHRH
      induced GH release in man. In the first study, CRH was injected iv at three
      different doses (100, 50, or 25 micrograms) at 0800 h together with 50 micrograms
      GHRH in six men and six women. In a second study, 100 micrograms CRH were given
      iv at 0800 h, 1 h before the administration of 50 micrograms GHRH in five men and
      five women. Each subject demonstrated a normal GH response after the
      administration of 50 micrograms GHRH plus saline. All doses of CRH administered
      simultaneously with GHRH significantly inhibited GHRH-induced GH release in women
      [peak value +/- SE after GHRH plus saline, 28.9 +/- 2.9 micrograms/L; after GHRH
      plus 100 micrograms CRH, 9.9 +/- 0.7 micrograms/L (P less than 0.001); after GHRH
      plus 50 micrograms CRH, 8.7 +/- 0.8 micrograms/L (P less than 0.001); after GHRH
      plus 25 microgram CRH, 9.5 +/- 1.6 microgram/L (P less than 0.001]). In contrast,
      in men, while a dose of 100 micrograms CRH was capable of suppressing GHRH
      induced GH secretion (peak value +/- SE, 8.1 +/- 0.6 vs. 20 +/- 2.9 micrograms/L;
      P less than 0.001), no inhibition was observed after 50- and 25-micrograms doses.
      When 100 micrograms CRH were injected 1 h before the administration of 50
      micrograms GHRH, it strongly inhibited GHRH-induced GH secretion in both men
      (peak value +/- SE, 6.2 +/- 2.8 vs. 24.6 +/- 5.9 micrograms/L; P less than 0.02)
      and women (peak value +/- SE, 14.2 +/- 4.5 vs. 37.8 +/- 6.7 micrograms/L; P less
      than 0.005), and this inhibition lasted up to 2 h post-CRH administration. These
      results demonstrate that CRH is capable of inhibiting GHRH-induced GH release in
      both men and women. Furthermore, the findings suggest that a sexual dimorphism in
      the neuroregulation of GH secretion may be present in man. In view of the
      inhibitory action of CRH on GH secretion, simultaneous administration of CRH and
      GHRH for testing should be avoided in clinical practice.

PMID- 2229293
TI  - Human follicular fluids contain tissue macrophages.
AB  - Tissue cells obtained from the follicular fluids of women undergoing in vitro
      fertilization and embryo transfer were found to contain interleukin-1 beta mRNA
      by Northern analysis. Since macrophages are known to produce interleukin-1 beta,
      we examined the follicular fluids of 20 women undergoing in vitro fertilization
      as well as tissue sections of normal human ovary for the presence of macrophages
      and monocytes. Although granulosa-luteal cells predominate in follicular fluid,
      we found that resident macrophages and monocytes comprise 5-15% of human
      follicular tissue cells. In addition, we observed that macrophages are present in
      the human ovarian follicle as well as in the corpus luteum.

PMID- 2229295
TI  - Levels of steroid-binding proteins and steroids in human preovulatory follicle
      fluid and serum as predictors of success in in vitro fertilization-embryo
      transfer treatment.
AB  - In an attempt to identify the embryos and cycles that have the best chances of
      resulting in establishment of pregnancies, after in vitro fertilization-embryo
      transfer (IVF-ET) treatment, the concentrations of sex hormone-binding globulin
      (SHBG) and cortisol-binding protein (CBP) were measured, using two new enzyme
      linked immunosorbent assays in serum and follicle fluid (FF) from 30 women (125
      FF) undergoing IVF-ET. The concentrations were compared to those of total
      estradiol and total progesterone, and correlated to oocyte cleavage and the
      establishment of pregnancies. Serum concentrations of CBP were significantly
      higher in women who became pregnant (1469 +/- 108) nM (+/- SEM] than in those who
      did not (CBP, 1200 +/- 58 nM; P less than or equal to 0.05). The concentrations
      of SHBG were not significant different in these two groups of women (72.4 +/- 9.3
      and 60.8 +/- 4.2 nM, respectively; P greater than or equal to 0.10). By contrast,
      in FF significantly higher concentrations of both SHBG and CBP were found in
      women achieving pregnancy (SHBG, 56.1 +/- 2.8 nM; CBP, 1198 +/- 37 nM) than in
      those who did not (SHBG, 45.5 +/- 1.4 nM; P less than or equal to 0.001; CBP,
      1079 +/- 29 nM; P less than or equal to 0.01). A positive correlation was found
      between serum and FF levels of both SHBG (r = 0.85; P less than or equal to
      0.001) and CBP (r = 0.70; P less than or equal to 0.001). FF levels of estradiol
      and progesterone did not differ regardless of whether the oocyte cleaved.
      However, a significant reduction of estradiol was found in fluid from follicles
      in which the oocyte cleaved and resulted in pregnancy (3046 +/- 180 nM) than in
      fluid from follicles in which the oocyte cleaved but without establishment of
      pregnancy (4162 +/- 282 nM; P less than or equal to 0.001). There was no
      correlation between estradiol and SHBG and between progesterone and CBP. However,
      levels of FF progesterone above 15,000 nM combined with CBP concentrations above
      the mean concentration found in FF (1,127 nM) were related with oocyte cleavage
      in 87% of the cases. The overall cleavage rate is 56%. The higher levels of SHBG
      and CBP in serum compared to those in FF, and the positive relationship between
      serum and FF levels suggest that both proteins arise from the circulation. The
      similar levels in serum and FF indicate that neither SHBG nor CBP is responsible
      for maintaining the concentration gradient of estradiol and progesterone from
      follicle to plasma.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2229296
TI  - Influence of estrogens on serum free fatty acid levels in women.
AB  - A relationship between plasma levels of FFA and incidence of hormone-dependent
      breast cancer has been suggested. This observation has drawn our attention to
      possible complementary actions of ovarian steroids on circulating FFA levels.
      Measurements taken in normal women during the menstrual cycle and in
      ovariectomized women with and without estrogen replacement therapy demonstrate
      that 1) levels of FFA present in serum are lower during the luteal phase than
      during the follicular phase; 2) levels of FFA are significantly higher after
      ovariectomy; and 3) these are again reduced by substitutive estrogen therapy.

PMID- 2229298
TI  - Charles-Edouard Brown-Sequard and the centennial of endocrinology.

PMID- 2229297
TI  - Recombinant human activin-A promotes proliferation of human luteinized
      preovulatory granulosa cells in vitro.
AB  - Ovarian granulosa cells synthesize and secrete activin, a member of the
      transforming growth factor-beta (TGF-beta) peptide family, during the follicular
      phase of the menstrual cycle. We examined the growth-promoting activity of human
      recombinant activin-A on human luteinized preovulatory granulosa cells obtained
      from women undergoing in vitro fertilization. Activin-A induced proliferation of
      granulosa cells on day 5 of culture in a dose-dependent manner. Maximal effects
      were seen at concentrations greater than or equal to 100 ng/mL with an ED50 of 15
      ng/mL. We suggest that activin-A is able to modulate growth of ovarian granulosa
      cells.

PMID- 2229299
TI  - Androgens, estrogens, and sex hormone-binding globulin in middle-aged men.
AB  - Although the administration of estrogens and androgens can affect the
      concentrations of sex hormone-binding globulin (SHBG) in men, the relationships
      between endogenous estrogens and androgens and SHBG are uncertain. Therefore, in
      a randomly selected cohort of 1640 middle-aged men we measured androgen,
      estrogen, and SHBG concentrations and obtained the subjects' weight, ethanol
      intake, and smoking histories. The data were analyzed by stepwise multiple
      regression, with SHBG as the dependent variable, to compare the role of hormones
      with that of other factors in the control of SHBG levels. Neither estrone or
      estradiol nor the testosterone/estradiol ratio was predictive of SHBG levels.
      However, SHBG concentrations were positively correlated with total testosterone
      and negatively correlated with percent free and percent albumin-bound
      testosterone. SHBG concentrations were negatively correlated with estrone
      sulfate, but were positively correlated with the testosterone/estrone sulfate
      ratio and the concentrations of free and albumin-bound testosterone. In addition,
      in all models tested age and body mass index (wt/ht2), but not smoking or
      ethanol, were strong predictors of SHBG concentrations. Thus, when present in
      physiological amounts in the blood as a result of glandular secretion, there is a
      positive relationship between SHBG concentrations and testosterone and, to a
      lesser extent, free- and albumin-bound testosterone, but age and body mass index
      appear to be more important in predicting the SHBG concentration.

PMID- 2229300
TI  - Association of fasting glucose levels with a delayed secretion of insulin after
      oral glucose in subjects with glucose intolerance.
AB  - Two hundred and nineteen second generation Japanese-American men were classified
      with a 75-g oral glucose tolerance test: 77 with normal glucose tolerance, 74
      with impaired glucose tolerance (IGT), and 68 with noninsulin-dependent diabetes
      mellitus (NIDDM). The peak insulin response to the oral glucose load was
      progressively delayed with each of the 3 glucose tolerance categories. A similar
      finding was observed with the peak C-peptide response to oral glucose, except for
      the absence of distinction between IGT and NIDDM. Variables measuring the initial
      rate of insulin or C-peptide secretion (0-30 min) after oral glucose also
      demonstrated a progressive diminution with increasing glucose intolerance. The
      relative incremental insulin response at 30 min and the relative incremental C
      peptide response at 30 min were highly correlated with the fasting glucose levels
      (r = -0.61 and r = -0.62; P less than 0.0001, respectively). Variables measuring
      the 0-30 min secretory response had high variances, whereas the variance for
      fasting glucose was low. Twelve men who were initially classified as IGT
      subsequently developed NIDDM. These 12 men had significantly higher fasting
      glucose levels at baseline than the remaining men who did not develop diabetes,
      but the 30 min secretory parameters after oral glucose, although lower in those
      who subsequently developed diabetes, were not significantly different at
      baseline. However, if fasting glucose is used as a surrogate measure of secretory
      response, these 12 men appear to have had an impairment of oral glucose
      stimulated insulin secretion antedating the development of NIDDM. The inability
      of the secretory parameters to detect the abnormality may be due to a type II
      statistical error, which may be resolved by a larger sample size.

PMID- 2229301
TI  - Alterations in aldosterone secretion and metabolism in low renin hypertension.
AB  - Low renin essential hypertensives (LRH) have normal plasma aldosterone levels
      which are inappropriately high in relation to their PRA. Posture is the major
      determinant for plasma aldosterone and PRA levels, but it is not known whether
      postural increments (delta) of plasma aldosterone and (delta) PRA are also
      abnormal in LRH. To evaluate this, LRH (n = 8), normal renin hypertensives (NRH;
      n = 9), normotensive controls (n = 18), and subjects with idiopathic
      hyperaldosteronism (IHA; n = 5) were studied in a metabolic unit on a controlled
      diet over 7 days. Overnight supine and 4-h upright PRA, plasma aldosterone, and
      24-h urinary tetrahydroaldosterone (THA) and aldosterone secretion rates (ASR)
      were measured. The delta in plasma aldosterone after 4 h of upright posture was
      not different in the four groups. The ratio of delta plasma aldosterone/delta
      PRA, however, was elevated in both IHA and LRH compared to that in NRH and
      normals. THA excretion was also elevated in IHA and LRH, but LRH had a normal
      ASR. This resulted in a higher fractional THA excretion (THA/ASR) in LRH compared
      to the other three groups. These data further support enhanced adrenal
      angiotensin-II sensitivity in LRH. Aldosterone was preferentially metabolized to
      THA in LRH. Since THA has reduced biological activity, this may be a compensatory
      mechanism to reduce mineralocorticoid activity in LRH.

PMID- 2229302
TI  - Comparative study of the changes in insulin-like growth factor-I, procollagen-III
      N-terminal extension peptide, bone Gla-protein, and bone mineral content in
      children with Turner's syndrome treated with recombinant growth hormone.
AB  - Six girls (7-13 yr old) with Turner's syndrome and short stature were treated for
      1 yr with recombinant human GH (0.15 U/kg.day, sc) and had sequential
      determinations of serum insulin-like growth factor-I (IGF-I), osteocalcin, and
      procollagen-III. Bone mineral content and density of the spine and radius were
      measured before treatment and at 90 and 360 days. Two girls received small doses
      of ethinyl estradiol (0.025 micrograms/kg) in addition to GH. Height velocity
      increased by 144% after 3 months of treatment. IGF-I was normal (0.75 +/- 0.20
      kU/L) before treatment and increased by 90% on day 1 and by 290% on day 360.
      Procollagen-III was low before treatment; it peaked at 53.0 +/- 14.7 micrograms/L
      (260% above baseline) on day 30, then decreased to the normal range. Serum
      osteocalcin increased more slowly to reach a plateau on day 90 of 23.7 +/- 1.2
      micrograms/L (46% above baseline). Before treatment, bone mineral content of the
      spine was 25% lower than that of children matched for bone age. Bone mineral
      contents of the peripheral and axial skeleton were increased by 10% and 17%,
      respectively, after 1 yr of treatment, an increase commensurate with that of bone
      age in the four patients who did not receive estrogen. On day 90, however,
      although radius mineral density was already increased by 3%, the mineral density
      of the lumbar spine was significantly decreased by 4%. We conclude that treatment
      with GH increases IGF-I, collagen turnover, osteoblastic function, and height
      velocity in Turner's syndrome. However, there is no catch-up of bone mineral
      content after 1 yr of treatment, and an early effect of GH is to decrease spine
      mineral density.

PMID- 2229303
TI  - Influence of physical activity on insulin-like growth factor-I in healthy younger
      and older men.
AB  - To examine the hypothesis that a lower level of physical activity influences the
      age-related decline in insulin-like growth factor-I (IGF-I), we measured serum
      concentrations in healthy nonobese younger and older men, characterized for
      maximal aerobic capacity (VO2 max) and energy expended in leisure time physical
      activity. To examine the independent influence of physical activity on IGF-I
      relative to other lifestyle variables, we also determined fat-free weight,
      percent body fat, body fat distribution (waist to hip and waist to thigh ratios),
      and habitual caloric intake in our population. IGF-I was 33% lower (P less than
      0.01) in older men than in younger men, inversely related to percent body fat (r
      = -0.55) and indices of upper body fat distribution (waist to hip ratio, r = 
      0.45; waist to thigh ratio, r = -0.47), and positively related to VO2 max (r =
      0.64) and leisure time physical activity (r = 0.45; P less than 0.01). IGF-I was
      not related to fat-free weight or daily caloric intake. After controlling for the
      effects of age by multiple regression analysis, VO2 max (r = 0.29) and leisure
      time physical activity (r = 0.24) were the sole factors independently related to
      IGF-I (P less than 0.05). Our results suggest that multiple factors contribute to
      the age-related decline in IGF-I. Lower levels of IGF-I in aging men are related
      at least in part to diminished physical activity.

PMID- 2229304
TI  - Growth hormone (GH) responsiveness to combined administration of arginine and GH
      releasing hormone does not vary with age in man.
AB  - At present, the mechanism(s) underlying the reduced spontaneous and stimulated GH
      secretion in aging is still unclear. To obtain new information on this
      mechanism(s), the GH responses to both single and combined administration of GH
      releasing hormone (GHRH; 1 microgram/kg iv) and arginine (ARG; 30 g infused over
      30 min), a well known GH secretagogue probably acting via inhibition of
      hypothalamic somatostatin release, were studied in seven elderly normal subjects
      and seven young healthy subjects. Basal GH levels were similar in both groups,
      while insulin-like growth factor-I levels were lower in elderly subjects (76.7 +/
      9.2 vs. 258.3 +/- 29.2 micrograms/L; P = 0.01). In aged subjects GHRH induced a
      GH increase (area under the curve, 314.9 +/- 91.9 micrograms/L.h) which was lower
      (P = 0.01) than that in young subjects (709.1 +/- 114.4 micrograms/L.h). On the
      other hand, the ARG-induced GH increase in the elderly was not significantly
      different from that in young subjects (372.8 +/- 81.8 vs. 470.6 +/- 126.5
      micrograms/L.h). ARG potentiated GH responsiveness to GHRH in both elderly
      (1787.1 +/- 226.0 micrograms/L.h; P = 0.0001 vs. GHRH alone) and young subjects
      (2113.0 +/- 444.3 micrograms/L.h; P = 0.001 vs. GHRH alone). The potentiating
      effect of ARG on the GHRH-induced GH response was greater in elderly than in
      young subjects (1013.0 +/- 553.5% vs. 237.9 +/- 79.1%; P = 0.0001); thus, the GH
      increase induced by combined administration of ARG and GHRH overlapped in two
      groups. In conclusion, these results show that, differently from the GHRH-induced
      GH increase, the somatotroph response to combined administration of ARG and GHRH
      does not vary with age. Our finding suggests that an increased somatostatinergic
      activity may underlie the reduced GH secretion in normal aging.

PMID- 2229305
TI  - Impaired growth hormone (GH) response to pyridostigmine in type 1 diabetic
      patients with exaggerated GH-releasing hormone-stimulated GH secretion.
AB  - In the present study we investigated the effects of the acetylcholinesterase
      inhibitor pyridostigmine (PD), which is hypothesized to decrease hypothalamic
      somatostatin tone, alone and in association with GH-releasing hormone (GHRH) on
      GH secretion in 18 type 1 diabetic patients and 12 normal subjects using a
      randomized double blind placebo-controlled protocol. All subjects received either
      120 mg oral PD or placebo 60 min before iv injection of either human GHRH-(1-29)
      NH2 (100 micrograms) or sterile water (2 mL). In normal subjects both PD alone
      and GHRH alone caused a significant increase in GH. PD and GHRH acted in a
      synergistic fashion when combined. In diabetic patients the GH response to GHRH
      was variable. To segregate the responses, the ratio between the GH increase after
      GHRH plus PD and after GHRH alone was calculated for each subject. In 10 diabetic
      patients (group A) the ratio was lower than 2 SD (P less than 0.05) from the mean
      response of normal subjects. These patients showed an exaggerated GH increase
      after GHRH and a lower GH increase after PD with respect to normal subjects.
      Eight diabetic patients (group B) showed a ratio similar to that in normal
      subjects and similar GH responses to the stimuli. No significant differences were
      found between groups A and B with respect to age, body mass index, and blood
      glucose levels. Duration of diabetes was longer and basal GH levels were higher
      in group A. Hemoglobin-A1c was higher in group A, but of only borderline
      statistical significance (P = 0.052). Our data demonstrate that in diabetic
      patients with exaggerated GH responses to GHRH an increase in cholinergic tone
      does not affect GH secretion. These data suggest that in some type 1 diabetic
      patients an altered somatostatinergic control of GH secretion may contribute to
      their abnormal GH response to GHRH.

PMID- 2229306
TI  - Adrenal medullitis in type I diabetes.
AB  - To investigate whether cell-mediated immunity against the adrenal medulla occurs
      in type I diabetes (IDDM), we conducted a retrospective autopsy study of adrenal
      glands from IDDM and nondiabetic subjects using formalin-fixed tissue. Forty-four
      IDDM subjects, aged 4-67 yrs (mean +/- SD, 44.8 +/- 15.4) with a duration of IDDM
      from 0-55 yr (28.6 +/- 14.2), and 29 nondiabetic controls, aged 8-82 yr (51.8 +/-
      18.6), were evaluated for a lymphocytic infiltrate using UCHL1, which recognizes
      a subpopulation of resting T-lymphocytes and most activated T-lymphocytes.
      Immunohistochemistry using antihuman B-cell antibody (L26) was also performed.
      Sections were scored for both lymphocytic infiltrates and fibrosis [none (0),
      small (1), moderate (2), or large (3)]. Blinded scoring was performed. A moderate
      to severe UCHL1 infiltrate was present in 9 of 44 (20%) IDDM, compared with 1 of
      29 (3%) control subjects (P less than 0.04). Mild to severe fibrosis (score 1, 2,
      or 3) was present in 22 of 42 (52%) IDDM subjects compared with 4 of 25 (16%)
      control subjects (P = 0.003). Eight of 42 (19%) IDDM subjects had moderate to
      severe fibrosis (score 2 or 3) compared with 1 of 25 (4%) control subjects.
      Seventeen of 44 (39%) IDDM subjects had either a moderate to large cellular
      infiltrate or moderate to severe adrenal medullary fibrosis compared with 2 of 29
      (7%) control subjects (P = 0.003). Staining of the adrenal medulla with L26
      revealed a large cellular infiltrate in only one subject who was UCHL1 negative.
      Adrenal medullitis was observed in 20% of IDDM subjects, suggesting that the
      adrenal medulla may be another immunological target in IDDM.

PMID- 2229307
TI  - Urinary human growth hormone measurement using a highly sensitive sandwich enzyme
      immunoassay: diagnostic and therapeutic uses in patients with growth hormone
      deficiency.
AB  - Several reports indicate that urinary hGH excretion is significantly lower in
      patients with either partial (PGHD) or complete GH deficiency (CGHD) than in
      normal but short children (NSC) or normal children (NC). However, there is an
      overlap between the NSC and NC groups and the PGHD group. Using a highly
      sensitive sandwich enzyme immunoassay, we investigated whether the measurement of
      urinary hGH can clearly separate the PGHD and CGHD groups from the NSC and NC
      groups. In addition, we measured the urinary excretion of synthetic methionyl-hGH
      (met-hGH) in PGHD and CGHD after sc injections of 2 and 4 IU and im injections of
      4 IU in an attempt to determine the optimal replacement dose. Total 24-h urinary
      hGH excretion in each patient examined for 2 consecutive days varied from 1 day
      to the next. There were no differences in urinary hGH excretions between the NSC
      group and the NC group. The lower values for daily urinary hGH excretion in the
      NSC group overlapped some of the higher values in the PGHD group. However, when
      the mean urinary hGH level of both days was used, the 24-h urinary hGH excretion
      clearly separated the PGHD (5.5 +/- 2.3 ng/day; range, 1.3-9.2; n = 21) and CGHD
      (1.9 +/- 0.9 ng/day; range, 0.6-3.6; n = 14) groups from the NSC (12.8 +/- 3.1
      ng/day; range, 9.3-17.5; n = 10) and NC (14.6 +/- 3.1 ng/day; range, 10.6-19.0; n
      = 6) groups without any overlap. A mean urinary hGH value less than 9.0 ng/day
      during a 2-day collection strongly suggested GH deficiency. Ten of 16 patients
      with PGHD and CGHD who received 2 IU met-hGH, sc, had urinary hGH levels within
      the range of the mean +/- SD in NSC. These patients received daily sc 0.097 +/-
      0.024 IU/kg hGH injections. These results suggest that the measurement of 24-h
      urinary hGH excretion is noninvasive, accurate, and useful for the screening of
      GH deficiency. The mean value on 2 days of 24-h urinary hGH excretion for the
      screening of GH deficiency is estimated to be less than 9.0 ng/day. The optimal
      dose of GH as therapy for GH deficiency is demonstrated as daily sc injection of
      0.1 IU/kg hGH, 0.7 IU/kg/week. To convert international units of met-hGH to
      milligrams, divide by 2.4.

PMID- 2229308
TI  - Changes in basal and stimulated growth hormone secretion in the aging rhesus
      monkey: a comparison of chair restraint and tether and vest sampling.
AB  - We studied basal serum GH and GH responses to iv clonidine and insulin-induced
      hypoglycemia in a group of four young (5-7 yr old) and four older (10-14 yr old)
      adult male rhesus monkeys under two restraint conditions, chair adaptation and a
      tether and vest system, to determine what changes in GH secretion occur with
      aging. The serum GH response to iv administration of GH-releasing hormone (GHRH)
      was also studied in the groups under tether and vest restraint. Serum samples
      were collected every 15 min and assayed for GH using a human GH RIA and for
      cortisol using an enzyme-linked immunosorbant assay. GH and cortisol
      concentrations in the young and older groups were analyzed with analysis of
      variance (ANOVA). In the chaired studies the older animals had a lower mean 6-h
      basal GH concentration than did the younger animals (2.7 +/- 0.8 vs. 3.5 +/- 0.5
      micrograms/L; P = 0.0002). Prestimulation GH was lower before clonidine and
      insulin in the older chaired group (1.1 +/- 0.5 and 2.3 +/- 0.6 micrograms/L,
      respectively) compared to the younger group (3.6 +/- 0.8 and 3.8 +/- 0.7
      micrograms/L, respectively; P less than 0.001). Poststimulation GH was lower
      after clonidine and insulin in the older chaired group (3.2 +/- 2.4 and 7.1 +/-
      2.8 micrograms/L, respectively) compared to the younger chaired group (6.3 +/-
      2.2 and 10.3 +/- 3.0 micrograms/L, respectively; P less than 0.05), but the
      differences in GH increments were not statistically significant. In the tether
      and vest studies the older animals had a lower mean 6-h basal GH concentration
      than did the younger animals (1.7 +/- 0.4 vs. 3.5 +/- 1.2 micrograms/L; P less
      than 0.0001). Prestimulation GH concentrations were also lower in the older
      tethered animals before clonidine (2.1 +/- 0.3 micrograms/L) and GHRH (1.4 +/-
      0.2 micrograms/L) compared to levels in the younger animals (3.1 +/- 0.9 and 3.2
      +/- 0.7 micrograms/L; P = 0.0023 and P = 0.0001, respectively). The younger
      tethered animals had greater poststimulation responses to clonidine (8.7 +/- 3.0
      micrograms/L), insulin (8.8 +/- 3.6 micrograms/L), and GHRH (6.0 +/- 2.4
      micrograms/L) than the older animals (3.8 +/- 0.9, 3.9 +/- 2.5, and 2.9 +/- 0.7
      micrograms/L; P less than 0.0001, P = 0.0025, and P less than 0.03,
      respectively).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2229309
TI  - Minimal model analysis of intravenous glucose tolerance test-derived insulin
      sensitivity in diabetic subjects.
AB  - Although minimal model analysis of frequently sampled iv glucose tolerance tests
      (FSIGTs) to measure insulin sensitivity is well recognized, application has been
      limited by the need for endogenous insulin secretion. In the present study we
      determined whether use of exogenous insulin could permit minimal model assessment
      of insulin sensitivity (SI) to be extended to diabetic subjects. Normal
      volunteers had separate FSIGT assessments supplemented with both tolbutamide and
      insulin to accelerate glucose disappearance, while diabetics had a FSIGT
      supplemented only with insulin. There was a strong and highly significant
      correlation between the two assessments in normal subjects (r = 0.87; P less than
      0.001), and the rank order of SI generally was maintained with the two
      assessments over a 3-fold range of SI; however, insulin-determined SI was 16%
      lower (3.4 +/- 0.4 vs. 4.1 +/- 0.4 x 10(-4) min/microU.microL; P less than 0.01).
      Diabetic subjects had markedly lower insulin sensitivity than controls (SI = 0.61
      +/- 0.16; P less than 0.0001). Across all subjects, the level of fasting serum
      glucose was correlated inversely with both insulin sensitivity (r = -0.62; P less
      than 0.05) and acute insulin responses (r = -0.72; P less than 0.02); however,
      insulin sensitivity in diabetic subjects with little insulin secretion (0.6 +/-
      0.2) was comparable to insulin sensitivity in diabetic subjects with near-normal
      responses (0.6 +/- 0.3). In subjects with fasting hyperglycemia, there were
      significant correlations between insulin sensitivity and body mass index, percent
      fat mass, and waist/hip ratio (all P less than 0.03). Among all female subjects,
      there was also a strong correlation between insulin sensitivity and upper body
      obesity, as measured by waist/hip ratio (r = -0.68; P less than 0.02). Model
      parameters also permitted glucose uptake to be estimated in diabetic vs. normal
      subjects at comparable hyperglycemia (11.1 mmol/L). Total glucose uptake was
      decreased in diabetic subjects (5.2 +/- 0.8 vs. 12.7 +/- 1.7 mg/min.kg in
      normals; P less than 0.001), insulin-dependent glucose uptake was diminished to a
      greater extent (1.3 +/- 0.4 vs. 6.2 +/- 1.2) than noninsulin-independent glucose
      uptake (3.9 +/- 0.5 vs. 6.4 +/- 0.9; both P less than 0.02). Administration of
      insulin permits minimal model FSIGT analysis to be applied to diabetic as well as
      normal subjects, yielding information about both insulin- and noninsulin-mediated
      glucose uptake as well as insulin sensitivity and insulin secretion.

PMID- 2229310
TI  - Pattern of oxytocin concentrations in the plasma and cerebrospinal fluid of
      lactating rhesus monkeys (Macaca mulatta): evidence for functionally independent
      oxytocinergic pathways in primates.
AB  - Two populations of oxytocin-staining neurons have been identified in the
      paraventricular nucleus: magnocellular neurons that terminate in the posterior
      pituitary and parvocellular neurons that terminate elsewhere in the central
      nervous system. Whether these oxytocin neurons are functionally separate was
      tested by measuring oxytocin concentrations in samples of peripheral blood and
      cerebrospinal fluid (CSF) obtained simultaneously from lactating rhesus monkeys
      during suckling. Lactating animals bearing temporary subarachnoid and venous
      catheters were maintained in a constant photoperiod (0600-1800 h). Samples of CSF
      were continuously withdrawn by peristaltic pump (0.1 mL/15 min) for 2-4
      consecutive days from subarachnoid catheters with the tips placed at the T12-L1
      level of the spinal column in four lactating monkeys 4 months postpartum and
      again after weaning. On 2 of these days, we observed and recorded periods of
      infant suckling and collected peripheral blood samples (1.2 mL) from the mother
      at 5-min intervals for 60 min. Oxytocin was measured in blood and CSF by RIA.
      Oxytocin concentrations increased in the plasma of the lactating monkeys during
      periods of nursing, with peak concentrations ranging from 4-16.7 microU/mL. No
      increase in plasma oxytocin was found on the day after the infant was weaned.
      Variations in the concentrations of oxytocin in CSF were independent of the
      suckling stimulus and plasma oxytocin concentrations and occurred during observed
      periods of no nipple contact by the infant and at the time of weaning after the
      infant had been removed from the mother. Each lactating animal also displayed a
      normal circadian variation in CSF oxytocin concentrations, with peak and nadir
      levels during light and dark hours, respectively. We conclude that release of
      oxytocin into the CSF of lactating monkeys is disassociated from release into the
      peripheral circulation. The data further support the conclusion that neuronal
      pathways giving rise to oxytocin in the CSF and the periphery are anatomically
      and functionally separate in primates.

PMID- 2229311
TI  - Nonosmotic stimuli alter osmoregulation in patients with spinal cord injury.
AB  - Studies on two quadriplegic patients who developed severe hyponatremia during
      episodes of acute respiratory distress were performed to determine whether
      differences in osmoregulation of vasopressin release could be identified in these
      patients compared to other quadriplegic subjects previously studied in a similar
      manner. Both patients were clinically stable and normonatremic, with no signs or
      symptoms of respiratory distress, when the studies were performed. However, both
      exhibited evidence of hemodynamic instability in the sitting posture. Linear
      regression analysis of the plasma vasopressin/plasma osmolality (Pavp:Posm)
      relationship during infusions of 0.85 M sodium chloride showed no significant
      differences in either the slope (sensitivity) or abscissal intercept (osmotic
      threshold) of this relationship compared to that of other quadriplegic subjects
      when the patients were supine. In contrast, when the patients were studied in the
      sitting posture there was a marked shift in the relationship of Pavp:Posm
      indicative of increased sensitivity and reduced osmotic threshold for vasopressin
      release. The slopes of the Pavp:Posm relationships were 0.249 and 0.178 for the
      two patients, respectively, compared to 0.092 +/- 0.03 ( +/- SD) for previously
      studied quadriplegic subjects. Oral water-loading studies performed on one
      patient revealed marked impairment of urine-diluting ability and free water
      clearance in the sitting posture compared with observations in similar studies
      performed when the patient was supine. Impairment of renal water excretion could
      not be attributed to an effect of vasopressin, which was reduced to
      unquantifiable levels by water loading. These studies have shown that hemodynamic
      stress related to autonomic dysfunction in quadriplegic patients may result in
      marked alteration of osmoregulation of vasopressin release in more severely
      affected individuals. Such altered osmoregulation, which may also be associated
      with vasopressin-independent impairment of renal water excretion in the sitting
      posture, may be a predisposing factor in the development of hyponatremia,
      especially in the presence of other potent nonosmotic stimuli.

PMID- 2229312
TI  - The circadian rhythm of intact parathyroid hormone-(1-84): temporal correlation
      with prolactin secretion in normal men.
AB  - Serum PTH-(1-84), PRL, and adjusted calcium concentrations were determined at 30
      min intervals for a 24-h period in six normal adult men. PTH-(1-84) and PRL both
      exhibited two peaks of increased secretion [1600-1900 and 0200-0600 h for PTH-(1
      84); 2000-2200 and 0400-0800 h for PRL]. For each subject there was a striking
      similarity in the magnitude of secretion of the two hormones and a consistent
      temporal relationship. Thus, the maximum correlation coefficients of 0.62-0.83
      were obtained for the six subjects when the PRL surge lagged that of PTH-(1-84)
      by 0.5-3.5 h. In contrast, the correlation between PTH-(1-84) and adjusted
      calcium was weaker (r = -0.36 to -0.66) and showed no consistent temporal
      relationship (0.0-10.5 h). These data support the concept of higher center
      control of PTH-(1-84) secretion with the possible involvement of factors common
      to the control of PRL secretion.

PMID- 2229313
TI  - Parathyroid hormone and cirrhosis of the liver.
AB  - Fifty patients with liver cirrhosis (36 alcoholic, 1 drug-induced, 7
      posthepatitic, and 6 cryptogenic) and normal renal function were investigated to
      determine whether PTH levels in serum, measured using the common midregion human
      PTH-(44-68) RIA, are elevated in such patients and whether this is related to
      impaired liver function rather than to the effect of secondary
      hyperparathyroidism. Their data were compared with those from 25 control
      subjects. The median PTH level of 462 +/- 18 ng/L (+/- SEM) was significantly
      increased (P less than 0.01) in cirrhotics compared with that of 236 +/- 13 ng/L
      in the control group. Significant correlations were found between PTH levels and
      parameters of liver function such as prothrombin time (r = -0.40; P less than
      0.01), albumin as a percentage of total protein (r = -0.48; P less than 0.01),
      bilirubin (r = 0.35; P less than 0.05), albumin (r = -0.34; p less than 0.05),
      and cholesterol (r = -0.32; P less than 0.05), but not for antipyrine clearance,
      suggesting increasing PTH with decreasing liver function. The median calcium
      level (2.26 +/- 0.03 mmol/L), corrected for changes in albumin, was near the
      lower limit of the normal range (2.25-2.60), but corrected calcium and PTH were
      positively correlated (r = 0.33; P less than 0.05), indicating that the elevation
      is not reactive to calcium depletion. A negative correlation existed between PTH
      and 25-hydroxy-cholecalciferol (r = -0.49; P less than 0.05), the main
      circulating metabolite of vitamin D. Normal values in an immunoradiometric assay
      that detects the whole sequence of human PTH-(1-84) suggest that fragments rather
      than the intact hormone are responsible for PTH elevations in cirrhosis. The
      positive correlation between midregion PTH and corrected calcium is probably an
      artifact of the correction formula. In conclusion, midregion PTH fragments are
      increased in patients with liver cirrhosis. The reason for this elevation may
      well be the impaired liver function rather than secondary hyperparathyroidism.

PMID- 2229314
TI  - Tumor necrosis factor: a putative mediator of the sick euthyroid syndrome in man.
AB  - Tumor necrosis factor-alpha (TNF) is believed to be an important mediator in many
      diseases that are associated with the sick euthyroid syndrome. To investigate the
      effect of TNF on thyroid hormone metabolism, we performed a controlled study in
      six healthy postabsorptive males, in whom plasma thyroid hormones and TSH were
      sequentially measured after iv bolus injections of recombinant human TNF (50
      micrograms/m2) and isotonic saline. During the 10.5-h study TNF produced the
      characteristic changes in circulating thyroid hormones and TSH observed in the
      sick euthyroid syndrome. Compared with the control experiment, TNF induced
      significant decreases in T3 (-36 +/- 2%; saline, -20 +/- 3%; P less than 0.05)
      and TSH levels (-68 +/- 3%; saline, -44 +/- 8%; P less than 0.05) and a
      significant increase in rT3 values (+48 +/- 11%; saline, -12 +/- 7%; P less than
      0.05). T4 and free T4 index were not affected by TNF. Free T4 showed a mean
      transient increase of 18% in five subjects (nonsignificant), which occurred
      synchronically with a transient 3.5-fold rise in circulating FFA levels. Our
      results suggest that TNF is involved, either directly or indirectly, in the
      pathogenesis of the sick euthyroid syndrome.

PMID- 2229315
TI  - Transport of thyroid hormones by human erythrocytes: kinetic characterization in
      adults and newborns.
AB  - The uptake of [125I]T3 and [125I]T4 by human erythrocytes was studied. The
      erythrocytes were obtained from adult subjects (28-41 yr old) and suspended in a
      protein-free medium. The half-times of equilibration for both T3 and T4 were 6
      min. At equilibrium, T3 was concentrated 55-fold inside the cells, while T4 was
      concentrated 40 times, but these accumulations were not dependent on either
      cellular ATP or the transmembrane Na+ gradient. The amounts of cell-associated
      thyroid hormones were 20 times (T3) and 17 times (T4) higher than the amounts of
      free extracellular hormones at 5 X 10(9) erythrocytes/mL (the blood
      concentration). Oligomycin and phloretin inhibited T3-saturable transport (but
      not T4 transport) independently of cellular energy. We suggest that thyroid
      hormones are concentrated by intracellular trapping. The rates of T3 and T4
      efflux from preloaded erythrocytes were similar to the influx rates. The initial
      velocities of T3 (but not T4) uptake and efflux were 70% saturable. The uptake
      was specific because the unlabeled analogs T4, triiodothyroacetic acid, rT3, D
      T3, and D,L-thyronine inhibited [125I]T3 uptake 60, 125, 160, 190, and 1600 times
      less, respectively, than did unlabeled T3. The kinetic parameters of T3-saturable
      uptake, Km, and maximum velocity were determined for three groups of subjects:
      newborns, 28 to 41-yr-old adults, and 76 to 90-yr-old adults. The Km (67 nmol/L
      in 28 to 41-yr-old adults) was not age dependent, BUT the maximum velocity was
      significantly higher in newborns than in adults. We conclude that T3 transport
      across the human erythrocyte membrane is mediated mainly by facilitated
      diffusion, whereas T4 transport results from free diffusion. Human erythrocytes
      might act as a circulating pool of thyroid hormones, especially T3 in newborns.

PMID- 2229316
TI  - Thyroid abnormalities in the McCune-Albright syndrome: ultrasonography and
      hormonal studies.
AB  - Hyperthyroidism and goiter have been reported frequently in association with the
      McCune-Albright syndrome (MAS). To assess the prevalence and extent of thyroid
      abnormalities in girls with MAS, we studied 19 patients [mean age, 6.6 +/- 1 (+/-
      SE) yr; mean bone age, 9.5 +/- 1 yr] and 18 normal control girls (mean age, 10.3
      +/- 0.5 yr). All patients appeared euthyroid when examined; 1 was taking
      antithyroid medication. Ultrasonography revealed thyroid abnormalities in 7
      patients, including generalized inhomogeneity, small (2-4 mm) and large (greater
      than 10 mm) hypoechoic regions, and echogenic nodule-like regions. Repeat
      ultrasonography after intervals of 9-18 months showed enlargement of large
      hypoechoic regions in 2 patients. In the patients with abnormal ultrasound
      findings, serum TSH was uniformly low or suppressed both at baseline and after
      administration of 7 micrograms/kg TRH. The mean serum T3 level in this group was
      significantly higher than that in controls (2.9 +/- 0.2 vs. 2.3 +/- 0.1 nmol/L; P
      less than 0.05), whereas mean serum T4, free T4, and T4-binding globulin levels
      did not differ from those of controls. In the remaining 11 patients, thyroid
      ultrasonography was normal, and the serum levels of T3, T4, free T4, and TSH were
      normal. Bioassay showed no detectable thyroid-stimulating activity in the plasma
      of the MAS patients with suppressed TSH levels. None of the patients became
      overtly thyrotoxic over 3-6 yr of observation, and their serum iodothyronine
      levels remained stable. We conclude that thyroid dysfunction is common in girls
      with MAS, but that it may be clinically occult and not rapidly progressive. The
      thyroid dysfunction, like that of the ovaries, is associated with structural
      abnormalities in the gland itself, together with suppressed levels of the
      respective stimulating hormones.

PMID- 2229317
TI  - Brain glucose metabolism in noninsulin-dependent diabetes mellitus: a study in
      Pima Indians using positron emission tomography during hyperinsulinemia with
      euglycemic glucose clamp.
AB  - To determine whether insulin or noninsulin-dependent diabetes mellitus affects
      brain glucose metabolism, brain glucose utilization was studied in the basal
      state and during hyperinsulinemic euglycemic glucose clamps in nondiabetic and
      diabetic Pima Indians by positron emission tomography with 2-[18F]fluoro-2-deoxy
      D-glucose (18FDG). Glucose utilization in 75 brain areas was determined by
      analysis of single scans and by least squares estimation of the rate parameters
      for the FDG model; these data were compared to results in normal caucasian
      volunteers. No effect of ethnicity or diabetic status on brain glucose
      utilization was observed. During the hyperinsulinemic clamps (mean insulin,
      11,708 +/- 3,026 pmol/L), clearance of 18FDG from blood was accelerated, and
      accumulation of brain radioactivity was reduced. However, glucose utilization by
      the brain was identical to results during sham glucose clamps (mean insulin, 204
      +/- 56 pmol/L) performed in the same patients. During the studies with
      hyperinsulinemia, k4 (representing loss of tissue radioactivity) was increased in
      most brain areas (mean increase, 0.0031 +/- 0.0018 min-1; P less than 0.02). The
      possible mechanisms for this effect are multiple, and the physiological
      significance, if any, is unknown. Further studies of the effects of insulin on
      brain glucose metabolism are needed.

PMID- 2229318
TI  - Endothelin family in human plasma and cerebrospinal fluid.
AB  - To clarify whether endothelin may be present in human cerebrospinal fluid (CSF)
      and, if it exists, to compare its molecular forms with those of endothelin in
      human plasma, we analyzed pooled human CSF and plasma by high performance liquid
      chromatography with specific enzyme immunoassays for each endothelin peptide. Of
      the four human endothelin peptides hitherto identified, big endothelin-1 was the
      major molecular form of endothelin present in human CSF. In addition, there was a
      small but significant amount of endothelin-1 and endothelin-3 in CSF, while
      endothelin-2 was not detectable. Similarly, big endothelin-1, endothelin-1, and
      endothelin-3 were identified in human plasma. Although big endothelin-1 was the
      most abundant, a substantial amount of endothelin-1 and endothelin-3 was found in
      plasma with a resultant lower molar ratio of big endothelin-1 to endothelin-1
      than in CSF. In all CSF samples from 17 patients requiring diagnostic lumbar
      puncture or lumbar anesthesia, endothelin was detectable, with a preponderance of
      big endothelin-1 relative to endothelin-1 and endothelin-3. The mean
      concentrations of endothelin-1 and endothelin-3 in simultaneously collected
      plasma were significantly (P less than 0.01) higher than those in CSF, while
      there was no significant difference between the mean big endothelin-1
      concentration in plasma and that in CSF. There was no significant correlation
      among concentrations of big endothelin-1, endothelin-1, and endothelin-3 in each
      paired sample. These results indicate that endothelin is present in human CSF
      that is differently processed from endothelin in vascular endothelial cells and
      suggest a possible role for endothelin as a modulator of neuronal functions.

PMID- 2229319
TI  - Human oxysterol-binding protein. I. Identification and characterization in liver.
AB  - The function of cellular oxysterol-binding proteins is not known. Because of the
      proposed receptor-like role of these proteins in regulating cholesterol synthesis
      and the importance of the liver in the cholesterol metabolism of the body, we
      have studied the oxysterol-binding sites found in specimens of human liver. A
      protein that binds with high affinity to certain oxygenated derivatives of
      cholesterol has been identified and characterized in several ways. When 25
      hydroxy-[3H]cholesterol is used as ligand, specific binding components can be
      identified in cytosolic liver extracts fractionated on sucrose density gradients
      in the fractions sedimenting at 4S and 7S. Cholesterol and steroid hormones do
      not compete for these binding components, but several oxysterols do. In cytosolic
      extracts, all binding appears to be a single class kinetically, with an apparent
      Kd of 28 x 10(-9) mol/L. We found the protein responsible to have a pI of about
      4.8. Purification of the protein allowed preparation of an antiserum and
      subsequent immunoprecipitation of a photoaffinity-labeled component from crude
      cytosolic extracts. Electrophoresis of the immunoprecipitates revealed a single
      specifically labeled protein band, with a mol wt of about 57,000. The protein
      described here may have a regulatory role in the synthesis of cholesterol in the
      human.

PMID- 2229320
TI  - Reliability of estimates of pulsatile characteristics of luteinizing hormone and
      growth hormone release in women.
AB  - The test-retest reliability of estimates of pulsatile LH and GH release was
      evaluated in 23 eumenorrheic women during the early follicular phase of the
      menstrual cycle. Each subject was studied during two successive or near
      successive menstrual cycles by repetitive blood sampling every 10 min for 24 h.
      Pulsatile parameters for LH and GH release were identified and characterized
      using the Cluster pulse detection algorithm. For LH, no significant differences
      existed in any parameter mean between the two 24-h admissions. Correlation
      coefficients for consecutive 24-h studies ranged from r = 0.22 (P less than 0.32)
      for number of LH peaks to r = 0.79 (P less than 0.0001) for 24-h integrated LH
      values (area under the concentration vs. time curve). No significant mean
      differences in any parameter were observed for consecutive 24-h GH evaluations.
      Correlation coefficients for 24-h GH ranged from r = 0.25 (P less than 0.34) for
      nadir to r = 0.71 (P less than 0.002) for incremental peak increase. Cosinor
      analysis was used to determine significant 24-h variations in LH and GH
      concentrations. Statistically significant differences existed between admissions
      for the amplitude of the nyctohemeral LH rhythm and its acrophase (time at which
      maximal hormone value was attained), but no mean differences were found for mesor
      (mean concentration). Correlation coefficients for LH were r = 0.10 (P less than
      0.65), r = 0.43 (P less than 0.08), and r = 0.78 (P less than 0.0001) for phase,
      amplitude, and mesor, respectively. No significant mean differences existed for
      any parameter of nyctohemeral GH rhythms. Correlation coefficients were r = -0.18
      (P less than 0.52), r = 0.49 (P less than 0.72), and r = 0.14 (P less than 0.80)
      for 24-h GH amplitude, phase, and mesor, respectively. We conclude that
      comparisons of mean and integrated LH and GH concentrations over a 24-h interval
      in the early follicular phase of the menstrual cycle are reliable; however,
      certain pulsatile properties responsible for the achievement of the mean daily
      concentrations of LH and GH may be nonuniform from menstrual cycle to menstrual
      cycle. In addition, nonuniformities may exist in the nyctohemeral rhythms of
      serum concentrations of LH and GH in the adult woman between cycles when a single
      24-h time series is the basis for the analysis.

PMID- 2229321
TI  - Gastrointestinal side-effects of octreotide during long-term treatment of
      acromegaly.
AB  - Gastrointestinal side-effects of prolonged therapy (greater than 2 yr) with the
      long-acting somatostatin analog octreotide were studied in 10 acromegalic
      patients. After 2 yr of therapy, 6 of 10 patients had newly developed gallstones,
      complicated by cholangitis and jaundice in 1. Serum vitamin B-12 concentrations
      declined in all 10 patients [from 380 +/- 32 to 172 +/- 21 pmol/L (mean +/- SE);
      P = 0.023] and became abnormally low in 4. Gastric biopsy specimens, obtained
      during gastroscopy (9 patients), showed moderate to severe active gastritis, with
      damage to the superficial and deeper layers of the mucosa in 9 of 9 and focal
      atrophy in 7 of 9 patients. Campylobacter pylori was found in the antral mucosa
      in 8 of 9 patients. Although information is lacking on similar studies in
      untreated acromegalic patients, we suggest that patients receiving chronic
      octreotide therapy be closely monitored for these and possible other side-effects
      related to gastrointestinal actions of octreotide.

PMID- 2229322
TI  - Thyroiditis as the presenting manifestation of disseminated extrapulmonary
      Pneumocystis carinii infection.
AB  - A 38-yr-old male with acquired immunodeficiency syndrome developed neck pain in
      association with mild hyperthyroidism and a diffusely enlarged thyroid gland.
      Radioactive iodine scanning was consistent with thyroiditis, and biopsy of the
      thyroid demonstrated the presence of pneumocystis carinii in thyroid tissue.
      Treatment with pentamidine followed by trimethoprim sulfamethoxazole led to rapid
      normalization of thyroid size in association with the development of
      hypothyroidism. This case illustrates the natural history of pneumocystis carinii
      thyroiditis and suggests that thyroid disease be added to the spectrum of human
      immunodeficiency virus-associated endocrine dysfunction.

PMID- 2229323
TI  - Anti-5 alpha-reductase autoantibodies in the serum of patients with prostatic
      cancer.
AB  - Human sera were tested for their ability to inhibit 5 alpha-reductase binding of
      a potent inhibitor of the enzyme. Thirty one of 227 serum samples from patients
      diagnosed or suspected of prostatic cancer had a significant inhibitory activity,
      whereas 128 serum samples from other patients were inactive. The majority of the
      inhibitory activity was in the IgG fraction purified by chromatography on a
      protein A-Sepharose affinity column and an anti-human IgG-agarose column. IgG
      fractions from non-inhibitory sera were inactive. Inhibitory IgG also inhibited
      the enzymatic activity of microsomal 5 alpha-reductase from liver, ventral
      prostate and preputial gland of rat, and liver, prostate, and facial skin of
      human. The inhibitory IgG had no effect on NADH-menadione reductase or 17 beta
      hydroxysteroid dehydrogenase. These results suggest that 5 alpha-reductase
      autoantibodies are present in the blood of some prostatic cancer patients.

PMID- 2229324
TI  - Women with preeclampsia have higher plasma endothelin levels than women with
      normal pregnancies.
AB  - Endothelin, a newly discovered endothelium-derived peptide, has potent vasoactive
      properties in vivo and in vitro. The actions of endothelin in clinical conditions
      of hypertension have not yet been defined. This study examined the possible role
      of endothelin in the vasospasm and hypertension associated with a well-defined
      syndrome of gestational hypertension, preeclampsia. Our results indicate that the
      concentration of immunoreactive endothelin is elevated significantly in plasma
      obtained from women with preeclampsia and rapidly returns to a normal pregnancy
      value within 48 hours of delivery, as predicted by the prompt clinical resolution
      of this disorder. The findings suggest that endothelin may contribute to the
      vasospasm associated with this syndrome and lend further support to the
      involvement of endothelial cells in the pathophysiology of preeclampsia.

PMID- 2229325
TI  - Human recombinant activin-A inhibits proliferation of human fetal adrenal cells
      in vitro.
AB  - Activins and inhibins are dimeric peptides which are structurally and
      functionally related to transforming growth factor-beta (TGF-beta). The mRNA for
      the activin and inhibin subunits is expressed in the adrenal gland. Because
      members of the TGF-beta superfamily have effects on mitogenesis, we examined the
      effect of recombinant human activin-A (rh-activin-A) on proliferation of
      midgestation human fetal adrenal cells in vitro. Dose-dependent growth inhibition
      by rh-activin-A was obtained, with an ED50 of 1 ng/ml. Rh-activin-A inhibited
      basal and epidermal growth factor (EGF)-stimulated fetal zone cell proliferation,
      but did not alter basic fibroblast growth factor (bFGF)-stimulated growth. TGF
      beta combined with rh-activin-A demonstrated additive inhibition of fetal adrenal
      growth. These findings suggest a potential autocrine or paracrine role for
      activin-A in modulating the growth and/or subsequent involution of the human
      fetal adrenal gland.

PMID- 2229326
TI  - Endothelin-like immunoreactivity in human breast cyst fluid.
AB  - Immunoreactive endothelin has been detected in 21 of 43 samples of breast cyst
      fluid (21 cases; 3.5 +/- 0.6 pmol/l, mean +/- SEM. Other 22 cases; not
      detectable, less than 0.5 pmol/l). Fast protein liquid chromatographic analysis
      of the immunoreactive endothelin of pooled breast cyst fluid showed two
      immunoreactive peaks; one in the void volume and the other in the position of
      endothelin-1. It is probable that endothelin-1 is produced by the epithelial
      cells lining breast cysts, but significance of the presence of endothelin-1 in
      breast cyst fluid remains to be elucidated.

PMID- 2229327
TI  - Electrical activities of pyramidal cells in the kindled hippocampus of the
      rabbit.
AB  - 1) The pyramidal cell in the kindled hippocampus of the rabbit was
      intracellularly studied and compared with that in the normal hippocampus. 2) As
      previously reported, what characterized the kindled hippocampus was the
      appearance of a spontaneous hyperpolarization in the pyramidal cell. Practically
      all the pyramidal cells in the kindled hippocampus showed spontaneous
      hyperpolarizations. The hyperpolarization consisted of Cl-dependent and Cl-non
      dependent components. The former was evidently the somatic IPSP. On the other
      hand, the latter was interpreted as the dendritic IPSP. This was supported by the
      fact that there was an interictal positivity in the apical dendrite layer. 3)
      There was no evidence whatsoever that indicated an increased excitability of the
      pyramidal cell. This showed that the kindled hippocampus was essentially
      different from the penicillin-treated hippocampus. It was suggested that the
      former was similar to the human brain in the interictal phase, whereas the latter
      was similar to that in status epilepticus. 4) In a few pyramidal cells there was
      a slow depolarization which could possibly trigger a seizure discharge and the
      nature of the slow depolarization was discussed. However, the slow depolarization
      was not peculiar to the kindled hippocampus.

PMID- 2229328
TI  - [The blood urea nitrogen/creatinine ratio in localizing the bleeding site in
      pediatric patients with gastrointestinal hemorrhage].
AB  - The reliability of the blood urea nitrogen/creatinine (B/C) ratio in localizing
      the bleeding site in pediatric patients with gastrointestinal hemorrhages was
      evaluated retrospectively. Supplementary experiments on rats and rabbits were
      also conducted. The study population included 69 children ranging in age from 6
      days to 16 years (mean age, 7y8m) with successful radiographic, endoscopic, and
      surgical identification of the bleeding site. Patients with renal disease, liver
      disease and coagulopathy were excluded. The upper gastrointestinal bleeding site
      was segregated from the lower one defined by the ligament of Treitz. For the 38
      upper gastrointestinal bleeders, B/C values ranged from 7.8-69.0 (mean 28.8 +/-
      15.4 SD). For the 31 lower gastrointestinal bleeders the values ranged from 4.3
      28.5 (mean 18.9 +/- 6.9 SD). A significant difference between the two groups was
      noted after (p less than 0.01) analysis. No patients with lower gastrointestinal
      bleeding had values higher than 30. In the group of 17 bleeders with a value
      higher than 30, 8 patients were examined again from 2-5 days after they had been
      identified as having bleeding to prove that the bleeding had stopped. At the time
      of identification of no-bleeding, B/C values were calculated at under 30 in every
      patient. There was no significant correlation between Hb (g/dl) and B/C. With
      respect to our experiments on animals, the B/C ratio was evaluated in rats with
      gastric or small intestinal ulcers. Though B/C was 34.4 +/- 4.4 under normal
      conditions, it increased significantly to 114.0 +/- 8.8 in rats with
      gastrointestinal ulcers, while in those with small intestinal ulcers B/C did not
      increase significantly (40.3 +/- 12.3). Twenty ml of blood from ear veins of
      rabbits was infused into a) stomach b) small intestine (no-hemolysis blood) c)
      small intestine (hemolysis blood). For a) and c), B/C increased in a similar
      pattern. For b) the increase was small. Infusing 5 ml, 10 ml, and 15 ml of the
      whole blood into the stomach indicated that the volume of blood did not influence
      the change of B/C values, while the infusion of 3 ml of serum caused only a small
      increase. According to these studies the increase in the B/C ratio after upper
      gastrointestinal hemorrhage has been postulated to result from the procedure in
      which the hemorrhage blood is fragmented or hemolyzed by HCl and digestive
      enzymes in the gastric juices; and consequently the BUN in red blood cells as
      well as in serum is rapidly absorbed from the upper small intestine. Volume of
      blood has little influence upon B/C.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2229329
TI  - Early increase in K+ conductance during metabolic inhibition by cyanide in guinea
      pig ventricular myocytes.
AB  - The underlying mechanism of the early increase in K+ conductance during metabolic
      inhibition was examined by the whole-cell patch clamp technique. To inhibit
      oxidative phosphorylation, cyanide (0.1-1.0 mM) was superfused to enzymatically
      isolated guinea pig ventricular myocytes. The increase in the outward K+ current
      during the metabolic inhibition consisted of at least two components; one was a
      gradual and small increase which appeared within 5 min, and the other was a
      subsequent sudden and large increase occurring 17.8 min on average after cyanide
      application at a concentration of 0.1 mM. The earlier component of the cyanide
      sensitive current was examined by the square pulse method. The current had a
      reversal potential of -76.0 mV and an inward-rectifying property. When cyanide
      (0.1 mM) was applied for 10-12 min, the chord conductance of the inward rectifier
      K+ current (IK1) was significantly increased and its voltage relation was shifted
      to hyperpolarizing direction (-2.3 mV). The cyanide could not induce an outward
      current in K(+)-free ionic condition or in the presence of extracellular Ba2+ (2
      mM), a blocker of the IK1. However, the outward current even appeared in the
      presence of 5 mM ATP in the perfused solution in pipette, while it attenuated
      when intracellular pH was buffered with 50 mM HEPES in the pipette solution.
      These observations suggest that the early increase in K+ conductance during the
      metabolic inhibition is due to the augmented IK1 conductance and not due to the
      induction of ATP-sensitive K+ current. The increase in the K+ conductance may be
      caused by the intracellular pH change, probably through intracellular metabolic
      acidosis by the inhibited oxidative phosphorylation.

PMID- 2229330
TI  - [A study of granular lymphocytes (GL) in children and young adults].
AB  - In this study, we investigate the percentage and absolute number of granular
      lymphocytes (GL) in venous blood smears and the percentage of CD16+ and CD57+
      lymphocytes in the peripheral venous blood of 91 healthy controls (1 to 29 years
      old) and 168 patients with various diseases (1 month to 36 years old). GL were
      morphologically classified into four subsets: large-sized lymphocytes with large
      granules (LL-LG), large-sized lymphocytes with small granules (LL-SG), medium
      sized lymphocytes with large granules (ML-LG) and medium-sized lymphocytes with
      small granules (ML-SG). The results were as follows: 1) In the controls, the
      percentage of GL in total lymphocytes was 10.0 +/- 6.2% (mean +/- 1SD). Therefore
      its normal value was below 22.4% (mean +/- 2SD). The absolute count of GL was
      320.7 +/- 221.0/mm3. The percentages of LL-LG, LL-SG, ML-LG and ML-SG in total
      lymphocytes were 1.7 +/- 2.2%, 2.3 +/- 2.8%, 2.6 +/- 2.3% and 3.4 +/- 2.7%,
      respectively. 2) In flow cytometric studies, the percentage of CD16+ in the
      controls was 10.2 +/- 6.7%; CD57+, 8.2 +/- 5.1%; CD57+ CD16+, 4.2 +/- 3.3%; CD57+
      CD16-, 4.0 +/- 2.8%; CD57- CD16+, 6.4 +/- 4.8%. The distribution patterns of
      lymphocytes by two-color analysis with FITC-labelled anti-CD16 and PE-labelled
      anti-CD57 monoclonal antibodies in the controls were classified into four groups.
      3) Only seven of the 168 patients exhibited significantly high percentage of GL
      in total lymphocytes. They consisted of 4 splenectomized patients and 3 patients
      with pancytopenia, two of whom had pancytopenia complicated by immunoglobulin
      deficiency. Five of the 7 patients also had markedly high percentage of CD16+
      and/or CD57+ lymphocytes. In these 5 patients, the ratios of four subsets of GL
      and the distribution patterns of lymphocytes with CD16 and CD57 surface antigens
      were different from the patient to patient and those for controls.

PMID- 2229331
TI  - [Clinical aspects and intracranial pressure monitoring in cases of traumatic
      posterior fossa hematoma].
AB  - Clinical signs, skull X-P, computerized tomography (CT), continuous monitoring of
      intracranial pressure (ICP), and serial recording of auditory brainstem response
      (ABR) were examined in 22 cases of traumatic posterior fossa hematoma. Fifteen of
      the patients were male and seven were female. Their ages ranged from 3 to 86
      years old (mean 35.2 years). The causes of the head injuries were traffic
      accidents in 13 cases and falls in 9 cases. The site of cranial impact was
      occipital in all cases but one. Sagittal impact was most common and skull
      fractures were found in the occipital regions in 19 cases. States of
      consciousness on admission as measured by the Glasgow coma scale (GCS) were GCS
      15 in 2 cases, GCS 9-14 in 9 cases and GCS 3-8 in 11 cases. CT findings of
      posterior fossa included 10 cases of intracerebellar hematoma, 8 cases of
      epidural hematoma, 2 cases of combined epidural and intracerebellar hematoma and
      2 cases of subdural hematoma. Associated CT findings of the supratentorial region
      were noted in 18 cases (82%), and most of them showed contrecoup injuries in the
      frontal region. Six cases of 8 epidural hematomas of the posterior fossa
      indicated combined epidural hematomas in the occipital region. ICP was monitored
      in 11 of the 22 cases. Pre-operative ICP monitoring (5 cases) indicated an
      operative decision. ABR was recorded in 5 cases. Serial ABR recording provides
      reliable information about brain stem function. The hematoma was evacuated in 15
      cases. The Glasgow outcome scale administered 3 months after trauma indicated
      good recovery in 2 cases, moderate disability in 6 cases, severe disability in 2
      cases, persistent vegetative state in 1 case and death in 9 cases. It has become
      obvious that there are many types of CT findings in posterior fossa hematomas,
      and that continuous ICP monitoring is very important to determine the timing of
      surgery and to protect against secondary brain damage caused by increased ICP.

PMID- 2229332
TI  - [Clinical and histopathological observations of pigmented spots on the feet].
AB  - Malignant melanomas, originating in the foot are said to have a higher frequency
      in Japan compared to Western countries, accounting for almost one third of all
      cutaneous malignant melanomas. In this context, pigmented spots on the feet which
      can be thought of as precursor lesions of malignant melanomas attract a great
      deal of attention from clinical dermatologists. In this study, 159 pigmented
      spots, consisting of 110 on the soles as well as 49 on the dorsal lesion have
      been studied clinically and histopathologically to clarify their relationship
      with the development of malignant melanomas. The results were as follows: 1)
      Junction nevi were most commonly observed at both sites. 2) Lesions tended to be
      darker in color and bigger in size as they proceeded from the simple lentigo to
      the junctional and compound nevi. 3) Most of the lesions were flat, but the
      elevated lesions were seen more frequently in the compound nevi and intradermal
      nevi which contained more dermal components. Also, lesions on the soles appeared
      to be more elevated. 4) Among the 21 cases which showed some cutaneous change,
      one case showed histopathological evidence of a premalignant lesion. 5) In the
      pigmented spots on the feet, the initial signs of premalignant transformation
      were skin elevation, more pronounced spot growth, measuring up to 5 mm in
      diameter, and dark black coloring (pigmentation). Therefore preventive excision
      of the lesion is recommended in cases where any of the three above features are
      in evidence.

PMID- 2229333
TI  - [Imaging diagnosis of breast disease].

PMID- 2229334
TI  - [Surgical treatment of breast cancer, today].

PMID- 2229335
TI  - [Autoradiographic method for measuring regional cerebral blood flow in rat].

PMID- 2229336
TI  - Abstracts of the second joint meeting of the European Society of Human
      Reproduction and Embryology and the European Sterility Organization.

PMID- 2229337
TI  - Mechanism of plasma clotting by Erysipelothrix rhusiopathiae.
AB  - Experiments were performed to determine the mechanism by which Erysipelothrix
      rhusiopathiae clots plasma. Detection of plasma-clotting activity in four strains
      of E. rhusiopathiae was carried out by mixing a 24-h broth culture of a tested
      bacterial strain with rabbit plasma (tube coagulation test). Sodium citrate,
      sodium oxalate, EDTA, and heparin were used as anticoagulants in preparing the
      rabbit plasma. E. rhusiopathiae strains clotted solely citrated plasma in 18 to
      24 h. A known coagulase-positive strain of Staphylococcus aureus clotted all of
      the plasma preparations within 1 h. Various constituents of the organisms, such
      as cell-free culture filtrates, sonicated extracts, and Formalin-killed bacteria,
      were also checked for their ability to clot citrated plasma. No constituents of
      any strain of E. rhusiopathiae clotted the plasma. Only culture filtrates of S.
      aureus clotted the plasma under these conditions. The spectrophotometric assay
      demonstrated that two plasma-clotting strains of E. rhusiopathiae consumed the
      citrate in the plasma just before clotting. Of 301 veterinary clinical isolates
      of E. rhusiopathiae, 267 (88.7%) were positive in the tube coagulation test. On
      the basis of these results, it was concluded that plasma clotting by E.
      rhusiopathiae was due not to extracellular factors such as staphylocoagulase but
      to consumption of the citrate in the plasma.

PMID- 2229338
TI  - Rapid biochemical test to identify verocytotoxin-positive strains of Escherichia
      coli serotype O157.
AB  - Fluorogenic procedures were used with the substrate 4-methylumbelliferyl-beta-D
      glucuronide (MUG) to identify Escherichia coli. Most strains produced beta
      glucuronidase and, thus, were MUG positive. A 20-min procedure was developed to
      detect glucuronidase activity in 1,295 bacterial cultures, representing 23
      genera, of strains that were isolated from clinical specimens. Very few organisms
      other than E. coli were MUG positive. Of 682 E. coli strains that were isolated,
      630 (92.4%) were MUG positive. When an additional 188 E. coli serotype O157
      isolates were examined, 155 E. coli O157:H7, 10 E. coli O157:H-, and 1 E. coli
      O157:H (rough) isolate were MUG negative. All 166 cultures were verocytotoxin
      positive. Of the remaining 22 E. coli O157 isolates, 2 isolates were O157:H-, 1
      isolate was O157:H (rough), and 19 isolates were other H types (H6, H16, H19,
      H25, H42, and H45); these 22 isolates were MUG positive. All 22 cultures were
      verocytotoxin negative. The rapid MUG procedure can be used to predict
      verocytotoxin-positive isolates of E. coli O157; that is, there is a very good
      likelihood that MUG-negative E. coli O157 isolates are verocytotoxin positive.

PMID- 2229339
TI  - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting
      analysis of smooth-lipopolysaccharide heterogeneity among Brucella biovars
      related to A and M specificities.
AB  - Smooth (S)-lipopolysaccharide (LPS) preparations from reference and field strains
      of several biovars of Brucella abortus, B. melitensis, and B. suis were prepared
      by (i) the hot phenol-water method, (ii) hot sodium dodecyl sulfate extraction
      and proteinase K digestion, or (iii) dimethyl sulfoxide extraction. These S-LPS
      enriched fractions were further analyzed by sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis and silver staining after periodate oxidation. Immunoblots
      were developed by using either monoclonal antibodies specific for Brucella A or M
      antigens or polyclonal polyspecific or monospecific sera from rabbits, cattle,
      and goats. The specificity of monoclonal antibodies reactive with Brucella unique
      (A or M) epitopes was demonstrated by enzyme-linked immunosorbent assay, LPS
      latex agglutination, or agglutination inhibition. The most-represented subunits
      of S-LPS ranged in Mr from 30,000 to 70,000 relative to marker proteins.
      According to A or M immunodominance, two sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis banding patterns were clearly distinguished among biovars,
      whatever the fraction tested: a close succession of regularly spaced narrow bands
      for A greater than M strains and regularly spaced triplets of bands including
      either (i) a first thin band followed by two thick bands for B. abortus M greater
      than A strains or (ii) one thick band between two thin bands for B. melitensis or
      B. suis M greater than A strains. Moreover, A and M specificities were reaffirmed
      by sandwich enzyme immunoassay and latex agglutination inhibition with monoclonal
      antibodies and polyclonal sera.

PMID- 2229340
TI  - Recombinant fusion protein for simple detection of Escherichia coli heat-stable
      enterotoxin by GM1 enzyme-linked immunosorbent assay.
AB  - A recombinant gene fusion protein composed of an Escherichia coli heat-stable
      enterotoxin (STa) peptide epitope fused to the amino end of the cholera toxin B
      subunit was used to detect STa produced by clinical isolates of enterotoxigenic
      E. coli (STa-ETEC) by a single monoclonal antibody-based inhibition GM1 enzyme
      linked immunosorbent assay. In this test, 100% sensitivity and 100% specificity
      were observed for use of the recombinant protein in either its purified form or
      as crude Vibrio cholerae culture supernatants in detection of STa-ETEC.

PMID- 2229342
TI  - Detection and quantitation by lysis-filtration of bacteremia after different oral
      surgical procedures.
AB  - Patients with bacteremia after dental extraction, third-molar surgery, dental
      scaling, endodontic treatment, and bilateral tonsillectomy were studied by means
      of lysis-filtration of blood samples with subsequent aerobic and anaerobic
      incubation. Samples were obtained before, during, and 10 min after treatment.
      Bacteremia was observed in 100% of patients after dental extraction, 55% of
      patients after third-molar surgery, 70% of patients after dental scaling, 20% of
      patients after endodontic treatment, and 55% of patients after bilateral
      tonsillectomy. Anaerobic microorganisms were isolated more frequently than
      aerobic microorganisms were, and viridans group streptococci were the most
      commonly isolated bacteria. Ten minutes after treatment, the frequency as well as
      the magnitude of bacteremia showed pronounced reduction.

PMID- 2229341
TI  - Monoclonal antibody recognizing a species-specific protein from Streptococcus
      pneumoniae.
AB  - Monoclonal antibodies (MAbs) against a nonencapsulated strain (R36A) of
      Streptococcus pneumoniae were produced to aid in a search for antigens common to
      this species. By Western immunoblot analysis, a species-specific 37-kilodalton
      (kDa) protein was found in lysates of 24 different encapsulated strains of S.
      pneumoniae. Monoclonal antibodies against the 37-kDa antigen did not react with
      55 heterologous strains representing 19 genera and 36 species of bacteria that
      can also cause acute lower respiratory tract disease. Immunogold staining
      suggests that the antigen is synthesized inside the pneumococcal cell. However,
      MAbs to the 37-kDa antigen bound whole cells in the enzyme-linked immunosorbent
      assay and the indirect immunofluorescence assay. Antibody-binding epitopes of the
      antigen are probably exposed on the outer surface of the pneumococcus cell wall.
      The effectiveness of the 37-kDa antigen as a useful diagnostic marker is under
      study.

PMID- 2229343
TI  - Characterization of flagella of Clostridium difficile and their role in
      serogrouping reactions.
AB  - Slide agglutination with rabbit antisera allows the differentiation of 10
      serogroups of Clostridium difficile, namely, A, B, C, D, F, G, H, I, K, and X.
      Each serogroup displays a specific protein profile in sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, except for A, which displays 12 different
      protein profiles (A1 to A12). In the present work, electron microscopy revealed
      the presence of uniformly distributed flagella in the reference strains of
      serogroups G and K and in all strains representative of the 12 subgroups within
      serogroup purified by differential centrifugation. Sodium dodecyl sulfate
      polyacrylamide gel electrophoresis of these preparations revealed one distinct
      band with an apparent molecular mass of approximately 39 kilodaltons. Antiserum
      was prepared by immunizing a rabbit with the serogroup A flagellin, which had
      been eluted from the gel. In immunoblotting, this antiserum cross-reacted with
      the flagellin of the other strains. When the cells were deflagellated by a short
      sonication, the cross-reactions observed by slide agglutination with A, G, and K
      antisera were suppressed. Similarly, shearing of flagella allowed specific slide
      agglutination of the 12 subgroups of serogroup A.

PMID- 2229344
TI  - Beta 2-microglobulin and neopterin: predictive markers for human immunodeficiency
      virus type 1 infection in children?
AB  - The value of beta 2-microglobulin and neopterin concentrations in serum for early
      diagnosis of infants born to human immunodeficiency virus type 1 (HIV-1)-infected
      mothers was assessed. Concentrations of both markers were measured in serum
      samples from pediatric patients (Centers for Disease Control classifications P0,
      P1, and P2), as well as in age-matched normal subjects. Both beta 2-microglobulin
      and neopterin were significantly increased in HIV-1-infected symptomatic subjects
      (P2) compared to controls. Seventy-five percent of asymptomatic patients (P1)
      also had increased values. On the other hand, a significant overlap in
      concentrations of both markers in serum was found between controls and P0
      patients. Thirty-eight percent of the P0 patients had values comparable to those
      of the P2 group. Persistently high concentrations of both markers in P0 patients
      may be indicative of HIV-1 infection.

PMID- 2229345
TI  - Short prereduced anaerobically sterilized (PRAS) biochemical scheme for
      identification of clinical isolates of bile-resistant Bacteroides species.
AB  - The rapid identification of isolates of bile-resistant Bacteroides species has
      clinical and therapeutic relevance because of differences in their patterns of
      susceptibility and virulence. Five hundred twenty-one strains of bile-resistant
      Bacteroides species that were previously identified by conventional biochemical
      methods were reexamined to determine the minimum essential parameters necessary
      for correct identification. Rapid tests for bile resistance, indole production,
      and catalase were combined with a novel scheme for biochemical determination of
      saccharolytic activity on arabinose, trehalose, rhamnose, and/or xylan that
      included the postincubation addition of bromthymol blue for visual pH
      determination. Organisms were inoculated into prereduced anaerobically sterilized
      (PRAS) carbohydrates directly from plates, and identification was complete within
      24 h of obtaining a pure culture. Ninety-three percent of bile-resistant
      Bacteroides species from routine clinical specimens were identified correctly by
      this scheme; a small number of other indole-positive strains, B. splanchnicus, B.
      eggerthii, and B. stercoris, were misidentified as B. uniformis.

PMID- 2229346
TI  - Occurrence of Clavispora lusitaniae, the teleomorph of Candida lusitaniae, among
      clinical isolates.
AB  - Of 13 clinical isolates of Candida lusitaniae from diverse geographical regions,
      7 represented the mating types (6 alpha, 1 a) of the ascomycete Clavispora
      lusitaniae. Selected nonfertile isolates showed significant DNA relatedness
      (greater than 90%) to representatives of both mating types. Phenotypic
      physiological characteristics, such as cellobiose fermentation and rhamnose
      assimilation, proved insufficient for separation of Clavispora lusitaniae and
      Clavispora opuntiae.

PMID- 2229347
TI  - Electrophoretic analysis of the surface components of autoagglutinating surface
      array protein-positive and surface array protein-negative Aeromonas hydrophila
      and Aeromonas sobria.
AB  - The protein and lipopolysaccharide (LPS) compositions of 10 autoagglutinating
      Aeromonas hydrophila and Aeromonas sobria strains were studied; one group
      consisted of five serogroup O:11 strains that contained an S layer, while a
      second group was composed of diverse serogroups that were S layer negative by
      transmission electron microscopy. All serogroup O:11 strains were found to
      contain a predominant 52,000- to 54,000-molecular-weight protein that was present
      on both whole-cell and outer membrane protein profiles; this protein was found to
      be glycine extractable under low-pH (pH 4) conditions and was identified as the
      surface array protein. LPS analysis revealed that all O:11 strains exhibited
      homogeneous-length O-polysaccharide side chains characterized primarily by two or
      three major bands. In contrast, S-layer-negative autoagglutinating strains of
      other serogroups lacked this predominant surface array protein, and silver stain
      analysis of LPS indicated that such profiles mainly consisted of core antigens
      and were deficient in or devoid of O-polysaccharide side chains. These collective
      results offer potential explanations for observed differences between these two
      groups in virulence, disease spectrum, and pathogenic properties.

PMID- 2229348
TI  - Application of monoclonal antibodies to the detection of black-pigmented
      Bacteroides spp. in subgingival plaques by immunoslot blot assay.
AB  - The aim of the present study was to assess the application of monoclonal
      antibodies to the detection of black-pigmented Bacteroides spp. in subgingival
      plaques by immunoslot blot assay. Subgingival plaque samples from adult
      periodontal patients were examined by immunoslot blot assay with monoclonal
      antibodies that specifically recognize Bacteroides gingivalis, Bacteroides
      intermedius serogroups I and II, and Bacteroides melaninogenicus. The assay can
      detect specifically these Bacteroides spp. in the subgingival plaques. Therefore,
      we investigated the distribution of these Bacteroides spp. in the subgingival
      plaques of patients classified by Russell's periodontal index. Reactivities of
      their plaques with monoclonal antibodies toward B. gingivalis and B. intermedius
      serogroup I were clearly related to the severity of the periodontal disease, but
      this was not the case with B. intermedius serogroup II and B. melaninogenicus.
      These results indicate that this immunoslot blot assay using monoclonal
      antibodies toward these Bacteroides spp. provides simple detection and monitoring
      of these organisms in periodontal patients.

PMID- 2229349
TI  - Phagocytosis of mastitis isolates of Staphylococcus aureus and expression of type
      5 capsular polysaccharide are influenced by growth in the presence of milk.
AB  - Phagocytosis by bovine polymorphonuclear granulocytes of seven capsular
      polysaccharide type 5 Staphylococcus aureus strains isolated from mastitis
      [corrected] was investigated by means of luminol-dependent chemiluminescence.
      Bacteria were grown on four different agar media (brain heart infusion, Columbia
      broth, modified staphylococcus medium 110, and skim milk) and were opsonized by
      normal bovine serum. When compared to growth on brain heart infusion agar,
      Columbia agar, and modified staphylococcus medium 110 agar, growth on skim milk
      agar rendered five of the strains more resistant to opsonization. The other two
      strains were resistant in all culture media used. Short periods of incubation in
      milk after growth on brain heart infusion agar did not augment resistance to
      phagocytosis, indicating that mere adsorption of milk components on bacteria was
      not responsible. The variability of the chemiluminescence response of
      polymorphonuclear leukocytes was pronounced among strains with each growth medium
      except milk. Growth on modified staphylococcus medium 110 and on milk agar
      favored the masking of teichoic acid, as shown by inagglutinability with rabbit
      antiserum. Interestingly, agglutination by a monoclonal antibody to capsular
      polysaccharide type 5 was optimal when bacteria were grown on skim milk agar.
      This suggests that capsular polysaccharide participated in the masking effect.
      These findings indicate that masking of the bacterial target of most of the
      naturally acquired opsonins present in normal bovine serum occurred when bacteria
      grew in the presence of milk, resulting in an increased resistance to
      phagocytosis by polymorphonuclear leukocytes.

PMID- 2229350
TI  - Detection of colonization factor antigen I-positive enterotoxigenic Escherichia
      coli with a cloned polynucleotide probe.
AB  - We compared a new colony hybridization assay with an established enzyme-linked
      immunosorbent assay for detection of enterotoxigenic Escherichia coli (ETEC)
      expressing colonization factor antigen I (CFA/I). The tests were applied to 135
      human ETEC strains. Of these isolates, 30 had previously been characterized for
      CFAs. A strain harboring the plasmid vector of the polynucleotide gene probe,
      nine non-ETEC strains from healthy infants, and eight ETEC strains of animal
      origin were included for further evaluation of probe specificity. The two assays
      showed a high level of concordance in the specific detection of ETEC strains
      expressing CFA/I. A total of 24 strains tested positive in the CFA/I
      hybridization assay, while 23 of those strains were positive in the CFA/I enzyme
      linked immunosorbent assay. The single discrepant result could be explained by
      the loss of a regulatory gene. The strain harboring the plasmid vector of the
      probe, the non-ETEC E. coli strains, and the ETEC strains of animal origin were
      all negative in the CFA/I probe assay.

PMID- 2229351
TI  - Biochemical and serological characterization of Bacteroides intermedius strains
      isolated from the deep periodontal pocket.
AB  - Fifty-one fluorescence-positive black-pigmented Bacteroides strains obtained from
      51 patients with deep periodontal pockets (greater than 6 mm) were identified and
      characterized. Fifty of these strains were presumptively identified as
      Bacteroides intermedius according to the indole reaction. This was confirmed by
      further biochemical characterization. The 50 strains from diseased sites were
      then compared with 16 B. intermedius strains isolated from periodontally healthy
      individuals with no signs of destructive periodontal disease. Tests for
      antimicrobial susceptibility showed similar patterns for all 50 pocket-derived
      strains, except for one beta-lactamase-positive strain that was resistant to
      penicillin G and ampicillin. Forty-seven strains were tested for binding of three
      monoclonal antibodies defining three distinct serogroups of B. intermedius.
      Thirty-one strains belonged to serogroup I, three to serogroup II and thirteen to
      serogroup III. In comparison to the strains from the shallow periodontal pockets,
      serogroup I was significantly overrepresented in the patient group with
      periodontal disease. We conclude that saccharolytic black-pigmented Bacteroides
      species from deep periodontal pockets constituted, with very rare exceptions, a
      biochemically homogeneous but antigenically heterogeneous group of B. intermedius
      and that serogroup I is predominantly found in deep periodontal lesions.

PMID- 2229352
TI  - Identification of a double-stranded RNA virus by using polymerase chain reaction
      and magnetic separation of the synthesized DNA segments.
AB  - A double-nested polymerase chain reaction assay (PCR), followed by magnetic
      separation of the PCR-synthesized DNA segments, was developed to detect a double
      stranded RNA virus, infectious pancreatic necrosis virus from salmonid fish.
      Viral RNA was extracted from cell cultures and used for cDNA synthesis. The cDNA
      produced was used as a template in a double PCR. The sensitivity of this double
      PCR was approximately 0.8 pg of template double-stranded RNA. The DNA segment
      produced from the first PCR was also used as a template in a second PCR with a
      set of two 5'-labeled primers, one with biotin and the other with 32P. The PCR
      segment that was then synthesized was separated from the solution by using
      streptavidin-coated, superparamagnetic beads. The levels of radioactivity
      measured in the magnetically separated fractions were significantly higher in the
      positive samples than they were in the negative samples.

PMID- 2229353
TI  - Evaluation of two monkey species (Macaca mulatta and Macaca fascicularis) as
      possible models for human Helicobacter pylori disease.
AB  - Endoscopic, histologic, and microbiologic evaluations of 21 cynomolgus and 34
      rhesus monkeys for naturally occurring Helicobacter pylori infection were done.
      H. pylori was never isolated from any cynomolgus monkey, but was found in 12
      rhesus monkeys. A general correlation existed between a positive culture and a
      gastric inflammatory response. Inoculation challenges were then undertaken. Four
      cynomolgus and five rhesus monkeys received two different H. pylori strains
      isolated from humans. Five rhesus monkeys received an isolate obtained from
      rhesus monkeys. Evaluation of the cynomolgus monkeys 7 and 14 days later revealed
      no H. pylori. Endoscopies of the rhesus monkeys were done 7, 14, 21, 28, and 56
      days later. One rhesus monkey, which received the isolate from humans, became H.
      pylori positive at day 21 and remained positive through day 56. Restriction
      enzyme analysis of genomic DNA at day 56 revealed that the isolate was not
      identical to the challenge strain isolated from humans. All five rhesus monkeys
      that received the strain isolated from rhesus monkeys became H. pylori positive
      by day 14 and remained positive through day 56 Antral inflammation developed in
      all monkeys. Restriction enzyme analysis of genomic DNA on day 56 confirmed that
      four of five isolates were identical to the challenge strain isolated from rhesus
      monkeys. DNA hybridization documented homology between the challenge strains
      isolated from humans and rhesus monkeys plus those isolated at day 56. In this
      study, we showed that the rhesus monkey, if given a strain of H. pylori isolated
      from rhesus monkeys, develops a gastric infection with accompanying histological
      changes, making this model suitable for further development.

PMID- 2229354
TI  - Impact on routine diagnosis of echovirus infections of intratypic differentiation
      and antigenic variation in echovirus type 25 studied by using monoclonal
      antibodies.
AB  - We studied the biological and antigenic properties of wild strains of echovirus
      type 25 isolated in France between 1982 and 1987 and compared them with the JV-4
      prototype strains isolated in 1957. The wild strains differed from the prototype
      strain in their cellular tropism. The prototype strain grew readily in five cell
      lines (MRC5, MA 104, Vero, BGM, and HT 29-18), while for wild strains MRC5 and HT
      29-18 cells were the most sensitive and supported growth to high titres (between
      4.5 and 7.4 50% tissue culture infective doses per 0.05 ml). Plaques produced by
      wild strains were larger (6.05 +/- 0.94 mm in diameter [mean +/- standard
      deviation]) than those of the prototype strain (2.3 +/- 0.97 mm in diameter) and
      heterogeneous, even after cloning by three terminal dilution passages, which
      suggested heterogeneous virus populations. Virus neutralization with polyclonal
      monovalent sera showed that wild strains were significantly less neutralized by
      two reference immune sera than the prototype strain was. Monoclonal antibodies
      were raised against the echovirus type 25 JV-4 prototype strain. Nine clones with
      neutralizing activity were identified. Heterologous neutralizations of 14
      clinical isolates revealed highly conserved, moderately conserved, and poorly
      conserved epitopes. The natural isolates differed from the prototype strain in
      two to four epitopes and can be classified into four different groups. We
      concluded that echovirus type 25, like coxsackie- and polioviruses, consists of
      heterogeneous viral populations with respect to biological and antigenic
      properties. In term of viral diagnosis, it may become increasingly difficult to
      identify recently isolated strains because of their antigenic variation.

PMID- 2229355
TI  - Rapid prenatal diagnosis of congenital Toxoplasma infection by using polymerase
      chain reaction and amniotic fluid.
AB  - Infection of pregnant women with Toxoplasma gondii places the developing fetus at
      risk for congenital infection. We report a prospective study of 43 documented
      cases of acute maternal Toxoplasma infections acquired during gestation in which
      the polymerase chain reaction (PCR) was evaluated for diagnosis of fetal
      infection and compared with the current standard methods. On the basis of direct
      lysis of pelleted amniotic fluid cells followed by amplification of a gene
      sequence specific for T. gondii, PCR correctly identified the presence of T.
      gondii in five of five samples of amniotic fluid from four proven cases of
      congenital infection. PCR also detected three of five positive cases from a
      nonprospective group. The two diagnostic methods of comparable speed, detection
      of specific immunoglobulin M from fetal blood and and inoculation of amniotic
      fluid into tissue culture, correctly identified only 3 and 4 of the 10 positive
      samples, respectively. The considerably more time-consuming methods of mouse
      inoculation of amniotic fluid and fetal blood both detected 7 of 10 positive
      samples. There were no false-positive diagnoses by any of the methods. Therefore,
      detection of T. gondii by PCR appears to be the most promising method for
      prenatal diagnosis of congenital Toxoplasma infection, since it is both extremely
      rapid and highly sensitive.

PMID- 2229356
TI  - Serological typing of spotted fever group Rickettsia isolates from Zimbabwe.
AB  - Eight rickettsialike organisms were isolated in tissue culture from ticks of dogs
      and cattle from various areas of Zimbabwe. These isolates and a reference strain,
      Rickettsia conorii Simko, were tested by microimmunofluorescence against
      homologous and heterologous antisera raised in mice. From the titers obtained by
      this method, specificity differences (SPDs) were calculated between each of the
      rickettsiae. Only small serological differences were detected among the isolates
      from ticks obtained from dogs (mean SPD, 0.5) and also among the isolates from
      ticks obtained from cattle (mean SPD, 0.3). However, when isolates from ticks
      obtained from dogs and cattle were compared, the serological differences were
      greater (mean SPD, 1.3). The isolates from ticks obtained from dogs were found to
      be very similar serologically to the Simko strain of R. conorii (mean SPD, 0.8),
      while three of four isolates from ticks obtained from cattle were different
      enough (SPD, greater than or equal to 3) to be identified as separate serotypes.
      These findings indicate that there is a high degree of antigenic heterogeneity
      among the tick-transmitted spotted fever group rickettsiae in Zimbabwe.

PMID- 2229357
TI  - Bovine lactoferrin binding to six species of coagulase-negative staphylococci
      isolated from bovine intramammary infections.
AB  - Bovine lactoferrin (BLf), an acute-phase iron-binding secretory protein present
      in secretions of the bovine udder, was demonstrated to bind to the following
      staphylococcal species associated with bovine intramammary infections: S.
      epidermidis, S. warneri, S. hominis, S. xylosus, S. hyicus, and S. chromogenes.
      The degree of 125I-labeled BLf uptake significantly varied among the blood agar
      grown cells of all six species of coagulase-negative staphylococci tested.
      Isolates identified as S. xylosus demonstrated the highest (mean, 35.1 x 10(6) +/
      13.3 x 10(6) nmol) and S. hyicus the lowest (mean, 10.7 x 10(6) +/- 5.9 x 10(6)
      nmol) binding to 125I-BLf. BLf binding was optimum at an acidic pH, with time
      dependent binding saturation ranging from 70 min for S. warneri to 240 min for S.
      hominis. The BLf-binding mechanism was specific, with affinity constants (Ka
      values) ranging between 0.96 x 10(6) and 11.90 x 10(6) liters/mol. The numbers of
      BLf-binding sites per cell, as determined by using Scatchard analysis, were as
      follows: S. epidermidis, 3,600; S. warneri, 1,900; S. hominis, 4,100; S. xylosus,
      4,400; S. hyicus, 6,100; and S. chromogenes, 4,700. 125I-BLf binding to all
      species was inhibited by unlabled BLf and unlabeled human lactoferrin, whereas
      none of the various plasma, connective tissue, or mucosal secretory proteins or
      carbohydrates tested caused significant interference. BLf-binding receptors of
      the six coagulase-negative staphylococcal species demonstrated marked differences
      in patterns of susceptibility to proteolytic or glycolytic enzyme digestion and
      to heat or periodate treatment. These data suggest that the BLf-binding
      components in S. epidermidis and S. warneri are proteins containing glycosidyl
      residues. In the remaining four species, the proteinaceous nature of the BLf
      binding component was evident, but the involvement of glycosidyl residues was not
      clear. Results of this study establish the presence of specific binding
      components for BLf on coagulase-negative staphylococci isolated from bovine
      intramammary infections.

PMID- 2229358
TI  - Nonvalue of antigen detection immunoassays for diagnosis of candidemia.
AB  - We evaluated the Cand-Tec (Ramco Laboratories Inc., Houston, Tex.) and LA-Candida
      antigen detection system (Immuno-Mycologics Inc., Norman, Okla.) tests as
      possible rapid alternatives to blood cultures for the identification of patients
      with candidemia. Tests were performed on sera from (i) 33 patients with
      candidemia, (ii) 82 patients with fever and risk factors for invasive
      candidiasis, and (iii) 13 healthy controls. A total of 21 patients had no
      evidence of invasive candidiasis, as determined by clinical course, blood
      culture, and/or autopsy; results for 61 patients were indeterminate regarding the
      presence of invasive candidiasis, or else the patients had invasive candidiasis
      with organ involvement. By using a threshold positive Cand-Tec titer of greater
      than or equal to 1:4, the sensitivity in candidemic patients was 49%; the
      specificity was 43% (patients with true-negative results had neither candidemia
      nor other evidence of invasive candidiasis). Coexistent disseminated candidiasis
      in some candidemic patients may have accounted for some positive Cand-Tec tests
      and possible overestimation of the sensitivity of the test for candidemia. Cand
      Tec test results were negative for healthy controls. All test results obtained by
      the LA-Candida antigen detection system assay were negative. Our findings
      indicate that neither of these assays reliably identifies patients with
      candidemia.

PMID- 2229359
TI  - Production of hemolysin and other extracellular enzymes by clinical isolates of
      Pseudomonas pseudomallei.
AB  - One hundred clinical isolates of Pseudomonas pseudomallei from humans were tested
      for their ability to produce extracellular, biologically active substances which
      are thought to contribute to the virulence of Pseudomonas species. All isolates
      produced at least on extracellular enzyme; 91 strains were positive for
      lecithinase, lipase, and protease; but none was positive for elastase. Ninety
      three strains produced a hemolysin which was detectable around the heavy growth
      on saline-washed sheep erythrocyte brain heart infusion agar but not demonstrable
      around individual colonies or in broth culture filtrate. In contrast, a hemolysin
      which was cytolytic around individual colonies of P. pseudomallei on the assay
      plate and in broth culture filtrate was exhibited by four strains. By using one
      of these four isolates as the test strain, the latter hemolysin was characterized
      further. It was heat labile, most active in an acid environment (pH 5.5), and
      cytolytic in broth culture filtrate for a variety of animal and human
      erythrocytes. Sterols, particularly cholesterol and 7-dehydrocholesterol,
      inhibited its hemolytic activity, but the activity was not enhanced by reducing
      agents or suppressed by reagents which modify sulfhydryl-activated hemolysins. A
      nonhemolytic mutant of the test strain of P. pseudomallei retained the
      extracellular enzymes of its parent, indicating that the hemolysin was not a
      lecithinase, lipase, or protease.

PMID- 2229360
TI  - Evaluation of the indoxyl acetate hydrolysis test for rapid differentiation of
      Campylobacter, Helicobacter, and Wolinella species.
AB  - A total of 410 well-defined Campylobacter, Helicobacter, and Wolinella strains,
      comprising 26 named species, subspecies, and defined groups, were tested for
      indoxyl acetate hydrolysis by a disk method by using disks prepared at the
      Centers for Disease Control, Atlanta, Ga. All C. coli (43 strains), C.
      cryaerophila (34 strains), C. fennelliae (5 strains), C. fennelliae-Campylobacter
      like organism 3 (2 strains), C. jejuni (66 strains), C. jejuni subsp. doylei (3
      strains), hippurate-negative C. jejuni-C. coli (15 strains), "C. upsaliensis" (39
      strains), H. mustelae (5 strains), W. curva (1 strain), and W. recta (1 strain)
      hydrolyzed indoxyl acetate. Four strains gave weak positive reactions, and the
      remaining 196 strains, which belonged to 15 species, subspecies, and defined
      groups, gave negative reactions. Of the 410 study strains, 246 and 125 strains
      were tested for indoxyl acetate hydrolysis by a disk method and a tube method,
      respectively, by using commercially produced disks. The disk method, regardless
      of source, required less time and interpretation than the tube method did. Better
      differentiation between Campylobacter spp. was obtained with the indoxyl acetate
      test than with the trimethylamine N-oxide test. The indoxyl acetate disk
      distinguished C. lari from C. jejuni and C. coli, C. cinaedi from C. fennelliae,
      and H. pylori from H. mustelae and suggested that W. succinogenes could be
      differentiated from W. recta and W. curva. The indoxyl acetate disk method could
      be performed in 5 to 30 min, was easy to read and interpret, and should be useful
      as a routine diagnostic test for identification of Campylobacter spp.

PMID- 2229361
TI  - Identification of Giardia lamblia-specific antigens in infected human and gerbil
      feces by western immunoblotting.
AB  - Western immunoblot analysis of aqueous extracts of feces obtained from five
      giardiasis patients and from experimentally infected gerbils (Meriones
      unguiculatus) with rabbit antiserum to Giardia lamblia cysts has revealed
      antigens of three molecular weight groups. A stepladderlike, evenly-spaced set of
      strongly reactive antigens (darkest at a molecular weight [m.w.] of 55,000 to
      70,000) appeared in the gerbil feces from day 4 (first experiment) or day 2
      (second experiment) and lasted to about day 7 but disappeared completely by day 8
      and did not reappear later. These antigenic bands were seen in gerbils infected
      with two isolates of G. lamblia. These bands were not revealed when antiserum to
      trophozoites was used as the probe, nor were they evident in specimens from the
      patients or in a preparation of sonicated cysts. A second group of antigens,
      represented by two to three low-m.w. bands of approximately 15,000 to 20,000, was
      evident in both the blots of gerbil feces after approximately day 8 and the
      specimens from the giardiasis patients. The third group of antigens revealed by
      blotting experiments was a high-m.w. band (approximately 110,000) which appeared
      on a number of days (beginning of day 8 of gerbil infection), but this band was
      not seen in the human specimens. A clear band corresponding to the previously
      reported GSA-65 antigen was not seen in either the gerbil or the human samples.
      Some low- and high-m.w. bands were also detected by antitrophozoite serum in the
      gerbil samples, but these were weak and unimpressive compared with those
      visualized using anticyst serum. A monoclonal antibody-based antigen capture
      enzyme-linked immunosorbent assay revealed that Giardia spp.-specific stool
      antigen rose suddenly at day 3 of gerbil infection, at the time when fecal cyst
      numbers began to rise rapidly.

PMID- 2229362
TI  - Differentiation of genes coding for Escherichia coli verotoxin 2 and the
      verotoxin associated with porcine edema disease (VTe) by the polymerase chain
      reaction.
AB  - Two sets of synthetic oligonucleotide primers were used in a polymerase chain
      reaction adaptation to distinguish the closely related genes for type 2 verotoxin
      (VT2 or Shiga-like toxin [SLT-II]) and the verotoxin associated with porcine
      edema disease (VTe or SLT-II variant [SLT-IIv]) in Escherichia coli.

PMID- 2229363
TI  - Importance of membrane-bound antigens of Toxoplasma gondii and their fixation for
      serodiagnosis of toxoplasmic encephalitis in patients with acquired
      immunodeficiency syndrome.
AB  - Titers in a direct agglutination test using Formalin-fixed toxoplasma tachyzoites
      were significantly higher in patients with acquired immunodeficiency syndrome
      with toxoplasmic encephalitis (TE) than in those without TE. In contrast, when
      fresh (not fixed) tachyzoites were used, the titers did not differ from those in
      patients without TE. The direct agglutination test using Formalin-fixed
      tachyzoites better distinguished between patients with TE and those without TE
      than an agglutination test using latex particles coated with Formalin-fixed
      sonicated-tachyzoite antigens. Thus, both selective use of membrane-bound
      antigens and their fixation are important for serodiagnosis of TE in patients
      with acquired immunodeficiency syndrome.

PMID- 2229364
TI  - Microbiological characteristics of Weeksella virosa (formerly CDC group IIf)
      isolated from the human genitourinary tract.
AB  - Weeksella virosa (formerly CDC group IIf) is a nonsaccharolytic, oxidase- and
      catalase-positive, gram-negative rod which is unable to grow on MacConkey agar.
      At 48 h of incubation on blood or chocolate agar, the colonies present a
      characteristic appearance: intensely mucoid, adherent, and cream colored as a
      result of the production of a nondiffusible yellow pigment. This microorganism
      has been isolated predominantly from the female genitourinary tract, which
      indicates the opportunity for sexual transmission. We present the microbiological
      study of three strains of W. virosa identified in a study of 707 female genital
      samples, representing an incidence of 0.42%. At the same time, we analyzed the
      principal biochemical tests used in the identification of this microorganism and
      the susceptibilities of the organism to the different antimicrobial agents
      assayed.

PMID- 2229365
TI  - Aerobic bacteria cultured from the mouth of the American opossum (Didelphis
      virginiana) with reference to bacteria associated with bite infections.
AB  - The American opossum inflicts bite injuries both when hunted for food and when
      accidentally provoked when handled in captivity. This study involved aerobically
      culturing organisms from the mouths of seven wild opossums (Didelphis
      virginiana). Isolates included streptococci, coagulase-positive and -negative
      staphylococci, Aeromonas spp., Citrobacter freundii, Eikenella corrodens, and
      Escherichia coli.

PMID- 2229366
TI  - Campylobacter-like organisms are uncommon pathogens in patients infected with the
      human immunodeficiency virus.
AB  - Over a 25-month period, we prospectively evaluated 36 patients with symptomatic
      human immunodeficiency virus disease (including 27 with unexplained chronic
      diarrhea) by flexible sigmoidoscopy for the presence of Campylobacter-like
      organisms. No Campylobacter-like organisms were isolated. Campylobacter-like
      organisms appear to be an uncommon cause of idiopathic chronic diarrhea in
      symptomatic human immunodeficiency virus disease.

PMID- 2229367
TI  - Microagglutination test for early and specific serodiagnosis of tularemia.
AB  - A microagglutination test with safranin-stained Francisella tularensis antigen
      was compared with a conventional tube agglutination test for the serodiagnosis of
      tularemia. The microagglutination test was performed in round-bottom microtiter
      plates by using 0.025 ml of the antisera and of the antigen. The antibody titers
      obtained by using the microagglutination test were 8 to 64 times higher than
      those seen with the tube agglutination. By the microagglutination test, the serum
      agglutinins were detected 3 days earlier in rabbits and 9 days earlier in humans
      than by the tube agglutination test. The microagglutination test also detected
      residual circulating antibodies in humans more than 20 years after recovery from
      infection. These early agglutinins were shown to be in the immunoglobulin M class
      because of their sensitivities to 2-mercaptoethanol. No significant group
      agglutination reaction with Brucella abortus was observed. These observations
      indicate that the microagglutination test is a useful tool for the early and
      specific serodiagnosis of tularemia.

PMID- 2229368
TI  - Eubacterium lentum ATCC 43055, a new reference strain for quality control of
      anaerobic susceptibility tests.
AB  - A strain of Eubacterium lentum (ATCC 43055) was selected for quality control of
      anaerobic susceptibility tests. Multilaboratory collaborative studies with 13
      different antimicrobial agents were reviewed, and MIC control limits were
      proposed for agar dilution tests with the new control strain.

PMID- 2229369
TI  - Clostridium septicum as a cause of pericarditis and mycotic aneurysm.
AB  - Clostridium septicum is a bacterial species associated with gas gangrene in both
      humans and animals. Although not usually a pathogen in humans, it has been
      implicated in some cases of abscesses and bacteremia. We now report the first
      case of pericarditis with mycotic aneurysm due to C. septicum.

PMID- 2229370
TI  - Selective staphylococcal broth.

PMID- 2229371
TI  - Reproducibility and indices of discriminatory power of microbial typing methods.
AB  - When microbial strain-typing methods are compared, the most important
      characteristics are typeability, reproducibility, and discriminatory power. While
      typeability and reproducibility can be presented as numerical values, indices of
      discriminatory power have only recently been described. This paper examines the
      relationship between reproducibility and indices of discriminatory power. In an
      individual typing method, an inverse relationship between reproducibility and
      discriminatory power appears as the number of test differences required in order
      to distinguish between strains is increased. A method of standardizing the
      discriminatory power of a typing method to a predetermined reproducibility is
      presented. In this way the discriminatory powers of different typing methods can
      be compared while being standardized for the effect of reproducibility.

PMID- 2229372
TI  - Rapid and sensitive detection of Mycobacterium leprae using a nested-primer gene
      amplification assay.
AB  - By using a set of four nested oligonucleotide primers, a two-step polymerase
      chain reaction assay for the detection and identification of Mycobacterium leprae
      that does not require the use of radioactivity labeled hybridization probes was
      developed. The nested-primer procedure amplified a 347-base-pair product from M.
      leprae genomic DNA. No amplification products were produced from DNAs of 19 other
      Mycobacterium species, 19 non-Mycobacterium species, mouse cells, or human cells.
      Minor amplification products were observed with three additional Mycobacterium
      species, i.e., "M. lufu", M. simiae, and M. smegmatis. These products were easily
      distinguished from the M. leprae product by size and restriction enzyme cleavage
      patterns. The assay could amplify the 347-base-pair product from samples
      containing as little as 3 fg of M. leprae genomic DNA--the amount of DNA in a
      single bacillus. The assay also amplified target sequences in crude lysates of M.
      leprae bacilli isolated from tissue biopsy specimens from infected animals and
      humans. The entire assay, from sample preparation to data analysis, can be
      completed in less than 8 h.

PMID- 2229373
TI  - Clinical comparison of isolator and BACTEC 660 resin media for blood culture.
AB  - The 10-ml Isolator system (E.I. du Pont de Nemours & Co., Inc., Wilmington, Del.)
      was compared with the BACTEC 16A-17A nonradiometric resin system (Johnston
      Laboratories, Inc., Towson, Md.) for isolation of organisms from 6,839 paired
      blood cultures. Equal volumes of blood (6 to 10 ml for each Isolator and 3 to 5
      ml for each BACTEC bottle) were cultured in parallel in the two systems, and 600
      isolates that were judged to be clinically significant by chart review were
      recovered during the study. The BACTEC resin system detected 510 (85%) and the
      Isolator system detected 435 (72%) of the clinically significant isolates (P less
      than 0.001). Of 45 polymicrobial blood cultures, the BACTEC system detected 32
      (71%) and the Isolator system detected 21 (47%) (P less than 0.05). Of 253 gram
      negative bacilli isolated during the study, 30% were detected only in the BACTEC
      system and 16% were detected only in the Isolator system (P less than 0.001), and
      of 56 nonfermentative or fastidious gram-negative bacilli detected, 46% were
      recovered only in the BACTEC system, while 14% were detected only in the Isolator
      system (P less than 0.001). Of 86 streptococci isolated during the study, 30%
      were detected only in the BACTEC system, and 4% were detected only in the
      Isolator system (P less than 0.001). Recoveries of anaerobic bacteria,
      staphylococci, and yeasts were equivalent in the two systems. Organisms judged to
      be contaminants were detected in approximately 1% of the cultures in each system.
      The results suggest that use of resin media renders the BACTEC nonradiometric
      system equivalent or superior to the Isolator system for detection of clinically
      significant organisms in blood cultures.

PMID- 2229375
TI  - Oerskovia xanthineolytica implicated in peritonitis associated with peritoneal
      dialysis: case report and review of Oerskovia infections in humans.
AB  - Oerskovia species are nocardialike bacteria that have been implicated as
      pathogens only rarely. These organisms are branched, gram-positive bacilli that
      are oxidase negative, catalase positive, and non-acid fast. Unlike Nocardia
      species, these organisms are motile, do not produce aerial mycelia, and possess a
      cell wall with large amounts of galactose. Colonies are bright yellow and produce
      branched vegetative hyphae on nutrient agar. A 70-year-old patient undergoing
      chronic ambulatory peritoneal dialysis for end-stage renal dysfunction developed
      recurrent peritonitis. Five peritoneal fluid cultures and one catheter specimen
      obtained over a period of two weeks yielded a gram-positive bacillus; Oerskovia
      xanthineolytica was isolated from all six cultures. Prolonged systemic therapy
      with gentamicin and vancomycin was unsuccessful in curing the peritonitis, but
      the infection resolved following removal of the peritoneal catheter. This is the
      first reported case of peritonitis associated with this microorganism. A review
      of previously described Oerskovia infections, most of which were associated with
      foreign bodies, showed that removal of infected foci was usually necessary for
      cure.

PMID- 2229374
TI  - Differential agglutination test for diagnosis of recently acquired infection with
      Toxoplasma gondii.
AB  - We evaluated the recently described differential agglutination test (HS/AC test)
      to differentiate recently acquired toxoplasma infections from those acquired in
      the more distant past in sera obtained from 38 patients with carefully defined
      symptomatic and asymptomatic infections. AC antigens detect acute-phase-specific
      immunoglobulin G (IgG) antibodies against Toxoplasma gondii tachyzoites that are
      formed only during the acute stage of infection in humans. The HS/AC test
      correctly identified recently acquired infections in patients with toxoplasmic
      lymphadenopathy or asymptomatic infections (including infections in 7 women who
      seroconverted during gestation) in 31 of 33 patients. We also studied 15
      individuals who had been infected for at least 2 years. In that group, only 13%
      had an acute pattern in the HS/AC test. However, the wide range in times from
      infection (from 2 to 14 years) did not allow for an estimate of when the pattern
      in the HS/AC test changed from acute to not acute. These results reveal that in
      the appropriate clinical situation, when both IgG and IgM tests are positive and
      a question still remains about the acuteness of infection, the HS/AC test may be
      useful for differentiating between toxoplasma infections acquired recently and
      those acquired in the more distant past.

PMID- 2229376
TI  - Evaluation of the updated Vitek yeast identification data base.
AB  - Using 398 isolates of yeasts and yeastlike fungi comprising 9 genera and 26
      species, as well as the hyphomycete Geotrichum candidum and the achlorophyllous
      alga Prototheca wickerhamii, we compared the API 20C yeast identification system
      with the modified Vitek yeast identification system with an expanded data base.
      We found 11 discrepancies between the two systems: five (1.3%) of the isolates
      (Blastoschizomyces capitatus, 1; Candida albicans, 1; Hansenula anomala, 1;
      Rhodotorula minuta, 2) had biocodes not included in the expanded Vitek data base,
      and six (1.5%) of the isolates (Candida lusitaniae, 1; Candida parapsilosis, 1;
      Cryptococcus uniguttulatus, 1; H. anomala, 1; Torulopsis candida, 2) were
      misidentified by the Vitek system. Overall, the efficacy of the Vitek system
      compares favorably with that of the API 20C in the identification of clinically
      important yeasts.

PMID- 2229377
TI  - Assessment of conventional and commercial methods for identification of clinical
      isolates of cysteine-requiring strains of Escherichia coli and Klebsiella
      species.
AB  - Cysteine-requiring strains of the family Enterobacteriaceae that are auxotrophic
      for this amino acid because of defects in the sulfur assimilatory pathway account
      for about 1.5% of urinary tract isolates of Escherichia coli and Klebsiella
      species. Forty Escherichia and eight Klebsiella cysteine-requiring strains were
      used to test the ease with which various test systems identified clinical
      isolates of cysteine auxotrophs. In a preliminary experiment, the growth yield of
      10 cysteine-requiring E. coli in 10 solutions of commercially available peptones
      was in each instance less than that of prototrophic control and showed that these
      sources of nutrients were suboptimal for these strains. A significant proportion
      of the cysteine-requiring strains were not adequately identified by growth
      dependent tests which used various peptones as a nutrient source. Problems were
      encountered with all test systems examined, which were as follows: conventional
      methods; the API 20E, Microbact, and Vitek systems; and two rapid methods for the
      identification of E. coli, the Rapidec coli and the beta-D-glucuronidase tests.
      The performance of the test systems was only partly improved when inocula were
      derived from appropriately supplemented media. However, the problems of the
      growth-dependent tests were resolved when a cysteine-supplemented suspension was
      used to inoculate each test system.

PMID- 2229378
TI  - Molecular cloning of Ehrlichia risticii and development of a gene probe for the
      diagnosis of Potomac horse fever.
AB  - A gene bank of Ehrlichia risticii was constructed in plasmid vector pUC13. Five
      clones representing discrete regions of the E. risticii genome were tested for
      their ability to hybridize specifically to E. risticii DNA. None of the clones
      cross-hybridized with Ehrlichia equi DNA, whereas four of these clones cross
      hybridized with Ehrlichia canis and Ehrlichia sennetsu DNAs. However, one clone
      carrying a 1-kilobase HindIII fragment of E. risticii DNA failed to cross-react
      with the genomes of E. sennetsu, E. canis, and E. equi in dot blot hybridization
      assays. The sensitivity of this probe for the detection of E. risticii DNA was
      approximately 0.5 pg. By using this probe, the E. risticii DNA was detected in
      the peripheral blood mononuclear cells of 30 experimentally infected horses by 7
      days postinfection (p.i.); the detection of E. risticii DNA peaked between 14 and
      17 days p.i., a period immediately after the peak of the second rise in body
      temperature, during leukopenia and at the onset of diarrhea. E. risticii DNA was
      not detectable by 25 to 30 days p.i. E. risticii DNA was not detected in
      noninfected control horses.

PMID- 2229379
TI  - Diagnosis of Chlamydia trachomatis cervical infection by detection of amplified
      DNA with an enzyme immunoassay.
AB  - A sensitive and specific system for detection of amplified Chlamydia trachomatis
      DNA from cervical specimens by fluorometric quantitation in an enzyme immunoassay
      (EIA) format (polymerase chain reaction [PCR]-EIA) is described. The primers
      selected for PCR-amplified DNA were from the 15 serovars of C. trachomatis and
      two strains of Chlamydia pneumoniae (TWAR). One strain of Chlamydia psittaci
      (Borg) was not amplified. One hundred four previously cultured cervical specimens
      were evaluated. Forty-six culture-positive specimens containing from 1+ to 4+
      inclusion bodies were all positive by PCR-EIA. Of 58 culture-negative specimens,
      2 were repeatedly positive and were nonreactive with control probes. This assay
      system represents a sensitive and specific combination of technologies for the
      quantitative detection of C. trachomatis DNA directly from a body fluid.

PMID- 2229380
TI  - Comparison of four Mycoplasma arthritidis strains by enzyme immunoassay,
      metabolism inhibition, one- and two-dimensional electrophoresis, and
      immunoblotting.
AB  - Four Mycoplasma arthritidis strains, two virulent (158p10p9 and 14124p10) and two
      avirulent (PG6 and H606), were examined for differences in their antigenic
      compositions. Rabbit antisera prepared against each strain were compared for
      their reactivities against both homologous and heterologous strains by enzyme
      linked immunosorbent assay and metabolism inhibition assay. These tests confirmed
      a close serologic relationship among the four strains. Only by cross-absorbing
      each antiserum with intact cells from both homologous and heterologous strains
      could serologic differences be detected. Interestingly, antigenic variability was
      minimal among those antigens involved in the metabolism inhibition reaction,
      suggesting that they may be highly conserved within this species. No differences
      in protein composition could be detected by one-dimensional sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis. However, slight variation was
      apparent on two-dimensional gels, and antigens possessing strain-specific
      epitopes were detected by two-dimensional immunoblotting experiments performed
      with cross-absorbed antisera. The enzyme-linked immunosorbent assay, two
      dimensional electrophoresis, and immunoblotting experiments showed that the two
      virulent strains were closely related to each other, while the avirulent strains
      were more distantly related to each other and to the other two strains. The
      relationship of M. arthritidis serologic diversity to virulence remains unclear:
      however, this study has demonstrated that it may be possible to subdivide M.
      arthritidis into serogroups on the basis of cross-absorption patterns and to
      identify those antigens bearing strain-specific epitopes by immunoblotting with
      cross-absorbed antisera.

PMID- 2229381
TI  - Analysis of a repetitive DNA sequence from Bordetella pertussis and its
      application to the diagnosis of pertussis using the polymerase chain reaction.
AB  - A tandemly repeated 1,046-base-pair (bp) ClaI DNA fragment from Bordetella
      pertussis was cloned into Escherichia coli by using the vector pUC19. This
      fragment, when isolated, hybridized strongly to DNA from all 100 clinical
      isolates of B. pertussis tested. It was shown to have homology to single-copy
      sequences in Bordetella bronchiseptica but not Bordetella parapertussis and did
      not hybridize to lysate blots of a wide range of other bacteria, including
      members of the closely related genera Pasteurella, Alcaligenes, and Haemophilus.
      The 1,046-bp fragment was sequenced, and complementary synthetic oligonucleotides
      flanking a 153-bp region within the repeated element were used as primers for
      specific amplification of this region using the polymerase chain reaction (PCR).
      This procedure was then applied to the rapid (5-h) detection of B. pertussis in
      nasopharyngeal secretions collected from 332 children with suspected pertussis.
      The test yielded positive results in a total of 98 samples, compared with 66 for
      culture and 33 for direct immunofluorescence (IF). All of the IF-positive samples
      were PCR positive, as were 63 of the samples from which B. pertussis was
      eventually cultured. Two hundred thirty-one specimens which were negative by IF
      and culture were also negative in the PCR assay. However, 33 culture- and IF
      negative specimens were positive by PCR assay. Several of these specimens were
      collected from close contacts of culture-proven pertussis patients, were follow
      up specimens from such patients, or were from patients with serological evidence
      of pertussis and therefore may be true-rather than false-positives.

PMID- 2229382
TI  - Comparison of immunofluorescence, particle agglutination, and enzyme immunoassays
      for detection of human T-cell leukemia virus type I antibody in African sera.
AB  - The effectiveness of four screening tests for detecting antibody to human T-cell
      leukemia virus type I (HTLV-I) was determined by using 2,700 African serum
      specimens. The tests studied were indirect immunofluorescence, particle
      agglutination from Fujirebio, and two enzyme immunoassays, one from Abbott
      Laboratories that used virus lysate from HUT 102 cells and the other from
      Cambridge BioScience Corp. that used an env recombinant protein. Positive and
      doubtful sera were confirmed by Western immunoblot and radioimmunoprecipitation
      assay with Food and Drug Administration seropositivity criteria. The best results
      were obtained with the two enzyme immunoassays, which were more sensitive (100
      and 98.6% [Abbott and Cambridge, respectively]) and more specific (98.7 and
      96.5%). Indirect immunofluorescence exhibited difficulties for reading and
      interpretation. With particle agglutination, prozone was observed for 9 of 78
      HTLV-I-positive serum specimens. False-positives in any of the tests were not
      linked to cross-reactions with human immunodeficiency viruses. However,
      confirmation tests remain necessary for HTLV-I screening.

PMID- 2229383
TI  - Identification of Haemophilus aphrophilus and Actinobacillus
      actinomycetemcomitans by DNA-DNA hybridization and genetic transformation.
AB  - DNA-DNA hybridization was used to identify clinical isolates as Haemophilus
      aphrophilus or Actinobacillus actinomycetemcomitans. Some of the isolates were
      naturally competent for genetic transformation and were also used as DNA
      recipients for identification of other isolates. The results obtained by
      hybridization were supported by interstrain-to-intrastrain transformation ratios.
      Distinction between the closely related species H. aphrophilus and A.
      actinomycetemcomitans was generally clear-cut by both methods. Distinction of H.
      aphrophilus and A. actinomycetemcomitans from type and reference strains of a
      diversity of species in the family Neisseriaceae and other gram-negative species
      was also demonstrated by both methods. This is the first description of the
      identification of clinical isolates of H. aphrophilus or A. actinomycetemcomitans
      by using them as recipients in genetic transformation. The results suggest that
      this is a reliable system for identification of new clinical isolates belonging
      to these taxonomic entities.

PMID- 2229384
TI  - Differentiation of Naegleria fowleri from Acanthamoeba species by using
      monoclonal antibodies and flow cytometry.
AB  - Monoclonal antibodies to Naegleria fowleri and Acanthamoeba polyphaga were
      analyzed by enzyme-linked immunosorbent assay, indirect immunofluorescence
      microscopy, and fluorescence flow cytometry to assess specificity and cross
      reactivity with axenically cultured N. fowleri and Acanthamoeba spp. Four
      monoclonal antibodies to N. fowleri were specific for N. fowleri and had no
      reactivity to A. polyphaga. Similarly, four monoclonal antibodies to A. polyphaga
      did not react with N. fowleri. Two of the four monoclonal antibodies to A.
      polyphaga did not react with other Acanthamoeba spp. tested, while two of the
      antibodies demonstrated a high degree of cross-reactivity with a putative
      Acanthamoeba castellanii strain by immunofluorescence microscopy; this was
      confirmed by fluorescence flow cytometry for one of the antibodies. These
      monoclonal antibodies were used to identify Acanthamoeba trophozoites in infected
      brain sections of a patient who died of suspected Acanthamoeba-caused
      granulomatous amoebic encephalitis, demonstrating potential utility in the direct
      identification of N. fowleri and Acanthamoeba spp. in clinical specimens.

PMID- 2229385
TI  - Application of a rapid microplaque assay for determination of human
      immunodeficiency virus neutralizing antibody titers.
AB  - To perform a human immunodeficiency virus (HIV) plaque assay in nonadherent host
      cells, we developed a novel technique in which HIV-infected MT-2 cells were
      formed into monolayers by centrifugation through molten agarose. Infection,
      formation of cell monolayers, and enumeration of plaques all took place in 96
      well microtiter plates. When this process was preceded by 18 h of incubation of
      HIV with patient serum samples, neutralizing antibody titers between 1:10 and
      1:5,000 could be accurately determined in patient serum samples. In addition to
      the determination of neutralizing antibody titers (with the use of various serum
      dilutions and a constant virus concentration), neutralization indices could also
      be determined with different virus dilutions and a single dilution of patient
      serum.

PMID- 2229386
TI  - Reservoir of four organisms associated with bacterial vaginosis suggests lack of
      sexual transmission.
AB  - This study consisted of a search for the possible reservoir and mode of spread of
      the four bacterial vaginosis-associated organisms Mobiluncus mulieris, Mobiluncus
      curtisii, Mycoplasma hominis, and Gardnerella vaginalis. Their occurrence in
      rectal, oral, and pharyngeal specimens from women with and without bacterial
      vaginosis, their male sexual consorts, four homosexual men, and children
      (altogether, 374 people) was studied. Genital samples were also obtained from all
      adults. All four organisms were isolated from the rectums of 45 to 62% of women
      with bacterial vaginosis and 10 to 14% of women without bacterial vaginosis. They
      also occurred in the rectums of males and children. M. hominis was recovered from
      the oropharynxes of 12 adults whose sexual consorts had genital occurrences of
      the organism. Mobiluncus spp. occurred only in the vaginas of women with
      bacterial vaginosis (97%). The organisms were only infrequently recovered from
      genital samples from 135 males. Organisms were recovered from the urethras and/or
      coronal sulci of 10 of 44 male consorts of women with bacterial vaginosis.
      However, after 2 weeks of condom use during sexual intercourse, only M. hominis
      remained in the urethra of one man. These findings suggest that the organisms
      associated with bacterial vaginosis are not spread sexually but colonize the
      vagina from an endogenous intestinal tract site. The pathophysiological
      mechanisms leading to bacterial vaginosis in a subpopulation of all women are
      still unknown.

PMID- 2229388
TI  - Vancomycin resistance in Staphylococcus haemolyticus causing colonization and
      bloodstream infection.
AB  - The increase in the incidence of infections due to beta-lactam-resistant
      coagulase-negative staphylococci has resulted in expanded use of vancomycin for
      such infections. Despite this, coagulase-negative staphylococci have remained
      susceptible to vancomycin in recent years. This report describes a strain of
      Staphylococcus haemolyticus with increased resistance to vancomycin (MIC, 8.0 to
      16 micrograms/ml). S. haemolyticus was initially isolated from a patient with
      acute leukemia and neutropenia in surveillance throat and stool cultures. The
      microdilution vancomycin MICs for these isolates were 1.0 to 2.0 micrograms/ml.
      Subsequent S. haemolyticus isolates from the bloodstream and tracheal aspirate
      occurred in the setting of prolonged empirical vancomycin therapy. MICs for these
      isolates were 8.0 to 16 micrograms/ml. Further vancomycin resistance (MIC, 32
      micrograms/ml) could be selected for in vitro in all four isolates. Restriction
      endonuclease analysis of plasmid DNA indicated that the isolates were very
      closely related and likely to be of the same strain. We conclude that
      colonization with a vancomycin-susceptible strain of S. haemolyticus was
      subsequently linked to a nosocomial bloodstream infection with an apparently
      identical strain with intermediate levels of vancomycin resistance. Prolonged
      empirical vancomycin therapy was temporally associated with this episode.

PMID- 2229387
TI  - Detection of Aspergillus antigens associated with invasive infection.
AB  - Serial urine samples were collected from 33 neutropenic patients, 10 of whom
      developed invasive aspergillosis (IA) while undergoing bone marrow
      transplantation or remission induction therapy for leukemia. Concentrated urine
      samples from the infected patients were subjected to polyacrylamide gel
      electrophoresis, blotted, and then incubated with antiserum raised to a cell wall
      extract of Aspergillus fumigatus (anti-CW) or an immunoglobulin G monoclonal
      antibody to A. fumigatus galactomannan (EBA1). When IA patient urine blots were
      probed with anti-CW, major bands at 11 and 18 kilodaltons (kDa); intermediate
      bands at 13, 14, and 29 kDa; and minor bands at 38 and 44 kDa were seen. In
      contrast, EBA1 showed diffuse staining at molecular masses larger than 45 kDa and
      a single weak band at 21 kDa. Urine samples from the 23 patients with no evidence
      of IA were unreactive with both anti-CW and EBA1. These antigen bands are likely
      to represent immunodominant antigens which are excreted during IA and should play
      a valuable role in the development of rapid diagnostic tests for aspergillosis.

PMID- 2229389
TI  - DNA probes for the identification of Nocardia asteroides.
AB  - DNA probes for the rapid identification of Nocardia asteroides were obtained by
      constructing a genomic library of strain GUH-2 in the lambda cloning vector
      EMBL3. Of 50 recombinant clones tested, 2 were identified that hybridized with
      31% of the N. asteroides strains in a reference collection without cross
      hybridization with related members of the Actinomycetales. Additional libraries
      were then generated from selected strains of N. asteroides that had failed to
      hybridize with any of the GUH-2 clones. Four additional clones were obtained from
      these strains which, when pooled, provided DNA probes specific for all of the N.
      asteroides strains tested.

PMID- 2229390
TI  - High-performance liquid chromatography patterns of mycolic acids as criteria for
      identification of Mycobacterium chelonae, Mycobacterium fortuitum, and
      Mycobacterium smegmatis.
AB  - Rapidly growing mycobacteria of clinical significance were identified by mycolic
      acids detected with high-performance liquid chromatography. Mycolic acids from
      whole cells were extracted, derivatized, and detected by a modified high
      performance liquid chromatography procedure in less than 3 h. Use of an internal
      standard allowed differentiation of Mycobacterium chelonae and Mycobacterium
      fortuitum by comparison of relative retention times. Peak height ratios were used
      for subidentification of M. chelonae strains; however, M. fortuitum and
      Mycobacterium smegmatis could not be separated by this system.

PMID- 2229391
TI  - Arylsulfatase activity for differentiating Mycobacterium avium and Mycobacterium
      intracellulare.
AB  - Arylsulfatase activities (96-h reaction) of various strains of Mycobacterium
      avium and M. intracellulare, as identified by a DNA probe test, were measured.
      The enzyme activities of M. avium strains were significantly lower [corrected]
      than those of M. intracellulare strains (P less than 0.005 to P less than 0.025).
      The enzyme activities did not vary with serovar; that is, the activities of
      serovars 1, 2, 8, and 9 (belonging to M. avium) were similar to each other, as
      were the activities of serovars 7, 12, 13, 14, and 16 (belonging to M.
      intracellulare). The results indicate the usefulness of the arylsulfatase test in
      distinguishing M. avium from M. intracellulare in an accurate manner.

PMID- 2229393
TI  - Bacillus species pseudobacteremia traced to contaminated gloves used in
      collection of blood from patients with acquired immunodeficiency syndrome.
AB  - Ten nonpathogenic Bacillus isolates were obtained from blood cultures collected
      over a 2-year period. Eight of these isolates were from patient with acquired
      immunodeficiency syndrome, and seven were recovered from blood cultures obtained
      in outpatient clinics. Five cases occurred during a 5-month period. These five
      cases were clinically evaluated, and the Bacillus isolates were characterized.
      The same Bacillus species was isolated from nonsterile gloves from the same lot
      worn by phlebotomists for blood collection in the outpatient clinics during this
      period, implicating the gloves as the cause of this pseudoepidemic. Awareness of
      the nonsterile nature of gloves used by laboratory personnel should be considered
      in the evaluation of Bacillus spp. in blood cultures.

PMID- 2229392
TI  - Immunoprecipitation of human immunodeficiency virus type 2 glycoproteins by sera
      positive for human immunodeficiency virus type 1.
AB  - Analysis by radioimmunoprecipitation of serum samples from 27 different human
      immunodeficiency virus type 1 (HIV-1)-infected individuals residing in Chile
      showed that the sera of 26% of these individuals also react with glycoprotein
      gp125 of HIV type 2 (HIV-2). This cross-reaction seems to reflect a qualitative
      difference among infected individuals, because the titer of antibodies against
      gp120 of HIV-1 in the cross-reacting samples did not differ significantly from
      that in the non-cross-reacting samples. Most of the HIV-1-seropositive sera,
      including many that did not react with gp125 of HIV-2, reacted with gp140, the
      precursor of HIV-2 glycoproteins. The observed cross-reactions allowed us to
      distinguish three groups of HIV-1-infected individuals: (i) those whose sera
      react with both gp140 and gp125, (ii) those whose sera react with gp140, and
      (iii) those whose sera react with neither of these glycoproteins. The possible
      cause and significance of these differences is under study.

PMID- 2229394
TI  - Use of modified norleucine-tyrosine broth in identification of Peptostreptococcus
      anaerobius.
AB  - Gas-liquid chromatography was employed to analyze the volatile and nonvolatile
      acids produced in modified norleucine-tyrosine (MNT) broth by various gram
      positive cocci. The MNT broth consists of 0.5% Trypticase (BBL Microbiology
      Systems, Cockeysville, Md.), 0.5% yeast extract (Difco Laboratories, Detroit,
      Mich.), 0.2% L-norleucine, and 0.1% L-tyrosine. The microorganisms included
      reference strains and clinical isolates of Peptostreptococcus spp. (P.
      anaerobius, P. asaccharolyticus, P. indolicus, P. magnus, and P. prevotii),
      Staphylococcus spp. (S. aureus, S. epidermidis, and S. saccharolyticus), and
      Streptococcus spp. (S. agalactiae, S. intermedius, S. mutans, S. sanguis I, and
      S. sanguis II). Only Peptostreptococcus anaerobius strains produced caproic and
      valeric acids in MNT broth cultures. All 11 P. anaerobius strains produced
      valeric acid in MNT broth, and only 1 strain failed to produce caproic acid in
      the medium. This unique feature aids in rapid, reliable identification of P.
      anaerobius with a minimum number of tests.

PMID- 2229395
TI  - Comparison of alkaline phosphatase-conjugated oligonucleotide DNA probe with the
      Sereny test for identification of Shigella strains.
AB  - We compared an alkaline phosphatase-conjugated oligonucleotide DNA probe with the
      Sereny test to determine the sensitivity and specificity of the probe in
      detecting virulent Shigella strains. The probe hybridized with all 52 Sereny-test
      positive strains (sensitivity, 100%) and 4 of 21 Sereny-test-negative strains
      (specificity, 81%). The probe did not hybridize with any of the Sereny-test
      negative S. dysenteriae type 1 strains. This nonradioactive, synthetic probe
      provides a simple, rapid way to test a large number of strains simultaneously in
      a field setting, which will contribute to an improved understanding of the
      epidemiologic patterns of shigellosis in developing countries.

PMID- 2229396
TI  - Meningitis in a neonate caused by Leuconostoc sp.
AB  - A case of meningitis in a neonate caused by vancomycin-resistant Leuconostoc
      mesenteroides is presented. This case was complicated by severe ventriculitis and
      was ultimately fatal. Infection with Leuconostoc spp. is rare but should be
      suspected when vancomycin-resistant organisms resembling streptococci are
      isolated. Previous reports of this infection are reviewed.

PMID- 2229397
TI  - Aerotolerant Clostridium tertium brain abscess following a lawn dart injury.
AB  - A young girl developed an intracranial abscess and necrotizing cellulitis
      following penetrating injury from a lawn dart. Initial identification of a gram
      positive rod growing aerobically from clinical specimens was as a Bacillus
      organism, but the observation that the isolate grew poorly in subcultures for
      susceptibility testing but quite well under standard anaerobic culture techniques
      led to the identification of the organism as an aerotolerant Clostridium tertium.
      Early management of penetrating head trauma should include cranial imaging
      studies to detect fractures and intracranial pathology. Clinical microbiologists
      and clinicians should be aware of the phenomenon of aerotolerance in anaerobic
      bacteria to avoid errors in choice of antibiotic therapy.

PMID- 2229398
TI  - Quantitation of human immunodeficiency virus DNA by using the polymerase chain
      reaction.
AB  - The polymerase chain reaction was used to measure the DNA copy number of human
      immunodeficiency virus (HIV). Differences in polymerase chain reaction
      amplification efficiency were controlled by amplifying known amounts of HIV DNA
      in parallel with samples. This technique is a sensitive, accurate, and
      reproducible method for the quantitation of HIV DNA.

PMID- 2229399
TI  - Western immunoblot and flagellum enzyme-linked immunosorbent assay for
      serodiagnosis of Lyme borreliosis.
AB  - Western immunoblot with a whole-cell lysate was compared with an enzyme-linked
      immunosorbent assay with a purified flagellum antigen of Borrelia burgdorferi for
      serodiagnosis of Lyme borreliosis. The assays showed similar sensitivities and
      specificities in detecting immunoglobulin M and/or immunoglobulin G antibodies in
      sera from 68 patients with neuroborreliosis and 44 controls with meningitis and
      encephalitis or with multiple sclerosis. Flagellum enzyme-linked immunosorbent
      assay is more easily standardized and seems to be a more suitable diagnostic test
      in a routine laboratory.

PMID- 2229400
TI  - Burn wound zygomycosis caused by Apophysomyces elegans.
AB  - A case of zygomycosis caused by Apophysomyces elegans in a patient having 25%
      full-thickness burns is described. Amputation of the leg was necessary to control
      rapid tissue invasion. The fungus was isolated from soil in the burn environment.

PMID- 2229401
TI  - Evaluation of monoclonal antibody F9-4 as immunological probe for Leptospira
      interrogans.
AB  - I assayed the lack of reactivity of monoclonal antibody (MAb) F9-4 with
      nonpathogenic leptospires. Of 47 saprophytic strains tested, 46 did not react in
      an enzyme immunoassay and 1 was recognized by MAb F9-4, as usually reported with
      pathogenic Leptospira strains. On the other hand, the MAb did not react with one
      pathogenic strain, thus showing that the ability of MAb F9-4 to discriminate
      between pathogenic and nonpathogenic leptospires is not absolute.

PMID- 2229402
TI  - Evaluation of different techniques for detection of virulence in Yersinia
      enterocolitica.

PMID- 2229403
TI  - Increased proliferation of blood mononuclear cells after plasmapheresis treatment
      of patients with demyelinating disease.
AB  - Induction of lymphocytic proliferation has been postulated to be a mechanism
      whereby plasmapheresis may enhance the action of cytotoxic immunosuppressive
      drugs. This study found increased spontaneous proliferation of peripheral blood
      mononuclear cells following intensive plasmapheresis treatment of patients with
      multiple sclerosis (MS) or Guillain-Barre syndrome (GBS). The increased
      proliferative response was reduced below baseline in four of six MS patients who
      received subsequent immunoglobulin intravenous (IGIV) and pulsed cyclophosphamide
      therapy, but not in three MS patients receiving IGIV alone. In five GBS patients
      with low baseline proliferation, proliferation also increased after
      plasmapheresis. High baseline proliferation found in three GBS patients may have
      reflected antecedent infection, since it fell during plasmapheresis in the two
      patients in whom it was measured. Plasmapheresis could possibly augment the
      effectiveness of cytotoxic drugs in controlling autoimmunity by inducing
      lymphocytes to proliferate, thereby making them more susceptible to drug action.

PMID- 2229404
TI  - Immunoglobulin binding to neuronal cell surface epitopes in murine systemic lupus
      erythematosus.
AB  - Screening serum by enzyme-linked immunosorbent assay (ELISA) to paraformaldehyde
      fixed neuroblastoma cells revealed spontaneous neuron-reactive antibodies in
      three strains of autoimmune mice not present in comparable studies of BALB/c
      mice. Immunoglobulin isolation from pooled sera by either ammonium sulfate
      precipitation or passage over a protein G column enabled quantitative binding by
      (1) ELISA to neuroblastoma cells and (2) Western blots of plasma membrane
      preparations of brain cortex and neuroblastoma cells. The antibodies recognized
      proteins of apparent molecular weights 101,000, 68,000, 63,000, 57,000, 53,000,
      43,000, 39,000, and 31,000 Da on the brain cortex and 63,000, 57,000, and 43,000
      Da on the neuroblastoma cell membranes. The class of antibody binding was
      predominantly IgG in the MRL/lpr and IgM in the NZB/W. Differences between
      MRL/lpr, NZB/W and BXSB mice were observed although it is not yet apparent if
      this represents a difference in autoantibody production between the strains.

PMID- 2229405
TI  - Effects of colony stimulating factors on isolated microglia in vitro.
AB  - Effects of colony stimulating factors (CSF), known regulators for cells in
      monocytic lineage, on isolated microglia were examined. Interleukin-3 (IL-3)
      induced only morphological changes in rod-shaped microglia, while granulocyte
      macrophage CSF (GM-CSF) and CSF-1 induced both morphological changes and
      proliferation of microglia. CSF-1 also activated the enzyme activity of
      microglia. These observations indicated that, in terms of regulation by
      cytokines, microglia are similar to mature cells in monocytic lineage. Although
      astrocytes reportedly produce IL-3 and GM-CSF, the effects of astrocyte
      conditioned medium (Ast-Sup) were different from those of either IL-3 or GM-CSF.
      Ast-Sup caused ameboid microglia to become ramified, and did not induce
      proliferation of microglia. Factors from astrocytes may have a role in the
      transformation of microglia which occurs in either normal developing brain or
      inflammation in the brain.

PMID- 2229406
TI  - Discontinuous distribution of IgG oligoclonal bands in cerebrospinal fluid from
      multiple sclerosis patients.
AB  - To test the effect of sampling on the detection of immunoglobulin (Ig)
      cerebrospinal fluid (CSF) abnormalities, we analyzed the first and last 1 ml
      fraction of 10 ml obtained during a single CSF removal from 27 multiple sclerosis
      (MS) patients and six patients with other neurological diseases. IgG index,
      hyperbolic function, and IgG synthesis rate decreased between the first and the
      last CSF aliquot. Discordant results were found in 4/27 (15%) MS patients. In
      2/27 (7.5%) clinically definite MS patients, the number of CSF oligoclonal bands
      (OCB) decreased between the first and the last fraction. In one of the two
      patients, the three OCB visualized in the first fraction were not found in the
      last. We conclude that fractionated sampling may partially account for the
      absence of OCB in the CSF of some definite MS patients.

PMID- 2229407
TI  - Astrocyte-conditioned medium stimulates HIV-1 expression in a chronically
      infected promonocyte clone.
AB  - Human promonocytic cells chronically infected with human immunodeficiency virus-1
      (HIV-1) (clone U1.1.5) were grown in the presence of media conditioned by primary
      rat cortical astrocytes and HIV-1 expression was assessed by measuring reverse
      transcriptase activity. Media conditioned by non-stimulated and
      lipopolysaccharide (LPS)-stimulated astrocytes induced the expression of HIV-1
      2.1-fold and 4.1-fold, respectively. LPS alone, media conditioned by the
      uninfected parental cell line of U1.1.5 (U937), and culture media from four other
      cell lines, had no effect on viral expression. The magnitude of induction was
      time- and dose-dependent. Tumor necrosis factor alpha (TNF-alpha) was detected in
      LPS-stimulated astrocyte-conditioned medium and the HIV-inducing capability of
      the medium was neutralized, in part, by an antibody to recombinant murine TNF
      alpha. These results suggest a role for astrocytes in the induction of HIV
      expression and thus in the pathogenesis of HIV-1 infection in brain.

PMID- 2229408
TI  - Identification of IgE-positive cells and mast cells in frozen sections of
      multiple sclerosis brains.
AB  - There is evidence that nervous system mast cells may be involved in the
      pathogenesis of experimental demyelinating diseases, and that their involvement
      may be mediated by IgE. In order to examine the possible relevance of these
      observations to human demyelinating diseases, we have histologically and
      immunocytochemically examined multiple sclerosis (MS) and control brains for the
      presence of mast cells and IgE. Using a highly specific antiserum, we found IgE
      positive cells in MS brains, but not in controls. IgE-positive cells could be
      detected in all regions of MS lesions, but were far more frequent in areas of
      active infiltration. Immunopositive staining was only observed when sections were
      pretreated with a methanolic peroxide solution, suggesting that the IgE was
      cytoplasmic. Positive cells typically exhibited plasma cell morphology. Mast
      cells were identified using chloroacetate esterase (CAE) staining, and we were
      able to confirm previous reports of an increased association of mast cells with
      MS lesions. Mast cells were seen in 7/14 MS brains compared with 1/8 controls.
      They were most commonly observed in demyelinated areas, but were also seen in
      association with infiltrate. Mast cells and IgE-positive cells were also observed
      in areas of perivascular infiltration in other inflammatory central nervous
      system diseases (subacute sclerosing panencephalitis, herpes encephalitis). Mast
      cells may represent a route for infiltrating cells to enter the brain in
      inflammatory disorders.

PMID- 2229409
TI  - Elevation of tumor necrosis factor in head injury.
AB  - Tumor necrosis factor (TNF) is a cytokine which mediates protein wasting in
      pathological states by promoting the catabolism of visceral tissues and skeletal
      muscle. The role that TNF plays in nitrogen wasting following head injury was
      studied by measuring TNF in the serum of 21 patients with severe head injury.
      Parallel measurements of TNF and urinary nitrogen excretion were performed on
      days 1, 3, and 5 after head injury. TNF values after head injury ranged from 65
      pg/ml to 7500 pg/ml, with a mean of 1147 pg/ml, compared to control values of
      serum TNF of less than 38 pg/ml. The mean daily urinary nitrogen loss was 13
      g/day with a range of 2.8 to 27.6 g/day, and the mean nitrogen balance was -5.8 g
      with a range of +4.6 to -19.1 g. While both serum TNF levels and nitrogen loss
      were increased after head injury, the elevation of TNF did not correlate strongly
      with nitrogen wasting.

PMID- 2229410
TI  - Brain specific autoantibodies in murine models of systemic lupus erythematosus.
AB  - Autoantibodies which bind to integral membrane proteins of brain were tested for
      their ability to bind to cross-reactive antigens on non-neural tissue. Both brain
      specific autoantibodies and antibodies which bind to cross-reactive antigens were
      found. There were two types of brain reactive autoantibodies which could not be
      adsorbed by non-neural tissue. One type was adsorbable by crude cell membrane
      preparations of brain. The second type was reactive against integral membrane
      proteins of brain, but not adsorbable by any of the crude membrane preparations
      tested. Autoantibodies of the first type reacted against integral membrane
      proteins with apparent molecular weights of 75, 70, 62, 50, 27, 24 and 20 kDa, as
      determined by gel electrophoresis and immunoblotting. As in previous studies, a
      diversity of brain reactive autoantibodies were found. The greatest numbers and
      strongest banding patterns were seen in the autoimmune strains of mice. The non
      autoimmune strain displayed these autoantibodies at much lower levels. These
      results are the first to find brain specific autoantibodies, from autoimmune
      mice, against integral brain membrane antigens. The data support the idea that
      there is a sub-population of brain reactive autoantibodies which are involved in
      the pathogenesis of neuropsychiatric manifestations in immunologic disorders,
      particularly systemic lupus erythematosus.

PMID- 2229411
TI  - Human astrocytes proliferate in response to tumor necrosis factor alpha.
AB  - Two different human astrocytic cell lines derived from adult epilepsy surgical
      specimens were exposed in vitro to concentrations of 1-100 ng/ml recombinant
      tumor necrosis factor alpha (TNF alpha). Results indicated dose-dependent
      stimulation of DNA synthesis and proliferation. Both of these effects were
      abrogated by treatment with monoclonal antibody specific for TNF alpha but not by
      irrelevant murine IgG. Immunocytochemical characterization of TNF alpha-treated
      and control cultures indicated that greater than 98% of proliferating cells
      contained cytoplasmic glial fibrillary acidic protein (GFAP), and were therefore
      astrocytic in nature. These studies demonstrate that growth of adult human non
      neoplastic astrocytes is stimulated by TNF alpha, an inflammatory cytokine
      produced primarily by macrophages but also by astrocytes.

PMID- 2229412
TI  - The health impact of "low intensity conflict".

PMID- 2229413
TI  - The future of public health: a survey of the states.
AB  - A survey of state health agencies was conducted to determine agreement and
      disagreement of state health officers with the recommendations contained in The
      Future of Public Health issued by the Institute of Medicine in 1988. The survey
      also measured the extent to which the IOM recommendations were judged currently
      in place or in the process of being implemented in the states. The survey showed
      almost unanimous consensus among the nation's state health officers for the vast
      majority of the recommendations. There was less consensus concerning the
      appropriateness of locating substance abuse, Medicaid, mental health, and
      regulation of health professions within state departments of health. However, a
      significant proportion of health officers favored a health agency location for
      these responsibilities (72%, 52%, 48%, and 38% respectively).

PMID- 2229414
TI  - A separate department of health in Washington State: four years before the mast.
AB  - This paper reviews the recent experience in Washington State which resulted in
      creation of a separate state Department of Health. Until the 1989 legislation was
      passed, Washington was one of 19 states in which public health was
      organizationally housed in a superagency. The Institute of Medicine, in its 1988
      report on The Future of Public Health, recommended that states organize core
      functions under a separate department of health. The effort in Washington State
      was led by local public health officials. Success followed four years of hard
      work during which mistakes were made, coalitions were built, and legislative
      process was learned.

PMID- 2229415
TI  - Non-participative policy development: the genesis of A New Perspective on the
      Health of Canadians.

PMID- 2229416
TI  - Citizen participation in rural health: a promising resource.
AB  - The role of consumers in rural health care is explored in this review of the
      literature. A brief history of public, private, and grassroots efforts to involve
      consumers in health care is presented. A more in-depth analysis of two primary
      areas where consumers can be useful resources for addressing rural health care
      problems--personnel shortages and improving community acceptance of health care
      innovations--is discussed. Emergency medical services, care for medically
      disabled persons, and prenatal care are specifically addressed. Barriers to
      effective citizen participation and policy recommendations are also presented.

PMID- 2229417
TI  - Risk communication about environmental hazards.
AB  - The development of the new field of risk communication of environmental hazards
      is briefly described and the term "risk communication" is defined. This is
      followed by a description of the eight basic steps in risk communication about
      environmental hazards including: 1) assessing the risk; 2) setting goals; 3)
      assessing the target audiences; 4) assessing the socio-cultural context; 5)
      choosing the approach; 6) constructing the communications; 7) implementing the
      risk program; and 8) evaluating the effects. In describing each step, relevant
      literature concerning risk communication is reviewed.

PMID- 2229418
TI  - Karl Evang: a giant in public health.
AB  - Karl Evang (1902-1981) was one of the leading figures in public health in the
      post-World War II era. His first contributions were in social epidemiology in the
      1920s-30s, and his studies on sexually transmitted diseases, nutrition and
      health, and occupation and health, were seminal. He was instrumental in framing
      the constitutions of two key U.N. agencies, the Food and Agricultural
      Organization and the World Health Organization, and he helped shape the WHO
      definition of health. Following the war, as Norway's Director General of Health,
      he helped create one of the preeminent humanitarian democracies and its welfare
      state. He and his generation of public health workers were so effective because
      of ties to the dominant labor parties, the need for government intervention as a
      result of the Great Depression and the Second World War, and the humanistic
      reaction to the Nazi horrors. At the same time, their excessive emphasis on
      medical care, and the role of the physician in health policy, resulted in the
      great medical costs of today. Those who believe in activist government and the
      goal of equality in health status owe an enormous debt to Evang and his
      generation.

PMID- 2229419
TI  - Testimony on alcohol advertising. U.S. House of Representatives Subcommittee on
      Transportation and Hazardous Materials, March 1, 1990.

PMID- 2229421
TI  - Direct enzyme-linked immunosorbent assay of anti-peptide antibodies using capture
      of biotinylated peptides by immobilized avidin.
AB  - Synthetic peptides were prepared by a solid-phase method and biotinylated
      selectively and in high yield at the amino terminus prior to peptide deprotection
      and detachment from synthesis resin. It was shown that peptides biotinylated in
      this manner could be bound by avidin immobilized on a plastic surface and used to
      detect anti-peptide antibodies in an enzyme-linked immunosorbent assay. The
      advantages of this method compared to conventional immunoassay techniques for
      anti-peptide antibodies are discussed.

PMID- 2229420
TI  - Validation in rat plasma of a direct radioimmunoassay for a luteinizing hormone
      releasing hormone antagonist (BIM 21009)
AB  - Rabbits were immunized with [Ac-D-beta-Nal1-, D-p-Cl-Phe2, D-Phe3, D-Arg6, Phe7,
      D-Ala10]LHRH (BIM 21009) coupled to bovine serum albumin using bis-diazotized
      benzidine. The best antiserum had an affinity of 5. 10(-10) M and a specificity
      directed against the C-terminal part of the molecule. The antiserum was not
      affected by native LHRH but reacted to some extent with detergents. Assay of free
      peptide plasma after gel filtration on Ultrogel AcA 34 showed apparent
      immunoreactivity associated with albumin and lipoproteins. The sensitivity of
      direct assay was 0.4 ng/ml. Measurements of BIM 21009 after s.c. injection in
      rats showed the resistance of the peptide to elimination. The specificity of the
      determinations in plasma were checked by High Performance Liquid Chromatography.

PMID- 2229422
TI  - Radioimmunoassay for albuterol using a monoclonal antibody: application for
      direct quantification in horse urine.
AB  - A monoclonal antibody was synthesized in mouse against the O-(3-carboxypropionyl)
      derivative of albuterol linked to bovine serum albumin. Isotyping of this
      material revealed the IgG1 class characterized by an affinity constant of 1.03 nM
      1 and a density of sites of 0.55 nM. This antibody was found specific as its
      cross-reactivity to structurally related molecules was less than 1% except for
      clenbuterol (75%). A radioimmunoassay was set up with culture supernatant (final
      dilution 1/1000) and [3H] albuterol. The calibration curve was characterized by a
      maximum binding of 28%, an ED50 of 1.15 pmol per tube, the detection limit was
      28.8 fmol/tube and the linearity of the response was up to 39.8 pmol/tube. This
      RIA method has been used for direct quantitation of albuterol in horse urine
      without any clean-up or extraction step.

PMID- 2229423
TI  - Enzyme immunoassay for pigeon breeders' disease without the use of extraneous
      antibody.
AB  - A rapid enzyme immunoassay technique is described for the detection in human sera
      of antibodies of any class to pigeon antigens. The method is based on binding
      human antibodies in excess to polystyrene-fixed antigens from pigeon droppings or
      pigeon serum, followed by capture of the same antigens coupled to peroxidase. A
      very good correlation was found of titers obtained by means of this 60-min assay
      with traditional sandwich immunoassay and with precipitation- and complement -
      fixation tests.

PMID- 2229424
TI  - A radioimmunoassay of bile acids.
AB  - A radioimmunoassay for beta-muricholic acid was developed using an antiserum
      which was prepared by injecting beta-muricholic acid conjugated with bovine serum
      albumin into rabbits. The antiserum reacted with glyco-beta-muricholic, tauro
      beta-muricholic and beta-muricholic acids, but not with other bile acids. The
      radioimmunoassay showed good reproducibility with inter- and intra-assay
      coefficients of variations of 6% to 15%. When the validity of the method was
      examined by comparing it with a gas-liquid chromatography method, a linear
      correlation was obtained.

PMID- 2229425
TI  - Simultaneous immunoenzymometric assay for antibodies against human interleukin-2
      and human serum albumin in rat serum.
AB  - A simultaneous immunoenzymometric assay for anti-human interleukin-2 antibody and
      anti-human serum albumin antibody in rat serum was developed. Two antigen
      immobilized polystyrene balls were immersed in a diluted serum sample in an assay
      tube and then the antibodies on the balls were made to react with a horseradish
      peroxidase labelled anti-rat IgG antibody in the same tube after washing. The
      enzyme activity of each ball was measured by fluorometry. Not only were the
      sensitivity (70 ng/ml each), assay recovery (100-101%), and precision (C.V. = 5
      13%) comparable to those of conventional immunoenzymometric assays using one
      antigen-immobilized ball but the assay was also much more feasible for mass
      routine assays. Thus, conventional immunoassays can be replaced by this
      convenient simultaneous method.

PMID- 2229426
TI  - ACP Broadsheet No 126: October 1990. Examination of specimens of the larynx.

PMID- 2229427
TI  - Pathology across Europe: differences and similarities. 3. Histopathology.

PMID- 2229428
TI  - Application of 1 nm gold probes on paraffin wax sections for in situ
      hybridisation histochemistry.
AB  - An in situ hybridisation technique that uses 1 nm immunogold reagents and silver
      enhancement was devised to detect biotinylated DNA viral probes in formalin
      fixed, paraffin wax sections of human cervix. DNA probes labelled with biotin-11
      deoxyuridine triphosphate were detected after hybridisation to nucleic acid
      sequences by an antibiotin antibody, followed by a gold labelled secondary
      antibody. Silver enhancement then permitted visualisation of the signal at the
      light microscopic level. The method was reliable and produced less background
      staining than previously described methods. The signal could be enhanced by epi
      polarisation microscopy. Furthermore, biotinylated DNA probes may be detected
      directly by a 1 nm gold labelled goat antibiotin antibody without loss of
      labelling intensity, and this may be preferable to the longer two layer
      technique, previously described.

PMID- 2229429
TI  - Use of immunoelectron microscopy to show Ebola virus during the 1989 United
      States epizootic.
AB  - A filovirus, serologically related to Ebola virus, was detected by "post
      embedment" immunoelectron microscopical examination of MA-104 cells. These had
      been infected by inoculation with serum samples obtained during the 1989
      epizootic in cynomolgus monkeys (Macaca fascicularis), imported from the
      Philippines and maintained at Reston, Virginia, USA, a primate holding facility.
      The immunoelectron microscopy method, when used in conjunction with standard
      transmission electron microscopy (TEM) of infected cells, provided consistent
      results and was simple to perform in this epizootic. It is concluded that
      immunoelectron microscopy is potentially useful in the direct immunological
      diagnosis of Ebola and related filoviral infections (such as Marburg) in clinical
      samples obtained from those with acute infection.

PMID- 2229430
TI  - Adenomyosis in Pakistani women: four year experience at the Aga Khan University
      Medical Centre, Karachi.
AB  - As part of a quality assurance programme at the Aga Khan University Medical
      Centre, Karachi, Pakistan, all hysterectomy specimens were reviewed from January
      1986 to December 1989. Adenomyosis was found in 237 of the 419 (56.5%) specimens
      studied. Of these 237 patients, 232 (97.9%) were parous and 196 (82.8%) were in
      the fourth and fifth decades of life. This high prevalence in parous women aged
      40-59 years was significant. Fibroids, cervicitis, and endometrial hyperplasia
      were the most common associated diagnoses. Of all the associations studied, only
      endometrial hyperplasia was significantly more prevalent in the group with
      adenomyosis. Adenomyosis was stated as an indication for surgery in 69 patients
      and was confirmed by histopathology in 49 (71%). Preoperative suspicion of
      adenomyosis was present in 49 (20.6%) patients of all those ultimately found to
      have the disease. There is a high prevalence of adenomyosis in the population
      studied, which indicates that the condition may have been underdiagnosed in the
      past, especially as it is difficult to diagnose without surgery and hysterectomy
      is currently the only treatment.

PMID- 2229432
TI  - Computer assisted selection and assessment of antibodies in the diagnosis of
      lymphomas.
AB  - With increasing numbers of reagents the problem of selecting appropriate
      antibodies to solve problems in the diagnosis of lymphoma is becoming more
      complex. One approach is to use a computer program to optimise the selection
      process. Such a program was devised, incorporating data from an extensive
      literature search. When presented with a differential diagnosis it selects the
      most appropriate antibody panel and when given the results evaluates the relative
      likelihood of each possible diagnosis. In a retrospective study 81% of the tests
      used had been non-discriminatory, but using the results of the remaining 19% of
      the tests, the computer was able to select the "correct" diagnosis with a high
      degree of certainty. The development and use of this system illustrated several
      problems in the application of computer assisted diagnostic techniques in
      histopathology. These problems include incomplete data and lack of understanding
      of the process of histopathological diagnosis.

PMID- 2229431
TI  - Tissue preparation for simultaneous flow cytometric quantitation of tumour
      associated antigens and DNA in solid tumours.
AB  - A multiparameter flow cytometric assay for the simultaneous study of tumour
      associated antigens (TAA) and DNA in fresh solid tumours was devised. Cell
      suspensions were prepared by disaggregating unfixed solid tumour samples
      mechanically over a stainless steel mesh. Indirect immunofluorescence was used to
      identify the TAA, and DNA was stained with propidium iodide. Cell morphology was
      well preserved, cell clumping was negligible, and high quality indirect
      immunofluorescence quality indirect immunofluorescence and DNA staining were
      obtained. The technique is simple, rapid, and reproducible. Multiparameter assays
      can be developed to study prognostic indicators such as membrane oncoproteins,
      receptors, and multidrug resistance in solid tumours. With a suitable panel of
      antibodies the technique might become an aid in the differential diagnosis and
      biochemical diagnosis of some solid tumours.

PMID- 2229433
TI  - Immunocytochemical analysis of lymph node aspirates in patients with human
      immunodeficiency virus infection.
AB  - Thirty four patients positive for human immunodeficiency virus (HIV) who had
      lymphadenopathy were investigated using fine needle aspiration. Cytological
      analysis included immunocytochemical investigation with the alkaline phosphatase
      antialkaline phosphatase (APAAP) method. All patients had confirmation of
      cytological diagnosis by lymph node biopsy. Fifteen aspirates with follicular
      hyperplasia were evaluated. Eleven patients showed B cell predominance. The B
      cell population did not show light chain restriction. Ten patients with B cell
      non-Hodgkin's lymphoma (five with Burkitt's lymphoma and five with B cell
      immunoblastic lymphoma) were investigated. Nine out of 10 cases were monoclonal
      with respect to their light chain determinants; only one case with Burkitt's
      lymphoma with partial lymph node metastasis did not show light chain restriction.
      The cytological diagnosis included two mycobacterial infections and four cystic
      lesions. Histological investigation was necessary to diagnose the extent of lymph
      node disease caused by Kaposi's sarcoma. These findings indicate that the
      immunocytological investigation of lymph node aspirates is useful for evaluating
      lymphadenopathy in HIV positive patients.

PMID- 2229435
TI  - Use of latex agglutination technique for detecting Legionella pneumophila
      (serogroup 1) antibodies.
AB  - Following the outbreak of Legionnaires' disease in Stafford in 1985, 500 serum
      samples were submitted to the indirect immunofluorescence antibody test and a
      latex agglutination. Latex agglutination using ultrasonically disrupted
      Legionella pneumophila antigens coupled to latex particles, proved a rapid,
      simple method for detecting circulating antibodies to L pneumophila in a one
      minute slide latex agglutination test. There was good correlation with the
      indirect immunofluorescence antibody test (IFAT), and the specificity and
      sensitivity with respect to a diagnostic result were 98.3% and 97.6%,
      respectively, using a series of well characterised sera. The latex agglutination
      test seems well suited as a screening test for presumptive cases of Legionnaires'
      disease; the latex reagent is easy to prepare and seems to remain stable at 4
      degrees C for up to six months.

PMID- 2229434
TI  - Observations on the haemopoietic response to critical illness.
AB  - Peripheral blood cytopenias are common in patients receiving intensive care,
      particularly in those with multiple organ failure. To assess the contribution of
      bone marrow hypoplasia in such patients 44 bone marrow samples from 24 patients
      under intensive care were studied by standard morphological techniques and by the
      granulocyte-macrophage colony forming cell (GM-CFC) assay. Frequently observed
      morphological abnormalities in the bone marrow included the following: (i) a
      reduction in overall cellularity in seven patients, with a progressive decrease
      in most patients studied sequentially; (ii) an increase in the number of actively
      phagocytic macrophages; and (iii) a disruption of normal bone marrow architecture
      with the accumulation of intercellular hyaluronic acid glycosaminoglycan. Mean GM
      CFC growth was significantly reduced when compared with that in a group of normal
      controls. In four of five patients studied sequentially GM-CFC growth became
      subnormal in association with a reduction in bone marrow cellularity. Inhibitory
      serum factors were not identified. These morphological abnormalities are similar
      to the changes observed in gelatinous degeneration of the bone marrow. In both
      situations disruption of the haemopoietic microenvironment, with the accumulation
      of hyaluronic acid proteoglycan, may be an important factor in the inhibition of
      haemopoietic progenitor cell growth. The proliferation of macrophages, by the
      release of a variety of cytokines or reactive oxygen intermediates, may also be
      implicated in impaired haemopoiesis and the development of disordered
      erythropoiesis.

PMID- 2229436
TI  - Comparison of methods for the diagnosis of typhoid fever.
AB  - Over five years the Bactec radiometric blood culture method yielded Salmonella
      typhi in 41 of 45 confirmed cases of typhoid fever, 90% of which were from the
      first culture set taken. Blood clot culture was positive in 18 (41%) of 44
      confirmed cases and stool culture in 24 (59%) of 41. The yield from 2189 Widal
      clot cultures was only 0.03%. There were 68 positive results in 2258 unpaired
      Widal tests: 23 of them were falsely positive and 13 falsely negative, but in 11
      out of 68 cases the Widal was the only positive laboratory test. It is concluded
      that routine clot culture is not cost effective if a sensitive blood culture
      method is used, and that the Widal test is useful only in selected patients.

PMID- 2229437
TI  - Production of extra-cellular slime by Staphylococcus epidermidis during
      stationary phase of growth: its association with adherence to implantable
      devices.
AB  - A method of optimising slime production produced by Staphylococcus epidermis and
      its quantitative assay was developed, which gave a preliminary indication of its
      identity and an assessment of the correlation between slime production and
      adherence of the organism to implants. After inducing vigorous growth in brain
      heart infusion broth to stationary phase, all nutrients were removed by washing
      and the organisms resuspended in sterile deionised water with added magnesium.
      After further incubation the culture was centrifuged and the supernatant reacted
      with alcian blue in 50 mM magnesium chloride/sodium acetate solution, and the
      amount of bound dye was measured spectrophotometrically at 620 nm after its
      resolubilisation using sodium dodecyl sulphate. Large quantities of slime were
      produced by some, but not all, strains. Preliminary electrophoresis of the slime
      showed mobility and staining similar to that of the glycosaminoglycans. Adherence
      was tested by growing strains in wells of tissue culture plates and aspirating
      the supernatant after incubation. After fixation and staining of adherent growth
      the amount of bound stain was determined spectrophotometrically after its elution
      with ethanol. In this series of organisms there was no correlation between the
      result of tests for adherence or production of extracellular slime, and no
      correlation between either of these and the clinical source of the organisms.

PMID- 2229438
TI  - Immunoblot technique to visualise serum pepsinogen A isozymogen patterns.
AB  - Pepsinogen A (PGA) isozymogen patterns in urine and gastric mucosa can be
      visualised in non-denatured polyacrylamide gel electrophoresis by showing
      proteolytic activity after the conversion of pepsinogen into pepsin by acid. This
      method is not suitable for visualising PGA patterns in serum due to low PGA
      concentrations. To obtain a more sensitive visualisation method an immunoblotting
      technique was developed. PGA isozymogen patterns from urine and sonified gastric
      mucosa specimens obtained by immunoblotting were identical with those obtained by
      activity staining. The immunostaining method was at least 50 times more
      sensitive. PGA isozymogen patterns could be visualised in serum. Preliminary
      results suggest that the PGA patterns in serum and gastric mucosa are identical.
      As an association has been found between the genetically determined PGA
      isozymogen patterns in gastric mucosa and gastric malignancies in man,
      immunoblotting of PGA isozymogens in serum may provide a screening tool for
      subjects at risk of malignant gastric disease.

PMID- 2229439
TI  - Rapid identification of Klebsiella.

PMID- 2229440
TI  - Screening of urines with dipstrips: does it reduce workload and consumable costs?

PMID- 2229441
TI  - Successful treatment of chronic immune thrombocytopenia using fresh frozen
      plasma.

PMID- 2229442
TI  - Leukaemic phase of mantle zone lymphoma.

PMID- 2229443
TI  - Hypercalcemia and osteolytic lesions associated with chronic lymphatic leukemia
      (CLL)

PMID- 2229444
TI  - Thoracic aortitis due to Salmonella.

PMID- 2229445
TI  - Risk of metastasis during fine needle aspiration.

PMID- 2229446
TI  - The regulatory status of radiopharmaceuticals in Europe.

PMID- 2229447
TI  - Drug delivery systems. 4. Implants in drug delivery.
AB  - In comparison with many of the other drug delivery systems, implantable pumps and
      implants for variable rate delivery are at a crude stage of development. Although
      exceptions exist, the typical implantable pump consists of an electromechanically
      complex mechanism to regulate drug delivery from a percutaneous refillable
      reservoir, while power to drive the system comes from a transcutaneous energy
      transmission system. The potential for electrical or mechanical failure is high,
      and the systems are not yet sufficiently convenient or easy to use to recommend
      in a routine therapy. Problems with refilling of an apparently well designed
      implanted reservoir have been observed while, at the same time, cutaneous energy
      transmission systems are not well established. In most instances, the development
      of an elementary osmotic pump system dosage form follows a well defined path of
      physical-chemical formulation and clinical testing. The benefits most often
      provided by the dosage form are expected to be (1) increase in selectivity of
      drug action achieved by the system's zero-order release rate, and (2) decrease in
      frequency of administration. The success in achieving these values is
      quantifiable from the pharmacology of the drug substance and its
      pharmacokinetics. Osmotic and other technical approaches to producing economical,
      rate-controlled dosage forms will make it possible for all new pharmaecutical
      products to carry kinetic specification of rate as well as static specification
      of content. This review considers the characteristics of the ideal implantable
      pump, the clinical situations which require pumps, the limitations of portable
      pumps, and the detailed characteristics of existing implantable pumps and
      implants. Most of the review, however, focuses on insulin delivery because of the
      importance of this subject.

PMID- 2229448
TI  - Globalization of the pharmaceutical industry: opportunities for physicians in
      clinical research.

PMID- 2229449
TI  - Pharmacokinetics of cephradine administered intravenously and orally to young and
      elderly subjects.
AB  - The pharmacokinetics of IV and oral cephradine in healthy young male and female
      volunteers (ages 19 to 25, n = 10) were compared to those of older individuals
      (ages 65 to 81, n = 9). Subjects received 1 gram of cephradine by a 5-minute
      intravenous (IV) infusion followed the next day by a 1-gram oral dose. Serial
      serum and urine samples collected over a period of 12 hours after the dose were
      analyzed for cephradine concentration by a microbiologic assay. After IV
      administration, mean serum cephradine concentrations in the elderly group were
      significantly higher at both 6 hours (1.52 +/- 0.41 mcg/mL) and 8 hours (0.73 +/-
      0.22 mcg/mL) than in the young group at 6 hours (0.43 +/- 0.11 mcg/mL). Total
      systemic clearance was significantly lower (2.64 +/- 0.34 vs. 4.81 +/- 0.59
      ml/min/kg) and the elimination half-life was significantly longer (1.71 +/- 0.20
      vs 1.12 +/- 0.13 hours) in the elderly group (P = .0001). Systemic cephradine
      clearance correlated positively with creatinine clearance (r2 = 0.34, P = .0110)
      and negatively with age (r2 = 0.79, P = .0052). The mean volume of distribution
      was not significantly different between the two groups. Mean renal clearance was
      significantly lower in the elderly group (P = .0001), but more than 80% of the
      dose was excreted in the urine within 6 hours in both groups. After oral
      administration, the mean peak concentration and time to peak concentration did
      not differ between groups. The relative oral bioavailability was approximately
      94% in both groups. The mean serum concentrations in the elderly were higher at
      both 6 and 8 hours than in the young group at 6 hours. There were no differences
      in pharmacokinetic parameters between male and female subjects. Because of
      reduced cephradine clearance secondary to an age-related decline in renal
      function, administration of cephradine every 8 hours, rather than every 6 hours,
      may be sufficient in elderly patients.

PMID- 2229450
TI  - Safety, tolerance, and pharmacokinetics of cefepime administered intramuscularly
      to healthy subjects.
AB  - Steady state pharmacokinetics, absolute bioavailability, and dose proportionality
      of cefepime were evaluated in healthy male subjects after single (250, 500, 1000,
      or 2000 mg) and multiple (1000 mg every 12 hours for 10 days) intramuscular
      injections. Safety and tolerance were also monitored. High performance liquid
      chromatography/UV methodology was used to determine cefepime concentrations in
      plasma and urine. Key pharmacokinetic parameters were determined using
      noncompartmental methods. Cefepime was absorbed rapidly; mean peak times were 1.0
      1.6 hours. Pharmacokinetics were linear over the 250-mg to 2000-mg dose range,
      with mean total body clearance ranging from 125 to 141 mL/min. The peak plasma
      concentration and area under the curve increased in a dose-proportional manner.
      The apparent elimination half-life (2 hours) did not appear to be influenced by
      dose or by duration of dosing. No accumulation of cefepime was observed during
      the multiple-dose study. More than 80% of the administered dose was excreted in
      the urine as unchanged cefepime, and absolute bioavailability after intramuscular
      dose was 100%. Cefepime was well tolerated. Most subjects experienced none to
      mild pain and only minimum discomfort at the site of injection.

PMID- 2229451
TI  - The effect of ciprofloxacin on the pharmacokinetic and ECG parameters of
      quinidine.
AB  - Ciprofloxacin decreases the clearance of antipyrine and other drugs which, in
      part, undergo oxidative metabolism. Based on these findings, the authors
      hypothesized that ciprofloxacin may decrease the clearance of quinidine, a drug
      which also undergoes oxidative metabolism. The purpose of this study was to
      evaluate the effect of ciprofloxacin on the pharmacokinetic and ECG parameters of
      quinidine in seven healthy men. Oral quinidine sulfate 400 mg was administered
      alone (Phase A) and after oral ciprofloxacin pretreatment (Phase B) in a
      randomized crossover fashion with a 2-week washout period between each phase.
      During Phase B, ciprofloxacin pretreatment (750 mg every 12 hours) was
      administered for 5 days before and 24 hours after quinidine administration.
      Quinidine serum samples were obtained over a 24-hour period. QRS and QTc
      intervals were measured over a 12-hour period. There were no significant
      differences in clearance (20.3 +/- 3.3 L/hr vs 20.1 +/- 2.3 L/hr, P = .836), half
      life (7.9 +/- 1 hr vs 7.8 +/- 0.8 hr, P = 0.8), maximum concentration (1.4 +/-
      0.6 mg/L vs 1.5 +/- 0.6 mg/L, P = 0.613), or time to maximum concentration (1.5
      +/- 0.2 hr vs 1.5 +/- 0.1 hr, P = 0.571) for quinidine between Phase A and Phase
      B, respectively. The largest decrease in clearance observed for Phase B compared
      to Phase A was 10%. There was also no significant difference in the degree of QRS
      and QTc prolongation between Phase A and Phase B. From these results, it appears
      that ciprofloxacin in the dose given does not alter the pharmacokinetic or ECG
      parameters of quinidine. Therefore, no adjustment in the dose of quinidine is
      needed when coadministered with ciprofloxacin.

PMID- 2229452
TI  - The long-term treatment of stable angina pectoris with verapamil.
AB  - In a double-blind 16-week crossover study, the effectiveness of verapamil therapy
      for chronic stable angina was evaluated in 19 patients (Phase I). Twelve of these
      patients were then followed for 38 to 58 months of open-label treatment (Phase
      II). Clinical responses were assessed with traditional indices, treadmill
      exercise tests, and a newly developed Performance Index (PI). During Phase I,
      verapamil resulted in a 50% mean reduction in the number of patients developing
      effort angina on treadmill exercise, a 15% mean increase in treadmill exercise
      time, and an 18% mean improvement in the PI. In eight of ten patients, diastolic
      blood pressure rises during exercise were significantly lowered during verapamil
      treatment in Phase I. In a limited population of patients followed for long
      periods of time, our data show that verapamil remains acceptably effective in the
      treatment of angina pectoris. Though diastolic blood pressure rises were
      decreased during Phase I, we could not confirm that effect over longer periods of
      time. Functional capacity as determined by the PI was sustained in Phase II.

PMID- 2229453
TI  - Estimation of hepatic blood flow in branches of hepatic vessels utilizing a
      noninvasive, duplex Doppler method.
AB  - The measurement of hepatic blood flow by indirect methods such as indocyanine
      green clearance has several limitations. The duplex Doppler offers the potential
      for noninvasive, real-time measurement of blood flow and has been employed in the
      evaluation of arterial disease in a variety of vascular beds. We evaluated
      Doppler ultrasound estimation of blood flow in branches of the hepatic artery,
      hepatic vein, and portal vein in 12 healthy subjects on two separate days. In
      vitro accuracy of the scanner was assessed using phantom targets of known
      diameter and velocity. Blood velocity and vessel diameter measurements were
      obtained five times over a period of 2 hours. No significant differences were
      seen in velocity or blood flow measurements within or between days. The interday
      coefficients of variation, which include intrasubject variability, were 10-15%
      and 14-20% for velocity and blood flow measurements, respectively. This study
      demonstrates the potential utility of Doppler ultrasound to detect intrinsic,
      drug, or disease-induced changes in hepatic blood flow.

PMID- 2229454
TI  - Pharmacokinetics of quinapril and its active metabolite, quinaprilat, in patients
      on chronic hemodialysis.
AB  - The pharmacokinetics of quinapril and its active metabolite, quinaprilat, were
      evaluated in 12 patients with end-stage renal disease (ESRD) on chronic
      hemodialysis. Each subject received a single 20-mg oral dose of quinapril 4 hours
      before a 4-hour hemodialysis treatment. Serial dialysate and blood samples were
      obtained over 4 and 96 hours, respectively. Samples were analyzed for quinapril
      and quinaprilat concentrations by gas chromatography. Mean tmax and Cmax values
      for quinapril were 1.2 hours and 129 ng/mL, respectively. Only one patient had
      detectable quinapril dialysate concentrations which accounted for 2.8% of the
      quinapril dose. Mean apparent plasma clearance for quinapril was 1275 mL/min with
      a mean half-life of 1.7 hours. Quinapril was extensively de-esterified to its
      diacid metabolite, quinaprilat. Mean tmax and Cmax for quinaprilat were 4.5 hours
      and 671 ng/mL, respectively. Mean apparent plasma clearance for quinaprilat was
      24.0 mL/min with a mean half-life of 17.5 hours. As with quinapril, quinaprilat
      was not readily dialyzable. Only 5.4% of the administered quinapril dose was
      recovered as quinaprilat during a single hemodialysis treatment. In view of these
      results, supplemental quinapril doses need not be routinely given to patients
      following hemodialysis. Overall, quinapril and quinaprilat pharmacokinetics in
      patients with ESRD on chronic hemodialysis were not markedly different from those
      previously observed in patients with moderate to severe renal dysfunction (CLcr
      less than 29 mL/min) not yet requiring hemodialysis (RDND).

PMID- 2229455
TI  - Multiple dose pharmacokinetics, safety, and tolerance of velnacrine (HP 029) in
      healthy elderly subjects: a potential therapeutic agent for Alzheimer's disease.
AB  - The pharmacokinetics, safety, and tolerance of 1,2,3,4-tetrahydro-9-aminoacridin
      1-olmaleate (HP 029) a potential therapeutic agent for Alzheimer's disease, were
      assessed after multiple oral doses in a randomized double-blind, placebo
      controlled, ascending dose study in 56 healthy elderly men (14 per dose group).
      The subjects in the first three groups received 25, 50, or 100 mg two times a day
      and a fourth group was administered 100 mg velnacrine tid for 28 days. All
      subjects received a final dose on day 29. Subjects were confined for continuous
      observation during the 36-day study period. Blood and urine samples were
      collected for the pharmacokinetic assessment. There were no clinically important
      changes in the safety variables in both age groups after any dose. There was no
      evidence of hepatotoxicity when elderly men were given 100 mg tid for 28 days.
      Nine subjects reported one or two episodes of gastrointestinal (diarrhea) side
      effects (6 in the 100 mg bid group and 3 in the 100 mg tid dose group) during a
      29-day trial. None required treatment or were discontinued from study. These
      results indicate that the safety and tolerance up to 100 mg tid for 28 days in
      healthy elderly men are acceptable. Velnacrine was rapidly absorbed after oral
      administration. There were dose-related increases in Cmax, AUCs, and amount of
      drug excreted in urine. During multiple dosing, the Cmax increased as a function
      of dose. The tmax and t1/2 were not affected by dosage nor multiple dosing.
      Steady state levels of velnacrine were reached between days 2 and 3 with no
      evidence of further accumulation of velnacrine thereafter. Approximately 11-30%
      of the administered dose was excreted in the urine over the course of the study.
      The favorable pharmacokinetic characteristics and acceptable safety and tolerance
      of multiple dosing oral doses of velnacrine support further testing of this
      compound for efficacy and safety in Alzheimer's patients.

PMID- 2229456
TI  - Effects of flurazepam and midazolam on sleep and next-day performance in chronic
      insomniacs: report of a multicenter study.

PMID- 2229457
TI  - Sleep, performance, and plasma levels in chronic insomniacs during 14-day use of
      flurazepam and midazolam: methodology.
AB  - Methods are described for a five-center study of flurazepam and midazolam, in
      which 107 patients with histories of benzodiazepine use for chronic insomnia were
      enrolled. Data were available for 99 of these patients. Staff and patient manuals
      and a behavior-based computer system were specially designed to measure and
      delineate clearly the study procedures and parameters. Patients were carefully
      followed and supported during a 20-day washout period and underwent extensive
      training on psychomotor performance tasks. They received placebo for 2 nights and
      were then randomly assigned to one of four study treatments--flurazepam 15 or 30
      mg, midazolam 15 mg, or placebo--for 14 consecutive nights. All-night sleep
      electroencephalographic recordings were obtained on study nights--1 and 0
      (placebo) and 1, 2, 7, 13, and 14 (treatment nights). Results of four computer
      generated psychomotor performance tasks and three cognitive tasks, plus
      subjective evaluations of sleep, performance, and mood, were recorded in the
      morning after each night spent in the sleep laboratory. Blood and urine samples
      were analyzed for drug concentrations in plasma and for compliance with the
      protocol. A pilot study, using a high (nonclinical) dose of flurazepam (45 mg),
      preceded the multi-center study and was designed to evaluate tests in healthy
      volunteers and to familiarize staff with equipment and tests.

PMID- 2229458
TI  - Drug performance sensitivity: a pilot study.
AB  - Thirty noninsomniac healthy adult men were enrolled in a multicenter pilot study
      to evaluate the sensitivity of psychomotor and cognitive tasks and subjective
      evaluation of performance and mood after treatment with flurazepam (Dalmane) 45
      mg (larger than the recommended prescribing dose of 15-30 mg). This pilot study
      was also used to standardize testing procedures. The subjects were given either
      flurazepam or placebo at 72-hour intervals in a double-blind Latin square
      crossover design. Choice reaction time, but not simple reaction time, was drug
      sensitive. Divided attention and vigilance tasks were also sensitive to drug
      effects. Of the two cognitive tasks tested, addition was impaired by drug, but
      reading comprehension was not. Subjective evaluations of performance and mood
      states indicate that these are useful measures, but responses on the Hopkins
      Symptom Checklist were not influenced.

PMID- 2229459
TI  - Characteristics of chronic insomniacs examined in a multicenter 14-day study of
      flurazepam and midazolam.
AB  - One hundred seven chronic insomniacs (41 men, 66 women; mean age, 37.9 years)
      with a history of use of benzodiazepines were recruited for a multicenter study
      testing the relative efficacy of flurazepam 15 mg or 30 mg, midazolam 15 mg, or
      placebo during a 14-day treatment period. Average duration of the complaint of
      insomnia was 13.5 years. Most (74%) of the patients met criteria for a diagnosis
      of persistent psychophysiological sleep disorder for both initiating and
      maintaining sleep.

PMID- 2229460
TI  - Clinical safety of flurazepam and midazolam during 14-day use in chronic
      insomniacs.
AB  - Data from evening questionnaires, reports of side effects, laboratory findings,
      and all-night respiratory measurements were collected on the 99 chronic
      insomniacs examined in this multicenter study. These data were used to compare
      the clinical safety and desirability of a benzodiazepine hypnotic with a very
      short half-life, midazolam 15 mg, with a hypnotic with a longer half-life,
      flurazepam 15 and 30 mg; both compounds were compared with a placebo control.
      There were 2 prestudy placebo nights followed by 14 consecutive nights of
      treatment. Of the 107 patients accepted, 99 completed the study. No marked
      adverse reactions were found in any area for any group. There was no increase in
      sleep apneas during the treatment period for any group. Results of this study
      provide additional evidence of the safety of benzodiazepine hypnotics.

PMID- 2229461
TI  - A multicenter study of sleep, performance, and plasma levels in chronic
      insomniacs during 14-day use of flurazepam and midazolam: executive summary.

PMID- 2229462
TI  - Sleep evaluation in chronic insomniacs during 14-day use of flurazepam and
      midazolam.
AB  - This article contains the sleep results of the efficacy study of flurazepam 30 mg
      and 15 mg, midazolam 15 mg, and placebo in the 99 chronic insomniacs studied as
      part of this multicenter study. After a 20-day drug washout, all-night sleep was
      recorded on 2 baseline nights, on the first 2 treatment nights, on treatment
      night 7, and on the last 2 nights of the study (nights 13 and 14). To reduce the
      number of comparisons, electroencephalographic (EEG) sleep latency, EEG wake
      time, EEG sleep efficiency, post-sleep questionnaire (PSQ) sleep latency, and PSQ
      total sleep were preselected as the major sleep variables. Between-groups
      comparisons indicated that, when compared with the placebo control, all drugs
      improved sleep, but differences were statistically significant only for the first
      2 nights, i.e., the early interval. Midazolam was more effective than either dose
      level of flurazepam on treatment night 1. Within-group analyses indicated that
      all drug groups showed significantly improved sleep from baseline throughout drug
      administration, but the placebo group did not significantly improve from baseline
      by either objective or subjective measures at any of the three time intervals.
      The sleep of patients taking flurazepam 30 mg did not differ significantly from
      the sleep of those receiving the 15 mg dose for any of the five major sleep
      variables at any interval. Objective EEG and subjective PSQ sleep variables
      showed significant positive correlations.

PMID- 2229463
TI  - Psychomotor performance in chronic insomniacs during 14-day use of flurazepam and
      midazolam.
AB  - Four skills performance (psychomotor) tasks, including simple and choice reaction
      time, divided attention, and vigilance, were given to 99 chronic insomniacs to
      determine whether the use of midazolam 15 mg, or of flurazepam 15 or 30 mg,
      compared with placebo would produce next-day impairment throughout a 14-day
      treatment period. Tests were administered during 2 baseline days and on treatment
      days 1 and 2 (early interval), 7 (middle interval) and 13 and 14 (late interval).
      Compared with placebo, performance on all four tasks was impaired by flurazepam
      30 mg. The deficits associated with flurazepam 15 mg were roughly half the
      magnitude of those produced by flurazepam 30 mg, but these changes did not reach
      statistical significance for single response measures at single time intervals.
      Midazolam showed no consistent pattern of performance effects; however, for
      divided attention tracking error, there was a significant decrement. The placebo
      group showed flat performance curves or improved performance as a result of
      learning (practice effect).

PMID- 2229464
TI  - Cognitive performance and mood in patients with chronic insomnia during 14-day
      use of flurazepam and midazolam.
AB  - The 99 chronic insomniacs examined in the present multicenter study were given
      three cognitive tasks (reading comprehension, addition, and digit symbol
      substitution test [DSST]) as well as the Hopkins Symptom Checklist (HSCL) and the
      Profile of Mood States (POMS) in order to evaluate the effects of flurazepam
      (Dalmane) 15 and 30 mg, midazolam 15 mg, and placebo on cognitive performance and
      mood. Subjective evaluation of performance was also obtained. A significant
      person in the patient's life was also asked to evaluate the patient's mood before
      and during the 14-day treatment interval. After a 20-day washout, next-day
      performance and mood were evaluated after placebo nights -1 and 0 (baseline) and
      after treatment nights 1, 2 (early interval), 7 (middle interval), and 13 and 14
      (late interval). Analysis of variance (ANOVA) on changes from baseline indicated
      no significant between-groups treatment effects for reading comprehension or any
      of the mood variables at any interval. Patients on flurazepam 30 mg performed
      less well compared with other groups even though, after completion of the tasks,
      this group believed that they performed as well as those on the other regimens.
      Performances by flurazepam 15 mg, midazolam, and placebo groups were similar.
      Significant others tended to rate high-dose flurazepam patients more negatively.
      High-dose flurazepam patients had a significant change on the DSST and addition
      tasks due to treatment after the first night, and change in performance remained
      significantly impaired for the DSST task relative to that of the other groups
      thereafter.

PMID- 2229465
TI  - Plasma concentrations of flurazepam and midazolam in chronic insomniacs during 14
      day use and their relationship to therapeutic effects and next-day performance
      and mood.
AB  - Blood samples were drawn from each of 99 chronic insomniacs twice during washout
      (days -20 and -6) and six times during the study (mornings after study nights -1,
      1, 2, 7, 13, and 14) to examine the relationship between morning-after drug
      plasma levels, sleep efficiency, next-day mood, and performance. Patients in the
      four treatment groups received either flurazepam 30 mg, flurazepam 15 mg,
      midazolam 15 mg, or placebo. Plasma drug concentrations of N-desalkylflurazepam
      and midazolam were measured by electron-capture gas chromatography. Values of
      midazolam during the 14-day study were at or near the sensitivity limit of the
      assay and were not used in the calculations. Levels of N-desalkylflurazepam
      increased as expected during the 14 days. Mean level for the high-dose flurazepam
      group was approximately twice that of the low-dose group. The main consistency in
      the correlations, which were found on days 13 and 14, was that the high-dose
      desalkylflurazepam concentrations had a negative correlation with two independent
      measures of sleep latency. However, otherwise there was little or no relationship
      between N-desalkylflurazepam levels and sleep efficiency or next-day behavior.
      Issues of tolerance, individual variability in baseline and response, and their
      contribution to the findings are discussed.

PMID- 2229466
TI  - A multicenter 14-day study of flurazepam and midazolam in chronic insomniacs:
      general discussion and conclusions.

PMID- 2229467
TI  - Correlates of a measure of coping in older veterans: a preliminary report.
AB  - Sense of Coherence (SOC) is a specific measure of perception of coping ability
      which is examined here in relation to demographic characteristics and measures of
      physical and mental health status of older veterans (N = 240). Results suggest
      that the SOC is strongly correlated with measures of subjective health status. It
      does not uniquely contribute to that dimension but does exhibit appropriate
      psychometric properties to encourage its use in further research.

PMID- 2229468
TI  - Injury among male migrant farm workers in South Carolina.
AB  - A record review and interview survey were carried out to determine the impact of
      injury on the health of male migrant workers in the Ridge area of South Carolina.
      Thirteen percent of the men's visits to the Rural Migrant Clinic were for
      injuries. A larger number, sixty percent, of men's visits to the local Emergency
      Room were due to injuries. Documentation of alcohol and drug use or the
      circumstances of the injury was more complete on the Emergency Room records than
      on the Clinic records. Interviews with 116 migrant workers were carried out in
      the camps during the summers of 1986 and 1987. Male migrant workers had similar
      rates of work related accidents as other hired farm workers in the United States.
      However, male migrant workers have more episodes of personal violence than black
      males living in other types of rural settings. Heavy drinking was associated with
      these violent episodes. Over 83 percent of the episodes of personal violence
      occurred in the camps after dark. It is suggested that camp conditions with poor
      sanitation, crowding, lack of recreational outlets, and high presence of
      available alcohol contributes to the high rates of injury in this group of men.

PMID- 2229469
TI  - Dietitians' beliefs about the importance of health promotion practices.
AB  - Registered dietitians throughout the state of Delaware (N = 146) were surveyed by
      mail to assess their beliefs about the importance of health promoting behaviors
      to the health of the average person. Respondents were instructed to rate each of
      25 health promotion practices on a Likert scale. Results were compared with
      investigations of other health care providers. "Eating a balanced diet" was rated
      among the top five items. "Taking vitamin supplements" received the lowest mean
      rating. Results of the present study compared well with the beliefs of
      pharmacists and physicians. Ratings by other registered dietitians from an
      earlier study tended to be more conservative. Dietitians are supportive of health
      promotion and disease prevention. Their current role in health promotion
      activities needs further investigation.

PMID- 2229470
TI  - Common illnesses and self-care.
AB  - Self-care has become a topic of widespread interest in recent years. However, few
      studies of the content and methods of self-care are available to inform health
      education program design. The present study identified common illnesses that were
      reported by 258 western university students and how those illnesses were
      typically cared for. Illness reporting differed significantly by gender, marital
      status, and perceived health status. Illness treatment differed only for
      perceived health status. Results suggest that treatment of an illness once self
      diagnosed does not differ across groups but that labeling of illnesses does. The
      suggestion is made that educational programs may need to place greater emphasis
      on appropriate diagnosis of illness.

PMID- 2229471
TI  - Cytoarchitecture and fiber connections of the nucleus lateralis valvulae in the
      carp (Cyprinus carpio).
AB  - The cytoarchitecture and fiber connections of the nucleus lateralis valvulae of
      the carp (Cyprinus carpio) were studied by Nissl, Bodian, Golgi, and horseradish
      peroxidase methods. Chief cells composing the nucleus lateralis valvulae (NLV)
      are small and granular, and their axons terminate in the cerebellum. These
      neurons have no dendrite, and the cell body is enveloped in a single terminal of
      afferent fibers to the NLV. In order to observed local cell clustering, the NLV
      was three-dimensionally reconstructed with the aid of a computer image analysis
      system. Afferent sources to the NLV were the nucleus pretectalis superficialis
      pars magnocellularis (Northcutt and Braford, '84: Brain Res. 296:181-184),
      nucleus ventromedialis thalami (Ito et al., '86: J. Comp. Neurol 250:215-227),
      and the inferior lobe. The NLV projects to the inferior lobe and the cerebellum.
      In particular, the cerebellar projections were strong and topographically
      arranged. Some larger neurons lying just beneath the NLV, some of which were
      intermingled with the NLV neurons, projected to the torus longitudinalis. On the
      basis of the local cell clustering as well as NLV-cerebellar connections, three
      subdivisions of the NLV could be recognized, i.e., anterior, central, and
      posterior portions. The posterior portion was further subdivided into lateral and
      medial parts.

PMID- 2229472
TI  - Auditory brainstem in the mole (Mogera): nuclear configurations and the
      projections to the inferior colliculus.
AB  - Anatomical organization of the central auditory system in the mole was studied at
      the lower brainstem levels. The cyto-, myelo-, and chemoarchitectures were
      examined in Nissl, myelin, and acetylcholinesterase stained materials, and then
      the origins of the ascending afferents to the inferior colliculus (IC) were
      identified by injecting wheatgerm agglutinin conjugated to horseradish peroxidase
      (WGA-HRP) into the unilateral IC and processing the tissue according to the
      standard retrograde tracing techniques. The results indicate that the auditory
      nuclei and pathways in the lower brainstem of the mole conform to the basic plan
      common to many other mammals. Nevertheless, several characteristic features are
      evidenced in the present study: (1) in the cochlear nucleus (CochN), granule cell
      fields are very large in both the ventral (VCN) and dorsal (DCN) nuclei; among
      several populations of neurons, fusiform cells in the DCN, multipolar cells in
      the VCN and DCN, and small spherical cells in the VCN project to the IC directly,
      (2) in the superior olivary complex (SOC), the medial nucleus (MSO) is well
      developed in comparison with that in the hedgehog, the opossum, the mouse, and
      the rat, although the general configuration of the SOC is similar to that in
      those mammals, most strikingly, the MSO projects to the IC bilaterally in the
      mole, and (3) the nuclei of the lateral lemniscus (NLL) show a great development
      and consist of three well-differentiated parts of the dorsal, intermediate, and
      ventral nuclei. The projections from these subnuclei to the IC conform to the
      basic mammalian plan.

PMID- 2229473
TI  - Distribution and projection pattern of motoneurons that innervate hindlimb
      muscles in the quail.
AB  - We characterized the motoneuron pool positions and projection patterns in the
      embryonic quail hindlimb and compared them to those in the chick to determine the
      degree of similarity and to form a baseline for future chimeric experiments. We
      find that the most similar parameters of pool position correlate with the major
      axonal pathway choices. First, the medial-lateral pool position, which is highly
      conserved among birds and mammals, is identical in the quail and chick and
      correlates with the dorsal-ventral pathway choice, the first and least plastic of
      the choices within the limb. Second, although quail pools were known to be
      compressed into seven rather than eight segments, we show that the map of pools
      is compressed about a central point (segment three) that preserves the spatial
      relationships between anterior pools and the crural plexus, and between posterior
      pools and the sciatic plexus. Access to guidance cues that are restricted to each
      plexus region is thus maintained between species. Third, pool position along the
      anterior-posterior axis is the least similar parameter between species. In fact,
      the entire lumbosacral motor complex may shift by +/- half a segment in
      individual quail. Despite the consequent differences in segmental projections,
      the specific projection pattern within each quail hindlimb is identical to that
      in the chick. There is no need to preserve the exact segmental pattern either
      phylogenetically or during development, because motoneurons accommodate to modest
      variations in their position along the anterior-posterior axis by sorting out at
      the limb base. The contrast between variable segmental and constant limb
      projections also demonstrates that neither the specification nor the precise
      projection of motoneurons is dependent upon the specification or development of
      somites.

PMID- 2229474
TI  - Muscarinic cholinergic receptors in the songbird and quail brain: a quantitative
      autoradiographic study.
AB  - In order to clarify the neuroanatomical basis for postulated muscarinic
      cholinergic control of a wide array of physiological processes in birds, the
      distribution of muscarinic cholinergic receptors in the brain of three avian
      species was investigated by quantitative autoradiography. The species consisted
      of two passerines (songbirds), the European starling (Sturnus vulgaris) and the
      song sparrow (Melospiza melodia), and one galliform, the Japanese quail (Coturnix
      coturnix japonica). [3H]N-methyl scopolamine (NMS), a muscarinic cholinergic
      antagonist was used as the ligand to label the receptors. Initial experiments
      demonstrated that the binding of this ligand in the three species is saturable in
      the nanomolar range and has a high affinity (Kd = +/- 0.6 nM). Displacement
      experiments revealed that three muscarinic ligands competed in an order of
      potency characteristic of the mammalian muscarinic receptor (i.e., atropine
      greater than oxotremorine greater than carbachol) for NMS binding in the avian
      brain. In all three species, portions of the basal ganglia, such as the
      parolfactory lobe and the paleostriatum augmentatum, exhibited the highest
      density of binding. On the other hand, the paleostriatum primitivum, the avian
      homologue of the mammalian globus pallidus, contained very few binding sites.
      Other telencephalic sites, such as the ventral and dorsal hyperstriatum, also
      revealed relatively high receptor density. However, the neostriatum and
      especially the ectostriatum showed much lower levels. In the hypothalamus, in all
      three species, specific binding could be observed in the ventromedial nucleus and
      adjacent areas. The paraventricular nucleus also showed moderate levels of
      binding density, especially in the two songbird taxa. At a more rostral level,
      the preoptic area showed low levels of binding. In the quail, the sexually
      dimorphic nucleus of the preoptic area was clearly outlined in the autoradiograms
      by the low level of binding sites compared to the surrounding areas. In the two
      passerine species, nuclei of the song system were identified by either high or
      low levels of NMS binding. High binding defined area X and the mesencephalic
      nucleus, intercollicularis (ICo). In contrast, the robust nucleus of the
      archistriatum and the magnocellular nucleus of the anterior neostriatum showed
      low levels of binding in comparison with the surrounding tissue. None of these
      nuclei were visible in the quail autoradiograms except for ICo, which appeared as
      in the passerines as a heavily labelled area surrounding the lightly labelled
      nucleus mesencephalicus lateralis pars dorsalis. In all three species, the
      hippocampal complex was devoid of NMS binding except for two lateral dark bands
      that were present along the entire rostral to caudal extent of the
      hippocampus.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2229475
TI  - Topographic disorganization of the optic tracts following long-term optic nerve
      regeneration: a quantitative image analysis study.
AB  - Experiments were designed to find the degree to which regenerated optic axons
      occupied their previous locations in the optic tracts. Following optic nerve
      crush and regeneration, either the dorsal, ventral, peripheral, temporal, or
      nasal part of the retina was ablated. The axons of the remaining retinal ganglion
      cells (RGCs) were labeled with cobalt. Density of the regenerated dorsal and
      ventral axons in the dorsal vs. ventral optic tracts was determined digitally. In
      addition, we determined the density of temporal and nasal axons in the temporal
      vs. nasal compartments of each optic tract and the density of central axons in
      the central vs. peripheral compartments of both optic tracts. Regenerated axons
      were not distributed randomly in the optic tracts. Instead, they were slightly
      but, significantly biased toward growing through the tract or compartment that
      they had occupied previously. Still, the pathway specificity exhibited by the
      regenerated axons was closer to random than it was to the pathway specificity
      seen in normal animals. Dorsal, ventral, and central RGC axons were significantly
      better localized to their correct tract or compartment than were temporal or
      nasal RGC axons. Also, over time, dorsal and ventral axons tended to disappear
      from incorrectly chosen optic tracts. The slight bias toward choosing the
      appropriate optic tract or optic tract compartment may be enough to account for
      the topographic specificity of the regenerated retinotectal projection. Near
      randomness of the axonal positions in the tracts argues against the presence of
      any specific guidance cues in the optic tracts of adult animals. Axonal density
      was highest in the correct compartment and diminished progressively with
      increasing distance into the incorrect compartment. Such a gradient of axonal
      density suggests that regenerating axons "drift" away from their previous
      positions in the optic pathways.

PMID- 2229476
TI  - Development redistribution of photoreceptors across the Macaca nemestrina
      (pigtail macaque) retina.
AB  - Redistributions of monkey cones and rods during the first year after birth
      include a fivefold increase in peak foveal cone density from 43,000 to 210,000
      cones/mm2, a decrease in the diameter of the rod-sparse area, and a two- to
      threefold decrease in peripheral photoreceptor density. Two weeks before birth,
      higher cone density is already apparent in the future fovea, as are the
      nasotemporal asymmetry in cone distribution, a higher density "cone streak" along
      the horizontal meridian, a large rod-sparse central fovea, and a ring of high rod
      density. Despite the early appearance of these basic patterns, photoreceptor
      distribution is not mature until 1 to 5 years postnatally. Total cones varied
      from 4 million at birth to 3.1 million in the average adult. The two oldest eyes
      had fewer cones, suggesting up to a 25% loss late in development. There were 60
      to 70 million rods in the adult macaque retina and little evidence of postnatal
      changes in number. Neither of these small changes is sufficient to account for
      the reduction in peripheral photoreceptor density and both are in the wrong
      direction to explain increasing foveal density, ruling out a major role for
      either photoreceptor death or generation. Retinal area increased by a factor of
      2.4 from 2 weeks before birth to adulthood. In contrast, the posterior pole of
      the retina was dimensionally stable throughout this period, with the distance
      between the fovea and optic disc varying nonsystematically from 3.37 to 4.05 mm.
      Retinal coverage of the globe was also stable at 48-60%. Thus postnatal growth
      can be ruled out as a factor in the density changes occurring in central retina.
      Adult retinas have a higher proportion of both cones and rods in midperiphery,
      whereas young retinas have a higher proportion of photoreceptors in far
      periphery. It appears that photoreceptors are radially redistributed from
      peripheral toward central retina during postnatal development, resulting in the
      marked increase in foveal cone density and the decrease in the eccentricity of
      the rod ring. Up to 13 weeks postnatally, midperipheral growth of the retina is
      substantial and increases with eccentricity. At later ages, expansion continues
      only in the very far periphery. Retinal growth appears sufficient to explain the
      decreases in peripheral rod and cone density with age. These and previous data
      strongly suggest that differentiated photoreceptors, with complex cytology and
      synaptic contacts, migrate toward the foveal center, explaining the increase in
      foveal photoreceptor density.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2229477
TI  - Immunocytochemical localization of protein kinase C subspecies in the rat spinal
      cord: light and electron microscopic study.
AB  - Distinct expression of protein kinase C (PKC) subspecies in the central nervous
      system suggested that each subspecies has a distinct neural function in the
      processing and modulation of a variety of physiological responses to external
      signals. In this study, the cellular and subcellular distributions of beta I-,
      beta II- and gamma-subspecies of PKC were demonstrated by using subspecies
      specific antibodies in the rat spinal cord. By light microscopy both gamma- and
      beta II-subspecies immunoreactivities were found only in neurons of the
      substantia gelatinosa and axons of the dorsal corticospinal tract in the spinal
      cord. Use of a double staining method, however, revealed that beta II-subspecies
      immunoreactivity was localized in the outer part of the lamina II, whereas gamma
      subspecies immunoreactivity was found in the inner part of lamina II.
      Immunoreactive neurons containing beta I-subspecies were scattered in the
      substantia gelatinosa. Beta I-subspecies immunoreactivity varied in neuronal
      types. Furthermore, electron microscopic analysis clearly showed the subcellular
      distribution of these subspecies to be different from one another. Dense gamma
      subspecies immunoreactivity was found in the cytoplasm except within cell
      organelles of the perikarya and dendrites. Some nuclei were stained as strongly
      as the cytoplasm and others were stained less heavily. The nucleoli had faint or
      no immunoreactivity. Reaction products of beta II-subspecies were located against
      the inner plasma membrane but not seen in the nuclei or nucleoli. Beta I
      subspecies immunoreactivity appeared to be associated with the Golgi complex. No
      immunoreactive products of any PKC subspecies were detected in the presynaptic
      terminals. The different patterns of expression described above imply that
      individual PKC subspecies may have a specific function in modulating the neuronal
      activity in the different neurons of the spinal cord.

PMID- 2229478
TI  - Direct catecholaminergic innervation of primate spinothalamic tract neurons.
AB  - Catecholaminergic axonal varicosities identified by immunocytochemical staining
      for dopamine-beta-hydroxylase were observed at the light microscopic level
      apposing the somata of retrogradely labeled spinothalamic tract neurons in the
      monkey spinal cord. Three retrogradely labeled and two intracellularly labeled
      spinothalamic neurons were serially sectioned and examined at selected intervals
      at the electron microscopic level. Electron microscopic study revealed that
      axonal boutons directly contacted the somata and/or dendrites of lamina I, IV,
      and V spinothalamic tract neurons. All of the profiles apposing one of the
      retrogradely labeled lamina I spinothalamic tract neurons were categorized from
      eight planes of section spaced at 1-micron intervals. Of the 305 profiles counted
      that were adjacent to this soma, 17 (5.6%) stained positively for dopamine-beta
      hydroxylase. Of these 17 appositions, three were followed in serial sections to
      confirm that they had synaptic thickenings and alignment of vesicles along the
      membrane contacting the spinothalamic tract soma. Catecholaminergic boutons were
      observed apposing the somata and dendrites of intracellularly filled STT cells
      characterized as high threshold and wide dynamic range neurons. These
      observations clearly indicate a direct innervation of spinothalamic tract neurons
      by catecholaminergic neurons, providing anatomical data to support previous
      physiological findings demonstrating that catecholamines modulate nociceptive
      transmission.

PMID- 2229479
TI  - Distribution of Met-enkephalin, Leu-enkephalin, substance P, neuropeptide Y,
      FMRFamide, and serotonin immunoreactivities in the optic tectum of the Atlantic
      salmon (Salmo salar L.).
AB  - The distribution of the neuropeptides methionine- and leucine-enkephalins,
      substance P, FMRFamide, neuropeptide Y, and vasoactive intestinal peptide, as
      well as the biogenic amine serotonin was studied in the optic tectum of the
      Atlantic salmon by means of immunocytochemistry. Peroxidase-antiperoxidase and
      indirect immunofluorescence methods were used to compare the differential laminar
      distribution of each of these substances. Nine parts of the optic tectum were
      selected for analysis on frontal sections: median, dorsolateral, and
      ventrolateral areas at rostral, medial, and caudal levels. Methionine- and
      leucine-enkephalin immunoreactive fibers were found in discrete sublayers in the
      following strata: stratum opticum, stratum fibrosum et griseum superficiale,
      stratum griseum centrale, stratum, and album centrale. Most of the substance P-,
      serotonin-, and vasoactive intestinal peptide-immunoreactive fibers were found in
      the stratum album centrale, whereas the FMRFamide- and neuropeptide Y
      immunoreactive fibers were more or less randomly distributed within most of the
      strata of the optic tectum. Neuropeptide Y-immunoreactive cell bodies were
      located in the stratum periventriculare. We suggest an extrinsic origin for most
      of the immunoreactive fibers observed in the optic tectum, except for the
      neuropeptide Y-immunoreactive fibers that probably originate in the
      periventricular neurons. Although retinal peptidergic input to the optic tectum
      has been proposed in other vertebrates, there is no evidence that any of the
      neuropeptidelike or serotonin immunoreactive fibers in the optic tectum of the
      salmon should be of retinal origin. Differences and similarities with the
      distribution of neuropeptides in the optic tectum in representatives of other
      vertebrate classes are discussed.

PMID- 2229480
TI  - Morphology of a population of mechanosensory ascending interneurones in the
      metathoracic ganglion of the locust.
AB  - A population of ascending interneurones with cell bodies in the metathoracic
      ganglion of the locust is described. Interneurones are characterised by their
      morphology (revealed by intracellular cobalt injection) and by their
      physiological responses to afferent stimulation. All interneurones have their
      somata in the ventral cortex of the ganglion, in an area just posterior to the
      medial tracheae. On the basis of gross morphology the interneurones can be
      divided into three groups: (1) those that have a main area of fine neurites
      ipsilateral to the soma and an ipsilateral ascending axon; (2) interneurones that
      also have their main neurites ipsilateral to the soma but have a contralateral
      ascending axon, and (3) interneurones that have their main stimulation of sensory
      receptors on the hind leg ipsilateral to the main neurites. Interneurones
      receiving excitatory inputs from tactile hairs on the hind leg have branches in
      the most ventral neuropil, whereas interneurones receiving input from leg
      proprioceptors have branches in the more intermediate and dorsolateral neuropil.
      The branching pattern of an interneurone and the size and position of the
      receptive field on the leg are correlated. Interneurones with restricted
      branching patterns have restricted receptive fields. The position of the ventral
      branching reflects the position of the receptive field on the leg. An
      interneurone with a receptive field restricted to the femur has ventral branches
      in an anterior position in the ganglion; an interneurone with a receptive field
      restricted to the tarsus has ventral branches in a more posterior position.

PMID- 2229481
TI  - Morphological variability, segmental relationships, and functional role of a
      class of commissural interneurons in the spinal cord of goldfish.
AB  - As part of an attempt to understand the spinal control of the segmented axial
      musculature in goldfish, commissural spinal interneurons that are electronically
      coupled to the Mauthner axon (M-axon) were studied with intracellular recording
      and staining to examine their morphology, segmental relationships, and functional
      role. Prior studies suggested that these cells might mediate the crossed
      inhibition that blocks excitation of motoneurons on one side of the body during
      an escape bend to the opposite side. Simultaneous intracellular recordings from a
      M-axon, a commissural interneuron coupled to it, and a presumed primary
      motoneuron show that: (1) the interneurons produce monosynaptic, Cl(-)-dependent
      IPSPs in contralateral motoneurons, (2) the interneurons are responsible for the
      short latency, crossed spinal inhibition in the M-cell network, and (3) more than
      one interneuron terminates on each postsynaptic cell. Reconstructions of
      interneurons from wholemounts show that they form a fairly homogeneous
      morphological class of cells. Each one is unipolar, with an axon that crosses the
      cord and then usually bifurcates into a short, thin ascending branch and a
      thicker, longer descending one. Neighboring interneurons have overlapping
      terminal arbors consistent with the physiological data showing convergence of
      interneurons onto the same postsynaptic cell. The interneurons showed little
      relationship with body segments as defined by ventral roots. Their axons usually
      straddled segmental boundaries, with terminals typically occupying parts of two
      adjacent segments. Thus the functional unit of these cells is probably not a
      segment or a complete group of segments, but instead includes only parts of two
      adjacent segments. The presence of interneurons like these suggests that the
      overt peripheral segmentation of trunk musculature is not necessarily reflected
      in the organization of neurons that control those segments. A consideration of
      some functional characteristics of the activation of overlapping, serially
      repeated arrays of interneurons by descending pathways leads to the conclusion
      that the high conduction velocity of the M-axon, and the large size and short
      longitudinal extent of the axons of the inhibitory interneurons promote a strong,
      brief inhibition that is appropriate for the production of an escape turn that
      has a rapid bend to one side.

PMID- 2229482
TI  - DARPP-32, a phosphoprotein enriched in dopaminoceptive neurons bearing dopamine
      D1 receptors: distribution in the cerebral cortex of the newborn and adult rhesus
      monkey.
AB  - DARPP-32, a dopamine (DA) and cAMP-regulated phosphoprotein, is associated with
      dopaminoceptive neurons bearing D-1 receptors in the basal ganglia. The present
      study addressed the distribution of DARPP-32 in the primate cerebral cortex and
      its putative association with D-1 receptor laden cells in this structure. DARPP
      32-like immunoreactive (LIR) neurons were examined in the cerebral cortex of 3
      day-old (P3), 6-week-old (P42), and adult rhesus monkeys. In the younger cases, a
      large number of DARPP-32 positive neurons, with the morphological characteristics
      of pyramidal cells, were observed throughout the cortex, in layers V-VI, and to a
      lesser extent in layer II and uppermost layer III. In the parietal, insular,
      temporal, and occipital cortices, DARPP-32 positive neurons were arranged in a
      monolayer in layer Va. They were often clustered in small groups with a bundling
      of their dendrites. In the primary motor cortex, Betz cells were among the
      labeled population. In the association and somatosensory areas, the basal
      dendrites of DARPP-32 positive neurons and the prominent tufting of their apical
      dendrites in layer I contributed to an essential bilaminar pattern resembling the
      distribution reported for DA afferents and D-1 receptors in these areas. The
      prominence and widespread distribution of DARPP-32 positive neurons in layer V
      may be a specialization of primate cortex since such cells are found only in
      restricted locations in rodents. The literature on the connections of the
      cerebral cortex suggests that a large number of the DARPP-32 positive neurons in
      layer VI and perhaps even in layer Va may be corticothalamic neurons. An
      important developmental observation was the presence of DARPP-32-LIR neurons in
      the white matter. They were prominent in the neonates but could not be seen in
      the adult. Their location as well as their type and shape were reminiscent of
      interstitial neurons. In the adult monkeys, the distribution of DARPP-32-LIR
      neurons was more circumscribed: they were numerous in the ventral temporal gyrus
      and in areas related to the limbic system: caudal orbitofrontal cortex, insula,
      temporal pole, entorhinal, and anterior cingulate cortex. Weak labeling was
      detected in layer Va of the superior temporal and parietal cortex, in some
      prefrontal areas (10, 13, and medial 9), and in the premotor and supplementary
      motor cortex; in adults, unlike neonates, few DARPP-32-LIR neurons were present
      in the dorsolateral prefrontal cortex, the primary motor or the primary visual or
      prestriate cortices.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2229483
TI  - Renewal of electrotonic synapses in teleost retinal horizontal cells.
AB  - In teleost retinas, the somata of same-type cone horizontal cells are
      electrically coupled via extensive gap junctions, as are the axon terminals of
      same-type cells. This coupling persists throughout the animal's life and is
      modulated by dopamine and conditions of light- vs. dark-adaptation. Gap junction
      particle density in goldfish horizontal cell somata has also been shown to change
      under these conditions, indicating that these junctions are dynamic. We have used
      electron microscopy to examine gap junctions in bass horizontal cells with a
      fixation method that facilitates detection of gap junctions. Annular gap junction
      profiles were observed in the somatic cytoplasm of all cone horizontal cell types
      in both light- and dark-adapted animals. Serial sections showed that most
      profiles represented gap junction vesicles free within the cytoplasm; the
      remainder represented vesicles still attached to extensive plasma membrane gap
      junctions by a thin cytoplasmic neck, suggestive of an intermediate stage in
      endocytosis. Observations of gap junction vesicles containing fragments of gap
      junctional membrane and/or fused with lysosomal bodies further supported this
      hypothesis. Because gap junctions persist between the horizontal cells, we
      propose that gap junction endocytosis and lysosomal degradation are balanced by
      addition of new junctions. While endocytosis has been widely demonstrated to
      serve in programmed removal of gap junctions (without subsequent replacement),
      from both nonneuronal cells and developing neurons, this study indicates that it
      can also function in the renewal of electrical synapses in the adult teleost
      retina, where gap junction elimination is not the goal.

PMID- 2229484
TI  - Rafael Lorente de No: 1902-1990.

PMID- 2229485
TI  - Single fiber studies of ascending input to the cuneate nucleus of cats: I.
      Morphometry of primary afferent fibers.
AB  - The morphology of afferent fibers ascending to the cuneate nucleus has been
      examined in this and the subsequent paper in order to quantify the pattern of
      arborization and bouton arrangement of selected classes of primary afferents and
      to compare these data with data from postsynaptic fibers ascending to the cuneate
      nucleus. Electrophysiologically identified G hair and Ia muscle afferent fibers
      in the cuneate fasciculus were intraaxonally injected with horseradish
      peroxidase. Cutaneous afferents terminated dorsal to proprioceptive afferents,
      especially at middle levels of the cuneate nucleus. The spacing of collaterals
      along G hair fibers was variable, but averaged 1.46 collaterals per mm;
      collateral density was higher at middle cuneate levels than in the rest of the
      nucleus. Collateral density of Ia fibers was lower than for G hair fibers and was
      lowest at caudal levels of the nucleus. Branches of G hair collaterals, though
      often initially diverging, usually converged to terminate in a single focus in
      the dorsal part of the nucleus. The probability of bifurcation of Ia collaterals
      decreased steadily at successive branch points. These collaterals branched less
      symmetrically than G hair collaterals, and terminated in the ventral cuneate with
      less dense arbors, stretched mediolaterally, but of comparable cross-sectional
      area. Individual G hair collaterals gave rise to more boutons than Ia
      collaterals; in both cases they were mostly of the en passant type. Boutons were
      restricted to distal branches of G hair collaterals, whereas boutons of Ia
      collaterals were also located on proximal branches. Bouton size was similar for
      the two classes of collaterals. The data reported here, in combination with the
      published literature, suggest that the collaterals of roughly 300 G hair fibers
      overlap at any given point at middle levels of the cuneate nucleus. This high
      degree of anatomical convergence is not predicted by the functional segregation
      described with electrophysiological mapping, implying the presence of intrinsic
      nuclear mechanisms enhancing response specificity.

PMID- 2229486
TI  - Cortical neurons expressing the cholecystokinin gene in the rat: distribution in
      the adult brain, ontogeny, and some of their projections.
AB  - Recent studies of neuronal cholecystokinin (CCK) expression performed with more
      sensitive techniques have demonstrated that the distribution of the expression of
      this peptide is more widespread than previously thought. In the present study,
      hybridization histochemistry was used to map cortical neurons expressing the CCK
      gene in adult and developing rats. Retrograde tracing with Fluorogold in
      combination with hybridization histochemistry was used to demonstrate some of the
      projections of these neurons. Neurons expressing the CCK gene were found in all
      areas of the neo- and allocortices. They were of several morphological types,
      including pyramidal neurons, and were found in almost all layers, albeit at
      different relative numbers and with different levels of expression. Generally,
      layers II and III, deep layer V, and layer VI had many neurons expressing CCK
      mRNA. Cortical CCK expression was first detected on the 15th day of gestation in
      the primordial plexiform layer. Expression developed thereafter in a regular and
      continuous fashion until an adult-like pattern was present on the 21st day after
      birth. Cortical neurons containing CCK mRNA were found in almost all the
      projections studied. Many neurons in both neo- and allocortical areas with
      cortico-cortical, associational, and commissural pathways contained CCK mRNA.
      Similarly, numerous corticostriatal neurons contained CCK mRNA; however, only a
      few corticothalamic neurons expressed CCK mRNA. These results demonstrate that in
      the rat cortex the distribution of projection neurons expressing CCK is much more
      widespread than had been previously shown and will stimulate further
      investigations into the role of CCK in these neurons.

PMID- 2229487
TI  - Topography of ganglion cells in human retina.
AB  - We quantified the spatial distribution of presumed ganglion cells and displaced
      amacrine cells in unstained whole mounts of six young normal human retinas whose
      photoreceptor distributions had previously been characterized. Cells with large
      somata compared to their nuclei were considered ganglion cells; cells with small
      somata relative to their nuclei were considered displaced amacrine cells. Within
      the central area, ganglion cell densities reach 32,000-38,000 cells/mm2 in a
      horizontally oriented elliptical ring 0.4-2.0 mm from the foveal center. In
      peripheral retina, densities in nasal retina exceed those at corresponding
      eccentricities in temporal retina by more than 300%; superior exceeds inferior by
      60%. Displaced amacrine cells represented 3% of the total cells in central retina
      and nearly 80% in the far periphery. A twofold range in the total number of
      ganglion cells (0.7 to 1.5 million) was largely explained by a similar range in
      ganglion cell density in different eyes. Cone and ganglion cell number were not
      correlated, and the overall cone:ganglion cell ratio ranged from 2.9 to 7.5 in
      different eyes. Peripheral cones and ganglion cells have different topographies,
      thus suggesting meridianal differences in convergence onto individual ganglion
      cells. Low convergence of foveal cones onto individual ganglion cells is an
      important mechanism for preserving high resolution at later stages of neural
      processing. Our improved estimates for the density of central ganglion cells
      allowed us to ask whether there are enough ganglion cells for each cone at the
      foveal center to have a direct line to the brain. Our calculations indicate that
      1) there are so many ganglion cells relative to cones that a ratio of only one
      ganglion cell per foveal cone would require fibers of Henle radiating toward
      rather than away from the foveal center; and 2) like the macaque, the human
      retina may have enough ganglion cells to transmit the information afforded by
      closely spaced foveal cones to both ON- and OFF-channels. Comparison of ganglion
      cell topography with the visual field representation in V1 reveals similarities
      consistent with the idea that cortical magnification is proportional to ganglion
      cell density throughout the visual field.

PMID- 2229488
TI  - Morphology of the octopus cell area of the cochlear nucleus in young and aging
      C57BL/6J and CBA/J mice.
AB  - The influence of aging and age-related cochlear impairment on the ventral
      cochlear nucleus was evaluated by measuring morphological properties of the
      octopus cell area (OCA) in five age groups of inbred C57BL/6J and CBA/J mice
      (young adult to very old). The former strain demonstrates progressive cochlear
      sensorineural pathology and hearing loss during middle age; the latter has only
      modest sensorineural pathology late in life. Histological sections of the OCA
      were evaluated with serial sections and several strains for neurons, glia, and
      fibers, and Golgi impregnations were also used. Aging was associated with a
      decrease in volume of the OCA, a loss of neurons, slight decrease in neuron size,
      increased packing density of glial cells, and changes in dendrites ranging from
      minor to total loss of primary branches. The greatest changes occurred in extreme
      old age, beyond the median lifespan. Age-related changes were not exacerbated by
      sensorineural pathology in aging C57BL/6J mice. Individual octopus cells varied
      greatly in the extent of age-related abnormality.

PMID- 2229489
TI  - Distribution of cholecystokinin-like-immunoreactive neurons in the guinea pig
      forebrain.
AB  - The distribution of cholecystokinin (CCK)-immunoreactive nerve fibers and cell
      bodies was studied in the forebrain of control and colchicine-treated guinea pigs
      by using an antiserum directed against the carboxyterminus of CCK octapeptide
      (CCK-8) in the indirect immunoperoxidase technique. Virtually all forebrain areas
      examined contained immunoreactive nerve fibers. A dense innervation was
      visualized in; neocortical layers II-III, piriform cortex, the medial amygdala,
      the medial preoptic area, a circumventricular organ-like structure located at the
      top of the third ventricle in the preoptic area, the subfornical organ, the
      posterior bed nucleus of the stria terminalis, the posterior globus pallidus
      (containing labeled woolly fiber-like profiles), the ventromedial hypothalamus,
      the median eminence, and the premammillary nucleus. A moderately dense
      innervation was visualized elsewhere excepted in the septum and thalamus where
      labeled axons were comparatively few. Immunoreactive perikarya were abundant in:
      neocortex (especially layers II-III), piriform cortex, amygdala, the median
      preoptic nucleus, the bed nucleus of the stria terminalis, the hypothalamic
      paraventricular (parvicellular part), arcuate, and dorsomedial (pars compacta)
      nuclei, the dorsal and perifornical hypothalamic areas, and throughout the
      thalamus. Areas also containing a moderate number of labeled cell bodies were the
      medial preoptic area, the globus pallidus, the caudate-putamen, and the
      periventromedial area in the hypothalamus. Immunostained perikarya were absent or
      only occasionally observed in the septum, the suprachiasmatic nucleus, the
      magnocellular hypothalamoneurohypophyseal nuclei, and the ventral mesencephalon.
      In the adenohypophysis, corticomelanotrophs were labeled in both males and
      females, and thyrotrophs were labeled in females only. This distribution pattern
      of CCK-8 immunoreactivity is compared to those previously recorded in other
      mammals. This shows that very few features are peculiar to the the guinea pig. It
      is discussed whether some interspecific differences in immunostaining are real
      rather than methodological.

PMID- 2229490
TI  - Sustained improvement with prolonged topical tretinoin (retinoic acid) for
      photoaged skin.
AB  - We performed a 22-month trial of topical tretinoin (retinoic acid) in the
      treatment of photoaging. Thirty patients participated in a 4-month, randomized,
      blinded, vehicle-controlled study that has been reported previously; 21 patients
      continued tretinoin therapy on an open-label basis, participating in the study
      for a total of 10 months, and 16 patients continued for 22 months. During the
      open-label study, the statistically significant improvement that had occurred in
      fine and coarse wrinkling and skin texture during our original study was
      sustained, despite reductions in dose or frequency of application of tretinoin.
      The number of discrete lentigines decreased by 71% compared with the number
      before therapy. Histologic findings included a statistically significant
      thickening of the epidermis. Side effects were limited to a cutaneous retinoid
      reaction that diminished as therapy proceeded.

PMID- 2229491
TI  - The Muir-Torre (Torre's) syndrome: the significance of a solitary sebaceous
      tumor.

PMID- 2229492
TI  - Identification of human immunodeficiency virus hybridizing sequences in the
      peripheral blood of a patient with systemic lupus erythematosus.
AB  - Systemic lupus erythematosus, a multisystemic disorder, is considered a prototype
      of the autoimmune diseases. Although its cause remains unknown, a viral etiology
      has been proposed. We report that a rapid and sensitive messenger RNA in situ
      hybridization technique detected hybridizing sequences to the human
      immunodeficiency virus type in the peripheral blood cells of a woman with
      systemic lupus erythematosus in whom the presence of acquired immuno-deficiency
      syndrome was reasonably excluded.

PMID- 2229493
TI  - Cutaneous manifestations of postthymic T cell malignancies: description of five
      clinicopathologic subtypes.
AB  - This study was undertaken to identify the cutaneous manifestations among
      different prognostic subgroups of postthymic T cell malignancies. Cutaneous
      involvement was demonstrated in 43 of 88 cases. We recognized five
      clinicopathologic subtypes: type I, classical cutaneous T cell lymphoma (CTCL) or
      mycosis fungoides, six cases; type II, primary large cell type CTCL, Ki-1 antigen
      (Ki-1+ or Ki-1-), seven cases; type III, primary angioinvasive T cell lymphoma,
      three cases; type IV, human T-lymphotropic virus type I (HTLV-I+) adult T cell
      leukemia/lymphoma (ATL), eight cases; type V, secondary cutaneous involvement by
      peripheral T cell lymphoma (PTL), 19 cases. Primary CTCL and ATL tend to involve
      papillary dermis with or without epidermotropism, whereas PTL and angioinvasive T
      cell lymphoma predominantly affect skin adnexae, vessels, and subcutis. Cutaneous
      lesions in type V PTL are heterogeneous and may be confused with panniculitis,
      vasculitis, or an eczematous eruption. Classic CTCL, Ki-1+ lymphoma, and
      angioinvasive T cell lymphoma have a chronic course, whereas ATL, Ki-1- large
      cell lymphoma, and PTL are clinically aggressive.

PMID- 2229494
TI  - Hypergammaglobulinemic purpura of Waldenstrom.
AB  - Hypergammaglobulinemic purpura of Waldenstrom is characterized by
      hypergammaglobulinemia, recurring purpura, an elevated erythrocyte sedimentation
      rate, and the presence of rheumatoid factor indicative of circulating immune
      complexes. There is a significant association with autoimmune diseases,
      especially Sjogren's syndrome and lupus erythematosus. Hypergammaglobulinemic
      purpura is considered primary when there is no other associated disease or
      secondary when associated with other diseases, usually autoimmune. Immune
      derangements are fundamental in its pathogenesis, although its cause is still
      unknown. Therapy is unrewarding and is probably unnecessary for this usually
      benign condition. Three cases are presented that are representative of patients
      with hypergammaglobulinemic purpura.

PMID- 2229495
TI  - Treatment of idiopathic guttate hypomelanosis with liquid nitrogen: light and
      electron microscopic studies.
AB  - Idiopathic guttate hypomelanosis is a common skin disorder of unknown cause. Our
      studies have shown that significantly fewer dopa-positive melanocytes are in the
      white macules of idiopathic guttate hypomelanosis than in normal skin. By
      electron microscopy we observed that the melanocytes in the lesional skin were
      round and less dendritic with fewer melanosomes than in normal pigment cells.
      Lesions gently frozen with liquid nitrogen repigmented in 6 to 8 weeks. The
      number of dopa-positive melanocytes was significantly greater in the repigmented
      areas than in untreated lesions but less than in normal skin.

PMID- 2229496
TI  - Treatment of molluscum contagiosum using a lidocaine/prilocaine cream (EMLA) for
      analgesia.
AB  - Eighty-three 4- to 12-year-old children, scheduled for curettage of at least five
      molluscum contagiosum lesions, participated in a double-blind study. The children
      were randomly allocated to receive lidocaine/prilocaine (EMLA) cream (n = 58) or
      placebo cream (n = 25), applied 15, 30, or 60 minutes before treatment. The pain
      was assessed by the children and the physician as none, slight, moderate, or
      severe. In addition, the children rated the pain on a visual analog scale. EMLA
      cream effectively prevented the pain after all three application times (p less
      than 0.01). No significant difference in pain was observed among the 15-, 30-,
      and 60-minute EMLA-treated groups, but the proportion of children reporting no
      pain on the verbal scale increased from 36% in the 15-minute group to 61% in the
      60-minute group. In the placebo group, only one of 24 children (4%) reported no
      pain. Transient local redness was the only skin reaction noted. In conclusion, an
      application time of EMLA cream of less than 60 minutes is satisfactory for the
      curettage of molluscum contagiosum in children.

PMID- 2229498
TI  - Prolonged remission after cyclosporine therapy in pemphigus vulgaris: report of
      two young siblings.
AB  - We report the clinical evolution of two young siblings with severe pemphigus
      vulgaris treated with cyclosporine for 30 and 12 months, respectively. One was
      resistant to treatment with high-dose corticosteroids and azathioprine. A good
      clinical response was achieved in both cases. No major side effects were
      observed. The patients have remained disease free for more than 20 months after
      stopping cyclosporine therapy.

PMID- 2229497
TI  - Intralesional interferon therapy for basal cell carcinoma.
AB  - In a clinical trial of 172 patients at four medical centers, interferon alfa-2b
      (1.5 x 10(6) IU) or a placebo was injected directly into biopsy-proved
      noduloulcerative or superficial basal cell carcinomas three times weekly for 3
      weeks, for a cumulative dose of 13.5 million IU. Efficacy of treatment was
      determined at 16 to 20 weeks by examination of biopsy specimens that demonstrated
      cure of lesions in 86% of interferon-treated patients and in only 29% of placebo
      treated patients. During the treatment course and follow-up, an initial
      inflammatory response was observed at the treatment sites, followed by diminished
      erythema, improvement in overall appearance, and a decrease in size of lesions.
      Side effects of treatment, mainly flu-like symptoms, were usually mild and
      transient and occurred more commonly in the interferon-treated group. Only three
      patients, all in the interferon-treated group, discontinued therapy because of
      side effects. One year after initiation of therapy, 81% of interferon recipients
      and 20% of those given the placebo remained tumor free. Noduloulcerative and
      superficial lesions were equally responsive to treatment with interferon. For
      some patients with noduloulcerative or superficial basal cell carcinomas,
      intralesional interferon alfa-2b may be an alternative, effective treatment.

PMID- 2229499
TI  - Extracorporeal photopheresis in psoriasis vulgaris: clinical and immunologic
      observations.
AB  - Four patients with chronic refractory plaque-type psoriasis without arthropathy
      were treated with extracorporeal photopheresis every other week for 6 to 13
      months. In patients 1 and 2, methotrexate was administered concomitantly during
      the initial part of the trial; the dose was gradually tapered and the drug was
      discontinued by 6 months. Both patients improved to 23% and 62% of baseline
      values for percentage of body surface involvement, but their disease then flared
      when maintenance extracorporeal photopheresis was used alone. Substantial
      improvement again occurred when lower doses of methotrexate were administered
      with extracorporeal photopheresis. Patients 3 and 4 were treated initially with
      extracorporeal photopheresis alone and both improved to 50% and 52% of baseline
      body surface involvement, respectively, after 4 months of treatment. However,
      their disease flared because of factors unrelated to treatment. Extracorporeal
      photopheresis was well tolerated by all patients without evidence of overt
      toxicity. However, prolonged treatment with extracorporeal
      photopheresis/methotrexate was accompanied by a decrease in skin reactivity to
      recall antigens and by decreased capacity of lymphocytes to produce interleukin 2
      in response to polyclonal stimuli in vitro. These findings indicate that
      alternate-week extracorporeal photopheresis has a definite but incomplete
      suppressive effect on psoriasis vulgaris that may be mediated through an effect
      on lymphokine production by photomodified cells and that the therapeutic effect
      of extracorporeal photopheresis may be enhanced by concomitant administration of
      low doses of methotrexate.

PMID- 2229501
TI  - Autoimmunity and malignancy.
AB  - In patients with autoimmune diseases malignancy is observed more frequently than
      in an age-matched control group. In strains of mice susceptible to autoimmune
      diseases, the incidence of lymphoreticular malignancies is increased. Although
      viruses have not been directly implicated in their pathogenesis or etiology,
      there are suggestions that slow viruses may be involved. Viruses have been found
      to be important in the development of lymphomas. Hence in genetically susceptible
      animals, viruses can initiate the autoimmune process. Prolonged stimulation of
      the autoimmune process or a prolonged state of immunodeficiency could trigger or
      activate genes or their products, which could result in the development of
      malignancy.

PMID- 2229500
TI  - Synthetic membranes and cultured keratinocyte grafts.
AB  - Significant progress has been made in skin replacement options in the past
      several decades. Although initially various materials have been used mainly for
      burn coverage, their application to dermatologic practice has increased
      significantly. We review the research, progress, and other aspects of wound
      coverage with synthetic membranes and cultured epithelial sheets in both burn and
      nonburn wound management.

PMID- 2229502
TI  - Buschke-Loewenstein tumor: verrucous carcinoma of the penis.
AB  - The Buschke-Loewenstein tumor is an anogenital tumor of characteristic clinical
      and histologic pattern best considered as a low-grade, well-differentiated
      squamous cell carcinoma. This remarkable neoplasm and its features are reviewed
      in detail, stressing salient advances in our understanding of it.

PMID- 2229503
TI  - Contact dermatoses from disposable glove use: a review.
AB  - Contact dermatoses from disposable gloves are being reported with greater
      frequency. A variety of eruptions can occur. These have become increasingly
      relevant for dermatologists, who for most procedures now use disposable gloves.
      This article represents a review of the relevant issues about the use of
      disposable gloves by dermatologists. Methods of management and prevention of
      morbidity associated with disposable glove use will also be discussed.

PMID- 2229504
TI  - Behcet's disease.

PMID- 2229505
TI  - Blastomycosis-like pyoderma caused by Pseudomonas aeruginosa: report of a case
      responsive to ciprofloxacin.

PMID- 2229506
TI  - Familial perifolliculitis capitis abscedens et suffodiens in two brothers
      successfully treated with isotretinoin.

PMID- 2229507
TI  - Porokeratosis in a patient treated with total body electron beam radiation.

PMID- 2229508
TI  - Corticosteroid-induced 'disappearing digit'.

PMID- 2229509
TI  - Trichonodosis in a patient with straight hair.

PMID- 2229510
TI  - Palmoplantar pustulosis as a manifestation of cutaneous T cell lymphoma (mycosis
      fungoides)

PMID- 2229512
TI  - Superficial epithelioma with sebaceous differentiation.

PMID- 2229511
TI  - Complete resolution of generalized eczema craquele after treatment with
      metronidazole of occult amebiasis.

PMID- 2229513
TI  - Ptychotropism as a cutaneous feature of the CHILD syndrome.
AB  - The hallmark of the CHILD syndrome is a unilateral ichthyosiform nevus that
      displays a pronounced affinity for the body folds. For this phenomenon the term
      ptychotropism is proposed. The expression is composed from the Greek words ptyche
      (fold) and trope (a turning). It is concluded that the cutaneous lesions of the
      CHILD nevus are determined by two factors, lyonization and ptychotropism. The
      phenomenon of ptychotropism constitutes an additional argument to distinguish the
      CHILD nevus from the inflammatory linear verrucous epidermal nevus because the
      latter is not ptychotropic.

PMID- 2229514
TI  - Nocturnal wakening caused by pruritus: organic or psychogenic?

PMID- 2229515
TI  - Abnormalities in structure and function of the thyroid gland in patients with
      alopecia areata.

PMID- 2229516
TI  - Comparative efficacy of two different formulations on xerosis.

PMID- 2229517
TI  - Psoriasis and tetracyclines.

PMID- 2229518
TI  - Immunohistologic investigation of the skin in primary Sjogren's syndrome.

PMID- 2229519
TI  - Jessner-Kanof lesion and Borrelia infection.

PMID- 2229520
TI  - Recognition of subungual hematoma as an imitator of subungual melanoma.

PMID- 2229521
TI  - History of antifungals.
AB  - Until two to three decades ago, only a few drugs were available for the treatment
      of fungal infections. The status of antifungal therapy changed dramatically in
      the late 1960s with the introduction of newer broader spectrum agents, such as
      the iodinated trichlorophenols and the imidazoles, that acted by disruption of
      the fungal cell membrane. Some of the more recently developed broad-spectrum
      antifungal drugs include the triazoles terconazole, itraconazole, and fluconazole
      and the dimethylmorpholine amorolfine. The allylamines represent one of the
      newest classes of compounds shown to be effective in the management of fungal
      disorders. The two members of this unique chemical class that have been studied
      clinically, naftifine and terbinafine, are effective against a wide spectrum of
      fungal organisms. Terbinafine has the added advantage of both topical and oral
      activity.

PMID- 2229522
TI  - Problems of resistant dermatophytes.
AB  - Recalcitrant fungal infections are defined as infections that are difficult or
      impossible to eradicate despite seemingly adequate treatment with appropriate
      oral or parenteral antibiotics. Relative or absolute microbial resistance is only
      one of the many causes of recalcitrance. Others include failure of the patient to
      comply with the prescribed treatment regimen, drug degradation in the liver, drug
      drug interactions, reabsorption or washout of the drug from the stratum corneum,
      and failure of the drug to reach the stratum corneum. Excretion in the eccrine
      sweat is the principal pathway by which griseofulvin and ketoconazole, the two
      currently available oral antifungal agents, are delivered to the stratum corneum.
      Measures that promote delivery of these drugs to this site by enhancing sweating
      and minimizing drug run-off and absorption onto clothing may aid in optimizing
      the therapeutic response to these agents.

PMID- 2229523
TI  - Pharmacology of the allylamines.
AB  - The allylamines are a new class of antifungal drugs that inhibit ergosterol
      synthesis at the level of squalene epoxidase. These agents are highly selective
      for the fungal enzyme and have a minimal effect on mammalian cholesterol
      synthesis. Naftifine, the original member of the allylamine series, possesses
      only topical activity, whereas the naftifine analog terbinafine is active both
      topically and orally. In vitro, terbinafine is exceptionally active against
      dermatophytes, molds, and dimorphic fungi in which it exerts a fungicidal action.
      This in vitro profile is reflected by the clinical effectiveness of this
      allylamine in the treatment of dermatophyte infections. When given orally,
      terbinafine is well absorbed and rapidly and extensively distributed to the skin
      and sebum in concentrations that exceed the minimum inhibitory concentrations of
      these organisms by several orders of magnitude.

PMID- 2229524
TI  - Treatment of chronic tinea pedis (athlete's foot type) with topical terbinafine.
AB  - Twenty-seven patients with chronic tinea pedis, athlete's foot type, were
      enrolled in a randomized, double-blind trial of topical treatment with
      terbinafine 1% cream versus its vehicle (placebo). Patients were examined weekly
      during 4 weeks of twice-daily treatment and at follow-up 2 weeks after the
      conclusion of therapy. No adverse events were reported in either treatment group.
      Drug efficacy was evaluated in 22 patients, of whom nine (41%) were treated with
      terbinafine and 13 (59%) with placebo. Analysis of combined mycologic and
      clinical results showed that terbinafine was significantly more effective than
      placebo at the end of therapy (78% vs zero) and at the 2-week follow-up (89% vs
      zero) (p less than or equal to 0.001 at both intervals.

PMID- 2229525
TI  - A clinical trial of topical terbinafine (a new allylamine antifungal) in the
      treatment of tinea pedis.
AB  - Twenty-three patients were enrolled in a randomized, double-blind trial of
      terbinafine 1% cream compared with placebo vehicle in the treatment of tinea
      pedis. Of the 20 patients who were evaluated for efficacy, 10 received
      terbinafine and 10 received placebo. Except for the terbinafine-treated patients
      being an average of 11 years older than the patients receiving placebo and the
      median duration of disease being 6 weeks longer in the placebo group, the two
      groups were demographically and clinically similar. Results of mycologic tests
      and clinical findings showed terbinafine to be significantly more effective than
      placebo in the treatment of tinea pedis. Significantly more terbinafine-treated
      patients than placebo-treated patients showed conversion to negative culture and
      microscopy at end of therapy and a significant reduction in scored signs and
      symptoms. Overall efficacy at follow-up (combined mycologic and clinical
      findings) was also significantly greater in the terbinafine group (78%) than in
      the placebo group (zero) (p less than 0.001). Unexplained elevation of liver
      function test results was noted in three placebo-treated patients and in one
      terbinafine-treated patient, but these changes were not considered clinically
      relevant or drug related.

PMID- 2229526
TI  - Efficacy and tolerability of topical terbinafine in the treatment of tinea
      cruris.
AB  - Thirty men with clinical and mycologic evidence of tinea cruris were enrolled in
      a controlled, randomized, double-blind trial comparing terbinafine 1% cream and
      its cream vehicle as placebo. Patients applied the test medications to the
      affected area twice daily for 2 weeks. Therapeutic response was evaluable in 18
      patients after each week of treatment and at a follow-up visit 2 weeks after
      therapy ended. At each visit, terbinafine was found to be more effective than the
      cream vehicle in the reduction of the signs and symptoms of infection and in the
      conversion of culture and microscopy findings to negative or normal. At the end
      of treatment, therapy was effective in 67% of the nine terbinafine-treated
      patients compared with only 11% of the nine placebo-treated patients. At the
      follow-up examination, efficacy rates were 78% in the terbinafine treatment group
      and 33% in the placebo group--a difference of borderline statistical significance
      (p = 0.077). Possible reasons for this result may include the higher incidence of
      chronic disease in the terbinafine group and the large number of patients who
      were classified as delayed exclusions because of negative initial culture for
      dermatophytes. No side effects or significant alterations in laboratory or
      hematologic tests were observed in either treatment group.

PMID- 2229527
TI  - Treatment of tinea cruris with topical terbinafine.
AB  - Twenty-three patients were enrolled in a randomized, double-blind trial of
      terbinafine 1% cream versus its vehicle (placebo) in the treatment of tinea
      cruris. One patient had a negative initial culture and was excluded, and two
      patients were dropouts, one because of poor study compliance (terbinafine) and
      one because of an adverse event (placebo). Twenty patients were examined for
      efficacy of treatment (9 terbinafine-treated, 11 placebo-treated). Both groups
      were similar in age, sex, duration of disease, prior therapy, size and location
      of lesion, infecting organism, and predisposing factors. Terbinafine 1% cream was
      more effective than vehicle cream in the reduction of the signs and symptoms of
      tinea cruris. In addition, there was a higher conversion rate to negative culture
      and normal microscopy findings in the terbinafine-treated group. Clinical results
      combined with evaluation of mycologic tests at end of therapy showed terbinafine
      to be a rapid and significantly more effective treatment for tinea cruris than
      placebo (78% vs 18% cure rate, respectively). Follow-up cure rates confirmed
      these findings (89% and 18%, respectively). No significant adverse events
      occurred during terbinafine treatment.

PMID- 2229528
TI  - Treatment of chronic moccasin-type tinea pedis with terbinafine: a double-blind,
      placebo-controlled trial.
AB  - Terbinafine is an orally and topically active fungicidal drug of the allylamine
      series. Its oral efficacy at 125 mg taken twice daily was evaluated in a
      randomized, double-blind, placebo-controlled study in moccasin-type tinea pedis.
      The study was conducted simultaneously in two centers and consisted of 41
      evaluable cases (23 terbinafine, 18 placebo). Mycologic cure and near to complete
      clearing of signs and symptoms were obtained in 59% of the terbinafine-treated
      patients after 6 weeks of treatment and in 65% at 2 weeks after treatment.
      Corresponding efficacy for placebo-treated patients was zero at both evaluations.
      Side effects in both groups were minimal. We conclude that terbinafine is well
      tolerated and highly effective in moccasin-type tinea pedis.

PMID- 2229529
TI  - Oral terbinafine versus griseofulvin in the treatment of moccasin-type tinea
      pedis.
AB  - The safety and effectiveness of oral terbinafine, 125 mg twice daily, and
      griseofulvin, 250 mg twice daily, in patients with moccasin-type tinea pedis were
      examined in a double-blind randomized trial. At the end of the 6-week treatment
      period, both a clinical and mycologic cure or a mycologic cure with minimal signs
      of infection was noted in 12 (75%) of the 16 terbinafine-treated patients
      compared with only 3 (27%) of the 12 patients treated with griseofulvin. The
      overall response rate 2 weeks after the completion of treatment was 88% in the
      terbinafine-treated group and 45% in the griseofulvin-treated group. When
      contacted again 6 to 15 months after completion of the study, 94% of the
      terbinafine-treated patients reported sustained clearing of tinea pedis, and 88%
      of those with nail involvement at the time of treatment reported improvement. In
      contrast, tinea pedis remained cured in only 30% of the patients who had received
      griseofulvin, and onychomycosis improved in only 14%.

PMID- 2229530
TI  - Cutaneous melanoma and bilateral retinoblastoma.
AB  - We report the case of an otherwise healthy 37-year-old man who had had bilateral
      enucleation during early childhood for bilateral retinoblastomas, in addition to
      two cutaneous melanomas (the first appearing at age 27 years). He also had
      dysplastic melanocytic nevi and a history of cutaneous melanoma in his mother.
      Retinoblastoma may aggregate in families and is associated with DNA abnormalities
      of chromosome 13. Recent reports have emphasized the appearance of second
      malignancies in retinoblastoma survivors. The second malignancies include
      osteosarcoma, soft tissue sarcoma, and cutaneous melanoma. Cutaneous melanoma
      also may aggregate in families, usually in the setting of dysplastic melanocytic
      nevi. The features of this case and of similar reported cases suggest that there
      may be a greater than expected association between retinoblastoma and cutaneous
      melanoma.

PMID- 2229531
TI  - Multicentric cloacogenic carcinoma: report of a case with anogenital pruritus at
      presentation.
AB  - A case of multicentric cloacogenic carcinoma of the perianal skin and vulva in a
      79-year-old woman is presented, and the embryologic basis for the multicentricity
      is discussed. Histologically, cloacogenic carcinoma can be differentiated from
      other small cell neoplasms that affect the area. Cloacogenic carcinoma should be
      considered a rare cause of anogenital pruritus. It is important to perform an
      early biopsy of anogenital lesions that do not respond to conventional therapy.

PMID- 2229532
TI  - Eosinophilic pustular folliculitis: fungal folliculitis?
AB  - Eosinophilic pustular folliculitis is a rare condition with no known cause.
      However, a fungal cause is suggested by (1) tinea-like annular lesions, (2)
      initial clinical consideration of fungal folliculitis in many reported cases, (3)
      an association with the acquired immunodeficiency syndrome, and (4) an
      association with scaly and vesiculopustular lesions of palms and soles. We report
      a case histologically identical to eosinophilic pustular folliculitis but in
      which hyphal fungal organisms were demonstrated in one of the involved hair
      follicles.

PMID- 2229533
TI  - Subacute cutaneous lupus erythematosus lesions progressing to morphea.
AB  - A women had annular lesions of subacute cutaneous lupus erythematosus that slowly
      resolved and were replaced by plaques of morphea. The immunologic implications of
      this unique transitional case of subacute cutaneous lupus erythematosus to
      morphea are discussed.

PMID- 2229534
TI  - Severe lidocaine intoxication by cutaneous absorption.
AB  - A severe lidocaine intoxication by cutaneous absorption is described. Data are
      presented to show a significant absorption of lidocaine through diseased skin
      when lidocaine cream is used as a local anesthetic. Awareness of this route of
      intoxication might be important in patients in whom neurologic or psychiatric
      symptoms develop while large amounts of lidocaine cream are being used.

PMID- 2229535
TI  - Persistent melanocytic lesions associated with cosmetic tanning bed use: "sunbed
      lentigines".
AB  - A patient with persistent melanocytic lesions after tanning bed use is described.
      A review of the literature provides two additional examples of similar clinical
      and histologic presentations after UVA exposure without psoralen. To our
      knowledge, this is the first reported case of "sunbed lentigines" in the United
      States.

PMID- 2229536
TI  - Miliary tuberculosis presenting as skin lesions in a patient with acquired
      immunodeficiency syndrome.
AB  - Acute miliary tuberculosis of the skin is an extremely rare infection that occurs
      in immunocompromised persons. We report an intravenous drug abuser with human
      immunodeficiency virus infection in whom erythematous papules developed on the
      trunk and proximal aspect of the extremities. Visceral lesions of unsuspected
      miliary tuberculosis were discovered at autopsy, and the cutaneous papules were
      found to contain Mycobacterium tuberculosis. This is the first reported case of
      this cutaneous infection in a patient with the acquired immunodeficiency
      syndrome.

PMID- 2229537
TI  - Disseminated Kaposi's sarcoma not associated with HIV infection in a bisexual
      man.
AB  - We report a 42-year-old white bisexual man with disseminated Kaposi's sarcoma
      limited to the skin and gastrointestinal tract. Results of several serum tests
      for human immunodeficiency virus (HIV) antibodies have been negative. The CD4/CD8
      ratio has remained normal, and his Kaposi's sarcoma has had a benign clinical
      course during 30 months of follow-up. Similar reports of disseminated Kaposi's
      sarcoma with a benign clinical course in homosexual or bisexual men without
      demonstrable HIV infection are reviewed. Some cellular immune impairment that
      might be more prevalent in the homosexual population may be implicated in the
      pathogenesis of this type of Kaposi's sarcoma.

PMID- 2229538
TI  - Traumatic asphyxia.
AB  - Traumatic asphyxia is a distinctive clinical syndrome characterized by
      cervicofacial cyanosis and edema, multiple petechiae, and subconjunctival
      hemorrhage after a severe crush injury of the thorax or of the upper part of the
      abdomen. A case of traumatic asphyxia is reported, and its clinical and
      pathophysiologic features are discussed.

PMID- 2229539
TI  - Linear porokeratosis: successful treatment with diamond fraise dermabrasion.
AB  - A patient with linear porokeratosis was successfully treated with diamond fraise
      dermabrasion. Follow-up evaluation revealed an excellent cosmetic result with
      adequate repigmentation, no scarring, and no recurrence of lesions. Long-term
      follow-up will be necessary to determine whether dermabrasion treatment of linear
      porokeratosis provides adequate prophylaxis against the subsequent development of
      malignancy.

PMID- 2229540
TI  - Vulvar melanosis.
AB  - Vulvar melanosis is a condition in which intensely pigmented irregular macules,
      clinically mimicking malignant melanoma, appear on the vulva. A biopsy specimen
      shows only marked lower epidermal pigmentation without any melanocytic atypia or
      nesting. The process is benign, and reassurance is the only treatment.

PMID- 2229541
TI  - Giant pilomatrix carcinoma: report and review of the literature.

PMID- 2229542
TI  - Eruptive seborrheic keratoses in a young woman with acromegaly.
AB  - The sign of Leser-Trelat, or eruptive seborrheic keratoses, is purported to be a
      cutaneous marker for many underlying malignancies. Elevation in levels of growth
      factors has been postulated to be the stimulus for the sudden eruption of
      multiple new seborrheic keratoses. In support of this hypothesis we present a
      case of eruptive seborrheic keratoses in a young woman with acromegaly and
      elevated levels of growth hormone.

PMID- 2229543
TI  - Neonatal nasopharyngeal hairy polyp: CT and MR appearance.
AB  - We report a rare tumor of the nasopharynx in the neonate: the teratoid or hairy
      polyp. In addition to the traditional modes of evaluation (barium swallow, plain
      radiography, and indirect laryngoscopy), CT and magnetic resonance were used to
      assess this unusual cause of respiratory distress and vomiting in a newborn.

PMID- 2229544
TI  - Temporomandibular joint chondrosarcoma: CT demonstration.
AB  - Chondrosarcoma of the temporomandibular joint is a rare lesion. A 49-year-old
      woman presented with painless left preauricular swelling. Computed tomography
      demonstrated a soft tissue mass in the left temporomandibular joint with
      extraarticular extension along the mandibular ramus. Calcification was present in
      the extraarticular component.

PMID- 2229545
TI  - Wegener granulomatosis presenting on CT with atypical bronchovasocentric
      distribution.

PMID- 2229546
TI  - CT and MR imaging of partial anomalous pulmonary venous return to the azygos
      vein.
AB  - Partial anomalous pulmonary venous return to the azygos vein is very unusual,
      occurring in 0.02% of autopsy examinations. We report the CT, magnetic resonance,
      and angiographic findings in a 67-year-old man with partial anomalous venous
      return to the azygos vein.

PMID- 2229547
TI  - CT monitoring of therapy for meconium ileus.
AB  - Meconium ileus equivalent is a common complication of cystic fibrosis in the
      postneonatal period. Because of the added risks of surgery in these patients,
      conservative management is preferred. We describe here a method of monitoring the
      conservative treatment of this condition using CT and suggest that its
      application will reduce the need for potentially dangerous surgical intervention.

PMID- 2229548
TI  - CT evaluation of atypical hepatic fatty metamorphosis.
AB  - Focal fatty metamorphosis of the liver is a well-recognized entity
      characteristically demonstrated by a nonspherical, low-density area without mass
      effect. We present a case of focal fatty metamorphosis of the liver that shows
      multiple areas of low attenuation within the liver with mass effect. Radionuclide
      liver-spleen scan shows multiple focal defects corresponding to the areas of
      fatty metamorphosis.

PMID- 2229549
TI  - Ciliated hepatic foregut cyst with solid tumor appearance on CT.
AB  - We report a patient with a rare cystic hepatic tumor that was demonstrated as a
      high density mass by unenhanced CT and as a cystic mass with high echoic spots by
      ultrasonography. At surgery, the tumor was a unilocular cyst containing viscid
      tan fluid. Histopathologically, it was lined by ciliated epithelium and diagnosed
      as ciliated hepatic foregut cyst. We discuss the correlation between radiological
      imaging and content of the cyst.

PMID- 2229550
TI  - Central dot sign on CT of liver cysts.
AB  - The central dot sign on CT in Caroli disease has been described previously. We
      describe a patient with the central dot sign who had periductal cysts but did not
      have Caroli disease.

PMID- 2229551
TI  - Pelvic mucocele following colostomy: CT and ultrasound findings.
AB  - Mucocele formation is a rare complication of colorectal surgery. We present a
      case of a mucocele following colostomy and mucosal proctectomy for fecal
      incontinence. The pathophysiologic and radiologic features are similar to those
      of mucocele of the appendix.

PMID- 2229552
TI  - Computed tomography of chronic nonpuerperal uterine inversion.
AB  - Uterine inversion is an unusual entity; chronic nonpuerperal inversion is rare.
      In this report we present a case of chronic nonpuerperal uterine inversion that
      was initially diagnosed as invasive endometrial carcinoma. The CT findings in
      this case are presented.

PMID- 2229553
TI  - Psoas muscle calcification and acute renal failure associated with nontraumatic
      rhabdomyolysis: CT features.
AB  - We present a case of reversible psoas muscle calcification associated with acute
      renal failure and alcohol intoxication. The CT demonstration of calcification led
      to the recognition of rhabdomyolysis.

PMID- 2229554
TI  - MR demonstration of intraosseous beta-2-microglobulin amyloidosis.
AB  - We present a case of intraosseous beta-2-microglobulin amyloidosis of a patient
      receiving long-term hemodialysis. Magnetic resonance imaging clearly demonstrated
      intraosseous amyloid deposits as hypointense masses in the femoral head.

PMID- 2229555
TI  - Meniscofemoral ligament simulating tear of the lateral meniscus: MR features.
AB  - The meniscofemoral ligament can simulate pathology on magnetic resonance images.
      It can be mistaken for a free osteochondral fragment on sagittal images. A less
      common pitfall is the simulation of a tear of the posterior horn of the lateral
      meniscus. A case demonstrating this meniscal pseudotear is presented.

PMID- 2229556
TI  - Rheumatoid iliopsoas bursitis: MR findings.

PMID- 2229557
TI  - Three-dimensional segmentation of MR images of the head using probability and
      connectivity.
AB  - We describe a three-dimensional (3D) segmentation method that comprises (a) user
      interactive identification of tissue classes; (b) calculation of a probability
      distribution for each tissue; (c) creation of a feature map of the most probable
      tissues; (d) 3D segmentation of the magnetic resonance (MR) data; (e) smoothing
      of the segmented data; (f) extraction of surfaces of interest with connectivity;
      (g) generation of surfaces; and (h) rendering of multiple surfaces to plan
      surgery. Patients with normal head anatomy and with abnormalities such as
      multiple sclerosis lesions and brain tumors were scanned with a 1.5 T MR system
      using a two echo contiguous (interleaved), multislice pulse sequence that
      provides both proton density and T2-weighted contrast. After the user identified
      the tissues, the 3D data were automatically segmented into background, facial
      tissue, brain matter, CSF, and lesions. Surfaces of the face, brain, lateral
      ventricles, tumors, and multiple sclerosis lesions are displayed using color
      coding and gradient shading. Color improves the visualization of segmented
      tissues, while gradient shading enhances the perception of depth. Manipulation of
      the 3D model on a workstation aids surgical planning. Sulci and gyri stand out,
      thus aiding functional mapping of the brain surface.

PMID- 2229558
TI  - Laser projection system for radiotherapy and CT-guided biopsy.
AB  - We devised a laser projection system combined with a CT scanner and radiotherapy
      treatment planning computer (CT stimulator). The irradiation field can be
      projected over a range of 180 degrees on the skin of a patient lying on the CT
      couch. For CT-guided biopsy, the system can project the skin entry point and
      needle direction.

PMID- 2229559
TI  - Normal and abnormal white matter tracts shown by MR imaging using directional
      diffusion weighted sequences.
AB  - A pulsed magnetic field gradient spin echo technique was used to study the brain
      of two volunteers and eight patients. The pulsed gradients were applied both
      perpendicular and parallel to the image slice. Striking changes in signal
      intensity were demonstrated in white matter depending on the direction in which
      pulsed gradients were applied. These effects enabled specific white matter tracts
      to be identified depending on the direction of their fibres. Abnormalities were
      also demonstrated in these tracts in patients with a variety of diseases,
      including cases where only minor abnormalities were seen with conventional,
      highly T2-weighted sequences. The effects were attributed to anisotropically
      restricted diffusion within white matter. The technique may have application in a
      wide range of neurological disease and result in better localisation of lesions
      and improved detection of disease.

PMID- 2229560
TI  - Three-dimensional time-of-flight MR angiography in the evaluation of cerebral
      aneurysms.
AB  - We review our preliminary experience with the use of three-dimensional (3D) time
      of-flight (TOF) magnetic resonance (MR) angiography (MRA) in the assessment of
      intra- and extracranial aneurysms. Six patients were examined: Five had
      intracranial aneurysms and one had a cervical carotid pseudoaneurysm. A 3D
      rephased gradient recalled echo pulse sequence and maximum intensity projection
      (MIP) reconstruction algorithm were used. Magnetic resonance angiography, spin
      echo MR, and conventional angiography were retrospectively reviewed with specific
      regard to individual vessel visualization, aneurysm depiction, and presence of
      artifact related to acquisition techniques or MIP reconstruction. All aneurysms
      were detected on MRA, and anatomical correlation with conventional angiography
      was excellent. Significant problems included loss of visualization of small
      vessels, intraluminal signal loss in large vessels, subacute thrombus simulating
      flow on MIP reconstructions, and limited projections obtainable with MIP
      techniques. Adequate MRA assessment of aneurysms can be obtained using a
      combination of T1-weighted spin echo images and 3D TOF MRA. Review of all
      components of the MRA is required. MRA may be useful in screening asymptomatic
      patients for intracranial aneurysms as well as in the follow-up of patients
      treated with balloon occlusion.

PMID- 2229561
TI  - Proton MR spectroscopy and imaging of the brain in AIDS: evidence of neuronal
      loss in regions that appear normal with imaging.
AB  - Central nervous system involvement is increasingly being recognised as a common
      manifestation of the acquired immunodeficiency syndrome (AIDS), either as a
      direct effect of the human immunodeficiency virus, or as a result of secondary
      infection or malignancy. A subset of patients with clinical or psychometric
      evidence of CNS involvement have normal appearances on imaging. This report
      describes proton magnetic resonance spectroscopy (1H MRS) in two patients with
      AIDS and discusses the role of 1H MRS in providing a marker of neuronal loss in
      patients with normal or borderline imaging.

PMID- 2229562
TI  - Proton MR spectroscopy of the brain in infants.
AB  - Proton magnetic resonance spectroscopy (MRS) was used to study the brain of 2
      normal and 15 abnormal infants aged from 33 weeks postmenstrual age (PMA) to 14
      months postnatal age. Eleven of the infants were examined on at least two
      occasions. The principal clinical diagnoses in the abnormal infants were
      perinatal ischemic and hemorrhagic brain injury. All proton spectra demonstrated
      peaks that were assigned to N-acetylaspartate (NAA), choline containing compounds
      (Cho), and creatine plus phosphocreatine (Cr). The NAA/Cho and NAA/Cr ratios
      increased with age, while the Cho/Cr ratio decreased with age in the majority of
      infants. The NAA/Cho ratio was generally lower in abnormal infants, but the
      difference was not apparent before 40 weeks (PMA). This ratio was lowest in
      infants with the severest degree of neurological abnormality. Proton and
      phosphorus MRS was compared in seven infants. In those with severe brain lesions,
      early phosphorus spectra were abnormal. On follow-up the phosphorus spectra
      became normal, but the proton spectra showed persistently low NAA/Cho and NAA/Cr
      ratios. Proton MRS provides new information that may be complementary to
      phosphorus MRS in the diagnosis and monitoring of brain development in normal and
      neurologically damaged infants.

PMID- 2229563
TI  - MR imaging of vertebrobasilar vascular disease.
AB  - Sixteen patients with vascular lesions of the vertebral and basilar arteries were
      studied with magnetic resonance imaging. The vascular abnormalities included
      seven cases of atherosclerotic disease with partial or complete thrombosis, six
      aneurysms, two cases of vertebrobasilar dolichoectasia, and one basilar artery
      dissection. Magnetic resonance effectively demonstrated vascular thrombosis with
      occlusion as high signal intensity on spin echo (SE) sequences with absence of
      flow void and no flow enhancement on gradient echo (GRE) images. Nonthrombosed
      aneurysms exhibited mixed signal intensity on SE images and hyperintensity on GRE
      images. Intraluminal thrombus also appeared heterogeneous, with variable signal
      intensity depending on the specific components of hemorrhage present. Correlation
      of the SE and GRE scans was helpful for distinguishing stasis and turbulent flow
      from thrombus. Compression of cranial nerves by vascular structures was clearly
      depicted in both cases of dolichoectasia. Basilar artery dissection was displayed
      as a focal area of flow void surrounded by a thrombosed false lumen. Magnetic
      resonance is an effective noninvasive method for evaluating vascular pathology of
      the vertebrobasilar system.

PMID- 2229564
TI  - White matter hyperintensities may correspond to areas of increased blood volume:
      correlative MR and PET observations.
AB  - A method for correlating positron emission tomography with magnetic resonance
      (MR) imaging enabled the authors to examine the high intensity white matter areas
      in T2-weighted images in patients with internal carotid artery occlusion. The
      high intensity areas showed increased cerebral blood volume compared with the
      ipsilateral and contralateral normal intensity white matter. This observation may
      have relevance in explaining some of the patchy white matter lesions seen in MR
      images.

PMID- 2229565
TI  - MR of cord transection.
AB  - Spinal cord transection following breech or difficult cephalic deliveries has
      been well described. It is important to be aware that spinal cord transection in
      children may occur following severe trauma such as motor vehicle accidents often
      without evidence of underlying skeletal injury. We report three pediatric cases,
      one of which showed no evidence of underlying skeletal injury and two where the
      level of cord transection was below and remote from the site of a cervical
      fracture. When a neurologic deficit does not correlate with a known bony or
      ligamentous level of injury or is present despite normal routine plain
      radiographs, further imaging is warranted to exclude a remote cord transection as
      demonstrated in our patients.

PMID- 2229566
TI  - Case of anaphylaxis and four cases of allergic reaction following Gd-DTPA
      administration.
AB  - Although Gd-diethylenetriamine pentaacetic acid (Gd-DTPA) is considered to be
      safe and well tolerated by patients, we have seen adverse reactions in 5 of 344
      cases. This paper reports those five cases of reactions to intravenous Gd-DTPA
      injection.

PMID- 2229567
TI  - Cholesterol granuloma of the frontal bone: CT diagnosis.
AB  - Cholesterol granuloma of the frontal bone is a distinct clinical entity. This
      expanding lesion grows slowly within the diploe of the frontal bone until it
      extends into the orbit and causes globe displacement. We report the clinical and
      the CT findings in 11 patients with cholesterol granuloma of the orbit. The CT
      characteristics of cholesterol granuloma of the frontal bone appear to enable a
      correct preoperative diagnosis.

PMID- 2229568
TI  - Pulmonary arteriovenous malformations: diagnosis by gradient-refocused MR
      imaging.
AB  - Six known or suspected pulmonary arteriovenous malformations (AVMs) in four
      patients were evaluated with magnetic resonance (MR) imaging at 1.5 T. All
      lesions were imaged using a gradient-refocused echo pulse sequence with a 25/13
      ms [repetition (TR)/echo (TE) times] and a 30 degrees flip angle, as well as with
      a cardiac-gated spin echo short TR/TE pulse sequence technique. Five of the
      lesions were vascular in nature based on their signal intensity characteristics,
      and one nonvascular lesion was a carcinoid tumor. On the spin echo images, the
      AVMs showed a central signal intensity void with a peripheral rim of intermediate
      signal intensity that was detectable for lesions greater than or equal to 1.5 cm
      in size. Smaller lesions were more difficult to distinguish from the surrounding
      air-filled lung, which normally generates no appreciable signal on MR images. The
      AVMs demonstrated uniform high signal intensity on the gradient echo pulse
      sequence and were more conspicuous, irrespective of size. With a single breath
      hold scan, the vascular nature of the lesion could be rapidly confirmed with an
      acquisition time of 13 s. In three patients, the cine MR gradient echo images
      showed a pulsatile quality to the signal intensity in the lesion over the cardiac
      cycle similar to that within adjacent pulmonary vessels. The results of this
      study show a potential role for gradient echo MR imaging as a rapid, noninvasive
      method to evaluate the vascular nature of an atypical pulmonary nodule.

PMID- 2229569
TI  - Staphylococcal mediastinitis due to sternoclavicular pyarthrosis: CT appearance.
AB  - Three cases of acute mediastinitis secondary to staphylococcal sternoclavicular
      pyarthrosis are reported. In each case, the patient presented with minimal signs
      and symptoms and mediastinitis was not suspected until demonstrated by
      preoperative CT. Since septic arthritis of the sternoclavicular joint may be
      insidious in onset and is associated with a high incidence of life-threatening
      secondary mediastinitis, CT is recommended as the initial imaging study in the
      evaluation of unexplained sternoclavicular joint pain and swelling.

PMID- 2229570
TI  - MR evaluation of chest wall involvement in malignant lymphoma.
AB  - Chest CT and magnetic resonance (MR) examinations of 28 patients with newly
      diagnosed or recurrent lymphoma involving the mediastinum were retrospectively
      evaluated for evidence of chest wall involvement. Computed tomography
      demonstrated seven sites of chest wall involvement in four patients; whereas MR
      demonstrated 14 sites in seven patients, including all sites shown by CT. Eight
      chest wall lesions were located in the extranodal soft tissues (three sites were
      contiguous with anterior mediastinal lymphadenopathy; three sites were contiguous
      with pleural/parenchymal disease; and one each involved the breast and multiple
      vertebral bodies). Six sites involved lymph nodes in the interpectoral (n = 4),
      submammary (n = 1), and infraspinatus (n = 1) areas. Lesion conspicuity in the
      chest wall was better on T2- than T1-weighted sequences and was best on short
      inversion time inversion recovery. Detection of chest wall lymphoma may alter
      staging; when present in this group of patients, it influenced management in two
      of the seven patients.

PMID- 2229571
TI  - Computed tomography of renal lymphoma.
AB  - The CT studies of 29 patients with renal or perirenal lymphoma were
      retrospectively reviewed. Four patterns of disease were identified. Seventeen of
      29 patients (59%) had bilateral renal masses. Only seven of these patients had
      associated enlarged retroperitoneal lymph nodes. Eight patients (28%) had single
      renal or perirenal lesions adjacent to or contiguous with bulky retroperitoneal
      lymphadenopathy. Three patients had infiltration of the perirenal space without
      significant renal parenchymal involvement, and one patient had a solitary renal
      mass. No patients in this series had diffuse involvement of the kidney without a
      focal mass. Renal involvement with lymphoma should be considered in any patient
      who develops multiple homogeneous solid renal or perirenal masses, even in the
      absence of other retroperitoneal disease.

PMID- 2229572
TI  - Gadolinium-DOTA enhanced MR imaging of adnexal tumors.
AB  - We conducted a retrospective study to assess the potential of contrast enhanced
      magnetic resonance (MR) imaging in evaluating adnexal tumors. Sixty patients with
      a total of 77 pelvic lesions underwent MR imaging at 1.5 T and transabdominal
      ultrasound (US). Precontrast T1- and T2-weighted and Gd-DOTA enhanced T1-weighted
      MR images were obtained. Diagnoses were proved by surgery in 57 patients. Of the
      77 lesions, 54 masses were of ovarian origin, including 12 malignant disorders.
      Ultrasound demonstrated the lesions in 92%, whereas the sensitivity of unenhanced
      T2-weighted and postcontrast MR images was 98 and 96%, respectively. Compared to
      the T2-weighted images, postcontrast MR imaging showed superior overall tumor
      delineation, assessment of intratumoral architecture, and definition of tumor
      origin. Contrast enhancement of tumors did not differ significantly between
      normal ovary and benign and malignant lesions. All modalities were unable to
      predict malignancy of complex lesions. Based on our study, US remains the
      screening modality of choice in the evaluation of adnexal tumors. Contrast
      enhanced MR imaging may be valuable for assessing complex lesions or when the
      origin of the mass cannot be determined by US. Using contrast enhanced T1
      weighted images instead of T2-weighted images may lead to a significant reduction
      in acquisition time.

PMID- 2229573
TI  - Impending rupture of nonaneurysmal bacterial aortitis: CT diagnosis.
AB  - The CT appearance of mycotic abdominal aortic aneurysms leading to eventual
      rupture has been well described. On the other hand, ruptured nonaneurysmal
      bacterial aortitis has not been demonstrated in the CT literature. We present two
      cases with subsequent rupture documented on CT. The characteristic findings of
      periaortic density and adjacent gas collection should suggest the diagnosis of
      acute aortic infection. This may herald impending rupture, even in the absence of
      aneurysmal dilatation, and should direct therapy accordingly.

PMID- 2229574
TI  - Proton chemical shift imaging of bone marrow for monitoring therapy in leukemia.
AB  - In three patients with different forms of leukemia, follow-up examinations
      before, during, and after chemotherapy and bone marrow transplantation were
      performed by proton chemical shift imaging (1H-CSI). The relative fat and water
      fractions were computed in representative regions of the marrow in the femur,
      pelvis, and lumbar spine. On serial examinations the fat fractions increased over
      time, in agreement with the responses to therapy proven by bone marrow biopsies
      from the iliac crest. These preliminary results suggest a role for magnetic
      resonance and CSI in the monitoring of therapy in leukemia and systemic
      neoplastic diseases.

PMID- 2229575
TI  - Grading liposarcomas with PET using [18F]FDG.
AB  - Five patients with liposarcomas of the thigh were studied using positron emission
      tomography (PET) with [18F]2-deoxy-2-fluoroglucose (FDG). There were three low
      grade tumors (all National Cancer Institute Grade 1 myxoid liposarcomas) and two
      high-grade tumors (both pleomorphic liposarcomas, Grades 2 and 3). The low-grade
      liposarcomas were easily identified with an average dose uptake ratio (DUR) of
      1.38 +/- 0.045 (mean +/- SD). The high-grade lesions were more avid for FDG with
      a mean DUR of 2.45 +/- 0.24. There was a significant difference (p = 0.004) in
      the DUR for the two groups and the histological grade of malignancy was highly
      correlated with the DUR for FDG (Rho = 0.89). These findings suggest that FDG-PET
      may be useful for distinguishing between low-grade and high-grade liposarcomas.

PMID- 2229576
TI  - MR evaluation of triangular fibrocartilage complex tears in the wrist: comparison
      with arthrography and arthroscopy.
AB  - To evaluate the accuracy of magnetic resonance (MR) in the detection of tears of
      the triangular fibrocartilage complex (TFCC), 10 consecutive patients with
      posttraumatic chronic wrist pain were examined with MR, arthrography, and
      arthroscopy and the results were compared. The MR images of 16 control subjects
      were also examined to define the MR appearance of the normal TFCC. When compared
      with arthroscopic findings, both MR and arthrography had two false-negative
      results (sensitivity, 80%) and no false-positive results. Regarding the sites of
      the TFCC tears, the findings on MR did not always correlate with the findings on
      arthrography. In no case was MR able to visualize the cartilaginous lesions
      visible by arthroscopy. These preliminary results illustrate the ability of MR to
      assess the integrity of the TFCC and suggest its use as the first imaging
      technique following plain radiography in the evaluation of patients with chronic
      posttraumatic pain on the ulnar side of the wrist.

PMID- 2229577
TI  - MR patterns of dialysis arthropathy.
AB  - Ten patients (average age 51 years) on long-term hemodialysis (average duration
      13.5 years) were examined by magnetic resonance (MR) (all cases) and CT (five
      cases) for cystic radiolucencies of the wrist, shoulders, and hips. MR and CT
      revealed more lesions of smaller size than plain films and both showed a constant
      communication with the joint space. Synovial hypertrophy was generally absent or
      very mild even in the case of large osseous erosions. The MR analysis of the
      content of the lesions in the wrist was quite variable: low signal on T1- and T2
      weighted images (12 of 24), low signal on T1- and high signal on T2-weighted
      images (10 of 24), and high signal on T1- and T2-weighted images (2 of 24). The
      patterns of transplanted (four cases) or ungrafted (six cases) patients were
      indistinguishable. These results suggest an articular origin of the lesions, but
      different from synovial processes such as rheumatoid arthritis, and confirm their
      probable multifactorial pathogenesis.

PMID- 2229578
TI  - The "notch" sign: meniscal contour deformities as indicators of tear in MR
      imaging of the knee.
AB  - Conventional magnetic resonance (MR) criteria for meniscal tearing emphasize
      intrameniscal signal and its communication with the articular surface. In this
      retrospective study, the value of a focal contour deformity of the meniscal
      articular surface, termed a "notch," as an additional MR sign of meniscal tearing
      was assessed. One hundred fifty-four menisci were evaluated. Twenty-three of 24
      notches correlated with the site of tear at arthroscopy. Seven notches improved
      the reading confidence from possible to definite tear; in eight notches, the
      diagnosis of tear would otherwise not have been considered. Five tears occurred
      without intrameniscal signal, four following recent trauma. The notch sign
      improved the sensitivity from 79.8 to 87.8%. Notches are useful additional signs
      of meniscal tearing, increasing the confidence of a reading when occurring near
      grade 1 or 2 meniscal signal, and are the only MR sign present in some tears.

PMID- 2229579
TI  - Cranial MR imaging in hypomelanosis of Ito.
AB  - Hypomelanosis of Ito (HI) is a rare neurocutaneous syndrome frequently associated
      with neurologic abnormalities. Approximately 95 cases have been reported in the
      literature. Intracranial findings demonstrated by magnetic resonance imaging in a
      patient with HI include hemimegalencephaly, abnormal white matter signal, and
      small discrete bilateral periventricular cysts. No gray matter heterotopias or
      other migrational abnormalities were identified. Periventricular cystic lesions
      have not been described previously in this condition.

PMID- 2229580
TI  - Lhermitte-Duclos disease: CT and MR findings.
AB  - The typical CT findings of Lhermitte-Duclos disease (dysplastic gangliocytoma of
      the cerebellum) are a hypodense nonenhancing unilateral posterior fossa mass,
      with or without adjacent occipital thinning, hydrocephalus, and calcification.
      Magnetic resonance (MR) has been found to be very helpful, and superior to CT, in
      delineating the margins of the lesion for determining the extent of surgical
      resection. Since recurrence is known, MR is important in the follow-up of these
      patients. To our knowledge this is the first reported case that included MR
      examination with administration of gadolinium. There was no enhancement of the
      lesion, consistent with previous reports of no contrast enhancement on CT.

PMID- 2229581
TI  - MR imaging of spinal pachymeningitis.
AB  - We report a case with pathologic correlation that demonstrates the magnetic
      resonance imaging characteristics of spinal pachymeningitis. Contrast enhanced T1
      weighted images clearly demonstrated the thickened contrast enhancing meninges in
      a patient with progressive radiculomyelopathy who had both clinical and imaging
      evidence of progression of disease.

PMID- 2229582
TI  - MR findings in a patient with Ramsay-Hunt syndrome.
AB  - A case of Ramsay Hunt syndrome (herpes zoster oticus) was studied with Gd
      diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging using a
      surface coil rather than a conventional head coil. This allowed us to demonstrate
      in detail the inflammatory changes of the multiple structures, involved.

PMID- 2229583
TI  - Estimation of maxillary alveolar cleft volume by three-dimensional CT.
AB  - Reconstruction of cleft lip and palate deformities is a challenging problem
      involving a variety of the subspecialties of surgery, dentistry, and medicine as
      well as radiology. This paper outlines the contribution of three-dimensional CT
      to preoperative treatment planning for bone grafting of a maxillary cleft
      alveolus.

PMID- 2229584
TI  - Nasopharyngeal melanotic melanoma: MR characteristics.
AB  - This report presents a rare case of nasopharyngeal melanoma with maxillary sinus
      extension and lymph node metastasis. The unusual magnetic resonance signal
      features and the differential diagnosis are discussed.

PMID- 2229585
TI  - Effects of florfenicol, chloramphenicol, and thiamphenicol on phagocytosis,
      chemiluminescence, and morphology of bovine polymorphonuclear neutrophil
      leukocytes.
AB  - Florfenicol, chloramphenicol, and thiamphenicol were tested in vitro to determine
      their potential toxic effects on bovine neutrophils. Antibiotics were tested at
      4000, 2000, and 10 micrograms/ml of incubation mixture. Percentage phagocytosis
      was determined by incubations with neutrophils isolated from milk of five cows
      and 32P-labeled Staphylococcus aureus and 5% skim milk. The effect of 4000
      micrograms of each antibiotic on chemiluminescence was determined on neutrophils
      isolated from mammary secretions of three nulliparous heifers. Morphological
      evaluation by transmission and scanning electron microscopy was performed on
      neutrophils isolated from two heifers at antibiotic concentrations of 4000 and 10
      micrograms/ml. Chloramphenicol depressed phagocytosis at the high and medium
      doses and blocked chemiluminescence activity at the high dose. No effects were
      observed for florfenicol and thiamphenicol. Transmission electron microscopic
      examination showed that at the high concentration of drugs, 99, 99, 97, and 76%
      of the neutrophils treated with florfenicol, chloramphenicol, thiamphenicol, and
      dimethyl sulfoxide were abnormal. Examination by scanning electron microscopy
      showed that the percentage of neutrophils without pseudopodia averaged 67, 94,
      32, and 16%, respectively. Results indicated that neither florfenicol nor
      thiamphenicol altered neutrophil function, but they did alter neutrophil
      morphology, although to a lesser extent than did chloramphenicol.

PMID- 2229586
TI  - Total and differential somatic cell counts and N-acetyl-beta-D-glucosaminidase
      activity in mammary secretions during dry period.
AB  - Eighteen Holstein cows free of intramammary infection were sampled during dry
      period to measure changes in total SCC, differential cell counts, and N-acetyl
      beta-D-glucosaminidase activity of milk or dry secretion. The design was to
      sample prior to and at drying off, two or more times during wk 1 of dry period,
      at 14 and 21 d of dry period, and after calving; 7 cows were sampled rotationally
      by quarters at 7, 14, and 21 d to avoid altering normal processes by repeated
      sampling. Total SCC of secretions declined just after drying off, increased to a
      peak of 6.593 (log10 scale) at 2 wk, and then declined slightly at 3 wk.
      Percentage of neutrophils rose from 33.3 at drying off to 83.8 at 1 wk and
      declined to 59.2 at 3 wk. Lymphocyte percentage declined in wk 1 of dry period
      but increased during wk 2 and 3. Activity of N-acetyl-beta-D-glucosaminidase in
      secretion rose throughout the first 3 wk of dry period.

PMID- 2229587
TI  - Bacterial counts associated with recycled newspaper bedding.
AB  - Bacterial counts associated with recycled newspaper, wood shavings, and pelleted
      corn cobs used as bedding for lactating dairy cows were compared. Chopped
      newspaper and pelleted corn cobs had similar gram-negative bacterial, coliform,
      and streptococcal bedding counts. Staphylococcal counts in pelleted corn cobs
      were greater than in chopped newspaper. Conversely, gram-negative bacterial,
      coliform, and staphylococcal counts in chopped newspaper were greater than in
      wood shavings. Coliform and streptococcal counts did not differ between chopped
      newspaper and wood shavings bedding materials. Teat swab counts from cows bedded
      on pelleted corn cobs were greater than those from cows bedded on chopped
      newspaper for gram-negative bacterial, coliform, Klebsiella species, and
      staphylococci. Streptococcal teat swab counts did not differ between cows bedded
      on chopped newspaper and pelleted corn cobs. Cows bedded on chopped newspaper and
      wood shavings had similar gram-negative bacterial, coliform, and Klebsiella
      species teat swab counts. Streptococcal and staphylococcal teat swab counts were
      greater from cows bedded on chopped newspaper than those from cows bedded on wood
      shavings. Teat swab and bedding counts were correlated. In general, bacterial
      counts in bedding suggest no advantage in using chopped newspaper over pelleted
      corn cobs or wood shavings in reducing exposure of teats to environmental
      mastitis pathogens.

PMID- 2229588
TI  - Sodium intake by pregnant cows and plasma aldosterone and cortisol concentrations
      in the fetus during late pregnancy.
AB  - The purpose of this study was to evaluate the influence of maternal dietary Na
      intake on the plasma concentrations of aldosterone and cortisol in cows and their
      fetuses during late pregnancy. Seven cows received a diet with normal amounts of
      Na (25 g Na per cow/d) and seven others an Na-loaded diet (210 g Na per cow/d)
      during the last 40 d of gestation. Maternal and fetal blood samples were
      collected regularly during the last month of gestation through jugular vein
      puncture and cotyledonary artery indwelling catheters. Serum Na and K
      concentrations and plasma osmolalities increased, but concentrations of
      aldosterone decreased in maternal and fetal plasma when cows were fed the Na
      loaded diet. Diets did not modify concentrations of cortisol in maternal and
      fetal plasma. Thus, an increase in Na intake by dams influenced concentration of
      Na and K in fetal plasma and fetal adrenal secretion of aldosterone.

PMID- 2229589
TI  - Double insemination and gonadotropin-releasing hormone treatment of repeat
      breeding dairy cattle.
AB  - Our objective was to determine if double inseminations during the same estrous
      period of dairy cattle eligible for their third or fourth service (repeat
      breeders) would improve pregnancy rates equivalent to injections of GnRH given at
      the time of AI. Repeat-breeding, lactating cows from six herds (five herds in the
      San Joaquin Valley of central California and one herd in northeast Kansas) were
      assigned randomly to four treatment groups when detected in estrus: 1) single AI
      plus no injection, 2) single AI plus 100 micrograms GnRH at AI, 3) double AI plus
      no injection, or 4) double AI plus 100 micrograms of GnRH at AI. Inseminations
      were performed according to the a.m.-p.m. rule. The second AI for the double AI
      treatment was given 12 to 16 h after the first AI. Injections of GnRH were given
      intramuscularly immediately following the single AI or the first AI of the double
      AI. Pregnancy rates of cows given a single AI and hormone injection were
      numerically higher in all six herds than those of their herdmates given only a
      single AI. In five of six herds, the pregnancy rates of cows given a double AI
      and hormone injection were numerically higher than pregnancy rates of their
      herdmates given only a double AI. Overall pregnancy rates for the four treatments
      were 1) 112/353 (32.1%), 2) 165/406 (41.6%), 3) 119/364 (33.5%), and 4) 135/359
      (37.5%). Gonadotropin-releasing hormone increased pregnancy rates of repeat
      breeders compared with controls given only a single AI. No further benefit beyond
      the single AI was accrued from the double AI treatment, with or without
      concurrent hormone administration.

PMID- 2229590
TI  - Effects of androgenizing dairy heifers with ear implants containing testosterone
      and estrogen on detection of estrus.
AB  - Lactating dairy cows in four lots were observed for sexual behavior for 6 mo. One
      freemartin heifer in each lot was implanted with testosterone propionate and
      estradiol benzoate to aid in detection of estrus. Blood samples were obtained
      from androgenized heifers every other week for determination of serum
      testosterone. The addition of an androgenized heifer to each lot increased the
      number of mounts and attempts to mount cows, both overall and within observation
      periods. Thus, the likelihood of detecting a cow in estrus was increased with the
      addition of the androgenized heifers. Greatest benefit was seen when one or two
      cows were simultaneously in estrus in each lot. Observational data and serum
      progesterone concentration of mounted cows indicated that androgenized heifers
      were selectively mounting open cows displaying estrus, whereas the remaining
      nonandrogenized cows were less selective with their mounting activity. Serum
      testosterone increased after heifers were implanted, but testosterone was not
      related to the proportion of sexual activity. Duration of sexual activity by the
      implanted heifers was approximately 90 d.

PMID- 2229591
TI  - Nonreturn rates of dairy cattle following uterine body or cornual insemination.
AB  - In the dairy cattle industry, uncertainty still remains regarding the most
      desirable site of inseminate deposition to maximize AI conception rates. The
      effect of site of inseminate deposition on nonreturn rates was determined from
      2195 cornual and 2428 uterine body-bred dairy cattle. Twelve technicians from
      various areas of Pennsylvania and New York were chosen on the basis of their
      accuracy of semen deposition in retraining sessions, average nonreturn rates, and
      their willingness to cooperate in the study. For a 3-mo period (June, July, and
      August 1988), technicians alternated weeks of cornual and uterine breeding on all
      dairy cattle inseminated. One-half (.25 ml) of each semen unit was deposited
      approximately 5.1 cm into each uterine horn for cornual insemination. No
      significant difference in nonreturn rates was found between horn-bred (70.8%) and
      body-bred (69.5%) cows. The range of differences in percent nonreturn rates for
      technicians was 19 and 30% for body and cornual inseminations, respectively. A
      significant difference in nonreturn rates was found between technicians and
      between months with significantly higher average nonreturn rates (6.8%) in June.
      Cornual and uterine body deposition of semen yielded similar results; therefore,
      depositing an inseminate in the uterine horns to maximize fertility is
      unnecessary.

PMID- 2229592
TI  - Dissociation of calcium soaps of long-chain fatty acids in rumen fluid.
AB  - Dissociation of 5% solutions of calcium soaps of soya, tallow, stearic acid, and
      palm fatty acid distillate was studied by titration with 1 N HCl. Release of
      calcium ions was directly correlated with decrease in pH value. Estimated pKa
      values were 5.6, 4.6, 4.5, and 4.5 for calcium soaps of soya, palm fatty acid
      distillate, tallow, and stearic acid, respectively. Dissociation of 5% solutions
      in acetate buffer at pH values of 5.0, 5.5, 6.0, and 6.5 was measured in terms of
      release of soluble calcium. Dissociation was maximum at pH 5.0, minimum at pH
      6.5, and dependent on unsaturation of fatty acids in the soaps. Soluble calcium
      in the acetate-buffered rumen fluid was higher than predicted from pKa of calcium
      soaps, due to formation of soluble calcium acetate; however, the relative
      patterns were similar to their pKa values. Unsaturated soaps are less
      satisfactory for maintaining normal rumen function, because dissociation is
      relatively higher. Calcium soaps of palm fatty acid distillate were
      satisfactorily stable to pH 5.5.

PMID- 2229593
TI  - Effects of feeding fungal culture extract and animal-vegetable fat on degradation
      of hemicellulose and on ruminal bacterial growth in heifers.
AB  - Four Holstein heifers cannulated in the rumen and proximal duodenum were used to
      analyze effects of Aspergillus oryzae fermentation extract and yeast culture
      (Amaferm Micro-Mix. Biozyme Enterprises, Inc., St. Joseph, MO) and 5% animal
      vegetable fat on ruminal and total tract digestibilities of nutrients. Heifers
      were assigned treatments in a 4 x 4 Latin square design with a 2 x 2 factorial
      arrangement of treatments. Few interactions between main effects were noted.
      Feeding fat decreased ruminal molar ratio of acetate:propionate. Rate of
      disappearance of potentially digestible NDF from orchardgrass hay was higher when
      heifers were fed fat. Thus, the lack of differences in digestibilities of NDF,
      ADF, or in the major hemicellulosic sugars is interpreted to suggest that 5%
      animal-vegetable fat had few toxic effects on ruminal microbes under the
      conditions of this study. Amaferm Micro-Mix tended to increase acetate:propionate
      in the rumen, but had little effect on site or extent of digestion of any of the
      fiber components measured. Efficiency of bacterial protein synthesis was not
      affected by treatment. Ruminal and total tract digestibilities of total
      hemicellulosic sugars were highly correlated (r = .82 and .72) with respective
      digestibilities of hemicellulose measured as NDF minus ADF.

PMID- 2229594
TI  - Influence of decoquinate fed to neonatal dairy calves on early and conventional
      weaning systems.
AB  - Forty-four Holstein calves were assigned randomly to treatments in a 2 x 2
      factorial arrangement of weaning age (4 or 7 wk) and coccidiostat (treatment or
      control). The objective of this study was to compare the effectiveness of a
      coccidiostat, decoquinate, on health parameters and growth of neonatal dairy
      calves on early and conventional weaning systems. Calves weaned at 4 wk had
      greater intakes of grain in wk 5 to 7 than did calves weaned at 7 wk. Differences
      in intakes between weaning groups were not apparent from wk 8 to 24. Fecal
      coccidia oocyst counts were not affected by age at weaning but were affected by
      coccidiostat feeding at the rate of .5 mg/kg BW/d offered from 3 d of age and
      throughout the trial. No effects due to age at weaning or coccidiostat treatment
      were found in plasma glucose, urea N, and minerals (Ca, P, Na, Cl, K, Mg). Growth
      parameters were significantly increased in treated animals. Total BW was
      increased (wk 9 to 24) in treated over control calves (127.3 versus 118.5 kg).
      Height at withers was also increased in treated calves (95.0 vs. 92.8 cm).
      Coccidiosis treatment increased growth of dairy calves from 9 to 24 wk, but no
      interactions were found between coccidiosis treatment and age at weaning.

PMID- 2229595
TI  - Effects of feeding frequency on ruminal parameters, plasma insulin, milk yield,
      and milk composition in Holstein cows.
AB  - Two experiments were conducted to determine the effects of frequency of feeding
      on ruminal fermentation, blood parameters, milk yield, and milk composition in
      cows fed a 60% pelleted concentrate and 40% chopped alfalfa hay (DM basis) diet.
      In Experiment 1, four ruminally cannulated cows were fed concentrates in 12 equal
      portions at 2-h intervals or in two equal portions at 0500 and 1500 h in a
      crossover design. In Experiment 2, treatments were as in Experiment 1 plus an
      additional treatment consisting of a total mixed diet fed at 2-h intervals in a 3
      x 3 Latin square design. All treatment periods were 2 wk. In Experiment 1,
      increased frequency of concentrate feeding tended to result in elevated ruminal
      pH and increased acetate to propionate ratio. Plasma insulin concentration tended
      to be higher (1.54 vs. 1.04 ng/ml) and milk fat percentage increased from 2.21 to
      2.60% for 2 and 12 times daily feeding, respectively. In Experiment 2, frequency
      of feeding concentrate or total mixed diet did not affect ruminal and blood
      parameters or milk yield. In both experiments, milk protein and lactose
      concentrations were not influenced by feeding frequency. Results suggest that
      where intake is kept constant, increased feeding frequency will not influence
      milk yield but could result in elevated milk fat percent in animals fed fat
      depressing diets.

PMID- 2229596
TI  - Stochastic modeling of multiple ovulation and embryo transfer breeding schemes in
      small closed dairy cattle populations.
AB  - Genetic changes and genetic drift in three small closed dairy cattle populations
      were examined with a stochastic simulation model. Multiple ovulation and embryo
      transfer and AI techniques were simulated in three populations, two with 88
      breeding females each and one with 352 breeding females. The selection goal was
      to maximize genetic improvement in milk yield. The reduction in genetic variation
      due to inbreeding and linkage disequilibrium was accounted for in the simulation.
      Strict restriction against inbred mating slowed genetic progress significantly in
      the small population but would not be consequential in the larger population.
      However, allowing inbred mating in the smaller population caused a rapid
      accumulation of inbreeding. Linkage disequilibrium was as important as inbreeding
      in reducing genetic variation. Genetic drift variance was much smaller in the
      larger population.

PMID- 2229597
TI  - Effect of sialoadenectomy on the ability of mouse serum to induce
      deoxyribonucleic acid synthesis in mammary epithelial cells: possible role of
      epidermal growth factor.
AB  - Serum was collected from sham-operated or sialoadenectomized mice and added to
      serum starved cultures of normal mouse mammary epithelial cells. Synthesis of
      DNA, estimated with a pulse of 1 microCi/ml [3H]thymidine between 17 and 18 h
      after adding serum, was increased by serum. Sialoadenectomy did not affect the
      ability of low serum concentrations (less than 4%) to increase DNA synthesis, but
      DNA synthesis induced by higher serum concentrations was reduced by
      sialoadenectomy. Physiological concentrations of epidermal growth factor restored
      the ability of serum from sialoadenectomized mice to increase DNA synthesis.
      Antiepidermal growth factor reduced DNA synthesis in cultures treated with high
      concentrations of serum from sham-operated mice, but not in cultures treated with
      serum from sialoadenectomized mice. Time course studies indicated that the time
      of maximum DNA synthesis was similar between cultures treated with serum from
      sham-operated and sialoadenectomized mice. Treatment with serum from
      sialoadenectomized mice for 4 d resulted in lower cell number than did treatment
      with serum from sham-operated mice. This effect of sialoadenectomy could be
      overcome by epidermal growth factor. These data indicate that sialoadenectomy,
      which has previously been shown to depress mammary gland development, alters the
      endocrine status of mice, such that serum from sialoadenectomized mice is less
      effective in inducing DNA synthesis by mammary epithelial cells. These
      differences in ability of serum to induce DNA synthesis can be explained by
      differences in epidermal growth factor concentration or the concentration of
      epidermal growth factor-like constituents.

PMID- 2229598
TI  - Effect of acute challenge with an extreme dose of somatotropin in a prolonged
      release formulation on milk production and health of dairy cattle.
AB  - Eight pregnant Holstein cows were given weekly injections of 15 g of recombinant
      bST over a 2-wk period for a total dose of 30 g to determine signs of acute
      toxicity. Cows were monitored intensively throughout the study, and samples were
      taken for analyses of hormones, metabolites, chemistries, hematology, and urine
      analytes. Animal health throughout the study was generally excellent. Mean rectal
      temperatures were significantly higher in treated cows (38.7 vs. 39.2 degrees C).
      Least squares means for 3.5% FCM production were 15.9 and 23.0 kg/d, and net
      energy intakes were 29.4 and 26.9 Mcal/d for control and treated cows,
      respectively. Somatotropin concentrations reached more than 250 ng/ml on d 10 and
      remained above 200 ng/ml. Insulin and glucose concentrations were also increased
      but returned toward baseline values. Free fatty acid concentrations were higher
      in treated cows, but beta-hydroxybutyrate was not affected. Most hematological
      measurements were unaffected except for a reduction in erythrocyte number in
      treated cows and decreases in hematocrit and hemoglobin, but values were within
      clinically normal ranges. Although cows received in 2 wk a dose that was
      equivalent to the amount administered during more than 2 yr of continuous use, no
      signs of acute toxicity to bST were observed.

PMID- 2229599
TI  - Effects of preventing periparturient hypocalcemia in cows by parathyroid hormone
      administration on hematology, conglutinin, immunoglobulin, and shedding of
      Staphylococcus aureus in milk.
AB  - The effects of hypocalcemia at parturition on concentrations of serum
      immunoglobulin and conglutinin, number of bacteria shed into milk, and leukograms
      of dairy cows were investigated from -4 wk prepartum to 4 wk postpartum. Ten
      healthy multiparous Holstein cows were fed a high calcium diet to induce
      hypocalcemia at parturition. Five cows received intramuscular parathyroid hormone
      to prevent hypocalcemia at parturition. All cows experienced a leukopenia
      (attributable to an absolute and relative neutropenia) during the 1st wk after
      calving, decreased serum conglutinin activity during the first 3 wk postpartum,
      and decreased concentration of serum IgG1 during the 3 wk before calving. At
      parturition, a large increase in organisms was found in foremilk (1000 to 10,000
      times more than prepartum values). Neither the hematological changes nor the
      decreased immunoglobulin concentration was influenced by hypocalcemia or the
      development of milk fever. This implies that the degree of hypocalcemia observed
      did not have a large or irreversible influence on bacterial infection,
      hematological, or humoral immunity changes in periparturient cows.

PMID- 2229600
TI  - Lymphocyte blastogenesis inhibition by milk whey as an indicator of mastitis.
AB  - Sixty milk whey samples prepared from quarters of five cows with a history of
      mastitis were tested for their ability to inhibit DNA synthesis in mitogen
      stimulated lymphocytes. The inhibitory activity was compared with milk SCC,
      electrical conductivity, pH, and the number of colony-forming bacteria in the
      milk. Milk whey contained factors that inhibited DNA synthesis in cultured
      lymphocytes. Inhibition of mitogen-induced DNA synthesis increased with the
      clinical severity of mastitis and with increased values of indirect indicators of
      mastitis. The increases in inhibition and electrical conductivity were delayed
      past the increases in SCC. Milk whey (10 microliters) from quarters with clinical
      mastitis and from quarters with SCC greater than 900,000 inhibited 96 to 100%, 84
      to 100%, and 69 to 100% of DNA synthesis in 3-d cultures of lymphocytes
      stimulated with Concanavalin A, phytohemagglutinin P, and pokeweed mitogen,
      respectively. The numbers of colony-forming bacteria correlated least with the
      inhibitory activity.

PMID- 2229601
TI  - Evaluation of a chlorous acid-chlorine dioxide teat dip under experimental and
      natural exposure conditions.
AB  - A postmilking teat dip containing chlorous acid-chlorine dioxide was evaluated by
      experimental challenge and in two herds under natural exposure. The test product
      had an efficacy of 78.9% against Staphylococcus aureus and 52.5% against
      Streptococcus agalactiae in the experimental challenge trial. The product was
      compared with a 1% iodine product in a 15-mo natural exposure study. Post-dipping
      with chlorous acid-chlorine dioxide reduced incidence of udder infection by major
      mastitis pathogens 36.1% when data were combined from the two herds. The 1%
      iodine and the chlorous acid-chlorine dioxide products were not equivalent for
      major mastitis pathogens; the test product was more effective. Incidence of udder
      infection by environmental mastitis pathogens was reduced 36.8% in both herds
      combined. Efficacy of the two teat dips was equivalent for environmental
      pathogens.

PMID- 2229602
TI  - Videomicroscopic comparison of bull sperm and leukocyte chromosome areas as
      related to gender.
AB  - Chromosomal areas from metaphase spreads of male bovine leukocytes were digitized
      and sex chromosomes identified using videomicroscopy. Autosomal areas were ranked
      in descending order within a cell and assigned to two categories based on
      alternating rank. X and Y chromosome areas were assigned to respective
      categories. Areas were divided by 4 to make their sum equivalent to sperm DNA
      content. Data were analyzed before and after inclusion of sex chromosomal areas.
      Before X and Y inclusion, rank contributed to difference in chromosomal areas.
      Rank by category interaction and category effects did not contribute to area
      variation. After X and Y inclusion, area variation was due to rank by category
      interaction, rank, and category. Differences between sums of chromosomal areas
      across categories was 3.57%. Head areas of morphologically normal sperm with
      intact acrosomes were digitized using the same optics as chromosomal areas. Sum
      of corrected chromosomal areas per category was used in discriminant analysis to
      assign sperm head areas to two categories with .5 prior probabilities. Assignment
      resulted in 1037 sperm in one category and 1177 in the other. Difference between
      largest sperm head area classes across categories was 3.2%. Discrimination of
      sperm head areas, based on sum of chromosomal area and measured with computerized
      videomicroscopy, may be used to evaluate sex of bovine spermatozoa.

PMID- 2229603
TI  - Digesta kinetics in sheep and cattle fed diets with different forage to
      concentrate ratios at high and low intakes.
AB  - Effect of maintenance and ad libitum intakes on digesta kinetics was studied with
      six ruminally fistulated cows and six ruminally fistulated wethers to validate
      the use of sheep as a model of cattle. Complete diets were made up of ratios of
      alfalfa:cracked corn and soybean meal of 80:20, 55:45, and 30:70. The rate of
      passage of Cr-mordanted alfalfa and soybean meal in the reticulorumen was
      negatively related to percentage of concentrate in the diet in both species at
      low intakes. Passage values of particulate and liquid markers were faster at high
      than at low intakes in both species for all diets. Rumen liquid volume increased
      with intake only in the cows on the low and intermediate concentrate diets. No
      substantial differences were found in particulate passage values between sheep
      and cattle. However, liquid passage rates from the rumen and the differentials
      between liquid and particulate dilution rates were higher in cows than in sheep
      for all diets at both intakes. These results together with those for
      digestibility data reported in a previous communication suggest that caution
      should be exercised when extrapolating results from one species to the other.

PMID- 2229604
TI  - Overall efficacy of chronically administered recombinant bovine somatotropin to
      lactating dairy cows.
AB  - Recombinant bST at daily dosages of 0, 10.3, 20.6, and 41.2 mg/d were injected
      for 266 d into 8, 10, 9, and 9 Holstein cows, respectively. Treatment effects of
      recombinant bST were assessed for milk production traits, BW, blood components,
      and health and reproductive variables. Data reported compare controls to all bST
      treated cows. There was an average increase of 18% in 3.5% FCM for bST versus
      control cows. This increase resulted in enhanced feed efficiency for bST cows, as
      their DM intakes were not elevated above those of the control cows. Recovery of
      BW was similar between control and bST groups. Milk composition was unaffected
      except for a slight decrease in protein percentage during the first 9 wk of
      treatment, and an elevated SCC between wk 19 and 28. Blood parameters were not
      different between control and bST cows, except for hematocrit, which decreased
      with bST treatment. The only health and reproductive parameters affected by bST
      were mastitis and days open, which were increased in the highest dosage groups.

PMID- 2229605
TI  - Dose response of dairy cows to ammonium salts of volatile fatty acids.
AB  - In previous studies ammonium salts of a mixture of isobutyrate, 2-methylbutyrate,
      isovalerate, and valerate were fed in a corn silage, corn, corn gluten meal, and
      urea diet to Holstein cows throughout lactation to define the optimum level of
      ammonium salts of milk production. The objective of this work was to conduct
      another dose response study using other forage and protein sources and to
      determine the effects of decreasing VFA intakes as lactation advanced. The
      concentrate portion of the diet contained 0, .4, .8, 1.2, or 1.6% ammonium salts
      of VFA. The forage to concentrate ratio was 50:50, 60:40, and 70:30 for the
      first, middle, and last third of lactation, respectively. The study was conducted
      at four university locations using 191 Holstein cows. Feeds used included corn
      silage, alfalfa silage or hay, corn, soybean meal, minerals, and vitamins.
      Treatment x location interactions were significant for milk yield during early
      lactation. During mid- and late lactation, supplemental VFA (.8%) improved milk
      and protein yield. Milk composition was not greatly affected by feeding VFA. In
      mid-lactation, cows fed .8% ammonium salts of VFA ate more feed than did
      controls. Feed efficiencies were similar among groups throughout the experiment.
      Cows fed VFA tended to gain less BW during lactation than did controls. Health
      and reproduction were not different among groups.

PMID- 2229606
TI  - Efficacy of chlorhexidine as a postmilking teat disinfectant for the prevention
      of bovine mastitis during lactation.
AB  - A natural exposure trial was conducted for 12 mo in a herd of 150 lactating
      Jersey cows to determine efficacy of a .35% chlorhexidine teat dip containing a
      glycerine emollient for the prevention of bovine intramammary infections. Right
      teats of cows were dipped in the experimental teat dip after milking machine
      removal and left teats were not dipped. The herd was free of Streptococcus
      agalactiae and had a low prevalence of Staphylococcus aureus. Most new major
      pathogen intramammary infections resulted from Streptococcus species, primarily
      Streptococcus uberis and Streptococcus dysgalactiae. New infections by
      Streptococcus species were significantly lower in teats dipped in chlorhexidine
      than in undipped teats. Overall efficacy of the chlorhexidine teat dip against
      major mastitis pathogens was 50%. The experimental teat dip also reduced
      coagulase-negative Staphylococcus species infections 49.0% and Corynebacterium
      bovis infections 65.2%. Overall efficacy against minor mastitis pathogens was
      54.0%. No irritation or chapping of teats dipped in the experimental teat dip was
      observed.

PMID- 2229607
TI  - The effect of sucrose application and implantation of mutans streptococci on the
      microbial composition of three-week experimental plaque--an in situ study.
AB  - This study describes the predominant cultivable microflora of three-week-old
      plaque samples obtained from human enamel sites, on the basis of microbial
      identification of over 9000 fresh isolates. Lower removable appliances, on which
      were mounted enamel sections and slabs, were worn by five young adult subjects
      under three experimental protocols. These were (1) 'normal' plaque conditions,
      (2) extra-oral sucrose applications nine times daily, and (3) inoculation of each
      subject's own mutans streptococci onto the enamel test sites and sucrose
      applications, as described above. With the exception of slightly higher
      proportions of Gram-negative bacilli associated with slab plaque following
      sucrose application, no significant differences in percentage or absolute counts
      of organisms were found between normal and sucrose plaques. The inoculation of
      mutans streptococci, combined with extra-oral sucrose applications, was
      associated with significantly higher percentages and absolute mean counts of both
      mutans streptococci and lactobacilli, and lower proportions of S. sanguis and S.
      oralis. Although the isolation frequency of mutans streptococci increased in all
      subjects and the overall mean proportion rose following inoculation, considerable
      inter-subject variation was seen in mean percentage counts of these organisms
      isolated from the three-week plaque samples.

PMID- 2229608
TI  - An intra-oral appliance study of the plaque microflora associated with early
      enamel demineralization.
AB  - An intra-oral appliance model was used to investigate the composition of the
      plaque microflora associated with early enamel demineralization. Enamel sections,
      with exposed windows, were mounted on lower removable appliances, and the devices
      were worn by volunteers for three-week periods under three experimental
      conditions. These were: (1) "normal" plaque conditions, (2) extra-oral sucrose
      applications nine times daily, and (3) inoculation of each volunteer's own mutans
      streptococci onto the test sites and sucrose applications as described for (2).
      After 21 days, the plaque overlying each window was removed, and the bacterial
      composition was determined. Changes in mineral content of the associated enamel
      were measured by microradiography and microdensitometry, and the total mineral
      loss (delta z) that had occurred at each site was calculated. The 144 sites
      studied were divided into four demineralization groups by delta z value, with an
      increase in mineral loss from group 1 to group 4. A progressive and significant
      increase in the isolation frequency of mutans streptococci occurred from delta z
      group 1 to group 4 sites. These organisms were isolated from the plaque of every
      location with enamel mineral loss of over 1000 delta z units, but were not
      detected in 27% of the group 3 sites. Lactobacilli comprised 2% to 3% of the
      total cultivable microflora in groups 1-3 sites, but were found in significantly
      higher proportions (18%) at those enamel sites experiencing the most extensive
      mineral loss (group 4). No significant relationship was found between
      demineralization and the levels of Actinomyces species or Veillonella.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2229609
TI  - Primary structure and anticandidal activity of the major histatin from parotid
      secretion of the subhuman primate, Macaca fascicularis.
AB  - A major macaque histatin (M-histatin 1) from the parotid secretion of the
      subhuman primate, Macaca fascicularis, was isolated by gel filtration on Bio-Gel
      P-2 and purified to homogeneity by reversed-phase high-performance liquid
      chromatography on a TSK-ODS C18 column. The complete amino acid sequence of M
      histatin 1, determined by automated Edman degradation, is: (formula; see text) M
      histatin 1 contains 38 amino acid residues, a phosphoserine at residue 2, has a
      molecular weight of 4881.8, a calculated pI of 8.5, and histidine forms 26.3% of
      the mass. The hydropathicity plot of M-histatin 1 predicts that the molecule is
      entirely hydrophilic, and Chou-Fasman secondary prediction indicates that the
      polypeptide is devoid of alpha-helix and beta-sheet conformation in aqueous
      solutions but contains a series of beta turns. M-histatin 1 includes a six-amino
      acid insert (residue 10-15) not present in human histatins and, with the
      introduction of gaps to maximize homology, it displays 89% and 91% sequence
      similarity with human histatins 1 and 3, respectively. M-histatin 1 exhibited
      fungicidal and fungistatic effects against the dimorphic pathogen, Candida
      albicans, in three separate bioassays. Its anticandidal effects were comparable
      with or greater than those of human histatins 1, 3, and 5. M-histatins 2, 3, and
      4 were not sequenced directly because insufficient materials were available, but
      the amino acid composition of M-histatin 3 was nearly identical to that of the N
      terminal 20 amino acid residues of M-histatin 1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229610
TI  - mRNAs for PRPs, statherin, and histatins in von Ebner's gland tissues.
AB  - A search was made for expression of genes for proline-rich proteins (PRPs) and
      other salivary-type proteins, including statherin and histatins, in taste-bud
      tissues of mice and primates because of previous genetic findings in mice (Azen
      et al., 1986) that Prp and taste genes for certain bitter substances are either
      the same or closely linked. Taste-bud tissues and other tissues were tested for
      specific mRNAs with labeled DNA probes by Northern blotting and in situ
      hybridization. It was found that PRP mRNAs were present in von Ebner's glands of
      mice and macaques, and that there was a much greater degree of PRP mRNA induction
      in mouse parotid (16-fold) than in von Ebner's gland (two-fold) after in vivo
      isoproterenol stimulation. This difference may be due, in part, to differences in
      autonomic nerve innervation. Statherin and histatin mRNAs were found in macaque
      taste-bud tissues containing von Ebner's gland, and statherin protein was found
      in human von Ebner's gland by immunohistochemistry. The finding of PRP gene
      expression in von Ebner's gland, whose secretions have been suggested to play a
      role in taste stimulation, adds further support to a possible function of PRPs in
      bitter tasting. The possible functions of statherin and histatins in von Ebner's
      gland secretions may be related to statherin's regulation of salivary calcium and
      histatins' antibacterial and antifungal properties.

PMID- 2229611
TI  - Effect of solution composition on morphological and structural features of
      carbonated calcium apatites.
AB  - The composition of enamel mineral corresponds to that of a calcium carbonato
      apatite. For insight to be gained into the precipitation of carbonato-apatites
      having specific properties (crystal size, morphology, and carbonate incorporation
      into the crystal lattice), apatites were prepared at 80 degrees C in aqueous
      systems having various CO3 concentrations and pH values of around 7.5 or 10.5 (+/
      0.5). The various preparations had a wide range (0.005 to 0.19) of CO3/Ca molar
      ratios that bracket the ratios found in porcine enamel mineral at various
      developmental stages. Fourier transform infrared spectroscopy (FTIR) and x-ray
      diffraction analyses showed that the calcium apatites precipitating at neutral pH
      incorporated the carbonate into both the hydroxyl and phosphate ion sites in
      their lattices (A,B-types), whereas the preparations made at the alkaline pH
      (high OH-(-)CO3(2-)-competition) or in the presence of fluoride (F-(-)CO3(2-)
      competition) yielded only the B-type carbonato-apatite. It was also ascertained
      that the size and morphology of the carbonato-apatites, assessed by specific
      surface area determination and high-resolution electron microscopy, were highly
      dependent on the driving force for precipitation and the presence of regulators
      (CO3(2-) and F-) in solution. In neutral media, early precipitates were thin
      ribbon in appearance, but grew into crystals having flattened-hexagonal cross
      sections. In the presence of fluoride or in alkaline media, acicular apatite
      crystals, precipitated initially, grew into large rod-like carbonato-apatites
      having a symmetric-hexagonal cross-section. In both neutral and alkaline
      solutions, carbonate inhibited the growth of apatite crystals along their c axis,
      leading to the formation of bulkier crystals. The formation of carbonato-apatites
      at the neutral pH and their properties are consistent with observations made on
      enamel minerals formed in the early developmental stages.

PMID- 2229612
TI  - Polymorphism of submandibular-sublingual salivary proteins which promote adhesion
      of Streptococcus mutans serotype-c strains to hydroxyapatite.
AB  - Previously, we showed that human submandibular-sublingual (SMSL) salivas contain
      one or more proteins, Mr circa 300,000 daltons, which specifically promote
      adhesion of Streptococcus mutans serotype-c strains to hydroxyapatite. Also,
      sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) showed that
      the adhesion-promoting proteins (APPs) exhibit heterogeneity. The aims of the
      present study were to determine whether APPs are generally present in human SMSL
      salivary secretions and to characterize the noted heterogeneity. Acid-stimulated
      SMSL saliva samples were obtained from 54 Japanese subjects, and Mr values were
      obtained by SDS-PAGE. APPs were present in all saliva samples examined, though at
      significantly different concentrations. The APPs occurred as either single (20
      subjects) or double bands (34 subjects), with a mean Mr (88 bands) of 297 kD and
      a range of 248-338 kD. A plot of the frequency distribution of the APPs according
      to Mr showed a trimodal distribution, with mean Mr values, standard deviations,
      and ranges for the three groups being 265 (S.D., 6.9; range, 248-278), 293 (S.D.,
      6.7; range, 280-305), and 320 (S.D., 7.0; range, 310-338) kD. Variations of Mr
      within groups may be attributed to experimental variation, although
      microheterogeneity cannot be excluded. Differences between groups can best be
      explained in terms of three polymorphic proteins, with low (L), intermediate (I),
      and high (H) Mr values. Six phenotypes were detected with L, I, H, LI, LH, and IH
      Mr bands. A Hardy-Weinberg analysis showed that the phenotype data fit a single
      gene, three-alleles model.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229613
TI  - Phenotypic changes of rabbit mandibular condylar cartilage cells in culture.
AB  - The present study describes the behavior of mandibular condylar cartilage (MCC)
      cells as a function of time in primary culture, since it is not yet clear whether
      these cells maintain their phenotype in culture. MCC cells from New Zealand white
      rabbits were seeded at high density and cultured in DMEM containing 50
      micrograms/mL ascorbic acid and 10% fetal bovine serum. These cells appeared as a
      heterogeneous population and changed their shape, size, and refractivity as
      cultures aged. Cartilage-like cells, which always dominated the culture, were
      infiltrated with a minority of fibroblast-like cells. Cell number increased
      progressively, and cultures reached confluence at nine days. Antibody activity
      for cartilage-specific glycosaminoglycan was determined by ELISA assay. This
      reaction reached a maximum at six days and decreased thereafter. Cultures stained
      with Alcian blue (pH 1.0) supported these results. Cytoplasmic mRNA analysis
      indicated that the transcription of type II collagen gene was present at all time
      points. Type I collagen and alkaline phosphatase mRNA levels showed progressive
      increases from 12 h to nine days, with significantly higher values in cells
      cultured for six, nine, and 12 days than in cells collected from earlier time
      points. These results suggest that in our present culture system, MCC cells
      undergo phenotypic changes that resemble their maturation processes in vivo.

PMID- 2229614
TI  - Effect of Pd on the clinical performance of amalgam.
AB  - The purpose of this study was to determine the effect of a small amount of Pd on
      the clinical performance of a high-copper spherical-particle dental amalgam. Two
      identical alloys, with and without 0.5% Pd, were investigated. The marginal
      fracture, surface texture, and surface luster of 193 clinical restorations were
      evaluated at one year, those of 182 at two years, and those of 144 at three years
      of service. In vitro corrosion tests of anodic polarization and constant
      potential coulometry were also conducted. Over the three-year period, the results
      showed no differences in marginal fracture or surface texture between the two
      alloys. However, the alloy with Pd showed a significant superiority in surface
      luster over this time period. Both corrosion tests showed less electrochemical
      activity on the part of the alloy containing Pd.

PMID- 2229615
TI  - A new, small-color-difference equation for dental shades.
AB  - Traditionally, dental-shade-guide standards are designated in terms of Munsell
      hue (H), value (V), and chroma (C). However, delta E color differences proposed
      as ADA tolerances for shade guides are in the CIE L*a*b* system. The purpose of
      this study was to evaluate a new color-difference equation, delta EM = C delta
      H/5 + 7 delta V + 4 delta C for estimation of small color differences by Munsell
      parameters. The published values of the Bioform shade-guide tooth colors
      determined with a Beckman spectrophotometer were used. Color differences among
      276 combinations of the 24 Bioform shade-guide colors were calculated with Eq. 1,
      with use of the Munsell notation, and also with the CIE L*a*b* equation for delta
      E. An estimate of the accuracy of Eq. 1 was 0.41 delta E units when delta E CIE
      was below 4.0. The Vita shade-guide colors were determined with a Beckman
      spectrophotometer. This data set contained 16 samples, and 120 combinations were
      used for calculation of color difference. An estimate of the accuracy for this
      set of data was 0.35 delta E units when delta E CIE was less than 4.0. The new
      color-difference equation provides a means for estimation of delta E CIE L*a*b*
      color difference between dental shades with Munsell notation. This equation will
      be useful for estimation of small delta E CIE L*a*b* values for shade-guide teeth
      that are designated in terms of Munsell notation.

PMID- 2229616
TI  - Development of horizontal tooth wear in maxillary anterior teeth from five to 18
      years of age.
AB  - Sizes of horizontal wear facets of maxillary anterior teeth were studied
      longitudinally from the primary dentition at age five to the young adult
      dentition at the age of 18 years. By a planimetric method, we calculated the wear
      areas on dental casts taken at the ages of five, ten, 14, and 18 years from the
      dentition of 39 healthy, orthodontically untreated subjects with good
      morphological occlusion. For young adults, we also studied the association
      between the amount of wear and reported parafunctions, maximal bite force,
      salivary buffer capacity, salivary flow rate, and some cephalometric variables.
      Size of wear facets on all anterior teeth increased with age. Significant
      correlations were found between the total wear areas of the six anterior primary
      teeth at five years of age and those of their permanent successors at age 14 (r =
      0.44) and 18 (r = 0.39). For an individual, tooth wear at five years of age was,
      however, of low predictive value for tooth wear in young adulthood, whereas tooth
      wear at 14 years of age predicted it well (r = 0.89). Highest correlations
      between tooth wear and background factors at 18 years of age were found for
      maximal anterior bite force (r = 0.44) and for the size of the gonial angle (r = 
      0.31). Wear of anterior teeth was not associated with reported parafunctions in
      young adulthood.

PMID- 2229617
TI  - A 24-month clinical study of the incidence and progression of dental caries in
      relation to consumption of chewing gum containing xylitol in school preventive
      programs.
AB  - The effect of chewing gum containing xylitol on the incidence and progression of
      dental caries was tested in a sample of 274 children, aged eight and nine years,
      of low socio-economic status and high caries rate. They were divided into two
      experimental groups (15% and 65% xylitol chewing gum distributed three times a
      day at school) and one control group (without chewing gum). The three groups were
      exposed to the same basic preventive program. Children who chewed gum had a
      significantly lower net progression of decay (progressions-reversals) over a 24
      month period than did the controls. Results for the two groups chewing gum were
      similar. Chewing xylitol gum had a beneficial effect on the caries process for
      all types of tooth surfaces, and especially for bucco-lingual surfaces. The two
      experimental groups had a DMF(S) increment of 2.24 surfaces, compared with 6.06
      surfaces for the control group. For this indicator, there was no difference
      between the two experimental groups. Results for the plaque index were in
      agreement with those of the DMF(S) increment and the net progression of decay.

PMID- 2229618
TI  - Variation of approximal tooth contact tightness with postural change.
AB  - In order to investigate the role played by posture in determining posterior
      dental contact tightness, we measured contact tightness of maxillary and
      mandibular posterior teeth in ten adult subjects, while each was initially seated
      upright, after each had assumed a supine posture for two h, and finally after
      each had returned to an upright posture for two h. The technique used for
      measurement of contact tightness was based on frictional force concepts and
      consisted of the recording of the force required to withdraw a 0.038-mm-thick
      stainless-steel strip that had been slipped into each contact. A decreased mean
      tightness of all maxillary and mandibular contacts followed the change from an
      upright to a supine posture. The most significant decrease (-32%) occurred at the
      mandibular first molar-second premolar contact, and the smallest decrease (-10%)
      occurred at the mandibular first premolar-canine contact. An increased mean
      tightness of all maxillary and mandibular contacts followed a return to an
      upright posture. The most significant increase (20%) occurred at the maxillary
      first molar-second premolar contact, and the smallest increase (8%) occurred at
      the maxillary first premolar-canine contact. We conclude that posterior dental
      contact tightness, generally regarded by dentists as a static feature of
      occlusion, varies significantly as a function of posture.

PMID- 2229619
TI  - Factors affecting dentist participation in a state Medicaid program.
AB  - Provider participation is one factor affecting access to care for Medicaid
      recipients. There is evidence that providers are increasingly limiting their
      acceptance of Medicaid patients. Reasons cited for physicians and dentists not
      participating in Medicaid include low reimbursement rates, excessive paperwork,
      denial of reimbursement, and bureaucratic complexities. Telephone interviews were
      conducted with 92 dentists in California to determine factors affecting their
      decisions to participate in the California Medicaid (Medi-Cal) program. Low fees,
      denial of payment, and broken appointments by patients were identified as the
      three most important problems with the program. Non-participating dentists were
      more concerned about broken appointments, and complicated paperwork while less
      likely to believe the complexity of the program had recently decreased.
      Participating dentists were more concerned about the lack of services covered by
      Medi-Cal. The fact that participating and non-participating dentist have similar
      concerns about most aspects of the program may indicate that dentists who
      currently participate in Medi-Cal may become non-participants if problems with
      the program are not addressed.

PMID- 2229620
TI  - Development and validation of a consumer quality assessment instrument for
      dentistry.

PMID- 2229621
TI  - First permanent molar restoration differences between those with or without
      dental sealants.

PMID- 2229622
TI  - Professional satisfaction among California general dentists.
AB  - Dentists' assessments of their jobs provide insights about issues in the dental
      profession needing attention. This study assessed professional satisfaction among
      558 California general dentists using the 54-item, multi-faceted Dentist
      Satisfaction Survey (DSS). Although dentists tended to be satisfied with various
      facets of their jobs and careers, substantial variation in the levels of
      satisfaction was noted. The most satisfied dentists were older, reported higher
      incomes, attended more continuing education, and employed more dental auxiliaries
      than dentists who were the most dissatisfied. Fifty-eight percent of the
      variation in overall job satisfaction was explained by quality of nonwork life
      and satisfaction with five facets of the profession: respect received from being
      a dentist, the actual process of delivering care, income derived from dentistry,
      relationships with patients, and reduced levels of job-related stress. Dentists
      were most dissatisfied with the threat of malpractice, level of income, demands
      of managing the practice, and amount of personal time. Professional organizations
      should direct programs to address these issues. Dental educators should use these
      findings to counsel predoctoral students about the realities of dental practice
      and as an outcome measure of their programs. Moreover, these findings document
      the perceptions of the practicing profession and support several components of
      the SELECT recruitment strategy.

PMID- 2229623
TI  - Dental implant patients and their satisfaction with treatment.

PMID- 2229624
TI  - Development of the Geriatric Oral Health Assessment Index.
AB  - The development of measures for assessing oral health status is essential to the
      evolution and maturation of a scientific knowledge base in geriatric dentistry.
      The literature suggests a high prevalence of dental diseases in older adults, yet
      valid and reliable instruments to assess the impact of oral diseases on older
      individuals or populations are lacking. This paper describes the rationale for
      and the development of the Geriatric Oral Health Assessment Index (GOHAI), a self
      reported measure designed to assess the oral health problems of older adults.
      Following a review of the literature and consultation with health care providers
      and patients, a pilot instrument was developed. The GOHAI was initially tested on
      a convenience sample of 87 older adults. A revised instrument was then
      administered to a sample of 1755 Medicare recipients in Los Angeles County. The
      GOHAI demonstrated a high level of internal consistency and reliability as
      measured by a Cronbach's alpha of 0.79. Associations of the GOHAI with a single
      item rating of dental health and with clinical and sociodemographic supported the
      construct validity of the index. Having fewer teeth, wearing a removable denture
      and perceiving the need for dental treatment were significantly related to a
      worse (lower) GOHAI score. Respondents who were white, well educated, and with a
      higher annual household income were more likely to have a high GOHAI score,
      indicating fewer dental problems. Additional applications of the GOHAI are
      necessary to further evaluate the instrument's validity and reliability, and to
      establish population norms of oral health in older adult populations as measured
      by the GOHAI.

PMID- 2229625
TI  - Modeling dental health care workers' risk of occupational infection from
      bloodborne pathogens.

PMID- 2229626
TI  - But, it's not what I expected.

PMID- 2229627
TI  - The role of health services research in developing practice policy: development
      of practice guidelines.

PMID- 2229628
TI  - The Agency for Health Care Policy and Research: expanding the opportunities for
      dental health services research.

PMID- 2229630
TI  - Treatment of the aging face: principles and practice.

PMID- 2229629
TI  - Institute of Medicine activities related to the development of practical
      guidelines.

PMID- 2229632
TI  - Histologic changes in skin associated with aging.
AB  - This is a review of histologic changes noted in the skin of elderly individuals.
      Among the epidermal changes associated with skin aging are a flattened dermal
      epidermal junction, giving the appearance of atrophy and cellular heterogeneity.
      The melanocyte density declines slowly, and the Langerhans cells decrease in
      number with advancing age. Among the dermal changes are attenuation in the number
      and diameter of elastic fibers in the papillary dermis, an increase in number and
      thickness of the same fibers in the reticular dermis, and a coarsening of
      collagen fibers with an increase in density of the collagen network. A decrease
      in the dermal cell population as well as a functional decline in glandular
      activity are also noted with intrinsic aging. A decline in hair number, rate of
      growth, and diameter, along with a slowing of the rate of growth of nails, have
      been well documented with progressive aging.

PMID- 2229631
TI  - The aging face: a psychocutaneous perspective.
AB  - The cutaneous stigmata of aging may affect an individual's mental well-being,
      body image, and quality of life. Before proceeding with treatment, the
      dermatologist should take into consideration the patient's overall life situation
      and evaluate whether or not there is severe psychopathology and body image
      distortion.

PMID- 2229633
TI  - Cellular and molecular mechanisms of cutaneous aging.
AB  - There are two major theories of aging: the programmatic theory states that aging
      is an inherent genetic process, and the stochastic theory states that aging
      represents random environmental damage. Processes that are associated with
      cellular damage and aging are the production of free radicals (a process much
      enhanced after ultraviolet irradiation) and an increasing number of errors during
      DNA replication. Cellular manifestations of intrinsic aging include decreased
      life span of cells, decreased responsiveness of cells to growth signals, which
      may reflect loss of cellular receptors to growth factors, and increased
      responsiveness to growth inhibitors. All these findings are more pronounced in
      cells derived from photodamaged skin. Molecular manifestations of intrinsic
      aging, studied mainly in fibroblasts, are altered membrane composition, adhesion
      properties, production of extracellular matrix, and activity of the enzyme
      catalase. Molecular changes as a result of photoaging are less well
      characterized; published studies mainly target differences in composition of the
      extracellular dermal matrix.

PMID- 2229634
TI  - Clinical features of photodamage and treatment with topical tretinoin.
AB  - Photodamage constitutes a skin disease that merits therapy. Immediate cosmetic
      improvement of photodamaged skin can be achieved most dramatically by surgical
      means. Medical intervention has been limited until the recent advent of topical
      retinoic acid products for photoaging. These medications have been shown to
      enhance cosmesis and to produce long-lasting physiologic changes. The clinical
      features of photodamage and treatment with topical tretinoin are discussed.

PMID- 2229635
TI  - Sunscreens and the prevention of skin aging.
AB  - It has been well established in both human and animal skin that ultraviolet
      radiation from both ultraviolet B (UVB) (290 nm-320 nm) and ultraviolet A (UVA)
      (320 nm-420 nm) can produce profound changes in the skin that with recurrent
      exposure, cause it to become what we recognize as photoaged skin. Experimental
      studies in animals have confirmed that some sunscreen chemicals are capable of
      providing protection against ultraviolet-induced photoaging. It is presumed that
      regular use of these effective sunscreens will also reduce skin aging changes in
      humans.

PMID- 2229636
TI  - The future of topical therapy for cutaneous aging.
AB  - The elements of cutaneous aging have been well described and include changes of
      intrinsic or chronologic aging as well as changes of extrinsic or environmental
      aging. We also include male pattern alopecia in this category. The current
      dominance of tretinoin in cutaneous aging therapy is likely to be challenged by
      newer classes of retinoids, by topical antiandrogens, and by alternative
      treatments for proliferative lesions.

PMID- 2229637
TI  - The role of chemical peeling in the treatment of photodamaged skin.
AB  - Management of the aging face involves evaluation of the degree of solar
      elastosis, rhytidosis, and the structural changes associated with senescent skin.
      Chemical facial exfoliation is divided into deep, medium, and superficial based
      upon depth of penetration of the caustic agent used. Knowledge of the appropriate
      indications and technique are essential in obtaining optimal clinical results.

PMID- 2229638
TI  - Silicone, fibrel, and collagen implantation for facial lines and wrinkles.
AB  - In recent decades, cutaneous surgeons have contributed to the development of a
      number of implantable materials useful in the management of facial lines and
      wrinkles. Among these, the most effective are injectable liquid silicone, bovine
      collagen implant (Zyderm/Zyplast, Collagen Corporation, Palo Alto, CA) and
      gelatin matrix implant (Fibrel, Mentor Corporation, Goleta, CA). Each of these
      treatments carries its own balance of efficacy, safety, and ease of use.
      Clinicians are encouraged to evaluate each of these treatments in order to be
      able to offer a full range of injectable therapy for the aging face.

PMID- 2229639
TI  - Microliposuction and autologous fat transplantation for aesthetic enhancement of
      the aging face.
AB  - The accumulation of subcutaneous fat that occurs with age in certain areas of the
      face, ie, heavy melolabial folds, prominent jowl formation, and accumulation of
      fat under the chin, can make a person look older than he or she is. Removal of
      fat from these areas by microliposuction can enhance and rejuvenate the aging
      face. Similarly, fat loss in certain facial areas due to aging can result in
      hollow cheeks and deep grooves in the face. Its replacement through autologous
      fat transplantation can also rejuvenate the aging face, giving it a less angular,
      more rounded appearance.

PMID- 2229640
TI  - The face lift and ancillary procedures.
AB  - In this article, face lift, forehead lift, and blepharoplasty procedures are
      addressed. Special emphasis is made on anatomical and surgical guidelines. Some
      results and complications of the different procedures are presented.

PMID- 2229641
TI  - Distribution of glial fibrillary acidic protein (GFAP) in the intermediate
      filaments of the cultured cells from a patient with tuberous sclerosis.
AB  - We established a cell line (TS) from adenoma sebaceum of a patient with tuberous
      sclerosis. Through our previous studies, the abnormal cell division and
      dysfunction of TS cells were indicated. Glial fibrillary acidic protein (GFAP)
      and 55 kd protein had been to be major cytoskeletal proteins in these cells. This
      time we have examined the structure and distribution of cytoskeletons in TS cells
      with immunoelectron microscopy. TS cells were found to coexpress GFAP and
      vimentin-like substance; both structures seem to be closely related. The
      coexistence of a few kinds of proteins integrated in the cytoskeletons might lead
      to the abnormal behavior of the nucleus during the process of cell division.

PMID- 2229642
TI  - Reversible inhibition of keratinocyte thymidine incorporation by the calmodulin
      antagonist, W-7.
AB  - Although calmodulin has been suggested as an important regulator of keratinocyte
      proliferation, its precise role remains unknown. We employed a calmodulin
      antagonist, N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7), to examine
      the role of calmodulin on keratinocyte proliferation. N-(6 aminohexyl-1
      naphthalenesulfonamide (W-5), a chlorine-deficient analogue of W-7 with little
      anti-calmodulin activity, was used as the control. W-7 markedly inhibited
      thymidine incorporation of pig epidermis at concentrations close to its anti
      calmodulin activity; W-5 had no effect on the thymidine incorporation. The
      inhibitory effect of W-7 was reversible; the removal of W-7 from the incubation
      medium resulted in the reinitiation of the thymidine incorporation, suggesting
      that W-7 is not a cytotoxic agent. These results are consistent with the view
      that calmodulin is an essential regulator of keratinocyte proliferation. The
      epidermal beta-adrenergic response, which is decreased in various
      hyperproliferative epidermal abnormalities, was increased in W-7-treated
      hypoproliferative epidermis. The epidermal SOD activity, which is also decreased
      in the hyperproliferative epidermis, however, was not affected by the W-7
      treatment.

PMID- 2229643
TI  - Effects of human recombinant tumor necrosis factor-alpha (TNF-alpha) on the
      proliferative potential of human keratinocytes cultured in serum-free medium.
AB  - The effects of human recombinant tumor necrosis factor-alpha (TNF-alpha) on human
      keratinocytes cultured in a serum-free medium were investigated. TNF-alpha
      markedly suppressed cell growth. The growth-inhibitory effect was reversible and
      cytostatic at a concentration of 1-5 U/ml, but appeared to be irreversible and
      cytocidal at 10 U/ml. The growth suppressive effect was more marked when TNF
      alpha was added in the late growth phase or preconfluent phase than when it was
      added in early or mid-growth phases. No effects of TNF-alpha on cell adhesion to
      the substrate were observed. These results indicate that TNF-alpha is a very
      potent anti-proliferative agent for human keratinocytes.

PMID- 2229644
TI  - Kaposi's sarcoma: a light and electron microscopic study.
AB  - A patient with diabetes mellitus who developed the typical classic lesions of
      Kaposi's sarcoma is described. Our patient presented with a reddish-purple
      papulonodular lesion on the right foot of five months' duration. A skin biopsy
      specimen showed a proliferation of spindle cells forming numerous vascular slits
      and a diffuse extravasation of erythrocytes. The patient's sera was negative for
      human immunodeficiency virus (HIV) antibodies and cytomegalovirus (CMV)
      antibodies. Ultrastructural examination demonstrated fibroblast-like spindle
      cells phagocytosing and digesting red blood cells to form vascular spaces. The
      patient died, due to gastrointestinal hemorrhage, and the autopsy revealed an
      extensive visceral involvement of Kaposi's sarcoma.

PMID- 2229645
TI  - Malignant histiocytosis with panniculitis--a case report.
AB  - We report a case of malignant histiocytosis which began with the skin lesions of
      panniculitis. A 32-year-old woman presented with recurrent erythematous plaques,
      subcutaneous nodules, and ulcers on the trunk and the extremities and
      intermittent fever for 7 months. The cutaneous lesions consisted of erythematous
      and brownish irregular-shaped patches and tender cutaneous nodules 0.5-1.0 cm in
      diameter. Central necrosis and shallow ulcers were seen in the lesions. The
      patient also suffered from general fatigue, arthralgia, and weight loss. She was
      anemic and thrombocytopenic and had progressive impairment of liver function with
      coagulation defect. Histopathological study of skin lesions showed lobular
      panniculitis without vasculitis in the subcutaneous fat tissue. In the
      panniculitis lesion, moderate mixed cell infiltration consisting of lymphocytes
      and histiocytes was observed. Bone marrow aspiration revealed an increase in the
      number of histiocytes, mostly immature with active phagocytosis of erythroid
      cells, myeloid cells, and platelets. She was diagnosed as having malignant
      histiocytosis and treated with cyclophosphamide, vincristine, and prednisolone
      which she responded well; her fever subsided and the lesions healed with
      hyperpigmentation. In this patient, benign histiocytes with hemophagocytosis
      without immature forms were found in the skin lesions. According to our
      knowledge, this is the first Thai report of malignant histiocytosis with clinical
      features of panniculitis.

PMID- 2229646
TI  - Psoriasis, necrobiosis lipoidica, granuloma annulare, vitiligo and skin
      infections in the same diabetic patient.
AB  - A diabetic patient is described presenting psoriasis, necrobiosis lipoidica
      diabeticorum, granuloma annulare, and vitiligo and with a history of recurrent
      erysipelas and mycotic infections. Scrupulous physical examination excluded
      further systemic or cutaneous involvement. The immunological workup revealed both
      phenotypic and functional defects in cellular immunity.

PMID- 2229647
TI  - Tinea of the scrotum--report of a case presenting as lichenified plaques.
AB  - A 57-year-old Japanese man with tinea of the scrotum was described. His lesions
      on the scrotum were unusual; they appeared as lichenified plaques.

PMID- 2229648
TI  - Senile hypertrophy of Tyson's glands.

PMID- 2229649
TI  - Defective DNA repair in cultured melanocytes from xeroderma pigmentosum patients.
AB  - The DNA repair of ultraviolet (UV)-induced damages in primary cultured
      melanocytes from xeroderma pigmentosum (XP) patients and normal subjects were
      studied by measuring unscheduled DNA synthesis (UDS) on autoradiographs.
      Melanocytes were cultured in alpha-minimum essential medium (alpha-MEM)
      supplemented with 10% fetal calf serum (FCS), 12-O-tetradecanoyl-phorbol-13
      acetate (TPA), and geneticin. The levels of UDS in XP melanocytes were compared
      with those in normal melanocytes. In both normal and XP melanocytes, post-UV-UDS
      increased dose-dependently at doses of 5-10 J/m2. XP melanocytes exhibited
      various levels of defect in DNA repair, depending on the type of XP. Melanocytes
      from XP-A patients displayed very low levels of UDS, only 6.2-8.4% that of the
      normal melanocytes. However, UDS values in melanocytes from intermediate groups,
      XP-D, XP-E, and XP-F, were relatively high, 37.2-53.5% of the control in XP-D,
      50.0-66.5% in XP-E, and 38.2-46.7% in XP-F, respectively. Melanocytes from XP
      variant patients exhibited almost normal levels of UDS, 87.7-91.6% of those from
      normal subjects. The levels of UDS in XP melanocytes were very similar to those
      in fibroblasts isolated from the same specimens.

PMID- 2229650
TI  - Infiltration of melanoma cells into the type I collagen gel.
AB  - Melanoma cells were cultured on type I collagen gel, and the infiltration of of
      those cells into the gel was observed. B16 murine melanoma cells initially
      adopted a spherical form on the gel, but they assumed a dendritic form after
      infiltration into the interior. The degree of infiltration increased very rapidly
      and was time-dependent. No correlations between the growth rate or melanogenic
      activity and infiltrative potential were observed. When Syrian hamster and human
      melanoma cell lines were cultured, the degrees of infiltration varied. This
      culture system using collagen gel is considered to be a useful in vitro model of
      tumor cell invasion.

PMID- 2229651
TI  - Significance of elevated serum LDH (lactate dehydrogenase) activity in atopic
      dermatitis.
AB  - Serum lactate dehydrogenase activity (LDH) was elevated in most cases with the
      severe type of atopic dermatitis (AD). We examined whether LDH correlated
      specifically with the clinical courses and the severity of AD skin eruptions.
      Blood eosinophil numbers (Eo), LDH and its isoenzymes, and serum IgE (IgE) levels
      in eighty patients with AD were measured before and after treatment. In improved
      groups, Eo and LDH decreased or returned to normal values after treatment. In
      contrast, both levels increased in patients who worsened after treatment. Thus
      changes in Eo and LDH correlated well with the clinical picture. However, IgE
      levels did not correlate with the clinical condition. High LDH levels were
      detected in the severe type of AD more frequently than in the mild type. A large
      majority of patients with elevated LDH (higher than 300 IU/l) before treatment
      had more severe skin eruptions. When the LDH before treatment was within normal
      limits, the LDH levels in improved patients showed a further decrease. Eo, LDH
      and IgE were correlated closely with the clinical scores of AD, and the
      relationship between LDH and clinical score was the highest. Elevations of LDH5
      and LDH4 among the LDH isoenzymes were more prominent in the severe type of AD
      than in the mild type. We concluded that LDH was useful as a marker for
      evaluating the disease condition and severity of skin eruption of AD.

PMID- 2229652
TI  - Treatment of PUVA- and retinoid-PUVA-resistant severe psoriasis with systemic
      cyclosporin A.
AB  - Twenty patients with severe psoriasis were treated with the oral administration
      of 5 mg/kg/day of cyclosporin A (CyA) for 12 weeks. These patients had either
      failed to respond to or had become unresponsive to conventional treatments
      including PUVA, UVB, or combinations of etretinate and PUVA or UVB. Complete
      clearance and marked improvement were observed in 12 (60%) and 4 patients (20%),
      respectively. The average score of the Psoriasis Area and Severity Index (PASI)
      was 26.2 before treatment, decreasing to 18.3 in 2 weeks, 8.2 in 6 weeks, and 5.1
      in 12 weeks of CyA treatment. There was a tendency for patients with lower blood
      levels of CyA to show smaller decreases in their PASI scores. In four patients
      who received skin biopsies, histological improvement was noted within 10 days of
      treatment; epidermal thickness had decreased by 32%, intraepidermal mitoses by
      66%, and parakeratosis had disappeared almost completely. No clinical side
      effects or alterations in laboratory values were observed that required cessation
      of CyA. Exacerbations of psoriasis occurred in 11 of 16 patients within 6 weeks
      after stopping treatment. These results suggest that CyA could be the first
      choice of treatment for resistant severe psoriasis.

PMID- 2229653
TI  - A case of Sneddon's syndrome with positive ANA and anti-cardiolipin antibodies:
      primary anti-phospholipid syndrome?
AB  - A 22-year-old woman developed ulcerative lesions on the lower extremities which
      usually exacerbated during the summer. Histological analysis revealed a micro
      thrombotic lesion in the deep dermis without inflammatory cell infiltration or
      fibrinoid degeneration of blood vessels. Magnetic resonance imaging revealed
      multiple cerebral infarctions. Abnormal laboratory findings included an elevated
      anti-cardiolipin antibody titer and positive speckled pattern ANA (x80), but
      without other manifestations or signs of SLE. FACS analysis revealed that the
      patient's serum reacted with ethanol fixed endothelial cells in addition to
      keratinocytes and peripheral blood neutrophils. This case was thought to be
      livedo reticularis and cerebral thrombotic lesions (Sneddon's syndrome)
      associated with atrophie blanche or livedo(id) vasculitis and may be one clinical
      subset of primary anti-phospholipid syndrome.

PMID- 2229654
TI  - Acquired perforating dermatosis: comparison of an acquired perforating dermatosis
      and perforation as an incidental histologic finding.
AB  - A 66-year-old Japanese woman with a rare acquired perforating disorder, usually
      called adult-type reactive perforating collagenosis, is reported. The patient had
      poorly controlled diabetes mellitus with retinopathy under oral diabetic
      medication. She was found to have multiple papules and umbilicated nodules on the
      trunk and four extremities when she was admitted and examined for the origin of
      jaundice and severe pruritus of sudden onset. In the biopsy specimen, collagen
      fibers were observed to be eliminated from the dermis through epidermal tunnel
      like perforations. No elastic fibers were eliminated, and serial sectioning of
      the specimen could not prove follicular perforation. Adenocarcinoma of the
      biliary duct was found to be the cause of the jaundice with pruritus. Although
      such cases are usually classified as acquired reactive perforating collagenosis
      of adult onset, proposed reclassification for acquired perforating disorders is
      discussed. Another case which also showed perforation and transepithelial
      elimination of both collagen and elastic fibers as an incidental histologic
      finding is described. Such elimination seems to be a not uncommon step in the
      formation of pruriginous eruptions. Therefore, these cases should be
      differentiated from acquired-type characteristic perforating disorders.

PMID- 2229655
TI  - Malignant eccrine tumor--a case report and a classification of tumors of eccrine
      sweat apparatus.
AB  - A case of malignant eccrine tumor and its histological findings were reported. In
      this case, we considered basal cell carcinoma or malignant melanoma clinically;
      however, the histological features matched those of malignant eccrine tumor. It
      has been said that it is very difficult to determine the origin of tumors of
      sweat apparatus; to contribute to this ongoing dialogue, the classification of
      tumors of eccrine sweat apparatus was also discussed.

PMID- 2229656
TI  - A combined case of desmoplastic trichoepithelioma and nevus cell nevus.
AB  - A 41-year-old woman with desmoplastic trichoepithelioma associated with pigmented
      nevus presented. Pigmented nevus had been present on her face at birth. She had
      received cryotherapy and dermabrasion at a small part of the pigmented nevus. As
      a result of the therapy, the discoloration disappeared. The lesion lately
      increased and became hard. Histologically, the lesion was composed of two
      distinctive but intimately mixed cellular components;  nevus cells and basaloid
      cells. In the pigmented lesion, basaloid cells were not present. To our
      knowledge, this is the first reported case of desmoplastic trichoepithelioma
      associated with nevocellular nevus in Japan.

PMID- 2229657
TI  - Infundibular keratosis--report of two cases.
AB  - Two cases of infundibular keratosis are presented, characterized
      histopathologically by funnel-shaped, invaginating, epithelial lobules showing
      infundibular keratinization and connection with pilosebaceous structures. Lightly
      staining, glycogen-laden epithelial cells predominated within the two tumors.
      Differential diagnoses with other infundibular tumors and relationships to
      trichilemmoma are discussed.

PMID- 2229658
TI  - Phototests in Japanese patients with papulovesicular light eruption: positive
      provocation with UVA.
AB  - In six Japanese patients with papulovesicular light eruption (PVLE),
      photoprovocative tests were performed by irradiating UVA or UVB on the skin of
      the back on three consecutive days. One patient developed the typical lesion of
      PVLE at the test site with two consecutive daily irradiations of UVA. The
      remaining 5 patients had no abnormal phototest reactions. It was obvious that UVA
      plays an etiological role in at least some cases of PVLE.

PMID- 2229659
TI  - Anisotropy of the ultrasonic attenuation in soft tissues: measurements in vitro.
AB  - This study was designed to measure the ultrasonic attenuation within phantoms and
      tissue samples over a broad bandwidth and at many angles of incidence with
      respect to intrinsic orientations in order to elucidate both the frequency and
      angular dependence of the attenuation coefficient. Significant angular
      dependence, or anisotropy, of the attenuation was observed in canine myocardium
      (maximum to minimum ratio: 2.2 to 1) and a tissue mimicking phantom of oriented
      graphite fibers in gelatin (max to min: 2 to 1). In control studies,
      insignificant anisotropy was observed in the attenuation in canine liver samples
      and phantoms with graphite powder suspended in gelatin. Comparisons of the
      magnitude of variations of the oriented-fiber phantom to that predicted by a
      viscous relative motion model are presented.

PMID- 2229660
TI  - Replacing tracheoesophageal voicing sources using LPC synthesis.
AB  - The feasibility of using the linear predictive coding (LPC) technique to replace
      the voicing sources of tracheoesophageal speech was explored. Four vowels, [i],
      [a], [e], [u], and one diphthong [ou], produced by two male and two female
      tracheoesophageal speakers were analyzed by the LPC autocorrelation method.
      Normalized prediction error functions were used to choose the algorithm and the
      control parameters of the analysis. Poles of the vocal tract transfer function
      were selected from frames whose normalized prediction errors were close to
      minimum with criteria derived from transfer functions of normally produced
      vowels. Vowels were synthesized with the reconstructed transfer function and a
      synthesized excitation input. Results of an identification task indicated that
      the synthesized vowels were highly intelligible, and the gender of the speaker
      was better identified from the synthesized vowels than from the original
      tracheoesophageal vowels.

PMID- 2229661
TI  - Sound-producing sources as objects of perception: rate normalization and
      nonspeech perception.
AB  - In a variety of experiments and paradigms, researchers have attempted to
      determine whether or not speech perception is specialized by comparing perception
      of speech syllables to perception of nonspeech analogs. While nonspeech analogs
      appear optimal as comparisons to speech because they are acoustically similar
      without being recognized as speechlike, it is argued that the comparison they
      offer is confounded and uninterpretable. Two experiments are designed to show
      that, in auditory perception generally where acoustic signals are causal
      consequences of mechanical events, perceptual experiences are of the mechanical
      events themselves, not of the acoustic signal. This has two consequences. One is
      that there is a confounding in comparisons of speech with sine wave analogs that,
      whereas the one perceived as speech also has a definite causal source, the other,
      perceived as nonspeech, has an indeterminate or ambiguous source. A second is
      that response patterns in classification tasks such as those used in the
      literature comparing speech to nonspeech will reflect properties of the perceived
      sound-producing event; they will not provide a clear window on auditory system
      processes used to recover event properties. Experiment 3 is designed to show that
      perception of many acoustic-signal-producing events can appear to be special by
      the logic of speech-sine wave comparisons--even events that cannot plausibly be
      supposed to involve a specialization.

PMID- 2229662
TI  - Spectral and duration properties of front vowels as cues to final stop-consonant
      voicing.
AB  - The perception of voicing in final velar stop consonants was investigated by
      systematically varying vowel duration, change in offset frequency of the final
      first formant (F1) transition, and rate of frequency change in the final F1
      transition for several vowel contexts. Consonant-vowel-consonant (CVC) continua
      were synthesized for each of three vowels, [i,I,ae], which represent a range of
      relatively low to relatively high-F1 steady-state values. Subjects responded to
      the stimuli under both an open- and closed-response condition. Results of the
      study show that both vowel duration and F1 offset properties influence perception
      of final consonant voicing, with the salience of the F1 offset property higher
      for vowels with high-F1 steady-state frequencies than low-F1 steady-state
      frequencies, and the opposite occurring for the vowel duration property. When F1
      onset and offset frequencies were controlled, rate of the F1 transition change
      had inconsistent and minimal effects on perception of final consonant voicing.
      Thus the findings suggest that it is the termination value of the F1 offset
      transition rather than rate and/or duration of frequency change, which cues
      voicing in final velar stop consonants during the transition period preceding
      closure.

PMID- 2229663
TI  - The role of contrast in limiting vowel-to-vowel coarticulation in different
      languages.
AB  - Languages differ in their inventories of distinctive sounds and in their systems
      of contrast. Here, it is proposed that this observation may have predictive value
      with respect to how extensively various phones are coarticulated in particular
      languages. This hypothesis is based on three assumptions: (1) There are "output
      constraints" on just how a given phone can be articulated; (2) output constraints
      are, at least in part, affected by language-particular systems of phonetic
      contrast; and (3) coarticulation is limited in a way that respects those output
      constraints. Together, these assumptions lead to the expectation that, in
      general, languages will tend to tolerate less coarticulation just where extensive
      coarticulation would lead to confusion of contrastive phones. This prediction was
      tested by comparing acoustic measures of anticipatory vowel-to-vowel
      coarticulation in languages that differ in how they divide up the vowel space
      into contrastive units. The acoustic measures were the first and second formant
      frequencies, measured in the middle and at the end of the target vowels /a/ and
      /e/, followed by /pV/, where /V/ was /i,e,a,o,u/. Two languages (Ndebele and
      Shona) with the phonemic vowels /i,e,a,o,u/ were found to have greater
      anticipatory coarticulation for the target vowel /a/ than does a language (Sotho)
      that has a more crowded mid- and low-vowel space, with the phonemic vowels
      /i,e,e,a,c,o,u/. The data were based on recordings from three speakers of each of
      the languages.

PMID- 2229664
TI  - Phonological primitives: electromyographic speech error evidence.
AB  - Speech error data have been used to argue for the psychological reality of
      distinctive features and phonemes as well as the hierarchical ordering levels of
      processing for speech production. The models of production that have emerged from
      analysis of these data are nearly unanimous in characterizing (implicitly or
      explicitly) the motor output level as entirely governed by prior selection and
      processing of larger units, especially the phoneme. This study reports on the
      laboratory elicitation of sublexical speech errors by means of tongue twisters.
      Simultaneous audio and electromyographic recordings were analyzed. Where
      possible, single-motor unit discrimination was carried out to preclude the
      possibility of signal contamination by activation of adjacent musculature. The
      results indicate that traditional methods of data collection on which most speech
      error corpora are based are inadequate. Production models based on these corpora
      are not supported by the electromyographic data and must accordingly be revised.

PMID- 2229665
TI  - Acoustic estimations of the front cavity in apical stops.
AB  - Sweep-tone measurements of front-cavity resonances in apical stops are reported.
      Volumes inferred from resonance frequency data are presented as a function of
      place of articulation. The results indicate that, for post-dental points of
      contact, a cavity located under the tongue tip is formed. It is shown that this
      sublingual cavity plays a very important role in shaping the spectral structure
      of apical stops.

PMID- 2229666
TI  - Gender comparisons of children's vocal fold contact behavior.
AB  - Vocal fold contact behavior was examined in separate groups of boys and girls
      through application of an electroglottograph(EGG). In general, a contact quotient
      (EGG duty cycle) showed minimal differences within and between boys and girls
      during sustained production of the vowels /i/, /u/, and /a/. The findings are
      discussed with respect to the laryngeal behavior of prepubescent children as well
      as the clinical utility and applicability of the EGG for examining phonatory
      behavior among young children.

PMID- 2229667
TI  - Masker fringe and binaural detection.
AB  - Yost [J. Acoust. Soc. Am. 78,901-907 (1985)] found that the detectability of a 30
      ms dichotic signal (S pi) in a 30-ms diotic noise (No) was not affected by the
      presence of a 500-ms dichotic forward fringe (N pi). Kollmeier and Gilkey [J.
      Acoust. Soc. Am. 87, 1709-1719, (1990)] performed a somewhat different experiment
      and varied the onset time of a 25-ms S pi signal in a 750-ms noise that switched,
      after 375-ms, from N pi to No. In contrast to Yost, they found that the N pi
      segment of the noise reduced the detectability of the signal even when the signal
      was temporally delayed well into the No segment of the noise and suggested that
      the N pi segment of noise acted as a forward masker. To resolve this apparent
      conflict, the present study investigated the detectability of a brief S pi signal
      in the presence of an No masker of the same duration as the signal. The masker
      was preceded by quiet or an N pi forward fringe and followed by quiet, an No, or
      N pi backward fringe. The present study differs from most previous studies of the
      effects of the masker fringe in that the onset time of the signal was
      systematically varied to examine how masking changes during the time course of
      the complex fringe-masker-fringe stimulus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229668
TI  - Detection of frequency modulation (FM) in the presence of a second FM tone.
AB  - A series of three experiments was undertaken to investigate detection of
      sinusoidal frequency modulation (FM) in the presence of FM at a separate
      frequency. The first experiment measured detection of modulation for an FM tone
      with a modulation frequency (fm) of 6 Hz as a function of carrier frequency (fc)
      under three conditions: (1) in quiet, (2) in the presence of a 2500-Hz pure tone,
      and (3) in the presence of a 2500-Hz FM tone with fm = 6 Hz, modulating in phase
      with the signal. Detection of FM in the presence of the second FM tone was worse
      than for either the signal presented in quiet or in the presence of the
      unmodulated tone. Threshold varied as an inverse function of frequency separation
      between the signal and the masker. In the second experiment, FM detection for a
      signal with fc = 1900 Hz and fm = 6 Hz was measured as a function of the
      modulation frequency (fm = 2-18 Hz) of the 2500-Hz masker tone. FM detection
      improved significantly with increasing difference between the modulation
      frequencies of the signal and the masker. The final experiment measured detection
      of FM for a signal (fc = 1900 Hz, fm = 6 Hz) in the presence of a second FM tone
      (fc = 2500 Hz, fm = 6 Hz) as a function of the relative phase of the 6-Hz
      modulators. Detection of FM improved monotonically as a function of increasing
      phase difference between the two modulators. The results are discussed in terms
      of modulation detection interference and perceptual grouping.

PMID- 2229669
TI  - Uncertainty about the correlation among temporal envelopes in two comodulation
      tasks.
AB  - The threshold of a 1250-Hz tonal signal was measured in the presence of five
      noise bands (each 50 Hz wide, centered at 850, 1050, 1250, 1450, and 1650 Hz)
      under five conditions of uncertainty about the waveform type ("correlated" or
      "uncorrelated"), and/or the specific waveform sample to be presented. The
      waveform type was correlated when the temporal envelopes of all of the noise
      bands were the same, and was uncorrelated when the temporal envelope of the band
      centered on the signal differed from the common envelope of the other bands. At
      the low-uncertainty end of the continuum of conditions, the same waveform type
      was presented throughout an entire block of trials, and, in addition, the same
      waveform sample was presented on the two observation intervals of a single trial
      (but changed across trials). At the high-uncertainty end of the continuum, both
      the waveform type and the waveform sample were chosen at random for every
      observation interval. Threshold estimates obtained from trials in which both
      observation intervals contained the same waveform type were not affected by
      uncertainty about the waveform sample within a trial, nor by uncertainty about
      the waveform type introduced across trials. Thus the comodulation masking
      release, or CMR (the difference in the thresholds obtained with the uncorrelated
      and correlated waveforms), calculated from these types of trials was robust
      across all of the uncertainty conditions. However, on those trials in which one
      correlated interval and one uncorrelated interval were paired, threshold
      estimates were influenced by a bias for listeners to choose the uncorrelated
      interval as the signal interval, whether or not it actually contained the signal.
      This bias reveals the importance of recognizing the contribution of the nonsignal
      interval in experiments involving masker uncertainty. Parallel results were
      obtained using the comodulation detection difference (CDD) task. In some
      conditions, marked individual differences were observed.

PMID- 2229670
TI  - On the dependence of (f2-f1) difference tones on subject and on additional
      masker.
AB  - For a group of eight subjects showing stronger than usual irregularities in the
      level dependence of the quadratic distortion product, the level and phase of the
      (f2-f1) difference tone were measured using the method of cancellation for three
      sets of primary frequencies as a function of the primary levels. An additional
      masker seems to "linearize" the level dependence toward regular behavior. Using
      data sets produced with and without the additional masker, it is possible to
      separate two sources of quadratic nonlinearity, one with regular behavior
      presumably located in the middle ear and another with irregular behavior (similar
      to that of cubic distortion) presumably located in the characteristics of outer
      hair cells. Through the "subtraction" of empirically determined patterns from
      idealized patterns, it is possible to approximate patterns stemming from the
      inner-ear source alone.

PMID- 2229671
TI  - Perceived sound quality of reproductions with different frequency responses and
      sound levels.
AB  - Three programs (female voice, jazz music, and pink noise) were reproduced using
      four different frequency responses and two different sound levels. Fourteen
      normal hearing subjects listened to the reproduction via earphones and judged the
      sound quality on seven perceptual scales (loudness, clarity, fullness,
      spaciousness, brightness, softness/gentleness, and nearness) and a fidelity
      scale. Significant differences among the reproductions appeared in all scales and
      could be attributed to the differences in frequency response or sound level or
      both. Interactions between the reproductions and the programs could be explained
      by the relations between the spectrum of the programs and the frequency responses
      used. The results for the noise program were similar to those for the jazz music
      program.

PMID- 2229672
TI  - Discrimination of modulation depth of sinusoidal amplitude modulation (SAM)
      noise.
AB  - The detection of sinusoidal amplitude modulation (SAM) provides a lower bound on
      the degree to which temporal information in the envelope of complex waveforms is
      encoded by the auditory system. The extent to which changes in the amount of
      modulation are discriminable provides additional information on the ability of
      the auditory system to utilize envelope fluctuations. Results from an experiment
      on the discrimination of modulation depth of broadband noise are presented.
      Discrimination thresholds, expressed as differences in modulation power, increase
      monotonically with the modulation depth of the standard, but do not obey Weber's
      law. The effects of carrier level and of modulation frequency are consistent with
      those observed in modulation detection: Changes in carrier level have little
      effect on modulation discrimination; changes in modulation frequency also have
      little effect except for standards near the modulation detection threshold. The
      discrimination of modulation depth is consistent with the leaky-integrator model
      of modulation detection for standards below--10 dB (20 log ms); for standards
      greater than--10 dB, the leaky integrator predicts better performance than that
      observed behaviorally.

PMID- 2229673
TI  - Electrically evoked whole-nerve action potentials: data from human cochlear
      implant users.
AB  - This study describes a method for recording the electrically evoked, whole-nerve
      action potential (EAP) in users of the Ineraid cochlear implant. The method is an
      adaptation of one originally used by Charlet de Sauvage et al. [J. Acoust. Soc.
      Am. 73, 615-627 (1983)] in guinea pigs. The response, recorded from 11 subjects,
      consists of a single negative peak that occurs with a latency of approximately
      0.4 ms. EAP input/output functions are steeply sloping and monotonic. Response
      amplitudes ranging up to 160 micro V have been recorded. Slope of the EAP
      input/output function correlates modestly (approximately 0.6-0.69) with results
      of tests measuring word recognition skills. The refractory properties of the
      auditory nerve were also assessed. Differences across subjects were found in the
      rate of recovery from the refractory state. These findings imply that there may
      be difference across subjects in the accuracy with which rapid temporal cues can
      be coded at the level of the auditory nerve. Reasonably strong correlations
      (approximately 0.74-0.85) have been found between the magnitude of the slope of
      these recovery curves and performance on tests of word recognition.

PMID- 2229675
TI  - Response timing constraints on the cortical representation of sound time
      structure.
AB  - The precision of spike response timing of 94 primary auditory cortex neurons was
      studied using conventional extracellular recording techniques in barbiturate
      anesthetized cats to which tone- and/or noise-burst stimuli were presented using
      sealed sound delivery systems. Precision of spike timing was indexed using the
      standard deviation of the first-spike latent period in responses evoked by
      repeated presentation of tonal stimuli systematically varied in frequency,
      amplitude, and/or repetition rate. Within a neuron, variability of first-spike
      timing was usually proportional to the mean first-spike latency, in agreement
      with previous reports. In cases where there was a systematic relation between the
      precision of response timing and the mean latency, a linear correlation accounted
      for up to 90% of the data variance. Across the 94 neurons, standard deviations
      seen in responses of minimum latency were related to minimal mean latencies, and
      were typically in the range from 0.15-1.5 ms. The data suggest that responses to
      transients in the cortex show a precision of spike timing which is only slightly
      worse than that seen in cochlear-nerve fibers. This, however, is in dramatic
      contrast to previous evidence on the steady-state temporal response of cortical
      cells, which is at least an order of magnitude poorer than that seen in auditory
      nerve fibers and many cochlear nucleus cells. These observations may be directly
      relevant to the known consequences of auditory cortex pathology in man.

PMID- 2229674
TI  - Cochlear action potential tuning curves recorded with a derived response
      technique.
AB  - Previous action potential (AP) tuning curve methods have used a reduction in
      amplitude of the probe-elicited AP as an indication of tone-induced masking. The
      reduction criterion used in different studies has varied from 25% to 100%. For
      low level probe stimuli, which elicit a low-amplitude AP, this is a sensitive
      indicator. In contrast, for high-amplitude AP responses elicited by high-level
      stimuli, the required reduction in absolute terms is large, making it an
      insensitive indicator. AP tuning curves have been recorded using a sensitive
      method for detecting masker/probe interaction with a fixed criterion, unrelated
      to the unmasked AP amplitude. For each masking condition, a derived response was
      obtained by digitally subtracting the tone-masked AP waveform from the unmasked
      response. Derived responses are generated if there are ANY changes in the AP
      waveform induced by the masker, including amplitude changes, latency changes, or
      even changes in AP morphology not necessarily associated with the major peaks. A
      fixed criterion (10 microV) of tone-derived (TD) response was used as an
      indication of interaction of the responses to the masker and probe. Tuning curves
      generated by this method were compared with those generated by conventional
      amplitude reduction (AR) methods. TD tuning curves show different
      characteristics, especially with respect to increasing probe levels. They appear
      to give a good representation of the array of afferent fibers responding to a
      probe stimulus. In addition, frequency regions making minor contributions to the
      AP are better represented in TD tuning curves.

PMID- 2229676
TI  - The representation of the spectra and fundamental frequencies of steady-state
      single- and double-vowel sounds in the temporal discharge patterns of guinea pig
      cochlear-nerve fibers.
AB  - Psychophysical results using double vowels imply that subjects are able to use
      the temporal aspects of neural discharge patterns. To investigate the possible
      temporal cues available, the responses of fibers in the cochlear nerve of the
      anesthetized guinea pig to synthetic vowels were recorded at a range of sound
      levels up to 95 dB SPL. The stimuli were the single vowels /i/ [fundamental
      frequency (f0) 125 Hz], /a/ (f0, 100 Hz), and /c/ (f0, 100 Hz) and the double
      vowels were /a(100),i(125)/ and /c(100),i(125)/. Histograms synchronized to the
      period of the double vowels were constructed, and locking of the discharge to
      individual harmonics was estimated from them by Fourier transformation. One
      possible cue for identifying the f0's of the constituents of a double vowel is
      modulation of the neural discharge with a period of 1/f0. Such modulation was
      found at frequencies between the formant peaks of the double vowel, with
      modulation at the periods of 100 and 125 Hz occurring at different places in the
      fiber array. Generation of a population response based on synchronized responses
      [average localized synchronized rate (ALSR): see Young and Sachs [J. Acoust. Soc.
      Am. 66, 1381-1403 (1979)] allowed estimation of the f0's by a variety of methods
      and subsampling the population response at the harmonics of the f0 of the
      constituent vowel achieved a good reconstruction of its spectrum. Other analyses
      using interval histograms and autocorrelation, which overcome some problems
      associated with the ALSR approach, also allowed f0 identification and vowel
      segregation. The present study has demonstrated unequivocally that the timing of
      the impulses in auditory-nerve fibers provides copious possible cues for the
      identification of the fundamental frequencies and spectra associated with each of
      the constituents of double vowels.

PMID- 2229677
TI  - A model for the computation and encoding of azimuthal information by the lateral
      superior olive.
AB  - A structural model is proposed for the processing of interaural intensity
      differences by the lateral superior olive. One fundamental assumption is that the
      incoming excitatory projections from the ipsilateral anteroventral cochlear
      nucleus innervate columns of LSO neurons serially according to threshold. A
      second fundamental assumption is that the inhibitory innervation from the
      ipsilateral medial nucleus of the trapezoid body is also serially arranged
      according to threshold but in the opposite direction along the LSO column. Using
      neurophysiological and neuroanatomical data for neuronal response curves,
      connectional patterns, and cell and synapse numbers, the model was formulated
      quantitatively and implemented for machine computation. Azimuthal location is
      encoded by the position along the LSO column where LSO cell firing first goes to
      zero. Accuracy of coding was tested for three different connectional schemes, for
      variations in neuronal parameters, and for cell and synapse death. Encoding is
      shown to be independent of absolute sound level and to vary linearly with
      interaural intensity difference.

PMID- 2229678
TI  - Sleep disturbances caused by vibrations from heavy road traffic.
AB  - The influence of whole-body vibrations, noise, and a combination of the two,
      caused by heavy road traffic (150 events/night) on sleep, subjectively
      experienced sleep quality, and performance was investigated under controlled
      laboratory conditions for male and female subjects 20-35 years of age. A room was
      built above a vibrator table, with the legs of the bed mounted directly on the
      table through holes in the floor. Vertical vibrations were found to be attenuated
      by the mattress with 20-40 dB for frequencies greater than 10 Hz, whereas
      horizontal vibrations were slightly amplified. It could be concluded that when
      traffic noise [50-dB (A) peak level] is accompanied by vibrations with peak
      levels of 0.24 m/s2 vertically and 0.17 m/s2 horizontally as measured on the
      frame of the bed (stimulus duration approximately 2 s, dominant frequency
      approximately 12 Hz), sleep is more disturbed than is the case when noise alone
      occurs. The amount of REM sleep, which was significantly reduced for the
      vibration level mentioned above, was even more disturbed when a higher exposure
      level, 0.34 m/s2 vertically and 0.24 m/s2 horizontally, was applied. The
      subjectively rated sleep quality was lower for the higher than for the lower
      vibration level. Performance in the morning was only influenced for the higher
      vibration level. It could be concluded that vibration exposure levels near the
      recommendation made in ISO-standard 2631 for the awake state disturb sleep in
      man.

PMID- 2229680
TI  - On the frequency separation of simultaneously evoked otoacoustic emissions'
      consecutive extrema and its relation to cochlear traveling waves.

PMID- 2229679
TI  - Critical ratio and critical bandwidth for the Atlantic bottlenose dolphin.

PMID- 2229681
TI  - Thoughts on the future of nursing.

PMID- 2229682
TI  - A new clinical career structure for nurses: trial and evaluation. The South
      Australian experience.
AB  - A new clinical career structure for nurses was planned, introduced, implemented
      and evaluated in South Australia in 1986. The new structure was based on the
      Royal Australian Nursing Federation (South Australian Branch) Model, and its
      trial took place in 11 health units, involving 5000 registered nurses, or one
      third of the nurse workforce in South Australia. The findings of the evaluation
      research were utilized by Government. The sociopolitical context within which the
      evaluation of the new clinical career structure was implemented is re-examined in
      this paper.

PMID- 2229683
TI  - Effects of early parent touch on preterm infants' heart rates and arterial oxygen
      saturation levels.
AB  - A descriptive exploratory design was used in this study to evaluate the effects
      of early parent touch on the heart rates and arterial oxygen (O2) saturation
      levels of 36 preterm infants. The infants were between 27-33 weeks gestational
      age at birth, and were free of congenital defects. Infants were videotaped during
      parent visits on up to three separate occasions during the first month of life.
      Parents were encouraged to interact with their infants as they usually would, and
      data on the infants' heart rates and O2 saturation levels were recorded every 6
      seconds on a portable computer that was interfaced with the infants' monitors.
      Mean O2 saturation levels were significantly lower during parent touch than
      during baseline periods on 45% of the visits, and significantly higher during
      parent touch periods on 19% of the visits. O2 saturation variability was greater
      during periods of parent touch, and there were more abnormal O2 saturation values
      during parent touch than during baseline periods. Mean heart rates during parent
      touch were significantly lower compared to baseline on 17% of the visits, and
      were higher during parent touch on 43% of the visits. There were no overall
      differences in mean heart rates between baseline, parent touch and post-visit
      classifications, although heart rate variability was greater during periods of
      parent touch. The results indicate that preterm infants' responses to early
      parent touch are variable, and suggest that blanket policies that limit parent
      touch during the early weeks of life may not be appropriate.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2229684
TI  - Autonomy of primary nurses: the need to both facilitate and limit autonomy in
      practice.
AB  - This paper explores the concept and implications of autonomy in relation to
      primary nurses. It explores the need to limit this autonomy to ensure assigned
      patients receive a consistent and congruent quality of care. Methods that enable
      primary nurses to demonstrate their pluralistic accountability, currently being
      used and tested in practice, are described, methods that limit the autonomy of
      primary nurses without compromising it.

PMID- 2229685
TI  - Gay men's perceptions and responses to AIDS.
AB  - Gay men continue to be the largest group in Canada developing AIDS. They have
      responded to this threat on a personal and community level. The purpose of this
      study was to explore the perceptions of gay men about AIDS, and how they
      responded to these perceptions. Data were gathered through unstructured
      interviews with 34 healthy gay men, from participant observations chosen from
      logs that described nursing interactions with gay men who had AIDS, and
      fieldnotes collected during AIDS education programmes with health care workers
      and gay men. Using constant comparative analysis, a substantive conceptual
      framework was developed. Trusting was identified as the basic social
      psychological process that determined how gay men responded to AIDS. AIDS was
      perceived by all gay men in this study to threaten their own health and their
      acceptance by society. Variables identified behaviour, ranging from denial of
      personal risk to taking leadership roles in organizations to fight AIDS related
      to the trusting theory. This theoretical explanation of gay men's responses
      provides direction for programmes to educate gay men about HIV-related diseases,
      as well as to support those who acquire the HIV.

PMID- 2229686
TI  - The study of psychological factors in couples receiving artificial insemination
      by donor: a discussion of methodological difficulties.
AB  - Artificial insemination by donor (AID) may be the only means by which many
      infertile couples are able to have a child. However, the treatment is not
      invariably successful and it is postulated in the literature that psychological
      factors may be implicated when conception does not occur. Further investigation
      is required to establish the nature of any relationship between psychological
      stress and conception after AID but designing an adequate study is confounded by
      many methodological difficulties. These include issues relating to ethics,
      recruitment, measurement and logistics. In this paper, such aspects are examined
      and the importance of research in this field for nursing is highlighted.

PMID- 2229687
TI  - Disreputable science: definition and detection.
AB  - This paper describes definitions of fraud and misconduct as disreputable science.
      Some causes and methods of detection of scientific misconduct are identified.
      These hallmarks of credibility are essential for nursing to advance as a science.

PMID- 2229688
TI  - Nursing in transition: an analysis of the state of the art in relation to the
      conditions of practice and society's expectations.
AB  - The discipline of nursing is in a process of rapid transition. In this paper, the
      developments are discussed that have affected nursing in its advancement to a
      full-grown profession. Nursing and medicine are the products of Cartesian
      thinking that has fragmented our perspectives on man and his living world. The
      consequences of this scientific viewpoint are reflected in all aspects of life.
      Attention is paid to advances in nursing practice and education, the development
      of nursing research and the emergence of a nursing science. These aspects are
      discussed in the context of professionalization and the position of nursing in
      the health care system and in society. The study findings of the Styles Report
      Project on the Regulation of Nursing (1985) serve as a framework of analysis.
      Links are made between the recommendations given in this report and the
      development of primary health care, the new tomorrow of a modern discipline.

PMID- 2229689
TI  - Student nurse attitudes to teaching/learning methods.
AB  - This article outlines the findings of a study which investigated the attitudes of
      203 general and psychiatric student nurses from nine schools of nursing towards a
      defined number of teaching/learning methodologies. All students were at the end
      of their first year or the beginning of their second year of a 3-year first-level
      training. Data were collected using an instrument based on a semantic
      differential scale. The findings, when compared against certain variables, for
      example, gender, showed that there were very few significant differences in
      relation to the defined and tested methodologies. Students generally showed
      themselves to be a homogeneous group and the findings indicate that students were
      more positively predisposed towards student-centred teaching/learning
      methodologies.

PMID- 2229690
TI  - Nursing Clinical Teacher Effectiveness Inventory: a replication study of the
      characteristics of 'best' and 'worst' clinical teachers as perceived by nursing
      faculty and students.
AB  - This study determined the characteristics of 'best' and 'worst' clinical teachers
      as perceived by 63 baccalaureate nursing faculty and 121 BSN students in Ohio. It
      is a replication of the 1987 study by Knox & Mogan. The Nursing Clinical Teacher
      Effectiveness Inventory (NCTEI) they developed is a 48-item Likert scale
      checklist which described discrete teacher characteristics clustered into five
      subscales or categories: teaching ability, nursing competence, personality
      traits, interpersonal relationship and evaluation. Respondents are asked to rate
      their 'best' clinical teacher using the NCTEI and then their 'worst' clinical
      teacher. Results show that both faculty and students agree, in both Knox &
      Mogan's sample and this sample, that the 'best' clinical teachers are good role
      models, enjoy nursing, enjoy teaching and demonstrate clinical skills and
      judgement. The 'worst' clinical teachers are not good role models. The most
      critical distinguishing characteristics between the 'best' and the 'worst'
      clinical teachers are being a good role model and encouraging mutual respect.

PMID- 2229691
TI  - Significant others benefit from preoperative information.
AB  - Little attention has been given to the preparation of the patient's family prior
      to surgery, even though nurses' clinical experience suggests that family members
      are often more anxious than the patient. This study explored the knowledge and
      anxiety of spouses and significant others of patients preparing for cardiac
      surgery. The subjects were selected by convenience from a preoperative class
      offered at the hospital where surgery was to occur. Before and after the class,
      the subjects completed a cardiac-surgery knowledge test and an anxiety test. The
      significant others were significantly more anxious than the patients prior to the
      class. The anxiety level of significant others was significantly reduced after
      the class. There were no statistically significant differences between patients
      and significant others on the cardiac-surgery knowledge test. These results
      suggest that significant others may benefit from preoperative instruction.

PMID- 2229692
TI  - The design of a stress-management programme for nursing personnel.
AB  - This study identifies the stressors and coping strategies of nursing staff
      (students, trained staff and those who had left the profession before
      qualification) in a variety of ward specialisms. The research instruments
      included an open-ended interview concerning pre-nursing experience, perceived
      stressors and satisfactions, and ways of coping, and psychometric tests of self
      esteem, assertion, ways of coping and personality. The five most frequently cited
      stressors were understaffing, conflict with nurses, dealing with death and dying,
      overwork and conflict with doctors. Experience of stressors was related to role
      and seniority of respondents, with different aspects of the same stressor
      differentially affecting nurses at different levels of experience. Coping
      strategies also depended on experience. Trained staff showed more use of problem
      focused ways of coping, whilst students and leavers relied more on emotion
      focused strategies to deal with stressful situations. These differences were
      related to personality characteristics of respondents and to self-esteem as well
      as to situational characteristics of the stressful episode. Social support was
      important in times of work-related stress, with students in particular making
      good use of peer group support. Respondents were generally lacking in
      assertiveness and high in anxiety. Although self-esteem was generally high,
      leavers scored markedly less than other subject groups in the areas of personal
      and social self-esteem. Leavers had little prior knowledge or experience of
      nursing before entering training and knew few nurses or doctors: consequently,
      nursing failed to meet their expectations. Stress was identified as the major
      cause of attrition and the sources of stress are identified. This study informed
      a major programme of stress-management training for student nurses which began in
      1988 at the North Wales School of Nursing and which is currently under
      evaluation. It includes relaxation therapy, assertiveness training, and on-going
      group discussions which foster peer-group support and which explore the stressors
      and coping strategies relevant to different stages of training and ward
      specialisms.

PMID- 2229693
TI  - Quantitative measurement of anxiety in patients undergoing surgery for renal
      calculus disease.
AB  - The anxiety experienced by patients undergoing surgical procedures is well
      documented and may affect the outcome of any operation. This has not been
      considered in modern urological surgery which is moving away from highly-invasive
      techniques towards minimal and even non-invasive procedures. Little work has been
      carried out to examine the patient's reaction to this new technology. This work
      has two aims: to assess patient anxiety before and after different procedures for
      renal calculus removal and to identify, where possible, factors that contribute
      to pre- and post-operative anxiety. The main method of quantifying stress was the
      measurement of palmar sweat by means of an evaporimeter. Other measurements used
      were a bi-polar visual analogue scale and the Spielberger State Anxiety
      Questionnaire. The results of the study demonstrated a highly significant
      reduction in the palmar sweat production (P less than 0.0001) and score obtained
      for the analogue scale (P less than 0.05) following open surgery, but no changes
      before and after treatment in any of the variables in patients undergoing
      percutaneous nephrolithotomy or lithotripsy. Analysis of the data in relation to
      the surgery demonstrated a significantly higher preoperative analogue score in
      patients undergoing open surgery compared with lithotripsy (P less than 0.05).
      Post-operatively, patients undergoing lithotripsy had a significantly higher
      palmar sweat response compared with patients undergoing open surgery (P less than
      0.01). Pre-operatively, fear of a general anaesthetic was identified as a factor
      contributing to anxiety and post-operatively, pain was the most commonly
      identified stressor. The implications of these results to the patient and to both
      nursing and medical staff in terms of practice are discussed. This must include a
      careful pre-operative explanation.

PMID- 2229694
TI  - Reluctant collaborators: do patients want to be involved in decisions concerning
      care?
AB  - Against the background of the popularity of the concept of 'patient
      collaboration' in care, this paper describes, from the frame of reference of the
      patients, how they perceive being involved in decisions concerning their own
      treatment and nursing care. A convenience sample of 12 patients were selected.
      The data collection and analysis were informed to some extent by the approach
      known as grounded theory. Although only 12 in-depth interviews were conducted,
      one major theme emerged from the data and that was named 'toeing the line'. The
      data suggests that some patients are more concerned about doing what is right,
      that is, pleasing the nurse, than participating in decisions concerning care. It
      is contended that if nurses adopt practices which encourage involvement they may
      unwittingly coerse patients to comply. It is argued that patients will accept
      this situation even if they do not wish a collaborative role. Despite the small
      sample size, interesting questions are raised concerning the underlying rationale
      of patient involvement. The conclusion is drawn that promoting individualized
      care is not necessarily synonymous with active patient involvement as advocated
      in much of the literature.

PMID- 2229695
TI  - The work style of students of mental health nursing undertaking the Project 2000
      schemes of training: a logical analysis.
AB  - The work methods of students of mental health nursing are analysed to see which
      are best suited to facilitate the central educational aims of the Project 2000
      schemes of training. Supervised primary nursing is found to be best because it
      engenders a professional cognitive style and a heightened sensitivity to the
      empirical, research-based culture. It is argued that team nursing causes, in its
      practitioners, a bureaucratic cognitive style, which acts as a structural
      constraint upon the learning and mastery of the process skills advocated by the
      Project 2000 authors.

PMID- 2229696
TI  - Review of experimental learning theory research in the nursing profession.
AB  - In this paper, Kolb's theory of experimental learning theory is briefly outlined.
      This overview is followed by a summary of research on the theory in nursing
      populations. Moderate support for various propositions of the theory suggests
      that further research is warranted and that Kolb's model may be useful as a basis
      for developing instructional activities in professional nursing education
      programmes.

PMID- 2229697
TI  - Cardiac nurses: coping with stress.
AB  - This paper describes issues relating to coping with stress as expressed by nurses
      in cardiology. The data were collected at a 1-day workshop on 'Coping with
      Stress', sponsored by the Israel Cardiac Nursing Association in response to
      repeated requests from nurses in cardiology. The programme included theoretical
      presentations. Group work focused on the nurses' self-evaluation of coping with
      stress, rather than on patients' needs. Twenty-two groups of 15 nurses each
      worked with pre-trained group leaders on the following issues: causes and origins
      of stress; coping strategies and mechanisms; feelings and emotions accompanying
      the different coping strategies; suggestions and alternatives for improving
      coping skills. The group process also included experiential exercises. Analysis
      of the nurses' coping strategies in relation to staff, patients and their
      families, and work-related issues suggests four distinct coping modes. Nurses'
      overall responses were positive and emphasized practical benefits for future
      work.

PMID- 2229698
TI  - Conceptual and theoretical approaches to patient care: associate versus
      baccalaureate degree prepared nurses.
AB  - The purpose of the study was to determine if there is a relationship between
      types of entry-level preparatory nursing programmes in which a nurse receives
      basic nursing education and conceptual and theoretical approaches to patient
      care. A secondary purpose of the study was to determine if there is a
      relationship between entry-level basic preparatory nursing education and nursing
      leadership, the ability to make nursing diagnosis, and implementation, as well as
      evaluation of the nursing process. Three nursing practice categories were
      identified and included: professional, all-nurse and technical. Useable data
      collected by short-essay questionnaire from 343 out of 344 sample subjects were
      computed to determine the relationship, if any, between basic preparatory nursing
      education and conceptual and theoretical approaches to patient care. Decisions
      about three null hypotheses were made at the 0.05 level of significance utilizing
      analysis of covariance and the 0.01 level of significance utilizing chi-square
      analysis. For Hypothesis 1, the main effect for degree work when covaried with
      Verbal Scholastic Aptitude Test scores, Quantitative Scholastic Aptitude Test
      scores, time and age indicated a significance of 0.001 for all item associations
      in the professional, all-nurse and technical categories utilizing analysis of
      covariance, and 0.001 utilizing chi-square analysis. For Hypotheses 2 and 3, the
      main effect for degree work when covaried with the aforementioned variables
      indicated a significance of 0.001 utilizing analysis of covariance, and 0.001
      utilizing chi-square analysis. In conclusion, the findings from the study suggest
      that graduates of baccalaureate degree programmes do vary in conceptual and
      theoretical approach to nursing care in specific nursing care
      situations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229699
TI  - The pill and cancer: a review of the literature. A case of swings and
      roundabouts?
AB  - The literature review has been carried out to determine the effects of the
      contraceptive pill in relation to the development of certain cancers. Current
      research findings are presented, in an attempt to evaluate the risks and benefits
      associated with oral contraceptive use. Particular attention is paid to the
      findings of a recent United Kingdom National Study, which supports the
      controversial link between the pill and breast cancer. The actions of the
      combined oral contraceptive pill and the progesterone-only pill are explored
      regarding their influence on the ovarian, breast, endometrial and cervical
      cancers. A background to the incidence and risk factors associated with these
      cancers is given. Included is a brief analysis of long and short-term use, dose
      variability and chemistry of the pill. It emerges through the literature that the
      pill clearly has a protective function in relation to cancers of the ovary and
      the endometrium. However, its influence on the development of breast cancer and
      cervical cancer remains irresolute pending further research. In the absence of
      firm guidelines for advice to clients concerning the sensible use of oral
      contraceptives, proposals are included for a more reasoned approach to choice.

PMID- 2229700
TI  - Diabetic patients facing long-term complications: coping with uncertainty.
AB  - A major problem of diabetes mellitus lies in its complications. Fourteen Type 1
      diabetic patients with severe long-term complications were interviewed on two
      occasions with the aim of gaining a deeper understanding of their coping
      strategies. The study has a qualitative design and a grounded theory approach was
      used. The data-based categories 'Coming to terms', 'Keeping going' and 'Making
      sense' serve as a framework for the presentation of the substantive issues raised
      by the respondents. It was found that the problem of uncertainty featured
      prominently.

PMID- 2229701
TI  - Nursing research in geriatric mental health.
AB  - As the population of older people in the world increases, concerns about the
      health and delivery of health care to these elderly people become increasingly
      more important. Geriatric mental health arose as a nursing specialty in response
      to this concern over the health of older adults. This paper focuses on a review
      of nursing literature relevant to the mental and cognitive health of older
      adults. Implications for current practice and future research are explored.

PMID- 2229702
TI  - Psychiatric patients' views of their lives before and after moving to a hostel: a
      qualitative study.
AB  - This study focuses upon the experiences of a group of 10 long-stay psychiatric
      patients as they moved from a large institution to a staffed community hostel.
      The residents were interviewed 2 weeks prior to moving and again 6 weeks after
      the move. Areas identified in the first set of unstructured interviews were
      followed up in the second set. Qualitative analysis of the interviews revealed
      seven recurrent themes that are discussed in relation to other research studies
      that consider how people experience the effects of institutionalization. The
      study tests the feasibility of unstructured interviews as a means of collecting
      accounts of the perceptions and experiences of a client group from which other
      research methods have failed to elicit detailed information. Unstructured
      interviews proved successful when undertaken by a researcher who was well known
      and accepted by the residents. Familiarity with the residents and the context of
      the interview was also found to be important in analysing interviews
      qualitatively and the study casts doubt upon the value of primary qualitative
      analysis of interview transcripts by researchers who have not also participated
      in the interviews. The methodological implications for future
      deinstitutionalization studies are discussed.

PMID- 2229703
TI  - Patients' perceptions of music during surgery.
AB  - Music, as an aesthetic and symbolic medium, has the ability to dispel much of the
      fear and anxiety associated with facing the unknown alone. As such it is an ideal
      support for patients undergoing surgery where a non-general anaesthetic is
      administered. However, it is important to consider whether, from the patient's
      perspective, the inclusion of music in such a situation is considered to be
      helpful. A pilot study conducted at an acute hospital involved interviewing 25
      patients who, through an attitudinal scale and their interview responses,
      revealed positive support for the music that they listened to during their
      operation. Their remarks focused on the ability of the music, as a familiar
      personal and cultural medium, to ease their anxiety, to act as a distractor and
      to increase their threshold of pain. From a nursing perspective, such an
      application of music as therapy to reduce fear and anxiety may be viewed as being
      highly relevant to the work of the anaesthetic nurse, with regard to a more
      individualized and holistic approach to patient care.

PMID- 2229704
TI  - Evaluation of an educational programme for patients taking warfarin.
AB  - The outcomes of a structured warfarin patient education programme were compared
      with those of an unstructured programme. For both programmes, knowledge and
      satisfaction levels were determined, incidence of complications of warfarin
      therapy were noted, and prothrombin time results were examined. The 23 patients
      who participated in the structured educational programme were selected from among
      vascular surgery patients. The comparison group was composed of 10 patients who
      had mechanical prosthetic valves inserted. The structured programme was designed
      for the study, and implemented by staff nurses. The comparison group received the
      usual unstructured educational programme. Post-treatment assessments were made
      before discharge and at 1 month and 3 months after discharge. Interview guides
      were developed, to determine knowledge and satisfaction. At the predischarge
      interview, significant differences between the treatment and comparison groups
      were observed related to knowledge of elements of warfarin therapy. The most
      important effects of the programme related to specific instructions to promote
      safety. The interviews 1 month and 3 months after discharge demonstrated that
      knowledge changed in several areas for both groups. Overall, both groups were
      satisfied with the information they received. The majority in both groups did not
      experience complications. Prothrombin times were available for some patients.
      Those obtained indicated that prothrombin times were not consistently within the
      therapeutic range for 60% of the time or more. The study supports the use of a
      structured educational programme as one element in achieving safe, effective
      warfarin therapy. Reasons for changes in knowledge over time merit further
      exploration, as does the relationship between optimal control of therapy and
      educational programmes.

PMID- 2229705
TI  - In-hospital counselling for first-time myocardial infarction patients and
      spouses: effects on satisfaction.
AB  - Self-ratings of satisfaction were studied over 6 months in 60 male first-time
      myocardial infarction patients and their wives. Couples were randomly assigned to
      either a treatment group, where they received a simple programme of education and
      psychological support in addition to routine care, or to a control group, where
      they received routine care only. All patients completed visual analogue scales
      measuring satisfaction regarding their general health, life in general, care and
      information received. All wives completed visual analogue scales measuring
      satisfaction regarding information received and care the patient received.
      Patients and wives in the treatment group reported statistically significantly
      more satisfaction than those in the control group. This effect was sustained for
      6 months after counselling.

PMID- 2229706
TI  - The congruence of elderly client and nurse perceptions of the clients' self-care
      agency.
AB  - Congruence of client and nurse perceptions is vital to mutual goal-setting as a
      means of achieving self-care in the elderly. The purpose of this descriptive,
      correlational study was to explore the relationship between nurse and elderly
      client perceptions of the clients' self-care agency. A sample of 40 elderly
      client subjects and registered nurses' selected from two community health
      agencies, completed a questionnaire consisting of three instruments: (a) a
      demographic sheet; (b) the appraisal of Self-Care Agency Scale; and (c) the
      Perceived Health Status. Pearson product moment correlation coefficients were
      significant for the relationships between: (a) client and nurse perceptions of
      clients' self-care agency (r = 0.42, P less than 0.01); (b) client and nurse
      perceptions of clients' health status (r = 0.38, P less than 0.01; and (c) nurse
      perceptions of clients' self-care agency and nurse perceptions of clients' health
      status (r = 0.44, P less than 0.01). With increasing emphasis on health promotion
      of the elderly in the community, identified relationships may have potential
      implications for gerontological and community nursing practice.

PMID- 2229707
TI  - Peri-operative anxiety in patients undergoing extracorporeal piezolithotripsy.
AB  - Twenty-four patients undergoing extracorporeal piezolithotripsy took part in this
      study and underwent treatment on a Wolf Piezolith 2300 Lithotripter, which does
      not require any type of anaesthesia and enables the patient to be treated as an
      out-patient. Previous work has investigated anxiety states of patients during
      investigative procedures and found that information given prior to the procedure
      is beneficial in reducing the levels of anxiety reported. Modern urological
      surgery carried out to remove kidney stones has progressed to non-invasive
      techniques with the introduction of extracorporeal piezolithotripsy (EPL).
      However, little work has examined the patient's reaction to this new procedure.
      Since patients undergoing EPL are awake throughout the procedure, it is possible
      to perform continuous assessment of anxiety by measurement of palmar sweat. The
      results demonstrated significantly increased levels of palmar sweat throughout
      treatment, with a return to pre-treatment levels afterwards. This was
      demonstrated by just under 50% (n = 10) of patients who appeared to be agitated
      during treatment, and by the comments made by patients about their treatment. One
      third of patients (n = 8) described pain as far more severe than had been
      anticipated when asked if they could identify a cause for anxiety. It is
      recommended that adequate patient preparation and education prior to the
      procedure should be provided, but that such education must also include a warning
      that some discomfort may occur.

PMID- 2229708
TI  - The patient's experience of diabetes and its treatment: construction of an
      attitude scale by a semantic differential technique.
AB  - An instrument for measuring attitudes towards diabetes and self-care was
      constructed by a semantic differential technique. The instrument contained nine
      adjective pairs. Factor analysis classified these into four factors: self
      esteem/autonomy, object evaluation, quality of life supporting factor and self
      strength/vulnerability. The reliability coefficient of test-retest by 28
      nurses/nurse tutors was 0.93. Fifty diabetic patients completed the attitude
      scale for testing the validity of the instrument. Male patients had a more
      positive attitude towards diabetes than females. Those who had had diabetes for
      less than 10 years were more positive than those with a longer duration of the
      disease. A higher degree of education, well-performed self-monitoring of blood
      glucose and achievement of good metabolic control were all associated with a more
      negative attitude towards diabetes. A group of nurses/nurse tutors who also
      completed the attitude scale had a more negative attitude towards diabetes than
      the investigated groups of patients.

PMID- 2229709
TI  - The health education needs of families caring for a schizophrenic relative and
      the potential role for community psychiatric nurses.
AB  - Community care policies for the mentally ill rely, to a large extent, on the
      informal contribution that often seems to be made willingly by families. In
      financial terms alone, it has been calculated by the British Government that
      families caring for a relative with schizophrenia at home save the country 25
      billion pounds a year. Nearly 15 years ago, it was argued that community mental
      health services were failing to monitor the relationships in homes where this
      situation prevailed and provide the support mechanisms that were required.
      Further, it has been noted that when there is an over-emphasis on community care,
      family crises can become severe and remain undetected. This paper reviews the
      literature relating to the needs of families caring for a schizophrenic relative
      at home. It concludes that a major service that should be offered to families is
      education about the illness, schizophrenia, itself. Strategies for undertaking
      this role are examined within the overall context of 'psychosocial interventions'
      and the literature on 'high expressed emotion'. Finally, an experimental course,
      funded by the Department of Health, and located in the Department of Nursing at
      Manchester University, is described. Here, community psychiatric nurses are being
      taught to recognize the value of health education for those living with a
      schizophrenic relative. As a consequence, a number of valuable initiatives have
      been developed and these are briefly outlined.

PMID- 2229710
TI  - Characteristics of students entering different forms of nurse training.
AB  - Developments in nurse training need to be based upon an understanding of the
      characteristics and aspirations of students. In this study, characteristics of a
      sample of registered nurses (n = 27) and students (n = 41) entering an
      undergraduate degree programme in nursing were compared with those of student
      nurses (n = 46) beginning training in a college of nursing. It was found that the
      three groups differed in terms of their social background, their reasons for
      becoming a nurse, their views on nursing, their perceived social competence and
      their views on the role of the nurse vis-a-vis the doctor. Certain sex and social
      class differences were also apparent. The findings are discussed with reference
      to the selection of students for different forms of training and the content of
      current nurse training programmes.

PMID- 2229711
TI  - Towards defining the organization of nursing care in hospital wards: an empirical
      study.
AB  - The method of organizing nursing care known as 'primary nursing' is increasingly
      being introduced into hospital wards on the assumption that it will have
      beneficial effects for both patients and staff. Operational definitions of
      primary nursing, essential to provide replicable research into the organization
      of nursing care, are, however, lacking in available research literature. This
      study describes the development of a questionnaire intended to identify and
      discriminate between three methods of organizing nursing staff and nursing work:
      task allocation or functional nursing, team nursing and primary nursing. The
      questionnaire was distributed to 36 ward sisters on 27 acute and rehabilitation
      care of the elderly wards. Questionnaires were returned from 17 wards, a response
      rate of 63%. Findings indicate that few wards meet five or more criteria for
      classification as a particular method of nursing organization. The findings
      illustrate the difficulties in matching and discriminating between wards in order
      to conduct research in which organizational modality is an independent variable.

PMID- 2229712
TI  - The nature and prevention of suffering.

PMID- 2229713
TI  - Education. Developing superstars.

PMID- 2229715
TI  - International affairs. International consultation--a partnership in shared goals.

PMID- 2229714
TI  - Inquiry, insights, and history. Past dialogues.

PMID- 2229716
TI  - Legal and ethical issues. Ethical and legal dilemmas of battered women.

PMID- 2229717
TI  - The nurse executive. The impaired nurse.

PMID- 2229718
TI  - Professional practice. The place from which the patient comes.

PMID- 2229719
TI  - Public Policy. Will the nurse be where the patient is? A case for setting
      redistribution.

PMID- 2229720
TI  - Research. Self-help groups offer prime areas for nurse researchers.

PMID- 2229721
TI  - Aid-in-dying: issues and implications for nursing.
AB  - A debate format describes questions arising from the Model Aid-in-Dying Act,
      drafted at the University of Iowa's College of Law, and the implications for
      nurses. The Act allows patients or their named surrogates to demand or request
      active aid-in-dying. The Act requires nurses and other health care providers to
      comply with the qualified patient's demand unless the health care provider is a
      registered conscientious objector.

PMID- 2229722
TI  - Relationships between nursing and women's studies.
AB  - The purpose of this study was to examine the relationships between nursing and
      women's studies units in institutions of higher education that have both units. A
      mailed survey was completed by 173 units (97 nursing and 76 women's studies) in
      38 states. Seventy-eight per cent of the nursing units and 75 per cent of the
      women's studies units reported some type of relationship with the counterpart.
      Collaborative activities included courses, guest lectures, joint sponsorship of
      seminars, research, and many other activities. Barriers to collaboration that
      were identified included different geographic locations and other structural
      barriers, as well as units' negative views of each other, and problems unique to
      nursing. Recommendations to foster communication and collaboration between
      nursing and women's studies units are discussed.

PMID- 2229723
TI  - Integration of international and transcultural content in nursing curricula: a
      process for change.
AB  - A brief review of education and nursing literature indicates that it is essential
      to help students develop a global perspective as they prepare to practice nursing
      in a world of increasingly interdependent nations and people. The process
      currently being implemented to integrate international and transcultural content
      in the undergraduate nursing curriculum at a Midwestern state university is
      described in this article. Assessment of the school indicated that the student
      population and faculty are characterized by a high degree of radical-ethnic
      homogeneity. Assessment also included the mapping of content in all required
      courses in the undergraduate curriculum in the following areas: cultural
      differences, health care delivery systems in other countries, nursing in other
      countries, and international health organizations and issues. Recommendations
      were then made regarding content in required courses, continuation of elective
      courses, and informal educational strategies. Examples of these are described, as
      well as the resultant changes. Some of the changes described include content
      added and educational strategies used to integrate transcultural and
      international health content in required courses. Elective courses, taught both
      on-campus and abroad, are briefly described. Evaluation is an ongoing part of
      overall program evaluation. Highest priority for future planning is currently
      being placed on development of a semester study-abroad program and increasing
      cultural diversity in all students' educational experiences.

PMID- 2229724
TI  - Managerial interests and personal attributes of nurses.
AB  - This study replicated another by Hanson and Chater (1983) that investigated the
      relationship between interest in management roles and personality, demographic,
      and career background characteristics of female nurses. For the present study,
      128 sophomore, senior, and master's degree students were asked to participate and
      a self-selected convenience sample of 69 was obtained. Three instruments were
      used: The Vocational Preference Inventory (VPI), to measure personality traits; a
      demographic data questionnaire, to measure demographic variables; and the Strong
      Campbell Interest Inventory, to measure managerial interests. The total sample of
      nurses exhibited an artistic-social-intellectual profile. The subhypothesis that
      nurses of different education levels would exhibit different personality profiles
      was supported. Analysis of VPI scores demonstrated a statistically significant
      association between higher educational levels of nurses and higher acquiescence
      scores, (F = 5.1729 with a significance level of 0.0082). Analysis of variance of
      Vocational Preference Inventory scale scores showed a statistically significant
      association between nurses interested in management and higher scores on the
      enterprising attribute (F = 5.7753 with a significance level of 0.0266). No
      significant difference was found between management and nonmanagement interest
      groups in demographic and career characteristics. The findings of this study
      contribute more insight and knowledge about nurses who select management and
      administrative roles.

PMID- 2229725
TI  - Visual clues to emotional states: Rodin's "Burghers of Calais".
AB  - In the well-known, recorded Gsell-Rodin conversations of 1911, Gsell summarized
      Rodin's theory of the expressiveness of the human image: "Generally the face
      alone is considered to be the mirror of the soul: the mobility of the features of
      the face seems to us the unique exteriorization of the spiritual life. In
      reality, there is not one muscle of the body that does not express variations
      within. Each speaks of joy or sadness, enthusiasm or despair, calm or rage. Out
      stretched arms, an unrestrained torso can smile with as much sweetness as eyes or
      lips. But in order to be able to interpret all aspects of the flesh, one must be
      trained patiently in the spelling and reading of the pages of this beautiful
      book" (Art: Conversations With Paul Gsell. Translated by deCaso J, Sanders PB.
      Berkeley, CA, University of California Press, 1984, p 10). The question thus
      arises, how can we as students of the human condition undertake this necessary
      training? How might we develop the aesthetic senses to appreciate the legibility
      of the human face and form more fully? For assistance in this undertaking we
      naturally turn to the artist. For the artist "sees" the world through eyes
      trained to acutely appreciate color, light and shadow, surface and volume, and
      inner truth. In particular, the education and training of Rodin, and the
      development of his artistic technique and insight, offer the health care
      professional rich intellectual material for this study. A closer look at the
      conception and evolution of Rodin's masterpiece, "The Burghers of Calais," amply
      illustrates this vision.

PMID- 2229727
TI  - Elimination of after-hours care at a university health service.

PMID- 2229726
TI  - Ambulatory care for patients with acute leukemia: an alternative to frequent
      hospitalization.
AB  - Over the past 5 years, 23 cancer patients diagnosed with adult acute leukemia
      have been able to receive their required therapies primarily on an ambulatory
      basis. This included chemotherapy, antimicrobials, and blood product infusions.
      The ambulatory primary nurse has been a vital facilitator in designing and
      implementing a care plan that includes drug administration, symptom management,
      and the complex coordination of community resources. The relationship that
      develops between the patient, family, and primary nurse is also a key factor in
      the effectiveness of such an ambulatory program.

PMID- 2229728
TI  - Health education in higher education's future.

PMID- 2229729
TI  - The fear of understanding schizophrenia and the avoidance of the acutely
      disturbed student.
AB  - Although it is generally believed that a treatment that is more effective than
      its alternatives will be used, psychological treatments for schizophrenic and
      other psychotic reactions have been avoided despite the evidence of their
      effectiveness from the time of "moral treatment" to the present. Less effective
      (or even destructive) treatments have been seized upon, in part because they do
      not require understanding patients. Understanding them means facing facts about
      ourselves, our families, and our society that we do not want to know, or, in the
      case of repressed feelings and experiences, do not want to know again. This
      reluctance to understand is particularly tragic in the case of the acutely
      disturbed college student, whose crisis may lead either to reorganization at a
      higher level of functioning and growth or to a wasted life. The central role of
      terror in producing symptoms and the genesis and handling of symptoms, including
      delusions and hallucinations, are briefly discussed.

PMID- 2229730
TI  - The relationship between urinary tract infections and the collegiate academic
      calendar.
AB  - College students believe that they are more likely to be ill during examination
      periods than at other times in the academic year. We in the health service
      hypothesized that urinary tract infections are not affected by the demands of the
      academic calendar. During a 4-year study, the university health service obtained
      urine culture data prospectively from 456 patients who had a total of 508
      episodes of urinary tract infections. Each year, the number of urinary tract
      infections decreased during both midterm and final examination periods, but
      rebounded to higher-than-average levels in the second week following the midterm
      examination period, as well as during the second week of the second (spring)
      semester, immediately after the mid-winter recess. Mean duration of symptoms was
      34 hours (range, from 12 to 60). Urinary tract infections were less common during
      examination periods, when students were preoccupied with academic
      responsibilities, but such infections increased in frequency in the period
      immediately after examinations, when sexual intimacy was resumed or when sexual
      intercourse with a new partner began. Urinary tract infections in college women,
      the study indicated, are primarily related to sexual intercourse, and
      susceptibility is only indirectly affected by the demands of the academic
      calendar.

PMID- 2229731
TI  - AIDS Info On-Line: a computer-based information system for college campuses.

PMID- 2229733
TI  - The toothpick debate continues.

PMID- 2229732
TI  - Using peer educators for a classroom-based AIDS program.
AB  - Frustration over their inability to reach sizable numbers of students for an AIDS
      education and prevention program, even after employing peer educators, prompted
      the staff of the SHS to devise a classroom-based program. Sixty-five faculty
      members gave permission for the presentations, and the students represented a
      captive audience for the SHS-certified peer educators. Students have given very
      little indication of resenting this intrusion and have, in fact, been very
      positive in their response. Our initial evaluation of the first 2 years of the
      program indicates a need for greater recruitment efforts among students to serve
      as peer educators and among faculty to participate. It is also evident that we
      need to refine our evaluative tools, especially in regard to measuring behavioral
      changes, through use of a pretest-posttest design.

PMID- 2229734
TI  - The white stuff.

PMID- 2229735
TI  - Impressed with implants.

PMID- 2229736
TI  - Balancing dental service requirements and supplies: epidemiologic and demographic
      evidence.
AB  - As a counterpoint to negative interpretations of recent trends, this article
      presents a positive picture of dentistry in the 1990s and 21st century. Reported
      trends show large increases in older dentate adults who are retaining more of
      their natural dentition, new diagnosis and treatment technologies, increased
      incidence of dental caries in older adults, increased awareness of periodontal
      diseases, greater interest in esthetic dentistry, and generally higher
      expectations for health and fitness in our society. All of these factors point to
      a greater need for adult dental services. Therefore, in the next 30 years, the
      dental profession should be prepared to provide increased amounts of diagnostic,
      preventive, adult operative, fixed prosthodontic, and endodontic and orthodontic
      services. Declines in need should be expected in children's operative dentistry,
      extractions, and complete dentures.

PMID- 2229737
TI  - Porcelain and resin veneers clinically evaluated: 2-year results.
AB  - A clinical comparison of two different types of dental veneers--baked porcelain
      veneer and heat-and-pressure processed urethane resin veneer--was made after 2
      years. Although the esthetic appearance and gingival response were equal for both
      systems, the resin veneers had a greater tendency to chip and fracture. By the
      end of 2 years, 20% of the resin veneers had failed, whereas all of the porcelain
      veneers remained.

PMID- 2229738
TI  - Life-threatening hemorrhage after placement of an endosseous implant: report of
      case.
AB  - This article reports an unusual but dangerous complication of implant surgery.
      Minimal perforations of the lingual plate and inferior border of the mandible had
      been considered previously to be benign occurrences. This report demonstrates the
      importance of managing acute airway problems resulting from perforations.

PMID- 2229739
TI  - Mandibular osteomyelitis in a patient with sickle cell anemia: report of case.
AB  - A case is presented in which mandibular osteomyelitis and mental nerve
      paresthesia developed in a patient with sickle cell anemia. This infection
      appeared to precipitate a sickle cell crisis. The mechanisms for these patients'
      propensity to infection and the diagnosis and management of sickle cell
      osteomyelitis of the jaws are discussed.

PMID- 2229740
TI  - Tongue ischemia from a soft-drink can: report of case.
AB  - A young girl was brought to the emergency department because her tongue became
      entrapped while she was drinking from an aluminum soft-drink can. A dental drill
      was used to remove the can. The tongue was observed for 48 hours, during which an
      ischemic area recovered spontaneously.

PMID- 2229741
TI  - Evaluating tooth eruption on sealant efficacy.
AB  - For patients aged 5 to 9 and 11 to 14, 100 occlusal surfaces on newly erupting
      permanent molars were treated with a self-curing pit and fissure sealant. All
      teeth were categorized according to stage of eruption and sealant thickness of
      the coating applied. After 36 months, 75 surfaces were examined for a final
      evaluation; 52 surfaces (70%) did not need retreatment. Of the 23 surfaces
      retreated as a result of sealant loss or marginal deterioration, 18 were
      retreated only once in the six recall evaluations. Those molars treated
      originally with the operculum covering the distal marginal ridge of the occlusal
      surface had twice the probability for retreatment as teeth not treated until the
      entire marginal ridge was exposed. The thickness of the sealant coating did not
      affect the early signs of sealant failure.

PMID- 2229742
TI  - The prevalence of periodontitis in a military treatment population.
AB  - A group of 1,984 males and females (age range 13 to 84) at a military dental
      clinic were given oral examinations with full-mouth circumferential periodontal
      probing. Diagnoses were made both for individual quadrants and for the entire
      mouth using clearly defined diagnostic criteria. The results showed 37% of the
      subjects had gingivitis only, 33% had early periodontitis, 14% had moderate
      periodontitis, 15% had advanced periodontitis, 0.5% had juvenile periodontitis,
      and 0.5% had necrotizing gingivitis. The prevalence of periodontitis increased
      with age to a peak in the 45- to 50-year-age group. The proportion of
      periodontitis-affected quadrants, although initially lagging behind the overall
      case diagnoses, also increased with age.

PMID- 2229744
TI  - Using removable partial denture framework as matrix for pin-retained restoration.
AB  - A quick and easy method can restore a broken-down partial denture abutment with a
      pin-retained amalgam restoration. It has a high degree of patient acceptance as
      only one appointment is required, eliminating the need for the patient to leave a
      partial denture for adaptation to a wax pattern. The cost can be minimal. This
      technique can be used for Class II restorations; however, the practitioner must
      ensure sufficient clearance for the condenser to pass between the tooth and the
      partial denture, so all areas can be properly condensed.

PMID- 2229743
TI  - Patient satisfaction in four types of dental practice.
AB  - There has been a significant growth in alternative types of dental practice. To
      determine satisfaction, patients were surveyed in urban private practices, a
      hospital dental clinic, a neighborhood health center, and a large group practice
      situated in a shopping center, using a 14-item survey and a 5-point rating scale.
      Patient satisfaction was related to the following factors in descending order:
      dentist, staff, efficiency, time-cost, and accessibility. Patients rated private
      practice most favorably for all factors with the exception of accessibility,
      which was rated highest for the shopping center practice. Patients rated the
      hospital least favorably for all factors with the exception of dentist, which was
      rated least favorably for the shopping center practice. Although private
      practices were the most favorably perceived, alternative types of practice were
      also highly rated and met specific patient needs. Satisfaction was greater for
      older patients, for patients with less education, and for white compared with
      black patients.

PMID- 2229746
TI  - Accredited dental schools. Commission on Dental Accreditation.

PMID- 2229745
TI  - Periodontics in general practice: professional plaque control.
AB  - Traditionally the primary emphasis of preventive periodontics was daily patient
      performed plaque control. Recent studies indicate that frequent professional
      subgingival toothcleaning is a mandatory treatment for prevention of recurrent
      periodontitis. Pathogenic subgingival bacterial complexes are disrupted by
      frequent cleaning and require time to reestablish. Disease progression is
      prevented if the recall interval does not exceed the time required for
      reestablishment of a pathogenic plaque. Legally, patients have acquired the duty
      to comply with the prescribed recall interval. Both the patient and the
      practitioner will benefit from a preventive program that includes frequent
      professional subgingival toothcleaning.

PMID- 2229747
TI  - Lip paresthesia associated with a jaw mass.
AB  - A case is reported in which mandibular swelling and lower lip numbness were the
      first signs of a metastatic adenocarcinoma of the lung. The development of
      paresthesia, with or without other oral symptoms, requires that a diagnosis of
      malignancy be considered until confirmed or ruled out by tissue biopsy. A
      thorough head and neck examination in all patients, especially in those whose
      history or habits may indicate increased risk of malignancy is necessary.

PMID- 2229748
TI  - Clinical competence in exercise testing. A statement for physicians from the
      ACP/ACC/AHA Task Force on Clinical Privileges in Cardiology.

PMID- 2229749
TI  - Progression of native coronary artery disease at 10 years: insights from a
      randomized study of medical versus surgical therapy for angina.
AB  - Repeat coronary angiography was performed in 42 patients 10 years after
      randomization to medical (n = 21) or surgical (n = 21) therapy for chronic
      angina. The native coronary arteries were classified into 15 angiographic
      segments and 3 arterial trunks for analysis of progression of coronary artery
      disease. The incidence rate of disease progression in coronary segments was 24%
      and 28% in medically and surgically treated patients, respectively (p = NS).
      Grafted segments showed a 38% rate of disease progression, which was higher than
      the 18% rate of for nongrafted segments (p less than 0.001) and the overall rate
      of 24% for medically treated patients (p less than 0.01). Similarly, 29 (94%) of
      31 grafted arteries exhibited disease progression compared with 19 (59%) of 32
      nongrafted arteries (p less than 0.01) and 42 (67%) of 63 arteries in medically
      treated patients (p less than 0.01). In grafted vessels, disease progression
      occurred more often in arteries proximal (84%) to the anastomosis than in
      arteries distal (16%) to graft insertion (p less than 0.001). Progression
      occurred in 46% of proximal segments compared with 23% of distal segments (p less
      than 0.02). Progression was seen in 23 (55%) of 43 segments with an occluded
      graft compared with 30 (31%) of 96 segments with a patent graft (p less than
      0.02). Ten years after randomization, medically and surgically treated patients
      showed a comparable rate of disease progression in coronary segments. However,
      surgical therapy appeared to significantly accelerate atherosclerotic progression
      in the grafted vessels, especially in the proximal portions. Occluded grafts also
      correlated with an adverse effect on disease progression.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2229750
TI  - Coronary Artery Surgery Study (CASS): comparability of 10 year survival in
      randomized and randomizable patients.
AB  - The Coronary Artery Surgery Study (CASS) includes 780 patients with mild or
      moderate stable angina pectoris or asymptomatic survivors of a myocardial
      infarction who were randomized to either medical or surgical therapy and 1,319
      patients who were eligible for randomization but were not randomized
      (randomizable patients). There were no substantial aggregate differences observed
      in any of the survival comparisons after 10 years of follow-up study between the
      randomized and randomizable patients assigned to the medical (79% versus 80%) or
      surgical (82% versus 81%) groups or in patient subgroups stratified according to
      coronary artery disease extent and left ventricular ejection fraction. Cox
      regression analyses were done with independent variables known to be predictors
      of survival, including surgical versus medical therapy and randomized versus
      randomizable group, to test the null hypothesis of a mortality difference between
      medical versus surgical assignment according to group assignment (randomized
      versus randomizable). In no case did the initial group category enter as a
      significant predictor of survival. The results in the randomizable group
      reinforce those in the randomized group with respect to the medical versus
      surgical comparison. Two subgroups are identified with a significant surgical
      advantage: 1) patients with proximal left anterior descending coronary artery
      stenosis greater than or equal to 70% and an ejection fraction less than 0.50,
      and 2) patients with three vessel coronary artery disease and an ejection
      fraction less than 0.50. In both groups, coronary bypass surgery had a
      statistically significant beneficial effect on survival (p less than 0.05). After
      a decade of follow-up, the CASS randomizable patients confirm conclusions reached
      on the basis of the CASS randomized trial.

PMID- 2229751
TI  - Coronary lesion morphology in acute myocardial infarction: demonstration of early
      remodeling after streptokinase treatment.
AB  - Coronary lesion morphology was analyzed in 72 patients 1 to 8 days after
      streptokinase treatment for acute myocardial infarction and compared with lesion
      morphology in a control group of 24 patients with stable angina. In the
      streptokinase group the infarct-related artery was patent in 55 patients (76%).
      Compared with stenoses in the stable angina group, there were no differences in
      the stenosis length, severity, calcification or in the proportion located at an
      acute bend or at a branch point. However, lesions in the streptokinase group were
      more often irregular (p less than 0.005) and eccentric (p less than 0.01), had a
      shoulder (p less than 0.0001), globular filling defects (p less than 0.01),
      linear filling defects (p less than 0.00005) and contrast staining (p less than
      0.05). Plaque ulceration index was higher in the streptokinase than in the stable
      angina group (6.2 +/- 7.9 versus 3.5 +/- 3.4, p less than 0.001). Of the 72
      streptokinase-treated patients, 35 were maintained on heparin infusion until
      angioplasty 2 to 10 days later. At repeat angiography before angioplasty,
      globular lesion filling defects seen in eight patients had disappeared, whereas
      linear filling defects persisted in 7 of 14 cases. Fewer lesions were irregular
      (p less than 0.0001) and the ulceration index decreased from 7.4 +/- 10.4 to 3.0
      +/- 1.6 (p less than 0.001). These data show that the lesion in the infarct
      related artery after streptokinase treatment is irregular and often associated
      with filling defects, perhaps corresponding to plaque fissuring and intraluminal
      thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229752
TI  - Coronary plaque morphology in postinfarction patients: implications for early
      versus deferred coronary angioplasty.

PMID- 2229753
TI  - Results of primary angioplasty for acute myocardial infarction in patients with
      multivessel coronary artery disease.
AB  - The influence of multivessel coronary artery disease on the outcome of
      reperfusion therapy for myocardial infarction has not been fully characterized.
      Direct coronary angioplasty without antecedent thrombolytic therapy was performed
      during evolving myocardial infarction in 285 patients with multivessel coronary
      artery disease at 5.2 +/- 4.2 h after the onset of chest pain. Two vessel disease
      was present in 163 patients (57%) and three vessel disease in 122 (43%). An
      anterior infarct was present in 123 patients (43%), cardiogenic shock in 33 (12%)
      and age greater than or equal to 70 years in 59 (21%). Angioplasty of the infarct
      related vessel was successful in 256 patients (90%), including 92% with two
      vessel and 88% with three vessel disease (p = NS). Emergency bypass surgery was
      needed in six patients (2%). In-hospital death occurred in 33 patients (12%),
      including 13 with two vessel and 20 with three vessel disease (p less than 0.05).
      The mortality rate was only 4% in the subgroup of 101 patients who met entry
      criteria for thrombolytic trials. The in-hospital mortality rate was 45% in
      patients in shock and 7% in patients not in shock (p less than 0.01). Logistic
      regression analysis identified shock and age greater than or equal to 70 years as
      independently associated with in-hospital death. In 135 patients who underwent
      predischarge left ventriculography, global ejection fraction increased from 50%
      to 57% (p less than 0.001) and regional wall motion in the infarct zone improved
      in 59% of patients. Follow-up data were available in 251 patients (99%) at a mean
      of 35 +/- 19 months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229754
TI  - Multivessel coronary angioplasty from 1980 to 1989: procedural results and long
      term outcome.
AB  - From June 1980 to January 1989, 3,186 patients had coronary angioplasty of two
      (2,399 patients) or three (787 patients) of the three major epicardial coronary
      systems. A mean of 3.6 lesions (range 2 to 14) were dilated per patient, with a
      96% success rate. Acute complications were seen in 94 patients (2.9%) and
      included Q wave infarction in 47 (1.4%), urgent coronary artery bypass surgery in
      33 (1%) and death in 31 (1%). Multivariate correlates of in-hospital death
      included impaired left ventricular function, age greater than or equal to 70
      years and female gender. Complete long-term follow-up data were available for the
      first 700 patients and the follow-up period averaged 54 +/- 15 months in
      duration. Actuarial 1 and 5 year survival rates were 97% and 88%, respectively,
      and were not different in patients with two or three vessel disease. By Cox
      regression analysis, age greater than or equal to 70 years, left ventricular
      ejection fraction less than or equal to 40% and prior coronary artery bypass
      surgery were associated with an increased mortality rate during the follow-up
      period. Repeat revascularization procedures were required in 322 patients (46%).
      Restenosis resulted in either repeat angioplasty or bypass surgery in 227
      patients (32%). Repeat coronary angioplasty was performed for isolated restenosis
      in 126 patients (18%), for restenosis and disease progression at new sites in 85
      patients (12%) and for new disease progression alone in 54 patients (8%).
      Coronary bypass surgery was required in 110 patients (16%) during the follow-up
      period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229755
TI  - Multivessel coronary angioplasty.

PMID- 2229756
TI  - Coronary angioplasty as the preferred approach to treatment of multivessel
      disease: promising, appealing but unproved.

PMID- 2229757
TI  - Plasma homocyst(e)ine levels in men with premature coronary artery disease.
AB  - Plasma homocyst(e)ine (that is, the sum of free and bound homocysteine and its
      oxidized forms, homocystine and homocysteine-cysteine mixed disulfide) levels
      were determined in 170 men (mean age +/- SD 50 +/- 7 years) with premature
      coronary artery disease diagnosed at coronary angiography and in 255 control
      subjects clinically free of coronary artery disease (mean age 49 +/- 6 years).
      Patients with coronary artery disease had a higher homocyst(e)ine level than
      control subjects (13.66 +/- 6.44 versus 10.93 +/- 4.92 nmol/ml, p less than
      0.001). High density lipoprotein (HDL) cholesterol levels were lower (32 +/- 10
      versus 46 +/- 13 mg/dl, p less than 0.001) and triglycerides levels were higher
      (193 +/- 103 versus 136 +/- 106 mg/dl, p less than 0.001) in the coronary disease
      group. Plasma total cholesterol and low density lipoprotein (LDL) cholesterol
      levels were not significantly different between patients with coronary disease
      and control subjects. The presence of hypertension, smoking or diabetes mellitus
      did not significantly alter homocyst(e)ine levels in the patient or the control
      group. Patients who were not taking a beta-adrenergic blocking drug (n = 70) had
      a nonsignificantly higher homocyst(e)ine level than did patients taking this
      class of drugs (n = 100) (14.67 +/- 8.92 versus 12.95 +/- 3.77 nmol/ml, p =
      0.087). By design, none of the control subjects were taking a beta-blocker. No
      significant correlations were observed between homocyst(e)ine and age, serum
      cholesterol, LDL cholesterol, HDL cholesterol or triglyceride levels. It is
      concluded that an elevated plasma homocyst(e)ine level is an independent risk
      factor for the development of premature coronary atherosclerosis in men.

PMID- 2229758
TI  - Prolonged anginal perceptual threshold in diabetes: effects on exercise capacity
      and myocardial ischemia.
AB  - Anginal perceptual threshold (the time from onset of 0.1 mV of ST segment
      depression to onset of angina during treadmill exercise) is prolonged in diabetic
      patients with coronary artery disease. In the present study, the functional
      significance of this perceptual abnormality was evaluated by analysis of its
      effect on exercise capacity and the severity of myocardial ischemia. Treadmill
      exercise in 32 diabetic patients and 36 nondiabetic control patients showed a
      close linear correlation between the time to onset of electrical ischemia (ST
      segment depression) and exercise capacity in both groups (r = 0.8 and 0.9,
      respectively; p less than 0.001). However, the slope of the relation was flatter
      in the diabetic group because prolongation of the anginal perceptual threshold
      permitted continued exercise as ischemia intensified. The anginal perceptual
      threshold itself showed a close linear correlation with exercise capacity in the
      diabetic group (r = 0.8, p less than 0.001), although in the nondiabetic group
      these variables were unrelated. The permissive effect of a prolonged anginal
      perceptual threshold on exercise capacity is undesirable as reflected by its
      correlation with ischemia at peak exercise (r = 0.6, p less than 0.001): the
      longer the threshold, the greater the exercise capacity and the more severe the
      ischemia. Indeed, the inverse relation between the severity of ischemia at peak
      exercise and exercise capacity in the nondiabetic group (r = 0.4, p less than
      0.02) was completely lost in the diabetic group. Thus, in diabetic patients with
      coronary artery disease, anginal perceptual threshold is a major determinant of
      exercise capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229759
TI  - Clinical and hemodynamic correlates of sympathetic nerve activity in normal
      humans and patients with heart failure: evidence from direct microneurographic
      recordings.
AB  - To characterize the neural excitatory state of heart failure, simultaneous
      measurements of efferent sympathetic nerve activity to muscle (by
      microneurography) and rest hemodynamics were obtained in 10 normal subjects (age
      25 +/- 2 years, mean +/- SEM) and 29 patients with heart failure (age 49 +/- 2
      years; New York Heart Association functional class II to IV; left ventricular
      ejection fraction 21 +/- 1%; cardiac index = 2.16 +/- 0.13 liters/min per m2;
      pulmonary capillary wedge pressure 23 +/- 2 mm Hg). Sympathetic nerve activity
      was significantly higher in the patients with heart failure (54.7 +/- 4.5
      bursts/min) than in normal subjects (16.7 +/- 2.2 bursts/min, p less than 0.001).
      Multiple linear regression analyses indicated that sympathetic activity in these
      human subjects was most strongly and inversely correlated with left ventricular
      stroke work index (r = -0.86, p less than 0.0001) and stroke volume index (r = 
      0.85, p less than 0.0001). There was a strong positive correlation between
      sympathetic nerve activity and pulmonary artery diastolic (r = 0.82, p less than
      0.0001) and mean (r = 0.81, p less than 0.0001) pressures. Similar correlations
      were seen when patients with heart failure were analyzed separately. There was no
      significant correlation between sympathetic nerve activity and mean arterial
      pressure, left ventricular ejection fraction (by radionuclide ventriculography),
      cardiac chamber size (by echocardiography) or arterial oxygen tension in the
      patients with heart failure. Direct measurements of sympathetic nerve activity
      correlated closely with plasma norepinephrine (r = 0.72, p less than 0.0001) in
      patients with heart failure. Thus, sympathetic nerve activity at rest parallels
      impairment of cardiac performance in patients with heart failure.

PMID- 2229760
TI  - Serial Doppler echocardiographic follow-up of left ventricular diastolic function
      in cardiac amyloidosis.
AB  - A spectrum of left ventricular diastolic filling abnormalities noted on Doppler
      echocardiography has been demonstrated in patients with cardiac amyloidosis. To
      determine how these filling abnormalities evolve over time and the significance
      of any change, serial pulsed wave Doppler studies of left ventricular inflow were
      performed over 12.6 +/- 4.9 months in 41 consecutive patients (36 men and 15
      women, mean age 59 +/- 11 years) with typical two-dimensional echocardiographic
      features of cardiac involvement. The measurements were peak left ventricular
      inflow in early diastole (E) and atrial contraction (A) velocities, E/A ratio,
      deceleration time and isovolumetric relaxation time. Patients were classified by
      mean left ventricular wall thickness into an early group (less than 15 mm) of 24
      patients and an advanced group (greater than or equal to 15 mm) of 17 patients.
      The total group showed an increased E/A ratio (1.7 +/- 0.9 versus 1.4 +/- 0.9, p
      = 0.009) and decreased deceleration time (164 +/- 57 versus 174 +/- 51 ms, p =
      0.11) at follow-up compared with baseline study. The early group showed
      significant changes in the E/A ratio (1.6 +/- 1.0 versus 1.2 +/- 0.7, p = 0.001)
      between the two studies. Seven patients (29%) in the early group showed a change
      from an abnormal relaxation or "normal" pattern to one of restriction, coincident
      with increased symptoms in six of these patients. Fifteen (88%) of the 17
      patients in the advanced group did not show significant changes in the measures
      during the follow-up study, but these patients already showed a restrictive
      pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229761
TI  - Simultaneous transesophageal atrial pacing and transesophageal two-dimensional
      echocardiography: a new method of stress echocardiography.
AB  - The diagnostic use of exercise echocardiography has been widely reported.
      However, transthoracic exercise echocardiography is inadequate in up to 20% of
      patients because of poor image quality related to exercise. In an attempt to
      overcome these limitations, a system was developed in which transesophageal
      echocardiography is combined with simultaneous transesophageal atrial pacing by
      means of the same probe. In a prospective study, transesophageal echocardiography
      was performed before, during and immediately after maximal atrial pacing in 50
      patients with suspected coronary artery disease. Results of transesophageal
      stress echocardiography were considered abnormal when new pacing-induced regional
      wall motion abnormalities were observed. Correlative routine bicycle exercise
      testing was carried out in 44 patients. Cardiac catheterization was performed in
      all patients. The success rate in obtaining high quality diagnostic images was
      100% by transesophageal echocardiography. All nine patients without angiographic
      evidence of coronary artery disease had a normal result on the transesophageal
      stress echocardiogram (100% specificity). Thirty-eight of 41 patients with
      coronary artery disease (defined as greater than or equal to 50% luminal diameter
      narrowing of at least one major vessel) had an abnormal result on the
      transesophageal stress echocardiogram (93% sensitivity). The sensitivity of the
      technique for one, two or three vessel disease was 85%, 100% and 100%,
      respectively, compared with 44%, 50% and 83%, respectively, for bicycle exercise
      testing; the 12 lead electrocardiogram (ECG) during rapid atrial pacing showed a
      sensitivity of 25%, 64% and 86%, respectively. Thus, rapid atrial pacing combined
      with simultaneous transesophageal echocardiography is a highly specific and
      sensitive technique for the detection of coronary artery disease. Ischemia
      induced wall motion abnormalities were detected earlier than observed ECG
      changes. The technique appears to be particularly suited to patients who are
      unable to perform an active stress test or those with poor quality transthoracic
      echocardiograms.

PMID- 2229762
TI  - Transesophageal atrial pacing or pharmacologic stress testing in detection of
      coronary artery disease in patients who are unable to undergo exercise stress
      testing.

PMID- 2229763
TI  - Left atrial dimensions in growth and development: normal limits for two
      dimensional echocardiography.
AB  - Reference values for normal left atrial dimensions have been based primarily on
      blind M-mode measurements, with no reports based on two-dimensional
      echocardiography to provide a comprehensive analysis of the two-dimensional
      measurements from infancy to old age. This report analyzes the left atrial
      dimensions from two-dimensional echocardiographic studies in 268 normal healthy
      subjects to determine normal limits and relations among linear, area and volume
      measurements of the left atrium. The group mean values change with body size,
      fitting well to the exponential growth model (r = 0.78 to 0.92). The variance
      about the mean (which determines normal limits) is represented effectively by a
      quadratic function of body surface area (r = 0.84 to 0.99). The variables
      determined by this modeling simplify evaluation of normal limits for any body
      size at any desired level of confidence, and the data are useful reference
      standards for interpretation of two-dimensional echocardiograms.

PMID- 2229764
TI  - Effects of nitroprusside on transmitral flow velocity patterns in extreme heart
      failure: a combined hemodynamic and Doppler echocardiographic study of varying
      loading conditions.
AB  - To explore the mechanisms of change of left ventricular diastolic filling
      associated with preload and afterload reduction, the influence of nitroprusside
      on the transmitral flow velocity pattern, pulmonary capillary wedge pressure and
      left ventricular pressure interaction was studied in 11 patients with end-stage
      heart failure. Pulsed Doppler echocardiographic recordings of mitral inflow were
      obtained with simultaneous high fidelity left ventricular and phase-corrected
      pulmonary capillary wedge pressure recordings before and during levels of
      nitroprusside infusion. With nitroprusside, left ventricular systolic and end
      diastolic pressures decreased by 14% and 41% (p less than 0.05, p less than
      0.05), respectively, and cardiac output increased by 67% (p less than 0.05). The
      pulmonary capillary wedge-left ventricular crossover pressure decreased by 41% (p
      less than 0.05), but the time constant of isovolumetric left ventricular pressure
      decrease T was insignificantly changed. Isovolumetric relaxation time and
      acceleration and deceleration times of the early diastolic filling wave were
      significantly prolonged with nitroprusside infusion (p less than 0.05, p less
      than 0.05 and p less than 0.05, respectively). Peak early diastolic filling
      velocity was maintained (65 +/- 11 to 62 +/- 13 cm/s, p = NS) in spite of the
      decreased absolute crossover pressure. Changes in peak early diastolic filling
      velocity correlated weakly with changes in the crossover pressure (r = 0.48, p
      less than 0.05) and correlated better with the crossover to left ventricular
      minimal pressure difference (r = 0.78, p less than 0.05). Peak early diastolic
      filling velocity appears to be most affected by the early diastolic pulmonary
      capillary wedge to left ventricular pressure difference rather than the absolute
      pulmonary capillary wedge pressure. The lack of peak flow velocity change during
      nitroprusside infusion could be explained by either the associated decrease in
      left ventricular minimal pressure or downward shift of left ventricular diastolic
      pressure by the same amount as the decrease in pulmonary capillary wedge
      pressure. This may reflect a reduction of external constraint to ventricular
      distensibility produced by a reduction in filling volume in patients with a
      markedly dilated ventricle. Thus, a prolonged early diastolic filling period and
      preserved peak early diastolic filling velocity in spite of decreased left
      ventricular filling pressure and constant relaxation rate are associated with the
      beneficial effects of nitroprusside on left ventricular function in patients with
      severe congestive heart failure.

PMID- 2229765
TI  - Comparison of ventricular arrhythmia induction with use of an indwelling
      electrode catheter and a newly inserted catheter.
AB  - Two methods of serial electrophysiologic testing are in widespread use. Most
      commonly, the electrode catheter is removed after each study and a new catheter
      reinserted through the femoral vein for every subsequent test. An alternative
      method employs an electrode catheter that remains in place during several days of
      serial testing. Little is known about differences between these two methods with
      respect to the likelihood of induction of arrhythmia or the frequency of
      complications. To determine whether inducibility of sustained arrhythmia is
      altered or if the frequency of complications is unacceptably high with use of an
      indwelling catheter, a prospective randomized study was conducted in 78 patients.
      Each patient underwent baseline testing, several days of electropharmacologic
      testing with an indwelling catheter, a 24 h drug elimination period and placement
      of a new electrode catheter. Ventricular stimulation studies were then performed
      in each patient with both the indwelling and new electrode catheters. No
      differences were found between the indwelling and new catheter tests with respect
      to induction of arrhythmia, number of extrastimuli required to induce arrhythmia,
      rate of arrhythmia or requirement for cardioversion. Ventricular pacing
      thresholds were higher and effective refractory periods were slightly longer when
      measured with the indwelling catheter. Complications related to the 156 catheter
      insertions included two that may have been related to the indwelling catheter
      (one episode of staphylococcal sepsis and one presumed pulmonary embolism) and
      four that were related to invasive procedures (pneumothorax in all). There were
      no long-term adverse sequelae of these complications.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2229766
TI  - Determinants of the ventricular rate during atrial fibrillation.
AB  - Determinants of the ventricular cycle length during atrial fibrillation were
      examined in 52 patients. Thirty-three patients had structural heart disease and
      none had an accessory atrioventricular (AV) connection. The AV node effective and
      functional refractory periods, the shortest atrial pacing cycle length associated
      with 1:1 conduction, the AV node conduction time and indexes of concealed
      conduction in the AV node were measured in the baseline state (36 patients) and
      after modification of sympathetic tone by infusion of isoproterenol or
      propranolol (8 patients each). Atrial fibrillation was then induced with rapid
      atrial pacing, and the mean, shortest and longest ventricular cycle lengths were
      measured. Variables that correlated most strongly with the mean RR interval
      during atrial fibrillation were the AV node effective refractory period (r =
      0.93; p less than 0.001), AV node functional refractory period (r = 0.87; p less
      than 0.001) and shortest atrial pacing cycle length associated with 1:1
      conduction (r = 0.91; p less than 0.001). The AH interval during sinus rhythm (r
      = 0.74; p less than 0.001) and during atrial pacing at the shortest cycle length
      with 1:1 conduction (r = 0.52; p less than 0.001) had weaker correlations.
      Measures of concealed conduction did not improve the prediction of the mean or
      longest ventricular cycle length during atrial fibrillation. In conclusion, the
      refractory periods and conductivity of the AV node are the best indicators of the
      potential of the node to transmit atrial impulses to the ventricles during atrial
      fibrillation. The degree of concealed conduction in the AV node is a less
      important determinant of the mean ventricular rate during atrial fibrillation.

PMID- 2229767
TI  - Is atrial activation beneficial in heart transplant recipients?
AB  - Because of the distortion of atrial morphology that occurs during cardiac
      allograft transplantation in humans, the beneficial effects of properly sequenced
      atrial and ventricular activation are unclear in these patients. To evaluate the
      atrial contribution to ventricular pump performance in heart transplant
      recipients, arterial pressure and cardiac output during pacing from either
      chamber were measured in nine patients 10 +/- 1 days after transplantation.
      Systolic, diastolic and mean systemic arterial pressures were significantly
      higher during atrial pacing compared with ventricular pacing: 143 +/- 23 versus
      125 +/- 20 mm Hg, 73 +/- 15 versus 66 +/- 14 mm Hg and 94 +/- 17 versus 84 +/- 16
      mm Hg, respectively (p less than 0.05 for all). In addition, cardiac output
      decreased from 5.5 +/- 1.4 to 4.6 +/- 1.5 liters/min (p less than 0.005) for
      atrial versus ventricular pacing. Thus, there is a significant atrial
      contribution to cardiac performance in patients after heart transplantation. This
      may have clinical implications in those patients who later require a permanent
      pacemaker.

PMID- 2229768
TI  - Comparative value of transthoracic and transesophageal echocardiography in the
      assessment of congenital abnormalities of the atrioventricular junction.
AB  - Information obtained from transthoracic and transesophageal echocardiography (two
      dimensional echocardiography with spectral Doppler and color flow imaging) was
      compared in 17 patients with major congenital abnormalities of the
      atrioventricular (AV) junction (10 discordant AV connections, 1 criss-cross
      connection, 5 absent right connections and 1 absent left connection). The
      findings by either technique were correlated with findings at cardiac
      catheterization (12 patients) and at surgery (5 patients). In two of six patients
      with an absent AV connection as defined by transthoracic echocardiography,
      transesophageal imaging demonstrated an imperforate AV valve. In 11 of 11
      patients with a discordant or criss-cross connection, assessment of AV valve and
      ventricular morphology (by defining the chordal attachments of both AV valves)
      was possible with transesophageal echocardiography (3 of 11 patients by
      transthoracic echocardiography); chordal straddling was detected in 1 patient and
      excluded in 3 others with an associated inlet ventricular septal defect.
      Anomalous pulmonary venous connection (one patient), atrial septal defect (three
      patients) and subpulmonary stenosis (five patients) were better assessed by
      transesophageal imaging, and atrial appendage morphology could be demonstrated in
      all. The transesophageal technique was less useful in demonstrating the anterior
      subaortic infundibulum or aortopulmonary shunt (two patients). Although systemic
      ventricular function could be assessed by either method with use of short-axis M
      mode scans, transesophageal pulsed Doppler interrogation of AV valve and
      pulmonary venous flow patterns provided clues to diastolic dysfunction of the
      systemic ventricle.

PMID- 2229769
TI  - Supraventricular tachycardia due to Wolff-Parkinson-White syndrome in children:
      early disappearance and late recurrence.
AB  - The clinical course of 140 patients with Wolff-Parkinson-White syndrome who had
      their initial episode of supraventricular tachycardia before 18 years of age was
      reviewed. Among those whose tachycardia began at age 0 to 2 months, it
      disappeared in 93% and persisted in 7%. In 31%, it disappeared and reappeared at
      an average age of 8 years. Among patients whose tachycardia was present after age
      5 years, it was persistent in 78% at a mean follow-up period of 7 years.
      Accessory connection location was mapped by electrophysiologic study in 87
      patients and estimated by electrocardiography in 53 patients. There were no
      differences in tachycardia onset or recurrence based on accessory connection
      location. Congenital heart defects were present in 37% of all patients, 23% of
      whom had Ebstein's anomaly. Among all patients who underwent cardiac
      catheterization, 63% of those with a congenital heart defect had a rightsided
      accessory connection, whereas 61% of patients with a normal heart had a left
      sided connection (p less than 0.01). Multiple accessory connections were found in
      12% of patients with a congenital heart defect compared with 6% of those without
      such a defect. IN CONCLUSION: 1) supraventricular tachycardia due to Wolff
      Parkinson-White syndrome that begins in infancy may disappear, but it frequently
      recurs in later childhood; 2) if tachycardia is present after age 5 years, it
      persists in greater than 75% of patients; and 3) the location of the accessory
      connection does not affect the clinical course of tachycardia in children with
      Wolff-Parkinson-White syndrome.

PMID- 2229770
TI  - Pediatric pre-excitation: say "no" to drugs?

PMID- 2229771
TI  - Ventricular arrhythmias after correction of ventricular septal defects:
      importance of surgical approach.
AB  - To compare the prevalence of conduction disturbances and ventricular arrhythmias
      in cases of postoperative ventricular septal defect, 100 patients (50 with repair
      by right atriotomy, group 1; and 50 with repair by right ventriculotomy, group 2)
      underwent complete evaluation including an electrocardiogram (ECG) and 24 h
      ambulatory ECG monitoring. The two groups were comparable except for a shorter
      follow-up duration (7 +/- 3 versus 12.4 +/- 7 years) and a younger age at
      evaluation (12.4 +/- 5 versus 16.9 +/- 7 years) in group 1. Complete right bundle
      branch block was less frequent in group 1 than in group 2 (20% versus 50%, p less
      than 0.05) but three of the four patients with complete atrioventricular (AV)
      block detected on ambulatory monitoring were in group 1. Six patients had
      significant supraventricular arrhythmias, all well tolerated. Ambulatory
      monitoring revealed significant ventricular arrhythmias (modified Lown grade 2 or
      higher) in 39 patients, with a lower prevalence in group 1 (30% versus 48%, p =
      0.05). No correlation was found between prevalence of ventricular arrhythmias and
      right ventricular systolic pressure, cardiopulmonary bypass duration, presence of
      a synthetic patch, previous pulmonary artery banding, presence of complete right
      bundle branch block and cardiomegaly on chest X-ray film. Prevalence of
      ventricular arrhythmias increased with follow-up duration, age at evaluation and
      age at surgery. These were always well tolerated and did not warrant treatment.
      Thus, right atriotomy reduces the prevalence of right bundle branch block but
      does not prevent late AV block. Ventricular arrhythmias are frequent after
      surgical closure of ventricular septal defect whatever the surgical approach and
      their prevalence is not statistically different from that in postoperative
      tetralogy of Fallot.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229772
TI  - Efficacy of propafenone in preventing ventricular tachycardia: inverse
      correlation with rate-related prolongation of conduction time.
AB  - The efficacy of propafenone in preventing induction of ventricular tachycardia
      was evaluated in 25 consecutive patients (mean age 62 +/- 8 years) with remote
      myocardial infarction who underwent programmed electrical stimulation for
      ventricular arrhythmia using up to three extra-stimuli after basic drive at the
      right ventricular apex. In nine patients (Group A), propafenone prevented
      induction of sustained ventricular tachycardia (noninducible in four,
      nonsustained [less than 30 s] in five). In the other 16 patients (Group B),
      sustained ventricular tachycardia was still inducible; in 11 of the 16, the
      tachycardia configuration was unchanged but the cycle length was significantly
      longer (431 +/- 99 versus 284 +/- 44 ms, p less than 0.001). Propafenone did not
      significantly affect either sinus cycle length or AH and HV intervals. However,
      it prolonged QRS duration during sinus rhythm equally in both groups of patients.
      With ventricular pacing, propafenone also prolonged right ventricular effective
      and functional refractory periods and surface QRS duration. There was greater
      lengthening of the paced surface QRS duration when drug therapy was ineffective
      (for example, +35 +/- 12 ms in Group A versus +69 +/- 23 ms in Group B at a basic
      drive of 400 ms, p less than 0.01). Drug-induced prolongation of a paced QRS
      complex greater than 40 ms had a 94% positive predictive value for drug failure
      to prevent induction of ventricular tachycardia. Drug-induced percent
      prolongation of ventricular tachycardia cycle length in Group B did not correlate
      well with percent QRS prolongation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229773
TI  - Sorting out the mechanisms of antiarrhythmic drug action.

PMID- 2229774
TI  - Surgical treatment of endomyocardial fibrosis: a new approach.
AB  - Endomyocardial fibrosis has been treated surgically for many years. For complete
      removal of fibrosis from both ventricles by the classic technique, each
      atrioventricular (AV) valve was removed and replaced with a prosthesis. Relapse
      of endomyocardial fibrosis has not been observed after surgical correction.
      Reoperations have been carried out because of complications of valve prostheses.
      A new surgical technique for removal of ventricular fibrous tissue with
      preservation of the mitral and tricuspid valves was used in nine consecutive
      patients with endomyocardial fibrosis. Initial results show a reduction of
      pulmonary hypertension, mean right and left atrial pressures and end-diastolic
      pressures in both ventricles. Tricuspid annuloplasty was performed in seven
      patients and mitral annuloplasty in five. No valve prosthesis was used. There was
      no death and New York Heart Association functional class improved from class III
      or IV in the preoperative period to class I or II in the postoperative period.
      These data suggest that resection of endocardial fibrous tissue can be indicated
      early in the clinical course and performed with preservation of the AV valves.

PMID- 2229775
TI  - Effect of intravenous streptokinase on the relation between initial ST-predicted
      size and final QRS-estimated size of acute myocardial infarcts.
AB  - Thrombolytic therapy has been documented to reduce acute myocardial infarct size.
      The previously established relation between initial ST segment elevation and
      final electrocardiographic (ECG) myocardial infarct size in patients without
      coronary reperfusion might therefore be altered by thrombolytic therapy. The
      effect of intravenous streptokinase on this relation was therefore studied in 73
      patients with initial acute myocardial infarction who had participated in the
      Second International Study of Infarct Survival (ISIS-2). Patients who received
      streptokinase were considered as one group and patients who did not receive
      streptokinase as a control group. Final myocardial infarct size, which was
      estimated from the QRS score, was predicted from the admission standard ECG by
      previously developed formulas based on ST segment elevation. In the 40 control
      patients there was no change from ST-predicted to final QRS-estimated infarct
      size (median 17.7% versus 18.3%; p = NS). In the 33 patients in the streptokinase
      group, there was a highly significant decrease from predicted to final myocardial
      infarct size (median 21.9% versus 16.2%; p less than 0.0002). This decrease was
      found for both anterior (median 23.7% versus 19.5%; p less than 0.03) and
      inferior (median 21.9% versus 12.0%; p = 0.001) infarct locations. Multiple
      regression analysis adjusting for differences in predicted infarct size confirmed
      the significance of streptokinase on the difference in infarct size (p = 0.006).
      Based on the variability of the percent change from predicted to final infarct
      size in the control group, a threshold decrease greater than or equal to 20% is
      required for identification of salvage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229776
TI  - Intraoperative assessment of regional myocardial perfusion using quantitative
      myocardial contrast echocardiography: an experimental evaluation.
AB  - To test the hypothesis that myocardial contrast echocardiography can be used to
      quantitate regional myocardial flow in the arrested heart at the time of delivery
      of cardioplegic solution, data were acquired in 13 dogs on cardiopulmonary
      bypass. Different degrees of stenosis were placed in random order on the left
      anterior descending coronary artery. For each stenosis, myocardial contrast
      echocardiography was performed by injecting sonicated albumin microbubbles into
      the cross-clamped aortic root at the time of delivery of cardioplegic solution.
      The resultant echocardiographic images were analyzed on an off-line computer.
      Background-subtracted time-intensity plots were generated, and an exponential
      function, f(t) = Ce-alpha t + De- beta t, was applied to each plot. Variables
      that reflected the total number of microbubbles entering the coronary artery bed,
      such as the area under the curve and the peak height of the curve, correlated
      best with radiolabeled microsphere-measured myocardial flow (r = 0.92 and r =
      0.91, respectively). Variables that reflected the appearance of contrast
      microbubbles in the myocardium, such as the initial slope and the slope at 1 s,
      also had a good correlation with myocardial flow (r = 0.84 and r = 0.89,
      respectively). Variables that reflected the washout of contrast medium from the
      myocardium, such as the slope of the descending portion of the curve, had only a
      fair correlation with myocardial flow (r = 0.65). In six dogs, the technique of
      injecting contrast medium into the cross-clamped aortic root was also examined.
      Although continuous infusion of contrast medium produced smaller perturbations in
      mean aortic and distal left anterior descending artery pressures compared with a
      bolus injection (p less than 0.01), the correlation between the variables of the
      time-intensity curves and flow was equally close with both techniques. It is
      concluded that it is possible to quantitate myocardial flow by using myocardial
      contrast echocardiography at the time of delivery of cardioplegic solution in
      dogs on cardiopulmonary bypass. The implementation of this technique in humans
      might be useful in guiding the sequence of graft placement and thereby improving
      myocardial preservation during coronary artery bypass operations.

PMID- 2229777
TI  - Prostaglandin modulation of early afterdepolarizations and ventricular
      tachyarrhythmias induced by cesium chloride combined with efferent cardiac
      sympathetic stimulation in dogs.
AB  - Prostaglandins inhibit efferent cardiac sympathetic nerve effects by acting at
      presynaptic sites and may act to suppress some arrhythmias. In the present study,
      the effects of intravenous administration of prostacyclin (PGI2) and
      prostaglandin E2 (PGE2) on early afterdepolarizations and ventricular tachycardia
      induced by cesium chloride (0.5 mmol/liter per kg body weight intravenously)
      combined with stimulation of bilateral ansae subclaviae in anesthetized dogs were
      examined. The right atrium was paced at a constant cycle length of 600 ms. A left
      ventricular endocardial monophasic action potential catheter was used to detect
      early afterdepolarizations. Prostacyclin (0.2 microgram/kg per min) reduced the
      amplitude of the early afterdepolarizations (39.2 +/- 8.4% of the monophasic
      action potential amplitude during control study to 28.7 +/- 5.5%, n = 10; p less
      than 0.001) as well as the prevalence of ventricular tachycardia (11 of 14 dogs
      during control study to 5 of 14 dogs; p = 0.031). Prostaglandin E2 (0.2 to 0.6
      microgram/kg per min) did not significantly reduce the early afterdepolarization
      amplitude (34.7 +/- 8.9% to 25.1 +/- 10.7%, n = 8; p = 0.085) or the prevalence
      of ventricular tachycardia (8 of 10 versus 6 of 10 dogs; p = 0.50). Alpha- and
      beta-adrenoceptor blockade with combined intravenous administration of
      propranolol (0.5 mg/kg) and phentolamine (0.3 mg/kg) decreased the amplitude of
      the early afterdepolarizations induced by cesium chloride and bilateral ansae
      subclaviae stimulation from 38.6 +/- 11.2% to 18.8 +/- 3.3% (n = 6; p = 0.005).
      Additional administration of PGI2 further reduced the early afterdepolarization
      amplitude from 18.8 +/- 3.3% to 9.8 +/- 4.8% (n = 6; p = 0.001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2229778
TI  - Effects of calcium channel blockers on coronary vasoconstriction induced by
      endothelin-1 in closed chest pigs.
AB  - The purpose of this study was to determine the effects of endothelin-1 on the
      coronary vascular bed of closed chest pigs. Endothelin-1 (3 to 30 pmol/kg body
      weight) was selectively administered into the left anterior descending coronary
      artery. Coronary blood flow and epicardial vessel diameter were measured by
      quantitative arteriography. Arterial pressure increased after a 30 pmol/kg dose
      and heart rate was not changed. Coronary blood flow and vessel diameter of the
      left anterior descending artery significantly decreased by 74% and 32%,
      respectively (p less than 0.01 versus control) after the 30 pmol/kg dose, whereas
      these variables modestly decreased in the left circumflex artery. Endothelin-1 in
      doses of 10 to 30 pmol/kg produced electrocardiographic ST segment elevation
      associated with decreased oxygen saturation of coronary sinus venous blood.
      Endothelin-induced coronary vasoconstriction was significantly inhibited after
      treatment with intravenous diltiazem (0.2 mg/kg, n = 6) or nifedipine (0.1 mg/kg,
      n = 5), but not after vehicle administration (n = 4). This study demonstrates
      that intracoronary administration of endothelin-1 causes significant myocardial
      ischemia through coronary vasoconstriction, which is inhibited by a calcium
      channel blocker. The data suggest that calcium influx into the smooth muscle
      cells appears to be involved at least in part in the mechanism of endothelin
      induced coronary vasoconstriction in vivo.

PMID- 2229780
TI  - Balloon expandable stent implantation in stenotic right heart valved conduits.
AB  - Although valved conduits have been used successfully in severe forms of right
      ventricular-pulmonary artery discontinuity, progressive valved conduit stenosis
      is an important clinical problem. To determine the feasibility of reducing right
      heart valved conduit stenosis with a balloon expandable stent, a baboon model was
      used, in which the pulmonary artery was ligated and a right ventricular to
      pulmonary artery 14 mm bioprosthetic Dacron valved conduit implanted. In five
      baboons, at an average of 40 months after valved conduit implantation,
      fibrointimal stenosis at the valve site resulted in narrowing and a mean
      transconduit pressure gradient of 49 mm Hg (range 33 to 65). A tubular slotted
      steel stent (1.2 cm long) was deployed within the valved conduit after inflation
      of an 8 to 15 mm diameter balloon catheter that was introduced through the
      femoral vein. A stent was delivered to all valved conduits; however, in two
      baboons, balloon undersizing resulted in stent dislodgment. In the remaining
      three baboons, the transconduit gradient was reduced by 59% (49 to 20 mm Hg) and
      right ventricular systolic pressure decreased acutely by 35% (77 to 50 mm Hg). It
      is concluded that stent deployment is feasible in right ventricular to pulmonary
      artery stenotic valved conduits and may result in significant hemodynamic
      improvement. However, successful stent delivery is critically dependent on the
      proper selection of stent length and balloon diameter.

PMID- 2229779
TI  - Cardiac teratogenesis of trichloroethylene and dichloroethylene in a mammalian
      model.
AB  - Recent epidemiologic studies have demonstrated a greater than expected number of
      pediatric patients with congenital heart disease in areas where drinking water
      was contaminated by halogenated aliphatic hydrocarbons. Trichloroethylene,
      trichloroethane and dichlorethylene were the principal contaminants in the
      groundwater. A previous study of chick embryos demonstrated that when injected
      into the air sacs of fertilized eggs trichloroethylene produced more than three
      times the number of cardiac defects that are found in control embryos. This
      mammalian study demonstrates similar effects of trichloroethylene and
      dichloroethylene when applied under provocative circumstances (that is, solutions
      delivered through a catheter into the gravid uterus from an intraperitoneal
      osmotic pump) to the developing rat fetus in utero during the period of organ
      differentiation and development. Furthermore, the effect is dose dependent for
      both agents. Although only a very small number of congenital heart anomalies (3%)
      were found in the control group, 9% and 12.5% were found in the lower dose
      trichloroethylene and dichloroethylene groups and 14% and 21% in the higher dose
      groups, respectively (p less than 0.05). A variety of cardiac defects were found.
      Dichloroethylene appears to be at least as great a cardiac teratogen as
      trichloroethylene even though it was administered at a 10-fold lower
      concentration. These agents appear to be specific cardiac teratogens because only
      a single noncardiac anomaly was found. This study in a rat model demonstrates a
      dose-dependent relation between fetal exposure to trichloroethylene and
      dichloroethylene in utero during the period of organogenesis and the appearance
      of a variety of congenital cardiac defects.

PMID- 2229781
TI  - Direct visualization of ruptured chordae tendineae by transesophageal two
      dimensional echocardiography.
AB  - To determine the value of transesophageal echocardiography in the detection of
      ruptured chordae tendineae, 28 patients who had surgical therapy for pure mitral
      regurgitation were evaluated prospectively by conventional transthoracic and
      transesophageal two-dimensional echocardiography. Seventeen patients (Group I)
      had ruptured chordae tendineae and 11 (Group II) had intact chordae tendineae.
      Transthoracic echocardiography detected ruptured chordae tendineae in 6 patients
      from Group I (sensitivity 35%) and flail leaflets in 11 patients from Group I
      (sensitivity 65%). Transesophageal echocardiography disclosed ruptured chordae
      tendineae in all 17 Group I patients (sensitivity 100%); the sensitivity was
      significantly higher than that of transthoracic echocardiography. No abnormal
      chordal echoes were visualized in any patient from Group II by either
      transthoracic or transesophageal echocardiography (specificity 100%).
      Transesophageal echocardiography is a highly sensitive method for detecting
      ruptured chordae tendineae and is superior to transthoracic echocardiography in
      establishing its diagnosis.

PMID- 2229782
TI  - Transesophageal echocardiography to detect atrial clots in candidates for
      percutaneous transseptal mitral balloon valvuloplasty.
AB  - Left atrial thrombi are common in patients with mitral stenosis. When
      percutaneous balloon mitral valvuloplasty is performed on such patients, there is
      a potential risk of thrombus dislodgment and embolization. In this study
      conventional transthoracic echocardiography and transesophageal echocardiography
      were performed for percutaneous balloon mitral valvuloplasty on 19 consecutive
      candidates (6 men, 13 women, 23 to 81 years old). In five patients (26%),
      transesophageal echocardiography revealed a left atrial thrombus; in only one of
      these was there a suspicion of left atrial thrombus on transthoracic
      echocardiography. Balloon mitral valvuloplasty was canceled in four of the five
      patients. Three underwent mitral valve surgery that confirmed the
      echocardiographic findings. Transesophageal echocardiography is better than
      conventional transthoracic echocardiography in detecting left atrial clots in
      candidates for balloon mitral valvuloplasty. Because of the potential risk of
      embolization, transesophageal echocardiography is recommended in all candidates
      for balloon mitral valvuloplasty.

PMID- 2229783
TI  - Detection of restenosis after successful coronary angioplasty: improved clinical
      decision making with use of a logistic model combining procedural and follow-up
      variables.
AB  - A prospective study of 111 patients who underwent repeat coronary angiography and
      exercise thallium-201 scintigraphy 6 +/- 2 months after complete
      revascularization by percutaneous transluminal coronary angioplasty was performed
      to assess whether clinical, procedure-related and postangioplasty exercise
      variables yield independent information for the prediction of angiographic
      restenosis after angioplasty. Complete revascularization was defined as
      successful angioplasty of one or more vessels that resulted in no residual
      coronary lesion with greater than 50% diameter stenosis. Restenosis was defined
      as a residual stenosis at the time of repeat angiography of greater than 50% of
      luminal diameter. Restenosis occurred in 40% of the patients. The 111 patients
      were randomly subdivided into a learning group (n = 84) and a testing group (n =
      27). A logistic discriminant analysis was performed in the learning group and the
      logistic model was used to estimate a logistic probability of restenosis. This
      probability of restenosis was validated in the testing group. In the learning
      group of 84 patients univariate analysis of 39 factors revealed 8 factors related
      to restenosis: recurrence of angina (p less than 0.0001), postangioplasty
      abnormal finding on exercise thallium-201 scintigram (p less than 0.0001),
      exercise thallium-201 scintigram score (p less than 0.0001), difference between
      exercise and rest ST segment depression (p less than 0.001), postangioplasty
      exercise ST segment depression (p less than 0.001), absolute postangioplasty
      stenosis diameter (p less than 0.003), postangioplasty exercise work load (p less
      than 0.03) and postangioplasty exercise heart rate (p less than 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2229784
TI  - Results of coronary surgery after failed elective coronary angioplasty in
      patients with prior coronary surgery.
AB  - The results of coronary artery bypass surgery after failed elective coronary
      angioplasty in patients who have undergone prior coronary surgery are unknown.
      Coronary angioplasty may be performed to relieve angina after surgery either to
      the native coronary vessels or to grafts. Failure of attempted coronary
      angioplasty may mandate repeat coronary surgery, often in the setting of acute
      ischemia. From 1980 to 1989, 1,263 patients with prior coronary bypass surgery
      underwent angioplasty; of these patients, 46 (3.6%) underwent reoperation for
      failed angioplasty during the same hospital stay. Of the 46 patients who
      underwent reoperation, 33 had and 13 did not have acute ischemia. In the group
      with ischemia, 3 patients (9.1%) died and 14 (42.4%) died or had a Q wave
      myocardial infarction in the hospital compared with no deaths (p = NS) and no
      deaths or Q wave myocardial infarction (p = 0.005) in the group without ischemia.
      At 3 years, the actuarial survival rate was 88 +/- 6% in the group with ischemia,
      whereas there were no deaths in the group without ischemia (p = NS), and freedom
      from death or myocardial infarction was 51 +/- 10% in the group with ischemia,
      versus no events in the group without ischemia (p = 0.006). In most patients with
      prior coronary bypass surgery, coronary angioplasty was performed without the
      need for repeat coronary bypass surgery. Should coronary angioplasty fail,
      reoperation in patients without acute ischemia can be performed with overall
      patient survival comparable to that of elective reoperative coronary bypass
      without coronary angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229785
TI  - Coronary angioplasty in patients with previous bypass surgery.

PMID- 2229786
TI  - Serial left ventricular performance evaluated by cardiac catheterization before,
      immediately after and at 6 months after balloon aortic valvuloplasty.
AB  - Although impaired ventricular function has been shown to improve after aortic
      valve replacement, there are few data on hemodynamic changes after balloon aortic
      valvuloplasty based on follow-up catheterization. Of 71 patients surviving 6
      months after balloon aortic valvuloplasty, 41 agreed to late recatheterization.
      All patients had pre- and postvalvuloplasty and 6 month catheterization data
      measured with high fidelity micromanometer pressure recordings and simultaneous
      digital subtraction left ventriculography. The hemodynamic result immediately
      after valvuloplasty included a reduction in the aortic valve gradient and a
      moderate increase in aortic valve area (0.51 +/- 0.14 to 0.81 +/- 0.19 cm2, p
      less than 0.0001). Ejection fraction increased slightly (52 +/- 18 to 55 +/- 17%,
      p less than 0.0001) despite a decrease in peak positive rate of rise of left
      ventricular pressure (dP/dt 1,650 +/- 460 to 1,500 +/- 490 mm Hg/s, p less than
      0.05). There was also a decrease in left ventricular afterload and a small
      decrease in preload. At 6 month recatheterization, the mean aortic valve gradient
      and area were similar to baseline values, with 31 (76%) of 41 patients
      demonstrating valvular restenosis. At 6 months many left ventricular hemodynamic
      variables, including peak positive dP/dt and stroke work, also resembled
      prevalvuloplasty values. However, left ventricular end-diastolic volume was
      reduced (111 +/- 40 ml at 6 months versus 136 +/- 52 ml before valvuloplasty, p
      less than 0.01). The mean left ventricular ejection fraction was unchanged from
      prevalvuloplasty values in the study group of 41 patients, but was significantly
      improved in 9 of 15 patients with a baseline ejection fraction less than
      50%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229787
TI  - Abnormal cardiac sensitivity in patients with chest pain and normal coronary
      arteries.
AB  - The causes of chest pain in patients found to have angiographically normal
      coronary arteries during cardiac catheterization remain controversial. Cardiac
      sensitivity to catheter manipulation, pacing at various stimulus intensities and
      intracoronary injection of contrast medium was examined in several groups of
      patients who underwent cardiac catheterization. Right heart (especially right
      ventricular) catheter manipulation and pacing and intracoronary contrast medium
      provoked chest pain typical of that previously experienced in 29 (81%) of 36
      patients with chest pain and angiographically normal coronary arteries and 15
      (46%) of 33 symptomatic patients with hypertrophic cardiomyopathy. In contrast,
      only 2 (6%) of 33 symptomatic patients with coronary artery disease experienced
      their typical chest pain with these sensitivity tests (p less than 0.001). None
      of 10 patients with valvular heart disease but without a chest pain syndrome
      experienced any sensation with these tests. Cutaneous pain threshold testing
      demonstrated that patients with chest pain and normal coronary arteries had a
      higher pain threshold to thermal stimulation compared with patients who had
      coronary artery disease or hypertrophic cardiomyopathy. No relation existed
      between cardiac sensitivity and cutaneous sensitivity testing. Thus, patients who
      have chest pain despite angiographically normal coronary arteries may have
      abnormal cardiac sensitivity to a variety of stimuli. This increased sensitivity
      may be of causal importance to their chest pain syndrome or may contribute to
      their perception of ischemia-induced pain. The same phenomenon was also commonly
      seen in symptomatic patients with hypertrophic cardiomyopathy. Whether this
      phenomenon represents abnormal activation of pain receptors within the heart or
      abnormal processing of visceral afferent neural impulses in the peripheral or
      central nervous system is unknown.

PMID- 2229788
TI  - Comparison of hemodynamic responses during dynamic exercise in the upright and
      supine postures after orthotopic cardiac transplantation.
AB  - Abnormal hemodynamic responses during supine exercise have been well documented
      in orthotopic cardiac transplant recipients. To determine the effect of posture,
      central hemodynamics were studied in 20 patients during a change from supine to
      sitting and during graded upright bicycle exercise (group U) and were compared
      with those of 20 patients matched for age, gender and time from transplantation
      who were studied after passive leg elevation and during exercise in the supine
      posture (group S). Passive leg elevation resulted in a 9% increase in stroke
      index (34 +/- 6 to 37 +/- 6 ml/m2, p less than 0.001) and a 10% increase in
      cardiac index (3.1 +/- 0.4 to 3.4 +/- 0.5 liters/min per m2, p less than 0.001)
      in group S patients compared with a 15% reduction in stroke index (34 +/- 7 to 29
      +/- 6 ml/m2, p less than 0.001) and a 9% decrease in cardiac index (3.2 +/- 0.6
      to 2.9 +/- 0.5 liters/min per m2, p less than 0.001) in group U patients on
      assuming the sitting posture. Likewise, both the pulmonary capillary wedge
      pressure and right atrial pressure increased significantly (13 +/- 4 to 17 +/- 8
      mm Hg, p less than 0.001 and 5 +/- 3 to 7 +/- 3 mm Hg, p less than 0.001) with
      passive leg elevation in group S and decreased on sitting (12 +/- 6 to 8 +/- 5 mm
      Hg, p less than 0.001 and 5 +/- 3 to 3 +/- 2, p less than 0.001) in group
      U.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229789
TI  - Single photon emission computed tomography with thallium-201 during adenosine
      induced coronary hyperemia: correlation with coronary arteriography, exercise
      thallium imaging and two-dimensional echocardiography.
AB  - The feasibility, safety and diagnostic accuracy of single photon emission
      computed tomography (SPECT) with thallium-201 imaging during adenosine-induced
      coronary hyperemia were evaluated in 53 patients with and 7 without coronary
      artery disease proved by coronary angiography. Adenosine was infused
      intravenously at a dose of 0.14 mg/kg body weight per min for 6 min and thallium
      was injected at 3 min. Adenosine caused an increase in heart rate (68 +/- 12 at
      baseline versus 87 +/- 18 beats/min at peak effect, p less than 0.0001) but no
      change in blood pressure. The sensitivity and specificity were 92% (95%
      confidence intervals 81% to 98%) and 100% (95% confidence intervals 59% to 100%),
      respectively; 20 (61%) of 33 patients with multivessel coronary artery disease
      were also correctly identified. In 30 patients, the predictive accuracy of
      adenosine thallium imaging was slightly higher than that of exercise SPECT
      thallium imaging (90% versus 80%, p = NS) (95% confidence intervals 72% to 97%
      and 61% to 92%, respectively). In 25 patients, two-dimensional echocardiography
      during adenosine infusion disclosed a new wall motion abnormality in 2 (10%) of
      20 patients with coronary artery disease; 80% of these patients had reversible
      thallium defects (p less than 0.001). Side effects were mild and transient;
      aminophylline was used in only three patients. Thus, adenosine SPECT thallium
      imaging provides a high degree of accuracy in the diagnosis of coronary artery
      disease. The results are comparable with those of exercise SPECT thallium
      imaging. Most reversible defects in the adenosine study are not associated with
      any transient wall motion abnormality.

PMID- 2229790
TI  - Adenosine-thallium imaging: faster and better.

PMID- 2229791
TI  - Reduction of left ventricular preload by lower body negative pressure alters
      Doppler transmitral filling patterns.
AB  - The objective of this study was to evaluate the effect of alterations in preload
      induced by lower body negative pressure on Doppler transmitral filling patterns.
      Echocardiograms and Doppler recordings were performed in 18 normal young men
      (aged 23 to 32 years) during various levels of lower body negative pressure (0, 
      20 and -50 mm Hg). Lower body negative pressure induced a reduction in diastolic
      velocity integral (from 12.17 +/- 0.79 to 8.42 +/- 0.71 cm, p = 0.0067) and
      consequently left ventricular diastolic diameter (from 5.11 +/- 0.09 to 4.45 +/-
      0.1 cm, p less than 0.0001). There was a significant reflex increase in heart
      rate from 59.9 +/- 1.9 to 77.1 +/- 2.4 beats/min (p less than 0.0001), but blood
      pressure was unchanged. This reduction in preload altered Doppler transmittral
      filling patterns as follows: 1) peak early velocity (E) decreased from 59.2 +/-
      3.8 to 39.1 +/- 1.7 cm/s (p less than 0.0001); 2) atrial filing velocity (A) was
      unchanged (35.58 +/- 1.5 to 33.52 +/- 1.4 cm/s, p = 0.517); 3) E/A ratio
      decreased from 1.7 +/- 0.13 to 1.19 +/- 0.08 (p = 0.0087); 4) mean acceleration
      (from 482 +/- 37 to 390 +/- 27 cm/s2, p = 0.03) and mean deceleration (from 327
      +/- 31 to 169 +/- 21 cm/s2, p less than 0.001) of the early filling wave were
      significantly reduced; and 5) peak acceleration (from 907 +/- 42 to 829 +/- 29
      cm/s2) and peak deceleration (from 771 +/- 94 to 547 +/- 76 cm/s2) also
      decreased, but not significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229792
TI  - Instantaneous and continuous cardiac output in humans obtained with a Doppler
      pulmonary artery catheter.
AB  - A new Doppler pulmonary artery catheter was used to measure instantaneous and
      continuous cardiac output in both an in vitro model and in 44 patients undergoing
      cardiac catheterization. Cardiac output was calculated with use of the Doppler
      catheter-determined instantaneous space-average velocity and the ultrasonically
      determined instantaneous vessel area. Doppler flow and thermodilution were
      compared with electromagnetic flow in the in vitro model and with Fick cardiac
      output in patients. Doppler catheter-determined flow was highly predictive of
      electro-magnetic flow in the pulsatile flow model (r = 0.99, slope [m] = 1.01 and
      SEE = 0.05) and appeared comparable to thermodilution measurements (r = 1.00, m =
      1.03 and SEE = 0.02). In patients undergoing cardiac catheterization, Doppler
      catheter-determined cardiac output appeared to modestly underestimate Fick
      cardiac output (r = 0.82, m = 0.80 and SEE = 0.09; mean error +/- SEM = -0.26 +/-
      0.14 liters/min). However, predictive accuracy was comparable to simultaneously
      obtained thermodilution measurements (r = 0.85, m = 1.07 and SEE = 0.10; mean
      error +/- SEM = 0.61 +/- 0.16 liters/min). This new Doppler catheter system
      utilizes multiple ultrasound transducers to provide angle-independent
      measurements of vessel diameter and instantaneous velocity within the main
      pulmonary artery, resulting in a more accurate assessment of Doppler-derived
      cardiac output. In addition, useful information concerning hemodynamic variables
      such as peak flow, acceleration, deceleration, stroke work and pulmonary
      impedance may be derived.

PMID- 2229793
TI  - Termination of acute atrial fibrillation in the Wolff-Parkinson-White syndrome by
      procainamide and propafenone: importance of atrial fibrillatory cycle length.
AB  - The effects of intravenous procainamide (n = 30) or propafenone (n = 25) were
      evaluated in 55 patients with acute atrial fibrillation and the Wolff-Parkinson
      White syndrome. All patients received either procainamide (12 to 15 mg/kg body
      weight) or propafenone (1 to 2 mg/kg) during sustained (greater than 10 min)
      atrial fibrillation or after termination of nonsustained atrial fibrillation.
      Termination of atrial fibrillation was attributed to a drug if it occurred less
      than or equal to 15 min after infusion. Measurements included mean cycle length
      of fibrillatory electrograms (mean AA interval) as measured at the high right
      atrium and shortest RR interval between pre-excited cycles during atrial
      fibrillation. Atrial fibrillation terminated more frequently after procainamide
      administration (65%) than after propafenone (46%), although this difference was
      not significant. Procainamide prolonged the shortest pre-excited RR interval (228
      +/- 41 to 339 +/- 23 ms, p = 0.0001) as did propafenone (215 +/- 40 to 415 +/-
      198 ms, p = 0.0001) and the magnitude of increase was greater for propafenone (p
      = 0.048). Patients with sustained atrial fibrillation had shorter mean AA
      intervals than did their counterparts with nonsustained atrial fibrillation (123
      +/- 25 versus 186 +/- 35 ms, p = 0.0001). Termination of sustained atrial
      fibrillation by either drug was accompanied by prolongation of the mean AA
      interval but not necessarily by the shortest pre-excited RR interval. Termination
      of atrial fibrillation was heralded by a 68% increase in the mean AA interval
      after procainamide administration compared with a 30% increase when the
      arrhythmia persisted. For propafenone the increases were 90% and 68%,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229794
TI  - Feasibility and cost savings of outpatient electrophysiologic testing.
AB  - The feasibility of outpatient electrophysiologic testing was examined by
      reviewing 100 consecutive outpatient tests performed in 95 patients. Seventy-one
      of the patients (75%) had no underlying heart disease. The electrophysiologic
      tests were performed to evaluate supraventricular tachycardias (n = 47),
      nonsustained ventricular tachycardia (n = 20), unexplained syncope (n = 21),
      palpitation (n = 9) or intermittent heart block (n = 2). A mean of 2.8 +/- 0.5 6F
      electrode catheters were inserted through a femoral vein. An electrode catheter
      was inserted into a subclavian or internal jugular vein in 28 tests and a 5F
      cannula was inserted into a femoral artery to monitor the blood pressure in 20
      tests. The results of 61 tests (61%) were abnormal. Patients were monitored for a
      mean of 3.8 +/- 1.2 h after the procedure and then discharged. No complications
      occurred. For cost analysis a subgroup of 60 of these patients was matched for
      age, gender, heart disease and indication for electrophysiologic testing with a
      group of 60 patients who underwent electrophysiologic testing as inpatients.
      Physicians' fees for the two groups were similar; however, the mean hospital
      charge was $5,845 +/- 3,763 for the inpatient group compared with only $2,120 +/-
      1,244 for the outpatient group (p less than 0.001). Thus, outpatient
      electrophysiologic testing is feasible and safe and results in substantial cost
      savings in patients without life-threatening arrhythmias.

PMID- 2229796
TI  - Coronary artery plaque morphology after balloon angioplasty.

PMID- 2229795
TI  - Plaque morphology and pathologic changes in arteries from patients dying after
      coronary balloon angioplasty.
AB  - Morphologic correlates of pathologic success or failure were studied at autopsy
      in 28 patients with 40 coronary arteries that had been subjected to balloon
      angioplasty. The presence of the following histologic features was evaluated:
      plaque concentricity or eccentricity, calcification, fibrous or fibropultaceous
      plaque, medial disruption, luminal thrombus and inflammation. Angioplasty was
      considered successful (residual cross-sectional luminal area greater than 25%) on
      pathologic examination in 14 arteries and unsuccessful in 26 arteries. Eccentric
      plaques were more likely to be successfully dilated than were concentric lesions
      (p less than 0.05). Six (50%) of 12 fibropultaceous plaques were successfully
      dilated compared with only 8 (29%) of 28 fibrous plaques. Moderate to severe
      calcification did not preclude morphologic success. Medial stretching or
      dissection, or both, was more often associated with a successful result. Thus,
      plaque morphology may be an important determinant of pathologic outcome after
      coronary angioplasty.

PMID- 2229797
TI  - Coronary morphology after percutaneous directional coronary atherectomy in
      humans: autopsy analysis of three patients.
AB  - The morphologic basis of angiographically successful percutaneous directional
      atherectomy and subsequent restenosis in human coronary arteries is unknown. The
      clinical and pathologic features of three patients who died after coronary
      atherectomy are described. Tissue fragments obtained with atherectomy
      demonstrated atheromatous and fibroproliferative intima, media and adventitia. At
      autopsy, treated vascular segments (from the left anterior descending artery in
      two patients and a vein graft in one patient) demonstrated discrete defects in
      the vascular wall. Defects extending into atheroma, media or adventitia
      corresponded with the presence of these tissues in the atherectomy specimens.
      Tissues were otherwise not disrupted in the manner associated with balloon
      angioplasty. Acute mural thrombus deposition was evident in the resection zone in
      one patient. Late findings included fibroproliferative intimal tissue extending
      from the resected areas into the vascular lumen. In one patient intimal
      hyperplasia was sufficient to narrow the vascular lumen by 82% and was implicated
      in subsequent myocardial ischemia and infarction. The study indicates that 1) the
      vascular injury associated with atherectomy is distinct from that associated with
      balloon angioplasty, 2) acute mural thrombus deposition may occur even with
      resection limited to the intima, and 3) intimal hyperplasia may develop in
      regions treated with atherectomy and may be associated with late myocardial
      ischemia and infarction.

PMID- 2229798
TI  - Intracardiac shunting in children with ventricular septal defect: evaluation with
      Doppler color flow mapping.
AB  - In children with a ventricular septal defect, transseptal blood flow has been
      demonstrated angiographically to be bidirectional in all but the smallest
      defects. To investigate this phenomenon noninvasively, two-dimensional Doppler
      color flow echocardiography was used in 77 patients (aged 1 day to 15.5 years,
      mean 24 months). During isovolumetric contraction, flow was seen from the left to
      the right ventricle in 82 (98%) of 84 studies. During isovolumetric relaxation,
      right to left flow was noted in 72 (96%) of 75 studies. During early diastole in
      patients with an isolated defect, flow was initially from the right to the left
      ventricle and subsequently reversed to become left to right in 29 (91%) of 32
      studies. In patients with concomitant right ventricular volume overload, flow
      across the ventricular defect was from the right to the left ventricle throughout
      diastole in 30 (86%) of 35 studies. In each of four patients with d-transposition
      of the great vessels and each of two patients with 1-transposition of the great
      vessels, blood flow was from the morphologic left ventricle to the morphologic
      right ventricle during isovolumetric contraction and from the morphologic right
      ventricle to the morphologic left ventricle during isovolumetric relaxation.
      These results demonstrate 1) the complex nature of intracardiac shunting in
      children with ventricular septal defect as previously shown by angiography; 2) an
      intrinsic functional difference in the contractile and relaxation properties of
      the morphologic left and right ventricles; and 3) differences in diastolic blood
      flow patterns between children with an isolated defect and those with a
      ventricular septal defect and right ventricular volume overload (p = 0.0001).

PMID- 2229799
TI  - Relation between color Doppler-detected directional flow in a ventricular septal
      defect and frame rate.

PMID- 2229800
TI  - Results of the arterial switch operation in patients with transposition of the
      great arteries and abnormalities of the mitral valve or left ventricular outflow
      tract.
AB  - Between January 1983 and October 1989, 290 patients underwent an arterial switch
      operation for transposition of the great arteries; 30 (10.3%) of the patients had
      abnormalities of the left ventricular outflow tract or mitral valve, or both.
      These abnormalities included isolated pulmonary valve stenosis (n = 9), septal
      (dynamic) subpulmonary stenosis (n = 5), anatomic (fixed) subpulmonary stenosis
      (n = 7), abnormal mitral chordae attachments (n = 2) or a combination of
      abnormalities (n = 7). There were two early deaths, one of which was due to
      previously unrecognized mitral stenosis and a subpulmonary (neo-aortic) membrane
      and one late death due to presumed coronary obstruction. Of the nine patients
      with pulmonary valve abnormalities due to either a bicommissural (n = 5) or a
      thickened tricommissural (n = 4) valve, only one underwent valvotomy. Peak
      systolic ejection gradients in these nine patients measured preoperatively ranged
      from 0 to 50 mm Hg. At follow-up study 5 to 30 months postoperatively, the neo
      aortic valve gradient was less than or equal to 15 mm Hg in all patients; three
      patients had mild neo-aortic regurgitation. Preoperative gradients may
      overestimate the degree of obstruction because of the increased pulmonary blood
      flow present in transposition. No patient with "dynamic" subpulmonary obstruction
      before the arterial switch operation had a surgical procedure performed on the
      left ventricular outflow tract; none had evidence of subaortic obstruction after
      the arterial switch.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229801
TI  - Long-term follow-up of patients after transcatheter direct current ablation of
      the atrioventricular junction.
AB  - The long-term follow-up study (41 +/- 23 months) of 47 patients undergoing direct
      current ablation because of drug-resistant supraventricular arrhythmias is
      reported. Significant early complications occurred in four patients and included
      hypotension, pericarditis, nonsustained polymorphic ventricular tachycardia and
      one sudden death. In 42 patients (86%), complete atrioventricular (AV) block was
      initially achieved. During the follow-up period, AV conduction resumed in 2 of
      these 42 patients. Of the seven patients in whom ablation was unsuccessful, two
      developed late complete AV block and three had symptomatic improvement. An
      improved activity level was reported among 83% of the patients with successful
      ablation. Health care utilization manifest as the number of hospital admissions
      per year before and after ablation decreased significantly after ablation (2.4 +/
      2.0 versus 0.3 +/- 0.5, p less than 0.001). Echocardiographic evaluation in five
      patients with a depressed left ventricular ejection fraction (27 +/- 7%) before
      ablation showed a significant increase (45 +/- 14%, p less than 0.05) after an
      average follow-up period of 31 months. New onset of congestive heart failure
      occurred after ablation in four patients, of whom two had no structural heart
      disease. The total mortality rate, including the one patient with sudden death,
      was 17% and was significantly higher among patients with underlying structural
      heart disease. Transcatheter direct current ablation is an effective treatment in
      patients with drug-resistant supraventricular tachycardia, providing a beneficial
      long-term outcome including an improved quality of life and a decrease in health
      care utilization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229802
TI  - Effect of cocaine on the coronary circulation and systemic hemodynamics in dogs.
AB  - This study investigated the effect of intravenous cocaine (0.5 to 2 mg/kg body
      weight) on the coronary circulation and systemic hemodynamics in closed chest
      sedated dogs. The role of alpha- and beta-adrenoceptor stimulation in mediating
      these effects was also investigated. Cocaine produced dose-dependent increases in
      mean arterial pressure and rate-pressure product. Although the lower doses of
      cocaine had no significant effect on the coronary circulation, the 2 mg/kg dose
      produced a 55 +/- 14% increase in coronary vascular resistance (p less than 0.05
      versus baseline) and a 19 +/- 3% reduction in diameter of the left anterior
      descending coronary artery (p less than 0.05 versus baseline). Despite these
      potentially deleterious effects on the coronary circulation (occurring at a time
      of markedly increased myocardial oxygen demand), the electrocardiogram did not
      demonstrate ischemic changes and there was no myocardial lactate production.
      Cocaine-induced coronary vasoconstriction was abolished by pretreatment with the
      alpha-adrenoceptor antagonist phentolamine, but not by pretreatment with the beta
      adrenoceptor antagonist propranolol. The findings that cocaine did not change
      systemic vascular resistance in dogs without adrenergic blockade, reduced
      systemic vascular resistance in dogs after alpha-blockade (p less than 0.05) and
      increased systemic vascular resistance in dogs after beta-blockade (p = 0.06)
      suggest that epinephrine (rather than norepinephrine) is primarily responsible
      for the peripheral vascular actions of cocaine. Thus, in this canine preparation
      with normal coronary arteries, cocaine produced vasoconstriction of both
      epicardial and coronary resistance vessels that was not associated with evidence
      of myocardial ischemia. The pharmacologic mechanism for the effect of cocaine on
      the coronary circulation is alpha-adrenoceptor stimulation, whereas systemic
      hemodynamic effects are mediated by combined alpha- and beta-adrenoceptor
      stimulation.

PMID- 2229803
TI  - Dissociation of changes in cardiovascular mass and performance with angiotensin
      converting enzyme inhibitors in Wistar-Kyoto and spontaneously hypertensive rats.
AB  - The effects of angiotensin-converting enzyme inhibitors on cardiovascular mass
      and function were measured in three groups of 22 week old male Wistar-Kyoto
      normotensive and spontaneously hypertensive rats treated with CGS-16617,
      cilazapril or quinapril. Left ventricular performance was assessed by
      electromagnetic flow meter during rapid whole blood infusion before and after
      arterial pressure and increased abruptly with aortic snare; aortic distensibility
      also was assessed in vitro. The systemic hemodynamic effects of these three
      agents were similar, yet their structural effects varied. Although left
      ventricular and aortic masses diminished and right ventricular mass remained
      unchanged (with all three agents) in the spontaneously hypertensive rats, CGS
      11617 and cilazapril also reduced left ventricular mass in the normotensive
      Wistar-Kyoto rats without changing aortic mass. All three agents improved aortic
      distensibility whether or not mass was decreased. Left ventricular structural
      changes were associated with variable changes in pumping ability. These data show
      that reduced mass associated with angiotensin-converting enzyme inhibitor
      treatment was not consistent in ventricles and aorta, that a dissociation exists
      between structural and functional changes and that reduction of cardiac mass
      alone does not relate to changes in chamber mass or in function. Thus, biologic
      and pharmacodynamic differences exist among angiotensin-converting enzyme
      inhibitors as well as between classes of antihypertensive agents.

PMID- 2229804
TI  - ACC agenda update.

PMID- 2229805
TI  - Circulating heart-reactive antibodies in patients with myocarditis or
      cardiomyopathy.
AB  - Heart-reactive antibodies are commonly observed in patients with myocarditis or
      cardiomyopathy. Such antibodies may be important in the pathogenesis of these
      disorders, yet the specific antigens recognized have not been studied
      systematically. This report characterizes circulating heart autoantibodies from
      patients with myocarditis (n = 17) or idiopathic cardiomyopathy (n = 71) and from
      healthy volunteers (n = 15). Indirect immunofluorescence demonstrated that high
      titer (greater than or equal to 1:20) immunoglobulin G (IgG) antibody activity
      occurred in 59% of the myocarditis samples, 20% of the cardiomyopathy samples and
      none of the normal samples. All samples were tested by Western immunoblotting for
      IgG activity against a normal human heart extract. The number of antigens
      recognized by each sample was enumerated and the molecular weight of each antigen
      estimated; the prevalence of reactivity against antigens in selected molecular
      weight classes was determined. There was no difference in the mean number of
      heart antigens recognized by serum from each group. For most weight classes,
      prevalence either did not differ significantly among the various groups or
      subgroups or was greatest among samples from healthy volunteers. Prevalence of
      reactivity with 190 to 199 kilodalton (kd) antigens was greatest (p less than
      0.05) among low titer serum samples from patients with myocarditis. High titer
      cardiomyopathy serum differed from normal serum by an increased (p less than
      0.05) prevalence of antibodies to 40 to 49 and 100 to 109 kd antigens. These
      results suggest that western immunostaining may ultimately contribute
      substantively to identifying patients with myocarditis or cardiomyopathy.

PMID- 2229806
TI  - Diagnostic value of a new myocardial perfusion agent, teboroxime (SO 30,217),
      utilizing a rapid planar imaging protocol: preliminary results.
AB  - Technetium-99m-labeled agents have advantages over thallium-201 in terms of
      photon statistics, cost and clinical availability. They have been suggested as an
      alternative to thallium for myocardial perfusion imaging. Teboroxime is a new
      boronic acid adduct of technetium dioxime (BATO) compound that demonstrates
      favorable characteristics in preliminary studies. With use of a novel (seated)
      patient positioning technique and a rapid dynamic acquisition protocol, 30
      patients underwent planar imaging with teboroxoime while at rest and after
      maximal treadmill exercise. Postexercise scans were completed in an average time
      (mean +/- SD) of 4.4 +/- 1.6 min, with 4.8 +/- 1.5 min for the views at rest.
      These results were compared with coronary arteriography or thallium scintigraphy
      after treadmill exercise, or both. Diagnostic agreement (abnormal versus normal)
      was present in 28 of the 30 patients (p less than 0.001). Regarding physiologic
      assessment as compared with thallium scintigraphy, the finding of infarction and
      ischemia was concordant in 89% and 86% of patients, respectively. This report
      describes the initial use of teboroxime with a rapid dynamic planar imaging
      technique, resulting in a high correlation with exercise thallium scintigraphy.
      Delayed postexercise images obtained 5 to 10 min after exercise demonstrated
      rapid disappearance of exercise-induced defects noted on the initial (0 to 5 min)
      postexercise views. The rapid differential washout with teboroxime has not been
      previously described and the possible clinical significance is discussed.

PMID- 2229807
TI  - Occupational asthma from vegetable gums.

PMID- 2229808
TI  - Cat skin as an important source of Fel d I allergen.
AB  - It is generally recognized that cat skin is an important extrasalivary source of
      the major cat allergen, Fel d I. Nevertheless, since cat saliva is readily
      applied to the skin during grooming, we tried to demonstrate that Fel d I can
      accumulate on cat skin without licking. Eight adult female cats were used. On day
      0, two separate sites of the trunk were shaved and a 6 cm2 area in each site was
      washed three times with 5 ml of distilled water. The first and third washes were
      collected and stored for assay. The areas were then covered with an occlusive
      dressing. Twenty-four hours later, the site was washed once and the sample
      stored. On day 7, washes were collected as on day 0, and a collar was attached to
      the neck to prevent contamination from saliva. A single wash was done 24 hours
      later. Comparison of data was achieved with an analysis of variance. Repeated
      washes significantly reduced Fel d I levels from 35 +/- 21 to 10 +/- 9 mU/cm2 on
      day 0 (p less than 0.01) and from 36 +/- 18 to 12 +/- 7 mU/cm2 on day 7 (p less
      than 0.01). Fel d I levels increased significantly after 24 hours of occlusion
      from 10 +/- 9 to 41 +/- 24 mU/cm2 (p less than 0.01) and collar wearing from 12
      +/- 7 to 54 +/- 21 mU/cm2 (p less than 0.001). These findings demonstrate that
      Fel d I is produced by cat skin. Mean daily production of Fel d I by cat skin is
      estimated to be 36 units. Cat skin is an important extrasalivary source of Fel d
      I.

PMID- 2229809
TI  - Acute hemorrhagic edema of infancy (AHEI)--a variant of Henoch-Schonlein purpura
      or a distinct clinical entity?
AB  - Acute hemorrhagic edema of infancy (AHEI) is an acute cutaneous leukocytoclastic
      vasculitis (LCV) of infants. The clinical picture has a violent onset with a
      short benign course followed by spontaneous complete recovery. We report 12
      infants with AHEI who were studied clinically, serologically, and
      immunohistologically. Edema and palpable purpuric skin lesions were present in
      all infants who were in good general condition. Serologic studies were
      unremarkable. Light microscopic examination of the skin biopsy specimens revealed
      LCV as in Henoch-Schonlein purpura (HSP). Direct immunofluorescent study revealed
      depositions of various immunoreactants, including fibrinogen, C3, IgG, IgM, IgA,
      and IgE (100%, 100%, 22%, 78%, 33%, and 33%, respectively) in the wall and around
      the small vessels. Similar deposition of Clq was also present in three infants in
      whom Clq could be studied (100%). The clinical similarities and differences
      between AHEI and HSP have been discussed in the literature. AHEI is observed
      before 2 years of age and is confined to the skin. The skin lesions of HSP are
      more polymorphic. Although histopathologic findings are similar, the
      immunohistologic pattern found in our series of AHEI is rather different from the
      pattern of HSP. Taking all of these findings into account, we suggest that AHEI
      should be considered as a separate, clinicopathologic entity or a possible
      variant of HSP. The more descriptive term "acute benign cutaneous LCV of infancy"
      is offered for this clinicopathologic entity.

PMID- 2229810
TI  - Role of nasal allergy in chronic maxillary sinusitis--diagnostic value of nasal
      challenge with allergen.
AB  - The role of nasal allergy in chronic maxillary sinusitis without an air-fluid
      level was studied in 37 patients. Seventy-three nasal provocation tests with
      various inhalant allergens were performed in 37 patients by means of
      rhinomanometry, and maxillary sinus radiographs were performed before and
      repeatedly after the allergen challenge. Forty-one positive nasal responses (NRs)
      occurred in 29 patients; 13 were immediate only, 18 were late only, and 10 NRs
      were dual responses. Of these responses, 32 demonstrated radiographic changes,
      primarily an increase in mucosal edema and/or opacification. These responses were
      accompanied by increased pressure in the maxillary sinuses, acute headache, and
      sometimes otalgia. Eight patients did not develop any NRs; however, increased
      thickening of the mucosal membrane of the maxillary sinuses, accompanied by
      subjective symptoms, was recorded in three of these nonresponders. These results
      demonstrate the role of nasal allergy in some patients with chronic maxillary
      sinusitis, which may affect the diagnostic and therapeutic approaches to this
      disorder.

PMID- 2229811
TI  - Suppression of mouse IgE response by immune complexes.
AB  - The effect of antibodies alone or complexed to antigen on an IgE response was
      compared in mice immunized with a low dose of antigen. The results demonstrated
      that immune complexes (ICs) at equivalence were more efficient than antibodies in
      promoting a suppression of this response when they were injected simultaneously
      or before, but not after, the antigen. This effect was dose dependent, antigen
      specific, and long lasting. Furthermore, only isologous ICs were suppressive. ICs
      prepared with IgG1 antibodies were more effective than ICs prepared with IgG2.
      Digestion of the Fc fragment of the antibody eliminated completely the
      suppressive action of antibodies alone, but not of ICs. These results indicate
      that, whereas an Fc-dependent mechanism is responsible for the effect of
      antibodies, an additional mechanism is also operating in suppression induced by
      ICs.

PMID- 2229812
TI  - Characteristics of patients with food-related complaints.
AB  - Forty-five patients with classic food-allergic symptoms and/or subjective food
      related complaints not traditionally associated with food allergy underwent
      evaluation. On the basis of a comprehensive clinical history, skin testing, and
      placebo-controlled, double-blind food challenges, patients were assigned to one
      of two groups: patients with reactions highly suggestive of IgE-mediated food
      hypersensitivity (group A, N = 22) and patients with atypical adverse food
      reactions that could not be confirmed by double-blind food challenge (group B, N
      = 23). Most patients in both groups were female, 77.3% and 91.3% of patients in
      group A and B, respectively. In group B, onset of symptoms occurred at an older
      age than in group A, 28.9 years +/- 17.2 versus 17.1 +/- 12.1 (p = 0.0015),
      respectively, and involved more foods, 25.6 +/- 22.1 versus 5.2 +/- 5.5 (p =
      0.0002). Foods causing most prominent symptoms among patients in group A included
      legumes, tree nuts, crustaceans, and fish. In group B, milk, white sugar, wheat,
      egg, smoked/cured meat, and yeast were among the most troublesome foods. All but
      one patient in group A gave a positive skin test response to food; only four
      patients in group B had a positive response. We conclude that a subset of
      patients with food-related complaints can be accurately predicted to have a
      negative double-blind challenge with suspected foods on the basis of information
      obtained by history and skin testing.

PMID- 2229813
TI  - Elevated serum interleukin-6 associated with a failure in B cell differentiation
      in common variable immunodeficiency.
AB  - Interleukin-6 (IL-6/B cell stimulatory factor 2) has been found to drive
      activated human B-lymphocytes through the final stages of differentiation to
      become immunoglobulin-producing cells. Most patients with common variable
      immunodeficiency (CVI) have B-lymphocytes that fail to differentiate into high
      rate immunoglobulin-secreting cells in vivo and in vitro. In view of (1) the
      known effects of IL-6 to promote B-lymphocyte terminal differentiation and (2)
      the defect in differentiation in B-lymphocytes of patients with CVI, we believed
      that it was important to analyze the role of this cytokine in patients with CVI.
      Using an IL-6-dependent murine hybridoma cell line in a bioassay, serum IL-6
      levels were determined in 17 patients with CVI and in eight normal control
      subjects. Thirteen of the 17 patients with CVI exhibited serum IL-6 levels that
      were twofold to 18-fold higher than the range (mean, +2 SD) of normal control
      subjects. Spontaneous IL-6 production by peripheral blood mononuclear cells
      (PBMC) of patients with CVI was significantly higher than that from normal
      control subjects, whereas lipopolysaccharide maximally stimulated IL-6 production
      by PBMCs of patients with CVI or PBMCs of normal control subjects was equivalent.
      A substance inhibitory of IL-6 bioactivity was found in equivalent amounts in
      sera of both patients and normal control subjects. Sera from patients with CVI
      with high IL-6 bioactivity were found to have saturated this IL-6 inhibitory
      substance, thus resulting in large amounts of free IL-6 in the sera. These
      studies suggest that the failure of B cells from patients with CVI to terminally
      differentiate into high-rate immunoglobulin-secreting cells cannot be attributed
      to a decrease in the serum levels of IL-6 and that the increased circulating IL-6
      levels in patients with CVI result from hyperproduction rather than decreased use
      of IL-6. The persistently elevated levels of IL-6 observed in some patients with
      CVI may secondarily result in the induction of the neoplastic and autoimmune
      phenomena associated with this disease.

PMID- 2229815
TI  - Prevalence of occupational asthma and immunologic sensitization to guar gum among
      employees at a carpet-manufacturing plant.
AB  - Guar gum is a high-molecular-weight agent that can cause occupational rhinitis
      and asthma. We surveyed the employees at a carpet-manufacturing plant in which
      guar gum is used to adhere the dye to the fiber; 162/177 of the employees (92%)
      participated in the first part of the survey that included a questionnaire and
      skin prick tests with common allergens and guar gum (1 mg/ml). IgE and IgG
      antibodies to guar gum were also measured in those subjects (133/162 or 82%) who
      agreed to blood tests. Thirty-seven subjects (23%) had a history suggestive of
      occupational asthma and 59 (36%), of occupational rhinitis. Eight subjects (5%)
      demonstrated immediate skin reactivity to guar gum. Eleven subjects (8.3%) had
      serum IgE antibodies to guar gum. All subjects, except one subject who had a
      history suggestive of occupational asthma (n = 37) or positive skin tests (n =
      4), participated in the second part of the study. A methacholine-inhalation test
      was performed during a workshift or in the 3 to 4 hours after the workshift. Five
      subjects had a concentration of methacholine causing a 20% fall in FEV1 of less
      than 16 mg/ml (significant bronchial hyperresponsiveness) and positive skin
      reactions to guar gum. Four of these subjects underwent specific inhalation
      challenges. The remaining subject had a history of severe bronchospastic reaction
      on exposure to guar gum, and his FEV1 of 1.6 L made specific challenges
      impossible. Two subjects had typical isolated immediate reactions.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2229814
TI  - Immunoblot analysis of sera from patients with allergic bronchopulmonary
      aspergillosis: correlation with disease activity.
AB  - Immunoblot analysis was used to evaluate the IgG, IgE, and IgA responses to
      Aspergillus fumigatus antigen with the sera of five patients with allergic
      bronchopulmonary aspergillosis (ABPA) before, during, and after suspected
      exacerbation of their disease. The results revealed a heterogenous antibody
      response, unique for each patient, to specific Aspergillus fumigatus antigens
      that correlated with the molecular weights of previously well-characterized
      antigens of importance in the immunopathogenesis of ABPA. A rating scale was
      devised for measuring band intensity that allowed the patient's antibody
      responses to be reproducibly semiquantitated. Immunoblot analysis demonstrated
      qualitative and semiquantitative information that is not available with other in
      vitro assays used in the study of patients with ABPA, such as ELISA. These
      initial results emphasize the need for additional evaluation of this technique to
      assess its potential clinical application in this disease.

PMID- 2229816
TI  - Chronic urticaria exacerbated by the antioxidant food preservatives, butylated
      hydroxyanisole (BHA) and butylated hydroxytoluene (BHT).
AB  - Two patients with chronic idiopathic urticaria in whom remissions were achieved
      with dye- and preservative-elimination diet had exacerbations of their urticaria
      when they were challenged under double-blind, placebo-controlled conditions with
      butylated hydroxyanisole and butylated hydroxytoluene. After elimination of
      butylated hydroxyanisole and butylated hydroxytoluene from their diets, there was
      marked abatement of the frequency, severity, and duration of their urticaria.
      These antioxidants appear capable of aggravating symptoms in certain patients
      with chronic urticaria.

PMID- 2229817
TI  - Different prevalence and degree of nonspecific bronchial hyperreactivity between
      seasonal and perennial rhinitis.
AB  - From the patients observed at our respiratory allergology service, we selected
      patients with rhinitis only, without any past or present respiratory symptoms,
      for our study. All these patients had normal pulmonary function, were
      administered carbachol or methacholine bronchial challenges, and had one or more
      skin reactions to perennial or seasonal allergens. Patients were allocated to
      three groups: group A, patients with seasonal rhinitis who were administered
      nonspecific challenges out of season; group B, patients with seasonal rhinitis
      tested during the season; and group C, patients with perennial rhinitis. The
      three groups were divided into subgroups according to the duration in years of
      rhinitis and to the degree of nonspecific bronchial responsiveness. The
      distribution into four groups of reactivity, arbitrarily defined as normal and
      mildly, moderately, and severely increased reactivity, was as follows: group A,
      124, 21, 30, 22; group B, 75, 15, 7, and 21: and group C, 69, 17, 39, and 72,
      respectively. The patients of group C (perennial rhinitis) demonstrated a
      distribution significantly (p less than 0.001) different from subjects with
      seasonal rhinitis, both group A and group B. Our results are consistent with the
      hypothesis that perennial rhinitis is much more important than seasonal rhinitis
      as a risk factor for developing nonspecific bronchial hyperresponsiveness.

PMID- 2229818
TI  - How should we use skin testing to quantify IgE sensitivity?

PMID- 2229819
TI  - Immunotherapy decreases skin sensitivity to ragweed extract: demonstration by
      midpoint skin test titration.

PMID- 2229820
TI  - Histamine and disease: a forum on current and future management. Carlsbad,
      California, August 25-26, 1989. Proceedings.

PMID- 2229821
TI  - Mast cell biology.
AB  - Mast cells are the repository for histamine in the body. They influence the
      pathophysiology of allergic diseases, such as rhinitis, urticaria, and asthma;
      regulate bone formation and integrity; help repair and maintain connective
      tissue; promote wound healing; and probably contribute to the development and
      preservation of the endothelium and small blood vessels. Although they are found
      in all human tissue, mast cells are most prevalent at the interface between the
      host and its environment, that is, in the skin and in the mucosa of the upper and
      lower respiratory tracts and the gastrointestinal tract. Recent evidence suggests
      that two types of mast cells exist: (1) the connective tissue type, found
      primarily but not exclusively in loose connective tissue and skin, and (2) the
      mucosal type, found primarily in gastrointestinal mucosa and peripheral airways.
      The factors that produce this differentiation are not fully known. Although both
      mast cell types have IgE receptors that can be activated by allergens,
      differences between the two types exist in their responses to nonallergic
      signals, the mediators they release, their proteoglycan constituents, and the
      makeup of their granular enzymes. The importance of these biochemical differences
      to cellular functioning remains to be investigated.

PMID- 2229822
TI  - Tryptase, a mediator of human mast cells.
AB  - Tryptase, a mediator secreted by human mast cells during immediate reactions, has
      demonstrated effects on several pathways in vitro. This enzyme can rapidly
      inactivate fibrinogen and, as a complex with heparin, may prevent coagulation
      that may otherwise occur when plasma enters tissues at sites of immediate
      reactions. Tryptase may also activate prostromelysin, which in turn activates
      latent collagenase. When canine pulmonary smooth muscle is incubated with canine
      tryptase, the contractile response to histamine is increased. Tryptase,
      quantifiable in complex biologic fluids by immunoassay, can serve as a specific
      indicator of mast cell involvement in certain clinical settings. For example,
      after bee sting--induced anaphylaxis, tryptase levels in the blood peak at
      approximately 1 hour, then decline with a half-life of approximately 2 hours.
      Additionally, elevated tryptase levels in bronchoalveolar lavage fluid of
      asymptomatic, atopic persons with asthma suggest ongoing mast cell activation,
      which may relate to adenosine hyperresponsiveness and a persistence of bronchial
      hyperreactivity. Tryptase levels in bronchial lavage fluid of atopic patients
      with asthma rise markedly after endobronchial allergen challenge but not after an
      exercise challenge, suggesting a lack of mast cell involvement in the latter
      condition.

PMID- 2229823
TI  - Performance effects of antihistamines.
AB  - In 1988 an estimated 30 million Americans spent more than $500 million for single
      entity antihistamines. Classic first-generation antihistamines, which are
      available without prescription, can cross the blood-brain barrier and have been
      reported to produce various central nervous system effects. Sedation, the most
      common adverse effect of these agents, occurs in 10% to 25% of antihistamine
      users. Drowsiness has been attributed to the blockade of central histaminergic
      receptors; antagonism of other brain receptors, such as serotonergic,
      cholinergic, and central alpha-adrenergic receptors, has also been proposed. The
      newer second-generation H1-receptor antagonists are typically large, lipophobic
      molecules with a charged side chain and are extensively bound to albumin.
      Consequently, these agents have difficulty entering the brain, and they appear no
      more likely to induce sedation than does placebo. The effects of antihistamines
      on psychomotor reflexes and driving, antihistamine-induced drowsiness, and
      interaction of antihistamines with alcohol and tranquilizers have been studied
      with numerous methodologies. The centrally acting first-generation agents
      commonly cause greater performance decrements as compared with the newer,
      nonsedating, second-generation antihistamines.

PMID- 2229824
TI  - Neuropeptides and nasal secretion.
AB  - Recent research has disclosed that neurotransmitters and neuropeptides released
      within the autonomic nervous system exert homeostatic control of nasal secretion.
      Although cholinergic and adrenergic influences have long been thought to be the
      predominant mechanisms, the nonadrenergic, noncholinergic responses may have more
      suitable, longer-lasting effects. Peptides from sensory nerves, such as
      calcitonin gene related peptide, substance P, and neurokinin A, may participate
      in axon response-mediated vasodilation and plasma extravasation. Substance P and
      gastrin releasing peptide may induce glandular secretion. Defensive responses to
      local mucosal injury may be amplified by axon response, which initiates these
      vascular and glandular reactions. Cholinergic effects are primarily responsible
      for mediating parasympathetic reflexes, but vasoactive intestinal peptide may
      regulate acetylcholine release, augment glandular secretory responses, and have a
      vasodilatory effect. In the sympathetic nervous system, neuropeptide Y probably
      functions as a long-acting vasoconstrictor. Integration of sympathetic and
      parasympathetic influence may regulate the normal nasal cycle, and sensory and
      parasympathetic defensive reflexes may respond to epithelial and mast cell
      stimulation. It is possible, then, that the pathophysiology of vasomotor rhinitis
      involves an exaggeration of these neural influences.

PMID- 2229825
TI  - The role of antihistamines in upper respiratory tract infections.

PMID- 2229826
TI  - The role of antihistamines in otitis.
AB  - Chronic and recurrent otitis media can manifest as otitis media with effusion.
      Both infection and eustachian tube obstruction (ETO) have been found to play an
      important role in its pathogenesis. ETO can be demonstrated during both early-
      and late-phase reactions in patients with allergic rhinitis after intranasal
      challenge with an allergen. Intranasal challenge with either histamine or
      prostaglandin D2 also provokes ETO, with the latter mediator perhaps more potent
      than the former. Middle ear effusions from patients with chronic or recurrent
      otitis media have been found to contain dramatically increased concentrations of
      histamine relative to the concentrations in their plasma. The development of
      nasal and eustachian tube obstruction in allergic rhinitis patients has been
      prevented by pretreatment with an antihistamine plus decongestant before
      intranasal challenge with pollen allergen. Investigations are currently under way
      to assess the effect of antihistamine pretreatment on nasal and eustachian tube
      obstruction in patients undergoing intranasal histamine challenge.

PMID- 2229827
TI  - Mast cells and histamine in asthma.

PMID- 2229828
TI  - Predictive value of airway reactivity.

PMID- 2229830
TI  - Blockage of a "nonspecific" provocational challenge as a model for predicting
      clinical efficacy.

PMID- 2229829
TI  - Patterns of airway responsiveness.

PMID- 2229831
TI  - The use of provocational challenge in office practice.

PMID- 2229832
TI  - The role of antihistamines in the treatment of chronic urticaria.
AB  - For many years, H1 antihistamines have been the primary management option for
      urticaria. However, undesirable side effects, particularly daytime sedation, have
      limited the usefulness of these classic antihistamines. A new class of
      peripherally acting, nonsedating antihistamines (e.g., terfenadine, astemizole,
      loratadine, and cetirizine) has proved to have clinical efficacy comparable with
      the classic antihistamines. In comparative trials between the various nonsedating
      agents, no significant difference in efficacy has been noted. All these agents
      have good safety profiles, although astemizole use has been correlated with
      increased appetite and weight gain in some patients, and cetirizine has caused
      slightly increased sedative effects compared with placebo. Although H1/H2
      antihistamine combinations have been proposed as possible treatments for
      urticaria, studies have produced mixed results.

PMID- 2229833
TI  - Mechanisms involved in allergic contact dermatitis.
AB  - Allergic contact dermatitis is a common inflammatory skin disease caused by
      agents such as plants, chemical compounds, and topical medications. Histologic
      features typically include edema within the epidermis and dermis and a
      lymphohistiocytic infiltrate with an admixture of basophils. Langerhans cells and
      keratinocytes play pivotal roles in allergic contact dermatitis reactions.
      Langerhans cells synthesize and express class II molecules that allow the
      presentation of exogenous antigens to T lymphocytes. Additionally, keratinocytes
      and Langerhans cells produce interleukin-1, which is thought to be a second
      signal that activates T cells. Mast cells and basophils also may play a
      proinflammatory role. Treatment primarily consists of removal of the offending
      agent. At times, systemic corticosteroids may be required, especially in the
      acute phase. In more chronic cases, topical corticosteroids may be beneficial.
      Antihistamines may be useful because of their soporific effects, but their
      usefulness is limited.

PMID- 2229834
TI  - The role of antihistamine therapy in vascular headaches.
AB  - Migraine (vascular) headache is a complex syndrome that involves vascular
      hyperreactivity. The functions of systemic mediators in migraine are not fully
      understood. It is unclear which mediators provoke this probably atopic disorder
      and which represent an attempt to correct an imbalance. However, it has been
      demonstrated fairly conclusively that increased histamine levels correlate with
      migraine attacks in susceptible persons. Recent studies showing that histamine
      seems to have many different receptors and to adopt different conformations for
      different receptors may serve as a useful guide to future scientific
      investigation. Further impetus may come from ongoing studies of H3 histamine
      receptors, which indicate that H3 agonists offer promise as prophylactic agents
      for people who suffer from vascular headaches.

PMID- 2229835
TI  - Arthritis and mast cell activation.
AB  - The significance of the mast cell in the pathogenesis of rheumatic diseases
      continues to receive attention. Increased numbers of mast cells are found in the
      synovial tissue and fluid of patients with inflammatory arthritides, and these
      mast cells can be activated by many of the substances found in inflammatory
      synovial fluid. This activation results in the release of mediators that are
      capable of amplifying the inflammatory process within the joint space. Recent
      research has shown that mast cells also produce a variety of cytokines and
      hematopoietic growth factors that may have paracrine and autocrine functions that
      are important to the development of the inflammatory cell infiltrate. Increased
      numbers of mast cells are also found in many fibrotic conditions, including
      scleroderma. These mast cells, directly or through mediator generation, affect
      the function of endothelial cells, fibroblasts, and growth factors important to
      the proliferation and function of these cells. A clearer understanding of mast
      cell involvement in the inflammatory arthritides and fibrotic processes should
      lead to new therapeutic strategies.

PMID- 2229836
TI  - Bioaerosols: prevalence and health effects in the indoor environment.
AB  - Assessing the role of bioaerosols in residence-related symptoms involves (1)
      determining that symptoms are related to the residence by medical examination and
      careful questioning, (2) connecting reported symptoms with known or hypothesized
      effects of bioaerosols, (3) examining the residence for bioaerosol risk factors
      such as overcrowding/poor ventilation, inappropriate outdoor air intrusion, and
      dampness/standing water, (4) and finally, if no obvious risk factors are present,
      air sampling. Air sampling should always be a last resort and should use a
      reliable volumetric method. Particulate samplers, such as the Burkard personal
      spore trap, are inexpensive alternatives to viable particle samplers and will
      provide data on most organisms implicated in hypersensitivity diseases.
      Interpretation of residential bioaerosol sample data requires both qualitative
      and quantitative comparison with adjacent outdoor air and examination of aerosol
      changes related to domestic activities. Recommendations that should lead to a
      decrease in indoor bioaerosols include the use of air conditioning to allow
      limitation of outdoor aerosols, prevention of dampness or moisture intrusion, and
      discouraging the use of humidifying devices other than steam. Bioaerosol
      assessment in the workplace is often more complex than for residences. Because
      the symptomatic subjects are not in charge of the environment, such situations
      often lead to difficult employee/management relations and occasionally to
      litigation. It is essential that each step in workplace bioaerosol assessment be
      defensible and that the best possible methods are used. The approach is similar
      to the approach used for residences, but on a larger scale. Symptom assessment
      must include stress and ergonomic factors. Air sampling, if this is necessary,
      must usually be extensive with controls for ventilation rates, occupancy, and
      spatial variation.

PMID- 2229837
TI  - Immunotherapy abrogates the generation of eosinophil and neutrophil chemotactic
      activity during pollen season.
AB  - In a group of 40 birch pollen-allergic patients with a history of
      rhinoconjunctivitis and wheezing during the pollen season, 20 were immunotherapy
      (IT) treated preseasonally with birch-pollen extract (Pharmacia, Uppsala,
      Sweden). Blood samples for determination of the levels of heat-labile eosinophil
      chemotactic activity (HL-ECA), heat-labile neutrophil chemotactic activity (HL
      NCA), and heat-stable neutrophil chemotactic activity were collected before the
      season, at the beginning of the study, at the start of the season, at the peak,
      at the end, and after the birch-pollen season. The symptoms from
      rhinoconjunctivitis and airways, peak expiratory flow, and use of medication were
      recorded throughout the season. Significant increases of HL-ECA and HL-NCA were
      observed in untreated compared with IT-treated patients at the start of the
      season (p less than 0.0001 for both activities) and at the peak of the birch
      pollen season (p less than 0.0005 and p less than 0.01, respectively). At the end
      of the season, HL-ECA levels were not significantly different between the patient
      groups, whereas HL-NCA levels were still higher in untreated patients (p less
      than 0.005). We conclude that IT completely abrogates the generation of HL-ECA
      and HL-NCA during a pollen season.

PMID- 2229838
TI  - Allergens as proteases: an Aspergillus fumigatus proteinase directly induces
      human epithelial cell detachment.
AB  - Allergic bronchopulmonary aspergillosis (ABPA) is characterized by pulmonary and
      systemic allergic and inflammatory processes triggered by fungal antigens. Airway
      damage is a feature of this disorder, and although Aspergillus-derived
      proteinases have been described, the capacity of Aspergillus, however, to
      directly induce damage to human epithelium has not previously been studied. We
      therefore cultured Aspergillus fumigatus from two patients with ABPA, extracted
      mycelial products by sonication and filtration, and then evaluated their capacity
      to induce epithelial cell (EC) desquamation from basement membrane using an in
      vitro model that uses intact human amniotic EC and native basement membrane. A.
      fumigatus extracts induced detachment of EC in a dose-dependent fashion,
      producing up to 34% +/- 6% detachment (p less than 0.05 compared to medium
      alone). Enzyme analysis of A. Fumigatus extract using synthetic substrates
      revealed the presence of a number of different enzymes; therefore, studies with
      specific proteinase inhibitors were undertaken to identify the proteinase(s)
      responsible for detachment. A. Fumigatus-induced desquamation was partially
      inhibited by phenylmethylsulfonylfluoride and substantially inhibited by
      glutathione and N-acetylcysteine, but not by alpha 1-antitrypsin, 1,10
      phenanthroline, ethylenediaminetetraacetic acid, aprotinin, or soybean trypsin
      inhibitor at concentrations that inhibit other serine- or metalloproteinases. Gel
      filtration of the extract with a Sepharose 6B column revealed that the major
      epithelium-detaching activity appeared in the 20 to 35 kd fraction. Comparison
      with proteinase standards suggested a role for a chymotrypsin-like proteinase.
      Thus, A. fumigatus releases a proteinase that is directly able to induce EC
      detachment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229839
TI  - It is children with atopic dermatitis who develop asthma more frequently if the
      mother smokes.
AB  - We elicited symptoms of atopic dermatitis (AD) and of asthma from 620 children
      who were themselves nonsmokers, were aged 1 to 17 years, and had been
      consecutively referred to an allergy clinic. A histamine bronchial-challenge test
      revealed bronchial hyperresponsiveness in 95% of the children who had a history
      of wheezing or asthma and who could perform the test reliably, indicating that
      most of them did indeed have asthma. Children with a history of AD were much more
      likely to have asthma if the mother was a smoker than if she was a nonsmoker (79%
      versus 52%; p = 0.001). Similarly, if AD was found on examination, the
      percentages with asthma were 74% and 44%, respectively. By contrast, the children
      with no history of AD had asthma as frequently if the mother was a nonsmoker
      (42%) as when she was a smoker (40%). In children with AD, the prevalence of
      asthma was greater in both boys and girls when the mother was a smoker, but only
      in boys when the father was a smoker. Multiple logistic regression confirmed that
      the risk of asthma was greatly increased when the child had both AD and a mother
      who smoked.

PMID- 2229840
TI  - Salsalate cross-sensitivity in aspirin-sensitive patients with asthma.
AB  - Ten aspirin (ASA)-sensitive patients with asthma underwent double-blind, placebo
      controlled oral challenges with salsalate followed by ASA-sensitive confirmatory
      challenges. All 10 patients sustained asthmatic reactions to ASA, but only two
      developed respiratory reactions to 2 gm of salsalate. In these two patients,
      repeat confirmatory challenges with 2 gm of salsalate reproduced the same
      asthmatic reactions. Both patients were desensitized to ASA, and cross
      desensitization with 2 gm of salsalate was then achieved. We conclude that
      salsalate, a weak inhibitor of cyclooxygenase in vitro, is less likely than ASA
      to induce asthma in known ASA-sensitive patients with asthma but may occasionally
      cross-react in these patients. Such reactions were mild and easily treated with
      beta 2-agonists.

PMID- 2229841
TI  - Immediate skin test reactivity to Food and Drug Administration-approved
      standardized extracts.
AB  - In an effort to determine whether recently introduced Food and Drug
      Administration-approved standardized extracts produce clinically appropriate
      responses in a population, 200 subjects were skin prick tested (SPT). Thirteen
      extracts (10 pollens, two house dust (HD) mites and cat) were tested in three
      groups of subjects, 50 with a history of asthma or allergic rhinitis (AL), 50
      without asthma or perennial or seasonal allergic rhinitis but with a positive
      immediate family history for these conditions (FAL), and 100 subjects without a
      personal or family history for these conditions (NAL). An SPT mean wheal diameter
      greater than or equal to 3 mm was considered positive. Ninety percent (95%
      confidence interval [CI], 82% to 98%) of AL subjects had at least one positive
      SPT. Forty-six percent of FAL subjects (95% CI, 30% to 58%) and 29% of NAL
      subjects (95% CI, 20% to 38%) had at least one positive SPT. More FAL than NAL
      subjects had at least one SPT (p less than 0.05), and FAL subjects had more
      positive SPTs than NAL subjects (p less than 0.05), further supporting the
      genetic regulation of allergen-specific IgE production. Of the five AL subjects
      with no SPT wheal greater than or equal to 3 mm, three subjects were available
      for intradermal tests. Thirteen nonstandardized allergens similar to allergens
      used for SPT were applied intradermally in each of these three subjects and were
      all negative. Compared with history, an SPT wheal greater than or equal to 3 mm
      to cat produced a sensitivity of 0.90, a specificity of 0.90, and diagnostic
      accuracy of 0.90. Tenfold dilutions of pollens and cat reduced sensitivity
      without significantly improving specificity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229842
TI  - The Hymenoptera venom study. III: Safety of venom immunotherapy.
AB  - One thousand four hundred ten (44%) of the 3236 subjects in the Hymenoptera venom
      study accepted venom immunotherapy (VIT). Time to maintenance averaged 95 days,
      and the largest number achieved maintenance (147 subjects, 10.4%) at day 56.
      Ninety-two percent of the treated subjects achieved maintenance, and 84%
      continued therapy, most subjects (91%) until the study was terminated. One
      hundred seventy-one subjects (12%) experienced 327 treatment systemic reactions
      (Srs). The incidence of pruritus and angioedema/urticaria was similar with mild,
      moderate, or severe SRs. The SR severity did not correlate with the severity of
      the most recent sting before entry into the Hymenoptera-venom study, the most
      severe historical sting SR, the most severe SR during venom skin tests, the total
      dose of venom, the degree of skin test reactivity, or the lowest concentration
      yielding a positive skin test. Most SRs occurred between 1 and 50 micrograms and
      at maintenance; honeybee or wasp venoms were most likely to produce SR. This
      study, the largest of its kind with the use of standardized extracts,
      demonstrates (1) that there was good compliance, (2) that various historical and
      diagnostic criteria did not predict SRs to VIT, (3) that SRs to VIT were most
      likely to occur between 1 and 50 micrograms and at maintenance, (4) that honeybee
      or wasp venoms were most likely to produce an SR, and (5) that VIT is relatively
      safe.

PMID- 2229843
TI  - Identification and characterization of important cockroach allergens.
AB  - Allergens extracted from American and German cockroach species have been
      identified as significant sensitizing agents in the induction/exacerbation of
      asthma. In the present study, gel-filtration fractions of saline extracts of
      American cockroach (Periplaneta americana) whole bodies (AWBE fraction 2) and
      German cockroach (Blattella germanica) whole bodies (GWBE fraction 2) were used
      to identify and characterize important cockroach allergens by immunoprinting. In
      addition, allergens from AWBE and GWBE fractions 2 were additionally fractionated
      by chromatofocusing on polybuffer exchanger. Immunoprinting studies demonstrated
      several important acidic allergens in cockroach whole body extracts. All but one
      allergen had an acid isoelectric point (pH 2.80 to 5.20). Two allergens, one that
      focused at pH 3.50 and another allergen (or group of isoallergens) that focused
      between pH 4.15 to 4.55 were reactive with most sera obtained from cockroach
      sensitive subjects. Chromatofocusing and subsequent skin test and RAST studies of
      AWBE and GWBE confirmed the presence of significant cockroach allergens with
      isoelectric points within the zone of pH 3.75 to 4.50. RAST-inhibition studies
      demonstrated the similarity of these allergens between AWBE and GWBE.
      Collectively, these observations identify the presence of several acidic
      cockroach allergens presumably shared between AWBE and GWBE.

PMID- 2229844
TI  - The control of house dust mite allergens in rugs.
AB  - Used rugs were vacuum cleaned, "wet cleaned," "shampooed," or heated in an
      autoclave. The effects on the live-mite population, on the allergen
      (Dermatophagoides pteronyssinus, Der p I and Der p II; and Dermatophagoides
      farinae, Der f II) content, and on the suitability of the rugs as a habitat for
      house dust mites was studied. Autoclaving was most effective in all three
      aspects. The cleaning methods were quite inefficient for killing the mites, but a
      significant reduction of allergens and deterioration of the habitat quality was
      established. "Wet cleaning" appears particularly promising.

PMID- 2229845
TI  - Measurement of histamine in nasal lavage fluid: comparison of a glass fiber-based
      fluorometric method with two radioimmunoassays.
AB  - The determination of histamine in nasal secretions and nasal lavage fluid may be
      of importance to monitor activation of histamine containing cells in the nasal
      cavity. However, such studies have been besieged by controversy, specifically to
      findings of changes in histamine levels in relation to allergenic stimulation.
      This controversy may be due to the specificity and accuracy of the various
      methods used to determine histamine in the nasal fluid. We have therefore applied
      and compared three new methods to determine histamine in nasal lavage fluids
      obtained before and after allergen challenge in normal subjects and patients with
      allergic rhinitis. We used a fluorometric glass fiber-based histamine method
      (FHR) and two RIAs, I and II. The FHR (detection limit, 7.0 nmol) and the RIA II
      (detection limit, 0.2 nmol) are specific for histamine itself, whereas the RIA I
      (detection limit, 18.0 nmol) measures mainly methylhistamine and cross-reacts to
      some extent with histamine. The histamine levels in the nasal lavage fluids from
      the nasal challenges demonstrated histamine values between 100 and 2000 nmol/L of
      histamine with significantly higher levels in the postallergen challenges for the
      allergic subjects as compared to the normal control subjects. The FHR correlated
      well with the RIA I and RIA II methods with correlation coefficients of 0.77 to
      0.88 (p less than 0.001), respectively. However, the RIA I (methylhistamine
      antibody) always demonstrated absolute histamine values 5% to 20% of values
      measured by the RIA II (at the level of cross-reactivity to histamine).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2229847
TI  - Opportunities for research-oriented dietitians.

PMID- 2229846
TI  - Down regulation in hypersensitivity pneumonitis.
AB  - Levels of soluble interleukin-2 receptor (sol-IL-2R) in the bronchoalveolar
      lavage fluid (BALF) of pigeon breeders with hypersensitivity pneumonitis were
      compared with BALF levels in asymptomatic pigeon breeders who had been exposed to
      pigeon allergens for an equivalent length of time. No mean difference in sol-IL
      2R levels was detected when these levels were expressed per milliliter BALF,
      epithelial lining fluid, or per T-lymphocyte. In sarcoidosis, the availability of
      sol-IL-2R per T cell was significantly higher for the group with inactive
      sarcoidosis compared with the group with active sarcoidosis. The results do not
      support the hypothesis that down regulation, in subjects exposed to allergens
      causing hypersensitivity pneumonitis, is a function of cell-free sol-IL-2R levels
      in BALF. In the dynamic situation, however, the hypothesis appears tenable.

PMID- 2229848
TI  - Credentials and skills required for hospital food and nutrition department
      directors.
AB  - The perceptions of hospital administrators, food and nutrition department
      directors, and management dietetic educators were compared with respect to the
      credentials and administrative skills required for a director of a food and
      nutrition department in a hospital with 300 beds or more. Questionnaires were
      mailed to the director of food and nutrition services and the vice president of
      hospital operations at 132 hospitals in five midwestern states. Fifty-six
      questionnaires were mailed to all educators on the 1986 to 1988 membership list
      of the Foodservice Systems Management Education Council. Response rates of
      directors, administrators, and educators were 68%, 53%, and 82%, respectively.
      The questionnaire consisted of three parts. Part one addressed credentials
      required; part two required participants to rank 14 skill categories in order of
      importance; and part three focused on facility descriptors and credentials of
      participating administrators and directors. Findings of the survey indicate that
      the minimum qualifications for department directors were registered dietitian
      status, at least a bachelor's degree in food and nutrition, and work experience
      in foodservice systems management. Although administrators ranked foodservice
      management skills higher than nutrition skills, they ranked nutrition skills
      significantly (p less than .001) higher than did directors or educators. These
      findings may guide career development of practitioners who aspire to department
      director positions.

PMID- 2229849
TI  - Contributions of food groups to intakes of energy, nutrients, cholesterol, and
      fiber in women's diets: effect of method of classifying food mixtures.
AB  - This study examined the effect of using two different methods for categorizing
      food mixtures when calculating the contribution of various food groups to energy,
      macronutrient, cholesterol, and fiber intakes. Using method 1, each food mixture
      was classified as a single item and assigned to a food group according to its
      main ingredient. Using method 2, most of the food mixtures were separated into
      their constituent ingredients, and each ingredient was assigned to its
      appropriate food group. Data were from 1,032 women who provided at least 4 days
      of dietary data in the U.S. Department of Agriculture's 1985 Continuing Survey of
      Food Intakes by Individuals. We found that the importance of each food group's
      contribution to individual dietary components varied depending on the method used
      to categorize the food mixtures. When food mixtures were separated into their
      constituent ingredients before assigning foods to food groups, the contributions
      of meat, fish, poultry, and grain products declined for each of the seven dietary
      components studied. At the same time, the contributions of milk products, fats,
      and oils increased for most of the seven components. The results highlight the
      importance of foods eaten as part of food mixtures to the intake of energy,
      macronutrients, cholesterol, and fiber.

PMID- 2229850
TI  - Dietary selenium intakes and plasma selenium concentrations of formula-fed and
      cow's milk-fed infants.
AB  - The plasma selenium concentrations of 57 infants 8 to 12 months of age were
      assessed using flameless atomic absorption spectrophotometry. The infants
      ingested either cow's milk or whey-predominant milk-based infant formula as their
      primary beverage as part of a mixed diet for at least 3 months. The calculated
      mean +/- standard deviation (SD) daily dietary selenium intake of 26 infants fed
      cow's milk (34 +/- 13 micrograms), assessed by a 3-day diet record and/or a 24
      hour diet recall, was significantly (p less than or equal to .001) greater than
      that of 31 formula-fed infants (22 +/- 11 micrograms). The mean +/- SD plasma
      selenium concentration of infants fed cow's milk (39 +/- 11 micrograms/L) was
      also significantly (p less than or equal to .05) greater than that of infants fed
      formula (31 +/- 12 micrograms/L). Both groups of infants ingested similar amounts
      of total energy; however, the infants fed cow's milk received more total protein
      and selenium and a greater percentage of protein and selenium from their primary
      beverage than did the infants receiving formula. Both groups of infants were
      consuming a mixed diet with similar sources of selenium. To examine the selenium
      status of infants as well as other individuals better, further analysis of foods
      is clearly needed to provide more information on dietary selenium sources. The
      influence of variables such as body size and ethnicity, intake, sources and forms
      of dietary protein, and dietary forms of selenium on plasma selenium
      concentrations must also be investigated.

PMID- 2229851
TI  - Folate status of adolescents: effects of folic acid supplementation.
AB  - This study was designed to determine the folate status of an adolescent
      population and to demonstrate the effect of folic acid supplementation on
      subjects with low folate status. In phase one, folate status was evaluated in a
      biracial sample of 164 adolescents 12 to 15 years old. Socioeconomic,
      demographic, anthropometric, and 7-day food record data were collected, and serum
      and erythrocyte folate levels were determined. Thirty-five adolescents considered
      to have had low folate status 6 months earlier participated in phase two, a 2
      month supplementation period and reevaluation. No racial differences were
      observed in folate status, as indicated by amount of folate in the blood and
      diet. Boys had significantly (p less than .05) higher folate levels in serum and
      erythrocytes than did girls. Thirteen percent of the boys and 40% of the girls
      were folate deficient as judged by amount of erythrocyte folate less than 317
      nmol/L (140 ng/mL). The folate-deficient subjects had significantly (p less than
      .05) lower values of hemoglobin than did the normal subjects. Seventeen percent
      of the boys and 42% of the girls had folate intakes below the recommended dietary
      allowance for folate. Supplementation of 400 micrograms folic acid daily for 2
      months resulted in significant (P less than .05) increases in serum folate,
      erythrocyte folate, and hemoglobin values and a decrease in mean corpuscular
      volume. Evidence of high prevalence of low folate status, positive relationship
      between erythrocyte folate and hemoglobin, and responses of hemoglobin and mean
      corpuscular volume to the supplement indicated that folate consumption may not be
      optimal in some groups of adolescents, especially in girls.

PMID- 2229852
TI  - The effects of moderate exercise training on nutrient intake in mildly obese
      women.
AB  - The relationship between moderate exercise training (five 45-minute sessions per
      week, brisk walking at 62 +/- 2% VO2 max for 15 weeks) and changes in nutrient
      intake was investigated in a group of 36 sedentary, mildly obese women. The study
      was conducted using a 2 x 3 factorial design (two groups of subjects: exercise
      and nonexercise groups; three periods: baseline, 6-week, and 15-week testing
      sessions). Data were analyzed using repeated measures ANOVA. The pattern of
      change in caloric intake over time tended to be different between groups (F[2,
      68] = 2.50, p = .089); the exercise group experienced a significant decrease in
      caloric intake by 15 weeks. Significant group x time interactions were found for
      intakes of carbohydrate, dietary fiber, thiamin, niacin, vitamin B-6, and folate.
      Intake tended to decrease in the exercise group and to increase in the
      nonexercise group. Change in intake of each of these nutrients was significantly
      correlated with change in bread and cereal consumption. The pattern of change in
      bread and cereal intake over time was significantly different between groups
      (Pillais Trace = 0.266, F[2, 33] = 5.99, p = .006); the exercise group had
      significant decreases in intake at 6 and 15 weeks vs baseline values. These data
      suggest that mildly obese women reduce energy intake subsequent to initiating an
      exercise program; concomitantly there is a decrease in the quality of nutrient
      intake from their diets compared with those of sedentary controls.

PMID- 2229853
TI  - An interdisciplinary nutrition assessment and intervention protocol for children
      with disabilities.
AB  - Because of the multifactorial nature of the nutrition problems associated with
      developmental disabilities, a well-organized, interdisciplinary effort is
      necessary to deal with such problems. A team composed of professional and support
      staff, the client, and the family needs to be involved in an integrated approach
      to service. The team members share their knowledge and expertise in developing an
      individual program plan to meet identified needs. This article describes the
      development and implementation of a prototype for interdisciplinary nutritional
      evaluation and intervention in an outpatient setting. In 1987, a Regional
      Nutrition and Feeding Diagnosis and Evaluation Clinic was established through a
      contractual agreement between the University of Georgia University Affiliated
      Program and St. Mary's Hospital in Athens, GA. The purposes of the clinic are
      twofold: to offer direct services to developmentally disabled infants and
      children who require outpatient services and to provide a unique community-based
      interdisciplinary training experience for graduate students in nutrition and
      other health disciplines. The interdisciplinary treatment protocol is based on
      current knowledge in the treatment of developmental disabilities.

PMID- 2229855
TI  - Diet quality and the eating environment of preschool children.

PMID- 2229854
TI  - A review of iodine toxicity reports.
AB  - This article summarizes case reports, population studies, and experimental
      studies from the literature concerning adverse effects of exposure to iodine from
      the mid-1880s to 1988. Exposure to excessive iodine through foods, dietary
      supplements, topical medications, and/or iodinated contrast media has resulted in
      thyroiditis, goiter, hypothyroidism, hyperthyroidism, sensitivity reactions, or
      acute responses for some individuals. Reports of maternal iodine exposure during
      pregnancy or lactation affecting newborn or nursing infants are cited.
      Susceptibility to excess iodine is discussed as well as the relationship between
      dose and response. It is concluded that some individuals can tolerate very high
      levels of iodine with no apparent side effects and that iodine intakes less than
      or equal to 1.000 mg/day are probably safe for the majority of the population,
      but may cause adverse effects in some individuals. Determination of maximum
      tolerable levels of iodine intake will require human experimental studies at
      levels between 0.150 and 1.000 mg/day for normal subjects, subjects with
      autonomous thyroid tissue, and iodine-sensitive subjects.

PMID- 2229856
TI  - Family physicians' opinions on nutrition after nutrition education.

PMID- 2229857
TI  - Members honored as Medallion Award winners in Denver on October 16.

PMID- 2229858
TI  - Nutrition labeling: issues and directions for the 1990s.
AB  - This report will become a part of the comment and rule-making process that FDA
      and USDA will conduct to achieve food and nutrition labeling reform. The agencies
      have requested interested parties to comment on the report's recommendations. The
      report will be of interest to Congress in developing legislative proposals to
      clarify the legal basis for anticipated reforms. For the food industry, health
      professionals, and consumer groups, it will be of interest in terms of their own
      objectives in promoting nutrition labeling changes that are in line with current
      dietary recommendations and in product development. Dietitians will want to
      comment on the recommendations in the Institute of Medicine report and on
      provisions of the proposed regulations. Dietitians should encourage their elected
      officials in Congress to support legislation for food labeling reform.

PMID- 2229859
TI  - The Senior Care Study. A controlled trial of a consultative/unit-based geriatric
      assessment program in acute care.
AB  - Successful models of inpatient geriatric assessment have often involved long
      hospital stays, specialized interdisciplinary care, and prolonged follow-up,
      which are difficult to achieve within a prospective payment system. A randomized
      clinical trial was undertaken to evaluate the efficacy (maintenance or
      improvement in mental, emotional, and physical function) of using a geriatric
      assessment process in acute hospital care without increasing hospital charges or
      lengths of stay. Four hundred thirty-six patients greater than or equal to 75
      years of age were randomly allocated to treatment (n = 221) or control (n = 215)
      conditions. Patients in the treatment group were admitted to a special unit and
      evaluated on admission by an interdisciplinary team, which developed a care plan.
      Although primary care was provided by the patient's own physician, the team
      followed the patients as consultants on the unit in the hospital, and by
      telephone for 2 months after discharge. The control group was placed on other
      units and received usual hospital care. The treatment and control groups were
      similar at study entry. At follow-up, there were no significant differences
      between the groups with respect to lengths of stay, hospital charges, mortality,
      change in physical function, or change in mental function. The treatment group
      changed more often in measured emotional function (chi 2 = 6.213, P = .045). This
      study indicates that it is feasible to implement consultative interdisciplinary
      team care in the acute-care hospital, but that its efficacy may be limited when
      applied to an unselected group of older patients.

PMID- 2229860
TI  - The Senior Care Study. The optimal use of medications in acutely ill older
      patients.
AB  - Geriatric assessment units have improved pharmacotherapy for their patients by
      decreasing the number of medications prescribed. The Senior Care Study, a
      randomized controlled trial, compared a multidisciplinary-team approach to
      patient care to the standard medical practice of the institution. As a part of
      the trial, the effectiveness of an interdisciplinary team intervention in
      improving the use of medications was studied. Study goals were to decrease
      medications used, decrease unnecessary medications, and improve medication
      choices in our acutely ill inpatient population. A pharmacist interviewed all
      experimental patients and patient records, and presented medication concerns and
      recommendations at a team conference. MEDICATIONs were counted on admission and
      on the third day, sixth week, and third month after randomization. MEDICATIONs
      were paired with patient problems. MEDICATION: problem pairs were judged as
      inappropriate choices if there were potential side effects that would affect
      patient function, and if better alternatives were available. The 215 control and
      221 experimental patients in the study were similar in age, sex, place of origin,
      and number of medications on admission. Experimental patients took fewer
      medications than controls on the third day (5.3 versus 5.9, P less than .05).
      Experimental patients received fewer multiple unpaired medications (11% versus
      19%, P less than .025) and fewer inappropriate medication choices (20% versus
      37%, P less than .005). The results suggest that the team intervention was
      effective in improving pharmacotherapy in the acute-care setting.

PMID- 2229861
TI  - Cognitive function testing in comprehensive geriatric assessment. A comparison of
      cognitive test performance in residential and clinic settings.
AB  - Tests of cognitive function are frequently used in geriatric assessment, but the
      effect of test setting has rarely been explored. To determine the effect of
      testing site on the performance of elderly patients undergoing a comprehensive
      geriatric assessment, we administered the Mini-Mental State Exam to 116 geriatric
      patients in the clinic and at their residence. Their cognitive abilities varied
      from normal to severely impaired. The patients' scores were 1.5 +/- 3.6 (mean +/-
      SD) higher at their residence. The clinical importance of a difference in score
      of 1.5 is not clear. For this reason a second analysis was performed in which a
      difference in scores of five points or greater between settings was considered
      clinically meaningful. Twenty-five percent (29 of 116) differed by five points or
      more. Of these 29 patients, 22 (76%) tested better in the residential setting.
      These differences were statistically significant (P = .001). We conclude that the
      testing site may affect test performance and that in-home assessment may reveal
      the optimal cognitive function of geriatric patients.

PMID- 2229862
TI  - Reference values for the Mini-Mental State Examination (MMSE) in octo- and
      nonagenarians.
AB  - The Mini-Mental State Examination (MMSE) was used in a population survey of all
      inhabitants of Leiden, the Netherlands, over 85 years (n = 1258). In this paper
      we report on 532 subjects without neurological or psychiatric disease. Results
      show that the median score and lowest quartile cut-off score remain high until
      the tenth decade (median score = 28, lowest quartile cut-off score = 26). Thus
      age, in itself, is not a major limitation in using the MMSE. In this study a
      comparatively low level of education (the majority had 6 to 7 years of education)
      did not affect the results on the MMSE in a negative way, nor did we find an
      association with the use of psychoactive drugs.

PMID- 2229863
TI  - Assessing treatment decision-making capacity in elderly nursing home residents.
AB  - Clinicians usually employ indirect measures of cognitive and physical function in
      order to assess medical decision-making capacity. We tested a reference group of
      well elderly (Mini-Mental State Exam [MMSE] score = 29.1 +/- 0.8, mean +/- SD),
      for their understanding of three increasingly complex, hypothetical treatment
      situations or "vignettes"--use of a hypnotic, need for thoracocentesis, and
      desire for CPR. From this, we have developed a more direct, Guttman-like
      assessment of decision-making capacity. Of 51 Veterans Affairs nursing home
      residents (MMSE score = 22.4 +/- 6.9), only 33.3% demonstrated intact decision
      making capacity by this method, whereas 77% were felt by their primary physicians
      to be capable of giving consent for oral surgery; 37.3% had very impaired
      decision-making capacity; and 29.4% were intermediate in this ability. Judged
      against our more direct assessment of decision-making capacity, primary
      physicians' judgment of capacity for consent was 31% to 39% sensitive in
      identifying impaired decision-making and the MMSE was 53% to 63% sensitive. These
      measures were 100% and 82% to 83% specific in identifying intact decision-making
      capacity, respectively. We conclude that (1) more directly assessed decision
      making capacity varies noticeably among elderly nursing home residents and
      correlates in only limited fashion with frequently used cognitive screening
      methods; and (2) cognitive screening tests underestimate the prevalence of
      impaired decision-making capacity in this population. For informed consent and
      advance directives, our study suggests that decision-making capacity should be
      directly, rather than indirectly, assessed.

PMID- 2229864
TI  - An objective measure of physical function of elderly outpatients. The Physical
      Performance Test.
AB  - Direct observation of physical function has the advantage of providing an
      objective, quantifiable measure of functional capabilities. We have developed the
      Physical Performance Test (PPT), which assesses multiple domains of physical
      function using observed performance of tasks that simulate activities of daily
      living of various degrees of difficulty. Two versions are presented: a nine-item
      scale that includes writing a sentence, simulated eating, turning 360 degrees,
      putting on and removing a jacket, lifting a book and putting it on a shelf,
      picking up a penny from the floor, a 50-foot walk test, and climbing stairs
      (scored as two items); and a seven-item scale that does not include stairs. The
      PPT can be completed in less than 10 minutes and requires only a few simple
      props. We then tested the validity of PPT using 183 subjects (mean age, 79 years)
      in six settings including four clinical practices (one of Parkinson's disease
      patients), a board-and-care home, and a senior citizens' apartment. The PPT was
      reliable (Cronbach's alpha = 0.87 and 0.79, interrater reliability = 0.99 and
      0.93 for the nine-item and seven-item tests, respectively) and demonstrated
      concurrent validity with self-reported measures of physical function. Scores on
      the PPT for both scales were highly correlated (.50 to .80) with modified Rosow
      Breslau, Instrumental and Basic Activities of Daily Living scales, and Tinetti
      gait score. Scores on the PPT were more moderately correlated with self-reported
      health status, cognitive status, and mental health (.24 to .47), and negatively
      with age (-.24 and -.18). Thus, the PPT also demonstrated construct validity. The
      PPT is a promising objective measurement of physical function, but its clinical
      and research value for screening, monitoring, and prediction will have to be
      determined.

PMID- 2229865
TI  - Hierarchical measures of physical function in ambulatory geriatrics.
AB  - Brief and uncomplicated methods for obtaining information on functional status
      would facilitate the assessment of older patients. We evaluated the potential
      usefulness, reliability, and validity of four hierarchical measures of physical
      function in 123 elderly subjects seen in four ambulatory geriatrics settings.
      Although the vast majority (83.2%) of subjects were fully independent on the Katz
      Activities of Daily Living Scale, a broader scope of functional difficulty was
      reported on the Spector-Katz, five-item OARS, and Rosow-Breslau scales. The three
      scales all had either borderline or more acceptable coefficients of scalability
      (0.57-0.77); the hierarchical order of items was not observed in 5.3% to 13.6% of
      subjects. Combining items from these established measures resulted in two new
      scales with acceptable scalability and construct validity; however, some errors
      in item order persisted. Although their ease of administration is clearly
      advantageous, clinicians using short hierarchical scales to assess functional
      status of older patients should be aware of their limitations.

PMID- 2229866
TI  - Timed manual performance in a community elderly population.
AB  - The extent of functional disability measured by performance of a series of simple
      manual tasks was determined in 1,286 elderly people, aged 66 to 98, who resided
      in central North Carolina. Missing data left 1,106 subjects for analysis. Poor
      manual performance was defined by either of two criteria: (1) inability to
      complete all the test items, or (2) taking longer than 350 seconds to complete
      the test. Using the first criterion, 113 persons (10.2%) were poor performers.
      When the two writing items were omitted from the analysis, 28 persons (2.4%) were
      in the poor performance group. Of the 993 persons who completed all items, 59
      persons (5.9%) performed poorly. Using both criteria, the extent of functional
      disability was 16.1%; excluding the writing items, the extent of poor performance
      was 8.3%. Compared to those who performed well, those who performed poorly were
      older, poorer, less educated, more likely to be black, and less healthy. Because
      manual ability correlates highly with functional dependency and identifies those
      at risk for increased care needs, the magnitude of manual dysfunction noted in
      this survey has important implications for care providers and policy-makers.

PMID- 2229867
TI  - The age-associated decline in glomerular filtration in healthy normotensive
      volunteers. Lack of relationship to cardiovascular performance.
AB  - Whether the well-documented age-associated decline in the glomerular filtration
      rate, manifest as a decline in creatinine clearance, is secondary to an age
      related change in cardiovascular performance is at present unknown. To answer
      this question, we measured arterial blood pressure, 24-hour creatinine clearance,
      and cardiac output determined from gated cardiac blood pool scans in the sitting
      position in healthy normotensive men (n = 75) and women (n = 42) (ages 25 to 82
      years), from the Baltimore Longitudinal Study on Aging. These subjects were
      selected for the absence of cardiovascular disease, renal disease, and
      confounding medications. By linear regression analysis, creatinine clearance,
      expressed in mL/min/m2, declined cross-sectionally with age (creatinine clearance
      = 90 -0.33[age], r = .31, P less than .001), whereas systolic blood pressure in
      mm Hg increased with age (systolic blood pressure = 111 + 0.27[age], r = .30, P
      less than .001); cardiac output in L/min/m2 did not vary with age (r = .03, P =
      .74). In stepwise multiple regression analysis with age, cardiac index, and
      systolic blood pressure as independent variables and creatinine clearance as the
      dependent variable, only age was a significant predictor of creatinine clearance.
      (F = 11.31, DF + 116, r = .30, P less than .001). Thus, the age-associated
      decline in creatinine clearance is not modulated by changes in cardiac index or
      systolic blood pressure in healthy normotensive subjects.

PMID- 2229868
TI  - Foci of increased T2 signal intensity in MR images of healthy elderly subjects. A
      follow-up study.
AB  - An 18-month follow-up study was conducted on 26 healthy elderly subjects with and
      without foci of increased T2 signal intensity on MR imaging. The subjects did not
      differ with respect to health status or cognitive performance as measured by the
      Cognitive Subscale of the Cambridge Mental Disorders of the Elderly Examination
      and the Mini Mental State Examination at follow-up. There was a significant
      decline in performance on the Digit Symbol Substitution Test in subjects who had
      evidence of T2 foci compared to the performance of subjects without T2 foci. This
      may indicate that the presence of T2 foci is correlated with subtle difficulties
      in learning and memory.

PMID- 2229869
TI  - Characteristics of an elderly driving population referred to a geriatric
      assessment center.
AB  - A retrospective, case-control study was performed to determine the
      characteristics of elderly drivers referred to an outpatient geriatric assessment
      center. It was hypothesized that the driving population was operating at a higher
      cognitive and functional level than nondrivers. One hundred eighty-two subjects
      meeting the entry criteria were studied. Twenty-three percent of the subjects
      were driving at the time of their assessment. Compared to nondrivers, drivers
      were younger (P = .0001), were more likely to be male (P = .003), scored higher
      on a mental status examination (P = .0001), and were more independent in Physical
      and Instrumental Activities of Daily Living (P less than .0001). Despite these
      findings, the mean Folstein Mini-Mental score for drivers (23.7) was below
      normal; 40% of drivers were diagnosed as having Alzheimer's dementia at the time
      of their evaluation, and over 26% of the drivers needed help with either dressing
      or bathing. The frequency of impaired elderly drivers in this referral setting
      was high. The authors conclude that conditions that affect the driving task are
      common in geriatric assessment centers. Prospective studies of elderly drivers
      are needed to answer the difficult question of who among the elderly should
      drive.

PMID- 2229870
TI  - Osteoporosis. New insights from bone densitometry.

PMID- 2229871
TI  - Osteoporosis made easy.

PMID- 2229872
TI  - An additional letter on CPR in nursing homes.

PMID- 2229873
TI  - Another swing of the pendulum.

PMID- 2229874
TI  - Postoperative erythropoietin levels.

PMID- 2229875
TI  - Foundations of psychoanalysis reconsidered.
AB  - Grunbaum's approach to psychoanalysis suffers from several difficulties. It
      imposes a standard of logical reductionism and methodological purity that not
      only violates the nature of psychoanalytic knowledge, but imposes an invalid
      standard of verification and scientific confirmation. It utilizes a brand of
      dichotomous reasoning that forces psychoanalytic propositions into artificial
      positions that do not reflect the actuality of analytic practice. It imposes a
      standard of verification that is impossible for psychoanalysis, along with all
      forms of psychological knowledge, to reach. It visualizes psychoanalysis as
      encompassing only one form of knowledge of human psychic life, forcing it into a
      model that eliminates other aspects of the psychoanalytic process, so that
      psychoanalysis is subjected to criticism only on one dimension among several--a
      kind of psychoanalytic straw man. The psychoanalysis that is so impaled often is
      difficult for the psychoanalytic practitioner to recognize. To the extent that
      Grunbaum's skillful and highly informed criticism of the philosophical bases of
      psychoanalysis encounters these difficulties, the value of his argument falls
      short of providing a useful basis for advancing psychoanalytic knowledge and
      particularly for promoting the quest for pertinent standards of validation within
      psychoanalysis.

PMID- 2229876
TI  - "Meaning" connections and causal connections in the human sciences: the poverty
      of hermeneutic philosophy.
AB  - In much of psychoanalytic theory and therapy, Freud repeatedly inferred a causal
      connection between thematically kindred events by relying on the kinship between
      their thematic contents. This paper strongly endorses his search for causal
      explanations. But it argues in detail that (1) his causal inferences from
      thematic connections rest on an important fallacy, which undermines major
      etiologic conclusions in psychoanalysis; (2) a related, weighty inferential error
      is damaging to the Freudian theory of transference, when it infers the pathogenic
      role of an early childhood scenario from the thematic reenactment
      (recapitulation) of that scenario in the adult patient's interactions with the
      analyst, and with other people. Both arguments draw on subject matter in
      psychoanalysis, physics, evolutionary biology, common-sense psychology, history,
      and medicine to arrive at a fundamental caveat for all of the sciences: Even when
      the thematic kinship (or so-called "meaning connection") between events is indeed
      of very high degree, this fact itself does not license the inference of a causal
      linkage between these events. A corollary of this result is that we must reject
      the accusation of Karl Jaspers and the hermeneutic philosophers that Freud's own
      conception of the psychoanalytic enterprise suffered from a "scientistic self
      misunderstanding."

PMID- 2229877
TI  - The rhetorical voice of psychoanalysis.
AB  - The rhetorical voice of psychoanalysis has a long history and has only recently
      come to be seen as a special feature of the theory. Its beginnings can be found
      in Freud's earliest pleadings for the usefulness of metaphor and analogy,
      although he felt that they were largely provisional and would eventually be
      replaced by more durable concepts. We have begun to see problems in replacing the
      central metaphors; the rhetorical base of psychoanalysis may be more enduring
      than we thought. While our metaphors may never provide epistemic access to the
      stuff of the mind, they can and do point to specific clinical encounters. Ways
      must be found to expand our rhetorical treasure chest and develop language even
      better suited to our concepts and observations.

PMID- 2229878
TI  - Helping patients by analyzing self-criticism.
AB  - This paper is addressed to patients' need for help with punitive self-critical
      attitudes. Such help has not always been sufficiently provided by psychoanalysts,
      owing to an unrecognized failure of neutrality. Historically, a gradual
      overemphasis on the concept of an unconscious sense of guilt has acted as a
      barrier to the appreciation of shame. An alternative concept, punitive
      unconscious self-criticism, which stands in contrast to constructive self
      criticism and is common to the painful affects of guilt, shame, humiliation, and
      depression, can facilitate helpful analytic treatment. Heinz Kohut's
      contributions are examined. His analytic stance is differentiated from his
      theories of development. In the former, characterized by an affirmative attitude,
      he takes a position of functional neutrality toward shame and pays consistent
      though unstated attention to the effects of punitive unconscious self-criticism.
      The affirmative attitude can be employed without adoption of Kohut's self
      psychology, i.e., without abandoning the basic psychoanalytic approach to mental
      conflict and development. The concept of punitive unconscious self-criticism and
      the concept of divergent conflict, provide sufficient explanatory power. Clinical
      examples are used to illustrate these ideas.

PMID- 2229880
TI  - Followup of psychoanalysis five to ten years after termination: III. The relation
      between the resolution of the transference and the patient-analyst match.
AB  - As part of a long-term followup study of the outcome of psychoanalysis, we
      examined the relation between the extent of resolution of the transference at
      termination and the characteristics of the patient-analyst match. For twelve of
      the seventeen patients interviewed five to ten years after termination of
      psychoanalysis, the researchers found that the patient-analyst match played a
      role in the outcome of the analysis. Illustrations of the influence of the match
      in cases where the transference was resolved and those where it was not are
      presented.

PMID- 2229879
TI  - Followup of psychoanalysis five to ten years after termination: II. Development
      of the self-analytic function.
AB  - Thirteen of seventeen patients in followup interviews five to ten years after the
      termination of analysis reported the development or refinement of a self-analytic
      capacity. According to the accounts of these patients, there did not appear to be
      a direct relation between the attainment of a self-analytic function and the
      extent of resolution of the transference neurosis or the maintenance of
      therapeutic gains after treatment.

PMID- 2229881
TI  - Neutrality in the analysis of action-prone adolescents.
AB  - An adolescent patient's action during analysis reflects both neurotic conflicts
      and the developmentally determined task of establishing an integrated self
      representation. Concern for the consequences of the action often provokes the
      analyst to respond, covertly, with interventions intended to change the action
      through influence rather than understanding. This can lead to a distortion of the
      analytic process which, in itself, may be an enactment of the developmental
      conflict. Examination of such interventions reveals a lack of analytic neutrality
      and an unconscious participation in the patient's neurotic and developmental
      conflicts. Clinical material from the analyses of two fourteen-year-old girls and
      a sixteen-year-old boy is presented to illustrate and support this hypothesis.

PMID- 2229882
TI  - An exploratory study of mother-child interaction during the second year of life.
AB  - The aim of this study was to further understanding of development during the
      crucial second year of life. The study employed a naturalistic, semistructured
      situation for the observation of mother-child behavior. The experimental stimulus
      was the progressive diversion of the mother's attention away from her child. This
      diversion evoked separation anxiety in the child and the individual and
      interactive regulatory behaviors of the mother-child pair. Concurrently, the
      child's behavior was observed in a play group situation. One set of rating scales
      was devised for assessment of the mother-child interaction, and another set for
      assessment of the child's functioning in the play group. The major hypothesis was
      that maternal and child behaviors that foster the child's successful handling of
      phase-specific stresses and developmental tasks will be positively correlated
      with the child's functioning in the play group. This hypothesis is supported by
      the findings of the study.

PMID- 2229884
TI  - On the girl's psychosexual development: reconsiderations suggested from direct
      observation.
AB  - Following on two decades of longitudinal direct observation of young children,
      revisions of two component parts of psychosexual theory seem warranted. First,
      direct observation does not support the concept of a "phallic" phase as being
      representative of the girl's first genital phase. Observational findings
      challenge "phallic" concept-dependent hypotheses Freud proposed in 1925,
      including how the girl enters her Oedipus complex as well as the nature of her
      wish to have a baby. In the children observed by the author, phallic aggression
      was not manifest as much in girls as in boys, between the ages of two and four.
      Second, it is proposed we put aside the "phallic" phase concept in our
      considerations of the girl's dynamics and that we heighten our awareness of her
      early experiences of ambivalence--which lie at the heart of the oedipal conflict-
      and which leads to a formulation of superego development in the girl more
      compatible with clinical findings.

PMID- 2229883
TI  - Does a panel discussion on analytic technique have any effect on an audience of
      analysts?
AB  - This is a report of a followup study to determine whether attending a panel
      discussion group on post-termination patient-analyst contact influenced the
      analytic audience's attitude on that subject. A questionnaire about post
      termination contact was given to 21 analysts who did not attend the discussion
      group and to 45 analysts before they attended. The same questionnaire was given
      again to both groups six months later. Responses by the 21 analysts who had not
      been present remained essentially unchanged. Responses of the 45 analysts, after
      attending the discussion group, when compared to responses of an earlier group of
      300 analysts, showed an increase in the proportion of analysts who said, in
      reference to psychoanalytic psychotherapy patients, either that they hoped to
      hear from the patient or that they would like the patient to return to see them
      at some specified period after treatment termination. Attendance at the
      discussion seems responsible for a significant effect on the analytic audience's
      attitude on post-termination patient-analyst contact.

PMID- 2229885
TI  - The nature of the therapeutic action of psychoanalysis: how analysis works. Panel
      report.

PMID- 2229886
TI  - Sadism and masochism in neurosis and symptom formation. Panel report.

PMID- 2229887
TI  - Sympathoadrenal preganglionic neurons in the adult rabbit send their dendrites
      into the contralateral hemicord.
AB  - Sympathetic preganglionic neurons projecting to the adrenal medulla of the adult
      rabbit were retrogradely labelled with horseradish peroxidase. Preganglionic
      neurons were located in thoracic spinal cord segments T3-T12, peaking in number
      at T8, and only ipsilateral to the side of injections. However, retrogradely
      labelled dendritic processes of preganglionic neurons in the intercalated nucleus
      pars paraependimalys, the intercalated nucleus, and possibly even in the
      intermediolateral cell column, were observed in the contralateral hemicord. This
      suggests that the activity of sympathoadrenal preganglionic neurons could be
      modulated by both ipsilaterally and contralaterally descending pathways.

PMID- 2229888
TI  - Colonic transit time and anorectal manometric anomalies in 19 patients with
      complete transection of the spinal cord.
AB  - In order to determine the relative importance of sympathetic and parasympathetic
      centers in the control of colorectal motility, colonic transit and anorectal
      motility were studied in 19 patients with complete spinal cord transection: group
      1 (n = 5) where transection was above T9; group 2 (n = 6) where transection was
      between T9 and L2; group 3 (n = 8) where transection involved S2-S4. Colonic
      transit time was calculated by the radiopaque markers. Methods and results were
      compared with those of eight controls, all bedridden for non-digestive surgery.
      Anorectal motility was investigated by anorectal manometry, and results were
      compared with those of 17 healthy controls. Both mean right and left colonic
      transit times were not different in the three groups of patients and the
      bedridden control group. Mean rectosigmoid and total transit time increased in
      groups 2 and 3. In five patients of group 3 the mean anal canal (lower part)
      pressure was higher than in controls. Recto-anal inhibitory reflex was present in
      all patients, but their was no correlation in group 3 between the volume of
      rectal distension and both amplitude and duration of the recto-anal inhibitory
      reflex, and in group 1 between rectal distension and the duration of the recto
      anal inhibitory reflex. Rectosigmoid transit time increased when sympathetic and
      parasympathetic spinal centers are injured, suggesting the importance of this
      extrinsic nervous control; right and left colonic transit are not affected by
      spinal cord lesion suggesting that the distal colon but not the proximal colon,
      is under spinal cord nervous control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229889
TI  - The innervation of tracheal smooth muscle in the ferret.
AB  - The innervation of tracheal smooth muscle in the ferret has been studied by
      monitoring pressure changes in a fluid-filled segment of trachea in
      pentobarbitone anaesthetized animals. Stimulation of the peripheral cut end of
      the vago-sympathetic trunk elicited increases in trachea segment pressure only
      when activity was evoked in non-myelinated efferent axons, myelinated axons were
      without effect. Such excitatory responses were blocked by atropine. After
      atropine and elevation of trachealis muscle tone with 5-hydroxytryptamine,
      stimulation of the vago-sympathetic trunk produced a fall in tracheal segment
      pressure. These inhibitory responses were completely blocked by bretylium
      tosylate in six animals and markedly reduced in a seventh. It is concluded that
      contraction of tracheal smooth muscle in the ferret is cholinergically mediated
      and solely dependent on activity in non-myelinated vagal efferent axons and that
      inhibition is mediated by noradrenaline released from sympathetic nerve endings.
      A non-adrenergic inhibitory system would not appear to be present in the ferret.

PMID- 2229890
TI  - Interaction between cholinergic and adrenergic pathways of the hypothalamic
      ventromedial nucleus on cardiovascular regulation.
AB  - In this work we studied the possible interaction between cholinergic (muscarinic
      and nicotinic) and adrenergic (alpha 1- and beta-adrenergic) pathways of the
      hypothalamic ventromedial nucleus on the regulation of arterial pressure and
      heart rate in conscious normotensive rats. Mean arterial pressure and heart rate
      were recorded in rats with cerebral chronic stainless steel cannulae implanted
      directly into the ventromedial nucleus. The changes in arterial pressure and
      heart rate produced by the injection of the cholinergic agonist (carbachol or
      nicotine) into the ventromedial nucleus were studied before and after the
      injection of prazosin (an alpha 1-adrenergic antagonist) or propranolol (a beta
      adrenergic antagonist) into this same area. The injection of carbachol (2 nmol)
      or nicotine (40 mmol) into the ventromedial nucleus induced pressor and
      tachycardia responses. Previous treatment with prazosin or propranolol blocked
      the pressor response to carbachol and nicotine. Propranolol also abolished the
      tachycardic response to carbachol or nicotine, but prazosin reduced only the
      tachycardia produced by carbachol into the ventromedial nucleus. These results
      show an interaction between cholinergic and adrenergic pathways of the
      ventromedial nucleus affecting cardiovascular regulation and suggest that the
      alpha 1- and beta-adrenoceptors of this nucleus are involved in these responses.

PMID- 2229891
TI  - Effect of urethane anesthesia on the micturition reflex in capsaicin-treated
      rats.
AB  - Cystometry was performed on rats with a chronically implanted intravesical
      catheter (2 days before cystometry) before and after induction of urethane
      anesthesia. Four groups of animals were investigated: group A, vehicle-treated;
      group B, capsaicin-treated as adults (50 mg/kg s.c.) 4 days before cystometry;
      group C, capsaicin-treated as adults (125 mg/kg s.c.) 4 days before cystometry;
      and group D, capsaicin-treated as newborns (50 mg/kg) 2 months before. Rats of
      group D had a markedly enlarged bladder. Before induction of urethane anesthesia,
      the bladder capacity of rats of groups A, B and C was not significantly different
      from each other, while that of rats of group D was larger than controls. After
      induction of anesthesia bladder capacity in groups B and C was significantly
      increased as compared to group A and micturition was abolished in group D
      (overflow incontinence). Amplitude of micturition contraction was significantly
      reduced in all groups after induction of anesthesia but was unaffected by
      capsaicin pretreatment. It is concluded that the facilitatory action of capsaicin
      sensitive nerves on micturition threshold is more evident in anesthetized than
      awake rats and that capsaicin-resistant bladder afferents are more sensitive to
      the depressant action of urethane than the capsaicin-sensitive ones.

PMID- 2229892
TI  - Controlled bradycardia induced by nasal stimulation in the muskrat, Ondatra
      zibethicus.
AB  - Respiration was disrupted and bradycardia induced in anesthetized muskrats by
      stimulating the nasal cavity with a stream of either water or various
      concentrations of ammonia vapors. When responses induced by either ammonia or
      water were compared, ammonia vapors were considered preferable because the
      responses could be maintained reliably through relatively rapid periods of
      stimulation, and the post-stimulus recovery of heart rate and respiration was
      more predictable. Moreover, the bradycardia induced in the first 5 s of
      stimulation by dilutions of ammonia vapors was graded. After injections of
      lidocaine were made into the nucleus tractus solitarius a profound bradycardia to
      ammonia stimulation persisted despite disruption of normal respiratory rhythms
      and an inhibition of the baroreceptor reflex induced by phenylephrine
      administration. These results show that ammonia vapors stimulating the nasal
      chambers effectively elicit cardio-respiratory adjustments in anesthetized
      muskrats and that the bradycardia may be controlled by varying the intensity of
      the peripheral stimulus. The trigeminal contribution for this is emphasized since
      the bradycardia persists after reversible blockade of the solitary complex. These
      data suggest that the trigeminal input to cardiac motorneurons is via relatively
      few synapses and is over circuits which run parallel to those modulating cardiac
      activity in response to chemoreceptors, baroreceptors and pulmonary afferent
      fibers.

PMID- 2229893
TI  - Effects of calcitonin gene-related peptide and vasoactive intestinal peptide on
      nicotine-induced sweating in man.
AB  - The effects of two neuropeptides, calcitonin gene-related peptide and vasoactive
      intestinal peptide on nicotine-induced sweating in human skin were investigated.
      Intradermal injection of nicotine induced local sweating and each peptide,
      administered together with nicotine, inhibited these responses in a concentration
      dependent manner. The concentration of calcitonin gene-related peptide for
      threshold and half-maximum inhibition were about 10(-10) M and 10(-8) M,
      respectively, while those of vasoactive intestinal peptide were approximately 10(
      9) M and 10(-7) M, respectively. The results suggest that calcitonin gene-related
      peptide and vasoactive intestinal peptide have inhibitory effects on the
      nicotinic action, and release of endogenous calcitonin gene-related peptide
      and/or vasoactive intestinal peptide may influence sweating in human skin under
      physiological conditions in vivo.

PMID- 2229894
TI  - [Scintigraphy of the lacrimal ducts: the value of the lateral view in the
      postoperative period].
AB  - Lacrimal scintillography, a simple, non traumatic, and physiological method, has
      been for a long time an useful exploration in the study of lacrimal excretory
      pathology. It allows an accurate diagnosis especially in the case of functional
      stenosis and, due to its ability to indicate the exact seat of obstruction, this
      technique is able to determine the surgical treatment required. This study
      underlines the contribution of lacrimal scintillography in the control of
      surgical anastomosis permeability, because of a modification in the initial
      technique: the use of scintillography in employing the lateral view rather than
      the front view, usually used, permits a better visualisation of the new
      surgically created excretory passage, particularly in the posterior area of nasal
      fossae.

PMID- 2229895
TI  - [Epikeratoplasty without sutures using collagen IV lens in monkeys: description
      of the surgical technic].
AB  - The authors describe their original epikeratoplasty technic without sutures which
      is compatible with the use of collagen IV lens. They describe the first four
      observations of primates operated on using this technic. At first the epithelium
      is removed at the cornea center and a trepanation is made of 4 mm diameter and
      0.1 mm depth. The bottom of the trepanation is then cut horizontally, and the
      periphery of the lens is put in the cornea stroma. Later the epithelium will
      recover the collagen lens. The lens is perfectly set in the cornea. We don't use
      any suture and so we avoid astigmatism and neovascularisation. The follow-up
      consisted of biomicroscopic examination photography, specular microscopy,
      pachymetry, photokeratoscopy (Nidek System) tonometry and histology. Clinical
      observance showed a perfect lens tolerance. The cornea is immediately transparent
      and within a week epithelial cells recovered the lens of three animals out of
      four. The photokeratoscopy study proved the important cornea refraction
      modification. This technic is reversible and the lens can be exchanged. A study
      of histology has begun and already shows a pluristratified epithelium. Further
      studies will test the biomaterial stability and ultra structural relations
      between the collagen IV lens and epithelial cells.

PMID- 2229896
TI  - [Keratoplasty in children. Analysis of 127 surgically treated eyes over 10
      years].
AB  - One hundred and twenty-seven eyes of children less than 15 years of age underwent
      keratoplasty with one to ten years follow-up. The cases were divided into three
      groups of age, and the results are compared. Graft transparency has a direct
      correlation with the age of patient and type of corneal disease. Penetrating
      keratoplasty carries a better surgical and visual prognosis when carried out late
      in childhood. This is not only the fact of the particular etiologies found in
      this subgroup of age. When adjusting the results to the both factors age and
      etiology, we have demonstrated their independent. The visual benefits of corneal
      transplantation in selected cases in children appear to outweigh the difficulties
      and problems engendred by this procedure.

PMID- 2229897
TI  - [Treatment of dry eye by temporary punctum plug. Comparison with a control
      group].
AB  - 35 patients with chronic dry eye were treated with punctum plug on one side only.
      The other side was a control: after simulation dilatation, the patient underwent
      a simulation insertion. This is an open study in which only the patient ignored
      the reality of treatment. The study was prospective. 28 females and 7 males were
      enrolled in this study. The age' average was 53. The follow-up average is 5.3
      months. The etiologies were: idiopathic dry eye: 10 cases, Sjogren's syndrome: 11
      cases, drug induced dry eye: 6 cases, filamentous keratitis: 4 cases. Other: 4
      cases. Enrollment criteria were: functional symptomatology not answering to
      topical therapy (physiological serum drops) associated with one or more of the
      following items: positive Rose Bengal staining and/or Schirmer lower than 5 mm in
      5 min and/or filamentary keratitis. Subjective improvement is significantly
      better after closing the two puncta on the same side (77%) than the other side
      (placebo) (17%) (p less than 0.001). This difference is also demonstrated for the
      improvement of Rose Bengal staining (p = 0.068) and for Schirmer's test (p =
      0.002). These results demonstrated the effectiveness of this therapy versus
      placebo. Results after closing the 2 puncta on the same side are better than
      after closing one punctum.

PMID- 2229898
TI  - [Complications of punctum plug in the symptomatic treatment of dry eye].
AB  - 76 patients with dry eyes were treated by mechanical obstruction of lacrymal
      puncta. The sex ratio is: 62 females and 14 males. The age average was 55,
      ranging from 12 to 88. The etiologies were: Sjogren's syndrome: 16 cases (21%);
      filamentous kerato-conjonctivitis sicca: 12 cases (15%); anxiolytical and anti
      depressant treatments: 10 cases (13%); complicated viral kerato-conjonctivitis: 4
      cases (5%); post radiotherapy dry syndrome: 3 cases (4%); idiopathic and various
      etiologies: 31 cases (40%). The 149 plugs are completely made of hydrophobic
      silicone; 20 had a barb inclined on the neck axis. Insertion was achieved after
      tropical anesthesia in 90% of the cases. 121 plugs (81%) did not lead to any
      anatomical complication (the average duration remaining on time interval of
      implantation per plug was of 5 months). Functional tolerance depends on the
      quality of plug-punctum adjustment. Plug protrusion is the main cause of
      intolerance and disappearance. The complications were: rupture of punctum during
      dilation: 1%; suppurative canaliculitis: 1.3%; disappearance: 16%; epiphora: 22%.
      No intra-canalicular migration was observed. We check canalicular permeability in
      26 cases, after loss or removal: che was normal 23 times (average time-interval:
      5 months). We had 3 cases of canalicular stenosis after 4 months, 5 months and 18
      months of intubation.

PMID- 2229899
TI  - [Treatment of superficial herpes simplex keratitis with vidarabine (Vira A):
      multicenter study of 100 cases].
AB  - The efficacy of 3% Ara-A ophthalmic ointment (Vira A) has been evaluated on 100
      epithelial herpetic keratitis; the poor intra-ocular penetration of Ara-A
      explains the exclusion of stromal keratitis and kerato-unveitis. Patients were
      treated 5 times a day until complete epithelial healing of ulcers, then twice a
      day during 7 days. Healing was obtained within 10.6 days for 87% of the patients,
      who have been treated by Ara-A at first (n = 77) or after failure of IDU or of
      IDC (n = 23). The healing rate was higher for the 52 first ocular episodes (92%)
      than for the 48 recurrences (81%); it decreases to 77% for recurrences after
      failure of IDU or IDC. Geographic ulcers heal in 76% of cases only. Their length
      has no influence on their healing. The longest healing time, 10.6 days, can be
      explained by the long period of time before beginning to apply Ara-A, 12.8 days:
      significative correlation between both periods of time is highlighted and shows
      the advantage of an early treatment. The need for a local corticotherapy (n = 8)
      does not hinder healing in 15.5 days. Two weeks after discontinuation of the
      treatment, 3 patients presented a relapse, sensitive to a 2nd Ara-A course; a
      maintenance treatment, superior to 7 days, is necessary. Tolerance to Vira A
      ointment is good. Indications of Ara-A during ocular herpes are superficial
      keratitis, especially those resistant to IDU or, from experimental data, to ACV,
      and their prevention by a possible long term treatment.

PMID- 2229900
TI  - [Malignant nasal oncocytoma disclosed by mucocele of the lacrimal sac with
      hemolacrimia].

PMID- 2229901
TI  - [Epithelioma of the medial canthus. Retrospective study of 47 surgically treated
      cases].
AB  - The authors report a retrospective study of 47 cases of carcinoma of the medial
      canthal area which were operated on between 1982 and 1987. Patient age and the
      histological frequency of basal cell carcinoma were similar to those of studies
      previously reported. Local extension must be evaluated at the initial clinical
      examination and computed tomography can be very useful. Frozen section for
      histopathologic study should be done if there is the least doubt. The surgical
      treatment and different methods of local reconstruction are discussed.

PMID- 2229902
TI  - [Idiopathic preretinal macular fibrosis. Study of correlation between morphologic
      changes and visual acuity].
AB  - Idiopathic preretinal macular fibrosis is an affection characterized by the
      development of preretinal membranes, macular distortion and, sometimes, macular
      edema. These changes as well as the consequent reduction of the visual acuity may
      vary very widely from one case to another. In this study, the degree of
      correlation among the various retinal morphological changes and among them and
      the visual acuity was investigated. This study shows that the importance of
      retinal distortion is strictly dependent on the appearance of the preretinal
      membranes that the appearance of the preretinal membrane and the importance of
      the retinal distortion are equally valid predictors of visual acuity, that the
      macular edema (defined as fluorescein leakage) depends mainly on the degree of
      contraction of the preretinal membrane and that such leakage does not represent
      the best parameter in order to predict the visual acuity.

PMID- 2229903
TI  - Symptomatic bipartite sesamoids.
AB  - The great toe sesamoids have been well reported in the literature, in every
      aspect. Much has been written about the normal anatomic variation of partite
      metatarsophalangeal sesamoids. It is the purpose of this article to present a
      theory explaining the common occurrence of a symptomatic partite sesamoid. The
      authors believe there is a high rate of occurrence of symptomatic partite
      sesamoids, especially when associated with hallux abducto valgus. Presented is
      information concerning the internal and external structural components of a
      bipartite metatarsal sesamoidal joint, which may inherently lead it to
      symptomatology.

PMID- 2229905
TI  - Correlation between hallux valgus angle and age.
AB  - A study was made of the relationship between the hallux valgus angle and age.
      Between January 1983 and June 1985, 464 hallux valgus operations were performed
      on 404 patients at the Department of Orthopedic Surgery at Huddinge Hospital. The
      mean age of the patients was 54 +/- 12 years (range 16 to 75). The patients were
      divided into six groups with regard to nature and extent of radiographic changes.
      Linear regression analysis was used for analysis of the correlation between age
      and hallux valgus angle. A significant correlation was found in group 1: hallux
      valgus grade 1, type I (great toe rotated, slight bunion) and group 6: hallux
      valgus grade 2, type III (great toe rotated, severe bunion and severe arthrosis).
      There was a large scatter around the lines, however, which means that age is poor
      predictor of the hallux valgus angle.

PMID- 2229904
TI  - In-situ chondrosarcoma of the foot arising in a solitary enchondroma.
AB  - Chondrosarcoma of the foot is very rare. Secondary malignant transformation of a
      solitary enchondroma of the foot occurring in a 66-year-old man is reported. A
      rapid increase in size of a previously known enchondroma and pain may suggest a
      malignant transformation. Surgical resection is the choice of therapy.

PMID- 2229906
TI  - Osteochondromatosis of the ankle.
AB  - Synovial chondromatosis is a rare condition that presents as juxta-articular
      masses which arise due to metaplasia of the synovia and formation of
      cartilaginous nodules. It will present as a monoarticular mass that is a
      chronically progressive condition without any tendency to resolve spontaneously.
      The authors present a review of the literature with a rare case study involving
      the ankle joint of a 29-year-old black male. The clinical presentation, surgical
      excision, histologic analysis, and postoperative course are discussed.

PMID- 2229907
TI  - Effects of ankle arthrodesis on the subtalar and midtarsal joints.
AB  - Proper positioning of an ankle arthrodesis is crucial, since it will allow
      compensatory motion to occur in the rearfoot complex. Arthrosis in the rearfoot
      can be expected several years after fusion; however, malalignment can potentiate
      rearfoot arthrosis and lead to a painful and nonfunctional gait.

PMID- 2229908
TI  - Scanning and light microscopic study of irrigated and nonirrigated joints
      following burr surgery performed through a small incision.
AB  - Research was conducted on young, adult male rabbits where osseous burr surgery
      was performed through a small incision using two methods of joint debris
      extrusion. Surgical joint debris was found in all specimens at 1 week following
      surgery. Also, 1 week postoperatively, the surgically untouched chondral and
      subchondral joint aspects were intact in both irrigated and nonirrigated
      specimens. There was, however, subchondral bone inflammation in all specimens but
      the nonirrigated population had a greater inflammatory subchondral infiltrate.
      The synovium was more inflamed in the nonirrigated group. Bone particles,
      observed with scanning electron microscopy, generally appeared to be only
      slightly more evident in the nonirrigated group. Metal particles were observed in
      several specimens. By 28 weeks, joint debris was practically undetectable. In the
      irrigated specimens the chondral and subchondral portions presented with
      occasional degenerative focal loss of the chondral and subchondral layers. In
      comparison, the nonirrigated group demonstrated not only occasional but moderate
      to-frequent focal loss with fissuring in the chondral and subchondral layers in
      addition to extrinsic repair of the cartilage surface. Subchondral bone
      inflammation was also more severe in the nonirrigated group. Observations from
      this project confirm that joint debris is removed through intrinsic joint
      processes and further suggests that the postoperative course of inflammation is
      not a totally abrasion-related phenomenon. The findings support the use of
      intraoperative irrigation as opposed to debris extrusion without irrigation in
      order to reduce both immediate and chronic postsurgical inflammation.

PMID- 2229909
TI  - Stenosing tenosynovitis of the flexor hallucis longus at the ankle joint.
AB  - The discussion of stenosing tenosynovitis of the flexor hallucis longus at the
      level of the ankle joint is not found in the literature with frequency. A
      thorough understanding of the involved anatomy is necessary when considering this
      condition. A strong clinical suspicion, coupled with appropriate diagnostic
      tests, is necessary to arrive at a proper diagnosis. Various treatment options
      may be considered. However, surgical decompression of the stenosed sheath
      ultimately is recommended by the authors.

PMID- 2229910
TI  - Cobb repair for tibialis posterior tendon rupture.
AB  - The tibialis posterior is the main dynamic stabilizer of the hindfoot against a
      valgus deformity. Its rupture results in hindfoot valgus with a considerable
      biomechanical disturbance and functional loss in the affected foot. A new method
      of reconstruction of this tendon is described which involves the use of half the
      tendon of tibialis anterior.

PMID- 2229911
TI  - Melorheostosis: a case report and literature review.
AB  - Melorheostosis is a rare form of cortical hyperostosis that resembles wax
      dripping down the side of a candle. This disease usually affects the long and
      short bones of an extremity. Literature review and a case report will be
      discussed with respect to incidence, clinical presentation, radiographic
      appearance, and treatment.

PMID- 2229913
TI  - Classification of tendo Achillis rupture with consideration of surgical repair
      techniques.
AB  - The author presents a classification system for complete tendo Achillis rupture.
      The system is based upon experience following 28 repairs and 102 lengthenings and
      gastrocnemius recessions. Specific surgical procedures based on this system are
      reviewed.

PMID- 2229912
TI  - Osteoblastoma of the distal phalanx of the hallux.
AB  - Osteoblastoma is a very rare bone tumor infrequently reported in the podiatric
      literature. The authors present a review of this tumor and the types of
      modalities that may be used to detect and diagnose these tumors. They also
      present a surgical approach to the resection of these bone tumors.

PMID- 2229915
TI  - Squamous cell carcinoma: a pedal case presentation.
AB  - Squamous cell carcinoma of the foot is a relatively uncommon pedal neoplasm. The
      authors discuss the etiology, metastatic rate, incidence, morphology, treatment
      and the histology of this entity. Additionally, the authors present a clinical
      case report successfully treated by surgical extirpation.

PMID- 2229914
TI  - Arthrodesis of the first metatarsophalangeal joint: a review of the literature
      and long-term retrospective analysis.
AB  - A retrospective analysis of arthrodesis of the first metatarsophalangeal joint
      was done to determine the procedure's long-term subjective and objective results.
      The authors reviewed the long-term results of arthrodesis in 25 patients with 32
      operated feet. The average age was 54.8 years (range 22 to 72 years), and the
      average length of follow-up was 31.9 months (range 12 to 84 months). The patients
      were questioned regarding pain, activity, cosmesis, and willingness to have the
      operation performed again. The subjective results were good or excellent in 26
      feet (81% success rate). The primary postoperative complaints were pain in the
      interphalangeal joint (four feet), and a callosity or pain under the first
      metatarsal head (four feet). Radiographic examination revealed that the procedure
      provided a good reduction of the hallux valgus angle (preoperative average 33.7
      degrees; postoperative average 17.4 degrees) and intermetatarsal angle
      (preoperative average 16.2 degrees; postoperative average 12.0 degrees). The
      authors believe that this procedure is a reliable, effective treatment whenever
      stability is required at the first metatarsophalangeal joint.

PMID- 2229917
TI  - Closed reduction of a proximal interphalangeal joint dislocation.
AB  - A case report involving the closed reduction of a simple dislocation of a lesser
      digit is presented. The technique of reduction is illustrated and discussed.
      Classification of both simple and complex dislocations are reviewed.

PMID- 2229916
TI  - Septic bursitis of the foot: diagnosis, management and end-result.
AB  - Septic bursitis of the foot is a disorder infrequently reported in the medical
      literature. This infrequent reporting may represent a true low incidence of
      occurrence or may be a reflection of failure to recognize and diagnose this
      condition. This paper retrospectively reviews the presentation, clinical course,
      and outcome of patients presenting with septic bursitis of the foot. The authors
      have reviewed those features of this disorder that may aid the clinician in
      diagnosis and management of this infrequent, but disabling entity. They describe
      a brief case history of 10 patients with septic bursitis of the foot, provide
      radiographic and microbacterial evaluation, and give an outcome determination.
      They make recommendations for diagnosis and treatment based upon this review of
      patients and review of the literature.

PMID- 2229918
TI  - Tumoral calcinosis with extensive pedal involvement.
AB  - Tumoral calcinosis is characterized by excessive calcified masses in the soft
      tissues of young adult extremities. The histologic and radiologic appearances are
      discussed. A 56-year-old female pathologic case is reviewed.

PMID- 2229919
TI  - Diseases of the foot: test of radiographic interpretation.

PMID- 2229920
TI  - Polyclonal stimulation of lymphocytes induced by beta blockers in the mouse:
      influences of age, sex and strain.
AB  - The immune effects of acebutolol, a beta-blocker, are investigated in various
      strains of mice. In 6-12 weeks old C57Bl/6 female mice, an increase in the number
      of immunoglobulin secreting cells is observed only at the age of 9 weeks. At that
      age, such an effect is seen neither in C57Bl/6 male mice nor in female mice from
      6 other strains including OF1 outbred mice. An increase in anti-trinitrophenol
      plaque forming cells is found in 9 week old C57Bl/6, Balb/c and CBA female mice.

PMID- 2229921
TI  - The effects of cytochalasins on lymphocytes: V. Interaction of trifluoperazine
      and cytochalasin B in inhibition of human lymphocyte proliferation.
AB  - Trifluoperazine (TFP), a phenothiazine derivative, is known to inhibit calmodulin
      mediated phenomena. We report here that TFP reversibly inhibited lymphocyte
      proliferative responses to mitogenic lectins. This inhibition was observed only
      when TFP was added during the early stages of exposure of lymphocytes to the
      stimulus. Furthermore, at suboptimally inhibitory concentrations of each
      compound, effects of TFP on lymphocyte proliferation were additive to those of
      cytochalasin B (CB). Incubation of lymphocytes in TFP (10(-5)-10(-4) M) markedly
      inhibited cytochalasin B binding to the actin associated, low affinity binding
      site without affecting its binding to the high affinity site or to the medium
      affinity site. This effect developed gradually during incubation with TFP,
      becoming demonstrable after 30 minutes reaching maximum after 30-60 min of
      incubation at 37 degrees. The findings suggest the occurrence of an interaction
      of TFP with the lymphocyte cytoskeleton, which may play a role in the impairment
      in the transmission of the mitogenic signal.

PMID- 2229922
TI  - Modulation of the interleukin 2 receptor by maternal and cord blood serum.
AB  - In this report, the potential inhibitive action, of maternal serum
      (retroplacental and peripheral), and cord blood serum on the expression of the
      Il2r has been studied. Calf and male serum were used as a control. In order to
      have an optimal Il2r expression, a previous PHA cellular stimulation was
      performed. The maternal serum's Il2r inhibitive property was measured during and
      after the pregnant period. The presence of Il2r on maternal lymphocytes, cord
      blood cells, and unrelated donor mononuclear cells has been investigated (after a
      PHA stimulation assay). The downregulated Il2r expression of neoplastic cell line
      (Hut78 cell line) under the influence of maternal serum has been observed. The
      examination of the inhibitive action due to maternal serum has suggested that a
      factor included in the IgG fraction is mainly responsible for the downregulating
      property concerning the Il2r expression. A possible mechanism for the action of
      this factor has been studied. Further experiments suggest that the addition of
      recombinant Il2 during the action of low doses of maternal IgG allows a partial
      reexpression of the Il2 receptor. However, at physiological concentrations of
      IgG, the Interleukin 2 receptor downregulation becomes irreversible.

PMID- 2229923
TI  - 3-Methylcholanthrene-induced immunosuppression in mice to Trichinella spiralis
      antigens.
AB  - The immunosuppressive effects of in vivo (subcutaneous) exposure to 40 or 80
      mg/kg 3-methylcholanthrene (MC) were examined in aryl hydrocarbon hydroxylase
      (AHH) responsive C57BL/6 (B6) and AHH non-responsive DBA/2 (D2) inbred strains of
      mice. Twenty-four hours after treatment with carcinogen or vehicle alone, animals
      were primed with crude L1 muscle larvae antigen from T. spiralis. Immune status
      was assessed in vitro after six days as antigen-specific lymphoproliferation. The
      proliferation of splenocytes from MC-treated D2 and B6 mice was significantly
      impaired compared to controls. To examine the cellular basis of the
      immunosuppression, primed splenocytes from control and MC-treated mice were
      separated into adherent and non-adherent fractions on Sephadex G-10 columns. When
      antigen-pulsed adherent cells from MC-treated B6 and D2 mice were recombined with
      control non-adherent cells from syngeneic and B6D2F1 mice, T-cell proliferation
      was significantly reduced. This suppression was not observed with the addition of
      increased numbers of adherent cells. Non-adherent cells from MC-treated mice
      showed a decreased capacity to respond to the presence of control antigen-pulsed
      adherent cells from appropriate mice. These results suggest that MC treatment has
      a similar suppressive effect on the immune responses of both B6 and D2 mice that
      involves the quality of accessory cell-T-cell interactions.

PMID- 2229924
TI  - Panax ginseng as a potential immunomodulator: studies in mice.
AB  - There has been continuing interest in the development of synthetic and natural
      compounds which modify the immune response, particularly for the treatment of
      AIDS and cancer. Panax ginseng, employed for its putative medicinal properties in
      South Asia, was examined for its immunomodulatory properties in mice. A
      systematic evaluation of multiple immune system components revealed that Panax
      ginseng stimulated basal natural killer (NK) cell activity following subchronic
      exposure and helped stimulate recovery of NK function in cyclophosphamide
      immunosuppressed mice but did not further stimulate NK activity in poly I:C
      treated mice. Other immunological parameters examined, including T and B cell
      responses were not affected. Panax ginseng provided a degree of protection
      against infection with L. monocytes but did not inhibit the growth of
      transplanted syngeneic tumor cells. Increased resistance to L. monocytogenes was
      not detected in challenged mice previously given immunosuppressive doses of
      cyclophosphamide. Taken together, these data suggest that Panax ginseng has some
      immunomodulatory properties, primarily associated with NK cell activity.

PMID- 2229925
TI  - Oral administration of Chlorella vulgaris augments concomitant antitumor
      immunity.
AB  - Chlorella vulgaris, an unicellular green algae, or its acetone-extract (Ac-Ex)
      were administered orally to Meth A tumor bearing BALB/c or (BALB/c x DBA/2)F1
      (CDF1) mice. When CDF1 mice were fed daily with 10% dried powder of Chlorella
      vulgaris (CVP) containing diet before and after Meth A tumor inoculation, the
      growth of rechallenged Meth A tumor was significantly suppressed in an antigen
      specific manner. Augmentation of antitumor resistance was exhibited also by Winn
      assay using lymph node cells of tumor-bearing mice orally administered with CVP
      or Ac-Ex. Antigen-specific concomitant immunity in these mice were mediated by
      cytostatic T cells but not by cytotoxic T cells. Natural killer cells seemed not
      to contribute in antitumor resistance in this system.

PMID- 2229926
TI  - Action of a mycotoxin (diacetoxyscirpenol) on the immune response of the mouse-
      interaction with an immunomodulator (OM-89).
AB  - The action of diacetoxyscirpenol (DAS)--a mycotoxin that belongs to the family of
      trichothecenes--on the immune system of the mouse was investigated. Two
      experimental models were used: 1) bacterial infection with Salmonella typhimurium
      and 2) the PFC (plaque-forming cells) test on the splenic lymphocytes of the
      mouse. The results obtained showed that these were dependent on the chronological
      order of the administration of DAS. When the toxin was administered after a
      bacterial infection or antigenic stimulation, it was observed an increase in the
      mortality rate and a very significant decrease in the antibody response. By
      contrast, when this mycotoxin was administered before the bacterial infection or
      antigenic stimulation, the results obtained were close to those from the
      controls. The importance of the administration of an immunomodulator of bacterial
      origin OM-89 before the immunodepression with DAS was shown.

PMID- 2229927
TI  - Epidemiology and clinical characteristics of endemic cretinism in Sicily.
AB  - In this study we report the prevalence of endemic cretinism in the general
      population of two iodine deficient areas in Northeastern Sicily that were
      described more than 10 yr ago. In addition, the individual characteristics of
      endemic cretins are considered in order to define the typical expressions of this
      major iodine deficiency disorder in Sicily. Forty-three mental defectives were
      identified: 22 were living in an area with three bordering and closely connected
      municipalities within the province of Messina and with a population of 17,485
      inhabitants (prevalence = 0.13%). Three out of the 22 were school-age children.
      The other community, in the province of Catania, was constituted by a unique and
      mostly agricultural hamlet, and showed a prevalence of cretinism that was 0.68%
      (21/3,100). Among the 43 mental defectives, 16 (37%) presented prominent
      neuromotor and neurosensorial disorders, including deafmutism and were euthyroid,
      thus conforming to the neurological type of cretinism; 13 (30%) were hypothyroid
      and exhibited stunted growth without significant neuromotor and neurosensorial
      impairment (myxedematous cretins). In the remaining 14 individuals (33%)
      neurological disorders were associated with stunted growth and clinical or
      biochemical hypothyroidism. These data indicate that also in Sicily endemic
      cretinism is a continuum of a variety of forms: among these the pure neurological
      and pure myxedematous forms represent the two extremes. Our observations also
      indicate that endemic cretinism still represents a major public health problem in
      Sicily. The finding of 3 endemic cretins younger than 13 yr suggests the
      persistence of this disorder even in the presence of improved economic, social
      and nutritional conditions.

PMID- 2229928
TI  - Plasma C-peptide response to oral glucose load in hyperthyroidism.
AB  - Aim of the present study was to evaluate the pancreatic beta cell response to
      oral glucose load in a group of patients with hyperthyroidism. For this purpose
      plasma C-peptide at fasting and after a 100 g oral glucose load was measured in 8
      newly-diagnosed untreated hyperthyroid patients with fasting normoglycemia, and 8
      sex-, age-, and weight-matched healthy controls. As compared to healthy subjects,
      patients with hyperthyroidism showed higher plasma glucose levels (incremental
      area 5405 +/- 742 vs 2729 +/- 539 mg/dl x 180 min, p less than 0.05), and
      slightly reduced plasma C-peptide concentrations (incremental area 166 +/- 12 vs
      182 +/- 36 pmol/ml x 180 min, p = NS) following oral glucose load. The ratios
      between plasma C-peptide and plasma glucose incremental areas were lower in
      hyperthyroid patients than in controls (3.66 +/- 0.85 vs 10.41 +/- 3.08, p less
      than 0.05). These data suggest that hyperthyroidism is characterized by a
      decreased pancreatic beta cell response to oral glucose load.

PMID- 2229929
TI  - Quantification of intracellular calcitonin gene transcripts in human medullary
      thyroid carcinoma (MTC) by in situ hybridization.
AB  - The human calcitonin gene generates 2 distinct mature mRNAs by alternative RNA
      processing, encoding calcitonin (CT) in thyroid C-cells or a neuropeptide (CGRP)
      in the brain. We evaluated quantitatively by in situ hybridization the expression
      of the CT gene in tissue section of 5 MTCs (2 sporadic and 3 familial forms). The
      primary tumor of one MTC was compared to a brain metastasis. In situ
      hybridization was carried out with tritiated cDNA probes coding for CT and CGRP
      mRNA. After autoradiography the number of silver grains was counted in 400 cells
      by computerized analysis of digitized images and expressed as the labelling level
      (L.L. = grain area/cell area per day of autoradiographic exposure). This was used
      to calculate the relative abundance per cell of the specific messengers studied,
      which depends on the autoradiographic efficiency and the specific activity of the
      probe used. The CT mRNA content was 3.25-6.55 10(-10) micrograms equivalents in
      the 3 familial forms of MTC and 4.95-9.25 10(-10) micrograms equivalents for the
      2 sporadic forms. The levels of CT mRNA in the brain metastasis and in the
      primary tumor were identical (4.10 10(-10) micrograms equivalents). CGRP mRNA
      expression was weaker in the sporadic and in the familial thyroid tumors (0.60
      1.65 10(-10) micrograms equivalents). The content of mRNA CGRP in the brain
      metastasis (0.60 10(-10) micrograms equivalents) was lower than that in the
      primary tumor (1.05 10(-10) micrograms equivalents).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2229931
TI  - Bone mineralization and calciotropic hormones in children with hyperthyroidism.
      Effects of methimazole therapy.
AB  - We studied bone mineralization and calcium homeostasis in two children with
      hyperthyroidism before and during 3 yr of methimazole therapy in order to
      evaluate the effects of thyrotoxicosis and its therapy on mineral metabolism.
      Case 1, female, 4.1 year old with hyperthyroidism from 6 months. Biochemical
      data: increased thyroid function, phosphate and osteocalcin, decreased 1,25(OH)2D
      levels. X-ray: severe osteoporosis; bone mineral content (BMC) -23.0%, BMC/BW 
      25.1%. Case 2, female, 7.4 year old with hyperthyroidism from 9 months.
      Biochemical data: thyroid function, ionized calcium and osteocalcin were
      increased, 1,25(OH)2D and intact PTH were decreased. X-ray: severe osteoporosis:
      BMC -32.8%, BMC/BW -36.0. After the patients were euthyroid, they showed an
      increase of 1,25(OH)2D and intact PTH into normal values and a fall in calcium
      and phosphate. Osteocalcin levels returned in normal range one yr after first
      evaluation. Bone mineral analysis showed no variation of BMC and BMC/BW in the
      first 6 months of therapy and an increase in the following 6 months. In the
      following two years BMC and BMC/BW rose to normal range. Our study provides
      further evidence that in hyperthyroidism an altered mineral homeostasis is
      present with a reversible disturbance in vitamin D metabolism. We found that the
      return to euthyroidism was associated with a normalization of mineral homeostasis
      and with a recovery of bone mineralization. Osteocalcin assay may be an useful
      index to monitor bone metabolism in hyperthyroidism.

PMID- 2229930
TI  - Chronobiology of catecholamine excretion in normal and diabetic men.
AB  - The adrenomedullary response to stimuli is often elevated in poorly controlled
      insulin dependent diabetic patients, and it is controversial whether the
      adrenomedullary hyperactivity induces the suppression of the circadian rhythm of
      catecholamines. We have studied the urinary excretion of catecholamines in 11
      diabetic patients during 48 h in 4-h collections. Eleven age and weight matched
      normal subjects served as controls. A circadian rhythm was detected for
      adrenaline and noradrenaline excretion both in normal and diabetic subjects, with
      the highest value for both catecholamines in the early afternoon. The mean daily
      adrenaline levels were significantly higher in diabetic than in control subjects
      (p less than 0.05). The dopamine excretion was correlated with noradrenaline
      excretion in normal subjects but did not show a definite circadian rhythm. We
      conclude that the adrenomedullary hyperactivity does not affect the rhythmic
      fluctuations of adrenaline and noradrenaline. The dopamine excretion does not
      show circadian variations and this probably reflects the absence of a single
      controlling oscillator.

PMID- 2229932
TI  - The social outcome of adults with constitutional growth delay.
AB  - It is well established that children with extreme short stature, secondary to GH
      deficiency (GHD) or achondroplasia, face a disability that may affect their adult
      psychosocial outcome, while contrasting data are reported for short normal
      children. In our hands, adults with GHD have shown an unsatisfactory psychosocial
      adjustment due to the low adult height and hypothetically to the persistent GHD.
      This study has been carried out to evaluate the influence of growth in height on
      the social outcome in 45 adults with constitutional growth delay (CGD).
      Interviews with subjects and parents were used for assessment. Data obtained were
      compared with those found in an age, sex and social matched control group of
      adults with normal height. Some issues were also compared with the data we
      previously found in adults with GHD. Present mean age of the patients is 24 +/- 2
      yr. A high percentage (32.8%) of unemployment or underemployment (part-time work)
      was found. Four patients (8.8%) were married, while 84.4% lived with their
      parents or relatives, confirming the notion of prolonged economic dependency on
      the family. The patients preferred single sporting activities, avoiding team
      work. Surprisingly, scholastic achievement was in general similar to that
      observed in controls. Similar findings have been previously observed in patients
      with GHD. Since no defect in GH secretion has been documented in CGD, the
      presence of a negative psychosocial outcome more probably seems to be due to the
      final unsatisfactory height rather than to a GH defect.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2229934
TI  - Cytogenetic analysis in congenital hypothyroidism.
AB  - In order to evaluate the possible role of genetic factors in the pathogenesis of
      congenital hypothyroidism (CH), we investigated the occurrence of chromosome
      aberrations in a consecutive series of 47 patients with CH and 208 matched
      healthy controls. No abnormal karyotype was found in CH patients. In 5 CH
      patients and in 3 healthy controls a number of heterochromatin variants was
      detected. Although chromosomal variants are devoid of phenotypic effects, the
      frequency of these variants was higher in CH patients than in the control group
      (10.6% vs 1.4%, p less than 0.005). These findings suggest that the association
      of congenital hypothyroidism with chromosomal variants may reflect more than
      chance concurrence.

PMID- 2229933
TI  - Lack of expression of antigens for islet cell antibodies in rat fetal pancreas.
AB  - It is not clear yet when pancreatic islet cells begin to express antigens for
      islet cell antibodies (ICA). Therefore, we studied whether human ICA-positive
      sera, crossreacting with adult rat islet cells, react with fetal and neonatal rat
      islet cells immunohistologically. The ICA did not react with fetal islet cells.
      On the other hand, neonatal islet cells over 2-3 weeks of age expressed the
      reactivities almost similar to those of the adult. It was suspected that
      pancreatic islet cells started to express their antigens to induce ICA gradually
      after birth.

PMID- 2229935
TI  - A possible association between cyclic disorder of glucose metabolism and adrenal
      medullary hyperplasia.

PMID- 2229937
TI  - Biomarkers of aging: do we know what to look for?
AB  - The identification of specific biomarkers of aging would be an important
      milestone in gerontologic research. In this communication, the goals of
      identifying biomarkers of aging are summarized and some criteria for defining
      biomarkers are suggested. An age-related alteration in a biological parameter is
      not necessarily a biomarker of aging. None of the previously observed age-related
      changes satisfies all the criteria. Potential biomarkers that are applicable to
      human aging include in vitro proliferative capacity of fibroblasts, glycation of
      collagen, and DNA unwinding rate. Future research should focus on identifying age
      related changes that are not merely expressions of aging, but also have some
      causal link to aging.

PMID- 2229938
TI  - Can an index of aging be constructed for evaluating treatments to retard aging
      rates? A 2,462-person study.
AB  - Biomarkers of aging are needed to evaluate proposed treatments to retard aging
      rates. At present, the only validated biomarker of aging is maximum life span,
      which remains impractical for human use. Identification of other biomarkers
      awaits development of a method of biomarker validation. This paper outlines an
      approach for this purpose intended for selecting biomarkers usable in humans.
      Prospective biomarkers are validated and weighted according to their correlation
      with interventions that, in healthy individuals, influence life span, namely
      mortality risk factors. A general mathematical method is presented for combining
      biomarker scores into an index of aging rate. This method addresses problems
      encountered with the traditional (multiple regression) method of calculating
      biological age and develops an index termed standardized biological age, SBA. In
      applying the method to 2,462 office workers, SBA, based on 12 physiological tests
      under investigation as biomarkers of aging, was found to depend on most of 17
      surveyed dietary, exercise, life style, and geographical risk factors for
      mortality or health, suggesting that many risk factors predict rates of common
      functional declines with age. The 12 candidate biomarkers of aging in this study
      differed widely in validity according to the criterion employed. The approach
      holds promise for assembling an experimentally useful battery of biomarkers of
      aging.

PMID- 2229936
TI  - Recent advances in the human physiology of inhibin secretion.

PMID- 2229939
TI  - Metabolic heat production during repeated cold stress in adult and aged male
      C57BL/6J mice.
AB  - Adult and aged male C57BL/6J mice were subjected to three consecutive 3-hour cold
      stress tests (partial physical restraint at 6 degrees C), repeated 2 weeks apart.
      Body mass and colonic temperature were measured before each test, and colonic
      temperature, O2 consumption, and CO2 production were measured during cold
      exposure. The slopes of colonic temperature and heat production and the mean
      metabolic heat production were calculated for each animal. Adult mice showed
      stronger cold tolerance compared to aged mice and also exhibited habituation to
      cold exposure (improvement of cold tolerance with repeated tests). Mean metabolic
      heat production during cold exposure was greater in adult mice, and only adults
      demonstrated significant increases across tests in both metabolic heat production
      and slope of metabolic heat production over time. We hypothesize that reduced
      cold tolerance in aged mice is related mainly to a decrease in metabolic heat
      production. Increased metabolic heat production in subsequent tests in adults is
      a probable mechanism for habituation to repeated cold exposure.

PMID- 2229940
TI  - Body fat distribution in healthy young and older men.
AB  - Central and/or intraabdominal (IA) fat is an independent predictor of obesity
      related metabolic abnormalities in young and middle-aged subjects. The elderly
      are "fatter" at any given relative weight and often have similar metabolic
      abnormalities. In this study we compare body composition, circumferences, and
      specific fat depots areas in a population of healthy young and older men.
      Although the two groups were similar in body mass index and percent body fat,
      their distribution of adiposity was different. The young subjects had 16% and 10%
      larger thigh (p = .0001) and arm (p less than .01) circumferences respectively,
      while the ratio of waist-to-hip circumference was greater in the older subjects
      (0.93 +/- 0.04 vs 0.97 +/- 0.04, p = less than .01). The most striking
      differences between the groups were noted on computed tomography, with a twofold
      greater IA fat area (72.6 +/- 38.2 vs 143.6 +/- 56.2 cm2, p less than .0001), and
      a twofold lesser thigh subcutaneous fat area (156.3 +/- 69.3 vs 82.4 +/- 29.7
      cm2, p less than .001) in the older subjects. We conclude there is an age-related
      central and intraabdominal redistribution of adipose mass, even in healthy older
      subjects. Since these changes occur in the absence of clinical disease, the
      associations between metabolic abnormalities and a central and or IA distribution
      of adiposity in the elderly must be investigated further.

PMID- 2229941
TI  - Functional reach: a new clinical measure of balance.
AB  - A new clinically accessible measure of balance, functional reach (FR), is the
      difference between arm's length and maximal forward reach, using a fixed base of
      support. The purposes of this study were to (a) establish FR as a measure of the
      margin of stability versus the laboratory measure, center of pressure excursion
      (COPE); (b) test reliability and precision, and (c) determine factors that
      influence FR, including age and anthropometrics. We evaluated FR in 128
      volunteers (age 21-87 years). FR was determined with a precise electronic device
      and a simple clinical apparatus (yardstick). FR correlates with COPE (Pearson r =
      .71) and is precise (coefficient of variation = 2.5%) and stable (intraclass
      correlation coefficient across days = .81). Age and height influence FR. FR is
      portable, inexpensive, reliable, precise, and a reasonable clinical approximator
      of the margin of stability. FR may be useful for detecting balance impairment,
      change in balance performance over time, and in the design of modified
      environments for impaired older persons.

PMID- 2229942
TI  - Cholesterol screening in 5,719 self-referred elderly subjects.
AB  - To assess the frequency of hypercholesterolemia as a potential major public
      health problem in the elderly, we studied 5,719 self-referred subjects greater
      than age 60 and 11,890 less than or equal to 60 years, whose nonfasting capillary
      blood cholesterol levels were measured during an 18-month screening in Cincinnati
      area grocery stores. We followed National Cholesterol Education Program
      guidelines for serum cholesterol (less than 200 mg/dl "desirable," 200-239
      "borderline-high," and greater than or equal to 240 mg/dl "high"). Of 4,011 61-70
      year-olds, only 19% had capillary blood total cholesterol less than 200, 38% were
      200-239, and 43% greater than or equal to 240 mg/dl. Of 1,493 aged 71-80 years,
      only 20% had total cholesterol less than 200, 36% had levels 200-239, and 44%
      were greater than or equal to 240 mg/dl. In 215 subjects, 81 and over, 29% had
      total cholesterol less than 200, 36% were 200-239, and 35% were greater than or
      equal to 240 mg/dl. Application of the non-age, non-race, non-sex specific
      National Cholesterol Education Program guidelines to the elderly may necessitate
      followup and perhaps therapy in 71-81% of subjects, suggesting that the
      appropriate intervention approach be general population-oriented, rather than the
      individual detection, diagnosis, and treatment approach which presents a huge,
      expensive load for a relatively unprepared health care community.

PMID- 2229943
TI  - Musculoskeletal impairments and physical disablement among the aged.
AB  - This article summarizes the results of a longitudinal investigation of the
      progression of sight, hearing, and musculoskeletal impairments and their
      association with change in physical disability, in 10 ADLs among members of the
      Massachusetts Health Care Panel Study. The findings confirm widely held clinical
      beliefs that specific types of musculoskeletal decrement are an important cause
      of physical disability among older persons. Decrement in hand function is a
      significant musculoskeletal impairment influencing limitations in Basic ADL, and
      progression of Instrumental ADL dysfunction is influenced by progression of lower
      extremity impairments. Progression of sight and hearing impairments was not
      associated with change in physical disability. Musculoskeletal impairments, one
      of the most prevalent and symptomatic chronic complaints of middle and old age,
      deserve increased attention from epidemiologists, disability researchers, and
      clinicians seeking ways to prevent disablement among the aged.

PMID- 2229944
TI  - Hypertension and acculturation in elderly Mexican Americans: results from 1982-84
      Hispanic HANES.
AB  - The purpose of our study was to describe the relationship between acculturation
      and hypertension in elderly Mexican Americans. Two age groups, 55-64 and 65-74,
      were examined from data provided in the Hispanic Health and Nutrition Examination
      Survey (HHANES). The prevalence of hypertension among subgroups of different
      acculturation was ascertained based on the modified Cuellar Acculturation Scale.
      Each age group was also stratified using the HHANES poverty index, with those
      above the index compared to those below. A stepwise logistic regression was
      performed among the variables of poverty, gender, age, and acculturation in
      relation to hypertension. The results indicate that acculturation and age are
      stronger predictors of hypertension than poverty in elderly Mexican Americans,
      with acculturation being a stronger predictor among those age 55-64. Factors
      related to acculturation may have a stronger influence on the prevalence of
      hypertension in older Mexican Americans than differences related to socioeconomic
      status.

PMID- 2229945
TI  - Recognizing and naming faces: aging, memory retrieval, and the tip of the tongue
      state.
AB  - Subjects over the age of 50 were presented with famous and nonfamous male faces.
      If they recognized the face, they were asked for his name and for as much
      information about the person as possible. For recognition, older subjects were
      less sensitive (lower d-prime) and more cautious (higher beta) than younger
      subjects. The number of "tip of the tongue" (TOT) naming responses as a
      proportion of faces recognized increased with age, while the number of responses
      where the right name was produced correspondingly decreased with age. Following
      responses of No, TOT, and Yes to "Do you know his name?", older subjects reported
      fewer correct semantic features than younger subjects in all three cases; but as
      proportions of the number of correct semantic features following Yes responses,
      there were no age effects (.21 and .59 for No and TOT responses, respectively).
      In multiple regression analyses, age surprisingly was often a better predictor of
      performance than measures of current cognitive ability. The results are
      interpreted as evidence of impairment with age associated with at least three
      stages in the face recognition process as identified by Bruce and Young (1986).

PMID- 2229946
TI  - The effects of memory skills training and incentives on free recall in older
      learners.
AB  - The impact of memory skills training and external reward on free recall of serial
      word lists was assessed in 60 elderly community-dwelling adults. Participants
      were divided into four groups: (a) skills training plus incentive, (b) skills
      training only, (c) placebo plus incentive, and (d) placebo without incentive. The
      memory skills training involved 2 hours of class instruction and a take-home
      manual. The incentive was introduced following the posttest study interval, prior
      to recall, and was in the form of a lottery. The three experimental groups
      (skills only, skills plus incentive, and incentive only) recalled more words at
      the posttest interval than the placebo group. Skills training was associated with
      the greatest number of words recalled, followed by the incentive. No additional
      performance gains were found when skills training was coupled with incentive. A
      significant relationship between study time and word recall performance was found
      at posttest. Those who received skills training used more study time than did the
      no skills groups. The results suggest that teaching an active memory skill
      enhances free recall performance. Additionally, incentives were superior to no
      training. Combining incentives with skills, however, does not extend memory
      performance over skills training alone.

PMID- 2229947
TI  - The game of bridge as an exercise in working memory and reasoning.
AB  - Fifty bridge players and 50 nonplayers, between the ages of 55 and 91, were given
      tests of working memory, reasoning, reaction time, and vocabulary. Data were
      analyzed using multivariate and univariate analyses of variance with age as a
      covariate. Results indicated that the players outperformed nonplayers in measures
      of working memory and reasoning, but not vocabulary and reaction time. Results
      were consistent with the hypothesis that bridge, which provides specific
      experience in working memory and reasoning, should enhance performance in tasks
      tapping these abilities and not enhance performance in unrelated abilities.
      Because the data were correlational, the rival hypothesis that bridge playing
      selects for individuals who perform better at working memory and reasoning tasks
      could not be rejected.

PMID- 2229948
TI  - Falls efficacy as a measure of fear of falling.
AB  - We developed the Falls Efficacy Scale (FES), an instrument to measure fear of
      falling, based on the operational definition of this fear as "low perceived self
      efficacy at avoiding falls during essential, nonhazardous activities of daily
      living." The reliability and validity of the FES were assessed in two samples of
      community-living elderly persons. The FES showed good test-retest reliability
      (Pearson's correlation 0.71). Subjects who reported avoiding activities because
      of fear of falling had higher FES scores, representing lower self-efficacy or
      confidence, than subjects not reporting fear of falling. The independent
      predictors of FES score were usual walking pace (a measure of physical ability),
      anxiety, and depression. The FES appears to be a reliable and valid method for
      measuring fear of falling. This instrument may be useful in assessing the
      independent contribution of fear of falling to functional decline among elderly
      people.

PMID- 2229949
TI  - The meaning of grandparenthood and its relationship to demographic, relationship,
      and social participation variables.
AB  - The meaning of grandparenthood has been a focus of research, especially during
      the last decade. Types of meanings and variables differentiating these
      grandparental meanings have been established. Most recently Kivnick (1981, 1982a,
      1982b, 1985) has derived a multidimensional framework representing five aspects
      of the meaning of grandparenthood. The present study attempted to verify whether
      these five aspects of meaning were related to unique combinations of demographic,
      social, personal, and health variables. Zero-order correlations showed high
      intercorrelations among Kivnick's five subscales, and low correlations among the
      majority of variables. Regression analyses indicated that no more than 30% of the
      variance in any one of the dimensions could be explained and that considerable
      overlap existed in the significant predictors across aspects of meanings.

PMID- 2229950
TI  - Family, households, and care arrangements of frail older women: a structural
      analysis.
AB  - Previous research has examined determinants of the living arrangements and the
      informal-care arrangements of older women; research on care arrangements has
      often taken living arrangements as given. Here we consider each separately, then
      go on to analyze the simultaneous determinants of living and care arrangements.
      Factors influencing these outcomes can be categorized as indicators of
      opportunities, resources, needs, or preferences. Of particular interest is the
      extent to which kin availability--specifically, the existence of living children-
      constrains opportunities, the role of financial resources, and the consequences
      of needs as revealed by levels of physical and mental disability. Our analysis
      consists of multinomial-logit models estimated with data from the 1982 National
      Long-Term Care Survey. The results indicate the importance of kin availability,
      with striking differences in the living and care arrangements between childless
      and other older women. Among those with children, there are less striking but
      consistent differences according to the number and sex composition of living
      children. Finally, variables representing needs for care are generally the
      strongest predictors of all the outcomes analyzed.

PMID- 2229951
TI  - Risk factors for nursing home admissions and exits: a discrete-time hazard
      function approach.
AB  - Discrete-time hazard functions were estimated to determine factors associated
      with the probability of admission to a nursing home from the community, and the
      probability of discharge to the community from nursing home care, for 3,332
      individuals enrolled in The National Long Term Care Channelling Demonstration.
      This was a relatively frail elderly population assessed to be at high risk for
      nursing home use. In predicting admissions, major factors were found to be
      ethnicity (Blacks and Hispanics were at much lower risk), homeownership,
      advancing age, living alone, exhibiting higher cognitive and functional
      impairment levels, physician use, and living in an area with a larger nursing
      home bed supply. The probability of being discharged alive was predicted by
      several factors, including ethnicity (Blacks being less likely to be discharged),
      homeownership, being of younger age, better (self-rated) health, functional and
      cognitive capacities, and medical acuity.

PMID- 2229952
TI  - Predictors of institutionalization among Alzheimer disease victims with
      caregiving spouses.
AB  - A theoretical model predicting "desire to institutionalize" and actual
      institutionalization was developed and tested on a sample of 220 persons caring
      for a demented spouse. Significant predictors of "desire to institutionalize"
      include age and education of caregiver, spouse's forgetful behaviors, ADL tasks
      done by the caregiver, medications taken by the caregiver, services used, and
      quality of relationship with spouse. Predictors of actual institutionalization
      are desire to institutionalize, length of time spent as a caregiver, religion,
      uplifts, and forgetful behaviors of the impaired spouse.

PMID- 2229953
TI  - Strain, social support, and mental health in rural elderly individuals.
AB  - This study examined the relationships among social support, life strain, and
      mental health in a sample of 210 rural elderly individuals. Life strain was
      operationalized as economic deprivation, illness disability, and ADL impairment.
      Demographic characteristics had little effect on mental health. Physical health
      status was highly predictive of life satisfaction and psychological distress
      among rural elderly individuals. Disability associated with chronic illness and
      ADL impairment was related to increased reports of symptoms of emotional and
      psychosomatic distress. Measures of social contacts and instrumental support
      exerted small to moderate effects on life satisfaction, psychosomatic distress,
      and emotional distress. Affective support moderated the effects of health-related
      strain on mental health.

PMID- 2229954
TI  - Are they ready? Discharge planning for older surgical patients.
AB  - 1. With ever-increasing cost containment, patients are being discharged from the
      hospital earlier. 2. The majority (96%) of elderly patients (average age 70
      years) in this study, after abdominal and cardiac surgery, thought they were
      ready to be discharged. 3. Surgical patients' level of functional ability was
      significantly improved from predischarge to postdischarge. There were no
      significant differences in their pain, strength, knowledge, and mood levels. 4.
      Predominantly non-nursing functions (eg, transportation, housekeeping) were
      identified as areas of needed help at home for elderly patients after surgery.

PMID- 2229955
TI  - Exploring the roles of men. Caring for demented relatives.
AB  - 1. Men are under-represented among family members providing care to a demented
      relative. 2. Few differences were noted among the male caregivers: men with
      demented relatives at home spent more time daily on caregiving tasks although
      both groups of men tended to rely on others for the "hands-on" care needed;
      institutionalized demented relatives were rated as being more impaired than those
      at home; and men caring for relatives at home seemed determined to continue in
      their role. 3. It is possible that men find it more difficult to become
      caregivers because of lack of support from other family members, the impairment
      of the relative and the need for direct care, and men's lack of involvement in
      providing direct care. 4. Nurses involved in dementia care should offer
      instructional sessions aimed at men, provide assistance in working through
      emotional problems, and encourage their participation in future research on the
      male caregiving experience.

PMID- 2229956
TI  - Oxygen saturation levels in the well elderly: altitude makes a difference.
AB  - 1. A reduction in oxygenation indicated by a lower PO2 and O2 saturation is a
      normal part of aging, but a change in carbon dioxide level is considered to
      reflect pulmonary disease. 2. The oxygen saturations of the well elderly living
      at moderate altitude and those living at low altitude were at the lower limits of
      normal for their respective altitudes. 3. Well elderly living at moderate
      altitude had an oxygen saturation that was significantly lower than the oxygen
      saturation of the people living at sea level. 4. Because of the wide range of
      oxygen saturation levels that exist in normal individuals, it is important to
      evaluate changes in oxygen saturation against the person's own level.

PMID- 2229957
TI  - Night life: nocturnal behavior patterns among hospitalized elderly.
AB  - 1. In contrast to previous studies where elderly living in an institution were
      found to demonstrate a consistent, predictable pattern of nocturnal activity,
      hospitalized elderly were found to be asleep less and awake more over a period of
      3 consecutive nights. 2. Medication, treatments, and assessment were scheduled
      with little regard for the hospitalized elderly's need for restorative sleep. 3.
      Each time an elderly patient was awakened, it took him or her at least 30 minutes
      to return to sleep. 4. Nurses are advised to determine and maintain as much as
      possible the patient's usual bedtime routine, keep interruptions during the night
      to a minimum, schedule medications and treatments efficiently, decrease noise,
      and medicate for pain as appropriate.

PMID- 2229958
TI  - Restraint-free care: is it possible?

PMID- 2229959
TI  - Using mental health principles as we age.

PMID- 2229960
TI  - Estrogen replacement therapy.
AB  - 1. Menopause, defined as the permanent cessation of menstruation resulting from
      loss of cyclic ovarian function, occurs spontaneously at a mean age of 51 years.
      More than 40 million American women are postmenopausal, and an additional 30
      million are expected to join their ranks during the next decade. 2. The depletion
      of naturally occurring hormones that accompanies menopause and the issue of
      hormone replacement therapy have become fundamental concerns in women's health
      care. 3. Many experts now advise estrogen-progestin replacement therapy to
      prevent osteoporosis in all women at high risk for this disorder, and for
      vasomotor flushes, genitourinary symptoms, and mood changes in women who have no
      contraindication to this therapy. 4. Hormone replacement therapy plays a pivotal
      role in preserving good health and vitality, but it should be presented within
      the context of other health-promoting measures to be adopted by menopausal and
      postmenopausal women.

PMID- 2229961
TI  - A role delineation study of hand surgery.
AB  - In 1986, The American Association for Hand Surgery and the American Society for
      Surgery of the Hand jointly sponsored a Role Delineation Study of Hand Surgery.
      The purpose of this study was to define the knowledge and skills necessary for
      competent hand surgery practice and to determine the responsibilities and
      activities of hand surgeons. Eight hundred thirty-eight hand surgeons returned a
      self-report questionnaire. This questionnaire was designed to collect information
      relative to the demographic characteristics of the respondents, the importance of
      38 surgical procedures, and 60 categories of knowledge related to hand surgery,
      and to elicit respondents opinions regarding certification in hand surgery. This
      study is a first attempt to define the domain of hand surgery. The data collected
      in this study provide the basis for designing residency fellowship and continuing
      education programs and may also be used to study manpower needs, regional
      variations in practice patterns, and to identify the educational needs of the
      profession of hand surgery.

PMID- 2229962
TI  - Scapholunate interosseous reconstruction and imbrication of palmar ligaments.
AB  - Twenty-eight patients with scapholunate interosseous ligament disruption, carpal
      instability, and persistent wrist pain were treated by carpal reduction,
      stabilization, and palmar ligament reconstruction. In twenty-two of these
      patients pain was well controlled, carpal alignment was maintained, and they were
      able to resume their previous employment. Grip and pinch strengths averaged
      eighty-two percent and range of motion averaged seventy-six percent of the normal
      uninvolved side.

PMID- 2229963
TI  - Scapholunate dissociation in the skeletally immature carpus.
AB  - A case of scapholunate dissociation with a dorsal carpal instability pattern is
      described in a skeletally immature 13-year-old male. The malrotation of the
      scaphoid was treated by soft tissue reconstruction, with use of a dorsal
      capsulodesis to provide a dorsal restraint to excessive palmar flexion of the
      scaphoid. In the skeletally immature carpus, isolated ligamentous injuries are
      less frequently recognized than epiphyseal injuries. To avoid interference with
      the successful conclusion of carpal growth, soft tissue reconstruction of
      deranged carpal relationships is preferable to intercarpal arthrodesis in the
      skeletally immature patient.

PMID- 2229964
TI  - Failure of trapeziometacarpal arthrodesis with use of the Herbert screw and
      limited immobilization.
AB  - Eighteen patients with trapeziometacarpal joint arthritis had arthrodesis with
      use of the 1.9 mm Herbert screw for internal fixation. Thumb spica cast
      immobilization was maintained for an average of 8 weeks, followed by thumb spica
      orthoplast splintage on a part time basis. Fourteen patients had radiographic
      follow-up an average of 12 months after operation. Seven had union and seven had
      a nonunion. There were three fixation-related complications and two nonfixation
      related complications. Eleven patients had clinical follow-up an average of 12
      months after operation. Four patients had no pain, five had mild pain, and two
      had moderate pain after operation. All had severe pain before operation. All were
      satisfied with the procedure. Although subgroups of patients had a higher rate of
      union with bone grafts or with immobilization over 8 weeks, the theory that
      arthrodesis with 1.9 mm Herbert screws does not require external splintage and
      allows early mobilization is not supported by this series.

PMID- 2229965
TI  - Ulnar styloid fixation in the treatment of posttraumatic instability of the
      radioulnar joint: a biomechanical study with clinical correlation.
AB  - Biomechanical displacement testing was done on nine fresh human upper extremities
      to define the stabilizing influence of the triangular fibrocartilage on the
      radioulnar joint and the efficacy of triangular fibrocartilage-ulnar styloid
      avulsion fracture repair in restoring lost stability. Test data confirmed that
      the triangular fibrocartilage is a major stabilizer of the radioulnar joint and
      internal fixation of triangular fibrocartilage-ulnar styloid avulsion fractures
      can restore preavulsion stability in all positions of forearm rotation. On the
      basis of this data and a successful clinical experience, primary repair of
      displaced ulnar styloid avulsion fractures is advised as a means of stabilizing
      the radioulnar joint and preventing the disability associated with chronic
      radioulnar joint instability.

PMID- 2229966
TI  - Effects of distal radius fracture malunion on wrist joint mechanics.
AB  - An experimental model using a static positioning frame, pressure-sensitive film
      (Fuji), and a microcomputer-based videodigitizing system was used to measure
      contact areas and pressures in the wrist. Contact areas and pressures were
      compared in a group of wrists between the normal state and with simulated distal
      radius fracture malunions of varying degrees. In simulated malunions, radial
      shortening to any degree slightly increased the total contact area in the lunate
      fossa, and was significant at 2 mm of shortening. By angulating the distal radius
      more than 20 degrees either palmar or dorsal, there was a dorsal shift in the
      scaphoid and lunate high pressure areas, and the loads were more concentrated,
      but there was no change in the load distribution between the scaphoid and lunate.
      Decreasing the radial inclination shifted the load distribution so that there was
      more load in the lunate fossa and less load in the scaphoid fossa.

PMID- 2229967
TI  - Effects of radioulnar instability on the radiocarpal joint: a biomechanical
      study.
AB  - Five fresh cadaver upper extremities were studied with use of a static
      positioning frame, pressure-sensitive film and a microcomputer-based
      videodigitizing system to assess the effect of increasing radioulnar instability
      on the load distribution within the proximal carpal joint. Three stages of
      radioulnar instability were studied: (1) an avulsion fracture at the base of the
      ulna styloid; (2) an avulsion fracture at the base of the ulna styloid plus
      disruption of the dorsal portion of the distal radioulnar joint capsule; and (3)
      an avulsion fracture at the base of the ulna styloid, disruption of the dorsal
      portion of the distal radioulnar joint capsule, and disruption of the radioulnar
      interosseous membrane. All stages of radioulnar instability demonstrated a
      decrease in the lunate contact area in positions with the forearm in supination.
      In stage 3 instability there was also less lunate contact area in positions with
      the forearm in neutral pronation/supination. In stage 3 instability the lunate
      high pressure area centroid was abnormally palmar in all positions and the
      scaphoid high pressure area centroid was abnormally palmar in positions with the
      forearm in pronation or supination.

PMID- 2229968
TI  - Results of dorsal wrist synovectomies in the rheumatoid hand.
AB  - Seventy-eight patients with rheumatoid arthritis had 102 dorsal wrist
      tenosynovectomies, intraarticular synovectomies, and Darrach resection from 1962
      to 1982. Follow-up after surgery averaged 11 years, with a range from 3 to 20
      years. Pain was diminished in all but 17 wrists and motion decreased an average
      of 13 degrees. Synovitis recurred in 16 wrists and x-ray evidence of progressive
      intraarticular destruction was seen in 45 wrists. Revision surgery was necessary
      in 28 wrists.

PMID- 2229969
TI  - Type IV flexor digitorum profundus avulsion.
AB  - Flexor digitorum profundus avulsions, are well-documented injuries occasionally
      associated with a distal phalanx fragment. While the injury may involve primarily
      either tendon or bone, a rarely observed variant combines both tendon and bone
      avulsions. A type IV variant seen after two sequential injuries is described.

PMID- 2229970
TI  - Flexor tendon ruptures secondary to hamate hook fractures.
AB  - Four patients with flexor tendon ruptures secondary to hook of the hamate
      fracture are described. None of the patients had the diagnosis of fracture made
      before tendon rupture. All patients were treated with excision of the fractured
      hook and tendon repair. The tendon repair was usually an end-to-side (Y junction)
      of the profundus of the small to the profundus of the ring finger. After
      operation, all patients were free of pain and returned to their preinjury
      activity levels, but most had some limitation of motion in the digit with the
      tendon repair. The complication of tendon rupture not uncommonly follows basilar
      hook of the hamate fractures. Treatment by excision of the fracture and end-to
      side tendon repair produces satisfactory results. Range of motion after tendon
      repair seems to depend more on the patient's age and the amount of inflammation
      at the site of repair rather than on the method of tendon repair.

PMID- 2229971
TI  - Closed traumatic rupture of the ring finger flexor tendon pulley.
AB  - We report an unusual case of closed traumatic rupture of the ring finger flexor
      tendon pulley not previously reported in the literature. This injury occurred in
      a 21-year-old athlete during rockclimbing. Lack of flexion of the distal
      interphalangeal joint was accompanied by a palpable subcutaneous cord on the
      palmar side of the proximal phalanx. A simple repair of the pulley was done. The
      postoperative functional result was satisfactory.

PMID- 2229972
TI  - Treatment of trigger finger by steroid injection.
AB  - A retrospective study of 235 patients with 338 primary trigger fingers determined
      the efficacy and safety of steroid injection. Initial treatment consisted of one
      to three injections of corticosteroid mixed with local anesthetic. Those fingers
      that failed injection therapy had conventional release of the first annular
      pulley. Seventy-seven percent of all fingers showed resolution or improvement;
      49% after a single injection, 23% after two injections, and 5% after three
      injections.

PMID- 2229973
TI  - Unilateral osteonecrosis in a patient with bilateral os centrale carpi.
AB  - Accessory carpal bones, although uncommon, are usually of no clinical
      significance. This report describes a patient who had bilateral presence of the
      accessory bone called the os centrale carpi. The patient was seen with disabling
      pain in the dominant right wrist and both radiologic and pathologic findings
      showed osteonecrosis and secondary degenerative arthritis. His left wrist was
      asymptomatic and the accessory ossicle was normal in appearance. We have not been
      able to discover any cases in the literature describing the development of
      unilateral osteonecrosis in a patient with bilateral os centrale capri.

PMID- 2229974
TI  - Fasciectomy for treatment of Dupuytren's disease and early complications.
AB  - This review of 103 cases of hands operated on for treatment of Dupuytren's
      disease demonstrates the significant increase of postoperative stiffness as
      related to recurrences and staging of the disease, but not to sex. On the
      contrary, the frequency of reflex sympathetic dystrophy after fasciectomy is sex
      related affecting females. The protective effect of guanethidine may be a
      valuable therapeutic adjunct for female patients. We propose that the disease be
      staged on the basis of anatomic findings, inasmuch as staging based on degree of
      contracture alone is insufficient for comparative studies.

PMID- 2229975
TI  - Role of antibiotics in open fractures of the finger.
AB  - The role of antibiotics was investigated prospectively in 91 open fractures of
      the finger. Antibiotics were administered to alternate patients with open
      phalangeal fractures. Only finger fractures distal to the metacarpophalangeal
      joint were included. Both groups were treated with aggressive surgical irrigation
      and debridement. In four patients in each group clinical signs of infection
      eventually developed; osteomyelitis did not develop in any patients, and no
      secondary surgical procedures were required in either group. This data indicates
      that vigorous irrigation and debridement is adequate primary treatment for open
      phalangeal fractures in fingers with intact digital arteries.

PMID- 2229976
TI  - YAG laser resection of complicated hemangiomas of the hand and upper extremity.
AB  - Complicated hemangiomas of the hand or upper extremity have been resected in
      eight patients with use of the YAG laser with sapphire scalpels. This laser
      allows excellent hemostasis and precise surgery, thus allowing resection of
      complicated problems. Many of the patients have had preoperative arteriography
      with selective embolization, which has aided in hemostasis. Almost complete but
      subtotal resection of hemangioma was possible in four of the eight patients with
      well localized lesions. Three patients had only partial resections of hemangiomas
      and one lesion was considered unresectable.

PMID- 2229977
TI  - Thrombosis of the vena comitantes of the ulnar artery.
AB  - A case of traumatic aneurysm of the vena comitantes of the ulnar artery is
      reported, which was seen initially as a painful hypothenar mass after blunt
      trauma. Ligation and excision produced complete relief without recurrence.

PMID- 2229978
TI  - Fractures of the sesamoid bones of the thumb.
AB  - Sesamoid fractures of the metacarpophalangeal joint of the thumb may be
      classified into two types: (1) with palmar plate intact, and (2) with palmar
      plate ruptured. In type 1, the patient maintains a normal flexion posture of the
      metacarpophalangeal joint as well as the ability to flex the metacarpophalangeal
      joint and interphalangeal joint. In type 2, the metacarpophalangeal joint assumes
      a hyperextension posture and the patient is unable to flex the
      metacarpophalangeal joint. Three cases are described to illustrate the two types
      of the injury. An open fracture of a thumb sesamoid associated with laceration of
      the palmar plate in a child was treated by reapproximating the palmar plate and
      the fracture fragments with sutures. Two additional closed fractures of the thumb
      sesamoid were treated by splinting the metacarpophalangeal joint in comfortable
      flexion for 2 to 3 weeks. Normal hand function was restored in all the three
      patients.

PMID- 2229979
TI  - Pathologic fracture of the proximal ulna through a bone graft donor site.
AB  - Complications of harvesting autologous bone graft from the iliac crest and tibia
      are well known; exclusive use of upper extremity donor sites in hand surgery has
      therefore been advocated. Six weeks of postoperative elbow splinting has been
      recommended after harvest of large proximal ulnar grafts. We report two cases of
      pathologic fracture of the proximal ulna complicating local bone grafting and
      question whether the risk of fracture and the attendant patient inconvenience and
      potential joint stiffness incurred by postoperative immobilization are exceeded
      by the morbidity of carefully done iliac crest grafting.

PMID- 2229980
TI  - The nerve of Henle.
AB  - The nerve of Henle, a branch of the ulnar nerve in the forearm, is thought to
      deliver sympathetic innervation to the ulnar artery. Forty cadaver forearms were
      dissected under magnification. Two distinct patterns of the nerve were found. In
      the typical pattern, 18 (45%) of 40 extremities, the nerve originates 16 cm
      proximal to the ulnar styloid, travels distally with the ulnar artery, and
      frequently, 13 (72%) of 18, branches to pierce the superficial fascia 6 cm
      proximal to the ulnar styloid and innervate the skin of the distal ulnar forearm.
      In the atypical pattern (12%), the nerve originates in the distal 8 cm of the
      forearm and travels briefly with the ulnar artery before branching to the skin.
      The palmar cutaneous branch of the ulnar nerve was absent in cadavers with the
      nerve of Henle and may be a distal variant of that nerve.

PMID- 2229982
TI  - Local neurovascular island flap.
AB  - Fingertip amputation, with loss of the terminal pulp and bone exposure presents a
      difficult problem. Reconstruction with use of a local neurovascular island flap
      has been done in twenty-one patients to restore sensibility and function with
      preservation of length. All patients achieved two-point discrimination values
      within two millimeters of the normal contralateral fingertip, with adequate pad
      for pain-free pinch. We advocate this procedure for deep pulp loss over the
      distal phalanx. It is reliable, single-staged, and provides skin coverage closer
      to normal than any regional flap technique.

PMID- 2229981
TI  - Multifocal neurilemomas in different nerves of the same upper extremity.
AB  - We report a case of multifocal neurilemomas originating from different nerves in
      the same upper extremity. In the excision of all seven tumors care was taken not
      to damage the nerves involved. The common features of multifocal neurilemomas
      that originated from different nerves of the same upper extremity are outlined
      and the consequent risk of potential nerve damage during the operation is
      discussed. We recommend intracapsular excisions of multifocal neurilemomas.

PMID- 2229983
TI  - The evolution of carpal nomenclature: a short review.

PMID- 2229984
TI  - Improved ORS formulations.

PMID- 2229985
TI  - Fatal dysentery in rural Bangladesh.
AB  - The purpose of this study was to find out the actual circumstances which lead to
      dysentery-related deaths in the rural Bangladesh. The Community Health Workers of
      the International Centre for Diarrhoeal Disease Research, Bangladesh have been
      collecting records of all deaths at the rural area of Matlab through a
      surveillance system since 1963. A review of existing data on dysentery-related
      deaths from this area during 1976-1981 suggests that deaths in children followed
      a recurring seasonal pattern with an increase during the post-monsoon season of
      August-November of each year. This seasonal pattern of death was not evident
      among adults. The overall dysenteric death rate during 1978-1981 was 13.3 per
      10,000 population per year. The highest rates were in patients of the two extreme
      age groups. Deaths reported recently by the health workers were re-investigated.
      Although the causal agents producing fatal dysentery in most patients in the
      community remained unidentified, it was likely to be species of Shigella in
      childhood deaths. To identify clinical determinants of a fatal outcome, a case
      control analysis was done with patients hospitalised with dysentery in 1980. The
      risk factors shown to be significantly associated with deaths were: longer median
      duration of illness (p = less than 0.001), female sex (p = 0.039), signs of
      respiratory infection (p = less than 0.001) and severe malnutrition (p = 0.002).

PMID- 2229986
TI  - Feasibility of home treatment of diarrhoea with packaged rice--ORS.
AB  - Feasibility of home treatment of diarrhoea with packaged rice-based oral
      rehydration salts (R-ORS) was compared, in terms of cost, with that for glucose
      based oral rehydration salts (G-ORS). Packets of G-ORS (World Health Organization
      recommended composition) were distributed in two Bangladeshi villages (G-ORS
      area). Packets of R-ORS with similar composition, except that glucose was
      replaced with rice flour (50 g/l), were distributed in other two villages (R-ORS
      area). During the 7-month study period, 1061 and 1348 diarrhoeal episodes were
      detected among 409 under-five children in each of the study areas. R-ORS was
      used, either alone or in combination with drugs, to treat 662 (62%) episodes in
      the R-ORS area, compared to 1101 (82%) episodes in the G-ORS area. The treatment
      cost per episode was more with R-ORS than with G-ORS, though fewer R-ORS packets
      were used per episode. Among others, the main factor for the higher cost was
      found to be the higher production cost of R-ORS packets. Expected early recovery
      from diarrhoea with use of R-ORS was not observed in this study. Under the study
      situation, the feasibility of home treatment of diarrhoea with packaged R-ORS was
      not apparent.

PMID- 2229987
TI  - Clinical and epidemiological features of sporadic infections with Vibrio
      fluvialis in Florida, USA.
AB  - The clinical and epidemiological features of sporadic illness were investigated
      in 12 persons from whom Vibrio fluvialis was recovered and who were reported to
      the Florida Department of Health and Rehabilitative Services between 1982 and
      1988. All 12 patients lived in Florida and denied any recent travel out of the
      state prior to the onset of their illness. V. fluvialis was recovered from the
      stools of 10 patients who presented clinically with gastroenteritis, from a wound
      in one patient, and from a caecostomy drainage specimen in one patient. Eight of
      the 10 patients with gastroenteritis reported eating seafood during the week
      before becoming ill: raw oysters (five patients), shrimp (two patients), and
      cooked fish (one patient). This represents the largest clinical series of V.
      fluvialis cases described in the United States.

PMID- 2229988
TI  - The zymodemes of Entamoeba histolytica in New Delhi, India.
AB  - The prevalence of various pathogenic and non-pathogenic zymodemes of Entamoeba
      histolytica in New Delhi, India was studied by characterising its isoenzyme
      patterns. Non-pathogenic zymodeme I was found to be most common and was detected
      in 39 of 49 infections. The other non-pathogenic zymodemes detected were XVII and
      XVIII in two cases each. The pathogenic zymodemes detected were II (four cases),
      II alpha- (alpha) (one case) and XIV (one case). Approximately 72% of those
      harbouring non-pathogenic zymodemes and 33% of those harbouring pathogenic
      zymodemes were asymptomatic. All the symptomatic individuals harbouring non
      pathogenic zymodemes were seronegative for amoebiasis. However, subjects
      harbouring pathogenic zymodeme but asymptomatic were seropositive for amoebiasis
      at a titre of greater than 1:80, indicating a past infection or subclinical
      tissue invasion by the parasite. The new zymodeme isolated from a case of acute
      dysentery was designated II alpha- on the basis of the banding pattern of the
      enzyme glucose phosphate isomerase.

PMID- 2229989
TI  - Prevalence of Campylobacter infections in animals and children in Haryana, India.
AB  - To study the prevalence of infections with Campylobacter spp in Haryana, India, a
      stool sample was collected using a rectal swab from 30 buffaloes, 62 cattle, 95
      pigs and 94 children and was bacteriologically cultured. The subjects were either
      apparently healthy or had diarrhoea. The organisms were isolated in a medium
      containing reducing agents and antibiotics, and culture plates were incubated in
      a candle jar at 42 degrees C. 63% of all thermophilic Campylobacter were cultured
      from rectal swabs taken from young livestock and children with diarrhoea. Of 32
      isolates fully identified, 23 were C. jejuni, 8 were C. coli and 1 was C.
      laridis. The C. jejuni isolates belonged to the Lior's biotype II.

PMID- 2229990
TI  - Crohn's disease: what about the pancreas?
AB  - Crohn's disease (CD) is now accepted as a systemic illness. The importance of
      extraintestinal manifestations is underlined by the fact that such
      "complications" can be more prominent and even more difficult to control than the
      intestinal disease itself. Lately, evidence for a more than accidental
      association of pancreatitis and exocrine pancreatic insufficiency with CD is
      growing. This might have a significant impact on the treatment of abdominal pain
      and diarrhea in CD, symptoms which have so far been attributed exclusively to the
      intestinal rather than the extraintestinal manifestations of the disease.

PMID- 2229991
TI  - Oncogenes and suppressor genes: their involvement in colon cancer.
AB  - Abnormalities in oncogenes, which are broadly classified into viral and cellular
      oncogenes, and suppressor genes appear critical for the development of colon
      cancer. Cellular oncogenes contribute to malignant transformation when they
      become activated by point mutation, translocation, amplification, or loss of
      regulator sequences. The properties of the oncoproteins, the proteins encoded by
      oncogenes which are essential for carcinogenesis, are unclear. Suppressor genes
      normally suppress the tumorigenic phenotype by keeping the growth of cells in
      check; it is their inactivation that contributes to malignant transformation.
      Development of colon cancer appears to take place by stepwise accumulation of
      multiple genetic alterations during the progression from normal colon to adenoma
      and carcinoma. Activation of ras, an early event in this sequence, is found in
      50% of colon cancers; overexpression of c-myc is found in approximately 80%.
      Inactivation of suppressor genes, which occurs during later stages, is noted in
      greater than 70% of tumors. A current model of colonic tumorigenesis is
      presented.

PMID- 2229992
TI  - Can the blood urea nitrogen/creatinine ratio distinguish upper from lower
      gastrointestinal bleeding?
AB  - We wanted to know if the blood urea nitrogen to creatinine (BUN/Cr) ratio could
      help distinguish upper from lower gastrointestinal bleeding. We analyzed
      retrospectively patients admitted to our hospital for gastrointestinal bleeding
      over the past 5 years. A total of 126 patients represented 74 upper bleeds and 52
      lower bleeds. The mean BUN/Cr ratio was significantly higher in upper than lower
      bleeders, 34.8 and 17.8 respectively (p less than 0.001). No lower bleeder had a
      ratio of greater than or equal to 36, whereas 38% of upper bleeders had a ratio
      of greater than or equal to 36. The BUN/Cr ratio may be an easy, cheap method of
      distinguishing upper from lower gastrointestinal bleeding in some cases. A BUN/Cr
      ratio of greater than or equal to 36 suggests upper gastrointestinal bleeding,
      whereas a ratio of less than 36 is not helpful in locating the source of
      bleeding.

PMID- 2229993
TI  - Stasis syndromes following gastric surgery: clinical and motility features of 60
      symptomatic patients.
AB  - We retrospectively reviewed the records of 60 patients who had been referred for
      gastrointestinal manometry because of stasis after gastric surgery. Nausea,
      vomiting, bloating, abdominal pain, and weight loss were the most common
      symptoms. Two thirds of these patients had a well-documented history of peptic
      ulcer before their initial operations; in others, surgery was performed for other
      reasons, such as obesity (5%) or reflux esophagitis (8%). Twelve patients had
      undergone truncal vagotomy and a "drainage operation" and 48 had received a
      partial gastrectomy with a gastroenterostomy: Billroth I (n = 8), Billroth II (n
      = 11), Roux-en-Y (n = 29). All patients had recordings of gastrointestinal
      manometry; 16 also had a scintigraphic measurement of gastric emptying.
      Measurements were compared with data from healthy controls. Gastric manometry,
      which could be assessed only in the group with an intact antrum, was
      characterized by antral hypomotility (p less than 0.05). Gastric emptying studies
      showed rapid early emptying of liquids and delayed emptying of solids (both p
      less than 0.05). In the whole group, fasting jejunal motility was characterized
      by absence of phase II in 13, presence of bursts of phasic activity in 18, and
      abnormal propagation of phase III in 8. A significantly increased frequency of
      phase III of MMC was noted in the patients after Billroth II and Roux-en-Y
      operations. Postprandially, 19 patients failed to develop a "fed
      pattern."(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229994
TI  - Limitations in the evaluation of therapy in inflammatory bowel disease:
      suggestions for future research.
AB  - The current treatment of inflammatory bowel disease (IBD), though improved over
      earlier therapies, remains variable rather than consistent and supportive rather
      than curative. The similar management of ulcerative colitis (UC) and Crohn's
      disease (CD), which are thought to be differing though related disorders,
      suggests that therapy is nonspecific. The variation in therapeutic practices
      results from the fact that the etiologies of the diseases are obscure, from
      limited knowledge of the biological and pharmacological actions of drugs commonly
      prescribed (sulfasalazine, 5-ASA compounds, steroids, 6-MP and azathioprine),
      from an inadequate understanding of genetic differences influencing drug
      metabolism, from insufficient awareness of the factors influencing drug
      efficiency (concurrent use of antimotility drugs, cigarette smoking, food
      combinations), from the variability of the patient groups studied (extent and
      severity of disease), and from incomplete documentation of the clinical status of
      patients at the time of therapeutic trial. Future advances in treatment will
      depend on gaining new information about the nature of IBD and of drug
      pharmacology and bioavailability, derived from collaborative studies by
      clinicians, clinical investigators, and basic scientists. Important areas for IBD
      research include the biology of intestinal epithelium, the nature of the IBD
      inflammatory reaction and of gut mucosal immune regulation (via the application
      of new biotechnologies) and more representative experimental animal models.
      Decisive multicenter therapeutic studies require agreement on definitions of
      ulcerative colitis and Crohn's disease, accurate characterization of patient
      groups, acceptable objective criteria of IBD severity and activity, and reliable
      indicators of therapeutic response.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2229995
TI  - Frequency of recovery of Blastocystis hominis in clinical practice.
AB  - We examined the frequency of isolation of Blastocystis hominis from stools of
      patients seen in an indigent-care teaching hospital. Over a 2-year period, 2,744
      stool specimens were examined prospectively. B. hominis was found in 262 stools
      (9.5% of all stool specimens and 53.5% of the positive specimens). Clinical data
      were obtained from 80 patients with stools positive for B. hominis. B. hominis
      was the only parasite isolated in 39 of 47 (83%) of the adults, compared with 17
      of 33 (52%) of the children (p = 0.006). All but 2 of 52 patients without
      concomitant parasitic infection or bacterial pathogens in stool had
      gastrointestinal symptoms (41 abdominal pain, 26 diarrhea, and 5 vomiting), but
      no association was seen with fever, peripheral leukocytosis, stool occult blood,
      fecal leukocytes, or endoscopic or radiologic evidence of colitis. Therefore, B.
      hominis was frequently recovered from stools examined in a hospital clinical
      parasitology laboratory. The clinical presentations of patients in our series did
      not suggest that B. hominis was invasive. Most patients with B. hominis probably
      do not require treatment since they will either have spontaneous resolution of
      symptoms or will be found to have an alternative explanation for their problem.

PMID- 2229996
TI  - Clinical significance of cholelithiasis in patients with decompensated cirrhosis.
AB  - There is general agreement that the prevalence of gallstones in cirrhotics is
      high (at least twice that in the general population), but the pathogenetic link
      between cirrhosis and cholelithiasis is still uncertain. The influence of
      cholelithiasis on survival in cirrhotics is also unknown. During an 8-year
      period, we observed 90 patients affected by decompensated cirrhosis: 36 of them
      (40%) turned out by cholecystographic/cholangiographic or ultrasonographic
      examination to have cholelithiasis. We were not able to demonstrate any
      correlation between cholelithiasis and sex, age of patients, etiology of
      cirrhosis, severity of the illness, degree of portal hypertension, previous
      gastrointestinal bleeding, number of pregnancies, or levels of serum cholesterol,
      bilirubin, and triglycerides. During the follow-up observation, (range, 1-91
      months), 30 patients died. Survival curves analyzed by the log-rank test did not
      show any difference between patients with or without gallstones. We therefore
      confirm that cirrhosis is a lithogenic condition, but we were not able to explain
      the reasons for the close relationship between cholelithiasis and cirrhosis.
      Gallstones, however, did not affect the survival of these patients.

PMID- 2229997
TI  - Risk factors for gallstones among Chinese in Taiwan. A community sonographic
      survey.
AB  - A health survey of adults aged 30 years or more was carried out in southwest
      Taiwan to determine the prevalence of gallstones and to study risk factors
      associated with gallstones. Blood samples were collected and abdominal
      sonographic examination and anthropometric measurements were performed on a total
      of 923 people. The 40 gallstone cases detected resulted in a prevalence of 4.3%.
      The risk factors explored included age, sex, hepatitis, obesity, hyperlipidemia,
      and diabetes mellitus (DM). Age and DM were the only significant factors
      associated with gallstones in our study. With a reference group of 30-39-year
      olds as a comparison, multiple logistic regression analysis showed a trend effect
      with odds ratios of 1.73, 3.74, and 6.32 for age groups of 40-49, 50-59, and 60
      or above, respectively. The odds ratio for DM was as high as 2.59. However, sex,
      body weight index, chronic hepatitis B, and hyperlipidemia were not significantly
      associated with gallstones.

PMID- 2229998
TI  - Gallstone disease in north India: clinical and ultrasound profile in a referral
      hospital.
AB  - We studied the prevalence of gallstones in patients with upper abdominal pain,
      heaviness, or discomfort by ultrasound examination of the gallbladder. The actual
      ultrasound examination was performed by a clinical gastroenterologist blinded to
      the symptoms. Of 1,680 consecutive dyspeptic patients, 500 (29.8%) had
      gallstones. The gallbladder was contracted in 450 (91.2%), normal-size in 36
      (7.2%), and distended in 8 (1.6%). Biliary colic was more frequently the
      presenting complaint in patients with a contracted gallbladder than in those with
      normal size gallbladder (p less than 0.001). Dyspepsia was more frequent in the
      presence of a normal size gallbladder than a contracted one (p less than 0.001).
      We conclude that ultrasonography of the gallbladder by the clinician has a high
      diagnostic yield, and the symptom complex has an excellent correlation with the
      sonographic appearance.

PMID- 2229999
TI  - Small bile duct abnormalities in sarcoidosis.
AB  - We report four patients with hepatic involvement of sarcoidosis manifested
      primarily by bile duct depletion. The patients developed fever, weight loss,
      anorexia, a markedly elevated alkaline phosphatase, and mildly abnormal serum
      levels of aspartate aminotransferase. Endoscopic retrograde
      cholangiopancreatography showed slight intrahepatic irregularities but were not
      diagnostic of sclerosing cholangitis. Liver biopsy showed predominantly bile duct
      depletion, ranging from an estimated 10-100% absence of bile ducts in portal
      areas, which correlated with the degree of fibrosis. The degree of bile duct
      depletion is useful as a histological marker in patients with sarcoid liver
      disease. Steroids improve symptoms, but do not inhibit the development of
      "ductopenia."

PMID- 2230000
TI  - Spontaneous reactivation in chronic hepatitis B: patterns and natural history.
AB  - We identified spontaneous reactivation of hepatitis B virus (HBV) retrospectively
      by utilizing serum alanine aminotransferase and HBV DNA in 19 men (79%
      homosexual), with an estimated annual incidence of 7.3%. In 11 patients,
      spontaneous reactivation occurred as a single episode and in eight patients,
      reactivation was recurrent, with two to five episodes each. The mean serum
      alanine aminotransferase level was elevated over 10-fold at the peak of
      reactivation. Serum anti-HBc IgM was detected during 73% of the reactivation
      episodes. Actuarial analysis revealed that reactivation was long lasting with 45%
      and nearly 20% of episodes continued after 6 and 24 months, respectively. The
      course of 24 chronic HBV carriers with a negative serum HBV DNA test and normal
      alanine aminotransferase levels at initial appearance was unremarkable. We could
      not identify clinical features predictive of reactivation or its resolution.
      Severe reactivation hepatitis occurred in three patients (10%), with two deaths
      (6%). None of the patients lost HBsAg. Spontaneous reactivation in chronic
      hepatitis B can appear variably, persist long term, recur, and be fatal.
      Therefore, accurate classification of chronic HBV infection requires prolonged
      observation, and spontaneous reactivation should be considered a variable in
      therapeutic trials for chronic hepatitis B.

PMID- 2230001
TI  - Mallory-Weiss syndrome after cardiopulmonary resuscitation.
AB  - We report hematemesis from Mallory-Weiss tears after successful cardiopulmonary
      resuscitation (CPR). A computer search of the English language literature
      disclosed only 3 similar cases, and we review them. This complication of CPR may
      occur more frequently than recognized and should be prevented by careful
      technique.

PMID- 2230002
TI  - A nongastrin malignant ampullary tumor causing gastric acid and pepsin
      hypersecretion. A case report.
AB  - We report a case of multiple duodenal ulcers with gastric hypersecretion due to a
      nongastrin secretagogue produced by a malignant tumor of the pancreas in a 78
      year-old man. The case resembled a Zollinger-Ellison syndrome (ZES) with high
      acid output (basal acid output 27, sham meal-stimulated 37, maximum acid output
      47 mEq/h), but with fasting gastrin 43 pg/ml, nonresponsive to secretin. As in
      ZES, pepsin output was comparatively low, and secretion was inhibitable by
      atropine (50% inhibited by 1 microM). The tumor removed at surgery contained less
      than 1 ng gastrin per gram, but was many times more potent than pentagastrin in
      stimulating acid from a lumen-perfused rat stomach. The tumor also contained
      cholecystokinin (CCK-8 and CCK-33), motilin, insulin, and somatostatin, which
      were also present in adjacent normal pancreas; in addition, the tumor contained
      pancreatic polypeptide and pancreatic cancer-associated antigen. This case
      represents a rare syndrome due to an as yet undefined peptide secreted by a
      (frequently malignant) pancreatic endocrine tumor and masquerading as ZES. This
      is the first report of studies of pepsin secretion and of the effect of atropine,
      suggesting that the physiologic effects of the secretagogue resemble that of
      gastrin.

PMID- 2230003
TI  - Chylous ascites should suggest constrictive pericarditis even in a patient with
      cirrhosis.
AB  - Chylous ascites, a milky, high triglyceride fluid is usually found in patients
      with lymphatic obstruction from malignancy. We describe a patient with cirrhosis
      who developed constrictive pericarditis and chylous ascites. Long-standing portal
      hypertension compounded by elevated central venous pressure provided several
      pathophysiologic contributions to the formation of the chylous ascites. Chylous
      ascites even in a cirrhotic requires prompt assessment for conditions leading to
      elevated central venous pressure.

PMID- 2230004
TI  - Morphological study of cholesterol hepatolithiasis. Report of three cases.
AB  - Three cases of pure cholesterol intrahepatic stones are compared morphologically
      to those of calcium bilirubinate stones. Cholesterol stones were found in the
      intrahepatic bile duct of the left lateral lobe in two cases and in both the left
      lateral and the right posterior lobe in one. Although the chronic inflammatory
      reaction and fibrous thickening of bile duct wall were similar in both types of
      hepatolithiasis, the proliferation of intrahepatic periductal glands and the
      production of mucin were rather mild, compared to that is the liner containing
      calcium bilirubinate stones. Multiple intramural cholesterol calculi and
      cholesterin granulomas (cholesterin crystals surrounded by foreign-body giant
      cells) were found within the cystically dilated small bile duct branches and/or
      conduits of periductal glands. The calculi and granulomas were characteristic for
      cholesterol hepatolithiasis. These findings suggest that the formation of the
      cholesterol stones differs from that of calcium bilirubinate stones; the
      perturbation of factors influencing cholesterol nucleation in the hepatic bile
      may be related to the changed microenvironment of the intrahepatic bile ducts,
      which is followed by the formation of cholesterol stones.

PMID- 2230005
TI  - Ultrasound-Doppler diagnosis of Budd-Chiari syndrome.
AB  - We report a case of apparently idiopathic Budd-Chiari syndrome, diagnosed by
      ultrasound and Doppler sonography, in a patient with latent myeloproliferative
      disease. This case proves that Doppler sonography shows in the hepatic veins a
      flow pattern suggestive of partial thrombotic obstruction. Moreover, we suggest
      that the search for a latent myeloproliferative disorder, by means of the
      spontaneous erythroid colonies formation in culture of bone marrow or blood
      mononuclear cells, should be routinely included in the diagnostic evaluation of
      each case of hepatic vein thrombosis without other recognizable causes.

PMID- 2230006
TI  - Portal venous gas in a patient with Crohn's disease.
AB  - Portal venous gas usually occurs in the setting of an acute abdomen. Several
      causes for benign portal venous gas (PVG) have been reported. We describe the
      finding of PVG by computed tomography in a febrile patient with Crohn's disease
      and discuss the clinical implications of such a finding.

PMID- 2230007
TI  - Iliocaval vein thrombosis as a presentation of Crohn's disease.

PMID- 2230008
TI  - Small bowel obstruction due to simultaneous volvulus and intrahernial
      incarceration of a carcinoid tumor.

PMID- 2230009
TI  - DNA ploidy of tumor cells and clinical outcome of colorectal cancer patients.

PMID- 2230010
TI  - Propranolol and metronidazole for the treatment of metronidazole-resistant
      giardiasis.

PMID- 2230011
TI  - Toxic megacolon (TM) due to Salmonella.

PMID- 2230012
TI  - Postoperative portal vein obstruction in patients with idiopathic portal
      hypertension.

PMID- 2230013
TI  - Development of a methodology for malariogenic stratification as a tool for
      malaria control.
AB  - Modified plan of operation (MPO) for malaria control launched in 1977 failed to
      curb malaria incidence beyond about 2 million cases per annum and thus
      necessitated development of multipronged malaria control strategies based upon
      malariogenic stratification. A model for such stratification based upon six most
      sensitive, but quantifiable, epidemiological parameters for which records are
      easily available at PHC level, namely, topography, average annual rainfall,
      vector(s), average annual parasite incidence (API) for the last five years,
      epidemic potential and vulnerability was developed. This model has been
      successfully tried in the State of Karnataka and on that basis the whole State
      has been divided into five strata in order of increasing endemicity. Objectives
      of malaria control for each of the stratum so defined have been proposed.

PMID- 2230014
TI  - Malaria as anthropo-ecosystem (MAES): Part V. Self-regulation and stability of
      MAES.
AB  - In biological ecosystems, population tends to fluctuate above or below asymptotic
      level or the 'carrying capacity'. Self-regulation is achieved by extrinsic, that
      is, environmental limiting factors and intrinsic, that is, physiological and
      genetic factors. In Malaria Anthropo-Ecosystem (MAES) which is much more
      intricate and complex system, Plasmodium being endoparasite is required not only
      to interact with intrinsic factors of its vertebrate and invertebrate host but
      also to regulate itself to environmental factors to which its both the hosts are
      subjected. Attempt has been made to provide, on the basis of present knowledge,
      the probable explanation of self-regulatory mechanisms from molecular, cell,
      organ/organism, population/community levels of vertebrate and invertebrate hosts
      which give stability to MAES as a whole system.

PMID- 2230015
TI  - Epidemiological study of measles in Singur, West Bengal.
AB  - A measles survey in 10 villages of Rural Health Unit and Training Centre, Singur
      revealed 581 cases of measles from January to June 1986. The overall attack rate
      was 40/1000. The highest attack rate (43.5 per cent) was observed in the age
      group of 1-2 years followed by 6-8 months age group. 11.5 per cent of the cases
      were below the age of 9 months and 10.4 per cent cases were above the age of 15
      years. 42.3 per cent of cases developed one or the other complications. Diarrhoea
      and respiratory infections were the two common complications. Case fatality rate
      was only 0.17 per cent. Epidemiological aspects of these observations are
      discussed.

PMID- 2230016
TI  - Seroepidemiology of hepatitis B in Nepal.
AB  - To assess the prevalence of BHV infection in Nepal sera of 2,555 healthy
      individuals of different age groups from different parts of the country were
      examined for the markers of the infection. BHsAg and anti-HBs were assayed by R
      PHA and PHA methods respectively and anti-HBc by ETA method. Anti-HBc was
      positive in 43.5 per cent of 2,555 sera of healthy individuals in Nepal. HBsAg
      was in 0.9 per cent (1.5 per cent in male and 0.5 per cent in female) and anti
      HBs in 7.7 per cent (7 per cent in male and 8 per cent in female). The prevalence
      of HBsAg and anti-HBs was higher in urban than in rural areas, and the highest
      prevalence of these markers was noted in health care personnels (HBsAg 2.6 per
      cent and anti-HBs 17 per cent). HBsAg was not detectable in infants and young
      children, and the highest prevalence rate was observed in 6 to 15 years age
      group. The main mode of spread of HBV infection in Nepal was the horizontal
      transmission in pre-adolescent and adolescent children. HBV infection is common
      in Nepal but the BHsAg carrier rate is much lower than reported from other Asian
      countries.

PMID- 2230017
TI  - Detection of HBsAg in newborns.
AB  - Cord blood samples collected from 150 newborns were tested for HBsAg using micro
      ELISA technique. Only 8 (5.3 per cent) out of 150 samples were found to be
      positive for HBsAg in variable titres. It is important to identify these HBsAg
      positive newborns so that appropriate measures could be adopted at the earliest
      to prevent the complications of HBsAg carriage.

PMID- 2230018
TI  - Cholera outbreak in Delhi--1988.
AB  - Delhi experienced an outbreak of cholera during July-August 1988 which affected
      residents from all walks of life. A total of 1824 laboratory confirmed cholera
      cases were detected in two months period at I.D. Hospital, Delhi alone. The
      number of cholera cases in July-August 1988 was 5-10 times that of the same
      period during the previous years in the Capital. The outbreak was caused by
      Vibrio cholerae Ogawa biotype ElTor. Majority of the laboratory confirmed cases
      (about 74 per cent) were seen in children under the age of 15 years. Though the
      cases were spread all over Delhi, almost three-fourths of total cases were
      reported from two specific zones (Shahdara and Civil Lines). Most of the isolates
      were sensitive to all antibiotics tested. The proportion of isolates resistant to
      furazolidone during this outbreak was substantially higher than in previous years
      suggesting that the outbreak may have been caused by the introduction of a new
      strain rather than proliferation of endemic strain. The salient features of the
      outbreak are discussed.

PMID- 2230019
TI  - Occurrence of salmonellae in slaughtered pigs, goat meat, meat handlers and
      slaughtered-house workers.
AB  - Of 413 samples comprising 200 goat meat, 100 pig's faeces, 50 faeces of
      slaughtered-house workers, 13 faeces and 50 nailwashings of goat meat handlers
      collected from different shops of Calcutta Corporation, 25 (6.05 per cent)
      yielded 13 serotypes of salmonellae. The commonest serotypes was S. newport (24
      per cent), followed by S. enteritidis (12 per cent), S. anatum (12 per cent) and
      S. typhimurium. Isolation rate of salmonellae was 12 (6 per cent) from goat meat,
      10 (10 per cent) in pig's faeces and 3 (6 per cent) in nailwashings. S. newport
      (50 per cent) in goat meat and S. anatum (30 per cent) in faecal contents of pigs
      were the predominant serotypes. None of the faecal samples of goat meat handlers
      and slaughtered-house workers yielded salmonellae.

PMID- 2230020
TI  - Diarrhoeal diseases in children--a survey in east Godavari District of Andhra
      Pradesh.
AB  - A survey carried out in East Godavari District of Andhra Pradesh to determine the
      extent of diarrhoeal disease problem in children under five years of age revealed
      an incidence of 7.5 per cent. It was two times more frequent in infants than in
      the age group of 1-4 years. Mortality due to diarrhoea was 1.1 per thousand
      children which was two times more in infants than in the age group of 1-4 years.
      As high as 68.5 per cent of children were treated with antibiotics. There is a
      need to standardize management of diarrhoeal diseases in order to eliminate
      wasteful use of antibiotics.

PMID- 2230021
TI  - Action of metronidazole on Entamoeba histolytica: an ultrastructural study.
AB  - Metronidazole (19 micrograms/ml) caused progressive increase in vacuolization in
      Entamoeba histolytica cells with disintegration of its plasma membrane leading to
      almost complete disappearance of the latter within 3 hours. The drug also induced
      formation of helical ribosomal aggregates in the cytoplasm and disappearance of
      button like structures inside the nucleus.

PMID- 2230022
TI  - Enzyme linked immunosorbent assay for the diagnosis of human neurocysticercosis:
      a preliminary report.
AB  - The diagnostic efficacy of an indirect enzyme linked immunosorbent assay (ELISA)
      was evaluated in cases of neurocystecercosis. Subjects studied included 22 cases
      and 30 controls (comprising 12 cases of surgically confirmed hydatid disease, 5
      cases each of tuberculoma and P.U.O. and 8 cases of pyogenic meningitis). A
      standard ELISA was performed using porcine cysticerci as antigen. Sensitivity and
      specificity of the test were calculated for serum and cerebrospinal fluid
      separately. The test was found to give a sensitivity of 68 and 33 per cent for
      serum and C.S.F. respectively. The specificity for confirmed case was found to be
      cent per cent for both with the criteria of reporting used. The sensitivity of
      the test may be increased by using purified specific antigen and/or sandwich
      ELISA instead of indirect ELISA technique.

PMID- 2230023
TI  - Biometrical variations in haematophagous arthropods. II. DV/D ratio of male
      terminalia of wild Culex quinquefasciatus SAY (Diptera: Culicidae) in India.
AB  - The DV/D ratio of male terminalia is considered as most reliable morphometric
      feature to distinguish Culex pipiens from Cx. quinquefasciatus. In India although
      only Cx. quinquefasciatus is known both in the filariasis (Bancroftian) endemic
      and non-endemic areas, there has been no study on the amounts of morphometric
      variation among wild strains of this species. This paper reports variation in the
      DV/D ratio of Cx. quinquefasciatus collected from 7 localities of Delhi (D),
      Lucknow (L), Patna (P), Varanasi (V), Rajahmundry (R), Jabua (J) and Alleppey (A)
      between June and October 1986. The mean value of DV/D ratio in all the strains
      varied from 0.78 to 0.99 with overall mean of 0.89. The range of the ratios was
      0.30 to 1.88. There were 1.28 per cent specimens (9 out of 700) with ratio below
      0.50 and the rest 98.72 per cent with ratio 0.50 and above. The DV/D ratio of
      0.50 should therefore be accepted as lower limit for Cx. quinquefasciatus instead
      of the earlier established value of 0.40. The coefficient of variation (CV) among
      the 7 strains indicates the following progression of variability in the DV/D
      ratio from most stable to most variable strain: L greater than V greater than R
      greater than A greater than J greater than P greater than D. The range of mean CV
      values in different strains was very close with most stable L strain 19.19 and
      most variable D strain 25.92. The amounts of variation, as estimated by
      coefficient of variation, were found to be significantly different between the
      following strains: Delhi and Lucknow (P less than 0.01 at 198 df), Lucknow and
      Patna (P less than 0.05 at 198 df), and Delhi and Varanasi (P less than 0.05 at
      198 df).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230024
TI  - Blood meal analysis of Phlebotomus argentipes in eight districts of West Bengal.
AB  - Eight districts of West Bengal (India) were surveyed for the biting habit of
      Phlebotomus argentipes using agar gel diffusion method. Blood meal indices were
      found different in the two biotopes, human dwellings and cowsheds. A total of 395
      blood meals were analyzed. The blood meal indices in the human dwellings were
      human 68.8 per cent, cow 38.9 per cent, both human and cow 10.2 per cent, others
      2.5 per cent and in the cowsheds: human 19.7 per cent, cow 91.6 per cent, human
      and cow 13.9 per cent and others 2.5 per cent. These indicated that P. argentipes
      did not show preference to any blood meal.

PMID- 2230025
TI  - Magnitude of DDT resistance in Anopheles culicifacies in Maharashtra State.

PMID- 2230026
TI  - Effective pretreatment by cysteine proteinase inhibitor for improved analysis of
      protein components of trematodes on SDS-PAGE.
AB  - Since Fasciola sp. contained proteolytic enzyme(s), it was confirmed that
      degradation took place in protein components in extracts of the liver flukes,
      which resulted in lack of clarity of sodium dodecyl sulphate polyacrylamide gel
      electrophoresis (SDS-PAGE). Degradation was shown to occur mostly during a
      heating process of the extract samples. The proteolytic activity in the extracts
      was completely blocked and electrophoretic patterns were improved only by the use
      of cysteine proteinase inhibitor N-[N-(L-3-trans-carboxyoxiran-2-carbonyl)-L
      leucyl]-agmatine (E-64). Great improvement was also noted in electrophoretic
      patterns of the extracts of other trematodes, such as Paragonimus westermani, P.
      miyazakii and Clonorchis sinesis, when their extracts were treated with E-64.

PMID- 2230028
TI  - On the morphology and life-history of Hemiurus luehei Odhner, 1905 (Digenea:
      Hemiuridae).
AB  - Previously undescribed cystophorous cercariae which develop in sporocyst germinal
      sacs in the tectibranch opisthobranch Philine denticulata (Adams) are shown to be
      cercariae of Hemiurus luehei Odhner, 1905 (Hemiuridae), a common stomach parasite
      of clupeid and salmonid fishes off the Atlantic coast of Europe, in the Baltic
      and the Mediterranean Sea. The free-swimming cercariae are seized by calanoid
      copepods. Temora longicornis (Muller) and Acartia tonsa Dana acted as suitable
      experimental intermediate hosts. Pressure by the copepod mouth appendages causes
      delivery tube eversion and the injection of the cercarcial body into the
      haemocoel. Sagitta sp. was found naturally infected with a metacercaria of H.
      luehei. The cystophorous cercaria and metacercaria are described using light and
      scanning electron microscopy. Adults from herring were examined under the
      stereoscan electron microscope.

PMID- 2230027
TI  - Scanning and transmission electron microscopy of the female reproductive system
      of Schistosoma margrebowiei Le Roux, 1933.
AB  - Transmission electron microscopy shows that the uterus of female Schistosoma
      margrebowiei possesses the same ultrastructure as that of the tegument but lacks
      spines and sense organs. It does not possess secretory cells and opens at the
      gonopore which by scanning electron microscopy was seen to be composed of
      numerous leaf-like protrusions. The morphology of the ovary is comparable with
      that of other Digenea. Immature and mature ova possess cortically arranged
      granules and occur within the posterior zone of the ovary. Cilia and lamellae
      line the luminal surface of the oviduct and ootype, the lamellae running
      unidirectionally along the duct. Only a single type of secretory cell is seen
      within Mehlis' gland and this produces dense bodies which are associated with
      Goldi bodies. Narrow cytoplasmic channels supported by microtubules deliver these
      secretory bodies to the ootype. The vitelline duct is lined with cilia and
      lamellae and the vitelline gland contains four types of cells, S1, S2, S3 and S4.
      Calcareous corpuscles are found within mature S4 cells.

PMID- 2230029
TI  - Effects of 5-hydroxytryptamine (serotonin) on the incorporation of 32P-inorganic
      phosphate into phospholipids in Hymenolepis diminuta (Cestoda).
AB  - 5-Hydroxytryptamine (5-HT) (1,2 and 5 mM) significantly stimulated the
      incorporation of radioactive inorganic phosphate (32Pi) into
      phosphatidylinositol, phosphatidylethanolamine, phosphatidic acid and also total
      phospholipid fraction of Hymenolepis diminuta after one hour of incubation. Such
      effect was both time and concentration dependent. In the presence of 5-HT early
      labelling of phosphatidylinositol was observed. Also, the percentage stimulation
      by 5-HT was the highest in this fraction under all experimental conditions. The
      inorganic, organic, total and phosphatidylcholine-bound phosphate of H. diminuta
      incubated with 5-HT were not significantly different from those of the control
      under all incubation conditions. Results reported herein suggest that messenger
      molecules that are derived from phosphoinositides may be involved in the
      stimulatory mechanism of 5-HT in H. diminuta.

PMID- 2230030
TI  - Epidemiology of hydatid disease in Sardinia: a study of fertility of cysts in
      sheep.
AB  - Hydatidosis, caused by Echinococcus granulosus, is a cyclozoonotic disease of
      economic significance in Sardinia. The life-cycle involves stray and sheep dogs
      as definitive hosts and sheep, pigs, goats and cattle as intermediate hosts. The
      most important intermediate host is sheep, due to home slaughtering with ready
      access of the viscera to dogs. This survey was undertaken in 1987 to ascertain
      the epidemiological significance of sheep in maintaining the life-cycle. A total
      of 700 (91.3%) of 767 sheep harboured hydatid cysts. The frequency distribution
      of the number of hydatid cysts was over-dispersed. Of 497 infected sheep, 7.6%
      had fertile cysts, 75.7% sterile cysts and 16.7% fertile + sterile cysts.

PMID- 2230032
TI  - The pig as an intermediate host for Taiwan Taenia infection.
AB  - Eggs (1000-100,000/animal) of Taiwan Taenia were inoculated per os into 14 Small
      Ear-Miniature (SEM), 19 Landrace-Small-Ear-Miniature (L-SEM), and 5 Duroc
      Yorkshire-Landrace (DYL) pigs. These animals were sacrificed 7-107 days after
      infection. Thirty-four pigs were found to be infected with Taiwan Taenia
      cysticerci and the infection rates of SEM, L-SEM, and DYL were 86%, 89% and 100%
      respectively. The cysticerci recovery rates of SEM, L-SEM and DYL pigs were
      27.2%, 1.7% and 0.27% respectively. Cysticerci were recovered only from the
      livers and none were found in muscles, viscera or other parts of the carcasses.
      More cysticerci were located in the liver parenchyma (71%) than on the liver
      surface (29%). Taiwan Taenia cysticerci were smaller than those of classical T.
      saginata or T. solium. Moreover, Taiwan Taenia cysticerci had 2 rows of
      rudimentary hooklets on the scolex. The results of this study indicate that young
      pigs are good intermediate hosts for Taiwan Taenia and that the SEM pig is a
      satisfactory host for experimental studies with this tapeworm. These results were
      similar to other studies with different geographic strains of the T. saginata
      like tapeworm in the Far East. These strains appear to be the same and possibly a
      new species.

PMID- 2230031
TI  - Establishment, development and fecundity of Taenia crassiceps in the intestine of
      prednisolone-treated Mongolian gerbils and inbred mice.
AB  - Worm establishment, development and fecundity of Taenia crassiceps in the
      intestine of prednisolone (PTBA)-treated, 15- and 4-week-old Mongolian gerbils
      and 9-week-old inbred mice of 4 strains (AKR/J, BALB/cAn, B10D2/oSn and
      C57BL/KsJ) were investigated following oral administration of metacestodes.
      Gerbils were divided into 5 groups of 4 animals each according to the host age
      and commencement day of PTBA-treatment (day -13, -7 or 0 relative to infection).
      Worm recovery from the intestine on day 35 postinfection was not affected by host
      age, but fewer worms were recovered the earlier the commencement of PTBA
      treatment. Worm size, determined by wet weight, total length and proglottis
      number, correlated inversely with worm burden, suggesting they were affected by
      the crowding effect. Proglottides were released normally in the faeces but were
      markedly depressed in all groups except for that of young gerbils. Furthermore,
      egg production and its development in gravid proglottides were markedly depressed
      in all groups. In PTBA-treated mice of 4 strains, sexually mature but not gravid
      worms were recovered from all mice of the AKR/J strain on days 20-32
      postinfection, but none or few worms from the intestine of the others. PTBA
      treatment did not inhibit all protective host defence mechanism(s) in the
      unnatural or alternative rodent definitive host of T. crassiceps.

PMID- 2230033
TI  - Comparative susceptibility to anthelmintics of Brugia pahangi in jirds infected
      by different methods.
AB  - It is possible to infect jirds with Brugia pahangi by three methods. Infective
      larvae (L3) can be injected either intraperitoneally (ip), when adults develop in
      the peritoneal cavity, or sub-cutaneously (sc), when they develop in the
      lymphatics or the heart and blood vessels associated with the lungs.
      Alternatively adult worms which have been grown in the peritoneal cavities of
      jirds can be implanted into the peritoneal cavities of other jirds. This latter
      system has been widely used for screening for new filaricides. We have compared
      the activity of 9 macrofilaricidal compounds against these 3 types of infection.
      Mebendazole and albendazole were more active against implanted adults than
      against L3 induced adults in the peritoneal cavity. Oxibendazole, flubendazole,
      CGP24588A and oxfendazole were equally active against both types of worm.
      CGP20376, Mel Ga and Mel Ni were more active against adult worms derived from
      inoculated L3 than implanted worms. When comparing intra-lymphatic and ip adults
      (both derived from L3 infections and in the same jirds) albendazole and CGP20376
      were active at the same levels against both types of infection. Mebendazole,
      flubendazole, oxfendazole, CGP24588A, Mel Ga and Mel Ni were more active against
      ip adults than intra-lymphatic adults. No drug was more active against intra
      lymphatic adults than against adults.

PMID- 2230034
TI  - Effects of infection with Angiostrongylus cantonensis on the circulating
      haemocyte population and the haematopoietic organ of the host snail M-line
      Biomphalaria glabrata.
AB  - The number of circulating haemocytes, the size of the haematopoietic organ, and
      the size of haemocyte capsules around the parasite were studied in M-line
      Biomphalaria glabrata snails exposed to 100 or 400 first-stage larvae of
      Angiostrongylus cantonensis. The number of haemocytes in exposed snails increased
      significantly at 1 day post-exposure, decreased to control value, and then
      increased again. The decrease in number of circulating haemocytes is probably due
      to the removal of cells from the circulation to participate in encapsulation of
      larvae. The majority of circulating haemocytes in M-line B. glabrata are fully
      spread granulocytes, which increase significantly in number in snails following
      exposure to A. cantonensis larvae. However, populations of partially-spread
      granulocytes, round cells, hyalinocytes and miscellaneous haemocytes were
      relatively constant. The size of capsules around the parasite increased during
      the 42-day interval of the experiment. The haematopoietic organ increased in size
      in response to infection.

PMID- 2230035
TI  - Characterization of glucose uptake by Trichuris globulosa (Nematoda) in vitro.
AB  - 14C-glucose uptake by adult Trichuris globulosa is found to be a non-linear
      function of time and limiting substrate concentration. The uptake is a two
      component process, an initial rapid burst is followed by a lower steady state,
      implying a mediated process. The uptake is dependent on Na+ ions which cannot be
      replaced by K+, Li+ or choline. The uptake is also dependent on pH, being maximal
      at pH 7.4. 14C-glucose absorption is markedly inhibited by glucose, phlorizin,
      ouabain and to a smaller extent by a number of monosaccharides and other sugar
      phosphates, nucleosides and metabolic inhibitors like p-nitrophenyl phosphate and
      iodoacetate. The inhibition constant for glucose, phlorizin and ouabain has been
      found to be 8 mM, 5 mM and 7 mM, respectively. A modified Dixon-plot shows that
      glucose is a completely competitive inhibitor for 14C-glucose uptake while the
      nature of competitive inhibition of phlorizin and ouabain are found to be
      partial.

PMID- 2230036
TI  - Scanning electron microscopy of the cuticular armature of the nematode
      Gnathostoma spinigerum Owen, 1836 from cats in Laos.
AB  - The body surface of an immature female Gnathostoma spinigerum found for the first
      time in the definitive host (Felis catus f. domestica) in Laos was studied using
      a scanning electron microscope. All types of cuticular spines, which are one of
      the most important features for species identification of gnathostomid nematodes,
      together with their spatial arrangement, are described and figured.

PMID- 2230037
TI  - Seasonal variations in the populations of infective larvae on pasture and the
      numbers of nematode eggs in the faeces of farmed goats.
AB  - The levels of nematode egg production in goats and the availability of infective
      larvae (L3) on pasture were investigated on a dairy unit in New South Wales,
      Australia. The output of eggs by adult goats was always above 300 epg. The
      profile of the graph of larval availability in herbage paralleled those for
      temperature and rainfall, suggesting that larval peaks occurred when the
      temperature and availability of moisture were optimal. The dominant genus was
      Trichostrongylus, followed by Haemonchus, then Ostertagia. A larger proportion of
      Haemonchus larvae in the cultures of faeces were collected during the summer
      months.

PMID- 2230038
TI  - Abstracts of the 25th meeting of the European Association for the Study of the
      Liver. Budapest, Hungary, 3-6 October, 1990.

PMID- 2230039
TI  - Surveillance of the surgical wound.

PMID- 2230040
TI  - Comprehensive surveillance of surgical wound infections in outpatient and
      inpatient surgery.
AB  - A surgeon-specific computer-generated monthly questionnaire was used to improve
      surveillance of surgical wound infections in outpatients as well as inpatients
      following discharge. From July 1988 through June 1989, 20,536 surgical procedures
      were performed at our medical center, of which 53% were for outpatients. The
      total wound infection rate was 0.63%: 0.13% in outpatients and 1.2% in inpatients
      (p less than .005). Of the infected wounds, 20% were reported by the survey alone
      and would have gone undetected by conventional surveillance methods (71.4% of
      outpatient and 13.8% of inpatient wound infections). As a whole, clean and clean
      contaminated wounds in outpatients were much less likely to become infected than
      those in inpatients. Wound cultures were not obtained in 85% of infections
      reported by the survey alone, and were less likely to be obtained in outpatients.
      The average time spent by the infection control department on the survey was
      approximately two hours per week.

PMID- 2230041
TI  - Variation in risk for falls by clinical department: implications for prevention.
AB  - To examine rates of falls and injuries by clinical department, a retrospective
      analysis was performed of 874 inpatient falls during a one-year period in a 1,000
      bed acute-care hospital. Incident reports were reviewed, and for those patients
      injured, medical records were abstracted. Fall rates were calculated by age, sex
      and service using total patient days as the denominator. During 1983, 874 falls
      occurred during 282,713 adult patient days (31/10(4) days). Fall rates were
      significantly higher (odds ratio = 2.12; 95% confidence interval [CI]: 1.84,
      2.45) in the neuroscience and psychiatry departments (53/10(4) days) compared
      with other adult services combined (25/10(4) days); this difference persisted
      after direct adjustment for age. Differences by clinical department persisted
      throughout four additional years of surveillance, although fall rates for the
      oncology service increased. Injuries following falls occurred among 200 (22.8%)
      patients. These data indicate that falls are not random events, and that falls
      and injury prevention programs can be more appropriately focused by consideration
      of clinical department.

PMID- 2230042
TI  - Plasmid DNA fingerprinting of Acinetobacter calcoaceticus subspecies anitratus
      from intubated and mechanically ventilated patients.
AB  - Forty-three intubated and mechanically ventilated patients in five intensive care
      units (ICUs) of one hospital developed respiratory colonization or infection with
      Acinetobacter calcoaceticus subspecies anitratus over a 16-month interval.
      Neither the frequency nor rate of A anitratus isolation exceeded the hospital
      endemic norms. Single isolates from 34 of the patients were subtyped by plasmid
      DNA analysis, two biotyping systems and antimicrobial susceptibility to 24 drugs.
      Plasmid DNA fingerprints were distinct in 18 isolates (they differed from each
      other and all others), similar in two and identical or similar in ten. The latter
      group of isolates were recovered from patients in four ICUs. Reproducibility of
      biotyping was poor. Neither biotyping nor antimicrobial susceptibility were
      successful in identifying sameness among the group isolates nor differences among
      other isolates. We conclude that plasmid DNA fingerprinting should be used to
      assess the possibility of multiple patient transmissions of the same A anitratus
      strain in the absence of an obvious outbreak.

PMID- 2230043
TI  - Achromobacter xylosoxidans bacteremia.

PMID- 2230044
TI  - Group A streptococcal bacteremias associated with intravascular catheters.

PMID- 2230045
TI  - JCAHO infection control indicators, part 1. JCAHO Infection Control Indicators
      Task Force report.

PMID- 2230046
TI  - Current epidemiologic evidence and case reports of occupationally acquired HIV
      and other bloodborne diseases.
AB  - Studies in which noninfected persons shared households with human
      immunodeficiency virus (HIV)-infected family members and friends, and had
      substantial though non-sexual contact with them revealed no transmissions of the
      HIV virus. These results suggest a similar low risk for healthcare workers,
      particularly those who have little or no contact with blood. However,
      occupational transmission of HIV, when it does occur, is most commonly caused by
      needlestick injuries. Nurses make up the largest group--nearly 80%--of hospital
      workers who contract HIV infection on the job. Generally, the risk ratio
      following an HIV needlestick is 1 in 250. Improper needle disposal, recapping and
      other ingrained behavior patterns are typical causes of needlestick accidents.
      Though the focus today is on HIV/acquired immunodeficiency syndrome (AIDS), it is
      important to realize that hepatitis B accounts for 200 to 300 deaths a year among
      healthcare workers. Awareness of the risk of needlestick injuries, and the
      considerable financial and emotional costs they can impose, should justify
      preliminary expenditures on needlestick prevention programs.

PMID- 2230047
TI  - Risk reduction through testing, screening and infection control precautions--with
      special emphasis on needlestick injuries.
AB  - Transmission of the hepatitis B virus (HBV) and human immunodeficiency virus
      (HIV) pose substantial risks to institutional healthcare employees working with
      blood. While the risk of contracting hepatitis B in the hospital setting is much
      greater than the probability of acquiring HIV, the cost of treating the acquired
      immunodeficiency syndrome (AIDS)--if it develops--is much greater in both dollars
      and human suffering. In addition to the risks posed by the presence of HIV
      infection in the hospital increase daily. By the end of 1990, one of every 14
      hospitalized patients will be an HIV carrier. Of all hospital-related injuries to
      employees, the highest percentage (35%) is caused by needlestick/"sharps"
      punctures. Over a 12-month period, approximately 18,000 hepatitis cases
      reportedly have been caused by needlestick accidents. After nurses, housekeeping
      personnel--victims of incorrectly disposed needles--are most at risk. Nurses
      incur 58% of needlesticks when needles are broken, cut or recapped. Currently,
      there are products on the market specifically designed to eliminate contact with
      needles. These cartridge-needle safety units allow for only one-time use, thus
      doing away with the possibility of recapping. Initial expenditures for new
      equipment are well worthwhile; the implementation of revised safety precautions
      are not only worthwhile but also required by law. The dollar costs imposed on
      hospitals by accidental transmission of bloodborne diseases include tests for the
      employee, treatment, outpatient visits and wages. One pilot study prevention
      program conducted in an 800-bed hospital resulted in a 53% reduction in
      needlestick injuries.

PMID- 2230048
TI  - The pharmacist's role in controlling bloodborne infections with emphasis on
      procuring safe injection systems.
AB  - The hospital's department of pharmacy plays an important role in lessening the
      risk of bloodborne disease transmission through its influences in the
      coordination and control of the hospital's drug distribution system, intravenous
      (IV) admixture service and purchasing decisions with regard to injectable drug
      products. A review of drug distribution systems has shown that the unit-dose
      system is the most advantageous in terms of accuracy, safety, time savings and
      overall costs to the institution. Needlestick injuries are an occupational hazard
      for healthcare workers. Today, the need for safety in medication administration
      is a priority in injectable medication systems. Pre-filled cartridges offer a
      number of advantages, one of which is their safety in preventing needlesticks,
      through facilitating administration of medication quickly and easily and disposal
      of the needle immediately thereafter.

PMID- 2230049
TI  - Adoption of guidelines for Universal Precautions and Body Substance Isolation in
      Canadian acute-care hospitals.
AB  - The impact of recently recommended hospital infection control guidelines on
      Canadian acute-care hospitals is unknown. A confidential cross-sectional mailed
      survey of all acute-care Canadian hospitals was conducted to determine rates of
      receipt and adoption of published guidelines for Universal Precautions (UP) or
      Body Substance Isolation (BSI), rationale for adoption and knowledge of costs and
      benefits. Five hundred and seventy-nine of 943 sites (61%) responded (exceeding
      80% in urban centers); 94% among hospitals with at least 300 beds and 57% among
      those under 300 beds. Seventy-four percent of responders claimed adoption of UP
      (65%) or BSI (9%), staff protection being their primary motivation. Adoption of
      either UP or BSI was associated with size (p less than .001), increasing
      progressively from 45% in the smallest group (less than 25 beds) to 84% in the
      largest (greater than or equal to 500 beds). Many hospitals introduced
      modifications and some substituted names other than UP or BSI in adopting a new
      strategy. In practice, UP and BSI now mean different things in different
      hospitals, and the distinction between them has become blurred. Furthermore, only
      5% claiming adoption of a new strategy adopted all of the fundamental policies
      expected under UP or BSI. Receipt of guidelines was also correlated with size:
      one-third of hospitals under 200 beds had not received key publications defining
      UP and BSI. Only 19% claiming adoption of a new strategy indicated knowledge of
      cost implications. These results suggest a need for closer collaboration among
      hospitals and government agencies in developing uniform infection control
      policies, and for systematic evaluation of the cost and effectiveness of new
      strategies.

PMID- 2230050
TI  - Influenza outbreaks in nursing homes: how effective is influenza vaccine in the
      institutionalized elderly?
AB  - During the 1984-1985 influenza season, outbreaks of influenza A (H3N2) occurred
      in three Connecticut nursing homes. Influenza vaccination rates were 67% (96 out
      of 144), 35% (30 out of 85) and 69% (332 out of 483), respectively. The relative
      risk of illness for vaccinated compared to unvaccinated residents was 1.8 (95%
      confidence interval, 0.6, 5.9), 1.6 (95% confidence interval, 0.8, 3.0) and 1.1
      (95% confidence interval, 0.8, 1.7) for each of the three nursing homes,
      respectively. In the third outbreak, 22 vaccinated residents without clinical
      illness had a geometric mean titer of hemagglutination-inhibition (HI) antibody
      of 20. Although low, this titer was significantly higher than that of nine
      unvaccinated residents without clinical illness (12, p less than .05); only three
      (14%) vaccinated residents had HI titers of greater than or equal to 40. These
      results suggest that levels of HI antibody in vaccinated residents were not
      protective at the time of the third outbreak, four to five months after
      vaccination. In general, the study of vaccine effectiveness in nursing homes is
      limited by sample size and statistical power. Despite these limits, the
      retrospective investigation of influenza outbreaks in nursing homes is often the
      only practical way to evaluate influenza vaccine effectiveness in the elderly on
      a yearly basis.

PMID- 2230051
TI  - Frequent acquisition of multiple strains of methicillin-resistant Staphylococcus
      aureus by healthcare workers in an endemic hospital environment.
AB  - Methicillin-resistant Staphylococcus aureus (MRSA) has been an endemic nosocomial
      pathogen at the VA medical center (VAMC) in Providence, Rhode Island since 1981.
      From 1985 to 1987, more than 30% of all unique S aureus isolates were methicillin
      resistant. To evaluate the frequency of acquisition of MRSA isolates by
      healthcare workers, we compared the antimicrobial susceptibility patterns,
      multilocus enzyme genotypes and plasmid profiles of isolates recovered from nasal
      and hand cultures from VAMC nurses and house staff on rotation at the VAMC with
      those of clinical isolates from patients at the VAMC and four other affiliated
      hospitals. Fifty-six percent of ward nurses cultured (n = 112) were colonized
      with S aureus, of which 65% was methicillin resistant. Six isolates of MRSA were
      identified on the initial culturing of house staff (n = 65); 16 MRSA isolates
      were recovered at the end of a four-week rotation (p less than .02). Phenotypic
      and genotypic analyses demonstrated that numerous distinct MRSA strains were
      recovered in the study period. The incidence of MRSA among clinical isolates at
      the VAMC and affiliated institutions was remarkably constant throughout the three
      year study period. Moreover, despite regularly sharing resident physicians,
      interns and medical students, MRSA isolates were commonly recovered at the other
      university-affiliated hospitals. Our study failed to reveal evidence of
      significant interhospital transmission of MRSA isolates by healthcare workers.
      While healthcare workers may contribute to the dissemination of MRSA within
      institutions, they appear to be less important in spreading MRSA between
      institutions.

PMID- 2230053
TI  - Strongyloides stercoralis.
AB  - In many aspects, S stercoralis is a unique opportunistic pathogen. Via its
      autoinfections cycle, it is capable of producing both parasitic and bacterial
      infections at remote organ sites. These infections are often nosocomial.
      Diagnosis can be very difficult if appropriate microscopic evaluation is not
      done. Concomitant bacterial infections must be treated with appropriate
      antimicrobial agents; thiobendazole is the treatment of choice for the parasitic
      phase of these infections.

PMID- 2230052
TI  - Aztreonam.
AB  - Aztreonam, the first commercially available monobactam, has a wide range of
      activity against aerobic gram-negative bacilli. It can be administered two to
      three hours daily because its half-life is 1.6 to 2 hours. Excellent blood and
      tissue concentrations are attained. The MIC of aztreonam against most
      Enterobacteriaceae is less than or equal to 2 micrograms/ml and against P
      aeruginosa less than or equal to 16 micrograms g/ml. Aztreonam has been used in a
      wide array of infections of the urinary tract and respiratory tract, blood, intra
      abdominal and gynecologic infections and infections of the skin, bones and
      joints. As empiric therapy, aztreonam is usually combined with another
      antimicrobial agent active against anaerobes and/or aerobic gram-positive cocci
      until culture results are available. One exception is empiric therapy for gram
      negative urinary tract infections in which aztreonam can be used initially as
      monotherapy against susceptible gram-negative pathogens. In general, the efficacy
      of aztreonam is equal or superior to that of the aminoglycosides. Adverse
      reactions to aztreonam are unusual, and it as been shown to be a poor hapten,
      permitting its administration to patients with proven allergy to the penicillins
      and cephalosporins. Aztreonam is a useful addition to the available antibiotics
      for treatment of gram-negative infections.

PMID- 2230055
TI  - The dilemmas of introducing routine HIV testing into the intensive care unit.

PMID- 2230054
TI  - Blood pressure measurement: an evaluation of direct and indirect methods.
AB  - In order to evaluate the differences between the blood pressure values obtained
      by direct intraarterial (DM) and indirect sphygmomanometer (IM) measurements,
      both systems were employed in 30 patients during their immediate postoperative
      period (24 hours) at our Intensive Care Unite after open heart surgery. The total
      number of determinations was 355. The statistical study of data lead us to the
      following conclusions: 1. There are significant differences between arterial
      pressure values obtained by DM and IM falling within an acceptable range of error
      for clinical purposes 2. Both methods of measurement, direct and indirect, are
      highly influenced by technical details that have to be carefully standardised if
      suitable research values are to be obtained.

PMID- 2230056
TI  - Nursing for a patient requiring long-term care in an intensive care unit (ICU).
AB  - Nursing care in ICUs has frequently been discussed, and importance of
      psychological care for each patient has been recognised. The care of a severely
      ill patient who remained in the ICU in Japan for an extended time is described
      here. During his stay in the ICU, an expanded nursing programme was developed to
      minimise his mental exhaustion. While considering his pathophysiological
      condition nursing support was also designed to satisfy his basic desires and
      human needs, anticipating that this would have therapeutic effects and contribute
      to improvement of his general condition. Nursing care included particular
      emphasis on four areas of nursing intervention promoting mobility, and
      communication between the patient and his family and nurses. Exercise, food
      intake, sleep, and mental condition were carefully evaluated. The basic human
      desires of the patient (such as to eat, sleep, walk, etc) should be satisfied,
      taking into account the pathophysiological condition, even with a severely ill
      patient. Nursing care should focus on supporting the quality of life for
      patients, even in the ICU.

PMID- 2230057
TI  - The use of a multidisciplinary group meeting for families of critically ill
      trauma patients.
AB  - Family members of any trauma patient admitted to the Level I trauma center are
      invited by the trauma staff to attend weekly multidisciplinary meetings. By the
      use of these meetings, family concerns can become a positive care factor and the
      tasks of nurses, doctors and social workers alike made easier.

PMID- 2230058
TI  - Use of an implantable left ventricular assist device for irreversible ventricular
      fibrillation secondary to massive myocardial infarction--a case study.
AB  - Mechanical circulatory support devices are currently being developed. The
      indications for their use are presently following acute myocardial infarction; in
      post cardiac-surgical cardiogenic shock; and as a mechanical 'bridge' to cardiac
      transplantation. Devices are being developed for permanent implantation in
      patients with end-stage left ventricular failure who are unacceptable for or
      denied transplantation. Intensive care nurses are required to care for patients
      who receive such mechanical support. These patients need intensive physical care
      with extensive nursing intervention and psychological support. The following case
      study describes the care of a patient who received an implantable left
      ventricular assist device (LVAD). The study illustrates the nursing care required
      in the management of such patients.

PMID- 2230059
TI  - High technology and humanity for intensive care.
AB  - At surface level it is obvious that high technology and humanity are involved in
      intensive care, since many sophisticated biomedical techniques and machines are
      used, and all varieties of humankind may pass through intensive care units
      (ICUs). But it is important to give deeper consideration to the title topic, and
      it is proposed here to consider first high technology, then human aspects of
      intensive care, and the context which affects both.

PMID- 2230060
TI  - A double-blind placebo-controlled trial of zopiclone 7.5 mg and temazepam 20 mg
      in insomnia.
AB  - Zopiclone, a cyclopyrrolone with hypnotic properties was compared with temazepam
      and placebo in the treatment of insomnia. After a week's washout period, suitable
      subjects were allocated at random to zopiclone 7.5 mg or temazepam 20 mg or
      placebo for 2 weeks. Measurements of psychomotor function using the Leed's
      psychomotor tester and letter cancellation were carried out on day 0, 7 and 14.
      Sleep latency, duration of sleep and number of times waking during the night were
      recorded on a sleep diary filled by the subjects nightly. Forty-four subjects
      completed the trial, 15 taking zopiclone, 16 taking temazepam and 10 taking
      placebo. Both zopiclone and temazepam had significant hypnotic properties when
      compared to placebo. Zopiclone increased total sleep time in both weeks of the
      trial while temazepam increased sleep time in the first week only. There was no
      significant deterioration in psychomotor performance at the end of both weeks for
      zopiclone. Critical flicker fusion was significantly increased in subjects on
      temazepam. There were no abnormalities for both zopiclone and temazepam subjects
      in the blood picture, renal profile, liver function, urine and ECG before and
      after the study. Zopiclone is an effective hypnotic comparable to temazepam.

PMID- 2230061
TI  - Zopiclone and triazolam in insomnia associated with generalized anxiety disorder:
      a placebo-controlled evaluation of efficacy and daytime anxiety.
AB  - In a double-blind placebo-controlled study, following a 1 week washout, 75
      outpatients suffering from generalized anxiety disorder with severe insomnia as
      the target symptom were randomly assigned to 4 weeks of treatment with zopiclone
      7.5 mg, triazolam 0.5 mg or placebo at bedtime. Zopiclone was significantly
      better than placebo on most sleep parameters. Triazolam tended to be superior to
      placebo, but its superiority was significant only on the sleep induction factor.
      Triazolam-treated patients presented significantly more day-time-interdose
      anxiety than zopiclone as assessed by the weekly HARS and Clinical Global
      Assessment of Anxiety. Although daytime-interdose anxiety was observed with both
      drugs, this treatment emergent symptom was more frequent and severe with
      triazolam. Side-effects were of a mild to moderate intensity for both zopiclone
      and triazolam; however, taste perversion frequently appeared with zopiclone.
      Although both drugs share similar pharmacological properties and bind to
      benzodiazepine receptors, they differ significantly with respect to side-effects
      and daytime anxiety.

PMID- 2230062
TI  - Lofepramine, desipramine and abnormal tests of liver function: a case report.

PMID- 2230063
TI  - Adverse interactions encountered when using trazodone to treat insomnia
      associated with fluoxetine.
AB  - The authors report adverse interactions encountered when using low dose (25-75
      mg) trazodone to treat insomnia associated with fluoxetine. Sixteen patients had
      good hypnotic responses to trazodone, but five needed to stop the medication due
      to excessive sedation. Three cases are described.

PMID- 2230064
TI  - The effects of codeine on human aggressive responding.
AB  - Ten healthy male research subjects received placebo, 25, 50 and 75 mg/70 kg of
      codeine in a controlled laboratory setting. During each session subjects had two
      response options. The non-aggressive response option was maintained by points
      exchangeable for ten cents. The aggressive response option ostensibly subtracted
      a point from the subject's fictitious partner. Aggressive responding was
      engendered by point subtractions attributed to a fictitious partner. Codeine did
      not significantly alter the frequency of monetarily reinforced, nonaggressive,
      responding. Aggressive responding was significantly increased at the 50 mg/70 kg
      dose of codeine. The frequency of aggressive responses during the placebo
      sessions preceding administration of the first codeine dose were significantly
      and positively correlated with scores on the Buss-Durkee Hostility Scale.
      Aggressive responding increased for four of five subjects scoring below the
      median on the Buss-Durkee Hostility Scale at the 50 mg/70 kg dose; while
      administration of 50 mg/70 kg increased aggressive responding of one subject who
      scored above the median. Aggressive responding for both groups of subjects was
      unaffected by the 75 mg/70 kg dose.

PMID- 2230066
TI  - Lithium and weight gain.
AB  - Lithium prophylaxis leads to weight gain in a high proportion of patients
      treated, with up to a quarter becoming clinically obese. This can have
      detrimental effects on compliance and is also a health risk. The mechanism of
      such lithium-induced weight gain is unknown, but increased calorie intake,
      particularly in the form of high calorie drinks, has been implicated. Remedial
      steps such as adjusting the lithium dose and giving appropriate dietary advice
      should be taken at the first sign of weight gain.

PMID- 2230065
TI  - Des-enkephalin-gamma-endorphin in the treatment of schizophrenia.
AB  - Ninety-three patients with an exacerbation of chronic schizophrenia were included
      in a 4 week trial comparing placebo with 1, 3 and 10 mg des-enkephalin-gamma
      endorphin (DE gamma E; beta-lipotrophin 66-77; Org 5878) per day (i.m.).
      Maintenance antipsychotic and other medications were continued unchanged.
      Treatment effects were assessed by means of the Comprehensive Psychopathological
      Rating Scale--subscale schizophrenia (CPRS-S), Brief Psychiatric Rating Scale
      (BPRS) and Global Assessment Scale (GAS) rating scales at weekly intervals.
      Safety data, i.e. laboratory investigations, vital signs and ECG recordings, were
      assessed before and during the trial. Side-effects were evaluated by means of a
      Record of Symptoms Emerging. Sixty-eight patients completed the trial, the reason
      for drop-out mainly being inadequate treatment effects and refusal of medication
      administration. One patient violated the protocol. After 4 weeks of treatment the
      mean CPRS-S score of the group receiving 10 mg DE gamma E daily had decreased
      statistically significantly more than the corresponding score of the placebo
      group (p less than 0.01). The same trend was apparent with BPRS (p = 0.08) and
      GAS (p greater than 0.1) scores. Therefore, the study should be considered
      inconclusive. No clinically relevant side-effects attributable to DE gamma E were
      observed.

PMID- 2230067
TI  - A controlled trial of adinazolam versus desipramine in geriatric depression.
AB  - Thirty outpatients between the ages of 60 and 85 with DSM-III Major Depression
      entered an 8 week randomized, double-blind comparison of desipramine and
      adinazolam mesylate, a triazolobenzodiazepine derivative. Outcome was assessed on
      several measures including the Hamilton Depression Rating Scale (HDRS),
      Montgomery-Asberg Rating Scale, Clinical Global Impressions (CGI), the 35-item
      Self-Rating Symptom Scale, and Carroll Depression Scale. Patients in both groups
      demonstrated a highly significant decrease in average HDRS scores (p less than
      0.001) over the course of the study. Adinazolam was associated with significantly
      greater reduction in average HDRS scores by the third day. Repeated measures
      analysis of variance showed a significantly greater reduction in HDRS scores for
      adinazolam over the course of the study. The study medications were associated
      with distinct patterns of adverse reactions. Desipramine more often produced dry
      mouth, constipation and nervousness, while adinazolam was more likely to cause
      drowsiness and lightheadedness. Three of these elderly patients, all of whom were
      taking desipramine reported at least one fall during the study. Adinazolam may be
      a promising agent in the treatment of depression in the elderly.

PMID- 2230069
TI  - Depression in the elderly.

PMID- 2230068
TI  - Diagnostic issues in depression in old age.

PMID- 2230070
TI  - Post-stroke depression.

PMID- 2230071
TI  - Treating refractory depression.

PMID- 2230072
TI  - Antidepressants: the implications of the cognitive and psychomotor effects in the
      elderly.

PMID- 2230073
TI  - Adverse effects of antidepressants.

PMID- 2230074
TI  - Depression in the elderly: pharmacokinetics of antidepressants and death from
      overdose.

PMID- 2230075
TI  - Affective disorder and physical illness in old age.

PMID- 2230076
TI  - Molecular genetic divergence of orang utan (Pongo pygmaeus) subspecies based on
      isozyme and two-dimensional gel electrophoresis.
AB  - The orang utan (Pongo pygmaeus), as currently recognized, includes two
      geographically separated subspecies: Pongo pygmaeus pygmaeus, which resides on
      Borneo, and P. p. abelii, which inhabits Sumatra. At present, there is no known
      route of gene flow between the two populations except through captive individuals
      which have been released back into the wild over the last several decades. The
      two subspecies are differentiated by morphological and behavioral characters, and
      they can be distinguished by a subspecies specific pericentric chromosomal
      inversion. Nei-genetic distances were estimated between orang utan subspecies,
      gorilla, chimpanzee and humans using 44 isozyme loci and using 458 soluble
      fibroblast proteins which were resolved by two-dimensional gel electrophoresis.
      Phenetic analysis of both data sets supports the following conclusions: the orang
      utan subspecies distances are approximately 10 times closer to each other than
      they are to the African apes, and the orang utan subspecies are approximately as
      divergent as are the two chimpanzee species. Comparison of the genetic distances
      to genetic distance estimates done in the same laboratory under identical
      conditions reveals that the distance between Bornean vs. Sumatran orang utans is
      5-10 times the distance measured between several pairs of subspecies including
      lions, cheetahs, and tigers. Near species level molecular genetic distances
      between orang utan subspecies would support the separate management of Bornean
      and Sumatran orang utans as evolutionary significant units (Ryder 1987).
      Evolutionary topologies were constructed from the distance data using both
      cladistic and phenetic methods. The majority of resulting trees affirmed previous
      molecular evolutionary studies that indicated that man and chimpanzee diverged
      from a common ancestor subsequent to the divergence of gorilla from the common
      ancestor.

PMID- 2230077
TI  - An X-linked recessive mutation producing cleft palate, crooked tail, and
      polydactyly in mice.
AB  - Palate-tail-digits abnormality (ptd) is a new X-linked recessive mutation
      affecting the morphogenesis of the mouse. It maps proximal to Tabby. Hemizygous
      males and homozygous females exhibit skeletal malformations of the tail,
      polydactyly of the hind feet, and in about 60% of the cases a cleft palate. A
      very high level of postnatal mortality is observed even among the mutants without
      a cleft palate.

PMID- 2230078
TI  - From the museum.

PMID- 2230079
TI  - Balloon valvuloplasty.
AB  - Percutaneous balloon valvuloplasty has been used for several years for the
      treatment of stenosis of all four cardiac valves. It has been particularly
      effective in pulmonary stenosis in children and in rheumatic mitral stenosis,
      especially in the younger age groups without severe calcification. After initial
      enthusiasm, results have not been as good in severe calcific aortic stenosis,
      although there is a place for aortic valvuloplasty in patients who are truly
      inoperable for reasons of age or coexisting disease. The procedure also may be
      applicable to occasional cases of tricuspid stenosis. The techniques used and
      results obtained with these procedures at Indiana University are described.

PMID- 2230080
TI  - Peripheral cardiopulmonary support during high-risk angioplasty.
AB  - We report the safety and feasibility of the first three patients using
      cardiopulmonary bypass support at the Indiana University Medical Center during
      PTCA. All patients had severe left ventricular dysfunction. Cannulation was
      performed using 18- or 20-French cannulae of the femoral vessels, either
      surgically or percutaneously. After heparinization with an activated clotting
      time of greater than 450 seconds, cardiopulmonary bypass was instituted using the
      Bard CPS system. Flows ranged from 3.0 to 4.3 L/min. Normasol was used to prime
      the pump. Blood was retransfused back into the patient at the end of the
      procedure. Bleeding was a problem in case 1 at the arterial cannulation site and
      subsequently was corrected for cases 2 and 3. Coronary angioplasties were deemed
      technically successful. We conclude that high-risk angioplasty can be performed
      in patients with poor left ventricular function using cardiopulmonary bypass
      support in the cardiac catheterization laboratory. Further study is indicated.

PMID- 2230081
TI  - Transient ischemic attack: the presenting manifestation of transient asystole.
AB  - A patient with a focal transient neurologic deficit and no evidence of other
      underlying disease as an etiology is diagnosed with episodic asystole. His
      neurologic deficit was reproduced with episodes of asystole. The combination of
      asystole and localized intracranial atherosclerotic disease can produce focal
      neurologic deficits and should be considered in the differential for transient
      ischemic attack. It is easily preventable and responds to permanent implantation
      of a transvenous pacemaker.

PMID- 2230082
TI  - Abnormal catheter position after central venous line placement.

PMID- 2230083
TI  - Triscaphe arthritis.

PMID- 2230084
TI  - Maternal mortality in Indiana: a report of maternal deaths in 1988.

PMID- 2230085
TI  - HCFA administrator answers questions.

PMID- 2230086
TI  - Sentinel director explains review process.

PMID- 2230087
TI  - Undocumented phone calls: a liability issue.

PMID- 2230088
TI  - Pregnancy, abruptio placentae and cocaine.
AB  - Widespread cocaine use has caused concern about possible harmful effects during
      pregnancy. Several studies have suggested an increased incidence of abruptio
      placentae and stillbirths with cocaine use during pregnancy. This study examined
      what percentage of pregnant women in a lower socioeconomic population use
      cocaine, as well as positive urine cocaine screens in those with abruptio
      placentae and intrauterine fetal death (IUFD). Thirty patients were enrolled in
      the control group, eight in the abruptio placentae group and five in the IUFD
      group. One of 30 controls, one of eight in the abruptio placentae group and none
      of the IUFD group urines were positive for cocaine. A higher percentage of those
      in the abruptio placentae group had a history of abruptio placentae or fetal
      death, suggesting possible prior drug use. This group also had little, if any,
      prenatal care. Cocaine abusers may show signs of abuse in their obstetrical
      histories.

PMID- 2230090
TI  - Breast-feeding failure.

PMID- 2230089
TI  - Cardiac myxoma: the Indiana Heart Institute experience.
AB  - Surgical resection of a cardiac myxoma was performed in 14 patients at the
      Indiana Heart Institute at St. Vincent Hospital and Health Care Center in
      Indianapolis from 1974 to 1989. Thirteen were located in the left atrium and one
      in the right atrium. The 10 women and four men ranged in ages from 28 to 75
      years. Surgical complications included one perioperative death, one late death
      and one late recurrence requiring reoperation. Physicians must be highly
      suspicious to correctly diagnose this unusual but surgically correctable entity.
      Two-dimensional echocardiography is the diagnostic technique of choice for both
      early diagnosis of a cardiac myxoma and late follow-up after resection.

PMID- 2230091
TI  - Intersection syndrome.

PMID- 2230092
TI  - National Practitioner Data Bank: what every physician should know.

PMID- 2230093
TI  - Defense of medical malpractice claims takes perseverance and patience.

PMID- 2230094
TI  - ICHIA offers insurance to high-risk patients.

PMID- 2230095
TI  - The Indiana Veterans Home and AIDS patients.

PMID- 2230096
TI  - [The individual variability of pyramidal neurons in the neocortex of the rat].
AB  - In Golgi-Kopsch impregnated pyramid neurons of the neocortex (regio precentralis
      agranularis and area striata) of adult rats the individual variability was
      investigated. As parameters served the dendritic lengths, spine numbers and spine
      densities along the dendritic orders (basal and apical), within single dendritic
      fields, the apical and basal parts of the dendritic tree and of the whole neuron.
      The statistical tests gave the following results: Pyramid neurons in the regio
      precentralis agranularis are more variable than pyramid neurons in the area
      striata. Within the area striata the lamina III-pyramid neurons are more
      invariable than the lamina V-pyramid neurons. The basal dendrites are
      statistically more invariable than the apical dendrites. The dendritic lengths
      are less variable than the spine values. In general, the variability is different
      in particular subdivisions of the neurons analyzed as well as for the parameter
      chosen. The variability of neuronal structures depends from genetical factors and
      from a functional training. The knowledges about this variability are still
      insufficient. They are of considerable importance for the planning of experiments
      followed by statistical analyses.

PMID- 2230097
TI  - The effects of soft laser (He-Ne) irradiation on pineal parenchyma.
      Ultrastructural and pinealocyte caryometric modifications.
AB  - A study is made of the ultrastructure and variations in pinealocyte caryometric
      indices in 45 male albino rats (240 +/- 40 gm). Fifteen animals were subjected to
      exposed pineal body irradiation for 6 continuous minutes with soft He-Ne laser
      light. The irradiated rats were sacrificed in groups of five 3, 6 and 15 days
      post-irradiation. The control and sham-operated (craniotomy without irradiation)
      groups consisted of the same number of animals as the experimental groups. The
      results show a significant decrease in indices (p less than 0.0005) in all
      experimental groups in relation to the control and sham-operated animals,
      although in terms of the latter p for the three days post-irradiation group was
      0.002. A progressive and significant decrease (p less than 0.002) was also
      observed between the experimental groups after 3 and 15 days and after 6 and 15
      days, but not between the experimental groups after 3 and 6 days.
      Ultrastructurally, there were signs of secretory activity increase in the groups
      after 3 and 6 days, and decrease in such activity after 15 days--along with the
      appearance of cells of mesoglial lineage. A significant increase was observed in
      the number of peri-canalicular dark cells. The results are discussed and compared
      with those of other authors and different light energies.

PMID- 2230098
TI  - [Quantitative cytoarchitecture point differences in experimental cortical
      hemiatrophy found by automatic image analysis].
AB  - For more than ten years automatic analysis procedures have been applied to
      explore cortical cytoarchitectonics of the brain. The investigations presented
      were carried out by a method described as "automatic morphocorticography".
      Attempts to find out quantitative criteria for early unilateral cortical
      alterations were carried out on a pig's brain with experimental cortical
      hemiatrophy caused artificially by wide spread meningeal fibrosis. Lateral
      differences of the relative volume density (V alpha) of all cells could be
      analysed for each cortical layer in detail by the automatically plotted
      morphocorticographs (MCG) of selected cortical parts from both hemispheres.
      Partial increases in the V alpha-values could be found in the whole cross-section
      of the cerebral cortex from the experimentally damaged hemisphere and the same
      value increases of between 10 and 15% were found in the 3rd an 5th cortical layer
      in particular. In contrast the mean values of the relative numerical cellular
      density in the whole cortical cross-section remained without significant changes.
      It can be concluded that the early alterations caused by this type of damage are
      predominantly due to changes in the neuropil structures.

PMID- 2230099
TI  - Development of the median eminence in the male mouse. Karyometric effect of
      neonatal and prepuberal castration.
AB  - We have studied the karyometric development of the ependymocytes of the median
      eminence and ependyma adjacent of the arcuate nucleus in a control group of male
      albino mice from the 5th to the 160th postnatal day, and in other two
      experimental groups of animals that were castrated at two different days: the
      first and the 20th day of life. We have found differences in the spontaneous
      development of both ependymocytes showing the median eminence ependyma a more
      closely relationship to changes of gonadal hormone levels around puberty. In both
      zones, the response of the ependymocytes to neonatal castration was clearly more
      significative than that obtained after prepuberal castration, with lower values
      in the castrated animals than in the control mice. We suggest that this could be
      related to nervous and hormonal mechanisms.

PMID- 2230100
TI  - NPY-like immunoreactivity in the brain of the teleost Tinca tinca (Cyprinidae).
AB  - The distribution of neuropeptide tyrosine (NPY) in the brain of the tench (Tinca
      tinca) was mapped immunohistochemically by the peroxidase-anti-peroxidase (PAP)
      technique. NPY-immunoreactive (NPYi) neurons were found in the nucleus
      entopeduncularis (ne). These perikarya were intensely immunostained and were
      surrounded by a large number of axons and fibre terminals. Additional
      immunoreactive neurons appeared in the nucleus dorsolateralis thalami (ndl) at
      the level of the commissura posterior (cp). Only a few scattered NPY-positive
      perikarya occurred in the nucleus ventromedialis (nvm) and in the nucleus
      posterior periventricularis (nppv). At more caudal levels immunoreactive NPY
      neurons were found in the nucleus lateralis valvulae of the dorsal tegmentum
      mesencephali. Besides some scattered neurons in the medulla oblongata the only
      immunostained neurons were located in a subependymal nucleus at the lateral
      border of the fourth ventricle. However, these perikarya were only weakly
      immunostained by the NPY-antiserum. From its location this cell group is
      considered as nucleus motorius nervi vagi (nmX). NPYi fibres and axon terminals
      were found in the bulbus olfactorius, in the dorsal and lateral areas of the
      telencephalon, in the near surrounding of the ne, below most of the hypothalamic
      nuclei, as a connection between the nucleus posterior periventribularis and the
      nucleus recessus lateralis, in the ventral hypothalamus, in the lateral parts of
      the pituitary and in the caudal diencephalic inferior lobe. NPY-fibres occurred
      in the medial and deep layers of the tectum opticum, in the marginal areas of the
      tegmentum and the torus semicircularis, and as a lateral fibre tract through the
      medulla oblongata, connecting to the rostral parts of the spinal cord.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2230101
TI  - Pattern of brain glucose utilization following magnetic stimulation.
AB  - The 2-deoxy-D-(14C) glucose technique was used for autoradiographic mapping of
      the local cerebral glucose utilization in pigeons which were exposed to a
      periodically inverted artificial magnetic field in the Earth's field range.
      Stimulation during daytime resulted in increased values particularly in primary
      or secondary visual structures. Stimulation during nighttime resulted in
      increased values in the optic tectum and within the nucleus isthmi. In both
      situations decreased values were determined in the hypothalamus and increased
      values in the pineal gland. The results support the concept that magnetic
      information is transduced by magnetoreceptors and is relayed to structures of the
      visual system. Moreover, it is suggested, that magnetic stimulation exerts
      suppressive metabolic effects on the basal hypothalamus.

PMID- 2230102
TI  - Tectal afferents in Rana pipiens. A reassessment questioning the comparability of
      HRP-results.
AB  - Studying afferents to the optic tectum in Rana pipiens by means of retrograde HRP
      transport, results were obtained, that cast doubt on the reliability of this
      neuronal tract tracing technique. The tectum was found to receive afferents from
      e.g. lateral mesencephalic tegmentum, torus semicircularis, contralateral large
      celled pretectal nucleus, and ipsilateral thalamic nuclei, which have not
      previously been demonstrated. In addition, the data obtained lack evidence of
      projections reported earlier. We suggest, that neuronal projections may be
      subject to hormone and/or activity dependent changes, that alter the probability
      of accumulating sufficient amounts of the tracer to become labeled.

PMID- 2230103
TI  - Electron microscopic observations of the trigeminal mesencephalic nucleus in the
      frog, Rana ridibunda.
AB  - The trigeminal mesencephalic nucleus (Mes V) of the frog Rana ridibunda, has been
      studied by means of electron microscopic techniques. Mes V neurons are large (20
      30 microns in diameter). They are dispersed in the optic tectum and show round to
      oval cell bodies. Both multipolar and unipolar cells were observed. Their
      cytoplasm is very rich in organelles with well-developed rough endoplasmic
      reticulum that forms prominent and scattered Nissl bodies. Numerous small
      mitochondria, Golgi dyctiosomes, neurotubules and neurofilaments are distributed
      among the granular endoplasmic reticulum. A striking feature is the existence of
      abundant lysosome-like particles throughout the cytoplasm. In the surface of Mes
      V neurons spinous processes are absent and synaptic contacts on the perikarya are
      scarce. Two types of synapses, one with spherical translucent vesicles and the
      other with elongated translucent vesicles, contact on either the cell body or the
      dendrites of Mes V cells.

PMID- 2230104
TI  - The spinal terminals into the midbrain periaqueductal gray of the rat. A light
      and electron microscope study of the projections ascending via the ventro-lateral
      funiculus.
AB  - Light and electron microscope studies of the terminal fields of the spinal
      afferents ascending in the ventrolateral quadrant of the spinal cord to the
      periaqueductal gray matter (PAG) were carried out using silver degeneration
      techniques and anterograde WGA-HRP transport. At all mesencephalic levels the
      terminal degeneration and the labelling of the spinal fibres to the PAG were
      fairly dense, mainly concentrated in the outer part of the annular ring. At the
      electron microscope, the spinal nerve terminals were found ending almost
      exclusively in the neuropil, impinging on small dendritic profiles. The majority
      of these synaptic contacts were of the asymmetrical type and contained a
      prevalence of round vesicles. This study provides an accurate representation of
      the terminal domain of the spino-PAG afferents and gives the conclusive
      anatomical evidence that the fibres ascending in the ventro-lateral funiculus of
      the spinal cord do not simply pass through the PAG, but actually terminate in it,
      synapsing in the neuropil.

PMID- 2230105
TI  - Thalamic afferents from the brain stem. An experimental study using retrograde
      single and double labelling with HRP and iron-dextran in the rat. II. Nucleus
      laterodorsalis and subnucleus compactus nuclei pedunculo-pontini.
AB  - The reticulo-thalamic projection arising from the ncl. latero-dorsalis and from
      the subncl. compactus nuclei pedunculo-pontini was studied in single and double
      experiments using 51 injections of HRP and/or iron-dextran. The ncl. latero
      dorsalis projects to the midline nuclei, to the ncl. mediodorsalis and to the
      ncl. ventralis lateralis, and, together with the subncl. compactus, also to the
      anterior, intralaminar nuclei, to the ncl. ventralis basalis and ncll.
      posteriores. Part of the substantia grisea centralis pontis adjoining the oral
      pole of the ncl. latero-dorsalis sends out fibres throughout the region of the
      above listed nuclei while projecting only scantily to the anterior nuclei and to
      the ventrobasal complex. The projection from the ncl. laterodorsalis has a major
      contralateral component (about one third of the labelled cells) whereas the
      contralateral component arising from the subncl. compactus is very scanty. We
      found no topographic arrangement in the projection (though there were signs of a
      crude mediolateral organization). The projection, mainly from the ncl. latero
      dorsalis, shows relatively dense collateralization (double-labelled cells): ipsi-
      as well as contralaterally to the intralaminar nuclei, or collaterals to the
      ipsilateral intralaminary nuclei and, at the same time, to the contralateral ncl.
      mediodorsalis. A similar, albeit smaller collateralization, was also seen in the
      ncl. pedunculo-pontinus, its subncl. compactus: ipsilateral collateralization
      between the anterior and intralaminar nuclei or between the anterior and
      posterior intralaminar nuclei of the ipsilateral side.

PMID- 2230106
TI  - Immunohistochemical demonstration of serotonin neuron system in the central
      nervous system of the Japanese dogfish, Scyliorhinus torazame (Chondrichthyes).
AB  - The distribution of serotonin immunoreactivity in the brain of the Japanese
      dogfish (Scyliorhinus torazame) was studied with the peroxidase-antiperoxidase
      immunohistochemical method with serotonin antiserum. The somata of the serotonin
      neurons were located in the raphe regions of the brain stem and the spinal cord.
      A small number of serotonergic neurons were also distributed as cerebrospinal
      fluid contacting neurons in the organum vasculosum hypothalami (OVH) and the
      paraventricular organ (PVO). These neurons were classified into nine groups (S1
      S9): spinal cord (S1), rhombencephalon (S2-S6), mesencephalon (S7), and
      prosencephalon (OVH, S8 and PVO, S9). Processes of the serotonin neurons were
      widely distributed in the central nervous system, forming dense networks in
      various regions. The highest concentrations of these fibers were in the dorsal
      area of the vagal lobe, the nucleus isthmi, the tuberculum posterium, the distal
      part of the PVO, and the dorsal regions of the olfactory tubercle.

PMID- 2230107
TI  - The influence of sexual orientation on career decision-making: a research note.
AB  - This study investigates differences between heterosexuals and homosexuals of both
      sexes with regard to several variables in the career decision-making process:
      anxiety about making a career choice, indecisiveness about the choice, need to
      acquire information about the career of choice, uncertainty about the choice, and
      career choice dissatisfaction. Significant interactions are found on choice
      uncertainty (gay men having the highest level of uncertainty and lesbian women
      the lowest) and choice dissatisfaction (heterosexual women and gay men showing
      more dissatisfaction than the other two groups).

PMID- 2230108
TI  - Aikane: accounts of Hawaiian same-sex relationships in the journals of Captain
      Cook's Third Voyage (1776-80).
AB  - The journals recorded by Captain James Cook and his associates on Cook's Third
      Voyage of discovery (1776-1780) include extensive eyewitness accounts and
      analyses of the Hawaiian people and their culture-the first to be made by
      Europeans and Americans. Among these are several reports of young men called
      aikane, who were attached to the court or train of the ali'i (chiefs), and whose
      functions were sexual, social, and political. Among these aikane were several who
      acted as intermediaries between the sailors and the Hawaiians, and whose
      influence and conduct profoundly affected the course of events at Kealakekua Bay,
      where Cook was killed in February, 1779. The information contained in these
      materials suggests that such Hawaiian same-sex relationships are more important
      than currently accounted for in accepted theories of Hawaiian ethnohistory.

PMID- 2230109
TI  - The Biblical prohibition of homosexual intercourse.

PMID- 2230110
TI  - Using Sexton to read Freud: the pre-oedipal phase and the etiology of lesbianism
      in Sexton's "Rapunzel".
AB  - In her poem "Rapunzel," Anne Sexton maps out a model of lesbian etiology that at
      once parodies the model proposed by Freud and significantly amends it. Freud's
      famous model for female development, as he articulates it first in "Some
      Psychological Consequences of the Anatomical Distinction Between the Sexes," and
      later in "Female Sexuality," may be profitably compared to the model implied by
      Sexton's poem. The female pre-Oedipal phase is crucially at stake in such a
      comparison, as Sexton's account suggests that the pleasures of the pre-Oedipal
      mother-daughter dyad are dangerously strong for the girl child, and seem to be
      the force that compels the majority of girls into the rechanneling of libidinal
      desire from the mother to the father. Sexton's poem emphasizes the continuous
      pressures exerted by the pre-Oedipal phase upon the psyche of the developing
      girl. Sexton's emphasis on the pre-Oedipal phase, and her depiction of
      heterosexual love, in "Rapunzel" and elsewhere, as regressive, suggests that the
      "normal" heterosexual female, who seeks a father figure in order to save herself
      from re-absorption into the primal mother-daughter dyad, is actually acting out
      an infantile fantasy of the devouring mother. The morbid irony of Sexton's
      "Rapunzel" stems from its depiction of a young woman who flees the boundary-less
      world of the pre-Oedipal state, only to resurrect the infantile fantasy of the
      devouring mother in the arms of a father substitute.

PMID- 2230111
TI  - The Multidimensional Scale of Sexuality.
AB  - Research on the assessment of sexual orientation has been limited, and what does
      exist is often conflicting and confusing. This is largely due to the lack of any
      agreed upon definition of bisexuality. The Multidimensional Scale of Sexuality
      (MSS) was developed to validate and to contrast six proposed categories of
      bisexuality, as well as categories related to heterosexuality, homosexuality, and
      asexuality. This instrument includes ratings of the behavioral and
      cognitive/affective components of sexuality. The MSS was completed by 148
      subjects, the majority of whom were from identified homosexual and bisexual
      populations. Although subjects' self-descriptions on the MSS were consistent with
      their self-descriptions on the Kinsey Heterosexual-Homosexual Scale, the MSS
      provided a more varied description of sexual orientation. Subject's self
      described sexual orientation on the MSS was more consistent with their
      cognitive/affective ratings than with their behavioral ratings. With the
      exception of self-described heterosexuals, the frequency of cognitive/affective
      sexuality was greater than that of behavioral sexuality.

PMID- 2230112
TI  - An examination of demographic variables, nurturance, and empathy among homosexual
      and heterosexual big brother/big sister volunteers.
AB  - Potential volunteers are often screened for sexual orientation and, in most
      circumstances, excluded if they are gay men or lesbians. This is especially true
      if the volunteer's work involves children. Big Brothers/Big Sisters of San
      Francisco deviates from this practice and screens volunteers based on other
      attributes. This study investigates differences in demographic variables,
      nurturance, and empathy among homosexual and heterosexual Big Brothers/Big
      Sisters of San Francisco. Two hundred nineteen questionnaires were returned and
      results indicated that there were no significant differences in demographic
      factors, nurturance, or empathy based on sexual orientation. Gender differences
      for the study variables were found and these are consistent with the results of
      earlier studies. Three significant factors were identified: stability, social
      support and personality attributes. Sexual orientation was not a significant
      factor.

PMID- 2230113
TI  - Activation of murine T cells by streptococcal pyrogenic exotoxin type A.
      Requirement for MHC class II molecules on accessory cells and identification of V
      beta elements in T cell receptor of toxin-reactive T cells.
AB  - We investigated the mechanisms of murine T cell activation by streptococcal
      pyrogenic exotoxin type A (SPE A), focusing on the role of MHC class II molecules
      on accessory cells (AC) and V beta usage in alpha beta TCR of SPE A-reactive T
      cells in comparison with staphylococcal enterotoxin B-reactive T cells. L cells
      transfected with I-Ab genes functioned as effective AC for SPE A-induced
      responses by C57BL/6 T cells, proliferation, and IL-2 production, but control L
      cells were not effective AC. Anti-I-Ab mAb inhibited the SPE A-induced responses.
      Staphylococcal enterotoxin B-induced C57BL/6 T cell blasts were composed of cells
      bearing V beta 3, members of the V beta 8 family, and V beta 11. Most of the SPE
      A-induced T cell blasts (about 80%) bore V beta 8.2. mAb reactive to V beta 8.2
      markedly inhibited SPE A-induced T cell responses. Apparently, SPE A activates
      mainly T cells bearing V beta 8.2 in physical association with MHC class II
      molecules expressed on AC. We also discuss the pathogenic activities of SPE A in
      relation to toxic shock syndrome.

PMID- 2230114
TI  - Hybridomas derived from lipopolysaccharide-activated anti-mu-treated B cells have
      active suppression of IgM secretion, demonstrable by secondary fusion.
AB  - Treatment of LPS-stimulated mouse B cells with bivalent anti-mu antibodies
      suppresses differentiation to Ig-secreting cells without interfering with
      proliferation. This treatment selectively inhibits up-regulation of transcription
      of differentiation-related genes. Induction of anti-mu suppression requires RNA
      and protein synthesis, suggesting involvement of a transcriptional repressor. We
      describe experiments designed to capture the repressed phenotype of anti-mu
      treated cells. Fusions of anti-mu-treated cells with the B lymphoma line M12.4.5,
      but not plasmacytoma Ag8.653, yielded a significantly lower frequency of
      secretory hybridomas than did parallel fusion of cells treated with LPS only. To
      test for active repression, nonsecreting cloned hybridomas were secondarily fused
      to LPS-activated normal B cells. Secondary hybridomas with anti-mu parentage had
      a very low frequency of IgM secretion. Active suppression could only be
      demonstrated by secondary fusion. Neither supernatants nor extracts of repressor
      hybridomas influenced LPS-driven differentiation of normal B cells. These results
      confirm that this form of differentiation suppression is an active process,
      probably mediated by transcriptional controls. Repressor hybridomas should prove
      useful for studies of molecular mechanisms.

PMID- 2230115
TI  - Development of B cell lineages during a primary anti-hapten immune response.
AB  - Cell lineage relationships were examined in large numbers of hybridomas derived
      from a single mouse at 7 days and from a single mouse at 12 days after a primary
      immunization. The properties of these developing lineages provide unique insight
      into their biologic selection and differentiation. The unique VDJ junctions, the
      characteristics of the somatic mutations, and the nonproductive H chain gene
      rearrangements observed at day 12 all indicate that the hybridomas were derived
      from a limited number of progenitor B cells. Clonally related hybridomas were
      also observed at day 7. The activation of these lineages occurred very early,
      because somatic variants were strongly selected for within a few days after the
      primary immunization.

PMID- 2230116
TI  - Aberrant regulation of IL-1 expression in macrophages from young autoimmune-prone
      mice.
AB  - IL-1 is a multifunctional, immunoregulatory polypeptide produced by many cell
      types. Because activated macrophages are a major source of IL-1 and have also
      been implicated in the pathogenesis of autoimmune disease, we investigated the
      regulation of IL-1 expression in several autoimmune-prone strains of mice.
      Peritoneal macrophages derived from the autoimmune-prone strains MRL/lpr, MRL/+,
      NZB, and NZB/W F1, as well as NZW, displayed transient expression of IL-1 in
      contrast to the stable expression characteristic of control normal strains
      including A. Thy, A/J, B10, B10.A, B10.D2, C57BL/6, BALB/c, and C3H/HeN. The down
      regulation of IL-1 by macrophages from the autoimmune-prone mice was not
      attributable to inherently defective signal transduction because macrophages from
      both the normal and autoimmune-prone strains displayed substantial initial levels
      of cell-associated and secreted IL-1. However, during the first 2 to 3 days in
      culture, macrophages from autoimmune-prone mice became progressively refractory
      to both induction and maintenance of IL-1, a pattern that correlated with changes
      in the levels of IL-1 alpha and beta mRNA. The progressive reduction in IL-1
      expression by macrophages from these autoimmune-prone strains was not due to a
      reduction in general metabolism or viability, because expression of cell surface
      antigens, including MHC class I and II Ag and LFA-1, was comparable to that of
      control macrophages. Because IL-1 plays a critical role in the homeostasis of a
      variety of cell lineages, defective expression, and maintenance of IL-1 (and
      perhaps other cytokines) by macrophages from the autoimmune-prone strains may
      contribute to the immune dysregulation that develops in these mice.
      Alternatively, cytokine dysregulation might not contribute directly to disease,
      but rather reflect a more basic defect related to specific signal transducing or
      gene regulatory pathways.

PMID- 2230117
TI  - Immune responses of intact and embryonically enucleated frogs to self-lens
      antigens.
AB  - Embryonically enucleated frogs (Xenopus) will tolerate an isogeneic eye implanted
      during adult life although their immune system has never been previously exposed
      to eye-specific Ag. We hypothesized that such self-implants survive because they
      induce tolerance to the eye-specific Ag. We have developed evidence to support
      this hypothesis by studying the responses of embryonically enucleated or intact
      frogs, with or without eye implants, to self-lens proteins. After immunization
      with a low concentration of bovine lens proteins, spleen cells from all intact
      and all embryonically enucleated frogs displayed significant in vitro
      proliferation against the Ag. All animals in both groups of frogs also produced
      high titered xenoantibodies. After immunization with a comparable preparation and
      concentration of self-lens Ag, splenocytes from only some of the embryonically
      enucleated and intact frogs showed significant proliferation, and fewer of these
      frogs produced antibody. When the immunization protocol and Ag concentration were
      modified to evoke consistent anti-self-lens proliferative and antibody responses
      from enucleated frogs, intact frogs responded equally well. Because there were no
      significant differences in the magnitude of the responses, and the percent of
      enucleated and intact frogs responding did not differ, we conclude that there is
      little or no immunologic tolerance to self-lens Ag in intact frogs. When either
      embryonically enucleated or intact frogs were heterotopically implanted with
      isogeneic eyes and then immunized with self-lens Ag or foreign lens Ag using the
      optimal immunization protocol, the Ag-specific proliferative responses of their
      lymphocytes were significantly reduced after immunization with self-, but not
      foreign Ag. This argues that embryonically enucleated frogs can become tolerant
      of the organ-specific Ag of the lens, even in adult life.

PMID- 2230118
TI  - Control of IL-2 receptor-alpha expression by IL-1, tumor necrosis factor, and IL
      2. Complex regulation via elements in the 5' flanking region.
AB  - We have analyzed the mechanisms by which IL-1, IL-2, and TNF regulate expression
      of IL-2R alpha chain in a rodent T cell line. All three cytokines induce
      detectable IL-2R alpha mRNA by themselves, but there is strong synergy between IL
      1 or TNF, on the one hand, and IL-2, on the other. The earliest phase of
      induction by IL-1 is independent of protein synthesis. IL-1, but not TNF, also
      stimulates transient secretion of IL-2. This leads to an autocrine stimulation of
      a further increase in IL-2R alpha mRNA levels. When IL-2 secretion has dropped
      off, continued IL-2R alpha expression requires both IL-2 and IL-1. Most or all of
      this regulation is due to changes in the rate of transcription of the IL-2R alpha
      gene. The response to IL-1 and IL-2 depends on a segment in the IL-2R alpha 5'
      flanking region, upstream of all cis-acting regulatory elements previously
      identified in the human gene.

PMID- 2230119
TI  - A small proportion of cationic antibodies in immune complexes is sufficient to
      mediate their deposition in glomeruli.
AB  - Positively charged antibodies mediate enhanced deposition of circulating immune
      complexes at the glomerular basement membrane. The presented experiments
      demonstrate that when soluble immune complexes were prepared with a mixture of
      antibodies containing 10 to 25% cationic antibodies, then noncationic antibodies
      in the complexes were deposited in mouse glomeruli. One or two cationic
      antibodies in each immune complex sufficed for deposition of the complexes. Proof
      for this was obtained by two kinds of experiments. First, the injected immune
      complexes were prepared in Ag excess from mixtures of radiolabeled noncationic
      rabbit antibodies to human serum albumin (HSA) and unlabeled cationized rabbit
      antibodies to HSA, thus permitting the specific quantitation of the deposition of
      noncationic antibodies in glomeruli because of the presence of cationized
      antibodies within the same complexes. As a control experiment, immune complexes
      prepared only with noncationic antibodies resulted in very little deposition in
      kidneys over the same time period. Second, detection of the localization of the
      noncationic antibody in deposits in glomeruli by immunofluorescence microscopy
      was accomplished using immune complexes prepared with mixtures of noncationic
      goat antibodies to HSA and cationized rabbit antibodies to HSA. Thus, the
      synthesis of a small population of cationic antibodies during the immune response
      may lead to the formation of circulating immune complexes with enhanced
      propensity for deposition in glomeruli in patients with SLE or other immune
      complex diseases.

PMID- 2230120
TI  - Ultraviolet cross-linking of helical oligonucleotides to two monoclonal MRL
      1pr/1pr anti-DNA autoantibodies. Variations in H and L chain binding to DNA.
AB  - Experiments were performed to determine whether both H and L chains of different
      anti-native DNA autoantibodies are uniformly involved in binding to DNA. Two
      purified monoclonal mouse (MRL-1pr/1pr) IgG autoantibodies, H241 and 2C10, were
      tested. They both bound synthetic helical oligonucleotides of 10 to 20 base pairs
      in a gel electrophoresis retardation assay but differed in their preferences for
      given base sequences. Exposure of antibody-radiolabeled oligonucleotide mixtures
      to UV light (254 nm) for 10 min led to specific covalent cross-linking of
      oligonucleotide to both the H and the L chains of H241 but only to the H chain of
      2C10. Single labeling events were detected without higher aggregation. The
      oligonucleotides were not cross-linked to unrelated IgG, even after 2 h of
      irradiation. Cross-linked (radioactively labeled) H and L chains of H241 and 2C10
      were isolated from denaturing electrophoresis gels and digested with lysyl
      endopeptidase and/or staphylococcal V8 protease. H241 and 2C10 H chains each
      yielded a major labeled peptide fragment, but the peptides from the two
      antibodies were different. These experiments measured only some of the antibody
      DNA interactions, probably with bases in the major groove of the DNA. They
      indicated that two MRL-1pr/1pr IgG anti-native DNA antibodies differ in their H
      and L chain contacts with DNA and provide an approach to identifying affinity
      labeled binding sites in the antibodies.

PMID- 2230121
TI  - Binding of staphylococcal enterotoxin A to purified murine MHC class II molecules
      in supported lipid bilayers.
AB  - The staphylococcal enterotoxins are a family of bacterial toxins that are thought
      to exert their pathogenic effects by the massive activation of T lymphocytes to
      produce lymphokines. Activation of T cells by these toxins is dependent on MHC
      class II+ APC. Recent studies from a number of laboratories have implicated MHC
      class II proteins as the APC surface receptor for a number of the staphylococcal
      enterotoxins. The present report shows that staphylococcal enterotoxin A, (SEA)
      binds to the purified murine MHC class II molecule I-Ed reconstituted in
      supported planar membranes, indicating that no other cell surface proteins are
      required for SEA binding. The Kd for SEA binding to I-Ed was determined to be 3.5
      +/- 1.6 x 10(-6) M. Specific binding of SEA to I-Ad was also observed, but the
      interaction was of significantly lower affinity. Binding of SEA to purified I-Ed
      was blocked by antibodies against both the alpha- and the beta-chain of the I-Ed
      molecule, but not by antibodies specific for an unrelated MHC class II protein.
      Binding of SEA to I-Ad was blocked by an A beta d but not by an A alpha d
      specific antibody. Planar membranes containing only lipid and purified I-Ed
      molecules were sufficient for activation of a V beta 1 expressing T hybrid by
      SEA. The T cells responded to as few as 180 toxin molecules per T cell.

PMID- 2230122
TI  - Bacterial killing and inhibition of inner membrane activity by C5b-9 complexes as
      a function of the sequential addition of C9 to C5b-8 sites.
AB  - The assembly of the C5b-9 complex on the outer membrane of C-sensitive cells of
      Escherichia coli results in a rapid inhibition of inner membrane function and
      ultimately a loss of cell viability. Cells bearing C5b-8 sites suffer no
      deleterious effects; however, the addition of C9 results in a rapid inhibition of
      inner membrane function and cell death. An attempt was made to examine the
      relationship between the toxic effects of the C5b-9 complex and the number of C9
      molecules per C5b-8 site. Cells bearing C5b-8 sites were exposed to excess C9 at
      0 degrees C and washed three times at 4 degrees C. The number of C9 molecules
      bound to each cell was equivalent to the number of C5b-8 sites present on each
      cell, and no additional C9 molecules could be bound when the cells were
      maintained at 4 degrees C. These cells were then incubated at 37 degrees C for 3
      min and returned to 0 degrees C, a technique which exposed additional C9-binding
      sites equivalent to the number of C9 molecules previously bound to the cells.
      This technique was repeated and demonstrated that the sequential build-up of a
      C5b-9 site with two C9 molecules per C5b-8 site was capable of inhibiting both
      inner membrane function (respiration and amino acid transport) and cell
      viability. Three C9 molecules per complex had effects that approached the
      inhibitory effects of complexes formed in the presence of excess C9.

PMID- 2230123
TI  - Proteolytic fragmentation of sialophorin (CD43). Localization of the activation
      inducing site and examination of the role of sialic acid.
AB  - Sialophorin (CD43) is the major surface mucin on many hematopoietic cells. It has
      been implicated in regulating the survival of T lymphocytes in the circulation,
      and its functions in vitro as the receptor of a T lymphocyte and monocyte
      activation pathway. The structure of CD43 was examined by protease treatment of
      lymphoblastoid cells bearing surface CD43. Trypsin treatment converts CD43
      (apparent Mr 115,000) to species of apparent Mr 100,000 called T-100, which
      remains cell-associated; however, the mechanism of trypsin action was not
      clarified. Pancreatic elastase and Staphylococcus aureus V8 protease cleave CD43
      at discrete extracellular sites. V8 protease generates two fragments, which
      together account for all properties and mass of the parent molecule. The COOH
      terminal fragment V-90 (apparent Mr 90,000) consists of the intracellular and
      transmembrane regions and part of the extracellular region. The fragment V-30
      (apparent Mr 30,000), which is released from the cell, comprises the NH2-terminal
      approximately 78 amino acids with attached oligosaccharides. V-30 contains the
      binding sites for the antibodies L2 and L10; the latter is the antibody that
      activates lymphocytes and monocytes. These findings subdivide the extracellular
      region of CD43 and indicate that the activation-inducing epitope is located in
      the most distal portion of the molecule. It is shown that CD43 is insensitive to
      all but very high concentrations of three proteases. Pretreatment with sialidase
      enhances sensitivity 13-fold for trypsin, 40-fold for S. aureus V8 protease, and
      400-fold for elastase, suggesting that sialic acid influences the survival of
      surface CD43 molecules when cells are exposed to protease.

PMID- 2230124
TI  - Protein D of Haemophilus influenzae. A novel bacterial surface protein with
      affinity for human IgD.
AB  - Protein D, a novel surface protein of the bacterial species Haemophilus
      influenzae with affinity for human IgD, was isolated after solubilization with
      sonication and Sarcosyl-extraction by a single SDS-PAGE step. From 1 ml of packed
      bacteria was prepared 0.25 mg of purified protein D. The apparent m.w. of protein
      D was estimated to 42,000 by SDS-PAGE and gel chromatography. Edman degradation
      cycles of protein D produced no amino acid phenylthiohydantoin derivatives and
      the amino-terminal end of the single protein D polypeptide chain is thus probably
      blocked. Protein D differs from all previously described outer membrane proteins
      (protein 1 to 6) of H. influenzae. Thus, protein D did not react with antibodies
      against protein 1 or protein 2 and the latter proteins did not bind IgD. Protein
      D was found to exhibit unique Ig-binding properties. Thus, in dot blots protein D
      bound four different human IgD myeloma proteins but not IgG, IgM, IgA, IgE, or
      some additional proteins. On the IgD molecule, constant parts of the H chains
      both in the Fab and Fc fragments appear responsible for the interaction with
      protein D. This novel Ig-binding reagent promises to be of theoretical and
      practical interest in immunologic and microbiologic research.

PMID- 2230125
TI  - Monosodium urate crystals stimulate phospholipase A2 enzyme activities and the
      synthesis of a phospholipase A2-activating protein.
AB  - Eicosanoids are important mediators of the inflammatory response to monosodium
      urate crystals (MSUC) that results in gout. Phospholipase enzymes cleave fatty
      acids from membrane phospholipids, and this is thought to be the rate-limiting
      step in eicosanoid production. To understand better the mechanism of eicosanoid
      production in this disease, we stimulated human peripheral blood neutrophils and
      monocytes with MSUC and measured phospholipase enzyme activities. MSUC stimulated
      both intracellular and secretory phospholipase A2 enzyme activities in a time and
      concentration-dependent manner. Specificity was observed, as phospholipase C
      activities were not affected. Pretreatment with colchicine, but not aspirin,
      indomethacin, allopurinol, or islet activating protein, abrogated the enhanced
      phospholipase A2 activities. We have recently isolated and characterized a
      phospholipase A2 activating protein termed PLAP from synovial fluid from patients
      with rheumatoid arthritis, and from murine and bovine cell lines. PLAP was
      detected in gouty synovial fluid by immunodot blotting and ELISA assays and
      expressed the same characteristics as PLAP identified from other sources. To
      examine the role of PLAP in MSUC-induced phospholipase A2 stimulation, we treated
      cells with MSUC and observed an increase in immunoreactive PLAP. This response
      also could be blunted by colchicine, but not other drugs. Both phospholipase A2
      and PLAP induced production by human monocytes of PGE2 and leukotriene B4 by
      neutrophils. These findings suggest that phospholipase A2 activation in response
      to MSUC requires an intact microtubule structure, and that phospholipase A2 and
      PLAP may be important modulators of at least a portion of the gouty inflammatory
      response.

PMID- 2230126
TI  - Developmental expression of plasminogen activator inhibitor type 1 by human
      alveolar macrophages. Possible role in lung injury.
AB  - Urokinase activity is regulated by the specific endogenous plasminogen activator
      inhibitors type 1 (PAI-1) and type 2 (PAI-2). One of these inhibitors, PAI-1, has
      been directly implicated in connective tissue metabolism by virtue of its ability
      to bind extracellular matrix proteins. Because the normal lung is relatively rich
      in urokinase and abnormalities in urokinase activity have been associated with
      fibrotic lung diseases, we have explored the possibility of local production of
      PAI-1 and PAI-2 in human lung. Reverse transcription and subsequent amplification
      by the polymerase chain reaction of total lung RNA revealed PAI-1 mRNA in each of
      three normal samples and in two specimens from patients with the adult
      respiratory distress syndrome (ARDS). In situ hybridizations of lung biopsy
      specimens from a patient with ARDS with cRNA probes to PAI-1 and PAI-2 indicated
      that alveolar macrophages express PAI-1 mRNA during the acute injury phase.
      Subsequent reverse transcription and PCR amplification of normal human monocyte
      and alveolar macrophage mRNA revealed that neither cell type expressed mRNA for
      urokinase inhibitors. However, after 24 h stimulation with endotoxin in vitro,
      monocytes were strongly positive for PAI-2 but negative for PAI-1 mRNA whereas,
      under the same conditions, alveolar macrophages exhibited mRNA for both PAI-1 and
      PAI-2. Metabolic labeling of endotoxin-stimulated alveolar macrophages with 35S
      methionine followed by immunoprecipitation with PAI-1 and PAI-2 antibodies
      revealed that macrophages synthesized both PAI-1 and PAI-2. As judged by
      immunoprecipitation and functional studies, PAI-2 was found to be the major
      intracellular PA inhibitor whereas PAI-1 was found to predominate outside the
      cell. Thus, mononuclear phagocytes exhibit a developmental potential for PAI-1
      expression. The release of PAI-1 by stimulated macrophages, as observed in the
      setting of ARDS, may be one mechanism by which these cells promote connective
      tissue accumulation.

PMID- 2230127
TI  - Failure to detect IL-3-binding sites on human mast cells.
AB  - IL-3, a pleiotropic lymphokine, has been termed mast cell growth factor because
      it promotes growth and differentiation of murine mast cells. Murine mast cells,
      in turn, express cell surface receptors for IL-3. Human rIL-3 has been shown to
      induce proliferation and differentiation of human basophils and to activate
      basophils via high affinity binding sites. To investigate whether human mast
      cells express IL-3R, binding studies with 125I-radiolabeled human rIL-3 were
      performed on HMC-1, a novel human mast cell line, and on pure populations (i.e.,
      93 to 99% purity) of human tissue mast cells obtained with mAb and C from
      dispersed lung (n = 2). Unexpectedly, neither enriched human lung mast cells nor
      HMC-1 cells bound radiolabeled human rIL-3 specifically. Moreover, human rIL-3
      failed to promote uptake of [3H]thymidine, synthesis of histamine, histamine
      releasability, or changes in expression of mast cell differentiation Ag (YB5B8,
      CD54/ICAM-1, CD9/p24, CD33/gp67) on either human lung mast cells or HMC-1 cells.
      It is hypothesized that the fundamental difference in the biologic response to IL
      3 between human and murine mast cells is due to a loss during evolution of mast
      cell high affinity IL-3 binding sites.

PMID- 2230128
TI  - Cellular immune response to hepatitis B virus-encoded antigens in acute and
      chronic hepatitis B virus infection.
AB  - The proliferative response of PBMC to hepatitis B virus (HBV) envelope, core, and
      e Ag was analyzed prospectively in 21 patients with acute self-limited HBV
      infection and compared with the response of patients with chronic HBV infection
      and different levels of HBV replication (i.e., hepatitis e Ag (HBeAg)- or anti
      HBe-positive) and liver damage (i.e., chronic active hepatitis or chronic
      asymptomatic carriers). Our results indicate that: 1) HBV-infected subjects who
      develop a self-limited acute hepatitis show a vigorous PBMC response to hepatitis
      B core Ag and HBeAg, as expression of T cell activation; 2) appearance of a
      detectable lymphocyte response to HBV nucleocapsid Ag is temporally associated
      with the clearance of HBV envelope Ag; 3) in patients with chronic HBV infection
      the level of T cell responsiveness to hepatitis B core Ag and to HBeAg is
      significantly lower than that observed during acute infection; 4) T cell
      sensitization to HBV envelope Ag in acute and chronic HBV infection is usually
      undetectable and when measurable is expressed transiently and at low levels.
      These results may reflect immune events of pathogenetic relevance with respect to
      evolution of disease and viral clearance.

PMID- 2230129
TI  - The kinetics of gene expression and maturation of IL-1 alpha after induction with
      the surface coat of Trypanosoma brucei rhodesiense or lipopolysaccharide.
AB  - The purpose of this study was threefold: to determine if the variant surface coat
      glycoprotein (VSG) of Trypanosoma brucei rhodesiense induces IL-1 alpha; to study
      the kinetics of IL-1 alpha transcription, maturation and secretion; and to
      compare VSG to LPS in its ability to induce IL-1 alpha. VSG was added to cultures
      of the P388D1 murine macrophage cell line. RNA was dotted onto nitrocellulose and
      hybridized with a murine IL-1 alpha cDNA probe. Maximal production of IL-1 alpha
      mRNA occurred in a dose- and time-dependent manner, peaking at 25 micrograms/ml
      VSG, within 2 h. Induction of IL-1 alpha was not due to contaminants because 1)
      absorption of VSG with a mAb abrogated IL-1 alpha mRNA synthesis, 2) the addition
      of polymyxin B did not affect mRNA levels, and 3) cellular IL-1 alpha was
      detectable in VSG-treated splenocytes from endotoxin nonresponder C3H/HeJ mice.
      Murine splenic macrophages also had enhanced levels of IL-1 alpha mRNA after
      administration of VSG in vivo or during an acute infection. Antiserum generated
      against the synthetic peptide SGDDSKYPV (amino acids 177-185 from the murine IL-1
      alpha sequence) was used to measure the levels of the 33-, 22-, and 14-kDa
      proteins in cell lysates and medium of VSG-stimulated P388D1 cells. The 22-kDa
      protein was the predominant cellular form until secretion started. Secretion of
      the 14-kDa form began abruptly 6 to 8 h after the addition of VSG. By 12 h, the
      33-kDa precursor was the major cytoplasmic form. In comparative analyses, LPS
      stimulated P388D1 cells produced more transcript, generated peak levels of 22-kDa
      protein 3 h earlier, and began to secrete the 14-kDa molecule 5 h earlier. The
      rate of IL-1 alpha accumulation in the medium was linear between 6 and 24 h after
      LPS treatment, but began to drop by 8 h in VSG-treated cells. Functional
      (comitogenic) IL-1 activity was also detected in media from VSG-treated splenic
      macrophages and P388D1 cells. Activity peaked at 50 micrograms/ml and was lost if
      0.2% IL-1 antisera were added to the cultures.

PMID- 2230130
TI  - Analysis of beta 2-microglobulin gene expression in the developing mouse embryo
      and placenta.
AB  - The major transplantation (MHC) Ag in the mouse are cell-surface glycoproteins
      composed of a 40- to 45-kDa H chain and a 12-kDa L chain, beta 2-microglobulin
      (beta 2 m). Regulation of MHC gene expression during early development is thought
      to play a critical role in maternal tolerance of the fetal allograft. We have
      used in situ hybridization techniques to characterize the temporal and spatial
      pattern of expression of the beta 2 m gene in the developing mouse embryo. beta 2
      m mRNA is first detected in the extra-embryonic derivatives of the early
      primitive streak stage embryo where it is specifically restricted to the tissues
      of the ectoplacental cone and chorion. Expression of the beta 2 m gene continues
      in these tissues during formation of the definitive placenta. beta 2 m
      transcripts were also detected in the tissues of the visceral yolk sac starting
      at 10.5 days. Comparable levels of expression were observed in both the visceral
      yolk sac endoderm and the extra-embryonic mesoderm. These results clearly
      indicate that the onset of beta 2 m gene expression is not restricted to early
      hemopoietic cells. In the embryo-proper, significant levels of beta 2 m mRNA were
      not detected until day 9.5. At this stage, we observed a strong signal over the
      liver rudiment. The remaining somatic tissues expressed low levels of
      transcripts. Similar results were obtained at later stages of development, i.e.,
      the fetal liver was consistently the most strongly positive organ. Overall these
      in situ hybridization studies define the pattern of beta 2 m gene transcription
      and thus potential sites of surface expression of class I proteins in specific
      cell lineages in the early postimplantation stage embryo.

PMID- 2230131
TI  - Syrian hamsters express diverse MHC class I gene products.
AB  - MHC class I glycoproteins are highly diverse in most species. The Syrian hamster
      has long been thought to express monomorphic MHC class I molecules and thus be an
      exception to this rule. Here we show that Syrian hamsters express diverse MHC
      class I gene products. The nucleotide sequences of the alpha 1 and alpha-2
      domains of classical Syrian hamster MHC class I molecules are highly variable and
      show evidence of having been under selective pressures at their Ag recognition
      sites. Interestingly, none of the Syrian hamster class I genes was closely
      related to their counterparts in the mouse. These observations suggest that
      Syrian hamsters in the wild may express diverse MHC class I molecules.

PMID- 2230132
TI  - Insulin-like growth factor-I supports proliferation of autocrine thymic lymphoma
      cells with a pre-T cell phenotype.
AB  - We have studied the phenotypic characteristics and growth properties of murine T
      lymphoma cell lines derived from primary x-ray-induced thymic lymphomas at the
      earliest stage at which they can be detected, and well before spreading to other
      organs has occurred. These cell lines serve as model systems for the earliest
      events in T cell lymphoma induction, before tumor cell progression and spreading
      to other organs. We find that primary x-ray-induced T cell lymphoma lines have
      phenotypic characteristics of thymic pre-T cells and show no proliferative
      response to any of the IL tested nor to other hematopoietic growth factors.
      However, they do proliferate in response to insulin-like growth factor I (IGF-I)
      and to a small autocrine peptide distinct from IGF-I, which we term lymphoma
      growth factor. One of the earliest lesions in T cell lymphoma induction may
      therefore be an inhibition of differentiation at one of several specific points.
      In its early stages, T lymphoma cell growth may be restricted to an environment
      where local concentrations of specific growth factors such as IGF-I or lymphoma
      growth factor are sufficiently high.

PMID- 2230133
TI  - Isolation of a novel tumor protein that induces resistance to natural killer cell
      lysis.
AB  - The human metastatic tumor cell line CAP-2, produces a soluble factor that
      induces resistance to NK lysis of K-562 susceptible leukemia cell line, and does
      not inhibit the cytotoxic capacity of effector cells. The use of sequential HPLC,
      hydrophobic interaction chromatography, and reverse phase chromatography, coupled
      with cytotoxic assays, resulted in the isolation and separation to homogeneity of
      a novel protein responsible for this biologic activity. Size estimation studies
      based on TSK HPLC columns showed that this protein has a mass of 8 to 12 kDa. The
      amino acid composition analysis of the CAP-2 protein calculated from HPLC
      chromatograms shows that this protein contains around 108 amino acids. Subsequent
      gas phase sequence analysis, however, was hampered because the N terminus of this
      protein was blocked and therefore unsuitable for sequencing by Edman degradation.
      The functional studies showed that the NK lysis-resistance activity of the CAP-2
      protein is mediated by interaction with and nonspecific binding to NK target
      cells. The lymphokine-activated killer and macrophage-mediated cytotoxicity and
      mitogen-induced proliferation is not affected. Unexpectedly, the CAP-2 protein
      appears to be mitogenic to its own cell line. Thus, the induction of NK lysis
      resistance and the mitogenic activity showed by CAP-2 protein could contribute to
      the tumor growth and metastatic establishment.

PMID- 2230134
TI  - The sensitivity of dot immunoassay for the peptides helodermin, histidine
      isoleucinamide (PHI) and histidine-methioninamide (PHM) increases after peptide
      cross-linking to proteins prefixed on nitrocellulose.
AB  - Two out of three rabbit anti-helodermin antisera previously shown to be useful
      for radioimmunoassay failed to detect up 100 ng of the peptide helodermin spotted
      directly on a nitrocellulose membrane. A lesser shortcoming of dot immunoassay
      was encountered with porcine PHI (peptide histidine-isoleucinamide), a member of
      the same peptide family, and an anti-PHI antiserum. To improve antigen-antibody
      interactions in the solid phase, we compared five methods of prior peptide
      immobilization. The best result was obtained when the nitrocellulose membrane was
      pretreated for 1 min in 4% ovalbumin, followed by 10 min activation with 2.5%
      glutaraldehyde, before peptide spotting. After cross-linking, the peptide was
      immunodetected with a F(ab')2 fragment of an anti-rabbit IgG coupled to alkaline
      phosphatase. The peptide cross-linking method was capable of increasing the
      sensitivity of ensuing immunodetection by more than 1000-fold, i.e., made
      feasible the detection of 0.1 ng peptide/dot in cases when the direct spotting
      method was inefficient. The sensitivity of this new, reliable and simple dot
      immunoassay for peptides was comparable to the conventional dot assay of directly
      immobilized large proteins.

PMID- 2230135
TI  - Antigen protection of monoclonal antibodies undergoing labelling.
AB  - The effectiveness of a methodology designed to protect the antigen binding
      capacity of monoclonal antibodies undergoing labelling with a number of reagents
      was examined. The antigen binding sites of monoclonal antibodies were protected
      by complexing them with their antigen. Chemical modification with 6 mM of the
      water soluble Bolton-Hunter reagent of site protected monoclonal antibodies to
      glucoamylase resulted in antibodies that could tolerate a four-fold increase in
      reagent incorporation, without any loss of antigen binding capacity. Iodination
      of these antibodies (modified under site protected conditions) yielded over 70%
      increase in radioactivity incorporated in the active antibody fraction, compared
      with the incorporation into unprotected antibodies. Site protected labeling was
      found to be effective in retaining the antigen binding capacity of monoclonal
      antibodies modified with all reagents tested with the exception of chloramine-T.

PMID- 2230136
TI  - An immunoassay for the quantitation of cell membrane MHC class II antigen.
AB  - A method is described for the quantitative assay of cellular MHC class II
      proteins. The assay has been developed for special use with epithelial cells
      isolated from the intestine, but has been successfully used with other cell
      types. It comprises a competitive immunoassay of anti-class II activity in cell
      lysates, using IgG-coated Sephacryl S300 as the solid phase and is sensitive over
      the range 1 ng-1 microgram.

PMID- 2230137
TI  - A chemiluminescent, microparticle-membrane capture immunoassay for the detection
      of antibody to hepatitis B core antigen.
AB  - A chemiluminescent, microparticle-membrane capture immunoassay (CLIA/MMC) for the
      detection of antibody to hepatitis B core antigen (anti-HBc) is described. The
      assay utilizes recombinant hepatitis B core antigen coupled to carboxylated latex
      microparticles. Human polyclonal IgG anti-HBc labelled with acridinium competes
      with antibody in the sample for a limited number of binding sites on the solid
      phase. After a 40 min incubation at 40 degrees C, the reaction mixture is
      transferred to a glass fiber capture membrane and washed. A chemiluminescent
      signal is produced by addition of alkaline peroxide and is quantitated on a semi
      automated reader as described. The CLIA/MMC assay was compared with standard EIA
      and RIA procedures (Corzyme and Corab, respectively, Abbott Laboratories, North
      Chicago, IL). Assay sensitivities were RIA greater than CLIA/MMC greater than
      EIA. A population of 200 normal blood donors showed nearly identical
      distributions with the CLIA/MMC and RIA (mean = 11% inhibition, SD = 13% for
      both), compared with the EIA (mean = 13% inhibition, SD = 15%). With a selected
      plasma population (n = 307), the CLIA/MMC immunoassay showed an excellent
      correlation (r = 0.94) with both the EIA and RIA procedures. Association of anti
      HBc reactivity near assay cutoffs with antibody to hepatitis B surface antigen
      suggested relative specificity in the order RIA greater than CLIA/MMC greater
      than EIA. The CLIA/MMC procedure, which can be readily automated, provides a non
      istopic alternative to current EIA testing with performance more nearly
      equivalent to RIA.

PMID- 2230138
TI  - Functional assay of C5-activating and nonactivating cobra venom factor
      preparations in the mouse system.
AB  - This paper deals with a new, functional assay of cobra venom factor (CVF)
      preparations with or without C5-activating property. Existing methods lack
      sensitivity and use diluted human complement as target of inactivation. An
      adapted assay using diluted mouse serum as complement source was hampered by
      underestimation of C3 depletion by bystander lysis and an overvaluation of C5
      consumption resulting from C3 inactivation in the reagent used. These
      disadvantages prompted us to develop the new assay which is based on the
      incubation of CVF preparations with undiluted mouse serum. After incubation,
      residual total C activity, as well as functional C3 and C5 are estimated by
      titration. The procedure permits the assessment of CVF activities with minimal
      interference from undesired processes. The conditions in the new assay approach
      the in vivo situation in mice by the use of undiluted serum from the same animal
      species.

PMID- 2230139
TI  - Effect of hapten heterology on thyroid hormone immunoassays.
AB  - We examined the effects of hapten heterology on triiodothyronine (T3) and
      thyroxine (T4) immunoassays configured with protein-conjugated diiodothyronine
      (T2), T3 or T4, using acridinium ester (AE) as a chemiluminescent label and
      paramagnetic particles (PMP) as a solid phase. Assays constructed with hapten
      heterologous combinations, such as immobilized anti-T4 plus labeled T3 or
      immunobolized anti-T3 plus labeled T2, were superior to the homologous ones in
      their potential for attaining higher sensitivity. This was manifested in a shift
      of the displacement curves to lower analyte concentrations, accompanied by
      unexpectedly high bound-tracer/total-tracer (B/T) ratios. This effect of hapten
      heterology was apparent with the use of either monoclonal or polyclonal
      antibodies and did not depend upon which component (antibody or protein
      conjugated hormone) was immobilized on the solid phase. In contrast, heterologous
      displacement curves with unconjugated hormone (125I-labeled) or with a labeled
      Fab fragment exhibited both a shift to lower analyte concentration and the
      expected decrease of B/T ratios. These results can be explained by the existence
      of positive binding cooperativity in the interaction between antibodies and
      haptenated proteins. Assay specificity was not adversely affected by hapten
      heterology when utilizing monoclonal antibodies, and hormone levels measured in
      serum samples correlated well with values obtained in homologous immunoassays.

PMID- 2230140
TI  - A comparison of immunoblotting, flow cytometry and ELISA to monitor the binding
      of anti-lipopolysaccharide monoclonal antibodies.
AB  - This study was designed to assess the use of flow cytometry to observe the
      binding, under physiological conditions, of anti-lipopolysaccharide (LPS)
      monoclonal antibodies (mAbs) to whole bacteria, and to compare this with the more
      conventional whole cell ELISA and immunoblotting techniques. The bacteria
      consisted of two clinical isolates of E. coli 018:K1 and 06:K5 and two isogenic
      mutants of the 018 parent: a non-capsulate (018:K-) and a rough mutant (018rf).
      Two cross-reactive anti-core mAbs and one 018 0-antigen-specific mAb were used.
      ELISA and flow cytometry showed that capsule and O-polysaccharide influenced the
      binding of mAbs to the bacteria, whilst the latter technique demonstrated that
      sub-populations existed. Immunoblotting showed the two anti-core mAbs to be
      different, one bound only to core which was not substituted with O-antigen,
      whilst the other bound both to substituted and unsubstituted core. This
      comparison for monitoring the binding of anti-LPS mAbs demonstrates the potential
      use of flow cytometry in bacterial cell surface research, and complements results
      obtained by ELISA and immunoblotting.

PMID- 2230141
TI  - A method for blocking antigen-independent binding of human IgM to frozen tissue
      sections when screening human hybridoma antibodies.
AB  - Using an indirect immunoperoxidase technique antigen independent binding of both
      human monoclonal and polyclonal IgM was found to a wide range of frozen sections
      of normal and malignant human glandular epithelia. Identical binding was found
      using dimeric human IgA (dIgA), whereas no binding was found with monomeric human
      IgA or human IgG. Secretory component (SC) was found to be the component in these
      tissues mediating antigen-independent binding of human IgM and dIgA antibodies. A
      method for the blocking of this antigen-independent binding of human IgM and dIgA
      was evaluated. Frozen sections of tissues containing SC were blocked with
      antibody to endogenous immunoglobulin and preincubated with rabbit anti-secretory
      component antibody (anti-SC) before applying the human monoclonal antibody. This
      treatment blocked the binding of control polyclonal and monoclonal human IgM to
      sections of SC-containing tissues such as respiratory and colonic epithelia. The
      influence of anti-SC on the binding of dIgA could not be established due to
      interactions between the anti-SC antibody and the IgA preparation. Using this
      method human hybridoma supernatants containing IgM could be readily screened for
      reactivity with frozen tissue sections from patients with colo-rectal cancer.
      This approach is recommended for the screening of human IgM monoclonal antibodies
      on frozen human tissue sections.

PMID- 2230142
TI  - An enzyme-linked immunosorbent assay for the measurement of human interleukin-6.
AB  - An enzyme-linked immunosorbent assay has been developed to measure human
      interleukin-6. The assay, based on the avidin-biotin amplified two-step sandwich
      method, is quick (requiring 4.5 h), sensitive (detecting 9.5 pg/ml) and
      satisfactory in reproducibility and specificity. It shows good correspondence
      with the results of bioassays, and it is not affected by serum and plasma
      components. These results indicate that this ELISA is suitable for application to
      clinical samples, which is a major advantage over the widely used bioassays.

PMID- 2230143
TI  - A rapid [3H]glycerol radioassay for determination of monocyte-mediated growth
      inhibition of Mycobacterium avium.
AB  - [3H]glycerol was used to radiolabel Mycobacterium avium (MA) bacteria after
      interaction with human monocytes in a rapid in vitro assay for determination of
      the growth inhibition of the mycobacteria by monocytes. Monocytes and MA were co
      cultured in 96-well microtiter plates for 1-5 days, and [3H]glycerol was added
      for an additional 3 days of incubation to radiolabel residual bacteria. The
      results indicate that monocytes inhibited mycobacterial growth within 24 h of co
      culture, an activity which increased during incubation until optimal growth
      inhibition was noted by 3-4 days. A comparison with conventional plate counting
      methodology demonstrated similar responses between the two assays except that the
      conventional assay required 2-3 weeks of culture before visible MA colonies could
      be detected and enumerated. Thus, the development of a rapid radiolabel assay to
      quantitate the interaction between monocytes and MA will facilitate the
      investigation of normal host responses to this opportunistic pathogen.

PMID- 2230144
TI  - Detection of peptide-MHC class II complexes on the surface of intact cells.
AB  - The interaction of peptides with major histocompatibility complex proteins on the
      surface of cells is required for their recognition by T lymphocytes. Many studies
      characterizing the formation of peptide-MHC class II complexes have used either
      assays for T cell responses or for peptide binding to purified class II
      molecules. Recently, specific peptide-class II interactions have been
      demonstrated convincingly on the surface of intact cells. The effects of varying
      peptide and class II structure have been examined in order to identify structural
      requirements for binding to cell surface class II molecules and to examine the
      conformation adopted by immunogenic peptides when bound.

PMID- 2230145
TI  - Affinity immunoblotting detection of serum monoclonal immunoglobulins reactive
      with glycosphingolipids.
AB  - The characterization of serum monoclonal IgM reactive with glycosphingolipid
      present in the nervous system is of major importance in patients with certain
      neuropathies. A rapid, sensitive and specific one-step method which permits such
      a characterization is described. Serum immunoglobulins separated by high
      resolution agarose electrophoresis are transferred to affinity filters
      (nitrocellulose sheets coated with glycolipids), and revealed with enzyme-tagged
      monospecific anti-immunoglobulin antibodies.

PMID- 2230146
TI  - Murine monoclonal anti-idiotype antibody (alpha) as a probe to detect human
      monoclonal antibody bound to human tumor tissues.
AB  - A new immunohistochemical assay was developed for the detection of human
      monoclonal antibody (HuMAb) bound to human biopsied tumor tissues. A murine anti
      idiotype monoclonal antibody, alpha type, 18C6 (IgGl), was raised against an IgM
      HuMAb, L612, defining a tumor-associated ganglioside antigen (GM3) and used as a
      probe in a three step cell-binding assay (HuMAb + anti-id + biotinylated anti
      mouse Ig). Anti-id 18C6 has an exclusive binding specificity for HuMAb L612, but
      does not interfere with the binding of L612 to antigen positive melanoma cell
      lines or to a purified antigen, GM3. The applicability of 18C6 in the three step
      cell-binding assay was tested first using a melanoma cell line, UCLASO-M12. L612
      bound to M12 cells was specifically detected by 18C6 without any background
      reactivity in ELISA. When this assay was compared with the standard two-step cell
      binding assay (HuMAb + peroxidase-conjugated anti-human IgM) using various
      cultured tumor cell lines, parallel reactivity was observed. The three-step cell
      binding assay was then applied to various fresh-frozen human tumor sections.
      Positive reactivity was demonstrated on various histologic types of human tumor
      tissues: primary melanoma (10/10), metastatic melanoma (4/4), nevus (10/10), lung
      cancer (3/6), breast cancer (2/6), and colon cancer (1/1). Adjacent normal
      tissues were unstained. Control experiments included the cell-binding assay with
      L612 alone, 18C6 alone. L612 + unrelated mouse IgG, and unrelated IgM HuMAb (L72)
      + 18C6; but biotinylated anti-mouse IgG did not react with these control
      preparations. The results indicate that anti-id 18C6 is a highly specific probe
      to assess the expression of the ganglioside antigenic epitope recognized by the
      L612 HuMAb on biopsied human tumor tissues.

PMID- 2230147
TI  - Development of technology for linking photosensitizers to a model monoclonal
      antibody.
AB  - A procedure is described whereby the photosensitizer, benzoporphyrin derivative
      monoacid ring A (BPD-MA) was covalently linked to a model monoclonal antibody in
      a manner which is reproducible, quantifiable, and retains both the biological
      activity of the antibody and the cytotoxicity of the photosensitizer. Preliminary
      steps involved the linkage of BPD-MA to a modified polyvinyl alcohol (PVA)
      backbone, followed by conjugation to the antibody using heterobifunctional
      linking technology. Briefly, polyvinyl alcohol (MW ca. 10,000) was modified with
      2-fluoro-1-methyl pyridinium toluene-4-sulfonate and 1,6-hexanediamine to produce
      side chains containing free amino groups. The free carboxyl group of BPD-MA was
      utilized to conjugate photosensitizer molecules to modified PVA using a standard
      carbodiimide reaction. Final linkage of the PVA-BPD to a model monoclonal
      antibody involved further substitution of the carrier with 3-mercaptopropionic
      acid and carbodiimide to introduce 3-4 sulfhydryl residues per carrier molecule,
      and introduction of sulfo-m-maleimidobenzoyl-N-hydroxysulfosuccinimide ester
      residues to the monoclonal (3-4 residues/molecule). Conjugation was effected by
      reaction of the two species at pH 5.5 for 18 h. Detailed methodology and tests
      for efficacy of the procedure are provided.

PMID- 2230148
TI  - Efficient hybridization of mouse-human cell lines by means of hypo-osmolar
      electrofusion.
AB  - The fusion of a mouse-human heteromyeloma with a mouse hybridoma is used as a
      model to define parameters to generate human hybridomas. Electrofusion of these
      cells in 300 mosM and 75 mosM solutions showed that strong hypo-osmolar
      conditions resulted in a dramatic increase in the efficiency of hybridoma
      formation. In contrast to iso-osmolar electrofusion, a high hybrid yield could be
      obtained by injection of only a single field pulse. The field strength was
      adjusted in proportion to the increased size of the cells in hypo-osmolar
      solutions. Hypo-osmolar electrofusion allowed the generation of approximately
      0.45% hybrids at a suspension density of 1.75 X 10(5) mouse-human cells/ml
      corresponding to an input number of 3.5 X 10(4) mouse-human cells. A further
      increase in the efficiency of hybridoma formation to about 0.6% was achieved by
      cell alignment in an alternating field of modulated field strength. Experiments
      in which the total cell number per fusion chamber was decreased at constant
      optimum suspension density showed that a further increase in the efficiency of
      hybridoma formation in hypo-osmolar solution was not possible because of the
      increasing influence of the heterogeneity of the cell lines with decreasing cell
      number. The results allow the conclusion that hypo-osmolar electrofusion is a
      potential tool to enhance successful immortalisation of human B lymphocytes.

PMID- 2230149
TI  - Methods to quantitate human haptoglobin by complexation with hemoglobin.
AB  - Native human haptoglobin isolated from normal human plasma by affinity
      chromatography on chicken hemoglobin -Sepharose was used as standard antigen. A
      direct sandwich ELISA for haptoglobin was developed, with human hemoglobin as a
      capturing agent. The peroxidase activity of the complex was measured as a means
      of detecting functional haptoglobin. The reactivities of monoclonal antibody vs.
      polyclonal antisera on the haptoglobin-hemoglobin complex were compared. Adopting
      a monoclonal antibody, clone 21.7, which is directed to the alpha chain of
      haptoglobin, a specific method to quantitate the native haptoglobin which can
      complex with hemoglobin has been developed.

PMID- 2230150
TI  - Cytotoxicity assays using cryopreserved target cells pre-labeled with the
      fluorescent marker europium.
AB  - We describe a method for standardizing cytotoxicity assays by the use of
      cryopreserved, fluorescently labeled target cells. The cells are labeled in
      batches with the fluorogenic element europium (Eu) and frozen in multiple
      aliquots. Replicate aliquots can be thawed on different days and used for
      cytotoxicity assays. Thawed pre-labeled cells from the same batch are killed
      reproducibly, allowing cytotoxicity assays to be standardized. The target cells
      need only be thawed, washed, counted for viability and used. The availability of
      pre-labeled, cryopreserved targets facilitates the assessment of cytotoxic
      activity of individual donors at different times. The method also simplifies the
      use of large panels of target cell types. By using this procedure it is not
      necessary to maintain active cultures of target cells, nor is it necessary to use
      and dispose of radioisotopes. These pre-labeled target cells can be used in
      various assays where the result is a destroyed target cell such as cell-mediated
      cytotoxicity, complement mediated cytotoxicity, or antibody-dependent cellular
      cytotoxicity.

PMID- 2230151
TI  - A silicon sensor-based filtration immunoassay using biotin-mediated capture.
AB  - A sensitive sandwich immunoassay for human chorionic gonadotropin (hCG) was
      developed with biotin-mediated filtration capture and silicon sensor detection. A
      high density of biotin on the membrane assured efficient capture of complexes
      containing streptavidin and analyte. Capture efficiency was not affected over a
      wide range of filtration flow rates or biotin concentrations. The assay utilized
      the pH sensing ability of the light addressable potentiometric sensor (LAPS) for
      the detection of urease-antibody conjugates. A LAPS reader was constructed which
      allowed the enzyme conjugate to be detected in approximately 1 microliter
      volumes. Effects from variations in detection volume were studied. 10 pg of hCG
      could be detected in an assay time of 20 min with four standard deviations
      separation from background. Comparison to a commercial RIA was made.

PMID- 2230152
TI  - A rapid method for monitoring DNA labelling reactions with haptens.
AB  - A rapid and simple method for evaluating the efficiency of DNA labelling
      reactions with haptens is described. The method, called the Flow-Through Hapten
      DNA Assay (FT-HDA), relies on binding of anti-hapten antibodies/alkaline
      phosphatase conjugates to hapten-DNA, immobilized on disposable capillary
      absorbent filters, and visual detection of blue-grey coloured spots appearing on
      the filter after chromogenic reaction with enzyme substrates. FT-HDA of hapten
      DNA is markedly faster and simpler than conventional diffusion assays on
      membranes.

PMID- 2230153
TI  - Comparison of an enzyme-linked immunosorbent assay (ELISA) with a
      radioimmunoassay (RIA) for the measurement of rat insulin.
AB  - A recently developed competitive enzyme-linked immunosorbent assay (ELISA) was
      compared with a conventional competitive radioimmunoassay (RIA) for the
      measurement of rat insulin in culture medium. Fifty-six samples were analysed by
      both assays. There was a correlation coefficient of r = 0.783 between results
      obtained using the two assay systems. The binding curves of the two assays were
      differently shaped, so that the ELISA gave good reproducibility over the
      concentration range 5-50 microU/ml insulin with inter- and intra-assay
      coefficients of variation less than 14%, but poor reproducibility at higher
      concentrations. Conversely, the RIA showed excellent reproducibility at
      concentrations greater than 50 microU/ml insulin, but poor sensitivity and high
      coefficients of variation below this level. The ELISA procedure offers practical
      advantages over the RIA, and performs well when measuring physiological
      concentrations of insulin.

PMID- 2230154
TI  - Problems in spina bifida in developing countries.

PMID- 2230155
TI  - Changing criteria of death.

PMID- 2230156
TI  - Orthopaedic industrial injuries.
AB  - A study of 600 consecutive cases of industrial injuries, who came from power
      using mechanised industries at Jaipur was undertaken to determine the incidence,
      pattern and causes of industrial injuries. The study revealed that there were
      fewer injuries in the 18 to 25 years age group than in those over the age of 36.
      Most of the injuries involved the upper limbs (66.2%), of which nearly 41%
      resulted from entrapment of hands in machines and were serious. This reflected
      the lack of adequate safety measures where it is most required.

PMID- 2230157
TI  - Anaerobic bacterial flora of wound sepsis.
AB  - Two hundred specimens from wound infection (surgical and non-surgical) were
      cultured for the isolation of anaerobic and aerobic bacteria. Positive cultures
      were obtained in 174 (87%) and 26(13%) were sterile. Anaerobes were isolated from
      31(17.8%), as single culture in 6(3.4%) and as mixed culture with aerobes in
      25(14.3%). Amongst anaerobes, anaerobic cocci were predominant (45.9%). Of
      aerobes Staph pyogenes (35%) was predominant. Metronidazole was the most
      effective drug against anaerobes and gentamicin against aerobes. No significant
      difference was noted in antimicrobial susceptibility of anaerobes of surgical and
      non-surgical wounds. Among aerobes high resistance was observed in surgical
      wounds.

PMID- 2230158
TI  - Conservative surgical management of intestinal tuberculosis.
AB  - Forty-seven proved cases of intestinal tuberculosis admitted to the surgical ward
      of MKCG Medical College, Berhampur from 1985 to 1987 were subjected to
      laparotomy. The common pathology found were tubercles over the peritoneum,
      multiple strictures of intestine, ileocaecal mass, perforation of the intestines,
      bands and adhesions and mesenteric node involvement. The patients with acute
      abdomen were operated in emergency and rest as an elective procedure.
      Conservative surgeries like stricturoplasty, local intestinal resection,
      perforation closure, by-pass procedures and local ileocaecal resection were done
      in most of the cases and only in 2 cases right hemicolectomy was done. Biopsy was
      taken from the viscera, peritoneum and mesenteric nodes. Postoperative mortality
      was 6.4%, mostly due to toxaemia and fluid and electrolyte imbalance.
      Postoperative complications in most of the cases were wound infection. All were
      given a short course of antituberculosis regimen containing INH, rifampicin and
      ethambutol. Patients were followed up to one year and definite improvement was
      noted.

PMID- 2230159
TI  - Course and prognosis of ulcerative colitis.
AB  - A study of 50 patients (23 males and 27 females) of ulcerative colitis, who were
      on follow-up showed that maximum number of patients had the disease before the
      age of 50 years. At the onset, the activity of the disease was severe in 44%,
      moderate in 32% and mild in 24% of cases. The commonest clinical course of the
      disease was chronic intermittent type (48%), followed by single attack with
      subsequent remission (42%). Chronic continuous type was seen in 10% patients
      only. There was no correlation of the extent of the bowel involvement with the
      clinical course. The precipitating factors for the onset or reactivation of the
      disease appeared to be emotional disturbances in 18% and pregnancy in 8%. The
      complications, both local and systemic, were not frequent. Serious complications
      like massive haemorrhage, perforation, toxic megacolon and carcinoma colon were
      not seen at all.

PMID- 2230160
TI  - Serum leucine aminopeptidase profile in cancers of gastro-intestinal tract with
      special reference to hepatic metastasis.
AB  - Serum leucine aminopeptidase (LAP) was estimated in 30 cases of gastro-intestinal
      cancers, and compared with 50 age and sex matched controls. Highly significant
      increase of serum LAP was seen in 7 patients with hepatic metastasis (p less than
      0.001) from adenocarcinoma of stomach, colon and rectum. The enzyme values showed
      a highly significant increase in carcinoma of colon, when compared with different
      anatomical sites of the gastro-intestinal tract (p less than 0.001). However, in
      adenocarcinoma of stomach and rectum, significantly increased level of serum LAP
      was observed (p less than 0.01) which contrasted sharply with the normal enzyme
      values in squamous cell carcinoma of oesophagus and anal canal.

PMID- 2230161
TI  - Litholapaxy: a fading art.
AB  - The bladder stones in 45 patients were treated with tactile litholapaxy over a
      period of 3 years. The overall success rate was 91.1%. The associated urological
      lesions like enlarged prostate, bladder neck contracture and urethral stricture
      could be safely dealt with simultaneously with litholapaxy in one sitting which
      was advantageous to the patient as well as to the surgeon.

PMID- 2230162
TI  - Occupational hazard of hydrocarbon pneumonitis in fire-eaters.

PMID- 2230163
TI  - Spontaneous rupture of renal pelvis secondary to ureteric calculous obstruction.

PMID- 2230164
TI  - Foetal hydantoin syndrome.

PMID- 2230165
TI  - Genetic counselling.

PMID- 2230166
TI  - Temporal lobe epilepsy.

PMID- 2230167
TI  - Brain death and the human organ transplants.

PMID- 2230168
TI  - Priorities in cardiological practice in a developing country.

PMID- 2230170
TI  - Spondylosis.

PMID- 2230169
TI  - Drug epidemic and the GPs.

PMID- 2230171
TI  - Glucocorticoid therapy for severe Pneumocystis carinii pneumonia.
AB  - The majority of patients with AIDS and Pneumocystis carinii pneumonia respond to
      treatment with either high-dose cotrimoxazole or IV pentamidine. Glucocorticoids
      have been given as 'adjuvant' therapy in those patients who fail to respond to
      cotrimoxazole or pentamidine. This article discusses the role of glucocorticoids
      therapy in the treatment of severe Pneumocystis carinii pneumonia and reviews the
      evidence for their efficacy.

PMID- 2230172
TI  - Prevalence of cryptosporidiosis in Israeli children with diarrhoea.
AB  - In a prospective study, Cryptosporidium oocysts were detected in seven (3.25%)
      immunocompetent children with diarrhoea. The predominant clinical features were
      watery diarrhoea and vomiting. The patients' mean age was 19 years and infection
      was more common in late summer-autumn than in the rest of the year. This first
      survey on cryptosporidiosis in Israeli children has shown a prevalence similar to
      that observed in other developed countries.

PMID- 2230173
TI  - A study of three blood culture media for isolating genital mycoplasmas from
      obstetrical and gynaecological patients.
AB  - Mycoplasma species are often found colonising the female genital tract. Their
      ability to become invasive and pathogenic, however, is often ignored, since
      attempts may not be made to culture these organisms from the bloodstream. We have
      investigated the ability of three types of blood culture media to support the
      growth of genital mycoplasmas. The media studied included brain-heart infusion
      broth, brain-heart infusion broth supplemented with 30% V/V sucrose and
      fastidious anaerobe broth. Genital mycoplasmas were cultured from the latter
      medium only. Since this was the sole medium which was liquoid-free, the
      inhibitory effects of liquoid on Mycoplasma spp. is discussed. This study
      comprised an investigation of 75 patients in obstetric and gynaecological wards
      with postpartum or post-operative fever. Genital mycoplasmas were isolated from
      five (6.7%) patients, four with Ureaplasma urealyticum and one with M. hominis.
      The value of considering these organisms in the differential diagnosis of fever
      in 'at risk' patients and of including appropriate media for their isolation is
      emphasised.

PMID- 2230174
TI  - Evidence of past delta co-infection with acute hepatitis B in intravenous drug
      abusers in the west of Scotland.
AB  - Two hundred sera from asymptomatic hepatitis B surface antigen (HBsAg) negative
      intravenous drugs abusers (IVDAs) were tested for delta antibody and antiHBc to
      determine the number of delta co-infections occurring with acute hepatitis B
      infection in this group. Of the 200 sera, 15 were positive for antidelta and 143
      for antiHBc, giving a delta co-infection rate of 10.5%. Laboratory records were
      consulted to ascertain which IVDAs had acute hepatitis B. Of 29 patients who
      submitted serum when HBsAg-positive, 10 are currently antidelta-positive. There
      was no evidence of loss of delta antibody after resolution of acute co-infection.
      The majority of those with delta co-infection had sought medical attention (10 of
      15), whereas only a minority (19 of 128) with only hepatitis B did so. These
      results suggest that delta co-infection more often results in significant
      clinical illness than acute hepatitis B alone.

PMID- 2230175
TI  - Incidence of malaria and efficacy of oral quinine in patients recently infected
      with human immunodeficiency virus in Kinshasa, Zaire.
AB  - There is concern that the impaired cell mediated immunity caused by the human
      immunodeficiency virus may increase the risk of severity of Plasmodium falciparum
      infection and could lead eventually to a decreased response to standard
      antimalarial treatment. In 1986, at Mama Yemo Hospital, Kinshasa, Zaire, the
      incidence of malaria was determined in a cohort of 59 patients who had recently
      acquired HIV-I infection through blood transfusion and in a cohort of 83 HIV-I
      seronegative controls who were recipients of HIV-I seronegative blood. All cohort
      patients were asked to visit the study physician whenever they developed fever.
      On each of these occasions thick film was examined for the presence of malarial
      parasites. HIV-I seropositive patients presented more often with episodes of
      fever per person month observation than HIV-I seronegative patients (P = 0.003).
      The total number of positive thick films per person months observation was
      significantly higher among HIV-I seropositive patients than among the HIV-I
      seronegative ones, but percentages of positive thick films per episode of fever
      were the same in both groups (46%). During a 5 month period, cohort patients
      presenting with a moderate attack of malaria were treated with oral quinine 20
      mg/kg daily in two doses for 5 days. Twenty-three (92%) of 25 HIV-I seropositive
      patients and 28 (82%) of 34 HIV-I seronegative patients had a negative film 7
      days after starting treatment. This study suggests that there seems to be no
      direct interaction of major clinical importance between HIV infection and
      malaria.

PMID- 2230176
TI  - The value of serum cryptococcal antigen in the diagnosis of cryptococcal
      infection in patients infected with the human immunodeficiency virus.
AB  - Serum cryptococcal antigen titres were measured in 828 HIV-infected patients with
      pyrexia, 69 of whom had meningism. Serum cryptococcal antigen was positive in 17
      patients of whom 16 had meningism with cryptococcus isolated from their CSF. The
      other patient had no meningism, had no evidence of cryptococcal infection on
      repeated CSF examination and remains well. A positive serum cryptococcal antigen
      test was therefore valuable in the diagnosis of cryptococcal meningitis, although
      in all 16 patients meningism was present and a diagnostic lumbar puncture was
      therefore carried out. In our experience routine screening for serum cryptococcal
      antigen did not predict patients who subsequently developed cryptococcal
      meningitis.

PMID- 2230178
TI  - Infected cephalhaematoma and neonatal osteomyelitis.
AB  - Neonatal osteomyelitis of the skull secondary to cephalhaematoma has been
      reported infrequently. The case reported here is that of a 7-week-old infant with
      a previously resolving cephalhaematoma who presented with cranial osteomyelitis.
      Cephalhaematomas should be considered potential sites of infection in any infant,
      even without a history of scalp trauma.

PMID- 2230177
TI  - False-negative dye-test findings in a case of fatal toxoplasmosis associated with
      cardiac transplantation.
AB  - False-negative dye-test results were recorded in a case of fatal toxoplasmosis
      associated with cardiac transplantation. Serological and histological data
      require individual consideration in cases of suspected toxoplasma infection of
      the immunocompromised.

PMID- 2230179
TI  - Salmonella septic arthritis: a case report and review.
AB  - We describe a case of septic arthritis in a child with no apparent predisposing
      conditions. Salmonella virchow was isolated from her knee and faeces, both
      isolates being identical except for the latter's resistance to ampicillin.
      Evidence is presented for the acquisition of ampicillin resistance in vivo,
      including the demonstration of the R plasmid and its ready transferability to
      Escherichia coli. The recent literature on the subject is reviewed and the role
      of group CI salmonellae in invasive disease is examined.

PMID- 2230180
TI  - Ciprofloxacin as a cause of Clostridium difficile-associated diarrhoea in an HIV
      antibody-positive patient.
AB  - Ciprofloxacin is an uncommon cause of pseudomembranous colitis. A case is
      described in which diarrhoea was associated with the presence of clostridial
      toxin in an HIV-infected patient and the possible implications are discussed.

PMID- 2230181
TI  - Infective endocarditis caused by Streptococcus suis serotype 2.
AB  - Infective endocarditis caused by Streptococcus suis serotype 2 is not uncommon in
      pigs but is rare in human beings. We describe the case of a pig-farmer with
      endocarditis due to S. suis serotype 2 and in whom prolapse of the mitral valve
      was the predisposing cardiac lesion. Streptococcus suis, a possible cause of
      infective endocarditis in endemic areas, may be confused with other group D
      streptococci. In suspected cases a history of contact with pigs or raw pork
      should be sought.

PMID- 2230182
TI  - Public Health Laboratory Service surveillance of prophylaxis by specific
      hepatitis B immunoglobulin in England and Wales during the period 1975-1987.
AB  - Surveillance of specific hepatitis B prophylaxis given after accidental or sexual
      exposure was continued throughout the period 1975-1987 by keeping records of
      exposures and ascertaining acute attacks of hepatitis B by postal enquiry. Acute
      hepatitis B developed in 53 (0.6%) of 9370 recipients of prophylaxis; the highest
      rate (3.7%) was among 564 sexually exposed, 0.9% among 2056 accidentally
      inoculated and 0.2% among 5747 persons who had other skin or minor exposures
      affecting the mucous membranes. There were no cases among 1003 recipients whose
      exposures did not meet the criteria for prophylaxis. None of the 53 patients died
      and only one of the 44, for whom sickness records were completed, reported a
      severe attack. Comparisons of six attacks among 623 who had inoculation injuries
      with material tested for hepatitis 'e' antigen and antibody gave no indication of
      better protection by early prophylaxis or by a two-dose schedule.

PMID- 2230183
TI  - Imported melioidosis in a British native.

PMID- 2230184
TI  - Prophylaxis for contacts of melioidosis.

PMID- 2230185
TI  - Inhibitory effect of fetal calf serum on the growth of Haemophilus ducreyi.

PMID- 2230186
TI  - Latent HIV infection following a low degree of exposure and the importance of
      repeated western blot.

PMID- 2230187
TI  - [Neuralgia of the pudendal nerve. Anatomo-clinical considerations and
      therapeutical approach].
AB  - The anatomic study of the pudendal nerve and its relation allows an approach of
      the mechanisms of compression likely to engender perineal neuralgia. Two
      conflictual zones are isolated: the first is linked to the clamp which is
      produced by the insertion of the sacro-epinous ligament on the ischial spine and
      the sacro-tuberal ligament; the second is linked to the falciform process of the
      sacrotuberal which threatens the nerve by its sharp upper edge. This conflict is
      particularly acute in a sitting position. The relation between the trunk of the
      nerve, its branches and these zones of conflict may explain the clinical
      observations. The electrophysiological investigations (detection of neurogenic
      muscles of the perineal floor. Increased sacral latency, pudendal nerve terminal
      motor latency) confirm the diagnosis. The anesthetic blocks of the pudendal nerve
      on the ischial spine only have a complimentary diagnostic value. The peridural
      blocks may also have an interesting therapeutic action (60% of good results 3
      months later). In some persistent cases, the nerve has been decompressed firstly
      by perineal approach, but latterly by transguteal approach.

PMID- 2230188
TI  - [Echoguided renal needle biopsy. Technique and results. Report of 413
      examinations].
AB  - Blindly executed for a long period with only X- Ray detection, renal biopsy
      benefits nowadays of precision and security of real-time echoguiding. The authors
      describe their technique without bondage between needle and transducer and
      comment their results about 413 examinations.

PMID- 2230189
TI  - [Cystinic lithiasis. Current aspects of the urologic treatment].
AB  - On the basis of a series of 9 patients (12 renal units) gathered over 19 years,
      the authors analyze the current possibilities of treatment of cystine lithiasis.
      They first describe the characteristics of this litiasis, which is rare but
      serious, being naturally prone to recurrence because it is caused by a genetic
      defect. The development of extracorporeal lithotripsy raised great hopes for the
      treatment of this lithiasis, but it was soon realized that cystine strones were
      hard to break. However, even the mere fragmentation of the stones improves the
      dissolving action of the various drugs proposed to modify the pH of urine. The
      authors consider that open surgery by means of posterior vertical lumbar section
      still is indicated for larger stones, and percutaneous nephrolithotomy seems to
      be a very useful technique, either exclusively or as a complement of
      extracorporeal lithotrity.

PMID- 2230190
TI  - [Urothelial bladder tumors in stage pTa. I.--What is the risk for the patient?].
AB  - We present 534 superficial (pTa) bladder cancer, followed in our institution
      between 1970 et 1990. During the "follow up" period, 20 patients (4%) died of
      their cancer, 64 patients (12%) presented an "infiltrative" recurrence and 338
      (63%) one or more "superficial" recurrence.

PMID- 2230191
TI  - [Our experience of spinal anesthesia for transurethral resection of the bladder
      and prostate. Retrospective study of 334 patients operated in 1986].
AB  - Retrospective study of one years is performed on 334 patients who undergo
      transurethral surgery. Spinal anesthesia is used in 263 cases, general anesthesia
      in 71. Spinal administration of local anesthetics (lidocaine hyperbaric 5% or
      bupivacaine 0.5%) or opioid (Pethidine 1 mg/kg) have been used in old patients
      without any complication. The advantages are less blood uses, early stand up, no
      discontinuity in oral nutrition. For our team there are only few contra
      indications for spinal anesthesia: blood coagulation abnormalities or some very
      rare heart diseases.

PMID- 2230192
TI  - [Urodynamic consequences of urethral stenosis. Hydrodynamic study with a
      theoretical model].
AB  - An urethral model was designed to assess the hydrodynamic consequences of
      stenosis of the bulbar urethra. This model was based on the geometric and
      hydrodynamic analysis of micturing urethrograms in a patient whose maximum flow
      rate was 24 ml/s for a bladder pressure of 40 cm of water. It corresponds to the
      conditions of flow observed wit maximum bladder pressure and flow rate. During
      this short period, the shape of the urethra is regarded as stable. Calculation
      took account of the characteristics of a turbulent flow of urine, of the head
      loss due to friction of the urine on the walls and of the head loss caused by the
      geometrical changes of the urethra from the neck of the bladder to the meatus. In
      these conditions, applying Bernouilli's equation allowed plotting of bladder
      pressure for various levels of urethral resistance. If there is no stenosis, the
      theoretical maximum flow rate of the model with a bladder pressure of 40 to 80 cm
      of water should be 19 to 26 ml/s. Calculation showed that a sudden reduction of
      the diameter to less than 2.5 mm occurring in a segment of the urethra with a
      diameter of 4 mm accounts for a flox rate lower than 15 ml/s, except when bladder
      pressure can exceed 100 cm of water. The decrease in the maximum flow rate caused
      by urethral stenosis is all the greater as bladder pressure remains low or
      normal, with other causes of head loss or with associated upstream dilatation.
      Lastly, progressive narrowing leads to a smaller head loss and will therefore be
      better tolerated than sudden narrowing to the same caliber. Inversely, a long
      stenosis will be less well tolerated as the head loss due to friction in a long
      and narrow passage is increased. The diameter of a stenosis accounting for a
      maximum flow rate of less than 15 ml/s cannot be determined in the absolute.
      Analyzing the hydrodynamic consequences of stenosis also requires knowing the
      associated urodynamic and geometric parameters.

PMID- 2230193
TI  - [Prevention of complications in inguinal lymphadenectomy].
AB  - Inguinal lymphadenectomy, as indicated in the treatment of metastases of
      carcinoma of the penis and of malignant melanoma in the inguinal lymph nodes,
      involves considerable mortality and morbidity. From February, 1988, to January,
      1990, we performed 15 inguinal lymphadenectomies in 10 patients with an average
      age 51.9 +/- 5.3 years. The technique used combined a transverse incision
      parallel to the inguinal fold, complete inguinal lymphadenectomy, transposition
      of the sartorius muscle and vaporization of a film of fibrin glue. The last 2
      operations, besides the effectives protection of the femoral pedicle, aim at
      suppressing dead spaces that may produce hematomas, subcutaneous infection or
      lymphoceles, and at avoiding the insertion of an aspiration drain, which causes
      persistent lymphorrhea. Out of the 15 cases of lymphadenectomy, 5 presented with
      a small- (48 ml in average) or medium-volume (200 ml) lymphocele, which was
      treated by a simple evacuating puncture. No necrosis of the skin edges,
      subcutaneous infection or lymphorrhea were observed. These results are
      encouraging, since our patients can rapidly resume their social life and have an
      acceptable quality of survival.

PMID- 2230194
TI  - Treatment of distal hypospadias. Comments about the MAGPI procedure.

PMID- 2230195
TI  - [Value of a scrotal myocutaneous flap in the repair of penile and urethral skin
      loss].
AB  - The authors report a case of a large penile skin and urethral defect repair using
      a scrotal myocutaneous flap. The modalities, advantages and defects of the method
      were detailed. This technique permitted to obtain a very satisfactory result.
      Then we extended it to the failures of the hypospadias and epispadias
      reconstruction.

PMID- 2230196
TI  - Psoriasis workshop: molecular, immunologic and pharmacologic aspects of
      psoriasis. Deer Valley, Utah, September 14-17, 1989. Proceedings.

PMID- 2230197
TI  - Epidermal growth factor/transforming growth factor alpha receptors and psoriasis.
AB  - The abnormal growth and differentiation in psoriasis is reflected in the abnormal
      regulation of Epidermal Growth Factor/Transforming Growth Factor Alpha (EGF/TGF
      alpha) receptor metabolism. In psoriasis and other hyperproliferative skin
      conditions these receptors are persistently expressed throughout the
      interfollicular epidermis as long as the growth stimulatory signal persists. One
      of the first biochemical signs of effective therapy of psoriasis is the return of
      the EGF/TGF alpha receptor pattern toward the primarily basilar distribution seen
      in normal human adult skin. Whether the abnormal expression of TGF alpha in the
      involved skin induces the persistent expression of EGF receptors is not known nor
      is the signal that causes the increased production of TGF alpha. Studies to
      determine what factors regulate EGF receptor expression and TGF alpha induction
      may yield important new insights into the pathogenesis and therapy of psoriasis.

PMID- 2230198
TI  - Immunologic mechanisms in psoriasis.
AB  - The demonstration of activated T lymphocytes, HLA-DR+, I-CAM1+, gamma IP-10+
      keratinocytes, and increased levels of lymphokines in active plaques suggests
      that immunologic mechanisms may play a role in the pathogenesis of psoriasis.
      Epidermal hyperplasia and inflammation in psoriasis may be linked by those
      cytokines many of which are produced by both keratinocytes and leukocytes.
      Epidermal acanthosis and keratinocyte mitoses have been observed in delayed-type
      hypersensitivity reactions and after the intradermal injection of gamma
      interferon. Gamma interferon and its induced proteins have been demonstrated in
      active psoriatic plaques. Increased levels of the keratinocyte autocrine
      cytokines, transforming growth factor (TGF)-alpha and interleukin (IL)-6, have
      been detected in active plaques. The apparent overexpression of IL-6 in
      hyperplastic psoriatic tissue may explain features of psoriasis that link
      keratinocyte proliferation with immune activation and tissue inflammation. Both
      IL-6 and gamma interferon increased TGF-alpha expression in normal cultured
      keratinocytes. Cytokines produced during immune activation and other inflammatory
      processes may lead to epidermal hyperplasia.

PMID- 2230199
TI  - Psoriasis vulgaris: a genetic approach.
AB  - Evidence for a genetic contribution in psoriasis comes from direct examination of
      a large segment of the population in an isolated island environment,
      epidemiologic and questionnaire studies presented to psoriatic patients, twin
      studies collected from the literature and from twin registries, and splitsibship
      analysis. The concordance of psoriasis in monozygotic twins was 65-72%, whereas
      psoriasis in dizygotic twins was 15-30%. Determination of concordance in older
      twin pairs from a national twin registry in Denmark revealed nearly 90-100%
      heritability. In order to link psoriasis with known markers within the human
      genome, serologic studies have been carried out with a variety of blood group and
      polymorphic protein antigens. A weak association with the MNS and Lewis Blood
      Groups Systems (relative risk, 3.5) has been identified. Stronger associations
      with class I B locus and class II D locus genes (relative risk, 8-12) have also
      been determined by studies of the human lymphocyte-antigen system. Finally, a
      strong association with HLA Cw6 has been determined; this marker is thought to be
      in linkage disequilibrium with B and D locus genes previously associated with
      psoriasis. The relative risk of developing psoriasis in HLA Cw6 positive
      individuals is about 24. A few large kindred have been reported in the
      dermatology literature. These support the hypothesis of autosomal dominant
      inheritance with penetrance of approximately 60%. In cooperation with The
      National Psoriasis Foundation, we have now identified over 90 families with
      psoriasis in three generations. We have begun the process of ascertainment, the
      construction of family trees, and the collection of leukocyte DNA for linkage
      analysis with established restriction fragment polymorphisms (RFLP). Our initial
      assessment is being directed to four RFLP that span approximately 30 centiMorgans
      of the short arm of human chromosome 6. Although karyotyping is uncommonly done
      in patients because of psoriasis, we now seek evidence of translocations of
      chromosome 6 in association with psoriasis.

PMID- 2230200
TI  - Speculations on the immunopathogenesis of psoriasis: T-cell violation of a
      keratinocyte sphere of influence.
AB  - The thesis is advanced that the differences in antigen processing and
      presentation described for "fresh" and "cultured" Langerhans cells in vitro
      reflect similar differences between intraepidermal and intranodal Langerhans
      cells in vivo. The functional properties of Langerhans cells are dependent upon
      the microenvironment in which they reside; thus, intraepidermal Langerhans cells
      are under the influence of cytokines secreted by keratinocytes, whereas
      intranodal Langerhans cells come under the influence of lymphokines from T
      lymphocytes. It is speculated that a genetic lesion in psoriasis robs
      keratinocytes of their capacity to create an "appropriate" epidermal
      microenvironment. As a consequence, intraepidermal Langerhans cells adopt the
      functional program of intranodal cells. When "uninvolved" psoriatic skin receives
      a cutaneous challenge with antigen, Langerhans cells, by activating naive T cells
      in situ, unwittingly engender a microenvironment that is more appropriate to a
      lymph node. This skin becomes "involved" as it gradually acquires features
      associated with lymph nodes (such as high endothelial venules). And the
      derangement is further complicated by abnormalities of proliferation and
      differentiation among keratinocytes and dermal fibroblasts as they respond to the
      inappropriate T-cell-derived lymphokines, giving rising to the typical, active
      psoriatic lesion.

PMID- 2230201
TI  - Lymphocyte chemoattractants in psoriasis and normal skin.
AB  - The local production of lymphocyte attractants may influence both physiologic
      lymphocyte trafficking in the skin as well as the infiltration of these cells in
      pathologic states. Recent evidence for the production of acidic lipid lymphocyte
      chemoattractants, particularly 12[R]-hydroxyeicosatetraenoic acid, in psoriatic
      lesions is reviewed. Water extractable lymphocyte attractant activity may also be
      recovered from both normal skin samples and psoriatic lesional stratum corneum,
      and may be important in the pathophysiology of lymphocyte trafficking. Less than
      10 kD activity from normal skin has undergone the most detailed characterization.
      This has led to the isolation of a novel, as yet unidentified compound from
      normal skin, which we have termed "plasma-associated lymphocyte chemoattractant"
      (PALC).

PMID- 2230202
TI  - Interleukin-1 in human skin: dysregulation in psoriasis.
AB  - Cytokine dysregulation is an attractive concept to explain many of the observed
      abnormalities in psoriasis. IL-1, in particular, can potentiate immune cellular
      activation, activate fibroblasts, and increase endothelial cell adhesiveness to
      leukocytes. Here, we review IL-1 regulation in normal and psoriatic skin in vivo
      in relation to normal skin and cultured keratinocytes. Contrary to expectations,
      IL-1 functional activity in psoriatic lesions is reduced, not increased, relative
      to normal skin. The reduction is attributable to the presence of IL-1 inhibitors,
      reduced IL-1 alpha levels, and an IL-1 beta that lacked function in T-cell
      assays. IL-1 beta protein is actually significantly increased in psoriatic
      lesions, but the mechanism of its non-functionality remains unclear. Unlike
      cultured keratinocytes, which accumulate large, inactive IL-1 beta precursors,
      both normal and psoriatic skin process IL-1 beta to a mature form. Novel
      mechanisms of post-translational processing by epidermis in vivo may generate a
      novel form of IL-1 beta with unknown functions. The marked abnormalities of IL-1
      regulation in psoriatic skin suggest that this molecule may be important in
      normal skin homeostasis.

PMID- 2230203
TI  - The role of epidermal cytokines in inflammatory skin diseases.
AB  - Cytokines (hormone-like polypeptide mediators) play a major role in inflammatory
      and immunoregulatory responses. Skin, and particularly keratinocytes in the skin,
      represent a potent source for many cytokines, including interleukins 1, 6, 8, and
      the hemopoietic colony stimulating factors. Cytokines initiate their biologic
      action by interacting with target cells bearing cytokine receptors and then
      initiating a cascade of cellular interactions. Certain inflammatory skin diseases
      have been associated with overproduction of cytokines, alteration in cytokine
      receptors, or dysregulation of cytokines. While data is still quite preliminary,
      it is likely that cytokines contribute to the pathogenesis of many inflammatory
      skin diseases.

PMID- 2230204
TI  - Lymphocyte adhesion to psoriatic dermal endothelium: mechanism and modulation.
AB  - Psoriasis is characterized by the hyperproliferation of keratinocytes in the
      epidermis and the accumulation of activated CD4+ T lymphocytes in the upper
      dermis. We have recently tested the hypothesis that the abnormal endothelial
      proliferation in the dermal papillae of psoriatic lesions may be mechanistically
      linked to the expression of endothelial ligands capable of promoting lymphocytes
      binding and extravasation. The results indicated that specialized endothelial
      cells lining the post-capillary venules of psoriatic lesions are capable of
      promoting the selective adherence of human CD4+ T cells and its memory subset. In
      contrast, B cells, CD8+ T cells, and CD45RA+ T cells are deficient in their
      capacities to bind. The adhesion process is energy and calcium dependent and
      involves tissue-specific lymphocyte receptors, with LFA-1 molecules playing an
      accessory role. We concluded that transformation of the dermal endothelium into a
      lymphocyte-receptive phenotype by defined growth factors or cytokines may
      represent a positive feedback mechanism promoting lymphocyte migration into the
      diseased sites.

PMID- 2230205
TI  - The role of the immune system in the pathogenesis of psoriasis.
AB  - Psoriatic involved skin contains an increased number of activated T cells. The
      mechanism through which these T cells achieve and maintain their activated state
      is unknown, and both antigen-dependent and -independent mechanisms may
      contribute. Recently a novel pathway of antigen-independent T-cell activation has
      been described. This pathway is identified by a monoclonal antibody that binds to
      a T-cell membrane surface molecule termed "UM4D4.". This molecule is expressed on
      a minority (20%) of psoriatic peripheral blood T cells but on a majority (75%) of
      the T cells in lesional skin. Thus, UM4D4 could play a role in antigen
      independent T-cell activation in psoriasis. Indeed the monoclonal antibody anti
      UM4D4 consistently induces proliferation of psoriatic UM4D4+ T-cell clones. The
      activity of antigen-dependent pathways are also enhanced in psoriatic epidermis
      in as much as involved skin relative to uninvolved skin contains an increased
      number and function of antigen-presenting cells. Upon activation, the lesional T
      cells release lymphokines. Central to the immune hypothesis of psoriasis is that
      some of these T-cell lymphokines act on keratinocytes to induce changes
      characteristic of psoriasis. Indeed lymphokines from lesional psoriatic T-cell
      clones directly alter in vitro keratinocyte phenotype through induction of
      intercellular adhesion molecule-1 (ICAM-1) and HLA-DR cell-surface expression.
      Furthermore, the lymphokines also enhance keratinocyte growth. These data suggest
      a critical role for the immune system in the pathogenesis of psoriasis.

PMID- 2230206
TI  - Lymphocyte trafficking in psoriasis: a new perspective emphasizing the dermal
      dendrocyte with active dermal recruitment mediated via endothelial cells followed
      by intra-epidermal T-cell activation.
AB  - Prominent within the inflammatory infiltrate of psoriasis are HLA-DR positive T
      lymphocytes and factor XIIIa positive dermal dendrocytes. Many investigators
      studying psoriasis have assumed that the HLA-DR positive T cells are activated,
      and thereby capable of producing lymphokines such as gamma interferon. However,
      by immunohistochemical analysis, greater than 95% of the dermal T cells in
      psoriatic lesions are Ki-67 negative, which suggests that they are in a resting
      or non-cycling (Go) state. In contrast to the dermal T-cell population, the
      epidermal T-cell population contains a greater population of Ki-67 positive
      lymphocytes. The entry of the T cells into the epidermis is, therefore,
      apparently associated with an important activation event, which in all likelihood
      involves interaction with the keratinocyte. The presence of activated
      intraepidermal T cells has been substantiated by the ability to detect gamma
      interferon mRNA by polymerase chain reaction in epidermal sheets of psoriatic
      lesions. The pathophysiologic implication in psoriasis for these distinctions and
      compartmentalization involving dermal and epidermal T cells are placed into the
      context of a cascade of cellular trafficking events, which are further dissected
      into a specific network of molecular mediators of inflammation. This report
      suggests that more attention should be placed on the microenvironment of the
      skin, with specific emphasis on the mechanism by which T cells accumulate in the
      dermis and epidermis, and elucidation of the selective inductive and recruitment
      capabilities of endothelial cells, perivascular dermal dendrocytes, and
      keratinocytes.

PMID- 2230207
TI  - Immunology of AIDS related to psoriasis.
AB  - The association of severe psoriasis with HIV infection, which dysregulates and
      destroys the human immune system, supports the hypothesis that psoriasis is an
      immunologically mediated disease. Psoriasis and Kaposi's sarcoma share
      angiogenesis as basic early findings and could both be caused by differential
      cytokine expression or responsiveness. AIDS and research models including
      transgenic mice offer new models in which to study the role of the immune system
      and specific gene products in the pathogenesis of psoriasis and other skin
      diseases.

PMID- 2230208
TI  - The expression of retrovirus-like particles in psoriasis.
AB  - Retrovirus-like particles have been isolated from patients with psoriasis.
      Antigens crossreacting with the major internal protein, pso p27, of these
      particles have been demonstrated in the wall of dermal vessels and in a
      subfraction of cells in psoriatic lesions. The antigen has also been observed in
      blood lymphocytes from psoriatic patients. Pso p27 antigen and anti-pso p27
      antibodies are present as complement-activating immune complexes in psoriatic
      scale and in the blood of patients with psoriasis and psoriatic arthritis. The
      potential contribution of the circulating immune complexes to the inflammatory
      process in psoriasis is discussed.

PMID- 2230209
TI  - Multi-stage program of differentiation in human epidermal keratinocytes:
      regulation by retinoids.
AB  - The proliferation and differentiation of epidermal keratinocytes in vivo and in
      vitro is influenced by a variety of different factors, including several peptide
      growth factors, protein kinase C activators, retinoids, and various cytokines.
      Retinoids can affect the proliferation of human epidermal keratinocytes either
      positively or negatively and influence the multi-step program of differentiation
      in epidermal keratinocytes at very specific stages. Epidermal keratinocytes
      express nuclear retinoic acid receptors, RAR alpha, and RAR gamma. It is likely
      that at least some of the alterations in gene expression induced by retinoids are
      mediated through these RAR. The cytosolic retinoic acid-binding protein (CRABP),
      which is differentially expressed during squamous differentiation of human
      epidermal keratinocytes, may control the effective concentration of retinoic acid
      in the cell and therefore regulate indirectly gene expression.

PMID- 2230210
TI  - Metabolism of natural retinoids in psoriatic epidermis.

PMID- 2230211
TI  - Cytotoxic and immunologic effects of methotrexate in psoriasis.
AB  - Based on recent experience that Cyclosporin A, an immunosuppressive drug,
      produces marked improvement in psoriasis, possible immunomodulatory activities of
      methotrexate (MTX) have been reviewed to look for alternate mechanisms of MTX
      action in psoriasis. It is generally considered that the therapeutic results of
      MTX in psoriasis are related to a direct effect on epidermal cell hyperplasia
      through inhibition of DNA synthesis. Several studies in the literature now
      suggest possible effects of MTX on the immune system of psoriatics as well as in
      animal models that may have some pathogenic similarities to psoriasis. In
      psoriatics receiving MTX, neutrophil chemotaxis is suppressed, resulting in a
      possible alteration in the potential pathologic activity of neutrophils commonly
      found in lesional skin. MTX does improve both psoriatic and rheumatoid arthritis.
      Animal studies of the latter using adjuvant arthritis and graft vs host disease
      (GVHD) have indicated several possible mechanisms for MTX that affect these
      processes. In GVHD, MTX selectively destroys cycling CD8+ cells, and in adjuvant
      arthritis the activation of macrophages is prevented by inhibition of T-cell
      function. While MTX generally has not been clinically utilized as an
      immunomodulatory drug for immunologically related diseases, it may, nonetheless,
      have selective actions that could be specific for some diseases. MTX and
      Cyclosporin A could work mechanistically in similar ways but at different steps
      in the activation of T cells and macrophages. It may be that the major direct
      effect of MTX on epidermal cell proliferation is complemented or even mediated by
      subtle immunoregulatory effects on the melange of cells in the affected skin and
      the systemic immune response.

PMID- 2230212
TI  - Excision repair of pyrimidine dimers induced by simulated solar radiation in the
      skin of patients with basal cell carcinoma.
AB  - One prominent lesion induced in DNA by ultraviolet (UV) radiation is the
      cyclobutyl pyrimidine dimer formed between adjacent pyrimidines on the same DNA
      strand. We investigated whether people who have developed basal cell carcinoma on
      sun-exposed skin have an altered ability to repair UV-induced pyrimidine dimers
      in DNA. Twenty-two patients with at least one basal cell carcinoma, aged 31-84
      years, and 19 healthy volunteers, aged 25-61 years, took part in the study. Both
      groups were given one minimal erythema dose (MED) of simulated solar radiation on
      the lower back. DNA was extracted from the irradiated skin 0 to 6 h later, and
      the number of UV-induced pyrimidine dimers was determined using a dimer-specific
      endonuclease. At time 0, the average number of dimers per unit of DNA was similar
      in the two groups. After 6 h, an average of 22 +/- 4% of the dimers were removed
      in the group with basal cell carcinoma compared to 33 +/- 4% in the cancer-free
      group. In the basal cell carcinoma group, only 23% of the patients repaired more
      than 30% of the dimers after 6 h, compared with 53% of the cancer-free subjects
      (p less than 0.05). We conclude that patients who develop basal cell carcinoma on
      sun-exposed skin may have a decreased ability to repair pyrimidine dimers induced
      in skin exposed to simulated solar radiation.

PMID- 2230213
TI  - Reversal effects of topical retinoic acid on the skin of kidney transplant
      recipients under systemic corticotherapy.
AB  - The systemic long-term corticosteroid treatment administered to kidney graft
      recipients (KGR) within the framework of the required immunosuppressive therapy
      induces an atrophy of the skin, from the sixth month onwards. We studied the
      effect of topical all-trans retinoic acid (0.05%; Galderma Labs.) applied to the
      forearms of 27 KGR (14 men, 13 women) over a 6-month period. Twenty-four subjects
      completed the trial. The following results were obtained in the treated forearm
      versus the untreated forearm (excipient alone): clinically, an increase in skin
      thickness; by noninvasive techniques, an increase in skin thickness, skin
      elasticity, skin conductance, and TEWL, and a reduction in the size of the
      corneocytes. No change in stratum corneum lipid content was observed. A sex
      related difference was noted in the response to treatment under our experimental
      conditions, the female patients responding better. A punch biopsy (4 mm) was
      performed on both forearms of four patients after the 6-month period. Histologic
      and ultrastructural examination revealed epidermal and dermal changes evoking
      increased cellular metabolism in the retinoic acid-treated forearms.

PMID- 2230214
TI  - Percutaneous retinoid absorption and embryotoxicity.
AB  - A single application of 17 micrograms/kg or 8.7 mg/kg all-trans-[10,11-3H2]
      retinoic acid dissolved in acetone to shaved dorsal hamster skin resulted in
      rapid absorption and dose-dependent rates of elimination. An equation describing
      a two-compartment open model with a very brief lag time and first-order uptake
      and elimination was used to describe the central plasma compartment kinetics.
      Unchanged all-trans-retinoic acid represented less than or equal to 4% of the
      total circulating radio-activity. Peak circulating concentrations of parent all
      trans-retinoic acid were less than those observed after an equivalent oral dose,
      but prolonged absorption from the skin appears to contribute to high total
      bioavailability of topical retinoid. Topical administration to intact skin of up
      to three consecutive doses of 10.5 mg/kg/d all-trans-retinoic acid or a single 5
      mg/kg dose of etretinate (Ro 10-9359) during a critical stage of embryogenesis in
      hamsters caused erythema and/or dose-dependent epidermal hyperplasia at the site
      of application, but failed to induce a significant teratogenic response. Topical
      application of 0.01-1.0 mg/kg arotinoid Ro 13-6298 resulted in dose-dependent
      mucocutaneous toxicity and an increase in the numbers of dead embryos and
      malformed offspring. The marked skin toxicity and attenuated concentrations in
      maternal blood, compared to the oral route, limit the amounts of retinoid that
      can reach the hamster embryo. It is thus more important to compare the retinoid
      systemic values (absorbed dose) than it is to compare the oral or topical
      (applied) dose, when interpreting the results of conventional teratogenicity
      bioassays. The data suggest that in the human it is skin toxicity that limits the
      amounts of retinoid that can be applied and subsequently reach the embryo. In the
      rodent, overt skin toxicity under continued dosing could increase the amounts of
      retinoid penetrating the skin and reaching the embryo.

PMID- 2230215
TI  - Cyclosporine A in the treatment of psoriasis: a clinical and mechanistic
      perspective.
AB  - Cyclosporine A, a unique immunomodulatory agent, has been used increasingly over
      the last 5 years in the management of severe psoriasis. The remarkable efficacy
      of this drug coupled with its known immunosuppressive properties have enabled a
      further appreciation of the role of the immune system in the induction and
      maintenance of psoriatic plaques. Although acting primarily on T lymphocytes,
      there is also evidence for an effect of cyclosporine A on other constitutive cell
      types within the skin. The future use of systemically administered cyclosporine A
      in the treatment of psoriasis and other cutaneous diseases is dependent on the
      successful balance of efficacy and side-effect profile; namely, the dose-related
      problems of hypertension and nephrotoxicity. As a result of the toxicity
      encountered with systemically administered cyclosporine A, attempts to formulate
      a successful topical preparation for use in cutaneous disease are being made. The
      advent of cyclosporine A provides the dermatologist with a new therapeutic
      strategem in the management of psoriasis, although the long-term safety of such
      interventional therapy remains to be discerned.

PMID- 2230216
TI  - Susceptibility to effects of UVB radiation on induction of contact
      hypersensitivity as a risk factor for skin cancer in humans.
AB  - Normal, healthy human volunteers and patients with proved history of non-melanoma
      skin cancer have been tested for their capacity to develop contact
      hypersensitivity to dinitrochlorobenzene (DNCB) following exposure of buttock
      skin to acute, low-dose ultraviolet B (UVB) radiation. Using a radiation protocol
      that achieves virtually complete depletion of normal-appearing Langerhans cells
      from irradiated skin, it was learned that approximately 60% of healthy volunteers
      developed vigorous contact hypersensitivity (CH) when 2000 micrograms DNCB was
      painted on the irradiated site. These individuals were designated UVB-resistant,
      and were distinguished from other individuals, designated UVB-susceptible, who
      failed to develop contact hypersensitivity following an identical treatment
      protocol. It was then discovered that virtually all (92%) skin cancer patients
      exposed to UVB and DNCB failed to develop CH, i.e., were UVB-susceptible. In
      subsequent experiments, epicutaneous application of 2000 micrograms DNCB to
      unirradiated skin of UVB-susceptible individuals revealed a further distinction
      between normal persons and skin cancer patients. Approximately 45% of the latter
      (and none of the former) remained unresponsive (failed to develop contact
      hypersensitivity following this second attempt at sensitization), implying that
      they had been rendered immunologically tolerant. These tolerant individuals
      responded normally to the unrelated hapten, diphencyprone. We conclude that human
      beings resemble inbred strains of laboratory mice in that some individuals are
      UVB-susceptible, whereas others are UVB-resistant. Because the incidence of UVB
      susceptibility was significantly higher in skin cancer patients, and as specific
      unresponsiveness could be demonstrated only in these patients, we propose that
      UVB-susceptibility, as we define it in this hapten system, may be a risk factor
      for the development of skin cancer.

PMID- 2230217
TI  - Sodium lauryl sulphate for irritant patch testing--a dose-response study using
      bioengineering methods for determination of skin irritation.
AB  - The dose-response relationship in patch testing with sodium lauryl sulphate (SLS)
      was studied. The irritant skin response was quantified by visual scoring as well
      as by the following noninvasive methods: measurement of transepidermal water loss
      (TEWL) by an evaporimeter, measurement of skin color by a colorimeter,
      measurement of superficial blood flow by laser Doppler flowmetry, and measurement
      of edema in the skin by ultrasound A-scan. Twelve volunteers were patch tested
      with 0.12, 0.25, 0.50, and 1.00% SLS, and the skin response was evaluated after
      24 and 48 h, respectively. We found a statistically significant linear dose
      response relationship between dose of SLS and skin response evaluated by
      measurement of TEWL, skin color, superficial blood flow, and edema. Statistical
      evaluation by regression analysis proved measurement of TEWL to be the method
      best suited overall for quantification in relation to patch testing with SLS,
      whereas colorimetry was found to be the least sensitive of the applied methods.
      Ultrasound A-scan was found to be a promising method for quantification of the
      inflammatory response, being consistently more sensitive than measurement of skin
      color.

PMID- 2230218
TI  - Minoxidil sulfate is the active metabolite that stimulates hair follicles.
AB  - An important step in understanding minoxidil's mechanism of action on hair
      follicles was to determine the drug's active form. We used organ-cultured
      vibrissa follicles to test whether it is minoxidil or its sulfated metabolite,
      minoxidil sulfate, that stimulates hair growth. Follicles from neonatal mice were
      cultured with or without drugs and effects were assessed by measuring
      incorporation of radiolabeled cysteine in hair shafts of the treated follicles.
      Assays of minoxidil sulfotransferase activity indicated that vibrissae follicles
      metabolize minoxidil to minoxidil sulfate. Dose-response studies showed that
      minoxidil sulfate is 14 times more potent than minoxidil in stimulating cysteine
      incorporation in cultured follicles. Three drugs that block production of
      intrafollicular minoxidil sulfate were tested for their effects on drug-induced
      hair growth. Diethylcarbamazine proved to be a noncompetitive inhibitor of
      sulfotransferase and prevented hair growth stimulation by minoxidil but not by
      minoxidil sulfate. Inhibiting the formation of intracellular PAPS with chlorate
      also blocked the action of minoxidil but not of minoxidil sulfate. Acetaminophen,
      a potent sulfate scavenger blocked cysteine incorporation by minoxidil. It also
      blocked follicular stimulation by minoxidil sulfate apparently by directly
      removing the sulfate from the drug. Experiments with U-51,607, a potent minoxidil
      analog that also forms a sulfated metabolite, showed that its activity was
      inhibited by both chlorate and diethylcarbamazine. These studies show that
      sulfation is a critical step for hair-growth effects of minoxidil and that it is
      the sulfated metabolite that directly affects hair follicles.

PMID- 2230219
TI  - Experimental models for psoriasis.
AB  - Evidence suggests that inherent in skin of psoriatic subjects are cells,
      architectural structures, and/or mediators, which are, at a minimum, responsible
      for its hyperproliferative epidermis. An objective of our laboratory has been to
      establish an in vitro definition of this inherent aberration. Fibroblasts are
      important to epidermal proliferation/differentiation. This, and an unconfirmed
      report that fibroblasts from psoriatic subjects might drive the abnormal
      epidermal proliferation in psoriasis, have caused further focus on the
      fibroblast. Data show that fibroblasts from patients with psoriasis, both
      involved and uninvolved, in the presence of human serum, either normal or
      psoriatic, have an increased rate of proliferation. Fibroblasts from uninvolved
      psoriatic sites are most responsive. To determine if fibroblasts from psoriatics
      could induce the psoriasiform phenotype on normal keratinocytes, an interactive
      skin equivalent system has been developed. With this system, fibroblasts from
      uninvolved and involved sites cause normal keratinocytes to have an enhanced
      outgrowth. Uninvolved fibroblasts cause the greatest changes. The nature of the
      skin equivalent system calls for this to occur via message over distance. We
      conclude that fibroblasts from psoriatic subjects can induce a psoriasiform
      phenotype via a soluble message.

PMID- 2230220
TI  - Production of paf-acether by human epidermal cells.
AB  - The production of the inflammatory mediator paf-acether (paf) from human
      epidermal cells was investigated in vitro. Human epidermal cells, freshly
      isolated from normal skin or in culture, were incubated in Tyrode's buffer
      containing 0.25% lipid-free bovine serum albumin in the presence of 2 microM
      calcium ionophore A23187, at 37 degrees C, for 1 to 60 min. Paf production
      slightly began at the first min of stimulation, was significant after 10 min,
      reached a maximum at 20 min (251 +/- 25 pg/l X 10(6) cells, mean +/- 1 SD), and
      decreased thereafter. About 50% of the paf amount produced by epidermal cells was
      recovered in supernatants. Addition of the non-acetylated paf precursor 1-O
      octadecyl-sn-glycero-3-phosphocholine, i.e., lyso-paf, at 0.1 microM to epidermal
      cells during A23187-stimulation did not alter this production. In contrast,
      addition of acetyl-coenzyme A at 0.1 mM enhanced paf production by 5 times. The
      material produced by epidermal cells was identical to synthetic paf because: 1)
      the aggregation of aspirin-treated and ADP-insensitive washed rabbit platelets it
      induced was inhibited by BN 52021, an antagonist of the paf putative receptor; 2)
      the factor was inactivated by phospholipase A2 but was insensitive to lipase from
      Rhizopus arrhizus; 3) it exhibited the same retention time as synthetic paf
      during standard and reverse-phase (RP) high-pressure liquid chromatography (HPLC)
      elution. The paf precursors, i.e., lyso-paf and 1-O-alkyl-2-acyl-sn-glycero-3
      phosphocholine, were also detected in epidermal cells, stimulated with A23187 or
      not. As determined by RP-HPLC analysis and confirmed by gas chromatography
      analysis, these precursors and the paf produced by epidermal cells exhibited more
      than 90% of a hexadecyl chain at the sn-1 position of the molecule. The present
      results demonstrate the synthesis and release of paf by normal human epidermal
      cells. Paf production within the epidermis might account for the development of
      cutaneous inflammation and the pathogenesis of many skin disorders.

PMID- 2230222
TI  - Immunosuppressive effects of clonidine on the induction of contact sensitization
      in the balb/c mouse.
AB  - The clonidine transdermal therapeutic system (clonidine-TTS) has been associated
      with a significant incidence of allergic contact sensitization. This incidence
      was not predicted by premarket skin sensitization testing in animals or humans.
      One possible explanation lies in recent findings in guinea pigs that clonidine
      exposure could inhibit the elicitation of skin reactions to unrelated strong
      contact sensitizers. However, these studies also showed that clonidine
      pretreatment did not appear to affect the induction of contact sensitization. On
      this basis, we sought to specifically evaluate the induction phase of
      sensitization to clonidine as an alternative means of assessing its sensitization
      properties. The method selected was the assay of in situ lymphocyte proliferation
      in lymph nodes draining the sites of clonidine exposure, a method recently
      promoted as an alternative means to assess contact allergenic potential.
      Utilizing various induction application techniques and regimens, we were
      consistently unable to demonstrate clonidine's allergenic potential through such
      an assessment of lymphocyte proliferation. We were also unable to demonstrate
      sensitization by in vivo ear swelling or in vitro lymphocyte blastogenesis assay
      techniques. However, a subsequent assessment of the effect of clonidine exposure
      on the induction of sensitization to unrelated strong contact allergens
      demonstrated a consistent 40-70% inhibition of the proliferative response to the
      contact allergens oxazolone and trinitrochlorobenzene. This was similar to the
      degree of suppression produced by the corticosteroids fluocinonide and
      hydrocortisone when they were tested at 80 and 10 times lower concentrations. In
      addition, we observed a comparable inhibition of the ear swelling response to
      oxazolone. These data extend our knowledge of the immunomodulatory effects of
      clonidine and offer additional mechanistic insights into the failure of short
      term predictive patch-test methods to detect this chemical's potential to induce
      allergic contact sensitization.

PMID- 2230221
TI  - Interspecies and interregional analysis of the comparative histologic thickness
      and laser Doppler blood flow measurements at five cutaneous sites in nine
      species.
AB  - Studies in dermatology, cutaneous pharmacology, and toxicology utilize skin from
      different animal species and body sites. However, regional differences exist in
      topical chemical percutaneous absorption studies in man and in animal. The
      objective of this study was to compare epidermal thickness and number of cell
      layers across species and body sites using both formalin-fixed paraffin and
      frozen sections. Cutaneous blood flow determined by laser Doppler velocimetry
      (LDV) was compared to histologic data. Six animals of each of the following
      species were used: monkeys, pigs, dogs, cats, cows, horses, rabbits, rats, and
      mice. Cutaneous blood flow was determined and 6-mm skin biopsies were taken
      directly from the following sites: buttocks, ear, humeroscapular joint,
      thoracolumbar junction, and abdominal area. When the two histologic methods were
      compared across all species and body sites, the thickness of the epidermis was
      significantly greater, and the thickness of the stratum corneum significantly
      less, in paraffin sections versus frozen sections (p less than 0.05). There were
      no differences in the number of viable cell layers determined by both methods.
      The values for LDV-determined blood flow did not significantly correlate (p
      greater than 0.05) to epidermal or stratum corneum thickness. However, regional
      and species differences were noted in all these parameters. In conclusion, these
      data indicate that thickness and LDV blood flow are independent and must be
      evaluated separately when comparisons are made between species and body sites.
      This work provides a data base for future comparative studies in which a
      knowledge of skin thickness or blood flow might be important variables.

PMID- 2230223
TI  - Targeting gene expression to the epidermis of transgenic mice: potential
      applications to genetic skin disorders.
AB  - The ability to specifically target gene expression to the epidermis of transgenic
      mice offers the exciting possibility of creating animal models of certain skin
      disorders that are inherited in man. It may be possible to produce mouse models
      of dominantly inherited keratinization disorders by targeting the expression of
      mutant genes encoding the major differentiation products of the epidermis, such
      as the differentiation specific keratins, filaggrin and cell envelope proteins.
      Mouse models for other skin disorders associated with abnormal regulation of
      growth, such as psoriasis, may be generated by targeting the overexpression of
      cytokines and growth factors, which are thought to play important roles in the
      pathogenesis of this disease. The development of currently unavailable animal
      models for certain inherited human skin diseases would not only contribute to our
      understanding of the pathogenesis of these diseases at the molecular level, but
      also provide interesting models for therapeutic intervention.

PMID- 2230224
TI  - Unusual cholesterol esters in the sebum of young children.
AB  - Cholesterol esters (CE) having fatty acids of more than 18 carbons are a
      prominent feature of fetal skin surface lipid (vernix caseosa), but are a minor
      component of adult lipid. The difference may be related to the fact that fetal
      sebaceous glands generally synthesize little lipid. If so, it would be expected
      that prepuberal children, who also have very inactive glands, would secrete CE
      with a large proportion of very-long-chain fatty acids. To test this conjecture,
      skin surface CE from young children were isolated and analyzed. Sebum was
      extracted from the hair of 38 children, aged six to nine. To obtain a measure of
      sebaceous lipogenesis, the class composition of the lipid was determined by
      quantitative thin-layer chromatography and the ratio of wax esters/[cholesterol +
      cholesterol esters] (WE/[CH + CE]) was calculated. CE were then isolated from the
      lipid and hydrolyzed. The freed fatty acids were converted to fatty acid methyl
      esters (FAME) and analyzed by capillary gas chromatography to determine the
      proportion with more than 18 carbons. FAME from five of the subjects were then
      separated into saturated and monounsaturated fractions and analyzed again by gas
      chromatography to identify chain types. Ratios of WE/[CH + CE] ranged from 0.08
      to 2.8 in the subjects. The proportion of CE FAME with more than 18 carbons
      ranged from 15 to 72%, with the highest proportion being found in the children
      with the lowest WE/[CH + CE]. The saturated FAME were mostly iso- or anteiso
      branched, whereas the monounsaturated FAME were mostly straight-chain extension
      products of 16: 1 delta 9 or 18: 1 delta 9.

PMID- 2230225
TI  - Transforming growth factor-beta modulates plasminogen activator activity and
      plasminogen activator inhibitor type-1 expression in human keratinocytes in
      vitro.
AB  - Transforming growth factor beta (TGF-beta) is a multifunctional mediator with
      effects on cellular growth, differentiation, and extracellular matrix (ECM)
      metabolism. Because TGF-beta stimulates fibronectin expression in cultured human
      keratinocytes, we wished to determine whether it might also affect ECM
      degradation through the plasminogen activator (PA)-plasminogen activator
      inhibitor (PAI) system. Immunofluorescence of human keratinocytes using a
      monospecific antiserum to type 1 PAI (PAI-1) showed enhanced cellular and ECM
      staining when they were cultured in the presence of TGF-beta. The antiserum also
      identified an Mr 50,000 protein in conditioned media that was markedly enhanced
      by TGF-beta. A corresponding stimulation of PAI-1 mRNA was demonstrated by
      quantitative RNA blot analysis. Total plasminogen activating activity of
      conditioned medium was markedly decreased by TGF-beta. Zymography showed this to
      be at least partially due to decreased secreted urokinase activity. TGF-beta may
      play an important role in stabilizing the provisional matrix synthesized by
      keratinocytes in healing wounds.

PMID- 2230226
TI  - Inherited mouse mutations as models of human adnexal, cornification, and
      papulosquamous dermatoses.
AB  - Nearly 100 mouse mutations have been described as causing some type of
      abnormality of the skin or hair. As only a few of these mutations have been
      studied in detail, they remain an untapped resource for furthering knowledge of
      basic cutaneous physiology and understanding the pathophysiology of analogous
      diseases in humans. Several diverse murine mutations are discussed. These include
      "asebia," a mildly hyperkeratotoic disorder with sebaceous gland hypoplasia;
      "ichthyosis," an example of abnormal hair growth associated with hyperkeratosis;
      "rhino" and "hairless," two related examples of congenital follicular
      malformations; and "flaky skin", a potential animal model of eruptive psoriasis.

PMID- 2230227
TI  - Growth factor and proto-oncogene expression in psoriasis.
AB  - The expression of several proto-oncogenes and growth factors was analyzed in
      normal skin and psoriatic lesions by RNA blot hybridization. Isolation of intact
      RNA from frozen biopsy samples required immediate exposure to denaturants during
      tissue homogenization. Lipocortin II and cyclophilin transcripts were used as
      internal controls. These transcripts were abundant and slightly but significantly
      elevated in psoriatic lesions. When results were normalized according to these
      reference transcripts, there was no increase in the expression of c-myc, c-Ha
      ras, c-erbB (EGF receptor), c-jun, or transforming growth factor-beta (TGF-beta)
      transcripts in psoriatic lesions, and lesional c-fos transcripts were decreased
      relative to normal skin. In contrast, expression of TGF-alpha mRNA transcripts
      were markedly increased in psoriatic lesions even after normalization. Placement
      of normal or psoriatic tissue in organ culture for 2 to 4 h resulted in strong
      induction of c-fos, c-jun, and c-myc transcripts, but not of the other genes
      studied. Thus, overexpression of proto-oncogenes may be more characteristic of
      the epidermal response to acute injury than of the steady-state hyperplasia
      characteristic of psoriasis. Interferon-gamma (IFN-gamma) increased TGF-alpha
      mRNA levels in cultured human KC at long time intervals (24-48 h). However, of
      various cytokines tested, only EGF and TGF-alpha induced TGF-alpha mRNA after
      short time intervals (2-4 h). These results as well as the selective
      overabundance of TGF-alpha mRNA in psoriatic lesions among various cytokines
      tested suggest that activation of the EGF receptor tyrosine kinase by TGF-alpha
      is important in the pathogenesis of psoriatic epidermal hyperplasia.

PMID- 2230228
TI  - Heterosexual transmission of human immunodeficiency virus among intravenous drug
      users.
AB  - To examine sexual transmission of human immunodeficiency virus (HIV) among
      heterosexual intravenous drug users (IVDUs), HIV antibody status of IVDUs with
      intravenous drug-using sexual partners (IVSPs) was compared with that of IVDUs
      with no IVSPs. Initial bivariate analyses indicated IVDUs with IVSPs were more
      likely to be HIV antibody-positive than those with no IVSPs. Analyses by gender
      indicated that this relationship held for men but not women. IVDUs with IVSPs
      also differed from those without IVSPs demographically, in drug use, and in other
      sexual behaviors. When effects of other variables were controlled, no
      statistically significant relationship was found between injection history of sex
      partners and HIV status for the total sample or separately for men or women.

PMID- 2230229
TI  - The role of human immunodeficiency virus infection in pneumococcal bacteremia in
      San Francisco residents.
AB  - Human immunodeficiency virus (HIV) is an important risk factor for invasive
      pneumococcal disease, but information on clinical course and infecting serotypes
      is limited. To help develop strategies to reduce the morbidity due to invasive
      pneumococcal disease, episodes of pneumococcal bacteremia were identified by
      retrospective review of microbiology records (November 1983-November 1987) at 10
      San Francisco hospitals and, for patients 20-55 years old living in San
      Francisco, HIV antibody status was determined by review of medical records.
      Pneumococcal isolates from one hospital were serotyped. Of 294 patients with
      pneumococcal bacteremia identified, 32 (11%) had AIDS at the time pneumococcal
      bacteremia was diagnosed and another 43 (15%) were HIV-infected but did not have
      AIDS; 12 HIV-infected patients developed AIDS after the episode of pneumococcal
      bacteremia. The rate of pneumococcal bacteremia in AIDS patients was estimated to
      be 9.4/1000 patient-years. Serotypes of 27 (82%) of 33 pneumococcal isolates from
      HIV-infected patients and 107 (90%) from 119 patients without known HIV infection
      were among the 23 serotypes included in the currently available polysaccharide
      vaccine. The rate of pneumococcal bacteremia is approximately 100-fold greater in
      AIDS patients in San Francisco than rates reported before the AIDS epidemic, but
      more than half the episodes of pneumococcal bacteremia in HIV-infected patients
      occurred in patients without AIDS. Data on pneumococcal serotypes causing
      invasive disease in HIV-infected patients suggest that the current pneumococcal
      vaccine, if effective in this population, could provide significant protection
      against pneumococcal disease.

PMID- 2230230
TI  - Clinical correlation and genetic polymorphism of the human immunodeficiency virus
      proviral DNA obtained after polymerase chain reaction amplification.
AB  - Polymerase chain reaction (PCR) was used to amplify a long sequence of human
      immunodeficiency virus (HIV) DNA, to assess the correlation between PCR signal
      and clinical stage of disease, and to demonstrate the genotypic variability of
      different HIV isolates. Twenty-four (96%) of 25 anti-HIV-reactive patients and
      none of 12 controls were positive for HIV proviral DNA by PCR. After
      quantification of the PCR signal, a significant difference in the relative amount
      of HIV proviral DNA per 10(5) peripheral blood mononuclear cells between
      symptomatic patients (Centers for Disease Control [CDC] class IV) (32,284 +/-
      5225 cpm [mean +/- SE], equivalent to 802 HIV plasmid DNA copies) and patients
      without symptoms (CDC class II/III) (5484 +/- 1469 cpm [mean +/- SE], equivalent
      to 67 HIV plasmid DNA copies) was observed (P less than .01). Restriction
      analysis of PCR products in selected samples showed extensive genetic
      polymorphism between different isolates and more than one viral genotype per
      isolate. There was a clear correlation between the appearance of clinical
      symptoms in HIV infection and high levels of viral replication.

PMID- 2230231
TI  - Measles antibody: reevaluation of protective titers.
AB  - A school blood drive before a measles outbreak permitted correlation of
      preexposure measles antibody titers with clinical protection using the plaque
      reduction neutralization (PRN) test and an EIA. Of 9 donors with detectable
      preexposure PRN titer less than or equal to 120, 8 met the clinical criteria for
      measles (7 seroconfirmed) compared with none of 71 with preexposure PRN titers
      greater than 120 (P less than .0001). Seven of 11 donors with preexposure PRN
      titers of 216-874 had a greater than or equal to 4-fold rise in antibody titer
      (mean, 43-fold) compared with none of 7 with a preexposure PRN titer greater than
      or equal to 1052 (P less than .02). Of 37 noncases with preexposure PRN titer
      less than 1052, 26 (70%) reported one or more symptoms compared with 11 (31%) of
      35 donors with preexposure PRN titers greater than or equal to 1052 (P less than
      .002). By EIA, no case had detectable preexposure antibody; the preexposure
      geometric mean titer of asymptomatic donors (220) was not significantly higher
      than that of symptomatic donors who did not meet the clinical criteria for
      measles (153) (P = .10). The study suggests that PRN titers less than or equal to
      120 were not protective against measles disease and illness without rash due to
      measles may occur in persons with PRN titers above this level.

PMID- 2230232
TI  - Measles incidence, vaccine efficacy, and mortality in two urban African areas
      with high vaccination coverage.
AB  - Measles incidence, vaccine efficacy, and mortality were examined prospectively in
      two districts in Bissau where vaccine coverage for children aged 12-23 months was
      81% (Bandim 1) and 61% (Bandim 2). There was little difference in cumulative
      measles incidence before 9 months of age (6.1% and 7.6%, respectively). Between 9
      months and 2 years of age, however, 6.1% contracted measles in Bandim 1 and 13.7%
      in Bandim 2. Even adjusting for vaccination status, incidence was significantly
      higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95% of the children
      had measles antibodies after vaccination, vaccine efficacy was not more than 68%
      (95% confidence interval [CI] 39%-84%) and was unrelated to age at vaccination.
      Unvaccinated children had a mortality hazard ratio of 3.0 compared with
      vaccinated children (P = .002), indicating a protective efficacy against death of
      66% (CI 32%-83%) of measles vaccination. These data suggest that it will be
      necessary to vaccinate before age 9 months to control measles in hyperendemic
      urban African areas.

PMID- 2230233
TI  - Properties of strains of Escherichia coli O26:H11 in relation to their
      enteropathogenic or enterohemorrhagic classification.
AB  - Thirty-seven strains of Escherichia coli O26:H11 from infants and calves with
      diarrhea were examined for properties associated with enteropathogenic (EPEC) or
      enterohemorrhagic E. coli (EHEC). Strains were heterogeneous with respect to Vero
      cytotoxin (VT) production and hybridization with the EHEC plasmid-specific
      (CVD419) probe; 26 strains produced VT1; 1 produced VT2. Twenty-four of 27 VT+
      strains and 5 of 10 VT- strains hybridized with the CVD419 probe and produced
      enterohemolysin; these properties are characteristic of EHEC. The strains did not
      hybridize with the EPEC adherence factor probe, a property characteristic of some
      EPEC. Nevertheless, 36 strains adhered to HEp-2 cells in a localized manner and
      were positive by the fluorescence actin staining (FAS) test that is considered to
      correlate with the ability to cause attaching and effacing lesions in vivo. EPEC
      and EHEC cause these lesions. Although the FAS test appeared to be the most
      general pathogenicity test for the O26:H11 strains, it could not be used to
      assign strains specifically to EPEC or EHEC groups.

PMID- 2230234
TI  - Fucosylated oligosaccharides of human milk protect suckling mice from heat
      stabile enterotoxin of Escherichia coli.
AB  - Human milk protects suckling mice from the diarrheagenic effects of heat-stabile
      enterotoxin of Escherichia coli (ST). To identify the human milk fraction
      responsible for this protection, pooled skimmed, deproteinated milk was passed
      through charcoal, whereupon lactose was separated from the oligosaccharides. The
      oligosaccharides contained ST-protective activity; the lactose did not. The
      neutral, but not the acidic, fraction exhibited protective activity against ST
      (22% vs. 57% mortality, respectively; P less than .001). The fucosylated, but not
      the nonfucosylated, subfractions of the neutral fraction contained the factor
      protective against ST (35% vs. 50% mortality, respectively; P less than .05). An
      oligosaccharide isolation scheme based on different principles produced
      confirmatory results. The commercially available neutral fucosylated
      oligosaccharides of human milk did not significantly protect the mice from the
      effects of ST. Thus, the protective factor against ST seems to be a minor neutral
      fucosyloligosaccharide of human milk.

PMID- 2230235
TI  - Platelet-activating factor or a platelet-activating factor antagonist decreases
      tumor necrosis factor-alpha in the plasma of mice treated with endotoxin.
AB  - When L-platelet-activating factor (PAF) or alprazolam (a PAF antagonist) was
      administered to lipopolysaccharide (LPS)-treated mice, the level of plasma tumor
      necrosis factor (TNF alpha) determined by either ELISA or a cytotoxic assay using
      WEHI cells was significantly lowered. The inactive stereoisomer, D-PAF, was not
      effective in lowering plasma TNF alpha levels in LPS-treated mice. The decrease
      in plasma TNF alpha induced by L-PAF or alprazolam was partly reversed by
      indomethacin. Despite a decrease in plasma TNF alpha, L-PAF or alprazolam caused
      an increase in the amount of TNF alpha mRNA present in the kidneys and the livers
      of LPS-treated mice, suggesting that a posttranscriptional event leading to the
      synthesis or release of TNF alpha was inhibited by these agents.

PMID- 2230236
TI  - Salmonella interactions with polarized human intestinal Caco-2 epithelial cells.
AB  - Polarized monolayers of the human intestinal epithelial Caco-2 cell line were
      grown on permeable filters and infected apically with either Salmonella
      choleraesuis or Salmonella typhimurium. Both Salmonella species penetrated
      through the monolayer, requiring 2 h before appearing in the basolateral medium.
      Both species caused a loss in transepithelial resistance by 3-4 h, and the
      monolayer's integrity was completely disrupted by 6 h. Scanning and transmission
      electron microscopy revealed that the bacteria interacted with well-defined
      apical microvilli and caused disruptions in the brush border, including
      elongation and denuding of the microvilli. The cytoplasm was also disrupted
      locally, with blebs protruding from the apical surface. The bacteria entered
      (invaded) these cells and were enclosed in membrane-bound vacuoles within the
      cytoplasm. By 6 h there were many bacteria within most Caco-2 cells, and these
      organisms caused serious cytopathic consequences. These morphologic observations
      correlated well with animal infection models, indicating that this in vitro
      system will be useful to study pathogens that interact with human intestinal
      epithelia.

PMID- 2230237
TI  - Antimicrobial resistance of Shigella isolates in the USA: the importance of
      international travelers.
AB  - A nationwide sample of Shigella isolates was collected and tested for resistance
      to 12 antimicrobial agents to assess the prevalence and epidemiologic correlates
      of antimicrobial resistance in Shigella. Of the isolates, 32% were resistant to
      ampicillin, 7% to trimethoprim-sulfamethoxazole, and 0.4% to nalidixic acid.
      Fifty (20%) of 252 isolates were associated with foreign travel. The best
      predictor of clinically important resistance was a history of foreign travel: 20%
      of isolates from foreign travelers showed trimethoprim-sulfamethoxazole
      resistance, compared with only 4% of isolates from those without such a history.
      Quinolone resistance was not identified in travel-related isolates, and
      quinolones may be more appropriate for initial therapy of travel-related
      shigellosis than is trimethoprim-sulfamethoxazole.

PMID- 2230238
TI  - Cefuroxime treatment failure of nontypable Haemophilus influenzae meningitis
      associated with alteration of penicillin-binding proteins.
AB  - A 10-year-old boy presented with nuchal rigidity and cerebrospinal fluid (CSF)
      leukocytosis initially and again on day 6 of intravenous cefuroxime therapy (200
      mg/kg/day). Both CSF specimens yielded nontypable beta-lactamase-negative
      Haemophilus influenzae that were susceptible by disk tests but relatively
      resistant to cefuroxime (MIC, 8- to 16-fold greater than that of control
      isolates). To define the mechanism of resistance, the cefuroxime resistance
      marker was transformed to a susceptible H. influenzae recipient; inactivation and
      permeability of beta-lactam substrate were tested and the penicillin-binding
      protein (PBP) profiles were examined. Inactivation of beta-lactam substrate was
      not detected and reduced permeability was not found. However, reduced beta-lactam
      binding to PBPs 4 and 5 was observed; 18- to 27-fold more penicillin and 2.5-to 4
      fold more cefuroxime was required to saturate or block 50% of the binding sites
      of these PBPs, respectively. Thus, reduced affinity of PBPs 4 and 5 for beta
      lactam substrate appears to be the mechanism of cefuroxime resistance in this
      strain. The reduced affinity of these targets appears to have contributed to the
      bacteriologic and clinical failure in this patient.

PMID- 2230239
TI  - Prevention of catheter-associated urinary tract infection with a silver oxide
      coated urinary catheter: clinical and microbiologic correlates.
AB  - In a prospective clinical trial involving 482 acutely hospitalized patients, the
      overall incidence of catheter-associated urinary tract infection (UTI; 10%) was
      similar in recipients of a silver oxide-coated urinary catheter (silver catheter)
      or a control silicone catheter. However, female sex and absence of antimicrobial
      use were independently associated with an increased risk of UTI. After
      stratification for these variables, the silver catheter reduced the incidence of
      UTI among women not receiving antimicrobial agents (19% for control catheter vs.
      0 for silver catheter, P = .04; confidence interval for the difference in
      incidence, 0.4%-38%) but not in the other subgroups. Gram-positive UTI was
      associated with absence of antimicrobial use, the control catheter, and catheter
      care violations. Gram-negative and candidal UTIs were more common after 7 days of
      catheterization, and candidal UTI was associated with being female and
      antimicrobial use. These findings demonstrate that several clinical variables
      influenced the incidence and microbiology of catheter-associated UTI and that the
      silver catheter appeared to prevent UTI among women not receiving antimicrobials.

PMID- 2230240
TI  - Circulating immune complex-associated parasite antigens in human onchocerciasis.
AB  - This study identified and characterized parasite antigens in sera from humans
      infected with Onchocerca volvulus. Immune complexes were precipitated from human
      sera with polyethylene glycol and analyzed by immunoblot with rabbit antibodies
      to O. volvulus. A 23-kDa parasite antigen was detected in sera from 17 of 23
      Nigerian onchocerciasis patients and 5 of 10 endemic controls. Other parasite
      antigens with apparent molecular masses of 62, 66, and 70 kDa were less
      consistently observed. These antigens were not present in Nigerian or US
      nonendemic control sera, in sera from patients with various other parasitic
      infections, or in sera from US patients with autoimmune diseases. Biochemical
      studies indicated that these antigens are nonglycosylated acidic proteins that do
      not contain phosphorylcholine. These antigens may be useful as targets for
      improved diagnostic tests for onchocerciasis based on parasite antigen detection.

PMID- 2230241
TI  - Coccidioidomycosis in human immunodeficiency virus-infected patients.
AB  - Coccidioidomycosis is at best a complicated fungal infection; often it is life
      threatening. Coccidioidomycosis is confined epidemiologically to the southwestern
      region of the USA, and most cases have occurred in that area, particularly in
      Arizona. However, we have seen several cases in San Francisco in patients with
      only a history of travel to endemic areas. In part because of its regional
      distribution, information about the clinical presentation, diagnosis, and
      treatment of patients with coccidioidomycosis has lagged behind information about
      other, more commonly encountered AIDS-associated opportunistic infections. Drs.
      Galgiani and Ampel have probably had the largest single experience with
      coccidioidomycosis in individuals infected with the human immunodeficiency virus.
      These specialists share their experience and make recommendations as to how these
      complicated conditions should be approached.

PMID- 2230242
TI  - Antibody affinity in infants after immunization with conjugated capsular
      polysaccharide from Haemophilus influenzae type b.
AB  - The affinities of IgG antibodies to Haemophilus influenzae b capsular
      polysaccharide (polyribosyl ribitol phosphate [PRP]) elicited 1 month after
      immunization of 47 infants 2-greater than 18 months of age with a PRP-outer
      membrane protein conjugate (PRP-OMP) were measured by ELISA. Thirty-four sera had
      affinities distributed normally about a logarithmic mean of 3.2 x 10(5) l/mol,
      but 13 samples had undetectable affinities (less than 10(4) l/mol). Median
      affinities of sera from children 2-6 (1.5 x 10(5) l/mol) and 7-11 months of age
      (1.6 x 10(5) l/mol) were significantly greater than the median affinities of sera
      from infants 12-18 (1.8 x 10(4) l/mol) or greater than 18 months of age (4.2 x
      10(4) l/mol). Sera from children greater than 18 months of age vaccinated with
      PRP conjugated to diphtheria toxoid had a median affinity of 6.1 x 10(4) l/mol,
      equivalent to that of the same age group vaccinated with PRP-OMP. Children
      vaccinated with PRP conjugate vaccines may produce antibodies of very low
      affinity, a finding that may have significance for protection from invasive
      disease.

PMID- 2230244
TI  - Differentiation of Shiga toxin and Vero cytotoxin type 1 genes by polymerase
      chain reaction.
AB  - Two sets of synthetic oligonucleotide primers were used in a polymerase chain
      reaction technique to distinguish genes for Shiga toxin in Shigella dysenteriae 1
      and type 1 Vero cytotoxin (VT1) in Escherichia coli. VT1a and VT1b primers
      directed at a common 130-base-pair (bp) fragment of the stx and sltI genes
      detected template nucleic acid in both Shiga toxin-positive S. dysenteriae 1 and
      VT1-producing E. coli strains. VT1c and VT1d primers, targeting a 140-bp fragment
      of the promoter region of the sltIA gene, were negative in the polymerase chain
      reaction with S. dysenteriae 1 nucleic acid and positive with nucleic acids from
      all strains found to produce VT1 in toxin-specific neutralization tests. Primer
      specificity was determined in the polymerase chain reaction using nucleic acid
      extracted from 49 strains of representative enteric pathogens defined in terms of
      their toxigenicity.

PMID- 2230243
TI  - Pneumococcal anticapsular antibodies in patients with chronic cardiovascular and
      obstructive lung disease in The Netherlands.
AB  - Differences in pneumococcal anticapsular antibody concentrations were assessed
      among patients with various chronic disorders and among young (25-35 years of
      age) and older adults (55-65 years). Antibody concentrations were determined by
      ELISA, using the whole 23-valent pneumococcal polysaccharide vaccine as antigen.
      No differences in mean or distribution of serum antibody concentrations were
      found among young adults (either healthy or asthmatic) or among older adults
      (healthy or with chronic obstructive pulmonary or chronic cardiovascular
      disease). Each group included individuals with low antibody levels. Therefore,
      the enhanced susceptibility to pneumococcal infections reported for some groups
      at risk, that is, elderly individuals and patients with chronic obstructive
      pulmonary or chronic cardiovascular disease, cannot be attributed solely to low
      anticapsular antibody concentrations.

PMID- 2230245
TI  - Neisseria mucosa endocarditis.
AB  - A case of Neisseria mucosa tricuspid valve endocarditis in an intravenous drug
      abuser is described. The patient was treated initially with intravenous
      penicillin G followed by oral penicillin VK but relapsed. He was cured after 4
      weeks of combined therapy with penicillin G and gentamicin. In vitro synergy
      studies performed on the patient's and two other isolates revealed synergy in all
      three. Thus, combination therapy is recommended for treatment of recalcitrant
      cases of bacterial endocarditis caused by N. mucosa.

PMID- 2230246
TI  - Detection of interleukin-3 in the serum of mice infected with Mycobacterium
      lepraemurium.
AB  - Infection of mice by Mycobacterium lepraemurium is accompanied by ablation of
      erythropoiesis in the bone marrow and gross enlargement of the spleen. This,
      together with increased monocytopoiesis and the earlier demonstration of
      macrophage colony-stimulating factor in the serum of infected mice, suggested the
      activity of additional cytokines. Eight weeks after infection of mice by M.
      lepraemurium, interleukin-3 (IL-3) activity was demonstrated in the serum (titer,
      1:3200). The serum titer of IL-3 activity was maximal after 13 weeks (greater
      than 1:6400) and was slightly reduced after 18 weeks (1:6400). That the IL-3
      activity detected in the serum of the M. lepraemurium-infected mice reflected the
      presence of IL-3 itself was confirmed by a neutralization assay using anti-murine
      IL-3 antibodies; IL-3 activity in the serum of mice 13 weeks after infection was
      completely abolished by the anti-IL-3 antibodies. Finally, a 1-kb signal of IL-3
      RNA was detected in the spleens of M. lepraemurium-infected mice 13 weeks after
      infection.

PMID- 2230247
TI  - Motility of Lyme disease spirochetes in fluids as viscous as the extracellular
      matrix.
AB  - When properties of extracellular fluids that might regulate the ability of the
      Lyme disease spirochete to locomote were investigated, the rate of progression
      correlated with viscoelasticity. Such spirochetes flexed and rotated but did not
      progress in relatively nonviscous fluids and migrated increasingly rapidly as the
      viscous characteristics of the medium increased. The viscoelastic properties of
      various kinds of hyaluronic acid resembled those of a methylcellulose standard.
      The maximum velocity that spirochetes achieved in such solutions related directly
      to viscoelasticity rather than to chemical composition. Spirochetes remained
      motile during 3 h of observation despite 100-fold dilution of the standard
      nutrient medium. The immobility of Lyme disease spirochetes in media less viscous
      in character than fixed tissue suggests dissemination via the intercellular
      ground substance of skin.

PMID- 2230248
TI  - Treatment of symptomatic children infected with human immunodeficiency virus.

PMID- 2230249
TI  - Antibody-mediated enhancement of respiratory syncytial virus infection.

PMID- 2230251
TI  - Disseminated bacille Calmette-Guerin infection in an AIDS patient 30 years after
      BCG vaccination.

PMID- 2230250
TI  - Pseudofailure of zidovudine prophylaxis after a human immunodeficiency virus
      positive needlestick.

PMID- 2230253
TI  - Cefepime for treatment of experimental chronic osteomyelitis due to
      Staphylococcus aureus.

PMID- 2230252
TI  - Recovery of viable bacteria from pelvic lymph nodes of patients with gynecologic
      tumors.

PMID- 2230254
TI  - Persistent chronic active cervicitis: a newly noted finding in an animal model of
      chlamydial genital disease.

PMID- 2230255
TI  - Prevalence of homozygous C4B deficiency in patients with deficiencies of terminal
      complement components and meningococcemia.

PMID- 2230256
TI  - AZT demonstrates anti-HIV-1 activity in persistently infected cell lines:
      implications for combination chemotherapy and immunotherapy.
AB  - A sensitive and quantitative focal immunoassay has been used to measure the
      effects of three different therapeutic agents on tissue culture cells infected
      with human immunodeficiency virus (HIV). The effects of the drugs were studied on
      both acutely and persistently infected CD4+ cell lines. The three agents,
      azidothymidine (AZT), interferon-alpha (IFN-alpha), and an anti-HIV envelope
      antibody coupled to ricin A chain, were tested alone and in combination. AZT was
      found to have its greatest effect during early stages of the infection, but also
      had an action on persistently infected T cell lines. The effect of AZT on
      persistently infected cells was seen within 24 h, increased with extended
      exposure to the drug, and persisted after its removal. IFN-alpha had variable
      effects on acutely infected cells but suppressed chronic infection. Combinations
      of the therapeutic agents were studied. Using a model that allowed for treatment
      during both acute and persistent stages of infection, the most effective
      combination in suppressing HIV infection was the continual use of both AZT and
      IFN-alpha at the highest tolerable doses. Knowledge of the efficacy of AZT on
      persistently infected cells will allow for the most effective design of clinical
      protocols.

PMID- 2230257
TI  - Quantitative detection of brain aberrations in human immunodeficiency virus type
      1-infected individuals by magnetic resonance imaging.
AB  - The brains of 65 individuals with antibodies to human immunodeficiency virus type
      1 (HIV-1), 20 HIV-1 seronegative homosexual men, and 75 heterosexual controls
      were examined by a quantitative magnetic resonance imaging technique. A white
      matter aberration was detected most frequently in patients with AIDS-related
      complex (ARC) or AIDS, but also in asymptomatic HIV-1 seropositive persons and in
      HIV-1 seronegative homosexual men, of whom two of three tested were reactive for
      HIV-1 DNA by polymerase chain reaction. The aberration was not found in the
      control group. Brain atrophy was mainly confined to patients with ARC or AIDS.
      The brain lesions correlated with the presence of HIV-1 in cerebrospinal fluid
      and with elevated levels of beta 2-microglobulin and neopterin. The most
      pronounced brain aberrations were in patients with AIDS-dementia complex. These
      findings indicate that brain aberrations may occur in persons in the early stages
      of HIV-1 infection, although to no greater extent than in HIV-1 seronegative
      homosexual men. The occurrence of pronounced brain lesions seems to be associated
      with the presence of an advanced immunodeficiency.

PMID- 2230258
TI  - Occurrence of groups A and B of respiratory syncytial virus over 15 years:
      associated epidemiologic and clinical characteristics in hospitalized and
      ambulatory children.
AB  - Over 15 years respiratory syncytial virus (RSV) isolates from 1209 hospitalized
      and ambulatory children were examined for strain group and in a subset for
      subgroup to determine the associated epidemiologic and clinical characteristics.
      Three patterns of yearly outbreaks existed: (1) strong predominance of group A
      strains (9 years with 83%-100% A strains), (2) relatively equal proportions of
      group A and B strains (4 years), and (3) strong predominance of group B strains
      (78%-85%) in 2 years, separated by a decade. The first pattern of highly dominant
      A strains occurred in cycles of 1 or 2 consecutive years with a single
      intervening year in which B strains were greater than or equal to 40% of the
      isolates. Subgroups A1 and A2 predominated, while B2, 3, and 4 occurred almost
      equally. A greater clinical severity for Group A strains was suggested by
      children with group A infections requiring intensive care significantly more
      often (15.4 vs. 8.3%, P = .008). Further, strongly dominant A strain years were
      associated with higher proportions of RSV admissions requiring intensive care
      (16.6% vs. 5.5%, P less than .01). Strains of subgroups A2 and B4 were more
      frequently found in hospitalized patients and A1 in outpatients, and the 2 years
      with the highest rates of intensive care admissions were those in which subgroup
      A2 dominated.

PMID- 2230259
TI  - Pichinde virus infection in strain 13 guniea pigs reduces intestinal protein
      reflection coefficient with compensation.
AB  - Pichinde virus inoculation into strain 13 guinea pigs is a model with features
      reputed to be similar to hemorrhagic fever in humans. Although the infection is
      lethal by day 13-19, guinea pigs of approximately 600 g do not show edema or
      effusions. This raises the questions of whether capillary damage is present in
      such infected animals and, if it is, why edema is absent. The effects of
      Pichinide virus on protein transport across jejunal capillaries were examined in
      38 normal and 7 infected strain 13 guinea pigs 12 days after inoculation. The
      latter lost 20.3% body weight but maintained normal blood pressure, serum protein
      concentration, and jejunal lymph flow. However, their protein solvent drag
      reflection coefficient (sigma) was reduced to .52 +/- .03 (mean +/- SE) from .73
      +/- .02 (2P less than .001), while permeability-surface area product was not
      changed. In the absence of gross edema or effusions, Pichinde virus-infected
      guinea pigs demonstrated a leaky gut capillary wall to protein compatible with an
      increase in pore size or large pore number less than sufficient to change
      permeability-surface area product. Compensatory mechanisms that prevent edema at
      this stage are efficient and may include reduced capillary pressure or some
      degree of capillary flow stasis.

PMID- 2230260
TI  - Partial characterization of Chlamydia trachomatis isolates resistant to multiple
      antibiotics.
AB  - In vitro susceptibility testing was done on urogenital isolates of Chlamydia
      trachomatis from five patients, four of whom were suspected treatment failures.
      At least one isolate from each patient was resistant to tetracycline at
      concentrations greater than or equal to micrograms/ml, although less than 1% of a
      population of organisms showed high-level resistance. Fully resistant populations
      selected by passage through 8 micrograms/ml tetracycline either died or lost
      their resistance on further passage in antibiotic-free medium. Relatively large
      inocula were required to demonstrate resistance, and morphology of inclusions was
      altered at high tetracycline concentrations. The observed resistance may be a new
      characteristic of the organism or merely newly recognized. Isolates resistant to
      tetracycline were resistant to doxycycline, erythromycin, sulfamethoxazole, and
      clindamycin but sensitive to rifampin, ciprofloxacin, and ofloxacin. Thus,
      resistance to tetracycline, erythromycin, and clindamycin occurs in C.
      trachomatis and may be a factor in some treatment failures.

PMID- 2230261
TI  - Bacterial meningitis in the United States, 1986: report of a multistate
      surveillance study. The Bacterial Meningitis Study Group.
AB  - A prospective, laboratory-based surveillance project obtained accurate data on
      meningitis in a population of 34 million people during 1986. Haemophilus
      influenzae was the most common cause of bacterial meningitis (45%), followed by
      Streptococcus pneumoniae (18%), and Neisseria meningitidis (14%). Rates of H.
      influenzae meningitis varied significantly by region, from 1.9/100,000 in New
      Jersey to 4.0/100,000 in Washington state. The overall case fatality rates for
      meningitis were lower than those reported in several studies from the early
      1970s, suggesting that improvements in early detection and antibiotic treatment
      may have occurred since that time. Concurrent surveillance was also performed for
      all invasive disease due to the five most common causes of bacterial meningitis.
      Serotypes of group B streptococcus other than type III caused more than half of
      neonatal group B streptococcal disease and mortality, suggesting that an optimal
      vaccine preparation must be multivalent. Of the organisms evaluated, group B
      streptococcus was the second most common cause of invasive disease in persons
      greater than 5 years old.

PMID- 2230262
TI  - A large outbreak of antibiotic-resistant shigellosis at a mass gathering.
AB  - In July 1987, a large outbreak of shigellosis occurred among attendees at a mass
      gathering in a national forest, the annual Rainbow Family Gathering. Sanitation
      in the campsite was poor, allowing widespread transmission of disease, probably
      by food, water, and person-to-person spread. The attack rate may have been
      greater than 50% among the estimated 12,700 attendees. The outbreak was caused by
      Shigella sonnei, resistant to ampicillin, tetracycline, and trimethoprim
      sulfamethoxazole; the organism was of colicin type 9 and contained a 90-kilobase
      plasmid not found in non-outbreak-related strains. The dispersal of the group
      resulted in nationwide dissemination of the organism, and outbreaks in three
      states were linked to transmission from attendees at the Gathering. This outbreak
      demonstrates the potential for rapid dissemination of disease in such a setting
      and the necessity for careful planning of mass gatherings.

PMID- 2230263
TI  - Prevalence and diagnosis of Legionella pneumonia: a 3-year prospective study with
      emphasis on application of urinary antigen detection.
AB  - During a 3-year period the frequency of legionellosis in hospitalized patients
      with community-acquired and nosocomial pneumonias was 3.4% (23/684 cases) and
      5.9% (33/559), respectively. Of the diagnostic tests evaluated, detection of
      Legionella pneumophila serogroup 1 antigen in urine had the highest sensitivity,
      with 86% of culture-proven cases being positive. Sensitivities of serologic tests
      and examination of respiratory secretions (culture and direct immunofluorescence)
      were 36% and 26%, respectively. The diagnostic value of serology and of
      examination of respiratory secretions can be low when specimens are obtained and
      processed under the typical conditions of hospitalization. Urinary antigen
      detection represents an important diagnostic addition, and examination of
      postmortem lung tissue from fatal cases with pneumonia is an important adjunct
      for estimating the prevalence of legionellosis and for assessing the
      effectiveness of premortem diagnostic tests.

PMID- 2230264
TI  - Tumor necrosis factor-alpha plays a role in host defense against Histoplasma
      capsulatum.
AB  - Tumor necrosis factor-alpha was detected in supernatants collected from BALB/c
      mouse peritoneal macrophages incubated continuously with Histoplasma capsulatum.
      The levels of TNF alpha measured by actinomycin D bioassay peaked within hours
      after exposure and then greatly declined by 24 h. TNF alpha was also measured in
      bronchoalveolar lavage fluid from BALB/c mice challenged intranasally with H.
      capsulatum. Lavage fluid TNF alpha levels exhibited the same pattern as the in
      vitro supernatants; they peaked within hours after challenge and lower levels
      were detected at 24 h. Treatment of mice with anti-TNF alpha antibody accelerated
      mortality in response to systemic infection and significantly increased tissue
      colony counts in the liver and spleen. In the murine model, TNF alpha is produced
      in response to H. capsulatum and appears to play some role in host defense to
      infection.

PMID- 2230266
TI  - Diagnosis of intestinal amebiasis using salivary IgA antibody detection.
AB  - This investigation sought to determine whether detection of salivary IgA
      antibodies to Entamoeba histolytica could identify intestinal amebic infections
      among 223 school children. Four groups of children were identified through
      coproparasitoscopic examination: E. histolytica as other parasites only (20%);
      and parasite-free (25%). The diagnostic accuracy of salivary IgA antibodies to an
      E. histolytica membrane extract was 91.5% (sensitivity, 85%; specificity, 98%),
      maintaining high predictive value at different prevalences. Also, a positive
      correlation (r = .753, P less than .001) was observed between fecal E.
      histolytica membrane antigen levels and salivary IgA antibody activity.
      Measurement of IgA antibodies in saliva may be useful in diagnosing intestinal
      infections with E. histolytica within a wide range of prevalences. Moreover,
      sampling of saliva may be a useful non invasive test for immunoepidemiologic
      surveys.

PMID- 2230265
TI  - Bacterial infections in patients with visceral leishmaniasis.
AB  - Bacterial infections are often seen in patients with visceral leishmaniasis. To
      determine the incidence of such infection and the more common infectious agents,
      30 consecutive patients with visceral leishmaniasis were followed throughout
      hospitalization. There were 24 episodes of bacterial infection in 18 patients
      (60%). The incidence of bacterial infections in these patients was 22.2/1000 days
      of admission. The proportion of patients becoming infected by time was
      significantly greater in the visceral leishmaniasis group than in controls (P
      less than .01). The skin, respiratory tract, and middle ear were the most common
      sites of infection, and Pseudomonas aeruginosa and Staphylococcus aureus were the
      most common agents. Low-grade-virulence bacteria (e.g., Serratia and Providencia
      species) were also isolated from some cases. Bacterial infections (mainly
      nosocomial) in patients with visceral leishmaniasis tend to be severe and can
      cause death. When bacterial infection is suspected in these patients, empiric
      antibiotic therapy should be started immediately, including coverage for P.
      aeruginosa and S. aureus, after appropriate diagnostic procedures are taken.

PMID- 2230267
TI  - The use of corticosteroids in Pneumocystis carinii pneumonia.

PMID- 2230268
TI  - Seroprevalence of human T cell leukemia viruses in selected populations of
      homosexual men.
AB  - This study sought to define the seroprevalence of human T cell leukemia virus
      (HTLV) types I and II in selected populations of homosexual men. Serum specimens
      were screened for antibodies to HTLV and to human immunodeficiency virus (HIV) by
      enzyme immunoassay; successive testing of specimens with positive results was
      done by Western blotting and radioimmunoprecipitation assay (RIPA) and then by
      polymerase chain reaction (PCR) assay on available peripheral blood mononuclear
      cells (PBMC). Of 1290 specimens, only 4 had antibodies against HTLV confirmed by
      RIPA. PCR analysis of DNA from PBMC from two subjects showed one to be HTLV-I and
      the other to be HTLV-II; both men also had HIV antibodies. These results
      demonstrate a lower seroprevalence rate for HTLV than some previous studies and
      emphasize the need for specific confirmatory tests.

PMID- 2230269
TI  - Confocal microscopic detection of human immunodeficiency virus RNA-producing
      cells.
AB  - A central anomaly in the pathogenesis of AIDS is that few actively infected CD4+
      cells (1 in 10(4)-10(5) have been detected in the peripheral blood, even though
      dramatic depletion (often greater than 90%) of CD4+ cells is the hallmark of
      disease progression. A sensitive, 35S-based human immunodeficiency virus (HIV)
      RNA in situ hybridization technique was coupled with a new detection method,
      confocal laser scanning microscopy, to examine transcriptionally active HIV
      infected cells from individuals at different disease stages. In 35 symptomatic
      HIV-infected individuals (AIDS and AIDS related complex), an average of 1 in 350
      mononuclear cells produced HIV RNA. In contrast, in an asymptomatic group of 30
      individuals, an average of 1 in 2000 mononuclear cells produced HIV RNA. These
      data, obtained using this improved detection method, suggest there are more HIV
      RNA-producing cells in HIV-infected individuals than previously reported. In
      addition, increased numbers of HIV transcribing cells were found to correlate
      with declining clinical condition as assessed by Karnofsky performance score.
      These data suggest that viremia per se may account for the pathologic
      consequences in HIV infection.

PMID- 2230270
TI  - Frequency of indeterminate western blot tests in healthy adults at low risk for
      human immunodeficiency virus infection. The NIAID AIDS Vaccine Clinical Trails
      Network.
AB  - As part of a phase 1 trial of a candidate AIDS vaccine, blood specimens were
      collected from 168 healthy adult volunteers at minimal or no risk for becoming
      infected with human immunodeficiency virus type 1 (HIV-1). These specimens were
      screened for evidence of HIV-1 infection by enzyme immunoassay (EIA) and the
      Biotech/Du Pont Western blot (n = 168), culture (n = 122), and polymerase chain
      reaction assay (n = 20). None of the subjects had a positive test result by any
      of these assays, but 32% had indeterminate Western blot tests, most of which
      demonstrated a single band of low intensity. The most common bands were p24
      (47%), p55 (34%), and p66 (36%); envelope bands were unusual (gp41, 2%; gp120,
      2%). No serum specimen collected after 2-11 months from individuals with
      indeterminate Western blot results was positive by EIA or Western blot. There was
      91% agreement in the test results of the first and second serum samples when the
      same lot of Western blot kit was used but only 36% agreement when different lots
      were used. The Biotech/Du Pont Western blot kit thus frequently yields
      indeterminate test results in the absence of HIV-1 infection, the reproducibility
      of which is subject to lot-to-lot variability.

PMID- 2230271
TI  - Transmission of Chlamydia pneumoniae in young children in a Japanese family.
AB  - Chlamydia pneumoniae strain TWAR was isolated from the respiratory tract of a 5
      year-old girl suffering from pneumonia. The IgM and IgG antibody titers to TWAR
      were 1:32 and 1:128, respectively. Cultures and serology for other common
      bacterial and viral respiratory pathogens were negative. Although she was treated
      with 35 mg/kg/day rokitamycin, TWAR was repeatedly isolated after treatment. Her
      3-year-old sister developed acute bronchitis, and TWAR was isolated from her
      nasopharynx. She was treated with 43 mg/kg/day erythromycin with prompt
      improvement, and TWAR was not isolated after treatment. Although her mother,
      grandmother, and 8-month-old sister suffered from respiratory illness during
      these periods, TWAR was not isolated from them. The repeated isolations from the
      index patient suggest that infection was transmitted from sister to sister. This
      case represents the first reported isolation of TWAR from young children in the
      same household and the first from Japan.

PMID- 2230272
TI  - Pilot trial of selective decontamination for prevention of bacterial infection in
      an intensive care unit.
AB  - Selective decontamination of the oropharynx and gastrointestinal tract with
      nonabsorbable antimicrobials and sucralfate, a stress ulcer prophylactic that
      maintains the normal gastric acid bacterial barrier, were compared for prevention
      of pneumonia in a cardiac surgery intensive care unit. Over 8 months, 51 patients
      received selective decontamination and 56 received sucralfate. The selective
      decontamination regimen included polymyxin, gentamicin, and nystatin given as an
      oral paste and as a solution; patients also received standard antacid or
      histamine2 blocker stress ulcer prophylaxis. Patients in the selective
      decontamination group had significantly less colonization of the oropharynx and
      stomach by gram-negative bacilli (12% vs. 55%, P less than .001), significantly
      fewer infections due to gram-negative bacilli (6% vs. 20%, P = .02), and fewer
      infections overall (12% vs. 27%, P = .04). There was one episode of pneumonia in
      the selective decontamination group and five in the sucralfate group. Mortality
      and length of stay did not differ between the groups, but those receiving
      selective decontamination had less than one-third as many days of systemic
      antibiotic therapy with no increase in colonization or infection with resistant
      gram-negative bacilli. Thus, selective decontamination appeared to reduce both
      extrapulmonary and pulmonary infections.

PMID- 2230273
TI  - Occurrence of secondary attenuating mutations in avirulent Salmonella typhimurium
      vaccine strains.
AB  - The attenuating delta aroA554 mutation in Salmonella typhimurium strain SL3261
      was complemented in vitro by selecting for AroA+ recombinant DNA clones. SL3261
      containing cloned aroA+ genes did not require exogenous phenylalanine,
      tryptophan, tryosine, p-aminobenzoic acid, or dihydroxybenzoic acid for growth in
      defined media. Cloned aroA+ genes did not restore wild-type virulence to SL3261,
      however, in a murine typhoid model. The delta aroA554 mutation was transduced
      into S. typhimurium strain SR-11, a mouse-virulent strain recently passaged in
      mice. The SR-11 delta aroA554 mutant was highly attenuated for mice challenged
      parenterally. The same cloned aroA+ genes isolated in SL3261 restored the
      virulence of the SR-11 delta aroA554 mutant to that of wild-type SR-11. These
      results suggest that while the delta aroA554 allele remains effective in reducing
      S. typhimurium virulence, laboratory passage of attenuated vaccine strains may
      lead to the accumulation of additional attenuating defects.

PMID- 2230274
TI  - Nasal carriage of Staphylococcus aureus: correlation with hormonal status in
      women.
AB  - In view of recent observations on hormone-microorganism interactions, a study of
      Staphylococcus aureus nasal carriage in relation to sex-hormone status was
      undertaken. Prospectively in 479 women attending a colpocytologic clinic,
      hormonal status was assessed by determining the karyopyknotic index (KI) on
      smears stained by the Papanicolaou method. Rates of S. aureus nasal carriage were
      29.3% in premenopausal women and 21.9% in postmenopausal women (P not
      significant). Carriage rates were significantly higher (P = .026, chi 2 7.32) for
      women with high KIs (40.7%) than for those with intermediate and low KIs (27.03%
      and 25.1%, respectively). S. aureus nasal carriage also correlated independently
      and significantly with previous antibiotic use and the presence of insulin
      treated diabetes mellitus. This preliminary observation confirms an association
      between levels of sex hormones as reflected by the KI and S. aureus nasal
      carriage rates.

PMID- 2230275
TI  - Effects of albendazole on Echinococcus multilocularis infection in the Mongolian
      jird.
AB  - Albendazole chemotherapy of larval Echinococcus multilocularis was studied in the
      Mongolian jird by administration of medicated feed at various concentrations and
      durations. The effects were evaluated by comparison of treated and control groups
      in terms of host mortality, larval metastases to the lungs, and final weight and
      histologic appearance of larval tissue. Viability of larval tissue at necropsy of
      each animal was tested by inoculation into two noninfected jirds. Albendazole
      medicated feed (0.05%-0.10%) significantly inhibited larval growth. Other effects
      of the drug included larval degeneration and necrosis, inhibition of protoscolex
      formation, decreased pulmonary metastases, and reduced mortality of hosts.
      Adverse effects on the parasite correlated significantly with serum albendazole
      metabolite levels and duration of therapy. However, serum albendazole levels in
      jirds equal to or exceeding concentrations achieved in humans receiving daily
      doses of 10 mg/kg of body weight did not kill the parasite.

PMID- 2230276
TI  - Activity of the anthelmintic benzimidazoles against Giardia lamblia in vitro.
AB  - In vitro growth of the protozoan parasite Giardia lamblia was highly sensitive to
      certain anthelmintic benzimidazoles. Albendazole and mebendazole were 30- to 50
      fold more active than metronidazole and 4- to 40-fold more active than
      quinacrine. Thiabendazole, a noncarbamate benzimidazole, was less active. Since
      lack of intestinal absorption makes mebendazole an attractive new antigiardial
      agent, its in vitro activity was further characterized. At low concentrations
      (0.05 micrograms/ml) mebendazole had a static effect on G. lamblia growth;
      however, lethal activity was observed at a concentration fivefold lower (0.3
      micrograms/ml) than necessary for the cidal agent metronidazole. Two observations
      are consistent with a microtubule target for mebendazole. First, attachment of
      cells to the culture tube, mediated by the ventral disk and flagella, was rapidly
      disrupted by mebendazole treatment. Second, the characteristic cell structure was
      grossly distorted by treatment. No mebendazole-resistant G. lamblia were detected
      in a population of 10(8) cells.

PMID- 2230277
TI  - Correct structure of repeating unit of group B Streptococcus type III capsular
      polysaccharide.

PMID- 2230278
TI  - Serum neopterin and interleukin-6 levels in chronic fatigue syndrome.

PMID- 2230279
TI  - Helicobacter pylori: has it a part in the lesion of the gastroesophageal reflux?

PMID- 2230280
TI  - Crepitant myonecrosis caused by Klebsiella pneumoniae in an immunocompromised
      diabetic patient.

PMID- 2230281
TI  - Life-threatening Edwardsiella tarda soft-tissue infection associated with catfish
      puncture wound.

PMID- 2230282
TI  - Detection of potentially diagnostic leishmanial antigens by western blot analysis
      of sera from patients with kala-azar or multilesional cutaneous leishmaniasis.

PMID- 2230283
TI  - The architecture of bone marrow cell populations.
AB  - Marrow is a loosely bound tissue in which hemopoiesis has frequently been
      considered to be randomly distributed. The case is presented, however, for an
      organized and structured marrow in which close relationships exist between
      hemopoietic tissue and a regulatory microenvironment. Distributions of myeloid
      cells in the mouse femur are described, and a dynamic picture of their movement,
      with differentiation and maturation from the endosteal surface of the bone to
      their release via the central venous sinus, is painted. It is also shown that
      this structure is established within three weeks of birth. By contrast, mature
      lymphoid cells (but not their progenitors) are uniformly distributed. Regulatory
      stromal elements in the marrow are also structured and their localization is
      found to correspond closely to the properties of the progenitor populations. Such
      structure has potential practical importance, particularly in the field of
      medical, industrial or accidental radiation exposure where bone may introduce non
      uniform dose distributions in the marrow.

PMID- 2230284
TI  - In vivo toxicity of 3'-azido-3'-deoxythymidine (AZT) on CBA/Ca mice.
AB  - CBA/Ca male mice were given 3'-azido-3'-deoxythymidine (AZT) in drinking water (1
      mg/ml) for up to 7 weeks. Water consumption and body weight decreased
      significantly. Neutropenia and lymphopenia were observed during and after
      exposure. Significant macrocytic anemia developed and disappeared as a function
      of red cell life span after stopping AZT intake. A microthrombocytosis was seen.
      Bone marrow cellularity and spleen colony-forming unit (CFU-s) content fell, but
      recovered completely and quickly after terminating AZT intake. Hemopoietic stem
      cell function measured by 2 different methods of rescuing fatally irradiated mice
      was normal 4 weeks after AZT exposure, suggesting that AZT treatment does not
      induce a long-lasting effect in genetic control of mitotic potential of stem
      cells. This is in marked contrast to exposure of CBA/Ca mice to benzene and
      ionizing radiation.

PMID- 2230286
TI  - Inhibition of hematopoietic progenitor colony growth by a monoclonal antibody
      against the transferrin receptor: comparison of unconjugated antibody with an
      immunotoxin containing recombinant ricin A chain.
AB  - We studied an immunotoxin consisting of recombinant ricin A chain (rRA)
      conjugated to 454A12 MoAb, a monoclonal antibody which recognizes an epitope on
      the human transferrin receptor, and compared the ability of 454A12 MoAb-rRA
      immunotoxin to inhibit the growth of erythroid burst-forming units (BFU-e) and
      myeloid colony-forming units (CFU-c) with unconjugated 454A12 MoAb. A significant
      reduction in BFU-e colony growth was observed at 0.001 microgram/ml of 454A12
      MoAb-rRA versus 0.1 microgram/ml of unconjugated 454A12 MoAb (p = 0.005).
      Comparison of the effects of 454A12 MoAb-rRA and 454A12 MoAb on myeloid colony
      development gave markedly different results. Unconjugated antibody had no effect
      on CFU-c colony growth; in contrast, 0.01 microgram/ml of 454A12 MoAb-rRA reduced
      the number of colonies from 139 per 1 X 10(5) to 75 per 1 X 10(5) cells plated (p
      = 0.0005). No myeloid progenitor colonies developed at 0.1 microgram/ml of
      immunotoxin. These observations suggest that 454A12 MoAb-rRA inhibits growth by a
      potent, ricin A chain-mediated toxic effect on any proliferating cells expressing
      transferrin receptors, whereas the 454A12 MoAb exerts a selective inhibitory
      effect primarily on erythroid progenitors by perturbing the transferrin cycle.
      While growth factor receptors expressed on hematopoietic cells represent
      promising targets for immunotoxin therapy, our data indicate that an immunotoxin
      could inhibit cellular proliferation by a different mechanism than the
      corresponding unconjugated MoAb. Depending on the antibody used, these
      differences may be important in trials using immunotoxins for in vivo treatment
      or in vitro purging of malignant hematopoietic cells.

PMID- 2230285
TI  - Examination of survival, proliferation and cell surface antigen expression of
      human monocytes exposed to macrophage colony-stimulating factor (M-CSF).
AB  - The effects of macrophage colony-stimulating factor (M-CSF or CSF-1) on the
      survival, proliferation, maturation and activation of human blood monocytes were
      examined. M-CSF (100-1,000 U/ml) doubled the number of monocytes surviving after
      eight days in culture and accelerated the usual increase in cell volume.
      Antiserum to M-CSF abolished both of these effects. There was no sizable increase
      in 3H-thymidine incorporation in monocytes over this time period. Of various
      factors tested, including gamma-interferon (gamma-IFN), interleukin (IL) 1 alpha,
      granulocyte CSF (G-CSF), platelet-derived growth factor (PDGF), and
      lipopolysaccharide (LPS), only granulocyte-macrophage CSF (GM-CSF) could also
      enhance survival and augment cell volume. While antiserum to human M-CSF
      eliminated the increase in survival induced by GM-CSF, it could not ablate the GM
      CSF-stimulated increase in monocyte cell volume. Monocyte cell surface markers
      that increase with maturation (i.e., Fc gamma RIII) or with activation (i.e., Fc
      gamma RI) were unaffected by incubation with M-CSF.

PMID- 2230288
TI  - On syngeneic GVHD.

PMID- 2230287
TI  - The effect of carbamylcholine on CFU-s differentiation.
AB  - The proportion of spleen colony-forming units (CFU-s) killed by hydroxyurea was
      greatly increased after bone marrow cells (BMCs) from LACA mice were exposed to
      carbamylcholine (Cach; 1 X 10(-13) to 1 X 10(-9) in vitro and there was a marked
      change in the proportion of spleen colony types. Following treatment with Cach,
      granulocytic and mixed erythroid-type colonies increased from 20 to 26.3% and
      16.1 to 29.6% in 9-day colonies and from 8.3 to 28.2% and 21.7 to 39.4% in 13-day
      colonies, respectively. Single cell suspensions of spleen colonies were made for
      granulocyte-macrophage progenitor (CFU-gm) and late erythroid progenitor (CFU-e)
      assays. The number of CFU-gm from Cach-treated BMC was about twice that from
      control BMC for both day 9 and day 13 groups; the number of CFU-e decreased
      relatively. The results suggest that cholinergic receptors on CFU-s may increase
      the tendency to differentiate into the granulocytic/monocytic line.

PMID- 2230289
TI  - Comparison of digital and cine coronary arteriography.
AB  - Digital coronary arteriography has advanced from a curiosity to a powerful
      clinical tool. This development has been motivated by the new imaging demands of
      interventional cardiology, by the need for quantifying atherosclerotic disease,
      and by advances in computer and video technology. Digital imaging has now
      essentially replaced cinefilm for clinical decision making in some
      catheterization laboratories, although uncertainty remains regarding the
      diagnostic comparability of the two modalities. Therefore, we compared
      simultaneously acquired digital and cine arteriograms from 18 patients with
      multivessel coronary artery disease. Digital utilized pulse-progressive
      technique, a 512 x 512 pixel x 8 bit image matrix, and no post processing. Four
      angiographers interpreted the arteriograms, identifying 131 stenotic lesions for
      measurement with manual calipers. Measurements of percent diameter stenosis by
      digital and cine correlated closely (r = 0.88), but digital estimated stenoses to
      be significantly more severe than cine (p less than 0.0001). This difference was
      most significant in small (less than 2 mm diameter) arteries, in branch arteries,
      and with mild stenoses. The differences between digital and cine were not
      statistically significant for stenoses greater than 50% diameter narrowing.
      Interobserver variability was similar for digital and cine imaging. Thus,
      unprocessed digital and film-based coronary arteriography yield similar
      assessments of atherosclerotic stenoses, but the techniques may not be
      diagnostically interchangeable. This paper discusses the technical advances which
      have occurred in digital coronary arteriography, the comparability of digital and
      cine imaging, and the factors which may be responsible for observed differences
      between the two modalities.

PMID- 2230290
TI  - Reproducibility of measurements of coronary narrowings by videodensitometry:
      unreliability of single view measurements.
AB  - Computer-assisted videodensitometry has been shown to be a reliable and
      reproducible method of measuring absolute and relative coronary narrowings. Using
      a commercially available analyzer (Vanguard XR70) we confirmed the intra- and
      interobserver reproducibilities in 34 narrowings in 9 patients. Analyses were
      performed on normal area and diameter, stenotic area and diameter, percent area
      stenosis and percent diameter stenosis. For all 6 analyses, excellent intra- and
      interobserver correlations were found (r = 0.93-0.98), with slopes close to 1 and
      intercepts close to zero. In a separate study of 16 lesions in 11 patients, each
      lesion was analyzed in both the RAO and LAO planes. Correlation between the
      measurements was reasonable with r = 0.76 for the stenotic area and r = 0.75 for
      the absolute diameter stenosis. However, with suboptimal slopes (0.54 and 0.63
      respectively), actual differences between measurements in the two planes were
      often unacceptably large. These data suggest that videodensitometry is a highly
      reproducible quantitative angiographic method; however, single view analyses are
      inadequate for comparative studies.

PMID- 2230291
TI  - Three-dimensional reconstruction of stenosed coronary artery segments with
      assessment of the flow impedance.
AB  - In this paper preliminary results of a study about the diagnostic benefits of 3D
      visualization and quantitation of stenosed coronary artery segments are
      presented. As is well known, even biplane angiographic images do not provide
      enough information for binary reconstruction. Therefore, a priori information
      about the slice to be reconstructed must be incorporated into the reconstruction
      algorithm. One approach is to assume a circular cross-section of the coronary
      artery. Hence, the diameter is estimated from the contours of the vessels in both
      projections. Another approach is to search for a solution of the reconstruction
      problem close to the previously reconstructed adjacent slice. In this paper we
      follow the first method based on contour information. The reconstructed coronary
      segment is visualized in three dimensions. Based on the obtained geometry of the
      obstruction the pertinent blood flow impedance is estimated on the basis of fluid
      dynamic principles. The results of applying the reconstruction algorithms to
      clinical coronary biplane exposure are presented with an indication of the
      assessed flow impedance.

PMID- 2230292
TI  - An expert system for the labeling and 3D reconstruction of the coronary arteries
      from two projections.
AB  - In this paper we present a rule-based expert system for the automatic delineation
      and 3D reconstruction of the left coronary artery on standard RAO and LAO
      angiographic projections. The approach is based on the application of a general
      blood vessel model and on anatomical models which take into account the normal
      variations of the coronary artery structure. In a first step, the arteries are
      delineated by detecting the maximum intensity on the centerline of the vessels.
      Then, we label the blood vessel segments according to an anatomical model of the
      left coronary artery. In general, only 1-2 labels remain for each blood vessel
      segment. Finally, these results are used for an automatic 3D reconstruction of
      the left coronary artery from two projections. Results from clinical RAO and LAO
      angiograms will be presented.

PMID- 2230293
TI  - Restenosis following coronary angioplasty.
AB  - The assessment of restenosis following angioplasty has become increasingly
      important in determining the clinical value of the procedure. Despite this there
      has been no uniformly accepted methodology for assessing the procedure and
      consequently the published results have often been misleading with little
      concensus. In this paper some of the irregularities are documented and practical
      ways for adapting methodology proposed.

PMID- 2230294
TI  - Arterial stenting with self-expandable and balloon-expandable endoprostheses.
AB  - Coronary angioplasty is complicated by acute occlusion (within 24 hours) and late
      restenosis (within 6 months) in 2-5% and 20-40% of the cases, respectively.
      Vascular endoprostheses (stents) may provide the cardiologist with a solution to
      some of these complications. Several stent-devices are now available for
      experimental and clinical evaluation. In this study we describe our experience
      with two metallic stents in normal arteries of swine. Self-expandable, stainless
      steel stents (3.5 mm diameter) were implanted in 17 peripheral arteries, eight of
      which were deendothelialized by prior balloon angioplasty. Following
      implantation, the animals received antithrombotic therapy with acenocoumarol and
      aspirin (8 stents), or aspirin alone (9 stents). After 1 week repeat angiography
      was performed, which showed patency of all stented arteries. Microscopy showed
      complete covering by neointima, 80 microns in thickness. This self-expandable
      stent (SES) and a balloon-expandable stent (BES), constructed of tantalum, were
      implanted in normal coronary arteries. SES (3.0 and 3.5 mm) receiving animals
      were treated with coumadines (10 stents) or received no antithrombotic treatment
      (16 stents) after implantation. BES receiving animals were also not treated (10
      stents). Three untreated animals with SES died suddenly within 48 hours.
      Postmortem examination showed partial or complete thrombosis of all six stents in
      these animals, resulting in a patency rate of 62% after 1 week. All animals with
      SES, which were treated with coumadines, and all animals with BES (untreated) had
      patent stents after one week. It is concluded that SES implanted in normal
      coronary arteries of pigs, which do not receive additional antithrombotic
      treatment, show a 38% occlusion rate within 48 hours, but show 100% patency after
      1 week, when the animals are treated with coumadines. BES implanted in normal
      coronary arteries of pigs, which do not receive antithrombotic drugs, are 100%
      patent after 1 week.

PMID- 2230295
TI  - Pulsatile coronary flow determination by digital angiography.
AB  - A new angiographic method to calculate absolute coronary arterial blood flow and
      its cyclic variations as a function of time, has been designed and evaluated. The
      method combines densitometric analysis of spatial and temporal aspects concerning
      the contrast propagation through the arterial system from digital images, and is
      based on applying the concept of conservation of contrast material in successive
      images. It requires a standard arteriographic procedure. In simulations with both
      constant as well as pulsatile flow through a coronary arterial phantom, an
      excellent agreement with electromagnetic flow measurements was demonstrated (r =
      0.993 and r = 0.982, respectively). Preliminary clinical results show, that the
      method yields reproducible assessment of coronary flow patterns after repeated
      injections in a patient. In a coronary artery bypass graft, coronary flow
      patterns in a baseline and a drug-induced hyperemic state were obtained. A
      consistent coronary flow reserve value was determined after repeated
      examinations. The method has been shown to be feasible in clinical applications,
      uncomplicated and fast, but requires further animal and clinical validation in
      order to determine the possible applications, limitations and accuracy.

PMID- 2230296
TI  - Mean transit time for videodensitometric assessment of myocardial perfusion and
      the concept of maximal flow ratio: a validation study in the intact dog and a
      pilot study in man.
AB  - Over the last decade it has become more and more obvious that besides anatomical
      information about the severity of coronary artery stenoses, information about
      coronary and myocardial blood flow is necessary to understand the functional
      significance of these obstructions and to evaluate the result of an intervention.
      Several methods have been proposed for this purpose, each of these having their
      particular limitations. In this study a new method is shortly described which
      allows the accurate calculation of relative maximal myocardial perfusion by ECG
      triggered digital radiography (videodensitometry), using mean transit time (Tmn)
      as time parameter; this technique is based on the original physiologic principles
      of indicator dilution theory. This method was validated in 8 instrumented dogs in
      which an excellent linear relation was present between 1/Tmn and flow (r = 0.96
      +/- 0.03). Although this method does not allow assessment of resting flow and
      therefore coronary flow reserve (CFR), it provides a means for the reliable
      comparison of maximal myocardial flow in different situations and it is
      independent of most factors affecting coronary flow reserve. The ratio between
      maximal flow after and before an intervention is called maximal flow ratio (MFR)
      and this concept was applied in a pilot study in man to evaluate PTCA results in
      10 patients undergoing elective angioplasty. MFR was compared with the result of
      exercise testing 24 hours before and 10 days after the angioplasty. MFR greater
      than or equal to 1.5 was always accompanied by reversal of exercise test result
      from positive to negative. We conclude that the accurate calculation of relative
      maximal perfusion of the myocardium is possible by videodensitometry and suggest
      that comparison of maximal flow after and before an intervention can be valuable
      in man for functional evaluation of the result of the intervention.

PMID- 2230297
TI  - Comparison of three different principles in the assessment of coronary flow
      reserve from digital angiograms.
AB  - In 70 patients without coronary disease we have compared three different
      principles to assess coronary flow reserve during diagnostic heart
      catheterization. Digital angiograms with ECG-triggered bolus injections of 4 to 8
      ml of contrast medium at rest and after stimulation by dipyridamole (0,5 mg/kg
      i.v.) or papaverine (12,5 mg i.c.) were acquired in a 512 x 512 matrix at 8 bit
      resolution (ADAC 4100) and stored on a digital disk at 25 frames/sec. or 2
      frames/cardiac cycle (PPR-mode). Angiograms were processed by cyclic R-wave-gated
      mask mode subtraction and coronary flow in the LAD area was assessed by three
      different approaches: 1. A traditional densitometric principle. 2. The 'CMAP'
      principle. 3. A modification of the Stewart-Hamilton principle comparing the
      total amount of contrast medium that enters the coronary circulation to the area
      of the contrast dilution curve in a fixed portion of the LAD. Flow was measured
      simultaneously during angiography using the thermodilution technique for coronary
      sinus/great cardiac vein flow. Drug stimulation resulted in an increased coronary
      blood flow up to five times of resting flow. Regression analysis revealed the
      following results for the assessment of the coronary flow reserved by digital
      angiography (y) when compared to thermodilution (x): [table: see text] Method 2
      could be improved by replacing the density factor by morphometrically measured
      proximal LAD volume (y = 0.77x + 0.55; r = 0.78; SEE = +/- 0.43). In conclusion,
      our data suggest that the Stewart-Hamilton principle may be advantageous over
      time parameter-dependent approaches in the assessment of coronary flow reserve by
      digital angiography.

PMID- 2230298
TI  - Developments towards the slice-wise three-dimensional reconstruction of the
      distribution of the contrast perfusion in the myocardial muscle from biplane
      angiographic views.
AB  - In theory, radiographic myocardial perfusion imaging allows a quantitative
      assessment of the functional significance of a coronary stenosis. However, in the
      conventional two-dimensional projection images there does not exist a one-two-one
      relationship between a selected myocardial region of interest (ROI) and one
      particular coronary segment perfusing that area due to over-projection of
      myocardial regions in front of and behind the selected ROI perfused by other
      arterial segments, which may result in measurements which are difficult to
      interpret or even unreliable. To overcome these problems, we have developed two
      algorithms to determine the spatial distribution of perfusion levels in slices of
      the heart, selected approximately perpendicular to the left ventricular long
      axis, from two orthogonal angiographic views: the Segmental Reconstruction
      Technique (SRT) and the Network Programming Reconstruction Technique (NPRT). Both
      techniques require a priori geometric information about the myocardium, which can
      be obtained from the epicardial coronary tree (epicardial boundaries) and the
      left ventricular lumen (endocardial boundaries). Using the SRT approach, pie
      shaped segments are defined for each slice within the myocardial geometric
      constraints such that superimposition of these segments when projected in
      orthogonal biplane views is minimal. The reconstruction process uses a model with
      identical myocardial geometry and definition of segments. Each segment of the
      model is assigned a relative perfusion level with unit one if no other a priori
      information is available. In this case, the model contains geometric information
      only. In case a priori information about expected segmental perfusion levels is
      available, a level between zero and one is assigned to each segment. The a priori
      information on the myocardial perfusion levels can be extracted from either
      anatomic information about the location and severity of existing coronary
      arterial obstructions, or from a slice adjacent to the one under reconstruction.
      Using the NPRT approach perfusion levels are computed for each volume picture
      element of a slice within the reconstructed myocardial geometry, thus resulting
      in a much higher spatial resolution than the SRT approach. A priori information
      of perfusion levels must be included in this approach, again based upon
      anatomical information, or upon the slice adjacent to the one under
      reconstruction. The very first slice of a myocardial study will be reconstructed
      by the SRT approach. Extensive computer simulations for the SRT have proved that
      the mean difference between the actual and reconstructed segmental perfusion
      levels, on a scale from 0 to 1, is smaller than 0.45 (SEE = 0.0033, REE = 1.80)
      for various coronary artery disease states without the use of a priori
      information on expected perfusion levels. This error becomes smaller than 0.36
      (SEE = 0.0026, REE = 1.42), if a priori information in the reconstruction
      technique is included. Similar computer simulations for the NPRT have proved that
      these mean differences in geometric segments equal to those defined for the SRT,
      are smaller than 2.94 (SEE = 0.0308, REE = 0.77) on a scale from 0 to 16, without
      the use of a priori information on expected perfusion levels, and smaller than
      1.72 (SEE = 0.0304, REE = 1.10) on the same scale when a priori information is
      included. Therefore, it may be concluded that slice-wise three-dimensional
      reconstruction of perfusion levels is feasible from biplane computer-simulated
      data, and that a similarity exists for mean perfusion levels in corresponding
      regions in the simulated and reconstructed slices, for various states of single
      coronary artery disease.

PMID- 2230299
TI  - A new approach for the automated definition of path lines in digitized coronary
      angiograms.
AB  - For the quantitative analysis of a coronary segment from a coronary
      (cine)angiogram, an initial path line is required which functions as a model for
      the subsequent automated contour detection. For on-line applications, a new
      method for the automated definition of arterial path lines has been developed.
      Required user-interaction consists of the manual definition of a beginning and an
      endpoint of the arterial segment to be analyzed. The method is based on a
      combination of a beam tracer and a box technique. A validation study was
      performed on 47 non obstructed arteries of various lengths and diameters, and on
      56 arterial segments with obstructions (up to 86 percent diameter stenosis). In
      89% of the cases an acceptable path line was found after the first iteration; the
      success score increased to 99%, if a simple manual correction was allowed (2
      iterations). The method is extremely fast: the overall average search time for
      the first iteration was 266 ms, for the second iteration 211 ms. Therefore, it
      may be concluded that this new technique for the automated definition of arterial
      path lines is extremely suitable for on-line applications.

PMID- 2230300
TI  - An objective computer system for the quantification of artery stenoses.
AB  - We have developed a low cost, clinically usable system for the objective
      assessment of the severity of coronary artery stenoses from single view
      angiograms. The system is based on a desktop computer with incorporated frame
      grabber. Images are captured by means of a video camera. The user selects a
      region of interest which encompasses the stenosis. Facilities are provided for
      automatic or manual definition of the artery centre line and edges. The computer
      then calculates the artery diameter and cross-sectional area by videodensitometry
      along profile lines which are orthogonal to the long axis of the artery. These
      results can be expressed numerically as a percentage stenosis when compared to a
      normal region of the artery. The image is corrected for geometric distortion
      using a grid test object. The image grey scale is corrected by means of a ramp
      test object such that a pixel value is proportional to the attenuator thickness.
      The ramp is placed on the patient during the X-ray examination and an iterative
      technique has been developed for subtracting the underlying structures from the
      superimposed ramp image. The system has been assessed using test objects
      constructed in Perspex which simulate arteries of known cross-sectional area and
      stenoses of known severity.

PMID- 2230301
TI  - Validation of a new automatic system for biplane quantitative coronary
      arteriography.
AB  - In a collaboration between the University of Texas (software) and the University
      of Zurich (hardware) a compact, automatic system for biplane quantitative
      coronary arteriography was developed. The system is based on a 35 mm film
      projector, a slow-scan CCD-camera (image digitizing) and a computer workstation
      (Apollo DN 3000, image storage and processing). A new calibration procedure based
      on two fixed reference points in the center of the image intensifier was used
      (isocenter technique). Contour detection of coronary arteries was carried out in
      biplane projection using a geometric-densitometric edge-detection algorithm. The
      proximal and distal luminal areas, as well as the minimal luminal area of the
      stenotic vessel segment were determined. Accuracy and precision were determined
      from precision drilled holes in a plexiglas cube which were filled with 50%, 75%
      and 100% contrast medium. The diameter of the holes ranged from 0.5 to 5.0 mm.
      The mean difference and the standard deviation of the differences between the
      true and the measured diameters were 0.12 +/- 0.14 mm for plane A and 0.26 +/-
      0.17 mm for plane B, respectively. After a second order correction the mean
      difference amounted to 0.02 +/- 0.09 mm for plane A and 0.02 +/- 0.12 mm for
      plane B, respectively. Intra- and interobserver variability were evaluated in 5
      patients (age 60 +/- 10 years) with coronary artery disease using 16 normal and 5
      stenotic vessel segments (cross-sectional area ranging from 0.8 to 8.7 mm2). Two
      independent observers analyzed the same vessel segment twice. Intraobserver
      variability expressed as the standard error of estimate in percent of the mean
      angiographic vessel area (SEE) amounted to 2.1% for observer 1 and 4.4% for
      observer 2, respectively. Interobserver variability expressed as SEE was 4.1% for
      measurement 1 and 3.6% for measurement 2, respectively.

PMID- 2230302
TI  - Effects of video frame averaging, smoothing and edge enhancement on the accuracy
      and precision of quantitative coronary arteriography.
AB  - Digital analysis of cine film provides numerous options for altering images by
      frame averaging or filtering algorithms that either smooth or enhance edges.
      While these may subjectively enhance image quality, there is no uniformity in
      their use among laboratories and effects on quantitative coronary analysis may
      not be ideal. To determine which processing algorithms might help or hinder
      quantitative coronary arteriography, cine film images of precision drilled
      stenotic cylinders (0.83 to 1.83 nm diameter) implanted in dog coronary arteries
      were analyzed with and without such algorithms. Video frame averaging of 1 to 49
      frames had no effect on measures of accuracy (mean differences) but precision
      (standard deviation of mean differences) was improved from 0.23 to 0.17 mm (p
      less than 0.05) with video averaging of greater than or equal to 25 frames. Edge
      enhancement filtering algorithms resulted in slight deterioration of accuracy and
      precision and smoothing filtering algorithms caused modest improvements in these
      parameters; however, these changes were not significantly different from
      unprocessed images. Using edge enhancement filtering algorithms, accuracy was
      significantly worse (-0.27 mm) compared to a smoothing filter enhancement
      algorithm (-0.08 mm, p less than 0.001). The combination of video averaging and
      smoothing algorithms had no additional beneficial effects. Thus, precision of
      quantitative coronary analysis of cine film can be optimized by appropriate video
      averaging. Edge enhancement filtering algorithms should be avoided whereas
      smoothing filter enhancement algorithms may improve accuracy.

PMID- 2230303
TI  - Aortic valvuloplasty of calcific aortic stenosis with monofoil and trefoil
      balloon catheters: practical considerations. An evaluation of balloon design and
      valvular morphology relationship, derived from experimental and
      clinicopathological observations.
AB  - In order to evaluate the relation between balloon design (monofoil, trefoil) and
      valvular configuration, experimental aortic valvuloplasty was performed in four
      post-mortem hearts with calcific aortic stenosis of various morphology. The
      degree of obstruction of the aortic orifice was assessed by computed axial
      tomography during inflation of monofoil 15 and 19 mm and trefoil 3 x 12 mm
      balloon catheters. We also evaluated the hemodynamic repercussion of balloon
      inflation (fall in systolic aortic pressure) in four elderly patients with
      acquired aortic stenosis who underwent a percutaneous transluminal aortic balloon
      valvuloplasty, with stepwise increasing balloon sizes of 15 mm, 19 mm and 3 x 12
      mm, as during our in vitro experiments, and who underwent aortic valve
      replacement later on. In these patients, we correlated the anatomy of the excised
      aortic valves with the retrospective analysis of aortic pressure curves recorded
      during previous valvuloplasty procedures. Our experimental and
      clinicopathological observations showed that the degree of obstruction of the
      aortic orifice in post-mortem specimens and the tolerance to balloon inflation in
      live patients are dependent of the valvular configuration. Although trefoil
      balloons have the theoretical advantage to avoid complete obstruction of the
      aortic orifice during inflation, we observed that in presence of a tricuspid
      configuration, they could be potentially more occlusive than monofoil balloons
      since each of the 3 individual components of the trefoil balloon occupied the
      intercommissural spaces while inflated. However, they offered more residual free
      space when inflated in aortic valves with a bicuspid configuration (i.e.
      congenitally bicuspid valves or tricuspid valves with one fused commissure). In
      our opinion, these observations are relevant, since degenerative disease of the
      aortic valve (i.e. tricuspid valve without commissural fusion) is now recognized
      as the most common etiology of aortic stenosis in the elderly.

PMID- 2230304
TI  - High compression of nuclear medicine dynamic studies.
AB  - As data compression plays now an important role in the development of medical
      PACS, a technique has been developed for medical image sequences storage and
      transmission in order to obtain very high compression ratio: in dynamic nuclear
      medicine studies it can achieve a compression ratio as high as 100:1 without
      significant degradation. The implemented technique combines two methods which
      multiply their effects. In a first step, a principal component analysis (PCA) of
      the image series is performed. It extracts a limited number of principal
      components and their associated images. For data compression it is not necessary
      to perform an oblique factor analysis to estimate the so-called 'physiological
      functions' and their spatial distributions as in factor analysis of dynamic
      structures (FADS). In a second step, the principal images are compressed by means
      of a transform coding procedure: an adaptive block-quantization technique using
      the 2D discrete cosine transform (DCT) is implemented, followed by a statistical
      quantization method to encode the DCT coefficients. To reconstruct the principal
      images, an inverse DCT is applied. Then the original series is computed from the
      reconstructed images combined with the principal components which have been
      stored without any modification. The reconstructed series is compared to the
      original series, as well as the time activity curves generated on different
      regions of interest (ROI) and the factor estimates obtained using FADS performed
      on the two series. Method and evaluation are illustrated on an example of first
      pass radionuclide angiocardiography.

PMID- 2230305
TI  - Transesophageal echocardiography after orthotopic heart transplantation.

PMID- 2230306
TI  - Human fascioliasis: T cell subsets in liver before and after bithionol treatment.
AB  - Liver biopsies from 5 patients with established fascioliasis, before and after
      bithionol treatment were studied by immunoalkaline phosphatase technique for
      relative distribution of T cells and their subpopulations. T cell and its subsets
      are defined for OKT3+ (pan T), OKT4+ (helper/inducer) and OKT8+
      (suppressor/cytotoxic) cells by using mouse monoclonal antibodies. Before
      bithionol treatment, lymphocytic infiltration in all hepatic lesions were
      predominantly of OKT3+ (pan T) lymphocytes. The distribution of OKT8+ cells was
      moderate to severe in comparison to the few OKT4+ cells presentation. After
      bithionol a noticeable regression of the OKT3 lymphocytic in all liver sections.
      The majority of the lymphocytic infiltration was of the OKT8+ cells, in
      comparison to the absence of the OKT4+ ones. This may indicate that
      suppressor/cytotoxic lymphocytes may have a role in the immune regulation of the
      disease and the mode of action of bithionol is by the accentuation of this
      immunoregulatory effect.

PMID- 2230307
TI  - Circulating E. histolytica antigens clear with successful treatment of amoebic
      liver abscess.
AB  - An antigen capture ELISA was used to measure serum E. histolytica antigen and
      antibody levels in 23 patients with amebic liver abscess (ALA), 15 patients with
      intestinal amebic infections (IAI), and 20 normal controls. 16 of the 23 (70%)
      with ALA had antigenemia. None of those with IAI or the normal controls had E.
      histolytica antigen titers of greater than 1:4. All 23 of the patients with ALA
      had positive antibody titers. Three (20%) with IAI and none of the normal
      controls had E. histolytica antibody titers greater than 1:100. Antigenemia
      cleared in all but one of the 23 patients within two months of initiating
      successful chemotherapy. Antibody titers were much slower to diminish. Measuring
      E. histolytica antigens in the sera of patients with ALA by increasing the
      diagnostic specificity may have some diagnostic advantage over measuring only the
      antibody levels. In addition, serial measurements of antigenemia are useful in
      monitoring result following chemotherapy.

PMID- 2230308
TI  - Human fascioliasis: ultrastructural study on the liver before and after bithionol
      treatment.
AB  - The pathology of human fascioliasis was studied before and after bithionol
      treatment using light and transmission electron microscopy. Fine needle biopsies
      were taken from five patients, with established fascioliasis, before and after
      drug administration. By light microscope the pathology of human fascioliasis was
      similar to that reported in experimental fascioliasis. The ultrastructural
      picture revealed bile ductular hyperplasia, fibrosis of portal tracts, widening
      of the interhepatic spaces by many microvilli and dilated Disse space with
      collagen fibres. Bile ductular hyperplasia may be the initial factor to
      fibrinogenesis, which subsequently enhance the development of the microvilli on
      the surface of the hepatocytes. Both light and electron microscopic studies
      revealed regression of the picture of fascioliasis to normal after bithionol
      treatment with no sign of toxicity on the liver.

PMID- 2230309
TI  - Pathologic examination of the placenta in human cases of toxoplasmosis.
AB  - One hundred sixty one placentae were examined grossly and microscopically, 131
      specimens belonged to seropositive patients and 30 specimens belonged to
      seronegative patients and used as control. 63.3% of the placentae of seropositive
      patients were macroscopically normal, 9% were hydropic, 21% were of mixed or
      partially hydropic pattern, 6% had areas of infarction & 0.7% showed areas of
      calcifications. The most consistent microscopic finding was focal low grade
      chronic villitis with mononuclear inflammatory infiltrate. In hydropic placentae
      villous edema was of very variable degree from one placenta to another and from
      one area to another in the same placenta. Nucleated red blood cells were
      demonstrated in villous capillaries. The patients had Rh positive factor in their
      blood.

PMID- 2230310
TI  - Evaluation of gastric carcinoembryonic antigen in endemic schistosomal
      hepatosplenomegaly.
AB  - In endemic hepatosplenomegaly with histopathologically proved atrophic gastritis,
      the gastric juice carcinoembryonic antigen (CEA) showed significant increase.
      Comparing this group of patients with histopathologically proved gastric
      neoplasia the levels were significantly higher in the later group. The level of
      (CEA) was only increased in 75% of cases with endemic hepatosplenomegaly and
      atrophic gastritis opposite to 100% of cases with gastric neoplasia. The level of
      serum (CEA) was also studied in patients and control groups. In patients with
      endemic hepatosplenomegaly and atrophic gastritis the level was insignificantly
      higher than the control group and significantly lower than the group with gastric
      neoplasia.

PMID- 2230311
TI  - Studies on gastric bacterial growth and gastric PH in endemic schistosomal
      hepatosplenomegaly.
AB  - Acid content and bacterial flora were studied in the gastric juice of 30 patients
      with endemic hepatosplenomegaly and 10 normal controls. The acid content in the
      gastric juice was significantly low in the group of patients. Also the bacterial
      flora were present in larger number of patients (80%) opposite to (30%) in normal
      control group.

PMID- 2230312
TI  - Histocompatibility (HLA) antigens in Egyptians with two parasitic skin diseases
      (scabies and leishmaniasis).
AB  - The frequency of human leucocytic antigens (HLA) were studied in 62 patients with
      scabies and 27 patients with cutaneous leishmaniasis to evaluate the role of HLA
      antigens as genetic markers in the pathogenesis of these parasitic skin diseases.
      A significant statistical association was proved between HLA-A11 antigen and
      scabies and between HLA-A11, -B5 and -B7 antigens and diffuse cutaneous
      leishmaniasis.

PMID- 2230313
TI  - Evaluation of immunodiagnostic tests in detection of trichinosis in
      experimentally infected rats.
AB  - The enzyme-linked immunosorbent assay (ELISA), the indirect immunofluorescent
      (IF) and the counter current immunoelectrophoresis (CEP) were evaluated in
      detection of anti-Trichinella antibodies in experimentally infected rats. The CEP
      was the most specific and highly sensitive test. Also, the IF was highly
      sensitive but less specific. ELISA was the least specific but extremely sensitive
      specially in detecting early infection.

PMID- 2230314
TI  - Ultra structure study of schistosomula recovered after cercarial penetration of
      isolated skin.
AB  - The ultrastructure, development and antigenic nature of the surface and the
      viability of schistosomula formed after cercariae had penetrated isolated skin
      has been studied. Within 2 hours of transformation, the surface membrane of
      schistosomula had changed from trilaminate to heptalaminate structures and lost
      their cercarial glycocalyx. The preacetabular glands of schistosomula were
      emptied, the mixed agglutination reaction demonstrated the presence of human A
      and B blood group-like antigenic determinant on approximately 30% of 3 hours old
      schistosomula. The first schistosomula reached the gut closed stage by day 12 (50
      70%), and between 40% of all schistosomula developed to maturity when injected
      intravenously into mice.

PMID- 2230315
TI  - Distribution of Phlebotomus species in the Nile Delta, Egypt.
AB  - The importance of sandflies of the genus Phlebotomus being in the fact that some
      species are the vectors of leishmaniasis and other pathogenic organisms such as
      virus of sandfly fever. In Egypt, cutaneous leishmaniasis and sandfly fever are
      known and recently visceral leishmaniasis has been identified in Alexandria.
      Consequently, there is a need to study the geographical distribution of
      Phlebotomus species and to present an illustrative key for their identification.
      In the present study, four species of Phlebotomus were reported; P. papatasi, P.
      sergenti, P. langeroni and P. bergeroti. While P. papatasi is a known vector of
      zoonotic cutaneous leishmaniasis, P. langeroni is an incriminated vector for
      infantile visceral leishmaniasis, P. papatasi is the predominant species in the
      Nile Delta, but P. langeroni is found in West Alexandria and as a very rare
      species at the Libyan Egyptian borders. The whole results were discussed.

PMID- 2230316
TI  - The mechanism of acquired immunity in experimental giardiasis.
AB  - Giardia-spontaneously cured mice were rendered resistant to challenge infection.
      This was documented by the decreased cyst excretion rate comparable to the
      control ones. Endoxan and irradiation treatment caused a breakdown in both
      humoral and cellular immunity. Immune-depressed mice were more susceptible to
      Giardia infection, thus proving the active role of antibodies and cell-mediated
      immune response in giardiasis.

PMID- 2230317
TI  - The relation between intestinal troubles and parasitic infection in Cairo.
AB  - Stool and urine from 320 subjects in Ain shams region, and 200 subjects in Nasr
      city were collected and examined for parasites. All these subjects were suffering
      from abdominal troubles. The results revealed a marked relation between parasitic
      infection and abdominal troubles, especially in Ain shams region (80%), and to a
      lesser extent in Nasr City (51%). The commonest parasite in Ain shams was Giardia
      lamblia (20.3%), and in Nasr city was E. histolytica (13%).

PMID- 2230318
TI  - Immunization against experimental visceral toxocariasis canis.
AB  - Immunization of rabbits against visceral toxocariasis using T. canis larval
      glycoproteins showed a marked reduction in the larvae burden and a significant
      rise of serum IgE in immunized rabbits infected with Toxocara canis as compared
      with non-immunized infected control group. More reduction of larval burden was
      observed after larger doses of T. canis larvated eggs inoculation.

PMID- 2230319
TI  - Detection of Giardia lamblia copro-antigens by enzyme-linked immunosorbent assay
      and counterimmunoelectrophoresis.
AB  - The enzyme-linked immunosorbent assay (ELISA) and counter-immunoelectrophoresis
      (CIEP) were used to detect G. Lamblia Copro-antigens. Rabbit antisera raised
      against Giardia trophozoites and cysts were used as anti-Giardia antibodies. The
      overall sensitivity of the ELISA was 96.15% and its specificity was 93.48% in
      contrast to 69.23% and 82.61% for the CIEP.

PMID- 2230320
TI  - Virulence of Giardia lamblia isolates to laboratory mice.
AB  - Laboratory breed albino mice free of G. muris infection were inoculated with G.
      lamblia cysts isolated from the stools of patients with different clinical
      manifestations, symptomatic diarrhoeic, symptomatic non-diarrhoeic and
      asymptomatic cyst carriers. The virulence of various isolates was assessed by
      cyst excretion rate in the stools, trophozoite counts in the duodenum and
      histopathological lesions of jejunal mucosa. A marked variation in the virulence
      of cysts obtained from the 3 groups of patients was proved.

PMID- 2230321
TI  - Fresh water malacologic fauna in Dakahlia Governorate.
AB  - Ten snail species representing the snail fauna in Dakahlia were identified as P.
      acuta, B. unicolor, L. carinatus, Cleopatra species, B. alexandrina, M.
      tuberculatus, H. duryi, B. truncatus, N. nilotica and L. caillaudi. The density
      of snail population has had a major peak at July and August while a minor peak
      was found at the winter closure period during the winter months.

PMID- 2230322
TI  - Histopathological and histochemical studies on experimentally infected hamsters
      with Stictodora tridactyla.
AB  - Histopathological changes in the intestinal mucosa in the form of inflammation
      with atrophic changes in the villi and foci of cellular reaction were seen at the
      sites of experimental infection in hamsters with Stictodora tridactyla. The
      activity of succinic dehydrogenase, non specific esterase and alkaline
      phosphatase enzymes in the villi and the activity of acid phosphatase in the
      glands were markedly reduced. These changes suggest a disturbance in both
      digestive and absorptive mechanisms of the small intestine.

PMID- 2230323
TI  - Placental villous maturation in patients with repeated abortions and chronic
      toxoplasmosis.
AB  - The conceptions products obtained from 20 patients with repeated abortions and
      chronic toxoplasmosis were examined histopathologically comparing the results
      with those of ten Toxoplasma seronegative patients. The results showed
      significant association between chronic toxoplasmosis and diffuse failure of
      growth of placental villi.

PMID- 2230324
TI  - Humoral and cellular immune response in schistosomiasis pre and post praziquantel
      therapy.
AB  - Humoral and cellular immune response in schistosomiasis was studied pre and post
      praziquantel therapy. After treatment the mean anti SEA IgM and IgG and anti SWAP
      IgM levels in all cases showed significant reduction. In patients with high
      eosinophilic count anti SEA IgE and IgA were statistically decreased. Other
      specific antibodies showed negligible changes Cellular immune response was not
      affected.

PMID- 2230325
TI  - ELISA in detection of Entamoeba histolytica antigens in stools.
AB  - The modified double antibody sandwich ELISA was applied to detect E. histolytica
      antigens in the stool samples of 20 patients have amoebiasis (symptomatic or
      asymptomatic), 10 with intestinal parasites other than E. histolytica and 10
      healthy individuals. The method was found to be sensitive (90%) and specific
      (85%). It is concluded that ELISA could be applied for a large scale
      epidemiological study and immunodiagnosis of amoebiasis.

PMID- 2230326
TI  - Serological studies on toxoplasmosis in Zagazig slaughterhouse.
AB  - This study intended to estimate the prevalence of Toxoplasma antibodies among
      farm animals in Zagazig slaughterhouses using indirect haemagglutination test
      (I.H.A.T.) and to evaluate the occupational exposure to infected animals and meat
      among abattoir workers. 25% of the tested animals were seropositive 19.2% of the
      exposed persons showed positive reactions while in a control group it was 12%
      with statistically insignificant difference.

PMID- 2230327
TI  - The mode of inheritance of fenitrothion resistance in Culex pipiens L. larvae
      (Diptera:Culicidae).
AB  - The genetics of fenitrothion resistance in Cx. pipiens larvae was studied to
      determine its mode of inheritance. A laboratory susceptible and fenitrothion
      resistant larval strains were used. Reciprocal crosses between the resistant and
      susceptible strains showed an F1 generation of partial dominance with slight
      cytoplasmic effect. The F2 generation underwent segregation into three genotypes,
      viz. susceptible, hybrid and resistant in the ratio of 1:2:1. The progenies of
      backcrosses to resistant and susceptible parents were in a 1:1 ratio of the same
      phenotypes as the parents and hybrids involved. After selection, the progeny of
      the back-crosses to resistant parent exhibited full resistance. It is concluded
      that fenitrothion resistance in Cx. pipiens larvae is due to monofactorial
      inheritance with partial dominance and slight cytoplasmic effect.

PMID- 2230328
TI  - Studies on cutaneous leishmaniasis in Al-Kharaj area, Riyadh, Saudi Arabia.
AB  - A total of 600 patients with lesions of cutaneous leishmaniasis were diagnosed
      clinically as suffering from the disease; 138 (23%) were confirmed
      parasitologically for amastigote forms of L. major; promastigotes grown in
      culture were confirmed in 180 (30%) cases. Lesions varying in number and sites
      and the disease showed a high prevalence among non-Saudis (88%) labourers
      compared to Saudis (12%). Cutaneous leishmaniasis was found to vary seasonally
      with most cases reported during December to February.

PMID- 2230329
TI  - The course of Giardia muris infection in immunocompetent and immunocompromised
      mice.
AB  - No significant sex-related difference was observed in immunocompetent mice.
      Sexually mature mice of both sexes excreted large numbers of Giardia cysts over a
      longer period than did immature ones. Cyclosporin A has compromised the
      immunological response of the primary Giardia infection. However, it does not
      affect the ability of the immune host to resist challenge infection. The use of
      this drug may cause fulmination of giardiasis.

PMID- 2230330
TI  - Comparative study of the Sabin-Feldman dye test and the indirect
      haemagglutination test in serodiagnosis of toxoplasmosis.
AB  - 200 women with history of abortion and 100 women with history of uneventful
      pregnancies were investigated serologically for anti-Toxoplasma antibodies using
      both the indirect haemagglutination test and the Sabin-Feldman dye test. Our
      results indicated a role for the first test in seroepidemiological surveys and
      for routine work. The second test may be reserved for cases with negative
      haemagglutination test in the presence of strong suspicion of toxoplasmosis.

PMID- 2230331
TI  - Haematological changes observed in Swiss albino mice infected with normal and
      gamma-irradiated E. granulosus larvae.
AB  - Five groups of Swiss albino mice (Mus Musculus albinus) were intraperitoneally
      inoculated with 2,000 aseptic normal (control group) and gamma irradiated E.
      granulosus, larvae at different dose levels of 40 Kr, 60 Kr, 80 Kr and 100 Kr,
      respectively. Haematological studies showed a marked leucocytosis, a progressive
      increase in the average percentage of eosinophils as well as a great successive
      decrease in haemoglobin concentration through out the time of infection in
      control group as compared to the treated ones. Meanwhile the leucocytic count and
      the Haemoglobin concentration in treated mice was dose dependent as well as time
      dependent whereas the eosinophil percentage was only dose dependent rather than
      time dependent.

PMID- 2230332
TI  - The breeding habitats of Phlebotomus sand flies (Diptera:Psychodidae) in El
      Agamy, Alexandria Egypt.
AB  - A prolonged search for the breeding habitats of Phlebotomus sand flies in El
      Agamy, resulted in the collection of 105 newly emerged P. papatasi and P.
      langeroni. These flies were from poultry sheds, rubbish on stone piles and
      rubbish piles.

PMID- 2230333
TI  - Total count of microorganisms contaminating water supply system of Ismailia City,
      Egypt.
AB  - The efficiency of water purification in the French and the British systems of
      Ismailia city was evaluated concerning the contaminating microorganisms. Counting
      of microbial contaminants was based on the phenotypic characters of the colony
      type. Colony-types of eubacteria, eumycetes, Micromonospores and Streptomyces
      enumerated in the crude water and the different steps of purification. Total
      counts of microflora in both systems were higher than the counts in canal water.
      Meanwhile, microbial isolates were higher in the French system than that of the
      British one. The increased counts in tap water, compared with canal water, were
      recorded in winter for bacteria and in spring for fungi. These data showed
      variations in the microbial total counts according to: plant system, steps of
      purification, chlorination season and type of microbes.

PMID- 2230334
TI  - Antioxidant enzymes in Trichomonas vaginalis.
AB  - The activities of artificial donor peroxidase, catalase, and superoxide dismutase
      in clinical isolates of T. vaginalis were studied. None of the tested strains
      exhibited activity of the three enzymes. Inclusion of catalase in Diamond-TYM
      solid medium did not support growth under aerobic conditions. The correlation
      between the absence of these enzymes and the growth conditions of the organism is
      discussed.

PMID- 2230335
TI  - Animals as reservoir hosts for Leishmania in Qualyobia Governorate, Egypt.
AB  - A total of 239 rodents were collected from El-Khanka, Shebin El-Kanater, El
      Kanater, Shoubra El Khima, Qualiob, Tokh, Benha and Kafr-Shokr and identified as
      Mus musculus (30), Rattus rattus (78), Rattus norvegicus (35), Arvicanthus
      niloticus (62) and Acomys cahirinus (34). Examination of these rodents showed the
      presence of cutaneous lesions in two R. rattus, three R. norvegicus and one A.
      cahirinus which showed no Leishmania parasites neither by smear nor by culture.
      On examination of the liver, spleen and bone marrow parasitologically, the spleen
      of two R. norvegicus grew promastigotes, one was lost and the other was typed.
      Serological examination of rodents revealed antileishmanial antibodies in one A.
      niloticus and in two R. norvegicus by IHAT and in one R. rattus by Dot-ELISA. A
      total of 33 stray dogs trapped from El-Khanka Shebin El-Kanater and Qualiob were
      free from natural Leishmania infection as indicated clinically, parasitologically
      and serologically.

PMID- 2230336
TI  - Evaluation of some direct diagnostic methods in intestinal parasitic infections.
AB  - Stool specimens of 100 cases attending the outpatient clinic of Cairo Medical
      Center Hospital suffering from gastro-intestinal disturbances were examined for
      intestinal parasites by direct smear, trichrome stained smear and formol ethyl
      acetate concentration methods. Although formol ethyl acetate concentration method
      gave the best results (45%), followed by trichrome stain (37%) then direct smear
      (32%) yet, for a reliable diagnosis a combination of several techniques is
      required.

PMID- 2230337
TI  - Histopathological studies of acute, chronic and congenital infections of
      toxoplasmosis in mice.
AB  - The histopathological picture of Toxoplasma gondu RH strain (virulent) and
      Beverley strain (a virulent) was experimentally studied in mice. Nearly all the
      internal organs and tissues showed pathological changes ranging between the mild
      congestion to the severe degeneration. However, the changes were more serious in
      mice infected with RH strain than those infected with Beverley strain. The lungs
      showed massive consolidation and severe congestion. The heart showed hyaline
      degeneration of a cardiac muscle fibers. Focal areas of necrosis were seen in the
      liver, spleen and kidneys which were enlarged as well as in the cerebral cortex
      of the brain. The bone marrow and skeletal muscles were infiltrated by
      mononuclear inflammatory cells. The eyes showed mononuclear inflammatory cells in
      the retina consisted mainly of lymphocytes and the photo receptors were damaged.
      In congenital toxoplasmosis the brain showed perivascular mononuclear
      inflammatory infiltrate as well as multiple areas of necrosis. Microglial nodules
      were sometimes seen. The eyes showed no pathological lesion.

PMID- 2230338
TI  - Assessment of IgG & IgM, ELISA and IFAT in diagnosis of toxoplasmosis in
      pregnancies at risk.
AB  - This study was carried out on 100 pregnant cases, divided into 5 groups of
      patients having congenitally malformed newborns, suffering from stillbirths,
      premature labours, repeated abortions and control group. The incidence of
      positive Toxoplasma antibodies was higher in the congenital malformation and
      stillbirths groups than other groups. Analysis of the results showed that an
      excellent correlation exists between ELISA and IFAT with a minimal differences
      (less than 5%).

PMID- 2230339
TI  - Phase-contrast study of the efficacy of Lampit (BAY 2502, Nifurtimox) on
      experimental infection with Trypanosoma rhodesiense.
AB  - Lampit (BAY 2502, Nifurtimox) was tested in experimental Wistar strain white rats
      with acute infection induced by Trypanosoma rhodesiense strain (180 TS1A1), which
      normally contains cytoplasmic granules of both Type (I) & (II). Lampit injected
      subcutaneously in low doses of 25, 50, 100, and 250 mg/kg b-w as one-time
      application, gave no effect. When repeated higher doses (500 mg/kg b-w) was given
      a reasonable effect was achieved and formation of additional granules in T.
      rhodesiense was noticed. In experimental animals, some what higher initial doses
      appear to be particularly advantageous.

PMID- 2230340
TI  - Rodents and their ectoparasites in Sharkia Governorate, Egypt.
AB  - Rodents serve as reservoir hosts for many parasitic and bacterial diseases which
      are spread to man and animals by their habits, their droppings or by their
      arthropod ectoparasites. Commensal (semi-domestic) rodents were collected by
      different methods from Sharkia Governorate over a period of one year, 1989. The
      trapped rodents in descending order of prevalence were Rattus norvegicus, Rattus
      rattus, Mus musculus and Gerbillus gerbillus. The ectoparasites were collected
      and identified as five species of fleas, one species of lice and one species of
      mites. The role of these rodents as animal reservoirs and their ectoparasites as
      vectors of zoonotic diseases was discussed.

PMID- 2230341
TI  - Rheumatoid factor among several cases of visceral leishmaniasis.
AB  - Rheumatoid arthritis is not an uncommon disease in Egypt. Its aetiology is still
      unknown. In this paper, 3 out of 7 visceral leishmaniasis cases and 1 out of 7
      controls gave positive rheumatoid factor. It was suggested that L. donovani
      infection plays a role in the aetiology of rheumatoid arthritis.

PMID- 2230342
TI  - Pattern of eosinophilia and muscle larval burdens in experimental trichinosis.
AB  - Absolute eosinophilic counts to different developmental stages of Trichinella
      spiralis in experimental trichinosis were studied to identify the stage
      responsible for eosinophilia. Two peaks of eosinophilia were noticed, the first
      (545 +/- 172.3) was attributed to the adult stage while the migrating larvae were
      accused to be responsible for the more pronounced second peak (1265 +/- 331.7).
      With encapsulation a steady raised level was demonstrated. Chromatographic
      studies to determine the nature of eosinophilogens produced by the different
      stages are recommended. The role of eosinophils in damaging the parasite is
      discussed in details. No correlation could be determined between muscle larval
      burden and eosinophilic count.

PMID- 2230343
TI  - Filariasis cross react in IHAT for leishmaniasis.

PMID- 2230344
TI  - Changes in anti-idiotype antibodies against anti-HBs during recombinant
      interferon treatment of chronic hepatitis B.
AB  - To determine the possible changes in the presence and level of anti-idiotype
      (anti-Id) antibodies against anti-HBs induced by recombinant interferon (rIFN)
      therapy in chronic hepatitis B virus (HBV) infection, a study of patients under
      rIFN treatment has been carried out. A total of 62 (38 treated and 24 controls),
      HBeAg and HBV-DNA positive HBsAg carriers were tested serially for the presence
      of IgG and IgM anti-Id antibodies. According to serological evolution, treated
      patients were divided in responders (HBeAg and HBV-DNA became negative) (n = 18)
      and nonresponders (n = 20). Control patients were also classified as having
      spontaneous seroconversion (n = 11) and without changes (n = 13). Basally all
      patients had IgG and IgM anti-Id. At the end of the follow-up period (15th
      month), a significant decrease was observed in the percentage of cases positive
      to anti-Id among rIFN-responders (IgG, 67%, p less than 0.01; IgM, 44%, p less
      than 0.001). In contrast, only one nonresponder lost IgM anti-Id during the
      study. Among controls, only one with spontaneous loss of HBV-DNA and HBeAg
      clearance became negative to both IgG and IgM anti-Id. In addition, in the basal
      sample, the rIFN-responders had significantly lower anti-Id levels than the
      nonresponders (p less than 0.05). Similar results were obtained when comparing
      the controls with or without spontaneous response (p less than 0.05).
      Furthermore, a significant decrease in the anti-Id levels among the rIFN
      responders at the 9th month was detected (p less than 0.01). In summary, the anti
      Id antibodies decreased significantly in patients who became HBV-DNA negative
      following rIFN administration. This result confirms the close relationship
      between HBV replication and the anti-idiotype against anti-HBs.

PMID- 2230345
TI  - Effects of prolonged exposure to interferon-alpha on the viability,
      proliferation, differentiation, and tumorigenicity of HL-60 promyelocytic
      leukemia cells.
AB  - HL-60 promyelocytic leukemia cells were cultured continuously in the presence of
      22,000 IU/ml of purified interferon-alpha (IFN-alpha) for up to 469 days. Study
      of the properties of the cells at various times during this period showed some
      changes in their expression of IgG Fc receptors, and in the maturation of the
      cells as indicated by their esterase content. The differences from control cells
      cultured in parallel were most marked after exposure to IFN-alpha for some 40-300
      days, but were no longer seen after 400-470 days. The difference in
      tumorigenicity was significant after 150 days, but no longer after 300 days.

PMID- 2230346
TI  - Distribution, kinetics and immunoscintigraphy of 131-I labelled intact
      antifibrinogen-fibrin antibody (AbFbg) and its F(ab')2 fragment.
AB  - 131-I-labelled anti fibrin-fibrinogen antibody (AbFbg) was compared with its
      F(ab')2 fragment in distribution studies and by immunoscintigraphy with a view to
      tumour visualization in tumour bearing rats. The distribution studies indicated
      that the intact antibody is more concentrated in tumour tissue than the F(ab')2
      fragment. By 168h after injection, when tumour-to-tissue ratios were highest in
      the majority of tissues, the tumour concentration of intact antibody was 3 to 4
      times that of the F(ab')2 fragment. The intact antibody is more suitable than the
      F(ab')2 fragment for tumour imaging especially in the abdominal region where the
      highest tumour-to tissue ratios were obtained with intact antibody in liver,
      spleen, intestines and kidneys.

PMID- 2230347
TI  - MCA in patients with breast cancer: correlation with CEA and CA15-3.
AB  - MCA serum levels were determined in 27 healthy subjects, 136 with benign
      pathology (42 breast) and in 289 patients with cancer (247 active). The last
      group includes 223 patients with breast cancer (96 without metastases, 89 with
      metastases and 38 no-evidence of disease). CEA and CA15-3 serum levels were
      determined in all the patients with breast diseases. The mean levels of MCA were
      4.7 + 2.4 U/ml in the control group, considering less than 11 U/ml as normal. MCA
      values were abnormal in 15.4% of patients with benign pathology, mainly in those
      with liver cirrhosis (8/20) and lung diseases (4/20). In the majority of these
      cases, the rise was only moderate, lower than 15 U/ml in 97.5% of patients. In
      malignant diseases, important increments were found in breast cancer (19.8% Mo,
      77.5% M1) and ovarian cancer stages III-IV (44.4%). When we compared MCA serum
      levels with CA15-3 and CEA in breast pathology, a similar specificity was
      observed: 92.3%, 92.3% and 100% in cases with benign pathology and 92.1%, 94.7%,
      and 97.4% in NED patients, respectively. MCA and CA15-3 sensitivity was similar
      in breast cancer without metastases (19.8%) and lower for CEA (16.7%). In
      patients with breast cancer without metastases, we found a relation between
      positivity of these tumor markers and prognostic factors (tumor size, nodal
      involvement). The disease free interval in patients with locoregional breast
      cancer was shorter in cases with abnormal presurgical levels of some of the tumor
      markers, but only the difference from MCA was significant (p less than
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230348
TI  - Clinical evaluation of CA 15.3 in the post-operative follow-up of breast cancer
      patients.
AB  - In 265 patients operated for breast carcinoma the monoclonal antibody serum test
      CA 15.3 was predictive of metastatic diffusion of the disease. Its level
      increased in cases of distant metastasis with no significant difference between
      multiple and single sites (p = 0.014). The concentration of the marker was higher
      in 21 (23.8%) patients without nodal involvement and in 19 (27.5%) with nodal
      involvement (p = 0.193). Our study suggests that CA 15.3 may be an aid in the
      follow-up of patients with metastatic diffusion of breast cancer.

PMID- 2230349
TI  - Immunoreactive calcitonin: a tumor marker for myelogenous leukemias.
AB  - In a series of 59 patients with chronic or acute myelogenous leukemia (CML, AML)
      we investigated whether circulating immunoreactive human calcitonin (i-hCT)
      levels correlate with diagnosis, response to therapy and clinical course. I-hCT
      was detectable in plasma samples of 88% of patients with CML in the chronic phase
      and in 100% of patients with CML in blastic transformation. In the AML patients,
      a significant relation was observed between the cytological subtype and i-hCT
      levels at diagnosis. In sequentially studied patients the i-hCT plasma
      concentration was related to the overall mass of leukemic cells, being lower when
      complete remission was achieved than at diagnosis and increasing at time of
      recurrence. These data suggest that circulating i-hCT levels can serve as a
      "tumor marker" in human myelogenous leukemias.

PMID- 2230351
TI  - MCA and CA 15.3 serum levels in non-malignant diseases. Some preliminary results.

PMID- 2230350
TI  - Prognostic significance of CA 15.3 in metastatic breast cancer.
AB  - We have investigated the possible relation between serum levels of CA 15.3 and
      disease status in 110 patients after radical mastectomy for breast cancer, with
      metastatic diffusion. Its persistent elevation was usually related to a very poor
      prognosis. In patients who died within 18 months the marker was always elevated.
      In case of progression of the disease, the marker level appeared to be
      consistently correlated with the general clinical condition. In healthy patients
      with stable disease the marker remained near the normal range.

PMID- 2230352
TI  - Correlation between BCM (breast cancer mucin) and CA 549 serum levels cystic
      breast disease.

PMID- 2230353
TI  - Serum BCM levels in patients with non-tumoral pathologies: a value of 25 U/ml can
      be used as threshold for tumoral activity.

PMID- 2230354
TI  - Tumor markers in squamous cell carcinoma of esophagus: immunometric assay in
      cytosol and membrane fraction.
AB  - Carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), ferritin, and
      the monoclonal antibody-detected tumor-associated antigens CA19.9 and CA50 were
      measured by radioimmunoassay in tissue fractions of carcinoma and normal
      esophageal mucosa from 59 patients with untreated primary squamous cell carcinoma
      of the esophagus. Tumor markers were measured in cytosol (118 samples) and in a
      membrane-enriched fraction (32 samples). CEA, TPA and ferritin were detected in
      almost all the cytosol samples evaluated, CA19.9 and CA50 in 66% and 50% of cases
      respectively. Ferritin was significantly higher in carcinoma than in normal
      mucosa. The cytosol concentrations of CEA, TPA, CA19.9 and CA50 were not
      significantly different in carcinoma and normal tissue. Concentrations of CEA,
      CA19.9 and CA50 in the membrane fraction tended to be higher in normal tissue
      than in carcinoma, whereas the cytosol-to-membrane ratio was significantly higher
      in carcinoma. For CEA, CA19.9 and CA50, the phenotypic pattern of the malignant
      transformation seems to involve a different intracellular distribution rather
      than a quantitative change. No correlations were found between tissue and serum
      concentrations of the tumor markers, the former being related to the phenotypic
      characteristics of the tumor, the latter to the tumor burden.

PMID- 2230355
TI  - Different role of liver dysfunction and damage in increasing serum CA 19-9, TPA,
      and CEA in patients with pancreatic cancer.

PMID- 2230356
TI  - Carcinoma of the pancreas: problems of diagnosis and treatment in Africa.

PMID- 2230357
TI  - Pancreatic exocrine and endocrine function in patients with pancreas divisum and
      abdominal pain.
AB  - Pancreatic exocrine and endocrine function is described in 29 patients with
      pancreas divisum and upper abdominal pain. The diagnosis was made by endoscopic
      pancreatography (ERP) after cannulation of the major, as well as the accessory,
      papilla in all patients. At ERP, six patients had signs of marked and six
      patients moderate pancreatitis, whereas 17 patients were free from pancreatitis
      changes. Pancreatitis was found in the dorsal anlage in 12 patients (41%) of whom
      seven (24%) had similar alterations also in the ventral anlage. Fecal fat
      excretion was increased in 48% of the patients, and abnormal serum levels of
      pancreatic enzymes were found in more than one-third. Impaired insulin release
      was detected in 21% of the 28 patients examined following ingestion of oral
      glucose. Including an additional patient with manifest diabetes, 24% (7/29) had
      signs of endocrine insufficiency. The serum-insulin, serum-C-peptide and
      insulin/glucose pattern following an oral glucose load reflected the degree of
      severity of pancreatitis changes at ERP. Altogether, 66% of the patients had
      morphological and/or functional evidence of pancreatic affection.

PMID- 2230358
TI  - Plasma osmolality and exocrine pancreatic secretion.
AB  - To confirm the influence of plasma osmolality on exocrine pancreatic secretion,
      hypertonic saline (4% saline) was given intravenously to dogs with gastric and
      pancreatic fistulae. Intravenous administration of hypertonic saline caused a
      reduction of pancreatic juice flow and bicarbonate output, but did not alter
      protein output stimulated by secretin and cerulein. The changes of pancreatic
      juice flow(X) exhibited negative correlations with the changes in plasma
      osmolality(Y) (Y = -2.2X + 6.4, r = -0.74, p less than 0.01). Plasma osmolality
      and plasma vasopressin level were measured simultaneously. Plasma osmolality was
      elevated from 292 to 315 mOsm/kg with concurrent increase of plasma vasopressin
      level from 2.4 to 19.6 pg/mL. On the other hand, exogenous administration of
      vasopressin inhibited pancreatic juice flow and bicarbonate output dose
      dependently. In conclusion, elevation of plasma osmolality decreased exocrine
      pancreatic secretion stimulated by secretin and cerulein, and vasopressin may
      play an important role in its mechanism.

PMID- 2230359
TI  - Two subclasses of EGF receptors in the human pancreatic cancer cell lines CAPAN-1
      and MIA PaCa-2.
AB  - The existence of different classes of EGF receptors in human pancreatic cancer
      cells has yet not been determined. EGF binding to two cancer cell lines (CAPAN-1
      and MIA PaCa-2) was studied. Two classes of EGF binding sites were characterized.
      The first class of EGF binding sites demonstrated a high affinity and low
      capacity for EGF, with a Kd of 0.25 +/- 0.11 nM, close to the concentration of
      EGF suggested to be present in human pancreatic juice. The second class of EGF
      binding sites had a lower affinity and a higher capacity for EGF, with Kd of 1.78
      +/- 0.61 nM. The total number of EGF binding sites was about 40,000/cell.
      Treatment of the cells with a phorbol ester, TPA, caused a complete loss of the
      high affinity binding sites and also caused a decrease in the concentration of
      the lower affinity binding sites present on the cells. Interestingly, with the
      increasing age of the cells, the concentration of both the high and low affinity
      EGF binding sites was significantly decreased. In the presence or absence of
      fetal calf serum, EGF, at concentrations higher than 1.10(-10)M, exerted a dose
      dependent mitogenic effect on the growth of the pancreatic cancer cells in
      culture. These data demonstrate the existence of two classes of binding sites for
      EGF on some human pancreatic cancer cells and a possible role of EGF in the
      growth of pancreatic tumors.

PMID- 2230360
TI  - Dissimilar trophic effects of cerulein and xenopsin on the rat pancreas.
AB  - Cholecystokinin (CCK), gastrin, cerulein, and other analogs are known to
      stimulate the growth of the rat pancreas. In the present study, we compared the
      trophic action of a member of this gastrin/CCK family, the amphibian peptide
      cerulein, with a member of the structurally unrelated neurotensin/xenopsin group,
      the amphibian peptide xenopsin. For this purpose, 0.56 nmols/kg cerulein, 1.0
      nmols/kg xenopsin, or normal saline were injected intraperitoneally three times a
      day in 28 rats for 3 d. Pancreatic weight, DNA, and incorporation of 3H-thymidine
      into DNA were determined. In another study, pancreatic weight, DNA, and the
      polyamines, putrescine, spermidine, and spermine, were determined after a single
      dose of 2.7 nmol/kg cerulein, 4.5 nmol/kg xenopsin, or saline. The polyamines
      were measured by reverse-phase HPLC and post-column derivatization. Cerulein
      increased pancreatic weight, stimulated 3H-thymidine incorporation into DNA, and
      raised putrescine concentrations significantly, but led to a significant
      reduction of pancreatic DNA concentration. Xenopsin also stimulated 3H-thymidine
      incorporation into DNA, but did not affect pancreatic weight, DNA concentration,
      or the polyamines during the 4 h of the experiment. These findings suggest that
      cerulein, in the dose and intervals applied, initiated hyperplasia and induced
      hypertrophy of the pancreas, whereas xenopsin only initiated hyperplasia. These
      results, together with the dissimilar secretory effects of the two peptide
      families, may be the expression of a dissimilar mode of action. However, it
      cannot be excluded that, since cerulein is more potent than xenopsin, the
      differences also are owing to dosage. We conclude that cerulein and xenopsin,
      which both have trophic effects on the pancreas, may act by different mechanisms.

PMID- 2230361
TI  - Pancreatic calcifications in patients with chronic pancreatitis. A sign of long
      lasting or severe disease?
AB  - Pancreatic calcifications are particularly frequent in patients with severe
      pancreatic insufficiency and long-lasting chronic pancreatitis. To clarify
      whether calcifications point to a more severe form of the disease, irrespective
      of its duration, we have retrospectively analyzed patients with chronic
      pancreatitis submitted to the secretin-cerulein test in our center over a six
      year period. Out of 120 patients, calcifications were found in 55. Higher alcohol
      intake and longer duration of the disease were found in patients with
      calcifications, compared with patients without calcifications (p less than
      0.001). In both groups, lipase and chymotrypsin were more severely impaired than
      bicarbonate; a greater reduction of pancreatic exocrine function was found in
      patients with calcifications, compared to those without (p less than 0.001, Mann
      Whitney U-test). When the patients were classified according to the duration of
      the disease or the severity of exocrine function impairment, higher percentages
      of patients with calcifications were found in the classes with more advanced
      disease. A log-linear analysis showed that the prevalence of calcifications was
      associated with pancreatic function impairment, even within the same class of
      duration of the disease. It is likely that calcifications mark more severe forms
      of chronic pancreatitis, even in the early phases of the disease.

PMID- 2230362
TI  - ABO blood groups and cancer of the pancreas.
AB  - Few investigations discussing an association between ABO blood groups and
      pancreatic cancer exist. We have selected a series of 224 patients with
      histologically-confirmed pancreatic cancer, and their ABO blood groups
      distribution was compared with two control groups: 7086 patients with various
      diseases (Group 1) and 7320 voluntary blood donors (Group 2). There was an
      increased number of pancreatic cancer among the patients with blood group B
      (relative risk 1.5 vs Group 1 p = 0.021; 1.7 vs Group 2 p = 0.0025) and a
      decreased number in patients with blood group O, when compared with the two
      control groups.

PMID- 2230363
TI  - Pancreatogastrostomy in experimental acute necrotizing pancreatitis.
AB  - Experimental acute necrotizing pancreatitis was induced retrogradely in dogs with
      sunflower oil injected intraductally. Then, a zipper was sutured into the
      abdominal wound. From the first postoperative day, three different treatments
      were started: first group: only conservative therapy was used; second group:
      removal of necrotized tissue and single peritoneal lavage were applied; and third
      group: the necrotic part of the pancreas was marsupialized into the stomach.
      Through the systematic opening of the zipper, the abdominal cavity could easily
      be explored and the temporal course of disease could be observed in all animals.
      During this regular procedure, the amylase concentration and the amount of
      peritoneal exudate were determined. The blood amylase and glucose levels were
      also measured. On the first postoperative day, the amylase level and the amount
      of peritoneal exudate were high in all groups. The dogs of the
      pancreatogastrostomized group showed a dramatic decrease of the exudate and the
      most advantageous temporal course of the blood amylase level. The survival rate
      similarly was advantageous in the pancreatogastrostomized group.

PMID- 2230364
TI  - Electron and light microscopy of pancreatic islets of Langerhans isolated by
      Trowell's T8 medium.
AB  - The isolation and purification of high yields of islets of Langerhans are
      important areas of investigation. Although it is well established that warm and
      cold ischemia affect islet yield and function, little information is available
      about the damage that occurs during the digestion period. We used Trowell's T8
      medium and conventional Hank's balanced salt solution to obtain high yields of
      islets with morphologically-intact cells. Light and electron microscopy were used
      to characterize the islets isolated by the two media. Results reveal that the
      islets isolated by Trowells T8 medium were less fragmented and had better fine
      structural integrity than those isolated by the conventional medium.

PMID- 2230365
TI  - [Development and application of enzyme-linked immunosorbent assay using
      monoclonal antibody against a hemolysin (Vp-TRH) of Vibrio paraheamolyticus-
      evidence that Vp-TRH producing-Kanagawa phenomenon-negative V. parahaemolyticus
      is a human pathogen].
AB  - Although it has been well established that Kanagawa phenomenon-positive Vibrio
      parahaemolyticus is a human enteropathogen, the Kanagawa phenomenon-negative one
      has been considered to be probably not pathogenic. We have found, however, an
      outbreak of gastroenteritis due to Kanagawa phenomenon-negative V.
      parahaemolyticus which produces a new toxin (Vp-TRH) resembling to Vp-TDH, a
      responsible toxin of Kanagawa phenomenon. In this study, we developed monoclonal
      antibodies against Vp-TRH which were used for development of an enzyme-linked
      immunosorbent assay (ELISA) for specifically detecting Vp-TRH. The ELISA was
      applied for analysis of production of Vp-TRH by various isolates of V.
      parahaemolyticus and we found that Vp-TRH-producing strains were derived mostly
      from human diarrheal stool, and not from the environment or sea foods. The
      results of the rabbit ileal loop test showed that Vp-TRH-producing (Kanagawa
      phenomenon-negative) strains, as well as Vp-TDH-producing (Kanagawa phenomenon
      positive) strains could induce fluid accumulation. These results indicate the
      possibility that Vp-TRH-producing Kanagawa phenomenon-negative V.
      parahaemolyticus is a human enteropathogen.

PMID- 2230366
TI  - [The epidemiological study on hepatitis B virus infection in Miyako district-
      relationship to the mass survey of filariasis].
AB  - It has been well known that the transmission of HB virus is associated with mass
      inoculation and other medical procedures. In order to make clear the relation
      between HBV infection and the mass survey for filariasis on which sera of the
      examinees were drawn from their earlobes for the detecting of microfilaria with
      inadequately sterilized instruments, a epidemiological study was conducted in
      Miyako district. Okinawa prefecture, Japan, in which both HBV infection and
      filariasis were prevalent. A total of 2,231 inhabitants were investigated for HBV
      seromarkers. The over all positive rate of HBs antigen was 6.3% with the highest
      rate of 15.5% in the group of age 25 to 29. On the other hand, the prevalence
      rate of HBs antibody continued to increase along with age group, and remained to
      be over 60% after 30 years of age. The positive rates of both HBs antigen and
      antibody in the subject district were higher than those in other place of Okinawa
      prefecture or Japan. Comparing yearly attack rates of HBV chronologically, which
      were calculated from the age-specific HBV exposure rates in the district, the
      annual incidence of HBV infection was 6.1% (%/year) between 1954 to 1958, 5.2%
      (%/year) between 1959 to 1963, and then 4.4 (%/year) in the period of 1964 to
      1968 in which the proportion of examinees for the survey of filariasis was the
      highest. In conclusion, the mass survey for filariasis was not the main factor
      contributing to the high prevalence of HBV infection in Miyako district.

PMID- 2230367
TI  - [The serotype distribution of Campylobacter jejuni strains among gastroenteritis
      in hospitals over 7 year period in Tokyo].
AB  - Campylobacter jejuni strains isolated from gastroenteritis at 4 general hospitals
      of Tokyo Metropolitan during the period from 1981 to 1987 were serotype according
      to the slide agglutination test (TCK system) developed by the Tokyo Metropolitan
      Research Laboratory of Public Health. Two thousand four hundred seventy-nine
      strains isolated from sporadic cases among infants and children, 1,962 (78.5%)
      were typed by 33 typing sera numbered TCK 1 through TCK 33 and leaving 537
      strains (21.5%) untypable. Out of the typable strains, 1,643 strains reacted with
      only single serum, while 319 strains reacted with 2 or more antisera. The most
      common serogroups included TCK 21, 20, 7, 1, 4, 23, 24, 10, 30 and 12. Out of the
      1,250 strains isolated from sporadic cases among adults, 974 strains (77.9%) were
      typed and 276 strains were untypable. The most common serogroups were similar to
      those of infants and children. Serogroups TCK 1, 7, 4 and 21 were consistently
      the common serogroups every year during the 7 year study. Isolation frequency of
      serogroup TCK 30 have increased remarkably since 1986, while TCK 23, 14 and 9
      have decreased.

PMID- 2230368
TI  - Biological and chemical studies on soluble protective antigen (SPA) from culture
      supernatant fluids of Salmonella enteritidis.
AB  - The chemical and biological characteristics of Soluble Protective Antigen (SPA)
      separated from culture fluids of Salmonella enteritidis strain 2547 were
      analysed. It was shown that SPA has 3-hydroxy, nonpolar fatty acids by thin-layer
      chromatography. The fatty acids were identified as lauric, myristic, palmitic and
      3-hydroxymyristic acid using gas chromatography-mass spectrometry and mass
      chromatography. These fatty acids are common constituents of the lipid A obtained
      from S. enteritidis. SPA was found to enhance the plaque-forming cell (PFC)
      response to sheep erythrocytes in the recipients' spleen. In addition, SPA
      enhanced the clotting activity of Limulus amebocyte lysate. These results show
      that SPA possesses the properties of lipopolysaccharides isolated from strain
      2547 by chemical procedures.

PMID- 2230369
TI  - [Epidemic of infectious disease with echovirus type 16--epidemic in Tono area,
      Gifu Prefecture in 1984].
AB  - During the period from May to August, 1984, an epidemic of infectious disease
      with echovirus type 16 occurred in Tono area of southeast in Gifu prefecture.
      This virus caused children to have different clinical symptoms, one was a
      exanthem disease and another was aseptic meningitis. These cases confirmed by
      virological and serological methods were 48 cases, that is, patients with aseptic
      meningitis were 24 cases and patients with exanthem disease were 24 cases. By
      serological examination of antibody against echovirus type 16, it was confirmed
      that this virus type invaded Gifu Prefecture before 1984.

PMID- 2230370
TI  - [Epidemic of aseptic meningitis with echovirus type 18 in Gifu Prefecture in
      1988].
AB  - On one hundred thirty seven cases with aseptic meningitis and 36 cases except
      aseptic meningitis in 1988, virological and serological investigations were
      performed. Cases with aseptic meningitis ranged from 0 to 15 years old age, and
      90.5% of them were under 8 years of age. Seven types of enteroviruses and one
      unidentified strain were isolated from 58 of the 137 cases (42.3%), and echovirus
      type 18 was recovered from 46 cases (79.3%). Echovirus type 18 was isolated also
      from 16 cases with acute febrile illness and exanthem etc. With the cross
      neutralizing test between the prototype and isolated strains in 1988 of echovirus
      type 18, a slight antigenic variation could be found. In the serological studies
      in 1989, the positive rate of neutralizing antibody to echovirus type 18, was
      raised remarkably in children under 8 years old.

PMID- 2230371
TI  - [Studies on the detection rate of Chlamydia trachomatis in married and unmarried
      pregnant women--field survey in Hokkaido].
AB  - Chlamydia trachomatis infection in the general population has recently been
      attracting attention. In this regard, we examined the incidence of positive
      antigen in the genital organs in pregnant female women in order to investigate
      the prevalence of this infection. EIA (Chlamydiazyme) was performed in 5,000
      married pregnant women, and in 317 unmarried women who underwent artificial
      termination of pregnancy. The study was carried out between June 1986 and
      September 1989 in Sapporo City (3,932 subjects), Kushiro City (328 subjects),
      Muroran City (280 subjects), Kitami City (357 subjects), Kucchan Town (220
      subjects) and Urakawa Town (200 subjects). 1. Among married pregnant women, the
      detection rate of C. trachomatis was 6.1% (222/3,666) in Sapporo City, 7.3%
      (24/328) in Kushiro City, 6.1% (17/280) in Muroran City, 7.8% (24/306) in Kitami
      City, 6.8% (15/220) in Kucchan Town and 7.5% (15/200) in Urakawa Town, showing no
      particular difference according to the area. The overall detection rate was 6.3%
      (317/5,000). 2. The rates of detection of C. trachomatis antigen by EIA were
      22.9% (61/266) and 15.7% (8/15) for the unmarried women who underwent artificial
      termination of pregnancy in Sapporo and Kitami, respectively. Both rates were
      higher than those in the married pregnant women. This result suggests the
      prevalence of C. trachomatis among young women showing a high level of sexual
      activity. 3. Among married subjects, the detection rate was 21.3% for those in
      their late teens, 8.9% for those in their early 20s, 6.0% for those in their late
      20s, 3.7% for those in their early 30s, and 2.9% for those 35 years or older;
      thus, the younger they were, the detection rate became elevated. The above
      findings show that latent epidemics of C. trachomatis infection are present to a
      considerable extent among young women.

PMID- 2230372
TI  - [Quantitation of IgG antibodies to type Ia group B streptococcal type-specific
      polysaccharides measured by enzyme-linked immunosorbent assay].
AB  - The type-specific polysaccharide antigen of the group B streptococcus (GBS) type
      Ia as extracted and purified according to the procedures of Kane and Karakawa.
      Using this purified polysaccharide antigen, we made a sensitive and specific
      assay system of enzyme-linked immunosorbent assay (ELISA) and measured the titres
      of of the type-specific antibodies in maternal sera and cord blood sera. The
      titres of antibodies in 78 pregnant women (26 Ia carriers, 18 other types of GBS
      carriers and 34 non carriers) were compared. A mother of an infant affected by
      early onset infection of GBS Ia had a titre of antibody 1:10 at delivery, while 2
      years later she became a non carrier and had a titre of antibody over 1:160. The
      titres of antibodies in 27 pair sera of mothers and cords were well correlated.

PMID- 2230373
TI  - [Effects of immunoglobulin preparations on the opsonic activities against various
      pathogens].
AB  - We evaluated the opsonic activities of human intravenous immunoglobulin (IVIG)
      preparations against pathogenic organisms by measuring the luminol-enhanced
      chemiluminescence (CL) from human polymorphonuclear leukocytes (PMN) during the
      phagocytosis of these organisms. Polyethylenglycol-treated IVIG significantly
      increased the CL of PMN by opsonization against various bacteria and Candida
      albicans (p less than 0.01). The high CL induced by IVIG with intact Fc-fragment
      showed no significant differences among lots or preparations made by different
      treatments. In both PMN-CL in the absence of human serum and whole blood CL at
      low concentration of serum complement, the CL response was not affected by pepsin
      treated IVIG. In the severely burned patients' blood with a very low
      concentration of serum immunoglobulin, IVIG with intact Fc-fragment significantly
      increased CL (p less than 0.01). It is suggested that administration of IVIG is
      useful against infections in these patients. The measurement of whole blood CL in
      vitro may be useful for evaluating the opsonic activity of IVIG against target
      pathogens in vivo.

PMID- 2230374
TI  - [An improved differential medium, CA medium, for differentiating Shigella].
AB  - We devised a Citrate-Acetate (CA) medium for rapidly differentiating Shigella.
      The medium consisted of 3.0 g of sodium citrate, 2.0 g of sodium acetate, 0.2 g
      of glucose, 1.0 g of dipotassium phosphate, 1.0 g of mono ammonium phosphate, 0.2
      g of magnesium sulfate, 5.0 g of sodium chloride, 0.08 g of brom thymol blue,
      15.0 g of agar, and 1000 ml of distilled water. An evaluation was made of the CA
      medium, for the rapid differentiation of 23 Shigella strains, 129 Escherichia
      coli strains and 130 isolates, that formed colourless colonies suspected to be
      Shigella on SS agar plate, from feces of healthy people. The results obtained
      were as follows 1) On the CA medium, all Shigella strains did not grow and there
      was no change in colour. 2) Positive growth rates of E. coli strains after
      incubation for 24 hr at 37 degrees C on CA medium, sodium acetate medium (Acet)
      and Christensen citrate medium (C-Cit) were 96.0%, 95.2% and 28.0%, respectively.
      Therefore, the positive growth rate of E. coli strains after incubation for 24 hr
      on CA medium was significantly higher (p less than 0.01) than that on C-Cit
      medium. 3) Positive growth rates of isolates after incubation for 24 hr at 37
      degrees C on CA medium, Acet medium and C-Cit medium were 95.4%, 83.1% and 71.5%,
      respectively. Therefore, the positive growth rates of isolates after incubation
      for 24 hr on CA medium was significantly higher (p less than 0.01) than that on
      Acet medium and C-Cit medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230375
TI  - [A case of Pasteurella multocida infection in bronchiectasis].
AB  - Pasteurella multocide (P. multocida), a small gram-negative bacillus, has been
      known to be the causative agent of hemorrhagic septicemia in animals. P.
      multocida infection in human was reported as skin abscess and/or septicemia after
      an animal bit or scratch. Pulmonary infections of P. multocida have been
      developed in the patients with chronic pulmonary diseases such as bronchiectasis.
      In Japan, however, P. multocida respiratory tract infections are rare. In this
      report, a 80-year-old female with bronchiectasis was admitted on August, 1985.
      She had a productive cough, hemosputum, and a low grade fever. The chest X-P on
      admission showed an atelectasis of the left middle lobe and severe bronchiectatic
      changes of the left lower lobe. P. multocida was isolated from her sputa. The
      chemotherapy of CTM resulted in clinical improvement. On May 1988, she complained
      of a productive cough and a low grade fever again. P. multocida was isolated from
      the sputum on several occasions in significant numbers (1 x 10(8)/ml). Recently,
      the cases of the chronic respiratory diseases have been increasing. We think, P.
      multocida is important and should be considered as a pathogen in the care of
      chronic pulmonary diseases.

PMID- 2230376
TI  - [64th symposium of the Japanese Association for Infectious Diseases. Matsuyama,
      19-21 April 1990. Abstracts].

PMID- 2230377
TI  - [Hemostatic changes after artificial valve replacement--especially tricuspid
      regurgitation].
AB  - To investigate hemostatic changes after artificial valve replacement, I studied
      platelets, fibrinogen (Fbg), antithrombin III (AT-III), fibrinogen degradation
      products (FDP), thrombotest (TT), prothrombin time (PT), bleeding time (BT) and
      activated partial thromboplastin time (APTT) in 75 patients complicated with
      combined cardiac valvular disease. Twenty-nine patients with tricuspid
      regurgitation (TR group) and 46 patients without that (control group) were
      compared. 1) TR group, that contained patients with severer cases, showed a
      significantly longer operative time and greater bleeding volume than control
      group (p less than 0.01). 2) Many patients in TR group showed high serum II,
      frequency of abnormal platelet functions during and after extracorporeal
      circulation total-bilirubin and GPT level after operation and higher ICG R-value
      before operation than in control group. 3) After operation, the platelet count
      was significantly lower in TR group (p less than 0.01) than in control group, and
      was lowest on the 3rd postoperative day in both groups. 4) In both groups Fbg
      increased significantly after operation, and was lower in TR group on the 7th and
      10th postoperative days than in control group. FDP was significantly higher in TR
      group than in control group after the 3rd postoperative day. 5) BT and APTT were
      similar in the two groups. 6) PT and TT were lower in TR group before operation
      (p less than 0.01) than in control group, and decreased after operation and
      administration of anticoagulants in both groups. These results indicate that
      patients with combined cardiac valvular disease with tricuspid regurgitation have
      a hemorrhagic tendency due to disorders of extrinsic coagulant, which may be
      caused by liver hypofunction, and are easy to bleed.

PMID- 2230378
TI  - [Tricuspid annuloplasty and right ventricular function in mitral valve disease].
AB  - From 1985 to 1987, we examined relationship between the lesion of tricuspid valve
      and right ventricular function in 31 patients (male: 9, female: 22) with mitral
      valve disease. The median age at operation was 52 years (range 37-69 years).
      Group I consisted of 17 patients (MS: 10, MSR: 5, MR: 2) accompanied with
      tricuspid regurgitation (TR) and Group II 14 patients (MS: 12, MSR: 2) without
      TR. In all cases of Group I tricuspid annuloplasty (TAP) were performed
      correctly. De Vega methods were done in 12 cases and Carpentier rings were used
      in 5 cases. Cardiac catheterization was done before and after operation. And
      right ventricular volume was measured by right ventricular angiography. In both
      groups pulmonary capillary wedge pressure, pulmonary artery pressure and cardiac
      index were improved postoperatively. Pulmonary artery resistance (PAR) and total
      pulmonary resistance (TPR) in Group I were significantly higher before operation
      but there were no difference between two groups postoperatively. Right
      ventricular end-diastolic volume index (RVEDVI) and right ventricular end
      systolic volume index (RVESVI) in Group I were significantly improved
      postoperatively, but in Group II these were within normal range both pre- and
      postoperatively. Preoperative PAR was correlated inversely with postoperative
      right ventricular ejection fraction (RVEF). It means that patients with severe
      pulmonary vascular lesion had postoperative lower right ventricular function. In
      both groups, RVESVI was in inverse correlation with RVEF pre- and
      postoperatively. In both groups, there was an inverse correlation between the per
      cent change of RVESVI and that of RVEF. This means that RVESVI influenced right
      ventricular pump function.

PMID- 2230379
TI  - [Left ventricular aneurysmectomy after myocardial infarction--comparative study
      between true aneurysms and functional aneurysms].
AB  - Postinfarction left ventricular aneurysms are pathophysiologically divided into
      true, functional and false aneurysm. On 14 patients treated by aneurysmectomy, we
      studied the difference of pre- and post-operative cardiac function between true
      aneurysms (9 patients) and functional aneurysms (5 patients). The aneurysm area,
      which is expressed as the end-diastolic perimeter (akinetic or dyskinetic
      area/left ventricular silhouette), was 51.6 +/- 7.7% in the true aneurysms versus
      35.7 +/- 6.0% in the functional aneurysms. Preoperatively, patients with a true
      aneurysm had a more severe clinical status than those with a functional aneurysm
      (Six of nine patients with a true aneurysm were in New York Heart Association
      functional class III or IV). Postoperatively, all patients except one with a true
      aneurysm and one with a functional aneurysm improved in clinical status.
      Nonaneurysmal EF, that is the function of the nonaneurysmal left ventricle, has a
      significant correlation to postoperative LVEF (r = 0.57, p less than 0.05).
      Nonaneurysmal EF was 54 +/- 4% in the true aneurysm group versus 51 +/- 16% in
      the functional aneurysm group. LVEF improved significantly (p less than 0.05)
      from 31 +/- 11% preoperatively to 55 +/- 10% postoperatively in the group of true
      aneurysm, but did not improved significantly from 43 +/- 12% to 50 +/- 9% in the
      functional aneurysm group. The postoperative akinetic area was 8.1 +/- 9.1% in
      the true aneurysm group versus 17.8 +/- 11.5% in the functional group. We
      conclude that larger and more adequate resection of aneurysms improves the
      cardiac function in the true aneurysm group more than in the functional aneurysm
      group.

PMID- 2230380
TI  - [Comparison by 31P magnetic resonance spectroscopy of effect of simple immersion
      and continuous perfusion methods on organ viability of preserved rat hearts].
AB  - 31P magnetic resonance spectroscopy was used to measure high energy phosphates of
      the heart continuously as an index of the viability of the preserved organ
      together with the cardiac function after preservation. Results with the simple
      immersion (SI) and the continuous perfusion (CP) methods were compared. With SI,
      ATP decreased to 14.8 +/- 4.1% of the base line after 12 hr of preservation, and
      phosphocreatine decreased to 27.8 +/- 6.2% after 3 hr, remaining at about 30% of
      the base line thereafter. With CP, ATP and phosphocreatine were unchanged even
      after 24 hr of preservation; they were 99.1 +/- 2.6% and 119.6 +/- 6.7%,
      respectively. The ATP/Pi ratio was 5.4 +/- 0.7% after 12 hr with SI and 62.2 +/-
      5.8% after 24 hr with CP. LV dP/dt was 96.6 +/- 11.5% after 3 hr of SI (3-SI),
      which was not significantly different from the control. After 6 hr of SI (6-SI),
      the value was 122.7 +/- 0.2%, significantly higher (p less than 0.01) than the
      control. After 9 hr of SI (9-SI) or after 24 hr of CP (24-CP), it was 80.8 +/-
      4.6% and 67.8 +/- 8.2%, respectively, both were significantly lower (p less than
      0.01) than the control. The rate-pressure product returned to the control level
      after 3-SI and 6-SI, but after 9-SI or 24-CP, it was 74.2 +/- 3.7% and 53.0 +/-
      11.0%, and they were significantly (p less than 0.01) lower than the
      control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230382
TI  - [The effect of the co-existence of verapamil and residual propranolol on the left
      ventricular contractility].
AB  - The combined effect of the residual propranolol, which was administrated up to
      the coronary revasculization, and verapamil, anti-supraventricular tachycardia
      drug, on the left ventricular contractility was evaluated with left ventricular
      end-systolic pressure-diameter relationship. Methods; Eighteen sheep were
      instrumented with ultrasonic crystals on the anterior and posterior wall,
      endocardium and epicardium. A pressure transducer was placed in the left
      ventricle. Propranolol (0.15 mg/kg) (n = 6) or verapamil (0.15 mg/kg) (n = 6) or
      both drugs (n = 6) were administrated intravenously, and cardiac function was
      evaluated. Results; In combined group, end-systolic pressure-diameter ratio
      (Emax) was significantly decreased (2.95 +/- 0.24 mmHg/mm) as compared to the
      control group (7.95 +/- 0.83), propranolol group (6.27 +/- 0.78), and verapamil
      group (4.54 +/- 0.77). Conclusion; Co-existence of propranolol and verapamil
      significantly decreased cardiac contractility. Therefore verapamil should be
      administrated carefully in the presence of residual propranolol, and the co
      existence of both drugs must be limited.

PMID- 2230381
TI  - [Effect of adenosine on recovery of lowered viability of preserved rat hearts
      measured by 31P magnetic resonance spectroscopy].
AB  - The restoration of the viability of rat hearts preserved for 5 hr by 50 microM
      adenosine (ADN) was evaluated in terms of the cardiac function after preservation
      and the recovery of myocardial high energy phosphates measured by 31P magnetic
      resonance spectroscopy. The hearts were perfused with modified Krebs-Ringer's
      solution (mKRS) with ADN (ADN group) or without AND (non-ADN group) for 1 hour
      after 5 hr of preservation by the simple immersion method. Control hearts were
      perfused but not preserved. ATP and phosphocreatine had decreased to 47.2 +/-
      6.6% and 28.0 +/- 8.6% of the base line by 5 hr of preservation, but the levels
      returned to 147.2 +/- 2.3% and 127.4 +/- 5.6% after 1 hr of perfusion with ADN;
      at the same time, in the non-ADN group, they were 103.8 +/- 2.3% and 115.8 +/-
      8.3% respectively. The same hearts were next perfused for 3 hr with standard
      Krebs-Ringer's solution so as to beat after the perfusion with mKRS. After 3 hr
      of beating, LV dP/dt was 3330 +/- 116 mmHg/s in the ADN group, which was not
      significantly different from the control (3034 +/- 60 mmHg/s). However, in the
      non-ADN group, the value was 2516 +/- 201 mmHg/s and significantly lower (p less
      than 0.05) than the control. The rate-pressure product was 19350 +/- 1154 in the
      ADN group, not significantly different from the control (20899 +/- 709), but it
      was 14559 +/- 1339 in the non-ADN group, which was significantly lower (p less
      than 0.01) than the control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230383
TI  - [Relationship between the nuclear DNA content and the prognosis in squamous cell
      carcinoma of the lung].
AB  - Analysis of the nuclear DNA content from paraffin-embedded specimens using flow
      cytometry was performed on 86 patients in squamous cell carcinoma of the lung.
      There were no relationships between the site of tumor origin and the nuclear DNA
      content or the survival of the patients. The frequency of DNA aneuploidy was
      74.4% among tumors, and it significantly (p less than 0.05) increased with
      advanced stage. The patients with DNA aneuploidy were significantly (p less than
      0.01) less favorable prognosed than those with DNA diploidy. Similar results were
      demonstrated in patients of absolute or relative curative resections. These
      results indicate that DNA aneuploidy is of higher grade malignant intensity than
      DNA diploidy in squamous cell carcinoma of the lung. In patients with absolute or
      relative curative resection, DNA aneuploid tumors occurred much more often in
      distant metastasis. In conclusion, there were no relationships between the site
      of tumor origin and the biological features or the prognosis of patients in
      squamous carcinoma of the lung. DNA ploidy pattern is related to relapse and
      prognosis of the tumors. If the DNA ploidy pattern of patients on whom absolute
      curative resection was performed is DNA aneuploidy, adjuvant therapy should be
      strongly performed and carefully followed up as long as possible.

PMID- 2230385
TI  - [Long-term results of valve replacement in the right side of the heart in
      congenital heart disease--comparative study of bioprosthetic valve and mechanical
      valve].
AB  - Valve replacements in the right side of the heart (TVR and PVR) were done on 16
      patients with congenital heart disease, mainly tetralogy of Fallot and Ebstein
      anomaly. Including reoperations, 19 operations were performed on them and 20
      artificial valves were inserted. Ten mechanical valves (7 St. Jude Medical
      valves, 3 Starr-Edwards valves) and 10 bioprosthetic valves (7 Carpentier-Edwards
      valves, 3 Ionescu-Shiley valves) were used. Age at valve replacement ranged from
      9 to 52 years (mean 23.0 years), and the follow-up period was 1.28-19.8 years
      (mean 5.7 years). Including 2 sudden deaths, late death occurred in 4 patients,
      on all of whom mechanical valve replacements were done at the primary operation.
      Five-year survival rate of all patients was 76.4 +/- 12.1%, and 10-year survival
      rate was 63.6 +/- 15.4%. All the patients who received bioprosthesis at the
      primary operation survived at the time of this follow-up study. On the contrary,
      long-term results of mechanical valve was unsatisfactory with the 5-year survival
      of 62.5 +/- 17.1%. In spite of anti-coagulation therapy with warfarin, three
      patients with mechanical valve complicated thrombotic valves, which necessitated
      re-operations. Calcified bioprosthetic valve occurred in one patient with I-S
      valve 8.5 years after the implantation. Five-year complication-free rate was 87.5
      +/- 11.7% for bioprosthesis, whereas it was 50.0 +/- 15.8% for mechanical valve
      (p less than 0.056). It is concluded that the bioprosthesis is the first choice
      for the valve replacement in the right side of the heart in congenital heart
      disease.

PMID- 2230384
TI  - [Surgical treatment of total anomalous pulmonary venous connection under three
      months of age].
AB  - Nine infants under 3 months of age with total anomalous pulmonary venous
      connection underwent total correction between June, 1986 and September, 1988. The
      age at operation ranged from 4 days to 59 days, averaging 19 days, and the body
      weight ranged from 1,814 g to 4,105 g, with a mean of 3,050 g. The types of TAPVC
      were Darling Ia in 4, Ib in 1 and III in 4. All the patients were operated by the
      posterior approach under cardiopulmonary bypass with high flow (130-200
      ml/kg/min) and mild hypothermia using modified GIK-cardioplegia, topical cooling
      and aortic cross clamping. Although the incision in the common pulmonary vein
      trunk was never extended into the pulmonary veins or vertical vein, the length of
      the mouth was at least 10 mm. In the postoperative management, care was taken to
      avoid overhydration and rapid volume infusion. Blood pressure was kept just
      enough to maintain urine output. Heart rate was kept over 170/min for early
      postoperative days with the use of isoproterenol or atrial pacing. There was no
      operative or late death. Postoperative course was uneventful in all cases except
      one with low output syndrome in which mechanical ventilation for 8 days was
      required. Postoperative catheterization and angiography revealed normal
      intracardiac pressure values and no pulmonary venous obstruction in all cases.
      Follow-up period ranged from 10 to 37 months, and there has been no patient with
      the signs of PVO.

PMID- 2230386
TI  - [Late results of coronary bypass grafting in patients with concomitant multifocal
      arteriosclerotic vascular diseases].
AB  - Late results of coronary bypass graftings (CABG) in the patients with multifocal
      arteriosclerotic vascular diseases were reviewed. Between September 1978 and July
      1989, 819 consecutive patients underwent CABG. There were 693 males and 126
      females, mean ages 58 +/- 8.5 years. Of 819 consecutive patients underwent CABG,
      95 patients had the coexistence of multifocal atherosclerosis (Group A). Seventy
      two patients had aortoiliac or femoropopliteal disease, and 29 patients had
      aortic aneurysm. The remaining 724 patients had no coexistence of multifocal
      atherosclerosis (Group B). The mean follow-up periods was 4.0 +/- 2.1 years, and
      the follow-up ratio was 99.4%. The 5- and 10-year survival rates were 80% and 52%
      in group A, and 92% and 82% in Group B, respectively. The 5- and 10-year free
      ratio from cardiac events were 79% and 42% in Group A, and 85% and 61% in Group
      B, respectively. The 5- and 10-year free ratio from noncardiac events were 53%
      and 38% in Group A, and 85% and 76% in Group B, respectively. The results showed
      that the coexistence of multifocal atherosclerotic vascular disease in patients
      underwent CABG significantly increase the ratio of noncardiac and cardiac events,
      and decreased life expectancy.

PMID- 2230388
TI  - [Surgical repair for pulmonary artery sling on a 46-day-old infant].
AB  - Surgical repair on a 46-day-old girl with pulmonary artery sling is reported. She
      was suffered from dypnea and admitted to a hospital on 12 days after her birth.
      On chest roentgenogram atelectasis of right lung was found. She had been on
      respirator since 21 days after her birth. On bronchogram and pulmonary
      arteriogram, the trachea and right bronchus were compressed and shifted with the
      anomalous origin of left pulmonary artery which originated from the right
      pulmonary artery and passed between the trachea and esophagus. These results
      confirmed the diagnosis of pulmonary artery sling. Hence, she was referred to our
      hospital for surgical treatment. She underwent surgical repair on 46-day-old. In
      operation, we chose a mid-sternal splitting incision, and excised 5 mm of ductus
      arteriosus. Under extracorporeal circulation, the left pulmonary artery was
      amptated from the right pulmonary artery and pulled back to left side between the
      trachea and the esophagus. The left pulmonary artery was anastomosed to the main
      pulmonary artery at the anterior to the left bronchus. She weaned from
      respirator, and was extubated on the 3rd day after procedure. She recovered
      uneventfully in post-operative course. On the 24th day after operation she
      discharged from hospital. On pulmonary perfusion scanning and pulmonary
      arteriography performed one year after operation, the left pulmonary artery was
      patient with slightly decreased perfusion in the left lung. Surgical repair for
      pulmonary artery sling was recognized as high mortality because of frequently
      associated tracheobronchial anomalies. In the Japanese literature, only 4
      patients survived surgically and lived in late stage.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2230389
TI  - [A case of concomitant repair of aortic regurgitation due to congenital aortic
      quadricuspid valve and coronary artery occlusive disease].
AB  - A case of rare congenital anomaly of quadricuspid aortic valve and coexisting
      coronary artery occlusive disease of a 60-year-old female was presented. She was
      admitted to our hospital for heart murmur and angina pectoris. The
      echocardiography and aortography showed quadricuspid aortic valve and aortic
      valve regurgitation. The coronary arteriography revealed the presence of triple
      vessels disease. Successful aortic valve replacement and Coronary bypass grafting
      were performed simultaneously.

PMID- 2230387
TI  - [The mutual effect of ultrasound stimulation and exogenous ATP on myocardial
      protection during cardiac arrest].
AB  - We have reported that ultrasound stimulations have a protective effect toward
      ischemic insult upon myocardial cells during cardioplegic arrest. However, the
      exact mechanism of ultrasound stimulation was not known. To elucidate this
      mechanism, we investigated the effect of ultrasound stimulation (UI) and/or 0.1
      mMATP added to the cardioplegic solution (A) on ventricular function and adenine
      nucleotide changes in isolated perfused rat hearts. The hearts were perfused by
      working heart mode for 10 min. to determine baseline values of hemodynamic
      variables and they received infusion of cardioplegic solutions, followed by 20
      min cardiac arrest with myocardial temperature 37 degrees C. Subsequently to the
      ischemic arrest, aerobic reperfusion was continued for 30 min. In group I,
      neither UI was irrigated nor ATP was added to cardioplegic solution. In group II
      and IV, ATP was added and in group III and IV, UI (1010 KHz, 0.25 W/cm2) was
      irrigated during cardiac arrest. Myocardial ATP was measured by Luciferase
      method. Myocardial ATP content after 20 min of cardiac arrest showed 12.4, 25.3,
      14.5 and 32.5 (nmol/mg protein) in group I, II, III, and IV respectively, whereas
      it was 32.6 at the pre-ischemic cardiac arrest. The recovery of aortic output
      after 30 min of reperfusion revealed 30.9%, 78.9%, 79.6%, 85.4%. These data
      suggested the ATP depletion during cardiac arrest was attenuated by the UI and
      exogeneous ATP, resulted in the high recovery level of ventricular function
      during reperfusion.

PMID- 2230390
TI  - [Total cavopulmonary shunt operation for single atrium and single ventricle].
AB  - A 17-year-old woman with single atrium, single ventricle, common atrioventricular
      valve and hemiazygous continuation underwent a total cavopulmonary shunt
      operation successfully. She had been cyanotic and with a heart murmur since two
      months of age. She was first seen at our hospital at three years of age.
      Catheterization, performed at the same time, had revealed pulmonary stenosis and
      transposition of the great arteries. At 17 years of age, catheterization was
      again performed, and a clinical diagnosis of single atrium, single ventricle,
      common atrioventricular valve and hemiazygous continuation was made. After the
      diagnosis was confirmed, a total cavopulmonary after ligation of the main
      pulmonary artery and shunt operation was performed division of the left superior
      vena cava, the distal end of the left superior vena cava was anastomosed to the
      confluent pulmonary artery. Two hours after return to ICU, extubation was done.
      The cardiac index was 4.36 L/min/m2 with central venous pressure of 145 mmH2O.
      The arterial oxygen saturation was 88.4%. After the surgery, this woman is doing
      well, with decreased CTR and improved exercise tolerance. Total cavopulmonary
      shunt can produce a marked improvement in the condition of patients with some
      type of complex cyanotic congenital heart disease.

PMID- 2230391
TI  - [Aortic valve replacement following percutaneous transluminal balloon
      valvuloplasty--a case report].
AB  - A 71-year-old female was operated on, because of massive aortic regurgitation
      following elective percutaneous transluminal balloon aortic valvuloplasty (PTAV)
      for calcified bicuspid aortic stenosis. The damaged aortic valve was successfully
      replaced with a 19 mm St. Jude Medical prosthetic valve. More careful
      consideration may be required in selection of the candidates of PTAV, as the
      procedure is not so satisfactory as reported in literatures concerning its
      efficacy and safety.

PMID- 2230393
TI  - [A case of thyroid carcinoma required the incision of the thyroid cartilage for
      inserting the silicone T tube after extensive tracheal resection and
      reconstruction].
AB  - A 57-year-old female with thyroid carcinoma, who had developed tracheal stenosis,
      underwent extensive tracheal resection and reconstruction. After the tracheal
      sleeve resection 5.2 cm in length, primary tracheal reconstruction was performed.
      Although complication did not occur at the anastomotic site, the patient had
      dyspnea due to cord dysfunction by bilateral recurrent nerve paralysis. After 20
      days transnasal intubation we reoperated to perform a tracheostomy under neck
      incision. But the reconstructed trachea was too short to pull out from the
      mediastinum. In order to insert the silicone T tube, the incision of thyroid
      cartilage must be done and vocal cords were injured. The patient inserting the T
      tube through the laryngeal stoma had no dyspnea and no aspiration about two years
      after the operation in spite of palliative operation. It seemed likely that the
      trouble that tracheostomy could not be done would occur in some patients who had
      undergone extensive tracheal resection and reconstruction. But the insertion of
      silicone T tube through the laryngeal stoma provided a satisfactory result for
      airway problem.

PMID- 2230392
TI  - [A case of surgically treated newborn with congenital tracheal stenosis].
AB  - This is a case report of a newborn with congenital tracheal stenosis which was
      fortunately healed by surgery. A 2,650 g female infant was born at 39 wk
      gestation. She began having respiratory difficulty soon after birth. Prompt
      endotracheal intubation was attempted, but failed. She was transferred to our
      hospital under assisted ventilation. Chest roentgenogram and bronchoscopy
      demonstrated segmental narrowing of the trachea about 2 cm distal from the vocal
      cord. A surgical operation was performed because respiratory management would not
      be enough to save the infant. Through a transverse collar incision and an upper
      median sternotomy, a stenotic 7 mm length of the trachea was resected and
      anastomosed with 5-0 Dexon suture. Postoperative course was uneventful.
      Histologically, the stenotic segment consisted of hypoplasia of the tracheal
      cartilage and fibrosis of the membranous portion. Squamous metaplasia was also
      recognized. There was no other report of tracheal stenosis successfully operated
      during the period of newborn.

PMID- 2230394
TI  - [An aorto-coronary bypass graft operation of left coronary ostial stenosis due to
      aortitis syndrome].
AB  - A 24-year-old female with unstable angina due to aortitis syndrome was reported.
      The coronary-arteriogram in hospital showed 75 percent stenosis of the left
      coronary ostium. Following two months' steroid therapy for active inflammation,
      aortocoronary bypass graft was implanted. After the operation. This patient
      became free from angina attack. Steroid therapy was continued postoperatively as
      well. The coronary-arteriogram taken seven months after the operation, revealed
      the patency of the graft.

PMID- 2230395
TI  - [A case of giant bullae of the lung with thrombosis in the inferior vena cava and
      the pulmonary artery].
AB  - A case of giant bullae of the lung is rarely accompanied with thrombosis in the
      inferior vena cava and the pulmonary artery, and because of the risk of pulmonary
      infarction, this case needed a surgical treatment. At this time, we removed the
      thrombus from the IVC as the first step of the operation, and two months later a
      bullectomy and the exploratory incision of the right main pulmonary artery were
      attempted as the second step of the operation. However, the thrombus in the
      pulmonary artery had spontaneously disappeared. The postoperative course was
      uneventful and there has been no evidence of recurrence with anticoagulant
      therapy.

PMID- 2230396
TI  - [Pleuropneumonectomy with thymectomy for invasive thymoma with pleural
      disseminations--a case report].
AB  - A case of invasive thymoma with pleural disseminations, treated with
      pleuropneumonectomy and thymectomy , is presented. A 30-year-old woman was
      admitted with abnormal shadows in left lung field and mediastinum. On chest CT
      examination, the tumor shadows were located anterior mediastinum and left chest
      wall. Thymoma with pleural disseminations was the most likely consideration by
      the needle biopsy specimen of the tumor under left chest wall. Preoperative
      radiotherapy for anterior mediastinum mass was effective. Pleuropneumonectomy and
      thymectomy combined with partial resections of intercostal muscles and diaphragm
      were performed. Histologically, the tumor was arranged in lobular structure,
      composed of epithelial cells, with poorly infiltration of lymphocytes, and
      invaded into intercostal muscles or lung. Postoperative radiotherapy for
      mediastinum and left chest wall was added. Tumors may be removed completely by
      pan-pleuropneumonectomy and thymectomy for invasive thymoma with pleural
      disseminations.

PMID- 2230398
TI  - [A case of intralobar pulmonary sequestration associated with abnormal connection
      between the aberrant artery and the pulmonary artery].
AB  - The patient was a 5-year-old girl and had a history of recurrent pneumonia.
      Angiogram demonstrated that the aberrant arteries arising from descending aorta
      communicated with left pulmonary A10 where the multi-lobulated cystic lesion was
      seen by chest X-P. The right heart catheterization revealed the step-up of oxygen
      saturation in distal part of left pulmonary artery A10. Diagnosis was the
      intralobar pulmonary sequestration with the aberrant arteries communicating with
      pulmonary artery. The connection between aberrant arteries and pulmonary artery
      in this case might be caused by the chronic inflammation in the sequestrated
      lung. We found 4 case reports in which the communication between aberrant
      arteries and pulmonary artery was evident.

PMID- 2230397
TI  - [An experience with simultaneous carotid endarterectomy and myocardial
      revascularization in a patient with calcified ascending aorta].
AB  - We reported a 65-year-old male with the history of both cerebral and myocardial
      infarctions. Simultaneous carotid endarterectomy and myocardial revascularization
      (coronary artery bypass grafting = CABG) were performed. Ascending aorta was
      severely calcified. CABG was performed without aortic cross clamp under systemic
      moderate hypothermia and elective ventricular fibrillation. The wean off from
      extracorporeal circulation was successful. The postoperative course was
      uneventful. We recommend the simultaneous revascularization for the carotid and
      coronary artery obstructive diseases. CABG under ventricular fibrillation without
      aortic cross clamp was useful and unhazardous in patients presenting calcified
      ascending aorta.

PMID- 2230400
TI  - [Mitral valve replacement in 12-month-old infant with parachute mitral valve
      associated with ventricular and coronary sinus septal defect].
AB  - A 12-month-old infant, weighting 6.7 kg, underwent mitral valve replacement with
      a 17 mm Bjork-Shiley prosthetic valve for parachute mitral valve, and patch
      closure of the associated ventricular and coronary sinus septal defects.
      Progressive pulmonary artery hypertension and heart failure required surgical
      intervention. The diagnosis of parachute mitral valve and associated lesions was
      established by echocardiogram and angiogram. Postoperative recovery was
      uneventful and he is doing well 3 years after the operation. To our knowledge
      this is the first successful case to be reported in the literature with such
      combination of the congenital anomalies.

PMID- 2230399
TI  - [A case of tricuspid atresia with unroofed coronary sinus].
AB  - Tricuspid atresia with unroofed coronary sinus is an extremely rare cardiac
      anomaly. A 15-year-old boy who was successfully operated was suspected this
      disease preoperatively. We speculated this disease by right atrial angiography
      and underwent the direct suture closure of a coronary sinus defect and Fontan's
      operation. When we perform Fontan's operation on tricuspid atresia, we should
      take the existence of unroofed coronary sinus into our consideration. The
      echocardiography, cardiac catheterization and angiography, especially, right
      atrial angiography had to be carried out preoperatively. During the operation, it
      is important to check over the influence of cardioplegic solution from the ostium
      of coronary sinus. If not, elaborate inspection have to be done on the back wall
      of the left atrium through ASD to search for abnormal communication directly or
      by inserting sound from coronary sinus.

PMID- 2230402
TI  - AIDS: the epidemiological significance of two different mean rates of partner
      change.

PMID- 2230401
TI  - An epidemic model with a density-dependent death rate.
AB  - This paper deals with a mathematical model for a disease where the death rate
      depends on the number of people in the population. This sort of model would be
      suitable for diseases in developing countries or for diseases amongst animal and
      insect populations. We also assume that the population under consideration is
      regulated by the disease so that there is a mortality induced by the disease. We
      use a compartmental model and perform an equilibrium and stability analysis to
      find that there is a threshold condition. If the threshold is exceeded, then
      there is a unique equilibrium with disease present which is locally stable to
      small perturbations. We conclude by looking at several specific models and seeing
      how the results relate to previous work.

PMID- 2230403
TI  - T cell regulation in autoimmune arthritis: possibilities for immunological
      intervention.

PMID- 2230404
TI  - Interactions between immunogenic peptides and HLA-DR molecules.

PMID- 2230405
TI  - [MHC class I antigen expression by molar trophoblast].
AB  - It is an issue for debate why molar tissues are not rejected by an
      immunologically potent host, since all genes in complete moles and 2/3 genes in
      partial moles are considered to be paternally derived. Molar trophoblasts are in
      direct contact with host cells, and therefore HLA expression by these cells may
      hold the key to the elucidation of the immunological reaction between molar
      tissues and the host. It has been reported that villous trophoblasts are negative
      and extravillous trophoblasts are positive for HLA-A, B,C, but the expressed HLA
      A,B,C molecule has been noted to lack their polymorphic determinants. We analyzed
      the reactivity of two monoclonal antibodies to a monomorphic determinant of HLA
      A,B,C (W6/32 and Cappel anti-HLA-A,B,C) with molar trophoblasts, using three
      uteri containing complete moles and two containing partial moles. The reactivity
      was examined by an indirect immunoperoxidase method. The staining patterns were
      almost identical in complete moles and partial moles. Villous trophoblasts showed
      a negative reaction with both antibodies. On the other hand, extravillous
      trophoblasts exhibited intense staining for W6/32 and negative staining for
      Cappel anti-HLA-A,B,C, which may suggest that the expression of a constant region
      as well as a variant region of HLA-A,B,C molecule is incomplete.

PMID- 2230406
TI  - [Influence of peritoneal fluid with endometriosis on the development of mouse
      embryos].
AB  - To clarify the mechanism of infertility associated with endometriosis (EM), the
      effect of peritoneal fluid (PF) on early embryogenesis was examined. The addition
      of PF (5%) had no effect on the development of mouse 2-cell embryos. Since the PF
      is supposed to enter the oviductal cavity, PF may influence reproductive
      processes by modulating the intraoviductal microenvironment. As expected, PF with
      EM inhibited the development of 2-cell embryos co-cultured with oviducts whereas
      PF without EM had no effect. An increase in interleukin 1 (IL-1) has been
      identified in PF with EM. As with PF with EM, IL-1 inhibited the development of 2
      cell embryos inasmuch as the oviducts were co-cultured. Indomethacin, an
      inhibitor of prostaglandin (PG) synthesis, effectively abolished the inhibitory
      action of both PF with EM and IL-1 on embryonic development. Moreover, PGE2
      directly inhibited embryonic development. PGE2 was shown to inhibit the synthesis
      of protein by early embryos. These results demonstrate that PF with EM inhibits
      the development of early mouse embryos by acting on the oviducts. From these
      results it seems that an increase in IL-1 may be a causative factor in the embryo
      toxic properties of PF with EM. We further suggest that PGE2 secreted from the
      oviducts by stimulation with PF with EM, may be an ultimate contributing factor
      in embryo-toxicity by inhibiting protein synthesis by early embryos.

PMID- 2230407
TI  - [Studies of structural changes in toxemic placentae].
AB  - To determine the pathogenesis and the pathophysiology of toxemia of pregnancy, we
      investigated ultrastructural changes in placentae. 1. Lumina of villous
      capillaries dilate in mild toxemia and narrow in severe toxemia as in premature
      delivery. Trophoblasts increase with the progress of toxemia. 2. Changes in
      capillaries and trophoblasts appear as a compensatory reaction at some parts of
      placenta and at others as dysfunction. 3. Villi of the toxemic placenta have few
      ramifications, and are similar to those of early gestation, but there are very
      few stromata. This is thought to be a maldevelopment of villi. 4. Ultrastructural
      changes are as follows; a) Luminal dilatation and/or narrowing of villous
      capillaries. b) Endothelial thickening of villous capillaries. c) Decrease in the
      number of slit-like capillaries. d) Increase in intermediate filaments. e)
      Endothelial projections like villi and vesicle in the lumen of the capillary. f)
      Enlargement of microvilli. g) Increase in the number of syncytial knots and
      cytotrophoblasts. h) Increase in the number of wrinkles on the villous surface.

PMID- 2230408
TI  - [Clinical significance of measurement of plasma melatonin concentration in women
      with irregular menstrual cycles].
AB  - To study the effects of melatonin on the human hypophyseal ovarian axis, we
      measured the concentrations of melatonin in the plasma of women with a regular
      menstrual cycle and of women with an abnormal menstrual cycle, at days 5 through
      10 after the onset of menstruation or withdrawal bleeding. In seven women with a
      regular menstrual cycle, there was a tendency for the plasma melatonin
      concentration to gradually decrease chronologically from 49.0 +/- 9.8pg/ml (M +/-
      S.E.) at 9:30 h to 19.0 +/- 4.0pg/ml at 12:00 h. On the other hand, the plasma
      melatonin concentration at 21:30 h was 50.3 +/- 7.4pg/ml which was almost the
      same as the level at 9:30 h, while the concentration during the night
      significantly increased chronologically to 106.3 +/- 28.6pg/ml at 24:00 h. By
      comparing the plasma melatonin concentration measured during the day with that
      measured during the night, a significant difference was discovered after 21:40 h
      (p less than 0.05). The plasma melatonin concentration at 10:00 h and 22:00 h in
      20 women with a regular menstrual cycle was 28.1 +/- 3.4pg/ml and 72.2 +/-
      9.9pg/ml, respectively, showing a diurnal rhythm with a significantly higher
      level during the night than during the day. On the other hand, the plasma
      melatonin concentration in most of the women with an anovulatory cycle or
      amenorrhea was within the range of the mean level of +/- 1.5 x the standard
      deviation obtained from the 20 women with a regular menstrual cycle. However, an
      increase in plasma melatonin during the night was not found in three of nine
      women with an anovulatory cycle and one of two women with second grade
      amenorrhea.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230409
TI  - [Ultrasonographic evaluation of advancement of uterine endometrial carcinoma;
      comparison with postoperative histological findings].
AB  - Preoperative ultrasonographic examinations of endometrial carcinoma have been
      performed in 47 patients in Tokushima University Hospital since 1976. The size of
      intrauterine echo masses, cervical involvement and thickness of uninvolved
      myometrium were measured by longitudinal and transverse scan. The results were
      compared with postoperative histological findings. The results were as follows;
      1) Endometrial echoes were identified in 94% (44/47). Echogenic masses which were
      characteristic of endometrial carcinoma were observed in 79% (37/47). 2) The
      average size of echogenic masses in pT1 carcinoma was significantly smaller than
      in more advanced cancers (pT2 or more). Especially when the area (longitudinal x
      anteroposterior diameter) of a mass was under 500 mm2 and the volume
      (longitudinal x anteroposterior x transverse diameter) was under 10,000 mm3, the
      probability of pT1 carcinoma was significantly high. 3) Eighty-seven percent
      (13/15) of cases with and 81% (22/27) of cases without cervical involvement of
      endometrial carcinoma were correctly diagnosed by ultrasonography. 4)
      Extrauterine extension of the tumor was found in 63% (5/8) when the thickness of
      the uninvolved myometrium measured by ultrasonography was under 3mm, whereas when
      the thickness was over 3mm, extrauterine extension of the tumor was found in only
      19% (5/27). From these data, ultrasonography was effective for the evaluation of
      the advancement of endometrial carcinoma, especially cervical involvement,
      myometrial invasion and extrauterine extension.

PMID- 2230410
TI  - [A case of fetal conjoined twins diagnosed prenatally by ultrasound].

PMID- 2230411
TI  - [Osteoporosis in postmenopausal women].

PMID- 2230412
TI  - [The role of insulin in reproductive endocrinology and perinatal medicine].
AB  - Soskin, in his 1946 textbook, stated that insulin may be regarded as the dominant
      instrument in the symphony of endocrine action that results in normal
      carbohydrate metabolism. After almost half a century, great progress in the
      medical field has revealed that insulin plays more than even he described. Some
      aspects of important actions of insulin in our field as investigated in our
      laboratory are summarized below. 1. Role of insulin in reproductive
      endocrinology. (1) Correlation of insulin and testosterone in normal young women
      and patients with polycystic ovary syndrome (PCO). The sum of serum insulin
      values during 75g OGTT and serum testosterone values were positively correlated
      in normal women and patients with PCO. Glucose transport activities in isolated
      adipocytes from a typical PCO patient were decreased, but insulin binding
      activities were not, which indicates that insulin resistance in this patients is
      due to some post-receptor defects. (2) Insulin may be a risk factor of
      endometrial carcinoma. It is well-recognized that several diseases associate with
      hyperinsulinemia, such as obesity, PCO, diabetes mellitus, and hypertension are
      risk factors for endometrial carcinoma. The sum of the insulin values during OGTT
      was significantly higher in patients with endometrial carcinoma than in those
      without. 2. Role of insulin in perinatal medicine. (1) Increase in insulin
      secretion during pregnancy. High serum insulin concentration during OGTT,
      increased secretion of urinary C-peptide, and enhanced staining of insulin in B
      cells by the PAP method suggest that insulin secretion is enhanced during
      pregnancy. (2) Insulin resistance during pregnancy. Glucose utilization rate in
      both pregnant and progesterone-treated rats, as assessed by a glucose clamp
      technique, is significantly decreased as compared to nonpregnant rats. The
      technique of 2-deoxyglucose injection revealed that whole body insulin resistance
      is due to insulin resistance in individual insulin-sensitive tissues. The
      activities of 3-0-methyl-D-glucose transport in isolated rat skeletal muscle and
      human adipocytes were found to decrease during late pregnancy, but insulin
      binding activities were not. These results suggest that insulin resistance during
      pregnancy is due to some post-receptor mechanisms. (3) Physiological meaning of
      insulin in fetal growth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230413
TI  - [Pregnancy complicated with autoimmune diseases].
AB  - Autoimmune disorders such as SLE and ITP occur more commonly in young women and
      are the most common complications in pregnancy. There is considerable controversy
      concerning the risk to the mother and fetus, and the optimal prepartum management
      for minimizing that risk. 1. SLE is an autoimmune disorder in which IgG
      antibodies such as anti dsDNA-IgG, anticardiolipin IgG, and anti SS-A/Ro IgG are
      produced. Lupus nephropathy accompanied by diminished serum complement (CH50) and
      a rise in antibodies against dsDNA is a frequent clinical problem during
      pregnancy, which represents the adverse effect of hypertension or superimposed
      toxemia and causes fetal death or intrauterine fetal growth retardation. Habitual
      abortion or fetal death is common in a case with high anticardiolipin IgG titre.
      Anti SS-A antibodies are often found in the infants of antibody-positive mothers,
      and the deposition of antibodies in the perinodal region cause congenital heart
      block. IgG or immune complexes crossing the placenta directly injures the cardiac
      conduction system. In these cases which have high titre crossing the placenta
      directly injuries the cardiac conduction system. In these cases which have high
      titre of autoimmune antibodies, corticosteroid therapy should be started. 2.
      Management of ITP in pregnancy involves the consideration of three issues: 1)
      treatment of maternal thrombocytopenia, 2) prediction of fetal thrombocytopenia,
      3) obstetrical management. ITP increases the risk for postpartum bleeding of
      sufficient severity to require blood transfusion. In most of these cases,
      maternal platelet counts are found to be less than 30,000/mm3. Women who have
      symptomatic severe steroid-unresponsive ITP may benefit from intravenous
      IgG(IvIgG) given as elective treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230414
TI  - [Hormonal control of lactation].
AB  - We studied the mechanism of normal lactation, especially the roles of prolactin
      (PRL) and oxytocin (OXT) in the initiation of lactation, the lactation in the
      women complicated with endocrinological disorders, and medical therapies for
      stimulation and suppression of lactation. The level of serum PRL increases as
      pregnancy progresses, and reaches to a peak on the day of delivery. Despite high
      PRL level, milk secretion does not appear during pregnancy, because the sex
      steroid hormones suppress binding of PRL to the receptor in the mammary gland.
      The initiation of milk secretion in puerperal women seems to be closely related
      to an increase in PRL levels induced by adequate suckling. In the mechanism of
      suckling-induced PRL increase, OXT from posterior pituitary seems to have an
      important role. Furthermore, the poor response of PRL to suckling was due to
      insufficient stimulation to the nipples by suckling because the size of nipples
      were relatively small in these mothers. The other mechanism involved in lactation
      is suckling-induced OXT secretion. OXT stimulates milk ejection. Anxiety or fear
      may inhibit the OXT release. We demonstrated that the number of pulsatile release
      of OXT by nursing was significantly decreased by the psychological stress induced
      by mental calculation. In the puerperal women with prolactinomas after surgery,
      the serum PRL level did not increase during pregnancy and milk secretion in
      puerperium was poor. In the puerperal women with diabetes mellitus, milk
      secretion was also poor. One of the causes may be related to the low PRL response
      to suckling stimuli. PRL stimulates milk yield in the mammary gland, but is not
      commercially available.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230415
TI  - [Treatment and follow-up for ovarian cancer].
AB  - Current status and problems concerning the theme of the treatment and follow-up
      against ovarian cancer were presented. In the early stage tumors, a newly
      proposed staging criteria by FIGO will help to resolve the problems. Accurate
      staging operation may clarify the definite criteria of 'early' cancer and allows
      to select out subgroup of curable patients by surgery alone. Systematic lymph
      adenectomy may also define how extensive the initial operation should be.
      Considering the situations surrounding the progressive disease, however, much
      remains to be resolved. Which should we take as the primary treatment, surgical
      or chemical cytoreduction? Since neither surgery nor chemotherapy has curative
      potential as a monotreatment, indeed, it is important to realize to know the best
      timing of sequencing or combining of these treatment modalities. To define the
      optimal management for patients with ovarian cancer, a randomized clinical trial
      should be designed using various treatment protocols.

PMID- 2230416
TI  - [Animal models in reproductive research].

PMID- 2230417
TI  - The 42nd annual scientific meeting of the Japan Society of Obstetrics and
      Gynecology. Tokyo, April 15-17, 1990. Abstracts.

PMID- 2230418
TI  - Quantitative analysis of cervical CSF and syrinx fluid pulsations.
AB  - The author has performed quantitative studies of cerebrospinal fluid (CSF)
      pulsations in the cervical region in 10 normal subjects and in 13 cases of
      syringomyelia using a superconducting MRI system. In the normal subjects, the
      caudally directed CSF flow in the anterior subarachnoid space reached its maximum
      velocity at 100-200 msec after the R-wave of the ECG. Measured velocities were 26
      44 mm/sec at upper cervical levels and 44-124 mm/sec at lower cervical levels.
      Further small peaks in the caudal direction were seen at approximately 500 msec
      after the R-wave. Cases of syringomyelia showed lower velocities in the syrinx
      than in the anterior subarachnoid space, and the movements varied greatly between
      the cases and levels examined. CSF pulsations in the subarachnoid space were
      observed in all cases with Chiari malformation. These results suggest that CSF
      pulsations in the subarachnoid space are transmitted to the syrinx fluid, and
      that the movements of the syrinx fluid are influenced by various factors.

PMID- 2230419
TI  - [Rotational instability of the lumbar spine--a three-dimensional motion study
      using bi-plane X-ray analysis system].
AB  - The purpose of this study is to investigate the rotational instability of the
      lumbar spine using bi-plane X-ray analysis system and to clarify mechanical
      etiology of the lumbar instability. The following results were obtained. (1) The
      range of rotational motion was about 2 to 3 degrees at each motion segment in the
      normal lumbar spine. The rotational motion was significantly large in
      spondylolysis, spondylolisthesis, and degenerative spondylolisthesis. (2) The
      rotational instability and the flexion-extension instability correlated to each
      other in spondylolysis and spondylolisthesis. However, in degenerative
      spondylolisthesis, the rotational instability and the antero-posterior
      instability were correlated to each other. (3) Instantaneous axis of rotation
      (IAR) was located at the posterior part of the intervertebral disc in the normal
      L4 vertebra, and more posteriorly in the L5 vertebra, while the IAR was located
      anteriorly in spondylolysis, and posteriorly in degenerative spondylolisthesis.
      (4) When the trunk was twisted, the lumbar lordotic angle was generally
      decreased, and the lumbar spine showed scoliotic curvature convex to the twisted
      direction. The apex was located at the L4/5 intervertebral level. Highly
      significant increases in flexion motion associated with rotation were observed at
      the pathological levels of spondylolysis and degenerative spondylolisthesis.

PMID- 2230420
TI  - [A clinicopathological study of cervical intervertebral discs--Part 1: On
      histopathological findings].
AB  - In order to examine the aging process of the cervical intervertebral discs, a
      histopathological study was performed on 158 cervical discs obtained at autopsy
      from 37 individuals ranging in age from 3 months to 87 years. In the nucleus
      pulposus, degenerative changes consisting of myxomatous and slightly hyalinized
      degeneration were already seen in the specimens obtained from subjects in the
      third decade of life. Degenerative changes of the annulus fibrosus, however,
      tended to develop from the fourth decade of life, with myxomatous degeneration
      mainly in the anterior and hyalinized degeneration in the posterior annulus. The
      horizontal fissure of the annulus extending to its outer portion was seen more
      frequently in the posterior portion. In the cartilaginous plate of the vertebral
      body, fissure formation and degeneration became evident in the fifth decade of
      life. In contrast to the disc, repairing processes were observed in the
      cartilaginous plate. Spur formation at the corner of the vertebral body may be
      due to the degeneration of the outer layer of the disc leading to enchondral
      ossification.

PMID- 2230422
TI  - [Meniscus transplantation using a cryopreserved allograft--an experimental study
      in the rabbit].
AB  - In twenty rabbits with completion of bone growth, the medial meniscus was
      replaced with an allograft meniscus that had been preserved at -80 degrees C for
      6 to 14 days. As a control, the medial meniscus was removed and reattached
      without cryopreservation in 14 rabbits. Replaced menisci were examined
      histologically and microangiographically. Allografted menisci were found to
      attach to the capsule at 4 weeks. However, the attachments of the anterior and
      posterior horns were not stable in the majority of rabbits, because the nylon
      thread for anchoring was broken in these cases. There was osteophyte formation on
      the medial tibial plateau and the medial femoral condyle. Histological
      examinations revealed proliferation of vascularized synovial tissue along the
      meniscal surface and invasion of para-meniscal connective tissue into the
      meniscal substance. Chondrocytes showed regeneration in the superficial layer at
      12 weeks. This study has demonstrated that cryopreserved meniscal allograft was
      capable of regeneration. The osteophyte formation of the medial femoral condyle
      and the tibial plateau appears to be produced by the abnormally unstable
      transplanted meniscus resulting from the insufficient anchorage of anterior
      and/or posterior horns.

PMID- 2230421
TI  - [A clinicopathological study of cervical intervertebral discs--Part 2: On
      morphological and roentgenologic findings].
AB  - One hundred and eleven cervical vertebral bodies and 153 cervical intervertebral
      discs obtained in 35 autopsy cases were studied first by plain roentgenograms,
      discography and CT discography (CTD), and then histologically. In addition to the
      above studies, morphological measurements of various parts of the disc were made.
      Following results were obtained: 1) The anterior portion of the disc tended to
      become thinner with aging than the middle and posterior portions, 2) The nucleus
      pulposus initially located slightly anterior to the middle portion of the disc
      tended to move gradually to the posterior portion of the disc with aging, 3) The
      antero-posterior diameter of the cartilaginous plate showed a gradual decrease
      with aging, 4) False-negative discography+ was observed more frequently in the
      anterior protrusion than in the posterior protrusion, 5) The false-positive
      discography+ was apparently often caused by the penetration of the contrast
      medium into the Luschka's joint, and 6) The osteophyte of the vertebral body may
      be formed by enchondral ossification triggered by disc degeneration according to
      the histological studies.

PMID- 2230423
TI  - [Prolonged inflammatory reactions induced by ceramic powders in the rat air pouch
      model].
AB  - The subcutaneous air pouch of the male Sprague-Dawley rat was used to study
      inflammatory potential of artificial ceramics. Local leukocyte influx,
      proteinase, prostaglandin E2 (PGE2) and tumor necrosis factor (TNF) levels were
      measured after injection of hydroxyapatite ceramic (HAP), tricalcium phosphate
      ceramic (TCP) and apatite-wollastonite glass ceramic (GC) into the pouch.
      Synthetic monosodium urate crystals (MSU) were used as positive controls and
      normal saline (NS) as a negative control. The response was monitored over a
      period of 168 hours by irrigating the pouch with 5 ml of NS and withdrawing 4 ml.
      MSU produced the greatest response in leukocyte counts, proteinase and PGE2,
      whereas HAP, TCP and GC often appeared later than with MSU. TNF was significantly
      detected only after ceramics and not after MSU. The chronic and relatively
      prolonged reaction to HAP, TCP and GC suggests that an inflammatory reaction may
      occur after implantation of these ceramics in humans. The increased levels of TNF
      and production of PGE2, which are substances proposed to contribute to osteolysis
      associated with loosening, are of special interest for further research.

PMID- 2230424
TI  - [Experimental study on chronic entrapment neuropathy].
AB  - This study was undertaken to clarify the pathology and pathophysiology of chronic
      entrapment neuropathy. Ten mm long Silastic tubes with internal diameter of 1.5
      mm were placed on the right sciatic nerves of adult Wistar rats. Morphological
      and functional changes were studied from one to 14 months after tubing. The
      earliest changes consisted of thickening of the epineurium and perineurium,
      followed by breakage of nerve-blood barrier. Intraneural edema and segmental
      demyelination were evident at the central and peripheral areas of funiculi from 4
      months after tubing. At 14 months after treatment, intraneural fibrosis was
      recognized. Compound action potentials and motor nerve conduction velocity were
      decreased in 4 and 8 month specimens respectively. Tadpole deformity of the
      myelin sheath was observed at 4 months and later. The fast axonal transport
      declined at 8 months after tubing. Our results were compatible with clinical and
      pathological findings of human materials. This model was thought to be useful one
      to elicit the pathology and pathophysiology of clinical entrapment neuropathy.

PMID- 2230425
TI  - [Ultrastructural studies on the articular cartilage of spontaneous osteoarthritis
      in C 57 black mice].
AB  - In order to clarify the cause and mechanism of joint degeneration in
      osteoarthritis (OA), a histopathological study and ultrastructural-histochemical
      analysis were performed on the articular cartilage of the C57 Black mouse, a
      model of spontaneous osteoarthritis. Using transmission electron microscopy
      (TEM), in all stages of light microscopically recognized OA, we found that Golgi
      apparatus++ were poorly developed, intracellular microfilaments markedly
      increased, proteoglycan granules decreased and collagen networks broken.
      Observing histologically normal models of different ages by TEM, we found Golgi
      apparatus++ and other organelles to be well developed regardless of age. Many
      proteoglycan granules were seen, mainly consisting of keratan sulphate in the
      later months. Collagen networks were maintained. These results suggest that
      disturbed protein transport and sugar synthesis in chondrocytes due to the
      deficient development of Golgi apparatus++ caused the degenerative change in
      articular cartilage and that, with aging, the structure and function of the
      matrix were maintained mainly due to the continued presence of keratan sulphate.

PMID- 2230426
TI  - [Treatment of carpal injury].

PMID- 2230427
TI  - [Analysis of the shear force exerted on the tibia during standing on bilateral
      legs with knee flexion].
AB  - Biomechanical analysis of the two-dimensional models composed of roentgenographic
      pictures and electromyographic analysis about the shear force (Fs) exerted on
      tibia during standing on bilateral legs was conducted in 21 young adult males.
      The simultaneous contraction of the quadriceps and hamstrings was observed in all
      electromyograms (EMGs). Amplitude observed on EMGs of the hamstrings increased as
      the trunk flexion angle increased. The calculated average values of Fs 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 represent the main factor
      that influenced these results. The standing on bilateral legs with knee and trunk
      flexion was considered to be applicable in the early stages after anterior
      cruciate ligament reconstruction.

PMID- 2230429
TI  - [Effect of serum factors on skeletal growth in Perthes' disease].
AB  - It is well known that patients with Perthes' disease have skeletal growth
      disturbances such as short stature and retardation of bone maturation. The
      purpose of this study was to identify serum factors which relate to the skeletal
      growth disturbances in Perthes' disease. The stature, bone age and the
      concentration of plasma somatomedin-C were measured. The stature and bone age
      were lower than those of normal subjects, and the concentration of plasma
      somatomedin-C was significantly lower than the normal value. Serum from patients
      with Perthes' disease was added to the culture medium of chondrocytes from rabbit
      articular cartilage to measure the cell number and the contents of protein and
      glycosaminoglycan per dish. Each of these parameters was slightly lower in the
      culture containing the patients' serum than that with normal serum. It may be
      concluded that there is some factors in the serum of patients with Perthes'
      disease which controls the proliferation and differentiation of chondrocytes, and
      somatomedin-C might be related to that factor.

PMID- 2230428
TI  - [An evaluation of cervical spinal canal stenosis--a correlation with
      cerebrospinal fluid pressure using a semiconductor and its coefficients].
AB  - This study was conducted to determine whether the cerebrospinal fluid pressure
      (CSFP) obtained by the lumbar puncture technique is capable of evaluating the
      pathological state of the cervical spinal canal stenosis (CSCS). A method was
      developed in which the CSFP was measured with a small piezoelectric semiconductor
      in combination with the lumbar puncture technique. The data thus obtained were
      quantitatively analysed using a personal computer. Using this method, we studied
      patients with cervical myelopathy due to vertebral canal stenosis. The CSFP wave
      form obtained by compression of the cervical region was converted into a
      regression curve using the computer. In order to estimate the vertebral canal
      stenosis ratio (spinal cord/dural tube) of patients with CSCS by CSFP, multiple
      regression analysis was performed to obtain a multiple regression with respective
      parameters as expository variables. Descending curve coefficients (CND, CFD and
      CED) were found to be useful as parameters estimating the state of CSCS by means
      of CSFP analysis. On the basis of these parameters, CND, the coefficient of a
      descending curve obtained at the neutral cervical position, and CED, the
      coefficient of a descending curve obtained at the extended position, patients
      with CSCS were able to distinguish from normal subjects. The multiple regression
      equation (Y = 73.2-3890 CNA-4740 CND + 3620 CFD-10470 CEA-802 CED-0.119 NPP) was
      statistically significant at P = 0.01, therefore, useful in estimating the
      vertebral canal stenosis ratio. On the contrary, the values calculated from the
      multiple regression equation were not well correlated with either the JOA
      (Japanese Orthopedic Association) scores evaluated in accordance with the JOA
      Criteria or with the spinal compression ratio (anterior-to-posterior
      diameter/right-to-left diameter).

PMID- 2230430
TI  - [Effect of human interleukin-1 on cartilage metabolism].
AB  - This study was undertaken to elucidate the effect of human interleukin-1 (IL-1)
      on the cartilage metabolism, with H235SO4 and 3H-proline as the respective
      indices for the metabolism of proteoglycan and collagen. We examined in vitro the
      35S and 3H rates of incorporation after IL-1 was added to free chondrocytes
      incubated from human and porcine joint cartilage. As a result, IL-1 suppressed
      dose-dependently the secretion of both 35S and 3H into the supernatant of the
      medium containing free human or porcine chondrocytes. There was no difference
      between the control and the IL-1 group in the elution pattern of proteoglycan on
      the column-chromatogram. These results indicated that human IL-1 did not affect
      the molecular weight of the proteoglycan produced by human and porcine
      chondrocytes.

PMID- 2230431
TI  - [Experimental investigations of osteogenesis and chondrogenesis by implant of BMP
      fibrin glue mixture].
AB  - The influence of fibrin glue on ectopic osteo-chondrogenesis induced by bone
      morphogenetic protein (BMP), which was extracted from decalcified rabbit long
      bones, was investigated histologically, radiographically, and
      electronmicroscopically. The mixtures, consisting of fibrin glue and BMP, were
      implanted between femoral biceps muscles of AKR mice. They were examined 3 days,
      5 days, 1 week, and 2 weeks after implantation, respectively. The fibrin glue did
      not affect osteo-chondrogenesis by BMP under the mixture conditions, and new bone
      formation was seen almost in every implant. The fine network of fibrin glue
      seemed to be effective for adhesion, differentiation of BMP responding cells and
      was well cooperated on BMP. Fibrin glue network could control the area of osteo
      chondrogenesis by BMP. It might be due to restriction of diffusion of BMP. In
      addition, the whole shape of the newly formed cartilage and bone was influenced
      by the quantity of Aprotinin administered to fibrin glue. Fibrin glue may be
      regarded as an effective cooperator of BMP in the case of clinical application of
      BMP in the future.

PMID- 2230433
TI  - Experimental study of osteogenic activity of sintered hydroxyapatite--on the
      relationship of sintering temperature and pore size.
AB  - In order to determine the most appropriate properties for hydroxyapatite, four
      kinds of sintered hydroxyapatite (50-250 microns & 900 degrees C, 50-250 microns
      & 1,100 degrees C, 300-600 microns & 1,100 degrees C, and dense & 1,100 degrees
      C, pore size and sintering temperature, respectively) were implanted in the
      animals and studied histologically. In addition, the responses at different
      implantation sites were compared. The results are 1) hydroxyapatite sintered at
      900 degrees C temperature showed higher osteogenic activity than that sintered at
      1,100 degrees C in the early period. However, this difference disappeared with
      time, and at 26 weeks, there was no significant difference between the two
      groups. 2) hydroxyapatite with a 300-600 microns pore size demonstrated
      osteogenic activity superior to that with a 50-250 microns pore size. 3)
      implantation at the epiphysis produced higher osteogenic activity in the early
      period, compared to implantations at the metaphysis or diaphysis. This difference
      in bone ingrowth had disappeared at the 26-week.

PMID- 2230432
TI  - [Immune responses to articular cartilage reconstruction using chondrocytes
      allograft transplant].
AB  - Epiphyseal cartilage grown in vitro was transplanted using fibrin clot into a
      cartilage defect produced on the femoral articular surface of the knee joints in
      white New Zealand rabbits 5-6 months of age. The transplantation was successful
      for two weeks in 64% and for 3-24 weeks in 26%. Almost dead transplanted tissues
      were replaced by fibrous tissues to preserve the joint function. Immunological
      studies such as counting of inflammatory cells in the joint fluid, evaluation of
      the anti-allo antibody titer by passive hemagglutination inhibition,
      immunofluorescence studies, and assay of cytolytic reaction by 51Cr labelled
      allogenic target cells suggested that the transplanted cartilage began to
      degenerate from two or three weeks after the transplantation partially due to
      humoral immunity but more importantly on account of cellular immunity.

PMID- 2230434
TI  - [Effect of weak direct current with silver electrodes on bacterial growth].
AB  - The author studied the effect of weak direct current on bacterial growth in vitro
      and in vivo. In vitro, electric current was applied 20 or 100 micro A/cm2 of
      direct current using electrode of carbon, silver or platinum. Its inhibitory
      effect was observed on the growth curve of Staphylococcus aureus, Escherichia
      coli and Pseudomonas aeruginosa in the anode bath respectively. A silk thread
      that adsorbed Staphylococcus aureus was inserted into the intramedullary space of
      the tibia of Wistar rats to induce osteomyelitis. Silver electrodes were placed
      to apply 100 microA/cm2 of direct current for two weeks. The therapeutic effect
      was then evaluated in terms of X-ray findings, histological findings and changes
      in the viable count of Staphylococcus aureus in the intramedullary space of the
      tibia. It was found that application of electric current using a silver electrode
      was most effective for the inhibition of bacterial growth both in vivo and in
      vitro, and seemed to be clinically useful for treating osteomyelitis.

PMID- 2230435
TI  - [Prevention and treatment of complications in open leg fractures].

PMID- 2230436
TI  - [Communication with the co-medical staff on orthopaedics].

PMID- 2230437
TI  - [How to write a medical paper?].

PMID- 2230438
TI  - [How to deal with equivocal subjects in statistical analysis of randomized
      controlled trials].
AB  - In randomized controlled trials, it is likely that several subjects with atypical
      features are registered. In this paper, it was discussed from a statistical point
      of view how properly the subjects with the following atypical features could be
      dealt with; 1) subjects who were found to be not eligible for the trial after
      randomization, 2) subjects who did not receive the assigned regimen by the
      treatment protocol, 3) subjects whose outcome was ambiguous as the designated
      endpoint, and 4) subjects who were ambiguous whether to be regarded as censored
      cases. It was also emphasized that informations on equivocal subjects should be
      masked in the committee which is responsible for the statistical judgement.
      Plausible examples were added to assist the readers to understand the rules
      discussed here.

PMID- 2230439
TI  - [Immunomodulating effect of intratumoral (IT) injection of biological response
      modifiers (BRM) on tumor-bearing hosts].
AB  - Preoperative endoscopic intratumoral injection (IT) of biological response
      modifiers (BRM), such as OK432, a compound composed of attenuated Streptococcus
      pyogens, in gastric cancer patients has been tried and this method has been
      improving the prognosis compared to surgical resection only. We tried to clarify
      this mechanism using experimental mouse system and demonstrated here the
      preoperative IT of OK432 significantly prolonged the survival and induced the
      tumor-specific cytotoxic T lymphocytes (CTL) in the spleen. By contrast, tumor
      necrosis factor (TNF) IT failed to prolong the survival and to induce specific
      CTL response, although it reduced primary tumor size significantly. To analyze
      why OK432 IT induce the systemic CTL response, viable tumor cells and
      infiltrating dish-adherent cells from the OK432 injected tumor mass were
      harvested and examined the class I and class II antigen expression by flow
      cytometer. Class I and class II antigen expression of the tumor cells remained
      unchanged, however, the class II positive dish-adherent cells markedly increased
      by OK432 pretreatment. As same in these results, histological finding in gastric
      cancer specimen has shown prominent increase of Langerhans cells, possessing
      potent antigen-presenting function and positive class II antigen, by OK432
      pretreatment. Taken together, these findings strongly suggest that the increased
      class II positive antigen-presenting cells (APC) activity by OK432 IT augment the
      CTL response via cascade reaction and finally, resulted in anti-tumor efficacy in
      vivo.

PMID- 2230440
TI  - [Examination of the effects of age on prognostic factors of squamous cell
      carcinoma of the uterine cervix].
AB  - The presence or absence of an association between age and prognostic factors of
      squamous cell carcinoma of the uterine cervix, including histologic cell type,
      depth of invasion, stromal reaction, CPL classification, and lymph node
      metastasis, was examined in 380 patients who had undergone radical hysterectomy.
      Age affected the rate of lymph node metastasis according to depth of invasion,
      and the metastasis rates in patients with invasion of 2/3 of the lateral side of
      the muscular layer (gamma type) in groups of patients in their 30s, 40s, 50s, and
      60s were 40.0% (4/10), 59.3% (16/27), 36.7% (18/49), and 21.6% (8/37),
      respectively. Similarly, the metastasis rates in patients with invasion of the
      parametrium (delta type) in the above age groups were 100% (1/1), 72.7% (8/11),
      46.4% (13/28), and 36.7% (11/30). Lymph node metastasis was significantly less in
      patients in their 60s than those in their 40s (gamma: p less than 0.01, delta: p
      less than 0.05). Moreover, 5-year survival rates of patients with lymph node
      metastasis (tested by Kaplan-Meier method) were 33.3% (N = 4), 65.0% (N = 15),
      81.9% (N = 17), and 100% (N = 8) in groups of patients in their 30s, 40s, 50s,
      and 60s respectively, in the gamma type, and 45.0% (N = 8), 45.7% (N = 10), and
      79.6% (N = 11) in groups of patients in their 40s, 50s, and 60s respectively, in
      the delta type. A significant difference was noted between the group of patients
      in their 60s and other age groups (gamma: p less than 0.01, delta: p less than
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230441
TI  - [Doppler ultrasonic assessment with hemodynamics of gynecologic tumor].
AB  - Color and pulsed Doppler ultrasound examinations were done on 11 normal
      volunteers (NU) and 286 patients that consisted of cervical carcinoma (CC),
      leiomyoma and/or adenomyosis (M), endometrial carcinoma (EC), trophoblastic
      disease (TD), benign ovarian tumor (BO), Krukenberg tumor (KT) and ovarian
      carcinoma (OC). The vascularity was based on the resistance index (RI) and
      maximum blood flow velocity (Vmax). In uterine disease, there was significant
      difference (p less than 0.01) among each group, except but one correspondence
      between NU and CC with RI, and there was significant difference (p less than
      0.001) between NU and M, CC and M with Vmax. In ovarian disease, there was
      significant difference among each group with RI, and there was no significant
      difference among each group with Vmax. Therefore, Doppler ultrasound is a useful
      diagnostic tool for assessing gynecologic tumor vascularity.

PMID- 2230442
TI  - [Mass screening for uterine cancer during the last 10 years--its present
      situation and problems].
AB  - In Omagari city and five towns, 37,793 women were subjected to mass screening of
      uterine carcinoma from 1979 to 1988. The detection rate of uterine carcinoma was
      0.058%. Initial screening rate was 41% 10 years ago, but in 1988, it was
      decreased to 18%. The peak age of the mass screening was 50-54 years old, but the
      carcinoma and dysplasia high degree were detected mostly in patients aged 60
      years old or more. And the constitution of the age of mass screening in this
      study was inadequate for the screening of endometrial carcinoma. It is important
      to emphasize that older women (aged 60 or above) and nullipara should be
      encouraged to actively participate in the screening of cervical and endometrial
      carcinoma.

PMID- 2230443
TI  - [Combined radiotherapy and pre-radiation chemotherapy with cisplatin and 5
      fluorouracil for advanced esophageal carcinoma. I. Clinical evaluation in cases
      with distant metastases].
AB  - Eight patients with untreated squamous cell carcinoma of the esophagus
      accompanying distant metastases who were treated by one to five cycles of
      chemotherapy consisting of Cisplatin and 120 hour infusion of 5-Fluorouracil were
      reported. Two patients showed complete response (CR), four partial response (PR),
      one minor response, and one no response. High response rate of 75% (6 of 8) was
      obtained. Radiation therapy was then administered to six of the patients. After
      definitive treatment, CR was obtained in four, and PR in two of the cases.
      However, relapses were noted in all four of the CR cases, with four at distant
      sites, and one locally. Five of the eight patients (62.5%) survived one year and
      two survived three years (25%). Two patients could not receive radiotherapy
      because of uncontrollable lung metastases or death from duodenal ulcer. Although
      the follow-up period is still short, the combined treatment of radiation and pre
      radiation chemotherapy appears to be an effective treatment, and has made a major
      impact upon survival time in cases of disseminated esophageal carcinoma.

PMID- 2230444
TI  - [Combined radiotherapy and pre-radiation chemotherapy with cisplatin and 5
      fluorouracil for advanced esophageal carcinoma. II. Clinical evaluation in cases
      with higher than T2 stage].
AB  - Thirteen patients with previously untreated advanced squamous cell carcinoma of
      the esophagus were treated with pre-radiation chemotherapy followed by radiation
      therapy. The chemotherapy consisted of two or three cycles of Cisplatin and 120
      hour continuous infusion of 5-Fluorouracil. Three patients showed complete
      response (CR), three partial response (PR), three minor response (MR) and four
      non-response (NR). The overall response rate was 46%. The predominant side
      effects were nausea, vomiting and anorexia. Mild or moderate degree of anemia and
      leukocytopenia were also noticed. However, no serious toxicity was observed.
      Radiation therapy was administered to eleven of the thirteen patients, excluding
      one patient who refused it and one patient who died during chemotherapy. In two
      of the eleven cases, however, radiotherapy was discontinued because of MR, and
      surgery was performed. In one additional case, post-radiotherapy surgery was
      performed. One of these three cases received curative esophagectomy. After
      definitive treatment, CR was obtained in 54% (7 of 13), PR in 15% (2 of 13), MR
      in 15% and NR in 15%. The non-effective patients (PR + MR + NR) died within nine
      months after the initiation of treatment. Two of the CR patients later died, one
      due to local recurrence and another due to aortic-esophageal fistula with no
      residual cancer discovered at autopsy. The remaining CR patients are still alive
      and well, after 11.5 to 32 months. Although the follow-up period is yet short,
      the combination of radiation therapy with pre-radiotherapy chemotherapy appears
      to be an effective treatment.

PMID- 2230445
TI  - [Clinical research on hyperthermia of cancer using microwave heating equipment of
      lens applicator type].
AB  - Ninety cases with 96 tumors were treated by the 430 MHz microwave heating
      systems, HTS-100, at Tokyo Metropolitan Komagome Hospital, Kyoto University and
      Aichi Cancer Center. The results of treatment were analyzed, and the following
      have been clarified. Three cases are demonstrated showing feature of HTS-100. 1)
      The results of 383 sessions of heating by HTS-100 were analyzed, and it has been
      clarified that even the larger tumors, more than 5 cm both in size and depth, can
      be heated satisfactorily to temperatures higher than 42 degrees C. This system is
      capable of heating remarkably wider areas compared with the conventional
      microwave heating systems. 2) Hyperthermia by HTS-100 and radiotherapy were
      combined for treatment. The success rate (total percentage of CR plus PRa) of 89
      cases analyzed was as high as 66.3%. Furthermore, local heating was successful
      for 60.7% of tumors, larger than 5 cm and deeper than 4 cm. 3) Combination of
      microwave heating and RF wave heating is a new method which is helpful for
      expansion of indications. 4) The frequencies of side effects of HTS-100 heating
      were: pain, 15.6%; sensation of heat, 6.3%; burns, 3.6%. Most of side effects
      were transient and slight. The higher frequency of pain than the conventional
      microwave heating is attributable to expansion of heating area.

PMID- 2230446
TI  - [Ovarian metastasis in patients with cervical cancer].
AB  - The study included a total of 634 patients with cervical cancer; 311 were in
      stage I b and 323 were in stage II. All patients received radical hysterectomy at
      the Department of Obstetrics and Gynecology, Kinki University, between May 1975
      and December 1986. One out of 311 patients in stage I b (0.3%) and eight out of
      323 patients in stage II (2.5%) had ovarian metastases confirmed histologically.
      Nine patients who had ovarian metastases were investigated about stages,
      histological types of the cervical cancer (WHO and CPL classification), incidence
      of metastases in pelvic lymph nodes, corpus infiltration, parametrial
      infiltration, and peritoneal cytology. Results obtained were as follows: 1. As to
      histological types, patients with adenocarcinoma and/or PL type in CPL
      classification had high incidence of ovarian metastases. 2. Patients with corpus
      infiltration had high incidence of ovarian metastases. 3. Metastases to both
      ovary and pelvic lymph nodes tended to occur on the same side, but ovarian
      metastases and parametrial infiltration did not necessarily occur on the same
      side. We suggest removal of ovaries, even before menopause, in patients with
      cervical cancer who have cervical adenocarcinoma, or corpus infiltration, or are
      suspicious for metastases in more than two pelvic lymph nodes.

PMID- 2230447
TI  - [A combined chemo-endocrine therapy with tegafur, adriamycin, methotrexate and
      tamoxifen for advanced renal cell carcinoma].
AB  - Six patients with advanced renal cell carcinoma was treated with a new chemo
      endocrine regimen consisting of Tegafur, Adriamycin, Methotrexate and Tamoxifen.
      Estrogen receptor was measured in four cases from renal or metastatic tumors by
      DCC method, presenting 14.7, 9.7, 1.0 and 0 f moles/mg protein respectively. The
      patients were medicated with 800-1,200 mg of Tegafur and 20 mg of Tamoxifen daily
      po, and 20 mg of Adriamycin and 10 mg of Methotrexate intermittently for two
      weeks interval iv. According to a criteria of Japan Society for Cancer Therapy,
      two were regarded as CR, one as PR, one as NC and two as PD. The one out of two
      cases with and without estrogen receptor responded favourably to this therapy.
      Side effects observed in the treatment were mild gastrointestinal disorders
      including nausea and vomiting, slight degree of leukopenia, stomatitis,
      pigmentation and liver dysfunction. The patients were found to be in good quality
      of life during the treatment because of less toxicity. This therapy can be
      regarded as a good modality for a treatment of advanced renal cell carcinoma.
      This is a first report of combined chemo-endocrine therapy with Tegafur,
      Adriamycin, Methotrexate and Tamoxifen for renal cell carcinoma in the world.

PMID- 2230448
TI  - [Studies on usefulness of postoperative adjuvant chemotherapy with lentinan in
      patients with gastrointestinal cancer].
AB  - The usefulness of Lentinan, as an agent for postoperative adjuvant therapy, was
      investigated in patients with gastrointestinal cancer. Sixty-one patients were
      classified into three stages by a degree of advance for cancer (Stage II, III,
      IV). Furthermore, each group was put into the control group (C group) and the
      Lentinan group (L group), received 600 mg/day of Tegafur p. o. only or 600 mg/day
      of Tegafur p. o. and 2 mg/week of Lentinan i. v., respectively. Then total
      lymphocyte counts and NK cell activities were measured and analysis of lymphocyte
      subsets by two color flow cytometry was carried out every two months. The results
      were as follows: 1) Some parameters were preserved in higher levels in the L
      group especially in the stage IV. 2) In the stage IV, total lymphocyte counts of
      the L group were preserved higher levels compared to those of the C group. The
      same tendency was observed in OKT3, OKT4 and OKT8 positive cell counts. 3) In the
      stage IV, both OKT8+ x Leu15+ cell (suppressor T cell) and OKT8+ x Leu15- cell
      (killer T cell) counts tended to decrease in the C group. 4) In the stage IV, the
      NK cell activities of the L group were preserved in higher level compared to
      those of the C group. Leu7+ x Leu11-, Leu7+ x Leu11+ and Leu11- x Leu11+ cells
      counts tended to preserve in the L group. From these results, it was suggested
      that Lentinan had a marked immunopotentiating efficacy in the stage IV among
      gastrointestinal cancer patients.

PMID- 2230449
TI  - [A case of esophageal carcinoma with the lung and liver metastases surviving more
      than 3 years].
AB  - A case of advanced esophageal carcinoma with liver and lung metastases who
      survived more than 3 years by combination chemotherapy consisting of Cisplatin
      and continuous 120 hours infusion of 5-Fluorouracil was reported. The primary
      lesion and liver metastases achieved complete response (CR) but the lung
      metastases attained only partial response. CR was, however, achieved by another
      regimen of chemotherapy. Forty months after the initiation of treatment, brain
      metastasis was recognized, which was controlled by radiotherapy. The patient is
      still alive three years after the onset of disease but with lung metastases.
      Quality of life in these 3 years was considered to be relatively good.

PMID- 2230450
TI  - [Respiratory function in respiratory failure].

PMID- 2230451
TI  - [Causative diseases of respiratory failure].

PMID- 2230452
TI  - [Hemodynamics of respiratory failure].

PMID- 2230453
TI  - [Clinical significance of sleep and exertion in respiratory failure].

PMID- 2230454
TI  - [Epidemiology and prognostic factors in respiratory failure].

PMID- 2230455
TI  - [Respiratory failure and oxygen inhalation therapy].

PMID- 2230456
TI  - [Treatment of acute respiratory failure].

PMID- 2230458
TI  - [Multiple organ failure].

PMID- 2230457
TI  - [Therapeutic management of chronic respiratory failure].

PMID- 2230459
TI  - [Future aspects of home oxygen therapy of respiratory failure].

PMID- 2230460
TI  - [An adult case of Alagille syndrome].

PMID- 2230461
TI  - [A case of systemic lupus erythematosus complicated by primary malignant of the
      liver].

PMID- 2230462
TI  - [A case of lupus cystitis complicated by membranous lupus nephritis].

PMID- 2230463
TI  - [Important points in diagnosis of thyroid diseases].

PMID- 2230464
TI  - [Essential diagnostic tests for diagnosis of thyroid diseases].

PMID- 2230465
TI  - [Important points in diagnosis of thyroid functional disorders ].

PMID- 2230466
TI  - [Important points in needle aspiration cytodiagnosis of thyroid diseases].

PMID- 2230467
TI  - [Etiology of Basedow's disease ].

PMID- 2230468
TI  - [Etiology and physiopathology of Hashimoto's disease ].

PMID- 2230469
TI  - [ Therapy and physiopathology of hypothyroidism].

PMID- 2230470
TI  - [Thyroid hormone resistance syndromes].

PMID- 2230471
TI  - [Conservative therapy of thyroid tumors ].

PMID- 2230472
TI  - [Diagnostic errors in thyroid diseases ].

PMID- 2230473
TI  - [Iodine and thyroid gland function ].

PMID- 2230474
TI  - [ Clinical diagnosis and therapy of thyroid diseases].

PMID- 2230475
TI  - [A case of chronic myeloid leukemia with tumor formation in megakaryoblastic
      crisis].

PMID- 2230476
TI  - [Two cases of bi-phenotypic type hybrid acute leukemia with 8;21 translocation].

PMID- 2230477
TI  - [A case of chronic rheumatoid arthritis with high level of anti-DNA antibody and
      complement deficiency].

PMID- 2230478
TI  - [Prevention of viral hepatitis].

PMID- 2230479
TI  - [Differential diagnosis of acute viral hepatitis].

PMID- 2230481
TI  - [Treatment of hepatitis B].

PMID- 2230480
TI  - [Prediction, diagnosis and therapy of fulminant hepatitis].

PMID- 2230482
TI  - [Clinical study of alcoholic hepatitis].

PMID- 2230483
TI  - [A case of vitamin E deficiency polyneuropathy after gastrectomy].

PMID- 2230484
TI  - [A case of non-cirrhotic portal-systemic encephalopathy treated by surgical
      portasystemic shunt ].

PMID- 2230486
TI  - [A case of malignant lymphoma associated with diabetes insipidus].

PMID- 2230485
TI  - [A case of Reifenstein syndrome].

PMID- 2230487
TI  - [Progress on diagnosis and therapy of viral hepatitis].

PMID- 2230488
TI  - [Clinical significance of hepatitis B virus markers ].

PMID- 2230489
TI  - The management of fractures in the hand.

PMID- 2230490
TI  - Sub-ungual melanoma.

PMID- 2230491
TI  - Peripheral nerve surgery today: turning point or continuous development?

PMID- 2230492
TI  - Subungual melanoma of the hand.
AB  - Thirteen patients with subungual melanoma on the fingers had a mean delay before
      diagnosis of 1.2 years. Four patients presented with local recurrence after
      inadequate initial treatment and two presented with systemic metastases. Mean
      primary subungual melanoma thickness was 6.1 mm. and nine patients had Clark
      level IV or V disease. All patients underwent digital amputation. Two of seven
      patients who had localised disease initially are alive at 29 and 44 months. One
      of four patients who had locally recurrent melanoma is alive at 36 months. Both
      patients with systemic disease at presentation died. Advanced disease and delayed
      presentation contributed to the poor prognosis of subungual melanoma in our
      patients.

PMID- 2230494
TI  - Metacarpal fractures and the clamp-on plate.
AB  - Since internal fixation of metacarpal fractures has a high complication rate,
      most fractures should be managed conservatively, with the emphasis on early
      mobilisation. However, some fractures do need internal stabilisation. We propose
      the use of the clamp-on plate, which is simple to use, has a very low
      complication rate and allows immediate mobilisation.

PMID- 2230493
TI  - The conservative management of Bennett's fracture-dislocation: a 26-year follow
      up.
AB  - Seventeen patients who had suffered a Bennett's fracture-dislocation have been
      reviewed with an average follow up of 26 years. All were treated conservatively.
      At review, only seven patients had symptoms, but all had a decreased range of
      movement and grip strength. Twelve had a characteristic deformity in the hand.
      Radiographs showed persistent subluxation of the first carpo-metacarpal joint and
      marked degenerative changes. We suggest that, in the light of the poor long-term
      outcome, this injury should not be managed conservatively but by some operative
      means.

PMID- 2230495
TI  - Why all finger fractures should be referred to a hand surgery service: a
      prospective study of primary management.
AB  - The quality of the treatment of finger fractures by Accident and Emergency
      Department staff has been prospectively assessed during a six-month period. 678
      finger fractures were seen in the A. & E. Department. The primary treatment of
      624 of these was performed by the A. & E. staff, but in 169 of these (27%), the
      treatment was inappropriate. Most management errors were elementary; they
      included failure to prescribe antibiotics for compound fractures, failure to
      reduce displaced fractures accurately and unsatisfactory splintage. It is
      recommended that all finger fractures should be assessed and treated by surgeons
      with training in the management of hand injuries.

PMID- 2230496
TI  - The Stockport Serpentine Spring System for the treatment of displaced comminuted
      intra-articular phalangeal fractures.
AB  - A new system has been designed to treat displaced comminuted intra-articular
      phalangeal fractures and 20 such fracture-dislocations were treated by it.
      Nineteen of the patients were satisfied at an average follow-up period of 13.6
      months, with a mean total active motion of 226 degrees. The results are rewarding
      considering the gravity of the injuries.

PMID- 2230497
TI  - Brachioradialis transfer for digital palsy.
AB  - Although brachioradialis tendon transfer is thought to offer limited tendon
      excursion and finger motion, we have used it to restore active thumb and digital
      function in eight patients. Three had Volkmann's contracture, one avulsion of
      forearm muscles and four had tetraplegia resulting in inability to perform
      activities of daily living and loss of pinch or grasp and extrinsic extension.
      The brachioradialis was transferred to the flexor pollicis longus, to the flexor
      digitorum profundus or to the common digital extensors. Except for one patient
      who had unremitting pain, all were pleased with their improved motion, pinch,
      grip, and independence. Function, however, remained abnormal in all but one.

PMID- 2230498
TI  - Brachioradialis forearm flap in a case of traumatic bone and skin loss at the
      elbow.
AB  - A case of traumatic skin and bone loss at the elbow is described. This was
      treated by a long brachioradialis flap, allowing early movements with thick and
      sensate cover. Anatomical studies delineate the extent of this flap.

PMID- 2230500
TI  - Is the treatment of enchondroma in the hand by simple curettage a rewarding
      method?
AB  - 46 enchondromata of the hand have been treated by simple curettage without bone
      grafting. 82% healed and 16% were left with only small bone defects. Only one
      patient had a clear-cut recurrence requiring re-operation. This simple method,
      performed on out-patient basis, is recommended.

PMID- 2230499
TI  - On the treatment of enchondroma.
AB  - We recommend simply removing an enchondroma without filling the cavity with
      cancellous bone or plaster-of-Paris. This method can also be applied to other
      benign bone conditions, such as aseptic necrosis.

PMID- 2230501
TI  - Properties of the fibrous structures of the wrist.
AB  - Every fibrous structure of ten wrists of fresh cadavers has been the object of an
      elastometric study. The opposite wrists have been studied surgically and then
      histologically with the optical microscope. Comparison between the two shows a
      close relationship between the mechanical features and the morphology of the
      bundles, which proved also to be perfectly measurable. It also displays the great
      differences between ligaments and tendons. Histological study of the tendons and
      ligaments of four other wrists subjected to manoeuvres of axial loading, rupture
      and bending, reinforces these statements. The therapeutic consequences are
      considered.

PMID- 2230502
TI  - The volar wrist ganglion: just a simple cyst?
AB  - The results of operation on 71 volar wrist ganglia are reported. The recurrence
      rate was 28%, occurring between 1 and 144 months (median: 5 months). The highest
      risk of recurrence is in a male patient, under 30 years of age, in a manual
      occupation, operated on by a junior surgeon. The use of a post-operative plaster
      slab seemed to be followed by significant wrist stiffness. 28% of the patients
      had evidence of damage to the palmar cutaneous branch of the median nerve. It is
      suggested that this could be avoided by positive identification of this nerve at
      operation.

PMID- 2230503
TI  - Volar wrist ganglia cured by carpal tunnel decompression.
AB  - Three patients are described, each of whom had both carpal tunnel syndrome and a
      volar wrist ganglion. Carpal tunnel decompression caused resolution of the
      ganglion. This suggests that both disorders may be caused by the same pressure
      phenomenon.

PMID- 2230504
TI  - Ice-skating injuries to the hand.
AB  - 166 patients with injuries due to ice-skating were seen in the local accident and
      emergency department over a six-month period; 60% of these involved the upper
      limb. 28 of the upper limb injuries were closed fractures and 24 were
      lacerations, almost all to the dorsum of the hand. The use of protective gloves
      would help to prevent these potentially avoidable injuries. "On-site" first-aid
      facilities help to reduce the demand on the local accident service.

PMID- 2230505
TI  - Morphological variations of the ulnar styloid process.
AB  - P.A. radiographs of both wrists were taken in 400 normal individuals to study the
      configuration of the styloid process of the ulna. Five different morphological
      variations were noticed, the commonest being an elongated process (102 wrists).
      Medially deviated (41 wrists), parrot beaked (27 wrists) and hypertrophic (16
      wrists) patterns were less common. One person had bilateral unfused separate
      ossification centres for the ulnar styloid. There was no correlation between the
      length of the styloid process and ulnar variance.

PMID- 2230506
TI  - Painful hypertrophic non-union of the ulnar styloid.
AB  - We report the case of a 16-year-old girl suffering from painful hypertrophic non
      union of the ulnar styloid. She fractured the distal end of the radius four years
      before and had been treated conservatively. The non-union was painful and
      severely limited the range of movement of the wrist. Excision of the
      hypertrophied styloid was performed and the patient promptly resumed her
      activities. We believe this is the first such case reported in an adolescent.

PMID- 2230508
TI  - Intramuscular haemangioma of the forearm.
AB  - Intramuscular haemangioma, though benign, may be a serious disorder, because its
      large size can cause functional impairment, pain and disfigurement, which may
      require surgical excision. These, as well as the baffling histopathological
      aspects, are exemplified by this report of an intramuscular haemangioma of the
      forearm in an adolescent girl. Clinical recognition of a cutaneous angioma
      overlying a deeply-situated soft tissue tumour may aid the diagnosis of an
      intramuscular haemangioma.

PMID- 2230507
TI  - A study of age-related changes of the articular disc of the wrist in Hong Kong
      Chinese.
AB  - A cadaveric study of age-related changes in the triangular fibrocartilage of the
      wrist in Hong Kong Chinese confirms the high incidence of tears with increasing
      age. There appears to be two distinct types, linear and degenerate, with no clear
      evidence that the former is simply a precursor of the latter.

PMID- 2230509
TI  - Day surgery: an economical way to reduce waiting lists.

PMID- 2230510
TI  - Isolated dorsal dislocation of the scaphoid.
AB  - A case of isolated dorsal dislocation of the scaphoid is reported. The patient
      was treated surgically with a good result.

PMID- 2230511
TI  - Rupture of flexor pollicis longus as a complication of Colles' fracture: a case
      report.
AB  - A case of flexor pollicis longus tendon rupture as a complication of a Colles'
      fracture in a 17-year-old male is described. Tendon repair by means of a one
      stage tendon graft produced a good functional result.

PMID- 2230512
TI  - Fibroma of tendon sheath with bone involvement.
AB  - The case is reported of a 62-year-old man presenting with a fibroma of tendon
      sheath of the left little finger with bone involvement. This is only the third
      such case reported. A brief discussion of this benign soft tissue tumour follows.

PMID- 2230513
TI  - Angiolymphoid hyperplasia with eosinophilia in the hand: a case report.
AB  - Angiolymphoid hyperplasia is an uncommon condition which may give rise to
      difficulty in diagnosis. The case described was originally regarded as Kaposi's
      sarcoma, but H.I.V. testing was negative. Excision of a further lesion
      established the diagnosis as angiolymphoid hyperplasia.

PMID- 2230514
TI  - Loss of proximal phalanx of thumb following a closed injury.

PMID- 2230515
TI  - Surgical emphysema of the dorsum of the hand.

PMID- 2230516
TI  - Founders of hand surgery. Recollections of Archibald McIndoe.

PMID- 2230517
TI  - A modified continuous passive motion apparatus.

PMID- 2230518
TI  - Ligament reconstruction in tendon interposition arthroplasty of the trapezium.

PMID- 2230519
TI  - Flexor tendon surgery. Part I: Primary flexor tendon repair.

PMID- 2230520
TI  - Re: Lymphangiosarcoma of the hand.

PMID- 2230521
TI  - Macroglossia: a review.
AB  - Macroglossia is defined as a resting tongue that protrudes beyond the teeth or
      alveolar ridge. Complications of macroglossia include articulation errors,
      mandibular deformities, deglutition difficulties, and airway obstruction.
      Etiologies include hypothyroidism, the Beckwith-Wiedemann syndrome,
      lymphangiomatosis, and amyloidosis. Surgical correction of this condition at an
      early age may prevent or minimize the maxillofacial deformities and speech
      defects.

PMID- 2230522
TI  - A fatal case of disseminated coccidioidomycosis in Louisiana.
AB  - We are reporting a fatal case of coccidioidomycosis, which is an uncommon mycotic
      infection in Louisiana. The patient was a 21-year-old, apparently
      immunocompetent, pregnant black woman who had fever of unknown origin for 6
      weeks. She had recently moved from Arizona. Despite her progressively worsening
      condition, the patient delivered a baby girl who has been doing well. An
      exhaustive workup and a laparotomy failed to lead to the diagnosis. The diagnosis
      was established by trans-bronchial biopsy a day before her death. At autopsy,
      disseminated coccidioidomycosis was observed. A review of the mycology records of
      Charity Hospital of New Orleans revealed this to be the second case of
      coccidioidomycosis in 20 years. Coccidioidomycosis should be considered in the
      differential diagnosis of fever of unknown origin in Louisianians who have lived
      in endemic areas, especially in pregnant patients, who are at an increased risk
      of disseminated infection.

PMID- 2230524
TI  - A case report of meningitis caused by penicillin resistant Streptococcus
      pneumoniae.
AB  - We report a case of invasive disease caused by penicillin resistant Streptococcus
      pneumoniae. The prevalence of penicillin and multiple drug resistant pneumococcal
      strains is increasing worldwide. We must assume that the incidence of clinically
      significant illness caused by these agents will also increase. Based on this
      assumption, we make suggestions as to how clinicians should alter their
      therapeutic approach to pneumococcal illness.

PMID- 2230523
TI  - The role of bacterial cultures from bronchoscopy washings in AIDS related
      patients.
AB  - The clinical significance of bronchoscopy washing cultures for bacteria had been
      questioned before the era of the acquired immune deficiency syndrome (AIDS), and
      the procedure was felt to be misleading more than helpful. Little has been
      mentioned of its utility in AIDS patients undergoing fiberoptic bronchoscopy. The
      correlation of these cultures was retrospectively reviewed for 30 bronchoscopies
      performed in 26 patients with advanced AIDS related illnesses. Normal respiratory
      flora was the most common finding in 14/28 (50%) of the cultures submitted,
      followed by Staphylococcus aureus in 7/28 (25%). Correlating chest radiographs
      with culture results revealed that in only five cases were cultures definitely or
      possibly relevant. All five had radiographic changes compatible with bacterial
      processes, and clinical findings suggestive of disease. The routine submission of
      bronchoscopy washings for bacterial culture in patients with HIV associated
      disease should be discouraged without clinical and radiologic correlation.

PMID- 2230525
TI  - ECG of the month. Spikes. Cardiac pacemaker rhythm.

PMID- 2230526
TI  - Radiology corner. Adrenal myelolipoma.

PMID- 2230527
TI  - Heparin, the miracle drug: a brief history of its discovery.
AB  - Heparin is a drug used widely in almost every field of medicine; nevertheless,
      very little is known about its discovery. Jay McLean, a second year medical
      student at Johns Hopkins University, discovered this wonderful drug in 1916 while
      performing research in the laboratory of W.H. Howell, MD. This is a brief account
      of the story told by Dr McLean before his death.

PMID- 2230528
TI  - Preoperative chemotherapy is beneficial for geriatric patients with locally
      advanced and metastatic breast cancer.
AB  - The relationship between aging and drug toxicity has been documented. We reviewed
      patients with Stage IIIB and Stage IV breast cancer with the primary tumor intact
      at presentation to compare the toxicity secondary to chemotherapy, the disease
      free survival, and the survival in both young and elderly women. Fifty-three
      patients were studied. All received preoperative chemotherapy and mastectomy as
      part of treatment for breast cancer. Sixty years was used arbitrarily to divide
      the patients into two groups. Data were analyzed by unpaired T-test. Hematologic,
      nutritional, infectious, and cardiac toxicities were noted and compared between
      groups. Disease-free survival was studied in patients with Stage IIIB disease.
      Survival was examined in patients with Stage IIIB and Stage IV disease. We could
      not detect any statistically significant differences between young and elderly
      patients in any of these groups. The elderly patients in this study seemed to
      derive as much benefit from chemotherapy as did younger patients.

PMID- 2230529
TI  - Pulmonary fibrosis as the initial manifestation of scleroderma.
AB  - We report a patient who developed pulmonary fibrosis before the appearance of
      cutaneous scleroderma. This unusual clinical presentation has been infrequently
      reported in the English literature. Recognition that pulmonary disease may occur
      before extensive skin changes in scleroderma is important to ensure proper
      management.

PMID- 2230530
TI  - The Louisiana cancer problem. Questions and answers.

PMID- 2230531
TI  - Atresia of the external auditory canal.
AB  - External auditory canal atresia (EACA) can occur bilaterally as well as
      unilaterally. Usually there is an accompanying auricular deformity. Surgical
      intervention in bilateral cases is mandatory to promote normal speech and
      language development. Unilateral EACA cases often do not receive surgical
      intervention until the patient is 18 years of age. Preoperative evaluation of the
      EACA patient requires behavioral audiometry, auditory brain stem evoked response,
      and a computerized tomographic scan.

PMID- 2230532
TI  - The rise of medical journalism in the United States.

PMID- 2230533
TI  - The immunologic paralysis of congenital infection.

PMID- 2230534
TI  - Building bridges in molecular rheology: the role of the microenvironment in
      platelet thrombogenesis.

PMID- 2230535
TI  - Stable isotope tracers for studies of glucose metabolism.

PMID- 2230536
TI  - Serum ferritin values in elite speed and synchronized swimmers and speed skaters.
AB  - Reports of subnormal serum ferritin values for elite athletes are widespread.
      Human studies evaluating performance in the ferritin-depleted state have led to a
      questioning of the significance of low ferritin levels for athletic performance.
      However, the accelerated iron metabolism and subnormal iron intake-uptake
      demonstrated by some athletes suggests that a point occurs in training at which
      the body must draw on its reserves. In consideration of this problem, serum
      ferritin, hemoglobin, hematocrit, serum Fe, and total iron-binding capacity
      levels were measured in elite Canadian female synchronized swimmers (n = 9), male
      speed swimmers (n = 7), and male and female speed skaters (n = 6, n = 6) over the
      course of two seasons of training and competition. Training sessions were
      monitored to document the workload carried out by each athlete. The midseason
      serum ferritin team values for the first and second years (mean +/- SEM) were as
      follows: synchro 48 +/- 10 micrograms.1 L, 24 +/- 6 micrograms.1 L; female speed
      skaters 57 +/- 14 micrograms.1 L, 51 +/- 7 micrograms.1 L; male speed skaters 94
      +/- 27 micrograms.1 L, 72 +/- 19 micrograms.1 L; and male swimmers 66 +/- 13
      micrograms.1 L, 56 +/- 7 micrograms.1 L. A significant decrease was seen in both
      serum ferritin and hemoglobin for the synchronized swimmers and in serum ferritin
      for the male speed skaters (p less than 0.05). These results suggest that a
      tendency exists for a decrease in serum ferritin levels from season to
      season.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230537
TI  - Lipid peroxidation and expression of copper-zinc and manganese superoxide
      dismutase in lungs of premature infants with hyaline membrane disease and
      bronchopulmonary dysplasia.
AB  - The putative involvement of reactive oxygen species in the etiology of lung
      damage in infants receiving mechanical ventilation has been examined by comparing
      the levels of peroxidation and expression of the antioxidant enzymes, CuZn and Mn
      superoxide dismutase, in lungs from control and affected infants as well as from
      fetuses and infants who died postnatally after term delivery. Mean levels (+/-
      SD) of lung peroxidation, determined with a thiobarbituric acid method, were
      similar in affected and control premature neonates and in fetal subjects (1.87 +/
      1.26, 1.92 +/- 2.07, and 1.19 +/- 1.36 nmol/mg protein, respectively).
      Expression of CuZn and Mn superoxide dismutases was also similar in these
      subjects and in the patients who died postnatally. Thus activity measurements and
      immunoblotting studies showed continuous expression of these enzymes throughout
      development with no apparent change in protein levels or size.
      Immunohistochemical examination of lung tissue showed expression of CuZn and Mn
      superoxide dismutases in epithelial, smooth muscle, endothelial, and some
      mesenchyme components. In patients with bronchopulmonary dysplasia, alveolar
      walls were thickened by an excess of fibrous tissue and terminal air spaces were
      lined mainly by type II pneumatocytes. All structures, including abnormal fibrous
      components, were positive for both CuZn and Mn superoxide dismutase. Our data
      show that, unlike some experimental animals, expression of at least these
      antioxidant enzymes in human infants born prematurely is similar to that in
      adults, and indicate that such infants are better adapted for life in an oxygen
      containing environment than previously suspected.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2230538
TI  - Glutathione, glutathione S-transferase, and transmembrane transport of
      glutathione conjugate in human neutrophil leukocytes.
AB  - Glutathione (GSH) conjugation is important in the detoxification of carcinogens
      and other exogenous electrophilic drugs and chemicals. The conjugation is
      catalyzed by GSH S-transferase. Neutrophil GSH content was 12.3 +/- 2.5 (mean +/-
      SD) nmol/10(7) cells, and transferase activity of cytosol preparations was 0.187
      +/- 0.035 nmol/min/mg protein with 1-chloro-2,4-dinitrobenzene (CDNB) as
      substrate. Maximal activity was found at a pH of 7.0 and a temperature of 40
      degrees C. Apparent Km of transferase was 1.25 +/- 0.18 mmol/L CDNB, and apparent
      Vmax was 0.621 +/- 0.22 nmol/min/mg. GSH-CDNB conjugate was quantitated by HPLC
      in cells and in medium after CDNB exposure. Transport of conjugate from cells to
      medium increased with CDNB concentration to 50 mumol/L, and kinetic data showed
      two saturable transport mechanisms with apparent Km of 5.90 mumol/L and 0.265
      mumol/L, respectively. Cellular GSH content fell rapidly with CDNB concentration
      greater than 2.5 mumol/L, and was depleted in a 10-minute incubation at a
      concentration of greater than 50 mumol/L CDNB. Neutrophils have a significant
      content of GSH and a significant amount of transferase activity, and transport of
      GSH conjugate involves two distinct saturable pathways. GSH depletion can be
      accomplished with a relatively low concentration of an exogenous chemical and
      could impair the ability of the cells to carry out their phagocytic functions.

PMID- 2230539
TI  - Conjugated catecholamines in human plasma: where are they coming from?
AB  - The origins of conjugated catecholamines remain poorly known. The aim of the
      present study was to see whether a major contribution comes from the sympathetic
      nervous system. We have assumed some kind of parallelism between the activity of
      the sympathetic nervous system, the amount of catecholamines released and taken
      up, and the amount of conjugated catecholamines circulating in plasma.
      Accordingly, an increase in sympathetic activity should be followed by an
      increase in the plasma level of conjugated catecholamines. The plasma levels of
      sulfoconjugated and glucuroconjugated catecholamines were measured in 10 patients
      with mental disease resistant to drug treatment, before and after
      electroconvulsive therapy. As expected, blood pressure, norepinephrine
      concentration, and epinephrine concentration in plasma were transiently
      increased. Neither sulfoconjugated nor glucuroconjugated catecholamines were
      significantly changed. Conjugated catecholamines were measured in 10 volunteers
      before and at the nadir of insulin-induced hypoglycemia. As expected, plasma
      levels of norepinephrine and epinephrine were drastically increased. Plasma
      levels of sulfoconjugates were decreased and glucuroconjugates increased; these
      were narrow but statistically significant variations. Data reported in the
      present article do not support a major role for the activity of the sympathetic
      system in fixing the level of conjugated catecholamines in human plasma. This is
      a negative, but nonetheless important, observation. In human subjects, currently
      available information suggests an important role for the intestinal wall and
      renal function in determining the level of circulating sulfoconjugates.

PMID- 2230540
TI  - Deposits of crystalline material containing silicon in surgically excised human
      valves.
AB  - Ninety-seven surgically excised natural cardiac valves were examined by scanning
      electron microscopy and x-ray energy spectroscopy to assess the occurrence of
      crystalline deposits that contain the element silicon. Valves examined included
      33 mitral valves, 63 aortic valves, and 1 tricuspid valve. To reduce the
      possibility of surface contamination, the deep layers of some valves were
      examined after exposure by fracture of the valve. Crystalline material containing
      silicon was observed in the deep tissue. Such crystalline material was sometimes
      entwined within subendothelial fibers. Crystalline deposits that contained
      silicon were associated with 34 of 97 of these valves (35%). Among the 34 valves
      that showed silicon, 24 (71%) also showed microdeposits of calcific material. In
      view of evidence that silicon may participate in the calcification of bone, and
      is found in the intima of arteries, a role for this element in ectopic
      calcification of valves may exist.

PMID- 2230541
TI  - Effect of fasting on the lung glutathione redox cycle in air- and oxygen-exposed
      mice: beneficial effects of sugar.
AB  - Fasting increases susceptibility to hyperoxic lung damage in mice, at least in
      part, by decreasing lung glutathione level. To determine whether fasting alters
      other components of the glutathione redox cycle, and whether a diet of sugar
      alone reverses fasting's effects, normally fed, sugar-fed, and fasted mice were
      exposed to room air or 100% oxygen for up to 4 days. In air-exposed mice, fasting
      decreased glutathione peroxidase (GP) and glutathione reductase (GR) activities
      15% to 20% on days 3 and 4 (p less than 0.01) and glutathione level 25% to 30% on
      days 2 to 4 (p less than 0.05). When corrected for protein concentration, GP and
      GR values were similar to those in the fed mice, but glutathione levels remained
      lower on days 2 and 3 (p less than 0.05). Oxidized glutathione (GSSG) was
      unchanged, but the ratio of GSSG to total glutathione (reduced glutathione plus
      GSSG) increased on day 2 (p less than 0.05). In oxygen-exposed fed mice, GP
      increased 62% and GR increased 39% on day 4 (p less than 0.05), the time when the
      lung injury was most severe; glutathione increased 30% on days 3 and 4 (p less
      than 0.05); and GSSG increased threefold and eightfold on days 3 and 4 (p less
      than 0.01). Oxygen-exposed fasted mice were all dead by day 3 (versus no deaths
      in the fed mice), failed to increase GR and total glutathione in response to the
      oxidant stress, and increased GP and GSSG on day 3 to the same extent as the fed
      mice did on day 4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230542
TI  - Serum immunoglobulins E and G anti-Aspergillus fumigatus antibody in patients
      with cystic fibrosis who have allergic bronchopulmonary aspergillosis.
AB  - Patients with cystic fibrosis frequently have pulmonary colonization with
      Aspergillus fumigatus (Af) and develop anti-Af immunoglobulin E (IgE) and IgG
      antibodies. The diagnosis of allergic bronchopulmonary aspergillosis in subjects
      with cystic fibrosis is difficult because of the high incidence of Af
      colonization, with development of humoral antibody responses. In this study, we
      sequentially measured serum anti-Af IgE (Af-E) and IgG (Af-G) antibodies by ELISA
      in subjects with cystic fibrosis. In subjects with cystic fibrosis who have
      allergic bronchopulmonary aspergillosis, Af-E and Af-G antibodies were
      significantly increased when compared with other groups of patients with cystic
      fibrosis who had positive skin tests or precipitins to Af (or both) (p less than
      0.01, p less than 0.01, respectively). In addition, increased Af-E and Af-G
      levels were sometimes seen in other groups, especially subjects with cystic
      fibrosis who had positive Af skin tests or precipitin tests, two of whom later
      developed criteria diagnostic of allergic bronchopulmonary aspergillosis. Thus,
      serum Af-E and Af-G levels were quantitatively increased in subjects with cystic
      fibrosis who had allergic bronchopulmonary aspergillosis and thus adjunctive data
      in diagnosis. However, it also suggested that subclinical pulmonary inflammation
      may also occur.

PMID- 2230544
TI  - Clinical and experimental. Zinc metabolism in patients with the syndrome of iron
      deficiency anemia, hepatosplenomegaly, dwarfism, and hypogonadism. 1963.

PMID- 2230543
TI  - Exacerbation of acute platelet thrombus formation in stenosed dog coronary
      arteries with smoke from a non-tobacco-burning cigarette.
AB  - The tobacco industry proposes to release a "new" cigarette with a burning
      charcoal tip, which heats the tobacco as air is drawn through it and into the
      lungs of the smoker. It is claimed to be safer because the tobacco does not burn.
      Using our established canine model of coronary artery stenosis with moderate
      intimal damage, we compared this new cigarette (0.4 mg nicotine) with a regular
      cigarette by ventilating dogs (n = 10) with room air and then either new or
      regular smoke (two cigarettes over about 10 minutes). In our dog model, periodic
      acute platelet thrombus formation followed by embolization produced cyclical flow
      reductions in coronary blood flow where the rate of flow decline was proportional
      to the degree of in vivo platelet-vessel wall interaction. The rate of flow
      decline increased from -4.81 +/- 1.29 ml/min2 to -9.60 +/- 2.29 ml/min2 after
      ventilation with the new-type smoke (p less than 0.01). Similarly, the rate of
      flow decline increased from -5.43 +/- 1.28 ml/min2 to -9.28 +/- 2.31 ml/min2
      after ventilation with regular cigarette smoke (p less than 0.01). Despite the
      lack of a clear causal link between cigarette smoking and the acute
      manifestations of cardiovascular disease, the data presented here indicate that
      the new cigarette is just as potent as regular cigarettes at increasing in vivo
      platelet activity and exacerbating acute platelet thrombus formation in the dog.
      We conclude that the new proposed non-tobacco-burning cigarette has deleterious
      effects similar to those of conventional cigarettes, and thus does not eliminate
      smoking as a risk factor in cardiovascular disease in human beings.

PMID- 2230545
TI  - Mosby-Year Book, Inc., through 84 years of scientific publishing.

PMID- 2230546
TI  - The role of functional dorsal rhizotomy for the treatment of children with
      spastic cerebral palsy.
AB  - Functional dorsal rhizotomy is now a frequently used procedure in the treatment
      of spastic cerebral palsy. Appropriate candidate selection is imperative for good
      results to be achieved. The pathophysiology of spasticity and candidate selection
      criteria are discussed.

PMID- 2230547
TI  - Outpatient left heart and coronary arteriography. The current practice at the
      University of Louisville School of Medicine.
AB  - The extension of coronary arteriography into the out-patient population provides
      more rapid assessment and determination of severity of coronary artery disease in
      a primary care and referred base population. The speed of the procedure and
      reduced recovery period are reflected in enhanced cost containment and improved
      patient compliance and satisfaction. Further technological advancement in this
      rapidly developing technological field continues to provide improved patient
      care.

PMID- 2230548
TI  - Current management of soft tissue sarcomas.
AB  - Sarcomas are rare. They comprise a heterogenous group of malignancies. Prognosis
      is determined by presence of distant metastasis, the size of the primary
      malignancy, and the grade and histogenic classification of the tumor. Careful
      consideration of the extirpative surgical resection is necessary for appropriate
      placement of the biopsy incision for diagnosis. Effective therapy includes
      adequate surgical resection in the form of radical compartmental resection, wide
      local excision with either pre- or postoperative radiotherapy, or amputation.
      Progress over the last two decades has resulted in limb salvage and maintenance
      of limb function for the vast majority of patients.

PMID- 2230549
TI  - Unterberger stepping test: a useful indicator of peripheral vestibular
      dysfunction?
AB  - Deviation of gait in a stepping test has been proposed as a useful indicator of
      peripheral labyrinthine dysfunction. A prospective study of 26 patients suspected
      of having uncompensated peripheral labyrinthine dysfunction and 49 normal
      patients with normal labyrinthine dysfunction showed no significant difference in
      performance of the Unterberger stepping test between patients with
      electronystagmographically significant canal paresis and those with normal
      vestibular function.

PMID- 2230550
TI  - Size variation of mastoid air cell system in Indian people at different age
      groups: a radiographic planimetric study.
AB  - A radiographic planimetric study of mastoid air cell system was carried out on
      100 normal human subjects of which 50 were males and 50 females--who were further
      subdivided into five age groups. They had no history of past ear disease or any
      other clinical ENT abnormality. The mean area of the mastoid air cell system was
      measured planimetrically on X-rays and the data analysed according to age and
      sex. It was 12.05 +/- 0.67 cm2 in males and 11.45 +/- 0.70 cm2 in females (which
      are more or less the same as that of Western people). The size of the cranial
      bones has no apparent role in the size variation of the mastoid air cell system.
      The development of the latter was very rapid up to 10 years of age in both sexes
      and it continued even after 20 years of age but at a much slower rate.

PMID- 2230551
TI  - Ligmaject system for local anaesthesia in otology.
AB  - The Ligmaject syringe for local anaesthetic injection incorporates a pistol-grip
      handle and a ratchet system designed to inject a very tiny aliquot of anaesthetic
      per 'click'. This instrument was used to provide local anaesthesia for 22
      otological procedures on consenting adults. The performance of the Ligmaject
      syringe compared favourably with that of the conventional dental syringe in terms
      of patient acceptability and user convenience.

PMID- 2230552
TI  - Comparison of the Goode T-tube with the Armstrong tube in children with chronic
      otitis media with effusion.
AB  - Treatment of otitis media with effusion is focused on reaeration of the middle
      ear cavity. In achieving long-term aeration, the insertion of ventilation tubes
      that have a long duration of stay can be beneficial. The results are presented of
      a trial in which the Goode T-tube was compared with the Armstrong tube. Fifteen
      children were treated between 1981 and 1986 with a T-tube in one ear and a
      conventional tube in the other. The results are different with regard to duration
      of stay in the tympanic membrane. Re-insertions were necessary in 47 per cent in
      the Armstrong group and in 20 per cent in the T-tube group. Otorrhoea occurred in
      20 per cent of the Armstrong and 13 per cent of the T-tube intubated ears. A
      persistent perforation was present in 6 per cent of the ears in both groups. It
      is concluded that the Goode T-tube is indicated primarily in cases when long-term
      ventilation is needed.

PMID- 2230553
TI  - Delayed facial palsy following uncomplicated stapedectomy.
AB  - We report six cases of partial lower motor neurone facial palsy occurring between
      four and ten days after uncomplicated stapedectomy. The aetiology is unclear but
      recovery was rapid and complete in all patients.

PMID- 2230554
TI  - Long-term results of revision endolymphatic sac surgery.
AB  - The results of revision endolymphatic sac surgery on 30 patients with unilateral
      Meniere's disease are presented. Good control is achieved in 73.3 per cent of
      cases at six months, falling to 56.7 per cent at one year and only 33.3 per cent
      by four years. The long-term results are disappointing but are more favourable if
      the initial surgery was successful, if the hearing remains fluctuant and improves
      on glycerol dehydration prior to the revision procedure and also if the sac is
      intubated. The current place of endolymphatic sac surgery is discussed and
      revision surgery only recommended for carefully selected cases.

PMID- 2230555
TI  - Comparison of electro and chemical cautery in the treatment of anterior
      epistaxis.
AB  - In the ENT Department of the Royal Victoria Hospital, Belfast, the impression
      (supported only by anecdotes) was that electro-cautery was superior to chemical
      cautery in the treatment of simple anterior epistaxis. Since no evaluation of the
      relative merits of electro and chemical cautery has been reported, a prospective
      randomized study was conducted to assess the effectiveness of electro-cautery and
      cautery with silver nitrate. The results of the study showed that there was no
      statistically significant difference between the two methods in either
      controlling the epistaxis or in the incidence of complications. It is concluded
      that since cautery with a silver nitrate tipped applicator is simpler, and of
      equal effectiveness, it would appear to be the treatment of choice for simple
      anterior epistaxis.

PMID- 2230556
TI  - Role of endoscopy in diagnosing scleroma in its uncommon sites.
AB  - Eighty cases suffering from rhinoscleroma were studied. Suspected cases were
      examined by sinoscopy, nasopharyngoscopy and bronchoscopy for detection of
      secondary involvement in these sites. Antroscleroma, salpingoscleroma and tracheo
      bronchoscleroma have been found in a relatively high percentage of cases. The
      role of endoscopy in early diagnosis, initial symptomatic treatment and follow-up
      cases is discussed.

PMID- 2230557
TI  - Laryngeal growth in infancy.
AB  - Growth of the cricoid ring in infants is studied. In the first two weeks of life
      a small ring seems correlated with the fact of early infant death. Therefore we
      suggest that mortuary specimens at this age are not a reliable guide to the size
      of the cricoid in thriving infants. Rates of growth from ages of two weeks to
      three years are given for the specimens examined. Comparison with similar
      measurements carried out in England show that the specimens collected here were
      systematically smaller for a given age.

PMID- 2230558
TI  - Smoking cessation in chronic Reinke's oedema.
AB  - In evaluating the long term results of surgical treatment of Reinke's oedema,
      there has been found to be a high incidence of recurrence. The recurrence rate is
      significantly lower amongst those patients who gave up smoking after treatment. A
      group of patients with chronic Reinke's oedema were followed for six months.
      Maximum efforts were made to help the patients to stop smoking. Twenty-nine
      patients entered the study, but only eight of them (28 per cent) refrained from
      smoking; all were women (39-70 years) and all experienced reduced discomfort,
      although none of the voices were restored to normal. Diffuse laryngitis
      disappeared completely, but the oedema did not disappear entirely in any patient.
      Before treatment of chronic Reinke's oedema patients must be well advised and
      informed, and if surgery is decided upon, they must be urged most strongly to
      stop smoking, if they wish to enhance the possibility of satisfactory long-term
      results.

PMID- 2230559
TI  - Second primary tumours of the larynx following bronchial carcinoma.
AB  - The occurrence of multiple primary malignancies in patients with laryngeal cancer
      is well known. The possibility that lung cancer patients may be at risk of
      subsequent laryngeal cancer is less well recognized. The possibility of laryngeal
      cancer developing later has implications for the follow-up of lung cancer
      patients. Three cases of subsequent laryngeal primary cancer occurring in
      survivors of bronchial cancer are presented and the implications are discussed.

PMID- 2230560
TI  - Alternating cisplatinum and VAC ineffective in end stage squamous cell carcinoma
      of the head and neck.
AB  - Sixteen patients with end stage squamous cell carcinoma of the head and neck were
      admitted to a phase II study of alternating courses of cisplatinum (100 mg/m2)
      and VAC (vincristine 1.4 mg/m2, adriamycin 50 mg/m2, cyclophosphamide 750 mg/m2)
      given at three weekly intervals. Only two patients achieved a response (12 per
      cent). The median survival time was 62 days which is much the same as that of a
      similar group of patients who received no chemotherapy in a previous trial (70
      days).

PMID- 2230561
TI  - Head and neck cancer and ageing: a retrospective study in 438 patients.
AB  - To evaluate whether age over 70 years represents a prognostic factor in head and
      neck cancer, we reviewed all cases observed between 1981 and 1984. Four hundred
      and thirty-eight (438) patients were considered in relation to three age groups
      (less than or equal to 59, 60-69, and greater than or equal to 70 years, defined
      as non-elderly, mid-elderly and elderly respectively). The main parameters
      analyzed included histological diagnosis (no difference emerged among the three
      age groups); anatomical site (hypopharyngeal carcinoma was most frequent in non
      elderly patients); TNM stage (an higher incidence of early stages was seen in the
      elderly); performance status (better in the non-elderly); previous illnesses
      (life-style related diseases were more frequent in the non-elderly);
      contraindications to surgery (more frequent in the elderly); surgical treatment
      ('en bloc' resections were more often employed in the non-elderly); post
      operative complications and local control (no difference between the three
      groups); multiple primary malignancies (head and neck, oesophagus and lung were
      more frequent in non-elderly patients) and survival (no difference). Although age
      affects several features of head and neck cancer patients, it does not appear
      from the present study to be an independent prognostic factor for local control
      and survival. With regard to survival, stage appeared to be the most important
      prognostic factor.

PMID- 2230562
TI  - Endolymphatic hydrops precipitated by haemodialysis.
AB  - We report a case of endolymphatic hydrops preceded by haemodialysis in the
      contralateral ear of a patient with known Meniere's disease, and discuss the
      possible mechanism. It is suggested that the sudden decrease of plasma osmolality
      during haemodialysis acts as a reverse glycerol test. The audiometric and
      electrophysiological recordings pre- and post-dialysis and the induction of the
      Meniere's triad of symptoms during dialysis, were strongly indicative of the
      presence of endolymphatic hydrops.

PMID- 2230563
TI  - Epistaxis as an unusual presentation of an antrochoanal polyp.
AB  - Antrochoanal polyps rarely present with severe epistaxis. We present the case of
      a young male patient who presented in such a manner, thus leading to the
      suspicion of an angiofibroma as the underlying pathology. The radiological
      investigations, treatment and pathological features are discussed.

PMID- 2230564
TI  - A 'silent' intracranial complication of frontal sinusitis.
AB  - Intracranial complications of frontal sinusitis, although rare today, do still
      develop despite widespread use of antibiotics. We report a case which
      demonstrates how silently a frontal lobe abscess may present with subtle changes
      in mood and behaviour, with no focal neurological signs. Diagnosis and management
      are discussed and a brief review of the incidence of intracranial complications
      of frontal sinusitis, mode of spread, clinical presentation, investigations,
      treatment and bacteriology is presented.

PMID- 2230565
TI  - Rhinosporidiosis associated with squamous cell carcinoma in the tongue.
AB  - The peritumoural region of a squamous cell carcinoma of the tongue when examined
      with light and electron microscope showed nodular bodies in the submucosa with
      all the distinctive features of 'sporangium and 'spores' of rhinosporidiosis. The
      occurrence of rhinosporidiosis in the tongue along with malignancy has not been
      reported hitherto. Some interesting observations and causal relationships are
      discussed.

PMID- 2230566
TI  - Infectious mononucleosis complicated by lingual tonsillitis.
AB  - Although upper airway obstruction and superimposed infection are well-known
      complications of infectious mononucleosis, lingual tonsillitis in this context
      has not been mentioned in the literature. We describe a case of acute bacterial
      lingual tonsillitis with airway obstruction complicating infectious
      mononucleosis. The role of the base of tongue region in the pathophysiology of
      infectious mononucleosis is discussed.

PMID- 2230567
TI  - Acute upper airway obstruction following Teflon injection of a vocal cord; the
      value of nebulized adrenaline and a helium/oxygen mixture in its management.
AB  - A 67-year-old man presented with a 45-year history of a week voice. This was
      result of polio which had left him with a right vocal cord palsy. The patient
      underwent a Teflon injection of the right vocal cord under general anaesthesia to
      improve the quality of his voice. In the immediate post-operative period, he
      suffered acute upper airway obstruction. The problem of acute upper airway
      obstruction following Teflon injection is considered and its management with
      nebulized adrenaline and a helium/oxygen mixture is discussed.

PMID- 2230568
TI  - Malignant adenolymphoma of the parotid gland: report of carcinomatous
      transformation.
AB  - Malignant transformation of an adenolymphoma (Warthin's tumour) is a rare event.
      This paper presents a case of carcinoma arising in an adenolymphoma of the
      parotid gland.

PMID- 2230569
TI  - Wegener's granulomatosis: anti-neutrophil cytoplasmic antibody hsi (ANCA)

PMID- 2230570
TI  - Adenocarcinoma of the para-nasal sinuses due to wood dust.

PMID- 2230571
TI  - Decline in the prevalence of childhood deafness in the Jewish population of
      Jerusalem: ethnic and genetic aspects.
AB  - A longitudinal study was performed on 147 Jewish children with bilaterally
      sensorineural hearing loss of moderately severe to profound degree, born in
      Jerusalem during the eighteen years 1968-85. The prevalence rate of these
      children declined during the years 1977-85, and at the same time the rate of
      consanguinity of their parents decreased; this decline was more evident in the
      genetic group among children with non-Ashkenazi ethnic origin. No such decline
      was found among the Ashkenazi children and no consanguinity among parents of
      these children was recorded. Our study supports the assumption that restriction
      of consanguineous matings may affect the prevalence of genetic deafness in
      children in a well-defined population. We have tried to remain unbiased and
      concede certain shortcomings in our present study.

PMID- 2230572
TI  - Dysequilibrium and otitis media with effusion: what is the association?
AB  - An association between non-suppurative otitis media (NSOM) and symptoms of
      dysequilibrium has been observed but not previously quantified in children
      (Gates, 1980; Busis, 1983; Blayney and Coleman, 1984). This study compared the
      incidence of balance related problems in 154 children with surgically proven glue
      ear and 51 children with normal ear function. Symptoms ranging from true vertigo
      to mild ataxia were discovered in 22 per cent of the children with NSOM but in
      none of those within the control group (p less than 0.001). Periods of
      dysequilibrium were associated with episodes of otalgia in 64 per cent of the
      children but were not increased in those with unilateral compared to those with
      bilateral effusions. Complete resolution of symptoms occurred in 85 per cent of
      children following the insertion of grommets. A history of balance disturbance
      should be actively sought in all children with otitis media with effusion, and
      when present, provides a strong indication for early operative intervention.

PMID- 2230573
TI  - Tympanosclerosis of the middle ear: late results of surgical treatment.
AB  - The late results of one stage operation for middle ear tymanosclerosis in 73
      patients during the period January 1965 to December 1980 are presented. Mean
      observation time was 11.2 years (range 3-20.2 years), with a follow-up rate 86
      per cent. Among 64 patients with stapes fixation, 59 had removal of
      tympanosclerotic masses and stapes mobilization, and five cases underwent
      stapedectomy. The series was divided into six groups and the results analyzed.
      The best and most stable results occurred in the group with stapes mobilization
      and an intact ossicular chain followed by the group with stapes mobilization and
      Type II tympanoplasty with incus interposition. The poorest late results were
      obtained in ears with lacking stapes crura and stapes mobilization, and in ears
      subjected to stapedectomy. No case of post-operative sensorineural hearing loss
      occurred. We recommend that care is taken to preserve an intact ossicular chain
      at stapes mobilization performed at the same stage as myringoplasty. Also in ears
      with a defective ossicular chain but intact stapes with tympanosclerotic fixation
      we recommend stapes mobilization in one stage. In ears with fixation of the
      stapes footplate and defective crura, we recommend stapedectomy or stapedotomy in
      two stages.

PMID- 2230574
TI  - Why paranasal sinuses?
AB  - This essay attempts to address the perennial question 'Why Paranasal Sinuses?'.
      In doing so it highlights the flaws in many much-favoured but ill-founded
      theories concerning the role of these sinuses in humans. It is concluded that the
      question can only be fully answered through a greater understanding of
      differential growth changes within the craniofacial massif.

PMID- 2230575
TI  - Mucosal thickening on sinus X-rays and its significance.
AB  - Mucosal thickening is commonly seen on X-rays of the paranasal sinuses taken in
      the ENT department. This sometimes leads to a sinus washout, which is clear, even
      though the X-rays were strongly suggestive of disease. This paper examines the
      prevalence of sinus X-ray anomalies in a general population, having facial X-rays
      for conditions other than possible sinus disease. The study suggests that up to
      50 per cent of the so-called normal population may have sinus X-ray appearances
      consistent with sinus disease, and this may partly explain clear returns on sinus
      washout.

PMID- 2230576
TI  - Multiple primary malignancies in patients with malignant tumours of the nasal
      cavities and paranasal sinuses.
AB  - The incidence of multiple primary malignancies (MPM) was analysed in 1297
      patients with malignant tumours of the nasal cavities and paranasal sinuses. The
      patients were followed for a minimum of six years or until death. The incidence
      of MPM was 3.4 per cent (44/1297) which is lower in patients with malignant
      tumours of other regions in the upper aerodigestive tract. Five of the 44
      patients had second malignancies within previously irradiated areas. There was a
      difference between the proportion of histologies occurring in irradiated tissues
      compared with the overall 1297 patients. This finding suggests that radiotherapy
      may induce a second cancer.

PMID- 2230577
TI  - Radiation therapy of laryngeal cancer: a twenty year experience.
AB  - This paper reviews a 20 year experience of radiation treatment of 286 laryngeal
      cancers and presents results with a minimum five year follow-up. All cases
      presented had glottic or supraglottic squamous cell carcinomas with no clinical
      evidence of nodal metastasis. A policy of primary radiotherapy with surgery for
      salvage of treatment failures, produced control of primary disease and prevention
      of metastases superior to most other regimes documented in the literature.

PMID- 2230578
TI  - Effect of microwave and ionizing radiation in patients with recurrent laryngeal
      carcinoma.
AB  - This study describes the treatment and survival of 54 patients with gross
      recurrent laryngeal carcinoma after radiotherapy. Twenty-six patients were
      treated with local ultra-high frequency hyperthermia in combination with
      radiotherapy and chemotherapy (HRCH). Twenty-eight control patients were treated
      with radiotherapy and chemotherapy (RCh). Eight patients (33 per cent) in HRCh
      showed a three year survival but no patient in the RCh group. At two years 18
      patients (75 per cent) in HRCh and two (7 per cent) in RCh survived.

PMID- 2230579
TI  - Another hazard of ear syringing: malignant external otitis.
AB  - A case of malignant external otitis is presented. This occurred in a healthy 72
      year-old non-diabetic, non-immuno-compromised man after ear syringing. The
      infection was treated with oral ciprofloxacin for eight weeks with complete
      resolution.

PMID- 2230580
TI  - Sudden sensorineural hearing loss as a complication of non-otologic surgery.

PMID- 2230581
TI  - Recurrent Bell's palsy in pregnancy.
AB  - A case of recurrent Bell's palsy occurring in two successive pregnancies in a 37
      year-old woman is presented. The causes of facial nerve paralysis of the lower
      motor neurone type are discussed. The rate of recurrence of Bell's palsy during
      pregnancy is unknown. Treatment with corticosteroids of Bell's palsy during
      pregnancy poses the threat of possible side effects on the fetus.

PMID- 2230582
TI  - Hoarseness as the sole presenting symptom of foramen magnum meningioma.
AB  - Foramen magnum tumours are rare. They may present with bizarre symptoms and mimic
      many conditions. We report a presentation with the sole complaint of hoarseness,
      never previously described in the literature. Voice returned to normal after
      surgical removal of the foramen magnum meningioma.

PMID- 2230583
TI  - Unusual type of foreign body in the maxillary sinus.
AB  - A broken end of the spear presenting as a foreign body in the nasopharynx and
      right maxillary sinus in a 19-year-old Papua New Guinean is described. The types
      of foreign bodies and their mechanisms of introduction into this site are
      summarized.

PMID- 2230584
TI  - Unusual lymphoproliferative oropharyngeal lesions in heart and heart-lung
      transplant recipients.
AB  - Three unusual cases of oropharyngeal lympho-proliferative lesions were seen in
      recipients of heart and heart-lung transplants. Two caused acute upper
      respiratory obstruction necessitating urgent ENT intervention. All patients were
      receiving immunosuppressive drugs including cyclosporin. The two obstructive
      cases were adenotonsillar enlargement in a 6-year-old, and a tumour of the tonsil
      and tongue base with cervical lymph node enlargement in a 32-year-old male. Both
      were caused by Epstein-Barr Virus-associated lymphoproliferative disorder. The
      third patient, a 32-year-old female, had a presumed low grade T-cell lymphoma
      that regressed spontaneously. Histopathological diagnosis of these lympho
      proliferative disorders after transplantation usually requires
      immunocytochemistry to distinguish polyclonal proliferative disorders from true
      lymphoma. Polyclonal lymphoproliferative disorders after transplantation do not
      usually require aggressive cytoreductive therapy, but respond to simple measures
      such as the reduction of immunosuppression.

PMID- 2230585
TI  - Inter-arytenoid glottic bar following intubation.
AB  - Inter-arytenoid glottic bar is a rare complication of prolonged endotracheal
      intubation. We present two such cases and their treatment. The aetiology of this
      complication is multifactorial and involves local factors--local trauma, movement
      of the endotracheal tube within the larynx, infection, and anatomical influences-
      together with systemic factors such as in our two cases. The relative importance
      of these factors is discussed. A comment is also made on the use of a pre
      operative topogram and the importance of an ENT assessment in patients with
      airway problems following prolonged intubation.

PMID- 2230586
TI  - Laryngeal metastasis from colonic adenocarcinoma.
AB  - Metastases to the larynx from distant primaries are very rare. Usually the
      secondary lesion comes from an hypernephroma or malignant melanoma. A case of
      metastatic laryngeal tumour from a colonic adenocarcinoma, occurring in a 59-year
      old woman, is presented and the routes for laryngeal spread are discussed. The
      poor survival-rate of these patients justified only conservative surgery.

PMID- 2230588
TI  - Mid-line presentation of cervical lymphomata.
AB  - Three cases of lymphoma are reported, all of which presented as a mid-line
      cervical swelling and appeared to be localised disease. The importance of early
      removal of such lesions is emphasized.

PMID- 2230587
TI  - Intralaryngotracheal thyroid.
AB  - A case of intralaryngotracheal thyroid in a 57-year-old man is presented. The
      treatment modalities are considered and the previous literature is reviewed.

PMID- 2230589
TI  - Impaired physicians. An overview and update of the legal issues.

PMID- 2230590
TI  - The effect of malpractice litigation on patient access to specialty physician
      services.

PMID- 2230591
TI  - Physicians' suits against medical malpractice insurers. An analysis of current
      issues in professional liability insurance litigation.

PMID- 2230592
TI  - Thiol proteinase inhibitors reverse the increased protein kinase C down
      regulation and concanavalin A cap formation in polymorphonuclear leukocytes from
      Chediak-Higashi syndrome (beige) mouse.
AB  - Protein kinase C (PKC) plays an essential role in intracellular signal
      transduction for various cell functions, including concanavalin A (Con A)-induced
      cap formation. This enzyme is known to be proteolysed by calpain, which is a
      Ca2(+)-dependent thiol proteinase. As reported previously, in polymorphonuclear
      leukocytes (PMNs) from beige mouse, the model of Chediak-Higashi syndrome, Con A
      induced cap formation significantly increased compared with that in normal mouse.
      However, after pretreatment of beige PMNs with the thiol proteinase inhibitors
      leupeptin or E-64, the capping decreased to normal levels. Meanwhile, Con A
      induced the translocation of PKC from the cytosolic to membrane fraction within 5
      min in both mice, which is essential to the activation of this enzyme. However,
      after the translocation, an abnormal rapid decline in membrane-bound PKC activity
      was noted in beige mouse PMNs. Both leupeptin and E-64 also corrected the rapid
      decline in PKC activity observed in the beige mouse. These findings suggest that
      the normalization of Con A cap formation in beige mouse PMNs by the thiol
      proteinase inhibitors is associated with the correction of abnormality in PKC
      activity.

PMID- 2230593
TI  - Down-regulation of macrophage I-A expression in tumor-bearing mice.
AB  - During the subcutaneous growth of a highly metastatic mammary adenocarcinoma
      line, C3-L4 in C3H/HeJ mice, there was a rapid decline in macrophage I-A
      expression in vivo. The incidence of I-A+ macrophage subset in the spleen
      declined from 90% to 10% or less within 5 days of tumor transplantation, with a
      parallel decline in their absolute number. I-A expression in these cells remained
      suppressed for a long time until tumors became necrotic and ulcerated. In spite
      of a low incidence (15-20%) of I-A+ macrophages in the normal peritoneal space,
      tumor transplantation caused a long-lasting decline in their incidence to one
      fourth of the original level. Tumor-associated macrophages were predominantly I-A
      throughout the tumor life span. Thus I-A- macrophages dominated in all
      anatomical compartments in tumor-bearing mice. Macrophage I-A expression was
      substantially restored (spleen) or stimulated (peritoneal space and tumor) in
      tumor-transplanted mice subjected to chronic indomethacin therapy in the drinking
      water, indicating a reversal of prostaglandin-mediated down-regulation of
      macrophage I-A expression in situ. Concomitantly, this therapy caused regression
      of the primary tumors and prevented lung metastasis. These results are relevant
      to the understanding of tumor-host interactions and its exploitation for
      immunotherapy.

PMID- 2230594
TI  - Activated neutrophils induce erythrocyte immunoglobulin binding and membrane
      protein degradation.
AB  - Neutrophil-induced alterations in feline erythrocytes were investigated to
      elucidate the pathogenesis of the erythrocyte destruction associated with
      inflammatory disease. Incubation of erythrocytes with zymosan-activated
      neutrophils, at target:effector concentrations of 50:1, resulted in
      immunoglobulin binding to the erythrocyte membrane and degradation of membrane
      proteins. Vitamin E and superoxide dismutase/catalase attenuated the
      immunoglobulin binding. Proteolysis was not prevented by addition of antioxidants
      or protease inhibitors to the erythrocyte:neutrophil coculture and was not
      reproduced with chemical oxidation or calcium loading of erythrocytes.

PMID- 2230595
TI  - Effect of retinoids on the release and gene expression of tumor necrosis factor
      alpha in human peripheral blood monocytes.
AB  - The effect of retinoic acid (RA) and retinol (ROH) on the release of tumor
      necrosis factor (TNF) by human peripheral blood monocytes (HPBM) was determined.
      HPBM were cultured for various periods of time in either 5% complete (cAB) or
      delipidized (DLS) AB serum. TNF release (L929 cytolytic assay) in the presence of
      cAB occurred during the first 3 days of in vitro culture. Delipidization of AB
      serum completely inhibited the lipopolysaccharide (LPS)-induced release of TNF by
      HPBM. Addition of RA (0.5 microM) to DLS restored LPS-induced TNF release by
      HPBM, and supplementation with ROH (1.0 microM) resulted in release of TNF-like
      activity, but only after 3 days of in vitro culture. The maintenance of TNF
      release by the addition of exogenous RA after 3 days of in vitro culture
      suggested that depletion of endogenous RA was partially responsible for loss of
      TNF-like activity. The levels of endogenous TNF protein and mRNA were not
      influenced by delipidization of serum and were found to be similar to those of
      HPBM cultured in the presence of AB serum. TNF protein and mRNA were undetectable
      in HPBM ROH-treated cell lysates, although cytolytic activity was observed in
      culture supernatants. These results suggest that retinoids are required for the
      release of cytolytic factors from HPBM and that non-TNF cytolytic factors may be
      released by these cells at different stages of maturation.

PMID- 2230596
TI  - Role of CR3 in induced myelomonocytic recruitment: insights from in vivo
      monoclonal antibody studies in the mouse.

PMID- 2230597
TI  - Decreased Fc receptor expression on macrophages following simple hemorrhage as
      observed by scanning immunoelectron microscopy.
AB  - Although it is known that macrophage (M phi) functions such as phagocytosis and
      antigen presentation are depressed following hemorrhage and resuscitation, the
      mechanism remains unknown. The aim of this study was to determine, using scanning
      immunoelectron microscopic techniques, whether there is any alteration in the Fc
      receptors on the M phi after hemorrhage. To study this, male C3H/HeN mice were
      bled to a mean blood pressure (BP) of 35 mm Hg and maintained at that pressure
      for 1 hr, then resuscitated with their own blood and adequate fluids. Twenty-four
      hrs later, Kupffer cells from livers and splenic adherent cells were isolated,
      incubated for 16 hr, and then exposed to polysterene beads conjugated with
      antimouse IgG that specifically binds to Fc receptors. The cells were then
      prepared for observation by scanning electron microscopy. At least 100 cells from
      each animal were examined. The number of Kupffer cells from posthemorrhage mice
      that exhibited specific receptor labeling was significantly decreased (41.0 +/-
      2.6, P less than 0.05) compared with control (64.2 +/- 7.5). The number of
      splenic adherent cells from posthemorrhage mice exhibiting specific receptor
      labeling was also significantly decreased (35.7 +/- 2.5, P less than 0.01)
      compared with control (61.2 +/- 3.9). The internalization of markers was also
      seen in some cells. The cause of the decrease in receptor labeling following
      hemorrhage may be the loss, inactivation, and/or internalization of receptors.
      Thus the decreased number of functional macrophages may contribute to the
      depression of antigen presentation and to the enhanced susceptibility to sepsis
      following hemorrhage.

PMID- 2230598
TI  - Human recombinant interleukin-2 induces maturation and activation signals for
      feline eosinophils in vivo.
AB  - Immunotherapy, with interleukin-2 (IL-2) or IL-2 plus lymphokine-activated killer
      (LAK) cells, has been used to treat cancer and acquired immunodeficiency syndrome
      (AIDS) in man. Similarities between feline leukemia virus (FeLV) infection in the
      cat and human immunodeficiency virus (HIV) infection in man have prompted
      immunotherapeutic studies in the cat. To develop baseline data on hematological
      responses to infused IL-2, cats were given daily (1-14 days) i.v. injections of 5
      x 10(4) U/kg of recombinant human IL-2 (rHulL-2). Complete blood cell (CBC)
      counts were done weekly. Red blood cell (RBC), neutrophil, and lymphocyte numbers
      did not change appreciably over the course of the study. In contrast, rHulL-2
      caused an eosinophilia in all but the 1 day treatment group. Treatment for 3 days
      generated a transient eosinophilia on day 7 that returned to baseline by 3 weeks.
      Five day and 7 day treatments generated an eosinophilia by day 7 that peaked on
      day 14 and returned to normal values by day 28. Treatment of cats for 14 days did
      not increase the magnitude or duration of the eosinophilia beyond the 5 or 7 day
      treatments. Bone marrow (BM) biopsies from rHulL-2-treated cats revealed a marked
      selective hyperplasia of eosinophil precursors. In the 5 day treatment group, all
      maturation stages of eosinophils were elevated by week 1 of treatment. By week 2,
      the early stages had returned to normal, whereas the late stage cells remained
      elevated, suggesting an ordered maturation response. Numbers of all eosinophil
      precursors approximated pretreatment numbers by weeks 3-4. Thus the BM
      hyperplasia preceded the blood eosinophilia by 1 week, suggesting that an
      enhanced maturation response of BM eosinophil precursors is a major contributor
      to the rHulL-2-induced blood eosinophilia. In addition to a maturation signal,
      rHulL-2 induces a potent activation signal for eosinophils as measured by a
      decrease in density and an increase in longevity in culture. The significance of
      the activated eosinophil in the therapeutic or toxicologic response to rHulL-2
      infusion is discussed.

PMID- 2230599
TI  - Lectin binding of rat bone marrow cells during colony-stimulating factor type 1-
      induced differentiation: soybean agglutinin as a marker of mature rat
      macrophages.
AB  - Rat bone marrow cells (BMC) cultured in the presence of murine colony-stimulating
      factor type 1 (CSF-1) differentiate within 7 days into a cell population
      containing 96-100% macrophages (M phi). In this study, binding of 10 different
      fluorescein isothiocyanate (FITC)-conjugated lectins to cultured BMC at various
      stages of differentiation into M phi was investigated. Only soybean agglutinin
      (SBA) showed a binding pattern that was significantly correlated to M phi
      differentiation. Nearly all adherent (A) cells bound SBA. Binding of SBA to
      nonadherent (NA) cells increased from 20% on day 0 to 80% on day 8. NA cells were
      separated by means of a fluorescence-activated cell sorter into SBA-, SBA +/-,
      and SBA+ fractions. On day 0 and day 2, M phi, blast-like cells, eosinophils, and
      some neutrophils were found in the SBA+ population. From day 4 onwards, the SBA+
      fraction contained almost exclusively M phi. Neutrophils and some blasts were
      found in the SBA- population on days 0 and 2. In the SBA +/- fraction, mainly
      blasts and lymphocytes were identified. With increasing time of culture, M phi or
      M phi precursors prevailed also in the SBA-/ +/- cell population. Cells forming
      colonies in soft agar in the presence of CSF-1 were highly enriched in the SBA +/
      fraction. A large number of cells in S-G2/M phases but few colony-forming cells
      were found in the SBA+ population. Our data suggest that SBA is a useful
      additional tool to define late stages of M phi differentiation.

PMID- 2230600
TI  - Bacterial lipopolysaccharide induces release of tumor necrosis factor-alpha from
      bovine peripheral blood monocytes and alveolar macrophages in vitro.
AB  - In this study, we demonstrate that freshly adherent bovine monocytes release
      tumor necrosis factor-alpha (TNF-alpha) in response to stimulation with bacterial
      lipopolysaccharide (LPS). TNF-alpha was detected using actinomycin D-treated WEHI
      164 murine fibrosarcoma cells as targets in an 18 hr cytotoxicity assay. Doses of
      LPS from 20 ng/ml to 20 micrograms/ml were capable of inducing bovine TNF-alpha.
      The kinetics of TNF-alpha release from bovine monocytes demonstrated peak levels
      of cytotoxic activity at 1-3 hr post-LPS treatment, with a subsequent decline to
      background levels by 18 hr post-LPS treatment. A monoclonal antibody that
      neutralizes recombinant human TNF-alpha (rHuTNF-alpha) significantly reduced the
      cytotoxicity of LPS-stimulated bovine monocyte culture supernatants. Size
      exclusion high-performance liquid chromatography (HPLC) analysis of LPS
      stimulated monocyte and alveolar macrophage culture supernatants resulted in a
      molecular weight elution profile similar to that of recombinant human TNF-alpha.
      These elution profiles are consistent with the presence of multimers of TNF
      alpha. This is believed to be the first report of the in vitro production of
      bovine TNF-alpha.

PMID- 2230602
TI  - Excitability changes in the crustacean motor axons following activity.
AB  - It has been shown experimentally that the crustacean motor axon is supernormally
      excitable following a train of action potentials (Zucker 1974). Such a phenomenon
      can lead to recruitment of terminals which are unexcited at low rates of
      stimulation. Although currents underlying the crustacean motor axon have been
      characterized (Connor et al. 1977), it is not known whether this membrane model
      accounts for a supernormal period, what might cause superexcitability in this
      model, or how excitability might change during repetitive stimulation. In present
      study, it is demonstrated that the crustacean motor axon model does predict a
      supernormal period, that the supernormal period results from slow recovery from
      inactivation of the transient potassium, or A, current, and that supernormal
      excitability is enhanced by repetitive stimulation.

PMID- 2230601
TI  - Modulation of nitrogen oxide synthesis in vivo: NG-monomethyl-L-arginine inhibits
      endotoxin-induced nitrate/nitrate biosynthesis while promoting hepatic damage.
AB  - Attempts were made to promote or inhibit nitric oxide (. N = O) synthesis in a
      murine model of hepatic damage (Corynebacterium parvum followed by
      lipopolysaccharide; LPS) to determine the role of . N = O in the liver injury.
      Moderate hepatic damage and increases in circulating NO2-/NO3- levels were
      detectable after C. parvum alone. Administration of LPS to these mice resulted in
      severe hepatic damage and acute elevations in circulating nitrogen oxide levels.
      L-arg had no influence on the C. parvum or LPS-induced changes. NG-monomethyl-L
      arginine (NMA) had no effect in the absence of LPS, but when given with LPS, a
      dose-dependent suppression in plasma NO2-/NO3- levels and an increase in liver
      injury were seen. The NMA-induced changes were partially reversed by the
      simultaneous administration of L-arg. These findings suggest a protective role
      for . N = O in this model.

PMID- 2230603
TI  - Theoretical analysis of the flow of cells over villi of the small intestine.
AB  - The flow of epithelial cells over villi of mouse small intestine is calculated
      from equations of cell number balance and irrotational flow. The influence of
      both villus geometry and crypt distribution about the villus base are studied.
      Specific, experimentally verifiable predictions are made.

PMID- 2230604
TI  - Effects of calcium input/output on the stability of a system for calcium
      regulated viscoelastic strain fields.
AB  - The Goodwin and Trainor model of pattern generation in calcium-regulated strain
      fields is studied in the case where calcium input and calcium output processes
      are involved. It is shown that the properties of the original model may still
      remain provided that the input-output processes are not unstable. In this last
      case, despite the eventual stabilizing effect of the calcium exchange term,
      perturbations of the generalized system can grow and lead to inhomogeneous
      solutions. Applications to cell differentiation and cell growth are discussed.

PMID- 2230605
TI  - Nonmedical illness behavior: a model of patients who seek alternatives to
      allopathic medicine.
AB  - This project investigated the process by which African-Americans in Chicago
      decided to access drugless, natural health care systems in conjunction with, or
      as alternatives to, orthodox medical care. The study focused on African-American
      users of the drugless, natural health care systems of chiropractic and
      naprapathy. The data for the study were qualitative and ethnographic, and
      included over 100 in-depth interviews, extensive field notes based on participant
      observation and related documents. The findings involved constructing a five
      stage sequential model that describes the process of conversion to regular use of
      natural health care. The purpose of this article is to present a model of
      nonmedical illness behavior that can sensitize health care practitioners to the
      situational and contingent factors affecting patients' choices.

PMID- 2230606
TI  - Counteracting nutritional misinformation: a curricular proposal.
AB  - Health authorities are concerned about community exposure to nutritional
      misinformation. Adequate education of health professionals in nutritional matters
      has been proposed as an important strategy for counteracting such misinformation.
      This paper provides an example of how the undergraduate chiropractic curriculum
      may be used to facilitate the development of a framework which enables
      discrimination between nutritional sense and nonsense. It also discusses how
      student awareness of discrepancies between personal belief, nutritional science
      and clinical practice reality may be enhanced.

PMID- 2230607
TI  - Atlantoaxial anomalies with particular emphasis on os odontoideum.
AB  - Anomalies of the atlantoaxial articulation are discussed with emphasis on os
      odontoideum. Normal and abnormal embryological and anatomical characteristics are
      described, as is their relevance upon stability of the upper cervical segments.
      This paper further discusses and reviews theories pertaining to the congenital
      and acquired forms of os odontoideum and a case report is presented. Some
      conclusions are drawn from the presented case report.

PMID- 2230608
TI  - Radiation induced fracture of the scapula.
AB  - A case of radiation induced osteonecrosis resulting in a fracture of the scapula
      in a 76-yr-old female patient with a history of breast carcinoma is presented.
      Diagnostic imaging, laboratory recommendations and clinical findings are
      discussed along with an algorithm for the safe management of patients with a
      history of cancer and musculoskeletal complaints. This case demonstrates the
      necessity of a thorough investigation of musculoskeletal complaints in patients
      with previous bone-seeking carcinomas.

PMID- 2230609
TI  - Code Blue: adolescent health, the crisis and the hope.

PMID- 2230610
TI  - The experience of a child and adolescent inpatient unit in London.
AB  - The Mildred Creak Unit of the Hospital for Sick Children, Great Ormond Street,
      London, England, has been evaluating and treating children and adolescents now
      for over 16 years. A portion of their valuable experience, with 394 patients
      reviewed, is presented in this article. Items discussed include: (1) major
      diagnostic labels utilized and their frequency of use; (2) ages and sex of young
      people within the major diagnostic categories; and (3) information on discharge
      status plus average length of stay. This paper affords the reader an opportunity
      to compare the Mildred Creak Unit experience with his or her own experience,
      hopefully enhancing further international sharing of child and adolescent data.

PMID- 2230611
TI  - The legacy of James Edgar Paullin, M.D.
AB  - The legacy of the man lives on, years after his death. Physicians from his own
      hospital have held and will hold his former posts as president of the AMA and the
      American College of Physicians (Harrison Rogers and Nick Davies, respectively).
      Organizations that he helped start, the Southeastern Clinical Society and the
      Atlanta Clinical Society, continue to thrive. His high standards of medical care
      continue from a grandson-in-law (David Watson) and great-grandson (Brooks Lide).
      To quote from Dr. R. Hugh Wood's letter in 1951: "From the life of Dr. Paullin
      one may learn to better serve his profession and his country. Possessed of a keen
      intelligence, he took full advantage of his exceptional educational
      opportunities, and with vigor and persistence he lived a full life of service as
      physician, teacher, citizen, and friend."

PMID- 2230613
TI  - Stepparents and stepchildren: the Phaedra complex.

PMID- 2230612
TI  - Exertional rhabdomyolysis in two prison inmates.
AB  - We have reported two cases of exertional rhabdomyolysis which resolved without
      serious complication. The denial and exclusion of significant historical
      information initially made the specific etiology of rhabdomyolysis indeterminate
      in the first case.

PMID- 2230614
TI  - Access to medical care: a perspective of internal medicine.

PMID- 2230615
TI  - The evolving role of surgery in the treatment of breast cancer.

PMID- 2230617
TI  - Smoking cessation strategies for the cardiac patient.
AB  - Studies involving subjects attempting to discontinue cigarette smoking reveal
      that long-term success rates remain disappointingly low--in the range of 10 to 33
      percent at 1 year. No single method or drug has proved to be a panacea. Serious
      commitment by the patient is of paramount importance in achieving long-term
      success. The physician is in a unique position to initiate a patient's attempted
      cessation, reinforce a patient's resolve, and offer support during the endeavor.
      Clonidine appears to decrease craving and nicotine gum decreases withdrawal
      symptoms in many patients.

PMID- 2230616
TI  - State regulation of abortion upon minors: the Supreme Court permits parental
      notification statutes.

PMID- 2230618
TI  - The philosopher as insider and outsider.
AB  - Philosophers may play the role of insider, e.g., serving as advisor to government
      commissions, or of outsider, commenting on the work of such commissions. Each
      role may raise dilemmas. It is argued that as insider the philosopher's primary
      duties should be to clarify and inform, as well as philosophize with the
      commissioners, and help them stay on a course in which moral considerations are
      given their proper weight. Fulfilling these duties means that the philosopher
      will sometimes have to help produce a weaker intellectual document than he would
      prefer, or lose a chance to directly promote the public good. The insider
      philosopher will also have to consider whether it is appropriate for a policy
      proposal from a commission to differ from much current government policy, and how
      morally appropriate compromise can be reached among commissioners. Given his
      understanding of how an insider philosopher should function and how commission
      reports are constructed, the outsider philosopher can comment both on how close a
      report comes to being perfect of its type, and how far short of an ideal
      philosophical analysis even a perfect government report is. It may be appropriate
      for him to give greater weight to the public good, if his comments are very
      likely to affect it, than the insider philosopher. Examples for discussion are
      drawn from government reports on organ transplantation, embryo research,
      terminating care, and compensation for research subjects.

PMID- 2230619
TI  - Philosophical integrity and policy development in bioethics.
AB  - Critically examining what most people take for granted is central to
      philosophical inquiry. Philosophers who accept positions on policy making
      commissions, tasks forces, or committees cannot, however, play the same
      uncompromisingly critical role in this capacity as they do in the classroom or in
      their personal research or writing. Still, philosophers have much to contribute
      to such bodies, and they can do so without compromising their integrity or
      betraying themselves as philosophers.

PMID- 2230620
TI  - Philosophers and the public policy process: inside, outside, or nowhere at all?
AB  - Three standard tasks undertaken by applied ethicists engaged in the public policy
      process are identifying value issues, clarifying concepts and meanings, and
      analyzing arguments. I urge that these should be expanded to include making
      specific moral judgments and advocating positions and policies. Three objections
      to philosophers/ethicists' engagement in the formation of public policy are
      advanced and evaluated: philosophers necessarily do public policy badly, doing it
      at all compromises one's integrity as a seeker after truth, and frequently
      participation is in the service of a repressive status quo that is structured
      simultaneously to preclude radical change and to co-opt ethicists. Finally,
      however, I argue that those who would be 'applied ethicists' cannot avoid all
      participation in some form of a public policy process; that engagement holds the
      hope as well for improved ethical theory; that the preferred form of
      participation is frequently from outside of establishment bodies; and that
      wherever philosophers do involve themselves in policy formulation, this is best
      done in the expanded sense urged at the outset.

PMID- 2230621
TI  - Public philosophy: distinction without authority.
AB  - An assumed core of normative ethical principles may constitute a philosophically
      proper framework within which public policy should be formulated, but it seldom
      provides any substantive solutions. To generate public policy on bioethical
      issues, participants still need to confront underlying philosophical
      controversies. Professional philosophers' proper role in that process is to
      clarify major philosophical options, to press wider-ranging consistency
      questions, and to bring more parties into the philosophical debate itself by
      arguing for particular substantive claims. Though questions of fact that mediate
      final policy conclusions frequently fall outside philosophical competence, one
      sort of fact, lack of political support, should seldom cause philosophers to
      stand aside; philosophers still have an important role as critics of culture,
      politics, and profession. They have no authority, however, on even the
      philosophical presuppositions of public policy.

PMID- 2230622
TI  - Physician investment and self-referral: philosophical analysis of a contentious
      debate.
AB  - A new economic phenomenon, in which physicians refer their patients to ancillary
      facilities of which they themselves are owners or substantial investors, presents
      a 'laboratory' for assessing philosophers' potential contributions to public
      policy issues. In this particular controversy, 'prohibitionists' who wish to ban
      all such self-referral focus on the dangers that patients and payers may receive
      or be billed for unnecessary or poor-quality care. 'Laissez-fairists', in
      contrast, argue that self-referral should be freely permitted, with a reliance on
      personal ethics and internal professional monitoring to guard against abuse.
      Undue government regulation, they argue, infringes providers' and patients'
      economic freedom, and stifles the competition that can yield better quality care
      at lower prices. As this debate features basic values and large amounts of money,
      it has been marked by rancorous rhetoric, shallow argument, and muddled
      reasoning. The philosopher's first contribution, therefore, is to expose
      simplistic and fallacious arguments, whether empirical, conceptual, moral, or
      legal. Beyond this the philosopher can help to identify the important values at
      stake and, perhaps, to identify resolutions that honor those values better than
      the more simplistic answers proffered previously. For abusive self-referral, as
      distinguished from kickbacks, the author recommends that civil remedies be
      favored over criminal prohibitions. She suggests that the doctrine of 'bad faith
      breach of contract' might appropriately be extended into this new area to provide
      a powerful means by which aggrieved patients and payers can hold physicians
      personally accountable for abusive self-referrals.

PMID- 2230623
TI  - Undetectable anti-bacterial activity of Andrographis paniculata (Burma) wall. ex
      ness.
AB  - Andrographis paniculata (Burma) Wall. ex Ness (AP) is a herbal medicine and has
      been used for therapy of upper respiratory tract infection (URI) as well as acute
      diarrhea with reported efficacy of 75-100 per cent. To investigate whether anti
      bacterial activity was responsible for the reported therapeutic success of AP, we
      carried out a number of studies. The first study was a direct assay of anti
      bacterial activity of AP suspended in water. The tested pathogens included
      Salmonella, Shigella, E.coli, gr. A Streptococci and S.aureus. Anti-bacterial
      activity was not demonstrable even in a solution containing 25,000 mg per litre
      of crude powder. The second was designed to detect serum bactericidal activity
      after oral intake of stem and leaves of AP. Ten healthy volunteers were enrolled
      in the study. They received a single oral dose of AP (1, 2, 3 and 6 g) in a
      randomized, cross-over manner. The washout period was one week. Blood samples
      were taken at 0, 1, 2, 4, 8 and 24 hours after ingestion. Serum bactericidal
      activity was assayed by agar diffusion technique using Bacillus spores and five
      strains of each pathogen (Shigella, Salmonella typhi, S.aureus and gr. A
      Streptococci) incubated for 24 hours. Again serum bactericidal activity was not
      detected in any of the sera tested. In a third study, ninety-six rats were daily
      fed with high doses of AP ranging 0.12-24 g per kg body wt. for six months before
      sacrifice. Antibacterial activity was still undetectable when lung parenchyma and
      liver tissue was placed on culture media containing bacteria tested. In
      conclusion, anti-bacterial activity of AP is undetectable in our study.

PMID- 2230624
TI  - The immunodiagnosis of tuberculosis in Thailand.

PMID- 2230625
TI  - Accuracy of two-dimensional echocardiography in diagnosis of aortic dissection.
AB  - The usefulness of transthoracic and transabdominal two-dimensional
      echocardiography (2-D echo) in patients who presented with dilated aorta with or
      without acute chest pain and/or abdominal pain was assessed for diagnosis of
      aortic dissection (AD) both acute and chronic forms. The criterion for diagnosis
      of AD was the constant appearance of undulating motion of abnormal linear echo in
      the aortic lumen in more than one scan plane. During a 4-year period (1984-1988),
      a prospective analysis of 16 patients was carried out and the result disclosed
      that 11 had AD (6 in acute AD, 5 in chronic AD) while the other 5 did not have
      AD. 2-D echo findings were diagnostic of De Bakey Type I in 7 patients, Type II
      in one, Type III in two, false negative Type I in one, and true negative in the
      remaining five. Therefore, the sensitivity was 91 per cent and the positive
      predictive value was 100 per cent. Thus, our data indicates that 2-D echo is a
      reliable non-invasive method for diagnosis of AD in either the acute or chronic
      form and proximal or distal AD.

PMID- 2230626
TI  - Ciprofloxacin in severe infections.
AB  - Ciprofloxacin is the most potent post-marketing fluoroquinolone. In vitro
      activity and pharmacokinetic properties of this agent, together with clinical
      trials of the drug may be very promising in the treatment of severe infections,
      especially when the bacteria involved are resistant to other conventional agents.
      We performed an open clinical trial of this agent in hospitalized patients with
      severe infections in a university hospital in Bangkok, Thailand. A total of 25
      patients were enrolled on the basis of clinical diagnosis of severe bacterial
      infections. Six of these patients were dropouts (3 of which proved to be non
      bacterial infections, 2 patients each had only anaerobic infection and
      nocardiosis. One suffered from a severe psychotic attack). The remaining 19
      patients were evaluated. There were 12 males and 7 females, the age ranged from
      13 to 77 years old (43.2 +/- 20.1). Most had severe underlying illnesses (17 out
      of 19). There were 23 infections in 19 patients. Septicemia was the most common
      infection treated. Other infections included complicated urinary infection, upper
      respiratory tract infection, skin/skin structure infection. P. aeruginosa was the
      most common pathogen infected. Other organisms were E.coli, Enterobacter,
      P.mirabilis, S.aureus, A.antitratus and mycobacterium. Ciprofloxacin was given as
      an initial 100 mg twice daily as intravenous infusion, and this was switched to
      an oral form of 500 mg b.i.d./at approximately day 4 to day 6. The overall cure
      rate was 68 per cent. There were 2 improvements, 2 relapses/reinfections and one
      failure. Toxic effect included one psychotic attack necessitating discontinuation
      of the drug. Other adverse drug reactions were mild and transient. These included
      elevation of transaminase and LDH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230628
TI  - Cass scores as a preoperative prediction for recurrences of cervical cancer after
      radical hysterectomy and pelvic lymphadenectomy at Srinagarind Hospital.
AB  - Risk factors for recurrence after radical hysterectomy and pelvic lymphadenectomy
      at Srinagarind Hospital was studied from 218 patients operated between 1976 to
      June 30, 1988. Four preoperative risk factors i.e., cell types, age, stages and
      size of the lesions were computed and cross-tabulated with the recurrence rate
      from the data of the whole patients. The correlation was found to be statistical
      significant. This scoring system should be called from the first letter of the
      factor as 'CASS' and used for selection of the patients for radical hysterectomy
      and pelvic lymphadenectomy.

PMID- 2230627
TI  - Mechanical ventilation in status asthmaticus: experience with 75 episodes.
AB  - Mechanical ventilation in 75 out of 560 status asthmaticus episodes during a five
      year period (1984-1988) at Chulalongkorn Hospital were analyzed. There were 58
      patients with an average age of onset of first asthmatic attack of 18.5 years and
      an average age when requiring mechanical ventilation of 33 years, which is
      significantly younger than among those who did not require assisted ventilation.
      At the time of intubation, four patients were in sudden unexpected arrest and 19
      patients were urgently ventilated because of respiratory muscle fatigue or carbon
      dioxide narcosis; the remaining 52 patients required elective mechanical
      ventilation. The arterial blood gas of 52 patients revealed a pH of 7.11 +/-
      0.66, PaCO2 of 58.0 +/- 5.5 mmHg, and HCO3 of 15.0 +/- 5.8 mEg/L. Controlled
      mechanical ventilation was maintained for a mean of 38.68 hours. Fifty-one
      patients required intravenous diazepam (average dose = 24.3 mg) and 37 required
      morphine (average dose = 11.1 mg) for good syncronization in controlling
      mechanical ventilation. Pneumothorax was the most common complication with four,
      nine and one episodes occurring prior to, during and after assisted ventilation,
      respectively. Four, one and two patients developed the complications of
      pneumonia, atelectasis of the left lung due to mucous plugging and upper
      gastrointestinal hemorrhage, respectively. There were six patients who died of
      complications: four of brain anoxia, one of pneumothorax and another of
      unexplained cause.

PMID- 2230629
TI  - Epidemiology of cancer in Khon Kaen.
AB  - The prospective and retrospective data collection of cancer cases in all the
      hospitals and death certificates in Khon Kaen province were reported as a
      population-based cancer registry of Khon Kaen province. Liver cancer especially
      cholangiocarcinoma and cervical cancer lead the group. The age-standardized
      incidence rate of cancer of Khon Kaen was about 72.4 to 173.3 per 100,000
      population per year and it is higher in males than in females.

PMID- 2230630
TI  - Community-acquired pneumonia in adults at Srinagarind Hospital.
AB  - A prospective study of community-acquired pneumonia in adults at Srinagarind
      Hospital, Khon kaen University was conducted from September 1987 to August 1988.
      Laboratory specimens were tested for bacterial and mycoplasmal culture, CIE for
      pneumococcal antigen and serological data for mycoplasma and P. pseudomallei. The
      results supported by clinical data were evaluated. We could identify the
      pathogens from 62 of 113 cases (55%). P. pseudomallei was the most frequent
      etiologic agent (32%) and S. pneumoniae was the second (27%). Overall mortality
      was 21 per cent and it was high in cases with bacteremia and pneumonia due to P.
      pseudomallei. Sixty-six per cent of the patients had associated diseases.
      Diabetes mellitus, chronic renal failure and renal calculi were commonly found in
      patients with pneumonia due to P. pseudomallei. The results of this study showed
      the relatively high prevalence of P. pseudomallei pneumonia in our region which
      was different from other reports.

PMID- 2230632
TI  - 181st meeting of the Society for Endocrinology. 14-16 November 1990, London.
      Abstracts.

PMID- 2230631
TI  - Giant cell arteritis.
AB  - An 80-year-old woman was admitted after a 4 months history of severe headache.
      Laboratory data revealed elevated ESR, mild anemia and alteration of liver
      function test. Temporal artery biopsy showed the classical picture of giant cell
      arteritis. The clinical symptoms and laboratory abnormalities reversed to normal
      after prednisolone therapy. Although the true prevalence of this disease is
      unknown in Thailand, previous studies in western countries have revealed that it
      is not a common disease. GCA may be missed or incorrectly diagnosed in elderly
      patients with headache and a high ESR. Such a diagnosis can subject the patient
      to complication of GCA, needless biopsy and serious side effects of therapy with
      large doses of prednisolone.

PMID- 2230633
TI  - The history of imitation in learning theory: the language acquisition process.
AB  - The concept of imitation has undergone different analyses in the hands of
      different learning theorists throughout the history of psychology. From
      Thorndike's connectionism to Pavlov's classical conditioning, Hull's monistic
      theory, Mowrer's two-factor theory, and Skinner's operant theory, there have been
      several divergent accounts of the conditions that produce imitation and the
      conditions under which imitation itself may facilitate language acquisition. In
      tracing the roots of the concept of imitation in the history of learning theory,
      the authors conclude that generalized imitation, as defined and analyzed by
      operant learning theorists, is a sufficiently robust formulation of learned
      imitation to facilitate a behavior-analytic account of first-language
      acquisition.

PMID- 2230634
TI  - Reflexes, fictive respiration and cell division in the brain and spinal cord of
      the newborn opossum, Monodelphis domestica, isolated and maintained in vitro.
AB  - 1. The entire central nervous system (CNS) was isolated from 1- to 4-day-old
      newborn South American opossums (Monodelphis domestica). At this stage the CNS
      has only an embryonic forebrain (two-layered) and no cerebellum and corresponds
      to a 14-day rat embryo. Its eyes, ears and hind-limbs are only at an early stage
      of formation. The isolated CNS preparations continue to develop and to produce
      electrical signals for up to 4 days in oxygenated Krebs' fluid at 23 degrees C.
      2. The longitudinal axis of the CNS showed markedly different stages of
      development. More neuroblast cells were present in the proliferative zone in
      lumbosacral than in cervical or thoracic regions of the cord. 3. The progeny of
      dividing cells were labelled in isolated preparations by applying
      bromodeoxyuridine (BrdU) to the bathing solution for 2 h. Stained precursor cells
      were observed in CNS that had been left in Krebs' fluid for 4 days before
      applying BrdU and also in CNS that had been exposed to BrdU shortly after
      dissection and then left for 4 days. 4. Compound action potentials were evoked
      from the isolated CNS by stimulation with extracellular electrodes. Compound
      action potentials increased in amplitude with stronger stimulation and showed
      discrete peaks of conduction velocity. All electrical activity was eliminated
      reversibly by 0.1 mumol l-1 tetrodotoxin applied to the bathing solution. Block
      and recovery occurred with a half-time of approximately 5 min. High
      concentrations of magnesium (20 mmol l-1) reversibly blocked slower components of
      the volley. 5. Reflexes in cervical and thoracic segments of the spinal cord
      continued to function in isolated preparations. Stimulation of a dorsal root
      evoked bursts of impulses in the appropriate ventral root. Spontaneous and evoked
      activity in ventral roots was eliminated reversibly by 20 mmol l-1 magnesium. 6.
      In thoracic segments, spontaneous rhythmical bursts of action potentials were
      recorded. Burst activity was correlated with respiratory movements of the ribs in
      semi-intact preparations in which a few ribs and muscles were left attached to
      the isolated CNS. 7. At raised temperatures of 28 degrees C compared to 23
      degrees C both spontaneous and evoked electrical activity were reversibly
      reduced. 8. Together these results show that the isolated CNS of the newborn
      opossum survives well in culture. The preparation offers advantages for
      pharmacological and physiological studies of spinal reflexes, for analysis of the
      mechanisms underlying rhythmical respiratory activity and for following the time
      course of CNS development in vitro.

PMID- 2230635
TI  - Ultrasound-triggered, flight-gated evasive maneuvers in the praying mantis
      Parasphendale agrionina. I. Free flight.
AB  - Free-flying male praying mantises Parasphendale agrionina (Gerst.) perform
      evasive maneuvers when stimulated by ultrasound and when attacked by hunting,
      echolocating bats. They do not, however, respond in any way when standing on a
      substratum. The maneuvers are graded in intensity with distance from the sound
      source: far from the source they are simple turns, whereas close to the source
      they are steep diving turns or spirals. The maneuvers are made under power, and
      the male's velocity doubles to almost 4 m s-1 by the end of a steep dive. The
      mantis does not show any directional preference. The behavioral threshold of 64
      dB SPL and minimum latency to course change of 125 ms indicate that these
      mantises should have adequate time to evade bats using calls of greater than 85
      90 dB SPL (at 10 cm). In field experiments with wild, hunting bats, P. agrionina
      successfully evaded capture in all five attacks to which they responded with
      evasive maneuvers. Out of three attacks on P. aeruginosa and three on a normally
      non-responding mantis, Miomantis paykullii Stal, in which there were no evasive
      maneuvers, the mantis was captured in five cases.

PMID- 2230636
TI  - Effects of taurine on Ca2(+)-dependent force development of skinned muscle fibre
      preparations.
AB  - The effects of the naturally occurring amino acid taurine (2-aminoethanesulphonic
      acid) on isometric force development were investigated using skinned muscle fibre
      preparations. In atrial and ventricular pig heart muscles, as well as in fibres
      of slow abdominal extensor muscle of crayfish, an increase of submaximal
      isometric force was observed in Ca2(+)-activated skinned fibre preparations at
      physiological concentrations of taurine. The maximal isometric force remained
      unaffected in all preparations. It is assumed that taurine increases the Ca2+
      sensitivity of the force-generating myofilaments in mammalian hearts and
      crustacean slow skeletal muscle fibres.

PMID- 2230637
TI  - Effect of activity on performance and morphology in ischaemic rat slow muscles.
AB  - Muscle performance and structure was studied in rat soleus muscle with limited
      blood supply in combination with chronic muscle stimulation. Blood supply to the
      lower leg was restricted by ligation of the common iliac artery, electrodes were
      implanted in the vicinity of the sciatic nerve and ankle flexors were denervated.
      Three days later, soleus and gastrocnemius muscles were stimulated at 4 Hz four
      times a day for a period of 20 min with 2 h intervals between stimulations; this
      procedure was continued for 4 days. Muscle performance, histochemistry and
      ultrastructure were studied on the eighth day after operation in these muscles
      and in ischaemic unstimulated muscles with denervated ankle flexors. Both were
      compared with control animals. Muscles with limited blood supply developed less
      isometric twitch tension than control muscles (peak twitch tension in ischaemic
      muscle was 60.3 +/- 4.8 g g-1 muscle, mean +/- S.E.M., compared to 79.7 +/- 6.9 g
      g-1 in control muscle; tensions after 5 min contraction were 54.5 +/- 5.5 g g-1
      in ischaemic muscle compared to 70.6 +/- 6 g g-1 in controls). Stimulated muscles
      with limited blood supply had higher peak (85 +/- 16.6 g g-1) and final (87 +/-
      12 g g-1) tensions, and also fatigued less than muscles with limited blood supply
      but no stimulation. Histochemical estimation of capillary density (by staining
      for alkaline phosphatase) and slow (SO) and fast (FOG) fibres (by myosin ATPase
      staining) revealed similar capillary to fibre ratios (2.5) and a similar
      proportion of FOG fibres (around 18%) in all muscles. The proportion of glycogen
      depleted fibres (estimated from the periodic acid Schiff reaction, PAS) in
      muscles removed from animals 10 min after a 5 min period of isometric twitches
      was significantly lower in ischaemic muscles (45.1 +/- 1.9%) than in control
      (80.5 +/- 1.5%) or chronically stimulated ischaemic muscles (67.3 +/- 4.0%).
      Electron microscopy showed disorganised myofibrils with Z-line streaming in 7.48
      +/- 3.04% of fibres in muscles with limited blood supply. Swollen and degenerated
      mitochondria, dilated sarcoplasmic reticulum and areas of disrupted sarcolemma
      were also observed. Stimulated ligated muscles showed a significantly lower
      proportion of fibres with disorganised filaments (0.65 +/- 0.32%) and other signs
      of damage were much less frequent. The reduced damage and improved performance of
      chronically stimulated slow muscle may be the result of improved
      microcirculation, preventing accumulation of lactate.

PMID- 2230638
TI  - Effects of prestretch at the onset of stimulation on mechanical work output of
      rat medial gastrocnemius muscle-tendon complex.
AB  - Work output of rat gastrocnemius medialis (GM) muscle (N = 5) was measured for
      stretch-shortening contractions, in which initiation of stretch occurred prior to
      the onset of activation, and for contractions with an isometric prephase.
      Duration of the active prephase (prestretch and pre-isometric) varied from 20 to
      200 ms. Subsequent shortening (from optimum length + 4 mm to optimum length -2mm)
      lasted 150 ms. Stretch velocities of 5, 10 and 20 mm s-1 were used, and the
      shortening velocity was 40 mm s-1. The effects of several combinations of active
      stretch duration and active stretch amplitude were compared. Using force
      compliance characteristics, the work of the contractile element (CE), elastic
      energy storage and release of the undamped series elastic component (SEC) were
      distinguished. During shortening, an extra amount of work output was produced,
      induced by active stretch, of which the largest contribution (70-80%) was due to
      higher elastic energy release. Enhancement of the storage and utilization of
      elastic energy during the stretch-shortening cycle, caused by higher transition
      point forces (i.e. force at onset of shortening), increased with active stretch
      amplitude and was associated with a net loss of work, probably due to cross
      bridge detachment during active stretch. Net work over the stretch-shortening
      cycle remained positive for all prestretch contractions, indicating that when a
      muscle performs this type of contraction, it is able to contribute to work
      performance on body segments. It is concluded that, in stretch-shortening
      movements of rat GM muscle, maximal positive work output is incompatible with
      maximal net work output. Consequences for complex movements in vivo are
      discussed.

PMID- 2230639
TI  - Ultrasound-triggered, flight-gated evasive maneuvers in the praying mantis
      Parasphendale agrionina. II. Tethered flight.
AB  - In tethered flight, Parasphendale agrionina (Gerst.) males respond to ultrasonic
      stimuli with a unique suite of behaviors that includes full extension of the
      forelegs, strong dorsiflexion of the abdomen, a head roll, a 5% decrease in
      wingbeat frequency and a 33% increase in forewing excursion. Latency for the
      foreleg extension averages 66 ms while the latency to onset of yaw is 174 ms. The
      direction of the turn is unrelated to the location of the speaker. Yaw magnitude
      and latency are only weakly related to sound pressure level, and variability in
      these and other parameters is high. The behavior shows moderately sharp tuning to
      40-60 kHz with a lowest mean threshold of 60 dB SPL. A male will not respond to
      ultrasound unless in flight, and the context-gating is independent of sensory
      input from the tarsi. Several components of the in-flight evasive behavior
      resemble defensive displays on the ground, and we suggest that this mantis has
      responded to predation pressure from bats with both flight-derived maneuvers and
      an aerial deimatic display.

PMID- 2230640
TI  - Transient behavior of sea urchin sperm flagella following an abrupt change in
      beat frequency.
AB  - Within the approximate range of 30-80 Hz, the flagellar beat frequency of a sea
      urchin sperm held by its head in the tip of a micropipet is governed by the
      vibration frequency of the micropipet. We have imposed abrupt changes in
      flagellar beat frequency by changing the vibration frequency of the micropipet
      within this range and used a high-speed video system to analyze the flagellar
      wave parameters during the first few cycles following the change. Our results
      demonstrate that the various flagellar beat parameters differ in the time they
      take to adjust to the new conditions. The initiation rate of new bends at the
      base is directly governed by the frequency of the vibration and changes
      immediately to the new frequency. The length and the propagation velocity of the
      developed bends become adjusted to the new conditions within approximately 1 beat
      cycle, whereas the bend angles take more than 4 beat cycles to attain their new
      steady-state value. Bends initiated shortly before the change in frequency occurs
      attain a final length and angle that depends on the relative durations of growth
      at the old and new frequencies. Our results suggest that the flagellar wavelength
      and bend angle are regulated by different mechanisms with the second not being
      directly dependent on bend initiation.

PMID- 2230641
TI  - Inhibition of escape tailflip in crayfish during backward walking and the defense
      posture.

PMID- 2230642
TI  - Failure of clonal deletion in neonatally thymectomized mice: tolerance is
      preserved through clonal anergy.
AB  - Self-tolerance is achieved in part through intrathymic deletion of self-reactive
      T cells. The necessity of the thymus for this process is suggested by the
      development of autoimmune diseases in neonatally thymectomized (neoTx) mice and
      by the failure of clonal deletion in nude mice. Indeed, the present study
      demonstrates that neonatal thymectomy on day 3 after birth results in the failure
      of clonal deletion of V beta 11+ T cells in BALB/c mice and V beta 5+ and V beta
      6+ T cells in DBA/2 mice. However, these potentially autoreactive cells are
      nonfunctional as measured by proliferation and lymphokine production after
      stimulation with appropriate anti-V beta mAbs or stimulator cells. It appears
      that this induction of nonresponsiveness may have occurred extrathymically: the
      early neonatal thymus (presumably the source of the peripheral T cells observed
      in neoTx mice) also contains T cells with self-reactive receptors, but these
      cells are fully functional. Therefore, neonatal thymectomy aborts deletion of
      self-reactive T cells, but self-tolerance is maintained through functional
      inactivation of potentially self-reactive clones.

PMID- 2230643
TI  - Low dosages of interleukin 1 protect mice against lethal cerebral malaria.
AB  - In cerebral malaria, pathological changes can be found in the brain of infected
      people and in the brain of Plasmodium berghei-infected mice. The pathogenesis of
      cerebral malaria in mice is believed to be due to an immunopathological reaction
      giving rise to an excessive production of cytokines such as interferon gamma (IFN
      gamma) and tumor necrosis factor (TNF). We find that low doses of interleukin 1
      (IL-1) protect mice against cerebral malaria; IL-1 also inhibits parasitemia. The
      IL-1 effect on parasitemia was not observed in nude mice and was at least partly
      reversed in mice treated with IL-1 in combination with antibody to IFN-gamma,
      indicating the involvement of T cells. Mice protected against development of
      cerebral malaria by IL-1 treatment developed the syndrome when TNF was given as
      observed in control infected mice or infected mice treated with inactivated IL-1.

PMID- 2230644
TI  - Prooxidant activity of transferrin and lactoferrin.
AB  - Acceleration of the autoxidation of Fe2+ by apotransferrin or apolactoferrin at
      acid pH is indicated by the disappearance of Fe2+, the uptake of oxygen, and the
      binding of iron to transferrin or lactoferrin. The product(s) formed oxidize
      iodide to an iodinating species and are bactericidal to Escherichia coli.
      Toxicity to E. coli by FeSO4 (10(-5) M) and human apotransferrin (100
      micrograms/ml) or human apolactoferrin (25 micrograms/ml) was optimal at acid pH
      (4.5-5.0) and with logarithmic phase organisms. Both the iodinating and
      bactericidal activities were inhibited by catalase and the hydroxyl radical (OH.)
      scavenger mannitol, whereas superoxide dismutase was ineffective. NaCl at 0.1 M
      inhibited bactericidal activity, but had little or no effect on iodination.
      Iodide increased the bactericidal activity of Fe2+ and apotransferrin or
      apolactoferrin. The formation of OH.was suggested by the formation of the OH.spin
      trap adduct (5,5-dimethyl-1-pyroline N-oxide [DMPO]/OH)., with the spin trap DMPO
      and the formation of the methyl radical adduct on the further addition of
      dimethyl sulfoxide. (DMPO/OH).formation was inhibited by catalase, whereas
      superoxide dismutase had little or no effect. These findings suggest that Fe2+
      and apotransferrin or apolactoferrin can generate OH.via an H2O2 intermediate
      with toxicity to microorganisms, and raise the possibility that such a mechanism
      may contribute to the microbicidal activity of phagocytes.

PMID- 2230645
TI  - Distinct fates of self-specific T cells developing in irradiation bone marrow
      chimeras: clonal deletion, clonal anergy, or in vitro responsiveness to self-Mls
      1a controlled by hemopoietic cells in the thymus.
AB  - Elimination of potentially self-reactive T lymphocytes during their maturation in
      the thymus has been shown to be a major mechanism in accomplishing self
      tolerance. Previous reports demonstrated that clonal deletion of self-Mls-1a
      specific V beta 6+ T lymphocyte is controlled by a radiosensitive I-E+ thymic
      component. Irradiation chimeras reconstituted with I-E- bone marrow showed
      substantial numbers of mature V beta 6+ T cells despite host Mls-1a expression.
      Analysis of the functional properties of such chimeric T cells revealed a
      surprising variability in their in vitro reactivity to host Mls-1a, depending on
      the H-2 haplotype of stem cells used for reconstitution. In chimeras
      reconstituted with B10.S (H-2s) stem cells, mature V beta 6+ lymphocytes were
      present but functionally anergic to host-type Mls-1a in vitro. In contrast, in
      chimeras reconstituted with B10.G (H-2q) bone marrow, nondeleted V beta 6+ cells
      were highly responsive to Mls-1a in vitro. These findings suggest that clonal
      anergy of V beta 6+ cells to self-Mls-1a may be controlled by the
      affinity/avidity of T cell receptor interactions with bone marrow-derived cells
      in the thymus depending on the major histocompatibility complex class II
      molecules involved. Furthermore, chimeras bearing host (Mls-1a)-reactive V beta
      6+ cells did not differ clinically from those with anergic or deleted V beta 6+
      cells and survived more than one year without signs of autoimmune disease.
      Interestingly, their spleen cells had no Mls-1a stimulatory capacity in vitro.
      Therefore, regulation at the level of antigen presentation may be an alternative
      mechanism for maintenance of tolerance to certain self-antigens such as Mls-1a.

PMID- 2230646
TI  - A monoclonal antibody (8H3) that binds to rat T lineage cells and augments in
      vitro proliferative responses.
AB  - A murine monoclonal antibody, designated 8H3, recognizes a cell surface antigen
      expressed exclusively on rat T lineage cells. 8H3 antibody immunoprecipitated 180
      , 120-, and 90-kD components from rat thymocytes as well as splenic T cells under
      nonreducing conditions. 8H3 antibody specifically inhibited the binding of
      thymocytes to fibronectin. Furthermore, binding of rat thymocytes to immobilized
      synthetic peptide Gly-Arg-Gly-Asp-Ser-Pro-Cys-BSA was inhibited by 8H3 antibody
      as was Gly-Arg-Gly-Asp-Ser-Pro-Cys, but not by Gly-Arg-Ala-Asp-Ser-Pro-Lys or Gly
      Arg-Gly-Glu-Ser-Pro. Crosslinking of 8H3 antigen on double-negative thymocytes
      and adult thymocytes, as well as splenic T lymphocytes by 8H3 antibody and
      F(ab')2 fragments of goat antibodies to mouse immunoglobulin, led to an increase
      in the concentration of cytoplasmic free Ca2+ due to the release of Ca2+ from
      intracellular stores as well as the influx of Ca2+ from extracellular sources.
      Expression of interleukin 2 receptor and subsequently cell proliferation was
      observed upon incubation of thymocytes and splenic T cells with 8H3 antibody.
      Furthermore, 8H3 antibody induced the proliferation of double-negative
      thymocytes. These data collectively indicated that a cell surface antigen, 8H3,
      is involved in not only cell adhesion but also involved in the expression of
      immature as well as mature thymocytes.

PMID- 2230647
TI  - Suppression of developmental anomalies by maternal macrophages in mice.
AB  - We tested whether nonspecific tumoricidal immune cells can suppress congenital
      malformations by killing precursor cells destined to cause such defects.
      Pretreatment of pregnant ICR mice with synthetic (Pyran copolymer) and biological
      (Bacillus Calmette-Guerin) agents significantly suppressed radiation- and
      chemical-induced congenital malformations (cleft palate, digit anomalies, tail
      anomalies, etc.). Such suppressive effects were associated with the activation of
      maternal macrophages by these agents, but were lost either after the disruption
      of activated macrophages by supersonic waves or by inhibition of their lysosomal
      enzyme activity with trypan blue. These results indicate that a live activated
      macrophage with active lysosomal enzymes can be an effector cell to suppress
      maldevelopment. A similar reduction by activated macrophages was observed in
      strain CL/Fr, which has a high spontaneous frequency of cleft lips and palates.
      Furthermore, Pyran-activated maternal macrophages could pass through the
      placenta, and enhanced urethane-induced cell killing (but not somatic mutation)
      in the embryo. It is likely that a maternal immunosurveillance system eliminating
      preteratogenic cells allows for the replacement with normal totipotent blast
      cells during the pregnancy to protect abnormal development.

PMID- 2230648
TI  - Characterization of a receptor for interleukin 5 on human eosinophils: variable
      expression and induction by granulocyte/macrophage colony-stimulating factor.
AB  - Interleukin 5 (IL-5) acts on eosinophil differentiation and activation,
      suggesting the existence of a membrane receptor for IL-5 on eosinophils. Here, we
      report that 125I-labeled recombinant human IL-5 bound, at 4 degrees C, to high
      affinity receptors on human eosinophils. The association constant was higher for
      hypodense eosinophils (1.93 x 10(9) M-1) than for normodense cells (0.39 x 10(9)
      M-1), with a closely related number of receptor sites per cell. No specific
      binding occurred on neutrophils. The specific binding of IL-5 was induced by
      overnight incubation at 37 degrees C of human eosinophils with
      granulocyte/macrophage (GM)-CSF. The levels of increase were significantly higher
      for normodense than for hypodense eosinophils, suggesting a previous in vivo
      activation of the later subpopulation by GM-CSF. IL-3 was ineffective by itself
      but synergistically enhanced the effect of GM-CSF. Specificity studies showed
      that the binding of 125I-labeled IL-5 was inhibited by IL-5, but not by other
      cytokines, on human eosinophils. These results show the existence of a specific
      binding site for IL-5 on human eosinophils with a variable affinity on eosinophil
      hypodense or normodense subpopulations, as previously reported for other membrane
      receptors.

PMID- 2230649
TI  - Differences defined by bone marrow transplantation suggest that lpr and gld are
      mutations of genes encoding an interacting pair of molecules.
AB  - Homozygosity for either of the lymphoproliferation (lpr) or generalized
      lymphoproliferative disease (gld) mutations of mice causes the development of
      systemic lupus erythematosus-like autoimmune syndromes that are characterized by
      severe lymphadenopathy and highly elevated serum immunoglobulin levels. Although
      the mutations are nonallelic, analysis of homozygous lpr/lpr and gld/gld mice on
      the same strain background has indicated that the pathology and severity of the
      autoimmune syndromes induced by these mutations are indistinguishable. To explain
      this, it has previously been suggested that lpr and gld may represent mutations
      in molecules involved in sequential steps of an intracellular metabolic pathway
      of T cells. We have now investigated the behavior of both lpr and gld in a
      variety of bone marrow chimeras and have found that functional differences
      between lpr and gld become apparent after bone marrow transfer. Transfer of
      lpr/lpr bone marrow to irradiated congenic +/+ recipients caused the development
      of a graft-vs.-host-like lymphoid wasting syndrome, whereas transfer of gld/gld
      bone marrow to +/+ recipients resulted in development of a gld-like autoimmune
      syndrome. Additionally, gld/gld hosts behaved like +/+ hosts irrespective of the
      genotype of the donor bone marrow, whereas lpr/lpr hosts behaved unlike +/+ hosts
      when reconstituted with either lpr/lpr, gld/gld, or +/+ bone marrow. These are
      the first clear differences between these two mutations yet described. Our
      studies indicate that the molecule altered by the gld mutation is expressed only
      by bone marrow-derived cells, whereas the molecule altered by the lpr mutation is
      expressed by both bone marrow-derived cells and by one or more peripheral
      radioresistant cell populations. To reconcile these differences with the fact
      that homozygous lpr/lpr and gld/gld mice are indistinguishable, we suggest an
      alternative model for the relationship between the lpr and gld mutations in which
      the two molecules affected represent an interacting ligand-receptor pair
      expressed by different cells.

PMID- 2230650
TI  - Coding sequences of the tal-1 gene are disrupted by chromosome translocation in
      human T cell leukemia.
AB  - The tal-1 proto-oncogene encodes a helix-loop-helix DNA-binding protein that has
      been implicated in the formation of T cell acute lymphoblastic leukemia (T-ALL).
      Patients with T-ALL harbor structural rearrangements of tal-1 that result from
      either local DNA deletion or t(1;14)(p34;q11) chromosome translocation. By
      analyzing t(1;14)(p34;q11) chromosomes from a series of patients, we have now
      identified a discrete region of tal-1 wherein most of the translocation
      breakpoints occur. Moreover, mapping of tal-1 genomic DNA revealed that coding
      exons are situated on both sides of the t(1;14)(p34;q11) major breakpoint region.
      Hence, the translocated allele of tal-1 is truncated in a manner that reduces its
      amino acid coding potential.

PMID- 2230651
TI  - Eosinophilia in transgenic mice expressing interleukin 5.
AB  - Experiments in vitro suggest that although interleukin 5 (IL-5) stimulates the
      late stages of eosinophil differentiation, other cytokines are required for the
      generation of eosinophil progenitor cells. In this study transgenic mice
      constitutively expressing the IL-5 gene were established using a genomic fragment
      of the IL-5 gene coupled to the dominant control region from the gene encoding
      human CD2. Four independent eosinophilic transgenic lines have thus far been
      established, two of which with 8 and 49 transgene copies, are described in
      detail. These mice appeared macroscopically normal apart from splenomegaly.
      Eosinophils were at least 65- and 265-fold higher in blood from transgenics,
      relative to normal littermates, and approximately two- or sevenfold more numerous
      relative to blood from mice infected with the helminth Mesocestoides corti. Much
      more modest increases in blood neutrophil, lymphocyte, and monocyte numbers were
      noted in transgenics, relative to normal littermates (less than threefold). Thus
      IL-5 in vivo is relatively specific for the eosinophil lineage. Large numbers of
      eosinophils were present in spleen, bone marrow, and peritoneal exudate, and were
      highest in the line with the greatest transgene copy number. Eosinophilia was
      also noted in histological sections of transgenic lungs, Peyer's patches,
      mesenteric lymph nodes, and gut lamina propria but not in other tissues examined.
      IL-5 was detected in the sera of transgenics at levels comparable to those seen
      in sera from parasite-infected animals. IL-3 and granulocyte/macrophage colony
      stimulating factor (GM-CSF) were not found. IL-5 mRNA was detected in transgenic
      thymus, Peyer's patches, and superficial lymph nodes, but not in heart, liver,
      brain, or skeletal muscle or in any tissues from nontransgenics. Bone marrow from
      transgenic mice was rich in IL-5-dependent eosinophil precursors. These data
      indicate that induction of the IL-5 gene is sufficient for production of
      eosinophilia, and that IL-5 can induce the full pathway of eosinophil
      differentiation. IL-5 may therefore not be restricted in action to the later
      stages of eosinophil differentiation, as suggested by earlier in vitro studies.

PMID- 2230652
TI  - The T alpha 2 nuclear protein binding site from the human T cell receptor alpha
      enhancer functions as both a T cell-specific transcriptional activator and
      repressor.
AB  - T cell-specific expression of the human T cell receptor alpha (TCR-alpha) gene is
      regulated by the interaction of variable region promoter elements with a
      transcriptional enhancer that is located 4.5 kb 3' of the TCR-alpha constant
      region (C alpha) gene segment. The minimal TCR-alpha enhancer is composed of two
      nuclear protein binding sites, T alpha 1 and T alpha 2, that are both required
      for the T cell-specific activity of the enhancer. The T alpha 1 binding site
      contains a consensus cAMP response element (CRE), and binds a set of ubiquitous
      nuclear proteins. The T alpha 2 binding site does not contain known
      transcriptional enhancer motifs. However, it binds at least two nuclear protein
      complexes, one of which is T cell specific. We now report that although the T
      alpha 2 nuclear protein binding site displays transcriptional activator activity
      in the context of the TCR-alpha enhancer, this site alone can function as a
      potent, T cell-specific transcriptional repressor when positioned either
      upstream, or downstream of several heterologous promoter and enhancer elements.
      These results demonstrate that a single nuclear protein binding site can function
      as a T cell-specific transcriptional activator or repressor element, depending
      upon the context in which it is located.

PMID- 2230653
TI  - Disappearance of certain acidic organelles (endosomes and Langerhans cell
      granules) accompanies loss of antigen processing capacity upon culture of
      epidermal Langerhans cells.
AB  - Freshly isolated epidermal Langerhans cells (LC) can actively process native
      protein antigens, but are weak in sensitizing helper T cells. During culture,
      when LC mature into potent immunostimulatory dendritic cells, T cell sensitizing
      capacity develops but antigen processing capacity is downregulated. Processing of
      exogenous antigens for class II-restricted antigen presentation involves acidic
      organelles. We used the DAMP-technique to monitor acidic organelles at the
      ultrastructural level in fresh, as well as cultured, mouse and human LC. We
      observed that the loss of antigen processing capacity with culture of LC was
      reflected by the disappearance of certain acidic organelles, namely endosomes
      (particularly early ones), and the hitherto enigmatic LC granules ("Birbeck
      Granules"). Our findings support the notion that endosomes are critical for
      antigen processing and suggest that LC granules might be involved as well.

PMID- 2230654
TI  - Migration and maturation of Langerhans cells in skin transplants and explants.
AB  - The behavior of Langerhans cells (LC) has been examined after skin
      transplantation and in an organ culture system. Within 24 h (and even within 4 h
      of culture), LC in epidermal sheets from allografts, isografts, and explants
      dramatically increased in size and expression of major histocompatibility complex
      class II molecules, and their numbers were markedly decreased. Using a new
      procedure, dermal sheets were then examined. By 24 h, cells resembling LC were
      found close to the epidermal-dermal junction, and by 3 d, they formed cords in
      dermal lymphatics before leaving the skin. In organ culture, the cells continued
      to migrate spontaneously into the medium. These observations establish a direct
      route for migration of LC from the epidermis into the dermis and then out of the
      skin. These processes are apparently induced by a local inflammatory response,
      and are independent of host-derived mediators. The phenotype of migratory cells
      was then examined by two-color immunocytochemistry and FACS analysis. The
      majority of migratory leukocytes were Ia+ LC, the remainder comprised Thy-1+,
      CD3+, CD4-, CD8- presumptive T cell receptor gamma/delta+ dendritic epidermal
      cells, which clustered with the LC, and a small population of adherent Ia-,
      FcRII+, CD11a/18+ macrophages. In contrast to the cells remaining within the
      epidermis of grafted skin at 1 d, the migratory cells were heterogeneous in
      phenotype, particularly with respect to F4/80, FcRII, and interleukin 2 receptor
      alpha expression, which are useful markers to follow phenotypic maturation of LC.
      Moreover, cells isolated from the epidermis of grafts at 1 d were more
      immunostimulatory in the allogeneic mixed leukocyte reaction and oxidative
      mitogenesis than LC isolated from normal skin, though less potent than spleen
      cells. The day 1 migratory cells were considerably more immunostimulatory than
      spleen cells, and day 3-5 migratory cells even more so, suggesting that
      functional maturation continues in culture. Thus, maturation of LC commences in
      the epidermis and continues during migration, but the cells do not need to be
      fully mature in phenotype or function before they leave the skin. In vivo, the
      migration of epidermal LC via the dermis into lymphatics and then to the draining
      nodes, where they have been shown previously to home to T areas, would provide a
      powerful stimulus for graft rejection.

PMID- 2230655
TI  - Engagement of major histocompatibility complex class II molecules induces
      sustained, lymphocyte function-associated molecule 1-dependent cell adhesion.
AB  - Antigenic stimulation is associated with enhanced adhesion between T cells and
      antigen-presenting cells (APC). Binding of ligands to the T cell antigen receptor
      activates the adhesion function of lymphocyte function-associated molecule 1 (LFA
      1; CD11a/CD18). We demonstrate here that ligand binding to major
      histocompatibility complex class II (Ia) molecules also activates LFA-1 function,
      providing a reciprocal mechanism for the induction of adhesion between T cells
      and Ia+ APC. Adhesion was affected by a qualitative change in LFA-1 molecules and
      was reversed by the protein kinase C inhibitor sphingosine. These results define
      a novel role for Ia molecules as signal transducing receptors that regulate LFA-1
      dependent adhesion via a putative, Ia-coupled protein kinase(s).

PMID- 2230657
TI  - Evidence for an association between the discriminative stimulus and the response
      outcome association in instrumental learning.
AB  - In 4 experiments, rats received 1 of several outcomes for engaging in various
      instrumental responses in the presence of discriminative stimuli. Discriminative
      stimuli shared some response-outcome relations but not others. When a response
      was subsequently extinguished in the presence of 1 discriminative stimulus, that
      produced relatively more decrement in responding in other stimuli that shared the
      same response-outcome relation. Other discriminative stimuli, in the presence of
      which that response had been reinforced by other outcomes and in which the
      original outcome had reinforced another response, were less affected. Moreover,
      postextinction devaluation of that outcome suggested that the particular response
      outcome relation extinguished had undergone decrement. These results suggest that
      discriminative stimuli have relatively specific associations with the response
      outcome relations that obtain in their presence.

PMID- 2230656
TI  - Aspergillus fumigatus allergen I, a major IgE-binding protein, is a member of the
      mitogillin family of cytotoxins.
AB  - A major 18-kD IgE-binding protein from Aspergillus fumigatus (Asp fI) has been
      purified. Partial amino acid sequencing of Asp f I showed extensive sequence
      homology (95%) between Asp fI and a cytotoxin (mitogillin) produced by A.
      restrictus. Crossinhibition radioimmunoassay using murine monoclonal antibody and
      human IgG and IgE antibodies showed that Asp fI and mitogillin were antigenically
      indistinguishable. Furthermore, both proteins inhibited protein synthesis in
      vitro by greater than 90%. Asp fI was expressed in A. fumigatus but not in seven
      other Aspergillus species. The results suggest that Asp fI could play a dual role
      in the pathogenesis of A. fumigatus-related diseases by promoting colonization
      through cytotoxic activity and by causing inflammatory reactions involving IgE
      antibodies.

PMID- 2230658
TI  - Schedule-induced kinesic and taxic behavioral stereotypy in the pigeon.
AB  - Two experiments explored the functional character of 2 schedule-induced interim
      behaviors (pacing and retreat) and 1 terminal behavior (keypecking) that
      developed on fixed-time (FT) schedules of food delivery with a keylight that
      increased in brightness throughout the interstimulus interval. In Experiment 1,
      this ramp procedure was compared with a less discriminable ramp, and FT and
      Random Time (RT) procedures without a signal. Decreased discriminability expanded
      keypecking in the trial. The FT schedule eliminated only keypecking and the RT
      procedure eliminated keypecking and retreat while pacing remained. In Experiment
      2, predictive and unpredictive ramps were added to the RT procedure. The data
      suggest that schedule-induced stereotypy can be divided into kinesic stereotypy
      (pacing), which arises from repeated reinforcer presentations, and taxic
      stereotypy, which is tied to an increase (keypecking) or decrease (retreat) in
      the momentary probability of reinforcement.

PMID- 2230659
TI  - Defeat-induced hypoalgesia in the rat: effects of conditioned odors, naltrexone,
      and extinction.
AB  - In Experiment 1, male rats were either defeated as a colony intruder by alpha
      conspecifics or had no defeat experience, and 24 hr later they were given a paw
      injection of formalin prior to observational tests with or without alpha-colony
      odors. The combination of defeat and tests with these odors produced conditioned
      hypoalgesia (i.e., a suppression in paw licking) and freezing. In Experiment 2,
      defeated rats were given either an injection of naltrexone or saline prior to
      defeat and 24 hr later prior to testing. An injection of naltrexone prior to
      defeat increased freezing during defeat and later testing. In contrast,
      naltrexone during testing did not affect freezing but significantly reduced
      hypoalgesia. In Experiment 3, a 12-hr exposure session with alpha-colony odors
      extinguished hypoalgesia in previously defeated rats. These findings are
      discussed in terms of associative, opioid/nonopioid, and adaptive evolutionary
      processes.

PMID- 2230660
TI  - Selective associations in the observational conditioning of fear in rhesus
      monkeys.
AB  - Three experiments explored the issue of selective associations in the
      observational conditioning of fear. Experiment 1 results indicated that observer
      rhesus monkeys acquired a fear of snakes through watching videotapes of model
      monkeys behaving fearfully with snakes. In Experiment 2, observers watched edited
      videotapes that showed models reacting either fearfully to toy snakes and
      nonfearfully to artificial flowers (SN+/FL-) or vice versa (FL+/SN-). SN+/FL-
      observers acquired a fear of snakes but not of flowers; FL+/SN- observers did not
      acquire a fear of either stimulus. In Experiment 3, monkeys solved complex
      appetitive discriminative (PAN) problems at comparable rates regardless of
      whether the discriminative stimuli were the videotaped snake or the flower
      stimuli used in Experiment 2. Thus, monkeys appear to selectively associate
      snakes with fear.

PMID- 2230661
TI  - Thrombocytes as interfering factors in clinical chemistry.

PMID- 2230662
TI  - Isotachophoretic determination of urea-ammonium in plasma: a candidate reference
      method.
AB  - Separation and determination of sample constituents by capillary isotachophoresis
      are entirely based on physical phenomena. The method has therefore been proposed
      as a universal reference method for ionic constituents. The present paper shows
      that even neutral species can be adequately determined after suitable preceding
      reactions. Urea was completely hydrolysed by urease (EC 3.5.1.5) to ammonia and
      bicarbonate, followed by direct measurement of the ammonium ion concentration by
      capillary isotachophoresis. Standard Reference Material No. 912a urea (National
      Bureau of Standards) was used as a primary standard. The analytical linear range
      of the method extends to 64 mmol urea per litre. The precision of the method was
      in the range of 1.05-2.64% (CV) and the analytical recovery of added urea was
      excellent (99.4%, SD 1.13%). Further proof of accuracy was obtained by analysing
      the NBS human reference serum (standard reference material 909). The mean result
      by the capillary isotachophoretic method, 9.52 +/- 0.085 mmol/l, agrees well with
      the reference value, 9.64 mmol/l. The results obtained by capillary
      isotachophoresis showed good agreement with those obtained by the coupled-enzyme
      method (r = 0.995).

PMID- 2230663
TI  - Comparison of two immunoinhibitory methods with agarose gel-electrophoresis for
      measuring the MB isoenzyme of creatine kinase in serum from cases of suspected
      myocardial infarction.
AB  - Two immunoinhibitory methods for measuring creatine kinase-MB (a dry chemical and
      a wet chemical method) were compared with the commonly used agarose gel
      electrophoretic method, using 563 serum samples from 235 patients with suspected
      acute myocardial infarction. Comparison of the electrophoretic and the dry
      chemistry methods showed the linear relationship: electrophoretic method = -6.5
      U/l + 1.22 x dry chemistry method, r = 0.943. For the wet chemistry method the
      relationship was: electrophoretic method = -7.2 U/l + 1.19 x wet chemistry
      method, r = 0.854. Parallel determinations of total creatine kinase were also
      done and the methods were virtually identical in performance. Compared with the
      electrophoretic method (which showed a 15% prevalence of acute myocardial
      infarction), these classifications showed sensitivities of 0.92 and 0.67 and
      specificities of 0.94 and 0.99 (dry and wet chemistry, respectively; using
      methods recommended by the manufacturers). After optimization of discriminators
      the sensitivity was increased to 0.94/0.92 and the specificity to 0.99/0.99.

PMID- 2230664
TI  - Aluminium binding to serum constituents: a role for transferrin and for citrate.
AB  - The binding of aluminium in rat serum was studied. Rats were loaded
      intraperitoneally with different doses of aluminium(III)chloride 4 times during
      one week, before being killed by cardiac puncture. One ml of serum was applied to
      a Sephacryl S-200 SF column and 70 fractions were collected. In the collected
      fractions, the distribution of aluminium was measured and compared with the
      concentrations of total protein, transferrin, and citrate. The presence of a high
      molecular weight aluminium-complex in serum is confirmed. Although a possible
      role for albumin cannot be excluded, it is most likely that transferrin plays a
      role as a carrier for biological transport of aluminium in plasma. In addition to
      transferrin, aluminium was shown to be associated with citrate in serum,
      resulting in a low-molecular weight complex. It is postulated that citrate acts
      as a chelator for aluminium, and that the Al/citrate complex in serum may play an
      important role in intracellular accumulation, and hence the toxicity, of
      aluminium.

PMID- 2230665
TI  - Synthesis and characterization of a new substrate of Photinus pyralis luciferase:
      4-methyl-D-luciferin.
AB  - A derivative of luciferin, 4-methyl-D-luciferin, was synthesized in low yield,
      and characterized by its ultraviolet and fluorescence spectra. The spectra of
      luciferin and its derivative are very similar. 4-Methyl-D-luciferin is a
      substrate of Photinus pyralis luciferase, and it causes light emission in
      luminometric assays.

PMID- 2230666
TI  - Spiroadamantane dioxetane substrates--stable labels for luminescence-enhanced
      enzyme immunoassays.
AB  - This short communication describes the use of spiroadamantane-1,2 dioxetane
      substrates for alkaline phosphatase and beta-D-galactosidase in the development
      of luminescence-enhanced enzyme immunoassays. Until the present work, only
      peroxidase-luminol/peroxidase systems had been used in such assays. The light
      reaction kinetics were studied from the time of initiation of the light reaction
      up to 2 days later. The methods is illustrated by the determination of
      myeloperoxidase, based on microtitre plate technology, coupled with a microtitre
      plate luminometer which needs no injector. The alkaline phosphatase and
      peroxidase systems were compared.

PMID- 2230668
TI  - Pseudohyperkalaemia in thrombocythaemia.
AB  - Pseudohyperkalaemia in thrombocythaemia, in its primary form or associated with
      polycythaemia vera, can occur with platelet counts in excess of 600 X 10(9)/l,
      and it is not related to high leukocyte or thrombocyte counts. An increment of
      0.15 mmol/l serum potassium was found for every 100 X 10(9)/l rise in platelet
      count with a correlation coefficient of 0.82. Potassium from platelets is not
      released during the aggregation phase but during the degranulation phase of the
      coagulation process.

PMID- 2230667
TI  - Diagnostic utility of a new monoclonal antibody pancreatic isoamylase assay in
      chronic pancreatic diseases.
AB  - In order to evaluate the efficacy of a monoclonal pancreatic (P) isoamylase assay
      in the diagnosis of chronic pancreatic disease and to compare the behavior of
      this test with that of amylase and elastase 1, these three enzymes were measured
      in the sera of 39 healthy controls, 28 patients with pancreatic cancer, 50 with
      chronic pancreatitis and 60 with extra-pancreatic diseases. In patients with
      chronic relapsing pancreatitis, increased P-isoamylase and elastase 1 values were
      found in similar percentages (about 70%), whereas the percentage for elevated
      amylase values was lower (52%). Elastase 1 was increased in 52% of patients with
      pancreatic cancer, while the other two enzymes were only occasionally elevated.
      The levels for all three enzymes were abnormal in some patients with extra
      pancreatic diseases. It may be concluded that this assay for P-isoamylase
      determination is sufficiently sensitive and reliable in detecting pancreatic
      inflammation, even though some limitations concerning its specificity should be
      born in mind.

PMID- 2230669
TI  - Determination of plasma alpha-amylase in the dog: a test of the specificity of
      new methods.
AB  - Commercially available chromogenic substrates for the assay of alpha-amylase were
      tested for specificity in dog plasma. Blocked alpha-4-nitrophenylmaltoheptaoside
      and non-blocked beta-4-nitrophenylmaltoheptaoside showed no interference with
      glucoamylase and were suitable for the measurement of alpha-amylase in dog
      plasma. In contrast, an alpha-4-nitrophenylmaltoheptaoside showed interference,
      and was therefore an inappropriate substrate. Reference values with the blocked
      substrate in a group of 82 non-selected 3 month- to 10 year-old male and female
      dogs were 355 +/- 131 U/l (mean +/- standard deviation) at 30 degrees C.

PMID- 2230670
TI  - Measurement of serum alcohol dehydrogenase activity at different pH-values during
      the course of viral hepatitis in children.
AB  - Serum alcohol dehydrogenase activity was estimated at pH 10.4 (optimum for the
      typical liver isoenzyme), 8.8 (optimum for atypical liver isoenzyme), at the
      physiological serum pH of 7.4, and at pH 9.2, with a view to obtaining the
      greatest possible difference between patients and controls. Measurements were
      performed on the sera of 39 children aged from 2 to 13 years, using the Technicon
      analyzer RA-1000 with the continuously measuring method of Bonnichsen & Brink.
      Blood sera were tested at the onset of viral hepatitis, in the first week of
      hospitalization, and three times thereafter at intervals of 7 to 9 days. During
      the illness, the activity of serum alcohol dehydrogenase, measured at different
      pH-values, was higher than that of controls. The ratio of activity at pH 10.4 to
      activity at pH 8.8 in the sera differed from that previously reported for liver
      cells. The highest increase in alcohol dehydrogenase activity was at pH 9.2. The
      diagnostic sensitivity of alcohol dehydrogenase determination at this pH is lower
      than that of alanine aminotransferase, gamma-glutamyltransferase and aspartate
      amino-transferase, but higher than that of lactate dehydrogenase, alkaline
      phosphatase and bilirubin; alcohol dehydrogenase activity also shows the best
      correlation with the activity of gamma-glutamyltransferase.

PMID- 2230671
TI  - Comparison of methods for neonatal bilirubin.

PMID- 2230672
TI  - Effects of patient education.

PMID- 2230673
TI  - Obstetric-enhanced family practice residency training.

PMID- 2230674
TI  - Implementation of a systematic health maintenance protocol in a private practice.
AB  - The impact of a policy to introduce a simple health maintenance protocol
      systematically to all patients belonging to a private practice is reported.
      Results after 18 months' experience in over 1400 patients indicate that (1)
      physician compliance was excellent (97% of eligible patients were included, and
      physician time taken to introduce the protocol at the index visit took less than
      4 minutes), and (2) patient acceptance (which varied from procedure to procedure)
      was good to excellent (minimum acceptance: 77% for sigmoidoscopy; maximum
      acceptance: 97% for cholesterol screening). For patients seen once, acceptance
      rates for procedures were generally comparable to prior published performance
      rates for highly selected patient populations. Integration of a simple health
      maintenance protocol into routine office care of unselected primary care patients
      was feasible, effective, and acceptable to patients. Patient refusal was a minor
      barrier to performance of health maintenance.

PMID- 2230675
TI  - Screening diabetic patients for microalbuminuria.
AB  - Abnormal rates of urinary albumin excretion have been shown to predict the
      development of nephropathy and may signal atherosclerotic disease in diabetic
      patients. This study demonstrated the feasibility of measuring microalbuminuria
      in diabetic patients from a large family practice population. Although only one
      half of the 473 diabetic patients offered free screening took advantage of the
      testing, those participating did not differ in terms of sex, race, type of
      diabetes, mean age, systolic blood pressure, and fasting blood glucose levels
      from those not electing to participate. Over 40% of those screened had abnormally
      elevated albumin excretion rates as defined as greater than 0.02 g of albumin per
      gram of creatinine. Those participating in the screening perceived the process as
      useful and were able to comply with directions for overnight urine collection.
      Results show that screening for microalbuminuria in diabetic patients cared for
      by family physicians is feasible, simple, and inexpensive. Interventions to slow
      or reverse the progression of abnormal microalbuminuria and future risk for
      nephropathy in those with diabetes are underway.

PMID- 2230676
TI  - Adult immunization in a network of family practice residency programs.
AB  - A substantial proportion of morbidity and mortality associated with vaccine
      preventable diseases occurs among adults. Teaching residents about disease
      prevention is mandated in the curriculum guidelines for family practice programs.
      A cooperative study among the Kansas City family practice residency programs was
      begun to look at immunization behaviors in these teaching programs. A
      retrospective audit of medical records and a prospective survey of residents and
      faculty were performed. From the medical records of 400 patients seen for health
      maintenance examinations, the frequency of tetanus-diphtheria immunizations
      recorded was 4.75%. The pooled immunization rate recorded for pneumococcal
      vaccine was 25%, and for influenza vaccine, 24%. Although 93% of respondents knew
      patients need tetanus-diphtheria immunization every 10 years, on a written
      questionnaire giving clinical examples, they were less likely to elect to
      immunize older patients eligible for tetanus-diphtheria vaccine. The following
      immunization criteria were listed by respondents: for pneumococcal vaccine, age
      over 65 years (86%); for influenza vaccine, age over 65 years (85%), chronic
      diseases (69%), residence in a chronic care facility (7%), and being a health
      care worker (28%). Educational interventions stressing the appropriate criteria
      and involvement of the patient are planned at the separate programs.

PMID- 2230677
TI  - The gap between patient reading comprehension and the readability of patient
      education materials.
AB  - Patient education materials and hospital forms are given to patients with little
      regard for their ability to read them. Nationwide sampling and data from the 1980
      census suggest that a high proportion of patients cared for in public hospitals
      are functionally illiterate. In this study, 151 adult primary care patients in
      five different ambulatory care settings were tested for reading comprehension.
      Patient education materials and forms from each clinic were analyzed for
      readability using a standard computer program. A large discrepancy was found
      between the average patient reading comprehension and the ability levels needed
      to read patient education materials. The average reading comprehension of public
      clinic patients was 6th grade 5th month. Most tested patient education materials
      required a reading level of 11th to 14th grade, and standard institutional
      consent forms required a college-level reading comprehension. In the public
      clinics there was a gap of more than 5 years between patient reading levels and
      the comprehension levels required by written patient materials.

PMID- 2230678
TI  - A comparison of morbidity and mortality for family physicians' and internists'
      admissions.
AB  - The quality of medical care delivered by physicians of different specialties has
      been the subject of debate for some time. Studies have suffered from a variety of
      flaws. This study used the MedisGroups comparative database to compare outcome
      measures in hospitalized patients aged 65 years and older treated either by the
      family physicians or internists as attending physicians. Using the 10 most common
      diagnostic related groups for internal medicine, 10,353 admissions to internists
      were compared with 5,473 admissions to family physicians. Patients admitted by
      family physicians had a significantly higher admission illness severity and were
      significantly older. There was no significant difference in morbidity and
      mortality. The lower average charges for patients admitted to family physicians
      were statistically significant.

PMID- 2230679
TI  - Group A beta-hemolytic streptococcal toxic shock from a mild pharyngitis.

PMID- 2230680
TI  - The match test revisited. Blowing out a candle as a screening test for airflow
      obstruction.

PMID- 2230681
TI  - Field performance of the Intoxilyzer 5000: a comparison of blood- and breath
      alcohol results in Wisconsin drivers.
AB  - Intoxilyzer 5000 and blood-alcohol results from drivers arrested for operating a
      motor vehicle while intoxicated and for related offenses were compared during a
      two-year period. Three hundred and ninety-five pairs of results were studied. The
      breath- and blood-alcohol specimens in this study were collected within 1 h of
      each other. The mean blood-alcohol concentration obtained was 0.180 g/dL, with a
      range from zero to 0.338 g/dL. By comparison, the mean Intoxilyzer 5000 result
      was 0.16 g/210 L with a range from zero to 0.32 g/210 L. Compared with the blood
      alcohol result, Intoxilyzer 5000 results were lower by more than 0.01 g/210 L 67%
      of the time, within 0.01 g/210 L 31% of the time, and higher by more than 0.01
      g/210 L 2% of the time.

PMID- 2230682
TI  - Determination of human immunodeficiency virus antibody status in forensic autopsy
      cases in Vancouver using a recombinant immunoblot assay.
AB  - Sera from 207 forensic autopsy cases were tested for the presence of antibody to
      the human immunodeficiency virus (HIV) using a recombinant immunoblot assay
      (RIBA) technique developed by Chiron Corporation of Emeryville, California--the
      Chiron RIBA-HIV216 test system. Out of these cases, 172 autopsies were of
      individuals with no known risk factors for HIV infection, and of these, 169 had
      no detectable antibodies to HIV. In 2 cases, the serum reacted with p24 alone on
      the RIBA-HIV216 assay, but these results were not confirmed by further testing
      and are considered to be false positive reactions. In 1 case, the serum reacted
      only with gp41 on the RIBA-HIV216 test but was nonreactive with further testing.
      This result has been designated equivocal. Of the 35 cases at high risk of HIV
      infection, 4 had antibodies to HIV detected in postmortem serum samples. The
      sensitivity (100%) and specificity (98.5%) of the RIBA-HIV216 test system are
      high. However, the test appears to be more suitable for routine diagnosis of HIV
      infection than for rapid screening in the mortuary.

PMID- 2230683
TI  - Cardiac pathology in 470 consecutive forensic autopsies.
AB  - Cardiovascular disease continues to be the single most common generic cause of
      sudden and unexpected deaths. Atherosclerotic coronary heart disease and acute
      myocardial infarction are the most prevalent forms of fatal cardiac disease
      observed at autopsy. Other cardiac lesions are frequently listed as causes of
      death, but the prevalence of such lesions as incidental findings in the general
      population is unknown. In this study, 470 consecutive forensic autopsies were
      evaluated for minor and major anomalies. The most frequently observed major
      congenital finding was floppy mitral valve (5%). Tunneled coronary arteries,
      considered minor congenital findings, were seen in 29%. Atherosclerotic coronary
      heart disease was the most common major acquired finding, observed in 16% of
      cases. Of the 470 hearts, only 8% were considered normal.

PMID- 2230684
TI  - Survey of gunshot residue analysis in forensic science laboratories.
AB  - The purpose of this survey was to determine the methods of analysis being used on
      gunshot residue (GSR) samples in forensic science laboratories across the United
      States. In addition, the two general techniques of GSR analysis are compared and
      contrasted. Problems encountered by analysts using scanning electron
      microscopy/energy-dispersive X-ray analysis (SEM/EDX) are discussed.

PMID- 2230685
TI  - Barium and antimony distributions on the hands of nonshooters.
AB  - Barium and antimony levels from selected areas of the left and right hands of 269
      nonshooters provide a database for interpretation of gunshot residue swab
      analysis results. The database represents a variety of activities of individuals
      sampled by collectors throughout the United States. Nonshooting exposure to
      barium and antimony can generally be distinguished from firearms-associated
      exposure by considering the relative levels of the elements, location on the
      hands, and condition of the swabs. Consistent definition of sampling procedures
      and accurate analytical results make this database applicable for interpretation
      of data generated by most gunshot residue swab examiners.

PMID- 2230686
TI  - The rapid determination of the ABO group from body fluids (or stains) by dot
      enzyme-linked immunosorbent assay (dot-ELISA) using enzyme-labeled monoclonal
      antibodies.
AB  - Using ABH enzyme-labeled monoclonal antibodies, the authors could rapidly detect
      the ABO group from body fluids and body fluid stains by the dot enzyme-linked
      immunosorbent assay (dot-ELISA). In this test, the antigen was immobilized on
      nitrocellulose paper; the entire piece of paper was coated with an appropriate
      dilution of enzyme-labeled McAb directly against the antigen of interest; and,
      finally, 3,3'-diaminobenzidine (DAB) substrate solution was added. The site of a
      positive reaction is clearly visible as a brown spot. We analyzed 521 samples and
      got satisfactory results. We also analyzed 99 practical case samples by this
      method and achieved the same results as those obtained by other researchers using
      other methods. This method is accurate, simple, direct, rapid, and sensitive; it
      also produces easily observed results, requires no equipment, and can be
      completed in 30 min. The test proved to be clearly more sensitive for the
      detection of the ABO blood group in secretor saliva than the conventional
      hemagglutination inhibition test. Also saliva diluted 10(-4) to 10(-5) and the
      ABO group of nonsecretor saliva and urine could be easily detected by this
      method.

PMID- 2230687
TI  - Concentration of urine samples by three different procedures: ABO typing from
      concentrated urine samples.
AB  - Urine samples from 28 donors with known blood group and secretor status were
      concentrated by three different procedures, and ABO typing on the concentrated
      samples was successfully performed after 12 weeks of storage. The effects of
      storage with or without sodium azide on ABO typing and on the pH values at
      several different temperatures were also studied.

PMID- 2230688
TI  - Fatal ethanol intoxication from household products not intended for ingestion.
AB  - Fatal acute ethanol intoxication is frequently encountered in medicolegal
      practice. Although the vast majority of acute ethanol toxicity deaths follow the
      ingestion of conventional alcoholic beverages, ethanol can be obtained from a
      variety of commercial products, which often contain high levels of ethyl alcohol
      but are not manufactured or designed for consumption. Such products may be easily
      purchased in locales where statutory limitations restrict liquor availability on
      Sundays or during the early morning hours. Several acute ethanol fatalities have
      been encountered in New Mexico that were directly related to consumption of non
      beverage ethanol-containing products, all of them occurring during times when
      alcoholic beverage sales were restricted. Despite the fact that manufacturers
      deliberately include compounds in these products that discourage ingestion, this
      policy apparently does little to deter individuals who are searching for a source
      of ethanol when no conventional beverages are available. The products that were
      consumed in these fatalities also contained other compounds which would be toxic
      at much greater concentrations, but which were inconsequential in their effects
      in comparison with the direct toxic effect of ethanol. Investigation of the scene
      and awareness that alcohol-containing products can be fatally abused are
      essential to detecting these unconventional ethanol sources.

PMID- 2230689
TI  - Causes of death in hospitalized intravenous drug abusers.
AB  - The authors reviewed at autopsy the causes of death of 274 patients with evidence
      of intravenous drug abuse who had been admitted to a large public hospital. There
      were 127 who died from diseases unrelated to intravenous drug abuse, and in 41%
      of these, chronic alcoholism was implicated. Deaths from overdose syndromes and
      drug-related organ pathology comprised only 11% of all cases. The mean age at
      death was 39 years. There was a male/female ratio of 3.6:1. Half of all patients
      died from infection--72 from acquired immunodeficiency syndrome (AIDS) alone.
      These findings indicate that persons hospitalized with a history of intravenous
      drug abuse usually die from causes other than overdose and that AIDS and chronic
      alcoholism are significant problems. Emphasis should be placed upon detecting
      "hidden" intravenous drug deaths to provide more accurate statistical
      information.

PMID- 2230690
TI  - The grief process in those admitted to regional secure units following homicide.
AB  - Although there is considerable literature on grief and grief work, there have
      been few studies of the grief process in those who have killed someone. This
      paper reviews the scope of this problem in England and Wales and examines a
      number of issues in connection with the grieving process in those who have killed
      but, because they were found to be suffering from an "abnormality of mind" at the
      time of the offence, were found not guilty of murder. Increasingly, these
      patients are referred for treatment to Regional Secure Units, under hospital
      orders of the Mental Health Act of 1983.

PMID- 2230691
TI  - Liberty and tardive dyskinesia: informed consent to antipsychotic medication in
      the forensic psychiatric hospital.
AB  - This paper addresses informed consent to antipsychotic medication of those
      incarcerated in a forensic psychiatric hospital. The ways in which the unique
      setting of the forensic psychiatric hospital impinge upon the three components of
      informed consent--information, voluntariness, and competency--are explored.
      Special attention is given to the risk-benefit ratio of receiving antipsychotic
      medication in terms of the liberty interests at stake--freedom of movement, that
      is, the effects of tardive dyskinesia, and freedom of space, that is, release
      from the forensic psychiatric facility.

PMID- 2230692
TI  - Orosomucoid 1 phenotyping from human urine by isoelectric focusing.
AB  - Orosomucoid 1 polymorphism was revealed in human urine by isoelectric focusing
      and immunoprinting on polyacrylamide gels. The orosomucoid in urine samples was
      recovered and concentrated by using immobilized allo A lectin. The orosomucoid 1
      phenotypes of 60 urine samples correlated with those of the corresponding serum
      samples.

PMID- 2230693
TI  - Amplification of a variable number of tandem repeats (VNTR) locus (pMCT118) by
      the polymerase chain reaction (PCR) and its application to forensic science.
AB  - A genetic locus (D1S58, defined by DNA probe pMCT118) that contains a variable
      number of tandem repeats (VNTR) has been successfully amplified from a very small
      amount of genomic deoxyribonucleic acid (DNA) by the polymerase chain reaction
      (PCR). The DNA sequence of the locus was determined and was found to consist of a
      16-base consensus sequence and flanking sequences. Oligonucleotide primers
      complementary to the flanking sequences were synthesized to serve as primers for
      amplification of MCT118 by the PCR method. Human genomic DNA isolated from blood
      (2 ng from each sample) was successfully amplified at the MCT118 locus, and
      polymorphic bands were detectable by ethidium bromide staining after
      electrophoresis on polyacrylamide gels. Determination of genotypes at this VNTR
      locus can now be routinely achieved within 24 h, without the need for Southern
      blots or radioactive materials. Furthermore, the small size (387 to 723 base
      pairs) of the DNA fragments produced in the PCR amplification permits good
      resolution of individual alleles that differ by only one repeat unit. The precise
      specification of the number of tandem repeats present in each allelic fragment is
      reproducible from one analysis to another.

PMID- 2230694
TI  - Distributions of genetic markers in a Nebraska population.
AB  - Seven genetic marker systems were analyzed from liquid blood and dried bloodstain
      specimens submitted to the Nebraska State Patrol Crime Laboratory from various
      law enforcement agencies throughout Nebraska. The phenotypic and genotypic
      frequencies for the ABO, Lewis, esterase D (ESD), phosphoglucomutase (PGM),
      adenylate kinase (AK), adenosine deaminase (ADA), and haptoglobin (HP) systems
      were calculated. The results indicate that the phenotypic frequencies are
      generally in agreement with frequencies reported in other populations in the
      United States.

PMID- 2230695
TI  - Inadvertent clavicular fractures caused by "chiropractic" manipulations in an
      infant: an unusual form of pseudoabuse.
AB  - A nine-month-old child was found unresponsive in his crib, five hours after his
      last feeding. At autopsy, there were no external or internal signs of abuse or
      neglect, and a few visceral pleural and epicardial petechiae were consistent with
      the sudden infant death syndrome (SIDS). However, postmortem total body
      radiographs revealed healing, symmetrical clavicular fractures and a healing left
      medial humeral epicondyle fracture. The parents had no explanation for these
      injuries and denied causing any harm to the child. The location and nature of the
      fractures strongly suggested abusive origin, and the case was reported to the
      police and the district attorney's office as child abuse. During the
      investigation, information from the parents indicated that the child had
      undergone "chiropractic" manipulations by an unlicensed therapist, between three
      and four weeks prior to death, to correct supposed "shoulder dislocations." This
      time interval correlated with the histologic age of the injuries, and the history
      explained their unusual bilateral location and appearance. The parents were
      exonerated of abuse charges, and the death was ascribed to SIDS.

PMID- 2230696
TI  - An elliptical incised wound of the breast misinterpreted as a bite injury.
AB  - Bite injuries upon homicide victims are most often initially identified by the
      forensic pathologist during the course of the autopsy examination. Following such
      recognition, the injury or photographs of the traumatized site are then referred
      to a forensic odontologist for his or her examination, further characterization,
      and subsequent comparison with any suspect's dentition. However, if the
      pathologist misidentifies an injury caused by another mechanism as a human bite,
      this mistake can potentially be perpetuated by the dental consultant, since
      relatively few dentists regularly examine traumatic injuries other than those
      arising from bites. To illustrate such an event, a case is presented involving an
      incised wound of the breast, which was originally identified as an avulsive bite
      wound. Detailed examination by two odontologic consultants confirmed the wound as
      having been caused by human teeth, and further, they related the "bite injury" to
      a specific individual. The bite injury interpretation represented the only
      scientific evidence implicating the suspect at a subsequent trial for capital
      murder. Later examination of the tissues and photographs by a forensic
      pathologist and another dental consultant revealed that the injury was not due to
      human dentition, but rather resulted from a sharp-edged instrument. These
      consultants conducted a unique experiment to reduplicate the injury and prove its
      causation. This information was presented to the jury during the suspect's trial
      and resulted in his acquittal on all charges.

PMID- 2230697
TI  - Multiple gunshot wounds of the head: an anthropological view.
AB  - A decomposed body was judged at the scene to have two gunshot wounds of the
      thorax and three of the head. Confirmed at autopsy, the condition of the remains
      precluded conclusions about the precise nature of the defects. Preparation and
      reconstruction of the skull disclosed seven large cranial defects and a series of
      fractures. This preparation allowed the application of well-known principles of
      gunshot wound analysis. Although the analysis of specific gunshot wound defects
      is well covered in the literature, there are few examples of the application of
      gunshot wound principles to complex wound cases. Three entrances and three exits
      were identified. A seventh defect resulted from bullet passage. Finally, the
      wounds were sequenced.

PMID- 2230698
TI  - Home health care. Another emerging Mr. Hyde?

PMID- 2230699
TI  - Lest we forget.

PMID- 2230700
TI  - James G. Lyerly remembered.

PMID- 2230701
TI  - PRO reviewers needed.

PMID- 2230702
TI  - Testing for HIV infection.

PMID- 2230703
TI  - Relationship between Type A personality and coronary heart disease. Analysis of
      five cohort studies.
AB  - Five prospective cohort studies were compared in order to evaluate the
      relationship between type A personality (aggressive behavior) and coronary heart
      disease (CHD). The Western Collaborative Group Study (WCGS) demonstrated
      increased risk for CHD in males with type A personality. A follow-up study
      revealed a greater incidence of second myocardial infarction. The Framingham
      study showed higher rates of CHD in type A men and women. Two studies, MRFIT and
      a third evaluation of the WCGS, revealed no relationship between type A
      personality and CHD and mortality due to CHD. Because the studies disagree in the
      relationship between type A personality and CHD, it is impossible to conclude
      that type A personality is a risk for CHD.

PMID- 2230704
TI  - Results of emergent versus elective cardiac transplantation procedures.
AB  - Twenty-six patients underwent emergent (Group I) and 34 patients elective (Group
      II) cardiac transplantation (C. Tx.) from June 1985 through June 1989. Age, sex,
      etiology, presence of diabetes, renal failure and pulmonary artery pressures were
      comparable for both groups (P greater than 0.5). Twenty-two patients were in New
      York Heart Association (NYHA) Class IV for Group I and 17 for Group II. Group I
      included 12 patients on inotropic agents, five on intra-aortic balloon pump
      (IABP) and one on IABP and cardiopulmonary bypass (CPB). Elective patients were
      stable at home. Location of the donor heart and mean ischemic times were
      comparable for both groups. Early mortality (within 30 days) included four
      patients for Group I and two for Group II. There were four late deaths for Group
      I patients and six for Group II. Four deaths were due to infection, six to
      rejection, two to malignancy, two neurological and one each to suicide and
      multisystem failure. Immunosuppression regimen was similar for both groups. The
      number and severity of early and late rejection episodes were similar despite
      blood group crossing in 11 patients for Group I (P less than .01). Incidence of
      infection was comparable. Favorable lifestyles were comparable, including
      employment of 12 patients for Group I and 16 for Group II. Cumulative survival
      for the entire series was 70% at two years. The study indicates that the results
      of emergent and elective cardiac transplantation procedures are equally
      gratifying, that mortality is mainly related to rejection and sepsis
      complications and blood group crossing does not significantly increase the number
      of rejection episodes.

PMID- 2230705
TI  - Unusual cases of perforated diverticulitis of colon.
AB  - Two extraordinary cases of perforated diverticulitis with extraperitoneal
      presentation are described. The diagnosis should be kept in mind in unusual cases
      of pain or sepsis in the elderly. A brief review of pathogenesis is given.
      Surgical treatment with primary resection and drainage is emphasized.

PMID- 2230706
TI  - R.C. Philips Research and Education Unit.

PMID- 2230707
TI  - Ophthalmic surgical management of facial paralysis.
AB  - Combinations of these procedures have been performed on more than 50 patients to
      date, with the longest follow-up being greater than 8 years. All of these
      patients presented with complaints of ocular irritation, tearing, photophobia,
      and impaired vision. Several had severe epithelial keratopathy. Some patients
      have also been treated following neurosurgical procedures which caused paralysis
      of the fifth and seventh cranial nerves, resulting in both corneal anesthesia and
      facial paralysis. Patients have done very well after these procedures and have
      achieved ocular comfort, reduced tearing, and corneal protection without the need
      for disfiguring and visually occluding tarsorrhaphies or other procedures. In
      some instances, they may still require artificial tears during the day or a
      lubricating protective ointment for the eye at bedtime. There have been no
      significant complications in this series; no cases of gold weight extrusion,
      recurrent ectropion, or persistent corneal epithelial keratopathy. Some patients
      have complained of continued excessive tearing which is most likely due to
      paralysis of the lacrimal pump, resulting in ineffective tear drainage to the
      nasal lacrimal duct. However, these patients have still noted markedly reduced
      tearing compared to their preoperative condition. One patient underwent secondary
      release of her medial canthoplasty following return of facial nerve
      function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230708
TI  - Absorbance signals from resting frog skeletal muscle fibers injected with the pH
      indicator dye, phenol red.
AB  - Singly dissected twitch fibers from frog muscle were studied on an optical bench
      apparatus after micro-injection with the pH indicator dye, phenol red. Dye
      related absorbances in myoplasm, denoted by A0(lambda) and A90(lambda), were
      estimated as a function of wavelength lambda (450 nm less than or equal to lambda
      less than or equal to 640 nm) with light polarized parallel (0 degrees) and
      perpendicular (90 degrees) to the fiber axis respectively. At all lambda,
      A0(lambda) was slightly greater than A90(lambda), indicating that some of the
      phenol red molecules were bound to oriented structures accessible to myoplasm.
      The phenol red "isotropic" signal, [A0(lambda) + 2A90(lambda)]/3, a quantity
      equal to the average absorbance of all the dye molecules independent of their
      orientation, had a spectral shape that was red-shifted by approximately 10 nm in
      comparison with in vitro dye calibration curves measured in 140 mM KCl. The red
      shifted spectrum also indicates that some phenol red molecules were bound in
      myoplasm. A quantitative estimate of indicator binding was obtained from
      measurements of the dye's apparent diffusion constant in myoplasm, denoted by
      Dapp. The small value of Dapp, 0.37 x 10(-6) cm2 s-1 (at 16 degrees C), can be
      explained if approximately 80% of the dye was bound to myoplasmic sites of low
      mobility. To estimate the apparent myoplasmic pH, denoted by pHapp, the isotropic
      absorbance of phenol red was fitted by in vitro calibration spectra. pHapp was
      found to be independent of dye concentration (0.2-2 mM), but varied widely
      (range, 6.8-7.5; mean value, 7.17) among fibers judged from functional
      characteristics to be normal. When fibers were subjected to acid or alkaline
      loads by exposure to Ringer's solution containing, respectively, dissolved CO2 or
      NH3, the changes in pHapp were in agreement with those expected from pH micro
      electrode studies. It is concluded that in spite of the several indications for
      the presence of bound phenol red inside muscle cells, the pHapp signal from the
      indicator is useful for monitoring changes in myoplasmic pH in response to
      physiological and pharmacological manipulations.

PMID- 2230709
TI  - Changes in phenol red absorbance in response to electrical stimulation of frog
      skeletal muscle fibers.
AB  - Intact single twitch fibers from frog muscle were stretched to long sarcomere
      length, micro-injected with the pH indicator dye phenol red, and activated by
      action potential stimulation. Indicator-related absorbance changes (denoted by
      delta A0 and delta A90) were measured with 0 degree and 90 degrees polarized
      light (oriented, respectively, parallel and perpendicular to the fiber axis). Two
      components of delta A were detected that had generally similar time courses. The
      "isotropic" component, calculated as the weighted average (delta A0 + 2 delta
      A90)/3, had the wavelength dependence expected for a change in myoplasmic pH. If
      calibrated in pH units, this signal's peak amplitude, which occurred 15-20 ms
      after stimulation, corresponded to a myoplasmic alkalization of average value
      0.0025 +/- 0.0002 (+/- SEM; n = 9). The time course of this change, as judged
      from a comparison with that of the fibers' intrinsic birefringence signal, was
      delayed slightly with respect to that of the myoplasmic free [Ca2+] transient. On
      average, the times to half-peak and peak of the phenol red isotropic signal
      lagged those of the birefringence signal by 2.4 +/- 0.2 ms (+/- SEM; n = 8) and
      8.4 +/- 0.5 ms (+/- SEM; n = 4), respectively. The other component of the phenol
      red signal was "dichroic," i.e., detected as a difference (delta A0-delta A90
      greater than 0) between the two polarized absorbance changes. The wavelength
      dependence of this signal was similar to that of the phenol red resting dichroic
      signal (Baylor and Hollingworth. 1990. J. Gen. Physiol. 96:449-471). Because of
      the presence of the active dichroic signal, and because approximately 80% of the
      phenol red molecules appear to be bound in the resting state to either soluble or
      structural sites, the possibility exists that myoplasmic events other than a
      change in pH underlie the phenol red isotropic signal.

PMID- 2230710
TI  - Perturbation of sarcoplasmic reticulum calcium release and phenol red absorbance
      transients by large concentrations of fura-2 injected into frog skeletal muscle
      fibers.
AB  - Intact single twitch fibers from frog muscle were studied on an optical bench
      apparatus after micro-injection with two indicator dyes: phenol red, to monitor a
      previously described signal (denoted delta pHapp; Hollingworth and Baylor. 1990.
      J. Gen. Physiol. 96:473-491) possibly reflective of a myoplasmic pH change
      following action potential stimulation; and fura-2, to monitor the associated
      change in the myoplasmic free calcium concentration (delta[Ca2+]). Additionally,
      it was expected that large myoplasmic concentrations of fura-2 (0.5-1.5 mM) might
      alter delta pHapp, since it was previously found (Baylor and Hollingworth. 1988.
      J. Physiol. 403:151-192) that the Ca2(+)-buffering effects of large fura-2
      concentrations: (a) increase the estimated total concentration of Ca2+ (denoted
      by delta[CaT]) released from the sarcoplasmic reticulum (SR), but (b) reduce and
      abbreviate delta[Ca2+]. The experiments show that delta pHapp was increased at
      the larger fura-2 concentrations; moreover, the increase in delta pHapp was
      approximately in proportion to the increase in delta[CaT]. At all fura-2
      concentrations, the time course of delta pHapp, through time to peak, was closely
      similar to, although probably slightly slower than, that of delta[CaT]. These
      properties of delta pHapp are consistent with an hypothesis proposed by Meissner
      and Young (1980. J. Biol. Chem. 255:6814-6819) and Somlyo et al. (1981. J. Cell
      Biol. 90:577-594) that a proton flux from the myoplasm into the SR supplies a
      portion of the electrical charge balance required as Ca2+ is released from the SR
      into the myoplasm. A comparison of the amplitude of delta pHapp with that of
      delta[CaT] indicates that, in response to a single action potential, 10-15% of
      the charge balance required for Ca2+ release may be carried by protons.

PMID- 2230711
TI  - Voltage-dependent block of charge movement components by nifedipine in frog
      skeletal muscle.
AB  - Potential-dependent inhibition of charge movement components by nifedipine was
      studied in intact, voltage-clamped, frog skeletal muscle fibers. Available charge
      was reduced by small shifts in holding potential (from -100 mV to -70 mV) in 2
      microM nifedipine, without changes in the capacitance deduced from control (-120
      mV to -100 mV) voltage steps made at a fully polarized (-100 mV) holding
      potential. These voltage-dependent effects did not occur in lower (0-0.5 microM)
      nifedipine concentrations. The voltage dependence of membrane capacitance at
      higher (10 microM) nifedipine concentrations was reduced even in fully polarized
      fibers, but shifting the holding voltage produced no further block. Voltage
      dependent inhibition by nifedipine was associated with a fall in available
      charge, and a reduction in the charge and capacitance-voltage relationships and
      of late (q gamma) charging transients. It thus separated a membrane-capacitance
      with a distinct and steep steady-state voltage dependence. Tetracaine (2 mM)
      reduced voltage-dependent membrane capacitance and nonlinear charge more than did
      nifedipine. However, nifedipine did not exert voltage-dependent effects on
      charging currents, membrane capacitance, or inactivation of tetracaine-resistant
      (q beta) charge. This excludes participation of q beta, or the membrane charge as
      a whole, from the voltage-dependent effects of nifedipine. Rather, the findings
      suggest that the charge susceptible to potential-dependent block by nifedipine
      falls within the tetracaine-sensitive (q gamma) category of intramembrane charge.

PMID- 2230712
TI  - Circadian rhythms in Limulus photoreceptors. II. Quantum bumps.
AB  - The light response of the lateral eye of the horseshoe crab, Limulus polyphemus,
      increases at night, while the frequency of spontaneous discrete fluctuations of
      its photoreceptor membrane potential (quantum bumps) decreases. These changes are
      controlled by a circadian clock in the brain, which transmits activity to the eye
      via efferent optic nerve fibers (Barlow, R. B., S. J. Bolanski, and M. L
      Brachman. 1977. Science. 197:86-89). Here we report the results of experiments in
      which we recorded from single Limulus photoreceptors in vivo for several days and
      studied in detail changes in their physiological and membrane properties. We
      found that: (a) The shape of (voltage) quantum bumps changes with the time of
      day. At night, spontaneous bumps and bumps evoked by dim light are prolonged. The
      return of the membrane potential to its resting level is delayed, but the rise
      time of the bump is unaffected. On average, the area under a bump is 2.4 times
      greater at night than during the day. (b) The rate of spontaneous bumps decreases
      at night by roughly a factor of 3, but their amplitude distribution remains
      unchanged. (c) The resting potential and resistance of the photoreceptor membrane
      do not change with the time of day. (d) the relationship between injected current
      and impulse rate of the second order neuron, the eccentric cell, also remains
      unchanged with the time of day. Thus the efferent input from the brain to the
      retina modulates some of the membrane properties of photoreceptor cells. Our
      findings suggest that the efferent input acts on ionic channels in the membrane
      to increase the sensitivity of the photoreceptor to light.

PMID- 2230713
TI  - An effective technique for enrichment and isolation of Candida cloacae mutants
      defective in alkane catabolism.
AB  - Techniques are described which allow mutated populations of Candida cloacae to be
      enriched efficiently (up to 167-fold in one round of enrichment) for mutants
      deficient in the alkane degradation pathway (Alk-). Such mutants, as well as
      being of scientific importance in studies of the degradation pathway, are also of
      commercial interest because several of the degradative intermediates are of value
      to the chemical industry. The Alk- mutants were readily isolated by their
      inability to grow on agar plates supplied with hexadecane as sole carbon source.
      A total of 288 Alk- mutants were isolated from, effectively, 4 x 10(6) mutagen
      treated cells. They were further characterized by replica-plating using palmitic
      acid (PA) or acetate (Ac) as sole carbon source. Preliminary screening studies
      showed that of the 84 Alk- PA- Ac+ mutants, most could accumulate dicarboxylic
      acids from hexadecane and palmitic acid and at least one mutant also produced 3
      hydroxyhexadecanedioic acid. Of the 80 mutants characterized as Alk- PA+, 16
      produced small amounts of hexadecanol.

PMID- 2230714
TI  - Urogenital, maternal and neonatal isolates of Haemophilus influenzae:
      identification of unusually virulent serologically non-typable clone families and
      evidence for a new Haemophilus species.
AB  - A collection of 117 strains of Haemophilus influenzae, including 112 non-typable
      isolates recovered predominantly in the USA and France from genital, obstetric
      and neonatal sources, was characterized by the electrophoretic mobilities of 10
      metabolic enzymes. Eighty-six distinctive multilocus chromosomal genotypes
      (electrophoretic types, ETs) were distinguished on the basis of allele profiles
      at the enzyme loci. Isolates of five allied biotype IV ETs were highly divergent
      from all other strains and hybridization of chromosomal DNA revealed that they
      undoubtedly represent a previously unrecognized species of Haemophilus. Isolates
      representing these ETs were recovered predominantly from obstetric infections and
      serious neonatal diseases and apparently possess specific tropism for the genital
      tract. Strains of these five ETs were present in samples from both the USA and
      France, but only in the USA did they cause bacteraemia and meningitis, an
      occurrence which probably reflects differences in patient management between the
      two countries. Although strains assigned to H. influenzae (sensu stricto) were
      strongly polymorphic in multilocus enzyme genotype, 69% of isolates recovered
      from patients with meningitis and/or septicaemia were assigned to only two clone
      families, a result suggesting that some serologically nontypable strains of H.
      influenzae originating from the genital tract are unusually virulent.

PMID- 2230715
TI  - Effect of ethanol on the phospholipid and fatty acid content of
      Schizosaccharomyces pombe membranes.
AB  - Ethanol at concentrations up to 5% (v/v) had no effect on the growth of
      Schizosaccharomyces pombe, whereas concentrations over 7.5% were inhibitory. The
      major membrane phospholipids in S. pombe cells growing aerobically in the absence
      of added ethanol were phosphatidylinositol, phosphatidylcholine and
      phosphatidylethanolamine. Oleic acid (18:1) was the main fatty acid. When ethanol
      (7.5%) was added to aerobically growing cultures, the phosphatidylinositol
      content increased, whereas the 18:1 content decreased. Similar changes were
      observed in the membrane phospholipids of cells grown anaerobically without
      ethanol. However, the presence of ethanol in anaerobically growing cultures had
      an opposite effect on fatty acids, as the 18:1 content increased. The results
      support the idea that ethanol tolerance in S. pombe may be connected with a high
      content of 18:1 fatty acids, and with the ability to maintain a high rate of
      phospholipid biosynthesis.

PMID- 2230716
TI  - Acetolysis and 1H NMR studies on mannans isolated from very flocculent and weakly
      flocculent cells of Pichia pastoris IFP 206.
AB  - Growth of the yeast Pichia pastoris IFP 206 in methanol- and glucose-containing
      media led respectively to very and weakly flocculent cells. Mannans from both
      kinds of cells were extracted and compared. Chemical analysis and molecular mass
      estimation showed some differences between the mannans from very and weakly
      flocculent cells, especially in quantitative amino acid content. 1H NMR analysis
      showed that both kinds of mannan contained alpha-1,2 and beta-1,2 linkages. Two
      acetolysis conditions, combined with 1H NMR analysis, revealed that mannans from
      both kinds of cells were composed of mannose, mannobiose, mannotriose,
      mannotetraose and mannopentaose side-chains with the following respective
      structures: Man; Man alpha 1---2Man; Man alpha 1----2Man alpha 1----2Man; Man
      beta 1----2Man alpha 1----2Man; Man beta 1----2Man beta 1----2Man alpha 1---
      2Man; Man alpha 1----2Man beta 1----2Man beta 1----2Man alpha 1----2Man.
      Additionally the beta-1,2 linkages of the non-reducing terminal residues of the
      mannotetraose were shown to be acetolysis-labile. The mannans from very
      flocculent cells were richer in mannopentaose than the mannans from weakly
      flocculent cells. According to these results, the extended conformations in the
      branching moieties of the mannan could be the basis of the higher degree of
      flocculation of the methanol-grown cells.

PMID- 2230717
TI  - Characterization of a glycerol kinase mutant of Aspergillus niger.
AB  - A glycerol-kinase-deficient mutant of Aspergillus niger was isolated. Genetic
      analysis revealed that the mutation is located on linkage group VI. The phenotype
      of this mutant differed from that of a glycerol kinase mutant of Aspergillus
      nidulans in its ability to utilize dihydroxyacetone (DHA). The weak growth on
      glycerol of the A. niger glycerol kinase mutant showed that glycerol
      phosphorylation is an important step in glycerol catabolism. The mutant could
      still grow normally on DHA because of the presence of a DHA kinase. This enzyme,
      probably in combination with an NAD(+)-dependent glycerol dehydrogenase, present
      only in the mutant, is responsible for the weak growth of the mutant on glycerol.
      Enzymic analysis of both the mutant and the parental strain showed that at least
      three different glycerol dehydrogenases were formed under different physiological
      conditions: the NAD(+)-dependent enzyme described above, a constitutive NADP(+)
      dependent enzyme and a D-glyceraldehyde-specific enzyme induced on D
      galacturonate. The glycerol kinase mutant showed impaired growth on D
      galacturonate.

PMID- 2230718
TI  - Molecular cloning and nucleotide sequence of a gene for alkaline cellulase from
      Bacillus sp. KSM-635.
AB  - A gene for alkaline cellulase from the alkalophilic Bacillus sp. KSM-635 was
      cloned into the HindIII site of pBR322 and expressed in Escherichia coli HB101.
      Although the recombinant plasmid contained two HindIII inserts of 2.6 kb and 4.0
      kb, the inserts were found to be contiguous in the Bacillus genome by
      hybridization analysis. Nucleotide sequences of a 2.4 kb region which was
      indispensable for the production of cellulase, and the flanking, 1.1 kb region,
      were determined. There was an open reading frame (ORF) of 2823 bp in the 3498 bp
      sequence determined, which encoded 941 amino acid residues. Two putative ribosome
      binding sites and a sigma 43-type, promoter-like sequence were found upstream
      from an initiation codon in the ORF. The deduced amino-terminal sequence
      resembles the signal peptide of extracellular proteins. A region of amino acids,
      249 to 568, of the deduced amino acid sequence of the cellulase from this
      organism is homologous with those of alkaline and neutral enzymes of other micro
      organisms, but nine amino acid residues were found to be conserved only in the
      alkaline enzymes.

PMID- 2230719
TI  - Molecular cloning and characterization of the spaB gene of Streptococcus
      sobrinus.
AB  - A gene of Streptococcus sobrinus 6715 (serotype g) designated spaB and encoding a
      surface protein antigen was isolated from a cosmid gene bank. A 5.4 kb
      HindIII/AvaI DNA fragment containing the gene was inserted into plasmid pBR322 to
      yield plasmid pXI404. Analysis of plasmid-encoded gene products showed that the
      5.4 kb fragment of pXI404 encoded a 195 kDa protein. Southern blot experiments
      revealed that the 5.4 kb chromosomal insert DNA had sequence similarity with
      genomic DNA of S. sobrinus 6715, S. sobrinus B13 (serotype d) and Streptococcus
      cricetus HS6 (serotype a). The recombinant SpaB protein (rSpaB) was purified and
      monospecific antiserum was prepared. With immunological techniques and the anti
      rSpaB serum, we have shown: (1) that the rSpaB protein has physico-chemical and
      antigenic identity with the S. sobrinus SpaB protein, (2) the presence of cross
      reactive proteins in the extracellular protein of serotypes a and d of the mutans
      group of streptococci and (3) that the SpaB protein is expressed on the surface
      of mutans streptococcal serotypes a, d and g.

PMID- 2230720
TI  - Structure of a Rhodococcus gene encoding pigment production in Escherichia coli.
AB  - A 2.1 kbp DNA fragment from Rhodococcus strain ATCC 21145 gave rise to the
      production of blue and pink pigments in Escherichia coli when cloned downstream
      of a strong promoter. The sequence of this DNA fragment contains a single open
      reading frame with a putative ribosome-binding site, potentially coding for a
      single protein of Mr 42,560. Deletion analysis and in vitro transcription
      translation experiments support the hypothesis that pigment production in E. coli
      is due to a single enzyme whose catalytic activity is still unknown. This small
      pigment gene may become useful for the development of a new generation of
      chromogenic cloning vectors which do not require expensive substrates for the
      detection of gene expression.

PMID- 2230721
TI  - Further biological and molecular characterization of actinophage VWB.
AB  - The development cycle of the temperate actinophage VWB was investigated.
      Adsorption of most phage particles occurred within 30 min and the adsorption
      constant was 0.6 x 10(-8) ml min-1. The latent and rise periods were 140 and 100
      min, respectively, and the burst size was estimated to be 130-250 p.f.u. Although
      phage VWB could infect only Streptomyces venezuelae ETH 14630 (ATCC 40755), of
      six different S. venezuelae strains tested, phage DNA could be introduced by
      transfection into most non-infectible strains. Upon transfection, phage DNA was
      propagated in these non-infectible strains and phage particles were released. In
      addition, the transfected strains could be lysogenized. By comparison of
      restriction fragments of VWB DNA, either free or integrated in the chromosomal
      DNA of the S. venezuelae ETH 14630 lysogen, the attachment site was localized.
      PAGE of the phage proteins revealed at least 17 different proteins with three
      major bands estimated as 16.5, 27.2 and 43 kDa in size. The N-terminal amino acid
      sequence of these supposed major head and tail proteins was determined. The
      corresponding DNA sequences on the phage genome were localized using
      oligonucleotides synthesized on the basis of the N-terminal amino acid sequences.
      The genes coding for the major structural proteins were shown to be clustered, as
      has been observed for other bacteriophages.

PMID- 2230722
TI  - Nutritional stress proteins in Candida albicans.
AB  - Starving cells of Candida albicans synthesize at least seven proteins that
      represent nutritional-stress proteins (NSP). Such NSPs are formed by both
      germination-competent and germination-deficient strains of C. albicans. Heat
      shock proteins (HSP) are not formed by starving cells. Germination-competent
      cells synthesize specific sets of proteins when incubated in a starvation medium
      that contains the germ-tube-inducing substances N-acetyl-D-glucosamine or L
      proline. Both sets of induced proteins were also synthesized by a germination
      deficient strain of C. albicans.

PMID- 2230723
TI  - Cloning and characterization of the gene for the '19 kDa' antigen of
      Mycobacterium bovis.
AB  - Monoclonal antibody CMA134.1 reacted with a protein antigen of apparent molecular
      mass 22 kDa from Mycobacterium bovis and Mycobacterium tuberculosis, and with an
      apparently 24 kDa antigen of Mycobacterium kansasii, but not with other
      mycobacteria or related species. This antibody was used to screen a gene library
      of M. bovis in lambda gt11 and identified a recombinant clone that expressed a
      protein with an apparent molecular mass of 19-20 kDa. Gene expression occurred
      from the lac promoter in lambda gt11, but used an unidentified vector promoter,
      possibly that of the replication primer RNA, in the final plasmid construct. The
      sequence of an 840 bp fragment was determined and shown to code for a product of
      15 kDa. This sequence is identical to that, independently determined, of a gene
      from M. tuberculosis, usually referred to as the 19 kDa antigen. The reasons for
      the apparent size discrepancies are discussed.

PMID- 2230724
TI  - Lactoferrin and transferrin damage of the gram-negative outer membrane is
      modulated by Ca2+ and Mg2+.
AB  - Lactoferrin and transferrin have antimicrobial activity against selected Gram
      negative bacteria, but the mechanism of action has not been defined. We studied
      the ability of lactoferrin and transferrin to damage the Gram-negative outer
      membrane. Lipopolysaccharide release by the proteins could be blocked by
      concurrent addition of Ca2+ and Mg2+. Addition of Ca2+ also blocked the ability
      of lactoferrin to increase the susceptibility of Escherichia coli to rifampicin.
      Transferrin, but not lactoferrin, increased susceptibility of Gram-negative
      bacteria to deoxycholate, with reversal of sensitivity occurring with exposure to
      Ca2+ or Mg2+. In transmission electron microscopy studies polymyxin B caused
      finger-like membrane projections, but no morphological alterations were seen in
      cells exposed to EDTA, lactoferrin or transferrin. These data provide further
      evidence that lactoferrin and transferrin act as membrane-active agents with the
      effects modulated by Ca2+ and Mg2+.

PMID- 2230725
TI  - Expression of cauliflower mosaic virus gene I in insect cells using a novel
      polyhedrin-based baculovirus expression vector.
AB  - An improved polyhedrin-based baculovirus expression vector was constructed to
      expedite distinguishing infections by putative baculovirus recombinants from
      infections by wild-type (wt) baculovirus. The vector utilizes the Escherichia
      coli beta-galactosidase gene (lacZ) as a genetic marker for positive
      recombination between wt Autographa californica nuclear polyhedrosis virus and
      the baculovirus transfer vector. The marker gene/expression cassette was
      constructed so that lacZ and the deleted polyhedrin gene were transcribed in
      opposite orientations, both terminating in a simian virus 40 DNA fragment which
      acts as a bidirectional terminator. In the constructed vector, lacZ is
      transcribed from the Drosophila melanogaster heat-shock promoter (hsp 70), which
      is constitutively expressed in baculovirus-infected Spodoptera frugiperda (Sf)
      cells, thereby making the site of the deleted polyhedrin gene available for the
      insertion and expression of foreign genes under the control of the polyhedrin
      promoter. Recombinant baculoviruses are readily selected in plaque assays by the
      development of a blue colour upon the addition of X-Gal. The colour selection
      renders the retrieval of recombinants less dependent on a high frequency of
      recombination between the transfer vector and wt baculovirus DNA. The usefulness
      of this new vector was illustrated by expressing gene I of cauliflower mosaic
      virus, which encodes a protein of Mr 46,000. Expression of gene I was at the same
      level as in cells infected with a conventional polyhedrin-based expression
      vector. Gene I protein formed large hollow fibre-like structures in the cytoplasm
      of infected Sf cells. This is the first plant virus protein to be expressed in
      insect cells by a recombinant baculovirus.

PMID- 2230726
TI  - Genomic characterization of phenotypic variants of beet curly top virus.
AB  - Full-length infectious DNA clones were constructed for four distinct phenotypic
      variants of beet curly top virus (BCTV). Southern hybridization assays indicated
      that each cloned BCTV genome shared sequence homology with pBCT-028, a full
      length infectious DNA clone of a California isolate of BCTV previously
      characterized by others. Restriction endonuclease maps of the cloned BCTV genomes
      were distinct from one another. Infectivity assays determined that plasmids
      containing tandem repeats of BCTV genomes were generally more infectious than
      excised linear DNA inserts. Progeny virus, derived from plants inoculated with
      cloned DNAs, differed in their ability to infect sugarbeet, Beta vulgaris L., and
      the severity of symptoms produced in B. vulgaris and other experimental hosts.

PMID- 2230727
TI  - Nucleotide sequence of rice dwarf virus genome segment 4.
AB  - The complete nucleotide sequence of rice dwarf virus (RDV) genome segment 4 was
      determined. Genome segment 4 was 2468 nucleotides long and had a long open
      reading frame initiating at nucleotides 64 to 66 and terminating at 2245 to 2247.
      The deduced polypeptide contained 727 amino acid residues with an Mr of 79.8K.
      Amino acid sequences similar to a 'zinc-finger' and purine NTP-binding motifs
      were present in the deduced polypeptide. Considerable amino acid sequence
      homology was detected between genome segment 4 of RDV and wound tumor virus
      (WTV). One of the sequences similar to the 'zinc-finger' motif was present in a
      conserved region of the polypeptide of both viruses. However, the sequence
      similar to the purine NTP-binding motif was not present in the polypeptide
      encoded by genome segment 4 of WTV.

PMID- 2230728
TI  - A classification of the tobamoviruses based on comparisons among their 126K
      proteins.
AB  - The products of partial proteolysis of the Mr 126,000 in vitro translation
      products of the RNA of eight tobamoviruses were separated by SDS-polyacrylamide
      gel electrophoresis. The peptide patterns obtained were compared using a computer
      program designed to establish phylogenetic relationships. The resulting most
      parsimonious phylogenetic trees grouped the tobamoviruses into clusters I
      (tobacco mosaic virus, tomato mosaic virus, tobacco mild green mosaic virus,
      pepper mild mottle virus) and II (sunn-hemp mosaic virus, cucumber green mottle
      mosaic virus, kyuri green mottle mosaic virus), with ribgrass mosaic virus in an
      intermediate position. This clustering resembles that obtained when the coat
      proteins of these viruses are compared. If the tobamoviruses have arisen by
      divergence from an ancestral type, the results suggest that different parts of
      the genome have diverged similarly and that recombination has not played a major
      role in the evolution of the group.

PMID- 2230730
TI  - Translation of cucumber necrosis virus RNA in vitro.
AB  - The in vitro translation products directed by cucumber necrosis virus (CNV) RNA
      were analysed in both rabbit reticulocyte lysate and wheatgerm extract cell-free
      translation systems. In rabbit reticulocyte lysates, one major protein of
      approximate Mr 34.6K was produced. In wheatgerm extracts, four proteins of
      approximate Mr values 41.6K, 34.6K, 24K and 20K were produced. The genomic
      locations of the CNV in vitro translation products were determined using several
      experimental approaches including, first, hybrid-arrested translation using
      negative-sense RNA corresponding to selected regions of the CNV genome, second,
      in vitro translation of synthetic positive-sense CNV transcripts and third, in
      vitro translation of CNV virion RNA fractionated according to size. Together
      these experiments demonstrated that the protein of Mr 34.6K is derived from the
      5'-proximal coding region, the 41.6K protein is derived from an internal coding
      region, and that at least one but probably both the 24K and 20K proteins are
      derived from the 3'-terminal coding region. In addition, immunoprecipitation of
      in vitro translation products using anti-CNV polyclonal serum demonstrated that
      the 41.6K protein is the coat protein. The templates for the expression of CNV
      cistrons were investigated by in vitro translation of sucrose gradient
      fractionated CNV virion RNA as well as in vitro translation of positive-sense
      synthetic transcripts.

PMID- 2230729
TI  - Antigenic analysis of the coat protein of beet necrotic yellow vein virus by
      means of monoclonal antibodies.
AB  - By means of monoclonal antibodies (MAbs), five (groups of) epitopes were
      identified on particles of beet necrotic yellow vein virus (BNYVV). Epitopes 1
      and 2, which were located on the opposite extremities of virus particles, are
      discontinuous (SDS-labile) epitopes which were destroyed when the particles were
      treated with trypsin. Epitope 3 is a continuous (SDS-stable) epitope located at
      the same extremity as epitope 2. It was not destroyed when the particles were
      treated with trypsin and was present on an Escherichia coli-expressed fusion
      protein containing amino acids (aa) 1 to 103 of the BNYVV coat protein. The
      continuous epitope 4, which was located along the entire length of the particles,
      was found to be present on a fusion protein containing aa 104 to 188 of the BNYVV
      coat protein but not on trypsin-treated virus particles. In Western blots, these
      treated particles yielded two slightly smaller coat proteins which failed to
      react with MAbs specific for epitope 4 but did react with polyclonal antisera and
      MAbs specific for epitope 3. BNYVV coat protein has a trypsin cleavage site on
      the carboxyl side of arginine in position 182, so it is therefore suggested that
      epitope 4 is located on the exposed C terminus, which is composed of aa 183 to
      188. Epitope 5 was also located along the entire length of the particles but in a
      more uneven distribution than epitope 4. This may be because it is a
      discontinuous epitope that is very sensitive to subtle changes in protein
      conformation.

PMID- 2230732
TI  - Expression of the genome of potato leafroll virus: readthrough of the coat
      protein termination codon in vivo.
AB  - An antiserum was raised against a fusion protein containing part of the 56K
      polypeptide (P5) encoded by the open reading frame (ORF) at the 3' end of the
      genome of potato leafroll virus (PLRV). This antiserum reacted specifically with
      80K and 90K polypeptides in PLRV-infected protoplasts, with a 90K polypeptide in
      infected potato tissue and with a 53K polypeptide in protein extracted from
      purified particles of PLRV. Monoclonal antibodies raised against purified PLRV
      particles also reacted with these polypeptides, as well as with the 23K coat
      protein. Virus particles partially purified from infected protoplasts contained
      some 90K polypeptide as well as the major 23K coat protein. The ORFs of the 23K
      coat protein and P5 are contiguous and in frame. The results suggest that the P5
      polypeptide of PLRV occurs in infected cells as part of a readthrough protein
      comprising the 23K coat protein joined to the P5 amino acid sequence. Moreover
      the readthrough protein can be assembled into virus particles as a minor
      component together with the main 23K component. The P5 protein may thus
      contribute to properties of PLRV determined by its virus particle surface.

PMID- 2230731
TI  - Nucleotide sequence and evolutionary relationships of cucumber mosaic virus (CMV)
      strains: CMV RNA 3.
AB  - The nucleotide sequence of RNA 3 of two subgroup I strains of cucumber mosaic
      virus (CMV), Fny-CMV and M-CMV, was determined and compared at both the nucleic
      acid and protein level with the previously determined, corresponding (partial)
      sequences of RNA 3 of five other subgroup I strains: C-CMV, D-CMV, I17F-CMV, O
      CMV and Y-CMV. Fny-CMV RNA 3 is composed of 2216 nucleotides (nt) and M-CMV RNA 3
      2214 nt. Both RNAs contain two open reading frames, the 3a gene and the coat
      protein gene. These RNAs showed very little nucleotide sequence divergence,
      either from each other or from the five other subgroup I strains. The nucleotide
      sequence variation observed was two to 13 differences in the 120 to 123 nt 5' non
      translated regions, six to 17 differences in the 840 nt 3a genes, two to 15
      differences in the 296 to 299 nt intergenic regions, three to 25 differences in
      the 657 nt coat protein genes and two to 10 differences in the 299 to 303 nt 3'
      non-translated regions. Protein sequence similarity was also high, with one to
      four differences in the 279 amino acids of the 3a proteins and two to 13
      differences in the 218 amino acids of the coat proteins. Limited nucleotide
      sequence variation among nine strains of CMV was also shown using an RNA
      protection assay and a probe specific for Fny-CMV RNA 3. The limited variation
      shown by RNA 3 of strains of CMV with different passage histories, isolated in
      different countries over a 50 year period, suggests that the maintenance of the
      highly conserved nucleotide sequence may be important for other viral RNA
      functions or interactions.

PMID- 2230733
TI  - Ribozymes that cleave potato leafroll virus RNA within the coat protein and
      polymerase genes.
AB  - Two ribozymes were synthesized which were designed to cleave potato leafroll
      virus (PLRV) positive strand RNA within the regions known to encode the viral
      coat protein and the predicted RNA polymerase gene. DNA sequences encoding the
      ribozymes were inserted into the Escherichia coli plasmids pTz18R and pTz19R
      under the control of the bacteriophage T7 promoter and enzymically active RNA
      molecules generated by transcription by T7 RNA polymerase in vitro. Each ribozyme
      cleaved its cognate site in RNA derived from either cDNA or PLRV particles.
      Ribozyme cleavage sites within the polymerase gene and coat protein gene were
      determined and shown to be at the predicted sequence immediately downstream from
      a GUC motif. An altered version of the ribozyme which recognized the sequence in
      the coat protein gene was isolated in which a single adenosine residue in the
      enzymic loop of the ribozyme was deleted. This mutated ribozyme was unable to
      cleave RNA molecules containing the coat protein ribozyme target site.

PMID- 2230734
TI  - Characterization of a potato leafroll luteovirus subgenomic RNA: differential
      expression by internal translation initiation and UAG suppression.
AB  - Northern blot analysis of Solanum tuberosum infected with potato leafroll
      luteovirus revealed the 6 kb genomic RNA and a major 2.3 kb subgenomic RNA. The
      5' end of the subgenomic RNA was located at nucleotide 3653 in an intergenic
      region located at the centre of the viral genome upstream of three open reading
      frames (ORFs). Transient expression in tobacco and potato protoplasts of the beta
      glucuronidase reporter gene fused to various putative regulatory sequences
      present in the subgenomic RNA was used to study their influence on expression
      levels. We observed a suppression of the amber stop codon separating the coat
      protein (CP) gene from a downstream ORF (56K protein), to a level of 0.9% to
      1.3%. Translation initiation at the AUG of an ORF (17K protein) which is nested
      within the CP gene, exceeds translation of the CP gene itself by a factor of 7.

PMID- 2230735
TI  - Attenuation of wild-type yellow fever virus by passage in HeLa cells.
AB  - During the 1960s three different research groups reported that passage of wild
      type yellow fever (YF) virus [strain Asibi (YF-Asibi)] in HeLa cells resulted in
      attenuation of the virus for monkeys so that the virus no longer caused
      viscerotropic disease. We have repeated and extended this observation to analyse
      the process of attenuation of YF virus during cell culture passage. A large
      plaque (LP) variant of YF-Asibi virus became attenuated for both monkeys and mice
      following six serial subcultures in HeLa cells (YF-Asibi-LP HeLa p6). Thus,
      attenuation was probably due to a genetic change in the virus population rather
      than to selective enrichment of a pre-existing variant of YF-Asibi-LP virus. No
      evidence was obtained to implicate defective interfering particles in the
      attenuation process. Comparison of the YF-Asibi-LP viruses before and after
      passage in HeLa cells, using a panel of envelope protein-reactive monoclonal
      antibodies (MAbs), showed that MAbs which specifically neutralize YF-Asibi-LP
      virus, and not YF 17D-204 vaccine virus, also neutralized YF-Asibi-LP HeLa p6.
      This indicated that the epitopes involved in the biological process of
      neutralization were not altered during attenuation. However, two MAbs that
      recognize envelope protein epitopes did distinguish between HeLa- and non-HeLa
      passaged YF-Asibi-LP virus. One of these (MAb 117) which is YF wild-type
      specific, recognized YF-Asibi-LP virus but not YF-Asibi-LP HeLa p6 virus, whereas
      the other (MAb411), which is YF vaccine-specific, recognized YF-Asibi-LP HeLa p6
      virus but not YF-Asibi-LP virus. These results suggest that antigenic changes in
      the viral envelope protein may determine the relative virulence or attenuation of
      YF virus.

PMID- 2230736
TI  - Generation and transmission of Rift Valley fever viral reassortants by the
      mosquito Culex pipiens.
AB  - Reassortant viruses containing heterologous S and M genomic RNA segments were
      obtained from both mosquito and vertebrate hosts that had been coinfected with
      Egyptian and Senegalese strains of Rift Valley fever (RVF) virus. The origin of
      the S and M RNA segments in each plaque-cloned virus was determined with
      monoclonal antibodies capable of differentiating the nucleocapsid protein (S
      segment marker) or the G1 glycoprotein (M segment marker) of the parental
      strains. In the mosquito Culex pipiens, reassortants were detected after
      sequential ingestion of parental viruses by interrupted feeding on two infected
      hamster hosts, after feeding on a single host that had been infected with both
      parental strains, and from individual mosquitoes inoculated intrathoracically
      with both parental strains. Reassortant viruses replicated efficiently in
      mosquitoes and were readily transmissible by bite to hamsters. Replication of a
      second infecting strain of RVF virus was, however, completely inhibited if that
      virus was inoculated into a mosquito greater than or equal to 48 h after the
      first viral strain. Genetic reassortment may provide a mechanism for increased
      heterogeneity, and thus affect the epidemiology and evolution of RVF virus.

PMID- 2230737
TI  - Morphological studies of the neutralization of influenza virus by IgM.
AB  - Quantitative relationships between neutralization, aggregation and attachment to
      monolayers of chick embryo fibroblast (CEF) cells have been studied using a
      constant amount of influenza A/fowl plague virus/Rostock/34 (H7N1) and varying
      amounts of purified mouse polyclonal IgM directed against the haemagglutinin, the
      major viral neutralization antigen. There are two major types of interaction. (i)
      At low concentrations of IgM there is aggregation of virus, but no neutralization
      provided that the aggregates are dispersed by vortexing and dilution. Maximum
      aggregation occurs at less than seven molecules of IgM per virion and the IgM is
      probably bound in the 'staple' or 'crab' conformation at these concentrations.
      (ii) At higher concentrations there is neutralization and this coincides with
      inhibition of attachment of virus to CEF cells. Neutralization of 50% infectivity
      requires about 35 molecules of IgM per virion. The maximum neutralization
      observed was only 87%. Quantitative data and electron microscopy observations
      suggest that molecules of IgM at the higher concentrations adopt a planar stance
      approximately perpendicular to the viral surface. It appears that IgM neutralizes
      fowl plague virus in vitro primarily by interfering with its attachment to cells;
      the fraction of neutralized virus that does attach is known not be internalized.

PMID- 2230738
TI  - Variable regions on the genome of Malawi isolates of African swine fever virus.
AB  - Restriction enzyme site mapping showed that most BamHI and all ClaI sites were
      conserved on the genomes of 17 African swine fever virus isolates from separate
      disease outbreaks that occurred between 1982 and 1989 in Malawi. However,
      frequent variation between virus genomes did occur due to addition or deletion of
      DNA sequences at various positions along the genome and 11 virus genotypes could
      thus be distinguished among the 17 isolates analysed. Length variations occurred
      at 10 different loci on the virus genome. These variable regions were located
      between the left DNA terminus and a position up to 48 kb from that terminus, in
      the centre of the genome 90 to 93 kb from the left DNA terminus and between the
      right DNA terminus and a position 22 kb from that terminus. Length variations in
      most of these regions were small (less than 1 kb) but variations of about 4 kb
      occurred in a region up to 20 kb from the left DNA terminus.

PMID- 2230739
TI  - Biochemical and immunological studies of proteins from polydnavirus Chelonus sp.
      near curvimaculatus.
AB  - Polydnavirus from Chelonus sp. curvimaculatus (CcV) was purified and 18
      structural polypeptides associated with CcV were identified by silver staining.
      Antibodies were raised against CcV protein and used in testing for ovary and in
      stung eggs. It was also established that the virus does not enter during the
      first 5 s of oviposition. Furthermore, no degradation of the virus proteins was
      Detected inside the egg within 2 h after oviposition. The glycoprotein nature of
      virus proteins was also determined by concanavalin A/horseradish peroxidase
      staining. The amino acid compositions of the most highly abundant peptides (41K,
      33K, 21K, 17K and 13K) were determined, as was the N-terminal amino acid sequence
      of the 41K protein. The latter did not show similarity with any reported protein
      sequences.

PMID- 2230740
TI  - Restriction maps and sequence homologies of two densovirus genomes.
AB  - The genomes of Junonia coenia densonucleosis virus (JcDNV) and Galleria
      mellonella densonucleosis virus (GmDNV) were analysed by restriction endonuclease
      analysis and Southern blot hybridization. A total of 37 and 33 restriction sites
      were mapped on JcDNV and GmDNV DNA, respectively. BglI, HaeII and BstEII were
      site-specific for JcDNV DNA, and BglII and ClaI for GmDNV DNA. The two genomes
      had nearly identical maps for several restriction endonucleases and Southern blot
      hybridization using a total genomic JcDNV probe indicated extensive DNA sequence
      homologies spanning the entire length of the two genomes. Symmetrical cleavage
      sites, mapping at the extremities of both genomes, confirmed the presence of
      inverted terminal repeats of at least 420 to 440 bases in length.

PMID- 2230741
TI  - A synthetic peptide elicits antibody reactive with the native duck hepatitis B
      virus pre-S protein.
AB  - Synthetic peptides P37-49 and P63-79, derived from the pre-S region of duck
      hepatitis B virus (DHBV), have been synthesized. Only P37-49 was reactive with
      rabbit anti-DHBs/pre-S antibodies by radioimmunoprecipitation. Antiserum prepared
      against P37-47 reacted with a 35K polypeptide of native DHBs/pre-S by
      immunoblotting. It is concluded that P37-49 (MGQHPAKSMDVRR) mimics one of the
      epitopes of the DHBV pre-S antigen.

PMID- 2230742
TI  - Molecular analysis of the haemagglutinin gene of an avian H1N1 influenza virus.
AB  - This study presents the first nucleotide sequence and deduced primary amino acid
      sequence of a subtype H1 haemagglutinin from the avian influenza virus
      A/duck/Alberta/35/76 (H1N1). The molecule is structurally, antigenically and
      molecularly similar to H1 haemagglutinins of human viruses but sequence homology
      differences indicate that there has not been a recent transfer of haemagglutinin
      genetic information between them.

PMID- 2230743
TI  - Temperature elevation enhances cell surface expression of measles virus fusion
      protein in infected cells.
AB  - Cell fusion proceeded gradually in measles virus-infected cells incubated at 35
      degrees C. Shift-up of incubation temperature to 39 degrees C induced rapidly
      increased cell fusion in spite of the cessation of de novo synthesis of the
      fusion (F) protein. Pulse-chase experiments showed that there was little
      difference in the acquisition of immunoreactivity by haemagglutinin (H) and F
      proteins between the two temperatures. H protein was detected on the cell surface
      60 min after the chase at either temperature. However, appearance of F protein on
      the cell surface took less than 3 h at 39 degrees C whereas it took 5 h at 35
      degrees C. These data indicate that temperature elevation induces more efficient
      expression of F protein on the cell surface accompanied by marked syncytium
      formation in measles virus-infected cells.

PMID- 2230744
TI  - Potato virus Y helper component protein is associated with amorphous inclusions.
AB  - The distribution of the helper component (HC) protein of potato virus Y in
      tissues and cells of infected plants was studied by immunoblotting and immunogold
      labelling techniques. This HC protein was found in leaf blade and vein tissue but
      not in the petiole of leaves. In infected cells, the protein was localized in rod
      shaped cytoplasmic inclusions known as amorphous inclusions.

PMID- 2230745
TI  - Psychological functioning in a cohort of gay men at risk for AIDS. A three-year
      descriptive study.
AB  - This study describes the mental health of a large cohort of gay men participating
      in the Chicago Multicenter AIDS Cohort Study/Coping and Change Study. Six
      biannual questionnaires were self-administered between 1984 and 1988. General
      mental health was determined by the Hopkins Symptom Checklist (HSCL). An
      abbreviated version of the Center for Epidemiologic Study Depression Scale (CESD
      5) and an adapted Diagnostic Interview Schedule (DIS) question also measured
      depression. Suicidal ideation was assessed by one question in the HSCL. AIDS
      specific distress was determined by three subscales specifically developed for
      this study. While mean HSCL and CESD-5 scores were stable during the
      observational period, AIDS-specific distress increased over time. The HSCL scores
      for the cohort were somewhat elevated above general population norms but
      considerably below psychiatric outpatient norms. Fewer than 12% of the men
      reported elevated HSCL or CESD-5 scores three or more times. A self-reported
      episode of depression of two weeks or more, measured by the DIS screening
      question, was experienced by 40.1% of the sample. Suicidal ideation was reported
      on three or more visits by 18.8% of the men. The younger members of this cohort
      exhibit greater general and AIDS-specific distress. Income was inversely
      associated with general distress. HIV-seropositive participants had generally
      higher AIDS-specific distress scores than those who were seronegative, but their
      scores were equivalent on the HSCL and CESD-5.

PMID- 2230746
TI  - Visual information processing in positive, mixed, and negative schizophrenic
      syndromes.
AB  - The purpose of this study was to determine whether schizophrenics with positive,
      mixed, and negative syndromes are distinguished in terms of visual stimulus
      registration thresholds and efficiency of information processing. Forty-five
      schizophrenic inpatients were classified accordingly into groups of 15 each and
      compared with one another and with 15 normal control subjects on a visual
      backward masking task. Repeated-measures analysis of variance revealed that all
      three schizophrenic groups were less efficient information processors than were
      normal subjects. Relative to the positive group, the negative group displayed
      significantly longer registration thresholds, fewer correct target stimulus
      detections, and longer time intervals to achieve their first significant
      improvement in performance and to first exceed chance response levels. The three
      syndrome groups were not significantly different in their rates of improvement
      over trials. Secondary correlational analyses showed that the information
      processing measures were unrelated to a variety of demographic, psychiatric, and
      cognitive developmental variables, although shorter recognition thresholds and
      shorter unmasking interval scores were associated with faster psychomotor rates.
      Complex interrelationships were uncovered between the information-processing
      measures, positive and negative symptomatology, and general psychopathology. The
      results were interpreted as supporting the validity of the positive-negative
      distinction for explaining some of the heterogeneity in schizophrenia.

PMID- 2230747
TI  - Dimensions of personality disorder. The DSM-III-R cluster A diagnoses.
AB  - The authors adopt a construct validity approach to examine the structural
      validity of diagnoses of paranoid, schizoid, and schizotypal personality
      disorders. Systematic descriptions of these diagnoses were developed based on
      features identified from the literature that were organized using the clinicians'
      ratings. Each diagnosis was described in terms of a series of behavioral
      dimensions. Sets of behavioral exemplars were developed to assess each dimension.
      Dimensions and diagnoses were found to exhibit satisfactory levels of internal
      consistency that were cross-validated in a general population sample of 274
      subjects and a clinical sample of 133 patients with a diagnosis of personality
      disorder. Some dimensions did not correlate highly with the total diagnosis
      score. Diagnoses could probably be refined by eliminating these dimensions. The
      structural relationships between dimensions delineating each diagnosis were
      explored using factor analysis. Diagnoses were not unifactorial. Instead, each
      diagnosis was found to be composed of two factors. The factorial structure of
      each diagnosis was found to be similar in the general population and clinical
      sample. It is suggested that the results support a dimensional representation of
      these diagnoses using three dimensions: paranoid behaviors, social avoidance, and
      perceptual cognitive distortion.

PMID- 2230748
TI  - Compliance, reliability, and validity of self-monitoring for physical
      disturbances of Parkinson's disease. The Parkinson's Symptom Diary.
AB  - Previous clinical research in Parkinson's disease has recognized the value of
      self-monitoring procedures in which patients observe and record the frequency and
      severity of their own symptoms as these occur within the patient's social and
      work environment. We discuss issues of methodology and report a study of
      compliance, test-retest reliability, and validity with a new self-monitoring
      instrument, the Parkinson's Symptom Diary. Two recordings of frequency (loss of
      balance, hesitation-freezing) and two ratings of severity (tremor, difficulty
      walking) were made four times daily for one week by patients (N = 73) who were
      without apparent loss of cognitive or memory functions. A total of 91% of the
      diaries received (97% of requested) met strict compliance criteria so that
      independent sampling over days could be assumed. Test-retest stability over one
      month was demonstrated for each score (all Spearman rho greater than .85) in a
      representative subsample of 28 patients. Criterion validity was demonstrated for
      each score by an expected pattern of correlations with independently obtained
      observer ratings of the same or related indices of disease, and by comparison
      with Hoehn and Yahr disability stages. By its simplicity, this self-assessment
      device can be an invaluable complement to traditional methods of clinical and
      laboratory assessment in the care and evaluation of Parkinson patients.

PMID- 2230749
TI  - Significance of cocaine history in schizophrenia.
AB  - Fifty-one schizophrenic inpatients were divided into two groups, those with and
      without history of cocaine use, and compared on historical, demographic,
      cognitive, and psychopathological measures. Patients with a cocaine history were
      found to be significantly more depressed, less socialized, and more impaired in
      conceptual encoding and verbal memory, while less disordered in attention. The
      two groups did not differ in severity of illness or positive and negative
      syndromes. There were also no differences in control variables such as age,
      gender, education, intelligence, premorbid adjustment, neuroleptic dose, onset
      and chronicity of illness, continuity of hospitalization, paranoid subtype, and
      psychiatric illness in the family. Cocaine history was associated with multiple
      illicit drug use, but for other substances there was no increased liability for
      depression or cognitive deficits. The results suggest that the clinical
      presentation in schizophrenia is significantly associated with prior cocaine
      experience.

PMID- 2230750
TI  - The empathic process and its mediators. A heuristic model.
AB  - Clinical empathy research has been plagued with conceptual and methodological
      difficulties. This paper describes a model of the empathic process that enables
      clinicians, teachers, and researchers to examine specific components of the model
      and to determine the influence of particular mediators on the empathic process.
      Empathy is conceptualized as a three-phase time-sequenced process rather than as
      a multidimensional or multicomponent phenomenon. Stripped of detail, the empathic
      process reveals an inducement phase, a matching phase, and a participatory
      helping phase. By examining these phases, it becomes possible to distinguish
      empathy from closely related concepts such as sympathy. Each of the phases
      reveals numerous mediating variables that influence the outcome of the phase,
      i.e., whether the process of empathy continues or an alternate terminal point is
      reached. Many of these mediators are derived from existing conceptual and
      empirical work on empathy. Particular attention is paid to situational or
      contextual mediators of empathy. Contextual mediators have only recently been
      acknowledged as an important variable in the empathic process. For clinicians,
      identification of contextual variables that may be responsive to intervention is
      a critical step in the modification of the clinical environment. We would suggest
      that clinical empathy research is largely the study of these mediating influences
      and should be recognized as such.

PMID- 2230751
TI  - Hyperemesis gravidarum as conversion disorder.
AB  - Psychosocial factors have long been believed to be important in the pathogenesis
      of emesis gravidarum (morning sickness) and hyperemesis gravidarum (HG). Although
      this has been confirmed during extensive studies over the last 30 years, HG has
      never been described as a conversion reaction. We describe two women presenting
      with hyperemesis who clearly fulfill diagnostic criteria for conversion. We
      suggest that strong psychodynamic conflicts are expressed by this potentially
      dangerous symptom in a subset of individuals and that dynamic interventions have
      a role in treating certain patients with HG.

PMID- 2230752
TI  - Dropping objects: possible mild cataplexy associated with clozapine.

PMID- 2230753
TI  - Untying the gordian knot: the genetics of Tourette syndrome.
AB  - A review of the current status of the genetics of Tourette syndrome is presented.
      Over the course of the 104 years since Gilles de la Tourette described the
      syndrome that bears his name, a body of carefully collected, described, and
      analyzed data has produced a model of the genetics that implicates a single
      dominant gene that is variably penetrant in males and females. Moreover, the
      locus of action of this gene is most likely in the dopaminergic system of the
      midbrain. A systematic search for this gene using recombinant DNA techniques is
      under way.

PMID- 2230754
TI  - Prevalence of mental disorders after catastrophic financial loss.
AB  - In a controlled study, the authors determined the risk of developing major mental
      illness after catastrophic financial loss. Seventy-two adults who lost their
      retirement savings in a bank fraud were interviewed using the Diagnostic
      Interview Schedule. Major depression by DSM-III criteria was present in 29% of
      the victims during the first 20 months after their loss as compared with 2% of 66
      age, gender, and residential area-matched control subjects (p less than .0001).
      Generalized anxiety disorder as defined by DSM-III criteria was experienced by
      27% of victims after the loss as compared with 10% of control subjects (p = .03).
      After the loss, victims had lower subjective health ratings, more functional
      somatic complaints, and higher tranquilizer usage than control subjects. There
      was no difference between depressed and nondepressed in types of coping responses
      or use of social supports and confidants. Only four of 21 victims who suffered
      major depression sought help from a mental health professional. We conclude that
      catastrophic financial loss may result in the onset of major depressive disorder
      and generalized anxiety disorder.

PMID- 2230755
TI  - DSM-III personality disorder dimensions.
AB  - Dimensional scores were computed for the 11 DSM-III personality disorders (PDs)
      in 797 relatives of psychiatric patients and never ill control subjects
      interviewed with the Structured Interview for DSM-III Personality Disorders. The
      distribution of scores for all 11 PD dimensions was skewed to the right. A
      principal components analysis with varimax rotation produced three factors that
      closely corresponded to DSM-III's suggested clustering of the PDs into eccentric,
      dramatic, and anxious types. Men scored significantly higher on the paranoid,
      schizoid, compulsive, antisocial, and narcissistic dimensions, whereas women had
      significantly higher histrionic, dependent, and avoidant scores. Age was
      negatively correlated with most of the PD dimensions, and the correlations were
      strongest with the four PDs in cluster 2 (histrionic, antisocial, narcissistic,
      and borderline). Each of the eight axis I disorders examined was associated with
      increased axis II pathology.

PMID- 2230756
TI  - DSM-III personality disorders among patients with major depression, anxiety
      disorders, and mixed conditions.
AB  - Of 298 mainly nonpsychotic psychiatric outpatients between 19 and 59 years of
      age, a group of patients having either pure major depression, major depression in
      combination with anxiety disorders, or pure anxiety disorders was extracted. The
      anxiety disorders were further differentiated in panic and nonpanic anxiety
      disorders. The groups were compared as to differences in frequency of personality
      disorders assessed by means of the Structured Interview for DSM-III Personality
      Disorders. The mixed major depression/anxiety disorder group appeared to be the
      most deviant with more severe personality disorders such as paranoid and
      borderline in addition to avoidant and dependent personality disorder. The
      differentiation between panic and nonpanic anxiety showed that it was patients
      with nonpanic anxiety features in addition to major depression who had this
      higher frequency of personality disorders. These findings imply that it is
      important to distinguish between major depression cases with and without anxiety
      disorders both in forthcoming research and in clinical practice.

PMID- 2230757
TI  - The effect of personality on placebo response in panic patients.
AB  - Twenty-eight patients who participated as a placebo group in a treatment study of
      panic disorder were studied to determine the effect of personality on study
      completion and outcome. Those subjects who completed only 3 weeks had
      significantly more pathological personality traits than those who continued in
      the study. For those continuing beyond 3 weeks, there were negative correlations
      between the paranoid and borderline personality traits and a global outcome
      measure. Spontaneous panic attacks were not affected by personality.

PMID- 2230758
TI  - Correlates of Korean immigrants' mental health.
AB  - The main objectives of this paper are an empirical investigation of major
      structural and situational variables related to Korean immigrants' mental health
      and a theoretical exploration of the meaning of the empirical findings. As part
      of a larger epidemiological research, the data for this paper derive from
      diagnostic interviews of 622 Korean immigrants (20 years and older) residing in
      the Chicago area. Data analyses reveal that, among the respondents in general,
      those who are married, highly educated, and currently employed in a high-status
      occupation indicate better subjective mental health (less demoralized and more
      satisfied with life) than others. Of other variables examined, however,
      significant gender differences in the correlates of mental health are observed.
      For the male immigrants, a set of work-related variables is clearly the strongest
      correlate of their mental health, whereas no such distinctive set of variables
      accounts for the female immigrants' mental health. Nevertheless, the family life
      satisfaction and several ethnic attachment variables are moderately related to
      the female immigrants' mental health. Theoretical implications of these findings
      are discussed in light of the confluence of ethnic attachment and acculturation
      on immigrants' mental health.

PMID- 2230759
TI  - Classification of natural and supernatural causes of mental distress. Development
      of a Mental Distress Explanatory Model Questionnaire.
AB  - This paper describes the background and development of a Mental Distress
      Explanatory Model Questionnaire designed to explore how people from different
      cultures explain mental distress. A 45-item questionnaire was developed with
      items derived from the Murdock et al. categories, with additional items covering
      western notions of physiological causation and stress. The questionnaire was
      administered to 261 people, mostly college students. Multi-dimensional scaling
      analysis shows four clusters of mental distress: a) stress; b) western
      physiological; c) nonwestern physiological; and d) supernatural. These clusters
      form two dimensions: western physiological vs. supernatural and impersonal vs.
      personalistic explanations. Natural and stress items are separated from
      supernatural and nonwestern physiological items along the first dimension. Brain
      damage, physical illness, and genetic defects have the greatest separation along
      the first dimension. Being hot, the body being out of balance, and wind currents
      passing through the body most strongly represent the non-western physiological
      category. The questionnaire has the potential to be used for community health
      screening and for monitoring patient care, as well as with students in the health
      sciences and with health practitioners.

PMID- 2230760
TI  - State-dependent tardive dyskinesia.

PMID- 2230761
TI  - Our race to the future.
AB  - The need for mosquito control is documented from history books with comments
      about hoards of mosquitoes, deaths from mysterious high fevers, and yellow fever,
      malaria and dengue. The paper traces the birth of mosquito control in the United
      States to the present time with a look into the future. Regulations are discussed
      and their effect on mosquito control methods. Public education and training of
      personnel is mentioned. The author's opinion of AMCA's role in the future of
      mosquito control and research is one of prominence and leadership.

PMID- 2230762
TI  - Apparent influence of the stage of blood meal digestion on the efficacy of ground
      applied ULV aerosols for the control of urban Culex mosquitoes. I. Field
      evidence.
AB  - The impact of ULV resmethrin on urban Culex mosquitoes was evaluated in 4 field
      trials by monitoring daily oviposition rate. A well-defined oscillation of
      effect, with a period corresponding to the duration of the gonotrophic cycle, was
      observed. We postulate that this oscillation arises from changes in
      susceptibility following blood feeding and/or behavioral factors. The data
      indicate that a single treatment with ULV may be inadequate for the effective
      control of vector mosquitoes.

PMID- 2230763
TI  - Apparent influence of the stage of blood meal digestion on the efficacy of ground
      applied ULV aerosols for the control of urban Culex mosquitoes. II. Laboratory
      evidence.
AB  - The susceptibility of adult Culex pipiens s.l., Culiseta melanura and Aedes
      aegypti to insecticide aerosols in wind tunnel exposures varied with time,
      depending on the stage of blood meal digestion. Greater than 2-fold differences
      were observed in the concentrations of malathion and synergized resmethrin
      required to kill test mosquitoes, depending on whether they had been given a
      blood meal and, if they had, the length of time following the blood meal. The
      period of lowest susceptibility varied from 24 h after feeding in Ae. aegypti to
      72 h in Cs. melanura. The greatest variability occurred during the period when
      undigested blood was present. Data from tests with a malathion-tolerant strain of
      Cx. pipiens s.l. suggested little change in susceptibility regardless of blood
      feeding and the associated weight changes that occur from ingestion of blood.

PMID- 2230764
TI  - Apparent influence of the stage of blood meal digestion on the efficacy of ground
      applied ULV aerosols for the control of urban Culex mosquitoes. III. Results of a
      computer simulation.
AB  - When posttreatment response to ultra low volume (ULV) application of insecticide
      has been followed for periods approaching a week, a damped oscillation in
      oviposition rates is observed, probably because females who have been recently
      blood-fed are more resistant to insecticides than their unfed siblings. We
      describe a simple model (ULVSIM) that incorporates physiologic changes in
      insecticide susceptibility and accounts for much of our field data. The model
      follows 30 cohorts over 30 days following insecticidal treatment. Multiple
      treatments or short-term residual activity can be evaluated. The model predicts
      that oviposition will follow a pattern of damped oscillations after an
      adulticidal treatment. The model gave a good fit to oviposition data obtained in
      2 field trials of resmethrin for 7 to 9 days after treatment. It can be used to
      evaluate the effect of single and multiple treatments on the total female Culex
      population and on numbers of infected females surviving for different periods
      following an infective blood meal.

PMID- 2230765
TI  - Fate and persistence of Bacillus sphaericus used as a mosquito larvicide in dairy
      wastewater lagoons.
AB  - The fate and persistence of the mosquitocidal bacterium, Bacillus sphaericus, in
      dairy wastewater lagoons was evaluated in conjunction with trials of its
      larvicidal efficacy against Culex stigmatosoma. Two commercial formulations, BSP
      2 (at 4.48 kg/ha) and ABG-6184 (at 2.24 kg/ha) gave about 90% reduction for up to
      4 weeks, although surface water lost its insecticidal activity by 3 days
      posttreatment. Spores settled to the bottom within 3 days of treatment, but could
      be recovered in surface water after reflooding. Spore concentrations in bottom
      water varied widely, yet insecticidal activity remained high for from 3 days (BSP
      2 at 4.48 kg/ha) to 2 weeks (ABG-6184 at 2.24 kg/ha). Spores persisted in the mud
      throughout the study period. These results indicate the extended control obtained
      was due primarily to the ingestion of spores from bottom water and mud by larvae,
      which routinely inhabit the shallow areas toward the edge of the pond and browse
      at the pond bottom.

PMID- 2230766
TI  - Habitat and temporal partitioning of tree hole Culicoides (Diptera:
      Ceratopogonidae).
AB  - Spring emergence patterns of tree hole Culicoides were examined at 11 geographic
      locations. Habitat selection was one mechanism of partitioning used by
      Culicoides. One group (3 species) occupied tree holes with standing water (wet),
      while the other (7 species) inhabited tree holes without standing water (dry).
      The wet tree hole species had sustained emergence patterns, emergence maintained
      over several consecutive weeks. The dry tree hole species had phasic or biphasic
      emergence lasting fewer days or occurring as 2 short periods. In both dry and wet
      habitats, species emerged in a temporal sequence. This temporal sequence was
      disrupted if a species occupied a type of tree hole (wet/dry) from which it did
      not normally occur.

PMID- 2230767
TI  - Correlation of nutritional reserves with a critical weight for pupation in larval
      Aedes aegypti mosquitoes.
AB  - The relationships between the readiness of fourth instar Aedes aegypti to
      metamorphose and their weight, nutritional reserves and sex were examined. Both
      the critical larval weight required for metamorphosis and the potential weight
      were influenced by the temperature at which the larvae were reared, and were
      greater for females than for males. Caloric levels of soluble carbohydrates and
      soluble lipids correlated strongly with weight. The accumulations of both
      carbohydrates and lipids were sex-dependent and were increased in both sexes at
      the higher temperature, but caloric levels of glycogen at the critical weights
      were all similar. We suggest that weight per se is not a critical factor in
      determining readiness to pupate, and that carbohydrate levels may be one
      important causal variable.

PMID- 2230768
TI  - A genetic study of the malaria vector Anopheles nuneztovari from western
      Venezuela.
AB  - A photomap of larval polytene chromosomes of Anopheles nuneztovari (population B)
      from western Venezuela is presented. Samples of An. nuneztovari B taken from 4
      study sites in the states of Barinas and Tachira comprise a single panmictic
      population, which is chromosomally identical to the cytotype identified by
      Kitzmiller et al. (1973) from western Venezuela and Colombia. The frequency of
      polymorphism 2La has increased significantly in the 16 years that have elapsed
      since the 1973 study. In addition, inversion 2La does not conform to Hardy
      Weinberg equilibrium. These 2 changes are most likely due to environmental
      alterations which have resulted in the heterozygous condition becoming more
      locally adaptive.

PMID- 2230769
TI  - Mosquito attraction to substances from the skin of different humans.
AB  - Mosquito attraction responses to substances collected from human skin and placed
      on glass petri dishes were studied. Mosquito response varied according to the
      source of the substance. Substances removed from the head and hands elicited the
      greatest attraction response in laboratory-reared mosquitoes. Mosquito response
      lasted up to 6 h when the substance was aged and was increased by warming the
      samples from ca. 25 degrees C to 37 degrees C. Of the 12 mosquito species
      studied, attraction response was greatest in Aedes aegypti. It is cautioned that
      residues deposited by handling traps or other apparatus used in mosquito studies
      may influence test results.

PMID- 2230770
TI  - Differences in the larval alarm reaction in populations of Aedes aegypti and
      Aedes albopictus.
AB  - The time spent submerged during the larval alarm reaction was measured for
      several strains of Aedes aegypti and Ae. albopictus from different locations.
      Differences between the 2 species were not significant. Differences in strains
      within the species were highly significant. Greater differences were seen among
      strains of Ae. albopictus than among strains of Ae. aegypti. These differences
      represent an additional indication of extensive local differentiation in Ae.
      albopictus.

PMID- 2230771
TI  - Distribution of the sibling species of Anopheles farauti in the Cape York
      Peninsula, northern Queensland, Australia.
AB  - The sibling species of Anopheles farauti s.l. were collected in larval and adult
      surveys from 34 localities on Cape York Peninsula and were identified by
      isoenzyme electrophoresis. The most common species near the coast was An. farauti
      1 which was often found breeding within 100 m of the sea in either brackish or
      freshwater habitats. Larvae of the other 2 species were not found in brackish
      water which accords with previous laboratory observations of their lower salinity
      tolerance. Anopheles farauti 2 appears to have the widest distribution of the 3
      sibling species on Cape York Peninsula as it was common in both coastal and
      inland localities. Anopheles farauti 3 was rarely found near the coast. In one
      locality at Lockhart River near the east coast of the peninsula larvae of the 3
      species were found together in a small muddy creek.

PMID- 2230772
TI  - Comparison of the effectiveness of two formulations of deet against Anopheles
      flavirostris.
AB  - The effectiveness of 2 formulations of deet (diethylmethylbenzamide) was tested
      against the principal vector of malaria in the Philippines, Anopheles
      flavirostris. A new extended duration repellent formulation (EDRF) was compared
      with the standard military-issue liquid formulation. The EDRF was significantly
      more effective than the liquid formulation between 6 and 12 h post-application.
      There was no difference between the 2 formulations in the first 6 h following
      application, or between 12 and 15 h post-application. The continued usefulness of
      the liquid formulation is discussed in light of these results.

PMID- 2230773
TI  - Factors affecting the human-feeding behavior of anopheline mosquitoes in Egyptian
      oases.
AB  - Blood meals were tested by a direct enzyme-linked immunosorbent assay (ELISA) for
      424 Anopheles sergentii and for 63 An. multicolor collected in Siwa, Farafra and
      Bahariya oases in the Western Desert of Egypt. Both species were highly
      zoophilic. Human blood-feeding by An. sergentii was less common in Bahariya
      (2.3%) and Farafra (1.3%) than in Siwa (15.3%). A likely explanation is that
      large domestic animals are held at night inside houses in Bahariya and in Farafra
      whereas in Siwa, animals are usually housed outdoors in sheds. These patterns of
      An. sergentii human-feeding behavior may contribute to the persistence of low
      level Plasmodium vivax transmission in Siwa in contrast to negligible or no
      transmission in Bahariya and Farafra.

PMID- 2230774
TI  - Isolation of Jamestown Canyon virus (California serogroup) from Aedes mosquitoes
      in an enzootic focus in Michigan.
AB  - Twenty isolates of Jamestown Canyon virus were obtained from adult females of 5
      Aedes species collected at the Houghton Lake Wildlife Research Area, Missaukee
      County, in north-central Michigan between 1985 and 1989. Fourteen were from Aedes
      provocans, and 6 were from 4 other snowmelt Aedes species. One isolate of
      trivittatus virus and one Cache Valley-like virus were also obtained. Seasonal
      succession patterns for numerous mosquito species were recorded over 4 years. The
      temporal association of adult mosquito emergence, virus isolations, and infection
      and seroconversion of sentinel deer suggest that Ae. provocans is a primary
      enzootic vector of Jamestown Canyon virus in that focus. We hypothesize that Ae.
      provocans provides an overwintering reservoir for Jamestown Canyon virus at the
      study site. A large dry ice-baited "tent trap" was the most productive method for
      collecting numerous aedine and other mosquito species.

PMID- 2230775
TI  - Attraction of mosquitoes to diethyl methylbenzamide and ethyl hexanediol.
AB  - Studies by prior workers have shown that insect repellents can act as attractants
      when present as low concentrations, deposits or residues. In the present study
      deet and ethyl hexanediol were tested in 2-fold serial doses from 1.9 X 10(-9) to
      1.6 X 10(-2) mg/cm2 on the forearms of volunteers against colonized Anopheles
      albimanus, Aedes aegypti and Ae. taeniorhynchus. Both compounds were
      significantly repellent at the high end of the dose range, as expected. Neither
      was significantly attractant to An. albimanus in low doses. However, deet was
      significantly attractant to Ae. aegypti in the dose range 7.6 X 10(-9) to 1.2 X
      10(-4) mg/cm2 and to Ae. taeniorhynchus in the dose ranges 1.9 X 10(-9) to 3.1 X
      10(-8) mg/cm2 and 2.0 X 10(-6) to 2.5 X 10(-4) mg/cm2. Ethyl hexanediol was
      significantly attractant to Ae. taeniorhynchus in the dose range 1.9 X 10(-9) to
      6.2 X 10(-5) mg/cm2. Based on these results and prior work of V.G. Dethier and
      C.N.E. Ruscoe, a model sequence of the effects of chemicals on insects with
      increasing dose was developed. It was concluded that the labels of commercial
      repellents should be amended to include instructions to wash off or reapply the
      repellent when it is no longer effective.

PMID- 2230776
TI  - Anopheles dirus species E: chromosomal and crossing evidence for another member
      of the dirus complex.
AB  - Cytogenetic and crossing data provide strong evidence for the existence of
      another species, dirus E in southwestern India, within the Dirus Complex of
      Anopheles. These findings are in accord with unpublished morphological
      observations. Our data suggest a significant genetic divergence between species E
      and its close relatives, An. dirus A, B and C in Thailand. These data also
      suggest that dirus E is an incipient sibling species of its geographically
      nearest relative, dirus D, and that it seemingly co-evolved through the process
      of allopatric speciation.

PMID- 2230777
TI  - Nectar feeding activity of Aedes mosquitoes, with special reference to Aedes
      communis females.
AB  - A total of 5,721 mosquitoes (6% males) of 16 species were collected with an
      aerial net, when attracted to the investigator, during May-August 1984 at 2 sites
      in central Sweden. The majority of the mosquitoes collected (63%) were Aedes
      communis. Aedes communis females at both localities showed peak flight activity
      at evening twilight. At one site, a diel pattern of nectar feeding was correlated
      with host seeking activity; at the other site no correlation was found. Seasonal
      differences in mean fructose content of the mosquitoes were found. Among the 94
      blood-fed females (belonging to 6 species) that were collected, 71% were fructose
      positive (n = 67) and in different ovarian stages.

PMID- 2230778
TI  - Estimation of absolute numbers of damselfly nymphs (Odonata: Coenagrionidae) by
      dipper sampling in California rice fields with seasonal, spatial distributions
      and vegetation association.
AB  - Estimates of relative and absolute density in rice field populations of damselfly
      nymphs (predominantly Enallagma civile with few Ischnura denticollis) were
      compared using the regression method. An equation, X = Y divided by 0.0016,
      allows estimation of absolute density (X) from a relative density index (Y,
      dipper count). In the rice growing area of Fresno, California, nymphal population
      peaks appeared during June and August approaching 3-5 million per 0.405 ha (1
      acre). Spatial distribution was theoretically represented fairly well by a
      negative-binomial distribution. The degree of clumping is one of overdispersed
      types; it is especially classified as a model of randomly distributed colonies
      with mean colony size fixed. Presence or absence of submerged vegetation markedly
      affected damselfly nymphal density but the biomass of submerged or emerged
      vegetation was not a significant factor.

PMID- 2230779
TI  - Evaluation of Bacillus sphaericus 2362 against Culex quinquefasciatus in septic
      ditches.
AB  - Four application rates of Bacillus sphaericus strain 2362 were tested for
      efficacy in septic ditches against Culex quinquefasciatus 2nd-4th instar larvae.
      Trials were conducted over a 2-year period. In 1987, all dosages applied to dairy
      effluent ditches resulted in substantial reductions after 48 h. Differences among
      dosages did not differ significantly (P greater than or equal to 0.05). After 5
      days, mosquito larval numbers increased with dosage rates of 0.6, 0.9 and 1.2
      liters/ha. Residual control was maintained, however, at 2.4 liters/ha for 17
      days. In 1988, B. sphaericus applied to domestic sewage effluent ditches at rates
      of 1.2 liters/ha, and 2.4 liters/ha induced greater than 79% suppression for a
      period of 15 days, and the 1.2 liters/ha rate induced greater than 79%
      suppression for a period of 20 days. A rate of 0.9 liters/ha provided good to
      excellent control (greater than 88%) for a period of 10 days. A rate of 0.6
      liters/ha produced less than 50% suppression after 48 h.

PMID- 2230780
TI  - Larvicidal effects of grain sorghum (Sorghum bicolor) seedling extracts upon
      Culex pipiens larvae.
AB  - A study of laboratory and field reared 2nd and 3rd instar Culex pipiens larvae
      suggests that extracts from 2 varieties of Sorghum bicolor seedlings are
      significant (P less than 0.05) larvicides under laboratory conditions. These
      plant extracts contain the organic cyanogen dhurrin and were calibrated to
      produce 90% mortality in 2nd instar Culex pipiens larvae at 0.82 ppm and 90%
      mortality in 3rd instar larvae at 1.12 ppm. A preliminary behavioral assessment
      of late 3rd instar larvae exposed to 1.42 ppm suggests that these plant extracts
      produce 80% mortality after only 4-5 h of contact. Plant extracts appear stable
      when stored at up to 32 degrees C in a closed container. Once the extracts are
      infused in water and exposed to air, however, they biodegrade after 24 h. These
      laboratory results emphasize the need for field tests against natural populations
      of Culex pipiens and nontarget organisms.

PMID- 2230781
TI  - Incrimination of Aedes provocans as a vector of Jamestown Canyon virus in an
      enzootic focus of northeastern New York.
AB  - A 2-year field study was conducted in southern Saratoga County, New York, to
      determine which species of the Aedes communis group mosquitoes were potential
      vectors of Jamestown Canyon (JC) virus. A total of 23,890 mosquitoes (890 pools)
      were processed for virus isolation in 1988-89, yielding 17 JC virus isolates from
      Ae. provocans and one isolate each from Ae. communis, Ae. intrudens and Ae.
      punctor. Minimum field infection rates (MFIR) and daily MFIRs as high as 1:219
      and 1:38, respectively, were found in adult female Ae. provocans. Virus isolation
      attempts from an additional 394 individual Ae. provocans produced a seasonal
      field infection rate (FIR) of 1:131 and daily FIRs of 1:71 and 1:22. Evidence of
      transovarial transmission of JC virus was demonstrated by the isolation of virus
      from 2 pools each of 50 male Ae. provocans reared in the insectary from pupae
      collected at the study site in 1989. We conclude that Ae. provocans is a
      potentially important vector of JC virus in northeastern New York.

PMID- 2230782
TI  - Colonization and maintenance of Anopheles deaneorum in Brazil.
AB  - Anopheles deaneorum, an important malaria vector and a member of the Anopheles
      albitarsis complex, was colonized by an artificial mating technique.
      Morphological and behavioral differences between An. deaneorum and An. albitarsis
      from Costa Marques, Rondonia, Brazil, are discussed. The essential methods and
      colonization techniques are described. Immature development and mortality rates
      were reduced when dried grass was added to larval rearing pans. Males frequently
      mate more than once using the force mating technique. However, insemination and
      larval eclosion rates decline as males are successively mated with unmated
      females.

PMID- 2230783
TI  - Baseline data on Aedes aegypti populations in Santo Domingo, Dominican Republic.
AB  - Baseline field studies were conducted from April 1987 to July 1988 on Aedes
      aegypti in Santo Domingo, an endemic area for dengue fever. Premise, container
      and Breteau indices were measured in one treated area and 2 nearby control areas.
      These indices averaged 69.6, 46.3 and 142.1, respectively. The principal larval
      habitats of Ae. aegypti were 208-liter (55-gal) concrete-lined drums. The
      estimated daily adult production was approximately 60 per house. Adult mosquito
      populations were monitored using oviposition traps and by sweep net collections.
      There was no correlation between adult abundance and the larval indices.
      Monitoring the natural adult densities was more efficient for evaluating the
      impact of ULV malathion application than the use of standard bioassay procedures.

PMID- 2230785
TI  - Ovipositional response of Aedes triseriatus females to horizontally and
      vertically open ovitraps in southern Illinois.
AB  - Aedes triseriatus oviposition in standard, horizontally open (open top) ovitraps
      was compared with that in vertically open (open-sided) ovitraps during 1989 in a
      deciduous woodland in southern Illinois. This comparison was to determine whether
      female oviposition preference changed as a result of seasonal photoperiod
      changes. Results show that Ae. triseriatus females prefer horizontally open
      ovitraps regardless of whether they are depositing eggs which hatch shortly after
      deposition or whether the eggs diapause because of shortened late summer/early
      fall photoperiods.

PMID- 2230784
TI  - Effects of controlled burning on Aedes taeniorhynchus eggs in an abandoned rice
      impoundment in South Carolina.
AB  - Controlled burning reduced the number of viable eggs in an Aedes population. The
      effectiveness of the burn was related to the amount of rainfall, surface moisture
      and dry vegetation. A greater reduction in viable eggs occurred when the burn was
      close to the ground. Variable results were achieved if the surface was moist but
      there was a significant reduction in the number of viable eggs, due to a heavy
      amount of dry vegetation accompanied by low rainfall.

PMID- 2230786
TI  - A new housing for the Battery-operated Aerosol Droplet Sampler Model 312.
AB  - Rotating impactors are more efficient aerosol droplet collectors than stationary
      impactors. Breakage of the phenolic plastic housing on a commercial rotating
      impactor during shipment has reduced this laboratory's ability to collect droplet
      data. Directions for replacing that housing with an aluminum BUD box are
      presented.

PMID- 2230787
TI  - Routine blood-feeding of Aedes aegypti via a new membrane.

PMID- 2230788
TI  - Comparison of New Jersey light traps for collection of adult Culicoides
      variipennis (Diptera: Ceratopogonidae).
AB  - Comparisons between standard incandescent New Jersey and modified ultraviolet New
      Jersey light traps were made. Both trap types collected the same proportions of
      males, nulliparous, parous empty, gravid and blood engorged female Culicoides
      variipennis. Although both traps were highly attractive to females that had taken
      at least one blood meal, the black light trap collected ca. 10-fold more parous
      empty and gravid flies than the incandescent and would therefore be recommended
      for use in trapping C. variipennis for virus assay.

PMID- 2230789
TI  - Distribution of Culex tarsalis larvae in a freshwater marsh in Orange County,
      California.
AB  - The distribution and abundance of mosquito larvae in a freshwater marsh were
      determined during a low water period in the late summer. Culex tarsalis larval
      abundance was significantly associated with the percent cover by Typha spp. root
      masses and Typha spp. stem density in 1-m2 quadrants. Larval mosquito abundance
      was not significantly related to bulrush (Scirpus californicus) stem density,
      position in the marsh (transect compass direction), position in the inundated
      vegetation on each transect or several physicochemical factors. As water levels
      decline seasonally, mosquito developmental sites in San Joaquin Marsh change from
      mats of decaying vegetation to cattail root masses.

PMID- 2230790
TI  - Analysis of the gut contents of naiads of Enallagma civile (Odonata:
      Coenagrionidae) from a Texas pond.
AB  - Foregut contents of naiads of the damselfly species, Enallagma civile, collected
      from a permanent pond, were analyzed to determine the natural prey for immatures
      of this species. The analyses revealed the naiads containing prey had fed
      predominantly on chironomid larvae. Corixid, cladoceran, ostracod and aquatic
      mite remains were found in some of the naiad specimens examined. However, no
      remains of mosquito larvae were detected in any of the specimens, even though
      mosquito larvae were observed as being continuously present in the pond sites
      where the naiad specimens were collected.

PMID- 2230792
TI  - Five kingdoms--reflections upon the classification of organisms.

PMID- 2230791
TI  - Records of Aedes albopictus, Ae. aegypti and Ae. triseriatus from the U.S. Air
      Force ovitrapping program--1989.
AB  - During 1989, ovitrapping was conducted by 36 U.S. Air Force bases, Ft. Sam
      Houston, TX, and the San Antonio Metropolitan Health District. Eleven
      organizations were positive for Aedes albopictus; the collection of Ae.
      albopictus at Arnold Air Force Base, TN, is a new record for Coffee County. Ten
      organizations were positive for Ae. aegypti; 18 were positive for Ae.
      triseriatus.

PMID- 2230793
TI  - Robert Charles Wallis. 1929-1989.

PMID- 2230794
TI  - Physiologic responses of paraplegics and quadriplegics to passive and active leg
      cycle ergometry.
AB  - The purposes of this study were three-fold: (a) to determine acute physiologic
      responses of spinal cord injured (SCI) subjects to peak levels of leg cycle
      ergometry utilizing functional neuromuscular stimulation (FNS) of paralyzed leg
      muscles, (b) to determine the relative contributions of passive and active
      components of FNS cycling to the peak physiologic responses, and (c) to compare
      these physiologic responses between persons who have quadriplegia and those who
      have paraplegia. Thirty SCI subjects (17 quadriplegics and 13 paraplegics)
      performed a discontinuous graded FNS exercise test from rest to fatigue on an
      ERGYS 1 ergometer. Steady-state physiologic responses were determined by open
      circuit spirometry, impedance cardiography with ECG, and auscultation. In the
      combined statistics of both groups, it was noted that peak FNS cycling
      significantly increased (from rest levels) mean oxygen uptake by 255%,
      arteriovenous O2 difference VO2 and VE, Q and a-vO2 and VCO by 69%, and stroke
      volume by 45%, while total peripheral vascular resistance decreased by 43%. Mean
      peak power output for paraplegics (15 W) was significantly higher than for
      quadriplegics (9 W), eliciting higher peak levels of pulmonary ventilation and
      sympathetically mediated hemodynamic responses such as cardiac output, heart
      rate, and systolic and diastolic arterial blood pressure. Passive cycling without
      FNS produced no statistically significant increases in physiologic responses
      above the resting level in either group.

PMID- 2230795
TI  - Augmentation cystoplasty and closure of the urethra for the destroyed lower
      urinary tract.
AB  - Five paraplegic patients with pressure ulceration complicated by incontinence
      related to fistula formation were treated by deliberate closure of the urethra
      and augmentation cystoplasty with a continent stoma. This procedure is similar in
      scope to urinary diversion but preserves a low-pressure reservoir and obviates
      the use of tubes for drainage of urine. Overall outcome was excellent. Valvular
      failure occurred in one patient and required revision. The follow-ups range from
      1 to 5 years, with a mean of 24 months. One patient developed reservoir calculi
      as a late complication, necessitating removal with flexible endoscopy via the
      continent conduit. All patients have preserved normal upper tracts. Augmentation
      cystoplasty with closure of the urethra is a reasonable procedure in such
      patients providing for low-pressure urinary storage and permitting secondary or
      simultaneous plastic surgical procedures on perineal pressure ulceration and
      osteomyelitis.

PMID- 2230796
TI  - Don't forget the serratus.
AB  - Patients quadriplegic at the C6 level may not be considered candidates for
      independent transfers and weight shifting because of lack of primary shoulder
      depressors. However, we have observed that some quadriplegics have been able to
      use the serratus anterior for this latissimus dorsi function. We present an
      example of this technique, demonstrated by a patient with a complete C6 injury,
      and compare him with a subject with normal musculature.

PMID- 2230797
TI  - Authors complimented. Augmentation cystoplasty.

PMID- 2230798
TI  - Expression of the ganglioside GD3 in human meningiomas is associated with
      monosomy of chromosome 22.
AB  - The ganglioside composition of 59 meningiomas has been compared with a molecular
      genetic analysis of chromosome 22 in the same specimens. Major gangliosides were
      GM3 (II3NeuAc-LacCer) and/or GD3 [II3(NeuAc)2-LacCer]. In specimens with no or
      partial deletions of chromosome 22, the GM3 ganglioside predominated, and the
      mean value for GM3, 61% of total sialic acid, was around four times higher than
      that for GD3. A loss of chromosome 22, found in 56% of the specimens, was shown
      to be associated with an increase in the proportion of ganglioside GD3, with the
      ratio between mean values of GM3 and GD3 being approximately 1:1. Logistic
      regression revealed that the probability of predicting monosomy of chromosome 22
      by the GD3 proportion was 66%.

PMID- 2230799
TI  - Labeling of retina and optic tectum phospholipids in chickens exposed to light or
      dark.
AB  - The labeling of retina ganglion cell and optic tectum phospholipids was
      determined in chickens given an intraocular injection of 32P and then either
      exposed to light or maintained in the dark. Significantly higher labeling was
      found in the optic tectum phospholipids of light-exposed compared with dark
      maintained animals after 3-24 h of labeling. In the ganglion cells, the labeling
      of phospholipids increased in dark with respect to light at 15 and 30 min of
      labeling; from 60 min to 24 h, the labeling of phospholipids was significantly
      higher in light with respect to dark, even if the precursor pool showed a higher
      labeling in dark at all times studied. When labeling was allowed to proceed in
      the dark for 30 min and then half of the animals were exposed to light for 15
      min, the labeling of ganglion cell phospholipids of light-exposed animals was
      significantly higher than those of animals kept in the dark. No individual
      phospholipid accounted for the differences observed in the labeling of the total
      phospholipid pool. These results are interpreted as an increase in the
      biosynthesis of phospholipids in the ganglion cell somas in light with respect to
      dark.

PMID- 2230800
TI  - Administration of vigabatrin (gamma-vinyl-gamma-aminobutyric acid) affects the
      levels of both inhibitory and excitatory amino acids in rat cerebrospinal fluid.
AB  - The effect of vigabatrin (gamma-vinyl-gamma-aminobutyric acid), a new
      anticonvulsant drug, on the transmitter amino acids in rat cisternal CSF was
      studied. CSF was collected through a permanently implanted polyethylene cannula
      from freely moving rats at 5, 24, 48, and 96 h after administration of 1,000
      mg/kg of vigabatrin. The free gamma-aminobutyric acid (GABA) level was elevated
      maximally (13.5-fold; p less than 0.01) at 24 h after injection. The
      homocarnosine (GABA-histidine) level also was increased (123%; p less than 0.01)
      at 24 h after injection, and its concentration remained at the same level for the
      next 3 days. Glycine and taurine concentrations had increased [31% (p less than
      0.05) and 63% (p less than 0.01), respectively] at 5 h after injection. It is
      interesting that the levels of glutamate and aspartate increased [330% (p less
      than 0.05) and 421% (p less than 0.01), respectively] at 96 h after injection,
      the time when the free GABA level had returned to the baseline concentration and
      the vigabatrin level was 3% of the maximal concentration. The present study
      indicates that a single dose of vigabatrin in rats elevates levels of both the
      inhibitory and excitatory amino acids in CSF. However, the temporal profile of
      observed changes in relation to vigabatrin injection shows that neither the long
      lasting elevation of GABA content nor the increase in glutamate and aspartate
      levels correlates with the level of vigabatrin in CSF. These findings suggest
      that the excitatory mechanisms are also augmented following acute administration
      of vigabatrin, especially when the content of GABA had decreased to the baseline
      level and the level of vigabatrin was low.

PMID- 2230801
TI  - Rapid rise in transcription factor mRNAs in rat brain after electroshock-induced
      seizures.
AB  - Recent studies have demonstrated that several transcription factor genes are
      rapidly activated by neuronal stimulation. For example, we have found that
      prolonged and repeated seizure activity produced by administration of chemical
      convulsants induces a rapid and transient increase in mRNA levels of four
      immediate early genes in rat brain. These genes, zif/268, c-fos, c-jun, and jun
      B, encode sequence specific DNA binding proteins thought to act as transcription
      regulatory factors. To ascertain whether a brief electrically induced seizure
      discharge of the type utilized in clinical electroconvulsive treatment is
      sufficient to induce a similar genomic response, we have examined the response of
      these mRNAs in rat brain following single and repeated electroshock-induced
      seizures. After electroshock, mRNA levels of each of these genes increase within
      15 min, and all except c-jun return to near baseline levels within 4 h. Although
      this response is most prominent in granule cell neurons of the hippocampus,
      increases are also apparent in neocortex and pyriform cortex. The rapid mRNA
      response persists in animals receiving a chronic electroshock protocol similar to
      that used in clinical electroconvulsive therapy. Intrahippocampal infusion of the
      sodium channel antagonist tetrodotoxin blocks hippocampal mRNA responses without
      blocking seizures, indicating a role for electrical excitation in the
      electroshock-induced mRNA response. By contrast, pretreatment with
      anticonvulsants or selective NMDA antagonists, which reduce seizure intensity and
      block hindlimb extension, fails to alter mRNA responses, suggesting that seizure
      induction, rather than spread, is linked to these mRNA responses. Because
      electroshock induces robust, highly reproducible mRNA responses, it may be useful
      to study the neuronal genomic response to stimulation.

PMID- 2230802
TI  - Lipid droplets in Schwann cells during tellurium neuropathy are derived from
      newly synthesized lipid.
AB  - Exposure of weanling rats to a diet containing elemental tellurium results in a
      peripheral neuropathy characterized by segmental demyelination and minimal axonal
      degeneration. One of the earliest ultrastructural abnormalities in tellurium
      neuropathy is an increased number of cytoplasmic lipid droplets in myelinating
      Schwann cells. The pathogenesis of these lipid droplets was investigated using
      light and electron microscopic autoradiography. Nerve lipids were either
      "prelabeled" with [3H]acetate via in vivo intraneural injection 3 days before a 2
      day exposure to tellurium, or "postlabeled" via in vivo intraneural injection or
      in vitro incubation with [3H]acetate following a 2-day exposure to tellurium. In
      the prelabeled nerves, myelin became heavily labeled, but the tellurium-induced
      cytoplasmic lipid droplets were rarely labeled. In the postlabeled nerves, the
      tellurium-induced cytoplasmic lipid droplets were the most heavily labeled
      structures within the nerve. These data indicate that the tellurium-induced lipid
      droplets in Schwann cells are derived from newly synthesized lipid rather than
      from the early breakdown and internalization of myelin lipids. The earliest
      biochemical abnormality observed in tellurium neuropathy is an inhibition of
      cholesterol synthesis at the squalene epoxidase step. This leads to an
      accumulation of squalene within the nerve. We conclude that the cytoplasmic lipid
      droplets in Schwann cells contain this accumulated lipid.

PMID- 2230803
TI  - Subcellular fractionation of prohormone processing products in the bag cell
      neurons.
AB  - Multiple biologically active peptides arising from a common prohormone are sorted
      into distinct classes of dense core vesicles within the bag cell neurons of
      Aplysia californica. In this study, pulse-chase analysis, combined with
      subcellular fractionation on Percoll gradients, are used to define the location
      of the prohormone processing events within the secretory pathway. Initial
      cleavage of the prohormone occurs in a light cellular compartment associated with
      the Golgi apparatus. The amino-terminal processing intermediate then accumulates
      in a denser compartment containing small dense cores enclosed in membranous sacs,
      as well as larger immature vesicles. After 4 h, amino-terminal products are found
      primarily in a much denser compartment which consists of large and small dense
      core vesicles. These large and small vesicles can be separated from each other
      using Percoll gradient centrifugation and are found to be enriched in amino- and
      carboxy-terminal products, respectively. Lastly, membrane association experiments
      suggest differential binding to membranes, or integral membrane proteins, as a
      possible mechanism for sorting of amino- and carboxy-terminal products.

PMID- 2230804
TI  - Characterization and distribution of transferrin receptors in the rat brain.
AB  - Transferrin receptors were characterized with 125I-ferrotransferrin on membrane
      fractions prepared from the rodent forebrain. The distribution of transferrin
      receptors in the rat brain was investigated further by in vitro autoradiography.
      Saturation binding analysis revealed an apparent single class of sites with a
      dissociation constant of 2 nM and a binding site density of 15 pmol/g. The Hill
      coefficient derived from these data was 1.05, indicating the absence of
      cooperativity and that 125I-ferrotransferrin binds to a single class of sites.
      Estimates of the kinetically determined KD for forebrain membranes were within
      the 2-4 nM range, in agreement with the equilibrium measurements. Apotransferrin
      and ferrotransferrin competitively displaced the binding of 125I
      ferrotransferrin, while ferritin, albumin, and cytochrome c failed to compete for
      the binding site. Ceruloplasmin, the copper transport protein, was a weak
      inhibitor of 125I-ferrotransferrin binding. Autoradiographic localization studies
      demonstrate a heterogeneous distribution of transferrin receptors in the rat
      brain. Transferrin receptor densities were markedly elevated over the cerebral
      cortex and the hippocampus. Moderate to high 125I-ferrotransferrin binding was
      also apparent throughout areas involved in motor functions, including the caudate
      putamen, the nucleus accumbens, the substantia nigra, the red nucleus, and the
      cerebellum.

PMID- 2230805
TI  - Interleukin-1 hyperproduction by in vitro activated peripheral macrophages from
      cerebellar mutant mice.
AB  - Several mutations in mice produce complex patterns of neuronal degeneration of
      the cerebellum and of its afferent pathways. In the staggerer (sg/sg) mutant,
      atrophy of the lymphoid organs and immunological abnormalities have been
      described. To search for a possible link between the neurological and the immune
      disorders in this mutant, we studied the production by its peripheral macrophages
      of interleukin-1 (IL-1), which roles in both immune and nervous systems are well
      established. Suspensions of peritoneal and/or spleen macrophages from mutants and
      their appropriate controls were stimulated in vitro by lipopolysaccharide.
      Northern and dot blots, performed with murine IL-1 cDNA probes, revealed a clear
      cut hyperexpression of IL-1 mRNA in staggerer macrophages. An IL-1 bioassay using
      the IL-1-responsive D10.G4 cell line also revealed a sixfold increase of IL-1
      activity in the macrophage supernatants of staggerer mutant mice. The
      hyperproduction was found in 3-week to 1-year-old staggerer and also in
      heterozygous (+/sg) mice. A similar phenomenon existed in cerebellar mutants
      lurcher, Purkinje cell degeneration (pcd), and to a lesser extent reeler and
      wobbler, but was absent in the neurological mutants weaver, jimpy, and motor end
      plate disease (medH). These observations establish that in several point
      mutations in mice, central nervous degeneration is associated with dysregulation
      of IL-1 production by peripheral macrophages.

PMID- 2230806
TI  - Decreased protein kinase C activity during cerebral ischemia and after
      reperfusion in the adult rat.
AB  - The possible activation of protein kinase C (PKC) during total cerebral ischemia
      was investigated in the rat. Translocation of PKC activity from the soluble to
      the particulate fraction was used as an index of PKC activation. There was a drop
      in the proportion of particulate PKC activity from 30% for controls to 20% by 30
      min of ischemia (p less than 0.01). By 20 min of cardiac arrest, there was a 40%
      decline of the total cellular PKC activity (p less than 0.01). This was not
      accompanied by an increase in activator-independent activity, a finding
      indicating PKC was not being converted to protein kinase M. These data suggest
      that PKC was not activated during ischemia, but rather that ischemia causes a
      reduction in cellular PKC activity. Translocation of PKC activity to the
      particulate fraction was not observed in the cerebral cortex or hippocampus of
      reperfused brain for up to 6 h of recovery following 11-13 min of total cerebral
      ischemia. The level of total, soluble, and particulate PKC activity in the
      cerebral cortex was reduced (p less than 0.05), corresponding to the decrease
      observed by 15 min of ischemia without reflow. A similar decline in activity was
      also observed in the hippocampus. No increase in activator-independent activity
      was observed. These data suggest that PKC was inhibited during cerebral ischemia
      and that this reduced level of PKC activity was maintained throughout 6 h of
      recovery. We conclude that pathological activation of PKC was not responsible for
      the evolution of ischemic brain damage.

PMID- 2230807
TI  - Purification and characterization of a novel brain-specific 14-kDa protein.
AB  - A new acidic protein specifically present in the brain was purified to
      homogeneity from bovine brain. The apparent molecular mass was estimated to be 14
      kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and 57 kDa by
      gel filtration, a finding suggesting that it exists as a tetramer under
      physiological conditions. The protein had a high content of Glu and Pro, and its
      pI was 4.3. The first six amino acid residues of the protein were Met-Asp-Val-Phe
      Met-Lys, and the amino terminal was blocked. The distribution of the protein
      examined by Ouchterlony gel immunodiffusion indicates that it is present
      specifically in brain, including rat, human, and bovine, but could not be
      detected in 10 other rat tissues examined. The protein was absent in Purkinje
      cell bodies, as examined by electron microscopic immunocytochemistry, but was
      present in nerve terminals that make synapse-like contacts with Purkinje cells
      and in neurons with dark granules in the globus pallidus of the rat.

PMID- 2230808
TI  - Volume regulation of nerve terminals.
AB  - Pinched-off presynaptic nerve terminals (synaptosomes) possess significant
      regulatory volume increase (RVI) and regulatory volume decrease (RVD)
      capabilities. Following a swelling induced by a hypotonic challenge, the
      synaptosomes regulate their volume and adjust it, in 2 min, to within 5% of its
      initial value (RVD) at an initial rate of -0.77 +/- 0.10%/s (mean +/- SEM).
      Following a shrinking induced by a hypertonic challenge, the synaptosomes also
      regulate their volume at an initial rate of 0.18 +/- 0.02%/s (RVI), resulting in
      a new steady state, reached within 5-10 min, with a synaptosomal volume below the
      original volume. The omission of Na+ or K+ ions from the extrasynaptosomal medium
      reduces the initial rate of RVI by 72.5 and 66.5%, respectively. The "loop
      diuretics" bumetanide and furosemide significantly inhibited the RVI of the
      synaptosomes. In contrast, ouabain, amiloride, or 4,4'-diisothiocyanatostilbene
      2,2'-disulfonic acid did not have any significant effect on RVI parameters.
      Furthermore, bumetanide-sensitive 86Rb uptake by rat brain synaptosomes was
      stimulated threefold by a hypertonic perturbation of 30%. Thus we conclude that
      the RVI of synaptosomes is mainly due to a stimulation of the Na+, K+, Cl- co
      transport system induced by the synaptosomal shrinking following the hypertonic
      challenge.

PMID- 2230809
TI  - Embryonic neural cell adhesion molecule in cerebrospinal fluid of younger
      children: age-dependent decrease during the first year.
AB  - Poly-alpha-2,8-N-acetylneuraminic acid (poly-alpha-2,8-NeuAc) is developmentally
      expressed in neural tissue of higher animals, where it is covalently attached to
      the neural cell adhesion molecule (NCAM), a large integral membrane glycoprotein
      mediating cell-cell adhesion during neuronal development. NCAM exists in several
      molecular forms, of which only embryonic NCAM carries lengthy chains (n greater
      than 5) of poly-alpha-2,8-NeuAc. Chemically identical poly-alpha-2,8-NeuAc of
      bacterial origin is an important virulence factor in infections caused by
      Neisseria meningitidis group B and Escherichia coli K1, the predominant pathogens
      of bacterial meningitis. A quantitative enzyme-linked immunoassay was developed
      using monoclonal antibody (MAb) 735, an MAb specifically recognizing poly-alpha
      2,8-NeuAc, and applied to CSF specimens from younger children. Poly-alpha-2,8
      NeuAc contents were within the range of 20-0.2 micrograms/ml, decreasing from day
      1 to day 300. Immunoprecipitation, immunoblot with a rabbit anti-mouse NCAM serum
      recognizing the protein part of human NCAM by cross-reactivity, affinity
      enrichment using immobilized MAb 735, and sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis revealed that poly-alpha-2,8-NeuAc in CSF is bound to human
      NCAM, probably NCAM-120.

PMID- 2230810
TI  - Purinergic modulation of hippocampal acetylcholine release involves alpha
      dendrotoxin-sensitive potassium channels.
AB  - Modulation of acetylcholine (ACh) release from superfused hippocampal slices was
      examined when the release of ACh was stimulated by exposure of slices to elevated
      K+ concentration. Evoked release was not sensitive to inhibition by 0.1 microM
      tetrodotoxin, but it could be inhibited in a dose-dependent manner by a
      muscarinic agonist (10-100 nM oxotremorine) and a purinergic agonist (10-100 nM 2
      chloroadenosine). The alpha-dendrotoxin (100 nM), which selectively blocks
      voltage-gated inactivating K+ channels in nerve endings, did not affect the
      release of ACh under resting or depolarized conditions. However, alpha
      dendrotoxin reduced the 2-chloroadenosine-induced inhibition of release, but did
      not alter the oxotremorine-induced inhibition. These results suggest that an
      alpha-dendrotoxin-sensitive K+ channel may be activated as an obligatory step in
      the modulation of ACh release by presynaptic purinergic receptor activation, but
      not in the modulation by presynaptic muscarinic receptors.

PMID- 2230811
TI  - Blood-brain transfer of L-phenylalanine declines after peripheral but not central
      nervous administration of vasopressin.
AB  - To determine whether a previously reported effect of vasopressin on blood-brain
      transfer of leucine extends to other large neutral amino acids, we measured the
      regional blood-brain transfer of L-phenylalanine with the integral technique.
      Intravenous co-injection of L-phenylalanine and arginine vasopressin (30 nmol to
      10 pmol) resulted in a decrease of the permeability-surface area (PaS) product of
      phenylalanine of between 11 and 39%. In addition, the peptide elicited a decrease
      of the cerebral blood flow of between 11 and 56% combined with a drastic decrease
      of the cardiac output (32-64%) and an elevation of the blood pressure to
      approximately 150% of control values. However, we found no changes of the cardiac
      output, the blood pressure, or the PaS product of phenylalanine after
      microdialysis (30 min, 5 microliters min-1) of arginine vasopressin (15 mumol L
      1) into the dorsal hippocampus, but cerebral blood flow was decreased. The
      results support the hypothesis that arginine vasopressin receptors at the blood
      brain barrier are involved in the regulation of large neutral amino acid transfer
      from blood to brain and indicate that these receptors are located at the luminal
      membrane of the endothelial cells.

PMID- 2230812
TI  - Evidence for functional activity of up-regulated nicotine binding sites in rat
      striatal synaptosomes.
AB  - A number of studies have found that the chronic administration of nicotine causes
      an increase in the density of nicotinic binding sites in the brain, but it is not
      known whether these additional binding sites are functionally active receptors.
      In this study, the effects of 1-week administration of the potent nicotinic
      agonist, (+)-anatoxin-a (96 nmol/day via osmotic minipumps), was assessed on
      [3H]nicotine binding and [3H]dopamine uptake and release in rat striatal
      synaptosomes. Chronic (+)-anatoxin-a treatment resulted in a 32% increase in the
      Bmax of [3H]nicotine binding in anatoxin-treated animals compared to control.
      There was a 43% increase in the activity of 3 microM nicotine to release
      [3H]dopamine from synaptosomes of anatoxin-treated animals, but the release
      induced by 20 mM K+ depolarization was unaffected. There was no effect of chronic
      (+)-anatoxin-a treatment on the uptake of [3H]dopamine. A strong positive
      correlation (r = 0.64) was found between the density of [3H]nicotine binding
      sites and the nicotine-induced stimulation of [3H]dopamine release in individual
      animals. These results indicate that (+)-anatoxin-a, like nicotine, produces an
      up-regulation of nicotine binding sites following chronic administration, and
      that these additional sites are functional receptors capable of mediating the
      release of dopamine from striatal synaptosomes.

PMID- 2230813
TI  - Gangliosides prevent ischemia-induced down-regulation of protein kinase C in
      fetal rat brain.
AB  - Complete obstruction of the maternal blood flow to fetal rats at 20 days of
      gestation for a period of 10 min causes a significant shift of approximately 22%
      in protein kinase C (PKC) activity from a cytosolic to a membrane-bound form in
      the fetal brain. This translocation can be entirely reversed without losses in
      activity by a single intraperitoneal injection into the gravid rat of either a
      mixture of disialo- and trisialoganglioside [polysialoganglioside (PSG)] or by
      GM1 (50 mg/kg of body weight) given 3 h before onset of the ischemic episode.
      Cessation of blood flow for 15 min followed by a reperfusion period of 24 h
      results in a 47% loss in total PKC activity. This down-regulation can be almost
      entirely prevented upon intraperitoneal administration of GM1 3 h before, but
      also during and even 90 min after the onset of ischemia. The PSG mixture is also
      effective, particularly when given 3 h before the insult. Down-regulation of PKC
      is accompanied by an increase in a Ca2(+)-phosphatidylserine-independent kinase
      [protein kinase M (PKM)] activity, which rises from 30 pmol/min/mg of protein in
      control animals to a maximal value of 83.1 pmol/min/mg of protein after 15 min of
      ischemia and 6 h of reperfusion. By 24 h, PKM activity is 46.8 pmol/min/mg of
      protein. Administration of GM1 blocks completely the appearance of PKM, a result
      suggesting that PKC down-regulation and PKM activity elevation are intimately
      associated events and that both are regulated by GM1 ganglioside.

PMID- 2230814
TI  - Nerve growth factor enhances the expression of the cholinergic-specific
      ganglioside Chol-1 in cocultures of rat septum and hippocampus.
AB  - Cocultures of septal and hippocampal tissues taken from 6- to 7-day-old rats were
      maintained in culture for up to 30 days in the presence and absence of nerve
      growth factor (NGF), and their Chol-1 contents determined at varying time
      intervals by a modified enzyme-linked immunosorption assay (ELISA). The major
      brain gangliosides were determined densitometrically after spraying chromatograms
      with resorcinol reagent. There was little change in the contribution of the major
      gangliosides to the total ganglioside content of the explants either with time or
      the presence or absence of NGF, the only exception being an NGF-insensitive fall
      in the contribution of GM1 to about 60% of its initial value at 20 and 30 days.
      By contrast, the concentration of Chol-1 expressed either per unit weight of
      ganglioside sialic acid or protein increased considerably in culture and this
      increase was enhanced by NGF. The effect of NGF resembles that on other
      cholinergic markers, choline acetyltransferase and acetylcholinesterase, and may
      be attributed to an NGF-stimulated hippocampal ingrowth of cholinergic fibres and
      enhanced survival of cholinergic septal neurons. The Chol-1 concentration finally
      attained in the presence of NGF and the time course of its increase parallel
      those previously found in vivo and indicate the potential usefulness of septal
      hippocampal cocultures for investigating the function of Chol-1.

PMID- 2230815
TI  - A novel potential metallopeptidase derived from the enkephalinase gene by
      alternative splicing.
AB  - Amplification of rat intestine mRNAs was performed by the reverse transcriptase
      polymerase chain reaction (RT-PCR) using various oligonucleotide primers mainly
      corresponding to the translated region of the enkephalinase (EC 3.4.24.11,
      membrane metalloendopeptidase, MME I) gene. In addition to the expected
      transcript, a shorter one was identified and its sequence indicated that it
      corresponds to an alternatively spliced mRNA from which exons 5-18 of MME I are
      deleted. It encodes a deduced 255 amino acid protein, MME II, instead of the 742
      amino acid sequence of enkephalinase. The deduced structure of MME II is
      consistent with its being a membrane-bound, zinc-containing glycoprotein with a
      modified peptidase activity. MME II mRNA is also expressed, together with MME I
      mRNA, in brain and thyroid in a tissue-specific manner.

PMID- 2230816
TI  - Computer predictions of bone remodeling around porous-coated implants.
AB  - Computer simulations of bone remodeling in response to mechanical stresses can be
      used to understand normal growth and development of the skeleton or to predict
      the remodeling of bone in response to prosthetic devices. Using a previously
      derived bone maintenance theory, a technique for computing bone density
      distributions was applied to the proximal femur and tibia using two-dimensional,
      multiple-loading finite element models. The models initially represented solid,
      homogeneous structures. Using an iterative bone remodeling technique that relates
      bone apparent density to loading history, the internal distributions of apparent
      density and elastic modulus for the normal bones were predicted. The finite
      element models were then modified to represent bones in which porous-coated
      femoral surface replacements and tibial tray components had been implanted. The
      same iterative remodeling method was then applied to predict the distribution of
      bone around these components. The predicted bone density distributions for the
      natural femur and tibia agree with previously documented normal bone morphology.
      The predicted bone density distributions around various implanted prostheses were
      characteristic of the component under investigation and were consistent with
      clinical and experimental findings of other investigators. In the femoral head,
      stress shielding occurred underneath the metal surface replacement cup, resulting
      in lower densities in the femoral head. The addition of a central femoral cup
      fixation peg caused bone hypertrophy around the peg. In the tibia, the stress
      concentrations around the pegs also resulted in denser bone, with a concomitant
      decrease in bone density at more peripheral locations underneath the prosthetic
      tray. This remodeling technique has the potential to be an important tool in
      predicting the possible remodeling consequences of new implant design features.

PMID- 2230817
TI  - Threaded acetabular components for primary and revision total hip arthroplasty.
AB  - A clinical and radiographic review of 48 total hip arthroplasty patients with
      threaded acetabular components was undertaken at 24-44 months of follow-up study.
      Twenty-five patients had primary hip arthroplasties and 23 had revision
      procedures. Clinical scores revealed good to excellent results in 60% of primary
      and 30% of revision procedures. Radiographic analysis revealed stable acetabular
      components in 88% of primary and 61% of revision procedures. Potentially loose
      acetabular components were noted in 8% of primary and 4.3% of revision procedures
      and loose acetabular components in 4% of primary and 34.7% of revision
      procedures. The rate of acetabular component loosening was considered
      unacceptably high in revision cases and an area of concern in primary cases.
      Discretionary use of these components is advised.

PMID- 2230818
TI  - Early loosening of revision hip arthroplasty. A roentgen stereophotogrammetric
      analysis.
AB  - The primary migration of 15 and 22 cemented acetabular and femoral prosthetic
      components was recorded in 23 patients operated because of type I (minimal
      endosteal bone loss) and type II (thinning of bone, enlargement of femoral canal
      and acetabulum) mechanical loosening. Roentgen stereophotogrammetric analysis was
      used to measure the three-dimensional displacements of the center of the
      acetabulum and the femoral head. All but 1 of the acetabular and 1 of 15 revised
      femoral stem prostheses migrated within 2 years after the operation, whereas 5 of
      7 revised femoral surface arthroplasties were stable. Femoral components with
      type II loosening migrated, on average, 1.5 mm (range, 0.6-3.0 mm) during the
      first postoperative year, compared with 0.7 mm (range, 0.3-1.1 mm) in patients
      with type I loosening (P less than .02). Increased bone loss of the acetabulum
      (type II), the quality of the bone-cement interface as judged from radiographs,
      and the presence of perforation of the femoral cortex did not significantly
      influence the rate of migration in this group. Compared with previously presented
      studies of cemented primary hip prostheses, cemented revisions seem not only to
      migrate more frequently but also at a higher rate. Poor primary fixation is
      probably one important cause of the high frequency of clinical failures in these
      patients.

PMID- 2230819
TI  - Cementless total hip arthroplasty with femoral head bone grafting for hip
      dysplasia.
AB  - Femoral head bone grafting was required to augment acetabular bone stock in 19
      cases of hip dysplasia treated with cementless total hip arthroplasty. All
      acetabular grafts provided mechanical support for the cementless acetabular
      component. Radiographic evaluation of the fixation of the femoral components at
      an average of 3 years after surgery revealed an optimum appearance in all cases.
      All porous-coated acetabular components remained stable, but only one of six
      (17%) nonporous threaded acetabular components maintained stability. One threaded
      acetabular component has been revised for symptomatic loosening. Acetabular graft
      healing was suspected in 18 of 19 cases (95%). Significant graft resorption was
      observed only in the cases with unstable threaded acetabular components. The
      clinical scores were high. Cementless total hip arthroplasty with structural
      acetabular grafting and porous acetabular components appears to produce
      satisfactory short-term results.

PMID- 2230820
TI  - Segmental fracture of the femoral stem of a low-friction arthroplasty. A case
      report.
AB  - Fracture of the femoral stem of a cemented hip arthroplasty is a well documented
      complication. However, double or segmental fracture is extremely rare, with only
      one other case appearing in the literature. The authors report a second case and
      discuss its etiology. They stress the importance of prolonged careful review of
      patients following total hip arthroplasty in order to obviate complications.

PMID- 2230821
TI  - A comparative study of uncemented tibial components.
AB  - The effect of tibial component stem and post design on load distribution and on
      displacements at the component-bone interface was investigated. Four different
      configurations were tested with a flat component used as a control. Loading
      conditions included vertical central, vertical offset (eg, varus/valgus), shear
      and torque. Both artificial and cadaveric bones were used in the study. Pressure
      sensitive film was used to obtain pressure patterns at the interface. Image
      processing was then used to quantify the load distribution. For shear and torque,
      relative motion was seen as a smeared pressure pattern. This was calibrated in
      terms of microns of displacement as a function of image density. The central
      stemmed and bladed designs performed better than short-pegged designs, in
      resistance to offset loading. In shear and torque, short pegs close to the
      component periphery, or a central stem with blades, produced the least interface
      displacement. The application of this work to the design of components for both
      press-fit and cemented application is discussed.

PMID- 2230822
TI  - Unconstrained knee arthroplasty after patellectomy.
AB  - The authors report seven cases of unconstrained knee arthroplasty with excision
      of both cruciate ligaments, after previous patellectomy. Six of these seven cases
      were completely painfree and function was satisfactory in all cases. The reasons
      for previously reported pain and instability after total unconstrained knee
      arthroplasty with excision of the cruciate ligaments and a previous patellectomy
      are discussed.

PMID- 2230823
TI  - Patellar resurfacing in total condylar knee arthroplasty. Technique and results.
AB  - One hundred thirty-two total condylar knee arthroplasties with a 3-8-year follow
      up period were studied prospectively with particular reference to the
      patellofemoral joint. All patients had significant patellofemoral disease and
      underwent primary patellar resurfacing. After operation 96% of patients had
      little or no pain and 98% had functional improvement. There were seven (5%)
      complications related to the patellofemoral joint. The importance of careful
      attention to preparation of the patella, the technique of prosthetic implantation
      and correct patellar tracking were emphasized. Routine patellar resurfacing
      proved highly successful with minimal complications.

PMID- 2230824
TI  - The results of treatment of supracondylar fracture above total knee arthroplasty.
AB  - This study analyzes the results of treatment of 22 patients with 24 supracondylar
      femur fractures above a total knee arthroplasty. Ten knees were treated by closed
      methods utilizing traction and then a cast, 10 knees with immediate open
      reduction and internal fixation, 2 knees with a custom total knee integrated with
      a distal femoral allograft, 1 knee with external fixation, and 1 knee with
      primary arthrodesis. Nine fractures treated by closed means and 5 fractures
      treated by open reduction and internal fixation healed primarily. Two of the 5
      surgical failures healed after replating and bone graft. The 3 failures of
      surgical therapy were salvaged utilizing custom total knee arthroplasty, 2 of
      which required integration with a distal femoral allograft. One knee treated with
      external fixation developed a deep infection necessitating implant removal and
      arthrodesis. Twelve of the 14 femoral fractures that united primarily healed with
      the femoral component in varus with respect to the long axis of the anatomic
      femur. Nine of these 12 implants developed progressive radiolucent lines at the
      tibial component. Three of these knees have required implant revision due to
      progressive loosening of the tibial and/or femoral components. The results of
      this evaluation indicate that fractures above a well-fixed total knee
      arthroplasty are difficult to manage. If anatomical alignment cannot be achieved
      by simple closed techniques, then primary open reduction and internal fixation
      should be considered. However, because of the complexity of the problem, the
      surgeon should be prepared to perform a primary arthrodesis or revision using
      custom components with or without a distal femoral allograft.

PMID- 2230825
TI  - Persistent infection after successful arthrodesis for infected total knee
      arthroplasty. A report of two cases.
AB  - Infection in total knee arthroplasty has been reported to range from 1.1% to
      12.4%. The literature contains numerous articles on salvage procedures including
      antibiotic suppression, surgical debridement, resection arthroplasty,
      arthrodesis, reimplantation, and amputation. Of those knees not reimplantable, a
      successful arthrodesis is felt by many to give the most predictable long-term
      results. The majority of literature on arthrodesis for infected total knee
      arthroplasty concentrates on technical factors and techniques to facilitate
      fusion. A successful fusion is considered an end point of treatment.

PMID- 2230826
TI  - A comparison of transfusion requirements after total knee arthroplasty using the
      Solcotrans autotransfusion system.
AB  - Twenty-five consecutive total knee arthroplasties were performed with the
      Solcotrans unit for scavenging postoperative drainage (study group) and were
      compared with the previous 25 arthroplasties performed without the Solcotrans
      unit (control group). Mean preoperative hematocrits, estimated blood loss, and
      fluid replacement for both control and study groups were nearly identical. When
      the autotransfusion system was not used, 10 patients in the control group
      required transfusion of a total of 20 units of packed red blood cells, while only
      two patients utilizing the Solcotrans unit required transfusion of five units of
      packed red blood cells (P less than .01). The total amount autotransfused in the
      study group averaged 607.9 mm, and the hematocrit of the scavenged drainage was
      29.3%. Samples from all autotransfusions were sent to the microbiology lab for
      routine culture and were finalized as no growth after 14 days. Serial
      postoperative hematocrits, platelet counts, prothrombin, partial thromboplastin,
      blood urea nitrogen, and creatinine values were compared between the two groups.
      No significant differences were found, and no evidence of coagulopathy,
      thrombocytopenia or renal dysfunction was found in the study group.

PMID- 2230827
TI  - Polyglucosan body axonal enlargement increases myelin spiral length but not
      lamellar number.
AB  - The area of the unrolled myelin sheet of internodes of myelinated fibers (MF) of
      peripheral nerve is thought to be determined by axonal caliber and internodal
      length. We studied the effect of a focal increase of axonal caliber due to the
      deposition of polyglucosan bodies (PGB), amylopectin-like glucose polymers, on
      number of myelin lamellae (NL), interlamellar distance (periodicity), and myelin
      spiral length (MSL) from a sural nerve biopsy specimen of a patient with chronic
      inflammatory demyelinating polyneuropathy. Axonal area, NL, periodicity, and MSL
      were estimated within internodes of MF above, at, and below PGB. The axon caliber
      at the level of the PGB was significantly (P less than 0.002) increased when the
      PGB was included. At the PGB, NL and their periodicity were not significantly
      different from those above or below the PGB. The MSL was significantly longer
      overlying the PGB than it was in the same internode above or below the PGB.
      Because slippage or stretching of the myelin sheath as well as movement of
      molecular constituents of myelin is not likely over large distances, localized
      biosynthesis and assembly of new myelin may explain this increase of MSL.

PMID- 2230828
TI  - Comparison of aminopeptidase, dipeptidyl aminopeptidase and tripeptidyl
      aminopeptidase activities in brain tissue from normal and Alzheimer's disease
      cases.
AB  - Recent evidence has suggested that Alzheimer's disease may result from an
      underlying defect of protein catabolism. In an attempt to identify such a defect,
      we have undertaken the systematic identification and characterization of the
      proteolytic enzymes responsible in human brain for oligopeptide breakdown via
      hydrolysis of NH2-terminal residues--the aminopeptidases, dipeptidyl
      aminopeptidases and tripeptidyl aminopeptidases. The activities of these enzymes
      were determined following anion exchange chromatographic fractionation of
      cortical soluble extracts, to prevent interference in the respective assay
      procedures by the major cortical aminopeptidase. Corresponding enzyme types
      showed similar levels of activity in soluble extracts of frontal cortex from
      normal and Alzheimer's disease cases. These data suggest that the characteristic
      neurodegeneration associated with Alzheimer's disease does not result from
      altered aminopeptidase, dipeptidyl aminopeptidase or tripeptidyl aminopeptidase
      activity in cortical tissues of patients with this disorder.

PMID- 2230829
TI  - Expression of various isoforms of neural cell adhesive molecules and their highly
      polysialylated counterparts in diseased human muscles.
AB  - Antibodies directed against neural cell adhesive molecules (NCAM) and in
      particular a monoclonal antibody recognizing polysialylated isoforms, were used
      to characterize the expression of these molecules in normal and diseased human
      muscles. Normal subjects as well as patients with inflammatory, dystrophic and
      denervating diseases were examined. By immunohistochemistry the main observations
      were (1) satellite cells expressed the non-sialylated form of NCAMs; (2)
      regenerative fibers strikingly expressed NCAMs and their sialylated isoforms both
      on membranes and in the cytoplasm; (3) in denervated muscles, fibers in atrophic
      groups and some fibers in acute denervation expressed NCAMs on their membrane but
      not the highly sialylated form; (4) finally, some fibers in myotonic dystrophy
      and fibers with rimmed vacuoles also expressed NCAMs. Biochemical approaches,
      using enzymes such as endoglycosidase N and phosphatidylinositol phospholipase C
      combined with immunoblot analysis allowed visualization of the nature of the
      expressed isoforms. We have shown that non activated cells, i.e. satellite cells
      and denervated fibers do not express polysialylated NCAMs. This post
      translational modification may be only observed in activated or regenerating
      fibers. This would parallel the sequence of NCAM expression occurring in normal
      myogenic pathways.

PMID- 2230830
TI  - Arteriolosclerotic leucoencephalopathy in the elderly and its relation to white
      matter lesions in Binswanger's disease, multi-infarct encephalopathy and
      Alzheimer's disease.
AB  - Arteriolosclerotic leucoencephalopathy in the elderly (ALE) is characterized by
      white matter lesions associated with atherosclerosis and arteriolosclerosis. Mild
      lesions are focal and probably represent early status cribosus or incomplete
      lacunar infarcts. Moderate and severe lesions are diffuse areas of demyelination
      in the centrum semiovale in which lacunar infarcts are seldom observed. The
      incidence of ALE in a consecutive necropsy series of 50 cases (mean age 62.6 +/-
      13.1 years) was 52%, it was rare in the fourth and fifth decades but increased
      thereafter to reach a prevalence of 100% at the age of 80 years. Mild lesions
      occurred in 19 patients and lesions were moderate or severe in 7 (14%). The mean
      age was higher in this group (74.7 +/- 7.6 years) than in patients with white
      matter changes as a whole. Dementia occurred only in 3 patients with moderate or
      severe ALE. These data suggest that (a) ALE is common in old age and is probably
      the cause of leuko-araiosis in most CT scans in the elderly; (b) ALE may be
      asymptomatic; (c) the severity of white matter changes may be not related to the
      severity of neurological deficits; and (d) multiple lacunar infarcts or
      associated degenerative diseases (i.e., Alzheimer's disease) may be the main
      cause of dementia in patients with ALE. White matter lesions in ALE, Binswanger's
      disease, transition areas in multi-infarct encephalopathy (MIE) and Alzheimer's
      disease (AD) are similar in morphology and are probably the result of a subacute
      hypoperfusion/hypoxic process. Increased arterial blood pressure is a frequent
      risk factor in ALE, Binswanger's disease and MIE, whereas congophilic angiopathy
      of the meningeal and cortical vessels, in addition to mild or moderate arteriolar
      hyalinosis in the white matter, may play a role in the pathogenesis of incomplete
      infarctation of the white matter in patients with AD.

PMID- 2230831
TI  - Potassium channel activity in sarcolemmal vesicles formed from skeletal muscle
      fibres of normal and dystrophic mice.
AB  - Sarcolemmal vesicles were produced from adult mouse extensor digitorum longus
      muscle (EDL) by treating swollen muscle fibres with collagenase. Vesicles formed
      from dystrophic (C57BL/6J dy/dy) and phenotypically normal animals were patch
      clamped and the single channel activity was recorded. Three types of K+ channel
      were observed in excised patches taken from normal and dystrophic muscle. A large
      conductance (300 pS) Ca2(+)-dependent K+ channel (KCa) was the most frequently
      observed of the K+ channels in both types of muscle preparation. In a number of
      patches taken from dystrophic muscle the open probability-voltage relationship
      for the KCa channel was markedly different from that in normal muscle, suggesting
      a possible reduction in Ca2+ sensitivity. An ATP-sensitive K+ channel (90 pS) was
      common to both normal and dystrophic muscle vesicles and was present in a large
      number of patches. An inwardly rectifying K+ channel (40 pS) was also observed in
      both types of sarcolemmal vesicles. The properties of all three K+ channels types
      were broadly consistent with other observations of skeletal muscle K+ channels,
      though all had higher conductances than had previously been noted in other
      species.

PMID- 2230832
TI  - Transferrin receptors in rat central nervous system. An immunocytochemical study.
AB  - Using an immunocytochemical method we demonstrated the presence of TfR on adult
      rat neurons, particularly in the cerebral cortex and brain stem. The monoclonal
      antibody (mab) against rat TfR (clone OX 26) stained neurons of all cortical
      layers and in the brain stem where the reaction was most evident. Purkinje cells
      in the cerebellum and scattered neurons in the gray matter of the cervical spinal
      cord were weakly stained. Choroid plexus cells also reacted with the mab against
      TfR whereas oligodendrocytes in the cerebral white matter were faintly outlined
      by the mab. The presence of TfR on endothelial cells of brain capillaries was
      here confirmed.

PMID- 2230833
TI  - Quantitative analysis of gait in Parkinson patients: increased variability of
      stride length.
AB  - Analysis of the spatio-temporal and kinematic parameters of locomotion recorded
      in 21 parkinsonian patients compared to 58 normal elderly subjects showed
      significant differences in all the recorded parameters. However the relationship
      between these parameters was preserved, as was the basic locomotor pattern. The
      variability of stride length, more marked in parkinsonian patients, increased as
      a function of the clinical stages of Hoehn and Yahr. This index could be useful
      in assessing the course of the disease in patients.

PMID- 2230834
TI  - Decreased brain pathology in organophosphate-exposed rhesus monkeys following
      benzodiazepine therapy.
AB  - Two benzodiazepine compounds, midazolam and diazepam, were administered as
      adjunctive treatment to soman-exposed rhesus monkeys to evaluate their effects on
      acute soman intoxication. Monkeys were pretreated orally with pyridostigmine,
      exposed to soman, and treated i.m. with atropine, pralidoxime chloride (2-PAM),
      and with midazolam, diazepam or sterile water (control). All monkeys that
      received the benzodiazepines recovered sooner and exhibited no convulsions.
      Neuronal degenerative and necrotic lesions were decreased or eliminated in the
      entorhinal cortex, caudate nucleus, and hippocampus of those animals that
      received benzodiazepine therapy. These findings support the continued evaluation
      of drugs with anticonvulsant activity as standard adjunct therapy for soman
      intoxication.

PMID- 2230835
TI  - Astrocyte growth stimulation by a soluble factor produced by cerebral endothelial
      cells in vitro.
AB  - Conditioned medium from isolated cerebral capillary endothelial cells (ECCM) was
      found to promote DNA synthesis in astrocytes and pericytes, but not in
      oligodendrocytes or endothelial cells (EC) in vitro. The astrocyte was the cell
      of primary interest and the cell tested in the following experiments. The effect
      of ECCM on astrocytes was concentration and time dependent. The growth factor was
      released by EC into the medium in a cumulative manner for up to 72 hours. This
      release was not the result of a nonspecific leakage of an internal store, since
      the DNA synthetic activity of cell lysates was negligible. The growth factor
      secretion per cell was higher in sparse than in confluent EC cultures and was
      partially inhibited by preincubation of EC with interleukin-1. The DNA synthetic
      activity was due to a peptide, different from basic fibroblast growth factor,
      transferrin, bovine fibronectin and platelet derived growth factor, with a
      molecular weight greater than 50,000. The peptide derived from the cerebral
      capillary EC could be involved in the local signaling between cell types that
      control new vessel formation in development, in regeneration after brain tissue
      injury, or in tumor formation.

PMID- 2230836
TI  - The fate of Schwann cell basement membranes in permanently transected nerves.
AB  - After peripheral nerve fiber degeneration, Schwann cell basement membranes (SCBM)
      persist, maintain the columnar orientation of multiplying Schwann cells, and
      provide pathways for regenerating axons to original target tissue. Despite the
      putative importance of these functions, there is little quantitative information
      on SCBM in chronic denervation. The number, integrity, shape, and size of SCBM
      were evaluated in transverse electron micrographs of peroneal nerves of groups of
      mice at various times after permanent sciatic nerve transection. With increasing
      time after transection, the SCBM fragment, the fragments become shorter,
      dispersed throughout the endoneurium and partially disappear. The discontinuity,
      dispersion, and partial disappearance of SCBM, which worsens with time after
      nerve transection, alters the scaffold by which neurites grow back to formerly
      innervated or appropriate target tissue. Without reaching appropriate target
      tissue, regenerating fibers may fail to develop or undergo retrograde atrophy and
      degeneration. The progressive changes of the SCBM may contribute to the
      demonstrated poor regeneration when nerve reconnection is delayed, or when
      proximal nerves are reconnected, so that much time may elapse before neurites
      grow back to distal nerve.

PMID- 2230837
TI  - Central nervous system involvement in nephropathic cystinosis.
AB  - Nephropathic cystinosis, an autosomal recessive lysosomal storage disorder due to
      impaired cystine transport, causes damage to multiple organs that results in end
      stage renal disease, hypothyroidism, and retinopathy, usually in childhood.
      Dialysis and renal transplantation now frequently enable patients with cystinosis
      to live into adulthood. Examinations at autopsy of a 28-year-old man who died of
      complications of this disease showed deposits of cystine crystals in multiple
      organs. There was severe cerebral involvement with multifocal cystic necrosis,
      dystrophic calcification, spongy change, and vacuolization that had produced
      profound neurologic deficits. Electron microscopy of the brain documented
      cytoplasmic deposition of cystine crystals in membrane bound vacuoles within the
      cytoplasm of pericytes and within parenchymal cells of the white matter. While
      affected patients who have received renal transplants may no longer die from
      renal failure, serious, potentially life-threatening, neurologic complications of
      this disorder may supervene.

PMID- 2230838
TI  - Morphologic and functional alterations in aging rat muscle.
AB  - To understand better the causes of reduced contractile force in aging skeletal
      muscle, we performed a physiologic and morphologic analysis of plantaris muscle
      in old rats. The peak twitch tension (Fmax) and rates of force development and
      relaxation were significantly lower in old (24 months old) rats than in young
      (six month old) rats. In teased muscle fiber preparations, there was a 5%
      reduction in the mean number of fibers in the aging plantaris muscle.
      Histologically, a net loss of fibers occurred only in the muscle belly.
      Histochemically, fewer Type I fibers were seen in the belly and proximal regions,
      whereas distally fewer Type IIa fibers were seen. The loss of Types I and IIa
      oxidative fibers suggested a conservation of fast-twitch Type IIb fibers in a
      fast-twitch muscle. The relatively small loss of muscle fibers does not explain
      the large decline in muscle contractile performance which, despite established
      doctrine, was independent of muscle mass, fiber number or size, or number of fast
      twitch fibers. The reduced force production in aging rat muscle appears to be due
      to a defect in excitation, contraction performance or metabolic activity, rather
      than a purely anatomical abnormality of muscle.

PMID- 2230839
TI  - A distinctive triad of malformations of the central nervous system in the Meckel
      Gruber syndrome.
AB  - A distinct triad of central nervous system (CNS) malformations (prosencephalic
      dysgenesis, occipital exencephalocele and rhombic roof dysgenesis) was present in
      seven cases of the Meckel-Gruber syndrome examined at autopsy. We compared our
      findings with those previously described. Microcephaly, sloping forehead,
      posterior occipital exencephalocele, cerebellar hypoplasia, Chiari malformation,
      hydrocephalus, polymicrogyria, arhinencephaly, holoprosencephaly and anencephaly
      constituted a broad spectrum of the reported CNS anomalies. Few reports contained
      a comprehensive description of the observed CNS malformations. In those reports,
      and in our cases, features of prosencephalic dysgenesis included agenesis of
      olfactory bulbs and tracts (arhinencephaly), hypoplasia of optic nerves and
      chiasm, agenesis of corpus callosum, fused thalami or complete holoprosencephaly.
      The occipital encephalocele has consisted of a displacement of rhombic roof
      elements, including caudal third ventricle, cerebellar vermis and fourth
      ventricle, extruded through an enlarged posterior fontanelle rather than through
      an occipital cranium bifidum and is thus more precisely labeled an
      exencephalocele. Different degrees of dysgenesis of posterior fossa structures,
      described by some as a variant of Dandy-Walker cyst with features of a Chiari
      malformation, were often associated with this occipital exencephalocele. This
      pattern of CNS anomalies represents a triad of malformations probably associated
      with defective ventral induction of the developing CNS by the prechordal
      mesoderm.

PMID- 2230840
TI  - Genetic spongiform encephalopathies.

PMID- 2230841
TI  - Dexamethasone increases plasma levels of albendazole.
AB  - Therapy of neurocysticercosis with cysticidal drugs is frequently complicated by
      the exacerbation of symptoms that follows the inflammation triggered by the acute
      destruction of cysticerci. Treatment of such adverse reactions with dexamethasone
      is highly effective. However, it has been shown that dexamethasone lowers the
      plasma levels of praziquantel, thus reducing its cysticidal efficacy. We measured
      plasma levels of albendazole, another strong cysticidal drug, when dexamethasone
      was given simultaneously. We found that dexamethasone increased the plasma levels
      of albendazole by about 50% (P less than 0.002); hence, it seems that
      cysticercosis and the ensuing inflammation can be treated simultaneously with
      albendazole and dexamethasone without diminishing the efficacy of the cysticidal
      drug.

PMID- 2230842
TI  - Electroencephalographic activity related to palatal myoclonus in REM sleep.
AB  - Polysomnography, including electroencephalography, electromyography and electro
      oculography was performed in three patients with palatal myoclonus (PM). The
      amplitude of the myoclonus decreased during sleep. The frequency did not change
      during non-REM sleep, but increased during REM sleep in two patients. Ocular
      myoclonus synchronized with PM disappeared during deep sleep stages in two
      patients and reappeared during REM sleep in one of them. In the other patient,
      ocular myoclonus was noted only in REM sleep, being absent even when the patient
      was awake. All patients showed episodic EEG activities synchronous with myoclonic
      jerks only in REM sleep. These episodes were noted 5-15 times throughout the
      night, and each episode lasting for 1-7 s. They were negative or positive waves
      of saw-tooth appearance which were distributed predominantly in the central
      region. During the episodes, the frequency of myoclonic jerks increased in two
      patients. Although it is known that REM sleep influences PM and ocular myoclonus,
      this is the first report demonstrating the electroencephalographic activity
      associated with PM.

PMID- 2230843
TI  - Resistance to ischaemia of small afferent nerve fibres in diabetes mellitus.
AB  - Thermal thresholds were measured in the left forearms of 26 healthy subjects and
      10 patients with diabetes mellitus during ischaemic compression block. During the
      period when ischaemic block of large fibres caused paraesthesia and loss of touch
      sensation, the cold threshold rose in normals. The cold threshold was less
      clearly elevated and the warm perception remained unaltered by ischaemia in
      diabetics. These results show that not only large afferent and efferent nerve
      fibres but also thinly myelinated A delta and unmyelinated C fibres are resistant
      to ischaemia in the diabetic nerve.

PMID- 2230844
TI  - Headaches and multiple sclerosis: a clinical study and review of the literature.
AB  - Whether multiple sclerosis (MS) can cause headaches is controversial. To clarify
      the association between headaches and MS we prospectively analyzed 104
      consecutive MS patients using detailed headache evaluations. Fifty-four patients
      (52%) reported headaches, compared with 5 of 35 (14%) patients initially
      suspected to have MS but subsequently proven to have other disorders, and 18 of
      100 (18%) matched general neurology patients. The MS patients had tension
      headaches or vascular headaches of the migraine type; there was no distinctive
      "MS headache." Seven of these patients had headaches with their first MS
      symptoms, but in only one did headaches recur with disease activity. Headaches
      did not correlate with any clinical features of MS. We conclude that an
      association between headaches and MS may exist.

PMID- 2230845
TI  - Serial studies of evoked potentials and circulating lymphocyte subsets for
      multiple sclerosis: attempts to monitor progress.
AB  - A concurrent change in evoked potential measurements and quantitation of
      circulating T-suppressor (CD8) lymphocyte subpopulations might indicate increased
      subclinical disease activity. Eight untreated patients with clinically definite
      multiple sclerosis were monitored monthly for changes in the numbers of cells
      positive for CD8 markers, and hence in the ratio of CD4: CD8 positive cells. Such
      changes were found not to be associated with changes in evoked potentials or
      clinical status.

PMID- 2230846
TI  - Fatal or severely disabling cerebral infarction during hospitalization for stroke
      or transient ischemic attack.
AB  - Six (1%) of 578 patients admitted for cerebral infarction or transient ischemic
      attack (TIA) suffered a fatal or severely disabling in-hospital cerebral
      infarction following a period of stabilization or improvement lasting more than 1
      day. These infarctions were characterized by the sudden onset of stupor or coma
      and subsequent development of transtentorial herniation due to carotid or middle
      cerebral artery territory infarction, or widespread brain-stem infarction due to
      basilar occlusion. Only one patient survived. Four patients had large-vessel
      disease documented by Doppler, angiography, or at autopsy. Each of these six
      infarcts occurred during the morning hours, 4-9 days after the initial event, 3-8
      days after initiation of intravenous heparin, and within 4-8 h after intravenous
      heparin had been discontinued. No coagulation abnormalities were documented. We
      believe that these cases indicate that among patients admitted for cerebral
      infarction or TIA, fatal or severely disabling in-hospital cerebral infarction
      after a period of stabilization or improvement may occur in patients having an
      initially mild to moderate clinical deficit, that those suffering large artery
      disease may be at greater risk, and that there may be a relationship between
      heparin withdrawal and cerebral infarction in some patients.

PMID- 2230847
TI  - "Quadriceps myopathy": a clinical variant form of Becker muscular dystrophy.
AB  - A 26-year-old male with "quadriceps myopathy" is presented. He had a family
      history and only the bilateral quadriceps were wasted, without symptomatic
      weakness. The specimen of the muscle biopsy showed typical myopathic features
      without inflammatory reactions. The patchy defect of muscular dystrophin was
      proved by immunohistochemical study. Dystrophin analysis revealed abnormal 380
      kDa dystrophin. Gene deletion was proved at exon 45-48 of Xp21 without
      frameshift. This case was considered to be a clinical variant form of Becker
      muscular dystrophy.

PMID- 2230848
TI  - Unusual blink reflex with four components in a patient with periodic ataxia.
AB  - Characteristic findings in blink reflex are reported in a 55-year-old female with
      periodic ataxia. The blink reflexes on the side ipsilateral to the stimulation
      consisted of four components with latencies of 11, 21, 35 and 47 ms, instead of
      the usual two components seen in normal subjects. On the contralateral side, the
      last three components were also present. The second component was different from
      the normal R2 response in that its latency was shorter than normal and it did not
      habituate by stimulation at a rate of 10 Hz. In addition, it was more affected by
      diazepam than the third or fourth components. It is considered that R2 may have
      consisted of three components and that a shorter latency of the second component
      could be explained by facilitation.

PMID- 2230849
TI  - Cardiac transplantation in female Emery-Dreifuss muscular dystrophy.
AB  - A young woman with humeroperoneal muscular dystrophy and contractures received a
      heart transplant for a severe dilated cardiomyopathy. Cardiac histopathology
      consisted of myocyte hypertrophy, interstitial fibrosis, and nuclear
      hyperchromaticity without mitochondrial abnormalities. Myopathy and heart disease
      were not clinically evident in her family, although three relatives had
      unexplained shortened Achilles tendons without weakness. Tendon contractures may
      be a partial expression of this myopathic disorder, suggesting an autosomal
      dominant inheritance with variable penetrance. A muscular dystrophy clinically
      similar to that of the Emery-Dreifuss (EDMD) type can thus occur in women. Rather
      than the cardiac arrhythmias typical of EDMD, a dilated cardiomyopathy may occur
      and present with severe congestive heart failure. This is the first report of
      cardiac transplantation in such a case.

PMID- 2230850
TI  - Treatment of chronic relapsing inflammatory demyelinating polyneuropathy by
      cyclosporin A and plasma exchange. A case report.
AB  - A patient with chronic relapsing inflammatory demyelinating polyneuropathy was
      successfully treated with plasma exchanges and cyclosporin A (CsA). Dynamometric
      measurements of hand force during the time of CsA treatment showed a highly
      significant correlation between hand force and CsA blood levels. The largest
      influence of CsA on hand force occurred 11-13 days after CsA uptake.

PMID- 2230851
TI  - Alcohol-dependent unilateral vestibular impairment persisting after a closed head
      injury.
AB  - A 20-year-old man suffered a closed head injury followed by symptoms of right
      sided labyrinthine concussion with complete clinical recovery within 3 weeks.
      Episodic vertigo and ataxic gait occurred after the ingestion of small amounts of
      alcohol over the next 2 years. Electro-oculography revealed a right-sided
      peripheral type vestibular lesion, only after taking alcohol. This was
      interpreted as an alcohol-induced impairment of central compensation following an
      incomplete recovery from right-sided labyrinthine trauma.

PMID- 2230852
TI  - Livedo reticularis and dementia.

PMID- 2230853
TI  - Neurobiological findings in a case of Gilles de la Tourette's syndrome.

PMID- 2230854
TI  - Auscultatory mean blood pressure.
AB  - This study examined the relationship between direct mean arterial blood pressure
      and cuff pressure for the maximum acoustic index calculated from the Korotkoff
      sounds in the dog. The acoustic index was computed by summing the squares of
      amplitudes in each Korotkoff sound complex, thereby providing a measure of
      acoustic energy content. Mean arterial pressure was compared with cuff pressure
      for the maximum acoustic index. Ten mongrel dogs were fitted with appropriately
      sized blood-pressure cuffs containing a microphone mounted inside the bladder and
      positioned over the brachial artery. The Korotkoff sounds, cuff pressure, and
      direct arterial pressure were recorded over a range of mean arterial pressures
      (23 to 155 mm Hg), achieved by manipulating the depth of anesthesia with
      halothane. It was found that cuff pressure at the maximum acoustic index
      overestimated mean arterial blood pressure by a mean of 14% (range, -8 to +30%).

PMID- 2230855
TI  - Placement of esophageal stethoscope by acoustic criteria does not consistently
      yield an optimal location for the monitoring of core temperature.
AB  - The esophageal stethoscope has evolved into a device for both acoustic and core
      temperature monitoring. To test whether routine placement according to acoustic
      criteria results in placement of the core temperature sensor in the region of
      contiguity between the esophagus and the heart, we determined the depth of
      placement electrocardiographically. All patients were undergoing nonthoracic
      elective operations requiring general anesthesia and tracheal intubation. First,
      we established that different observers selected the same esophageal depth within
      +/- 1 cm electrocardiographically, using the criterion of a symmetric biphasic P
      wave of maximal amplitude (7 patients). Then, in 30 more patients, we compared
      routine acoustic placements with the depths of the maximal-amplitude biphasic P
      wave. Stethoscopes placed according to acoustic criteria were within +/- 3 cm of
      P-wave depths in 15 of 30 patients. In the remaining patients, measured
      discrepancies ranged up to 13.5 cm. We conclude that the prevailing stethoscope
      design, with a thermistor at the tip, below the acoustic window, does not ensure
      placement of the thermistor within the optimal region for monitoring of core
      temperature. A modification in design that would take advantage of the
      reliability of electrocardiographic positioning is suggested.

PMID- 2230856
TI  - Observer reliability in detecting surreptitious random occlusions of the monaural
      esophageal stethoscope.
AB  - The esophageal stethoscope is used often during anesthesia to monitor ventilation
      and cardiac function. Deficiencies in observer vigilance may limit the
      effectiveness of this monitoring instrument. The aim of this study was to
      determine how long it took for an observer to detect a surreptitiously occluded
      monaural esophageal stethoscope in the setting of clinical anesthesia. During
      routine anesthesia, where an esophageal stethoscope was in use, a computer-guided
      device would artificially, silently, and at random time intervals, occlude the
      stethoscope tubing. Personnel using the stethoscope noted when they perceived the
      absence of stethoscope sounds. We studied 320 stethoscope occlusions in 32
      patients. The time between stethoscope occlusion and detection was 34 +/- 59
      seconds (mean +/- SD). Eighty-seven percent of detections were made in less than
      60 seconds. However, 13% of detections were delayed for more than 60 seconds, and
      2.3% for more than 240 seconds. While anesthesia personnel using an esophageal
      stethoscope could detect most stethoscope occlusions, failure to appreciate such
      episodes occurred in a small but significant number of cases. This suggests that
      the esophageal stethoscope has some definite limitations as a continuous monitor
      and that other monitoring techniques, such as oximetry, capnography, and
      ventilator disconnect alarms, as well as visual/tactile inspection of the
      patient, should be used as well.

PMID- 2230857
TI  - Rib cage and abdominal piezoelectric film belts to measure ventilatory airflow.
AB  - Piezoelectric film-based respiratory belts are described and tested. To the
      extent that a two-degree of freedom model consisting of rib cage and abdominal
      motion is able to assist in quantifying ventilation, the piezoelectric belts can
      monitor flow in a manner analogous to the monitoring of volume with two
      magnetometer pairs or two respiratory inductive plethysmograph belts. The
      piezoelectric belts are shown to measure flow linearly when compared with a
      screen pneumotachometer to a flow of at least 2.6 L/s. There is no phase shift
      between the peak flow of belts and the pneumotachometer up to a frequency of at
      least 9.2 Hz. During normal ventilation, 68 and 95% of the peak flows measured
      with the belts fall within +/- 10 and 20%, respectively, of the flows measured
      with a screen pneumotachometer.

PMID- 2230859
TI  - Recognition accuracy with a voice-recognition system designed for anesthesia
      record keeping.
AB  - We tested on three occasions, with anesthetists as subjects, the accuracy of two
      voice-recognition systems designed for anesthetic record keeping. Initially, a
      prototype system was tested (10 subjects); several years later the resulting
      commercial system was tested in a quiet environment (11 subjects) and in noisy
      operating rooms (10 subjects). For each test an anesthetist first trained the
      system to recognize his or her voice by reading aloud a list of common anesthetic
      terms. To determine recognition accuracy, the percentage of words recognized
      correctly by the computer, each subject repeated the vocabulary words ten times.
      Although accuracy was similar during the three tests, it was slightly higher with
      the laboratory test (mean percent of words recognized correctly, 96.5%; range of
      accuracy for individual anesthetists, 91.6 to 98.8%) than with the prototype test
      (95.9%; range, 89.1 to 99.6%). Accuracy was lowest with the operating room test
      (95.3%; range, 87.8 to 98.4%). Twenty-four words caused particular difficulty
      during the laboratory test and were eliminated from the vocabulary of the
      subsequent operating room test. Omitting these 24 words from the laboratory
      vocabulary list allowed a more nearly direct comparison with the results from the
      operating room list; recognition accuracy improved in the former to 97.5% (range,
      92.1 to 98.9%). Two anesthetists--one each from the laboratory and operating room
      tests--performed poorly, and eliminating their scores changed the respective
      overall scores to 98.2% (range, 96.7 to 98.9%) and 96.5% (range, 94.3 to 98.4%).
      Thus, the corrected difference between the laboratory accuracy and the operating
      room accuracy was 1.7%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230858
TI  - Accuracy of four indirect methods of blood pressure measurement, with hemodynamic
      correlations.
AB  - In 38 adults undergoing cardiac surgery, 4 indirect blood pressure techniques
      were compared with brachial arterial blood pressure at predetermined intervals
      before and after cardiopulmonary bypass. Indirect blood pressure measurement
      techniques included automated oscillometry, manual auscultation, visual onset of
      oscillation (flicker) and return-to-flow methods. Hemodynamic measurements or
      calculations included heart rate, cardiac index, stroke volume index, and
      systemic vascular resistance index. Indirect and intraarterial blood pressure
      values were compared by simple linear regression by patient and measurement
      period. Measurement errors (arterial minus indirect blood pressure) were
      calculated, and stepwise regression assessed the relationship between measurement
      error and heart rate, cardiac index, stroke volume index, and systemic vascular
      resistance index. Indirect to intraarterial blood pressure correlation
      coefficients varied over time, with the strongest correlations often occurring at
      the first and last measurement periods (preinduction and 60 minutes after
      cardiopulmonary bypass), particularly for systolic blood pressure. Within-patient
      correlations between indirect and arterial blood pressure varied widely--they
      were consistently high or low in some patients. In other patients, correlations
      were especially weak with a particular indirect blood pressure method for
      systolic, mean, or diastolic blood pressure; in some cases indirect blood
      pressure was inadequate for clinical diagnosis of acute blood pressure changes or
      trends. The mean correlations between indirect and direct blood pressure values
      were, for systolic blood pressure: 0.69 for oscillometry, 0.77 for auscultation,
      0.73 for flicker, and 0.74 for return-to-flow; for mean blood pressure: 0.70 for
      oscillometry and 0.73 for auscultation; and for diastolic blood pressure: 0.73
      for oscillometry and 0.69 for auscultation. The mean measurement errors (arterial
      minus indirect values) for the individual indirect blood pressure methods were,
      for systolic: 0 mm Hg for oscillometry, 9 mm Hg for auscultation, -5 mm Hg for
      flicker, 7 mm Hg for return-to-flow; for mean: -6 mm Hg for oscillometry, and -3
      mm Hg for auscultation; and for diastolic: -9 mm Hg for oscillometry and -8 mm Hg
      for auscultation. Mean measurement error for systolic blood pressure was thus
      least with automated oscillometry and greatest with manual auscultation, while
      standard deviations ranging from 9 to 15 mm Hg confirmed the highly variable
      nature of single indirect blood pressure measurements. Except for oscillometric
      diastolic blood pressure, a combination of systemic hemodynamics (heart rate,
      stroke volume index, systemic vascular resistance index, and cardiac index)
      correlated with each indirect blood pressure measurement error, which suggests
      that particular numeric ranges of these variables minimize measurement
      error.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230860
TI  - Pressure measurement artifact with analog-to-digital conversion.
AB  - Pressure was transduced with the use of a fluid-filled catheter and standard
      medical monitoring equipment. When the signal was sampled at 200 Hz with an
      analog-to-digital converter, an artifact was observed. The 3.5-Hz artifact had an
      amplitude of 0.3 to 0.9 mm Hg and was caused by aliasing of a noise contaminant
      from the 2,403.5-Hz electrical excitation signal of the transducer. The artifact
      was completely eliminated with a 100-Hz low-pass filter. Electrical filtering is
      necessary for accurate acquisition of pressure measurements with analog-to
      digital conversion, even when the sampling rate satisfies the Nyquist criterion
      for the frequency response of the mechanical system. Although the impact of the
      artifact is small in the clinical area, it is important under some research
      circumstances.

PMID- 2230861
TI  - Continuous measurement of cardiac output with the use of stochastic system
      identification techniques.
AB  - The limitations of developing a technique to measure cardiac output continuously
      are given. Logical explanations are provided for the economic, technical, and
      physiologic benefits of a stochastic system identification technique for
      measuring cardiac output. Heat is supplied by a catheter-mounted filament driven
      according to a pseudorandom binary sequence. Volumetric fluid flow is derived by
      a cross-correlation algorithm written in the C language. In vitro validation is
      performed with water in a flow bench. The computed flow (y) compared with the in
      line-measured flow (x) yields the linear regression y = 1.024x - 0.157 (r =
      0.99). The average coefficient of variation is less than 2% over a volumetric
      fluid flow range of 2 to 10 L/min.

PMID- 2230862
TI  - Will we see automated record keeping systems in common use in anesthesia during
      our lifetime? The automated anesthetic record is inevitable and valuable.
AB  - The automated anesthetic record is inevitable for at least three reasons: First,
      much of the information is in electronic form. Second, all the necessary tools
      for transferring this information into a computer and hence onto a piece of paper
      are already available. Third, the need for an improvement over the current way of
      keeping records is widely recognized. Manual records are often inaccurate,
      biased, incomplete, and illegible, and they divert attention from more important
      tasks of the anesthetist. Although automated record keeping will not produce
      perfection, it will improve the situation enough to justify the effort.

PMID- 2230863
TI  - Will we see automated record keeping systems in common use in anesthesia during
      our lifetime? The automated anesthetic record will not automatically solve
      problems in record keeping.
AB  - The proponents of automated anesthetic records list the ostensibly logical
      reasons for them and then claim that automated records will make everything
      better. The logic goes as follows: (1) It is good to have accurate records
      because accurate records (a) make clinical decision making more effective and
      improve patient safety, (b) provide better defense against frivolous lawsuits,
      and (c) enable more astute medical policy decisions based on improved
      retrospective case reviews; (2) automatic record-keeping systems will give more
      nearly accurate records; (3) therefore, quality of care will improve if we
      acquire automatic record-keeping systems. This logic fails on several counts,
      which are detailed in this essay. Having said all this, however, I do believe
      that automated record systems will be implemented and they will be extremely
      useful, both for the patient and for those who care for the patient. However, we
      must exercise great care in their design and implementation, lest they wind up
      doing more harm than good.

PMID- 2230864
TI  - The present and future medicolegal importance of record keeping in anesthesia and
      intensive care: the case for automation.

PMID- 2230865
TI  - Spinal cord ischemia and motor evoked potentials.

PMID- 2230866
TI  - Who should pay for clinical research?

PMID- 2230867
TI  - Prognostic value of c-myc proto-oncogene overexpression in early invasive
      carcinoma of the cervix.
AB  - The prognostic effect of c-myc oncogene overexpression was assessed in a
      multivariate analysis of 93 patients with invasive carcinoma of the cervix, stage
      Ib, IIa, and IIb proximal. The treatment was based on the association of
      brachytherapy-colpohysterectomy and lymphadenectomy. Analysis of c-myc gene
      expression was done using Northern and slot blot hybridization techniques.
      Overexpression of c-myc (ie, levels at least three times the mean observed in
      normal tissues) was present in 33% of the tumors. The proportion of carcinomas
      with c-myc overexpression significantly increased with the size of the primary
      tumor (P = .04). No relationship was found between c-myc overexpression and the
      other clinical and histologic parameters, including the nodal status. The
      relative risk of relapse (overall, pelvic failure, distant metastases) was
      analyzed in a Cox's proportional hazards model. Three factors were significantly
      related to the risk of overall relapse when the multivariate analysis was
      performed, namely, the tumor size, the nodal status, and c-myc expression. A
      combination of c-myc expression and the nodal status provided a very accurate
      indication of the risk of relapse. Indeed, patients with negative nodes had a 3
      year disease-free survival rate of 93% (95% confidence interval [Cl], 79% to 98%)
      when c-myc was expressed at a normal level, whereas this rate was only 51% (95%
      Cl, 26% to 63%) when c-myc was overexpressed (log-rank test, P = .02). In
      addition, in the subgroup of patients with positive nodes, this rate was 44% (95%
      Cl, 25% to 77%) and 15% (95% Cl, 4% to 49%) when c-myc gene was expressed at
      normal level, or overexpressed, respectively. Finally, c-myc gene overexpression
      was, in the multivariate analysis, the first factor selected by the model
      regarding the risk of distant metastases.

PMID- 2230868
TI  - High- versus standard-dose megestrol acetate in women with advanced breast
      cancer: a phase III trial of the Piedmont Oncology Association.
AB  - One hundred seventy-two patients with advanced breast cancer were randomized to
      receive oral standard-dose megestrol acetate (MA), 160 mg/d or high-dose MA, 800
      mg/d. All but two patients had one prior trial of tamoxifen therapy for either
      metastatic disease (74%) or as adjuvant treatment (26%). Pretreatment
      characteristics were similar for both arms. High-dose MA resulted in a superior
      complete plus partial response rate (27% v 10%, P = .005), time to treatment
      failure (median, 8.0 v 3.2 months, P = .019), and survival (median, 22.4 v 16.5
      months, P = .04) when compared with standard-dose therapy. These differences
      remained significant after adjustment for other covariates. Thirty-four patients
      were given high-dose MA after failure of standard-dose MA treatment, and none
      responded. Weight gain was the most distressing side effect, with 13% of standard
      dose and 43% of high-dose patients gaining more than 20 lbs. Four major
      cardiovascular events occurred in patients receiving high-dose treatment and one
      in patients given standard doses. Other toxicity was modest. High-dose MA may
      represent a significant improvement in secondary endocrine therapy for advanced
      breast cancer patients refractory to initial endocrine treatment, but its use on
      a regular basis should be reserved until these results are confirmed by other
      clinical trials.

PMID- 2230869
TI  - Epirubicin cardiotoxicity: a study of 135 patients with advanced breast cancer.
AB  - The cardiotoxicity of epirubicin (EPI) was evaluated clinically, radiologically,
      with ECG, and with multiple ECG-gated radionuclide determination of the left
      ventricular ejection fraction (LVEF) during rest in 135 patients with advanced
      breast cancer. The EPI doses were 60 mg/m2 on days 1 and 8 every 4 weeks or 45
      mg/m2 plus vindesine 3 mg/m2 on the same schedule. The median cumulative dose of
      EPI was 500 mg/m2 (range, 47 to 1,563). Eight of the 135 patients developed
      congestive heart failure (CHF). Of 67 patients treated with EPI less than 500
      mg/m2, none developed CHF. Among 48 patients treated with doses between 500 and
      1,000 mg/m2, one had CHF (2%; 95% confidence limits, 0.1 to 11.1). Among 20
      patients who received EPI from 1,000 to 1,563 mg/m2, seven developed CHF (35%;
      95% confidence limits, 15.4 to 59.2). Four patients died due to cardiotoxicity.
      The risk of EPI cardiotoxicity at the present schedule is considerable at doses
      above 1,000 mg/m2. At doses between 500 and 1,000 mg/m2 the risk of CHF
      decreases, and at doses below 500 mg/m2, it is negligible. For all patients, the
      prevalence of CHF was 6% and the sensitivity of LVEF high (95%), mainly due to
      the low incidence of CHF. Among the 20 patients who received EPI at more than
      1,000 mg/m2, the prevalence of CHF was 35% and the sensitivity only 64%. The
      specificity was maximally 62%. Our results suggest that LVEF is of no value as a
      predictor for CHF.

PMID- 2230871
TI  - Long-term sequelae of conservative treatment by surgery, brachytherapy, and
      chemotherapy for vulval and vaginal rhabdomyosarcoma in children.
AB  - Between 1970 and 1978, 17 girls with rhabdomyosarcoma (RMS) of the vulva or
      vagina were treated at the Institut Gustave-Roussy (IGR) by conservative
      treatment including surgery, brachytherapy, and chemotherapy. Twelve pubescent or
      postpubescent girls were studied for long-term sequelae. Eleven of 12 patients
      have had a normal puberty, two have a total of three healthy children, 11 have
      normal menses, and 10 normal menarche (one after hormonal replacement). Only one
      patient underwent hysterectomy following low-dose brachytherapy. Five girls have
      no vaginal complications, and three are sexually active. Three have had minimal
      vaginal sequelae, which required surgical correction to permit sexual
      intercourse. Four girls sustained serious sequelae (colorectal, vaginal,
      urethral, and ureteral stenosis). These sequelae, secondary to irradiation, are
      potentially avoidable in the future given the current advances in brachytherapy
      and improvements in dosimetry. This conservative treatment is useful and
      appropriate for girls with RMS of vulvar or vaginal origin when complete
      remission cannot be obtained with chemotherapy and partial colpectomy.

PMID- 2230870
TI  - Acute renal dysfunction during interleukin-2 treatment: suggestion of an
      intrinsic renal lesion.
AB  - Adoptive immunotherapy with interleukin-2 (IL-2) and lymphokine-activated killer
      (LAK) cells has been effective in treating some advanced malignancies in animals
      and humans. One complication of this treatment is a reversible, oliguric, acute
      renal failure, which has been ascribed to renal hypoperfusion and resultant
      prerenal azotemia. We serially studied renal function in 10 patients receiving
      high-dose regimens of recombinant interleukin-2 (rIL-2) to attempt to delineate
      further the nature of the renal dysfunction caused by IL-2 treatment. Renal
      plasma flow was computed from iodine 131 (I-131 Hippuran; Mediphysics, Paramus,
      NJ) orthoiodohippurate, excretion curves, and glomerular filtration rate (GFR)
      was determined by creatinine clearance. Studies done prior to and on day 4 of
      treatment showed that GFR fell in nine of 10 patients, with a mean decrease of
      43% +/- 8%, and renal plasma flow fell in five of the 10 patients with a mean
      decrease of 5% +/- 10%. The average pretherapy filtration fraction was calculated
      to be 23% +/- 1% and after 4 days of treatment, decreased to a mean value of 15
      +/- 2%. The BUN to creatinine ratio also declined in all patients. These findings
      collectively suggest that IL-2 nephrotoxicity may result from an intrarenal
      defect in addition to the previously described prerenal azotemia. Additionally,
      radionuclide studies of renal function are a reliable and reproducible
      noninvasive method of assessing these changes in renal function.

PMID- 2230872
TI  - Questionable role of CNS radioprophylaxis in the therapeutic management of
      childhood rhabdomyosarcoma with meningeal extension.
AB  - A series of 15 consecutive children with head and neck nonorbital
      rhabdomyosarcoma (RMSA) with meningeal extension were prospectively treated with
      chemotherapy consisting of Adriamycin (doxorubicin; Adria Laboratory, Columbus,
      OH) (ADM), vincristine (VCR), cyclophosphamide (CPM), and dactinomycin (DACT)
      followed by radiotherapy (60 Gy) to the primary tumor volume, along with
      intrathecal methotrexate (IT MTX). Thirteen of 15 responded to preradiation
      chemotherapy. Four of 13 relapsed. Relapse occurred at the level of the primary
      tumor in three of four. The 3-year progression-free survival (PFS) was 59%,
      similar to that achieved in a previous series treated with a comparable
      therapeutic approach that also included whole-brain radiotherapy as a prophylaxis
      of possible occult meningeal seeding. It is concluded that CNS prophylaxis with
      radiotherapy is questionable in the management of childhood RMSA with meningeal
      extension.

PMID- 2230873
TI  - Treatment of metastatic melanoma with an autologous tumor-cell vaccine: clinical
      and immunologic results in 64 patients.
AB  - We treated 64 patients with metastatic melanoma using a melanoma vaccine preceded
      by low-dose cyclophosphamide (CY), and monitored immunologic effects and
      antitumor activity. On day 0, the patients were given CY 300 mg/m2 intravenously.
      Three days later, they were injected intradermally with vaccine consisting of 10
      to 25 x 10(6) autologous, enzymatically dissociated, cryopreserved, irradiated
      (25 Gy) tumor cells mixed with bacillus Calmette-Guerin (BCG). This treatment
      sequence was repeated every 28 days. Of 40 assessable patients with measurable
      metastases, five had responses, four complete and one partial, with a median
      duration of 10 months (7 to 84+ months). In six additional patients, we observed
      an antitumor response that seems to be peculiar to this vaccine therapy: the
      regression of metastatic lesions that appeared after the immunotherapy was begun.
      Delayed-type hypersensitivity (DTH) to autologous, mechanically dissociated
      melanoma cells that had not been exposed to extraneous antigens, such as enzymes
      or fetal calf serum, increased significantly following immunotherapy (day 0 v day
      49, P less than .001; day 0 v day 161, P less than .001; day 0 v day 217, P =
      .021). Antitumor responses to the vaccine were strongly associated with DTH, as
      indicated by three observations: (1) eight of 10 patients who exhibited tumor
      regression had positive DTH, (2) in postsurgical adjuvant patients, there was a
      highly significant linear relationship (P less than .001) between the intensity
      of DTH to autologous melanoma cells and the time to recurrence of tumor, and (3)
      nine patients who developed DTH to the autologous melanoma cells in their
      original vaccine developed new metastases that failed to elicit DTH or elicited a
      much smaller response. In three cases, we were able to excise regressing tumors
      for histologic examination; such tumors were characterized by an intense
      infiltration of lymphocytes. This demonstration that an immune response to
      melanoma-associated antigens can be elicited in cancer-bearing patients provides
      some basis for optimism about the prospects for developing active immunotherapy
      that has practical therapeutic value.

PMID- 2230874
TI  - Human tumor fluorouracil trapping: clinical correlations of in vivo 19F nuclear
      magnetic resonance spectroscopy pharmacokinetics.
AB  - We previously reported that fluorouracil (5FU) accumulation and metabolism in
      human livers and tumors can be studied by in vivo nuclear magnetic resonance
      spectroscopy (NMRS). We have extended these observations by evaluating the
      pharmacokinetics of 5FU in the tumors of 11 patients with carcinoma of the
      breast, colon, endometrium, cervix, and kidney, using 19F-NMRS in a 1.5 Magnetom
      (Siemens Medical Systems, Cerrito, CA) magnetic resonance imaging unit (MRI).
      These NMRS measurements detected a long-lived tumor pool of 5FU in six of 11
      tumors in our patients including carcinomas in the pelvis, breast, lung, and
      liver. The half-life (T1/2) of this tumor pool of "trapped" 5FU was 0.33 to 1.3
      hours (20 to 78 minutes), much longer than the T1/2 of 5FU in blood (5 to 15
      minutes). Neither the anabolites of 5FU (fluorinated nucleosides, nucleotides,
      5FU-RNA, or 5FU-thymidylate synthase) nor the catabolites (eg, fluorobetaalanine
      [FBAL]) were detectable by 19F NMRS. Patient response to chemotherapy appeared to
      correlate with the extent of trapping of free 5FU in the human tumors: in the
      seven patients receiving 5FU, or 5FU or FUdR plus leucovorin, four of four
      patients whose tumors trapped 5FU responded to fluorinated pyrimidine
      chemotherapy, whereas three patients in whom there was a failure to detect tumor
      trapping were resistant to 5FU. We conclude that NMRS is clinically feasible, and
      enables investigators to study 5FU pharmacokinetics and metabolism in tumors in
      vivo. 19F-NMRS of 5FU allows for in vivo evaluation of 5FU metabolic modulation
      and might be able to guide therapeutic decisions.

PMID- 2230875
TI  - Changes in the clearance of total and unbound etoposide in patients with liver
      dysfunction.
AB  - The disposition of total and non-protein-bound etoposide was investigated in 21
      cancer patients receiving etoposide and cisplatin combination chemotherapy.
      Etoposide plasma concentrations were determined using a specific high-performance
      liquid chromatography (HPLC) method, and etoposide plasma protein binding was
      determined by equilibrium dialysis. The patients had a wide range of renal
      function (creatinine clearance, 32 to 159 mL/min/m2) and hepatic function (total
      bilirubin range, 0.3 to 21.5 mg/dL; aspartate aminotransferase [AST] range, 14 to
      415 IU/L; serum albumin range, 2.7 to 4.1 g/dL). The mean etoposide total
      systemic clearance was not different in 15 patients with total bilirubin less
      than 1.0 mg/dL versus six patients with total bilirubin 1.1 to 21.5 mg/dL (18.7
      +/- 5.9 mL/min/m2 v 26.4 +/- 10.7 mL/min/m2; t-test P = .06), with a trend toward
      higher total clearance in the patients with abnormal bilirubin values. However,
      the mean clearance of unbound etoposide was significantly lower in patients with
      increased total bilirubin (220 +/- 90 mL/min/m2 v 135 +/- 61 mL/min/m2; t-test P
      = .027). The fraction of etoposide unbound (fu) in plasma was significantly
      higher in patients with increased bilirubin (9% +/- 3% v 27% +/- 15%; t-test P =
      .002), explaining the trend toward higher total clearance in these patients.
      Etoposide clearance (total or unbound) in the 14 patients with measurable hepatic
      metastases was not different from the clearance in the seven patients without
      hepatic metastases. This study provides an explanation for why patients with
      increased bilirubin do not have lower total systemic clearance of etoposide, and
      indicates that such patients have a higher exposure to unbound etoposide. The
      results of ongoing pharmacodynamic studies of total and unbound etoposide in
      patients with increased bilirubin will determine the clinical relevance of
      altered etoposide protein binding.

PMID- 2230876
TI  - Clinical evaluation of a side entry access port: a novel dual-lumen venous access
      device.
AB  - The initial clinical experience with a low-profile side entry access (SEA) dual
      lumen implantable venous access port for cancer chemotherapy administration is
      summarized in this report. The catheter material is polyurethane. The overall
      experience in 35 patients in this study was a total of 6,224 patient days, with a
      mean of 178 days per patient. A variety of chemotherapeutic agents, biologic
      response modifiers, and antibiotics were administered. In 26% of the patients,
      the device chambers were in simultaneous use during the treatment period. A 6%
      incidence of clinical subclavian vein thrombosis was noted. There was no
      infectious complications. Inconsistencies in blood withdrawal and temporary
      catheter dysfunction were comparable to other access ports in clinical use. The
      novel design of this side entry port and the catheter material of low
      thrombogenicity make this device a good option in patients requiring a low
      profile system and dual access. Nursing staff should be made aware of the side
      entry design and that in-service training for accessing the septum is required in
      centers where such devices are not routinely used.

PMID- 2230877
TI  - Quantitative analysis of antibody localization in human metastatic colon cancer:
      a phase I study of monoclonal antibody A33.
AB  - A33 is a mouse immunoglobulin G2a (IgG2a) monoclonal antibody (mAb) that detects
      a heat-stable, protease- and neuraminidase-resistant epitope. The antigen is
      homogeneously expressed by virtually all colon cancers and in the colon mucosa
      but not other epithelial tissues. The biodistribution and imaging characteristics
      of iodine-131 (131I)-mAbA33 were studied in colorectal carcinoma patients with
      hepatic metastases. Antibody labeled with 2 to 5 mCi of 131I was administered
      intravenously (IV) 7 to 8 days before surgery at five dose levels, ranging from
      0.2 mg to 50 mg, with three or more patients entered at each dose level. In
      addition, three patients received 2 mg 131I-mAbTA99 (an isotype-matched control
      mAb) together with 125I-mAbA33. Evaluation included whole-body imaging with a
      gamma camera, technetium-99 (99mTc)-human serum albumin blood pool scans,
      liver/spleen scans, abdominal computed tomographic (CT) scans, hepatic
      arteriograms, antibody pharmacokinetics, and assessment of antibody distribution
      in biopsied malignant and normal tissues. Selective mAbA33 localization to tumor
      tissue was demonstrated in 19 of 20 patients, and external imaging correlated
      with surgical inspection, pathologic examination, and tissue radioactivity. One
      week after antibody administration, tumor:liver ratios ranged from 6.9:1 to 100:1
      and tumor:serum ratios from 4.1:1 to 25.2:1. 99mTc-albumin blood pool studies
      showed that liver metastases were hypovascular, emphasizing the selective
      localization of mAbA33 despite poor tumor-blood flow. Control mAbTA99 studies
      showed mAbA33 localization was antigen-specific; tumor:liver ratios were 2.3- to
      45-fold higher for specific antibody. In metastatic lesions, radioisotope was
      localized primarily in the viable periphery; however, even the necrotic tumor
      core concentrated specific antibody. External imaging showed isotope
      visualization in some patients' large bowel; whether this represents specific
      antibody uptake or gastric iodine secretion is unclear.

PMID- 2230878
TI  - An early phase II study of CPT-11: a new derivative of camptothecin, for the
      treatment of leukemia and lymphoma.
AB  - An early phase II study of a new camptothecin analog and an inhibitor of
      topoisomerase I, CPT-11, was conducted in 62 patients with refractory leukemia
      and lymphoma by four different treatment schedules in a multiinstitutional
      cooperative study. CPT-11 therapy resulted in four complete remissions (CRs) and
      three partial remissions (PRs) in 29 assessable non-Hodgkin's lymphoma (NHL)
      patients, one PR in three Hodgkin's disease (HD), one CR and one PR in 11 acute
      lymphoblastic leukemia (ALL), and one PR in 15 acute myelogenous leukemia (AML)
      patients. Single infusion of 200 mg/m2 every 3 to 4 weeks produced no response in
      both leukemia and lymphoma patients. Sixty-minute infusions of 40 mg/m2/d for 5
      days every 3 to 4 weeks or for 3 days weekly produced four CRs (17%) and four PRs
      (17%) in 24 patients with malignant lymphoma. Sixty-minute infusions of 20 mg/m2
      twice a day for 7 days every 3 to 4 weeks resulted in one CR and two PRs in 12
      patients with acute leukemia. No response was seen in an acute leukemia patient
      by another treatment schedule. CPT-11 was effective in two (15%) of 13 primarily
      refractory leukemia and lymphoma cases, in two of four relapsed cases, and in
      seven (17%) of 41 relapsed and refractory cases. Major side effects were
      leukopenia (91%) and gastrointestinal (GI) (76%). CPT-11 was shown to be
      effective against refractory leukemia and lymphoma, and thus deserves further
      clinical study; the novel antitumor activity mode of this drug predicts no cross
      resistance to presently available antitumor drugs.

PMID- 2230879
TI  - The unique aspects of acute promyelocytic leukemia.
AB  - Acute promyelocytic leukemia (APL) accounts for approximately 10% of cases of
      acute myeloid leukemia (AML). Distinctive features of this disorder at the time
      of diagnosis include leukopenia coexisting with a marrow replaced with granulated
      dysplastic promyelocytes, disseminated intravascular coagulopathy, lack of Ia
      (HLA-DR) antigen expression, and translocation between the long arms of
      chromosomes 15 and 17 (t[15;17]). Heparin is widely but not universally used to
      interfere with the coagulopathy during the initial phases of treatment. Serial
      bone marrow examinations during the induction period demonstrate the achievement
      of remission despite the persistence of malignant-appearing promyelocytes.
      Patients with APL are generally younger than those with other subtypes of AML,
      have a 70% to 80% likelihood of entering remission, and are thought to have a
      more favorable prognosis than other individuals with AML. Remission may be
      achieved with a conventional anthracycline-cytarabine combination, anthracycline
      alone, or, apparently, all-trans retinoic acid. Genes potentially important in
      myeloid differentiation such as granulocyte colony-stimulating factor (G-CSF) and
      myeloperoxidase are located close to the breakpoint in the t(15;17) but have not
      been conclusively shown to be rearranged in the translocation. A better
      understanding of the unique aspects of APL may well shed light on the
      pathogenetic processes of AML.

PMID- 2230880
TI  - Chemohormonal therapy for older women with node-positive breast cancer.

PMID- 2230881
TI  - The reporting of trials of adjuvant therapy for breast cancer.

PMID- 2230882
TI  - What determines actual chemotherapy dose intensity?

PMID- 2230883
TI  - Dose intensity in the treatment of diffuse large-cell lymphoma.

PMID- 2230884
TI  - Concomitant chemoradiotherapy.

PMID- 2230885
TI  - The calculation of received dose intensity.

PMID- 2230886
TI  - Monoclonal antibodies and radioimmunoconjugates: keeping feasibility at center
      stage.

PMID- 2230887
TI  - Intraperitoneal yttrium-90-labeled monoclonal antibody in ovarian cancer.
AB  - From March 1987 to March 1988, a phase I to II study was carried out in 25
      patients with ovarian cancer. They received escalating doses of intraperitoneally
      (IP) administered yttrium-90 (Y-90)-labeled monoclonal antibody, HMFG1, against a
      tumor cell-surface antigen. Myelosuppression prevented an escalation of the
      administered Y-90 activity above 25 mCi. Y-90-labeled antibody was absorbed from
      the peritoneal cavity into the circulation. Maximum blood Y-90 activity was
      observed 40 hours after the IP injection with a mean of 21% of the injected
      activity (range, 14.2% to 26.4%) in the circulation. The radiation dose the bone
      marrow received from circulating Y-90-labeled antibody (the blood radiation dose)
      was calculated by applying the Medical Internal Radiation Dose (MIRD) formulation
      to the measured Y-90 activity in patients blood. Myelosuppression occurred
      following calculated blood radiation doses to bone marrow of only 10 to 30 cGy.
      The excessive myelosuppression following such modest radiation doses from
      circulating Y-90-labeled antibody could be explained by the uptake of Y-90 by
      bone. In an attempt to reduce bone absorption of Y-90, seven patients received an
      intravenous (IV) infusion of EDTA (Sinclair Pharmaceuticals Ltd, Godalming,
      United Kingdom). This increased the urinary excretion of Y-90 from a mean of
      11.1% to 32.3% of the injected activity (P = .0001). Fourteen patients had
      assessable tumor at laparoscopy. Tumor regression was observed in one patient,
      and palliation of ascites in a further patient.

PMID- 2230888
TI  - Clinical correlates of distinct immunophenotypic and histologic subcategories of
      lymphocyte-predominance Hodgkin's disease.
AB  - Histologic and paraffin immunohistologic studies were carried out on 32 patients
      with lymphocyte-predominance Hodgkin's disease (LPHD) seen from 1970 through
      1982. While nodular histology was accurately predictive of B-cell phenotype (Leu
      M1 -/L26+), diffuse histology corresponded to either B-cell or Hodgkin's (Leu M1
      +/L26-) phenotype, not invariably predictable even when attention was paid to
      subtle paragranuloma cytology. Clinical characteristics were compared between
      histologic (diffuse v nodular) and immunophenotypic (Leu M1 +/L26-, Hodgkin's
      phenotype, v Leu M1 -/L26+, B-cell phenotype) subgroups. Ten patients have since
      died, and the median follow-up of the living patients was 14 years (range, 6 to
      31). Of the several clinical parameters compared, only axillary nodal
      presentation was strongly associated with both B-cell phenotype and nodular
      histology, while male predominance related more to B-cell phenotype than nodular
      histology. No significant difference in overall survival or relapse rate was
      apparent among either the histologic or the immunophenotypic subgroups. However,
      very late but salvageable relapses were associated with nodular histology. The
      incidences of secondary malignancies and death from Hodgkin's disease (HD) were
      also comparable between the subgroups. Although difference in clinical
      presentation may exist, neither the histologic nor the immunophenotypic
      subcategories of LPHD could be demonstrated to correlate with differences in
      clinical outcome.

PMID- 2230889
TI  - Gallium-67 imaging: a predictor of residual tumor viability and clinical outcome
      in patients with diffuse large-cell lymphoma.
AB  - Durable complete remissions (CRs) can be achieved in patients with diffuse large
      cell lymphoma (DLCL) with multidrug chemotherapy. The length of time to reach CR
      may be predictive of treatment outcome. However, defining CR by chest radiograph
      or computed tomography (CT) is often difficult since residual abnormalities do
      not always indicate residual disease. We have prospectively evaluated the ability
      of gallium-67 citrate (Ga-67) imaging to define residual disease and predict
      outcome in 37 consecutive patients with DLCL. Patients received 296 to 370
      megabecquerels (MBq) Ga-67 and were imaged prior to, following cycles 4 to 6, and
      at completion of intensive chemotherapy. Ga-67 scan results were correlated with
      radiographic studies. Seventeen of 37 patients (46%) showed persistent, abnormal
      Ga-67 uptake halfway through chemotherapy. Of these, four were in CR, 11 were in
      partial remission (PR), and two showed no change in tumor size. At follow-up, 10
      (59%) have died (three who were scored as CR and seven who were in PR halfway
      through therapy), two are alive with active tumor, one relapsed and survives
      following bone marrow transplant, and four (three in PR and one in CR at the
      therapeutic halfway point) are without disease at a median of 28 months from
      presentation. Of the 20 patients who were Ga-67-negative halfway through therapy,
      11 were in CR and nine were in PR. Five of 20 patients (25%) have died. Three, in
      radiographic CR died at 11, 26, and 28 months, and two in radiographic PR died at
      15 and 17 months. One patient is alive with active tumor, and 14 patients (70%)
      are alive without disease at a median of 34 months from presentation. Ga-67
      imaging proved to be an excellent indicator of residual viable tumor; a positive
      scan halfway through therapy predicted for a poor outcome and may well justify a
      change in treatment.

PMID- 2230890
TI  - Pediatric osteosarcoma: therapeutic strategies, results, and prognostic factors
      derived from a 10-year experience.
AB  - Ninety-eight pediatric patients were treated with three separate protocols
      (Treatment and investigation of Osteosarcoma [TIOS] I, II, and III) and 47
      developed recurrent disease (metastases and/or local recurrence). Actuarial
      overall disease-free survival (hereafter designated survival) was 43%. Over 90%
      of the patients were treated initially with preoperative intraarterial cisplatin
      (CDP). Postoperative chemotherapeutic regimens comprised high-dose methotrexate
      with leucovorin rescue (MTX-CF), Adriamycin [( ADR] doxorubicin; Adria
      Laboratories, Columbus, OH), and cyclophosphamide. Primary definitive treatment
      comprised amputation or limb salvage (TIOS I and TIOS III). Patients treated with
      preoperative CDP and surgery (TIOS I and III) had a 62% survival. Patients in
      TIOS II refused surgical extirpation; they were treated exclusively with
      chemotherapy and had a 23% survival. Survival in patients treated with amputation
      was 55% and limb salvage 58%. Prognostic factors considered significant in
      relation to development of pulmonary metastases comprised tumor burden (P = .04)
      and the percentage of tumor necrosis induced by preoperative chemotherapy (P =
      .01). Histopathologic subtype was marginally significant: chondroblastic was more
      favorable as opposed to osteoblastic (P = .05). These findings are compared with
      results and prognostic factors published in the literature.

PMID- 2230891
TI  - Early hospital discharge of children with cancer treated for fever and
      neutropenia: identification and management of the low-risk patient.
AB  - Children with leukemia and solid tumors are often hospitalized for empiric broad
      spectrum antibiotic therapy because of fever during periods of chemotherapy
      induced neutropenia. Conventional practice dictates that parenteral antibiotics
      be continued until the patient is afebrile and has recovered from neutropenia,
      ie, until the absolute neutrophil count (ANC) exceeds 500 cells per cubic
      millimeter. However, the practice in our center has been to discontinue
      parenteral antibiotic therapy and discharge many such patients before resolution
      of neutropenia. Since the feasibility and safety of this approach has not been
      studied, we reviewed the records of 114 consecutive hospitalizations for fever
      and neutropenia in 61 patients during a 13-month period. Seventy-seven children
      (68%) were discharged to their homes while still neutropenic after they had been
      afebrile for 1 to 2 days on parenteral antibiotics, had negative blood cultures,
      appeared well, and usually had some evidence of bone marrow recovery. Five
      patients (4.4%) developed recurrent fever and required rehospitalization within 7
      days of discharge. Only three of the 77 patients (3.9%) who were sent home with
      neutropenia had recurrent fever. Each had a brief and uneventful second
      hospitalization. Two of the 37 children discharged with an ANC over 500 cells per
      cubic millimeter required rehospitalization. A declining ANC and advanced
      malignancy were risk factors in predicting recurrence of fever following
      discharge. A rising monocyte count was a predictor of imminent recovery from
      neutropenia. These results suggest that "early" discharge of an afebrile yet
      still neutropenic patient is safe when the patient is in remission, has no
      evidence of serious infection, appears clinically stable, and has indications of
      bone marrow recovery. The conventional approach of routinely continuing the
      hospitalization until resolution of neutropenia may be unnecessary in such low
      risk patients.

PMID- 2230892
TI  - Current urinary mass screening for catecholamine metabolites at 6 months of age
      may be detecting only a small portion of high-risk neuroblastomas: a chromosome
      and N-myc amplification study.
AB  - We studied 96 infants and children with untreated neuroblastomas. Chromosomes of
      tumor cells were analyzed in 68, and N-myc copy numbers were determined in 67
      patients. Patients found by a mass screening program for 6-month-old infants
      (group A1, 39 patients) or those less than 12 months of age found clinically
      (group A2, 13 patients) were rarely in the disseminated stage (A1, three of 39;
      A2 one of 13); their tumors usually had near-triploid (3n) or hypertetraploid
      (greater than 4n) karyotypes (A1, 28 of 37; A2, nine of 11), and never had N-myc
      amplification (A1, zero of 34; A2, zero of 11). In contrast, children 12 months
      or over (group B, 27 patients) were usually in the disseminated stage (19 of 27)
      (P less than .0001); their tumors usually had near-diploid (2n) or near
      tetraploid (4n) karyotypes (16 of 20) (P = .0027), and often had N-myc
      amplification (nine of 22) (P less than .0001). Of the 40 clinically found
      patients (A2 and B), six had undergone the screening with a negative result at
      the age of 6 months. Two of the six patients had N-myc amplification in the
      tumors. Most tumors found by the screening showed known characteristics
      predicting a good prognosis, and the majority of tumors showing characteristics
      predicting a poor prognosis were found in patients aged between 12 and 36 months.
      Our chromosome and N-myc amplification studies suggest that a low-risk tumor does
      not usually evolve to a high-risk tumor. Thus, the current mass screening program
      may be detecting only a small portion of highly malignant neuroblastomas at the
      earliest stage. Infants should be screened twice, at 6 months as well as at 12
      months of age, for the early detection of high-risk neuroblastomas.

PMID- 2230893
TI  - Mechlorethamine, vincristine, and procarbazine chemotherapy for recurrent high
      grade glioma in adults: a phase II study.
AB  - We undertook a phase II study of combination chemotherapy with mechlorethamine
      (nitrogen mustard) 6 mg/m2 intravenously day 1 and day 8, vincristine 2 mg
      intravenously day 1 and day 8, and procarbazine 100 mg/m2 orally days 1 through
      14 (MOP) in adults with recurrent high-grade glioma. There were 31 patients
      entered and 27 patients assessable for response. The median age was 49 years old.
      All patients had prior maximal radiotherapy, and eight had previous chemotherapy.
      Responses were determined based on clinical and computed tomographic (CT)
      scan/magnetic resonance imaging (MRI) criteria. The response rate (partial
      response [PR] plus objective qualitative response [OQR] plus complete response
      [CR]) was 52% with one CR. The response rate was higher in patients with
      anaplastic astrocytoma as compared with glioblastoma multiforme (P less than
      .05). The median duration of response was 42 weeks. Median survival for all
      assessable patients was 30 weeks, and for responders, it was 60 weeks. Response
      was correlated with ability to decrease dexamethasone doses and improved
      performance status. Toxicity was mainly hematologic with leukopenia being common.
      There was one treatment-related death from listeria meningitis, and two patients
      developed Pneumocystis carinii pneumonia. There were three episodes of
      neutropenic fever. We conclude that MOP is active and merits further
      investigation in adult high-grade glioma.

PMID- 2230894
TI  - Phase II study of fluorouracil and recombinant interferon alfa-2a in previously
      untreated advanced colorectal carcinoma.
AB  - We conducted a phase II clinical trial of fluorouracil (5FU) and recombinant
      interferon alfa-2a (rIFN alpha-2a) in 52 previously untreated patients with
      bidimensionally measurable metastatic colorectal cancer. During week 1, 5FU was
      administered as a continuous intravenous infusion, 750 mg/m2/d for 5 consecutive
      days. Intravenous bolus administration of 5FU 750 mg/m2 was given weekly for 7
      weeks starting on day 12. rIFN alpha-2a (Roferon; Hoffman-LaRoche, Nutley, NJ), 9
      x 10(6) U, was administered subcutaneously three times weekly during weeks 1 to
      8. Patients were evaluated for response on week 9. Of 52 patients enrolled in the
      study, 51 were assessable for toxicity, and 45 were assessable for response.
      Fifteen patients experienced partial response, and one patient achieved a
      clinical complete response for an overall response rate of 35% (95% confidence
      interval [CI], 22%, 50%). Median duration of response is 7.5 months (range, 4 to
      11 months). Seventy percent of patients entered on the study are alive with a
      median follow-up duration of 7 months. Twenty-five percent of patients developed
      grade 4 toxicity, and 82% developed grade 3 toxicity. One drug-related death in
      the presence of sepsis was reported, and two treatment-related seizures occurred.
      Our experience with this schedule produced a lower response rate with greater
      toxicity than previously reported. Current randomized trials comparing this
      schedule of 5FU with rIFN alpha-2a to 5FU plus folinic acid (leucovorin) or
      single-agent 5FU may determine its role in the treatment of advanced colorectal
      carcinomas.

PMID- 2230895
TI  - Adjuvant cyclophosphamide, methotrexate, and fluorouracil in patients with
      axillary node-positive breast cancer: an update of the Guy's/Manchester trial.
AB  - Between 1976 and 1985, 391 patients (202 premenopausal, 189 postmenopausal) with
      operable breast cancer and positive axillary lymph nodes were randomized after
      total mastectomy and axillary clearance to receive cyclophosphamide,
      methotrexate, and fluorouracil (CMF) (n = 193) or no adjuvant therapy (n = 198).
      After a median follow-up of 8 years, both relapse-free survival (RFS) and
      survival (S) were significantly prolonged in premenopausal patients receiving CMF
      (RFS, P less than .001; S, P = .003). Treatment with CMF resulted in a
      significant improvement in RFS in premenopausal patients both with steroid
      receptor-positive and steroid receptor-negative tumors and also in subgroups of
      premenopausal patients defined by the number of axillary nodes involved.
      Premenopausal patients who developed permanent amenorrhea following CMF had a
      significantly better RFS than those who continued to menstruate. Induction of
      amenorrhea following CMF was related to age, with almost all patients over 40
      years becoming amenorrheic. For patients less than or equal to 40 years,
      development of amenorrhea following CMF did not influence outcome. No difference
      was detected between control and CMF groups (RFS, P = .9; S, P = .9) in
      postmenopausal patients nor in any subgroup of these patients. The results of
      this trial of the efficacy of CMF for improving RFS and S have strengthened with
      longer follow-up.

PMID- 2230896
TI  - Node-negative breast cancer: prognostic subgroups defined by tumor size and flow
      cytometry.
AB  - Adjuvant systemic therapy for women with node-negative breast cancer is most
      easily justified for those patients at highest risk of relapse. We have examined
      the impact of tumor size, histologic grade, estrogen receptor (ER) status, tumor
      ploidy, and S-phase fraction (SPF) on relapse-free survival (RFS) for 169
      patients with node-negative breast cancer in order to identify groups of patients
      at high and low risk of relapse. Patients with small tumors (less than or equal
      to 1.0 cm) had a significantly better RFS than those with larger tumors (P =
      .005), with 96% remaining relapse-free at 5 years. Patients with tumors less than
      or equal to 1.0 cm were thus excluded from analysis when attempting to define a
      group with a poor prognosis. Within the group of patients with tumors greater
      than 1.0 cm, tumor ploidy (P = .63), ER status (P = .3), or progesterone receptor
      (PgR) status (P = .24) did not predict for RFS. Patients with grade 1 or 2
      infiltrating ductal tumors had a significantly better prognosis than those with
      grade 3 tumors (P = .04). The prognostic factor that gave the widest separation
      between subgroups, however, was SPF. Patients whose tumors were greater than 1.0
      cm with an SPF less than or equal to 10% had a 5-year RFS of 78% compared with a
      5-year RFS of 52% for those with an SPF greater than 10% (P = .006). We have
      combined tumor size and SPF to identify three prognostic groups: (1) tumor less
      than or equal to 1.0 cm, 5-year RFS 96%; (2) tumor greater than 1.0 cm plus SPF
      less than or equal to 10%, 5-year RFS 78%; 3) tumor greater than 1.0 cm plus SPF
      greater than 10%, 5-year RFS 52%. These prognostic groupings may help identify
      patients most suitable for adjuvant therapy.

PMID- 2230897
TI  - Phase I clinical and pharmacologic study of intraperitoneal cisplatin and
      fluorouracil in patients with advanced intraabdominal cancer.
AB  - Fluorouracil (5-FU) and cisplatin display marked therapeutic synergy in
      preclinical models and are effective in the treatment of a number of solid tumors
      when combined and administered intravenously (IV). Each drug has also been
      administered intraperitoneally (IP) and displays a favorable pharmacologic
      profile and acceptable clinical toxicity. We therefore undertook a phase I study
      to determine the feasibility and toxicity of combination IP chemotherapy with
      these agents. Thirty-one patients with histologically documented malignancy
      confined to the peritoneal space were treated with cisplatin 90 mg/m2 mixed with
      5-FU in 2 L of lactated Ringer's solution and given IP for 4 hours every 28 days.
      Cohorts of at least three patients received starting 5-FU concentrations ranging
      from 5 mmol/L (1,300 mg in 2 L) to 20 mmol/L. The dose-limiting toxicity was
      neutropenia with a median granulocyte nadir of 156 cells per microliter occurring
      at a 5-FU dose of 20 mmol/L. Intrapatient escalation of the 5-FU dose was
      permitted and 15 cycles of chemotherapy were delivered at 5-FU concentrations
      greater than 20 mmol/L, the highest concentration being 30.7 mmol/L (8 g of 5-FU
      in 2L). Other toxicities included mild to moderate nausea during all cycles of
      therapy, vomiting in 54% of cycles, and diarrhea in 15% of cycles. Abdominal
      pain, renal dysfunction, peripheral neuropathy, and oral mucositis occurred
      infrequently and were not related to the 5-FU dose. Peritoneal fluid and plasma 5
      FU concentrations were measured by high-performance liquid chromatography (HPLC)
      in selected patients. Mean peak plasma 5-FU concentrations ranged from 6.19
      mumol/L to greater than 60 mumol/L, and peritoneal fluid to plasma 5-FU area
      under the curve (AUC) ratios ranged from 85 to 1,150. Nine of 15 patients with
      nonbulky disease had resolution of malignant ascites or at least a 50% reduction
      of peritoneal studding by tumor at repeat laparotomy. We conclude that
      combination IP chemotherapy with cisplatin and 5-FU is technically feasible and
      has acceptable clinical toxicity and a favorable pharmacologic profile. The
      recommended starting 5-FU dose for phase II trials is 3,900 mg mixed with 90
      mg/m2 of cisplatin in 2 L of isotonic fluid.

PMID- 2230898
TI  - Drug-induced DNA damage and tumor chemosensitivity.
AB  - Cytotoxic drugs act principally by damaging tumor-cell DNA. Quantitative analysis
      of this interaction provides a basis for understanding the biology of therapeutic
      cell kill as well as a rational strategy for optimizing and predicting tumor
      response. Recent advances have made it possible to correlate assayed DNA lesions
      with cytotoxicity in tumor cell lines, in animal models, and in patients with
      malignant disease. In addition, many of the complex interrelationships between
      DNA damage, DNA repair, and alterations of gene expression in response to DNA
      damage have been defined. Techniques for modulating DNA damage and cytotoxicity
      using schedule-specific cytotoxic combinations, DNA repair inhibitors, cell-cycle
      manipulations, and adjunctive noncytotoxic drug therapy are being developed, and
      critical therapeutic targets have been identified within tumor-cell
      subpopulations and genomic DNA alike. Most importantly, methods for predicting
      clinical response to cytotoxic therapy using both in vitro markers of tumor-cell
      sensitivity and in vivo measurements of drug-induced DNA damage are now becoming
      a reality. These advances can be expected to provide a strong foundation for the
      development of innovative cytotoxic drug strategies over the next decade.

PMID- 2230899
TI  - Further consideration of improved methodology for analyzing local and distant
      recurrence.

PMID- 2230900
TI  - Dose reduction of etoposide in jaundiced patients.

PMID- 2230901
TI  - Acute nonlymphocytic leukemia after radiation and MOPP chemotherapy for Hodgkin's
      disease.

PMID- 2230902
TI  - Oligodendroglioma: a new chemosensitive tumor.

PMID- 2230903
TI  - Potentiation of cisplatin ototoxicity by noise.

PMID- 2230904
TI  - Combination therapy in systemic mycosis.

PMID- 2230905
TI  - Impact of antimicrobial agents on human intestinal microflora.
AB  - The most common and significant cause of disturbances in the normal intestinal
      microflora is the administration of antimicrobial agents. The microflora can be
      influenced by antimicrobial agents because of incomplete absorption of any orally
      administered antimicrobial agent, secretion of an antimicrobial agent in the
      bile, or secretion from the intestinal mucosa. In most cases, the influence is
      not beneficial to the patient because suppression of the indigenous
      microorganisms often permits potential pathogens to overgrow and cause septic
      conditions, stomatitis, diarrhea, or colitis. Antimicrobial agents that influence
      the normal microflora also promote the emergence of antimicrobial-resistant
      strains. During the last fifteen years, the impact of different antimicrobial
      agents on the human microflora has been studied by several investigators. In this
      article published data on the impact of beta-lactam antibiotics, macrolides,
      tetracyclines, nitroimidazoles, clindamycin and quinolones on the human
      intestinal microflora are reviewed.

PMID- 2230906
TI  - Heavy metals, chlorine and antibiotic resistance in Escherichia coli isolates
      from ambulatory patients.
AB  - The susceptibility of Escherichia coli strains isolated from ambulatory patients
      to heavy metals, chlorine and antibiotics was evaluated. It seemed that heavy
      metal resistance was associated with antibiotic resistance. On the other hand,
      chlorine resistant strains seemed to be more sensitive to antibiotics. Clinical
      and ecological implications of these results are discussed.

PMID- 2230907
TI  - Resistance to apramycin in two enterobacterial clinical isolates: detection of a
      3-N-acetyltransferase IV.
AB  - Considering the possible role of farm animals in the contamination of human
      consumers by plasmid-mediated apramycin-resistant enterobacteria strains, this
      type of resistance should be tested more systematically in human isolates. Very
      recently we isolated in Zaragoza one apramycin-resistant Escheria coli strain
      obtained from the blood of a hospitalized patient; this clinical isolate produced
      a plasmid-mediated 3-N-aminoglycoside acetyltransferase IV. We describe also the
      isolation in Madrid of one multiresistant Klebsiella pneumoniae clinical strain.
      This isolate harbored a single plasmid and carried determinants for apramycin,
      gentamicin, tobramycin, hygromycin B, streptomycin, and ampicillin, which could
      be transferred en bloc to E. coli K-12 J62. Extracts from donor and
      transconjugant strains carrying pUZ6776 plasmid produce acetyltransferase
      activity AAC(3)-IV and double phosphotransferase activity (HPH and APH(3'')).

PMID- 2230908
TI  - Acute prostatitis: which antibiotic to use first.
AB  - Six antimicrobial agents were administered to 48 patients (divided in 6 groups)
      who underwent prostatectomy. Half of the patients received the antibiotic in a
      single dose one hour before the operation and the rest in divided doses 24 hours
      before the operation. The concentration levels in serum and in prostatic tissue
      were measured for each of the antibiotics and for each mode of administration.
      The obtained ratios of prostatic tissue to serum concentrations and the relative
      antimicrobial activity to local pathogens of each agent indicate that the agent
      of choice for prostatic disease is netilmicin followed by aztreonam, cefuroxime
      and the ticarcillin-clavulanic acid combination.

PMID- 2230909
TI  - Imipenem/cilastatin treatment of acute infections in AIDS/ARC patients.
AB  - We studied the clinical efficacy and safety of imipenem, a broad spectrum beta
      lactam antibiotic, in acute bacterial infections in 21 patients with AIDS or AIDS
      related complex (ARC). Imipenem/cilastatin was administered as a 30-min
      intravenous infusion using a dose of 500 mg/8 h. Bacterial pathogens were
      isolated before treatment in 80% of cases; 87.5% of all strains were susceptible
      to imipenem in vitro. Treatment resulted in rapid control of the infections in
      80% of patients. Clinical and laboratory adverse reactions probably related to
      imipenem treatment were noted in 8 patients.

PMID- 2230910
TI  - Prophylactic mezlocillin-netilmicin combination in permanent transvenous cardiac
      pacemaker implantation: a single-center, prospective, randomized study.
AB  - A prospective, randomized study was carried out in order to assess the efficacy
      and safety of the mezlocillin-netilmicin combination in the prophylaxis of first
      permanent transvenous cardiac pacemaker implantation. Five hundred and fifty-two
      consecutive patients were randomly administered either 2 g mezlocillin and 200 mg
      netilmicin both as an i.v. bolus before implantation or 2g mezlocillin before and
      then 6 and 12 hours after surgery and 200 mg netilmicin before and then 12 hours
      after implantation. No adverse events were seen. Neither pocket nor electrode
      infections were observed in the 457 subjects still alive (mean follow-up: 29.2
      months) or in patients who died after 1 year of follow-up (mean follow-up: 20.1
      months) or before this time (mean follow-up: 4.7 months). The serum and pocket
      concentrations of mezlocillin and netilmicin at the end of surgery were found to
      be adequate to cover microorganisms that most often cause infections, including
      methicillin-resistant staphylococci.

PMID- 2230911
TI  - Short-term antibiotic prophylaxis in open urologic surgery.
AB  - The aim of the present study was to compare the efficacy of a single dose of
      ceftriaxone with a triple dose of gentamicin as prophylactic agents in patients
      undergoing open urologic surgery. Fifty-two patients were allocated into two
      groups which were well matched with respect to sex, age and surgical procedure: -
      24 were given single-dose ceftriaxone (2 g i.v.) at the time of anesthesia
      (ceftriaxone group); --28 received gentamicin (80 mg i.v.) at the time of
      anesthesia and two additional doses of the same antibiotic were subsequently
      administrated every 8 hours (gentamicin group). The incidence of urinary tract
      infection (UTI) was 3.5% in the gentamicin group and 0% in the ceftriaxone group
      (p = n.s.); postoperative fever (greater than 38 degrees C) occurred in 28.3% and
      8.3% in the gentamicin and ceftriaxone groups respectively (p = n.s.). There was
      no clinical or hematological evidence of drug side effects in any patient.
      Results of the study show that short-term antibiotic regimens can improve UTI
      rates after open urologic surgery; moreover a single preoperative dose of
      ceftriaxone resulted to be as effective as three doses of gentamicin.

PMID- 2230912
TI  - Advanced epithelial ovarian cancer: no difference in survival rate between
      exploratory laparotomy and inadequate debulking surgery as treatment approach
      before chemotherapy.
AB  - In this study we have retrospectively evaluated 40 untreated patients with stage
      III-IV (FIGO) epithelial ovarian cancer. Sixteen patients had received, as
      initial treatment, inadequate surgical removal of the tumor with bulky residue
      (BR) of disease and 24 had had an exploratory laparotomy (EL) only. Subsequently,
      both groups received equivalent chemotherapy consisting of AC combination
      (adriamycin, cyclophosphamide) in 25 patients. Following surgery plus
      chemotherapy the two groups achieved a similar high remission rate (BR patients:
      73% with AC scheme and 80% with PEC scheme; EL patients: 57% with AC and 100%
      with PEC). Furthermore, when all responsive patients were surgically re-explored,
      there was a pathologically complete remission in 5/12 BR patients and in 4/10 EL
      patients. Median survival was 20 months (range 3-50) in BR patients and 16 months
      (range 3-31) in EL patients. The statistical comparison between the two groups
      showed no significance; similarly, there was no significant difference in
      comparing AC-treated with PEC-treated patients. These data show that in poor risk
      patients with advanced ovarian carcinoma, inadequate surgery with BR is not
      prognostically superior to EL alone; therefore, chemotherapy as first treatment
      approach could be a valid alternative to surgery in such cases.

PMID- 2230913
TI  - Cardiotoxicity during chemotherapy treatment with 5-fluorouracil and cisplatin.
AB  - Cardiotoxicity of 5-fluorouracil and cisplatin chemotherapy for esophageal, head
      and neck and gastric carcinoma was studied. Before treatment all patients had a
      cardiac evaluation and during treatment serial electrocardiographic (ECG)
      recordings were performed. In the pre-treatment evaluation signs of
      cardiovascular disease were found in 31(38.75%) patients. During treatment
      cardiotoxicity was observed in 12(15%) patients. The incidence of cardiotoxicity
      was not higher in patients with signs of cardiovascular disease than in those
      without in the pre-treatment evaluation. The most common signs of cardiotoxicity
      were chest pain, ST-T wave changes and arrhythmia. This study suggests that
      patients on 5-fluorouracil and cisplatin treatment should be under close
      supervision and that the treatment should be discontinued if chest pain and/or
      arrhythmias are observed.

PMID- 2230915
TI  - Organizing principles for single-joint movements. IV. Implications for isometric
      contractions.
AB  - 1. Normal human subjects made isometric pulse and step contractions about the
      elbow to visually defined target torques of different amplitudes and at different
      rates. We measured joint torque and electromyograms (EMG) from two agonist and
      two antagonist muscles. 2. When the task specification requires that the subject
      explicitly alter the rate at which torque is increased, the rates of rise of the
      agonist and antagonist EMG bursts covary with the rate of rise of the torque. For
      pulses of torque the duration of motoneuron excitation varies with the duration
      of the task-defined contractile event. 3. When a subject is asked to generate
      torques of different amplitudes without specifying a time interval, torque
      amplitude is positively correlated with how long, and therefore how high, the EMG
      rose. Subjects usually proportionately covary the strength of the agonist and
      antagonist contractions but are not constrained to do so. Some subjects use a
      strategy of varying the antagonist inversely with the agonist contraction. 4. We
      extend the organizing principles for the control of movement about a single joint
      to the control of isometric torque. These rules state that control of torque
      about a single joint is exercised by one of two strategies: the speed-sensitive
      strategy modulates the rate at which contraction rises by varying the intensity
      of motoneuron-pool excitation. The speed-insensitive strategy varies the duration
      over which contraction rises but does not change the rate. These two respective
      patterns of torque emerge from pulse-height and pulse-width modulation of
      motoneuron-pool excitation. 5. The rules defining speed-sensitive and speed
      insensitive strategies for movements are broadened for isometric contractions
      because of the wider range of torque patterns that we observe under these
      conditions. We propose a step-excitation component for prolonged isometric step
      contractions and slowly rising ramp patterns of excitation for contractions that
      develop over several hundreds of milliseconds. 6. The choice of strategies is
      based on task-specific torque requirements. The same two strategies that control
      torque to produce movement apply to the control of isometric torque. Unlike
      movements, however, isometric tasks are more often controlled by a blending of
      the two patterns. Possible reasons for this are discussed.

PMID- 2230914
TI  - Model of synchronized epileptiform bursts induced by high potassium in CA3 region
      of rat hippocampal slice. Role of spontaneous EPSPs in initiation.
AB  - 1. We constructed a computer model of the in vitro CA3 region of the rat
      hippocampal slice bathed in a high-potassium medium. Our aim was to understand
      better the mechanisms of initiation of synchronized bursts and the processes that
      regulate the interburst interval in the experimental system. 2. Our model began
      with a previously published model of the longitudinal CA3 hippocampal slice. The
      model contains three interconnected cell populations: 9,000 (excitatory)
      pyramidal cells; 450 inhibitory cells whose postsynaptic action is somatic and
      decays quickly, corresponding to chloride-dependent inhibition mediated by gamma
      aminobutyric acid (GABA)A channels, and 450 inhibitory cells whose postsynaptic
      action is dendritic, of delayed onset and long lasting, that corresponds to K
      dependent inhibition mediated by GABAB channels. 3. The model was then modified
      to account for specific features of the high-K experimental system: 1) the
      pyramidal cells do not generate intrinsic bursts; 2) EIPSP(CI) and EK are both
      shifted in a depolarizing direction; 3) spontaneous (i.e., not caused by
      presynaptic firing) excitatory postsynaptic potentials (EPSP)s were included; and
      4) a steady current was injected into the pyramidal cells to depolarize them. 4.
      This model generates synchronized population bursts with interburst intervals of
      approximately 1.0-1.5 s. Bursts in individual pyramidal cells are preceded by
      barrages of EPSPs. These results agree with experiment. 5. Our model agrees with
      the following additional experiments: 1) synchronized bursts are abolished by
      partial blockade of excitatory synapses; 2) burst frequency is increased by
      partial blockade of a slow-intrinsic-K conductance; and 3) blockade of chloride
      dependent inhibition leads to bursts of longer duration with longer interburst
      intervals. 6. The basic structural features of this model are similar to, but not
      identical to, the model of the disinhibited hippocampal slice. Spontaneous EPSPs
      appear to be critical in the high-K system for initiating, but not for
      synchronizing, population bursts. The experimental data and simulation results
      raise interesting questions about the role of spontaneous EPSPs in initiating
      synchronized discharges in other epileptic systems and on the possible role of
      spontaneous EPSPs in the normal brain.

PMID- 2230916
TI  - Independent influences of rod adaptation on cone-mediated responses to light
      onset and offset in distal retinal neurons.
AB  - 1. The influence of rod adaptation on cone-mediated intracellular responses of
      distal retinal neurons was examined in the larval tiger salamander. Rods were
      selectively stimulated by the use of 450-520 nm adapting stimuli too dim to
      appreciably influence cones. Cones were primarily stimulated with the use of deep
      red stimuli (maximally sensitive to wavelengths greater than 650 nm). The
      qualitative properties of rod-cone interaction were assessed with the use of
      several different photic-stimulus paradigms. 2. Confirming results of prior
      studies, we showed that rod adaptation changed the time course of cone-mediated
      responses to the onset of square-wave light flashes in horizontal cells (HCs);
      rod adaptation had no similar influence in other distal retinal neurons. Rod
      adaptation also enhanced cone-mediated responses to rapid flicker in cones,
      hyperpolarizing (HPBCs) and depolarizing (DPBCs) bipolar cells, as well as HCs.
      3. We also examined the influence of rod-stimulating background fields on cone
      mediated responses to slow (approximately 1-Hz) flicker composed of sawteeth with
      a rapid onset (ramp offset) or with a rapid offset (ramp onset). Such stimulation
      maintained a constant state of long-term adaptation while providing cones with
      transient-ON or transient-OFF stimulation. 4. Rod adaptation speeds up the
      response of HCs to rapid onset and increases response amplitude. Rod adaptation
      had no reliable influence on response to rapid onset in cones or bipolar cells.
      5. Rod adaptation enhanced the amplitude of responses of HCs to rapid offset
      without altering response time course. 6. Rod adaptation greatly enhanced the
      amplitude of DPBC responses to rapid offset having no reliable influence on the
      time course of the response. 7. Rod adaptation caused responses of HPBCs to rapid
      offset to become much more transient. Rod backgrounds had a similar but smaller
      and less reliable influence on the response of cones to rapid offset. 8. The
      foregoing results indicate that rod adaptation exerts a minimum of two separate
      influences on cone-mediated responses in distal amphibian retina. Changes at
      light onset must reflect the operation of a mechanism that alters response
      kinetics of the HC membrane. Changes at light offset reflect the operation of a
      separate mechanism or set of mechanisms that must act in part presynaptically to
      the HCs.

PMID- 2230918
TI  - Purkinje cell simple spike activity during grasping and lifting objects of
      different textures and weights.
AB  - 1. Three monkeys (2.5-3.5 kg) were trained to pinch an object between the thumb
      and forefinger and to lift it a vertical distance of 1.0-2.0 cm. Either the
      object weight (15, 65, or 115 g) or the surface texture (sand paper or polished
      metal) contacting the fingers could be varied. The object was equipped with a
      vertical position transducer, an accelerometer, and strain gauges that measured
      the grip force and the vertical load force. 2. In accordance with similar
      previously published studies on human subjects, it was found that monkeys
      appropriately scaled the grip forces according to the weight and coefficient of
      friction of the object. The grip force preceded the load force by 25 ms, and they
      both covaried with the changes in surface friction. 3. An analysis of
      electromyograms (EMGs) recorded intramuscularly from the muscles of the wrist and
      fingers including both flexors and extensors indicated that 26 muscles were
      active during pinching and lifting. Of these, 17 produced the maximum activity
      for the slippery surface and the greatest weight and the least activity with the
      roughest surface and lightest weight. 4. A total of 59 Purkinje cells and 123
      unidentified units recorded from the paravermal and lateral cerebellar cortex
      were found to change their firing frequency during lifting the experimental
      object. 5. Increased discharge during the grasping and lifting was found for 56%
      (33/59) of the Purkinje cells and 80% (98/123) of the unidentified neurons,
      whereas 44% (26/59) of the Purkinje cells and 20% of the unidentified neurons
      decreased activity during the same period. 6. Significant modulations of the
      firing frequency with surface texture or object weight occurred for 59% (35/59)
      of the Purkinje cells and 67% (82/123) of the unidentified neurons. 7. One
      hundred and three Purkinje and unidentified neurons recorded in the paravermal
      and lateral region of the cerebellar cortex were examined for peripheral
      receptive fields, and of these, 43/103 (42%) responded exclusively to imposed
      displacements and tapping of muscles suggesting afferents originating from
      proprioceptors. A further 28/103 (27%) had exclusively cutaneous receptive fields
      on the hand that could be stimulated by brushing the skin lightly with a sable
      hair brush. Only six neurons demonstrated convergent cutaneous and proprioceptive
      receptive fields and no response to peripheral stimulation could be found for 26
      neurons. No difference was found between the receptive fields of Purkinje cells
      and those of the unidentified neurons.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230917
TI  - Inferotemporal units in selective visual attention and short-term memory.
AB  - 1. This research was designed to further clarify how, in the primate, the neurons
      of the inferotemporal (IT) cortex support the cognitive functions of visually
      guided behavior. Specifically, the aim was to determine the role of those neurons
      in 1) selective attention to behaviorally relevant features of the visual
      environment and 2) retention of those features in temporary memory. Monkeys were
      trained in a memory task in which they had to discriminate and retain individual
      features of compound stimuli, each stimulus consisting of a colored disk with a
      gray symbol in the middle. A trial began with brief presentation of one such
      stimulus, the sample for the trial. Depending on the symbol in it, the monkey had
      to memorize the symbol itself or the background color; after 10-20 s of delay
      (retention period), two compound stimuli appeared, and the animal had to choose
      the one with the symbol or with the color of the sample. Thus the test required
      attention to the symbol, in some trials also to the color, and short-term
      retention of the distinctive feature for each trial, either a symbol or a color.
      Single-unit activity was recorded from cortex of the IT convexity, lower and
      upper banks of the superior temporal sulcus (STS), and from striate cortex (V1).
      Firing frequency was analyzed during intertrial periods and during the entirety
      of every trial, except for the (match) choice period. 2. In IT cortex, as in V1,
      many units responded to the sample stimulus. Some responded indiscriminately to
      all samples, whereas others responded selectively to one of their features, i.e.,
      to one symbol or to one color. Fifteen percent of the IT units were symbol
      selective and 21% color selective. These neurons appeared capable of extracting
      individual features from complex stimuli. Some color cells (color-attentive
      units) responded significantly more to their preferred color when it was relevant
      (i.e., had to be retained) than when it was not. 3. The latency of IT-unit
      response to the sample stimulus was, on the average, relatively short in
      unselective units (mean 159 ms), longer in symbol units (mean 203 ms), and
      longest in color-attentive units (mean 270 ms). This order of latencies
      corresponds to the presumed order of participation of those three types of units
      in the selective attention to the component features of the sample as required by
      the task. It suggests intervening steps of serial processing before color
      information reached color-attentive cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230919
TI  - Characteristics of electrically induced locomotion in rat in vitro brain stem
      spinal cord preparation.
AB  - 1. Electrical stimulation of two brain stem regions in the decerebrate neonatal
      rat brain--the mesencephalic locomotor region (MLR) and the medioventral medulla
      (MED)--were found to elicit rhythmic limb movements in the hind-limb-attached, in
      vitro, brain stem-spinal cord preparation. 2. Electromyographic (EMG) analysis
      revealed locomotion similar to that observed during stepping in the adult rat.
      The step-cycle frequency could be increased by application of higher-amplitude
      currents; but, unlike the adult, alternation could not be driven to a gallop. 3.
      Threshold currents for inducing locomotion were significantly lower for
      stimulation of the MED compared with the MLR. Brain stem transections carried out
      at midpontine levels demonstrated that the presence of the MLR was not required
      for the expression of MED-stimulation-induced effects. 4. Substitution of the
      standard artificial cerebrospinal fluid (aCSF) by magnesium-free aCSF did not
      affect interlimb relationships and resulted in a significant decrease of the
      threshold currents for inducing locomotion. 5. Fixation of the limbs during
      electrical stimulation of brain stem sites altered the amplitude and duration of
      the EMG patterns, but the basic rhythm and timing of each muscle contraction
      during the step cycle was not affected. 6. These studies suggest that, although
      peripheral afferent modulation is evident in the neonatal locomotor control
      system, descending projections from brain stem-locomotor regions appear capable
      of modulating the activity of spinal pattern generators as early as the day of
      birth. However, there may be ceiling to the maximal frequency of stepping
      possible at this early age, perhaps suggesting a later-developing mechanism for
      galloping.

PMID- 2230920
TI  - Identification of histaminergic neurons in Aplysia.
AB  - 1. We have identified putative histaminergic neurons in the central nervous
      system of Aplysia californica by light-microscopic autoradiography after uptake
      of [3H]histamine and by immunohistochemistry with the use of an antibody specific
      for histamine. 2. In the cerebral ganglion cells previously shown to contain
      histamine (C2 and 2 large neighboring cells in the E cluster and a group of
      smaller cells in the L cluster) were identified both by uptake of [3H]histamine
      and by histamine immunoreactivity. The identification of C2 was confirmed by
      experiments in which individual C2s were characterized electrophysiologically and
      injected with Lucifer yellow before processing for immunohistochemistry. The
      giant serotonergic neuron did not take up [3H]histamine and was not
      immunoreactive. 3. In the abdominal ganglion two clusters of cells--one in the
      left hemiganglion and the other in the right--took up [3H]histamine and were
      histamine immunoreactive. These clusters are located in the regions occupied by
      the 30 identified respiratory interneurons, R25 and L25. Individual cells in the
      R25 and L25 clusters were identified electrophysiologically, marked by injection
      of Lucifer yellow, and processed for immunocytochemistry. Eleven of the 30 L25
      cells examined (from 7 ganglia) and 2 of the 25 R25 cells (from 6 ganglia) that
      had been marked with Lucifer yellow were also histamine immunoreactive. 4. Also
      in the abdominal ganglion, identified cells in the L32 cluster were not histamine
      immunoreactive and did not take up [3H]histamine. These interneurons, which
      mediate presynaptic inhibition, had previously been considered histaminergic.
      Neurons in the ganglion known to use transmitters other than histamine (L10, R2,
      RB cells, and bag cells) were not histamine immunoreactive.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2230921
TI  - Adaptive control for backward quadrupedal walking. I. Posture and hindlimb
      kinematics.
AB  - 1. To gain new perspectives on the neural control of different forms of quadruped
      locomotion, we studied adaptations in posture and hindlimb kinematics for
      backward (BWD) walking in normal cats. Data from four animals were obtained from
      high-speed (100 fr/s) cine film of BWD treadmill walking over a range of slow
      walking speeds (0.3-0.6 m/s) and forward (FWD) treadmill walking at 0.6 m/s. 2.
      Postural adaptations during BWD walking included flexion of the lumbar spine,
      compared to a relatively straight spine during FWD walking. The usual paw-contact
      sequence for FWD walking [right hindlimb (RH), right forelimb (RF), left hindlimb
      (LH), left forelimb (LF)] was typically reversed for BWD walking (RH, LF, LH,
      RF). The hindlimbs alternated consistently with a phase difference averaging 0.5
      for both forms of walking, but the phasing of the forelimbs was variable during
      BWD walking. 3. As BWD walking speed increased from 0.3 to 0.6 m/s, average
      hindlimb cycle period decreased 21%, stance-phase duration decreased 29%, and
      stride length increased 38%. Compared to FWD walking at 0.6 m/s, stride length
      was 30% shorter, whereas cycle period and stance-phase duration were 17% shorter
      for BWD walking. For both directions, stance occupied 64 +/- 4% (mean +/- SD) of
      the step cycle. 4. During swing for both forms of walking, the hip, knee, and
      ankle joints had flexion (F) and extension (E1) phases; however, the F-E1
      reversals occurred earlier at the hip and later at the knee for BWD than for FWD
      walking. At the ankle joint, the ranges of motion during the F and E1 phases were
      similar for both directions. During BWD walking, however, the knee flexed more
      and extended less, whereas the hip flexed less and extended more. Thus horizontal
      displacement of the limb resulted primarily from hip extension and knee flexion
      during BWD swing, but hip flexion and knee extension during FWD swing. 5. At the
      knee and ankle joints, there were yield (E2) and extension (E3) phases during
      stance for both forms of walking; however, yields at the knee and ankle joints
      were reduced during BWD walking. At the hip, angular motion was unidirectional,
      as the hip flexed during BWD stance but extended during FWD stance. Knee
      extension was the prime contributor to horizontal displacement of the body during
      BWD stance, but hip extension was the prime contributor to horizontal
      displacement during FWD stance. 6. Our kinematic data revealed two discriminators
      between BWD and FWD walking.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230922
TI  - Adaptive control for backward quadrupedal walking. II. Hindlimb muscle synergies.
AB  - 1. To compare the basic hindlimb synergies for backward (BWD) and forward (FWD)
      walking, electromyograms (EMG) were recorded from selected flexor and extensor
      muscles of the hip, knee, and ankle joints from four cats trained to perform both
      forms of walking at a moderate walking speed (0.6 m/s). For each muscle, EMG
      measurements included burst duration, burst latencies referenced to the time of
      paw contact or paw off, and integrated burst amplitudes. To relate patterns of
      muscle activity to various phases of the step cycle, EMG records were
      synchronized with kinematic data obtained by digitizing high-speed cine film. 2.
      Hindlimb EMG data indicate that BWD walking in the cat was characterized by
      reciprocal flexor and extensor synergies similar to those for FWD walking, with
      flexors active during swing and extensors active during stance. Although the
      underlying synergies were similar, temporal parameters (burst latencies and
      durations) and amplitude levels for specific muscles were different for BWD and
      FWD walking. 3. For both directions, iliopsoas (IP) and semitendinosus (ST) were
      active as the hip and knee joints flexed at the onset of swing. For BWD walking,
      IP activity decreased early, and ST activity continued as the hip extended and
      the knee flexed. For FWD walking, in contrast, ST activity ceased early, and IP
      activity continued as the hip flexed and the knee extended. For both directions,
      tibialis anterior (TA) was active throughout swing as the ankle flexed and then
      extended. A second ST burst occurred at the end of swing for FWD walking as hip
      flexion and knee extension slowed for paw contact. 4. For both directions, knee
      extensor (vastus lateralis, VL) activity began at paw contact. Ankle extensor
      (lateral gastrocnemius, LG) activity began during midswing for BWD walking but
      just before paw contact for FWD walking. At the ankle joint, flexion during the
      E2 phase (yield) of stance was minimal or absent for BWD walking, and ankle
      extension during BWD stance was accompanied by a ramp increase in LG-EMG
      activity. At the knee joint, the yield was also small (or absent) for BWD
      walking, and increased VL-EMG amplitudes were associated with the increased range
      of knee extension for BWD stance. 5. Although the uniarticular hip extensor
      (anterior biceps femoris, ABF) was active during stance for both directions, the
      hip flexed during BWD stance and extended during FWD stance.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2230923
TI  - Functional organization within the medullary reticular formation of intact
      unanesthetized cat. I. Movements evoked by microstimulation.
AB  - 1. The present article described the various patterns of movement evoked in the
      limbs and neck by microstimulation (33-ms trains, 330 Hz, 0.2-ms pulses at less
      than or equal to 35 microA) of the medullary reticular formation (MRF) of seven
      chronically implanted, unanesthetized, intact cats. Altogether 878 loci were
      stimulated in 83 penetrations. However, as stimulation in the more lateral
      regions of the MRF was less effective, the results are based on stimulation in
      592 loci made in 56 penetrations at distances of between 0.5 and 2.5 mm lateral
      to the midline. 2. Of these 592 loci, movement of one or more parts of the body
      was evoked from a total of 539 (91%) sites. Most of these movements were compound
      in nature, involving movement of one or more limbs as well as the head. Discrete
      movements were observed only with respect to the head; limb movements were always
      accompanied by head movement. In addition, hindlimb movements were always
      accompanied by forelimb movements, although the inverse was generally not true.
      3. The most common effects of the stimulation were as follows: a turning of the
      head to the ipsilateral side (79% of stimulated sites); flexion of the
      ipsilateral elbow (41%); and extension of the contralateral elbow (45%). Effects
      in the hindlimbs were more variable and less frequent, with the majority of the
      effective loci causing flexion of the ipsilateral knee (9%) together with
      extension of the contralateral knee (8%). In total, including both flexion and
      extension, 18% of the stimulated sites caused movement of the ipsilateral
      hindlimb and 11% of the contralateral hindlimb. 4. Although movements of the head
      were obtained from the whole extent of the brain stem, movements of the forelimbs
      showed a dorsoventral organization with flexion of the ipsilateral elbow being
      evoked from the more dorsal regions of the brain stem, whereas contralateral
      elbow extension was evoked more frequently from the ventral regions. There was a
      large area of overlap from which movements of both limbs could be obtained
      simultaneously. Movements of the hindlimbs were more frequently evoked from
      central and ventral areas of the brain stem and from the most rostral aspect of
      the explored region. 5. In examining the combinations of movements evoked by the
      MRF stimulation, it was found that the most commonly evoked pattern was movement
      of the head to the stimulated side together with flexion of the ipsilateral
      forelimb and extension of the contralateral forelimb (26.5% of sites).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2230924
TI  - Functional organization within the medullary reticular formation of intact
      unanesthetized cat. II. Electromyographic activity evoked by microstimulation.
AB  - 1. The present study has examined the detailed organization of the medullary
      reticular formation (MRF) as revealed by microstimulation (33-ms trains of 0.2-ms
      duration pulses at 330 Hz and 35 microA or less) in the intact, chronically
      implanted, unanesthetized cat. Stimulus-locked electromyographic (EMG) responses
      were recorded from flexors and extensors of each of the four limbs, as well as
      bilaterally from muscles of the neck and back, during stimulation of the same 592
      loci that formed the basis of the preceding article. 2. The thresholds of the
      responses were different for each group of muscles, with, on the average, the
      neck muscles being activated at the lowest range of currents, 13.8-16.5 microA;
      forelimb muscles at 16.9-17.9 microA; back muscles at 25.4-25.7 microA; and
      hindlimb muscles at 21.1-25.7 microA. 3. Whereas stimulation within the MRF
      evoked movement of the head only to the stimulated side (preceding article),
      analysis of the EMG responses showed there was frequently bilateral activation of
      the neck muscles. Similarly, even though stimulation produced predominantly
      ipsilateral elbow flexion and contralateral elbow extension, most loci caused
      cocontraction of antagonistic muscles at these joints. Cocontraction was also
      frequently observed for the hindlimbs. Reciprocal activation of antagonistic
      muscles was less frequent but was observed in the ipsilateral forelimb as well as
      in both hindlimbs; it was never observed in the contralateral forelimb. 4.
      Although excitatory responses were observed from widespread regions for all of
      the muscles under study, those regions of the MRF that evoked the strongest
      responses in each muscle showed a large degree of segregation. Muscles of the
      ipsilateral forelimb were most strongly activated from the rostrodorsal MRF,
      whereas muscles of the contralateral forelimb were most strongly effected by
      stimulation caudoventrally. Muscles of the hindlimbs were more strongly activated
      from the rostral brain stem, although with some exceptions. Responses in axial
      muscles were evoked from widespread regions of the brain stem but were
      concentrated further caudally than were the limb muscles. 5. Excitatory responses
      were much more prevalent than inhibitory responses and were evoked from all
      regions of the MRF, including the most caudal and ventral areas. The shortest
      latency responses in each track were, on the average, as follows: 6.6-8.8 ms for
      the neck; 11.2-13.4 ms for the forelimbs; 13.8-14.2 ms for the back; and 15.9
      17.2 ms for the hindlimbs. Inhibitory responses were also evoked from widely
      distributed regions, which were intermingled with those loci evoking excitatory
      responses.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230925
TI  - Stimulus-response function studies of esophageal mechanosensitive nociceptors in
      sympathetic afferents of opossum.
AB  - 1. Single-unit activity was recorded from afferent fibers in either the
      paravertebral sympathetic chain or the splanchnic nerves. Forty-three fibers that
      responded to distension of the smooth-muscle portion of esophagus were selected
      for further study. 2. Out of the 43 fibers, 27 (62%) had ongoing resting
      activity, and 16 (38%) were silent. The mean resting activity of these fibers was
      0.28 +/- 0.06 imp/s (range, 0-2.6 imp/s). 3. Repeated distensions of the
      esophagus to a fixed pressure (80 mmHg) evoked spike discharge at a reproducible
      rate. There was no evidence of facilitation or inhibition of subsequent
      responses. The mean coefficient of variation (CV) was 0.17 +/- 0.05 imp/s (n =
      5). 4. The stimulus-response function (SRF) to intraluminal graded distension was
      studied in 35 fibers. Thirty-three fibers showed linear increase in firing that
      did not saturate up to 120 mmHg. Two fibers reached maximal discharge rate at 60
      mmHg. The mean discharge rate at 120 mmHg pressure was 14.87 +/- 1.52 imp/s. 5.
      Threshold pressure for activation of each fiber was calculated by a least-squares
      linear-regression plot of the SRF. The threshold pressure varied from 0 to 50
      mmHg (mean, 16.21 +/- 2.86 mmHg). The distribution profile of the threshold
      values showed that there were two separate populations of mechanosensitive
      receptors: 1) wide-dynamic-range mechanonociceptors (WDR-MN) with mean threshold
      pressure of 2.89 +/- 0.75 mmHg (range, 0-7 mmHg; n = 22); and 2) high-threshold
      mechanonociceptors (HT-MN) with mean threshold of 33.26 +/- 2.52 mmHg (range, 19
      50 mmHg; n = 13). 6. Discharge evoked by esophageal peristalsis was studied in
      five WDR-MN and five HT-MN units. Whereas all five WDR-MN units (threshold value,
      2.6 +/- 0.96 mmHg) responded to peristalsis, none of the HT-MN units (threshold
      value, 31.2 +/- 4.01 mmHg) did so. The mean response to peristaltic contraction
      in WDR-MN units was 5.32 +/- 1.36 imp/s, which was 24.7% of the maximal response
      (21.53 +/- 1.92 imp/s; n = 5) at 120 mmHg. The duration of evoked response to
      peristaltic contraction was 10-12 s. 7. The activity profile of the units to 60-s
      balloon distension at near threshold and higher pressures showed three patterns:
      1) rapid adaptation, 2) slow adaptation, and 3) slow adaptation with after
      discharge. The rapidly adapting fibers became slowly adapting with greater
      degrees of esophageal distension. The units that showed rapid or slow adaptation
      at low-distension pressure became indistinguishable from one another at high
      distension pressure.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230926
TI  - Ensemble discharge from Golgi tendon organs of cat peroneus tertius muscle.
AB  - 1. The responses of individual tendon organs of the cat peroneus tertius muscle
      to motor-unit contractions were recorded in anesthetized cats during experiments
      in which all the Ib-afferent fibers from the muscle had been prepared for
      recording in dorsal root filaments. This was possible because the cat peroneus
      tertius only contains a relatively small complement of approximately 10 tendon
      organs. 2. Motor units of different physiological types were tested for their
      effects on the whole population of tendon organs in the muscle. Effects of
      unfused tetanic contractions were tested under both isometric and anisometric
      conditions. Each motor unit activated at least one tendon organ, and each tendon
      organ was activated by at least one motor unit. Individual slow-type units were
      found to act on a single or two receptors, whereas a fast-type unit could
      activate up to six tendon organs. 3. In one experiment, the effects of 8 motor
      units on 10 tendon organs were examined. One fast-twitch, fatigue resistant (FR)
      type unit acted on six tendon organs, of which four were also activated by
      another FR unit. The contraction of each unit, on its own, elicited a range of
      individual responses, from weak to strong. The discharge frequencies of
      individual responses displayed no clear relation with the strength of
      contraction, nor did they accurately represent the shape of force profiles. But
      when all the discharges were pooled, a fairly good correspondence appeared
      between variations of contractile force and variations of averaged discharge
      frequencies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230927
TI  - Distribution and response properties of cat SI neurons responsive to changes in
      tooth temperature.
AB  - 1. The activity of 214 tooth pulp-driven neurons (TPNs) in the primary
      somatosensory cortex (SI) activated by electrical stimulation of the canine tooth
      pulp was studied in anesthetized cats. These neurons were tested for their
      responses to thermal stimulation of the tooth pulp. 2. One hundred fifty-five
      TPNs were not responsive to changes in tooth temperature (thermally insensitive,
      TINS-TPNs) and 59 TPNs were responsive (thermally sensitive, TS-TPNs: 38 TS-TPNs
      were heat sensitive and 21 were cold sensitive). TS-TPNs were also tested for
      responsiveness to mechanical and thermal stimulation of the skin, mucosa, or
      periodontal membrane. Each TS-TPN was classified on the basis of cutaneous,
      mucosal, or periodontal mechanical receptive-field properties as either low
      threshold mechanoreceptive (LTM: 57%), wide dynamic range (WDR: 25%), nociceptive
      specific (NS: 10%) or pulp specific (PS: 8%). 3. TS-TPNs were distributed in an
      upper bank of the orbital sulcus of SI. The majority were located in laminae III
      (32%) and IV (60%) of area 3b. 4. Heat-sensitive LTM, WDR, PS TS-TPNs, and cold
      sensitive LTM TS-TPNs were characterized by a rapid rise in firing rate during
      thermal stimulation of the tooth pulp. In contrast, heat-sensitive NS and cold
      sensitive NS and PS TS-TPNs responded with a slow rise in firing frequency during
      thermal stimuli delivered to the tooth pulp. 5. A linear regression analysis was
      applied to the stimulus-response functions of neuronal discharges of TS-TPNs.
      Fifty-six percent of heat-sensitive LTM, WDR, and cold-sensitive LTM TS-TPNs
      showed statistically significant relation (P less than 0.5) between peak firing
      frequency and stimulus temperature and increasing firing frequency after
      increases in stimulus temperature, whereas heat-sensitive and cold-sensitive NS
      and PS TS-TPNs did not show a clear increase in firing frequency during the
      thermal stimulus. 6. These findings suggest that heat-sensitive LTM and WDR TS
      TPNs and cold-sensitive LTM TS-TPNs that showed high regression coefficients in
      stimulus-response function may be involved in encoding the intensity of noxious
      thermal stimulation of the tooth pulp.

PMID- 2230928
TI  - Ipsilateral and contralateral effects on cutaneous reflexes in a back muscle of
      the female rat: modulation by steroids relevant for reproductive behavior.
AB  - 1. Multiunit EMG recordings of cutaneous reflexes--evoked in the back extensor,
      lateral longissimus (LL), by bilateral stimulation of nerves to dorsal flank skin
      -were studied in ovariectomized female rats with and without estrogen
      pretreatment. 2. Poststimulus time (PST) histograms of data from rats with and
      without estrogen pretreatment show that the axial EMG response (10-30 ms) to
      ipsilateral (ipsi) flank skin nerve stimulation is significantly shorter in
      latency (1.4 ms) and 67% larger than the response to contralateral (contra) flank
      skin nerve stimulation recorded at the same site (n = 29 pairs). 3. When late EMG
      responses were also evoked at 50-120 ms in 37% of ipsi and 29% of contra
      cutaneous reflexes, the incidence of multiunit activity in the late peak was
      significantly greater in rats pretreated with silastics containing 100% estradiol
      (E) compared with 10% E or cholesterol controls. 4. When an ipsi cutaneous reflex
      in LL was conditioned by a stimulus to the contra flank skin nerve at a condition
      test interval of 30 ms (C-T 30 ms), the average number of discharges in the early
      peak of the histogram was double that in the histogram obtained from the
      unconditioned ipsi reflex, independent of estrogen pretreatment. 5. In 12 out of
      19 cases in which a contra cutaneous reflex was conditioned by a stimulus to the
      ipsi flank skin nerve (C-T 30 ms), the number of discharges in the early peak of
      the histogram was less than that in the early peak of the histogram derived from
      the unconditioned contra response, independent of estrogen pretreatment. 6.
      Intravenous injections of progesterone (P) or its metabolite 5 alpha-pregnane-3
      alpha-ol-20-one (tetrahydraprogesterone, THP) decreased the magnitude of the
      early peak of the ipsi cutaneous reflex and the contra cutaneous reflex in LL,
      independent of estrogen pretreatment. At the same time, it did not reduce the
      magnitude of the early peak evoked by either ipsi or contra nerves after
      conditioning from the other side at C-T 30 ms. 7. As a consequence, the
      percentage facilitation of ipsi cutaneous reflexes by contra cutaneous
      conditioning was significantly increased after P or THP. This suggests that these
      steroids can selectively enhance behaviors involving bilateral inputs. 8. An
      unchanged axial motoneuron pool output to bilateral cutaneous inputs after P and
      THP, in spite of reduced motoneuron responses to cutaneous inputs from each side
      of the body, implies an increased gain in the reflex circuit.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2230929
TI  - Motoneuron and muscle-unit properties after long-term direct innervation of
      soleus muscle by medial gastrocnemius nerve in cat.
AB  - 1. This study addresses the following questions. 1) In a previous experiment,
      when the combined lateral gastrocnemius-soleus nerve was cross-innervated by the
      medial gastrocnemius (MG) nerve, was the predominance of slow muscle units in
      soleus muscle a result of selective routing of slow motor axons into soleus? 2)
      Is MG-nerve-induced conversion of soleus muscle fibers from slow to fast more
      complete at very long (18 mo vs. 9-11 mo) postoperative times? 3) Do MG
      motoneurons that cross-innervate soleus muscle recover their normal membrane
      electrical properties at very long postoperative times? 2. The proximal portion
      of approximately one-third of the MG nerve was coapted directly with the distally
      isolated soleus nerve. The MG muscle remained innervated by the unoperated
      portion of the MG nerve. At 6, 10, or 18 mos postoperative, motoneuron and/or
      muscle-unit properties were determined for MG motoneurons innervating MG, soleus,
      or neither muscle, and for axotomized soleus motoneurons. 3. In the partially
      denervated MG muscle, the proportions of motor units of each type were normal.
      This suggests that the population of MG motor axons that had been directed to the
      soleus nerve also contained a representative distribution of MG motoneuron types.
      4. Most motor units (74%) in cross-innervated soleus (Xsoleus) were type S (based
      on muscle-unit contractile properties), in spite of the soleus nerve's having
      been cross-connected by approximately 75% fast MG motoneurons. Thus, even at very
      long postoperative times, slow soleus muscle units resisted conversion by fast MG
      motoneurons. 5. Thirty-two percent of MG motoneurons that had been cross
      connected to soleus nerve elicited no measurable muscle contraction, compared
      with approximately 10% in previous reinnervation experiments in which the MG
      nerve was coapted with the MG or lateral gastrocnemius-soleus nerve. Thus MG
      motoneurons may be disadvantaged in their ability to innervate soleus muscle
      fibers. 6. It appears that at long postoperative times, those fast MG motoneurons
      tha had innervated large soleus muscle units had failed to convert those muscle
      fibers to fast types and had failed also to recover their normal motoneuron
      electrical properties. Conversion and recovery did occur for fast MG motoneurons
      that innervated small soleus muscle units and for slow MG motoneurons.

PMID- 2230930
TI  - Forcing of coupled nonlinear oscillators: studies of intersegmental coordination
      in the lamprey locomotor central pattern generator.
AB  - 1. This paper reports the results of an investigation of the basic mechanisms
      underlying intersegmental coordination in lamprey locomotion, by the use of a
      combined mathematical and biological approach. 2. Mathematically, the lamprey
      central pattern generator (CPG) is described as a chain of coupled nonlinear
      oscillators; experimentally, entrainment of fictive locomotion by imposed
      movement has been investigated. Interpretation of the results in the context of
      the theory has allowed conclusions to be drawn about the nature of ascending and
      descending coupling in the lamprey spinal CPG. 3. Theory predicts and data show
      that 1) the greater the number of oscillators in the chain, the smaller is the
      entrainment frequency range and 2) it is possible to entrain both above and below
      the rest frequency at one end but only above or below at the other end. 4. In the
      context of the experimental results, the theory indicates the following: 1)
      ascending coupling sets the intersegmental phase lags, whereas descending
      coupling changes the frequency of the coupled oscillators; 2) there are
      differences in the ascending and descending coupling other than strength; and it
      also suggests that 3) coupling slows down the oscillators.

PMID- 2230931
TI  - Azimuthal sensitivity of neurons in primary auditory cortex of cats. I. Types of
      sensitivity and the effects of variations in stimulus parameters.
AB  - 1. Preliminary to studying the organization of azimuthal sensitivity of neurons
      along frequency-band strips in the primary auditory cortex (AI) of cat (see
      companion paper), this study examined the sensitivity of 251 units in cat AI to
      variations in the azimuthal location of sound sources in the frontal hemifield.
      Most units (231) were tested with tones at the characteristic frequency (CF;
      frequency to which the unit had the lowest threshold). Unit CFs ranged from 5 to
      36 kHz. A large number of units (91) were tested with broadband noise stimuli,
      and a few units were also tested at other frequencies within the cell's tuning
      response area. 2. When tested at stimulus intensities 20-30 dB above CF or noise
      threshold, the different forms of azimuthal sensitivity exhibited by AI neurons
      could be divided into (1) contra-field azimuth functions; (2) ipsi-field
      functions; (3) central-field functions; (4) omnidirectional functions, and (5)
      multipeaked functions. Contra-field azimuth functions were the most prevalent,
      with 45.9% of units tested with CF tones and 42.9% of units tested with noise
      exhibiting this type of azimuthal sensitivity. Ipsi-field azimuthal sensitivity
      was found in 16.9% of units tested with CF tones and 19.8% of units tested with
      noise. Central-field azimuthal sensitivity was seen in 10.8% of units tested with
      CF tones and 17.6% of units tested with noise. Omnidirectional azimuthal
      sensitivity was seen in 19.9% of units tested with CF tones and 17.6% of units
      tested with noise, whereas multipeaked azimuthal sensitivity was found in 6.5% of
      units tested with CF tones and 5.5% of units tested with noise. 3. The effects of
      increasing stimulus intensity on azimuthal sensitivity were examined in 185 units
      tested with CF tones and 67 units tested with noise. For four major classes of
      azimuthal sensitivity (contra-field, ipsi-field, central-field and
      omnidirectional), the most common effect (approximately 60% of each class) was
      for the azimuth function to remain constant in form by the defining criteria for
      these classes. The next most common effect for all classes except omnidirectional
      azimuth functions was for an expansion of the azimuthal range eliciting
      responses. (The definition of omnidirectionality precluded any expansion of the
      response range in this class of azimuth function). A smaller number of units in
      some classes showed a compression of the azimuth function to a smaller response
      range, and others showed more complex expansive and compressive effects with
      increasing stimulus intensity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230932
TI  - Azimuthal sensitivity of neurons in primary auditory cortex of cats. II.
      Organization along frequency-band strips.
AB  - 1. The organization of azimuthal sensitivity of units across the dorsoventral
      extent of primary auditory cortex (AI) was studied in electrode penetrations made
      along frequency-band strips of AI. Azimuthal sensitivity for each unit was
      represented by a mean azimuth function (MF) calculated from all azimuth functions
      obtained to characteristic frequency (CF) stimuli at intensities 20 dB or more
      greater than threshold. MFs were classified as contrafield, ipsi-field, central
      field, omnidirectional, or multipeaked, according to the criteria established in
      the companion paper (Rajan et al. 1990). 2. The spatial distribution of three
      types of MFs was not random across frequency-band strips: for contra-field, ipsi
      field, and central-field MFs there was a significant tendency for clustering of
      functions of the same type in sequentially encountered units. Occasionally,
      repeated clusters of a particular MF type could be found along a frequency-band
      strip. In contrast, the spatial distribution of omnidirectional MFs along
      frequency-band strips appeared to be random. 3. Apart from the clustering of MF
      types, there were also regions along a frequency-band strip in which there were
      rapid changes in the type of MF encountered in units isolated over short
      distances. Most often such changes took the form of irregular, rapid
      juxtapositions of MF types. Less frequently such changes appeared to show more
      systematic changes from one type of MF to another type. In contrast to these
      changes in azimuthal sensitivity seen in electrode penetrations oblique to the
      cortical surface, much less change in azimuthal sensitivity was seen in the form
      of azimuthal sensitivity displayed by successively isolated units in penetrations
      made normal to the cortical surface. 4. To determine whether some significant
      feature or features of azimuthal sensitivity shifted in a more continuous and/or
      systematic manner along frequency-band strips, azimuthal sensitivity was
      quantified in terms of the peak-response azimuth (PRA) of the MFs of successive
      units and of the azimuthal range over which the peaks occurred in the individual
      azimuth functions contributing to each MF (the peak-response range). In different
      experiments shifts in these measures of the peaks in successively isolated units
      along a frequency-band strip were found generally to fall into one of four
      categories: 1) shifts across the entire frontal hemifield; 2) clustering in the
      contralateral quadrant; 3) clustering in the ipsilateral quadrant; and 4)
      clustering about the midline. In two cases more than one of these four patterns
      were found along a frequency-band strip.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2230933
TI  - Event-related potentials in the retina and optic tectum of fish.
AB  - 1. Compound field potentials were recorded with up to 18 microelectrodes in comb,
      brush, or spear arrays on and in the optic tectum and with suction electrodes
      from the distal stump of the cut optic nerve and from the optic nerve head in the
      opened eye in elasmobranchs and teleosts. Diffuse light flashes of different
      durations and submaximal intensities were delivered in trains with regular or
      irregular interstimulus intervals (ISI). 2. Event-related potentials (ERPs) are
      visible in single trials and begin at 50-200 ms after an "oddball" flash,
      especially one that is slightly weaker, briefer, or delayed by as little as 6% of
      ISI, compared with the more frequent stimulus. ERPs to the opposite condition are
      not of the same form or size. 3. One or more stimuli were omitted from a train or
      the train terminated after various conditioning times. Deflections occur beyond
      the expected visual-evoked potentials (VEPs) to the last flash and are called
      omitted-stimulus potentials (OSPs). They occur on schedule--approximately 100 ms
      after the next flash would be due--almost independent of intensity, duration, or
      conditioning time. They are considered to be ERPs without any necessary
      implication or denial of a temporally specific expectation. 4. Three components
      of OSP occur alone or in combination: an initial fast peak, a slow wave, and an
      oscillatory spindle up to ls or more in duration. This resembles the OFF response
      to steady light. 5. All these components are already present in the retina with
      optic nerve cut. 6. The same mean ISI with a high proportion of jitter gives OSPs
      with only slightly longer latencies and smaller amplitudes; the OSP acts as
      though the retina makes an integrated prediction of ISI, intensity, and duration.
      7. During a conditioning train the equilibrium between excitation and inhibition
      after each flash changes according to frequency, intensity, duration, and
      conditioning time; the VEP reflects this in a shape unique to the ISI; inhibition
      increases rapidly after each flash and then decays slowly according to the recent
      mean ISI. This allows rebound disinhibition after missing, weak, or delayed
      flashes (OSP or ERP) or causes an altered VEP after a longer or stronger oddball.
      8. It seems unlikely that the OSP or oddball ERP in fish tectum is equivalent to
      mammalian ERPs under the same regime or signals higher cognitive events, because
      they are already present in the retina, require flash frequencies greater than 1
      Hz, and grow with frequency up to and beyond flicker fusion.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2230934
TI  - Effect of bilateral auditory cortex lesions on sound localization in Japanese
      macaques.
AB  - 1. The ability of four Japanese macaques (Macaca fuscata) to localize sound was
      determined after bilateral ablation of auditory cortex. The animals were given
      two tests: a "midline" test in which they had to discriminate noise bursts
      presented from a loudspeaker located to the left from identical noise bursts
      presented from a loudspeaker located to the right of midline, and a "hemifield"
      test in which both loudspeakers were located in their right hemifield. 2. Both of
      the tests were administered by the use of two different behavioral tasks: a
      conditioned-avoidance task in which the animals were trained to make or break
      contact with a water spout to indicate the location of a sound source, and a two
      choice task that required the animals to walk to the source of the sound. 3. The
      results of both the conditioned-avoidance and the two-choice tasks demonstrated
      that the animals were able to perform the midline discrimination although their
      localization acuity was reduced. However, the animals had great difficulty in
      learning to walk to the source of a sound in spite of the fact that they had
      received previous sound-localization training in the conditioned-avoidance task.
      This difficulty suggested that the monkeys no longer associated the sound with a
      location in space. 4. The results of both the conditioned-avoidance and the two
      choice tasks demonstrated that the animals were unable to discriminate the locus
      of a sound source when both loudspeakers were located in the same hemifield. 5.
      Bilateral ablation of auditory cortex results in both sensory and perceptual
      deficits. The presence of sensory deficits is indicated by the decreased acuity
      in the left-right discrimination and the inability to discriminate between two
      loudspeakers located in the same hemifield. The deficit in the perception of the
      locus of sound is indicated by the difficulty in learning to approach the source
      of a sound, an ability which normal monkeys exhibit without training. 6. There
      appear to be species' differences in the effect of auditory cortex lesions on
      sound localization. Although cortical lesions result in a sound-localization
      deficit in several species of primates and carnivores, they have little or no
      effect on rats.

PMID- 2230935
TI  - Intracellular responses of identified rat olfactory bulb interneurons to
      electrical and odor stimulation.
AB  - 1. Intracellular recordings were made from 28 granule cells and 6 periglomerular
      cells of the rat olfactory bulb during odor stimulation and electrical
      stimulation of the olfactory nerve layer (ONL) and lateral olfactory tract (LOT).
      Neurons were identified by injection of horseradish peroxidase (HRP) or biocytin
      and/or intracellular response characteristics. Odorants were presented in a
      cyclic sniff paradigm, as reported previously. 2. All interneurons could be
      activated from a wide number of stimulation sites on the ONL, with distances
      exceeding their known dendritic spreads and the dispersion of nerve fibers within
      the ONL, indicating that multisynaptic pathways must also exist at the glomerular
      region. All types of interneurons also responded to odorant stimulation, showing
      a variety of responses. 3. Granule cells responded to electrical stimulation of
      the LOT and ONL as reported previously. However, intracellular potential,
      excitability, and conductance analysis suggested that the mitral cell-mediated
      excitatory postsynaptic potential (EPSP) is followed by a long inhibitory
      postsynaptic potential (IPSP). An early negative potential, before the EPSP, was
      also observed in every granule cell and correlated with component I of the
      extracellular LOT-induced field potential. We have interpreted this negativity as
      a "field effect," that may be diagnostic of granule cells. 4. Most granule cells
      exhibited excitatory responses to odorant stimulation. Odors could produce
      spiking responses that were either nonhabituating (response to every sniff) or
      rapidly habituating (response to first sniff only). Other granule cells, while
      spiking to electrical stimulation, showed depolarizations that did not evoke
      spikes to odor stimulation. These depolarizations were transient with each sniff
      or sustained across a series of sniffs. These physiological differences to odor
      stimulation correlated with granule cell position beneath the mitral cell layer
      for 12 cells, suggesting that morphological subtypes of granule cells may show
      physiological differences. Some features of the granule cell odor responses seem
      to correlate with some of the features we have observed in mitral/tufted cell
      intracellular recordings. Only one cell showed inhibition to odors. 5.
      Periglomerular (PG) cells showed a response to ONL stimulation that was unlike
      that found in other olfactory bulb neurons. There was a long-duration
      hyperpolarization after a spike and large depolarization or burst of spikes (20
      30 ms in duration). Odor stimulation produced simple bursts of action potentials,
      Odor stimulation produced simple bursts of action potentials, suggesting that PG
      cells may simply follow input from the olfactory nerve.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2230936
TI  - Induction of long-term potentiation at hippocampal mossy-fiber synapses follows a
      Hebbian rule.
AB  - 1. The induction of long-term potentiation (LTP) at hippocampal mossy-fiber
      synapses requires an increase in postsynaptic [Ca2+]i but is independent of N
      methyl-D-aspartate (NMDA) receptor activation. Voltage-gated Ca2+ channels have
      been proposed as one alternative source for raising [Ca2+]i during the induction
      of LTP. We tested the hypothesis that voltage-gated Ca2+ channel activation could
      mediate the induction of LTP by examining whether 1) the induction of mossy-fiber
      LTP was dependent on postsynaptic depolarization and 2) depolarization alone, of
      a magnitude presumably capable of activating Ca2+ channels, was sufficient to
      induce LTP. 2. Intracellular recordings were made from rat CA3 pyramidal cells in
      the hippocampal slice preparation under both current- and voltage-clamp
      conditions. Mossy-fiber postsynaptic potentials and currents were recorded before
      and after high-frequency stimulation (HFS) in the presence of 20-50 microM D-2
      amino-5-phosphonovaleric acid (D-APV), an NMDA-receptor antagonist. 3. Voltage
      clamping of CA3 neurons between -80 and -100 mV during HFS reversibly blocked the
      induction of mossy-fiber LTP. Conversely, HFS paired with depolarizing-current
      steps under current clamp increased the magnitude of LTP compared with controls.
      These results indicate that mossy-fiber LTP is dependent on postsynaptic
      depolarization, and presynaptic activation alone was not sufficient to induce
      mossy-fiber LTP. 4. Depolarizing-current injections, which presumably depolarized
      CA3 cells to potentials sufficient to activate voltage-gated Ca2+ channels, had
      no effect on mossy-fiber synaptic responses. These results suggest that synaptic
      activation, in addition to postsynaptic depolarization, is required for the
      induction of mossy-fiber LTP. 5. Single mossy-fiber afferent volleys were also
      paired with depolarizing-current pulses. In the presence of APV, pairing of
      single-mossy-fiber excitatory postsynaptic potentials (EPSPs) with postsynaptic
      depolarization did not potentiate synaptic responses, suggesting that some form
      of HFS is also required for mossy-fiber LTP. In the absence of APV, however, the
      contamination of mossy-fiber synaptic responses by CA3-recurrent inputs resulted
      in some potentiation. 6. These results suggest that the induction of mossy-fiber
      LTP is dependent on both pre- and postsynaptic activity and thus follows a
      Hebbian rule for synaptic modification. In contrast to that demonstrated at
      Schaffer-collateral-commissural synapses, however, the induction of mossy-fiber
      LTP may require HFS in addition to postsynaptic depolarization.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2230937
TI  - GABA actions within the caudal cochlear nucleus of developing kittens.
AB  - 1. The effects of gamma-aminobutyric acid (GABA), microionophoretically applied
      onto neurons within the dorsal and posteroventral divisions (i.e., caudal
      regions) of the cochlear nucleus (CN), were studied during postnatal development
      in kittens with the use of extracellular recording techniques. Approximately 80%
      of all neurons encountered within the caudal CN responded to exogenously applied
      GABA regardless of neuronal response type or postnatal age. 2. GABA reduced
      acoustically evoked as well as spontaneous discharge rates in a dose-dependent
      manner at all ages studied, and generally abolished discharge activity at
      sufficiently high doses (i.e., ejection currents). Dose-response curves generated
      during acoustic stimulation by varying GABA ejection current were sigmoidal at
      all ages studied, and the range of slopes relating discharge rate to applied
      currents increased during the first 10 postnatal days. 3. Neural thresholds to
      acoustic stimuli were elevated, and slopes of discharge-rate-versus-sound
      pressure-level curves were depressed regardless of age when GABA was
      microionophoresed onto CN neurons. 4. GABA's capacity to reduce spontaneous or
      acoustically evoked discharge rates was a voltage-dependent phenomenon directly
      related to control discharge rates (i.e., efficacy was high when discharge rates
      were high) for neurons recorded from both immature and mature animals. 5. A small
      set of neurons recorded from animals younger than 2 wk exhibited prolonged GABA
      "activation" and "deactivation" times (i.e., times required to achieve 90% of the
      maximal effect evoked by GABA and to recover from that effect, respectively) and
      may represent a group of actively differentiating units. 6. Bicuculline
      microionophoresis effectively blocked the actions of exogenously applied GABA and
      endogenous GABA, which, presumably, was synaptically released as a result of
      acoustic stimulation. The actions of bicuculline were dose dependent in animals
      ranging in age from 2 postnatal days to adulthood. These results suggest that
      recognition sites for GABA and bicuculline and the ionophore associated with the
      GABA receptor are present and functionally coupled in the caudal CN before the
      developmental period during which the full complement of inhibitory projections
      form synaptic contacts with these cells.

PMID- 2230938
TI  - Human platelets contain brain-derived neurotrophic factor.
AB  - Neurotrophic support to peripheral sensory neurons is provided by 2 factors of
      related sequence, NGF and brain-derived neurotrophic factor (BDNF). NGF is
      present in peripheral target tissues, while BDNF has only been reported in the
      CNS. We now report the biological characterization and molecular cloning of a
      cDNA for BDNF from human platelets. BDNF in human platelets has biological
      activities very similar to those of BDNF obtained from adult porcine brain in
      neuron-enriched cultures prepared from peripheral ganglia of chick embryos at 8
      12 d of incubation. BDNF from human platelets promoted the survival and neurite
      outgrowth of placodal and neural crest-derived sensory neurons, but not to
      parasympathetic or sympathetic neurons. Activity of the factor was additive to
      that of NGF in dorsal root ganglia (DRG) neuron cultures and is equivalent to
      porcine brain BDNF in nodose ganglion neuron cultures. On SDS-PAGE, BDNF from
      human platelets is recovered at an apparent molecular weight equivalent to
      porcine brain BDNF (13,000 D). A BDNF cDNA fragment was amplified from human
      platelet RNA by using a coupled reverse transcriptase-polymerase chain reaction.
      Molecular cloning and DNA sequence analysis of the amplified cDNA fragment
      revealed complete identity for the deduced amino acid sequences of human and
      porcine BDNF [amino acid (aa) 10-108 of the mature factor]. Thus, human platelets
      might provide an important source of BDNF for regenerating peripheral sensory
      neurons at the site of nerve injury.

PMID- 2230939
TI  - Amygdalar interaction with the mediodorsal nucleus of the thalamus and the
      ventromedial prefrontal cortex in stimulus-reward associative learning in the
      monkey.
AB  - Cynomolgus monkeys (Macaca fascicularis) were assessed for their ability to
      associate visual stimuli with food reward. They learned a series of new 2-choice
      visual discriminations between colored patterns displayed on a monitor screen.
      The feedback for correct choice was the delivery of food. In order to promote
      associative learning between the visual stimuli and the incentive value of the
      food reward, reward delivery was not accompanied by any distinctive visual
      feedback on the display screen. The rate of learning new problems was assessed
      before and after surgery in a total of 16 monkeys. Three groups of 3 monkeys
      received bilaterally symmetrical ablations in either the amygdala, the
      mediodorsal nucleus of the thalamus, or the ventromedial prefrontal cortex. All
      these groups showed a severe postoperative learning impairment. Seven other
      animals were given a unilateral ablation in 1 of those 3 structures and a second
      unilateral ablation, in each case contralateral to and different from the first,
      in order to produce 2 groups in which a putative amygdalo-thalamo-prefrontal
      pathway had been disconnected by crossed unilateral lesions. One disconnection
      group had lesions in the amygdala and ventromedial prefrontal cortex; the other
      had lesions in the amygdala and the mediodorsal nucleus of the thalamus. The
      disconnection groups showed a significant impairment, but the effect of the
      disconnection surgeries was significantly milder than the effect of any of the 3
      bilaterally symmetrical lesions. Therefore, symmetrical bilateral lesions in
      either the amygdala, the mediodorsal nucleus, or the ventromedial prefrontal
      cortex produce similar impairments in the present task, implying that these
      structures are functionally related to each other; but the relatively mild effect
      of disconnecting these structures from each other argues against the hypothesis
      that they are serial stages in a single, tightly linked functional pathway.

PMID- 2230940
TI  - Survival effect of ciliary neurotrophic factor (CNTF) on chick embryonic
      motoneurons in culture: comparison with other neurotrophic factors and cytokines.
AB  - In previous studies, it has been demonstrated that ciliary neurotrophic factor
      (CNTF) has a potent survival effect on various populations of neurons in culture,
      in particular, neurons isolated from chick ciliary, dorsal root sensory, and
      sympathetic ganglia (Barbin et al., 1984). After recent investigations
      demonstrated that CNTF prevents the degeneration of motoneurons in newborn rats
      after axonal lesion (Sendtner et al., 1990), the question arose as to whether
      CNTF also has a survival effect on embryonic chick motoneurons at the
      developmental stage where physiological cell death occurs. To study this, it was
      essential to develop an isolation and culture procedure for the survival of chick
      E6 spinal motoneurons in which non-neuronal cells were eliminated and the
      motoneurons were highly enriched. In these cultures, virtually all of the
      initially plated motoneurons survived for at least 3 d in the presence of muscle
      extract, which was chosen as a positive control. Retrograde labeling of the
      motoneurons prior to their isolation showed that there is more than an 80%
      enrichment for motoneurons by the method used. The retrogradely labeled neurons
      also fulfilled the morphological criteria (diameter of neurons, appearance of
      processes) to identify motoneurons independent of retrograde labeling. Under
      these conditions, CNTF at a concentration of 1.5 ng/ml (EC50, 0.023 ng/ml)
      supported maximally 64% of the initially plated spinal motoneurons after 3 d and
      53% after 6 d (the longest time period investigated). Other neurotrophic factors,
      such as NGF, brain-derived neurotrophic factor (BDNF), and neurotrophin-3, had no
      survival effect at all, even at concentrations up to 10 micrograms/ml for NGF and
      BDNF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2230941
TI  - Motor nerve regulates muscle extracellular matrix proteoglycan expression.
AB  - Denervation of rat leg muscles caused a 2-3-fold increase in 35S-sulfate and 3H
      glucosamine incorporation into proteoglycans of the muscle extracellular matrix.
      The size of the proteoglycans and the glycosaminoglycan chain length and degree
      of sulfation were unchanged. Because the rate of degradation of proteoglycans was
      also unchanged by denervation, we infer that denervation increases proteoglycan
      synthesis. Muscle reinnervation restored the original rate of synthesis of
      proteoglycans. Paralysis of innervated muscle caused increased incorporation of
      sulfate comparable to that seen in denervation. Thus motor nerve activity appears
      to regulate the level of proteoglycans in the muscle extracellular matrix.

PMID- 2230943
TI  - Hippocampal representation in place learning.
AB  - The generality of the place-learning impairment associated with hippocampal
      system damage was challenged using methods of training that permitted subjects to
      form an individual association between the place of escape and a particular
      navigational route in an open-field water maze. Both normal rats and rats with
      fornix lesions (FX rats) acquired this task rapidly, although FX rats were
      slightly slower in achieving minimum escape latencies. In postcriterion testing,
      FX rats occasionally made near misses but, more often, their escape performance
      was indistinguishable from that of intact rats. Results from a variety of probe
      tests indicated that FX rats, like normal rats, had based their performance on a
      representation of multiple distal cues but their representation, unlike that of
      normal rats, was inflexible in that it could not be used to guide performance
      when the cues or starting position were altered. These results parallel those
      from other studies of hippocampal function in animals and humans: The learning
      deficit consequent to hippocampal system damage (1) is not specific to a
      particular category of learning materials, but is dependent on the
      representational demands of the task; (2) is observed when task demands encourage
      a representation based on relations among multiple cues, but not when the task
      encourages adaptation to an individual (or compound) stimulus; (3) spares
      acquisition of fundamental procedures needed to perform the task; and (4) impairs
      the flexible use of learned information in tests other than repetition of the
      learning experience.

PMID- 2230942
TI  - Opiate antagonist nalmefene improves intracellular free Mg2+, bioenergetic state,
      and neurologic outcome following traumatic brain injury in rats.
AB  - Treatment of CNS trauma with the opiate antagonist naloxone improves outcome,
      though the mechanisms of action remain speculative. Nalmefene is another opiate
      receptor antagonist, but it has substantially greater potency and duration of
      action than naloxone. It also has increased activity at kappa opiate receptors
      and has recently been shown to limit histological changes and neurological
      dysfunction after traumatic spinal cord injury. The present study examined the
      effects of treatment with nalmefene on outcome after fluid-percussion-induced
      traumatic brain injury in rats, using magnetic resonance spectroscopy to monitor
      acute metabolic changes and behavioral tests to determine chronic neurological
      recovery. Single-dose treatment with nalmefene (100 micrograms/kg, i.v.) at 30
      min after trauma significantly improved (p less than 0.05) neurological outcome
      (up to 4 weeks) as compared to saline-treated controls. Early changes in
      intracellular free-magnesium concentration, adenosine diphosphate concentration,
      and cytosolic phosphorylation potential were all significantly improved by
      nalmefene treatment, reflecting improved bioenergetic state. We suggest that the
      ability of nalmefene to improve cellular bioenergetics after trauma may in part
      account for the neuroprotective effects of this and related compounds.

PMID- 2230944
TI  - How well do response changes of striate neurons signal differences in
      orientation: a study in the discriminating monkey.
AB  - Just-noticeable differences (JNDs) in orientation were measured in 2 monkeys
      using a temporal same-different task, with stationary rectangular gratings as
      stimuli, and compared to those of humans tested in the same setup. The JNDs of
      one monkey (1.5 degree) were similar to those of humans; those of the other
      monkey were larger (5.8 degrees). We recorded from V1 neurons in these monkeys
      while they were performing the orientation discrimination with the same stimuli
      and under the same conditions as used in the behavioral testing. In order to
      determine how small a difference in orientation the V1 neurons can, in these
      conditions, signal reliably by small changes in firing rate, we performed 2
      different receiver-operating characteristic (ROC) analyses. One ROC analysis was
      performed on the number of spikes evoked by the first of the 2 stimulus
      presentations as a function of the orientation of this stimulus. Neural JNDs
      derived from the neurometric curve were obtained in this way for 50 cells. In the
      second ROC analysis, the difference in the number of spikes evoked by the 2
      stimuli presented in succession during 1 trial was analyzed as a function of
      orientation difference between the 2 stimuli. Neural JNDs were obtained by this
      procedure for 21 cells. These 2 complementary ROC analyses yielded very similar
      results. Also, the results were similar for the 2 monkeys. A minor fraction of V1
      cells can reliably signal difference in orientation as small as 2.5 degrees, but
      none could signal differences smaller than 2 degrees. Our results also showed
      that the neural JND obtained by the ROC analysis depends on the duration of the
      interval during which spikes are counted. In these experiments, this duration
      could be chosen rather precisely, because the reaction times of the 2 monkeys
      were measured. Also, our results showed that the neural JND depends on the point
      of the tuning curve at which the measurement is made and is smallest when this is
      done on the steepest part of the tuning curve. Finally, our results show that the
      discriminative capacity of V1 neurons does not depend so much on each of the
      tuning characteristics--bandwidth, response strength, and variability--as on the
      combination of these factors.

PMID- 2230945
TI  - Retrosplenial cortex: possible role in habituation of the orienting response.
AB  - A patient with a unilateral lesion that included the retrosplenial area had a
      propensity to attend to contralateral stimuli. To determine whether the
      retrosplenial-area lesion was inducing this defect, unilateral retrosplenial
      lesions were produced in rats by surgical aspiration. Animals were assessed
      preoperatively and postoperatively for orientation and habituation to bilateral
      simultaneous stimulation in 3 sensory modalities: visual, tactile, and auditory.
      At each session, the orientation test was terminated upon completion of 5 trials
      per modality, and the habituation test ended after 4 consecutive response
      failures or upon completion of 15 trials per modality. Postoperatively,
      contralateral orientation was not significantly different from ipsilateral
      orientation, suggesting that there was no neglect. However, there was a
      significant delay in habituation to contralateral stimulation in postoperative
      weeks 2 and 3-5. Our results suggest that rats with retrosplenial area lesions
      have normal orientation but fail to habituate to contralateral stimuli.

PMID- 2230946
TI  - The distribution of free calcium in transected spinal axons and its modulation by
      applied electrical fields.
AB  - Intracellular free-calcium concentration ([Ca2+]i) was measured in lamprey spinal
      axons using the fluorescent calcium indicator fura 2. We used both a
      photomultiplier tube and a video-image processing system to measure the temporal
      and spatial distributions of [Ca2+]i in the proximal segments of transected
      axons. Within 3 min following transection, a spatially graded increase in the
      [Ca2+]i was apparent in the last few millimeters of the axons. Superimposed on
      the initial gradient was a moving front of calcium that progressed up the axon,
      reaching 1.6 mm from the cut end in 3 hr. The [Ca2+]i behind the moving front
      exceeded 10 microM. This movement of Ca2+ was greatly reduced by an externally
      applied electrical field with the cathode distal to the lesion and was increased
      by an applied field of the opposite polarity. When axons were transected in
      Ca2(+)-free medium, no increases in [Ca2+]i occurred. One d after transection,
      [Ca2+]i was at or below the precut levels, except in the distal 250 microns,
      where it remained slightly elevated. Therefore, axons can survive the high levels
      of [Ca2+]i that occur after transection and can reestablish normal [Ca2+]i levels
      within 24 hr. Measurements of both the diffusion coefficient and the fluorescence
      polarization of fura 2 indicate that the dye is not significantly bound to
      axoplasmic components.

PMID- 2230947
TI  - Changes in instrumentally and classically conditioned limb-flexion responses
      following inferior olivary lesions and olivocerebellar tractotomy in the cat.
AB  - Lesions were placed in various parts of the inferior olivary nucleus and
      olivocerebellar tract in an attempt to define further the role of the inferior
      olive in the performance of a conditioned limb-flexion response (LFR) in cats.
      Thirty-two cats were trained to make an LFR using either classical or
      instrumental conditioning. The conditioned stimulus (CS) was a tone, and the
      unconditioned stimulus (US), a shock to the forelimb. Following training, lesions
      were placed in various parts of the inferior olivary nucleus in 20 animals (radio
      frequency lesions, 17; electrolytic lesions, 3). Midline section of the
      olivocerebellar tract was carried out in 12 animals. The degree of conditioned
      response (CR) loss resulting from a given lesion was closely related to the
      precise locus of the lesion. Rostromedial olivary lesions, which included the
      spino- and cortico-olivary forelimb projection zones and the olivocerebellar
      projection area, resulted in varying degrees of CR loss (from partial to near
      total), deregulation of response latency, and a significant reduction of response
      amplitude. The CR deficit and degree of post-operative CR recovery were directly
      related to the extent of damage to this part of the rostromedial olive. Lesions
      restricted to the caudal olive or to caudal levels of the olivo-cerebellar tract
      resulted in no postoperative CR deficits. Animals with caudal lesions, however,
      showed more severe general motor deficits postoperatively than did those with
      rostromedial lesions and loss of the CR. Prolonged training of animals with the
      most complete CR deficits resulted in some relearning, but response patterns were
      typified by long-latency, low-amplitude CRs and a highly unstable response
      pattern.

PMID- 2230948
TI  - Inhibition of neurite outgrowth on astroglial scars in vitro.
AB  - Traumatic injury to the adult mammalian CNS results in the formation of an
      astroglial-mesenchymal scar that seals the wound site but blocks axonal
      regeneration in the process. The mechanism that leads to this inhibition of axon
      outgrowth has been proposed to be either a physical barrier blocking the
      advancement of the growth cone or chemical factors actively inhibiting axon
      outgrowth. At present, it is unknown whether one or both of these mechanisms are
      responsible for the inhibitory nature of the glial scar in vivo. Using a model of
      CNS trauma that allows for removal of an adult rat glial scar intact on a
      nitrocellulose support and placement in vitro with the upper surface exposed, we
      addressed the question of whether the inhibitory effects could be accounted for
      by chemical components at the scar surface. A purified population of rat
      hippocampal neurons was seeded onto the scar explants as well as onto explants
      taken from neonatal rat cerebral cortex, and the extent of neurite outgrowth was
      compared. We found that the glial scar, at best, stimulates only minimal neurite
      outgrowth over its surface when compared to the immature environment explanted in
      the same manner. This growth-inhibitory state cannot merely be explained by
      neuronotoxic factors or fibroblasts preventing astrocyte-mediated neurite
      outgrowth. The inhibition is more probably due to the expression of molecules on
      the surface of the adult scar that either directly inhibit growth cones or
      inhibit them indirectly by occluding neurite-promoting factors in the
      extracellular matrix or on the astrocyte surface.

PMID- 2230949
TI  - Nerve growth factor infusion in the primate brain reduces lesion-induced
      cholinergic neuronal degeneration.
AB  - NGF is a protein that promotes survival, differentiation, and process extension
      of selected neuronal populations during development and, in some cases, in the
      mature organism. Previous lesion and aging studies in the rat have shown that
      intracerebroventricular NGF infusions can prevent degenerative changes in basal
      forebrain cholinergic neurons. We sought to determine whether salutory effects of
      NGF occur in the primate brain. Cholinergic fibers of the septohippocampal
      projection in the primate were surgically transected, followed by infusion of
      either a vehicle or an NGF solution into the ventricular system for a 4-week
      period. Quantification of cholinergic neurons in the medial septal nucleus at the
      end of the infusion period demonstrated that only 45 +/- 5% of cholinergic
      neurons could be identified after fornix lesions in vehicle-infused animals,
      whereas 80 +/- 6% of neurons were visible in NGF-treated animals. Thus, NGF
      substantially reduced lesion-induced cholinergic neuronal degeneration in the
      adult primate brain. This finding may be relevant to the hypothesis that NGF has
      potential use as a cholinergic "neurotrophic-factor therapy," given that loss of
      basal forebrain cholinergic neurons is common in Alzheimer's disease.

PMID- 2230950
TI  - Development of the retinotectal projection in zebrafish embryos under TTX-induced
      neural-impulse blockade.
AB  - The influence of neural activity on the morphology of retinal-axon-terminal
      arbors and the precision of the developing retinotectal projection in zebrafish
      embryos was explored. Terminal-arbor morphology and their distribution in the
      tectum was determined with anatomical fiber-tracing methods using the fluorescent
      dyes dil and diO. To allow development under activity-deprived conditions, TTX
      was injected into the eyes of 30-38-hr-old zebrafish embryos at concentrations
      that effectively blocked neural activity both in retinal ganglion cells and
      throughout the CNS. Much like axons with normal neural-activity patterns,
      activity-deprived axons from dorsal and ventral and from temporal and nasal
      regions in the retina terminated over retinotopically appropriate and
      nonoverlapping regions of the tectum. Even after ablation of 1 hemiretina at the
      time of axonal outgrowth, activity-deprived axons from the remaining hemiretina
      grew directed toward and arborized selectively within their retinotopically
      appropriate tectal half in the same way as would nondeprived axons. Besides being
      retinotopic, the area over which small populations of activity-deprived axons
      from neighboring ganglion cells arborize is as small as that of active axons. The
      size of terminal arbors of retinal ganglion cell axons was unaffected by blockade
      of neural activity. The mean terminal-arbor size was 27 x 18 microns for the TTX
      injected and 31 x 22 microns for the control embryos. The tectal coverage of TTX
      blocked and control axons was equally small, with values of 1.4% and 1.6%,
      respectively. These data show that a precisely organized retinotopic map in
      developing zebrafish forms independent of neural-impulse activity.

PMID- 2230951
TI  - Inhibition of Schwann cell myelination in vitro by antibody to the L1 adhesion
      molecule.
AB  - The specific axonal and Schwann cell surface molecules that mediate the
      initiation of myelination have not been identified. We have used cocultures of
      purified rat dorsal root ganglion neurons and Schwann cells and purified
      polyclonal antibodies to the L1 adhesion molecule to study the role of L1 in
      myelin formation. Schwann cells were first arrested in a basal-lamina-free
      premyelination stage (by serum/ascorbate deprivation), then manipulated to allow
      basal lamina deposition and myelination (by serum/ascorbate addition) in the
      absence or presence of anti-L1. Using electron microscopy, immunocytochemistry,
      and myelin sheath quantitation after Sudan-black staining, we determined the
      effect of anti-L1 on (1) basal lamina formation, (2) the segregation by Schwann
      cells of axons into a 1:1 relationship, (3) galactocerebroside (Gal-C)
      expression, (4) laminin deposition, and (5) myelin formation. Anti-L1 strongly
      blocked myelin formation, Gal-C expression, and axon segregation but did not
      block basal lamina formation. In controls, elongated Schwann cell processes
      completely covered the axons and exhibited uniform surface staining for laminin;
      in anti-L1-treated cultures, shortened Schwann cells, intensely stained for
      laminin, were observed in clusters separated by unstained lengths of axons. When
      50 micrograms/ml exogenous purified laminin was added to the medium, Schwann cell
      length and laminin staining were similar in control and treated cultures.
      However, the inhibition of myelination of anti-L1 was not altered by the addition
      of laminin. Myelination was also inhibited with antigen-binding fragments (Fab)
      of polyclonal anti-L1, but an antibody to liver membranes did not block
      myelination. These results indicate that L1 is involved in the linear extension
      of Schwann cell processes along axons, the engulfment of axons, and the induction
      of myelin-specific components within the Schwann cell. We conclude that anti-L1
      prevents myelination by blocking these events rather than by blocking basal
      lamina deposition.

PMID- 2230952
TI  - Serotonin synthesis and distribution in Drosophila dopa decarboxylase genetic
      mosaics.
AB  - In Drosophila, the enzyme dopa decarboxylase (DDC) catalyzes the last step in the
      biosynthesis of serotonin (5HT) and dopamine. In the present study, the
      distribution of DDC and one of its biosynthetic products (5HT) was determined in
      CNSs that were genetic mosaics, composed of neurons that have DDC activity and
      neurons that lack DDC activity. Phenotypic mosaicism, that is, immunoreactive
      (IR) and non-IR neurons within the same nervous system, was observed for both DDC
      and 5HT immunoreactivity. DDC-IR neurons were always 5HT-IR, but some 5HT-IR
      neurons devoid of DDC immunoreactivity were also observed. 5HT-IR neurons devoid
      of DDC immunoreactivity were always in close apposition to other DDC-IR neurons.
      We suggest that in vivo uptake mechanisms are responsible for 5HT accumulation in
      neurons devoid of DDC immunoreactivity.

PMID- 2230953
TI  - Circadian timekeeping in BALB/c and C57BL/6 inbred mouse strains.
AB  - Circadian rhythms of locomotion (wheel-running activity) in 12 inbred mouse
      strains were recorded for interstrain differences in tau DD, the endogenous (free
      running) period of the circadian pacemaker measured in constant environmental
      darkness. The results indicate that 1 or more genetic loci influence the value of
      tau DD, and a large (50 min) difference in mean tau DD between 2 of the strains,
      BALB/cByJ and C57BL/6J, allowed further characterization of the origins and
      inheritance of the polymorphic expression of this circadian pacemaker property.
      The interstrain difference in mean tau DD was associated with an interstrain
      difference in light-induced shifts of the phase of the free-running locomotor
      rhythm; the BALB/c strain (with the shorter mean tau DD) displayed relatively
      fewer advance phase shifts. Neither the history of previous light exposure,
      albinism, nor elevated circulating testosterone levels could account for the
      interstrain difference in mean tau DD. The value of tau DD based on the circadian
      rhythm of drinking activity (with the running wheel removed) was longer than that
      based on locomotion; this discrepancy was significantly greater and more variable
      in BALB/c than in C57BL/6 mice, though the interstrain difference in mean tau DD
      could not be attributed entirely to this effect. Reciprocal F1 hybrids of BALB/c
      x C57BL/6 matings revealed dominance of the C57BL/6 genotype, no sex linkage, and
      a significant (but small) maternal effect. Examination of CXB recombinant inbred
      strains provided no support for the hypothesis of monogenic inheritance. Further
      study of inherited differences in the BALB/c and C57BL/6 strains may be a useful
      noninvasive experimental approach for investigation of the neurobiological
      substrates of circadian rhythmicity.

PMID- 2230954
TI  - Brain IL-1-induced immunosuppression occurs through activation of both pituitary
      adrenal axis and sympathetic nervous system by corticotropin-releasing factor.
AB  - Intracerebroventricular infusion of femtomolar quantities of interleukin-1 (IL-1)
      or stimulated release of endogenous IL-1 in the brain suppresses various cellular
      immune responses, decreasing natural killer cell (NK) activity, response to
      mitogen, and interleukin-2 production of splenic and blood lymphocytes (an effect
      hereafter called "brain IL-1-induced immunosuppression"). The present study
      examines mechanisms by which IL-1 produces this effect. First, because IL-1 in
      the brain activates the pituitary-adrenal axis by stimulating release of
      corticotropin-releasing factor (CRF), the role of CRF was investigated. To block
      CRF, affinity-purified antibody to CRF was infused into the lateral ventricle 30
      min before introduction of IL-1. When this was done, suppression of cellular
      immune responses that normally follow IL-1 infusion was completely prevented.
      Infusion with an equal quantity of non-CRF IgG prior to IL-1 was without effect.
      Second, the role of sympathetic nervous activity was examined. To block neural
      transmission at sympathetic ganglia, chlorisondamine (3.0 mg/kg) was injected
      intraperitoneally 60 min before IL-1 infusion. When this was done, suppression of
      immune responses by IL-1 was partially blocked. These results indicate that IL-1
      in the brain suppresses various cellular immune responses by activating both the
      pituitary-adrenal axis and the sympathetic nervous system, and that these systems
      are both activated through the influence of IL-1 on CRF.

PMID- 2230955
TI  - Discrimination learning alters the distribution of protein kinase C in the
      hippocampus of rats.
AB  - Protein kinase C (PKC), an enzyme that plays an essential role in eukaryotic cell
      regulation (Nishizuka, 1988; Huang et al., 1989), is critical to memory storage
      processes both in the marine snail Hermissenda crassicornis and in the rabbit
      (Alkon et al., 1988; Bank et al., 1988; Olds et al., 1989). Specifically,
      activation of PKC mimics neurobiological correlates of classical conditioning in
      both Hermissenda and the rabbit, and the distribution of the enzyme within the
      rabbit hippocampus changes after Pavlovian conditioning. Here, we report that the
      amount of PKC, as assayed by specific binding of 3H-phorbol-12,13-dibutyrate (3H
      PDBU), decreased significantly within the hippocampal CA3 cell region in rats
      trained to solve a water maze task either by cognitive mapping or by visual
      discrimination strategies, but not in control rats. Furthermore, hippocampal
      lesions interfered with acquisition of both of these tasks. We interpret these
      findings to support the conclusion that distributional changes of PKC within the
      mammalian hippocampus play a crucial role in memory storage processes.

PMID- 2230956
TI  - Transfected rat high-molecular-weight neurofilament (NF-H) coassembles with
      vimentin in a predominantly nonphosphorylated form.
AB  - A fully encoding cDNA for the high-molecular-weight rat neurofilament protein (NF
      H) has been isolated from a lambda gt11 library, sequenced and subcloned into
      eukaryotic expression vectors. Sequence analysis shows that rat NF-H has an
      overall homology of 72 and 88% with human and mouse NF-H, respectively. The head
      and rod domains are almost entirely identical, and the divergences are due to
      differences in the long C-terminal extensions of the molecule. The consensus
      phosphorylation sequence for neurofilaments Lys-Ser-Pro (KSP) is present 52
      times. The predicted molecular mass of the protein is 115 kDa, 42% lower than
      that observed by SDS-PAGE. Upon transfection into vimentin-containing
      fibroblasts, such as L tk-, L929, and 3T6 cells, NF-H is seen distributed with
      vimentin by light and electron microscopic examinations indicating that
      copolymers of NF-H and vimentin are formed in these cells. Only a negligible
      proportion of the cells is positive when stained with a number of antibodies
      directed against phosphorylated NF-H epitopes. This is in contrast with the
      middle molecular weight NF protein (NF-M) transfected into L tk- and L929 cells,
      which can readily be detected by antibodies against phosphorylated neurofilament
      epitopes. The mobilities of the transfected protein on 1- and 2-dimensional gels
      confirm that NF-H is predominantly in a nonphosphorylated form. These results
      indicate that phosphorylation of NF-H, but not NF-M, on the KSP sequence is due
      to protein kinases, which are not present in fibroblasts and are presumably NF-H
      specific. The stable NF-H-expressing cell lines can therefore be used to study
      these putative neurofilament kinases in vitro and in vivo.

PMID- 2230957
TI  - The visuotopic component of the multisensory map in the deep laminae of the cat
      superior colliculus.
AB  - A well-defined map of visual space is located in the deep laminae of the cat
      superior colliculus. The horizontal meridian is oriented rostral-caudal, while
      the vertical meridian is oriented perpendicular to it in the rostral third of the
      structure. This map represents the entire contralateral visual field and extends
      approximately 40 degrees into ipsilateral visual space. Although the deep-laminae
      visuotopy is similar to that found in the superficial laminae of the same
      structure, the topographic register among these maps is most secure rostrally but
      becomes increasingly poorer at more caudal and lateral locations. The combination
      of 2 features distinguish the deep-layer visual representation from that found in
      the superficial laminae and in geniculocortical systems: (1) the constituent
      visual receptive fields are very large (mean diameter, 66.9 degrees), and (2) the
      majority (greater than 70%) of the neurons composing it receive nonvisual inputs.
      Because the visual receptive fields of visual-multisensory neurons are
      significantly larger than those of neighboring neurons that respond only to
      visual stimuli, far more visual-multisensory neurons are activated by any given
      visual stimulus. These data, when coupled with those from previous studies,
      suggest that, from a functional perspective, deep-laminae visual neurons form one
      component of an integrated multisensory map, and that their topographic
      organization is essential for the normal dynamics of multisensory integration.

PMID- 2230959
TI  - Orthodontic application of proximal clasps.
AB  - Removable plates are widely used for various purposes in orthodontics. In order
      to accomplish the designed treatment objective, it is necessary to provide
      sufficient retention of the removable appliance. In this regard, clasps such as
      Adams, Schwarz, Arrowhead, Duyzing, Jackson, Crozat, ball, triangular, c and so
      on, have been developed. Furthermore, as much importance must be given to the
      level of comfort provided by the clasp as is given to its retentive property,
      particularly in appliances where long-term wear is essential. With regard to
      these two properties, proximal clasps render the greatest contribution through
      their high retentive capacity and ease of placement in the mouth. Hence, in spite
      of being developed originally for dentures, these clasps may be accommodated
      effectively in orthodontic appliances. In this paper, experiences acquired
      through practical application of proximal clasps are presented.

PMID- 2230958
TI  - New attachment formation following periodontal surgery in a dog.
AB  - We evaluated new attachment following treatment of experimental periodontitis in
      a canine model. Periodontal destruction was induced over an 8-month period using
      silk ligatures and a soft diet, and this remained stable for 170 days before
      surgery. After surgical scaling and root planing of eight bicuspid teeth, the
      apical end of the pockets was estimated using an occlusal stent and a periodontal
      probe, then marked with a blade. The root surfaces of three bicuspids were
      treated with citric acid for 3 min, and tetracycline salt was applied to the root
      surfaces of two teeth. The remaining three bicuspids served as controls.
      Postoperatively, no attempts were made to improve oral hygiene, and on day 48
      light microscopic examination of biopsy materials revealed new attachment in all
      treated teeth. However, in some sections new cementum and new collagen formation
      was much more extensive and complete in both groups of experimental teeth than in
      the control teeth.

PMID- 2230960
TI  - Dental abrasion pattern in a selected group of Malaysians.
AB  - Among 350 inhabitants of two villages, 31 (8.9%) cleaned their teeth using table
      salt and charcoal applied to their forefinger or a Melastoma brush. As a result,
      all had distinct forms of abrasion cavity on the labial surfaces of their teeth.
      All of the above three agents are highly abrasive and injurious to both the hard
      and soft oral tissues. This dying practice is only popular among a very small
      number of persons in the older age group, and should be discouraged.

PMID- 2230961
TI  - Protein breakdown in submandibular glands rendered hypertrophic by amputation of
      lower incisor teeth in rats.
AB  - Protein breakdown in submandibular glands rendered hypertrophic by amputation of
      the lower incisor teeth in rats was investigated. Reduced protein breakdown was
      observed in the hypertrophic gland tissues, and was found to be inhibited by 20
      mM epsilon-amino-n-caproic acid, an inhibitor of serine protease, and 50 microM
      leupeptin, an inhibitor of trypsin, plasmin, papain and cathepsin B, but not by 2
      mM PMSF (phenylmethylsulfonyl fluoride), an inhibitor of serine protease, 10
      microM pepstatin, an inhibitor of cathepsin D and 20 microM antipain, an
      inhibitor of cathepsin A and B. These results suggest that some serine proteases
      and leupeptin-sensitive proteases (presumably cathepsin B) participate in protein
      breakdown in hypertrophic gland tissues, and that hypertrophy of the
      submandibular glands is closely related to the reduced protein breakdown in these
      tissues.

PMID- 2230962
TI  - Squamous odontogenic tumor.
AB  - The twenty-fifth reported case of squamous odontogenic tumor is presented. The
      patient was a 39-year-old Chinese Malaysian male. The lesion was asymptomatic and
      did not recur after excision. It is important to distinguish this type of lesion
      from squamous odontogenic tumor-like proliferation. The rest of Malassez is
      thought to be responsible for the histogenesis of the lesion. Better
      understanding will only be achieved when more cases are reported and studied.

PMID- 2230963
TI  - An electron microscopic study of ectomesenchymal contacts in rat incisors.
AB  - In order to clarify connections between epithelium and mesenchymal tissue in the
      early stage of odontogenesis, the formation of ectomesenchymal contacts and the
      presence of coarse-textured material at the interface between ameloblasts (AMs)
      and odontoblasts (ODs) on growing rat incisors were studied by electron
      microscopy. The presecretory zone was classified into five regions according to
      the ultrastructure of each preameloblast (PA). The region where collagen fibrils
      could be observed was designated PZ-2, the region where predentin existed PZ-3,
      the region where the basal lamina began to disappear PZ-4, and the region where
      the basal lamina had disappeared PZ-5. In PZ-2, the cytoplasmic processes of PAs
      penetrated the basal lamina and reached the dental papilla cells. In some
      locations, ectomesenchymal contacts were also observed, in which the cytoplasmic
      processes of the PAs were in contact with those of the preodontoblasts (POs). In
      PZ-3, the distal cytoplasm contained large amounts of type-1 vesicles, and
      secretory granules. In the distal membrane of the PA, membrane invaginations
      containing fibrillar structures were visible. Also in some areas, the cytoplasmic
      processes at the distal ends of the PAs invaded the predentin. In the predentin,
      a large amount of coarse-textured material, considered to be the precursor of the
      enamel matrix, was observed. In PZ-3, a large number of cytoplasmic processes
      extended into the predentin, while in PZ-4, microvillus-like processes extended
      from the distal ends of the PAs, showing a high frequency of ectomesenchymal
      contact. It was suggested that secretory activity of the PAs was induced after
      ectomesenchymal contact had been accomplished, but that the PAs did not undergo
      morphological change into secretory ameloblasts.

PMID- 2230964
TI  - A clinicopathological study of so-called denture fibroma.
AB  - We investigated 60 cases of so-called denture fibroma, most of which occurred in
      women in their 50s to 70s. The most commonly affected areas were the upper
      alveolar ridge and the bottom of the alveolabial sulcus, and most of the
      prostheses responsible were complete dentures. Elevated and tumor-like lesions
      were most frequent. Histopathologically, about 60% of the lesions were of the
      fibromatous type. Degeneration and inflammation of the salivary glands were
      identified in one third of cases.

PMID- 2230965
TI  - Role of the United States in a changing world. The 1990 Harvey Cushing oration.
AB  - In discussing the role of the United States in world politics, President Jimmy
      Carter described the changes in Europe as it prepares for unification into one
      economic bloc; the deteriorating conditions in the third world; the impact of the
      recent changes in communist countries; and the persistence of regional wars and
      civil disputes. He summarized the policies and activities of The Carter Center in
      Atlanta, Georgia. This nonprofit organization receives no government funds and
      can act as an independent agent in areas such as disease eradication and
      promotion of food production in the third world countries, and can intercede on
      behalf of peace in countries with civil unrest. He urged the members of the
      Association, as leaders of society, to use their influence in alleviating
      worldwide suffering.

PMID- 2230967
TI  - Clinoidal meningiomas.
AB  - Anterior clinoidal meningiomas are frequently grouped with suprasellar or
      sphenoid ridge meningiomas, masking their notorious association with a high
      mortality and morbidity rate, failure of total removal, and recurrence. To avoid
      injury to encased cerebral vessels, most surgeons are content with subtotal
      removal. Without total removal, however, recurrence is expected. Recent advances
      in cranial-base exposure and cavernous sinus surgery have facilitated radical
      total removal. The author reports 24 cases operated on with vigorous attempts at
      total removal of the tumor with involved dura and bone. This experience has
      distinguished three groups (I, II, and III) which influence surgical
      difficulties, the success of total removal, and outcome. These subgroups relate
      to the presence of interfacing arachnoid membranes between the tumor and cerebral
      vessels. The presence or absence of arachnoid membranes depends on the origin of
      the tumor and its relation to the naked segment of carotid artery lying outside
      the carotid cistern. Total removal was impossible in the three patients in Group
      I, with postoperative death occurring in one patient and hemiplegia in another.
      Total removal was achieved in 18 of the 19 patients in Group II, with one death
      from pulmonary embolism. In the two patients in Group III, total removal without
      complications was easily achieved.

PMID- 2230966
TI  - Magnetic resonance imaging contrast agents: theory and application to the central
      nervous system.
AB  - The theoretical aspects of magnetic resonance (MR) imaging contrast agents are
      reviewed, and their current applications to the central nervous system (CNS) and
      their future applications are discussed. Profound differences exist between
      contrast agents used for MR imaging and computerized tomography (CT). In MR
      imaging, the contrast agents are not imaged directly but rather act on adjacent
      protons to shorten T1 and T2 relaxation times. This in turn results in signal
      intensity changes. The lanthanide metal, gadolinium, in the form of gadopentetate
      dimeglumine, has been found to be both safe and efficacious as the only currently
      approved contrast agent for MR imaging. Magnetic resonance imaging revolutionized
      the detection and treatment of disease affecting the brain and spine. Initially,
      it was thought that signal characteristics on MR imaging would allow
      differentiation of specific pathology. It was soon found that MR studies were
      able to detect more abnormalities but were less able to characterize them. The
      recent development of contrast agents for MR imaging has allowed this modality to
      surpass CT for the evaluation of most CNS lesions. At present, contrast-enhanced
      MR imaging is generally accepted as the study of choice for evaluating acoustic
      neurinomas, pituitary lesions, meningeal disease, primary and secondary brain
      tumors, active multiple sclerosis, intradural spinal neoplasms, intramedullary
      spinal disease, and postoperative states in both the spine and brain. Even when
      contrast-enhanced CT can detect the same abnormalities, evaluation of the lesions
      in multiple planes on MR imaging can sometimes yield invaluable information,
      especially prior to surgery. Future developments of contrast material for MR
      imaging include non-gadolinium compounds, intrathecal contrast media, cerebral
      blood flow and volume evaluation, and, possibly, antibody-labeled contrast
      agents.

PMID- 2230968
TI  - Cruciate paralysis: a clinical and radiographic analysis of injuries to the
      cervicomedullary junction.
AB  - Fourteen patients with superior cervical spinal cord injuries and the clinical
      signs and symptoms of cruciate paralysis are presented. This rare injury pattern
      is characterized by weakness of the upper extremities with little or no
      compromise of lower-extremity function following trauma to the superior spinal
      cord. Anatomically, cruciate paralysis is thought to represent selective injury
      to descending corticospinal tracts as they decussate at the cervicomedullary
      junction. The clinical and radiographic findings of each patient are outlined and
      the incidence and natural history of the injury syndrome, including a review of
      the literature, are presented.

PMID- 2230969
TI  - Unruptured intracranial aneurysms and arteriovenous malformations: frequency of
      intracranial hemorrhage and relationship of lesions.
AB  - Among 91 patients with unruptured intracranial arteriovenous malformations
      (AVM's), 16 patients had 26 unruptured intracranial saccular aneurysms. An
      actuarial analysis showed the risk of intracranial hemorrhage among patients with
      coexisting aneurysm and AVM to be 7% per year at 5 years following diagnosis
      compared to 1.7% for patients with AVM alone. The difference in length of
      survival free of hemorrhage was significant (log-rank, p less than 0.0007).
      Several angiographic and clinical parameters were investigated to better
      understand the relationship of these lesions. The aneurysms occurred in similar
      percentages in patients with small, medium, and large AVM's. Twenty-five
      aneurysms were on arteries feeding the malformation system, almost equally
      distributed proximally and distally. Eleven aneurysms were atypical in location,
      and all arose from primary or secondary branch feeders to the malformation; 24
      were on enlarged feeding arteries. Eleven (16%) of the 67 patients with high-flow
      AVM's had associated aneurysms, compared with five (21%) of the 24 patients with
      low-flow AVM's. Four (16%) of 25 low-shunt malformations and 12 (18%) of 65 high
      shunt malformations had associated aneurysms. All five aneurysms associated with
      low-shunt malformations were on a direct arterial feeder of the malformation.
      These data suggest that the intracranial AVM's predispose to aneurysm formation
      within AVM feeding systems and that the mechanism is not simply based upon the
      high blood flow or high arteriovenous shunt in these systems.

PMID- 2230970
TI  - Systems analysis of cerebrovascular pressure transmission: an observational study
      in head-injured patients.
AB  - In an observational study in head-injured patients, cerebrovascular pressure
      transmission was investigated using a systems analysis approach whereby the blood
      pressure (BP) waveform was used as a measure of an input stimulus to the
      cerebrovascular bed (CVB) and the intracranial pressure (ICP) waveform as the
      response to that stimulus. The transfer function is a measure of how much
      pressure is transmitted through the CVB at a given frequency and is calculated
      using Fourier analysis of the pressure waveforms. The transfer function allows
      quantification of the pressure transmission performance of the CVB, thus
      providing a basis for comparison between normal and abnormal function. Fifteen
      hundred samples of ICP and BP waveforms were collected from 30 head-injured
      patients via microcomputer. Off-line spectral analysis of the waveform database
      revealed four main classes of transfer function: those with an overall flat
      transfer function (curve type 1); those with an elevated low-frequency response
      (curve type 2); those with an elevated high-frequency response (curve type 3);
      and those exhibiting both an elevated low- and high-frequency response (curve
      type 4). Curve types 2 and 4 were most often associated with raised ICP (greater
      than 20 mm Hg), whereas curve types 1 and 3 were most often affiliated with ICP
      less than 15 mm Hg. Studies of this type may provide insight into the
      pathophysiology of the CVB and ultimately aid in the prediction and treatment of
      raised ICP.

PMID- 2230971
TI  - Motility factor produced by malignant glioma cells: role in tumor invasion.
AB  - To better understand the cellular mechanism of tumor invasion, the production of
      a cell motility-stimulating factor by malignant glioma cells was studied in
      vitro. Serum-free conditioned media from cultures of rat C6 and human T98G cell
      lines contained a factor that stimulated the locomotion of the producer cells.
      This factor was termed the "glioma-derived motility factor." The glioma-derived
      motility factor is a heat-labile protein with a molecular weight greater than 10
      kD and has relative stability to acid. The factor showed not only chemotactic
      activity but also chemokinetic (stimulated random locomotion) activity in the two
      types of glioma cells studied. Although glioma-derived motility factors in
      conditioned media obtained from two different cell origins are likely to be the
      same, chemokinetic migration of T98G cells to their conditioned medium was much
      stronger than that of C6 cells to theirs. Coincubation of cells with cytochalasin
      B, which disrupts the assembly of cellular actin microfilaments, almost
      completely inhibited the cell migration stimulated by glioma-derived motility
      factor. Cytochalasin B also induced marked alterations in cell morphology,
      including cell retraction and arborization, while the drug did not affect cell
      attachment to culture dishes. These results indicate that glioma cells produce a
      motility factor which may play a role particularly when tumor cells are detached
      and migrate away from the original tumor mass, thus promoting tumor invasion.
      Also, glioma cell migration stimulated by the motility factor requires the normal
      organization of cytoskeletons such as actin microfilaments.

PMID- 2230972
TI  - Antigen related to cell proliferation in malignant gliomas recognized by a human
      monoclonal antibody.
AB  - A human monoclonal antibody (CLN-IgG) was produced from a human-human hybridoma
      derived from lymphocytes of a patient with cervical carcinoma. The reactivities
      of this antibody with various human glioma tissues and cultured glioma cells and
      the characterization of the antigen recognized by CLN-IgG on malignant glioma
      cells were analyzed and reported. CLN-IgG reacted with various human glioma cells
      and glioma tissues, especially glioblastoma, but did not react with normal brain
      tissues or fetal brain tissues. A large amount of antigen recognized by CLN-IgG
      was expressed on cell membranes of undifferentiated glioma cells and of glioma
      cells at the G2/M tumor growth phase in cycling cells. Antigen recognized by CLN
      IgG was detected in only one of seven samples of cyst fluid, and was not detected
      in 27 serum samples or 18 samples of cerebrospinal fluid from glioma patients.
      CLN-IgG exhibited antibody-dependent cell cytotoxicity against U-25 1 MG glioma
      cells and primary cultured cells of glioblastomas and anaplastic astrocytomas.
      These data suggest that the antigen recognized by CLN-IgG might be related to
      cell proliferation in malignant gliomas. Thus, CLN-IgG might be useful for
      immunotherapy or immunoimaging of malignant gliomas.

PMID- 2230973
TI  - Cerebrovascular and metabolic effects on the rat brain of focal Nd:YAG laser
      irradiation.
AB  - To investigate the effects of focal neodymium:yttrium-aluminum-garnet (Nd:YAG)
      laser irradiation (lambda = 1060 nm) on regional cerebral blood flow, cerebral
      protein synthesis, and blood-brain barrier permeability, the parietal brain
      surface of 44 rats was irradiated with a focused laser beam at a constant output
      energy of 30 J. Survival times ranged from 5 minutes to 48 hours. Laser
      irradiation immediately caused well-defined cortical coagulation necrosis. Within
      5 minutes after unilateral irradiation, 14C-iodoantipyrine autoradiographs
      demonstrated severely reduced blood flow to the irradiation site and perilesional
      neocortex, but a distinct reactive hyperemia in all other areas of the forebrain.
      Apart from a persistent ischemic focus in the vicinity of the cortical
      coagulation necrosis, blood flow alterations in remote areas of the brain
      subsided within 3 hours after irradiation. Autoradiographic assessment of 3H
      tyrosine incorporation into brain proteins revealed rapid onset and prolonged
      duration of protein synthesis inhibition in perifocal morphologically intact
      cortical and subcortical structures. Impairment of amino acid incorporation
      proved to be completely reversible within 48 hours. Immunoautoradiographic
      visualization of extravasated plasma proteins using 3H-labeled rabbit anti-rat
      immunoglobulins-showed that, up to 1 hour after irradiation, immunoreactive
      proteins were confined to the neocortex at the irradiation site. At 4 hours,
      vasogenic edema was present in the vicinity of the irradiation site and the
      subcortical white matter, and, at later stages (16 to 36 hours), also extended
      into the contralateral hemisphere. Although this was followed by a gradual
      decrease in labeling intensity, resolution of edema was still not complete after
      48 hours. Analysis of sequential functional changes in conjunction with
      morphological alterations indicates that the evolution of morphological damage
      after laser irradiation does not correlate with the time course and spatial
      distribution of protein synthesis inhibition or vasogenic edema. Although the
      central coagulation necrosis represents a direct effect of radiation, the final
      size of the laser-induced lesion is determined by a delayed colliquation necrosis
      due to persistent perifocal ischemia. Extent and severity of ischemia in a zone
      with initial preservation of neuroglial cells can be explained by the optical
      properties of the Nd:YAG laser; extensive scattering of light within brain
      parenchyma associated with a high blood-to-brain absorption ratio selectively
      affects blood vessels outside the irradiation focus.

PMID- 2230974
TI  - Long-term evaluation of hemiparkinsonian monkeys after adrenal autografting or
      cavitation alone.
AB  - Autografts of adrenal medulla were implanted into preformed cavities in the
      caudate nuclei of four rhesus monkeys with hemiparkinsonism induced by 1-methyl-4
      phenyl-1,2,3,6-tetrahydropyridine (MPTP). Five other hemiparkinsonian monkeys
      underwent caudate cavitation, but received no tissue implant. All of the animals
      had marked bradykinesia of the affected arm and stable apomorphine-induced
      turning before cavitation or implantation. Moderate behavioral recovery was seen
      in all five monkeys with cavitation and two of the three monkey with long-term
      adrenal autografts (the fourth adrenal recipient was sacrificed 10 days after
      grafting). The improvement occurred months after the procedure and was not as
      early or as complete as that seen after fetal dopaminergic grafts. Surviving
      adrenal tissue was found only in the animal that showed no behavioral recovery.
      The other two adrenal autograft recipients (with no surviving adrenal medulla)
      and all of the animals with cavitation had ingrowth of dopaminergic fibers from
      the area olfactoria and nucleus accumbens into the caudate, oriented toward the
      cavity. These findings show that the mechanism of improvement after adrenal
      medullary implants for parkinsonism is not dopamine secretion by chromaffin
      cells, but may be related to the sprouted host fibers. The results also indicate
      that the limited recovery after adrenal implants in parkinsonian patients may be
      a result of the cavitation, and not necessarily the result of tissue
      implantation.

PMID- 2230975
TI  - Cerebral venous oxygen content as a measure of brain energy metabolism with
      increased intracranial pressure and hyperventilation.
AB  - In order to test the hypothesis that the cerebral arteriovenous oxygen difference
      (AVDO2) and venous oxygen content (VO2) could be used to monitor brain energy
      metabolism in the setting of increased intracranial pressure (ICP). 12 cats were
      studied with 31P-magnetic resonance spectroscopy. six cats were subjected to
      intracranial hypertension by cisternal infusion of saline. Energy failure
      occurred at an average AVDO2 of 8.4 +/- 3.2 vol% (+/- standard deviation) (range
      4.7 to 14.7 vol%). The VO2 at the point of metabolic failure averaged 1.45 +/-
      0.6 vol% and extended over a narrower range (1.0 to 2.9 vol%). In an additional
      six cats, ICP was raised to the threshold of metabolic failure and
      hyperventilation was then instituted (pCO2 10 to 18 torr). Five of the six cats
      experienced a drop in VO2 with hyperventilation. In two of these animals,
      hyperventilation resulted in a VO2 of 1.1 vol% or less and in metabolic failure
      as evidenced by a fall in phosphocreatine. It is concluded that a VO2 of less
      than 2 vol% is correlated with brain ischemia and that the safety of
      hyperventilation in the setting of increased ICP can be monitored by the use of
      VO2.

PMID- 2230976
TI  - Evidence of a local immune activation in cystic brain tumors.
AB  - The fluid of cystic brain tumors was characterized with regard to the protein
      content. In most malignant tumors, the concentrations of immunoglobulins G and M
      (IgG and IgM) were higher relative to other proteins in the cyst fluid than in
      the serum of the same patient. A markedly elevated ratio of monomeric to
      pentameric IgM was detected in the cyst fluid of two patients with glioblastomas.
      The results indicate a local immunoglobulin synthesis in malignant cystic brain
      tumors. It is hypothesized that higher-than-expected concentrations of IgG and
      IgM in cyst fluid as compared to plasma are a sign of an ongoing immune response
      triggered by the tumor.

PMID- 2230977
TI  - Biologically inert synthetic dural substitutes. Appraisal of a medical-grade
      aliphatic polyurethane and a polysiloxane-carbonate block copolymer.
AB  - Two types of artificial membranes, a medical-grade aliphatic polyurethane and a
      polysiloxane-carbonate block copolymer, were tested as substitutes for dura in 24
      and 12 rabbits, respectively. The films were placed either epidurally,
      subdurally, or as dural grafts in equal subgroups of animals. The postoperative
      course was uneventful with no manifestations of convulsive disorder or
      cerebrospinal fluid leak. The animals were sacrificed 3, 6, or 9 months after
      implantation of the artificial membranes. Both types of artificial membranes were
      easily removed from the underlying nervous and the other surrounding tissues. The
      histological examination failed to reveal adhesions, neomembrane formations, or
      any type of foreign body reactions to the polyurethane film. The implantation of
      the polysiloxane-carbonate film caused no reaction when it was applied
      epidurally. As a dural graft, the polysiloxane-carbonate copolymer induced the
      formation of a thin neomembrane of one to two layers of fibroblasts which formed
      a watertight seal of the dural defect. A similar thin neomembrane was found to
      encase this artificial membrane in the group of animals in which it was implanted
      subdurally. There was no foreign body reaction to the polysiloxane-carbonate
      film. The authors conclude that these materials hold promise as dural substitutes
      or in the prevention of spinal dural scarring, and should be evaluated
      clinically.

PMID- 2230978
TI  - Epithelial cyst of the fourth ventricle. Case report.
AB  - A case of epithelial cyst in the fourth ventricle of a 4-year-old child is
      described. A single epithelial layer with a clear basement membrane lining the
      cyst wall was observed. There were no prominent histological findings to suggest
      a pathogenesis for this cyst based on immunohistochemical or ultrastructural
      studies; however, the cyst fluid contained significant amounts of
      carcinoembryonic antigen. It is considered that the epithelial layer lining the
      cyst wall was possibly of endodermal origin.

PMID- 2230979
TI  - Recurrence of acoustic neurilemoma as a malignant spindle-cell neoplasm. Case
      report.
AB  - A 75-year-old man presented with a right cerebellopontine angle tumor 11 months
      after complete macroscopic resection of a right acoustic neurilemoma.
      Histological examination of the recurrent tumor showed a malignant spindle-cell
      neoplasm with positive staining for S-100 protein. The patient had no stigmata of
      von Recklinghausen's disease. It is proposed that this recurrence represents
      progression from a benign to a malignant acoustic nerve-sheath tumor, an event
      that is extremely rare outside the clinicopathological context of
      neurofibromatosis.

PMID- 2230980
TI  - Toxoplasmosis of the conus medullaris in a patient with hemophilia A-associated
      AIDS. Case report.
AB  - Toxoplasma gondii has been reported to be the most common cause of focal brain
      lesions in patients with acquired immunodeficiency syndrome (AIDS). A case of
      intramedullary toxoplasmosis of the conus medullaris is reported in a patient
      with hemophilia A-associated AIDS. The diagnosis is discussed, with particular
      emphasis on the magnetic resonance imaging appearance.

PMID- 2230981
TI  - Spontaneous regression of giant arteriovenous fistulae during the perinatal
      period. Case report.
AB  - A unique case of spontaneous regression of giant arteriovenous fistulae during
      infancy is described in this report. A female infant, the product of normal labor
      and delivery, demonstrated severe ventriculomegaly and an intracranial hemorrhage
      at birth. Cerebral angiography at 5 days of age revealed several large fistulae
      fed by the anterior and middle cerebral arteries draining into the deep venous
      system through a dilated internal cerebral vein and ectatic vein of Galen. Two
      days following the angiogram, a second intracranial hemorrhage occurred. Active
      hydrocephalus developed over the next 6 months and was treated with
      ventriculoperitoneal shunting. When the child was 8 months of age, angiography
      failed to demonstrate the fistulae. It was postulated that pressure effects from
      the intracranial hematoma and long-standing intracranial hypertension as well as
      stenosis in the anomalous venous outflow resulted in vascular stasis, venous
      thrombosis, and selective arterial occlusion. Hydrocephalus was a result of the
      compression of the intraventricular foramina by dilated embryonic vessels. This
      anomaly, predominantly involving the anterior circulation, may be homologous to
      the vein of Galen aneurysm in the posterior circulation.

PMID- 2230982
TI  - Angiographic demonstration of acute phase of intracranial arterial spasm
      following aneurysm rupture. Case report.
AB  - A case documenting the acute phase of intracranial arterial spasm following
      rupture of an aneurysm arising from the left internal carotid artery is reported.
      The patient deteriorated due to recurrent hemorrhage while undergoing angiography
      12 hours after the initial aneurysm rupture. The acute deterioration was
      accompanied by dilatation of the ipsilateral pupil and occurred during injection
      of contrast material. There was delayed filling of the middle cerebral artery
      complex along with this narrowing. The arterial narrowing was confirmed to have
      completely disappeared on an angiographic series performed 14 minutes after the
      first series of films. The etiology of the acute vasospasm is discussed.

PMID- 2230983
TI  - Subarachnoid hemorrhage caused by a fungal aneurysm of the vertebral artery as a
      complication of intracranial aneurysm clipping. Case report.
AB  - Intracranial aneurysms are an uncommon manifestation of fungal infection. A case
      is described in which the formation of an aneurysm followed an intracranial
      intraoperative Aspergillus infection attributable to a long period of
      preoperative antibiotic medication and immunosuppressive therapy with steroids.

PMID- 2230984
TI  - Propionibacterium encephalitis.

PMID- 2230985
TI  - Interposition vein grafts: cervical-to-petrous ICA bypass.

PMID- 2230986
TI  - Cancer clusters: latest studies do not support link between cancer mortality and
      radiation discharges.

PMID- 2230987
TI  - Nonuniformity in myocardial accumulation of fluorine-18-fluorodeoxyglucose in
      normal fasted humans.
AB  - In initial studies using fluorine-18-fluorodeoxyglucose (FDG) in normal fasted
      subjects, we observed disparities in the regional myocardial accumulation of this
      tracer. Accordingly, we systematically evaluated regional myocardial FDG
      accumulation in comparison with regional myocardial perfusion assessed with
      oxygen-15-water and oxidative metabolism assessed with carbon-11-acetate in nine
      normal subjects (four studied after a 5-hr fast and five studied both fasted and
      following glucose loading). Under fasting conditions, myocardial accumulation of
      FDG in the septum and anterior wall averaged 80% of that in the lateral and
      posterior walls (p less than 0.03). In contrast, after glucose loading the
      regional distribution of myocardial FDG accumulation became more homogeneous.
      Regional myocardial perfusion, oxidative metabolism, and accumulation of carbon
      11-acetate were homogeneous under both conditions. Thus, under fasting conditions
      there are regional variations in myocardial accumulation of FDG, which are
      visually apparent, are not associated with concomitant changes in oxidative
      metabolism or perfusion, and cannot be attributed to partial-volume effects. This
      significant heterogeneity may limit the specificity of PET with FDG for detecting
      myocardial ischemia in fasting subjects.

PMID- 2230988
TI  - Regional heterogeneity of cardiac substrate metabolism?

PMID- 2230989
TI  - Quantification of the reversibility of stress-induced thallium-201 myocardial
      perfusion defects: a multicenter trial using bull's-eye polar maps and standard
      normal limits.
AB  - A multicenter trial was performed on 140 patients from four centers to determine
      the accuracy of quantitative analysis of stress/delayed thallium-201 myocardial
      tomograms using normal limits to assess the relative amount of reversibility of
      stress-induced defects. The patients were found to have 85 fixed and 124
      reversible defects, as determined by visual interpretation. Reversibility bull's
      eye polar maps were compared to gender-matched normal limits from 36 normals.
      Regions were identified as reversible if their normalized difference between
      stress and 4 hr greater than 1.5 s.d.s. from the mean normal limits. Overall
      agreement between experts at multicenter sites and reversibility maps was 73% for
      reversible defects and 80% of fixed defects. Sensitivity in detecting
      reversibility was highest for the left circumflex (88%) and lowest for the right
      coronary (60%). These results indicate that reversibility polar maps and normal
      limits offer an objective, accurate technique for determining the reversibility
      of stress-induced perfusion defects.

PMID- 2230990
TI  - Limited precision of lumbar spine dual-photon absorptiometry by variations in the
      soft-tissue background.
AB  - The estimation error due to variations in soft-tissue baseline in lumbar bone
      mineral content (BMC) measured by dual-photon absorptiometry (DPA) was calculated
      with a new method of automatic baseline subtraction. In water phantom
      measurements, the s.d. of the soft-tissue (ST) baseline matched closely (r =
      0.98) to the random error, calculated using 44 keV and 100 keV count rates and
      the directly determined baseline variations. In 21 volunteers and in 70 patients
      with osteoporosis, the ST variations were larger than the expected random error,
      revealing a source of error related to the inhomogeneity of soft tissue. The
      estimation error in BMC caused by ST variations was 0.7% in healthy subjects
      (mean BMC 40.5 gHA) and 1.5% in patients (mean BMC = 26.4 gHA). These results
      indicate that ST-related errors are an important limit to the precision of lumbar
      DPA measurements.

PMID- 2230991
TI  - Dual-photon absorptiometry in clinical practice.

PMID- 2230992
TI  - Imaging of tumor in patients with indium-111-labeled biotin and streptavidin
      conjugated antibodies: preliminary communication.
AB  - Tumor localization in patients has been achieved through the in vivo use of
      streptavidin and biotin. In these preliminary studies, the monoclonal antibody
      HMFG1 was conjugated with streptavidin and 1 mg was administered intravenously to
      each of 10 patients with documented squamous cell carcinoma of the lung. Two to 3
      days later, 111In-labeled biotin was also administered intravenously. No evidence
      of toxicity was observed. Background radioactivity levels were reduced in liver
      (1% ID at 24 hr) and kidneys (2%) and in all other normal tissues and blood.
      Images of lung tumor were obtained in as little as 2 hr following administration
      of labeled biotin. In eight patients, tumor was detected with labeled biotin
      alone without the previous administration of streptavidin-conjugated antibody but
      in three of these patients, the images were improved with the prior
      administration of conjugated antibody. These results suggest that this approach
      may improve the tumor-to-normal tissue radioactivity ratios in
      radioimmunotargeting.

PMID- 2230993
TI  - Immunoscintigraphy of ovarian cancer with indium-111-labeled OV-TL 3 F(ab')2
      monoclonal antibody.
AB  - The safety and diagnostic accuracy of immunoscintigraphy with the indium-111
      labeled monoclonal antibody OV-TL 3 F(ab')2(111In-OV-TL 3 F(ab')2) for diagnosis
      and follow-up of ovarian cancer was prospectively studied in 31 patients. Planar
      and SPECT scintigraphy were performed up to 4 days after i.v. injection of 140
      MBq 111In-OV-TL 3 F(ab')2. Surgical evaluation was possible in 22 out of 31
      patients. Imaging results were compared with X-ray computed tomography,
      ultrasound, and CA 125 serum level using the histologically confirmed surgical
      findings as a "gold standard." Apart from a transient rash observed in two
      patients, no other immediate or delayed adverse reactions were observed. Within
      the surgically evaluated group, ovarian cancer lesions were detected in 16 out of
      17 patients (94%). Of 45 distinct tumor deposits found at operation, 67% were
      detected and localized with immunoscintigraphy while X-ray computed tomography
      and ultrasound visualized 53% and 23%, respectively.

PMID- 2230994
TI  - Myocardial accumulation of iodinated beta-methyl-branched fatty acid analogue,
      iodine-125-15-(p-iodophenyl)-3-(R,S)methylpentadecanoic acid (BMIPP), in relation
      to ATP concentration.
AB  - To clarify the relationship between the myocardial accumulation of 125I-15-(p
      iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and intracellular adenosine
      5'-triphosphate (ATP) content, the effect of 2,4-dinitrophenol (DNP, an electron
      transport uncoupler) on myocardial BMIPP accumulation was studied, in comparison
      with that of thallium-201-chloride (201Tl-Cl). In the mouse myocardium, DNP
      decreased the intracellular ATP and ADP levels, without affecting either acyl-CoA
      synthetase activity or the level of CoA-SH. Following treatment with DNP,
      decreases in myocardial BMIPP accumulation correlated well with those of ATP,
      while 201Tl-Cl showed slightly increased accumulation in the myocardium. Thus, in
      some diseases, BMIPP may be useful in evaluating myocardial ATP levels.

PMID- 2230996
TI  - The potential of 2-deoxy-2[18F]fluoro-D-glucose (FDG) for the detection of tumor
      involvement in lymph nodes.
AB  - To assess the potential of FDG for PET imaging of nodal tumor metastases, we
      evaluated its uptake into normal lymph nodes, tumor-involved lymph nodes, and
      subcutaneous tumor xenografts in rodents. Normal lymph nodes in mice and rats
      accumulate FDG moderately, developing node/blood ratios of 1.3-11.9/1 at 2 hr
      following i.v. injection. By contrast, FDG given subcutaneously to healthy
      Sprague Dawley rats developed very high normal draining lymph node/blood ratios
      (272/1) versus 7.7/1 by i.v. injection. In nude mice, subcutaneous human ovarian
      cancer xenografts had 1.27-fold more uptake relative to blood than did normal
      popliteal lymph nodes. Subcutaneous tumor xenografts of rat breast cancer
      developed tumor/normal node uptake ratios of 4.91 +/- 0.43/1 and tumor/blood
      ratios of 6.6 +/- 0.9 at 2 hr postinjection. Mouse nodes involved with 38C13
      murine B-cell lymphoma had mean node/blood ratios of 42.9 +/- 6.7/1 and tumored
      node/normal lymph node uptake of 6.3/1. Thus, FDG given intravenously but not
      subcutaneusly (due to high normal nodal uptake) has potential as an agent for the
      detection of metastatic tumors in regional lymph nodes using PET scanning.

PMID- 2230997
TI  - Axillary lymphoscintigraphy for breast cancer: should we do it? Can we do it?

PMID- 2230995
TI  - Metabolism of beta-methyl-heptadecanoic acid in the perfused rat heart and liver.
AB  - The metabolism of beta-methyl-[1-14C]heptadecanoic acid, a potential myocardial
      imaging agent, was investigated in perfused hearts and livers from rats. Hepatic
      uptake is approximately 4.5 times greater than cardiac uptake. In the heart, 66%
      of beta-methyl-heptadecanoic acid metabolism occurs via omega-oxidation, 33% by
      esterification and less than 1% via alpha-oxidation. In contrast, 53% of hepatic
      metabolism of beta-methyl-heptadecanoic acid occurs via alpha-oxidation, 27% via
      omega-oxidation, and 20% via esterification. Perfusion of hearts and livers with
      concentrations of beta-methyl-heptadecanoic acid 100 to 1000 times greater than
      that used for myocardial imaging does not alter any of the physiological and
      biochemical parameters measured. In the perfused liver, 3-methyl-[1-14C]glutarate
      was identified as the principal hydrosoluble catabolite of beta-methyl
      heptadecanoic acid.

PMID- 2230998
TI  - Complex partial epilepsy: the role of neuroimaging in localizing a seizure focus
      for surgical intervention.

PMID- 2230999
TI  - Diagnostic use of angiotensin converting enzyme (ACE)-inhibited renal
      scintigraphy in the identification of selective renal artery stenosis in the
      presence of multiple renal arteries: a case report.
AB  - In patients with renovascular hypertension, it is unknown whether the angiotensin
      converting enzyme-(ACE) inhibited renal scan will identify stenosis of a
      segmental branch of a single renal artery or of an accessory artery where
      multiple renal arteries are present. Since multiple renal arteries may be present
      in approximately 25% of all individuals, it will be important to establish
      whether the ACE-inhibited renal scan is useful in this population. We report a
      case of stenosis involving a renal artery in a patient with multiple renal
      arteries, successfully identified by ACE-inhibited renal scintigraphy.

PMID- 2231000
TI  - Myocardial uptake of indium-111-labeled antimyosin in acute subendocardial
      infarction: clinical, histochemical, and autoradiographic correlation of
      myocardial necrosis.
AB  - Indium-111-labeled antimyosin has been utilized in the diagnosis and localization
      of acute transmural myocardial infarction. The present report describes a patient
      who presented with a massive subendocardial infarction. Two days after the
      injection of antimyosin, the patient's clinical status markedly deteriorated and
      he expired. Postmortem examination demonstrated severe three-vessel coronary
      artery disease with extensive myocyte death in the endocardium. Autoradiography
      and histochemical staining of the prosected heart demonstrated high correlation
      for myocardial necrosis and corresponded to clinical evidence for diffuse
      subendocardial infarction.

PMID- 2231001
TI  - Radioimmunoscintigraphy using iodine-131-anti-CEA monoclonal antibodies and
      thallium-201 scintigraphy in medullary thyroid carcinoma: a case report.
AB  - This case report demonstrates the use of thallium-201 (201Tl) scans versus iodine
      131- (131l) anti-CEA F(ab')2 scans in a patient with high serum CEA levels due to
      metastases of medullary thyroid carcinoma in the suprarenal region and
      sacroiliacal region. Scintigraphy using monoclonal antibodies directed against
      CEA showed a higher tumor uptake (0.26% dose and 0.64% dose, respectively) than a
      thallium scan and is believed to be promising for future radiotherapeutic
      applications.

PMID- 2231002
TI  - Reconstruction of Fourier coefficients: a fast method to get polar amplitude and
      phase images of gated SPECT.
AB  - Gated SPECT (GASPECT) during radionuclide ventriculography (RNV) is a time
      consuming procedure requiring extended hard- and software. Furthermore, the
      procedure suffers from poor count statistics. Our method tries to overcome these
      difficulties by exploiting the count summation effect of Fourier analysis. The
      sine and cosine coefficients of the first harmonic are extracted from the gated
      views and reconstructed. This, in fact, results in an improvement of the count
      statistics by a factor of four combined with a tremendous reduction of disc space
      requirements. Using short-axis slices, bull's-eye plots of the amplitude and
      phase of the left ventricle are calculated. Cardiac functions and localization
      and extent of any malfunction are documented three-dimensionally without
      superposition.

PMID- 2231003
TI  - "CORT-EX:" a program for quantitative analysis of brain SPECT data.
AB  - A program was developed to extract from brain SPECT data global as well as
      regional concentrations of a radiopharmaceutical while allowing for improved
      subjective evaluation of its distribution. This program was used to process the
      data obtained from 17 normal subjects, 20 min, 2 hr, and 4 hr after the injection
      of iodine-labeled iodoamphetamines. The mean absolute cortical uptake at these
      three time periods was 0.921 (+/- 0.185), 0.803 (+/- 0.107), and 0.748 (+/-
      0.103) in arbitrary units (+/- s.d.), respectively. The regional distribution of
      the tracer became more uniform with time due to an uneven washout rate. The
      cerebellum was noted to have a very high variability in its uptake and a high
      washout rate, making it unsuitable as an internal standard for relative
      quantification. Finally, a repeat study was performed on 10 subjects. No
      significant difference could be demonstrated in the mean uptake of the group at 2
      and 4 hr, however the difference observed in the 20 min uptake values was
      significant at the p = 0.05 level.

PMID- 2231004
TI  - Evaluation of techniques for the elimination of "hot" bladder artifacts in SPECT
      of the pelvis.
AB  - The purpose of this study was to validate the usefulness of two digital filtering
      techniques used to eliminate the artifacts caused by rapid bladder filling during
      SPECT of the pelvis. A dynamic phantom model was used containing two hips and a
      bladder. The phantom was studied under three conditions--bladder empty, filling,
      and full. The ability of the pixel truncation and interpolative background
      replacement techniques to eliminate bladder artifacts was assessed. Both
      techniques gave similar results and resulted in significant (but not complete)
      recovery of activity in the hips. Quantitative analysis of pixel counts over each
      hip shows that the measured activity was variable and approximately 20%-30% less
      than that seen in the empty bladder study. The use of left/right ratio to
      quantitate differences in hip activity was highly inaccurate despite the use of
      these filtering techniques. In summary, while these techniques significantly
      improve image quality, caution should be exercised, particularly in the
      evaluation of the medial aspects of the hips.

PMID- 2231005
TI  - Three-dimensional assessment of myocardial oxidative metabolism: a new approach
      for regional determination of PET-derived carbon-11-acetate kinetics.
AB  - We have developed a new analysis algorithm which generates polar coordinate maps
      of myocardial carbon-11-(11C) acetate kinetics. In 10 normal subjects (n = 20
      studies), myocardial 11C clearance rate constants (k) averaged 0.057 +/- 0.009
      (per minute). Regional k-values varied only 10.6 +/- 2.4% in the normal left
      ventricle. However, there was a small but significant segmental variation with
      increased 11C clearance in the septal, anterior, and basal regions (p less than
      0.05). Since 11C clearance rates reflect tri-carboxylic acid cycle flux, these
      results suggest that myocardial oxidative metabolism is relatively homogeneous in
      the normal human heart at rest with minor regional variations, which possibly
      reflect varying regional wall stresses or substrate utilization. The proposed
      approach provides three-dimensional evaluation of regional oxidative metabolism
      which will permit characterization of the location, extent, and severity of
      myocardial disease.

PMID- 2231006
TI  - Treatment planning for internal radionuclide therapy: three-dimensional dosimetry
      for nonuniformly distributed radionuclides.
AB  - A calculational approach is described that provides the spatially varying
      radiation absorbed dose, presented as isodose contours superimposed on CT images,
      from nonuniform and/or irregular cumulated activity distributions. CT images are
      read from magnetic tape and are displayed on a high-resolution color graphics
      display monitor. Source tissue geometries are defined on a series of contiguous
      CT images automatically (by an edge detection algorithm) or manually (using a
      trackball), thereby obtaining a three-dimensional representation of the various
      source volumes of activity. Dose calculations are performed using a radionuclide
      specific absorbed dose point kernel in the form of a lookup table. The method
      described yields the spatially varying dose delivered to tumor and normal tissue
      volumes from a patient-specific cumulated activity distribution in a clinically
      implementable manner. This level of accuracy in determining normal tissue and
      tumor doses may prove valuable in the evaluation and implementation of
      radionuclides and radiolabeled compounds for therapeutic purposes.

PMID- 2231008
TI  - Defective parallel-hole collimator encountered in SPECT: a suggested approach to
      avoid potential problems.

PMID- 2231007
TI  - Preparation of technetium-99m-HMPAO.

PMID- 2231009
TI  - NRC issues interim rule on medical use of radionuclides.

PMID- 2231010
TI  - Ambulatory care. An objective assessment.
AB  - Budget constraints, loss of staff, and the inability of administrators to define
      nursing needs in the outpatient department lead to the development of a tool to
      define the role of the healthcare provider in the outpatient department. The
      author discusses the tool's use in categorizing and quantifying nursing
      activities. Administrators in ambulatory care now have an opportunity to use this
      readily adaptable method in their outpatient areas to assist in developing
      quality, cost-effective nursing.

PMID- 2231011
TI  - Nursing research utilization techniques.
AB  - The author reviews the literature to identify techniques for the facilitation of
      nursing research utilization. Nine general themes were employed to organize
      techniques. Techniques within each theme may be implemented by individual nurses,
      small groups, or organizations. The review supports the need for the concerted
      efforts of the entire profession to implement research findings into practice.

PMID- 2231012
TI  - Planning your replacement budget.

PMID- 2231013
TI  - Evaluation: myths, mystiques, and obsessions.
AB  - Nurse executives, administrators, and managers are constantly being challenged by
      the changes in healthcare. Although it sometimes seems there is really nothing
      new, proactive visionary nurse administrators can rediscover, redesign, and
      redirect their own and others' activities to achieve organizational
      effectiveness. Such approaches require periodic examination of all strategies and
      practices--past, present, and future--for their relevance, practicality, and
      success. The editors of "Executive Development" reflect on topics important to
      organizational life.

PMID- 2231014
TI  - Team nursing revisited.
AB  - The use of team nursing as a model of nursing care is being reconsidered by many
      nurse executives as a strategy to meet patient needs while efficiently using
      nursing resources. The author examines the historical development and original
      concepts of team nursing, discusses problems that led to the criticism of team
      nursing, and suggests ways in which team nursing can be enhanced for future use.

PMID- 2231015
TI  - The impact of the 23-hour patient on nursing workload.
AB  - Decreasing length of in-patient stay and increasing the number of outpatient
      procedures being performed has led to the creation of the 23/24-hour observation
      patient. In this study, the authors show that the addition of observation
      patients to aggregate workload data causes a meaningful staffing deficit 60-90%
      of the time in three out of four clinical areas studied. The authors explore the
      statistical impact on staffing of the addition of observation patients to
      aggregate inpatient data and provide several strategies for staffing.

PMID- 2231016
TI  - Marketing the home healthcare agency. Do nurses and physicians agree?
AB  - Increasingly, hospital nurse administrators are being called upon to organize and
      implement home care services and to market these services to physicians,
      patients, and family members. A survey of hospital personnel revealed that both
      nurses and physicians perceived themselves as the persons primarily responsible
      for determining the patient's need for postdischarge home care. In listing
      criteria for selecting a home care agency for patient referral, nurses and
      physicians rated service dependability and nursing care quality as the most
      important criteria.

PMID- 2231017
TI  - Failure to demonstrate an effect of dietary fatty acid composition on body
      weight, body composition and parameters of lipid metabolism in mature rats.
AB  - The objectives of the present study were to examine the effects of dietary fatty
      acid composition on body composition and on several parameters of lipid
      metabolism in adipose tissue and to assess the ease of weight loss with
      restricted dietary intake. Rats were fed diets containing 14% fish oil, safflower
      oil or beef fat plus 2% corn oil. These diets were fed ad libitum for 4 wk (first
      phase). A number of the animals from each group were killed, and the others were
      fed 50% of their first-phase food intake for an additional 4 wk (second phase).
      The diets used in the second phase contained 3% of the above fats plus 2% corn
      oil. Food consumption, food efficiency and body weights were monitored. After the
      rats were killed, fatty acid composition of epididymal fat pads was examined. In
      addition, in vivo lipolysis and in vitro lipogenesis in epididymal fat pads were
      examined. The results indicate that dietary fatty acid composition had no effect
      on body weight, food consumption, in vivo lipolysis and in vitro lipogenesis in
      epididymal fat pads. In addition, although dietary fatty acid manipulation
      resulted in alteration in adipose tissue fatty acid composition, it had no effect
      on the rate of weight loss, body composition, in vivo lipolysis and in vitro
      lipogenesis in epididymal fat pads. It is concluded that dietary fatty acid
      composition does not play a role in body composition and in lipid metabolism in
      adipose tissue of mature rats.

PMID- 2231018
TI  - Pectin isolated from prickly pear (Opuntia sp.) modifies low density lipoprotein
      metabolism in cholesterol-fed guinea pigs.
AB  - The effect of prickly pear soluble fiber on low density lipoprotein (LDL)
      metabolism was investigated by feeding male guinea pigs either a nonpurified diet
      containing 0.25% cholesterol (HC diet) or the HC diet + 1% prickly pear pectin
      (HC-P diet). Plasma cholesterol levels were significantly decreased by the HC-P
      diet, with a 33% decrease in LDL levels (p less than 0.02) and an increase in LDL
      density. Hepatic free and esterified cholesterol levels were reduced 40 and 85%,
      respectively (p less than 0.002), by the HC-P diet. Hepatic microsomal 3-hydroxy
      3-methylglutaryl coenzyme A reductase levels were not different. 125I-LDL binding
      to hepatic membranes was increased 1.7-fold by the HC-P diet (p less than 0.001),
      with receptor affinity (Kd) being unaltered and receptor number (Bmax) being
      significantly increased (p less than 0.001). These data suggest that prickly pear
      pectin may act by a mechanism similar to that of bile acid-binding resins in
      lowering plasma cholesterol levels. The observed reduction in LDL and hepatic
      cholesterol levels and increase in LDL density and hepatic apolipoprotein B/E
      receptors are responses suggesting an increased demand on hepatic cholesterol
      from increased excretion of bile acids and interruption of the enterohepatic
      circulation.

PMID- 2231019
TI  - Less body fat accumulation in rats fed a safflower oil diet than in rats fed a
      beef tallow diet.
AB  - The effects on body fat accumulation of long-term feeding of high fat diets of
      differing fatty acid composition were studied in rats. The rats were meal-fed
      isoenergetic diets based on safflower oil or beef tallow for 4 mo. Each diet was
      freshly prepared every day throughout the experimental period. Oxygen consumption
      and carbon dioxide production for 6 h after meals were measured between the 50th
      and 54th d of the experimental period. Oxygen consumption for 3 h after meals was
      significantly greater in the safflower oil diet group than in the beef tallow
      diet group, indicating greater diet-induced thermogenesis in the former group.
      From the assessment of respiratory quotient, the fat oxidation rate was also
      higher in the former. After the experimental period (4 mo), body fat accumulation
      was significantly less in the rats fed safflower oil. This difference was, at
      least in part, ascribed to increased diet-induced thermogenesis and fat
      oxidation. Serum triacylglycerol level was markedly lower in the rats fed
      safflower oil than in those fed beef tallow. The lipoprotein lipase activities in
      heart and soleus muscle after meals appeared to be higher in the former than in
      the latter. These results suggest that the consumption of the safflower oil diet
      increased lipoprotein lipase activity in heart and skeletal muscle, resulting in
      the elevation of fat oxidation rate and the depression of serum triacylglycerol
      level.

PMID- 2231020
TI  - Plasma amino acids and cholesterol following consumption of dietary casein or soy
      protein in minipigs.
AB  - Numerous investigators have claimed that protein-induced differences in plasma
      cholesterol are mediated by differences in amino acid composition. We have
      explored whether the venous postprandial amino acid profile reflects differences
      in the amino acid composition of the protein consumed. Six adult Gottingen
      miniature pigs were fed a semisynthetic diet based on either casein or soy
      protein isolate. Frequent blood sampling was performed over a whole day after
      consumption of each diet for 6 wk. Postprandial plasma amino acid concentrations
      reached their maxima within the first 3 h. A group of eight protein amino acids
      (Met, Arg, Tyr, Val, Trp, Leu, Lys and Cys) exhibited the most marked and
      significant protein-dependent differences during this early postprandial phase,
      whereas Thr and His showed less marked differences. With one exception (Ser) all
      protein amino acids exhibited venous plasma concentration changes in qualitative
      accordance with their content in the dietary protein consumed. In quantitative
      terms, however, venous plasma amino acid changes were less marked than expected
      from the amino acid composition of the dietary proteins. We conclude that neither
      the considerable number of amino acids showing differences as reported herein nor
      the multitude of contradictory reported by others concerning single amino acids
      affecting serum cholesterol favor the hypothesis that one or several amino
      acid(s) cause protein-induced hypercholesterolemia.

PMID- 2231021
TI  - Comparison of effects of dietary glucose versus fructose during pregnancy on
      fetal growth and development in rats.
AB  - Dietary carbohydrate during pregnancy is essential. Whether this requirement is
      specific to glucose was investigated. We examined whether fructose at low,
      intermediate and high levels can substitute for an isoenergetic amount of glucose
      by feeding graded levels of both carbohydrates (0, 4, 12, 60%) in a triglyceride
      based diet throughout pregnancy. It was concluded that the carbohydrate
      requirement for the rat during pregnancy is not specific to glucose and that the
      level, not the type, of carbohydrate was critical (experiment 1). A second aspect
      of the study (experiment 2) was the comparison of isoenergetic, low carbohydrate
      diets containing different sources of 4% glucose equivalents: glucose, fructose
      or lipid-glycerol. Fructose and lipid-glycerol were not equivalent substitutes
      for glucose in the pregnant rat dam at these very low intakes.

PMID- 2231022
TI  - Relationship between blood, liver and brain pyridoxal phosphate and pyridoxamine
      phosphate concentrations in mice.
AB  - Plasma pyridoxal 5'-phosphate (PLP) concentrations are considered to be the most
      reliable single indicator of vitamin B-6 nutritional status and are thought to
      reflect tissue PLP and pyridoxamine 5'-phosphate (PMP) levels. We investigated
      the relationship between dietary level of pyridoxine hydrochloride (PN-HCl) and
      concentrations of PLP in blood and PLP and PMP in liver and brain of mice. Female
      heterogeneous stock mice, 60 to 90 d old, were fed purified diets containing 0.5,
      1.0, 2.0, 3.0, 5.0, or 7.0 mg PN-HCl/kg diet for 5 wk. PLP and PMP concentrations
      were determined by a spectrophotometric apotryptophanase assay. PLP content of
      plasma, erythrocytes, whole blood, liver and brain and PMP levels in liver and
      brain were highly correlated with dietary level of PN-HCl (r values ranged from
      0.81 to 0.94, n per correlation = 32 to 43). By using the entire range of dietary
      levels of PN-HCl, both plasma and erythrocyte PLP were found to be significantly
      correlated with tissue PLP and PMP concentrations. For any one dietary level,
      however, correlations between plasma or erythrocyte PLP and tissue PLP and PMP
      concentrations were low and nonsignificant. These results suggest that plasma PLP
      levels may be suitable to determine vitamin B-6 status of populations, but not to
      reliably predict tissue concentrations of PLP or PMP in individuals.

PMID- 2231023
TI  - Dependence of vitamin B-6 status assessment on alcohol intake among elderly men
      and women (Dutch Nutrition Surveillance System).
AB  - To obtain more insight into the effect of moderate alcohol intake on vitamin B-6
      status indicators, we studied the associations of alcohol intake (unadjusted and
      adjusted for intake of vitamin B-6 and protein) with the erythrocyte aspartate
      aminotransferase activation coefficient (EAST-AC) and plasma pyridoxal 5'
      phosphate (PLP) level. Data obtained from men (n = 224) and women (n = 217) aged
      65-79 (nationwide sample in the Netherlands) were used for this purpose. Although
      alcohol intake (a maximum of 21% of the energy came from alcohol) tended to be
      positively associated with PLP, this association never reached statistical
      significance (p greater than or equal to 0.05). EAST-AC was inversely associated
      with alcohol intake, whether or not it was adjusted for vitamin B-6 and protein
      intake. Similar results were found for the total EAST activity (after adding PLP)
      or apoenzyme activity; the basal EAST activity (before adding PLP) or holoenzyme
      activity was not associated with the alcohol intake. These results indicate that
      caution is needed in the interpretation of the specificity of EAST-AC (i.e., the
      degree to which EAST-AC is unaffected by other factors) as an indicator of
      vitamin B-6 intake.

PMID- 2231024
TI  - Relationship between vitamin B-6 status and elevated pyridoxal kinase levels
      induced by theophylline therapy in humans.
AB  - Theophylline administration to seven healthy male volunteers resulted in a rapid
      and significant decline in both plasma and erythrocyte pyridoxal-5'-phosphate
      levels. Total erythrocyte pyridoxal kinase levels increased during 15 wk of
      theophylline treatment from a mean initial activity of 19.23 +/- 5.03 (mean +/-
      SD) to 62.64 +/- 11.59 nmol pyridoxal-5'-phosphate formed/(g hemoglobin.h).
      Although plasma pyridoxal levels remained normal, the threefold increase in total
      erythrocyte pyridoxal kinase activity levels did not normalize plasma and
      erythrocyte pyridoxal-5'-phosphate levels. Pyridoxal-5'-phosphate hydrolysis was
      not affected by theophylline therapy. Increased pyridoxal oxidation was confirmed
      by elevated urinary 4-pyridoxic acid excretion after 15 wk of theophylline
      treatment. Mean erythrocyte alanine aminotransferase activity declined by 70%,
      and aspartate aminotransferase activity declined by 50%, indicating that
      decreased availability of pyridoxal-5'-phosphate can have widespread metabolic
      consequences. We conclude that the effect of theophylline on vitamin B-6
      metabolism is not transitory and cannot be overcome by elevated intracellular
      levels of pyridoxal kinase. However, pyridoxine supplementation (10 mg/d for 1
      wk) normalized indices of vitamin B-6 status and reversed the downward trend in
      both alanine aminotransferase and aspartate aminotransferase activity levels.

PMID- 2231025
TI  - Effects of dietary minerals on acid-base balance and eggshell quality in
      chickens.
AB  - Three experiments were conducted in hens to determine the effects of high levels
      of dietary phosphorus (P, 1-1.5%), chloride (Cl, 0.8%) or both on acid-base
      balance and eggshell quality and to consider whether any adverse effects on
      eggshell quality can be attributed to alteration of blood acid-base balance.
      Eggshell quality and values for a blood indicator of acid-base balance were
      reduced by high levels of dietary P or Cl in all of the experiments. Eggshell
      quality and values for the blood acid-base indicator were further reduced by high
      dietary levels of the combination of minerals. The adverse effects associated
      with high levels of the combination were greater than the sum of adverse effects
      associated with high levels of each mineral. The effects of P and Cl on plasma
      levels of these minerals were inconsistent and varied among experiments. The use
      of pair-fed controls revealed that the adverse effects of combined P and Cl on
      eggshell quality and acid-base balance were independent of their effects on feed
      and calcium intake. Calcium excretion was increased by consumption of the high P,
      high Cl diet. The information obtained from these experiments suggests that the
      adverse effects of high levels of dietary P and/or Cl on eggshell quality may be
      due, at least in part, to increased Ca excretion. This, in turn, may be mediated
      by acidemia resulting from the dietary manipulations, although the present data
      were insufficient to provide a direct link between acidemia and Ca excretion.

PMID- 2231026
TI  - Effects of cellular copper content on copper uptake and metallothionein and
      ceruloplasmin mRNA levels in mouse hepatocytes.
AB  - The intracellular copper content of mouse hepatocytes has been altered by
      incubating with either increasing amounts of extracellular copper or increasing
      amounts of diamsar, a copper chelator. Metallothionein 1 (MT1) and MT2 mRNA
      levels in the cells increased in proportion to the intracellular copper
      concentration. The degree of stimulation was similar for both MT1 and MT2, with
      mRNA levels increasing approximately fourfold for a six- to eightfold increase in
      intracellular copper levels. In contrast, neither copper uptake nor ceruloplasmin
      mRNA showed any response to intracellular copper levels. Unlike the situation in
      the rat, there was no clear evidence for saturation of copper uptake. Incubating
      cells with increasing amounts of 64Cu resulted in a linear increase in the amount
      taken up over 2 h. The amount of 64Cu accumulated was the same in control and
      copper-depleted cells, which suggests that neither ceruloplasmin production nor
      copper uptake is regulated by intracellular copper levels. However, other
      possibilities, such as the chelators not being able to deplete the pool(s)
      responsible for the control of ceruloplasmin production or copper uptake, must
      also be considered.

PMID- 2231027
TI  - Response of hormones modulating plasma cholesterol to dietary casein or soy
      protein in minipigs.
AB  - To elucidate the mechanism mediating the effect of dietary casein or soy protein
      on serum cholesterol concentrations we followed the endocrine response to the
      intake of these dietary proteins. The hormones analyzed were those known to
      modulate serum cholesterol concentration. A 7-wk crossover nutrition study was
      performed with six adult Gottingen minipigs consuming semisynthetic diets based
      on either 20 wt% casein or soy isolate. At d 42 and 49, concentrations of six
      hormones were determined in 22 blood samples taken over the whole day. There were
      no significant differences in insulin, glucagon, the insulin/glucagon ratio,
      hydrocortisone or triiodothyronine among dietary groups. In the late postprandial
      phase (5 h after the meal and later) there were significantly higher growth
      hormone concentrations in soy-fed animals. At all times of the day, total and
      free thyroxine concentrations were higher after soy feeding than after casein
      feeding. On average, total and free thyroxine concentrations were 34 and 26%
      higher with soy protein feeding than with casein feeding. Our data agree with
      other reports of protein-dependent changes of thyroid hormones and may explain
      why different dietary proteins have different effects on serum cholesterol levels
      in sensitive species.

PMID- 2231028
TI  - Effects of dietary restriction on age-related immune dysfunction in the
      senescence accelerated mouse (SAM).
AB  - The effects of age and dietary restriction on immune response were investigated
      using an animal model of accelerated senescence (senescence accelerated mouse,
      SAM). The experimental groups consisted of control (ad libitum fed) and
      restricted groups (fed 60% of energy intake of the controls). Spleen weight and
      total number of splenic cells were significantly lower in the food-restricted
      group at 8 mo of age. Percentages of T (Thy-1.1+) and B (surface Ig+) cells in
      the splenic cells were not significantly different between the two groups. The
      number of direct hemolytic plaque-forming cells per 10(6) spleen cells 4 d
      following immunization with sheep red blood cells and dinitrophenyl-Ficoll was
      significantly greater in the 8-mo-old mice in the food-restricted group than in
      the control group. In the latter group, antibody responses Progressively
      decreased with age. Mitogen responses to concanavalin A and lipopolysaccharide
      were maintained in the food-restricted group but were depressed in the control
      group at 8 mo. In addition, though autoantibody to single-stranded DNA increased
      in the control group with advancing age, there was a steady decrease in the food
      restricted group until 8 mo. Serum immunoglobulin (IgA and IgM) concentrations
      were significantly lower in the food-restricted group than in controls at 8 mo of
      age. Therefore, our results suggest that when senescence accelerated mice are
      subjected to food restriction, there may be a modulatory effect on the immune
      dysfunction associated with advancing age.

PMID- 2231029
TI  - Dietary energy restriction in mice reduces hepatic expression of glucose
      regulated protein 78 (BiP) and 94 mRNA.
AB  - The influence of life span-prolonging dietary energy restriction on hepatic
      expression of glucose-regulated protein 78 and 94 (GRP78 and GRP94) RNA was
      investigated in female C3B10RF1 mice. Mice were either fed ad libitum or fed
      diets reduced 20 or 40% in energy but containing approximately equivalent amounts
      of protein, fats, vitamins and minerals. Aging produced no changes in GRP mRNA.
      However, GRP78 and GRP94 mRNA levels were reduced approximately 50 and 40%,
      respectively, by 40% energy restriction. This level of energy restriction
      produced a 43% reduction in the mean plasma glucose levels of young and old mice.
      The changes in GRP mRNA expression appear to be specific, because the levels of
      these RNAs were normalized to the level of polyadenylated RNA, and no changes
      were detected in the levels of a number of other mRNAs. Although extreme glucose
      deprivation increases GRP mRNA levels in cultured cell lines, physiologically
      relevant reductions in blood glucose had the opposite effect in the liver, in
      vivo. The regulatory pathway responsible for these effects is not known. GRP mRNA
      levels are elevated by agents that increase the level of malfolded proteins in
      the endoplasmic reticulum. Thus, energy restriction may act to reduce malfolded
      proteins in the endoplasmic reticulum of hepatic cells.

PMID- 2231030
TI  - Macronutrient selection in rats: effect of fat type and level.
AB  - The effect of type and level of dietary fat on subsequent diet selection was
      examined in young Sprague-Dawley rats. Isoenergetic, isonitrogenous diets
      composed of corn oil or tallow (commercial grade), each at 5 or 34%, were fed to
      rats for 2 wk, and their preference for diets covarying in carbohydrate and
      protein was subsequently tested. When compared to either of the corn oil groups
      or the 5% tallow group, rats previously fed the high tallow diet selected more
      protein and less carbohydrate. Subsequent experiments testing the effects of 5,
      20 or 34% tallow indicated that this preference for protein was induced by
      exposure to the tallow diets for only 18 h. In addition, the 34% tallow group
      selected more protein than did rats fed 5 or 20% tallow. Tests of diet selection
      with 5 or 34% corn oil, tallow or hydrogenated coconut oil indicated that rats
      fed 34% tallow ate significantly more protein than the 34% corn oil group.
      Furthermore, animals fed a 34% pure, additive-free tallow diet exhibited a
      preference for protein. These studies suggest that the type and level of dietary
      fat interact to influence dietary selection.

PMID- 2231031
TI  - Pteroylpolyglutamate concentration and glutamyl chain length in rat tissues.

PMID- 2231032
TI  - Impact of the availability of a prior electrocardiogram on the triage of the
      patient with acute chest pain.
AB  - STUDY OBJECTIVE: To determine whether information from a prior electrocardiogram
      (ECG) improves diagnostic accuracy in the emergency department (ED) evaluation of
      patients with acute chest pain. DESIGN: Analysis of prospectively collected data
      from a cohort study. SETTING: Emergency departments of four community and three
      university hospitals. PATIENTS: 5,673 patients aged greater than or equal to 30
      years who presented to the EDs of participating hospitals for evaluation of acute
      chest pain, including 772 (14%) with acute myocardial infarction (AMI).
      MEASUREMENTS AND MAIN RESULTS: After adjusting for clinical characteristics, no
      significant difference was found in the sensitivities of admission to the
      hospital or to the coronary care unit (CCU) between AMI patients with and without
      prior ECGs available for review. However, non-AMI patients with prior ECGs
      available for review were more likely to avoid CCU admission than were non-AMI
      patients without prior ECGs. This improvement in specificity was most marked in
      the 2,024 patients whose current ED ECGs had changes consistent with ischemia or
      infarction: when a prior ECG was available, non-AMI patients were more than twice
      as likely to be discharged (26% vs. 12%) and about 1.5 times as likely to avoid
      CCU admission (39% vs. 27%) (both p less than 0.0001). Admission rates of AMI
      patients with and without prior ECGs were similar. CONCLUSION: When the current
      ECG is consistent with ischemia or infarction, the availability of a prior ECG
      for comparison to determine whether the ECG changes are old or new improves
      diagnostic accuracy and triage decisions by reducing the admission of patients
      without AMI or acute ischemic heart disease (increased specificity) without
      reducing the admission of patients with these diagnoses (unchanged sensitivity).

PMID- 2231033
TI  - Needlestick injuries among resident physicians.
AB  - OBJECTIVE: To assess the frequency and causes of needlestick injuries in medical
      and surgical housestaff. DESIGN: A retrospective survey. SETTING: Urban
      university teaching hospital. PARTICIPANTS: 386 housestaff; 221 responded.
      INTERVENTION: Survey questionnaire. MAIN RESULTS: 1) Frequency of needlestick: Of
      221 respondents, 57 (26%) reported never having had a needlestick, while 164
      (74%) reported at least one needlestick injury with a suture or hollow-bore
      needle. The average frequencies were 0.63 per resident-year among 149 non
      surgical residents and 3.8 per resident-year among 72 surgical residents. Among
      residents in internal medicine, 12 of 78 needlestick injuries (15%) sustained
      were from patients documented to be HIV-positive. 2) Causes of needlestick: The
      causes of injury were assessed in detail in a sample of the 157 most recent
      needlestick injuries. Suturing was the cause in 35 of 61 (57%) surgical
      residents, while recapping needles was the cause in 36 of 96 (38%) non-surgical
      residents. Inexperience was not the cause of injury; in 94% of cases the
      residents felt comfortable performing the procedure, and in 74% of cases the
      residents had performed the procedure more than 50 times before. 3) Reporting of
      injury: Only 30 (19%) of 157 injuries were reported to the personnel health
      service, thus compromising documentation for potential workmen's compensation.
      CONCLUSIONS: Needlestick injuries are common among medical and surgical
      housestaff. Efforts should be made to prevent needlestick injuries and to report
      those that occur.

PMID- 2231034
TI  - Management of asymptomatic chronic aortic regurgitation with left ventricular
      dysfunction: a decision analysis.
AB  - STUDY OBJECTIVE: To determine the optimal strategy for the timing of aortic valve
      replacement in patients with chronic, severe aortic regurgitation with left
      ventricular dysfunction. DESIGN: Decision analysis comparing early surgery (timed
      at the onset of left ventricular dysfunction) with delayed surgery (timed at the
      onset of symptoms) using data from the literature and expert opinion for
      variables in a representative case scenario (40-year-old man with bicuspid aortic
      valve disease). SETTING: Tertiary care center doing valve replacement surgery.
      MEASUREMENTS AND MAIN RESULTS: The early-surgery approach was preferred based on
      quality-adjusted life years. Sensitivity analysis showed that the result was not
      affected by the following variables within their derived ranges: rate of symptom
      development after onset of left ventricular dysfunction for the delayed-surgery
      approach, perioperative mortality for both approaches, and occurrence of major
      nonfatal stroke or congestive heart failure for both approaches. Although the
      decision was sensitive to the yearly postoperative mortality rates, the delayed
      surgery operative mortality rate had to be almost as low as the early-surgery
      rate to change the preference to the delayed-surgery approach. The preference
      could also change if survival were much more important to the patient in the
      first five years than after five years or if the patient disliked living on
      anticoagulants enough to value a year on anticoagulants as worth only 80% of a
      year not on anticoagulants. CONCLUSION: This decision analysis provides
      quantitative support for the impression that patients similar to the case
      scenario do better with surgery timed at the onset of ventricular dysfunction
      than with surgery delayed until symptoms develop. It thus supports the practice
      of following these patients noninvasively in order to time surgery.

PMID- 2231035
TI  - Interpretation of graphic data by patients in a general medicine clinic.
AB  - OBJECTIVE: To assess how patients use graphic data to decide on preferences
      between alternative treatments. DESIGN: Cross-sectional survey of patients,
      physicians, and medical students. The physicians and medical students served as a
      control group with which to compare the patients' responses. SETTING: A
      university-based Department of Veterans Affairs Medical Center. PARTICIPANTS: 152
      patients seen in a general medicine clinic, 57 medical students, and 11
      physicians. MEASUREMENTS AND RESULTS: Subjects were given a survival graph
      showing the patient outcomes for two different unidentified treatments for an
      unidentified serious disease. They were asked to indicate which treatment they
      preferred and which portion(s) of the curves most influenced their preference. A
      large majority of both patients and health professionals preferred the treatment
      that had worse short-term and better long-term survival. Eleven percent of
      patients and 51% of health professionals identified mid-curve data (points other
      than the curve end-points) as most influencing their preferences. CONCLUSIONS: A
      graphic survival curve appears to provide enough information to assess patient
      preferences between two alternative treatments. Patients appeared to differ from
      physicians and medical students in their interpretation of the curves.

PMID- 2231036
TI  - Expert testimony based on decision analysis: a malpractice case report.
AB  - OBJECTIVE: Expert testimony in malpractice cases is often subjective and biased.
      Decision-analytic techniques might provide an objective basis for such testimony.
      DESIGN: Case report. This article reports the case of a patient with chest pain
      that resulted in a malpractice suit alleging a delay in diagnosis of coronary
      artery disease. SETTING: The case occurred in a private practice; the expert
      witnesses and the decision analysis originated from a university teaching
      hospital. METHODS: A decision tree and threshold analysis were used to define the
      thresholds of disease probability at which either testing or treatment should be
      implemented. The expert testimony of two witnesses that exercise stress testing
      was the standard of care was compared with the results of the decision analysis.
      MAIN RESULTS: Decision analysis supported the view that cardiac catheterization
      would have been the more appropriate test. CONCLUSIONS: Techniques of decision
      analysis provide a structured and quantitative basis for empirical judgment and
      may help to minimize current problems with expert testimony.

PMID- 2231037
TI  - The use of nurses to evaluate houseofficers' humanistic behavior.
AB  - OBJECTIVES: 1) To determine whether nurse evaluations of humanistic behavior
      discriminate between houseofficers in an internal medicine training program, and
      2) to compare nurse and attending physician evaluations. DESIGN: Prospective, six
      month comparison of nurse and attending ratings of houseofficer humanistic
      behavior. PROCEDURE: Using a six-item, Likert-scale humanistic behavior rating
      form, nurses and ward attendings evaluated 76 PGY-1, PGY-2, and PGY-3
      houseofficers over a six-month period. Nurses and attendings voluntarily
      evaluated houseofficers on all inpatient units in both university and Veterans
      Administration teaching hospitals. MEASUREMENTS AND MAIN RESULTS: Nurse ratings
      discriminated residents from one another throughout the six months of the study
      and over all units in both hospitals. Attending physician ratings were only
      moderately correlated with nurses' and were significantly more lenient.
      Exploratory analyses of the nursing evaluations revealed that female
      houseofficers received significantly more favorable evaluations than did men and
      that ward nurses were significantly more lenient than were critical care nurses.
      Nurse ratings did not differ by hospital, training year, or month of evaluation.
      CONCLUSIONS: Nurses can provide information about humanistic behavior that will
      allow program directors to discriminate among different levels of houseofficer
      behavior. Information from nurses differs from that provided by attending
      physicians. Nurse ratings are affected by gender and by the type of unit from
      which they are obtained.

PMID- 2231038
TI  - Residents' attitudes towards and skills in counseling: using undetected
      standardized patients.
AB  - OBJECTIVE: To identify the frequency and quality of certain prevention-oriented
      counseling skills of resident physicians and to compare these skills with the
      residents' attitudes towards and knowledge about primary prevention. DESIGN:
      Longitudinal descriptive study. PATIENTS/PARTICIPANTS: 54 PGY-1-3 internal
      medicine and family practice residents enrolled in three training programs
      affiliated with Michigan State University's College of Human Medicine.
      INTERVENTION: Trainees' attitudes towards and knowledge about certain prevention
      activities were captured by an instrument designed for this study using 127
      Likert scales. Counseling skills were assessed with one of two standardized
      patients. Residents were unaware of the simulation, which occurred in their
      routinely scheduled ambulatory care setting. Audiotapes of the interactions were
      rated by blinded, independent raters. Residents had strong positive beliefs about
      the role of primary care physicians in counseling patients, high levels of
      knowledge about what the counseling should entail, and high self-assessment about
      the frequency and quality of their own counseling interventions. Skill levels,
      however, were at or below a level defined as minimally acceptable. CONCLUSION:
      Resident physicians' skill levels, as measured in this study, are inadequate to
      accomplish routine counseling interventions in the primary care setting. These
      results suggest that more reliance should be placed on direct observation of
      physicians, ideally in nonreactive settings, for purposes of drawing conclusions
      about physician performance. Further, these results have implications for the
      training of students and residents in the area of counseling for prevention.

PMID- 2231039
TI  - Residents' perception of evaluation procedures used by their training program.
AB  - OBJECTIVE: To determine the methods of evaluation used routinely by training
      programs and to obtain information concerning the frequencies with which various
      evaluation methods were used. DESIGN: Survey of residents who had recently
      completed internal medicine training. PARTICIPANTS: 5,693 respondents who
      completed residencies in 1987 and 1988 and were registered as first-time takers
      for the 1988 Certifying Examination in Internal Medicine. This constituted a 76%
      response rate. MAIN RESULTS: Virtually all residents were aware that routine
      evaluations were submitted on inpatient rotations, but were more uncertain about
      the evaluation process in the outpatient setting and the methods used to assess
      their humanistic qualities. Most residents had undergone a Clinical Evaluation
      Exercise (CEX); residents' clinical skills were less likely to be evaluated by
      direct observation of history or physical examination skills. Resident responses
      were aggregated within training programs to determine the pattern of evaluation
      across programs. The majority of programs used Advanced Cardiac Life Support
      (ACLS) certification, medical record audit, and the national In-Training
      Examination to assess most of their residents. Performance-based tests were used
      selectively by a third or more of the programs. Breast and pelvic examination
      skills and ability to perform sigmoidoscopy were thought not to be adequately
      assessed by the majority of residents in almost half of the programs.
      CONCLUSIONS: While most residents are receiving routine evaluation, including a
      CEX, increased efforts to educate residents about their evaluation system, to
      strengthen evaluation in the outpatient setting, and to evaluate certain
      procedural skills are recommended.

PMID- 2231040
TI  - General internal medicine and technologically less developed countries.
AB  - OBJECTIVE: To assess the international health activities of departments of
      medicine, divisions of general medicine, and general medicine faculty and the
      interest among departments of medicine in joint international health ventures.
      DESIGN: 15-item, mailed questionnaire. PARTICIPANTS: 100 chiefs of divisions of
      general medicine associated with training programs in internal medicine.
      INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Completed questionnaires were
      returned by 87 division chiefs representing 1,355 general medicine faculty. 49%
      of division had faculty with six weeks' experience in less developed countries.
      8.5% of general medicine faculty had six weeks' experience in less developed
      countries. 7.6% of general medicine faculty were interested in spending extended
      time in less developed countries. 19% of departments had formal collaborations
      with schools in less developed countries. 45% of departments were interested in
      affiliations with U.S. institutions for the purpose of joint international health
      ventures. CONCLUSIONS: The international health interests of current general
      medicine faculty may not be satisfied. Departmental and divisional encouragement
      of international interests would increase the number of U.S. general internists
      participating in less developed countries. The authors discuss the potential for
      greater involvement of general medicine faculty in international health.

PMID- 2231041
TI  - Behavioral complications of dementia: a clinical approach for the general
      internist.

PMID- 2231043
TI  - Caring for people with AIDS and HIV infection in hospital-based primary care
      practice.

PMID- 2231042
TI  - Cognitive screening tests: an aid in the care of elderly outpatients.

PMID- 2231044
TI  - Decision making in the management of asymptomatic patients with aortic
      regurgitation: a cardiologist's perspective.

PMID- 2231045
TI  - Declining interest in internal medicine residencies: a crisis or a quirk?

PMID- 2231046
TI  - International health and general internal medicine.

PMID- 2231047
TI  - IV administration of phenytoin.

PMID- 2231048
TI  - Racial bias in case presentation.

PMID- 2231049
TI  - Are physicians obligated to provide preventive services?
AB  - Preventive care is considered a benefit to the patient. Physicians express a
      positive attitude towards prevention, but their performance of recommended
      activities is low, as shown in a five-year trial at the Seattle VA Medical
      Center. The release of the U.S. Preventive Services Task Force's guide to
      clinical preventive services has provided physicians with authoritative
      prevention recommendations. While most physicians are specialists with little
      interest or skill in preventive care, primary care providers do accept an
      obligation to provide comprehensive care, including prevention. This paper
      examines the ethical basis for the idea of obligation. External pressures, legal,
      economic, and organizational, are affecting the physician-patient relationship in
      ways that encourage a contract mode of medical practice and limit physicians'
      ability to provide preventive care. As a profession, medicine needs to speak for
      the health needs of the public. As practitioners, physicians need to seek the
      welfare of their patients.

PMID- 2231050
TI  - Prevention in medical education: an uncertain future.
AB  - There is reason for pessimism about the incorporation of prevention into medical
      education. In addition to what might be called the standard reasons for
      resistance to prevention, there are at least three other structural barriers: the
      destabilization of the health care system, the loss of interest in careers in
      primary care, and preventive medicine's failure to adopt a far-reaching critique
      of medicine and medical education. Only through linkages to progressive health
      care reform, to primary care, and to the biopsychosocial model can prevention
      achieve an important place in medical education.

PMID- 2231052
TI  - Implementation of cancer prevention guidelines in clinical practice.
AB  - Data from several sources, including consumer surveys, physician surveys, and
      medical record audits, indicate that consumers do not receive cancer screening
      tests as recommended by the National Cancer Institute, the American Cancer
      Society, and the U.S. Preventive Services Task Force. Performance rates are
      consistently below published standards for all tests except Pap tests. Major
      reasons physicians do not perform the recommended tests include physician
      forgetfulness, disagreement with recommendations, lack of time, and patient
      refusal. Physicians also tend to overestimate their own performance rates.
      Barriers to screening test performance can be categorized into patient factors,
      physician factors, test factors, and health care delivery system factors.
      Interventions, such as computerized reminder systems, physician audits with
      feedback, and patient education and reminders, can be effective in promoting
      performance of such screening. Interventions that target both physician and
      patient may be particularly effective.

PMID- 2231051
TI  - Background and objectives of the U.S. Preventive Services Task Force.
AB  - Clinical preventive services have always been recognized by clinicians as an
      important part of primary care medicine, but for many years there has been some
      uncertainty as to the effectiveness of these maneuvers in preventing disease and
      exactly how and when they should be performed. The recent report of the U.S.
      Preventive Services Task Force provides a comprehensive review of the science
      base for preventive services and offers specific recommendations for clinicians
      on the appropriate delivery of screening tests, counseling interventions,
      immunizations, and other preventive services. The recommendations provide
      guidance on how to design an appropriate package of services based on the medical
      history and risk profile of each patient. This article describes the historical
      background behind the formation of the task force, its methodology and rationale,
      and the format of the final report, the "Guide to Clinical Preventive Services."
      The potential implications of this report and its limitations are also discussed.

PMID- 2231053
TI  - Implementation of preventive services in an HMO practice.
AB  - Practice does not conform to guidelines unless the guidelines are specifically
      implemented and performance is monitored. Several examples of implementation in
      one health maintenance organization (HMO) are given. These include immunization
      for influenza and follow up of positive screening tests for colorectal and
      cervical cancer. Each implementation effort has required the development of
      systems, which in this HMO are automated. Several issues influencing
      implementation are discussed, including resource constraints and priorities for
      the allocation of new resources. Developers cannot expect that their guidelines
      will be incorporated into clinical practice. They must foster specific
      implementation plans.

PMID- 2231054
TI  - British perspective on the U.S. Preventive Services Task Force guidelines.
AB  - The clinical approach to prevention, cogently documented in the Task Force
      guidelines, implies the medicalization of prevention. The concentration of
      resources on those most in need is efficient, the widening of physicians'
      responsibility is welcome, and the influence on the recipients diffuses into the
      community. The Task Force report, however, fails to stress the problems and the
      limitations of this approach. The adverse effects of "labeling" can be serious.
      They need to be measured and taken into account, and there should be no screening
      without counseling and long-term care; the latter cannot be guaranteed unless
      there is a comprehensive general practitioner system. Screening readily generates
      overmedication, particularly since many physicians lack the skills, the
      inclination, or the staff to provide expert and continuing health advice. Concern
      for high-risk individuals should be only one part of a much wider preventive
      strategy. This is illustrated by the close correlations between the prevalence of
      high-risk status and the population mean value (0.85 for hypertension vs. mean
      blood pressure, 0.97 for excess use of alcohol vs. population mean intake). The
      medical approach, important though it is, must not distract attention from the
      more fundamental population strategy of prevention.

PMID- 2231055
TI  - Prevention in developing countries.
AB  - Developing countries have implemented primary health care programs directed
      primarily at prevention and management of important infectious and nutritional
      problems of children. Successful programs have emphasized the need for individual
      and community involvement and have been characterized by responsible government
      policies for equitable implementation of efficacious and cost-effective health
      interventions. Unfortunately, developing countries must also face increases in
      the chronic disease and social problems commonly associated with industrialized
      countries. Prevention efforts, for example, to reduce tobacco smoking, to modify
      the diet, to reduce injuries, or to avert environmental contamination, are needed
      to contain future morbidity and rapidly increasing medical care costs. Developing
      countries can build on their successful approaches to program implementation and
      add other measures directed at preservation of health and prevention of disease
      in adult as well as child populations.

PMID- 2231056
TI  - The future of disease prevention.
AB  - The success of curative medical strategies calls attention to a lack in the
      completeness of health care: disease prevention. Bringing prevention
      appropriately into health care requires five types of effort: 1) broadening the
      view of health beyond the medical model to include the environment, social
      services, and personal health habits; 2) improving the science of prevention; 3)
      institutionalizing preventive services by relating them to all the participants,
      from the professionals to the government to the payers to the public; 4)
      encouraging non-physician health professionals to assume their suitable, possibly
      majority, share of providing preventive services; and 5) emphasizing preventive
      services notwithstanding an unevenness of access to them.

PMID- 2231057
TI  - Evaluating the evidence for the effectiveness of prevention.
AB  - This report reviews a number of issues that should be considered in evaluating
      the evidence for the effectiveness of primary and secondary prevention. In
      evaluating primary prevention, changes in disease incidence are the ideal index
      but mortality may also be a useful surrogate in certain cases. Both relative risk
      and attributable risk are valuable concepts in evaluating the benefits of primary
      prevention. In evaluating screening, the most notable approach to secondary
      prevention, certain potential biases should be taken into account. These include
      selection biases due to referral or length-biased sampling, lead time bias, and
      overdiagnosis bias. An understanding of the methodologic issues involved in
      evaluating prevention will help ensure the validity of any conclusions drawn
      regarding the effectiveness of preventive measures and programs.

PMID- 2231058
TI  - Reflections on the U.S. Preventive Services Task Force recommendations for
      screening for hypertension and hypercholesterolemia.
AB  - The U.S. Preventive Services Task Force recommendations for screening for
      hypertension and high blood cholesterol are generally consistent with preexisting
      national guidelines promulgated by the Joint National Committee for Detection,
      Evaluation, and Treatment of High Blood Pressure and the National Cholesterol
      Education Program Expert Panel on Detection, Evaluation, and Treatment of High
      Cholesterol in Adults. While a welcome addition to the armamentarium of the
      clinician, the Task Force recommendations represent only a partial solution to
      our current epidemic of blood-pressure- and cholesterol-related cardiovascular
      disease. A meaningful reduction in society's burden of cardiovascular disease can
      be achieved only by complementing the Task Force recommendations with community
      based mass treatment strategies aimed at shifting the distribution of blood
      pressure and cholesterol toward a biologically more normal pattern.

PMID- 2231059
TI  - Breast cancer screening: who should be included?
AB  - The recommendations of the U.S. Preventive Services Task Force are reviewed in
      regard to screening for breast cancer. In contradistinction to those issued by
      some other national organizations, screening for breast cancer using mammography
      at ages 40-49 is not recommended. It is concluded that the scientific evidence is
      insufficient at present to recommend mammography screening for women aged 40-49.
      The recommendations of the task force are: all women over age 40 should receive
      an annual breast examination; all women should have mammography every one or two
      years beginning at age 50 and concluding at approximately age 75 unless disease
      has been detected; and it may be prudent to begin mammography at an earlier age
      for women at high risk of breast cancer. These recommendations are appropriate in
      light of the available evidence; though at present there is no evidence that
      clinical examination of the breasts at any age reduces breast cancer mortality;
      the upper age beyond which breast cancer screening no longer has a significant
      effect in reducing breast cancer mortality is unknown; and there is no evidence
      that women at high risk for breast cancer benefit to a different degree from
      screening than women not at high risk.

PMID- 2231060
TI  - Colorectal cancer: have we identified an effective screening strategy?
AB  - Three currently used screening methods are aimed at detecting colorectal cancer
      when it is asymptomatic and curable, and at detecting polyps so that they can be
      removed before they can progress to cancer. Digital rectal examinations are
      relatively cheap and easy but can detect only a small fraction of large-bowel
      cancers. Sigmoidoscopy is more sensitive, but its low acceptability to patients
      has been only partially mitigated by the introduction of the 35-cm flexible
      instrument. Fecal occult blood testing has limited sensitivity because blood from
      cancers and polyps is neither continuously shed nor uniformly distributed in
      feces; specificity and positive predictive value are also low because of other
      sources of blood in the stool. Prudent judgment suggests that all of these
      screening tests may prevent death from colorectal cancer in some patients.
      However, none has been proven effective in general use by well-controlled
      studies. Case-control studies can provide timely and valuable new evidence in
      this regard; the authors' investigations in progress are described. The current
      lack of strong evidence in support of these screening tests should not be
      interpreted as evidence against their use.

PMID- 2231061
TI  - The impact of the U.S. Preventive Services Task Force guidelines on cancer
      screening: perspective from the National Cancer Institute.
AB  - The U.S. Preventive Services Task Force evaluated the medical literature,
      utilizing strict criteria to judge the merits of experimental trials designed to
      show benefit in screening for cancer. For individuals at normal risk, the task
      force was not able to make recommendations for or against screening for
      colorectal, prostate, skin, oral, or testicular cancers. Only one physical
      examination cancer-screening procedure has ever been tested in a randomized
      trial. During the past 27 years, the National Cancer Institute (NCI) has funded
      six randomized screening trials. Thus far, only one has shown a decrease in
      mortality. Recognizing the limitations of such trials, the NCI published "Working
      Guidelines for Early Cancer Detection." Designed for the practicing physician,
      these guidelines were based upon the best available evidence and on the judgment
      of representatives of medical professional organizations.

PMID- 2231062
TI  - Glaucoma screening: too little, too late?
AB  - Screening for glaucoma, usually by measuring intraocular pressure, has been
      popular, but repeated analysis indicates poor sensitivity and specificity. More
      extensive testing is required. Such testing should be focused on high-risk
      groups, including blacks and the elderly. Regular comprehensive eye examinations,
      on a schedule adjusted for these and other risk factors, are probably the most
      cost-efficient means of identifying patients with glaucoma. The primary care
      provider has a pivotal role: to encourage patients to undergo such examinations
      when warranted; and to encourage those on intraocular-pressure-lowering
      medications to comply with their medication use.

PMID- 2231063
TI  - Screening for psychiatric and substance abuse disorders in clinical practice.
AB  - Psychiatric disorders, particularly depression and alcohol abuse, represent a
      large burden of illness to the society. Many individuals with these disorders
      receive all of their care from health care providers who are not mental health
      specialists. There is evidence that non-psychiatric physicians frequently do not
      recognize these disorders in their patients. Screening questionnaires have been
      introduced to improve detection of these patients. Several studies have found
      that these screening questionnaires can increase detection rates, but no
      important impact on patient outcomes has been demonstrated. This review article
      outlines several reasons why it has been difficult to discern improvement in
      patient outcomes: inadequate study design, insufficient physician education,
      interdependence of psychiatric and medical conditions, and vague treatment
      guidelines. Practical use of the current psychiatric screening questionnaires and
      key areas for further investigation are considered.

PMID- 2231064
TI  - Selective screening: when should screening be limited to high-risk individuals?
AB  - Issues related to selective screening are discussed. The distinction between test
      accuracy and program accuracy is presented in the context of impact on cost/true
      case detection, which in turn reflects the gain in specificity and loss in
      sensitivity for the total target population. When two or more risk factors are
      combined to define high-risk subjects, a gain in program accuracy and a relative
      reduction in cost/true case found ensue if there is additive interaction between
      these risk factors. The author also discusses periodicity of screening and
      emphasizes the inappropriateness of using the notion of risk for disease
      occurrence as a criterion to define periodicity.

PMID- 2231065
TI  - How serious are the adverse effects of screening?
AB  - The adverse effects of screening are not commonly studied. False-positive tests
      lead to discomfort, costs, and risks from additional diagnostic and therapeutic
      procedures. False-negative tests lead to a sense of security and delays in
      seeking medical help when symptoms develop. Labeling an individual with a false
      positive test, or with a true-positive test for which there is no evidence that
      intervention makes a difference, e.g., intervention on an 80-year-old
      asymptomatic woman with hypercholesterolemia, can have a markedly negative impact
      on the quality of life. Interpreting statistical abnormalities out of clinical
      context, e.g., lending importance to a multiphasic blood screen showing "high"
      alkaline phosphatase in a teenager, leads to unnecessary costs and anxiety. The
      cost of screening programs that may not have been shown to do more good than harm
      is already having an impact on the resources available to diagnose and treatment
      symptomatic persons. Premature implementation of unproved screening programs will
      continue to decrease physician and public confidence in prevention.

PMID- 2231066
TI  - Prevention of cardiovascular disease: risks and benefits of aspirin.
AB  - Aspirin has been tested for its benefit in preventing cardiovascular disease in
      randomized trials in three categories of patients. In secondary prevention among
      those with a history of myocardial infarction (MI), stroke or transient cerebral
      ischemia, or unstable angina pectoris, 25 randomized trials demonstrated
      significant reductions from aspirin of 25% for the occurrence of an "important
      vascular event" (nonfatal MI, nonfatal stroke, or vascular death), 32% for
      nonfatal MI, 27% for nonfatal stroke, and 15% for vascular mortality. Among those
      evolving an MI, the Second International Study of Infarct Survival (ISIS-2)
      showed a significant reduction of 23% in five-week vascular mortality among those
      started on a one-month regimen of daily aspirin within 24 hours of the onset of
      symptoms of suspected MI. Aspirin also significantly reduced reinfarction,
      nonfatal stroke, and important vascular events. Finally, in primary prevention,
      the US Physicians' Health Study (PHS) showed a significant 44% reduction in the
      occurrence of a first MI among apparently healthy male physicians; numbers of
      strokes and vascular deaths were insufficient to permit conclusions for these
      endpoints. Thus, aspirin is of clear benefit in reducing MI, stroke, and vascular
      death in secondary prevention and among those evolving an MI. It is also
      beneficial in the primary prevention of MI among men over 40, but data concerning
      its effects on stroke and vascular death remain inconclusive.

PMID- 2231067
TI  - Adult immunizations: are they worth the trouble?
AB  - There are good data to recommend routine use of vaccines against measles,
      rubella, tetanus, influenza, and pneumococcal infections in adults. An adolescent
      or an adult born after 1956 is considered to be susceptible to measles unless he
      or she has received two doses of live measles vaccine or has suffered a physician
      diagnosed case of measles. Tetanus is largely a disease of the elderly, and there
      is a universal need for immunizations with tetanus toxoid. Influenza continues to
      be a major public health problem, and influenza vaccine should be given annually
      to the elderly and to those at high risk. The efficacy of pneumococcal vaccine in
      American adults is still being debated. Results from case-control studies show
      that the vaccine is about 60% effective in reducing the incidence of disease due
      to vaccine-related strains. Its use in the elderly and in those at higher risk
      for pneumococcal infection is recommended.

PMID- 2231068
TI  - Initiation and maintenance of patient behavioral change: what is the role of the
      physician?
AB  - If the physician is to help a patient adopt and maintain "preventive behaviors,"
      the processes that influence and shape both patient and physician behaviors must
      be understood, the physician's role in the behavioral change process must be
      acceptable to both the patient and the physician, and an environment that both
      permits the physician to act and reinforces the physician for acting
      appropriately must be designed for the physician. A physician's role that is
      acceptable to both the patient and the physician can be seen as six obligations.
      The physician must 1) evaluate the medical literature on prevention to determine
      which services are indicated for which types of patients, 2) when seeing an
      individual patient, identify the services and behaviors needed by that patient,
      and 3) advise the patient of the need for action. As the patient responds
      positively to the physician's advice, the physician must 4) enable and assist the
      patient to have the indicated tests or procedures and accomplish the suggested
      behavioral changes, and 5) reinforce the patient's new and ongoing preventive
      behaviors. The sixth obligation of the physician is to establish, support, and
      maintain a system to facilitate tasks 2 through 5.

PMID- 2231070
TI  - Nicotine dependence: a preventable risk factor for other diseases.
AB  - Nicotine meets all critical criteria for an addictive drug. Furthermore, there is
      no evidence that there would be widespread compulsive use of tobacco without
      nicotine. These findings have led to consideration of the cigarette as a
      contaminated vehicle for an addictive drug (nicotine). Nevertheless, nicotine
      itself may also be used therapeutically to reduce exposure to carcinogens and
      other tobacco toxins. Nicotine replacement is a useful adjunct in treating
      tobacco dependence. For example, nicotine replacement in the form of a polacrilex
      resin (chewing gum) can alleviate physically based signs and symptoms of tobacco
      abstinence. The fact that this form of nicotine replacement is not attractive to
      non-users of tobacco has opened the door to the use of nicotine in a therapeutic
      modality, permitting hope of eliminating tobacco dependence.

PMID- 2231069
TI  - The physician's role in injury prevention: beyond the U.S. Preventive Services
      Task Force report.
AB  - Injuries and their prevention have received little attention by the medical
      community, despite the fact that injuries are the leading cause of premature
      death. However, much can be done to reduce the number and severity of injuries,
      and the practicing physician has an important role to play in this process. This
      report outlines the U.S. Preventive Services Task Force report recommendations
      for prevention strategies to reduce injuries and then seeks to define a broader
      role for the physician in prevention injuries that extends beyond the confines of
      office-based practice. While screening and counseling have proven effectiveness
      in certain situations, interventions that are passive or automatic in action,
      such as air bags, have proven to be more effective long-term solutions to reduce
      both the number and the severity of injuries. The author outlines and provides
      examples of seven areas where physicians can have a major impact either directly
      or through implementing effective injury-control strategies. These are:
      treatment, education, screening, hazard identification, research, advocacy, and
      policy making. Using all of these approaches, physicians can play a truly
      effective role in reducing the burden of injuries for their patients.

PMID- 2231071
TI  - Sexual practices: are physicians addressing the issues?
AB  - The literature suggests that prior to 1981, the only groups concerned with sexual
      history taking were urologists, psychiatrists, and gynecologists. The appearance
      of AIDS, however, has made competency in this area of interviewing essential for
      all primary care physicians. The teaching of sexual history taking presents a
      challenge to educators, since it involves all three educational domains-
      cognitive, affective, and skills. The authors have developed an approach to
      teaching sexual history taking to providers in small groups utilizing videotapes
      that model the content and sequence of questions and confront learners about the
      fears and the emotional concerns they may have in obtaining these data.

PMID- 2231072
TI  - Adolescent pregnancy: the clinician's role in intervention.
AB  - Adolescent childbearing has adverse sequelae that are intensified when the onset
      of sexual activity takes place at a particularly early age. A relationship
      between the onset of sexual activity and the age of maturation has been
      demonstrated; as the mean age of menarche has become younger, a greater
      discontinuity has been created between physical development on the one hand and
      cognitive and emotional development on the other. Initiatives to prevent early
      sexual initiation and unintended pregnancy must be designed in that context and
      with an appreciation of normative social pressures. This report reviews research
      on adolescent development and sexual behavior, including the relationship between
      maturation and the onset of sexual activity, the timing of pregnancy risk, clinic
      utilization and reasons for delay in clinic attendance, and clusters of high-risk
      behaviors. It discusses the role of clinical interventions, suggesting ways in
      which those who treat adolescents can assist them in acquiring and maintaining
      protective behaviors.

PMID- 2231073
TI  - The costs of prevention.
AB  - A prevention program is cost-effective if it yields more health benefits than do
      alternative uses of health care resources. Some prevention programs meet this
      standard: either they actually save more health care resources than they utilize,
      or their net costs per healthy year of life gained are lower than those of
      alternatives such as curative or palliative medicine. Other prevention programs,
      however, are less cost-effective than are medical treatments for the same
      disease. One lesson for public policy is that generalizations about the cost
      effectiveness of "prevention" are unwise. Another lesson is that prevention
      programs should not be subjected to a higher standard than other health programs:
      they should not be expected to save money, but they should be expected to yield
      improved health at a reasonable price.

PMID- 2231074
TI  - Diffusion of the U.S. Preventive Services Task Force recommendations into
      practice.
AB  - The U.S. Preventive Services Task Force's "Guide to Clinical Preventive Services"
      summarizes the results of a critical review of the literature pertaining to the
      effectiveness of 169 interventions in modifying 60 risk factors or conditions.
      The ultimate impact of the guide depends on the diffusion into clinical practice
      of its recommendations. This report reviews the factors influencing the diffusion
      process. Three categories of behavioral influence--predisposing, enabling, and
      reinforcing factors--apply to this diffusion process. Predisposing factors
      include knowledge and attitudes, personal health behaviors, confidence, and
      beliefs about patients' interests in health-promotion advice. Enabling factors
      include competence to perform preventive services, reimbursement for preventive
      services, organization of the practice setting, time to provide preventive
      services, a reminder system, and a coherent set of guidelines that are perceived
      as scientific and unambiguous. Reinforcing factors include peer support,
      feedback, evidence of results, and an enhanced sense of self-efficacy in
      fulfilling one's role as a healer. Recommendations are given for using these
      factors to increase the diffusion of preventive services into clinical practice.

PMID- 2231075
TI  - Changes in pelvic muscle strength and stress urinary incontinence associated with
      childbirth.
AB  - Pelvic muscle strength and stress urinary incontinence were studied in 20
      nulliparous women at 32 to 36 antepartum weeks and 6 postpartum weeks. Measures
      used included a digital muscle strength score, observed incontinence, and urine
      flow interruption. Pelvic muscle strength declined from the antepartum to
      postpartum periods in women with vaginal births; however, women with greater
      antepartal pelvic muscle strength tended to preserve a higher level of strength
      during the postpartum period. In general, less pelvic muscle strength was found
      in women who demonstrated stress urinary incontinence.

PMID- 2231077
TI  - Extracorporeal membrane oxygenation and indications for cardiopulmonary bypass in
      the neonate.
AB  - Extracorporeal membrane oxygenation (ECMO) is a rescue technique used for term
      and near-term neonates who have respiratory failure that is unresponsive to
      conventional therapy. The complexity of the equipment necessitates intensive
      training of a specialized team before setting up an ECMO unit. An understanding
      of the physiology underlying ECMO and the criteria used for patient selection
      assists the nurse in identifying neonates who might benefit from the technique.

PMID- 2231076
TI  - Incorporating infant stimulation concepts into prenatal classes.
AB  - Prenatal classes provide an opportunity for childbirth educators to teach couples
      about parenting, as well as labor and delivery. Infant stimulation concepts can
      be interwoven into prenatal classes to help facilitate the development of
      prenatal bonding and parenting skills.

PMID- 2231078
TI  - Genital herpes. An overview.
AB  - Data from the National Disease and Therapeutic Index (NDTI) Survey indicate that
      the number of physician-patient consultations concerning genital herpes increased
      15-fold between 1966 and 1984. Because of the increased incidence of genital
      herpes, the great variance in symptoms and severity of outbreaks, and the
      frequent misrepresentation of the nature of herpes simplex, all health-care
      practitioners should receive up-to-date information on the disorder. This article
      is intended to educate health-care professionals about genital herpes.

PMID- 2231079
TI  - Relationships between stated feelings and measures of maternal adjustment.
AB  - Nurses need to identify those women who are experiencing difficulties with
      maternal-role transition. A study was conducted in which the relationships
      between women's self-reported feelings during the postpartum period and scores
      from observational and paper-and-pencil measures of maternal adjustment were
      explored. The results indicated that self-descriptions of negative physical
      feelings were related to scores indicating less mothering capability. Self
      descriptions of negative emotional feelings were related to poorer relationships
      with husbands, less life satisfaction, and less support for the maternal role.

PMID- 2231080
TI  - The effect of nipple shields on maternal milk volume.
AB  - This study was conducted to evaluate nipple shields and determine whether altered
      nipple shield design would change the amount of milk obtained during breast
      pumping. The study also sought to determine whether milk volume would change
      depending on the presence or absence of a nipple shield during breast pumping.
      Among the 25 participants, pumping without a shield yielded statistically
      significantly larger milk volumes than pumping with either one of the two kinds
      of shields evaluated, regardless of the order of nipple shield use. The slight
      difference in milk volumes obtained when comparing the shields used was not
      statistically significant. The article includes several questions designed to
      alert the clinician to the risks of nipple shield use, particularly when the
      mother and neonate are still learning to breastfeed.

PMID- 2231082
TI  - Identifying and validating nursing diagnoses in a gynecologic ambulatory-care
      setting.
AB  - This descriptive study was conducted to identify the nursing diagnoses made in
      providing care to 100 gynecologic ambulatory-care patients and to determine the
      defining characteristics of the three most frequently made diagnoses. Nurse
      observers studied nurse and patient interactions, recorded the defining
      characteristics, and assigned a nursing diagnosis to the patient. Twenty-five
      nursing diagnoses were used in the study, and the type and frequency of the
      defining characteristics varied. The findings of the study will add to the
      nursing diagnoses' knowledge base.

PMID- 2231081
TI  - A community-based approach to the promotion of breastfeeding in Mexico.
AB  - A comprehensive education strategy is presented that links training, community
      education, research, and mass-media efforts to enhance breastfeeding practices.
      Breastfeeding promotion models, an administrative system, and lessons learned
      during the project are described. The keys to effective breastfeeding promotion
      are shown to be accurate information; appropriate education, training, and follow
      up; and a supportive administrative system.

PMID- 2231083
TI  - Combined Registry for the Clinical Use of Mechanical Ventricular Assist Pumps and
      the Total Artificial Heart in conjunction with heart transplantation: fourth
      official report--1989.

PMID- 2231084
TI  - Heart-lung transplantation for cystic fibrosis and subsequent domino heart
      transplantation.
AB  - Between September 1984 and October 1988, 27 patients underwent combined heart
      lung transplantation for treatment of end-stage respiratory disease caused by
      cystic fibrosis. The actuarial patient survival was 78% at 1 year and 72% at 2
      years. Bacterial respiratory infections were common in the early postoperative
      period and necessitated vigorous medical therapy. The dose of cyclosporine
      required in these patients was higher than in conventional transplant recipients,
      and this contributed to an increased cost of postoperative care. Lung function
      was greatly improved after transplantation, and long-term survivors achieved an
      excellent quality of life. Lymphoproliferative disorders developed in two
      patients; these disorders regressed after a reduction in immunosuppression. Two
      patients required retransplantation: one because of obliterative bronchiolitis
      and the other because of recurrent respiratory infections associated with a
      moderate tracheal stenosis and severe deterioration in lung function. A
      modification of the technique used for heart-lung transplantation allowed 20
      hearts from cystic fibrosis patients to be used for subsequent heart
      transplantation. Immediate heart function was satisfactory in all cases. The
      actuarial survival of the recipients of these domino heart transplants was 75% at
      1 year. No coronary artery disease was present in the 12 patients who have
      undergone coronary angiography at 1 year.

PMID- 2231085
TI  - High-risk heart surgery in the heart transplant candidate.
AB  - Because of the limited supply of donor hearts, transplant physicians are
      searching for alternative treatments for patients referred for orthotopic heart
      transplantation. A group of 20 patients (7% of patients accepted for heart
      transplantation at Loyola University Medical Center) were nonrandomly sent for
      conventional heart surgery. Of 20 patients, 17 survived their hospitalization,
      and 11 of the original 20 have avoided heart transplantation or having their
      names added to the transplant list. This group represents a high-risk subset of
      patients. Patients with poor ventricular function and ventricular arrhythmias or
      with poor ventricular function who underwent first-time revascularization were
      well served by more conventional heart surgery (all 10 patients survived
      surgery). Patients with poor ventricular function who required redo bypass
      operation had a poor result (three of six died), and such patients should be
      considered carefully for initial heart transplantation.

PMID- 2231086
TI  - Bridge to heart transplantation: importance of patient selection.
AB  - Since 1986, 26 candidates were evaluated for mechanical support as a bridge to
      heart transplantation. Group 1 consisted of 15 patients who were accepted and who
      received support with a ventricular assist device (14 patients) or a total
      artificial heart (1 patient). Seven of the 15 patients received transplants and
      survived, whereas contraindications to transplant developed in seven patients
      while they were receiving support, and these seven died. One patient remains
      hospitalized after transplantation. Group 2 consisted of 11 patients rejected for
      circulatory support because of renal insufficiency or infection (9), pulmonary
      embolus (1), and cerebrovascular accident (1). Two group 2 patients underwent
      transplant procedures after their complications resolved, and one survived. One
      other group 2 patient who recovered without transplantation or mechanical support
      was discharged. There was no significant difference in age, gender, or cause of
      cardiogenic shock between the two groups. Four of five patients accepted for
      mechanical support on the first evaluation survived, and three of 10 accepted
      after the initial evaluation survived, indicating that delayed selection often
      results in complications that preclude transplantation and survival. Only one of
      the 26 patients survived without transplantation or support. These data emphasize
      the importance of patient selection on the outcome of bridging to
      transplantation.

PMID- 2231087
TI  - New technique for intrathoracic heart-lung transplantation in the rat.
AB  - A technique for intrathoracic heart-lung transplantation in the rat is described.
      The combined heart and left lung were transplanted into the recipient's thorax in
      place of the excised left lung. The graft's aorta was anastomosed end to side to
      the recipient's descending aorta. The bronchial anastomosis was made by the
      telescoping technique. When the aortic anastomosis was carried out, a total
      aortic clamp was used in group 1 (26 animals), and an internal shunt was used in
      group 2 (20 animals). One rat in group 1 and seven rats in group 2 survived with
      well-functioning grafts for more than 7 days after transplantation. This model of
      intrathoracic heart-lung transplantation appears to be suitable for
      investigations of rejection because the grafted lung is ventilated through the
      anastomosed bronchus. Our internal shunt method makes it possible for this system
      to be used as an experimental model.

PMID- 2231088
TI  - Influence of the donor lung on development of early infections in lung transplant
      recipients.
AB  - Infection of the lung allograft is the greatest cause of morbidity and mortality
      after heart-lung transplantation. To better understand the pathogenesis of these
      infections, we compared the results from cultures of the donor tracheas with the
      type and prevalence of early intrathoracic infections in the recipients. In the
      last 37 recipients, intrathoracic infections occurred within 2 weeks of operation
      in 16 (43%). Organisms isolated from the donor tracheal cultures were different
      from those associated with early infections, except for three of four recipients
      with heavy growth of Candida in donor tracheal cultures, in whom fatal invasive
      candidiasis developed caused by the same species of Candida isolated from the
      donor culture. Comparisons were made between recipients with (n = 16) and without
      early infection (n = 21) for age of donors and recipients, ischemic time, length
      of donor stay in an intensive care unit, donor arterial oxygen pressure, duration
      of recipient intubation, sterile donor tracheal culture or culture with presence
      of mouth flora, bacterial pathogens, or Candida, method of lung preservation, and
      antibiotic prophylaxis of donor. The only factor significantly associated with
      the onset of early infection was the presence of mouth flora in the donor
      tracheal culture (p = 0.004, Fisher's exact test, two sided). Multiple logistic
      regression was performed to test the additional contribution of other covariates
      after adjusting for the presence of mouth flora. None of the other covariates
      contributed to the occurrence of early infection. Recipients with early infection
      had a significantly lower survival compared with those without early infection (p
      = 0.04) by the Kaplan-Meier survival analysis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231089
TI  - Natural history of chronic rejection in heart-lung transplant recipients.
AB  - Chronic rejection is the major cause of death of long-term survivors of heart
      lung transplantation. Of our 61 patients who have received heart-lung
      transplants, 29 have been followed up for a year or longer. Seven patients had
      clinical evidence of chronic rejection within 15 months of transplantations of
      these seven, four died with postmortem confirmation of extensive obliterative
      bronchiolitis, interstitial and pleural fibrosis, and vascular sclerosis in the
      heart and lungs. All seven patients had evidence on transbronchial biopsy
      specimens of submucosal fibrosis and vascular sclerosis. Twelve of our remaining
      patients have shown similar areas of lung fibrosis on transbronchial biopsy
      specimens, and the other 10 are well and without fibrosis seen on transbronchial
      biopsy specimens. Studies of the 201 biopsy specimens obtained from 29 patients
      confirmed rejection on 130 occasions, with more frequent, more persistent, and
      more severe rejection in the chronic-rejection group than in the without-fibrosis
      or lung-fibrosis group. Opportunistic infections resulted in pneumonia on 19
      occasions, and these were most commonly found in patients with lung fibrosis. We
      conclude that chronic lung rejection is the likely outcome in patients with
      early, poorly controlled, severe rejection.

PMID- 2231090
TI  - Comparison of mononuclear cell subpopulations in bronchoalveolar lavage fluid in
      acute rejection after lung transplantation and Mycoplasma infection in rats.
AB  - Acute lung rejection after orthotopic left lung transplantation and Mycoplasma
      pulmonis infection were studied immunohistologically by bronchoalveolar lavage
      (BAL) in inbred rats using monoclonal antibodies differentiating lymphocyte and
      macrophage subpopulations. Twenty transplants in a major histocompatibility
      complex (MHC)-different strain combination (Brown-Norway/Lewis) were examined 2,
      4, and 6 days after transplantation. Thirty isotransplants (Lewis/Lewis) and
      normal Lewis rats were used as controls. Eight Lewis rats with acute Mycoplasma
      pulmonis infection and six Lewis rats with chronic Mycoplasma infection also
      underwent BAL. Mononuclear cell subpopulations were analyzed using a panel of
      monoclonal antibodies to MHC and macrophage differentiation antigens: ED1
      monocyte/macrophages, ED2 inflammatory tissue macrophages, OX19 T lymphocytes,
      and OX12 B lymphocytes. The following results were obtained: (1) All
      allotransplants developed acute rejection on day 2, and it advanced until day 6,
      demonstrating severe perivascular and peribronchiolar infiltration of
      inflammatory tissue macrophages (ED1+/ED2+): (2) the proportion and number of
      inflammatory macrophages (ED2+) in BAL fluid increased on day 6; (3) in BAL the
      proportion and number of T lymphocytes (OX19+) increased more prominently than B
      lymphocytes (OX12+) on day 6 of acute rejection; (4) in infection with Mycoplasma
      pulmonis the increase of T lymphocytes (OX19+) in BAL was more prominent than
      that of B lymphocytes (OX12+). In conclusion, serial analysis of macrophage, T-
      and B-lymphocyte antigens was performed. The increase of the proportion of
      inflammatory macrophages (ED2+) and lymphocytes (OX19+, OX12+) in BAL fluid
      occurred rather late in the rejection response. This limits the use of BAL as an
      early diagnostic method of allografted lung rejection.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2231091
TI  - Influence of preoperative transpulmonary gradient on late mortality after
      orthotopic heart transplantation.
AB  - We reviewed the transpulmonary gradient, pulmonary arterial systolic pressure,
      pulmonary vascular resistance (Wood units), and pulmonary vascular resistance
      index (Wood units X Body surface area), recorded preoperatively in 109 recipients
      aged 44.6 +/- 13.5 (mean +/- SD) years who underwent orthotopic heart
      transplantation between March 1984 and March 1988, to identify which measure of
      pulmonary hypertension most accurately predicts poor outcome after orthotopic
      heart transplantation. These recipients were followed up as many as 57 (24.7 +/-
      14.5) months after their transplant procedure. Preoperative hemodynamic values
      were as follows: transpulmonary gradient, 10.4 +/- 4.7 mm Hg; pulmonary artery
      systolic pressure, 53.6 +/- 14.8 mm Hg; pulmonary vascular resistance, 2.7 +/-
      1.8 Wood units; pulmonary vascular resistance index, 4.9 +/- 2.7. Nineteen
      recipients died within 1 year after orthotopic heart transplantation. Causes of
      death were acute rejection (8), chronic rejection (1), infection (2), nonspecific
      orthotopic heart transplant failure (4), bowel ischemia (1), pancreatitis (1),
      lymphoma (1), and liver failure (1). Preoperative pulmonary arterial systolic
      pressure, pulmonary vascular resistance, and pulmonary vascular resistance index
      were not predictive of 1-month, 6-month, or 1-year mortality. One-month mortality
      rates of orthotopic heart transplant recipients with transpulmonary gradient
      greater than or equal to 12 mm Hg and of those with transpulmonary gradient less
      than 12 mm Hg were not significantly different (11% vs 3%; p = 0.12). The 6-month
      mortality rate of orthotopic heart transplant recipients with transpulmonary
      gradient greater than or equal to 12 mm Hg, however, was five times greater than
      that of orthotopic heart transplant recipients with transpulmonary gradient less
      than 12 mm Hg (24% vs 5%; p = 0.003), and 12-month mortality of orthotopic heart
      transplant recipients with transpulmonary gradient greater than or equal to 12 mm
      Hg was increased sevenfold when compared with that of orthotopic heart transplant
      recipients with transpulmonary gradient less than 12 mm Hg (36% vs 5%; p =
      0.0005). These results suggest that presently used measures of pulmonary
      hypertension do not predict mortality in the first month after orthotopic heart
      transplantation, but that elevated preoperative transpulmonary gradient is
      associated with a significant increase in mortality at 6 and 12 months after
      orthotopic heart transplantation. Prospective randomized trials are needed to
      determined whether extended preload and afterload reduction before and/or after
      transplant will favorably influence long-term prognosis of orthotopic heart
      transplant recipients with elevated preoperative transpulmonary gradient.

PMID- 2231092
TI  - Echo-controlled endomyocardial biopsy.
AB  - Endomyocardial biopsy is an essential procedure for the diagnosis and grading of
      rejection in heart transplant patients. Direct control of the bioptome
      positioning has classically been obtained by fluoroscopy. Starting in June 1988,
      at our institution an alternative approach involving the use of two-dimensional
      echocardiography was introduced in clinical practice. In 125 patients 1591
      biopsies have been performed: 445 under echographic control and 1146 under
      fluoroscopic control with 3.6 and 4.5 samples/biopsy, respectively. The
      percentages of inadequate samples caused by biopsy site sampling were 0.4% and
      1.3%, respectively, in the two groups. Cardiac perforation has occurred twice in
      the fluoroscopic group; it has not been observed in the echographic group. One
      case of iatrogenic tricuspid regurgitation was detected in each group. We now
      consider echocardiography the method of choice to guide the bioptome. We prefer
      it to fluoroscopy because it eliminates the risks of x-ray exposure, increases
      the number of sampling sites in cases of echocardiographic evidence of rejection,
      can be easily performed as a bedside procedure, allows choice and variation of
      sampling sites, and permits monitoring of cardiac complications during and after
      the procedure. A randomized clinical trial is probably needed to assess with
      statistical significance the superiority of the echographic-controlled biopsy.

PMID- 2231093
TI  - Adenosine enhances left ventricular flow during 24-hour hypothermic perfusion of
      isolated cardiac allografts.
AB  - Left ventricular flow progressively decreases during preservation of ex vivo
      hearts by continuous hypothermic perfusion, according to previous studies. This
      study was done to determine whether left ventricular flow could be maintained
      during 24-hour hypothermic perfusion by the addition of adenosine to the
      perfusate. Isolated canine hearts were perfused with either a modified Krebs
      Henseleit solution or with the control solution containing adenosine (20 mumol/L)
      for either 4 or 24 hours. On completion of the perfusion period, radioactive
      microspheres were injected into the arterial inflow of the hearts. Myocardial
      samples were then taken from the endocardial, midcardial, and epicardial portions
      of the free wall and papillary muscles of the right and left ventricles, as well
      as the interventricular septum. Concentrations of radioactivity were determined
      for each sample, summed, and averaged for each ventricle. The ratio of average
      concentrations (L/R ratio) was significantly increased in the 24-hour adenosine
      hearts compared with 24-hour controls (1.10 +/- 0.15 vs 0.64 +/- 0.21, p less
      than 0.005). The L/R ratio of 4-hour controls (1.30 +/- 0.48) was also greater
      than that of 24-hour controls (p less than 0.005). These results suggest that
      left ventricular flow decreases during continuous hypothermic perfusion. The
      tendency toward diminished left ventricular perfusion after 24 hours is reduced
      when adenosine is added to the perfusate. Adenosine may be beneficial in ex vivo
      heart preservation with hypothermic perfusion by improving left ventricular flow.

PMID- 2231095
TI  - Regeneration of adult human myocardium after acute heart transplant rejection.
AB  - From August 1984 to March 1989, 1535 endomyocardial biopsy specimens from 79
      heart transplant patients were evaluated for rejection. Electron microscopy was
      performed on 664 of these specimens. Three hundred eighty-eight were diagnosed as
      accelerating, moderate, severe, or resolving acute rejection. Regeneration of
      adult human myocardium after acute rejection was seen in 22 specimens.
      Regeneration was identified in myocytes showing ultrastructural and light
      microscopic evidence of nuclear division and cytoplasmic dedifferentiation.
      Regenerating cell nuclei showed complex surface involution and large nucleoli.
      Cytoplasm appeared embryonic with abundant ribosomes, rough endoplasmic
      reticulum, and numerous mitochondria. Sarcomerogenesis was associated with
      cytoplasmic and subsarcolemmal clumps of Z band material. Myofibrillogenesis
      occurred throughout the cytoplasm but was favored in subsarcolemmal areas.
      Intercalated discs were primitive and depended on the differentiation state of
      adjoining myocytes. Nexus junctions were not seen. We conclude that myocyte
      injury during acute rejection of heart transplants is reversible and that adult
      human myocytes have a hitherto unsuspected capacity for regeneration.

PMID- 2231094
TI  - Factors influencing the development of hypertension after heart transplantation.
AB  - In this study we investigated the factors influencing the development of
      hypertension in 488 consecutive heart transplant recipients. The cumulative
      probability of hypertension (blood pressure persistently above 150/95 mm Hg)
      developing was 52% at 1 year, 67% at 2 years, 73% at 3 years, and 77% at 4 years
      after transplantation. The incidence was higher in patients receiving
      cyclosporine and azathioprine compared with those receiving prednisone and
      azathioprine immunosuppression. The dose of cyclosporine used did not appear to
      influence the development of hypertension. Intermittent steroid exposure did not
      increase the incidence in the cyclosporine group. Male transplant recipients and
      those older than 20 years appeared more prone to the development of hypertension.
      A family history of cardiovascular disease also increased the incidence.
      Preoperative and postoperative kidney dysfunction and transplantation because of
      ischemic heart disease did not appear to affect the incidence of hypertension.
      Donor characteristics, including the use of hearts from donors who weighed more
      than the recipients and from patients dying of spontaneous intracranial
      hemorrhage, did not appear to increase the incidence of hypertension after heart
      transplantation.

PMID- 2231096
TI  - Treatment of rejection after heart transplantation: what dosage of pulsed
      steroids is necessary?
AB  - Histologically proved rejection after heart transplantation is commonly treated
      with intravenous steroids, 1 gm/day for 3 days. This regimen may result in severe
      side effects, however, both metabolic and infectious. In a total of 663 rejection
      episodes, we treated 397 with conventional steroid therapy, 1000 mg per day for 3
      days (group 1), 199 with 500 mg/day for 3 days (group 2), and 67 with 250 mg/day
      for 3 days (group 3). Response to treatment was assessed by control biopsy after
      1 week and graded as ongoing, resolving, or resolved rejection. The efficacy of
      the three regimens showed no significant differences between the groups as
      determined by the results of the subsequent biopsy. Ongoing rejection, resolving
      rejection, and resolved rejection, respectively: group 1-3.3%, 66.5%, 30.2%;
      group 2-8.0%, 66.8%, 25.2%; group 3-4.5%, 73.1%, 22.4%. We conclude that
      comparable effects, even with a considerable reduction of pulsed steroids, may be
      obtained in the treatment of cardiac allograft rejection, if triple-drug
      immunosuppression is used for maintenance therapy. It seems likely that steroid
      side effects may be decreased without jeopardizing the graft.

PMID- 2231097
TI  - Kinking of the pulmonary artery: a treatable cause of acute right ventricular
      failure after heart transplantation.
AB  - Kinking of the pulmonary artery has been reported only once as a cause of acute
      right ventricular failure after heart transplantation. We report two cases of
      kinking of the pulmonary artery encountered during a 3-year period (120 heart
      transplants). An analysis of the causes of this complication and a diagnostic and
      therapeutic approach are presented.

PMID- 2231099
TI  - Inferior vena caval filters in heart transplant recipients with perioperative
      deep vein thromboses.
AB  - Heart transplant recipients may constitute a high-risk group for pulmonary
      embolism and subsequent complications. We present the cases of two patients who
      underwent prophylactic filter insertion after deep venous thrombosis developed
      perioperatively and discuss our rationale for this approach.

PMID- 2231098
TI  - Azathioprine-related cholestatic jaundice in heart transplant patients.
AB  - Azathioprine is an immunosuppressive drug occasionally indicted as the cause of
      some episodes of acute cholestasis. The case described confirms the possibility
      of acute, severe, and reversible cholestatic hepatopathy of iatrogenic (toxic
      rather than idiosyncratic) origin.

PMID- 2231100
TI  - Cyclosporine neurotoxicity in heart transplantation.
AB  - The neurotoxic potential of cyclosporine in previous clinical experience has not
      been considered a significant problem. Recently a significant incidence of severe
      neurotoxicity has been related to cyclosporine therapy in liver transplant
      recipients. In our heart transplant program we have observed an unexpectedly high
      incidence of serious neurologic toxicity, presumably caused by use of
      cyclosporine. Coma, cerebral hemorrhage, hemiparesis and dysphasia, confusion,
      and visual hallucinations were reported in four patients. Cyclosporine
      discontinuation or dose reduction eliminated the neurologic effects in all but
      one patient. Cyclosporine neurotoxic effects should be suspected in heart
      transplant recipients with central nervous system syndromes.

PMID- 2231101
TI  - Multidimensional digital image representations using generalized Kaiser-Bessel
      window functions.
AB  - Inverse problems that require the solution of integral equations are inherent in
      a number of indirect imaging applications, such as computerized tomography.
      Numerical solutions based on discretization of the mathematical model of the
      imaging process, or on discretization of analytic formulas for iterative
      inversion of the integral equations, require a discrete representation of an
      underlying continuous image. This paper describes discrete image representations,
      in n-dimensional space, that are constructed by the superposition of shifted
      copies of a rotationally symmetric basis function. The basis function is
      constructed using a generalization of the Kaiser-Bessel window function of
      digital signal processing. The generalization of the window function involves
      going from one dimension to a rotationally symmetric function in n dimensions and
      going from the zero-order modified Bessel function of the standard window to a
      function involving the modified Bessel function of order m. Three methods are
      given for the construction, in n-dimensional space, of basis functions having a
      specified (finite) number of continuous derivatives, and formulas are derived for
      the Fourier transform, the x-ray transform, the gradient, and the Laplacian of
      these basis functions. Properties of the new image representations using these
      basis functions are discussed, primarily in the context of two-dimensional and
      three-dimensional image reconstruction from line-integral data by iterative
      inversion of the x-ray transform. Potential applications to three-dimensional
      image display are also mentioned.

PMID- 2231102
TI  - Effect of yellow-tinted lenses on brightness.
AB  - Magnitude estimates of brightness were obtained for small (5-deg diameter) and
      large (15 deg X 20 deg) targets viewed through yellow-tinted lenses (ytl's) and
      luminance-matched neutral lenses. The results indicate that brightness perception
      with ytl's is up to 40% greater than that with neutral lenses when the spatial
      extent of the stimulus exceeds the fovea. The onset of the enhancement effect is
      coincident with the chromatic threshold, and its end point is coincident with
      psychophysical estimates of rod saturation. In a second experiment, brightness
      estimates were obtained for the ytl's and neutral lenses during the cone plateau
      of the dark adaptation curve when rods, but not cones, were desensitized by
      bleach. The brightness-enhancement effect was negligible. These results confirm
      the subjective impression that brightness perception is enhanced by ytl's and
      indicate that this effect is mediated, in large part, by the contribution of rod
      signals to the chromatic pathway.

PMID- 2231103
TI  - Spectral sensitivity and adaptation characteristics of cone mechanisms under
      white-light adaptation.
AB  - Increment-threshold spectral-sensitivity (ITSS) functions and threshold-versus
      intensity (tvi) curves were measured under white-light adaptation in rhesus
      monkeys. The tvi curves showed shape and test wavelength invariance, implying
      that three cone mechanisms were mediating detection. In general, the results were
      in agreement with the differential adaptation hypothesis proposed by Stiles that
      predicted spectral shape invariance of the cone mechanisms but overall changes in
      the shape of the spectral-sensitivity function with increases in the intensity of
      the adapting field. The principal changes occurring in the ITSS function as the
      level of adaptation increased involved a smaller loss in sensitivity of the short
      wavelength and the long-wavelength peaks compared with the corresponding loss in
      sensitivity of the middle-wavelength peak. A three-channel model with an opponent
      L-M mechanism and a nonopponent L-M mechanism (both with S-cone input) and an
      independent S-cone mechanism described the ITSS data as well as other increment
      threshold and suprathreshold data. The model values for the ITSS functions, along
      with parameters derived from the transformation of these data to cone-contrast
      coordinates, permitted the factoring out of first-site adaptation, second-site
      adaptation, and the relative strengths of contribution of the L and M cones
      within the opponent and nonopponent L-M channels.

PMID- 2231104
TI  - Lightness and brightness over spatial illumination gradients.
AB  - We extended our studies of lightness and brightness in complex scenes to cathode
      ray-tube simulations of an array of 35 gray reflective patches under spatially
      varying illuminants. There were three illuminance profiles, an abrupt step, a
      linear gradient, and a simulation of side illumination, with nine steepnesses of
      each. In half the sessions observers adjusted a test patch at one end of the
      illumination gradient in order to match the lightness of a standard patch at the
      other end of the gradient. In the remaining sessions they matched the brightness
      of the test patch to that of the standard. For all three illuminance profiles the
      lightnesses of the patches matched when they had approximately the same simulated
      reflectance; i.e., there was excellent lightness constancy even though the
      illuminance gradients were clearly visible.

PMID- 2231105
TI  - Perceptual-components architecture for digital video.
AB  - A perceptual-components architecture for digital video partitions the image
      stream into signal components in a manner analogues to that used in the human
      visual system. These components consist of achromatic and opponent color
      channels, divided into static and motion channels, further divided into bands of
      particular spatial frequency and orientation. Bits are allocated to an individual
      band in accord with visual sensitivity to that band and in accord with the
      properties of visual masking. This architecture is argued to have desirable
      features such as efficiency, error tolerance, scalability, device independence,
      and extensibility.

PMID- 2231106
TI  - Visual artifacts in chromatically subsampled images.
AB  - Colors sampled in an array of pixels were converted into various luminance
      chrominance representations, and the chrominance values were spatially subsampled
      to achieve a compression of the data. For viewing, the chrominance values were
      reinterpolated and then transformed back to RGB. For each of a range of image
      types and color spaces, we varied the chromatic sample spacing to determine how
      much compression would be possible before perceptual artifacts appeared, as
      determined by a panel of individual viewers. The spacing at which an image was
      mistaken half the time for a remembered original depended on image content and
      also on the color representation. Some color spaces, such as hue-lightness
      saturation, a polar-coordinate color space, are inherently ill suited for
      chrominance averaging and produce noticeable artifacts on almost any image.
      Likewise, some images cannot be subsampled satisfactorily, regardless of the
      color space used. In general, however, images with 16-fold reduction in the
      amount of chrominance information (that is, a factor of 4 in each spatial
      direction) are still satisfactory in appearance.

PMID- 2231107
TI  - Discriminability metric based on human contrast sensitivity.
AB  - We evaluated a metric for predicting the discriminability of different digitized
      versions of alphanumeric characters. The metric is based on the assumption that
      there exists a visual filter such that discriminability is monotonic with the
      contrast energy in the visually filtered difference between stimuli. To test this
      hypothesis, we presented two same or different digital versions of a master
      character and asked subjects to indicate whether the characters were the same or
      different in a forced-choice procedure with feedback. The filtered contrast
      energy difference was calculated by convolving the difference between stimulus
      pairs with filters derived from published human contrast sensitivity functions,
      following an initial nonlinear transformation of stimulus intensity, and summing
      the squared result. For some types of stimulus difference, such as contrast
      quantization errors and Gaussian blurring, performance on discrimination tasks is
      monotonically related to the contrast energy of the filtered difference vector.
      The results are consistent with the hypothesis that there exists a single
      psychometric function that can predict the discriminability of different
      digitized versions of characters when displayed on various devices.

PMID- 2231108
TI  - Segregation of basic colors in an information display.
AB  - Previous studies of the role of color in visual search have shown efficient
      coding for as many as six colors in a high-density display. In an effort to
      increase this limit, we established an optimal basic color code from extensive
      surface-color-naming data. This code yielded excellent segregation in a visual
      search task: The time required to find a critical target of a cued color
      increased only marginally as up to nine groups of different colors were added to
      the display. It made no difference whether the cue was provided by name or by
      example. Significant color differences in this task triggered a second
      experiment, which examined the detectability of the critical target feature in
      the periphery. A close correlation was found to exist in the order of color
      performance between the two experiments. Color segregation was tested again in a
      third experiment, in which subjects were required to count the number of targets
      of the cued color. The colors again segregated well. A final experiment tested
      the proposition that it was the basic nature of the colors that was responsible
      for the good segregation. When seven basic colors were pitted against seven
      equally discriminable nonbasic ones in a modified version of the visual search
      task, no significant difference was found between the two groups. It is concluded
      that basic colors segregate well not because they are universally named but
      because they are well separated in color space.

PMID- 2231109
TI  - Visual search for color differences with foveal and peripheral vision.
AB  - Color differences required for fast parallel searches were measured for small and
      large display fields. The main purpose of the measurement was to test the
      hypothesis that serial searches obtained with small color differences in large
      display fields are due to poor discrimination in the peripheral visual field and
      to the need for foveal fixation. Results do not support this hypothesis but show
      that the color differences required for parallel search are just as large in a
      display confined to an area roughly the size of the fovea as in a large display.
      However, results also show that the color difference required for a fast,
      parallel search is dependent on the size of the stimuli in a large display field.
      This result is consistent with the possibility that poor discrimination in the
      periphery may contribute to the size of the required differences if the stimuli
      are small.

PMID- 2231110
TI  - Psychophysics of reading. XI. Comparing color contrast and luminance contrast.
AB  - Text can be depicted by luminance contrast (i.e., differences in luminance
      between characters and background) or by color contrast (i.e., differences in
      chromaticity). We used a psychophysical method to measure the reading speeds of
      eight normal and ten low-vision subjects for text displayed on a color monitor.
      Reading speed was measured as a function of luminance contrast, color contrast
      (derived from mixtures of red and green), and combinations of the two. When color
      contrast is high, normal subjects can read as rapidly as with high luminance
      contrast (greater than 300 words/min). Curves of reading speed versus contrast
      have the same shape for the two forms of contrast and are superimposed when
      contrast is measured in multiples of a threshold value. When both color and
      luminance contrast are present, there is no sign of additive interaction, and
      performance is determined by the form of contrast yielding the highest reading
      rate. Our findings suggest that color contrast and luminance contrast are coded
      in similar ways in the visual system but that the neural signals used in letter
      recognition are carried by different pathways for color and luminance. We found
      no advantages of color contrast for low-vision reading. For text composed of 6
      degrees characters, all low-vision subjects read better with luminance contrast
      than with color contrast.

PMID- 2231112
TI  - Characterization of task performance with viewing instruments.
AB  - Recognition of one military vehicle of a group of six was investigated
      experimentally as a realistic observation task both for vision through image
      intensifiers and for thermal viewing devices. It is shown that recognition of
      real targets is visually equivalent to the detection of a circular disk of a
      certain size. The size of the equivalent disk is characteristic of the difficulty
      of the observation task. The image quality of viewing instruments can be related
      to the size of the disk that can just be detected. This measure of image quality
      includes resolution, low contrast, low luminance, and noise effects. The
      effective range of viewing instruments is directly scaled to equivalent-disk size
      and can be taken as a practical measure of image quality.

PMID- 2231111
TI  - Reading with fixed and variable character pitch.
AB  - We compared the effects of fixed and variable (proportional) spacing on reading
      speeds and found variable pitch to yield better performance at medium and large
      character sizes and fixed pitch to be superior for character sizes approaching
      the acuity limit. The data indicate at least two crowding effects at the smallest
      sizes: one that interferes with individual character identification and one that
      interferes with word identification. A control experiment using rapid serial
      visual presentation suggests that it is the greater horizontal compression and
      consequently reduced eye-movement requirements of variable pitch that are
      responsible for its superiority at medium and large character sizes.

PMID- 2231113
TI  - Contrast in complex images.
AB  - The physical contrast of simple images such as sinusoidal gratings or a single
      patch of light on a uniform background is well defined and agrees with the
      perceived contrast, but this is not so for complex images. Most definitions
      assign a single contrast value to the whole image, but perceived contrast may
      vary greatly across the image. Human contrast sensitivity is a function of
      spatial frequency; therefore the spatial frequency content of an image should be
      considered in the definition of contrast. In this paper a definition of local
      band-limited contrast in images is proposed that assigns a contrast value to
      every point in the image as a function of the spatial frequency band. For each
      frequency band, the contrast is defined as the ratio of the bandpass-filtered
      image at the frequency to the low-pass image filtered to an octave below the same
      frequency (local luminance mean). This definition raises important implications
      regarding the perception of contrast in complex images and is helpful in
      understanding the effects of image-processing algorithms on the perceived
      contrast. A pyramidal image-contrast structure based on this definition is useful
      in simulating nonlinear, threshold characteristics of spatial vision in both
      normal observers and the visually impaired.

PMID- 2231115
TI  - Mesopic color matching: some theoretical issues.
AB  - In this paper I address some theoretical issues concerning the additivity laws of
      Grassmann as they might apply to color matches in mesopic vision (in which light
      intensities are such that both rods and cones are active). It is first shown that
      rods and cones have linearly independent spectral responses, and hence rod and
      cone spectral responses span a four-dimensional matching space. Next, the
      iterative tetrachromatic-matching experiment of Trezona [Vision Res. 13, 9
      (1973)] is examined for consistency with a four-dimensional Grassmann structure;
      convergence conditions for the technique are derived and shown to be consistent
      with the actual conditions of the experiment. Finally, a discussion is presented
      of the conditions under which mesopic color matching would require only three
      primaries, even when color matching obeys four-dimensional (but not three
      dimensional) Grassmann laws. A two-dimensional rod-cone diagram gives significant
      but not complete insight into the conditions for trichromacy in a four
      dimensional color-matching space.

PMID- 2231114
TI  - Image segmentation by object color: a unifying framework and connection to color
      constancy.
AB  - A unifying framework is presented for algorithms that use the bands of a
      multispectral image to segment the image at material (i.e., reflectance)
      boundaries while ignoring spatial inhomogeneities incurred by accidents of
      lighting and viewing geometry. The framework assumes that the visual stimulus
      (image field) from a uniformly colored object is the sum of a small number of
      terms, each term being the product of a spatial and a spectral part. Based on
      this assumption, several quantities depending on the reflected light can be
      computed that are spatially invariant within object boundaries. For an image
      field either from two light sources on a matte surface or from a single light
      source on a dielectric surface with highlights, the invariants are the components
      of the unit normal to the plane in color space spanned by the pixels from the
      object. In some limited cases the normal to the plane can be used to estimate
      spectral-reflectance parameters of the object. However, in general the connection
      of color-constancy theories with image segmentation by object color is a
      difficult problem. The concomitant constraints on segmentation and color
      constancy algorithms are discussed in light of this fact.

PMID- 2231116
TI  - Ophthalmic changes during normal and toxemic pregnancy.

PMID- 2231117
TI  - Dementia and Alzheimer's disease: resources in Oklahoma.
AB  - Senile dementia and Alzheimer's disease (often considered a single process) rank
      as the fourth most common cause of death in the United States and outrank in cost
      to the nation the three leading causes of death combined. Autopsy studies of
      patients with the clinical diagnosis of dementia have clearly shown that a wide
      variety of pathological conditions can produce clinically similar symptomatology.
      In order to address the many possible causes and treatments of these various
      forms of dementia, the Alzheimer's Association (formerly known as the Alzheimer's
      Disease and Related Disorders Association), the Oklahoma Autopsy Assistance
      Network at the Oklahoma Medical Research Foundation, and The Alzheimer's
      Foundation (also known as the Familial Alzheimer's Disease Research Foundation)
      have begun a concerted effort to develop a regional network which can aid
      patients and their relatives in the diagnosis and management of dementia.
      Awareness of these organizations by all physicians will help in the development
      and dissemination of the newer and more specific treatments to patients (and
      their relatives) with Alzheimer's disease and other forms of dementia in
      Oklahoma.

PMID- 2231118
TI  - Rural physician survey.
AB  - In August 1989, the Physician Manpower Training Commission conducted a survey in
      an effort to learn what factors influence the recruitment and retention of
      physicians in rural Oklahoma communities. The results of the survey are
      summarized in this article.

PMID- 2231119
TI  - Dural tears associated with lumbar burst fractures.
AB  - A retrospective review of 817 spinal fracture patients revealed a 7.7% (20 of
      258) incidence of dural tears in surgically treated patients. Dural tears were
      most common in the lumbar burst fractures (10 of 85). Twenty-five percent of
      patients with lumbar spine burst fractures and a neurologic deficit had a dural
      tear requiring repair. Eighty-six percent of patients with lumbar burst injuries
      and dural tears had a neurologic deficit. An initial posterior approach with
      inspection of the dura and stabilization of the fracture is recommended when
      treating lumbar burst fractures with a neural deficit.

PMID- 2231120
TI  - Non-invasive low-intensity pulsed ultrasound accelerates bone healing in the
      rabbit.
AB  - The effect of ultrasound (US) on the rate of fibula osteotomy healing in 139
      mature New Zealand white rabbits was assessed in this study. Bilateral midshaft
      fibular osteotomies were made using a 1-mm Gigli saw. US was noninvasively
      applied to one limb for 20 minutes daily, while the contralateral limb served as
      a control. A 2.5-cm PZT transducer was applied to both limbs, with the treated
      limb receiving a 200-microseconds burst of 1.5-MHz sine waves repeated at 1.0
      kHz. The incident intensity was approximately 30 mW/cm2. Animals were killed at
      intervals between 14 and 28 days. Maximum strength increases (significant to p
      less than or equal to 0.01) ranged from 40 to 85% from postoperative day 14 to
      23. On day 28, no significant difference in ultimate strength was noted. From day
      17 through day 28, all US-treated fractures were as strong as intact bones (p
      less than or equal to 0.005). On the other hand, the ultimate strength of the
      control osteotomies attained intact values only by day 28. These results indicate
      that biomechanical healing is accelerated by a factor of nearly 1.7. This occurs
      with an overall acceleration of the healing curve in this fresh fracture model.
      If noninvasive low-intensity pulsed sine wave ultrasound can significantly
      accelerate bone repair in clinical application with an in-home treatment of 20
      minutes daily, then US may be a useful adjunct for fracture care with a
      concomitant impact on patient morbidity.

PMID- 2231122
TI  - Internal fixation of the distal humerus: a biomechanical comparison of methods.
AB  - Three commonly used configurations of various implants used for fixation of
      distal humeral fractures were quantitatively compared. The double plate
      construct, irrespective of plate type (1/3 tubular and/or 3.5 mm reconstruction
      plate), was significantly stronger, both in rigidity and fatigue testing, than
      cross screws or the single "Y" plate. If rigid stabilization of supracondylar or
      bicondylar distal humeral fractures is desired, then two plate constructs, at
      right angles (the ulna plate medially, the lateral plate posteriorly), are
      biomechanically optimal.

PMID- 2231121
TI  - Open reduction and internal fixation of delayed union and nonunion of the distal
      humerus.
AB  - Nonunion of a condylar fracture of the distal humerus rarely occurs, but when
      present it is difficult to manage. We recommend internal fixation of the nonunion
      in combination with decortication and autogenous iliac crest bone grafting along
      with careful selection and placement of the implant. Postoperatively, the goal is
      preservation of elbow motion until the nonunion heals. We reviewed the cases of
      five patients who had surgery for nonunion of this fracture, all of which healed
      within 2-3 months after surgery. At final follow-up their average arc of motion
      was 88 degrees.

PMID- 2231123
TI  - Supracondylar fractures of the humerus in children: analysis of the results in
      142 patients.
AB  - One hundred forty-two children who had supracondylar humerus fractures and who
      were treated either by open reduction and internal fixation or by closed methods
      were reviewed. There were 104 boys and 38 girls. Their ages ranged between 2 and
      14 years, with an average age of 8 years. One hundred thirteen of the fractures
      were of the extension type and 29 were of the flexion type. Sixty-two patients
      were treated by manipulative reduction and immobilization in a plaster of Paris
      cast, and 20 were treated by overhead skeletal traction followed by the
      application of a plaster of Paris cast. The other 60 patients were treated by
      open reduction and internal fixation. The follow-up period ranged from 4 years to
      11 years, with an average of 7.5 years. The results were evaluated based on the
      range of motion, the subsequent deformity, if any, and the carrying angle. In the
      overall series we had 72 (50.70%) excellent, 31 (21.83%) good, 13 (9.15%) fair,
      and 26 (18.30%) poor results.

PMID- 2231124
TI  - Internal fixation of proximal radial head fractures.
AB  - The treatment of choice for proximal radial head fractures remains controversial.
      The goal of any treatment for an intra-articular fracture must be the complete
      restoration of the joint and its function. Nonoperative treatment leads to full
      motion in cases of less than 1-2 mm of fracture displacement. Resection of the
      radial head can be recommended only for very comminuted fractures. All other
      fracture types should be treated by open reduction and internal fixation. Our own
      personal follow-up observation of 19 patients who had surgical intervention
      demonstrated restoration of elbow function after an average follow-up time of
      11.7 months. Five patients had a slightly restricted range of motion of less than
      10 degrees extension and flexion as well as less than 8 degrees pronation and
      supination, without signs of arthritis. Because complications were minimal, we
      recommend internal fixation of displaced proximal radial head fractures to
      restore the anatomic function of the elbow. This is especially true in cases with
      accompanying proximal ulna fractures and/or ruptured collateral ligaments of the
      elbow joint and/or disruption of the distal radio-ulnar joint.

PMID- 2231125
TI  - Biomechanical and histological evaluation of the Herbert screw.
AB  - The Herbert screw has been demonstrated to have widespread clinical
      applicability. A biomechanical and histological evaluation of the Herbert screw
      was conducted to better define its applications. When subjected to pull-out,
      toggle, and compression testing, in a cancellous bone calf model, it was
      demonstrated to be biomechanically inferior to the 4.0 mm ASIF cancellous screw.
      The use of two Herbert screws minimized but did not eliminate this difference.
      Articular cartilage healing in a rabbit model was consistently demonstrated if
      the Herbert screw was buried deep to the osteochondral junction. However,
      toluidine blue histochemical staining showed that the hyaline-like repair
      cartilage differed qualitatively from normal cartilage. Utilization of the
      Herbert screw should include an understanding of the limitations of its fixation
      potential and a recognition of the repair response after intraarticular
      applications.

PMID- 2231126
TI  - Traction force profiles associated with the use of a fracture table: a
      preliminary report.
AB  - A load cell was developed that can reliably monitor longitudinal traction forces
      applied to limbs during several different orthopaedic procedures. This permitted
      determination of tensile loads and the effects of patient limb positions on
      tension magnitudes. The relationships between the magnitude and duration of
      applied tension to functional nerve changes were also studied. This preliminary
      report reviews traction force data on seven patients for eight operations. Mean
      peak loads for femoral, tibial, and hip procedures were 686, 356, and 306 N,
      respectively. Adduction of the limb around a fixed peroneal post caused great
      increases in traction forces.

PMID- 2231128
TI  - Ipsilateral fractures of femoral neck and shaft.
AB  - Thirteen cases of ipsilateral intracapsular femoral neck and shaft fractures were
      seen. All cases occurred in young adults, with the mechanism of injury in all
      instances being high-energy trauma. The diagnosis of the femoral neck fracture
      was missed initially in four cases. The patients were divided into four groups
      according to treatment protocol: group 1 (two cases), both fractures treated
      nonoperatively; group 2 (four cases), femoral neck fracture treated
      nonoperatively, open reduction and internal fixation of femoral shaft fracture;
      group 3 (three cases), McMurray's osteotomy for femoral neck fracture and
      internal fixation for the femoral shaft fracture; and group 4 (four cases), open
      reduction and internal fixation of both fractures. The follow-up period ranged
      from 6 months to 10.1 years. There was a nonunion of one femoral neck fracture,
      while all shaft fractures united. The best results were seen in group 4 cases. It
      is also recommended that routine high-quality X-ray films of the hip should be
      done in all cases of femoral shaft fracture to decrease the high incidence of
      missed femoral neck fractures in ipsilateral injuries of the femur.

PMID- 2231127
TI  - The neglected hip fracture.
AB  - An untreated fracture of the hip will usually present as a nonunion or a malunion
      and can present a great challenge to the surgeon. We present our experience with
      54 neglected hip fractures, of which 48 had surgical treatment. Malunions were
      treated with corrective osteotomy. Total hip arthroplasty was used for the older
      patients with femoral neck nonunions. The younger patients with femoral neck
      nonunion represented the most difficult problem, and we found valgus osteotomy to
      be the best procedure for this group.

PMID- 2231129
TI  - The Partridge nylon cerclage: its use as a supplementary fixation of difficult
      femoral fractures in the elderly.
AB  - We report on our early experience with the use of the Partridge nylon cerclage.
      This system was employed as a supplementary fixation in 18 femoral fractures in
      elderly patients (average age, 78 years). Indications of its use were reduction
      of comminuted fragments and enhancement of the grip of the main fixation device
      on osteoporotic femora or in femora with a prosthesis in situ. All fractures but
      one healed primarily. At an average follow-up time of 25 months, 15 of the 18
      patients were ambulatory. Radiographic review showed that the cerclage did not
      cause cortical avascularity and that none of the straps used failed. We concluded
      that the internal fixation of difficult femoral fractures in the elderly can be
      easily and effectively strengthened by the use of this cerclage system.

PMID- 2231130
TI  - Fractures of the ipsilateral femur and tibia: emphasis on intra-articular and
      soft tissue injury.
AB  - Twenty-one patients with fractures of the ipsilateral femur and tibia were
      treated at Boston City Hospital from 1982 through 1987. Fourteen (67%) of the 21
      patients sustained a total of 17 open fractures (76% of which were grade II or
      III wounds). Over 50% of the patients suffered concomitant ipsilateral knee
      injuries. Associated injuries required 37 nonorthopaedic procedures; 30
      orthopaedic procedures were required to stabilize the axial skeleton and the
      other three extremities. Five patients ultimately required amputation, reflecting
      the magnitude of the initial high-energy trauma. Superior results were achieved
      when early rigid intramedullary fixation of the femur and rigid stabilization of
      the tibia with either an intramedullary nail or an external fixator was
      undertaken. Patients that underwent initial rigid intramedullary fixation of both
      the femur and tibia required fewer secondary operative procedures than those
      treated with primary external fixation. Rigid internal fixation allowed for
      thorough evaluation and treatment of the ligamentous structures of the knee and
      facilitated management of the soft tissue trauma.

PMID- 2231131
TI  - Successful use of reaming and intramedullary nailing of the tibia.
AB  - The records and radiographs of 87 patients with 88 fractures of the tibial
      diaphysis who underwent intramedullary reaming and nailing were retrospectively
      reviewed. The mean patient age was 37 years. Seventy fractures were closed, and
      18 were open. The indications for nailing were failures of closed treatment (n =
      48), nonunions (n = 24), multiple injuries (n = 14), and fixation of osteotomy (n
      = 2). Seventy-six patients with 77 nails who were followed for an average of 26.2
      months were studied. For acute fractures, the average time to complete clinical
      and radiographic union was 5.3 months. For established nonunions, the average
      healing time was 9 months. The only fractures that failed to unit were nonunions
      developing from previously open Type III injuries. Angular deformities greater
      than 5 degrees did not occur. Significant tibial shortening occurred in only one
      fracture. Decreased motion in the ankle or knee was present in six patients.
      Major complications as a result of tibial nailing occurred in three patients: two
      deep infections and one patellar tendon rupture. Minor complications included 10
      patients with pain at the nail insertion site necessitating removal in four
      patients, three patients with transient sensory peroneal nerve dysesthesias, and
      one patient with a superficial wound infection that cleared with local care. Nine
      patients required reoperation. Intramedullary reaming and nailing of the tibia
      can be used advantageously in the treatment of difficult fractures of the tibial
      shaft and their sequelae. Attention to the technical details of nail insertion
      will minimize the most frequent complications.

PMID- 2231132
TI  - Effects of dynamization after interlocking tibial nailing: an experimental study
      in dogs.
AB  - Dynamization of statically locked tibial nails was studied in a canine model.
      Reamed static interlocking nails were inserted in 16 canine tibiae with unstable
      osteotomies. At 8 weeks, half were dynamized. At 20 weeks, the tibiae were
      harvested and studied radiographically, biomechanically, and histologically.
      Apparent clinical union was present in all tibiae. Complete radiographic bony
      union was achieved in 13 of 16, with residual radiolucent lines in two tibiae in
      the static and one in the dynamic group. Biomechanically, dynamization improved
      stiffness at the fracture site. Histological patterns were similar, but there
      were trends toward a denser trabecular callus pattern in the dynamized group. The
      results of this animal study indicate that although dynamization may have a
      beneficial effect on the quality of early bony healing, static interlocking does
      not decrease the rate of bony union.

PMID- 2231134
TI  - Posterior collicular fractures of the medial malleolus.
AB  - The posterior colliculus of the medial malleolus gives origin to the deep part of
      the deltoid ligament. Posterior collicular fractures are rare injuries, usually
      nondisplaced due to stabilization by the tibialis posterior and flexor digitorum
      longus tendons. This nondisplaced fracture is best identified on external oblique
      radiographs, which are not usually included in standard ankle views. Thus, some
      index of suspicion is necessary for their detection. A satisfactory result can be
      achieved by nonoperative treatment of the posterior collicular fracture.

PMID- 2231133
TI  - What's in a nail?
AB  - To determine the incidence of subclinical infection using routine swab methods in
      asymptomatic patients, 30 consecutive hollow intramedullary nails were studied.
      Variables identified were leukocyte count and differential, patient complaints,
      time elapsed from injury to nail implantation, duration of nail implantation, and
      the size of the nail. Specimens were gathered from the lumen of intramedullary
      nails using the routine swab method for bacterial culture as well as fungal and
      acid-fast growth. This material was also subjected to pathologic review with
      routine hematoxylin and eosin staining. There were no significant positive
      cultures in this study. The pathologic review indicated that the material in the
      canal of an intramedullary nail was either granulation tissue, fibrous tissue, or
      osseous tissue. No patient had a deep or superficial wound infection after
      implant removal. The results of this study indicate that the material in the
      lumen of the hollow intramedullary nail will fail to grew organisms when the swab
      method is used in gathering the specimen or the material is sent for quantitative
      bacteriology.

PMID- 2231136
TI  - Volumetric three-dimensional computed tomography for acute calcaneus fractures:
      preliminary report.
AB  - Volumetric three-dimensional (3-D) computed tomographic reconstructions were
      performed on three cadaver specimens before and after fracture for 16 acute
      calcaneal fractures. This "second-generation" 3-D reconstruction technique
      produced accurate, detailed images of the extra-articular fracture anatomy. Use
      of this method provided visualization of specific fracture component displacement
      otherwise unappreciated prior to surgery. In two cases, vertical splits in the
      superomedial fragment were demonstrated to best advantage by this 3-D technique.

PMID- 2231135
TI  - Long-term results of pronation-external rotation ankle fracture-dislocations
      treated with anatomical open reduction, internal fixation.

PMID- 2231137
TI  - Fractures of the calcaneal apophysis.
AB  - Eleven patients with 12 open or closed fractures of the calcaneal apophysis were
      reviewed. The patterns of fracture varied, although all could be classified by a
      scheme similar to that used for physeal injuries in the long bones. Open injuries
      involved young children and were associated with subsequent maldevelopment of the
      posterior (nonarticular) portion of the calcaneus due to growth mechanism damage.
      The other susceptible age group, adolescence, had two patients with slipped
      calcaneal apophysis (type 1 injury), similar to slipped capital femoral
      epiphysis, and three patients with a splitting fracture through the apophysis and
      physis into the main part of the calcaneus (type 4 injury). Microscopic physeal
      injury was also observed in the calcaneus of a fatally injured boy.

PMID- 2231138
TI  - Remodeling of the skeletally immature distal radius.
AB  - This case report describes the clinical course of a boy 12 years and 11 months
      old with the skeletal maturity of an 11.5-year-old, with a distal radial fracture
      that completely remodeled with 36 degrees of radial and 10 degrees of dorsal
      angulation. As this case demonstrates, the distal forearm may correct angulation
      in more than one plane. The remodeling capacity depends on the skeletal maturity
      of the patient, the proximity of the fracture site to the growth plate, the
      extent of angulation, and the relationship between the plane of angulation and
      motion of neighboring joints.

PMID- 2231139
TI  - Lateral ankle dislocation without fracture.
AB  - Ankle fracture dislocations are a common entity in orthopaedic practice and their
      treatment is well documented. Dislocations of other joints are usually treated by
      closed reduction with a brief period of immobilization. This ankle dislocation
      without fracture is a rare injury which was treated similarly to other joint
      dislocations. An intact bony construct of an ankle following dislocation allows
      for subsequent joint stability when soft tissues have healed.

PMID- 2231140
TI  - Deficit (14 cm) of the tibia solved by a double sliding graft using the Ilizarov
      apparatus.
AB  - A 14 cm deficit of the tibia with a soft tissue deficit was resolved using the
      apparatus of Ilizarov. The apparatus was applied using a double corticotomy of
      the proximal and distal remainder of the tibia. The fragments were moved until
      they met each other in the central part of the deficit. Afterwards, a part of the
      apparatus was changed (the constructions for sliding grafts were replaced with
      two new circles). This enabled the compression between the "kissed" fragments,
      and the space between those fragments and distal and proximal tibial adjacent to
      the remaining joints was filled by the newly formed bone formation.

PMID- 2231141
TI  - Putting your reputation in the bank.

PMID- 2231142
TI  - Facial trauma in women resulting from violence by men.
AB  - In a 2 1/2-year period, 546 women with facial injuries were treated. In 8.2%, the
      injury was related to some form of violence exerted by a man. In cases where the
      individual was known, it was usually the husband or boyfriend (almost 67%). The
      assault consisted of a beating with the hands in over 70% of the cases. Fracture
      of the mandible was the most common injury. There were also 62 cases of home
      accidents.

PMID- 2231143
TI  - The problem of the bifid mandibular condyle.
AB  - In a survey of 1,882 prehistoric and historic skulls with 2,077 condyles, 7
      double (bifid) mandibular condyles were found. One mandible with bilaterally
      bifid condyles is presented in detail. Possible causes and consequences of the
      anomaly are discussed. It is assumed that bifid mandibular condyles with
      anteroposteriorly situated heads are caused by early childhood fractures, whereas
      those with mediolaterally situated heads are caused by the persistence of
      connective tissue septa.

PMID- 2231144
TI  - Conventional radiographic and computed tomographic findings in cases of fracture
      of the mandibular condylar process.
AB  - A total of 40 patients with 46 fractures of the mandibular condylar process were
      examined an average of 47 months after the injury. The conventional radiologic
      examination consisted of panoramic radiography and lateral transcranial view of
      the fracture in the mouth-open and mouth-closed positions. Sixteen patients with
      21 fractures of the condylar process were examined additionally by computed
      tomography (CT) because of temporomandibular joint problems in the sagittal and
      coronal projection. Computed tomography revealed bony changes in the fractured
      mandibular condyle and its position in the mandibular fossa more exactly than
      conventional radiographic examinations. Furthermore, the results showed that
      disturbances in the position and function of the articular disc may be more
      common than was earlier anticipated, suggesting the more frequent use of CT
      examinations to evaluate temporomandibular joint changes after condylar process
      fractures.

PMID- 2231145
TI  - Speech, velopharyngeal function, and hearing before and after orthognathic
      surgery.
AB  - Articulation, voice, resonance, hearing sensitivity, and middle ear function were
      examined in 34 patients before and 3, 6, 9, and 12 months after orthognathic
      surgery. Thirty of the 34 patients had articulation errors before surgery. Errors
      on the sibilants /s/ and /z/ occurred most frequently, followed by those on
      /j,zh,ch/ and /sh/. Errors were predominantly distortions with both visual and
      acoustic components. After surgery, articulation improved spontaneously in the
      absence of intervention. Most of the preoperative articulation errors were
      eliminated by 3 months postoperative, but, thereafter, a gradual decline was
      noted so that by 12 months, errors occurred on /s/ and /z/. Voice, resonance,
      velopharyngeal port area, and hearing sensitivity were not altered by surgery.
      This study suggests that severe skeletal malocclusions requiring surgical
      correction have deleterious effects on the patients' articulation of consonants
      and that surgical alteration leads to the correction of most of these errors.

PMID- 2231146
TI  - Evaluation of anterior maxillary alveolar ridge resorption when opposed by the
      transmandibular implant.
AB  - Fifteen edentulous patients with complaints regarding denture comfort and/or
      function were treated with the transmandibular implant. All patients were
      restored with conventional maxillary dentures opposed by implant-supported
      removable prostheses. Two to 4 years after surgery, these patients were evaluated
      for vertical and horizontal maxillary bone loss with a radiographic analysis
      developed by the authors. With this technique, attention was focused on vertical
      alveolar ridge resorption in the anterior maxilla. Although the sample size was
      small, the findings from this study indicate that vertical bone loss in the
      anterior maxilla does occur when a maxillary denture is opposed by an implant
      supported overdenture. Comparison of these results with a previous study that
      evaluated anterior maxillary resorption when a complete maxillary denture opposed
      natural mandibular anterior teeth and a distal extension removable partial
      denture demonstrated no statistically significant difference.

PMID- 2231148
TI  - Facial muscle reanimation using the trigeminal motor nerve: an experimental study
      in the rabbit.
AB  - Surgical repair of facial nerve deficits may be marred by lack of muscle control
      and donor region paresis. Using New Zealand white rabbits, a study was undertaken
      to evaluate facial muscle reanimation with a donor source not previously used:
      the motor division of the trigeminal nerve. The results were compared with the
      severed facial nerve and hypoglossal-facial coaptation. An atrophy scale was
      calibrated for facial muscles of the rabbit. Clinical, electromyographic, and
      histomorphometric findings confirmed that the trigeminal nerve was a suitable
      donor source. The neurorrhaphy produced an exponential rate of repair.

PMID- 2231147
TI  - Squamous cell carcinoma-antigen for detection of squamous cell and mucoepidermoid
      carcinoma after primary treatment: a preliminary report.
AB  - This study evaluated the efficacy of using the periodic measurement of the serum
      level of squamous cell carcinoma antigen (SCC-antigen) for determining the local
      recurrence and/or metastasis of squamous cell and mucoepidermoid carcinomas after
      primary treatment. It was found that at the time of clinical recognition of
      recurrence, the SCC-antigen level was normal, but metastasis to regional lymph
      nodes or to remote organs generally was accompanied by an increase of SCC
      antigen. Changes in the SCC-antigen level with mucoepidermoid carcinoma seemed to
      be less sensitive than with squamous cell carcinoma.

PMID- 2231149
TI  - Poly(L-lactide) implants in repair of defects of the orbital floor: an animal
      study.
AB  - Because of the life-long presence of alloplastic, nonresorbable orbital floor
      implants and the complications of their use mentioned in literature, the use of a
      resorbable material appears to be preferable in the repair of orbital floor
      defects. A high-molecular-weight, as-polymerized poly(L-lactide) (PLLA) was used
      for repair of orbital floor defects of the blowout type in goats. An artificial
      defect was created in the bony floor of both orbits. Reconstruction of the
      orbital floor was then carried out using a concave PLLA implant of 0.4-mm
      thickness. At 3, 6, 12, 19, 26, 52, and 78 weeks postoperatively, one goat was
      killed. Microscopic examination showed full encapsulation of the implant by
      connective tissue after 3 weeks. After 6 weeks, resorption and remodeling of the
      bone at the points of support of the implant could be detected. A differentiation
      between the sinus and orbital sides of the connective tissue capsule was
      observed. The orbital side showed a significantly more dense capsule than the
      antral side, which had a loose appearance. At 19 weeks, a bony plate was
      progressively being formed, and at 78 weeks, new bone had fully covered the plate
      on the antral and orbital side. No inflammation or rejection of the PLLA implant
      was seen.

PMID- 2231150
TI  - Pedunculated soft-tissue mass on the alveolar gingiva.
AB  - A case of peripheral ameloblastoma, a rare intraoral neoplasm, has been
      presented. The lesion appears most commonly as a mass on the mandibular lingual
      gingiva of patients in their fifth and sixth decades of life. The peripheral
      ameloblastoma does not share the aggressive nature of the intraosseous variant.
      The lesion has been overtreated in the past and warrants only a local
      supraperiosteal excision.

PMID- 2231151
TI  - Paraganglioma of the tongue.

PMID- 2231152
TI  - Fibrous dysplasia-induced hypocalcemia/rickets.

PMID- 2231153
TI  - Mucous cell hyperplasia in an odontogenic cyst from a patient with Muir-Torre
      syndrome.
AB  - Mucous cell proliferation in a periapical radicular cyst from a patient with a
      family history of colonic malignancies and multiple sebaceous neoplasms of the
      skin, so-called Muir-Torre syndrome, is reported. Such goblet cell hyperplasia
      has not been previously reported to be associated with any known syndrome. We
      believe the finding of mucous cell hyperplasia in an odontogenic cyst may not
      simply be coincidental, but should raise suspicion of paraneoplastic potential
      and warrant further evaluation for possible occult neoplastic disease.

PMID- 2231154
TI  - Metastatic leiomyosarcoma of the palate.

PMID- 2231156
TI  - Adaptation to mental nerve anesthesia.

PMID- 2231155
TI  - Nasal-vestibular drainage systems for infections of the maxilla.

PMID- 2231157
TI  - Effect of undercut placement on crown retention after thermocycling.
AB  - The aim of this study was to examine the effect of undercuts in castings and/or
      tooth structure on the retention of crowns luted with glass ionomer cement. After
      routine full-crown preparations had been made in 48 human premolars, wax patterns
      were fabricated for each tooth. Retentive coves were then produced with a round
      bur in either the tooth structure or the wax patterns, or in both. One group of
      teeth and patterns did not receive any undercuts; this was the control group.
      Castings were made in non-precious metal. All crowns were luted with glass
      ionomer cement. Half of the samples were thermocycled, and the remainder were
      kept at 37 degrees C. Crowns were removed using tension (0.012 cm min-1) and the
      mean bond strengths calculated. The differences in retentive strengths were
      tested for statistical significance using ANOVA and Scheffe's test. The presence
      of coves in castings and/or tooth structure significantly increased the retentive
      strength of castings cemented with glass ionomer, as compared with conventional
      crown preparations without retentive undercuts. The effect of thermocycling on
      the retentive strength of castings cemented with glass ionomer was not
      statistically significant.

PMID- 2231158
TI  - A potential MRI hazard: forces on dental magnet keepers.
AB  - The objective of this study was to determine the forces on dental prosthetic
      magnet keepers, with a view to assessing the potential for patient injury during
      magnetic resonance imaging (MRI). Four pre-formed keepers and one castable keeper
      alloy were tested. Magnetizations and high field susceptibilities were determined
      for each of the five specimens using data from a vibrating sample magnetometer.
      The magnetic field intensity with respect to distance from the main magnet coil
      was obtained from the manufacturer (1-5 tesla General Electric Signa Imaging
      System). A plot of force versus distance from the main coil and the maximum force
      at the magnet portal was determined for each specimen. The maximum forces ranged
      from 0.12-0.24 N for the pre-formed keepers and 3.67 MNm-3 for the castable
      alloy. It was concluded that the risk of patient injury by displacement is
      minimal, if the keepers are properly attached to supporting structures.

PMID- 2231159
TI  - Nocturnal bruxing events in healthy geriatric subjects.
AB  - Thirty healthy geriatric subjects were studied during a single night of sleep in
      a sleep laboratory. Unilateral masseter muscle activity was recorded in addition
      to the standard polysomnographic study. The geriatric subjects in this study
      exhibited fewer bruxing events than other subjects reported in the literature.
      Certain conditions that have not been previously investigated, such as sleep
      position, type of bruxing event, and relationship to the state of the dentition,
      are reported.

PMID- 2231160
TI  - Electrical potentials of restorations in subjects without oral complaints.
AB  - The electrical potentials of 183 amalgam and 11 precious metal restorations, and
      one set of brackets, were measured. None of the 28 subjects had galvanism,
      leukoplakia, oral lichen planus, or toxic or allergic reactions to restorations.
      The potentials of the amalgam restorations increased with age, from about -350 mV
      NHE at 30 days, to about +100 mV NHE after more than 1000 days. In most subjects
      potential differences of more than 50 mV were present between restorations; this
      phenomenon is therefore assumed to be common in healthy populations.

PMID- 2231161
TI  - Retention of denture adhesives--an in vitro study.
AB  - Denture adhesives are being used by patients to aid the retention and stability
      of their dentures. A number of laboratory and clinical investigations have been
      conducted to study the effects of such adhesives. This study describes a simple
      in vitro method for measurement of their retentive effect and its relation to
      loss of adhesive. The results show that there is a reduction in the effectiveness
      of adhesives, and that there is also an increase in adhesive loss, with time.
      There appears to be a correlation between these two properties.

PMID- 2231162
TI  - Further studies of mandibular movement at initial tooth contact.
AB  - By measurement of movement of the mandible immediately after tooth contact during
      tooth tapping tasks, it has been shown that patterns of direction are less
      regular in bruxist subjects than in non-bruxist individuals. The qualitative
      differences in these patterns are more apparent than the quantitative ones in
      both cessation and commencement of movement.

PMID- 2231163
TI  - The effects of an occlusal splint on the electromyographic activities of the
      temporal and masseter muscles during maximal clenching in patients with a habit
      of nocturnal bruxism and signs and symptoms of craniomandibular disorders.
AB  - The effects of a full arch maxillary plane occlusal splint on the level of
      electromyographic (EMG) activity in the anterior temporal and masseter muscles
      during maximal clenching were studied in 31 patients with a habit of nocturnal
      bruxism and signs and symptoms of craniomandibular disorders, before and after
      occlusal splint therapy. The results showed, before treatment, that the occlusal
      splint changed significantly (in 71% of patients) the level of EMG activity
      during maximal clenching. However, these changes were not consistent and differed
      between patients and even, in some patients, between muscles. After long-term
      occlusal splint therapy and improvement of the signs and symptoms of
      craniomandibular disorders, the number of patients who had an identical level of
      EMG activity during maximal clenching in the intercuspal position and on the
      occlusal splint tended to increase. Moreover, in these patients the level of
      symmetry of action in pairs of muscles during maximal clenching was strong, and
      the splint did not change this level of symmetry.

PMID- 2231165
TI  - Clinical oral test for the assessment of oral symptoms of glossodynia and
      glossopyrosis.
AB  - Subjective oral symptoms of a burning sensation and pain in the tongue may exist
      in the absence of any pathological changes in the oral mucosa. Owing to different
      treatment approaches and the lack of any specific therapy, it appeared
      potentially useful to identify these subjective symptoms by means of a test for
      an improved therapy evaluation. In this study, we have attempted to develop a
      method for the objective assessment of oral symptoms of glossodynia and
      glossopyrosis, by recording the local temperature. The temperature of the tongue
      was determined using a DT-1 electron thermoesthesiometer, that was highly
      sensitive to temperatures between 36 degrees C and 38 degrees C. Measurements
      were performed in topographic areas recommended by the World Health Organization
      in 1980. The study sample consisted of a group of 50 patients with glossopyrosis
      and glossodynia, without any clinically manifest pathological changes in the oral
      cavity, who were compared with a group of 50 age- and sex-matched subjects free
      of these oral symptoms and with normal oral mucosa. Statistically significant
      temperature differences were observed between the patients and the controls, as
      measured in seven different areas. The lowest temperatures (33 degrees C) were
      measured in the apex linguae area. The minimum temperature was significantly
      lower in the study group. Significant differences in temperature were also
      observed between the sexes. It was concluded that glossodynia and glossopyrosis,
      both inflammation and diminished circulation without any visible clinical signs,
      can be diagnosed using the thermoesthesiometry test. Such an objective test
      allows appropriate therapeutic treatment to be selected for patients with the
      above-mentioned symptoms.

PMID- 2231164
TI  - Dental cutting behaviour of mica-based and apatite-based machinable glass
      ceramics.
AB  - Some recently developed industrial ceramics have excellent machinability
      properties. The objective of this study was to evaluate the dental cutting
      behaviour of two machinable glass-ceramics, mica-containing Macor-M and apatite-
      and diopside-containing Bioram-M, and to compare them with the cutting behaviour
      of a composite resin typodont tooth enamel and bovine enamel. Weight-load cutting
      tests were conducted, using a diamond point driven by an air-turbine handpiece,
      While the transverse load applied on the point was varied, the handpiece speed
      during cutting and the volume of removal upon cutting were measured. In general,
      an increase in the applied load caused a decrease in cutting speed and an
      increase in cutting volume. However, the intensity of this trend was found to
      differ between four workpieces. Cutting Macor-M resulted in the second-most
      reduced cutting speed and the maximum cutting volume. Cutting Bioram-M gave the
      least reduced cutting speed and the minimum cutting volume. It was suggested that
      two machinable glass-ceramics could be employed as typodont teeth. This study may
      also contribute to the development of new restorative dental ceramic materials,
      prepared by machining.

PMID- 2231166
TI  - [Prognostic significance of the DNA ploidy of the early glottic cancer].
AB  - The stage classification is most frequently used at the present in predicting the
      outcome of laryngeal carcinoma. Recently, DNA ploidy pattern as detected by DNA
      flow cytometry and cytofluorometry has been also shown to be predictive. In this
      study, DNA cytofluorometry was performed on formalin-fixed paraffin-embedded
      tissues from 18 patients with T1 and T2 glottic squamous cell carcinoma for whom
      long-term follow-up data were available. The DNA ploidy pattern was classified
      into three types, diploid, diploid + tetraploid and aneuploid according to the
      DNA content of Go/G1 cells and mitotic cells. In these 18 cases, 8 cases (44%)
      had diploid pattern, 3 cases (17%) had the diploid + tetraploid pattern and 7
      cases (39%) had the aneuploid pattern. The ploidy pattern was significantly
      associated with the relapse-free rate, but did not correlate with the stage of
      the carcinoma and differentiation of the cancer cells. Distribution of the
      patients by histology, stage and therapy was almost equal among the diploid,
      diploid + tetraploid and aneuploid groups. All the patients were treated with
      irradiation (60Gy). In the group as a whole, no patient died of glottic
      carcinoma. Relapse-free survival rates for diploid, diploid + tetraploid and
      aneupoid were 88%, 33% and 29% respectively. This retrospective study of glottic
      cancer treated with radiation therapy suggests the possibility that the DNA
      ploidy pattern would significantly predict patient outcome and would be useful
      for selecting patients whose poor prognosis demands more aggressive therapy.

PMID- 2231167
TI  - [Changes of the threshold level in patients with 22-channel cochlear implant].
AB  - Psychophysical responses of the patients to electrical stimulation were examined
      in order to clarify long-term effects of the cochlear implant in 9 patients who
      had received a 22-channel cochlear implant. Measured items were the minimal
      threshold level (T-level), the maximum comfortable level (C-level), and the
      dynamic range between T- and C-level. Measurements were repeated for each
      electrode every three months over more than 6 months. Following results were
      obtained. 1) The changes of the T-level were classified into four types as
      follows, a type with no change, a type with gradual decrease, a type with
      decrease in two to three months followed by gradual increasing threshold and a
      type with gradual increasing just after surgery. Even in a last type, the maximum
      increase in the T-level did not exceed 200 microA and, in most cases, these
      changes were stabilized within a few months after implantation. 2) The dynamic
      range gradually increased. It was obvious in both in the middle and apical
      electrodes, while such increased threshold was not observed in the basal
      electrodes. 3) In some cases, a few basal electrodes could not been used since
      they caused uncomfortable sensation or those dynamic ranges became below a
      certain extent. As a result, it was suggested that the electrical stimulation had
      not induced serious degeneration of the ganglion cells and the auditory nerve
      fibers. The reduction in the number of usable electrodes might be due to the
      surgical trauma to the intracochlear tissue. Therefore, exposing of the scala
      tympani should be minimal in order to avoid the damage of the cochlea.

PMID- 2231168
TI  - [Epidermal growth factor in cholesteatoma--the first report: the localization in
      the cholesteatoma tissue].
AB  - The localization of epidermal growth factor (EGF) in human cholesteatoma tissue
      was examined immunohistochemically, using sections of formalin-fixed, paraffin
      embedded tissue with avidin-biotin peroxidase complex method. Thirty-three cases
      of active cholesteatoma which had abundant granulation and debris were studied.
      Out of 33 cases, EGF was positive in 32 cases (97%) in the epidermis, 30 cases
      (91%) in the fibroblast, and 21 cases (64%) in the endothelial cells. In 9 cases
      of inactive cholesteatoma, on the other hand, EGF was positive in 5 cases (56%)
      in the epidermis, no case in the fibroblast, and a case (11%) in the endothelial
      cells. Active cholesteatoma had higher immunoreactivity in the epidermis than
      inactive cholesteatoma. This suggests that the activity of cholesteatoma is
      indicated by the immunoreactivity of EGF. Difference of EGF immunoreactivity
      between active and inactive cholesteatoma was bigger in the fibroblast in the
      subcutaneous tissue of cholesteatoma than in the epidermis. This gives the reason
      that the activity of cholesteatoma exists in the subcutaneous tissue. These
      results suggest that EGF plays an important role in accelerating the growth of
      cholesteatoma.

PMID- 2231169
TI  - [Epidermal growth factor in cholesteatoma--the second report: the localization in
      the horny layer].
AB  - The localization of epidermal growth factor (EGF) in human cholesteatoma tissue,
      normal ear drum and external auditory canal skin was examined
      immunohistochemically, using avidin-biotin peroxidase complex method. Bouin-fixed
      tissue was stained for investigation of horny layer in the epidermis, because
      fixation in Bouin's solution provides better preservation of the antigen. In the
      horny layer of cholesteatoma tissue, 19 out of 24 cases had EGF-positive
      immunoreactivity (79%). In 2 cases of normal external auditory canal skin, 4
      cases of normal ear drum and a case of postauricular skin, no EGF
      immunoreactivity was revealed in the horny layer. EGF was assayed in the debris
      of cholesteatoma and the horny layer of the normal bony external canal with dot
      blot immunoassay. EGF content of the debris was higher than that of the horny
      layer of normal skin. The result of the first report suggests the activity of
      cholesteatoma exists in the subcutaneous tissue (see the previous paper). In this
      report EGF content of cholesteatoma in the horny layer was found higher than that
      of normal external skin. This result demonstrates that EGF in the horny layer
      plays an important role in accelerating the growth and bony destruction in
      cholesteatoma. To summarize these two reports, the following conclusion was
      reached. In the epidermis EGF content is equal in cholesteatoma and normal skin.
      But in the subcutaneous tissue and the horny layer EGF content of cholesteatoma
      is higher than that of normal skin. EGF in situ may be strongly related to the
      growth and bony destruction of cholesteatoma.

PMID- 2231170
TI  - [Allergen skin tests to insects, chironomid, caddis fly and silkworm moth, in
      patients with nasal allergy].
AB  - The present study was undertaken to assess the importance of insects as allergens
      causing nasal allergy. We performed intradermal skin tests with extracts from
      three insects, chironomid, caddis fly, and silkworm moth, on patients with nasal
      allergy and on volunteers among medical students. Twenty-two (27.5%) of 80 nasal
      allergic patients showed positive reactions to chironomid allergen and 9 (11.3%)
      had positive reactions to caddis fly allergen and 18 (22.5%) to silkworm moth
      allergen. These positive rates were as frequent as those to Candida or ragweed.
      Medical students were divided into two groups, symptomatic and asymptomatic,
      according to the presence or the absence of nasal allergy. Three (11.5%) of 26
      symptomatic group showed positive reactions to chironomid and one (3.8%) to
      caddis fly and 5 (19.2%) to silkworm moth. While even 4 (8.3%) of 48 asymptomatic
      group showed positive reactions to chironomid, 2 (4.8%) to caddis fly, and 6
      (12.5%) to silkworm moth. These results suggested that these insects, chironomid,
      caddis fly, and silkworm moth, are relatively common than we expected and
      suspected as important allergens in nasal allergy.

PMID- 2231171
TI  - [An ultrastructural study on the regeneration of blood vessels of the curetted
      tracheal mucosa in rat].
AB  - After the respiratory tract is damaged by trauma or infection, it is repaired
      rapidly. The purpose of this study is to observe morphologically the regenerative
      process of tracheal mucosae, especially the regeneration of blood vessels in the
      mechanically injured tracheal mucosa of rats. The total mucosal layer of trachea
      was removed by curetting in 95 adult rats. Then, at several interval from one
      hour to ten weeks after treatment, 5 rats were killed, and their curreted area of
      the trachea were removed as specimen for transmission electron microscopical and
      scanning electron microscopical observation. For scanning electron microscopy,
      vascular network casts were made by the infusion of Mercox resin through the
      aortic arch. One hour after curetting, the injured blood vessels formed terminal
      blind branches. From three hours to one week after curetting, many vascular bud
      like-processes appeared in venules at the floor and margin of the curetted wound.
      Twelve hours after curetting, new vascular network were observed in the curetted
      area. One week after curetting, the vascular network was consisted of
      capillaries, veins, and arteries. The vascular networks were almost completely
      rearranged at six weeks after curetting. However the irregular arrangement were
      still observed partially after ten weeks of curetting. The formation of terminal
      blind branches in vessels were noted as the initial healing process of injured
      vascular networks. Then many "bud-like-processes" appeared. Six weeks after
      curetting, the vascular networks were almost completely rearranged.

PMID- 2231172
TI  - [A case of epipharyngeal tuberculosis with tuberculosis otitis media].
AB  - A 23-years-old female with no known previous contact with tuberculosis complained
      of right otorrhea. Treatment with antibiotics agent was resisted, and a tympanic
      perforation became two. Her tuberculin test was positive, but her chest X-ray
      showed no signs of lung tuberculosis. Posterior rhinoscopy revealed a granuloma
      in the epipharynx. Histological examination of a biopsy specimen revealed
      tuberculosis changes. Treatment with antituberculosis agents, SM.INH.RFP greatly
      reduced the mass and the tympanic perforation.

PMID- 2231173
TI  - [The histologic study of the inner ear in guinea pigs on anaphylatoxin].
AB  - Complement is known to relate to many inflammatory reactions. C4a, C3a and C5a,
      known as anaphylatoxins, are known to cause strong inflammatory reactions. In
      this study, the role of anaphylatoxins on the pathogenesis in the cochlea was
      examined. On hundred forty six male Harley guinea pigs, weighing about 350 grs,
      all susceptible to preyer's reflex, were used in this study. Anaphylatoxins were
      made from guinea pig serum treated with zymosan, and inoculated into the carotid
      artery of the guinea pigs. Parts of these animals were sacrificed and examined at
      ten minutes, one day, two days, three days, seven days, ten days and fifteen days
      after injection of anaphylatoxins. Pathological changes in inner ears were
      observed by light microscopy. After 10 minutes, inner ears were found
      morphologically normal. After one day, inner ears were found to be almost
      morphologically normal but the stria vascularis was observed with cystic
      formation. After two days, cystic formations in the stria vascularis were
      enlarged and Reissner's membranes were collapsed in some other animals. After
      three days, the stria vascularis in the various cochlear turns except in the
      basal turn, were extremely atrophied, some cochlear nerves showed degeneration
      and some cochlea showed endolymphatic hydrops. After seven days, ten days and
      fifteen days, the morphological changes showed atrophy in the stria vascularis
      similar to the results observed on the third days. Atrophy in the stria
      vascularis was improved gradually with time, but the degeneration of the cochlear
      nerve was not improved. Opinions have been divided on the cause of inner ear
      disease including Meniere's disease. Many authors have reported that infectious
      diseases, for example mumps, measles and cytomegalovirus infection, have caused
      human sensorineural hearing loss. These diseases have been reported to result in
      atrophy in the stria vascularis, degeneration of the cochlear nerve and some
      other pathological changes. In this study, it was clearly observed that the
      atrophy of the stria vascularis, the endolymphatic hydrops and other
      morphological changes were caused by introduction of anaphylatoxins. These
      results were similar to the pathological changes observed in inner ear diseases
      in human beings. Therefore, inflammatory substances, including anaphylatoxins,
      were closely related to the cause of inner ear diseases. The animal model used in
      this report is considered to be important for elucidating the pathogenesis of
      inner ear diseases.

PMID- 2231174
TI  - [Effects of uvulopalatopharyngoplasty in adult patients with obstructive sleep
      apnea syndrome].
AB  - We performed uvulopalatopharyngoplasty (UPPP) in 51 adult patients with
      obstructive sleep apnea syndrome (OSAS). After UPPP, there were statistically
      significant improvements in apnea-hypopnea index (AHI), the lowest value of
      oxygen saturation during sleep and total time of apnic episodes. 28 patients
      (54.9%) were good responders who represented more than 50% improvements in their
      AHI. Poor responders tended to be more severe and older than good responders.
      After cephalometric analysis, poor responders were revealed to show significantly
      poor mandibular prognatism and also lower positioned hyoid bone than good
      responders.

PMID- 2231175
TI  - [Pathohistological study on active endolymphatic hydrops in guinea pig--with
      stress stimulations].
AB  - Recently Meniere's disease is believed to show a pathological features of
      endolymphatic hydrops, but the etiology of this disease has not yet been
      ascertained. Many investigators tried to create animal models with endolymphatic
      hydrops by obliterating endolymphatic sac and duct. However, these methods have
      not been adequate to explain the mechanism of development of Meniere's disease,
      because it gives mechanical damage to destroy endolymphatic sac and duct. On the
      other hand, Meniere's disease is thought to develop even as a result of stress.
      The present paper reported the conduction of an acute experiment, creating active
      endolymphatic hydrops by stress load, to study the occurrence rate of
      endolymphatic hydrops and the pathological findings of inner ears by a light
      microscope. This was followed by a light and electron microscopic study on the
      changes in permeability of the cochlear lateral wall with horseradish peroxidase
      and a study of the development mechanism of endolymphatic hydrops. Results
      obtained were as follows: 1. Although it was impossible to cause endolymphatic
      hydrops with a single stimulation, four kinds of stress stimulations could cause
      endolymphatic hydrops with the rate of 37.8%. 2. Judging from the different
      pathological findings between the group with four kinds of stress stimulations
      and the untreated control group, vessel permeability in the stria vascularis was
      highly changeable, while that in the spiral ligament was not. 3. It was found out
      that increased permeability of the stria vascularis vessels was by increased
      pinocytotic vesicular transport and through tight junctions from vessel lumen to
      basal lamina and that it was presumably only by increased pinocytotic vesicular
      transport beyond basal lamina. 4. It was assumed that increased permeability of
      the stria vascularis vessels was one of the causes of endolymphatic hydrops which
      were believed to be pathological features of Meniere's disease.

PMID- 2231176
TI  - Conduction in the giant nerve fiber pathway in temperature-sensitive paralytic
      mutants of Drosophila.
AB  - To study electrogenic conduction in neurons of the cervical giant nerve fiber
      (CGF) pathway in Drosophila adults carrying temperature-sensitive paralytic
      mutations that affect sodium channels, we recorded dorsal longitudinal muscle
      (DLM) responses evoked by electrical stimulation of the brain. In the mutants
      tipE, napts and parats, conduction in certain neurons presynaptic to the CGF
      failed at about the same temperature at which paralysis occurred in each mutant.
      Conduction in the CGF and neurons postsynaptic to it remained active in all
      mutants even at very elevated temperatures. In contrast, analysis of sei mutants
      showed enhanced spontaneous activity at elevated temperatures in at least some
      neurons of the CGF pathway. The implications of these results with respect to the
      normal in vivo functions of these genes in neuronal signalling are considered.

PMID- 2231177
TI  - Cell loss in the inferior olive of the staggerer mutant mouse is an indirect
      effect of the gene.
AB  - Staggerer (sg) is an autosomal recessive mutation in mouse that causes severe
      cerebellar atrophy. In this mutant, the Purkinje cell (PC) number is reduced by
      about 75% and the remaining Purkinje cells have a reduced dendritic arbor and an
      ectopic location. Previous analysis of staggerer chimeras has demonstrated that
      the Purkinje cell phenotypes are all direct consequences of the cell-autonomous
      action of the staggerer gene. The two major afferents to the Purkinje cell are
      also affected. Virtually all of the granule cells die by the end of the first
      postnatal month. This death, however, has been shown to be an indirect
      consequence of mutant gene action. The second major afferent system is from the
      cells of the inferior olive that project to the main trunks of the Purkinje cell
      dendrite via the climbing fiber system. Quantitative studies of cell number in
      the inferior olive have shown that the number of cells is reduced by about 62% in
      adult sg/sg mutants. We report here the results of our quantitative analysis of
      three staggerer chimeras. beta-glucuronidase activity was used as an independent
      cell marker. Our findings demonstrate that inferior olive cell death in staggerer
      mutant mice is an indirect effect of staggerer gene action. Thus, as for the
      granule cells, the loss of olivary neurons most likely results from a target
      related cell death.

PMID- 2231178
TI  - Detection of a case of pseudolymphocytosis due to cryoglobulins.
AB  - A new type of interference of cryoglobulins on hemocytometric tests is described.
      The precipitation of temperature-dependent proteins produced a
      pseudolymphocytosis on a three-part differential leukocyte count of Coulter S
      Plus VI, whereas unaffected results, identical to the microscopical count, were
      obtained using the cytometer Coulter VCS. The laboratory detection of
      cryoglobulin interference on hematological data is very important in patients
      with underlying diseases, where the accuracy of absolute and differential
      leukocyte counts is critical for follow-up. Histograms from the Coulter S-Plus VI
      can help detect these cases.

PMID- 2231179
TI  - An ELISA procedure to detect anti-double-stranded and anti-single-stranded DNA
      binding antibodies in connective tissue disorders.
AB  - A simple and sensitive enzyme-linked immunosorbent assay (ELISA) is described for
      the measurement of antibodies to native DNA (double-stranded) and to heat
      denatured DNA (single-stranded) in sera of patients with connective tissue
      disorders. DNA bound to polyvinylchloride plates is incubated with serum samples,
      and antibodies to both single- and double-stranded DNA are detected by means of
      goat antihuman IgG alkaline phosphatase conjugate. The binding in individual sera
      is expressed as binding units per milliliter and refers to the absorbance in
      relation to the absorbance value obtained with a set of standards. The various
      parameters of the ELISA assay are described, and the results are compared with
      results of the Crithidia and Farr DNA antibody assays. Two case reports are
      discussed.

PMID- 2231180
TI  - Myeloid leukemia differentiation by phorbol ester and retinoic acid: a practical
      approach.
AB  - The effects of TPA (12-0-tetradecanoylphorbol-13-acetate) and RA (retinoic acid)
      were investigated on the cell lines HL60 (acute promyelocytic leukemia) and K562
      (erythroleukemia) and on cells from patients with several kinds of leukemia.
      There were 14 cases of acute lymphocytic leukemia (ALL), 2 cases of chronic
      lymphocytic leukemia (CLL), 23 cases of acute myeloid leukemia (M1-M7), 5 cases
      of chronic myelocytic leukemia in blast crisis (CML-BC) and 2 mixed leukemias. In
      almost all of the cases examined, after TPA exposure cells from patients with
      proven myeloid leukemia became adherent to the substrate, while lymphoid leukemia
      cells remained in suspension, allowing the differentiation of lymphoid from
      myeloid blasts. The only exception was in one case of CLL, which had cells that
      became adherent with long filamental projections. In addition, increased
      phagocytosis following TPA exposure permitted characterization of M7 as this was
      the only myeloid leukemia negative for phagocytosis. Further discrimination
      between the subtypes of myeloid leukemia could be based on the increased lysozyme
      production seen after TPA in M4 and M5. Esterase positivity allowed the
      discrimination of M1 cells, which were negative before and after TPA treatment.
      In agreement with the results of other authors, TPA and RA led to independent
      ways of differentiation, granulocytic-like lineage and monocytic-like cells being
      favored by RA and TPA, respectively. The capacity of the same cell to
      differentiate into more than one lineage, depending on whether RA or TPA was
      used, was only seen in the present study with M3 cells.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2231181
TI  - Optimal conditions for protease use in the assay of serum mitochondrial aspartate
      aminotransferase.
AB  - The optimal conditions for selective proteolytic inactivation of cytosolic
      aspartate aminotransferase (c-AST) to determine mitochondrial aspartate
      aminotransferase (m-AST) in serum were studied. Protease 401 was found to be
      effective over a pH range of 6.0-10.0. A pH of 9.5 with 0.5% albumin in the
      reagent mixture was determined to be optimal for inactivation of c-AST and
      preservation of m-AST, lactic dehydrogenase (LDH), and malic dehydrogenase (MDH)
      in the assay procedure. The presence of serum endogenous protein inhibitors such
      as alpha 1-antitrypsin and alpha 2-macroglobin did not inhibit protease 401.

PMID- 2231182
TI  - Novel and sensitive enzyme immunoassay (immune-complex-transfer enzyme
      immunoassay) for antihuman T cell leukemia virus type 1 IgG in human serum using
      recombinant gag-env hybrid protein as antigen.
AB  - A novel and sensitive enzyme immunoassay (immune-complex-transfer enzyme
      immunoassay) for antihuman T cell leukemia virus type 1 IgG (anti-HTLV-1 IgG) in
      human serum using recombinant gag(14-139)-env-(197-295) hybrid protein is
      described. Anti-HTLV-1 IgG in test serum was reacted with dinitrophenyl biotinyl
      bovine serum albumin-recombinant gag-env hybrid protein conjugate. The complex
      formed was trapped onto polystyrene balls coated with affinity-purified
      antidinitrophenyl group IgG. After washing to eliminate nonspecific IgG in the
      test serum, the complex was eluted from the polystyrene balls with dinitrophenyl
      L-lysine and transferred to polystyrene balls coated with streptavidin. After
      washing, anti-HTLV-1 IgG in the complex trapped onto the streptavidin-coated
      polystyrene balls was reacted with antihuman IgG gamma-chain Fab'-peroxidase
      conjugate. Peroxidase activity bound to the streptavidin-coated polystyrene balls
      was assayed by fluorometry. By transfer of the complex, the nonspecific binding
      of nonspecific human IgG was considerably reduced, and the detection limit of
      anti-HTLV-1 IgG in serum was lowered 30-300-fold compared with that by Western
      blotting, gelatin particle agglutination, and the conventional enzyme
      immunoassay, in which a recombinant gag-env hybrid protein-coated polystyrene
      ball was incubated with test serum and, after washing, with antihuman IgG gamma
      chain Fab'-peroxidase conjugate. Usefulness of the immune-complex-transfer enzyme
      immunoassay was demonstrated using 271 serum samples.

PMID- 2231183
TI  - Evaluation of the stick enzyme immunoassay in Caranx sp. and Seriola dumerili
      associated with ciguatera.
AB  - The stick enzyme immunoassay (S-EIA) using monoclonal antibody to ciguatoxin (MAb
      CTX) was used to examine clinically implicated fish and to pre-screen two species
      of fish, Caranx sp. (ulua or jack) and Seriola dumerili (kahala or amberjack),
      supplied by sports fishermen. All of the clinically implicated fish from the
      Department of Health gave S-EIA values greater than or equal to 1.3. The Caranx
      sp. and Seriola dumerili considered safe (less than or equal to 1.2 value) and
      consumed after testing gave no false-negative results. The S-EIA procedure using
      MAb-CTX proved to be specific, sensitive, and simple to use in the laboratory. It
      also proved to be useful in screening two large carnivorous fish for ciguatoxin
      and related polyethers prior to consumption.

PMID- 2231184
TI  - Alloalbumin in cerebrospinal fluid: report of a case and remarks on
      physiopathology.
AB  - Alloalbumin Tagliacozzo (313 Lys------Asn) was detected in the cerebrospinal
      fluid of a 27-yr-old woman. We studied this rare finding by means of high
      resolution electrophoresis, isoelectric focusing, and immunofixation. We herein
      discuss the importance of molecular mass versus superficial electrical charge in
      the transfer of plasma proteins through the blood-brain barrier.

PMID- 2231185
TI  - Effect of azidothymidine on soluble CD4 levels in patients with AIDS or AIDS
      related complex.
AB  - Circulating soluble CD4 (sCD4) levels were measured in 20 patients (11 with the
      acquired immunodeficiency syndrome [AIDS] and 9 with AIDS-related complex [ARC])
      treated with azidothymidine (AZT) and in 12 patients (nine with AIDS and three
      with ARC) who were in the placebo group. The mean CD4 level in the AZT treatment
      group at baseline was 41 +/- 12 (SEM) U/ml. After 4 wk of treatment, the mean
      level decreased to 23 +/- 5; it was 29 +/- 10, 31 +/- 14, and 21 +/- 5 at 8, 12,
      and 16 wk of therapy, respectively. No significant changes were observed in the
      placebo group. These results suggest that AZT administration may be associated
      with reduced sCD4 levels in these patients.

PMID- 2231186
TI  - Clonal dermatoses: a conceptual and diagnostic dilemma.

PMID- 2231187
TI  - Detection of endothelin immunoreactivity and mRNA in pulmonary tumours.
AB  - Paraffin sections of 66 surgically resected lung tumours were immunostained with
      antisera to human endothelin-1 and to the C-terminal peptide of big endothelin.
      With both antisera, strong immunoreactivity was demonstrated in 11 of 15 squamous
      cell carcinomas and 11 of 16 adenocarcinomas. Focal immunoreactivity was seen in
      small cell carcinoma (2/12), large cell carcinoma (2/5), and carcinoid tumours
      (2/11). Four lymphomas and three sarcomas did not show endothelin
      immunoreactivity. Cryostat sections of 22 of the 66 tumours were hybridized with
      radiolabelled complementary RNA probes prepared from the 3' non-coding region of
      endothelin-1 cDNA, and the chromosomal genes encoding endothelin-2 and -3. In
      situ hybridization demonstrated the presence of endothelin mRNAs in 4 of 7
      squamous cell carcinomas and in 5 of 8 adenocarcinomas, in a pattern similar to
      that shown by immunocytochemistry. No hybridization signals were obtained from
      the other types of tumours. In lung tissue adjacent to the tumours, endothelin
      like immunoreactivity and mRNA were detected in pulmonary endocrine cells and, in
      some cases, other epithelial cells, and in alveolar capillary endothelial cells.
      This study demonstrates the expression of endothelin in a number of pulmonary
      tumours and suggests a possible role for this peptide in the growth and/or
      differentiation of these tumours.

PMID- 2231188
TI  - The expression of Lewis(a) and Lewis(b) antigens reflects changes in fucosylation
      between normal and neoplastic cervical squamous epithelium.
AB  - Antibodies against the carbohydrate antigens Lewisa (Lea) and Lewisb (Leb) allow
      further investigation into the changes in fucosylation of the glycocalyx
      occurring during the normal and neoplastic development of cervical squamous
      epithelium. Lea and Leb are expressed on a broad zone of suprabasal cells in
      normal cervical squamous mucosa often independent of individual Lewis gene and
      secretor status. A proportion of Lea is expressed in sialylated form. In cervical
      intraepithelial neoplasia, the progressive dedifferentiation of the squamous
      mucosa is mirrored by loss of both Lea and Leb expression. In invasive squamous
      carcinomas, Lea and Leb expression is seen only on cells in areas of
      differentiation. The expression of Lea and Leb in normal and neoplastic cervical
      squamous epithelium resembles that of the Lex antigen described by us previously.
      The structural similarity between these antigens is highlighted and evidence for
      a common functional role in maintaining the integrity of squamous mucosae is
      discussed.

PMID- 2231189
TI  - Alpha-smooth muscle actin as a marker for soft tissue tumours: a comparison with
      desmin.
AB  - The immunoreactivity of a range of vascular and non-vascular smooth muscle
      tumours, rhabdomyosarcomas, and non-myoid lesions has been examined with the use
      of a monoclonal antibody to smooth muscle-specific actin and the muscle
      intermediate filament, desmin. In all cases of smooth muscle-derived tumours, the
      alpha-actin antibody yielded superior results. Staining of the myofibroblasts of
      fibromatoses was also seen. In contrast to desmin, immunoreactivity was not
      exhibited by rhabdomyosarcomas. We propose that this monoclonal antibody to alpha
      smooth muscle actin is a useful addition to the panel of reagents used for the
      characterization of soft tissue proliferations and tumours. The technical aspects
      of the application of this monoclonal antibody to immunohistochemistry are
      discussed.

PMID- 2231190
TI  - Bacillus Calmette-Guerin-treated superficial bladder cancer: correlation of
      morphology with immunophenotyping.
AB  - Thirty-five biopsies from 19 patients with superficial transitional cell
      carcinoma of the bladder, treated with intravesical bacillus Calmette-Guerin
      (BCG), were assessed histologically and immunohistochemically. Pretreatment
      biopsies were available for comparison in all cases and five cases of non
      specific cystitis were also examined. The inflammatory infiltrate was assessed
      with a streptavidin-biotin-peroxidase method using UCHL1, MT1, LN3, L26, HAM56,
      MAC387, Leu7 and anti-S100 in paraffin sections, and in 18 specimens were frozen
      tissues were available, Leu1, 2, 3, 4, 14, OKT10, HLA-DR and anti-Tac antibodies
      were applied. Post-treatment bladder biopsies showed severe oedema and a variable
      degree of inflammation. A granulomatous inflammation was seen in 11 cases, with
      granulomas present in six prostatic biopsies and acid-fast bacilli in two cases.
      The lymphoid infiltrate in all biopsies were largely T lymphocytes with a
      predominance of T helper cells present, often as a band-like infiltrate pressing
      against the residual epithelium, or the denuded bladder surface, and distributed
      in the vicinity of the granulomas. Activated lymphocytes were prominent in seven
      cases, although a moderate infiltrate of such cells was seen in all instances.
      Tac antigen was only occasionally expressed, and in a few NK cells were present
      among the infiltrates. In eight cases, HLA-DR was expressed in epithelial cells
      following BCG treatment, whereas all pre-treatment epithelial were negative.

PMID- 2231191
TI  - Silver stained nucleolar organizer region proteins (Ag-NORs) as a predictor of
      prognosis in colonic cancer.
AB  - Using a one-step silver nitrate staining technique, routinely processed tumour
      tissues of 49 carcinomas of the colon were investigated to demonstrate silver
      stained nucleoli (Ag-nus) and argyrophilic proteins associated with the so-called
      nucleolar organizer regions (Ag-NORs). Patients with attempted curative
      resections and tumour stages Dukes' A, B, C1 and C2, with an uneventful follow-up
      period of at least 48 months (N = 17), showed a statistically significant (P =
      0.0001) lower mean number of scattered Ag-NORs (3.04; SD: 1.08) compared to
      patients who developed metastases during their follow-up period (N = 15; 5.40;
      SD: 1.28), as well as to patients who underwent palliative surgical treatment (N
      = 17; 4.48; SD: 1.67). Mean numbers of scattered Ag-NORs per nucleus and staging
      of the tumour were strongly related (P = 0.0001) to cancer-specific survival. The
      results indicate that the evaluation of silver-stained particles according to
      their different distribution patterns is of great value with regard to the
      clinical outcome of colonic carcinoma and may even allow a more accurate
      prognostic assessment of these patients than the WHO grading system, UICC staging
      system, the so-called Jass-scoring system, and Dukes' classification.

PMID- 2231192
TI  - Mutant p53--the commonest genetic abnormality in human cancer?

PMID- 2231193
TI  - DNA analysis by flow cytometry in malignant pleural mesothelioma: relationship to
      histology and survival.
AB  - In a retrospective study of 70 patients with malignant pleural mesothelioma, 168
      formalin-fixed, paraffin-embedded tumour specimens were examined for DNA content
      by flow cytometry. In 20 patients where two or more blocks of the same tumour
      were available, there was considerable agreement between ploidy status and S
      phase percentage in the different specimens. There were no significant
      differences for survival for patients who had been exposed to asbestos and those
      in whom no exposure could be elicited, nor for aneuploid and diploid tumours. The
      S-phase content was examined for different areas of the same tumour and the
      percentages were largely in agreement. However, those patients who had tumours
      with an S-phase percentage greater than the median (6 per cent) had a
      significantly shorter survival than those with tumours of lower S-phase
      percentage. Differences in DNA content and other cell cycle parameters were not
      associated with the histological subtypes.

PMID- 2231194
TI  - A morphometrically-based classification rule for the diagnosis of primary
      mesothelial lesions.
AB  - A computer-aided morphometrical study was performed on histological specimens of
      reactive hyperplastic (n = 10) and malignant (n = 17) mesothelium. For each cell,
      seven nuclear features were measured and 13 parameters computed. Using stepwise
      variable selection, discriminant analysis chose the nuclear contour index, the
      standard deviation of the nuclear area, and the mean of the nuclear perimeter as
      discriminating features between hyperplastic and malignant mesothelium. The
      coefficients of these variables were included in a discriminant function which
      gave perfect discrimination between the two groups of lesions. When the function
      was assessed on a test set of hyperplastic (n = 10) and malignant (n = 17)
      mesothelial lesions treated as 'unknown', complete separation between these two
      diagnostic categories was achieved. This classification rule may help to increase
      the level of confidence with which a histological diagnosis of mesothelioma can
      be established.

PMID- 2231195
TI  - Histopathological changes in simian immunodeficiency virus infection.
AB  - The histological lesions were studied in seven rhesus and three cynomolgus
      monkeys infected with simian immunodeficiency virus for periods ranging from nine
      weeks to 18 months. Lymphoreticular changes included hyperplasia, follicular
      involution and depletion, and one animal had amyloidosis of the spleen.
      Hyperplastic changes also took place in mucosa-associated lymphoid tissue and
      infiltrations occurred in the vaginal mucosa of one animal, which could be
      significant in sexual transmission of the infection. The range of opportunistic
      infections was small compared with that in human AIDS patients, although two
      monkeys had Pneumocystis carinii pneumonia. Enterocolitis was a common finding
      and brown adipose tissue was transformed into a large vacuolated type. Lesions of
      the central nervous system were found in five of nine monkeys, and consisted of
      foci of glial activity and perivascular and meningeal lymphocytic infiltration. A
      lymphoma involving the lumbar spinal cord developed in one animal.

PMID- 2231196
TI  - Tracing disease genes through family studies.

PMID- 2231198
TI  - Culture, pain and cancer.

PMID- 2231197
TI  - Role of sinusoidal pressure in the development of vacuolation in liver cells.
AB  - Vacuolation of liver cells, which is often seen in patients with right-sided
      heart failure, is sometimes confused with fatty change, but the contents are
      components of blood. This study was undertaken using an isolated rat liver
      perfusion model to clarify the pathogenesis of vacuolation of liver cells. It has
      been demonstrated that (1) hypoxia alone cannot cause vacuolation; (2) elevation
      of the sinusoidal pressure leads to vacuoles in liver cells, irrespective of the
      oxygen content of the perfusate; and (3) the number and size of vacuoles are
      proportional to the height of the sinusoidal pressure, but not to the oxygen
      content of the perfusate. The reason why vacuolation generally appears in the
      pericentral area in patients with right-sided heart failure may be that the
      sinusoidal pressure in this area rises in parallel with the inferior vena cava
      pressure.

PMID- 2231199
TI  - Ectopic pregnancy in adolescents: a clinical review for pediatricians.
AB  - Pediatricians caring for sexually active female adolescents and young adults need
      to be aware of the history, symptoms, and signs of an ectopic pregnancy. A
      thorough history and physical examination, including the pelvic examination, as
      well as specific diagnostic tests such as repeated quantitative hCG measurements,
      and ultrasonography when indicated, are crucial to proper and early diagnosis of
      a nonruptured ectopic pregnancy manageable by laparoscopy. The key to early
      diagnosis is to include ectopic pregnancy in the differential diagnosis in any
      sexually active female patient who has abnormal vaginal bleeding or abdominal
      pain. With early diagnosis, close observation, and appropriate management, the
      outcome is more likely to be favorable, with minimal morbidity and risk of death.

PMID- 2231200
TI  - Very low birth weight children: behavior problems and school difficulty in a
      national sample.
AB  - We addressed three questions concerning the behavioral and academic status of low
      and very low birth weight infants through a secondary analysis of the 1981
      National Health Interview Survey--Child Health Supplement: (1) in children born
      with very low birth weight, what is the risk of behavior problems and school
      difficulty compared with that in heavier low birth weight and normal birth weight
      children? (2) What are the correlates of school difficulty? (3) Are behavior
      problems associated with school difficulty when variables are controlled for
      these correlates? The analysis revealed that 34% of very low birth weight
      children could be characterized as having school difficulty, compared with 20%
      and 14% of the other groups, respectively, and that they were more likely to have
      higher scores on the hyperactive subscale of the Behavior Problems Index.
      Although a broad array of sociodemographic factors correlated with school
      difficulty, very low birth weight and hyperactivity scores contributed
      independently to the risk of academic problems. We conclude that very low birth
      weight infants are at risk of having school problems that are in part associated
      with hyperactive behavior.

PMID- 2231201
TI  - Serial magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy.
AB  - We prospectively performed magnetic resonance imaging (MRI) studies during the
      neonatal period, and at 4 and 8 months of age, on 15 term infants with hypoxic
      ischemic encephalopathy, and compared the results with their neurodevelopmental
      outcome at 18 months of age. Cerebral palsy developed in nine infants, two
      infants were classified as having abnormalities of tone and delayed motor
      milestones that were suggestive of cerebral palsy, and four infants were normal.
      Structural abnormalities, delayed myelination, or a combination of the two were
      detected with MRI at 8 months of age in all nine infants with later development
      of cerebral palsy. Three of the four normal infants and one infant with
      suggestive abnormalities had normal serial MRI findings. Each of the remaining
      two infants (one normal, one with suggestive abnormalities) had isolated
      persistent ventricular dilation on all three MRI studies. Our results suggest
      that 8 months appears to be the earliest time at which MRI findings correlate
      well with later adverse neurodevelopmental outcome in this population.

PMID- 2231202
TI  - Transient renal acidification defect during acute infantile diarrhea: the role of
      urinary sodium.
AB  - We studied urinary acidification daily during the hospital course of 16 infants
      with acute gastroenteritis and metabolic acidosis. Urine pH value on admission
      was higher than 5.5 in 14 (87%) patients. We hypothesized that inappropriate
      urinary acidification was due to sodium deficiency and inadequate sodium delivery
      to the distal nephron. Forty-one urinary samples were collected during metabolic
      acidosis. The mean pH of 24 urine samples with sodium concentration less than 10
      mmol/L was significantly higher than the pH of 17 samples with sodium
      concentration greater than 10 mmol/L (6.04 +/- 0.06 vs 5.19 +/- 0.1; p less than
      0.001). The urine ratios of titratable acid to creatinine and of total acidity to
      creatinine were significantly higher in urine samples containing more sodium (p
      less than 0.02), whereas the ammonium/creatinine ratio was not. After
      administration of furosemide or correction of the sodium deficit, appropriate
      acidification was observed. We conclude that impaired urinary acidification is
      frequently found during metabolic acidosis in infants with acute gastroenteritis
      and results from a sodium deficit rather than from transient distal renal tubular
      acidosis.

PMID- 2231203
TI  - Azathioprine and the treatment of chronic inflammatory bowel disease.

PMID- 2231204
TI  - Ruptured ectopic pregnancy complicating sexual abuse in an 11-year-old girl.

PMID- 2231206
TI  - Urolithiasis associated with the ketogenic diet.

PMID- 2231205
TI  - Advanced lung disease in a patient with cystic fibrosis and
      hypogammaglobulinemia: response to intravenous immune globulin therapy.

PMID- 2231207
TI  - Kasabach-Merritt syndrome: treatment with epsilon-aminocaproic acid and
      assessment by indium 111 platelet scintigraphy.

PMID- 2231208
TI  - Homozygous protein S deficiency in an infant with purpura fulminans.

PMID- 2231209
TI  - Association of Henoch-Schonlein purpura glomerulonephritis with C4B deficiency.

PMID- 2231210
TI  - Holoprosencephaly associated with diabetes insipidus and syndrome of
      inappropriate secretion of antidiuretic hormone.

PMID- 2231211
TI  - Arthrogryposis multiplex congenita with renal and hepatic abnormalities in a
      female infant.

PMID- 2231212
TI  - Prolonged indomethacin therapy for the prevention of recurrences of patent ductus
      arteriosus.
AB  - We tested the hypothesis that prolonged maintenance indomethacin therapy would
      allow more effective closure of patent ductus arteriosus (PDA) and thereby
      decrease the recurrence rate. Thirty-nine low birthweight neonates (less than
      1500 gm) with confirmed PDA were randomly assigned in a double-blind fashion to
      receive standard indomethacin therapy (three doses), followed either by
      maintenance indomethacin therapy (0.2 mg/kg/day) for 5 days or by an equivalent
      volume of placebo for 5 days. Of the 20 infants who received maintenance
      indomethacin therapy, two (10%) required additional therapy and one of these
      required surgical ligation. Of the 19 infants who received only the first three
      indomethacin doses, nine (47%) required additional therapy for PDA (p less than
      0.05) and seven of these had a ligation (p less than 0.05). We conclude that
      maintenance indomethacin therapy, in comparison with short-term indomethacin
      therapy, decreases the incidence of surgical PDA ligations, eliminates most PDA
      recurrences, and does not increase toxic effects of indomethacin in the low birth
      weight infant with PDA.

PMID- 2231213
TI  - Postexposure prophylaxis for measles in a neonatal intensive care unit.

PMID- 2231214
TI  - Renal blood flow velocity in preterm infants with severe respiratory distress
      syndrome.

PMID- 2231216
TI  - Azathioprine in the treatment of children with inflammatory bowel disease.
AB  - During a 6-year period, we treated 21 patients with azathioprine, 2 mg/kg/day, as
      an adjunct to their customary regimen. Nine patients had ulcerative colitis and
      12 patients had Crohn disease; the patients' ages ranged from 3 to 17 years. The
      median duration of disease before the start of azathioprine therapy was 2 years,
      and median follow-up was 2 years. Sixteen patients seemed to respond to
      azathioprine therapy: six patients in each disease group had complete responses
      and four patients (one with ulcerative colitis and three with Crohn disease) had
      partial responses. Two patients with ulcerative colitis and three patients with
      Crohn disease did not respond. The median time until patients responded was less
      than 3 months for patients with ulcerative colitis and 4 months for those with
      Crohn disease. Reduction of corticosteroid dose was possible for all patients who
      responded to azathioprine therapy. Only minimal side effects were attributable to
      the drug. We conclude that azathioprine is an effective adjunctive agent for the
      treatment of inflammatory bowel disease in childhood, but because questions
      remain regarding its long-term safety, its use should be reserved for children
      with refractory disease or severe and unacceptable side effects of
      corticosteroids.

PMID- 2231215
TI  - Early ribavirin treatment of respiratory syncytial viral infection in high-risk
      children.
AB  - A 3-year prospective, blinded, multicenter study was done to assess the efficacy
      of early ribavirin intervention in mild respiratory syncytial virus illness in
      children with bronchopulmonary dysplasia or with congenital heart disease. A
      cohort of 178 children younger than 36 months of age with bronchopulmonary
      dysplasia or congenital heart disease were followed. Forty-seven infants whose
      respiratory syncytial virus infection resulted in mild symptoms of less than or
      equal to 72 hours' duration received ribavirin (n = 20) or water placebo aerosol
      (n = 27) either in a hospital or at home. Outcome measures included respiratory
      and analog score, room air oxygen, saturation, and oxygen flow needed to maintain
      saturation at greater than or equal to 91%. No difference in age, gender, family
      size, passive smoking, baseline oxygen saturations in room air, or duration of
      symptoms before treatment was found between groups. After 3 days of therapy,
      ribavirin produced a greater rate of improvement of analog scores (p = less than
      or equal to 0.001), lower oxygen requirements (p = 0.01), and higher oxygen
      saturation (p = 0.01). Respiratory scores and total hospital days did not differ
      significantly between the groups. Treatment failure occurred in 2 of 20 children
      (10%) in the ribavirin group versus 5 of 27 children (18%) in the placebo group,
      a nonsignificant difference. No child required assisted ventilation or had an
      adverse reaction. We conclude that early ribavirin therapy may help to reduce
      morbidity from respiratory syncytial virus infection in high-risk young children.

PMID- 2231217
TI  - Effects of cisapride in patients with cystic fibrosis and distal intestinal
      obstruction syndrome.
AB  - In a double-blind, placebo-controlled, crossover trial, we investigated the
      effects of the prokinetic drug cisapride in patients with cystic fibrosis and
      chronic recurrent distal intestinal obstruction syndrome (DIOS). After a baseline
      period, 17 patients (12.9 to 34.9 years; 12 boys) received, in random order,
      cisapride (7.5 to 10 mg) and placebo three times daily by mouth, each for 6
      months. Gastrointestinal symptoms (flatulence, abdominal pain, fullness,
      abdominal distension, nausea, anorexia, heartburn, diarrhea, vomiting and
      regurgitation) were scored three times monthly and physical examinations
      assessed. At baseline and at each 6-month period, assessment included food intake
      for 7 days, 3-day stool collection, pulmonary function tests, and abdominal
      radiographs. During cisapride therapy compared with placebo, there were
      significant reductions in flatulence (p less than 0.005), fullness, and nausea (p
      less than 0.05). Patients with the worst symptom scores benefited most from
      cisapride. With cisapride, 12 patients felt better and three worse (p less than
      0.05); physicians judged 11 patients improved and two worse (p less than 0.05).
      No side effects were noted. There were no significant differences between
      cisapride and placebo periods in nutritional status, x-ray scores, pulmonary
      function, food intake (fat, protein, calories), stool size and consistency, and
      fecal losses of fat, bile acids, chymotrypsin, and calories. For acute episodes
      of DIOS, intestinal lavage was needed 6 times in 4 patients during treatment with
      cisapride, and 11 times in 6 patients receiving placebo. In comparison with
      unselected patients with cystic fibrosis and pancreatic insufficiency who were
      receiving enzyme supplements and who had no distal intestinal obstruction, fecal
      fat losses (percentage of intake) were almost twice as high in the study group
      with DIOS (31.2 +/- 20.6% vs 16.2 +/- 17.6%; p less than 0.01). We conclude that
      in the dosage used, long-term treatment with cisapride appears to improve chronic
      abdominal symptoms in patients with cystic fibrosis and DIOS, but fails to
      abolish the need for intestinal lavage. Cisapride treatment had no effect on
      digestion and nutritional status of cystic fibrosis patients with pancreatic
      insufficiency.

PMID- 2231219
TI  - Fungal peritonitis in children on peritoneal dialysis.

PMID- 2231218
TI  - Interaction between trimethoprim-sulfamethoxazole and methotrexate in children
      with leukemia.
AB  - Because trimethoprim-sulfamethoxazole (TMP-SMX) causes neutropenia in children
      with leukemia, we investigated the possibility that pharmacokinetic interaction
      between methotrexate (MTX) and TMP-SMX causes accumulation of the antileukemia
      agent. We studied the pharmacokinetics of MTX given intravenously or orally to
      nine children with acute lymphoblastic leukemia, once with and once without TMP
      SMX. There was an increase in free MTX fraction during TMP-SMX therapy in all
      patients, from (mean +/- SD) 37.4 +/- 11% without TMP-SMX to 52.2 +/- 6.4% with
      TMP-SMX (p less than 0.01). Plasma clearance of total MTX did not change
      significantly, whereas clearance of free MTX decreased significantly (from 12.5
      +/- 4 to 7.6 +/- 1.5 ml/kg/min; p less than 0.05). There was a consistent
      decrease in the renal clearance of free MTX (from 12.1 +/- 6.8 to 5.6 +/- 2.4
      ml/kg/min; p less than 0.05). Elimination half-life of MTX was not affected
      significantly by TMP-SMX. There was a significant correlation between serum
      concentrations of TMP-SMX and the percentage of decrease in the renal clearance
      of free MTX (r = 0.91; p less than 0.05). These changes in protein binding and
      tubular clearance of MTX, caused by competition with TMP-SMX, result in a mean
      66% increase in systemic exposure to MTX and may explain the myelotoxicity often
      observed with the coadministration of the two drugs.

PMID- 2231220
TI  - Neonatal necrotizing enterocolitis: bridging the basic science with the clinical
      disease.

PMID- 2231221
TI  - Convulsions in children with ventriculoperitoneal shunts.

PMID- 2231222
TI  - Metoclopramide for gastroesophageal reflux in infants.

PMID- 2231223
TI  - Urodynamics and hypercalciuria.

PMID- 2231224
TI  - Uridine diphosphate glucose and uridine diphosphate galactose in galactosemia.

PMID- 2231225
TI  - Prevention of rheumatic fever.

PMID- 2231226
TI  - The fetus as a patient. Sixth International Symposium. Detroit, Michigan, USA,
      October 25-27, 1990. Abstracts.

PMID- 2231227
TI  - Antibodies directed to the chemotactic factor receptor detect differences between
      chemotactically normal and defective neutrophils from LJP patients.
AB  - Localized juvenile periodontitis (LJP) is a progressively destructive infection
      of the supporting tissues of the teeth, primarily affecting adolescents. In this
      disease, patients' polymorphonuclear leukocytes (PMN) exhibit decreased
      chemotaxis (CTX) and decreased binding of the chemotactic peptide N-formyl-l
      methionyl-l-leucyl-l-phenyl-alanine (FMLP) to specific receptors on the PMN
      surface. Since the FMLP receptor is involved in the activation of the PMN, and
      its subsequent response to chemotactic stimuli, a decrease in the chemotactic
      peptide receptor, as seen in LJP patients, is suspected to be a predisposing
      factor for this disease. To define differences in the FMLP receptor between CTX
      defective LJP patients and CTX normal donors, a battery of monoclonal antibodies
      reactive against the FMLP receptor was prepared. The FMLP receptor was affinity
      purified, and was found to be comprised of two components, one of 68 kDa, and the
      other of 94 kDa. Only the 68 kDa component specifically bound a radioiodinated
      FMLP analogue in a photoaffinity experiment. Seven monoclonal antibodies were
      selected on the basis of their reactivity with the 68 kDa receptor component, and
      of these, 5 showed reduced binding against PMN from CTX defective LJP donors when
      compared to their reactivity against PMN from CTX normal subjects. Two of the 7
      anti-68 kDa antibodies reacted with PMN from both sets of subjects at a
      comparable extent. Furthermore, the presence of 20 nmol of FMLP inhibited the
      binding of 5 of the anti-receptor antibodies to whole PMN, including one that
      showed no difference in binding between CTX normal and defective PMN, and 4 of
      the 5 that did show such difference.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231228
TI  - Periodontal disease morbidity quantification. I. Optimal selection of teeth for
      periodontal bone loss surveys.
AB  - The assessment of alveolar bone loss with bite-wing radiographs is attractive
      because bite wings are relatively convenient, inexpensive, and available. The
      choice of teeth used influences the validity of global bone loss assessments
      based on partial mouth measurements. The objective of this study was to validate
      periodontal bone loss indices based on a few teeth. The mandibular posterior
      teeth were considered as a basis for abbreviated indices. The optimum number of
      teeth included was evaluated, and the utility of abbreviated indices was
      determined experimentally. The teeth from 75 skulls were measured from the
      cemento-enamel junction (CEJ) to the alveolar bone at six locations per tooth.
      The subsets of teeth which best represent the average whole mouth bone loss were
      found with all-possible-subsets regression analysis. Bone loss data from 179
      prehistoric skulls were used to test the validity of selected teeth indices. Bone
      loss measurements from the mandibular posterior areas were representative of full
      mouth bone loss measurements. Mandibular second premolars plus any other
      mandibular posterior teeth were the optimal combination of tooth for an
      abbreviated index. This subset is suitable for use with bite-wing radiographs.

PMID- 2231229
TI  - Periodontal disease morbidity quantification. II. Validation of alveolar bone
      loss measurements and vertical defect diagnosis from digital bite-wing images.
AB  - Quantitative alveolar bone loss evaluation by digital processing of dental
      radiographs was performed. More than 20 contrast and edge enhancement techniques
      were applied to bite-wing radiographs of adult molar teeth and the results
      subjectively evaluated. Wallis space variant image enhancement was selected as
      the most promising candidate for improved visualization of the cemento-enamel
      junctions and alveolar crests. Seventy-three skulls were radiographed, the films
      digitized, and enhancement performed on the digital images. Alveolar bone loss
      measurements from skulls (truth) were compared with those from the original
      radiographs, unprocessed digital images, and enhanced digital images. The average
      intraclass correlation coefficient for two observers was 0.83 for radiographs,
      0.86 for digital images, and 0.91 for enhanced images. The intraclass correlation
      coefficient between the 2 sets of dry skull measurements made by two additional
      observers was 0.88. Means and 95% confidence limits were determined for
      differences between measurements from dry skulls and radiograph-based images. In
      the worst case for measurements from enhanced images, the mean difference from
      truth was -0.40 mm with a 95% confidence interval from -0.54 to -0.25 mm.
      Receiver operating characteristic (ROC) analysis was used to determine the
      utility of radiograph-based images for the diagnosis of vertical defects. The
      ability of two observers to diagnose vertical defects on dry skulls was also
      tested. All methods of vertical defect diagnosis, including the identification of
      vertical defects on dry skulls, had relatively low diagnostic performance. Image
      processing technology has considerable potential in periodontal disease studies
      for quantitative evaluations of alveolar bone height. The diagnosis of vertical
      defects using current definitions and techniques is problematic, with
      considerable room for improvement.

PMID- 2231230
TI  - HTR polymer grafts in human periodontal osseous defects. I. 6-month clinical
      results.
AB  - HTR polymer was evaluated as a grafting material in periodontal osseous defects
      in 21 adult patients. Following initial preparation and pre-surgical
      documentation with standardized measurements, radiographs, and photographs,
      vertical osseous defects were treated with surgical open flap debridement alone
      (DEBR) or with DEBR plus placement of HTR polymer graft material. Patients were
      followed with frequent recalls until surgical re-entry at about 6 months for
      documentation and any needed remedial therapy. Re-entry data show that use of HTR
      polymer grafts resulted in significantly better mean defect fill of 2.2 mm
      (60.8%) compared to 1.0 mm (32.2%) with DEBR alone (P less than .001). Other hard
      tissue findings such as residual defect depth, crestal resorption, and percent
      defect resolution showed similar clinically superior results with the use of HTR
      polymer. Soft tissue findings showed significant differences in favor of HTR for
      decrease in probing depth and gain in clinical attachment. These results are
      similar to those reported with other graft materials. Over a 6-month period, HTR
      polymer was found to show promise for the repair of periodontal osseous defects.

PMID- 2231231
TI  - Actinobacillus actinomycetemcomitans in families afflicted with periodontitis.
AB  - The purpose of this study was to determine the prevalence of Actinobacillus
      actinomycetemcomitans (Aa) in individuals from families where at least one
      individual has an early onset form of periodontitis. Twenty-three families with
      73 subjects were evaluated in this study. Forty-seven early onset periodontitis
      subjects outside the 23 families were also studied. Prevalence of detection of Aa
      in family members ranged from 49% to 66% among groups constituted by clinical
      findings indicative of no loss of attachment, adult periodontitis, generalized
      severe juvenile periodontitis, or localized juvenile periodontitis. Whether the
      data were analyzed by subject or by site, no statistical differences could be
      found in prevalence (proportion of positive samples) among those clinical groups.
      The only significant difference was that localized juvenile periodontitis
      subjects had higher concentrations of Aa in their Aa-positive sites than did the
      other clinical groups. The prevalence of Aa-positive sites in subjects without
      attachment loss, but who are members of families in which early onset
      periodontitis is represented, was much higher than in other reports where
      periodontally healthy subjects were not related to early onset periodontitis
      cases. This suggests that Aa may be transmitted among members of families in
      which one or more members has an early onset form of periodontitis.

PMID- 2231232
TI  - Peripheral ameloblastoma of the gingiva. A case report.
AB  - Reports of gingival peripheral ameloblastoma are extremely rare and have been
      sporadic. This paper reports a pertinent case of a 40-year-old woman who for 2
      years had a progressively enlarging asymptomatic firm mass in the buccal gingival
      region of the lower premolars. Cupping of the underlying bone was
      radiographically demonstrated. The lesion was excised surgically together with
      extraction of the first premolar, and no evidence of recurrence was seen 5 years
      later. The clinical, radiological, and histopathological characteristics of
      gingival peripheral ameloblastoma were analyzed in the 33 previously reported
      cases. The differential diagnosis and treatment of this case report are
      discussed.

PMID- 2231233
TI  - Repair potential in localized juvenile periodontitis. A case in point.
AB  - An aggressive form of localized juvenile periodontitis (LJP) in a 12-year old
      West African female is reported. The case was treated with scaling, root planing,
      debridement, and tetracycline therapy, which resulted in complete resolution of
      the disease, including elimination of periodontal inflammation, regeneration of
      lost periodontal structures, and spontaneous repositioning of teeth that had
      pathologically migrated. A hopelessly involved mandibular right first molar was
      successfully replaced by an incompletely developed maxillary third molar tooth
      bud whose roots and pulp structure continued to develop after
      autotransplantation. It is suggested, that LJP can be successfully treated
      without periodontal surgery and that the potential for repair in LJP cases is
      apparently greater than what one can anticipate in adult forms of periodontitis.

PMID- 2231234
TI  - Stability of MMPI scale scores within four codetypes across forty years.
AB  - The changes in the standard validity and clinical scales on the Minnesota
      Multiphasic Personality Inventory (MMPI) were examined within four frequently
      occurring codetypes (Spike 4, 2-4/4-2, 2-7/7-2, and 6-8/8-6) in samples of
      psychiatric patients over a time span of 40 years. The validity and clinical
      scale scores within these four codetypes were very stable over this time span
      with differences in the range of only a few T-score points. These results are
      very similar to those reported by Pancoast and Archer (1989) who found remarkable
      stability in the MMPI scale scores of normal adult samples across 40 years.

PMID- 2231235
TI  - The Levels of Emotional Awareness Scale: a cognitive-developmental measure of
      emotion.
AB  - The Levels of Emotional Awareness Scale (LEAS) is based on a new cognitive
      developmental model of emotional experience. The scale poses evocative
      interpersonal situations and elicits descriptions of the emotional responses of
      self and others which are scored using specific structural criteria. Forty
      undergraduates (20 of each sex) were tested. Interrater reliability and intratest
      homogeneity of the LEAS were strong. The LEAS was significantly correlated with
      two measures of maturity: the Washington University Sentence Completion Test
      (SCT) of Ego Development, and the Parental Descriptions Scale-a cognitive
      developmental measure of object representation. In addition, the LEAS correlated
      positively with openness to experience and emotional range but not with measures
      of specific emotions, repression or the number of words used in the LEAS
      responses. These findings suggest that it is the level of emotion, not the
      specific quality of emotion, that is tapped by the LEAS.

PMID- 2231236
TI  - Attitudinal body-image assessment: factor analysis of the Body-Self Relations
      Questionnaire.
AB  - This article presents an analysis of the factor structure of the Body-Self
      Relations Questionnaire (BSRQ), an attitudinal body-image instrument. Random
      stratified samples, drawn from a national survey, included 1,064 females and 988
      males. In order to evaluate the replicability of the BSRQ factor structure,
      separate split-sample factor analyses (principal components with varimax
      rotation) were conducted for each sex. Largely consistent with the conceptual
      basis of the BSRQ, the resultant factors derived from each analysis were:
      Appearance Evaluation, Appearance Orientation, Fitness Evaluation, Fitness
      Orientation, Health Evaluation, Health Orientation, and Illness Orientation.
      Subsequent concordance analyses revealed marked stability of the factor structure
      both within and between sexes. Females demonstrated somewhat greater
      differentiation of body-image attitudes than did males. The utility of the BSRQ
      is discussed relative to extant body-image measures.

PMID- 2231237
TI  - Does test anxiety bias scholastic aptitude test performance by gender and
      sociocultural group?
AB  - This study examines the commonly held contention that test anxiety may serve as a
      source of bias in the scholastic aptitude test performance of gender and ethnic
      minority groups. In addition, this study examines sex and sociocultural group
      differences in the level and pattern of test anxiety among Israeli college
      students. The sample was composed of 163 male and 198 female students sitting for
      scholastic aptitude tests routinely administered to all student applicants as
      part of their college admissions procedures. About 67% were of Western cultural
      extraction whereas the remainder were of Eastern extraction. Significant
      differences in text anxiety scores for males and females were observed, with
      greater sex group differentiation on the Emotionality than on the Worry scale.
      Test anxiety scores were not discernible by ethnicity or social class.
      Furthermore, test anxiety was not differentially related to aptitude test scores
      by sex or sociocultural group membership. Thus, this study lends little evidence
      to the common contention that test anxiety differentially debilitates the
      aptitude test scores of females and ethnic minority student candidates.

PMID- 2231238
TI  - The measurement of principled morality by the Kohlberg Moral Dilemma
      Questionnaire.
AB  - The four stages preceding the postconventional level in the Kohlberg (1958, 1971,
      1976) system of moral development are described as involving moral judgments that
      conform to external conditions of punishment, reward, social expectation, and
      conformity to the law. No special level of self-control seems necessary to behave
      in keeping with these conditions of external reinforcement. In contrast, the two
      stages of postconventional (principled) mortality involve defiance of majority
      opinion and defiance of the law--actions that would seem to require greater self
      control. This study was concerned with whether postconventional moral reasoning,
      as measured by the Kohlberg Moral Dilemma Questionnaire (MDQ), can be associated
      with higher self-control. If so, prediction of principled moral behavior from the
      MDQ would be based not only on postconventional moral reasoning but bolstered by
      the necessary level of self-control as well. College students who came the
      closest to postconventional moral reasoning showed better self-control than
      college students who were more conventional or preconventional in their moral
      judgments. These results support the validity of the MDQ for predicting
      principled moral behavior.

PMID- 2231239
TI  - Estimation of MCMI DSM-III axis II constructs from MMPI scales and subscales.
AB  - Wiggins, Harris and Lingoes, and Serkownek Minnesota Multiphasic Personality
      Inventory (MMPI) scores were used to predict Millon Clinical Multiaxial Inventory
      (MCMI) scores in a 100-patient sample. Equations from the first sample were cross
      validated on a sample of 212 inmate subjects. We conclude that scores on 19 of
      the 20 MCMI scales can be successfully predicted by the Wiggins, Harris and
      Lingoes, and Serkownek subscales of the MMPI. In further cross-validation, the
      equations were used to predict the Morey, Waugh, and Blashfield MMPI composites
      for the prison sample, again with strongly positive results. The results appear
      quite promising for the estimation of personality disorder constructs from MMPI
      scales and subscales.

PMID- 2231240
TI  - Retest reliability of the Millon Clinical Multiaxial Inventory.
AB  - This article reports on two studies which examined the temporal stability of the
      personality disorder subscales from the Millon Clinical Multiaxial Inventory
      (MCMI). The scales demonstrated adequate stability in psychiatric inpatients
      (retested with an average of just over 1 year between testings). Furthermore, a
      separate sample of depressed inpatients assessed when depressed and 6 weeks later
      showed that the stability of MCMI personality scales was observed even after
      patients displayed an initial reduction in depression severity. Although
      stability is vital to the accurate assessment of personality disorders, both
      studies also found high retest correlations for the MCMI clinical syndrome
      subscales. In general, these results suggest that patients displayed similar
      symptom patterns over time, whether construed as personality traits or
      characteristic patterns of responding when symptomatic.

PMID- 2231241
TI  - Stability of the MCMI among depressed psychiatric outpatients.
AB  - The Millon Clinical Multiaxial Inventory (MCMI) is a promising, yet somewhat
      unproven psychometric inventory developed to identify clinical syndromes and
      personality traits consonant with the Diagnostic and Statistical Manual of Mental
      Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980). The
      stability of its measures for both the theoretically more stable personality
      characteristics and the clinical syndromes was investigated in a group of
      depressed psychiatric outpatients. In this test-retest design with a 3-month
      interval between tests, clinical syndrome scales of relevance changed
      significantly as expected. However, many of the personality scales also changed
      significantly. Only four of the personality scales met a two-fold test of
      stability. Findings are discussed in terms of characteristics of self-report
      inventories such as the MCMI, the uniqueness of the depressed population, and
      characteristics of personality disorders.

PMID- 2231242
TI  - MCMI-II scoring: weighted and unweighted algorithms.
AB  - This brief report examines the relationship between the scale scores derived
      through weighted and unweighted item scoring on the Millon Clinical Multiaxial
      Inventory-II (MCMI-II). The inventories of 356 subjects across three samples were
      scored using weighted and unweighted algorithms. Correlations between the
      weighted and unweighted MCMI-II scales were found to approach unity. This casts
      doubt on whether the weighting system has substantial effect on the profiles that
      are generated or on reducing interscale correlations.

PMID- 2231243
TI  - The Beck Depression Inventory: item order and the impact of response sets.
AB  - The lack of subtle content in the item groups of the Beck Depression Inventory
      (BDI) and the consistency in the ordering of the items from least to most
      pathological make this instrument unduly susceptible to either defensive or
      malingering response sets. Two experimental forms were developed for the BDI: a
      backwards version (a simple reversal of the order of items within each group) and
      a random-order version. These forms, together with the original item order, were
      given to college undergraduate women along with the Depression scale from the
      MMPI and the Burks-Martin Questionnaire covering recent life changes and current
      stressful situations. The random order BDI results in a significantly higher
      depression score than did either the original or backwards version. Correlations
      with the other instruments were comparable for all three forms. The random order
      of items within each set appears to break up a response set to endorse either the
      first or last item and is, therefore, recommended.

PMID- 2231245
TI  - Gender differences in depression in an employment setting.
AB  - This study extends the literature on sex differences in depression to an
      employment setting, using Minnesota Multiphasic Personality Inventory (MMPI; T
      and raw scores) and Depression (D) 30 measures. In contrast to previous findings,
      no gender differences remained on any of the measures after the effects of
      salary, age, education, and job classification had been taken into account.
      Findings replicated earlier results showing depressed males to have greater
      difficulty with concentration and motivation than depressed females. Data suggest
      that MMPI sex-based T-scores may overcorrect for sex differences in raw scores.
      Possible explanations for the findings are discussed, including a general
      improvement in women's well-being associated with changes in social conditions
      such as employment, or the possibility of a self-selection bias in our sample.

PMID- 2231244
TI  - Multimethod assessment of depression in sexually abused girls.
AB  - This study measured depression in sexually abused Black girls using the
      Children's Depression Inventory (Kovacs & A. T. Beck, 1977), the Internalization
      scale of the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and the
      Rorschach Depression Index (Exner, 1986). There were no significant correlations
      between these self-report, behavior observation (by parental report), and
      projective measures. The abused subjects had high scores on the behavior
      observation and Rorschach scales. Consistent with past research, negative results
      were obtained with the self-report instrument. We suggest that the low scores on
      self-report measures of distress produced by sexually abused children may be the
      result of guardedness or defensiveness rather than a genuinely low level of
      dysphoria in this population. There were no significant relations between abuse
      characteristics and scores on the depression measures. Scores on Rorschach
      measures of organizational activity (Zf) and available coping resources (EA) were
      generally positively related to depression within the abuse group and negatively
      related to depression within the control group.

PMID- 2231246
TI  - Contingent reinforcement effects on movement responses of prison inmates to the
      Holtzman Inkblot Technique.
AB  - Prison inmates were administered the Holtzman Inkblot Technique (HIT) under
      conditions of either verbal or nonverbal reinforcement of movement responses.
      Overall, there were no differences among the verbal, nonverbal, and control
      groups. Inmates charged with violent crimes were found to give the fewest
      movement responses. With crime category controlled, more movement responses were
      given under nonverbal conditions. There were no sex differences for movement
      responses but testing time increased significantly when administered by the
      female examiner.

PMID- 2231247
TI  - A Rorschach investigation of narcissism and hysteria in antisocial personality.
AB  - We investigated Rorschach responses associated with narcissism and hysteria in a
      group of antisocial personality disordered offenders. The Rorschach protocols of
      42 subjects who met the criteria from the Diagnostic and Statistical Manual of
      Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association,
      1987) for antisocial personality disorder were analyzed using Exner's (1986)
      criteria for pairs, reflections, and personal responses, and Gacono's (1988)
      criteria for the impressionistic response. Severe, or primary psychopaths (n =
      21), scoring greater than or equal to 30 on the Hare (1980) Psychopathy Checklist
      (PCL), were compared to moderate, or secondary pscyhopaths (n = 21), scoring less
      than 30 on the PCL. The mean number of pair and impressionistic responses did not
      significantly differ for the two antisocial groups. The highly psychopathic
      group, however, did exhibit a significantly greater mean number of reflection and
      personal responses. We discuss pair and reflection responses and their
      relationship to narcissism in psychopathic disturbance. We recommend interpreting
      the personal response within the context of the psychopathic character and view
      personal responses as expressions of narcissism and omnipotence in highly
      psychopathic subjects. We also hypothesize that the impressionistic responses are
      indicative of primitive dissociative processes and hysteria in psychopathic
      subjects, and that their presence provides construct validity for the work of
      Guze (1976) and others who suggested an underlying histrionic dimension to
      psychopathy.

PMID- 2231249
TI  - Severe disturbance or trauma-induced adaptive reaction: a Rorschach child case
      study.
AB  - In interpreting children's Rorschachs, it is often difficult to discriminate
      between a severe disturbance and an adaptive reaction to a trauma. To explore
      this difficult differential diagnostic issue, a child was tested three times. It
      was suggested that complexity, references to the trauma, and evidence of
      psychological disturbance are associated with an attempt to master the trauma.
      Rorschach data were presented and were found to be consistent with these
      speculations. The author concluded that such "openness" to an environmental
      stress may allow an adaptive reaction and that understanding Rorschach data in
      context helps to reduce ambiguity and to recognize the test's limitations.

PMID- 2231248
TI  - Oral-dependence and gender: factors in help-seeking response set and self
      reported psychopathology in psychiatric inpatients.
AB  - Psychoanalytic theory suggests that orality and being female are positively
      related to adopting a help-seeking stance in the world. This may result in
      inflated scores on self-report psychological tests. These hypotheses were
      investigated using Rorschach-based, oral-dependence scores (Masling, 1986), the
      Minnesota Multiphasic Personality Inventory (MMPI) help-seeking F minus K index
      (Gough, 1950; Meehl, 1951), and the MMPI clinical and supplementary scales. High
      orals are found to be more likely than low orals to adopt a help-seeking response
      set which in turn results in inflated scores on a number of MMPI clinical scales.
      Contrary to stereotypes, women are no more likely than men to be help seeking or
      oral dependent. Several other significant findings, including that orality is
      positively related to MMPI Scale 2 (Depression) scores for women, not men, are
      also discussed.

PMID- 2231250
TI  - Object relations in borderlines, depressives, and normals: an examination of
      human responses on the Rorschach.
AB  - Recently, researchers and clinicians have become increasingly interested in
      diagnostic distinctions between borderline and mood disorders. Object relations
      theory provides a useful framework for the comparison of these two overlapping
      diagnostic categories. In our study, a measure of object relations as represented
      on the Rorschach, developed by Blatt, Brenneis, Schimeck, and Glick (1976), was
      applied to data produced by borderline and depressive inpatients and by normal
      comparison subjects. Portions of the Blatt measure that tap the subject's
      experience of human action and interaction distinguish among the three diagnostic
      groups. Specifically, borderlines tend to understand human action as more highly
      motivated and human interaction as more malevolent in nature than do either
      depressive or normals. The data indicate that borderlines experience the object
      relational world in a way that is fundamentally different from the way normals
      and depressives perceive it. Implications are discussed for theories of
      borderline object relations.

PMID- 2231251
TI  - Assessing object representations as a continuous variable: a modification of the
      concept of the object on the Rorschach scale.
AB  - Current methods for assessing the quality of internalized object representations
      have not provided a continuous variable that simultaneously includes both an
      accuracy and a maturity component. A modification of Blatt, Brooks, Brenneis, and
      Schimek's (1976) Concept of the Object on the Rorschach scale that would combine
      the two components by weighting the quality of each response according to its
      form level was proposed. Initial discriminant and convergent validity of this
      modification was checked through correlations and multiple regression analyses
      using behavioral, diagnostic, and demographic data from 84 adolescent inpatients
      as dependent variables. Results indicate the modified score was directly related
      to measures of peer relatedness, intelligence, psychological health, and reality
      testing, and indirectly related to measures of psychosis and hostile,
      unmanageable behavior. The results support the utility of the modification for
      providing a continuous score that assesses both developmental maturity and
      accuracy, the two dimensions on which the concept of object representation is
      based.

PMID- 2231252
TI  - Rorschach responses in healthy, community dwelling older adults.
AB  - Five predicted relationships between age and intellectual level and 16 Rorschach
      variables were examined through a cross-sectional analysis of 47 healthy,
      community-dwelling elderly men and women. Subjects were compared by age and
      intellectual level using gender, level of medication, and scores on the Geriatric
      Depression Scale (GDS) and the Geriatric Social Readjustment Questionnaire (GSRQ)
      as covariates. Screening tests for psychiatric and physical illness, recent life
      events, and hearing and vision loss were administered. In contrast to prior
      research suggesting changes in Rorschach scores with differences in age and
      intellectual level, only one significant difference was found for these
      variables. The data suggest that age and intellectual level may contribute less
      to Rorschach responses than was previously thought.

PMID- 2231253
TI  - Relationships between Hand Test variables and maladjustment in school children.
AB  - Twenty-two Hand Test variables significantly differentiated a group of children
      referred to school psychologists for social and emotional maladjustment from a
      control group matched on age and sex. Eleven variables emerged from a subsequent
      stepwise discriminant analysis, resulting in a 80.85% hit rate. Results are
      interpreted as providing statistical support for the use of the Hand Test as a
      screening and/or ancillary projective technique in assessing school children.

PMID- 2231254
TI  - Personality characteristics of eating-disordered outpatients as measured by the
      Hand Test.
AB  - The Hand Test was administered to 34 eating-disordered and 26 noneating
      disordered college-age women to determine discriminating projective personality
      features. Eating-disordered women scored higher on response time, overall
      pathology, and passivity. Anorexics present more tension, aggression, and acting
      out potential whereas bulimics demonstrate significantly more passive responses.
      The more severely affected women scored higher on crippled, passive, and
      withdrawal variables. Similarities as well as differences between the groups may
      have important implications for the diagnosis of subgroups of eating-disordered
      women and for treatment planning.

PMID- 2231256
TI  - Further evidence concerning motivational distortion on the Sixteen Personality
      Factor primaries by male felons.
AB  - A multiple regression analysis was used to determine the susceptibility of the 16
      Personality Factor Test (16PF) to faking for a sample of male felons. The study
      is a replication of an earlier study of a similar sample. Motivational distortion
      (MD) correlated significantly with the 16PF primary scores. The relationship was
      most evident when the structure coefficients rather than the beta weights were
      analyzed. The findings were consistent with the previous results which indicated
      a fairly high degree of support for the MD corrections provided in the manual. An
      important exception was that Dominance (E) was suppressed by individuals from
      both samples when MD was present.

PMID- 2231255
TI  - Personality factors, family structure, and sex of drawn figure on the Draw-A
      Person Test.
AB  - One hundred seventy-four youthful psychiatric inpatients were given the Draw-A
      Person Test (DAP) as part of an assessment battery. Sex of person drawn was
      compared to subject's sex, Achenbach aggression and delinquency scores, and
      scores on Children's Inventory of Anger and Nowicki-Strickland Locus of Control
      Scale. The sex of the person drawn was also compared to family composition,
      specifically whether or not the child came from an intact family with both a male
      and female parent or role model. Results support drawing of a same-sexed
      individual as normative, regardless of age or sex. Adolescent girls and young
      boys were the only groups that differed significantly from this norm. Personality
      measures and family composition were not significantly related to the tendency to
      draw same versus opposite sex.

PMID- 2231257
TI  - Augmenting Hopkins SCL scales to measure dissociative symptoms: data from two
      nonclinical samples.
AB  - A 13-item Dissociation scale is introduced, and preliminary data regarding its
      reliability are presented. Designed to complement the Symptom Checklist (SCL-90;
      Derogatis, Lipman, & Covi, 1973) and the Hopkins Symptom Checklist (HSCL;
      Derogatis, Lipman, Rickels, Ulenhuth, & Covi, 1974), this scale may be especially
      useful in research on the effects of psychological trauma.

PMID- 2231258
TI  - Personality assessment training in counseling psychology programs.
AB  - Although data about personality assessment training in clinical psychology
      programs have often been gathered, little comparable data have been collected
      about assessment training in counseling psychology programs. To collect such
      information, we conducted a survey of all programs identified as part of the
      Council of Counseling Psychology Training Programs. A two-page questionnaire was
      sent out to the 64 program directors, with 56 (88%) of the questionnaires being
      returned. Information about availability of required personality assessment
      courses, availability of elective assessment courses, and types of personality
      tests covered in the counseling curriculum is presented and discussed.

PMID- 2231259
TI  - The Depressive Experiences Questionnaire: a critical review.
AB  - The Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan,
      1976) is critically reviewed. First the developmental, object representations
      theory differentiating depression into anaclitic and introjective subtypes is
      presented. The DEQ factors of Dependency and Self-Criticism were initially found
      to be consistent with these clinically meaningful depressive subtypes. Subsequent
      research has generally demonstrated that these subtypes, at least as measured by
      the DEQ, do not hold up well in clinical populations. Furthermore, the validity
      of the developmental theory of these subtypes is weak. We suggest that more
      internally consistent and distinct factors should be developed from clinical
      populations because of their potential clinical usefulness.

PMID- 2231260
TI  - Psychometric properties of the Depressive Experiences Questionnaire in a college
      population.
AB  - The Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan,
      1976) was developed to permit the study of the continuities between normal and
      pathological forms of depression. Since its publication over 10 years ago, the
      DEQ has been increasingly used in a wide range of investigations of depression in
      clinical and nonclinical samples and as a measure of two major personality
      dimensions in a number of studies of differential responsiveness to various life
      stressors. This study provides an analysis of the DEQ responses in a large sample
      of undergraduate subjects in an attempt to articulate more clearly the
      psychometric properties of the DEQ. The DEQ consists of 66 items describing
      experiences frequently reported by depressed individuals. In the original
      development of the DEQ, factor analyses using male and female undergraduate
      samples yielded three orthogonal factors, Dependency, Self-Criticism, and
      Efficacy (Blatt et al., 1976). Most subsequent studies have used the factor
      scoring coefficients from the female sample to score men and women's DEQs. The
      factor loadings in the new male and female samples were very similar to one
      another and to the original female factor loadings. Thus, the continued use of
      the scoring parameters from the original female sample is recommended. Factor
      scores for Dependency and Self-Criticism continue to be uncorrelated in both men
      and women. Normative data are presented from the new samples, with men scoring
      higher on Self-Criticism and women scoring higher on Dependency.

PMID- 2231261
TI  - External validity of the new Devereux Adolescent Behavior Rating scales.
AB  - The discriminant and concurrent validity of the five new scales for the Devereux
      Adolescent Behavior Rating Scale (DAB) was explored using a heterogeneous sample
      of psychiatric and substance abuse patients. Consistent with predictions, the
      substance abuse patients scored higher on the Acting Out Behaviors (AOB) and
      Heterosexual Interests (HI) scales, and psychiatric patients scored higher on the
      Psychotic Behaviors scale. Gender differences also were found, including boys
      being rated higher on Acting Out Behaviors, and girls higher on Heterosexual
      Interests. The new DAB scales demonstrated sufficient concurrent validity using a
      thorough record review and a patient rating scale (the Child Behavior Checklist
      [CBCL]). The Neurotic/Dependent Behaviors scale (NDB) showed a consistent
      relationship with substance abuse and several other measures of more
      externalizing behaviors, in addition to the predicted relationships with anxious,
      tense, and dependent behaviors. The Withdrawn/Timid Behaviors scale (WTB) proved
      to be a purer measure of internalizing behaviors in both sexes.

PMID- 2231263
TI  - Cognitive-perceptual theory and the projective use of autobiographical memory.
AB  - Most clinicians know little about the operation of autobiographical memory. Yet
      as assessment people, clinicians are frequently called upon to make important
      decisions about the individuals they evaluate. It is not surprising that
      clinicians are ignorant regarding many aspects of autobiographical memory because
      most have not been trained to understand how autobiographical memory functions.
      This article focuses on a vital domain of autobiographical memories--early
      memories--and discusses from a clinical perspective the purpose, function, and
      organization of autobiographical memory as seen by cognitive-perceptual theory.

PMID- 2231262
TI  - Item factor structure of the Personality Adjective Check List.
AB  - This study reports on a principal-components analysis of the Personality
      Adjective Check List (PACL) at the item level. Data came from a national sample
      of normal adults and included the responses of 1,058 men and 1,194 women (N =
      2,252). Analyses were conducted separately for men and women, and for the sexes
      combined. The scree test was applied to decide on the number of factors to
      extract. Retained factors were rotated by varimax and direct oblimin procedures.
      Results were very similar for each analysis, with coefficients of congruence for
      the five orthogonal factors obtained from men and women separately being .95,
      .92, .94, .94, and .92. The five unipolar personality dimensions isolated were
      interpreted as Aggressive/Dominant, Neurotic, Conscientious,
      Detached/Introverted, and Surgent/Extraverted. These were compared to item
      factors of the Million Clinical Multiaxial Inventory (MCMI-I), MCMI-II, Adjective
      Check List (ACL), and to Norman's Big Five dimensions.

PMID- 2231264
TI  - Dose-dependent pharmacokinetics and first-pass metabolism of acetaminophen in
      rats.
AB  - In order to investigate the in vivo first-pass metabolism of acetaminophen (AAP)
      following the oral and intraduodenal administration in rats, a pharmacokinetic
      compartment model including absorption process was developed. Using the
      parameters for the disposition kinetics of AAP and its metabolites, sulfate and
      glucuronide, which were determined in the separate study, the extent of the first
      pass metabolism and the contribution of sulfation and glucuronidation to the
      total first-pass metabolism in vivo were quantitatively estimated. As for the
      results, the first-pass metabolism of AAP following the oral and intraduodenal
      administration was mainly attributable to the sulfo-conjugation pathway in rats.
      The sulfation of AAP in the intestine and/or in the liver during the first-pass
      was proved to be a saturable process. Then, the sulfation in the first-pass
      metabolism showed the dose- and absorption rate-dependent kinetics. Thus, the
      pharmacokinetic model including the absorption process proposed in the present
      study was proved to be valid and useful for the estimation of in vivo first-pass
      metabolism of AAP in rats.

PMID- 2231265
TI  - Inhibition of testosterone biosynthesis in testicular microsomes by various
      imidazole drugs. Comparative study with ketoconazole.
AB  - Ketoconazole (KCZ), an imidazole-containing antimycotic, has been demonstrated to
      inhibit testosterone biosynthesis in man. In this study, the inhibitory
      activities of various imidazole drugs such as miconazole (MCZ), cimetidine (CIM),
      ozagrel (OZA) and its metabolites (M-1 and M-2) on the pathway of testosterone
      biosynthesis in testicular microsomes were compared with that of KCZ in vitro.
      Additionally, the changes in serum testosterone level in the patients by the
      treatments with MCZ were followed. KCZ inhibited 17 alpha-hydroxylase and C17,20
      lyase activities in a dose-dependent manner, while it did not affect 17 beta
      hydroxysteroid dehydrogenase activity. Although the patterns of the inhibitory
      actions and the interaction of either imidazole drugs with cytochrome P-450 as 17
      alpha-hydroxylase and C17,20-lyase were similar to those of KCZ, the inhibitory
      potencies and affinities for the cytochrome P-450 system decreased in the order
      of KCZ greater than MCZ greater than OZA greater than M-2 greater than M-1
      greater than CIM. At the end of the intravenous injection of 200 mg MCZ to the
      patients, the serum testosterone levels decreased by about 16% of the original
      level and then returned to the original level 5 h after the end of injection.
      These results indicate that either imidazole drugs tested could inhibit a
      cytochrome P-450 enzyme C17,20-lyase mainly in testicular microsomes, and suggest
      that MCZ, a potent inhibitor subsequent to KCZ, induces a slight alteration in
      the testosterone biosynthesis in its clinical use.

PMID- 2231266
TI  - In vivo and in vitro evidence for a common carrier mediated transport of choline
      and basic drugs through the blood-brain barrier.
AB  - The blood-brain barrier (BBB) transport system for choline and basic drugs was
      characterized by the in vivo carotid artery injection technique (Oldendorf, Brain
      Res., 24, 372-376, 1970) and in vitro uptake into isolated bovine brain
      capillaries (Pardridge et al., J. Neurochem., 44, 1178-1184, 1985). Basic drugs
      such as eperisone, thiamine and scopolamine significantly inhibited choline
      uptake by the BBB with the half inhibitory concentration, IC50 value of 1.45,
      2.06, and 0.47 mM, respectively. On the contrary, the uptake of choline was not
      inhibited by amino acids (L-phenylalanine and L-arginine) and acidic drugs
      (nicotinic acid, salicylic acid and valproic acid). Choline was taken up by the
      isolated brain capillaries in concentration and temperature dependent manners.
      The uptake of choline by the isolated bovine brain capillaries was significantly
      inhibited by eperisone, scopolamine and thiamine in consistent with the in vivo
      results. Furthermore, eperisone inhibited competitively the uptake of choline
      with the inhibition constant, Ki value of 455 microM. According to these results
      it was suggested that in the BBB choline and basic drugs would share a common
      carrier-mediated transport system.

PMID- 2231267
TI  - Isolation of bacterial strains, which hydrolyze glycyrrhizin and produce
      glycyrrhezic acid, from soil.
AB  - We isolated eight bacterial strains which could hydrolyze glycyrrhizin to
      glycyrrhezic acid. The bacterial strains were identified as three strains of
      Pseudomonas saccharophila, two of Plesiomonas sp., one of Pseudomonas stutzeri,
      one of Klebsiella pneumoniae subsp. ozaenae and one of Kluyvera ascorbata. Their
      capacity for the conversion of glycyrrhizin to glycyrrhezic acid was assayed by
      high performance liquid chromatography. P. saccharophila 11 was the most
      effective among the eight strains. Then, beta-glucuronidase, which is responsible
      for hydrolysis of glycyrrhizin, activity was assayed with p-nitrophenyl-beta-D
      glucuronide as a substrate. P. saccharophila 11 showed the highest beta
      glucuronidase activity among the eight strains. This indicates that P.
      saccharophila 11 may be useful for production of glycyrrhezic acid from
      glycyrrhizin by industrial fermentation.

PMID- 2231268
TI  - Relation of disposition kinetics to pharmacological effect of intravenous
      administration of chlorzoxazone in rats.
AB  - The quantitative relationship between a drug disposition and the pharmacological
      effect was examined in rats using chlorzoxazone (CZX), a centrally acting muscle
      relaxant, as a model drug. After intravenous administration of CZX, the decay of
      the plasma concentration was rapid and it was found that CZX obeyed one
      compartment open model in the dose range of 5 to 25 mg/kg studied. The
      pharmacological response intensity was determined by means of the crossed
      extensor reflex. The duration of the muscle relaxant effect was proportional to
      the logarithm of the dose of CZX. The time course of the calculated plasma
      concentration was well related to the pharmacological response intensity via a
      Hill's equation and the simulated pharmacological response intensity which was
      obtained by means of the equation was coincident to the time course of the
      response data. These results indicated that the time course of pharmacological
      response intensity was able to be predicted using the time course of plasma
      concentrations. From the analysis of the quantitative relationship between the
      concentration and the effect under the present experimental conditions studied,
      it was found that the biophase compartment was identical to the central
      compartment as long as the first order processes were proceeding. These findings
      implied that the time course of pharmacological response would be quantitatively
      predictable from the disposition kinetics of CZX after the intravenous
      administration.

PMID- 2231269
TI  - Pharmacological studies of lappaconitine. Analgesia produced by
      intracerebroventricular, intracisternal and intrathecal injections.
AB  - The antinociceptive effects of lappaconitine (LA) and morphine (MOR) when
      injected intracerebroventricularly (i.c.v.), intracisternally (i.cist.) or
      intrathecally (i.t.) were investigated in mice by use of the tail pinch, hot
      plate and acetic acid-induced writhing tests. In addition, the effects of
      naloxone (NLX) administered subcutaneously on the antinociceptive action of LA
      and MOR were studied. LA and MOR after i.c.v., i.cist. and i.t. injection
      produced dose-dependent antinociception. MOR was more potent in the tail pinch
      and acetic acid-induced writhing tests by i.t. injection than by i.c.v. or
      i.cist. injection, but the potency in the hot plate test was independent of the
      injection site. On the other hand, like MOR, LA was more potent after i.t.
      injection than after i.c.v. or i.cist. injection in the tail pinch and acetic
      acid-induced writhing test. Its antinociceptive action was less potent than that
      of MOR. The antinociceptive actions of MOR were antagonized by NLX (1 mg/kg,
      s.c.) in every test and injection site, whereas the antinociceptive actions of LA
      were not inhibited, except for the antinociception on the tail pinch test, which
      was partially antagonized by NLX. It is suggested that LA mainly produced an NLX
      resistant antinociceptive effect at the spinal site.

PMID- 2231270
TI  - Light suppression of melatonin in the squirrel monkey (Saimiri sciureus).
AB  - This study examined plasma melatonin levels and the suppressant effect of light
      on melatonin production in the squirrel monkey. Monkeys were maintained on a
      12:12 light-dark cycle (LD 12:12) with lights on from 07:00 to 19:00. Plasma
      levels of melatonin were determined by gas chromatography negative chemical
      ionization mass spectrometry. Melatonin levels at 00:00 (99.5 +/- 18.9 pg/ml)
      were significantly higher than at 02:00 (57.21 +/- 7.7 pg/ml; Student's t =
      2.859; P less than or equal to 0.021). Baseline values at 02:00 were compared
      with levels at the same time of day after exposure to 2 hours of 200 lux of light
      (30.6 +/- 13.1 pg/ml), which caused an average suppression of 54.8% in melatonin
      levels. One animal did not show light suppression. Results indicated that the
      squirrel monkey suppressant response to light, as well as baseline values of
      melatonin, varied between animals.

PMID- 2231271
TI  - Choline acetyltransferase in bovine pineal gland.
AB  - Recent studies from our laboratories have shown that the bovine pineal gland
      contains a muscarinic cholinergic receptor with a Kd value of 0.423 +/- 0.010 nM
      and a Bmax value of 69.75 +/- 20.91 fmol/mg protein. In order to substantiate
      further the possible existence of a pineal cholinergic transmission, we have
      measured the activity of choline acetyltransferase and delineated its kinetic
      properties in the bovine pineal gland. This enzyme exhibited an activity of
      0.0339 +/- 0.0042 nmol/mg protein/min. Furthermore, the bovine pineal choline
      acetyltransferase possessed a Km value of 124.86 +/- 24.06 microM and a Vmax
      value of 0.0598 +/- 0.0034 nmol/mg protein/min for acetyl CoA, and a Km value of
      3.11 +/- 0.94 mM and a Vmax value of 0.0155 +/- 0.0016 nmol/mg protein/min for
      choline. The presence of muscarinic cholinergic receptors along with a specific
      choline acetyltransferase are supportive evidences that the bovine pineal gland
      may receive cholinergic innervation.

PMID- 2231272
TI  - Correlation between salivary and serum melatonin: dependence on serum melatonin
      levels.
AB  - Saliva and serum samples were collected from eight healthy volunteers every two
      hours during a 26-hour period. Melatonin concentrations were measured by
      radioimmunoassay after chloroform extraction using radioiodinated melatonin as a
      tracer. Five of the subjects had high serum melatonin levels at night (peak
      levels higher than 75 pg/ml); in three subjects the highest serum melatonin
      concentration was 20-40 pg/ml. All subjects had low levels (less than 10 pg/ml)
      during the day. The correlations between salivary and serum levels were
      calculated. The regression line y = 0.33x + 3.7 pg/ml, r = 0.95, P less than
      0.001, was obtained for all detectable value pairs (n = 73). The regression and
      correlation coefficients were almost equal for the peak values of melatonin and
      during the rising and descending phases of the secretion patterns. However, no
      significant correlation was found between low daytime salivary and serum
      concentrations when calculated separately. In the five high-secretors the
      melatonin levels in saliva reflected reliably the changes in serum, but in the
      three low-secretors the correlation between salivary and serum melatonin was not
      significant. The proportion of melatonin found in saliva decreased with
      increasing serum melatonin levels. Circadian rhythm parameters were estimated by
      single cosinor analysis. The acrophases did not differ significantly within a
      subject in the concomitant measurements of serum and salivary melatonin. The
      measurements of salivary melatonin levels seem valid for studies on melatonin
      rhythms, but the melatonin concentrations measured in saliva do not always
      consistently reflect the absolute concentrations in blood.

PMID- 2231273
TI  - Pineal gland free amino acids and indoles during postnatal development of the
      rat: correlations in individual glands.
AB  - Free amino acids and indoles were measured by HPLC in single pineal glands of 5-,
      10- and 20-day-old rats sacrificed during mid-light and mid-dark at each age.
      Melatonin was detectable in neonates (5-day-old), but day vs night differences in
      indole constituents did not occur until 10 days of age. Free amino acid steady
      state levels were high in neonates and there was a tendency for reversal of day
      vs night differences coinciding with the onset of circadian rhythmicity in indole
      biosynthesis. High correlations (r greater than 0.85) existed for taurine vs.
      glutamate in individual glands regardless of age and time of sacrifice. These
      findings suggest that taurine and glutamate are biochemically interrelated and
      that developmental changes in amino acid metabolic pools reflect functional
      innervation of the gland.

PMID- 2231275
TI  - Thymidine incorporation by chick pineal glands as studied by pulse-labelling in
      vitro.
AB  - We have studied the pattern of variations in extent of thymidine incorporation
      during pulse-labelling in cultured chick pineal glands. During the first 24-30 h
      in culture the extent of pulse-labelling varied in parallel with the cycle in
      cumulative incorporation. Pulse-labelling was seen during the period of apparent
      arrest of cumulative incorporation. However, it was probably "masked" by the SD
      of assays of cumulative incorporation and represented a minor, but distinct,
      process of thymidine incorporation. The pattern of variation in extent of pulse
      labelling was qualitatively consistent under a wide variety of conditions.
      Control of this pattern appeared to be different from that of the circadian
      rhythm in cumulative thymidine incorporation.

PMID- 2231274
TI  - Propranolol blockade of short photoperiod-induced gonadal regression:
      modification by melatonin injections or implants.
AB  - Male Syrian hamsters were exposed to short photoperiods (10L:14D) for ten weeks
      and received daily ethanolic saline (1:10), propranolol (125 micrograms, sc) or
      melatonin (25 micrograms, sc) injections at 16:45. Some hamsters also received
      melatonin implants (1 mg in 24 mg beeswax, sc) every two weeks in addition to the
      above treatments. Testicular weights were determined at the beginning, every
      three weeks, and at the end of the experiment. Serum hormone levels, hypothalamic
      amine levels and cortical amine levels were also determined at the conclusion of
      the experiment. Propranolol prevented the decline in testes weight produced by
      short photoperiod (P less than 0.001 versus control). Propranolol was not able to
      prevent daily injections of melatonin from producing gonadal regression.
      Melatonin implants blocked testicular regression produced by both short
      photoperiod and melatonin injections. No differences in hypothalamic or cortical
      amine levels were observed between the treatment groups. These results add
      further support to the suggestion that propranolol is acting at the pineal gland
      preventing melatonin synthesis and not at a post-pineal central site which would
      affect melatonin binding and action.

PMID- 2231276
TI  - Familiarity and differences in self- and other-representations.
AB  - Two studies compared representations of the self and of other people, guided by
      the hypothesis that self-other differences derive from one's greater familiarity
      with oneself than with others. For the first study, participants wrote open-ended
      descriptions of themselves, a familiar person, and an unfamiliar person, which
      were analyzed for the amount and types of information they contained and for
      consistency in specific content across stimulus people and situations.
      Participants returned for a second study 1 week later and made timed judgments of
      information taken from their written protocols. The response latencies for these
      judgments were used to infer how information is organized in self- and other
      concepts. The results supported most of the predicted self-other differences, but
      almost all were matched by differences between familiar and unfamiliar others.
      Familiarity does provide a parsimonious explanation for many self-other
      differences.

PMID- 2231277
TI  - "Do I know you?" The role of significant others in general social perception.
AB  - This research used an idiographic method to examine the proposition that
      significant others are mentally represented as well-organized person categories
      that can influence social perception even more than representations of
      nonsignificant others, stereotypes, or traits. Together, Studies 1 and 2 showed
      that significant-other representations are richer, more distinctive, and more
      cognitively accessible than the other categories. Study 3 replicated the
      accessibility data and gauged inferential power by indirectly activating each
      category in a learning trial about a fictional person and then testing
      recognition memory. The results showed that participants made more category
      consistent false-positive errors about targets who activated significant others
      vs. any other category. This constitutes the first experimental demonstration of
      transference and has implications both for social categorization and for basic
      personality processes.

PMID- 2231278
TI  - Credit and blame among American and Japanese children: normative, cultural, and
      individual differences.
AB  - Japanese and American 5th graders (N = 593 children, 198 American and 395
      Japanese) assigned credit and blame to good and bad classroom deeds and
      performances. Theoretically, a morality of aspiration involves assigning more
      credit for a good deed than blame for a corresponding bad deed; a morality of
      duty involves assigning more blame than credit. In both countries academic
      achievement norms were most consistent with aspiration, moral norms were judged
      as duties, and procedural norms were intermediate. Japanese children's responses
      were more consistent with aspiration than those of Americans. Analyses also
      explored cultural versus individual differences in sanctioning. The conclusion
      addresses the relevance of the concept of aspiration to the study of achievement
      and other norms.

PMID- 2231279
TI  - Perceived social support, self-efficacy, and adjustment to abortion.
AB  - Prior to their having a 1st trimester abortion, women's perceptions of social
      support from their partner, family, and friends and self-efficacy for coping were
      assessed. Depression, mood, physical complaints, and anticipation of negative
      consequences were measured after the 30-min recovery period. As predicted,
      perceived social support enhanced adjustment indirectly through its effects on
      self-efficacy. Women who perceived high support from their family, friends, and
      partners had higher self-efficacy for coping. Higher self-efficacy, in turn,
      predicted better adjustment on the psychological measures but not on the physical
      complaint measure. No direct path between social support and adjustment was
      observed. In addition, women who told close others of their abortion but
      perceived them as less than completely supportive had poorer postabortion
      psychological adjustment than either women who did not tell or women who told and
      perceived complete support.

PMID- 2231280
TI  - Rational selective exploitation and distress: employee reactions to performance
      based and mobility-based reward allocations.
AB  - Prior research has demonstrated that allocators frequently distribute greater
      rewards to persons with high professional and geographic mobility than to persons
      with constrained mobility, especially among the very competent. This phenomenon
      has been termed rational selective exploitation. Do the recipients of such
      allocations actually experience this distribution rule as unjust and distressing,
      or is it a misnomer to refer to this phenomenon as exploitation? Two studies were
      conducted to explore this question. Study 1 was a laboratory experiment in which
      we manipulated relative performance level, relative mobility level, and
      allocation standard: performance based versus mobility based. Study 2 was a cross
      sectional survey of actual employees in which subjects reported the degree to
      which performance and mobility were the basis for pay decisions at their places
      of employment, as well as the degree to which they perceived each standard to be
      fair. Both studies demonstrated that people regard mobility-based allocations as
      less fair and more distressing than performance-based allocations. Furthermore,
      the degree of distress resulting from mobility-based allocations is greater among
      persons who are disadvantaged by that standard: among people with constrained
      mobility, especially those who perform at high levels. These findings provide
      good support for the assertion that so-called rational selective exploitation is
      indeed distressing to employees. Reactions to this form of distress are also
      explored, and the implications of these findings for the allocation process are
      discussed.

PMID- 2231281
TI  - Similarity of outcomes, interdependence, and conflict in dating relationships.
AB  - Dating couples (N = 59) participated in a longitudinal study of hypotheses
      derived from interdependence theory. Whether each partner's activity preferences
      and similarity of preferences, weighted by liking, would predict joint activity
      participation was examined. Preferences explained participation better than
      similarity, and own preferences predicted better than other's preferences. We
      hypothesized that conflict would increase with the strength of preferences but
      would decrease with similarity. The hypothesis concerning similarity was
      confirmed for some activities. Participation, similarity, and conflict explained
      relationship satisfaction and stability, but participation predicted better for
      men, whereas conflict and similarity predicted better for women. The findings
      support the theory but suggest that interdependence problems vary by activity
      type and gender. Three patterns are discussed: turn taking, unresolved
      competition, and cooperation.

PMID- 2231282
TI  - Effect of actor depression on observer attributions: existence and impact of
      negative attributions toward the depressed.
AB  - This experiment examined whether others explain the successes and failures of
      depressed versus nondepressed people differently and how these attributions are
      related to affective and behavioral reactions to a request for psychological
      help. Ss reported attributions about the success and failure experiences of
      hypothetical depressed and nondepressed people. Ss also responded to a
      hypothetical request for psychological help by indicating their attributions,
      affective reactions, willingness to help, and desire for future social contact.
      As hypothesized, Ss displayed more negative attributions toward depressed people.
      Replicating prior research, Ss responded to the depressive's request for help
      with mixed emotional and behavioral reactions. Path analyses revealed that
      attributions influenced affective reactions, which influenced willingness to
      help; but a more complex pattern emerged from the analysis of desire for future
      social contact. Results are discussed in terms of the interpersonal impact and
      possible causes of negative attributions about the experiences of depressed
      people.

PMID- 2231283
TI  - Coping as a personality process: a prospective study.
AB  - The study tested the proposition that coping is personality in action under
      stress. Using a stressful medical school entrance examination, the study examined
      (a) whether neuroticism emerged in coping patterns over time and (b) whether the
      influence of neuroticism on coping accounted for changes in anxiety and
      examination performance. Fifty premedical students reported their coping efforts
      at 35 days before, 10 days before, and 17 days after the examination. They
      provided daily reports of anxiety for 35 days surrounding the examination.
      Neuroticism influenced coping efforts and increases in daily anxiety under
      stress. Two types of coping, wishful thinking and self-blame, explained over half
      the relationship between neuroticism and increases in preexamination anxiety.
      Consistent with previous research, neither neuroticism nor specific coping
      efforts influenced examination performance.

PMID- 2231284
TI  - Self-esteem and clarity of the self-concept.
AB  - This article examines the association between evaluative and knowledge components
      of the self. Four studies tested the hypothesis that the self-concepts of low
      self-esteem (LSE) people are characterized by less clarity or certainty than
      those of high-self-esteem (HSE) people. LSE Ss exhibited less extremity and self
      reported confidence when rating themselves on bipolar trait adjectives (Study 1),
      less temporal stability in their trait ratings over a 2-month interval (Study 2),
      less congruence between their self-concepts and their subsequent perceptions of
      situation-specific behavior and memory for prior behavior (Study 3), and less
      internal consistency, lower self-rated confidence, and longer reaction times when
      making me/not me responses to pairs of opposite traits (Study 4). Alternative
      accounts of the results and the implications of self-concept clarity for
      understanding the pervasive impact of self-esteem on behavior are discussed.

PMID- 2231285
TI  - Intrinsic religiousness and religious coping as life stress moderators for
      Catholics versus Protestants.
AB  - Two prospective studies were conducted to test the stress-moderating effects of
      intrinsic religiousness and overall religious coping on the depression and trait
      anxiety of Catholic and Protestant college students. Both studies found a
      significant cross-sectional interaction between controllable life stress and
      religious coping in the prediction of Catholics' depression, with religious
      coping serving a protective function at a high level of controllable negative
      events. Both studies also found a significant prospective interaction between
      uncontrollable life stress and intrinsic religiousness in the prediction of
      Protestants' depression; the relationship between uncontrollable stress and
      depression was positive for low intrinsic Protestants, flat for medium intrinsic
      Protestants, but negative for high intrinsic Protestants. The findings are
      discussed in terms of their implications for the role of religion in life stress
      adjustment.

PMID- 2231286
TI  - Reasoning about the self and relationships in maturity: an integrative complexity
      analysis of individual differences.
AB  - This study examined age (35-55 versus 65-85), gender, and self-concept
      orientation differences in reasoning about the self, relationships, and morality,
      on the basis of the theorizing of Gilligan (1982). Participants were interviewed
      about general relationship issues, a specific relationship, and about the self.
      Reasoning was scored for integrative complexity (Suedfeld & Tetlock, 1977). Life
      experience measures and the standard Kohlberg justice reasoning index were
      obtained. Results showed gender differences in the connectedness of the self
      concept for middle-aged, but not older, adults. No age or gender differences in
      the complexity of relationship reasoning or in justice reasoning were found.
      Those with more connected self-concepts reasoned in more complex ways about
      relationships and about the self.

PMID- 2231288
TI  - Methodological issues in AIDS clinical trials. A symposium sponsored by the
      National Institute of Allergy and Infectious Diseases and Food and Drug
      Administration. Bethesda, Maryland, November 20-21, 1989. Proceedings.

PMID- 2231287
TI  - Appraised changeability of a stressor as a modifier of the relationship between
      coping and depression: a test of the hypothesis of fit.
AB  - The goodness of fit among the appraised changeability of a stressor, coping, and
      depression in people with psychiatric, physical health, work, and family problems
      was examined (N = 746). It was expected that problem-focused coping (as opposed
      to emotion-focused coping) would be used more and be more adaptive in situations
      appraised as changeable as compared with situations appraised as not changeable.
      Although few relationships existed between appraisal and coping, tests of fit
      between coping and depressed mood (maladaption) were much stronger. In people
      with nonpsychiatric conditions, problem-focused coping and depressed mood were
      negatively related when a stressor was appraised as changeable but were unrelated
      when a stressor was appraised as not changeable. Emotion-focused coping was
      positively related to depression when a stressor was appraised as changeable. No
      general relations were observed in the people with psychiatric conditions.

PMID- 2231289
TI  - The need for early randomization in the development of new drugs for AIDS.

PMID- 2231290
TI  - Methodological issues in AIDS clinical trials. Issues in the testing of drug
      combinations.

PMID- 2231291
TI  - Methodological issues in AIDS clinical trials. Application of the combination
      index method in the design of a clinical antiretroviral trial: ACTG 068.

PMID- 2231292
TI  - Methodological issues in AIDS clinical trials. Intent-to-treat analysis.

PMID- 2231293
TI  - Methodological issues in AIDS clinical trials. Data monitoring and sequential
      analysis--an academic perspective.

PMID- 2231294
TI  - Methodological issues in AIDS clinical trials. Analysis and interpretation of
      trial results. Discussion.

PMID- 2231295
TI  - Methodological issues in AIDS clinical trials. Discussion. Incorporation of trial
      results into clinical practice.

PMID- 2231296
TI  - Design considerations for AIDS trials.

PMID- 2231297
TI  - Methodological issues in AIDS clinical trials. Introduction.

PMID- 2231298
TI  - Implications of an alternative approach to dose-response trials.

PMID- 2231299
TI  - Methodological issues in AIDS clinical trials. Discussion. Design of clinical
      trials--approaches to clinical trials design.

PMID- 2231301
TI  - Rationale for variations in clinical trial design in different HIV disease
      stages.

PMID- 2231300
TI  - Methodological issues in AIDS clinical trials. Statutory and regulatory framework
      for drug approval.

PMID- 2231302
TI  - AIDS in intravenous drug users: issues related to enrollment in clinical trials.

PMID- 2231304
TI  - Practical issues and considerations in the design of clinical trials for HIV
      infected infants and children.

PMID- 2231303
TI  - Evaluation of the AIDS dementia complex in clinical trials.
AB  - The AIDS dementia complex (ADC) is one of the most common and important causes of
      morbidity associated with infection by human immunodeficiency virus type 1 (HIV
      1). The evaluation of ADC in clinical trials is significant not only because of
      the clinical impact of this syndrome, but also because of the value of measuring
      its cardinal features as an index of drug efficacy and because of its emerging
      role as a major clinical end point. The objectives of therapy include both
      prevention of ADC in the presymptomatic patient and alleviation of established
      disease. At present, the pathogenesis of ADC is incompletely understood in
      several critical aspects, particularly the processes underlying the clinical
      manifestations of central nervous system (CNS) HIV-1 infection and, further, how
      such processes are related to systemic disease. Consequently, it is not yet clear
      to what extent, or in which patients, it is necessary to achieve "therapeutic"
      drug levels within the CNS. Nevertheless, the assessment of ADC prevention and
      treatment relies principally on the complementary approach of neurological
      examination for diagnosis and neuropsychological testing for quantitative serial
      measurement of treatment effects. Additionally, surrogate markers in
      cerebrospinal fluid (CSF) may hold promise for objective, rapid assessment of
      treatment response and dose adjustment. Other measurements, including more
      routine CSF analysis, neuroimaging, and neurophysiological assessments, are used
      principally for differential diagnosis rather than for monitoring ADC status.
      Accumulating experience with available antiviral agents suggests that ADC can be
      effectively prevented and treated, at least for some period of time, and that
      assessment of this condition is indeed a valuable approach for measuring
      antiviral therapy.

PMID- 2231305
TI  - Methodological issues in AIDS clinical trials. Discussion. Design of clinical
      trials--end points.

PMID- 2231307
TI  - Methodological issues in AIDS clinical trials. Discussion. Design of clinical
      trials--active control (equivalence) trials.

PMID- 2231306
TI  - Evaluation of active control trials in AIDS.
AB  - In settings in which effective standard treatment exists, active control trials
      provide an ethically appealing approach to evaluating experimental therapies by
      allowing all patients to be randomized either to a promising new regimen or to
      the standard as it would be routinely delivered in clinical practice. This paper
      describes an appropriate statistical approach for analyzing the clinical efficacy
      of new treatments in such studies. Confidence intervals for the relative efficacy
      of the new treatment vis-a-vis standard therapy are used to provide information
      required to determine whether the experimental treatment has an improved
      therapeutic index. Desirable properties of this approach include the ability to
      implement standard group sequential guidelines for early trial termination, the
      ability to use valid surrogates for hard clinical outcomes, and the availability
      of straightforward formulas for sample size calculations.

PMID- 2231308
TI  - Effectiveness of multidrug therapies in tuberculosis.

PMID- 2231309
TI  - [Studies on anti-tumor activity of crude drugs. III. The effects of decreasing
      resistance of cancer cell in long-term in vitro screening test with aqueous
      extracts of some crude drugs].
AB  - When human cancer cell (JTC-26) was subjected to aqueous extracts of some crude
      drugs for a long time, its drug resistance against the cancer cell decreased.
      However, the cancer cell with decreased resistance recovered its proliferative
      power completely when cultured without the addition of the specimens. This
      revealed that the drug resistance-decreasing action or cytostatic action was
      entirely reversible. On the other hand, chemical anticancer agents increased
      cancer cell resistance, but the cancer cell did not recover itself and then
      perished when damage was given to it to a certain extent. Normal cell showed no
      decrease in resistance to the aqueous extracts.

PMID- 2231310
TI  - [The pharmacokinetics of pranoprofen in humans].
AB  - The pharmacokinetics of pranoprofen, 2-(5H-[1]benzopyrano[2,3-b]pyridin-7-yl)
      propionic acid (I) in humans were examined. 1-O-Acylglucuronide of I (II) and its
      isomer (III) were isolated from the human urine after oral administration of I.
      The stability of II was tested in order to establish the suitable conditions for
      the storage and handling of biological samples. Maximum stability of II was found
      at pH 3-4. Unchanged drugs, II and III were detected in the human plasma after
      oral administration of I. Plasma concentrations of these compounds reached the
      maximum at 1-2 h after the administration and thereafter decreased biphasically.
      From the urinary sample, 1-O-acylglucoside of I (IV) was detected in addition to
      unchanged drugs, II and III. Within 24 h after dosing, 1.3, 84.0, 7.0 and 0.6% of
      the dose were excreted as I, II, III and IV, respectively and the total urinary
      excretion amounted to 92.9% in term of unchanged drug.

PMID- 2231311
TI  - [Study of crystalline drugs by means of a polarizing microscope. XI. Analysis of
      the particle size distribution of a principle agent in a trituration of
      phenytoin].
AB  - By the immersion method with a polarizing microscope a principle agent phenytoin
      was identified from its 10 times trituration containing vehicles such as lactose
      and starch. A particle size distribution of phenytoin crystals in its trituration
      was determined by observing one of the habit parameters b from all the detectable
      particles of phenytoin under a microscope in a suspension of an immersion oil,
      nD: 1.555, in which phenytoin crystals having key refractive indexes, n1: 1.606,
      n2: 1.631, were clearly detectable from other vehicles. By the similarity of
      crystal habits in the same lot the particle size distribution of phenytoin
      crystals in its trituration was calculated from the values of observed parameter
      b and average values of habit coefficients, T(square root of ab/c): 2.004,
      L(b/a): 2.545, which were obtained from some previously identified phenytoin
      crystals.

PMID- 2231313
TI  - Analysis of T-2 toxin metabolites in tissues and excreta of rats.
AB  - In previous journal articles, we have demonstrated that microsomal
      carboxyesterase deacetylated specifically the C-4 acetyl residue of T-2 toxin and
      the resulting HT-2 toxin was an end product of the in vitro system. In an attempt
      to confirm this evidence in the in vivo system, we have analyzed the metabolism
      of T-2 toxin in rats. Male rats received orally 2-5 mg/kg of T-2 toxin, and the
      contents of T-2 toxin, HT-2 toxin, and neosolaniol in the liver, kidney, and
      serum were analyzed by using GLC method. The data revealed that HT-2 toxin was
      found in the liver shortly after the administration, and neither T-2 toxin nor
      neosolaniol was detected in the tissues. Blue spot test on TLC by using 4-(p
      nitrobenzyl)pyridine revealed the presence of HT-2 toxin and T-2 tetraol in the
      urine and HT-2 toxin in the feces.

PMID- 2231312
TI  - Primary liver cancer and aflatoxin intake in Transkei.
AB  - Transkei has an intermediate primary liver cancer (PLC) rate that is unusually
      high for a corn-based subsistence economy. The situation is complicated by a very
      high esophageal carcinoma incidence rate and known exposure to hepatocarcinogenic
      N-nitrosamines. A total of 623 cooked food samples were collected from two
      northeastern and two southern districts over two seasons, in a single-sample grid
      pattern, for aflatoxin analysis. Aflatoxin B1 was quantitated in 26% of all
      samples during 1976, resulting in a mean contamination rate of 0.65 microgram/kg
      wet food. Mean contamination during 1977 was 0.66 microgram/kg, and 24% of
      samples were positive. Thus for both years a mean aflatoxin B1 intake of 16.5
      ng/kg body weight per day was calculated. When the data were plotted on our
      published PLC incidence-aflatoxin intake graph constructed with standardized data
      from four countries, Transkei was well within the 95% confidence limits.
      Individual district comparisons are handicapped by as yet inadequate PLC
      incidence data, but rank order correlations (rs) between aflatoxin intakes and
      the PLC incidence in goldminers originating from the study districts were
      significant (P less than .05). Corn was the basis of 95% of the meals and was
      also the main source of contamination. Six of 23 samples of home-brewed corn beer
      were positive for aflatoxin, resulting in an overall contamination of 0.69
      microgram/L.

PMID- 2231314
TI  - Antimicrobial action of roquefortine.
AB  - Roquefortine, a secondary metabolite of Penicillium roqueforti, was investigated
      with regard to its effect on microorganisms. The growth of gram-positive bacteria
      was inhibited by roquefortine, whereas gram-negative bacteria were not influenced
      at all. The minimal inhibitory concentrations for gram-positive organisms were
      about 80 micrograms/mL cells on the average. The sensitive bacterium
      Corynebacterium flaccumfaciens was chosen for characterizing the antimicrobial
      action of the mycotoxin. Addition of low roquefortine concentrations at the
      beginning of bacterial growth resulted in prolongation of both the lag and
      logarithmic phases. High toxin concentrations (100 micrograms/mL cells) added to
      growing cells caused prolongation of logarithmic growth and decreased maximum
      cell density. This effect could be abolished when the cells, inhibited during the
      logarithmic growth, were centrifuged, washed, and transferred into fresh nutrient
      medium. In that case a second prolonged lag phase occurred, but the following
      logarithmic growth was comparable to normal cell growth. These results indicate
      that the antimicrobial effect of roquefortine is bacteriostatic but not
      bactericide. The growth inhibition might be a consequence of a roquefortine
      influence on bacterial respiration. The uptake of oxygen was reduced to 50% at a
      toxin concentration of 100 micrograms/mL cells.

PMID- 2231315
TI  - The mode of action of ochratoxin A in acute enteritis in rats.
AB  - The mode of action of ochratoxin A(OCT A) was studied in male Wistar rats in
      connection with the development of acute enteritis. Acute enteritis in the
      duodenum and jejunum identical with that induced by oral administration was also
      induced by parenteral application at the dose level of 15 mg/kg OCT A and was
      completely inhibited by ligation of the choledochus. Direct application of OCT A
      into the jejunal blind sac lumen constructed by two ligations induced severe
      inflammation in situ and also revealed remote action to the duodenum and jejunum
      where separated from the blind sac by ligation. This remote action was inhibited
      by ligation of the choledochus. These results clearly demonstrated the
      enterohepatic circulation of OCT A. The ileal injection also revealed remote
      action of OCT A, although no pathologic change was caused in the ileal mucosa.
      The results obtained suggest that the enteritis may be induced by direct exposure
      of OCT A to the intestinal mucosa without metabolic activation, although certain
      participation of ochratoxin alpha to accelerate the inflammation was suspected.

PMID- 2231316
TI  - Transplacental transfer of T2-toxin: pathological effect.
AB  - Radioactivity was recovered in fetuses of pregnant rats following administration
      of radioactive T2-toxin. The transplacental effects of T2-toxin were studied by
      ip administration or oral feeding of pregnant rats at doses equivalent to natural
      contaminations and compatible with the maintenance of pregnancy. Body weights of
      the newborn rats from treated females were similar to the body weights of the
      control animals but their thymuses were atrophic. This atrophy was reversible in
      one week. Since the measurement of antibody production for fetuses and newborns
      is not feasible, the lymphoblastic response to mitogen of the splenic and thymic
      cells of baby rats from treated and control females was tested. At 4 and 6 days
      after birth, a good response to PHA for the thymic cells of the mother treated
      young rats was observed. Histological examination of the thymus showed that one
      day after birth the cortex was atrophic while the medulla was proliferative; on
      day six the situation was reversed. For the spleen, both B and T cells were
      impaired and their responsiveness to PHA and LPS decreased. On days 1 and 6, the
      periarteriolar sheats, as well as the follicles, appeared atrophic. These results
      show that T2-toxin easily passes the placental barrier and that T2-toxin
      injection or feedings at levels (2 ppm) similar to those in naturally
      contaminated foods, produced an impairment of the immune system of the newborn.

PMID- 2231317
TI  - Synergistic effects of T-2 toxin and a low protein diet on erythropoiesis in
      mice.
AB  - Young male Swiss mice fed on a semipurified diet containing 8% protein and 10 ppm
      of T-2 toxin developed erythroid hypoplasia within 2 weeks. Red blood cell counts
      declined to 36% of control values by 6 weeks but had risen to 45% of control
      values by 8 weeks. Between 4 and 8 weeks, erythropoietic tissues regenerated and
      reticulocyte counts became greatly elevated. The toxin-free semipurified diet was
      adequate for normal growth and did not cause anemia in control mice fed either ad
      lib, or at a restricted rate. Anemia did not occur in mice fed the 10-ppm level
      to T-2 toxin in either a semipurified diet containing 16% protein, or in a
      balanced natural-ingredient mouse diet. These observations demonstrated that the
      inhibitory effect of T-2 toxin in erythropoiesis in mice was transient, and
      depended on the nutritional composition of the diet.

PMID- 2231318
TI  - Contribution of pharmacokinetic computerized simulations in toxicological
      approach of ochratoxin A.
AB  - An open two-compartment model described the fate of ochratoxin A in the rat.
      Curves of toxin quantities contained in the two compartments and predicted plasma
      concentrations following 1-, 2-, or 3-daily administrations were simulated by use
      of mathematical expressions programmed for a digital computer. These studies
      clearly showed residues of ochratoxin A in deep compartment tissues such as
      muscle, fat, and skin. The pharmacokinetic profiles of ochratoxin A in pigs and
      broilers were also investigated and discussed.

PMID- 2231319
TI  - Tissue deposition and passage into eggs of ochratoxin A in Japanese quail.
AB  - Laying Japanese quail (Coturnix coturnix japonica) were given single oral doses
      of 0, 1, 5, and 20 mg of ochratoxin A (OA) per kg of the body weight. After 6,
      12, and 24 hours and 2, 3, 4, 5, 6, and 7 days an appropriate number of birds was
      sacrificed and OA in blood, muscles, liver, kidney, abdominal yolks, and
      collected eggs was measured. The highest concentration of OA was found in kidneys
      and the lowest in muscles. Four days following the application, OA could still be
      detected in kidney, liver, muscles, yolk, and eggs, although even after six days
      traces of OA were found in the muscles of birds given 20 mg/kg.

PMID- 2231320
TI  - Hydralazine dose-response curve analysis.
AB  - A multicenter, parallel, double-blind, 181-patient study compared the safety and
      antihypertensive efficacy of immediate-release (IR) and extended-release (ER)
      hydralazine. After 2 to 4 weeks on diuretic, patients were maintained on diuretic
      and randomized to a hydralazine treatment regimen: IR thrice daily, ER twice
      daily, or ER once daily. Daily doses of hydralazine were 75, 150, or 300 mg.
      Although designed as a titration study, important dose-response data were
      available for analysis with nonlinear mixed effect modeling (NONMEM). Sitting
      diastolic blood pressure (BP) was selected as the response variable. Several
      factors were tested for importance, including body weight, time (week) effects,
      concomitant beta-blocker (BB) therapy, acetylator class, and treatment regimen.
      All factors were important (p less than 0.05) except treatment regimen (p greater
      than 0.30). The maximum antihypertensive response (Emax) to hydralazine was 9.4
      mm Hg. The daily dose that elicited 50% of the maximum response (D50) was 0.87
      mg/kg for slow acetylators and 1.68 mg/kg for fast acetylators. BP fell 0.52 mm
      Hg per week independent of other effects, and concomitant BB therapy induced a
      drop of 6.6 mm Hg in addition to hydralazine, diuretic and week effects. NONMEM's
      use assisted in evaluations and provided information not obtainable through
      traditional means.

PMID- 2231321
TI  - Comparison of methods to calculate cyclosporine A bioavailability from
      consecutive oral and intravenous doses.
AB  - The pharmacokinetics of cyclosporine A (CyA) was studied in 21 uremic patients.
      The plasma concentrations after an oral dose and a subsequent short-term infusion
      were analyzed simultaneously by nonlinear regression. Bi- and triexponential
      disposition models with either zero- or first-order absorption were fitted to the
      data. A triexponential disposition model with zero-order absorption was generally
      found to best describe the concentration-time profile. The bioavailability and
      clearance were estimated to be 0.24 +/- 0.10 and 21 +/- 8 L/hr, respectively.
      These values differed only marginally from those predicted by the other models.
      Similar bioavailability estimates were also obtained from a three-compartment
      model where elimination was assumed saturable, from a deconvolution procedure,
      and from analyses based on blood concentrations. Markedly higher
      bioavailabilities (0.34 +/- 0.13) were obtained when a model-independent AUC
      correction procedure, commonly used to calculate CyA bioavailability, was used.
      The difference could not be explained by poor description of data in the model
      dependent analyses, but rather by overestimation in the model-independent
      analyses mainly due to errors in the extrapolations used. Thus, by the
      simultaneous fitting procedure, which is a new approach for estimating CyA
      bioavailability, drawbacks of the AUC correction procedure could be avoided.
      Further, future studies of CyA bioavailability could be designed with a markedly
      shorter and more convenient length of time if analyzed by the proposed method.

PMID- 2231323
TI  - Relationship between train-of-four ratio and first-twitch depression during
      neuromuscular blockade: a pharmacokinetic/dynamic explanation.
AB  - Fade, as measured by train-of-four, lags behind twitch depression during the
      initial phase of nondepolarizing neuromuscular blockade, i.e., the ratio of the
      fourth to first twitch height in a train (T4/T1) is greater at the onset of the
      block than during spontaneous recovery for the same level of first twitch
      depression. We believe that these data can be explained by picturing the muscle
      as having localized regions that respond much more slowly than the rest, leading
      to a delay in drug effect in that area, especially when the drug concentration
      rises rapidly as during bolus administration. This was modeled by computer as a
      muscle of 15 compartments distributed in a log-normal fashion according to
      equilibration rate. Experimental data consisting of the time course of first
      twitch and train-of-four ratio were fitted by nonlinear regression to the model.
      A good fit was obtained with a median equilibration time t1/2 of 3.3 min and a
      standard deviation of 2.1. The difference between train-of-four during onset and
      regression of block at the same level of first twitch depression was reproduced.

PMID- 2231322
TI  - Kinetic analysis of the dose-dependent hepatic handling of 1-anilino-8
      naphthalene sulfonate in rats.
AB  - The dose dependency in the hepatic transport of an anionic fluorescent dye, 1
      anilino-8-naphthalene sulfonate (ANS), was investigated by measuring the plasma
      disappearance and biliary excretion in rats. Bulk of the administered ANS
      distributed into the liver at 10 min after iv bolus injection. The plasma
      disappearance curves of ANS were then kinetically analyzed based on a two
      compartment model, in which the ligand is eliminated only from the peripheral
      compartment (liver compartment). The total body clearance (CLtot) decreased with
      increasing dose of ANS. That is, the values of CLtot were 4.06 and 1.98
      ml/min/per kg at the doses of 3 and 100 mumol/kg, respectively. The clearances of
      the uptake and sequestration processes (CLup and CLseq, respectively) for a total
      ligand were constant irrespective of dose, while the efflux clearance (CLeff) for
      a total ligand was increased by twofold with increasing dose. A mechanism for the
      increase in the CLeff value might be explained by a saturation of the ANS binding
      to the intracellular proteins. The hepatocellular distribution and the binding of
      ANS to cytosolic proteins were then determined. ANS mainly distributed to the
      cytosol fraction, and the unbound fraction in the cytosol increased from
      approximately 0.04 to 0.09 when the cytosolic concentrations of ANS increased
      from 40 to 900 microM, respectively. In spite of such increase in the unbound
      fraction in the cytosol, the CLseq values remained unchanged with increasing
      dose, suggesting that the saturation of sequestration clearance for unbound ANS
      might occur. Furthermore, the plasma disappearance curves of ANS at various doses
      were simultaneously analyzed based on three nonlinear kinetic models: Model I is
      a model incorporating both saturable intracellular binding and saturable
      sequestration; Model II is a model incorporating only saturable intracellular
      binding; Model III is the model incorporating only saturable sequestration.
      Goodness-of-fit evaluated by AIC value was best for Model I. Taken together, the
      nonlinearity in the plasma clearance of ANS was confirmed to be attributed to
      saturation of both its binding to cytosolic proteins and sequestration process.

PMID- 2231324
TI  - Experimental design and efficient parameter estimation in population
      pharmacokinetics.
AB  - A computer simulation technique used to evaluate the influence of several aspects
      of sampling designs on the efficiency of population pharmacokinetic parameter
      estimation is described. Although the simulations are restricted to the one
      compartment one-exponential model, they provide the basis for a discussion of the
      structural aspects involved in designing a population study. These aspects
      include number of subjects required, number of samples per subject, and timing of
      these samples. Parameter estimates obtained from different sampling schedules
      based on two- and three-point designs are evaluated in terms of accuracy and
      precision. These simulated data sets include noise terms for both inter- and
      intraindividual variability. The results show that the population fixed-effect
      parameters (mean clearance and mean volume of distribution) for this simple
      pharmacokinetic model are efficiently estimated for most of the sampling
      schedules when two or three points are used, but the random-effect parameters
      (describing inter- and intraindividual variability) are inaccurate and imprecise
      for most of the sampling schedules when only two points are used. This drawback
      was remedied by increasing the number of data points per individual to three.

PMID- 2231325
TI  - Estimation and inference in pharmacokinetic models: the effectiveness of model
      reformulation and resampling methods for functions of parameters.
AB  - It is well known that high parameter estimate correlations and asymptotic
      variance estimates can cause estimation and inference problems in the analysis of
      pharmacokinetic models. In this paper we show that analysis of three important
      functions of pharmacokinetic parameters, the half-life, mean residence time, and
      the area under the curve, can sometimes be greatly improved by reformulating the
      model to address collinearity and by using the bootstrap to form confidence
      intervals. The resultant estimators can be more accurate than the original ones,
      and resultant confidence intervals can be narrower. Of the three measures, the
      half-life estimator is much better behaved than the estimators of mean residence
      time and area under the curve under collinearity, suggesting that it (or measures
      like it) should be used more often.

PMID- 2231326
TI  - Formulation parameters affecting the preparation and properties of
      microencapsulated ion-exchange resins containing theophylline.
AB  - A method of microencapsulating theophylline ion-exchange resins with
      ethylcellulose was developed to produce smooth and uniform coats which were
      predominantly mononucleated. This was achieved by controlling the amount of
      ethylcellulose and the particle size, and through the use of a protective
      colloid, polyisobutylene. The rate of release of theophylline was influenced by
      the ion-exchange resin crosslinking, the amount of ethylcellulose, and the
      smoothness of the coat. Mesh size and polyisobutylene did not appear to affect
      the rate in a regular manner. It was found that the release rate from coated
      resins with low crosslinking followed a logarithmic plot, indicating membrane
      controlled release, whereas coated resins with high crosslinking fitted a t1/2
      plot, suggesting particle diffusion control.

PMID- 2231327
TI  - Preparation and evaluation of sterically stabilized liposomes: colloidal
      stability, serum stability, macrophage uptake, and toxicity.
AB  - Sterically stabilized liposomes were produced by incorporating a nonionic
      surfactant, polysorbate 80 (Tween 80), into the lipid bilayer. The sterically
      stabilized liposomes exhibited a superior entrapment stability compared with
      surfactant-free liposomes (i.e., liposomes prepared with lipids and cholesterol).
      The sterically stabilized liposomes were stable at high calcium ion
      concentrations, and liposome-entrapped carboxyfluorescein was retained within the
      stabilized liposomes in the presence of serum for at least 5 h. The macrophage
      uptake of the sterically stabilized liposomes was comparable to that of liposomes
      containing lipids and cholesterol. The sterically stabilized liposomes were non
      toxic, in concentrations up to 3.0 mM, to macrophages. These results indicate
      that polysorbate 80 can be used to produce stable liposomes without changing the
      unique macrophage distribution of this drug delivery system.

PMID- 2231328
TI  - Tumor cell growth inhibition by liposome-encapsulated aromatic polyamidines.
AB  - Apart from its antiproteinase activity, the aromatic polyamidine TAPP-Br [the
      bromo derivative of 1,3-di-(p-amidinophenoxy)-2,2-bis-(p
      amidinophenoxymethyl)propane (TAPP-H)] is able to inhibit the in vitro growth of
      a variety of tumor cell lines, including human melanoma, and breast and kidney
      carcinoma. We have now shown that TAPP-Br can efficiently be encapsulated into
      egg phosphatidylcholine vesicles. When incorporated into these liposomes, the
      inhibitory effect of TAPP-Br is significantly enhanced compared with that of the
      free drug. Based on these promising results, a proposal is made for the delivery
      of this antiproliferative agent to tumor cells by using liposomes as the vehicle.

PMID- 2231329
TI  - Isobolographic assessment of the convulsant interaction between theophylline and
      caffeine or pentylenetetrazol in rats.
AB  - To characterize the convulsant interaction between theophylline and caffeine,
      male Sprague-Dawley rats received an iv infusion of one of seven different
      combinations of these drugs and of each drug individually until the onset of
      maximal seizures (which occurred within 30 to 40 min after the start of the
      infusion). The total infused doses of the two drugs and their respective
      concentrations in the serum, brain, and cerebrospinal fluid (CSF) were used for
      isobolographic analysis. The results are consistent with classical dose- and
      concentration-addition and do not suggest either antagonism or synergism. The
      potency ratio based on the doses or serum concentrations was appreciably
      different from that based on brain or CSF concentrations. The brain:serum and
      CSF:serum concentration ratios of caffeine were appreciably higher than those of
      theophylline. Similar experiments were performed with seven combinations of
      theophylline and pentylenetetrazol (PTZ) and with each of these drugs
      individually. This second set of experiments also yielded essentially linear
      isobolographs indicative of dose- and concentration-addition. The potency ratio
      based on CSF concentrations was appreciably different from ratio values based on
      doses, and from those based on brain or serum concentrations. These results
      illustrate a useful strategy for the characterization of pharmacodynamic drug
      interactions and highlight the importance of the choice of sampling site for
      determinations of the potency of drug.

PMID- 2231330
TI  - Effects of epinephrine pretreatment and solution pH on ocular and systemic
      absorption of ocularly applied timolol in rabbits.
AB  - The ratio between ocular and systemic drug concentrations describes the relative
      safety of ophthalmic dosage forms of the same drug in terms of its systemic side
      effects. In this study, we evaluated the effects of epinephrine pretreatment and
      solution pH on the aqueous humor:plasma and iris-ciliary body:plasma ratios of
      peak timolol concentrations after ocular application of timolol. Timolol eyedrops
      (5 mg/mL, 25 microL) were applied ocularly in pigmented rabbits. Raising pH of
      the eyedrops from 6.2 to 7.5 did not affect the ratio between ocular and systemic
      peak drug concentrations, since both ocular and systemic concentrations of
      timolol were increased. Administration of epinephrine (20 mg/mL, 50 microL) 5 min
      prior to timolol eyedrop administration reduced the peak timolol concentrations
      in plasma 65-80%. Epinephrine did not affect the ocular concentrations of
      timolol. The decreased peak concentrations in plasma were due to the conjunctival
      and nasal vasoconstricting effects of epinephrine and to the subsequent slower
      absorption of timolol. Our study demonstrates that compared with currently
      available eyedrops (pH 6.9), the ocular:systemic concentration ratio of
      ophthalmic timolol can be improved four- to sixfold in rabbits by combining
      epinephrine-induced conjunctival and nasal vasoconstriction and improved ocular
      absorption from pH 7.5 eyedrops.

PMID- 2231331
TI  - Moment analysis of drug disposition in kidney. II: Urine pH-dependent tubular
      secretion of tetraethylammonium in the isolated perfused rat kidney.
AB  - Effects of urine pH on the renal tubular secretion of an organic cation
      (tetraethylammonium, TEA) and an organic anion (p-aminohippurate, PAH) were
      investigated using the isolated erythrocyte-perfused rat kidney. The method was
      based on a multiple indicator dilution experiment and noncompartmental moment
      analysis. Treatment with sodium bicarbonate and sodium dihydrogen phosphate
      increased and decreased urine pH, respectively, but affected neither the
      condition of the perfused kidney nor the renal handling of albumin and inulin. In
      TEA studies, the increase of urine pH prolonged the mean residence time in renal
      epithelial cells (T cell) and reduced the apparent secretion intrinsic clearance,
      but did not influence the volume of distribution in the kidney (Vd drug). The
      decrease of urine pH did not affect these kinetic parameters. By contrast, PAH
      secretion was constant against the change of urine pH. Since any change in the
      basolateral membrane transport is reflected in Vd drug, the net transport from
      blood to cells can be regarded as similar under these treatments. On the other
      hand, the prolonged T cell of TEA with the increased urine pH suggested a slow
      transport from cells to lumen across the brush-border membranes. The present
      results coincide with the hypothetical mechanism that organic cations are
      secreted via an active transport system, coupled to the countertransport of H+
      into cells. In conclusion, the present method is useful to separately evaluate
      the transmembrane transport across both sides of the renal epithelial cells in a
      morphologically intact kidney.

PMID- 2231332
TI  - Mechanism of nasal absorption of drugs. III: Nasal absorption of leucine
      enkephalin.
AB  - The nasal absorption of a model peptide, leucine enkephalin (LE), was studied in
      rats using an in situ technique in which 4 mL of perfusion solution was
      circulated. Leucine enkephalin (LE) was found to undergo hydrolysis to its major
      metabolite des-tyrosine leucine enkephalin (DTLE). The addition of 1% sodium
      glycocholate (SGC) to the perfusion solution resulted in an increase in the
      overall rate of disappearance of LE and a decrease in the rate of formation of
      DTLE. When LE was added to nasal washings (i.e., Ringer's buffer that was
      precirculated through the nasal cavity to extract enzymes), LE was found to form
      DTLE. When SGC or puromycin was added to the nasal washings prior to the addition
      of LE, the rate of conversion of LE to DTLE was significantly reduced, suggesting
      that these two agents can inhibit peptidase enzyme activity in the nasal cavity.
      Since the volume of the solution has been shown to influence the kinetics of
      absorption of drugs administered nasally, a new experimental technique, the in
      vivo-in situ technique, which utilizes small volumes of solution and simulates
      realistic use of nose drops, was employed to further examine the mechanism of
      absorption and hydrolysis of LE in rats. Leucine enkephalin (LE) dissolved in 100
      microL of Ringer's buffer was placed in the isolated nasal cavities of rats. The
      disappearance of LE and the appearance of DTLE were followed by rinsing the nasal
      cavity with fresh buffer. Disappearance of LE was always accompanied by
      appearance of DTLE, and the fraction of LE converted to DTLE decreased as the
      concentration of LE increased, suggesting a saturable enzymatic process.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2231333
TI  - Hydrolysis and acyl migration of a catechol monoester of L-dopa: L-3-(3-hydroxy-4
      pivaloyloxyphenyl)alanine.
AB  - Hydrolysis and acyl migration studies on L-3-(3-hydroxy-4
      pivaloyloxyphenyl)alanine (1, NB-355), which produced long-lasting plasma L-dopa
      levels after oral dosing, have been conducted. Compound 1 exists as pure 4-O
      pivaloyl-L-dopa in the solid state, but it converts rapidly to a mixture of the 3
      and 4-O-isomers in solution. The rate of acyl migration increased with increases
      in pH and temperature, and the content of the 4-O-isomer in the equilibrium state
      was 53-59%. The hydrolysis rate of 1 to L-dopa (6) also increased with increases
      in pH and temperature, and accelerated steeply at neutral and alkaline pH. The
      rapid hydrolysis at neutral pH was not observed with O-pivaloyl-L-tyrosine (3),
      di-O-pivaloyl-L-dopa (4), or L-dopa methyl ester (5). Because of this chemical
      lability, 1 was hydrolyzed in rat plasma far faster than the other tested
      catechol esters. However, in rat intestinal homogenate at pH 6.0, 1 was
      hydrolyzed at the slowest rate among the tested esters, predominantly by a
      diisofluorophosphate (DFP)-sensitive esterase. Thus, 1 showed a unique in vitro
      profile on hydrolysis and acyl migration due to the existence of a neighboring
      hydroxyl group. The stability of 1 in the intestine might be essential for the
      long-lasting plasma L-dopa profile after oral dosing of 1.

PMID- 2231334
TI  - A study of the electrokinetic and stability properties of nitrofurantoin
      suspensions. II: Flocculation and redispersion properties as compared with
      theoretical interaction energy curves.
AB  - The stability and redispersion properties of nitrofurantoin dispersions are
      experimentally studied using simple but reproducible techniques. Solutions of
      different electrolyte concentrations and pH values are employed as dispersing
      media. The pH appears to be a determinant factor in the properties studied. Thus,
      with all the electrolytes considered (NaCl, CaCl2, and AlCl3, almost optimum
      redispersion was achieved when the pH was maintained close to neutrality.
      However, the important effect of AlCl3 as compared with the other electrolytes is
      also clearly demonstrated. Especially interesting are the results obtained when
      0.1% Carbopol is added to the suspensions. The important effect of this polymer
      on the surface charge of nitrofurantoin, mainly at pH 7, manifests in excellent
      redispersion of the suspensions with either of the electrolytes employed. Using
      simple expressions that approximate the equations proposed in the DLVO theory of
      interaction between colloidal particles, the variation of the total interaction
      energy between nitrofurantoin particles is calculated as a function of
      interparticle distance. The results are compared with the experimental
      determinations of the sedimentation and redispersion properties of
      nitrofurantoin. Although some discrepancies between theory and experiments are
      found, the results indicate a reasonable agreement between the general features
      of both.

PMID- 2231335
TI  - Anticonvulsant properties of 3-oxo- and 3-imino-4-substituted 1,2,5
      thiadiazolidine 1,1-dioxides.
AB  - Selectively substituted 3-oxo-4-substituted 1,2,5-thiadiazolidine 1,1-dioxides
      (2, four examples), and 3-imino-4-substituted 1,2,5-thiadiazolidine 1,1-dioxides
      (3, eight examples) have been evaluated in the maximal electroshock seizure
      (MES), subcutaneous pentylenetetrazole seizure threshold (scMet), and rotorod
      (Tox) tests. These compounds can be considered as sulfonyl analogues of
      hydantoins (1). In those cases where comparison between 1 and 2 (or 1 and 3) was
      possible, replacement of the central carbonyl group in 1 by a sulfonyl moiety led
      to a significant reduction or abolition of the anticonvulsant activity.

PMID- 2231336
TI  - Structure-pharmacokinetic relationships in a series of short fatty acid amides
      that possess anticonvulsant activity.
AB  - Valpromide (VPD) and valnoctamide (VCD) are two isomers which are aliphatic
      amides derived from short fatty acids that possess anticonvulsant activity. Our
      previous studies with VPD, VCD, and other related compounds showed that the
      biotransformation of these amides to their respective homologous acids is the key
      issue in their possessing pharmacological activity. In this study, we explored
      the structure--pharmacokinetic relationships of the following five isomers or
      analogues of VPD: diisproprylacetamide (DID), diallylacetamide (DAD), octanamide
      (OAD), ethylisobutylacetamide (EID), and dimethylbutylacetamide (DBD). In
      addition, the anticonvulsant activity of these compounds was evaluated and
      compared with that of VPD and VCD. No plasma levels of OAD could be detected
      after its iv administration. Octanamide (OAD) was very rapidly metabolized to its
      homologous acid, octanoic acid (OAA). Octanamide (OAD) was different from the
      other four amides investigated, having a high clearance (due to metabolic
      processes in the blood) and possessing the least anticonvulsant activity. All of
      the other amides were stable in blood and showed similar pharmacokinetic
      parameters. Unlike the other amides, DID and VCD did not metabolize to their
      respective homologous acids due to the fact that they had a substituted beta
      position in their aliphatic side chain. Our study showed that, despite
      similarities in the chemical structures of the amides investigated, significant
      differences were observed in their pharmacokinetics and in the fraction of the
      amide (fm) biotransformed to its homologous acid. These differences in fm values
      may, therefore, account for the observed differences in the respective
      pharmacological activities, in general, and in the extent of the anticonvulsant
      activity, in particular, of the amides.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231337
TI  - Computer automated structure evaluation of antifungal 1-vinylimidazoles, 1,2
      disubstituted propenones, and azolylpropanolones.
AB  - The Computer Automated Structure Evaluation (CASE) program has been applied to a
      series of 1-vinylimidazoles, 1,2-disubstituted propenones, and azolylpropanolones
      exhibiting in vitro antifungal properties. Relevant molecular fragments were
      obtained for activity against the fungal strains Candida albicans, Aspergillus
      fumigatus, and Trichophyton asteroides. Fragments were utilized as descriptors to
      derive quantitative structure-activity relationships (QSAR) within each
      respective biological endpoint. A high degree of correlation was observed between
      fragments derived from C. albicans and A. fumigatus. The relevant activating and
      inactivating fragments from each of the respective biological endpoints analyzed
      are discussed.

PMID- 2231338
TI  - Stability and kinetics of degradation of imipenem in aqueous solution.
AB  - In weakly acidic solution, the broad-spectrum antibiotic imipenem undergoes
      complex oligomerization initiated by intermolecular carboxyl group attack on the
      beta-lactam group. In weakly alkaline solution, intermolecular reaction between
      the beta-lactam and formimidoyl groups occurs instead. Both beta-lactam and
      formimidoyl groups also hydrolyze at pH-dependent rates. Complex decomposition
      schemes were determined in kinetic studies at pH 4.0 and 9.0-9.5 using HPLC and
      mathematical models. The rates of the several initial reactions, calculated as
      functions of pH and imipenem concentration by fitting the models to kinetic data,
      fully account for imipenem decomposition rates throughout the neutral pH range.

PMID- 2231339
TI  - Radioimmunoassay of a new angiotensin-converting enzyme inhibitor (perindopril)
      in human plasma and urine: advantages of coupling anion-exchange column
      chromatography with radioimmunoassay.
AB  - Perindopril (P) is a prodrug whose active metabolite perindoprilat (PT) is an
      antihypertensive agent which acts by inhibition of angiotensin-converting enzyme
      (ACE). Anti-PT antiserum was produced in a rabbit immunized against PT that was
      covalently linked to bovine serum albumin. The radioligand is an iodinated (125I)
      derivative of PT-glycyltyrosinamide. Both the drug (PT) and the prodrug (P) are
      assayed in the same sample; PT is assayed as is and P is assayed after
      quantitative alkaline hydrolysis into PT. Certain data obtained from such assays
      suggest the occurrence in plasma and urine of a third immunoreactive component. A
      chromatographic fractionation of samples allowed us to isolate a new
      immunoreactive metabolite which was further identified as a glucuronide of PT (PT
      G). Therefore, the whole assay was carried out as follows: biological samples
      were fractionated by stepwise chromatography on a anion-exchange resin (the first
      fraction contained P, the second contained PT, and the third contained PT-G); and
      RIA was performed on fractions 2 and 3 as is, and on fraction 1 after alkaline
      hydrolysis. Performances and assessments of this method are presented together
      with an example of a pharmacokinetic profile.

PMID- 2231340
TI  - Determination of norethindrone stability on red delicious apples.
AB  - A stability-indicating assay procedure for the determination of norethindrone on
      the surface of Red Delicious apple slices was developed. The apple slice is
      homogenized in pH 10 borate buffer solution and norethindrone is then partitioned
      into chloroform using a diffusion chamber that has a membrane that is permeable
      to hydrophobic compounds separating the buffer and chloroform. An aliquot of the
      chloroform extract is then evaporated to dryness and reconstituted in
      tetrahydrofuran. The reconstituted sample is then chromatographed on a C18
      reversed-phase column using a mobile phase consisting of
      water:tetrahydrofuran:methanol (63:26:11, v/v/v). Detection is in the UV range at
      254 nm. The chromatographic system is specific for norethindrone in the presence
      of its autoxidation products. Stability data indicate that norethindrone is
      stable for up to 6 h on the surface of Red Delicious apples.

PMID- 2231341
TI  - Synthesis and antitumor activities of platinum complexes of unsymmetrical
      alicyclic diamines as carrier ligands.
AB  - The synthesis and biological activities of the platinum complexes of 2
      aminomethylaziridine, 2-aminomethylazetidine, 2-aminomethylpyrrolidine, 2
      aminomethylpiperidine as carrier ligands are described. The platinum complexes of
      2-aminomethylazetidine and 2-aminomethylpyrrolidine are significantly effective
      against murine tumors. In particular, 2-aminomethylazetidine (1,1
      cyclobutanedicarboxylato)platinum II (13) and 2-aminomethylpyrrolidine(1,1
      cyclobutanedicarboxylato)platin um II (16) exhibited potent antitumor activity
      and were soluble in water, and their antitumor activities against Colon 26
      carcinoma (sc-ip system) were superior to CBDCA and comparable to CDDP.

PMID- 2231343
TI  - Aging integumentary system. Podiatric review.
AB  - The authors present a concise review of age-related changes that occur in the
      skin and its derivatives, as they pertain to the podiatric practitioner. A brief
      discussion of wound healing and several common skin disorders that affect the
      elderly is also included.

PMID- 2231342
TI  - Isoxazoles. VI: Aspects of the chemical stability of a new naphthoquinone-amine
      in acidic aqueous solution.
AB  - Some aspects of the chemical degradation of N-(3,4-dimethyl-5-isoxazolyl)-4-amino
      1,2-naphthoquinone were investigated as a function of pH and temperature. In acid
      and neutral pH, four main degradation products were identified: 2-hydroxy-1,4
      naphthoquinone, 2-butanone, ammonia, and hydroxylamine. No significant buffer
      effects were observed for the buffer species used in this study. The pH-rate
      profile exhibited a specific acid catalysis which is important at pH values less
      than 3.5, and an inflection point at pH 1.10 corresponding to a pKa value. From
      Arrhenius plots, the activation energy was found to be 17.8 +/- 0.3 kcal/mol.

PMID- 2231344
TI  - Efficacy of twice-daily dosing of econazole nitrate 1% cream for tinea pedis.
AB  - This study was conducted to determine the efficacy of twice-daily applications of
      econazole nitrate 1% for the treatment of tinea pedis within a typical podiatric
      practice. The study showed that twice-daily application of econazole nitrate 1%
      is an effective therapy and is especially successful at preventing immediate
      fungal recurrence.

PMID- 2231345
TI  - Aneurysmal bone cyst of the cuboid.
AB  - Aneurysmal bone cysts are a rare entity encountered in podiatric medicine. The
      frequency of aneurysmal bone cysts distal to the ankle joint is low. The authors
      present a literature review of the etiologies and possible treatments of an
      aneurysmal bone cyst. An unusual case of an aneurysmal bone cyst in the cuboid is
      also presented. Only one other documented case of an aneurysmal bone cyst in the
      cuboid has been reported since 1967.

PMID- 2231346
TI  - First metatarsophalangeal joint arthrodesis. Treatment for sesamoid fractures.
AB  - Fractures of both hallucal sesamoids are not commonly reported in the literature.
      The authors address various surgical procedure choices and present a case
      history. In their case, conservative treatment failed; therefore, surgical
      intervention was elected, and fusion of the first metatarsophalangeal joint was
      performed.

PMID- 2231347
TI  - Human myiasis caused by Phormia regina in Pennsylvania.
AB  - A case of human myiasis caused by the black blowfly, P. regina, has been
      presented. Although various reports have documented the therapeutic effects of
      maggot infestation, infection and mortality by gas-forming anaerobic organisms
      also have been reported. The removal of maggots from a wound can be accomplished
      using various methods. The authors successfully used topical application of
      dichlorotetrafluoroethane.

PMID- 2231348
TI  - Lateral subtalar dislocation. A case report.

PMID- 2231349
TI  - Post-traumatic osteochondroma of the calcaneus.
AB  - Osteochondroma is the most common bone and cartilage tumor. It is usually
      congenital but may be related to trauma. A case of osteochondroma affecting the
      calcaneus, an unusual location for this lesion, is presented. Surgical excision
      appears to be as effective a cure in this location as in others.

PMID- 2231350
TI  - Epidermal inclusion cysts as a complication of nail surgery.
AB  - The authors presented a study of 93 patients who underwent a total of 183 nail
      matricectomies. The study was undertaken to establish the incidence of
      postoperative epidermal inclusion cysts, which was 5.5%.

PMID- 2231352
TI  - Research process. Preparing a research proposal.
AB  - The preparation of a research proposal is often a necessary step in the research
      process. Research proposals are used to secure permission to undertake a study,
      to ensure protection of subjects, to secure needed resources, and to achieve a
      refined perspective of the proposed study. This third article of a series of six
      on the research process describes the steps involved in preparing a research
      proposal, demonstrating a parallel to the research planning process.

PMID- 2231351
TI  - Urticaceae poisoning.

PMID- 2231353
TI  - Medicolegal case involving a bear paw.

PMID- 2231354
TI  - Tarsal tunnel syndrome. Comprehensive review of 87 cases.
AB  - The results of the study indicate that tarsal tunnel syndrome is a pathologic
      condition in which there are multiple etiologies, which in some cases are poorly
      defined. In order to arrive at a definitive diagnosis, all available tests,
      including pathology reports, are important. Where proper diagnosis is made and
      followed with appropriate adjunctive care, the probability of recurrence will be
      minimized. Statistical information in itself is of some value, because it may
      help the podiatrist to more clearly diagnose and treat the patients in whom vague
      or general symptoms may exist.

PMID- 2231355
TI  - Koenig total great toe implant. Preliminary report.
AB  - A new first metatarsophalangeal joint implant arthroplasty is described. The two
      component, titanium alloy and polyethylene prosthesis designed for weightbearing
      is noncemented and press-fit. Sixteen cases involving 18 implants were evaluated
      over 18 months with evidence that good correction and pain free motion can be
      obtained.

PMID- 2231357
TI  - Behavior of orthotic materials in chiropody.
AB  - The author provides insight into the functioning of materials used in shoe
      inserts. This study could be the basis for criteria with which to appraise
      materials that are in use today, and also to properly evaluate new materials
      before clinical trials.

PMID- 2231356
TI  - Epidemic and classic Kaposi's sarcoma of the feet. A comparative study.
AB  - The clinical behavior of Kaposi's sarcoma involving the feet is compared for
      patients with and without AIDS. Although AIDS-related Kaposi's sarcoma is less
      likely to be confined to the legs than is non-AIDS-related Kaposi's sarcoma, the
      legs are the most common site of disease in both forms. Kaposi's sarcoma
      occurring in the AIDS setting is as radiosensitive as that which occurs in the
      patient without AIDS. Palliative radiotherapy can offer substantial relief for
      affected patients.

PMID- 2231358
TI  - Subchondral bone cysts of the phalanges.
AB  - Subchondral phalangeal bone cysts frequently are encountered when reviewing foot
      x-rays. Radiologically, these lesions appear as a focus of subchondral
      radiolucency surrounded by a rim of sclerotic bone. Radiologic and histologic
      examinations demonstrate that these lesions are identical to the subchondral bone
      cysts associated with osteoarthritis of the hip and the more recently described
      cysts of the hallucal sesamoids and the head of the first metatarsal.

PMID- 2231359
TI  - Treatment of verrucae via radio wave surgery.
AB  - Verrucae are common skin lesions seen mainly in younger patients. They often are
      seen on the plantar surface of the foot. Many different types of treatments have
      been used over the years, with varying levels of success. The authors present a
      thorough review of previous treatments and present a new and effective method of
      surgical excision using radio wave technique. The success of this treatment is
      high, and the postsurgical pain and complication level is minimal.

PMID- 2231360
TI  - Stress fracture of the tarsal middle cuneiform bone. A case report.
AB  - The authors have presented what they believe is the only reported case of a
      stress fracture of the tarsal middle cuneiform bone. Stress fracture
      pathogenesis, as well as diagnosis and treatment, were reviewed. It has been
      proposed that the middle cuneiform may be subject to increased stress in the
      runner during the propulsive phase, as this is the midfoot bone that transmits
      weight proximally in the medial column. This is evident by studying the
      cancellous structure of the tarsal bones. The ligamentous and osseous
      architecture of this region also can produce a midfoot buckling when the foot is
      plantarflexed against resistance. Prompt diagnosis and treatment is the key in
      preventing the stress fracture from becoming a chronic source of discomfort.

PMID- 2231361
TI  - Fibroepithelial polyps. An unusual case report.
AB  - Fibroepithelial polyps usually present as small, benign dermal growths known as
      skin tags. The incidence of this lesion in the foot has not been precisely
      determined. An unusual case and a literature review were presented.

PMID- 2231362
TI  - Correction of hallux varus via split tendon transfer.
AB  - The split tendon transfer is introduced as an additional procedure for the
      correction of hallux varus. More clinical and statistical evaluations are
      required to fully appreciate its potential benefits.

PMID- 2231363
TI  - Cutaneous angiosarcoma. A literature review and case report.
AB  - A case of angiosarcoma of the lower extremity was presented. This rare but highly
      malignant soft tissue tumor usually presents as a raised pigmented lesion. Wide
      surgical excision or amputation is the treatment of choice. Radiotherapy may
      offer some relief in cases that are inoperable.

PMID- 2231364
TI  - Research process. An overview.
AB  - It has been suggested that podiatric education, training, and practice too often
      are not well understood outside of the profession. If this is the case, a
      potential remedy is for more podiatric health professionals to publish work that
      has significance. Beginning with this article and continuing through a total of
      six articles, the research process is used as a paradigm for enhancing podiatric
      literature in the future.

PMID- 2231365
TI  - Predicting hallux abducto valgus.

PMID- 2231367
TI  - Advances in intraocular lens biomechanics.

PMID- 2231366
TI  - Human immunodeficiency virus.

PMID- 2231368
TI  - Measurement of elastic resisting forces of intraocular haptic loops of varying
      geometrical designs and material composition.
AB  - The relationship between experimentally induced intraocular lens (IOL) haptic
      deformation and resulting elastic haptic counter-resisting forces measured by
      electronic dynamometry was examined for 34 different IOL haptics of varying
      material composition and geometrical designs. Poly(methyl methacrylate) (PMMA)
      and polypropylene loops of similar geometry did not fundamentally differ from one
      another, although lenses of differing geometry behaved differently. Unlike PMMA
      and polypropylene loops, soft haptics of poly-HEMA and silicone rubber
      demonstrated a larger elastic resistance force to the same degree of deformation.
      This was based upon design characteristics of the lenses and not upon intrinsic
      properties of the materials, which would have produced the opposite result. By
      comparative analysis of these dynamometer measurements and considerations of the
      lens design and elastic properties (including memory) of the component materials,
      we can calculate the stresses upon the zonular and capsular bag structures during
      and after IOL implantation.

PMID- 2231369
TI  - Multilamellar hydrodissection in phacoemulsification and planned extracapsular
      surgery.
AB  - Multilamellar hydrodissection is the injection of balanced salt solution into
      multiple lamellae of the lens, cleaving it into a small nucleus and multiple
      layers of cortex. In phacoemulsification, the smaller nucleus reduces
      phacoemulsification time, and the thicker bed of cortex provides greater
      protection for the posterior capsule. In extracapsular extraction, the smaller
      nucleus can be more readily extracted, which is particularly advantageous when
      capsulorhexis is performed. Creation of multiple cortical lamellae facilitates
      their aspiration, either with the phacoemulsification or irrigation/aspiration
      tips. Multilamellar hydrodissection increases the predictability and safety of
      phacoemulsification and planned extracapsular cataract extraction.

PMID- 2231370
TI  - Displacement of bag-placed hydrogel lenses into the vitreous following neodymium:
      YAG laser capsulotomy.
AB  - We report two cases in which hydrogel lens implants have dislocated posteriorly
      into the vitreous body following YAG laser capsulotomy. These lenses were placed
      in the bag in conjunction with a capsulorhexis. A comparison with our results
      using silicone and poly(methyl methacrylate) implants indicates that this
      phenomenon has occurred only with hydrogel implants. Analysis of the various
      parameters associated with the laser capsulotomy procedure suggests that the
      overall length and design of the hydrogel implants were key factors. Because of
      the severity of this complication, we have discontinued the use of this type of
      implant.

PMID- 2231371
TI  - Evaluation of 150 consecutive cases of poly HEMA posterior chamber lenses
      implanted in the bag using a small-incision technique.
AB  - We report the results of 150 capsular bag implantations of the IOGEL PC-12
      hydrogel lens. Mean follow-up was seven months. Following capsulorhexis and
      phacoemulsification, a Faulkner folder was used to insert the lens through a 3.5
      mm to 4.0 mm scleral tunnel incision. Initially, a number of surgical
      complications were encountered. Because of increasing experience and modified
      instrumentation and technique, these did not occur in the later cases. Visual
      results were good, all eyes gaining a best case visual acuity of 20/40 or better
      and 97% achieving 20/25 or better. Morphological results were satisfactory.
      Generally the lenses remained centered and at a distance from the iris. Retention
      of viscoelastic substance or debris between the lens and the posterior capsule,
      occasionally observed at the start of the series, has been avoided by retrolental
      aspiration. Persistent pigment dispersion, which was observed when the lens had
      been implanted in the sulcus, was not seen. Tolerance of the lens material was
      generally satisfactory. There were six cases (4%) of fibrinoid uveitis, which is
      a relatively high incidence. From our experience and results we conclude that
      this implantation procedure allowed controlled insertion and placement of the
      IOGEL lens, provided that adequate instrumentation and technique was used; visual
      performance was comparable to that of poly(methyl methacrylate) lenses; capsular
      bag fixation furnished satisfactory morphological results, provided an adequately
      shaped capsulorhexis was performed.

PMID- 2231372
TI  - Early results with the 8 mm and 9 mm HEMA disc intraocular lens.
AB  - This study presents our experience with 34 HEMA disc intraocular lenses implanted
      in the capsular bag. Despite the small number of cases and the relatively short
      mean postoperative follow-up of nine months, the results show a low incidence of
      uveitis and capsular fibrosis and excellent biocompatibility. The following
      complications were observed: four luxations of the 8 mm lens and one of the 9 mm
      lens in the anterior chamber. A visual acuity of 20/20 to 20/40 was obtained in
      32 patients (94%).

PMID- 2231373
TI  - Capsular bag fixation of one-piece silicone lenses.
AB  - One hundred sixteen (116) one-piece silicone implants (STAAR 4203C) designed for
      capsular bag placement have been implanted since July 1987 and followed for up to
      two years. It appears that the posterior capsular opacification rate is
      significantly less than with sulcus-fixated one-piece silicone implants. This has
      been achieved by incorporating the small round capsulotomy using the
      capsulorhexis technique in addition to a modified endocapsular
      phacoemulsification technique. The percentage of posterior capsules requiring
      neodymium:YAG laser treatment in the first four months was 4.3 for the 4203C
      silicone IOLs and 20.0 for the sulcus-fixated one-piece silicone IOLs. The
      opacification rates for the one-year follow-up were 11% and 31%, respectively.

PMID- 2231374
TI  - Prediction of postoperative intraocular lens chamber depth.
AB  - The postoperative intraocular lens (IOL) chamber depth was predicted using a
      multiple linear regression analysis of the postoperative chamber depth as a
      function of the corneal height, the preoperative chamber depth, and the axial
      length in 279 patients with a posterior chamber lens implant. Based on a linear
      regression formula incorporating these preoperatively defined parameters, the
      postoperative IOL chamber depth could be predicted with a correlation coefficient
      of 0.71 and an error of +/- 0.30 mm (SD). It is concluded that an individual
      prediction of the IOL chamber depth will improve the accuracy in IOL calculation.

PMID- 2231375
TI  - Preoperative astigmatic influence on the predictability of intraocular lens power
      calculation.
AB  - The preoperative and postoperative influence of different parameters on the
      predictability of formulas used for intraocular lens (IOL) power calculation
      (axial length, corneal dioptric power, IOL malposition, postoperative
      astigmatism) has been shown by various authors. In this study, we evaluated the
      preoperative astigmatic influence on the prediction of postoperative refraction
      in eyes operated on for cataract with IOL implantation. Three hundred and fifty
      nine eyes were evaluated after cataract surgery and IOL implantation. We
      calculated predictive errors of both the Binkhorst and SRK formulas for each eye.
      Based on the outcome of the predictive errors we divided the eyes into six
      groups: three of high and three of low predictability. Preoperative astigmatism
      in these groups was statistically compared (using the Student's t-test). The
      preoperative astigmatism was always higher in the group with low predictability
      than in the group with high predictability (P less than .05).

PMID- 2231376
TI  - Comparison of the protective effects of methylcellulose and sodium hyaluronate on
      corneal swelling following phacoemulsification of senile cataracts.
AB  - The protective effects of two viscoelastic substances (hydroxypropyl
      methylcellulose and sodium hyaluronate) on the cornea during phacoemulsification
      of senile cataracts were investigated in a prospective, randomized, clinical
      study. The viscoelastic substances were placed in the anterior chamber before and
      during phacoemulsification. The mean increase in central corneal thickness
      (measured by ultrasonic pachymetry) on the first postoperative day was
      statistically significantly higher (P less than .05) in the methylcellulose group
      (35 eyes) than in the sodium hyaluronate group (35 eyes). Five weeks
      postoperatively the difference in mean central corneal thickness between the two
      groups was not statistically significant. However, one eye in the methylcellulose
      group developed bullous keratopathy. The present study indicates that
      methylcellulose does not protect the corneal endothelium as effectively as sodium
      hyaluronate during phacoemulsification procedures.

PMID- 2231377
TI  - Air bubble endothelial damage during phacoemulsification in human eye bank eyes:
      the protective effects of Healon and Viscoat.
AB  - Following insertion of either Healon (sodium hyaluronate) or Viscoat (sodium
      chondroitin sulfate-sodium hyaluronate) into the anterior chamber of human eye
      bank eyes, a controlled amount of small air bubbles was introduced into the
      anterior chamber during phacoemulsification. After vital staining, damage to
      endothelial cells in the central cornea was quantified. Endothelial damage
      averaged 4.5% in eyes in which no viscoelastic was used (positive control),
      whereas damage was only 0.4% (P less than .001) in eyes in which a viscoelastic
      was inserted but no air bubbles were introduced (negative control). Endothelial
      damage in test specimens using air plus Healon averaged 4.9%. Damage in test
      specimens using air plus Viscoat averaged 0.3% (P less than .02). As demonstrated
      by scanning electron microscopy, many areas in the positive controls and in the
      Healon test specimens were damaged too extensively to quantitate accurately by
      the method we used. Thus, Viscoat may prevent or lessen damage to the corneal
      endothelium by small air bubbles during phacoemulsification.

PMID- 2231378
TI  - Comprehensive study of damage to intraocular lenses by single and multiple
      nanosecond neodymium: YAG laser pulses.
AB  - The results of an extensive study of the probability of damage induced in implant
      quality intraocular lenses (IOLs) by a commercially available nanosecond Nd:YAG
      photodisruptor are presented. These results were compared with the morphology of
      damage seen on scanning electron microscopy. The differences in the shape of the
      damage probability curves derived for the different lens groups demonstrate that
      a single threshold value does not characterize the threshold for IOL damage. We
      suggest that a standard method using a clinical photodisruptor be used by all
      workers to derive these curves for all IOLs in clinical use. The clinical
      relevance of our findings is emphasized.

PMID- 2231379
TI  - New refractive method for laser thermal keratoplasty with the Co:MgF2 laser.
AB  - We have observed corneal curvature changes from laser thermal keratoplasty with a
      Co:MgF2 laser. We studied corneal curvature changes in rabbits and have
      identified specific treatment patterns and laser parameters that can correct
      myopia and astigmatism. These corneal changes, some as large as 8 diopters, have
      been stable for at least one year, and slitlamp examination demonstrates clear
      central corneas with normal appearance.

PMID- 2231380
TI  - Preliminary study of argon fluoride (193 nm) excimer laser trabeculectomy.
      Scanning electron microscopy at five months.
AB  - There is an increasing interest in the use of the excimer laser in ophthalmology,
      particularly in refractive surgery. The argon fluoride (193 nm) excimer laser
      ablates tissue with a high degree of precision and without any mechanical or
      thermal damage to surrounding structures. In this study, the argon fluoride
      excimer laser was experimentally used in the rabbit model to perform a
      trabeculectomy. Clinical and scanning electron microscopic evaluations showed a
      successful and patent filtering procedure. At the five-month follow-up the
      trabeculectomy was smooth and regular and there was no evidence of inflammation
      or thermal damage on the surrounding structures.

PMID- 2231381
TI  - Intraocular lens implantation in developing countries.
AB  - One of the chief aims of ophthalmic workers in developing countries is to operate
      on as many cataract patients as possible in the most cost-efficient manner.
      Therefore, our intraocular lens (IOL) implantation policy in Nakuru and Kikuyu,
      Kenya, is to reserve IOLs for monocular cataract patients of all ages, who
      otherwise would not have use of the aphakic eye. In this study, we review 105 of
      our first IOL implantations. In 60%, the uncorrected postoperative visual acuity
      was 20/60 or better.

PMID- 2231382
TI  - Practice styles and preferences of ASCRS members--1989 survey.
AB  - A survey of the practice styles and preferences of 1989 ASCRS members with a U.S.
      zip code was performed in September 1989. More than 3,700 questionnaires were
      mailed and over 42% (1,543) were returned prior to the cut-off date. Three main
      profile questions were used to cross-analyze the results: the age of the
      ophthalmologist, the volume of cataract surgery per month, and the geographic
      location. This report also compared the data with previously published surveys of
      the ASCRS membership.

PMID- 2231383
TI  - Severe fibrinous reaction after cataract and intraocular lens implantation
      surgery requiring neodymium:YAG laser therapy.
AB  - Fibrous membrane formation on the anterior surface of an intraocular lens with
      occlusion of the pupil was noted in five patients having phacoemulsification and
      one patient having planned extracapsular cataract extraction. Initial onset of
      pain and decreased vision ranged from eight to 36 postoperative days. Since these
      patients did not respond fully to steroid therapy, the neodymium:YAG laser was
      used to disrupt the fibrinous membrane which occluded the pupil. In all but one
      case, the fibrinous reaction responded to laser therapy. Generally, less energy
      was required when laser therapy was initiated early in the treatment plan.

PMID- 2231384
TI  - New posterior chamber lens with open circular haptic for a small capsular
      opening: preliminary report.
AB  - This report describes a single-piece poly-(methyl methacrylate) posterior chamber
      lens for implantation through a small capsular opening. It has open circular
      loops with an eyelet at each loop end. The optic is 6 mm in diameter and the
      overall diameter of the intraocular lens (IOL) is 11 mm. The lens diameter can be
      reduced to 7 mm by grasping the eyelets at both open loop ends with a specially
      designed holding forceps. The IOL is inserted in the capsular bag after circular
      capsulorhexis or through a linear capsulotomy in the intercapsular technique.
      This IOL is adaptable to a small capsular opening and maintains the usual shape
      of the capsular bag, similar to a disc lens.

PMID- 2231385
TI  - Specular microscopic observation of eye-bank corneal endothelium using the
      clinical specular microscope.
AB  - A special holder for endothelial evaluation of eye-bank corneas using the
      clinical specular microscope was developed. Using this holder, pictures of the
      corneal endothelium can be taken without the eye-bank specular microscope.

PMID- 2231386
TI  - One-handed method of posterior chamber phacoemulsification.
AB  - An alternative method of posterior chamber phacoemulsification is presented. This
      method is one-handed, uses a 30-degree tip, and emulsifies the nuclear rim in a
      circumferential manner.

PMID- 2231387
TI  - Scleral pocket incision applied to insertion of the nut and bolt
      keratoprosthesis.

PMID- 2231388
TI  - Viscoat aspiration with an enlarged Simcoe cannula.

PMID- 2231389
TI  - Consultation section. Blunt trauma to the eye.

PMID- 2231390
TI  - [Autografts and tooth transplants. Operative indications].
AB  - In order to evaluate the prognosis in tooth transplant procedure the literature
      on this subject was reviewed. The survival of the periodontal ligament is
      necessary to prevent ankylosis and root resorption. In order to obtain optimal
      clinical results, the following guidelines are proposed: preparation of the
      recipient site 2 weeks prior to graft placement, preservation of intact Pdl at
      time of extraction, rapid reimplantation of tooth in new socket, short term
      contention (2-3 weeks); endodontic therapy 8-10 weeks after tooth
      transplantation.

PMID- 2231391
TI  - [Clinical research on the etiopathology of gingival recession].
AB  - Frequency severity of gingival recessions was studied with Stahl and Morris
      indices. The results showed that the localization of gingival recession was more
      important on the mandible (37%) than on the maxillary (27.6%) it, also
      demonstrated the importance of various etiologies and particularly the
      association of trauma - tooth malposition (81%).

PMID- 2231393
TI  - [Role of Kiel bone in periodontal surgery. Report of a case].
AB  - A case in which an infrabony pocket was treated with Kiel bone is presented. The
      healing of the lesion was assessed by reentry 9 months after the procedure was
      completed.

PMID- 2231394
TI  - [Comparative efficiency of 3 experimental ultrasonic instruments in vivo].
AB  - A clinical study was performed to compare the in vivo effectiveness of three
      different instruments for calculus removal. The instruments were Odontoson,
      Cavitron and Siroson. Following scaling of the roots, the teeth were extracted,
      stained and assessed for remaining calcareous deposits. Comparative statistical
      analysis revealed no significant differences among the three methologies.

PMID- 2231392
TI  - [Preprosthetic periodontal examination. Clinical observations].
AB  - A detailed and comprehensive clinical examination is an important and fundamental
      basis for establishing a proper diagnosis for prosthetic treatment. It is
      important to make an accurate diagnosis, a rational treatment plan and
      establishing a prognosis. A careful examination of teeth and periodontium must be
      done and the prosthetic plan must consider the periodontal status of the teeth.
      The prosthetic treatment plan must take into consideration problems of appliance
      retention, iatrogenic tooth injuries and other factors. A classification based on
      6 different clinical situations suggested and their therapeutic solution
      proposed.

PMID- 2231395
TI  - [Prevalence of juvenile periodontitis in Ille-et-Vilaine. Study of an orthodontic
      population].
AB  - The incidence of Juvenile Periodontitis was studied in 1600 patients residing in
      Ille et Vilaine, France. The diagnosis was established by the use of panoramic
      radiography on orthodontic patients. Among this population of patients only 3
      cases of Juvenile Periodontitis were found. This incidence of 0.187% is similar
      to that found in other industrialized countries.

PMID- 2231396
TI  - [Treatment of a vestibular gingival papilloma: report of a case].
AB  - A 14 years old patient showed a vestibula papilloma. The lesion and the treatment
      are described. This inflammatory etiology is confirmed by the histologic features
      of the biopsy.

PMID- 2231397
TI  - The control of limb geometry in cat posture.
AB  - 1. The aim of this study is to address the problem of the controlled variable in
      quadrupedal stance. In particular, we considered whether the projection of the
      centre of mass of the body on the support surface or the joint torques or the
      geometrical configuration of the limbs are primarily controlled. 2. Cats were
      trained to stand freely on a platform which could be tilted in the sagittal plane
      by up to +/- 20 deg. The normal and tangential components of the contact forces
      at each paw were measured by means of load cells. The position of limb joints was
      recorded by means of the ELITE system. 3. The projection of the centre of body
      mass on the platform, as well as the orientation and length of limb axes, varied
      to only a limited extent with tilt angle. In particular, the limb axes were
      closely lined up with the vertical, as were the vectors of the contact forces at
      the paws. As a result, the torques at the proximal joints (scapula and hip) were
      close to zero and the torques at the other joints varied little with table tilt.
      4. In order to test the different hypotheses on postural control, an external
      load (10-20% of the animal weight) was applied to the cat forequarters. The
      projected centre of mass consistently shifted forwards, contrary to the
      hypothesis that this parameter is controlled in stance. Instead, the geometry of
      limb posture remained unmodified after load application, even though the torques
      at forelimb joints were much greater than in the control. 5. This postural
      behaviour showed no sign of adaptation over a period of 24 h of continuous load
      application. 6. It is concluded that limb geometry is primarily controlled in
      stance. The results are discussed in the context of current notions on
      hierarchical control and body scheme.

PMID- 2231399
TI  - Response behaviour of cat dorsal horn neurones receiving input from skeletal
      muscle and other deep somatic tissues.
AB  - 1. In chloralose-anaesthetized cats, lumbosacral dorsal horn neurones driven by
      receptors in skeletal muscle and other deep tissues (tendon, joint, bone) were
      studied. 2. Upon mechanical stimulation two main types of neurones were found:
      units having exclusive input from deep tissues (D cells, 28.8%) and units with
      input from both cutaneous (C) and deep (D) receptors (C-D cells, 71.2%). In both
      categories, low-threshold mechanosensitive (LTM) and high-threshold
      mechanosensitive (HTM) elements were present. 3. Neurones responding exclusively
      to noxious stimulation of skeletal muscle were not found; the input from muscle
      nociceptors converged on the dorsal horn cells together with other deep or
      cutaneous input. D cells with exclusively HTM input were numerous; these could
      from the anatomical basis for a specific spinal pathway for deep pain. 4. For C-D
      neurones with input from deep nociceptors the cutaneous receptive field (RF) was
      usually located distal to the deep one. This arrangement might be of relevance
      for the occurrence of hyperaesthetic skin distal to painful deep lesions. 5. Cold
      block of the spinal cord resulted in a marked increase in the neurones'
      mechanical responsiveness and in the number of RFs per neurone. Simultaneously,
      the proportion of HTM RFs increased, particularly in cells with input from
      skeletal muscle. 6. The recording sites in the dorsal horn were located in the
      superficial dorsal horn and in and around laminae V/VI. Evidence is presented
      that in dorsal horn cells with deep input not only the mechanical excitability
      but also the degree of convergence is controlled by descending spinal pathways.

PMID- 2231398
TI  - Low-threshold mechanoreceptive and nociceptive units with unmyelinated (C) fibres
      in the human supraorbital nerve.
AB  - 1. In recordings from the human supraorbital nerve with tungsten microelectrodes,
      eleven afferent units with unmyelinated (C) axons were identified on the basis of
      their conduction velocities (0.6-1.4 m/s). 2. Eight units had low mechanical
      thresholds (less than or equal to 0.23 g) and could be activated up to their
      maximal firing rates of about 100 impulses/s by weak tactile stimuli, whereas
      three units had higher thresholds (5.5 g) and responded vigorously to noxious
      stimuli only. 3. During a skin indentation the low-threshold units adapted to an
      irregular low-frequency discharge, and release of the stimulus elicited a
      prominent off-response often ending with an after-discharge. Slow stroking was a
      particularly effective stimulus, even when done with cotton wool, whereas rapid
      stroking reduced the response. All types of stroking stimuli were occasionally
      followed by after-discharges. Repeated mechanical stimulation at short intervals
      resulted in a decline of the response, indicating receptor fatigue. For two units
      a response to skin cooling was observed. 4. The above low-threshold C units have
      all the main characteristics of the C mechanoreceptors known from the cat and
      primates but not previously proven to exist in man. The high-threshold C units
      are similar to the polymodal nociceptors found in other human skin areas.

PMID- 2231400
TI  - Developmental changes in the half-life of acetylcholine receptors in the myotomal
      muscle of Xenopus laevis.
AB  - 1. Tail preparations, containing myotomal muscle and associated spinal cord, were
      isolated from embryos and tadpoles of Xenopus laevis between stages 25 and 49
      (1.15-12 days) and were pulse-labelled with 125I-alpha-bungarotoxin (125I alpha
      BT) so that the half-life (T1/2) of their acetylcholine receptors (AChRs) could
      be estimated in organ culture. 2. For the entire population of AChRs, estimates
      of T1/2 based on a single exponential decline in radioactivity (but see item 4
      below) increased from 53-55 h at stages 25-31 (1.15-1.56 days) to approximately
      135 h at stage 47 (5.5 days). Beyond stage 47 T1/2 increased only slightly. 3.
      Radioautographic estimates of the T1/2 of extrajunctional AChRs at stages 47-48
      (5.5-7.5 days) were 41-50 h. It follows that the developmental change in the T1/2
      of the entire population of AChRs was due to the junctional AChRs. 4. At stages
      47-49 (5.5-12 days) the decline in radioactivity for the entire population of
      AChRs was fitted well by a double exponential. Assuming a T1/2 of 50 h for the
      extrajunctional AChRs and 210 h for the junctional AChRs, the correlation
      coefficient (r) was 0.9947 +/- 0.0014 (mean +/- S.E.M.; n = 14) and junctional
      AChRs were estimated to comprise 80 +/- 3% of the entire population. Similar
      analysis, as well as experiments in which the degradation of junctional AChRs was
      assessed by pulse-labelling with fluorescent alpha-bungarotoxin, suggested that
      at earlier stages of development the junctional AChRs have a shorter T1/2 and
      comprise a smaller fraction of the entire population. 5. The developmental
      increase in T1/2 occurred even when animals were raised in the anaesthetic
      tricaine or in tetrodotoxin, conditions which abolished all motor activity. 6.
      Developmental increases in T1/2 also occurred in culture but were smaller than
      those in vivo. The increases in culture did not occur amongst those AChRs which
      were pre-labelled with 125I alpha BT. 7. It is concluded that in Xenopus myotomal
      muscle the T1/2 of junctional AChRs begins to increase within a day after the
      onset of innervation and that the increase does not require nerve or muscle
      impulse activity. We suggest, among other possibilities, that it may depend upon
      incorporation of a different molecular species of AChR into the postsynaptic
      membrane.

PMID- 2231401
TI  - Brown adipose tissue thermogenic responses of rats induced by central
      stimulation: effect of age and cold acclimation.
AB  - 1. Urethane-anaesthetized, age-matched cold-(4 degrees C) and room (21 degrees C)
      acclimated groups of Sprague-Dawley rats were given repeated (three) ventromedial
      hypothalamic electrical stimulations. Interscapular brown adipose tissue (IBAT),
      colonic, surface tail temperatures and blood pressure were monitored before and
      after each electrical stimulation. Propranolol HCl (2.5 mg kg-1 i.v.) was given
      10 min prior to the last (third) ventromedial hypothalamic stimulation. 2.
      Repeated electrical stimulation of the ventromedial hypothalamic (VMH) nucleus to
      either small or large rats (kept at 21 degrees C) caused no significant change in
      interscapular brown fat, colonic or surface temperatures compared to respective
      pre-stimulation control values whereas mean arterial pressure was slightly but
      significantly increased during the 30 s stimulation period. 3. Electrical
      stimulation of the ventromedial hypothalamic nucleus of small or large rats, kept
      at 4 degrees C for 3 weeks prior to testing, caused significant (greater than
      0.25 and greater than 0.40 degrees C, respectively) rises in interscapular BAT
      temperature from respective prestimulation control values. Colonic temperatures
      increased following ventromedial hypothalamic electrical stimulation only in the
      small, 4 degrees C-acclimated group whereas surface tail temperatures did not
      significantly change after stimulation of either cold-exposed group. Mean
      arterial pressures were significantly increased during ventromedial hypothalamic
      electrical stimulation in both 4 degrees C-acclimated groups, compared to pre
      stimulation control levels and, in addition, were above those of age-matched rats
      kept at 21 degrees C. Intravenous propranolol, which decreased interscapular
      brown fat and colonic temperatures in all groups, blocked the rise in
      interscapular brown fat and colonic temperatures of the 4 degrees C-acclimated
      rats following the last electrical stimulation of the ventromedial hypothalamic
      nucleus. 4. In vitro biochemical analysis of the interscapular brown fat pads of
      another four groups of age-matched, small and large 21 and 4 degrees C-acclimated
      rats revealed that the thermogenic capacity of the 4 degrees C-acclimated groups
      was, in all cases, significantly increased from age-matched groups previously
      kept at 21 degrees C, as shown by significant increases in brown adipose tissue
      mass, BAT DNA and protein content, BAT mitochondrial protein and BAT
      mitochondrial GDP binding.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231402
TI  - Effects of systemic hypoxia on the distribution of cardiac output in the rat.
AB  - 1. Studies were made in unanaesthetized rats of cardiovascular responses induced
      during 3 min periods of systemic hypoxia (inspirate 8 or 6% O2). Arterial
      pressure and heart rate were recorded continuously; cardiac index and regional
      blood flows were measured in normoxia and at the 2nd min of hypoxia by injection
      of radiolabelled microspheres. Comparisons are made with changes recorded in
      Saffan-anaesthetized rats during 8% O2 using microspheres and in previous studies
      using electromagnetic transducers on renal, mesenteric and femoral arteries
      (Marshall & Metcalfe, 1988a). 2. In unanaesthetized rats, the initial 1-1.5 min
      of hypoxia evoked behavioural arousal associated with a short-lasting rise in
      arterial pressure and heart rate. This agrees with our previous proposal that
      hypoxia activates the brain stem defence areas by stimulating peripheral
      chemoreceptors. 3. In unanaesthetized rats, these changes were superimposed upon
      a gradual fall in arterial pressure and tachycardia, the responses being greater
      during 6 than 8% O2 (cf. Saffan-anaesthetized rats). Further, in all rats at the
      2nd min of hypoxia, cardiac index and vascular conductance of most body tissues
      was increased. It is concluded that the fall in arterial pressure is due to
      peripheral vasodilatation. 4. In the unanaesthetized rats, the tendency for
      vascular conductance in kidney, intestine and gastrocnemius muscle to increase
      (more during 6 than 8% O2) allowed increases in blood flow in the last two
      regions. These changes accord with those recorded under Saffan anaesthesia. 5. In
      both unanaesthetized and anaesthetized rats, hypoxia induced pronounced increases
      in vascular conductance of diaphragm, adrenal gland, cerebral hemispheres,
      cerebellum and brain stem, the resultant increases in blood flow being larger in
      the unanaesthetized rats. 6. It is proposed that in unanaesthetized, as in
      anaesthetized, rats the regional dilator responses predominantly reflect the
      local dilator effects of tissue hypoxia. Possible dilator factors are considered.

PMID- 2231403
TI  - Respiratory-related discharge pattern of sympathetic nerve activity in the
      spontaneously hypertensive rat.
AB  - 1. Synchronization of spontaneous sympathetic discharge during the respiratory
      cycle was studied in the cervical and renal nerves of vagotomized, normotensive
      Wistar-Kyoto rats (WKYs) and age-matched spontaneously hypertensive rats (SHRs).
      Phrenic nerve discharge was used as an index of central inspiratory activity. 2.
      In normotensive Wistar-Kyoto rats depression of sympathetic activity appeared at
      the onset of inspiration reaching a minimum at mid-inspiration. Peak maximal
      sympathetic discharge corresponded to postinspiratory phase; a second increase
      sometimes appeared in late expiration. Variations of respiratory frequency over
      wide range of experimental conditions by hypoxia, hyperoxia, hyper- or hypocapnia
      and transection of carotid sinus nerves did not affect this pattern. 3. In SHRs
      the respiratory-phase-related timing of sympathetic discharge was variable. In
      normoxia, the maximal sympathetic activity occurred in late inspiration, preceded
      by short depression at early inspiration and followed by postinspiratory
      depression. A second increase in sympathetic activity was observed in mid
      expiration. 4. The pattern of respiratory phase modulated sympathetic activity in
      SHRs was altered by hypoxic stimulation of the peripheral chemoreceptors. The
      early inspiratory depression of sympathetic activity was substantially prolonged
      and the maximal sympathetic discharge was shifted from inspiration to early
      expiration. This effect was abolished after carotid sinus nerves had been cut. 5.
      Hypercapnic stimulation of central chemoreceptors in SHRs with carotid sinus
      nerves cut did not influence the timing of the sympathetic activity in relation
      to the respiratory phase, though the magnitude of rhythmical sympathetic
      discharges was increased. 6. We discuss the possibility that altered
      synchronization between central respiratory drive and sympathetic neuronal system
      may contribute to the neurogenic mechanisms of arterial hypertension in SHRs.

PMID- 2231404
TI  - Human placental L-tyrosine transport: a comparison of brush-border and basal
      membrane vesicles.
AB  - 1. The mechanisms responsible for L-tyrosine transport at both the maternal
      facing and fetal-facing surfaces of the human full-term placenta have been
      studied using isolated brush-border and basal membrane vesicles under conditions
      where a direct comparison of the transport properties of the two membranes can be
      made. 2. Brush-border vesicle uptake of L-tyrosine was substantially into an
      osmotically active space. Transport was Na(+)-independent, N-ethylmaleimide
      sensitive (half-maximal inhibition, Ki = 1.1 mM), and insensitive to pH over the
      range 5.5-8.5. The initial rate of brush-border L-tyrosine uptake as a function
      of concentration showed saturation and obeyed Michaelis-Menten kinetics with
      Michaelis constant (Km) and maximum velocity (Vmax) values of 54.2 microM and
      1.28 pmol (mg protein)-1 s-1, respectively. Influx of L-tyrosine was
      stereospecific and was virtually completely abolished by L-phenylalanine, L
      tryptophan, L-leucine or by 2-aminobicycloheptane-2-carboxylic acid. These
      properties suggest that system L is responsible for brush-border L-tyrosine
      transport. 3. Basal membrane transport of L-tyrosine was more complex and uptake
      was slower than that found in the brush border. Although, as in the brush-border
      membranes, uptake was completely Na(+)-independent, N-ethylmaleimide was a less
      effective inhibitor, there was stimulation of transport at more alkaline pH and
      uptake did not show marked stereospecificity. An apparent Km of 168.9 microM and
      a Vmax of 0.31 pmol (mg protein)-1 s-1 were calculated for basal L-tyrosine
      transport. There was clear inhibition by L- and D-tyrosine, L-phenylalanine and L
      tryptophan. 2-Aminobicycloheptane-2-carboxylic acid was not as effective. 4.
      These findings suggest the existence of non-identical carrier-mediated transport
      systems for L-tyrosine in brush-border and basal membranes. Brush-border
      transport resembles that by system L; L-tyrosine transport at the basal membrane
      may be via system t.

PMID- 2231406
TI  - Dynamics and dimensions of cardiac output changes in humans at the onset and at
      the end of moderate rhythmic exercise.
AB  - 1. An improved Doppler ultrasound technique was used to measure stroke volume
      (SV) and cardiac output (CO) on a beat-to-beat basis in a group of supine humans
      before, during and after periods of standardized, rhythmic exercise, involving
      the quadriceps muscle groups on both sides. The development of CO on such bouts
      of exercise was compared to Doppler ultrasound records of the simultaneous
      femoral arterial flow (FF) response. 2. Records of CO at rest revealed
      spontaneous fluctuations around a mean level, with differences between the
      minimal and maximal values of the order of 1 l min-1. The mean CO level at rest
      again varied considerably from one day to another and from test run to test run.
      3. Upon start of exercise an immediate and rapid increase in heart rate (HR) and
      CO took place. The entire increase, the size of which varied appreciably from
      test run to test run, was completed within 10-15 s. No or only minor changes were
      seen in the mean SV level during the exercise periods. 4. The time course of the
      increase in FF was indistinguishable from that of the increase in CO, which
      occurred without any detectable delay relative to the changes in FF. These
      closely parallel developments indicate a tight regulatory coupling between the
      two types of flow changes. 5. In the majority of tests the total and two-sided
      increase in FF seen in the steady-state situation in the last part of an exercise
      period was significantly larger than the recorded increase in CO. This
      discrepancy implies that some redistribution of flow from tissues other than the
      working muscles might take place, even at this moderate level of work. 6. Upon
      the end of exercise a striking but transient increase in CO occurred, resulting
      from an increase in SV concomitant with a maintained HR. In the course of five to
      eight post-exercise cardiac cycles about 100 extra milliliters of blood were
      expelled from the heart. This cardiac outflow overshoot was found to occur during
      a post-exercise fall in mean arterial blood pressure (MAP).

PMID- 2231405
TI  - Synchronization of motor units in human masseter during a prolonged isometric
      contraction.
AB  - 1. The action potentials of concurrently active motor units in human masseter
      were recorded on several fine-wire intramuscular electrodes and synchronization
      was assessed by cross-correlation of their firing times. 2. Long recording
      sessions and a test of significance for peaks in histograms were used to enhance
      detection of synchrony. 3. Synchrony in masseter units was found to be very weak,
      and was observed consistently only in histograms with a large number of counts.
      However, synchrony was widespread within the motoneurone pool; of the unit pairs
      whose cross-correlation histograms contained more than 100 counts per 1 ms bin,
      89% were significantly synchronized. 4. The strength of synchrony between pairs
      of units did not change consistently during 15 min of continuous activity. 5. It
      was concluded that most, if not all, low-threshold masseter motoneurones have
      some common synaptic inputs, although the origin of those inputs remains unclear.

PMID- 2231407
TI  - Electrophysiology of glutamate and sodium co-transport in a glial cell of the
      salamander retina.
AB  - 1. Muller cells were isolated from salamander retinas and their membrane voltage
      was controlled with a whole-cell voltage clamp. External D-aspartate, L-aspartate
      and L-glutamate each induced a membrane current. D-Glutamate, kainate,
      quisqualate and N-methyl-D-aspartate were more than 100x less effective than L
      aspartate. Kynurenic acid had no effect on the current produced by L-glutamate, L
      aspartate or D-aspartate. 2. The current induced by an acidic amino acid (AAA)
      was completely dependent on the presence of external Na+. Neither Li+, Cs+,
      choline nor TEA+ were able to substitute for Na+. The relationship between
      external Na+ concentration and current amplitude can be explained if the binding
      of three Na+ ions enabled transport. The apparent affinity constant for Na+
      binding was 41 mM. Altering K+, H+ and Cl- concentrations demonstrated that these
      ions are not required for transport. 3. The shape of the current-voltage relation
      did not depend on the external amino acid concentration. The relationship between
      D-aspartate concentration and current amplitude can be described by the binding
      of D-aspartate to a single site with an apparent affinity constant of 20 microM.
      4. Influx and efflux of AAA were not symmetric. Although influx was electrogenic,
      efflux did not produce a current. Moreover, influx stimulated efflux; but efflux
      inhibited influx. 5. Removing external Na+ demonstrated that Na+ carried a
      current in the absence of an AAA. Li+ was a very poor substitute for Na+. This
      current may be due to the uncoupled movement of Na+ through the transporter. The
      relationship between the external Na+ concentration and the amplitude of the
      uncoupled current can be explained if the binding of two or three Na+ ions
      enabled the translocation of Na+ in the absence of an AAA. The apparent affinity
      constant for Na+ binding was approximately 90 mM. 6. The temperature dependence
      of the AAA-induced current had a Q10 between 8 and 18 degrees C of 1.95. The Q10
      is consistent with a rate constant for influx of 10(4) s-1 (at -70 mV and 20
      degrees C). The maximum rate of influx was measured following a concentration
      jump produced by the photolysis of 'caged' L-glutamate. The onset of the observed
      current was limited by the 1.3 ms resolution of the recording system. Hence, the
      rate constant for influx must be faster than 10(3) s-1.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2231408
TI  - Strong Pasteur effect in rabbit corneal endothelium preserves fluid transport
      under anaerobic conditions.
AB  - 1. The hydration and transparency of the mammalian cornea are maintained by a
      metabolically dependent fluid transport system located in the endothelial cell
      layer. The purpose of the study was to determine whether this pump activity is
      dependent upon aerobic or anaerobic metabolism. 2. The ability of the cornea,
      superfused in vitro with a bicarbonate-Ringer solution containing glucose and
      adenosine, to maintain normal hydration (thickness) when respiration is inhibited
      has been examined in intact and de-epithelialized preparations and correlated
      with glycolytic activity and cellular concentrations of ATP. 3. In respiring
      intact and de-epithelialized corneas thickness was maintained for periods up to 5
      h during superfusion with the control Ringer solution. 4. KCN (10(-3) M) or
      antimycin A (10(-6) M) caused the intact cornea to swell at 15 +/- 3 microns h-1,
      whereas the de-epithelialized tissue maintained normal thickness under these
      conditions. This swelling of the intact tissue appears to be due to the osmotic
      effect of increased epithelial lactate production under anaerobic conditions. 5.
      Pre-swollen de-epithelialized corneas deturgesced fully to original thickness at
      a rate of 43 +/- 7 microns h-1 under aerobic conditions, but with KCN or
      antimycin they deturgesced at only 65% of that rate and generally failed to
      return to their original thickness. 6. Ouabain (10(-4) M) caused de
      epithelialized corneas to swell in the presence of KCN or antimycin, as it did
      under aerobic conditions, showing that maintenance of hydration or deturgescence
      are pump-dependent processes under both conditions. 7. Lactate production was
      markedly stimulated by KCN or antimycin in intact and de-epithelialized
      preparations, but not in the stroma alone. The magnitude of the Pasteur effect
      was calculated to be 5-fold in the endothelium and 2.5-fold in the epithelium.
      Ouabain inhibited anaerobic lactate production in the endothelium by 50%. 8. ATP
      content of the epithelium following 5 h superfusion was 22.0 nmol cm-2 in control
      (aerobic) corneas, but fell to 1.9 nmol cm-2 in the presence of 10(-3) M-KCN,
      whereas the endothelial value fell only from 1.1 to 0.7 nmol cm-2 under these
      conditions. 9. Omission of glucose from the medium containing KCN or antimycin
      caused immediate swelling of tissues and a rapid decline of ATP content to less
      than 1% of that in control conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231410
TI  - Reflex coronary vasodilation evoked by chemical stimulation of cardiac afferent
      vagal C fibres in dogs.
AB  - 1. Veratridine injected into the coronary circulation stimulates afferent vagal
      endings in the heart to evoke bradycardia and systemic hypotension (Bezold
      Jarisch reflex, coronary chemoreflex) and coronary vasodilation. We have examined
      certain features of the reflex coronary vasodilator response in anaesthetized
      dogs. 2. When the circumflex coronary artery was perfused at constant pressure
      (100 mmHg), injection of veratridine (0.3 micrograms kg-1) into the anterior
      descending artery decreased blood pressure and heart rate, and increased
      circumflex blood flow by 54%; when heart rate was kept constant, circumflex flow
      increased by 57%. The increase in circumflex flow was reduced 63% by atropine,
      and finally abolished by phentolamine. 3. During severe coronary underperfusion
      (perfusion pressure 45 mmHg), veratridine still increased coronary flow by 35%,
      an increase amounting to 24-64% of the coronary vascular reserve. Flow increased
      in all layers of the myocardium, but the relative distribution of flow between
      subendocardial and subepicardial layers was unaltered. 4. Veratridine stimulates
      both mechanosensitive and chemosensitive cardiac endings. Stimulating
      chemosensitive afferents selectively by injecting capsaicin (1.5 micrograms kg-1)
      into the anterior descending artery decreased blood pressure and heart rate, and
      increased circumflex flow by 50% (and by 36% when heart rate was kept constant).
      5. In ten of fifteen dogs, veratridine and capsaicin still evoked coronary
      vasodilatation when vagal A fibres were blocked selectively by cooling to 7.5
      degrees C, the increase in coronary flow averaging 45% of that at 37 degrees C.
      All responses were abolished by cooling to 0 degrees C. 6. We conclude that
      coronary vasodilatation can be evoked by selective stimulation of cardiac
      chemosensitive vagal C fibres, although the coronary vasodilation of the
      veratridine-induced Bezold-Jarisch reflex may be due to stimulation of both
      mechanosensitive and chemosensitive C fibres. We speculate that during periods of
      coronary underperfusion ischaemic stimulation of chemosensitive vagal C fibres
      evokes a reflex dilatation of the coronary vascular bed that supplements the
      dilatation dependent upon autoregulatory mechanisms.

PMID- 2231409
TI  - Permeability of frog mesenteric capillaries after partial pronase digestion of
      the endothelial glycocalyx.
AB  - 1. The proteolytic enzyme pronase, which degrades the endothelial cell
      glycocalyx, was perfused through single capillaries of frog mesentery. Hydraulic
      conductivity (Lp) of each vessel was determined before and after pronase
      perfusion. In three vessels in which Lp increased, the ultrastructure of
      interendothelial clefts was examined. In a separate group of frogs the effect of
      pronase on the endothelial glycocalyx was assessed by using cationized ferritin
      to label the capillary luminal surface. 2. Control Lp was 2.0 x 10(-7) cm s-1
      cmH2O-1 (10 mg ml-1 bovine serum albumin, BSA, in frog Ringer solution). Vessels
      were then perfused with a solution containing 0.1 mg ml-1 pronase and 10 mg ml-1
      BSA for 1 min. Lp measured in the same eleven vessels increased to 4.9 x 10(-7)
      cm s-1 cmH2O-1 (P less than 0.005). 3. Transverse sections of three of these
      vessels were examined by transmission electron microscopy at eight sites along
      each vessel. In these sections a total of 156 interendothelial cell clefts were
      found and photographed. No morphological features, such as fenestrations,
      transendothelial channels, or intercellular gaps associated with inflammation,
      were found which might account for the increases in Lp. 4. Measurement of cleft
      dimensions yielded a harmonic mean cleft depth (delta x) of 0.32 microns and an
      arithmetic mean cleft depth of 0.64 microns. Mean width (w) of the clefts outside
      the tight regions was 0.012 microns and the cleft length per unit area (L) was
      1330 cm-1. The mean fractional pore area of vessel wall per unit cleft depth,
      Ap/delta x, calculated as Lw/delta x, was 48.7 cm-1. 5. There was less cationic
      ferritin (CF) labelling of the luminal glycocalyx in pronase-perfused than in
      control capillaries. On average, the proportion of the luminal surface covered by
      CF was 85% in controls and 42% in pronase-treated capillaries (P less than 0.01).
      In some vessels the CF pattern was greatly disrupted, indicating large changes in
      the glycocalyx structure. 6. It is concluded that the moderate increases in Lp
      induced by pronase perfusion are associated with partial digestion of the
      endothelial glycocalyx but are not accompanied by changes in the dimensions of
      the intercellular cleft. These observations support the fibre matrix hypothesis
      of capillary permeability and suggest that the endothelial glycocalyx contributes
      as much as 60% of the hydraulic resistance of the capillary wall.

PMID- 2231412
TI  - Resting calcium concentrations in isolated skeletal muscle fibres of dystrophic
      mice.
AB  - 1. Single, intact muscle fibres were dissociated enzymatically from skeletal
      muscles of phenotypically normal (+/?) and dystrophic mice (129/ReJ dy/dy:
      Dystrophia muscularis), and resting Ca2+ levels were measured by image analysis
      of intracellular Fura-2 fluorescence in distinct parts of the fibres. 2. Fura-2
      was introduced into fibres by ionophoresis with glass microelectrodes to
      concentrations of between 50 and 200 microM. Over this concentration range there
      was no apparent buffering of intracellular Ca2+ by Fura-2. 3. Fibres isolated
      from the soleus, flexor digitorum brevis (FDB) and extensor digitorum longus
      (EDL) muscles of normal animals maintained resting [Ca2+] of 106 +/- 2 nM. Ca2+
      distributions within individual fibres were homogeneous. 4. Fibres from
      dystrophic animals maintained [Ca2+] that was elevated two- to fourfold in
      comparison to normal fibres. 5. The population of skeletal fibres from dystrophic
      mice which displayed morphology similar to that of fibres of normal animals were
      found to have Ca2+ levels that averaged 189 +/- 2 nM. The distribution of Ca2+
      within these fibres appeared uniform. 6. The population of dystrophic fibres that
      possessed morphological abnormalities maintained even higher Ca2+ concentrations
      (368 +/- 3 nM). Several fibres from this morphological group displayed obvious
      heterogeneity in Ca2+ distribution with distinct, localized areas of higher Ca2+.
      7. These results support the contention that Ca2+ homeostasis is markedly
      impaired in dystrophic muscle. The elevated Ca2+ levels are near the threshold
      for contraction and, together with severe morphological fibre abnormalities, are
      probably centrally involved in fibre necrosis apparent in muscular dystrophy.

PMID- 2231411
TI  - Effect of melittin on renin and prostaglandin E2 release from rat renal cortical
      slices.
AB  - 1. The present experiments were designed to determine the effect of melittin on
      renin secretion. Melittin is a polypeptide component of bee venom which
      stimulates phospholipase A2 activity, thereby increasing arachidonic acid release
      and prostaglandin (PG) synthesis, and which inhibits protein kinase C activity.
      Either of these actions might be expected to stimulate renin secretion, since
      renin secretion is stimulated by arachidonic acid and by several PGs, and since
      renin secretion is inhibited by several activators of protein kinase C. 2. In rat
      renin cortical slices incubated at 37 degrees C in a buffered and oxygenated
      physiological saline solution, 0.1-10 microM-melittin produced a concentration
      dependent stimulation of both prostaglandin E2 (PGE2) synthesis and renin
      secretion. However, melittin-stimulated renin secretion is independent of
      melittin-stimulated phospholipase A2 activity, arachidonic acid release, and PG
      synthesis, since 20 microM-quinacrine (a phospholipase A2 antagonist) and 50
      microM-meclofenamate (a cyclooxygenase antagonist) antagonized basal and melittin
      stimulated PGE2 synthesis but had no effects on basal or melittin-stimulated
      renin secretion. 3. Furthermore, melittin-stimulated renin secretion is not
      produced by inhibition of protein kinase C, since an activator of protein kinase
      C (12-O-tetradecanoylphorbol 13-acetate, TPA), enhanced rather than antagonized
      melittin-stimulated renin secretion. Ouabain partially antagonized, but did not
      completely block, melittin-stimulated renin secretion. 4. Thus, melittin
      stimulated phospholipase A2 activity probably accounts for stimulated PGE2
      production, but not for stimulated renin secretion. The mechanism of melittin
      stimulated renin secretion is unclear; an effect on protein kinase C does not
      appear to be involved, and in contrast to the stimulatory effects of a variety of
      other substances, melittin-stimulated renin secretion is only partially
      antagonized by ouabain.

PMID- 2231413
TI  - An ATP-activated conductance in pheochromocytoma cells and its suppression by
      extracellular calcium.
AB  - 1. ATP-activated inward current in PC12 pheochromocytoma cells was characterized
      using the whole-cell voltage-clamp technique. 2. ATP (100 microM) applied
      extracellular elicited an inward rectifying current with a reversal potential of
      about +7 mV. The current was desensitized in seconds in spite of continued
      presence of ATP. 3. A comparison was made of the ability of ATP and its
      analogues. The order of potency in activating the inward current was ATP greater
      than ATP gamma S greater than ADP; AMP, adenosine and alpha, beta-methylene ATP
      were inactive at concentrations up to mM. 4. The ATP-activated current was also
      observed when external Na+ and Ca2+ were replaced with K+, TEA, Tris or
      glucosamine. The order of ion selectivity was Na+ greater than K+ greater than
      TEA not equal to Tris greater than glucosamine. 5. The ATP-activated current was
      also recorded in extracellular solutions containing Ca2+ as the only external
      cation. The amplitude increased as the concentration of Ca2+ was increased in the
      range between 1.8 and 16.2 mM. However, the current amplitude decreased at higher
      Ca2+ concentrations and the current was not recorded in 110 mM-Ca2+ solution. 6.
      In the presence of 140 mM-Na+ in the external solution, the current amplitude
      also decreased as the external Ca2+ concentration was increased (from 1.8 to 16.2
      mM). 7. The results indicate that Ca2+ as well as monovalent cations permeate
      through the ATP-sensitive pathway and that Ca2+ blocks ion permeation, including
      its own permeation through the pathway. This regulation by extracellular Ca2+ is
      different to the ATP-activated current in smooth muscle cells.

PMID- 2231414
TI  - Voltage-dependent currents in isolated cells of the frog retinal pigment
      epithelium.
AB  - 1. Retinal pigment epithelial (RPE) cells were isolated enzymatically from
      bullfrog retinae. The patch-clamp technique was employed to investigate whole
      cell currents under voltage-clamp conditions. 2. Isolated RPE cells were columnar
      or cuboidal in form, often with long processes protruding from the apical
      surface. Distinct apical and basal membrane domains were maintained for several
      hours following isolation. 3. The mean membrane capacitance was 62 pF. The
      resting potential averaged -30 mV, but it was as high as -75 mV in some cells. 4.
      Three voltage-dependent currents were observed: a time-independent and inwardly
      rectifying current and two time-dependent outwardly rectifying currents that had
      distinct kinetic properties. 5. Voltage pulses from a holding potential of -70 mV
      to potentials ranging from -30 to -120 mV produced membrane currents that were
      essentially time independent. The I-V relationship in this voltage range depended
      on the resting potential. It was usually inwardly rectifying in cells with
      resting potentials negative to about -50 mV, but tended to be linear in cells
      with more positive potentials. Three observations strongly suggested that the
      inwardly rectifying current is carried by K+. First, increasing the extracellular
      K+ concentration [( K+]) from 2 to 112 mM shifted the zero-current potential of
      the I-V relationship in the positive direction from an average value of -60 mV to
      0 mV. Second, the addition of the K+ channel blockers Ba2+ (2 mM) or Cs+ (5 mM)
      to the extracellular solution inhibited a major component of the inwardly
      rectifying current. Finally, the reversal potential (Vr) of the Ba2(+)-sensitive
      current averaged -90 mV, near the K+ equilibrium potential (EK). 6. In
      approximately 50% of the cells, depolarizing voltage pulses to potentials more
      negative than -30 mV evoked an outward current that resembled the delayed
      rectifier present in other non-excitable cells. It activated with sigmoidal
      kinetics in less than 100 ms following a brief delay and then declined
      exponentially with a time constant of approximately 1 s. The peak chord
      conductance associated with this current was half-maximal at +14 mV. Several
      observations indicated that this outwardly rectifying current is carried
      primarily by K+: its Vr closely matched EK over a wide range of extracellular
      [K+]; it was inhibited 80% by exposure to the K+ channel blockers 4-aminopyridine
      (1 mM) and tetraethylammonium (20 mM); and it was abolished by intracellular
      dialysis with a K(+)-free solution.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231415
TI  - Central action sites of interleukin-1 beta for inducing fever in rabbits.
AB  - 1. Intravenous (I.V.) human recombinant interleukin-1 beta (IL-1 beta) in high
      doses caused biphasic fever in rabbits. In lower doses it produced only the first
      phase of fever. 2. Intracerebroventricular (I.C.V.) or intrapreoptic-anterior
      hypothalamic (IPOAH) injection of IL-1 beta produced a rather rapid and marked
      increase in rectal temperature. 3. Subcutaneously administered indomethacin
      partly reduced the first phase and more substantially the second phase of the
      biphasic fever induced by high doses of I.V. IL-1 beta. The first phase may thus
      be prostaglandin independent at least in part. 4. In the fever induced by I.C.V.
      injection of IL-1 beta, subcutaneous indomethacin reduced the elevation of the
      rectal temperature considerably and delayed the onset of fever. Administration of
      indomethacin (I.C.V.) caused marked inhibition of the fever induced by a lower
      I.C.V. dose of IL-1 beta, but with a high dose the onset of the fever was delayed
      for about 1 h, without the total rise being affected. 5. It is concluded that the
      first phase of biphasic fever is caused by IL-1 beta acting via an extravascular
      component of the organum vasculosum laminae terminalis (OVLT) or the
      circumventricular organs accessible from only the blood side, to release
      arachidonate metabolites, presumably prostaglandin E2 (PGE2), and the second
      phase by IL-1 beta acting via the blood-brain interface accessible both from the
      blood side and the brain side, to release metabolites other than PGE2.

PMID- 2231416
TI  - Sympathetic-parasympathetic interactions at the heart, possibly involving
      neuropeptide Y, in anaesthetized dogs.
AB  - 1. Stimulation of cardiac sympathetic nerves caused prolonged inhibition of vagal
      effects on heart rate, an effect which has been proposed on the basis of previous
      studies to be due to neuropeptide Y or a neuropeptide Y-like substance, released
      from the sympathetic nerves. 2. This prolonged vagal inhibitory effect was
      attenuated or abolished when the sympathetic stimulation responsible was given
      together with continuous vagal stimulation. 3. Continuous vagal stimulation alone
      did not modify the ability of administered neuropeptide Y to cause inhibition of
      cardiac vagal action. 4. The results are consistent with the cardiac vagal nerves
      releasing a transmitter (probably acetylcholine) which acts on cardiac
      sympathetic nerve endings, inhibiting them from releasing neuropeptide Y or a
      neuropeptide Y-like substance.

PMID- 2231417
TI  - Selective control of sympathetic pathways to the kidney, spleen and intestine by
      the ventrolateral medulla in rats.
AB  - 1. Electrical activity of multifibre renal, splenic, mesenteric and greater
      splanchnic nerves and 13th thoracic white rami was recorded in artificially
      respired, urethane-anaesthetized rats. Discharge of neurones in the rostral
      ventrolateral medulla was blocked by unilateral microinjections of the inhibitory
      amino acid glycine and effects on the electrical activity of these sympathetic
      nerves were compared. 2. Blockade of the rostral ventrolateral medulla caused
      greater decreases in discharge of renal than splenic nerves and had no consistent
      effect on mesenteric nerves. This blockade also decreased the discharge of the
      preganglionic white rami more than that of the preganglionic splanchnic nerves.
      3. Postganglionic responses to rostral ventrolateral medulla blockade were always
      greater than preganglionic responses. 4. The arterial pressure and renal nerve
      responses to rostral ventrolateral medulla blockade in urethane-anaesthetized
      rats were not different from those in rats anaesthetized with alpha-chloralose.
      5. These findings demonstrate that pre- and postganglionic sympathetic pathways
      to the kidney are more dependent upon excitatory drive from the rostral
      ventrolateral medulla than pathways directed to the spleen and intestine.

PMID- 2231418
TI  - Activation of human respiratory muscles during different voluntary manoeuvres.
AB  - 1. This study used three techniques (bilateral phrenic nerve stimulation, motor
      cortex stimulation and quantitative electromyography) to assess the degree of
      activation of the diaphragm, intercostal-accessory muscles and abdominal muscles
      during postural tasks and respiratory manoeuvres. They included maximal
      inspiratory and expulsive efforts. 2. Bilateral phrenic nerve stimuli at
      supramaximal levels produced an average change in transdiaphragmatic pressure
      (Pdi) of 28 cmH2O during relaxation. During maximal inspiratory or expulsive
      efforts, all subjects were able to activate the diaphragm fully at functional
      residual capacity as judged by the failure of stimuli delivered during the
      voluntary efforts to increase Pdi. Peak voluntary Pdi was about 30% less for
      inspiratory than expulsive manoeuvres. 3. By contrast, transcranial activation of
      motor cortical output to the diaphragm and abdominal muscles produced an
      increment in abdominal pressure of 25 +/- 7 cmH2O during maximal voluntary
      expulsive efforts. Given the lack of response to phrenic nerve stimulation at
      similar voluntary pressures, this suggests that abdominal muscles, and not the
      diaphragm, fail to generate their full contractile force during maximal voluntary
      expulsive manoeuvres. 4. Motor cortical stimulation during weak inspiratory
      efforts produced a small reduction in oesophageal pressure (i.e. increase in net
      inspiratory force) of 7-14 cmH2O. This response could not be extinguished during
      maximal voluntary inspiratory efforts in two of three subjects. This occurred
      despite the cortical co-activation of 'antagonist' muscles in the chest wall and
      abdomen, and passive transmission of pressure from the abdominal to thoracic
      compartments. 5. Integrated electromyographic activity (EMG) recorded from
      abdominal muscles (rectus abdominis, external oblique) was greater during trunk
      flexion than during maximal expulsive efforts. Similarly, integrated EMG of the
      intercostal-accessory muscles (sternomastoid, scalenes, parasternal intercostals)
      was greater during tasks requiring head and/or neck flexion than during the
      maximal inspiratory efforts. 6. These data show that the diaphragm can be fully
      activated by the central nervous system during voluntary respiratory tasks but
      that other agonist 'respiratory' muscles need not be activated fully. Given the
      complex actions of 'inseries' respiratory muscles revealed here, it is argued
      that differences in the transdiaphragmatic pressure during various postural and
      respiratory tasks do not necessarily imply variation in the level of
      diaphragmatic neural drive.

PMID- 2231419
TI  - Responses of type I cells dissociated from the rabbit carotid body to hypoxia.
AB  - 1. The carotid body chemoreceptors are stimulated in situ by hypoxia. We have
      studied type I cells freshly dissociated from the carotid body of the rabbit. We
      have used microfluorimetric and patch clamp techniques to examine the responses
      to hypoxia, to anoxia, and to metabolic inhibition. 2. NADH autofluorescence
      measured at both 400 and 500 nm increased rapidly and reversibly in response to
      anoxia or to cyanide (CN-), reflecting a change in mitochondrial metabolism. 3.
      Indo-1 was used to measure changes in intracellular calcium, [Ca2+]i. Anoxia
      reversibly increased [Ca2+]i from approximately 50-100 to approximately 200-450
      nM in all cells tested. The response showed a striking temperature sensitivity.
      Responses to hypoxic stimuli were barely detectable at 17-20 degrees C, and were
      dramatically increased on warming to 36 degrees C. In contrast, responses to K(+)
      induced depolarization were only slightly increased in rate of onset and recovery
      by warming. 4. The rise in [Ca2+]i originated largely from an intracellular store
      which was slowly depleted by exposure to nominally Ca2(+)-free solutions.
      Responses were unaffected by blockade of Ca2+ channels with organic (D600,
      verapamil) or inorganic (Co2+) blockers, by blockade of Na+ channels with
      tetrodotoxin (TTX), or by increasing action potential duration with
      tetraethylammonium (TEA). Responses to anoxia were increased by the increased
      [Ca2+]i loading that follows prior exposure to Ca2(+)-free solutions. 5.
      Responses to anoxia, to blockade of electron transport by CN-, and to the
      mitochondrial uncoupler, carbonyl cyanide p-trifluoromethoxy-phenylhydrazone
      (FCCP), were equivalent in amplitude. The response to anoxia was occluded by
      concurrent application of FCCP, suggesting that the Ca2+ originates from the same
      pool in each case. 6. At 35-36 degrees C, responses to graded levels of PO2 were
      also graded. Thresholds varied between cells, but were typically 30-50 mmHg.
      Stimulus-responses curves were essentially hyperbolic, increasing dramatically as
      the PO2 approached 0 mmHg. 7. The sensitivity of cells to hypoxic solutions was
      increased by acidification of the superfusate over the pH range from 7.3 to 6.85.
      8. Cell-attached patch clamp recordings showed depression of spontaneous action
      potentials associated with a rise in [Ca2+]i during exposure to anoxic solutions.
      Whole-cell recordings showed that anoxia increased a voltage-gated gK as
      described previously for CN-, while producing no change in resting conductance.
      9. These data suggest that the rise in [Ca2+]i originates largely from Ca2+
      efflux from a mitochondrial pool.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231421
TI  - Maturation of the cutaneomuscular reflex recorded from the first dorsal
      interosseous muscle in man.
AB  - 1. Cutaneous reflexes have been recorded from the first dorsal interosseous
      muscle following electrical stimulation of the digital nerves of the index finger
      in man. Recordings have been obtained from 127 children, aged from 3 to 18 years
      while each performed an isometric abduction of the index finger and whole hand
      grips. 2. In the adult, reflexes recorded while subjects performed an isometric
      abduction of the index finger consisted of three readily identifiable components
      within the first 100 ms. These were an initial short spinal latency increase in
      EMG (E1), followed by a decrease (I1), followed by a prominent longer-latency
      increase (E2) which was normally larger in size than the shorter-latency
      increase. 3. The configuration of the reflex changed during development. When
      recorded during an abduction, the E1 component was present in all children and
      showed a small but progressive reduction in size with age. With increasing age,
      both the I1 and E2 components were present in an increasing proportion of
      children and increased in size until the adult configuration was reached at 14-15
      years. 4. Comparison of reflexes recorded during sustained whole hand grips with
      reflexes recorded during an isometric index finger abduction revealed differences
      in all three components. When recorded during those grips used in the present
      study the E1 component was generally significantly larger while the I1 component
      was generally significantly smaller than when recorded during index finger
      abduction. At all ages the E2 component was significantly smaller when recorded
      during a grip. 5. The configuration of the reflex during an isometric index
      finger abduction was compared with the ability of the child to perform rapid
      finger movements. Those children who had no E2 component tended not to perform
      well in the tests of rapid finger movement. However, there was no simple
      relationship between the size of the E2 component and ability to produce rapid
      finger movements.

PMID- 2231420
TI  - Rabbit sino-atrial node cells: isolation and electrophysiological properties.
AB  - 1. A method has been developed for isolating calcium-tolerant, single rabbit
      sinoatrial node cells which maintain their natural shape following isolation. The
      majority of viable, spontaneously active cells were elongated and measured about
      100 microns in length. 2. Staining fixed cells with Haematoxylin-Eosin revealed
      that a 'cell' with projections was usually an aggregate of more than one cell. 3.
      Single, elongated, spontaneously active cells were current and voltage clamped
      using the whole-cell configuration of the patch-clamp recording technique. The
      spontaneous activity and time-dependent currents recorded were similar to those
      reported previously in multicellular nodal preparations and in single cells. 4.
      An assessment was made of the time course of L-type calcium current run-down: a
      stable period of between 10 and 20 min followed by a rapid run-down (over about 2
      min) was typically observed. 5. In most cells, a fast, TTX-sensitive Na+ current
      component was seen. A few cells showed a transient outward K+ current (iA). 6.
      The activation range for the hyperpolarization-activated current, if, varied from
      cell to cell. In the majority of actively beating cells, the threshold for if was
      near the maximum diastolic potential (about -65 mV in most cells) but in other
      cells, no if could be recorded within the pacemaker range. 7. Millimolar
      concentrations of MnCl2 caused a marked increase in if, but only when the pipette
      solution did not contain EGTA. Inclusion of EGTA (to buffer Ca2+ to about pCa 8)
      significantly reduced the effect of Mn2+ which therefore probably occurs through
      inhibition of Na(+)-Ca2+ exchange and consequent rise in intracellular Ca2+
      concentration.

PMID- 2231422
TI  - Mirror movements studied in a patient with Klippel-Feil syndrome.
AB  - 1. Electromyographic (EMG) recordings have been made from upper limb muscles in a
      patient with well-defined congenital mirror movements occurring in association
      with Klippel-Feil syndrome and the results compared to those obtained in normal
      control subjects. 2. In the patient, liminal percutaneous electrical or magnetic
      brain stimulation applied over either hemisphere elicited bilateral and
      symmetrical short-latency muscle responses in relaxed intrinsic hand muscles. In
      the normal subjects unilateral brain stimulation only elicited contralateral
      muscle responses. 3. F response and H reflex studies for the patient's ulnar
      supplied intrinsic hand muscles were normal. No crossed responses were recorded
      in the homologous muscles of the contralateral hand. 4. Scalp-recorded
      somatosensory-evoked responses following ulnar or median nerve stimulation were
      of normal latency and distribution in the patient. 5. In the patient, cross
      correlation analysis of on-going single and multiunit needle EMGs recorded
      between muscles of left and right hands revealed a central peak in the cross
      correlogram. No cross-correlogram peaks were found between left- and right-hand
      muscles in normal subjects. The magnitude and time course of the central peaks in
      the cross-correlograms constructed between the firing of motor units on opposite
      sides of the body in the patient were similar to those found in cross
      correlograms constructed between the firing of motor units from muscles on the
      same side of the body in the patient and in normal subjects. 6. The magnitude of
      cross-correlogram peaks detected within a muscle and those detected between left
      and right homologous muscles showed a gradient in which the largest peaks were
      found in the intrinsic hand and forearm extensor muscles. The smallest peaks were
      observed in the forearm flexor muscles. No peaks were detected between left and
      right biceps brachii muscles. In intrinsic hand muscles, the size of the cross
      correlogram peak detected between the EMGs of homologous muscle pairs was greater
      than that found for non-homologous muscle pairs. 7. Cutaneous reflex responses
      were recorded from first dorsal interosseous muscle following unilateral
      electrical stimulation of the digital nerves of the index finger. In the patient,
      this produced an early excitatory (E1) response on the stimulated side. Later
      excitatory (E2 and E3) responses, of approximately equal size and latency, were
      distributed bilaterally. In the normal subjects, reflex responses were confined
      to the stimulated side.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231423
TI  - Measurement of intracellular calcium and pH in avian neural crest cells.
AB  - 1. Intracellular pH (pHi) and calcium (Cai2+) were studied in freely migrating
      neural crest cells and in closely packed non-migrating cells derived from avian
      neural tubes in vitro, using the fluorescent dyes 2,3-dicyanohydroquinone (DCH)
      and Indo-1 to measure pHi and Cai2+ respectively. 2. In freely migrating crest
      cells the pHi was approximately 0.2 pH units more alkaline and Cai2+ 90 nM lower
      than in closely packed cells. 3. Experiments to establish the cellular mechanisms
      regulating pHi in isolated neural crest cells demonstrate the presence of Na(+)
      H+ exchange in 66% of the cells and Na(+)-HCO3(-)-dependent pHi-regulating
      mechanisms in all cells examined. 4. Interactions between pHi and Cai2+ were
      examined. pHi was altered using either NH4Cl pulses resulting in small changes in
      Cai2+ or using a weak acid and base (propionate and trimethylamine), which
      produced a fall and a rise in Cai2+ respectively. 5. Exposure to Ca2(+)-free
      media caused a lowering of Cai2+ and induced a transient acidification. 6.
      Application of BAPTA-AM (50 microM), a cell-permeant analogue of EGTA, resulted
      in a fall in Cai2+ and an intracellular acidification. 7. Co2+ and La3+ (2 mM)
      each induced a reversible fall in Cai2+ that was accompanied by intracellular
      acidification. These data suggest the presence of a transmembrane flux of Ca2+ in
      the resting cells. 8. It would appear that the mechanisms influencing Cai2+ and
      pHi are linked. This idea is discussed in terms of possible mechanisms and roles
      for Ca2+ and pH as modulators of neural crest cell behaviour.

PMID- 2231424
TI  - On the localization of the stretch reflex of intrinsic hand muscles in a patient
      with mirror movements.
AB  - 1. The patient studied showed the typical mirror movements of the Klippel-Feil
      syndrome. Earlier intensive electrophysiological analysis suggests that many of
      her corticospinal axons branch abnormally to supply motoneurones on both sides of
      the spinal cord. Thus, in her, a long-latency reflex utilizing the motor cortex
      should manifest itself bilaterally. 2. EMG recordings were made simultaneously
      from the first dorsal interosseous (FDI) muscles of both hands while they were
      being voluntarily activated by the subject. The FDI of one hand was then briefly
      stretched by forcibly adducting the index finger. Similar but more limited
      studies were made using flexor pollicis brevis. 3. The reflex response of the
      stretched muscle consisted of a typical mixture of early (M1) and late (M2)
      components, with mean latencies of 32 and 49 ms respectively. 4. Unlike normal
      controls, the contralateral muscle responded on stretch of the ipsilateral
      muscle. However, its response consisted solely of a long-latency reflex. This was
      comparable in size, latency and waveform to the ipsilateral late component. (Mean
      size, 84% of the ipsilateral M2 response; mean latency 46 ms, or 3 ms less than
      the ipsilateral response due to the absence of M1). 5. The short-latency response
      did not spread to the homologous contralateral muscle even when it was large
      ipsilaterally. The long-latency response elicited from FDI did not spread to the
      abductor digiti minimi muscle of either hand. 6. Reducing the duration of the
      stretch reduced the duration of the crossed response by an equivalent amount.
      Unloading the ipsilateral muscle produced a delayed reduction of EMG activity
      contralaterally. Thus her long-latency pathway can act tonically as well as
      phasically. 7. These findings strongly support the hypothesis that delayed
      components of the human stretch reflex are relayed via the motor cortex and the
      corticospinal tract.

PMID- 2231425
TI  - Neuronal activity in the lateral cerebellum of trained monkeys, related to visual
      stimuli or to eye movements.
AB  - 1. The responses of neurones in the lateral cerebellar cortex to visual stimuli
      and to eye movements were recorded in rhesus monkeys trained to perform visually
      guided arm and eye movements in a tracking task. 2. Twenty-two of 134 units
      recorded (16%) modulated their discharge in response to a bright Xenon flash.
      They were mainly located in the dorsal paraflocculus. Among those identified as
      Purkinje cells both simple spike and climbing fibre responses to the flash were
      seen. (72% of the units were related to arm movements; these were centred in the
      paramedian lobule, and have been described fully in Marple-Horvat & Stein
      (1987).) 3. The visual responsiveness of one of the units varied according to the
      phase of the monkey's task. Around the time that the target stepped, which was
      the monkey's cue to move, its sensitivity to other stimuli disappeared. 4. Only
      two neurones responded to the movements of the tracking target. These responses
      were conditional upon the monkey using visual signals to guide his movements;
      they did not respond to the target step if he moved before the target did. 5.
      Fourteen units (10%) located in crus I and II and lobulus simplex correlated
      strongly with the velocity of horizontal eye movements. Only one of these also
      responded to visual stimuli. 6. Thus most neurones were found to carry only
      visual, or eye movement, or limb movement information rather than combinations of
      these signals; they were located in different but overlapping regions of lateral
      cerebellar cortex. Visually responsive neurones are probably involved in planning
      the visual goal of movements, while eye and arm movement neurones probably help
      to create co-ordinative structures for executing voluntary eye and arm movements.

PMID- 2231426
TI  - Synaptic excitation of inhibitory cells by single CA3 hippocampal pyramidal cells
      of the guinea-pig in vitro.
AB  - 1. In simultaneous recordings from pairs of neurones in hippocampal slices from
      guinea-pigs, single action potentials fired by CA3 pyramidal cells could initiate
      inhibitory postsynaptic potentials (IPSPs) in nearby pyramidal cells. 2. The
      latencies of these IPSPs could be as short as 3 ms. However, they were mediated
      disynaptically via chemical, excitatory synapses, since inhibitory coupling was
      suppressed by an excitatory amino acid antagonist. 3. The properties of
      excitatory synapses made onto inhibitory cells were examined to assess the basis
      for this strong coupling. Inhibitory cells were identified either by showing that
      they inhibited another cell or by their characteristic firing pattern. 4.
      Excitatory postsynaptic potentials (EPSPs) elicited by single pyramidal cell
      action potentials had a mean amplitude of 1-4 mV and a time to peak of 1.5-4 ms.
      In most cases they decayed with a time constant similar to that of the inhibitory
      cell membrane. 5. EPSP amplitude increased with hyperpolarization of the
      postsynaptic membrane. Membrane polarization had little effect on EPSP shape. 6.
      EPSPs fluctuated in amplitude and transmission sometimes failed, suggesting
      transmission was quantal and that few quanta were released. 7. When presynaptic
      cells were made to fire bursts of action potentials, EPSPs in inhibitory cells
      were initially potentiated. 8. EPSPs could cause inhibitory cells to fire. The
      interval between pre- and postsynaptic spikes could be as short as 2.5 ms and the
      probability of spike transmission could be as high as 0.6. Some inhibitory cells
      which received feedback excitation were also excited in feedforward fashion by
      mossy fibre stimuli. 9. One pyramidal cell could activate several disynaptic
      inhibitory pathways terminating on another pyramidal cell. This suggests that
      excitatory synapses made by pyramidal cell axon collaterals onto inhibitory cells
      are divergent. 10. This strong, divergent excitation of inhibitory cells ensures
      recurrent inhibition is sufficiently widespread, rapid and potent to control the
      spread of activity by recurrent excitatory connections between CA3 pyramidal
      cells.

PMID- 2231427
TI  - Muscle injury, cross-sectional area and fibre type distribution in mouse soleus
      after intermittent wheel-running.
AB  - 1. It was previously noticed that mouse soleus, but not extensor digitorum longus
      (EDL) muscles, suffer fibre damage at the onset of voluntary wheel-running
      without further injuries thereafter. 2. In CBA/J mice trained continuously for 5
      months and rested for periods of 1, 2, 3, 4 and 5 weeks acute muscle damage was
      found in soleus 7 days after the resumption of wheel-running. On single cross
      sections damage was present on average in 8.7 +/- 3.5% (mean +/- S.D., n = 15) of
      the fibres, but only in 0.47 +/- 0.21% (n = 9) and 1.3 +/- 1.1% (n = 4) in
      control animals rested for 0-6 weeks after continuous running or in untrained
      controls. 3. Repeated muscle damage occurred when mice exercised for 4 days at
      intervals of 21-25 days, and after thirteen running episodes within 12 months
      marked changes in soleus, but not EDL muscles, were present. In cross-sections
      the total number of muscle fibre profiles was significantly larger in soleus of
      intermittent runners (768 +/- 68, n = 6; P less than 0.05), compared to
      continuous runners (676 +/- 54, n = 3) and sedentary animals (683 +/- 33, n = 4).
      This is probably due to incomplete repair which results in 'split fibres'. 4. At
      the same time total muscle fibre cross-sectional area was significantly elevated
      in intermittent runners (P less than 0.05), mainly due to increase in fibre
      diameters. Net cross-sectional areas were 0.59 +/- 0.069 mm2 (n = 6) in
      intermittent, 0.53 +/- 0.076 mm2 (n = 3) in continuous runners and 0.46 +/- 0.031
      mm2 (n = 3) in sedentary controls. 5. Tetanic and twitch force were also
      significantly elevated in soleus of intermittent runners while the ratio
      force/area remained the same. 6. There was an increase in the proportion of type
      I fibres in soleus from 75 +/- 0.9% (n = 4) in untrained controls to 90 +/- 4.4%
      (n = 6; P less than 0.05) in intermittent runners and 81 +/- 5.6% (n = 3; n.s.)
      in continuous runners. 7. Resistance to block of synaptic transmission in soleus
      was significantly higher in intermittent runners for two levels of curare,
      indicating enhanced safety margins. 8. EDL muscles in intermittent runners were
      not different from sedentary controls in any of the parameters studied. In
      particular, muscle fibres with signs of previous damage (split fibres, central
      nuclei) were rare (on average 0.5-0.6%) and equally frequent in all experimental
      groups.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231428
TI  - The frequency of isomerization-like 'dark' events in rhodopsin and porphyropsin
      rods of the bull-frog retina.
AB  - 1. The dark current and responses to dim flashes were recorded with the suction
      pipette technique from single rods in pieces of bull-frog retina taken from
      either the dorsal porphyropsin or the ventral rhodopsin field. 2. The composition
      of visual pigment in the rods was determined by microspectrophotometry. Rods from
      the dorsal pieces contained 70-88% porphyropsin523 mixed with rhodopsin502. The
      ventral rods contained almost pure rhodopsin, any possible admixture of
      porphyropsin being below the level of detectability (less than 5%). 3. In most
      cells, the responses to dim flashes were well fitted by a four-stage linear
      filter model, with no systematic differences in the response kinetics of
      porphyropsin and rhodopsin rods. The amplitude of saturated responses varied
      between 8 and 55 pA and that of responses to single isomerizations between 0.4
      and 3.5 pA. 4. In porphyropsin rods, discrete events similar to the response to
      one photoisomerization were clearly seen in complete darkness. The dark current
      amplitude histogram was fitted by a convolution of the probability densities for
      the Gaussian continuous noise component and the averaged dim-flash response
      waveform. This allows estimation of the frequency and amplitude of discrete
      events and the standard deviation of the continuous component. The mean frequency
      of discrete dark events thus obtained from six porphyropsin cells was 0.057 rod-1
      s-1 at 18 degrees C. 5. In rhodopsin rods, the dark current amplitude histogram
      appeared completely symmetrical, indicating that the frequency of discrete events
      must be lower than 0.005 rod-1 s-1 (except in one rod where it was 0.006 events
      rod-1 s-1). Per molecule of rhodopsin, the events are then at least 5 times rarer
      than reported for toad rhodopsin rods at the same temperature. 6. The low rate of
      isomerization-like 'dark' events in bull-frog rhodopsin rods shows, firstly, that
      results cannot be generalized across species even for rhodopsins which appear
      spectrally identical. Secondly, it suggests that these events need not (in an
      evolutionary sense) constitute an irreducible noise factor which must set the
      ultimate limit to the sensitivity of dark-adapted vision. 7. The difference
      between porphyropsin and rhodopsin rods shows that, given (presumably) the same
      opsin, the pigment utilizing retinal2 and absorbing maximally at longer
      wavelengths produces more noise. The signal/noise ratio attained in the
      photoreceptor may be an important factor in the natural selection of visual
      pigments.

PMID- 2231429
TI  - Nucleus tractus solitarius as mediator of evoked parabrachial cardiovascular
      responses in the decerebrate rabbit.
AB  - 1. The present study has assessed the importance of neurones within the nucleus
      tractus solitarius (NTS) in mediating the cardiovascular response evoked from the
      parabrachial nucleus (PBN) in the decerebrate rabbit. Microinjection techniques
      were employed so that the magnitude of the circulatory responses elicited from
      the PBN could be compared before, and after, kainic acid or bicuculline were
      microinjected into restricted regions of the NTS. 2. Electrical stimulation of
      the PBN (both medial and lateral regions) evoked variable changes in heart rate,
      a pressor response, vasoconstriction in the hindlimb and an increase in renal
      sympathetic nerve activity. Glutamate injected into these regions of the PBN
      elicited a similar pattern of response except that a tachycardia was observed
      consistently. 3. Both electrical and chemical stimulation of restricted regions
      of the NTS evoked bradycardia and a depressor response together with an increase
      in femoral vascular conductance and an inhibition of activity in the renal nerve.
      4. Chemical lesions placed in these regions of the NTS by microinjecting kainic
      acid were found to attenuate both the heart rate and arterial blood pressure
      responses elicited from sites in the medial and lateral PBN using either
      electrical or chemical stimulation. Equivalent effects were produced on
      microinjecting the GABAa receptor antagonist bicuculline into the NTS. 5. These
      data indicate that NTS neurones play a part in mediating the cardiovascular
      responses that are evoked from the PBN and suggest that the action of the PBN at
      the level of the NTS is mediated via a GABAergic mechanism.

PMID- 2231430
TI  - Characteristics of miniature inhibitory postsynaptic currents in CA1 pyramidal
      neurones of rat hippocampus.
AB  - 1. Recordings were made in vitro from chloride-loaded CA1 rat hippocampal
      pyramidal neurones in the presence of tetrodotoxin (TTX) to examine miniature
      inhibitory postsynaptic currents (IPSCs). 2. Most spontaneous synaptic events
      recorded before TTX was applied, and all events that were resolved in the
      presence of TTX, were blocked by the GABAA receptor antagonist bicuculline. 3. At
      25 degrees C, averaged miniature IPSCs had time to peak of about 3 ms and in most
      cases decayed with a single time constant close to 25 ms. 4. With a driving force
      for chloride ions between 70 and 80 mV, the mean miniature IPSC amplitude was
      19.6-27.9 pA, yielding a conductance of 258-326 pS. The mean amplitude of unitary
      IPSCs recorded before TTX was applied was in the range of 31-73 pA. 5. When
      intervals between miniature IPSCs were compared with an exponential distribution,
      there was an excess of events at intervals shorter than 5 ms. Some individual
      events appeared to represent the nearly simultaneous release of two inhibitory
      quanta. 6. Miniature IPSC amplitude distributions were better fitted with the sum
      of two Gaussians than with one Gaussian. The variance in amplitude of a single
      quantal event exceeded that of the baseline noise. 7. Comparison of the
      conductance changes corresponding to the first Gaussian distribution with single
      GABA channel data suggests that one inhibitory quantum opens twelve to twenty
      chloride channels and that GABA molecules bind once to a postsynaptic receptor.

PMID- 2231431
TI  - Effects of tension and stiffness due to reduced pH in mammalian fast- and slow
      twitch skinned skeletal muscle fibres.
AB  - 1. The pH dependence of the Ca2+ sensitivities of isometric tension and stiffness
      was investigated at 10 and 15 degrees C in skinned single fibres from rat and
      rabbit fast- and slow-twitch skeletal muscles. Stiffness was determined by
      recording the tension responses to sinusoidal length changes (3.3 kHz); peak-to
      peak amplitude of the length change was monitored by laser diffraction and
      averaged approximately 1.3 nm (half-sarcomere)-1. We have assumed that stiffness
      provides a measure of the number of cross-bridge attachments to actin. 2. At
      maximal Ca2+ activation, stiffness was depressed by 22 +/- 2% (mean +/- S.E.M.)
      in fast-twitch fibres but was unchanged in slow-twitch fibres when pH was lowered
      from 7.00 to 6.20. As reported previously, maximum tension was depressed by 20
      45% at low pH, with the effect being greater in fast-twitch compared to slow
      twitch fibres. 3. In fast-twitch fibres at 10 and 15 degrees C the Ca2+
      concentrations for half-maximal activation of tension and stiffness were
      increased at low pH. In slow-twitch fibres, similar effects were observed at 15
      degrees C, but at 10 degrees C there were no changes in the Ca2+ sensitivities of
      tension and stiffness when pH was lowered. 4. Linear relationships between
      relative tension and relative stiffness were obtained at all temperatures, with
      slopes of 1.04 +/- 0.01 at pH 7.00 and 0.76 +/- 0.01 at pH 6.20 in fast- and slow
      twitch fibres, indicating that force per cross-bridge attachment is similarly
      reduced at low pH in both types of fibres. 5. In both fast- and slow-twitch
      fibres, rigor tension (no added ATP or creatine phosphate; pCa 9.0) was depressed
      by 35 +/- 7% and stiffness by 12 +/- 4% when pH was reduced from 7.00 to 6.20.
      Since cross-bridge cycling is inhibited in rigor the effect of low pH to depress
      rigor tension suggests that pH directly modulates the strength of the bond formed
      between actin and myosin. 6. The effect of low pH to reduce the apparent number
      of cross-bridge attachments during maximal Ca2+ activation in fast- but not slow
      twitch fibres could account for the greater H(+)-induced depression of maximum
      force in fast-twitch fibres. In both fibre types, the decrease in the number of
      cross-bridge attachments at submaximal concentrations of Ca2+ may in part account
      for the loss in Ca2+ sensitivity of tension at low pH, due perhaps to a reduction
      in co-operative activation of the thin filament by bound cross-bridges.

PMID- 2231434
TI  - Assessment of the value of immunofluorescence microscopy in the diagnosis of oral
      mucosal lichen planus.
AB  - Accurate diagnosis of oral mucosal lichen planus (OMLP) is essential if
      appropriate management is to be instituted. Direct immunofluorescence microscopy
      (DIF) has facilitated the diagnosis of some dermatologic diseases with oral
      manifestations, but its use in the diagnosis of OMLP is less well documented. In
      the present study, 165 biopsies from consecutive cases for which a provisional
      diagnosis of OMLP was suggested clinically or on the basis of routine
      histopathologic, or DIF assessment were studied. In 27 cases the results of DIF
      were non-contributory. In 13 cases the diagnosis could only be established by DIF
      examination. Nine cases clinically diagnosed as OMLP were assigned to a different
      condition on the basis of routine histology and DIF. It was concluded that DIF
      was an integral step in the diagnosis of OMLP.

PMID- 2231432
TI  - pH modulation of the kinetics of a Ca2(+)-sensitive cross-bridge state transition
      in mammalian single skeletal muscle fibres.
AB  - 1. The rate constant of tension redevelopment (ktr) following a rapid release and
      subsequent re-extension of muscle length has been demonstrated to be Ca2+
      sensitive and is thought to reflect the rate-limiting step in the cross-bridge
      cycle leading to the formation of the strongly bound, force-bearing state. The
      kinetics of this cross-bridge state transition were investigated at 15 degrees C
      over a wide range of Ca2+ concentrations while varying pH from 7.00 to 6.20 in
      rat slow-twitch soleus, rat fast-twitch superficial vastus lateralis (SVL) and
      rabbit fast-twitch psoas skinned single fibres. 2. At maximal levels of Ca2+
      activation, ktr was unaffected by changes in pH from 7.00 to 6.20 while isometric
      tension was depressed to 0.60 +/- 0.02 P0 (mean +/- S.E.M.) at the low pH in fast
      twitch fibres and to 0.78 +/- 0.01 P0 in slow-twitch fibres (P0 is the maximum
      isometric tension obtained at pH 7.00). 3. At reduced levels of Ca2+ activation,
      corresponding to pCa (-log [Ca2+]) greater than 5.0, ktr was markedly depressed
      in all fibre types when pH was lowered. The Ca2+ sensitivity of steady-state
      isometric tension was also reduced in all fibres at pH 6.20 compared to pH 7.00.
      4. The results suggest that pH has a modulatory effect upon an apparent rate
      constant which is rate limiting in terms of the formation of the strongly bound,
      force-bearing cross-bridge state. This effect of altered pH may in part account
      for the reduction in the Ca2+ sensitivity of isometric force at low pH as well as
      the depression of the rate of rise of tension in living fibres during fatiguing
      stimulation.

PMID- 2231433
TI  - Oxytocin excites gastric-related neurones in rat dorsal vagal complex.
AB  - 1. Dorsal medullary injections of oxytocin (OT) influence gastric motor and
      secretory function via a vagally mediated mechanism. Thus, it was hypothesized
      that OT altered the firing rate of brain stem vagal neurones that were
      specifically related to gastric function. 2. To study this, glass
      microelectrode/injection pipette arrays were used to record the activity of
      gastric-related neurones in the dorsal vagal complex (DVC), which includes vagal
      sensory neurones in the nucleus tractus solitarius (NTS) and motor neurones in
      the dorsal motor nucleus (DMN). After identifying such a neurone, spontaneous
      activity was monitored before and after micropressure injection of OT and vehicle
      solutions from the pipettes. 3. Two methods were used to identify neurones that
      were related to gastric function. One method employed a gastric balloon to
      identify DVC neurones that were responsive to gastric inflation. The second
      method employed a gastric vagal stimulating electrode, which permitted the
      identification of gastric-related NTS and DMN cells via orthodromic or antidromic
      activation, respectively. 4. Twenty-four of forty-two gastric-inflation-related
      neurones responded to administration of OT (100-400 fmol in 100-400 pl). The
      majority of those responding to OT were activated by this peptide (21/24). All
      the cells tested (n = 13) remained sensitive to gastric inflation after
      administration of OT. Also, OT was found to excite the majority of cells that
      were identified as gastric-related NTS (nine excited; one no effect) or DMN cells
      (eleven excited; two no effect). 5. These studies support the hypothesis that
      central oxytocinergic neurones influence gastric motility and secretion by
      increasing the excitability of central vagal neurones in the NTS and DMN that are
      related to gastric function.

PMID- 2231435
TI  - A transforming Kirsten ras oncogene in an oral squamous carcinoma.
AB  - This investigation has employed the NIH 3T3 cell transfection assay in an effort
      to detect transforming genes in DNA from squamous carcinomas of the head and
      neck. Of 11 tumor DNAs tested, 1 DNA sample from a gingival squamous carcinoma
      was able to produce primary and secondary transformants containing the human K
      ras oncogene. This is the first report of an activated ras oncogene derived from
      a carcinoma of the head and neck. Head and neck cancers may possess activated ras
      oncogenes more often than is indicated by this study because of the relative
      inefficiency of transfection assays in detecting large transforming genes such as
      K-ras.

PMID- 2231436
TI  - Effect of cannabis use on oral candidal carriage.
AB  - The effects of cigarette smoking on oral candidal carriage and candidosis have
      been well documented but few similar studies on cannabis smoking have appeared,
      therefore it was felt that such a study needed to be undertaken. In this
      investigation, the effect of cannabis smoking combined with methaqualone and
      tobacco on candidal prevalence, density and candidosis was examined in 55 users.
      Age and sex matched tobacco-smoking (n = 58) and non-smoking controls (n = 50)
      were examined similarly. The imprint culture technique was used for harvesting
      Candida. Results showed an increased prevalence and density of C. albicans in
      cannabis users while there was no apparent difference in the prevalence of
      candidiasis. However, two subjects presented with oral multifocal candidiasis.

PMID- 2231438
TI  - In vivo effects of Candida albicans products on rat oral epithelium.
AB  - Candida albicans has been associated with epithelial hyperplasia in some diseases
      of oral mucosa and skin but its etiologic role in these lesions is poorly
      understood. To test its ability to induce epithelial proliferation, the invasive
      hyphal form was cultured for 5 h and 23 h in chemically defined medium and yeast
      free culture supernatants were injected below the buccal epithelium of young
      adult Sprague Dawley rats. The mitotic activity was assessed using the metaphase
      arrest technique 11 h and 31 h after supernatant injection. There was a
      significant increase in epithelial mitotic activity 31 h after injection with 5 h
      culture supernatants compared to control media indicating that the supernatants
      have an effect on epithelial cells, possibly by direct action on them.

PMID- 2231437
TI  - Orofacial manifestations from accidental exposure to caesium 137 in Goiania,
      Brazil.
AB  - The accidental close exposure of over 200 adults and children to a caesium-137
      (137Cs) source in Goiania, Brazil in 1987 produced significant short-term
      morbidity in about 50 patients, and four deaths within a few weeks. Some 57% of
      those maximally exposed to radiation, developed orofacial lesions, notably
      purpura, spontaneous bleeding, ulcers and/or acute candidiasis. These lesions
      were probably mainly the consequences of depression of bone marrow elements by
      the radionuclide. Though the oral lesions that may follow iatrogenic exposure to
      ionizing radiation are well recognized this appears to be the first report on the
      oral sequelae of a serious radiation accident.

PMID- 2231439
TI  - Additional funding for AIDS drugs.

PMID- 2231440
TI  - Situational instruction: teaching students with care.

PMID- 2231441
TI  - Your CE topic (No. 49). Breastfeeding and medications: an update (Part II).

PMID- 2231442
TI  - Peaceful patient.

PMID- 2231443
TI  - Baloney bologna.

PMID- 2231444
TI  - Preceptorship: socialization of students into the world of work.

PMID- 2231445
TI  - Bell's palsy. Signs, symptoms, outcomes.

PMID- 2231447
TI  - Combination intraoral and extraoral maxillofacial prostheses retained by
      osseointegrated implants placed in previously irradiated bone: a clinical report.

PMID- 2231446
TI  - Use of a sectional prosthesis following partial maxillary resection. A clinical
      report.

PMID- 2231448
TI  - Advantages and limitations in the use of porcelain veneer restorations.
AB  - Porcelain veneer restorations including preparations, impression materials, cast
      materials, refractory casts, handling of porcelain, the try-in, and the final
      luting are discussed. Techniques are described to increase marginal accuracy,
      establish predictable natural polychromatic color within the porcelain, establish
      good contours and surface textures, and shorten final placement time. Tooth
      preparation is routinely recommended, as is the combination of epoxy dies,
      refractory casts, and anatomic buildup techniques. Emphasis is placed on a close
      working relationship and communication among the dentist, dental technician, and
      patient.

PMID- 2231449
TI  - Stress distribution surrounding endodontic posts.
AB  - This study compared the stress distribution during insertion and function of
      three prefabricated endodontic posts with different designs using the criteria of
      post length and diameter. Test blocks of photoelastic material were prepared with
      simulated endodontic canals. Three posts for each design, diameter, and depth
      were cemented. Each specimen was examined and photographed without load, with 135
      Newton (N) compressive force, and with 90 N and/or 135 N oblique force applied at
      26 degrees by use of a circular polariscope. Para-Post and Para-Post Plus posts
      produced similar, evenly distributed patterns of stress using the criteria of
      diameter, depth, and load. Flexi-Post posts produced asymmetric stress patterns
      with concentration of stress at each thread. During compressive loading and after
      cementation alone, Flexi-Post posts displayed significantly higher shoulder
      stresses and substantially greater stresses along the coronal surface of the
      post's length than Para-Post and Para-Post Plus posts. Apical stresses were
      similar for Flexi-Post, Para-Post, and Para-Post Plus posts during compressive
      loading.

PMID- 2231450
TI  - Effect of post adaptation on fracture resistance of endodontically treated teeth.
AB  - This study determined the effect of different post designs and varying amounts of
      post-to-canal adaptation on the fracture resistance of endodontically treated
      teeth. Forty freshly extracted maxillary central incisors were endodontically
      treated. Groups of 10 teeth were prepared according to four experimental designs.
      Cast post and cores and crowns were waxed, cast, and luted with zinc phosphate
      cement on a static loading device. The teeth were embedded in acrylic resin and
      the crowns were loaded on a universal testing machine at 130 degrees to the long
      axis of the tooth until failure. Maximum adaptation of the residual root
      structure with a tapered post significantly increases the fracture resistance of
      endodontically treated teeth, but upon failure renders the tooth nonrestorable.
      Tapered posts resulted in fractures that were directed more apically and
      lingually. Parallel-sided posts had a lower frequency of fracture upon failure,
      involving less tooth structure. Parallel-sided posts surrounded by large amounts
      of cement had no significant effect on failure loads.

PMID- 2231451
TI  - Three-dimensional color coordinates of natural teeth compared with three shade
      guides.
AB  - The three-dimensional color coordinates of 2832 human teeth were measured in vivo
      and were plotted in a cylindrical Hue, Value/Chroma space, using a program in
      BASIC. The commonly used Vita, and Bioform shade guides, and a surviving shade
      guide of E. B. Clark were compared with these natural teeth. The shade guides did
      not match well with the color space of the human teeth, and the anticipated
      deficiencies were in the yellow-red Hues, higher Values, and higher Chromas.
      However, the points for natural teeth were in a narrow flounder-like
      configuration, suggesting that a representative shade guide matching natural
      teeth could be generated with limited samples.

PMID- 2231452
TI  - Occlusion for the Class II jaw relations patient.
AB  - Each patient with a small mandible presents an occlusal pattern that differs from
      most of the criteria established for a class I occlusion. The components of a
      class II occlusion are unlike other occlusions. The anterior teeth do not provide
      the protection and guidance normally provided by horizontal and vertical overlap.
      The posterior teeth bear the full force of occlusion. Protrusive movement is the
      dominant and the most used movement. The posterior teeth must function from
      centric relation forward to an anterior separation. Most of the posterior teeth
      exhibit balancing contacts. This occlusion is a type of bilateral balanced
      occlusion. Greater interocclusal clearance must be provided and tested for
      adequacy of space during speech and function. A class II occlusion is a most
      exacting occlusion. The controlling factors are the posterior determinants of
      occlusion.

PMID- 2231453
TI  - Prosthodontic rehabilitation of patients with Class II malocclusions.
AB  - The Angle's class II malocclusion patient challenges the prosthodontist because
      optimal treatment may include orthodontic therapy, orthognathic surgery,
      periodontics, and fixed or removable prosthodontics. Compromises in the treatment
      plan are necessary when patients cannot accept optimal dental treatment. However,
      specific prosthodontic principles should be observed. This article discusses
      Angle's class II malocclusions, including the theories and therapies to treat
      patients with this malrelationship successfully. Prosthodontic management of the
      malocclusion is an adjunct to other care rendered.

PMID- 2231454
TI  - Clinical implications of the response of enamel and dentin to masticatory loads.
AB  - The success of restorative procedures is dependent on comprehension of the
      responses of enamel and dentin, including responses to masticatory forces. The
      regional variation resulting from masticatory forces is critical because
      clinically it relates to the thickness of enamel and dentin occlusogingivally.
      Three-dimensional finite element models of an intact mandibular molar were
      developed to analyze stresses in enamel and dentin occlusogingivally,
      buccolingually, and mesiodistally. There were dramatic regional variations in the
      magnitude and character of different stresses caused by masticatory forces, and
      despite being organically "bonded," enamel and dentin responded independently.
      This unique behavior with regional variations of these tissues could have serious
      clinical implications during restorative procedures.

PMID- 2231455
TI  - Temperature changes during the finishing of amalgam restorations.
AB  - The finishing and polishing of amalgam restorations may be harmful to the pulp
      because of the heat generated during these procedures. In this study, changes in
      temperature of the pulp in extracted teeth were determined in vitro. During the
      polishing procedure, a variety of instruments were used under a variety of
      circumstances: with or without a water coolant, intermittent or continuous
      operation, high or low rotation speed, and high or low pressure. Finishing or
      polishing without a water coolant always increased the temperature of the pulp.
      When the pressure was high, during continuous polishing, or during a higher
      velocity of rotation, pulpal temperatures increased more than 20 degrees C within
      30 seconds. However, when a water coolant was used, a decrease in the temperature
      was always observed. Procedures carried out with low pressure showed a decrease
      in the pulpal temperature of approximately 9 degrees C. High pressure decreased
      the temperature of the pulp by only 4 degrees C. Therefore a water coolant is
      always advised when amalgam restorations are being finished and polished.

PMID- 2231457
TI  - Gravity-induced stresses by an obturator prosthesis.
AB  - Recontruction after surgical resection of tumors of the maxillae and paranasal
      sinuses is difficult. In addition to the intermittent forces encountered during
      function, the prosthesis is subjected to the constant force of gravity. This
      investigation photoelastically studies the gravity-induced stresses transmitted
      to the remaining oral structures by various obturator prosthesis framework
      designs. Frameworks which used I-bar and circumferential retainers with buccal
      retention were most severe, while the swinglock and light wire retainers were
      intermediate in generated stress.

PMID- 2231456
TI  - A study of the importance of the neutral zone in complete dentures.
AB  - Mastication, comfort, and speech were determined and compared for patients using
      conventional complete dentures and dentures made with the neutral zone concept.

PMID- 2231458
TI  - Modification of osseointegrated implants for distal-extension prostheses.
AB  - The use of a distal implant abutment splinted to a natural tooth by a fixed
      partial denture has been employed for distal-extension prostheses. There is a
      differential difference between the viscoelastic deflection of a natural tooth by
      its periodontal ligament, and the almost negligible elastic deformation of an
      osseointegrated implant. This difference may induce a fulcrum-like effect and
      overstress the implant. In this study a new modification of osseointegrated
      implants was proposed to counteract this problem. This modification was achieved
      by using a resilient layer material under the superstructure of the implant.
      Finite element modeling (FEM) was used to examine stresses and displacement
      distribution around a commercially available implant and one experimental implant
      with a resilient layer material. The results of this study showed that the new
      modification is a simple and efficient way to mimic the structural natural tooth
      unit. It also showed that it allowed movement of the superstructure without
      movement of the implant three times that of the nonresilient model.

PMID- 2231459
TI  - A survey of dentists practicing implant dentistry in Israel.
AB  - Due to the increasing interest in the field of implant dentistry, a first survey
      of dentists in Israel who used implants was conducted. Out of a total of 312
      dentists questioned, 97 reported using dental implants in their practice. In
      spite of the team approach advocated in the literature, 40% of the dentists in
      the survey conducted both the surgical and the prosthetic phases of treatment.
      Over 60% of the respondents had less than 3 years' experience in the field, which
      is in keeping with the worldwide trend. A smaller number than expected regarded
      red gingival color and bone resorption based on radiographic findings as grounds
      for implant failure. In the view of at least 10 respondents, pain, discomfort,
      exudate, and fistulization did not indicate unsuccessful implants. A disparity
      was revealed between the dentists' practice methods and their hypothetical choice
      of self-treatment. Although the Core-Vent method was the most widely employed,
      only 50% of those using this system preferred it for themselves. Even fewer (25%)
      of those using blade implants considered it their self-treatment of choice. In
      contrast, although only 10% of the dentists had used the Branemark method, 30%
      preferred it for their own treatment.

PMID- 2231460
TI  - Anterior guidance: group function/canine guidance. A literature review.
AB  - Anterior guidance, which can be categorized as group function or canine guidance,
      is essential for esthetics, phonetics, and mastication. This article reviews the
      historical development and philosophies of both occlusal schemes. There is no
      scientific evidence that supports one occlusal scheme over the other. Where
      anterior guidance must be reestablished or where it changes, there currently
      appear to be more authorities who favor canine guidance over group function.

PMID- 2231461
TI  - The rotational aspect of mandibular flexure.
AB  - A rotational aspect to mandibular flexure has been demonstrated by means of
      photographic comparisons. The importance of this movement in relation to anatomic
      considerations, periodontal therapy, restorative dentistry, and implant-supported
      prostheses, is discussed.

PMID- 2231462
TI  - Psychologic facets of esthetic dental health care: a developmental perspective.
AB  - A developmental perspective is presented to explore dental health and esthetics
      in dentistry and to describe the specific ways human behavior and various aspects
      of esthetic health care interrelate. An investigation of the fascinating links
      between mind and mouth over the life cycle are elucidated to explain how and why
      the oral cavity is so psychologically important. Clinical examples of how
      personality factors can influence dental treatment and its outcome are
      illustrated.

PMID- 2231464
TI  - Dental laboratory work authorization forms: a survey.
AB  - Dental laboratory work authorization forms embrace a diversity of material
      content and design. This survey examined 51 dental laboratory work authorization
      forms and delineated each content item and format features into a frequency
      percentage. This information has a high potential for use in changing prospective
      dental laboratory and authorization form design.

PMID- 2231463
TI  - Effect of retention grooves on tooth-denture base bond.
AB  - The bond strength of acrylic resin teeth with and without retention grooves
      processed onto standard and high-impact denture base resin was investigated. A
      shear compressive force was applied at an angle of 130 degrees to the lingual
      surface of the teeth until fracture occurred. The values were subjected to a two
      way analysis of variance with repeated measures. Canine teeth bonded better than
      central or lateral incisors (p less than 0.01). A significantly greater force was
      required to fracture teeth from high-impact resin (p less than 0.01). Vertical
      retention grooves enhanced bond strength (p less than 0.01).

PMID- 2231465
TI  - A prosthesis to control microstomia.

PMID- 2231466
TI  - Mesiolingual amalgam rest seat for a mandibular canine.

PMID- 2231467
TI  - The diagnosis of extracapsular craniomandibular disorders.

PMID- 2231468
TI  - The effect of powder/water ratio of irreversible hydrocolloid on the bond
      strength of irreversible hydrocolloid and agar combinations.

PMID- 2231469
TI  - A provisional and new crown to fit into a clasp of an existing removable partial
      denture.

PMID- 2231470
TI  - Experimental studies on thallium toxicity in rats. II--The influence of several
      antidotal treatments on the tissue distribution and elimination of thallium,
      after subacute intoxication.
AB  - The influence of several antidotal treatments--e.g. Prussian Blue + Furosemide,
      Furosemide, activated Charcoal, Potassium Chloride and Potassium Iodide--on the
      tissue distribution and elimination of thallium after subacute intoxication is
      studied. From these experiments, the fate of electrolytes (Na+, K+, Cl-) may be
      evaluated. It was established that the efficacy of an antidotal treatment in
      thallium intoxication may be judged not only by the determination of its ability
      to interfere in the reabsorption and redistribution of thallium. Prussian Blue
      was the only antidotal that did not cause such a dangerous redistribution.

PMID- 2231471
TI  - [The anti-implantation effects of various savine extracts on the pregnant rat].
AB  - Ether and ethyl acetate extracts obtained after savin essential oil extraction,
      were administered, on days 1 to 4, to pregnant rats by intragastric catheter, at
      doses of 0, 50 or 150 mg/Kg, to search for their possible effects on
      implantation. The ethyl acetate extract was not toxic. Inversely, the ether
      extract was responsible for a dose-dependent anti-implantation effect, thus
      showing that essential oil is not alone responsible for the abortive effect
      generally attributed to Savin.

PMID- 2231472
TI  - [Phenytoin and the popliteal lymph node test in the Sprague-Dawley rat].
AB  - The detection of xenobiotics which the potential to induce autoimmune reactions
      is currently hardly possible. The popliteal lymph node assay initially developed
      in mice may prove useful in this regard. Results obtained with phenytoin in
      Sprague Dawley rats are presented. Single doses of phenytoin were injected into
      one hind footpad and the popliteal lymph node was excised and weighed 3, 7 or 10
      days after injection. Only the 5 mg dose level produced a significant increase in
      popliteal lymph node weight, structural and cellular changes in the lymph node
      indicating a humoral stimulation was noticed in the males at 2 mg and in the
      males and females at 5 mg. These results warrant further progress in the
      development of this assay.

PMID- 2231473
TI  - [The Stevens-Johnson syndrome from maprotiline and propranolol?].
AB  - A wide variety of agents have been associated with erythema multiforme,
      particularly drugs and infectious agents. We describe a typical Stevens-Johnson's
      syndrome developing 15 days after initiation of propranolol and maprotiline
      therapy. Other etiologies have been excluded by appropriate investigations and
      the responsibility of each drug is discussed.

PMID- 2231475
TI  - Functional correlates of characteristic frequency in single cochlear nerve fibers
      of the Mongolian gerbil.
AB  - Single-unit recordings obtained from the auditory nerve of the Mongolian gerbil,
      Meriones unguiculatus, revealed functional differences in the response properties
      of neurons tuned to low and high frequencies. The distribution of neural
      thresholds displayed a distinct rise for auditory nerve fibers with
      characteristic frequencies (CFs) between 3-5 kHz. This frequency band also marked
      abrupt changes in both the distribution of spontaneous discharge rates and the
      shape of the neural tuning curve. For neurons of all CFs, spontaneous firing
      rates were inversely related to neural threshold but unrelated to sharpness of
      neural tuning. The range of CF thresholds encountered, even when data from many
      animals were combined, rarely exceeded 20 dB, suggesting that cochlear nerve
      responses obtained from this species display little inter-animal variability.
      These results are compared with similar data from other species and discussed in
      terms of recent studies on sound communication and cochlear anatomy in gerbils.

PMID- 2231474
TI  - Olfactory interneurons in the brain of the larval sphinx moth Manduca sexta.
AB  - 1. The physiology and morphology of olfactory interneurons in the brain of larval
      Manduca sexta were studied using intracellular recording and staining techniques.
      Antennal olfactory receptors were stimulated with volatile substances from plants
      and with pure odorants. Neurons responding to the stimuli were investigated
      further to reveal their response specificities, dose-response characteristics,
      and morphology. 2. We found no evidence of specific 'labeled-lines' among the
      odor-responsive interneurons, as none responded exclusively to one plant odor or
      pure odorant; most olfactory interneurons were broadly tuned in their response
      spectra. This finding is consistent with an 'across-fiber' pattern of odor
      coding. 3. Mechanosensory and olfactory information are integrated at early
      stages of central processing, appearing in the responses of some local
      interneurons restricted to the primary olfactory nucleus in the brain, the larval
      antennal center (LAC). 4. The responses of LAC projection neurons and higher
      order protocerebral interneurons to a given odor were more consistent than the
      responses of LAC local interneurons. 5. The LAC appears to be functionally
      subdivided, as both local and projection neurons had arborizations in specific
      parts of the LAC, but none had dendrites throughout the LAC. 6. The mushroom
      bodies and the lateral protocerebrum contain neurons that respond to olfactory
      stimulation.

PMID- 2231476
TI  - Analysis of associative learning in the terrestrial mollusc Limax maximus. II.
      Appetitive learning.
AB  - The odor and taste processing systems of the terrestrial mollusc Limax maximus
      have been shown capable of a number of complex computations. Most of the complex
      higher-order features of Limax learning have been demonstrated using differential
      aversive conditioning. The present experiments probe the appetitive learning
      ability of Limax. In the first experiment a differential appetitive classical
      conditioning procedure was used. An aversive CS+ odor was paired with an
      attractive taste while a CS- odor was explicitly unpaired with the attractive
      taste. This appetitive conditioning procedure dramatically increased the
      preference for the CS+ odor. Further experiments determined the time course of
      acquisition, the effect of an extinction procedure and long-term retention of the
      appetitive conditioning. Now that Limax has been shown capable of appetitive
      conditioning, the neural network simulation of Limax learning, called LIMAX, can
      be examined for its ability to display appetitive conditioning.

PMID- 2231477
TI  - Evoked pre- and post-synaptic activity in the optic tectum of the cannulated
      tadpole.
AB  - We describe the cannulated Rana pipiens, tadpole preparation that allows for
      stable recording in the tectum of the extracellular potential elicited by optic
      nerve stimulation. The largest components of the evoked tectal response consist
      of two previously identified waves and a major third, long-latency wave of long
      duration. These components were reversibly eliminated by perfusion of high
      magnesium/no calcium Ringer's solution or Ringer's solution containing cobalt
      chloride. In contrast, perfusion of high calcium/no magnesium Ringer's increased
      the amplitude and area of these components. We conclude that these components
      represent post-synaptic activity. Additionally, small, short-duration waves were
      identified as arising from the activity of retinal afferents. They consisted of a
      short-latency (3.1-7.6 ms) and a long-latency (12-23 ms) group. Waves belonging
      to both of these classes were still visible in both high magnesium/no calcium
      Ringer's solution or Ringer's solution containing cobalt chloride and were
      unaffected by high calcium/no magnesium Ringer's. The average conduction
      velocities of the short- and long-latency groups matched the conduction
      velocities of, respectively, edge and convexity detectors in the adult. This
      indicates that retinal afferent input may already be present in adult patterns at
      the time that tectal circuitry is developing.

PMID- 2231478
TI  - Reference in single sentences and in texts.
AB  - This study investigated the comprehension and production of reference terms in
      both sentences (Experiments 1 and 2) and texts (Experiments 3 and 4) using a
      sentence completion task. In Experiments 1 and 2, the use of a sentence-level
      strategy (subject assignment) was investigated. In Experiments 3 and 4, the use
      of a text-level strategy (topic assignment) was also investigated. There was a
      clear preference for continuing the sentences by referring to the subjects of the
      sentences regardless of the availability of gender cues, in both single sentences
      and in texts. There was also an influence of the topic of each text on both the
      choice of referent and the type of reference term used. However, the choice of
      reference term was affected by the number of potential antecedents in the
      preceding text. Overall, the results suggest that the sentence subject is a
      salient item in working memory. This salience is increased if the sentence
      subject is also the textual topic. In addition, it appears that the presence of a
      pronoun in a text triggers a specific strategy to assign the pronoun to the
      (salient) sentence subject.

PMID- 2231479
TI  - Conversational time patterns and mutual influence in parent-child interactions: a
      time series approach.
AB  - Mutual influencing processes are assumed to be the basic building blocks in
      establishing parent-child bonding and in influencing cognitive and language
      behavior. A study by Jasnow and Feldstein (1986) revealed that, within the
      temporal domain of speech, preverbal (9-month-old) infants and their mothers
      exhibit a pattern of mutual influence (attunement) in their average durations of
      switching pauses. The general purpose of this research was to extend those
      findings to children with higher verbal functioning. In addition, parent and
      child genders, nature of the interaction, and specific aspects of parents'
      personalities, expressiveness, and instrumentality were considered. Each parent
      interacted with their 4- or 5-year-old son or daughter in each of two
      conversations--unstructured (social conversation) and structured (task activity).
      Conversations were processed by an automated computer system yielding objective
      measure of turns, vocalizations, pauses, and switching-pause durations. To
      examine interspeaker influence of attunement of temporal speech patterns,
      "influence coefficients" were computer for each speaker on a "turn-by-turn" basis
      using time series regression. Analysis of these coefficients revealed that: (1)
      Mutual influence is most evident with switching-pause duration. (2) Structure in
      the conversation (as defined by the task or parental instrumentality) seems to
      facilitate attunement for vocalization and switching pause duration. (3)
      Attunement with girls seems to occur equally well with both parents, while boys
      exhibit a style of temporal patterning influence which suggests greater
      identification with the father. (4) Expressiveness seems to facilitate attunement
      to the child's switching-pause duration.

PMID- 2231480
TI  - The use of heuristic strategies in the interpretation of pronouns.
AB  - The aim of the two experiments reported here was to distinguish between two
      heuristic strategies that have been proposed to account for the assignment of
      pronouns: the subject assignment strategy and the parallel function strategy.
      According to the subject assignment strategy, a pronoun is assigned to a
      preceding subject noun phrase, whereas according to the parallel function
      strategy, a pronoun is assigned to a previous noun phrase in the same grammatical
      position as the pronoun. These two strategies were tested by examining the
      interpretation of single object pronouns, first in a reading task and second in
      an assignment task. In both experiments, there was a strong preference for
      assigning an object pronoun to the preceding subject noun phrase, thus supporting
      the subject assignment strategy. However, this was only the case for pronouns
      that were linguistically ambiguous. When assignment was constrained by gender,
      there was no effect of either strategy. It is suggested that heuristic strategies
      are only used in the absence of other strong cues to assignment.

PMID- 2231481
TI  - Physical symptom severity, psychological and social dysfunction in a series of
      outpatients with irritable bowel syndrome.
AB  - Details of physical symptoms, psychological and social dysfunction of 42
      outpatients diagnosed as having irritable bowel syndrome (IBS) were collected by
      interview and questionnaire. Social stresses and problems were also elicited as
      well as the impact of symptoms on their subjects' daily lives. High proportions
      of subjects were handicapped in their social, sexual and working lives by IBS
      symptoms and social stresses and problems were common. Forty-eight per cent were
      classified as having a 'minor psychiatric illness' using the Clinical Psychiatric
      Interview. Women were more severely affected by physical symptoms (with the
      exception of diarrhoea) and were more likely to be in pain longer and for more
      days in the month. They were also more likely than men to be diagnosed as having
      a psychiatric illness.

PMID- 2231482
TI  - Effects of temporary withdrawal from regular running.
AB  - Forty regular male runners were divided into two similar groups and studied for
      six weeks. One group continued normal running, but the other stopped running for
      the middle two weeks of the study. Questionnaires were completed at the end of
      each week. Symptoms of depression were greater in the withdrawn than in the
      control group at the end of the second week of withdrawal. Somatic symptoms,
      anxiety, insomnia and feelings of being under strain were greater in the
      withdrawn group after both the first and second weeks of withdrawal. The groups
      did not differ in the final two weeks, when running had been resumed. These
      effects strengthen the view that stopping regular physical exercise produces a
      'withdrawal syndrome', and that exercise might therefore be regarded as
      addictive. The increase in depression may reflect a more gradual loss of the
      antidepressive effect of exercise training.

PMID- 2231483
TI  - Cultural factors in the eating disorders: a study of body shape preferences of
      Arab students.
AB  - A replication of an American study of body shape preference was conducted in a
      group of 218 Arab students attending the American University in Cairo, Egypt.
      Arab female students felt their ideal shape to be significantly thinner than
      their current shape, while male students did not. Hence the appraisal of body
      shape shows gender differences in Egypt consistent with the American study. The
      Arab women reported a current shape similar to American women but had a smaller
      discrepancy between ratings of their ideal and current body shape. There was no
      difference for either Arab women or men between the shape thought most attractive
      to the opposite sex and that which the other gender actually reported as most
      attractive. The study shows a clear preference for thinness in the Arabic
      culture, inferences are made to its role in predisposing to eating disorders.

PMID- 2231484
TI  - Motivational factors in women requesting augmentation and reduction mammaplasty.
AB  - This study confirms that women requesting breast reduction and breast
      augmentation differ beyond the anatomical. There were significantly more single
      and co-habiting women in the breast reduction group, and significantly more
      separated and divorced women in the breast augmentation group, compared to women
      attending an obstetric clinic. The majority of women requesting surgery agreed
      that to feel more confident was an important reason for seeking surgery, but
      those requesting breast augmentation also stressed the need to feel more feminine
      and less shy with men. A significantly higher percentage of the breast
      augmentation group had been pregnant, and they had a higher average number of
      pregnancies than the obstetric comparison group, together with a significantly
      higher experience of miscarriage. The psychodynamic proposal that women
      requesting breast augmentation are seeking to symbolically boost their sense of
      femininity and womanliness is supported by this study.

PMID- 2231485
TI  - Education, lifestyle and arterial blood pressure.
AB  - Lower education is associated with higher blood pressure and mortality from
      cardiovascular disease. Reasons for this are explored in this paper. It is
      hypothesized that education is most important as a risk factor for high blood
      pressure to the extent that an individual's style of life is incongruent with his
      or her education. Style of life is defined here on the basis of the accumulation
      of consumer goods and exposure to mass media. It was found, in a study of blood
      pressure in an African-American community, that lifestyle incongruity, or the
      degree to which style of life exceeded education, was associated with higher
      systolic and diastolic blood pressure, adjusting for age, sex, Body Mass Index,
      income, chronic social stressors, and Type A behavior. It is argued that this
      incongruity leads to recurring frustrating social interactions, which in turn are
      related to higher blood pressure.

PMID- 2231486
TI  - Sex differences in general practice attendance and help seeking for minor
      illness.
AB  - Women's rates of utilization of almost all health care services are higher than
      men's. General practice surveys endorse these findings with women attending more
      frequently, particularly in the child bearing years. The present study sought to
      explore the variables associated with consultation and help seeking behaviour for
      minor illnesses. Samples of male and female low and high attenders aged between
      20 and 45 were drawn from one general practice to investigate which factors were
      important in explaining sex differences in consultation. Analysis of the results
      suggests that attendance and help seeking in men and women was closely linked to
      physical illness, the presence of physical symptoms was predictive of more
      frequent consultation in both men and women. The presence of psychosocial
      problems or distress, however, predicted consultation behaviour in women but not
      in men. The women had more confidants and contacted more social agencies than the
      men, also suggesting that they found it easier to divulge personal information to
      others than the men. There was no evidence from this study that such enabling
      factors as physical accessibility and time available were related to differential
      attendance rates.

PMID- 2231487
TI  - Insulin-dependent diabetes mellitus: a risk factor in anorexia nervosa or bulimia
      nervosa? An empirical study of 116 women.
AB  - A number of recent studies suggest that diabetes mellitus confers a high risk for
      the development of anorexia nervosa or bulimia nervosa. In order to test this
      hypothesis, 56 women with IDDM and 60 non-diabetic female controls were studied.
      All subjects completed the Eating Attitudes Test (EAT), and the Bulimic
      Investigatory Test, Edinburgh (BITE). The subjects were interviewed in order to
      obtain clinical and demographic information as well as to determine test
      validity. The DSM-III-R criteria of anorexia nervosa and bulimia nervosa were
      used. Four items were removed from the original EAT in order to eliminate
      possible bias related to IDDM. The results did not support the hypothesis that
      eating disturbances occur more frequently in IDDM-patients. Six criteria are
      proposed to improve the methodological standards of future studies in order to
      facilitate comparison of results.

PMID- 2231488
TI  - The treatment of tension headache by acupuncture: a controlled single case design
      with time series analysis.
AB  - A single case design, with time series analysis, was employed to evaluate the
      efficacy of acupuncture in the treatment of tension headache. Fourteen patients
      were given eight weekly treatments, four of true acupuncture and four of sham in
      random order. Mean pain in medication scores were reduced by 52% and 54%
      respectively at initial follow-up. Reductions in pain scores of over 50% were
      achieved by half the patients and the significance of these changes confirmed by
      time series analysis. The majority of patients maintained their gains at four
      month follow-up. True acupuncture was shown to be significantly superior to sham,
      demonstrating a specific therapeutic action, in four patients. In the remainder
      no difference was observed. Possible mechanisms for these effects are discussed.
      Acupuncture is a potentially valuable treatment for tension headache but further
      research is needed.

PMID- 2231489
TI  - The functional role of exercise in the development of weight and diet concerns in
      women.
AB  - The functional role of exercise in the development of weight preoccupation and
      body dissatisfaction was examined. One hundred and twelve females, identified as
      regular participants in exercise programmes, completed an inventory that provided
      information on attitudes, behaviours and psychological characteristics related to
      dieting and weight-control, as well as a self-report of physical activity. A
      structural equation model was tested that provides support for the notion that
      Body Mass Index, emotional reactivity and physical activity have statistically
      significant direct effects on weight and diet concerns, but that weight and diet
      concerns do not predict the degree of participation in physical activity.
      Significant differences in eating disorder indicators were found between sub
      groups identified as 'constantly dieting' and 'rarely dieting'. The tentative,
      but important, conclusion was drawn that regular participation in a fitness
      programme may be causally related to excessive concern with weight and dieting.

PMID- 2231491
TI  - The negative correlations between Type A behavior and somatic risk factors of
      coronary heart disease (CHD) in adolescent boys.

PMID- 2231490
TI  - Cardiovascular responses to behavioral stressors: laboratory-field generalization
      and inter-task consistency.
AB  - Blood pressure and heart rate responses were monitored while 30 medical, dental
      or graduate students completed four laboratory tasks. On a second day, subjects
      wore an ambulatory blood pressure monitor, and during this day they completed the
      real-world challenge of presenting their research in front of a small audience.
      Heart rate and blood pressures correlated significantly between all four
      laboratory tasks for both absolute levels and reactivity scores (calculated as
      task level minus pre-task baseline level). However, while heart rate and blood
      pressure absolute levels for each task correlated significantly with those
      attained during the real-world stressor, correlation coefficients obtained when
      similarly comparing reactivity scores were uniformly non-significant. Laboratory
      field generalization was thus evident only for absolute values. Consideration was
      then given to the fact that the laboratory tasks were undertaken in a seated
      position, while subjects stood during the real-world task. Activity diaries
      completed by subjects during the time they wore the ambulatory monitor were
      examined to search for readings that could be regarded as standing baselines.
      Such values were obtained for 12 of the subjects. Real-world reactivity scores
      were recalculated using these standing baselines, and compared again with
      reactivity scores during the laboratory tasks. Marked increases in correlation
      coefficients were obtained for systolic and diastolic pressure, but not for heart
      rate.

PMID- 2231492
TI  - What's new in orthopaedic surgery.

PMID- 2231493
TI  - Progress in the assessment of liver blood flow in health and disease.
AB  - Several of the reasons why the liver is a vital organ are illustrated in this
      review. The fundamental importance of its dual arterial and portal venous supply
      is shown in a wide range of physiological and pathological conditions, ranging
      from digestion to regeneration, cirrhosis, mesenteric ischaemia and malignancy.
      In most, if not all, of these functions the blood supply exerts an important, if
      not prime, role. This article reviews some of the progress made in evaluating
      these vital hepatic circulatory phenomena.

PMID- 2231494
TI  - Risk factors in patients with ischaemic rest pain of the lower limbs.
AB  - One hundred and three consecutive out-patients with ischaemic rest pain were
      studied. There were 77 men and 26 women with a mean (s.d.) age of 71 (10) years.
      Thirty-six (35.0%) patients had rest pain alone, 41 (39.8%) in association with
      an ischaemic ulcer and 26 (25.2%) with digital gangrene. A significantly
      increased risk of amputation was seen in those patients with an elevated serum
      cholesterol (greater than 5.2 mmol/l; P = 0.01), white blood cell count of
      greater than 10 x 10(9)/l (P = 0.05), fibrinogen greater than 4g/l (P = 0.04),
      and in women with elevated triglyceride levels (greater than 1.8 mmol/l; P less
      than 0.03). An increased risk of death for all patients was also associated with
      elevated triglyceride levels (P = 0.03). Few of the women smoked (P less than
      0.0004), but they were more likely to have suffered a stroke (P = 0.01). They
      also had a significantly increased cholesterol level (P = 0.03) and tended to
      have a higher mortality rate than the men (P = 0.08). Surprisingly, smokers did
      not have a significantly higher amputation or death rate than non-smokers.
      Elevated plasma viscosity, packed cell volume, platelet count, haemoglobin and
      creatinine levels were not independent risk factors for any group. At 30 days
      after presentation the limb salvage rate was 73% (75/103), amputation was
      required in 15 (14.6%) cases and 13 (12.6%) patients died. Patients with
      ischaemic rest pain constitute a heterogeneous group with multiple diseases and
      risk factors. Early identification and treatment of risk factors may help to
      improve limb salvage and the mortality rate in this condition.

PMID- 2231495
TI  - Repair of coronal and subcoronal hypospadias: an 8-year retrospective study.
AB  - Twenty-three patients undergoing treatment for coronal and subcoronal hypospadias
      over an 8-year period were reviewed. A ventral skin tube inlay graft was used in
      all cases, and a comparison made between Nesbitt's button hole technique and
      three other procedures used for ventral skin cover. The button hole procedure was
      associated with fewer fistulae and provided acceptable cosmesis.

PMID- 2231496
TI  - Primary gastrointestinal non-Hodgkin's lymphoma: a study of 35 patients.
AB  - In a retrospective study of 35 patients (29 men, 6 women) with primary non
      Hodgkin's lymphomas of the gastrointestinal tract, 13 of the tumours were located
      in the stomach, 21 in the small bowel and one in the colon. Various radiological
      findings were detected, and the majority of tumours (23) had high grade
      histology. Three patients had immunoproliferative small intestinal disease. Only
      tumours in stages I and II were included in the study, and the majority (25) were
      in stage IIA. All patients except one had undergone resection of the neoplasm.
      This was followed by combined chemotherapy in 25 patients, and chemotherapy
      followed by radiotherapy in three cases. There were two (5.7%) hospital
      mortalities. Two- and 5-year survival rates were better in those patients with
      low stage and low grade tumours. The overall 5-year survival rate was 38%.

PMID- 2231497
TI  - Early gastric cancer: a report of 30 cases.
AB  - Thirty patients with early gastric cancer have been reviewed. Endoscopy
      demonstrated gastric abnormality in 93% of patients examined and biopsy was
      accurate in 96% of cases. Twenty-nine patients were treated by partial
      gastrectomy, although three required further procedures. The commonest
      morphological type was type III (45%). Five patients with early gastric cancer
      had lymph node spread at the time of presentation. The relative 5-year survival
      rate was 68%. Four patients eventually died of gastric cancer. Three patients
      (10%) developed a second primary carcinoma. The significance of this diagnosis is
      emphasized and selective screening is considered.

PMID- 2231498
TI  - Bacterial colonization of the skin after chemical depilation.
AB  - A study of the effects of preoperative skin depilation on skin microflora has
      been performed. Areas of skin were prepared with a chemical depilatory agent and
      compared with areas of unprepared skin. Preparation of skin with a chemical
      depilatory agent causes no increase in skin microflora, in contrast to the
      effects of shaving as demonstrated by earlier studies.

PMID- 2231499
TI  - Grafting without a donor site: an easy approach to pretibial lacerations.
AB  - Pretibial lacerations are a common soft tissue injury especially amongst elderly
      women. An alternative repair approach to this problem is described. The
      traumatized and often necrosed-looking flap of skin from the injured area is made
      into a full thickness 'fenestrated' skin graft to cover the defect. Experience of
      30 cases shows the method to be useful for accident and emergency departments as
      well as surgical units. The healing time is shorter than in conservative methods
      and similar to 'meshed split skin grafting' as an out-patient procedure, but the
      great advantage is the absence of a donor site.

PMID- 2231500
TI  - Early experience with reconstructive surgery at Mpilo Central Hospital, Zimbabwe.
AB  - A total of 46 patients were admitted to Mpilo Central Hospital for various
      reconstructive procedures between August 1988 and February 1989. The majority of
      patients had postburn contractures, i.e. 18 cases (39%). The rest of the patients
      were admitted for treatment of bed sores (nine cases, 20%), keloids (nine cases,
      20%), post-traumatic complex soft tissue defects (five cases, 11%), lower lip
      defects following a human bite (three cases, 6%) and complex lesions on the face
      (two cases, 4%). Although a few complications were encountered the results
      overall were very good. There was no mortality recorded in this series.

PMID- 2231501
TI  - Spontaneous duodenocolic fistula.

PMID- 2231502
TI  - Fatal clostridial pancreatitis following transduodenal biopsy of the pancreas.

PMID- 2231503
TI  - Surgery in Singapore--the Scottish link.

PMID- 2231504
TI  - Ten-year experience of bone and joint tuberculosis in Blackburn 1978-1987.
AB  - A retrospective review of 70 cases of bone and joint tuberculosis seen between
      1978 and 1987 is reported. Forty-nine of the cases were patients of Indian
      subcontinent ethnic origin. There was a wide range of sites affected. Pain,
      swelling or sinus formation were the commonest presenting features. Delay in
      diagnosis from the first hospital visit was significantly longer in the Caucasian
      population (mean delay; Caucasian 17.6 weeks, Indian subcontinent 2.8 weeks).
      Drug treatment was used in all cases, combined with biopsy in 21 cases and more
      radical surgery in 28 cases. The results of treatment were good with low
      morbidity and mortality, long-term problems have been few, and no relapses have
      occurred. Nine months of chemotherapy and the joint system of orthopaedic and
      medical management employed locally are strongly recommended.

PMID- 2231505
TI  - Eikenella corrodens osteomyelitis of the spine.

PMID- 2231506
TI  - Humeral shaft fracture and arm-wrestling.

PMID- 2231507
TI  - Fracture-dislocation of the cervical spine: complication of traditional Zulu
      dancing.

PMID- 2231508
TI  - Locking of the metacarpophalangeal joint.

PMID- 2231509
TI  - Role of surgery in the treatment of pseudomyxoma peritonei.

PMID- 2231510
TI  - Obstructing carcinoma of the left colon managed by subtotal colectomy.

PMID- 2231511
TI  - Extrahepatic biliary cystadenoma: report of a case and review of the literature.

PMID- 2231512
TI  - Primary adenocarcinoma of the appendix.

PMID- 2231513
TI  - Changes in the incidence of medical conditions at the Commando Training Centre,
      Royal Marines.

PMID- 2231514
TI  - A narcoleptic in the Navy.

PMID- 2231516
TI  - The management of heat illness.

PMID- 2231515
TI  - Resuscitation box--what do I put in M88?

PMID- 2231517
TI  - The neurological sequelae to toluene inhalation.

PMID- 2231518
TI  - An outbreak of 'flu.

PMID- 2231519
TI  - Operating at sea in an aircraft carrier.
AB  - The policy of the Medical Officers serving in HMS Ark Royal between January 1988
      and June 1989 with regard to surgery and anaesthesia at sea is described. The
      skills and equipment available, techniques used, operations performed and
      complications that resulted are outlined. The advantages and disadvantages of an
      active operating policy are discussed and the postulate ventured that in order to
      achieve maximum efficiency within the medical department of an aircraft carrier
      such a policy is justified. Finally, in the light of present day litigious
      trends, the question of the propriety of the policy is posed.

PMID- 2231520
TI  - NBCI--another threat to operational effectiveness?
AB  - Battle casualties are well recognised as a threat to Operational Effectiveness
      (OE) at times of conflict. Less well appreciated is that naturally occurring
      illnesses and injuries--Non-Battle Casualties and Injuries (NBCI)--continue to
      present at such times and will add to the problems of fighting the ship. This
      prospective study showed that NBCI resulted in a total of 1369 man days of lost
      personnel effectiveness among some 1738 RN servicemen during a 180 day
      deployment. That is just 0.42% of the possible man working days. This represents
      a loss of 4.3 man days per 1000 at risk per day in terms of fitness for Full
      Duties or 2.74/1000/day excluding those able to perform Light Duties. It is
      unlikely that such rates would affect the OE of the fighting units but they do
      represent a significant challenge to the Royal Naval Medical Service to continue
      to maintain the rates at such low levels, so that when aggregated to the numbers
      of battle casualties, OE is maintained as far as possible.

PMID- 2231521
TI  - The effect of clothing on the initial responses to cold water immersion in man.
AB  - The protection provided by three clothing assemblies against the cold shock
      response was investigated. Nine healthy male volunteers each undertook three two
      minute head-out immersions into stirred water at 10 degrees C. The subjects wore
      a different clothing assembly for each immersion, these were: a) Swimming trunks
      only; b) Conventional clothing (equivalent to RN No 8s); c) Conventional clothing
      plus windproof/shower-proof clothing (RN foul-weather clothing Mk III). The
      cardiac, ventilatory and thermal responses of the subjects were examined before
      and during the immersions. No significant differences were found between the
      magnitude of the responses recorded on immersion when conventional clothing or
      foul-weather clothing were worn. Mean skin temperature was lower (P less than
      0.05) and respiratory frequency and minute ventilation were higher (P less than
      0.05) on immersion in swimming trunks compared to the other two conditions. It is
      concluded that when policies for the use of immersion protective clothing are
      being formulated, consideration should be given to all of the potentially
      hazardous responses associated with cold water immersion.

PMID- 2231522
TI  - The fluorosis risk index: a method for investigating risk factors.
AB  - The fluorosis risk index (FRI), a new index developed for use in analytical
      epidemiologic studies, is designed to permit a more accurate identification of
      associations between age-specific exposures to fluoride sources and the
      development of enamel fluorosis. The FRI divides the enamel surfaces of the
      permanent dentition into two developmentally related groups of surface zones,
      designated either as having begun formation during the first year of life
      (classification I) or during the third through sixth years of life
      (classification II). Data from the first use of this index in a population-based
      case-control study are given to illustrate the high reliability of the index, its
      validity, and its unique utility for the identification of risk factors of enamel
      fluorosis.

PMID- 2231523
TI  - Caries prevalence in Head Start children, 1986-87.
AB  - Since the early 1970s, caries prevalence among school-aged children in the United
      States has declined. It appears that a small percentage of the children
      experience most of the caries increment. In addition, a large proportion of
      children in the US who need dental care receive it. An important factor in the
      amount of treatment received by children is the socioeconomic status of the
      family. Data on caries prevalence among preschool populations are limited. The
      Head Start program serves low-income families in the US and offers a unique
      opportunity to look at individuals who may be at greater risk of health problems
      and may experience less access to health services. A survey of 1,796 three- to
      five-year old Head Start children from low-income families was conducted in 1986
      87. Caries prevalence, baby bottle tooth decay prevalence and relative need for
      dental care are reported for fluoridated and non fluoridated communities in
      California, Hawaii, and Micronesia. The data reveal scores that are higher in the
      sample population than in five-year-olds in national surveys and among Head Start
      children in previous surveys.

PMID- 2231524
TI  - Infection control in the Indian Health Service Dental Program: estimated costs
      and effects on productivity.
AB  - The dental literature contains many recommendations defining standards for
      infection control. Little information is available, however, documenting the cost
      of implementing these standards. This article describes the cost incurred by the
      Indian Health Service Dental Program in the Oklahoma area between 1985 and 1988
      for infection control. During this period, comprehensive infection control
      recommendations were published for oral health programs serving Native Americans
      and data were collected on supply utilization. While productivity data were
      collected for that same time period do not support the premise that infection
      control practices lead to decreased clinical productivity, infection control
      supply costs did increase over fourfold during this period.

PMID- 2231525
TI  - Patterns of sealant delivery under variable third party requirements.
AB  - Despite evidence indicating dental sealants to be effective in preventing caries
      on the pit and fissure surfaces of teeth, only 8 percent of school-aged US
      children had received sealants as of 1986-87. While many rationales have been
      suggested and scientifically answered for this low level of utilization, issues
      of cost and cost effectiveness remain considerable barriers to many insurers and
      public programs. This study reports dentist behavior when sealants were added
      with few restrictions as a new benefit to an existing third party system of care.
      Results are compared to another third party program with stricter reimbursement
      policies. Overall, sealants were provided in a reasonable fashion to both groups
      of patients, relative to teeth selected for sealing and costs. Only a small
      proportion of patients receiving sealants were under age six or above age 19.
      Even under the most liberal program, sealants were predominantly targeted to
      teeth at highest risk to decay. Still, for both groups, a significant proportion
      of the sealants were placed in teeth at points in time quite distant from
      expected eruption patterns and, thus, their periods of highest risk to decay.
      Overall, dentists appeared to use sealants only minimally in their practices.
      These data suggest that sealants can be added to third party dental programs with
      little overall risk of inappropriate use or abuse. They also suggest that
      specific efforts are merited to educate providers as to the most effective times
      at which to provide sealants for preventing the maximum amount of decay in a
      population.

PMID- 2231526
TI  - A fluoridation campaign: the Phoenix experience.
AB  - On January 31, 1989, the city council of Phoenix, Arizona, voted to approve water
      fluoridation. Despite a small number of campaign participants and a limited
      budget, profluoridationists launched a successful 16-month effort that included
      novel marketing techniques, intensive collaboration with media representatives,
      and an aggressive challenge of the antifluoridation movement. Public support was
      garnered through an advisory petition effort and positive media coverage;
      political support resulted from a carefully orchestrated educational strategy
      that included expert testimony and comprehensive reference materials. With a
      population of approximately 1 million people, Phoenix is the ninth largest city
      in the country and, until the measure was implemented, the third largest
      nonfluoridated city.

PMID- 2231527
TI  - Workshop to Develop Competency Objectives in Dental Public Health. Proceedings.
      American Association of Public Health Dentistry Ad Hoc Committee to Update the
      Behavioral Objectives in Dental Public Health.

PMID- 2231528
TI  - Workshop to Develop Competency Objectives in Dental Public Health. Keynote
      address: Creating a future for dental public health.

PMID- 2231529
TI  - Competency objectives for dental public health.

PMID- 2231530
TI  - The John W. Knutson Distinguished Service Award in Dental Public Health--1989
      recipient: John M. Frankel (posthumously).

PMID- 2231532
TI  - Co-culture of mouse embryos with oviduct and uterine cells prepared from mice at
      different days of pseudopregnancy.
AB  - Oviduct and uterine cell cultures were prepared from mice at different days of
      pseudopregnancy and their effects on the development of 1- and 8-cell mouse
      embryos in co-culture were examined. One-cell mouse embryos in co-culture with
      oviduct cells from 20 h to 120 h after hCG had a mean (+/- s.e.) cell number of
      70.1 +/- 3.6, significantly (P less than 0.001) higher compared with those
      cultured in Whittingham's T6 medium supplemented with 5% fetal calf serum (T6 +
      5% FCS) (30.4 +/- 1.6). Transfer of embryos, at 96 h after hCG, to synchronous
      pseudopregnant recipients showed that more embryos in oviduct co-culture formed
      fetuses than those cultured in T6 + 5% FCS. Co-culture of 1-cell embryos with
      uterine cells did not confer an advantage in cell numbers over T6 + 5% FCS.
      However, more 8-cell embryos formed blastocyst outgrowths after 100 h in co
      culture with uterine cells prepared from mice at Day 3 of pseudopregnancy than
      with uterine cultures prepared from mice at Day 1 of pseudopregnancy or oviduct
      cells. In addition, there was further improvement when the Day 3 uterine co
      cultures were supplemented with 1 or 10 ng progesterone/ml. These results
      highlight the importance of the oviduct and uterine cells during the different
      stages of preimplantation embryo development.

PMID- 2231531
TI  - Luteal inadequacy during the early luteal phase of subfertile cows.
AB  - A study was made of early luteal function (up to Day 6) in cyclic and pregnant
      heifers and also in older, subfertile cows. There were no differences in vivo or
      in vitro between cyclic and pregnant heifers, indicating no luteotrophic effect
      of the embryo at this stage, but the increase in postovulatory peripheral
      progesterone concentrations was delayed (P less than 0.01) and occurred more
      slowly (P less than 0.001) in the subfertile cows than in the heifers. The
      corpora lutea of the subfertile cows were heavier (P less than 0.001) than those
      of the heifers on Day 6. Basal progesterone production by dispersed luteal cells
      was similar between heifers and subfertile cows, but there was a difference (P
      less than 0.001) in the pattern of response to exogenous LH and PGE-2. Cells from
      subfertile cows were less sensitive to the stimulatory effects of PGE-2 and
      although LH increased (P less than 0.001) progesterone production by all cells,
      this stimulation by a low dose of LH was inhibited by PGE-2 in luteal cells from
      subfertile cows. This effect did not occur in the luteal cells from heifers.
      These results indicate the possibility that luteal inadequacy, due to a
      diminished response to circulating luteotrophic hormones, may contribute to
      embryo mortality in subfertile cows.

PMID- 2231533
TI  - Prostaglandin E-2 as a potential luteotrophic agent during early pregnancy in
      cattle.
AB  - Heifers slaughtered on Day 18/19 of pregnancy had significantly higher (P less
      than 0.001) concentrations of PGE-2 (measured as its methyl oxime) in uterine
      flushings than did animals slaughtered on Days 6 or 12 of pregnancy, or on Days 6
      or 12 of the oestrous cycle. In addition, concentrations were higher in the
      uterine horn ipsilateral to the corpus lueum on Days 12 (P less than 0.05) and
      18/19 (P less than 0.01) than in the contralateral horn. Incubation of dispersed
      luteal cells for 3 h with LH (0.1 or 100 ng/ml) and/or PGE-2 (0.01-1000 ng/ml) in
      vitro showed no differences in basal progesterone production or in the responses
      to exogenous hormones between pregnant and non-pregnant cattle. However, low
      doses of PGE-2 (0.01-10 ng/ml) inhibited the stimulation of progesterone
      secretion by the lower dose of LH. These findings indicate that although PGE-2
      can stimulate progesterone synthesis by luteal cells it may also have inhibitory
      effects, and therefore its role in pregnancy requires further definition.

PMID- 2231534
TI  - Effect of season on seminal traits and serum hormone concentrations in captive
      male Siberian tigers (Panthera tigris).
AB  - Electroejaculates and serum samples were collected throughout the year from 5
      male Siberian tigers. Semen quality, seminal plasma chemistry and serum hormone
      concentrations were evaluated and analysed as a function of season. Semen volume,
      concentration, motility, viability and morphology were not influenced by season.
      The ability of spermatozoa to undergo capacitation and penetrate zona-free
      hamster eggs did not differ due to season. Season had no influence on seminal
      plasma concentrations of acid phosphatase, calcium, glucose, potassium and
      phosphorus. Serum values of thyroxine and triiodothyronine were lowest (P = 0.002
      and P = 0.03, respectively) during the summer months while cortisol showed no
      seasonal variation. Serum testosterone concentrations were higher in fall and
      early winter (P less than 0.001) than at other times of the year but were not
      correlated with semen quality. These results demonstrate that season has no
      effect on the semen production and quality of captive male Siberian tigers.

PMID- 2231535
TI  - In-vivo microscopy of the rat endometrial subepithelial capillary plexus during
      the oestrous cycle and after ovariectomy.
AB  - Blood flow through the endometrium was visualized by using incident-light
      fluorescence microscopy and a video image recorded for later detailed analysis.
      The subepithelial microvascular density was calculated for each day of the
      oestrous cycle and at 7 days after ovariectomy. The results showed that the
      microvasculature was significantly more dense at dioestrus I, pro-oestrus, and
      after ovariectomy than at oestrus, with dioestrus II being in between. Mean
      capillary path lengths running from arteriole to venule were longest at pro
      oestrus, followed by oestrus, dioestrus II, dioestrus I, and shortest after
      ovariectomy. The results suggest that endometrial growth and regression precede
      microvascular growth and regression. The technique of in-vivo microscopy provides
      an important new avenue for investigating the role of local factors in the
      control of the endometrial microcirculation.

PMID- 2231536
TI  - Effect of caffeine and of pentoxifylline on the motility and metabolism of human
      spermatozoa.
AB  - Human spermatozoa were washed and incubated with 6 mM-caffeine or 0.15-1.2 mM
      pentoxifylline. Sperm motility was measured by time-lapse photography, the rate
      of glycolysis by the release of tritiated water from 1 mM-[3-3H]D-glucose and the
      rate of mitochondrial respiration by the release of 14CO2 from 1 mM-[U-14C]-L
      lactate or 1 mM-[2-14C]pyruvate. Caffeine stimulated the majority of spermatozoa
      to convert from the 'rolling' to the 'yawing' mode of progression with a
      concomitant increase in lateral head displacement from 4.1 +/- 0.09 microns (343)
      to 6.7 +/- 0.25 microns (105) (mean +/- s.e.m. (number of spermatozoa)). There
      was a 45% decline in the percentage of progressively motile spermatozoa and a
      very small decrease in their velocity. Pentoxifylline had only a slight effect on
      lateral head displacement or percentage motility but produced a significant
      increase in velocity. Both compounds increased the rate of glycolysis by greater
      than 40% but elevated the rate of 14CO2 production to a smaller extent. The
      concentrations of ATP and ADP changed very little. We conclude that the
      glycolytic pathway in human spermatozoa can respond efficiently to changes in
      energy demand.

PMID- 2231537
TI  - Administration of pig relaxin to beef heifers 4 or 7 days pre partum.
AB  - Crossbred beef heifers (N = 36) were assigned to one of three treatment groups:
      untreated controls (C; N = 15); Group R4, treated with pig relaxin (1.0 mg i.m.)
      4 days pre partum (N = 11); or Group R7, treated with pig relaxin (1.0 mg i.m.) 7
      days pre partum (N = 10). Bioactivity of the pig relaxin (UMC-R-P8) was
      determined by the mouse interpubic ligament assay to be greater than or equal to
      3000 U/mg, both before and after the experiment was conducted. Peripheral serum
      immunoreactive relaxin values were 7.5, 3.4, 2.5, and 1.5 ng/ml at 2, 4, 6 and 8
      h after injection of relaxin, respectively. Gestation lengths were 282.9 +/- 1.1,
      285.5 +/- 1.3 and 285.6 +/- 1.5 days for Groups C, R4 and R7 (C vs R4 + R7; P
      congruent to 0.08). Calving difficulty score (1 to 4) tended to be greater (P
      congruent to 0.08) for Group R4 and R7 heifers (C vs R4 + R7; 1.3 +/- 0.24 vs
      1.75 +/- 0.28 + 2.04 +/- 0.32), but the incidences of dystocia and retained
      placentae were not influenced by treatment (P greater than or equal to 0.10). The
      mean concentration and concentration profile of daily serum progesterone,
      oestradiol-17 beta, dihydroprostaglandin F-2 alpha and relaxin were not affected
      by treatment from 6 days pre partum through 2 days post partum. Cervical
      diameter, cervical softness score, pelvic measurements, and vulva opening length
      during the periparturient period were not affected (P greater than or equal to
      0.10) by treatment, but all of these characteristics changed over time (P less
      than or equal to 0.01), relative to calving. We conclude that i.m. administration
      of pig relaxin (greater than or equal to 3000 U) does not effectively alter
      periparturient characteristics of beef heifers. Discrepancies between these
      results and those reported for intracervical administration cannot be readily
      explained.

PMID- 2231538
TI  - Effect of immunization of ewes against prostaglandin F-2 alpha on the life-span
      of corpora lutea and oestrous behaviour during two breeding seasons.
AB  - Two adjuvants, Freund's complete adjuvant (FCA) and GNE (proprietary product;
      Intervet Ltd, The Netherlands), were used to immunize cyclic Finnish Landrace
      ewes (4-6/treatment) against a prostaglandin F-2 alpha-human serum albumin (PGF
      HSA) conjugate. Ewes were randomized to the following treatments: (a) control
      untreated, (b) control-5 mg HSA in FCA (control-HSA), (c) 5 mg PGF-HSA in FCA
      (FCA-5 mg), (d) 15 mg PGF-HSA in FCA (FCA-15 mg), (e) 5 mg PGF-HSA in GNE (GNE-5
      mg) and (f) 15 mg PGF-HSA in GNE (GNE-15 mg). Ewes were monitored for oestrus
      (twice daily) and ovarian activity (progesterone concentrations in blood samples
      taken twice weekly) for 2 consecutive breeding seasons. In the first breeding
      season, the mean number of oestrous periods detected was 6.0, 5.7, 0.0, 0.2, 1.8
      and 0.5 in control, control-HSA, FCA-5 mg, FCA-15 mg, GNE-5 mg and GNE-15 mg
      assigned ewes, respectively [pooled standard error of difference (s.e.d.) = 1.2].
      A persistent CL formed, on average, 10.0, 10.0, 29.8 and 32.5 days after primary
      immunization (pooled s.e.d. = 14.6) in 6/6 FCA-5 mg, 6/6 FCA-15 mg, 5/6 GNE-5 mg
      and 4/4 GNE-15 mg-assigned ewes, respectively; these CL were maintained for, on
      average, 138.7, 139.0, 127.8 and 129.0 days, respectively (pooled s.e.d. =
      15.9).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231539
TI  - Numbers of steroidogenic luteal cells in Booroola Merino ewes.
AB  - In Exp. 1 ovulation rates, plasma concentrations of progesterone, mean individual
      and total CL weights were determined on Days 4, 10 and 12 after oestrus of
      Booroola Merino ++ ewes and FF ewes. Mean ovulation rates ranged from 1.5 to 1.8
      in ++ ewes and from 5.3 to 6.2 in FF ewes (P less than 0.01). There were no
      differences in plasma concentrations of progesterone or total luteal weight
      between the two groups on any of the days studied. Individual CL were smaller (P
      less than 0.01) in FF ewes than in ++ ewes. In Exp. 2 the numbers of luteal cells
      in CL collected from 5 ++ and 5 FF ewes on Day 10 of the oestrous cycle were
      morphometrically determined. The CL from FF ewes were smaller (P less than 0.01)
      and had fewer total steroidogenic cells (P less than 0.01), fibroblasts (P less
      than 0.01), and capillary endothelial cells and pericytes (P less than 0.05).
      However, the luteal cell volume density, number of cells/g tissue, average cell
      diameter or average cell volume was not different between the two groups of ewes
      for any cell type studied. It is concluded that the 5-6 CL in FF ewes function in
      an identical fashion to the 1-2 CL in ++ ewes.

PMID- 2231540
TI  - Microencapsulation of single, multiple, and zona pellucida-free mouse
      preimplantation embryos in sodium alginate and their development in vitro.
AB  - Preimplantation embryos obtained from immature superovulated B6D2F1 female mice
      were microencapsulated in sodium alginate singly, in multiples of 2 or 3, or
      denuded of their zona pellucida. Encapsulated embryos developed in vitro at a
      rate similar to control embryos. Development of zona pellucida-free embryos was
      significantly less than that of intact embryos, but there was no difference
      between encapsulated and non-encapsulated zona pellucida-free embryos.
      Development of 2- and 4-cell embryos in sodium alginate was independent of cell
      stage. This report demonstrates the usefulness of a viable, biodegradable
      embedding material for the microencapsulation of manipulated preimplantation
      mammalian embryos.

PMID- 2231541
TI  - Tissue spaces during development and regression of the decidual cell reaction in
      ovariectomized, steroid-treated mice.
AB  - Changes in the extracellular and blood spaces of the uterus were assessed from
      the distribution volumes of 51Cr-EDTA and 51Cr-labelled red blood cells during
      the development and regression of the artificially induced decidual cell reaction
      in ovariectomized, steroid-treated mice. The normally high values for uterine
      extracellular space (0.35-0.40 microliter/mg) fell to less than 0.20
      microliter/mg in association with decidual growth. Uterine blood space increased
      from around 0.02 microliter/mg to 0.03-0.05 microliter/mg with decidual
      development. Induction of decidual regression by removal of s.c. progesterone
      implants caused a rapid decline in tissue blood volume to reach control values
      (0.01-0.02 microliter/mg) within 24 h and preceded any reduction in uterine
      weight. Uterine vascular permeability, as determined from the tissue accumulation
      of 125I-labelled human serum albumin, fell with a similar time course. Tissue
      extracellular space returned to the higher control values within 48 h of
      initiating decidual regression.

PMID- 2231542
TI  - Immunization against recombinant bovine inhibin alpha subunit causes increased
      ovulation rates in gilts.
AB  - Immunization of gilts in a commercial piggery against a fusion protein of the
      alpha subunit of bovine inhibin, produced by recombinant DNA methods, resulted in
      mean ovulation rate increases of 35% at the oestrus at which, under the piggery's
      management practices, they would have been mated. Sera from two immunized groups
      showed mean binding of 6.6% and 4.9% when assayed, at 1:800 final dilution,
      against iodinated bovine inhibin (Mr 31,000). Ovulation rates of immunized gilts
      were highly correlated with the ability of serum to bind iodinated native inhibin
      (r = 0.62; P less than 0.001), particularly when weight and age were included in
      the correlation (r = 0.72; P = 0.001), and inhibin binding accounted for 38% of
      the total variation in ovulation rate. Immunization caused no deleterious effects
      on growth rate or onset of oestrus. These results demonstrate the potential for
      use of such immunization to increase prolificacy in gilts and young sows.

PMID- 2231543
TI  - Opioid modulation of LH secretion by pig pituitary cells in vitro.
AB  - The effects of naloxone and beta-endorphin on LH secretion by pig pituitary cells
      were studied in primary cultures. On Day 4 of culture, cells (10(5) seeded/well)
      were challenged with 10(-9), 10(-8) or 10(-7) M gonadotrophin-releasing hormone
      (GnRH), 10(-10), 10(-9), 10(-8) or 10(-7) M-beta-endorphin or 10(-6) M-naloxone
      individually or in combinations. Secreted LH was measured at 4 h and 24 h after
      treatment and cellular content of LH was measured after 24 h. Basal LH secretion
      (control) was 23.5 +/- 7.6 and 36.9 +/- 10.3 ng/well at 4 h and 24 h,
      respectively. Relative to control at 4 h, 10(-9), 10(-8) or 10(-7) M-GnRH
      stimulated (P less than 0.05) LH secretion 140%, 210% and 250%, respectively. At
      24 h, LH secretion was increased (P less than 0.05) by GnRH compared to control,
      but the dose-response to GnRH was absent. Naloxone increased (P less than 0.01)
      LH secretion 166 +/- 13% at 4 h and 141 +/- 13% (P less than 0.06) at 24 h.
      Secretion of LH after simultaneous addition of 10(-8) M-GnRH plus naloxone was
      greater (P less than 0.01) than after GnRH alone at 4 h but not at 24 h. beta
      Endorphin at 10(-10), 10(-9), 10(-8) or 10(-7) M failed to alter basal LH
      secretion at 4 h but decreased secretion at 24 h, while cellular LH content was
      similar to control at 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231544
TI  - Interrelationships between progesterone, 13,14-dihydro-15-keto PGF-2 alpha (PGFM)
      and LH in cyclic and early pregnant cows.
AB  - Plasma progesterone and LH secretion patterns were examined in 18 mature dairy
      cows during the oestrous cycle and after insemination. Blood samples were
      collected every 15 min for 8 h per day on Days 3, 5, 6, 7, 8, 9, 10, 12, 14, 16,
      17, 18, 19, 20 and 21 of the oestrous cycle, then, in the same cows, at the same
      times during early pregnancy. PGF-2 alpha secretion rates (as determined by
      plasma PGFM concentrations) were also monitored on Days 14, 16 and the day of, or
      equivalent to, luteal regression. Mean daily plasma progesterone concentrations
      were similar until Day 16 in cyclic and pregnant cows, after which values in non
      pregnant animals declined. Regression analysis indicated that progesterone
      concentrations were best described by a quadratic expression with fitted maximum
      values on Day 13 in non-pregnant animals but values increased linearly over the
      whole period to Day 21 in pregnant cows. The frequency, amplitude and area under
      the curve of LH episodes showed no significant differences between cyclic and
      pregnant animals. In pregnant cows, the amplitude and area under the curve of
      progesterone episodes increased linearly between Days 8 and 21, although no such
      increase occurred in cyclic cows. Low-level PGFM episodes were present in cyclic
      and pregnant cows on Days 14 and 16 after oestrus, and high amplitude episodes
      occurred in non-pregnant cows during luteal regression. Pregnant cows showed a
      significant depression of the amplitude, but not the frequency of episodes at the
      expected time of luteal regression. These results confirm that the corpus luteum
      of pregnancy secretes an increasing amount of progesterone per se and per unit of
      LH until at least Day 21 after mating. They further suggest that the corpus
      luteum of the cyclic cow may experience small episodes of PGF-2 alpha and be
      subjected to initial degenerative changes by Day 14 after oestrus, some time
      before the onset of definitive luteolysis.

PMID- 2231545
TI  - Expression of major histocompatibility complex antigens on the bovine placenta.
AB  - Immunohistochemistry was utilized to determine expression of the major
      histocompatibility complex (MHC) antigens on Day 8-9 hatched blastocysts and
      fetal membranes of mid- to late gestation cows and to examine the pattern of
      leucocytic infiltration into the gravid uterus. Hatched blastocysts were weakly
      positive for MHC class I antigens. In the mature placenta, chorioallantoic
      membranes in the interplacentomal area showed positive immunostaining for class I
      antigens on the chorionic epithelium but had no staining for class II antigens.
      There was an accumulation of lymphoid cells expressing class II antigens directly
      beneath the luminal epithelium of the endometrium. In addition, cells staining
      for leucocyte common antigen were present both within and beneath the luminal
      epithelium. Some cells positive for class II and leucocyte common antigen (CD45)
      were also associated with uterine glands. In the placentomes, class I antigens
      were expressed only on maternal caruncular septa. Fetal cotyledonary villi had no
      detectable immunostaining for class I and II antigens. No distinct pattern of
      leucocyte infiltration in the maternal caruncular tissue was observed; the
      caruncular septa contained some cells that were labelled for CD45 and a few class
      II-positive cells around blood vessels. The results indicate that the fetal
      placenta of the cow expresses MHC class I antigens in a regionally defined manner
      and there is a differential accumulation of lymphoid cells in the uterus.

PMID- 2231546
TI  - Prostaglandin F-2 alpha causes regression of an hCG-induced corpus luteum before
      day 5 of its lifespan in cattle.
AB  - The experimental objective was to evaluate how a spontaneously formed corpus
      luteum (CL) differed in its response to prostaglandin (PG) F-2 alpha, given
      during the first 5 days after ovulation, from a CL induced during dioestrus with
      hCG. Sixteen Holstein heifers were used during each of 2 consecutive oestrous
      cycles. During the first cycle (sham cycle), heifers were given no PGF-2 alpha
      (control) or PGF-2 alpha (25 mg, i.m.) on Day 2, 4 or 6 (oestrus = Day 0). During
      the second cycle (hCG-treated cycle), heifers were given hCG (5000 i.u., i.m.) on
      Day 10, followed by no PGF-2 alpha (control) or PGF-2 alpha on Day 12, 14 or 16,
      corresponding to 2, 4 or 6 days after the ovulatory dose of hCG. A new ovulation
      was induced in 13 of 16 heifers given hCG on Day 10. Luteolysis did not occur
      immediately in heifers given PGF-2 alpha on Day 2 or 4 during the sham cycle, but
      concentration of progesterone in serum during the remainder of the cycle was
      lower in heifers given PGF-2 alpha on Day 4 than in sham controls or heifers
      given PGF-2 alpha on Day 2 (P less than 0.05). Luteolysis occurred immediately in
      heifers given PGF-2 alpha on Day 6 of the sham cycle or on Day 12, 14 or 16 of
      the hCG-treated cycle, with concentration of progesterone in serum decreasing to
      less than 1 ng/ml within 2 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231547
TI  - Purification, partial characterization, and development of a specific
      radioimmunoassay for goat placental lactogen.
AB  - Placental lactogen (PL) was isolated from goat cotyledonary tissue by a
      combination of mild alkaline extraction, anion and cation exchange
      chromatography, chromatofocussing and molecular filtration. The product, enriched
      15,000-fold from the initial extract, was homogeneous when examined by SDS-gel
      electrophoresis (Mr 22,500) and isoelectricfocussing indicated a pI of 8.35 with
      a trace contaminant of pI 8.0. When assessed by relative binding activity in
      radioreceptor assays (RRA), goat PL exhibited somatotropic activity equivalent to
      2.2 units/mg dry weight and lactogenic activity equivalent to 28.5 units/mg. A
      radioimmunoassay (RIA) for goat PL is described that is highly sensitive (190
      pg/tube) and has acceptable repeatability within and between assays (6 and 13%,
      respectively). The assay is not affected by goat pituitary extracts or partly
      purified goat growth hormone and prolactin. Despite the marked increase in
      sensitivity of the RIA over that previously available when goat PL was measured
      by RRA, the hormone was not detected in jugular plasma of goats before Day 44 of
      pregnancy; concentrations increased thereafter and highest levels were measured
      during the last third of pregnancy in animals bearing triplets. Measurements by
      RIA are in general agreement with those obtained earlier in several studies in
      which RRAs were used. The hormone was detected in amniotic fluid. Maternal
      concentrations of goat PL declined before parturition and were undetectable by 18
      h post partum.

PMID- 2231548
TI  - Morphology and proportion of inner cell mass of bovine blastocysts fertilized in
      vitro and in vivo.
AB  - The morphology and proportion of inner cell mass (ICM) of bovine blastocysts
      cultured in vitro or in vivo in rabbit oviducts after in-vitro fertilization of
      in-vitro matured follicular oocytes were compared with those of blastocysts
      fertilized in vivo by a differential fluorochrome staining technique. The
      delineation of each ICM cell was improved by the transfer of embryos derived from
      in-vitro fertilization to a rabbit oviduct although the cell-cell contacts of ICM
      cells were not as tight as those from in-vivo fertilization. The proportions
      (15.8 and 14.9%) of ICM in blastocysts cultured in vitro at early and expanded
      stages were significantly lower than those cultured in rabbit oviducts after in
      vitro fertilization and fertilized in vivo. These results show that the transfer
      of bovine embryos derived from in-vitro fertilization to the rabbit oviduct
      increased the proliferation of ICM cells to the level of embryos fertilized in
      vivo although the cell-cell contact of ICM cell is not improved by the process.

PMID- 2231549
TI  - Increased ovulation rate in gilts after oral administration of epostane.
AB  - In Phase I of this study to enhance ovulation rate and hence litter size, gilts
      received 0 (sham control), 0.625, 1.25, 2.5 or 5.0 mg epostane/kg body weight on
      Days 10, 11 and 12 of the oestrous cycle (5 gilts/group). After epostane
      treatment, plasma progesterone concentrations were reduced (P less than 0.01) in
      a dose-related manner, % progesterone decline = 21.30 x square root of (dose) +
      10.45, R2 = 0.70, but recovered to pretreatment levels by 24 h. In Phase II the
      effects of epostane on ovulation rate and litter size were tested at two study
      centres. At each centre 108 gilts were treated with the same doses of epostane as
      used in Phase I and the doses were given for 7 days (Days 15-21) or 12 days (Days
      10-21) during the first oestrous cycle. Gilts were inseminated twice during the
      oestrus after treatment and were slaughtered 30 days later. Mean (+/- s.d.)
      ovulation rate was 16 +/- 2.7 (N = 8) and 21 +/- 4.0 (N = 61) for control and
      epostane-treated gilts in Centre A and 12 +/- 2.4 (N = 5) and 17 +/- 3.8 (N = 55)
      respectively in Centre B (P less than 0.01 for both) and was dose related
      (ovulation rate = 3.38 x square root of (dose) + 16.17, R2 = 0.31). The effects
      of 7- or 12-day epostane treatment on ovulation rate were not different (P
      greater than 0.05), indicating that effects of treatment after Day 14 of the
      oestrous cycle are most important to subsequent ovulation frequency.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2231550
TI  - Changes in protein synthesis and phosphorylation patterns during bovine oocyte
      maturation in vitro.
AB  - Sequential protein synthesis and protein phosphorylation patterns were generated
      by radiolabelling bovine cumulus-oocyte complexes after various periods of
      culture with [35S]methionine and [32P]orthophosphate respectively. The
      radiolabelled oocytes were assessed for their nuclear status and used
      individually for gel electrophoresis. Marked changes in the protein synthesis
      patterns were observed exclusively after germinal vesicle breakdown (GVBD),
      whereas oocytes which remained in the germinal vesicle stage showed a consistent
      protein synthesis pattern. The changes were observed after 8 and 16 h or culture,
      shortly after GVBD and before first polar body extrusion. From 3 h of culture,
      dominant phosphoprotein bands with apparent molecular weights of 24,000 and two
      between 50,000 and 60,000 were observed. The latter bands displayed slight
      molecular weight changes, which were not closely time related. After GVBD, the
      phosphoprotein band with Mr 19,000 was no longer observed. This study
      demonstrates that specific changes in protein synthesis and protein
      phosphorylation are programmed during bovine oocyte maturation.

PMID- 2231551
TI  - Folliculogenesis during the transitional period and early ovulatory season in
      mares.
AB  - Individual follicles were monitored by ultrasonography in 15 mares during the
      transitional period preceding the first ovulation of the year and in 9 mares
      during the first interovulatory interval. During the transitional period, 7 mares
      developed 1-3 anovulatory follicular waves characterized by a dominant follicle
      (maximum diameter greater than or equal to 38 mm) that had growing, static, and
      regressing phases. The emergence of a subsequent wave (anovulatory or ovulatory)
      did not occur until the dominant follicle of the previous wave was in the static
      phase. After the emergence of the subsequent wave, the previous dominant follicle
      regressed. The mean (+/- s.d.) length of the interval between successive waves
      was 10.8 +/- 2.2 days. Before the emergence of waves (identified by a dominant
      follicle), follicular activity seemed erratic and follicles did not reach greater
      than 35 mm. During the interovulatory interval, 6 mares developed 2 waves (an
      anovulatory wave and a subsequent ovulatory wave) and 3 mares developed only 1
      detected wave (the ovulatory wave). The ovulatory follicle at the end of the
      transitional period reached 20 mm earlier (Day - 15), grew slower (2.6 +/- 0.1
      mm/day; mean +/- s.e.m.) but reached a larger diameter on Day - 1 (50.5 +/- 1.1
      mm) than for the ovulatory follicle at the end of the interovulatory interval
      (Day - 10, 3.6 +/- 0.2 mm/day, 44.4 +/- 1.0 mm, respectively; P less than 0.05
      for each end point). The interval from cessation of growth of the largest
      subordinate follicle to the occurrence of ovulation was longer (P less than 0.05)
      for end of the transitional period (9.5 +/- 0.7 days) than for the end of the
      interovulatory interval (6.8 +/- 0.6 days). Results demonstrated the occurrence
      of rhythmic follicular waves during some transitional periods and the occurrence
      of 2 waves during some of the first oestrous cycles of the year.

PMID- 2231552
TI  - Extra-ovarian production of mature viable mouse oocytes from frozen primary
      follicles.
AB  - Isolated primary mouse follicles can be frozen successfully and thawed in the
      presence of 1.5 m-DMSO. Similar proportions of freshly collected and frozen
      thawed primary follicles undergo folliculogenesis in the absence of other ovarian
      tissue. Some of the mature oocytes recovered from these follicles were fertilized
      in vitro and, after transfer to pseudopregnant recipients at the 2-cell stage,
      developed into live young. Cryopreservation and extra-ovarian development of
      immature follicles provide a unique opportunity to store large numbers of female
      gametes.

PMID- 2231553
TI  - Photoperiodic requirements for LH release in juvenile broiler and egg-laying
      strains of domestic chickens fed ad libitum or restricted diets.
AB  - Photoperiodic response curves for LH release were obtained for juvenile female
      domestic chickens at 8 weeks of age by measuring changes in plasma LH
      concentrations after increasing the daily photoperiod from 8 to 10.5, 12.75,
      15.25, 17.75 or 20 h. The birds were bred either for meat production (broiler) or
      commercial egg-laying and were fed ad libitum or a restricted diet, similar to
      that used under commercial conditions. Ovarian and oviduct growth was stimulated
      by 2 weeks after transfer to 20 h light/day in the dwarf broiler strain,
      irrespective of the dietary treatment, but not in birds of the egg-laying strain.
      Baseline concentrations of plasma LH were higher in the egg-laying than in the
      dwarf broiler strain birds. A significant effect of dietary treatment was
      observed on the changes in concentration of plasma LH in the nonphotostimulated
      dwarf broiler, but not in the egg-laying bird. There was no significant
      interaction between dietary treatment and photoinduced LH release in birds of
      either strain. The shortest photoperiod needed to stimulate LH release (critical
      daylength) was less than 10.5 h in the dwarf broilers and between 10.5 and 12.75
      h in the egg-laying birds. The shortest photoperiod needed to stimulate the
      maximum release of LH (saturation daylength) was between 10.5 and 12.75 h in the
      dwarf broiler strain. The saturation daylength in birds of the egg-laying strain
      was longer, being between 12.75 and 15.25 h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231556
TI  - Factors affecting the acrosome reaction in human spermatozoa.
AB  - Large pieces of human cumulus oophorus were exposed for 20-30 min to washed
      spermatozoa or to spermatozoa recovered after a swim-up procedure, and then fixed
      for electron microscopy. Spermatozoa of both populations penetrated deeply into
      the cumulus within that time, and none of 48 observed clearly had undergone an
      acrosome reaction (AR). As measured by fluorescence microscopy, an AR rate of 12%
      in spermatozoa obtained at 4 h following a swim-up increased to about 25% in
      samples incubated in culture dishes for approximately 20 h. However, this latter
      AR rate was no different in the presence or absence of a cumulus/oocyte complex,
      and was only moderately greater in 50% follicular fluid. Nor was it affected to
      any degree by the absence of calcium or by a low (26 degrees C) temperature, both
      of which are regulators of the physiological AR in other species. By contrast, a
      clear dose-related enhancement of the AR by the calcium ionophore A23187 was
      almost completely Ca2(+)-dependent. We conclude that the human cumulus oophorus
      does not rapidly induce an AR in spermatozoa capacitated in vitro and, unlike the
      situation in some other mammals, that washed human spermatozoa do not first
      require a period of capacitation in order to penetrate it. The results also point
      to the likelihood that ARs monitored in free-swimming human spermatozoa are for
      the most part spurious or artefactual, and they show that in-vitro AR rates in
      such populations do not parallel their fertilizing ability.

PMID- 2231555
TI  - Critical progesterone requirement for maintenance of pregnancy in ovariectomized
      rats.
AB  - The minimum progesterone concentration required to maintain the pregnancy was
      studied by varying doses of progesterone given subcutaneously to rats
      ovariectomized on Day 8 of pregnancy. Injecting 3 mg progesterone plus 200 ng
      oestradiol benzoate daily provided serum progesterone values between 25.4 +/- 7.0
      and 35.2 +/- 6.2 ng/ml throughout Days 10-19 which were significantly lower than
      normal levels (P less than 0.05), but resulted in 93.6% of fetal survival on Day
      19 which was not significantly different from 93.3% in the control group.
      Injecting 2 mg progesterone plus 200 ng oestradiol benzoate daily gave
      progesterone values between 13.2 +/- 4.6 and 19.0 +/- 6.2 ng/ml and could not
      maintain fetal viability to Day 19 (14.2%, P less than 0.05 compared with control
      group). Critical times to supplement progesterone in rats ovariectomized on Day 8
      or Day 15 were studied by varying the time of progesterone implantation after
      ovariectomy. Progesterone implants were administered 8, 12 and 24 h after
      ovariectomy on Day 8 and 24, 36 and 48 h after ovariectomy on Day 15. On Day 8,
      progesterone replacement could be delayed to 8 h but not 12 h, while on Day 15,
      progesterone replacement could be delayed up to 36 h but not 48 h after
      ovariectomy without affecting fetal survival.

PMID- 2231554
TI  - Seasonal variations in prolactin, growth hormone and thyroid hormones and the
      prolactin surge at ovulation do not affect litter size of ewes during pregnancy
      in the oestrous or the anoestrous season.
AB  - Injection of bromocriptine from 5 days before until 5 days after mating clearly
      suppressed the periovulatory prolactin surge in ewes in the anoestrous and
      oestrous season but did not change the litter size significantly. Progesterone,
      GH, TSH or thyroid hormone concentrations were not influenced by the
      bromocriptine treatment. The progesterone concentrations were lower during the
      first weeks after mating in the anoestrous season compared to the oestrous
      season, while there was no difference between pregnant and non-pregnant ewes.
      During later gestation this seasonal difference was only observed in the non
      pregnant ewes. At the same time there was a clear difference between pregnancy
      and non-pregnancy in both seasons. The prolactin, GH and thyroid hormone values
      also varied significantly during gestation. Since these patterns are identical in
      pregnant and non-pregnant ewes, the fluctuations are due to environmental factors
      and not to pregnancy or altered progesterone concentrations. In the anoestrous
      season prolactin, GH, T4 and T3 levels were higher than in the breeding season,
      while rT3 showed the opposite pattern. The TSH concentration did not differ
      between the two seasons. These results suggest that seasonal variations in
      prolactin, GH and thyroid hormones or the periovulatory prolactin surge do not
      affect litter size of ewes during pregnancy in the oestrous or the anoestrous
      season.

PMID- 2231557
TI  - Maintenance of human epididymal epithelial cell function in monolayer culture.
AB  - Cells liberated by enzyme treatment of tubules dissected out of human
      epididymides obtained at castration for prostatic carcinoma were cultured for up
      to 42 days on permeable supports. Outgrowth and monolayer formation was unrelated
      to the age of the patient or his treatment with anti-androgens. The cells
      comprising the monolayer were cuboidal and shorter than those in situ but their
      ultrastructure was characteristic of epithelial cells. There was no evidence of
      smooth muscle cells or fibroblast overgrowth. The cells manifested fluid-phase
      and adsorptive endocytosis from both apical and baso-lateral aspects and released
      into the medium alkaline and acid phosphatases and N-acetylglucosaminidase.

PMID- 2231559
TI  - Hysterectomy. A critical review.
AB  - Hysterectomy is of interest to the practicing obstetrician-gynecologist not only
      from the medical and surgical points of view but also because of the societal
      interest that the procedure attracts. The operation was first described in the
      third century A.D. writings of Soranus and before the turn of this century
      carried a very high surgical morbidity and mortality rate. With the technologic
      advances made during this century in both medical and surgical specialties, the
      operation has become quite safe, with a mortality rate of approximately 12/10,000
      procedures. However, although it is possible to objectively measure the improved
      quality and increased quantity of life when hysterectomy is done for cancer
      treatment or other life-threatening conditions, it is difficult to so measure
      those parameters when hysterectomy is done solely to improve the quality of life.
      Today the physician's medical judgment and patient's understanding of the
      procedure are no longer the only criteria that have to be considered before
      surgery. Input by third-party payers, hospital administrators, quality assurance
      programs, second opinion programs and standards of practice in the geographic
      region also play a role. Also, alternatives to hysterectomy are being evaluated;
      in many circumstances they are being utilized today when hysterectomy would have
      been the treatment of choice before this decade.

PMID- 2231558
TI  - Sertoli cell-secreted protein(s) stimulates DNA synthesis in purified rat Leydig
      cells in vitro.
AB  - We have examined the effects of Sertoli cell-secreted proteins (SCSP) on
      [3H]thymidine incorporation by purified preparations (greater than 96%) of rat
      Leydig cells to determine whether Sertoli cells influence DNA synthesis in these
      cells in vitro. Incubation of Leydig cells isolated from testes of rats of ages
      16 to 90 days with SCSP (Mr greater than 10,000) induced significant dose-, time-
      and age-related increases in [3H]thymidine incorporation by the cells. A dose
      response curve to SCSP showed that as little as 0.2 micrograms SCSP/ml
      consistently induced a small but significant increase (31% and 10% above control;
      P less than 0.001) in [3H]thymidine incorporation by Leydig cells isolated from
      immature (26 days) and mature (70 days) rats, respectively. The maximum response
      (230% and 48% above control) was obtained with a concentration of 18 micrograms
      SCSP/ml in cells isolated from immature and mature rats, respectively.
      Hydroxyurea, a specific inhibitor of replicative DNA synthesis, significantly (P
      less than 0.001) inhibited both basal and SCSP-induced [3H]thymidine
      incorporation in Leydig cells from immature and adult rats without affecting the
      viability of the cells. Incubation of immature rat Leydig cells in SCSP for 48 h
      also stimulated a 3-fold increase in cell number. The component of the crude SCSP
      which stimulated Leydig cell [3H]thymidine incorporation is trypsin-sensitive,
      heat-stable, and adsorbs to a heparin-agarose affinity column but not to
      concanavalin A-Sepharose. The secretion of this factor(s) by Sertoli cells is
      stimulated independently by FSH and testosterone. These results demonstrate for
      the first time that cultured Sertoli cells secrete a protein(s) which, in vitro,
      stimulates rat Leydig cell replicative DNA synthesis.

PMID- 2231560
TI  - Effect of interleukin-1 on gamete interaction and mouse embryo development.
AB  - Early stages of endometriosis have been shown to be associated with infertility.
      The pathophysiology of this relationship is unclear. To determine if interleukin
      1 (IL-1), a peritoneal macrophage product, has any effect on gamete interaction
      and early embryo development, human recombinant IL-1 was added to the
      coincubation of gametes in the sperm penetration assay (SPA), human zona
      pellucida assay (ZPPA) and culture medium (Ham's F-10) used for processing semen
      samples with the layering method, with analysis of velocity and motility after 24
      hours. IL-1 was also added to mouse embryos (two cells) cultured for 72 hours.
      The results showed that IL-1 caused impairment of SPA and ZPPA when compared to
      control medium, without significant alterations in sperm velocity and motility.
      Also, IL-1 demonstrated significant inhibition of mouse embryo development. These
      results help explain subfertility associated with early stages of endometriosis.

PMID- 2231561
TI  - Two urogenital sinus syndromes. Interstitial cystitis and focal vulvitis.
AB  - Forty-six young women had unusual and presumably noninfectious disorders of
      unknown etiology involving tissues derived from the embryonic urogenital sinus
      (urogenital sinus syndromes). Ten women had interstitial cystitis, and 25 had
      focal vulvitis. Eleven women had both interstitial cystitis and focal vulvitis.
      The affected groups were similar in demographic and other characteristics. Most
      were white and in their mid-20s. Both unusual conditions occurred in the same
      woman more often than could be expected by chance. This observation suggests that
      some common, perhaps autoimmune mechanism may be involved in the etiology of
      these syndromes.

PMID- 2231562
TI  - Stress incontinence and low urethral closure pressure. Correlation of
      preoperative urethral hypermobility with successful suburethral sling procedures.
AB  - Forty-eight women with genuine stress incontinence and low urethral closure
      pressure were treated with a suburethral sling procedure using
      polytetrafluoroethylene. All patients underwent a preoperative clinical
      evaluation and multichannel urodynamic testing. The clinical examination included
      a "Q-tip" test to determine the presence or absence of urethral hypermobility.
      Urethral hypermobility was defined as a maximal angle change of greater than or
      equal to 30 degrees from the horizontal, measured during straining or coughing in
      the lithotomy position. Thirty-four patients underwent repeat multichannel
      urodynamic testing three months postoperatively to determine the objective
      surgical success. Ninety-three percent of patients (27/29) with a positive
      preoperative Q-tip test were cured. Of patients with a negative preoperative Q
      tip test, only 20% (1/5) were cured. Preoperative urethral hypermobility was a
      good prognostic indicator of operative success when a suburethral sling procedure
      was used to treat genuine stress incontinence and low urethral closure pressure.

PMID- 2231563
TI  - Perinatal outcomes of twin pregnancies at term.
AB  - A review of a two-year experience in our community disclosed that 57% of twin
      pregnancies (118/207) deliver at term. Little attention has been focused on
      perinatal outcomes of twin pregnancies remaining undelivered after 36 completed
      weeks. Therefore, we reviewed our experience to determine whether our practice
      should change to maximize perinatal care. Nearly all the study pregnancies
      (115/117, or 97.5%) delivered by the estimated date of confinement. Fetal
      malpresentation, failure to progress and the patient's lack of desire for a
      vaginal birth after cesarean delivery were common reasons for the high cesarean
      rate (62/117, or 52%). The neonatal outcomes were favorable regardless of the
      route or interval between deliveries. Discordant fetal growth was found in only
      eight cases (6.8%). No perinatal deaths occurred, and five-minute Apgar scores
      less than 7 (2/234, or 0.9%) and rates of anomalies (5/234, or 2.1%) were not
      different from those in singleton pregnancies delivering during the same period.
      Using the principles of obstetric practice used in our community, we would expect
      the perinatal outcomes in term twin gestations to be favorable.

PMID- 2231564
TI  - Epidural analgesia. Effect on the likelihood of a successful trial of labor after
      cesarean section.
AB  - From October 1984 to April 1986, 237 women who had had an earlier cesarean
      section underwent a trial of labor (TOL). The delivery outcomes for 87 who
      received epidural analgesia were compared retrospectively with those for the 150
      who did not. There were no overt uterine ruptures. The rates were similar for
      successful TOL, uterine scar dehiscence, blood transfusions, endometritis and one
      and five-minute Apgar scores. The rate of operative vaginal delivery was higher
      in the epidural group. When epidural subjects were divided into vaginal and
      cesarean delivery groups, the failed-TOL group differed from the successful-TOL
      group in greater maternal weight gain, heavier and longer infants, higher rate of
      oxytocin administration, less cervical dilation and higher station at epidural
      activation. When the oxytocin-treated subjects were excluded, however, the
      epidural and no-epidural patients had the same successful TOL rates (94% and 92%,
      respectively) and spontaneous vaginal delivery rates (70% and 76%, respectively).
      Epidural analgesia, when controlled for oxytocin use, appears to have no effect
      on the failed-TOL or operative vaginal delivery rate.

PMID- 2231565
TI  - Training obstetrics-and-gynecology residents to manage breast disease.
      Incorporation into a breast care clinic.
AB  - The American Board of Obstetricians and Gynecologists recently issued a directive
      that education in breast disease be incorporated into all residency training
      programs. At the University of Michigan Medical Center, the Comprehensive Breast
      Care Center (BCC) provides the vehicle for the education and training of
      residents in the area of breast disease. The department of obstetrics and
      gynecology is fully integrated and participates actively in the care of patients
      in the BCC.

PMID- 2231567
TI  - The nonstress test. Criteria for the duration of fetal heart rate acceleration.
AB  - Although the most common definition of a reactive nonstress test is an
      acceleration in the fetal heart rate of 15 beats per minute (bpm) for 15 seconds,
      some investigators require that the fetal heart rate acceleration be maintained
      at 15 bpm above the baseline for the entire 15 seconds (long criterion), and
      others require simply that the acceleration be 15 seconds from the beginning
      until the return to the baseline (short criterion). In 1,241 nonstress tests
      (NSTs) there was a statistically significant difference in the number of reactive
      tests between the short and long criteria (1,108 [89%] vs. 985 [79%], P less than
      .001). This difference in percentage of reactivity may be important when
      comparing studies performed by various investigators. In comparing cesarean
      section deliveries for fetal distress we were unable to find a difference in the
      ability to predict a poor outcome between use of the short and long criteria.
      However, a type II error is possible since the number of poor outcomes was small.
      We now use the short criterion for NST interpretation.

PMID- 2231566
TI  - Value of a screening fetal heart rate tracing in the latent phase of labor.
AB  - We studied the value of a screening fetal heart rate (FHR) tracing obtained on
      405 women in the latent phase of labor on presentation to the labor-and-delivery
      suite. All pregnancies were at term and had a cephalic presentation. Thirty-two
      women in the sample studied underwent a cesarean section for fetal distress.
      Using that end point, a screening FHR tracing in the admitting room had a
      sensitivity of 57%, specificity of 98%, positive predictive value of 75% and
      overall efficiency of 95%. One- and five-minute Apgar scores and thick meconium
      staining of the amniotic fluid were also examined. While no statistically
      significant differences were found (P less than .2 for Apgar score and less than
      .06 for meconium), there was a trend that might have been significant if more
      women had been studied. A screening FHR tracing on all women at term in the
      latent phase of labor will identify the majority of those who will develop fetal
      distress in labor. Women with an abnormal screening tracing should be admitted to
      the hospital and the fetal status evaluated further.

PMID- 2231568
TI  - Occlusion of the vas deferens in dogs with a biocompatible hydrogel solution.
AB  - The surgically exposed vasa deferentia of 21 dogs were injected, under visual
      inspection, with Hypan N-90 acrylic hydrogel (50-150 microL). The hydrogel was
      deposited inside the vas lumen via a 22-gauge Teflon intercatheter. The solution
      gelled within 120 seconds. Semen was collected by manual collection and analyzed
      for volume, sperm count and viability. After occlusion with 150 microL of the
      polymer in the distal direction (direction of the testis), the volume of
      ejaculate (2.2 mL) did not change. Subsequent samples showed no viable or dead
      spermatozoa. The stained smears of the ejaculate showed the presence of cell
      debris, granulocytes and few epithelial cells. When the vas was injected with 50
      microL of the polymer in either a distal or proximal direction, the occlusion
      effectiveness was 75% and 25%, respectively. In the proximal direction,
      granulomas were noticed in the vas wall where semen leaked through the injection
      port. Histology of successfully occluded vasa (with Hypan) showed no cellular
      reaction or fibrotic changes in the proximity of the polymer. For less than or
      equal to 20 weeks after vas occlusion, no evidence of abnormal morphology was
      found in the epididymal and testicular tissue. This highly biocompatible polymer
      solution, when gelled in contact with tissue fluid, offers safe and effective
      occlusion of the vas with the promise of reversibility.

PMID- 2231569
TI  - Amniography for confirming the diagnosis of monoamniotic twinning. A case report.
AB  - In a case of monoamniotic twinning, amniography was used to confirm the
      diagnosis. This modality, old but now employed infrequently, helps establish the
      absence of a dividing membrane and complements currently used ultrasound
      diagnostic methods. A successful outcome resulted. Amniography should be
      considered a useful diagnostic modality in the management of twin gestations and
      not be relegated to the past.

PMID- 2231570
TI  - Intrapartum, intranasal cocaine use and acute fetal distress. A case report.
AB  - Intrapartum, intranasal cocaine was used for relief of labor pains by a healthy
      woman with an uncomplicated pregnancy. Fetal hypoxemia and distress followed the
      event. A causal relationship between the intrapartum use of cocaine and the fetal
      distress was postulated. Cocaine abusers could benefit from hospitalization early
      in labor for close surveillance and monitoring, thus avoiding exposure to cocaine
      and its unpredictable systemic effects.

PMID- 2231571
TI  - Open section--open minds.

PMID- 2231572
TI  - Myalgic encephalomyelitis: an alternative theory.

PMID- 2231573
TI  - Wind of change-IV. Teaching hospitals in London 1938-1988.

PMID- 2231574
TI  - Measuring vitality.
AB  - Subjective perceptions of mental and physical energy were measured by the use of
      visual analogue scales (VAS) over the course of a week in a group of normal
      volunteers. These variables were found to correlate, highly both with one another
      and with assessments of vigour and fatigue measured with a standard adjectival
      format. In addition, high correlations were found with a measure of positive
      affect. These five variables also displayed characteristic patterns of diurnal
      variation. Physical and mental energy, vigour and positive affect were highest in
      the morning, falling progressively and significantly over the day. In contrast,
      fatigue showed the opposite pattern. Extraversion showed positive correlations
      with physical and mental energy, vigour and positive affect, and negative
      correlations with fatigue and negative affect, most being significant (P less
      than 0.05). Conversely, neuroticism showed a negative correlation with the first
      four energy variables but was positively related to fatigue and negative affect,
      most correlations again being significant. Physical and mental energy, vigour and
      positive affect also showed a positive correlation (P less than 0.01) with a
      measure of happiness. It is concluded that VAS-derived ratings of physical and
      mental energy are reliable indicators of self-perceived vigour and fatigue. They
      are easy to record and show sufficient short-term stability to be used in more
      extensive studies both of well-being and of its physiological correlates.

PMID- 2231576
TI  - Anorexia nervosa associated with acromegaloid features, onset of acrocyanosis and
      Raynaud's phenomenon and worsening of chilblains.
AB  - Patients with anorexia nervosa may develop many physical and endocrinological
      complications. We wish to report two patients who developed soft tissue swelling
      of their hands and worsening of their peripheral vascular disease, evidenced by
      the appearance of acrocyanosis and Raynaud's phenomenon and more severe
      perniosis, following the onset of their anorexia nervosa.

PMID- 2231577
TI  - Intolerance to oral and intravenous calcium supplements in atopic eczema.
AB  - Children treated with dietary restriction for food intolerance may require
      calcium supplementation, particularly if cows' milk and milk substitutes are not
      tolerated. We report two children with atopic eczema who reacted adversely to a
      number of calcium supplement formulations.

PMID- 2231575
TI  - Skin damage in chronic venous insufficiency: does an oxygen diffusion barrier
      really exist?
AB  - Eleven patients with lipodermatosclerosis (LDS) and 14 patients without venous or
      arterial disease underwent measurement of xenon-133 (133Xe) half-clearance times
      from the gaiter region of the leg. Xenon has similar diffusion characteristics to
      oxygen, and the investigation reflects the ability of the isotope to diffuse from
      the skin surface into capillary blood. Median skin half-clearance time for skin
      in the LDS group was 2.2 min and in the control group 2.1 min. From the
      subcutaneous tissues, the respective times were 14.1 and 17.4 minutes. These
      differences are not statistically significant. The study fails to yield evidence
      suggesting that an oxygen diffusion barrier exists in lipodermatosclerosis.

PMID- 2231578
TI  - Relationship between longevity and lifeline: a manual study of 100 patients.
AB  - The relationship between length of lifeline and age at death has been evaluated
      in 100 consecutive autopsies. A highly significant association between the two
      was discovered which was strengthened further when hand size was controlled for.
      We feel that a powerful new prognostic sign may thus be within grasp.

PMID- 2231579
TI  - Laboratory medicine--an American system: discussion paper.

PMID- 2231580
TI  - Styles of liaison psychiatry: discussion paper.

PMID- 2231581
TI  - Ovine toxoplasmosis: a review.

PMID- 2231582
TI  - Saint Vitus' dance: vital misconceptions by Sydenham and Bruegel.

PMID- 2231583
TI  - Heine's illness: the case for multiple sclerosis.

PMID- 2231584
TI  - Satire of medicine: the 18th century and beyond.

PMID- 2231585
TI  - Closed loop large bowel obstruction secondary to pancreatitis.

PMID- 2231586
TI  - Familial Raynaud's phenomenon and localized scleroderma associated with essential
      telangiectasia and cytogenetic abnormalities.

PMID- 2231587
TI  - Munchausen meningitis.

PMID- 2231588
TI  - Fatal cerebral oedema following trichloroethane abuse.

PMID- 2231589
TI  - Road traffic accidents and seatbelts.

PMID- 2231590
TI  - Cardiac arrhythmia and epilepsy.

PMID- 2231592
TI  - Mechanism and inhibition of cytochrome P-450 aromatase.

PMID- 2231591
TI  - Epistaxis induced by a non-steroidal anti-inflammatory drug.

PMID- 2231593
TI  - Benzotriazinones as "virtual ring" mimics of o-methoxybenzamides: novel and
      potent 5-HT3 receptor antagonists.

PMID- 2231594
TI  - Phosphorus-containing inhibitors of HMG-CoA reductase. 1. 4-[(2
      arylethyl)hydroxyphosphinyl]-3-hydroxy-butanoic acids: a new class of cell
      selective inhibitors of cholesterol biosynthesis.

PMID- 2231595
TI  - Selective inhibition of urokinase by substituted phenylguanidines: quantitative
      structure-activity relationship analyses.

PMID- 2231597
TI  - Structural, conformational, and theoretical binding studies of antitumor
      antibiotic porfiromycin (N-methylmitomycin C), a covalent binder of DNA, by X
      ray, NMR, and molecular mechanics.
AB  - X-ray, NMR, and molecular mechanics studies on antitumor antibiotic porfiromycin
      (C16H20N4O5), a covalent binder of DNA, have been carried out to study the
      structure, conformation, and theoretical interactions with DNA. The crystal
      structure was solved by direct methods and refined to an R value of 0.052. The
      configurations at C(9), C(9a), C(1), and C(2) are S, R, S, and S, except for the
      orientation of the aziridine ring and (carbamoyloxy)methyl side chain. The five
      membered ring attached to the aziridine ring adopts an envelope conformation. The
      solution conformation is similar to that observed in the solid state except for
      the (carbamoyloxy)methyl side chain. Monovalent and cross-linked models of the
      drug bound to DNA have been energetically refined by using molecular mechanics.
      The results indicate that, in the case of monocovalent binding, the drug clearly
      prefers a d(CpG) sequence rather than a d(GpC) sequence. In the case of the cross
      linked model there is no clear-cut preference of d(CpG) over d(GpC), indicating
      that the binding preference of the drug may be kinetic rather than thermodynamic.

PMID- 2231596
TI  - Synthesis, biological profile, and quantitative structure-activity relationship
      of a series of novel 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors.
AB  - A series of 9,9-bis(4-fluorophenyl)-3,5-dihydroxy-8-(alkyltetrazol-5-yl)- 6,8
      nonadienoic acid derivatives 1 were synthesized and found to inhibit
      competitively the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA)
      reductase. The analogues having 1N-methyltetrazol-5-yl attached to the C8
      position (3a, 4a, R1 = R2 = F) are the most active in suppressing cholesterol
      biosynthesis in both in vitro and in vivo models: the IC50 for the chiral form of
      3a is 19 nM, Ki = 4.3 x 10(-9)M when Km for HMG-CoA is 28 x 10(-6) M;1 the ED50
      (oral) value corresponding to the lactone derivative (4a, BMY 22089) is
      approximately 0.1 mg/kg. Further, BMY 21950 is nearly 2 orders of magnitude more
      active in parenchymal heptaocytes, from which most of the serum cholesterol
      originates, than in other cell preparations (such as spleen, testes, ileum,
      adrenal, and ocular lens epithelial cells; Table III). This apparent tissue
      specificity may be highly beneficial since the blocking of cholesterol
      biosynthesis in other vital organs could eventually lead to undesirable side
      effects. In addition to the chemical synthesis and biological evaluation, a
      theoretical study aimed at relating the HMG-CoA reductase inhibitory potency to
      the three-dimensional structure of the inhibitors was undertaken. With a
      combination of molecular mapping and 3D-QSAR techniques, it was possible to
      determine a logical candidate for the conformation of the bound inhibitor and to
      quantitatively relate inhibitory potency to the shape and size of both the
      binding site and the C8-substituent.

PMID- 2231598
TI  - DNA-directed alkylating agents. 2. Synthesis and biological activity of platinum
      complexes linked to 9-anilinoacridine.
AB  - Two different classes of cis-diaminedichloroplatinum(II) complexes linked to the
      DNA-intercalating chromophore 9-anilinoacridine have been synthesized and
      evaluated as DNA-targeted antitumor agents. Two different Pt chelating ligands
      were investigated (based on 1,2-ethanediamine and 1,3-propanediamine), designed
      to deliver the Pt in an orientation likely to respectively enhance either
      intrastrand or interstrand cross-linking. Although both sets of ligands were
      somewhat unstable under neutral or basic conditions with respect to
      disproportionation, the corresponding Pt complexes, once prepared, appeared to be
      quite stable. All the Pt complexes were monitored for purity by TLC, HPLC, and
      FAB mass spectra, and the mode of Pt coordination was established by 195Pt NMR
      spectroscopy. The complexes appeared to cause simultaneous platination and
      intercalative unwinding of plasmid DNA. In vitro studies were carried out with
      both wild-type and cisplatin-resistant P388 cell lines. Whereas cisplatin itself
      and the ethylenediamine and 1,3-propanediamine complexes used as standards were
      about 10-fold less active against the resistant line, the ethylenediamine-linked
      Pt complexes showed no differential toxicity between the two lines and the
      propanediamine-linked complexes showed significant differentials (up to 8-fold)
      in favor of the cisplatin-resistant line. However, these were no greater than
      those shown by the unplatinated ligands themselves. The majority of the acridine
      complexes were inactive in vivo against the wild-type P388 leukemia. They were
      very insoluble, and although a suitable formulation was found, this may have been
      a factor. It is also possible that these compounds bind in such a way as to
      direct the Pt away from the major groove.

PMID- 2231600
TI  - Synthesis, in vitro binding profile, and central nervous system penetrability of
      the highly potent 5-HT3 receptor antagonist [3H]-4-(2-methoxyphenyl)-2-[4(5)
      methyl-5(4)-imidazolylmethyl]thiazole.
AB  - 4-(2-Methoxyphenyl)-2-[4(5)-methyl-5(4)-imidazolylmethyl]thiazole (5) is a highly
      potent member of a structurally novel series of selective serotonin-3 receptor
      antagonists. The synthesis of tritiated 5 and its binding profile in
      neuroblastoma-glioma 108-15 cells are described. Furthermore, in vivo studies in
      rat with this radioligand indicate that it effectively penetrates the blood-brain
      barrier upon peripheral administration. Thus, 5 should be a useful
      pharmacological tool for both in vitro and in vivo studies of this class of
      compounds.

PMID- 2231599
TI  - DNA-directed alkylating agents. 3. Structure-activity relationships for acridine
      linked aniline mustards: consequences of varying the length of the linker chain.
AB  - Four series of acridine-linked aniline mustards have been prepared and evaluated
      for in vitro cytotoxicity, in vivo antitumor activity, and DNA cross-linking
      ability. The anilines were attached to the DNA-intercalating acridine
      chromophores by link groups (-O-, -CH2-, -S-, and -SO2-) of widely varying
      electronic properties, providing four series of widely differing mustard
      reactivity where the alkyl chain linking the acridine and mustard moieties was
      varied from two to five carbons. Relationships were sought between chain length
      and biological properties. Within each series, increasing the chain length did
      not alter the reactivity of the alkylating moiety but did appear to position it
      differently on the DNA, since cross-linking ability (measured by agarose gel
      assay) altered with chain length, being maximal with the C4 analogue. The in vivo
      antitumor activities of the compounds depended to some extent on the reactivity
      of the mustard, with the least reactive SO2 compounds being inactive. However,
      DNA-targeting did appear to allow the use of less reactive mustards, since the S
      linked acridine mustards showed significant activity whereas the parent S-mustard
      did not. Within each active series, the most active compound was the C4
      homologue, suggesting some relationship between activity and extent of DNA
      alkylation.

PMID- 2231602
TI  - Relaxant activity of 4-amido-3,4-dihydro-2H-1-benzopyran-3-ols and 4-amido-2H-1
      benzopyrans on guinea pig isolated trachealis.
AB  - A series of 4-amido-3,4-dihydro-2H-1-benzopyran-3-ols and 4-amido-2H-1
      benzopyrans related to the potassium channel activator cromakalim have been
      prepared and evaluated for their relaxant activity in guinea pig isolated
      tracheal spirals. Several analogues show enhanced relaxant activity relative to
      cromakalim in this preparation and the rank order of potency for those
      substituents investigated at C-6 was CF3 greater than CN greater than C2H5
      greater than aza greater than or equal to CH3. One compound, trans-3,4-dihydro
      2,2-dimethyl-4-(2-oxopiperidin-1-yl)-7-(trifluor omethyl)-2H- 1-benzopyran-3-ol
      (24), was resolved into its two enantiomers and the activity was shown to reside
      essentially in the (+)-isomer, adding further support to the suggestion that the
      smooth muscle receptor for these potassium channel activators is stereoselective.

PMID- 2231601
TI  - Variation in the aromatic ring of cromakalim: antihypertensive activity of
      pyranopyridines and 6-alkyl-2H-1-benzopyrans.
AB  - The synthesis and antihypertensive activity in the spontaneously hypertensive rat
      of two new series of analogues related to cromakalim (1) are described. In the
      first series, where the benzopyran nucleus has been replaced by a pyranopyridine
      nucleus, the position of the nitrogen atom has been found to be critical for
      activity, and the most potent compounds are the pyrano[3,2-c]pyridines. In the
      second series, where the powerful electron-withdrawing cyano group of compound 1
      has been replaced by alkyl and phenyl groups, the order of antihypertensive
      potency is ethyl, isopropyl, tert-butyl greater than propyl, cyclopentyl greater
      than methyl greater than phenyl.

PMID- 2231603
TI  - Potential antimitotic agents. Synthesis of some ethyl benzopyrazin-7
      ylcarbamates, ethyl pyrido[3,4-b]pyrazin-7-ylcarbamates, and ethyl pyrido[3,4-e]
      as-triazin-7-ylcarbamates.
AB  - Ring analogues and derivatives of the 1,2-dihydropyrido[3,4-b]pyrazin-7
      ylcarbamates (e.g., 29), antimitotic agents with antitumor activity, were
      prepared in the search for compounds with greater selectivity. Methods were
      developed for the conversion of substituted benzoic acids (1-4) to give
      benzopyrazines (12-16 and 21) and of substituted pyridin-2-carbamates (23, 38,
      and 41) to give 2-aminopyrido[3,4-b]pyrazin-7-ylcarbamates (32 and 36) and
      pyrido[3,4-e]-as-triazin-7-ylcarbamates (47 and 50). In vitro evaluation
      indicated that activity was reduced by removal of the pyridine ring nitrogen of
      29 to give 14 and was destroyed by increasing the basicity of the pyrazine ring
      of 29 to give 32 and 47.

PMID- 2231604
TI  - Inhibition of enzymes of estrogen and androgen biosynthesis by esters of 4
      pyridylacetic acid.
AB  - A variety of esters of 4-pyridylacetic acid have been prepared by base mediated
      exchange from the methyl ester. Several of the esters of alcohols that contained
      a cyclohexyl ring were potent inhibitors of human placental aromatase and of the
      rat testicular 17 alpha-hydroxylase/C17-20lyase complex. The most potent agents
      found against both enzyme complexes were the borneyl, isopinocampheyl, and 1
      adamantyl esters. These were over 100 times more potent than aminoglutethimide
      against aromatase and of greater potency than ketoconazole against
      hydroxylase/lyase. Potency against either enzyme complex was reduced if the ester
      function was borne on the cyclohexyl ring in an axial rather than an equatorial
      position. Some differential selectivity could be introduced since whereas methyl
      substitution adjacent to the carbonyl group reduced the inhibition of aromatase,
      it increased that against hydroxylase/lyase.

PMID- 2231605
TI  - Inhibitors of the P450 enzymes aromatase and lyase. Crystallographic and
      molecular modeling studies suggest structural features of pyridylacetic acid
      derivatives responsible for differences in enzyme inhibitory activity.
AB  - Derivatives of 4-pyridylacetic acid are known to be inhibitors of the cytochrome
      P450 enzymes aromatase and lyase (17 alpha-hydroxylase/C17-20lyase), and are
      therefore of interest in the treatment of hormone dependent breast and prostate
      cancers. We report the determination of the crystal structure of one such
      derivative, the 4-tert-butyl cyclohexyl ester, and molecular modeling studies on
      two related inhibitors, the cyclohexyl ester and its alpha-methyl derivative.
      These latter two compounds show a marked difference in their relative activities
      against aromatase and lyase. Two models are proposed for the interaction of these
      molecules with the target enzymes on the basis of their ability to adopt
      conformations that partially mimic steroid substrates. From these models an
      explanation can be advanced for the fact that, compared with the unmethylated
      analogue, the (racemic) alpha-methylated compound is seven times poorer as an
      inhibitor of aromatase but seven times better as an inhibitor of lyase. The model
      proposed for binding to aromatase places the alpha-carbon of the ester group in
      the position occupied by C(2) of steroid substrates. In contrast, that proposed
      for binding to lyase places this atom in the position occupied by C(17) of
      steroid substrates. The introduction of steric bulk at C(2) is known to be
      unfavorable for aromatase inhibition, while its introduction at C(17) may lead to
      a better mimicry of the steroid D-ring and so improve lyase inhibition.

PMID- 2231606
TI  - Quinazoline antifolate thymidylate synthase inhibitors: alkyl, substituted alkyl,
      and aryl substituents in the C2 position.
AB  - Modification of the potent thymidylate synthase (TS) inhibitor N-[4-[N-[(2-amino
      3,4-dihydro-4-oxo-6-quinazolinyl)methyl]-N-prop-2- ynylamino]benzoyl]-L-glutamic
      acid (1a) has led to the synthesis of quinazoline antifolates bearing alkyl,
      substituted alkyl, and aryl substituents at C2. In general the synthetic route
      involved the coupling of the appropriate diethyl N-[4-(alkylamino)benzoyl]-L
      glutamate with a C2-substituted 6-(bromo-methyl)-3,4-dihydro-4-oxoquinazoline
      followed by deprotection using mild alkali. Good enzyme inhibition and
      cytotoxicity were found with compounds containing small nonpolar groups in the C2
      position with the 2-desamino-2-methyl analogue 3a being the most potent. Larger
      C2 substituents were tolerated by the enzyme, but cytotoxicity was reduced.
      Highly potent series were followed up by the synthesis of a number of analogues
      in which the N10 substituent was varied. In this manner a number of interesting
      TS inhibitors have been prepared. Although none of these was more potent than 1a
      against the isolated enzyme, over half of the compounds prepared were more potent
      as cytotoxic agents against L1210 cells in culture. The potential of such
      compounds as useful antitumor agents was further enhanced by the finding that the
      improved aqueous solubilities of compounds such as 3a over 1a were reflected in
      vivo in that 3a was at least 5 times less toxic to mice than 1a.

PMID- 2231607
TI  - Quinazoline antifolate thymidylate synthase inhibitors: 2'-fluoro-N10-propargyl
      5,8-dideazafolic acid and derivatives with modifications in the C2 position.
AB  - The synthesis of 2'-fluoro-10-propargyl-5,8-dideazafolic acid and its 2-desamino,
      2-desamino-2-hydroxymethyl, and 2-desamino-2-methoxy analogues is described. In
      general the synthetic route involved the coupling of diethyl N-[2-fluoro-4-(prop
      2-ynylamino)benzoyl]-L-glutamate with the appropriate 6-(bromomethyl)quinazoline
      followed by deprotection with mild alkali. These four compounds together with the
      2-desamino-2-methyl analogue were tested for their activity against L1210
      thymidylate synthase (TS). They were also examined for their inhibition of the
      growth of the L1210 cell line and of two mutant L1210 cell lines, the L1210:R7A
      that overproduces dihydrofolate reductase (DHFR) and the L1210:1565 that has
      impaired uptake of reduced folates. Compared with their non-fluorinated parent
      compounds, the 2'-fluoro analogues were all approximately 2-fold more potent as
      TS inhibitors. Similarly, they also showed improved inhibition of L1210 cell
      growth (1.5-5-fold), and this activity was prevented by co-incubation with
      thymidine. All had retained or improved activity against both the L1210:R7A and
      L1210:1565 cell lines.

PMID- 2231608
TI  - Quinazoline antifolate thymidylate synthase inhibitors: benzoyl ring
      modifications in the C2-methyl series.
AB  - The synthesis of nine new 2-methyl-10-propargylquinazoline antifolates with
      substituents in the p-aminobenzoyl ring is described. In general the synthetic
      route involved the coupling of the appropriate ring-substituted diethyl N-[4
      (prop-2-ynylamino)benzoyl]-L-glutamate with 6-(bromomethyl)-3,4-dihydro-2-methyl
      4-oxoquinazoline followed by deprotection using mild alkali. The compounds were
      tested as inhibitors of partially purified L1210 thymidylate synthase (TS). They
      were also examined for their inhibition of the growth L1210 cells in culture.
      Compared to the parent compound 1a the 2'-fluoro analogue 2a exhibited enhanced
      potency in both systems whereas the 3'-fluoro analogue 3a showed enhanced growth
      inhibitory properties against L1210 cells despite being a poorer inhibitor of the
      isolated enzyme. Chloro, hydroxy, methoxy, and nitro substituents in the 2'
      position were also well tolerated by the enzyme but failed to give enhanced
      growth inhibition. The series was extended to cover analogues of the 2'-fluoro,
      3'-fluoro, 2'-chloro, 2'-methyl, 2'-amino, 2'-methoxy, and 2'-nitro derivatives
      with modified alkyl substituents at N10.

PMID- 2231610
TI  - Synthesis and structure-activity relationships of new 9-N-alkyl derivatives of
      9(S)-erythromycylamine.
AB  - A series of new 9-N-alkyl derivatives of 9(S)-erythromycylamine has been
      synthesized by reductive alkylation of erythromycylamine with aliphatic aldehydes
      and sodium cyanoborohydride. Alternative syntheses employing hydrogenation
      methods have also been developed. These new 9-N-alkyl derivatives possess
      excellent antimicrobial activity in vitro and in vivo, especially when
      administered orally to treat experimental infections in mice. From structure
      activity studies, 9-N-(1-propyl)erythromycylamine (LY281389) was selected as the
      most efficacious derivative. These methods have also been extended to the
      synthesis of some 9-N,N-dialkyl derivatives of erythromycylamine.

PMID- 2231609
TI  - Design of potent and selective linear antagonists of vasopressor (V1-receptor)
      responses to vasopressin.
AB  - We report the solid-phase synthesis of 21 linear analogues of A and D, two
      nonselective antagonists of the vasopressor (V1) and antidiuretic (V2) responses
      to arginine vasopressin (AVP). A is Aaa-D-Tyr(Et)-Phe-Val-Asn-Abu-Pro-Arg-Arg-NH2
      (where Aaa = adamantylacetyl at position 1). D is the des-Arg9 analogue of A.
      Nine new analogues of A (1-9) and 12 new analogues of D (10-21) were obtained.
      The following substitutions either alone or in combination were incorporated in A
      and/or in D: phenylacetic acid (Phaa) and tert-butylacetic acid (t-Baa) at
      position 1; D-Tyr2, D-Tyr(Me)2; Gln4; Arg6, Lys6, Orn6, MeAla7. The nine new
      analogues of A are (1) [Arg6], (2) [Lys6], (3) [Orn6], (4) [Phaa1,Lys6], (5)
      [Phaa1,Orn6], (6) [D-Tyr2], (7) [D-Tyr2,Arg6], (8) [Phaa1,D-Tyr2], (9) [Phaa1,D
      Tyr2,Arg6]. The 12 new analogues of D are (10) [Arg6], (11) [Lys6], (12) [Orn6],
      (13) [Phaa1,Lys6], (14) [Phaa1,Gln4,Lys6], (15) [Phaa,D-Tyr(Me)2,Lys6], (16)
      [Phaa,D-Tyr(Me)2,Gln4,Lys6], (17) [Phaa1,D-Tyr2,Gln4,Lys6], (18) [t-Baa1,Lys6],
      (19) [t-Baa1,Gln4,Lys6], (20) [Arg6,MeAla7], (21) [t-Baa1,Arg6,MeAla7]. All 21
      peptides were examined for agonistic and antagonistic potencies in AVP V2 and V1
      assays in rats. With the exception of 6, the eight remaining new analogues of A
      are equipotent or more potent than A as V1 antagonists. Peptides 2-9 are less
      potent than A as V2 antagonists. Three, 4, 5, and 9, exhibit significant gains in
      anti-V1/anti-V2 selectivities (selectivity ratio = 41, 14, and infinite,
      respectively), compared to A (anti-V1, pA2 = 7.75 +/- 0.07; selectivity ratio =
      0.44). Peptide 9 is unique in both series. It is a highly potent V1 antagonist
      (anti-V1 pA2 = 8.62 +/- 0.11 and is the first linear peptide to exhibit
      substantial antidiuretic agonism (4.1 +/- 0.2 units/mg). With the exception of
      12, the remaining 11 analogues of D are 8-40 times more potent than D as V1
      antagonists. Eight of these peptides exhibit significant gains in anti-V1/anti-V2
      selectivities compared to D (anti-V1 pA2 = 7.43 +/- 0.06; selectivity ratio =
      1.6).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231611
TI  - Synthesis and antiarrhythmic activity of 5,11-dihydro[1]benzoxepino[3,4
      b]pyridines.
AB  - During further modification of the new antiulcer agent 5 (KW-5805), a 5,11
      dihydro[1]benzoxepino[3,4-b]pyridine derivative, we found that some new
      derivatives had antiarrhythmic activity. So we continued synthesis and evaluation
      of a series of 5-substituted 5,11-dihydro[1]benzoxepino[3,4-b]pyridines for
      antiarrhythmic activity in chloroform-induced ventricular arrhythmias in mice and
      in ouabain-induced ventricular arrhythmias in dogs. In chloroform-induced
      ventricular arrhythmias, the 7-methoxy group played an important role in activity
      and the type of terminal side chain at position 5 had not obvious effect on
      potency. On the other hand, in ouabain-induced ventricular arrhythmias, the
      structure-activity relationship was highly specific and only four compounds, 9,
      30, 34, and 35, were effective. Compound 9,5-[[2-(diethylamino)ethyl]amino]-7
      methoxy-5,11-dihydro[1] benzoxepino[3,4-b]pyridine 1.5-fumarate, which exhibited
      low affinity for muscarinic acetylcholine receptors and a high
      ED100(mydriasis)/ED50(antiarrhythmic activity) ratio, was selected for further
      development and clinical evaluation as KW-3407. The synthesis and antiarrhythmic
      activity of optically active 9 is described. The order of potency of
      antiarrhythmic activity in ouabain-induced ventricular arrhythmias in dogs was (
      )-9, (+/-)-9, and (+)-9.

PMID- 2231612
TI  - Evolutionary relationships among California serogroup viruses (Bunyaviridae) and
      Aedes mosquitoes (Diptera: Culicidae)
AB  - More than 100 published and four unpublished papers recording virus isolations of
      California (CAL) serogroup viruses from mosquitoes and other arthropods were
      analyzed, followed by a comparison of a contemporary classification of mosquitoes
      of the genus Aedes with a contemporary classification of CAL serogroup viruses.
      Using criteria of five or more total isolations of a given virus from a given
      species of mosquito, and a minimum infection rate of 1:10,000 or greater (more
      frequent), Aedes, and to a lesser extent Culiseta, species were found to be the
      arthropods most frequently involved as vectors. Such a comparison could not
      explain all virus-vector associations on the basis of coevolution of viruses in
      Aedes mosquito species, probably because of the crossing over of viruses to other
      mosquito species through horizontal transmission and because of deficiencies in
      currently available classifications. Coevolution of host-parasite systems is
      discussed, as are the inadequacies of contemporary taxonomic treatments of
      viruses and Aedes mosquitoes. The paper ends with hypothetical reconstructions of
      virus-mosquito relationships over time and possible routes of dispersal of
      California serogroup viruses to their present geographical distributions.

PMID- 2231613
TI  - Comparative efficiency of flagging and carbon dioxide-baited sticky traps for
      collecting the lone star tick, Amblyomma americanum (Acarina: Ixodidae).
AB  - Collections of Amblyomma americanum (L.) from five habitat types showed that
      significantly more ticks of all life stages could be collected by CO2-baited
      sticky traps than by the standard flagging technique. The effect of habitat type
      and season significantly influenced the number of ticks collected by both
      techniques. Traps baited with carbon dioxide revealed adult tick activity in
      several habitats several weeks earlier than did flagging, because flagging failed
      to efficiently recover ticks unless they had ascended vegetation. The CO2-baited
      traps required less time and effort and showed less variation for tick population
      surveys when compared with flagging.

PMID- 2231614
TI  - Survival and development of the immature stages of Culex annulirostris (Diptera:
      Culicidae) at the Ross River Dam in tropical eastern Australia.
AB  - Immature stages of Culex annulirostris Skuse from Ross River Dam were reared in
      the laboratory at constant temperatures (18.0, 24.5, 28.5 and 35.0 degrees C) and
      in the field in the presence or absence of predators. In the laboratory, survival
      from first instar to adult emergence increased from 5.5% at 18 degrees C to 96.5%
      at 35 degrees C. In the field predators increased mortality by almost 60%. Adult
      wing length increased inversely with constant temperature except at 18 degrees C.
      In the field the largest adults were produced in the presence of predators. The
      developmental threshold temperature (to) and thermal constant (K) were estimated
      from laboratory data to be 13.7 degrees C and 129.3 DD, respectively. K
      determined in the laboratory did not differ significantly from that required in
      the field (132.8 and 153.5 DD above 13.7 degrees C in the presence and absence of
      predators). Numbers of immature Cx. annulirostris at four sites in the dam rose
      to a peak after four or five generations and then rapidly declined. Overall
      survival of immatures was very low but was significantly higher at the one site
      where Melaleucas also occurred. Age-specific survival was highest in the first
      instar. Estimated survival from hatching to eclosion ranged from 4/1,000 to
      185/1,000. Mortality appeared to be density independent and was attributed mostly
      to predation.

PMID- 2231615
TI  - Culex species (Diptera: Culicidae) from central Argentina: identification by
      electrophoretic zymograms and genetic relationships.
AB  - Starch gel electrophoretic zymograms were used for the taxonomic separation of
      mosquitoes of the genus Culex, possible vectors of encephalitis in Argentina.
      Catalase, hexokinase, malic enzyme, isocitrate and malate dehydrogenases, and
      leucine aminopeptidase were species markers that allowed the clear identification
      of individual Culex apicinus Philippi, Cx. bidens Dyar, Cx. brethesi Dyar, Cx.
      declarator Dyar and Knab, Cx. dolosus Arribalzaga, Cx. maxi Dyar, Cx.
      quinquefasciatus Say, Cx. saltanensis Dyar, and Cx. tatoi Casal & Garcia.
      Intraspecific polymorphism was revealed but did not preclude species separation.
      On the basis of allele frequencies, an index of genetic distance between species
      was calculated. Genetic affinities determined by electrophoretic data agreed with
      taxonomic affinities ascertained by conventional systematics. Thus,
      electrophoretic zymograms proved to be a powerful tool for the study of the genus
      Culex in Argentina.

PMID- 2231616
TI  - Failure to transmit Ehrlichia canis (Rickettsiales: Ehrlichieae) with Otobius
      megnini (Acari: Argasidae).
AB  - An ear tick, Otobius megnini (Duges) recovered from a child who had serologic
      evidence of ehrlichiosis, was examined for Ehrlichia species microscopically and
      by inoculation into a susceptible dog; no evidence of infection was found in the
      tick. Experimental transmission of E. canis by laboratory-reared O. megnini was
      attempted; neither transstadial nor transovarial transmission occurred.

PMID- 2231617
TI  - Nocturnal oviposition behavior of blow flies (Diptera: Calliphoridae).
AB  - It is widely held that blow flies, in general, and Phaenicia sericata (Meigen),
      in particular, are not active at night and do not lay eggs during that time. P.
      sericata is thought to require sunlight and warmth for oviposition. Three common
      and forensically important flies--Calliphora vicina (Robineau-Desvoidy), P.
      sericata, and Phormia regina (Meigen)--oviposited during the dark hours of the
      night during the summers of 1988 and 1989. Nocturnal oviposition can alter the
      usual estimate of the postmortem interval in homicide cases by as much as 12 h.
      Cases are presented that serve to change our concept of P. sericata from an
      obligate heliophile to a facultative heliophile that has a willingness to enter
      dim or dark places to oviposit.

PMID- 2231618
TI  - Mosquito bionomics and the lack of arbovirus activity in the Chino area of San
      Bernardino County, California.
AB  - Mosquito bionomics, including temporal abundance, metabolic status, and blood
      feeding patterns, and arbovirus activity were studied at representative dairy and
      residential habitats in Chino, Calif., during 1987 and 1988. Host-seeking Culex
      tarsalis Coquillett and Cx. quinquefasciatus Say females were more abundant and
      appeared earlier each season at traps near dairy breeding sources than at traps
      in residential areas, whereas Cx. stigmatosoma Dyar, which also breeds in dairy
      effluent, was most abundant at residential traps. All three Culex species
      remained gonotrophically active throughout winter and did not appear to enter
      diapause. Dairy cows diverted the normally ornithophagic Cx. tarsalis and Cx.
      quinquefasciatus females from avian hosts in dairy, but not in residential,
      habitats. Cx. stigmatosoma fed almost exclusively on birds. The diversion of host
      seeking Cx. tarsalis females to bovine hosts and reduced abundance because of
      mosquito abatement may have combined to reduce the receptivity of the Chino area
      to St. Louis encephalitis virus.

PMID- 2231619
TI  - Intraspecific variation in the reproductive capacity of Anopheles stephensi
      (Diptera: Culicidae).
AB  - Intraspecific variation in the reproductive capacity of Anopheles stephensi
      Liston females was studied under constant laboratory conditions. Of 421 engorged
      females examined individually throughout their lifetimes, 260 laid a total of 479
      egg batches with a maximum of nine ovipositions per female. The number of eggs
      per oviposition varied from 5 to 247 (average 96.8). The number of ovipositions
      per female were correlated positively with the average number of eggs per batch
      and exhibited a negative binomial distribution among females, indicating that a
      small portion of the population exhibited a particularly high fecundity. Among
      the ovipositing females, the total fecundity and fertility ranged, respectively,
      from 5 to 1,084 eggs and from 0 to 1,036 larvae per female. The estimated maximal
      number of female progeny produced by a female in her lifetime was 317, and the
      estimates of net reproductive rate (Ro) and capacity for increase (rc) were 25.7
      and 0.17, respectively. The number of eggs in the first oviposition was
      predictive of the total fecundity of a female. The wide range of individual
      variation in the reproductive capacity of An. stephensi emphasized the
      requirement for a large sample size for reliable estimation.

PMID- 2231620
TI  - Comparative field evaluation of permethrin and deet-treated military uniforms for
      personal protection against ticks (Acari).
AB  - The effectiveness of permethrin-impregnated (PI) versus permethrin-sprayed (PS)
      military battle dress uniforms was evaluated in protecting soldiers from tick
      bite. At the same time, an extended-duration formulation of N,N-diethyl-m
      toluamide (deet), when applied to clothing only, was evaluated and compared with
      the permethrin-treated uniforms. Testing consisted of exposing subjects, clothed
      in either untreated or the variously treated uniforms, to field populations of
      ticks during a series of 30-min field trials over a period of 21 d during July
      and August 1988. Permethrin, applied as either a spray (0.5% [AI]), or as an
      impregnant (0.125% [AI]/cm2), was more effective than deet (33.25% [AI]) applied
      to clothing only in protecting individuals from tick bite. The mean numbers of
      ticks on deet-treated, PI, and PS uniforms were 60, 97, and 98% lower,
      respectively, than on untreated uniforms against all encountered life stages of
      Amblyomma americanum (L), Dermacentor variabilis (Say), and Ixodes dammini
      Spielman, Clifford, Piesman and Corwin.

PMID- 2231621
TI  - Fecundity, metabolism, and body size in Anopheles (Diptera: Culicidae), vectors
      of malaria.
AB  - In four Anopheles species, An. albimanus, An. gambiae, An. stephensi, and An.
      quadrimaculatus Say, total protein, lipid, and carbohydrate present at eclosion,
      after feeding on sucrose, and after extreme starvation were quantified to study
      the effect of teneral and maximal reserves on subsequent fecundity and to judge
      the extent of reserve mobilization and the minimal irreducible amounts required
      for survival. All parameters were regressed on body size, presented as the cubic
      value of wing length. Teneral reserves were isometric with body size, were
      considerably lower than previously reported for Aedes aegypti (L.) and were
      sexually dimorphic with respect to reserves and body size, all being slightly
      reduced in males. On the average, up to 70% of the teneral female lipids and up
      to 50% of their teneral protein could be mobilized during nutritive stress.
      Conversely, access to sucrose for a few days led to a pronounced glycogenesis (up
      to 509%) and lipogenesis (up to 450% of the teneral values), depending on the
      species. In absolute terms, lipogenesis prevailed over glycogenesis. On a caloric
      basis, up to 30% of the blood meal protein was utilized for synthesis of yolk
      protein and lipid, and another 15% was deposited as an extra-ovarian, maternal
      protein and lipid store, perhaps compensating for the limited teneral reserves. A
      complete nitrogen budget revealed that in a given class of body size, roughly 80%
      of the blood meal protein was catabolized and excreted through the three major
      pathways of uricotely, ureotely, and ammonotely. Quantification of the hematin in
      fecal samples allowed a stoichiometrical determination of the amount of blood
      ingested. Eco-physiological aspects of larval feeding, teneral reserves, blood
      meal utilization, and possible behavioral adaptations to these physiological
      constraints are discussed and compared with previous data on culicine mosquitoes,
      stressing the invalidity of generalizations among these taxa.

PMID- 2231622
TI  - Survey of microhymenoptera (Hymenoptera: Chalcidoidea) parasitizing filth flies
      (Diptera: Muscidae, Calliphoridae) breeding in refuse and poultry farms in
      peninsular Malaysia.
AB  - Nine species of parasitoids were found parasitizing the pupae of filth flies
      breeding in refuse dumps and poultry farms throughout peninsular Malaysia.
      Spalangia were most common, consisting of Spalangia endius Walker, S. cameroni
      Perkins, S. gemina Boucek, S. nigroaenea Curtis, and two undescribed species.
      Other parasitoids collected were Pachycrepoideus vindemmiae Rondani, Dirhinus
      himalayanus Westwood, and an unidentified Hymenoptera. The parasitized fly hosts
      included Musca domestica L., Chrysomya megacephala (F.), Fannia sp., and Ophyra
      sp. S. endius was the most common parasitoid attacking M. domestica and C.
      megacephala at refuse dumps and poultry farms D. himalayanus were found to
      parasitize only M. domestica pupae collected at poultry farms.

PMID- 2231623
TI  - Attempted transmission of Ehrlichia risticii (Rickettsiaceae) with Stomoxys
      calcitrans (Diptera: Muscidae).
AB  - Experimental transmission of Ehrlichia risticii, the causal agent of Potomac
      horse fever, was attempted with adult stable flies, Stomoxys calcitrans, (L.)
      using two feeding schedules. In schedule A, a set of 140 flies was allowed to
      feed once on an experimentally infected donor pony and once 24 h later on a
      recipient pony. A different set of flies was used each day for a 12-d period. In
      schedule B, 240 flies were allowed to feed once daily for 12 consecutive d on the
      donor pony followed by five consecutive daily feedings on the recipient pony. E.
      risticii was isolated from the blood of the experimentally infected pony during
      the entire fly-feeding schedule. The recipient pony did not develop clinical
      signs of Potomac horse fever and remained seronegative to E. risticii up to 60 d
      after the last stable fly feeding. Mice injected intraperitoneally with emulsions
      of schedule A and B stable flies were seronegative for E. risticii 30 d after
      inoculation, and ehrlichial organisms were not demonstrated in impression smears
      from the digestive tracts of the flies. The stable fly did not transmit E.
      risticii under these experimental conditions.

PMID- 2231624
TI  - Temperature-dependent development and survival rates of Culex quinquefasciatus
      and Aedes aegypti (Diptera: Culicidae).
AB  - Development, growth, and survival of Culex quinquefasciatus Say and Aedes aegypti
      (L.) were determined at six constant temperatures (15, 20, 25, 27, 30, 34 degrees
      C). The Sharpe & DeMichele four-parameter model with high-temperature inhibition
      described the temperature-dependent median developmental rates of both mosquito
      species. In both species, body size generally decreased as temperature increased.
      Head capsule widths in all instars in both species were significantly greater at
      15 than at 30-34 degrees C. Except for the third instar of Ae. aegypti, the
      larval body lengths in both species were significantly greater at 15 than at 34
      degrees C. All instars and pupae of both species and the adults in Cx.
      quinquefasciatus were significantly heavier at 15 than at 27-34 degrees C. In Cx.
      quinquefasciatus, survival from eclosion to adult emergence was highest in the
      range from 20 to 30 degrees C (85-90%) and dropped drastically at 15 (38%) and 34
      degrees C (42%). In Ae. aegypti, survival to adult stage was high at 20 (92%) and
      27 degrees C (90%) and lowest at 15 degrees C (3%).

PMID- 2231625
TI  - Cleavage of purified bovine complement component C3 in larval Hypoderma lineatum
      (Diptera: Oestridae) hypodermins.
AB  - Proteinases isolated from first instars of Hypoderma lineatum (Villers) were
      assayed for their ability to degrade purified bovine complement component C3.
      Cleavage products were analyzed by SDS-PAGE followed by immunoblotting. Crude
      extracts (raw insect homogenate) and purified hypodermin A and B were effective
      in degrading the alpha chain of C3 at a concentration of 1 microgram/ml. At 10
      micrograms/ml, raw insect homogenate caused total degradation of both chains of
      the molecule, whereas 50 micrograms/ml of hypodermin A was required to obtain
      similar results. Hypodermin B did not appear to cleave the beta chain of C3. No
      degradation of the C3 molecule was observed in the absence of added hypodermins.
      Complement degradation associated with Hypoderma infestations may allow the
      parasite to escape host defense reactions.

PMID- 2231626
TI  - Method for in situ hybridization to polytene chromosomes from ovarian nurse cells
      of Anopheles gambiae (Diptera: Culicidae).
AB  - A procedure for in situ hybridization to polytene chromosomes from the ovarian
      nurse cells of Anopheles gambiae Giles has been developed. This procedure
      involves a modification of established methods for Drosophila larval salivary
      gland polytene chromosomes. Treatment of chromosome squashes with xylene followed
      by slow rehydration provides required resolution of chromosome banding patterns,
      possibly because fatty contaminants are removed from ovarian nurse cell
      preparations. Using this procedure, unique DNA sequences from a genomic library
      of An. gambiae have been mapped on adult mosquito polytene chromosomes. The
      ability to locate genetic markers on chromosomes will allow correlation of
      physical and genetic maps. Such maps will facilitate identification of genetic
      loci and expand our knowledge of the genomic organization of An. gambiae.

PMID- 2231627
TI  - Ovicidal and larvicidal modes of action of fenoxycarb against the cat flea
      (Siphonaptera: Pulicidae).
AB  - The mode of action of the insect growth regulator, fenoxycarb, on embryogenesis
      of cat flea eggs, Ctenocephalides felis (Bouche), was evaluated biologically and
      morphologically. Newly oviposited flea eggs were aged for 0, 3, 6, 12, 24, 48, or
      72 h and exposed to fenoxycarb (1.1 micrograms/cm2) on filter paper disks for 0
      (60 s), 2, 4, 8, 12, or 24 h at 23 +/- 1 degree C and 70 +/- 3% RH. Following
      exposure, samples of flea eggs were processed for microscopic examination and
      seeded onto carpet swatches containing flea-rearing medium in order to assess egg
      hatch, and larval, pupal, and adult development. Fenoxycarb exhibited embryocidal
      activity against eggs in early blastoderm formation, blastokinesis, and advanced
      larval development up to hatching. The ovicidal effect of fenoxycarb was not
      restricted to any specific developmental stage of embryogenesis, and no
      significant relationship was found between duration of exposure and lethal or
      inhibitory effects. Indeed, exposure for as little as 60 s produced a lethal
      inhibition of embryonic development. Conventional microscopy and ultrastructural
      observations of flea eggs exposed to fenoxycarb showed extensive cellular and
      tissue damage of the developing embryos, including membrane lysis, burst cells,
      pycnotic nuclei with coalesced and clumped heterochromatin, swollen and ruptured
      mitochondria, cellular autolysis, and collapse and discoloration of the eggshell.
      Fenoxycarb also exhibited larvicidal activity against newly emerged and 24-h-old
      flea larvae. The midguts of larvae exposed to fenoxybarb appeared disrupted and
      distorted with large gaps. These data document the ovicidal and larvicidal modes
      of action of fenoxycarb against the cat flea.

PMID- 2231628
TI  - Longevity and fecundity of Musca domestica (Diptera: Muscidae) as a function of
      temperature.
AB  - Longevity and fecundity of adult house flies were determined at constant
      temperatures of 20, 25, 30, and 35 degrees C. At the four temperatures,
      respectively, the median mortality rates (1/days to 50% mortality) for females
      were 0.023, 0.041, 0.060, and 0.099 and for males were 0.029, 0.047, 0.066, and
      0.085. The numbers of days for 50% of the eggs to be deposited for each
      temperature were 34.5, 21.3, 10.2 and 7.1, respectively. The total numbers of
      eggs deposited per female for each temperature were 184, 729, 709, and 506,
      respectively. Models were developed for longevity and fecundity and their
      distributions as functions of temperature.

PMID- 2231629
TI  - Notes on Dermacentor ticks (II): Taxonomic status of D. dentipes Koch and D.
      ferrugineus Koch (Acari: Ixodidae).
AB  - The type specimens of Dermacentor dentipes Koch and D. ferrugineus Koch were
      studied. D. dentipes is a junior synonym of D. marginatus Sulzer, and D.
      ferrugineus is a junior synonym of D. reticulatus Koch.

PMID- 2231630
TI  - Attempted Ehrlichia risticii transmission with Dermacentor variabilis (Acari:
      Ixodidae).
AB  - Larval Dermacentor variabilis (Say) (n = 327) were fed on Balb/C mice inoculated
      with Ehrlichia risticii, the etiologic agent of equine monocytic ehrlichiosis
      (Potomac horse fever). All mice displayed clinical signs of E. risticii infection
      at the time of feeding. After molting, resulting nymphs (n = 74) were fed on
      susceptible mice. No clinical signs were observed, and the mice remained
      seronegative for 6 wk after feeding.

PMID- 2231631
TI  - Evaluation of membranes for feeding Culicoides variipennis (Diptera:
      Ceratopogonidae) with an improved artificial blood-feeding apparatus.
AB  - An artificial blood-feeding apparatus for Culicoides variipennis (Coquillett) was
      improved by developing a simpler design to heat and mix the blood meal and by
      increasing the surface area for insect feeding. The skin from a 1- to 3-d-old
      chick and a reinforced silicone membrane were the most satisfactory of nine
      membranes evaluated for C. variipennis, with 81 and 83% mean blood-feeding rates,
      respectively. The operational advantages of the reinforced silicone membrane for
      feeding C. variipennis included its composition of readily available synthetic
      materials, easy fabrication, faster preparation than the chick skin, and its
      suitability for repeated use in colony maintenance and virus infection studies.

PMID- 2231632
TI  - Professional ethics: on transmitting complaints to one's colleagues.

PMID- 2231633
TI  - The kidney trade: or, the customer is always wrong.
AB  - Much of the opinion scandalized by recent reports of kidneys being sold for
      transplant is significantly inconsistent. The sale of kidneys is not
      substantially different from practices espoused, and indeed endorsed, by many of
      those who condemn the former. Our moral concern, I suggest, needs to focus on the
      customer's actions rather than the seller's; and on the implications for larger
      questions of the considerations to which this gives rise.

PMID- 2231634
TI  - Against the magnanimous in medical ethics.
AB  - Supererogatory acts are considered by some to be part of medicine, whereas others
      accept supererogation to be a gratuitous virtue, to be extolled when present, but
      not to be demanded. The present paper sides with those contending that medicine
      is duty-bound to benefit patients and that supererogation/altruism must per
      definition remain outside and beyond any role-description of the profession.
      Medical ethics should be bound by rational ethics and steer away from separatist
      views which grant exclusive privileges but also create excessive demands, way
      beyond what physicians perform or are willing and able to offer.

PMID- 2231635
TI  - Resource allocation: a plea for a touch of realism.
AB  - The problem of resource allocation in health has stimulated much thought and
      research, in attempts to provide objective, rational methods by which necessary
      choices can be made. One such method was proposed in a paper in this journal. The
      authors argued for a utilitarian approach, which they claimed to demonstrate was
      acceptable to society at large. This paper argues that the evidence supporting
      such a claim was flawed; such a utilitarian approach is not socially acceptable,
      and is therefore not relevant. Rather more relevant directions for research are
      discussed, based on the assertion that a degree of realism is essential when
      considering the problems of resource allocation.

PMID- 2231636
TI  - Resource allocation: whose realism?

PMID- 2231637
TI  - A plea for a touch of idealism: reply to P Whitaker.

PMID- 2231638
TI  - Let the patients smoke: a defence of a patient privilege.
AB  - I examine two kinds of arguments in favour of imposing restrictions on smoking by
      hospitalised psychiatric patients. First, I look at patient-centered arguments in
      favour of restrictions. These arguments focus on the benefits that patients will
      receive if their smoking is stopped or curtailed. Second, I examine arguments
      that seek to justify restrictions by citing the costs that smokers impose on
      others. Neither kind of argument justifies any meaningful restrictions on the
      smoking of hospitalised psychiatric patients.

PMID- 2231639
TI  - Evaluating ethical sensitivity in medical students: using vignettes as an
      instrument.
AB  - As a preliminary step to beginning to assess the usefulness of clinical vignettes
      to measure ethical sensitivity in undergraduate medical students, five clinical
      vignettes with seven to nine ethical issues each were created. The ethical issues
      in the vignettes were discussed and outlined by an expert panel. One randomly
      selected vignette was presented to first, second and third year students at the
      University of Toronto as part of another examination. The students were asked to
      list the issues presented by the patient problem. Responses from 281 students
      were obtained. These students identified an average of 2.72 ethical issues per
      vignette. Each response was classified under the domains of autonomy, beneficence
      and justice. Comparisons were made between classes and between vignettes. There
      was considerable variation between classes and the responses to different
      vignettes seem to indicate that different vignettes measure the various domains
      in different ways. It does appear that the use of vignettes is one way to measure
      aspects of ethical sensitivity in medical students but more study is required to
      clarify exactly what is being measured.

PMID- 2231640
TI  - A national committee for the ethics of research.
AB  - A National Committee for the Ethics of Research could consider new questions
      arising from innovations in research or practice, deal with multi-centre trials,
      adjudicate when separate local committees give conflicting advice about similar
      projects, or oversee the work of district committees. The value of each of these
      functions is assessed and it is concluded that a national committee would be most
      valuable in providing detailed evaluations of difficult or controversial issues.
      Though it could offer useful advice about multi-centre trials, local committees
      would probably wish to continue to consider research involving patients within
      their health districts even though approval had been given by a central
      committee. A national committee could usefully oversee the working of a system of
      quality control throughout the country, but the detailed monitoring of district
      committees would be done more effectively at regional level.

PMID- 2231641
TI  - Ethical appraisal for multi-centre medical research.

PMID- 2231642
TI  - Ethical review of multi-centred trials.

PMID- 2231643
TI  - The global distribution of health care resources.
AB  - The international disparities in health and health-care provision comprise the
      gravest problem of medical ethics. The implications are explored of three
      theories of justice: an expanded version of Rawlsian contractarianism, Nozick's
      historical account, and a consequentialism which prioritizes the satisfaction of
      basic needs. The second too little satisfies medical needs to be cogent. The
      third is found to incorporate the strengths of the others, and to uphold fair
      rules and practices. Like the first, it also involves obligations transcending
      those to an agent's relations and fellow-citizens. These conclusions are applied
      to international health-care provision, which they would transform.

PMID- 2231644
TI  - Temperance.
AB  - The kind of temperance discussed is the virtue of moderation concerning the
      pleasures of eating and drinking. A person lacks this moderation if either his
      desire for such pleasures causes conflicts with his own standards of appropriate
      behaviour or the standards themselves attach too much importance to the pleasures
      concerned. Opinions vary about the proper status of these pleasures, but people
      surely value them too highly if they place them above their health or the moral
      duty not to cause unnecessary suffering. Temperance concerns medicine because of
      its connection with health, ethics because it involves not only the good life for
      the individual but also the welfare of other creatures.

PMID- 2231645
TI  - Criteria of death.

PMID- 2231646
TI  - Genes and epilepsy.

PMID- 2231647
TI  - Adult polycystic kidney disease: knowledge, experience, and attitudes to prenatal
      diagnosis.
AB  - One hundred and ninety subjects from 100 adult polycystic kidney disease (APKD)
      families on the North Western Regional Genetic Register were interviewed to
      determine the likely demand for prenatal diagnosis. A detailed questionnaire was
      used to assess understanding and experience of clinical, therapeutic, and genetic
      aspects of APKD. Major features of the disease (presence of renal cysts which can
      lead to renal failure) and forms of therapy (dialysis and transplantation) were
      known; knowledge of less common features was related to experience. The cohort
      had had genetic counselling and the majority knew the risk to their own
      offspring, although the mechanics of the mode of inheritance was often
      misunderstood. Uptake of presymptomatic ultrasound testing was high, and some
      implications of early diagnosis are noted. A minority changed their reproductive
      behaviour as a result of APKD, and although the majority felt a prenatal test
      should be available, only 23% at high risk of passing on the disease and
      contemplating children felt they would be interested, and so far only one request
      for prenatal diagnosis has been received. Thus, demand appears to be low and to
      be related to perception of the seriousness of APKD.

PMID- 2231648
TI  - Genetic and environmental factors in hypospadias.
AB  - A case control study of hypospadias was performed from 1979 to 1987 in Alsace,
      north-eastern France. A total of 176 out of 60 847 male infants had hypospadias
      giving a prevalence at birth of 2.89 per 1000 male newborns; 15.3% of all infants
      with hypospadias also had other malformations. Renal and urinary tract
      malformations were present in 37.0% of the infants with hypospadias and other
      additional malformations. None of the numerous aetiological factors which were
      studied was correlated with hypospadias except low weight of the placenta. The
      recurrence risk for brothers was 17.0% (an empirical risk of about 1 in 6) and
      the heritability coefficient was 56.9%. First degree relatives of infants with
      hypospadias had more malformations other than hypospadias than controls. These
      results have to be taken into consideration for genetic counselling.

PMID- 2231649
TI  - Repeated freezing and thawing of peripheral blood and DNA in suspension: effects
      on DNA yield and integrity.
AB  - The possibility of DNA degradation is of concern to all involved in the storage
      of DNA, whether for diagnostic or research purposes. Many DNA banks are at
      present maintained at low temperatures, but optimum conditions for storage and
      handling have yet to be fully assessed. Both DNA and fresh blood have been
      subjected to repeated cycles of freezing and thawing and DNA extracted from the
      blood. DNA yield has been established and integrity examined by digestion,
      electrophoresis, and Southern blot analysis using DNA fingerprinting techniques.
      No degradation of DNA could be detected using these techniques; however, DNA
      yield was shown to be adversely affected by freezing, with yield reduced by more
      than 25% in blood samples frozen only once.

PMID- 2231650
TI  - Sotos syndrome.

PMID- 2231651
TI  - Occurrence of the alpha thalassaemia-mental retardation syndrome (non-deletional
      type) in an Australian male.
AB  - The rare association of alpha thalassaemia and mental retardation has been
      described previously. Molecular studies of the alpha globin cluster in these
      cases have been heterogeneous, with some patients having large deletions while in
      others the alpha globin complex appears to be intact (non-deletional). The non
      deletional cases form a distinct group whose features include severe mental
      retardation, haematological changes of haemoglobin H (Hb H) disease,
      developmental defects, and unusual patterns of inheritance. To date, five cases
      have been described with non-deletional alpha thalassaemia-mental retardation. We
      present here a further example of a young male of Northern European origin who
      appears to have the non-deletional form of the disease. Clinical features
      included severe mental retardation, Hb H disease, and developmental defects
      similar to those reported previously. DNA mapping, including pulsed field
      electrophoresis, showed no evidence of deletions within the alpha globin cluster.
      Karyotypic analysis indicated an increase in random breakage, which has been
      observed previously in one case of deletional alpha thalassaemia-mental
      retardation. Profuse Hb H bodies and Hb H on electrophoresis were consistent with
      Hb H disease. However, the latter was present at a relatively low level (1.6%)
      and, as well, the mean corpuscular volume (82.8 fl) and mean corpuscular
      haemoglobin (26.4 pg) were surprisingly high. Our findings are compared to other
      cases described with the non-deletional Hb H-mental retardation syndrome.

PMID- 2231652
TI  - Chromosome imbalance, normal phenotype, and imprinting.
AB  - A duplication of the sub-bands 1q42.11 and 1q42.12 was found in a boy and his
      mother. The proband has short stature (around the 10th centile) but a normal
      phenotype and psychomotor development. His mother is also asymptomatic. We found
      30 published cases of normal subjects with an imbalance of autosomal euchromatic
      material. In these cases the imbalance involved either only one G positive band
      or a G positive and a G negative band. Thus the absence of a phenotypic effect
      cannot always be ascribed to the deficiency in the G positive bands of coding
      DNA. Moreover, in some cases, the method of transmission of the chromosome
      abnormality was such that an imprinting effect could be postulated.

PMID- 2231653
TI  - Partial monosomy for chromosome 22 in a patient with del(22)(pter---
      q13.1::q13.33----qter).
AB  - An 18 month old girl with partial monosomy for the long arm of chromosome 22 is
      described. The karyotype was 46,XX,del(22)(pter----q13.1::q13.33----qter). To our
      knowledge this is the first report of monosomy for this specific segment of
      chromosome 22. Clinical features include developmental delay in all areas,
      hypotonia, macrosomia, full cheeks, eyebrows, and eyelids, mild epicanthus, wide
      nasal bridge, long philtrum, and thick lower lip. Parental chromosome studies
      were normal.

PMID- 2231654
TI  - Alstrom's syndrome: further evidence of autosomal recessive inheritance and
      endocrinological dysfunction.
AB  - We report a case of Alstrom's syndrome with hypothyroidism in addition to the
      cardinal features of blindness, deafness, obesity, and insulin dependent diabetes
      mellitus. The parents were first cousins once removed which strengthens the case
      for autosomal recessive inheritance.

PMID- 2231655
TI  - Another case of microcephaly, facial clefting, and preaxial polydactyly.
AB  - We describe a nine month old boy with failure to thrive, developmental delay,
      bilateral cleft lip and palate, and left preaxial polydactyly. The features are
      similar to those in a child described by Howard and Young and may be the second
      case of a previously unknown syndrome.

PMID- 2231657
TI  - Deletion Xp22.3.

PMID- 2231656
TI  - Dominantly inherited cleft lip and palate.

PMID- 2231658
TI  - Medical genetics in Romania.

PMID- 2231659
TI  - Laser Doppler flowmetry.

PMID- 2231660
TI  - Laser Doppler flowmetry.

PMID- 2231661
TI  - A critical review of laser Doppler flowmetry.
AB  - Laser Doppler flowmetry (LDF) is now a well-established, non-invasive technique
      for measuring microvascular blood perfusion. However, there are a number of
      factors which can seriously affect the interpretation of the laser Doppler signal
      which are often not considered during routine use. These include: consideration
      of signal processing limitations, choice of processing bandwidth, problems with
      motion artefact and instrument calibration, the effect of probe pressure on the
      skin, and the type of laser used. This paper reviews many of the problems and
      limitations frequently encountered using the laser Doppler technique.

PMID- 2231662
TI  - Lower limb sympathectomy assessed by laser Doppler blood flow and transcutaneous
      oxygen measurements.
AB  - In a retrospective study of critical ischaemia of the lower limb, sympathectomy
      appeared to be of value in the majority of patients. We therefore assessed
      sympathectomy by measuring skin blood flow before and after the procedure using
      laser Doppler flowmetry (LDF) and transcutaneous oxygen tension (TCpO2)
      techniques. Twenty patients underwent chemical sympathectomy and there was one
      surgical procedure. Measurements were performed before and 1 week after
      sympathectomy below the knee and on the forefoot. Symptomatic improvement
      occurred in 20 of 21 patients. This study demonstrates that skin blood flow in
      the leg and foot is improved by sympathectomy and confirms objectively our
      clinical impression.

PMID- 2231663
TI  - The microvascular lesion in venous ulceration and the role of the white blood
      cell.
AB  - White blood cells have recently been implicated in the development of venous
      ulceration. Fifty subjects (14 normal controls, 21 with superficial venous
      insufficiency (SVI), and 15 with deep venous insufficiency (DVI] have been
      studied in the supine and dependent positions in a constant environment using
      video capillary microscopy, laser Doppler flowmetry and transcutaneous oxygen
      measurements to the gaiter skin. All three groups had an increase in visible
      capillary loops and a reduction in blood flux in the gaiter region when the leg
      was placed in the dependent position. There was a decrease in the leg/chest
      transcutaneous oxygen ratio in all three groups on dependency. These results
      suggest that the 'oedema protection reflex' (as measured by the laser Doppler
      probe) is present not only in normal and SVI limbs but also in DVI limbs. The
      increase in visible capillary loops suggests that intraluminal capillary
      occlusion is not occurring within the period of this study. The exact
      microvascular defecit of venous ulceration remains to be explained.

PMID- 2231664
TI  - Laser Doppler assessment of human colonic blood flow.
AB  - We have used laser Doppler flowmetry to assess human colonic blood flow in
      patients with healthy mucosa and in those with active proctitis. We report a
      significant correlation between colonic serosal laser Doppler flux readings and
      serosal tissue oxygen tension (n = 45: r = 0.671: p = 0.001). Mucosal blood flow
      was measured using the PF309 probe of a Perimed Pf2b set on 12 kHz frequency
      shift. There was no significant difference throughout the colon in healthy
      patients. The flow in rectal mucosa was significantly higher in patients with
      proctocolitis than in normal mucosa.

PMID- 2231665
TI  - Skin blood flow changes following intradermal bradykinin injections measured by
      laser Doppler flowmetry: comparison with weal and flare.
AB  - Intradermal injections of normal saline and different concentrations of
      bradykinin were made into the forearms of healthy volunteers. Cutaneous blood
      flow was recorded just outside and over the centre of the weals by laser Doppler
      flowmetry (LDF), and flare area and weal volume were measured. There were
      concentration-related changes in the mean LDF output adjacent to the weal, flare
      area and weal volume. LDF recordings performed over the centre of the weals,
      however, failed to show any dose-response relationship. When similar
      concentrations of bradykinin were injected intradermally and the skin response
      measured by the above parameters, there was less variation in the mean LDF output
      adjacent to the weal than flare or weal measurements. The non-invasive technique
      of LDF is a useful, objective and sensitive technique of quantifying the skin
      blood flow changes induced by intradermal bradykinin and provides an alternative
      method of quantifying skin response to intradermal bradykinin to measurement of
      flare or weal sizes.

PMID- 2231666
TI  - Assessment of the neurogenic flare response as a measure of nociceptor C fibre
      function.
AB  - A modified method for quantitative measurement of nociceptor C fibre function is
      described. The electrophoresis of acetylcholine stimulates C fibres to produce an
      axon reflex flare which is measured by laser Doppler flowmetry. The use of the
      dorsal, rather than the plantar, surface of the foot at a skin temperature of 32
      33 degrees C rather than 34-35 degrees C improves the sensitivity of the
      technique. Acetylcholine produces an earlier and more predictable response than
      normal saline, which is approximately half maximal at a current of 0.2 mA and
      maximal at 1.0 mA. The use of different current strengths should allow more
      detailed assessment of neurogenic inflammation and the effects of drugs and
      disease states on C fibre function.

PMID- 2231667
TI  - Laser Doppler flowmetry and bone blood flow in an isolated perfused preparation.
AB  - A preparation of an isolated bovine forefoot was established which could be
      perfused with blood at variable rates. A laser Doppler flowmeter probe inserted
      into the cancellous bone of the metatarsal produced a signal which varied with
      changes in perfusion rate and oscillated in synchrony with the peristaltic
      perfusion pump. A stronger laser Doppler signal was obtained when the probe was
      inserted into a drill hole than when inserted into a hole bored with a guide
      wire. It appears that laser Doppler flowmetry has potential intraoperative use
      when the viability of bone is in question.

PMID- 2231668
TI  - Measurement of blood flow in the chick egg yolk sac membrane.
AB  - Blood vessels of the yolk sac membrane are the transport route by which a chick
      embryo obtains nutrients from the egg yolk. After 4 days of incubation at 37
      degrees C a sparse network of blood vessels are visible within the membrane and
      they become denser over the following days. The preparation has been used to
      assess angiogenesis. Using visual inspection to assess the growth of new vessels
      towards pellets of test substances placed on the membrane surface, responses are
      judged negative or positive. Laser Doppler flowmetry has been used to investigate
      the potential of this technique to quantify blood flow through the yolk sac
      membrane. Measurements have been taken from capillary beds and single larger
      vessels over a range of temperatures and from avascular yolk and egg white using
      a Perimed PF3 with PF310 bent-tipped probe. Capillary beds exhibited vasomotion
      (about one cycle per minute) and oscillations of longer duration (about five
      cycles per hour). Cardiac pulses, strongly present in larger vessels (mean 90 pu,
      pulse 75 pu), were not easily identified in the capillary bed. Avascular yolk
      measurements gave flux values (due to Brownian motion of yolk proteins) which
      were greater than for capillary beds but without oscillations. Angiogenesis was
      stimulated by pellets containing 2 micrograms of basic fibroblast growth factor.
      There were significant increases in single vessel blood flow after 24 h compared
      with blank control pellets placed on the same egg.

PMID- 2231669
TI  - Electrophoretic type B2 of carboxylesterase B for characterisation of highly
      pathogenic Escherichia coli strains from extra-intestinal infections.
AB  - The frequency of electrophoretic types B1 (fast mobilities) and B2 (slow
      mobilities) of carboxylesterase B, and alpha-haemolysin and mannose-resistant
      haemagglutinin (MRHA) production were compared in 705 strains of Escherichia coli
      isolated from cases of septicaemia, urinary tract infection (UTI) and other extra
      intestinal infections from different geographical origins, in particular France,
      America (USA and Canada) and Oceania (Australia and New Zealand). In all groups
      of strains, whether classified according to their clinical or their geographical
      origin, electrophoretic type B2 was phenotypically linked with alpha-haemolysin
      and MRHA production. Haemolytic type B2 strains were isolated more frequently
      from France and Oceania than America whereas the proportions demonstrating
      production of MRHA were similar among the three groups. Type B2 strains were more
      frequently isolated from UTI and other infections than from septicaemia. This is
      attributed to the high frequency of immunocompromised subjects in the septicaemia
      group. Our results establish the suitability of using the type B2 of
      carboxylesterase B as a molecular marker for highly pathogenic E. coli strains
      implicated in extra-intestinal infections in man.

PMID- 2231670
TI  - Analysis of the porphyrin content of fluorescent pus by absorption
      spectrophotometry and high performance liquid chromatography.
AB  - Extracts of 19 samples of pus which showed red fluorescence with ultraviolet
      light were screened for the presence of porphyrins by absorption
      spectrophotometry. All those which showed spectra typical of metal-free
      porphyrins were analysed by high performance liquid chromatography to identify
      the porphyrins present. These were predominantly the di-carboxylic porphyrins,
      deuteroporphyrin and mesoporphyrin, and another which was thought to be
      pemptoporphyrin. This combination matched those reported previously in normal
      stools. Protoporphyrin IX was shown not to be the most common fluorescent pigment
      in pus and was never present alone. However, the di-carboxylic porphyrins may be
      produced by bacterial metabolism of its labile vinyl side-chains. Black-pigmented
      bacteroides (the melaninogenicus group of Bacteroides spp. and Porphyromonas
      spp.) were isolated from 12 (63%) of the 19 pus samples; these may produce
      protoporphyrin IX by the demetallation of haem.

PMID- 2231671
TI  - The relationship between colonisation, secretor status and in-vitro adhesion of
      Candida albicans to buccal epithelial cells from diabetics.
AB  - This study investigated whether oral candida infection in diabetics and adhesion
      of Candida albicans to buccal epithelial cells in vitro were related. Buccal
      cells from 50 patients with diabetes mellitus showed a significant increase in
      adhesion of C. albicans strain CDS 88 compared with those collected from 50 non
      diabetic controls matched for age, sex and denture status. Oral candida carriage,
      candida infection and secretor status were also investigated in both groups. The
      frequency of carriage was increased, but not significantly, and there was a
      significantly higher incidence of candida infection in diabetic patients compared
      with controls. Diabetic patients who were non-secretors had a significantly
      increased frequency of oral candida carriage.

PMID- 2231672
TI  - Characterisation of opacity factor from group-A streptococci.
AB  - Extracellular opacity factor (OF) from group-A Streptococcus M-type 22 was
      purified by ammonium sulphate precipitation followed by ion-exchange on DE-52
      cellulose and gel filtration on sephacryl S-400. OF was eluted near the void
      volume and shown to be heterogenous by sodium dodecyl sulphate-polyacrylamide gel
      electrophoresis. Antiserum to ammonium sulphate-purified OF from a cell-free
      culture supernate was prepared in rabbits. All preparations of OF from supernate
      and cell-extract were inhibited by the antiserum. No M protein was detected in
      the OF samples from various purification steps. The purified OF showed activity
      at a broad pH range with optimal activity at pH 6; it was inactivated
      considerably at high temperatures. Enzyme activity was inhibited by pepstatin A,
      but was unaffected by serine proteinase inhibitor, aprotinin, ethylene diamine
      trichloroacetic acid, N-ethylmaleimide, iodoacetamide and mercaptoethanol. This
      suggests that OF is an aspartic proteinase.

PMID- 2231673
TI  - Ultrastructure of a spiral micro-organism from pig gastric mucosa
      ("Gastrospirillum suis").
AB  - The ultrastructural features of a helical-shaped bacterium occurring in the
      stomach of pigs, within the mucus on the mucosal surface of antral pits, were
      examined. The bacterial cell had three to eight spiral turns, flattened and
      truncated ends and was approximately 4.0 microns long and 0.6 microns wide. In
      some sections, up to six flagella, about 22 nm in diameter, were seen arising
      from each pole. The cytoplasm contained sparse, irregular granules, numerous
      ribosomes and large single-layered membrane-bound granules. In the flagella
      insertion area, there was a highly electron-dense component, the "polar
      membrane". This micro-organism differed from similar bacteria described in cats,
      dogs and monkeys, and may cause inflammation in the antral mucosa of pigs similar
      to Helicobacter pylori infection in man. Furthermore, it was morphologically
      similar to the spiral micro-organism distinct from H. pylori which has been
      described recently in human antral mucosa from patients with gastritis and may be
      of potential significance as a pathogen in man. The name "Gastrospirillum suis"
      is proposed for this bacterium.

PMID- 2231674
TI  - Bactericidal action of PD127,391, an enhanced spectrum quinolone.
AB  - The 4-quinolone PD127,391 displays a biphasic effect on Escherichia coli,
      Staphylococcus aureus and S. epidermidis in nutrient broth. It is as active as
      ciprofloxacin in terms of its optimum bactericidal concentration against E. coli.
      However, against staphylococci it is six times as active as ciprofloxacin or any
      other 4-quinolone previously investigated. Although protein and RNA synthesis are
      not required for bactericidal activity, cell division is essential.

PMID- 2231675
TI  - Plasmid profiles of Shigella dysenteriae type 1 isolates from Ethiopia with
      special reference to R-plasmids.
AB  - Plasmid profiles of 80 Shigella dysenteriae type 1 (Shiga's bacillus) strains,
      collected between 1974 and 1985 in Ethiopia, were examined. Strains with the
      dominant antibiotic-resistance (R-) type--resistance to ampicillin (A),
      chloramphenicol (C), streptomycin (S), sulphadiazine (Su) and tetracycline (T)-
      showed two distinct plasmid profiles (PP). Six plasmid bands were demonstrated in
      "Ethiopian strains" with PP-1A isolated between 1974 and 1982. In mating
      experiments with these strains, Escherichia coli K12 recipients showed plasmids
      pYH10a (72 Mda, atypical Inc FIme, coding for ACSSuT resistance). Eight plasmid
      bands were demonstrated in strains with PP-2A. These strains were first isolated
      in 1980 and carried plasmid pYH11a (40 Mda, Inc X, coding for ACT resistance).
      Strains with PP-2A were identical with a "Zairian strain" described elsewhere.
      Strains with R-type ACT were "Zairian strains" lacking the 5.1- and 4.2-Mda
      plasmids. Those with R-type CSSuT were temporally clustered in 1978-1980 and
      carried plasmid pYH12 (58 Mda, Inc B, coding for the same R-type). A trimethoprim
      resistant strain (Gimira strain) had a pattern of small plasmids similar to those
      of the "Zairian strain" and is probably a subclone of the latter. The fact that a
      limited number of plasmid profiles have remained constant over many years shows
      the limitation of plasmid profile analysis as an epidemiological tool. However,
      when the usual profile is known for a given area, identification of a distinctly
      different pattern becomes easy and epidemiologically useful.

PMID- 2231676
TI  - Plasmids and factors associated with virulence in environmental isolates of
      Vibrio cholerae non-O1 in Bangladesh.
AB  - Plasmid profiles and factors associated with toxigenicity in 51 strains of Vibrio
      cholerae non-O1 isolated from water samples collected in Bangladesh were
      analysed. Eleven (21.5%) strains were found to harbour at least one plasmid of
      1.7-115 Mda; seven of these strains shared a 115-Mda plasmid. Six of 13 strains
      tested gave positive cytotoxic and enterotoxic responses. However, two non
      cytotoxic strains were enterotoxigenic. Only three of the six cytotoxic and
      enterotoxic strains caused haemagglutination of human erythrocytes which
      indicated that toxin production and haemagglutinating activity were unrelated in
      these V. cholerae non-O1 strains. Conjugal transfer assays demonstrated that the
      115-Mda plasmid harboured by some of the toxigenic V. cholerae non-O1 strains
      carried genes coding for antibiotic resistance and cytotoxin production but not
      for enterotoxin production. However, this plasmid was also carried by non
      toxigenic strains. Some other strains carrying no plasmids or only small-mol.-wt
      plasmids, were found to be toxigenic. Therefore, toxin production is not plasmid
      mediated in all V. cholerae non-O1 strains. Regardless of their pathogenic
      potential, V. cholerae non-O1 strains possessed the capacity to grow in
      conditions of iron limitation and, under these conditions, synthesis of at least
      two new outer-membrane proteins was induced.

PMID- 2231677
TI  - Pathogenic factors of Pseudomonas cepacia isolates from patients with cystic
      fibrosis.
AB  - One hundred and nineteen isolates of Pseudomonas cepacia, 98 of which were from
      cystic fibrosis (CF) patients and 21 from environmental and other human sources,
      were examined for biochemical and exo-enzymatic properties that may contribute to
      the pathogenicity of this bacterium. The following characteristics were
      demonstrated significantly more frequently in isolates from CF patients than in
      control isolates: production of catalase, ornithine decarboxylase, valine
      aminopeptidase, C14 lipase, alginase and trypsin; reduction of nitrate to
      nitrite; hydrolysis of urea and xanthine; complete haemolysis on bovine red blood
      cells; cold-sensitive haemolysis on human red blood cells; greening of horse and
      rabbit red blood cells. The role of these factors in the pulmonary disease
      associated with cystic fibrosis is not clear. However, several factors which have
      been reported previously as being associated with pathogenic processes with other
      bacteria have now been described in P. cepacia. Additional factors not previously
      reported as "pathogenicity factors" are also described.

PMID- 2231678
TI  - The use of selective media for the isolation of Pseudomonas pseudomallei in
      clinical practice.
AB  - Ashdown's selective-differential agar medium, with or without preenrichment in
      selective broth, was evaluated for the isolation of Pseudomonas pseudomallei from
      1972 clinical specimens obtained from 643 subjects in Northeast Thailand; 226
      patients proved to have meliodosis. The use of Ashdown's medium significantly
      increased the frequency of recovery of P. pseudomallei from sites or specimens
      with an extensive normal flora (throat, rectum, wounds and sputum) as compared to
      the recovery on blood and MacConkey agars (p less than 0.01). The isolation
      frequency from throat, rectal and wound swabs was further increased by the use of
      the broth pre-enrichment. The colonial morphology of P. pseudomallei on Ashdown's
      medium was sufficiently characteristic to allow presumptive identification. With
      the use of these selective media it was possible to culture P. pseudomallei from
      throat swabs taken from 87% of the patients from whom the organism could also be
      isolated from corresponding tracheal aspirates or sputum specimens. P.
      pseudomallei was isolated from rectal swabs taken from 51 patients, the first
      time that faecal excretion of the organism has been demonstrated in man. The
      diagnosis of melioidosis would not have been confirmed bacteriologically in eight
      patients (3.5%) without the use of the selective media. It is suggested that, in
      areas endemic for melioidosis, all sputum specimens should be cultured on
      selective media, such as Ashdown's. For the investigation of clinically suspected
      cases of melioidosis, and for follow-up during treatment of the disease, the use
      of broth pre-enrichment is recommended for specimens obtained from sites with an
      extensive normal flora.

PMID- 2231679
TI  - Phagocytosis of Legionella pneumophila.

PMID- 2231680
TI  - Virulence of ten serogroups of Clostridium difficile in hamsters.
AB  - A slide agglutination technique identifying 10 serogroups of Clostridium
      difficile (A,B,C,D,F,G,H,I,K and X) has been described previously. In this study,
      we have used the hamster to compare the ability of the 10 serogroup reference
      strains to colonise and produce disease. Groups of four hamsters were each given
      a single intraperitoneal injection of either clindamycin or cefoxitin, and an
      oral challenge dose of C. difficile. The time taken to establish faecal
      colonisation and the length of survival after colonisation were monitored. All
      hamsters treated with cefoxitin became colonised by day 3 and those challenged
      with the cytotoxigenic strains of serogroups A,C,H and K developed colitis and
      died. Among those challenged with the non-toxigenic strains of groups B,D,I and X
      and the toxigenic strains of groups F and G, faecal colonisation was established
      without signs of disease. This demonstrates that there are differences in
      virulence even among toxigenic strains of C. difficile. The same phenomenon was
      observed after treatment with clindamycin but the pattern of colonisation was
      quite different with some strains. In the hamsters challenged with toxigenic
      strains of groups C and K and non-toxigenic strains of groups D and I, which are
      highly resistant to clindamycin, the response was the same as with cefoxitin. The
      results were different with strains which were susceptible to clindamycin. Some
      animals became colonised much later than those treated with cefoxitin but the
      mortality was similar.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231681
TI  - The simian immunodeficiency virus (SIV) rev gene regulates env expression.
AB  - The rev gene product is a trans-acting nuclear regulatory protein that is
      essential for AIDS virus replication. To define the effect of the SIV rev gene on
      its gp160 expression, two SV40 constructs have been made: pBC17 is a rev+env+
      construct, and pBD21 is a rev-env+ construct. After transfecting the constructs
      into COS-1 cells, RNA, protein, syncytium formation, and monoclonal antibody
      blocking assays were performed. The results indicated that the SIV rev gene
      positively influenced the level of full-length env mRNA and was required for
      expression of SIV gp160.

PMID- 2231682
TI  - Mutational analysis of simian immunodeficiency virus from African green monkeys
      and human immunodeficiency virus type 2.
AB  - We constructed ten mutants of simian immunodeficiency virus isolated from African
      green monkey (SIVAGM), and nine mutants of human immunodeficiency virus type 2
      (HIV-2) in vitro. Their infectivity, cytopathogenicity, transactivation
      potential, virus RNA, and protein synthesis were examined by transfection and
      infection experiments. Mutations in three structural (gag, pol, env) and two
      regulator (tat, rev) genes abolished the infectivity of both viruses, but vpx,
      vpr (HIV-2), and nef were dispensable and mutant viruses were indistinguishable
      phenotypically from wild type virus. A vif mutant of HIV-2 showed poor
      infectivity in cell-free condition, whereas SIVAGM mutants grew equally well with
      wild type virus. In transient transfection assays, rev mutants derived from both
      viruses produced mainly small mRNA species and no detectable virus proteins and
      particles. Transactivation potential of tat mutants originated from both viruses
      was about three- to ten-fold less than that of respective wild type DNAs,
      generating small amounts of virus.

PMID- 2231683
TI  - Identification of SIV/SMM viral proteins that induce T cell response in
      experimentally infected rhesus macaques and naturally infected sooty mangabeys by
      the cellular western blot assay.
AB  - Initial studies have revealed subtle differences in the T cell proliferative
      response to whole SIV antigen in the peripheral blood mononuclear cells (PBMC)
      from sooty mangabeys and rhesus macaques. Preliminary findings utilizing the
      cellular Western blot assay are described.

PMID- 2231684
TI  - Antibody-dependent enhancement of SIV infection: further characterization and
      cross reactivity between macaque and sooty mangabey isolates.
AB  - Plasma from four rhesus macaques (Macaca mulatta), of which two were
      experimentally infected with the simian immunodeficiency virus (SIV) isolate
      SIVmac251, one with isolate SIVsmF236, and another with a SIVsmF236 molecular
      clone, SIVsmH-4, enhanced SIVmac infection of MT-2 cells. In addition to SIV
      positive plasma, infection-enhancement required complement, CD4, and CR2. Titers
      of infection-enhancing antibodies appeared to correlate with disease progression.
      The MT-2/SIVmac251 system should be useful in future studies of complement
      mediated, antibody-dependent enhancement of macaque and sooty mangabey SIV
      isolates.

PMID- 2231685
TI  - Molecular characterization of SIV in tissues from experimentally infected
      macaques.
AB  - Tissues from SIV-infected, immunodeficient macaques were analyzed by southern
      blot and polymerase chain reaction (PCR) amplification of env sequences. Provirus
      was readily detected in both lymphoid and non-lymphoid tissues by southern blot
      analysis. The majority of virus was in an unintegrated state. Analysis of
      envelope sequences by PCR revealed that tissues contain many distinct, but
      closely related genotypes; however, only a subset of these proviral genomes are
      recovered after tissue culture passage in human cell lines. Thus, tissue culture
      isolates of SIV do not represent the complete spectrum of genotypes in an
      infected macaque.

PMID- 2231686
TI  - Molecular characterization of simian lentiviruses from east African green
      monkeys.
AB  - Asymptomatic infection with simian lentiviruses (also called simian
      immunodeficiency viruses, or SIV) is common among feral African green monkeys. To
      characterize the range of SIV genetic diversity among infected African green
      monkeys, we have determined nucleotide sequences from complete or partial
      molecular clones of four distinct SIVagm isolates from Kenya and Ethiopia. The
      nucleotide and amino acid variability we observed among the SIVagm isolates was
      greater than the variability within any other group of primate lentiviruses.
      These data suggest that: a) African green monkeys have been infected with simian
      lentiviruses for many years; and b) novel and uncharacterized primate
      lentiviruses may exist in the feral African green monkey population in other
      parts of Africa.

PMID- 2231687
TI  - Sequence variability of simian immunodeficiency virus in a persistently infected
      rhesus monkey.
AB  - A juvenile rhesus monkey that was inoculated intravenously with molecularly
      cloned SIVmac239 became persistently infected. A modified polymerase chain
      reaction (PCR) procedure was used to specifically amplify full-length envelope
      (env) gene sequences from DNA extracted from peripheral blood mononuclear cells
      (PBMC), lymph node tissue, and cells infected with recovered virus at 69 and 93
      weeks post-infection. Extensive sequence variability accumulated in vivo in spite
      of infection with molecularly cloned virus. In the central portion of env.
      sequence variability was largely confined to three discrete regions.

PMID- 2231688
TI  - Characterization of clones of HIV-1 infected HuT 78 cells defective in gag gene
      processing and of SIV clones producing large amounts of envelope glycoprotein.
AB  - Single-cell clones of HIV-1 (FRE-3) or SIV/Mne infected HuT 78 cells were
      obtained by plating dilutions of virally infected HuT 78 cells on a monolayer of
      sheep choroid plexus cells in 96-well microtiter plates. Several of these clones
      produce HIV-1 virus mutants that accumulate the gag precursor polyprotein and
      lack a functional protease. These protease-deficient viruses are non-infectious
      and consist of aberrant "immature" virus particles as determined by electron
      microscopy. Several SIV mutants are also described that produce large amounts of
      either the envelope glycoprotein gp120 or the nucleic acid binding gag protein.
      These mutants are useful for the purification of these retroviral proteins, in
      developing assays of protease inhibitors, and in preparing SIV envelope protein
      vaccines.

PMID- 2231689
TI  - Inoculation of Macaca fascicularis with simian immunodeficiency virus, SIVmne
      immunologic, serologic, and pathologic changes.
AB  - Previous studies had tested the susceptibility of two macaque species, Macaca
      nemestrina and M. mulatta, to infection with the primate lymphotropic lentivirus
      SIVmne. In this report we describe the results obtained after infecting eleven M.
      fascicularis with SIVmne. Six of the animals had previously been immunized with a
      recombinant vaccinia virus expressing the envelope gene of HIV-1. All eleven
      animals became seropositive. To date ten animals have died 43 to 155 weeks post
      infection of an AIDS-like disease.

PMID- 2231690
TI  - Experimental infection of timed-pregnant rhesus monkeys with simian
      immunodeficiency virus (SIV) during early, middle, and late gestation.
AB  - Ten rhesus monkeys were inoculated with SIV/DeltaB670 during various stages of
      gestation to determine factors predictive of transplacental infection. Two
      abortions associated with rapid disease occurred shortly after infection;
      uninfected infants were caesarean delivered from eight other females. SIV
      specific RNA accompanied by deciduitis was identified in the maternal portion of
      two placentas suggesting that opportunistic infections may promote entry of SIV
      into placental tissue. The lack of evidence for SIV infection of caesarean
      delivered infants suggests that fetal infection may often occur during
      parturition.

PMID- 2231691
TI  - Use of simian immunodeficiency virus for vaccine research.
AB  - Rhesus monkeys were immunized with purified, disrupted, noninfectious simian
      immunodeficiency virus (SIV) in adjuvant induced SIV neutralizing antibodies. Two
      of six previously vaccinated macaques were protected against infection when
      challenged with 200-1,000 animal infectious doses of uncloned, pathogenic SIV and
      both have remained free of signs of virus infection for 19 and 30 months. Prior
      vaccination appeared to be of benefit in decreasing the virus load and in
      delaying the onset of AIDS in animals that became infected. Nonetheless, two of
      four previously vaccinated monkeys that became infected following challenge
      eventually developed AIDS and died 505 and 538 days after infection. Thus, for a
      vaccine to be truly effective against AIDS, it may have to protect absolutely
      against initial infection.

PMID- 2231692
TI  - Gag precursors of HIV and SIV are cleaved into six proteins found in the mature
      virions.
AB  - During retroviral maturation gag precursors are proteolytically cleaved to mature
      gag proteins. The number of mature gag proteins and their order in the gag
      precursors of HIV-I3B, SIVMne (captive macaque isolate), and SIVCat (wild
      mangabey isolate) has been determined by N-terminal amino acid sequence analysis
      of mature gag proteins and alignment with predicted sequences of homologous gag
      precursors. For HIV-1 and SIVs maturation proteolysis results in six gag proteins
      and the gag precursor cleavage pattern is distinctive and different from cleavage
      patterns for all other known retroviruses.

PMID- 2231693
TI  - Nef genes of SIV.
AB  - Molecular clones of SIVmac were constructed that differed only in sequences
      within the nef gene. DEAE-transfection of viral DNA containing an open from of
      nef yielded virus that replicated with similar kinetics and to a similar extent
      in macaque peripheral blood lymphocyte (PBL) cultures as virus with a deletion or
      stop codon within nef. Rhesus monkeys that received each kind of molecularly
      cloned virus became infected. Our results additionally suggest that mutant forms
      of virus are selected in vitro while open, functional forms are selected in vivo.
      In animals infected with virus containing a stop codon within nef, reversion of
      the stop codon to a coding codon was demonstrated in five of five clones
      analyzed. These results indicate that nef is playing some role crucial to the
      virus life cycle in vivo.

PMID- 2231694
TI  - Molecular changes associated with replication of simian immunodeficiency virus in
      human cells.
AB  - The SIVmac239 infectious clone does not have a premature stop codon in its
      transmembrane protein (TMP) region and it produces full-length (41 kilodalton,
      kDa) TMP in macaque peripheral blood lymphocytes (PBL) in vitro and in vivo.
      However, viruses with truncated forms of TMP (28kDa) are selected during
      propagation in human cell types; truncated forms arise from point mutations, CAG
      (glutamine) to TAG (stop), in the viral genome. These results document molecular
      changes associated with adaptation of SIVmac for growth in human cells.

PMID- 2231696
TI  - Electrophysiology of cultured human lens epithelial cells.
AB  - The lens epithelial K+ conductance plays a key role in maintaining the lens ionic
      steady state. The specific channels responsible for this conductance are unknown.
      We used cultured lens epithelia and patch-clamp technology to address this
      problem. Human lens epithelial explants were cultured and after 1-4 passages were
      dissociated and used in this study. The cells from which we measured had a mean
      diameter of 31 +/- 1 microns (SEM, n = 26). The resting voltage was -19 +/- 4 mV
      (SEM, n = 10) and the input resistance was 2.5 +/- 0.5 G omega (SEM, n = 17) at 
      60 mV. Two currents were prominent in whole-cell recordings. An outwardly
      rectifying current was seen in nearly every cell. The magnitude of this current
      was a function of K+ concentration and was blocked by 3 mM tetraethylammonium.
      The instantaneous current-voltage relationship was linear in symmetric K+,
      implying that the outward rectification was due to gating. The current showed
      complex activation and inactivation kinetics. The second current seen was a
      transient inward current. This current had kinetics very similar to the
      traditional Na+ current of excitable cells and was blocked by 0.1 microM
      tetrodotoxin. In single-channel recordings, a 150-pS K+ channel and a 35-pS
      nonselective cation channel were seen but neither account for the macroscopic
      currents measured.

PMID- 2231697
TI  - Visualization and coding in three-dimensional image processing.
AB  - A system for calculating orthographic views of three-dimensional objects from a
      confocal microscope has been implemented in a high-level language. It is used on
      a regular basis in a number of projects and on different computers. The system
      enables the user to filter the original data and make a selection of which points
      and parts of the objects to show in a projective view. The information to be
      shown is coded in a compact format that is well suited for projection
      calculations. Several display principles were implemented that enhance different
      aspects of the objects.

PMID- 2231698
TI  - Measuring the forces acting during microtomy by the use of load cells.
AB  - The forces acting upon the cutting blade during microtomy can be accurately
      measured by using a load cell. From the information obtained, the optimal knife
      angles (rake, clearance and slant) can be determined. In addition, the speed of
      cutting and thickness of sections can also be optimized. The information obtained
      from the load cell additionally reveals variations in tissue composition which
      affect the cutting forces. This paper is a preliminary communication to
      illustrate the possible roles for a modified microtome in (a) the study of
      microtomy and (b) comparative studies of tissue density.

PMID- 2231699
TI  - Concentration of solutes during preparation of aqueous suspensions for cryo
      electron microscopy.
AB  - It is demonstrated that solutes are likely to be significantly concentrated under
      conditions commonly used to prepare vitrified aqueous suspensions for
      transmission electron microscopy. Muscle thick filaments in such suspensions were
      largely dissolved, probably due to an increase in salt concentration caused by
      evaporation of water immediately prior to freezing. The extent of solubilization
      indicated that salts had been concentrated by at least 50%. Simple tests showed
      that, under the conditions used, the rate of reduction in the height of a thin
      water layer was approximately 1 micron/s. Apparatus is described which reduces
      evaporation, by clamping the hydrated grid in a filter paper sandwich until just
      before it enters the ethane coolant. High-speed cine photography showed that,
      using this device, exposure of the thinned specimen to the atmosphere was
      approximately 200-fold less. Frozen-hydrated thick filaments prepared using the
      device had the expected length of about 1.6 microns.

PMID- 2231700
TI  - Improving access to pediatric health care in Mississippi.
AB  - Working under the Mississippi Postneonatal Death Impact Project, the Mississippi
      Chapter of the American Academy of Pediatrics, in conjunction with the State
      Department of Health, helped improve access to pediatric health care in
      Mississippi. This was accomplished by developing a statewide telephone
      information and referral service (telephone case management), enlisting primary
      care physicians to treat a limited number of children without specific
      compensation and staging a public awareness campaign. System barriers encountered
      were identified and interagency coordination and cooperation suggested. This
      effort could be easily replicated and expanded.

PMID- 2231701
TI  - Multiple pterygium syndrome: neuromuscular findings in a case.
AB  - A woman with multiple congenital joint deformities and webbing (multiple
      pterygium syndrome) is described. The electrophysiologic study revealed normal
      sensory and motor nerve conduction velocities. However, the compound muscle
      action potential amplitude and the voluntary motor unit size were reduced,
      suggesting a decrease in the number of muscle fibers. The muscle biopsy was
      otherwise unremarkable histologically and histochemically. Possible explanations
      for these findings are discussed.

PMID- 2231702
TI  - Correlation of urinary tract infection with urinary screening at the first
      antepartum visit.
AB  - Urinary tract infection contributes to the morbidity of pregnancy since 4-10
      percent of antepartum patients have asymptomatic bacteriuria and 20-40 percent of
      these will result in pyelonephritis. A cost-effective outpatient assessment for
      asymptomatic bacteriuria in undelivered obstetric patients is described. In this
      study, 56 patients between 6-24 weeks gestation were assessed over a seven-month
      period by photometric urinary screening. This assessment was more accurate in
      identifying those patients with asymptomatic bacteriuria than prior history or
      symptoms. A 7 percent incidence of asymptomatic bacteriuria was noted with 75
      percent being Escherichia coli and the remainder Klebsiella. Single-dose, oral
      antibiotic therapy was evaluated and resulted in no recurrences. Such screening
      for asymptomatic bacteriuria was felt to represent preventive and economic
      medical benefits.

PMID- 2231704
TI  - Medicare fee schedule.

PMID- 2231703
TI  - "Adopted standards for the regulation of medical waste" in health care facilities
      licensed by the Mississippi State Department of Health.

PMID- 2231695
TI  - Use of Xenopus oocytes for the functional expression of plasma membrane proteins.

PMID- 2231706
TI  - Hospital acted properly in revoking privileges.

PMID- 2231705
TI  - Severe movement disorder.

PMID- 2231707
TI  - Preliminary crystallographic analysis of trypanothione reductase from Crithidia
      fasciculata.
AB  - Trypanothione reductase, a flavoprotein disulfide reductase specific to
      trypanosomatid parasites, has been crystallized by vapor diffusion of a protein
      solution (10 mg/ml) against 22% polyethylene glycol (average Mr 8000) containing
      100 mM-ammonium sulfate. Crystals of a size suitable for structure determination
      by X-ray diffraction have been obtained by seeding protein solutions with smaller
      crystals. The space-group is P21 (a = 60.9 A, b = 161.8 A, c = 58.4 A, beta =
      99.1 degrees). The molecular mass and volume of the unit cell suggest that there
      is a dimer of the enzyme in the asymmetric unit, and this is confirmed by self
      rotation functions calculated using data to 4.5 A resolution. The crystals
      diffract to beyond 3 A resolution. Crystals of another P21 form (a = 91.3 A, b =
      114.4 A, c = 92.0 A, beta = 141.3 degrees) are observed to grow under similar
      conditions.

PMID- 2231708
TI  - Narbonin, a 2 S globulin from Vicia narbonensis L. Crystallization and
      preliminary crystallographic data.
AB  - A seed globulin from Vicia narbonensis L. has been crystallized by vapour
      diffusion induced pH-shift. Crystals are suitable for high-resolution X-ray
      structural analysis and diffract to better than 1.5 A. Narbonin crystallizes in
      the monoclinic space group P21 with alpha = 46.9 A, b = 75.5 A, c = 50.9 A, alpha
      = gamma = 90 degrees, beta = 120.5 degrees. The protein consists of one
      polypeptide chain that does not coincide with the subunits of legumin or vicilin
      after SDS/polyacrylamide gel electrophoresis and has a relative molecular mass of
      about 33,000.

PMID- 2231709
TI  - Trigonal crystals of porcine mitochondrial aspartate aminotransferase.
AB  - Crystals suitable for X-ray analysis of porcine mitochondrial aspartate
      aminotransferase in the closed conformation were obtained after the apoenzyme was
      reconstituted with N-5'-phosphopyridoxyl-L-aspartate, an inhibitor in which the
      cofactor is covalently bound to the substrate. This results in a crystal form
      that has not been encountered previously in studies of aspartate
      aminotransferases. The crystals belong to the trigonal space group P3121 (or the
      enantiomeric P3221) with unit cell dimensions alpha = b = 202.0 A, c = 58.0 A,
      alpha = beta = 90 degrees, gamma = 120 degrees and contain one dimer in the
      asymmetric unit.

PMID- 2231710
TI  - Order-disorder phenomena in myelinated nerve sheaths. I. A physical model and its
      parametrization: exact and approximate determination of the parameters.
AB  - An algorithm is developed for the analysis of the X-ray scattering spectra of
      lamellar systems, by reference to a precise physical model. The model consists of
      identical planar lamellae (the motif), all parallel and stacked in a one
      dimensional crystal with four types of defect: stacking disorder, finite size of
      the crystallites, and presence of diffuse and blank scattering. In addition, the
      spectra are distorted by collimation aberrations. In order to evaluate the
      effects of these distortions, the following assumptions are made: (1) beyond some
      point Slimit the intensity curve can be expressed as a function of a (small)
      number of parameters; (2) the blank scattering, restricted to very small angles,
      can be identified and eliminated; and (3) the diffuse scattering is entirely
      defined by the values of idiff(h/D) at the lattice Sh = h/D (h is a positive
      integer less than or equal to DSlimit). These assumptions lead to an expression
      of the whole of the intensity curve as a function of a finite number of
      parameters: the average D and the variance sigma 2D of the repeat distance, the
      average number [N] of lamellae per crystallite, the set [idiff(h/D)] and the set
      [imotif(k/2D)] (where k is a positive integer), which defines the structure of
      the motif. An algorithm is proposed to determine the value of the various
      parameters. The derivation of the algorithm involves several operations:
      construction in real space of periodic functions whose motifs are step-sections
      of the autocorrelation function; expression in reciprocal space, and in terms of
      the experimental scattering curves, of the Fourier transform of those periodic
      functions; analysis of the properties of the two functions. The algorithm is
      tested using a variety of simulated scattering curves whose parameters
      [imotif(k/2D)], [idiff(2/D)], D, sigma D, [N] (and collimation distortions) are
      within the range commonly encountered in experimental conditions. The results
      show that the values of the parameters retrieved by the algorithms are very close
      to those used in the simulation. The calculations are fast and easy to implement
      on a computer. The main virtues of the algorithm are (1) to determine the values
      of all the parameters at once, eliminating most of the intermediate (and
      questionable) manipulations (separation of signal from noise, discrimination of
      overlapping reflections, integration of the intensities) and (2) to yield the
      continuous intensity curve of a single motif.

PMID- 2231711
TI  - Order-disorder phenomena in myelinated nerve sheaths. II. The structure of myelin
      in native and swollen rat sciatic nerves and in the course of myelinogenesis.
AB  - The algorithm described in the accompanying paper was applied to X-ray scattering
      experiments performed with rat sciatic nerves, either as a function of the age of
      the animal (4 to 30 days), or with adult nerves swollen in non-isotonic media.
      The results were all consistent with the model of disorder used in the
      theoretical treatment. The algorithm leads, in one step, from the data to the
      numerical values of the parameters, avoiding all intermediate manipulation. For
      each experiment a variety of parameters was determined: the average D and the
      variance sigma 2D of the repeat distance, the average number [N] of motifs per
      crystallite, the set [idiff(h/D)], which defines the diffuse scattering, the
      fraction alphaloose of myelin that does not belong to the compact sheaths, and
      the set [imotif (k/2D)], which suffices to define the continuous intensity curve
      of the motif imotif(s). Note the remarkable wealth of information, especially by
      contrast with conventional analyses which, as a rule, only yield the values of D
      and of the set [imotif(h/D)] (insufficient to determine the function imotif(s].
      The function imotif(s) and the parameters D and sigma D (and thus the local
      structure of the myelin sheaths) were shown to be almost invariant in the course
      of myelinogenesis; what varies is mainly the total amount of myelin in the nerve
      and the number of membranes per sheath. Swelling agents have a dramatic influence
      on the X-ray scattering spectra, but in spite of the conspicuous variation of D,
      sigma D and [N] the structure of the motif is invariant. The structure of the
      motif was shown to be quite different in the native and in the swollen samples;
      the stacking disorder appears to involve mainly the cytoplasmic space in native
      myelin, the external space in swollen nerves. The very notion of electron density
      profile, when disorder is present, is discussed. Two criteria were proposed to
      select the "best" signs of the reflections: two sets came out at almost the same
      rank, one corresponding to Caspar & Kirschner's the other to Worthington &
      McIntosh's proposals, neither of which can be ruled out according to the criteria
      used in this work.

PMID- 2231712
TI  - Basic local alignment search tool.
AB  - A new approach to rapid sequence comparison, basic local alignment search tool
      (BLAST), directly approximates alignments that optimize a measure of local
      similarity, the maximal segment pair (MSP) score. Recent mathematical results on
      the stochastic properties of MSP scores allow an analysis of the performance of
      this method as well as the statistical significance of alignments it generates.
      The basic algorithm is simple and robust; it can be implemented in a number of
      ways and applied in a variety of contexts including straightforward DNA and
      protein sequence database searches, motif searches, gene identification searches,
      and in the analysis of multiple regions of similarity in long DNA sequences. In
      addition to its flexibility and tractability to mathematical analysis, BLAST is
      an order of magnitude faster than existing sequence comparison tools of
      comparable sensitivity.

PMID- 2231713
TI  - Solution conformation of purine-pyrimidine DNA octamers using nuclear magnetic
      resonance, restrained molecular dynamics and NOE-based refinement.
AB  - The solution structures of two alternating purine-pyrimidine octamers, [d(G-T-A-C
      G-T-A-C)]2 and the reverse sequence [d(C-A-T-G-C-A-T-G)]2, are investigated by
      using nuclear magnetic resonance spectroscopy and restrained molecular dynamics
      calculations. Chemical shift assignments are obtained for non-exchangeable
      protons by a combination of two-dimensional correlation and nuclear Overhauser
      enhancement (NOE) spectroscopy experiments. Distances between protons are
      estimated by extrapolating distances derived from time-dependent NOE measurements
      to zero mixing time. Approximate dihedral angles are determined within the
      deoxyribose ring from coupling constants observed in one and two-dimensional
      spectra. Sets of distance and dihedral determinations for each of the duplexes
      form the bases for structure determination. Molecular dynamics is then used to
      generate structures that satisfy the experimental restraints incorporated as
      effective potentials into the total energy. Separate runs start from classical A
      and B-form DNA and converge to essentially identical structures. To circumvent
      the problems of spin diffusion and differential motion associated with distance
      measurements within molecules, models are improved by NOE-based refinement in
      which observed NOE intensities are compared to those calculated using a full
      matrix analysis procedure. The refined structures generally have the global
      features of B-type DNA. Some, but not all, variations in dihedral angles and in
      the spatial relationships of adjacent base-pairs are observed to be in synchrony
      with the alternating purine-pyrimidine sequence.

PMID- 2231714
TI  - Temperature dependence of dynamics of hydrated myoglobin. Comparison of force
      field calculations with neutron scattering data.
AB  - Molecular dynamics is used to probe the atomic motions of the carboxy-myoglobin
      protein as a function of temperature. Simulations of 150 picoseconds in length
      are carried out on the protein at 20, 60, 100, 180, 220, 240, 260, 280, 300, 320
      and 340 K. The simulations attempt to mimic neutron scattering experiments very
      closely by including a partial hydration shell around the protein. Theoretical
      elastic, quasielastic and inelastic neutron scattering data are derived from the
      trajectories and directly compared with experiment. Compared to experiment, the
      simulation-derived elastic scattering curves show a decrease in intensity as a
      function of the scattering wavevector, q2. The inelastic and quasielastic spectra
      show that the inelastic peak is shifted to lower frequency than the experimental
      value, while quasielastic behavior is in good agreement with experiment. This
      suggests that the theoretical model is too flexible in the harmonic limit (low
      temperature), but accurately reproduces high-temperature behavior. Time
      correlation functions of the intermediate scattering function are determined. At
      low temperature there is one fast decay process, and at high temperatures there
      is an additional slow relaxation process that is due to quasielastic scattering.
      The average atomic fluctuations show that the protein behaves harmonically at low
      temperatures. At approximately 210 K, a glass-like transition in atomic
      fluctuations is seen. Above the transition temperature, the atomic fluctuations
      exhibit both harmonic and anharmonic behavior. Comparison of protein mobility
      behavior with experiment indicate the fluctuations derived from simulations are
      larger in the harmonic region. However, the anharmonic region agrees very well
      with experiment. The anharmonicity is large at all temperatures, with a gradual
      monotonic increase from 0.5 at 20 K to greater than 0.7 at 340 K without a
      noticeable change at the glass transition temperature. Heavy-atom dihedral
      transitions are monitored as a function of temperature. Trends in the type of
      dihedral transitions that occur with temperature are clearly visible. Dihedral
      transitions involving backbone atoms occur only above the glass transition
      temperature. The overall protein behavior results suggest that at low
      temperatures there is purely vibrational motion with one fast decay process, and
      above the glass transition temperature there is more anharmonic motion with a
      fast and a slower relaxation process occurring simultaneously.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2231715
TI  - Hydrogen bond stereochemistry in protein structure and function.
AB  - Fifty high resolution protein structures from the Brookhaven Protein Data Bank
      have been analyzed for recurring motifs in hydrogen bond stereochemistry.
      Although an exhaustive analysis of hydrogen bond statistics has been presented by
      Baker & Hubbard, a detailed stereochemical analysis of classical donor (N-H, O-H,
      or S-H) and acceptor (N:, O:, or S:) structure within proteins is lacking. Here,
      we describe the preferential hydrogen bond stereochemistry for the side-chains of
      glutamate and aspartate (carboxylate), glutamine and asparagine (carboxamide),
      arginine (guanidinium), histidine (imidazole/imidazolium), tryptophan (indole),
      tyrosine (phenolic hydroxyl), lysine (ammonium), serine and threonine (alkyl
      hydroxyl), cysteine (thiol), methionine (thioether) and cystine (disulfide).
      Preferential hydrogen bond stereochemistry is governed by (1) the electronic
      configuration of acceptor atoms, (2) the steric accessibility of donor atoms and
      (3) the conformation of amino acid side-chains. Applications of hydrogen bond
      stereochemistry are useful in the interpretation of protein structure, function
      and stability. Additionally, this stereochemistry is a prerequisite to the
      interpretation of protein-other molecule recognition and biological catalysis.

PMID- 2231716
TI  - Preliminary crystal structure analysis of an Fab specific for a Salmonella O
      polysaccharide antigen.
AB  - The Fab from an IgG1, lambda murine monoclonal antibody with specificity for the
      O-polysaccharide antigen of Salmonella typhimurium has been crystallized in the
      absence and presence of hapten. The conditions for crystal growth were vapor
      diffusion equilibration with 16 to 23% polyethylene glycol 8000 solutions. Data
      have been collected from crystals of the complex in space group P212121, a = 60.6
      A, b = 111.3 A, c = 61.1 A, and refinement of a molecular replacement solution is
      underway.

PMID- 2231718
TI  - Binding of the regulatory protein VirG to the phased signal sequences upstream
      from virulence genes on the hairy-root-inducing plasmid.
AB  - The VirG protein is a positive regulator for the virulence genes of which
      expression is induced by a plant factor, and is essential for Agrobacterium
      pathogenicity on dicotyledonous plants. The VirG protein of the hairy-root
      inducing plasmid A4 was overproduced in Escherichia coli cells, and purified to
      homogeneity. DNase I footprinting experiments revealed that the purified VirG
      protein was bound to the upstream region of virulence genes including the phased
      vir box sequences, which had been presumed to be the VirG recognition signal from
      the sequence analysis. In dimethyl sulfate footprinting, the VirG protein
      specifically protected the guanine residues within every vir box sequence. It was
      concluded that the VirG protein was bound to the phased vir box sequences from
      the major groove along one side of double-helical DNA.

PMID- 2231717
TI  - Characterization of the Escherichia coli araFGH and araJ promoters.
AB  - The identities of two cloned, arabinose-inducible promoters were tested by
      hybridizing promoter DNA fragments with restriction digests of chromosomal DNA
      containing Mudlac phage inserted in either araFGH or in araE transport operons.
      One promoter, thought to be araE, is within 10(3) base-pairs of a Mudlac
      insertion in the araE gene. The second promoter was not found within several
      thousand base-pairs of either of the known transport genes. This promoter is now
      named araPJ (araJ). The DNA sequence of the fragment containing the araFGH
      promoter was determined. The start site of transcription in vivo was located to
      within +/- 1 base-pair (bp) by S1 nuclease mapping. DNase 1 footprinting revealed
      that, in comparison with the araBAD and araE promoters, the locations of the AraC
      and cyclic AMP receptor protein (CRP) binding sites are reversed with CRP lying
      between AraC and RNA polymerase. The central location of the CRP binding site may
      explain why the araFGH promoter is more catabolite sensitive than the other ara
      promoters. AraC and CRP were both required for maximal transcription in vitro,
      although a low level of transcription was detected with CRP alone. S1 nuclease
      mapping of mRNA-DNA hybrids from the araJ promoter located the transcription
      start point to within #/- 3 bp, and demonstrates that the promoter is dependent
      upon AraC protein and CRP in vivo. DNase footprinting showed that the location of
      the AraC protein binding site on araJ is adjacent to the RNA polymerase site, as
      seen at the araBAD and araE promoters. Two CRP sites were observed; one is
      upstream from the AraC site and one is downstream from the transcription start
      site.

PMID- 2231719
TI  - Novel mutants of elongation factor G.
AB  - A novel mutant form of elongation factor G (EF-G) in Escherichia coli is
      described. This variant EF-G restricts reading frame errors by a factor of 2 to 3
      in vivo at two different positions in a lacIZ fusion. In addition, a conventional
      fusidic acid resistant (fusR) mutant of EF-G was compared with the restrictive
      mutant. Both mutants were characterized in vitro in a steady-state poly(U)
      translating system. The data indicate that the restrictive EF-G variant has an
      altered interaction with the ribosome both in vivo and in vitro. In contrast, the
      conventional fusR variant is altered in its interaction with GTP, which is
      evident in vitro.

PMID- 2231720
TI  - Structure of adenovirus fibre. I. Analysis of crystals of fibre from adenovirus
      serotypes 2 and 5 by electron microscopy and X-ray crystallography.
AB  - An analysis by electron microscopy in amorphous ice and X-ray diffraction of four
      types of three-dimensional crystals of adenovirus fibre is presented. Fibre from
      adenovirus type 2 (Ad2) crystallizes in two forms depending on whether it is
      native or cleaved near the N terminus at Tyr17. Fibre from Ad5 also crystallizes
      in two forms, both of which contained fibre cleaved at Tyr17. Analysis of the
      packing of the fibres in each of these crystals suggests that the overall length
      of the fibre may be considerably longer (about 350 to 370 A) than previously
      reported. Crystals of cleaved Ad2 fibre are of sufficient quality to be
      characterized by X-ray diffraction. They are of space group C2 and cell
      dimensions a = 134.4 A, b = 77.6 A, c = 539.4 A, beta = 92.7 degrees. These
      crystals are remarkable in that, despite being monoclinic, the ab plane forms a
      perfect hexagonal lattice. This is explained by a trigonal packing of the
      trimeric fibre heads in the crystal. A similar feature is found for one type of
      Ad5 crystal, although the hexagonal lattice is 12% smaller. The crystals of
      cleaved Ad2 show very strong meridional intensity at a Bragg spacing of 4.4 A and
      weaker diffuse intensity corresponding to layer-lines of spacing 26.4 A. This
      must reflect the quasiperiodicity of the structure of the fibre shaft, which is
      apparent in the primary sequence. The occurrence of these features combined with
      the new determination of the length of the fibre (see also the accompanying
      paper) require a reappraisal of the cross-beta model of the fibre shaft proposed
      by Green et al.

PMID- 2231721
TI  - Structure of adenovirus fibre. II. Morphology of single fibres.
AB  - Adenovirus type 2 fibres in crystals appear to be significantly longer than found
      previously (accompanying paper). We therefore examined isolated fibre by electron
      microscopy and measured a length of 370 A, consistent with the length found in
      the crystals. The specific N-terminal structure of the fibre caused a
      heterogeneity in the length that may at least partially explain the values of 280
      to 310 A published previously. Green et al. described a 15 amino acid repeat in
      the primary structure of the shaft of the fibre thought to be associated with the
      specific three-dimensional folding of the shaft. We compared the adenovirus type
      2 (with 22 repeats) and type 3 (with 6 repeats) fibre lengths and derived a
      contribution of 13.2 A to the length of the shaft per 15 amino acid repeat.
      Specific morphological features of the fibre are discussed in relation to its
      amino acid sequence.

PMID- 2231722
TI  - Studies of synthetic helical peptides using circular dichroism and nuclear
      magnetic resonance.
AB  - We have designed a set of 17-residue synthetic peptides to be monomeric helices
      in aqueous solution. Circular dichrosim experiments indicate the presence of
      helical structure in aqueous solution at low temperature and low pH. The two
      dimensional nuclear magnetic resonance results for one of the peptides show a
      segment of ten residues which clearly meets all of the criteria for the existence
      of helical structure at both 5 degrees C and 15 degrees C. The first four
      residues of the peptide are in a largely extended conformation. Calculations
      suggest that residues 5 through 14 are significantly helical at 5 degrees C. When
      the temperature is increased, circular dichroism spectra indicate that the
      helical content decreases. At 15 degrees C, the 3JN alpha coupling constants
      increase in the helical region, indicating an increase in motion or
      conformational averaging in the helical segment. None of the peptides has pH
      titration behavior consistent with salt bridge stabilization of helical
      conformation. Our data lend themselves to interpretation with the helix dipole
      model and specific side-chain interactions. When the N and C termini charges are
      removed the helical content of the peptides increases. The amount of helicity
      increases as the pH is lowered, due to the ionization of His16. Much of the
      helical stabilization appears to be due to a specific side-chain interaction
      between His16 and Tyr12.

PMID- 2231723
TI  - Three-stranded paranemic joints: architecture, topological constraints and
      movement.
AB  - The RecA and SSB proteins will catalyze the joining of two DNA molecules
      containing homologous sequences but lacking homologous ends in a reaction termed
      paranemic joining. The absence of homologous ends can be achieved by (1) pairing
      two circular DNAs or (2) using linear DNA(s) with ends lacking homology to the
      pairing partner. Here we have used electron microscopy (EM) to examine such
      pairings. Circular M13 single-stranded (ss) DNA enveloped by RecA protein into a
      presynaptic filament was paired with linear M13mp7 double-stranded (ds) DNA
      containing non-M13 sequences at its ends. Joint complexes were frequently seen in
      which the dsDNA was joined with the presynaptic filament over several kilobase
      (10(3) bases) lengths of the dsDNA. In this region, the presynaptic filament
      appeared disorganized as contrasted to the customary helical structure of the
      filament containing only a single strand of DNA. The same ultrastructure, but
      with greater detail, was observed when the samples were prepared for EM without
      fixation using a new method of fast-freezing and freeze-drying. EM immunogold
      staining demonstrated the presence of SSB protein in the disorganized region
      containing all three strands, but not in the regular helically arranged region.
      Psoralen photo-crosslinking of the DNA in the joint complexes revealed that the
      three DNA strands were in close proximity only over a single short (200 to 300
      base-pairs) region. The joining of nicked circular M13 dsDNA and presynaptic
      filaments containing circular M13 ssDNA resulted in the intertwining of the dsDNA
      about the circular presynaptic filament. The joints produced in this case were
      short, as was the single region of psoralen photo-crosslinking of the three DNA
      strands. A model of how these long three-stranded joints form is presented
      involving the movement of a short "true" paranemic joint along the presynaptic
      filament.

PMID- 2231724
TI  - 2.2 A resolution structure analysis of two refined N-acetylneuraminyl-lactose-
      wheat germ agglutinin isolectin complexes.
AB  - The crystal structures of complexes of isolectins 1 and 2 of wheat germ
      agglutinin (WGA1 and WGA2) with N-acetylneuraminyl-lactose (NeuNAc-alpha(2-3)-Gal
      beta(1-4)-Glc) have been refined on the basis of data in the 8 to 2.2 A
      resolution range to final crystallographic R-factors of 17.2% and 15.3% (Fo
      greater than 1 sigma), respectively. Specific binding interactions and water
      association, as well as changes in conformation and mobility of the structure
      upon ligand binding, were compared in the two complexes. The temperature factors
      (B = 16.3 A2 and 18.4 A2) were found to be much lower compared with those of
      their respective native structures (19 to 22 A2). Residues involved in sugar
      binding, dimerization and in lattice contacts exhibit the largest decreases in B
      value, suggesting that sugar binding reduces the overall mobility of the protein
      molecules in the crystal lattice. The binding mode of this sialyl-trisaccharide,
      an important cell receptor analogue, has been compared in the two isolectins.
      Only one of the two unique binding sites (4 per dimer), located in the
      subunit/subunit interface, is occupied in the crystals. This site, termed the
      "primary" binding site, contains one of the five amino acid substitutions that
      differentiate WGA1 and WGA2. Superposition of the refined models in each of the
      independent crystallographic environments indicates a close match only of the
      terminal non-reducing NeuNAc residue (root-mean-square delta r of 0.5 to 0.6 A).
      The Gal-Glc portion was found to superimpose poorly, lack electron density, and
      possess high atomic thermal factors. In both complexes NeuNAc is stabilized
      through contact with six amino acid side-chains (Ser114 and Glu115 of subunit 1
      and Ser62, Tyr64, Tyr(His)66 and Tyr73 of subunit 2), involving all NeuNAc ring
      substituents. Refinement has allowed accurate assessment of the contact distances
      for four hydrogen bonds, a strong buried non-polar contact with the acetamido CH3
      group and a large number of van der Waals' interactions with the three aromatic
      side-chains. The higher affinity of N-acetylneuraminyl-lactose observed by
      nuclear magnetic resonance studies for WGA1 can be explained by the more
      favorable binding interactions that occur when residue 66 is a Tyr. The tyrosyl
      side-chain provides a larger surface for van der Waals' stacking against the
      NeuNAc pyranose ring than His66 and a hydrogen bond contact with Gal (C2-OH), not
      possible in WGA2.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2231725
TI  - Protonated polypurine/polypyrimidine DNA tracts that appear to lack the single
      stranded pyrimidine loop predicted by the "H" model.
AB  - Three synthetic oligomers: 5'd(AG)8.dA.d(CT)(8)3'(A),
      5'd(TC)7.d(TTA).d(GA)(8)3'(B) and d(GA)17(C) were cloned into the plasmid vector
      p915 in order to study the effects of sequence symmetry on pH-dependent
      structural transitions in polypurine/polypyrimidine DNA. When present in linear
      molecules all three sequences undergo transitions to protonated states. These are
      kinked to different degrees as determined by a non-denaturing gel mobility shift
      assay. Chemical probe analysis shows that the protonated states adopted by the
      linear forms of A and C exhibit certain features which have been regarded as
      indicating partially triple stranded "H" transition structures. The chemical
      reactivities of the transition structure adopted by linear molecule B and certain
      features of those exhibited by the transition structures of linear molecules A
      and C do not conform to the predictions of the "H" model.

PMID- 2231726
TI  - Deoxymyoglobin studied by the conformational normal mode analysis. II. The
      conformational change upon oxygenation.
AB  - The conformational change taking place in myoglobin concomitantly with the
      observed geometrical change at the heme-His(F8) linkage upon oxygenation is
      studied by normal mode analysis, which is based on the quadratic approximation of
      the conformational energy function. The heme-globin interaction energy increases
      for this change by 8.114 kcal/mol when both the heme group and the globin
      molecule are held rigid. When they are permitted flexibility, the interaction
      energy relaxes by 7.038 kcal/mol, and the difference (1.076 kcal/mol) is
      distributed as strain energy within the molecule. This increase is the work
      necessary for the heme group to move against the force exerted by the globin. If
      the force is assumed to be invariable during this move, the work is small, 0.276
      kcal/mol, meaning that the force is strongly variable. Furthermore, this means
      that the heme group is located near the equilibrium point of the potential energy
      of the heme-globin interaction. The change in the localized strain energy stored
      in the force field at the linkage between the heme and the imidazole of HisF8 is
      estimated to be of the same order of magnitude as the distributed energy. The
      largest atomic displacements are observed at the region from the F helix to the
      beginning of the G helix, and secondary large displacements occur at several
      regions, i.e, the A helix, from the C helix to the CD corner, the E helix, and
      the C-terminal side of the H helix. All of these regions have strong dynamic
      interactions with the heme group, either directly or indirectly. Their secondary
      structures show complex deformations. In other parts, relatively rigid segments
      undergo rotational and/or bending changes in a way consistent with the large
      changes described above and close atomic packing within the molecule. The
      calculated conformational change is decomposed to vibrational normal modes of
      deoxymyoglobin. The magnitude of the conformational change, measured by the mass
      weighted mean-square atomic displacement, is accounted for up to 92.0% by the 151
      normal modes with frequencies lower than 40 cm-1. In descending order of
      contribution, the first six modes, each of which has a frequency lower than 12 cm
      1, account for up to 57.4%. This means that the functionally important
      conformational change can well be expressed in terms of a relatively small number
      of collective low frequency normal modes.

PMID- 2231728
TI  - 2.9 A resolution structure of the N-terminal domain of a variant surface
      glycoprotein from Trypanosoma brucei.
AB  - The variant surface glycoprotein (VSG) of Trypanosoma brucei forms a coat on the
      surface of the parasite; by the expression of a series of antigenically distinct
      VSGs in the surface coat the parasite escapes the host immune response. The 2.9 A
      resolution crystal structure of the N-terminal domain of one variant, MITat 1.2,
      has been determined. The structure was solved using data collected from two
      crystal forms. Initially a partial model was built into an electron density map
      based on multiple isomorphous replacement phases and improved by phase
      combination methods. Subsequently this model was used to obtain the molecular
      replacement solution for a second crystal form, providing starting phases which
      were refined using 2-fold non-crystallographic symmetry averaging. The current
      model includes 362 residues and has been refined using X-PLOR to an R value of
      0.22 for data between 7 and 2.9 A. The molecule is a dimer, approximately 100 A
      long, having an asymmetrical cross section with maximum dimensions of
      approximately 40 A x 60 A. Two long, approximately 70 A, alpha-helices from each
      monomer pack together to form, with several other helices, a core helix bundle
      that extends nearly the full length of the molecule. The "top" of the protein,
      which in the surface coat may be exposed to the external environment, is formed
      from the ends of the two long helices, a short three-stranded beta-sheet, and a
      strand having irregular conformation that packs above these secondary structure
      elements. Two conserved disulfide bridges are in this part of the molecule.
      Several elements of the MITat 1.2 sequence, which contribute to the formation of
      the helix bundle structure, have been identified. These elements can be found in
      the sequences of several different VSGs, suggesting that to some extent the VSG
      structure is conserved in those variants.

PMID- 2231727
TI  - Structure of oncomodulin refined at 1.85 A resolution. An example of extensive
      molecular aggregation via Ca2+.
AB  - The crystal structure of oncomodulin, a 12,000 Mr protein isolated from rat
      tumours, has been determined by molecular replacement using the carp parvalbumin
      structure as a starting model. Refinement was performed by cycles of molecular
      fitting and restrained least-squares, using area-detector intensity data to 1.85
      A resolution. For the 5770 reflections in the range 6.0 to 1.85 A, which were
      used in the refinement, the crystallographic R-factor is 0.166. The refined model
      includes residues 2 to 108, three Ca2+ and 87 water molecules per oncomodulin
      molecule. The oncomodulin backbone is closely related to that of parvalbumin;
      however, some differences are found after a least-squares fit of the two
      backbones, with root-mean-square (r.m.s.) deviations of 1 to 2 A in residues 2 to
      6, 59 to 61 of the CD loop, 87, 90 and 108. The overall r.m.s. deviation of the
      backbone residues 5 to 108 is 0.62 A. Each of the two Ca2+ atoms that are bound
      to the CD and EF loops is co-ordinated to seven oxygen atoms, including one water
      molecule. The third Ca2+ is also seven-co-ordinated, to five oxygen atoms
      belonging to three different oncomodulin molecules and to two water molecules
      which form hydrogen bonds to a fourth oncomodulin; thus, this intermolecular Ca2+
      and its equivalents interlink the molecules into zigzag layers normal to the b
      axis with a spacing of b/2 or 32.14 A. No such extensive molecular aggregation
      has been reported for any of the related Ca-binding regulatory proteins of the
      troponin-C family studied thus far. The Ca-O distances in all three polyhedra are
      in the range 2.07 A to 2.64 A, indicating tightly bound Ca polyhedra.

PMID- 2231729
TI  - Mutants of pheV in Escherichia coli affecting control by attenuation of the pheS,
      T and pheA operons. Two distinct mechanisms for de-attenuation.
AB  - Two mutants of pheV, a gene coding for tRNA(Phe) in Escherichia coli, were
      previously isolated because they affect attenuator control of the pheS, T operon
      when the mutant pheV genes are carried by the plasmid pBR322. We show that the
      two mutants (A44 and A46) affect attenuator control by different mechanisms. The
      effect of mutant A44 on pheS, T expression can be progressively decreased by
      overproduction of Phe-tRNA synthetase, consistent with the mutant tRNA acting as
      a competitive inhibitor of the enzyme. By contrast, the effect on attenuation of
      mutant A46 increases with overproduction of Phe-tRNA synthetase, indicating that
      the mutant must be charged to affect attenuation; we propose that this mutant
      affects translation directly and causes derepression by competing with wild-type
      tRNA in translation of the attenuator region leader peptide. Mutant A46 but not
      mutant A44 leads to further de-attenuation in a miaA background. The presence of
      two different mechanisms for de-attenuation is further indicated by the finding
      that a second attenuator controlled by Phe codon translation, from the pheA
      operon, is affected quite differently by the mutant tRNAs. Finally, experiments
      involving the introduction of the mutations A44 and A46 into an amber suppressor
      derived from tRNA(Phe) suggest that both species can function in protein
      synthesis but with reduced efficiency; mutant A46 is less efficient than mutant
      A44, consistent with a defect in elongation.

PMID- 2231730
TI  - Average orientation of aromatic residues in proteins determined from linear
      dichroism spectroscopy. A comparison of results on bovine gamma-crystallins with
      X-ray data.
AB  - The structures of the two very closely related proteins, bovine gamma II- and
      gamma IVa-crystallin have been studied by means of near-ultra-violet linear
      dichroism spectroscopy on squeezed polyacrylamide gel systems. The crystallin
      spectra are discussed in terms of the spectra of the aromatic chromophores
      present in these proteins and provide detailed information on the average
      orientation of these residues in the proteins. A comparison of our results with
      information based on crystallographic X-ray experiments shows excellent
      agreement, reflecting even some of the minor differences between the two proteins
      studied. Since linear dichroism measurements as performed here take a few days
      only, and can be done on most aqueous protein solutions, linear dichroism
      spectroscopy may give a valuable contribution to structural studies on proteins.

PMID- 2231732
TI  - Deoxymyoglobin studied by the conformational normal mode analysis. I. Dynamics of
      globin and the heme-globin interaction.
AB  - Dynamic properties of deoxymyoglobin are studied theoretically by the analysis of
      conformational fluctuations. Root-mean-square atomic fluctuations and distance
      fluctuations between different segments reveal the mechanical construction of the
      molecule. Eight alpha-helices behave as relatively rigid bodies and corner
      regions are more flexible, showing larger fluctuations. More particularly, corner
      regions EF and GH are specific in that flanking alpha-helices extend their
      rigidity up to a point in the corner region and the two rigid segments are
      connected flexibly at that point. The FG corner is exceptional. A segment from
      the F helix to the beginning of the G helix, in which the FG corner is included,
      becomes relatively rigid by means of strong interactions with the heme group. The
      whole myoglobin molecule is divided into two large units of motion, one extending
      from the B to the E helix, and the other from the F to the H helix. These two
      units are connected covalently by the EF corner. However, dynamic interactions
      between these two units take place mainly through contacts between helices B and
      G and not through the EF corner. From correlation coefficients between
      fluctuational motions of residues and the heme group, 55 residues are identified
      as having strong dynamic interactions with the heme moiety. Among them, 18
      residues in the three segments, one consisting of residues from the C helix to
      the CD corner, a second consisting of the E helix, and a third from the F helix
      to the beginning of the G helix, are in close contact with the heme group. Twenty
      two of the 55 residues are within four residues of the 18 residues in their
      sequential residue number and are more than 3 A away from the heme group. The
      other 15 residues are located further in the sequential residue number and are
      all found in helices A and H. They are more than 6 A away from the heme group. By
      the use of correlation coefficients of fluctuations between residues, it is found
      that dynamic interaction with the heme group is transmitted to the A helix and
      the beginning of the H helix in the direction Leu(E15)----[Val(All) and
      Trp(A12)]. The transmission to the C-terminal end of the H helix is mediated by a
      long segment, from the end of the EF corner to the beginning of the G helix, that
      lies on the heme group and has close contacts over a wide range.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2231731
TI  - Replacement of the Escherichia coli trp operon attenuation control codons alters
      operon expression.
AB  - To test features of the current model of transcription attenuation in amino acid
      biosynthetic operons, alterations were introduced into the trp operon leader
      region and expression of the mutated operons was examined in miaA and miaA+
      Escherichia coli strains that lacked the trp repressor. The miaA mutation
      prevents modification of the adenosine residue immediately 3' of the anticodon of
      tRNAs that interact with codons beginning with uridine. The undermodified
      tRNA(Trp) in miaA strains is thought to increase readthrough at the trp
      attenuator by slowing ribosome movement over two tandem Trp codons in the 14
      codon leader peptide coding region. The rate of translation of these two "control
      codons" is thought to be the key step in determining the extent of transcription
      attenuation in the trp leader region. Sequential deletion of trpL DNA specifying
      the leader peptide initiation region, RNA segment 1, RNA segment 2 and RNA
      segment 3 alternately decreased and increased trp operon expression, a result
      consistent with previous findings in another bacterium and the generally accepted
      model for transcription attenuation. Replacement of the tandem Trp control codons
      by AGG-UGC (Arg-Cys) codons eliminated the miaA-dependent increase in
      transcription readthrough. Replacement of the Trp control codons by AGG-UGA (Arg
      stop) codons caused complete readthrough at the trp attenuator as well as
      abolishing the miaA effect. Presumably, the ribosome terminating translation at
      the new UGA codon mimics the effect of a stalled ribosome at the Trp control
      codons. This finding suggests that ribosome dissociation at some stop codons is
      slow relative to the time required for transcription of the trp leader region.
      Thus, most ribosomes translating the trp leader peptide coding region may remain
      attached to the natural UGA stop codon until after the attenuation decision is
      made. The interpretation supports models for trp operon attenuation in which the
      elevated basal level readthrough is determined by occasional ribosome release
      prior to synthesis of the 3:4 terminator hairpin.

PMID- 2231733
TI  - Improved post-ischemic ventricular recovery in the absence of changes in energy
      metabolism in working rat hearts following heat-shock.
AB  - We have previously demonstrated that induction of the heat-shock response in rats
      results in improved recovery of isolated Langendorff-perfused rat hearts
      subjected to low-flow ischemia followed by reperfusion (Currie et al., 1988). The
      mechanisms underlying this protective effect of heat-shock are uncertain although
      the protection was associated with enhanced content of the antioxidant enzyme
      catalase but not superoxide dismutase or glutathione peroxidase (Currie et al.,
      1988). Various investigators have suggested the importance of improved energy
      metabolism in determining recovery following ischemia (Pasque and Wechsler, 1984;
      Haas et al., 1984; Devous and Lewandowski, 1987). We therefore examined, using a
      working rat heart model subjected to 10 or 15 min zero flow ischemia whether
      changes in energy metabolites could account for the protective effect of the heat
      shock response. Hearts perfused 24 h after induction of heat-shock failed to
      demonstrate significant improvement of recovery following 10 min ischemia,
      however recovery was significantly enhanced in hearts reperfused after 15 min
      ischemia. Ischemia produced a depression in both ATP and creatine phosphate (CP)
      content whereas a moderate elevation in ADP and AMP and a marked increase in
      tissue lactate were evident. These changes were unaffected by prior heat-shock
      treatment. For both durations of ischemia tissue metabolites were determined
      during early (5 min) and late (30 min) reperfusion. Although partial recovery in
      high energy phosphates and a return of ADP, AMP and lactate to near-normal levels
      were evident, no differences in energy products were observed between hearts from
      normal or heat-shocked animals, in spite of significantly enhanced
      recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231734
TI  - Role of oxygen free radicals generated by blood monocytes and neutrophils in the
      pathogenesis of rheumatic fever and rheumatic heart disease.
AB  - The generation of oxygen free radicals by peripheral blood monocytes and
      neutrophils of patients with rheumatic fever and rheumatic heart disease has been
      studied using luminol enhanced chemiluminescence technique. Five groups of
      patients; acute rheumatic fever, recurrence of rheumatic activity, chronic
      rheumatic heart disease, acute pharyngitis and normal controls were studied. In
      all groups except the controls, measurements were made on 0, 15, 90 and 180 days.
      The chemiluminescence was measured in response to streptococcal membrane antigen,
      carbohydrate antigen and latex as triggering agents. Chemiluminescent response of
      monocytes, as well as, neutrophils was significantly higher (P less than 0.01) in
      acute rheumatic fever and recurrence of rheumatic heart disease as compared to
      patients with acute pharyngitis and chronic rheumatic heart disease through the
      study period and with all the triggering agents. A significant decline (P less
      than 0.001) in chemiluminescence was observed from day 0 to day 180 in the acute
      rheumatic fever, recurrence of rheumatic heart disease and pharyngitis patients
      while no such change, was observed in the chronic rheumatic heart disease group.
      This study raises the possibility that these phagocytic cells, which infiltrate
      the myocardium, may have a role in the pathogenesis of cardiac disease seen in
      patients with rheumatic heart disease, through the generation of oxygen free
      radicals.

PMID- 2231735
TI  - Ischemia and reperfusion induced multilamellar vesicles in isolated rabbit
      hearts: time correlation between morphometric data and metabolic alterations.
AB  - In normoxic hearts a limited number of multilamellar vesicles was found in both
      endothelial cells and myocytes. The total number of multilamellar vesicles
      observed in myocytes, particularly those extruded from mitochondria,
      significantly increased in hearts rendered ischemic for at least 60 mins. The
      number of multilamellar vesicles extruded from sarcolemma was increased in hearts
      reperfused after this period of ischemia. The number of multilamellar vesicles in
      or adjacent to lipid droplets was independent of the duration of ischemia.
      Multilamellar vesicles were similar in size and periodicity of the lamellae. It
      is proposed that the number of multilamellar vesicles can be used to quantitate
      ischemic membrane injury. The formation of multilamellar vesicles was
      significantly related in time to (a) the accumulation of arachidonic acid and
      total fatty acids; (b) a decrease in the tissue content of ATP and (c) the
      release of lactate dehydrogenase (LDH). No significant alterations in the total
      tissue content of triacylglycerols and phospholipids were detected. The amount of
      arachidonic acid accumulated in the hearts reflects the degradation of only a
      minor fraction of the phospholipid pool. Assuming a close relationship between
      phospholipid degradation, induction of multilamellar vesicles and loss of
      cellular integrity, the present findings might indicate that the loss of a small
      part of phospholipids might have serious pathophysiological consequences, as
      indicated by the morphological changes in cellular membranes and the release of
      cytoplasmic macromolecules.

PMID- 2231736
TI  - Oxygen radical-mediated injury of myocytes-protection by propranolol.
AB  - UIe effects of propranolol and atenolol on free radical mediated injury in
      myocytes were examined. Freshly isolated adult canine myocytes were incubated
      with a superoxide generating (from dihydroxyfumarate) and Fe-catalyzed free
      radical system. Exposure of the myocytes to free radicals for 20 min resulted in
      more than a 5-fold increase in thiobarbituric acid reactant (peroxide) formation
      and elevated levels of lactate dehydrogenase (LDH) activity released into the
      media compared to controls. Ultrastructurally, severe sarcolemmal damage,
      mitochondrial and myofibril derangements were evident. At 40 min, cellular
      viability (trypan blue exclusion) in the samples exposed to free radicals
      decreased to about one-third of controls; concomitantly, major losses in total
      cellular phospholipids occurred. When the cells were pretreated with 200 microM
      propranolol before the addition of free radicals, both peroxide formation and
      increased LDH release were inhibited; in agreement, complete ultrastructural
      preservation was observed. In addition, the subsequent losses in cellular
      viability and phospholipids were prevented. For comparison, the more water
      soluble beta-blocker, atenolol at 200 microM was shown ineffective in providing
      significant protection against the induced injury. The results suggest that
      propranolol may provide antiperoxidative protection to myocytes when elevated
      levels of free radicals are present.

PMID- 2231737
TI  - Effects of hypoxia, acidosis, and simulated ischemia on repriming of caffeine
      contracture in rat myocardium.
AB  - This study was designed to examine the effects of hypoxia, acidosis, glucose-free
      medium and their combination on contraction and sarcoplasmic reticulum (SR)
      function in rat ventricular trabeculae. The isometric twitch tension was measured
      during superfusion with hypoxic (PO2 less than 30 mmHg), acidic (pH 6.80),
      glucose-free, or their combined ("ischemic") Tyrode's solution at 20 degrees C.
      The time needed to fully recover the contraction induced by 10 mM caffeine
      (repriming time) was measured to indirectly estimate the Ca2+ uptake of the SR.
      In "ischemia" and acidosis, the peak developed tension decreased progressively
      for the first 30 min (37.6 +/- 9.2% and 56.6 +/- 8.4% of control at 30 min,
      respectively), and then became steady. In hypoxic solution, the peak developed
      tension decreased moderately for the first 30 min (86.8 +/- 4.8% of control at 30
      min), and thereafter remained steady. Developed tension did not change
      significantly during 60 min of superfusion with glucose-free solution. The
      repriming time of caffeine contraction was significantly delayed in both
      "ischemic" and hypoxic solutions, but was unchanged in acidic and glucose-free
      solutions. These results lead us to suggest that depressed SR function to
      accumulate Ca2+ may contribute to the decline in tension in ischemia and hypoxia,
      but that other mechanisms are important in the tension decline induced by
      acidosis.

PMID- 2231738
TI  - Regulation of systolic force and control of free energy of ATP-hydrolysis in
      hypoxic hearts.
AB  - In isolated isometrically working rat hearts during graded, constant pressure
      hypoxic saline perfusion (PO2 140-700 mmHg) heart rate was changed experimentally
      between 80 and 400/min. The following parameters were recorded or estimated: peak
      systolic pressure, dP/dtmax, dP/tmin, oxygen consumption (VO2), venous PO2, ATP,
      ADP, phosphocreatine, creatine and inorganic P. Free energy of ATP hydrolysis
      (dG/d xi) was calculated from cytosolic concentration using CK-equilibrium
      equation. Two predominant responses of the hearts to hypoxia were observed,
      pronounced negative force frequency relationship; maintained energetic state
      (Free energy, dG/d xi) at the respective level of hypoxia if contractile force
      and beating rate were varied by a factor of 4-5. The enhanced force frequency
      relationship with a maintained free energy level is interpreted in terms of
      downregulation of EC-coupling (including duration of action potential) which
      comprises a possible cardioprotective effect.

PMID- 2231739
TI  - Functional interconversion of rest decay and ryanodine effects in rabbit and rat
      ventricle depends on Na/Ca exchange.
AB  - Rapid cooling contractures were used to assess changes in sarcoplasmic reticulum
      (SR) Ca content in isolated rabbit and rat ventricular muscle during rest, with
      altered transsarcolemmal [Na] and [Ca] gradients and in the presence and absence
      of 100 nM ryanodine. In rabbit there is normally a rest-duration dependent
      decline in SR Ca content (rest decay), whereas in rat there is a short-term
      increase in SR Ca content (rest potentiation) and little evidence of rest decay.
      Ryanodine greatly accelerates the rate of rest decay in rabbit, depleting the SR
      of Ca in approximately 1 s, whereas in rat, ryanodine does not appear to drain
      the SR even after a 10 min rest. Elevation of intracellular Na activity in rabbit
      (by Na-pump inhibition) to a level similar to that measured in control rat during
      rest (Shattock and Bers, Am. F. Physiol., 256: C813-C822, 1989) makes rest
      dependent changes of SR Ca content in these two tissues similar. The rest decay
      in rabbit in the presence of ryanodine is also markedly slowed after Na-pump
      inhibition. In rat, reduction of [Ca]0 allows rest decay to occur (+/-
      ryanodine), but this rest decay can be largely prevented by simultaneous
      reduction of [Na]o (to maintain [Na]3/[ Ca] constant) which serves to keep the
      thermodynamic driving force on a 3:1 Na/Ca exchange constant. We conclude that
      the process of rest decay and rest potentiation in both rabbit and rat ventricle
      depends on the sarcolemmal Na/Ca exchange. Furthermore, these species can be
      functionally interconverted by manipulation of the [Na] and [Ca] gradients. The
      ability of ryanodine to deplete the SR of Ca also depends critically on other
      transport systems (particularly Na/Ca exchange) to remove Ca from the cytoplasm.

PMID- 2231740
TI  - Protein kinase C activation enhances the delayed rectifier potassium current in
      guinea-pig heart cells.
AB  - The possible involvement of protein kinase C in modulating membrane currents was
      investigated in isolated guinea-pig ventricular cells. In a Na(+)-and K(+)-free
      external solution, the delayed rectifier K+ current (IK) was increased by the
      activator of protein kinase C (PKC), 12-O-tetradecanoylphorbol-13-acetate (TPA).
      The amplitude of the IK tail elicited by a return from a depolarizing pulse for 3
      s at + 50 mV to a holding potential of -30 mV was increased by 32 +/- 4% (mean +/
      S.E., (n = 6) after the external application of 1 nM TPA, and by 60 +/- 17% (n =
      5) after 10 nM. The increase in IK produced by 1 nM TPA was abolished by the
      inhibitor of PKC, 1-(5-isoquinolinesulfonyl)-2-methylpiperazine (H-7, 10 microM).
      In addition, the synthetic diacylglycerol 1-oleoyl-2-acetylglycerol (OAG, 125
      microM) also increased IK (58 +/- 9%, n = 3). PKC purified from bovine brain
      remarkably increased IK (151 +/- 101%, n = 5) in the presence of 1 nM TPA when it
      was internally applied using the cell dialysis method. The concentration-response
      curve of IK for the intracellular concentration of Ca2+ was shifted to the left
      by 1 nM TPA, suggesting a Ca2(+)-dependent action of PKC and/or altered Ca2(+)
      sensitivity of IK channels by phosphorylation. On the other hand, 1 nM TPA had no
      substantial influence on the Ca2+ current (decreased by 7 +/- 4%, n = 5) or the
      inward-rectifier K+ current (decreased by 5 +/- 5% in outward component, and 3 +/
      8% in inward component, n = 6). Therefore, the action of PKC was to specifically
      increase IK without affecting the other two currents.

PMID- 2231741
TI  - Israeli Group for Heart Research (IGHR). Abstracts presented at the VIth annual
      meeting. April 26, 1990, Tel Aviv, Israel.

PMID- 2231742
TI  - Angiotensin II: hemodynamic regulator or growth factor?
AB  - The evolution of our understanding of the actions of ANG II can be described in
      terms of 3 paradigms that also characterize the development of our knowledge of
      cardiovascular regulation. The first paradigm, organ physiology, described the
      variable performance of the heart in terms of length-dependent changes in
      myocardial contractile function (Starling's Law), and Ang II as a pressor factor
      that elevated blood pressure. With the shift to the second paradigm, cell
      biochemistry and biophysics, regulation of cardiac performance came to be
      explained by altered calcium fluxes and changing myocardial contractility, while
      the clinical effects of Ang II were understood in terms of changes in the calcium
      fluxes that control smooth muscle contraction. The third paradigm, gene
      expression (molecular biology), probably describes the most primitive--and
      complex--of these regulatory mechanisms. Altered gene expression in response to a
      variety of chemical and physical forces can explain several aspects of the long
      term regulation of cardiac performance in terms of adaptative changes in the
      architecture and composition of a heterogeneous population of myocardial cells.
      This third paradigm also describes important effects of Ang II to increase
      protein synthesis and promote cell growth that appear able both to ameliorate and
      exacerbate human disease. It is, therefore, probably inappropriate to view Ang II
      mainly as a vasoconstrictor with secondary effects to induce cell hypertrophy.
      Instead, Ang II may have been derived from a primitive growth factor that,
      because it utilized Ca2+ to mediate its effects on gene expression, later in
      evolution acquired the ability to increase smooth muscle tone and myocardial
      contractility.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231743
TI  - Spatial arrangements of microfibrils in myocardial scars: application of antibody
      to fibrillin.
AB  - Acute myocardial infarction kills myocytes; viable and necrotic myocytes
      disconnect and the ends of the viable cells become anchored to collagen fibers
      during reparative scar tissue formation. These anchorages have not been examined
      in detail, although previous studies have shown that microfibrils (MFs)
      concentrate at the edges of scars and at the tips of normal papillary muscles. We
      examined the spatial arrangements of MFs at these two sites in human hearts.
      Light and electron microscopic observations were made on tissue samples oriented
      in the long axis of myocytes and stained with monoclonal antibodies to fibrillin,
      a glycoprotein component of human microfibrils. MFs had identical arrangements at
      both sites, where they formed fibrous connections between myofibers and collagen
      fibers. These connections were oriented in the long axis of the muscle cells. At
      the myocyte ends, MFs appeared to intertwine with MFs in the normal endomysium;
      in the main body of the connections, MFs formed compact, 200 to 500 nm thick,
      fibrillin-positive fibers; and at the collagen ends, MFs splayed out among
      collagen fibrils. These observations indicate that MFs form myofiber-collagen
      fiber linkages at sites where the power of myocardial contraction is being
      transmitted to the extracellular connective tissue framework. Formation of such
      linkages seems to be an important step in the successful repair of necrotic
      myocardial lesions.

PMID- 2231744
TI  - Protective effect of verapamil in ischemic porcine hearts: analysis of
      ultrastructural and metabolic changes using in vivo 31P-NMR spectroscopy.
AB  - To assess the protective effect of verapamil on ischemic myocardium, the changes
      in high energy phosphates, inorganic phosphate, and intracellular pH were
      serially and quantitatively measured in ischemic porcine hearts without
      collateral circulation using 31P-NMR spectroscopy, together with ultrastructural
      examination. Twenty-six farm pigs weighing 11 to 14 kg were anesthetized with
      fluothane and were divided into control (C) group and verapamil pretreatment (V)
      group. In V group 0.2 mg/kg of verapamil was administered for 20 mins before
      occlusion of the anterior descending coronary artery. 31P-NMR spectra were
      serially obtained throughout the experiment, and ultrastructural examination was
      done at 20-min occlusion and at 120-minute occlusion in each group. At 10-min
      ischemia, creatine phosphate was significantly preserved in V group (C/V = 11 +/-
      4%/16 +/- 5% P less than 0.05). At 20 min ischemia, ATP was significantly
      preserved (C/V = 60 +/- 9%/73 +/- 8% P less than 0.05), and intracellular pH was
      significantly higher in V group (C/V = 6.4 +/- 0.2/6.6 +/- 0.1 P less than 0.05).
      Morphologically, clumping of the nuclear chromatin, mitochondrial swelling and
      decrease in glycogen were milder in V group at 20 min ischemia. However, these
      beneficial effects disappeared at 120 min ischemia. Thus pretreatment with
      verapamil attenuated depletion of high energy phosphates, progression of
      acidosis, and ultrastructural changes. There was no significant difference of
      rate pressure product and regional blood flow between hearts with and without
      pretreatment of verapamil. Therefore, this protective effect may be due to the
      energy sparing effect or other direct subcellular effect of verapamil on ischemic
      myocyte.

PMID- 2231745
TI  - The cell surface of isolated cardiac myocytes--a light microscope study with use
      of fluorochrome-coupled lectins.
AB  - In cells isolated from guinea-pig or rat ventricular muscle occurrence and
      distribution of carbohydrate components of the surface coat were monitored using
      fluorochrome-coupled lectins. Fluorescence of membrane-bound lectins was assayed
      by an image analysis system. The lectins ConA, WGA, sWGA, LFA and RCA-I showed
      specific binding to the whole myocyte surface, indicating a homogeneous
      distribution of alpha-mannosyl, alpha-glycosyl, N-acetylglucosaminyl, N
      acetylneuraminate and beta-galactosyl residues. Binding of DBA and SBA, with
      specific affinity for N-acetylgalactosaminyl residues, to guinea-pig cardiac
      myocytes was mainly at the cell poles corresponding to intercalated discs in
      intact tissue. Both lectins failed to interact with rat myocytes. UEA-I, specific
      for alpha-L-fucose, bound slightly to rat and not to guinea-pig myocytes. Binding
      of PNA to guinea-pig myocytes was observed only after cleaving off sialic acids
      from cell surface, suggesting that sialic acids mask galactosyl-beta(1,3)-N
      acetylgalactosamine residues. Specificity of lectin-cell interaction was tested
      by an inhibition assay where free sugars were tested for their capacity to
      inhibit lectin binding to the myocytes. When comparing different isolation
      procedures based on different proteolytic enzymes, the myocytes' affinity to any
      lectin was found to be qualitatively unchanged. Investigation of lectin-decorated
      myocytes by means of confocal laser scan microscopy showed that lectin binding
      sites are not confined to the cell surface but are also present in sarcolemmal
      invaginations, i.e. transverse tubules. This suggests that the tubular system is
      lined with a carbohydrate layer similar to, and continuous with, that of the
      peripheral cell surface.

PMID- 2231746
TI  - Purine release from isolated rat heart: a new approach to the study of energy
      metabolism.
AB  - The rate of release of purines (adenosine, inosine, hypoxanthine, xanthine and
      uric acid) from isolated working rat hearts was measured and compared to tissue
      concentrations of high energy phosphate compounds. Hearts were subjected to
      different workloads, and perfusions were performed: with normal oxygen supply
      (group 1); with the addition of insulin to the standard perfusion buffer, which
      contained glucose as energy source (group 2); in hypoxic conditions (group 3). In
      each group purine release increased (P less than 0.01) at higher workload and was
      closely related to indices of mechanical performance such as cardiac output or
      minute work (r = 0.902 and 0.858 in group 1, r = 0.902 and 0.851 in group 2, r =
      0.851 and 0.881 in group 3, P less than 0.001 in each case). Work had no effect
      on adenine nucleotides but produced a significant (P less than 0.01) reduction in
      phosphocreatine/creatine ratio. The comparison of different groups showed that at
      any level of heart performance purine release was higher (P less than 0.001) in
      group 3 vs. group 1, and lower (P less than 0.001) in group 2 vs. group 1. High
      energy phosphates were reduced in group 3 vs. group 1 but were unchanged in group
      2 vs. group 1. We conclude that in the isolated heart purine release is directly
      related to the rate of energy consumption, and inversely related to the rate of
      energy production. Purine release provides a sensitive method to evaluate
      myocardial energy metabolism, which is more sensitive than measurement of high
      energy phosphates.

PMID- 2231747
TI  - Subcellular distribution of myocardial 5'-nucleotidase.
AB  - The controversial subject of the subcellular location of myocardial adenosine
      production was studied employing density gradient fractionation of heart muscle
      combined with a novel method for analyzing distribution profiles based on
      multiple regression (correlation) analysis. Bungarotoxin binding, N-acetyl-beta-D
      glucosaminidase, cytochrome c oxidase, NADPH-dependent cytochrome c reductase and
      lactate dehydrogenase were used as markers for the plasma membrane, lysosomes,
      mitochondria, sarcoplasmic reticulum and cytosol, respectively. The normalized
      distribution frequencies (fraction of total) of 5'-nucleotidase in mitochondria,
      lysosomes, plasma membranes, sarcoplasmic reticulum and cytosol in the 50 x g
      supernatant of total homogenate of heart muscle were found to be 0, 0.25, 0.44,
      0.08 and 0.23, respectively. To increase the resolution power of this approach
      with respect to mitochondria, a crude mitochondrial fraction was also studied, in
      which the normalized distribution of 5'-nucleotidase in the homogenate was 0,
      0.16 and 0.84 in mitochondria, plasma membranes and lysosomes, respectively. This
      mainly lysosomal 5'-nucleotidase activity was 61% inhibited by the alpha,beta
      methylene analog of ADP, indicating that although the latter has been considered
      specific to the plasma membrane enzyme, it also inhibits the lysosomal enzyme.
      The intercellular distribution of 5'-nucleotidase was not studied, but the lack
      of this enzyme in the mitochondria indicate that the adenosine production
      observed during mitochondrial AMP production, e.g. during acetate oxidation in
      intact heart muscle, must involve AMP transport out from the mitochondria.

PMID- 2231748
TI  - Are reperfusion-induced arrhythmias caused by disinhibition of an arrhythmogenic
      component of ischemia?
AB  - Isolated rat hearts were used to examine whether reperfusion-induced arrhythmias
      may be caused by washout of substances accumulating during ischemia. This was
      achieved by subjecting hearts to 10 min of regional ischemia and rendering them
      transiently inexcitable during the first 1.5 min of reperfusion. Transient
      inexcitability was induced by switching to cold solution (4 degrees C) shortly
      before reperfusion (-1.5 min). In controls (no hypothermia), the incidences of
      ventricular tachycardia (VT) and ventricular fibrillation (VF) were 83% and 92%,
      respectively, during the first 1.5 min of reperfusion. Transient hypothermia
      caused inexcitability and asystole, impaired recovery of coronary flow and
      abolished VT and VF (all P less than 0.05). On subsequent rewarming to 37 degrees
      C, coronary flow and sinus rate recovered in all hearts. However, VT and VF
      occurred in only 58% and 25%, respectively (P less than 0.05). These values were
      similar to those of new episodes of VT and VF occurring in controls during the
      equivalent period. Therefore arrhythmias had been abolished during transient
      hypothermia, not merely delayed. The relative contributions of transient
      impairment of recovery of coronary flow and transient asystole to the
      antiarrhythmic effects were examined in a further 10 groups of hearts (n =
      12/group) in which reperfusion conditions were transiently manipulated. We
      utilized combinations of hypothermia, ventricular pacing, acetylcholine (ACh) 55
      microM (to cause asystole and impairment of recovery of coronary flow), and right
      atrial excision and left atrial pacing (to permit bradycardia to be transiently
      induced during reperfusion by temporarily switching off the pacemaker). The
      results indicated that transient hypothermia was antiarrhythmic as a result of a
      reduction of excitability, not because of bradycardia or impairment of recovery
      of flow. The data support the hypothesis that reperfusion unmasks (disinhibits)
      latent arrhythmogenic components of ischemia (particularly during the first 1.5
      min of reperfusion) and that, by inducing inexcitability, transient hypothermia
      allows these substances to be washed out without their arrhythmogenic effects
      being manifested. The identities of the arrhythmogenic and antiarrhythmic
      substances remain to be determined; we suggest that cyclic AMP and potassium,
      respectively, are likely candidates.

PMID- 2231749
TI  - Effect of 2,3-butanedione 2-monoxime on slow inward and transient outward
      currents in rat ventricular myocytes.
AB  - The effect of 2,3-butanedione 2-monoxime (BDM), a substance possessing
      phosphatase-like activity, was studied on action potentials of isolated rat heart
      and on the slow inward calcium current and outward current (including the 4
      aminopyridine (4-AP)-sensitive transient outward component), in rat ventricular
      myocytes. In contrast to what was observed by other authors in different species
      and cardiac tissues, BDM increased markedly the amplitude and duration of the rat
      ventricular action potential plateau. On the other hand, in the presence of 4-AP
      and ryanodine BDM shortened action potential duration. BDM decreased in a dose
      dependent manner the amplitude of both the slow inward calcium current and the
      transient outward current, accelerated their inactivation and shifted their
      steady-state inactivation-voltage relationships towards negative potentials. BDM
      also depressed other components of outward current. It is suggested that the
      lengthening effect of BDM on action potential duration results mainly from the
      simultaneous reduction of both the slow inward calcium current and the transient
      outward current, two antagonistic currents with unequal influences on action
      potential plateau development. The similarity of effect of BDM on these two
      currents also suggests that ionic channels generating them might require similar
      phosphorylation for their functioning.

PMID- 2231751
TI  - Scientists closer to using alpha-particle-emitting isotopes as cancer treatment.

PMID- 2231750
TI  - Implications of potential positive correlation between autologous tumor-cell
      killing activity and prognosis in lung cancer.

PMID- 2231752
TI  - OTA report disputes success of unconventional cancer therapies.

PMID- 2231753
TI  - NCI awards Jackson Lab $9.5 million to rebuild.

PMID- 2231754
TI  - Bone marrow transplant pioneer wins Nobel.

PMID- 2231755
TI  - Race, nutritional status, and survival from breast cancer.
AB  - The effects of nutritional status on differences in the survival of black and
      white women with breast cancer were studied in a cohort of 1,960 Georgia women
      diagnosed during 1975-1979. After data were adjusted for stage of disease,
      socioeconomic status, and other prognostic factors, poorer survival rates were
      shown in black women. Within each stage classification, lower levels of serum
      albumin and hemoglobin and higher relative body weight were more common among
      blacks and were independently associated with poorer survival. Among women with
      stage 3 disease, adjustment for these variables substantially reduced the excess
      mortality rate among blacks, suggesting that racial differences in survival may
      be partly explained by differences in nutritional status or extent of disease
      within stage.

PMID- 2231756
TI  - Effect of tamoxifen on serum insulinlike growth factor I levels in stage I breast
      cancer patients.
AB  - Insulinlike growth factor I (IGF-I) has been shown to be a potent mitogen for
      breast cancer cells in vitro, and IGF-I receptors have been demonstrated on human
      primary breast neoplasms. In a randomized, placebo-controlled study, we document
      that administration of the antiestrogen tamoxifen to patients with breast cancer
      was associated with a statistically significant (P = .002) reduction in the serum
      level of IGF-I. The mean IGF-I level was 1.4 U/mL in the placebo-treated group
      and 0.9 U/mL in the tamoxifen-treated group. Because serum IGF-I level is growth
      hormone (GH) dependent and because data suggest that the pubertal surge in GH and
      IGF-I levels is sex steroid dependent, we speculate that the mechanism underlying
      our observation may involve blockade by tamoxifen of estrogen action in the
      hypothalamic-pituitary axis. We conclude that tamoxifen treatment reduces IGF-I
      levels and that this reduction may contribute to the therapeutic effect of the
      drug.

PMID- 2231757
TI  - Prediction of postoperative clinical course by autologous tumor-killing activity
      in lung cancer patients.
AB  - Fifty patients with primary localized lung cancer were tested at the time of
      surgery for the ability of their lymphocytes to kill autologous, freshly isolated
      tumor cells, and the assay was evaluated for prognostic significance. Peripheral
      blood lymphocytes of 27 patients (54%) demonstrated significant autologous tumor
      killing activity in 6-hour 51Cr-release assays. Twenty-three of the 27 patients
      with autologous tumor-killing activity remained tumor free and survived more than
      5 years after curative surgery, while all 23 who were negative for autologous
      tumor-killing activity relapsed by 18 months after surgery and died within 42
      months after surgery. The differences in survival curves for the two groups were
      highly significant (P less than .00003). Autologous tumor-killing activity was
      not correlated with natural killer (NK) cell activity against K562 human myeloid
      leukemia cells or proliferation of lymphocytes stimulated with autologous,
      freshly isolated tumor cells in mixed culture. There were no differences in total
      survival between patients with positive results and those with negative results
      in tests of NK cell activity and autologous mixed lymphocyte-tumor culture
      reaction. These results indicate that autologous tumor-killing activity is a
      meaningful prognostic indicator and provide evidence for immunological control of
      tumor growth and metastasis. According to our preliminary data, it is unlikely
      that lung cancer patients who remain tumor free after 60 months of follow-up will
      develop recurrence or die from the disease. We are conducting a study to
      determine whether induction of autologous tumor-killing activity before surgery,
      by treatment with biological response modifiers,can improve the clinical outcome
      in patients who do not naturally have this potential.

PMID- 2231758
TI  - Reduction of the membrane fluidity of human breast cancer cells by tamoxifen and
      17 beta-estradiol.
AB  - The intracellular steady-state levels of methotrexate were previously shown to be
      reduced in estrogen receptor (ER)-negative human breast cancer MDA-MB-436 cells
      and ER-positive human breast cancer MCF7 cells following treatment with
      pharmacologically relevant concentrations of 17 beta-estradiol (E2). We now
      report that both E2 and tamoxifen (TMX) significantly decreased the fluidity of
      MCF7 and MDA-MB-436 cellular membranes. With E2 or TMX at concentrations greater
      than 1 microM, perturbations in membrane fluidity were accompanied by apparently
      non-ER-mediated cytotoxicity. Alterations in membrane structure may have
      contributed to the cytotoxicity of high-dose endocrine therapy and to the ability
      of E2 to inhibit methotrexate transport and cytotoxicity in some human breast
      cancer cells.

PMID- 2231759
TI  - Antitumor activity of liposome-encapsulated doxorubicin in advanced breast
      cancer: phase II study.
AB  - Previous studies in animals have demonstrated liposome-encapsulated doxorubicin
      (LED) has substantially less cardiac toxicity than free doxorubicin but retains
      antitumor activity. In a phase I clinical study of LED, the maximum tolerated
      dose was 90 mg/m2 and dose-limiting toxicity was considered to have been reached
      when granulocytopenia was produced. We used LED to treat 20 patients with
      advanced, measurable breast cancer. LED was given at doses of 60-75 mg/m2 every 3
      weeks as an intravenous infusion. Regression of disease was objectively measured
      in nine patients; in five of these patients, complete regression of the index
      lesion occurred. The mean duration of the responses was 7 months. Hematologic
      toxicity consisted of grade 1-2 leukopenia in some patients. Gastrointestinal
      toxicity and mucositis were generally mild and tolerable. Alopecia occurred in
      all patients and usually was complete. Twelve patients received cumulative doses
      of LED of greater than 400 mg/m2 and were evaluated with radionuclide
      ventriculograms. In eight patients, the cumulative dose was greater than 500
      mg/m2, and five had endomyocardial biopsies. Four of these biopsy results were
      Billingham grade 0, while one (cumulative LED dose, 750 mg/m2) showed grade 1
      changes with mild myofibrillar loss and dilatation of the sarcoplasmic reticulum
      involving less than 5% of cardiac myocytes. Two patients had decreases in left
      ventricular ejection fraction. One of these patients had received a total dose of
      LED of 630 mg/m2 and had a decline of 13% in left ventricular ejection fraction,
      but had no clinical evidence of congestive heart failure and had a Billingham
      grade 0 endomyocardial biopsy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231760
TI  - Oral zidovudine, continuous-infusion fluorouracil, and oral leucovorin calcium: a
      phase I study.
AB  - A phase I clinical, pharmacologic, and biochemical evaluation of escalating oral
      zidovudine (AZT) given over 2 days with a fixed dose of continuous-infusion
      fluorouracil (800 mg/m2 per day X 3 days) and oral leucovorin calcium was
      performed. Eighteen patients were treated with doses of AZT ranging from 1.0 to
      9.0 g/m2 per day. Nausea and vomiting were dose limiting, with a maximally
      tolerated dose of 7.5 g/m2 per day. Rash and mucositis occurred but were not dose
      limiting. A dose-related increase in peak plasma levels of AZT was observed, and
      the alpha half-life of AZT in plasma (75 min) was unaffected by these high doses.
      At doses above 4.0 g/m2 per day, trough levels significantly increased, perhaps
      reflecting prolonged absorption from the gut. No responses were observed;
      however, a significant increase in DNA single-strand breaks was observed in
      peripheral blood cells after a threshold dose of 4.0 g/m2 per day, confirming a
      biological effect of AZT in this regimen. Further trials with an intravenous
      formulation capable of maintaining plasma levels and circumventing dose-limiting
      toxicity are warranted.

PMID- 2231761
TI  - Language preference as an indicator of mammography use among Hispanic women.

PMID- 2231762
TI  - Indoor radon and lung cancer in China.

PMID- 2231763
TI  - Staurosporine: a prototype of a novel class of inhibitors of tumor cell invasion?

PMID- 2231764
TI  - Low-fat diet trial set to take off.

PMID- 2231765
TI  - Prevention trial with tamoxifen being considered.

PMID- 2231766
TI  - 1991 appropriations for cancer research approved by Senate.

PMID- 2231767
TI  - False screening claims undermine breast cancer detection efforts.

PMID- 2231768
TI  - Guidelines set for early release of clinical data.

PMID- 2231769
TI  - Validation of intermediate end points in cancer research.
AB  - Investigations using intermediate end points as cancer surrogates are quicker,
      smaller, and less expensive than studies that use malignancy as the end point. We
      present a strategy for determining whether a given biomarker is a valid
      intermediate end point between an exposure and incidence of cancer. Candidate
      intermediate end points may be selected from case series, ecologic studies, and
      animal experiments. Prospective cohort and sometimes case-control studies may be
      used to quantify the intermediate end point-cancer association. The most
      appropriate measure of this association is the attributable proportion. The
      intermediate end point is a valid cancer surrogate if the attributable proportion
      is close to 1.0, but not if it is close to 0. Usually, the attributable
      proportion is close to neither 1.0 nor 0; in this case, valid surrogacy requires
      that the intermediate end point mediate an established exposure-cancer relation.
      This would in turn imply that the exposure effect would vanish if adjusted for
      the intermediate end point. We discuss the relative advantages of intervention
      and observational studies for the validation of intermediate end points. This
      validation strategy also may be applied to intermediate end points for adverse
      reproductive outcomes and chronic diseases other than cancer.

PMID- 2231770
TI  - Inhibition of invasion of invasive human bladder carcinoma cells by protein
      kinase C inhibitor staurosporine.
AB  - To study the effect of the protein kinase C (PKC) inhibitor staurosporine on
      invasion, we selected the invasive human bladder carcinoma cell line EJ. Total
      PKC activity was more than twofold higher in the EJ cells than in RT4 cells
      (superficial human bladder carcinoma cells), which do not pass through an
      artificial basement membrane. There was more PKC activity in the cytosol than in
      the membrane of EJ cells. Staurosporine, at nontoxic concentrations, inhibited
      the invasion of EJ cells through an artificial basement membrane in a dose
      dependent manner. Staurosporine caused a dose-dependent inhibition of cell
      motility but did not inhibit cell attachment. Staurosporine represents a new
      agent for the inhibition of tumor cell invasion and may prove useful in studying
      the mechanisms responsible for this phenomenon.

PMID- 2231771
TI  - Feasibility of cellular microencapsulation technology for evaluation of anti
      human immunodeficiency virus drugs in vivo.
AB  - We investigated the feasibility of micro-encapsulation technology for the
      evaluation of anti-human immunodeficiency virus (HIV) drugs in vivo. The ability
      to place human cells in microcapsules with semipermeable membranes for
      implantation into test animals led to the development of this assay. The anti-HIV
      activity assay involves microencapsulating human T-lymphoblastoid cells sensitive
      to the cytopathic effects of HIV; the encapsulated cells are then implanted into
      athymic nude mice and recovered after drug treatment in vivo. A positive
      antiviral effect of the test substance is indicated by growth or survival of the
      virus-infected cells in the microcapsules. Several HIV-sensitive cell lines of T
      lymphocyte, monocyte, and nonlymphocyte origin were examined for growth in
      microcapsules in vitro and in vivo. Light and electron microscopic analysis of
      the capsules and the human cells contained therein revealed the invasion of mouse
      immune cells and other adverse effects that could not be overcome by any of
      numerous technical modifications attempted. We conclude that cellular
      microencapsulation technology is not feasible for in vivo drug-testing protocols
      because of immunogenic reactions.

PMID- 2231772
TI  - Nonrandom chromosomal abnormalities in primary uveal melanoma.
AB  - We report on 14 cases of clonal chromosomal anomalies in patients with primary
      uveal melanoma. An increased dosage of chromosome 8 or of parts of the long arm
      of chromosome 8 (8q) were detected in eight patients (57%). The smallest
      multiplied area of 8q appeared to be the region 8q2.1----qter. Monosomy of
      chromosome 3 was seen in six patients (43%), five of which were associated with
      anomalies of chromosome 8. Increased dosage of parts of chromosome 8q and loss of
      heterozygosity of chromosome 3, or the combination of both, seemed to be
      nonrandom for uveal melanoma and may distinguish it genetically from cutaneous
      malignant melanoma. Anomalies of chromosome 6, mostly resulting in additional
      material of 6p or a deletion of 6q, were found in six patients (43%). These
      anomalies, which seem to be common features of cutaneous malignant melanoma, were
      considered secondary rather than primary changes in uveal melanoma, since they
      were present only in subclones in most cases. Loss of the Y chromosome,
      restricted to tumor cells, was detected in four male patients, and loss of one X
      chromosome was detected in a female patient.

PMID- 2231773
TI  - Prospective study of the frequency and size distribution of polyps missed by
      colonoscopy.
AB  - An important determinant in interpreting the results of colorectal polyp
      chemoprevention trials is the rate of polyps missed during colonscopic
      examination. We prospectively examined 90 patients by tandem colonoscopy
      performed by two alternating examiners. In 69 (76.7%) patients, 221 neoplastic
      lesions were documented histologically. Of a total of 58 lesions detected in 31
      patients, no neoplastic lesion greater than or equal to 10 mm in size was missed;
      16% of diminutive (less than or equal to 5 mm) neoplastic polyps and 12.3% of
      medium-sized (6-9 mm) neoplastic polyps were missed by the first examiner. We
      conclude that an experienced colonoscopist will miss about 15% of colorectal
      neoplastic polyps less than 10 mm in size in the setting of adequate bowel
      preparation. Large (greater than or equal to 10 mm) polyps were rarely missed,
      however, with the "miss" rate in our study equal to 0, with a 95% confidence
      limit of 4.64%.

PMID- 2231774
TI  - Phase II investigation of pentostatin in multiple myeloma: a Southwest Oncology
      Group study.

PMID- 2231775
TI  - Potential misclassification in some studies claiming an association between
      chlorophenol exposure and various malignancies.

PMID- 2231776
TI  - Neurotoxicity and carcinogenicity of N-methylolacrylamide in F344 rats and B6C3F1
      mice.
AB  - Toxicology and carcinogenicity studies of N-methylolacrylamide were conducted by
      administering the chemical by gavage in water to both sexes of F344/N rats and
      B6C3F1 mice 5 times per week for 16 d, 13 wk, or 2 yr. In 16-d studies, rats
      receiving doses of 200 mg/kg or higher and mice receiving 400 mg/kg died. In 13
      wk studies, all rats given 100 mg/kg or higher doses died. Rats receiving 50
      mg/kg or higher doses developed hindlimb ataxia progressing to paralysis. In
      neurobehavioral assessments, decreased forelimb and hindlimb grip strength
      occurred in rats at doses as low as 12.5 mg/kg. Landing footspread was also
      increased in dosed rats compared to controls. Axon filament and myelin sheath
      degeneration in the spinal cord and/or peripheral nerves occurred in rats
      receiving doses of 25 mg/kg or higher. Necrosis in the granular cell layer of the
      cerebellum was seen in rats given 200 mg/kg. Mice receiving 200 mg/kg in 13-wk
      studies died. Decreased grip strength was noted in mice at doses as low as 25
      mg/kg, and rotarod performance was also affected by N-methylolacrylamide
      administration, but no neuropathology was seen microscopically. Testicular
      weights were decreased at doses as low as 12.5 mg/kg, and hepatocellular
      necrosis, thymic lymphocyte necrosis, and hemorrhage, necrosis, and
      mineralization of the zona reticularis of the adrenal gland were seen in mice
      that died (200 mg/kg). In 2-yr studies, survival and weight gains in male and
      female rats receiving doses of 6 or 12 mg/kg/d were minimally affected. No
      biologically important clinical signs or neoplastic or nonneoplastic lesions were
      attributed to N-methylolacrylamide administration to rats, suggesting that higher
      doses could have been tolerated. In mice, survival was not different between
      dosed and control groups (0, 25, or 50 mg/kg/d). Body weights were higher by as
      much as 25% in dosed compared to control groups. No compound-related clinical
      signs were observed, but increases in neoplasms of the harderian gland, liver,
      and lung were clearly related to chemical administration in both sexes of mice.
      Benign granulosa-cell neoplasms of the ovary were also increased in dosed female
      mice.

PMID- 2231777
TI  - Metabolism of 1-nitropyrene by human, rat, and mouse intestinal flora:
      mutagenicity of isolated metabolites by direct analysis of HPLC fractions with a
      microsuspension reverse mutation assay.
AB  - The metabolism of [14C]-1-nitropyrene by human, rat and mouse intestinal
      microflora and a bioassay-directed chemical analysis of the isolated metabolites
      by assaying HPLC fractions with a microsuspension reverse mutation assay were
      examined. [14C]-1-Nitropyrene was metabolized by human, rat, and mouse intestinal
      microflora to 1-aminopyrene, N-acetyl-1-aminopyrene, N-formyl-1-aminopyrene, and
      two unknown metabolites identified as A and B. The predominant metabolite
      produced by human, rat, or mouse intestinal microflora following a 12-h
      incubation with [14C]-1-nitropyrene was 1-aminopyrene, which accounted for 93,
      79, and 88% of the total 14C, respectively. Only minor amounts of N-formyl-1
      aminopyrene (1.4, 1.2, and 1.0%), N-acetyl-1-aminopyrene (4.4, 3.0, and 3.4%),
      unknown A (1.0, 1.2, and 1.0%), and unknown B (3.3, 5.0, and 1.2%) were detected.
      These data suggest that a similar mechanism exists in the biotransformation of 1
      nitropyrene by intestinal microflora from all three sources. Direct mutagenicity
      analysis of the HPLC fractions produced by intestinal microflora with the
      microsuspension reverse mutation assay indicated that mutagenic fractions can be
      resolved using this methodology.

PMID- 2231778
TI  - Morphometric analysis of osteosclerotic bone resulting from hexachlorobenzene
      exposure.
AB  - Hexachlorobenzene (HCB) exposure has been shown to induce hyperparathyroidism and
      osteosclerosis in rats. Experiments were undertaken to investigate the effects of
      HCB-induced hyperparathyroidism and osteosclerosis on femur morphometry as well
      as femur breaking strength. Fischer 344 rats were dosed 5 d/wk for 15 wk with 0,
      0.1, 1, 10, or 25 mg HCB/kg body weight. Hyperparathyroidism was produced in the
      two higher dose groups as reported previously (Andrews et al., 1989). Femur
      weight was significantly increased in the rats receiving 0.1, 1, and 25 mg HCB/kg
      body weight, whereas density was increased significantly at 1, 10, and 25 mg
      HCB/kg dose levels. Bone strength was also significantly increased at the three
      higher dose levels. Cross-sectional area of the midpoint of the femur was
      significantly increased at the 1 mg/kg HCB dose level. Cortical area and the
      proportion of the total area of the bone that the cortex occupied were
      significantly increased at the three higher dose levels. Medullary cavity area
      was significantly increased at the 0.1 mg/kg dose level but significantly
      decreased at the 2 higher dose levels of HCB. The right femur was significantly
      predominant to the left femur in weight, volume, and density through all dosing
      regimens. HCB exposure significantly altered bone morphometry and strength
      characteristics in the Fischer 344 rat.

PMID- 2231779
TI  - Chlorinated aliphatic hydrocarbons promote lipid peroxidation in vascular cells.
AB  - Chlorinated aliphatic hydrocarbons such as trichloroethylene and trichloroethane
      cause acute and chronic cardiotoxicities via mechanisms that are still obscure.
      Some of these toxic effects may result from free-radical-induced membrane damage
      to the vascular tissues. The pro-oxidant effects of carbon tetrachloride,
      trichloroethylene, 1,1,1-trichloroethane, 1,2-dichloroethane, and trans-1,2
      dichloroethylene were assessed in cultured arterial endothelial and aortic smooth
      muscle cells. Exposure of the cells to the above chemicals alone did not increase
      the formation of thiobarbiturate reactive products above background levels.
      However, in the presence of low levels of iron (3.1-25 microM Fe3+ chelated by
      ADP), all five agents promoted lipid peroxidation up to 200% of control. The rank
      order of potency is carbon tetrachloride greater than or equal to
      trichloroethylene greater than 1,1,1-trichloroethane greater than trans-1,2
      dichloroethylene greater than 1,2-dichloroethane. The synergistic interaction
      between iron and chlorinated hydrocarbons in promoting lipid peroxidation may
      contribute to the cardiotoxicities of these agents.

PMID- 2231780
TI  - Failure of benzene and phenol to serve as substrates for the peroxidatic action
      of catalase.
AB  - Evidence from several reports in the literature indicates a possible role for
      catalase in the metabolism of benzene. To investigate possible peroxidatic
      activity of catalase on benzene or its major metabolite, phenol, we employed an
      in vitro assay system that had been used previously to study the peroxidation of
      ethanol by catalase. Under conditions identical to those used to demonstrate
      catalase-mediated ethanol peroxidation we observed no peroxidase activity of
      catalase toward either benzene or phenol. We conclude that catalase is not
      involved in benzene metabolism and make the observation that, to date, no
      aromatic compounds have been demonstrated to be substrates for the peroxidatic
      mode of action of catalase.

PMID- 2231781
TI  - Subtractive cDNA cloning of RC3, a rodent cortex-enriched mRNA encoding a novel
      78 residue protein.
AB  - A rodent cortex-enriched mRNA, RC3, was identified by screening a rat brain cDNA
      library with a cortex-minus-cerebellum subtracted cDNA probe. Conceptual
      translation of RC3 cDNA sequences indicates that the rat and mouse mRNAs encode
      identical, novel 78 amino acid proteins. The RC3 protein amino terminus contains
      a cysteine-rich domain similar to those found in snake venom neurotoxins; the
      carboxyl terminus contains a collagen-like motif that may function in the
      assembly of RC3 subunits into a multimeric protein. Western blot experiments with
      an antiserum to a synthetic peptide corresponding to 27 residues of the 78
      residue sequence identify an immunoreactive polypeptide with 18 kDa gel mobility
      that is likely to correspond to the RC3 protein. Northern blot analysis and in
      situ hybridization experiments show that RC3 mRNA is highly enriched in rat
      brain, with restricted expression in neuronal subsets primarily in the cortex,
      striatum, and hippocampus as well as certain nuclei within the thalamus,
      hypothalamus, the olfactory bulb.

PMID- 2231782
TI  - GD3 ganglioside is prevalent in fully differentiated neurons from rat retina.
AB  - Adult mammalian retinas contain unusually high amounts of GD3, a ganglioside of
      the lactosylceramide series. In this respect, they differ from adult avian retina
      and other regions of the adult avian and mammalian brain, where GD3 is a minor
      ganglioside and gangliosides of the gangliotetraosylceramide series (GM1, GD1a,
      GD1b, GT1b) are the predominant ones. We compare here the ganglioside patterns of
      rat, human, horse, and guinea pig retinas, which are known to differ in the
      degree of vascularization and astrocytic cell content. All these retinas showed a
      prevalence of pathway "b" gangliosides over pathway "a" gangliosides but showed
      no correlation between GD3 content and the degree of vascularization and
      astrocytic cell content. Immunostaining of rat retina sections showed the
      presence of GD3 in the inner and outer plexiform layers and also in the ganglion
      cell and inner nuclear layers. About 60% of the cells dissociated from rat retina
      showed immuno-colocalization of GD3 and the neuronal marker class III beta
      tubulin isotype or cholera toxin binding. All morphologically identifiable glial
      Muller cells coexpress GD3 and gangliotetraosylgangliosides. GD3 was a minor
      ganglioside among these axonally transported by ganglion cells in rats and guinea
      pigs, suggesting that it is either not synthesized by ganglion cells or, if so,
      it is restricted to the cell soma and/or dendritic tree. Our results demonstrate
      that, unlike neurons from avian retina and other regions of avian and mammalian
      brain, neurons from mammalian retina not only contain gangliosides of the
      gangliotetraosylceramide series but also keep a prevalence of gangliosides of the
      lactosylceramide series (GD3) when they are fully differentiated.

PMID- 2231784
TI  - Protein synthesis in the neuropil of the rat dentate gyrus during synapse
      development.
AB  - Previous studies have shown that there are dramatic accumulations of
      polyribosomes under developing synapses on dendrites of CNS neurons. The present
      study was designed to evaluate what types of proteins might be synthesized by the
      synapse-associated polyribosomes. Hippocampal slices from rat pups sacrificed at
      4, 7, 10, 12, 14, and 21 days after birth as well as slices from adult animals
      were incubated in a modified Eagle's medium containing 3H-leucine. After a 30 min
      exposure to radiolabeled amino acids, the slices were microdissected, separating
      the dendritic enriched molecular layer from the cell bodies of the dentate gyrus
      and the hippocampus proper. The level of protein synthetic activity was assessed
      by comparing the incorporation in cell body and dendritic laminae. Polypeptides
      present in each dissected zone were separated electrophoretically on 1D SDS
      polyacrylamide gels according to their molecular weight and the newly synthesized
      proteins were analyzed through gel fluorography. The overall level of 3H-amino
      acid incorporation into protein (measured as cpm/microgram protein) was higher
      than that of the adult at all postnatal ages. When the entire slice was analyzed,
      the maximum incorporation was at 12 days after birth. In the dissected subregions
      of the slice the peak protein synthetic activity in cell-body-enriched regions of
      dentate gyrus and hippocampus proper was at 4-7 days postnatal, declining between
      7 and 21 days to values comparable to the adult. By contrast, protein synthesis
      in the molecular layer of the dentate gyrus did not peak until 12 days after
      birth, decreasing toward adult rates after 14 days. The overall pattern of
      Coomassie stained polypeptides present in the dentate molecular layer was
      comparable at all ages examined. Moreover, one-dimensional gel analysis showed no
      qualitative differences in the proteins that were synthesized in the three
      dissected zones across ages.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231783
TI  - Intracellular Na+ activity in cultured mouse oligodendrocytes.
AB  - Na(+)-selective double-barrelled microelectrodes were used to measure the
      intracellular Na+ activity (aiNa) and membrane potential (Em) in oligodendrocytes
      from cultures of embryonic mouse spinal cord. In Na(+)-free solutions aiNa
      rapidly fell from its baseline of about 15 mM to values below 1 mM. Elevation of
      the K+ concentration in the bath ([K+]o) from 5.4 to 15 or 50 mM elicited an aiNa
      decrease of 4.7 or 9.0 mM, respectively. Ouabain blocked the aiNa decrease in
      response to 50 mM K+ by 37%. Bath application of 1 mM glutamate resulted in a
      membrane depolarization of 4.5 mV and a concomitant rise of aiNa by 8.6 mM. aiNa
      increased by approximately 11 mM after washout of a solution containing 20 mM
      NH4+. This aiNa increase was not blocked by amiloride, excluding a major
      contribution of a Na+/H+ antiporter. We conclude that, in cultured
      oligodendrocytes, transmembraneous Na+ movements are involved in pH regulation,
      glutamate causes an influx of Na+, and that the Na+/K+ pump and passive KCl
      uptake contribute to K+ accumulation.

PMID- 2231785
TI  - Acute toxicity tests of mofezolac (N-22) in mice and rats.
AB  - Mofezolac (N-22) is a newly developed analgesic and anti-inflammatory agent. The
      acute toxicities of N-22 were investigated in ICR mice and Wistar rats in oral
      (p.o.), intraperitoneal (i.p.) and subcutaneous (s.c.) routes. LD50 values of N
      22 in mice were 1528 mg/kg (p.o.), 275 mg/kg (i.p.) and 612 mg/kg (s.c.) for
      males, and 1740 mg/kg (p.o.), 321 mg/kg (i.p.) and 545 mg/kg (s.c.) for females.
      Those in rats were 920 mg/kg (p.o.), 378 mg/kg (i.p.) and 572 mg/kg (s.c.) for
      males, and 887 mg/kg (p.o.), 342 mg/kg (i.p.) and 510 mg/kg (s.c.) for females.
      The sex difference was not clearly observed in mice and rats, but the species
      difference was observed in p.o. routes. As an initial toxic sign, the
      hypoactivity was observed in mice and rats of all routes, subsequently, paleness
      of skin, anemic conjunctiva, emaciation, stupor and/or coma were observed in mice
      and rats of p.o. and i.p. routes. In rats of those routes, tonic and/or asphyxial
      convulsion and dyspnea were also observed. In pathological examination of mice
      and rats, gastrointestinal disorders were observed in p.o. and i.p. routes, and
      changes of subcutaneous tissue at the injection site were observed in s.c. route.

PMID- 2231786
TI  - [Three-month oral subacute toxicity study of mofezolac (N-22) in rats].
AB  - A three-month oral subacute toxicity study of mofezolac (N-22), a non-steroidal
      anti-inflammatory agent, was performed using dose levels of 6, 20, 60 and 200
      mg/kg in rats, and recovery was also assessed one month after withdrawal. 1.
      Toxic signs caused by N-22 administration, observed only in the 200 mg/kg group,
      were as follows: soiling around the mouth and/or nose, piloerection, anemia,
      diarrhea, emaciation and decreased spontaneous locomotor activity. Nine males and
      thirteen females in the 200 mg/kg group excreted bloody diarrhea and died of
      general exhaustion between weeks four and thirteen of study. 2. In the 200 mg/kg
      group, decrease in food consumption and suppression of body weight gain were
      noted in males from about week four and in females from about week six after
      initiation of administration, and increase in water consumption was noted in
      males from about week seven. 3. Urinary examination revealed a decline in urinary
      pH in males of the 20 mg/kg and above groups and elevation of urobilinogen levels
      in males of the 60 and 200 mg/kg groups. 4. Hematological examination showed
      decreases in erythrocyte count (RBC), hematocrit value (Ht) and hemoglobin
      concentration (Hb) and increase in reticulocyte rate in both sexes of the 200
      mg/kg group and an increase in neutrophil rate in males of the 200 mg/kg group.
      5. Biochemical examination demonstrated a decrease in chloride (Cl-) in males
      receiving the 20 mg/kg or above doses and a decrease in calcium (Ca++) in males
      of the 60 and 200 mg/kg groups. Moreover, there were decreases in cholinesterase
      (ChE) activity, total protein (TP) and albumin (Alb) values, as well as increases
      in blood urea nitrogen (BUN), uric acid (UA) and potassium (K+) in both sexes of
      the 200 mg/kg group, along with elevations in GOT and lactate dehydrogenase (LDH)
      activities in females of the 200 mg/kg group. 6. The absolute and/or relative
      organ weights for liver, kidneys, spleen and adrenals were increased in the 200
      mg/kg group. 7. On pathological examination, perforating ulceration in the
      jejunum and ileum, turbid ascites, adhesion and inflammatory changes in capsules
      of the abdominal organs, splenomegaly, mesenteric lymph node hyperplasia and
      inflammatory changes in the thoracic cavity were observed in dead animals of the
      200 mg/kg group. Similar pathological changes were observed in a few survival
      cases of the 200 mg/kg group. 8. After a one month recovery period, the above
      mentioned changes had mostly recovered, indicating that they were
      reversible.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231787
TI  - [Fifty two-week chronic oral toxicity study of mofezolac (N-22) in beagle dogs].
AB  - The chronic toxicity study of mofezolac (N-22), a new developed analgesic and
      anti-inflammatory agent, was carried out in beagle dogs by oral administration of
      the test compound at dose levels of 1, 3, 6 and 12 mg/kg once daily for 52 weeks.
      The recovery study was also carried out by withdrawal for 5 weeks. 1. No death
      occurred during the administration and recovery periods in all groups, there were
      no abnormal findings due to N-22 administration on behavior and appearance, body
      weight and food consumption. 2. There were no abnormal findings due to N-22
      administration on fecal test, urinalyses, hematological and biochemical
      examinations, hepatic and renal function tests, ophthalmological examination,
      electrocardiography, blood pressure and organ weight. 3. By histopathological
      examination, loss of villi in small intestine was found in one female of 6 mg/kg
      group, erosion in small intestine in one male of 12 mg/kg group, and shortening
      of villi and ulcer in small intestine in each one female of 12 mg/kg 4.
      Accordingly, the non-effective dose levels of N-22 were estimated to be 6 mg/kg
      for male and 3 mg/kg for female in this study.

PMID- 2231788
TI  - [Reproductive and developmental toxicity study of mofezolac (N-22) (1)--Study by
      oral administration of N-22 prior to and early stages of pregnancy in rats].
AB  - Mofezolac (N-22), a newly developed analgesic and anti-inflammatory agent, at
      dose levels of 0, 10, 30 and 90 mg/kg/day were administered orally to males from
      pre-mating to mating period and to females from pre-mating to early gestation
      period. Effects on reproductive performance of both sexes, especially
      reproductive capability, and development of offspring were examined. 1. In male
      parents, no changes in body weight and food consumption were found in all male
      groups, but the increase in gastric mucosal lesions such as ulcers were observed
      in 30 and 90 mg/kg/day groups. 2. In female parents, the decrease in body weight
      and food consumption of 90 mg/kg/day group during early gestation period were
      found, but at necropsy no changes were shown in all female groups. 3.
      Reproductive capability, mating and pregnancy performance were not affected. 4.
      No effects of N-22 on fetuses were observed. 5. The suggestions were as follows:
      No effect dose levels (NOELs) for male and female general-toxicologically were 10
      and 30 mg/kg/day, respectively. NOELs for reproductive capability and for fetal
      development were 90 mg/kg/day.

PMID- 2231789
TI  - [Reproductive and developmental toxicity study of mofezolac (N-22) (2)--Study by
      oral administration of N-22 during the period of fetal organogenesis in rats].
AB  - The teratogenicity of mofezolac (N-22), a new developed analgesic and anti
      inflammatory agent, was investigated in rats. N-22 was given orally to pregnant
      rats of the Jcl: Wistar strain (30 rats per group) at dose levels of 10, 50, 100
      and 150 mg/kg/day from days 7 to 17 of gestation. Caesarean sections were
      performed on 20 dams per group on day 20 of gestation and their fetuses were
      examined for external, visceral and skeletal abnormalities. The remaining 10 dams
      per group were allowed to deliver and their offspring were examined for growth
      and reproductive performance. Results were as follows. 1. Effects on F0
      generation At 150 mg/kg, eleven out of the 30 dams exhibited decreased motor
      activity, pale eyes, unkempt fur, urine-smeared lower abdomen, weakness and
      emaciation. At autopsy, twelve dams revealed gastrointestinal ulcers, peritonitic
      lesions, hypertrophy of the spleen, adrenal and mesenteric lymph node, atrophy of
      the submaxillary gland, thymus and liver and discoloration of the liver and
      kidney. Death, sacrificing in extremis, premature or delayed delivery and poor
      nursing occurred in one to two dams each. Food consumption was significantly
      decreased and body weight gain was significantly retarded in this dose level
      group. At 100 mg/kg, urine-smeared lower abdomen, hypertrophy of the spleen and
      poor nursing were observed in one dam each. 2. Effects on F1 generation At 150
      mg/kg, significantly decreased fetal weight, increased number of immature fetuses
      and significantly retarded ossification of the 5th and 6th sternebrae and
      coccygeal vertebrae as well as significantly depressed body weight gain of female
      offspring were observed. No abnormalities were observed in each treated group in
      terms of development, behavior, learning ability and reproductive performance of
      offspring. 3. Effects on F2 generation No abnormalities were observed in fetuses
      and newborn young in each treated group. Based on these results, the maximum non
      effective doses of N-22 in this study were considered to be 50 mg/kg/day for dams
      and offspring and 100 mg/kg/day for fetuses.

PMID- 2231790
TI  - [Reproductive and developmental toxicity study of mofezolac (N-22) (3)-
      Teratogenicity study in rabbits by oral administration].
AB  - Mofezolac (N-22) is a new developed analgesic and anti-inflammatory agent. A
      teratogenicity study of N-22 was carried out in New Zealand White rabbits to
      examine the effect on the dams and the teratogenic potentiality. N-22 was
      administered orally at the dose levels of 12.5, 50 and 200 mg/kg during the
      organogenesis from day 6 to day 18 of gestation. All pregnant females were
      sacrificed on day 28 of gestation and their fetuses were examined. There were no
      growth retardation and teratogenic effects on fetuses from the dams administered
      N-22, although the administration of 200 mg/kg produced a decrease in food
      consumption of the dams concomitant with the embryocidal effects as shown by an
      increase in the early resorption rate. Thus, non-toxic dose level of N-22 on the
      dams and fetuses was considered to be 50 mg/kg.

PMID- 2231791
TI  - [Reproductive and developmental toxicity study of mofezolac (N-22) (4)--Study by
      oral administration of N-22 during the perinatal and lactation periods in rats].
AB  - peri- and postnatal study of mofezolac (N-22), a new developed analgesic and anti
      inflammatory agent, was carried out with Wistar rats. N-22 at dose levels of 0,
      25, 50 and 100 mg/kg/day were administered orally to pregnant and subsequent
      delivered dams from day 17 of gestation through day 21 of lactation. Body weight
      gains of dams treated with 50 and 100 mg/kg/day were depressed during perinatal
      period. Prolongation of pregnancy period, low performance of pup care with
      decrease in body weights and food consumptions were observed in 100 mg/kg/day
      group. Decrease in number and birth index, increase in number of stillborns and
      tendency to decrease in viability index on day 4 were found in 100 mg/kg/day
      group. Other parameters of development, behavior or reproductive capability of F1
      animals showed no changes related to administration of N-22. It was suggested
      that no effect dose levels of N-22 were 25 mg/kg/day for dams viewpoint of
      general toxicity and that was 50 mg/kg/day for dams on reproductive performance
      and for offspring on development.

PMID- 2231792
TI  - Mutagenicity tests of mofezolac (N-22).
AB  - 1. The reverse mutation test was carried out on mofezolac (N-22) at dose range of
      50-5000 micrograms/plate using Salmonella typhimurium strains, TA100, TA98,
      TA1535 and TA1537, and Escherichia coli strain WP2uvrA. In all tester strains no
      significant increases were observed in the number of revertant colonies as
      compared with solvent control in the absence or presence of mammalian metabolic
      activation system. 2. The chromosomal aberration test on N-22 was carried out
      using cultured Chinese hamster lung cells (CHL). The cells were treated with N-22
      at the doses of 37.5, 75.0, 150 and 300 micrograms/ml without S9 Mix and at the
      doses of 150, 300, 450 and 600 micrograms/ml with S9 Mix. No significant
      differences were found in the incidence of structural-and numeral-aberrations of
      chromosomes as compared with the solvent control in the system without S9 Mix.
      However, in the system with S9 Mix, structural aberration (11.5%) and numeral
      aberration (14.2%) of chromosomes were observed in the groups of dosing 600
      micrograms/ml with dose dependency. 3. These results indicate that N-22 has
      clastogenic activity by the metabolic activation.

PMID- 2231793
TI  - Micronucleus test of mofezolac (N-22).
AB  - A micronucleus test using BDF1 male mice was conducted in order to evaluate the
      in vivo mutagenicity of mofezolac (N-22). N-22 was orally administered at doses
      of 75, 150, 300 and 600 mg/kg, with a sampling time of 24 hr. The frequency of
      polychromatic erythrocytes with micronuclei was 0.07-0.08% in the groups treated
      with N-22 and did not differ markedly from that of the vehicle control (0.13%).
      The present study indicates that N-22 has no in vivo mutagenic properties.

PMID- 2231794
TI  - [Antigenicity test of mofezolac (N-22)].
AB  - Antigenicity studies of mofezolac (N-22) were examined in mice and guinea pigs
      and the following results were obtained. The findings of active systemic
      anaphylaxis, passive hemagglutination test, 4 hour passive cutaneous anaphylaxis
      (4-hr PCA) and 8-day PCA in guinea pigs revealed that N-22 possessed neither
      immunogenic nor eliciting potentiality. However, N-22 was shown to be eliciting
      antigenicity in mice when given N-22-ovalbumin conjugate plus Freund's complete
      adjuvant (FCA) as immunogen.

PMID- 2231795
TI  - [Three-month subacute oral toxicity study of mofezolac (N-22) in dogs].
AB  - Mofezolac (N-22) is a new developed analgesic and anti-inflammatory agent. A
      subacute oral toxicity test of N-22 was carried out at dose-levels of 0, 2, 6 and
      20 mg/kg/day using male and female beagle dogs. Treatment for 3 months was
      followed by 1 month recovery period except in the case of both sexes receiving 20
      mg/kg/day. The results obtained from the present study were as follows. 1.
      Observation of general conditions revealed vomiting, sporadic bloody feces,
      anemia, recumbency and hyposthenia in both sexes receiving 20 mg/kg/day. Anemia
      or erosion of tongue was observed in each female receiving 6 mg/kg/day. 2.
      Respectively 3 dogs of both sexes receiving 20 mg/kg/day died during dosing
      period. In these animals, perforating ulcers were observed in the pars pylorica
      ventriculi or duodenum, and loss of blood, peritonitis and aggravation of general
      exhaustion were considered as causes of death. 3. Body weight tended to decrease
      in both sexes receiving 20 mg/kg/day, and food and water consumption levels
      decreased in males receiving 2 mg/kg/day or above and females receiving 2
      mg/kg/day. 4. Urinalysis demonstrated an increasing tendency for specific gravity
      of urine and a decreasing tendency for urine volume in males receiving 2
      mg/kg/day or above. 5. Hematological examination showed decreases in red blood
      cell count and Hb concentration in males receiving 2 mg/kg/day or above, and in
      Ht values in males receiving 6 mg/kg/day or above. 6. Serum biochemical
      examination revealed decreases in total protein and albumin in both sexes
      receiving 20 mg/kg/day. 7. There were no remarkable changes in hepatic and renal
      function, ophthalmological findings or electrocardiogram. 8. In the organ
      weights, significant decrease in thymus weights was observed in the dead animals
      receiving 20 mg/kg/day. 9. Pathologically, the dead animals receiving 20
      mg/kg/day were found to exhibit peritonitis with perforating ulcers in the pars
      pylorica ventriculi or duodenum. In the surviving animals of this group, scar
      ulcers in the pars pylorica ventriculi and small intestine were evident on
      necropsy, and histopathology revealed neutrophils infiltration and thrombosis in
      blood vessels in the thickened submucosal stomach tissues. Moreover, localized
      hepatocyte necrosis and intrasinusoidal cellular infiltration in liver, as well
      as interstitial cellular infiltration, degeneration and dilatation of the renal
      tubules in the kidney were observed. In females receiving 6 mg/kg/day, the
      changes in kidney were similar to those in surviving animals receiving 20
      mg/kg/day, and male of the group showed atrophy of thymus.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 2231796
TI  - [Fifty two-week chronic oral toxicity study of mofezolac (N-22) in rats].
AB  - Fifty two-week oral toxicity study of mofezolac (N-22), a new developed analgesic
      and anti-inflammatory agent, was carried out in Wistar rats with dose levels of
      5, 20, 60 and 120 mg/kg/day, and the 5-week withdrawal was followed for recovery
      study. Hematuria, blanching of the skin and suppression of body weight gain were
      observed in females given 120 mg/kg, and 9 of these prostrated and died from week
      20 to week 52, or were euthanized when moribund. These symptoms were not seen in
      males at any dose levels. In 120 mg/kg group, increased positive cases of fecal
      occult blood were observed during the administration period, and the pathological
      examination revealed gastrointestinal lesions such as erosion, ulcer, hemorrhage
      and mucosal regeneration in the small intestine. Renal disorder was also involved
      mainly in females given 120 mg/kg, as shown by increase in urine volume with
      declined osmotic pressure and specific gravity, serum urea nitrogen, creatinine,
      inorganic phosphorus, and other related parameters. In addition to enlargement,
      rough surface and scar formation, dilated tubular lumen and papillary ducts of
      the kidney were observed as a main lesion. Incidental findings with those
      disorders, observed mainly in females given 120 mg/kg, included increase in
      leucocytes with high neutrophils ratio, and enlargement of the spleen, adrenals
      and mesenteric lymph node. There were some of the similar gastrointestinal and
      renal changes mainly in females given 60 mg/kg. Anemic findings were noted in
      both sexes of 120 mg/kg and in females of 60 mg/kg group, and mainly females
      given 120 mg/kg showed increase in platelets, reticulocytes and fibrinogen,
      shortening of blood coagulation time, as well as extramedullary or accented
      hematopoiesis of the liver, spleen and bone marrow. Other serum biochemical
      changes observed mainly in females given 120 mg/kg were decrease or decreasing
      trend in total protein, A/G ratio, and transaminase activity. Fine structure of
      the liver from females given 20 mg/kg or more revealed cisternal dilatation of
      smooth-surfaced endoplasmic reticulum of hepatocytes, and the increased liver
      weight was observed in females given 120 mg/kg. Accordingly, non-effective dose
      level of N-22 in 52-week chronic toxicity study was estimated to be 20 mg/kg for
      males and 5 mg/kg for females.

PMID- 2231797
TI  - The way we were: 1989 Presidential address, American Association for the Surgery
      of Trauma.

PMID- 2231798
TI  - Auto-PEEP in the multisystem injured patient: an elusive complication.
AB  - Auto-PEEP (A-PEEP), unrecognized alveolar positive and expiratory pressure during
      mechanical ventilation, is an acknowledged hazard in patients with chronic
      obstructive lung disease. We evaluated 50 consecutive trauma patients for the
      presence of A-PEEP and its effect on hemodynamic stability. Injury Severity
      Scores (ISS) were 8 to 41 (21 +/- 1); Revised Trauma Scores (RTS) ranged from 2.0
      to 7.8 (6.2 +/- 0.2). Mode of ventilation was assist control, inspiratory flow
      rates were 40 to 120 L/M (78 +/- 2). A-PEEP, determined in the non-assisting
      patient by occluding the expiratory port at end exhalation, was present in 28
      patients (56%) and ranged from 1 to 12 cm H2O (5.3 +/- 0.4 cm H2O). Data
      segregated by A-PEEP versus no A-PEEP were as follows (Mean +/- SEM): [table: see
      text] *P less than 0.05, VE = minute ventilation, Paw = mean airway pressure.
      Upon reversal of A-PEEP in the eight patients with levels greater than 5 cm H2O,
      mean blood pressure rose from 90 +/- 17 to 102 +/- 22 mm Hg and central venous
      pressure fell from 13 +/- 5 to 7 +/- 5 mm Hg. A-PEEP was successfully treated in
      these eight patients by increasing peak flows, minimizing VE requirements and
      selective use of bronchodilators. In sum, the hypermetabolic ventilated trauma
      patient should be monitored routinely for this common phenomenon which may have
      profound cardiopulmonary effects in the setting of acute resuscitation.

PMID- 2231799
TI  - Gunshot injuries to the hip and abdomen: the association of joint and intra
      abdominal visceral injuries.
AB  - A retrospective review of all gunshot injuries to the hip at our medical center
      over a 24-year period was performed. Adequate information and radiographs were
      available for 49 patients. Of these, five patients (10.2%) had associated
      abdominal visceral injuries. These five patients were examined at an average of
      5.9 years after their injury, and compared by utilizing the Harris Hip Score
      rating. Radiographs were also obtained. Four of these five patients (80%) had
      initially developed infections in their hip joints, with all four having poor
      functional outcomes, with an average Harris Hip Score of 48.5 from their hip
      injury. Careful initial evaluation and aggressive surgical and antibiotic
      treatment are recommended to prevent these poor results.

PMID- 2231800
TI  - Effect of endotoxin and a burn injury on lung and liver lipid peroxidation and
      catalase activity.
AB  - Both endotoxin and a burn alone produce oxidant-induced tissue lipid
      peroxidation. The endotoxin response is due in large part to hydrogen peroxide.
      The combination of endotoxin after a burn results in an increased liver, but not
      lung, oxidant injury. Our purpose was to determine whether the burn oxidant
      injury inactivated endogenous liver tissue catalase, thereby amplifying a
      subsequent H2O2 insult. Twenty-six adult sheep were studied. Twelve sheep had a
      15% TBS burn. Tissue catalase activity, measured in lung and liver 3 days
      postburn, was significantly decreased from a control of 3.58 +/- 1.8 and 193 +/-
      63, respectively, to 1.72 +/- 0.63 and 148 +/- 33 k(sec-1)/0.5 gram tissue. The
      addition of endotoxin 3 days postburn resulted in an increase in liver
      malondialdehyde, MDA, a measure of lipid peroxidation, from a control of 110 +/-
      80 to 450 +/- 54 nmol/gram tissue. This value was significantly greater than the
      210 +/- 80 nmol/gram tissue seen after endotoxin alone. Lung tissue MDA with burn
      and endotoxin was 65 +/- 8 compared to 42 +/- 7 for control and 80 +/- 6
      nmol/gram for endotoxin alone. We conclude that a decrease in liver catalase
      activity occurs after a burn. The decrease corresponds to an accentuated oxidant
      induced lipid peroxidation after an added endotoxin insult where H2O2 is known to
      be an etiologic agent. The catalase activity also decreases in postburn lung, but
      accentuated lung damage was not seen, indicating a variable tissue response from
      the burn-induced decrease in antioxidant activity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2231801
TI  - Facial bone fracture associated with carotid-cavernous sinus fistula.
AB  - Out of 989 cases of facial bone fracture, ten patients had carotid-cavernous
      sinus fistulas (1.01%). Their ages ranged from 25 to 48 years. Seven were male
      and three female. Two of the ten patients had lower third, three patients had
      middle third, three patients had upper third, and two patients had combined
      middle and lower third facial bone fractures. The signs and symptoms of a fistula
      appeared from the first postinjury day up to 50 days after the injury (mean, 21
      days). Four patients had symptoms after operation for facial bone fracture. Most
      fistulae were identified by arteriography before treatment. Followup ranged from
      1 year, 8 months, to 5 years, 9 months (mean, 2 years, 9 months). One patient had
      a malocclusion. Nine patients had complete resolution of their bruits.
      Complications included unilateral complete visual loss (two), CSF rhinorrhea
      (two), and stroke in one of the two CSF rhinorrhea patients. One patient expired
      due to a severe head injury, and there was one death from an unrelated cause.

PMID- 2231802
TI  - The abdominal trauma index--a critical reassessment and validation.
AB  - The Abdominal Trauma Index (ATI) was devised to quantify the risk of
      complications following abdominal trauma. With scores greater than 25, the risk
      of postoperative complications became exponential. The purpose of the present
      study was to determine if: 1) the organ risk factors previously assigned were
      more statistically valid; and 2) the addition of physiologic variables would
      enhance the prediction of postinjury intra-abdominal sepsis. Fifteen abdominal
      organ systems and 17 physiologic variables in 300 consecutive patients were
      analyzed to determine ability to predict intraabdominal sepsis. There were no
      significant differences in predictive ability between the old and new organ risk
      factors. The addition of physiologic factors did not enhance the prediction of
      intra-abdominal sepsis. This clinical study demonstrates that: 1) the risk of
      intra-abdominal sepsis increases with increasing ATI score; 2) the previous (1979
      initial) organ risk grading concept is statistically valid; 3) six of the 15
      organ systems warrant a change in their relative rank order (1989-revision); 4)
      the addition of demographic, physiologic, and immunologic variables did not
      significantly improve the prediction of intra-abdominal sepsis.

PMID- 2231803
TI  - Diagnostic peritoneal lavage: accuracy in predicting necessary laparotomy
      following blunt and penetrating trauma.
AB  - The purpose of this study was to evaluate the ability of diagnostic peritoneal
      lavage (DPL) to predict intra-abdominal injuries that required surgical repair.
      To do this, we retrospectively reviewed 944 patients with blunt and penetrating
      abdominal trauma who underwent 975 DPLs. Initial DPL in 608 patients sustaining
      blunt trauma had a sensitivity of 87%, a specificity of 97%, an accuracy of 95%,
      a positive predictive value (PPV) of 85%, and a negative predictive value (NPV)
      of 97%. Initial DPL in 336 patients with penetrating trauma had a sensitivity of
      87%, a specificity of 89%, an accuracy of 89%, a PPV of 75%, and a NPV of 95%.
      When utilizing final lavage results on the 944 patients, DPL had a sensitivity of
      91%, a specificity of 94%, an accuracy of 93%, a PPV of 80%, and a NPV of 98% in
      predicting intra-abdominal injury requiring surgical repair.

PMID- 2231804
TI  - The Major Trauma Outcome Study: establishing national norms for trauma care.
AB  - The Major Trauma Outcome Study (MTOS) is a retrospective descriptive study of
      injury severity and outcome coordinated through the American College of Surgeons'
      Committee on Trauma. From 1982 through 1987, 139 North American hospitals
      submitted demographic, etiologic, injury severity, and outcome data for 80,544
      trauma patients. Motor vehicle related injuries were most frequent (34.7%).
      Twenty-one per cent of patients had penetrating injuries. The overall mortality
      rate was 9.0%. The mortality rate for direct admissions was strongly related to
      the presence of serious head injury, 5.0% and 40.0%, when head injuries were less
      than or equal to AIS (Abbreviated Injury Scale) 3 or greater than or equal to AIS
      4, respectively. Survival probability norms use the Revised Trauma Score, Injury
      Severity Score, patient age, and injury mechanism. Patients with unexpected
      outcomes were identified and statistical comparisons of actual and expected
      numbers of survivors made for each institution. Results provide a description of
      injury and outcome and support evaluation and quality assurance activities.

PMID- 2231805
TI  - Cadaveric organ donor availability: regional trauma center vs. community
      hospital.
AB  - Organ donor shortage is now the greatest limitation to the success of organ
      transplantation. To assess and compare the role of a regional trauma center in
      identifying and referring cadaveric organ donors to that of a community hospital,
      we retrospectively reviewed records of potential cadaveric organ donors during a
      comparable 5-year period in each. The trauma center (TC) contributed 44 donors,
      while the community hospital (CH) supplied seven. Five hundred sixty-five
      possible donors were not harvested at the TC, compared to 126 at the CH. While
      most "non-donors" from both institutions were not suitable candidates, 8% could
      have served as good organ donors. Inability to obtain consent was the major
      obstacle in obtaining good candidates (70% at CH, 83% at TC). Failure to
      recognize and refer possible donors occurred in 2% of the cases at CH, compared
      to 0.4% at the TC. We conclude that regional trauma centers can play an important
      role in alleviating organ donor shortage.

PMID- 2231806
TI  - Studies on B-lymphocyte dysfunctions in severely burned patients.
AB  - We studied in vitro functional parameters of peripheral blood B-lymphocytes from
      severely burned patients (n = 10; burn injuries ranging from 25 to 72% TBSA).
      While the number of B-cells remained unchanged, B-cell proliferation induced by
      Staphylococcus aureus strain Cowan I (SAC) was normal or even enhanced at early
      and late phases postburn, but showed a marked suppression during the second to
      fourth week. A similar pattern was observed for the pokeweed mitogen (PWM)- or
      SAC-stimulated synthesis of immunoglobulin M (IgM), whereas IgG production was
      decreased over the whole postburn period monitored. Cytokine (interleukin 4)
      induced B-cell activation as indicated by the expression of the CD23 surface
      antigen was impaired throughout the second to fifth week. In parallel, the
      release of the proteolytic cleavage product sCD23 which represents a B-cell
      growth and differentiation factor was reduced. Our data provide evidence that
      activation, proliferation, and differentiation processes of B-lymphocytes are
      impaired in severely burned patients, which may contribute to their enhanced
      susceptibility to infection and sepsis.

PMID- 2231807
TI  - Parotid gland and facial nerve trauma: a retrospective review.
AB  - Included in this study are all patients with trauma to the parotid region seen at
      our center from 1979 to 1989. There was a total of five patients with injury to
      the parotid area: two patients with isolated facial nerve injury; one with
      isolated parotid duct injury; two with combined duct and nerve injury. There were
      four males and one female, with a mean age of 34 years (range, 16 to 62 years).
      The three patients with parotid duct injury required other procedures for
      associated trauma. A total of eight nerve branches were severed in four patients.
      Seven of the eight nerve branches (82.5%) were primarily repaired, with excellent
      functional results. Two of the three ductal injuries were repaired primarily over
      a stent, and one was ligated. No complications resulted from either treatment.
      Based on our clinical experience and review of the literature, we suggest that
      the treatment of parotid region injuries should include: 1) a complete initial
      assessment; 2) primary repair of parotid duct transection within 24 hours when
      possible; 3) primary repair of all facial nerve injuries, although delayed nerve
      repair remains a viable alternative; and 4) nonsurgical treatment of sialoceles
      and fistulae.

PMID- 2231808
TI  - Subxiphoid pericardial windows--helpful in selected cases.
AB  - There is a small group of patients who sustain multiple penetrating injuries who
      present with haemodynamic changes, making it difficult to clinically exclude or
      prove the presence of penetrating cardiac injury. It is in this select group of
      patients that we found subxiphoid pericardial windows to be extremely useful to
      prove or disprove the existence of a cardiac injury and thereby prevent a delay
      in diagnosing these injuries.

PMID- 2231809
TI  - Bilateral sacroiliac joint fracture-dislocation: a case report.
AB  - Bilateral sacroiliac joint fracture-dislocation of the sacrum with displacement
      is a rare injury. We found only four such injuries previously reported in the
      literature. Nonoperative management in this case led to complete functional
      return and acceptable alignment.

PMID- 2231810
TI  - Use of recombinant human erythropoietin (r-HuEPO) in a Jehovah's Witness refusing
      transfusion of blood products: case report.
AB  - Recombinant human erythropoietin (r-HuEPO) administration to a Jehovah's witness
      refusing blood transfusions increased her nadir packed cell volume from 13% to
      37% and reticulocyte count from 2% to 17.7%. R-HuEPO may provide an alternative
      safe and effective therapy in life-threatening anemia when blood transfusions are
      unacceptable to the patient.

PMID- 2231811
TI  - Pediatric blunt liver injury and coagulopathy managed with packs and a silo: case
      report.
AB  - Packing the abdomen can be lifesaving when severe hepatic trauma is complicated
      by refractory hypothermia, coagulopathy, and continuing hemorrhage requiring
      large-volume transfusion. This report describes the successful use of abdominal
      packs and a modified silo in a child following blunt liver injury.

PMID- 2231812
TI  - Acute aortic valvular incompetence following blunt thoracic deceleration injury:
      case report.
AB  - Blunt trauma leading to aortic valvular incompetence is rarely encountered, with
      27 cases reported to date. All cusps and commissures are involved to a similar
      degree. Treatment includes either reattachment of cusps to the annulus (80%
      recurrence of incompetence) or valvular replacement (no recurrence). Valve
      replacement is the treatment of choice for these patients.

PMID- 2231813
TI  - Brachial plexus injury associated with chest restraint seatbelt: case report.
AB  - Rapid deceleration while wearing a lap-shoulder strap seatbelt may result in a
      traction injury to the brachial plexus on the side of the shoulder strap. Occult
      vascular injury should be considered in patients with this injury pattern. The
      deficit will recover after a neuropraxic type injury.

PMID- 2231814
TI  - Bilateral simultaneous fractures of the femoral neck: case report.
AB  - A case of bilateral fractures of the femoral neck resulting from high-voltage
      electric injury is reported. Surgeons caring for patients with electrical
      injuries must be aware of the possibility of this injury as well as other
      skeletal injuries which may result from muscle contraction or falls related to
      electric shock. Without vigilance for these injuries, diagnosis may be delayed.

PMID- 2231815
TI  - Hypogastric arterial embolization in pelvic fracture hemorrhage: case report.

PMID- 2231816
TI  - Impact of pre-trauma center care on length of stay and hospital charges.

PMID- 2231817
TI  - Morbidity and mortality following fractures of the femoral neck and trochanteric
      region: analysis of risk factors.

PMID- 2231818
TI  - Acute compartment syndrome of the thigh: case report.

PMID- 2231819
TI  - Endoscopic guided percutaneous tracheostomy: early results of a consecutive
      trial.

PMID- 2231820
TI  - The mortality of childhood falls.

PMID- 2231821
TI  - Response to inquiries regarding the exact formulary constituents of Betadine
      solution.

PMID- 2231822
TI  - Organ injury scaling, II: Pancreas, duodenum, small bowel, colon, and rectum.
AB  - The Organ Injury Scaling (O.I.S.) Committee of the American Association for the
      Surgery of Trauma (A.A.S.T.) has been charged to devise injury severity scores
      for individual organs to facilitate clinical research. Our first report (1)
      addressed O.I.S.'s for the Spleen, Liver, and Kidney; the following are proposed
      O.I.S.'s for Pancreas (Table I), Duodenum (Table II), Small Bowel (Table III),
      Colon (Table IV), and Rectum (Table V). The grading scheme is fundamentally an
      anatomic description, scaled from 1 to 5, representing the least to the most
      severe injury. We emphasize that these O.I.S.'s represent an initial
      classification system which must undergo continued refinement as clinical
      experience dictates.

PMID- 2231823
TI  - Eating disorders: a primer for the substance abuse specialist: 1. Clinical
      features.
AB  - The eating disorders of anorexia nervosa (AN) and bulimia nervosa (BN) are no
      longer rare or esoteric syndromes. Because they affect about 5% of young adult
      women in westernized societies, and because there is a greater than chance co
      morbidity with substance abuse disorders, it has become increasingly important
      for the substance abuse specialist to be knowledgeable about AN and BN. This
      paper will describe the epidemiologic, clinical, diagnostic, and prognostic
      features of the two eating disorders; a subsequent paper will examine theories of
      etiology and approaches to treatment, and discuss the special considerations that
      pertain when co-morbidity with substance abuse is indeed present.

PMID- 2231824
TI  - Alcoholic blackouts: legal implications.
AB  - Alcoholic blackouts are defined as the temporary, complete inability to form long
      term memory as the result of a high blood alcohol level. This means that a neuron
      to-neuron system has been blocked. Since that is the case, such central nervous
      dysfunction should have legal implications, both from the blackout itself and
      also from the fact that this degree of neural interference in one system is at
      least suggestive that other dysfunction may be present. The subject of blackouts
      is updated with recent developments in neuroscience. The legal significance of
      the blackout is examined in enough depth to allow for further discussion and
      exploration.

PMID- 2231826
TI  - The role of buspirone in the management of alcohol withdrawal: a preliminary
      investigation.
AB  - One hundred eighteen patients, 77 men and 23 women ranging in age from 18 to 70
      years of age, admitted to an inpatient facility in Central New York were
      administered buspirone HCl for treatment of the alcohol withdrawal syndrome.
      Although one patient had an unwitnessed seizure, none of the subjects required
      discontinuance of buspirone HCl because of symptoms of dizziness, nausea,
      headache, nervousness, or lightheadedness, typical side effects described by the
      manufacturer. All but one of the individuals given buspirone HCl for alcohol
      detoxification completed that phase of treatment within six days in a manner
      which effectively controlled their withdrawal symptoms. The findings were
      suggestive of an important role for buspirone HCl in the detoxification of the
      alcohol-dependent patient using a pharmacologic agent other than traditional
      medications such as benzodiazepines, phenobarbital, beta blockers, magnesium
      sulphate, or clonidine.

PMID- 2231825
TI  - Cranial electrostimulation (CES) use in the detoxification of opiate-dependent
      patients.
AB  - This paper reviews the scientific literature on cranial electrostimulation (CES)
      as a non-chemical means to alleviate opiate withdrawal symptoms. CES involves
      applying small amounts of electrical stimulation through electrodes applied to
      the skin surface over the cranium. The paper summarizes major theories (gate,
      endorphin, and Chinese acupuncture) which attempt to explain how CES may help
      alleviate drug withdrawal and craving. Two of the studies reviewed show that CES
      patients experienced more severe withdrawal during the early part of treatment
      than comparison groups of methadone patients. Other studies show that CES
      patients did better than methadone patients. The findings from all studies
      reviewed, however, were limited because of low participation rates, high dropout
      rates, difficulties in blinding subjects and evaluators, and the absence of
      standardized procedures and equipment. The evidence reviewed suggests that CES is
      a promising line of inquiry for continued efforts to develop nonchemical ways to
      detoxify opiate-dependent individuals. Improved research designs, larger sample
      sizes, more integrity in data collection, and improved data analysis are needed
      in the future.

PMID- 2231827
TI  - In memorium. Kenneth F. Lampe.

PMID- 2231828
TI  - ATSDR (Agency for Toxic Substances and Disease Registry) case studies in
      environmental medicine. Vinyl chloride toxicity.

PMID- 2231829
TI  - Anabolic steroids--a review of the clinical toxicology and diagnostic screening.
AB  - Anabolic steroids have been used by athletes since the 1950s to increase size and
      strength in order to improve their performance. The abuse of these substances has
      since expanded to include junior high and high school male and female athletes
      and non-athletes. The anabolic and androgenic effects of these agents, when taken
      in the doses needed to produce increases in size and strength, result in
      significant serious adverse effects involving the skin, liver, cardiovascular,
      musculoskeletal, endocrine and reproductive systems. Some of these effects are
      irreversible. It is essential that clinical toxicologists, emergency room
      physicians and psychiatrists are familiar with the physical and psychological
      effects, as well as the changes in laboratory parameters, that typically occur
      from chronic use of anabolic steroids. The toxicities and representative clinical
      profiles of steroid users are presented, and the methods available for diagnostic
      screening using psychological testing and urine analysis are also reviewed.

PMID- 2231830
TI  - Gastrointestinal pathology in adult iron overdose.
AB  - The gastrointestinal effects of iron overdose have been described in children.
      They may occur acutely, ranging in severity from mucosal injury to complete
      infarction, or several weeks later, as obstruction due to stricture formation.
      They typically occur in the stomach or proximal small bowel. We describe an adult
      example of both, each occurring in the distal portion of the small intestine.
      Both patients had ingested enteric-coated iron preparations and both experienced
      significant, protracted abdominal pain. Thus adults as well as children are at
      risk for severe gastrointestinal complications after iron overdose. Significant
      protracted abdominal pain should alert the clinician of its possibility. Damage
      to distal areas of the bowel can occur with complete sparing of proximal portions
      particularly if the iron is an enteric-coated preparation.

PMID- 2231831
TI  - Rhabdomyolysis and acute renal failure associated with cocaine abuse.
AB  - Cocaine abuse has emerged as a major public health problem among young adults.
      Illicit use of cocaine has been associated with an increasing array of medical
      complications. Both traumatic and nontraumatic rhabdomyolysis, often complicated
      by acute renal failure, has recently been described following cocaine abuse. The
      present report describes our experience with 15 such patients and serves to
      further define the spectrum of muscle injury associated with cocaine abuse
      ranging from the incidental finding of elevated serum levels of muscle enzymes to
      acute renal failure. Those patients who developed renal failure experienced more
      severe rhabdomyolysis in association with trauma, seizures or hyperpyrexia.

PMID- 2231832
TI  - The effects of fluoxetine in the overdose patient.
AB  - Fluoxetine (Prozac) is a new antidepressant, first marketed in the United States
      in January 1988. Only limited toxicologic information during a fluoxetine
      overdose is available. The goal of this prospective multi-center study was to
      develop a toxicity profile of initial signs and symptoms observed in fluoxetine
      overdose. A standardized data collection form was used on all patients ingesting
      fluoxetine as reported to four poison centers. Information obtained included age,
      dose, co-ingested drugs, presenting symptoms, vital signs, EKG abnormalities and
      lab values. Of the 127 cases of acute fluoxetine overdose collected, 106 cases
      met the criteria of the study. Of these, 69/106 ingested other drugs, including
      ethanol and 37/106 ingested fluoxetine alone. Of the latter group, the amounts
      ingested ranged from 20 to 1500 mg. It was observed that 48.6% (18/37) remained
      asymptomatic, 16.2% (7/37) were sleepy, 24.3% (9/37) had a sinus tachycardia (of
      100 beats per minute or greater), and 8.1% (3/37) had a diastolic pressure over
      100 mm Hg. Data collection is ongoing. Based upon our initial experience,
      fluoxetine in overdose appears to be relatively benign.

PMID- 2231834
TI  - Toxicological screening: a three year experience in poisonings in Kuwait.
AB  - The results of toxicological screening of body fluids (urine, blood and gastric
      lavage) from pediatric patients were analyzed for the period January 1985 -
      December 1988. Of the 119 cases, approximately one half were positive for at
      least one foreign substance. In about one fifth of the cases, multiple substances
      were detected. The most commonly implicated drugs were those acting on the
      central nervous system including the barbiturates, tricyclic antidepressants,
      phenothiazines, benzodiazepines and carbamazepine.

PMID- 2231833
TI  - Clinical experience with the benzodiazepine antagonist flumazenil in suspected
      benzodiazepine or ethanol poisoning.
AB  - The clinical efficacy of different doses of the specific benzodiazepine
      antagonist flumazenil was studied in a total of 72 patients with benzodiazepine
      or ethanol overdose. In a randomized double-blind study, 18 patients (group 1)
      and eight patients (group 2) with suspected benzodiazepine overdose received 5 mg
      (group 1) or 1 mg (group 2) flumazenil or placebo, respectively. The stage of
      coma, heart rate, blood pressure and respiratory rate were monitored within the
      following 15 min. If no change in the stage of coma was observed, 5 mg (group 1)
      or 1 mg (group 2) flumazenil were given, and the stage of coma, heart rate and
      blood pressure were again monitored. In a similar way, the effect of 5 and 1 mg
      flumazenil was investigated in 13 patients (group 3) and four patients (group 4)
      with ethanol intoxication. In an open trial, the clinical efficacy of flumazenil
      for the diagnosis of benzodiazepine or ethanol overdose was studied in 29
      patients (group 5). In all patients, a toxicological screening confirmed
      benzodiazepine or ethanol overdose. None of the patients receiving placebo showed
      effects on stage of coma, heart rate, blood pressure or respiratory rate.
      Patients with benzodiazepine overdose who received 5 mg flumazenil regained
      consciousness about 1-2 min after the end of injection. The effect of 1 mg
      flumazenil (group 2) on benzodiazepine-induced coma was less pronounced. In
      patients with ethanol overdose (group 3), ethanol-induced coma was reversed after
      5 mg flumazenil more slowly than in patients of group 1. No effect of flumazenil
      on ethanol-induced coma was observed in group 4. In group 5, flumazenil proved to
      be useful for diagnosing benzodiazepine or ethanol intoxication. In one patient
      with coma due to carbamazepine overdose, flumazenil was also found to be
      effective. Additionally, a possible analytical interference of flumazenil and its
      metabolites with the identification of other benzodiazepines by a toxicological
      screening procedure was studied. Even after an oral dose of 200 mg flumazenil, no
      interference with immunological benzodiazepine assays (EMIT, TDX, and RIA) was
      found. A metabolite and an artifact of flumazenil could be identified in urine by
      gas chromatography/mass spectrometry.

PMID- 2231835
TI  - Morphine excretion in breast milk and resultant exposure of a nursing infant.
AB  - We report the case of an infant who was breastfed while his mother was receiving
      low doses of morphine. Morphine concentration in his serum was in the analgesic
      range (4 ng/ml), while concentrations in the milk varied substantially in three
      samples collected within 2 hours (10, 100, 12 ng/ml). The calculated dose that
      the infant must have received to achieve the observed serum concentration had to
      be between 0.8 to 12% of maternal dose, based on reference literature values of
      clearance and bioavailability. The current perception that maternal morphine
      exposure is safe for the breastfed infant is based on a 50 year old data which
      were determined by an analytical method 1000 fold less sensitive than the present
      HPLC, thus leading to a likely erroneous conclusion.

PMID- 2231836
TI  - Clinical course and pharmacokinetics following a massive overdose of amphotericin
      B in a neonate.
AB  - Amphotericin is the drug of choice for the treatment of fungal infections in
      infants and children. When used in the recommended doses, amphotericin therapy is
      associated with high rates of adverse effects, including nephrotoxicity,
      hepatotoxicity, decrease in white blood cells, platelets and hemoglobin, chills,
      fever and even death (1). We report a case involving a neonate who was exposed to
      a 50 fold overdose of Amphotericin over a three day period.

PMID- 2231837
TI  - Suicide by captopril overdose.
AB  - We report a case of a 75 year-old male who committed suicide by taking an
      overdose of captopril. He took approximately ninety 12.5 mg captopril tablets.
      The postmortem plasma concentration of captopril was 60.4 mg/L. A review of the
      medical literature revealed five cases of captopril overdose all from
      unsuccessful suicide attempts. To our knowledge, this is the first case report of
      fatal captopril overdose with the measurement of plasma concentration of the
      drug.

PMID- 2231838
TI  - Skin blisters as a manifestation of oxazepam toxicity.
AB  - A 75 year-old comatous patient was admitted after ingestion of 200 mg oxazepam.
      Skin blisters, attributed to oxazepam toxicity, appeared on the left forearm the
      following day and regressed spontaneously nine days later.

PMID- 2231839
TI  - Compliance with malaria chemoprophylaxis over a five-year period among children
      in a rural area of The Gambia.
AB  - We have reviewed a malaria chemoprophylaxis programme in which Maloprim
      (pyrimethamine and dapsone) has been administered fortnightly by village health
      workers (VHWs) to approximately 1500 children each year aged 6-59 months resident
      in 15 primary health care villages in a rural area of The Gambia over 5 years.
      Reasonable levels of compliance with chemoprophylaxis have been maintained by
      many children over this period. this has occurred despite minimal outside
      supervision and support of the programme. Factors which may have affected the
      level of compliance in individual villages are identified. Large villages and
      those where social or political factionalism were evident tended to have low
      levels of compliance. The attitudes of VHWs and mothers to the programme were
      determined. Most VHWs cooperated enthusiastically and kept accurate records of
      compliance, despite receiving no compensation from the villagers for
      administering chemoprophylaxis. The administration of a drug to prevent illness
      in children was complementary to the curative service provided by VHWs. The
      chemoprophylactic was widely acceptable and nearly all mothers stated that the
      tablets were good for their children's health. However, knowledge of the specific
      purpose of chemoprophylaxis in the prevention of malaria was limited.
      Improvements in the programme which may result in higher levels of compliance are
      discussed.

PMID- 2231840
TI  - Androctonus crassicauda sting and its clinical study in Iran.
AB  - Androctonus crassicauda is the second most frequent cause of scorpion sting in
      southwest Iran. Its toxin can cause severe pain, autonomic, CNS, and muscle
      function disturbances, and death. Appropriate medical and nursing care can lead
      to complete recovery with no sequelae.

PMID- 2231841
TI  - Clinical study of Hemiscorpion lepturus in Iran.
AB  - Hemiscorpion lepturus (HL) sting accounts for 10-15% of all scorpion stings in
      south-west Iran. HL toxin is a cytotoxic and fatal venom which may affect any
      organ system, especially CNS, cardiovascular, skin and blood cells. Surgical
      excision of the sting site may prevent harmful or fatal consequences.
      Corticosteroids, adequate hydration, blood transfusion and diuretics may help
      some severely envenomed patients; some may die from cardio-respiratory arrest or
      renal failure.

PMID- 2231842
TI  - A survey of Ampullarium canaliculatus for natural infection of Angiostrongylus
      cantonensis in south Taiwan.
AB  - Ampullarium canaliculatus were collected monthly from the field in five areas in
      Pintung County and examined for larvae of Angiostrongylus cantonensis. Snails
      from one area showed the highest positive rate (30.8%) and the highest number
      (31) of larvae per snail. Snails were placed in four groups according to size.
      The positive rates in snails increased from 10.0 to 29.4% and the average number
      of larvae per snail increased from 11 to 40 as the size of snails increased from
      1.0 to 4.0 cm height or more. In the seasonal fluctuation of snails in the field,
      positive snails could be examined every month; however, the positive rate in
      snails (28.2%) and the average number of larvae per snail (33) in the dry season
      (November to April) were significantly higher than those (15.2% and 23
      respectively) in the rainy season (May to October). Ampullarium canaliculatus
      were confirmed naturally infected with A. cantonensis in this investigation so
      more attention should be paid to the snails to prevent the infection in humans.

PMID- 2231843
TI  - Pattern of alimentary tract tumours in Plateau State: a middle belt area of
      Nigeria.
AB  - Forty-five neoplastic surgical specimens from the alimentary tract were studied
      in Jos University Teaching Hospital, Jos, Plateau State, Nigeria, over a 5-year
      period (1983-1987). Rectal carcinomas were found to be the commonest alimentary
      tract tumours (28.9%). They are followed by carcinomas of the stomach (24.4%),
      colon (20.1%) and oesophagus (13.3%). Lymphomas constitute 6.7% while squamous
      cell carcinomas of the anus represent 2.2%.

PMID- 2231844
TI  - High prevalence of giardiasis in an urban population in Niger.
AB  - A sample of 2569 persons (1190 m, 1379 f) from Niamey (population 329,000),
      Niger, showed a giardiasis prevalence of 28.5%. The prevalence was similar
      between males and females and highest in the age range 3-29 years.

PMID- 2231845
TI  - Manifestations of Behcet's syndrome from Pakistan.

PMID- 2231846
TI  - Antimicrobial agent susceptibility patterns of staphylococci isolated in urban
      and rural areas of Bolivia.
AB  - Staphylococcal strains obtained from cutaneous swabs of hospital staff and school
      students of Camiri and Boyuibe and healthy people living in Javillo, Bolivia,
      were tested for their in-vitro antimicrobial susceptibility. The highest
      percentages of resistance to the antibiotics tested were found in staphylococcal
      strains isolated from hospital personnel. All the S. aureus strains from these
      subjects were resistant to penicillin. Coagulase-negative staphylococci from
      hospital personnel evidenced a high rate of multiresistant strains, mainly to
      penicillin, ampicillin, tetracycline, and chloramphenicol. The staphylococcal
      strains isolated in the rural population of Javillo were highly susceptible to
      all the antibiotics tested.

PMID- 2231847
TI  - Endurance running performance in athletes with asthma.
AB  - Laboratory assessment was made during maximal and submaximal exercise on 16
      endurance trained male runners with asthma (aged 35 +/- 9 years) (mean +/- S.D.).
      Eleven of these asthmatic athletes had recent performance times over a half
      marathon, which were examined in light of the results from the laboratory tests.
      The maximum oxygen uptake (VO2max) of the group was 61.8 +/- 6.3 ml kg-1 min-1
      and the maximum ventilation (VEmax) was 138.7 +/- 24.7 l min-1. These maximum
      cardio-respiratory responses to exercise were positively correlated to the degree
      of airflow obstruction, defined as the forced expiratory volume in 1 s (expressed
      as a percentage of predicted normal). The half-marathon performance times of 11
      of the athletes ranged from those of recreational to elite runners (82.4 +/- 8.8
      min, range 69-94). Race pace was correlated with VO2max (r = 0.863, P less than
      0.01) but the highest correlation was with the running velocity at a blood
      lactate concentration of 2 mmol l-1 (r = 0.971, P less than 0.01). The asthmatic
      athletes utilized 82 +/- 4% VO2max during the half-marathon, which was correlated
      with the %VO2max at 2 mmol l-1 blood lactate (r = 0.817, P less than 0.01). The
      results of this study suggest that athletes with mild to moderate asthma can
      possess high VO2max values and can develop a high degree of endurance fitness, as
      defined by their ability to sustain a high percentage of VO2max over an endurance
      race. In athletes with more severe airflow obstruction, the maximum ventilation
      rate may be reduced and so VO2max may be impaired. The athletes in the present
      study have adapted to this limitation by being able to sustain a higher %VO2max
      before the accumulation of blood lactate, which is an advantage during an
      endurance race. Therefore, with appropriate training and medication, asthmatics
      can successfully participate in endurance running at a competitive level.

PMID- 2231848
TI  - Somatotypes of weight lifters.
AB  - The present paper reviews published studies on the body shape of weight lifters.
      The differences between the somatotype ratings of weight lifters studied using
      the Sheldon and the Heath-Carter methods, and the differences between performance
      levels and age groups of weight lifters are discussed. The differences in mean
      somatoplots among the weight lifters studied as a whole group, weight lifters
      divided into two, three or four groups according to body weight, and weight
      lifters considered according to the official weight classes, are assessed. Weight
      lifters in the lighter weight classes are found to be ectomorphic or balanced
      mesomorphs, while those in the heavier weight classes tend to be endomorphic
      mesomorphs. Ectomorphy decreases, whereas mesomorphy and endomorphy increase with
      weight class. When three age groups of weight lifters were compared within each
      weight class, the same pattern of differences between ages occurs. The younger
      lifters in each weight class have higher endomorphy and lower mesomorphy than the
      senior lifters. Ectomorphy is higher in the younger lifters below the weight
      class of 82.5 kg. Since significant differences in all three somatotype
      components between 10 weight classes of weight lifters and also within three age
      groups were noted, it will be necessary in future studies to consider the
      somatotypes of weight lifters according to the official weight classes.

PMID- 2231849
TI  - The 4 mM blood lactate level as an index of exercise performance in 11-13 year
      old children.
AB  - The aim of this study was to assess the use of the 4 mM blood lactate level
      measured during incremental treadmill exercise as an indicator of exercise
      performance in 11-13 year old children. Fifty girls and 53 boys (means age 12.2
      +/- 0.6 years) gave informed consent to participate in the study. The children
      completed a discontinuous, incremental running test on a motorized treadmill. A 1
      min pause separated the 3 min exercise stages during which time duplicate
      capillary blood samples were taken for immediate assay of whole blood lactate
      concentration. Cardiorespiratory variables were measured continuously during
      exercise using a computerized on-line system. Mean values for peak oxygen uptake
      were 48 +/- 7 ml kg-1 min-1 and 42 +/- 7 ml kg-1 min-1 in boys and girls
      respectively. The exercise intensity corresponding to a blood lactate
      concentration of 4 mM was interpolated from plots of % peak oxygen uptake vs
      blood lactate and was reached at 91 +/- 7% peak oxygen uptake in both boys and
      girls. The results indicate that children can exercise at intensities close to
      their peak oxygen uptake without accumulating high levels of blood lactate and
      the use of the 4 mM blood lactate level to assess and monitor exercise
      performance in children of this age may therefore be inappropriate.

PMID- 2231850
TI  - Psychological characteristics of male gymnasts: differences between competitive
      levels.
AB  - The purpose of this study was to examine whether any differences exist in the
      cognitive and behavioural strategies of gymnasts competing at different elite
      levels. Thirty-eight male gymnasts competing at different competitive levels in
      an Australian gymnastic championship completed a standardized questionnaire prior
      to the first day of the competition. The questionnaire focused on a number of
      psychological factors that may affect both training and competition. Using both t
      tests and simple discriminant function analysis, it was revealed that gymnasts
      competing at different elite levels could be distinguished on the basis of two
      psychological factors, psychological recovery and self-confidence, as well as the
      behavioural measure, training hours. Specifically, gymnasts competing at higher
      elite levels versus those at lower elite levels, were better able to recover from
      their competitive mistakes, were more confident and trained longer per week.

PMID- 2231851
TI  - Sports performance.

PMID- 2231852
TI  - An analysis of the relationship between hostility and training in the martial
      arts.
AB  - Contrasting views and data are available on the issue of whether combative sports
      facilitate or reduce aggression. In the present study levels of hostility were
      assessed in two groups of martial arts students using the Buss-Durkee Inventory.
      Levels of hostility on a variety of the sub-scales were compared with scores from
      similar samples of participants in a body contact, aggressive but non-combative
      sport (rugby football) and a competitive sport with no body contact or direct
      aggression (badminton). When the effects of age and length of training were
      controlled by use of partial correlation there was no evidence to support group
      differences in either the combined score from the varied sub-scales of the
      inventory or the more specific assaultive sub-scale. However, there was evidence
      to suggest a significant effect of length of training on hostility levels in
      martial artists. Beginners attracted to the martial arts were more hostile but
      the hostility declined with the duration of training. No difference was apparent
      in this respect for students participating in either jui jitsu or karate. It is
      suggested that such differential effects with respect to length of training may
      lead to the overall absence of the between-sport differences. The results provide
      tentative support for the notion that the discipline of the martial arts may
      reduce assaultive hostility rather than serve as a model for such behaviour, yet
      support the need for prospective longitudinal studies on intra-individual
      hostility.

PMID- 2231853
TI  - Coronal biparietal diameter. A reliable alternative to the traditional transverse
      biparietal diameter.
AB  - The traditional ultrasonically derived fetal biparietal diameter (BPD) is
      important in the determination of fetal age, weight, and growth. This measure
      cannot be obtained, however, with direct occiput anterior or posterior or with a
      head in the pelvis. This study looked at the BPD utilizing coronal (anatomically
      at right angles to the traditional BPD through the thalami, third ventricle, and
      cavum septum pellucidum) rather than transverse section through the fetal head.
      In 265 patients at 14 to 41 weeks' gestation, simultaneous measurement of the
      coronal and transverse BPDs revealed that they were interchangeable (r = 0.99).
      The major drawback of the coronal BPD is the inability to obtain a head
      circumference because of the absence of the occipitofrontal diameter.

PMID- 2231854
TI  - Sonographic appearance and ultrasound-guided fine-needle aspiration biopsy of
      breast carcinomas smaller than 1 cm3.
AB  - The purpose of this study was to review the sonographic appearance and the
      results of ultrasound-guided fine-needle aspiration biopsies of a series of 49
      breast carcinomas smaller than 1 cm3. No tumor was found to be hyperechoic.
      Contours were irregular in 69% of cases. In 53%, an echogenic rim was present,
      and the echotexture was nonhomogeneous in 41%. Sound beam attenuation was present
      in 39%. The ratio of longitudinal diameter to anteroposterior diameter ranged
      from 0.67 to 2.25 (mean, 1.08 +/- 0.28). Fine-needle aspiration biopsy under
      continuous real-time sonographic guidance was performed on 36 patients and
      yielded 30 positive and four suspicious results (sensitivity, 94%), one
      inadequate specimen, and one false-negative result. With high-resolution hand
      held transducers, breast sonography can depict small carcinomas and provides
      accurate, cost-effective guidance for fine-needle aspiration biopsy.

PMID- 2231855
TI  - Sonographic imaging of the fetal azygous vein. Normal and pathologic appearance.
AB  - Sonologists should be familiar with the frequency of resolution and the
      ultrasonic appearance of the normal fetal azygous vein. In this study, 66
      consecutive uncomplicated pregnancies were scanned to determine the frequency of
      imaging the fetal thoracic azygous vein. Between 21.7 and 30 gestational weeks,
      the azygous vein could be imaged in 50% of the cases and measured 1-2 mm in
      caliber. In the last 10 weeks of pregnancy, the azygous vein could be imaged in
      98% of the cases and measured 2-4 mm. A case of fetal azygous continuation of the
      inferior vena cava is shown where the vein was abnormally dilated to a caliber of
      8 mm.

PMID- 2231856
TI  - Device for the calibration of flow-velocity-measuring Doppler ultrasound
      equipment.
AB  - A new device is described for verifying the calibration accuracy of flow-velocity
      Doppler ultrasound (US) equipment. A rotating circular disk whose circumferential
      velocity may be fixed or modulated provides a strong signal source suitable for
      calibrating clinical Doppler US instruments. Circumferential edge velocity,
      derived from the disk angular frequency, is used to verify the accuracy of
      Doppler instrument calibration. A limited survey of routinely used Doppler US
      instruments demonstrates that calibration accuracy generally is satisfactory for
      clinical purposes, with minimal variation between instruments. Factors that
      affect measurements include transducer type, scale range, and display size. All
      transducers used on a specific piece of equipment need to be tested because the
      transducer design is an important part of the instrument operation. Variations
      were observed in reported velocities obtained from different transducers on the
      same equipment and for the same transducer with different scale ranges. In
      particular, some scales were more accurate than others, suggesting that
      individual scales should be tested when performing clinical Doppler US instrument
      calibration. Other measures of performance including scale display range, sample
      depth, aliasing, and transducer selection may be studied to identify their effect
      on measurement accuracy. Temporal modulation of angular velocity produces
      waveforms that may be used to simulate pulsatile velocity characteristics. The
      device is simple to construct and use, and it provides a convenient way to verify
      high-quality instrument performance.

PMID- 2231857
TI  - The biophysical profile. A literature review and reassessments of its usefulness
      in the evaluation of fetal well-being.
AB  - Antenatal monitoring studies to assess fetal well-being and to identify the
      compromised fetus are in widespread use. This literature review analyzes the
      theoretical basis for fetal monitoring and the clinical research that has defined
      its utility, and it discusses the variations in protocols and scoring systems for
      the biophysical profile. While recognizing that there, is as yet, no consensus on
      the optimal monitoring protocol, the authors espouse one approach in which the
      cardiac nonstress test and the amniotic fluid volume are the initial tests, with
      full biophysical profile reserved for abnormal test outcomes. This approach to
      monitoring should be expeditious without diminishing its predictive value.

PMID- 2231858
TI  - Cephalothoracopagus janiceps disymmetros twinning.

PMID- 2231859
TI  - Echocardiography in acute myocarditis associated with left ventricular thrombus
      formation and systemic embolization.

PMID- 2231860
TI  - Sonographic detection of a small-bowel bezoar.

PMID- 2231861
TI  - The snowflake sign. A sonographic marker for prenatal detection of fetal skin
      denudation.

PMID- 2231862
TI  - Inexpensive technique for hard copy demonstration of color flow data using gray
      scale format.

PMID- 2231863
TI  - First trimester conceptus.

PMID- 2231864
TI  - The benzimidazole anthelmintic agents--a review.

PMID- 2231865
TI  - Bovine mastitis--why does antibiotic therapy not always work? An overview.

PMID- 2231866
TI  - Contrasting effects of nitrofurans on plasma corticosterone in chickens following
      administration as a bolus or diet additive.
AB  - Administration of furazolidone as a bolus dose (8-500 mg/kg), produced a decrease
      in plasma corticosterone in chickens. In contrast, addition of furazolidone or
      furaltadone to the diet (0.04% or above, 10 days), increased plasma
      corticosterone. Pre-treatment with a 200-mg/kg bolus of furazolidone or
      furaltadone did not affect pentobarbitone anaesthesia time in the birds. In
      chickens pre-treated with a nitrofuran in the diet, however, pentobarbitone
      anaesthesia time was significantly less than that in controls. Furaltadone in the
      diet, produced significant increases in the amount of cytochrome P-450 and the
      activity of aniline hydroxylase in the liver microsomes. It is suggested that
      nitrofurans given in the diet stimulated corticosterone biosynthesis in the
      adrenal glands and induced mixed-function oxidase activity in the liver.
      Nitrofurans given as a bolus did not produce these effects. Furazolidone (200
      mg/kg) produced severe anorexia, which lasted 2 days in T-line birds. The
      anorexia seemed to be associated with tissue damage in the birds rather than the
      ensuing adrenal cortical insufficiency.

PMID- 2231867
TI  - Tissue concentrations of clindamycin after multiple oral doses in normal cats.
AB  - Eighteen normal cats were randomly allocated into two blocks with three treatment
      groups and dosed orally with clindamycin aqueous solution for 10 days at a dosage
      rate of 5.5 mg/kg twice daily (Group 1), 11 mg/kg twice daily (Group 2), or 22
      mg/kg once daily (Group 3). At the end of dosing, all cats were killed and
      tissues were taken for clindamycin concentration analysis. Clindamycin was
      extracted from tissues using solid-phase extraction columns followed by
      microbiological assay of clindamycin using a cylinder plate assay using M.
      luteus. Recovery from each tissue was determined by inoculating known
      concentrations of clindamycin into drug-naive tissues and comparing the observed
      concentration from the expected concentration. Confirmation that the bioassay
      detected clindamycin and not N-desmethylclindamycin, its active metabolite, was
      done using gas-chromatography-mass-spectrometry. Concentrations were highest in
      the lung, with tissue:serum ratios greater than 3 in all groups. Concentrations
      were higher in Group 3 than Group 1 (P less than 0.05). Only liver concentrations
      in Group 3 were statistically higher than in Group 2, although all tissues except
      bone marrow and CSF had numerically higher concentrations in Group 3 than Group
      2. The tissue:serum ratio was greater than 1 in all tissues studied except bone,
      cerebrospinal fluid, brain, and skeletal muscle.

PMID- 2231868
TI  - Chronopharmacokinetics of theophylline in the cat.
AB  - Studies of theophylline pharmacokinetics in humans have shown that a higher peak
      concentration and area under the curve (AUC), with a shorter time to peak (tp)
      occur after a morning dose than after an evening dose. The purpose of this study
      was to determine whether theophylline pharmacokinetics in the cat were also
      influenced by the administration time of day. Theophylline was administered to
      six cats in a three-way cross-over study as a single dose of intravenous
      aminophylline and oral sustained-release theophylline (Slo-bid Gyrocaps and Theo
      Dur Tablets), between 08.00-09.00 h (Phase I) and 20.00-21.00 h (Phase II).
      Subjects were maintained on a 12-h light (08.00-20.00 h): 12-h dark cycle.
      Similar to the human studies, the tp was shorter following the morning dose.
      Conversely, however, the peak plasma theophylline concentrations achieved in
      these cats following intravenous aminophylline and oral Slo-bid were
      significantly higher following the evening dose. The AUC obtained for Theo-Dur
      was also significantly greater following the evening dose. No single
      pharmacokinetic parameter could account for the higher plasma concentrations
      achieved following the evening dose.

PMID- 2231869
TI  - The effects of ambient temperature on amikacin pharmacokinetics in gopher
      tortoises.
AB  - The pharmacokinetics of amikacin were compared in two groups of tortoises, one
      held at 20 degrees C and the other at 30 degrees C. The mean (+/- SD) residence
      time for amikacin in the 30 degrees C tortoises was 22.67 +/- 0.50 h;
      significantly (P less than 0.05) less than those held at 20 degrees C (41.83 +/-
      3.23 h). There was no significant difference (P greater than 0.05) in the steady
      state volume of distribution (Vd(ss] between the tortoises held at 30 degrees C
      (0.241 +/- 0.520 l/kg) and those held at 20 degrees C (0.221 +/- 0.019 l/kg). The
      clearance rate was faster (P less than 0.05) in the warmer tortoises (10.65 +/-
      2.42 ml/min/kg at 30 degrees C compared to 5.27 +/- 0.152 ml/min/kg at 20 degrees
      C). These data indicate that while the volume of distribution was approximately
      the same, amikacin remained in the colder tortoises longer because of its slower
      elimination. The oxygen consumption and metabolism were measured and found to be
      lower in the colder tortoises, almost by the same 2:1 ratio as clearance time
      (Cl), mean residence time (MRT), and area under the curve (AUC). The data derived
      from this limited study indicated that an appropriate therapeutic dosage regimen
      for amikacin in gopher tortoises at 30 degrees C is 5 mg/kg given i.m. every 48
      h.

PMID- 2231870
TI  - The effects of dexamethasone, betamethasone, flunixin and phenylbutazone on
      bovine natural-killer-cell cytotoxicity.
AB  - A series of in-vitro experiments was performed utilizing the ability of bovine
      peripheral-blood mononuclear cells (PBMC) to induce lysis of Madin-Darby bovine
      kidney (MDBK) cells infected with bovine herpesvirus 1 (BHV1), in an antibody
      independent natural-killer(NK)-cell cytotoxic assay. The effects of dexamethasone
      (dexamethasone sodium phosphate), betamethasone (betamethasone sodium phosphate),
      flunixin (flunixin meglumine) and phenylbutazone on this NK cytolysis were
      studied using concentrations of the drugs ranging from well below to well above
      those normally attained in plasma at recommended therapeutic doses. All four
      drugs inhibited NK activity. For each agent a minimum inhibitory concentration
      (MIC50) required to inhibit NK activity by approximately 50% was calculated. For
      dexamethasone, betamethasone and flunixin the MIC50 was lower after a 24-h pre
      incubation of PBMC with each drug, although a marked inhibition was seen when the
      drug was only present during the 5-h NK assay itself. In contrast the MIC50 for
      phenylbutazone rose after a 24-h pre-incubation with PBMC.

PMID- 2231871
TI  - Comparative benzylpenicillin pharmacokinetics in the dromedary Camelus
      dromedarius and in sheep.
AB  - Benzylpenicillin pharmacokinetics were compared in the dromedary Camelus
      dromedarius (n = 5) and in sheep (n = 5) after administration of a single
      intravenous injection of benzylpenicillin. The data were described by an open
      three-compartment model with elimination from the central compartment. Body
      clearance (Clb) was 4.87 +/- 0.63 ml/min/kg in the dromedary and 9.17 +/- 1.39
      ml/min/kg in sheep, the steady-state volumes of distribution (Vss) were 0.151 +/-
      0.023 l/kg and 0.165 +/- 0.038 l/kg and the mean residence times (MRT) 27.34 +/-
      1.38 min and 14.95 +/- 4.16 min in the dromedary and in sheep, respectively. It
      was concluded that benzylpenicillin elimination occurs more slowly in the
      dromedary than in sheep and that use of the same dosage regimen for the two
      ruminant species may lead to significant differences in plasma concentrations and
      therapeutic efficacy.

PMID- 2231872
TI  - Influence of feeding on the bioavailability of ronidazole prolonged-release
      formulations in pigeons.
AB  - The influence of feeding on the bioavailability of ronidazole (5 mg per animal)
      formulated as a hydrophilic-matrix tablet or as lipophilic pellets, was evaluated
      in pigeons. Administered to fed pigeons, prolonged drug absorption was obtained
      for both formulations. In non-fed pigeons an immediate grinding of the
      formulations in the gizzard resulted in rapid drug absorption. This indicates
      that prolonged residence of the prolonged-release formulations in the crop
      obtained in the fed condition seemed the only possible means of obtaining
      prolonged drug release in pigeons.

PMID- 2231873
TI  - Drug plasma levels following administration of trimethoprim and sulphonamide
      combinations to broilers.
AB  - Trimethoprim (TMP) was administered in combination with either sulphadiazine or
      sulphadimidine to broilers, and plasma concentrations were determined
      simultaneously by newly developed thin-layer and/or high-performance liquid
      chromatographic procedures, which also allowed quantification of the N4-acetyl
      metabolites of the sulphonamides. After i.v. injection of TMP (20 mg/kg body wt)
      and sulphadiazine (100 mg/kg body wt), both compounds were rapidly eliminated
      from plasma with half-lives of 1 and 2.7 h, respectively. Apparent volumes of
      distribution (3.3 and 0.96 l/kg, respectively) indicated that the tissue
      distribution of TMP was more extensive than that of the sulphonamide. After oral
      administration of the same dosages, elimination appeared to be slower compared to
      the i.v. injection, but this was obviously related to delayed absorption.
      Bioavailability after oral administration was approximately 100% of
      sulphadiazine, but only about 60% for TMP. Oral dosing of TMP in combination with
      sulphadimidine yielded similar maximum plasma concentrations of both compounds to
      those obtained with the combination of TMP with sulphadiazine, but the plasma
      concentration decline of sulphadimidine appeared to be more rapid than that of
      sulphadiazine after oral administration. During prolonged administration of
      different dosages of TMP-sulphadiazine combinations via drinking water, only low
      plasma concentrations were attained by the recommended dosage of the combination.
      Up to 10-fold higher dosages were tolerated by the animals without side-effects.
      In view of the fact that the sensitivity of bacterial strains to TMP-sulphonamide
      combinations differs widely, the plasma concentrations determined in the present
      study during prolonged drinking-water medication with different dosages of a TMP
      sulphadiazine combination can be used to select effective doses for treatment of
      different poultry diseases.

PMID- 2231874
TI  - The pharmacokinetics of oxytetracycline following intravenous administration in
      healthy and diseased pigs.
AB  - The pharmacokinetics of oxytetracycline (OTC) were studied in healthy pigs and in
      pigs endobronchially inoculated with Actinobacillus pleuropneumoniae toxins. In
      two groups of seven pigs OTC was administered intravenously in a single dose of
      10 or 50 mg/kg, respectively. OTC was administered to clinically healthy pigs and
      7 days later at 3 h after a challenge with A. pleuropneumoniae toxins. Pneumonia
      developed in toxin-treated pigs. In the challenged pigs there was a decreased
      distribution-rate constant (alpha) and a significantly increased elimination-rate
      constant (beta) (P less than 0.05). Moreover, the apparent volume of distribution
      (Vd beta) was decreased. The elimination half-lives (t1/2 beta) were
      approximately 6 h in the healthy pigs and 5 h in the diseased animals. There was
      no difference in the pharmacokinetic profile of OTC following administration of
      50 mg/kg compared to 10 mg/kg.

PMID- 2231875
TI  - Effects of E. coli endotoxin, some interferon-inducers, recombinant interferon-
      alpha 2a and Trypanosoma brucei infection on feed intake in dwarf goats.

PMID- 2231877
TI  - Anatomical relationship between the renal venous arrangement and the kidney
      collecting system.
AB  - The anatomical relationships between the renal venous arrangement and the
      pelviocaliceal system were studied in 52, 3-dimensional polyester resin corrosion
      endocasts. In 53.8% of the cases, there were 3 large venous trunks and in 28.8%
      there were 2 venous trunks joining to form the main renal vein. Intrarenal veins
      demonstrated free anastomoses that were disposed in 3 systems of longitudinal
      arcades (stellate, arcuate and interlobar veins). There were large venous collars
      around caliceal necks and also horizontal arches crossing over calices to link
      anterior and posterior veins. In 84.6% of the cases the upper caliceal group was
      encircled anteriorly and posteriorly by venous plexuses, which coursed parallel
      to the infundibulum. In 50.0% of the cases the lower caliceal group also was
      enriched by 2 venous plexuses. A close relationship existed between a large
      inferior tributary of the renal vein and the anterior aspect of the ureteropelvic
      junction in 40.4% of the cases. In 69.2% of the cases there was a posterior
      (retropelvic) vein: in 48.1% this vein had a close relationship to the junction
      of the pelvis with the upper calix and in 21.1% it crossed the middle posterior
      surface of the renal pelvis.

PMID- 2231876
TI  - Neoadjuvant chemotherapy in invasive bladder cancer: the evolving role of
      surgery.
AB  - The role of an operation in patients receiving neoadjuvant chemotherapy for
      clinically localized but invasive transitional cell carcinoma of the bladder
      currently is evolving. An operation is essential for case selection and
      evaluation of local response but it also contributes to bladder preservation and
      survival. The procedure that is necessary to select for and assess response to
      chemotherapy may itself alter the actual or proceed to evolution of invasive
      bladder cancer. Neoadjuvant chemotherapy is a reasonable therapeutic strategy in
      selected patients but it remains to be seen whether the results will prove to be
      superior to those achieved with standard endoscopic and open operations.

PMID- 2231878
TI  - Incidence and properties of renal masses and asymptomatic renal cell carcinoma
      detected by abdominal ultrasonography.
AB  - Renal ultrasonography was performed in 45,905 adults, including 41,364 without
      any signs suggesting urinary tract malignancies, 1,667 with microscopic hematuria
      only and 2,874 with some signs of malignancy. Renal lesions were found in 355
      adults (0.858%) in the asymptomatic, 39 (2.3%) in the microscopic hematuria and
      75 (2.6%) in the symptomatic groups, respectively. Renal cell carcinoma was found
      in 35 (7.5%) lesions: 19 (5.4%) in the asymptomatic, none in the microscopic
      hematuria and 16 (21.3%) in the symptomatic groups. A total of 47 patients,
      including 12 other renal cell carcinoma patients transferred from related
      hospitals, was grouped into 28 without and 19 with symptoms. Primary tumor size
      and clinical stages were significantly smaller and lower, respectively, in the
      asymptomatic group than in the symptomatic group. Radical nephrectomy was
      performed in all but 2 asymptomatic patients. The 5-year survival rates after
      nephrectomy were 94.7 and 60.9% for the asymptomatic and symptomatic groups,
      respectively (p less than 0.01). The results indicate that ultrasonography is a
      useful tool to detect low stage asymptomatic renal cell carcinoma at low cost.

PMID- 2231879
TI  - Magnetic resonance imaging for assessment of vena caval tumor thrombi: a
      comparative study with venacavography and computerized tomography scanning.
AB  - We assessed the accuracy of magnetic resonance imaging in demonstrating the
      presence and extent of vena caval tumor thrombi. The study group included 20
      patients with vena caval thrombi from renal cell carcinoma (18), renal pelvic
      transitional cell carcinoma (1) and adrenal pheochromocytoma (1). Preoperative
      diagnostic studies included magnetic resonance imaging in all patients, inferior
      venacavography in 16 and computerized tomography scanning in 15. All patients
      underwent an operation in which the presence and extent of the vena caval
      thrombus were confirmed. Magnetic resonance imaging accurately delineated the
      presence and extent of the thrombus in all 20 patients (100%). Venacavography was
      accurate in 15 patients (94%) but 8 (50%) required a retrograde and antegrade
      study. Computerized tomography scanning demonstrated the presence of a tumor
      thrombus in all 15 patients but accurately delineated the cephalad extent of the
      thrombus in only 5 (33%). In patients with vena caval tumor thrombi magnetic
      resonance imaging can provide accurate information regarding the extent of vena
      caval involvement while avoiding the need for an invasive contrast imaging study.

PMID- 2231881
TI  - Ureterosigmoidostomy: long-term results, risk of carcinoma and etiological
      factors for carcinogenesis.
AB  - We followed postoperatively 75 patients who underwent ureterosigmoidostomy
      between 1942 and 1987. Of the patients 30 were asked to undergo routine
      examination, including fiberoptic sigmoidoscopy with biopsy and analysis of a
      urine-feces slurry for nitrate, nitrite and nitrosamines in comparison to 20
      control volunteers. After a mean observation of 14 years 7 months (1 to 46 years)
      64.5% of the patients had bilaterally normal kidneys without any previous
      complications, 77.5% of the renal units being normal. Sigmoidoscopic biopsy
      revealed 3 carcinomas at the ureterocolonic junction resulting in an 8.5 to 10.5
      fold increased risk of colon carcinoma compared to the general population. The
      excretion of nitrite and N-nitrosamines was increased, and nitrate excretion was
      decreased compared to healthy control volunteers, suggesting endogenous formation
      of nitrosamines by bacterially reduced nitrate and endogenous amines. The
      urological long-term results of ureterosigmoidostomy are similar to those of
      conduits. However, the increased incidence of colon carcinoma is not yet proved
      to be higher than in conduits.

PMID- 2231880
TI  - Extravesical versus Leadbetter-Politano ureteroneocystostomy: a comparison of
      urological complications in 320 renal transplants.
AB  - The urological complications of 320 consecutive renal transplants performed at
      our institution between October 17, 1985 and November 10, 1989 are reviewed. The
      Leadbetter-Politano technique of ureteroneocystostomy was used in the first 160
      patients (group 1) and an anterior extravesical technique modified from the
      methods of Witzel, Sampson and Lich was performed in the second 160 patients
      (group 2). Urological complications occurred in 15 patients (9.4%) in group 1 and
      6 (3.7%) in group 2 (p = 0.04). Ureterovesical junction obstruction occurred in 6
      patients (3.7%) in group 1 and 1 (0.6%) in group 2 (p = 0.05). Complications of
      leakage, ureteral necrosis and ureteral stricture were comparable in the 2
      groups. Therefore, we advocate the use of the anterior extravesical technique
      over Leadbetter-Politano ureteral reimplantation based on the lower incidence of
      urological complications and various technical advantages, including less
      operative time, avoidance of a separate cystotomy, less hematuria and ability to
      use short donor ureters.

PMID- 2231882
TI  - Primary adenocarcinoma of the bladder: favorable prognostic significance of
      deoxyribonucleic acid diploidy measured by flow cytometry.
AB  - Flow cytometric nuclear deoxyribonucleic acid ploidy analysis was done
      successfully on 38 specimens of primary bladder adenocarcinoma treated between
      1954 and 1985. Of the specimens 10 (26%) were deoxyribonucleic acid diploid, 8
      (21%) were tetraploid and 20 (53%) were aneuploid. Distribution of ploidy
      patterns between the 14 histological low grade and 24 high grade tumors was
      similar. Of 38 tumors 35 (92%) showed muscle invasion. One tumor arose in a
      previously exstrophied bladder, 10 were of urachal origin and 27 arose in an
      anatomically normal bladder. Of the urachal origin tumors 80% were
      deoxyribonucleic acid aneuploid. At 5 and 10 years after diagnosis 80 and 70%,
      respectively, of the patients with diploid tumors were free of disease. By
      contrast, at 5 and 10 years after treatment only 20 and 12%, respectively, of the
      patients with nondiploid tumors have not had disease progression (p less than
      0.001 log-rank test). None of the 6 patients with diploid, high grade, high
      stage, muscle invasive tumors had subsequent progression. In contrast, 16 of 17
      patients (94%) with high grade, high stage, nondiploid tumors had either local or
      distant tumor recurrence (p less than 0.0005). Nuclear deoxyribonucleic acid
      ploidy pattern appears to be the most significant prognostic information
      currently available to stratify expected prognosis for patients with muscle
      invasive adenocarcinoma of the bladder. This test probably should be a standard
      tool in the clinical management of patients with this rare bladder malignancy.

PMID- 2231884
TI  - Perioperative methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) for
      poor risk transitional cell carcinoma of the bladder: an Eastern Cooperative
      Oncology Group pilot study.
AB  - A total of 18 patients with locally advanced transitional cell carcinoma of the
      bladder underwent 2 preoperative cycles of chemotherapy with methotrexate,
      vinblastine, doxorubicin and cisplatin followed by radical cystectomy and 2
      postoperative cycles of chemotherapy. Radical cystectomy was performed in 17 of
      18 patients (94%) with a pathological partial response in 3 (17%) and a
      pathological complete response in 2 (11%), for an over-all response rate of 28%
      (95% confidence limits 10 to 53%). At 23-month median followup 9 patients (50%)
      remained without evidence of recurrent disease, while 9 (50%) died of metastatic
      bladder cancer. Average relative dose intensity of all therapy given was 78%.
      Hematological toxicity was moderate, with no septic deaths or bleeding
      complications. However, 4 thromboembolic events occurred. While downstaging of
      the primary bladder tumor can occur with this perioperative schedule our results
      were not as impressive as some previously reported findings. The incidence of
      thromboembolic events is worrisome.

PMID- 2231883
TI  - Randomized phase II evaluation of carboplatin and CHIP in advanced transitional
      cell carcinoma of the urothelium. The Eastern Cooperative Oncology Group.
AB  - A total of 83 patients with metastatic transitional cell carcinoma who had
      previously received no systemic therapy entered a randomized phase II evaluation
      of carboplatin and cis-dichloro-transdihydroxy-bis-isopropylamine platinum IV
      (CHIP), administered respectively at 400 and 270 mg./m.2 every 28 days. Among
      evaluable patients with measurable disease response rates were 3 of 22 (14%, 95%
      confidence interval 5 to 35%) for carboplatin and 4 of 25 (16%, 95% confidence
      interval 5 to 36%) for CHIP. Among 17 patients with evaluable but not measurable
      metastases (10 carboplatin and 7 CHIP recipients) there were no responses. Median
      survival for 64 evaluable patients was 4.8 months (5.0 months for carboplatin and
      4.3 months for CHIP recipients). Independent factors prognostic for survival (p
      less than 0.01) were performance status (0 or 1 versus 2 or 3), liver metastases,
      prior radiation therapy and recent weight loss (p = 0.02). Multivariate analysis
      confirmed that a performance status of 2 or 3 and liver metastases were
      predictive of shorter survival. A total of 31% of the patients treated with
      carboplatin and 34% of those who received CHIP experienced severe or life
      threatening myelosuppression. While the response rates with carboplatin and CHIP
      are modest, we believe that the characteristics of these agents indicate that
      they should be evaluated further.

PMID- 2231885
TI  - Local recurrence and survival following nerve-sparing radical cystoprostatectomy.
AB  - From March 1982 through July 1988, 76 men underwent nerve-sparing radical
      cystoprostatectomy for carcinoma of the bladder at our hospital. Of the 76
      patients 2 (2.6%) had positive surgical margins (dome of the bladder and left
      ureter) and neither had positive margins at the site of nerve-sparing
      modifications. Of 3 patients (3.9%) who had local recurrence none had positive
      surgical margins. The 5-year actuarial local recurrence rate is 7.5%. Thirteen of
      76 patients (17%) died of transitional cell carcinoma and 7 (9%) died of other
      causes, while 53 (70%) are alive without evidence of disease with a mean followup
      of 38.4 months. The 5-year actuarial survival rates are 64% over-all, 68% without
      disease and 78% disease-specific. Of the 42 evaluable men who underwent
      cystoprostatectomy alone 27 (64%) are potent, compared to 2 of the 12 men (17%)
      who also underwent urethrectomy. We conclude that the nerve-sparing modifications
      do not compromise cancer control, that local recurrence and survival rates are at
      least comparable to those achieved with standard radical cystoprostatectomy, and
      that it is possible to preserve potency in most men undergoing this procedure.

PMID- 2231886
TI  - Recurrent urethral stricture disease managed by clean intermittent self
      catheterization.
AB  - We studied 41 patients with urethral stricture who had failed at least 1
      operation, and were being maintained with filiform and follower dilation every 6
      to 12 weeks. The patients were instructed in clean intermittent self
      catheterization with a 16F red rubber catheter, which was performed every 1 to 30
      days. Followup from 9 to 36 months revealed excellent compliance and average peak
      uroflow rates increased from 5.5 cc per second before dilation to 17.1 cc per
      second at the last followup visit. Clean intermittent self-catheterization is a
      simple method to maintain a patent urethra and obviates the need for further
      operations or painful dilations.

PMID- 2231887
TI  - The microarchitecture of the intracavernosal smooth muscle and the cavernosal
      fibrous skeleton.
AB  - The bulk of the parenchyma of the corpora cavernosa consists of bundles of smooth
      muscle fibers. These bundles are oriented in all directions and establish at
      least 2 insertions upon elements of the fibrous skeleton of the corpora. The
      fibrous skeleton includes the tunica albuginea and its fibrous columns, the
      intracavernous fibrous framework, and the periarterial and perineural fibrous
      sheaths. The cavernous vascular spaces (sinusoids) form an intercommunicating
      network embedded within the mass of smooth muscle. Thus, the smooth muscle does
      not form a muscular wall proper for each sinusoid.

PMID- 2231888
TI  - Arteriographically determined occlusive disease within the hypogastric-cavernous
      bed in impotent patients following blunt perineal and pelvic trauma.
AB  - To determine the presence, location and pattern of arterial occlusive disease
      within the hypogastric-cavernous arterial bed in impotent men following blunt
      perineal and pelvic trauma, we reviewed the selective internal pudendal
      arteriograms of 20 patients with a history of blunt perineal and 7 with blunt
      pelvic trauma who had immediate development of impotence. Arteriographic studies
      of 104 other impotent patients also were reviewed and compared. Patients with
      persistent impotence immediately after blunt pelvic and perineal trauma had
      significantly different patterns of arteriographically demonstrated occlusive
      disease within the distal hypogastric-cavernous arterial bed consistent with the
      site of the traumatic injury. Those who sustained blunt pelvic trauma and
      complained of immediate impotence revealed arterial occlusive lesions mainly in
      the internal pudendal, common penile, cavernous and dorsal arteries. The
      incidence of arterial lesions in the distal internal pudendal or common penile
      artery was significantly higher (p less than 0.01) in patients with blunt pelvic
      trauma (92%) than in those with blunt perineal trauma (35%). Patients who
      sustained blunt perineal trauma and complained of immediate impotence
      demonstrated a more focal pattern of pathological arterial occlusion primarily in
      the cavernous and dorsal arteries. The incidence of a solitary arterial lesion in
      the cavernous artery without proximal disease was significantly higher (p less
      than 0.05) in patients with blunt perineal trauma (48%) than in those with blunt
      pelvic trauma (8%). It is hypothesized that blunt trauma without immediate
      impotence may be a potential risk factor for later development of arterial
      vasculogenic impotence, and that unrecognized or seemingly innocuous trauma may
      be a factor in cases of idiopathic impotence. Patients without trauma and with
      vascular risk factors have a more diffuse pattern of arteriographically
      demonstrated arterial lesions.

PMID- 2231889
TI  - Patient acceptance of and satisfaction with an external negative pressure device
      for impotence.
AB  - Patient acceptance of and satisfaction with an external negative pressure device
      as a treatment for impotence were retrospectively analyzed among 100 men. The
      over-all satisfaction rate was 68%. Reasons for dissatisfaction with and
      discontinuing the use of the device included premature loss of penile tumescence
      and rigidity, pain or discomfort either during application of suction or during
      intercourse and inconvenience. Negative pressure therapy is an effective
      treatment for impotence of various etiologies and should be among treatment
      options offered to the impotent patient.

PMID- 2231891
TI  - Radical prostatectomy for clinical stage T1-2N0M0 prostatic adenocarcinoma: long
      term results.
AB  - A total of 441 stage T1-2N0M0 and 11 stage T1-2N0M0 cancer patients with an
      elevated acid phosphatase level only, and 18 stage T1-2N+M0 cancer patients
      underwent radical prostatectomy. Analysis of the 441 stage T1-2N0M0 cancer
      patients demonstrated that failure and survival were a function of the disease
      being organ-confined, specimen-confined or margin-positive, with 10-year failure
      rates of 12, 30 and 60%, respectively. Of the patients with positive margins 44
      were and 79 were not irradiated postoperatively. Postoperative radiation produced
      no survival advantage. No difference in interval to failure or of survival could
      be identified between 105 patients whose disease was diagnosed by transurethral
      resection and 328 who had a palpable abnormality. Eleven patients had negative
      bone and node findings but they had an elevated acid phosphatase level. All 8
      patients not treated with immediate androgen deprivation failed within 36 months.

PMID- 2231890
TI  - Testicular carcinoma in patients positive and at risk for human immunodeficiency
      virus.
AB  - Patients with the acquired immunodeficiency syndrome are at increased risk for
      certain malignancies. Because acquired immunodeficiency syndrome and testicular
      cancer affect primarily young men, the potential complications that acquired
      immunodeficiency syndrome might impose raise significant concern. To address this
      question we performed a retrospective review of all cases of testicular cancer
      during an 11-year period. Of 140 patients 6 had human immunodeficiency virus
      infection and 7 were from human immunodeficiency virus risk groups. All cases
      were either stage I or II disease with seminoma in 8, teratocarcinoma in 3,
      embryonal cell carcinoma in 1 and teratoma in 1. The clinical presentations of
      these patients were comparable to those of patients without human
      immunodeficiency virus risk factors. The majority of the patients received
      standard therapy, including orchiectomy followed by lymphadenectomy, radiation
      therapy or chemotherapy depending on stage and pathological subtype. Patients
      tolerated therapy well with only 1 course of radiation therapy complicated by
      Pneumocystis carinii pneumonia. All patients achieved complete remission and none
      died of testicular cancer. Since treatment of these patients may worsen the
      immunosuppression, surveillance is recommended after orchiectomy for acquired
      immunodeficiency syndrome patients with stage I disease. However, the majority of
      patients with human immunodeficiency virus infection should receive standard
      therapy.

PMID- 2231892
TI  - Improved technique for creation of ileal conduit stoma.
AB  - Creation of a circumferentially protruding urinary intestinal stoma is an
      important aspect to prevent stomal regression, stenosis and parastomal
      herniation. Furthermore, an improperly fashioned stoma may make fitting of an
      ostomy appliance difficult, resulting in urinary leakage with secondary
      dermatitis and incrustation. The major difficulty in fashioning the stoma is
      everting the mucosa over the intestinal mesentery. We describe our method of
      stoma formation that creates a circumferentially symmetrical protruding stoma
      free of tension that has been used successfully even in obese patients. This
      technique has made the use of a Turnbull stoma unnecessary in our recent
      experience.

PMID- 2231893
TI  - A new technique for ileal nipple fixation: preliminary report.
AB  - A new technique for ileal nipple fixation is described in 6 post-cystectomy
      patients (4 with an ileal bladder substitute and 2 with an ileal reservoir) for
      the prevention of reflux. Nipple formation is helped by deperitonealization and
      defatting of the nipple mesentery. A full circumferential incision is made,
      except for the mesenteric border, and through both nipple layers down to the
      mucosa of the inner layer. The seromuscular layers on each side of the incision
      are closed together with continuous 3-zero polyglycolic acid suture. The
      overlying outer mucosa of both edges then is closed. Endoscopic and radiographic
      study 6 to 12 months postoperatively showed a stable nipple without reflux. The
      anatomical and physiological rationale of the technique is discussed.

PMID- 2231894
TI  - Mohan's urethral valvotome: a new instrument.
AB  - Electrothermic fulguration of posterior urethral valves with a resectoscope is
      difficult in newborns, especially in small for gestation date and premature
      newborns because of a small caliber urethra. This difficulty has prompted the
      innovation of the valvotome described. The outer diameter of the valvotome is 3
      mm. and it can be easily introduced without stretching the urethra. This
      instrument has been used successfully in 8 patients to date. Patient age ranged
      from 3 days to 3 1/2 years with varying degrees of hydronephrosis and
      hydroureter. All patients have a good urinary stream with regression of the
      hydronephrosis and hydroureter.

PMID- 2231895
TI  - The urethral plug: a new treatment modality for genuine urinary stress
      incontinence in women.
AB  - A new modality, the urethral plug, was used to treat 22 women with genuine
      urinary stress incontinence. The plug is made of thermoplastic elastomer (Kraton
      G), and consists of a meatal plate, a soft stalk and 1 or 2 spheres along the
      stalk. The spheres were located according to the result of the urethral pressure
      profile. The midpoint of the proximal sphere was placed at the bladder neck and
      the distal sphere was placed just above the maximum urethral pressure point. At
      voiding the plug was removed and afterwards a new plug was inserted. The plug
      with 2 spheres was tested in week 1 (period 1) and the plug with only the distal
      sphere was tested in week 2 (period 2). A total of 22 patients completed period
      1. Eight patients did not complete period 2, mostly due to either unchanged
      incontinence during period 1 or a repeated loss of the plug with 1 sphere. In
      periods 1 and 2, 73 and 79% of the patients were subjectively and objectively
      continent or improved. A total of 14 patients completed both periods. Eight
      patients preferred the plug with 2 spheres, 1 preferred the other plug and 5 had
      no preference. The side effects were few. This preliminary study shows that the
      urethral plug seems to be a promising alternative treatment for female genuine
      urinary stress incontinence.

PMID- 2231896
TI  - Uncircumcision: a technique for plastic reconstruction of a prepuce after
      circumcision.
AB  - A simple technique is described for plastic reconstruction of the prepuce. Penile
      skin is used and the defect created is covered by implantation of the penis into
      the scrotum. At a second stage the penis is released from the scrotum.

PMID- 2231897
TI  - Urinary retention due to sacral myeloradiculitis: a clinical and
      neurophysiological study.
AB  - We report 5 cases of sacral myeloradiculitis presenting with transient urinary
      retention. Neurophysiological testing, including bulbocavernosus reflex, pudendal
      evoked response and external anal sphincter electromyography, was performed.
      Parasympathetic pelvic nerves, pudendal nerves as well as the spinal cord seem to
      be involved to various degrees in this infrequent disorder.

PMID- 2231898
TI  - Long-term urinary continence and renal function in neonates with posterior
      urethral valves.
AB  - Posterior urethral valves are known to be associated with considerable morbidity
      and mortality especially in the neonate. Recently the role of bladder dysfunction
      in the pathophysiology of renal function impairment and urinary incontinence
      after valve ablation has been questioned. From 1976 to 1986 we treated 50 male
      newborns with posterior urethral valves at our institution. Initial treatment in
      all cases consisted of bladder drainage by a urethral catheter, and correction of
      existing fluid and electrolyte abnormalities. Subsequent treatment was dictated
      by the degree of upper tract abnormalities and it included valve ablation alone
      in 24 patients, vesicostomy and later valve ablation in 8, valve ablation and
      later upper tract reconstruction in 14 and cutaneous ureterostomy in 4. Followup
      ranges from 2 to 12 years (mean 6.8). Long-term renal functional impairment was
      related to the serum creatinine at age 1 year. If the serum creatinine was below
      1.0 mg.% all patients (31) had normal values at long-term followup and if it was
      greater than 1.0 mg.% (19) then only 7 patients had normal values at followup.
      Urinary continence was assessed in 42 patients and it was normal in 34 (81%). The
      etiology of incontinence in the remaining 8 patients was bladder dysfunction in 6
      and sphincter incompetence in 2. Those patients with urinary incontinence also
      had a high incidence of upper tract abnormalities (6 of 8, 75%) compared to
      continent valve patients (10 of 34, 29%).

PMID- 2231899
TI  - The management of posterior urethral valves by initial vesicostomy and delayed
      valve ablation.
AB  - We managed 32 neonates and infants with temporary vesicostomy and delayed valve
      ablation. The criterion on which successful management was gauged was estimated
      creatinine clearance. Renal failure or death occurred in 30% of the patients and
      7% required transplantation. There was no apparent difference between our
      patients managed initially with vesicostomy and other series managed initially
      with valve ablation in preventing the complications of posterior urethral valves.

PMID- 2231900
TI  - Pheochromocytoma in the pediatric age group: the prostate--an unusual location.
AB  - Pheochromocytomas of the prostate are rare, with only 3 cases in adults reported
      in the literature. We present the case of an 8-year-old boy with a
      pheochromocytoma of the prostate and a second tumor in the region of the left
      internal iliac artery.

PMID- 2231901
TI  - Nuclear morphometry as a prognostic indicator for genitourinary rhabdomyosarcoma:
      a preliminary investigation.
AB  - Rhabdomyosarcoma of the urogenital tract is a malignant mesenchymal tumor seen
      primarily in childhood. Multimodal therapy, encompassing surgery, radiotherapy
      and chemotherapy, has dramatically improved the survival of patients with this
      disease. However, the quest for markers of tumor aggression is important to
      decrease the morbidity of treatment given to patients with good prognosis tumors,
      while at the same time intensifying treatment of tumors with poor prognosis.
      Using archival tumor specimens from 13 patients with genitourinary
      rhabdomyosarcoma, a multivariate analysis of multiple nuclear shape descriptors
      was done with the Hopkins Morphometry System. Three nuclear shape descriptors
      clearly separated patients with no evidence of disease recurrence or progression
      from those with recurrent disease, progressive disease or death of disease. These
      nuclear shape descriptors were standard error of the chain code standard
      deviation analysis (p = 0.010), range of the feret ellipticity distribution (p =
      0.016) and standard error of the chain code range analysis (p = 0.037). With
      multivariate analysis these shape descriptors taken together separated patients
      with good and poor prognoses to a level of significance of p = 0.007. Thus,
      nuclear morphometric analysis may prove to be useful as an individual prognostic
      indicator in childhood genitourinary rhabdomyosarcoma and warrants further
      analysis in a much larger, blinded, controlled study.

PMID- 2231903
TI  - Massive hemorrhage from an arterioureteral fistula associated with chronic renal
      transplant failure.
AB  - A case of arterioureteral fistula from the graft artery stump of a failed
      transplant and the native ureter is reported. This case illustrates one of the
      possible complications of graft anastomosis. The etiological factors involved in
      the formation of the aneurysm and eventually the fistula are discussed.

PMID- 2231902
TI  - Embolization of a giant renal arterial aneurysm.
AB  - A 49-year-old man presented with right flank pain. Angiography revealed a giant
      right renal arterial aneurysm. Giant renal arterial aneurysms are typically
      treated by nephrectomy. In this patient the aneurysm was embolized successfully
      with multiple Gianturco-Wallace coils and polyvinyl alcohol. This case indicates
      that embolization may be a reasonable alternative to nephrectomy.

PMID- 2231904
TI  - Cyclophosphamide-induced hemorrhagic pyelitis and ureteritis associated with
      cystitis in marrow transplantation.
AB  - A 29-year-old woman suffered fatal hemorrhagic pyelitis, ureteritis and cystitis
      after receiving 4,800 mg./m.2 cyclophosphamide in preparation for marrow
      transplantation despite intravenous hydration and a Foley catheter.
      Cyclophosphamide-induced urothelial damage is not limited to the bladder and
      upper tract monitoring also is necessary.

PMID- 2231905
TI  - De novo carcinoma of the lower urinary tract in renal allograft recipients.
AB  - Immunocompetence has been postulated as an important defense against the
      progression of urothelial carcinoma. Three cases of de novo lower urinary tract
      carcinoma in renal transplant recipients demonstrated the potential for unusually
      rapid urothelial extension and invasion in chronically immunosuppressed patients.
      Two patients had a history of perineal condyloma acuminata; tumors from 1 of
      these harbored the genetic sequences of human papillomavirus type 6. One patient
      had multiple manifestations of cyclophosphamide-related urothelial injury,
      including bladder carcinoma. Treatment of 2 patients culminated in a radical
      operation during which the remaining native urinary system was resected
      completely, with sacrifice of the allograft kidney in 1 and diversion into an
      ileal conduit in 1. The remaining patient underwent urethrectomy and partial
      cystectomy with a sigmoid conduit.

PMID- 2231906
TI  - Burkitt's lymphoma of the testicle: report of 2 cases occurring in elderly
      patients.
AB  - Burkitt's lymphoma is rare in patients older than 50 years and almost never
      presents as a testicular tumor. We report 2 cases of primary Burkitt's lymphoma
      of the testicle in men 68 and 79 years old. In 1 man the extragonadal tumor had a
      rapid and lasting response to combination chemotherapy. The cases are of interest
      for the unusual presentation of the disease and for the possibility to control
      Burkitt's lymphoma in older patients without undue toxicity. The management of
      testicular lymphoma requires radical orchiectomy and prophylactic irradiation of
      the contralateral testis. Chemotherapy is indicated for advanced disease and may
      prevent relapses in patients with early disease. The role of central nervous
      system prophylaxis is controversial.

PMID- 2231907
TI  - Retroperitoneal lymph node dissection in malignant mesothelioma of tunica
      vaginalis testis.
AB  - A case of metastatic mesothelioma of the tunica vaginalis testis in a 57-year-old
      man is reported. Clinicopathological findings and treatment options are reviewed.

PMID- 2231908
TI  - Re: Adrenal hemorrhage in the newborn with evidence of bleeding in utero.

PMID- 2231909
TI  - Re: Prostatic needle biopsy: a simple technique for increasing accuracy.

PMID- 2231910
TI  - This month in Investigative Urology: the production of lymphokines following BCG
      therapy.

PMID- 2231911
TI  - Synchronized electrical stimulation of the sympathetic and parasympathetic
      innervation of the bladder: facilitation of the initiation of micturition in the
      dog.
AB  - To improve the quality of bladder contractions induced by parasympathetic
      stimulation and to facilitate the initiation of voiding, we investigated the
      effect of sympathetic stimulation on the parasympathetic innervation of the
      bladder in 12 dogs. For the sympathetic system, the lumbar sympathetic trunks
      were electrically stimulated; for the parasympathetic system, either the pelvic
      nerve or the ventral root of S2 was stimulated. With voltages at or just above
      the threshold for achieving a measurable effect on bladder pressure, stimulation
      of the sympathetic system or the pelvic nerve alone did not lead to voiding, and
      sacral root stimulation alone elicited voiding in only 7.4 per cent of
      stimulations. However, when the same stimulus parameters were used for
      synchronous stimulation, the voiding process was facilitated when sympathetic
      stimulation was begun five to 10 seconds before parasympathetic stimulation. When
      the pelvic nerve was used, voiding resulted in 77.7 per cent of stimulations and
      the bladder was emptied by a mean of 68.7 per cent; with S2 ventral root
      stimulation, voiding resulted in 83.3 per cent of stimulations and the bladder
      was emptied by 59.7 per cent. The facilitory effect of sympathetic stimulation
      was not abolished when the sympathetic trunks were cut centrally to the point of
      stimulation, but was absent when the hypogastric nerves were transected. We feel
      that sympathetic stimulation modulates the parasympathetic innervation of the
      bladder.

PMID- 2231912
TI  - Mechanical properties of the urethra in healthy and stress incontinent females:
      dynamic measurements in the resting urethra.
AB  - The relationship between pressure and cross-sectional area in the resting urethra
      during its inflation and deflation was examined in 30 healthy females and in 30
      patients with genuine stress incontinence (GSI). Measurements were performed at
      the bladder neck, in the high-pressure zone and distally in the urethra. The
      mechanical properties of the urethra were found to vary significantly as a
      function of time after induction of a cross-sectional area (stress episode) in
      both groups of women. The pattern of response of the urethra showed significant
      differences between normals and GSI particularly during dynamic conditions. Our
      results indicate that mechanical laxity of the urethra at the bladder neck and
      midurethrally especially at dynamic events (stress episodes) is of
      pathophysiological importance in GSI.

PMID- 2231914
TI  - Long term effects of gastrocystoplasty in rats.
AB  - Twenty prepubescent rats underwent microsurgical gastrocystoplasty by a technique
      which is described. An equal number of control rats had their bladders opened and
      closed. Rats were sacrificed at 16 to 18 months postoperatively. There were no
      differences in final weight, serum electrolytes, or renal function between the
      two groups. Prominent histopathologic changes of the bladder occurred in the
      gastrocystoplasty group. These changes included papillomas present in five of the
      15 rats surviving long term. No significant changes occurred in the bladders of
      the control group of rats. Possible etiologies and the significance of the rats.
      Possible etiologies and the significance of the gastrocystoplasty related lesions
      are discussed.

PMID- 2231913
TI  - Time-course of alterations of bladder function following acetone-induced
      cystitis.
AB  - Although chemical cystitis is known clinically to cause decreased bladder
      function, there are few experimental studies on the progression of, and recovery
      from chemical cystitis. Mature male rabbits underwent intravesical instillation
      of 50% acetone solution through a urethral catheter. Micturition profiles showed
      a marked decrease of the mean and maximal micturition volume and an increase in
      number of micturitions as early as one day after treatment. The micturition
      profile gradually normalized between four and eight weeks after instillation. In
      vivo cystometry showed a very small bladder capacity and low compliance during
      the first week following instillation, and gradually recovered to control levels
      by four weeks. Functional studies using the in vitro whole bladder model showed a
      significant decrease in the ability of the bladder to generate pressure and to
      empty at three days after instillation. These parameters recovered partially by
      two weeks, and completely by four weeks. Chemical cystitis induced by
      intravesical acetone instillation resulted in a severe decrease in the bladder
      function, i.e. contracted bladder with low compliance and poor ability to
      generate pressure and empty. However, these changes were reversible within the
      two month period of study.

PMID- 2231915
TI  - Comparison of antigen expression on normal urothelial cells in tissue section and
      tissue culture.
AB  - Antigenic characterization of urothelial cells cultured from normal adult ureter
      was performed. These cells were cultured using a simplified isolation and culture
      technique and a commercially available serum-free medium. The cells growing in
      these cultures had epithelioid morphology and normal quantities of DNA. The
      antigen expression on these cultured normal urothelial cells was evaluated using
      a panel of monoclonal antibodies: 5G6.4, AN43, URO-5, anti-keratin and anti-blood
      group antibodies, and 425 (anti-epidermal growth factor receptor). Lower levels
      of anti-A and AN43 binding on cultured cells were observed than are seen on
      urothelial cells in sections of normal ureter, while the binding of anti-blood
      group H, 5G6.4, and URO-5 was unchanged. Binding of anti-epidermal growth factor
      receptor antibody 425 was improved if the cells were grown in medium lacking
      epidermal growth factor. These results confirm the urothelial origin of these
      cultured urothelial cells but indicate that some antigenic differences between
      cultured normal urothelial cells and urothelial cells in situ in the normal
      ureter exist.

PMID- 2231916
TI  - Hyperfiltration-induced renal injury in normal man: myth or reality.
AB  - Current knowledge fails to support the notion that adaptive hyperfiltration of
      the remnant kidney after donor nephrectomy is deleterious. Rather than being
      maladaptive, hyperfiltration appropriately compensates for the loss of functional
      renal mass. Accordingly, most kidney donors can be expected to maintain a stable
      level of renal function without proteinuria or hypertension. Essential to this is
      proper selection of donors for nephrectomy and exclusion of high risk potential
      donors, bearing in mind the fact that apparently healthy, asymptomatic relatives
      of end stage renal disease patients are prone to the same disease processes that
      inflict the general population and have a higher risk of underlying renal
      disease.

PMID- 2231917
TI  - Fatal sepsis following intravesical bacillus Calmette-Guerin administration for
      bladder cancer.
AB  - Intravesical administration of bacillus Calmette-Guerin has been shown to be
      highly effective treatment of superficial bladder cancer. Complications from
      bacillus Calmette-Guerin therapy are usually minor but serious and even fatal
      reactions can occur. Five recent cases illustrate the gravity of bacillus
      Calmette-Guerin sepsis. One man with severe debility and the organic brain
      syndrome died acutely with a fever of 40 C. Two men had frank sepsis that
      progressed to multiorgan failure and death. Sepsis progressed despite the use of
      isoniazid, rifampin and streptomycin. Two men who had equally progressive sepsis
      with intravesical bacillus Calmette-Guerin survived with the use of cycloserine
      for the first 72 hours of treatment. Triple antituberculous antibiotics,
      including cycloserine, may be lifesaving. Sepsis resulted from intravenous
      absorption through inflamed or disrupted urothelium. Bacillus Calmette-Guerin
      treatment should not be administered in the presence of severe cystitis or after
      grossly traumatic catheterization.

PMID- 2231919
TI  - 3-dimensional imaging of the pelviocaliceal system by computerized tomographic
      reconstruction.
AB  - Safe and efficient performance of percutaneous nephrolithotomy requires 3
      dimensional visualization of the pelviocaliceal anatomy. However, currently
      available modalities offer only 2-dimensional images, from which the operator
      must mentally reconstruct a 3-dimensional picture of the pelviocaliceal
      configuration. We evaluated the feasibility of obtaining 3-dimensional images of
      the pelviocaliceal system with the aid of computerized tomographic reconstruction
      and present 3 illustrative cases.

PMID- 2231918
TI  - Fatal disseminated mycobacterial infection following intravesical bacillus
      Calmette-Guerin.
AB  - We describe a fatal case of disseminated mycobacteriosis after intravesical
      bacillus Calmette-Guerin immunotherapy. We summarize the prior safety record of
      this therapeutic modality, discuss local and systemic pathophysiological
      mechanisms by which dissemination might have occurred, and review the reported
      clinical experience with antituberculous chemotherapy for significant bacillus
      Calmette-Guerin infection. Finally, we offer suggestions for prophylaxis of
      certain patients with a history of exposure to intravesical bacillus Calmette
      Guerin.

PMID- 2231920
TI  - Triamterene nephrolithiasis: renewed attention is warranted.
AB  - Although triamterene has been known to contribute to urinary calculus formation,
      it has been presumed to be a rare phenomenon. Our review of stone analyses
      performed during the last decade by a single laboratory reveals an increasing
      incidence of triamterene stones. Awareness of the calculogenic potential of
      triamterene-containing medications should be re-emphasized.

PMID- 2231921
TI  - Prospective comparison of plain abdominal radiography with conventional and
      digital renal tomography in assessing renal extracorporeal shock wave lithotripsy
      patients.
AB  - Most publications citing the effectiveness of renal extracorporeal shock wave
      lithotripsy have used plain abdominal radiography to assess residual calculi
      after treatment. We compared radiologist sensitivity and specificity in the
      detection of calculi on plain abdominal radiographs versus conventional film
      screen and digital renal tomograms in extracorporeal shock wave lithotripsy
      patients. Of the patients 50 were imaged before and within 24 hours after
      lithotripsy. Six radiologists evaluated the resultant 300 studies for the
      presence and location of calculi. The mean sensitivity for digital tomograms was
      83% for pre-lithotripsy and post-lithotripsy studies, which was significantly
      higher than for plain abdominal radiography and conventional tomography after
      lithotripsy. However, there were significantly more false positive stone
      diagnoses associated with digital tomogram interpretation. Signal detection
      analysis verified the over-all superiority of digital tomography for post
      extracorporeal shock wave lithotripsy imaging. Calculus detection by conventional
      and digital tomography is superior to detection by plain abdominal radiography.
      However, because we did not perform delayed imaging, it is not possible to say
      what impact digital tomography might have on the management of extracorporeal
      shock wave lithotripsy patients.

PMID- 2231922
TI  - Extracorporeal shock wave lithotripsy in patients with bleeding diatheses.
AB  - Five patients with known bleeding diatheses were treated with extracorporeal
      shock wave lithotripsy. Specific therapy was administered before extracorporeal
      shock wave lithotripsy to reverse the bleeding disorder. After treatment each
      patient was monitored with serial hemoglobin determinations and renal
      ultrasonography. The course during and after lithotripsy was uneventful in all
      patients. We conclude that extracorporeal shock wave lithotripsy is a viable
      option for patients with significant bleeding diatheses provided that specific
      therapy to reverse the coagulopathic condition is available and used before
      treatment.

PMID- 2231923
TI  - Outcome of renal transplantation after urinary diversion and enterocystoplasty: a
      retrospective, controlled study.
AB  - A total of 17 patients with intestinal urinary diversion of enterocystoplasty
      underwent renal transplantation between 1970 and 1988. Patient age ranged from 4
      to 35 years (mean age 20 years). The patients were divided into 2 groups. In
      group 1 (10 patients, 2 of whom required retransplantation) the ureter of the
      transplanted kidney was implanted into an ileal (7) or colonic (1) conduit or
      enterocystoplasty (2). In group 2 (7 patients, 1 of whom required a second
      transplant) the diversion was taken down and the transplanted ureter was
      implanted into the defunctionalized bladder. There were 14 living related and 6
      cadaveric kidneys transplanted. Graft survival rates were 58 and 87% in groups 1
      and 2, respectively, with an over-all rate of 70% (14 of 20 kidneys). There was
      no statistical difference in the graft survival rate between the 2 groups. The
      complications in group 1 included ureteroileal anastomotic leak (3 patients),
      ureteroileal stenosis (1), calculus formation (1), urosepsis (1), hyperchloremic
      metabolic acidosis (1), and wound infection and dehiscence (1). There were no
      complications in group 2. Renal transplantation into a pre-existing urinary
      intestinal conduit or augmented bladder does not statistically adversely affect
      patient or graft survival. However, the complication rate is much higher when the
      ureter is implanted into an intestinal segment. Therefore, it is preferable
      whenever possible to implant the ureter into the native bladder.

PMID- 2231924
TI  - Nephron-sparing surgery for renal cell carcinoma with venous involvement.
AB  - A nephron-sparing operation recently has been shown to provide extended survival
      free of disease in selected patients with localized renal cell carcinoma,
      particularly for tumors of lower stage. To define better the role of conservative
      surgical treatment in more locally advanced renal cell carcinoma we reviewed 9
      patients with venous tumor involvement in solitary functioning kidneys who
      underwent a nephron-sparing operation. Complete tumor resection with adequate
      preservation of renal function was accomplished in all cases. Of the 9 patients 5
      had no evidence of disease 7 to 93 months (mean 33.2 months) postoperatively. The
      remaining 4 patients died of metastatic renal cell carcinoma 17 to 47 months
      (mean 35.5 months) postoperatively, 2 of whom had concomitant local recurrences
      in the renal remnant. Based on previously reported results of total nephrectomy
      for renal cell carcinoma with venous involvement and the morbidity associated
      with renal replacement therapy, we believe that a nephron-sparing operation is a
      viable option in the management of these patients.

PMID- 2231925
TI  - Radiation exposure during ureteroscopy.
AB  - Use of fluoroscopy during ureteroscopy increases the risk of radiation exposure
      to the urologist and patient. Radiation entrance dosages were measured at skin
      level in 37 patients, and at the neck, trunk and finger of the urologist, and
      neck and trunk of the circulating nurse. Radiation exposure time was measured in
      79 patients, and was related to the purpose of the procedure and the type of
      ureteroscope used, whether rigid or flexible. Exposure could be minimized by
      decreasing the fluoroscopy time. A portable C-arm fluoroscopy unit with
      electronic imaging and last image hold mode should be used to minimize exposure
      time. Lead aprons and thyroid shields should be used by the urologist and other
      personnel in the endoscopy room.

PMID- 2231926
TI  - The detubularized right colonic segment as urinary reservoir: evolution of
      technique for continent diversion.
AB  - Continent diversion of urine via a cecal-right colonic reservoir has been
      performed at our university hospital since 1977. Several modifications of
      surgical technique have been devised to prevent problems of urinary leakage and
      difficulties in catheterization. The current technique, used during the last 3
      years on 14 patients, involves use of a detubularized right colonic segment as a
      reservoir, ileal mesenteric exclusion, fashioning the intussuscepted ileal nipple
      valve with staples and anchoring of a fascia strip sling around the nipple base
      to the anterior rectus sheath. Complication from the reservoir outlet occurred in
      only 1 patient.

PMID- 2231927
TI  - Adverse impact of fibrin clot inhibitors on intravesical bacillus Calmette-Guerin
      therapy for superficial bladder tumors.
AB  - Although intravesical bacillus Calmette-Guerin therapy has proved to be
      efficacious in the treatment and prophylaxis against tumor recurrence of
      superficial bladder tumors, its mechanism of action has not been fully
      elucidated. Previous work has suggested that bacillus Calmette-Guerin organisms
      attach to the matrix protein, fibronectin, during fibrin clot formation at sites
      of urothelial disruption and that this attachment was required for the antitumor
      effect of bacillus Calmette-Guerin to be expressed. Furthermore, drugs inhibiting
      clot formation were found to abrogate the antitumor effect of intravesical
      bacillus Calmette-Guerin therapy in a murine bladder tumor model. To examine the
      effect of inhibitors of fibrin clot formation on the results of intravesical
      bacillus Calmette-Guerin therapy, a retrospective analysis of 149 evaluable
      patients receiving intravesical bacillus Calmette-Guerin for superficial bladder
      tumors was performed. The over-all response rate free of tumor for 29 patients
      who concomitantly received inhibitors of fibrin clot formation with bacillus
      Calmette-Guerin therapy was 48%, as compared with 67% for 120 patients who were
      not receiving these medications (p = 0.0655, chi-square). The most striking
      difference was noted for patients who failed with recurrent superficial disease.
      Of the patients who received fibrin clot inhibitors during intravesical bacillus
      Calmette-Guerin therapy 35% had recurrent superficial tumors compared to only 8%
      of those who did not receive these drugs during a mean followup of 29.8 plus or
      minus 11 months (p = 0.005, chi-square). Our study suggests that inhibitors of
      fibrin clot formation may have an adverse influence on the results of
      intravesical bacillus Calmette-Guerin therapy for superficial bladder tumors.

PMID- 2231928
TI  - Outpatient flexible cystoscopy and fulguration of recurrent superficial bladder
      tumors.
AB  - Flexible cystoendoscopy and fulguration were used in the outpatient management of
      185 patients with superficial bladder tumors followed for 24 months. This method
      provided optimal surveillance for recurrence and successful tumor control in
      selected cases.

PMID- 2231929
TI  - Primary malignant lymphoma of the bladder.
AB  - We treated 11 patients with primary malignant lymphoma of the bladder. The
      typical patient is a woman more than 50 years old who presents with urgency and
      frequency of micturition, and occasionally gross hematuria. Hydronephrosis is
      present in half of the patients and cystoscopy usually reveals a solid tumor.
      Partial cystectomy, when feasible, with or without radiotherapy and chemotherapy
      is the usual treatment modality. When localized to the bladder, malignant
      lymphoma has an over-all favorable prognosis.

PMID- 2231930
TI  - Salvage posterior urethroplasty after failed initial repair of pelvic fracture
      membranous urethral defects.
AB  - Experience with 20 salvage urethroplasties in patients with pelvic fracture
      membranous urethral defects who failed previous delayed urethroplasty is
      presented. A total of 15 patients was successfully managed by 1-stage procedures,
      14 by bulboprostatic reanastomosis and 1 by a tubed pedicled island of skin.
      Substitution urethroplasty with a staged perineoscrotal skin tube inlay was
      performed in 5 patients in whom an anastomosis could not be achieved either due
      to an excessively long urethral defect or inelasticity of the anterior urethra
      precluding its elongation for an anastomosis free of tension. A successful result
      was achieved in 19 of the 20 patients (95%). The rationale for procedure
      selection is discussed.

PMID- 2231931
TI  - Prostacyclin-to-thromboxane A2 ratio in arteriogenic impotence.
AB  - It has been suggested that penile hypercoagulability predisposes to aging penile
      vascular changes and impotence, and that elevated thromboxane A2 during erection
      may contribute to hypercoagulability and atherosclerosis. Since the ratio of the
      prostacyclin concentration to the thromboxane A2 concentration is constantly
      maintained in normal hemostatic responses, an imbalance between thromboxane A2
      and prostacyclin may be a factor to initiate vascular diseases and decrease blood
      flow. We assess the usefulness of the prostacyclin-to-thromboxane A2 ratio in
      penile blood during erection for diagnosis of arteriogenic impotence. The ratio
      in the arteriogenic impotence group was significantly lower (p less than 0.01)
      than in the psychogenic and venogenic impotence groups. Therefore, the
      prostacyclin-to-thromboxane A2 ratio seems to be useful to diagnose arteriogenic
      impotence.

PMID- 2231932
TI  - The natural history of Peyronie's disease.
AB  - The natural history of Peyronie's disease was evaluated in 97 men by means of a
      questionnaire. Disease duration ranged from 3 months to 8 years. Questions
      addressed pain, bending, ability for intercourse, over-all effect of the disease,
      psychological effects, treatments received and degree of disease progression.
      Approximately 40% of the patients found pain, bending, ability for intercourse
      and over-all effects to be unchanged during the course of the disease. Bending
      and ability for relations worsened in 40% of the patients during the same
      interval, while only 6% had worsening of pain. Of the patients 77% reported
      psychological effects due to Peyronie's disease, which improved in 28%, did not
      change in 36% and worsened in 36%. Over-all, 13% of the patients believed the
      disease to be one of gradual resolution, 47% believed there had been little or no
      change and 40% believed that the disease pattern was one of gradual progression.
      We found no statistically significant association between disease duration and
      spontaneous improvement in penile bending. A similar lack of statistical
      significance was found when improvement in a variety of categories was compared
      in patients who received no therapy versus those who received a variety of
      conventional medical therapies.

PMID- 2231933
TI  - Ultrasonographic characteristics of the seminal vesicles after ejaculation.
AB  - A total of 12 men from a sperm donor bank underwent transrectal ultrasonography
      before and after ejaculation to investigate possible changes that could influence
      interpretation of seminal vesicle ultrasonography. The mean length of the seminal
      vesicles was 2.98 cm. before and 2.95 cm. after ejaculation. The anteroposterior
      diameter decreased only from 0.59 to 0.52 cm. Minimal differences were noted
      between the right and left seminal vesicles, and the greatest variation in size
      in an individual was only 3 mm. These results indicate that interpretation of
      seminal vesicle anatomy as seen by ultrasonography does not depend upon the
      temporal relationship to ejaculation.

PMID- 2231934
TI  - Clinical and pathological findings in prostates following intravesical bacillus
      Calmette-Guerin instillations.
AB  - The prostates of 36 patients who were treated with intravesical bacillus Calmette
      Guerin were evaluated by digital rectal examination and transrectal
      ultrasonography. When abnormal palpatory and/or ultrasonographic findings were
      detected, core needle biopsies from the suspicious areas were performed. Of the
      36 patients 20 underwent biopsies of the prostate. Pathological findings revealed
      typical granulomas in 8 patients (3 caseating and 5 noncaseating multifocal
      granulomas). Nonspecific chronic prostatitis was noted in 4 patients and benign
      prostatic hyperplasia was noted in 8. The number of bacillus Calmette-Guerin
      instillations ranged from 6 to 19. The interval from initiation of therapy to
      biopsy ranged from 1.5 to 14.5 months. Caseating granulomas were found during the
      early course of bacillus Calmette-Guerin instillations (1.5 to 3.0 months),
      whereas noncaseating granulomas were detected at later stages (4 to 14.5 months).
      These findings present a high incidence of granuloma formation in patients
      treated with intravesical bacillus Calmette-Guerin. The duration of therapy is a
      determinant factor in the induction of granuloma type.

PMID- 2231935
TI  - The prognostic value of modal deoxyribonucleic acid in low grade, low stage
      untreated prostate cancer.
AB  - We selected for a prospective surveillance study 167 patients with untreated
      grades 1 and 2 prostate cancer. The tumors were classified regarding modal
      deoxyribonucleic acid value (ploidy) by flow cytometry, cytological grade by
      transrectal fine needle aspiration biopsy and local tumor stage. Of the patients
      146 could be evaluated. Mean followup was 50 months. The initial ploidy was
      statistically correlated to cytological grade but not to initial local tumor
      stage, prostatic acid phosphatase activity or patient age. Initial ploidy and
      cytological grade had a prognostic value regarding local tumor progression when
      considered as single predictors and in combination. Two patients with diploid and
      8 with nondiploid tumors initially had metastases during the surveillance. Five
      patients (1 with diploid and 4 with nondiploid disease) died of prostatic cancer.
      Modal deoxyribonucleic acid value and cytological grade were of prognostic value
      in untreated prostate cancer.

PMID- 2231936
TI  - Evaluation of tumor progression by repeated fine needle biopsies in prostate
      adenocarcinoma: modal deoxyribonucleic acid value and cytological
      differentiation.
AB  - Repeated fine needle aspiration biopsies of the prostate were taken during a
      period of 24 months or more from 84 patients with untreated prostate cancer.
      Serial followup regarding modal deoxyribonucleic acid values and cytological
      differentiation of the tumor cells was possible in 72 and 78 patients,
      respectively. During followup the modal deoxyribonucleic acid values in the tumor
      cells changed towards an increased aneuploidy in 17 patients and the cytological
      differentiation decreased in 18. These findings of a change in modal
      deoxyribonucleic acid values and cytological differentiation of prostate cancer
      cells during the course of untreated patients support the concept of a gradual
      dedifferentiation of prostate cancer.

PMID- 2231937
TI  - Total pelvic exenteration with simultaneous bowel and urinary reconstruction.
AB  - The technique of total pelvic exenteration with simultaneous bowel and urinary
      reconstruction is described as a surgical option for the management of pelvic
      sarcoma in adults and for highly selected patients with other types of advanced
      pelvic malignancy. The surgical technique is presented in detail as performed in
      a 43-year-old man who presented with extensive primitive pelvic sarcoma. We
      believe that this approach may provide the benefits of an exenterative operation
      without the undesirable psychosocial sequelae of a permanent colostomy and
      external urinary diversion.

PMID- 2231938
TI  - The value of leak pressure and bladder compliance in the urodynamic evaluation of
      meningomyelocele patients.
AB  - A total of 61 patients with myelodysplasia underwent water cystometry and
      electromyography of the external sphincter. Of these patients 27 underwent video
      fluorourodynamics as a part of preoperative evaluation or instead of a voiding
      cystometrogram. Renal quantitative scintillation camera studies detected 7
      patients with mild upper tract deterioration, even when other tests failed to do
      so. A total of 31 patients had upper tract deterioration as detected by excretory
      urography, ultrasound and/or renal scan studies, and were designated as group 1,
      while 30 had normal upper tracts and were designated as group 2. Bladder
      compliance in group 1 was significantly lower than that in group 2 (4.5 versus
      11.3 ml./cm. water, p = 0.001). Leak pressure in group 1 was significantly higher
      than in group 2 (42.3 versus 26.1 cm. water, p = 0.019). In summary, patients
      with evidence of upper tract deterioration had lower bladder compliance and
      higher leak pressure than patients with normal kidneys.

PMID- 2231939
TI  - Renal autotransplantation in children: a successful treatment for renovascular
      hypertension.
AB  - Renovascular hypertension in children is not a common disease. With improved
      surgical technique the incidence of nephrectomy has decreased and renovascular
      reconstruction is currently the preferred method to manage this entity. Between
      1977 and 1988, 21 patients with renovascular hypertension were treated at our
      hospital: 7 patients 6 to 16 years old underwent renal autotransplantation. Of
      the children 4 had unilateral and 3 had bilateral disease requiring bilateral
      autotransplantation. Autotransplantation was performed by anastomosis of each
      renal artery end-to-side to the common iliac artery. The renal veins were
      anastomosed end-to-side to the common iliac veins. The ureters were left intact
      in all but 1 patient who required a bench operation. Of the 4 patients who had a
      unilateral procedure 3 are cured and 1 is improved with a normal blood pressure
      on a small dose of antihypertensive medication. The 3 patients with bilateral
      autotransplants are cured. These results, with normalization of the blood
      pressure in 86% of the patients and improvement in blood pressure in 14% with a
      patency rate of 87%, are similar to other reported reconstructive modalities in
      children.

PMID- 2231940
TI  - Management of children with myelodysplasia: urological alternatives.
AB  - Recent reports have suggested that the prophylactic use of clean intermittent
      catheterization in selected infants with myelodysplasia and with normal upper
      tracts may prevent their deterioration. The selection of these patients at risk
      depends on urodynamic criteria. We reviewed our experience with clean
      intermittent catheterization instituted when upper tract deterioration was found.
      Of 130 patients with myelodysplasia followed at our clinic 25 (19%) had or
      presented with radiological upper urinary tract deterioration. A total of 21
      patients had vesicoureteral reflux and 4 had hydronephrosis without reflux.
      Treatment consisted of clean intermittent catheterization alone in 5 patients and
      combined with anticholinergic medication in 16. Four patients with no post-void
      residual urine were carefully observed without intervention. Urodynamic
      evaluation was performed selectively in 11 of these 25 patients for persistence
      of upper urinary tract deterioration or urinary incontinence after institution of
      treatment. Of the 21 children with reflux 19 (90%) had resolution or improvement
      for an average followup of 47 months. Hydronephrosis completely resolved in the 4
      patients without reflux. Thus, the over-all resolution or improvement rate was
      92% for an average of 41 months. Although these excellent results may not be
      superior to the prophylactic use of clean intermittent catheterization, they
      validate the assumption that upper tract deterioration can be reversed. The
      application of current urodynamic selection criteria may result in overtreating a
      significant number of infants who otherwise may not have upper tract
      deterioration. Further refinements in these criteria may be necessary to select
      better not only patients at risk but also to determine the frequency of imaging
      necessary in this urologically heterogeneous population. In addition, careful
      consideration should be given to urethral dilation as a third and equally viable
      alternative to prevent upper tract deterioration.

PMID- 2231941
TI  - Isolated primary aldosteronism in a patient with adrenal carcinoma and XY/XXY
      mosaic Klinefelter's syndrome.
AB  - Although breast cancer, germ cell tumors and other neoplasms are known to occur
      in patients with Klinefelter's syndrome, adrenal carcinoma has not yet been
      reported in such patients. We describe a rare case of severe primary
      aldosteronism as the unique manifestation of a large adrenocortical carcinoma in
      a patient with Klinefelter's syndrome. Complete biological and hormonal
      evaluation was performed. Surgical treatment was successful and the patient
      remained asymptomatic with normal biological and hormonal values after 1 year of
      followup.

PMID- 2231942
TI  - Renal scintigraphy in the diagnosis and surgical management of a patient with
      caliceal colic: a case report.
AB  - A patient with persistent renal colic and a caliceal stone is presented.
      Furosemide renography, commonly used to differentiate functional stasis from
      mechanical obstruction of an entire kidney or duplicated collecting system, can
      make this determination at the caliceal level. As in this case such determination
      can affect clinical management of the patient.

PMID- 2231943
TI  - A giant renal artery aneurysm diagnosed post partum.
AB  - We report a case of a 5.8 cm. right renal artery aneurysm diagnosed intact 8
      weeks post partum. Rupture of a renal arterial aneurysm during pregnancy is a
      rare but well described catastrophic event. There are no previous reports of an
      intact renal artery aneurysm diagnosed either ante partum or post partum. To our
      knowledge, this also represents the largest reported renal artery aneurysm. The
      aneurysm was repaired successfully with kidney salvage and closure of the
      fistulous connection to the renal vein.

PMID- 2231944
TI  - Recurrent vesicogluteal fistula due to sequestrum.

PMID- 2231945
TI  - Nonsteroidal anti-inflammatory drugs in the treatment of eosinophilic cystitis.
AB  - A 30-year-old white woman with urinary frequency, left costovertebral angle pain
      and hematuria had left hydronephrosis, a marked decrease in bladder capacity and
      severe eosinophilic cystitis on biopsy. She was treated with a nonsteroidal anti
      inflammatory drug and an antihistamine, with a dramatic, complete and rapid
      recovery. The nonsteroidal anti-inflammatory drug was believed to have been
      responsible for the favorable outcome, since antihistamines have not produced
      reliable benefits in this disease. Nonsteroidal anti-inflammatory drugs are
      recommended in cases of eosinophilic cystitis.

PMID- 2231946
TI  - Reverse coitus: mechanism of urethral injury in male partner.
AB  - Reverse coitus, a rarely used sexual position, makes the male urethra more
      vulnerable to injury from the pubic arch and symphysis pubis of the female
      partner. Severe pain, bleeding and immediate detumescence were observed in 3
      patients. The lesion usually occurred at the fossa navicularis, responded well to
      conservative management and did not hinder micturition. Potency has been well
      preserved in all 3 patients.

PMID- 2231947
TI  - Transrectal ultrasonography in the evaluation of the infertile man: a report of 3
      cases.
AB  - The traditional evaluation of the infertile man with azoospermia or low ejaculate
      volume includes determination of serum testosterone and follicle-stimulating
      hormone levels, a seminal fructose test, post-ejaculate urinalysis and,
      sometimes, vasography. Transrectal ultrasonography, a technique currently
      familiar to most urologists, recently has been added to our diagnostic
      armamentarium. This office-based imaging procedure provides an accurate
      assessment of the prostate, ejaculatory ducts and seminal vesicles, which can be
      helpful in the evaluation of certain infertile patients. We describe 3 patients
      who presented with either azoospermia or decreased ejaculate volume in whom
      transrectal ultrasonography had a critical role in the fertility evaluation. The
      clinical indications for and interpretation of transrectal ultrasonography in the
      infertile population are described. Transrectal ultrasonography currently is the
      most accurate, inexpensive and readily available noninvasive imaging technique
      used to diagnose obstruction of the ejaculatory ducts in the infertile patient
      with either azoospermia or low ejaculate volume.

PMID- 2231948
TI  - Gonadoblastoma in an anatomically normal man: a case report and literature
      review.
AB  - Gonadoblastoma, a rare gonadal neoplasm, presents most frequently in phenotypic
      female or phenotypically male patients with dysgenetic gonads or undescended
      testes. To date, only 2 cases of gonadoblastoma have been reported in
      anatomically normal male patients with scrotal testes. Both of these patients
      presented with testicular masses and germ cell tumors. We report a case of a
      genotypically and phenotypically normal, fertile man with descended testes who on
      evaluation for chronic orchialgia had a gonadoblastoma unaccompanied by a germ
      cell neoplasm. The tumor was nonpalpable and was initially discovered on scrotal
      ultrasound.

PMID- 2231949
TI  - Re: Radiographic assessment of renal trauma: a 10-year prospective study of
      patient selection.

PMID- 2231950
TI  - Ureteral stenosis in renal transplantation.

PMID- 2231951
TI  - Re: Review of an 8-year experience with modifications of endoscopic suspension of
      the bladder neck for female stress urinary incontinence.

PMID- 2231952
TI  - Size considerations for custom penile prostheses.

PMID- 2231953
TI  - Re: Carcinoma in situ of the testis.

PMID- 2231954
TI  - The kinetics of cellular proliferation in rat urinary bladder treated with N
      butyl-N-(4-hydroxybutyl)nitrosamine.
AB  - The cellular proliferation of the bladder epithelium was determined sequentially
      in rats treated with N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN). The
      incorporation of bromodeoxyuridine (BrdUrd) into the DNA synthesis phase was
      determined by an in vitro labeling technique. The percentage of labeled cells was
      expressed as the labeling index (LI). The average LI values in normal subjects
      and cancer-bearing subjects were 5.1(%) and 24.2(%) respectively. With the
      transition of the bladder epithelium from simple hyperplasia to cancer, the LI
      values of the bladder epithelium were increased. Cases of papillary or nodular
      (PN) hyperplasia were divided into two types according to the localization of the
      BrdUrd-labeled cells. The LI in PN hyperplasia was 12.4(%); the difference from
      cancer was significant. In another experiment, the effect of partial cystectomy
      on bladder tumors was examined. The group with partial cystectomy showed
      increases in grade and stage of cancer, and the LI of cancer was more than that
      in the group without partial cystectomy. The results indicate that partial
      cystectomy may play a role as promotor for bladder tumors. The current study may
      be of more practical value than is the conventional one for investigating the
      histogenesis and progression of human bladder cancer.

PMID- 2231955
TI  - Relaxation mechanisms of antispasmodics papaverine and thiphenamil on the human
      corpus cavernosum.
AB  - The relaxation mechanism of the antispasmodics, papaverine and thiphenamil on
      isolated human corpus cavernosum (CC) was investigated. CC tissues were obtained
      from 12 impotent men undergoing surgery for insertion of penile prostheses. CC
      preparations were mounted in a tissue bath and the isometric tension was
      recorded. Papaverine and thiphenamil consistently inhibited high-potassium ([K])
      induced contractions in a dose-dependent manner. Noradrenaline (NA)-induced
      contractions were inhibited by both agents in a non-competitive manner. The pD'2
      values were 4.77 +/- 0.20 for papaverine and 4.58 +/- 0.13 for thiphenamil.
      Papaverine at 10(-4) M, the concentration at which high-[K]-induced contraction
      was abolished, suppressed NA-induced contraction by approximately 85%. In the
      Ca2(+)-free solution containing two mM EGTA, NA-induced contraction was
      suppressed by approximately 90%. This contraction was inhibited by papaverine or
      thiphenamil in a dose-dependent manner and was abolished by papaverine at 10(-4).
      These results suggest that papaverine and thiphenamil relax CC tissue by the
      inhibition of extracellular Ca2+ influx (mainly voltage-dependent Ca2+ influx)
      and by the inhibition of release and/or storage of intracellular stored Ca2+.

PMID- 2231956
TI  - The use of prostaglandin F2 alpha for the prophylaxis of cyclophosphamide induced
      cystitis in rats.
AB  - It is well-established that cystitis is a significant cause of morbidity after
      cyclophosphamide administration in clinical populations. We induced hemorrhagic
      cystitis in rats using cyclophosphamide and compared controls to those pretreated
      with prostaglandin F2 alpha. Rats were then evaluated for differences in bladder
      weights, gross edema, gross bleeding, and histologic changes. The weights of the
      bladders which had been treated with cyclophosphamide were 94% greater than the
      controls. The weights of the bladders which were pretreated with prostaglandin F2
      alpha before cyclophosphamide were only 19% greater than controls. Significant
      differences were found between cyclophosphamide controls and prostaglandin F2
      alpha pretreated groups for gross weight (p less than .0005), gross edema (p less
      than .0005), and histology (.0005 less than p less than .005). We conclude that
      prostaglandin F2 alpha may be helpful in preventing cyclophosphamide induced
      cystitis.

PMID- 2231957
TI  - Pressure threshold for shock wave induced renal hemorrhage.
AB  - Studies were performed with an interest in determining a pressure threshold for
      extracorporeal shock wave induced renal damage. Histological evidence of
      intraparenchymal hemorrhage was used as an indicator of tissue trauma. Depilated
      C3H mice were anesthetized and placed on a special frame to enhance visualization
      and treatment of the kidneys in situ. A Wolf electrohydraulic generator and 9
      French probe designed for endoscopic use were utilized to expose the kidneys to
      10 double spherically divergent shock waves. Measurements of the shock waves
      revealed two positive pressure peaks of similar magnitude for each spark
      discharge. The kidneys were exposed to different peak pressures by choice of
      distance from the spark source and were removed immediately after treatment for
      histologic processing. A dose response was noted with severe corticomedullary
      damage apparent following 15 to 20 MPa shocks. Hemorrhage was more apparent in
      the medulla where evidence of damage could be seen following pressures as low as
      three to five MPa. When a latex membrane was interposed to prevent possible
      collapse of the initial bubble from the spark source against the skin surface,
      histological evaluation revealed substantial reduction of severe tissue damage
      associated with the highest pressures tested, 20 MPa. However, the threshold
      level for evidence of hemorrhage remained about three to five MPa. Hydrophonic
      measurements indicated that the membrane allowed transmission of the acoustic
      shock waves and suggested that collapse of the bubble generated by
      electrohydraulic probes may have local effects due to a cavitation-like
      mechanism.

PMID- 2231958
TI  - Physiologic and pathologic alterations associated with ultrasonically generated
      shock waves.
AB  - Kidneys of 25 dogs were treated with ultrasonic shock waves and examined for both
      physiologic and pathologic changes. The number of pulses ranged from 2,000 to
      8,000. The rate of the shock waves varied from one to 20 pulses per second. The
      difference in pulse rate did not affect the changes seen either acutely or in the
      delayed examination of the kidneys during the repair process. The physiologic and
      pathologic changes which occurred involved the renal tubule to a greater degree
      than the glomerulus. These alterations were resolving by one week following
      exposure to the shock waves.

PMID- 2231959
TI  - Cell injury associated calcium oxalate crystalluria.
AB  - Renal tubular cell damage, resulting in membranuria, was induced by the
      administration of subcutaneous gentamicin to male Sprague-Dawley rats. One group
      of rats received gentamicin only, while a second group was given gentamicin plus
      ethylene glycol in drinking water at a concentration which increased urine
      oxalate but alone did not cause calcium oxalate crystalluria. Crystalluria
      occurred early in the combined treatment groups and persisted for the duration of
      the experiment. Crystalluria was not present in animals receiving gentamicin or
      ethylene glycol only. These results suggest that cellular fragments can serve as
      heterogeneous foci for the nucleation of calcium oxalate crystals.

PMID- 2231960
TI  - Effect of thiorphan on the response of guinea-pig isolated urinary bladder to
      exogenous and endogenous tachykinins.
AB  - Thiorphan, a well known inhibitor of 'enkephalinase' (endopeptidase 24.11)
      potentiated and prolonged the contractile response to substance P (SP) and
      neurokinin A (NKA) on strips of the guinea-pig isolated urinary bladder and this
      effect was evident both in presence and absence of the mucosal layer. Thiorphan
      also enhanced and prolonged the capsaicin-induced contraction in strips from the
      bladder dome which is thought to be mediated by release of endogenous
      tachykinins. Exposure to capsaicin produced simultaneous release of SP- and
      tachykinin-like immunoreactivity both in presence and absence of mucosa. This
      effect of capsaicin was potentiated by thiorphan. Endopeptidase 24.11 activity
      was detected in the guinea-pig urinary bladder, being more concentrated in the
      mucosal than the muscular layer. These findings indicate that endopeptidase 24.11
      terminates the activity of tachykinins in the guinea-pig urinary bladder and
      modulates the intensity of the biological response produced after their release
      from peripheral endings of sensory nerves.

PMID- 2231961
TI  - Doppler color-flow images from a stenosed arterial model: interpretation of flow
      patterns.
AB  - The capability of the recently introduced Doppler color-flow mapping devices to
      accurately detect flow patterns in the region of an arterial stenosis was
      evaluated by use of an in vitro flow model. Pulsatile flow simulating that in a
      low-resistance vessel was induced through a straight acrylic tube, which
      alternatively contained axisymmetric stenoses of 0%, 20%, 40%, 60%, and 80%
      diameter reduction. Doppler color-flow mapper images were taken in realtime along
      the tube midplane from 0 to 8 diameters downstream of each stenosis. Comparison
      of the Doppler color-flow mapping results with similarly recorded flow
      visualization (hydrogen bubble) images showed a close correspondence of key
      features of the flow, including detection of a high-velocity, centerline jet and
      near-wall separated flow zones. Distinctive flow patterns exist with each
      stenotic case, and these should be of considerable value in diagnosing clinical
      disease conditions.

PMID- 2231962
TI  - Everted cervical vein for carotid patch angioplasty.
AB  - Because of the theoretic benefits of autologous vein we undertook an
      investigation to evaluate cervical veins (facial, external jugular) as patch
      material after carotid endarterectomy. A device that stimulated both
      circumferential fixation by sutures and radial tension exerted on in vivo patches
      was constructed to measure burst strength of tissue. Mean bursting pressure for
      groin saphenous vein (n = 10) was 94.5 +/- 15.1 pounds per square inch (psi),
      75.5 +/- 8.9 psi for ankle saphenous vein (n = 10), 83.3 +/- 14.5 psi for everted
      (double layer) cervical vein (n = 5) and 10 +/- 3.3 psi for single layer cervical
      vein (n = 5). No significant differences between saphenous vein at any level and
      everted (double layer) cervical vein, but all were significantly different from
      single layer cervical vein (p less than 0.05). From June 1987 through November
      1989, 19 patients underwent 21 carotid endarterectomies complemented with
      adjunctive everted cervical vein patch angioplasty. Indications for surgery were
      asymptomatic stenosis (53%), transient ischemic attack (29%), and cerebrovascular
      accident with recovery (18%). All patients were studied after surgery with duplex
      scanning. Asymptomatic recurrent stenosis was observed in one patient. Transient
      hypoglossal nerve dysfunction occurred in one other patient. One postoperative
      death occurred as a result of massive aspiration. These results indicate that
      everted cervical vein is comparable to the saphenous vein in resistance to
      bursting and can yield similar results as patch material after carotid
      endarterectomy. Accordingly, saphenous vein can be spared and lower extremity
      incisions avoided.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2231963
TI  - Inflammatory abdominal aortic aneurysm masquerading as occlusion of the inferior
      vena cava.
AB  - Inflammatory aneurysms are an uncommon disorder that represent between 5% and 10%
      of abdominal aortic aneurysms. Their presentation is often variable and may
      include pain and obstruction of adjacent anatomic structures. This report
      describes a 68-year-old man who sought treatment after insidious onset of
      progressive bilateral lower extremity edema over a 6-month period. Noninvasive
      studies were suggestive of bilateral iliac vein occlusion, and a venogram showed
      a nearly obstructed vena cava from external compression. A CT scan showed a thick
      walled infrarenal abdominal aneurysm. At exploration an inflammatory abdominal
      aortic aneurysm was found. Because of the presence of dense inflammatory changes
      surrounding the aneurysm and extending into the pelvis, the surgical procedure of
      choice was an aortobifemoral bypass graft done with Dacron. The aneurysmal wall
      was debrided from the vena cava. His postoperative course was uneventful, his
      edema resolved, and follow-up noninvasive studies were normal. Postoperative
      venography showed resolution of the extrinsic compression of the vena cava.

PMID- 2231964
TI  - Material and structural characterization of human saphenous vein.
AB  - Saphenous vein patch rupture after carotid endarterectomy is an infrequent but
      devastating complication. This study was undertaken to evaluate the material and
      structural properties of fresh human saphenous veins to understand the causes of
      this complication. Segments of saphenous veins were obtained from 22 patients
      from vein harvested during coronary artery bypass surgery. Ninety-three
      specimens, oriented in both circumferential (n = 45) and longitudinal (n = 48)
      directions, were prepared from the available vein segments for testing. Specimens
      were mounted on specially designed grips and then subjected to uniaxial tension
      testing. For each specimen the following material and structural parameters were
      determined: vessel diameter, tensile stiffness, failure and ultimate forces, and
      tensile modulus, failure stress, and strain. The physical properties of specimens
      evaluated in longitudinal orientations and thus limit the inherent strength of
      the vein. The physical properties of circumferentially tested vein specimens were
      negatively correlated to age, female gender, diabetes, and hypertension. The data
      obtained in this investigation suggest that age, hypertension, as well as
      diabetes and gender may adversely influence the circumferential tensile strength
      of human saphenous veins used as patch grafts.

PMID- 2231965
TI  - An animal model for instructing and the study of in situ arterial bypass.
AB  - A canine model that used the cephalic vein to bypass from the brachial to the
      ulnar artery was designed for use in instructing and evaluating surgical
      technique needed for constructing an in situ arterial bypass. This model was used
      for instructing vascular residents in the in situ vein bypass technique. The use
      of this model enabled the resident to become more adept with the instruments for
      valve incision and construction of small vessel anastomosis. The improvement in
      the resident's operative technique was reflected by a decrease in the number of
      technical complications (missed valves, missed arteriovenous fistulas, poorly
      constructed anastomoses) and improved patency rate.

PMID- 2231966
TI  - Indications for distal arterial reconstruction in the presence of palpable pedal
      pulses.
AB  - Eight patients with severe pedal ischemia in the presence of palpable foot pulses
      are described. All had atherosclerosis, and seven patients also had diabetes.
      There were two anatomic patterns of disease, including supramalleolar obstruction
      with reconstitution of pulsatile flow in three patients and segmental occlusion
      of the pedal vessels in five. All patients underwent arterial reconstructive
      surgery. Patency was sustained in six patients, with limb salvage in five and
      below-knee amputation in one patient for persistent necrosis and infection of an
      open amputation. Of the two eventual bypass failures, a transmetatarsal
      amputation continued to heal in one patient, and the other required amputation
      below the knee. Palpable pedal pulses and satisfactory ankle/brachial indexes did
      not rule out the presence of surgically correctable distal arterial occlusive
      disease. Therefore arteriography is indicated in any patient with persistent
      forefoot ischemia that fails to respond to conservative measures. The safety and
      patency of the distal reconstructive procedures performed in this series suggest
      that salvage of weight-bearing tissue and rapid healing, as well as limb salvage,
      are legitimate indications for revascularization.

PMID- 2231967
TI  - Femur fracture with limb shortening causing occlusion of a
      polytetrafluoroethylene femoral popliteal graft.
AB  - Traumatic occlusion of lower extremity polytetrafluoroethylene arterial grafts is
      exceedingly rare. We report a patient who suffered a supracondylar femur fracture
      resulting in shortening of her right lower extremity with kinking and thrombosis
      of her above-knee polytetrafluoroethylene arterial graft. This is the first
      report in the English language of prosthetic graft occlusion as a result of
      traumatic limb shortening. The graft thrombus was successfully lysed by use of
      intraarterial urokinase, and the kink was repaired by graft resection and
      reanastomosis. The mechanism of injury and treatment are discussed.

PMID- 2231968
TI  - Intraabdominal hemorrhage as a result of segmental mediolytic arteritis of an
      omental artery: case report.
AB  - This article describes the fifth reported case of segmental mediolytic arteritis
      and the second in a survivor. The patient had intraabdominal bleeding as a result
      of a ruptured omental artery. The pathologic and arteriographic findings are
      described. The pathology is characterized by segmental disruption of the medial
      smooth muscle cells and the initiation of mediolysis. Mediolysis is associated
      with marked segmental thinning of the vessel wall, often with only the adventitia
      intact. Fibrin is deposited at the adventitial and medial surfaces, and
      hemorrhage into the media may occur. As in this reported case, lysis of the
      adventitia leads to sudden, often catastrophic intraabdominal hemorrhage. Little
      associated adventitial inflammation occurred. Segmental mediolytic arteritis
      seems to involve the intra-abdominal muscular arteries in elderly patients with
      nonspecific abdominal symptoms. An angiogram showed patchy areas of narrowing
      involving ileal, gastroduodenal, and renal arteries that correlated with the
      pathologic findings observed in the excised omental arteries.

PMID- 2231969
TI  - Popliteal artery agenesis: a new anatomic variant.
AB  - Agenesis of the popliteal artery has not been described as a vascular anomaly in
      the lower extremity. This case report describes congenital absence of the
      popliteal artery discovered during operative exploration after a traumatic injury
      to the lower extremity. The preoperative arteriogram suggested acute occlusion of
      the popliteal artery. Intraoperative exploration and arteriography were
      consistent with agenesis of the popliteal arterial segment, and postmortem
      examination confirmed these arteriographic and intraoperative observations.
      Embryologically, failure of the middle portion of the sciatic artery to persist
      would account for this anomaly. A review of series reporting congenital anomalies
      of the lower extremity vasculature failed to discover previous mention of this
      particular abnormality. Agenesis of the popliteal artery should be included among
      those vascular anomalies that may affect management of lower extremity vascular
      disease.

PMID- 2231970
TI  - Disseminated histoplasmosis with embolic endovascular complications: a case
      report.
AB  - A 57-year-old man had subacute embolic ischemia of his right foot and subsequent
      acute embolic ischemia of his left foot after angiography. Thrombus removed at
      the time of the left femoral thromboembolectomy grew Histoplasma capsulatum
      confirming the diagnosis of disseminated histoplasmosis. Surgical
      revascularization of the right leg and parenteral amphotericin B was followed by
      chronic ketoconazole therapy for 16 months. The patient has remained asymptomatic
      at 30 months after operation. Effective treatment of endovascular infection with
      ischemic complications of Histoplasmosis requires surgical revascularization and
      intensive chemotherapeutic intervention. Histoplasmosis is a ubiquitous infection
      in endemic areas that often has an asymptomatic subclinical course. Involvement
      of the cardiovascular system is rarely reported. Previous case reports have
      described infected cardiac valves and aortic aneurysms. This report describes the
      uncommon presentation of disseminated Histoplasma capsulatum infection as a
      peripheral embolic event and the successful management with revascularization
      combined with systemic amphotericin B followed by ketoconazole therapy.

PMID- 2231971
TI  - Indirect revascularization of the lower extremity by means of microvascular free
      muscle flap--a preliminary report.
AB  - We describe the treatment of a patient with end-stage peripheral vascular disease
      and ischemic ulceration of the lower extremity in whom an obliteration of the
      distal arterial bed precluded conventional arterial reconstruction. A nonhealing
      dorsal foot ulcer was debrided, and soft tissue reconstruction was accomplished
      by the free microsurgical transfer of a muscle flap to the distal lower
      extremity. Arterial inflow to this free flap was provided by a contralateral
      reversed saphenous vein graft from the proximal arterial tree of the leg. This
      procedure resulted in a healed wound, stable coverage, and limb salvage. The
      patient also noted complete relief of rest pain and improvement in his
      claudication symptoms. A follow-up arteriogram was done 2 months after surgery.
      Contrast injection directly into the artery of this flap showed new blood vessel
      growth from the muscle flap into the foot with anastomoses of these "new vessels"
      to the patient's native circulation. This experience suggests that limb salvage
      may be possible by the free microvascular transplantation of a muscle flap onto
      the limb in selected patients whose limbs are deemed "nonreconstructible."

PMID- 2231972
TI  - Unusual aspects of aortovenous fistulas associated with ruptured abdominal aortic
      aneurysms.
AB  - Three unusual cases of an abdominal aortic aneurysm spontaneously rupturing into
      the retroperitoneum and an adherent posterior vein are reported. No patient
      demonstrated signs or symptoms of an aortovenous fistula before surgery. Emergent
      surgery prevented extensive preoperative diagnostic testing. The three abdominal
      aortic aneurysms were very large and averaged 13 cm in diameter. One fistula
      involved an inflammatory aneurysm, which is the fifth such case reported. The
      aortic fistulas were to the inferior vena cava (158 other cases reported in the
      English-language literature), a left renal vein (16 other cases reported), and an
      iliac vein (7 other cases reported). Routine use of the cell-saver, oversewing of
      the fistula from within the aneurysm, and a heightened awareness that this
      unusual complication is more common in the presence of a very large, ruptured
      abdominal aortic aneurysm should improve survival.

PMID- 2231973
TI  - Popliteal artery occlusion caused by cystic adventitial disease: successful
      treatment by urokinase followed by nonresectional cystotomy.
AB  - Preoperative diagnosis of an occluded popliteal artery caused by cystic
      adventitial disease allowed use of urokinase to successfully dissolve secondary
      thrombosis. Subsequent non-resectional adventitial cystotomy and evacuation of
      cyst contents allowed lasting restoration of a patent arterial lumen and return
      of normal distal pulses. This nongrafting technique may serve as a model for
      future patients with occluded arteries caused by this condition.

PMID- 2231974
TI  - Deep vein obstruction and leg swelling caused by femoral ganglion.
AB  - We present a case of a rare ganglion cyst originating from the hip joint and
      compressing the common femoral vein producing signs and symptoms that mimicked a
      deep vein thrombosis. Excision of the mass promptly restored normal venous
      return. This condition has not been previously reported in the English-language
      medical literature.

PMID- 2231975
TI  - Hemodynamic characteristics of failing infrainguinal in situ vein bypass.
AB  - The successful follow-up of distal arterial reconstructions for the
      identification of the failing bypass in the postoperative period hinges on a
      knowledge of the natural history of flow characteristics in these
      reconstructions. Over a 4-year period resting and hyperemic bypass flow, fistula
      flow, conduit diameter, and distal peak systolic velocity of 350 in situ bypasses
      were measured serially. B-mode ultrasound imaging of the entire bypass was
      performed to identify specific stenoses. Measurements were performed 5 to 9 days
      after operation, every 2 months for the first year, and every 6 months
      thereafter. Distal bypass flow less than 25 ml/min, a ratio of hyperemic/resting
      distal bypass flow less than 2.5, and vein size less than or equal to 3.0 mm
      inner diameter all correlated with bypass stenosis (greater than 50%) or
      occlusion (p less than 0.01). Contrary to previous studies, a distal peak
      systolic velocity of less than 45 cm/sec did not correlate with bypass stenosis
      or occlusion. A low distal peak systolic velocity did correlate with bypass
      stenosis or occlusion in bypasses larger than or equal to 3.5 mm inner diameter
      (p less than 0.03). However, no combination of these factors was able to
      accurately predict preocclusive stenosis or occlusion. Distal bypass flow was
      highest initially but reached a plateau 6 to 12 months after operation. Fistula
      flow, although very high initially, showed marked decrement with time.

PMID- 2231976
TI  - Angioscopy guided semiclosed technique for in situ bypass.

PMID- 2231977
TI  - Should vascular surgery become an independent specialty?

PMID- 2231978
TI  - Perspectives from the Residency Review Committee.

PMID- 2231979
TI  - Vascular surgery--a specialty of surgery.

PMID- 2231980
TI  - Should vascular surgery become an independent specialty? Perspective of a program
      chairman and Residency Review Committee member.

PMID- 2231981
TI  - Should vascular surgery become an independent specialty? Implications of data
      about operative experience.

PMID- 2231982
TI  - Accreditation of vascular laboratories.

PMID- 2231983
TI  - Extended vein graft donation from a single lower extremity.

PMID- 2231984
TI  - Physicians hear about incontinence.

PMID- 2231985
TI  - Decade may be more than half over before acellular pertussis vaccines arrive on
      scene.

PMID- 2231986
TI  - Pertussis toxins, other antigens become likely targets for genetic engineering.

PMID- 2231987
TI  - British firm halts vaccine manufacture, research.

PMID- 2231988
TI  - From the Food and Drug Administration.

PMID- 2231989
TI  - From the Centers for Disease Control. Vaccine-preventable diseases among adults:
      standards for adult immunization practice.

PMID- 2231990
TI  - Frozen pre-embryos.

PMID- 2231991
TI  - Pertussis vaccine encephalopathy.

PMID- 2231992
TI  - Dobutamine overdose.

PMID- 2231993
TI  - The pituitary incidentaloma beyond the first year of follow-up.

PMID- 2231994
TI  - Admission source to the medical intensive care unit predicts hospital death
      independent of APACHE II score.
AB  - This study was conducted to determine if the source of admission to the medical
      intensive care unit (MICU) is associated with hospital death independent of the
      Acute Physiology and Chronic Health Evaluation (APACHE) II score. We calculated
      APACHE II scores and predicted risks of hospital death for 235 patients who were
      admitted to the MICU. The predicted death rate was the same as the actual rate
      for patients who were admitted directly from the emergency department (25% vs
      22%), but was less than the actual rate for patients who were transferred from
      hospital floors (38% vs 55%), the medical intermediate care unit (32% vs 59%),
      and other hospitals (21% vs 36%). Logistic regression analysis confirmed an
      independent association between the MICU admission source and risk of death. Our
      findings suggest that APACHE II does not measure illness severity accurately in
      all patients who are admitted to intensive care units. If our results are
      generalizable, using APACHE II to compare intensive care outcomes among hospitals
      could lead to wrong conclusions about quality of care. Improving predictions of
      hospital death rates among patients who are in MICUs may require the inclusion of
      new types of information in the classification system.

PMID- 2231995
TI  - Head injury--associated deaths from motorcycle crashes. Relationship to helmet
      use laws.
AB  - A review of US mortality data from 1979 to 1986 identified 15,194 deaths and
      nearly 600,000 years of potential life lost before age 65 years that were
      associated with head injuries from motorcycle crashes. White males from 15 to 34
      years of age accounted for 69% of the deaths. The rate of motorcycle-related
      deaths associated with head injury declined modestly between 1979 and 1986 (19%
      using rates based on resident population and 8% based on motorcycle
      registrations). Population-based rates adjusted for age, sex, and race in states
      with partial or no motorcycle helmet-use laws were almost twice those in states
      with comprehensive helmet-use laws. Two states that weakened their helmet-use
      laws from comprehensive to partial during the study period had increases in
      motorcycle-related head injury death rates (184% and 73%), and one state that
      strengthened its law from partial to comprehensive had a decline in its death
      rate (44%). Head injury death rates based on motorcycle registrations were also
      lowest in states with comprehensive helmet-use laws. Since helmets reduce the
      severity of nonfatal head injuries in addition to lowering the rate of fatal
      injuries, we urge the adoption and enforcement of comprehensive motorcycle helmet
      use legislation.

PMID- 2231996
TI  - Visual impairment in a rural Appalachian community. Prevalence and causes.
AB  - A population-based survey of 1136 subjects aged 40 years and older was conducted
      in a rural valley of Kentucky to determine the nature and extent of visual
      disability in an underserved area of rural America. Data on corrected visual
      acuity and ocular history, along with demographic, socioeconomic, and health care
      utilization parameters, were gathered. Those subjects with an acuity below 20/60
      in either eye underwent a comprehensive ophthalmologic examination. The
      prevalence of binocular blindness (acuity worse than 20/400 in the better eye)
      was 0.44% and of monocular blindness (acuity worse than 20/400 in one eye) was
      3.3%, approximately twice the national rates. The chief cause of bilateral visual
      impairment was macular degeneration among men and cataract among women. Cataract,
      trauma, and amblyopia were the major causes of monocular visual impairment in
      both sexes. Risk factor analysis revealed younger age, higher education, active
      employment, access to a health care facility, and comprehensive health insurance
      coverage to be inversely associated with visual impairment.

PMID- 2231997
TI  - Aspirin increases blood alcohol concentrations in humans after ingestion of
      ethanol.
AB  - Gastric first-pass metabolism of ethanol is an important determinant of blood
      alcohol concentrations. We studied five healthy volunteers after ingestion of
      ethanol (0.3 g/kg of body weight) and found that blood alcohol concentrations in
      the fed state (ie, 1 hour after a standard breakfast) were significantly higher
      when the subjects received 1 g of aspirin 1 hour before ingestion of ethanol than
      without the drug. In vitro, aspirin clearly decreased the activity of gastric
      alcohol dehydrogenase in human subjects and in rat models, but not that of
      hepatic alcohol dehydrogenase in rats. Furthermore, blood alcohol concentrations
      in rats were unaffected by ingestion of aspirin when ethanol was infused
      intravenously. Thus, aspirin may increase the bioavailability of ingested ethanol
      in humans, possibly by reducing ethanol oxidation by gastric alcohol
      dehydrogenase.

PMID- 2231998
TI  - The federal regulation of prescription drug advertising and promotion.
AB  - Prescription drug advertising has been regulated by the Food and Drug
      Administration since 1962. In the past decade, pharmaceutical companies have
      employed new communication mechanisms to reach physicians and, with increasing
      frequency, consumers. Examples of physician-oriented promotional activities are
      medical symposia and teleconferences. Consumer-oriented efforts include press
      conferences, use of celebrity spokespeople, and direct-to-consumer advertising.
      The Food and Drug Administration has asserted its legal jurisdiction over these
      nontraditional promotional activities and is regulating them on a case-by-case
      basis. As nontraditional promotional efforts become more prevalent, the Food and
      Drug Administration's regulatory framework must be able to meet the challenges of
      a changing environment.

PMID- 2231999
TI  - HIV infection, pregnant women, and newborns: A policy proposal for information
      and testing.
AB  - As the public health impact of human immunodeficiency virus (HIV) infection in
      women and children has increased, so has interest in screening pregnant women and
      newborns for evidence of HIV infection. However, screening of pregnant women and
      newborns raises profound moral, legal, and policy issues. In this article, we
      present and defend a detailed 10-point program of policy recommendations for both
      pregnant women and newborns. We advocate informing all pregnant women and new
      mothers about the HIV epidemic and the availability of testing.

PMID- 2232001
TI  - FDA regulation of prescription drug advertising.

PMID- 2232000
TI  - A formal audit of continuing medical education activity for license renewal.
AB  - Formal audits of the continuing medical education activities of physicians
      licensed in Michigan were undertaken to assess compliance with a law mandating
      participation in 150 hours of continuing medical education each 3 years. A random
      sample of all physicians renewing their licenses in 1987 and 1988 were asked to
      provide documentation of their continuing medical education activities. The
      average physician participated in 175 hours of category I approved activities;
      53.1% of the hours were obtained in a different state, and only 27.6% were
      obtained in the home community. A total of 13.7% (132/967) of the physicians were
      initially unable to document 150 hours of credit. Documentation deficiencies and
      addition errors were found on 72.5% of forms. If formal audits of compliance with
      legislation are to be undertaken, early notification of the participants and
      specific instructions for compliance are needed. Because of problems with
      documentation, only category I approved activities, with exclusions for trainees,
      should be used to assess compliance.

PMID- 2232003
TI  - A piece of my mind. View from a room.

PMID- 2232002
TI  - Continuing medical education at a crossroads.

PMID- 2232004
TI  - From the Office of the General Counsel. The right to die after Cruzan.

PMID- 2232005
TI  - Effects of exogenous steroids on basal body temperature.

PMID- 2232006
TI  - Chronic lower abdominal pain.

PMID- 2232007
TI  - Persistent open anterior fontanelle.

PMID- 2232008
TI  - 'Decade of brain' holds promise for answers to schizophrenia.

PMID- 2232009
TI  - Epidemiology indicates a disorder that assaults much of patients' 'humanness' in
      prime of life.

PMID- 2232010
TI  - Controversy grows over monitoring system for new schizophrenia drug.

PMID- 2232012
TI  - From the Centers for Disease Control. Cigarette smoking cessation--United States,
      1989.

PMID- 2232011
TI  - Psychiatrists increasingly able to assess, treat mental health problems of the
      very young.

PMID- 2232013
TI  - Determination of HIV-1 status of discarded sharps: polymerase chain reaction
      using minute quantities of blood.

PMID- 2232014
TI  - What matters magnesium?

PMID- 2232015
TI  - QALYs: their ethical implications.

PMID- 2232016
TI  - The myth of heterosexual AIDS: a review.

PMID- 2232017
TI  - The evaluation of hematuria in adults.

PMID- 2232018
TI  - Comorbidity of mental disorders with alcohol and other drug abuse. Results from
      the Epidemiologic Catchment Area (ECA) Study.
AB  - The prevalence of comorbid alcohol, other drug, and mental disorders in the US
      total community and institutional population was determined from 20,291 persons
      interviewed in the National Institute of Mental Health Epidemiologic Catchment
      Area Program. Estimated US population lifetime prevalence rates were 22.5% for
      any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and
      6.1% for other drug dependence-abuse. Among those with a mental disorder, the
      odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence
      of about 29% (including an overlapping 22% with an alcohol and 15% with another
      drug disorder). For those with either an alcohol or other drug disorder, the odds
      of having the other addictive disorder were seven times greater than in the rest
      of the population. Among those with an alcohol disorder, 37% had a comorbid
      mental disorder. The highest mental-addictive disorder comorbidity rate was found
      for those with drug (other than alcohol) disorders, among whom more than half
      (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals
      treated in specialty mental health and addictive disorder clinical settings have
      significantly higher odds of having comorbid disorders. Among the institutional
      settings, comorbidity of addictive and severe mental disorders was highest in the
      prison population, most notably with antisocial personality, schizophrenia, and
      bipolar disorders.

PMID- 2232019
TI  - Ten-year follow-up of behavioral, family-based treatment for obese children.
AB  - Using a prospective, randomized, controlled design, we examined the effects of
      behavioral family-based treatment on percent overweight and growth over 10 years
      in obese 6- to 12-year-old children. Obese children and their parents were
      randomized to three groups that were provided similar diet, exercise, and
      behavior management training but differed in the reinforcement for weight loss
      and behavior change. The child and parent group reinforced parent and child
      behavior change and weight loss, the child group reinforced child behavior change
      and weight loss, and the nonspecific control group reinforced families for
      attendance. Children in the child and parent group showed significantly greater
      decreases in percent overweight after 5 and 10 years (-11.2% and -7.5%,
      respectively) than children in the nonspecific control group (+ 7.9% and + 14.3%,
      respectively). Children in the child group showed increases in percent overweight
      after 5 and 10 years (+ 2.7% and + 4.5%, respectively) that were midway between
      those for the child and parent and nonspecific groups and not significantly
      different from either. At 10 years, child height was related strongly to the
      height of the parent of the same sex (r = .78 children were 1.8 cm taller than
      their parents, with no differences in height between groups.

PMID- 2232020
TI  - Anaphylaxis following ingestion of a psyllium-containing cereal.
AB  - Recently, psyllium hydrophilic mucilloid, a bulk-forming laxative, has been added
      to breakfast cereals for cholesterol-lowering effects. We report a case of a 60
      year-old woman with no prior history of psyllium ingestion who developed
      anaphylactic symptoms after eating a psyllium-containing cereal. Her only
      previous exposure was dispensing a psyllium-containing laxative as a nurse.
      Immunoglobulin E-mediated sensitization was documented by skin testing and
      basophil histamine release. The literature is reviewed regarding allergic
      reactions to psyllium. Health care workers and pharmaceutical workers handling
      psyllium may be at increased risk due to sensitization from inhalation.
      Physicians and consumers should be aware of potential serious reactions from
      eating psyllium-containing cereals even without prior history of ingestion of
      psyllium.

PMID- 2232021
TI  - The diagnosis and management of aortic dissection.
AB  - Aortic dissection is a severe disease. Most untreated patients with types I and
      II (proximal) dissection and over half of those with type III (distal) dissection
      die within 1 year. Most of the deaths occur within 2 weeks and are caused by
      rupture, aortic insufficiency, and branch vessel obstruction. Aortic dissection
      is suspected in patients with anterior chest and back pain that progresses
      downward. Diagnosis is confirmed by computed tomography, aortography, or
      echocardiography. Appropriate medical treatment and corrective surgery, including
      total aortic replacement, performed in the acute and chronic stages, are now
      successful in over 90% of the cases; long-term results of treatment are steadily
      improving and are expected to exceed 50% at 10 years. The keys to a successful
      outcome are being aware of the symptoms of dissection, early diagnosis, and
      prompt application of appropriate treatment; diligent follow-up includes
      controlling blood pressure, decreasing the velocity of left ventricular
      contraction, monitoring the size of the residual aorta, and taking appropriate
      action if redissection, aneurysmal formation, or rupture occurs.

PMID- 2232022
TI  - The future of psychiatry. Council on Long Range Planning and Development.
AB  - The American Medical Association Council on Long Range Planning and Development
      has been publishing a series of reports that assess trends in the environment of
      medicine and their impact on physicians and health care provision. The Council
      believes each specialty in medicine will respond differently to changes in the
      health care arena. This report, developed in cooperation with the American
      Psychiatric Association, provides an overview and environmental analysis of the
      specialty of psychiatry. Socioeconomic data pertinent to psychiatry are reviewed
      first, followed by a review of scientific and clinical developments in the
      specialty. Next, the changing provision patterns of psychiatric care, the
      emerging patient populations served by psychiatrists, and recent developments in
      graduate medical education in psychiatry are reviewed. The Council also addresses
      changes in the financing of psychiatric care. In conclusion, the Council suggests
      implications of these and other environmental trends for psychiatry.

PMID- 2232023
TI  - The progress and prospects of psychiatry.

PMID- 2232024
TI  - Treatment of obesity in children.

PMID- 2232025
TI  - Animal rights vs research? A question of the nation's scientific literacy.

PMID- 2232026
TI  - Diagnostic and therapeutic technology assessment. Dorsal rhizotomy.

PMID- 2232027
TI  - Synthetic vascular graft trials start; endothelialization seen as possible.

PMID- 2232028
TI  - Advances in diabetic retinopathy could save sight, money with more frequent eye
      exams.

PMID- 2232030
TI  - And some recommend it as a vampire prophylactic.

PMID- 2232029
TI  - Individualized care, as well as intensive care, may reduce morbidity among
      premature infants.

PMID- 2232031
TI  - From the Congressional Office of Technology Assessment.

PMID- 2232032
TI  - From the Centers for Disease Control. Cigarette brand use among adult smokers-
      United States, 1986.

PMID- 2232033
TI  - From the Centers for Disease Control. Analysis of L-tryptophan for etiology of
      eosinophilia-myalgia syndrome.

PMID- 2232034
TI  - Free cefixime in community health centers.

PMID- 2232035
TI  - The diagnosis of pulmonary embolism.

PMID- 2232036
TI  - HBV, HIV, and the proscription of intercourse.

PMID- 2232037
TI  - Air sampling for Legionella.

PMID- 2232038
TI  - The AMA specialty journals: everyone, including grunts, squeals unfair.

PMID- 2232039
TI  - The efficacy of preemployment drug screening for marijuana and cocaine in
      predicting employment outcome.
AB  - We present a prospective, controlled study of the association between
      preemployment drug screening results and employment outcomes in 2537 postal
      employees. For identified marijuana users, relative risk for turnover was 1.56
      (95% confidence interval [Cl], 1.17 to 2.08); accidents, 1.55 (95% Cl, 1.16 to
      2.08); injuries, 1.85 (95% Cl, 1.30 to 2.64); and discipline, 1.55 (95% Cl, 1.03
      to 2.32). Their mean absence rate was 7.1% compared with 4.0% for nonusers. For
      identified cocaine users, relative risk for turnover was 1.15 (95% Cl, 0.65 to
      2.05); accidents, 1.59 (95% Cl, 0.95 to 2.67); injuries, 1.85 (95% Cl, 1.01 to
      3.39); and discipline, 1.40 (95% Cl, 0.62 to 3.17). Their mean absence rate was
      9.8%. Our study shows that a preemployment drug screen positive for marijuana or
      cocaine is associated with adverse employment outcomes. The level of risk,
      however, is much less than previously estimated. This finding has important
      implications for the social, legal, and economic arguments for and against drug
      testing.

PMID- 2232040
TI  - Association of group C beta-hemolytic streptococci with endemic pharyngitis among
      college students.
AB  - Throat cultures were performed throughout 2 school years to determine whether non
      group A beta-hemolytic streptococci (NGA BHS) could be isolated more frequently
      in 232 college students who had symptomatic pharyngitis than from 198 age-matched
      controls with noninfectious problems. Duplicate throat swabs were inoculated onto
      plates that contained sheep blood agar, one plate being incubated in a 5% CO2
      atmosphere and the other in an anaerobic environment. The BHS were grouped using
      latex agglutination. Among the NGA BHS, only those from group C were isolated
      significantly more often among the patients compared with the controls (26% vs
      11%). Quantitative colony counts of isolates of group C BHS were generally higher
      among patients than controls. Patients with group C BHS had fever, exudative
      tonsillitis, and anterior cervical adenopathy significantly more frequently than
      did patients who had throat cultures that were negative for group C BHS. Group C
      BHS were epidemiologically associated with endemic pharyngitis in this college
      student population.

PMID- 2232042
TI  - Excess deaths from nine chronic diseases in the United States, 1986.
AB  - To assess excess mortality from chronic disease in the United States, state age
      adjusted combined mortality rates for nine chronic diseases in 1986 were compared
      with three "minimum" rates--two calculated from rates actually achieved in states
      and a third estimated as the mortality remaining after elimination of one risk
      factor for each disease. Hawaii had the lowest mortality rate of combined
      diseases (305/100,000); state excesses ranged from 0% to 37%. The sum of lowest
      disease-specific rates in any state was 284 per 100,000, indicating excesses of
      between 7% and 41%. A minimum mortality rate of 224 per 100,000 was estimated to
      result from elimination of one risk factor for each of the nine diseases,
      indicating state excesses from 26% to 54%, or 524,000 US deaths. Reduction of US
      mortality from the nine diseases to the risk factor--eliminated rate is estimated
      to be associated with an increased life expectancy at birth of 4 years.

PMID- 2232041
TI  - Prospective study of estrogen replacement therapy and risk of breast cancer in
      postmenopausal women.
AB  - We prospectively examined the use of estrogen replacement therapy in relation to
      breast cancer incidence in a cohort of women 30 to 55 years of age in 1976.
      During 367 187 person-years of follow-up among postmenopausal women, 722 incident
      cases of breast cancer were documented. Overall, past users of replacement
      estrogen were not at increased risk (relative risk, 0.98; 95% confidence
      interval, 0.81 to 1.18), including even those with more than 10 years since last
      [corrected] use (relative risk after adjustment for established risk factors,
      0.70; 95% confidence interval, 0.45 to 1.10). However, the risk of breast cancer
      was significantly elevated among current users (relative risk, 1.36; 95%
      confidence interval, 1.11 to 1.67). Among current users, a stronger relationship
      was observed with increasing age but not with increasing duration of use. These
      data suggest that long-term past use of estrogen replacement therapy is not
      related to risk of breast cancer but that current use may modestly increase risk.

PMID- 2232043
TI  - Diclofenac-associated hepatotoxicity.
AB  - Diclofenac sodium, a phenylacetic acid-derived nonsteroidal anti-inflammatory
      drug (NSAID) recently released in the United States, was associated with the
      development of significant hepatitis in seven patients, with one associated
      death. Signs and symptoms developed within several weeks of initiation of drug
      use and generally resolved 4 to 6 weeks following discontinuation of use of the
      drug. The only patient rechallenged with the drug developed a recurrence of her
      hepatic abnormalities. In one patient, fatal, fulminant hepatitis developed
      despite early withdrawal of the drug. Review of the European literature disclosed
      three additional fatalities associated with diclofenac therapy. It is unclear
      whether the incidence of hepatotoxicity is higher with this drug compared with
      other nonsteroidal anti-inflammatory drugs. Careful patient monitoring is
      advised, and prompt discontinuation of the drug is suggested when signs or
      symptoms of liver disease develop.

PMID- 2232044
TI  - Treatment of speech and voice disorders with botulinum toxin.

PMID- 2232045
TI  - Preemployment drug screening.

PMID- 2232046
TI  - Another side effect of NSAIDs.

PMID- 2232047
TI  - A piece of my mind. The only outlet.

PMID- 2232048
TI  - Mother to child: first living donor lung transplant.

PMID- 2232049
TI  - Helicobacter: new name, new hypothesis involving type of gastric cancer.

PMID- 2232050
TI  - Cold laser, arterial stent studies continue.

PMID- 2232051
TI  - Gene scene.

PMID- 2232052
TI  - From the National Institutes of Health.

PMID- 2232053
TI  - From the Centers for Disease Control. Cigarette sales to minors--Colorado, 1989.

PMID- 2232054
TI  - Fatal occupational injuries.

PMID- 2232055
TI  - House staff supervision and working hours.

PMID- 2232056
TI  - Informed consent and abortion.

PMID- 2232057
TI  - New approaches for inflammatory bowel disease.

PMID- 2232058
TI  - Substance abuse and anesthesiology training.

PMID- 2232059
TI  - Making a complete orthopod.

PMID- 2232060
TI  - Unbundling: neither canny nor fraud, merely unwitting.

PMID- 2232061
TI  - Senile lens exfoliation.

PMID- 2232062
TI  - Primary hypertriglyceridemia with borderline high cholesterol and elevated
      apolipoprotein B concentrations. Comparison of gemfibrozil vs lovastatin therapy.
AB  - A common pattern of dyslipidemia is elevated levels of plasma triglyceride,
      borderline high total cholesterol, reduced high-density lipoprotein, and
      increased apolipoprotein B. This pattern of dyslipidemia frequently is associated
      with premature coronary heart disease. Nicotinic acid is the drug of first choice
      for this pattern. In this study, gemfibrozil and lovastatin were compared for
      their effects on the overall lipoprotein profile in 13 men with this type of
      dyslipidemia. Both drugs significantly reduced very-low-density lipoprotein and
      intermediate-density lipoprotein cholesterol levels, and both modestly raised
      high-density lipoprotein cholesterol levels. Gemfibrozil therapy, however, failed
      to reduce total cholesterol or total apolipoprotein B levels, whereas lovastatin
      therapy lowered levels of total cholesterol by 28%, low-density lipoprotein
      cholesterol by 33%, and total apolipoprotein B by 32%. Moreover, lovastatin
      therapy caused greater declines in lipoprotein cholesterol ratios than
      gemfibrozil therapy. Lovastatin thus seems to have certain advantages over
      gemfibrozil for treatment of elevated plasma triglyceride levels accompanied by
      borderline high total cholesterol and raised apolipoprotein B levels; therefore,
      lovastatin therapy should be considered as one approach for management of this
      condition.

PMID- 2232063
TI  - The HIV-testing policies of US hospitals.
AB  - To determine the human immunodeficiency virus-testing policies adopted by US
      hospitals, we surveyed a stratified random sample of all nonfederal general acute
      care hospitals, drawn from the American Hospital Association's 1987 database.
      Interviews were completed with the chief administrator in 561 hospitals (response
      rate, 78.4%). Two thirds of hospitals have admitted at least one patient with the
      acquired immunodeficiency syndrome, and over 83% have formal written policies
      about human immunodeficiency virus testing. Most contain provisions protecting
      patients' rights; eg, 78% require pretest informed consent, 66% require a special
      human immunodeficiency virus-testing consent form, and 75% require that patients
      who test seropositive be so informed. Many policies also contain provisions that
      protect providers; eg, 56% require that test results appear in patients' records,
      38% require review of treatment plans when a patient tests seropositive, and 3%
      require transferring such patients. Hospital characteristics are not strongly
      associated with the adoption of testing policies.

PMID- 2232064
TI  - Adult open heart surgery in New York State. An analysis of risk factors and
      hospital mortality rates.
AB  - This study analyzes data from New York State's new Cardiac Surgery Reporting
      System, which contains information about cardiac preoperative risk factors,
      postoperative complications, and hospital discharge. The purposes of the study
      were to determine the set of significant clinical risk factors and to identify
      cardiac surgical centers most likely to have serious quality-of-care problems.
      Significant risk factors for in-hospital death were age, gender, ejection
      fraction, previous myocardial infarction, number of open heart operations in
      previous admissions, diabetes requiring medication, dialysis dependence,
      disasters (acute structural defect, renal failure, cardiogenic shock, gunshot),
      unstable angina, intractable congestive heart failure, left main trunk narrowed
      more than 90%, and type of operation performed. Four of the 28 hospitals had
      significantly higher mortality rates than expected, given the risk factors of
      their patients. Subsequent site visits and medical record reviews confirmed that
      these facilities had high percentages of quality-of-care problems among cases
      resulting in mortality.

PMID- 2232065
TI  - Bhopal tragedy's health effects. A review of methyl isocyanate toxicity.

PMID- 2232067
TI  - Treatment choices for hypertriglyceridemia.

PMID- 2232066
TI  - Public health lessons from the Bhopal chemical disaster.

PMID- 2232068
TI  - Hyperosmia and depression following exposure to toxic vapors.

PMID- 2232069
TI  - Why study medical history?

PMID- 2232070
TI  - Early chapters in the stethoscope's evolution.

PMID- 2232071
TI  - Curiosities of contraception: a historical perspective.

PMID- 2232072
TI  - Troubled past of 'invisible' profession.

PMID- 2232073
TI  - Disease pattern changes with food system.

PMID- 2232074
TI  - From the Food and Drug administration.

PMID- 2232075
TI  - From the Centers for Disease Control. Health beliefs, compliance--hypertension.

PMID- 2232076
TI  - Maternal ginseng use associated with neonatal androgenization.

PMID- 2232077
TI  - Cystic fibrosis and heterozygote fitness.

PMID- 2232078
TI  - Endothelin-1 and vasculitis.

PMID- 2232079
TI  - The effect of extracorporeal shock wave lithotripsy on blood pressure.

PMID- 2232080
TI  - Fluoxetine and fibromyalgia.

PMID- 2232081
TI  - Doctors with gilt complex calculate golden means.

PMID- 2232082
TI  - Radium exposure and longevity: not mutually exclusive.

PMID- 2232083
TI  - Tubal sterilization and the long-term risk of hysterectomy.
AB  - To assess the effect of tubal sterilization on the risk of hysterectomy, we
      studied 7414 women aged 20 to 49 years who had had a tubal sterilization at a
      health maintenance organization between January 1, 1968, and December 31, 1983.
      Compared with a population-based cohort of nonsterilized women, women sterilized
      while 20 to 29 years old were 3.4 times more likely to have had a subsequent
      hysterectomy (95% confidence interval, 2.4 to 4.7). Adjustment for the effects of
      potential confounders with a subset of 276 women did not appreciably alter this
      association. For multivariate comparisons with 5323 wives of vasectomized men,
      there was no significant elevation in the risk of hysterectomy following
      sterilization among women sterilized while 20 to 29 years old. Tubal
      sterilization was not associated with hysterectomy for married women who
      underwent tubal sterilization at age 30 or older. These results do not support a
      biological basis for the relationship between tubal sterilization and
      hysterectomy.

PMID- 2232084
TI  - A public hospital closes. Impact on patients' access to care and health status.
AB  - We studied the impact of the closing of a public hospital on patients' access to
      care and health status. We surveyed individuals who had been medical inpatients
      at Shasta General Hospital, Redding, Calif, in the year prior to its closing and
      compared them with those in a second county, San Luis Obispo, whose public
      hospital did not close. Surveys were administered after the closing of Shasta
      General Hospital and 1 year later. We assessed outcomes using the Medical
      Outcomes Study Short Form and a series of transition questions that asked about
      changes in health over time. Data were available for 88% of patients at 1 year:
      219 from Shasta County and 195 from San Luis Obispo County. At follow-up, the
      percentage of patients from Shasta County who reported no regular provider
      increased from 14.0 to 27.7 and the percentage who reported they were denied care
      rose from 10.8 to 16.9. Meanwhile, patients in San Luis Obispo County reported
      improved access to a regular provider and the level of denied care was unchanged.
      Patients in Shasta County had significant declines on the Medical Outcomes Study
      Short Form in health perception, social and role function, and increases in pain
      as compared with those patients in San Luis Obispo County. The closing of a
      public hospital had a significant effect on access to health care and was
      associated with a decline in health status.

PMID- 2232085
TI  - The epidemiology and natural history of pressure ulcers in elderly nursing home
      residents.
AB  - We analyzed prospective data from 19,889 elderly residents of 51 nursing homes
      from 1984 to 1985 to determine the prevalence, incidence, and natural history of
      pressure ulcers. Among all residents admitted to nursing homes, 11.3% possessed a
      stage II through stage IV pressure ulcer. For those residents admitted to the
      nursing home without pressure ulcers during the study period, the 1-year
      incidence was 13.2%. This increased to 21.6% by 2 years of nursing home stay.
      People already residing in a nursing home at the start of the study had a 1-year
      incidence of 9.5%, which increased to 20.4% by 2 years. Pressure ulcers were
      associated with an increased rate of mortality, but not hospitalization.
      Longitudinal follow-up of residents with pressure ulcers demonstrated that a
      majority of their lesions were healed by 1 year. Most of the improvement occurred
      early in a person's nursing home stay. Although nursing home residents with
      pressure ulcers have a higher mortality, with good medical care pressure ulcers
      can be expected to heal.

PMID- 2232086
TI  - Pneumococcal vaccine. Efficacy and associated cost savings.
AB  - We evaluated the efficacy and cost savings of the pneumococcal pneumonia vaccine
      in a retrospective cohort study of 762 vaccinated and 1161 randomly selected
      unvaccinated age-sex matched persons in Blue Cross/Blue Shield of Minnesota using
      medical and pharmaceutical claims. The pneumonia incidence and the ratio of
      incidence in the postvaccination to prevaccination periods (rate ratio) were
      examined in the vaccine group by sex and risk factors. Vaccination significantly
      reduced pneumonia incidence, with overall efficacy of 69% and higher efficacy in
      women (86%) than in men (33%). We assigned persons to risk categories based on
      disease conditions as recorded in the claims by the ICD-9-CM (International
      Classification of Diseases, Ninth Revision, Clinical Modification) diagnostic
      codes. In the risk categories, efficacy varied from 50% to 75% and was confounded
      by sex. Immunocompromised and immunocompetent women had high efficacy (83% to
      88%), while immunocompetent and immunocompromised men had lower efficacy (33%).
      Persons with a precondition of pneumonia exhibited similar vaccine efficacy to
      the overall cohort relative to the comparison group. Projected costs of pneumonia
      cases are 3.6 times the observed costs of vaccination and postvaccination
      pneumonia costs. We conclude that the pneumococcal pneumonia vaccine is
      efficacious in persons having had pneumonia, persons "at risk" of developing
      pneumonia, or persons over 50 years of age, and it corresponds to overall savings
      of $141 per person.

PMID- 2232087
TI  - Positive Lyme serology in subacute bacterial endocarditis. A study of four
      patients.
AB  - Lyme borreliosis is a multisystem inflammatory disorder caused by the tick-borne
      spirochete Borrelia burgdorferi. Clinical manifestations are protean, involving
      the skin, joints, peripheral and central nervous systems, and the heart. However,
      the presentation of Lyme disease often overlaps with that of other conditions. We
      describe four patients from a region endemic for Lyme disease who had elevated
      levels of antibodies reactive to B burgdorferi and whose signs and symptoms were
      initially attributed to Lyme borreliosis but whose subsequent blood cultures
      established a diagnosis of nonspirochetal subacute bacterial endocarditis.
      Although immunoblots on serum samples from three of the four patients were
      consistent with prior infection from B burgdorferi, a positive immunoblot does
      not establish active infection. Similarly, seropositivity to B burgdorferi only
      indicates possible exposure to this organism. The occurrence of positive
      serologies to B burgdorferi in the presence of other diseases can lead to
      diagnostic confusion.

PMID- 2232088
TI  - Medical and nonmedical uses of anabolic-androgenic steroids. Council on
      Scientific Affairs.
AB  - Recent trends in the use, abuse, and diversion of steroids for nonmedical
      purposes illustrate a growing problem that not only imposes health risks but
      presents ethical dilemmas as well. Concern over the known adverse effects, the
      limited research into the long-term effects, and the ethics of engineering body
      size and performance through anabolic-androgenic steroid use has led to
      legislative, legal, and education responses. Increased penalties for distribution
      to minors and stricter controls in prescribing practices have been enacted
      through state legislation and federal initiatives. Government, some health
      professional organizations, and some sports groups have denounced the nonmedical
      use of anabolic-androgenic steroids and have developed materials to educate their
      members, other professionals, athletes, educators, and the public at large.

PMID- 2232089
TI  - A multicenter study of physicians' knowledge of the pulmonary artery catheter.
      Pulmonary Artery Catheter Study Group.
AB  - We administered a 31-question multiple-choice examination to 496 physicians
      practicing in 13 medical facilities in the United States and Canada to assess
      their knowledge and understanding of the use of the pulmonary artery catheter and
      interpretation of data derived from it. The mean test score was 20.7 (67%
      correct), with an SD of 5.4 and a range of 6 to 31 (19% to 100%). Mean scores
      varied independently by training, frequency of use of pulmonary artery catheter
      data in patient treatment, frequency of inserting a pulmonary artery catheter,
      and whether the respondent's hospital was a primary medical school affiliate.
      Given the variability in physician understanding of the pulmonary artery
      catheter, we believe that credentialing policies should be reevaluated and that
      consideration should be given to restricting its use to individuals with
      documented competency.

PMID- 2232090
TI  - High-tech predicament: pulmonary artery catheter.

PMID- 2232091
TI  - Preincubation with intravenous lipid emulsion reduces chemotactic motility of
      neutrophils in cord blood.
AB  - Neutrophils from cord blood of healthy term infants were isolated and incubated
      for 30 min with varying concentrations of intravenous lipid emulsion (ILE)
      solution (4, 8, 20 mg/ml). In vitro assay of chemotaxis was performed after
      incubation for 120 min with endotoxin-activated serum (EAS). Neutrophil random
      motility was unchanged after ILE incubation yet chemotactic factor (EAS)
      stimulated motility was significantly reduced in a dose-related pattern.

PMID- 2232092
TI  - Protein metabolism assessed by 1-13C leucine infusions in patients undergoing
      bone marrow transplantation.
AB  - Patients receiving cytoreductive therapy and bone marrow transplantation (BMT)
      are known to develop marked protein catabolism. To assess the contribution of
      whole body protein breakdown, amino acid oxidation and incorporation into
      proteins, plasma leucine kinetics (1-13C-leucine infusion technique) were
      determined in six patients five times within 14 days before and after
      cytoreductive therapy (Cyclophosphamide and total body irradiation) and marrow
      transplantation. Nitrogen balance became negative (-0.20 +/- 0.04 g/Kg/24 hr)
      after cyclophosphamide (p less than 0.01) and was -0.25 +/- 0.05 g/Kg/24 hr 7
      days after BMT in spite of total parenteral nutrition. Plasma leucine
      concentration increased after BMT by 67% (p less than 0.0015). Leucine plasma
      appearance was 1.20 +/- 0.15 mumol/kg/min before treatment, it increased slightly
      and transiently after cyclophosphamide, and increased again from day 5 to day 7
      after BMT (p less than 0.01), suggesting increased protein break-down. Leucine
      oxidation increased from 0.27 +/- 0.07 before therapy to 0.97 +/- 0.16
      mumol/kg/min (p less than 0.02) after cyclophosphamide and BMT. Nonoxidative
      leucine disappearance rate decreased slightly from 0.92 +/- 0.08 to 0.75 +/- 0.16
      mumol/kg/min after BMT (ns). Leucine metabolic clearance rate decreased from 11.8
      +/- 1.65 before therapy to 6.9 +/- 0.70 ml/kg/min (p less than 0.02) after
      cytoreductive therapy. After BMT it increased again to 9.9 +/- 1.5 ml/kg/min (p
      less than 0.02). The results demonstrate that patients undergoing cytoreductive
      therapy and bone marrow transplantation develop negative nitrogen balance due to
      increased protein breakdown associated with increased leucine oxidation and
      increased metabolic clearance rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232094
TI  - Rapid spectrophotometric determination of plasma carnitine concentrations.
AB  - A spectrophotometric enzymatic assay for plasma carnitine concentrations has been
      automated on the Monarch 2000. Prior to the assay, each plasma sample was divided
      into three fractions, ie, free carnitine, acid-soluble carnitine and total
      carnitine, in order to determine the concentration of both free and esterified
      carnitine. Using the method developed by Tachikawa et al (Seikagaku 56:998,
      1984), each of the samples was then chromatographed on an anion exchange resin to
      eliminate those compounds which could adversely impact the accuracy of the
      enzymatic assay for carnitine. After the completion of these preparatory steps,
      32 specimens were assayed in less than 16 min on the Monarch 2000 with a high
      degree of both accuracy and precision. The assay was linear over a wide
      concentration range (5.0-80 mumol/liter), with the lower limit of sensitivity
      being 5.0 mumol/liter. The coefficient of variation (CV%) of the within run
      precision was 2.1%, 2.8%, and 6.7% for the determinations of free carnitine, acid
      soluble carnitine, and total carnitine, and 17.4% and 27.8% for the calculated
      values of short-chain and long-chain acylcarnitines, respectively. The CV% of the
      between run precision for the same fractions was 6.5%, 2.7%, 3.8%, 14.2%, and
      14.3%, respectively. When authentic L-carnitine was added to the plasma, the mean
      recovery rate was 94.7 +/- 11.0%. Reference values were determined using plasma
      obtained from 40 healthy adult volunteers.

PMID- 2232093
TI  - Comparison of three methods for the estimation of total nitrogen losses in
      hospitalized patients.
AB  - Since the measurement of total nitrogen output (TNO) is not routinely determined
      in the clinical setting, its level is frequently estimated using formulas based
      on the urinary urea nitrogen excretion (UUN). We measured TNO in 124 surgical
      patients over 990 days (TNO, 19.22 +/- 8.72 g N/day; total urinary nitrogen (TUN)
      18.17 +/- 8.70 g N/day; UUN, 15.17 +/- 7.70 g N/day; mean gastrointestinal
      nitrogen (MGIN) 0.68 +/- 0.49 g N/day; integumental nitrogen (ITGN), 0.34 +/-
      0.08 g N/day) and compared the results with the daily estimations using three
      different formulas: formula A, UUN + 4; formula B, UUN x 1.20 + 1.05, where 1.20
      is the reciprocal of the mean ratio UUN/TUN and 1.05 the mean extraurinary
      nitrogen losses; and formula C, UUN x 1.0986 + 2.55, derived from the regression
      analysis of UUN vs TNO. TNO estimated by these formulas were 19.17 +/- 7.70,
      19.26 +/- 9.24, and 19.22 +/- 8.70 g N/day, respectively. The regression analyses
      of the estimated TNO from the three formulas versus the measured TNO indicated
      that formulas A, B and C were equally accurate in estimating TNO over the entire
      range of UUN. However, when only values of UUN greater than or equal to 30 g N
      were considered, a modified formula A (UUN + 6) was the best predictor of TNO.
      Daily audits of the differences between the estimated and measured TNO showed
      comparable results for the three formulas. In 28.4 to 31.1% of the observed days
      the differences were higher than +/- 2 g N/day, an error which is not acceptable
      when estimating the protein requirements in many clinical conditions.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2232095
TI  - Is exogenous fructose metabolism truly insulin independent?
AB  - Although fructose is widely regarded as an insulin-independent fuel source, its
      in vivo conversion to glucose represents a theoretical limitation to its clinical
      usefulness in diabetics, particularly if given in large doses. To determine
      whether small amounts of fructose can be well utilized in the setting of
      insulinopenia, we administered a low-dose fructose infusion (4.2 g/hr) to a
      fasting type 1 diabetic patient receiving continuous subcutaneous insulin at a
      dose that had previously maintained stable euglycemia for 72 hr (plasma glucose =
      80-110 mg/dl). Despite the low infusion rate (less than 20% of calorie
      requirement), fructose caused an immediate and marked rise in plasma glucose (to
      370 mg/dl after 27 hr). Glucose loss in the urine and accumulation in plasma
      could account for fully half of the administered hexose load. Thus, the
      utilization of even small quantities of exogenous fructose is profoundly impaired
      under hypoinsulinemic conditions. It is misleading to regard fructose as a truly
      insulin-independent fuel source.

PMID- 2232096
TI  - Resting energy expenditure in patients with esophageal carcinoma.

PMID- 2232098
TI  - Clinical biochemistry: implications for nutritional support.

PMID- 2232097
TI  - No short cuts to height.

PMID- 2232099
TI  - What getting sick means.
AB  - The concepts of health, disease and death have intrigued man since the beginning
      of time and are continually evolving. In the nonwestern societies the models
      which have been proposed for the etiology of disease have a dichotomous view of
      disease causation which is derived from either natural or supernatural forces. In
      the Western societies these concepts are well defined. The numerous advances in
      the fields of genetics and molecular biology have added a new dimension to the
      understanding of the various factors involved in the pathogenesis of disease
      processes. These advances have allowed a greater understanding of numerous
      disease processes including the inborn errors of metabolism, endocrine disorders
      and human neoplasia. Several recent advances in the areas of molecular biology
      and physiology allowing this increased understanding of human disease are
      presented.

PMID- 2232100
TI  - How nutrition intervention changes what getting sick means.

PMID- 2232101
TI  - Kupffer cell and hepatocyte interactions: a brief overview.

PMID- 2232102
TI  - Metabolic and intestinal effects of short-chain fatty acids.
AB  - Current research has identified the metabolic and intestinal effects of SCFA in
      experimental models and humans. Ample physiologic rationale has come forth to
      justify controlled studies of the administration of SCFA in selected patients
      with intestinal dysfunction.

PMID- 2232103
TI  - Perioperative nutritional support: immunologic defects.

PMID- 2232104
TI  - Assessment of nutritional status.

PMID- 2232105
TI  - Lipids, membrane receptors, and enzymes: effects of dietary fatty acids.
AB  - Dietary polyunsaturated fatty acids can significantly affect many biochemical and
      physiologic functions that are related to inflammatory, immune, and protective
      reactions. The different types of fatty acids can impact on energy metabolism,
      determine the lipid composition of membranes, and influence eicosanoid synthesis,
      all of which are relevant to prevention of and recovery from illness. In this
      paper, the effects of dietary polyunsaturated fatty acids on membrane
      composition, membrane-associated enzyme and receptor functions, signal
      transduction, second messenger, and eicosanoid generation are summarized. The
      differential effects of the polyunsaturated fatty acids of the n-6 and n-3
      families are reviewed in the context of optimizing levels in diets.

PMID- 2232106
TI  - Practicalities of lipids: ICU patient, autoimmune disease, and vascular disease.
AB  - Although the use of lipids should be individualized, certain generalizations are
      appropriate. 1. Lipid infusion should be limited in the fulminately septic
      patient to 10% of total calories in an effort to reduce immunosuppression. 2. The
      stressed, nonseptic patient with difficulties in ventilator weaning or TPN
      induced hepatic dysfunction may reap benefit from a reduction in dextrose
      calories and the provision of daily lipids. 3. Patients with severe autoimmune
      disease have had mild amelioration of symptoms with PUFA supplementation. The
      relative benefits of omega-6 vs omega-3 continue to be examined. 4. Dietary
      immunomodulation in transplant and burns remains an area of active investigation.
      5. Patients with fat-free TPN show transient declines in serum lipids. The
      development of a "fat-solubilizer" remains in the experimental realm. 6. The
      provision of fish oil, high in W-3 EPA, has shown promise in atherosclerosis and
      immunomodulation. The changes in the relative amounts of each prostaglandin class
      depend on precursor prevalence.

PMID- 2232107
TI  - Role of arginine in trauma, sepsis, and immunity.

PMID- 2232108
TI  - Influence of energy levels and trace metals on health and life span.

PMID- 2232110
TI  - Left ventricular filling pattern in congestive heart failure patients with normal
      sinus rhythm--a decreased ratio of peak mitral flow velocity in atrial systole
      relative to that in early diastole may reflect markedly increased left
      ventricular end-diastolic pressure.
AB  - The left ventricular filling pattern was studied by pulsed Doppler
      echocardiography in 13 congestive heart failure patients with normal sinus
      rhythm. The first study was done when congestive heart failure was present; the
      second after the signs and symptoms of congestive heart failure disappeared. In
      12 of the 13 patients, the peak mitral flow velocity in atrial systole (PFVA)
      increased after the congestive heart failure disappeared (mean increase from 50.5
      cm/sec to 74.8 cm/sec : p = 0.0001, paired t test), and the peak mitral flow
      velocity in early diastole (PFVE) decreased significantly in all 8 patients in
      whom secondary mitral regurgitation became less severe after improvement of
      congestive heart failure (mean decrease from 90.8 cm/sec to 52.0 cm/sec : p =
      0.0001, paired t test). The ratio of PFVA to PFVE (PFVA/PFVE) increased in all
      cases after the congestive heart failure improved (mean increase from 0.59 to
      1.33 : p = 0.0001, paired t test). The PFVA/PFVE is a simple index of left
      ventricular diastolic function. A PFVA/PFVE greater than one indicates disturbed
      left ventricular diastolic function. However, when the PFVA/PFVE is in a normal
      range for the patients' age ("pseudo-normalization") and is accompanied by
      impaired left ventricular systolic function in congestive heart failure, markedly
      increased left ventricular end-diastolic pressure must be considered.

PMID- 2232109
TI  - Glutamine nutrition: theoretical considerations and therapeutic impact.
AB  - In critically ill surgical patients, nutritional therapy is an important
      component of overall care. As our knowledge increases, "tailor-made" diets
      designed to meet specific nutritional requirements in specific patients may play
      an important role. Although the data reviewed here suggest that glutamine
      supplemented diets may have a significant impact in some clinical settings, it
      should be emphasized that additional carefully designed studies are necessary
      before the use of glutamine-enriched nutrition in critically ill patients should
      be advocated. It is clear, however, that the concept that the intestine is an
      organ of inactivity during critical illness merits reconsideration.

PMID- 2232111
TI  - Kinetic analyses of creatine kinase release patterns in patients with acute
      myocardial infarction undergoing emergency coronary arteriography.
AB  - To quantify the effects of early reperfusion on the size of infarcts, an enzyme
      indicator was developed: myocardial creatine kinase (CK) release rate (kr), based
      on a compartmental kinetics model. In 59 patients with acute myocardial
      infarction (MI) who received intracoronary thrombolysis therapy in the acute
      phase, the kr showed a good correlation with the flow condition of infarct
      related coronary artery and the time required to reach peak enzyme activity.
      Apparent serum CK disappearance rate (kd') was estimated by using the method of
      Norris. The kd' was significantly underestimated in patients without reperfusion,
      suggesting the presence of prolonged enzyme release from the infarcted area. In
      22 of 59 patients, who had a first acute anterior MI (left anterior descending
      arterial lesion), the correction of cumulative enzyme release by myocardial
      enzyme release (kr) resulted in a closer correlation with chronic phase left
      ventricular function. Thus, kinetic analyses of serum enzyme release provide a
      useful means to estimate the infarct size during intracoronary thrombolysis
      therapy.

PMID- 2232112
TI  - Treatment of unstable angina with cholesterol embolization as a complication of
      left heart catheterization.
AB  - We describe 3 patients with cholesterol embolization after left heart
      catheterization via the femoral route. The left catheterizations were performed
      via the femoral route in all reported cases in which cholesterol embolization
      occurred as a complication of left catheterization. Postmortem examinations
      reveal that PTCA, using the right brachial approach, is the safest method for
      treatment of intractable angina in patients with evidence of cholesterol
      embolization.

PMID- 2232113
TI  - Metabolic risk factors in the normolipidemic male patients with angiographically
      defined coronary artery disease.
AB  - The relationship of plasma lipid and apolipoprotein (apo) concentrations and
      plasma insulin response to oral glucose load to angiographically determined
      coronary artery disease (CAD) was investigated in 65 normolipidemic (plasma
      cholesterol less than 230 mg/dl and plasma triglyceride less than 150 mg/dl)
      males. According to the results of coronary angiography, the patients were
      divided into 2 groups: patients with normal coronary artery, NCA group (n = 21);
      and patients with coronary artery disease, CAD group (n = 44). No significant
      differences in concentrations of plasma cholesterol and triglyceride were
      observed between the CAD and NCA groups. In the CAD group cumulative lifetime
      tobacco consumption was higher and high density lipoprotein (HDL) cholesterol
      concentration was lower than those in the NCA group. The variables that
      correlated with the severity of CAD, defined by the number of lesions and percent
      stenosis, were levels of plasma apo A-I and apo B. Prevalence of subjects with
      reduced oral glucose tolerance did not differ between 2 groups. However,
      hyperinsulinemic response to oral glucose load was present in the CAD group. HDL
      cholesterol concentration, the sum of plasma insulin levels and the magnitude of
      the early insulin response during oral glucose challenge were accurate predictors
      of the presence of but not the severity of CAD. Multivariate analysis of the data
      confirmed the independent effect of plasma levels of apo A-I and apo B on the
      severity of CAD. The present data indicated that plasma levels of apo A-I and apo
      B were powerful discriminators in the normolipidemic CAD patients and that a high
      insulin response might be an indicator of enhanced susceptibility to the distinct
      coronary atherosclerosis.

PMID- 2232114
TI  - Changes in vascular wall production of prostacyclin and thromboxane A2 in
      spontaneously hypertensive rats during maturation and the concomitant development
      of hypertension.
AB  - The purpose of this study was to clarify how the metabolism of vascular
      prostacyclin (PGI2) and thromboxane (TX) A2 in spontaneously hypertensive rats
      (SHR) is involved in aging and development of hypertension. We removed the aortic
      walls from 5-week-old and 20 to 25-week-old SHR and age-matched Wistar Kyoto rats
      (WKY). At 5 weeks of age, there was no significant difference in basal and
      maximal (arachidonic acid 0.1 mM) 6-keto-PGF1 alpha production between SHR and
      WKY, but the TXB2 generation in the SHR aortic wall was markedly enhanced as
      compared with that in WKY. At 20 to 25 weeks of age, the SHR aortic wall
      synthesized about 1.5 times more 6-keto-PGF1 alpha in the basal condition and
      twice as much as in the maximal condition as did the WKY wall. However there was
      no significant difference in TXB2 production between SHR and WKY. Age-dependent
      increase of vascular 6-keto-PGF1 alpha was greater in SHR than in WKY. Moreover,
      the maximal/basal 6-keto-PGF1 alpha production ratio increased with age in SHR,
      but not in WKY. The synthesis of vascular TXB2 was enhanced with age in WKY, but
      did not change with age in SHR. These data suggest that not only the enhanced
      basal generation of vascular 6-keto PGF1 alpha but also a much greater reservoir
      of 6-keto-PGF 1 alpha synthesis in SHR was induced by both hypertension and
      maturity. The increased production of vascular TXB2 in young SHR may affect the
      development of hypertension.

PMID- 2232115
TI  - The Mikamo lecture. Role of higher nervous activity in sudden cardiac death.
AB  - The brain receives and catalogues myriads of information from within and without
      the organism. These inputs promote neural integration of bodily function through
      a multiplicity of cybernetic feedback loops. Higher nervous activity shapes the
      contours of perceived well-being and determines the course and progress of
      disease. Behavioral and neural factors play an important role in cardiovascular
      function and are especially relevant to the problem of sudden cardiac death
      (SCD). Clinical data attesting to the role of biobehavioral factors in SCD derive
      from a diversity of sources. It has long been known that bereavement increases
      the prevalence of cardiac fatality. Business failure rates are strongly related
      to increased mortality among persons aged 55 and over. Recession in economic
      activity, with increasing unemployment, is associated with augmented death rates
      from ischemic heart disease. In extensive surveys conducted among London civil
      servants, Rose and Marmot found not only the level but the type of employment to
      be a factor determining coronary heart disease mortality. Blue collar workers had
      a 3.6 times greater chance of dying from heart disease than an age-matched
      population in the higher ranks of civil service. A man's employment status was a
      stronger predictor of risk for dying from coronary heart disease than any of the
      usual risk factors, such as smoking, blood pressure, height-weight ratio, leisure
      time activities, glucose tolerance, or plasma cholesterol. Operation of
      behavioral factors is also suggested by the time of occurrence of sudden death.
      Among 3,983 men followed for more than 30 years, Rabkin and co-workers observed
      an excess proportion of fatalities on Mondays. No such pattern was noted for
      cancer mortality. Not only the day of the week but the time of day appears to be
      a factor. Muller and co-workers found a significant preponderance in the
      occurrence of myocardial infarction and sudden death from 6:00 AM to noon. They
      could not implicate operation of circadian rhythm, but suggested a role for
      augmented autonomic neural discharge associated with early morning activities
      following waking from sleep. The longitudinal epidemiologic studies of the Health
      Insurance Plan of New York (HIP) have indicated an important association between
      behavioral and psychologic factors and the prevalence of sudden cardiac
      death.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2232116
TI  - Afterload mismatch in patients with hypertrophic nonobstructive cardiomyopathy.
AB  - To investigate the cardiac reserve of hypertrophic nonobstructive cardiomyopathy
      (HNCM), an echocardiographic study was performed before and during angiotensin II
      loading in 22 HNCM patients without left ventricular (LV) systolic dysfunction at
      rest and 8 normal subjects. LV end-diastolic dimension (LVDd) and time velocity
      integral (Ie) at aortic annulus were obtained as parameters of preload and
      forward ejection respectively. Responses of these indices to afterload stress
      were compared with clinical findings and right ventricular biopsy findings. Based
      on the reserve of forward ejection characteristics to afterload stress, 22 HNCM
      patients were divided into 2 groups; Group I: 9 cases with more than 15% decrease
      of Ie which corresponded to the value of mean - 1SD in normal subjects, Group II:
      13 cases with a decrease of Ie less than 15%. There were no significant
      differences in echocardiographic findings between Group I and II before
      angiotensin II loading. On the other hand, Group I had a smaller increase of LVDd
      (p less than 0.05) to afterload stress, a higher incidence of ventricular
      tachycardia on a Holter electrocardiogram (p less than 0.05), lower maximal
      oxygen consumption with treadmil exercise test (p less than 0.01), and a larger
      value of LV end-diastolic pressure (p less than 0.05) than those in Group II,
      respectively. Although no difference in myocyte diameter was found between the 2
      groups, myocardial fibrosis was more severe (p less than 0.001) and the incidence
      of moderate or severe disarray was higher (p less than 0.05) in Group I than in
      Group II. Thus, some HNCM patients cannot maintain forward ejection to afterload
      stress because of impaired preload reserve attributable to a greater stiffness of
      the left ventricle with severe myocardial lesion.

PMID- 2232117
TI  - Global and regional diastolic filling dynamics in compensated dilated
      cardiomyopathy.
AB  - To assess the left ventricular (LV) global and regional (anterior, apical,
      inferior) diastolic filling dynamics in compensated dilated cardiomyopathy (DCM),
      we measured left ventricular pressure and instantaneous volume from angiography
      in 7 normal controls (CTL) and 6 DCM patients with sinus rhythm. Global and
      regional peak filling rate (PER), time constant of LV pressure decline (T;
      Weiss's method) and LV chamber stiffness (k; Gaasch's method) were calculated. In
      DCM, left ventricular end-diastolic volume (ml/m2) was larger than in CTL (137 +/
      29 vs. 74 +/- 6, p less than 0.001), and stroke index (ml/m2) was not different
      from CTL (46 +/- 14 vs. 46 +/- 8, NS), indicating a compensated state of LV.
      Mitral valve opening pressure (mmHg) tended to increase in DCM compared with CTL
      (12 +/- 6 vs. 8 +/- 4). Global PFR (ml/sec/m2) (CTL = 216 +/- 47 vs. DCM = 201 +/
      36) and k (CTL = 0.044 +/- 0.023 vs. DCM = 0.029 +/- 0.016) were not different
      between 2 groups. However, T (msec) was markedly prolonged in DCM compared with
      CTL (61 +/- 10 vs. 35 +/- 5, p less than 0.001). In CTL, regional PFR (1/sec)
      showed almost the same values in each region, but in DCM, apical region showed
      higher PFR than in other regions. Thus, early diastolic filling might play an
      important role in maintaining the total transmitral flow in DCM despite severe
      impairment of LV relaxation. This compensation could be related mainly to
      accelerated regional lengthening of the LV apical region.

PMID- 2232118
TI  - Hematoma of the interatrial septum associated with complete atrioventricular
      block.
AB  - A 70-year-old man who had been treated for tongue cancer began to suffer from
      repeated syncopal attacks. His electrocardiogram indicated complete
      atrioventricular block. A permanent pacemaker was implanted. He was well for
      about 2 years after which time he developed dyspnea, suffered from general
      fatigue, and then suddenly died. A postmortem examination revealed a hematoma
      approximately 4 x 4. cm in size in the interatrial septum, connected to a
      noncoronary sinus and rupture of the noncoronary leaflet, which compressed the
      tricuspid and aortic valves. This hematoma might have been related to the
      conduction disturbance caused by destructive compression on the conduction
      system, and his death by the rupture of the noncoronary leaflet.

PMID- 2232120
TI  - Arrhythmia after the release of inhibited oxidative phosphorylation.
AB  - Automaticities due to delayed afterdepolarizations, elicited upon reoxygenation,
      are thought to be caused by Ca overload. Since tissue Ca uptake upon
      reoxygenation has been reported to be closely related to metabolic inhibition
      during hypoxic perfusion, the relationship between the degree of metabolic
      inhibition during hypoxia and reoxygenation-induced arrhythmias was investigated
      in guinea pig papillary muscles. (1) Arrhythmias occurred after 60 min substrate
      free hypoxia, but not after 30 min hypoxia. The chance of automaticities was
      closely related with the increase in resting tension achieved during hypoxic
      period. The incidence of arrhythmias was, however, lower after 90 or 120 min
      hypoxia. (2) There were arrhythmias after 20-30 min hypoxia with glycolytic
      inhibition (20 mM 2-deoxyglucose + 5 mM acetate). On the other hand, 60-min
      hypoxia in the presence of 5 mM glucose did not elicit arrhythmias on
      reoxygenation. (3) Stimulation of glycolysis (50 mM glucose) during substrate
      free hypoxia prolonged the action potential duration, but did not cause
      arrhythmias. Washout of cyanide (1 mM) after 60 min perfusion in the presence of
      oxygen, caused arrhythmias and aftercontractions. These results suggest that the
      degree of metabolic inhibition during hypoxia is closely related to Ca overload
      and the resultant arrhythmias upon reoxygenation. The release of inhibited
      oxidative phosphorylation, rather than the reintroduction of oxygen per se, was
      thought to be the key mechanism of reoxygenation-induced arrhythmias.

PMID- 2232119
TI  - Stroke-prone spontaneously hypertensive rats as a model for toxemia of pregnancy
      and aggravating and preventive effects of maternal modifications during pregnancy
      on offspring's growth.
AB  - Genetical differences in changes in blood pressure (BP) were chronologically
      investigated during pregnancy in stroke-prone spontaneously hypertensive rats
      (SHRSP), Wistar-Kyoto rats (WKY) and Sprague-Dawley (SD) rats. Especially, the
      early stages were carefully studied. Maternal conditions in SHRSP were modified
      by the treatments with NaCl and taurine, respectively. BP in SHRSP and WKY rose
      significantly at the early stage of pregnancy compared to prepregnancy levels
      (SHRSP; 208 +/- 2 mmHg vs 197 +/- 5 mmHg, WKY; 133 +/- 2 mmHg vs 126 +/- 1 mmHg)
      (p less than 0.05). In contrast, no such changes were observed in SD rats.
      Differences in 24-hour urinary epinephrine excretion before and during pregnancy
      ran parallel with such BP changes among these strains. NaCl-loaded SHRSP died
      during pregnancy with severe pathohistological changes in their kidneys and
      severe proteinuria. Taurine treatment had a marked prophylactic effect on these
      maternal pathological changes during pregnancy, resulting in better growth in
      offsprings. These results suggest that SHRSP could be one of the suitable animal
      models for the studies on toxemia of pregnancy and also suggest an important role
      of hypertensive genetical disposition in the development of toxemia of pregnancy.

PMID- 2232121
TI  - Field emission scanning electron microscopic study on the noninfarcted myocardium
      after myocardial infarction.
AB  - Intracellular membranous ultrastructural changes in the noninfarcted myocardium
      of the left ventricle were studied by examining experimental myocardial
      infarction in rats with a field emission scanning electron microscope. The left
      coronary artery was ligated at its origin for 7 days. The resulting infarcts
      comprised approximately 40% of the total area of the left ventricles. In a light
      microscopic study, the transverse diameter of myocytes had increased to 17.1 +/-
      2.9 microns in the noninfarcted myocardium, compared to 14.1 +/- 3.1 microns in
      the myocardium of sham-operated rats (p less than 0.01). For the scanning
      electron microscopic study, the specimens were processed according to the Osmium
      DMSO-Osmium method. Marked morphological changes of intracellular membranous
      structures were found in the noninfarcted myocardium, especially in the lacelike
      network of sarcoplasmic reticulum which occasionally formed large flattened
      cisternae, and in the marked proliferation of surface caveolae. It is speculated
      that these early ultrastructural changes in the noninfarcted myocardium reflect
      an adaptation of microorganellae in the failing hearts of the rats.

PMID- 2232123
TI  - Proceedings of the 54th Annual Scientific Meeting of the Japanese Circulation
      Society. March 1990, Fukuoka. Abstracts.

PMID- 2232122
TI  - Some enzyme characteristics of spontaneously hypertensive rats myocardium.
AB  - In order to ascertain the pathogenesis of myocardial cell vulnerability in
      spontaneously hypertensive rats (SHR), several enzyme activities were examined by
      using subcellular fractions of myocardium and compared to those in Wistar-Kyoto
      rats (WKY). In the normotensive WKY heart, both 5'-nucleotidase and Na+/K(+)
      ATPase, which are plasma membrane associated enzymes, increased with age. But in
      the SHR heart, both enzymes were lower at 16 weeks than they were at 10 weeks of
      age. Moreover, at 16 weeks of age they were lower in SHR than in WKY. On the
      other hand, NADP(+)-isocitrate dehydrogenase activity, a mitochondria associated
      enzyme, was higher in SHR than in WKY at 6 weeks, but lower at 10 and again at 16
      weeks of age. The activities of both acid phosphatase and N-acetyl-beta
      glucosaminidase, which are lysosomal enzymes, decreased with age in SHR but not
      in WKY. These results suggest that an enzymatic alteration in the plasma membrane
      and mitochondria may be one of important factors behind myocardial vulnerability
      in the SHR heart.

PMID- 2232124
TI  - Chromium, nickel and welding.

PMID- 2232125
TI  - [Diuretic effects of aminophylline in patients after cardiac surgery].
AB  - Diuretic effects of aminophylline in patients after cardiac surgery were studied
      by using the local renal thermodilution catheter (Goodman Co. Ltd.). The subjects
      were 11 patients who underwent cardiac surgery in our hospital. All patients had
      shown almost normal renal and endocrine function. On the day of operation, we
      indwelld renal thermodilution catheter into the left renal vein under
      fluoroscopy. After operation, when the urinary volume decreased below 1 ml.kg
      1.hr-1, we administered aminophylline at a rate of 2 ml.kg-1.hr-1. We measured
      HR, BP, CO, PAP, CVP, renal blood flow, urinary volume, urinary electrolytes,
      plasma renin activity, angiotensin II, aldosteron, ADH and alpha hANP just before
      and after infusion of aminophylline. The urine volume, renal blood flow and renal
      blood flow distribution rate showed significant increases of about 70%, 40% and
      35% respectively. But hemodynamic parameters including HR, mean BP and CO
      increased for 5%, 10% and 8% respectively after administration of aminophylline.
      In the endocrine system, only angiotensin II increased significantly but
      aminophylline did not cause any change in endocrine system. The results suggest
      that diuretic effect of aminophylline is mainly achieved by increasing renal
      blood flow.

PMID- 2232126
TI  - [Reversal of high-dose fentanyl anesthesia by naloxone].
AB  - The EEG, respiratory and hemodynamic responses to postoperative reversal by
      naloxone of high-dose fentanyl anesthesia were studied in 20 patients (17 cardiac
      and 3 non-cardiac surgeries). In power spectrum analysis of EEG, power of delta
      band markedly decreased after naloxone drip infusion. Respiratory and hemodynamic
      responses were minimum, but increase in HR by 6.4 +/- 9.2 bpm, increase in
      diastolic BP by 5.3 +/- 9.6 mmHg, and decrease in CVP by 1.9 +/- 2.9 mmHg were
      statistically significant. Emergence of pain was also minimum and severe side
      effect was not observed. Reversal of high-dose fentanyl anesthesia by naloxone
      can reduce the incidence of postoperative respiratory depression and enables
      early extubation.

PMID- 2232127
TI  - [Ventilatory effects of halothane and enflurane in dogs].
AB  - The ventilatory effects of halothane and enflurane were studied in permanently
      tracheostomized dogs at the same anesthetic depth of 1 MAC. Inspiratory and
      expiratory durations were longer and tidal volume greater during enflurane than
      during halothane anesthesia. Mean inspiratory flow rate and minute ventilation
      during enflurane anesthesia were less than those during halothane anesthesia. As
      a result, end-expiratory carbon-dioxide concentration was higher during enflurane
      than during halothane anesthesia. When end-expiratory carbon-dioxide
      concentration was held at 7.5%, tidal volume was not different between the two
      anesthetics, while the difference of other parameters still remained. In
      addition, the magnitude of Hering-Breuer reflex determined by end-expiratory
      airway occlusion was essentially identical between halothane and enflurane
      anesthesia. The present results indicate that 1) depressant effect of enflurane
      on respiratory drive is greater than that of halothane and 2) the two anesthetics
      act on the respiratory timing mechanism differently.

PMID- 2232128
TI  - [Apnea and oxygen desaturation following nitrous oxide inhalation].
AB  - Apnea and desaturation following nitrous oxide inhalation were studied in seven
      adult volunteers breathing spontaneously. Arterial oxygen saturation (SpO2), end
      tidal CO2 concentration in the nasal cavity and respiratory patterns were
      measured in volunteers breathing air after N2O (50% or 67%) + O2. SpO2 was
      measured with Biox 3700 and end-tidal CO2 concentration was measured with
      Normocap, and respiratory patterns were recorded with RESPIGRAPH. After breathing
      N2O, two volunteers had frequent apnea (greater than 20 sec) accompanied by
      desaturation (SpO2 less than 90%). The lowest value of SpO2 was 82%. When the
      apnea occurred, the airway seemed to be open and end-tidal CO2 concentration
      values were lower than those before N2O inhalation. The authors considered that
      this kind of apnea was due to several factors, such as hypocapnia caused by
      hyperventilation during N2O anesthesia, dilution of alveolar O2 and CO2 during
      N2O excretion, loss of consciousness by N2O, and depression of CO2 ventilatory
      response by N2O. Inhalation of O2 at high concentrations for five minutes could
      improve the hypocapnia and prevent the apnea.

PMID- 2232129
TI  - [The effects of ulinastatin on the release of granulocyte elastase during
      pancreas surgery].
AB  - During a major abdominal surgery, intraoperative manipulation may cause
      circulatory changes, which lead to release of granulocyte elastase. Twenty one
      patients were studied to elucidate the release of granulocyte elastase and the
      inhibitory effect of a protease inhibitor (ulinastatin) on lysosomal enzyme
      release during pancreas surgery. Patients were divided into 3 groups. Patients in
      group A served as control. Patients in group B were given ulinastatin 10,000
      units.kg-1 intravenously prior to surgery. Patients in group C were given
      ulinastatin 5,000 units.kg-1 intravenously twice prior to surgery and 3 hours
      after the start of surgery. The granulocyte elastase was measured by commercially
      available kits, at 7 points: prior to induction of anesthesia, immediately after
      tracheal intubation, 30, 60, 120, 180 min after the start of surgery and 30 min
      after surgery. The plasma level of elastase increased markedly during the
      operation in group A, it did not increase in groups B and C during the operation.
      Thirty min after the operation, the plasma level of elastase increased markedly
      in group A (354 +/- 63 micrograms.l-1), and in group B (396 +/- 167 micrograms.l
      1). The plasma level of elastase was restored to normal levels 30 min after the
      operation in group C. These results indicate that granulocyte elastase values
      were maintained at significantly higher levels during and after pancreas surgery,
      and suggest that ulinastatin inhibits the release of granulocyte elastase during
      pancreas surgery.

PMID- 2232130
TI  - [Anesthetic experience of a patient for splenectomy with severe liver dysfunction
      and hyperammonemia].
AB  - A case of a patient with severe liver dysfunction and hyperammonemia undergoing
      splenectomy and liver biopsy was reported. Preoperative examination revealed that
      this patient's liver function was severely impaired due to liver cirrhosis (ICG15
      = 60%, HPT = 29%, serum NH3 = 110 micrograms.dl-1). Preoperatively, kanamycin 2
      g.day-1 and lacturose 60 ml.day-1 were given and FFP 3-5 units.day-1 were
      infused. With no premedication, general anesthesia was induced with dTc 3 mg,
      thiopental 200 mg and SCC 80 mg. Anesthesia was maintained with N2O-O2-enflurane
      and pancuronium. Though N2O concentration was kept at 50% to prevent
      intraoperative hypoxemia, the necessary enflurane concentration was low (almost
      1% or lower). Serum NH3 level during operation was stable (100-110 micrograms.dl
      1), and the level decreased (66-90 micrograms.dl-1) postoperatively.
      Postoperatively, this patient's consciousness level fluctuated with or without
      flapping tremor. The treatment of hepatic encephalopathy with lactulose,
      aminoleban EN and maalox were effective. Problems of perioperative and anesthetic
      management of a patient for upper abdominal surgery with severe liver dysfunction
      associated with hyperammonemia were discussed.

PMID- 2232131
TI  - [Intraoperative anoxic spells in patients with tetralogy of Fallot].
AB  - We experienced 5 cases of intraoperative anoxic spell in 48 patients with
      tetralogy of Fallot (TOF). One of 5 cases had tetralogy with pulmonary atresia
      (Type A), and the others had tetralogy alone (Type D). The patient of type A who
      had anoxic spells during preoperative period had been on chronic propranolol
      therapy. However, the patients of type D had no anoxic spells during preoperative
      period and one in this type had not been on beta-adrenergic blocking drugs
      preoperatively. One patient was anesthetized with fentanyl-diazepam-O2, and the
      others were anesthetized with morphine-diazepam-O2. We used mainly alpha
      adrenergic drugs and sodium bicarbonate for the therapy of intraoperative anoxic
      spells. Concerning the intraoperative anoxic spell, we have to be aware in the
      management of the patients with TOF, whether the patient had anoxic spells during
      preoperative period or not.

PMID- 2232132
TI  - [Anesthetic experience of a patient with blue rubber bleb nevus syndrome].
AB  - We report an anesthetic experience of a 63-year-old female patient with blue
      rubber bleb nevus syndrome who underwent an open reduction of the fracture of the
      right femur. The syndrome is characterized by bluish nevus scattered throughout
      the skin of the whole body and angiomas of the gastrointestional tract causing
      serious bleeding. Anesthesia was induced with thiopental followed by intravenous
      injection of succinylcholine chloride and maintained with neuroleptanesthesia in
      nitorous oxide and oxygen. The course of anesthesia and emergence from anesthesia
      were uneventful. Anesthetic management of patients with blue rubber bleb nevus
      syndrome was also discussed.

PMID- 2232133
TI  - [Anaphylactic shock following topical use of thrombin for irrigation of urinary
      bladder].
AB  - A 55-yr-old male with carcinoma of bladder received transurethral coagulation
      (TUC) under epidural anesthesia. A few min after the operation, he went into
      anaphylactic shock during irrigation of urinary bladder with thrombin solution.
      The symptoms were epigastralgia, circulatory collapse, skin rashes over the whole
      body and dyspnea. Oxygen inhalation and iv administration of epinephrine and
      steroid were performed, and his general condition improved within several hours.
      On the 2nd day after recovery from the anaphylactic shock, the patient received
      prick test on several agents which he had been given during operation. Prick test
      and RAST (radioallergosorbent test) on thrombin were positive. Based on our
      experience, thrombin may act to produce anaphylactic reaction. Although
      anaphylactic shock following topical thrombin is rare, we feel that thrombin
      should not be used without prick test.

PMID- 2232134
TI  - [Massive water infusion into the patient's trachea during the use of cascade type
      heated humidifier].
AB  - A case of an inadvertent massive infusion of water via the humidifier module into
      the trachea during the use of cascade type heated humidifier is described. A
      Fisher and Paykel anesthetic humidifier was employed in the exhalation side of
      Jackson Rees type breathing circuit between the anesthesia machine and patient's
      endotracheal tube. During anesthesia for inguinal hernia, fresh gas flow was 6
      liters per minute in the breathing circuit. Humidifier module was inadvertently
      upside down, and the water in the module was abruptly injected into the patient's
      trachea and we could not ventilate for a short period of time. This water
      infusion into the trachea was caused by a large supply of fresh gas flow into the
      breathing circuit and by narrowing of tube diameter. It is essential, when using
      heated humidifier, to examine it carefully before anesthesia.

PMID- 2232135
TI  - [A cone shaped one-way valve for an extracorporeal bypass circuit].
AB  - For an extracorporeal circulation, either a unidirectional pump or a one-way
      valve is required. Most of the one-way valves developed so far for a cardiac
      valve operation have excellent rheological features. But, they are too expensive
      to be thrown away after a short usage in a disposable bypass circuit. Though a
      ball valve is simple to make and not expensive, the spherical float inside the
      valve causes a turbulence in the down stream. This turbulence in the blood stream
      will become a cause of hematological side effects during the extracorporeal
      circulation. To prevent this turbulence, we designed a cone shape float with a
      hemispherical head and a tapered tail. The valve chamber was also changed to a
      similar shape with a diameter 4 mm larger than that of the float. Three small
      notch-like spacers were made near the head of the float to prevent wedging of the
      float into the cone shape region of the valve chamber. Water passed through the
      valve with a laminar flow without much resistance. Regurgitation at the valve by
      reversing pressure was insignificant. But, the valve sometimes fell into
      dysfunction suddenly. Observation with a videocamera revealed that the float
      often began a long axis rotation and tail swung in the flow. Then the valve
      suddenly fell in to dysfunction due to the oblique fixation of the float in the
      valve chamber. A gentle knock of the valve could resume the valve function.
      However, the cone shaped valve will not be suitable for an extracorporeal life
      support system where any hazard must be avoided.

PMID- 2232136
TI  - [Clinical and laboratory research in anesthesiology].

PMID- 2232137
TI  - [A study on the psychological status of perioperative patients].
AB  - To evaluate the causes of psychic disturbances after operation, three different
      psychological tests, Spielberger's rating scale "The State-Trait Anxiety
      Inventory (STAI)", Maudsley Personality Inventory (MPI) and Baum test, were
      performed during perioperative periods in 25 patients who received simple total
      hysterectomy. The score of the A-Trait analyzed from STAI that is trait anxiety,
      did not change significantly, while the score of the A-State analyzed from that,
      that is state anxiety, decreased significantly in postoperative period.
      Especially, the score of the A-State showed gradual decreasing tendency during
      perioperative period in the patients, who were classified as N+ group in MPI,
      showing the tendency of nervousness. On the contrary, in the patients of N-
      group, showing no tendency of nervousness, the score of the A-State increased
      significantly immediately before operation. In Baum test, most of the patients
      showed some psychological disturbances even during the postoperative period. From
      the Baum test, it was shown that they had psychologic fragility and lability even
      postoperatively, in spite of stabilization of general status.

PMID- 2232138
TI  - [Effect of epidural anesthesia on the function of hormonal regulation in the
      hypothalamic-pituitary-testicular axis].
AB  - To evaluate the effects of epidural anesthesia on the hypothalamic-pituitary
      testicular axis, we examined the concentrations of luteinizing hormone (LH),
      follicle-stimulating hormone (FSH) and testosterone (T). The effects of epidural
      anesthesia on plasma levels of LH, FSH and T were investigated in 8 men aged from
      64 to 87 years, suffering from untreated prostate cancer. There were no
      significant differences in plasma levels of LH, FSH or T between patients under
      epidural anesthesia and patients under no anesthesia. The effects of epidural
      anesthesia on plasma levels of LH, FSH and T after LH releasing hormone (LH-RH)
      administration were studied in 10 men between 65 and 84 years with diagnoses of
      untreated prostate cancer. Plasma LH and FSH levels increased significantly after
      LH-RH administration under epidural anesthesia or no anesthesia. Plasma LH and
      FSH were lower under epidural anesthesia than under no anesthesia. No change in
      plasma T level was observed after LH-RH administration under epidural anesthesia.
      We conclude that there is no effect of epidural anesthesia on the hypothalamic
      pituitary-testicular axis.

PMID- 2232139
TI  - [Endocrine effects of hypotension induced by nicardipine in rabbits].
AB  - Endocrine effects of hypotension induced by nicardipine, a calcium antagonist,
      were studied in 18 male rabbits under halothane anesthesia. They were randomly
      divided into two groups; nicardipine (group N; n = 10) and controls (group C; n =
      8). No change was noted in plasma catecholamines in group C throughout the
      experiment, but plasma renin activity decreased progressively. During and after
      induced hypotension, in group N, plasma epinephrine was significantly higher than
      the control value. The highest level of plasma epinephrine was seven times of the
      control value during 30 minutes after induction of hypotension. Plasma
      norepinephrine of group N was significantly higher than the controls. The maximum
      increase occurred 60 minutes after induction of hypotension. Plasma renin
      activity of group N was significantly higher than the control value. Compared
      with the control value (15.1 +/- 1.8 ng.ml-1.hr-1), plasma renin activity was
      activated 30 and 60 minutes after induction of hypotension (55.5 +/- 6.0 ng.ml
      1.hr-1, P less than 0.001, 50.3 +/- 7.1 ng.ml-1.hr-1, P less than 0.01,
      respectively). In conclusion, our data show that hypotension by nicardipine
      activates the renin-angiotensin-sympathetic system.

PMID- 2232140
TI  - [Free and conjugated catecholamines in gastric and bile juice during surgical
      operations].
AB  - From 40 patients under surgical operation, gastric or bile juice was obtained to
      determine the possible excretion of free and conjugated catecholamine (CA) into
      the two kinds of juice. The patients were divided into normal renal function
      group and chronic renal failure group and former group was further divided into
      the dopamine (DA)-administered group and the non-DA-administered group. In the
      non-DA group with normal renal function, the gastric juice contained 0.30 +/-
      0.11ng.ml-1 of free and 0.12 +/- 0.06ng.ml-1 of conjugated norepinephrine (NE)
      and also 0.09 +/- 0.07ng.ml-1 of free and 0.40 +/- 0.10ng.ml-1 of conjugated DA.
      In DA group, the gastric juice contained 2.01 +/- 0.41ng.ml-1 of free and 3.66 +/
      0.84ng.ml-1 of conjugated DA respectively. Significant differences in DA were
      observed between two groups. In the bile juice, the conjugated NE increased
      significantly from 0.15 +/- 0.05 ng.ml-1 to 1.24 +/- 0.34ng.ml-1 and also the
      conjugated DA increased significantly from 2.17 +/- 0.77ng.ml-1 to 21.33 +/-
      5.23ng.ml-1 by infusion of DA at the rate of 2 micrograms.kg-1.min-1 for 197 +/-
      48min. In chronic renal failure group, the conjugated NE and DA increased
      significantly to 1.04 +/- 0.27ng.ml-1 and 1.64 +/- 0.61ng.ml-1 respectively
      compared to that of normal renal group. It was confirmed that gastric juice and
      bile juice contain the free and conjugated CA during surgical operation and by
      the infusion of DA, free and conjugated DA are excreted into gastric juice and
      bile juice and also conjugated CA in the gastric juice from chronic renal failure
      group is increased.

PMID- 2232141
TI  - [Effects of ketamine on somatosensory evoked potentials during nitrous oxide
      anesthesia in humans].
AB  - The effects of ketamine with 60% nitrous oxide were studied on subcortical
      sensory evoked potentials recorded at Erb's point (N9), neck (N13) and on
      cortical potentials recorded at the scalp (N20) following median nerve
      stimulations in 7 neurologically normal patients. Latencies and amplitudes of the
      potentials were measured and compared with postinduction control values taken
      during inhalation of 60% nitrous oxide. Ketamine 2 mg.kg-1 (iv) was administered
      initially and incremental dose was 50 micrograms.kg-1.min-1. N20 latency
      decreased at 15, 30 minutes after ketamine administration from a control value of
      18.7 +/- 0.9 msec to 18.2 +/- 1.1, 18.2 +/- 1.1 msec respectively, and N13-N20
      interpeak latency decreased from 6.0 +/- 0.4 msec to 5.5 +/- 0.7, 5.4 +/- 0.7
      msec (mean +/- SD). The author concluded that during nitrous oxide-based
      anesthesia, ketamine did not inhibit specific thalamoneocortical pathways.

PMID- 2232142
TI  - [Effects of ketamine on voltage-dependent Ca2+ current in single smooth muscle
      cells from rabbit portal vein].
AB  - The effects of ketamine on membrane potentials and voltage-dependent Ca2+ current
      were studied in dispersed single smooth muscle cells from rabbit portal vein. The
      resting membrane potential (-56.2 +/- 1.5mV) was not affected by ketamine (10(-5)
      10(-3)M). The duration and the amplitude of the action potential evoked by
      intracellular stimulation were significantly decreased by ketamine in the
      concentrations of 10(-4)M and 10(-3)M. Voltage-gated Ca2+ current in single
      smooth muscle cells was apparently decreased by ketamine at concentrations of
      between 10(-5)M to 10(-3)M. The activation threshold of Ca2+ current (approx. 
      30mV) was also decreased by ketamine. Therefore, these results suggest that
      inhibition of the contractile response by ketamine in vascular smooth muscle from
      rabbit portal vein may be attributable to the inhibition of the Ca2+ current.

PMID- 2232143
TI  - [Antibacterial activity of local anesthetics].
AB  - In order to study the antibacterial activity of local anesthetics quantitatively,
      we procured their minimum inhibitory concentration (MIC), killing curves and
      postantibiotic effect (PAE), using the standard colony of Staphylococcus aureus
      ATCC 25923, Staphylococcus epidermidis ATCC 14990 and Pseudomonas aeruginosa NCTC
      10490. Both bupivacaine and lidocaine had bactericidal activity at a clinical
      concentration. MIC of the former was lower than that of the latter, and it means
      that bupivacaine has a greater antibacterial activity than lidocaine. At the same
      concentration, the commercial solutions, such as Xylocaine and Marcain, which
      contain preservatives, showed a greater antibacterial activity than the pure
      anesthetic solutions which contain no preservatives. However, the preservatives
      had no bactericidal activity, but weak bacteriostatic activity.

PMID- 2232144
TI  - MRSA meningitis in postoperative patients. Report of 4 cases.
AB  - Four cases of postoperative meningitis caused by methicillin-resistant
      Staphylococcus aureus (MRSA) are reported together with a review of the
      literature. These 4 cases were treated successfully by intravenous administration
      of minomycin, fosfomycin, and cefmetazole. Factors associated with the
      development of meningitis included multiple craniotomies, the presence of
      ventricular drainage or a ventriculo-peritoneal shunt, and irradiation.

PMID- 2232145
TI  - [Clinical experience with chemotherapy using sulbactam/cefoperazone for severe
      infections accompanying malignant hematological disorders].
AB  - Clinical and bacteriological efficacies of sulbactam/cefoperazone (SBT/CPZ) were
      studied in 44 patients with serious infections associated with hematological
      malignancy. 1. SBT/CPZ was clinically effective in 33 cases (76.7%). Excellent
      effects were obtained in 23 cases, good effects in 10 cases and fairly good
      effects in 7 cases. Clinical effectiveness of SBT/CPZ was not dependent on
      neutrophil number in peripheral blood. 2. Bacteriologically SBT/CPZ was effective
      against all of the isolated organisms from 21 cases. 3. Adverse reactions were
      not significant except one case with eruption, 2 cases with abnormalities in
      hepatic function tests and 3 cases with abnormalities in renal function tests.

PMID- 2232146
TI  - [Studies on acetylspiramycin. 1. Separation and chemical structures of
      acetylspiramycin components].
AB  - 1. A macrolide antibiotic acetylspiramycin (ASPM) was separated into seven
      fractions using high performance liquid chromatography (HPLC) with Lichrosorb RP
      8 and mobile phase of a mixed solvent of 0.025M phosphate ammonium (pH 7.4) and
      acetonitrile at a ratio of 10:18. 2. Five components were purified over 90%, and
      analyzed using mass spectroscopy, 1H NMR, and 13C NMR, and their chemical
      structures were determined as 4''-acetylspiramycin I, 4''-acetylspiramycin II,
      4''-acetylspiramycin III, 3'',4''-diacetylspiramycin II and 3'',4''
      diacetylspiramycin III, respectively. 3. The weight component ratio of the seven
      fractions of ASPM separated by HPLC was constant throughout several lots of ASPM
      which had been stocked for nearly 15 years at room temperature, indicating an
      excellent chemical stability of the antibiotic. 4. Some physicochemical
      parameters were determined for the five ASPM components. Solubilities in water at
      24 degrees C were in a range from 0.14 mg/ml to 4.9 mg/ml, and they were, in the
      decreasing order, 3'',4''-diacetylspiramycin III, 3'',4''-diacetylspiramycin I
      4''-acetylspiramycin III, 4''-acetylspiramycin II, and 4''-acetylspiramycin I.
      Relationships between solubilities and numbers and positions of acyl substituents
      in spiramycin molecule are discussed.

PMID- 2232147
TI  - [A clinical study on ceftazidime in the treatment of intractable respiratory
      infections].
AB  - Ceftazidime (CAZ) was administered to 51 patients (37 males, 14 females) with
      respiratory infections including severe cases, accompanied by various underlying
      respiratory diseases. The clinical efficacy and side effects of CAZ were
      investigated. The mean age and body weight of these 51 cases were 62.6 years and
      48.0 kg, respectively. CAZ was administered by intravenous drip infusion (daily
      dose of 2-4 g) for a mean of 14.7 days to a mean total dose of 56.7 g. Clinical
      efficacy rates were 64% (18 of 28 cases), 80% (16 of 20 cases) and 67% (2 of 3
      cases) for airway and intermediary regional infections, pneumonia (including lung
      abscess) and pyothorax, respectively. In the bacteriological study, efficacy
      rates and bacterial eradication rates were 69% and 67%, 33% and 20%, 100% and
      100%, and 100% and 100% for infections caused by Pseudomonas aeruginosa (13
      cases), Staphylococcus aureus (6 cases), Streptococcus pneumoniae (6 cases) and
      Klebsiella pneumoniae (4 cases), respectively, and bacterial eradication was
      achieved in both of 2 cases of Peptostreptococcus anaerobius and 2 cases of
      Haemophilus influenzae, and 1 case each of Peptococcus sp., Fusobacterium
      necrophorum and Serratia marcescens. Side effects observed were eruption in 1
      case (2%) and elevated GOT, GPT and Al-P values in 1 case (2%), but these cases
      tended to recover after CAZ treatment was discontinued.

PMID- 2232148
TI  - [Cerebrospinal fluid transfer of cefbuperazone in the blood-brain barrier lesions
      of neurosurgical patients].
AB  - Cefbuperazone (CBPZ) was given in 15 patients after surgery. There was no
      infections except for 1 case in which signs of infections were suspected. As side
      effects, slight elevations in hepatic transaminase levels were observed in 3
      patients during the CBPZ chemotherapy. CBPZ concentrations in 7 patients were
      studied. The subjects were divided into 3 groups according to CT finding during
      the chemotherapy to correlate CBPZ concentrations to degrees of blood-brain
      barrier lesions; Group I: no enhancement, Group II: mild or focal enhancement,
      Group III: diffuse and marked enhancement. It was interesting to note that the
      more marked enhancement were obtained, the higher levels of CSF concentration of
      CBPZ.

PMID- 2232150
TI  - [Influence of cefodizime via intravenous bolus injection on human fecal flora].
AB  - Cefodizime (CDZM), a newly developed injectable cephem antibiotic, was given to 8
      healthy male volunteers with ages 23-28 years (mean: 24 years) and body weights
      54-73 kg (mean: 64 kg). 4 volunteers received 2 g b.i.d., intravenous infusion
      for 5 days, and 4 volunteers had 4 g b.i.d. for the same duration. We studied
      changes in bacterial flora and drug levels in feces, as well as changes in
      susceptibility of isolated microbes to CDZM, cefmetazole, cefotaxime (CTX) and
      cefoperazone. Adverse drug reactions and changes in laboratory findings were also
      investigated. The following results were obtained. 1. In fecal flora for the 2 g
      b.i.d. group, on day 3 of treatment Enterobacteriaceae were identified in only 2
      of the 4 cases. Individual microbe counts decreased or fell below detection limit
      (10(2) cells/g) on day 3 of treatment. Colony forming units (CFUs) of
      Enterobacteriaceae on day 5 of treatment were similar to those on day 3. After
      the end of treatment, its CFUs increased. The mean CFU of Enterobacteriaceae on
      day 10 after the end of treatment increased to about the same level as before
      dosing. However, some microbes did not revert to pretreatment levels. Of other
      Gram-negative bacilli, Pseudomonas sp. increased in one case transiently on day 3
      of treatment. After day 3 of treatment, its CFU decreased. Gram-positive microbes
      showed various changes. Mean CFU of yeast like organism (YLO) increased between
      day 3 of treatment and day 3 after the end of treatment and its mean CFU
      decreased on day 10 after the treatment. As for anaerobes, CFUs of Bacteroides
      fragilis group organisms and overall anaerobes showed no distinctive changes.
      Clostridium difficile were detected in two cases. In one case, C. difficile was
      noted at levels between 1.1 X 10(3) cells/g and 2.0 X 10(6) cells/g at the
      following sampling times: days 1 and 3 of treatment and days 3, 5, 10 and 20
      after the end of treatment. In other case, it was noted at levels of 1.8 X 10(5)
      cells/g on day 20 after the end of treatment. D-1 toxin was detected in one case
      before dosing, and in three cases (the concentration of D-1 toxin was 250 ng/g or
      500 ng/g) on day after treatment. Enterobacteriaceae in fecal flora of 4 cases
      given 4 g b.i.d. frequently decreased or fell below detection limit on days 3 and
      5 of treatment and day 3 after the end of treatment.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2232149
TI  - [Comparative studies on activities of antimicrobial agents against causative
      organisms isolated from urinary tract infections (1987). II. Background of
      patients].
AB  - In the retrospective survey of the sensitivity of clinical isolates reported in
      this journal, patients' backgrounds were also investigated. Some findings are
      summarized below. 1. Age distribution by sex: Patients with ages 50 years and
      older accounted for a majority, irrespective of their sexes amounting 67.6% for
      both sexes combined. 2. Annual distribution of sexes by age group: Females
      accounted for a majority in younger age brackets, but the proportion of males
      increased with age, accounting for a majority in patients 70 years or older. This
      pattern has been repeated practically every year. 3. Distribution of infection
      types by sex: Complicated urinary tract infections were predominant in males,
      while simple urinary tract infections were more frequent in females. 4. Annual
      distribution of sexes by type of infection: Complicated and simple urinary tract
      infections combined accounted for approximately 70% in both males and females.
      This pattern has been repeated practically every year. 5. Distribution of
      infection types by age: Patients of advanced ages were predominant as a whole but
      this trend was particularly pronounced in complicated urinary tract infection
      cases. 6. Annual distribution of infection types by age: The frequency of simple
      urinary tract infections among patients older than 20 years of age declined with
      age and this pattern has been repeated practically every year. Among patients
      older than 20 years of age, annual frequencies of complicated urinary tract
      infections have been on the decrease. 7. Distribution of isolated bacteria by
      sex: Escherichia coli was more frequent in females, while Enterococcus faecalis
      and Pseudomonas aeruginosa were more frequent in males. Compared with the
      previous year, the frequencies of coagulase-negative staphylococci, Enterococcus
      spp., and E. coli increased, while that of P. aeruginosa decreased. 8.
      Distribution of isolated bacteria by age: E. coli was most frequent on the whole,
      followed by E. faecalis, P. aeruginosa, Klebsiella spp., and coagulase-negative
      staphylococci, in that order. By age group, E. coli was frequent in younger
      patients and the frequencies of E. faecalis and P. aeruginosa increased with age.
      9. Annual distribution of isolated bacteria by infection type: Coagulase-negative
      staphylococci increased as a whole and P. aeruginosa and Serratia marcescens
      decreased compared to 1986, but E. coli continued to be the most frequent. E.
      coli was isolated from a majority of simple urinary tract infection cases. The
      frequencies of E. faecalis and P. aeruginosa were high in cases of complicated
      urinary tract infections.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2232151
TI  - [Synergy between sulbactam and ampicillin or cefoperazone in antimicrobial
      activity against beta-lactamase producing microorganisms. Results with the use of
      microdilution broth method].
AB  - Antimicrobial activities of sulbactam (SBT) with ampicillin (ABPC) or with
      cefoperazone (CPZ), in other words, the effects of SBT, an beta-lactamase
      inhibitor, against beta-lactamase producing strains of clinical isolates, were
      studied using microdilution broth method. 1. beta-Lactamase producing strains
      such as Staphylococcus aureus, Branhamella catarrhalis, Haemophilus influenzae,
      Escherichia coli and Klebsiella pneumoniae decompose benzylpenicillin (PCG) which
      is one of substrates of the acid-metry disc method and show a strong reaction,
      while they do not decompose cefazolin (CEZ), another substrate, showing no or
      weak reaction. Thus, it is suspected that beta-lactamases produced by these
      organisms are mainly penicillinase (PCase). MIC-distributions of ABPC and CPZ
      against these clinical isolates which seemed to produce PCase shifted to lower
      MIC ranges with MIC's reduced to 1/4 or below when 0.025 to 0.39 microgram/ml of
      SBT was added. 2. It appears that beta-lactamase produced by Proteus vulgaris may
      be oxyiminocephalosporinase (CXase), because P. vulgaris showed strong reaction
      on CEZ, but moderate reaction on PCG in the acid-metry disc method. MIC
      distribution of ABPC and CPZ against P. vulgaris shifted to a lower range with
      MIC's of 1/4 or below when 0.20 to 0.39 microgram/ml of SBT was added. 3. All the
      test strains of Pseudomonas aeruginosa showed strong reaction on CEZ but only 56%
      of the test strains showed reaction on PCG. It appears that the beta-lactamases
      which showed strong reaction on CEZ is cephalosporinase and is encoded in
      chromosome, while those beta-lactamase that showed strong reaction on PCG is
      encoded in a plasmid which was acquired secondarily by P. aeruginosa. MIC
      distribution of CPZ against P. aeruginosa shifted to a lower range with MIC
      values of 1/2 or below with the addition of SBT at 1.56 micrograms/ml. 4. It
      appears that the synergy of SBT with ABPC or with CPZ against the PCase or CXase
      producing strains may occur in the presence of SBT at a concentration far less
      than that reported previously.

PMID- 2232152
TI  - [Influences of postoperative prophylaxis treatments on vaginal bacteria flora at
      hysterectomy].
AB  - We performed abdominal hysterectomy and administered aztreonam (AZT) for
      prophylaxis of postoperative infections, and investigated influences of the
      antibiotics on vaginal bacterial flora. The obtained results are summarized as
      follows. 1. Patients administered with AZT were studied (n = 48) for bacteria
      isolated from their vaginae preoperatively and at the 7th and the 14th days
      postoperatively. Groups of patients administered with cephalothin (CET),
      cefamandole (CMD) and latamoxef (LMOX) were also studied for comparison. 2. In
      the AZT group, the rate of isolation of aerobic Gram-positive bacteria was high
      (68.8-81.4%) whereas those of aerobic Gram-negative and anaerobic bacteria were
      low. 3. When changes in isolation frequencies of bacteria from the subjects
      preoperatively to postoperatively were compared, the following tendencies were
      observed: increase in the rate of aerobic Gram-positive bacteria was larger in
      the LMOX group than in the AZT group whereas decrease in the rate of aerobic Gram
      negative bacteria was largest in the LMOX group followed by the AZT group then by
      the CMD group. Rates of decrease of anaerobic bacteria showed similar tendencies
      to the latter. Isolation rates of Candida sp. showed the largest increase in the
      LMOX group, followed by CET, CMD then AZT groups.

PMID- 2232153
TI  - [Cardiotoxicity study of ME2303 with the interval intravenous injections to
      rats].
AB  - Cardiotoxic effects of ME2303 were studied upon interval intravenous
      administrations to rats in comparison with those of doxorubicin (ADR). ME2303 at
      two dose levels of 3 and 9 mg/kg/day or ADR at a dose levels of 3 mg/kg/day was
      injected once a week for 3 weeks to female Sprague-Dawley rats (SPF) of 5-weeks
      of age. ADR depressed body weight gain, decreased food intake and increased water
      intake. Microscopic observation on the myocardial tissues revealed that ADR
      caused necrosis and cell infiltration, edema and disarrangement of myofibrils in
      some of ADR-treated rats. On the other hand, ME2303 showed no significant effects
      except that some decrease of food intake was observed at a dose level 9
      mg/kg/day. No changes in left ventricular functions were observed in perfused
      hearts isolated from ADR- or ME2303-treated rats. However, about 133 ng/g of ADR
      remained in the hearts even at 1 week after the final administration whereas
      ME2303 or its metabolites were not detected, suggesting that ADR may cause
      disturbance of ventricular function and more cardiomyopathy after a longer term
      than 1 week following the final administration. These results suggest that the
      cardiotoxicity of ME2303 is weaker than that of ADR in rats.

PMID- 2232154
TI  - [Single dose oral toxicity study of BMY-28100 in juvenile rats and dogs].
AB  - In order to investigate the single dose oral toxicity of BMY-28100 in juvenile
      animals, the drug was administered in single doses to 4-day-old and 14-day-old
      Crj: CD (SD) rats of both sexes at a dose of 2,000 mg/kg, and to 4-week-old
      beagle dogs of both sexes at doses of 500, 1,000 and 2,000 mg/kg by oral route.
      The results obtained are summarized as follows: 1. In rats, decreases of the body
      weight gain were observed for male and female rats treated with the drug on
      postnatal day 4 through 5 days and 3 days after dosing, respectively. There were
      no apparent drug-related toxic signs. No deaths occurred during the observation
      period. Enlargement of the cecum was found in a few rats of both sexes
      administered the drug on postnatal day 4 or 14. 2. In dogs, watery-mucous
      diarrhea observed at 2 to 3 hours after dosing in all dose groups was not dose
      related. This finding lasted in some dogs till 4 days after dosing. An increased
      incidence of emesis was induced in all males at 2,000 mg/kg and all females of
      all dose groups except one female at 2,000 mg/kg. Body weights increased normally
      for all dogs, but one male at 1,000 mg/kg showed a transient decrease in food
      consumption. No drug-related histopathological changes were found. Based upon
      these results, BMY-28100 at 2,000 mg/kg induced no apparent toxic changes in the
      present experimental conditions. Therefore, the single dose oral toxicity of the
      drug in juvenile animals appeared to be very slight and generally similar to that
      in adults.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232155
TI  - [Four-week repeated dose oral toxicity study of BMY-28100 in juvenile rats].
AB  - In order to investigate the repeated dose oral toxicity of BMY-28100 in juvenile
      rats, the drug was administered orally to 4-day-old Crj: CD(SD) rats of both
      sexes at daily doses of 250, 750 and 1,500 mg/kg for 4 weeks. The results
      obtained are summarized as follows: 1. Soiling around the anus apparently
      correlated to soft stool or diarrhea was observed at 750 and 1,500 mg/kg and the
      incidence appeared to be dose-related. Three deaths including 1 death due to
      cannibalization occurred at 750 and 1,500 mg/kg, but they were considered to have
      been caused by misadministration. 2. Slightly depressed body weight gains were
      noted in the 750 and 1,500 mg/kg dose groups during early dosing period. 3.
      Slightly increased averages of food and water consumption observed predominantly
      in the 1,500 mg/kg dose group at later dosing period and the recovery period were
      considered as incidental and unrelated to the treatment. 4. Though average values
      of some blood chemical parameters were slightly suppressed or elevated compared
      with those of controls at the completion of the dosing and recovery periods,
      these differences appeared to be generally within normal ranges and to be
      irrelevant to the drug treatment. No definitive drug-related changes were
      detected in hematological examinations and urinalyses. 5. The average absolute
      and/or relative organ weights of the brain, thymus, lungs and liver from male
      rats in the 1,500 mg/kg dose group were lower than those of the corresponding
      organs from controls. However, these findings were not considered to be
      toxicologically significant because no corroborative changes were detected
      microscopically. 6. Macroscopic and microscopic examinations demonstrated
      dilatation of the cecum in a dose-related fashion. This phenomenon has been
      reported with other antibiotics and appears to be drug-related and reversible
      caused by an alteration of the gut flora. There were no other microscopic changes
      that were considered to be related to the administration of the drug. 7. Electron
      microscopic examination revealed no drug-related changes in the liver and kidneys
      from rats of the 1,500 mg/kg dose group. Based upon these results, the no-effect
      dose level of BMY-28100 was estimated to be 250 mg/kg/day for both male and
      female juvenile rats in the 4-week repeated dose oral toxicity study if the
      finding of cecum dilatation was not considered.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2232156
TI  - [Four-week repeated dose oral toxicity study of BMY-28100 in juvenile beagle
      dogs].
AB  - Three groups, each consisting of 3 male and 3 female juvenile beagle dogs, were
      orally given BMY-28100 for 4 weeks at dose levels of 50, 160 and 500 mg/kg/day,
      respectively. Additionally, one male and one female dogs were added to each of
      the control and high dose groups in order to examine the recovery, and observed
      for 4 weeks after withdrawal of BMY-28100. The results obtained are summarized as
      follows: 1. BMY-28100 provoked an increased incidence of emesis in the 500 mg/kg
      group during the treatment period. 2. BMY-28100 sporadically brought distention
      of the cecum containing considerable amounts of contents in dogs sacrificed after
      the 4-week administration period. However, no macroscopic or microscopic changes
      were observed in the cecum itself after removal of the contents. In the 500 mg/kg
      group, hypocellularity in the sternum bone marrow was observed in a male and a
      female, and thymic atrophy in a male. 3. No changes ascribed to BMY-28100
      treatment were detected after the 4-week recovery period. Based upon these
      results, the no-effect dose level of BMY-28100 was estimated to be 160 mg/kg/day,
      except for effects on the cecum.

PMID- 2232157
TI  - [Immunological properties of BMY-28100 and cefepime].
AB  - Immunogenicity, eliciting antigenicity and cross-reactivity of new cephem
      antibiotics, BMY-28100 and cefepime, were studied by means of passive cutaneous
      anaphylaxis (PCA), passive hemagglutination (PHA) and active systemic anaphylaxis
      in guinea pigs, and of PCA in mice and the results were compared with those
      obtained with reference antibiotics. In addition, the direct Coombs' reaction of
      the human blood was examined in vitro for the test antibiotics as compared with
      reference antibiotics. The results obtained are summarized as follows: 1.
      Immunogenicity Immunogenicity of unconjugated antibiotics was examined using the
      corresponding conjugates with bovine gamma-globulin (BGG) as eliciting antigen.
      When used as emulsions with Freund's complete adjuvant, cephalothin (CET) and
      benzylpenicillin (PCG) produced IgG1 and IgM antibodies in guinea pigs. However,
      cefepime as well as cephalexin (CEX) did not produce these antibodies, and BMY
      28100 showed slightly active sensitization only for anaphylactic shock. In BALB/c
      and C3H/He mice, BMY-28100 and cefepime failed to produce antibodies under the
      experimental condition while IgE antibody formation to CET was observed. 2.
      Eliciting antigenicity Unconjugated CET and PCG provoked anaphylactic signs in
      guinea pigs sensitized with their conjugates with rabbit serum albumin (RSA).
      Cefepime, however, provoked no anaphylactic shock and BMY-28100 as well as CEX
      showed slight signs. In the other systems examined, no reactions were observed
      when elicited with BMY-28100, cefepime or the reference antibiotics. 3.
      Immunological cross-reactivity BMY-28100 did not cross-react with the reference
      antibiotics. While the antiserum to the RSA conjugate of CET provoked weak cross
      reaction on PHA with the BGG conjugate of cefepime, the antiserum to the RSA
      conjugate of cefepime failed to react with the BGG conjugate of CET. Other cross
      reactivities of cefepime were not observed against the reference antibiotics. 4.
      In vitro direct Coombs' reaction BMY-28100 did not induce the Coombs' reaction of
      the human blood in vitro at the testable concentration of 10 mg/ml. Cefepime or
      cefazolin (CEZ) caused no reaction even at a high concentration of 80 mg/ml,
      while CET and PCG caused a positive reaction at 10-40 mg/ml and 60 mg/ml,
      respectively. As shown above, immunogenicity and eliciting antigenicity of BMY
      28100 and cefepime were somewhat weaker than CET and PCG but similar to CEX, and
      cross-reactivities of the test antibiotics with these reference antibiotics were
      not observed in general. The ability of BMY-28100 to give a positive reaction in
      the Coombs' test was weaker than that of CET, and that of cefepime was weaker
      than CET and PCG and equivalent to CEZ.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2232158
TI  - [General pharmacology of BMY-28100].
AB  - General pharmacological properties of BMY-28100, a new semisynthetic oral
      cephalosporin, were studied in experimental animals. The obtained results are
      summarized as follows: 1. BMY-28100 had no effect on gross behavior and the
      central nervous system in mice and rats nor on EEG activities in rabbits. 2. BMY
      28100 did not affect the smooth muscle isolated from rats, guinea pigs or rabbits
      nor did it influence ganglionic transmission in cats. 3. Effects of BMY-28100 on
      the atrium and heart isolated from guinea pigs were not obvious. Several
      parameters of the cardiovascular system were examined and found unchanged by
      administration of BMY-28100 to rabbits. 4. In the digestive system, BMY-28100 had
      no effect on charcoal meal transport in the small intestine of mice. In rats,
      however, gastric secretion was reduced at a dose level of 125 mg/kg or higher and
      bile secretion was enhanced at a dose level of 500 mg/kg. 5. BMY-28100 had no
      effect on neuromuscular transmission in rabbits and showed no local anesthetic
      activity in guinea pigs. 6. BMY-28100 decreased urine volume and urinary
      excretion of electrolytes in dose-dependent manners in rats. Sulfobromophthalein
      excretion in rats was inhibited only at the highest dose tested. BMY-28100 had no
      effect on blood coagulation and red blood cell resistance in rats or rabbits. BMY
      28100 revealed no antiinflammatory activity in rats. 7. BMY-28167, a trans-isomer
      of BMY-28100, had no or weak effects on some of above test systems when compared
      with BMY-28100. These results suggest that BMY-28100 has hardly any
      pharmacological properties leading to severe adverse reactions in clinical use.

PMID- 2232159
TI  - [Studies on the pharmacokinetics of BMY-28100 (I)].
AB  - The pharmacokinetics of BMY-28100 have been studied in rats and monkeys upon oral
      administration of 14C-BMY-28100. 1. In rats administered with BMY-28100 at a
      single oral dose of 20 mg/kg, the peak blood level of the drug was 6.30
      micrograms equiv./ml at 1 hour after administration. Blood levels declined
      biphasically, thereafter. The AUC value was 37.0 micrograms equiv..hr/ml, and was
      97% of that observed after intravenous administration. This suggests that BMY
      28100 is absorbed at a high absorption rate from the gastro-intestinal tract. 2.
      In monkeys administered with a single oral dose of 20 mg/kg, the peak blood level
      was 4.26 micrograms equiv./ml at 3 hours after administration. Thereafter, blood
      levels declined biphasically as did in rats. The AUC was 38.9 micrograms
      equiv..hr/ml, which is similar to that observed in rats. 3. Urinary and fecal
      excretion after 20 mg/kg oral administration were 60.9% and 38.1%, respectively,
      in rats, and 40.3% and 51.2%, respectively, in monkeys. 4. Although absorption
      from gastro-intestinal tract was delayed by food intake, this did not affect the
      total amount absorbed in rats. 5. The absorption rates were similar in rats
      administered with 20 and 60 mg/kg, while a lower rate was obtained with 200
      mg/kg. 6. In rats, biliary excretion was 28.5% of dose administered. Thirty-nine
      percent of the biliary radioactivity was reabsorbed from the intestinal tract. 7.
      No differences between sexes were observed in absorption and excretion in rats
      administered with the drug at 20 mg/kg orally. 8. In rats administered with 20
      mg/kg, the radioactivity distributed rapidly to the whole body. High levels of
      radioactivity were found in gastro-intestinal tract, kidney, urinary bladder,
      aorta and liver. The radioactivity was removed rapidly from the tissues.
      Autoradiograms of the whole body were consistent with the measured tissue
      distribution. Relatively high levels of radioactivity were found in aorta,
      fascia, and ligament at 0.5, 1, 6, and 24 hours. 9. In vivo protein binding,
      which increased with time after administration, was 56.8 to 73.5% in rat and 36.3
      to 58.6% in monkey. The in vitro protein binding at 0.4 to 50 micrograms/ml of
      drug concentration was 50.0 to 54.7% in rat, 32.3 to 35.0% in monkey, and 33.4 to
      36.3% in human. 10. A stability test of 14C-BMY-28100 in plasma solution showed
      that the drug decomposed gradually into relatively polar compound(s). At 8 and 24
      hours, the proportions of unchanged 14C-BMY-28100 were 53.2% and 5.9%,
      respectively.

PMID- 2232160
TI  - [Studies on the pharmacokinetics of BMY-28100 (II)].
AB  - Studies were done in rats on placental transfer and excretion into milk of 14C
      BMY-28100 upon single oral administration. Studies on absorption, distribution
      and excretion of 14C-BMY-28100 were also done upon multiple dosing. 1. Fetal
      tissue concentration of the drug reached a maximum at 6 hours after dosing on day
      18 of gestation. The highest concentration observed was only 0.56 microgram
      equiv./g in fetal kidney; The transfer of radioactivity into the fetus was low.
      Similar results were obtained from whole body autoradiograms performed in rats on
      day 12 and day 18 of gestation. 2. Concentrations of radioactivity in milk
      reached a maximum of 0.60 microgram equiv./ml at 1 hour after administration, and
      gradually decreased thereafter. The maximum concentration in milk was 10% of the
      plasma concentration measured at the same time. 3. In the multiple oral
      administration study, 24 hours blood levels of radioactivity rose progressively
      with each dose, and reached a level 3.8 times higher than that observed with
      single dosing by the final (21st) administration. Tissue concentrations were
      relatively high in aorta, kidney and large intestine as were found upon single
      administration. However, the ratios of these levels between multiple and single
      dosing were lower than those observed in blood; 1.7, 3.6 and 2.9 for aorta,
      kidney and large intestine, respectively. Urinary and fecal excretion were
      constant after the 2nd administration.

PMID- 2232161
TI  - [Studies on immunity to Babesia gibsoni in dogs immunostimulation by Bordetella
      bronchiseptica].
AB  - Four species of bacteria, Corynebacterium anaerobium 578, Actinobacillus
      pleuropneumoniae G-4, Mycobacterium bovis BCG, and Bordetella bronchiseptica A-2,
      were injected intravenously into mice (5 weeks old, ICR-SPF). The clearance of
      carbon from the blood stream and the weights of the spleen and liver were
      determined as indicators of RES stimulation. Mouse footpad reaction was assessed
      as an indicator of delayed-type hypersensitivity to each species of bacteria. The
      immuno-stimulative activity of each species of bacteria against bovine serum
      albumin was monitored by passive hemagglutination assay and the macrophage
      migration-inhibition test in guinea pigs. Based on the results of the experiments
      described above, B. bronchiseptica was selected as an immunostimulator (Ims) for
      immunization trials of the hemo-protozoan parasite, Babesia gibsoni, with
      inactivated merozoites of B. gibsoni (BgK). Twelve dogs, pointers about 6 months
      old, were divided into four groups of three dogs each. Group 1 dogs were
      initially injected with Ims, and later injected with BgK and Ims (BgK+Ims) after
      a 3-week interval. Group 2 and Group 3 dogs were injected twice, at a 3-week
      interval, with BgK+Ims and BgK, respectively, and Group 4 served as a control. As
      the results, the serum antibody titres of Group 1 and 2 were several times higher
      than that of Group 3, and the cell-mediated immunity to parasites was noticeably
      stimulated by immunization with BgK+Ims. The peak level of parasitemia following
      the challenge were over 10% for Group 4 and 4.5% for Group 3, while levels for
      Group 1 and 2 were 2.5% and less than 1%, respectively. No such major clinical
      signs of babesiosis as jaundice and anemia were observed in Group 1 or 2.

PMID- 2232162
TI  - [Relationship between an offensive smell given off from human foot and
      Staphylococcus epidermidis].
AB  - The bacteria isolated from foot skins of 17 volunteers by the swab sampling
      method were mostly gram-positive cocci, which were identified as Staphylococcus
      epidermidis by the ID-kit SP-18 (Nissui Co., Ltd). After incubation of S.
      epidermidis on agar plates containing oleic acid and Tween 80 for 24 h at 35 C,
      the smell noticed was similar to an offensive smell of human pes. However, under
      the same conditions, the smell of another staphylococcal species was different
      from that of S. epidermidis. Except for the staphylococcal species, the colonies
      isolated from the skins were mostly those of yeast (unidentified) and gave off no
      offensive smell. From these results, it was considered that the smell of human
      pes might be given off by S. epidermidis, and if this species is inhibited, the
      smell would also be inhibited. A selective bactericide for gram-positive
      bacteria, which is a lotion containing deoxycholic acid, was applied to the feet
      of the 17 volunteers. The experiments showed that the application obviously
      decreased the counts of colonies of S. epidermidis and inhibited the smell as
      compared with controls.

PMID- 2232163
TI  - Ultrastructural pathological study of left ventricular myocardium in patients
      with isolated rheumatic mitral stenosis with normal or abnormal left ventricular
      function.
AB  - An electron microscopic study of left ventricular myocardium was carried out in
      15 patients who had isolated rheumatic mitral stenosis, with particular reference
      to the relation among ultrastructural pathological findings, the severity of
      mitral stenosis and left ventricular function. They were divided into 2 groups
      based on left ventricular performance evaluated by 2-dimensional echocardiography
      and angiocardiography. The severity of mitral stenosis was determined by
      hemodynamic data and mitral valve areas measured by 2-dimensional
      echocardiography. Regardless of the level of left ventricular contractile
      function we consistently demonstrated varying degrees of ultrastructural
      pathological alterations of left ventricular muscle cells, involving the
      myofibrils, mitochondria, nuclei and other elements of the sarcoplasm and
      membranes surrounding the myocardial cells in all specimens examined. The
      ultrastructural pathological findings did not correlate with the severity of
      mitral stenosis reflected in the echocardiographic and hemodynamic data. However,
      those patients with abnormal left ventricular function always exhibited more
      extensive loss of myofibrils resulting from either disproportion of the
      mitochondria-to-myofibril ratio or myofibrillar degeneration. The present
      investigation provides the morphological data at the ultrastructural level to
      support the widely held concept of a myocardial factor i.e., the extent of
      myocardial involvement by the rheumatic process as the basic pathogenetic
      mechanism responsible for left ventricular dysfunction in patients with isolated
      rheumatic mitral stenosis. Furthermore, it is suggested that pathological
      alterations of myocardial ultrastructure were related to the extent of myocardial
      involvement by the rheumatic process rather than being structural adaptations in
      response to the hemodynamic derangement.

PMID- 2232164
TI  - Crossover in baroreflex pathways controlling renal sympathetic nerve activity.
AB  - Experiments were performed to investigate the physiologic significance of the
      crossover of baroreceptor afferent input to the contralateral nucleus tractus
      solitarius (NTS) in terms of reflex control of renal sympathetic nerve activity
      and to determine the physiologic significance of neuronal crossover which may
      occur beyond the NTS. Experiments were done in 14 alpha-chloralose anesthetized
      rabbits. Baroreflex control of left renal nerve activity was determined from
      responses to phenylephrine-induced increases and nitroglycerin-induced decreases
      in arterial pressure. Under control conditions, the mean regression slope for
      changes in renal nerve activity (imp/sec/mmHg change in arterial pressure) was 
      2.2 +/- 0.5. After unilateral NTS lesion (n = 14) the gain of the reflex was -2.4
      +/- 0.4 imp/sec/mmHg. Denervation of baroreceptors ipsilateral to the NTS lesion
      (n = 6) did not alter the regression slope (-2.7 +/- 0.5 imp/sec/mmHg), but
      interruption of the contralateral carotid and aortic baroreceptor afferent fibers
      (n = 8) markedly reduced the slope of the linear regression relationship from 
      2.4 +/- 0.3 to -1.1 +/- 0.3 imp/sec/mmHg. We interpret these data to suggest that
      baroreceptor afferent input exerts its major reflex influence via the ipsilateral
      NTS and that there is modest influence exerted by fibers which cross over to the
      contralateral side. In addition, since we recorded from the left renal nerves and
      alternated the side of the NTS lesion, we interpret our findings regarding a
      lesion in only one NTS to suggest that there is crossover in the baroreflex
      pathway beyond the NTS which permits the NTS on one side to exert an influence on
      the renal nerves on the contralateral side similar to that seen when the NTSs on
      both sides are intact.

PMID- 2232166
TI  - The spontaneously hypertensive rat. Proceedings of the XXV annual scientific
      meeting of the Society for the Spontaneously Hypertensive Rat (SHR). September 4
      5, 1989, Tokyo.

PMID- 2232165
TI  - Effects of a calcium-antagonist on vascular sympathetic nerve activity in salt
      dependent hypertension.
AB  - The purpose of the present study was to investigate the effects of a Ca2(+)
      antagonist on vascular sympathetic nerve activity in salt-dependent hypertension.
      Isolated mesenteric vasculature preparations from reduced renal mass-salt
      hypertensive and age-matched normotensive control rats were used to examine the
      effects of diltiazem on vascular responsiveness and norepinephrine release from
      sympathetic nerve endings. Pressor responses and endogenous norepinephrine
      release during electrical nerve stimulation were significantly greater in
      preparations from salt-dependent hypertensive rats than from normotensive control
      rats. Diltiazem inhibited both stimulation-evoked pressor responses and
      norepinephrine release in a dose-dependent manner. The attenuation of these
      responses was more pronounced in preparations from rats with salt-dependent
      hypertension than in those from control rats. These results indicate that
      norepinephrine release from vascular adrenergic neurons is enhanced in the
      mesenteric vasculatures of rats with salt-dependent hypertension. The marked
      reduction of stimulation-evoked pressor responses and norepinephrine release by
      diltiazem suggests that enhanced Ca2(+)-dependent adrenergic transmission may
      contribute to the exaggerated vascular sympathetic tone in salt-dependent
      hypertension.

PMID- 2232167
TI  - [Orofacial lymphomas in seropositive patients manifesting the type I human
      lymphotropic virus (HTLV-I)].
AB  - Eleven cases of extranodal orofacial lymphomas (EOFL), consisting of 4 HTLV
      related and 7 HTLV unrelated EOFLs, have been investigated with regard to their
      immunohistological and clinical features. The HTLV related EOFLs were found to be
      of the T-cell phenotype and were associated with a poorer prognosis than the HTLV
      unrelated EOFLs, most of which were of B-cell origin. The comparatively high
      incidence of T-cell type in our series was considered to be related to the high
      percentage of HTLV carriers in our district, an area in which adult T-cell
      leukemia lymphoma has been found to be endemic.

PMID- 2232168
TI  - [The expression of NCC-ST-439, a tumor marker, in human breast cancer patients].
AB  - The expression and serum level of NCC-ST-439, a tumor marker, has been
      investigated in 20 primary and 28 recurrent breast cancer patients, and the
      positive rate was found to amount to 21.1% in primary cases and 42.9% in
      recurrent cases, respectively, thereby indicating a positive correlation between
      the expression of NCC-ST-439 and the progression of the diseases. The accordance
      rate between NCC-ST-439 and CEA was 64.6%; in contrast, the rate between NCC-ST
      439 and CA 15-3 was 82.1%, suggesting a difference in specificity against tumor
      between NCC-ST-439 and CEA. The change in the serum level of NCC-ST-439 in
      recurrent cases clearly correlated with the effectiveness of the therapy. These
      findings suggest that measurement of the NCC-ST-439 level, especially in
      combination with the CEA level, may be useful for the early detection and the
      monitoring of relapses in breast cancer patients.

PMID- 2232169
TI  - [Radiotherapy of local regional recurrences of a mastectomized breast carcinoma
      and its results].
AB  - Local-regional recurrences of a breast carcinoma after the mastectomy have been
      studied. A complete response rate of 89% was noted and this rate was found to
      decrease with an increase in the size of the mass. The most favorable local
      control rate was noted in carcinomas of the solitary nodular type where as the
      worst control late was seen in those with a lymph node metastasis. The 5-year
      survival rate in all cases was found to be 28.0%, and best in the solitary
      nodular type carcinomas and worst in carcinomas of the invasive type. Chestwall
      recurrences associated a local lymph node metastases were found to have a poorer
      prognosis compared to those without a lymph node metastasis.

PMID- 2232170
TI  - [The DNA ploidy patterns in early gastric cancers as a criterion for surgery].
AB  - A study of the ploidy patterns in gastric cancer has been conducted, focusing on
      20 cases diagnosed prior to surgery as early stage gastric cancers. The gastric
      cancer in 10 cases was confined to the submucosa, where as in the other 10, the
      gastric cancer had invaded the muscle propria. The DNA ploidy patterns were
      classified as follows: Type D, Type A1 and Type A2. Even with gastric cancers of
      less than 2 cm, the likelihood that those with Type A1, and Type A2 patterns
      would spread into the lymph node was high (A1, 43% and A2, 67%), suggesting that
      careful consideration should be given to limiting the intended surgery. With
      gastric cancers of the Type D pattern, however, the incidence of a lymph node
      metastasis was low. These results are felt to be important factors when
      considering the extent of surgery.

PMID- 2232171
TI  - [A clinical and pathological study of small renal cell carcinomas].
AB  - Ten cases of a small renal cell carcinoma having a tumor that was 3 cm or less
      have been studied both clinically and pathologically. In nine of the 10 cases,
      the tumor had been detected incidentally, and all 9 were asymptomatic. Renal
      lesion were diagnosed all of the 10 cases by computed tomography and in 9 cases
      by ultrasonography. The pathological characteristics of small renal cell
      carcinoma are characterized by an expansive development, an alveolar structure, a
      clear cell subtype, a low grade nuclear atypism, and a general lack of
      infiltration. The postoperative follow up period was 20 months on average, and
      all patients had survived with no appearance of a new lesion.

PMID- 2232173
TI  - [A case of primary early duodenal cancer].
AB  - Reported is a case of a suprapapillary primary early duodenal cancer in a 50 year
      old male patient who had had a hemicolectomy 15 years earlier for a colon cancer.
      The patient had undergone upper gastrointestinal endoscopy during a mass
      screening for abnormalities in the gastro-intestinal tract, and a slightly
      depressed lesion of the IIa + IIc type, 25 x 20 mm in diameter, was discovered
      accidentally at the superior duodenal flexure. The subsequent biopsy revealed a
      well differentiated tubular adenocarcinoma. Thus, the patient underwent a
      subtotal gastrectomy and a partial duodenectomy with a lymph node dissection. The
      histology of the resected specimen was the same as that of the biopsy, but only
      the mucosa was involved. Adenomatous lesions of the colon are known to
      occasionally accompany upper gastro-intestinal tumor, so that periodic gastro
      intestinal scrutiny follow-ups are mandatory.

PMID- 2232172
TI  - [An esophageal cancer with a renal metastasis that was detected and resected as
      the only focus of recurrence].
AB  - Reported is the case of an esophageal cancer presenting a renal metastasis, which
      was detected and resected as the only recurrent focus. The patient was a 62-year
      old male. Five months after an esophagectomy, a left renal mass was detected by
      abdominal computerized tomography, and a rise in the SCC antigen. The urinary
      cytology suggested a renal metastasis of the esophageal cancer. Thus,
      chemotherapy and irradiation was performed, followed by a resection. The
      histology of the resected mass showed a squamous cell carcinoma, similar to the
      findings at the primary site. A renal metastasis of an esophageal carcinoma
      usually is latent, but not rarely found on postmortem examination. A nephrectomy
      for a renal metastasis of an esophageal cancer is rare, and only 8 cases are
      reported in the literature.

PMID- 2232174
TI  - [A biliary endocrine cell carcinoma: a report of two cases].
AB  - An endocrine cell carcinoma is a carcinoid tumor that has an especially malignant
      prognosis. We herein report on 2 cases of a biliary endocrine cell carcinoma.
      Case 1 involved a 68 year old man manifesting a fever, jaundice, hepatomegaly and
      a ballooned gallbladder. After decreasing the jaundice by PTCD, an exploratory
      abdominal operation was performed. As a tumor was found at the papilla of Vater,
      a pancreaticoduodenectomy was done. Case 2 involved a 72 year old woman who was
      diagnosed as having a gallbladder tumor and cholelithiasis. She was given a
      cholecystectomy and a choledocholithotomy. These 2 cases had hepatic metastasis
      within a year and subsequently died. Procedurally, an endocrine cell carcinoma
      should be treated separately from classical carcinoid tumors.

PMID- 2232175
TI  - [A case of unresectable pancreatic cancer that responded to UFT chemotherapy].
AB  - A 77-year-old patient with an unresectable pancreatic cancer was treated with a
      combination chemotherapy of UFT (600 mg/day, p.o.) and Lentinan (2 mg/week,
      i.v.). After three and a half months, a partial response (PR) was achieved, based
      on the criteria of Koyama, Saito, et al. The findings of the follow up CT scans
      suggested that 600 mg/day of UFT, rather than 300 mg/day, was effective as a
      chemotherapeutic agent. Although transient thrombocytopenia (62,000/mm2) and
      eruption were observed during this therapy, no serious side effects were
      experienced. After eighteen months of this chemotherapy, the patient has not
      succumbed and manifests a good quality of life.

PMID- 2232176
TI  - [Clinicopathological analysis of leiomyosarcomas of the small intestine and a
      review of the Japanese literature].
AB  - An analysis has been made of 9 cases of a leiomyosarcoma of the small intestine
      that were treated from 1974 through 1989. In two patients (22.2%), a perforation
      was seen, and a case report of a 59-year-old woman is presented. Further, case
      reports of leiomyosarcomas in the Japanese literature from 1980 through 1989 were
      clinico-pathologically analyzed. The frequency of a perforation was found to be
      8.6%, and the distribution of the perforated leiomyosarcomas was the same as for
      the non-perforated cases. The five-year postoperative survival rate was 41.2%. Of
      note is that 3 out of 10 patients that had survived for 5 years subsequently died
      of sarcomatosis.

PMID- 2232177
TI  - [A primary malignant lymphoma of the appendix].
AB  - A malignant lymphoma (ML) of the gastrointestinal tract occurs most frequently in
      the stomach, and ML of the appendix is very rare, with only 16 cases reported in
      the Japanese literature. Reported is a case of a primary ML the appendix in a 48
      year old male, in whom an ileocecal resection was carried out. This case was
      pathohistologically diagnosed as a diffuse large lymphoma of the B cell type,
      according to the LSG classification. Therapeutic problems were encountered
      because of the difficulty in making an early diagnosis.

PMID- 2232178
TI  - [A renal cell carcinoma mimicking a multilocular renal cyst].
AB  - A 38-year old man was admitted to the hospital for an investigation of abnormal
      ultrasonographic findings of the left kidney. Ultrasonography demonstrated
      multiple, fluid-filled masses separated by a highly echogenic septa and CT
      revealed a large cystic mass and a thick, irregular wall in the upper and middle
      poles. Selective, left renal arteriography showed a hypovascular mass. Thus, a
      presumptive diagnosis was made of multilocular renal cysts. Taking into accounted
      the possibility of a renal cell carcinoma. Surgical exploration and a left
      nephrectomy was performed. Microscopically, a multiloculated renal cell carcinoma
      thus was diagnosed, A definite, preoperative diagnosis is very difficulty to make
      in most cases, and surgical exploration is considered to be the only way to
      achieve an accurate diagnosis. Treatment for a multiloculated cystic renal mass
      containing multilocular renal cysts is a total or partial nephrectomy.

PMID- 2232179
TI  - [A carcinosarcoma of the ovary: a case report and a review].
AB  - A carcinosarcoma of the ovary, which is a combined epithelial and mesenchymal
      tumor, is exceeding rare and usually has poor prognosis. Only four known cases,
      including this case, have been reported in Japan. In our case, after resection a
      combined chemotherapy consisting of cisplatinum, adriamycin cyclophosphamide and
      etoposide was administered and the patient had no uneventful postsurgical course.

PMID- 2232180
TI  - [A pathological study of primary malignant lymphomas of the thyroid].
AB  - Thirty cases of a primary malignant lymphoma (ML) have been studied
      clinicopathologically and immunohistochemically. The average age of the patients
      was 59.1 years, and the ratio of males to females was 1:1.7. According to the
      Kiel classification of MLs, 53.3% had a low grade malignancy and 46.7% were a
      high grade malignancy. Therefore, the number with a low or a high grade
      malignancy was almost equal. Most of the low grade malignancies were ML,
      centroblastic centrocytic, and most of the high grade malignancies were ML,
      lymphoblastic. From histopathological and immunohistochemical studies, most cases
      were considered to be of B-cell origin and two thirds of the cases were regarded
      as being of a follicular center cell origin. Prognosis was better than that of
      other MLs. Finally, MLs of the thyroid were found combined more frequently with
      chronic thyroiditis of the Hashimoto type than malignant epithelial neoplasms.

PMID- 2232181
TI  - [A case-control study of risk factors of breast cancer detected by mass
      screening].
AB  - A case-control study has been performed to elucidate the risk factors of women
      with a breast cancer that was detected by mass screening. Studied were the cases
      of fifty-two women with a primary breast cancer that had been detected by mass
      screening from 1978 to 1989. Age-matched mass screening controls and hospital
      controls were randomly selected at the rate of two controls for each case. Risk
      factors investigated were the age at menarche, the age at marriage, the number of
      pregnancies, the number of full-term pregnancies, the age at first delivery, the
      status of lactation, the age at menopause, the family history of breast cancer,
      benign breast disease, exogenous hormonal agents, and obesity. In comparing the
      mass screening subjects with the controls, a significant odds ratio (OR) was
      shown in no lactation (OR = 2.67, p = 0.02) and the history of a previous benign
      disease (OR = 2.56, p = 0.03). No lactation (OR = 2.29, p = 0.02) was significant
      when compared with the hospital controls. Furthermore, early menopause and an
      early age at first delivery seemed to act as a protective factor against breast
      cancer.

PMID- 2232182
TI  - [The relation of stone and carcinoma of the gallbladder based on the mucosal
      findings].
AB  - Based on the mucosal findings in gallbladder patients, intestinal metaplasia was
      found in 18.4% of such cases without a stone or a carcinoma, in 30% of the with a
      bilirubin stone, in 37.7% of those with a cholesterin stone, in 69.1% of those
      with a carcinoma but without a stone and in 78.9% of those with both a carcinoma
      and a stone. In contrast the incidence of a well differentiated adenocarcinoma
      was more frequent in the cases with a stone (more often a cholesterin stone than
      a bilirubin stone) than in cases without a stone. Similarly, the incidence of
      intestinal metaplasia was more frequent in those with a cholesterin stone than in
      those with a bilirubin stone. Further, small size lesions were found to be more
      frequent in the cases of a cancer with a stone. Granular early carcinomas within
      the superficial muscle layer are usually resected under the diagnosis of
      gallstone, whereas early carcinoma that protrude are resected as a carcinoma.

PMID- 2232183
TI  - [A clinical evaluation of the CA 72-4 serum level as a possible tumor marker].
AB  - The level of CA 72-4 in serum has been measured in various diseases by an
      immunoradiometric assay using CA 72-4 RIA Kit for an evaluation of its clinical
      significance as a possible tumor marker. CA 72-4 showed a high positive rate in
      patients with ovarian and bile duct cancers. In contrast, the false positive rate
      was low in benign gynecological and digestive diseases. Serum CA 72-4 was found
      to be increased in patients with a mucinous cystadenocarcinoma and in other
      histological types in the early stages of an ovarian cancer. Further, the serum
      CA 72-4 level changed in parallel with the clinical course of the ovarian cancer.
      Therefore, our results suggest that measurement of CA 72-4 be combined with
      measurement of CA 125, so as to provide a better sensitivity and specificity in
      monitoring an ovarian cancer.

PMID- 2232184
TI  - [An epithelial myoepithelial carcinoma of the parotid gland].
AB  - A case of epithelial myoepithelial carcinoma is reported. Histologically, this
      tumor shows tubular and solid growth pattern. The inner layer of the tubules is
      composed of cells with an eosinophilic cytoplasm that is surrounded by cells with
      clear cytoplasms. Clear cells also manifest a solid growth pattern.
      Immunohistochemical and electron microscopic examinations has revealed that the
      cells with an eosinophilic cytoplasm have the characteristics of the ductal
      epithelium and that the clear cells have the characteristics of the
      myoepithelium. Immunohistochemically, keratin positive clear cells and S-100
      protein positive ductal cells were found in our case. This suggests the existence
      of cells having both ductal and myoepithelial characteristics and this inspected
      tumor had derived from multipotential cells of intercalated ducts.

PMID- 2232186
TI  - [A case of asbestos exposure complicated by a malignant pheochromocytoma].
AB  - Reported is a case of non-functioning malignant pheochromocytoma. The patient had
      an occupational history of asbestos exposure and pleural plaque was seen in the
      chest X-rays. The tumor appeared from right adrenal gland and its size was 12 x
      15 cm, which was measured by CT scanning. This determined to be non functioning
      because catecholamines in the serum and VMA in the urine were within normal
      limits. A metastasis of this tumor was seen in the lung, the liver, and the bone.
      So far as is known, this is the first case of asbestos exposure complicated with
      malignant pheochromocytoma that has been reported in the Japanese literature.

PMID- 2232185
TI  - [A basal cell carcinoma of the esophagus--a case report].
AB  - Reported is the case of a 58-year-old male who visited our hospital with the
      chief complaint of anorexia. Diagnosed as having an esophageal cancer, a subtotal
      esophagectomy was performed including the dissection of the tumor. According to
      the surgical findings, the tumor was not exposed to the tunica externa and no
      lymph node metastasis or infiltration to the pleura or a metastasis to the lung
      or liver was note. On histopathological examination a basal cell carcinoma of
      esophagus was determined but no squamous epithelium was seen. The carcinoma was
      the muscular propria, and neither infiltration into the epithelium nor invasion
      into the vessels was noted. The postoperative progress appeared good, however
      seven months later the patient died from multiple hepatic metastasis.

PMID- 2232187
TI  - [Eleven cases of spindle cell carcinoma of the breast, with special reference to
      cystic changes in the tumor].
AB  - The clinicopathological features of 11 cases of a spindle cell carcinoma handled
      by our department have been investigated and are presented, with two cases that
      demonstrated cystic changes. Out of a total of 1,524 breast carcinomas that were
      treated, 11 (0.72%) were spindle cell carcinomas. The size of the tumor was
      generally larger than in other more common types of breast carcinomas, but the
      degree of a lymph node metastasis was low and the prognosis was better. As for
      the ER status, 4 out of 5 cases were negative. As cystic changes in the tumor
      were found in 5 of the 11 cases, it would seem that spindle cell carcinomas of
      the breast tend to show cystic changes in their tumors.

PMID- 2232188
TI  - [A case of type I early gastric cancer discovered after gastrectomy of depressed
      type early gastric cancer].
AB  - Greater clarification has resulted since the discussion at the 38th Stomach
      Cancer Research Meeting on the frequency of a cancer developing in the remaining
      portion of a stomach after excision of a previous gastric cancer. Further, fewer
      reports have appeared of early stage cancers in the remaining stomach. Reported
      here is a case of a patient with an early stage stomach cancer, type I, that
      occurred 5.5 years after resection of an early stomach cancer, type IIc + III, at
      a point some distance removed from the anastomosis of the remaining stomach.
      Total extirpation of the remaining stomach resulted. Two years later, surgery to
      remove a pulmonary small cell carcinoma in this patient also was performed. The
      paper presents a study of this case.

PMID- 2232189
TI  - [Gastric cancer presenting a variety of macroscopic and histopathological
      findings].
AB  - A 68-year-old man was admitted to hospital because of nausea and vomiting.
      Examination of the upper digestive tract led to a total gastrectomy. A
      histopathological examination revealed a Borrmann type 3 advanced cancer in the
      prepyloric antrum that showed a moderately differentiated adenocarcinoma. Found
      on the anterior wall of the middle corpus was an advanced cancer, mimicking a
      type IIc early cancer, that was poorly differentiated with dispersed signet ring
      cells. Between these two advanced cancers, another superficially extended cancer,
      consisting of a type IIa and IIb early cancer, was found. The type IIa cancer,
      located on the posterior wall of the angle, was a papillary adenocarcinoma and
      the type IIb cancer on the lesser curvature of the antrum was moderately
      differentiated. Therefore this patient displayed not only a type IIa and a type
      IIb cancer, but also a Borrmann type 3 cancer and an advanced cancer, mimicking
      type IIc, that were linked into one large lesion. Although the present case was
      not determined as being a multiple gastric cancer, it suggests the likelihood of
      a multicentric generation, growth, and extension of synchronous multiple cancers,
      in view of the variety of macroscopic and histopathological findings presented.

PMID- 2232190
TI  - [A case of triple carcinomas: stomach carcinoma surgically removed, renal tumor,
      and carcinoma of the remnant stomach].
AB  - Reported is the case of a 57-year-old male patient, who manifested tarry stool
      and who had undergone a subtotal gastrectomy at our hospital in 1983 for an early
      carcinoma, type IIc, which proved to be a well differentiated tubular
      adenocarcinoma. Three years later, he returned complaining of epigastralgia,
      although no evidence of a recurrence could be seen. An abdominal ultrasonogram
      and a CT scan, however, revealed a right renal tumor and he subsequently
      underwent an operation for the removal of a renal cell carcinoma, a clear cell
      type. In 1988, he again was readmitted to hospital, this time because he easily
      became fatigued. An upper GI series and gastroscopy located a polypoid lesion in
      the remnant stomach. Thus, a total gastric resection was performed, and the
      lesion was diagnosed as being a well differentiated tubular carcinoma, an early
      gastric cancer, type I. Triple carcinomas are very rare, and the details of this
      case are discussed.

PMID- 2232191
TI  - [A case of complete remission from acute unclassified leukemia achieved by using
      a prodrug of ara C, stearyl-ara-CMP (YNK01)].
AB  - YNK01 (a daily oral dose of 450 mg) was administered for 22 days to a 58-year-old
      female with Ph1-positive acute unclassified leukemia. Leukemia cells were
      negative for peroxidase and esterase, but were positive for CD19, CD13, CD34,
      CD9, HAL-DR, CD25, and TdT. Complete remission was obtained and continued for at
      least a month. The main side effects noted were diarrhea and melena. The
      administration of YNK01 resulted in plasma ara C levels that ranged between 15.4
      to 23.0 ng/ml, which appear to be nearly equivalent to dose achieved during
      continuous IV infusion of a low dose (20 mg/m2/day) of ara C.

PMID- 2232192
TI  - [Advance in bone marrow transplantation and bone marrow donor registry in the
      world].

PMID- 2232193
TI  - [MHC-restricted antigen recognition by T cells].

PMID- 2232194
TI  - [Clonal anergy as a mechanism of transplantation tolerance].

PMID- 2232195
TI  - [Roles of non-MHC genes in the induction of graft-versus-host reaction].

PMID- 2232196
TI  - [Advances in hematopoietic growth factor research and bone marrow transplantation
      -hematopoietic stem cells and their growth factors].

PMID- 2232197
TI  - [Application of recombinant hematopoietic factors for bone marrow
      transplantation].

PMID- 2232198
TI  - [The process of hematological reconstitution after human bone marrow
      transplantation].

PMID- 2232199
TI  - [T cell depletion for allogeneic bone marrow transplantation].

PMID- 2232200
TI  - [Graft-versus-leukemia effect (GVL effect): pathophysiological and clinical
      aspects].

PMID- 2232201
TI  - [Physical and radiobiological considerations of total body irradiation and total
      lymphoid irradiation for bone marrow transplantation].

PMID- 2232202
TI  - [HLA-mismatched bone marrow transplantation].

PMID- 2232203
TI  - [Indications of allogeneic bone marrow transplantation].

PMID- 2232204
TI  - [Schedule for bone marrow transplantation and selection of marrow donor].

PMID- 2232205
TI  - [Conditioning regimens for diseases treated by allogeneic bone marrow
      transplantation].

PMID- 2232206
TI  - [Technology of bone marrow transplantation--harvest and manipulation of bone
      marrow cells].

PMID- 2232207
TI  - [Prevention and treatment of various infections after bone marrow
      transplantation].

PMID- 2232208
TI  - [Monitoring of graft versus host (GVH) reaction and host versus graft (HVG)
      reaction].

PMID- 2232209
TI  - [Complications classified under clinical stages following bone marrow
      transplantation].

PMID- 2232210
TI  - [Acute GVHD: pathogenesis, symptomatology, stage/severity, and treatment].

PMID- 2232211
TI  - [Immunopathogenesis and clinical aspects of chronic GVHD after allogeneic bone
      marrow transplantation].

PMID- 2232212
TI  - [Allogeneic bone marrow transplantation for acute lymphoblastic leukemia].

PMID- 2232213
TI  - [Results and proposal standard for the indication of bone marrow transplantation
      in acute nonlymphocytic leukemia].

PMID- 2232215
TI  - [Bone marrow transplantation for myelodysplastic syndrome].

PMID- 2232214
TI  - [Bone marrow transplantation for chronic myelogenous leukemia].

PMID- 2232217
TI  - [Ex vivo purging methods for autologous bone marrow transplantation].

PMID- 2232216
TI  - [Allogeneic bone marrow transplantation for aplastic anemia].

PMID- 2232218
TI  - [Method and clinical results of autologous bone marrow transplantation].

PMID- 2232219
TI  - [Autologous bone marrow transplantation in the treatment of solid tumors: current
      status of clinical results].

PMID- 2232221
TI  - [Immunological tests ].

PMID- 2232220
TI  - [Antiviral chemotherapy for AIDS: dideoxynucleosides and clinical application].

PMID- 2232222
TI  - [Tumor and immunology].

PMID- 2232223
TI  - [List of diagnostic reagent kits for immunological tests and review of
      immunoreplacement, suppressant, modulator and complement control factor].

PMID- 2232224
TI  - [Transplantation immunology].

PMID- 2232225
TI  - [Aging and immunity].

PMID- 2232226
TI  - [Reproduction and immune response (including in pregnancy)].

PMID- 2232227
TI  - [Clinical immunology in various field of medicine].

PMID- 2232228
TI  - [Immunosuppressive therapy ].

PMID- 2232229
TI  - [Basic concept and clinical application of monoclonal antibody].

PMID- 2232230
TI  - [Thrombospondin].

PMID- 2232231
TI  - [Plasminogen activator inhibitor-2].

PMID- 2232232
TI  - [Molecular basis for hereditary deficiency of alpha 2-plasmin inhibitor].

PMID- 2232233
TI  - [Studies on the pathogenesis of hypercoagulability in patients with arterial
      thrombosis and malignancy].

PMID- 2232235
TI  - [The tissue factor activity in plasma in patient with DIC].

PMID- 2232234
TI  - [Abnormality of blood coagulation before onset of DIC--risk factors for DIC].

PMID- 2232236
TI  - [Plasma level of activated factor IX-antithrombin III complex in hypercoagulable
      state].

PMID- 2232237
TI  - [Leukemia and pre-DIC--coagulation and fibrinolytic parameters in severe
      infection at the nadir of leukocyte after chemotherapy].

PMID- 2232238
TI  - [Protein C--possible usefulness as a therapeutic weapon].

PMID- 2232239
TI  - [Mechanism of platelet activation induced by TP 82, a monoclonal antibody against
      CD9].

PMID- 2232241
TI  - [Congenital factor IX abnormalities].

PMID- 2232240
TI  - [Binding of calpain to plasma membrane and its role in platelets].

PMID- 2232243
TI  - [Structure, function and expression of human tissue factor].

PMID- 2232242
TI  - [Structure and function of von Willebrand factor: GPIb binding domain].

PMID- 2232244
TI  - [Progress in clinical chemistry].
AB  - The basic and clinical studies that are expected to influence future laboratory
      medicine were presented by five speakers in the symposium held at the National
      Cardiovascular Center, in Osaka on January 27, 1990. Dr. Y. Katayama reported a
      new method for analyzing glycated protein by HPLC and the data on the positive
      error caused by superoxide anion in the value of fructosamine. Dr. Y. Harano
      described a sensitive method for enzyme immunoassay of apoprotein B and discussed
      cases of diabetes mellitus, hyperlipidaemia and hypo-apoprotein B with respect to
      the apoprotein B level. Dr. T. Noguchi reported the excellent results in DNA
      analysis of pyruvate kinase. Dr. N. Taniguchi presented a basic study on
      superoxide dismutase and noted the increased activity of this enzyme in certain
      diseases. The assay of this enzyme activity can now be routinely performed. Dr.
      H. Matsuo, the last speaker in this symposium, had received the Gakusiin award in
      1989 for his studies on atrial natriuretic hormone (ANH). He outlined the history
      of ANH study developed in his laboratory. ANH also will be added to routine
      assay. We, the chairmen in this symposium, added comments concerning useful
      modern techniques for the clinical chemistry and the role of the clinical
      laboratory in large hospitals.

PMID- 2232245
TI  - [Highly sensitive apo B assay and its clinical significance].
AB  - Two sensitive and accurate methods for the determination of apo B using
      polyclonal antibody for human purified LDL are reported. Modified one step EIA by
      sandwich method is highly sensitive and serum has to be diluted by 1,000-3,000
      times, but suited for the diagnosis of hypo or abetalipoproteinemia, detailed
      analyses of lipoprotein subfractions and in vitro study of lipoprotein
      metabolism. Latex method is moderately sensitive (serum dilution: 100 times),
      automated, simple and accurate with CV, 1.5-2.5%. Serum apo B assay is useful not
      only for the diagnosis of hyperlipidemia, hypolipidemia, but also for the
      analyses of atherogenic lipoproteins which are frequently associated with large
      vessel atherosclerotic changes in diabetes, obesity and coronary, cerebral or
      peripheral vascular diseases. A family pedigree of elevated apo B with frequent
      association of diabetes (type 2 b) and prominent hypercholesterolemia with
      autoimmune apo B antibody has been described. In obesity, either hyperinsulinemia
      or hyperglycemia plays a role in the elevation of VLDL and IDL probably through
      hepatic overproduction of VLDL. The size of VLDL tends to be larger in VLDL while
      IDL and LDL seem to become smaller judging from relative lipid contents to apo B.

PMID- 2232246
TI  - [Regulation of pyruvate kinase gene expression and its clinical application].
AB  - Pyruvate kinase (PK), an important glycolytic enzyme, has two genes per haploid
      genome in mammals and each gene encodes two isozymes. The L gene produces the L-
      and R-types using alternative promoters. The M gene generates the M1- and M2
      types by alternative RNA splicing. Expression of the PK isozymes is tissue
      specific and regulated developmentally. Carcinogenesis apparently reverses the
      developmental process. Expression of the L-type is regulated by dietary and
      hormonal factors. These regulations occurred at post-transcriptional as well as
      transcriptional levels. The transcription of hepatic L-type PK is stimulated by
      insulin and inhibited by glucagon. The insulin action requires ongoing protein
      synthesis and metabolism of glucose, and is enhanced by glucocorticoid. Dietary
      fructose also stimulates expression of the L-type in liver, kidney, and small
      intestine, but its mechanism is dependent on tissues, and on plasma insulin
      levels in the case of the liver. In normal liver, the fructose induction is
      explained by stimulation of gene transcription. On the other hand, fructose acts
      mainly at the post-transcriptional level in diabetic liver and other tissues.
      These fructose effects are attributable to common metabolite(s) of fructose and
      glycerol. Studies on transgenic mice indicate that the 5'-flanking region up to 
      3 kb of the L-type PK gene contains cis-acting elements responsible for insulin
      regulation and tissue-specific expression of the L-type. Further analysis using a
      transient expression assay revealed the presence of multiple elements necessary
      for expression of the L-type in hepatocytes in the region up to -170b.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2232247
TI  - [Superoxide dismutases: significances in aging, diabetes, ischemia and cancer].
AB  - Superoxide dismutases (SOD) and their changes in diabetes, aging, ischemia and
      cancer were studied, Cu, Zn-SOD undergoes glycation reaction in vitro and in vivo
      and loses its activity by formation of Amadori compounds. Two lysine residues of
      Cu, Zn-SOD, Lys-122 and Lys-128 are primary glycated sites which are located on
      the surface of the molecule. The sites are also located on the active site
      liganding loop which plays a major role in the activity. The glycated Cu, Zn-SOD
      increased in the red cells of diabetic patients, especially those with diabetic
      complications. Mn-SOD appears in the serum of patients with acute myocardial
      infarction in a biphasic manner. The enzyme appears in sera 16 hr and 108 hr
      after the attack as determined by ELISA. The Mn-SOD levels are also increased in
      the serum of patients with epithelial ovarian cancer and it is a good marker for
      detecting and monitoring this cancer. Mn-SOD may play an important role in the
      ischemic and cancer tissues.

PMID- 2232248
TI  - [Development of ELISPOT assay for thyroid autoantibody-producing cells].
AB  - A new assay system for detection of thyroid-autoantibody-producing cells was
      developed. This assay is based on the ELISPOT method with antigen-coated
      nitrocellulose membranes in 96-well microfilter plates. This was more sensitive
      than conventional methods such as a radioimmunoassay and a passive agglutination
      method for detection of thyroid-autoantibody production. The coefficients of
      inter- and intra-assay variations for antibody-producing cells were less than
      6.5%. Thus, this assay system can be used to analyse the thyroid-specific
      immunological abnormalities as a routine test.

PMID- 2232249
TI  - [The significance of autoantibodies coexisting with anti-centromere antibodies in
      sera of patients with primary biliary cirrhosis].
AB  - Anti-centromere antibody (ACA) has been believed to be specific to patients with
      CREST syndrome, a variant of scleroderma (PSS). This study was undertaken to
      clarify the distribution of ACA in various diseases and the significance of
      autoantibodies coexisting with it. The sera of patients with primary biliary
      cirrhosis (PBC) along with collagen diseases and aged subjects were examined for
      ACA by immunofluorescence method (IF) using cultured HEp-2 cells and chromosomes
      prepared from K 562 cells. ACA were found in sera of 10 patients with PBC, one
      with scleroderma, one with cerebral infarction and one with chronic renal failure
      respectively. ACA positive sera were examined for antibodies against other
      nuclear antigens including nRNP, Sm, Scl-70, SS-A and SS-B and cytoplasmic
      antigens by double immunodiffusion methods using rabbit thymus extract etc. as
      the antigens and by IF method using cryostat sections of rat kidney and stomach.
      In 13 sera with ACA, antimitochondrial antibody (AMA), anti-smooth muscle
      antibody (ASMA) and anti SS-A antibody were found in 10, 4 and one sera
      respectively. In 10 PBC patients with ACA, various collagen disease-related
      disorders were found to coexist; CREST syndrome in one, CRST syndrome in one,
      Raynaud's phenomenon in two and Sjogren's syndrome in 5. These results would
      indicate that ACA may be one of the common serological abnormalities among
      patients with PBC, CREST syndrome and Sjogren's syndrome.

PMID- 2232250
TI  - [Determination of hepatitis B virus pre-S 2 antigen by reversed passive
      hemagglutination and its clinical significance].
AB  - Pre-S 2 antigen has been distinct as one of the hepatitis B virus (HBV) markers
      recently. We detected Pre-S 2 antigen by reversed passive hemagglutination (R
      PHA) in 98 samples and investigated the correlation between Pre-S 2 antigen and
      other HBV markers. Forty-two samples in 98 surface(s) antigen positive samples
      were positive for Pre-S 2 antigen (42.9%). Nineteen samples in 21 e antigen
      positive samples and 20 samples in 74 e antibody samples were positive for Pre-S
      2 antigen (90.5% and 27.0% respectively). Pre-S 2 antigen titers by half
      quantitative 2n dilution method ranged from 256 to 2048 or more in e antigen
      positive samples and from 8 to 64 in e antibody positive samples. They showed two
      peak distributions. There were no significant correlation between Pre-S 2 antigen
      titers and GPT values. In conclusion, determination of Pre-S 2 antigen might be
      one of the useful indexes of proliferation of HBV.

PMID- 2232251
TI  - [Plasma concentration of polymorphonuclear leukocyte elastase-alpha 1-proteinase
      inhibitor complex in patients with gastric ulcer].
AB  - To test the possible participation of activated leukocytes in the pathogenesis of
      gastric ulcer, plasma levels of polymorphonuclear leukocyte-elastase-alpha 1
      proteinase inhibitor complex (PMN-EC), a discerning indicator for the activation
      of leukocytes, were determined in patients with gastric ulcer. Plasma levels of
      PMN-EC in patients with gastric ulcer (185.2 +/- 21.6 micrograms/l, mean +/-
      S.E.M.) were significantly higher than those in normal healthy subjects (67.6 +/-
      4.4 micrograms/l, p less than 0.01). On the other hand, plasma levels of C
      reactive protein and sialic acid increased in only 17.8% and 7.1% of patients
      with gastric ulcer, respectively. No significant correlation was observed between
      PMN-EC and the plasma levels of CRP or sialic acid. Plasma levels of PMN-EC
      decreased with the healing of the ulcerative lesion as judged by gastro
      endoscopic observation. These findings suggested that activation of leukocytes
      might deeply be correlated with the pathologic mechanism of gastric ulceration
      and the measurement of PMN-EC might be useful for monitoring the patients with
      gastric ulcer.

PMID- 2232252
TI  - [Population pharmacokinetic analysis of indocyanine green retention rate at 15
      minutes].
AB  - Using the population pharmacokinetic (Bayesian) method, we investigated the
      indocyanine green (ICG) retention rate at 15 minutes (R 15) in patients with
      liver disease. For the Bayesian analysis, the mean and variance of parameters,
      the disappearance rate (K) and the distribution volume, were calculated by the
      one compartment analysis with data of inpatients. The mean value of the
      disappearance rate (K) was shown to be smaller and the variances of parameters of
      the patients were larger than normal values reported, so that it was suggested
      that the studied group included patients with various kinds of liver diseases.
      Accordingly, the Bayesian analysis was performed using above statistical results.
      The distribution volumes, calculated from three points measurements by Bayesian
      method, were estimated smaller and the initial concentrations higher than those
      obtained by the one compartment analysis. However, the retention rate (R 15) were
      well correlated the results of one compartment analysis. The Bayesian analysis
      using one point measurement at 15 minutes, resulted that the values of retention
      rate (R 15) were shown about 17% lower, but well correlated with the coefficient
      gamma = +0.9972 to those obtained by usual method. The disappearance rate (K),
      which calculated simultaneously from the one point analysis, showed the lowest
      value on liver cirrhosis. So that, the application of Bayesian analysis to the
      one point measurement of ICG test was useful to clinical evaluation of liver
      disease.

PMID- 2232253
TI  - [Chromosome abnormalities in myelodysplastic syndrome].
AB  - We performed chromosomal analysis in 18 patients with myelodysplastic syndrome
      (MDS). According to the French-American-British (FAB) cooperative study group and
      Research Group of Japanese Ministry of Welfare Classification, our cases with MDS
      were classified into four subtypes as follows; refractory anemia [RA], 6 cases;
      refractory anemia with excess of blasts [RAEB], 4; chronic myelomonocytic
      leukemia [CMML], 3; refractory anemia with excess of blasts in transformation
      [RAEB-T], 4; and refractory cytopenia [RC], 1. Thirteen patients (72%) had
      chromosomal abnormalities and frequently observed chromosomal abnormalities were
      trisomy 8, -7/7q-, 20q-, trisomy 1q and 5q-. The mean survival were as follows;
      RA: 22.5 months, RAEB: 13.2 months, CMML: 15 months, RAEB-T: 5.5 months.
      Progression to overt leukemia occurred in 5 patients (27.7%): 1 of four patients
      with RAEB, 1 of three patients with CMML and 3 of four patients with RAEB-T. In
      conclusion, chromosomal abnormalities were most frequently observed in the
      patient with RAEB-T who had shortest survival time among the patients with MDS.
      On the other hand, chromosomal abnormalities were less frequently observed in the
      patients with RA and they showed relatively better prognosis than the other types
      of MDS.

PMID- 2232254
TI  - [Serum adenosine deaminase and its isozyme activity in leukemia and MDS].
AB  - We studied the activity of serum adenosine deaminase (ADA) and its isozyme in 36
      leukemic patients (16 ANLL, 11 ALL, and 9 CML) and 8 MDS. Isozyme was measured by
      erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA) inhibitory assay. This assay was
      simple and reliable. The appearance rate of abnormally high ADA value were 81.24%
      for ANLL, 100% for ALL, 77.8% for CML and 37.5% for MDS. The ADA level became
      high when MDS turned into overt leukemia. In isozyme pattern, there was a clear
      difference between ANLL and ALL. The isozyme I/II ratio was significantly higher
      (p less than 0.001) in ALL than ANLL. Lymphoblastic crisis of CML also had a high
      isozyme I/II ratio. There was a correlation between isozyme I and absolute number
      of peripheral blasts in ALL (r = 0.768). When observed time sequentially, ADA and
      isozyme changed correlatively with the number of blasts counts. Serum ADA and its
      isozyme are useful parameters both for leukemic diagnosis and treatment.

PMID- 2232255
TI  - [Serum and urinary cell growth factors in non-insulin-dependent diabetes
      mellitus].
AB  - Serum very low molecular weight growth factor like-activity (S-VLMGA, molecular
      weight less than 3,000) and serum and urinary epidermal growth factor (S-, U-EGF)
      were investigated in 180 patients of non-insulin-dependent diabetes mellitus
      (NIDDM) by bioassay using skin fibroblast cells (CCD-27 SK) and enzyme- and radio
      immunoassay, respectively. S-VLMGA was slightly elevated in NIDDM patients with
      retinopathy (RET) and/or neuropathy (NEU), but slightly decreased in those with
      nephropathy (NEP) compared with patients without complications, though the
      differences were not significant (without complications: 122 +/- 9, with RET
      and/or NEU and without NEP: 145 +/- 15, all with NEP: 110 +/- 8% of increased
      growth activity, mean +/- SE). The similar tendencies were seen in S- and U-EGF
      in the same groups. However the changes in S-EGF were small and the decrease of U
      EGF in patients with NEP was remarkable (U-EGF of without complications: 22.7 +/-
      2.5, with RET and/or NEU and without NEP: 24.5 +/- 4.2, all with NEP: 17.6 +/-
      3.2 ng/mg creatinine, mean +/- SE). Furthermore, S-VLMGA was inversely, but U-EGF
      was positively related with the creatinine urinary vs serum ratio. Thus the
      concentrations of VLMGA and EGF in serum and urine depend on a renal
      permeability.

PMID- 2232256
TI  - [Identification and susceptibility of clinically isolated yeast-like fungi].
AB  - We studied the identification and susceptibility of clinically isolated yeast
      like fungi at Showa University Hospital from April 1988 to March 1989. Clinically
      significant of yeast-like fungi were observed in 7.1% of specimens from
      outpatients, 13.0% of inpatients. In both outpatients and inpatients, yeast-like
      fungi were isolated mainly from sputum and urine. But, one third of them were
      considered as non-pathogenic and not identified. The species of isolates were,
      Candida albicans 57%, Candida tropicalis 14% and Candida glabrata 8% in both
      inpatients and outpatients, and these species shared most part. The isolation
      frequency of Candida parapsilosis was higher in blood and cerebrospinal fluid
      (CSF) specimen than the others. The susceptibility test by agar dilution method
      indicated most of the isolates were susceptible to Amphotericin B and Miconazole
      (MIC less than or equal to 25 micrograms/ml). There was no difference in MIC
      between predominantly isolated fungi and commonly isolated fungi. Notably,
      isolates from blood and CSF showed a significant high tolerance against
      Amphotericin B and Miconazole than from the other specimens. The MICs of
      Fluconazole were shown to be very high (greater than 100 micrograms/ml) in normal
      Sabouraud agar, were decreased dose-dependently by human sera in the medium.
      These findings indicated the component(s) of sera enhanced the anti-fungal
      activity of Fluconazole.

PMID- 2232257
TI  - [Study of chromogenic substrate on protein C activity assay--in patients treated
      with warfarin].
AB  - Protein C is an anticoagulant protein that circulates in blood as a zymogen of a
      serine protease. Recently the exogenous Protein C activator has been obtained
      from the venom of Agkistrodon Contortrix Contortrix. We also reported a
      functional assay method which activates Protein C with PROTAC and then measure
      the amidolytic activity with chromogenic substrate (S-2366) by COBAS FARA. At
      present, S-2366 (Glu-Pro-Arg-pNA), CBS 65-25 (Lys-Pro-Arg-pNA) and SPECTROZYME
      PCa (Lys-Pro-Arg-pNA) are used as the chromogenic substrate for activated Protein
      C. We studied which substrate is more suitable for amidolytic activity assay for
      Protein C by PROTAC in 99 patients under long-term Warfarin therapy and 29 as
      normal subjects. Our results indicate that SPECTROZYME PCa and CBS 65-25 are
      unsuitable for Protein C activity assay with PROTAC. Because change of absorbance
      was detected in Protein C deficient plasma and we couldn't gain good correlation
      between amidolytic activity of activated Protein C measured with these
      chromogenic substrates and antigenicity of Protein C by EIA. On the other hand, S
      2366 is the most specific for activated Protein C and we also obtained good
      correlation against Protein C antigen.

PMID- 2232258
TI  - [A resected case of mucin-secreting malignant papillomatosis (villous tumor) of
      ductus choledocus and left intrahepatic duct].
AB  - A resected case of remarkably mucin-secreting malignant papillomatosis (villous
      tumor) of the ductus choledocus and left intrahepatic duct in a 79 year-old
      female was reported. In this case, cholecystectomy and choledocho-duodenal
      anastomosis for the gallbladder stone were performed 14 years ago. Villous or
      papillary tumors arose in the ductus choledocus and spread into the left
      intrahepatic duct. Histological examination revealed villous proliferation
      similar to the villous tumor in the large intestine, in which cancerous and
      adenomatous changes intermingled showing remarkable mucin secretion. Tumor
      invasion was limited in the wall without extracanal dissemination, and nodal
      metastasis was absent. Interestingly, exceeding mucin-secretion was observed as
      the frog-egg like appearance in the ductus choledocus and as the regurgitation
      into the stomach by the endoscopic examination. This type carcinomas usually show
      favorable prognosis compared with the ordinary adenocarcinomas of the bile duct.

PMID- 2232259
TI  - [Cerebral blood flow and event-related potential in patients with cerebral
      infarction].
AB  - Cerebral blood flow (CBF) and P 300, a long-latency positive component of the
      scalp-recorded event-related potential (ERP) associated with cognitive processing
      were investigated in patients with cerebral infarction to elucidate the
      relationship between CBF and cognitive function. Twenty-five patients with
      cerebral infarction with a mean age of 66.8 years were studied. ERP was recorded
      during auditory discrimination tasks. The latency of the P 300 from Pz region was
      recorded. The regional CBF was measured by the 133Xe inhalation method. The F1
      (cortical gray matter flow) values were calculated using the Obrist's method. The
      mean F1 values in patients with cerebral infarction were significantly lower
      compared to the values obtained for the 15 control subjects (mean age, 68.4
      years) (p less than 0.01). Patients with cerebral infarction showed significant
      prolongation of the P 300 latency compared to the 20 control subjects (mean age,
      64.4 years) (p less than 0.02). There was a significant correlation between the P
      300 latency and the mean F1 values in patients with cerebral infarction (p less
      than 0.01). Present results suggest that the cognitive impairment with respect to
      ERP may be related to the reduction of cortical blood flow in patients with
      cerebral infarction.

PMID- 2232260
TI  - [Mitral valve prolapse syndrome as an etiologic factor of anxiety disorder].
AB  - To assess whether a certain somatic disease is involved in the etiology of
      anxiety disorder, we examined the relationship between anxiety disorder and
      mitral valve prolapse syndrome (MVP). Patients with anxiety disorder were
      diagnosed according to the criteria of the American Psychiatric Association
      (Quick Reference to the Diagnostic Criteria from DSM-III). Two-dimensional
      echocardiography was carried out on 36 normal controls (15 males and 21 females)
      and 39 patients with anxiety disorder (19 males and 20 females); including 21
      patients with panic disorder, 12 with generalized anxiety disorder, and 6 with
      atypical anxiety disorder. The echocardiograms were evaluated by a cardiologist
      unaware of clinical background about these patients. The presence of MVP was
      diagnosed according to the criteria by Yoshikawa, et al. or Nagata, et al.
      Findings of MVP were seen in 18 (46.1%) of the patients and 5 (13.9%) of the
      controls indicating a significantly higher incidence (chi 2 = 7.711, p less than
      0.01) in the patients. In the patient subgroups, 14 patients with panic disorder
      (66.6%) and 4 with generalized anxiety disorder (33.3%) had MVP, showing a
      significantly higher incidence in the former (chi 2 = 14.335, p less than 0.01)
      than in the normal controls, but no statistical significance in the latter. No
      MVP was found in the patients with atypical anxiety disorder. These results
      suggest that some somatic diseases such as MVP may play a role in the etiology of
      anxiety disorder, especially panic disorder.

PMID- 2232261
TI  - [In vitro thermosensitivity of various human tumors evaluated using the SDI
      (succinate dehydrogenase inhibition) test].
AB  - In vitro thermosensitivity of various human tumors including 90 esophageal, 10
      gastric and 40 colo-rectal cancers were evaluated using the succinate
      dehydrogenase inhibition (SDI) test. Tumor fragments minced with scissors were
      incubated at 43 degrees C as heat treated cells and at 37 degrees C as controls
      for 20 hrs, and assayed for the succinate dehydrogenase (SD) activity using 3-(4,
      5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) as a hydrogen
      acceptor. The thermosensitivity was estimated by the percentage of SD activity of
      heat treated cells compared to that of each control. A variation in the
      thermosensitivity was noted between patients. The SD activity was 60.1 +/- 20.3%
      (mean +/- standard deviation) for esophageal cancers, 34.9 +/- 21.7% for gastric
      cancers, 50.3 +/- 20.6% for colo-rectal cancers. Significant differences were
      noted between esophageal cancers and gastric cancers, colo-rectal cancers (p less
      than 0.01 and p less than 0.05, respectively). When the thermosensitivity was
      arbitrarily defined as reduction in the SD activity to 50% of control or less,
      the positive rates were 31.1% for esophageal cancer, 70% for gastric cancer and
      62.5% for colo-rectal cancer. Our results show that the SDI test is a useful
      method for determination of the thermosensitivity of clinical samples.

PMID- 2232263
TI  - [Molecular basis of mucopolysaccaridosis type VII (beta-glucuronidase
      deficiency)].
AB  - We have identified several mutations causing beta-glucuronidase (beta Gl)
      deficiency in three cases with mucopolysaccaridosis type VII (MPS VII). Enzyme
      assay of lysates of these lymphocytes or cultured fibroblasts showed little
      residual activity and that the beta Gl-specific mRNA levels were normal, as
      revealed by Northern blot analysis. Mutated cDNA clones including the entire
      coding sequencing were isolated from a library in case 1 and PCR (polymerase
      chain reaction) products in case 2 and 3 derived from cultured fibroblasts.
      Sequencing of the full-length mutated cDNA revealed C----T transitions, an event
      causing a single Ala619----Val change (cases 1 and 2) and Arg382----Cys and
      Pro649----Leu changes (case 3). The former change is detected by loss of the
      cleavage site for the enzyme Fnu 4 HI in the mutated cDNA. On the basis of the
      loss of Fnu 4 HI restriction site, the patients (cases 1 and 2) were shown to be
      a homozygote with this mutation and the parents and brother in case 1 were
      heterozygotes. The Ala619----Val and Arg382----Cys mutations disrupt a functional
      domain consisting of a region of sequence highly conserved among human, rat and
      bacterial beta Gl's, and they lower the enzyme activity, as tested by
      transfection of COS cells with expression vectors harboring the mutated cDNA.
      However the Pro649----Leu mutation does not lower the enzyme activity.

PMID- 2232262
TI  - [Methicillin-resistant Staphylococcus aureus (MRSA) infection--significance of
      MRSA in respiratory tract infection].
AB  - We have examined background factors in MRSA infection in cases in which S. aureus
      had been isolated from sputa. The incidence of isolation of S. aureus was high
      and still increasing in expectorated sputa, and causative organisms in the cases
      of pneumonia and autopsied lungs. A significant correlation was observed between
      high incidence of isolation of S. aureus and abuse of third-generation cephems.
      MRSA isolation rates of inpatients was higher than that of outpatients. Among the
      inpatients such cases with severe underlying diseases and prolonged admission
      showed the highest incidence of isolation of MRSA. There seemed to be a
      correlation between distribution of patients with S. aureus and that of rooms
      with S. aureus in the air. This suggests nosocomial infection. Although MRSA was
      frequently isolated from sputa, most cases showed no signs of infection, and this
      suggested that they had been transient colonization. Such antimicrobial agents as
      rifampicin, teicoplanin, vancomycin reveal excellent antibacterial activity
      against MRSA and minocycline, ofloxacin were moderately effective. The physician
      must be informed of the significance of MRSA, because their understanding of MRSA
      still remains insufficient.

PMID- 2232264
TI  - [Detection of serum hepatitis B virus DNA using the polymerase chain reaction
      assay].
AB  - We compared the sensitivity of the polymerase chain reaction (PCR) assay to that
      of slot blot hybridization for detecting hepatitis B virus (HBV) DNA in the serum
      of a chimpanzee infected with HBV and 52 patients. Also, we utilized a rapid PCR
      procedure for the detection: Viral DNA was released from virions by incubating
      serum with NaOH. After a primary PCR amplification, the sample was reamplified
      using a second set of primer pairs (PCR/PCR). In the chimpanzee, HBV DNA was
      detected 3 weeks earlier than the appearance of hepatitis surface antigen (HBsAg)
      and persisted for two weeks with antibody to HBsAg. Of the 14 chronic hepatitis B
      patients positive for both HBsAg and HBV e antigen (eAg), 9 were positive for HBV
      DNA by slot blot hybridization and all 14 by PCR. Also, of 9 patients positive
      for HBsAg and antibody to eAg, 2 were positive for HBV DNA by slot blot
      hybridization and 8 by PCR. Three of the 11 patients who had lost HBsAg during
      follow up examination of chronic hepatitis B were positive for HBV DNA by PCR,
      whereas none of them was positive by slot blot hybridization. Six patients who
      had recovered from acute hepatitis B more than one year ago and 12 cases who had
      had vaccination of HBV were negative for HBV DNA by PCR. This technique should
      yield valuable information on the biology of HBV.

PMID- 2232265
TI  - [Molecular diagnosis of inherited coagulation disorders--sequence analysis of
      hemophilia B patients with anti-factor IX antibodies].
AB  - Seven hemophilia B patients with anti-factor IX antibodies are studied with
      molecular means. A total factor IX gene deletion was detected in four patients
      from three distinct families. Three other patients without detectable gene
      arrangements were investigated at the DNA sequence level. Enzymatic amplification
      of the factor IX gene and subsequent DNA sequencing revealed four novel
      nucleotide mutations in these patients. Patient HB 5 had two point mutations in
      his factor IX gene. One is located at nucleotide -793 from the translation start
      (G-A) and the other (C-T) was found in the codon for 191-Gln changing to a
      termination codon. Patient HB6 had a point mutation (G-A) in the splicing
      junction of intron g. A2 bp nucleotide deletion was detected in the third exon of
      the patient HB7 yielding 8 frameshifted amino acids and a stop codon. These
      results suggested that not only a large deletion of the factor IX gene but also
      point mutations or small deletion of the gene which may cause the substantial
      loss of the coding information for the mature protein are involved in the
      development of anti-factor IX antibodies in hemophilia B patients.

PMID- 2232266
TI  - [Quantitative estimation of malignancy of gastric cancer by DNA ploidy and
      proliferative activities].
AB  - Paraffin-embedded tumor samples from 493 patients with gastric cancer were
      analyzed by DNA flow cytometry, and proliferative activities of 155 tumors were
      measured by bromodeoxyuridine (BrdU) labeling, Ki-67 monoclonal antibody (Mab),
      and anti-p105 Mab. The results were correlated with clinicopathological findings
      and patients prognoses. Of the 493 patients, 183 (37%), 225 (46%), and 85 (17%)
      showed diploid, single DNA a neuploid, and DNA-multiploid. The relative risk of
      death was three-fold higher in DNA-multiploid tumors than in DNA-diploid tumors.
      BrdU labeling indices also proved to be an independent prognostic factor.
      Multiploid tumors had the highest median BrdU LI associated with the most
      frequent lymph node metastases and hepatic metastases. When the DNA histogram and
      all the clinicopathological parameters were entered simultaneously into the Cox
      regression model, DNA ploidy, hepatic metastasis, peritoneal dissemination, BrdU
      LI, and nodal status emerged as independent prognostic parameters. These results
      indicate that DNA ploidy and proliferative activities may be useful prognostic
      factors for the patients with gastric cancer.

PMID- 2232268
TI  - [Studies on faint attack due to arrhythmias with Holter electrocardiogram].
AB  - Out of 1,400 Holter ECGs, 15 records revealed arrhythmias which would be
      responsible for faint attack, including 8 sick sinus syndrome with cardiac
      arrest, 4 non-sustained ventricular tachycardia (VT), 2 paroxysmal atrial
      fibrillation and 1 paroxysmal supraventricular tachycardia. All of cardiac arrest
      corresponding to faint attack lasted for longer than 4 sec, and an averaged
      duration of the arrest was 5.8 +/- 2.3 sec. This was significantly longer than
      that with no subjective symptoms, 3.4 +/- 0.7 sec. Duration and rate of VT did
      not show any significant relationship with faint attack. The result suggests that
      cardiac arrest is mostly responsible for arrhythmia-induced involvement of
      cerebral circulation and faint attack. It is also suggested that cardiac arrest
      longer than 4 sec should be extensively treated including pacemaker implantation.

PMID- 2232267
TI  - [Structural analysis of abnormal hemoglobin by the polymerase chain reaction
      (PCR) of genomic DNA].
AB  - Determination of the primary structure of abnormal Hbs on the basis of DNA
      sequencing of the globin gene obtained from a carrier of abnormal Hb was
      performed. DNA obtained from the leukocytes of the peripheral blood was amplified
      by the polymerase chain reaction (PCR) using the proper amplification primer set.
      Amplified DNA was digested with two different restriction endonucleases and
      cloned to vector M 13 mp 18 or mp 19, which had been digested with the same
      enzymes. DNA sequencing was done by the dideoxy chain termination method using T
      7 DNA polymerase, and the abnormal Hbs whose primary structure was determined
      were as follows: Hb Fukuoka [beta 2 His(CAC/T)----Tyr(TAT)], Hb Machida [beta 6
      Glu(GAG)----Gln (CAG)], Hb Hope [beta 136 Gly(GGT)----Asp(GAT)], Hb Hiroshima
      [beta 146 His(CAC)----Asp(GAC)] and Hb Kodaira [beta 146 His(CAC)----Gln(CAA)].
      This method for determining the primary structure of abnormal Hbs might be more
      effective than the ordinary method, which involves amino acid analysis and amino
      acid sequencing of the abnormal peptide obtained from abnormal Hb.

PMID- 2232269
TI  - Basic and clinical aspects of methicillin-resistant Staphylococcus aureus (MRSA).

PMID- 2232270
TI  - [Present status of methicillin-resistant Staphylococcus aureus and susceptibility
      to antimicrobial agents in 6 hospitals in Okinawa].
AB  - During the period from November 1987 to March 1988, 301 strains of S. aureus
      isolated from clinical specimens were collected from 6 hospitals in Okinawa main
      island. Thirty seven percent of the strains were resistant to methicillin (MRSA,
      MIC greater than or equal to 12.5 micrograms/ml). There was a difference in an
      isolation frequency among the hospitals from 13 to 52%. The strains were isolated
      from pus, sputum and urine with high frequency. As coagulase typing of MRSA, Type
      II and III strains predominantly isolated with 54% and 40%, respectively. Among
      the antimicrobial agents tested, about 90-99% MRSA were resistant to beta-lactam
      antibiotics and aminoglycosides and no resistant strain was observed to MINO. To
      IPM/CS and OFLX, 84% and 75% of the strains were sensitive, respectively. MRSA is
      a hospital strain and may be a causative microorganism for a hospital and
      opportunistic infection.

PMID- 2232271
TI  - [Mechanism of beta-lactam-resistance in methicillin-resistant Staphylococcus
      aureus].
AB  - The role of penicillin-binding protein (PBP) 2' in the expression of beta-lactam
      resistance was investigated using methicillin-resistant Staphylococcus aureus
      (MRSA) strains with different level of resistance. Both high- and moderate-level
      MRSA produced very similar PBP 2' with low affinities for beta-lactam
      antibiotics. Affinities of antibiotics for PBP 2' (I50, concentration which
      inhibits [14C] benzylpenicillin-binding by 50%) correlated well with their
      antibacterial activities (MIC) in a high-level MRSA, but did not in a moderate
      level MRSA. High-level MRSA contained a larger amount of PBP 2' than moderate
      level MRSA, and the amount of PBP 2' decreased by increasing the temperature of
      the culture; the extent of decrease was larger in a strain which was sensitive at
      37 degrees C than a strain which exerted relatively high level resistance even at
      40 degrees C. A cephamycin-resistant, methicillin-sensitive strain began to
      synthesize PBP 2' by adding cephamycin-type antibiotics to the medium and
      consequently acquired resistance to methicillin. Latent MRSA producing no PBP 2'
      generated clones which produced PBP 2' constitutively and were highly resistant
      to all beta-lactams. These results suggest that the presence of PBP 2' is
      critical for the expression of beta-lactam-resistance in MRSA and the degree of
      the resistance depends mainly on the amount of PBP 2' which differs from strain
      to strain and is influenced by environments such as temperature and the presence
      of inducer.

PMID- 2232272
TI  - [Nosocomial infection with methicillin-resistant Staphylococcus aureus].
AB  - Methicillin-resistant Staphylococcus aureus (MRSA) isolated in our hospital
      between 1986 and 1989 were mainly examined for their susceptibility to various
      antibiotics and coagulase types. The isolation frequency of MRSA among S. aureus
      isolated from clinical specimens has been steadily increasing; 37.8% in 1986,
      49.8% in 1987, 60.6% in 1988 and 63.2% in 1989. This trend was particularly
      noticeable in the specimens associated with the respiratory tracts. The isolation
      rate of MRSA in the surgery and pediatrics wards was higher than that in the
      internal medicine ward. More than 80% of MRSA were coagulase type II, which were
      multi-resistant to penicillins, cephems, aminoglycosides and macrolides, and
      sensitive to MINO, new quinolones and VCM. These epidemic strains were also
      isolated from the nose of medical staff and from air samples in the wards. These
      findings suggest that the hospital environment including the patients and
      hospital personnel is extensively contaminated with multi-resistant MRSA of
      coagulase type II. Measures should be taken for prevention and control of
      nosocomial infection with MRSA in the whole hospital.

PMID- 2232273
TI  - [Methicillin-resistant Staphylococcus aureus infection in the Kagoshima
      University Hospital--special attention to prevalence in otolaryngological
      infectious disease].
AB  - A retrospective study of the characteristics of MRSA (methicillin resistant S.
      aureus) in Kagoshima University Hospital and its ENT department was reported.
      There were 231 samples (104 strains) MRSA in all S. aureus 448 samples from Jan.
      to Sep. 1989 in Kagoshima University Hospital, in which 58 strains (55.8%) were
      coagulase type II and 35 strains (33.7%) were type VII. The much more predominant
      numbers of MRSA were observed in all the cases inpatients clinics in surgery,
      pediatrics, urology, gynecology and dermatology than internal medicine as well as
      outpatients clinics. In ENT department of this hospital, only 15.4% of all S.
      aureus were MRSA. On the other hand, bacteriological survey showed 26% of MRSA
      out of all S. aureus which were detected at Tokyo clinical research center on
      otorrhea in the patients with chronic otitis media as multicenter clinical trial
      of Japan. Two cases involved by MRSA after postoperative administration of many
      types of antibiotics were also demonstrated. These MRSAs were producing type II
      coagulase and very high concentrations of MICs to many antibiotics were observed.
      But these cases were not severe and MINO (minocyclin) or GM (gentamicin) were so
      effective. The effect of combined therapy of some antibiotics or antimicrobial
      agents was discussed briefly.

PMID- 2232274
TI  - [Intravenous DSA as a screening method for cerebral aneurysms].
AB  - Intravenous DSA (IVDSA) was evaluated as a screening method for cerebral
      aneurysms. It was performed 390 times in 372 cases. Clinically useful images were
      obtained in 94.1% in all examinations. Nineteen aneurysms were visualized in
      cerebral angiography among 21 cases with SAH or 3rd nerve palsy, whereas in IVDSA
      15 aneurysms were noted. Aneurysms not visualized in IVDSA were all 4 mm or less
      in size. Therefore, aneurysms, more than 4 mm in size, which have higher risks
      for rupture, were detectable in IVDSA. Based on these findings, IVDSA is
      considered to be clinically useful in screening for aneurysms. In all 372 cases,
      33 aneurysms were suspected in IVDSA findings, whereas in cerebral angiography 21
      of them turned to be aneurysms. Such 12 false positive cases were distributed
      mainly at anterior communicating and middle cerebral arteries. Improvement of
      image resolution, avoidance of vessel overlapping and proper selection of
      screened cases should be investigated for further development of this screening
      method.

PMID- 2232275
TI  - [CT findings complicating percutaneous nephrostomy, lithotomy and lithotripsy].
AB  - Reviews of the CT scans of percutaneous nephrostomy, lithotomy and lithotripsy
      disclosed 14 out of 78 cases (17.9%) with evidence of complications. Renal and
      perirenal hematomas were detected in five cases and the other five cases showed
      collections of contrast material in the retroperitoneum except for the anterior
      pararenal space. CT demonstrated clearly the anatomic distribution and extent of
      renal hemorrhage and extravasation of contrast material. Three cases of pleural
      effusion on CT were accompanied by blood or contrast material collections in the
      posterior pararenal space. No patients required immediate surgery and CT findings
      helped the choice of conservative therapies.

PMID- 2232276
TI  - [MRI of pheochromocytoma].
AB  - MRI features of 8 patients were reviewed and correlated with pathological
      findings. It was characteristic finding that the intensity of pheochromocytoma on
      T2-weighted image and proton image was very high. The detectability of
      pheochromocytoma by MRI and CT was almost equal and MRI was also useful for
      determining aberrant pheochromocytoma. MRI was more helpful for detection of
      necrotic lesion than CT. We considered that the double ring sign on MRI was
      characteristic for pheochromocytoma. In the cases which are difficult for
      diagnosis, other diagnostic studies such as endocrine and other imaging studies
      are necessary.

PMID- 2232278
TI  - [MR imaging of the arm].
AB  - Thirty arms of healthy adults were studied with MR imaging using surface coil.
      Fine structures of the arm, such as muscular bundles, small vessels and nerves
      were clearly demonstrated. Deep fascia dividing muscular bundles appeared as high
      intensity on T1-weighed image due to fat deposition beneath the fascia.
      Aponeurosis is also flat sheet of densely arranged collagen fibers. With rather
      thicker layer of collagen fibers than fascia, aponeurosis appeared as low
      intensity sheet that was frequently demonstrated on MR images of the extremities.

PMID- 2232277
TI  - [Non-quantitative analysis of the renography using 99mTc-DTPA; clinical efficacy
      and limitation].
AB  - The purpose of this paper is to evaluate the efficacy and limitation of the non
      quantitative analysis of renography using 99mTc-DTPA, and to determine the
      clinical indication of the quantitative analysis of the study. We evaluated the
      clinical records of the patients and the findings of dynamic imagings and
      renograms. The non-quantitative analysis of the examination seemed to be useful
      to the selected cases, and quantitative analysis appeared to be dispensable
      except for the cases to evaluate the grade of parenchymal damages and causes of
      asymptomatic hematuria.

PMID- 2232279
TI  - [Intercostal-pulmonary arterio-arterial fistula with rib notching].

PMID- 2232280
TI  - [A case of xanthoma of the skull].
AB  - The reports in the radiologic literature of osseous xanthoma are very rare. We
      reported a case of xanthoma of the skull without hyperlipidemia. The bony changes
      is well-marginated radiolucent lesion with marginal sclerosis and an central
      nidus of bone.

PMID- 2232281
TI  - [Lateral position of the external carotid artery].
AB  - Lateral position of the external carotid artery was seen in 17 cases (4.3%), of
      which 13 cases were on the right side and 4 cases on the left. It is necessary to
      know the lateral position of the external carotid artery for the correct
      diagnosis by IVDSA and doppler scanning.

PMID- 2232282
TI  - [A case of aortitis syndrome].
AB  - A 57 years old woman was admitted for the investigation of anginal chest pain.
      Her coronary angiography didn't show any typical finding seen in the aortitis
      syndrome, but coronary sclerosis and stenosis seen in the usual atherosclerotic
      patients. The cerebral angiography was performed, too. The right vertebral
      artery, which was tortuous and dilated, was seen, but the other three cerebral
      vessels were not seen. These rare findings were reported in this report. We added
      the discussion about the relation between the aortitis syndrome and angina
      pectoris.

PMID- 2232283
TI  - [Two cases of abdominal bronchogenic cyst].
AB  - Two cases of abdominal bronchogenic cyst were reported. In the first case, the
      cyst was communicated with gastric fundus and existed as gastric abscess. In the
      second case, the cyst showed high CT number and chemical analysis of the contents
      revealed high range of Ca, Fe and Amylase levels.

PMID- 2232284
TI  - [A case report of great omental leiomyosarcoma with perforation into the
      jejunum].
AB  - The case is a 56-year-old woman, who came to our hospital for bloody flux as
      chief complaint. Small intestine radiography examination revealed findings
      suspected of jejunal leiomyosarcoma, but selective angiography confirmed a tumor
      deep-infected image with omental artery alone as arteria nutricia, leading to the
      diagnosis as omental tumor.

PMID- 2232285
TI  - [A case of secondary hemochromatosis, in which MRI is useful to evaluate
      therapeutic effect].
AB  - The therapeutic effects of phlebotomy were evaluated by MRI in a case of
      secondary hemochromatosis. Low intensity of the liver on T1 image remarkably
      changed and increased after treatment. MRI was very useful to value the changes
      of iron in the liver.

PMID- 2232286
TI  - [A case of multiple intrahepatic portosystemic venous shunts associated with
      multiple hemangioma-like lesions of the liver].
AB  - Intrahepatic portosystemic venous shunts (IPVS) are rare, except for the minute
      ones observed in cirrhotic liver. This report concerns a case with frequent
      episodes of consciousness loss, diagnosed as IPVS and multiple hemangioma-like
      lesions of the liver by US, CT and angiography. To our knowledge, this is the
      first report of association of IPVS and such angiographically evident hemangioma
      like lesions of the liver. The etiology of IPVS is mostly considered to be
      congenital though, there are still many arguments about it. The relation between
      IPVS and the hemangioma-like lesions of the liver is discussed.

PMID- 2232287
TI  - [Successful emergency superselective embolization for hemobilia with a new
      coaxial catheter and steerable guidewire].
AB  - Hemobilia occurred in a 70 year old female from the left hepatic artery
      pseudoaneurysm induced by PTBD. A Tracker-18 catheter introduced into the left
      lateral posterior hepatic artery superselectively and embolization was performed
      with both sponge gel and Ivalon. This new coaxial catheter system allowed
      selective occlusion of the hepatic artery pseudoaneurysms with minimal loss of
      liver function.

PMID- 2232288
TI  - [A report of renal cell carcinoma in a horseshoe kidney].
AB  - A case of renal cell carcinoma associated with horseshoe kidney is reported. The
      patient was a 67 years old man with the chief complaints of dull pain of right
      upper abdomen. Ultrasonography (US) revealed horseshoe kidney and abnormal mass
      sign at the right isthmus of the kidney. By the computed tomography (CT) and
      angiography, renal cell carcinoma associated with horseshoe kidney was diagnosed.
      Only 18 cases of this rare disease have been reported in Japan. The diagnostic
      procedures are discussed and the usefulness of selective arteriography of the
      isthmus is emphasized, as the presentation of vascular anatomy is of great value
      for diagnosis, surgical treatment and preoperative arterial embolization.

PMID- 2232289
TI  - [A case of renal hemangiopericytoma].
AB  - The patient is a 33-year-old female. On precontrast CT, the tumor shows a high
      density area with a low density area. On postcontrast CT, the tumor demonstrates
      a well-marginated low density area. Angiographically, the tumor shows a
      hypervascular mass with tumor vessels like a weeping willow and unhomogeneous
      stain. This is only the fourth such case ever reported before in Japan.

PMID- 2232290
TI  - [Nuclear DNA content in the cells of squamous cell carcinoma and Bowen's disease.
      I. Relationship between nuclear DNA content and grade of clinical and
      histological malignancy].
AB  - Nuclear DNA content of squamous cell carcinoma (SCC) was assayed by use of
      microfluorometry in an attempt to know the relationship between the content and
      grade of malignancy. As the results, we found that polyploid cell (greater than
      4C) population tends to increase with advancing histological malignancy. However,
      the population of polyploid cells of grade 1, 2 and 3 SCC was almost the same.
      The number of polyploid cell of recurred lesion of SCC was increased than that of
      primary lesion. And polyploid cell (greater than GC) population in the primary
      lesion of the recurred case was higher than that in the tumor of non-recurred
      case. From these findings, it may be concluded that the polyploid cell population
      in SCC was proportional to clinical and histopathological malignancy in some
      extend.

PMID- 2232291
TI  - [Nuclear DNA content in the cells of squamous cell carcinoma and Bowen's disease.
      II. A study on DNA contents of deeply invaded cells in comparison with non
      invading cells at the upper dermis].
AB  - To know the variation of DNA contents of SCC cells due to invasion activity,
      cytophotometric assay was used. The specimens for this study were paraffin
      embedded tissue section of SCC stained with azocarmin G for blocking the non
      specific fluorescence. By comparing the nuclear DNA content of tumor cells at the
      upper dermis and at the subcutaneous fat tissue, it was found that polyploid
      cells (greater than 4C and greater than 6C) populations in deep tissue was
      significantly higher than those in the upper dermis. This finding suggests that
      SCC cells capable to invade deeply are having larger amount of nuclear DNA that
      cells at the upper dermis.

PMID- 2232293
TI  - [Generalized granuloma annulare with primary biliary cirrhosis].
AB  - Fifty-six year-old woman had a wide spread nodular and papular eruption on the
      trunk and arms for one week. She had suffered from primary biliary cirrhosis
      (PBC) for 8 years. The clinical appearance of the eruption was that of
      generalized granuloma annulare. Skin biopsy revealed a palisading granuloma in
      the dermis consisting of suppressor/cytotoxic T cells, Langhans type giant cells,
      plasmacytoid epithelioid cells and phagocytic macrophages with
      immunohistochemical analysis and electron microscopy. Liver biopsy showed
      Scheuer's IIIrd stage of PBC without associated granuloma. In PBC granulomata at
      the portal area of the liver, lung, muscle, skin and so on has been reported. And
      the histological findings of the granuloma of this case consisted with that of
      reported cases. Therefore the skin granuloma in this case was assumed to be
      related to PBC.

PMID- 2232292
TI  - [Do OKT6 positive Langerhans cells play a role in the suppression of ultraviolet
      induced carcinogenesis?].
AB  - Langerhans cells (LC) in epidermis are antigen presenting cells. LC may play a
      role in immune surveillance system and are considered to suppress development of
      ultraviolet (UV) induced skin cancers. We studied effect of UVB irradiation to LC
      of xeroderma pigmentosum (XP) and normal subjects by using OKT6 monoclonal
      antibody. When 3 minimal erythema dose (MED) of UVB were irradiated, density of
      OKT6 positive LC of XP began to decrease 6 hours after irradiation, and showed
      the least numbers on day 2 and returned completely to the pre-irradiation level
      on day 14. Further, after 3 MED irradiation, LCs of both normal subjects became
      the least on day 3 and returned to the pre-irradiation level on day 14. In XP
      variant and normal subjects, the number of LC in chronic sun-exposed skin
      decreased significantly in a similar way comparing to that of non-exposed skin.
      These results suggest that epidermal LC may not play an essential role in
      prevention of UV-induced tumor development.

PMID- 2232294
TI  - [Three-dimensional culture of plucked human hair follicles inside the collagen
      gel matrix].
AB  - Plucked human hair follicles were cultured in collagen gel matrix. Epithelial
      cells, possibly outer root sheath keratinocytes, appeared from the outer root
      sheath 4 to 5 days after culturing and continually grew into the gel to form
      spike-like structures for next 3 weeks. The number and size of the spikes
      differed in each follicle. Autoradiographically, many DNA-synthesizing cells were
      seen at the outer cell layer in the enlarged outer root sheath and at the edges
      in the newly formed spike-like structures. The culture method described here
      appears to be suitable to study the three-dimensional growth, morphogenesis and
      differentiation of the outer root sheath cells in vitro.

PMID- 2232295
TI  - [The influence of coptidis rhizoma to lipase activity of Propionibacterium
      acnes].
AB  - Gas chromatography was applied for determination of the amounts of propionic and
      butyric acids in the medium produced by Propionibacterium acnes. The organism was
      incubated in Peptone-Yeast extract-Glucose medium containing 0.017 mEq/ml of
      tributyrin and various amounts of Coptidis Rhizoma at 37 degrees C for 24 to 96
      hr. The amount of butyric acid produced by the lipase was reduced parallel with
      that of propionic acid resulted from the growth of P. acnes in the medium. These
      facts were also confirmed by counting the cell numbers of P. acnes. Furthermore,
      any lipase-negative colonies were not observed on the Kishishita's Lipase Medium.
      These findings indicate that Coptidis Rhizoma inhibits growth of P. acens and
      anti-lipase activity of the drug against the organism is resulted from the fact.

PMID- 2232296
TI  - [Esophageal motility and gastric emptying in PSS patients, correlation with
      symptoms].
AB  - Progressive systemic sclerosis (PSS) commonly involves the esophagus. Dysphagia
      and heartburn are the most common esophageal symptoms. In this study we evaluated
      the relationship between esophageal symptoms and esophago-gastric motility. On
      esophageal manometry, loss of peristalsis, peristaltic contraction amplitude of
      distal esophagus less than 30 mmHg and decreased LES pressure were critical for
      esophageal symptoms. The degree of symptoms correlated to esophageal dysmotility.
      The gastric emptying in PSS patients was delayed, but there was no significant
      difference in gastric emptying between the patients with and without reflux
      esophagitis. Esophageal dysmotility is considered to be much responsible for the
      reflux esophagitis in PSS patients than gastric emptying.

PMID- 2232298
TI  - [Cytoprotection by 16,16-dimethyl prostaglandin E2--role of gastric content and
      mucus gel layer].
AB  - The mechanism of cytoprotection by prostaglandins (PGs) is still unknown,
      although many hypotheses have been proposed. We postulated a hypothesis that
      increased gastric content and thickened mucus gel layer by PGs may protect the
      gastric mucosa against damage from necrotizing agents. Two series of experiments
      were performed on Wistar male rats, weighing 250-300 g. (1) 16,16-dimethyl
      prostaglandin E2 (dmPGE2) in doses of 20 micrograms/kg was given orogastrically.
      Fifteen minutes later, the stomachs were emptied and/or the mucus gel layer
      removed, and several concentration of ethanol applied. After ten minutes, the
      stomachs were removed and lesions of the gastric mucosae were evaluated
      macroscopically and histologically. (2) Volume and pH of the gastric content and
      mucus thickness were measured 15 minutes after dmPGE2 administration. DmPGE2 did
      not protect the gastric mucosa against 40% ethanol in the emptied stomach. This
      agent had no cytoprotective action on the emptied and mucus gel-removed stomach
      in 30% ethanol application. These results had no significant difference with
      control group (saline 1 ml p.o.) about the extent of erosion. In histological
      study of the erosive region by scanning and light microscopy, we also found no
      differences in the depth of erosion between dmPGE2 group and control. In
      addition, dmPGE2 increased the gastric volume and mucus thickness significantly.
      These data suggest that following two effects by PGs play major role in
      cytoprotection of the gastric mucosa; (1) dilution of necrotizing agents by
      increased gastric content, and (2) thickening of the mucus gel layer.

PMID- 2232297
TI  - [An experimental study of the action of dopamine in suppressing pentagastrin
      stimulated gastric acid secretion and its mechanism in rats].
AB  - The action of dopamine (DA, 10 micrograms/kg/min) on pentagastrin (16
      micrograms/kg/hr) stimulated gastric acid secretion was studied by use of Ghosh
      Schild's rats. DA suppressed pentagastrin-stimulated gastric acid secretion 44.6
      percent compared with the level before administration. This decrease in acid was
      inhibited by pretreatment with beta 1 and beta 1 + beta 2 blockers and
      pretreatment with DA1 + DA2 and DA1 antagonists. The gastric acid secretion with
      DA1 agonist decreased 36.4 percent from the level at the time of pentagastrin
      administration. This decrease was inhibited by pretreatment with beta 1 blocker,
      but suppression of gastric acid secretion by beta 1 + beta 2 stimulator was not
      inhibited by pretreatment with DA1 antagonist. These results suggest that DA
      stimulated beta 1 adrenalin receptor via DA1 receptor and thereby suppresses
      pentagastrin-stimulated gastric acid secretion.

PMID- 2232299
TI  - [Role of tissue kallikrein in chronic gastritis].
AB  - Tissue kallikrein could be specifically demonstrated in the human gastric mucosa
      using sandwich-type enzyme-linked immunosorbent assay. Eighty-five patients with
      chronic gastritis were then studied to investigate the relationship of tissue
      kallikrein to endoscopic and pathologic findings. The endoscopic Congo red method
      was used to classify the atrophic pattern of each patients gastric mucosa into
      the normal, closed or open type. Tissue kallikrein increased significantly in the
      closed type compared with the normal type (P less than 0.01) and in the open type
      compared with the closed type (P less than 0.001). Pathological findings were
      classified into three groups: (A) normal surface epithelium, with slight
      infiltration by inflammatory cells; (B) atrophic surface epithelium, with marked
      infiltration by inflammatory cells; and (C) atrophic surface epithelium, with
      marked infiltration by inflammatory cells and intestinal metaplasia. Tissue
      kallikrein significantly increased in the B group compared with the A group (P
      less than 0.01) and in the C group compared with the B group (P less than 0.001).
      Tissue kallikrein markedly increased with the appearance of intestinal metaplasia
      in the open type rather than in the closed type. An immunohistological study
      demonstrated that tissue kallikrein was present in the cells showing intestinal
      metaplasia and goblet cells. These findings suggest that chronic gastritis is a
      process of reconstruction of gastric mucosa.

PMID- 2232300
TI  - [Role of PAF for the formation of gastric mucosal injury induced by ischemia
      reinfusion in the rat].
AB  - Oxyradicals of neutrophils are supposed to play a role in the formation of
      gastric mucosal injury induced by ischemia-reinfusion (I-R). Recently, platelet
      activating factor (PAF) is suggested to be involved in the I-R injury as one of
      chemical mediators since this substance may be produced in hypoxic tissue,
      stimulating oxyradical generation of neutrophils. In the present study, using CV
      3988, a PAF antagonist, the severity of gastric mucosal damage and
      chemiluminescence (CL) activity of neutrophils of circulating blood were measured
      to evaluate the role of PAF in the I-R injury. SD rats fasted overnight were
      anesthetized and instilled 0.1N HCl into the stomach. Rats were then subjected to
      reduction of blood pressure to 20-30 mmHg for 20 min by bleeding followed by
      reinfusion of shed blood for 20 min. Two groups of rats each received 10 mg/kg CV
      3988 (PAF-A grup) or saline (I-R group) i.v. 5 min prior to bleeding. After
      killing rats, the area of gross gastric lesions and the index of histologic
      damage were assessed. In separate PAF-A and I-R groups of rats, and control rats
      received saline i.v. and no hypotension, blood samples were collected from the
      portal vein and the abdominal aorta 45 min after acid instillation. Luminol
      dependent CL stimulated by PMA of blood samples was measured using the photometer
      Monolight 401. CL activity was expressed as [peak CL/neutrophils
      number].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232301
TI  - [Protease activities in gastric and colon cancer tissues].
AB  - Activities of cathepsin B, cathepsin L, and plasminogen activators (urinary type
      plasminogen activator and tissue type plasminogen activator) were assayed in
      homogenates of cancer tissue, normal tissue closely surrounding the cancer
      tissue, and normal tissue distant from the cancer tissue from 30 patients
      undergoing surgery for gastric cancers and 10 patients undergoing surgery for
      colon cancers. Activities of those proteases were also assayed in homogenates of
      adenoma tissue from 10 patients undergoing polypectomy for colon polyps. In the
      gastric cancer tissue homogenates, the activities of cathepsin B, cathepsin L and
      tissue type plasminogen activator were significantly higher than in normal
      tissues. By contrast, the activities of urinary type plasminogen activator of
      gastric cancer tissues were significantly lower than normal tissues. In the colon
      cancer tissue homogenates, the activities of cathepsin, B, cathepsin L, and
      urinary type plasminogen activator were significantly higher than in normal
      tissues. On the other hand, the activities of tissue type plasminogen activator
      of cancer tissues were significantly lower than normal tissues. But there were no
      significant differences in the activities of plasminogen activators between the
      cancer tissues and adenoma tissues. These results suggest that cathepsin B and
      cathepsin L play an important role in gastric and colon cancer proliferation and
      evolution, although the roles of plasminogen activators in gastric and colon
      cancer proliferation and evolution and in the colon adenoma-carcinoma sequence
      are still unknown.

PMID- 2232302
TI  - [Endotoxemia and its compensatory mechanisms in experimental liver cirrhosis].
AB  - This study was performed in order to elucidate the mechanisms of systemic
      endotoxemia in liver cirrhosis. For this purpose, the method of measuring biliary
      endotoxin was established. Endotoxin levels between in the bile and in the plasma
      in cirrhosis were compared using a modified method of chromogenic quantitative
      endotoxin assay in an attempt to clarify liver function of clearing portal
      endotoxin originated from the gut. And functional activities of the
      reticuloendothelial system were also examined by radioassay with 59Fe-labelled
      iron-chondroitin sulfate colloid and by enzymohistochemistry of acid phosphatase.
      Both the plasma and biliary endotoxin levels in liver cirrhosis were
      significantly higher, compared to those in control. The functional activities of
      the reticuloendothelial system, particularly of the Kupffer cells, were decreased
      in liver cirrhosis. These data provide evidence that in liver cirrhosis systemic
      endotoxemia is mainly due to a decrease of functional activities of Kupffer
      cells. On the other hand, the excretion of endotoxin into the bile is increased,
      compensating the decreased functional activities of Kupffer cells. This implies
      that the uptake of endotoxin and its excretion into the bile by hepatocytes might
      be one of the mechanisms of clearing excess endotoxin in the plasma in liver
      cirrhosis. This study also draws the importance of measurements of endotoxin
      levels in the bile in liver diseases.

PMID- 2232303
TI  - [A case of enterocolitis with diffuse multiple aphthoid lesions in which non
      caseous granulomas were demonstrated microscopically].

PMID- 2232304
TI  - [A case of hepatitis A associated with thrombocytopenia, leukopenia and acute
      renal failure].

PMID- 2232305
TI  - [A case of evaluation of hepatic hemangioma on phosphorus 31 magnetic resonance
      spectroscopy (31P-MRS)].

PMID- 2232306
TI  - [A case of retroperitoneal schwannoma mimicking a cystadenoma of the pancreas].

PMID- 2232307
TI  - [Osteoporosis--from the view point of the orthopedic surgeon].
AB  - It is commonly accepted that the incidence of osteoporosis, as well as
      hypertension and diabetes, increases with age. With the expansion of the elderly
      portion of the population in society, the number of cases of osteoporosis and its
      related fractures must correspondingly increase. Regarding the effect of the
      level of decreased bone mass or bone mineral density of patients with vertebral
      body or hip fracture, the incidence rate of fractures significantly increases
      when the bone mass level of patients becomes less than -3 S.D. of the peak bone
      mass level at each of the respective sites. As a result, areas of under -3 S.D.
      area of te peak bone mass level are considered to be fracture risk area. When
      treating osteoporosis patients, special consideration must be given to other age
      related complications. One third of hip fracture patients already have dementia,
      hypertension, or cerebrovascular disorders at the time of injury. Exercise and
      weight bearing are important for the treatment and prevention of osteoporosis
      because of their positive influence on the muscles and the bone tissue of the
      patients.

PMID- 2232308
TI  - [Trends, risk factors, and prevention of ischemic heart disease in Japan].
AB  - The mortality from ischemic heart disease has increased steadily in most
      industrialized countries from the 19th century up to 1970. In some developed
      countries, such as the U.S.A. and Australia, it started to decrease in the
      nineteen seventies and accelerated recently. However, it has increased in some
      East European countries, such as Rumania, Poland and Hungary. The mortality had
      been extraordinarily low and the age standardized rate declined since the
      nineteen seventies in our country as in the U.S.A. These finding strongly
      suggests the possibility of prevention of ischemic heart disease worldwide. Among
      the risk factors, hypertension has gradually decreased due to treatment and lower
      intake salt in Japan. However, the compliance of antihypertensive treatment could
      be improved and the average intake of salt further decreased. The frequency of
      hypercholesterolemia was quite low for many years, but increased recently in
      Japan. However, the national average level of serum cholesterol is probably close
      to 200 mg/dl, and the new cholesterol level data will be revealed by the national
      survey in 1990. The world-famous high figure of smoking among Japanese men has
      been declining for these 20 years down to 61.2% in 1988, along with an
      exceptionally low rate for women in industrialized countries. The average figure
      of body weight by stature was in line with the desirable body weight for Japanese
      and the average intake of lipids has leveled off recently according to the
      National Nutrition Survey. After all it can be concluded that incidence of
      ischemic heart disease could be reduced further, even in Japan.

PMID- 2232309
TI  - [Development of coronary atherosclerosis in the elderly].
AB  - The role of aging, hypertension and plasma cholesterol in the development of
      coronary atherosclerosis was examined in 3569 consecutive autopsy cases, aged 60
      to 99 years, at the Tokyo Metropolitan Geriatric Hospital. The prevalence of
      coronary atherosclerosis increased with aging. Both systolic and diastolic
      hypertension were related to the prevalence of coronary atherosclerosis. High
      plasma cholesterol (230 mg/dl) was related to increased prevalence of coronary
      atherosclerosis. This effect was observed in a hypertensive group, but not in a
      normotensive group. To define the effect of hypertension on vascular diseases,
      endothelial cells from spontaneously hypertensive rats (SHR) were obtained and
      characterized in terms of cellular response. Cellular Ca2+ level in response to
      A23187 was significantly enhanced in SHR compared to normotensive Wistar-Kyoto
      rats (WKY). Thus, aging, hypertension and high plasma cholesterol are risk
      factors for coronary artery atherosclerosis in the elderly.

PMID- 2232310
TI  - [Angiographic progression and regression of coronary atherosclerosis].

PMID- 2232311
TI  - [Progression of coronary atherosclerosis and the non-invasive evaluation in older
      patients].
AB  - To evaluate characteristics of coronary atherosclerosis in older patients and to
      elucidate the role of dipyridamole myocardial perfusion scintigraphy (DMPS) in
      the assessment of patients with coronary artery disease, 437 patients (330 men,
      107 women, age range 13-85 years) initially underwent coronary angiography (CAG)
      and DMPS. Coronary risk factors were evaluated in relation to the severity and
      progression of coronary atherosclerosis. Cardiac events were also evaluated
      during the follow-up period of 39 +/- 19 months (range 1-77 months). Assessment
      of five coronary risk factors, including hypercholesterolemia, diabetes,
      hypertension, positive family history, and history of smoking, was made in 212
      patients in relation to the severity of coronary atherosclerosis. In patients
      with insignificant lesions or single vessel disease, prevalence of
      hypercholesterolemia and positive family history was lower in older patients (65
      years or older) than in younger patients (64 years or younger), but significant
      difference was not found in prevalence of diabetes, hypertension, and history of
      smoking. In patients with multivessel disease, there was no significant
      difference in prevalence of coronary risk factors between the two groups except
      history of smoking. Repeated CAG was performed in 27 patients during follow-up.
      Nineteen of them experienced increased symptoms of angina and eight patients
      newly developed acute myocardial infarction. The patients with increased angina
      had more risk factors, and majority of them (74%) showed some progression of
      previously noted severe stenoses in the proximal coronary arteries. In patients
      with new infarction, 62% of them showed new total occlusions as infarct-related
      lesions, although there were some patients who showed progression of previously
      noted severe lesions. DMPS was performed in 437 patients.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2232312
TI  - [The effect of conventional therapy on coronary risk factors].

PMID- 2232313
TI  - [Risk factors relating to coronary artery disease in the elderly].
AB  - A total of 224 patients with coronary artery disease (CAD) and 167 healthy
      control beings (C) were evaluated for coronary risk factors. Analysis of low age
      subset (age less than 55) disclosed hypertension and hypercholesterolemia were
      more common findings in CAD compared with C. Significantly elevated plasma
      triglyceride (TG) and low density lipoprotein cholesterol (LDL-C), and reduced
      high density lipoprotein cholesterol (HDL-C) concentrations were found in CAD,
      accompanied by significant increase of atherogenic index (AI). In CAD, a
      decreased number of males and smokers was noted in high age subset (age over 65).
      Significantly reduced plasma TG and elevated HDL-C were observed in the elderly
      compared with the young. AI was also significantly higher in this group.
      Therefore, in CAD, the level of coronary risk factors seemed to be attenuated in
      the hig age subset compared with the low age group, which was different from the
      findings in C in whom significantly increased AI was noted in the elderly. In 61
      CAD cases, lipid profiles were monitored for 5 years in average. Significant
      changes recognized during this period were the reduction of TG, LDL-C and AI
      along with the elevation of HDL-C, suggesting their risk to be improved. To
      examine the metabolic effects of diuretics, 52 patients with essential
      hypertension on trichlormethiazide for long periods were subjected to the
      substitution of this drug by the inhibitor of angiotensin converting enzyme,
      enalapril, for more than 3 months. At the end of each treatment, measurements of
      blood sugar (BS) and insulin (IRI) were made together with lipid
      analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232314
TI  - [Prevention of progression of coronary atherosclerosis by drug and diet therapy].
AB  - In 102 patients with ischemic heart disease the severity of stenosis was
      classified into 7 grades (0, 25, 50, 75, 90, 99, 100%) in accordance with the AHA
      reporting system. The coronary angiograms were compared at first and second
      catheterization (intervals 2-84 months) and progression was considered present if
      the stenosis in the second study showed more than one grade increase in
      comparison with the first study. Fifty six patients met criteria for progression.
      Risk factors were obtained within the first second catheterization. Drug and diet
      therapy were evaluated by interview. No significant difference could be found
      between the progression (P) group and the nonprogression (N) group in relation to
      family history and obesity. A history of hypertension was more common in the P
      group. In respect to blood sampling, the values of total cholesterol, Apo B, CII,
      E and Apo B/AI were significantly higher in the P group than those in the N group
      at first and second catheterization. The percentage of patients showing abnormal
      levels of blood sugar and lipid were higher in the P group than the N group
      although the percentage of patients with drug and diet therapy were higher in the
      P group than in the N group. The percentage of patients with diet therapy for
      hyperglycemia and hyperlipidemia were higher in the P group, however weight
      increase was more common in the P group. These data suggest that sufficient diet
      and drug therapy is necessary for patients with risk factors.

PMID- 2232315
TI  - [Hyperlipidemia impairs vascular endothelium-dependent relaxation in pig coronary
      arteries].
AB  - We examined the effects of a low pathophysiological level of hyperlipidemia and
      atherogenic lipoprotein (LDL) on the vascular responsiveness of isolated pig
      coronary arteries. Firstly, we studied the change of vascular responsiveness
      after feeding a cholesterol-rich diet to pigs for 4 or 9 weeks. Serum cholesterol
      level in pigs fed with the cholesterol-rich diet reached 218.5 +/- 32.9 mg/dl
      compared with 85.5 +/- 8.4 mg/dl in controls. Segments of the arteries were
      mounted in organ chambers for isometric tension recording. Contraction caused by
      KCl or prostaglandin F2 alpha was not altered significantly by
      hypercholesterolemia. Relaxation in response to Ca2+ ionophore A23187 or
      nitroglycerin was not altered significantly by hypercholesterolemia. Relaxation
      in response to Ca2+ ionophore A23187 or nitroglycerin was not altered.
      Endothelium-dependent relaxation evoked by high but not low concentrations of
      bradykinin and substance P were reduced in pigs fed with the cholesterol-rich
      diet for 4 weeks as compared with those in normal pigs. Those evoked by
      bradykinin, substance P, and serotonin were significantly reduced in pigs fed
      with the cholesterol-rich diet for 9 weeks. Histologically, the fatty changes or
      intimal thickening were not so evident in coronary arteries of pigs fed for 4
      weeks with the cholesterol-rich diet, but only minimal changes were observed in
      those fed with the diet for 9 weeks by light or electron microscopy. Secondly,
      the direct effects of LDL on the vascular responsiveness were examined.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2232316
TI  - [Some considerations on progression and regression of coronary arteriosclerosis
      based on histological studies of acute coronary thrombosis].
AB  - This study showed that studies of structural changes of arteriosclerotic coronary
      lesion and coronary flow in the stenotic segments are very important for
      understanding the progression and regression of coronary sclerosis. In control
      groups of both sex over 50 years of age (544 males and 400 females), the
      frequency of stenosis of over 75% of 3 main coronary branches was approximately
      20% in cases under 69 years of age and about 30% in cases over 70 years. In cases
      of myocardial infarction over 50 years of age (157 males and 89 females),
      stenosis of over 90% was approximately 90% in te left anterior descending artery,
      70-80% in the right coronary artery and 70% in the left circumflex artery and
      three vessels showing stenosis over 90% were found in half of the cases. Of 70
      coronary arterial lesions found in 67 cases of acute myocardial infarction, 48
      were found in over 90% stenotic segments, 16 in over 75%, the rest in under 75%.
      Hemorrhage in atheroma was found in 55 lesions, atheroma or thick intima without
      hemorrhage in 9, calcified focus in 3 and coronary embolism in 3. Of 67 thrombi,
      44 occlusive and 3 mural thrombi were found in over 90% stenotic segments, 13 and
      2 in over 75% stenotic segments and 2 and one in segments and 2 and one in
      segments with under 75% stenosis, respectively. Histological findings of coronary
      thrombi showed that in 45 of 65 thrombi, two zones of differing age of thrombus
      could be identified and the rest were fresh thrombi.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2232317
TI  - [Left ventricular diastolic filling in elder patients with systemic
      hypertension].
AB  - To study the significance of left ventricular (LV) diastolic filling in elder
      patients with hypertension (HT), cardiac blood pool imagings with Tc-99m were
      obtained at rest in 17 normal subjects and 28 patients with systemic
      hypertension. The patients with hypertension did not show any evidence of
      coronary heart disease, renal insufficiency or other disease. Moreover, they
      showed normal LV ejection fraction (LVEF) and normal LV wall motion. They were
      divided into 4 groups: 1) normal-young (less than 60 years old, n = 10), 2)
      normal-old (greater than or equal to 65 years old, n = 7), 3) HT-young (less than
      60 years old, n = 15), 4) HT-old (greater than or equal to 65 years old, n = 13).
      From the LV volume curve and its first differentiation curve, LVEF, mean first
      third ejection rate (ERm) and peak ejection rate (PER) were obtained as indices
      of the LV systolic function, and LV diastolic filling rate during the first third
      of diastole (FRm) and peak filling rate (PFR) were obtained as indices of LV
      diastolic function. All indices of LV systolic function were similar in all
      groups. In contrast, LV diastolic indices (FRm and PFR) of older groups were
      significantly lower than those of young groups both in HT and normal. Also, LV
      diastolic indices in HT groups decreased significantly in comparison with normal
      groups of the same age group. Among diastolic indices, FRm could distinguish
      patients with HT from normal subjects of the same age group more accurately than
      PFR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232319
TI  - [Localized callosal infarctions and dementia].

PMID- 2232318
TI  - [An aged case of orthostatic hypotension possibly due to parasympathetic
      neurodysfunction].
AB  - 94-year-old male patient, with orthostatic hypotension, possibly due to
      impairment of vasoconstriction and parasympathetic nervous system dysfunction was
      reported. This patient experienced faintness and lower muscle weakness on
      standing. The blood pressure was 180/90 mmHg in a supine position, while it
      significantly decreased to 100/58 mmHg in an upright position. There was no
      evidence indicating the presence of organic brain diseases, cardiovascular
      diseases, and endocrine diseases, plasma catecholamine, renin, aldosterone, and
      vasopressin levels at rest were within normal range. Thus, the cause of
      orthostatic hypotension of this patient was unknown. His systolic blood pressure
      decreased by 70 mmHg, and his diastolic blood pressure also decreased by 25 mmHg
      in response to a 70 degrees head-up tilting test (170/71-100/46 mmHg). Plasma
      vasopressin level significantly increased in response to this test (0.62-67.2
      pg/ml). Plasma catecholamine levels also increased (Adr 0.01-0.10 ng/ml, Ndr 0.05
      0.22 ng/ml). Other autonomic nervous system examinations revealed normal
      responses to mental arithmetic test, hyperventilation test, cold pressure test,
      and adrenalin test. However, the results of the carotid occlusion test,
      acetylcholine test, atropine test, phenylephrine test were considered to be
      abnormal. From these findings, we concluded that the functions of sympathetic
      nervous system were almost intact, while the parasympathetic functions were
      impared in this case. The orthostatic hypotension of the patient as effectively
      treated with fludrocortisone. This report suggests that impairment of
      vasoconstriction and parasympathetic neurodysfunction might be involved in the
      development of orthostatic hypotension in the elderly.

PMID- 2232320
TI  - [Assessment of physical activity by means of a calorie counter combined with an
      accelerometer].
AB  - To establish an easy and convenient method for assessing the daily physical
      activity of workers, validity of a calorie counter combined with an accelerometer
      (KENZ Calorie Counter) was tested and compared with the method of daily survey
      and Stanford's interview method for energy consumption of daily physical
      activity. The subjects of this study were 92 volunteers. Energy expenditure of
      daily physical activity during 3-4 d was measured in 20 volunteers by means of a
      calorie counter, and the daily energy consumption was calculated from relative
      metabolic rates of physical activity. In the remaining 72 volunteers the energy
      consumption over 4-7 d was measured by means of a calorie counter and calculated
      from the Stanford's interview method. Correlation of the energy expenditure of
      daily physical activity measured by calorie counter (y) and that calculated from
      daily survey (x) was y = 0.74 x + 473 (r = 0.91, n = 56). Correlation of the
      calorie expenditure over 4-7 d measured by the calorie counter (y) and that
      predicted by Stanford's interview method (x) was high (y = 0.65 x + 3513, r =
      0.86, n = 72). Relationship between the energy expenditure measured by the
      calorie counter (y) and that calculated by both daily survey and Stanford's
      interview method (x) showed a high correlation (y = 0.84 x + 518, r = 0.98, n =
      128). These results suggest that a calorie counter combined with an accelerometer
      is valid for assessing the daily physical activity of workers.

PMID- 2232321
TI  - [Mental health in software engineers. II. Classification of occupational
      stressors, and relationship between occupational stressors and psychiatric
      disorders].
AB  - Occupational stressors and psychiatric disorders were studied in a sample of 101
      male software engineers. Psychiatric diagnosis was based on DSM-III (Diagnostic
      and Statistical Manual of Mental Disorders, Third Edition). The results can be
      summarized as follows: 1) More than 30% of the subjects were not satisfied with
      their work. 2) Occupational stressors ascertained in the interview could be
      classified into "quantity of job," "quality of job," "role in organization,"
      "relations with others," "work conditions," "career development," "reward,"
      "organizational structure and climate," "low social support," and "lack of
      decision making." "quality of job" (35%), "quantity of job" (30%), and "role in
      organization" (33%) were the most common stressors for the subjects. 3) Among the
      occupational stressors, only "quantity of job" was significantly related to
      psychiatric disorders (p less than 0.05). The results suggest that many software
      engineers are not satisfied with their work and that "quantity of job" has the
      greatest influence on their mental health. Some measures should be taken to avoid
      potential health hazards, for the research findings indicate a relationship
      between occupational stressors and mental health in software engineers.

PMID- 2232322
TI  - [Twenty years' follow-up study of asbestos workers].
AB  - This report describes a cohort study conducted on workers who were employed in a
      factory mainly manufacturing asbestos yarn and cloth and were followed from 1964
      to 1981. A total of 208 workers (73 males and 135 females) could be traced and 15
      deaths were observed by the end of 1983. Among them, three had lung cancer and
      its relative risk was 6.8 (p less than 0.05) computed based on the age, sex and
      year specific death rates of Osaka Prefecture. One case of peritoneal
      mesothelioma was also found. The period from first asbestos exposure to death of
      these four cases of asbestos-related malignancies was more than 25 yr. In the
      analysis of the employees who had more than 1 yr of exposure to asbestos and
      those who had already been engaged in this factory at the beginning of the
      observation, the relative risk of lung cancer was 8.1 and 13.6, respectively.

PMID- 2232323
TI  - [Disturbance of acid-base balance in cadmium-induced renal tubular dysfunction].

PMID- 2232324
TI  - [Determination of cadmium, cobalt, copper, nickel and lead in urine by
      inductively coupled argon plasma emission spectrometry after solvent extraction].

PMID- 2232325
TI  - [Prognosis of cadmium-induced renal dysfunction after reduction of exposure].

PMID- 2232326
TI  - [Nondestructive X-ray fluorescence spectroscopic imaging of trace elements on
      methylmercury and selenium administered guinea pigs].

PMID- 2232327
TI  - [Effects of soft drink intake on the concentration of urinary hippuric acid in
      workers exposed to toluene].

PMID- 2232328
TI  - ABO blood-typing of bloodstains by dot-ELISA method.
AB  - The ABH antigens of bloodstains which were effectively solubilized in phosphate
      buffered saline by crushing in a mortar were detected on a nitrocellulose
      membrane by enzyme-linked immunosorbent assay (ELISA). The analyses for
      characterization showed that the extracted substances consisted of various
      components of the red cell with molecular weights of more than 30,000. ABO types
      of some aged bloodstains were determined by this simple procedure. This method is
      a useful tool for determining various blood-groups from bloodstain.

PMID- 2232329
TI  - The movement of blood formaldehyde in methanol intoxication. II. The movement of
      blood formaldehyde and its metabolism in the rabbit.
AB  - The movement of blood formaldehyde in rabbits that were intoxicated with methanol
      has been investigated by simple headspace gas chromatography-mass spectrometry
      for the microdetermination of formaldehyde in the blood. When methanol alone was
      administered to rabbits orally, formaldehyde could not be detected in the blood.
      Further, in an experiment on the metabolism of methanol in vitro, formaldehyde
      was not detected in specimen samples but formate was. In contrast, when methanol
      was orally administered to rabbits that had been pretreated with
      diethyldithiocarbamate (DDC), an aldehyde dehydrogenase (ALDH) inhibitor, 17 to
      33 microM of formaldehyde were detected in the blood 4 hours later. However,
      formaldehyde was not detected in the blood when methanol was orally administered
      to rabbits that had been pretreated with pyrazole, an alcohol dehydrogenase (ADH)
      inhibitor. After rabbits were given an intravenous administration of
      formaldehyde, and on the addition of formaldehyde to a rabbit liver homogenate
      and blood, the formaldehyde in both instances was metabolized rapidly.
      Formaldehyde that was not metabolized within 10 to 15 minutes, however, bound to
      the tissue proteins. Therefore, according to the results of this study,
      formaldehyde was seen to be rapidly metabolized to formate without accumulating
      in the blood or binding to the tissue proteins. Formaldehyde thus appears to have
      little influence on the symptoms of methanol poisoning.

PMID- 2232331
TI  - Studies on asphyxia; on the changes of the alveolar walls of rats in the hypoxic
      state. III. The hypoxic state by carbon monoxide gas.
AB  - Experimental studies on asphyxia due to the hypoxic state produced by carbon
      monoxide gas were achieved. The morphological changes such as 1) faint pinkish
      homogeneous substance in the alveoli by H&E staining, 2) debris-like structure of
      medium electron dense substance on the surface of alveoli and/or full-filling the
      space of alveoli which were almost the same as observed in our previous reports
      except the appearance of a plenty of fibrin fibers in the debris-like structure
      and in part the close connection with myelin configurations as well.

PMID- 2232330
TI  - Blood group antigens transformed by proteinase K-treatment and the discovery of a
      natural autoantibody of these treated red blood cells.
AB  - Proteinase K-treatment of red blood cells either diminished or abolished the
      antigenic activities of glycophorin A and glycophorin B, and revealed the
      presence of a cryptic antigen that was recognized by antibody naturally existing
      in the autoplasma. About ninety five percent of all healthy persons have this
      autoantibody belonging to the IgM classification, whose titer ranges from 2 to
      32. The activity of this autoantibody was absorbed by histidine and glutaminic
      acid. We were able to isolate this autoantibody from the plasma by means of an
      alkaline elution method and the autoantibody did not agglutinate chymotrypsin
      treated red blood cells and red blood cells treated with chymotrypsin, following
      proteinase K-treatment. These results indicate that after proteinase K-treatment
      this autoantibody may not have an affinity for glycolipids, but for proteins
      digested by chymotrypsin.

PMID- 2232332
TI  - Demonstration of ingested thinner.
AB  - Taking a practical forensic case that provided an opportunity, an attempt was
      made to prove that paint thinner had been ingested by the victim. One ml of
      standard thinner solution, which was prepared by mixing toluene, ethyl acetate,
      and isobutanol, was given by gavage to rats, after which, on sacrifice of the
      animals, the distribution of thinner components in the body tissue and in the
      gastric contents was examined by gas chromatography, using the salting-out
      technique and the headspace method. Three thinner components and ethanol, a
      metabolite of ethyl acetate, were found to be present in the gastric contents,
      whereas only toluene was found in the blood and in the other tissue. From these
      results we thus have concluded that paint thinner taken can be proved by
      detecting the presence of ethyl acetate and isobutanol together with toluene in
      the stomach, whereas only toluene can be detected in the body fluids and the
      other tissue.

PMID- 2232333
TI  - Characterization of a monoclonal crossreacting anti-A, B antibody.
AB  - Ten monoclonal antibodies (MAbs) have been produced from mouse-mouse hybridomas
      raised to dispase-treated human group AB red blood cells (RBCs). One of these
      antibodies, T-1435A, reacted with the RBCs of the human group A, B, and AB, but
      not to the RBCs of group O. The reactivity of T-1435A was specific to a single
      anti-A, B but not to a mixture of an anti-A and an anti-B. Also, T-1435A reacted
      strongly with protease- and neuraminidase-treated RBCs, and the susceptibility of
      its corresponding antigen was markedly reduced by alpha-galactosidase treatment.
      T-1435A agglutinated group A RBCs from chimpanzees, and its reactivity to RBCs
      was recognized in tamarins and in owl monkeys. However, this antibody
      demonstrated a stronger affinity for human RBCs. Further, using A- or B
      transferase, human and chimpanzee RBCs that transferred from group O to A or to B
      were agglutinated by T-1435A. Finally, the corresponding antigen appears to have
      a structural determinant that fits the T-1435A combining site. Therefore, this
      monoclonal antibody is useful for determining the ABO blood-grouping when used as
      a conventional reagent that segregates group O RBCs from the RBCs of the other
      groups.

PMID- 2232334
TI  - [Locomotor activity and urinary excretion of orthocresol in rats exposed to
      toluene].
AB  - To clarify the effect of toluene on behavior, and to evaluate urinary orthocresol
      excretion as an indicator of toluene exposure and locomotor activity, we have
      investigated the urinary orthocresol excretion and levels of locomotor activity
      in rats exposed to 0-3000 ppm of toluene intermittently for 2 hours. The levels
      of locomotor activity were measured by a laboratory animal activity measuring
      apparatus (ANIMEX-III). Exposure of adult male rats to more than 1000 ppm (v/v)
      of toluene caused an elevation of the urinary orthocresol excretion and a good
      correlation was noted between the amount of toluene in the air and the urinary
      orthocresol excretion. Exposure to over 2000 ppm of toluene suppressed the level
      of locomotor activity, and there was a good correlation between the level of
      locomotor activity and the urinary orthocresol excretion. Further, rats exposed
      to 3000 ppm toluene showed elevated levels of locomotor activity during a 10-hour
      period after exposure. These patterns of urinary orthocresol excretion and the
      levels of locomotor activity remained unchanged even when rats were exposed to
      3000 ppm of toluene intermittently over a 4-day period.

PMID- 2232335
TI  - [Sudden death of alcohol withdrawal syndrome--report of a case].
AB  - A 50-year-old driver was arrested in a drunken stupor while he was driving a
      track. He suddenly died after five days of the arrest in a jail. As time went by,
      various symptoms of alcohol withdrawal appeared. He was in the state of delirium
      treatments for about a day before he died. Gross and microscopical examination
      revealed fibrosis and fatty degeneration of liver and heart lesions representing
      chronic and acute ischemia. We discussed the cause and the mechanism of the death
      in the case and reviewed those in the previous observations.

PMID- 2232336
TI  - [Calculation of carbon monoxide concentration based on a ventilation model for
      two rooms].
AB  - We have estimated the gas concentration in an upstairs room following leakage of
      gas from a ground-floor room. The method used to calculate the gas concentration
      in the upstairs room was based on a ventilation model for two rooms. The
      assumptions on which the calculation was based were: 1) Uniform diffusion of gas.
      2) Presence of slight openings in the room wall. 3) Reported data on the volume
      of the openings between the downstairs ceiling and the upstairs floor. 4)
      Calculation of the ventilation rate based on buoyant force. The upstairs gas
      concentration became steady within 4-7 h after the leakage. The ventilation rates
      for the 1st and 2nd floors at a steady state were 0.86 and 0.63 (room volume/h),
      respectively. The volume of the room did not affect the gas concentration at the
      steady state.

PMID- 2232337
TI  - [Detection of restenosis after successful percutaneous transluminal coronary
      angioplasty (PTCA)--usefulness of exercise thallium scintigraphy].
AB  - We studied the efficacy of stress thallium scan in detecting restenosis after
      primary successful PTCA. There were 21 patients with angina pectoris and 16
      patients with previous myocardial infarction. The sensitivity and the specificity
      of stress thallium scan in detecting restenosis were superior to those of stress
      electrocardiography or chest pain complained in follow-up period. In multi-vessel
      disease, we could assess the vessel developing restenosis more easily than stress
      electrocardiography. Initial thallium %UPTAKE RATIO was significantly improved
      after PTCA but redecreased in patients developing restenosis. In patients showing
      residual redistribution despite of not developing restenosis, we could judge
      vessel patency by gradually improving initial %UPTAKE RATIO after PTCA. Thus,
      stress thallium scan proved to be useful in detecting restenosis after PTCA.

PMID- 2232338
TI  - [Serial change of 123I-metaiodobenzylguanidine (MIBG) myocardial concentration in
      patients with dilated cardiomyopathy].
AB  - 123I-Metaiodobenzylguanidine (MIBG) is expected to be useful agent for functional
      evaluation of the myocardial sympathetic innervation. The aim of this paper is to
      investigate serial change of 123I-MIBG myocardial concentration in patients (pts)
      with dilated cardiomyopathy (DCM) as compared with 201Tl uptake. Eight pts with
      DCM and six non-cardiac subjects (controls) were examined. After injection of 111
      MBq (3mCi) 201Tl and 111 MBq (3 mCi) 123I-MIBG, simultaneous myocardial imaging
      in anterior view was performed for both tracers in every 30-60 minutes during 5
      hours (6 images). Myocardial uptake ratio per pixel to the injected dose was
      calculated for each tracer with background and cross-talk correction on each
      image. In pts with DCM, myocardial uptake ratio of 123I-MIBG did not differ
      significantly from that of controls. The washout of 123I-MIBG from the
      myocardium, however, was significantly increased in pts with DCM as compared with
      controls. The % decrease of the radioactivity in 3 hours was 46.9 +/- 13.8% in
      DCM, whereas 18.0 +/- 7.7% in controls (p less than 0.05). Especially, the
      decrease in the early phase (less than 1 hour) was significantly larger in DCM
      than controls (21.2 +/- 7.5% vs 5.3 +/- 4.0%, p less than 0.01). For 201Tl, on
      the other hand, neither uptake ratio nor washout rate, differed significantly
      between the two. In conclusion, the rapid washout of 123I-MIBG in the early phase
      may reflect some sympathetic dysfunction in pts with DCM.

PMID- 2232339
TI  - [Serial assessment of denervated but viable myocardium following acute myocardial
      infarction by using 123I-MIBG and 201TlCl myocardial SPECT].
AB  - 123I-MIBG is taken up by sympathetic nerve ending and provides a scintigraphic
      image of myocardial sympathetic innervation. We investigated the scintigraphic
      detection of denervated but viable myocardium following acute myocardial
      infarction by serial 123I-MIBG and 201TlCl myocardial SPECT. Fourteen patients
      were studied at acute (10 +/- 2 days) and chronic stage (86 +/- 10 days).
      Simultaneous dual SPECT was carried out after IV administration of 111 MBq (3
      mCi) of 201TlCl and 123I-MIBG. The defect size of 123I-MIBG and 201TlCl were
      compared visually by using Bull's eye display generated from each myocardial
      SPECT. In all patients, 123I-MIBG defect showed larger compared to 201T1Cl defect
      at acute stage, which suggest the existence of denervated but viable myocardium.
      Of these patients, seven showed significant improvement of both defects, though
      123I-MIBG defect showed slightly larger compared to 201TlCl defect, even at
      chronic stage. These patients had exercise induced thallium transient defect at
      infarcted area. The remaining 7 patients had no improvement of both defects at
      chronic stage, which suggest the complete scar at infarcted area. In addition to
      above study, 4 patients of old myocardial infarction demonstrated larger 123I
      MIBG defect compared to 201TlCl defect even at old stage, which thought to be
      pathogenesis of ventricular tachycardia. In conclusion, 123I-MIBG could evaluate
      sympathetic denervation and reinnervation noninvasively in the patients with
      acute myocardial infarction.

PMID- 2232340
TI  - [123I-IMP accumulation in the lung with bronchial asthma--early uptake and
      delayed washout].
AB  - 123I-IMP is taken up by the pulmonary capillary endothelial cells during the
      first pass through the lung, and is slowly released from them. To look up the
      factors which influence on the prolonged 123I-IMP retention in the diseased lung,
      we examined the correlation between the 123I-IMP uptake during the first pass and
      the 123I-IMP retention. Patients with bronchial asthma had no abnormal finding in
      the chest X-ray photograph. However 123I-IMP release from their lungs was
      delayed. Some patients show a tendency that 123I-IMP uptake during the first pass
      was uneven, which suggested the change in amine uptake function of endothelial
      cells. However their correlation coefficients between the uptake during the first
      pass and the prolonged retention were very small. It was considered that the
      prolonged 123I-IMP retention in the diseased lung was not explained only by the
      change in uptake function of pulmonary capillary endothelial cell.

PMID- 2232341
TI  - [Myocardial adrenergic derangement due to myocardial ischemia: decreased
      myocardial uptake of I-123 metaiodobenzylguanidine after PTCA in a patient with
      effort angina].
AB  - Regional denervation of adrenergic nerves has been clinically demonstrated in
      patients with myocardial infarction using I-123 metaiodobenzylguanidine (MIBG)
      scintigraphy. However, it is not clarified whether adrenergic denervation can be
      induced by prolonged myocardial ischemia as well as by myocardial infarction.
      This case with effort angina had 99% stenosis of right coronary artery and showed
      perfusion defects at inferior myocardial regions in the exercise thallium-201
      study. However, inferior wall motion estimated by echocardiography and left
      ventriculography was normal indicating the absence of myocardial infarction.
      After percutaneous transluminal coronary angioplasty for the stenosis, I-123
      metaiodobenzylguanidine (MIBG) and thallium-201 (Tl-201) myocardial
      scintigraphies were done to estimate the therapeutic effect of PTCA. Although the
      Tl-201 study during exercise showed normal findings indicating the success of
      PTCA, marked defects was detected at inferior myocardial regions in the I-123
      MIBG studies just after and 4 hours after an intravenous injection of I-123 MIBG.
      These results suggest that adrenergic derangement may be induced by prolonged
      myocardial ischemia and may persist for periods even though myocardial perfusion
      is normalized.

PMID- 2232343
TI  - [A case of subacute cerebral infarction demonstrating hyperemia and crossed
      cerebellar diaschisis in I-123 IMP SPECT].
AB  - SPECT with N-isopropyl-p-[I-123]iodoamphetamine were performed in a 81-year-old
      man with cerebral infarction. In the subacute phase, the radioactivity was
      increased in the infarct area where fogging effect and remarkable contrast
      enhancement was demonstrated in X-ray CT. The contralateral cerebellar hemisphere
      showed reduced activity due to crossed cerebellar diaschisis (CCD). In the
      chronic phase, the decrement of the activity in the infarct was observed.
      Increased activity in the subacute phase was thought to reflect the hyperemia in
      the infarct, while CCD suggested the decreased metabolic activity in the lesion.
      The coexistence of the hyperemia and the CCD indicates flow and metabolic
      uncoupling, which means "luxury perfusion". This case was also thought to
      demonstrate atypical findings of CCD in SPECT imaging.

PMID- 2232342
TI  - [A case of Hurthle cell carcinoma in the superior mediastinum].
AB  - This is a report for an unusual case of oxyphilic cell adenocarcinoma originating
      from anterior mediastinum in a 36-year-old male who complained of his neck
      lymphoadenopathy. 201Tl whole body scanning showed increased uptake of the left
      supraclavicular and upper mediastinal regions. There was no history of prior
      operation nor irradiation to the thyroid or neck region. Chest CT scanning also
      demonstrated the tumor in the superior mediastinum, but the mass has no increased
      67Ga uptake. No tumor in the thyroid lobes was apparent on thyroid
      scintiscanning, ultrasonography and neck CT. The mediastinal tumor resection, the
      right and left thyroid lobectomy and the neck lymphonodectomy were completed.
      Serial sectioning of the resected thyroid lobes failed to show any tumorous
      tissue. The light microscopic features of a Hurthle-cell tumor arising in the
      mediastinal ectopic thyroid and diagnosed by neck lymph node biopsy were
      presented. The tumor was clinically malignant, having metastasized to the bone
      and the neck lymph nodes. Non surgical treatment including radioactive iodine
      (131I) therapy and combination chemotherapy were disappointing. The patient
      deteriorated progressively and died 16 months after thyroidectomy. We describe
      here an unusual case of a papillary growing and thyroglobulin producing tumor in
      the superior mediastinal region without evidence of a primary thyroid gland
      tumor.

PMID- 2232344
TI  - [Thallium-201 thyroid scintigraphy of thyroid nodules--washout pattern of Tl-201
      in thyroid nodules].

PMID- 2232345
TI  - [Clinical trial of 111In-antimyosin antibody imaging: (5). Follow-up study and
      its safety].

PMID- 2232346
TI  - [Basic and clinical studies of measurement of serum neopterin concentrations
      utilizing radioimmunoassay].

PMID- 2232347
TI  - [Studies on radioimmunoassay kit for measuring urinary neopterin].

PMID- 2232348
TI  - [Correction of time resolution of an ambulatory cardiac monitor (VEST)--using a
      pulsate cardiac phantom].
AB  - Using ambulatory cardiac monitor (VEST) at exercise study, its time resolution is
      very important factor. We evaluated the time resolution of VEST using pulsate
      cardiac balloon phantom. Four analyses were carried out; no smoothing (NS)
      method, 3 points smoothing (3S) method, short sampling interval (SS) method, and
      digital filter (DF) method. By comparison of [delta EF[ ([EF: HR120-EF: HR60[)
      among 4 analysis methods, [delta EF[ by DF method was significant small. (NS:
      3.58 +/- 3.01, 3S: 4.46 +/- 0.95, SS: 3.35 +/- 3.26, DF: 1.11 +/- 1.28%). We
      conclude that correction of time resolution by digital filter is necessary when
      we use VEST during exercise.

PMID- 2232349
TI  - [The development of a highly sensitive IgE immunoradiometric assay using
      monoclonal antibodies].
AB  - We have developed two-site immunoradiometric assay (IRMA) for quantitation of
      human serum IgE, using two different anti-IgE monoclonal antibodies which
      recognize different epitopes on IgE molecule. We obtained 25 different monoclonal
      antibodies classified seven groups, and then two different monoclonal antibodies
      were selected for bead coater and tracer after checking the titer and specificity
      of each antibody. IgE IRMA we developed here showed good performance in terms of
      specificity, sensitivity and reproducibility. No cross-reactivity to IgG, IgM and
      albumin in the level of normal range was observed. The sensitivity for IgE assay
      was 0.6 x 10(-3) IU/tube and measurable range was 0.01-20.0 IU/tube (0.5-10(3)
      IU/ml). Coefficient of variations of Intra assay were 2.2-4.3% and average
      recovery yield was 92.5-108%. Good correlations with Phadebas IgE PRIST and
      Pharmacia IgE RIA were obtained i.e., y = 1.12x-0.19 (r = 0.96) and y = 0.97x-5.9
      (r = 9.7), respectively. These results indicate that the assay system will
      contribute much to the routine diagnosis for atopic allergy disease and parasitic
      infections.

PMID- 2232350
TI  - [Assessment of ischemic damage of the cardiac sympathetic nerve function by
      semiquantitative analysis of 123I-MIBG (metaiodobenzylguanidine)-SPECT-
      comparison with 201Tl-Cl-SPECT].
AB  - Recently 123I-MIBG scintigraphy has been developed for evaluating the function of
      cardiac sympathetic nerve. To assess its ischemic damage, dual SPECT with 123I
      MIBG and 201Tl-Cl were performed in 24 patients with ischemic heart disease and 8
      normal subjects. In order to evaluate extent and severity of ischemic damage, Tl
      and MIBG abnormal scores were calculated by Bull's eye map. In patients with Non
      Q wave myocardial infarction (NQMI), MIBG abnormal scores were significantly
      higher than Tl scores (p less than 0.01). In the regions where regional wall
      motion showed hypokinesis, MIBG abnormalities were detected in all cases whereas
      Tl abnormalities existed only in 42%. MIBG abnormality score in NQMI group with
      negative T wave and wall motion asynergy was significantly higher than that of
      NQMI group without T wave abnormality and asynergy (p less than 0.01). Ischemic
      damage of cardiac sympathetic nerve seemed to contribute to negative T wave and
      stunned myocardium. 123I-MIBG scintigraphy was thought to be a sensitive and
      useful method for clinical evaluation of ischemic heart disease.

PMID- 2232351
TI  - [99mTc-MDP abnormal uptake in the femur shaft in hemi-lateral hip joint
      disorders].
AB  - During the past 4 years, three-phase bone scintigraphy using 99mTc-MDP has been
      studied in 68 patients suffering from hemi-lateral hip-joint disorders. We were
      impressed on abnormal uptake of the shaft of femur on the involved side. 99mTc
      MDP uptake in the shaft of femur is compared with between involved leg and normal
      leg of 68 cases with hemi-lateral hip-joint disorders (76 examinations). We
      excluded cases of osteomyelitis, cases of malignant tumor, and post-operative
      cases. In early images, the 99mTc-MDP uptake is not always increased in involved
      side. But in delayed images, there are no patients whose normal side's 99mTc-MDP
      uptake is increased. The 99mTc-MDP uptake in early image is not related only with
      blood flow of the thigh but with the amount of soft tissue of the thigh. And the
      99mTc-MDP uptake in delayed image is related with disuse osteoporosis.

PMID- 2232352
TI  - [Usefulness of ventilation and perfusion scans in patients with collagen-vascular
      diseases].
AB  - We studied 32 patients with collagen-vascular diseases with Xe-133 ventilation
      scans (V) and Tc-99m MAA perfusion scans (Q). Five patients underwent sequential
      studies at intervals of more than 3 months. Mean transit time (MTT) was
      calculated from the Xe-133 wash-out curve. V, Q images and MTT were compared with
      chest X-ray films and the values of %DLco. Of 32 patients, 17 had no abnormal
      finding on the chest X-ray films. Of the 17 patients, however, V and/or Q
      abnormalities were found in 10 (59%), 14 patients (82%), respectively. Every
      patient with abnormal findings on the chest X-ray film showed both V and Q
      abnormalities. Overall, Q abnormality was more frequent and severer than V one.
      Of the 5 patients with the sequential studies, 3 showed prolongation of MTT in
      concordance with deterioration of pulmonary fibrosis. V and Q abnormalities were
      not necessarily relevant to %DLco. In conclusion, ventilation and perfusion
      studies are useful in assessing the regional pulmonary function in patients with
      collagen-vascular diseases.

PMID- 2232353
TI  - [Left ventricular ejection fraction derived from resting 201Tl myocardial
      images].
AB  - To determine if resting 201Tl myocardial scintigraphy (rest-Tl) provides the
      information on left ventricular function, we compared preliminarily the
      parameters derived from rest-Tl with left ventricular ejection fraction (LVEF)
      derived from left ventriculography; while the parameters included Extent Score
      (ES), Severity Score (SS), Percent Uptake (PU), Area Index (AI). AI was derived
      from the averaging of [(A/B) x 100] in three or four central slices of short axis
      view on single photon emission computed tomography (A; area surrounded by inner
      edge of 201Tl myocardial image, B; area surrounded by outer edge of 201Tl
      myocardial image). The patients were comprised of 38 males and 16 females with a
      mean age of 53 years old (range 15-70) and classified into two groups; patients
      with myocardial infarction (n = 28, Group I), and patients with miscellaneous
      disease but without myocardial infarction (n = 26, Group II). In Group I, ES, SS
      and AI correlated with LVEF. If ES was less than 0.30, SS was less than 26.2, or
      AI was less than 19.8, LVEF was suggested more than 60% with an accuracy of 92%,
      85% and 85%, respectively. In Group II, these did not correlate with LVEF. If
      there were area with PU less than 70% in the region perfused by left anterior
      descending artery or left circumflex artery, LVEF was less than 60% with an
      accuracy of 78%. In conclusion, rest-Tl images provide some informations on left
      ventricular function in some patients.

PMID- 2232354
TI  - [Platelet production, clearance and distribution in patients with idiopathic
      thrombocytopenic purpura].
AB  - We have studied 8 normal subjects, and 12 patients with idiopathic
      thrombocytopenic purpura whose platelet counts ranged from 9 x 10(9)/L to 40 x
      10(9)/L. Autologous platelets labeled with 111Intropolone were used for
      evaluation of mean platelet survival, platelet turnover, platelet sequestration
      sites, and platelet production (turnover) to clearance (sum of platelet uptake in
      the liver and the spleen) ratio. Platelet survival correlated directly with
      platelet counts. There was no significant correlation between the platelet
      sequestration pattern and platelet count, survival, or turnover. Sum of platelet
      uptake in the liver and the spleen showed a significant inverse correlation with
      platelet survival. No significant correlation was found between platelet turnover
      and platelet count. There was a significant correlation between the platelet
      production to clearance index when all subjects were analyzed. The distribution
      of platelet turnover showed considerable individual variation; eight of twelve
      patients showed platelet turnover less than mean minus 2SD of the control value,
      but others showed normal range. We conclude that although platelet destruction
      mechanism in RES shows a primary role of thrombocytopenia, impaired rate of
      effective thrombopoiesis may also contribute to disease severity in ITP.

PMID- 2232355
TI  - [123I-iodoamphetamine single photon emission computed tomography in three
      patients with amyotrophic lateral sclerosis].
AB  - We examined the 123I-iodoamphetamine SPECT for 3 patients with ALS, who were
      clinically diagnosed. Patient 1 was a 31-years-old man, who had bilateral muscle
      weakness of his upper extremities, and spasticity in lower extremities. Patient 2
      was a 51-years-old woman, who had marked weakness of her upper extremities and
      bulbar sign. Patient 3 was a 68-years-old man, who had severe degree of marked
      weakness of his upper extremities and mild bulbar signs. Cerebral cognitive
      function were all normal in three patients. Computed tomographic and magnetic
      resonance imagings showed moderate degree of cortical atrophy in patient 1, but
      no abnormalities in patients 2 and 3. In 123I-IMP SPECT, however, hypoperfusion
      were recognized on the bilateral fronto-parietal border zone areas in these three
      patients with ALS. It was suggested that patients with ALS showed varying degrees
      of impaired perfusion in the fronto-parietal border zone areas in spite of normal
      cognitive functions.

PMID- 2232356
TI  - [A case of pulmonary embolism diagnosed by 111In labeled platelet scintigraphy].
AB  - Although the role of 111In platelet scintigraphy is established in the diagnosis
      of deep vein thrombosis, its indication in pulmonary embolism remains uncertain.
      We performed platelet scintigraphy in a patient with recurrent pulmonary
      thromboembolism, which revealed abnormal accumulation in the left hilar region.
      Pulmonary perfusion scintigraphy performed at the same time did not show
      perfusion defect. However, pulmonary angiography and thromboembolectomy
      demonstrated recurrent embolus in the hilus. This suggested that platelet
      aggregation in the left hilus shown by platelet scintigraphy was indeed related
      with recurrence of pulmonary embolism, and platelet scintigraphy is useful in
      detecting new development of thrombus in patient with recurrent pulmonary
      thromboembolism.

PMID- 2232357
TI  - [Diagnostic value of the transesophageal atrial pacing stress for Tl-201
      myocardial SPECT].
AB  - The stress study for Tl-201 myocardial SPECT (single photon emission computed
      tomography) of a patient with old myocardial infarction, who had occasionally
      felt a chest pain for the last 8 months was performed with the transesophageal
      atrial pacing. The examination was fastly started and regular pacing rates were
      completely obtained for every pacing rate (50-100/min). In spite of a little
      amount of the pacing stress, the finding of stress induced ischemia and MI were
      obtained on this patient. This result suggests that the transesophageal atrial
      pacing stress might be useful for the evaluation of ischemic heart disease by Tl
      201 myocardial SPECT, and is easily applied to the old and the patient with
      disorder of leg movement.

PMID- 2232358
TI  - [Preparation and assessment of an animal model of Alzheimer's disease].

PMID- 2232359
TI  - [Basic and clinical studies on radioimmunoassay of pancreatic phospholipase A2
      (PLA2) (Part I)].

PMID- 2232360
TI  - A historical pulmonary perspective.

PMID- 2232361
TI  - Dissociation of serum fructosamine from fasting plasma glucose or hemoglobin A1c
      in diabetics.
AB  - To evaluate serum fructosamine as an indicator for diabetic control, serum
      fructosamine (FRA), glycosylated hemoglobin (HbA1c) and fasting plasma glucose
      (FPG) were simultaneously measured in 452 diabetics in stable diabetic control.
      We divided the measured FRA according to the degree of deviation from the
      expected FRA into three types, hyper-FRA, normo-FRA and hypo-FRA. In the hypo-FRA
      to HbA1c group, frequencies of male (70 vs 35, 43%) and of nephropathy (61 vs 30,
      18%) were higher and mean total serum protein (6.5 vs 7.4, 7.4 g/dl) and albumin
      (3.4 vs 4.1, 4.0 g/dl) were lower than those in the other two corresponding
      groups. Correlation was also poorer in the insulin-treated group than the others.
      These results probably reflect conditions of diabetic control and complication,
      and protein metabolism. Similar tendencies were observed in case of FPG.
      Therefore, the discrepancy of FRA gives a clue to detect poor control and
      complications of diabetes.

PMID- 2232362
TI  - Cellular immunity in myasthenia gravis after thymectomy and corticosteroid
      therapy.
AB  - Clinical and immunological changes in patients with myasthenia gravis (MG) who
      had extended thymectomy (Tx) and/or corticosteroid therapy were examined to
      elucidate the mechanisms of improvement following the treatments. The changes
      found were: 1) After Tx and steroid therapy, in patients with MG who showed
      clinical improvement, the CD4/CD8 ratio and B lymphocyte subpopulations were
      markedly decreased. 2) Linear correlations between two T-cell subsets were
      evident in CD3 against CD4 and CD4/CD8 against CD4 after both Tx and steroid
      therapy. 3) T lymphocytes-CD8 decreased immediately after Tx and returned to pre
      treatment levels within three weeks. 4) Cellular sensitization against a nicotine
      acetylcholine receptor (AChR)-like protein isolated from fetal calf thymus
      decreased after steroid therapy. These results indicate that clinical improvement
      in MG after the treatments was accompanied by a decrease in helper/inducer T
      lymphocytes, B lymphocytes and specific lymphocyte sensitization against
      nicotinic AChR.

PMID- 2232364
TI  - Pulmonary drug-metabolizing enzyme in alveolar macrophages in relation to
      cigarette smoking.
AB  - We measured the aryl hydrocarbon hydroxylase (AHH) activity in alveolar
      macrophages (AMs) and the AHH inducibility in peripheral blood lymphocytes (PBLs)
      of 56 subjects with and without lung cancer. There were no differences in the AHH
      inducibility in PBLs whether or not the host had lung cancer, regardless of a
      smoking history. The AHH activity in AMs in the current smoker group was
      significantly higher than in the non-smoker group. The AHH activity in AMs in the
      lung cancer group was higher than that in the non-lung cancer group, and the
      central-type group was significantly higher than the peripheral-type group. These
      results suggest that the AHH activity in AMs is associated with the development
      of lung cancer and a history of cigarette smoking.

PMID- 2232363
TI  - A survey regarding the disclosure of the diagnosis of cancer in Toyama
      Prefecture, Japan.
AB  - A survey regarding the revelation of the diagnosis of cancer to patients was
      conducted on 116 medical doctors (MD), 206 paramedical personnel (PP) and 789 lay
      persons (LP) in June 1989 in Toyama prefecture, Japan. When asked in the case
      that their parents or spouse had cancer, only 29.8% of all respondents answered
      that they would reveal the diagnosis of cancer to their family member. On the
      contrary, if they themselves had cancer, 56.3% of all respondents answered that
      they wished the diagnosis to be revealed, and 77.4% of these answered that they
      wished to be informed of the cancer diagnosis by the doctor in charge. They
      wanted to know the details of their condition from their medical doctor, and
      thought that they could receive this knowledge calmly. Thirty-one percent
      (34/108) of the doctors questioned reveal the diagnosis of cancer to their
      patients and 79.4% of these answered that they felt that telling the true
      diagnosis was good. A serious responsibility for the medical doctor was
      indicated.

PMID- 2232365
TI  - A family case of pyruvate kinase variant, PK 'Nichinan'.
AB  - A case of congenital hemolytic anemia caused by pyruvate kinase (PK) deficiency
      variant designated PK 'Nichinan' is presented. A 29-old patient with a history of
      anemia and hepatosplenomegaly had an episode of aplastic crisis associated with
      fever, abdominal symptoms and worsening hepatosplenomegaly. Study of the family
      members revealed that his mother and two of three siblings showed decreased PK
      activity whereas his father showed normal PK activity with a normal level of
      glycolytic intermediates. The patient was assumed to be a double heterozygote
      with two separate mutant genes from the parents despite the apparent normality of
      his father's erythrocyte PK.

PMID- 2232366
TI  - Pressor and hormonal responses to intravenous injection of metoclopramide in
      normotensive and hypertensive patients.
AB  - To assess the dopaminergic regulation of blood pressure and the renin-angiotensin
      aldosterone system in fourteen essential hypertension (EHT) and six normotensives
      (NT), intravenous injections of 10 mg of the dopamine antagonist, metoclopramide
      (MCP), were given. Essential hypertension patients were divided into two
      subgroups according to the basal values of plasma renin activity (PRA). Plasma
      prolactin (PRL), aldosterone (ALDO), norepinephrine (NE) and epinephrine (E) in
      seven high-renin EHT revealed significantly higher basal values than normal- and
      low-renin EHT. Intravenous injections of MCP caused significant increases in PRL
      and ALDO but not in NE, E and PRA in all subjects. However, in high-renin EHT the
      responses of PRL and ALDO were significantly marked compared to other subjects.
      In spite of these hormonal changes after MCP, blood pressure was unaltered. The
      present data suggest that "tonic inhibition" of PRL and ALDO by the dopaminergic
      system is partially regulated by the renin-angiotensin system regardless of the
      levels of blood pressure.

PMID- 2232367
TI  - Amyloidosis (AA type) with gastrointestinal involvement: resolution of gastric
      amyloid deposition in parallel with disappearance of the serum component of
      amyloid A protein.
AB  - The prognosis for secondary amyloidosis is better than that for the primary form.
      With arrest of the triggering disease, clinical improvement can be expected.
      Dramatic resolution of amyloid deposits, as proven by repeated biopsies, has been
      reported. We report on the effectiveness of amputation of the left thigh with
      chronic osteomyelitis in a patient with AA amyloidosis presenting with extensive
      amyloid involvement of the gastrointestinal tract and kidneys. Clinical
      improvement associated with reversibility of gastric amyloid deposition was
      observed in accordance with disappearance of the serum component of amyloid A
      protein.

PMID- 2232369
TI  - Alterations of glomerular filtration rate during cold exposure in progressive
      systemic sclerosis: measurement with technetium-99m DTPA.
AB  - We investigated the changes of the glomerular filtration rate (GFR) that occurred
      when the right hand was soaked in 7 degrees C water. The subjects were 5 patients
      with progressive systemic sclerosis who did not have clinical evidence of renal
      involvement. The clearance rate constant of 99mTc-DTPA, which is excreted by
      glomerular filtration, was measured with a cadmium telluride detector placed over
      the chest wall. In response to the cold exposure, the constant rose in 2 patients
      and remained unchanged in the remaining 3 patients. After termination of cold
      exposure, the constant fell in all 5 patients, suggesting renal Raynaud's
      phenomenon. These findings suggest that the renal vasculature in these patients
      has an abnormal response to cold exposure.

PMID- 2232368
TI  - A case of swallow syncope induced by vagovagal reflex.
AB  - A 65-year-old man experienced syncope associated with advanced atrioventricular
      (AV) block upon swallowing. Continuous electrocardiogram (ECG) monitoring
      revealed first and second degree AV block. ECG revealed advanced AV block (Max R
      R 6.38 s) upon swallowing, a cold drink. Demand ventricular pacing alleviated his
      symptoms. In this patient, the advanced AV block might have been precipitated by
      a vagovagal reflex triggered by expansion of the esophagus, resulting in
      selective suppression of the atrioventricular node.

PMID- 2232370
TI  - IgD multiple myeloma with renal involvement: case report.
AB  - IgD multiple myeloma is a unique type of multiple myeloma which is characterized
      by increased serum IgD and IgD type M-component in immunoelectrophoresis. It
      frequently shows renal involvement but it is a rare form of myeloma. The
      distinctive features of IgD myeloma are the dominance in males, high frequency in
      younger persons, and the uncertain appearance of M-component in serum
      electrophoresis. We experienced 3 cases of IgD multiple myeloma with renal
      failure which required hemodialysis before IgD myeloma was diagnosed. It is
      important to consider IgD myeloma when treating the patients with renal
      involvement of unknown origin.

PMID- 2232371
TI  - Immediate improvement of diabetic mononeuropathy after intravenous administration
      of prostaglandin E1.
AB  - The effects of intravenously administered prostaglandin E1 (PGE1) on diabetic
      mononeuropathy was investigated in three patients with diabetic oculomotor palsy.
      PGE1 (1.0-1.5 micrograms/day) was intravenously administered every morning for 4
      or 6 weeks. Diplopia, blepharoptosis and decreased range of ocular movement,
      which were observed on admission, immediately began to improve at 1-4 days after
      the beginning of the treatment. On the final day of the treatment, none of the
      above signs remained in the three cases. The present study suggests that
      improvement of intraneural microcirculation by PGE1 administration results in an
      immediate recovery from diabetic oculomotor nerve palsy.

PMID- 2232372
TI  - Primary myelofibrosis terminating in megakaryoblastic crisis.
AB  - Primary myelofibrosis terminating in megakaryoblastic crisis is uncommon. A case
      with this condition is reported. The patient, a 62-year-old female, having had
      primary myelofibrosis for 13 years and a splenectomy 4 years before, was admitted
      because of high fever, hepatomegaly, thrombocythemia and leukocytosis. On
      admission, blasts appeared in the peripheral blood and thereafter gradually
      increased in number. The blasts were proven to be of megakaryocytic lineage. To
      our knowledge this is the third case of primary myelofibrosis terminating in
      megakaryoblastic crisis to be reported in Japan.

PMID- 2232373
TI  - [Two cases of pulmonary alveolar proteinosis with increased CEA].
AB  - Two cases of pulmonary alveolar proteinosis (PAP) with increased CEA were
      reported. Case 1 was a 62-year-old male with suspected pulmonary fibrosis, who
      was transferred to our hospital. Laboratory findings on admission revealed 31.3
      ng/ml of CEA. Because he had severe dyspnea, lung biopsy was not carried out. His
      condition gradually deteriorated and he died of respiratory failure. Autopsy
      revealed he had PAP and no malignancy. Case 2 was a 48 year-old male referred to
      our hospital because of dyspnea. Serum CEA was 52.8 ng/ml. Microscopic
      examination of a transbronchial lung biopsy showed PAP. The level of CEA in
      bronchoalveolar lavage fluid was 151 ng/ml. Unilateral whole lung lavage was
      performed twice. With the improvement of chest X-ray findings, serum levels of
      CEA fell to normal level. The molecular weight of CEA in bronchoalveolar lavage
      fluid was 180,000. Immunochemical staining of CEA in lung revealed nonspecific
      findings.

PMID- 2232375
TI  - [Williams-Campbell syndrome complicated by multiple meniscus signs in an adult
      case; is it a characteristic finding?].
AB  - A 49-year-old woman visited our hospital for further examination of abnormal lung
      shadows in September 1984. She had suffered from pneumonia at the age of 3 years
      and had been treated for bronchial asthma until the age of 15. Many thin-wall
      cystic shadows were seen on her chest X-ray film in 1983. In July 1984, a mass
      like lesion with a meniscus sign appeared in one of the cystic shadows. The
      number and the size of similar lesions increased with worsening of productive
      cough. An infiltrative shadow was recognized in the left lower lobe in September
      1987 and January 1988, but was resolved by treatment by ofloxacin. Frequent
      bacterial examinations of sputum and bronchial secretions revealed numerous
      Pseudomonas aeruginosa but no fungi. Serum antibody to Aspergillus fumigatus was
      negative and antifungal therapy was not effective. Bronchography showed many
      cystic dilated bronchi, which ballooned during inspiration and collapsed with
      expiration. The peripheral bronchi seemed to be normal. These findings along with
      her clinical course led us to make a diagnosis of Williams-Campbell syndrome. The
      mass-like shadows were considered to have arisen from viscid secretions that were
      rendered round by the characteristic movement of the ectatic bronchi.

PMID- 2232376
TI  - [Differentiation of intra-pulmonary lymph nodes from intra-pulmonary metastasis].
AB  - In each case of primary or metastatic lung cancer, CT reveals multiple pulmonary
      nodules in addition to primary or metastatic lesions. All of these small
      pulmonary nodules were approximately 5 mm in size and were located in the
      subpleural region of a lower lobe of the lung. It was difficult to differentiate
      these small nodules from lung metastases. We were able to confirm that these
      nodules were subpleural intra-pulmonary lymph nodes by open thoracotomy. It
      should be noted that small pulmonary nodules in the subpleural region of a lower
      lobe of the lung might be intra-pulmonary lymph nodes.

PMID- 2232374
TI  - [An autopsy case of chronic pulmonary thromboembolism associated with congenital
      portal hypoplasty and pulmonary artery aneurysm].
AB  - A 44 year-old woman died after a history of chronic right heart failure for 25
      years. Roentgenological studies showed marked pulmonary aneurysm, and
      hemodynamics at rest revealed severe pulmonary hypertension. The diagnosis of
      chronic pulmonary thromboembolism was made by MRI which identified a high
      intensity mass in the dilated right pulmonary artery. At autopsy, a large
      organized thrombus adhered to the atherosclerotic pulmonary artery, and pulmonary
      thromboembolism or hemorrhagic infarction were identified. Microscopic
      examination revealed intimal and medial proliferation in small arteries and
      plexiform lesions. In addition, hypoplasty of the portal vein and portacaval
      shunt, which were thought to be congenital, were present. It has been recognized
      that the portacaval shunt can be attributed to pulmonary hypertension. In this
      case it was considered that the main cause of pulmonary thrombus formation was
      both pulmonary atherosclerosis and pulmonary artery aneurysm caused by prolonged
      pulmonary hypertension. This is the first case of chronic pulmonary
      thromboembolism associated with congenital hypoplasty of portal vein.

PMID- 2232377
TI  - [A case of simultaneous double cancer (lung and stomach cancer) related to
      asbestos exposure].
AB  - A 76 year-old male with simultaneous double cancer (lung and stomach cancer) was
      reported. The patient was followed up for pleural plaque on chest X-ray from
      1986. The diagnosis of stomach cancer was decided by biopsy and lung cancer by
      operation at the same time in 1989. The histology of these two tumors were
      different (stomach: well differentiated tubular adenocarcinoma, lung: moderately
      differentiated papillary adenocarcinoma) and the stomach cancer was early stage
      and lung cancer was stage IIIa. He had a definite history of asbestos exposure in
      Japanese naval shipyard. Pleural plaque with calcification was found on chest X
      ray and numerous asbestos bodies were detected in the resected lung tissue.
      Almost all asbestos fibers examined by an X-ray analyzer with scanning microscopy
      were chrysotile or tremolite. Furthermore, he was a heavy smoker (B.I., 1650).
      These tumors developed after 59 years of the first asbestos exposure. Asbestos
      exposure and smoking are considered to be important pathogenesis factors related
      to these two tumors.

PMID- 2232378
TI  - [Evaluation of FCR (Fuji Computed Radiography) images applied to standard
      radiography for the diagnosis of chest diseases].
AB  - FCR (Fuji Computed Radiography) was added to plain chest radiography in order to
      evaluate its image characteristics and to determine the best image
      characteristics and to determine the best image processing program by comparing
      the visibility of shadows on conventional X-rays and on six FCR hard copy images
      processed by six mutually different image processing program. FCR showed
      excellent ability to visualize abnormal lung shadows as well as normal chest
      structures when processed by a moderate spatial frequency enhancement (spatial
      frequency 0.11 cycle/mm, level of enhancement). FCR also proved superior to the
      conventional film-screen system in the visualization of hilar and mediastinal
      structure as well as lung shadows. The effects of the image processing program on
      the visibility of shadow, granular and linear shadows were clearly demonstrated
      when a more intense spatial frequency enhancement (spatial frequency 0.18
      cycle/mm, level of enhancement) was performed. The same results were obtained in
      terms of reticular and linear shadows and calcified lesions. On the contrary, low
      density shadows with poorly defined margins the lung field and infiltrates from
      mycoplasma pneumonia were well depicted by a program with a slightly steeper
      gradation (gamma; 1.0) and minimal frequency enhancement. Accordingly, FCR was
      found to be useful for the screening of abnormal chest X-ray shadows whereas it
      was also likely to demonstrate the best image when processed by the most
      appropriate image processing programs, depending on the characteristics of the
      shadows.

PMID- 2232379
TI  - [Analysis of patients with resected small-size (less than or equal to 2 cm in
      diameter) peripheral type lung cancer lesions].
AB  - From 1953 to 1985, a total of 1289 patients with primary carcinoma of the lung
      underwent surgical treatment. Of these 116 (8.9%) had small-sized (less than or
      equal to 2 cm in diameter) peripheral type lung cancer lesions. This study had
      three purposes: 1) to analyse how small-sized lung cancer lesions were detected;
      2) to evaluate the reliability of diagnosis of small-sized cancer lesions; and 3)
      to evaluate pre- and post-prognostic factors of such patients compared with
      patients with peripheral type lung cancer lesions 2.1-3 cm in diameter. Of the
      115 patients with small-sized lung cancer lesions were detected in the course of
      mass surveys. Cytopathological diagnosis in 75% of the patients resulted from
      transbronchial brushing cytology. The 5-year survival rate of patients who
      underwent resection of small-sized peripheral type lung cancer lesions was 70%
      (2.1-3 cm; 52%). Various factors such as histologic type, nodal involvement,
      pleural involvement, pathological stage, and success of the operation were shown
      to significantly affect survival. A comparison of two groups, i.e., those with
      lesions smaller than 2 cm in diameter and those with lesions 2.1-3 cm in
      diameter, showed the rate of lymph node metastasis to be significantly different.
      Of the patients with peripheral lung cancer lesions smaller than 2 cm who
      underwent surgery, 21% had peribronchial, hilar, or mediastinal lymph node
      metastasis. On the other hand, lymph node metastasis was seen in 43% of cases
      with peripheral lung cancer lesions 2.1-3 cm in diameter who underwent surgery.

PMID- 2232380
TI  - [Reproducibility of peak expiratory flow rate measured at home].
AB  - In 8 stable patients with chronic asthma, the reproducibility of peak expiratory
      flow rate (PEFR) measured and recorded 4 times per day for longer than 1 month at
      home and at work was assessed. Average %PEFRs of individuals through the periods
      observed were higher than 80%, and coefficients of variation were less than 10%
      regardless of the time measured. This suggested that a decrease in %PEFR more
      than 10% reflects early phase of deterioration of airways narrowing and frequent
      measurement of PEFR is essential for long-term management and for self-assessment
      of chronic asthma.

PMID- 2232381
TI  - [Respiratory pathophysiology during sleep in patients with myotonic dystrophy].
AB  - Myotonic dystrophy is a genetic disorder inherited as an autosomal dominant
      trait. It is known to be associated with endocrine dysfunction, polar cataracts,
      cardiac abnormalities and other conditions. Respiratory distress constituents the
      principal problem in myotonic dystrophy. The author investigated postural change
      of respiratory function in 12 patients with myotonic dystrophy (MYD), and 7
      patients with limb-girdle dystrophy (LG) and overnight polysomnography was
      performed on 10 patients with MYD and 5 patients with LG. The respiratory
      function in seated posture showed no significant difference between LG and MYD,
      but in patients with MYD, the vital capacity and the expiratory reserve volume in
      a supine posture was reduced in comparison to that during seated posture.
      However, the respiratory function in patients with LG was not significantly
      different in seated and supine postures. Also, in patients with MYD, there was a
      significant decrease in arterial PO2 from the seated posture to the supine
      posture, without a significant change in the arterial PCO2. However, in patients
      with LG, there was no significant change in arterial blood gas analysis
      parameters. It was speculated that these findings concerning respiratory function
      and blood gas analysis in patients with MYD were caused by the involvement of the
      diaphragm. In the supine posture, the diaphragm shifted to the cranial position
      because of the abdominal contents rising into thorax, therefore the lung volume
      was reduced and the ventilation-perfusion ratio deteriorated. The changes of
      respiratory function parameters and PaO2 were partly responsible for the
      hypoxemia observed during sleep in patients with MYD. Overnight polysomnography
      showed that 9 of the 10 patients with MYD and 1 of the 5 patients with LG
      presented apneas during sleep, particularly during REM, stage 1 and stage 2.
      Almost all apneas were central type, with a low percentage of obstructive apneas
      and the apnea index was 19.0/h (mean) in MYD, 6.5/h in one case of LG. These
      result strongly suggest that sleep apnea is of central origin, but the
      distinction between a central and an obstructive etiology is difficult in
      neuromuscular disease and particularly when a disorder of central ventilatory
      responsiveness is suspected. The respiratory function of MYD and LG in seated and
      supine postures was studied and overnight polysomnography performed. It was
      emphasized that it was important for the respiratory care of neuromuscular
      disease to consider the influence of postural changes in the respiratory
      function. The present series of studies revealed central sleep apnea in the
      patients with myotonic dystrophy.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2232383
TI  - [The possible involvement of immune complexes in pulmonary granuloma formation in
      experimental hypersensitivity pneumonitis].
AB  - Hypersensitivity pneumonitis (HP) is a disease caused by inhaled organic dust.
      The alveolitis and granuloma are characteristic features of HP. The precise
      mechanism of granuloma formation is still unclear. The roles of immune complexes
      and primed T cell in relation to granuloma formation were studied. Local lymph
      node cells were obtained from C57BL/6 mice immunized by injection of ovalbumin
      (OA) or keyhole limpet haemocyanin (KLH) emulsified in complete Freund's adjuvant
      into footpads. Thereafter enriched T cells were obtained by passage through nylon
      wool columns. Antigens (OA, KLH) were chemically coupled to Sepharose 4B beads
      (OA-beads, KLH-beads). The immune complex was made by the incubation of the
      antigen-coupled beads and the immunized mouse serum at 37 degrees C for 2 hours.
      The recipient mouse irradiated by 6.5 Gy was transferred with 3 X 10(7) T cells
      and challenged with intratracheal instillation of 1 X 10(4) antigen-coupled beads
      or 1 X 10(4) immune complex-coupled beads. The recipient mice were sacrificed day
      3 after cell transfer and challenge. The radius of pulmonary granuloma was
      measured by microscopic examination of the HE-stained section. The radius of
      granuloma increased in the recipient mouse which received the primed T cell and
      was challenged with immune complex-coupled beads compared with any other
      combination of cell transfer and antigen challenge. This result suggests that not
      only T cell but also immune complexes play an important role in granuloma
      formation in HP.

PMID- 2232382
TI  - [Echo guided percutaneous needle biopsy for diagnosis of thoracic lesions].
AB  - Echo guided percutaneous needle biopsy was performed in 32 cases with thoracic
      lesions. A definitive diagnosis was made histopathologically in 11 (100%) of 11
      malignancies, 4 (67%) of 6 benign tumors and 7 (47%) of 15 inflammatory lesions.
      Furthermore, using cytological specimens, definitive diagnosis was successfully
      made in 10 (91%) of 11 malignancies and 1 (17%) of 6 benign tumors. Such highly
      accurate diagnostic rates were due to 1) the accurate puncture of the lesions
      under real time sonographic guidance, 2) repeated biopsy in case in which sample
      was inadequate for cytological diagnosis, and 3) aggressive application of needle
      biopsy for histopathological diagnosis. Following this procedure, three patients
      suffered from a minor pneumothorax. To prevent pneumothorax, great care is
      necessary, especially in high risk cases, such as with a pneumatic pattern and
      thin lesion. One patient suffered from minor hemoptysis but recovered without any
      medication. No complications were noticed in cases of extrapulmonary lesions. We
      conclude that echo guided percutaneous needle biopsy is not only a complementary
      method for biopsy of mediastinal, peripheral pulmonary and chest wall lesions,
      but due to its simplicity and convenience, it should be a routine method for
      biopsy of thoracic lesions.

PMID- 2232385
TI  - [A case of massive hemoptysis occurring after lung injury due to a torn segment
      of pleural calcification].
AB  - A 64-year-old man was referred to our hospital because of little improvement of
      hemoptysis lasting three days after drug therapy. A chest roentgenogram and
      fiberoptic bronchoscopic examination performed on the second hospital day when
      the patient experienced a massive hemoptysis of about 2,000 ml revealed arterial
      bleeding from the left upper lobe. Even after extensive embolizations of the left
      upper bronchial, the first, second, third and 4th intercostal arteries, the
      patient's hemoptysis did not improve. On the 73rd hospital day the patient
      underwent left upper lobectomy. Macroscopic and microscopic examinations in the
      resected specimen revealed lung injury due to a torn segment of pleural
      calcification after tuberculous pleuritis, resulting in the massive hemoptysis.
      Although physicians encounter many patients complaining of hemoptysis and/or
      hemosputum, this case is considered to be very rare.

PMID- 2232384
TI  - [A case of Swyer-James syndrome diagnosed at age 70].
AB  - A male case of Swyer-James syndrome, who had been followed for bronchiectasis for
      a long time, detected at age 70 and diagnosed by radiological studies was
      reported. The movement of his left diaphragm was impaired. Arterial oxygen
      tension was 68 torr while breathing room air. Pulmonary function tests showed
      mixed ventilatory impairment, increase of residual volume, and uneven gas
      distribution, but diffusing capacity was normal with the single breath method.
      Chest radiograph revealed hyperlucency of the left lung and the right middle lung
      field. In these areas, pulmonary angiography showed marked hypovascularity and
      diffuse vascular atrophy, and perfusion and inhalation scans also showed marked
      decreased perfusion and ventilation. Pulmonary hypertension was not detected by
      right heart catheterization. Fiberoptic bronchoscopy was performed and showed no
      abnormality of the left bronchial tree, and bronchography demonstrated diffuse
      cylindrical bronchiectasis of the left lung with no alveolar filling. He had
      suffered from chronic sinusitis for a long time, which might suggest that he had
      sinobronchitis due to congenital abnormality of the airway and this caused
      continuous respiratory infection, which could cause this syndrome. Including our
      own case, about 80 cases of Swyer-James' syndrome have been reported in Japan.
      But only 4 cases were above 70 years of age and all of them were male, and there
      has been no female cases above age 50. Males predominate over females, and in
      both sexes the left lung was more commonly affected than the right.

PMID- 2232386
TI  - [A review of coronary artery bypass grafting distal to the total obstruction].
AB  - Coronary artery bypass grafting (CABG) distal to the total obstruction has been
      carried out in 10 patients during 17 month period. There were neither operative
      deaths nor perioperative myocardial infarction. All patients were free from
      angina pectoris postoperatively. There were 13 completely obstructed coronary
      arteries. CABG was successfully placed on 9/9 (100%) of the distal artery filled
      with collaterals including thread-like caliber, but 0/4 (0%) without
      opacification suggesting no collaterals. The graftability to the left anterior
      descending branch was 6/6 (100%), to the circumflex system was 3/5 (60%), and to
      the right coronary system was 0/2 (0%). Postoperative regional ejection fraction
      and cardiac index improved significantly. In conclusion, CABG distal to the total
      obstruction should be performed in case of the distal lumen opacified by
      collaterals. Especially CABG to the left anterior descending artery might be
      worth-while.

PMID- 2232387
TI  - [A study of five cases of traumatic diaphragmatic rupture].
AB  - During the last 5 years, 5 cases of traumatic diaphragmatic rupture were
      surgically treated. These cases were reported and the literature concerning
      traumatic diaphragmatic hernia in the last one decade in Japan, including 80
      cases was studied. The purpose of this study is to discuss the most important
      early diagnostic tools and to consider the choice of incision and approach. The
      following two results were gotten. (1) Plain chest X-ray, computed tomography and
      ultrasonography were the most valuable diagnostic tools. (2) The choice of
      incision and approach depends on the stage at which the rupture is recognized
      (early or late), the site of rupture and associate injuries.

PMID- 2232388
TI  - [The effects of pulsatile pumping on tissue perfusion and renal function during
      deep hypothermic low flow perfusion].
AB  - The effects of pulsatile pumping on tissue perfusion and renal function during
      deep hypothermic low flow perfusion were compared with non-pulsatile pumping.
      Twelve dogs were classified into 2 groups by the perfusion technique used.
      Animals were core cooled to 20 degrees C esophageal temperature with 80 ml/kg/min
      perfusion rate and maintained at the level for 2 hours with low flow perfusion
      (LFP) (30 ml/kg/min), then rewarmed to 35 degrees C with 80 ml/kg/min flow rate.
      As compared with the non-pulsatile group, pulsatile group demonstrated greater
      urine output during rewarming (p less than 0.05) and greater lymph flow during
      core cooling (p less than 0.05). The non-pulsatile group showed higher
      lymph/plasma protein concentration ratio (Lc/Pc) during LFP and rewarming (p less
      than 0.05), and greater plasma protein clearance during rewarming (p less than
      0.05), and much higher increase of interstitial fluid pressure. The lesser water
      retention during bypass was also noted in the pulsatile group (28.6 +/- 27.6
      ml/kg vs 85.4 +/- 52.1 ml/kg, p less than 0.05). These findings have suggested
      that the pulsatile perfusion may be useful for the infant cardiopulmonary bypass
      reducing tissue edema and preserving better renal function.

PMID- 2232389
TI  - [The method of fixation of intra-aortic balloon catheter in the iliac artery
      without sheath introducer].
AB  - This paper showed the procedure of fixation of intra-aortic balloon without
      sheath. For this purpose, we found to use Implantaid Lead Introducer (peel away
      type). This introducer can be removed from balloon catheter after insertion into
      iliac artery. Consequently, the incidence of thromboembolism of iliac artery and
      complications such as myonephropathic metabolic syndrome may be decreased.

PMID- 2232390
TI  - [A surgical case of eventration of diaphragma in ten-year-old boy: a newer
      approach of operative correction of eventration].
AB  - A ten-year-old boy was admitted to our hospital for surgical treatment of
      eventration of diaphragma. He had operative correction of eventration with
      intrathoracic approach and recovered good health. We present a newer method of
      operative correction of eventration, which can be beneficial in prevention of "re
      eventration", especially, on younger patients.

PMID- 2232391
TI  - [Prosthetic valve endocarditis].
AB  - From January/1983 to March/1988, 28 patients were submitted to valve replacements
      for prosthetic valve endocarditis in 1,512 valve replacements. Seventeen patients
      were male, their mean age was 36.7 +/- 12.9 years old, and eight cases were
      operated under emergency condition. The blood cultures were positive in 14 (50%),
      the agent most commonly found being Streptococcus viridans in 5 cases. Hospital
      mortality was 28.5%. The causes of death were septicemia in 4 cases, low output
      syndrome in 2 cases, cerebrovascular accident in 1 case, and coagulopathy in 1
      case. Mortality was higher with statistical significance in the cases whose blood
      cultures were negative, the cases in which the time from valve replacement to the
      onset of endocarditis was less than one year, and the cases under emergency
      condition.

PMID- 2232392
TI  - [Torsion after left lower lobectomy and cerebral infarction following the re
      exploratory thoracotomy: a case report].
AB  - A 38-year-old man had a left lower lobectomy for pulmonary carcinoid. Following
      the operation, torsion of the left residual upper lobe occurred. Re-explosive
      thoracotomy was performed on the second postoperative day. The left upper lobe
      showed a clockwise 180-degree rotation. Pneumonectomy was not done. After the re
      thoracotomy, the patient developed right hemiplegia. Head CT showed a cerebral
      infarction due to the thrombus of pulmonary vein that was released after the
      repair of the torsion.

PMID- 2232393
TI  - [A case of an operation for lung cancer after PTCA].
AB  - A 64-year-old lung cancer patient combined with angina pectoris was admitted to
      our hospital. Chest roentgenogram showed a coin lesion in the left upper lobe.
      Broncho-fiberscopic examination proved adenocarcinoma. Coronary angiography
      revealed 90% stenosis of the left circumflex artery. Percutaneous transluminal
      coronary angioplasty (PTCA) was done and resulted in success. Eight days after
      PTCA, left upper lobectomy for lung cancer was undergone. Postoperative course
      was uneventful. Compared with coronary artery bypass grafting, PTCA was very
      useful for the patient having malignant disease combined with angina pectoris
      because of little surgical stress and no delay of operation.

PMID- 2232394
TI  - [A case report of isolated congenital tricuspid regurgitation].
AB  - Reports of isolated congenital tricuspid regurgitation are very rare. A 20-year
      old female with severe tricuspid regurgitation was reported. The patient was
      admitted to our hospital with complaints of easy fatigability and palpitation.
      Right ventriculogram showed severe tricuspid regurgitation. She was treated with
      tricuspid valve replacement with a 33 mm bioprosthetic valve. Seven surgical
      treated cases of isolated congenital tricuspid regurgitation including our case
      were collected from literature and reviewed.

PMID- 2232395
TI  - [Myocardial infarction complicating left ventricular free wall blowout rupture: a
      survival case after surgical repair].
AB  - A 58-year-old man who suffered from acute myocardial infarction complicated with
      left ventricular rupture and subacute pericardial tamponade was reported. On
      admission, echocardiography strongly suspected presence of intrapericardial
      fluid. And immediate pericardiocentesis proved left ventricular free wall rupture
      (LVFWR). Coronary angiography with the support of IABP revealed occlusion of LAD
      (# 8). Percutaneous transluminal coronary angioplasty was performed with partial
      success. After pericardiotomy, the hemodynamic state was improved, however, 2
      hours later, his blood pressure fell down to 40 mmHg suddenly. Emergent operation
      (re-mediastinumotomy+ ) was performed under the suspicion of left ventricular
      blowout rupture with the direct closure of the perforated site with 4 woven
      Dacron pledgets at bedside in ICU. The patient ran an uneventful postoperative
      course and is now doing well. Clinical and therapeutic features of LVFWR were
      discussed.

PMID- 2232396
TI  - [Report of a case successfully weaned from long left ventricular assist with
      complete recovery after coronary artery bypass grafting].
AB  - A 45-year-old female underwent coronary artery bypass grafting (CABG) due to
      medically uncontrollable unstable angina. After completion of CABG, left
      ventricular contraction was remarkably diminished to maintain systemic
      circulation. Because intraaortic balloon pumping and veno-arterial bypass with
      large amount of catecholamines could not improve left ventricular wall function,
      we decided to use left ventricular assist device (LVAD). After application of
      LVAD, the patient could easily be weaned from cardio-pulmonary bypass. LVAD was
      used for 25 days and the patient was successfully weaned from LVAD too, and are
      now living 6 months postoperatively. As far as we know, this case is the first
      survival patient after the longest cardiac assist in our country.

PMID- 2232397
TI  - [A case of infective endocarditis with hemorrhagic fibrinous pericarditis].
AB  - A case of infective endocarditis which was complicated with hemorrhagic fibrinous
      pericarditis was reported. The hemorrhagic fibrinous pericarditis is a rare
      complication of infective endocarditis of the aortic root and is observed massive
      hemorrhage into the pericardial space. These patients should be considered for
      the aortic valve replacement early in the course of the disease.

PMID- 2232398
TI  - [A case of ventricular septal perforation with bidirectional shunt and Hegglin
      like syndrome].
AB  - A 47-year-old man with ventricular septal perforation (VSP) was repaired
      successfully. His preoperative examinations revealed Hegglin like syndrome with
      fixed and split second heart sound due to early closure of aortic valve (QT-Q II
      A = 58 ms), and bidirectional shunt through the VSP. These abnormal phenomena
      occurred due to shortening of left ventricular ejection time and prolongation of
      right ventricular ejection time, and were completely abolished after the
      operation.

PMID- 2232400
TI  - [Experience of the malignant complete intrathoracic goiter: discussion on 13
      cases of Japan].
AB  - A 56-year-old woman was found to have a mediastinal mass on routine examination.
      Chest X-ray, CT scan, MRI and superior vena cavography showed a right upper
      mediastinal tumor invading the SVC. And it was diagnosed malignant intrathoracic
      goiter by histological examination by percutaneous needle biopsy. On thoracotomy
      and mediastinotomy, the tumor located only in the right upper mediastinum and had
      no relation to the cervical thyroid gland. Histological examination revealed
      papillary adenocarcinoma. We reported a malignant complete intrathoracic goiter
      and added discussion on another 12 cases seen in Japanese literature.

PMID- 2232399
TI  - [Double chambered right ventricle: surgical experience in a 60-year-old woman].
AB  - The patients reported as double chambered right ventricle are mainly children. A
      60-year-old woman had been pointed out for her systolic cardiac murmur without
      any symptom. She was admitted to our hospital for her gradual onset of fatigue,
      lassitude. Cardiac catheterization data revealed a 105 mmHg peak-to-peak gradient
      within the right ventricular cavity with normal pulmonary pressures [20/5 (12)
      mmHg]. Right ventricular end-diastolic pressure was 4 mmHg. Right ventriculogram
      demonstrated double chambered right ventricle. Electrocardiogram showed neither
      right ventricular hypertrophy nor upright T wave in V3R. In order to release
      intraventricular pressure gradient and her symptom, the anomalous muscle bundles
      were resected through both the right atrium and the pulmonary artery. Surgical
      repair without right ventriculotomy is suitable for such an elder patient with
      double chambered right ventricle whose ventricular function may decrease.

PMID- 2232401
TI  - [A rare case of airway foreign bodies complicated with flail chest following
      traffic accident].
AB  - A 30-year-old man was taken to the emergency room of this hospital because of
      chest injury following traffic accident. On arrival he was found to be dyspneic
      due to multiple rib fractures (flail chest) and tension pneumothorax on the left,
      and was intubated immediately concomitantly with a chest drainage. During the
      management with the respirator, he was also noticed to have continuous bleeding
      from the airway. The X-ray film of the chest showed a suspicion of foreign
      materials on the right hilar region and subsequent bronchoscopic examination
      revealed the presence of several fragments of a broken windshield in the
      bronchial trees. Nine fragments were removed bronchoscopically. Tracheal tube was
      extubated on the 14th day and he was discharged on the 28th day without any
      sequela.

PMID- 2232402
TI  - [Successful surgical treatment of ruptured thoracic aortic aneurysm into the
      lung].
AB  - A 62-year-old man was admitted to the hospital because of massive hemoptysis.
      Chest X-ray film, CT scan and IADSA demonstrated a large aneurysm of the thoracic
      aorta, extending from the ascending aorta to the descending aorta. Bronchoscopy
      revealed bleeding from left B1+2. Six days after the onset, replacement of the
      thoracic aorta with woven Dacron prosthetic graft, autoclaved after immersion in
      albumin, was performed with cardiopulmonary bypass and separate cerebral
      perfusion (700 ml/min) under moderate hypothermia (25 degrees C). Left upper lobe
      of the lung, adherent tightly to the posterior and medial wall of the aneurysm,
      was not dissected because bleeding from left bronchus was trivial even after
      systemic heparinization. Because of the cardiac dilatation, delayed chest closure
      was needed. Postoperative cardiac failure, necessitating much catecholamine
      support, was seen with gradual improvement and no neurological deficit was
      recognized. He was discharged from the hospital without any sequelae 2 months
      after the onset. Pathologic diagnosis was an atherosclerotic aneurysm.

PMID- 2232403
TI  - [New trends in urodynamic investigation].
AB  - Urodynamic approach to the disorders of the urinary tract has been based on the
      knowledge of anatomy and neurophysiology of this abnormality. The development of
      this field included uroflowmetry, cystometry, urethral profilometry, and
      electromyogram of the external sphincter. In addition to these investigations new
      trends in urodynamic field were reviewed. With the advent of muscle biochemistry
      intra-renal urodynamics has been advocated. These researches would be expected to
      clarify the mechanism of intra-renal reflux. The another investigation was
      urophonography. When the urine passed through the posterior urethra the urethral
      sound occurred. The detecting, recording and analyzing systems were developed.
      This method would be entirely a new method of urodynamic study.

PMID- 2232404
TI  - [A study of the native kidneys in patients with chronic renal failure. Report 1:
      Morphological changes and occurrence of acquired cysts of the native kidneys in
      patients with chronic renal failure].
AB  - As morphological changes of the native kidneys, the presence of acquired cysts,
      intra-renal calcification and renal tumor was investigated mainly by
      ultrasonography and computed tomography in 151 patients with chronic renal
      failure. 1) Among 140 uremic patients caused by medical diseases. 40 patients had
      simple cysts, and 37 had acquired cystic disease of the kidneys (ACDK). However
      4, uremic patients caused by urological diseases were not seen to be with an
      acquired cysts. 2) The patients with ACDK were with significantly longer
      durations of dialysis therapy than those with simple cysts or no cysts.
      Furthermore, the patients with ACDK were younger than those of the other groups.
      3) Intra-renal calcification was more frequently found in patients with cystic
      disease (simple cyst, ACDK and polycystic disease) than in those without cystic
      disease with statistic significance. 4) Native kidneys became larger after the
      occurrence of ACDK. 5) Three cases of renal tumor were found.

PMID- 2232405
TI  - [A study of the native kidneys in patients with chronic renal failure. Report 2:
      Correlation between cystic changes in native kidneys and development of renal
      tumor].
AB  - The factors which made acquired cysts develop to renal tumors in chronic
      hemodialysis patients was investigated from clinical and histological findings.
      Although three renal tumors were found among 151 patients with chronic renal
      failure, clinically, one case had acquired cystic disease of the kidneys (ACDK),
      one case had simple cysts and the other case did not have any cyst. However, the
      last two cases had multiple small cysts histologically. In ACDK, renal tubules
      were degenerated and dilated, fused to each other, forming more larger cysts.
      Furthermore, epithelium of acquired cysts showed columer and dysplastic change,
      and papillary adenomas were developed into the inner space of the cyst wall. And
      ACDK kidney without renal tumor also revealed the same findings in histological
      examinations. It was postulated that renal tumor occurred from the papillary
      projections of the dysplastic epithelium of cysts. Therefore cysts in uremic
      patients seemed to be different from the simple cyst in normally functioning
      kidneys.

PMID- 2232406
TI  - [Clinical application of compact ESWL (Direx Tripter X-1)].
AB  - Clinical trials using Extracorporeal Shock Wave Lithotripter (Tripter X-1) were
      performed on 30 cases for upper urinary tract calculi (16 cases: renal stone, 14
      cases: ureter stone) with one trial per individual case from December, 1988 till
      February 1989. The fragmentation rate of 100% resulted. One month after
      treatment, evaluation on the X-ray film showed that 10 cases (33%) were found to
      be excellent where stone silhouette was no more observed. Effective cases where
      residual stone having dimension of below 5mm counted 10 (33%), and clinically
      effective rate, sum of both excellent and effective rates was 67 percent.
      Effective rate was 75 percent in case of kidney stone, and 57 percent in case of
      ureter stone respectively. Side effects of visual hematuria, skin ecchymosis and
      fever were observed, yet none of them was of serious grade, and post operative
      changes in blood chemistry were mild and transient. No remarkable side effects
      due to radiation exposure were observed. We concluded therefore that
      Extracorporeal Shock Wave Lithotripsy by this system is an effective therapy for
      upper urinary tract stones.

PMID- 2232407
TI  - [Evaluation of serum S100ao protein in patients with renal cell carcinoma].
AB  - In order to evaluate the clinical significance of S100ao protein, we measured
      serum S100ao protein in 36 patients with renal cell carcinoma by EIA developed by
      Kimura et al. In addition, the distribution of S100ao protein was studied by the
      immunohistochemical method. Previous study demonstrated that mean level of serum
      S100ao protein in healthy volunteers was 203 +/- 107 pg/ml, therefore the cut off
      level was set to 524 pg/ml. The results obtained in this study were as follows:
      1) The mean level of serum S100ao protein was 1162 +/- 2056 pg/ml, and its
      positive rate was 44% in 36 patients with renal cell carcinoma. When the patients
      were divided into 2 groups according to tumor stage, the mean level of serum
      S100ao protein in the high stage group was significantly higher than that in the
      low stage group (p less than 0.01). 2) In the sequential study of serum S100ao
      protein, patients with progressive disease showed a gradual increase in the level
      of serum S100ao protein while patients with no evidence of tumor showed a normal
      level of serum S100ao protein. 3) There was no correlation between the level of
      serum S100ao protein and the histological grade of renal cell carcinoma. 4)
      Immunohistochemical analysis (10 cases) showed that S100ao protein was observed
      in all of 10 renal cell carcinomas. Thus, the present study suggests that serum
      S100ao protein might be a useful clinical marker especially in monitoring
      patients with renal cell carcinoma.

PMID- 2232408
TI  - [Ultrasonographic study on kidneys in patients with chronic renal failure. Part
      I. Ultrasonic measurement of renal size and analysis of renal
      ultrasonotomograms].
AB  - Ultrasonograms of 546 kidneys were obtained in 280 patients undergoing chronic
      dialysis. Dialysed kidneys could be detected in 529 of the 546 kidneys (96.9%) by
      ultrasonic examination. The ultrasonic diagnoses on dialysed kidneys were
      contracted kidney in 313 kidneys (59.2%) and acquired cystic disease of the
      kidney in 107 kidneys (20.2%). Ultrasonic measurement of the size of kidney
      (length and thickness) revealed that the kidneys in patients with chronic renal
      failure were much smaller than normal ones. But the kidneys in patients
      undergoing dialysis for more than 8 years gradually increased in size with
      incidence of acquired renal cysts. The kidneys in patients with diabetic
      nephropathy were greater in length and thickness than those with chronic
      glomerulonephritis. Sonographic features of dialysed kidneys were unclear renal
      imaging, unidentified central echoes, cortico-medulla + border and increased
      parenchymal echogenicity. Irregularity of the renal contour had a tendency to
      increase in number with incidence of cysts in long-term dialysis patients. The
      ultrasonograms of the kidneys with diabetic nephropathy showed fewer changes than
      normal ones. No major complication of the kidney was detected in the present
      study. However, two retroperitoneal hematomas and one renal cell carcinoma
      developed within two years after this examination. We believe that regular
      screening of the kidneys by ultrasonic examination is mandatory in patients on
      chronic dialysis for early diagnosis and treatment of these complications.

PMID- 2232409
TI  - [Ultrasonographic study on kidneys in patients with chronic renal failure. Part
      II. Acquired cystic disease of the kidneys].
AB  - Ultrasonic examination of the kidney was performed on 280 patients undergoing
      chronic dialysis. Acquired cystic disease of the kidney (ACDK) was detected in
      107 of 529 kidneys (20.2%). This paper presents an analysis of ultrasonotomograms
      of ACDK. Ultrasonic measurement of the size of ACDK was 72.5 +/- 15.2 mm in
      length and 41.7 +/- 9.8 mm in thickness. The size of ACDK was significantly
      greater than that of contracted kidneys by ultrasonographic diagnosis. With
      regard to sex distinction the length and thickness of ACDK were significantly
      greater in males than in females. As for laboratory data, patients with ACDK
      showed significantly higher values of red blood cell count, hematocrit and serum
      creatinine concentration compared with contracted kidneys. Prolongation of the
      dialysis peirod increased the incidence of ACDK. The size of ACDK showed a
      tendency to increase with duration of dialysis. However, no correlation was noted
      statistically between the incidence of ACDK and duration of dialysis and between
      the size of ACDK and duration of dialysis. There was a significantly lower
      incidence of ACDK in patients with diabetic nephropathy than those with chronic
      glomerulonephritis. A sonographic feature of ACDK is irregularity of the renal
      contour because of cystic transformation. Renal imaging, identification of the
      corticomedullary border, identification of the central echoes and increased
      parenchymal echogenicity were similar to other dialyzed kidneys. The main
      complications of ACDK are hemorrhage and tumor formation. We observed two
      retroperitoneal hematomas and one renal cell carcinoma developed within two years
      after this examination. The incidence of complications of ACDK was 5.1 per cent.
      We believe that patients with ACDK should be watched carefully by regular
      ultrasonic examination for early diagnosis and treatment of these complications.

PMID- 2232410
TI  - [Clinical evaluation of bone turnover in patients with bone metastasis of various
      cancer of urogenital tract].
AB  - To study the bone turnover in patients with bone metastasis from cancers of the
      kidney, bladder, prostate and other organs, Ca metabolism, vitamin D related
      hormones and various markers, such as bone glaprotein (BGP) and hydroxyproline,
      were investigated. In the group with osteolytic metastasis of non-prostatic
      cancer patients, BGP which is a measure of bone absorption was significantly
      increased and urinary excretion of hydroxyproline, Ca and P was elevated. Serum
      Ca was also higher and 1 alpha 25 (OH)2D and 250HD, measures of the metabolism of
      vitamin D, were lower. It was shown that bone absorption was promoted with the
      osteolytic findings by clinical X-ray examination, but osteoblastic changes which
      did not depend on osteoblast cells, seemed to exist in this group. On the
      contrary, in the group with osteoblastic metastasis from prostatic cancer, the
      level of BGP was not increased, but urinary hydroxyproline was moderately
      increased. Serum and urinary Ca and P levels were increased. In addition, 1 alpha
      25 (OH)2D and 24 x 25 (OH)2D were lower than in the control group. These results
      indicate that urinary hydroxyproline is a useful marker for patients with bone
      metastasis, but BGP was correlative with neither the clinical findings of bone
      metastasis nor the bone turn over and metabolisms.

PMID- 2232411
TI  - [Long-term bioeffects of extracorporeal shock waves on renal tissue and blood
      pressure in normotensive and spontaneously hypertensive rats].
AB  - In order to examine chronic effects of shock waves on renal structure and blood
      pressure, normotensive Wistar Kyoto rats (WKY) and spontaneously hypertensive
      rats (SHR) were uninephrectomized and shock waves were given on the lower half of
      the residual kidney by Piezolith with the focus pressure of 1020 bar. In the
      first experiment, 36 WKY were divided into 6 groups; Group 1 served as control,
      Group 2, 4 and 6 received a single session of 1250, 2500 and 5000 shocks,
      respectively, whereas the animals in Group 3 and 5 received repeated dose of 1250
      or 2500 shocks within 3 days after the first session. All the animals in Group 6
      died within 48 hours due to remarkable renal hemorrhage, leaving only 5 Groups
      for the evaluation of long-term study. The blood pressure, measured by tail-cuff
      method 60 days after shock wave administration, was not significantly different
      between the control and shock-waved WKY. Neither was there any remarkable
      difference between the blood pressures measured prior to and 60 days after the
      intervention in each Group. At 16th week after the shock wave administration, the
      animals were sacrificed. There was a slight but statistically significant
      increase in serum creatinine level in Groups 2, 4 and 5, as compared to the level
      of control animals in Group 1. On light microscopic sections, there was no
      remarkable histological change in the kidney of Group 2, however, the renal
      parenchyma was frequently replaced with interstitial fibrosis in Groups 3, 4 and
      5.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232412
TI  - [Partial sacral agenesis. Characteristics of urodynamic findings].
AB  - We investigated fifteen patients with partial sacral agenesis who complained of
      urological disorders. Those with a myelomeningocele were not included. The mean
      age at the first visit was 13 years old. Bilateral and unilateral sacral agenesis
      were observed in nine and six patients, respectively. Chief complaints comprised
      incontinence and/or nocturnal enuresis in 10 patients, pollakisuria 5, recurrent
      fever attack due to urinary tract infection 5 and difficulty in micturition 2. In
      4 cases vesicoureteral reflux was observed. At an initial urodynamic study
      bladder compliance varied from 1.4 to 37.0 (mean 10.4) ml/cmH2O and uninhibited
      contractions were present in 10 of them. Three patients were judged to have
      normal or almost normal bladder function. After treatment with clean intermittent
      catheterization and/or anticholinergics, compliance improved to a mean of 15.1
      ml/cmH2O and the uninhibited contraction decreased in its amplitude or
      disappeared completely in 8 of 10 cases. It was suggested that patients with
      partial sacral agenesis originally suffered from a lower motor neuron lesion. The
      severity of the sacral deformities and other neurological symptoms (gait or
      sensory disturbance) were not related with the urodynamic findings. However, it
      was found that the more the cystogram was deformed the lower was the bladder
      compliance.

PMID- 2232413
TI  - [Immunological study on chyluria].
AB  - Immunological studies were performed in 87 patients with chyluria referred to our
      clinic from January 1982 to December 1988. White blood cell count in 78 patients
      was 5210.3 +/- 1440.9/mm3. The fraction and the number of lymphocyte were 18.7 +/
      9.5% and 934.1 +/- 521.6/mm3, respectively: they were lower than normal limit.
      The percentages of T and B lymphocytes studied in 46 patients were 79.3% +/-
      11.2% (normal range: 76-86) and 10.4 +/- 7.9% (normal range: 8-16), respectively:
      both lymphocytes tended to decrease in percentage. Lymphocyte blast formation
      stimulated with phytohemagglutinin (PHA) was carried out in 20 patients. The mean
      of the blast formation was 17410.0 +/- 10275.1 c.p.m. (normal range: 377700
      62400), and much lower than normal value. Of 22 patients who had PPD skin test,
      only 9 (40.9%) were positive. These findings signified that cellular immunity was
      suppressed in patients with chyluria. On the other hand, the value of
      immunoglobulin was within normal range (IgG: 1325.3 +/- 475.6 mg/dl, IgA: 242.0
      +/- 98.3 mg/dl, IgM 130.4 +/- 95.9 mg/dl). Study on the values of laboratory
      examinations showed statistically positive correlation between total lymphocyte
      population and T cell number, and between total lymphocyte population and
      lymphocyte blast formation. In patients with chyluria, serious sequelae have not
      been reported. However, care should be taken for possible opportunistic infection
      and, particularly, malignant tumors because suppression of cellular immunity may
      be one of the promoting factors of malignant tumors.

PMID- 2232414
TI  - [Prognostic factor for prostate cancer. Gunma Urological Oncology Study Group].
AB  - The study of prognostic factors in patients with prostate cancer (Pca) may be of
      value in understanding the natural history of the disease and may also assist in
      planning and analyzing the results of clinical trials. Moreover some information
      through this study would be beneficial to assessing the prognosis and decision of
      better therapy form of individual patients. The significance of items studied was
      evaluated from the two view points, survival rate and Pca death rate. Stage,
      pathological differentiation and acid phosphatase were significantly related to
      them, in the category grade depending manner. Past history and complication, and
      age were also significantly related to them but higher category grade as a
      survival factor showed lower Pca death rates. ESR, gait disturbance and hematuria
      were related to only survival rate. Any significant relationship was not observed
      in serum testosterone, voiding disturbance and cancer-pain. Prognostic factors
      should be clinically used through the well understanding of each characteristics.
      This paper also showed that statistical significance not always provide a wide
      difference between categories compared.

PMID- 2232415
TI  - [Study on small renal cell carcinoma diagnosed by ultrasonography].
AB  - Sixty-seven patients underwent a resection of renal cell carcinoma in our
      hospital between July 1984 and Mar. 1989. Out of them 31 patients with small
      renal cell carcinoma less than 4 cm in diameter were examined. The proportion of
      small renal cell carcinoma to all renal cell carcinoma was 36% (14 patients) in
      the first half period (July 1984-July 1987) and 61% (17 patients) in the last
      half (Aug. 1987-Mar. 1989), i.e. in total more than half of all the carcinomas.
      The patients diagnosed by ultrasonographic screening were 25 (80%) out of the 31
      patients. The incidence of small renal cell carcinoma was 4 (0.06%) out of 6892
      patients in our health check-up center and 6 (1.0%) out of 610 hemodialysis
      patients, and they were found by ultrasonic examination. The carcinoma was
      protruded from the renal contour in 24 patients (77%) and was inside the renal
      parenchyma (23%) in 7 patients. The carcinoma in the 24 patients was associated
      with the deformity of its outline. The patients with a positive IVP were 5 out of
      31 patients and the carcinoma in 4 out of the 5 patients was inside the renal
      parenchyma. Of all patients with protrusion of te renal contour, only one patient
      was with a positive IVP. The above findings indicate that ultrasonic examination
      is a useful method for the early diagnosis of small renal cell carcinoma.

PMID- 2232416
TI  - [Follow-up of 104 children with "primary" VUR. Incidence of unstable bladder, its
      impact on resolution of VUR and progression of renal scar].
AB  - One hundred and four children (48 boys and 56 girls, ranging in age from 3 months
      to 15 years, and follow-up period of more than 2 years in all) with "primary"
      vesicoureteral reflux (VUR) were retrospectively analyzed with particular
      emphasis on resolution of VUR and occurrence of renal scar. All underwent
      cystoscopic examinations which failed to demonstrate any organic vesicourethral
      obstruction, and all were neurologically normal. The patient population was
      divided into 2 groups based on cystometric findings. Group 1 consisted of 74
      patients with unstable bladder and Group 2 consisted of 30 patients without
      unstable bladder. Although both groups were initially kept under antibacterials,
      in Group 1 frequent voiding and anticholinergics were maintained until the
      bladder stabilized by itself. There was no difference in the grade of reflux
      between the two groups. The rate of spontaneous resolution of reflux was 18% in
      group 1 in which more than 60% of the patients were with high grade reflux, while
      in Group 2 it was 17%, similarly to Group 1, but all were with low grade reflux.
      The presence or absence of renal scar and its subsequent evolution were
      determined in 73 patients in whom serial urograms were available enough to
      evaluate nephrographic renal outline. The incidence of renal scar at the first
      visit was 26% in Group 1 and 36% in Group 2. New formation of renal scar was not
      found in either group. The progression of preexisting renal scar was seen only in
      Group 1 (5/55 patients, 9%), and not in Group 2 (0/18 patients, 0%).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2232417
TI  - [Percutaneous endoscopic surgery for obstructive diseases in the upper urinary
      tract--preliminary report].
AB  - Fifty-two patients with obstructive diseases of the upper urinary tract were
      treated by percutaneous endoscopic surgery between May, 1986 and July, 1989.
      Fifty-nine procedures consisting of endopyelotomy (24 procedures),
      endopyeloureterotomy (29) and balloon dilation under direct vision (6) were
      performed in 54 units of the urinary drainage system. Causative diseases were
      congenital in 24 units, scar due to calculi in 17, scar due to previous surgery
      in 11 and tuberculous ureteritis in 2. The postoperative follow-up periods ranged
      from 3-41 months, mean +/- S.D.; 12.2 +/- 7.3 months. Of the 59 procedures, 49
      (83.1%) achieved improvement but 10 could not on the postoperative excretory
      pyelogram and/or TcDTPA renogram. Three procedures (5.5%) required blood
      transfusion. Retroperitoneal leakage of the perfusate was observed in 3
      procedures (5.0%). No other severe complications were observed. These results
      indicate that this procedure may be used for the reconstructive surgery in
      obstructive diseases of the upper urinary tract such as the ureteropelvic
      junction and the proximal 1/3 ureter.

PMID- 2232418
TI  - [Simultaneous occurrence of renal cell and transitional cell carcinoma in the
      same kidney and ureter. A case report].
AB  - An unusual case of 2 concurrent primary renal tumors within the same kidney is
      reported. A 70-year-old woman presented with gross hematuria when she was in the
      hospital for cerebral infarction. Excretory urography revealed a marked expansion
      of the right kidney with no renal function. CT scan showed a mass arising from
      the right kidney, the hydronephrotic right renal pelvis, and a mass in the lower
      right ureter. Selective renal angiogram showed marked neovascularity of the mass.
      There was an encasement of the intrarenal artery to the lower pole. Angiographic
      findings were highly suggestive of a renal cell carcinoma with a second neoplasm
      in the renal pelvis. Subsequently, the patient underwent right radical
      nephroureterectomy and partial cystectomy. Section of the removed specimen
      revealed a 4.0 X 3.8 cm solid tumor confined to the kidney in the upper pole and
      a transitional cell carcinoma arising from the renal pelvis. In addition,
      transitional cell carcinoma was present in the distal ureter.

PMID- 2232419
TI  - [A case of medullary sponge disease associated with horseshoe kidney].
AB  - A 60-year-old man visited our hospital with complaints of micturition pain and
      interruption of urinary stream. X-ray examinations were performed, showing no
      bladder and urethral stone. However, KUB revealed bilateral multiple renal
      stones. Excretory urography showed a horseshoe kidney and a concentration of the
      contrast medium in the ectatic tubules at the pyramidal apices. Calculi were also
      located in these ectatic tubules. Thus, we considered that this was a very rare
      case of medullary sponge disease associated with horseshoe kidney. So far there
      has been no case report of medullary sponge disease with horseshoe kidney in our
      country.

PMID- 2232420
TI  - [Male infertility].

PMID- 2232421
TI  - [Fluorescence microscopy of the absorption and disappearance of adriamycin
      through the bladder epithelium in the rat].
AB  - The absorption and disappearance of adriamycin (ADM) through the bladder
      epithelium in the rat was investigated using a fluorescence microscope. In the
      absorption study in vitro, ADM permeated through the epithelium into the lamina
      propria or the inner layer of the muscle within 15 minutes after instillation,
      showing no further infiltration into the deeper part of the bladder wall. In
      addition, fluorescence histological evidence for the uptake of ADM by the
      endothelial cells of the blood vessels in the lamina propria suggested a systemic
      diffusion of ADM to the whole blood by blood circulation. These data coincided
      well with the absorption study in vivo. On the other hand, ADM once absorbed in
      the bladder wall disappeared from the lamina propria or the inner layer of the
      muscle and was confined only in the epithelium at 60 min after the excretion of
      ADM. The intensity of ADM fluorescence then decreased gradually with time
      elapsed. No ADM fluorescence was recognized in the bladder tissue 48 hr later. In
      the absorption study with the BBN induced rat bladder tumor, ADM permeated into
      all the cells of papillary tumor within 5 minutes of instillation. The
      fluorescence histological method used in the present study is harmless and may
      readily be applicable to the pharmacodynamic study of ADM in human bladder
      tumors. This method proves to be a promising approach to the development of an
      ideal instillation therapy effective on bladder tumor cells without side-effects.

PMID- 2232423
TI  - [Neurogenic bladder in patients with lumbar vertebral disorders].
AB  - Bladder and urethral functions were evaluated urodynamically in 114 patients with
      lumbar disorders including prolapsed lumbar intervertebral disc (66 patients),
      lumbar canal stenosis (19 patients), lumbar spondylolysis and/or
      spondylolisthesis (21 patients), lumbar spondylosis deformans (5 patients) and
      ossification of the yellow ligament of the lumbar spine (3 patients). The
      patients consisted of 88 males and 26 females with an average age of 47 years
      (range 17 to 73 years). Symptomatic organic infravesical obstruction was excluded
      by physical and radiographic examination. Cystometry revealed preoperative
      neurogenic bladder in 23 patients (20%); normal detrusor with overactive
      sphincter in 2 (9%), underactive in 8 (36%), overactive in 5 (23%) and equivocal
      in 7 (32%). One patient not receiving cystometry revealed abnormal uroflowmetry
      with 140 ml residual urine. Twenty of them underwent electromyographic
      examination of the external sphincter and 15 (75%) had an overactive sphincter.
      Nine (39%) of them complained no urological symptoms. Neurogenic bladder seemed
      to highly associate in those having abnormal tendon reflex in the lower
      extremities, decreased bulbocavernosus reflex and sensory disturbance in the
      perineal area, but there was no statistical significance. Of twenty-three
      neurogenic bladder patients, eighteen underwent a lumbar vertebral operation and
      fifteen received postoperative urodynamic evaluation. Uroflowmetry was improved
      in more than half of the patients within 3 months after the operation and
      cystometry was normalized in 4 of 7 patients who underwent cystometry over 6
      months after the operation. Preoperative overactive detrusor remained unchanged
      in two of three patients who underwent cystometry over 6 months after the
      operation.

PMID- 2232422
TI  - [The analysis of prognostic factors for prostate cancer by multivariate
      analysis].
AB  - Multivariable analysis (quantification method I and II) was used to investigate
      the relationship between survival rates and prognostic factors. The items studied
      were age, stage, pathological differentiation, gait disturbance, acid phosphatase
      and erythrocyte sedimentation rate (ESR). The data were available for 353
      patients for all items. The significance of each item was evaluated in all
      patients-group, subgroup stratified by their cause of death, and subgroup
      stratified by their stage. The significance of age and gait disturbance which
      represent the general condition was proven in all patients, non-cancer death
      group and stage ABC group. In the cancer death group, stage D group was the most
      significant as prognostic factor. ESR was the most significant in the stage D
      group and the significance was gradually increased with the observation time.

PMID- 2232424
TI  - [A combined treatment with 8 MHz radiofrequency hyperthermia, HPC-adriamycin,
      immunotherapy, radiation, systemic chemotherapy and irradiation for invasive
      bladder carcinoma].
AB  - Hyperthermia was induced for the treatment of invasive bladder carcinoma in order
      to study its usefulness. The subjects were 12 cases of invasive bladder cancer;
      including 5 cases of T2, 3 cases of T3, 2 cases of T4, and 2 cases of recurrence
      after total cystectomy. As previous treatment, 4 patients received radiotherapy
      and the other received TUR, systemic chemotherapy, and intravesical injection of
      anticancer drugs. For hyperthermia treatment, a Thermotron RF-8 was used for
      heating a deep seated tumor. Each case received hyperthermia 2 to 10 times.
      Combined therapy included injection of HPC-adriamycin into the urinary bladder in
      5 cases, immunotherapy in 3 cases, M-VAC therapy in one case, radiotherapy in one
      case, radiotherapy and intra-arterial injection in one case, and Peplomycin and
      OK-432 local injection in one case. The treatment results showed a 75%
      effectiveness; with CR in 4 cases, PR in 5 cases, MR in 2 cases and PD in one
      case. Three patients died and 9 survived. Of four patients who had received
      radiotherapy as a previous treatment 3 cases obtained CR and one case MR.
      Therefore, it was considered that a favorable treatment effect with hyperthermia
      could be obtained after radiotherapy.

PMID- 2232425
TI  - [A study on cisplatin adsorbed to activated carbon particles as a new drug
      delivery system and its anti-cancer effect against human bladder cancer cell
      lines].
AB  - Activated carbon characteristically shows an extremely high transmigration to the
      lymph node, as well as a sustained release of the adsorbed drugs. Therefore,
      several attempts to use activated carbon as a carrier in cancer chemotherapy have
      been done. In the present study, we first introduced a new drug-dosage form of
      cisplatin (CDDP) adsorbed to activated carbon particles (CDDP-CH), and examined
      its characteristics and anti-cancer effect against human bladder cancer cell
      lines. CDDP solution of varied concentrations (Randa) was mixed with activated
      carbon particles (Norit A) and examined for adsorption and discharge by atomic
      absorption spectrophotometry and high performance liquid chromatography. Total
      CDDP adsorption increased in proportion to the amount of activated carbon. CDDP
      CH was successfully prepared at an efficient concentration for cancer
      chemotherapy and CDDP-CH slowly discharged CDDP, indicating it as a useful means
      for the anti-cancer drug. Using cultured human bladder cancer cell lines (KU-1,
      HTB9), the anti-cancer effect was compared between CDDP and CDDP-CH by MTT-assay
      and double layer soft agar colony assay. CDDP-CH revealed an inhibitory effect
      against human bladder cancer cell lines. In view of the fact that activated
      carbon readily migrates to the lymph node, clinical application of this drug
      dosage form may be useful in cases of malignant tumor metastasis to the lymph
      node.

PMID- 2232426
TI  - [Suburethral sling procedure for urinary stress incontinence. With special
      reference to determination of tension of suspension from posturethrovesical angle
      measured by ultrasonography].
AB  - Ten patients with urinary stress incontinence were treated by suburethral sling
      procedure using a polytetrafluoroethylene tube as the sling. The tension of
      suspension was determined by the post-urethrovesical angle measured by
      transrectal ultrasonography in each patient. In nine patients, the post
      urethrovesical angle ranged from 90 to 110 degrees, and urinary continence of the
      patients was completely obtained. The remaining one patient whose post
      urethrovesical angle was determined as 120 degrees could not obtain complete
      continence. None of the patients had subjective post-operative disturbance in
      urination and the peak flow rate of post-operative uroflowmetry hardly decreased
      in 7 patients in whom this was performed. Although post-urethrovesical angles
      reduced as the tension which suspended the bladder neck increased, the tension
      reforming the post-urethrovesical angle was various in each patient. Since one of
      the aims of suspension of the bladder neck for patients with stress incontinence
      is reform of the post-urethrovesical angles, correct and reasonable tension of
      suspension is to be obtained by measuring the post-urethrovesical angle.

PMID- 2232427
TI  - [Upper urinary tract tumors following bladder cancer].
AB  - We treated in total 795 patients with primary transitional cell carcinoma of the
      urinary bladder between April, 1964 and December, 1988. Eighteen patients of them
      had upper urothelial cancer during the follow-up period. Thirteen of the 18
      patients had received transurethral resection for the initial bladder cancer,
      while 3 total cystectomy and 2 segmental resection. The over-all incidence of
      bladder cancer patients who subsequently developed upper urinary tract tumors was
      2.3 per cent. The interval between initial treatment of the bladder cancer and
      treatment for the upper urinary tract tumor ranged from 2 to 74 months (median 20
      months). The five-year survival rate after treatment for the upper urinary tract
      tumor was 31.7 per cent. We conclude that the following are high risk patients
      for development of upper urinary tract recurrences: 1) patients with bladder
      cancer near orifices, 2) patients with recurrent bladder cancer under bladder
      preserving treatment for a long time, 3) patients with G2 multifocal bladder
      cancer.

PMID- 2232428
TI  - [The clinical efficacy of outpatient extracorporeal shock wave lithotripsy].
AB  - From March 1989 through December 1989, 123 patients, 9 to 78 years old, were
      treated by extracorporeal shock wave lithotripsy (ESWL) with the Wolf Piezolith
      device. Outpatient treatment was performed routinely. Anesthesia was not required
      in all of the patients. No analgesia or sedation was given routinely. When pyuria
      had been found before treatment, a course of prophylactic oral antibiotics was
      given. Treatment consisted of 2000 to 6000 shocks in adults. The need for re
      treatment was decided on the basis of the follow up X-rays. Fragmentation into
      particles 5 mm in size or less occurred in 144 of the 149 renoureteral units
      (96.6%). Unfragmented stones were treated successfully by the combination therapy
      of ESWL and fiberoptic transurethral nephroureterolithotripsy (f-TUL). Of 144
      renoureteral units, 3-month follow-up data are available for 96. Among the 96
      units, the rate of being free of stones was 67 per cent for renal stones and 96
      per cent for ureteral stones treated in situ. The over-all rate of being free of
      stones was 80.2 per cent. There were no significant complications. Ultrasound
      imaging has proved to be as effective as X-ray imaging. Outpatient ESWL with the
      Wolf Piezolith device is considered to be safe and efficient for the initial
      treatment of urinary stones. On the other hand, ESWL monotherapy is not
      sufficient for the treatment of complete staghorn calculi or long-term impacted
      ureteral calculi. We think that the combination use of ESWL and f-TUL is the most
      effective procedure for treatment of complicated stones.

PMID- 2232429
TI  - [Clinical studies on thirty-two cases of childhood urolithiasis].
AB  - We evaluated 32 patients with urinary calculi under 16 years of age over the past
      14 years since the founding of the Department of Urology, Kinki University School
      of Medicine. They comprised 0.8% of the total urolithiasis patients. They
      consisted of 18 boys and 14 girls with a male-to-female ratio of 1.29. The
      average age was 8.7 years for boys and 10.4 years for girls without any marked
      peak. The most frequently chief complaint was hematuria which was present in 15
      cases (47%). Although pyuria was seen in seven cases (22%), urinary bacterial
      culture was positive only in 5. The underlying diseases could be diagnosed in 13
      cases (41%), of which eight cases (62%) developed metabolic disorder. The sites
      of calculi were determined in 29 cases (91%), of which 28 had stones in the upper
      urinary tract. Surgical treatment was performed on 16 cases in 17 sessions.
      Ureterolithotomy was done in as many as five cases, followed by pyeloplasty in
      four cases. Nephrectomy was performed in only one case. There was only one case
      which had been treated with extracorporeal shock-wave lithotripsy (ESWL). The
      composition of calculi was found in 21 cases (66%), the majority or 13 cases
      (57%) of which had calcium-containing stones. Nevertheless, there was no case of
      hypercalciuria. When compared to the previous reports in Japan, it was worthy of
      note that calculi in the upper urinary tract and calcium-containing stones had
      higher incidences. It is expected that more patients will be treated with ESWL in
      the future.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232431
TI  - [Chromosome analysis of renal cell carcinoma].
AB  - Of 8 tumors surgically extirpated from 8 patients with renal cell carcinoma, 7
      were successfully processed in short-term culture by collagenase method, and 130
      metaphases were extracted from these 7 tumors and were subjected to chromosomal
      analysis according to the G banding technique. As for karyotype, 4, 2 and 1 cases
      were mainly diploid, hypodiploid and aneuploid, respectively. The highest
      incidence of chromosome aberration was marked by #3 chromosome (5 of 7 cases of
      which 4 and 1 showed monosomy as clonal aberration and trisomy as non-clonal
      aberration, respectively). The commonest gain of chromosome was noted for #7
      trisomy (4 of 7 cases). Two cases had already had metastases at the time of
      surgery, each showing #7 trisomy. Marker chromosome was noted in 6 of 7 cases.
      Structural chromosome aberration had a lesser incidence compared with numerical
      aberration; only clonal aberrations were long-arm aberrations (2q+, 6q+) of #2
      and #6 chromosomes. Short-arm aberrations (3p-, 8p-) of #3 and #8 chromosomes
      were noted in one case each. 3p deletion, which is reported to be predominant in
      the literature, was noted only in one case. This was observed in triploid cells.
      However, all of metaphases showing 2q+ and 6q+ had concomitant #3 monosomy, and
      excess portions of #2 and #6 chromosomes were in good agreement with the band
      pattern of #3 chromosomal long-arm. Therefore, translocation of 3q12-qter in #2
      and #6 chromosomes is supposed to lead to 3p deletion. A similar mechanism seems
      to be involved in the formation of marker chromosomes, suggesting the involvement
      of deleted #3 chromosome in marker chromosomes.

PMID- 2232430
TI  - [Relation of tumor number to clinical course of superficial papillary bladder
      tumors].
AB  - Clinical courses of 293 patients with superficial papillary bladder tumors were
      analysed on the basis of tumor number at the first presentation. The follow-up
      period ranged from 6 to 266 months with a median of 59 months. 171 patients (58%)
      had a single tumor, while 122 (42%) had multiple tumors. Those older than 60
      years occupied 68% in the latter group and 51% in the former (p less than 0.01).
      High grade tumors were more frequent in the latter than the former (p less than
      0.05). The five-year recurrence rate was 68% for the latter and 39% for the
      former single tumor group (p less than 0.01). Malignant progression was observed
      in 3.6% of patients with a single tumor and 13.4% of those with multiple tumors
      (p less than 0.01). The results would offer a theoretical background to the
      finding of a poor ten-year actuarial survival rate of 54% for multiple tumor
      group compared with 76% for the single tumor group (p less than 0.05). However,
      the rate of primary cancer death was similar in both groups.

PMID- 2232432
TI  - [Histological and flow cytometric analyses of carcinogenesis of rat prostate
      cancer].
AB  - Histological and flow cytometry (FCM) analyses were performed of carcinogenesis
      of rat prostate cancer induced with N-Nitroso-N-methylurea (NMU). Ten-week-old
      rats were inoculated intravenously (i.v.) with twice injections of NMU (30 mg/kg
      body weight) and then, divided into 3 groups; Group 1: the rats were injected
      subcutaneously with LH-RH analogue (100 micrograms/kg b.w.) every 4 weeks. Group
      2: the rats were injected subcutaneously with testosterone enanthate (10 mg/body)
      every 2 weeks and Group 3: the rats were untreated to serve as controls. We
      further divided Groups 1 and 2 into (+) and (-) subgroups at 34 weeks after
      initial injection. Group 1 (+) or 2 (+) rats were continuously given the drug and
      in Group 1 (-) or 2 (-) rats the drug was suspended. At 44 or 53 weeks after
      initial injection, we removed the prostate and seminal vesicles of all rats and
      performed histological and FCM analyses of them. Histological analysis of rat
      prostates revealed hyperplasia in each group, and both Groups 2 (+) and 2 (-)
      showed an incidence as high as 87.5%. Atypical hyperplasia was sometimes observed
      in each group and its incidence was not significantly different between any 2
      groups. At 51 weeks after initial injection, a macroscopic adenocarcinoma
      (weighing about 11 g) was found in the prostate of a dead rat of Group 2 (+).
      Histological analysis of rat seminal vesicles revealed hyperplasia in each group,
      in particular in Groups 2 (+) and 2 (-). In these groups all rats showed
      hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232433
TI  - [Preoperative adjuvant therapy for urinary bladder cancer--preoperative intra
      arterial anticancer drugs infusion using artificial liver, and preoperative
      radiotherapy].
AB  - One hundred patients with carcinoma of the urinary bladder were treated with
      preoperative intra-arterial anticancer drug infusion in combination with an
      active carbon-based artificial liver or preoperative radiotherapy (400 rad X 5
      days, total 2000 rad) in order to alleviate systemic side effects after
      preoperative adjuvant therapy and to perform radical cystectomy as soon as
      possible. Five-year survival was 69.8% in the artificial liver combined
      preoperative intra-arterial anticancer drug infusion group, and that of the no
      pretreatment group and the preoperative irradiated group was 48.6% and 45.8%,
      respectively. In particular, the CDDP treated group had a higher 5-year survival
      of 77.4% than did the without CDDP treated group. This was attributable mostly to
      improved prognosis of T2, whereas either of these preoperative adjuvant therapies
      failed to ameliorate the prognosis of T3 or T4 stage patients. Therefore,
      systemic preoperative anticancer chemotherapies such as M-VAC are necessary to
      destroy "micrometastases" and to improve the prognosis of highly advanced bladder
      cancer.

PMID- 2232434
TI  - [Adverse reactions of antituberculous agents, especially about its onset and
      duration].
AB  - We examined the adverse reactions of the antituberculous agents in 225
      hospitalized patients (150: male, 75: female, average age: 45.4 years old) and
      the results were summarized as follows: 1) The side effects were seen in 53
      patients (23.6%), and the abnormal laboratory findings were observed in 94
      patients (41.8%). 2) The incidence of adverse reactions in patients treated with
      three drugs (INH, RFP, EB) and four drugs (plus SM) were 45.9% and 82.4%,
      respectively. 3) Adverse reaction appeared within one month after starting
      treatment in 67.9% of eligible patients, and it disappeared within one month from
      its onset in 76.8% of patients. There results suggested the importance of careful
      clinical observation especially soon after starting antituberculous therapy.

PMID- 2232435
TI  - [The significance of pleural fluid cytology in the differential diagnosis of
      pleurisy showing lymphocyte-predominant pleural effusion].
AB  - We examined the significance of pleural fluid cytology in differentiation between
      tuberculous and non-tuberculous pleurisy in patients with lymphocyte-predominant
      pleural effusion. We divided pleural fluid cytologic findings into two patterns,
      that is "tuberculous" and "non-tuberculous pattern", according to the report by
      Spieler, and compared the cytologic pattern with the final clinical diagnosis.
      Thirteen out of 19 cases (68.4%) with tuberculous pleurisy showed "tuberculous
      pattern" in the pleural fluid cytology, while four (pleurisy associated with
      collagen-vascular disease, asbestosis and carcinoma, and idiopathic pleurisy) out
      of 13 (30.8%) with non-tuberculous pleurisy revealed "tuberculous pattern". The
      pleural fluid cytology could be used as one of the additional means to
      differentiate between tuberculous and non-tuberculous pleurisy, though it is
      impossible to differentiate between them with the pleural fluid cytology alone.

PMID- 2232436
TI  - [Effect of atypical mycobacterial infection on the cell-mediated immunity induced
      by Mycobacterium bovis BCG in mice. I. Suppression of delayed-type
      hypersensitivity].
AB  - Mycobacterium avium Mino grows well in the lung, spleen or liver of susceptible
      mice, such as C57BL/6, C57BL/10, and B10 congenics. Infection with Mino inhibited
      the induction of delayed-type hypersensitivity (DTH) to BCG in the mouse
      receiving subcutaneous injection of BCG 2 weeks later. Post-infection with Mino
      did not affect DTH to BCG already established. Preceding infection with avirulent
      strains of atypical mycobacteria weakly suppressed the induction of DTH by BCG.
      On the other hand, Mino infection did not affect DTH to SRBC. DTH to Mino and DTH
      to BCG detected by PPD-I and PPDs hardly showed cross-reactivity. These results
      suggest that tuberculin skin reaction after BCG vaccination could be suppressed
      by the infection with atypical mycobacteria in humans, especially where these
      bacterial infections are prevailing.

PMID- 2232437
TI  - [Four cases of simultaneous discovery of familial tuberculous infection].
AB  - Index case is a 17-year-old boy who was admitted to our hospital with pleurisy
      and a minimal pulmonary lesion, and tubercle bacilli were recovered from pleural
      fluid. A diagnosis of primary tuberculosis was made based on the onset by
      pleurisy and the existence of hilar and mediastinal lymph node swelling. On the
      same day, a 76-year-old man, grandfather of the index case was admitted for
      precise examination of suspected extensive pneumonia. Tubercle bacilli were also
      isolated from the pus of infected bulla obtained by puncture. Neither of these
      two cases, however, seemed to be the source of the familial tuberculous infection
      because of such sudden onset of the disease as pleurisy and pneumonia. Two months
      later, a 46-year-old man, father of the index case was examined at our hospital.
      He was considered to be the source of the familial infection because he was
      diagnosed as tuberculosis with positive smear and a thick wall cavity (3.2 cm in
      diameter) on the left apex, and abnormal shadow was detected on his chest X-ray
      already two years ago. The fourth case was a mother of the index case, and wife
      of the third case, whose chest radiography revealed an infiltrative shadow on the
      right apex by a family contacts examination. Though tubercle bacilli were not
      isolated from her sputum, pulmonary lesions considered to be tuberculosis due to
      their typical location and nature, a positive PPD skin test, and the response to
      antituberculous drugs.

PMID- 2232438
TI  - [Clinical immunology of tuberculosis].
AB  - The standard tuberculin skin test has been known as the prototype of delayed type
      hypersensitivity testing which is mediated by T cells and macrophages and plays
      an important role in the pathogenesis of tuberculosis. Tuberculosis is indeed a
      chronic infectious disease, but variation in the host immune responses to
      tubercle bacilli results in the various clinical manifestations of the disease
      ranging from an immunologically hyperreactive state observed in pleural fluid
      lymphocytes in tuberculous pleurisy to an almost totally unresponsive state
      observed in those severely ill with refractory tuberculosis. In tuberculous
      pleurisy, T cells in pleural fluid respond remarkably in vitro to PPD tuberculin
      whereas T cells in peripheral blood responded poorly to PPD stimulation.
      Compartmentalization of PPD-reactive T cells in the pleural fluid and
      immunosuppression by T cells and/or macrophages in the peripheral blood were
      responsible for this immunological difference observed between the lymphocytes in
      pleural fluid and those in peripheral blood of tuberculous pleurisy. In advanced,
      drug-resistant tuberculosis as well as in nontuberculous mycobacterial infection,
      the proliferative responses of T cells in vitro to PPD stimulation were impaired.
      This depressed T cell response was due to depressed interleukin-2 (IL-2)
      production and not due to depressed IL-2 responsiveness. Therefore, the addition
      of exogenous IL-2, returned the depressed PPD-induced lymphocyte proliferation in
      vitro in these patients to the level of the response observed in lymphocytes from
      patients with newly-diagnosed tuberculosis. Our results suggest that recombinant
      IL-2 offers a novel approach to the therapy of advanced, drug-resistant
      tuberculosis and nontuberculous mycobacterial infection. Preliminary clinical
      trials of immunotherapy with recombinant IL-2 reveals the effectiveness of this
      therapy and encourages us to extend the trial to a larger scale. Tubercle bacilli
      have various biological activities. Research on tuberculosis and tubercle bacilli
      have contributed much to the progress of biochemistry, pathology and immunology.
      Mycobacterium is a fascinating organism, which now presents another big appeal to
      those studying immunology: Study of immunological interaction between gamma delta
      T cells and the highly conserved protein in mycobacteria, HSP, heat shock protein
      will contribute to the elucidation of the mechanism of immunological surveillance
      and the mechanism of autoimmune diseases. In addition, it will also contribute to
      the development of a new mycobacterial vaccine which will give direct, protective
      immunity against tuberculosis.

PMID- 2232439
TI  - [Development of a scale to measure the self concept of cesarean section mothers].
AB  - Recently, the rate of cesarean section in Korea has been increasing. The results
      of several previous studies in foreign countries on the emotional responses of
      cesarean section mothers showed that they might experience difficulties in the
      mother-infant interaction due to fatigue, lack of early mother-infant
      interaction, disappointments, anger, feelings of loss of control, and other
      factors. Human behavior is said to be determined by one's self concept, and self
      concept is influenced by both internal and external environmental factors. A
      scale to measure the self concept of cesarean section mothers was needed in order
      to identify those who might have difficulties in the mother-infant interactions
      in future. The purposes of this study were to develop a measuring scale, and to
      test its reliability and validity. The process of this study was as follows. A
      structured interview was done with 50 cesarean section and vaginal delivery
      mothers to find their state of emotional reaction after giving birth to their
      babies. Based on the results of the interviews, a 50 items Likert scale was
      developed. The self concept of 268 cesarean section and vaginal delivery mothers
      who were hospitalized at six hospital in seoul were measured, during the period
      between Feb. 1 and April 30. Reviewing the discriminating power of each item by
      means of crosstabulation, ten items were selected for the final scale. The
      reliability and validity of this ten item scale were tested by Cronbach's alpha
      and t-test, using spss pc + package. The results of this study and recommendation
      are as follows. 1. The ten selected items were as follows. I feel pains in my
      breast. (-) I have a good appetite now. (+) I feel pains in my flank. (-) I feel
      fine now. (+) My body seems to have returned to its prepregnant state. (+)
      Thinking of the delivery process, I feel sorry. (-) I want to hold my baby in my
      arms. (+) I want to keep my own life, even if I became a mother. (-) I want to
      delegate the care of the baby to my mother/mother in law. (-) I think baby is my
      alter ege. (+) 2. The reliability of this scale was tested by Cronbach's alpha,
      and the coefficient of this scale was .8066. 3. The construct validity of this
      scale was tested by means of known group methods. The value of self concept for
      cesarean section mother was significantly lower than for vaginal delivery mothers
      (t = -5.51, df = 266, p = 0.007).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2232440
TI  - [A study on autistic children in Korea].
AB  - This Study was to determine the trend of child rearing attitude, to investigate
      how variables affect the child rearing attitudes, and to suggest directions for
      developing much needed parental effective training programs or counselling for
      autistic child in community. The subjects were seventy six mother's of autistic
      children who attending to 13 treatment institutions in Korea. The data were
      collected from 1, March to 30, May, 1985. Maternal Behavior Research Instrument
      exploited by Schaefer, used as a tool in this study. The research findings
      obtained were as follows: 1. Mothers, in general, had affective, restrictive
      attitudes, and were found to be affective, yet did not give a positive evaluation
      of children's behavior and used fear control extensively, thus made their
      children dependent. 2. There were no significant differences in child rearing
      attitude by children's sex and age. 3. There were no significant differences in
      child rearing attitudes by mother's age, education level and religion. 4. There
      was no significant difference in child rearing attitudes by father's occupation.

PMID- 2232441
TI  - [Primaparas' perceptions of their delivery experience and their maternal-infant
      interactions: compared according to delivery method].
AB  - One of the important tasks for new parents, especially mothers, is to establish
      warm, mutually affirming interpersonal relationships with the new baby in the
      family, with the purpose of promoting the healthy development of the child and
      the wellbeing of the whole family. Nurses assess the quality of the behavioral
      characteristics of the maternal-infant interaction. This study examined the
      relationships between primiparas perceptions of their delivery experience and
      their maternal infant interaction. It compared to delivery experience of mothers
      having a normal vaginal delivery with those having a cesarean section. The
      purpose was to explore the relationships between the mother's perceptions of her
      delivery experience with her maternal infant interaction. The aim was to
      contribute to the development of theoretical understanding on which to base care
      toward promoting the quality of maternal-infant interaction. Data were collected
      directly by the investigator and a trained associate from Dec. 1, 1987 to March
      8, 1988. Subjects were a random sample of 62 mothers, 32 who had a normal vaginal
      delivery and 30 who had a non-elective cesarean section (but without other
      perinatal complications) at three general hospitals in Seoul. Instruments used
      were the Stainton Parent-infant Interaction Scale (1981) and the Marut and Mercer
      Perception of Birth Scale (1979). The first observations were made in the
      delivery room (for vaginally delivered mothers only), followed by day 1, day 2,
      day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8
      contacts (Cesarean section mothers were observed on days 4 and 5 but the data not
      used for analysis). Observations in the hospital were made during the hour prior
      to scheduled feedings. The infant was placed beside the mother. Later contacts
      were made at home. Data analysis was done by computer using as SPSS program and
      included X2 test, paired t-test, t-test, and Pearson Correlation coefficient: the
      results were as follows. 1. Mothers who had a normal vaginal delivery tended to
      perceive the delivery experience more positively than cesarean section mothers (p
      = 0.002). The finding supported the hypothesis I that perception of delivery
      would vary according to the method of delivery. Mother's perceptions of birth
      were classified into three dimensions, labor, delivery and the baby. There was a
      significantly different and positive perception by the vaginally delivered
      mothers to the delivery experience (p = 0.000) but no differences for labor or
      the baby according to the delivery method (p = 0.096, p = 0.389).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2232442
TI  - [Effect of individual patient teaching through home visiting on compliance with
      sick role behavior in diabetic patients and duration of the effect of the
      teaching].
AB  - In order to determine the effect of individual patient teaching through home
      visiting on compliance with sick role behavior and the blood sugar level in
      diabetic patients, to determine if the effectiveness of the education was still
      present four years later and to inquire as to the effective time for a repeat
      education program this study was done through two quasi-experimental researches.
      The subjects consisted of 52 diabetic patients. The results of the study may be
      summarized as follows: 1. Hypothesis I, in which the compliance with sick role
      behavior, the knowledge on diabetes and the health belief of the experimental
      group who received a diabetic education program will be higher than those of the
      control group who didn't receive the diabetic education, was supported by both
      studies in 1984 and 1988, confirming the effect on diabetic patients of the
      individualized education through home visiting: In the 1984 study: Compliance(t =
      -11.7, p less than .001) Knowledge(t = -5.41, p less than .001) Health belief(t =
      -4.74, p less than .001) In the 1988 study: Compliance(t = -4.85, p less than
      .001) Knowledge(t = -2.85, p less than .01) Health Belief(t = -2.99, p less than
      .005) 2. The Hypothesis II, the blood sugar level of the experimental group will
      be lower than that of the control, was rejected in both studies, 1984 and 1988.
      3. The Hypothesis III, the compliance, knowledge and health belief of the
      experimental group who received the education program in 1984 will not last till
      1988, was supported in part, in compliance and health belief, but not in
      knowledge. In conclusion those who received the education program twice with an
      interval of 2 weeks, 4 years ago still had knowledge of diabetes but compliance
      and health belief had disappeared.

PMID- 2232443
TI  - [A study on the relationships of discomfort, self-esteem, personality and life
      satisfaction in persons with rheumatoid arthritis].
AB  - The purpose of this study was to investigate the correlation of discomfort, self
      esteem, personality and life-satisfaction in persons with rheumatoid arthritis
      and to provide basic data to help them attain a better quality of life. From Jan.
      27 to Feb. 24, 1988, 53 patients, registered at a rheumatic clinic at one general
      hospital in Seoul, were accepted as subjects for this study. The instruments used
      for this study were a discomfort scale and life-satisfaction scale developed by
      the researcher, Rosenberg's Self-esteem Scale and Wallston and Wallston's
      Multidimensional Health Locus of Control (MEILC) Scale. The reliability of the
      scales were tested by Cronsbach's alpha. The collected data were analyzed by the
      SAS program using unpaired t-test, ANOVA, and Pearson's Correlation Coefficients.
      The results were as follows: 1. There was a significant difference in the
      subjects perceived discomfort level (t = -3.49, p = .0010) between the onset of
      the disease (14.87 +/- 9.02) and the present (19.87 +/- 8.44). 2. There was a
      significant correlation between the MHLC-internal score and the MHLC-chance score
      (r = -.4366, p = .0011). 3. The findings related to the demographic variables
      regarding the MHLC scores were as follows: 1) Regarding sex, there was a
      significant difference for the MHLC-internal score (t = 4.2572, df = 15.2, p =
      .0007) between male (32.13 +/- 2.47) and female (27.56 +/- 4.17). But the MHLC
      chance score for male (15.13 +/- 2.85) was lower (t = 3.153 9, df = 21.8, p =
      .0047) than for female (19.47 +/- 6.29). 2) Regarding educational background, the
      MHLC-chance score for the below-high school group (20.52 +/- 5.81) was higher (t
      = 2.5450, df = 51.0, p = .0140) than the college graduate group (16.41 +/- 5.76).
      4. The average Self-esteem score was 26.87 (S.D. = 5.29) and there was a
      significant correlation between the Self-esteem score and the MHLC-chance score
      (r = .3122, p = .0026). 5. It was found that the subjects' Discomfort score was
      correlated with the Self-esteem score (r = -.3788, p = .0051) and the Life
      satisfaction score (r = -.3570, p = .0087). It was also found that subjects' Self
      esteem score was correlated with the Life-satisfaction score (r = .4474, p =
      .0008).

PMID- 2232445
TI  - [Influence of stress experience on change of attention].
AB  - For a man to maintain attention, he needs to keep a certain level of arousal. An
      inordinate increase or decrease in the level of arousal eventually has a negative
      influence on attention. Precedent research has shown that the degree of attention
      changes when an experience of stress is related to anxiety resulting in a rise in
      arousal. This research was done to examine this hypothesis by looking at the 27
      female students, 14 of whom had failed in the annual examination. The results of
      the investigation are as follows: The stress of failure in the examination was
      seen to raise the level of physiological arousal. Although pulse and
      electromyography showed no significant change, further inquiries should be made
      based on other types of methodology. In spite of the rise of arousal, the
      performance of selective task was degraded. This suggests those students failed
      to give moderate attention to given information for that kind of task. But the
      exact reason of that failure was not identified: that is it was difficult decide
      whether they gave too much attention to the anxiety brought about by stress.
      Performance of integral tasks, however, did not show any degradation. Judging
      from these results, stress seems to exert significant influence on attention in
      the selection of the appropriate information among the various options given.
      This offers an important hint in relation to the health care situation where
      nursing information is offered. Clients who receive nursing information in
      stressful situations may have difficulty in separating and selecting this helpful
      information from other options which they have acquired through their life
      experience. The content and terminology of nursing information may be strange and
      unintelligible to clients, although they are quite familiar and distinct to
      nurses. So, it is desirable for nurses to give, in addition and at the same time
      when nursing information is given, some certain related information as devices
      for selection, instead of merely giving nursing informations as such. So far it
      is not clear whether the concepts of information processing theory can be
      suitably applied to nursing. However, it is obvious, according to this research,
      that the quality of attention is disturbed in the stress situation. This is why
      further inquiries should be made into attention in practical nursing situation.

PMID- 2232444
TI  - [The effect of EMG level by EMG biofeedback with progressive muscle relaxation
      training on tension headache].
AB  - The purpose of this study is to assess if EMG biofeedback training with
      progressive muscle relaxation training is effective in reducing the EMG level in
      patients with tension headaches. This study which lasted from 23 October to 30
      December 1989, was conducted on 10 females who were diagnosed as patients with
      tension headaches and selected from among volunteers at C. University in Seoul.
      The process of the study was as follows: First, before the treatment, the
      baseline was measured for two weeks and the level of EMG was measured five times
      in five minutes. And then EMG biofeedback training was used for six weeks, 12
      sessions in all, and progressive muscle relaxation was done at home by audio tape
      over eight weeks. Each session was composed of a 5-minute baseline, two 5-minute
      EMG biofeedback training periods and a 5-minute self-control stage. Each stage
      was followed by a five minute rest period. So each session took a total of 40
      minutes. The EMG level was measured by EMG biofeedback (Autogenic-Cyborg: M 130
      EMG module). The results were as follows: 1. The average age of the subjects was
      44.1 years and the average history of headache was 10.6 years (range: 6 months-20
      years). 2. The level of EMG was lowest between the third and the fourth week of
      the training except in Cases I and IV. 3. The patients began to show a
      nonconciliatory attitude at the first session of the fifth week of the training.

PMID- 2232446
TI  - [An operations study on a home health nursing demonstration program for the
      patient discharged with chronic residual health care problems].
AB  - The study was conceived in relation to a concern over the growing gap between the
      needs of chronic patients and the availability of care from the current health
      care system in Korea. Patients with agonizing chronic pain, discomfort, despair
      and disability are left with helplessly unprepared families with little help from
      the acute care oriented health care system after discharge from hospital. There
      is a great need for the development of an alternative means of quality care that
      is economically feasible and culturally adaptable to our society. Thus, the study
      was designed to demonstrate the effectiveness of home health care as an
      alternative to bridge the existing gap between the patients' needs and the
      current practice of health care. The study specifically purports to test the
      effects of home care on health expenditure, readmission, job retention,
      compliance to health care regime, general conditions, complications, and self
      care knowledge and practices. The study was guided by the operations research
      method advocated by the Primary Health Care Operations Research Institute
      (PRICOR) which constitutes 3 stages of research: namely, problem analysis
      solution development, and solution validation. The first step in the operations
      research was field preparation to develop the necessary consensus and
      cooperation. This was done through the formation of a consulting body at the
      hospital and a steering committee among the researchers. For the stage of problem
      analysis, the Annual Report of Seoul National University Hospital and the
      patients records for last 5 years were reviewed and selective patient interviews
      were conducted to find out the magnitude of chronic health problems and areas of
      unmect health care needs to finally decide on the kinds of health problems to
      study. On the basis of problem analysis, the solution development stage was
      devoted to home care program development asa solution alternative. Assessment
      tools, teaching guidelines and care protocols were developed and tested for their
      validity. The final stage was the stage of experimentation and evaluation.
      Patients with liver diseases, hemiplegic and diabetic conditions were selected as
      study samples. Discharge evaluation, follow up home care, measurement and
      evaluation were carried out according to the protocols of care and measurement
      plan for each patient for the period of 6 months after discharge. The study was
      carried out for the period from Jan. 1987 to Dec. 1989. The following are the
      results of the study presented according to the hypotheses set forth for the
      study; 1.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2232447
TI  - [A study of the ethical values of Korean nurses].
AB  - The purpose of this study is to identify whether ethical values of Korean nurses
      are deontological or utilitarian. Nurse's ethical value questionnaire was
      developed from review of literature and interview of nurses in the clinical
      settings. Content validity was tested from three nursing faculties and staffs.
      Ethical problems are categorized into four areas: 1) human life area 2) nurse
      patient relationship area 3) nurse-nursing task relationship area 4) nurse
      colleague relationship area The data were obtained from the 404 nurses in the
      clinical settings from Feb. to Mar. in 1990 by ethical value questionnaire. The
      analysis of data was done by Pearson's correlation coefficient, t-test, anova.
      The results of this study were as follows: 1. The ethical values of human life
      slightly took up the position of utilitarian. 2. The ethical values of nurse
      patient relationships slightly took up deontological position. 3. The ethical
      values of nurse-nursing task relationships slightly took up deontological
      position. 4. The ethical values of nurse-colleague relationships greatly took up
      deontological position. 5. The ethics of nurses related to demographic
      characteristics of religion, attitude of nursing, ethical standards, education
      level and post. Those who have religion took up more deontological position than
      those who have not. Those who have positive attitude of nursing and firm ethical
      standards took up more deontological position than those who have not. Those who
      have higher education level and post took up more deontological position than
      those who have not.

PMID- 2232448
TI  - Future trends in nursing education.

PMID- 2232449
TI  - Computer-based video instruction in nursing: one nurse's experience as author.

PMID- 2232451
TI  - Kansas Newman College off-campus BSN program for R.N.'s.

PMID- 2232450
TI  - Converting the last diploma school in Kansas: a perpetual of caring.

PMID- 2232452
TI  - [Genetic aspects of systemic arterial hypertension].

PMID- 2232453
TI  - [Comparative study of the hypotensive action of monotherapy using
      hydrochlorothiazide and its combination with triamterene and amiloride and their
      effect on hemodynamics at rest and during exercise therapy].
AB  - A comparative study was undertaken to examine antihypertensive effects and impact
      of hydrochlorothiazide (HCT) alone or in combination with triamterene or
      amiloride on the hemodynamics of 79 patients with Stage II hypertension. With
      small doses, the resting recumbent systolic blood pressure was decreased to a
      significantly greater extent when the combinations (HCT + triamterene, in
      particular HCT + amiloride) were used than when the agent alone was given;
      diastolic blood pressure became lower only with a combination of HCT + amiloride
      than its monotherapy. When double doses were used, no potentiating
      antihypertensive action of potassium-sparing diuretics was ascertained. It was
      concluded that it was more preferable to use HCT in combination with diuretics,
      amiloride in particular, than as monotherapy.

PMID- 2232454
TI  - [Changes in lipid fractions of blood during the treatment of hypertension with
      prazosin and trasicor].
AB  - The paper deals with the study into the benefits of prazosin and trasicor used in
      arterial hypertension. Their effects on the blood lipid composition were
      evaluated. With prazosin, the steady antihypertensive effect was reached in
      81.0%, whereas with trasicor, it was attained in 46%. When prazosin was given,
      total cholesterol and triglycerides were statistically significantly decreased by
      6.8 and 14.8%, respectively, while high density lipoproteins was increased by
      9.1%. When trasicor was administered, no changes were observed in the spectrum of
      serum lipids. Thus, prazosin is effective in correcting two major risk factors
      for coronary heart disease, namely arterial hypertension and
      hyperlipoproteinemia, thereby reducing a risk for coronary heart disease.

PMID- 2232455
TI  - [Changes in various biophysical parameters of blood circulation during physical
      exertion in patients with a mild form of hypertension].
AB  - Sixty four patients (mean age, 46 +/- 3.1 years) with mild hypertensive disease
      (MHD) were examined. The diastolic pressure recorded in MHD patients in the
      control period ranged from 95 to 104 mm Hg. There was no evidence of left
      ventricular hypertrophy (LVH) in 46 patients, whereas 16 had significant signs of
      LHN. MHD patients without LVH signs showed regularly increased cardiac mechanical
      performance and its static component through slightly diminished propulsive
      performance of the myocardium. As moderate LVH evolved in MHD patients, a
      reduction in kinetic energy of cardiac output was observed, which tended to
      decrease the static component of mechanical work of the heart, which suggested
      that the adaptive response of the circulatory system was impaired to some extent.

PMID- 2232456
TI  - [Characteristics of peripheral circulation and tissue metabolism in patients with
      functional venous hypertension and various forms of arterial hypertension].
AB  - Venous-occlusion plethysmography was used to examine peripheral hemodynamics.
      Oxygen transport, serum lactate and pyruvate levels, and ++intra-tissue pressure
      in the forearm muscles were studied. A total hypoxemic test was employed as a
      functional tool. The findings suggest that the changes in venous blood flow and
      tone, transcapillary and tissue metabolism are unidirectional in functional
      venous hypertension, borderline hypertension, and hypertensive disease, which
      should be taken into account in the diagnosis and treatment.

PMID- 2232457
TI  - [Regulation of calcium metabolism in hypertension].
AB  - In patients with hypertensive disease, the intravenous calcium tolerance test
      revealed a delayed elimination of loading hypercalcemia, which totally reflects
      the effectiveness mechanisms aimed at removing excessive calcium from the
      extracellular space. In hypertensives, renal calcium excretion was also delayed
      due to a lower suppression of calcium channel reabsorption. The patients showed a
      greater background concentration of parathyroid hormone (PTH) and during the
      calcium tolerance test a much lower PTH levels and higher calcitonin
      concentrations, though their homeostatic effects remained inadequate due to their
      diminished sensitivity of target organs. Thus, there was an increase in the
      activity of parathyroidal glands in patients with hypertensive disease.

PMID- 2232458
TI  - [Use of autologous pericardium in plastic surgery of the right coronary artery in
      patients with ischemic heart disease].
AB  - The paper describes the procedure developed by the authors for surgical
      myocardial revascularization in patients with coronary heart disease (CHD) via
      direct reconstruction of the ostium and all the segments of the right coronary
      artery by performing direct endarterectomy and subsequent plasty with free
      autopericardial flaps. The findings indicate that this surgical method is
      beneficial for CHD patients. In some cases, it may be the method of choice in the
      surgical treatment of CHD patients.

PMID- 2232459
TI  - [Work capacity of patients with ischemic heart disease after aortocoronary
      bypass].
AB  - A comparison was made of the clinicofunctional efficiency and social significance
      of surgical therapy techniques in patients with coronary heart disease (CHD). One
      hundred and seventy eight patients aged 25 to 59 years who had been operated on
      in the A. N. Bakulev Institute of Cardiovascular Surgery from 1984 to 1987 were
      examined. In prolonged periods (mean 2.8 +/- 0.2 years) following surgeries,
      85.6% of the patients showed clinical improvement as compared to the preoperative
      period. At the same time, a total of 43.3% of the patients returned to work, the
      figure being much less than that observed in the preoperative period. (78.1%).
      Following the surgery, there was a high rate (94.4%) of disability. Two groups of
      factors were defined, which determined the patients' return to work after
      coronary aorta bypass grafting. The low work resumption and high disability rates
      after surgery are due to the lack of a national social rehabilitation programme
      for this group of patients.

PMID- 2232460
TI  - [Clinical evaluation of transient myocardial ischemia].
AB  - Out of 432 patients with coronary heart disease, 106 (24.5%) were found to have
      transient myocardial infarction during ECG monitoring of ST segment for 10 hours
      of daily activity. High-grade ventricular arrhythmias were revealed in 74.6% of
      mainly male and middle-aged subjects. 63.4% of the patients exhibited congestive
      heart failure, 48.1% had postinfarct cardiosclerosis, and 25.5% presented with
      diabetes mellitus. Transient myocardial ischemia was more frequently detected
      during exercise and more rarely during emotional stress (21.7%), meal (19.8%),
      and smoking (7.8%). Asymptomatic episodes of ST segment elevation were recorded
      in 36.8%, while asymptomatic episodes of ST segment depression, in 29.2%. The
      duration of asymptomatic episodes of ST segment elevation and depression was
      twice and 1.5 times, respectively, less than that of symptomatic ones.
      Substantial myocardial perfusion and metabolic impairments were revealed with an
      asymptomatic ST segment depression frequency of at least one an hour, an
      amplitude of more than 2 mm, and a duration of no less than 40 min.

PMID- 2232461
TI  - [Study of metabolic characteristics in patients with ischemic heart disease based
      on the insulin test].
AB  - The study was undertaken to examine 68 healthy males and 34 patients with
      Functional Class I coronary heart disease. The insulin test (fasting intravenous
      simple insulin, 0.15 U/kg body weight, was given in the morning) was performed.
      The study was conducted in 3 stages: 1) before, 2) 30 min, and 3) 2 hr after
      insulin administration. Examination of glycemia and gas exchange revealed changes
      resulting in impaired energy supply of the body in CHD. In CHD patients, the
      enhanced glucose uptake after insulin was followed by abnormalities both in
      aerobic and anaerobic glucose oxidation. The insulin test detected the signs of
      excessive overtension and diminished reserve potentialities of the sympathetic
      adrenal system early in CHD.

PMID- 2232462
TI  - [Various indicators of vascular-thrombocytic hemostasis and blood rheology in
      ergometrine tests].
AB  - The function of platelets and erythrocytes and content of Willebrand's factor in
      the plasma from 45 patients with exercise-induced or spontaneous angina pectoris
      were examined before and after ergometrine, 0.1 mg. The patients with a negative
      ergometrine response showed a lower platelet sensitivity to all the aggregation
      inductors used in vitro, spontaneous platelet aggregation being absent. The
      function of erythrocytes and plasma levels of Willebrand's factor remained
      unchanged. The patients with a significant ischemic response to ergometrine
      exhibited platelet activation attended by the release of granule contents and
      formation of blood circulating platelet microaggregates. Concurrently, there was
      a decrease in erythrocyte deformability, as well as spontaneous blood red cell
      aggregation, the plasma levels of Willebrand's factor were increased 1.5-2-fold.

PMID- 2232463
TI  - [Treatment of patients with arterial hypertension and the ways of its optimal
      management (results of long-term and controlled therapy)].

PMID- 2232464
TI  - [Antioxidant emoxipin: its effect on the formation of a necrotic focus and
      reparative processes in myocardial infarction].
AB  - The effect of the water soluble antioxidant emoxipin given intravenously in a
      dose of 10 mg/kg for 5 days, then intramuscularly 1 mg/kg for 15 days. Comparison
      with the values found in the control group of patients with myocardial infarction
      revealed that emoxipin contributed to limitation of the size of a necrotic focus
      and accelerated reparative processes, whose result was a lower incidence of
      circulatory failure. One of the main mechanisms responsible for beneficial
      effects of emoxipin on the clinical course of myocardial infarction consists in
      normalization of lipid peroxidation and parameters of the antioxidative status.

PMID- 2232465
TI  - [Use of integral indicators of precordial mapping in differential diagnosis of
      focal-cicatricial lesions of the myocardium].
AB  - The paper proposes new criteria for differential diagnosis of myocardial "focal
      scarring" and "++pseudo-scarring" changes in various cardiac abnormalities and
      homogeneous morphological alterations in the ventricular complex on ECG (the QS,
      Qr-type abnormalities of the R line) by using the findings of 35 lead ECG mapping
      (PM-35). ECG-12 and PM-35 were analysed in 427 patients, including those with
      coronary heart disease (n-122), arterial hypertension and aortic malformations (n
      130), dilated cardiomyopathy, congenital cardiac disease (n-175).
      Electrocardiographic signs of focal scarring lesions were revealed in all the
      cases with coronary heart disease and 66 with myocardial hypertrophy. The total
      value of ST segment depression and the sum of Q wave squares in three to five
      vertical mapping columns were found to be the most significant differential and
      diagnostic criterion. When scars and ++pseudo-scars were differentiated, a
      sensitivity of 75% was obtained at a specificity of 87%.

PMID- 2232466
TI  - [Diagnostic and prognostic value of quantitative indicators of 12 ECG leads in
      ischemic heart disease].
AB  - The study was undertaken to examine 35 patients with chronic coronary heart
      disease and 20 patients with neurocirculatory dystonia concurrent with the
      cardialgic syndrome, the latter were enrolled into a control group. Detection of
      sigma R in the standard leads of resting ECG and at the peak of atrial pacing
      made it possible to single out groups of chronic coronary heart disease patients,
      which differed in clinical manifestations of the disease, myocardial
      contractility, hemodynamics, and myocardial lactate extraction. In patients with
      chronic coronary heart disease ti is recommended to use ECG measurements (sigma R
      and nST) in the standard leads during loading tests to give a comprehensive
      characterization of the pump function and the severity of myocardial ischemia,
      the prognosis of the natural history of the disease and risk for myocardial
      infarction. To enhance the sensitivity and specificity of loading tests, it is
      recommended to take into account higher sigma R in combination with ST segment
      depression when the results of the tests are assessed.

PMID- 2232467
TI  - [Neuro-psychological status and its role in the formation of adaptive
      compensatory reactions in patients with myocardial infarction].
AB  - The course of adaptative and compensatory responses are associated not only with
      the extent of myocardial lesion, but with the status of ++psycho-autonomic
      regulation. Lack of true psychogenias and nervous and mental disorders, mainly
      the adrenomedullary pattern of sympathetic activation in the acute period of the
      disease contribute to stabilization of cardiovascular values and an uncomplicated
      course of myocardial infarction. On the contrary, asthenization of the ++neuro
      mental sphere due to premorbid conflict was accompanied largely by a
      noradrenaline++ sympathetic activation and reversible complications of myocardial
      infarction. Prolonged psychogenias and neurotic personality disadaptation
      promotes the development of depressive and hypochondriacal disorders in the acute
      period of the disease; these are followed mainly by parasympathetic autonomic
      responses and concurrent with severe myocardial infarction.

PMID- 2232468
TI  - [Radiocardiography and rheography of the pulmonary artery in the diagnosis of
      disorders of hemodynamics and right-ventricular contractility in patients with
      chronic obstructive bronchitis].
AB  - Radiocardiography and rheography of the pulmonary artery were used to examine
      impairments in hemodynamics and contractile function of the right ventricle in 40
      patients with chronic obstructive bronchitis complicated with persistent
      hypertension. Right ventricular hemodynamic and contractile impairments were
      shown to be not equivalent with similar clinical and functional signs of
      pulmonary hypertension. This fact indicates that the use of special techniques is
      of practical value in the determination of right ventricular hemodynamics and
      myocardial contractility in patients with chronic obstructive bronchitis.
      Radiocardiography and rheography of the pulmonary artery are sufficiently
      reliable noninvasive techniques for examining the hemodynamics and contractile
      function of the right ventricular myocardium.

PMID- 2232469
TI  - [Effect of the optimal dose of finoptin on various components of the circulatory
      system in heart failure in patients with ischemic heart disease].
AB  - Following sublingual finoptin and following its course therapy, 27 patients with
      coronary heart disease in the presence of Stages I-IIA circulatory failure
      displayed positive central hemodynamic changes, myocardial contractile function
      improvement, afterload decrease, and a tendency to normalization of vascular and
      intravascular alterations.

PMID- 2232470
TI  - [Clinico-functional characteristics of patients with arteriosclerosis obliterans
      of the lower extremities and painless myocardial ischemia].
AB  - During manually performed exercise, ECG revealed silent myocardial ischemia
      related ST segment depression in 62 patients with atherosclerosis obliterans in
      the lower limbs in the absence of evident signs of coronary abnormalities. The
      patients displayed decreased cardiac output, elevated total peripheral
      resistance, structural and functional alterations in the end blood flow system,
      and diminished exercise tolerance as compared to healthy subjects and
      atherosclerosis obliterans patients with negative loading tests. The
      aforementioned abnormalities were also revealed in subjects suffering from
      atherosclerosis obliterans in the lower limbs and documented coronary heart
      disease.

PMID- 2232471
TI  - [Pathophysiological and clinical evaluation of the effectiveness of dalargin in
      the treatment of arterial occlusive diseases of the lower extremities].
AB  - Eighty seven patients with Stages II-III vascular occlusions in the lower
      extremities were examined. The clinical and biochemical parameters of the course
      of the disease were found to improve in the patients who received in earlier
      periods dalargin supplemented to the combined therapy than in those from a
      matched group. There was a decrease in femoral venous blood lactate
      concentrations in the diseased extremity, blood cholesterol and parathyroid
      hormone levels. The mechanisms responsible for effects of dalargin on metabolic
      parameters and clinical indices of the patients' condition were also discussed.
      Whether it is possible to use dalargin in the combined therapy for extremity
      vascular occlusive diseases is considered.

PMID- 2232472
TI  - [Plasma mineralocorticoids--aldosterone and desoxycorticosterone-- in patients
      with"low-renin"arterial hypertension].
AB  - The plasma aldosterone (A) and desoxycorticosterone (DOCS) levels were measured
      in 10 patients with primary aldosteronism and in 2 subgroups with low-renin
      hypertensive disease (LRHD): (1) those with normal adrenal glands++ (n - 11) and
      (2) those with structural changes in the cortex (n - 11). The patients from
      Subgroup 1 showed the lowest basal A and DOCS levels (107.29 +/- 12.90 and 0.080
      +/- 0.013 ng/ml, respectively) and low concentrations of the two hormones after
      stimulation of 4-hour walk (211.57 +/- 30.47 and 0.095 +/- 0.024 ng/mg,
      respectively). In the patients from Subgroup 2, the basal and 4-hour post-walk++
      A and DOCS contents were increased in the cortex (basal 201.50 +/- 41.59 and
      0.177 +/- 0.36 ng/mg and poststimulation 331.33 +/- 30.47 and 0.302 +/- 0.061
      ng/ml, respectively). Some patients with primary aldosteronism displayed the same
      DOCS response to stimulation as did those with LRHD in the presence of structural
      cortical changes. Histological examination of operative biopsy specimens
      indicated that higher DOCS levels were associated with diffuse nodal hyperplasia
      of the zona fasciculata in the cortex. The results suggest that there may be a
      LRHD variant running with excessive DOCS secretion and related to
      pathogenetically related to hyperplasia of predominantly the zone fasciculata in
      the adrenal cortex.

PMID- 2232473
TI  - [Predicting congenital cardiovascular defects on the basis of their immunogenetic
      characteristics].
AB  - The study was undertaken to examine 80 children with congenital heart and vessel
      malformations, their parents (50 married couples), and 100 families with healthy
      children. The antigen typing of the HLA system was accomplished by using the
      Terasaki microlymphocytotoxic test. A statistically significant correlation was
      found between B35 antigens and septal malformations, vascular diseases, and
      congenital cardiomyopathies. The unfavorable obstetric history was shown to play
      a role in the occurrence of developmental malformations. The data of an analysis
      of HLA antigens in the parents of the children with congenital malformations
      suggest that a marked HLA antigen compatibility of married couples is one of the
      cause of pregnancy complications and developmental malformations in their
      offspring.

PMID- 2232474
TI  - [A method of modeling of occlusion-reperfusion induced myocardial infarction and
      quantitative evaluation of the effectiveness of limitation of its size].
AB  - An experimental mathematical model was proposed to assess the efficiency of
      experimental myocardial infarction (MI) size limitation. A canine model of
      occlusion-reperfusion myocardial lesion was used in an acute experiment with an
      open chest. 90-minute occlusion and 4-hour reperfusion were performed by carotid
      coronary bypass surgery. The necrotic zone and the risk area were visualized by
      double perfusion with tetrazolium staining. Retrograde coronary blood flow was
      used as a measure of collateral blood flow. The multiple linear regression
      equation with values of the risk zone and retrograde blood flow/risk area ratio
      used as independent variables enabled the size of myocardial infarction to be
      highly accurately predicted. Comparison of the true size of MI with the
      "expected" one provided methods for quantitative assessment of pharmacological
      limitation of MI sizes. Calculating an individual value for each animal made it
      possible to examine its relation to coronary circulation parameters and
      facilitated comparison of benefits from various agents.

PMID- 2232475
TI  - [Central, pulmonary and cerebral hemodynamics in various stages and hemodynamic
      variants of hypertension].

PMID- 2232476
TI  - [Evaluation of hemodynamic changes after repeated trans-esophageal cardiac
      electric stimulation in the diagnosis of ischemic heart disease].

PMID- 2232477
TI  - [Psychological reactions of patients with ischemic heart disease to aortocoronary
      bypass].

PMID- 2232478
TI  - [Use of trans-esophageal cardiac electric stimulation in the evaluation of anti
      arrhythmia therapy in patients with paroxysms of atrial fibrillation and atrial
      flutter].

PMID- 2232479
TI  - [Active detection of arrhythmia in patients with cardiac and extracardiac
      pathology].

PMID- 2232480
TI  - Summary: Symposium on Lymphocyte Activation.

PMID- 2232481
TI  - Is glomerulosclerosis a consequence of altered glomerular permeability to
      macromolecules?

PMID- 2232482
TI  - Glomerular basement membrane degradation by endogenous cysteine proteinases in
      isolated rat glomeruli.
AB  - Recent in vitro and in vivo studies suggest that cysteine proteinases may play an
      important role in degradation of the glomerular basement membrane (GBM) by renal
      glomeruli. However, little information is available concerning the cysteine
      proteinases present in glomeruli, the distribution of cysteine proteinases in
      other areas of the kidney, or the potential role of endogenous glomerular
      cysteine proteinases in GBM degradation. Using well characterized fluorogenic
      substrates, we have documented the presence of the cysteine proteinases,
      cathepsins B, H, and L, in glomeruli (0.45 +/- 0.06, 0.39 +/- 0.05, and 0.66 +/-
      0.14 mU/mg protein, mean +/- SEM, N = 8) and other fractions prepared from normal
      rat kidney. The presence of cysteine proteinases in glomeruli was verified by
      fluorescence microscopy. For each proteinase, the activity was: proportional to
      the amount of tissue protein and time of incubation; dependent on the presence of
      exogenously added dithiothreitol; and completely inhibited by the specific
      cysteine proteinase inhibitor, E-64. The pH optimum for cathepsin B (substrate: Z
      Arg-Arg-HNMec) and L (substrate: Z-Phe-Arg-HNMec in the presence of Z-Phe-Phe
      CHN2) was approximately pH 6.0 for both glomeruli and renal cortex; while that
      for cathepsin H (substrate: Arg-HNMec) was approximately 6.5. Incubation of
      sonicated glomeruli with 3H-GBM under conditions optimal for cysteine proteinase
      activity (pH 4.5, 1 mM EDTA, and 1 mM dithiothreitol, 37 degrees C) resulted in
      significant GBM degradation as measured by the release of non-sedimentable
      (10,000 x g, 10 min) radioactivity or hydroxyproline.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2232484
TI  - Renin release from microdissected superficial, midcortical, and juxtamedullary
      afferent arterioles in rabbits.
AB  - Renal renin content and release decrease from outer to inner cortex; this may be
      due to a cortical-to-medullary gradient in glomerular density and/or renin
      content per afferent arteriole. Although low sodium diets have been reported to
      decrease the tissue renin gradient, little information is available on renin
      release by different areas of the renal cortex or the effect of a low sodium
      diet. In the present study, we examined basal- and isoproterenol-stimulated renin
      release and content in microdissected superficial, midcortical, and
      juxtamedullary afferent arterioles from rabbits on normal and low sodium diets.
      Renin content was 25.8 +/- 3.6, 1.4 +/- 0.32, and 0.27 +/- 0.09 ng angiotensin I
      (Ang I)/hour/arteriole in the superficial, midcortical and juxtamedullary
      arterioles, respectively. Dietary sodium restriction significantly increased it
      to 60.1 +/- 7.3, 13.8 +/- 3.1, and 1.48 +/- 0.6, respectively. Renin release was
      0.64 +/- 0.13, 0.15 +/- 0.04, and 0.025 +/- 0.013 ng Ang I/hour/arteriole/hour
      incubation of arteriole in the superficial, midcortical and juxtamedullary
      arterioles, respectively. With sodium restriction it increased significantly for
      the superficial, (1.77 +/- 0.27) and midcortical (0.62 +/- 0.11) but not the
      juxtamedullary arterioles (0.038 +/- 0.02). With either diet, renin release and
      content among the three types of arterioles were significantly different.
      Isoproterenol (1.6 x 10(-4) M) significantly stimulated renin release from all
      three types of arterioles whether rabbits were fed a normal or low sodium diet;
      however, only in the superficial arterioles was the increase (delta) greater with
      dietary sodium restriction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232483
TI  - Effect of chronic respiratory acidosis on urinary calcium excretion in the dog.
AB  - It is currently believed that the two chronic acidemic disorders exert disparate
      effects on urinary calcium excretion: chronic metabolic acidosis induces
      consistent hypercalciuria, but no appreciable change or even a decrease in
      calcium excretion is reported to attend chronic respiratory acidosis. Whereas the
      effect of metabolic acidosis is well documented, little work has been carried out
      in chronic hypercapnia. In fact, most of the studies on chronic respiratory
      acidosis were short in duration, had employed only mild hypercapnia, or had
      failed to control carefully the prevailing metabolic conditions. We have carried
      out balance observations in nine dogs exposed to a 10% CO2 atmosphere in an
      environmental chamber for a period of two weeks. Chronic respiratory acidosis led
      to a significant increase in urinary calcium excretion from a mean control value
      of 0.4 +/- 0.1 mmol/day to 0.6 +/- 0.1 mmol/day during both week 1 and 2 of
      hypercapnia (P less than 0.05). Hypercalciuria occurred even though filtered load
      of calcium fell. Mean fractional excretion of calcium increased significantly
      during each week of hypercapnia averaging 0.60 +/- 0.12% during control, 1.05 +/-
      0.13% during week 1, and 1.26 +/- 0.17% during week 2 of hypercapnic exposure (P
      less than 0.05). There were no changes in plasma levels of immunoreactive
      parathyroid hormone or 1,25-dihydroxyvitamin D3. These findings suggest that
      chronic respiratory acidosis, just like chronic metabolic acidosis, augments
      urinary calcium excretion by a direct depressive effect on the tubular
      reabsorption of calcium.

PMID- 2232485
TI  - Nephron function in the early phase of ischemic renal failure. Significance of
      erythrocyte trapping.
AB  - Trapping of red blood cells (RBCs) in renal medulla vasculature in postischemic
      acute renal failure (ARF) was found to depend upon the length of the ischemic
      period. Thus trapping occurred after 45 minutes but not 25 minutes of ischemia.
      By prior hemodilution to a hematocrit (hct) of 30%, RBC trapping after 45 minutes
      of ischemia could be completely prevented. Likewise hemo-concentration (hct =
      60%) before 25 minutes of ischemia resulted in extensive RBC trapping. By
      increasing or decreasing the hct, the contribution of RBC trapping to the
      functional defects and decrease in renal blood flow that follows minor (25 min)
      and more substantial (45 min) ischemia was investigated. Renal blood flow (RBF)
      was measured by microspheres, and vascular and tubular pressure by the
      micropuncture technique. Glomerular filtration rate (GFR) was estimated from
      inulin clearance, and tubular function from urine osmolality and sodium and
      potassium excretion. It was found that postischemic RBF was not correlated to RBC
      trapping but depended on the length of ischemia. After both 25 and 45 minutes of
      ischemia tubular obstructions occurred in the proximal tubules and/or loops of
      Henle, causing an increase in proximal tubular pressure. These obstructions were
      dependent on the length of ischemia but not on RBC trapping. After
      hemoconcentration and 25 minutes of ischemia there was an increment in distal
      tubular pressure, indicating that abundant RBC trapping may contribute to an
      increase in tubular pressure by compression of medullary tubules and thereby
      reduce GFR. When the damage was more severe other factors came into play and the
      contribution of RBC trapping to the decrease in GFR was minimal.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2232486
TI  - Effect of acute stimulation of renin secretion on renal renin content in vivo.
AB  - Acute stimulation of renal renin secretion has been reported to increase, not
      change, or decrease intra-renal renin (IRR) content. However, these effects and
      the potential mechanisms for acute changes in IRR content have not been studied
      directly. In this study, the effect of acute stimulation of renin secretion on
      IRR content was studied directly using a new in vivo blood perfused rabbit kidney
      preparation. Following removal of the right kidney for determination of IRR
      content (N = 7) the left kidney was cannulated and perfused for an average of 55
      minutes (baseline) at mean arterial blood pressure. Renin secretion by the left
      kidney was subsequently stimulated by reducing renal perfusion pressure to 60 mm
      Hg and administering enalapril, 1 mg/kg intravenously. After 38 to 140 minutes
      (mean 90 min) of stimulation, the left kidney was also removed and IRR content
      assessed. Renal blood flow and renin secretory rate (RSR) were determined
      frequently at baseline and following stimulation of renin secretion. The total
      amount of renin secreted in response to acute stimulation was calculated by
      integrating the RSR response over time. RSR from the left kidney increased by
      515% during acute stimulation. IRR content in the left kidney also increased and
      averaged 16% greater than the right kidney from the same animal. In order to
      account for all of the renin secreted as well as the increase in IRR content
      following acute stimulation, it was calculated that the renin synthesis rate
      would have been required to increase over 26-fold.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2232487
TI  - Role of enhanced glomerular synthesis of thromboxane A2 in progressive kidney
      disease.
AB  - Normotensive rats of the Milan strain (MNS) spontaneously develop focal
      glomerulosclerosis. In order to explore the contribution of glomerular
      thromboxane (TX) A2 synthesis to the development of the disease, we have
      characterized the time course of renal functional and biochemical changes, and
      their modification by long-term treatment with a TX-synthase inhibitor. Oral
      administration (150 mg.kg-1 from 1 to 14 months of age) of FCE 22178 suppressed
      enhanced glomerular TXB2 production at all experimental times (mean inhibition
      80%) and proteinuria (varying between 27.1 and 73.0%) while preserving renal
      blood flow and glomerular filtration rate. These effects of TX-synthase
      inhibition were seen in the absence of any statistically significant changes in
      systemic blood pressure. Moreover, FCE 22178 had no antihypertensive effects in
      hypertensive rats of the Milan strain (MHS) nor in spontaneously hypertensive
      rats (SHR). Treatment also prevented the age-related hypoalbuminemia and
      hyperlipidemia observed in control MNS and significantly (P less than 0.01)
      reduced glomerular histologic damage, as demonstrated by light microscopy studies
      and measurement of sclerotic area. We conclude that: 1) MNS rats provide an
      animal model of long-lasting proteinuria characterized by an age-related increase
      in glomerular TXB2 production paralleled by progressive loss of renal structural
      integrity and function and by a secondary dyslipidemia; 2) pharmacological
      inhibition of glomerular TX-synthase attenuates the structural as well as the
      functional expression of kidney disease, without a primary effect on systemic
      blood pressure. These data are suggestive of an important modulating role of TXA2
      in the progression of MNS renal disease.

PMID- 2232488
TI  - Mild ischemia predisposes the S3 segment to gentamicin toxicity.
AB  - The purpose of these studies was to determine if a functionally insignificant
      ischemic insult, occurring prior to gentamicin administration, enhanced
      gentamicin nephrotoxicity. Bilateral renal pedicle clamp studies demonstrated
      that 15 minutes of ischemia did not increase the plasma creatinine yet markedly
      enhanced gentamicin nephrotoxicity. Further studies, in uninephrectomized rats,
      demonstrated that following fifteen minutes of renal ischemia and four hours of
      reperfusion inulin clearance, FENa+ and cellular morphology were normal. This
      model, therefore, was used in all subsequent studies. While the plasma creatinine
      concentrations were normal 24 hours following 15 minutes of ischemia and only
      slightly increased following gentamicin administration (100 mg/kg, i.p.)
      gentamicin administered four hours following 15 minutes of renal ischemia
      resulted in significantly increased 24-hour plasma creatinine values. Light
      microscopic quantitation of tissue injury, performed 24 hours following
      experimental manipulation, was notable for S3 segment damage in the ischemia plus
      gentamicin group. This was not observed in either the ischemia group or the sham
      operated gentamicin group. Cortical gentamicin levels were elevated in the
      ischemia plus gentamicin group, despite similar plasma gentamicin half-lives.
      However, the elevation in cortical gentamicin levels was dissociated from the
      enhanced nephrotoxicity seen following mild ischemic injury. Taken together these
      data indicate that mild renal ischemia, occurring prior to gentamicin
      administration, greatly enhanced gentamicin nephrotoxicity with the greatest
      damage occurring to S3 cells.

PMID- 2232489
TI  - A phenomenological interpretation of the variation in dialysate volume with dwell
      time in CAPD.
AB  - Intraperitoneal fluid volume (IPV) changes versus time were followed in patients
      undergoing continuous ambulatory peritoneal dialysis (CAPD) using a simple volume
      recovery method. In each patient dialysates containing 1.36 and 3.86 percent
      glucose as an osmotic agent were investigated. The patients' IPV versus time data
      were fitted to a function determined by four "arbitrary" coefficients, from which
      both the initial ultrafiltration (UF) rate immediately following intraperitoneal
      (i.p.) fluid instillation and the "final" peritoneal-to-blood fluid absorption
      rate could be assessed. The peritoneal osmotic conductance to glucose, that is,
      the peritoneal ultrafiltration coefficient (Kf), times the peritoneal osmotic
      reflection coefficient to glucose (sigma g), Kf sigma g, was determined using two
      related approaches. Kf sigma g is a major determinant of the transperitoneal
      volume exchange, and it was calculated to be 3.54 +/- 0.85 (+/- SE) and 3.81 +/-
      0.52 microliters/min/mm Hg, respectively, depending on the assumption employed.
      Kf sigma g was further analysed according to a three-pore model of membrane
      permeability to determine the possible range of Kf and sigma g compatible with a
      peritoneal small solute sieving coefficient (phi) ranging from 0.3 to 0.61.
      According to these calculations both Kf and sigma g ranged from 0.043 to 0.081
      (ml/min/mm Hg and dimensionless, respectively). The maximal peritoneal lymph flow
      (L) realistic according to this analysis, and compatible with a measured total
      peritoneal-to-blood fluid absorption rate of 1.25 +/- 0.14 ml/min, was 0.75
      ml/min, the most plausible values, however, falling between 0.3 to 0.5 ml/min.

PMID- 2232490
TI  - Proximal nephron and renal effects of DuP 753, a nonpeptide angiotensin II
      receptor antagonist.
AB  - The purpose of these studies was to quantitatively assess the role of endogenous
      angiotensin II activity in controlling transport in the proximal convoluted
      tubule (PCT) and whole nephron. We used the nonpeptide angiotensin II receptor
      antagonist DuP 753, which lacks the agonist and kinin/prostaglandin-inducing
      properties of saralasin and captopril, respectively. During in vivo
      microperfusion in the Munich-Wistar rat, we found that DuP 753 had a powerful
      inhibitory effect on bicarbonate (370 +/- 3 to 200 +/- 9 pEq/mm.min, P less than
      0.001), chloride (214 +/- 3 to 105 +/- 9 pEq/mm.min, P less than 0.001), and
      water (5.2 +/- 0.1 to 2.8 +/- 0.2 nl/mm.min, P less than 0.001) absorption in the
      S1 subsegment of the PCT. At maximally effective doses, DuP 753 (10 mg/kg i.v.)
      was significantly more effective than was captopril (3 mg/kg i.v.) in inhibiting
      sodium chloride transport in the S1 PCT. DuP 753 is the most potent diuretic ever
      described in this segment. Consistent with the axial decline of angiotensin II
      receptor density in the PCT, DuP 753 was a less effective transport inhibitor in
      the S2 subsegment of the PCT, similar to captopril. Though downstream
      reabsorptive elements partially compensate for the action in the earliest segment
      of the nephron, we also showed using free-flow micropuncture and clearance
      techniques that DuP 753 induces a substantial diuresis, natriuresis and
      chloruresis. In conclusion, the marked decrease in S1 PCT fluid and electrolyte
      absorption induced by DuP 753 indicates that endogenous angiotensin II exerts
      significant tonic support of proximal transport in vivo.

PMID- 2232491
TI  - Improvement of brain function in hemodialysis patients treated with
      erythropoietin.
AB  - To evaluate the effects of recombinant human erythropoietin (rHuEPO) on brain
      function, 15 chronic hemodialysis patients were studied by event-related P300,
      stimulus-related evoked potentials, and trailmaking before (hematocrit 22.7%) and
      after rHuEPO (hematocrit 30.6%). P300 peak latency elicited by a tone
      discrimination paradigm improved (391 before vs. 366 ms after; Cz = vertex; P
      less than 0.01) confirming beneficial effects on cerebral cognitive processing.
      P300 amplitude (13.6 vs. 15.8 microV; P = 0.06) and trailmaking tended to improve
      (55 vs. 43 s). P300 measures were influenced by low hemoglobin levels before
      rHuEPO (P less than 0.01), suggesting that severe anemia may contribute to uremic
      brain dysfunction. Furthermore, decrease of stimulus-related auditory brainstem I
      V interpeak latency (4.28 before vs. 4.17 ms after; P less than 0.05) and
      increase of somatosensory N20/P25 amplitude (4.8 vs. 7.0 microV; P less than
      0.05) pointed to improvement of sensory pathways by mechanisms unrelated to
      cognition. Brain dysfunction in chronic hemodialysis patients may, beside other
      factors, in part be caused by severe anemia and can be improved by rHuEPO
      treatment.

PMID- 2232492
TI  - Effect of in vivo contact between blood and dialysis membranes on protein
      catabolism in humans.
AB  - To investigate whether the contact between blood and dialysis membranes might
      induce muscle protein degradation, the exchange of free amino acids across leg
      tissues was measured by catheterization technique in three groups of healthy
      subjects before and after a 150 minute sham-hemodialysis procedure (SHDP), that
      is, in vivo passage of blood (100 ml/min) through a dialyzer but with no
      circulating dialysate. Dialyzers with either regenerated cellulose membrane
      (group CU, N = 10 and group CU-IND, N = 6) or polyacrylonitrile membrane (group
      AN, N = 8) were used in group CU-IND indomethacin was administered before (100
      mg) and at the end (50 mg) of SHDP. Leg blood flow was measured by venous
      occlusion plethysmography. In group CU net leg release of tyrosine and
      phenylalanine increased from 3.4 +/- 0.8 and 3.6 +/- 0.8 nmol/min/100 g tissue,
      respectively, before SHDP to 7.8 +/- 1.8 and 8.3 +/- 1.8 nmol/min/100 g tissue,
      respectively, at 345 minutes after the start of SHDP (P less than 0.01). The
      total release of all measured amino acids increased from 148 +/- 31 to 309 +/- 50
      nmol/min/100 g tissue (P less than 0.01). The results indicate that interaction
      between blood and regenerated cellulose membranes leads to accelerated net
      protein breakdown. In group CU-IND no change in leg amino acid release was
      observed following SHDP, suggesting that the increased net protein catabolism is
      mediated by prostaglandins. Sham hemodialysis using AN membranes did not result
      in increased amino acid efflux from leg tissues, implying that the protein
      catabolic effect of blood-membrane contact depends on the biochemical properties
      of dialyser.

PMID- 2232493
TI  - Peritoneal transport in CAPD patients with permanent loss of ultrafiltration
      capacity.
AB  - During a 10 year period, 14 out of 227 patients (6.2%) undergoing continuous
      ambulatory peritoneal dialysis (CAPD) developed permanent loss of ultrafiltration
      capacity (UFC). The risk of UFC loss increased from 2.6% after one year to 30.9%
      after six years of treatment. A six hour, single dwell study with glucose 3.86%
      dialysis fluid was carried out in nine of the UFC loss patients and in 18 CAPD
      patients with normal UFC. Intraperitoneal dialysate volumes were calculated using
      131I-tagged albumin (RISA) as volume marker with a correction applied for its
      elimination from the peritoneal cavity. The RISA elimination coefficient (KE),
      which can serve as an estimation of the upper limit of the lymphatic flow, was
      also calculated. Diffusive mass transport coefficients (KBD) for investigated
      solutes (glucose, creatinine, urea, potassium, total protein, albumin and beta 2
      microglobulin) were calculated during a period of dialysate isovolemia. Two
      patterns of UFC loss were observed: (a) seven patients had high KBD values for
      small solutes resulting in rapid uptake of glucose, whereas KBD values for
      proteins were normal; (b) two patients had normal KBD values but a threefold
      increase both in the fluid reabsorption rate and KE. We conclude that loss of the
      osmotic driving force (due to increased diffusive mass transport for small
      solutes) and increased fluid reabsorption (possibly due to increased lymphatic
      reabsorption) are the two major causes of permanent loss of UFC in CAPD patients.

PMID- 2232494
TI  - Removal of an inorganic acid load in subjects with ketoacidosis of chronic
      fasting.
AB  - When a large inorganic acid load is ingested by normals, the proton load is
      eliminated because the rate of excretion of ammonium can rise to 200 to 300
      mmol/day. In subjects with ketoacidosis of chronic fasting, such a large increase
      in the rate of excretion of ammonium might not be possible because of ATP balance
      considerations in proximal cells. Subjects with ketoacidosis of chronic fasting
      excreted less net acid as defined in the conventional way when they consumed a
      large inorganic acid load (136 +/- 6 vs. 176 +/- 26 mmol/day in control fasted
      subjects). Nevertheless, the vast majority of this inorganic acid load was
      eliminated because they were in steady state and had only a slightly lower
      concentration of bicarbonate (13 +/- 0.6 vs. 15 +/- 0.5 mmol/liter) and ketoacid
      anions (3.3 +/- 0.2 vs. 5.5 +/- 0.2 mmol/liter) in their blood. Using a
      definition of net acid excretion where the component of bicarbonate loss was
      expanded to include "potential bicarbonate" (ketoacid anions) in the urine, the
      rate of excretion of net acid was higher in subjects who ingested the inorganic
      acid load, owing to a much lower rate of excretion of ketoacid anions (9 +/- 2
      vs. 120 +/- 7 mmol/day). This lower rate of excretion was not only due to a lower
      filtered load, but also to a higher fractional reabsorption of ketoacid anions
      during acidosis (97 +/- 0.1 vs. 77 +/- 0.2%). This higher fractional reabsorption
      could not be explained by a lower filtered load of ketoacid anions or to a
      restricted intake of sodium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232495
TI  - Angiotensin II receptor regulation in anti-glomerular basement membrane
      nephritis.
AB  - The expression of the glomerular receptor for angiotensin II (Ang II-R) was
      examined longitudinally following the induction of anti-glomerular basement
      membrane (GBM) nephritis in the rat. The specific aim of the project was to
      determine whether immunologically-induced glomerular injury led to significant
      abnormalities of the relationship between glomerular Ang II-R and its circulating
      ligand, Ang II. Scatchard analysis was used to measure Ang II-R on purified
      glomeruli at selected time intervals over two months following a single dose of
      sheep anti-rat GBM antibody. Corresponding values for plasma Ang II were
      determined. Receptor density fell to approximately 50% by 16 hours following the
      injection of antibody (control 96.4 +/- 9.3 x 10(6); nephritic 52.6 +/- 5.6 x
      10(6) receptors/glomerulus; P less than 0.001) and there was a corresponding
      threefold increase in plasma Ang II (control 21.0 +/- 2.5; nephritic 66.6 +/-
      20.6 pg/ml; P less than 0.01). However, this reduction in receptor binding could
      not be explained by the rise in plasma Ang II concentration, as effective
      blockade of the RAS by enalapril did not alter receptor expression (56.1 +/- 4.6
      x 10(6) receptors/glomerulus). Subsequently, a rise in receptor density and a
      corresponding fall in plasma Ang II were observed: three days after antibody
      administration, receptor concentration had increased significantly above control
      values (150.5 +/- 11.9 x 10(6] while plasma Ang II was undetectable (that is,
      less than 5 pg/ml). Ang II-R remained elevated for the next two weeks but
      returned to normal four to eight weeks after the administration of nephrotoxic
      antibody.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232496
TI  - Renal biopsy.

PMID- 2232497
TI  - Australasian Society of Nephrology 26th annual meeting. Brisbane, Queensland,
      Australia, March 14-16, 1990. Abstracts.

PMID- 2232498
TI  - Renal regulation of extracellular fluid composition. Symposium in honor of Donald
      W. Seldin, M.D.

PMID- 2232499
TI  - Physiologic adaptations of the tubuloglomerular feedback system.
AB  - Knowledge of the existence of a tubuloglomerular feedback system has been
      available for many years. Only recently, however, have tenable hypotheses and
      supporting experimental data become available which have served to provide
      details regarding the complex inner workings of this system. The facility for
      examining this integrated physiologic network has derived, in large part, from
      the routine ability to perform in vivo micropuncture. We anticipate that further
      advances in this field will hinge on the development of additional experimental
      techniques to allow cellular biologic aspects of the system to be closely
      monitored in situ.

PMID- 2232500
TI  - Influence of converting enzyme inhibition on glomerular filtration rate and
      proteinuria.

PMID- 2232501
TI  - Role of branched-chain ketoacids in protein metabolism.

PMID- 2232502
TI  - Cellular mechanisms of prostaglandin E2 and vasopressin interactions in the
      collecting duct.

PMID- 2232503
TI  - Defenses of an unstable compromise: crystallization inhibitors and the kidney's
      role in mineral regulation.

PMID- 2232504
TI  - Determinants of renal damage in rats with systemic hypertension and partial renal
      ablation.

PMID- 2232505
TI  - Inhibition of 11 beta-hydroxysteroid dehydrogenase and its effect on epithelial
      sodium transport.

PMID- 2232506
TI  - Countercurrent system.
AB  - Urinary concentration is achieved by countercurrent multiplication in the inner
      medulla. The single effect in the outer medulla is active NaCl absorption from
      the thick ascending limb. While the single effect in the inner medulla is not
      definitively established, the majority of experimental data favors passive NaCl
      absorption from the thin ascending limb. Continued experimental studies in inner
      medullary nephron segments will be needed to elucidate fully the process of
      urinary concentration.

PMID- 2232508
TI  - Catastrophic medical events with exhaustive exercise: "white collar
      rhabdomyolysis".

PMID- 2232507
TI  - Renal control of extracellular calcium.

PMID- 2232509
TI  - Disorders of distal acidification.

PMID- 2232511
TI  - Chronic tubulo-interstitial nephritis: correlation between structural and
      functional findings.

PMID- 2232510
TI  - Renal handling of citrate.

PMID- 2232512
TI  - Single-nephron studies: implications for acid-base regulation.

PMID- 2232513
TI  - [Some new treatment strategies for lung involvement in patients with
      mucoviscidosis].
AB  - Autogenic drainage, PEP mask breathing as well as physical exercise are now well
      established in the treatment of pulmonary disease in cystic fibrosis, but there
      are different opinions about oxygen therapy over a long period as well as
      corticosteroid treatment. First reports on amiloride inhalations seem to be
      hopeful, but there is no experience with cystic fibrosis children till now,
      therefore clinical use can not be recommended. Heart lung transplants are not to
      consider as an alternative treatment for all cystic fibrosis patients, in special
      cases it may be successful.

PMID- 2232514
TI  - [Problems of perinatal transmission of hepatitis B].
AB  - This review of recent publications and of the results of our own research brings
      our insights into the perinatal transmission of hepatitis B up to date. It
      includes facts concerning epidemiology, means of transmission, serological
      detection and problems of infection specific to newborns. The detailed discussion
      of the issue of prevention is intended to serve the basic objective of
      counteracting the further spread of the hepatitis B virus by a systematic
      screening of all pregnants followed by immunoprophylaxis for the newborns.

PMID- 2232515
TI  - [Micturition retention and urinary tract infection in girls. Detection of
      functional micturition disorders with special reference to anamnesis].
AB  - The normalization of functional micturition disturbances obtains an increasing
      importance in the treatment and guidance of girls with urinary tract infections.
      Our experience in the detection of an abnormal micturition pattern is reported. A
      detailed interrogation of the parents feasible in any outpatient practice is more
      emphasized than investigations by means of technical devices.

PMID- 2232516
TI  - [Frontonasal dysplasia. Case report and review of the literature].
AB  - FND is a non-uniform malformation complex with symptoms ranging between severe
      hypertelorism with bidfid nose and cranium bidfidum occultum with agenesis of the
      corpus callosum. Etiology and pathogenesis are discussed on the basis of a case
      history and some hints regarding differential diagnosis and genetic counselling
      are given. The exclusively sporadic occurrence of FND tells against a hereditary
      pathomechanism. Consequently, there is no recurrence risk. However, in families
      with an affected child, malformations generally tend to occur a little more
      often.

PMID- 2232517
TI  - [The value of sleep EEG following sleep deprivation before terminating
      anticonvulsive therapy in epileptic children and adolescents].
AB  - A sleep electroencephalogram was carried out after deprivation of sleep in 70
      epileptic children and young people. The EEG was done before an intended
      reduction of anticonvulsants. Patients who had generalized paroxysmal patterns in
      the sleep EEG suffered from significantly more frequent relapse after and of
      therapy than those ones with local paroxysmal activity or electroencephalogram
      without paroxysmal activity respectively. A sleep EEG after deprivation of sleep
      should be carried out before a decision is made on the end of the therapy in
      patients with expected generalized paroxysmal patterns.

PMID- 2232518
TI  - [The microbial colonization pattern of newborn infants. What is its significance?
      Results of a study at a district hospital in the Gera district].
AB  - A microbiological investigation was performed under standardized conditions both
      on mother and child for total of 151 births, 112 of which being classified as
      normal, the remainder of 39 as risk births. Significant differences were found
      between the microbial colonization patterns for normal and risk births,
      respectively, as judged from cultures of smears from maternal cervices and from
      their neonates. In addition, colonization patterns of the newborn children turned
      out to be age-dependent. No correlation between the colonization pattern of the
      neonatal surface and infections of the newborn infants has been found.

PMID- 2232519
TI  - [Post-hypoglycemic encephalopathy in type I diabetes mellitus in childhood and
      its treatment].
AB  - In type-I-diabetes insuline-induced hypoglycaemia is the most frequent and
      permanent therapeutic complication. In severe courses proceeding to
      unconciousness, it is essential to decide on the irritation of exclusively
      cortical or subcortical structures. The latter one is classified as
      posthypoglycaemic encephalopathy correlated with a relatively high lethality.
      Consequently, differential diagnosis and carefully calculated treatment are of
      vital importance.

PMID- 2232520
TI  - [Surgical treatment of diseases of the brachiocephalic arteries].
AB  - The authors have summarized the experience with surgical treatment of 147
      patients with the brachiocephalic arterial pathology. Transient disorders in the
      cerebral circulation were noted in 54%, chronic vascular cerebral insufficiency-
      in 15%, ischemic insult and its sequelae--in 19% of the patients. Occlusive
      stenotic lesions of the extracranial vessels, aneurysms, tortuosity of the
      brachiocephalic++ trunk, compression of the carotid arteries by chemodectoma were
      the indications for operative treatment. When choosing a method for operative
      intervention, the preference was given to extrathoracic techniques. The positive
      results were achieved in 90% of the patients.

PMID- 2232521
TI  - [Use of ultrasonics and antibiotics in the treatment of wounds in patients with
      high risk of infection of vascular transplants].
AB  - The level of bacterial colonization of the operative wounds in performance of the
      reconstructive operations on the vessels equal to 10(3) bacteria in 1 g of tissue
      is critical for the development of suppuration. The use for treating the wounds
      of the low-frequency ultrasound and gentamycin solution in 17 patients permitted
      to reduce the critical level of bacterial wound colonization, and due to this, to
      decrease the incidence of the purulent-septic complications from 35.7 to 5.9%. In
      14 patients after the operations for late reocclusion performed in presence of
      cicatrices of the tissues, there was no wound suppuration.

PMID- 2232522
TI  - [Roentgenoendovascular dilatation of the renal arteries in the treatment of
      vasorenal hypertension].
AB  - The possibilities of the use of roentgenoendovascular dilatation of the renal
      artery were studied in 57 patients with stenosis of the renal artery and
      vasorenal hypertension. The authors managed to perform the manipulation in 48
      patients. Occlusion of the renal artery, pronounced atherosclerosis of the iliac
      and axillary arteries, coarctation of the aorta were the causes of failure. In
      52.6% of the patients, the "residue" of stenosis was less than 30% of the normal
      arterial lumen, in 31.6%--30-50%, in the remaining patients, the dilatation has
      failed. Stable normotension was achieved in 39.5%, the state improved in 50% of
      the patients. The absence of hypotensive effect for the first 6 mos after the
      operation was caused by recurrency of the dilated artery stenosis, which resulted
      from the improper choice of a balloon catheter. The diameter of such a catheter
      should be 100-110% of a width of the renal arterial lumen proximally to stenosis.
      The later recurrency of hypertension was caused by the development of the
      stenosis of the artery of the contralateral kidney.

PMID- 2232523
TI  - [Tissue oxygen metabolism, hemodynamics and microcirculation in vasorenal
      hypertension in patients with different types of blood circulation].
AB  - The authors examined 68 patients with vasorenal hypertension (VRH). In
      hyperkinetic type of VRH, the tissue hypoxia is caused by the increase in the
      cardiac index and rate of blood flow, changes in the microcirculation; in
      hypokinetic type--by decrease in the cardiac index, sharp increase in the
      specific peripheral vascular resistance and pronounced changes in all the links
      of microcirculatory channel as well is observed. Timely correction of the
      hyperkinetic type of VRH in patients leads to normalization of hemodynamics and
      elimination of tissue hypoxia. After correction of the hypokinetic type of VRH in
      patients, neither hemodynamics, nor impairment in the oxygen regimen of the
      tissues normalizes, even if the positive effect of treatment is noted.

PMID- 2232524
TI  - [Changes in peripheral hemodynamics in patients with chronic circulatory
      insufficiency in the extremities after the treatment by reinfusion of UV
      irradiated blood].
AB  - Reinfusion of the blood irradiated with the ultra-violet rays in patients with
      chronic insufficiency of the blood supply of the extremities leads to significant
      increase in the linear and volumetric blood flow rate in the damaged extremities,
      improvement in the microcirculation, reduction in the blood viscosity. The effect
      doesn't depend on the genesis of occlusion and degree of the impairement of
      circulation.

PMID- 2232525
TI  - [Venous hemodynamics in chronic occlusive diseases of arteries of the lower
      extremities].
AB  - The authors have revealed a gradual development of venous hypertension and
      deceleration of the rate of venous blood flow in the damaged extremities in
      chronic obliterative arterial diseases. Decompensation of arterial hemodynamics
      is accompanied by the development of pronounced venous congestion with reduced
      venous pressure and tension. This may cause the incompetence of the deep venous
      valves.

PMID- 2232526
TI  - [Possibilities of prevention of pulmonary thromboembolism in patients with
      vascular pathology according to clinical data and patho-anatomical studies].
AB  - In a work, the retrospective analysis of the case records and materials of the
      postmortem studies in 42 patients with pathology of the major vessels, who died
      from pulmonary thromboembolism, is presented. A number of pathogenetic mechanisms
      of the development and ways for prophylaxis of this complication is considered.

PMID- 2232527
TI  - [Various aspects of prognosis, treatment and prevention of pulmonary
      thromboembolism].
AB  - In a work, the analysis of sectional investigations in 47 patients, who died from
      pulmonary thromboembolism (PTE), is presented. The causes and results of
      treatment of PTE after operation in 34 patients are studied. The non-specific and
      specific measures for PTE prophylaxis are suggested.

PMID- 2232529
TI  - [Pre-amputation freezing of the extremity in acute ischemic gangrene].
AB  - When preparing for amputation in 153 patients with acute ischemic gangrene of a
      lower extremity, the tourniquet-cold isolation was used. In 137 patients, the
      damaged extremity was freezed by means of a special portable freezing chamber,
      which can be used in any surgical in-patient department. The duration of cooling
      ranged from 18 hrs to 14 days. The state improved in 136 patients, the amputation
      of the extremity was performed in them. The use of freezing of the damaged
      extremity permitted to reduce the postoperative lethality from 41 to 19.1%. A
      high effectiveness of the method in gangrene of the extremity against the
      background of diabetes mellitus was noted.

PMID- 2232528
TI  - [Current methods of the treatment of varicocele].
AB  - The results of complex examination and treatment of 172 patients with varicocele
      are presented. Roentgenoendovascular occlusion of the testicular vein was
      performed in 52 patients with the positive result in 43 of them. The disease
      recurrence was revealed in control examination 6 mos later in 9 patients. A new
      microsurgical operation of creating the double spermatico-venous++ anastomosis,
      which permits to accomplish the more complete correction of venous hemodynamics
      in the system of the testicular vein, to reduce the traumatism of the operation,
      to improve the conditions for normalization of spermatogenesis, is suggested. A
      recurrence of varicocele after its treatment by means of the microsurgical
      correction occurred in 1 patient. Of the 56 women, whose husbands suffered from
      infertility, after microsurgical operations performed for varicocele, the
      pregnancy resulted in 19.

PMID- 2232530
TI  - [Quantitative evaluation of hemodynamics in varicose veins].
AB  - The experience with the clinical use for many years of the quantitative
      plethysmographic indices for solving the diagnostical and tactical problems in
      varicose disease has shown their advantage over the clinical and
      roentgenophlebographical signs in detecting the presence and degree of retrograde
      blood flow in the perforating veins of a crus, making clear distinction between
      the stages of compensation and decompensation with subdivision of the latter into
      the subgroups according to the pronouncement of perforans shunting, choice of a
      method for operation.

PMID- 2232531
TI  - [Status of the musculo-venous pump of the thigh in varicose veins].
AB  - By means of the ultrasound flowmetry, phlebography, rheovasography and
      phlebotonometry, 51 patients with varicose disease was examined. It was
      established, that musculo-venous++ "pump" of a thigh played the leading part in
      the venous return. In stages I and II of varicose disease, the function of
      musculo-venous++ "pump" of a thigh was impaired moderately, its sharp disfunction
      was noted in stage III of the disease.

PMID- 2232532
TI  - [Comparative characteristics of the forearm and crus as donor sites for obtaining
      composite skin flaps on vascular pedicles].
AB  - The ++topographo-anatomical investigations on 67 forearms and 58 crura permitted
      to establish the possibility for formation of the free similar types of island
      composite cutaneous flaps on the large vascular bundles. On the crus, the
      possibility to elevate two more types of the island cutaneous flaps without
      transection of the major vessels is substantiated. The variants of microsurgical
      autotransplantation and trasplantation+ of the composite cutaneous flaps of the
      forearm and crus on the vascular pedicles are discussed.

PMID- 2232533
TI  - [The "steal" syndrome in patients with occlusive diseases of the aorta and iliac
      arteries].
AB  - In the work, the findings of clinical, functional and angiographic investigations
      in patients with the "steal" syndrome are systematized. In 39 of the 152 patients
      with atherosclerosis of the vessels of the aortoiliofemoral segment, the two
      forms of the "steal" syndrome (external iliac and pelvic "steal") causing the
      arterial erectile impotence were revealed. For objectivization of the syndrome, a
      test of "coitus loading" on the muscles of the lower extremities was used.

PMID- 2232534
TI  - [Possibilities of improving the methods of making vascular prostheses using human
      umbilical veins].
AB  - In the experiment, the possibilities for intensification and acceleration of the
      umbilical vein tissue stabilization, increasing the strength and improving the
      plastic properties, increasing the resistance of biological grafts to thrombosis
      due to the use of the improved method of conservation according to the scheme:
      dynamic stabilization in the glutaraldehyde-enzyme-glutaraldehyde-heparin
      solution are studied. The developed biological grafts were used in 12 patients
      with occlusion of the arteries of the femoropopliteal segment. After 18 mos, the
      grafts are patent in 8 patients.

PMID- 2232535
TI  - [Ultrastructure of skin flaps obtained in vivo by graded tissue expansion of
      different intensity].

PMID- 2232536
TI  - [Surgical treatment of circulatory disorders in the upper extremities].
AB  - The authors operated on for circulatory disturbances in the upper extremities 216
      patients. Differential approach to the choice of a method for surgical correction
      permitted to achieve excellent and good results in 89% of them.

PMID- 2232537
TI  - [Surgical tactics in aneurysm of the abdominal aorta].
AB  - The results of treatment of 164 patients with aneurysms of the abdominal aorta
      are summarized. Of these patients, 95 were operated on. Realization of the
      developed tactics of treatment permitted to reduce the incidence of postoperative
      complications 3.8-fold, and lethality--5.3-fold.

PMID- 2232538
TI  - [Thrombembolectomy in the treatment of patients with acute disorders of
      mesenteric circulation].
AB  - In acute impairement of the mesenterial circulation, the authors in 31 patient
      performed thrombembolectomy from the superior mesenteric artery, which in 22 was
      supplemented with resection of a necrotized area of the intestine. Five patients
      recovered. In these patients within the first 24 hours, the control relaparotomy
      was performed and the early postischemic disorders were cupped off with the use
      of tubal decompression, active aspiration of the intestinal contents, lavage of
      the intestine with the balanced electrolyte solution, hemosorption and
      intraintestinal administration of the oxygenated 10% glucose solution.

PMID- 2232539
TI  - [Direct long-term endolymphatic treatment of patients with arterial occlusive
      diseases of the lower extremities].

PMID- 2232540
TI  - [Non-invasive diagnosis of the degree of aortic coarctation].
AB  - Examined were 42 patients with aortal coarctation at the age of from 6 to 35
      years. The differences in hemodynamics, microcirculation and oxygen regimen of
      tissues depending on the degree of aortal coarctation were revealed. To diagnose
      the degree of aortostenosis, it is suggested to use the transcutaneous monitoring
      of PO2 distally to the site of coarctation.

PMID- 2232541
TI  - [Ultrasonic vascular scanning in the diagnosis of acute arterial obstruction].
AB  - In thrombosis of the aorta and major arteries (52 cases), postthrombotic
      occlusion (26), arterial embolism (14), the ultrasound vascular scanning++ was
      performed. The method permits to define the presence and location of arterial
      occlusion, differentiate thrombosis and embolism, atherosclerotic and autoimmune
      diseases of the vessels and as well to assess the outcome of restorative and
      reconstructive operations in acute arterial obstruction.

PMID- 2232542
TI  - [Possibilities of Doppler ultrasonics in the diagnosis of lesions of the
      brachiocephalic arteries].

PMID- 2232543
TI  - [Use of Doppler ultrasonics in the diagnosis of postphlebitic syndrome].

PMID- 2232544
TI  - [Surgical correction of valvular insufficiency of deep varicose veins of the
      lower extremities].
AB  - A scheme for preoperative examination of the patients with varicose disease is
      presented. Incompetence of the deep venous valves was revealed in 74.1% of the
      patients with varicose disease and in 76.5%--with its postoperative recurrences.
      Correction of ++phlebo-hemodynamics was accomplished by means of a carcass
      spiral, fascial paravasal structures and suggested by the authors method of
      placing the three corrective ligatures, which has proved to be the most
      effective. One hundred and forty two operations on the deep veins were performed
      in 102 patients. In observation for up to 4 years, in 94.7% the excellent and
      good results were noted.

PMID- 2232545
TI  - [Autologous venous prosthesis in microsurgery].

PMID- 2232546
TI  - [Use of external brachial cutaneo-fascial flap for plastic microsurgery of
      defects of functionally important areas of the hand and foot].
AB  - On the basis of morphological investigations on 20 non-fixed cadavers, the
      microsurgical anatomy of the external fasciocutaneous brachial flap was detailed
      . A flap was successfully used for plasty of the tissue defects of the foot,
      forearm and hand in 14 patients. The recommendations concerning the technique of
      flap elevation and transplantation are given.

PMID- 2232547
TI  - [Effect of lumbar sympathectomy on late results of reconstructive operations on
      the abdominal aorta and arteries of the lower extremities].
AB  - The use of reconstructive operation in combination with lumbar sympathectomy for
      the treatment of obliterative lesion of the vessels of the aortoiliofemoral
      segment permits to reduce the incidence of development of the early postoperative
      vascular thrombosis and late reocclusion. A good patency of vascular transplants
      after combined operation was noted in 62% of cases, after isolated reconstruction
      -in 38%.

PMID- 2232548
TI  - [Lumbar sympathectomy in patients with arteriosclerosis obliterans of the lower
      extremities and diabetes mellitus].
AB  - In 72 patients with obliterative atherosclerosis of the arteries of the lower
      extremities and diabetes mellitus, the lumbar sympathectomy was performed. A good
      result was noted in 35 of them, amputation of the extremity was performed in 8
      patients. Lumbar sympathectomy is indicated to the patients in initial stages of
      the disease.

PMID- 2232549
TI  - [Optimal hemodynamic conditions for performing reconstructive- restorative
      operations on the aorto-femoral segments].
AB  - According to the results of examination of 170 patients with atherosclerotic
      lesions of the vessels of the aortofemoral segment and 170 virtually healthy
      subjects by means of the tetrapolar rheography, the prognostic value of the
      hypokinetic type of circulation in the development of cardiologic complications
      after reconstructive operations on the vessels mentioned was established. It is
      admitted that the value of cardiac index equal to 1.4 l/(min.m2) is a
      contraindication for the performance of reconstructive-restorative operations on
      the vessels of the aortofemoral segment.

PMID- 2232550
TI  - [Treatment of complicated retroampullar duodenal ulcers].
AB  - Of the 450 patients with complicated duodenal ulcer disease, in 23 (5.8%) the
      ulcer was located distally to the duodenal ampulla. On the basis of studying the
      results of surgical treatment, a conclusion is made, that the selective proximal
      vagotomy in combination with the ulcer excision and duodenoplasty is an operation
      of choice in complicated retroampullary ulcers. The operative interventions
      correcting the disturbances in the duodenal patency in preserved function of the
      pyloric sphincter contribute to prevention of duodenogastric reflux and alkaline
      reflux-gastritis.

PMID- 2232551
TI  - [Varicose dilatation of the external pudendal vein in a pregnant woman,
      simulating inguinal hernia].

PMID- 2232552
TI  - [Complications of central venous catheterization].

PMID- 2232553
TI  - [Complications of surgical treatment of patients with non-organic neoplasms of
      the small pelvis].

PMID- 2232554
TI  - [Tactics in the surgical treatment of aortic thrombosis in suppurative-necrotic
      lesions of the lower extremities].

PMID- 2232555
TI  - [Rupture of aneurysm of the abdominal aorta to the inferior vena cava].

PMID- 2232556
TI  - [Thrombosis of mesenteric blood vessels in a patient after intestinal surgery].

PMID- 2232557
TI  - [Endolymphatic therapy in vascular surgery].

PMID- 2232559
TI  - [Diagnosis of the acute phase of peripheral nonspecific aortoarteritis].

PMID- 2232558
TI  - [Successful treatment of thromboembolism of the artery of the solitary kidney].

PMID- 2232560
TI  - [Recurrent and residual echinococcosis of the abdominal organs].
AB  - The article gives information on 14 patients who were operated on for a second
      time for echinococcosis of various localization. The authors conclude that all
      cases in which the carrier of the germ elements of the parasite remains in the
      organism should be logically called residual and not false recurrence. A disease
      caused by a new infection should be called ++re-invasive echinococcosis but not a
      true recurrence.

PMID- 2232562
TI  - [Internal fistulas of bile ducts caused by cholelithiasis].
AB  - Operative treatment of 41 patients is analysed. It is shown that internal
      fistulas of the bile tract are severe complications of cholelithiasis. Late
      detection and treatment of diseases of the biliary system is the main cause of
      formation of the fistulas. Removal of the internal biliary fistula as well as
      correction of abnormal changes in the bile ducts is the object of the operative
      intervention. The postoperative fatality was 12.2%.

PMID- 2232561
TI  - [Precision sutures of bile ducts in experimental cholangitis].
AB  - Experimental study of the use of the precision suture techniques in application
      to the hepaticocholedochus and in formation of biliodigestive anastomoses in
      cholangitis revealed the advantages of the precision suture over the
      "traditional" one. The precision suture is very strong and air-tight, provides
      adequate adaptation of the coats of the hepaticocholedochus and the small
      intestine and creates thus optimum conditions for healing; when used in
      combination with absorbable suture material it excludes the formation of ligature
      cholelithiasis and reduces the risk of cicatricial stenosis.

PMID- 2232563
TI  - [Combined interventions in non-organic neoplasms of the small pelvis].
AB  - Experience with 62 combined operations on patients with nonorganic new growths of
      the true pelvis is discussed. They accounted for 33.3% of 227 radical
      interventions undertaken for this disease. The ages of the patients ranged from 4
      months to 64 years. Ten patients were admitted after exploratory laparotomies.
      Benign new growths were diagnosed in 14 and malignant new growths in 48 patients.
      Different variants of operative approaches were used. Most frequently the tumor
      was resected together with bones, iliac vessels, genitalia, and urinary bladder.
      Various complications were noted in 39 patients who were operated on. Hemorrhage
      was the most frequent and menacing complication--in 26 patients. Two patients
      died. Recurrences were found in 8 of a group of 60 patients discharge from the
      clinic. After combined operations for malignant nonorganic tumors of the true
      pelvis 3-year survival was 36.0%, 5-year survival was 29.4%.

PMID- 2232564
TI  - [Causes of respiratory insufficiency in acute pancreatitis].

PMID- 2232565
TI  - [Inflammatory processes in soft tissues and osteomyelitis caused by bone nails].

PMID- 2232566
TI  - [A method of determining intestinal viability].

PMID- 2232567
TI  - [Intestinal intubation in peritonitis].

PMID- 2232568
TI  - [Late results of selective proximal vagotomy with transverse gastroduodenal
      anastomosis in pyloric stenosis caused by duodenal ulcer].
AB  - The late-term results of treatment of pyloroduodenal ulcerous stenosis by means
      of selective proximal vagotomy (SPV) in combination with transverse
      gastroduodenoanastomosis (GDA) were studied in 110 patients. The results are
      compared with those of SPV combined with longitudinal GDA after Jaboulay.
      Clinical, radiological, endoscopic, biochemical, and morphological examination
      showed the advantages of transverse GDA over longitudinal GDA. It is concluded
      that combination of SPV with transverse GDA is the operation of choice.

PMID- 2232569
TI  - [Duodenal obstruction caused by cholelithiasis].

PMID- 2232570
TI  - [Rare cause of relaparotomy].

PMID- 2232571
TI  - [Internal incarceration of the small intestine].

PMID- 2232572
TI  - [Fulminant gangrene of the scrotum].

PMID- 2232573
TI  - [Fournier's disease in a patient after relaparotomy in postoperative
      peritonitis].

PMID- 2232574
TI  - [Cancer of the gallbladder].

PMID- 2232575
TI  - [Multiple organ failure syndrome in surgery].

PMID- 2232576
TI  - [Repeated operations in gastric and duodenal ulcers].
AB  - The results of repeated operations in 165 patients were studied. A second
      operative intervention was indicated most frequently after closure of a
      perforating ulcer (h = 126). The character of the second operative intervention
      was determined by the method of the previous operation and the complication of
      the ulcer for which the operation had to be repeated, the patient's condition and
      age, and the urgency of the surgery. The mortality rate after repeated operative
      interventions was 3%.

PMID- 2232577
TI  - [Vagotomy in emergency surgery of complicated duodenal ulcer].
AB  - The article deals with general information on the immediate and late-term results
      of operations with vagotomy for perforating and bleeding duodenal ulcers in 670
      patients. Indications for economical operative interventions in emergency
      situations were determined. The immediate and late-term results of economical
      operations with vagotomy allow them to be recommended for introduction into wide
      surgical practice.

PMID- 2232578
TI  - [Treatment of patients with perforated gastroduodenal ulcer].
AB  - The immediate results of treatment of 114 patients with perforating
      gastroduodenal ulcer were analysed. The causes of late hospitalization and late
      operations and their effect on postoperative complications and mortality are
      discussed. Preference is given to closure of the perforation with sutures (108
      patients); closure of the perforation with creation of a gastroentero-anastomosis
      was carried out in 3 and primary resection of the stomach in 3 more patients.
      Complications occurred in the immediate postoperative period in 8 patients (7%),
      which were due either to late admission to the hospital or to delayed operative
      intervention. The postoperative mortality rate was 7%. Early hospitalization and
      early operative intervention are the real means of improving the results of
      treating patients with perforating gastroduodenal ulcer.

PMID- 2232579
TI  - [Prevention of dumping syndrome after distal gastrectomy in peptic ulcer].
AB  - Operations were performed on 386 patients with peptic ulcer by a method suggested
      by the authors for gastric resection with formation of a sphincter in the region
      of the anastomosis. In 18 patients a Billroth II anastomosis was reconstructed
      into a Billroth I anastomosis by the authors' modification in severe dumping
      syndrome. Complex examination was conducted in late-term postoperative periods in
      324 patients after primary resection and in 18 after reconstructive operation. A
      mild dumping syndrome was found in 9 (2.8%) and 3 patients, respectively. The
      results of the study show that if the authors' requirements regarding the volume
      and method of gastric resection are abided by, there is no doubt that the
      suggested method has advantages over the classical method in that the reservoir
      function of the stomach is maintained, hydrochloric acid secretion reduces to a
      state of hypo- or normoacidity, and the peristaltic component of evacuation is
      preserved due to the formed functionally active anastomosis.

PMID- 2232580
TI  - [Anterior seromyotomy of the body and the functional part of the stomach combined
      with posterior truncal vagotomy and ulcer excision in the surgical treatment of
      complicated stomach ulcer].
AB  - Anterior seromyotomy of the body and fundus of the stomach was combined with
      posterior truncal vagotomy and excision of the ulcer in 23 patients with gastric
      ulcer complicated by bleeding or perforation. Seventeen patients had chronic
      ulcers of the body of the stomach (type I), 3 patients had concurrent ulcers
      (type II), and 3 more patients had acute ulcers of the body of the stomach.
      Operation was undertaken for active bleeding from the ulcer in 20 patients and
      for perforating ulcer in 3 patients. One patient died. Mild disorders of
      evacuation of an aqueous barium sulfate suspension from the stomach were noted in
      4 patients.

PMID- 2232581
TI  - [Surgical tactics in bleeding duodenal ulcers].
AB  - The article gives a review of literature on the determination of surgical tactics
      in patients with duodenal ulcer complicated by bleeding. The authors are
      supporters of the actively-temporizing tactics. They claim that the period of the
      delay in the decision should not exceed 24 hours and depends on the intensity of
      the bleeding, the degree of blood loss, the location and nature of the ulcer, the
      patient's age, and the concomitant diseases. They believe resection of the
      stomach to be the operation of choice in bleeding duodenal ulcer. One of the
      authors suggested a modified method of gastric resection in "difficult" duodenal
      ulcers which excludes the occurrence of incompetence of the duodenal stump
      sutures.

PMID- 2232582
TI  - [Clinico-morphological parallels in Mallory-Weiss syndrome].
AB  - The article deals with the results of treatment of 180 patients with the Mallory
      Weiss syndrome. Morphological studies of the gastric wall was conducted in 16
      patients who underwent operation. It was established that developmental
      anomalies, chronic gastritis, and pathological changes of the vessels of the
      lamina muscularis mucosae impairing its mobility and strength may be the
      morphological substrate which precedes the development of the Mallory-Weiss
      syndrome.

PMID- 2232583
TI  - [Clinico-roentgenological diagnosis of dumping syndrome in expert medical
      evaluation of work capacity].
AB  - The authors conducted complex clinical and X-ray examination of 80 patients
      suffering from the dumping syndrome of various degree. They were sent to the
      Central Scientific Research Institute of Expert Medical Assessment of Working
      Capacity for establishing the degree of severity of morphological and functional
      disorders affecting their capacity for work. The method of examination of such
      patients, including X-ray and other clinical methods, is described. The main
      clinical and roentgenosemeiotic signs characteristic of the mild, moderately
      severe, and severe forms of the dumping syndrome are pointed out. Clinical cases
      are described in illustration of the diagnostic possibilities and the expert
      approach to the results of the examination of such patients.

PMID- 2232584
TI  - [Pathogenetic aspects of the treatment of diffuse suppurative peritonitis].
AB  - Experience with the treatment of 130 patients with generalized purulent
      peritonitis is analysed. The complex of therapeutic measures included
      intraoperative cleansing of abdominal cavity with ultrasound; postoperative
      prolonged laparoscopic cleansing with the use of rational antibacterial therapy
      and laser irradiation of the abdominal cavity. The cell immunity values in
      patients with peritonitis were studied and the principles of immunocorrective
      therapy substantiated. It is shown that detoxification measures are necessary in
      the treatment of this category of patients. A complex approach to the treatment
      of purulent peritonitis led to a decrease in mortality to 13.8%.

PMID- 2232585
TI  - [Hemosorption in the complex treatment of patients with suppurative peritonitis
      of appendicular etiology].
AB  - Analysis of the results of treatment of 240 patients with generalized peritonitis
      of appendicular origin showed that the application of hemosorption led to
      noticeable and stable diminution of intoxication in 84% of cases. In the ++post
      sorption period, the severity of endotoxicosis did not change essentially in 12%
      of cases and increased in the remaining cases. The therapeutic effect of
      hemosorption was found to be unstable in patients with signs of multiple organ
      insufficiency developing in prolonged poorly effective therapy as well as in
      patients with unrecognized abdominal abscesses, incompetence of the sutures of
      anastomoses, thrombosis of the mesenteric vessels, and early intestinal
      obstruction due to adhesions. Endotoxicosis intensified during hemosorption in
      patients with extensive epifascial phlegmons. It is proved that hemosorption
      applied repeatedly in the early postoperative period with due account for the
      individual features of the course of the disease ensures an optimal therapeutic
      effect.

PMID- 2232586
TI  - [Metabolic function of the liver in middle-aged and elderly patients with
      peritonitis].
AB  - From analysis of experimental (576 rats) and clinical (104 patients) materials,
      the authors drew the conclusion that the pharmacological activity of certain
      drugs metabolized in the liver increased markedly in old rats with experimental
      peritonitis. The drug-metabolizing function of the liver was inhibited
      significantly in peritonitis in elderly and senile patients. A method was
      developed for establishing the stages of peritonitis.

PMID- 2232587
TI  - [Toxemia syndrome in patients with acute intestinal obstruction].
AB  - The results of examination and treatment of 216 patients with acute intestinal
      obstruction of benign genesis are discussed. The values of blood plasma toxicity
      and the values of hemostasis determined before and after the operation were
      compared. Intoxication of patients was found to increase in the postoperative
      period. Its increase was appraised according to the duration of the disease. The
      causes of mortality were analysed and the risk factors of intoxication increase
      in the postoperative period were revealed. The authors suggest a classification
      of the phases of intoxication in patients with acute intestinal obstruction on
      the basis of the degree of intoxication and the condition of homeostasis.

PMID- 2232588
TI  - [Carcinoid tumor of the appendix].
AB  - The authors discuss data in the literature and analyse the features of the
      clinical picture, diagnosis, and treatment of carcinoid of the vermiform process
      in 8 patients. The late-term results are shown.

PMID- 2232589
TI  - [Use of dalargin in complex anesthesiological protection during operations on the
      abdominal organs].
AB  - The authors analyse experience in the use of the synthetic analogue of ++leu
      enkephalin dalargin in multicomponent balanced anesthesia in operations on the
      abdominal organs in 36 patients. With the use of the suggested method the
      intraoperative expenditure of narcotic analgesics is 6 times less but the
      efficacy of the anesthesia remains the same. Study of the activity of the liver
      specific enzymes (histidase and urokinase) in blood plasma and biopsy material
      taken from the liver and the content of malonic dialdehyde in the hepatic biopsy
      specimen revealed hepatoprotective properties of dalargin. The decrease of the
      total peripheral resistance and increase of the elasticity of the arterial
      reservoir++ in the main group as compared to these values in patients treated by
      the traditional method were considered by the authors to be the consequence of
      the autonomic priming effect of the opiopeptide used. It is concluded that the
      use of synthetic analogues of endogenous opioids (dalargin) in the
      anesthesiological protection complex in operations on the abdominal organs is
      expedient.

PMID- 2232590
TI  - [Characteristics of the course of gastroduodenal ulcer and its surgical treatment
      in elderly patients].
AB  - The authors analyze in detail the literature on the subject and the results of
      treatment of 234 patients over 60 years of age. It is confirmed that peptic ulcer
      in elderly and old-aged individuals has some specific features. The mortality
      rate after planned surgical interventions for gastric and duodenal ulcer in
      patients over 60 years was 5.0% and 3.9%, respectively. Emergency surgical
      interventions for complications of peptic ulcer at old age led to death in 44.4%
      and 50% of cases, respectively. It is concluded that the range of indications for
      planned and earlier surgical treatment of peptic ulcer in the elderly must be
      widened.

PMID- 2232591
TI  - [Combined surgical operations in the abdominal cavity and retroperitoneal space].
AB  - The authors discuss their experience in combined operations on the organs of the
      abdominal cavity and retroperitoneal space in 366 patients whose ages ranged from
      16 to 81 years. In 96 patients (26.2%) the operations were carried out for
      emergency indications and in 270 (73.8%) in a planned order. The authors
      substantiate the expediency of performing combined operations by a low mortality
      rate (1.9%) (in carrying out the operations separately the mortality rate comes
      up to 15%) and by an economical effect.

PMID- 2232592
TI  - [Selection of the method of treatment of complicated hemorrhoids].
AB  - The authors make a comparative analysis of the immediate complications after
      hemorrhoidectomy conducted by various methods in 504 patients engaged in heavy
      physical work. Group 1 consisted of 172 patients with hemorrhoidectomy performed
      by the ligature method. Group 2 was made up of 151 patients who had been operated
      on by A. N. Ryzhikh's modification of Martynov's method. Group 3 included 145
      patients treated by the Milligan-Morgan operation involving the restoration of
      the anal mucosa. Group 4 consisted of 36 patients who had undergone ligation of
      the terminal branches of the superior rectal artery with economical excision of
      the hemorrhoids. In appraisal of the results of operative treatment of
      hemorrhoids, the least number of complications were found in patients of groups 3
      and 4.

PMID- 2232593
TI  - [Treatment of patients with bleeding hemorrhoids].
AB  - The article discusses the choice of the optimal therapeutic tactics, the volume
      of preoperative examination, and the rational techniques of surgical treatment in
      65 patients with profuse bleeding from the hemorrhoids. It is shown that digital
      examination, proctosigmoidoscopy, as well as adequate examination of the whole
      large intestine must be undertaken without fail in this group of patients.
      Assessment of the volume of blood loss, its correction under hemoglobin control,
      and consideration for the patient's general condition allows radical operative
      treatment to be conducted in the majority of cases (96.4%). Good results were
      produced with the use of advanced surgical techniques of hemorrhoidectomy.

PMID- 2232594
TI  - [Surgical treatment of cancer of the large intestine, complicated by intestinal
      obstruction].
AB  - Retrospective analysis of the treatment of 3,080 patients with cancer of the
      large intestine made it possible to distinguish compensated, sub- and
      decompensated degrees of the neoplastic stenosis and place the two last named
      into the category of a complicated course of cancer. In subcompensated stenosis
      (complications in 16.3% of cases, mortality 5.9%), irrespective of the location
      of the tumor, the authors consider one-stage intervention with primary
      restoration of the continuity of the intestine to be the operation of choice. In
      decompensated stenosis (complications 28.9%, mortality 13.2%) caused by tumors of
      the right colon and the rectum they recommend a similar policy, while in tumors
      of the left colon they believe Hartmann's operation to be indicated.

PMID- 2232596
TI  - [Morbidity and mortality in anesthesia].

PMID- 2232595
TI  - [Clinical course and treatment of traumatic rectal fistula].
AB  - From experience in treatment of 104 patients with rectal fistulas of traumatic
      origin the authors distinguished the specific features of the clinical
      manifestations of the disease which must be taken into consideration in choosing
      the therapeutic tactics. In contrast to the management of common chronic
      paraproctitis, the treatment of traumatic rectal fistulas differs in principle,
      particularly when the internal opening of the fistula is in the wall of the
      rectal ampulla++. The authors determined the indications for various methods of
      treatment and techniques of operative interventions, including multistage
      surgical treatment with the creation of temporary colostomy.

PMID- 2232598
TI  - [Avoidance of positioning-induced damage].

PMID- 2232597
TI  - [Notes on safety in anesthesia. Part 1: human and technical errors].

PMID- 2232599
TI  - [Quantifying volume loss].

PMID- 2232600
TI  - [Stabilization of the perioperative heat balance].

PMID- 2232601
TI  - [Safety-relevant characteristics of infants and young children].

PMID- 2232602
TI  - [Avoiding technical complications in epidural conduction anesthesia].

PMID- 2232603
TI  - [An analysis of anesthetic incidents from the medical point of view].

PMID- 2232604
TI  - [Avoiding technical complications in peripheral nerve blocks].

PMID- 2232605
TI  - [Safety of the anesthesia breathing equipment].

PMID- 2232606
TI  - [Dosage equipment, concentration monitoring and the anesthesia system].

PMID- 2232609
TI  - [An analysis of anesthesia incidents from the legal point of view].

PMID- 2232607
TI  - [Detection and avoidance of disconnections in the breathing system].

PMID- 2232608
TI  - [Reliability and error possibilities in monitoring].

PMID- 2232610
TI  - [Measures for the prevention of infections in anesthesia].

PMID- 2232611
TI  - [Reliability of infusion systems and equipment].

PMID- 2232613
TI  - [Training in medical technological equipment].

PMID- 2232612
TI  - [Prevention of electric accidents and electric injuries].

PMID- 2232614
TI  - [Computer simulation of anesthesia and anesthesia-related incidents].

PMID- 2232615
TI  - [Decision support].

PMID- 2232616
TI  - [The critical incident conference as an instrument of quality control].

PMID- 2232618
TI  - [Organizing and equipping the workplace].

PMID- 2232617
TI  - [Teaching methods in continuing education].

PMID- 2232619
TI  - [Qualitative and quantitative personnel planning].

PMID- 2232620
TI  - [Quality assurance through organizational measures].

PMID- 2232621
TI  - [Risk minimization in arterial and venous catheterization].

PMID- 2232622
TI  - [Intubation and the avoidance of its risks].

PMID- 2232623
TI  - [Lessening the aspiration risk].

PMID- 2232624
TI  - New approaches in the treatment of the dystonias.
AB  - At this point the treatment of dystonias remains highly empirical. Secondary
      dystonias, especially those related to specific drug treatment, have to be ruled
      out carefully. A few dystonic subgroups respond well to levodopa medication. In
      the other syndromes, anticholinergics are the usual first choice. In focal
      conditions botulinum toxin injections seem to be the most effective regimen,
      although there are only a few long-term studies. Surgical procedures are an
      ultimate option.

PMID- 2232625
TI  - The influence of penbutolol and placebo on blood sugar levels and insulin
      consumption in the glucose-controlled insulin infusion system ("artificial
      endocrine pancreas").
AB  - The aim of the study was to investigate the influence of 40 mg of the beta
      blocker penbutolol (Betapressin TM; Hoechst Ltd., Frankfurt/Main) in comparison
      to placebo on the insulin consumption on the blood sugar profile in twelve
      insulin-dependent diabetes (IDDM) patients. The patients were treated with
      penbutolol and placebo for a period of three days, and then were examined with
      the help of the glucose-controlled insulin infusion system. The blood sugar
      profile and insulin consumption over a 24 hour period was not affected by either
      penbutolol or placebo, nor could any changes be measured in these parameters when
      measured after food intake. After a submaximal exercise load on the bicycle
      ergometer (1 watt per kg body weight) following an evening meal, no difference
      could be observed between penbutolol and placebo in the above-mentioned
      parameters. The same was also true for hormonal parameters as STH, ACTH,
      cortisol, and catecholamines. These findings demonstrated that medication of
      penbutolol over a three-day period has no influence on the baseline blood sugar
      profile and insulin consumption or on insulin consumption after food intake
      during rest and physical exercise.

PMID- 2232626
TI  - Gastric emptying in non-responders to H2-receptor antagonists.
AB  - H2-receptor antagonists are known to fail to increase the intragastric pH in some
      patients (so-called non-responders), and we have recently found a higher
      frequency of non-responders among cirrhotics. Since intragastric pH is also
      affected by gastric emptying, in the present study we determined the gastric
      emptying of 300 ml orange juice labelled with [99mTc]-Solco Nanocoll using a
      gamma camera. Measurements were made over a period of 60 min in cirrhotic
      patients and controls without liver disease who either responded to 300 mg
      ranitidine or showed no response. The mean (+/- SD) liquid half-emptying time
      (T1/2) was 26.3 +/- 17.5 min (range, 9-75 min) in responders (n = 10), 20.9 +/-
      8.6 min (range, 7-34 min) in non-responders (n = 10), 19.4 +/- 19.2 min (range, 7
      75 min) in cirrhotics (n = 11), and 27 +/- 4.6 min (range, 17-33 min) in controls
      (n = 9). In 19 of the 20 subjects gastric emptying was normal (T1/2, less than 40
      min). Since gastric emptying was not delayed in any of the non-responders, it
      would appear very unlikely that gastric motility plays a major role in the non
      response to H2-receptor antagonists.

PMID- 2232627
TI  - [The role of TSH psychological and somatic changes in thyroid dysfunctions].
AB  - The characteristic psychic and somatic features found in patients with overt
      hyper- or hypothyroidism are usually attributed to elevated or diminished levels,
      respectively, of thyroid hormones. This concept does not sufficiently explain our
      previous investigations in which the same symptoms, albeit attenuated, were also
      seen in patients suffering from so-called latent disturbances of thyroid
      function. This state of disorder, however, exhibits normal concentrations of
      peripheral thyroid hormones. Only the response of thyroid-stimulating hormone
      (TSH) to thyrotropin-releasing hormone (TRH) stimulation is in accordance with
      the behaviour of the overt thyroid dysfunction and enables its differentiation
      from the euthyroid state. In this context, we investigated the question as to
      whether pathologic signs in thyroid disorders are correlated to alterations of
      peripheral thyroid hormones or to changes in the hypothalamus pituitary axis.
      Therefore, we investigated two groups of ten patients each who suffered from
      latent hyper- or hypothyroidism, respectively, and ten euthyroid controls. All
      were matched from sex and age. Endocrine function was estimated by TRH testing,
      TT3, TT4 and thyroxine binding globulin (TBG). Psychologic testing was performed
      by questionnaires concerning subjective somatic symptoms, emotional disturbances,
      psychomotoric performance, cognitive impairment and personality. Patients with
      latent hyperthyroidism were more subject to somatic symptoms and affective
      complaints than were those who had latent hypothyroidism. As compared with
      controls, there were significant differences in exhaustion and pain in the limbs
      and heart. In terms of affective complaints, patients were more depressive,
      anxious, touchy and irritable; their personalities showed a higher degree of
      emotional lability, excitement and irritability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232628
TI  - Acute tubulo-interstitial nephritis with uveitis (TINU syndrome) in a patient
      with serologic evidence for Chlamydia infection.
AB  - A 38-year-old female patient with acute tubulo-interstitial nephritis and uveitis
      (TINU syndrome) is described. The cause of this rare disease is unknown; most
      patients affected are adolescent females. Serologic investigations in the patient
      reported point to a possible etiologic role of Chlamydia infection in this
      disease.

PMID- 2232630
TI  - Concurrent hypercortisolism and hyperaldosteronism due to an adrenal adenoma.
AB  - The case of a 39-year-old woman with Cushing's syndrome, hypertension and severe
      hypokalemia, caused by a unilateral adrenal adenoma composed of cells of the zona
      fasciculata histological type, is described. Plasma renin activity, plasma levels
      of mineralocorticoids and the aldosterone secretion rate were determined before
      and after surgical removal of the adenoma. The tumor appeared to produce
      autonomously cortisol as well as corticosterone, 18-hydroxycorticosterone and
      aldosterone. This condition has not previously been described in the literature
      and might be explained by strong expression of the full spectrum of activities of
      the mitochondrial enzyme P450 C11 by the tumor cells. Interestingly, despite
      hyperaldosteronism, plasma renin activity was not suppressed.

PMID- 2232629
TI  - Successful therapy of meningococcal sepsis in acute disseminated lupus
      erythematosus with plasmapheresis, immunosuppression, and antibiotics.
AB  - A 17-year-old female with a 5-year history of disseminated lupus erythematosus
      has remained without immunosuppressive therapy for the last 3 years. She was
      admitted to the hospital for acute abdominal pain, generalized edema, and rapidly
      developing dyspnea and somnolence. Although all symptoms were consistent with
      active SLE, septicemia was suspected because of leukocytosis
      (20,000/microliters), greatly elevated C-reactive protein (45 mg/dl), and normal
      complement values (C3 0.74 g/l, C4 0.21 g/l). Directly after bacterial blood
      cultures were prepared, a combined treatment was instituted consisting of
      plasmapheresis (3 x 2.1 l against fresh frozen plasma), antibiotics,
      prednisolone, and cyclophosphamide following the last plasmapheresis. Within
      three days cerebral function returned to normal, edema improved, and CRP fell to
      0.5 mg/dl. The blood cultures and pericardial effusion displayed meningococcal
      colonies.

PMID- 2232631
TI  - Studies on proteolysis of protein kinase C with calpain I and II.
AB  - Earlier reports from this laboratory have shown that protein kinase C (PKC) is
      cleaved with Ca2(+)-dependent neutral protease (calpain) I or II to produce a
      catalytically active fragment, and that calpain I, which is active in the
      micromolar range of Ca2+, may react preferentially with the active form of PKC
      that is associated with membranes. Subsequently, PKC is shown to exist as a large
      family of multiple subspecies with subtle individual characteristics. Three types
      of PKC designated types I, II, and III are purified from rat brain cytosol, which
      are shown to correspond to the cDNA clones gamma, beta, and alpha, respectively.
      The aim of the present study was to characterize the proteolysis of each PKC
      subspecies with calpain I and II. All types of PKC (82 kDa) were converted to two
      major fragments: a 47-49-kDa catalytic and a 36-kDa regulatory fragments by the
      cleavage with either calpain I or II. Analysis of the NH2-terminal sequence of
      the resulting catalytic fragments indicated that both calpain I and II cleaved at
      one or two specific sites in the variable region (V3) of each PKC molecule of
      which structure was clearly different among PKC subspecies. From kinetic studies,
      the cleavage of PKC subspecies with calpain I, and to a lesser extent, with
      calpain II (active in the millimolar range of Ca2+), was remarkably enhanced by
      the simultaneous presence of phospholipid and diacylglycerol or phorbol ester,
      suggesting that the active forms of PKC subspecies were the preferred targets for
      proteolysis. Whereas, stimulatory abilities of the lipids were variable among PKC
      subspecies and inactive form of type I PKC was cleaved with calpain I at a
      significant rate. Quantitative analysis with a fixed amount of calpain under
      comparable conditions showed that the susceptibilities of the PKC subspecies were
      distinctly different one another; the relative rates of cleavage of types I, II,
      and III PKC with calpain I and II were approximately 100:16:2 and 100:48:23,
      respectively. These results indicated that within the cell various PKC subspecies
      might be cleaved at different rates under different physiological conditions.

PMID- 2232632
TI  - [Chemotherapy of epilepsy (review of foreign literature)].

PMID- 2232633
TI  - [Ultrasonic diagnosis of liver diseases].
AB  - Sonography has become widely used in the diagnosis of liver diseases. Fatty
      infiltration of the liver (adiposis hepatica), hepatic cirrhosis, cysts,
      metastases and tumors can be reliably diagnosed. A valid differentiation between
      benign and malignant new growths, however, can only be obtained by cytologic and
      histologic techniques. The lowest sensitivity can be expected in chronical benign
      diffuse diseases. Our results were compared with those in literature.
      Furthermore, other diagnostic approaches and procedures, e.g. fine needle biopsy
      and sclerotherapy in cysts, are recorded.

PMID- 2232634
TI  - [Recurrent meningococcal meningitis].

PMID- 2232635
TI  - [A case of Wissler-Fanconi allergic subsepsis syndrome].

PMID- 2232636
TI  - [A case of skin amyloidosis in an elderly patient].

PMID- 2232637
TI  - [Selection of therapeutic tactics for nonspecific spontaneous hemopneumothorax].
AB  - The results of treatment have been analyzed for 45 patients with nonspecific
      spontaneous hemopneumothorax. Therapeutic policy was decided upon individually
      basing on the patient's condition and clinical appearance of the disease. Urgent
      surgery was performed in 68.0% of patients for continuous intrapleural bleeding
      and tense pneumothorax. The rest cases underwent pleural puncture. Pleural
      drainage failed to eliminate spontaneous hemopneumothorax in all the patients.
      The causes of SHP were established mostly intraoperatively. In 81.8% of the cases
      it resulted from a rupture of a bullous lung. Long-term follow-up (1-18 years) of
      28 patients treated surgically and conservatively recorded no recurrences.

PMID- 2232638
TI  - [Family physician: problems and realities].
AB  - The experience gained in the Soviet Union and abroad with family physician
      service is reviewed. The scope of his duties is outlined which are to be adjusted
      for specific conditions of rural and city health care. The family physician is to
      be neither a particular specialist nor an expert in all fields of medicine,
      rather a broad-minded and skilled internist informed about social and
      psychological matters and able to attend both adults and adolescents. The chief
      goal of his practice should be prophylaxis medicine, regular check-ups. Extensive
      experimental research is needed to adopt the system of family physician in this
      country as it necessitates revision of conventional principles of industrial,
      school, outpatient services, training of medical staff, etc.

PMID- 2232639
TI  - [The first in Russia center of higher medical education (on the 280th anniversary
      of the Moscow hospital and the Moscow medico- surgical school--the S.M. Kirov
      Military Medical Academy)].

PMID- 2232640
TI  - [S.P. Botkin and the St. Petersburg Society of Russian Physicians (biographical
      data)].

PMID- 2232642
TI  - [Intravascular coagulation in acute and chronic hepatitis].

PMID- 2232641
TI  - [Medical observations in A.P. Chekhov's novel "From Siberia"].

PMID- 2232643
TI  - [Chronic enteropathies].

PMID- 2232644
TI  - [Respiratory infections as a risk factor for patients with ischemic heart
      disease].
AB  - The effect of respiratory infection (influenza, parainfluenza, adenovirus and
      enterovirus) on clinical and functional states was assessed for coronary (n-850)
      and noncoronary (n-250) patients. The infection-related pathology turned out more
      severe in coronary patients. Disaggregation agents were found useful in early
      diagnosis of coronary heart disease and prevention thereof.

PMID- 2232645
TI  - [Comparative value of electrocardiographic criteria of myocardial ischemia in
      exercise tests].
AB  - Treadmill and isometric tests were carried out in 108 patients with coronary
      heart disease confirmed at coronary arteriography versus 51 healthy subjects.
      Among myocardial ischemia criteria depressed S-T segment came out as most
      reliable (probability of valid diagnosis greater than 90%), less significant was
      wave T inversion, wider wave R amplitude, painful syndrome (probability 70%). The
      rise and depression of oblique upward segment S-T, abnormal T amplitude proved
      inferior to the above signs (probability less than 50%). To achieve valid
      diagnosis of coronary heart disease and to assess its severity, exercise tests
      should produce reliable criteria of myocardial ischemia.

PMID- 2232646
TI  - [Variants of the clinical course of ventricular pre-excitation syndrome].

PMID- 2232647
TI  - [Difficulties in the diagnosis of rheumatic heart defects in elderly patients].
AB  - Clinical and autopsy data presented in this paper illustrate difficulties arising
      in diagnosis of rheumatic heart disease (RHD) in elderly patients. RHD
      misdiagnosis is explained by unclear clinical symptoms, undone laboratory tests,
      concomitant diseases, misinterpretation of some objective indications
      (auscultatory symptoms, ECG). To diagnose acquired RHD earlier the physicians are
      recommended to refer their patients to ultrasound investigations of the heart.

PMID- 2232648
TI  - [Esophageal diseases in patients with stenocardia and angiographically changes
      and little-changed coronary arteries].
AB  - Angiography conducted in 29 anginal patients has shown that coronary arteries
      were intact in 23 and little affected in 6 of them. Signs of myocardial ischemia
      were recorded at myocardial scintigraphy, bicycle ergometry, 24-h ECG monitoring
      in 17 patients. Esophageal lesions confirmed by endoscopy, manometry, esophageal
      pH-metry with Bernstein test were revealed in 20 examinees (68%). It is suggested
      that patients with persistent chest pain and unaffected coronary arteries who are
      resistant to antianginal therapy should undergo functional study of the esophagus
      including endoscopy, manometry and pH-metry.

PMID- 2232650
TI  - [Evaluation of the effectiveness of calcium antagonists combined with digoxin and
      furosemide in hypertension complicated by circulatory insufficiency in elderly
      patients].
AB  - Clinical, hemodynamic and neurohumoral data are available supporting the validity
      of a differentiated approach to administration of combined treatment with
      furosemide, digoxin and calcium antagonists nifedipine and verapamil in advanced
      aged patients with hypertension complicated by circulatory disorders. The choice
      of the drugs should be based on the criterion of per hour diuresis following a
      single dose of the combination.

PMID- 2232649
TI  - [Laser acupuncture in the complex treatment of stenocardia].
AB  - Acupuncture points were exposed to helium-neon laser beam in 200 anginal
      patients. This therapeutic modality yielded good results: the number of attacks
      and nitroglycerin intake reduced, exercise tolerance grew, echocardiographic
      evidence showed a positive trend, hemodynamics improved, Spilberger's test values
      changed for the better.

PMID- 2232651
TI  - [Clinical value of 24-hour monitoring of arterial blood pressure using a portable
      apparatus].

PMID- 2232652
TI  - [Evaluation of the effect of intravenous administration of streptodecase on the
      extent of the damage in myocardial infarction].
AB  - Precordial mapping was employed to examine 29 patients with acute anterior
      transmural myocardial infarction (MI). Seventeen of them received intravenous
      streptokinase, eleven underwent symptomatic therapy. The size of the lesion was
      assessed in the course of the disease. It is shown that streptokinase
      administration within the initial 6 hours of MI promotes arrest of the ischemic
      lesion augmentation and eventually diminishes the area of MI.

PMID- 2232653
TI  - [Use of dynamic transesophageal electric stimulation of the heart in patients
      with functional disorders of the sinoatrial node].
AB  - Transesophageal pacing used for sinus dysfunction detection in 103 patients has
      been assessed for informative appropriateness in design of the attendance policy
      and efficacy of outpatient chemotherapy. The response control by
      electrophysiological monitoring was performed in 22 patients with true sick sinus
      syndrome (group 1) and 27 ones with sinus dysfunction (group 2). The rest
      patients were not controlled objectively. Transesophageal pacing of 5 group 1
      patients brought about indications for surgical treatment. For 8 patients the
      follow-up revealed evolution of the sinus vegetative dysfunction into organic
      lesion which required surgical intervention in one case. The effect of
      chemotherapy with sympathomimetic drugs in adequate doses tended to reduction
      with increasing duration of the follow-up. In those with true sick sinus syndrome
      this process ran more actively. Long-term chemotherapy for sinus dysfunction is
      found effective as it warrants appreciable improvement of sinoatrial conduction,
      outpatient therapy control by dynamic transesophageal pacing is objective and can
      be recommended as adequate.

PMID- 2232654
TI  - [Effectiveness of long-term antihypertensive therapy with tenoretic--a combined
      long-acting drug].

PMID- 2232656
TI  - [Diagnosis of drug intolerance].

PMID- 2232655
TI  - [Status of microcirculation in patients with ischemic heart disease and
      concomitant bronchopulmonary diseases].
AB  - Microcirculation was studied by bulbar biomicroscopy in 111 coronary patients
      (105 males and 6 females) treated at sanatorium. Eighty-three of them exhibited
      concomitant bronchopulmonary impairment: chronic obstructive, chronic
      nonobstructive bronchitis and bronchial asthma in 40, 36 and 7 patients,
      respectively. The combined effect of the diseases leading to mutual aggravation
      has an adverse sequelae in terminal circulation, which can be managed by
      therapeutic impact on cardiorespiratory system. Special measures aimed at better
      ventilation result in microcirculatory improvement and should be included into
      rehabilitation programs for patients with cardiorespiratory pathology. Such
      patients are recommended to undergo microcirculation study which would be able to
      indicate the condition severity and serve a criterion of sanatorium treatment
      effectiveness.

PMID- 2232657
TI  - [Evaluation of the quality of drug therapy of middle-aged and elderly patients].

PMID- 2232658
TI  - [Neurologic disorders in insulinoma].
AB  - Three cases of insulinoma-related neuropsychic disturbances and literature data
      are considered. Special emphasis is given to polymorphism of epileptiform
      syndrome, concomitant disphoric paroxyms and lethargy. A case of a rare syndrome
      coma vigil is described in the advanced stage of the disease. The discussion
      covers pathogenetic mechanisms and differential diagnosis.

PMID- 2232660
TI  - [Computerized tomo-myelography in the diagnosis of lesions of the spinal cord].

PMID- 2232659
TI  - [Effect of the treatment on hemodynamic indicators and plasma testosterone level
      in patients with juvenile hypertension].
AB  - The effect of anapriline, corinfar and reserpine on parameters of hemodynamics
      and plasma testosterone was evaluated in 60 juvenile hypertension patients who
      achieved pronounced hypotensive response. It was established that the level of
      sex hormones tended to diminution by the end of the treatment month 1 or 2, this
      drop being more noticeable in reserpine administration. Basing on this evidence
      it would be beneficial for patients suffering from juvenile hypertension in need
      of chemotherapy to take courses of the above drugs.

PMID- 2232661
TI  - [Liver abscesses with intrathoracic complications].

PMID- 2232662
TI  - [The masks of violence].

PMID- 2232663
TI  - [Don't wait until it is too late].

PMID- 2232665
TI  - [Report from Italy. A little piece of humanity].

PMID- 2232664
TI  - [Health education for shelter seekers. Values to respect].

PMID- 2232666
TI  - [Atomic energy: an abuse of creation].

PMID- 2232667
TI  - [The body language of the soul].

PMID- 2232668
TI  - [Promotion of urinary continence in hospitalized aged: a worthwhile expenditure].

PMID- 2232670
TI  - [Voluntary re-entry--involuntary exit. Changes undesirable].

PMID- 2232669
TI  - [Visit in a cooperative for the aged. "We maintain a high grade of culture in our
      dialogue"].

PMID- 2232671
TI  - [A working day in a small private hospital. "Like a film that is running too
      fast"].

PMID- 2232672
TI  - [Health for all: talking about it and doing it. . ].

PMID- 2232673
TI  - [Poor and sick in a rich country?].

PMID- 2232674
TI  - [Disturbed nutritional behavior--psychological problems?].

PMID- 2232675
TI  - [Transplantation: the 2 faces of progress].

PMID- 2232676
TI  - [Man--a piece of merchandise?].

PMID- 2232677
TI  - [Medico-ethical guidelines for transplantation].

PMID- 2232678
TI  - [Transplantation: emotionally we are left behind].

PMID- 2232679
TI  - [The viewpoint of a patient with liver transplantation. "The new liver is feeling
      fine in my body"].

PMID- 2232680
TI  - [The operating room nurse's viewpoint. "We would like to transplant more"].

PMID- 2232681
TI  - [Organ transplantation in Switzerland].

PMID- 2232682
TI  - [Bone marrow transplantation].

PMID- 2232684
TI  - [Organ removal. What is going on in the operating room?].

PMID- 2232683
TI  - [Community nurses are cooperating in a regional program of health promotion:
      prevention of "heartbreakers"].

PMID- 2232685
TI  - [3 practitioners talk about grafts. Love of the profession].

PMID- 2232686
TI  - [The childrens' problem: refusing the lie].

PMID- 2232687
TI  - [Stress, questioning, subtlety--from the donor to the transplant patient: a
      difficult passage].

PMID- 2232688
TI  - [Organization and coordination. Programs for organ exchange].

PMID- 2232689
TI  - [Profile of a patient with liver transplantation and the course of care: looking
      for a better method of care].

PMID- 2232691
TI  - [Report from Italy: a little humanity].

PMID- 2232690
TI  - ["Learning happiness". Interview by Francoise Taillens].

PMID- 2232692
TI  - [Refuse in the hospital].

PMID- 2232693
TI  - [Refuse disposal in the hospital. 2. Practical refuse disposal in clinical
      practice].

PMID- 2232694
TI  - [Recycling of disposable materials is objectionable from medical, legal, economic
      and ecologic viewpoints].

PMID- 2232695
TI  - [Ways of artificial fecal diversion].

PMID- 2232696
TI  - [Colorectal cancer].

PMID- 2232697
TI  - [Ambulatory care is better and less expensive].

PMID- 2232698
TI  - [Changes in health care delivery--new perspectives for ambulatory patient care].

PMID- 2232699
TI  - [Postoperative confusion in aged patients].

PMID- 2232700
TI  - [Freedom].

PMID- 2232701
TI  - Extracellular matrix biosynthesis by cultured fetal rat lung epithelial cells.
      II. Effects of acute exposure to epidermal growth factor and retinoic acid on
      collagen biosynthesis.
AB  - The effects of acute exposure to epidermal growth factor (EGF), retinoic acid,
      and EGF + retinoic acid on collagen biosynthesis by fetal rat lung epithelial
      (FRLE) have been evaluated. Acute exposure to either EGF or retinoic acid
      resulted in a small increase in the amount of radioactive substrate incorporated
      into total proteins, but simultaneous exposure to EGF + retinoic acid increased
      total protein synthesis approximately 2-fold. Quantitative evaluation of the
      genetic types of collagen synthesized by FRLE cells (types I, III, IV, and V)
      revealed that each experimental condition affected collagen production in a
      different manner. Acute exposure to EGF selectively inhibited type III collagen
      production, minimally affected type I and type IV collagen synthesis, but
      enhanced type V collagen production. Acute exposure to retinoic acid minimally
      affected type III production but slightly enhanced the synthesis of type I
      molecules. Simultaneous acute exposure to both EGF and retinoic acid
      significantly increased the amounts of types I, IV, and V collagen synthesized
      but minimally affected type III collagen production. Evaluation of the molecular
      forms of type I collagen (the type I-heterotrimer-molecular composition [alpha 1
      (I)]2 alpha 2(I) and the type I-homotrimer-molecular composition [alpha 1 (I)]3)
      synthesized under each condition revealed that EGF minimally affected the
      production of either molecular form of type I collagen. In contrast, acute
      exposure to retinoic acid in the absence or presence of EGF caused a greater than
      2-fold increase in the amount of type I-homotrimers synthesized but substantially
      decreased the amount of type I-heterotrimers produced. These results demonstrate
      that alone, either EGF or retinoic acid modulate collagen synthesis by FRLE cells
      and that in combination, these substances exert effects on collagen production
      that differ from their individual actions. Thus, in addition to documenting that
      EGF and retinoic acid modulate collagen biosynthesis in a cell line derived from
      the fetal type II pneumocyte, these studies establish that FRLE cells constitute
      a useful in vitro model system for investigating the regulation of matrix
      biosynthesis and its relationship to the development of the alveolar epithelial
      cell.

PMID- 2232703
TI  - Fate of nerve fibers in necrotic, healing, and healed rat myocardium.
AB  - Myocardial infarction, myocardial scar tissue formation, and cardiac
      arrhythmogenesis seem to be associated. There are electrophysiological data
      suggesting that myocardial nerves are involved in arrhythmia development;
      however, there are no morphologic studies describing the fate of these nerves
      following necrotizing myocardial injuries. To describe the reactions of Schwann
      cells and axons following such injuries, we induced lesions in rat hearts with
      ischemia or transdiaphragmatic freeze-thawing and examined the acutely necrotic,
      healing, and healed lesions with light and electron microscopy. Antibodies to
      Schwann cell-associated S-100 protein were used to facilitate histologic
      detection. Both forms of injury produced focal lesions in which Schwann cells
      were killed and axonal segments destroyed; however, the basal lamina sheaths of
      cardiac myocytes and capillaries, and probably also of nerve fibers, remained
      largely intact. During 4 weeks of sequential observations, Schwann cells and
      axons were components of a hypercellular healing front that began at the
      periphery and moved toward the center of each lesion. Their proliferation and
      growth may have occurred within the original nerve basal lamina sheaths, and
      reparative axonal enlargements contained an abundance of 50- to 100-nm clear and
      dense storage granules. Fully developed nerve fibers were not only present in
      newly formed scar tissue but also appeared to be present in significantly greater
      density than in uninjured myocardial tissue. These findings demonstrate that
      proliferative nerve fiber regeneration occurs from the edges of necrotizing
      myocardial injuries, that healing results in relatively large number of nerve
      fibers in newly formed scars, and that axons in these scar-associated nerve
      fibers contain an abundance of neurosecretory granules. The functional
      significance of these observations remains to be determined.

PMID- 2232702
TI  - Two rat models of hepatic fibrosis. A morphologic and molecular comparison.
AB  - We present a morphologic and molecular comparison of two models of hepatic
      fibrosis. Immune complexes are the source of insult in one model. In the other
      model, CCl4 induces fibrosis. For the immune complex model, rats were immunized
      intraperitoneally over the course of 4 weeks with human albumin, then injected
      through a tail vein three times a week for at least 5 more weeks with the same
      albumin. Seventy-five percent of all treated animals developed fibrosis
      characterized by fine collagen bands. There was a mild degree of hepatocyte
      trapping and necrosis as well as some bile duct hyperplasia and tissue
      eosinophilia. However, there was no significant Kupffer cell hyperplasia or
      inflammatory reaction. Quantification of specific mRNA species was determined by
      Northern blot hybridization analysis of total RNA. In comparison with CCl4
      induced fibrosis in rats, a hepatotoxin-mediated model with a much greater
      inflammatory response, this immune complex model showed a less pronounced
      increase in type I procollagen mRNA, but a relatively greater increase in types
      III and IV procollagen mRNA. Whereas transforming growth factor-beta 1 mRNA
      levels were markedly increased in CCl4-induced fibrosis, there was only a slight
      increase in this cytokine, known to stimulate type I collagen synthesis, in the
      immune complex model. A comparison of the two model systems indicates that a
      variety of mechanisms may be involved in the process of hepatic fibrogenesis. It
      appears that an inflammatory response and elevated transforming growth factor
      beta 1 levels are associated with a marked increased synthesis of type I collagen
      in a hepatotoxin model while other, as yet undefined, mediators may be
      responsible for the increase in types III and IV procollagen mRNA species found
      in the immune complex model.

PMID- 2232705
TI  - Smooth muscle differentiation in cultured human breast gland stromal cells.
AB  - We analyzed in cultures from the human breast the potential of stromal cells
      resembling fibroblasts to undergo smooth muscle differentiation. The cellular
      components of the breast tissue from 10 biopsies were disaggregated by
      collagenase digestion and further purified by differential centrifugation into
      suspensions of single cells and intact blood vessels. These two fractions of
      stromal cells were plated in culture and their phenotypic traits analyzed within
      24 hours. During this time, the blood vessel fraction gave rise to stromal cells
      with smooth muscle differentiation as judged immunocytochemically using
      monoclonal antibodies to alpha-/gamma-muscle actins, to alpha-smooth muscle
      actin, to type IV collagen, and to laminin. Furthermore, the cells of this
      fraction resembled smooth muscle cells based on 2D gel electrophoresis and
      immunoblotting determination of isoactin content. After 24 hours in culture, the
      single-cell fraction consisted of an almost pure population of cells not
      exhibiting smooth muscle differentiation but rather resembling fibroblasts.
      Maintenance of fibroblast-like cells without smooth muscle differentiation was
      possible for more than 14 days on chemically defined medium. These cells remained
      quiescent, as measured by cell quantification and immunoreactivity to the
      proliferation-associated antigen, Ki-67. Growth of these cells could be
      stimulated by adding serum at any time during the experimental period. Single
      cell fractions from seven biopsies were allowed to grow exponentially in the
      presence of serum for up to 10 days, and the kinetics of smooth muscle
      differentiation were monitored immunocytochemically and biochemically. These
      experiments showed that alpha-smooth muscle actin synthesis was induced in 10 to
      80% of the fibroblast-like cells after 4 to 11 days in culture. Both the final
      number of alpha-smooth muscle actin-positive cells and the onset of synthesis
      varied with the initial seeding density. Dose-response experiments (at constant
      cell density) revealed that serum exerted maximal effect at concentrations above
      10%. It was therefore concluded that elements of smooth muscle differentiation
      may arise in non-smooth muscle stromal cells taken directly from human breast
      tissue.

PMID- 2232704
TI  - Propylthiouracyl-induced hypothyroidism results in reversible
      transdifferentiation of somatotrophs into thyroidectomy cells. A morphologic
      study of the rat pituitary including immunoelectron microscopy.
AB  - Two-month-old female Fischer-344 rats were rendered hypothyroid by ingestion of
      propyl-thiouracyl (PTU) (0.1% in drinking water) and sacrificed 3, 7, 14, and 28
      days after the start of PTU administration as well as 3, 7 and 14 days after
      interruption of a 14-day PTU treatment. Controls received no PTU. The pituitaries
      were studied by histology, immunohistochemistry, electron microscopy, and
      immunoelectron microscopy, using the immunogold double-labeling technique. In the
      course of hypothyroidism, pituitary thyrotrophs had undergone the well-known
      thyroidectomy change. In addition, a contingent of growth hormone (GH) cells lost
      their large secretory granules, enlarged, displayed progressive dilation of rough
      endoplasmic reticulum, thereby transforming into thyroidectomy cells. These
      bihormonal thyrosomatotrophs contained gH in their secretory granules and
      thyrotropin in the dilated rough endoplasmic reticulum as documented by the
      immunogold double-labeling method for GH and thyrotropin. After discontinuation
      of PTU treatment, a rapid increase in size, number and GH labeling of secretory
      granules and simultaneous involution of distended rough endoplasmic reticulum
      with reduction of thyrotropin labeling took place in thyrosomatotrophs. A
      practically complete restitution of normal pituitary structure was seen in 2
      weeks. Results implicate that, contrary to previously accepted concepts,
      adenohypophysial cells may not be irreversibly committed to one morphologically
      recognizable cell line.

PMID- 2232706
TI  - Inherited lysozyme deficiency in rabbits. The absence of a primary isozyme of
      lysozyme as the cause of the condition.
AB  - Lysozyme from normal and genetically lysozyme-deficient rabbits was extracted
      from three types of tissue: leukocytic (bone marrow), lymphoepithelial (thymus
      and appendix), and gastrointestinal (colon). Extracts were analyzed by
      electrophoretic, chromatographic, and kinetic techniques. Identification of at
      least two isozymes of rabbit lysozyme was made with these techniques. The
      distribution of the isozymes was tissue specific. Leukocytic and gastrointestinal
      isozymes were clearly distinguished, and a possible lymphoepithelial isozyme that
      resembled the gastrointestinal isozyme electrophoretically and
      chromatographically but not kinetically was identified. Mutant, lysozyme
      deficient rabbits lacked completely a detectable leukocytic isozyme but had
      gastrointestinal and lymphoepithelial isozyme(s) indistinguishable from those of
      normal rabbits. By electrophoretic methods, the mutant rabbits were demonstrated
      to lack a protein band corresponding to that of the leukocytic isozyme of
      lysozyme from normal rabbits. These observations considered collectively were
      interpreted as evidence that at least two primary isozymes of lysozyme are
      present in rabbits and that inherited lysozyme deficiency in rabbits is caused by
      the absence of a single primary isozyme.

PMID- 2232707
TI  - Photoaffinity labeling of human c-myc protein with deoxythymidine triphosphate.
AB  - The recombinant human c-myc protein expressed in Escherichia coli can be
      efficiently labeled by ultraviolet-mediated cross-linking to dTTP and to a lesser
      extent to other nucleoside diphosphates and triphosphates, but not to nucleoside
      monophosphates. Specificity of nucleoside phosphate binding is suggested by (a)
      concentration-dependent competition by some nucleoside phosphates but not by
      others and (b) by the observation that the denatured myc protein does not bind
      the nucleotides. Competition experiments also indicate that the affinity of c-myc
      protein for nucleoside diphosphates and triphosphates is approximately the same
      irrespective of the nature of the base, or of the pentose sugar, but the thymine
      base permits the most efficient photoactivated cross-linking. The ultraviolet
      mediated photoactivated cross-linking of deoxythymidine triphosphate has been
      used to identify the c-myc protein in extracts of cells which overexpress c-myc,
      and to identify the intermediates in myc oncoprotein degradation.

PMID- 2232708
TI  - A novel diagnostic method of Pneumocystis carinii. In situ hybridization of
      ribosomal ribonucleic acid with biotinylated oligonucleotide probes.
AB  - The reactivity and specificity of the in situ hybridization of ribosomal RNA in
      the diagnosis of Pneumocystis carinii were investigated. Three complementary
      oligonucleotide probes, 22 and 25 nucleotides long, corresponding to the species
      specific regions of 5S and 18S ribosomal RNA of Pneumocystis carinii were
      synthesized and labeled with biotinylated dUPT at the 3' termini. In situ
      hybridization was performed on formalin-fixed paraffin-embedded human lung
      tissues using the mixture of these probes and detected with the avidin-biotin
      peroxidase complex method. The reactions were positive in all 12 cases of
      Pneumocystis carinii pneumonia, but in none of the infections with other
      pathogenic agents, including virus (6 cases), mycobacteria (4 cases), protozoa (4
      cases) and fungi (8 cases). The reactivity and specificity of this method was
      comparable with that of immunohistochemistry using a monoclonal anti-human
      Pneumocystis carinii antibody. Because the specificity of in situ hybridization
      is based on nucleotide sequences of ribosomal RNAs, that are constant among
      species, contrary to morphology of protista or expression of antigens, it should
      complement conventional staining and immunohistochemical methods, and provide a
      useful tool for the diagnosis of Pneumocystis carinii.

PMID- 2232709
TI  - Human MCTC type of mast cell granule: the uncommon occurrence of discrete scrolls
      associated with focal absence of chymase.
AB  - Two types of mast cells were previously defined based on neutral protease
      composition and ultrastructurally distinguished by granule morphology. The MCT
      cell contains tryptase with little, if any, chymase and was noted to have varying
      numbers of irregularly-shaped granules with discrete scrolls or particulate or
      beaded material. The MCTC cell contains both tryptase and chymase and was noted
      to have more regularly-shaped electron-dense granules with characteristic grating
      or lattice substructures. This study reports the use of electron microscopy and
      immunogold staining with antibodies against tryptase and chymase to demonstrate
      in mature unstimulated MCTC cells in situ, the focal occurrence of discrete or
      complete scrolls in peripheral regions of certain granules where chymase is
      deficient. these scrolls often appeared to be protruding from the granule.
      Granules containing discrete scrolls were observed in 10 of 340 mature MCTC
      cells, accounting for less than 1% of MCTC granules. Other granules in such cells
      as well as other regions of the granule under consideration, showed strong
      staining for both tryptase and chymase. These results strengthen the association
      of morphology with protease composition in human mast cell secretory granules,
      but weaken the use of morphology alone to identify the MCTC and MCT types of
      human mast cells. Whether the uncommon occurrence of focal absence of chymase in
      MCTC cells arises by chance or as a result of factors relating to mast cell
      development, interconversion, activation, or regranulation will require further
      clarification. In conclusion, the appearance of grating or lattice structures in
      mast cells indicates the presence of chymase and tryptase, characteristic of the
      MCTC phenotype, whereas multiple discrete scrolls in irregularly shaped granules
      suggests the MCT phenotype.

PMID- 2232711
TI  - Heparan sulfate proteoglycans in amyloidogenesis: an epiphenomenon, a unique
      factor, or the tip of a more fundamental process?

PMID- 2232710
TI  - Amyloid enhancing factor and inflammatory reaction.

PMID- 2232712
TI  - Determinants of immune cell trafficking in the skin.

PMID- 2232713
TI  - localization of type VI collagen in the lining cell layer of normal and
      rheumatoid synovium.
AB  - Types I to VI collagens were immunolocalized in normal and rheumatoid synovium
      using monospecific antibodies. Immunofluorescence studies showed type VI in the
      extracellular matrix of the lining cell layer, whereas positive staining for type
      III collagen was observed in both the lining and sublining cell layers. All other
      collagens could not be detected in the lining cell layer. Immunogold staining of
      the rheumatoid synovium localized type VI collagen to filamentous material, which
      was the major extracellular structure of the lining cell layer. Type III collagen
      was associated with thin cross-striated collagen fibrils. A brief treatment of
      rheumatoid synovial tissue with bacterial collagenase produced in the lining cell
      layer numerous broad-banded fibrils with 100-nm periodicity; these fibrils could
      be labeled with the antibody against type VI collagen. This suggests that type VI
      collagen filaments have the potential to form periodic structures under certain
      conditions. We further studied the susceptibility of type I to VI collagens to
      matrix metalloproteinase 1, 2 and 3 (collagenase, gelatinase of molecular weight
      72,000, stromelysin), which are secreted by synovial lining cells in rheumatoid
      synovium, and found only type VI collagen to be completely resistant to all these
      metalloproteinases. These data indicate that type VI collagen, which has the
      ability to bind to cells and to interstitial collagens, plays an important role
      in supporting the synovial lining cells in the normal and rheumatoid synovium.

PMID- 2232714
TI  - Increased production of tumor necrosis factor by normal immune cells in a model
      of the humoral hypercalcemia of malignancy.
AB  - The rat Leydig cell tumor is a well characterized model of the humoral
      hypercalcemia of malignancy. The studies reported here were provoked by the
      observation that tumor-bearing rats become extremely cachectic and develop
      hypertriglyceridemia as they become hypercalcemic. Since the bone resorbing
      cytokine tumor necrosis factor (TNF)/cachectin is associated with cachexia and
      hypertriglyceridemia, we examined hypercalcemic tumor-bearing rats for evidence
      of increased TNF production using a TNF radioimmunoassay. We found that
      immunoreactive TNF was increased in the plasma of tumor-bearing rats. The
      increase in plasma TNF was comparable to that previously shown in hypercalcemic
      nude mice bearing Chinese hamster ovarian cell tumors transfected with the human
      TNF gene. There was no detectable TNF activity in tumor culture media which
      suggested that the tumor itself was not the source of excess TNF production.
      However, we found that tumor cell conditioned media enhanced the production of
      TNF activity by normal macrophages in vitro, indicating that increased TNF
      production in vivo may result from a tumor factor(s) which stimulates TNF
      production by normal immune cells. When TNF was added together with tumor
      products to organ cultures of fetal rat long bones, osteoclastic bone resorption
      was potentiated. These data are consistent with the concept that in this model of
      the humoral hypercalcemia of malignancy, increased TNF production by normal
      immune cells is increased, has systemic effects as suggested by cachexia and
      hypertriglyceridemia, and may work in concert with factors produced directly by
      tumor cells to overwhelm normal calcium homeostasis.

PMID- 2232715
TI  - Expression of native and deglycosylated colon cancer mucin antigens in normal and
      malignant epithelial tissues.
AB  - Immunohistochemical techniques were used to determine the distribution and
      cellular location of the mature and precursor forms of a colonic-type mucin in
      normal and malignant epithelial tissues. The antisera used in this study were
      prepared against native human colon cancer mucin (LS), partially deglycosylated
      mucin (HFA or GalNAc-apomucin), and fully deglycosylated mucin (HFB or apomucin).
      These antisera reacted with most mucin-producing cells of the normal
      gastrointestinal tract, salivary ductular cells, bronchial epithelial cells, some
      bronchial mucous glands, and squamous epithelial cells of the esophagus. Breast,
      endometrium, ovary, prostate, liver, and thyroid were nonreactive. In most normal
      organs, HFB reactivity was present in the supranuclear and perinuclear cytoplasm
      and LS and HFA were located primarily in goblet cell vacuoles, apical cytoplasm,
      and luminal secretions. These findings are consistent with the expected
      subcellular locations of apomucin and more "mature" mucins. LS, HFA, and HFB were
      frequently expressed in adenocarcinomas of the colon, stomach, pancreas, and
      lung. Lymphoma, sarcoma, and melanoma specimens were nonreactive. Alterations in
      the expression of these mucin antigens in malignant tissues included loss of
      subcellular compartmentalization, increased intensity of staining, and
      disappearance of staining. In addition, de novo expression of HFB was observed in
      one of five breast carcinomas and three of five ovarian mucinous
      cystadenocarcinomas. These data demonstrate that LS, HFA, and HFB are useful for
      studying the organ specificities and biosynthetic pathways of one type of mucin
      in normal and malignant tissues.

PMID- 2232717
TI  - The checkerboard tissue block. An improved multitissue control block.
AB  - We describe an improved method of embedding a large number of tissue samples in a
      single, normal-sized paraffin block. Because the tissues are evenly distributed
      in a checkerboard arrangement, they can be readily identified by their position
      in the resulting sections. This device permits rapid and inexpensive screening of
      new histologic reagents, and facilitates intra- and interlaboratory quality
      control.

PMID- 2232716
TI  - Effects of reduced dietary magnesium on platelet production and function in
      hamsters.
AB  - The increased vulnerability of animals fed a magnesium (Mg)-deficient (MD) diet
      to ischemia-induced myocardial necrosis has been attributed to changes in
      myocardial electrolyte metabolism. However, a variety of hematologic changes have
      also been reported in MD and some of these, such as an increase in platelet
      aggregability, may contribute to the increased myocardial vulnerability. In the
      present study, we quantified the effect of MD on platelet and megakaryocyte
      abundance as well as on platelet aggregability with and without an administered
      calcium channel blocker (nifedipine). Hamsters were fed either a "minimal Mg"
      diet, in which the level of Mg was kept just high enough to prevent seizures, or
      a "preset Mg" diet containing precisely known amounts of Mg. Animals fed the
      minimum Mg diet showed an initial increase in the platelet count, which returned
      to control range when the dietary Mg was increased to 9 mmoles/kg. Animals on the
      preset Mg diet showed an increased platelet count if the Mg level was 10
      mmoles/kg or less. In addition to the increase in number, platelets from MD
      animals were less responsive to the aggregation-inhibiting effect of nifedipine
      than were platelets from control animals, although MD itself did not result in an
      increased aggregability under the conditions used here. Animals with an increase
      in circulating platelets showed decreased megakaryocyte abundance in the femoral
      marrow, but megakaryocytes that were present were larger than those in control
      animals. These results indicate a profound effect of dietary Mg deficiency on
      platelet biology. The observed changes could contribute to the increase in
      myocardial vulnerability to injury found in MD animals.

PMID- 2232718
TI  - Clearance of IgA in patients with IgA nephropathy.

PMID- 2232719
TI  - Cocaine in pregnancy: confronting the problem.

PMID- 2232720
TI  - Cocaine use and effect: a major perinatal risk factor in the nineteen nineties.

PMID- 2232721
TI  - A modification of the PEG technique.

PMID- 2232722
TI  - Complications of augmentation mammaplasty and their treatment.

PMID- 2232723
TI  - Cocaine abuse in pregnancy--a myriad of unanswered questions.

PMID- 2232724
TI  - Breast augmentation--is there a risk?

PMID- 2232725
TI  - Living wills and the identification bracelet.

PMID- 2232726
TI  - South Carolina medicine fifty years ago.

PMID- 2232727
TI  - Guidelines for HIV and AIDS student support services.

PMID- 2232728
TI  - Developmentally-based AIDS/HIV education.
AB  - A growing number of health and education professionals argue that AIDS/HIV
      education curricula should be developmentally-based. They suggest the principles
      of developmental psychology be used to design curricula based on the sequentially
      ordered ways children of different ages understand AIDS. Relying on findings of
      research on development of children's conceptions of illness, a specific
      developmentally-based approach to educating school-age children about AIDS/HIV is
      presented in this paper. For each of three major age groups, the paper describes
      general characteristics for children's thought processes, ways in which children
      assimilate information about various aspects of AIDS, and implications for
      educating children about causes, prevention, and fear of AIDS. The focus of
      AIDS/HIV education can move from reducing fear in the younger group, to
      identifying and differentiating causes and noncauses of AIDS in the intermediate
      groups, to articulating strategies for AIDS prevention in the older group.

PMID- 2232729
TI  - AIDS/HIV education for preservice elementary teachers.
AB  - Professional preparation programs should provide future elementary teachers
      opportunities to develop competence in dealing with school-related AIDS issues.
      Curriculum writers and instructors of preservice elementary teachers could be
      more effective if they were aware of this groups' beliefs about school-related
      AIDS issues. A survey was conducted to assess the beliefs and opinions of
      preservice elementary teachers about school-related AIDS issues. Subjects (n =
      157) generally agreed they would eventually have a child with AIDS in their
      classroom and agreed AIDS education should be included in the elementary grades,
      yet a substantial number did not believe they understood the basics about AIDS.
      Less than one-third indicated they knew how to clean up blood or body fluids
      safely. About one-third indicated they would feel personally threatened to teach
      a student with AIDS. These results are reflected in recommended AIDS educational
      content and resources for preservice elementary teachers and future research in
      this area.

PMID- 2232730
TI  - A professional preparation course on AIDS/HIV infection.
AB  - This paper describes the conceptualization, development, planning, and
      implementation of a new professional preparation course entitled "AIDS/HIV
      Education: Issues and Strategies." The 15-week, campuswide course was offered
      through the Dept. of Health Science Education at the University of Florida during
      spring semester 1990. Though universities have been identified as providers of
      preservice education for future teachers and health professionals, current
      activities often have been deemed inadequate to meet the needs of those charged
      with providing AIDS/HIV education. This course was implemented to address an
      array of issues related to HIV education, ranging from epidemiological and
      biomedical information and educational strategies to examination of personal and
      ethical issues surrounding the disease. Delivery of a successful course and
      student reaction are discussed, along with recommendations for programs
      considering similar educational efforts. A detailed planned information packet is
      available from the authors.

PMID- 2232731
TI  - Differences in AIDS knowledge and attitudes by grade level.
AB  - Grade-related similarities and differences in AIDS knowledge and attitudes were
      assessed in 441 fifth, seventh, and tenth graders from one school district. Grade
      level was a significant variable (p less than .01) on 53% of items. Grade-related
      differences in knowledge were apparent when students responded to questions
      tapping information not covered widely in the media and in attitudes when
      personal engagement in behavior was implied. Cognitive and emotional factors
      related to developmental milestones were postulated to account for these
      differences. These findings need to be considered in planning and implementing
      AIDS prevention programs, especially as education is begun for younger children.

PMID- 2232732
TI  - A comparison of AIDS and STD knowledge between sexually active alcohol consumers
      and abstainers.
AB  - Effective curricula should influence knowledge levels of all students, including
      high-risk populations. In this study, a modified version of the National
      Adolescent Student Health Survey was administered to a group of eighth and 10th
      grade students (N = 3,803) exposed to a curriculum designed to improve AIDS and
      STD knowledge levels. The analysis examined the influence of gender, ethnicity,
      alcohol use, and sexual activity as they related to AIDS and STD knowledge.
      Findings indicated poor knowledge scores on STD items, with no significant
      differences on group comparisons. Comparisons of AIDS knowledge scores indicated
      significant differences based on gender, ethnicity, and behavior. Females scored
      higher than males, whites scored higher than blacks, and abstainers from sexual
      activity and alcohol scored higher than their active counterparts. Results
      suggest current educational efforts are not equally effective. Future educational
      initiatives should be sensitive to group membership.

PMID- 2232733
TI  - HIV-related knowledge and behaviors among high school students--selected U.S.
      sites, 1989.

PMID- 2232734
TI  - HIV risk continuum.

PMID- 2232735
TI  - Impact of television news exposure on children's perceptions of violence in
      Northern Ireland.
AB  - The present study assessed the impact of television news exposure on Irish
      children's perceptions of the level of violence in their neighborhoods. Estimates
      from children (N = 570) of the local levels of violence in three areas (high-,
      low-, and no-violence) were subjected to a four-way analysis of variance (Area x
      Sex x Age x News Exposure) that showed a main effect for area and sex with
      respect to the high-violence area and boys. Two two-way interactions also reached
      statistical significance. The first suggested that the perception of lower levels
      of violence by girls was confined to the high- and low-violence areas. The second
      concerned the level of actual violence and the amount of reported news exposure.
      Only in the high-violence area were these two variables related: Accurate
      estimates of actual violence levels were associated with more frequent news
      exposure.

PMID- 2232736
TI  - Perceived intimacy of expressed emotion.
AB  - Research on norms for emotional expression and self-disclosure provided the basis
      for two hypotheses concerning the perceived intimacy of emotional self
      disclosure. The first hypothesis was that the perceived intimacy of negative
      emotional disclosure would be greater than that of positive emotional disclosure;
      the second was that disclosures of more intense emotional states would be
      perceived as more intimate than disclosures of less intense emotional states for
      both negative and positive disclosures. Both hypotheses received support when
      male students in Canada rated the perceived intimacy of self-disclosures that
      were equated for topic and that covered a comprehensive sample of emotions and a
      range of emotional intensities. The effects were observed across all the topics
      of disclosure examined.

PMID- 2232737
TI  - Grouping students for instruction: effects of learning style on achievement and
      attitudes.
AB  - The present study examined the effects of matching and mismatching American
      middle-school students with a preference for learning alone or learning with
      peers with selected instructional treatments in order to determine the impact
      upon their attitudes and achievement in social studies. Analysis revealed that
      the learning-alone preference performed significantly better in the learning
      alone condition and that the learning-with-peers preference performed
      significantly better in the learning-with-peers condition. However, no-preference
      students also performed significantly better in the learning-alone condition than
      with peers. In addition, data revealed that the learning-alone and the learning
      with-peers students had significantly more positive attitudes when matched with
      their preferred learning style; the nopreference students had more positive
      attitudes in the learning-alone condition.

PMID- 2232738
TI  - Social support as a moderator of the relationship between poverty and coping
      behavior.
AB  - This study examined the relationship between poverty and coping and defense
      behaviors and the way social support moderates this relationship. One hundred
      fifty Indian adults responded to scales of income, perceived economic status,
      coping, defense and social support. In addition, physical quality of living was
      rated on the basis of observation and a short interview. Results showed that
      income and physical quality of living were positively associated with perceived
      economic status. Income, physical quality of living, and perceived economic
      status were negatively related to coping and defense behaviors. Finally, social
      support did not moderate the impact of poverty on coping and defense behaviors.

PMID- 2232739
TI  - Belief in a just world and attitudes toward AIDS sufferers.

PMID- 2232740
TI  - Effect of transient mood state on the self-serving bias.

PMID- 2232742
TI  - Who shall be called language disordered? Some reflections and one perspective.
AB  - This paper discusses some issues involved in identifying children who have
      language problems. The perspective taken is that (a) the goal of identification
      must be clearly distinguished from other goals of assessment; (b) identification
      of children with language disorders is better based on language performance than
      on inferences about the language knowledge that underlies this performance; (c)
      language performance must be sampled in more than one context, including, for
      purposes of identification, contexts that stress the language system; (d) the
      standards of expectations for comparing performance and determining differences
      must be explicit; (e) standards used to determine differences are better based on
      the performance of chronological-age peers than on the performance of children
      with similar mental abilities; and (f) children who do not evidence poor language
      performance but are considered at risk for language-related problems should be
      distinguished from children who demonstrate poor language skills.

PMID- 2232741
TI  - Taxonomies in biology, phonetics, phonology, and speech motor control.
AB  - This article begins with a review explaining the different purposes of biological
      taxonomies. Taxonomic units are often dependent on the purpose for which the
      taxonomy has been constructed. Biological taxonomies provide an analogy that we
      use to emphasize some of the distinctions among the units of phonetic
      transcription systems, competence phonologies, and performance phonologies. The
      units of both phonology and phonetic transcription are considered as possible
      units of the speech motor system, and some of the difficulties of this assumption
      are explained. Although phonemic units, like units of phonetic transcription, are
      useful for many purposes, it is not theoretically necessary to use units derived
      as part of competence phonologies in systems attempting to explain phonological
      performance or speech motor performance. In this regard, we challenge the concept
      of coarticulation, because it is based on assumptions about the role of
      phonological or phonetic units in speech motor control. We offer an integrated
      perspective that has implications for research in speech motor control and
      deficits of the speech motor system. We see speech motor deficits as distinct
      from, yet possibly interacting with, phonological deficits.

PMID- 2232743
TI  - Effects of repair strategies on visual identification of sentences.
AB  - This investigation determined whether information elicited by repair strategies
      enhances an individual's ability to lipread a misperceived sentence. Five groups
      of subjects were each assigned one of five repair strategies: (a) asking the
      talker to repeat a sentence, (b) simplify it, (c) rephrase it, (d) say an
      important keyword, and (e) speak two sentences. Subjects viewed sentences spoken
      by six different talkers. When a subject did not recite a sentence verbatim, the
      talker performed the assigned repair strategy and then repeated the original
      sentence. A control group of subjects saw only the original sentence repeated
      twice. All five test groups demonstrated a significantly greater improvement for
      the second presentation score (referenced to the first presentation score) than
      the control group. The benefits provided by the repair strategies were
      independent of the talker, and benefits did not differ significantly among the
      groups.

PMID- 2232744
TI  - Spoken and written English errors of postsecondary students with severe hearing
      impairment.
AB  - This investigation compared the spoken and written English errors of 20 hearing
      impaired postsecondary students with intelligible speech and poor English
      language. Error categories used to assess the language samples were function,
      content, and structure. Spoken and written performances were distinguished only
      by a greater number of function word errors in writing samples. A trend toward
      greater complexity in writing was also found. Implications for instruction are
      discussed.

PMID- 2232745
TI  - Tabletop versus microcomputer-assisted speech management: response evocation
      phase.
AB  - This is the third in a series of studies on the use of microcomputers with speech
      delayed children. Two repeated-measures designs (n = 15) and five case studies
      were completed to compare tabletop management at early and late stages of the
      response development phase with two comparable, computer-assisted drill-and
      practice activities. Discrimination of correct articulatory responses was
      mediated by the clinician in all modes, rather than by speech recognition
      hardware, but all contingent reinforcement in the computer modes was presented by
      animation graphics. The two computer modes were identical except for the addition
      of fantasy involvement in one of the modes. Findings indicated that the three
      modes of intervention were equally effective, efficient, and engaging. Subject
      level analyses suggested that microcomputer software has excellent potential to
      engage children in drill-and-practice for late-phase response evocation, when the
      target sound is stimulable, but limited usefulness with young children at early
      phase response evocation, when specific articulatory behaviors need to be cued.
      Discussion considers learning, child, and hardware/software factors in
      microcomputer-assisted speech management.

PMID- 2232746
TI  - The relationship between communication problems and psychological difficulties in
      persons with profound acquired hearing loss.
AB  - Communication strategies, accommodations to deafness, and perceptions of the
      communication environment by profoundly deaf subjects were correlated with
      indices of psychosocial adjustment to determine whether accommodations to
      deafness could play a role in the presence of psychological difficulties among
      deaf persons. Persons with postlingually acquired profound deafness were
      administered the Communication Profile for the Hearing Impaired (CPHI) and
      several standardized tests of psychological functioning and adjustment.
      Inadequate communication strategies and poor accommodations to deafness reported
      on the CPHI were associated with depression, social introversion, loneliness, and
      social anxiety. Limited communication performance at home and with friends was
      related to both social introversion and the experience of loneliness; perceived
      attitudes and behaviors of others correlated with depression as well as
      loneliness. In general, the pattern of correlations obtained suggests that
      specific communication strategies and accommodations to deafness, rather than
      deafness per se, may contribute to the presence of some psychological
      difficulties in individuals.

PMID- 2232747
TI  - Generalized learning of receptive and expressive action-object responses by
      language-delayed preschoolers.
AB  - This study examined the effectiveness of matrix-training procedures in teaching
      action + object utterances in both the receptive and expressive language
      modalities. The subjects were 4 developmentally delayed preschool boys who failed
      to produce spontaneous, functional two-word utterances. A multiple baseline
      design across responses with a multiple probe technique was employed. Subjects
      were taught 4-6 of 48 receptive and 48 expressive responses. Acquisition of a
      word combination rule was facilitated by the use of familiar lexical items,
      whereas subsequent acquisition of new lexical knowledge was enhanced by couching
      training in a previously trained word combination pattern. Although receptive
      knowledge was not sufficient for the demonstration of corresponding expressive
      performance for most of the children, only minimal expressive training was
      required to achieve this objective. For most matrix items, subjects responded
      receptively before they did so expressively. For 2 subjects, when complete
      receptive recombinative generalization had not been achieved, expressive training
      facilitated receptive responding. The results of this study elucidate benefits to
      training one linguistic aspect (lexical item, word combination pattern) at a time
      to maximize generalization in developmentally delayed preschoolers.

PMID- 2232748
TI  - Generalization to conversational speech.
AB  - Although changes in children's phonological systems due to treatment have been
      documented in single-word testing, changes in conversational speech are less well
      known. Single-word and conversation samples were analyzed for 10 phonologically
      disordered children, before and after treatment and 3 months later. Results
      suggest that for most of the children, there were system changes in both single
      words and in conversational speech. It appears that many phonologically
      disordered children are able to extend their correct production to conversation
      without direct treatment on spontaneous speech.

PMID- 2232749
TI  - Comprehension monitoring in language-disordered children: a preliminary
      investigation of cognitive and linguistic factors.
AB  - This study provided a preliminary investigation of the relative influence of
      cognitive and communicative factors in comprehension monitoring. This question
      was approached by studying language-disordered (LD) children for whom these
      abilities are presumably dissociated. Their performance on an ambiguity detection
      task was compared to that of two groups of control children, one matched for
      comprehension level and the other for cognitive level. Results revealed that LD
      children performed similarly to the control children who were matched for level
      of comprehension. The LD children's performance was examined along a continuum of
      the relative influence of cognitive and communicative factors, given that neither
      type of factor alone could sufficiently account for effective comprehension
      monitoring. It was concluded that communicative factors, both active primary
      comprehension and social communicative knowledge, had a stronger influence than
      the cognitive factors in our particular comprehension monitoring task.

PMID- 2232750
TI  - Verbal behaviors of preschool stutterers and conversational partners: observing
      reciprocal relationships.
AB  - Standard counseling practices with the families of young stutterers include
      recommendations that listeners' negative verbal behaviors be modified in order to
      reduce the likelihood of stuttering. This study tested the hypothesis that
      stuttering and normal disfluencies in preschool stutterers are related to
      selected verbal behaviors in conversational partners. Twelve 2- to 6-year-old
      stutterers were video recorded while playing with their mother, father, and a
      familiar peer. The resulting videotapes were transcribed and two types of social
      communicative analyses (total number of words and utterances, verbal intent of
      the speaker) were undertaken. Results suggested that fathers used more words and
      utterances than mothers and peers. Parents provided more positive interactions
      with their stutterer offspring than did peers. Parents also asked significantly
      more negative and routine questions when talking to their stuttering child. Peer
      playmates were significantly more negative and generally commented more
      frequently when interacting with stutterers than did the parents. Stutterers were
      involved in significantly more positive interactions with their fathers. The
      frequency of fluency failures did not differ significantly when stutterers
      communicated with their mother, father, or peer partners. Implications regarding
      verbal styles of partners in relationship to the stuttering of preschool children
      are discussed.

PMID- 2232751
TI  - Aphasic and non-brain-damaged adults' descriptions of aphasia test pictures and
      gender-biased pictures.
AB  - Twelve aphasic and 12 non-brain-damaged adult males described the speech
      elicitation pictures from the Boston Diagnostic Aphasia Examination (BDAE), the
      Minnesota Test for Differential Diagnosis of Aphasia (MTDDA), the Western Aphasia
      Battery (WAB), and six pictures representing male-biased or female-biased daily
      life situations. For each speech sample we calculated number of words, words per
      minute, number of correct information units, percentage of words that were
      correct information units, and percentage of correct information units that were
      nouns or adjectives (amount of enumeration or naming). The WAB picture elicited
      more enumeration than the BDAE or MTDDA pictures, and information was produced at
      a slower rate in response to the WAB picture than the other two pictures. These
      differences were statistically significant and appear to be clinically important.
      Gender bias had statistically significant effects on two measures. Male-biased
      pictures elicited significantly more words and significantly more correct
      information units than female-biased pictures. However, these differences were
      small and do not appear to be clinically important. Two of the five measures
      (words per minute and percentage of words that were correct information units)
      differentiated non-brain-damaged speakers from aphasic speakers. The magnitude of
      these differences suggests that these measures provide clinically important
      information about the problems aphasic adults may have when they produce
      narrative discourse.

PMID- 2232752
TI  - Impairment of speech intelligibility in men with amyotrophic lateral sclerosis.
AB  - Speech intelligibility was studied in a group of 25 male patients with
      amyotrophic lateral sclerosis (ALS). The object of the study was to determine the
      phonetic impairments underlying the speech intelligibility deficits that
      frequently accompany ALS. Analyses with a word intelligibility test indicated
      that the most disrupted phonetic features involved phonatory (voicing contrast)
      function, velopharyngeal valving, place and manner of articulation for lingual
      consonants, and regulation of tongue height for vowels. The mean error proportion
      for the five most severely affected features correlated highly (0.97) with the
      intelligibility score (percent correct). The phonetic feature analyses are one
      index of bulbar muscle impairment in amyotrophic lateral sclerosis and also may
      help to direct the speech management in these individuals.

PMID- 2232753
TI  - Facilitating changes in supervisees' clinical behaviors: an experimental
      investigation of supervisory effectiveness.
AB  - This research was conducted to determine whether supervisees altered their
      clinical behaviors as a consequence of a joint data-analysis method of clinical
      supervision. Four beginning graduate student clinicians assigned to articulation
      clients were supervised in accordance with tenets of Cogan's Clinical Supervision
      Model and Anderson's Continuum of Supervision. Supervision focused on the
      targeted dependent variables of clinician "explanations," "informative feedback,"
      and "directive responses to off-task utterances." Visual inspection of multiple
      baseline data indicated that target behaviors improved after they became the
      focus of supervision. The supervisory procedures implemented in this study
      effected positive changes in the supervisees' clinical behaviors. Qualitative
      discoveries that relate to the practicalities of daily supervision are discussed.

PMID- 2232754
TI  - Patient compliance with cleft palate team regimens.
AB  - A cleft palate team's prescribed regimen requires prompt and continued compliance
      in order to meet the management objective and to justify the large investment of
      professional time. The purposes of this clinical investigation were to determine
      the rate of compliance with the recommendations made by a cleft palate team for
      its patients and to identify variables associated with compliance. A subject was
      defined as the person(s) who could best respond to questions concerning the
      management of the team's patient. Each subject was interviewed using a
      questionnaire. The mean patient compliance rate was 64.4%, and noncompliance with
      specific recommendations ranged from 12.5% to 100%. Using Jones and Caldwell's
      (1981) classification, 17.1% of the patients were classified as compliers, 78% as
      partial compliers, and 4.9% as noncompliers. The best predictor of compliance was
      a set of nine variables.

PMID- 2232755
TI  - A sindscal analysis of perceptual features for consonants produced by esophageal
      and tracheoesophageal talkers.
AB  - This study was concerned with the perceptual responses of normal-hearing
      listeners to consonants produced by esophageal and tracheoesophageal (TE) talkers
      and a single talker who was proficient in both of these alaryngeal speech modes.
      The listeners' perceptual responses were analyzed using Symmetric Individual
      Differences Scaling (SINDSCAL) to determine whether distinctive feature
      differences existed between these two methods of alaryngeal speech. This a
      posteriori analysis revealed that primary features retrieved for both speech
      methods included sibilant, affricate, dental, nasal, and sonorant. Although
      greater perceptual weightings were observed for TE speech, these
      productive/perceptual features were weighted similarly for both speech methods.
      Some secondary group-specific feature differences were also observed, but these
      features did not contribute substantially to the total amount of variance
      accounted for in the analysis. Thus, the SINDSCAL results showed that the groups
      did not use different feature systems. These results are discussed in regard to
      the unique alaryngeal speech production methods employed by esophageal and TE
      talkers and the relative limitations of the alaryngeal (esophageal) voicing
      source they use. General clinical implications of the data are discussed.

PMID- 2232756
TI  - Normative data in quiet, broadband noise, and competing message for Northwestern
      University Auditory Test No. 6 by a female speaker.
AB  - Two descriptive experiments were performed on a version of the Northwestern
      University Auditory Test No. 6 (NU No. 6) recorded by a female speaker that is
      included on an audio compact disc recently produced by the Department of Veterans
      Affairs. In Experiment 1, normative psychometric functions for the female speaker
      version of the NU No. 6 materials were established on 24 young adults for three
      monaural listening conditions (in quiet, in 60-dB SPL broadband noise, and in 60
      dB SPL competing message). The 60-dB SPL broadband noise shifted the psychometric
      function for the NU No. 6 words 33 dB, whereas the 60-dB SPL competing message
      shifted the function only 18-22 dB. In contrast to the slopes of the quiet and
      noise conditions (4.5%/dB), the slope of the competing message function was more
      gradual (3.5%/dB). In Experiment 2, comparisons between the psychometric
      functions for the female and the original male speaker versions of NU No. 6 in
      quiet and in broadband noise were made on 8 young adults. In comparison to the
      psychometric functions for the male speaker version of NU No. 6, the functions
      for the female speaker version of NU No. 6 were displaced between the 10-90%
      correct points to higher sound-pressure levels by 10-13 dB in quiet and by 12-16
      dB in noise. The difference in performance on the two versions of NU No. 6 is
      attributed to spectral differences between the two sets of materials that
      produced a calibration anomaly.

PMID- 2232758
TI  - Comment on "Concomitant speech and language disorders in stuttering children: a
      critique of the literature".

PMID- 2232757
TI  - The Iowa Articulation Norms Project and its Nebraska replication.
AB  - The purpose of the Iowa Articulation Norms Project and its Nebraska replication
      was to provide normative information about speech sound acquisition in these two
      states. An assessment instrument consisting of photographs and a checklist form
      for narrow phonetic transcription was administered by school-based speech
      language pathologists to stratified samples of children in the age range 3-9
      years. The resulting data were not influenced by the demographic variables of
      population density (rural/urban), SES (based on parental education), or state of
      residence (Iowa/Nebraska); however, sex of the child exerted a significant
      influence in some of the preschool age groups. The criteria used to determine
      acceptability of a production appeared to influence outcomes for some speech
      sounds. Acquisition curves were plotted for individual phoneme targets or groups
      of targets. These curves were used to develop recommended ages of acquisition for
      the tested speech sounds, with recommendations based generally on a 90% level of
      acquisition. Special considerations were required for the phonemes /ng s z/.

PMID- 2232759
TI  - Comment on "Methodological variables affecting phonational frequency range in
      adults".

PMID- 2232760
TI  - Genetic implications of gender differences in the prevalence of spontaneous
      otoacoustic emissions.
AB  - Spontaneous otoacoustic emissions (SOAEs), which occur in about 40% of normal
      hearing humans, do not have a firm explanation in auditory theory nor are their
      distributional properties well understood. To enhance our understanding of SOAEs,
      we have pooled data from three reports (Hammel, 1983; Strickland, Burns, & Tubis,
      1985; Zurek, 1981) to assemble a large enough sample to assess the relevant
      hypotheses about the effects of ear and gender on their presence. The results,
      based on loglinear analyses of the pooled sample of 131 normal-hearing subjects,
      indicated that (a) the prevalence of SOAEs for female subjects [P(S/F) = .533]
      was significantly higher than that for male subjects [P(S/M) = .268]; (b) the
      percentage of right ears with SOAEs (36.6%) was significantly greater than that
      of left ears (25.2%); and (c) right and left ears were not independent with
      respect to the presence of SOAEs. These results can be explained by assuming that
      the (a) tendency to exhibit emissions is inherited, perhaps as a sex-linked trait
      and (b) ears are asymmetric with respect to the anatomical anomalies of the
      apical portion of the organ of Corti that may precipitate SOAEs.

PMID- 2232761
TI  - A comparison of psychometric functions for detection in normal-hearing and
      hearing-impaired listeners.
AB  - Psychometric functions (PFD) for the detection of pure tones were obtained with a
      two-interval forced-choice procedure from a group of listeners with normal
      hearing and a group of listeners with sensorineural impairments of presumed
      cochlear origin. Five PFDs were obtained for each group at each of the four test
      frequencies (500, 2000, 4000, and 8000 Hz). The slopes of PFDs were abnormally
      steep in some of the hearing-impaired listeners, but were statistically
      significant only at 2000 Hz.

PMID- 2232762
TI  - Recognition of voiceless fricatives by normal and hearing-impaired subjects.
AB  - The purpose of this study was to investigate the sufficient perceptual cues used
      in the recognition of four voiceless fricative consonants [s, f, theta, integral
      of] followed by the same vowel [i:] in normal-hearing and hearing-impaired adult
      listeners. Subjects identified the four CV speech tokens in a closed-set response
      task across a range of presentation levels. Fricative syllables were either
      produced by a human speaker in the natural stimulus set, or generated by a
      computer program in the synthetic stimulus set. By comparing conditions in which
      the subjects were presented with equivalent degrees of audibility for individual
      fricatives, it was possible to isolate the factor of lack of audibility from that
      of loss of suprathreshold discriminability. Results indicate that (a) the
      friction burst portion may serve as a sufficient cue for correct recognition of
      voiceless fricatives by normal-hearing subjects, whereas the more intense CV
      transition portion, though it may not be necessary, can also assist these
      subjects to distinguish place information, particularly at low presentation
      levels; (b) hearing-impaired subjects achieved close-to-normal recognition
      performance when given equivalent degrees of audibility of the frication cue, but
      they obtained poorer-than-normal performance if only given equivalent degrees of
      audibility of the transition cue; (c) the difficulty that hearing-impaired
      subjects have in perceiving fricatives under normal circumstances may be due to
      two factors: the lack of audibility of the frication cue and the loss of
      discriminability of the transition cue.

PMID- 2232763
TI  - The relationship of age and cardiovascular health to certain acoustic
      characteristics of male voices.
AB  - The purpose of this investigation was to obtain information about the acoustic
      characteristics of men's voices as a function of age and cardiovascular health.
      Eighteen adult males, divided equally into groups of healthy young and elderly
      men and elderly men diagnosed with chronic atherosclerosis in the absence of
      other systemic complaints, prolonged the vowel /a/ at a comfortable pitch
      maintained within 70-78 dB SPL. Measures of mean fundamental frequency (F0), mean
      jitter and shimmer (both absolute and relative), and the standard deviation of
      F0, SPL, and peak-to-peak vocal amplitude were computed. Significant differences
      were found between the healthy young and healthy elderly subjects on measures of
      F0 and amplitude SD, percent jitter, and shimmer. Differences were generally
      magnified when the younger subjects were compared with the elderly
      atherosclerotic subjects. Although only percent jitter significantly
      differentiated between the two geriatric groups, the atherosclerotics' phonations
      were generally associated with greater short- and long-term variability (as well
      as intersubject variability) than the healthy elderly men. Unlike the younger
      subjects, the elderly (especially the elderly atherosclerotic) subjects'
      perturbation measures fell much closer to the upper limits established in the
      literature for normal voices, indicating that the elderly speaker may be more
      prone to vocal disruption in the face of pathology.

PMID- 2232764
TI  - Speech production time and judgments of disordered nasalization in speakers with
      cleft palate.
AB  - The purpose of this study was to investigate the effect of production time on the
      perception of disordered nasalization in children with cleft palate. The subjects
      with cleft palate included 5 who produced acceptable speech consistently, 5 who
      produced disordered nasalization consistently, and 10 who were inconsistent in
      the production of disordered nasalization. We examined a range of production
      times similar to those for the production of single-word and connected speech
      tasks. Ten judges used direct magnitude estimation to rate severity of disordered
      nasalization. An accelerometric ratio technique was used to estimate the extent
      and timing of nasal acoustic activity. The results showed that reducing the
      production time did not change perceptible nasalization.

PMID- 2232765
TI  - Estimating respiratory volumes from rib cage and abdominal displacements during
      ventilatory and speech activities.
AB  - This methodological study examined the predictive strength associated with
      modeling respiratory volumes from chest-wall movements during selected
      ventilatory and speech activities. A linearized magnetometry system transduced
      the anterior-posterior diameters of the rib cage and abdomen, supplying kinematic
      data that were used to estimate respiratory volumes. Kinematic and airflow
      measures were acquired during (a) tidal ventilation, (b) vital capacity
      maneuvers, (c) Rainbow Passage reading at customary loudness, (d) Rainbow Passage
      reading at twice-customary loudness, (e) extemporaneous speech, and (f) /a/
      prolongation. Multiple-regression statistics were applied to the body surface and
      integrated airflow data to obtain (a) intercepts, (b) volume-motion coefficients
      for the rib cage and abdomen, and (c) coefficients of determination. Volumes
      estimated by applying regression-derived intercepts and volume-motion
      coefficients to the respiratory kinematic data were then compared to integrated
      airflow signals. Two magnetometer-based, volume-estimation strategies were
      contrasted for the speech tasks, one based on volume-motion coefficients derived
      from that particular speech activity and one based on volume-motion coefficients
      derived from tidal ventilation. Regression-derived intercepts and volume-motion
      coefficients for the abdomen varied significantly across subjects but not tasks.
      Volume-motion coefficients for the rib cage varied significantly across both
      subjects and tasks. Coefficients of determination for the magnetometer-based
      volume estimates were affected significantly by subjects and tasks but not by
      volume-estimation strategies. The calibration, use, and potential limitation of
      respiratory kinematic devices for speech research are discussed.

PMID- 2232767
TI  - Acoustical durations of speech segments during stuttering adaptation.
AB  - Acoustical durations of stutter- and disfluency-free speech segments from
      Readings #1 and #5 in an adaptation series were measured in 4 adapting, 4
      nonadapting, and 4 nonstuttering subjects. The segment durations measured were
      intervocalic interval, stop-gap, voice onset time, and vowel duration. No clear
      trends in the change of acoustical durations from Reading #1 to Reading #5
      distinguished the adapting, nonadapting, or nonstuttering subjects. Moreover, on
      the basis of speech naturalness judgements, listeners did not differentiate the
      Reading #1 and #5 phrase segments of subjects with high adaptation versus those
      with low adaptation scores. From these findings and related literature,
      adaptation of stuttering, as well as other fluency-inducing conditions, are
      viewed as circumstances that reduce demands upon central motor-linguistic
      processes.

PMID- 2232766
TI  - Acoustic dimensions of hearing-impaired speakers' intelligibility: segmental and
      suprasegmental characteristics.
AB  - Regression and principal components analyses were employed to study the
      relationship between 28 segmental and suprasegmental acoustic parameters of
      speech production and measures of speech intelligibility for 40 severely to
      profoundly hearing-impaired persons in an effort to extend the findings of Metz,
      Samar, Schiavetti, Sitler, and Whitehead (1985). The principal components
      analysis derived six factors that accounted for 59% of the variance in the
      original 28 parameters. Consistent with the findings of Metz et al., a subsequent
      regression analysis using these six factors as predictor variables revealed two
      factors with strong predictive relationships to speech intelligibility. One
      factor primarily reflected segmental production processes related to the temporal
      and spatial differentiation of phonemes, whereas the other primarily reflected
      suprasegmental production processes associated with contrastive stress. However,
      the predictive capability of the present factor structure was somewhat reduced
      relative to the findings of Metz et al. (1985). Data presented indicate that the
      populations sampled in the two studies may have differed on one or more
      dimensions of subject characteristics. Considered collectively, the present
      findings and the findings of Metz et al. support the tractability of employing
      selected acoustic variables for the estimation of speech intelligibility.

PMID- 2232768
TI  - Selected acoustic characteristics of voices before intubation and after
      extubation.
AB  - Effects of endotracheal intubation on acoustic characteristics of voices were
      investigated for 8 male and 8 female subjects using a miniature neck
      accelerometer and computerized analysis methods. Variables extracted from
      sustained vowels were (1) spectral slopes of the average waveforms, (2) harmonics
      to-noise ratios (H/N), (3) coefficients of variation for amplitude (CVA), (4)
      coefficients of variation for fundamental frequency (CVF), (5) amplitude
      perturbation (shimmer), and (6) fundamental frequency perturbation (jitter).
      Fundamental frequency (Fo) distributional statistics (mean Fo, Fo standard
      deviation, and Fo mid-90% range) were also obtained from oral readings. Results
      for the sustained vowel samples showed that after extubation, (1) spectral slopes
      were less steep, and (2) both shimmer and jitter were greater than before
      intubation. Results for the passage reading revealed that the mean Fo was lower
      and the Fo standard deviation and mid-90% range were smaller after the extubation
      than before intubation. It was concluded that even short-term endotracheal
      intubation affects acoustic characteristics of voice and that selected measures
      of waveform characteristics are sensitive enough to reveal such effects.

PMID- 2232769
TI  - Performance of cochlear implant patients as a function of time.
AB  - The speech perception abilities of 15 patients were measured preoperatively using
      hearing aids and postoperatively using the Nucleus 22-channel cochlear implant
      over a period of 1, 2, or 3 years. Analysis of mean data revealed that, although
      the greatest amount of improvement in speech perception scores occurred between
      the preoperative and 3-month poststimulation evaluation, there was also
      significant improvement in perception of segmental features and open-set speech
      recognition over the 3-year time period. When individual patient data were
      examined, however, it was clear that these improvements were due, in large part,
      to the performance of a subset of patients who had measurable open-set speech
      recognition abilities at the time of their 3-month, poststimulation evaluation.
      Subjects who used the processing scheme that included coding of F1 showed
      significantly more improvement over time than subjects who used the original F0F2
      processing scheme exclusively. It was concluded that open-set speech recognition
      ability at 3 months is an important prognostic indicator of continued improvement
      in speech perception abilities over time.

PMID- 2232770
TI  - Preferred insertion gain of hearing aids in listening and reading-aloud
      situations.
AB  - Nine hearing-impaired subjects with primarily high-frequency hearing loss (Group
      A) and 8 hearing-impaired subjects with hearing loss in both the high- and low
      frequency regions (Group B) participated in the experiment. Subjects wore
      binaural programmable multimemory hearing aids and selected the preferred amount
      of insertion gain while they listened to discourse passages read by a male
      speaker (listen). Subjects also selected the preferred amount of gain while they
      listened to themselves as they were reading the same passages (read-aloud).
      Subjects' word-recognition performances and their subjective impressions of the
      hearing aids determined in listen and read-aloud conditions were examined on
      subsequent listening and reading tasks. Hearing-impaired subjects preferred more
      insertion gain in the listen condition than in the read-aloud condition.
      Different insertion gains led to different objective and subjective performances.
      Hearing-aid responses selected for a particular condition (listening vs. reading
      aloud) yielded the best performance in that condition. Assuming the primary
      purpose of a hearing aid is for amplifying the speech of others, these findings
      suggest that one should not adjust the gain of a hearing aid using one's own
      voice as the reference. In addition, one should be careful in soliciting
      subjective comments from hearing-impaired patients during hearing-aid fittings to
      avoid underamplifying those individuals in the low frequencies. Multimemory
      hearing aids may be necessary for some hearing-impaired patients to use their
      hearing aids satisfactorily in listening and speaking conditions.

PMID- 2232771
TI  - Simple triangular approximations of auditory filter shapes.
AB  - At present, the most popular auditory filter shape model is one with a rounded
      peak and exponentially decaying filter skirts (Patterson & Moore, 1986).
      Unfortunately, the complex nature of this "roex" filter model may, in some
      instances, have hindered the application of the auditory filter shape in clinical
      measurements of frequency selectivity. Moreover, some of the assumptions of the
      roex filter model may be violated at high sound-pressure levels (SPLs) and this
      limitation has also been a factor when considering the roex auditory filter shape
      in the clinic. Our purpose is to introduce a simplified method that is adequate
      for obtaining clinically useful estimates of triangular-shaped auditory filters.
      Although the triangular-shaped filter model faces the same problems as the roex
      model at high SPLs, the calculations and assumptions underlying the former are
      far less complicated. The triangular filter model also retains many of the
      qualitative properties and advantages afforded by roex-fitted auditory filter
      shapes. In this report, we review the basic concepts underlying auditory filter
      shape estimates and describe our methods for measuring and fitting the triangular
      shaped filter model. We then present normative triangular filter shapes and
      compare these estimates with auditory filter shapes fitted by other means.
      Finally, we present selected examples of triangular filter shapes fitted to the
      masked thresholds of hearing-impaired patients. For the most part, the triangular
      shaped filter model offers the clinician a satisfactory compromise for obtaining
      estimates of auditory filter shape and frequency selectivity at moderately
      intense and high SPLs.

PMID- 2232772
TI  - Differential learning of phonological oppositions.
AB  - This study evaluated whether variations in the structure of minimal versus
      maximal opposition treatments would result in empirical differences in
      phonological learning. Subjects were 3 children who excluded at least six sounds
      from their pretreatment phonetic and phonemic inventories. An alternating
      treatments design in combination with a staggered multiple baseline across
      subjects was used to evaluate differences in learning the two types of
      oppositions. Results indicated that treatment of maximal oppositions led to
      greater improvement in the children's production of treated sounds, more
      additions of untreated sounds to the posttreatment inventory, and fewer changes
      in known sounds than treatment of minimal oppositions. Moreover, individual
      differences suggested that phonological learning was enhanced not only by the
      number but also by the type of distinctions being taught. A potential sequence of
      relative clinical effectiveness was proposed such that teaching multiple and
      major class distinctions greater than teaching multiple distinctions greater than
      teaching few distinctions among sounds.

PMID- 2232773
TI  - Rotation and translation of the jaw during speech.
AB  - A two-dimensional rigid-body model of jaw movement was used to describe jaw
      opening and closing gestures for vowels and for bilabial and alveolar consonants.
      Jaw movements were decomposed into three components: (a) rotation about the
      terminal hinge axis, (b) the horizontal translation of that axis, and (c) the
      vertical translation of that axis. Data were collected for 3 subjects in two
      separate recording sessions. Multiple regression analysis was used to examine the
      relationships among the three jaw movement components. For 2 subjects, but not
      for the third, an interdependence between jaw rotation and the first principal
      component of jaw translation, horizontal translation, was observed. For these 2
      subjects, the first degree of freedom of jaw movement corresponded to a
      combination of rotation and the first principal component of jaw translation. For
      the third subject, the first degree of freedom of jaw movement corresponded to
      rotation alone. The results of this study, like those of Westbury (1988),
      indicate that an accurate description of jaw movement during speech requires the
      recording of two points of jaw movement.

PMID- 2232774
TI  - Semantic memory deterioration in Alzheimer's subjects: evidence from word
      association, definition, and associate ranking tasks.
AB  - The nature of semantic memory impairment in 23 persons with dementia of the
      Alzheimer type (DAT) was studied using three semantic tasks: word association,
      definition, and associate rank ordering. Using hierarchical log-linear analysis
      of the responses to the word association task, DAT subjects were more likely than
      normal control subjects to give multiword, repetitious, or unrelated responses.
      Additionally, the ratio of paradigmatic to syntagmatic responses was
      significantly decreased in DAT subjects. Surprisingly, DAT subjects were able to
      provide definitions for many stimulus words for which they were unable to provide
      meaningful associates. This finding suggests the need for caution in interpreting
      a decrease in the number of paradigmatic responses as indicative of a loss of
      conceptual knowledge. Results of other analyses demonstrated that DAT subjects
      had significant impairment in identifying highly related and unrelated semantic
      associates of words. Taken together, results of this study indicate that one
      feature of DAT is deterioration in the associative relations between concepts.

PMID- 2232775
TI  - Syllable durations of preword and early word vocalizations.
AB  - The continuity in development of syllable duration patterns was examined in 7
      young children as they progressed from preword to multiword periods of
      vocalization development. Using a combination of lexical and chronological age
      points, monthly vocalization samples were analyzed for bisyllable duration and
      final syllable lengthening. Results revealed no systematic increase or decrease
      in the duration of bisyllables produced by the children as a group. Lengthening
      of final syllables was observed across nearly all recording sessions for all
      children. It is likely that the feature of bisyllable duration is not discernibly
      sensitive to changes associated with a developing speech mechanism and
      environmental input. On the other hand, the regularity in final syllable
      lengthening is consistent with a continuity theory of development.

PMID- 2232776
TI  - Distortion-product otoacoustic emissions in humans with high frequency
      sensorineural hearing loss.
AB  - Distortion-product otoacoustic emissions (DPOAEs) and pure-tone behavioral
      thresholds were compared in 20 ears with normal hearing and in 20 ears with high
      frequency sensorineural hearing loss. The purpose was to determine if DPOAE
      amplitude is associated with pure-tone behavioral threshold. Comparison of
      results from the two groups of ears indicated that DPOAEs were reduced in
      amplitude or were absent in ears with high-frequency hearing loss. The
      differences occurred at frequencies above 1,500 Hz. Comparing results from 750 to
      8,000 Hz within the same ear revealed a frequency-related correspondence of
      elevated behavioral threshold to reduced DPOAE amplitude. When behavioral
      thresholds were better than 20 dB HL, DPOAE amplitude was within the range (+/- 2
      SDs) determined for the ears with normal hearing. When pure-tone threshold was
      greater than 50 dB HL, DPOAEs were absent or were significantly attenuated in
      16/17 subjects (94%). The association of emission level with behavioral threshold
      level was variable when threshold was between these two extremes. Results imply
      that the measurement of DPOAEs has clinical potential as a means of detecting
      hearing loss by frequency.

PMID- 2232777
TI  - Glottal closure and perceived breathiness during phonation in normally speaking
      subjects.
AB  - Glottal closure and perceived breathiness were evaluated in 9 female and 9 male
      normally speaking subjects ranging in age from 20 to 35 years. Phonations of the
      vowel /i/ at three loudness and pitch levels were performed. The degree of
      glottal closure was judged by speech clinicians from video-fiberstroboscopic
      recordings. Later they rated the degree of perceived breathiness both in the
      vowels recorded during the fiberscopy and in separately tape-recorded vowels.
      Intra- and interjudge reliabilities were satisfactory. The degree of incomplete
      glottal closure and the degree of perceived breathiness increased significantly
      as an effect of decreased loudness. Neither the degree of closure nor the
      perceived breathiness were significantly affected by changes in pitch or by
      interaction effects. It was concluded that incomplete glottal closure of the
      posterior parts of glottis should be regarded as normal primarily in women and
      that loudness should be taken into consideration when studying glottal closure
      and breathiness.

PMID- 2232778
TI  - Critical differences in aided sound field thresholds in children.
AB  - Variability of aided sound field thresholds (ASFTs) was examined in 30 children
      comprising two age groups (5-9 and 10-14 years). Test-retest ASFTs were collected
      at six frequencies (250, 500, 1000, 2000, 3000, and 4000 Hz). No statistically
      significant difference was found in mean test and retest ASFTs between the two
      groups (p greater than .05). Test-retest difference data from both groups of
      children were combined and used to generate critical differences (in dB) for two
      ASFTs. At a 95% confidence level, two ASFTs would have to differ by more than 10
      dB across signal test frequencies to attain statistical significance. In clinical
      decision-making, if one accepts smaller differences in ASFTs as statistically
      significant, larger probabilities of error must be assumed.

PMID- 2232779
TI  - Fine-grained discrimination deficits in language-learning impaired children are
      specific neither to the auditory modality nor to speech perception.

PMID- 2232780
TI  - Vocal fundamental frequency variability in young children: comments on Robb and
      Saxman (1985)

PMID- 2232781
TI  - Vasa previa.
AB  - Diagnosis of vasa previa requires a high index of suspicion. Vasa previa must be
      included in the differential diagnosis of all cases of third trimester bleeding.
      When pulsatile vessels are palpated preceding the fetal vertex, vasa previa
      should be considered along with cord prolapse. Early diagnosis and intervention
      result in a favorable fetal outcome in this rare condition.

PMID- 2232782
TI  - More than 17,000 transurethral prostatic resections (TURs): some of the things I
      have learned.

PMID- 2232783
TI  - Traumatic lung cyst.

PMID- 2232784
TI  - An unusual case of ventricular tachycardia.

PMID- 2232785
TI  - A case of refractory hypotension.

PMID- 2232786
TI  - Communicable disease reporting: why?

PMID- 2232788
TI  - Rockin' the boat: a footnote on history.

PMID- 2232787
TI  - Durable powers of attorney for health care decisions: understanding the latest
      malpractice risk.

PMID- 2232789
TI  - Compared to what?

PMID- 2232790
TI  - Alcohol consumption by college undergraduates: current use and 10-year trends.
AB  - In a carefully executed study with a high response rate, a random sample of 10%
      of the undergraduate student body at a rural New England university was surveyed
      as to the subjects' use of alcohol in 1987. Over 87% of the surveyed students
      returned questionnaires. The results were compared to similar studies conducted
      on the campus in 1977 and 1983. "Daily or almost daily" use of alcohol was
      registered by 4.7% of the respondents, which represents a continuing decrease in
      daily consumption from earlier studies. One-fourth of the sample indicated
      drinking only one drink or fewer per week, contrary to the common perception on
      the campus. Nevertheless, 25.5% recorded a hangover, 7.5% recorded vomiting from
      drinking too much and 4.4% recorded a blackout, all "in the last week." Compared
      to the U.S. population, alcohol consumption appears to be more evenly distributed
      in the college sample but, still, most of the drinking is done by one-fifth of
      both groups.

PMID- 2232791
TI  - Alcohol consumption and problem drinking in Vietnam era veterans and nonveterans.
AB  - The relationship between Vietnam era veteran status and 13 indicators of alcohol
      consumption and problem drinking is examined using data from the 1977, 1983 and
      1985 National Health Interview Surveys conducted by the National Center for
      Health Statistics. Compared to a group of nonveterans frequency matched on age, a
      greater proportion of Vietnam era veterans are currently heavy drinkers and a
      smaller proportion are abstainers, after simultaneous adjustment for seven
      demographic factors (age, region of the U.S., urbanization, ethnicity, marital
      status, education and income). Further, both white veterans and white nonveterans
      demonstrate an effect of increasing abstention with increasing age across the 3
      interview years. In all race and veteran groups the proportion of lifetime
      abstainers can be ranked in increasing order as follows: white veterans, white
      nonveterans, non-white veterans and non-white nonveterans. This ranking is
      reversed for lifetime heavy drinking. Nearly half of the white veterans report
      drinking heavily at some point in their lives. Among both whites and non-whites,
      a significantly greater proportion of veterans than nonveterans report alcohol
      related motor vehicle crashes or violations.

PMID- 2232793
TI  - Agreement between two dietary methods in the measurement of alcohol consumption.
AB  - This study compares estimates of alcohol consumption from two dietary methods: a
      self-reported diet diary and a quantitative food frequency questionnaire. In the
      1984-85 University of Michigan Food Frequency Study, 228 black and white, male
      and female respondents, ages 23-51 years, kept diet diaries covering 16 days
      during a 1-year period. At the end of the year, the same respondents completed a
      dietary quantity-frequency questionnaire that included alcoholic beverages. The
      two methods showed excellent agreement in estimated group mean ethanol
      consumption and good agreement in the ranking of individual respondents.
      Respondents described alcohol consumption in abstract terms on the questionnaire
      in a way that was consistent with the consumption recorded in the diary. However,
      the two methods showed only poor to moderate agreement in classifying individuals
      as infrequent, moderate or heavier drinkers, suggesting that such classifications
      should be used cautiously. These results suggest that in general population
      studies a dietary quantity-frequency questionnaire and a diet diary covering
      several weeks can measure moderate levels of alcohol consumption similarly. The
      degree of consistency suggests that, for moderate levels of intake, measures of
      alcohol consumption derived from the two methods are equally valid.

PMID- 2232792
TI  - Recall of alcohol consumption during pregnancy.
AB  - This is a test-retest reliability study of self-reported alcohol use during
      pregnancy, in which two groups of women provided two reports about their first
      trimester drinking over a 3-month interval (Group 1) and over a 5-month interval
      (Group 2). Women in Group 1 (n = 91) were queried about first trimester alcohol
      consumption during their fourth month of pregnancy and again during their seventh
      month, a 3-month recall interval. Group 2 women (n = 88) provided first trimester
      drinking reports during their fourth month of pregnancy and again at delivery, a
      5-month recall interval. The test-retest Pearson correlation coefficient for
      recall of first trimester average daily volume (ADV) was .61 (p = .000) for Group
      1 and .53 (p = .000) for Group 2. When the ADV scores were grouped into five
      ordinal categories, 51.6% of Group 1 and 56.8% of Group 2 remained in the same
      category at test and retest. This leads to the conclusion that self-reported
      alcohol consumption is moderately reliable over a 3-month and a 5-month time
      period.

PMID- 2232794
TI  - Anomie, alcohol abuse and alcohol consumption: a prospective-analysis.
AB  - Cross-sectional and 36-month prospective analyses of the relationships among
      anomie and both alcohol abuse and alcohol consumption patterns provided little
      support that anomie was directly associated with ethanol ingestion patterns in a
      sample of 302 male air traffic controllers. This lack of association was observed
      for self-reported alcohol consumption, interview-established alcohol abuse and
      biochemical markers of alcohol intake. In addition, anomie was not predictive of
      change in alcohol use/abuse over 36 months, controlling for baseline levels of
      alcohol use and abuse and for relevant demographic factors. Measurement of anomie
      and alcohol use/abuse, the relative importance of anomie in various socioeconomic
      groups and issues related to prospective research on this topic are discussed.

PMID- 2232795
TI  - The situational riskiness of alcoholic beverages.
AB  - Using face-to-face interview data on a sample of young adults, this study
      investigates the perceived risk of alcohol consumption in drinking and driving,
      interactions with police and the probability of intoxication. Results show that
      beer is perceived as less risky than liquor in two risk situations, with men and
      drinkers in particular ranking beer as a lower risk beverage. When intoxication
      is considered, drinkers rank their preferred beverage as less risky than their
      alternative. Finally, an analysis of the relative riskiness of beer in comparison
      to liquor reveals that beer is perceived as less risky than liquor. This
      consensus does not vary significantly by sex or most other respondent
      characteristics.

PMID- 2232796
TI  - Portrayals of alcohol on prime-time television.
AB  - Alcohol portrayals were analyzed for a 3-week composite sample of prime-time
      fictional television programs aired in the fall of 1986. Approximately 64% of the
      195 episodes contained one or more appearances of alcohol. Alcohol was ingested
      on 50% of all programs. Overall, there were 8.1 alcohol drinking acts per hour.
      Movies made-for-television had the highest rate of drinking acts per hour (10.0)
      followed by situation comedies (9.2) and then theatrical movies (7.4) and dramas
      (7.4). Within the category of dramas, evening soap operas stand out with 13.3
      acts per hour. Drinking and nondrinking characters were compared on a number of
      attributes relevant to role modeling. Regularly appearing characters were more
      likely to drink than nonregular characters. Drinking characters also tended to be
      of high status, largely being white, upper-class professionals. A time trend
      analysis showed a regular increase in alcohol on television from 1976 to 1984,
      reaching 10.2 acts in 1984. After 1984 the trend appears to reverse.

PMID- 2232797
TI  - Public support for policy initiatives regulating alcohol use in Minnesota: a
      multi-community survey.
AB  - Public support for policies to control alcohol sales and consumption was surveyed
      in seven Minnesota communities. A total of 438 women and 383 men were asked to
      indicate their level of support of or opposition to nine different proposals
      designed to regulate alcohol. There was general support for all policies, which
      was strongly related to characteristics of respondents and type of policy
      proposed. Women were significantly more supportive of all items than were men.
      Marriage, older age and low alcohol consumption were also associated with
      support. Education and voter status generally were not. Policies and activities
      that serve primarily to protect youth received the strongest support.
      Restrictions and prohibitions such as limiting advertisements were less popular.
      The least support was expressed for increases in taxes on alcohol and for
      measures that would eliminate an existing practice such as prohibiting wine
      cooler sales at convenience stores. The majority of respondents also indicated
      that they felt the individual, as opposed to the manufacturer or retailer, was
      responsible for problems associated with alcohol and should be the focus of
      intervention. Strategies for shifting the focus from the individual to
      environmental and regulatory control are discussed.

PMID- 2232799
TI  - The relationship between ethanol intake and DSM-III-R alcohol dependence.
AB  - The purpose of this investigation was to quantify the relationship between
      ethanol consumption and DSM-III-R alcohol dependence using mathematical modeling
      techniques that allowed for the control of confounding and assessment of
      interaction. Although sex, education, ethnicity and marital status were not
      identified as actual confounders in the logistic regression model, the ethanol
      intake-dependence association was stronger among younger as opposed to older
      respondents. For 20 year olds, the average log odds for dependence increased .62
      for each additional ounce of ethanol consumed daily, while the corresponding
      increase in risk among 60 year olds was .26. Implications of these results are
      discussed in terms of age differences in drinking patterns and differential
      social control of drinking behavior. Separate analyses in which aggregates of the
      alcohol dependence criteria served as outcome measures helped qualify the
      interpretation of the overall ethanol intake-dependence relationship. The need to
      examine components of global classifications of alcohol dependence using better
      operationalizations is highlighted.

PMID- 2232798
TI  - A comparison of familial and nonfamilial male alcoholic patients without a
      coexisting psychiatric disorder.
AB  - Both family history of alcoholism and the presence of additional psychiatric
      disorder in male alcoholic patients are associated with an earlier onset of
      problem drinking, greater alcoholism severity and poorer clinical outcomes. To
      assess the relative contribution of family history alone, a sample of 212 male
      alcoholics not positive for any other psychiatric disorder was selected and
      divided into those with a family history of alcoholism (FH+) or no family history
      of alcoholism (FH-) among first degree relatives. Although FH+ alcoholics
      reported a younger age of onset of problem drinking and greater severity of some
      alcohol-related sequelae, the differences were not as extensive or pronounced as
      those found in a previous study of a sample of psychiatrically heterogeneous
      patients (Penick et al., 1987). A bi-dimensional typology of alcoholism
      incorporating both additional psychiatric diagnoses and a positive family history
      of alcoholism is suggested.

PMID- 2232800
TI  - The MAC scale in a normal population: the meaning of "false positives".
AB  - The MAC scale has been very successful in identifying alcoholics and, in studies
      of clinical populations, is often considered a test for predisposition to
      alcoholism. MacAndrew, however, holds that the MAC scale assesses a more general
      personality trait characterized by sociability, boldness, rebelliousness and
      pleasure seeking. The present study examines the distribution of MAC scale scores
      in a normal population and tests for correlates of high MAC scores other than
      alcohol-related problems (e.g., arrest history). The sample consisted of 1,117
      men, participants in the Normative Aging Study (mean age = 61.6). As expected,
      heavier drinkers and problem drinkers reported significantly higher MAC scale
      scores than did lighter and nonproblem drinkers. However, arrestees without
      drinking problems had MAC scale scores nearly identical to those of problem
      drinkers without arrest histories (23.19 and 23.42, respectively). Further, 36%
      of the sample without problem drinking or arrest histories had MAC scale scores
      of 24 or above, the clinical indicator of alcoholism, and more than 32% of these
      had scores above 27. In the entire sample, of the 152 men who had MAC scores
      above 27, 71% had no problems, either with arrest or drinking. Results are
      interpreted as supporting MacAndrew's interpretation of the meaning of the MAC
      scale as a general personality measure rather than a specific alcoholism
      instrument.

PMID- 2232801
TI  - The effect of gender and subtype on platelet MAO in alcoholism.
AB  - Decreased platelet MAO activity has been identified in male alcoholics with
      suggestions that this is primarily true of Type 2 alcoholics as defined by
      criteria from the Stockholm Adoption Study. Little information has been available
      regarding platelet MAO activity in female alcoholics. This study evaluated a
      group of 71 alcoholics receiving inpatient treatment, including 16 female
      alcoholics, for platelet MAO activity compared to controls. Female alcoholic's
      platelet MAO was significantly lower than controls and not different from
      activity levels in male alcoholics. Among male alcoholics, both Type 1 and Type 2
      subgroups were lower than controls and Type 2 levels did not differ from Type 1
      levels. Thus, we were unable to replicate a gender and subgroup low platelet MAO
      specificity among alcoholics, but did find significant differences between
      alcoholics and controls.

PMID- 2232802
TI  - The acute effects of alcohol on the blood pressure of young, normotensive men.
AB  - Alcohol's acute effects on arterial blood pressure (BP) were examined. To
      separate the effects of alcohol on BP from those of fluid volume and expectancy,
      normotensive men were divided into three groups. The alcohol group received 1.0
      ml of absolute alcohol/kg of body weight. The expectancy group expected alcohol
      but received only tonic. The control group expected and received only tonic. With
      age as a covariate, significant changes in systolic BP were found only in the
      alcohol group, indicating that the changes in systolic BP were not attributable
      to subject expectancy or volume of fluid consumed. The expectancy control groups
      did not differ from each other. A significant quadratic trend was found for
      systolic BP in the alcohol group, suggesting that alcohol may have an acute
      biphasic effect on systolic BP, with an initial decrease as the alcohol is
      ingested followed by an increase toward the basal level during detoxication. No
      significant effects were found for diastolic BP.

PMID- 2232803
TI  - Preoperative cell-mediated immune function and the prognosis of patients with
      gastric carcinoma.
AB  - The cell-mediated immune function of 83 patients with gastric carcinoma was
      assessed preoperatively and the results were compared to that of 52 patients with
      benign lesions. The data were subjected to an analysis in order to evaluate their
      prognostic significance. The abilities to induce allogeneic cytotoxicity and to
      produce interleukin 2 (IL2) in patients with stage IV carcinoma were
      significantly depressed, as compared to those in patients with benign lesions,
      whereas natural killer (NK) cell activity was not significantly impaired. There
      was no significant correlation among these immune functions. When the patients
      were stratified into two groups, those who had high (greater than the mean value
      in patients with benign lesions) and low (less than the same value) values of
      these immune reactivities, the survival of patients with high NK activity
      (greater than or equal to 43%) was significantly better, as compared to that of
      patients with low cytotoxicity (less than 43%). However, there was no correlation
      between the survival and allogeneic cytotoxicity in these patients. The high
      ability to produce IL2 (greater than or equal to 1.3 U/ml) correlated with the
      better survival in the patients, but not in the group of patients who underwent
      curative resection.

PMID- 2232804
TI  - Toxicity comparison of neoadjuvant versus adjuvant methotrexate, vinblastine,
      doxorubicin, and cisplatin (M-VAC) in radical cystectomy patients.
AB  - A reduction in the toxicity of M-VAC chemotherapy has been postulated for
      patients who receive these drugs prior to radical cystectomy for muscle invasive
      bladder carcinoma. A review of the toxicity and patient dropout rates from a
      group of 9 patients who received neoadjuvant M-VAC was little different from 9
      patients who were treated with M-VAC after radical cystectomy. This similarity
      suggests that preoperative M-VAC should not be favored on the basis of reduced
      patient morbidity.

PMID- 2232805
TI  - Adenocarcinoma arising in Barrett's esophagus.
AB  - A review of nine adenocarcinomas of the esophagus arising in Barrett's epithelium
      was undertaken. We found the disease among white males disproportionately. Risk
      factors and incidence rate remain to be clarified. Only one patient was in a
      surveillance program and only he had carcinoma discovered "early." He still
      survives while only one of the eight whose diagnosis followed investigation of
      symptoms remains alive.

PMID- 2232807
TI  - Obstructing carcinoma of the cecum.
AB  - Carcinoma of the cecum, the third most common location for malignancy of the
      large bowel, was examined with attention centered upon cecal cancers producing
      obstruction. Reviewing 136 patients revealed 11 obstructing lesions (8.1%)
      presenting as distal small bowel obstructions. The mean age of the patients was
      74 years. All but one patient had resection for cure which consisted of a right
      hemicolectomy with ileotransverse colostomy. There was no operative mortality or
      significant morbidity. Bowel obstruction due to cecal carcinoma is an infrequent
      occurrence arising in elderly patients and carries a poor survival rate due to
      advanced disease at the time of diagnosis and treatment.

PMID- 2232806
TI  - Neoadjuvant Cis-DDP in esophageal cancers: an experience at a regional cancer
      centre, India.
AB  - We are analysing the results of 80 patients who underwent surgery during 1983-84
      for esophageal cancer. Forty patients who received pre-operative single agent Cis
      DDP were grouped under "A" and 40 patients who went for surgery directly were
      grouped under "B". Twenty-two patients (55%) of Group A showed tumor necrosis.
      Both groups underwent resection and hand-sewn anastamosis of the esophagus. There
      were 10 post-operative deaths among 80 resected cases, 9 of them being from
      anastomatic leak. Cis-DDP has induced negligible side effects. A comparatively
      high survival rate during early years in patients who responded to Cis-DDP
      suggests that neoadjuvant chemotherapy might be of value.

PMID- 2232809
TI  - Carcinoma of the pancreas: a retrospective review.
AB  - Eighty-five patients with adenocarcinoma of the pancreas were reviewed in order
      to evaluate the efficacy of our methods of diagnosis and treatment. The most
      useful diagnostic test was percutaneous transhepatic cholangiography (PTC) with a
      diagnostic rate of 96%. Pancreaticoduodenectomy (Whipple procedure) and total
      pancreatic resection were performed in 13 and 2 patients, respectively. The
      remaining 50 patients underwent various palliative drainage procedures. Twenty
      patients did not undergo operation for various reasons. The primary tumor was
      found in the head of the pancreas in 50 patients (59%), the body in 6 patients
      (7%), and in the tail in 8 patients (9%). Postoperative complications, including
      sepsis, bleeding, intra-abdominal abscesses, and anastomotic leaks, occurred in
      37% of the patients. There were one operative and 9 postoperative deaths. The
      average survival for those patients undergoing surgical intervention was 6
      months. There were no 5-year survivors.

PMID- 2232810
TI  - In vivo selection and characterization of a murine mammary tumor subline with
      high potential for spontaneous lymph node metastasis.
AB  - A transplantable mammary adenocarcinoma, grown in Balb/c mice, with a marked
      enhancement in its draining lymph node metastatic ability (MM3LN), was obtained
      through an in vivo procedure from a variant tumor moderately metastatic to lymph
      nodes (MM3). Both MM3 and MM3LN presented a similar latency and tumor growth rate
      and reached the same tumor mean diameter at death. MM3LN tumor-bearing mice
      exhibited a larger mean survival time. The new variant showed a 2.5-fold higher
      incidence of tumor-draining lymph node metastases than MM3 line, with no
      differences in the incidence of lung metastases. Morphology as well as
      cytogenetic and in vitro adhesion properties were studied in order to
      characterize the new subline. This murine tumor model has potential application
      in the study of the metastatic process in lymphoid tissue.

PMID- 2232808
TI  - Complications of stapled anastomoses in anterior resection for rectal carcinoma:
      colorectal anastomosis versus coloanal anastomosis.
AB  - Postoperative results of 48 patients who underwent anterior resection using the
      EEA-stapler were evaluated. In all but 2 cases the indication for surgery was
      colorectal carcinoma. In 24 patients an anastomosis was created above the 5 cm
      level (above the anal verge: colorectal anastomosis) and in 24 at the 0-5 cm
      level (coloanal anastomosis). There was no perioperative mortality. The only
      complication observed in the colorectal anastomosis group was one case of late
      anastomotic stenosis. In the coloanal anastomosis group there were 4 cases with
      early anastomosis leaks, 3 cases with late stenosis and 5 cases with various
      degrees of late fecal incontinence, ultimately resulting in a permanent diverting
      stoma in 5 (10.4%) patients. We conclude that for rectal tumors the EEA-stapled
      anterior resection provides excellent functional results in most cases. Stapled
      coloanal anastomoses more often demonstrate various (early and late)
      complications. Nevertheless in spite of chronic discomfort, many patients still
      prefer their complaints to a permanent stoma.

PMID- 2232812
TI  - Ampullary carcinoma in patients under 50 years of age with a poor prognosis.
AB  - Clinicopathologic features of 145 Japanese patients with ampullary carcinoma were
      compared among three age groups. The 145 patients were divided into three groups
      by the patient's age at the time of operation; there were 24 patients in group I
      (younger) aged less than or equal to 50 years, 99 in group II (ordinary) aged 51
      69, and 22 in group III (elderly) aged greater than or equal to 70. The three
      groups showed no significant difference in sex, icterus, duration of icterus,
      size of the tumor, year of operation, macroscopic type, histopathologic type,
      tumor margin, lymphatic permeation, venous invasion, or pancreatic invasion. The
      survival curve of group I was worse than those of groups II and III. Multivariate
      regression analysis using 11 prognostic variables failed to reveal that the age
      of the patient at the time of operation was an independent factor. The younger
      patients aged less than or equal to 50 fared worse than the elderly patients aged
      greater than or equal to 70, because the group I tumors included a significantly
      greater number of advanced ampullary carcinoma with more frequent perineural
      invasion than did the group III tumors.

PMID- 2232811
TI  - Rat liver tolerance for partial resection and intraoperative radiation therapy:
      regeneration is radiation dose dependent.
AB  - We studied the feasibility of delivering a large single dose of intraoperative
      radiation as an adjuvant to partial hepatic resection. Intraoperative radiation
      therapy (IORT) was delivered to the remaining liver of 84 rats after partial
      hepatectomy to determine the acute and chronic effects of treatment on blood
      chemistry values, histology, survival, hepatic regeneration, and cellular
      appearance of the normal liver. Transient elevations in SGOT, SGPT, and alkaline
      phosphatase were attributed both to hepatectomy and to liver parenchymal damage
      induced by IORT. Microscopic examination upon necropsy, performed at frequent
      intervals post-treatment revealed hepatic capsular thickening with some
      alteration of liver architecture mainly underneath the capsule, with localized
      inflammation and some areas of necrosis. Survival in all groups was 100% at 45
      days. Liver weight increase proved to be dose-dependent and displayed a bisphasic
      pattern. This study demonstrated that IORT is a feasible adjunct to surgical
      resection of the liver in the rat model.

PMID- 2232813
TI  - Colon carcinoma associated with ureterosigmoidostomy.
AB  - A patient developing a colonic adenoma 38 years following ureterosigmoidostomy is
      presented. The mechanisms of neoplastic transformation associated with
      ureterosigmoidostomy is now better understood. This knowledge is being applied to
      develop modifications both of the surgical technique and the management of
      patients with this form of urinary diversion, and is a subject of discussion.

PMID- 2232814
TI  - Metastatic tumors of the umbilicus: a review 1830-1989.
AB  - Umbilical metastases from known and unknown primary cancers are rare. The eponym
      "Sister Mary Joseph's nodule" has been used by generations of physicians. The
      first reports of this clinical sign were from Walshe in 1846. A review of the
      literature revealed 265 cases from then until 1989. Only 85 cases of umbilical
      metastasis from unknown primary tumors were found. This review should help us to
      focus on the common and uncommon primary sites in the diagnosis of patients with
      this finding. A single case report and the work-up for the hidden primary tumor
      are described.

PMID- 2232815
TI  - Simple and effective procedure for complete urine collection from infant macaques
      (Macaca nemestrina).
AB  - A diaper method, used in pediatric medicine, has been adapted and validated for
      total urine collection from infant macaques (Macaca nemestrina). The device
      consists of cellulose sponges and polyethylene sheets. The method proposed is non
      invasive, simple, and does not significantly hinder the movement of the infant.
      The method should be useful when one is conducting pharmacokinetic studies in
      which total urine collection is required.

PMID- 2232816
TI  - Methamphetamine- and apomorphine-induced changes in spontaneous motor activity
      using a new system to detect and analyze motor activity in mice.
AB  - A new system was devised to detect animal spontaneous motor activity in more
      detail, and methamphetamine- and apomorphine-induced changes in spontaneous motor
      activity were analyzed using this system. The system consists of a doughnut
      shaped cage with 36 units of detectors. Scanning of each detector unit was three
      dimensionally carried out, and then scanning data were fed into a personal
      computer. These steps were completed within 0.1 sec and repeated. Spontaneous
      motor activity was analyzed as changes in parameters, such as total activity,
      locomotor activity, vertical activity (the number of rearings and the rearing
      time), motion time, and average speed. Regarding dependence on the dosages of
      methamphetamine and apomorphine, the time courses of changes in total activity
      and locomotor activity markedly differed from those for changes in vertical
      activity. Changes in the numbers of rearings and rearing time induced by 2 mg/kg
      methamphetamine peaked 40-80 min after administration, whereas those in other
      parameters did so 15-25 min after. Three mg/kg apomorphine-induced changes in
      total activity and locomotor activity showed two peaks 10-15 and 40-50 min after
      administration, respectively. At the same dosage, apomorphine markedly increased
      rearing time with slight but not significant effects on the number of rearings.
      These effects peaked 20-30 min after administration. These results indicate this
      system to be quite useful to detect and analyze drug-induced changes in
      spontaneous motor activity.

PMID- 2232817
TI  - Extraction of physostigmine from biologic fluids and analysis by liquid
      chromatography with electrochemical detection.
AB  - A rapid and simple method is described for the extraction of physostigmine (Phy)
      and its hydrolysis product, eseroline, from plasma, whole blood, and
      cerebrospinal fluid (CSF) and their subsequent quantitation by high-performance
      liquid chromatography (HPLC) with dual electrode electrochemical detection. Phy
      and eseroline were extracted from biologic fluids with cyano-phase columns eluted
      with 0.1 M citrate buffer, pH 4 containing 20% acetonitrile. Phy recovery from
      citrate buffer and CSF was nearly 100%. Phy recovery from plasma was 82% when
      methanol was used to precipitate proteins and 62% when HClO4 was used to
      precipitate proteins. Phy recovery from whole blood was only 17%. These results
      are discussed in the context of attempting to measure Phy in fluids of patients
      receiving this drug in clinical trials for the treatment of Alzheimer's disease.

PMID- 2232818
TI  - Transitory models of experimentally induced intraocular pressure changes in the
      rabbit. A reappraisal.
AB  - The purpose of this study was to evaluate the relationship between inducer
      dosage, animal weight, and kinetics intraocular pressure (IOP) changes in three
      transitory-induced models for antiglaucoma drugs screening: oral water-loading,
      5% glucose intravenous administration, and 20% NaCl infusion. For these models, a
      dose-dependent elevation of IOP was observed in three weight groups of rabbits
      (1, 2.2, and 3.8 kg). Dose-effect relationships were established, considering for
      each weight group two relevant parameters: maximal IOP changes and areas under or
      upper the kinetic curves of IOP changes. Among the three models studied, our
      results led us to consider water-loading as a weight-independent model, allowing
      us to compare results obtained by this model in New Zealand rabbits with
      different ages (40-150 days) or weights (0.9-3.8 kg).

PMID- 2232820
TI  - Strong stability and density-dependent evolutionarily stable strategies.
AB  - Stability conditions for equilibria of the evolution of population strategies in
      a single species are developed by comparing frequency and density dependent
      fitnesses of pairs of strategies. Stability of such equilibria is shown for
      general haploid frequency and density dynamics. It is also shown that this
      stability is stronger than that of multispecies population dynamical systems. A
      biological interpretation of the conditions is provided in terms of the fitness
      of invading subpopulations.

PMID- 2232821
TI  - Group selection among alternative evolutionarily stable strategies.
AB  - Many important models of the evolution of social behavior have more than one
      evolutionarily stable strategy (ESS). Examples include co-ordination games,
      contests, mutualism, reciprocity, and sexual selection. Here we show that when
      there are multiple evolutionarily stable strategies, selection among groups can
      cause the spread of the strategy that has the lowest extinction rate or highest
      probability of contributing to the colonization of empty habitats, and that this
      may occur even when groups are usually very large, migration rates are
      substantial, and "extinction" entails only the disruption of the group and the
      dispersal of its members. The main requirements are: (1) individuals drawn from a
      single surviving group make up a sufficiently large fraction newly formed groups,
      and (2) the processes increasing the frequency of successful strategies within
      groups are strong compared to rate of migration among groups. The latter
      condition suggests that this form of group selection will be particularly
      important when behavioral variation is culturally acquired.

PMID- 2232819
TI  - Isolated perfused rat kidney as a tool in the investigation of renal handling and
      effects of nonsteroidal antiinflammatory drugs.
AB  - An isolated perfused rat kidney (IPK) preparation is described in which renal
      perfusion flow, perfusion pressure, urinary flow, urinary pH, and glomerular
      filtration rate (GFR) are recorded continuously during the perfusion experiment.
      The usefulness of this IPK system in studying the renal handling and the effects
      of non-steroidal antiinflammatory drugs (NSAIDs) is shown using salicyluric acid
      (SU), salicylic acid (SA), and naproxen (NA). Excretion of SU involves glomerular
      filtration, active secretion, and passive reabsorption. The excretion rates of SA
      and NA were both much lower than their filtration rate, indicating extensive
      reabsorption. All three drugs accumulate in the IPK but at different levels. SU
      accumulates much more than either SA or NA. The effects on renal function were
      different for the three drugs studied. SU had no effect on kidney function. SA
      perfusate concentrations greater than 100 micrograms/mL caused diuresis and
      natriuresis, while SA concentrations less than 100 micrograms/mL did not
      influence kidney function. NA perfusate concentrations ranging from 0.16 to 25
      micrograms/mL caused a decrease in urinary flow and sodium excretion. Very high
      NA concentrations (greater than 500 micrograms/mL) caused an increase in urinary
      flow and sodium excretion. We conclude that the IPK is a suitable preparation for
      characterizing and comparing renal handling and effects of NSAIDs.

PMID- 2232822
TI  - Drosophila segmentation: supercomputer simulation of prepattern hierarchy.
AB  - Spontaneous prepattern formation in a two level hierarchy of reaction-diffusion
      systems is simulated in three space co-ordinates and time, mimicking gap gene and
      primary pair-rule gene expression. The model rests on the idea of Turing systems
      of the second kind, in which one prepattern generates position dependent rate
      constants for a subsequent reaction-diffusion system. Maternal genes are assumed
      responsible for setting up gradients from the anterior and posterior ends, one of
      which is needed to stabilize a double period prepattern suggested to underly the
      read out of the gap genes. The resulting double period pattern in turn stabilizes
      the next prepattern in the hierarchy, which has a short wavelength with many
      characteristics of the stripes seen in actual primary pair-rule gene expression.
      Without such hierarchical stabilization, reaction-diffusion mechanisms yield
      highly patchy short wave length patterns, and thus unreliable stripes. The model
      yields seven stable stripes located in the middle of the embryo, with the
      potential for additional expression near the poles, as observed experimentally.
      The model does not rely on specific chemical reaction kinetics, rather the effect
      is general to many such kinetic schemes. This makes it robust to parameter
      changes, and it has good potential for adapting to size and shape changes as
      well. The study thus suggests that the crucial organizing principle in early
      Drosophila embryogenesis is based on global field mechanisms, not on particular
      local interactions.

PMID- 2232823
TI  - Frequency specific modulation of bone adaptation by induced electric fields.
AB  - A frequency specificity for the response of bone tissue to a physical stimulus is
      proposed. This is obtained by comparing the spectral power of exogenously induced
      electric fields to the efficacy of those fields to inhibit immobilization induced
      bone loss in an in vivo model of skeletal adaptation. Analysis of a family of
      related waveforms shows that the effectiveness of the induced electric fields
      could be related to the induced spectral power below approximately 75 Hz. The
      analysis suggests that bone tissue may be extremely sensitive to induced power
      levels at or below this frequency, as amplitude variations of less than a factor
      of two within this range correspond to significantly different bone remodeling
      responses. The analysis also suggests that bone tissue may be strongly frequency
      selective, with bone capable of responding specifically to induced power in this
      osteogenic frequency band, even though the band includes less than 0.1% of the
      total induced power. As normal functional activity generates strain components
      encompassing this osteogenic frequency band, a distinct frequency selectivity may
      indicate that the tissue response is tuned to a specific endogenous stimulus. A
      detailed characterization of the frequency response of bone tissue could well
      point to the primary source for the control of the cells responsible for
      functional adaptation in the skeleton.

PMID- 2232824
TI  - The role of a thymus-pineal axis in an immune mechanism of aging.
AB  - The Immune Theory of Aging cannot explain the cause of immune decline. It is
      hypothesized that the pineal gland acting in utero and during neonatal life in
      altricial mammals serves as a component of the immune system. Evidence in support
      of the presence of a thymus-pineal axis is presented. It is postulated that the
      pineal gland carries a considerable burden of immunological defense during
      maturation of the thymus, and also acts in the programming of the immune system.
      By relating thymus and immune function to the pineal and its known role as a
      neuroendocrine transducer for the entrainment and control of biorhythms, a
      consilence is developed between the role of the immune system in senescence and
      the pineal function in biorhythmicity. The relationships developed thus permit an
      extension of the immune theory as regards causative mechanisms.

PMID- 2232826
TI  - Effects of exercise and chills on entropy production in human body.
AB  - Entropy flows and changes of entropy content for naked subjects in the
      respiration calorimeter in exercise and chills are calculated from the energetic
      data given by Hardy et al. (1938, J. Nutr. 16, 477) and Du Bois (1939, Bull. N.Y.
      Acad. Med. 15, 143). By use of these values, entropy productions in the human
      body in exercise and chills are estimated. The entropy production in mild
      exercise is 1.5-2.4 times as great as that in basal conditions. The entropy
      production in violent exercise is six to eight times as great as that before
      exercise. The entropy production in chills in cold environments is about twice as
      large as that in basal conditions. The entropy production in a malarial chill is
      about four times of that in normal subjects. These increases in entropy
      production will be due to the increase in heat production within the body. It
      seems that there is a parallel between energy and entropy viewpoints for human
      physiology.

PMID- 2232825
TI  - Preferential ligand binding to multi-state acceptor systems: the unexplored
      paradox of acceptor self-association that is ligand-mediated but detrimental to
      ligand binding.
AB  - Consideration is given to the interactions of ligand with self-associating
      acceptor systems for which preferential ligand binding is an ambiguous term, in
      that the acceptor species with greater affinity for ligand possesses relatively
      fewer binding sites. A paradoxical situation wherein ligand-mediated self
      association is seemingly detrimental to ligand binding is shown to be the
      predicted outcome for a transient range of ligand concentrations. This outcome
      reflects the existence of a critical point in the dependence of the extent of
      acceptor self-association upon ligand concentration that coincides with a cross
      over point of ligand-binding curves for different, fixed total concentrations of
      acceptor. By classical differentiation methods the conditions for the existence
      of these critical points are established not only for two-state acceptor systems
      but also for three-state acceptor systems in which the ligand-binding form of
      monomer also undergoes reversible isomerization to an inactive state. Similar
      procedures are used to comment upon the forms of binding curves for the three
      state acceptor systems, the Scatchard representations of which may exhibit as
      many as three critical points (two maxima and a minimum). This delineation of
      quantitative expressions for critical points and other distinctive features
      associated with the conflicting interplay of ligand-binding and self-association
      behaviour should provide a more definitive means of characterizing systems with
      one acceptor state the preferred binding form on affinity grounds but with the
      other the preferred state from the viewpoint of binding-site numbers.

PMID- 2232827
TI  - The mechanical behaviour of cell membranes as a possible physical origin of cell
      polarity.
AB  - The mechanical behaviour of a closed layered membrane enclosing a structureless
      interior is considered. The shape of such an object in flaccid conditions is
      determined theoretically by assuming that it corresponds to the minimum value of
      the membrane bending energy. The symmetry breaking properties of this system are
      revealed. It is suggested that a continuous transition from an axisymmetrical
      shape involving mirror symmetry with regard to the equatorial plane of the object
      to the shape with polar asymmetry could be the primary event in establishing cell
      polarity.

PMID- 2232828
TI  - Adventures in surgery.

PMID- 2232829
TI  - Rupture of thoracic aorta caused by blunt trauma. A fifteen-year experience.
AB  - During the 15 years from 1971 through 1985, 114 patients with rupture of the
      thoracic aorta caused by blunt trauma were admitted to the Shock Trauma Center of
      the Maryland Institute for Emergency Medical Services Systems. Mean age was 31.3
      years (range, 15 to 80). Ninety were male and 24 were female, a 3.75:1 ratio. Of
      the 114, 89 (78.1%) survived initial resuscitation in the admitting area. Twenty
      five of the 89 initial survivors (28.1%) died during or after surgical repair.
      Paraplegia occurred in 11 of the 78 operating room survivors (14.1%). Further
      analysis was done of the 83 patients admitted in the 10-year period from 1976
      through 1985. Mean Injury Severity Score, excluding aortic injury, was 18.2.
      Twenty-five of the 83 (30.1%) died during resuscitation in the admitting area or
      operating room. Seven others died during surgical repair and 12 died
      postoperatively, leaving 39 survivors (39/83 [47%] of total admissions and 39/58
      [67.2%] of survivors of resuscitation). Paraplegia/paresis developed
      postoperatively in six of 34 (17.6%) cases involving shunt and four of 17 (23.5%)
      without shunt. Other major complications occurred in 21 of the operating room
      survivors. Statistically significant risk of death or major complication was
      associated with female sex, higher Injury Severity Score, lower admission blood
      pressure, larger hemothorax on admission, less qualified surgeon, major operation
      before aortic repair, use of shunt, and transfer directly from scene of injury.
      There was no advantage in this series to using or not using a shunt in preventing
      paraplegia. Mortality rates are realistic for a highly developed trauma system.
      Better techniques are needed to manage exsanguination and prevent paraplegia.

PMID- 2232830
TI  - Repair of transposition of the great arteries with intact ventricular septum and
      left ventricular outflow tract obstruction.
AB  - Repair of transposition of the great arteries in patients with intact ventricular
      septum and fixed left ventricular outflow tract obstruction has been restricted
      to atrial baffle procedures, with or without attempts to relieve or bypass the
      left ventricular outflow obstruction. However, the suboptimal results of these
      procedures, coupled with excellent functional results with the arterial switch
      operation in patients without obstruction, has made anatomic correction the goal
      in repairing these anomalies. We report a technique for the anatomic correction
      of transposition of the great arteries, intact ventricular septum, and fixed left
      ventricular outflow tract obstruction. Its consideration in these difficult cases
      is advocated.

PMID- 2232831
TI  - Extended ex vivo preservation of the heart and lungs. Effects of acellular oxygen
      carrying perfusates and indomethacin on the autoperfused working heart-lung
      preparation.
AB  - The autoperfused working heart-lung preparation has been proposed as a method for
      long-term heart-lung preservation. We investigated the effects of acellular
      oxygen-carrying perfusates (study 1) and the effect of donor pretreatment with
      indomethacin (study 2) on the working ex vivo heart-lung block. In study 1
      perfusion with stroma-fee hemoglobin resulted in significantly reduced survival
      (118 +/- 46 minutes) compared with autologous blood (561 +/- 125 minutes, p less
      than 0.05) or perfluorocarbon (438 +/- 114 minutes, p less than 0.05). Decrease
      in survival with stroma-free hemoglobin perfusate is associated with a marked
      decrease in left ventricular performance and a significant increase in pulmonary
      vascular resistance. Perfusion with autologous blood is associated with a
      significant increase in pulmonary vascular resistance after 240 minutes of
      explantation, which is significantly delayed by perfusion with perfluorocarbon.
      Perfusion for 6 hours with blood pretreated with indomethacin (study 2) resulted
      in a decrease in the concentration of prostacyclin and thromboxane A2 metabolites
      but an increase in the prostaglandin/thromboxane A2 metabolite ratio. This is
      associated with abrogation of the increase in pulmonary vascular resistance
      (12,787 +/- 1682 dynes/sec/cm-5, T = 0; 13,134 +/- 2654 dynes/sec/cm-5, T = 360
      minutes) observed in preparations perfused with autologous blood (13,194 +/- 1942
      dynes/sec/cm-5, T = 0; 24,768 +/- 3325 dynes/sec/cm-5, T = 360 minutes, p less
      than 0.05). We conclude that alteration of the cellular and humoral components of
      autologous blood may prove advantageous for increasing the utility of the
      autoperfused working heart-lung preparation as a preservation technique.

PMID- 2232832
TI  - Importance of acid-base strategy in reducing myocardial and whole body oxygen
      consumption during perfusion hypothermia.
AB  - During induced hypothermia with cardiopulmonary bypass, acid-base management
      usually follows one of two strategies: the so-called ectothermic or alpha-stat
      strategy, in which the pH of the arterial blood increases 0.015 pH units for
      every degree Celsius decrease in body temperature, or the pH-stat strategy, in
      which pH remains 7.4 at all temperatures. It has been assumed that oxygen
      consumption decreases approximately equally during hypothermia with either
      strategy, although there are biochemical reasons to hypothesize that oxygen
      consumption would be better maintained with the alpha-stat strategy. We also
      hypothesized that venous oxygen tension would be lower with the more alkaline
      alpha-stat strategy than with the pH-stat acid-base strategy, because of the Bohr
      effect. We tested these hypotheses by placing 10 anesthetized immature domestic
      pigs on cardiopulmonary bypass. We measured whole body oxygen consumption and
      myocardial oxygen consumption. Control measurements were made at 37 degrees C.
      Then the animals were cooled to 27 degrees C and the measurements were repeated.
      The alpha-stat strategy (pH 7.554 +/- 0.020 at 27 degrees C) was used in five
      animals and five animals received pH-stat management (pH 7.409 +/- 0.012 at 27
      degrees C). Whole body and myocardial oxygen consumption rate decreased in both
      groups, but more so in the alpha-stat animals than in the pH-stat animals. The
      unexpectedly high oxygen consumption in the pH-stat animals also resulted in a
      lower than expected venous oxygen tension. Thus the effect of hypothermia in
      reducing oxygen consumption was less pronounced with pH-stat acid-base
      management.

PMID- 2232833
TI  - Effect of supplementing cardioplegic solution with deferoxamine on reperfused
      human myocardium.
AB  - Fourteen randomized patients undergoing myocardial revascularization were divided
      into group A standard hypothermic cardioplegic solution) and group B (the same
      cardioplegic solution supplemented with deferoxamine 1000 mg/L). In all patients
      myocardial biopsy specimens were obtained before ischemia and during reperfusion
      and were assessed for chemiluminescence (to indirectly determine oxygen-free
      radical activity) and for electron microscopic studies. Chemiluminescence in
      group A showed a photoemission of 36.5 +/- 1.5 cpm/mg protein X10(-3) for the
      preischemia samples and 72 +/- 5.7 cpm/mg protein X10(-3) for the reperfusion
      samples (p less than 0.01). In the patients who received deferoxime (group B),
      values for chemiluminescence for preischemia and reperfusion samples were not
      significantly different. Electron microscopic studies showed a significant
      increase in grade 4 (severely damaged) mitochondria in reperfusion biopsy
      specimens from both groups as compared with preischemia samples. However,
      reperfusion samples from group B showed a better preservation of myocardial cells
      with marked reduction of grade 4 (severely damaged) mitochondria. These results
      support the hypothesis that oxygen-free radicals are responsible in part for the
      production of reperfusion injury in the human heart. They suggest that this
      mechanism may be at least partially controlled by adding an iron chelating agent
      such as deferoxime.

PMID- 2232835
TI  - Studies of controlled reperfusion after ischemia. XVII. Reperfusion conditions:
      controlled reperfusion through an internal mammary artery graft--a new technique
      emphasizing fixed pressure versus fixed flow.
AB  - This study tests the usefulness of delivering a controlled reperfusate through an
      internal mammary graft after acute ischemia by applying a percutaneous technique
      of mammary artery cannulation and compares reperfusion at fixed pressure versus
      fixed flow. METHODS: Twenty-one dogs underwent 2 hours of ligation of the left
      anterior descending coronary artery followed by regional controlled
      revascularization on total vented bypass. A reperfusion catheter was introduced
      percutaneously from the brachial artery into the internal mammary artery. Five
      dogs received normal blood reperfusion at 50 mm Hg pressure, and eight dogs
      received a regional blood cardioplegic reperfusate at 50 mm Hg before reperfusion
      with normal blood. Eight additional dogs received regional cardioplegia at 30
      ml/min for 20 minutes. Coronary vascular resistance, segmental shortening
      (ultrasonic crystals), tissue water content, and histochemical damage
      (triphenyltetrazolium chloride stain) were assessed. RESULTS: Reperfusion with
      normal blood increased coronary vascular resistance progressively to 62% above
      initial values (p less than 0.05) and failed to restore regional contractility
      (9% +/- 6% systolic shortening, p less than 0.05). In contrast, coronary
      resistance remained low throughout blood cardioplegic reperfusion at fixed
      pressure and the reperfused muscle recovered immediate contractility (73%
      systolic shortening, p less than 0.05). Controlled reperfusion at a fixed flow
      rate resulted in pressure that ranged from 30 to 80 mm Hg, slightly less recovery
      of systolic shortening (57%), and less return of contractile reserve (81% versus
      114%, p less than 0.05). Regional blood cardioplegic reperfusion limited edema
      formation (79.5 versus 82% water content, p less than 0.05) and histochemical
      damage (11% versus 50% area of necrosis/area at risk, p less than 0.05).
      CONCLUSION: An internal mammary artery graft can be used effectively in the
      setting of acute ischemia if a controlled blood cardioplegic reperfusate is
      delivered through it to ensure limitation of histochemical damage, low reflow
      phenomenon, and restoration of immediate segmental contractility. Controlled
      pressure reperfusion seems superior to fixed-flow reperfusion. A technique is
      described that may allow preoperative insertion of the reperfusion catheter in
      the internal mammary artery in the catheterization laboratory.

PMID- 2232834
TI  - The effects of dopamine on myocardial functional recovery after reversible
      ischemic injury.
AB  - Dopamine frequently is used to improve cardiac performance after acute myocardial
      ischemia. Inotropic agents, however, increase myocardial oxygen demand and could
      potentially delay recovery from ischemic injury. To evaluate this problem, we
      studied eight chronically instrumented dogs in the conscious state and performed
      two 15-minute coronary occlusions 48 hours apart. After one of the occlusions,
      either dopamine (15 micrograms/kg/min) or saline placebo was administered
      intravenously from 1.0 to 1.5 hours of reperfusion. The alternative infusion was
      given during the second study. Preload recruitable work area, the area beneath
      the stroke work versus end-diastolic length relationship, was used to assess
      intrinsic myocardial performance. Ischemia decreased preload recruitable work
      area to 13% of control after both occlusions. After reperfusion, a 30-minute
      dopamine infusion acutely increased myocardial function nearly threefold as
      compared with placebo. Myocardial performance after dopamine administration,
      however, was significantly depressed compared with placebo throughout the
      remaining 24 hours of reperfusion (p less than 0.01). These data indicate that
      dopamine may impair functional recovery after ischemic myocardial injury and
      suggest that inotropic interventions should be used in this setting only when
      absolutely indicated.

PMID- 2232836
TI  - Studies of controlled reperfusion after ischemia. XVIII. Reperfusion conditions:
      attenuation of the regional ischemic effect by temporary total vented bypass
      before controlled reperfusion.
AB  - This study tests the hypothesis that total vented bypass can attenuate the
      regional ischemic effect during a defined time interval before controlled blood
      cardioplegic reperfusion. Thirty-three dogs underwent 2 or 4 hours of occlusion
      of the left anterior descending coronary artery and then received a regional
      blood cardioplegic reperfusate on total vented bypass. Cardiopulmonary bypass and
      reperfusion were started after 2 hours of ischemia in eight dogs, and after 4
      hours of ischemia in 25 others. Among the 25 dogs, seven had total vented bypass
      started after the first 2 hours of the 4 hours of regional ischemia. Segmental
      shortening (ultrasonic crystals), tissue water content (wet/dry weight), and
      histochemical damage (triphenyltetrazolium chloride stain) were assessed 2 hours
      after reperfusion. Dogs reperfused after 2 hours of ischemia recovered 73% +/- 8%
      of control systolic shortening and sustained only 11% triphenyltetrazolium
      chloride nonstaining. Dogs undergoing 4 hours of regional ischemia, but with
      total vented bypass 2 hours before reperfusion had improved recovery of systolic
      shortening (49% versus 31%, p less than 0.05), limited epicardial edema (79.6%
      versus 81.1% water content, p less than 0.05), and reduced histochemical damage
      (24% versus 39% triphenyltetrazolium chloride nonstaining, p less than 0.05).
      These findings imply that institution of total vented bypass during ischemia
      attenuates the infarct process, increases regional recovery of contractility,
      limits edema and restricts histochemical damage, and may be a useful adjunct to
      myocardial salvage when controlled reperfusion can be provided.

PMID- 2232837
TI  - Intraoperative transesophageal color-coded Doppler echocardiography for
      evaluation of residual regurgitation after mitral valve repair.
AB  - Because mitral valve competence after mitral valve reconstruction is awkward to
      assess during this procedure, we evaluated in this respect transesophageal color
      coded Doppler echocardiography in 23 patients undergoing mitral valve
      reconstruction for severe mitral regurgitation. Transesophageal echocardiographic
      examinations were performed after induction of anesthesia but before sternotomy
      (baseline), after mitral valve repair before decannulation, and at sternal
      closure, all at similar mean aortic pressure and echocardiographic instrument
      settings. The degree of mitral regurgitation by transesophageal color Doppler
      flow mapping was visually quantified on a 5-point scale (0 to 4), pending the
      left atrial extent of the regurgitant jet. This was compared with the degree of
      mitral regurgitation by left ventricular cineangiography performed within several
      weeks after operation and also visually quantified on a 5-point scale (0 to 4),
      with use of the right anterior oblique projection. There was good correlation
      between the two methods (r = 0.83; p less than 0.001). We conclude that residual
      mitral regurgitation, as assessed by transesophageal color flow mapping in the
      operating room, highly correlates with the ultimate mitral regurgitation by
      cineangiography. Therefore transesophageal echocardiography can be helpful for
      evaluation of mitral valve competence during mitral valve reconstruction, and
      hence, in case of repair failure, allow valve replacement in the same surgical
      session, thus avoiding reoperation.

PMID- 2232838
TI  - Mitral valve replacement in the first year of life.
AB  - From 1973 through 1987 25 patients underwent mitral valve replacement in the
      first year of life for mitral stenosis and mitral regurgitation. The patients
      with mitral stenosis included two with mitral arcade, two with supravalvular
      mitral stenosis with hypoplastic mitral valve, and one with parachute mitral
      valve. Included in the group of patients with mitral regurgitation were 12 with
      atrioventricular canal defect, six with chordal and leaflet defects, one with
      Marfan's syndrome, and one with bacterial endocarditis. Prostheses included 12
      Bjork-Shiley (17 mm), seven St. Jude Medical (19 mm in four, 21 mm in three),
      five stent-mounted dura mater valves (12 mm to 16 mm), and one porcine xenograft
      (19 mm). In four patients the valves were placed in the left atrium in a
      supraannular location. There were nine operative (atrioventricular canal defect
      seven, mitral regurgitation two) and five late (atrioventricular canal defect
      four, mitral stenosis one) deaths, giving actuarial 1- and 5-year survival rates
      of 52% and 43%, respectively. All 6 patients with tissue valves died; the four
      with supraannular mitral valve replacement survived. Since 1983 operative
      mortality has been reduced to 0% (70% confidence limits 0% to 24%). Nine patients
      required a second mitral valve replacement for prosthetic stenosis 5 to 69 (mean
      30) months after the original mitral valve replacement (one operative death).
      Because of improvements in repair of atrioventricular canal defect in infancy,
      the need for mitral valve replacement at atrioventricular canal defect repair has
      decreased. Although valvuloplasty has been advocated for repair of congenital
      mitral valve disease and is applicable in some infants with mitral regurgitation,
      mitral valve replacement is frequently unavoidable for congenital mitral disease
      and can now be accomplished at a low operative risk, even when the prosthesis has
      to be positioned supraannularly.

PMID- 2232840
TI  - Aortic replacement with composite grafts created with a sutureless intraluminal
      ringed prosthesis.
AB  - From 1980 to 1988, 30 patients from a total population of 123 recipients of
      sutureless grafts (24%) have required aortic reconstruction with a composite
      ringed graft. Replacement of the ascending aorta was required in 12 patients, of
      the aortic arch in six patients, of the descending aorta in two patients, of the
      thoracoabdominal aorta in two patients, and of the abdominal aorta in eight
      patients. Eight patients (27%) needed an emergency operation at the time of
      admission. No patients had permanent neurologic or renal deficits. There was no
      evidence of pseudoaneurysm formation, graft erosion, graft migration, or aortic
      bleeding in the postoperative period. Two operative deaths (7%) occurred, both in
      patients undergoing arch reconstruction. Composite grafts can be created that
      vary in length and shape, incorporate different graft materials, and accommodate
      the aorta and its branches. The ability to modify the sutureless prosthesis to
      suit the disease encountered at operation allows the quickest repair with the
      least chance of anastomotic complication.

PMID- 2232839
TI  - Endotoxins in cardiopulmonary bypass.
AB  - Endotoxins are biologically active substances derived from the cell wall of
      degraded gram-negative bacteria. Since sterile water may also contain large
      amounts of endotoxins, these are easily introduced into the manufacturing
      processes of technical medical material, such as the extracorporeal components
      used in cardiopulmonary bypass. In hemodialysis, the presence of endotoxins has
      been related to untoward effects in patients. Using the limulus amebocyte lysate
      test, we determined the serum concentration of endotoxin in 42 patients
      undergoing coronary bypass operations. The values increased during
      cardiopulmonary bypass, exceeding the normal range of 0 to 20 ng/L in 10 patients
      with a maximum of 82 ng/L, which probably indicates endotoxin release from the
      extracorporeal equipment. We found no obvious relation to postoperative
      morbidity. The endotoxin levels of this study are considerably lower than those
      reported in two other studies of patients having cardiopulmonary bypass. This
      might be due to less intraoperative contamination but possibly also to
      differences in analytic methods.

PMID- 2232841
TI  - A flexible sutureless intraluminal graft that becomes rigid after placement in
      the aorta.
AB  - A new sutureless intraluminal graft has been developed with a ring made of a
      coiled, overlapping, stainless steel spring with ratchets in one overlapping end.
      This graft is flexible during insertion but becomes rigid after proper
      intraaortic placement as the spool is dilated and the ratchest lock into
      position. The new graft was implanted in 10 dogs and was evaluated histologically
      and angiographically at various intervals. No ring dislodgment, aortic rupture,
      stenosis, or aneurysmal dilation was observed. The flexible component of this
      graft allows it to be introduced and secured in place easily and provides a
      technical advantage compared with the clinically used rigid intraluminal graft.

PMID- 2232842
TI  - Invited letter concerning: simulated left ventricular aneurysm and aneurysm
      repair in swine.

PMID- 2232843
TI  - Questions regarding internal mammary hypoperfusion.

PMID- 2232844
TI  - Revascularization with the right gastroepiploic artery in Kawasaki's disease.

PMID- 2232845
TI  - Thrombosed CarboMedics mitral valve prosthesis.

PMID- 2232846
TI  - Right ventricular outflow tract obstruction in simple and corrected transposition
      of the great arteries.

PMID- 2232847
TI  - GM-CSF incubation prior to treatment with cytarabine or doxorubicin enhances drug
      activity against AML cells in vitro: a model for leukemia chemotherapy.
AB  - We studied the effect of preincubation with recombinant GM-CSF on the activity of
      cytarabine and doxorubicin against clonogenic acute myeloid leukemia cells (CFU
      AML). Leukemia cells from seven persons with AML, three myeloid cell lines (HL60,
      KG1, K562) and two control cell lines (U937, MOLT3) were tested. Preincubation
      with GM-CSF (0.01-0.1 microgram/ml) increased DNA synthesis as measured by
      tritiated thymidine incorporation and intranuclear Ki67 expression in cells from
      six persons with AML and in HL60 cells. Leukemia cells preincubated with GM-CSF
      for 6-48 h were exposed to cytarabine (2-200 micrograms/ml) or doxorubicin (0.01
      0.1 microgram/ml) for 3 h and CFU-AML assayed. This approach further reduced CFU
      AML in samples from six persons with AML and in HL60 and KG1 cells compared to
      cells not preincubated with GM-CSF prior to drug treatment. In most instances,
      reduced CFU-AML correlated with GM-CSF induced DNA synthesis. These data suggest
      a possible strategy of GM-CSF pretreatment to increase anti-leukemia efficacy of
      chemotherapy in AML.

PMID- 2232848
TI  - Biochemical characterisation studies on a leukocyte alloantigen expressed with
      high frequency in leukaemia patients.
AB  - In this report we describe, using a previously characterised monoclonal antibody
      (NC-2), the biochemical characteristics of a human leukaemia-associated
      alloantigen. Two proteins with molecular weights of 50 kDa and 15 kDa were
      immunoprecipitated from 125I surface labelled HL-60 cells. Both proteins appeared
      to be sensitive to digestion with trypsin, the 50 kDa protein in particular.
      Treatment with glycopeptidase F indicated the presence of N-linked
      oligosaccharides, whereas treatment with neuraminidase had no effect on the
      mobility of the antigens in SDS-PAGE indicating the absence of detectable sialic
      acid residues. Sensitivity to glycopeptidase F indicates that the reacting
      antigens are glycoproteins in nature. The antibody reacts with a range of normal
      tissues and appears to be associated with cytoplasmic granules in HL-60 cells.

PMID- 2232850
TI  - Response to intermediate and standard doses of IFN-beta in hairy-cell leukaemia.
AB  - Thirteen hairy-cell leukaemia patients were treated with IFN-beta (6 X 10(6)
      IU/m2) for 7 days, alternate weeks, for three cycles. IFN-beta was then continued
      at the same dose twice a week for 24 weeks. Treatment was discontinued in 2 non
      responders and 2 partial responders (1 haem PR, 1 path PR) because of
      complications unrelated to IFN. The objective response in the nine patients who
      completed therapy was 66% (1 CR, 3 path PR and 2 haem PR); 2 patients achieved
      MR. Responses lasted from 5 to 45+ months. Four newly diagnosed patients and 3 in
      relapse after discontinuation of IFN-beta therapy (6 X 10(6) IU/m2), were treated
      with a lower dose of IFN-beta (2 X 10(6) IU/m2). The objective response to this
      dose was 57% (3 path PR, 1 haem PR). Another patient obtained MR. No patient has
      relapsed 6-12 months after therapy discontinuation. IFN-beta was well tolerated,
      especially at the lower dose and no chronic toxicity was observed. Therefore IFN
      beta may be suggested as an alternative treatment for HCL.

PMID- 2232849
TI  - A study of multidrug resistance and cell kinetics in a child with near-haploid
      acute lymphoblastic leukemia.
AB  - Marked hypodiploidy is found in a small group of patients with acute
      lymphoblastic leukemia (ALL) and is associated with very poor prognosis. Cells
      from a patient with near-haploid ALL (karyotype: 27 XY, DNA index = 0.5) were
      investigated by multiparameter flow cytometry at relapse and at multiple time
      points during reinduction chemotherapy. The cell cycle of these near-haploid
      leukemic blasts and their chromatin structure was studied by acridine orange (AO)
      DNA/RNA flow cytometric assays. Most leukemic cells were in "G0", and no
      recruitment of the bone marrow cells into the G1 phase of the cell cycle was
      found during reinduction therapy with high dose cytosine arabinoside. After two
      cycles of chemotherapy, the patient achieved clinical remission, but persistent
      haploid cells were identified by flow cytometry and he relapsed after 8 weeks and
      died after 16.7 weeks. The leukemic blasts expressed very high levels of a 180 kd
      p-glycoprotein associated with multidrug resistance and daunomycin efflux could
      be blocked by verapamil. Expression of gp 180 and the verapamil effect on
      intracellular daunomycin concentration indicate multidrug resistance. We conclude
      that cell kinetic quiescence and multidrug resistance may both be factors
      responsible for the poor prognosis of this patient with near-haploid ALL. Further
      studies of this patient group should determine if these mechanisms are indeed
      responsible for the poor prognosis associated with near-haploid leukemia.

PMID- 2232851
TI  - The monitoring of acute leukemia patients: Part 1. Basic morphometric
      characteristics of bone marrow blast cells in acute lymphoblastic leukemia.
AB  - Morphologic types L1 and L2 (FAB) of acute lymphoblastic leukemia were classified
      by computer morphometry of bone marrow blast cells in 57 patients. Measurements
      were made on MOP-Videoplan Analyser (Reichert) by means of cell image contouring.
      The decision rule that had been deduced by us on the basis of multidimensional
      analysis of variance in two-cell training sets, and the selection of the
      following combination of the best discriminating features [the discriminant
      coefficients are in brackets: maximal nuclear diameter (-0.338), nuclear
      perimeter (-6.145), cell area (-0.044), nuclear area (1.007), relative nucleoli
      eccentricity (-0.279), cytoplasmic/nuclear relation (-5.920) and integral
      nucleoli area (-0.640)] were used for computer classification of L1 and L2 blast
      cells. The threshold score for discriminant function in this case was -117.766.
      Complete clinical remission rates in L1 ALL appeared to be higher than in L2 but
      remission duration in those groups did not differ significantly. The morphometric
      parameters of leukemic cells seem to characterize their maturity or their
      position in cell cycle phases and may be used in acute leukemia patient
      monitoring.

PMID- 2232852
TI  - Lineage non-specific down regulation of P210bcr/abl in the CML cell line, KU-812
      F, during differentiation.
AB  - CML cell line, KU-812-F, originally established from a patient with Philadelphia
      chromosome-positive chronic myelocytic leukemia has maintained the ability to
      differentiate into both granuloid (basophilic) and erythroid lineages. The
      expression of P210bcr/abl in KU-812-F cells during differentiation was studied by
      immunoblotting and immunoprecipitation. Immunoblotting with anti-phosphotyrosine
      sera revealed the down-regulation of P210bcr/abl in both granuloid and erythroid
      lineages. Immunoprecipitation with anti-abl antibodies of 35S-methionine-labelled
      cells revealed a reduced rate of synthesis of P210bcr/abl protein. Cytotoxic
      agents that caused growth inhibition of the cells did not alter the expression of
      P210bcr/abl. These results indicate that the down regulation of P210bcr/abl
      protein is a lineage non-specific event accompanied by differentiation.

PMID- 2232853
TI  - B8.7 antigen expression on B-CLL cells and its relationship to the LMW-BCGF
      responsiveness.
AB  - In this work, we studied the expression of B8.7 antigen on B lymphocytes from
      patients suffering from B type chronic lymphocytic leukemia (B-CLL) as well as on
      non Hodgkin lymphoma cells (NHL). B8.7 is an activation marker, which has been
      reported to be associated with the capacity of activated B cells to respond to
      LMW-BCGF. B lymphocytes of 11 out of 22 patients tested were B8.7 positive. With
      the exception of one case, LMW-BCGF is able to induce DNA synthesis by these
      cells in the absence of costimulation by anti-mu antibodies (anti-mu Ab). The LMW
      BCGF dependent proliferation of these malignant cells is inhibited by the anti
      B8.7 monoclonal antibody (anti-B8.7 MoAb), in the same line as that of normal B
      cells. These results obtained with monoclonal B cells confirm that the B8.7
      molecule is involved in the signalling pathway of the LMW-BCGF.

PMID- 2232854
TI  - Repression of nuclear lamin A and C gene expression in human acute lymphoblastic
      leukemia and non-Hodgkin's lymphoma cells.
AB  - The lamins A, B and C which are differentially expressed during ontogenesis and
      differentiation are karyoskeletal proteins forming a polymeric meshwork at the
      inner nuclear membrane. Using Northern blot analyses we investigated the steady
      state levels of the three lamin specific RNA transcripts in neoplastic cells
      derived from 16 untreated patients with acute lymphoblastic leukemia (ALL) or non
      Hodgkin's lymphoma (NHL) and in ALL and NHL established cell lines. Whereas lamin
      B mRNA was present in all, lamin A and C transcripts were observed in none of the
      malignant cell samples except one of a common-ALL patient (precursor B-ALL,
      cytoplasmic mu chain negative). All three lamin mRNAs were detected in normal
      peripheral blood lymphocytes, however, only after mitogenic stimulation with
      concanavalin A. Our results provide evidence that expression of lamin A and C is
      repressed in neoplastic blast cells derived from patients with ALL or NHL and
      suggest that lamin A and C gene repression is not related to cell proliferation
      but might be relevant to the differentiated stages of the lymphoid cells in vivo.

PMID- 2232855
TI  - Neutrophil functions in chronic myeloid leukemia.

PMID- 2232858
TI  - Methods for estimating release rates during high frequency quantal secretion and
      for testing such methods.
AB  - The rate of spontaneous quantal release must be estimated in some investigations
      of synaptic transmission, even when frequencies are so high that individual
      quanta cannot be distinguished. An obvious method is to measure the time
      integrals of the summed MEPPs and then dividing this value by the integral of an
      average MEPP. The method was tested by recording miniature end-plate potentials
      (MEPPs) at frog neuromuscular junctions, counting the number of MEPPS, and then
      adding together records from the same junction to simulate high frequencies. The
      estimates from the integral method agreed well with the actual counts. The method
      can readily be used with a microcomputer and does not require stationary data.
      Methods based on fluctuation analysis were also used to estimate quantal
      frequencies, but they did not always give good estimates. This was not a thorough
      test of the fluctuation method, but an example of testing with MEPP data. The
      integral method might be reasonably reliable, but there are further potential
      complications, like changes in MEPP size and short-circuiting of the end-plate
      membrane, which may make it difficult to obtain reliable measurements of high
      frequency quantal secretion without voltage clamping and protocols that permit
      measurements of individual MEPCs during the course of the frequency measurements.

PMID- 2232857
TI  - Age-related features of the resting and P300 auditory evoked responses using the
      dipole localization method and cortical imaging technique.
AB  - Two mathematical techniques, the dipole localization method (DLM) and the
      cortical imaging technique (CIT), are used to analyze the resting and P300
      auditory responses in young and old normal volunteers. These methods identify
      certain age-related features of these evoked responses that are not found by
      standard topographic methods. These features include the orientation of the P200
      resting response, and the laterality of the N120 response, and the eccentricity
      of the P300 response in the P300 stimulus condition. Theoretical dipole sources
      and simulated cortical surface maps are also constructed for one normal subject
      and one psychiatric inpatient and compared. These mathematical methods appear to
      enhance the discriminating power of traditional electrophysiological measures.

PMID- 2232856
TI  - An improved system for single unit isolation from multiunit nerve recordings by
      velocity analysis.
AB  - A system for recording and decomposition of complex extracellular spike trains by
      analog computing is presented. Unlike other systems, it is not necessary to
      establish templates for the analysis. Rather by adjustments of a single knob, the
      velocity band can be adjusted. The velocity measurement can be made to a
      precision of better than 1%, where the velocity jitter in individual spikes of a
      unit becomes apparent. Spike trains on the connective of a stick insect are
      analyzed which occur during an intersegmental reflex, the CLP reflex.

PMID- 2232860
TI  - Easily-implantable electrodes for chronic recording of electromyogram activity in
      small fetuses.
AB  - A method is described for the construction of simple, robust electrodes suitable
      for obtaining long-term chronic recordings of electromyogram activity from
      delicate muscles of small experimental animals. The electrodes are equipped with
      small, gold-plated barbed tips which have the form of harpoons that may be pushed
      directly into a muscle, where they remain without being sutured into place. These
      features greatly facilitate the instrumentation of muscles which are very thin or
      of limited accessibility. The electrodes have been used successfully to obtain
      chronic recordings of respiratory muscle activity from early gestation fetal
      lambs in utero.

PMID- 2232859
TI  - Fast cyclic voltammetry: improved sensitivity to dopamine with extended oxidation
      scan limits.
AB  - Fast cyclic voltammetry at carbon fibre microelectrodes has been used in vitro
      and in vivo mainly to monitor the release and uptake of dopamine. The 'standard'
      input voltage waveform (-1000 to +1000 mV, vs. Ag/AgCl, 300 V/s scan rate) has a
      lower limit of detection for dopamine of about 200 nM. In the present study, the
      scan rate and cathodic limit (-1000 mV) were kept constant while the range of the
      anodic scan was altered between 800 and 1400 mV. Extension of the oxidation scan
      to 1400 mV led to a sevenfold increase in dopamine oxidation current relative to
      the 'standard' waveform. This was accompanied by a decrease in the dopamine
      oxidation peak potential. Increased reactant adsorption for both dopamine and
      DOPAC was the likely cause of enhanced sensitivity. In vivo experiments indicate
      that, when used with the 1400 mV scan, the carbon fibre electrodes do not poison
      on contact with brain tissue and can measure dopamine concentrations lower than
      50 nM.

PMID- 2232861
TI  - A technique for controlling the membrane potential of neurons during unit
      recording.
AB  - While extracellular unit recordings are technically easier to perform than
      intracellular recordings, the latter permits control of neuron excitability by
      changing the membrane potential with steady current passed across the recording
      micropipette. Utilizing an intracellular amplifier with bridge circuit for the
      passage of low current (1-10 nA), we show that an extracellular recording
      micropipette of high resistance (5-20 M omega) can be used in a similar fashion
      while monitoring single unit activity in the rat brain. This procedure allows
      fine control of two neuronal mechanisms which are voltage-sensitive: action
      potential discharge and regenerative bursting. Control of a neuron's membrane
      potential expands the capabilities of unit recording in the study of evoked
      synaptic input and bursting behaviour. It can also facilitate classification of
      neurons based on their firing characteristics.

PMID- 2232862
TI  - Preservation of the NMDA response of neurons acutely dissociated from the mature
      guinea pig hippocampus.

PMID- 2232863
TI  - Dye-induced photopermeabilization and photodegeneration: a lesion technique
      useful for neuronal tracing.
AB  - Using as a neural system the fly retina, which is visually accessible in vivo, we
      describe a lesion technique that takes advantage of the photodynamic damage
      produced by extrinsic dyes. Contrary to the photo-inactivation technique
      described by Miller and Selverston (1979), this technique does not involve
      intracellular injection, since the dye is applied to the extracellular space of
      the tissue. This treatment was found to trigger neuronal degeneration and cell
      permeabilization in fly photoreceptor neurones. We coined the names
      'photodegeneration' and 'photopermeabilization' for these two phenomena. While
      the technique can be used to delete given neurones from the neural circuit after
      several days' survival time, it was found to produce adequate cytoplasmic
      labelling for anatomical studies with both light and electron microscopy. Since
      the area occupied by the degenerating cells is restricted to the light spot
      imaged onto the nervous tissue, the resolution with this lesion technique can
      range from single cells to whole neuronal populations. The remarkable precision
      of the 'photolesions' produced in this way makes this technique a powerful tool
      for physiological and anatomical investigations on real neural networks, whenever
      these can be made optically accessible in vivo or in situ.

PMID- 2232864
TI  - Cresyl violet: a red fluorescent Nissl stain.
AB  - Cresyl violet is widely used by neurobiologists to visualize Nissl substance in
      bright-field microscopy. Here we describe a method for using this dye as a red
      fluorescent Nissl stain. Unlike the bright-field staining technique, fluorescent
      cresyl is compatible with other fluorescent dyes and tracers, such as
      fluorescein, Fluoro-Gold and Fast Blue. The procedure requires only minor
      modifications of routine bright-field cresyl staining, the most significant being
      dilution of the stain. Thus, fluorescent red cresyl violet is simple to implement
      and may be of general use in fluorescence microscopy.

PMID- 2232865
TI  - Neuron simulations with SABER.
AB  - Computational models can provide critical tests of hypotheses of neuronal
      function. These models are essential for dealing with the complications of time-
      and voltage-dependent (active) ionic conductances. Commercial circuit analysis
      programs have been useful tools for this work. We report our experience modelling
      biophysically realistic membrane properties with SABER (Analogy, Inc.), a new
      general purpose simulator. SABER allows construction of models with arbitrary
      membrane properties. This is a major advantage over similar programs (e.g.
      SPICE), which are limited to a predefined library of electronic components. The
      empirically determined equations that describe rate constants, ionic
      conductances, currents, and concentration shifts can be translated directly into
      model elements ('templates') written in C-like code. We describe the development
      of SABER models that simulate a synapse and an action potential.

PMID- 2232866
TI  - A new medium for in vitro peripheral nervous tissue myelination without the use
      of antimitotics.
AB  - This paper describes a new medium which promotes myelin formation in cultures of
      rat dorsal root ganglia, and controls fibroblast proliferation. The medium,
      medium 'M', contains D-valine rather than L-valine and is added to cultures after
      seven days in vitro (DIV). The presence of D-amino acid oxidase in Schwann cells
      and neurons permits these cells to convert D-valine to L-valine, an essential
      amino-acid. Fibroblasts however lack D-amino acid oxidase but as some L-valine is
      present in the fetal calf serum component of medium 'M' those fibroblasts already
      present in the cultures by day 7 are maintained. Further fibroblast proliferation
      is however inhibited. The use of medium 'M' does not require the use of specific
      antimitotic agents making it cheaper and quicker to obtain myelinated cultures
      than with previous methods. The medium results in widespread myelin formation by
      21 DIV. Cultures may be grown on plastic or collagen coated glass coverslips.

PMID- 2232867
TI  - Chemical brain stimulation as a means to circumvent electrical stimulation
      artefacts in single-unit recording studies of evoked vocalization.
AB  - This study describes a combined single-unit recording/chemical brain stimulation
      technique that proved to be helpful in cases in which the behavior pattern to be
      studied electrophysiologically is difficult to elicit repetitively by external
      stimuli, but is easily obtained by brain stimulation. The advantage of this
      technique over electrical elicitation of the behavior is the avoidance of
      periodic stimulation artefacts that make detailed analyses of pattern-correlated
      neuronal activity often impracticable. Out of a number of substances tested for
      chemical brain stimulation, kainic acid proved to be the most effective one. With
      a single injection of 50 ng (in 200 nl water) into the periaqueductal gray of the
      squirrel monkey up to 6480 vocalizations could be obtained over a period of 65
      min. Up to 22 injections could be made at this dose before a site became
      unresponsive.

PMID- 2232868
TI  - A simple, inexpensive method of monitoring brain temperature in conscious
      rodents.
AB  - A method was developed to monitor brain temperature in conscious, unrestrained
      rodents. A commercially available thermocouple microprobe was modified so that it
      could be screwed firmly into a guide cannula that had been stereotactically
      implanted in the brain. Because the microprobe remains firmly in place, it is
      possible to record continuously for several hours from a single animal. Because
      the microprobe is easily removed, one can also record intermittently from several
      animals at once. The necessary equipment is relatively inexpensive and the
      modified microprobe can be sterilized and reused indefinitely. This method has
      proved especially useful for monitoring brain temperature during and after
      transient cerebral ischemia, an insult that destroys CNS neurons in a temperature
      sensitive fashion.

PMID- 2232871
TI  - Miniaturized optoelectronic system for telemetry of in vivo voltammetric signals.
AB  - In vivo voltammetry is an electrochemical technique that uses carbon fiber
      microelectrodes stereotaxically implanted in brain areas to monitor monoamine
      metabolism and release continuously, in freely moving animals. Electric wires
      connect the polarograph to the animal. A wire-less transmission system
      (optoelectronic transmission, OPT) of voltammetric signals is described here. It
      uses infrared diffused light, exploiting the diffusion of the transmitted light
      over walls and ceiling towards a receiver. The transmission system consists of a
      main unit and a satellite unit (40 x 30 x 5 mm) positioned on the animal's back.
      Voltammetric recordings obtained by the classical system (with wires) and by OPT
      are well defined and almost identical in shape. The power supply is provided by
      two thin lithium batteries (+/- 3V) that can record for up to 20 h. OPT permits
      detailed behavioral observations since the animal can be left free to move in a
      spacious environment. Voltammetry using OPT allows simultaneous recording of
      neuronal firing activity as well as electroencephalographic recordings (EEG)
      since there is no cross-talk between the circuits used. The results illustrate
      the reliability and usefulness of this wire-less transmission system for studying
      relationships between neurochemical, behavioral and electrophysiological
      activities.

PMID- 2232870
TI  - Monosodium urate test: a new analgesic test by crystal-induced monoarthritis in
      rats.
AB  - The analgesic effects of various agents were evaluated in knee joint
      monoarthritic rats where arthritis was induced by monosodium urate (MSU) crystals
      injected into the knee joint cavities. The weight supported by each hind limb was
      measured quantitatively using pressure transducers, which revealed dose-dependent
      recovery produced by various analgesics including morphine but no changes in
      value by sedatives such as chlorpromazine. Relative potency obtained from the
      value of ED50 of each analgesic agent was congruent with that in clinical use.
      The MSU test may be quite suitable for quantitative and objective evaluation of
      the analgesic effects of various agents, particularly for spontaneous and tonic
      pain.

PMID- 2232869
TI  - A simple quantitative dot-immunobinding assay for glial and neuronal marker
      proteins in SDS-solubilized brain tissue extracts.
AB  - Immunoassays for quantitative determinations of the S-100 protein, the glial
      fibrillary acidic protein, the neuron specific enolase and the neurofilament
      proteins with molecular weight of 68 and 200 kDa in hot SDS sonicated rat brain
      extracts have been developed and characterized. The assays utilize a dot
      immunobinding technique, poly- or monoclonal antibodies and 125I-protein A. The
      SDS-sonication procedure was not found to affect the radioactivity recovery in
      the assay of the soluble S-100 protein or the neuron specific enolase. All 5
      antigens can be measured with a within-assay variance below 10%. Even at a
      coefficient of variation less than or equal to 5%, the working ranges are
      approximately 30-100-fold with regard to the different antigens. It was found
      that gelatin-coated nitrocellulose membranes considerably increase the recovered
      radioactivity in the assay of the purified bovine S-100 protein, possibly by
      protein-protein interaction. This effect was not observed when SDS-sonicated rat
      brain extracts were assayed. The assay appears to be reproducible, convenient and
      rapid, and provides a high degree of precision in the determination of large
      number of samples.

PMID- 2232872
TI  - A slope-based approach to spike discrimination in digitized data.
AB  - A spike discrimination algorithm based on the analysis of spike up- and down
      slopes can advantageously replace those based only on amplitude with a minimal
      increase of programming complexity and processing time. Such an algorithm was
      developed to sort muscle depolarizations from nerve spikes in electromyograms in
      insects. It could also be used to sort spikes according to their direction of
      travel in bipolar recordings from mixed nerves.

PMID- 2232873
TI  - Law and aging.

PMID- 2232874
TI  - Realism, law and aging.

PMID- 2232875
TI  - Assessing decision-making capacity.

PMID- 2232876
TI  - The values history: an innovation in surrogate medical decision-making.

PMID- 2232877
TI  - Trends in guardianship reform: implications for the medical and legal
      professions.

PMID- 2232878
TI  - Refusals of medical care in the home setting.

PMID- 2232879
TI  - Assuring quality of care for the elderly.

PMID- 2232880
TI  - Legal issues in nursing home admissions.

PMID- 2232881
TI  - The fear of liability and the use of restraints in nursing homes.

PMID- 2232882
TI  - Financial planning for health care in older age: implications for the delivery of
      health services.

PMID- 2232883
TI  - State of the law: nursing homes.

PMID- 2232885
TI  - BCR-ABL and BCR proteins: biochemical characterization and localization.
AB  - The Philadelphia translocation results in the expression of a family of chimaeric
      proteins in which a portion of the bcr protein is fused to c-abl protein. Using
      antibodies which recognize different portions of the bcr gene and abl gene
      products we have compared the normal bcr products with their chimaeric
      counterparts. We first conclude that the enhanced kinase activity of the
      rearranged bcr-abl products (p210 and p190) is recovered almost exclusively from
      the cytosolic fraction. This methodology was confirmed by the demonstration that
      in cells transformed by the Abelson murine leukemia virus (A-MuLV) the gag-abl
      kinase activity was recovered equally from the membrane and cytosolic fractions,
      in agreement with previous studies. To determine whether the distribution of
      kinase activity reflected the bulk distribution of the bcr-abl proteins, in vivo
      labeling followed by subcellular fractionation was performed. Both normal bcr
      proteins and the p210 bcr-abl protein were recovered from the cytosolic fraction
      with little detectable amounts present in other fractions. In vivo labeling was
      also used to demonstrate that both normal bcr products and the p210 bcr-abl had a
      relatively long half-life. It is concluded that bcr-abl products, like normal bcr
      products are located in the cytosolic fraction.

PMID- 2232884
TI  - Comparison of outcome, clinical, laboratory, and immunological features in 164
      children and adults with T-ALL. The Groupe d'Etude Immunologique des Leucemies.
AB  - T cell acute lymphoblastic leukemia (T-ALL) is a disease of poor prognosis,
      usually studied separately in adults or children. Controversial clinical or
      biological prognostic factors have been reported, and little information is
      available regarding the frequency and prognostic value of membrane markers
      identified on blast cells. We report an extensive investigation of the incidence
      and prognostic value of immunophenotypic, clinical, and laboratory data in T-ALL,
      performed as a multicenter study in 164 patients. CD7, CD5, and CD2 were the most
      frequently expressed T cell antigens, and CD2 and CD4 were more frequently
      observed in children than in adults. MHC class II, CD9, and CD10 were observed in
      16, 22, and 21% of the patients, respectively. The male prevalence of T-ALL, and
      the more frequent presence of a tumoral syndrome in children were confirmed, but
      mediastinal enlargement and high leukocyte counts were observed in less than half
      the patients. A poor prognosis was associated with the expression of MHC class II
      in adults. The presence of a mediastinal mass appeared to be of good prognosis in
      adults, as well as a leukocyte count lower than 100 x 10(9)/l whatever the age of
      the patient.

PMID- 2232886
TI  - P190 BCR/ABL transcript in a case of Philadelphia-positive multiple myeloma.
AB  - Philadelphia positive multiple myeloma is a very rare event and, so far, no
      molecular data about the involvement of the BCR and C-ABL genes are available. We
      report here the case of a 64-year-old woman presenting with a typical multiple
      myeloma and a complex Philadelphia (Ph) chromosome that we investigated at a
      molecular level using conventional DNA techniques and the polymerase chain
      reaction (PCR). No rearrangement was observed within the major breakpoint cluster
      region (M-BCR) although she was found to have a P190 BCR/ABL hybrid transcript
      using PCR. As far as we know, this is the first description of a P190-type mRNA
      in a patient with a chronic lymphoid disorder. Since P190 is almost always
      associated in man with acute forms of hematological malignancies, this suggests
      that other factors may play a role in determining the phenotype of the disease.

PMID- 2232887
TI  - Blastic phase of chronic myeloid leukemia (blCML): a proposal for standardization
      of diagnostic and response criteria.
AB  - The selection of optimal treatment among the alternatives that are available is
      especially difficult in blastic phase of chronic myeloid leukemia (blCML) because
      of the absence of universally agreed upon criteria for the diagnosis of this
      phase and the absence of definitions of response. Variable response rates, from
      less than 10 to greater than 90% have been reported, but the highest response
      rates, in general, have not been reproducible. The application of strict
      morphologic, cytogenetic, and molecular biologic studies should provide the means
      for selection of optimal treatment among the new therapies that will be
      introduced in the future.

PMID- 2232888
TI  - Splenectomy in advanced chronic lymphocytic leukemia.
AB  - Between February 1972 and February 1989, splenectomies were performed in 30
      patients with chronic lymphocytic leukemia (CLL) and three with prolymphocytic
      leukemia (PLL) at our institution. Indications for splenectomy included anemia
      and/or thrombocytopenia (hypersplenism) in 31 patients and symptomatic
      splenomegaly in two patients. Median time from the diagnosis of CLL to
      splenectomy was 25 months. Twenty (87%) of the 23 patients splenectomized for
      thrombocytopenia with or without anemia had platelet increments of greater than
      or equal to 50 x 10(9)/liter. Hemoglobin increments of greater than or equal to 3
      gm/dl were noted in 12 (71%) of 17 patients splenectomized for anemia with or
      without thrombocytopenia. The median duration of platelet response was 18 months
      for 19 evaluable patients, and the median duration of hemoglobin response was 62
      months for 10 evaluable patients. Median survival time from splenectomy was 36
      months. Median survival from diagnosis was 103 months for 10 patients with stage
      III or IV disease at diagnosis and 79 months for 10 patients with stage II. A
      prospective study of the effect of splenectomy in a larger number of patients
      with advanced CLL should be considered.

PMID- 2232889
TI  - Concordant changes of pyrimidine metabolism in blasts of two cases of acute
      myeloid leukemia after repeated treatment with ara-C in vivo.
AB  - Though data from cell lines are abundant, the reason for the development of
      resistance to 1-beta-D arabinofuranosylcytosine (ara-C) in vivo remains
      unresolved. A broad interpatient variation of metabolic parameters has further
      complicated interpretation of the results. The present study compares ara-C
      metabolism in leukemic blasts of two patients with newly diagnosed disease,
      before and after repeated treatment with ara-C containing chemotherapy regimens
      in vivo. Membrane transport of ara-C was unchanged after treatment. In addition,
      cell-free extracts of blasts obtained after treatment failure showed an unchanged
      cytidine deaminase activity. Though deoxycytidine kinase activity in cell
      extracts was unaltered or increased after treatment failure, the activity in
      situ, measured as the rate of 1-beta-D-arabinofuranosylcytosine triphosphate (ara
      CTP) formation, was decreased. This could be shown to be due to an expansion of
      the deoxycytidine triphosphate (dCTP) pool. The severalfold increase in dCTP pool
      was accompanied by a decrease in thymidine triphosphate (dTTP) pool and
      correlated with a decrease in deoxycytidylate deaminase (dCMP-deaminase) activity
      in cell free extracts. Low dCMP-deaminase activity had been shown to confer an
      ara-C resistant phenotype to cell lines in vitro. Data presented in this paper
      show that a selection for leukemic blasts with low dCMP-deaminase activity can
      also be favored by ara-C containing treatment regimens in vivo. Our data suggest
      that this mechanism might contribute to treatment failure.

PMID- 2232890
TI  - Chronic myelomonocytic leukemia.
AB  - Thirty adult patients with CMML were evaluated to determine prognostic factors
      that might have an impact on conversion to acute leukemia and survival. Neither
      leukocyte count nor monocyte count correlated with survival. The median survival
      for all 30 cases was 41 months. Patients with less than 5% marrow blasts had a
      median survival of 60 months but those with 5-20% blasts had only a 9-month
      median survival.

PMID- 2232891
TI  - In vitro studies of erythropoietin-dependent regulation of erythropoiesis in
      myelodysplastic syndromes.
AB  - Erythropoietin-dependent regulation of erythropoiesis in myelodysplastic
      syndromes (MDS) was evaluated by measuring the in vitro response of primitive
      (BFU-E) and relatively mature (CFU-E) erythroid progenitors from 12 patients and
      from eight healthy donors to recombinant human erythropoietin (rhEPO), and by
      quantifying relationships between circulating EPO levels and progenitor cell
      frequencies in MDS marrow. Half-maximal growth of MDS CFU-E and BFU-E was
      detected at a 4-fold higher rhEPO concentration than required by control
      erythroid progenitors. Nine of the patients evaluated exhibited maximal growth of
      erythroid colonies at 5- to 20-fold higher than control saturating rhEPO
      concentrations. Circulating EPO levels in MDS patients were elevated, with a mean
      value approximately 35-fold higher than that of controls. The frequency of MDS
      marrow CFU-E and BFU-E was 57 +/- 42% and 18 +/- 9% of the mean control values,
      respectively. Correlation analysis of the relationships between MDS EPO levels
      and erythroid progenitors indicated that the anemia in MDS is not attributable to
      an abnormality in the capacity of EPO to induce the generation of CFU-E, but may
      be influenced by the BFU-E population, whose severe deficiency results in
      insufficient influx of EPO-responsive cells. Our findings therefore suggest that
      treatment of MDS patients with rhEPO may be of limited benefit, since the
      generation of BFU-E from more primitive ancestors and the initial growth
      requirements of these cells are not under the regulatory influence of this
      hormone.

PMID- 2232892
TI  - Trisomy/tetrasomy 13 in seven cases of acute leukemia.
AB  - We report the clinical presentation and the morphologic, histochemical, and
      immunophenotypic characteristics of seven patients with acute leukemia who had
      trisomy/tetrasomy 13 as the sole cytogenetic abnormality in their leukemia. Five
      patients had trisomy 13 at diagnosis of acute leukemia. All five of these
      patients had undifferentiated leukemias. The sixth patient, who had French
      American-British (FAB) type M2 acute nonlymphocytic leukemia (ANLL), and the
      seventh patient with biphenotypic acute leukemia developed the trisomic clone as
      a new abnormality late in the course of their disease. A review of the literature
      revealed 28 previously reported hematologic malignancies with trisomy 13 or
      tetrasomy 13q as a solitary cytogenetic abnormality. Trisomy 13 appears to
      represent another rare but nonrandom cytogenetic abnormality in acute leukemia.
      In our series trisomy 13 is largely associated with acute leukemia with little
      myeloid or lymphoid differentiation.

PMID- 2232894
TI  - Mayo Alumni Association Anniversary.

PMID- 2232893
TI  - Rationales for a pharmacologically optimized treatment of acute nonlymphocytic
      leukemia with cytosine arabinoside.

PMID- 2232895
TI  - Parathyroid hormone-related peptide in lactation and in umbilical cord blood.
AB  - Parathyroid hormone-related peptide (PTHrP) is expressed in lactating rat mammary
      glands after suckling, as a result of increases in prolactin rather than suckling
      per se. In addition, PTHrP produced in the fetal parathyroid glands and placenta
      may be responsible for stimulation of placental calcium transport. In the current
      study, we used a radioimmunoassay for human PTHrP to measure levels of the
      peptide in (1) human breast milk, cow's milk, and two infant formulas; (2)
      sequential plasma samples in prepartum and postpartum lactating women; (3) women
      with pathologic hyperprolactinemia; and (4) human umbilical cord blood. In normal
      subjects, plasma PTHrP levels ranged from less than 2 to 5 pmol/liter. In
      contrast, human breast milk contained substantially increased levels of
      immunoreactive PTHrP. Similar elevations were found in cow's milk and in one
      infant formula. Column chromatography of breast milk demonstrated that PTHrP
      immunoreactivity included a region of adenylate cyclase stimulating activity,
      consistent with the presence of biologically active PTHrP. Plasma prepartum PTHrP
      values did not differ from corresponding postpartum values in lactating women.
      Women with hyperprolactinemia had a mean plasma PTHrP value in the high-normal
      range. Umbilical cord blood had considerably suppressed parathyroid hormone
      values but PTHrP levels that were indistinguishable from those in normal human
      plasma. Thus, PTHrP is present in high concentrations in breast milk but
      apparently does not gain access to the maternal circulation in significant
      amounts. In addition, women with pathologic hyperprolactinemia seem not to have
      increased levels of circulating PTHrP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232896
TI  - Diagnosis of malignant cardiac disease by endomyocardial biopsy.
AB  - Among oncology patients, endomyocardial biopsy has been used primarily for the
      evaluation of anthracycline cardiotoxicity. In addition, however, endomyocardial
      biopsy may be useful for the detection of malignant cardiac neoplasms. Between
      1982 and 1989, metastatic involvement of the heart was diagnosed by
      endomyocardial biopsy in seven patients at our institution. All except one of
      these patients were older than 50 years of age and had dyspnea as an initial
      symptom, and all had a known malignant lesion. Results of endomyocardial biopsy
      confirmed cardiac involvement by a hematologic malignant lesion in four patients
      and metastatic melanoma in two patients. In one patient, who had a history of
      breast cancer and lymphoma, a metastatic neoplasm of uncertain differentiation
      was observed. Myocyte damage was evident in endomyocardial biopsy specimens from
      two of the four patients with hematologic malignant disease. Endomyocardial
      biopsy was performed to confirm the possibility of metastatic involvement in five
      patients; in the other two, endomyocardial biopsy was performed to determine
      whether anthracycline cardiotoxicity was present, and metastatic involvement was
      unanticipated.

PMID- 2232897
TI  - Paraneoplastic cerebellar degeneration: a clinical comparison of patients with
      and without Purkinje cell cytoplasmic antibodies.
AB  - In a review of 32 patients with paraneoplastic cerebellar degeneration (PCD), 16
      (all of whom were women) had Purkinje cell cytoplasmic antibodies (PCAb) and 16
      (8 women) did not. Most patients (15 of 16 seropositive and 12 of 16 seronegative
      patients) had active cancer at the time of neurologic diagnosis. Gynecologic or
      breast cancers were found in 14 of 16 seropositive and in 2 of 8 seronegative
      female patients; lung cancer was diagnosed in 7 of 16 seronegative patients but
      in no seropositive patient. In seropositive patients, the onset of the syndrome
      was more often abrupt and abnormalities of affect, mentation, ocular motility,
      and cerebrospinal fluid IgG index were more common than in seronegative patients.
      Additional paraneoplastic neurologic syndromes were present in five seronegative
      patients but in no seropositive patient. Clinical impairment was equivalent in
      both groups; approximately 75% of patients were confined to a wheelchair or bed
      at last follow-up. Four of 16 seropositive patients died (4 to 18 months after
      onset of PCD), and 7 of 16 seronegative patients died (7 to 120 months after
      onset of PCD). Thus, PCAb seem to be a marker for a clinical subset of female
      patients with gynecologic or breast cancer. The high frequency of other
      autoimmune paraneoplastic syndromes in patients with seronegative PCD suggests
      that PCD in both seropositive and seronegative patients may have a common
      pathogenic basis that involves an as yet unidentified antineuronal autoimmune
      mechanism.

PMID- 2232898
TI  - The mechanism of blood flow during closed chest cardiac massage in humans:
      transesophageal echocardiographic observations.
AB  - Despite years of research, the mechanism of forward blood flow during closed
      chest cardiac massage remains controversial. Two theories have been suggested:
      the cardiac pump theory and the thoracic pump theory. Transesophageal
      echocardiography offers a new approach for study of the flows and cardiac
      morphologic features during chest compressions in humans. Case reports are
      presented to illustrate the use of transesophageal echocardiography during
      cardiopulmonary resuscitation. The findings included right and left ventricular
      compression, closure of the mitral valve during compression, opening of the
      mitral valve during the release phase, and atrioventricular valvular
      regurgitation during compression, indicating a positive ventricular-to-atrial
      pressure gradient. These findings suggest that direct cardiac compression was the
      predominant mechanism of forward blood flow during cardiopulmonary resuscitation
      in these patients. An understanding of the actual mechanisms involved is
      necessary if improved cardiopulmonary resuscitative techniques or adjuncts are to
      be rationally developed for enhancing the outcome of resuscitation.

PMID- 2232899
TI  - Endothelin: a new cardiovascular regulatory peptide.
AB  - Endothelin, a recently discovered peptide produced by endothelial cells,
      contracts vascular strips in vitro with greater potency than any previously known
      vasoconstrictor. Infusions of pharmacologic doses of endothelin in vivo result in
      a prolonged pressor response and a preferential impairment of renal hemodynamic
      and excretory functions. Endothelin also directly stimulates the release of
      aldosterone from the adrenal gland and inhibits renin release in vitro. A highly
      sensitive and specific radioimmunoassay has confirmed that endothelin circulates
      in human plasma, and increased plasma endothelin levels have been associated with
      various cardiovascular disease states. This review summarizes the current
      knowledge about the molecular biologic features and physiologic actions of
      endothelin and also explores the role of endothelin, through its local and
      systemic function, as a regulator of vascular tone in normal and pathophysiologic
      states.

PMID- 2232900
TI  - Assessment of functional gastrointestinal disease: the bowel disease
      questionnaire.
AB  - A need exists for a self-report questionnaire that reliably and accurately
      measures symptoms and that distinguishes patients with functional
      gastrointestinal disease from those with other conditions. We have developed such
      an instrument, the bowel disease questionnaire, and herein describe details of
      its discriminatory validity. Data from 399 subjects were analyzed. Patients with
      gastrointestinal symptoms were ultimately diagnosed as having functional
      gastrointestinal disease (82 with the irritable bowel syndrome and 33 with
      functional dyspepsia) or organic gastrointestinal disease (N = 101). There were
      145 healthy control subjects and 38 patients with a psychiatric disease,
      somatoform disorder (which includes those with a diagnosis of hypochrondriasis,
      psychogenic pain, and somatization or conversion disorder). All subjects
      completed the questionnaire before undergoing an independent diagnostic
      assessment by experienced physicians. Functional gastrointestinal disease could
      be distinguished from organic disease, somatoform disorder, and health by using
      models derived from logistic discriminant analysis. With use of these models, the
      estimated probability of functional gastrointestinal disease was then calculated.
      Descriptive symptom scores were of less value than the scores derived from the
      data sets by logistic discriminant analysis. Age did not significantly affect the
      responses to the questionnaire items. We conclude that, in the population
      studied, the bowel disease questionnaire is a valid measure of symptoms of
      functional gastrointestinal disease, and this instrument may have clinical and
      research applications.

PMID- 2232901
TI  - Polymyositis: a case history approach to the differential diagnosis and
      treatment.
AB  - A wide range of conditions can mimic polymyositis. Thus, diagnosing this
      condition can be a challenge. Although no single criterion is diagnostic of
      polymyositis, the following criteria have been proposed and widely used: (1)
      symmetric proximal muscle weakness; (2) characteristic violaceous rash on the
      hands, elbows, and knees; (3) increased muscle enzymes in the serum; (4)
      characteristic electromyographic findings (insertional activity, fibrillation
      potentials, motor unit potentials of increased frequency and decreased duration,
      and normal conduction velocity in nerves); and (5) muscle biopsy specimen with
      characteristic inflammatory and myopathic changes. Although polymyositis
      primarily involves muscle, up to 20% of patients may have extramuscular problems.
      The main treatment for polymyositis is high-dose corticosteroids. In
      corticosteroid-resistant patients, methotrexate is often effective. In this
      report, case histories are presented to highlight the usefulness and the
      limitations of the common diagnostic criteria for polymyositis.

PMID- 2232902
TI  - Renal cell carcinoma associated with sarcoidlike tissue reaction.
AB  - A 60-year-old man was referred to our institution with the diagnosis of
      sarcoidosis. Because of several months' complaint of right flank pain and weight
      loss, the patient had consulted his local physician. After an extensive workup
      revealed only cholelithiasis, he underwent a cholecystectomy for presumed chronic
      cholecystitis. At the time of operation, biopsy of several liver nodules and
      peripancreatic nodes revealed noncaseating granulomas, consistent with
      sarcoidosis. On initial examination at our institution, the patient had
      microhematuria. A chest roentgenogram demonstrated multiple pulmonary nodules, an
      abdominal computed tomographic scan showed an indeterminate left renal mass, and
      magnetic resonance imaging of the spine revealed abnormal signals in the body of
      T-12. Open-lung biopsy showed an adenocarcinoma with clear cell features, likely
      of renal origin. The patient was diagnosed as having a metastatic renal carcinoma
      associated with a sarcoidlike tissue reaction. Although noncaseating granulomas
      have been reported in association with other malignant lesions, to our knowledge
      this is the first report of such an association with renal carcinoma. In
      addition, this case illustrates several points. First, sarcoidosis is a
      multisystem disorder with protean extrapulmonary manifestations. In fact, all our
      patient's findings could have been attributed to sarcoidosis. Second,
      noncaseating granulomas occur with many types of processes, including infections,
      chemical exposures, and, as in this case, neoplasms. Thus, noncaseating
      granulomas are not pathognomonic for sarcoidosis. Third, sarcoidosis is a
      clinical diagnosis that cannot be based on histologic findings alone.

PMID- 2232903
TI  - Parathyroid hormone-related protein.

PMID- 2232904
TI  - The endomyocardial biopsy revisited.

PMID- 2232905
TI  - Medical symbols: the staff of Aesculapius.

PMID- 2232906
TI  - Accessory molecules and antigen requirements for young and aging cytotoxic
      lymphocytes.
AB  - In this study I have investigated whether young and aging alloreactive cytotoxic
      T-lymphocytes (CTL) have comparable antigen requirements, and whether the
      accessory molecules Ly2 and LFA-1 participate similarly in cytolysis mediated by
      young and old cells. Spleen and lymph node cells from young and aging, naive and
      primed mice were stimulated in bulk culture with allogeneic cells; cytotoxicity
      and proliferation were then measured. Additionally, lymph node cells were
      cultured under limiting dilution conditions, and the resultant clones here tested
      for cytotoxicity in the presence or absence of antibodies against Ly2 and LFA-1.
      I found that accessory molecules from naive and primed, young and aging splenic
      CTL participated similarly in cytolysis. However, both cytotoxic and
      proliferating splenic T-cells from aging mice required a greater alloantigen
      concentration for optimal response. Heterogeneous lymph node CTL from old mice
      demonstrated less cytotoxicity than young CTL, and, on the clonal level, old
      naive CTL clones were less active than young clones. Naive aging clones were more
      resistant than young clones to anti-Ly2 and anti-LFA-1. After priming, clone
      activity among the various age groups did not differ. These results suggest a
      qualitative difference between young and old cytolytic cells prior to alloantigen
      priming in vivo.

PMID- 2232908
TI  - Age-related changes in the cholinergic components within the central nervous
      system. II. Working memory impairment and its relation to hippocampal muscarinic
      receptors.
AB  - Cognitive performance in aging Wistar rats was monitored using the radial arm
      maze and the latter was correlated with the density of muscarinic receptors in
      the CNS, using quantitative in vitro receptor autoradiography. Significant
      working memory deficits were observed in 12, 17 and 24-month-old rats as compared
      to 3-month-old animals. In addition, the number of the muscarinic receptors
      declined significantly with age (from 27 to 42% depending on the brain region
      sampled) utilising [3H]QNB and [3H]PZ receptor binding assays. The above trend
      became evident already at the age of 12 months. The present findings support the
      association of central cholinergic activity with memory processes.

PMID- 2232907
TI  - Protein carboxyl methylation and methyl ester turnover in density-fractionated
      human erythrocytes.
AB  - A widely distributed methyltransferase modifies protein D-aspartyl and L
      isoaspartyl residues which arise spontaneously as proteins age. Protein carboxyl
      methylation reactions were analyzed in human erythrocytes which had been
      separated on density gradients, a procedure which provides fractions enriched in
      older cells in the denser areas of the gradient. The total flux of methyl groups
      through the carboxyl methylation pathway was monitored by incubating cells from
      each fraction with L-[methyl-3H]methionine and measuring the formation of both
      protein [3H]methyl esters and [3H]methanol, derived from the hydrolysis of
      protein [3H]methyl esters in vivo. Cells isolated from denser areas of the
      gradient showed progressively higher rates of both protein carboxyl methylation
      and methanol production. In all cases, only 10-20% of the total methyl groups
      transferred were still present as intact protein [3H]methyl esters, consistent
      with the rapid hydrolysis of protein methyl esters in erythrocytes of all ages.
      The total flux of methyl groups through the carboxyl methylation pathway was
      approximately 3-fold higher in cells isolated from densest areas of the gradient
      compared to cells isolated from least dense areas of the gradient. Increases of a
      similar magnitude were observed in the numbers of both membrane protein carboxyl
      methyl esters and cytosolic protein carboxyl methyl esters. The only protein
      whose methylation was unchanged in denser cells was a 35,000 Da cytosolic
      protein. It has been proposed that protein carboxyl methyl esters are
      intermediates in either the repair or metabolism of structurally damaged
      proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2232909
TI  - Cholesterol accumulation in plasma membrane and changes of membrane enzyme
      activity of Acholeplasma laidlawii cells during culture ageing.
AB  - The data presented in this report show that the microviscosity of the plasma
      membrane and the cholesterol/phospholipid molar ratio of its lipid bilayer
      increases during ageing of Acholeplasma laidawii cultures. At the same time the
      age changes of other lipid components content do not correlate with the change of
      membrane viscosity. It is also shown that membrane enzyme activities of
      mycoplasma cell decrease with age. These results confirm the membrane hypothesis
      of ageing according to which increased microviscosity is the essential factor of
      cell ageing.

PMID- 2232910
TI  - Ascorbic acid uptake by young and aged guinea pig lenses.
AB  - The dynamics of in vitro uptake of [14C]-ascorbic acid into intact lenses of
      young (50 days old) and old (730 days old) guinea pigs was evaluated in this
      study. Two-dimensional protein gel analysis of [35S]-methionine labeled proteins
      provided evidence that the isolated lenses were viable throughout the culture
      period. It was found that the in vitro uptake of ascorbate into these lenses
      follows similar saturation kinetics for lenses from both age groups. Moreover,
      the linear uptake rate was identical. Ascorbate transport was inhibited by
      phloretin, p-chloromercuribenzoate, insulin, glucose and ouabain; however, no
      inhibition was observed with 2,4-dinitrophenol or NaF. These results suggest that
      the lenticular ascorbate concentration is regulated by a facilitated diffusion
      process and it not energy-dependent. Data on ascorbate transport into lenses from
      aged guinea pigs provide strong evidence that the abnormally low ascorbic acid
      concentrations in lenses of old mammals is not likely the result of a decreased
      lenticular uptake ability.

PMID- 2232911
TI  - Hepatic cytosolic glutathione S-transferase activities in ageing brown Norway
      rats--importance of sex differences and phenobarbital treatment for studies of
      ageing.
AB  - Age-associated alterations of hepatic cytosolic glutathione S-transferase
      activities towards 1-chloro-2,4-dinitrobenzene and 1,2-dichloro-4-nitrobenzene
      were investigated in Brown Norway rats of both sexes (11-144 weeks old), under
      control conditions and after administration of phenobarbital. With both
      substrates, small changes in glutathione S-transferase activities are observed
      for the control rats (15-53 weeks old). For these specific age groups, male
      glutathione S-transferase activities are significantly higher than those of their
      female counterparts, with sex-related differences being most pronounced after 1,2
      dichloro-4-nitrobenzene conjugation. Using 1-chloro-2,4-dinitrobenzene as a
      'general' substrate, the sex-differences tend to decrease from the age of 53
      weeks onwards to become non-significant at the age of 112 weeks. Phenobarbital
      administration significantly increases the total and the isoenzymes 3-3 and 3-4
      activities in both sexes, with the highest and the lowest increase being observed
      in the youngest and oldest animals, respectively. It therefore can be concluded
      that some age-related variations exist as far as the glutathione S-transferase
      activity of both control and phenobarbital-treated rats are concerned, but that
      the changes observed are rather small. On the contrary, the parameters 'Sex' and
      'Phenobarbital treatment' are found to be responsible for the major activity
      changes observed.

PMID- 2232912
TI  - Influences of physical training on the functional changes of young and old red
      blood cells.
AB  - Eleven male elite endurance-trained athletes and 10 male elite strength-trained
      athletes were compared to a non-trained group of men, to determine the effect of
      training on some haematological parameters and some indicators of red cell
      membrane properties. Erythrocytes were age-fractionated by centrifugation in
      Percoll gradients. It has been found that in the reticulocytes and young
      erythrocytes of endurance trained athletes activity of acetylcholinesterase
      (AChE) and concentration of glutathione (GSH) were higher than in strength
      trained athletes and control. The red cell osmotic fragility (RCOF) and glycerol
      lysis time (GLT) of young cells were similar in all investigated groups. The
      endurance training indicating chronic adaptation mechanisms in significant
      changes of red cell metabolism but non membrane properties.

PMID- 2232913
TI  - Longitudinal Gompertzian analysis of amyotrophic lateral sclerosis mortality in
      the U.S., 1977-1986: evidence for an inherently susceptible population subset.
AB  - Age-adjusted mortality rates for amyotrophic lateral sclerosis (ALS) for men and
      women in the United States from 1977 to 1986 were determined and subjected to
      longitudinal Gompertzian analysis. The exponential decline in the rate of
      increase of age-adjusted ALS mortality rates after age 55 years is most
      consistent with the existence of an inherently susceptible population subset that
      is decreasing faster than the general population. In the U.S. between 1977 and
      1986, annual age-adjusted ALS mortality rate distributions were determined by a
      common fixed intersect point (for men, the death rate at age 46.38 years was
      0.91/100,000; for women, the death rate at age 45.85 years was 0.46/100,000); and
      an environmental factor that varied erratically during the decade by a factor of
      7.21 for men and 11.64 for women. On the average, the U.S. environment during
      this period was 4.33 times more conducive to mortality from ALS in men than in
      women. Overall ALS mortality between 1977 and 1986 increased 46% and 49% for men
      and women, respectively. The common fixed intersect point in mortality rate
      distributions suggests that these increases were real and not merely the result
      of improved diagnosis and/or better reporting. The overall increase in ALS
      mortality most likely results from an effective increase in the susceptible
      population subset due to increasing life expectancy, rather than to environmental
      factors. That is, as life expectancy increases, more of the susceptible
      population subset live long enough to express the disease.

PMID- 2232914
TI  - Longitudinal Gompertzian analysis of Parkinson's disease mortality in the U.S.,
      1955-1986: the dramatic increase in overall mortality since 1980 is the natural
      consequence of deterministic mortality dynamics.
AB  - Age-adjusted mortality rates for Parkinson's disease (PD) for men and women in
      the United States, from 1955 to 1986, were calculated and subjected to
      longitudinal Gompertzian analysis. Annual age-adjusted PD mortality rate
      distributions were determined by a common intersect point and a variable
      environmental factor. For men, the death rate at age 73.75 years was
      19.15/100,000; for women, the death rate at age 78.99 years was 28.64/100,000 for
      each year from 1955 to 1986. The environmental factor declined (improved) 360.7
      fold for men and 319.6-fold for women in 1986 compared to 1955. Despite this
      dramatic environmental improvement favoring survival in PD, there has been a
      57.6% increase since 1980 in the annual crude PD mortality rate for men compared
      to the stable annual crude mortality rate from 1955 to 1979. A corresponding
      37.9% increase in the annual crude PD mortality rate for women has also occurred
      since 1980. The increase in overall mortality is due entirely to rapidly
      increasing age-adjusted mortality rates at ages greater than the intersect points
      for men and women. The results suggest that overall mortality due to common
      'degenerative' diseases may increase dramatically as has occurred in PD.

PMID- 2232915
TI  - Longitudinal Gompertzian analysis of stroke mortality in the U.S., 1951-1986:
      declining stroke mortality is the natural consequence of competitive
      deterministic mortality dynamics.
AB  - Age-adjusted mortality rates for stroke in the United States from 1951 to 1986
      were subjected to longitudinal Gompertzian analysis. Age-adjusted stroke
      mortality rate distributions were determined by a variable environmental factor
      and a constant Gompertz slope. Compared to 1951 values, the environmental factor
      in 1986 had declined (improved) 49.8% for men and 59.1% for women. This was
      associated with a 51.9% and 31.4% decrease in the annual crude mortality rate
      from stroke for men and women respectively. However, the Gompertz slope remained
      remarkably constant from 1951 to 1986; 0.050152 for men and 0.048341 for women.
      The constant Gompertz slope for age-adjusted mortality rate distributions for
      stroke is in sharp contrast to the increasing Gompertz slope which occurs with an
      improving environment in 'degenerative' diseases and aging in general. These
      findings suggest that the recent dramatic decline in overall stroke mortality is
      the natural consequence of competitive deterministic mortality dynamics. As the
      overall environment becomes more conducive to human survival, Gompertzian
      diseases with converging mortality rate distributions must increase as causes of
      human mortality at the expense of diseases with constant Gompertz slopes.

PMID- 2232916
TI  - Tumor necrosis factor reduces lifespan of human endothelial cells in vitro.
AB  - Tumor necrosis factor (TNF) is known to regulate the proliferation and function
      of vascular endothelial cells (ECs). We have examined the effects of TNF on the
      growth and aging of human ECs of different origins and compared them with those
      in human normal diploid fibroblasts. The results obtained were as follows: (1)
      TNF reduces the growth rate and in vitro life span of ECs in both dose- and
      treatment length-dependent fashions; (2) ECs are significantly more sensitive to
      TNF than fibroblasts; and (3) the life span shortening effect of TNF on ECs
      increases as a function of in vitro cell age. These results suggest that the
      aging of ECs is modified by TNF exposure.

PMID- 2232917
TI  - Periodic clustering of human disease-specific mortality distributions by shape
      and time position, and a new integer-based law of mortality.
AB  - Human mortality distributions were analyzed for 29 disease-specific causes-of
      death in male and female, White (U.S.A.), Black (U.S.A.) and Japanese (Japan)
      populations, constituting a total of 162 separate cohorts. For each cohort
      distribution, the curve moments and the parameter values for fits to model
      equations were determined. The differences between cohort distributions were
      characterized by two degrees of freedom, related to distribution position and
      shape, respectively. A form of the Weibull function was shown to contain two
      parameters that mapped to these two degrees of freedom. Parametric analysis on
      136 best-fitting cohorts yielded periodic clustering in the set of values for
      both Weibull parameters as quantitated using a Fourier transform method and an
      independent statistical method. This periodicity was unlikely to have occurred by
      chance (P less than 0.01). We have combined these results into a Law of
      Mortality, based on a Weibull function containing only integer parameters and
      constants, which is valid for all human age-related disease mortality. We show
      that the life expectancy differences between races and sexes is completely
      described by this formalism. We conclude that human mortality is controlled by
      discrete events, which are manifested in the appearance of only allowed mortality
      curve shapes and positions.

PMID- 2232918
TI  - Administrative data and outcomes research.

PMID- 2232919
TI  - The effects of monitoring and feedback on compliance.
AB  - A two-group randomized experimental design was employed to assess the effects of
      monitoring and feedback on the compliance of 93 psychiatric outpatients treated
      with lithium. Compliance in both groups was measured using self-report, lithium
      level, appointment-keeping, and medication refill frequency. The experimental
      group was also monitored using a unique electronic device that records the time
      and day pills are removed. At the midpoint of the study, the experimental group
      received feedback about serum lithium levels and patterns of removing medications
      from the monitoring device while the control group received feedback about serum
      lithium levels only. The study demonstrated no sustained effect of the monitoring
      and feedback interventions on compliance.

PMID- 2232920
TI  - Services and charges by PPO physicians for PPO and indemnity patients. An episode
      of care comparison.
AB  - Physicians who participate in preferred provider organizations (PPOs) usually
      agree to various types of utilization review and sometimes discount their charges
      or agree to accept lower fees. This study was performed to determine whether they
      provided more or fewer services to their PPO patients than to their indemnity
      patients and whether the discounting resulted in lower expenditures for each
      episode of illness. In 1984, Metropolitan Life offered PPO coverage to Dade
      County (Florida) school board employees and dependents but only a standard
      indemnity plan to Dade County government employees and dependents. Episodes of
      care were examined for patients with chest pain, hypertension, joint pain,
      gastrointestinal or liver disorders, and lower back pain cared for by physicians
      who treated patients in both the PPO and indemnity employee groups. For PPO
      patients, charges per physician service were the same or lower, but total
      physician charges during an episode were higher. For services such as laboratory
      tests, diagnostic x-rays, and room and board, PPO and indemnity patients' charges
      were not significantly different.

PMID- 2232921
TI  - The effect of drug co-payments on utilization and cost of pharmaceuticals in a
      health maintenance organization.
AB  - This study analyzed how the use and cost of pharmaceuticals varied by level of
      drug co-payment in a staff model health maintenance organization (HMO). An
      historical cohort design was used to study changes in drug utilization and drug
      costs in 19,982 continuously enrolled beneficiaries less than the age of 65. The
      beneficiaries initially had no drug co-payments, but experienced co-payment rates
      of $1.50, $3.00, and $3.00 plus other benefit changes during a three-year period.
      A comparison cohort of 23,164 beneficiaries was selected from the same setting
      who were subject to no drug co-payment during the same time period. Data on the
      use and cost of medications were obtained from an automated data system. Adjusted
      analyses for each time period controlled for age, sex, years in the Group Health
      Cooperative (GHC), and prior year utilization (or cost). The initial $1.50 drug
      co-payment was associated with a drop of 10.7% in the number of prescriptions
      filled relative to change in the comparison cohort. The decrease was greatest for
      discretionary drugs at each level of co-payment. The implementation of
      progressively greater levels of co-payments continued to have a significant
      effect on drug utilization since each co-payment level resulted in an additional
      reduction in drug utilization; 10.6% with the $3 co-payment and 12.0% when the $3
      drug co-payment was combined with other cost-sharing provisions. Co-payments were
      associated with lower per capita drug costs and higher per prescription unit
      costs.

PMID- 2232922
TI  - HMO enrollment by Medicare beneficiaries in heterogeneous communities.
AB  - This study examines the effect of ethnicity, race, and other socioeconomic and
      utilization variables on belonging to a fee-for-service or capitated plan by
      Medicare beneficiaries. Native-born beneficiaries cite health status, physical
      access to health care facilities, and income levels as affecting their choice.
      Immigrants, on the other hand, mention age, a lifestyle of living alone, and
      income as influencing their decision. Among foreign-born nationals, race appears
      to play an important role in choosing health care plans. A key factor affecting
      enrollment among immigrant populations appears to be the availability of ethnic
      sensitive providers of health care. While the elderly Hispanic immigrant
      population utilizes participating providers in prepaid plans catering to a
      Spanish-speaking population, the lack of similar facilities among predominantly
      black immigrant neighborhoods inhibits participation in HMOs by elderly
      immigrants from places such as Haiti and the Caribbean Basin. Policy implications
      are discussed.

PMID- 2232923
TI  - Drug formularies: myths-in-formation.
AB  - Drug formularies are pivotal tools for delineating and directing prescribing to
      the "drugs of choice." Full realization of their potential has been hampered by
      insufficient comparative data on drug efficacy/safety and local resources for
      formulary development. However, misconceptions concerning fundamental formulary
      concepts pose an even more formidable obstacle. This article identifies
      statements illustrating formulary misconception a) made by physicians attending
      Pharmacy and Therapeutics Committee meetings during a three-year period and b)
      appearing in published sources. The paper highlights basic objectives and
      operational requirements of an effective formulary, and contrasts this definition
      with 20 myths and misinformation culled from these two sources. Not only does
      such misinformation impair formulary development, many critics are so preoccupied
      with alleged shortcomings that progress in minimizing the real limitations of
      formularies has been impeded.

PMID- 2232924
TI  - A proposed new system for valuing dental procedures. The relative time-cost unit.
AB  - The relative time cost unit (RTCU) is a proposed new system for valuing dental
      procedures that provides an alternative to traditional relative value units in
      fee-setting and reimbursement allowances. It incorporates personnel costs, task
      mixes, and task times into relative weights for dental procedures. The frequently
      performed procedure, "2-surface amalgam restoration," is used to illustrate how
      the RTCU values are derived from hospital task analysis data. The RTCU, as a data
      based construct, holds appeal for restructuring fee schedules and has been used
      for almost a decade by insurance companies to value dental services, construct
      fee schedules, and evaluate reimbursement to providers.

PMID- 2232925
TI  - The risk of nursing home use in later life.
AB  - Data from the 1982-1984 National Long-Term Care Survey were used in this paper to
      estimate the risk of nursing home use. The data revealed that 37% of a nationally
      representative sample of individuals dying between 1982 and 1984 used a nursing
      home sometime after turning 65. This proportion increased with longevity and was
      higher among females and whites and in the North Central and Western regions of
      the country. Because individuals now turning 65 have a longer life expectancy
      than the persons studied, they face an even higher remaining lifetime risk of
      nursing home use (43%). Assuming that past utilization patterns will continue,
      over half of the women and almost one-third of the men turning 65 in 1990 can be
      expected to use a nursing home sometime before they die.

PMID- 2232926
TI  - Expanding Medicaid drug formulary coverage. Effects on utilization of related
      services.
AB  - Effects on utilization and expenditures occurring concurrently with an expansion
      of coverage in the South Carolina Medicaid drug formulary were investigated. Data
      were collected for prescriptions, physician office visits, and outpatient and
      inpatient hospital visits. Data were evaluated for a cohort of 12,139 individuals
      who had at least one prescription claim and were continuously eligible for
      benefits during the two-year study. A repeated measures design was employed to
      control the differences between subjects. A multivariate analysis of variance was
      used to detect overall differences in utilization and expenditures. A priori
      comparisons of means were performed to detect changes in levels and rates of
      expenditures and utilization for each service. Increases were observed in the
      number of prescriptions, physician visits, and outpatient visits per person while
      the number of inpatient hospital admissions declined. Similarly, expenditures
      increased for all service areas except the inpatient hospital service. The
      proportion of variance explained by the formulary change was small in all service
      areas, but would be of practical significance because of the large number of
      Medicaid recipients affected. From a theoretical perspective, an association of a
      reduction in inpatient hospital use and expenditures following the elimination of
      drug formulary restrictions is particularly noteworthy. These findings support
      the thesis that medical care services should not be viewed in isolation but
      rather as a system of interrelated activities. Interventions in one portion of
      the system are mirrored by changes in utilization of other components.
      Frequently, private and public medical care programs are managed with
      organizationally distinct benefit budgets, which are controlled independently. In
      view of the results of this study, this organizational approach may lead to a
      suboptimal allocation of resources.

PMID- 2232927
TI  - Parent anxiety and satisfaction with a pediatric visit.

PMID- 2232928
TI  - Using the delay tool to attribute causes for unnecessary pediatric hospital days.

PMID- 2232929
TI  - Note on controlling risk in capitation payment. Actuaries rate HMOs in a
      different fashion.

PMID- 2232930
TI  - Energy imbalance and cancer of the breast, colon and prostate.
AB  - In Western societies, energy imbalance is characterized by obesity and sedentary
      life styles and is associated with increased morbidity and mortality from all
      causes of cancer, including cancer of the breast, colon and prostate. The
      interrelationships of energy intake and energy retention, to energy expenditure
      and physical fitness need further investigation from the physiologic, metabolic,
      endocrine and genetic aspects of cancer development, since obesity, energy
      expenditure and cancer have a familial predisposition. The effects of exercise on
      estrogen and prostaglandin metabolism and their relationship to cancer
      development require further investigation. Although the exact amount and
      intensity of exercise that confers benefit is not known, physical activity and
      physical fitness are inversely associated with all-cause mortality, including
      cancer. These findings have important public health implications, because about
      one-third of persons in industrialized societies are quite sedentary, and the
      prevalence of low physical fitness is quite high. The balance between total
      energy intake and expenditure may be more important in cancer development than
      the intake of any given dietary component or energy source. Exercise increases
      prostacyclin and decreases the aggregation of platelets and possibly decreases
      the platelet derived growth factors (PDGF). One could speculate that exercise may
      in turn decrease the probability of developing colon cancer in those who are
      predisposed to it, since the SIS oncogene is in fact a variant of PDGF.

PMID- 2232933
TI  - Conjugated dienoic derivatives of linoleic acid: a new class of anticarcinogens.
AB  - Evidence establishing the anticarcinogenic activity of the conjugated dienoic
      derivatives of linoleic acid (CLA) is reviewed. Our findings demonstrate that CLA
      is a potent antioxidant and that the c-9,t-11 CLA isomer is selectively
      incorporated into cellular phospholipid, which may at least in part explain the
      anticarcinogenic activity of CLA. Dietary sources of CLA include grilled beef,
      cheese, and related foods. Another source of CLA is its endogenous generation via
      the carbon centered free radical oxidation of linoleic acid. We propose that the
      formation and action of CLA represents a previously unrecognized in situ defense
      mechanism against membrane attack by oxygen radicals.

PMID- 2232932
TI  - Short-term tests and long-term prospects for colon cancer prevention.
AB  - Five assay systems that have been used for identifying possible carcinogenic
      factors responsible for human colon cancer are described. These are: Salmonella,
      colonic micronuclei, colonic epithelial proliferation and aberrant crypt assays,
      and polyp recurrence trials. The assays have led to the development and testing
      of 7 hypotheses. A review of this process points to the importance of specificity
      in the assay system.

PMID- 2232931
TI  - Dietary prevention of breast cancer.
AB  - A review of the epidemiological and experimental data suggests that dietary
      modification does have a place in breast cancer prevention. This needs to be
      considered at three levels: dietary recommendations for the general population,
      dietary intervention in the management of women at high risk for breast cancer,
      and the place for dietary therapy as a component of regimens intended to reduce
      risk of recurrence after primary treatment of breast cancer ('secondary
      prevention'). Based on present evidence, a dietary approach to breast cancer
      prevention should include weight control, when indicated, a reduction in dietary
      fat intake to approximately 20% of total fats, and an increase in fiber
      consumption to 25-30 g day-1. Further studies are indicated to determine the
      optimal qualitative composition of dietary fat consumed, and the nature of
      supplemental fiber.

PMID- 2232934
TI  - The importance of N-6 and N-3 fatty acids in carcinogenesis.
AB  - Cross-cultural comparisons show that total fat intake is related to breast and
      colon cancer mortality. Total fat consists of different fatty acid families.
      Therefore different fatty acids should be studied in relation to breast and colon
      carcinogenesis. Animal experiments suggest that N-6 polyunsaturated fatty acids
      may have a tumor promoting effect and that N-3 polyunsaturated fatty acids may
      exert an inhibitory effect on chemically-induced mammary and colon tumorigenesis.
      Data from epidemiologic studies in this area are scarce. Comparisons between
      Japan and Iceland and between Eskimos and Danes suggest that a low-fat diet in
      combination with a N-3/N-6 polyunsaturated fatty acid ratio of about 0.5 seems to
      be associated with low mortality rates from breast and colon cancer. Much more
      research is needed to determine the optimal intake of total fat, N-6 and N-3
      polyunsaturated fatty acids in relation to breast and colon cancer prevention.

PMID- 2232936
TI  - Mineral insufficiency and cancer.
AB  - There are excellent theoretical reasons why the mineral nutrients selenium,
      manganese, copper and zinc, known as the antioxidant minerals, may be involved in
      the prevention of cancer aetiogenesis. The biochemistry is discussed of the part
      played by the antioxidant minerals, in the wider context of the other dietary
      antioxidants vitamins A, E and C, and beta carotene, in preventing tissue damage
      caused by activated metabolites of oxygen. The likely part played by these oxygen
      metabolites is described and a detailed review given of the evidence that
      suggests a role for antioxidant minerals, notably selenium, in preventing
      carcinogenesis in a range of animal models. There follows a summary of the
      emerging epidemiological evidence that suggests clearly that low selenium intake
      is a risk factor in the aetiology of human cancer.

PMID- 2232937
TI  - Strategies for cancer prevention through diet modification.
AB  - Diet and cancer research at the National Cancer Institute has grown from a budget
      of $2.5 million in 1974 to $55 million in 1988. The emphasis is partially on
      demonstrations of prevention strategies and chemoprevention trials. Studies to
      disseminate dietary goals in practical ways are undertaken with the aid of the
      food industry.

PMID- 2232935
TI  - Experimental approaches to nutrition and cancer: fats, calories, vitamins and
      minerals.
AB  - Chronic energy intake restriction (CEIR) inhibits lymphoproliferative disease,
      autoimmune-based renal disease and mammary adenocarcinoma in mice of numerous
      short-lived strains (MRL/lpr, C3H/Bi, C3H/Ou). Doubling and tripling of life span
      and health span and inhibition of development of diseases associated with aging
      could be attributed to restriction of calories but not to restriction of dietary
      fat in the absence of calorie restriction. In mice of both long- and short-lived
      strains, CEIR dramatically prevents the waning of immunologic vigor that commonly
      occurs with aging, delays thymic involution, impairs formation of circulating
      immune complexes, prevents the renal injury that accompanies autoimmune disease,
      and significantly forestalls development of genetically determined
      lymphoproliferative or neoplastic disease. Evidence suggests that CEIR may exert
      these beneficial influences in part through regulation of cellular proliferation.
      Trace elements, particularly zinc, as well as vitamins may play important roles
      in maintaining immunocompetence and also appear to be of significance in the
      dietary prevention of certain experimental cancers.

PMID- 2232939
TI  - Nutrition and cancer. The fourth international symposium organized by the
      Hematology Collaborating Group. Stockholm, Sweden, 21-22 September 1989.
      Proceedings.

PMID- 2232938
TI  - Nutritional intervention studies in cancer prevention.
AB  - Nutritional intervention trials are important tools in the search for efficient
      cancer prevention strategies. They can be divided into two types of trials;
      chemoprevention in which intervention is a defined chemical agent or a
      micronutrient, and diet trials in which intervention is a change in dietary
      habits. The most commonly used chemopreventive agents are retinoids, beta
      carotene, and vitamins. The chemopreventive trials are directed to general cancer
      prevention or focus on target organs. The diet intervention studies include
      subjects at increased risk for cancer, cancer patients and community-based
      intervention programs. Although several completed chemopreventive studies
      indicate that certain micronutrients can prevent neoplastic growth, the follow-up
      period is still too short for most nutritional intervention studies to determine
      whether their preventive strategies are effective.

PMID- 2232940
TI  - Inducers and scavengers of free radicals in the food.

PMID- 2232942
TI  - Gastric carcinogenesis: diet as a causative factor.
AB  - Gastric cancer is a very typical cancer related to life styles, including
      nutrition and dietary conditions. Cigarette smoking has also been pointed out as
      an enhancing factor in gastric cancer development. Improvement of dietary
      conditions, regular dietary habits including lower salt, nitrite and nitrite
      intake and balanced nutritious food may be factors suppressing the incidence of
      gastric cancer. At the same time, advances in technology for early diagnosis and
      early surgical treatment have elevated the cure rate of gastric cancers. From
      both primary and secondary cancer prevention aspects, gastric cancer is now a
      conquerable disease.

PMID- 2232943
TI  - The diet and cancer hypothesis: current trends.
AB  - The current decade has witnessed an increasing interest in the diet-cancer issue
      as a central one for public health. Notwithstanding a substantial amount of
      epidemiological investigations, firm evidence of carcinogenicity exists only for
      alcoholic beverages with respect to cancers at several sites, and for aflatoxin
      with respect to liver cancer; also, the relation is established between diet
      related excess of energy intake, as translated into obesity, and cancer of
      endometrium and gallbladder. For a number of other dietary factors the evidence
      for a causal or protective role still remains at a presumptive level (e.g. intake
      of fresh vegetables and fruits with respect to cancers at several sites), or is
      still frankly open to debate (e.g. fat with respect to breast and colon cancer).
      Methodological inadequacies in past studies have been identified and clearer
      results should derive in the coming decade from epidemiological investigations
      substantially improved in methodology, particularly from the long-term
      prospective studies as now planned by the International Agency for Research on
      Cancer. Fortunately for cancer prevention, such dietary advice as can be derived
      from the highly incomplete and unsatisfactory knowledge on the role of dietary
      factors on cancer, turns out to be in broad agreement with the advice aimed at
      preventing other major diseases such as ischaemic heart disease and hypertension.
      This allows the issuing of a set of simple but important 'prudent diet'
      recommendations.

PMID- 2232944
TI  - [Dexfenfluramine: a new approach in the treatment of overweight].

PMID- 2232945
TI  - [Acute myelofibrosis].

PMID- 2232941
TI  - Dietary carcinogens, environmental pollution, and cancer: some misconceptions.
AB  - Various misconceptions about dietary carcinogens, pesticide residues, and cancer
      causation are discussed. The pesticides in our diet are 99.99% natural, since
      plants make an enormous variety of toxins against fungi, insects, and animal
      predators. Although only 50 of these natural pesticides have been tested in
      animal cancer tests, about half of them are carcinogens. About half of all
      chemicals tested in animal cancer tests are positive. The proportion of natural
      pesticides positive in animal tests of clastogenicity is also the same as for
      synthetic chemicals. It is argued that testing chemicals in animals at the
      maximum tolerated dose primarily measures chronic cell proliferation, a threshold
      process. Cell proliferation is mutagenic in several ways, including inducing
      mitotic recombination, and therefore chronic induction of cell proliferation is a
      risk factor for cancer.

PMID- 2232946
TI  - [Pulmonary microvascular cytology in critical patients].
AB  - Cytology in blood drawn through a wedged Swan-Ganz catheter appears as a
      sensitive method for the diagnosis of carcinomatous lymphangitis in patients in
      whom transbronchial biopsy is considered dangerous or who refuse to undergo the
      latter procedure. However, its usefulness has not been assessed in critical
      patients with acute respiratory failure of unknown etiology in whom malignant
      disease is suspected. We report our experience in two patients admitted to the
      Intensive Care Unit with acute respiratory failure of unknown etiology: they were
      a female with breast carcinoma and a male with lymphoma in whom the cytological
      study of pulmonary capillary blood disclosed malignant cells. The clinical
      evaluation and the subsequent histological studies confirmed the pulmonary
      involvement by malignant disease in both cases.

PMID- 2232948
TI  - [Success with enalapril after captopril-induced neutropenia].

PMID- 2232949
TI  - [Mortality statistics and validity of the certification of causes of death in
      Spain: a necessary specification].

PMID- 2232947
TI  - [Drug treatment of male infertility].

PMID- 2232950
TI  - [Search, critical selection and citation of bibliographic references in medical
      articles].

PMID- 2232951
TI  - [Tolerance of continuous positive nasal pressure treatment in obstructive sleep
      apnea syndrome].

PMID- 2232953
TI  - Validation and testing of medical decision aids. Introduction.

PMID- 2232952
TI  - [Infectious endocarditis in drug addicts: a study of 71 cases].
AB  - Infective endocarditis (IE) is a severe and relatively common condition in
      parenteral drug abusers (PDA). Seventy-one IE episodes in 59 PDAs admitted to the
      Hospital General Vall d'Hebron from August 1978 to December 1988 were evaluated.
      The disease basically involved young males, with a progressively increasing
      incidence throughout the decade and a higher frequency during August. Fever was a
      constant symptom, with a duration of less than 10 days before admission in 73% of
      cases. Staphylococcus aureus was the most common pathogen (85% of episodes).
      Vegetations were detected by echocardiography in 70% of cases. In 82% of episodes
      the right side of the heart was involved, particularly the tricuspid valve. The
      initial chest X-ray film was abnormal in 57.5% of episodes. In 7 patients
      features of heart failure were present at admission; most had left heart
      endocarditis. Three patients with left heart endocarditis required surgical
      therapy. Overall mortality was 13%; it was 6% in patients with only tricuspid
      involvement and 27% when the left heart was involved.

PMID- 2232954
TI  - The evaluation of clinical decision support systems: what is necessary versus
      what is interesting.
AB  - The evaluation of clinical decision support systems has long been recognized as
      an important part of the overall field of medical computing, as well as a complex
      and varied field in its own right. There are a number of purposes for which such
      an evaluation might be performed. This paper focuses on one of those purposes,
      the assurance of safety when preparing to release the system for general use. The
      assurance of safety involves two major stages: (1) a comprehensive validation of
      the system's knowledge and advice, and (2) a period of use which exposes the
      system's advice and interface to the clinical environment.

PMID- 2232955
TI  - Evaluation stages and design steps for knowledge-based systems in medicine.
AB  - After the early experiments in artificial intelligence a methodology is emerging
      around advanced systems for the management of medical knowledge. The stress is
      moving away from the implementation of prototypes to the evaluation. It is
      possible to adapt and to apply this to field evaluation techniques already
      developed in similar contexts of knowledge management (books, drugs,
      epidemiology, consultants, etc.). The time is ready for a further step: to
      envisage a methodology for the design of real systems that cope with the
      'knowledge environment' of the user. Every stage of the evaluation process is re
      examined here, and considered as a framework to define goals and criteria about a
      step of design: (1) the impact of the system on the progress of health care
      provision (priorities, cost-benefit analysis, share of tasks among different
      media); (2) effectiveness in the end-user's environment and long-term effects on
      his behaviour (changes in people's role and responsibilities, improvements in the
      quality of data, acceptance of the system); (3) the intrinsic efficiency of the
      system apart from the operational context (correctness of the knowledge base,
      appropriateness of the reasoning). The need to differentiate the test sample into
      three classes (obvious, typical, atypical) is emphasized, discussing the
      influence on both evaluation and design. In particular the difficulty of having
      'gold standards' on atypical cases, due to the disagreement among the experts,
      leads to the definition of two alternative attitudes: the 'standardization mode'
      and the 'brain-storming mode'.

PMID- 2232956
TI  - Evaluating medical expert systems: what to test and how?
AB  - Many believe that medical expert systems have great potential to improve health
      care, but few of these systems have been rigorously evaluated, and even fewer are
      in routine use. We propose the evaluation of medical expert systems in two
      stages: laboratory and field testing. In the former, the perspectives of both
      prospective users and experts responsible for implementation are valuable. In the
      latter, the study must be designed to test, in an unbiased manner, whether the
      system is used in clinical practice, and if it is used, how it affects the
      structure, process and outcome of health care encounters. We conclude with
      proposals for encouraging the objective evaluation of these systems.

PMID- 2232957
TI  - The evaluation of decision aids: the role of the decision owner.
AB  - This paper is a discussion of the role patient preferences should play in the
      evaluation of medical decision aids. The use of 'practitioner acceptability' as
      an unproblematic criterion in the evaluation of such aids is questioned, along
      with the wider imbalance in resource allocation between research relevant to the
      'technical' and 'value' aspects of medical decision-making.

PMID- 2232958
TI  - Evaluating black-boxes as medical decision aids: issues arising from a study of
      neural networks.
AB  - The rigorous evaluation of medical decision aids will be critical to promoting
      their development, establishing their clinical value and legalizing their use.
      Many decision aids are transparent in the sense that their internal structure and
      function can be examined and verified. Some decision aids, however, use complex
      models of associations in training data to construct 'black-box' systems whose
      workings are largely impenetrable and inexplicable. The issues surrounding the
      evaluation of such systems, as exemplified by connectionist (neural network)
      models, are discussed. For such systems the two major aspects that can be
      evaluated are the training data from which the system is derived, and its
      performance on test data. A number of questions about the use of black-box
      systems as medical decision aids are posed which require consideration by the
      medical informatics community.

PMID- 2232959
TI  - Evaluating and validating very large knowledge-based systems.
AB  - Most knowledge-based systems for use in medicine have been developed in response
      to specific problems such as the diagnosis of abdominal or chest pain in an
      accident and emergency department, or the diagnosis and treatment of meningitis.
      There is a role for a general decision support system capable of answering
      queries about any aspect of medicine, particularly in primary care. However,
      evaluating such a knowledge base requires more elaborate methodology than a
      simple iterative test and refine cycle. At the design stage an adequate knowledge
      base structure is required to allow focused modification of the knowledge base
      when errors are discovered. During the prolonged evaluation cycle the partially
      formed knowledge base must be tested with such techniques as validation checks
      for consistency and completeness and examination of characteristics of problem
      solving procedures. Finally a variety of criteria that represent the performance,
      robustness, flexibility, predictability, validity, coverage, relevance and
      congruity of the knowledge base are needed for a full description of the system's
      worth. Two case studies from the Oxford System of Medicine project are provided
      as examples of this philosophy: validating specific medical facts and comparing
      two methods for aggregating reasoning for and against a decision option.

PMID- 2232960
TI  - Human-computer interface evaluation: not user-friendliness but design for
      operation.
AB  - This paper considers human-computer interface evaluation in the context of design
      and development. It is argued that it is not helpful to view evaluation as a
      method for achieving user-friendliness, rather it should be seen as a
      participating activity within design and development. The centre of concern is
      the operation of the system when employed in practice. Such evaluation is not
      necessarily to be conducted by independent observation and experiment, but may be
      closely integrated with other design activities. In fact the very theory
      underlying the evaluation finds its embodiment in the artifact of the user
      interface. Taking this view has technical, as well as human factors,
      implications.

PMID- 2232961
TI  - Field trials of Baby Check: a scoring system to quantify illness in babies under
      6 months.
AB  - Baby Check, a scoring system for quantifying illness in young babies, was
      developed from a study of 1007 well and ill babies in Cambridge and Melbourne.
      This paper describes the setting up of field trials to test the performance of
      the scoring system when used by mothers, GPs and hospital doctors. Preliminary
      results suggest that the scoring system is attractive, easy to use, useful and of
      high specificity. Its sensitivity to serious illness is also thought to be high
      but this will become clearer when the main hospital field trial has been
      completed.

PMID- 2232962
TI  - Assessing the clinical impact of a predictive system in severe head injury.
AB  - Many computer-assisted diagnostic or prognostic systems have been described in
      the literature, but as yet such systems have had little impact upon routine
      clinical practice. There are many possible explanations for the limited success
      which these systems have enjoyed, but one of the most significant must be the
      dearth of well-designed and carefully executed trials to assess their
      performance. Many evaluations only address the scientific question of whether the
      diagnoses or prognoses are accurate; they stop short of answering the crucial
      pragmatic question of whether the system benefits patients, i.e. is clinical care
      improved by the use of such a system? This brief paper describes a predictive
      system in severe head injury which has been developed by an international group
      based in the Institute of Neurological Sciences at the Southern General Hospital,
      Glasgow. The various steps involved were first the establishment of a clinical
      databank according to a strict protocol and with carefully designed scales to
      quantify the impairment of consciousness and outcome, the development of
      prognostic models relating outcome to initial severity, the comparison of the
      performance of this model with predictions made by clinicians, and finally a
      multi-centre prospective trial assessing the clinical impact of the system. The
      results of this trial are not yet available, but a consideration of the design of
      the trial raises important points which are relevant to many other clinical
      fields where 'decision aids' need to be evaluated.

PMID- 2232963
TI  - Evaluation of clinical decision aids--more to think about.
AB  - Validation and clinical testing of medical decision aids is a hot topic at
      present. We state a few main points which, in our opinion, have not received the
      attention they deserve. Our main concerns have to do with the statistical design
      and analysis of field evaluation studies; with long-term effects; and with the
      interplay between medicine and the software industry. The points represent our
      reaction to a recent symposium on the topic, published in this special issue. We
      take the opportunity to supplement the papers at hand in various ways and, where
      we see a risk of misconceptions or poor practice becoming cemented, try to point
      out the proper course.

PMID- 2232964
TI  - Does GABA act through dopaminergic/cholinergic interaction in the regulation of
      higher environmental temperature-induced change in body temperature?
AB  - Acute exposure of adult male albino rats to higher ambient temperature (40
      degrees C) for 2 h significantly increased body temperature (BT). Administration
      of either bicuculline (1 mg/kg, i.p.), a GABA antagonist, or physostigmine (0.1
      mg/kg, i.p.), an inhibitor of acetylcholinesterase, significantly increased BT of
      normal and heat-exposed rats. Treatment with muscimol (1 mg/kg, i.p.), a GABA
      agonist, produced hypothermia in normal rats and prevented an increase in BT of
      heat-exposed rats. The dopamine agonist, L-dopa (100 mg/kg, p.o.) along with
      carbidopa (10 mg/kg, p.o.) reduced BT of normal rats. Further, the bicuculline-or
      physostigmine-induced enhancement of BT in normal and heat-exposed rats was
      potentiated when both drugs were administered concomitantly. But this
      potentiating effect remained unaltered when dopamine antagonist haloperidol (1
      mg/kg, i.p.) was administered along with bicuculline and physostigmine. Treatment
      with atropine (5 mg/kg, i.p.), a cholinergic antagonist, abolished the
      hyperthermic effect of bicuculline but potentiated the hypothermic effect of
      muscimol either at 28 degrees C or at 40 degrees C. Bicuculline-induced
      hyperthermia was attenuated at normal or higher temperature by pretreatment with
      L-dopa + carbidopa. The administration of L-dopa + carbidopa either abolished or
      reduced the hyperthermic effect of physostigmine at room temperature or at higher
      ambient temperature. These results suggest that (a) GABAergic, cholinergic and
      dopaminergic systems are involved in thermoregulation, (b) exposure to high
      environmental temperature may inhibit central GABAergic activity which activates
      the cholinergic system without affecting the dopaminergic system and raises BT,
      (c) central dopaminergic and GABAergic systems act independently through the
      modulation of cholinergic activity in the regulation of BT under normal ambient
      temperature.

PMID- 2232965
TI  - Rheoencephalographic and electroencephalographic studies on nicergoline.
AB  - The effect of nicergoline on the rheoencephalogram (REG) and on spontaneous
      electroencephalographic activity (EEG) was studied in acute experiments in cats.
      The following REG parameters were assayed: amplitude, anacrotic section of the
      curve and its relative part and dicrotic index. EEG spectra were derived from 10
      sec samples of ECoG and the relative amplitude was estimated at 2 Hz-intervals
      from 0-44 Hz. The REG study showed that nicergoline (0.05 mg/kg i.v.) caused an
      increase of the amplitude, and a decrease of the anacrote, of the relative part
      of the anacrote and the dicrotic index - changes indicating a lowering of
      cerebrovascular resistance. EEG study showed a decrease of the slow activities
      (theta and delta), and an increase of the fast activities (alpha and beta-1).

PMID- 2232966
TI  - Investigations on cell-mediated immunity in patients with breast and ovarian
      carcinomas receiving a combination of chemotherapy and immunotherapy with
      thymopentin.
AB  - In 78 patients with breast and 37 patients with ovarian cancer the effect of
      combined chemo- and immunotherapy with thymopentin (Timunox, Cilag) on different
      parameters of cell-mediated immunity (leukocyte migration inhibition test, serum
      level of TNF-alpha, IL-1, interferon-alpha, distribution of lymphocyte subsets)
      and the clinical course of disease was evaluated and compared to patients
      receiving only chemotherapy. In cancer patients additionally treated with
      thymopentin an increase in reactivity in the LMI test and an increase of IFN
      alpha serum levels could be observed, whereas serum levels of TNF-alpha and IL-2
      and the distribution of T-helper, T-suppressor, total T and natural killer cells
      did not change. Concerning the clinical course of disease, no significant
      differences could be observed in patients with disseminated spread of disease,
      whereas in patients receiving combined chemo-immunotherapy in the course of an
      adjuvant treatment a benefit was found compared to those receiving only
      chemotherapy. Thus, it seems that the additional administration of thymopentin in
      breast and ovarian cancer patients under chemotherapy results in a reduction of
      immunosuppressive side effects of chemotherapy and a positive effect of the
      survival time in patients with limited spread of disease.

PMID- 2232967
TI  - Histaminergic system: neuroendocrine function of brain histamine.

PMID- 2232979
TI  - [Roots of the health care crisis--a perspective on its development].

PMID- 2232968
TI  - The medical history of waters and spas. Introduction.

PMID- 2232980
TI  - [Curtail prolonged compulsory isolation in the departments of infectious
      diseases].

PMID- 2232982
TI  - [How should the progress of cancer prevention be measured?].

PMID- 2232981
TI  - [Antibiotic resistance of anaerobic bacteria--an increasing clinical problem].

PMID- 2232983
TI  - [Increased incidence of carpal tunnel syndrome in dialysis patients].

PMID- 2232984
TI  - [Let us avoid cholesterol tests performed by pharmacies!].

PMID- 2232985
TI  - [Shall we stop to use Miraxid?].

PMID- 2232986
TI  - [A pilot study shows incompletely filled out forms at maternal health care and
      obstetric centers].

PMID- 2232987
TI  - [Eye movements during normal reading and in dyslexia--review of the literature].

PMID- 2232989
TI  - [Sufficient national supply of all blood products--a pressing goal].

PMID- 2232988
TI  - [Chronic pain patients with well-defined diagnosis feel better than patients with
      unclear diagnosis].

PMID- 2232990
TI  - [Virginia Apgar Award to Petter Karlberg. After 45 years of pioneering commission
      as a pediatrician, the research on body-soul-environment is tempting].

PMID- 2232991
TI  - [Strong arguments against legalization of euthanasia].

PMID- 2232992
TI  - [Intensive care of extremely low birth weight infants--is selection by prognosis
      ethically acceptable?].

PMID- 2232993
TI  - [Future needs of rheumatology. A young specialty with expanding content].

PMID- 2232994
TI  - [Ethics and interest conflicts--a question not only for general practitioners].

PMID- 2232996
TI  - [A new therapeutic program. Thrombolysis in myocardial infarction and treatment
      of unstable coronary disease].

PMID- 2232995
TI  - [A new study: unclear results of psychotherapy in schizophrenia. Better to wait
      than to create false expectations].

PMID- 2232997
TI  - [Migraine as a sociomedical problem].

PMID- 2232998
TI  - [Psychotherapy in schizophrenia--a prospective study].

PMID- 2232999
TI  - [The family--an underestimated but heavily burdened resource in health care].

PMID- 2233001
TI  - [Along the Silk Road and in Sweden. Behcet's syndrome--a rare systemic disease
      affecting mostly younger persons].

PMID- 2233000
TI  - [Diet and health. The process of civilization brings about change of dietary
      habits].

PMID- 2233002
TI  - [The man behind the syndrome. Hulusi Behcet. He performed a detailed survey of
      the syndrome with mouth ulcers, iritis and genital ulcers].

PMID- 2233003
TI  - [Endoscopic thoracic sympathectomy. A surgical method employed in severe hand
      sweating].

PMID- 2233004
TI  - [The right to starve and die--reject legislation].

PMID- 2233005
TI  - [A Swedish model for psychosocial relief work. A group takes care of the persons
      hit by disasters].

PMID- 2233006
TI  - [The Nobel Prize. This year's prize-winners are rewarded for clinical methods].

PMID- 2233007
TI  - [Scandinavian guidelines for clinical trials].

PMID- 2233008
TI  - [Drugs exist--but changing of life style can be sufficient in the prevention of
      osteoporosis].

PMID- 2233009
TI  - [The USA report on cardiovascular disease research and (un)equality: white middle
      aged men as a norm for the whole population].

PMID- 2233010
TI  - [Implantation of defibrillators--a final measure at German clinics].

PMID- 2233011
TI  - [Hippocratic respect for patients' self-determination?].

PMID- 2233012
TI  - [Physical activity has a certain positive effect on the skeleton].

PMID- 2233013
TI  - [British treatment of autism. High scientific level in spite of small resources].

PMID- 2233014
TI  - [A center for rehabilitation technology at the Lund Institute of Technology. A
      dynamic workshop of ideas activating research of everyday rehabilitation
      technology].

PMID- 2233015
TI  - [Is waiting for surgery more difficult in Stockholm than in rural areas?].

PMID- 2233016
TI  - [Histamine and methacholine tests in cases of sensitive bronchi--a 10-year
      experience].
AB  - Ten years' experience of standardised bronchial histamine and methacholine tests
      is presented. For measuring non-specific hyperreactivity was used an
      internationally adopted dose-response technique, where histamine or methacholine
      is inhaled at doses increasing in two-fold steps. The fields of application have
      been clinical research on hyperreactivity, the diagnosis of asthma, evaluation of
      anti-asthmatic drugs, establishing (or excluding) the presence of bronchial
      obstruction or functional breathing disorder--the latter being a relatively new
      field. On the basis of this experience, the existence of a relationship between
      subjective hyperreactivity and breathing complaints has been hypothesized; and in
      clinical studies the place of histamine and methacholine tests as diagnostic aids
      in cases of bronchial asthma or functional breathing disorder has been better
      established. The tests yield information as to any tendency to develop
      bronchospasm, but must always be combined with other diagnostic tests and the
      taking of a careful history. Some important findings are reported--e.g., abnormal
      and steep dose-response curves, false low FEV1 values, or the occurrence of non
      asthmatic symptoms during testing--which have not previously been fully
      considered in published reports, and which may lead to incorrect interpretation
      of test results.

PMID- 2233017
TI  - [Borderline conditions--a difficult terminology problem, but an interesting
      exercise in creativity].

PMID- 2233018
TI  - [Information and general guidelines for prescription of psychopharmaceuticals].

PMID- 2233019
TI  - [A consulting group for ethical questions in perinatology--experiences from the
      Ostra hospital in Gothenburg].

PMID- 2233020
TI  - [Diagnosis of cystic fibrosis by means of genetic technology--guidelines from an
      expert meeting].

PMID- 2233021
TI  - [Organizational problems behind the casualties in health care--why don't we learn
      more from experience?].

PMID- 2233022
TI  - [How does molecular biology influence clinical research and health care in the
      1990's?].

PMID- 2233023
TI  - [Segmental pain--can the patients be identified and treated successfully?].

PMID- 2233024
TI  - [Child stammering. Parental anxiety is the most important referral indication].

PMID- 2233025
TI  - [England is en example for Sweden concerning psychiatric care. Lobbying inspires
      politicians to reforms].

PMID- 2233026
TI  - [Rehabilitation of schizophrenic patients demands an individually based
      combination of psychosocial therapy and medicine].

PMID- 2233027
TI  - [Preliminary experiences show good results. Extracorporeal membrane oxygenation
      in respiratory insufficiency in children].

PMID- 2233029
TI  - Belching caused inversion of the inserted gastroscope.

PMID- 2233028
TI  - [Extracorporeal membrane oxygenation as a life-saving method in neonatal
      pneumonia].

PMID- 2233030
TI  - [Kleine-Levin syndrome--an unusual behavioral disorder in young men].

PMID- 2233031
TI  - [High incidence of cerebral concussion among elite ice hockey players].

PMID- 2233033
TI  - [The Karolinska institute: a trial of local admission will broaden the selection
      of students to medical schools].

PMID- 2233032
TI  - [Diagnostic equipments owned by neonatal departments make their use more
      efficient].

PMID- 2233034
TI  - [Problems with narcotics at the workplace].

PMID- 2233035
TI  - [Forbid beards among health personnel].

PMID- 2233036
TI  - [Can spermatocidal agents give protection even against HIV?].

PMID- 2233037
TI  - [Pregnancy in diabetes and fetal abnormalities--importance of a strict insulin
      therapy regimen].

PMID- 2233038
TI  - [Do not forget tuberculosis screening of pregnant immigrant women].

PMID- 2233039
TI  - [Greatly increased number of elective surgery of aortic aneurysm].

PMID- 2233040
TI  - [Surgical or non-surgical abdominal aortic aneurysm--the choice of treatment is
      based on the size of the aneurysm].

PMID- 2233041
TI  - [Management of visceral aneurysm].
AB  - In the article we discuss our experience in dealing with visceral aneurysms at
      Malmo General Hospital during the period, 1971-85. Of the total of 25 patients
      diagnosed, eight had ruptured aneurysms, six underwent elective surgery, and 11
      underwent no surgical intervention. Of the aneurysms found, nine were of the
      splenic artery, five of the superior mesenteric artery and its branches, three of
      the pancreaticoduodenal artery, two of the celiac artery, and one of the
      gastroduodenal artery. There was no mortality either among patients undergoing
      surgery, or from complications among those treated conservatively without
      surgery.

PMID- 2233042
TI  - [Education, chemotherapy and a vaccine can stop increasing of schistosomiasis].

PMID- 2233043
TI  - [The man behind the syndrome. Theodor Bilharz. He tried to explain the mystery of
      the worm--it is still a big global health problem].

PMID- 2233044
TI  - [Acute schistosomiasis can be diagnosed by early serology].

PMID- 2233045
TI  - [Impaired pulmonary function after welding of painted steel].

PMID- 2233046
TI  - [Lars Olof Kallings appointed as an advisor on AIDS questions at the WHO. The
      rapidly developed laboratory research on HIV/AIDS makes the WHO to guard
      carefully the research ethics].

PMID- 2233047
TI  - [Dynamic development of the research on a vaccine and drugs against HIV].

PMID- 2233048
TI  - [Women and AIDS as the topic of the international AIDS day this year].

PMID- 2233049
TI  - [Cheap copies are a threat to research].

PMID- 2233050
TI  - [Rehabilitation for 15 billions--a humanitarian endeavor or a futile effort].

PMID- 2233051
TI  - [Is obstetric analgesia hazardous to the newborn infant?].

PMID- 2233052
TI  - [A neuroorthopedic clinic for the management of vertebral column injuries].

PMID- 2233054
TI  - [Headache among the young is more frequent than thought. Promising methods in
      tension headache].

PMID- 2233053
TI  - [Disorders caused by video display terminals and hypersensitivity to electricity-
      the affected persons experience a cruel reality].

PMID- 2233055
TI  - [Swedish research-workers in neurology showered with awards].

PMID- 2233056
TI  - [Promising new results with transplantation of nerve cells to the brain in
      Parkinson disease].

PMID- 2233057
TI  - [Tonsillectomy--an old-fashioned therapeutic method in recurrent tonsillitis].

PMID- 2233058
TI  - [Families with hereditary cancer--a target group for prevention].
AB  - Although a large proportion of the population contract cancer, the risk is not
      uniform. In a small group (an estimated five per cent) with hereditary
      predisposition, the risk of cancer is high (often as high as 50 per cent) in
      every child of an affected parent. Another, considerably larger group consists of
      individuals at high risk (though how high is unknown), where a combination of
      hereditary and environmental factors is probably involved. In all likelihood, it
      is this group which would benefit most from general recommendations as to
      preventive measures. The study of such individuals will enhance our knowledge of
      the source of their vulnerability, thus facilitating the understanding of
      tumorigenic mechanisms in general, and on the basis of such knowledge improve the
      prospect of general and specific screening programmes, prevention and treatment.

PMID- 2233059
TI  - [Losec after 2 years: satisfactory safety of short-term therapy].

PMID- 2233060
TI  - [Can the quality of surgery be guaranteed in the future?].

PMID- 2233061
TI  - [Care strategies in North America: strengthened nurses' role and intense
      concentration on leadership].

PMID- 2233062
TI  - [Prevention of pre-eclampsia with ASA--continuous caution is recommended].

PMID- 2233063
TI  - [Investigation of sexual child abuse: professionalism--an absolute necessity].

PMID- 2233064
TI  - [Work and sick-listing seen from a Scandinavian perspective].

PMID- 2233065
TI  - [A consensus on dementia diseases (I): Classification and investigation].

PMID- 2233066
TI  - [Benign cyst can signal tonsillar cancer].

PMID- 2233067
TI  - [Toxic hepatitis after exposure to dimethylformamide].

PMID- 2233068
TI  - [Adrenomyeloneuropathy--an unusual X chromosome-linked disease].

PMID- 2233069
TI  - [Cervical manipulation can cause cerebral infarction].

PMID- 2233070
TI  - [Diet during childhood and adolescence can influence health even in adulthood].

PMID- 2233071
TI  - [A medical controversy: is orthopedic medicine needed? (1). Development within
      scientific medicine can be more effective in musculoskeletal pain].

PMID- 2233072
TI  - "Tissue welding" with the argon laser in middle ear surgery.
AB  - Over the past 10 years the argon laser has been recognized as a valuable adjunct
      to middle ear surgery. It has been used to vaporize and cut tissue and to
      coagulate microbleeding. It has been used by many other surgical specialties to
      "weld" adjacent tissues together. This welding process appears to have a limited
      but helpful role in middle ear surgery. A pilot study of 30 surgical cases in
      which argon laser "tissue welding" has been used are reported. The benefits,
      limitations, and possible future implications are discussed.

PMID- 2233073
TI  - Efficacy and morbidity of partial laryngectomy and postoperative radiation
      therapy.
AB  - In recent years, we have seen increasing use of partial laryngectomies for larger
      lesions that were previously treated by total laryngectomy. The resultant closer
      margins have made postoperative radiation therapy an important adjuvant treatment
      to conservation laryngeal surgery. We review the University of California, Los
      Angeles, experience with combination partial laryngectomy and postoperative
      radiation therapy between 1973 and 1987 for treatment of carcinoma of the larynx.
      Twenty-four such patients who underwent partial laryngectomies and postoperative
      radiation therapy are examined. Techniques of treatment, complications, and the
      functional ability of the remaining larynx are discussed. The locoregional
      control rate at 5 years was 80%. Risk factors associated with an increased risk
      of recurrence were positive margins, vascular invasion, and extranodal spread.
      There were no major problems with postoperative wound healing or airway
      management during the radiation treatment. Vocal and swallowing function were
      well preserved in most cases. We conclude that combination partial laryngectomy
      and radiation therapy permits preservation of laryngeal function without serious
      complications, and therefore is an effective treatment for selected patients with
      carcinoma of the larynx.

PMID- 2233074
TI  - Auditory-evoked responses in benign intracranial hypertension syndrome.
AB  - In this study, auditory brainstem-evoked responses were conducted on 28 patients
      with otologic symptoms (pulsatile tinnitus, hearing loss, aural fullness)
      secondary to benign intracranial hypertension syndrome. Abnormalities consisting
      mainly of prolonged interpeak latencies were detected in one third of these
      patients. It is speculated that the pathophysiologic mechanisms responsible for
      these auditory brainstem-evoked abnormalities are stretching-compression of the
      cochlear nerve and brainstem caused by the intracranial hypertension and/or
      primary edema of the same structures due to the benign intracranial hypertension
      syndrome itself. Normalization or improvement was noticed in the majority of the
      patients after management. Since the number of patients in this study is small,
      it is felt that the diagnostic and prognostic value of this test needs further
      evaluation.

PMID- 2233076
TI  - Computed tomography staging of the paranasal sinuses in chronic hyperplastic
      rhinosinusitis.
AB  - In this study, the computed tomography scans of 100 patients with chronic
      hyperplastic rhinosinusitis were reviewed to establish a clinical staging system.
      Fourteen percent of the patients were classified as Stage I (single-focus
      disease); 36% as Stage II (multifocal disease responsive to conservative
      therapy); 32% as Stage III (diffuse disease partially responsive to medication);
      and 16% as Stage IV (diffuse disease associated with bony changes and poorly
      responsive to conservative treatment). The incidence of recurrent or persistent
      disease ranged from 13% for Stage II to 30% for Stage IV. Stage I and III
      patients had 13% and 18% recurrence rates, respectively. Computed tomography
      staging is shown to be useful in outlining operative strategies and is a reliable
      prognosticator of the disease process.

PMID- 2233075
TI  - Angioedema from angiotensin converting enzyme inhibitors: a cause of upper airway
      obstruction.
AB  - Angiotensin-converting enzyme (ACE) inhibitors have several side effects of
      concern to the otolaryngologist. Angioedema is a rare, but potentially lethal
      adverse effect when associated with upper airway obstruction. Four cases of ACE
      inhibitor-induced angioedema, three with significant upper airway obstruction,
      are reported. Angioedema secondary to ACE inhibition appears to be mechanism
      based. The probable link is the potentiation of bradykinin, which results in
      vasodilation, increased vascular permeability, and angioedema. Since angioedema
      can progress to upper airway obstruction, otolaryngologists must be aware of this
      association. The differential diagnosis and treatment of this adverse effect is
      discussed, as well as a review of ACE inhibitors and other causes of angioedema.

PMID- 2233077
TI  - Intraoral-extramaxillary sinus approach for ligation of the maxillary artery: an
      anatomic study with clinical correlates.
AB  - Surgical control of severe epistaxis is usually reserved for cases refractory to
      more conservative techniques. We present our experience with intraoral ligation
      of the maxillary artery as it courses through the buccal fat pad before it enters
      the pterygopalatine fossa and branches posterior to the maxilla. This technique
      has been found useful in the control of nasal hemorrhage as well as an adjunct to
      other surgical procedures, such as removal of benign and malignant neoplasms
      involving the maxilla and paranasal sinuses. This technique was used for ligation
      of the maxillary artery in 20 patients. The artery was readily identified in some
      cases, but required more extensive dissection in others; therefore, an anatomic
      study in 18 preserved and fresh cadaver specimens was undertaken to investigate
      the variability of the maxillary artery in the region of the buccal fat pad.
      There appeared to be significant variation in the distance from the buccal
      mucosal incision site, as well as variation in the relationship to the pterygoid
      muscles. This relationship to the pterygoids explains the occasional difficulty
      in locating the artery for ligation. This technique represents a reasonable
      alternative to the more traditional transantral approach to ligation of the
      maxillary artery, as long as the surgeon understands the anatomy of the region,
      its variations, and where the artery may be located if not immediately apparent.
      No major complications have been experienced.

PMID- 2233078
TI  - The efficacy of brainstem auditory evoked potentials in acoustic tumor surgery.
AB  - As the identification of patients with small acoustic neuromas and salvageable
      hearing increases, intraoperative auditory nerve monitoring has been used
      increasingly in an attempt to improve the hearing preservation rate. Far-field
      recordings obtained by brainstem auditory evoked potentials (BAEP), at times
      enhanced by electrocochleography, have become a standard method of intraoperative
      auditory nerve assessment. To evaluate the usefulness of this monitoring
      technique, the hearing preservation results of a series of unmonitored acoustic
      tumor removals were compared to a series of patients monitored via the standard
      brainstem auditory evoked potentials. With comparable average tumor sizes, 4 of 7
      unmonitored patients had hearing preserved at preoperative levels compared to 4
      of 9 monitored patients. Neither preoperative BAEP assessments nor absolute tumor
      size were predictive of hearing preservation. This report brings into question
      the effectiveness of far-field intraoperative BAEP monitoring during acoustic
      tumor resection and suggests that direct auditory nerve monitoring may be more
      appropriate.

PMID- 2233079
TI  - Vocal cord paralysis in children.
AB  - Bilateral vocal cord paralysis is a common cause of stridor in infants and
      children. There are significant differences in this entity between children and
      adults with regard to etiology, diagnosis, management, and outcome. A review of
      10 years' experience at Children's Hospital of Philadelphia identified 51
      children seen with the diagnosis of vocal cord paralysis. These cases were
      evaluated with respect to etiology of paralysis, whether unilateral or bilateral,
      delay in diagnosis, need for tracheotomy, abnormality of voice, surgical
      treatment, and outcome. Guidelines for management for a child with vocal cord
      paralysis are presented with emphasis on flexible endoscopic evaluation and
      conservative management.

PMID- 2233081
TI  - Evaluation of neonatal subglottic stenosis: a 3-year prospective study.
AB  - Subglottic stenosis is the most common cause of chronic airway obstruction. It
      results in prolonged tracheal cannulation of infants and children. Following the
      widespread adoption over the past 20 years of prolonged intubation for
      respiratory support in neonates, the incidence of acquired subglottic stenosis
      increased dramatically. On January 1, 1987, we began a 3-year prospective study
      to delineate potential etiologic factors involved in the development of
      subglottic stenosis in neonates. The present study analyzes data from 289
      infants. Relationships between birth weight, gestational age, endotracheal tube
      size, duration of intubation and ventilation, number and difficulty of
      intubations, and the subsequent need for medical and surgical therapy are
      discussed. Whole organ larynges from autopsy specimens provide histological
      correlation.

PMID- 2233080
TI  - Myogenic influences on the electrical auditory brainstem response (EABR) in
      humans.
AB  - Two cases demonstrating the effects of myogenic artifact on the electrical
      auditory brainstem response (EABR) when using a promontory stimulation site are
      presented. Intensity-response functions were obtained in the unparalyzed
      condition, then repeated after infusion of a neuromuscular paralyzing agent. In
      both cases, the myogenic response was observed at lower stimulus intensities than
      the EABR components. As intensity increased, the myogenic responses grew at
      extremely rapid rates and made any subsequent identification of auditory
      responses virtually impossible. To alleviate the adverse influence of myogenic
      components, general anesthesia and a paralyzing agent must be incorporated into
      the test protocol when acquiring the EABR using a promontory site of stimulation.

PMID- 2233082
TI  - 1990 Ogura memorial lecture: moral dilemmas in head and neck cancer.
AB  - Neither morality nor dilemma can be defined meaningfully in the concept of the
      practical management of head and neck cancer. Although both have important
      implications, particularly with regard to ethnic and social factors, they play a
      relatively minor role in determining management policy. With little knowledge of
      the intrinsic causes of cancer and with a treatment strategy limited to
      radiotherapy and surgery, our desire for cure must be tempered by concern to
      avoid any increase in patient privations. My philosophy, based upon the care of
      more than 3500 patients over almost 30 years, reflects some of the difficulties
      of applying the concept "do nothing that may cause harm," while offering each
      patient the opportunity for long-term cure.

PMID- 2233083
TI  - The efficacy of comprehensive neck dissection with or without postoperative
      radiotherapy in nodal metastases of squamous cell carcinoma of the upper
      respiratory and digestive tracts.
AB  - Neck recurrence-free curves corrected for local recurrence were compared for 494
      patients who underwent 565 comprehensive neck dissections. In 42 dissections, no
      radicality could be obtained. Of the 523 histologically radical dissections,
      examination revealed tumor in 352 cases. Patients in whom three or more positive
      nodes or extranodal spread in one or more nodes were found received postoperative
      radiotherapy. In the histologically N0 group, the incidence of neck recurrence
      after 5 years was 3%; in the N+ group as a whole, it was 10%. Analysis of the
      influence of extranodal spread and the number of positive nodes showed that the
      group with one or two positive nodes without extranodal spread (that did not
      receive postoperative radiotherapy) did not statistically differ from the other
      groups. This suggests that the results of the group with one or two positive
      nodes without extranodal spread can be improved by postoperative radiotherapy.

PMID- 2233084
TI  - Esthesioneuroblastoma: surgical treatment without radiation.
AB  - This study compares the treatment of two groups of patients diagnosed with
      esthesioneuroblastoma limited to the nasal cavity without evidence of cribriform
      plate erosion. Five patients were treated with radiation and extracranial
      excision, and eight patients were treated by craniofacial resection only. The
      incidences of local recurrence were 60% and 12%, respectively. The paper also
      presents a new staging classification for these tumors.

PMID- 2233085
TI  - A new low-resistance, self-retaining prosthesis (Provox) for voice rehabilitation
      after total laryngectomy.
AB  - Prosthetic rehabilitation of voice after total laryngectomy has gained wide
      acceptance in the last 10 years. Several reliable voice prostheses have been
      developed and used successfully. Priorities for further development of the
      methods and instruments for prosthetic voice rehabilitation have led to the
      design of a low-resistance, self-retaining voice prosthesis (Provox) and an
      adapted replacement method. The results obtained in 79 patients are described. In
      vivo airflow resistance ranged from 1.0 to 3.8 kPa (mean = 1.9 kPa). Speech
      quality was good in 91% of the patients. The self-retaining properties of the
      prosthesis appeared to be satisfactory. The average device-life was more than 5
      months. Replacement of the prosthesis with a new disposable guide wire was done
      quickly as an outpatient procedure. Maintenance of the prosthesis by the patient
      was simple. The new low-resistance, self-retaining Provox voice prosthesis and
      the modified replacement method appeared to further improve the results of
      prosthetic voice rehabilitation after total laryngectomy.

PMID- 2233086
TI  - Carcinoma of the external auditory canal: an update.
AB  - This review is a continuation of the series of 35 cases of carcinoma of the
      external auditory canal originally reported by the senior author and colleagues.
      Eighteen additional cases have been evaluated and treated since 1976.
      Preoperative high-resolution computed tomographic scanning has replaced
      polytomography, and improved surgical skull base approaches have allowed for
      extended resections of advanced lesions. A revised classification for local and
      extensive lesions is presented. The prognosis for localized tumors treated by en
      bloc resection remains excellent, whereas prognosis for extensive lesions might
      be more dependent on histologic type and grade of tumor.

PMID- 2233088
TI  - Indications of the carbon dioxide laser in tracheobronchial pathology of the
      infant and young child: 14 cases.
AB  - Fourteen children aged between 6 months and 7 years (mean age = 3.5 years) were
      treated by CO2 broncholaser in the ENT Department of Trousseau Hospital. Three
      groups of diagnostic indication were identified: 1. Granulomas treated after
      mucosal trauma (tracheotomy, foreign body). 2. Granulomas due to pulmonary and/or
      lymph node tuberculosis. 3. Adhesions and stenosis secondary to neonatal
      ventilation. The operative and anesthetic technique is described in detail,
      together with any possible adverse events. The CO2 broncholaser appears to be a
      technique of choice in this age group, in which the narrowness of the airways
      makes any endoscopic procedure difficult. The broncholaser allows the early
      treatment of obstructive tracheobronchial pathology with its risks of severe
      ventilatory sequelae.

PMID- 2233087
TI  - Artificial restoration of voice. I: Experiments in phonatory control of the
      reinnervated canine larynx.
AB  - Coordinated electronic pacing of implanted nerve pedicles into paralyzed
      laryngeal muscles has allowed selective dynamic control of abduction, adduction,
      and elongation of the vocal cords. Modifications of the original circuit in a
      cervical muscle model has added fine tuning to basic "all-or-none" pacing.
      Rehabilitation of phonation illustrated the sophisticated nature of voice and the
      need for restoration of fine tuning. Five mongrel dogs received nerve-muscle
      pedicles into the thyroarytenoideus, cricothyroideus, and posterior
      cricothyroideus after denervation of one hemilarynx. Following appropriate
      reinnervation time, pedicles and intact recurrent laryngeal nerves were injected
      with currents of variable amplitudes and pulse widths to achieve graded vocal
      fold control while air was blown intratracheally towards the glottic chink.
      Videoscopic and spectral analyses indicated that artificial phonation could be
      restored to frequencies measured in the normal state. These experiments suggested
      that rehabilitation of the impaired voice by servocontrol might eventually be
      feasible.

PMID- 2233089
TI  - An in vivo canine model for testing treatment effects in laryngeal hyperadduction
      disorders.
AB  - Adductor spastic dysphonia is a voice disorder characterized by a strained,
      squeezed, effortful voice produced by true and false cord hyperadduction. An in
      vivo canine model has been developed to simulate hyperadduction of the true
      cords. Using this model, the thyroarytenoid muscle was found to have a greater
      effect on intraglottic and subglottic pressure than cricothyroid muscle
      contraction. The intraglottic and subglottic pressure was reduced after simulated
      recurrent laryngeal paralysis. This model can be used in future studies to
      compare laryngeal treatment modalities for disorders that have a component of
      vocal cord hyperadduction, such as spastic dysphonia.

PMID- 2233090
TI  - Variations on the temporoparietal fascial flap.
AB  - An improved understanding of the vascular supply of the layers of the temporal
      fossa has increased the potential of this region for new and ingenious
      reconstructive techniques. Separate and independently vascularized layers of this
      region include hair-bearing scalp, glabrous skin, tempororoparietal fascia (and
      galea aponeurotica), temporalis muscle and fascia, and pericranium. Island flaps
      of glabrous skin and scalp provided esthetically appropriate tissue to cover a
      variety of defects. The malleable bulk of the subcutaneous fascial layers were
      combined with skin grafts to restore thin lining, and used as a vascularized bed
      for cartilage grafts in otherwise unsatisfactory recipient sites. Illustrative
      cases from our 5-year clinical experience are presented to demonstrate various
      combinations of the temporoparietal fascial pedicle with tissues from the
      temporal region to reconstruct the eyebrows, eyelids, orbits, cheeks, and lips.

PMID- 2233091
TI  - Titanium lag-screw osteosynthesis for the restoration of mandibular continuity in
      mandibular "swing" procedures.

PMID- 2233092
TI  - Incisive canal and pterygopalatine fossa injection for hemostasis in
      septorhinoplasty.

PMID- 2233094
TI  - Dependence of the XeCl laser cut rate of plaque on the degree of calcification,
      laser fluence, and optical pulse duration.
AB  - A XeCl laser with an optical pulse duration of 35 ns was used to determine the
      cut depth per laser pulse of postmortem human aorta as a function of laser
      fluence for four main categories of plaque development. The data indicate that
      the cut depth per pulse progressively decreases as the degree of calcification
      increases even at very high (100 mJ/mm2) laser fluences. A comparison was made
      between the XeCl laser cut rate data obtained using the 35-ns duration laser
      pulses to data obtained using 200-ns duration pulses for each of the four plaque
      types. As the degree of tissue calcification increased higher XeCl laser fluences
      were required for the long pulse case to achieve the same cut depth per pulse as
      that observed using the shorter pulse duration.

PMID- 2233093
TI  - Holmium:YAG laser ablation of vascular tissue.
AB  - The ablation of atherosclerotic lesions without collateral thermal or shock wave
      damage is thought to be a key element for successful laser angioplasty. This
      study evaluated the effectiveness of pulsed holmium:YAG laser (2.1 microns
      wavelength) for this application. Fresh normal tissue (n = 139) and
      arteriosclerotic canine arteries (n = 21) as well as formalin-preserved normal
      canine (n = 31) and atherosclerotic human arteries (n = 177) were irradiated
      under saline via a 600 microns diameter fiber placed perpendicular to the intimal
      surface with 0-10 gm of force. The laser was operated in the free running mode
      (FRM; 250 microseconds pulsewidth, 5 Hz, 30-7,100 mJ/mm2) and in the Q-switched
      mode (QSM; 200 nsec pulsewidth, 6 Hz, 30-1,100 mJ/mm2). Following the
      experiments, the samples were prepared for histologic and morphometric analysis.
      Ablation thresholds in the FRM were 60 and 180 mJ/mm2 in fresh and preserved
      canine tissue, respectively. Ablation thresholds in the QSM for fresh and
      preserved canine tissues were 75 and 180 mJ/mm2, respectively. Thresholds for
      human atherosclerotic tissue were dependent on the amount of calcification. In
      the QSM and FRM, there were no samples that could not be penetrated at 1,100
      mJ/mm2 and above. Histologic examination of the FRM samples revealed confined
      columns of tissue ablation, with approximately 55-250 microns and 70-140 microns
      zones of thermal effect being apparent in the fresh and formalin-preserved
      samples, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233095
TI  - Thermal laser probe angioplasty: influence of constant tip temperature, plaque
      composition, and probe/vessel diameter ratio.
AB  - Thermal laser angioplasty uses constant laser power, producing widely variable
      tip temperatures in vivo. Results have been suboptimal. We studied the effect of
      50-400 degrees C tip temperatures on depth of ablation at 192 sites on plaqued
      and normal human aorta in vitro, and the angiographic and histologic response in
      vivo of 300-400 degrees C at probe/vessel ratios of 0.5-1.0, in 40 normal canine
      femoral artery segments. In vitro, there was a direct relationship between tip
      temperature and depth of ablation, r = 0.71 (all segments), r = 0.74 for fibrous
      plaque, but a poor correlation in fatty plaque r = 0.35. In fibrous plaque, there
      was proportionately more ablation at tip temperatures greater than 300 degrees C,
      mean depth 0.62 mm, than at 150-300 degrees C, mean 0.37 mm, (P less than .001).
      Ablation was similar in plaqued and normal aorta. In vivo, 300 degrees C, 350
      degrees C, and 400 degrees C produced similar effects. At probe/vessel ratios
      less than 0.8, only disruption of internal elastic lamina was observed. At ratios
      greater than or equal to 0.8, spasm occurred in 39% (7/18), transmural damage in
      28% (5/18), and perforation in one of 18. Ablation is not selective for plaque
      and is highly variable in fatty plaque. Tip temperatures above 300 degrees C
      produce greater ablation than at lower temperatures. In clinical applications,
      probe/vessel rations less than or equal to 0.7 may be most appropriate, and it
      appears that thermal remodeling may contribute more to outcome than plaque
      ablation.

PMID- 2233096
TI  - Vasovasostomy in dogs using the carbon dioxide milliwatt laser: Part II.
AB  - This is the second study of a two-prong investigation conducted to learn two
      different aspects of vasovasostomy in dog vas deferens by using the carbon
      dioxide milliwatt laser. This investigation involves the evaluation of patency
      and analysis of sperm. Six dogs underwent vasectomy, followed by vasovasostomies
      performed between 4 and 12 weeks later, utilizing two approximating sutures and
      welding with the carbon dioxide milliwatt laser. Metal clips were used both for x
      ray analysis and localization of the vasovasostomy site. All dogs had pre
      vasectomy semen analysis. Following vasectomy each dog underwent ejaculation
      until azoospermia was obtained. Vasovasostomy was performed and semen was
      examined. Prior to harvesting, vasography was also obtained. All ejaculates had
      active sperm noted and 12 of 12 vasograms (100%) revealed patency. The dogs were
      sacrificed at 4 weeks, 6 weeks, and 8 weeks post-vasovasostomy. The vasovasostomy
      specimens were studied with electron microscopy and by histological evaluation.
      The vasovasostomy was completed in under 90 minutes by using this laser-assisted
      technique. This procedure offers to the urologist a more simplified and
      reproducible operation that can be performed easily and with a potential decrease
      in hospital costs.

PMID- 2233097
TI  - Carbon dioxide laser-assisted thyroarytenoid myomectomy.
AB  - CO2 laser-assisted myomectomy of the thyroarytenoid muscle (TA) was carried out
      through a thyroplasty approach in ten laryngeal specimens and the TA was examined
      histologically. Using the CO2 laser at super-pulsed mode, the TA can be cut or
      resected using 3-5 W of laser power. There is good control of the depth and
      extent of TA resection. Histologically, there is little evidence of collateral
      injury, with sparing of vital surrounding vocal structures. The use of CO2 laser
      for TA resection offers better access and surgical hemostasis in an otherwise
      difficult surgical field. Laser-assisted myomectomy may be a feasible alternative
      to current methods to treat spasmodic dysphonia.

PMID- 2233099
TI  - Lasers for otosclerosis--which one if any and why.
AB  - Laboratory stapedotomy and stapedectomy revisions were performed in human
      temporal bones while pyroelectric wave energy analyzers and ultrasensitive
      thermocouples measured energy absorption at the stapes footplate and in the
      vestibule. Analysis of these data shows that the visible lasers (argon and KTP
      532) possess ideal optical properties and precision for otosclerosis surgery but
      conversely have less than ideal tissue characteristics. The CO2 laser possesses
      ideal tissue characteristics. Recent advances in optical engineering and pulsing
      the energy have increased the precision of this laser to now provide the accuracy
      required for delicate microsurgery. Two clinical studies analyze the long-term
      hearing results and complications in patients who had undergone CO2 laser
      stapedectomy revision (59 patients) and CO2 laser stapedotomy (153 patients). The
      advantages that these laser techniques provide over conventional surgery methods
      are discussed.

PMID- 2233098
TI  - Laser assisted fixation of ear prostheses after stapedectomy.
AB  - Three different lasers (erbium:YAG, holmium:YAG, alexandrite) were used to drill
      a hole at the end of the long process of the incus in order to fix an ear
      prosthesis after stapedectomy or small fenestra stapedectomy. The energy was
      coupled into a 250-microns core diameter zirconium-fluoride fiber. The operations
      were carried out on human temporal bone models from cadavers. The fiber was
      guided to the incus under the stereoscopic surgical microscope. The tissue
      response was examined under the scanning electron microscope, and after
      decalcification, histologically. These studies suggest the feasibility of using
      the erbium:YAG laser to improve the anchorage of the prosthesis on the incus and
      to increase the stability in ossicular chain reconstruction.

PMID- 2233100
TI  - Scanning electron microscopic study of laser-induced morphologic changes of a
      coated enamel surface.
AB  - A low-energy Nd:YAG laser was used to irradiate extracted human teeth coated with
      a black energy-absorbent laser initiator in a study to determine the extent of
      the morphologic changes produced in the enamel surface. The laser initiator was
      applied to a cleaned enamel surface and irradiated at an energy output of 30 mJ
      or 75 mJ. Both energy levels produced morphologic changes of the surface. There
      was a sharp line of demarcation between the coated, irradiated area and the
      surrounding noncoated enamel surface. The scanning electron microscope view at
      the lower energy level showed that the surface had melted and reformed with
      numerous small, bubble-like inclusions. The 75 mJ energy level showed individual
      impact craters with shallow centers and raised edges containing numerous pores
      and large, bubble-like inclusions. Etching is a dental procedure in which an acid
      is normally used to remove a thin outer layer of the tooth structure. This is
      necessary to create a roughened, irregular surface in order to provide mechanical
      retention for dental restorative materials. The changes produced by the laser in
      this study suggest a simple, effective, and controlled method of etching the
      enamel surface of a tooth by altering its surface characteristics.

PMID- 2233101
TI  - Laser in situ keratomileusis.
AB  - A new laser refractive procedure is being developed in a rabbit model. With a
      modified microkeratome, central corneal flaps were created. An ArF excimer laser
      was used to produce 3-mm-diameter circular ablations on the central part of the
      exposed stromal bed. One group of animals was sacrificed immediately
      postoperatively, and both the dissected and ablated areas were studied using
      scanning electron microscopy. A second group of animals was sacrificed 4 weeks
      postoperatively. In this group, the subsequent healing of the corneas was studied
      using light microscopy. At 3 days, the wounded stromal areas showed some degree
      of haze. Haze was progressively reduced over 1 month, but it could be still
      discerned biomicroscopically. A hemicircular opacification corresponding to the
      flap edges was also apparent on slit-lamp examination. Microscopic observation
      showed that the epithelium was normal, except at the flap margins, where it was
      thickened. An increased number of keratocytes was observed in the interface
      between the flap stroma and the ablated area. The procedure might induce stable
      corneal changes because of the preservation of the anterior layers of the cornea.

PMID- 2233104
TI  - [Expensive hospital? Current situation and perspectives].

PMID- 2233102
TI  - Determination of retinal blood velocity with respect to the cardiac cycle using
      laser-triggered release of liposome-encapsulated dye.
AB  - A system of selective angiography has been developed for measuring blood velocity
      in retinal arteries and veins. It uses a liposome-encapsulated fluorescent dye
      that is released by application of laser energy in a specific retinal vessel. The
      method is shown to be able to distinguish between peak systolic velocity and
      minimum diastolic velocity. In the cynomolgus monkey, the two values were found
      to differ by approximately a factor of three. It is known that many ocular and
      systemic diseases affect retinal circulation, and therefore a method of blood
      velocity measurement with such sensitivity may prove highly valuable in the
      practice of ophthalmology. As an example, the velocity in a retinal vein was
      measured before and after partial occlusion by photocoagulation. The two values
      obtained were significantly different, and the blood velocity was found to return
      to the value prior to occlusion when measured at 18 days.

PMID- 2233103
TI  - Pulsed carbon dioxide laser ablation of burned skin: in vitro and in vivo
      analysis.
AB  - Pulsed lasers produce efficient and precise tissue ablation with limited residual
      thermal damage. In this study, the efficiency of pulsed CO2 laser ablation of
      burned and normal swine skin was studied in vitro with a mass loss technique. The
      heats of ablation for normal and burned skin were 2,706 and 2,416 J/cm3 of tissue
      ablated, respectively. The mean threshold radiant exposures for ablating normal
      skin and eschar were 2.6 J/cm2 and 3.0 J/cm2, respectively. Radiant exposures
      greater than 19 J/cm2 produced a plasma, which decreased the efficiency of laser
      ablation. Thus the radiant exposures for efficient ablation range from 4 to 19
      J/cm2, and within this radiant exposure range 20-40 microns of tissue are ablated
      per pulse. We also examined, on a gross and histopathologic basis, in vivo burn
      eschar excision with a pulsed CO2 laser. The laser allowed bloodless excisions of
      full thickness burns on the backs of male hairless rats. The zone of thermal
      damage was approximately 85 microns over the subjacent fascia. The pulsed CO2
      laser can ablate burn eschar efficiently, precisely, and bloodlessly and may
      prove valuable for the excision of burned and necrotic tissue.

PMID- 2233105
TI  - [Liver hemangioma. I. Diagnosis, spontaneous course, complications].
AB  - Hemangioma is the most frequent benign tumor of the liver. Clinical signs range
      from complete absence of any complaints to the life threatening complication of
      hemorrhage. Ultrasound, computed tomography, angiography, scintigraphy and
      magnetic resonance tomography are appropriate diagnostic tools. The spontaneous
      course depends on diameter and localization of the tumor; the majority of
      complications are documented for hemangiomas of more than 5 cm in diameter and
      superficial position.

PMID- 2233106
TI  - [Detection of antibodies to Helicobacter pylori with the immunoenzyme test and
      indirect immunofluorescence].
AB  - Sera from 56 adult patients were screened for the presence of IgG antibodies
      against Helicobacter pylori by enzyme immunoassay and indirect
      immunofluorescence. In addition, the detection of Helicobacter pylori in antral
      biopsy specimens was attempted by culture and histological methods. Colonisation
      of the antrum mucosa with Helicobacter pylori was observed in 39 of the 56
      patients. IgG antibodies against Helicobacter pylori were detected by enzyme
      immunoassay in 34 of 39 infected patients. Thus, the enzyme immunoassay showed a
      sensitivity of 87.2 percent and a specificity of 82.4 percent. IgG antibodies
      against Helicobacter pylori were further detected by indirect immunofluorescence
      in 28 of 39 infected patients. Thus, indirect immunofluorescence showed a
      sensitivity of 66.7 percent and a specificity of 88.2 percent. Our results
      demonstrate that the enzyme immunoassay for IgG antibodies and other invasive or
      noninvasive methods for the detection of infection with Helicobacter pylori
      appear to be of equal sensitivity and specificity.

PMID- 2233107
TI  - [Myelolipoma of the adrenal gland].
AB  - Myelolipomas of the adrenal gland are rare, nonfunctioning and benign tumors. The
      etiologic feature of these tumors, composed of fat and hematopoietic elements,
      remains unclear. Usually, myelolipomas of the adrenal gland, which are mostly
      asymptomatic, are recognized incidentally. Sonographic demonstration of the
      hyperechoic tumor combined with fine-needle aspiration biopsy reveals a prompt
      diagnosis. Computed tomography and adrenal angiography are complementary
      techniques. In most of the cases, a surgical treatment is indicated if the tumor
      becomes evidently symptomatic.

PMID- 2233108
TI  - [Critical analysis of drugs in 1989].
AB  - Changes and trends in the drug field in the world and in Yugoslavia in 1989 are
      presented and discussed. 1. World. There appeared only a few new drugs all over
      the world, and new chemical entities (NCE) rather rarely represent a significant
      contribution to materia medica. Japan is the first in producing NCE (12) followed
      by United Kingdom and the USA (4 NCE each). 2. Yugoslavia. In Yugoslavia were 125
      drugs discussed approval, new dose, new formulation or generic parallel. More
      than 84% of these have been related to generic or clinical ("me too") parallels;
      less than 9% of drugs had a certain contribution to materia medica, while,
      according to the authors, the number of drugs that contributed significantly to
      the materia medica and of those which should not have been approved was equal
      (3.2%). Octreotide, erythropoietin, almitrine and flumazenil were placed in
      category A. Insulin appeared in the largest number of parallels (as many as 19)
      succeeded by cardiovascular, antimicrobial and gastrointestinal drugs. 3. Drug
      formularies exist in all the developed countries and represent a way of limiting
      prescribing. Yugoslav list of drugs expenses of which will be covered by the
      Health Insurance will be prepared. 4. The Federal Institute for Health Protection
      through its special committee for diagnostics, pharmacotherapy and side effects
      represents a useful activity in rationalizing drug use. 5. Yugoslav publication
      of defined daily doses (DDD) is being prepared. 6. A review of causes of
      deficient or inadequate drug supply in Yugoslavia, which still represents a major
      problem in this country, has been given at the end.

PMID- 2233109
TI  - [The effect of leukocytes and erythrocytes on the metabolism and function of
      thrombocytes during preservation of thrombocyte concentrate at 22 degrees
      centigrade].
AB  - The effect of leukocytes and erythrocytes on metabolic and functional changes was
      studied in 70 platelet concentrates kept for 72 hours at 22 degrees C in plastic
      PVC bags. On separating the platelet-rich plasma, a portion of buffy coat (i.e. a
      layer of leukocytes and erythrocytes) was added to one of the two series of
      platelet concentrates. These platelet concentrates did not differ from platelet
      concentrates prepared by the usual method, either by the platelet volume or count
      (p less than 0.05). The mean leukocyte count was 2.42 x 10(9)/L and 21.2 x
      10(9)/L in the control and study series, respectively. After a 72 hour storage, a
      statistically significant difference (p less than 0.05) in the increase of
      lactate and ammonium concentrations, and a decrease in the glucose concentration
      and plasma pH were observed in platelet concentrates with a higher leukocyte
      count. The metabolic changes were accompanied by a statistically significant fall
      in the hypotonic shock (p less than 0.05). The results obtained in this study
      indicate that leukocytes in platelet concentrates elicit an adverse effect upon
      the platelet metabolism and function in vitro. In order to maintain the pH value
      at 6.0 during a 72 hour storage, the leukocyte count in platelet concentrates
      should not exceed 15.6 x 10(9)/L.

PMID- 2233110
TI  - [The effect of certain factors on the occurrence of sudden infant death
      syndrome].
AB  - Although sudden infant death syndrome (SIDS) has been well known for a long time,
      in our country it has not been registered adequately yet and has seemed not to be
      present those years. But, it has not been true. A number of predisposing factors
      make that this phenomenon has a high share in postneonatal mortality, especially
      in those environments where the infant's mortality rate is low. A pathologist is
      imperative to establish a diagnosis following not only inadequate clinical
      picture and sudden death but also uncertain autopsy finding which does not make
      clear the cause of death in the majority of cases. In this paper, the frequency
      of SIDS during the epidemic of acute respiratory infection caused by respiratory
      syncytial virus being the potential indirect cause of the infants' deaths is
      presented. In 2/3 of cases this have been the infants born with perinatal risk
      factors and more often they have been males. SIDS has usually occurred at night,
      during autumn and winter and with infants coming from lower socio-economic and
      culturo-hygienic environments. In our environment, the frequency of SIDS has
      amounted to 22% of the total infant mortality rate.

PMID- 2233111
TI  - [An epidemic of legionellosis at a hotel at the Makarska seashore].
AB  - The paper describes the epidemic of Legionellosis that occurred among guests and
      employees of a hotel at the Makarska littoral in May 1988. According to the so
      far reported data in the medical literature that was the third epidemic in our
      country and all three of them occurred in the Dalmatian touristic area. In this
      epidemic, nine foreign tourists were registered ill with the clinical picture of
      Legionnaires' disease. Five patients required hospitalization. The disease could
      be serologically proved in 4 patients and Legionella pneumophila SG1 was isolated
      from samples of 2 patients and from sediment of the hot-water tank. Since the
      opening of the hotel until the end of May, 19 hotel employees developed a febrile
      illness of short duration. The disease was serologically proved in 7 of them. The
      morbidity rate in tourists was 2.5%, while it amounted to 7.1% in the hotel
      employees. The epidemic lasted for 16 days. The infection spread through the hot
      water, and antiepidemic measures were limited to its pasteurization and
      hyperchloridation. The chain of infection was broken off by the application of
      those measures.

PMID- 2233112
TI  - [Computer-assisted teaching in medical education--development of methods and
      supplemental materials].
AB  - A review of the elementary types of materials for the computer assisted learning
      (CAI--Computer Assisted Instruction) is given in this paper. It shows our initial
      experiences in creating the computer educational materials of the patient
      management simulation type, destinated for the primary care physicians. A
      computer simulation program "First Aid in Traffic Accident" is described as an
      example. A typical structure of these materials is shown. The materials had been
      developed using the own authoring system, a computer program which enables the
      teachers and other experts to create the computer educational materials
      independently, with the minimal help of the professional computer experts.

PMID- 2233113
TI  - [Is there a rheumatic fever?].
AB  - In 1988, 11 patients with a suspicion to rheumatic fever (RF) or acute
      polyarthritis were admitted to the Department of Internal Medicine, University
      Hospital, "Dr. M. Stojanovic". Eight patients have been extensively treated
      together with a physiatrist, while one of them on an outpatient basis. Follow-up
      has been from 3 to 9 months. Rheumatic fever was diagnosed with a certainty in
      only one patient. Three have had the diagnoses of Reiter's syndrome and
      individually, of infectional, ankylosing and rheumatoid arthritis. One patient is
      still followed up because of the symptomatic diagnosis of partially cured
      oligoarthritis or recurrent RF. The numerical relation of established diagnoses
      for the followed up patients has been in accordance with the decrease in
      incidence of RF both in our country and the world some decades ago. The possible
      causes of frequent diagnoses of RF in adults and the necessity of careful
      evaluation of clinical and laboratory parameters and the need to follow-up
      unclear polyarthritis even when the patients are not hospitalized, until the
      definite diagnosis has not been made is stressed in this paper. Therefore, the
      administration of corticosteroids has to be avoided in these patients, except in
      special cases.

PMID- 2233114
TI  - [Intestinal pseudoobstruction in hypothyroidism].
AB  - Just as gastrointestinal functional diseases affect the thyroid, so thyroid
      disfunction affects the structure and function of almost all parts of the
      gastrointestinal tract. Hypothyroidism has frequently been associated with
      various gastrointestinal manifestations, including constipation, bloating,
      flatulence, atrophic gastritis, ileus, atony and dilatation of the oesophagus,
      stomach, gallbladder, small intestine and colon. Characteristic intestinal
      hypomotility in a severe hypothyroidism may progress to intestinal
      pseudoobstruction, paralytic ileus and megacolon. These rare but potentially
      serious complications must be recognized and treated promptly with adequate doses
      of thyroid hormone replacement therapy. The case history of a 64-year-old woman
      with hypothyroidism and intestinal pseudoobstruction is described.

PMID- 2233115
TI  - [The effect of diltiazem and nifedipine in persons with essential hypertension].
AB  - After a two-week placebo period, 40 patients were randomly divided into two
      groups in a six-week double blind parallel study. Group A received diltiazem
      (Cortiazem retard, Hemofarm) 90 mg twice daily and group B nifedipine 10 mg three
      times daily. Blood pressure and heart rate were measured at the end of weeks 2, 5
      and 8 at rest, in the supine and standing positions and during ergometric
      exercise of 50, 75 and 100 wattes. Blood pressure at rest, in the supine
      position, decreased comparably in both groups. The response rate (reduction in
      diastolic blood pressure of at least 10 mmHg or less than or equal to 90 mmHg)
      was 83% in the diltiazem group and 80% in the nifedipine group. Exercise blood
      pressure was also comparable in both groups. Resting heart rate was unchanged in
      the diltiazem, whereas in the nifedipine group a tendency to increase was
      observed. The pressure rate product significantly decreased (p less than 0.05) in
      the diltiazem only in exercise of 100 W and increased slightly in the nifedipine
      group. There were two drop-outs in the nifedipine group due to side effects and
      none in the diltiazem group.

PMID- 2233117
TI  - [Mechanisms of epidermal growth factor activity].
AB  - Epidermal growth factor is a Mr 6045 polypeptide which binds to its own cell
      surface receptor and stimulates its intrinsic tyrosine kinase activity.
      Activation of this signal transducing system is believed to be involved in many
      physiological and pathophysiological processes. Some aspects of these processes
      are discussed in this review.

PMID- 2233116
TI  - [Pathophysiology of atherosclerosis. II. Etiopathogenic mechanisms and risk
      factors].
AB  - The authors present an up-to-date review on etiopathogenesis of atherosclerosis.
      Theories of etiology of atherosclerosis are described: response-to-injury
      hypothesis, lipid deposition hypothesis, lysosome hypothesis, encrustation
      hypothesis, mural thrombi hypothesis, monoclonal and clonal senescence
      hypothesis. The role of endothelial injury and platelet adhesion as well as
      smooth muscle cells proliferation due to these events, their growth control and
      the role of macrophages in atherogenesis are explained thoroughly. Special
      attention is focused on the interaction of arterial cells and lipoproteins at
      sites of vessel injury, lipid metabolism of the lesion and on synergy of arterial
      injury caused by various injury mechanisms and hypercholesterolemia in
      atherogenesis. Atherosclerotic risk factors and their impact on atherogenesis are
      discussed as well (e.g. hyperlipoproteinemia, hypertension, tobacco smoking,
      diabetes and abnormal glucose tolerance, gout, obesity, menopause and oral
      contraceptives, diminished physical activity, type A of personality behavior
      etc.). The possibilities of regression or reversal of ateromatous plaques are
      presented too.

PMID- 2233118
TI  - [Modern referral-information service in the Central Medical Library of the
      University of Zagreb Medical School].
AB  - New technologies in information and retrieval services of the Central Medical
      Library are presented, as well as comparison between traditional search of
      biomedical literature and search of biomedical bases available on CD-ROM and on
      line. MeSH thesaurus represents the basis for all modes of searches, either
      through published indexes (Index Medicus, Biomedicina Iugoslavica), searches
      through on-line, or via CD-ROM technology. Experience in indexing according to
      MeSH structure helps us to search and retrieve biomedical literature on new media
      too. Great interest in new media for search and retrieval of biomedical
      literature among our users (100%) justifies their introduction into the Library.
      In the period of four months, 75% of our users chose CD-ROM technology in their
      search, 25% chose on-line search, and both technologies were combined by 33% of
      the users. Having these new media in our library we have reached the point from
      which we join the world biomedical information network and successfully meet the
      growing need for information in the field of biomedicine.

PMID- 2233119
TI  - [The work of Dr. Lavoslav Glesinger in the history of medicine (1901-1986)].
AB  - In this paper special attention has been given to the analysis of the elements of
      the life and work of Professor Lavoslav Glesinger, M.D.,Ph.D., being at the same
      time the indicators of his role in the process of the development and recognition
      of the history of medicine as a profession and scientific, educational and
      academic discipline in our environment. With regard to the assigned object, all
      available bibliographic material has been studied. Professor Glesinger, being a
      physician practitioner, showed the interest in that field even in the period from
      1931 to 1948 and wholly devoted himself to it working as a professional
      researcher and professor at the School of Medicine, University of Zagreb in the
      period from 1948 to 1976, and as a scientist at the Institute for History of
      Science, Mathematics and Medicine of the Yugoslav Academy of Arts and Sciences,
      Zagreb, in the period from 1960 to 1981.

PMID- 2233120
TI  - [A rational approach to the prevention and treatment of osteoporosis].

PMID- 2233121
TI  - [Hypocritical humanism].

PMID- 2233122
TI  - [Prevention of AIDS transmission].

PMID- 2233123
TI  - Pentoxifylline inhibits lipopolysaccharide-induced serum tumor necrosis factor
      and mortality.
AB  - Tumor necrosis factor, a mononuclear phagocyte-derived peptide produced in
      response to lipopolysaccharide, has been shown to mediate certain aspects of
      septic shock and multiple organ failure resulting from gram-negative septicemia.
      In the present investigation, pretreatment of animals with pentoxifylline
      inhibited lipopolysaccharide-induced serum tumor necrosis factor in a dose
      dependent fashion. Pentoxifylline prevented the sequestration of neutrophils seen
      in animals given intravenous lipopolysaccharide. Furthermore, pentoxifylline
      protected animals from the lethal effects of an intravenous challenge with
      lipopolysaccharide. These data indicate that pentoxifylline inhibits
      lipopolysaccharide-induced tumor necrosis factor and may be an effective agent in
      mitigating the lethal consequences of sepsis and other disease processes mediated
      by this cytokine.

PMID- 2233124
TI  - Protective effect of human epidermal growth factor against the experimental
      gastric mucosal lesions in rats.
AB  - The protective effect of human epidermal growth factor (hEGF) on the gastric
      mucosal lesions in rats was examined in relation to the immunoreactive
      concentration of plasma. Human EGF (30 micrograms/kg) was administered
      intravenously, intraperitoneally or subcutaneously. At different times following
      the administration of hEGF, rats received acidified ethanol solution to induce an
      experimental gastric mucosal lesion. Sum of lesion length in the gastric mucosa
      was used as a lesion index. Human EGF administered parenterally markedly
      decreased the gastric mucosal lesions in 10 min after administration of
      necrotizing solution, and 10 to 30 min delay was observed in the development of
      maximal protective action. Profiles of protective potency against the hEGF dose
      administered intraperitoneally or subcutaneously 30 min before administration of
      necrotizing solution revealed that the effective dose of hEGF (ED50) was about
      5.2 and 2.6 micrograms/kg, for intraperitoneal and subcutaneous administrations,
      respectively.

PMID- 2233125
TI  - Ethanol and diolein stimulate PKC translocation in astroglial cells.
AB  - Ethanol exposure stimulates taurine release from astroglial cells. To determine
      if ethanol mediates this release using protein kinase C (PKC), PKC activity was
      measured using LRM55 astroglial cells. When ethanol (25-200 mM) or diolein (3
      microM) was applied to cells for 30 seconds, PKC activity was observed to
      decrease in the cytosol and increase in the membrane fraction of the cell while
      the whole cell activity remained unchanged. The membrane-associated activity
      increased by almost 100%. When ethanol (100 mM) and diolein (3 microM) were
      applied simultaneously, membrane-associated activity increased to become 3-5
      times greater than when either PKC activator was applied alone. These changes in
      PKC activity parallel changes in taurine release observed when cells are exposed
      to ethanol and the PKC activator diolein. Ethanol-stimulated release may be
      associated with the translocation of PKC activity from the cytosol to the
      membrane.

PMID- 2233126
TI  - The role of acetate in alcohol-induced alterations of uterine glucose metabolism
      in the mouse during pregnancy.
AB  - The acute exposure of mice to ethanol during post-implantation pregnancy has been
      reported to cause alterations in the levels of several glycolytic intermediates
      in the uterus, suggesting a possible indirect mechanism of alcohol embryo
      toxicity. The present study was undertaken to assess whether the ethanol
      metabolite, acetate is implicated in this phenomenon. Blood and uterine alcohol
      concentrations in day 9--pregnant Quackenbush Swiss mice were maximal 15 minutes
      after the intraperitoneal injection of ethanol (3.5 g/kg body weight), and fell
      to almost negligible levels 6 hours later. In response to this treatment, the
      levels of blood and uterine acetate increased, liver glycogen decreased, plasma
      glucose increased, and uterine glucose, glucose-6-phosphate (G-6-P), fructose-6
      phosphate (F-6-P), and citrate increased. When acetate was administered to
      pregnant mice in amounts approximating those generated by exposure to alcohol,
      the levels of uterine F-6-P and citrate increased while other metabolic
      parameters remained unaffected. The administration of 4-methylpyrazole to mice
      subsequently treated with alcohol produced conditions of alcohol exposure in the
      absence of ethanol-derived acetate and depressed the ethanol-induced rise in
      uterine G-6-P and citrate. The results support the notion that acetate
      contributes to the alcohol-induced alterations in metabolism, at least as far as
      the regulation of uterine citrate and hexose monophosphates are concerned. This,
      together with stress responses induced by exposure to the acute dose of alcohol,
      may present mechanisms underlying the fetal alcohol syndrome associated in
      particular with "binge" drinking.

PMID- 2233127
TI  - Lipid activators of protein kinase C.
AB  - Among the many reported lipid activators of protein kinase C only those of high
      affinity can be considered true physiological effectors, at present the tumor
      promoters, e.g., phorbol esters; 1,2-diacyl-sn-glycerols; and
      phosphatidylinositol 4,5-bisphosphate. Many other compounds (including
      arachidonic acid) are activators at high, unphysiological concentrations only,
      and they seem to be sterically unsuited for bonding to the enzyme. Such pseudo
      activators possibly act by scrambling the structure of the regulatory moiety of
      the kinase.

PMID- 2233128
TI  - Difference in the effects of the antidepressant tianeptine on dopaminergic
      metabolism in the prefrontal cortex and the nucleus accumbens of the rat. A
      voltammetric study.
AB  - The effects of the new tricyclic antidepressant tianeptine were investigated on
      dopaminergic (DAergic) metabolism in the anteromedian prefrontal cortex and the
      nucleus accumbens of the rat. DAergic metabolism was assessed by the measurement
      of DOPAC, the main presynaptic metabolite of dopamine, using in vivo voltammetry
      in rats ventilated with halothane (0.5-0.75% in air). Acute treatment with
      tianeptine (10 mg/kg, 20 mg/kg) only increased significantly DOPAC levels in the
      anteromedian prefrontal cortex. After chronic treatment with tianeptine (15 days,
      2 times/day) the increases in DOPAC levels in this structure were altered and
      less pronounced with the 20 mg/kg dose. Previous studies led to suggest that both
      acute and chronic effects on DAergic terminals in the anteromedian prefrontal
      cortex may be involved in the therapeutic action of this new antidepressant.

PMID- 2233130
TI  - Effect of human epidermal growth factor (hEGF) on splanchnic circulation in dogs.
AB  - The effect of intravenous administration of human epidermal growth factor on the
      splanchnic blood flows was examined in anesthetized dogs, using an ultrasonic
      transit-time volume flow meter. Human epidermal growth factor (0.1, 0.5 and 1
      microgram/kg) significantly increased blood flows in the portal vein (36.9 +/-
      7.4% at 1 microgram/kg) and the superior mesenteric artery (49.0 +/- 16.8% at 1
      microgram/kg). Systemic blood pressure monitored simultaneously was significantly
      decreased (8.4 +/- 1.2% at 1 microgram/kg). This study is the first to
      demonstrate that intravenous administration of epidermal growth factor increases
      the portal venous blood flow.

PMID- 2233129
TI  - Effect of cocaine and cocaine metabolites on cerebral arteries in vitro.
AB  - Cocaine has pronounced peripheral vasoconstrictor effects. Despite the short half
      life of cocaine in the body these effects are relatively long-lived. The role of
      cocaine metabolites in vasoconstriction attributed to cocaine has not been
      reported. We evaluated the contractile ability of cocaine and its major
      metabolites in isolated cat cerebral arteries. The primary cocaine metabolite,
      benzoylecgonine was a potent contractile agent, causing a 50% decrease in cross
      sectional area at 10(-5) M. This was less than caused by serotonin, but greater
      than caused by norepinehrine. Ecgonine and cocaine were less active contractile
      agents than was benzoylecgonine, and ecgonine methyl ester was a mild relaxant.

PMID- 2233132
TI  - Effects of cocaine and morphine on IgG production by human peripheral blood
      lymphocytes in vitro.
AB  - Elevated serum levels of IgG are amongst the immunological abnormalities
      exhibited by intravenous drug addicts. We therefore addressed the hypothesis that
      cocaine and morphine (the major metabolite of heroin) exert a direct effect on
      human B cell function in vitro. Human peripheral blood mononuclear cells from
      normal individuals were incubated for 7 days with the T cell-dependent B cell
      activator pokeweed mitogen (PWM) and serial dilutions of either cocaine or
      morphine. At the end of this time total IgG was measured by use of a sandwich
      ELISA incorporating a biotin-labelled affinity-purified anti-IgG and streptavidin
      peroxidase. At concentrations relevant to those found in plasma, morphine and
      cocaine did not affect PWM-stimulated IgG synthesis in vitro. We suggest that
      these drugs of abuse do not directly influence human B cells, but in vivo exert
      immune modulatory effects via indirect mechanisms.

PMID- 2233131
TI  - Affinity profile of the novel muscarinic antagonist, guanylpirenzepine.
AB  - The study reports the functional affinity of an amidino derivative of
      pirenzepine, guanylpirenzepine, for muscarinic receptors mediating relaxation of
      rat duodenum, inhibition of rabbit vas deferens twitch contraction (both
      receptors previously classified as M1), guinea pig negative inotropism (M2) and
      ileal contraction (M3). Unlike pirenzepine, guanylpirenzepine discriminated
      between duodenum and vas deferens receptors, with a 30-fold greater affinity for
      the former subtype. The unique selectivity pattern of guanylpirenzepine (duodenum
      greater than vas deferens greater than ileum greater than atrium) renders it a
      promising tool for the classification of muscarinic receptor subtypes.

PMID- 2233134
TI  - In vivo stereological assessment of caudate volume in man: effect of normal
      aging.
AB  - Using intermediate weighted magnetic resonance imaging (MRI) and a systematic
      sampling stereological method in 39 normal volunteers aged 24-79 years old, we
      demonstrated a marked age-associated decline in caudate nuclei volume (r = -0.69,
      p less than 0.0001). The mean absolute volume of the caudate nuclei in this study
      (9.4 cm3) was almost identical to that reported in a previous autopsy study and
      further confirms the validity of this stereological technique for use with MR
      images. This technique will provide a method for measuring the caudate and other
      nuclei in vivo, from brain images and, as such, a research tool to correlate age
      associated changes in cognitive, sensory and motor function with caudate nucleus
      volume and other brain regions.

PMID- 2233133
TI  - Effects of bile acids on actin polymerization in vitro.
AB  - Bile acids are major determinants of canalicular bile secretion, and there are
      indications that choleretic bile acids increase bile canalicular contractions, in
      isolated rat hepatocytes. Therefore, we examined the influence of various bile
      acids on the rate of actin polymerization in vitro. The free forms of cholic
      acid, ursodeoxycholic acid, and chenodeoxycholic acid, as well as their taurine
      and glycine conjugates, were incubated with purified muscle actin, at a
      concentration of 100-300 nmoles/mg actin. The rate of actin polymerization was
      measured by viscometry and the fluorescence of the pyrene probe, linked to actin.
      Results showed that all bile acids slow the rate of polymerization, and that the
      effect was dose-dependent. However, the reduction by chenodeoxycholic acid was
      greater than that caused by the other bile acids. The results indicate that bile
      acids, particularly in high concentrations interact with actin, a finding that
      may be related to the increased bile canalicular contractility, and altered
      canalicular membrane morphology, induced by choleretic bile acids.

PMID- 2233135
TI  - Effect of plasma from essential hypertensives on vascular tone of aortic strips,
      isolated perfused mesentery and isolated perfused kidney.
AB  - Different vascular models of normotensive Wistar rats, including aortic strips,
      isolated perfused mesentery and isolated perfused kidney, were used to study
      hemodynamic effects of plasma fractions obtained by gel filtration from the blood
      of essential hypertensive and normotensive subjects. Plasma fractions from
      essential hypertensives studied had been shown to increase blood pressure after
      intravenous injection in rats. In the aortic strips, 50 microliters of a
      hypertensive fraction (HF) elicited a calcium-dependent contraction of 0.14 +/-
      0.035 mN (n = 20, p less than 0.05), which was inhibited by nifedipine, whereas
      tension of the strips was not significantly changed by normotensive fractions
      (NF) (n = 17). In the isolated perfused mesentery preparation, no significant
      change of perfusion pressure by HF or NF could be demonstrated (n = 10). In the
      isolated perfused kidney, a transient increase of perfusion pressure was induced
      by HF (19.5 +/- 16.6 mm Hg, n = 40, P less than 0.001) but not by NF. This
      increase was abolished in calcium-free, 2 mmol/l EGTA containing perfusion
      medium. The response was diminished, but not abolished by nifedipine. These data
      demonstrate vasopressor properties of plasma from essential hypertensives, which
      might be the consequence of a circulating vasoconstrictor substance in the blood
      of essential hypertensives.

PMID- 2233136
TI  - Leucocytes and pulmonary disorders: mobilization, activation and role in
      pathology.

PMID- 2233137
TI  - Current concepts in olfaction.
AB  - Because of the location of the olfactory epithelium and bulb, the processes
      involved in olfaction have been difficult to evaluate. However, the recent
      application of comprehensive nasal endoscopy, reproducible olfactory testing, and
      molecular biologic techniques to the study of the transduction of olfactory
      information has elucidated some of the events in odorant perception.

PMID- 2233138
TI  - The In Vitro Fertilization Program at the Greater Baltimore Medical Center.

PMID- 2233139
TI  - Pathogenic factors in the development of type I and type II diabetes mellitus:
      1990.
AB  - The pathogenesis of IDDM and NIDDM indicates a distinct difference between these
      diseases. Viral illness is implicated in IDDM, linked with evidence for an immune
      deficiency. NIDDM is not linked to viral illness or autoimmunity but is highly
      influenced by the inheritance of a defect in insulin production.

PMID- 2233140
TI  - Cervical spondylosis: a therapeutic update.

PMID- 2233141
TI  - Role of the community hospital in cancer research.

PMID- 2233142
TI  - Evaluation of patients with claudication.

PMID- 2233143
TI  - The Physician Rehabilitation Program of the Medical and Chirurgical Faculty of
      Maryland: twelve years and going strong.

PMID- 2233144
TI  - The effect of physician impairment on the family.
AB  - There are few studies on the effect of physician impairment on the marriage and
      the family. There is a need for research on both the functional and non
      functional medical marriage, and treatment needs to be devised to focus on the
      special needs of the medical family.

PMID- 2233145
TI  - The role of the medical review officer in the workplace.
AB  - MROs need to be knowledgeable and experienced in the area of substance abuse.
      This relatively new field raises many clinical issues, complicated by legal and
      ethical issues. It is advisable that MROs be independent from the companies,
      laboratories, and collection sites with which they contract or to which they
      relate in the process of performing their evaluations.

PMID- 2233146
TI  - Physician addiction to pharmaceuticals: personal history, practice setting,
      access to drugs, and recovery.
AB  - Specialists in the field of anesthesiology, emergency medicine, and general or
      family practice are at increased risk of addiction. They may manifest a pattern
      of habitual overwork and/or grandiosity, have unrestricted access to drugs, and
      initiate use through self-medication.

PMID- 2233147
TI  - The Physician Rehabilitation Program of Maryland.
AB  - The Physician Rehabilitation Program of Maryland has been developed by Med Chi's
      Committee on Physician Rehabilitation over the last twelve years. Its primary
      purpose is to assist physicians who are experiencing problems because of
      substance abuse, physical disability, or psychiatric illness. Rapid changes in
      the field have challenged the Committee in recent years. New funding which
      started in July of 1990 will assist Med Chi in meeting these new challenges.

PMID- 2233148
TI  - Venomous snakebites.

PMID- 2233149
TI  - Near-drowning accidents among children.

PMID- 2233150
TI  - Sunlight, ultraviolet radiation, and the skin excerpts: NIH consensus statement.

PMID- 2233151
TI  - Thoracic spine schwannoma: the role of Gd-DTPA enhanced MRI.

PMID- 2233152
TI  - Centralized credentialing: state-of-the-art confidential clearinghouse.

PMID- 2233153
TI  - The duty to warn: the present law.

PMID- 2233154
TI  - Morality and sex: BPQA decisions.

PMID- 2233155
TI  - Sequential decision making with continuous disease states and measurements: I.
      Theory.
AB  - The question of whether to perform a continuous valued test to assess a
      continuous valued health state such as blood pressure or serum cholesterol is
      explored by decision analysis. Principal assumptions are that the underlying
      health state and measurement variability are both normally distributed, and that
      the impact of treatment on the utility of outcomes varies linearly with the
      underlying health state. Using Bayes' theorem, an expression for the expected
      utility of performing the test is derived and compared with immediate treatment
      or decision to withhold treatment. The calculations can be carried out with a
      pocket calculator and a table of the normal distribution. Iterating the analysis,
      a sequential decision making process is developed, leading to a series of no
      treat/test again and test again/treat thresholds with which a running average of
      independently obtained measurements can be compared to produce stepwise optimal
      results. The thresholds are readily calculated on a microcomputer. Finally, the
      conjugate-normal-linear model is extended to encompass the correlated
      observations that may be made on a single visit. This paper concentrates on the
      mathematics of decision making with continuous variables. The companion paper
      illustrates its application to diastolic blood pressure.

PMID- 2233156
TI  - Sequential decision making with continuous disease states and measurements: II.
      Application to diastolic blood pressure.
AB  - The model and strategy for sequential decision making using normally distributed
      measurements proposed in a companion paper are applied to the problem of
      diagnosing diastolic hypertension. The assumptions of the model are discussed and
      justified clinically. Methods for assigning values to the model's parameters are
      explained and illustrated in the context of a hypothetical "generic" patient.
      Although current national recommendations and the sequential strategy both lead
      to an average of 1.89 measurements per patient prior to diagnosis, the sequential
      strategy applies a sequence of four or more measurements to 12% of patients.
      Fewer than 1% of patients would require ten or more measurements under this
      strategy. The sequential strategy leads to fewer patients' receiving unnecessary
      treatment and substantially higher expected utility for the patient. The role of
      multiple blood pressure determinations per visit is explored in the absence of
      appropriate estimates. Even under "best-case" assumptions, however, it is shown
      that obtaining more than one observation per visit is called for only in about
      15% of visits. While the exact role of multiple determinations cannot be
      specified from existing data, it is likely to be much more limited than current
      recommendations suggest.

PMID- 2233157
TI  - Improvement of decisions regarding hemodialysis patients by urea kinetic
      modeling.
AB  - The potentials for improving decisions about adequacy of dialysis (AD) and daily
      protein intake (DPI) by urea kinetic modeling (UKM) were examined. Four
      nephrologists evaluated AD, DPI, and metabolic stability in 62 patients. UKM was
      done three times; but the results were not revealed. Clinicians' decisions were
      then compared with UKM measures of effective dialysis (Kt/V) and protein
      catabolic rate (pcr). Detection of inadequately treated patients by the
      clinicians was poor (28%, Kt/V less than 1.0; and 40%, Kt/V less than 0.9).
      Specificities of the clinicians' decisions were 0.96 and 0.92, respectively.
      Combining pcr and consensus decisions, 59 patients could be assigned a probable
      DPI. Using this as "gold standard," the average clinician detected 77% of 13 low
      DPIs. Single or triple pcr determinations alone detected 77% or 62%,
      respectively. Specificities were 0.91, 0.85, and 1.0. Simulated decision making
      suggested that combining pcr with clinical evaluation in a logical way would lead
      to detection of most patients with low DPI. Qualitative data from individual
      patient cases causing controversies are presented and discussed. It is concluded
      the UKM should be used routinely to assess the adequacy of dialysis and daily
      protein intake.

PMID- 2233158
TI  - Determining a range of false-positive rates for which ROC curves differ.
AB  - Many indices have been proposed for summarizing the information contained in the
      ROC curve. When comparing two ROC curves, though, there are times when global
      summary measures are either not optimal or not appropriate. The author presents a
      method for directly comparing true-positive rates for two diagnostic, screening
      or prognostic tools, determining over what range of false-positive values the
      tests differ. The method is applicable for independent or dependent samples. An
      example concerning gallium citrate imaging is presented, as well as an example
      using a prognostic index for severity of illness in the ICU. The range of false
      positive rates for which the ROC curves differ is determined for each example.

PMID- 2233159
TI  - Twisted sisters: when is the optimal tme for delivery?

PMID- 2233160
TI  - Recent developments in medical decision making.

PMID- 2233161
TI  - [The physicotechnical support of radiation diagnosis and therapy].

PMID- 2233162
TI  - [The problems of medical radiobiology].

PMID- 2233163
TI  - [The basic problems of radionuclide diagnosis in the USSR].

PMID- 2233164
TI  - [The suspicion of obstructive jaundice].

PMID- 2233165
TI  - [The use of Gruntzig-type balloon catheters for dilatation in stenoses of the
      pylorus and the duodenum].
AB  - The paper is concerned with original methods of balloon dilatation with high
      pressure low-profile balloon catheters of Gruntzig type of pyloric and duodenal
      stenoses. A new informative method of recording of this procedure and its results
      with computer for radiography was described. In 10 patients this method was used
      alone as well as in combination with sparing operation--selective proximal
      vagotomy. In 80% of cases a positive effect of this procedure was obtained and
      confirmed by clinical observation and instrumental methods. No complications were
      noted. Therefore this methods could be recommended for a wider clinical use.

PMID- 2233166
TI  - [The All-Union Congresses of Roentgenologists and Radiologists].

PMID- 2233167
TI  - The interplay of culture and symptoms: menstrual symptoms among Samoans.
AB  - Menstrual symptomatology has received much attention in recent years but little
      attention has been given to the interplay of culture with these symptoms.
      Interview data from male and female Samoans in rural Western Samoa, rapidly
      modernizing American Samoa, and modern Hawaii are used to explore the role of
      culture and culture change in explaining variations in reports of menstrual
      symptomatology and menstrual distress. I suggest that culture plays a significant
      role in the recognition, evaluation, and expression of menstrual symptoms, and
      thus culture must be considered along with biological and psychosocial variables
      in the evaluation of symptomatological differences, including differences in
      number and kind.

PMID- 2233168
TI  - Chiropractors for and against vaccines.
AB  - The publications of philosophically conservative chiropractors document their
      allegiance to a posture of hostile opposition to health prevention based upon
      immunization procedures. The challenge to medical anthropology is to make sense
      of what seems scientifically senseless. This paper attempts to come to an
      understanding of this position by tracing professional attitudes which are
      derived from a history of political and economic conflict with the American
      medical establishment, which emanate from an explanatory model of disease
      causation that preserves a nineteenth century monocausal theory, and which
      reflect a process of cultural schizmogenesis. In preserving these heretical
      medical beliefs, conservative chiropractors, who are trained in the basic medical
      sciences, defend themselves by basing their opposition to immunization upon
      imperfections in vaccines that relate to the efficacy, safety and necessity of
      immunizations. Further, they persist in a belief that chiropractic spinal
      manipulation provides an alternative method for achieving immune status. This
      belief has not been subjected to testing in clinical trials or laboratory
      experiments, and thus becomes a matter of belief rather than of scientific
      verity. A refusal to advocate or submit to vaccines serves conservative
      chiropractors as an understandable cultural symbol, but it is a symbol with
      sinister health costs to those who translate it into non-immune status in a world
      otherwise still hostage to disease-producing organisms.

PMID- 2233169
TI  - Navajo childbirth in transition.
AB  - For the Navajo Indians, the transition from home-centered childbearing practices
      based on religious ritual to biomedically directed childbirth in hospitals was
      completed over a relatively short time in the middle decades of this century. For
      Anglo-American society, the acceptance of medically oriented childbirth occurred
      during an equally short period earlier in the century. The transition was driven
      for both by many common factors. For Navajo women it was additionally influenced
      by the social and economic changes that affected the Reservation following the
      beginning of the Second World War. This paper examines the changes in Navajo
      childbearing practices and, for comparison, those of the dominant American
      society. It reviews factors that permitted the acceptance of biomedical
      childbirth by Navajo women and explores the health implications of the
      transition.

PMID- 2233171
TI  - Migration, changing gender roles and stress: the Samoan case.
AB  - The impact of migration and social change on male and female role expectations is
      examined in an urban Samoan community. Expanding role expectations and role
      conflicts in the urban context are linked to differential experiences of stress
      by gender, which are in turn examined with respect to the health outcomes of
      arterial pressure, a measure of physical health status, and a psychosomatic
      complaint index.

PMID- 2233170
TI  - The forty-day rest period and infant feeding practices among Negev Bedouin Arab
      women in Israel.
AB  - Four hundred and twelve Bedouin Arab women were interviewed within 48 hours of
      delivering a newborn in 1982 and two months later to examine the effect of social
      support during the forty-day postpartum rest period on the incidence of exclusive
      breast feeding at two months. Whereas the distribution of infant feeding
      practices at two months did not differ among women with and without support
      during the "forty days," the number of days of help during the "forty days" was
      significantly associated with type of feeding at two months. The longer the
      duration of help, the greater were the odds of maintaining exclusive breast
      feeding after adjustment for covariates by multinomial logistic regression
      analysis. The association between duration of help and infant feeding practices
      at two months was modified by the interview month and the feeding practices of
      the respondents' primary social supports. More respondents with infants who
      reached two months of age in May and June were exclusively breast feeding than
      respondents with infants who reached two months in the hot, dry months of July
      and August. Also, respondents with sisters-in-law who breast fed alone or in
      combination with the bottle were feeding their infants in the same way after
      adjustment for covariates. Given the beneficial effects of breast feeding on
      infant health and development, these findings identify potential avenues of
      intervention for programs promoting breast feeding.

PMID- 2233172
TI  - Order and healing: the concept of order and its importance in the
      conceptualization of healing.
AB  - This paper concerns the notion of order and its role in the conceptualization of
      healing, and therefore its importance to healing itself. It proposes a model of
      healing in which order is central. The paper begins with an example drawn from
      Javanese mystical practices which are based upon the concept of the unity of the
      human and natural orders. The Javanese case provides a metaphor for an expanded
      notion of order. This prefigures a consideration of the nature of the concept of
      order in medical anthropology, science, and medicine. The importance of the
      notion of analogy (and metaphor) in the concept of order and how order may be
      simultaneously conceptualized in both cognitive and biological domains is also
      discussed in the paper. The perspective on order and healing developed here goes
      beyond conventional biomedical categories and provides a basis for the
      fundamental reconceptualizations necessary for addressing contemporary
      developments in psychoneuroimmunology, for example.

PMID- 2233173
TI  - Falling through the cracks: contradictions and barriers to care in a prenatal
      clinic.
AB  - Prenatal care is often cited as a major factor in the prevention of poor birth
      outcomes. Yet, the social environment of care has been little studied. This paper
      illustrates how contradictory features in the structure of the health care system
      create barriers that weaken effective health care delivery. Social relations in a
      large urban public outpatient clinic are described and analyzed regarding their
      impact on clinic procedures. The paper focuses on: 1) the division of labor in
      which work is compartmentalized and power is diffused; 2) the asymmetrical doctor
      patient relationship magnified by social class differences; and 3) the training
      of resident physicians who provide primary prenatal care. Improvements in the
      quality of care in public clinics cannot come about without an understanding of
      the effects that contributing factors have on the way care is organized.

PMID- 2233174
TI  - Postmodernism and medical anthropology: words of caution.
AB  - Of late, discourse in anthropology increasingly has been set within the frame of
      postmodernism. While debate continues as to whether postmodernism represents a
      particular period or an historically conditioned perspective (or interrelated set
      of perspectives) within the social sciences and beyond, it is clear that
      assessment is needed of the impact of postmodernism on work within the field.
      This paper represents a critique of the potential effect of postmodernism within
      medical anthropology. It is the argument of this paper that despite the
      postmodern eschewal of so-called grand theory, postmodern writers in anthropology
      smuggle a theoretical perspective into their work. The problems of this
      perspective in terms of the critical turn within medical anthropology are
      examined.

PMID- 2233175
TI  - Doctoring as business: a study of entrepreneurial medicine in Nigeria.
AB  - Medicine is often regarded as a philanthropic science in the service of humanity.
      Rather than universalistic humanitarian service (a la Hippocrates), this study of
      private practice illustrates that medicine has been commoditised and is now a
      lucrative business much like the sale of beer and other commodities. This growing
      medical enterprise is explained against the backdrop of the wider dynamics of the
      Nigerian political economy. The implications of this growing privatisation and
      commercialisation, of which the doctoring business is a part, are examined. It is
      concluded that it is only a question of time before entrepreneurial medicine
      completely eclipses the beleaguered public medical system.

PMID- 2233176
TI  - Access to traditional medicine in a western Canadian city.
AB  - This paper examines the question of access to traditional Indian medical systems
      in the western Canadian city of Saskatoon. The data demonstrate that many Natives
      desire such access, and do not see difficulties in having Indian healers
      available in Western-style biomedical clinics. A variety of language variables
      proved to be the best predictors of access questions, indicating that those with
      the greatest cultural adherence were most likely to want a more formal access. It
      is argued that a lack of access to traditional Indian medical services represents
      a legitimate health need. Considerations for the implementation of such a formal
      access to traditional Indian medicine are discussed.

PMID- 2233177
TI  - Rewarding medical teaching excellence in a major Canadian teaching hospital.
AB  - A major Canadian teaching hospital has developed a program to recognize and
      reward excellence in medical education. The program includes a system to collect
      and evaluate feedback from trainees and administrators--with an annual
      celebration event where awards are presented. Three categories of hospital-wide
      awards are presented: educational administration, program development, and
      extraordinary contribution. There are departmental awards for best undergraduate
      and postgraduate physicians, allied health professional, and house staff/fellow.
      This program functioned well to evaluate teachers across departments and for all
      levels of trainees in the hospital and will expand to become part of the ongoing
      evaluation of teachers in the institution.

PMID- 2233178
TI  - Teaching physicians about teaching: an experiential workshop.
AB  - Teaching improvement workshops are most effective when they engage teachers
      actively in practice teaching, particularly when the teaching situation is
      similar to the actual one to which the teachers will return. Teachers, however,
      often find such involvement threatening. In this paper we describe a 3 h workshop
      which succeeds in overcoming teachers' reluctance to participate in situations
      that are relevant to their real teaching problems, students, and subject matter.
      The most exciting outcome, in our view, was teachers' increased sensitivity to
      the limitations of their teaching approach and their increased awareness of the
      role of their concept of teaching in shaping their teaching strategies.
      Weaknesses of the workshop include its dependence on the skills of a group
      director, the tendency of the group to seek a single right answer instead of
      exploring alternatives and the usual danger of role rigidity which troubles all
      role enactment procedures.

PMID- 2233179
TI  - Teaching the teachers at Leicester: the general practice approach.
AB  - This article describes a systematic induction programme devised for newly
      appointed lecturers in general practice. The programme aims to help them develop
      skills in both teaching and assessment and to encourage self-appraisal. The
      progress of participants is monitored by direct observation and video-recording
      with the regular provision of feedback a prominent characteristic. All the
      lecturers have found participation in the programme an effective way of
      developing their teaching capabilities.

PMID- 2233180
TI  - Training managers for primary health care: teaching about community involvement.
AB  - Community involvement is a key element of the Primary Health Care (PHC) approach,
      and thus an essential topic on a course for managers of Primary Health Care
      programmes. This paper describes the teaching approach adopted on the Management
      for Primary Health Care course-a 3-month programme for PHC managers from
      developing countries, offered by the Liverpool School of Tropical Medicine, which
      attempts to overcome the difficulty of discussing this subject without a common
      reference point. Following a series of visits to community organizations in
      Liverpool, participants analyse factors which have influenced the formation and
      operation of these groups. Whilst preparing a report on key issues facing the
      community groups, and developing an analytic framework based on the Liverpool
      experience, participants are encouraged to draw parallels with their own working
      situation. Several advantages of this approach have been identified in the paper,
      but course organizers will have to balance these potential benefits with the
      investment of time and resources required to make it a success.

PMID- 2233181
TI  - Development of competence in clerkship.
AB  - Students' perceptions of their educational experience on Surgery and Medicine
      rotations of a clerkship program were analysed. Six components of the education
      process, namely (1) frequency of individual teaching, (2) quality of contact with
      staff-clinicians, (3) appropriateness of responsibility for patient care, (4)
      appropriateness of supervision received, (5) frequency of admissions reviewed and
      (6) frequency of opportunity to follow-up patients admitted, were correlated with
      students' confidence in their ability to function competently. Mean scores of
      clerks' confidence in their competence was the same for both rotations. Breakdown
      by sex revealed females to feel more competent on medicine, and males on surgery.
      On the medicine rotation a moderate relationship was found between two of the
      components tested and the dependent variable; on surgery, strong correlations
      were found between four of the components tested and the dependent variable.
      Regression analysis demonstrated appropriateness of responsibility for patient
      care to have a low predictor value for achievement of competence on medicine,
      while quality of contact with staff-clinician and appropriateness of supervision
      received were strong predictors of achievement of competence on the surgery
      rotation.

PMID- 2233182
TI  - Role play for the clinical tutor: towards problem-based learning.
AB  - A method of helping students learn paediatrics was developed utilizing role play
      as a stimulus to problem-based learning to arrive at a diagnosis. The tutor
      briefly stated a common paediatric problem and then took on the role of the
      patient and/or child, allowing himself to be interviewed by students working co
      operatively in a group. This process was interrupted by the students to discuss
      their progress and to determine what further information was required. A suitable
      patient was available to be examined if requested by the students. Although there
      was an initial tendency on the part of students to regard the exercise as
      'unreal', they delighted in refining their communication skills and trying out
      their skills in problem solving. The tutor had to adopt a non-traditional role,
      as he was not directing the students or interrupting, so as to 'teach' the
      students more efficient information-gathering techniques or to correct any error
      made. The students were able to define and complete set tasks which they derived
      out of the session. The introduction of this technique encourages independent
      learning and the acquisition of problem-solving skills, and the students
      enthusiastically accepted this novel way of learning. The ready availability and
      versatility of the tutor allowed him to be used as the principal resource, and
      did away with the need for (and the additional expense of) specially constructed
      problem-based learning units, often unavailable in most departments. The method
      is described in detail so that other clinical tutors may feel encouraged to adopt
      a similar strategy.

PMID- 2233183
TI  - The surgeon simulator.
AB  - A new technique of small group surgical teaching has been developed wherein the
      surgeon takes on the role of the patient. This technique, which incorporates
      extensive and immediate formative evaluation, has all the advantages of
      simulation techniques while avoiding the major problems of training, scheduling
      and cost. This method has been used to teach a wide variety of surgical disease
      processes with the major emphasis being teaching patient management strategies.
      Sixty-one medical students have been taught using this method and they have found
      it superior to conventional seminar teaching, particularly in the domains of
      problem solving, patient management strategies and thought provocation.

PMID- 2233184
TI  - Effectiveness of an independent sexology course for Colombian medical students.
AB  - The outcome of an independent sexology course for Colombian medical students was
      evaluated by means of the Sex Knowledge and Attitude Test (SKAT), stressing the
      'material' or 'substantial', rather than statistical, significance of changes
      after instruction. The results indicate that the course was as effective in
      producing increases in the students' sexual knowledge as previous non-independent
      courses, and as effective as them, or more, in modifying positively the students'
      sexual attitudes. These results are at variance with those of most sex education
      programmes described so far in the literature, whose effectiveness is in doubt
      due to the small magnitude of changes after instruction.

PMID- 2233185
TI  - What is ... a study guide?

PMID- 2233186
TI  - Community health staff's prejudice and knowledge about AIDS.
AB  - Health service workers' attitudes to their patients carry significant health care
      consequences. In order to investigate the relationships between health workers'
      attitudes to groups at high risk of AIDS and their knowledge of the disease and
      views on procedures for care, community health care workers and students
      completed a social distance questionnaire concerning groups defined by ethnicity,
      sexual proclivity, or illness. There was strong negativity towards individuals of
      minority sexual proclivity and AIDS high risk groups. Fear of the disease and
      ignorance of its transmission and effective care procedures increase with
      prejudice towards these groups. Analysis of their relevant prior learning
      experiences demonstrates the need for an educational programme which addresses
      the identified sources of ignorance and which also necessarily concentrates on
      the prejudices which serve as a barrier to effective patient care.

PMID- 2233187
TI  - The influence of laboratory experimental work on concept acquisition in a medical
      physiology course with implications for curriculum deliberations and
      instructional design.
AB  - Following revision of the curriculum the effectiveness of a traditional cookbook
      experiment, used in conjunction with an 'interpretation seminar', was evaluated.
      Curriculum revision had been predominantly concerned with an avoidance of
      overloading and provision of self-study periods. The preceding lectures were
      integrated with the experiment. The learning resulting from the practical
      experience was assessed using pre- and post-tests. The practical exercise was
      ineffective and did not facilitate conceptual understanding. Due to the central
      role of passive teaching methods the students adopted a surface approach to all
      learning, were teacher dependent and did not make effective use of their private
      study. Furthermore, owing to a broad-based entry into medical school many
      students lacked the basic skills essential to the achievement of meaningful
      learning. Clearly, for effective learning the curriculum and pedagogy must be
      geared to the background and educational needs of the students.

PMID- 2233188
TI  - Regulating patient flow for educational benefit in the pediatric teaching clinic:
      promoting learning through telephoned reminders.
AB  - As trends in medical care delivery shift from the inpatient to the outpatient
      setting, it is important that practices in medical education adapt accordingly.
      The environment of the teaching clinic should be warm, considerate of the needs
      of students, faculty, patients and their parents, and should allow ample time for
      discussion and independent learning. It may be difficult to cultivate such an
      environment in a medical school setting, if patient flow is uncontrolled. We
      piloted a simple program of telephone reminders for parents of children with
      appointments. Telephone reminders increased appointment compliance and improved
      the educational process.

PMID- 2233189
TI  - The child study: a multipurpose practical project in behavioural science.
AB  - This paper describes a behavioural science practical project suitable for
      preclinical medical students, in the form of a child study. The practical has low
      costs yet offers multiple benefits to students, including (a) first-hand
      exploration of the concepts of psychosocial development, (b) encouragement of
      self-directed learning and appraisal of research methodology, and (c) teaching
      and assessment of communication skills.

PMID- 2233190
TI  - J.B. Wolffe memorial lecture. Biomechanics: a bridge builder among the sport
      sciences.

PMID- 2233191
TI  - Bone mineral content of cyclically menstruating female resistance and endurance
      trained athletes.
AB  - The bone mineral content (BMC) at four sites on the axial and appendicular
      skeleton was compared among four groups of young adult (age = 17-38 yr)
      cyclically menstruating athletes (N = 40) who regularly performed either
      weightlifting resistance exercise (body builders) or nonresistance endurance
      exercise (runners, swimmers) and an inactive group of females (N = 18) of about
      equal age. Forearm BMC was measured using single photon absorptiometry at
      proximal (shaft) and distal sites on the radius. Dual photon absorptiometry was
      used to measure BMC at the lumbar vertebrae (L2-4) and femur at the femoral neck,
      Ward's triangle, and greater trochanter. Fat-free body mass (FFBM) was estimated
      from densitometry. Body builders had greater BMC than swimmers, collegiate
      runners, recreational runners, and controls. Mean differences in BMC among
      runners, swimmers, and controls were not significant (P less than or equal to
      0.05). FFBM was correlated significantly with BMC (r = 0.35-0.56) at each site in
      the combined group of athletes (N = 39), whereas total body weight and BMC were
      correlated significantly at the distal radius site (r = 0.38) only. The results
      suggest that weight training may provide a better stimulus for increasing BMC
      than run and swim training.

PMID- 2233192
TI  - Variation in bone mineral content and estimated body fat in young adult females.
AB  - This study was designed to determine whether variability in bone mineral content
      (BMC) at the lumbar vertebrae (L2-4), radius shaft (RS), femoral neck, and distal
      radius can significantly contribute to the variability observed in body density
      (Db) among 89 females (age = 25.1 +/- 5.3 yr) of varying activity levels and
      menstrual status. Theoretical differences in Db were calculated at +/- 1 and +/-
      2 standard deviations of BMC (SDBMC) for the population as well as for the
      subgroups: eumenorrheic inactive controls (C), recreational runners (RR),
      collegiate runners (CR), body builders (BB), swimmers (S), and amenorrheic
      runners (AR). Multiple regression to predict Db yielded significant coefficients
      (b) for BMC at L2-4 (b = 0.0190, P less than 0.001) and RS (b = 0.0425, P less
      than 0.01) when added separately to the sum of four skinfolds (subscapula,
      abdomen, thigh, calf). The differences in % BFHW at +/- 1 and +/- 2 SDBMC for the
      sample mean for RSBMC were +/- 1.0% and +/- 2.0%, respectively. Variability in L2
      4 contributed differences of +/- 1.3% and +/- 2.6% at +/- 1 and +/- 2 SDBMC. The
      subgroup % BFHW differences (due to L2-4 and RS combined) ranged from an average
      overestimation of 1.3% for the AR to an average underestimation of 1.4% for the
      BB. Estimated mean errors for remaining groups were less than or equal to 0.5%.
      Individual differences ranged from a 3.3% underestimation (BB) to a 3.0%
      overestimation (AR).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233193
TI  - Bone density in eumenorrheic female college athletes.
AB  - Information is limited on the effect of exercise on bone density in young
      eumenorrheic athletes. We studied 12 Caucasian intercollegiate volleyball players
      (V), nine basketball players (B), ten swimmers (S), and 13 non-athletes (N) with
      bone density measurements by photon absorptiometry of their calcaneus and lumbar
      spine (L2-L4). The effect of athletic status on bone density was analyzed by
      multivariate analysis of covariance, with height and weight as covariates. The
      bone densities reported below are mean +/- SE, adjusted for the covariates; units
      = g.cm-2, P less than 0.005. The swimmers had a significantly lower mean density
      in the lumbar spine than all other groups; the non-athletes' mean density was
      also lower than that of volleyball players (V = 1.31 +/- 0.03, B = 1.26 +/- 0.04,
      N = 1.18 +/- 0.03, S = 1.05 +/- 0.03). The volleyball and basketball players'
      mean calcaneal densities were greater than those of the swimmers and non-athletes
      (V = 0.530 +/- 0.017, B = 0.564 +/- 0.023, N = 0.438 +/- 0.018, S = 0.375 +/-
      0.019). The higher bone densities for athletes in vertical weight-bearing
      activities are consistent with some but not all published data. The swimmers' low
      bone density in the lumbar spine, less than published values for amenorrheic
      runners, was unexpected.

PMID- 2233194
TI  - Effects of menstrual phase and amenorrhea on exercise performance in runners.
AB  - There are few well controlled studies in terms of subject selection, menstrual
      classification, and exercise protocol that have examined both maximal and
      submaximal exercise responses during different phases of the menstrual cycle in
      eumenorrheic runners and compared these runners to amenorrheic runners. Thus, the
      purpose of this study was to measure selected physiological and metabolic
      responses to maximal and submaximal exercise during two phases of the menstrual
      cycle in eumenorrheic runners and amenorrheic runners. Eight eumenorrheic runners
      (29.0 +/- 4.2 yr) and eight amenorrheic runners (24.5 +/- 5.7 yr) matched for
      physical, gynecological, and training characteristics were studied. The
      eumenorrheic runners performed one maximal and one submaximal (40 min at 80%
      VO2max) treadmill run during both the early follicular (days 2-4) and midluteal
      (6-8 d from LH surge) phases. The amenorrheic runners performed one maximal and
      one submaximal (40 min at 80% VO2max) treadmill run. Cycle phases were documented
      by urinary luteinizing hormone and progesterone assays and by plasma estradiol
      and progesterone assays. No differences were observed in oxygen uptake, minute
      ventilation, heart rate, respiratory exchange ratio, rating of perceived
      exertion, time to fatigue (maximal), and plasma lactate (following the maximal
      and submaximal exercise tests) between the follicular and luteal phases in the
      eumenorrheic runners and the amenorrheic runners. We conclude that neither
      menstrual phase (follicular vs luteal) nor menstrual status (eumenorrheic vs
      amenorrheic) alters or limits exercise performance in female athletes.

PMID- 2233195
TI  - Plasma volume and renal function during and after ultramarathon running.
AB  - Plasma volume (PV) and renal function were studied in eight subjects for 3 d
      prior to and 6 d after a 56 km footrace. Immediately following the race, PV,
      creatinine clearance, and urine flow were unchanged from pre-race values. Over
      the subsequent 3 d, PV increased due initially to a 17 g influx of serum albumin
      and an associated increase in plasma sodium content, which persisted throughout
      the study period. A reduction in urine sodium secretion occurred during the race
      day. Creatinine clearance increased after the race and remained elevated for 48
      h. Increases serum enzyme activities, C-reactive protein concentration, serum
      uric acid content, and plasma creatinine concentration and production suggest
      muscle damage. We suggested the following. First, the persistent post-exercise
      plasma volume expansion is initiated by an influx of albumin into the
      intravascular space with an associated increase in plasma sodium content. A
      decrease in urine sodium excretion during the race day would contribute to the
      latter. Second, the interpretation of post-race changes in serum constituents
      must take account of changes in plasma volume. Third, there is an increase in
      creatinine clearance, indicating an increase in glomerular filtration rate, after
      both standard and ultramarathon running. This may be caused by the products of
      muscle cell damage although the physiologic mechanism for this is unclear.

PMID- 2233196
TI  - Immediate and delayed effects of marathon running on lipids and lipoproteins in
      women.
AB  - The purpose of this investigation was to examine the immediate and delayed
      effects of prolonged strenuous exercise on plasma lipid and lipoprotein
      concentrations in female runners. Venous blood samples were collected from 12
      female runners 24 h before, 10 min after, and 1, 3, and 5 d after running a 42 km
      marathon. Whole blood was analyzed for hematocrit and hemoglobin to determine
      plasma volume shifts. Plasma aliquots were assayed for total cholesterol, high
      density lipoprotein cholesterol (HDL-C), and triglyceride concentrations, while
      low-density lipoprotein cholesterol (LDL-C) was estimated. Total cholesterol
      concentrations were significantly reduced 1 d following the exercise and were
      still lower 3 and 5 d post-marathon. LDL-C was lower immediately and 1 d after
      the marathon. HDL-C concentrations, corrected for changes in plasma volume, were
      elevated 24 h post-exercise. The ratio of HDL/total cholesterol was increased 24
      h post-exercise. Triglyceride concentrations were elevated immediately following
      the marathon but returned to baseline levels by 24 h post-exercise. These results
      demonstrate that prolonged strenuous exercise in women produces changes in blood
      lipid profiles that can last for several days.

PMID- 2233197
TI  - Effects of exercise mode on muscle glycogen restorage during repeated days of
      exercise.
AB  - The purpose of this study was to examine differences in muscle glycogen storage
      during three successive days of running or cycling. In a crossover design, seven
      male subjects performed two 3-d trials of either running (trial R) or cycling
      (trial C) for 60 min at 75% VO2max. Biopsy samples were obtained before and after
      each day's exercise from the gastrocnemius (trial R) or vastus lateralis (trial
      C) muscle. Diets in the 2 d preceding and during each trial contained 5 g
      carbohydrate.kg-1.d-1 and 14,475 +/- 402 kJ.d-1. Mean pre-exercise glycogen
      content (mmol.kg-1 wet wt.) was significantly reduced in both trials on day 3
      (103.4 +/- 6.0) when compared to day 1 and day 2 (119.9 +/- 6.8 and 116.4 +/-
      5.7, respectively). Day 1 glycogen reduction was significantly greater in trial C
      (P less than 0.03), and glycogen restorage was greater (P less than 0.02) only in
      trial C between the 1st and 2nd d. On day 3, spectrophotometric analysis of PAS
      strains showed that pre-exercise glycogen content in either muscle group was
      significantly (P less than 0.01) less in Type I as compared to Type II fibers.
      This difference in fiber glycogen storage did not appear to be attributable to
      muscle damage as negligible leukocyte infiltration and low blood CK levels were
      obtained. No difference between modes were observed for CK values throughout the
      trials. These data suggest that the depressed glycogen storage before the 3rd d
      of exercise was due to the moderate carbohydrate intake.

PMID- 2233198
TI  - Changes in the protein nutritional status of adolescent wrestlers.
AB  - The protein nutritional status of adolescent wrestlers was studied to determine
      whether changes occur during a season of competition and weight loss. Subjects (N
      = 18) were measured prior to the start of the season (PRE), twice in the
      midseason, and once during late season (LATE) for weight, percent body fat, and
      height. At each of these times, a venous blood sample was obtained from the
      subjects, who were fasted, and analyzed for concentrations of albumin,
      prealbumin, retinol binding protein (RBP), blood urea nitrogen (BUN), hemoglobin,
      hematocrit, and 23 amino acids. Diet records were kept by subjects to assess
      daily energy, protein, fat, and carbohydrate intake. Data were analyzed by
      repeated measures ANOVA. Results showed that wrestlers decreased weight by an
      average of 6.6 +/- 0.9% and that percent body fat, fat-free weight, plasma levels
      of prealbumin and RBP, the ratio of total essential amino acids to total amino
      acids, and dietary energy nutrient intakes were significantly lower at LATE
      compared to PRE. RBP decreased during midseason and averaged (+/- SE) 3.21 +/-
      0.15 mg.100 ml-1 at LATE; prealbumin was significantly lower at LATE with a mean
      value of 19.8 +/- 1.0 mg.100 ml-1. Total energy intake decreased from PRE values
      by 35%, to approximately 27 kcal.kg-1.d-1 during the season. In conclusion, in
      these high school wrestlers who lost approximately 6.6% of weight, there were
      adverse effects on some of the indices of protein nutritional status.

PMID- 2233199
TI  - Strength training effects in prepubescent boys.
AB  - Possible changes in muscle size and function due to resistance training were
      examined in prepubertal boys. Thirteen boys (9-11 yr) volunteered for each of the
      training and control groups. Progressive resistance training was performed three
      times weekly for 20 wk. Measurements consisted of the following: 1 repetition
      maximum (RM) bench press and leg press; maximal voluntary isometric and
      isokinetic elbow flexion and knee extension strength; evoked isometric
      contractile properties of the right elbow flexors and knee extensors; muscle
      cross-sectional area (CSA) by computerized tomography at the mid-right upper arm
      and thigh; and motor unit activation (MUA) by the interpolated twitch procedure.
      Training significantly increased 1 RM bench press (35%) and leg press (22%),
      isometric elbow flexion (37%) and knee extension strength (25% and 13% at 90
      degrees and 120 degrees, respectively), isokinetic elbow flexion (26%) and knee
      extension (21%) strength, and evoked twitch torque of the elbow flexors (30%) and
      knee extensors (30%). There were no significant effects of training on the time
      related contractile properties (time to peak torque, half-relaxation time), CSA,
      or %MUA of the elbow flexors or knee extensors. There was, however, a trend
      toward increased MUA for the elbow flexors and knee extensors in the trained
      group. Strength gains were independent of changes in muscle CSA, and the
      increases in twitch torque suggest possible adaptations in muscle excitation
      contraction coupling. Improved motor skill coordination (especially during the
      early phase of training), a tendency toward increased MUA, and other undetermined
      neurological adaptations, including better coordination of the involved muscle
      groups, are likely the major determinants of the strength gains in this study.

PMID- 2233200
TI  - The influence of exercise intensity on heat acclimation in trained subjects.
AB  - Low-intensity exercise (less than or equal to 50% VO2max) has been demonstrated
      to produce heat acclimation (HA) in trained subjects. The purpose of this study
      was to determine whether shorter-duration, moderate-intensity exercise would also
      result in HA. Nine trained runners performed two 9-d exercise heat-stress
      protocols. Each protocol consisted of a 90-min heat tolerance test on days 1
      (HTT1) and 9 (HTT2). On days 2-8 the subjects exercised at 50% VO2max for 60
      min.d-1 (T50) or at 75% VO2max for 30-35 min.d-1 (T75). Final HTT2 heart rate and
      rectal temperature (Tr) were significantly (P less than 0.001) reduced, as
      compared to HTT1, with no differences between T50 and T75. Both protocols
      resulted in significant (P less than 0.05) reductions in HTT2 pre-exercise Tr and
      total exercising caloric expenditure, both of which are known to contribute to
      HA. No changes in resting plasma volume, osmolality, protein, post-HTT
      aldosterone, and exercising sweat rate were observed. These results demonstrate
      that equal levels of HA were obtained with T50 and T75, which suggests that
      moderate-intensity, short-duration exercise in the heat can produce HA in trained
      subjects.

PMID- 2233201
TI  - Carbohydrate-electrolyte replacement during a simulated triathlon in the heat.
AB  - Effects of a 7% carbohydrate-electrolyte drink (CE) or a flavored water placebo
      (P) on physiological function and performance were compared during a simulated
      triathlon (ST) in the heat. Ten trained male triathletes performed two STs,
      consisting of 1.5 km swimming, 40 km cycling, and 10 km running in an
      environmentally controlled area at self-selected race pace. Subjects consumed 2
      ml.kg-1 (130-174 ml) of CE or P following the swim, at 8.0-km intervals during
      cycling, and at 3.2-km intervals during running. Sweat rate, rectal and mean skin
      temperatures, perceived exertion, heart rate, plasma osmolality, percent change
      in plasma volume, total protein, Na+, K+, and lactate were similar during the ST
      under both drink conditions, but RER and plasma glucose were higher (P less than
      0.05) with CE. During the last 4 km of running, VO2 was significantly higher with
      CE. Mean run time and total ST time were faster with CE (by 1.4 and 1.2 min)
      although not significantly different (P less than 0.06 and P less than 0.10) from
      P. Subjects reported no significant difference in nausea, fullness, or stomach
      upset with CE compared to P. General physiological responses were similar for
      each drink during 2 h of multi-modal exercise in the heat; however, blood
      glucose, carbohydrate utilization, and exercise intensity at the end of a ST may
      be increased with CE fluid replacement.

PMID- 2233202
TI  - Circulatory and thermal adjustments to prolonged exercise in paraplegic women.
AB  - The circulatory and thermal responses to 90 min of wheelchair ergometer exercise
      were examined in five wheelchair dependent (WD) women with low level spinal
      dysfunction and five able-bodied (AB) women who served as a comparison group.
      Metabolic rate during exercise was 221 W for WD and 255 W for AB (P greater than
      0.05). Oral temperature (Tor), mean skin temperature (Tsk), oxygen uptake (VO2),
      heart rate (HR), and cardiac output (Qc) were assessed periodically throughout
      the exercise period. Ambient conditions were 24-25 degrees C and 38-52% relative
      humidity. A significant group X time interaction was found for Tor (P less than
      0.001) and Tsk (P less than 0.001). Tor of the WD group steadily increased during
      the exercise, whereas the AB group showed a stable Tor. Tsk of WD increased
      rapidly during the first 5-10 min of exercise and continued to rise at a slower
      rate throughout the exercise. In contrast, Tsk of AB rose to a peak during the
      first 10 min and then showed a decreasing trend. VO2 and HR remained stable in
      both groups throughout the exercise period. Following an initial increase in Qc
      from minute 10 to minute 20 in both groups, values for WD continually decreased
      until Qc at 80 min was 14% lower than at 10 min. The findings suggest that the WD
      women had greater thermoregulatory strain than the AB women as indicated by a
      higher Tor and Tsk and by an inability to maintain Qc due to paralysis of the
      lower limbs and perhaps an increase in cutaneous blood volume.

PMID- 2233203
TI  - Body temperature rhythm and response to pyrogen in exercising and sedentary
      hamsters.
AB  - In this study, we tested the hypothesis that daily voluntary exercise results in
      a chronic elevation in core temperature in the female golden hamster. Temperature
      and activity were measured by biotelemetry. Hamsters ran 6-7 km per night (12:12
      L:D) when permitted access to wheels. No running occurred during the light
      periods. During the 3rd wk of running, temperatures of exercising hamsters were
      significantly elevated by 0.5 degree C (P less than 0.001) during the dark period
      and by 0.3 degree C (P less than 0.003) during the light period compared with
      sedentary hamsters. Cessation of running removed the difference between groups,
      and resumption of running restored it. Both the injection of endotoxin and the
      psychological stress of cage switch resulted in similar peak temperatures in
      exercising and sedentary hamsters despite higher pre-treatment temperatures in
      the exercise group. We interpret these results to support the hypothesis that
      regular exercise may cause an upward resetting of the set-point for body
      temperature.

PMID- 2233204
TI  - Daily pattern of %VO2max and heart rates in normal and undernourished school
      children.
AB  - The pattern of usage of the VO2max, expressed as %VO2max during ordinary school
      days, with minute-by-minute heart rate recording, was studied in 106 boys and 83
      girls, 6-16 yr of age divided into three age groups (6-8, 10-12, and 14-16 yr),
      living under economically deprived conditions in Colombia and classified as
      nutritionally normal or marginally malnourished. In a 12-h period, the 12 groups
      of children spent, on the average, 7-10 h at less than 30% VO2max, 1.5-4 h at 30
      50% VO2max, and an accumulated time of 20-60 min above 50% VO2max. The latter
      occurred in short bursts rather than during sustained periods. There was a
      statistically significant but small decrease (approximately -3%) in the average
      12 h %VO2max with age but no effects of sex or nutritional status. The overall
      average was about 25% VO2max in all groups. The data may suggest the existence of
      the regulation of physical activity to some level easily sustainable for long
      periods. Expressing the data as 30 min averages during 5 h of school and 5 h of
      free-time activity allows for the possibility of seeing group differences during
      shorter periods of time. This may prove useful in exercise training programs and
      studies of effort in the workplace.

PMID- 2233205
TI  - Cross-modal exercise prescription at absolute and relative oxygen uptake using
      perceived exertion.
AB  - Cross-modal exercise prescription at absolute and relative oxygen uptake using
      perceived exertion. Med. Sci. Sports Exerc., Vol. 22, No. 5, pp. 653-659, 1990.
      The validity of cross-modal prescription of exercise intensity based on rated
      perceived exertion (RPE) was determined for eight men (26 +/- SE 1.9 yr) at
      absolute and relative VO2. Exercise modes were treadmill (TM), cycle ergometer
      (C), and bench stepping while pumping 0.91 kg handweights (HB). Relative (Rel)
      constant load sessions were performed for each mode at 70% of mode-specific VO2
      peak. Absolute (Absol) constant load sessions were performed for C and HB at the
      VO2 equivalent to 70% of TM VO2 peak. The five 12 min sessions were presented on
      separate days in random order. RPE-Overall during TM-Rel (11.1) was a) lower (P
      less than 0.05) than C-Absol (12.6) and HB-Absol (12.5) and b) the same as C-Rel
      (11.3) and HB-Rel (10.7). RPE-Legs during TM-Rel was a) lower (P less than 0.05)
      than C-Absol and HB-Absol and b) the same as C-Rel and HB-Rel. RPE-Chest a) did
      not differ between TM-Rel and C-Absol or HB-Absol and b) was lower (P less than
      0.05) for C-Rel and HB-Rel than TM-Rel. RPE-Arms was higher (P less than 0.05)
      for C-Absol, HB-Absol, and HB-Rel than TM-Rel but did not differ between TM-Rel
      and C-Rel. Oxygen uptake, heart rate, and ventilation during TM-Rel were a) the
      same as C-Absol and HB-Absol and b) higher (P less than 0.05) than C-Rel and HB
      Rel. Perceptually based cross-modal prescription of exercise intensity using a
      psychophysical estimation method is valid provided that the physiological
      reference is the relative, not the absolute, VO2.

PMID- 2233206
TI  - Mechanical output about the ankle joint in isokinetic plantar flexion and
      jumping.
AB  - The purpose of this study was to compare for a group of ten subjects the
      mechanical output about the ankle during isokinetic plantar flexion with that
      during one-legged vertical jumps. For evaluation of the mechanical output the
      plantar flexion moment of force was related to the angular velocity of plantar
      flexion. The relationship for isokinetic plantar flexion was obtained using an
      isokinetic dynamometer; that for plantar flexion in jumping was obtained by
      combining kinematics and ground reaction forces. It was found that, at any given
      angular velocity of plantar flexion above 1 rad.s-1, the subjects produced much
      larger moments during jumping than during isokinetic plantar flexion. In order to
      explain the observed differences in mechanical output about the ankle, a model
      was used to simulate isokinetic plantar flexion and plantar flexion during
      jumping. The model represented both m. soleus and m. gastrocnemius as a complex
      composed of elastic tissue in series with muscle fibers. The force of the muscle
      fibers depended on fiber length, shortening velocity (Vfibers), and active state.
      The input variables of the model were histories of shortening velocities of the
      complexes, determined from kinematics, and active state. Among the output
      variables were Vfibers and plantar flexion moment. The simulation results were
      very similar to the experimental findings. According to the simulation results
      there are two reasons why at the same angular velocity of plantar flexion larger
      moments were produced during jumping than during isokinetic plantar
      flexion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233207
TI  - Stance phase knee and ankle kinematics and kinetics during level and downhill
      running.
AB  - To study possible mechanisms for muscle soreness in downhill running, ground
      reaction force and kinematic data were collected on seven male runners during 4.5
      m.s-1 level running (LR) and 8.3% downhill grade running (DR). For DR, a force
      platform was mounted on a sloped concrete block flush with the surface of a ramp.
      A two-dimensional link segment model was used to calculate net stance phase
      moments for the knee and ankle. Data were averaged over all subjects for each
      condition. There was no significant difference (P less than 0.05) between DR and
      LR for peak flexion velocity, peak extensor moment, or peak power absorption at
      the knee. Negative work done on the extensor muscles of the knee during stance
      was significantly greater for DR (58.0 +/- 13 J) than for LR (30.0 +/- 9.0 J).
      Peak ankle power absorption was significantly greater for DR (619 +/- 85 W) than
      for LR (396 +/- 180 W). The negative work done on the extensor muscles of the
      ankle during stance was significantly greater for DR (26.1 +/- 3.2 J) than for LR
      (12.6 +/- 6.6 J). The results suggest that muscle soreness during DR may be
      related to high peak power absorption values since the peak joint extensor
      moments are similar between conditions.

PMID- 2233208
TI  - The health belief model: predicting compliance and dropout in cardiac
      rehabilitation.
AB  - We investigated the health belief model and the health locus of control
      constructs as predictors of group membership (compliers or dropouts) with cardiac
      rehabilitation and whether they added predictive utility to routinely assessed
      patient demographics and health behaviors. Questionnaires were completed on entry
      into the study by 120 patients with coronary artery disease, and by the end of
      the 6 month program there were 58 compliers and 62 dropouts. Discriminant
      function analyses were carried out to determine prediction of group membership.
      The health belief model predicted group membership 64.6% of the time, explaining
      5.2% of the variance. Demographics, health behaviors, and health belief model
      factors accounted for 21.1% of the variance between compliers and total dropouts
      with group membership correctly predicted 74.4% of the time; avoidable and
      unavoidable dropout was correctly predicted 84.2% of the time with 56.9% of the
      variance explained. Health locus of control did not distinguish between compliers
      and dropouts. The addition of the health belief model provided additional
      information about compliance with cardiac rehabilitation beyond that explained by
      demographic and health behavior variables alone, particularly when predicting
      avoidable/unavoidable dropout.

PMID- 2233209
TI  - The accuracy of self-reports of physical activity.
AB  - This investigation determined the accuracy of self-reports of physical activity
      compared to observations obtained surreptitiously. Subjects were 44 adults
      engaged in 1 h of their preferred physical activity while actual activity levels
      were surreptitiously obtained and compared to immediate self-reported estimates
      of physical activity. Results indicated that subjects were moderately accurate in
      recalling their physical activity levels (R = 0.62) but underestimated sedentary
      activities and overestimated aerobic activities by over 300%. Males overestimated
      their activity relative to females, and obese subjects underestimated their
      activity levels compared to normal-weight subjects. Finally, a number of two-way
      interactions that moderated the accuracy of those subjects engaging in high
      chronic levels of physical activity were observed.

PMID- 2233210
TI  - The Caltrac accelerometer as a physical activity monitor for school-age children.
AB  - The performance of the Caltrac accelerometer was studied in elementary school-age
      children under field and laboratory conditions. In Study 1, 35 children (20 boys,
      15 girls, mean age = 10.8 yr) wore the accelerometer and a heart rate (HR)
      monitor for 2 d. Caltrac activity counts per hour were compared to the mean
      "activity HR", which was calculated by subtracting the mean of the five lowest
      HRs of the day from each recorded HR. Pearson r's between accelerometer and
      activity HR were 0.54 (P less than 0.001) on day 1 and 0.42 (P less than 0.02) on
      day 2. Inter-instrument reliability in the field was r = 0.96. Both accelerometer
      and HR data were significantly correlated with physical activity recalls of the
      same day. In Study 2, 15 children walked/ran for 10 min at 3, 4, and 5 mph on a
      horizontal treadmill while wearing two accelerometers. Oxygen uptake was directly
      measured each minute. Reliability of the Caltracs in the laboratory was 0.89.
      Activity count correlated r = 0.82 (SEE = 23%) with net calorie cost per kg of
      body weight. Net caloric expenditure per kg of weight was 0.101 kcal.kg-1.d-1 per
      Caltrac activity count. These data support the use of the Caltrac accelerometer
      as a physical activity measure for school-age children, and the objective data
      tended to corroborate the children's short-term activity recalls.

PMID- 2233211
TI  - Accurate prediction of VO2max in cycle ergometry.
AB  - Numerous equations exist for predicting VO2max from the duration (an analog of
      maximal work rate, Wmax) of a treadmill graded exercise test (GXT). Since a
      similar equation for cycle ergometry (CE) was not available, we saw the need to
      develop such an equation, hypothesizing that CE VO2max could be accurately
      predicted due to its more direct relationship with W. Thus, healthy, sedentary
      males (N = 115) and females (N = 116), aged 20-70 yr, were given a 15 W.min-1 CE
      GXT. The following multiple linear regression equations which predict VO2max
      (ml.min-1) from the independent variables of Wmax (W), body weight (kg), and age
      (yr) were derived from our subjects: Males: Y = 10.51 (W) + 6.35 (kg) - 10.49
      (yr) + 519.3 ml.min-1; R = 0.939, SEE = 212 ml.min-1. Females: Y = 9.39 (W) + 7.7
      (kg) - 5.88 (yr) + 136.7 ml.min-1; R = 0.932, SEE = 147 ml.min-1 Using the 95%
      confidence limits as examples of worst case errors, our equations predict VO2max
      to within 10% of its true value. Internal (double cross-validation) and external
      cross-validation analyses yielded r values ranging between 0.920 and 0.950 for
      the male and female regression equations. These results indicate that use of the
      equations generated in this study for a 15 W.min-1 CE GXT provides accurate
      estimates of VO2max.

PMID- 2233212
TI  - Genucom knee analysis system: reproducibility and database development.
AB  - The Genucom is a relatively new computerized system that performs a
      multidimensional analysis of knee laxity. Therefore, the purposes of the present
      investigation were twofold: 1) to estimate the reproducibility of the testing
      system in its ability to obtain similar test values on the same test subject
      within a back-to-back two-test protocol and 2) to develop a database of normal
      values as a standard against which values of suspected ligament injury can be
      compared to reliably determine whether, in fact, ligament injury has occurred. In
      the reproducibility phase of the study, 20 subjects were tested in two trials
      each of eight tests, yielding 20 separate test values per trial, accounting for
      each angle of flexion and plane of force tested. Both legs were tested, providing
      an N of 40. Test-retest correlations of the two trials and dependent t-tests
      indicated that the Genucom provided generally stable and reproducible results. In
      the normal value database phase of the study, 218 different subjects were given
      one trial of the same eight tests. Testing of both legs provided an N greater
      than 400. Means and standard deviations were calculated for each test.

PMID- 2233213
TI  - A simulation of speed skating performances based on a power equation.
AB  - Using kinetics of aerobic and anaerobic power production as measured during
      supramaximal bicycle tests of five speed skaters of international level, a model
      of the kinetics of power production during skating is obtained. Velocity time
      courses of a generalized speed skater were calculated for all Olympic distances
      (500 m, 1000 m, 1500 m, 5000 m, and 10,000 m) by means of simulation of an
      equation of produced power, power dissipated to air and ice friction, and rate of
      change of kinetic energy of the skater. Different strategies of distribution of
      anaerobic energy during a race were compared. With a single equation it appeared
      to be possible to simulate the mean split and final times of the five distances
      realized during the Winter Olympics 1988 within an error which does not exceed
      1.6% (mean error in final times: 0.8%). The results show that a fast acceleration
      (high initial power output) is crucial for the sprinting events (500 m and 1000
      m). It is shown that this initial power output level is even more important than
      the total amount of energy available for a 500 m and 1000 m race. For the long
      distances the simulations show that skaters should combine a fast but short
      lasting start with a constant power output following the start in order to
      minimize air frictional losses.

PMID- 2233214
TI  - Anthropometric estimation of muscle mass in men.
AB  - Twelve male cadavers (aged 50-94 yr) were subjected to comprehensive
      anthropometry, dissection, and weighing of all skeletal muscle. Correlation
      coefficients of limb girths with total skeletal muscle mass (MM) were high:
      forearm r = 0.96, mid-thigh r = 0.94, calf r = 0.84, and midarm r = 0.82. These
      increased when limb girths were corrected (by subtracting pi times the skinfold
      thickness) to estimate muscle girth. For dimensional consistency, variables in
      the regression analyses included the product of stature and the square of each
      corrected girth. For the six unembalmed cadavers, this yielded a three-girth
      equation for MM (r2 = 0.93; SEE = 1.56 kg), which was then validated using data
      from the embalmed cadavers. It predicted MM with an SEE of 1.58 kg and r2 = 0.93.
      Because the values of these SEEs were similar, we pooled the subjects from the
      two groups to generate the final estimation equation: MM = STAT (0.0553CTG2 +
      0.0987FG2 + 0.0331CCG2) - 2445 (SEE = 1.53 kg, r2 = 0.97), where STAT is stature
      (cm), CTG is thigh circumference corrected for the front thigh skinfold thickness
      (cm), FG is the uncorrected forearm circumference (cm), and CCG is the calf
      circumference corrected for the medial calf skinfold thickness (cm). Despite the
      limitations of the cadaver sample, the proposed equation appears to provide the
      best estimate of skeletal muscle mass to date, in that it is the only cadaver
      validated equation and it gives values that are consistent with all known
      dissection data.

PMID- 2233215
TI  - In vivo NMR spectroscopy of lithium-7 in humans.
AB  - The pharmacokinetics of lithium uptake was measured by 7Li NMR spectroscopy at
      24.83 MHz in vivo in the brain and muscle of a normal subject and a patient
      suffering from bipolar affective disorder, using a modified General Electric
      Signa clinical magnetic resonance imaging system. Comparison was made to standard
      phantoms to estimate Li concentrations. The levels of Li in brain and muscle were
      similar, were typically less than the level in serum, and generally tracked the
      level in serum. The Li level at steady state in the brain of a patient suffering
      from schizoaffective disorder was measured over a 7-month period. Substantial
      variation was seen, which showed some correlation with serum level. Serum level
      peaked about 2 h after a single 300-mg dose at steady state, and muscle level,
      immediately thereafter. Brain level peaked considerably later at 4 h. Localized
      in vivo 7Li NMR spectroscopy was demonstrated by acquisition of a 125-cm3 DRESS
      slice from the occipital region in less than 7 min.

PMID- 2233216
TI  - Application of interlaced orientation slices in orthogonal planes for system
      characterization and as a basis for standardized brain sections in multiple
      oblique positions.
AB  - Interlaced acquisition of orthogonal spin-echo orientation slices yields
      saturated intersection lines, which are available for a system characterization
      (spatial distortions, slice thickness, chemical shift displacement).
      Additionally, these scout images contain complete information for a
      transformation of the gradient coordinate system into the oblique coordinate
      system of the patient, bearing standardized planes for improved image
      interpretation and quantitative examinations.

PMID- 2233217
TI  - Aortoiliac and femoropopliteal phase-based NMR angiography: a comparison between
      FLAG and RSE.
AB  - To assess the performance of FLAG and RSE NMR angiography 22 aortoiliac (AI) and
      22 femoropopliteal (FP) angiograms in 11 healthy males, mean age 38 +/- 7.6
      years, were acquired. The image quality was graded in a blinded fashion by two
      independent readers. The readers grades were not statistically different (kappa =
      0.5696). The representation of diagnostic images was 6/11 FLAG and 8/11 RSE AI as
      well as 8/11 FLAG and 8/11 RSE FP. On back-to-back comparison six RSE AI and
      seven RSE FP were graded better than their FLAG counterparts. Although these
      differences did not achieve a statistical significance RSE NMR angiography
      provided consistently better images and appears preferable for imaging of the
      peripheral vascular system in normal subjects.

PMID- 2233218
TI  - NMR imaging in the earth's magnetic field.
AB  - The most important and very expensive part of a magnetic resonance imaging set-up
      is the magnet, which is capable of generating a constant and highly homogeneous
      magnetic field. Here a new MR imaging technique without the magnet is introduced.
      This technique uses the earth's magnetic field instead of a magnetic field
      created by a magnet. This new method has not yet reached the stage of medical
      application, but the first images obtained by MRIE (magnetic resonance imaging in
      the earth's field) show that the resolution is close to that expected based on
      sensitivity estimations.

PMID- 2233219
TI  - An apparatus for applying a mechanical massage to rat hearts inside a wide-bore
      NMR spectrometer.
AB  - A device for applying mechanical massage to the isolated perfused rat heart
      inside a wide-bore NMR spectrometer was developed. This device exerts a squeezing
      pressure on a fibrillating heart placed inside a NMR spectrometer without
      interfering with the NMR measurements. It appears that the apparatus is important
      for obtaining reliable results in the postischemic reperfusion period.

PMID- 2233220
TI  - Cooperative T1 and T2 effects on contrast using a new driven inversion spin-echo
      (DISE) MRI pulse sequence.
AB  - A pulse sequence is presented for obtaining a single image with combined T1/T2
      weighting. T2 relaxation is made to increase intensity, in cooperation with the
      effect of T1 relaxation, by providing T2 weighting with a 90 degrees-180 degrees
      90 degrees driven inversion pulse triplet in an inversion recovery method. Unlike
      the inversion spin-echo method having a short inversion time (TI), signals in the
      new driven inversion spin-echo (DISE) method need not be negative and the most T1
      sensitive region of the recovery curve can be used. Selecting sensitivity to one
      relaxation time does not degrade the sensitivity to the other relaxation time. T1
      sensitivity is thus extended to longer echo times (TE intervals). T2 sensitivity
      is extended to longer TI intervals, and the combined T1/T2-weighted technique
      with intermediate TE and TI has highly cooperative and near-maximal T1 and T2
      effects on contrast. Intensity is not multiplicatively degraded by T1 and T2
      weighting so that the signal-to-noise of the combined T1/T2-weighted method is
      high. High intensity and T1 and T2 cooperatively occur for a much wider range of
      relaxation times, and especially for images heavily weighted to the pathologic
      intermediate and long T1 and T2 regime.

PMID- 2233222
TI  - Rapid radiofrequency calibration in MRI.
AB  - A collection of modified procedures for setting rf transmitter levels using a
      three-pulse sequence is described. Based on a geometrically weighted ratio of
      four signals, an estimate of the flip angle is calculated and used for an
      updating prescription. These techniques are designed to perform rapidly yet
      eschew systematic errors due to relaxation during the pulse sequence.

PMID- 2233221
TI  - Signal-to-noise in phase angle reconstruction: dynamic range extension using
      phase reference offsets.
AB  - The dynamic range of phase-reconstructed magnetic resonance images is compared to
      that of magnitude-reconstructed images. From analysis of propagation of errors,
      the phase angle noise is phase-independent and given in radians by sigma
      ([I])/[I], the noise-to-signal ratio of the corresponding magnitude-reconstructed
      image. As the phase can range from minus pi to pi, the phase angle dynamic range
      is 2 pi times that of the signal magnitude. These results agree with experiment,
      verifying that the noise in the two receiver channels is uncorrelated. An
      artifact-free technique is presented for correcting phase spillover, which
      further extends the phase angle dynamic range. The reconstruction-based reference
      phase is adjusted on a local basis so that the boundary of phase wraparound is
      reconstructed near the center of the [- pi, pi] interval. For a particular flow
      study, the phase signal-to-noise was extended over twofold by spillover
      correction, to a value 15 times that of the magnitude signal-to-noise.

PMID- 2233223
TI  - The effect of cardiopulmonary bypass on brain and heart metabolism: a 31P NMR
      study.
AB  - The development of a large animal preparation using 31P nuclear magnetic
      resonance (NMR) spectroscopy for the study of cerebral and myocardial metabolism
      during cardiopulmonary bypass (CPB) is reported. The effect of normothermic CPB
      on myocardial and cerebral metabolism was evaluated. Adolescent sheep were used
      which have low levels of 2,3-diphosphoglycerate, a compound which can interfere
      with the calculation of intracellular pH and inorganic phosphate content. CPB was
      performed using standard procedures modified for the presence of a high magnetic
      field and limited access to the animal. High quality 31P NMR data were obtained
      from the brains and hearts of these animals before and during normothermic CPB.
      These results demonstrate that the initiation of normothermic CPB does not change
      high energy phosphate levels or intracellular pH. In particular, the decreased
      myocardial oxygen demand associated with CPB is not associated with improvement
      in the levels of adenosine triphosphate or phosphocreatine. The measurements of
      energy metabolism and intracellular pH of the brain and heart during CPB were
      possible within the constraints of the NMR experiment without compromising the
      CPB procedure. Combining NMR and CPB techniques permits future studies of
      cerebral and myocardial metabolism, especially those relating to ischemia.

PMID- 2233224
TI  - Application of reverse-DEPT polarization transfer pulse sequence to study the
      metabolism of carbon-13-labeled substrates in perfused organs by 1H NMR
      spectroscopy.
AB  - Metabolism of 13C-enriched metabolites can be advantageously studied by reverse
      polarization transfer methods. In this work an improved reverse-DEPT sequence has
      been applied for the first time on perfused organs in a 20-mm probe. The
      metabolic fate of 99% enriched [2-13C]acetate perfused in excised rat liver and
      heart has been documented.

PMID- 2233225
TI  - In vitro 31P NMR spectroscopy of the reproductive organs of the male rat: an
      improved preparation method.
AB  - In vitro 31P spectroscopy can be applied to disentangle the broad resonances in
      in vivo 31P NMR spectra of the reproductive organs of the male rat. However,
      adenosinetriphosphate (ATP) and glycerophosphocholine (GPC), present in large
      amounts in vivo, are nearly completely absent in vitro. With a modified PCA
      extraction method, in which the organs were lyophilized before extraction, a
      large amount of ATP and GPC could be found in vitro. This new extraction method
      is probably not only restricted to in vitro analysis of the testis but is likely
      to be useful for analysis of other organs such as kidney and liver.

PMID- 2233226
TI  - High-speed line scan MR angiography.
AB  - We describe a system which forms MR angiographic images at high speed. Multiple
      axial sections are imaged sequentially using a 2DFT GRASS sequence with TR/TE
      50/15 ms, 64 phase encodings per image. Reconstruction and projection of each
      image are performed immediately (within 220 ms) after data for that image are
      acquired. The projection angiogram is constructed line by line as the scan
      progresses, thereby totally eliminating any additional time required for
      reconstruction and projection.

PMID- 2233227
TI  - A simple method of generating variable T1 contrast images using temporally
      reordered phase encoding.
AB  - A rapid method of generating T1 images by means of an inversion pulse followed by
      a fast low-angle imaging experiment is presented. The T1 contrast is manipulated
      by a temporal reordering of the phase-encoding gradient, resulting in an almost
      completely free choice of T1 contrast, without any extra restriction on the size
      of the data acquisition matrix. The intrinsic rapidity of the sequence renders it
      insensitive to motion artifacts and lends itself to multipoint T1 calculations.
      The method is particularly well suited to high-field imaging.

PMID- 2233229
TI  - Multislice snapshot FLASH using SIMUSIM.
AB  - A combination of the SIMUSIM technique and snapshot FLASH which allows efficient
      multislice snapshot FLASH imaging is described. Simultaneously acquired images of
      deliberate slice position and thickness are obtained with an increased SNR
      compared to standard time sequential multislice experiments. Experimental results
      show four coronal cross sections through the human head measured in four
      acquisitions.

PMID- 2233228
TI  - 1H MR imaging of anatomical compartments within the finger flexor muscles of the
      human forearm.
AB  - Fast T2-weighted 1H MRI following exercise allows investigation of the location
      of muscle fiber activity within skeletal muscle. Using this method, we have
      demonstrated that the finger flexor muscles of the human forearm consist of
      anatomical compartments, located at various depths, which are involved
      individually in flexion of the index, middle, or ring and little fingers. The
      results of this study indicate that the exercise protocol in 31P MRS studies of
      the finger flexor muscles of the human forearm, in which a small surface coil is
      used for detection, should be carefully reviewed.

PMID- 2233230
TI  - A chronic granulomatous syndrome of unknown origin.
AB  - A small clinically distinct group of patients with widespread tissue granulomata
      are described. The principal presenting symptoms are malaise, fever, and weight
      loss, although a wide variety of complaints are documented. Pulmonary involvement
      is uncommon. The granulomata are noncaseating with a few multinucleate giant
      cells and some surrounding chronic inflammatory infiltrate. There is no evidence
      of an associated arteritis. The disease has a relapsing and remitting course and
      although it may require treatment with immunosuppressive drugs, particularly if
      the kidneys are involved, the prognosis is relatively good. We propose that this
      entity be called granulomatous syndrome of unknown origin. The characteristics
      that set this syndrome apart from the other granulomatous vasculitides are
      discussed. The current limited understanding of granuloma formation does not
      allow us to propose a definite etiology for this condition. It is emphasized that
      it is not helpful to encompass it within a label of sarcoidosis. First, it may
      only serve to confuse the doctor in assessing and treating this very particular
      group of patients. Secondly, it may hinder future attempts to understand the
      different pathogenetic mechanisms underlying the various conditions in which
      granulomata may arise.

PMID- 2233231
TI  - Pancreaticopleural fistula. Report of 7 patients and review of the literature.
AB  - Pancreaticopleural fistula is an uncommon clinical condition. Its presentation is
      often confusing because of the paucity of clues suggestive of pancreatic disease
      and the preponderance of pulmonary symptoms and signs. Most patients are
      alcoholics but only one-half will have a clinical history of previous
      pancreatitis. Pleural effusions are large, recurrent, and highly exudative in
      nature. Many patients go through extensive pulmonary evaluation before the
      pancreas is identified as the site of primary pathology. An elevated serum
      amylase may be the first clue to the diagnosis. However, the key to the diagnosis
      is a dramatically elevated pleural fluid amylase. Effusions in association with
      acute pancreatitis, esophageal perforation, and thoracic malignancy are important
      to consider in the differential diagnosis of an elevated pleural fluid amylase
      but are usually easy to exclude. Computed tomography is excellent in defining
      pancreatic abnormalities and should be the first abdominal imaging study in
      suspected cases. Endoscopic retrograde cholangiopancreatography (ERCP) is used as
      a diagnostic tool only in confusing cases. Although no systematic study evaluates
      medical versus surgical therapy, we recommend an initial 2 to 4-week trial of
      medical therapy, including allowance of no oral intake, total parenteral
      nutrition, chest tube thoracostomy, and possibly a regimen of somatostatin or its
      analogs. The major complication in these patients is superinfection, which
      results in significant morbidity and mortality. Failure of medical therapy should
      be considered failure of pleural effusion(s) to clear, recurrence after
      reinstatement of oral intake, or superinfection. For those patients who fail to
      benefit from medical therapy, surgery is indicated.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2233232
TI  - Primary central nervous system lymphoma in patients with and without the acquired
      immune deficiency syndrome. A retrospective analysis and review of the
      literature.
AB  - Twenty-two cases of PCL were reviewed, in which 9 patients had AIDS and 13 did
      not. A review of the literature identified 247 cases of AIDS-related PCL.
      Differences between patients with AIDS and immunocompetent PCL were noted in our
      series. AIDS-related PCL when compared to non-AIDS PCL in our series has the
      following notable clinical features: 1) significantly younger age at
      presentation, median age 34 versus 59 years; 2) significantly higher incidence of
      B symptoms, 44% versus 8%; 3) worse median performance status at presentation, 3
      versus 1; and, 4) shorter median survival, 3 versus 10 months. Differences in
      performance status and survival, however, were not significant. AIDS-related PCL
      is further characterized by frequent (44%) ring-enhancing mass lesions on head CT
      scan, a finding that makes it clinically difficult to distinguish from
      toxoplasmosis. Median survival appears to be improved in the absence of
      opportunistic infection at time of diagnosis of PCL, 6 versus 2 months. The
      therapeutic approach to patients with PCL, with and without AIDS, is variable.
      Combined modality therapy may improve the survival in patients with non-AIDS PCL.
      Therapy for patients with AIDS-related PCL is tailored to the status of the
      individual and it is, therefore, difficult to make comparisons to non-AIDS PCL
      patients. AIDS patients are often too ill to tolerate aggressive surgery or
      systemic treatment and in this instance, radiotherapy alone may be an acceptable
      alternative. Nonetheless, overall survival for patients with AIDS-related and non
      AIDS PCL remains poor.

PMID- 2233235
TI  - [Occupational medicine in the XXI century--the role and tasks of the Institute of
      Occupational Medicine in Lodz].
AB  - The article presents strategy and goals of study program in occupational health
      for the years 1991-1995. Five strategy lines and corresponding to them goals have
      been determined. These are: (1) Development and implementation of detailed
      programmes for preventing the main occupational and work-related diseases causing
      the substantial social-economic losses to limit health effects induced by
      occupational exposure; (2) Development, integration and improvement of chemical
      safety system to limit environmental exposure to chemicals and to reduce health
      consequences due to living and working environment pollution with chemicals; (3)
      Development and implementation of methods of psychophysical effort load
      evaluation, methods of proper vocational selection and principles of preventive
      action to limit work strenuosness and changes in health status induced by process
      and organization of work; (4) Increasing the effectiveness and extension of
      health care and preventive activities for national economy workers; (5)
      Development and practical implementation of modern programmes of training in
      occupational health (under- and postgraduate) together with preparing didactic
      aids and scientific-technical information. The last line of study programme will
      be preceded by discussion taking into account the currently available financial
      means and scientific facilities.

PMID- 2233233
TI  - Disseminated histoplasmosis in the acquired immune deficiency syndrome: clinical
      findings, diagnosis and treatment, and review of the literature.
AB  - Histoplasmosis is a serious opportunistic infection in patients with AIDS, often
      representing the first manifestation of the syndrome. Most infections occurring
      within the endemic region are caused by exogenous exposure, while those occurring
      in nonendemic areas may represent endogenous reactivation of latent foci of
      infection or exogenous exposure to microfoci located within those nonendemic
      regions. However, prospective investigations are needed to prove the mode of
      acquisition. The infection usually begins in the lungs even though the chest
      roentgenogram may be normal. Clinical findings are nonspecific; most patients
      present with symptoms of fever and weight loss of at least 1 month's duration.
      When untreated, many cases eventually develop severe clinical manifestations
      resembling septicemia. Chest roentgenograms, when abnormal, show interstitial or
      reticulonodular infiltrates. Many cases have been initially misdiagnosed as
      disseminated mycobacterial infection or Pneumocystis carinii pneumonia. Patients
      are often concurrently infected with other opportunistic pathogens, supporting
      the need for a careful search for co-infections. Useful diagnostic tests include
      serologic tests for anti-H. capsulatum antibodies and HPA, silver stains of
      tissue sections or body fluids, and cultures using fungal media from blood, bone
      marrow, bronchoalveolar lavage fluid, and other tissues or body fluids suspected
      to be infected on clinical grounds. Treatment with amphotericin B is highly
      effective, reversing the clinical manifestations of infection in at least 80% of
      cases. However, nearly all patients relapse within 1 year after completing
      courses of amphotericin B of 35 mg/kg or more, supporting the use of maintenance
      treatment to prevent recurrence. Relapse rates are lower (9 to 19%) in patients
      receiving maintenance therapy with amphotericin B given at doses of about 50 mg
      weekly or biweekly than with ketoconazole (50-60%), but controlled trials
      comparing different maintenance regimens have not been conducted. Until results
      of such trials become available, our current approach is to administer an
      induction phase of 15 mg/kg of amphotericin B given over 4 to 6 weeks, followed
      by maintenance therapy with 50 to 100 mg of amphotericin B given once or twice
      weekly, or biweekly. If results of a prospective National Institutes of Allergy
      and Infectious Disease study of itraconazole maintenance therapy document its
      effectiveness, alternatives to amphotericin B may be reasonable.

PMID- 2233234
TI  - Extrapulmonary pneumocystosis: clinical features in human immunodeficiency virus
      infection.
AB  - Pneumocystis carinii infection is reported with increasing frequency as a cause
      of disease outside of the respiratory tract in patients with human
      immunodeficiency virus (HIV) infection. Extrapulmonary pneumocystosis is not
      limited to patients in any discrete risk group for HIV infection. Patients with
      HIV infection who develop extrapulmonary pneumocystosis frequently do not have
      concurrent P. carinii pneumonia. Signs and symptoms of extrapulmonary
      pneumocystosis are nonspecific but when present are frequently referable to the
      tissues or organs involved. Extrapulmonary pneumocystosis can be diagnosed by
      examination of tissue biopsies from affected sites using standard histologic
      techniques. Therapy with antimicrobial agents used to treat P. carinii pneumonia
      has been effective in some patients. An association between use of aerosolized
      pentamidine for prevention of P. carinii pneumonia and development of
      extrapulmonary pneumocystosis has been suggested but remains unconfirmed. Other
      factors such as the use of zidovudine and duration of immunodeficiency may also
      be important to the pathogenesis of extrapulmonary pneumocystosis. Further
      studies are needed to better identify risk factors that may predispose patients
      to the development of extrapulmonary pneumocystosis.

PMID- 2233236
TI  - [Diseases of the upper respiratory tract in furniture industry workers].
AB  - A group consisting of 100 cabinet-makers (at average age of 44.6 +/- 12.8 years)
      employed at furniture manufacturing plants exposed to wood dust at concentrations
      exceeding several times (from 7 to 8 times) the hygienic standard was subject to
      examination. The higher, as compared to the data for general population,
      prevalence of chronic rhinitis , pharyngitis, laryngitis--among other--atrophic
      rhinitis and pharyngitis which occurred in 37% of examined population, increasing
      together with prolonging period of exposure was found. At the same time there
      have not been found any cases of allergy, nasal or nasal sinuses neoplasms which
      could be a result of exposure to wood dust.

PMID- 2233237
TI  - [Olfactory adaptation as a factor limiting the warning role of odors].
AB  - Threshold concentrations of olfactory sensation of odorants change due to
      adaptation to polluted atmosphere. The study was aimed at determination of
      trimethylamine and n-butanol threshold concentrations of olfactory sensation
      under standard laboratory conditions. The results were analysed from two
      viewpoints: the role of odour as a warning against chemical hazard, a possibility
      of using the shift of sensation threshold of appropriately selected reference
      standards as a measure of discomfort created by odours in working environment.

PMID- 2233238
TI  - [Evaluation of the status of nasal mucosa in workers engaged in the production of
      chlorfenvinphos (enolophos)].
AB  - In 41 men aged from 23 to 59 years (on an average--37.5 years) and employment
      duration from 1-10 years (on an average--4.9 years) working in the division of
      chlorfenvinphos synthesis and manufacturing "enolophos"--a preparation for
      agriculture, laryngological examinations were carried out including cytologic
      assessment of nasal mucosa and olfactometric tests. Rhinoscopy as well as
      cytological examinations confirmed the higher prevalence of nasal mucosa changes
      of inflammatory or allergic character as compared to the control group. The
      association between duration of employment and the changes perceived was found.
      Simultaneously olfactometric tests revealed in this group of workers frequent
      lowering of odours sensation and identification threshold.

PMID- 2233239
TI  - [Effect of occupational exposure to lead, zinc and cadmium on various indicators
      of the circulatory system of metallurgical workers].
AB  - 386 workers occupationally exposed to Pb, Cd and Zn in metallurgical plants were
      examined to evaluate the influence of lead, cadmium and zinc on circulatory
      system. The workers were divided into groups according to age and degree of
      poisoning with metals. Control group included 325 persons, selected according to
      age, occupationally unexposed to metals. All groups of persons were subject to
      medical examinations including ECG. Significantly higher prevalence of systolic
      murmur and heart ventricles repolarization disorders was found in the group
      exposed irrespective of the age of particular individuals. The workers exposed
      aged up to 40 years develop more frequently arterial hypertension and heart
      rhythm disorders. The results obtained indicate that Pb, Cd and Zn adversely
      affect the circulatory system.

PMID- 2233240
TI  - [Acid phosphatase and non-specific esterase activities in peripheral blood
      lymphocytes of coke plant workers].
AB  - In 32 workers of coking plants cytoenzymatic reaction was examined in lymphocytes
      peripheral blood to determine the presence of acid phosphatase and unspecific
      esterase expressed in total score values. Statistically significant decrease of
      unspecific esterase activity and lower mean values of acid phosphatase activity
      were found as compared to the results obtained in the control group. It seems
      that periodical determinations of cytoenzymatic activity of unspecific esterase
      in lymphocytes of peripheral blood may be useful in assessment of biological
      effects of occupational exposure in coking plants workers.

PMID- 2233241
TI  - [Study of morbidity among industrial workers based on periodic medical
      examinations].
AB  - The report presents the results of periodical medical examinations in a group of
      530 men working in machine-building industrial plant. Average age of men examined
      was 37.4 +/- 11.4 years. The population examined was exposed to silica dust,
      noise, vibration, carbon monoxide, benzene irritative gases. Most of them worked
      in a forced position: standing and stooping. In the population examined 1632
      cases of chronic diseases were found and the calculated morbidity rate amounted
      to 308.0 per 100 workers. Calculating the morbidity rate some not well determined
      states and symptoms as well as oral cavity, salivary glands and maxillary
      diseases were excluded. It was found that in the population examined 91.1% of
      workers developed chronic diseases and only 8.9% could be conventionally
      considered as healthy subjects. The report presents structure of diseases and
      their prevalence. A conclusion is drawn that in workers of machine-building
      industry exposed to many occupational hazards the prevalence of some chronic
      diseases is higher than in some other industrial branches. It is recommended to
      adopt age criteria, apart from occupational exposure, as one of principal
      measures of effectiveness of health care provided by occupational health care
      units.

PMID- 2233242
TI  - [Effect of the selection of reference population on the evaluation of the degree
      of the risk of death among industrial cohorts].
AB  - The report is devoted to one of the main problems of studies on death rate in
      industrial cohorts. In the study on cohort consisting of workers of asbestos
      processing plant in Lodz, the general population of Poland was selected as a
      reference population. Such method of analysis was used chiefly due to the fact
      that the data for local population of the Lodz district were unavailable. The
      report presents a comparative analysis of mortality based on the standardized
      death rate calculated for the total Polish and the Lodz district populations for
      the period for which appropriate data were available (1974-1985). The conclusions
      resulting from both analyses point to overmortality due to some selected causes
      regardless which reference population was taken into consideration although
      absolute number of these surpluses depends on selection of reference population.

PMID- 2233243
TI  - [Biochemical basis of the effect of organophosphate pesticides on humans].
AB  - The rapidly increasing use of organophosphorous compounds in everyday life causes
      that greater attention should be paid to the toxic effect exerted by these
      compounds on human organism. Acute toxic effects have been relatively well known
      whereas chronic effects require further studies. It is essential especially in
      view of progressive pollution of environment. The report presents data on the
      mechanism of action of organophosphorous compounds on human organism with
      particular regard to those effects which lead to the so called delayed
      neuropathy. The occurrence of that phenomenon as a result of single exposure to
      high concentrations of organophosphorous compounds as well as due to long-term
      exposure to the relatively low doses of those substances has been discussed.

PMID- 2233244
TI  - Molecular pathology of type 1 diabetes.
AB  - Evidence from epidemiological and histopathologic studies in humans with
      autoimmune type 1 (insulin-dependent) diabetes suggests that beta-cell
      destruction within the islets of Langerhans progresses through a number of
      stages. In this review we draw on recent experimental evidence in an attempt to
      define the molecular pathology of these stages. Stage 1 is postulated to be
      initiated by modification of the beta cell by virus, chemical or other factors,
      leading to the production of interferon-alpha, hyperexpression of major
      histocompatibility complex (MHC) class I molecules and induction of MHC class II
      molecules. Experiments in transgenic mice suggest that overexpression of MHC
      molecules is in itself detrimental to beta-cell function. Shedding of antigen(s)
      from dying beta cells in combination with hyperexpression of MHC molecules may be
      a powerful immunogenic stimulus. Stage 2 commences with infiltration of the
      islets by immuno-inflammatory cells (termed insulitis). It is proposed that
      production of cytokines from the infiltrating cells induces "phenotypic
      switching" in beta cells, with further upregulation of MHC molecules and the
      induction of intracellular adhesion molecule-1 expression and interleukin-6
      production. Together, these properties are seen as a prerequisite for the
      presentation of autoantigen by beta cells to adherent T lymphocytes and
      autoimmune activation. The final stage encompasses autoimmune-mediated
      destruction of the beta cells by the targeted delivery of cytotoxic cytokines and
      other mediators.

PMID- 2233245
TI  - Development of antigen-specific therapies for autoimmune disease.
AB  - Reversal of autoimmune disease with monoclonal antibodies to polymorphic
      determinants associated with class II gene products of the major
      histocompatibility complex (MHC) and to T-cell receptor variable region segments
      has been demonstrated in animal models. Recent studies have shown that it is also
      possible to use mutant peptides to block recognition of self-antigen associated
      with MHC by T-cells that mediate autoimmune disease. These mutant peptides have
      been used to prevent the model autoimmune condition experimental allergic
      encephalomyelitis. The possibility of extending these approaches to human disease
      is discussed.

PMID- 2233246
TI  - Tolerance to self-antigens in transgenic mice.
AB  - Transgenic mice represent a versatile experimental approach for understanding the
      pathways by which the immune system regulates responsiveness to self-antigens,
      thereby establishing self-tolerance. The introduction of immunoglobulin and T
      cell receptor genes with specificity for self-antigens into the germline of mice
      has enabled the fate of self-reactive lymphocyte precursors to be followed in
      vivo. The influence of both developmentally regulated, and tissue-specific gene
      expression on tolerance to self-antigens has been addressed using transgenic mice
      expressing novel self-antigens under the transcriptional control of heterologous
      gene promoters. The generation of transgenic mice expressing structurally altered
      forms of self-antigens has allowed the role of antigen-processing in the
      induction of tolerance to be examined. Significantly, while these studies have
      confirmed the classically derived principles of immunological self-tolerance,
      they also point to the existence of pathways, as yet undefined, by which
      tolerance to self-antigens may be implemented and maintained.

PMID- 2233247
TI  - Sequence of a cDNA encoding human galactose-1-phosphate uridyl transferase.
AB  - We report a revised sequence of a cDNA that encodes a human galactose-1-phosphate
      uridyl transferase. The cDNA is 1295 bases in length and encodes a 43,000 Mr
      protein. The sequence was derived from a cDNA clone isolated from a transformed
      human lymphoblast cell line and amplified in a polymerase chain reaction. The
      revised sequence reveals a higher degree of amino acid conservation between the
      human enzyme and the homologous enzymes from Escherichia coli and yeast than was
      previously thought to exist.

PMID- 2233248
TI  - Surface-induced swarmer cell differentiation of Vibrio parahaemolyticus.
AB  - Vibrio parahaemolyticus distinguishes between life in a liquid environment and
      life on a surface. Growth on a surface induces differentiation from a swimmer
      cell to a swarmer cell type. Each cell type is adapted for locomotion under
      different circumstances. Swimmer cells synthesize a single polar flagellum (Fla)
      for movement in a liquid medium, and swarmer cells produce an additional distinct
      flagellar system, the lateral flagella (Laf), for movement across a solid
      substratum, called swarming. Recognition of surfaces is necessary for swarmer
      cell differentiation and involves detection of physical signals peculiar to that
      circumstance and subsequent transduction of information to affect expression of
      swarmer cell genes (laf). The polar flagellum functions as a tactile sensor
      controlling swarmer cell differentiation by sensing forces that restrict its
      movement. Surface recognition also involves a second signal, i.e. nutritional
      limitation for iron. Studying surface-induced differentiation could reveal a
      novel mechanism of gene control and lead to an understanding of the processes of
      surface colonization by pathogens and other bacteria.

PMID- 2233249
TI  - The normally periplasmic enzyme beta-lactamase is specifically and efficiently
      translocated through the Escherichia coli outer membrane when it is fused to the
      cell-surface enzyme pullulanase.
AB  - Hybrid proteins were constructed in which C-terminal regions of the bacterial
      cell surface and extracellular protein pullulanase were replaced by the mature
      forms of the normally periplasmic Escherichia coli proteins beta-lactamase or
      alkaline phosphatase. In E. coli strains expressing all pullulanase secretion
      genes, pullulanase-beta-lactamase hybrid protein molecules containing an N
      terminal 834-amino-acid pullulanase segment were efficiently and completely
      transported to the cell surface. This hybrid protein remained temporarily
      anchored to the cell surface, presumably via fatty acids attached to the N
      terminal cysteine of the pullulanase segment, and was subsequently specifically
      released into the medium in a manner indistinguishable from that of pullulanase
      itself. These results suggest that the C-terminal extremity of pullulanase lacks
      signal(s) required for export to the cell surface. When beta-lactamase was
      replaced by alkaline phosphatase, the resulting hybrid also became exposed at the
      cell surface, but exposition was less efficient and specific release into the
      medium was not observed. We conclude that proteins that do not normally cross the
      outer membrane can be induced to do so when fused to a permissive site near the C
      terminus of pullulanase.

PMID- 2233250
TI  - Sequence, localization and function of the invasin protein of Yersinia
      enterocolitica.
AB  - The inv locus of Yersinia enterocolitica is sufficient to convert a non-invasive
      Escherichia coli K12 strain into a microorganism that is able to penetrate
      cultured mammalian cells. The nucleotide sequence of inv reveals an open reading
      frame corresponding to an 835-amino-acid protein that is homologous to the
      invasin protein from Yersinia pseudotuberculosis. A polyclonal antiserum elicited
      by a synthetic peptide corresponding to the C-terminal 88 amino acids of this
      open reading frame detected a unique 100 kD protein in cell lysates of Y.
      enterocolitica strain 8081 c and in an E. coli strain harbouring the cloned inv
      gene. This protein localized to the outer membranes of both microorganisms and
      was cleaved by low concentrations of extracellular trypsin. HEp-2 cells were
      shown to attach to surfaces coated with bacterial outer membranes containing
      invasin and this attachment was destroyed by treatment of the membranes with
      trypsin. Thus it appears that the invasin protein from Y. enterocolitica is able
      to mediate both attachment to and entry of cultured epithelial cells.

PMID- 2233251
TI  - Streptococcus pneumoniae possesses canonical Escherichia coli (sigma 70)
      promoters.
AB  - Seventeen DNA fragments from Streptococcus pneumoniae were randomly cloned in
      Escherichia coli with selection for promoter activity. The fragments were
      sequenced and the promoter locations were determined by primer extension
      analysis. Examination for sites similar to the E. coli major consensus promoter
      sequence revealed such a site in each of the seventeen fragments, located five to
      eight base pairs upstream of the point at which transcription was initiated in
      the E. coli host. Thus, the abundance of promoter activity found in pneumococcal
      DNA cloned in E. coli hosts arises primarily from sigma-70-type promoter
      structures. Combined with the observation that such sequences are usually found
      just upstream of, but not within, pneumococcal genes, this implies that one class
      (perhaps the major class) of pneumococcal promoters closely resembles the
      canonical E. coli promoter consensus.

PMID- 2233252
TI  - Characterization of the virB operon of an Agrobacterium tumefaciens Ti plasmid:
      nucleotide sequence and protein analysis.
AB  - The virulence regulon of the Agrobacterium tumefaciens TiC58 plasmid is composed
      of six operons, virA, virB, virG, virC, virD and virE, which direct the transfer
      of T-DNA into plant cells. The 9.5 kbp virB operon is the largest of these
      operons and its entire nucleotide sequence was determined and found to contain
      eleven open reading frames (ORFs). Gene fusions of each VirB ORF to T7 phi 10
      were made and overexpressed in Escherichia coli to confirm that they encode
      proteins of predicted size. Hydrophobic analysis of these peptide sequences
      revealed nine proteins that contain hydrophobic spanning regions including signal
      peptide-like sequences. These data suggest that the majority of VirB proteins may
      associate with bacterial cell membranes, while the two additional proteins
      possess a potential ATP-binding site. Strong homologies in amino acid sequences
      were observed between nopaline- and octopine-type plasmids. Specific differences
      in amino acid sequence encoded by VirB ORFs of nopaline and octopine Ti plasmid
      and a functional role of the gene products are discussed.

PMID- 2233253
TI  - Isolation and characterization of the recA gene of Bordetella pertussis.
AB  - This report describes the detection and cloning of the Bordetella pertussis recA
      gene. Escherichia coli clones having recombinant plasmids containing the B.
      pertussis recA gene were isolated by complementing an E. coli RecA- mutant's
      inability to survive in the presence of methylmethanesulphonate (MMS). This gene
      was shown to complement the deficiency of E. coli RecA- strains to tolerate the
      DNA-damaging effects of both a chemical agent and ultraviolet light (u.v.).
      Deletion mapping experiments localized the gene to a 2.5 kb StuI-EcoRI fragment,
      and expression of the gene in E. coli resulted in the production of a 40 kD
      protein. These data strongly suggest that a region of the B. pertussis chromosome
      that encodes RecA-like activity has been isolated and cloned.

PMID- 2233254
TI  - Identification and characterization of a porcine-specific transferrin receptor in
      Actinobacillus pleuropneumoniae.
AB  - All six strains of Actinobacillus pleuropneumoniae screened for the ability to
      use different transferrins as a source of iron for growth were capable of using
      porcine but not human, bovine, or avian transferrins. A specific binding activity
      for porcine transferrin (pTf) was expressed in cells grown in the presence of
      specific iron-chelators and was repressed by addition of excess iron. Two iron
      repressible outer-membrane proteins of 105 and 56 kD were specifically isolated
      from serotype 1, 2 and 7 strains of A. pleuropneumoniae by an affinity-isolation
      method using biotinylated porcine transferrin and streptavidin-agarose.

PMID- 2233256
TI  - COBIOTECH's role in biotechnology worldwide.
AB  - Curious or sceptical friends often ask, 'What and why is COBIOTECH? What is it
      doing?'. After serving as President during its formative first years, I attempt
      here to provide information for the curious and allay concerns of the sceptics
      about COBIOTECH's emerging role in biotechnology internationally.

PMID- 2233255
TI  - Inducible erythromycin resistance in staphylococci is encoded by a member of the
      ATP-binding transport super-gene family.
AB  - A Staphylococcus epidermidis plasmid conferring inducible resistance to 14
      membered ring macrolides and type B streptogramins has been analysed and the DNA
      sequence of the gene responsible for resistance determined. A single open reading
      frame of 1.464 kbp, preceded by a complex control region containing a promoter
      and two ribosomal binding sites, was identified. The deduced sequence of the 488
      amino-acid protein (MsrA) revealed the presence of two ATP-binding motifs
      homologous to those of a family of transport-related proteins from Gram-negative
      bacteria and eukaryotic cells, including the P-glycoprotein responsible for
      multidrug resistance. In MsrA, but not these other proteins, the two potential
      ATP-binding domains are separated by a Q-linker of exceptional length. Q-linkers
      comprise a class of flexible interdomain fusion junctions that are typically rich
      in glutamine and other hydrophilic amino acids and have a characteristic spacing
      of hydrophobic amino acids, as found in the MsrA sequence. Unlike the other
      transport-related proteins, which act in concert with one or more hydrophobic
      membrane proteins, MsrA appears to function independently when cloned in a
      heterologous host (Staphylococcus aureus RN4220). MsrA might, therefore, interact
      with and confer antibiotic specificity upon other transmembrane efflux complexes
      of staphylococcal cells. The active efflux of [14C]-erythromycin from cells of S.
      aureus RN4220 containing msrA has been demonstrated.

PMID- 2233257
TI  - Processing speed and mental retardation: deadline procedures indicate fixed and
      adjustable limitations.
AB  - Brewer and Smith (1984) showed that control mechanisms mediating speed-accuracy
      regulation contribute to retarded-nonretarded differences in processing speed,
      with poorly controlled trial-to-trial RT adjustments underlying the greater RT
      variability of retarded individuals. In Experiment 1, response deadlines
      controlled processing time, thus minimizing the influence of such control
      mechanisms. The obtained speed-accuracy relations showed that retarded subjects
      were unable to match nonretarded subjects' accuracy when responding as rapidly,
      thus indicating structural limitations on processing speed. The results of
      Experiment 2 showed, however, that significant adjustments to retarded subjects'
      processing speed--exceeding those produced by practice--are achievable. Extended
      training at a short deadline led to tighter control of RT adjustments, with
      substantial improvements in mean RT when subjects transferred to a self-paced RT
      task.

PMID- 2233258
TI  - Role of the preprobe delay in memory-scanning tasks.
AB  - In a variation of Sternberg's (1966, 1969) memory-scanning task not requiring an
      explicit negative response, Diener (1988) found that a preprobe delay was
      necessary to produce the usual set-size effect. In Experiment 1 of the present
      study, the effect of the preprobe delay was investigated in the typical two
      response task. In the absence of a preprobe delay, the function relating response
      latency to set size was virtually flat for negative responses, but was described
      by a slope of about 18 msec/item for positive responses. Further research
      suggested that the reduced set-size effect in the absence of a preprobe delay is
      the result of expectancy effects usually controlled by the preprobe delay.
      Informing the subject of the size of the memory set before it was presented
      (Experiment 2) produced a set-size effect of the usual magnitude in the absence
      of a preprobe delay. Experiment 3 was designed to assess the effects of
      expectancy in the absence of a memory search. A task similar in stimulus
      arrangement to the memory-scanning task but requiring the subject to indicate
      whether the last digit in the set was odd or even produced a decrease in response
      latency with set size of 29 msec/item in the absence of a preprobe delay.

PMID- 2233259
TI  - Cuing efficiency in a Stroop-like task with visual half-field presentation.
AB  - Stroop-like stimuli were presented to either the left or the right visual half
      field. Subjects responded to the identity of the words above and below (the
      target dimension), which appeared above or below a reference point (the cuing
      dimension). Automatic Stroop-like effects were assessed as the difference in
      reaction times between congruent trials (e.g., above the reference point) and
      incongruent trials (e.g., above below the reference point) when both trial types
      were equally frequent. In blocks in which most trials were of one type (e.g., 80%
      congruent trials), controlled Stroop-like effects could be assessed. Automatic
      Stroop-like effects remained unchanged under different task manipulations. In
      contrast, controlled Stroop-like effects were reduced by lowering cue-response
      compatibility and by increasing the response alternatives from two to four. Thus,
      similar to other cuing effects, controlled Stroop-like effects are susceptible to
      manipulations that affect the response-decision stage and appear to involve
      response-selection processes. The resources supporting these response-selection
      decisions were not hemisphere-specific, and were sufficiently nonspecific that
      interference from a memory-load task was found. When resources were scarce, a
      consistent bias to attend to stimuli presented or responded to on the right was
      evident.

PMID- 2233260
TI  - Physical interaction and association by contiguity in memory for the words and
      melodies of songs.
AB  - Three experiments were designed to investigate two explanations for the
      integration effect in memory for songs (Serafine, Crowder, & Repp, 1984;
      Serafine, Davidson, Crowder, & Repp, 1986). The integration effect is the finding
      that recognition of the melody (or text) of a song is better in the presence of
      the text (or melody) with which it had been heard originally than in the presence
      of a different text (or melody). One explanation for this finding is the physical
      interaction hypothesis, which holds that one component of a song exerts subtle
      but memorable physical changes on the other component, making the latter
      different from what it would be with a different companion. In Experiments 1 and
      2, we investigated the influence that words could exert on the subtle musical
      character of a melody. A second explanation for the integration effect is the
      association-by-contiguity hypothesis, which holds that any two events experienced
      in close temporal proximity may become connected in memory such that each acts as
      a recall cue for the other. In Experiment 3, we investigated the degree to which
      simultaneous presentations of spoken text with a hummed melody would induce an
      association between the two components. The results gave encouragement for both
      explanations and are discussed in terms of the distinction between encoding
      specificity and independent associative bonding.

PMID- 2233262
TI  - Vivid memories of emotional events: the accuracy of remembered minutiae.
AB  - It has been claimed that emotional arousal causes a narrowing of attention, and,
      therefore, impoverished memory encoding. On this view, if details of an emotional
      event are reported subsequently, these details must be after-the-fact
      reconstructions that are open to error. Our study challenges these claims. Using
      a long-term (2-week), incidental learning procedure, we found that emotion
      promotes memory both for information central to an event and for peripheral
      detail. This contrasts with the results of explicit instructions to remember or
      to attend closely to the event, both of which seem to promote memory for the
      event's gist at the expense of detail. The likely mechanisms underlying these
      effects are discussed.

PMID- 2233263
TI  - On the differential nature of implicit and explicit memory.
AB  - In this article, we report two experiments that provide further evidence
      concerning the differential nature of implicit and explicit memory. In Experiment
      1, subjects first undertook a sentence-verification task. While carrying out this
      task, half of the subjects were also required to carry out a secondary processing
      task involving tone monitoring. Twenty-four hours later, the subjects' memory for
      target items in the sentence-verification task was tested explicitly by means of
      a recognition task and implicitly by examining the extent to which the items
      primed fragment completion. Recognition performance was significantly impaired by
      the imposition of secondary processing demands during the original learning
      phase. In contrast, fragment completion was completely unaffected by this
      additional processing, even though substantial priming was observed. In
      Experiment 2, we examined whether priming in fragment completion is influenced by
      the nature of repetition during initial learning. Subjects studied a list of
      target items that were each repeated twice. Half the items were repeated
      immediately (lag 0) and half were repeated after six intervening items (lag 6).
      Memory for the items was assessed by recognition and by priming in fragment
      completion. Recognition was affected by lag, with lag 6 items being recognized
      better than lag 0 items. However, although significant priming was obtained, the
      extent of this priming was uninfluenced by lag. These data indicate two
      additional dimensions along which implicit and explicit memory differ and,
      furthermore, they support recent conceptualizations of processing differences
      underlying these two forms of memory.

PMID- 2233261
TI  - Processes underlying dimensional interactions: correspondences between linguistic
      and nonlinguistic dimensions.
AB  - In six experiments, we examined speeded classification when one dimension was
      linguistic and the other was nonlinguistic. In five of these, attributes on the
      dimensions corresponded meaningfully, having in common the concepts "high" and
      "low." For example, in Experiment 1, the visually presented words HI and LO were
      paired with high- or low-pitched tones; in Experiment 2, the dimensions were
      visual words and vertical position, in Experiment 3, they were spoken words and
      position, and in Experiments 4 and 5, spoken words and pitch. For each dimension
      in each pair, subjects suffered Garner interference when dimensions were varied
      orthogonally. Garner interference remained constant across 15 blocks of trials
      (Experiment 5). Subjects also showed significant congruity effects in all
      experiments, with attributes from congruent stimuli (e.g., HI/high pitch)
      classified faster than attributes from incongruent stimuli (e.g., HI/low pitch).
      These results differ from those obtained previously with noncorresponding pairs
      of linguistic-nonlinguistic dimensions. The results also differ from those
      obtained with traditional Stroop dimensions (colors and color words; Experiment
      6), which showed minimal Garner interference and diminishing congruity effects
      across blocks of trials. We conclude that the interactions found here represent
      cross-talk between channels within a semantic level of processing. We contrast
      our view with current models of dimensional interaction.

PMID- 2233264
TI  - The effect of context on discrimination and bias in recognition memory for
      pictures and words.
AB  - When the context accompanying a to-be-remembered word is changed between study
      and test, recognition memory is impaired. The deleterious effect of context
      change on recognition memory can be viewed as support for encoding specificity
      theory, semantic theory, or the existence of two bases for recognition. A fourth
      possible interpretation, examined here, is that the effect of context change on
      recognition memory is due to an accompanying change in response bias, rather than
      a "true" decrease in sensitivity to old and new items. In two experiments, the
      effect of context change on discrimination and bias in recognition of simple line
      drawings and their names was examined. Bias was measured using two measures shown
      by Snodgrass and Corwin (1988) to be theoretically independent of their
      associated discrimination measures. Context change produced marked conservatism
      in response bias in both experiments but demonstrated an effect on discrimination
      in the second experiment only. The shift from a neutral to a conservative
      response strategy as a result of context change may also be seen in other
      experiments, in which the same experimental paradigm was used with a variety of
      stimulus materials. We suggest that the major effect of context manipulation is
      to produce a change in bias. A stimulus in a familiar environment appears to be
      more familiar than a stimulus in a strange environment, regardless of its old/new
      status. In addition, there appears to be a true decrease in discrimination with
      context change, but this is more difficult to detect. The finding that pictures,
      which are less polysemous than words, are as affected by context change as words
      are supports encoding specificity theory over semantic theory.

PMID- 2233265
TI  - The relation between syllable number and visual complexity in the acquisition of
      word meanings.
AB  - Four experiments were conducted to explore the correlation between syllable
      number and visual complexity in the acquisition of novel words. In the first
      experiment, adult English speakers invented nonsense words as names for random
      polygons differing in visual complexity. Visually simple polygons received names
      containing fewer syllables than visually complex polygons did. In addition,
      analyses of English word-object pairings indicated that a significant correlation
      between syllable number and visual complexity exists in the English lexicon. In
      Experiments 2 and 3, adult English speakers matched monosyllabic novel words more
      often than trisyllabic novel words with visually simple objects, whereas
      trisyllabic matches were more common for visually complex objects. Experiment 4
      replicated these findings with children, indicating that the assumption of a
      correlation between word and visual complexity exists during the period of
      intense vocabulary growth. Although the actual correlation between syllable
      number and visual complexity is small, other posited constraints on word meaning
      are also limited in strength. However, an increasing number of small, language
      specific word-meaning correlations are being uncovered. Given the documented
      ability of speakers to detect and use these subtle correlations, we argue that a
      more fruitful approach to word-meaning acquisition would forgo the search for a
      few broad, powerful word-meaning constraints, and we attempt to uncover
      individually weak, but perhaps jointly powerful word-meaning correspondences.

PMID- 2233266
TI  - Cue interaction in human contingency judgment.
AB  - Most studies of human contingency judgment have been based on the assumption that
      frequency information about one predictor is assessed in isolation of information
      about other predictors. Recent evidence, however, suggests that the judged
      predictive strength of one cue is influenced by the predictive strengths of other
      copresent cues. Two experiments demonstrate that stimuli with the same outcome
      contingencies may nonetheless have different predictive strengths as the result
      of cue interaction. The first experiment, in which a within-subject design was
      used, provides a demonstration of blocking. A stimulus presented in compound with
      a strong predictor was rated as less predictive than another stimulus that was
      presented in compound with a nonpredictive cue. In the second experiment, cue
      interactions in conditioned inhibition were examined. A stimulus gained negative
      predictive strength as the result of compound presentations with a positive
      predictor when the outcome was not presented. This negative predictor was
      compared with an otherwise analogous stimulus that was not presented in compound
      with a positive predictor. These results support the use of animal-conditioning
      models as accounts of human contingency learning.

PMID- 2233268
TI  - The effect of apparent movement on mental rotation.
AB  - Eleven subjects were timed as they judged whether a small bar perpendicular to
      one side of a clockhand would point left or right if the hand was pointing upward
      (i.e., at the "12 o'clock" position). The clockhand was shown in two successive
      orientations 30 degrees apart, so that it was perceived to jump from one to the
      other in either a clockwise or a counterclockwise direction. Reaction times were
      consistent with the interpretation that the subjects "mentally rotated" the
      clockhand from its perceived orientation back to the upright before making their
      decisions. The direction of the jump influenced perceived orientation but did not
      influence either the direction or rate of mental rotation itself.

PMID- 2233267
TI  - Sex differences in visual-spatial ability: the role of performance factors.
AB  - Two studies were designed to explore the role of performance factors as sources
      of the frequently noted higher male scores on visual-spatial ability tests. In
      the first study, the mental rotations test (MRT) was administered to male and
      female college students of equally high quantitative ability (based on SAT math
      scores). Although males had significantly more correct responses on the test than
      did females, their advantage was eliminated when the ratio of correct responses
      to items attempted was used as the dependent measure. In the second study, the
      same test was administered to new groups of male and female college students. In
      this sample, the males had significantly higher SAT math scores. The MRT was
      administered under standard, timed conditions and under untimed conditions. Both
      raw and ratio scores were calculated. With SAT math score as the covariate,
      analyses of covariance indicated that males demonstrated higher performance in
      the timed, raw-score condition but not in the untimed or in the ratio-score
      conditions. The theoretical and social policy implications of these studies are
      discussed.

PMID- 2233269
TI  - Patient care episodes in mental health organizations, United States: selected
      years between 1955 and 1986.
AB  - The 4,747 mental health organizations (excluding territories) providing mental
      health services in the United States during 1986 generated almost 7.9 million
      patient care episodes including those in Veterans Administration outpatient and
      partial care programs. However, in order to make comparisons between 1986 data
      and all years dating back to 1955, outpatient and partial care programs
      administered by the Veterans Administration (VA) are omitted. Thus the 7.5
      million patient care episodes (exclusive of the aforementioned VA programs)
      represented a more than four-fold increase over the 1.7 million patient care
      episodes in mental health organizations observed 31 years earlier in 1955. The
      major shifts in patient care episodes over the 1955-1986 period have been from
      inpatient to ambulatory care services in mental health organizations, and from
      State and county mental hospitals to community-based mental health organizations.
      For example, in 1955, 77 percent were inpatient care episodes, and the remaining
      23 percent were outpatient episodes; by 1986, inpatient care episodes constituted
      only 27 percent of the total, while 68 percent were outpatient episodes, and 5
      percent were partial care episodes. Moreover, between 1955 and 1986, the primary
      locus of inpatient care episodes shifted from State and county mental hospitals
      to non-Federal general hospitals, and by 1986 over one-half of the outpatient
      care episodes and about two-thirds of the partial care episodes occurred in the
      multiservice mental health organizations.

PMID- 2233270
TI  - Fluoride stimulates [3H]thymidine incorporation and alkaline phosphatase
      production by human osteoblasts.
AB  - The effect of sodium fluoride on alkaline phosphatase (ALP) release and
      [3H]thymidine uptake by human osteoblasts in culture was investigated. Sodium
      fluoride stimulated both ALP release and [3H]thymidine uptake at concentrations
      of sodium fluoride greater than 250 mumol/L. This stimulation was similar in
      magnitude to that induced by 1,25-dihydroxycholecalciferol. The fluoride-induced
      increase in ALP was inhibited by verapamil, a calcium channel blocker. We
      conclude that sodium fluoride stimulates osteoblasts to proliferate and to
      release ALP. This stimulation by fluoride is dependent on calcium influx.
      Fluoride-induced stimulation of human osteoblasts may be relevant to its effect
      in enhancing bone formation in patients with osteoporosis.

PMID- 2233271
TI  - Time-dependent variations in bone turnover parameters during 2 months' cyclic
      treatment with different doses of combined estrogen and progestogen in
      postmenopausal women.
AB  - We determined the time-dependent variations in biochemical estimates of bone
      resorption and bone formation in 30 healthy postmenopausal women treated for two
      consecutive cycles of 28 days with a sequential estrogen/gestagen therapy. The
      women received either 1, 2, or 4 mg estradiol (E2) for 22 days and 1 mg
      norethisterone acetate (NETA) from day 13 to 22 of each cycle. Blood samples were
      drawn twice a week, ie, 16 blood samples in each woman. Biochemical estimates of
      bone resorption (fasting urinary hydroxyproline/creatinine, fasting urinary
      calcium/creatinine) decreased significantly during the two treatment cycles. In
      contrast, there was no overall decrease in bone formation parameters (plasma bone
      Gla protein [pBGP], serum alkaline phosphatase), and serum alkaline phosphatase
      decreased significantly during the estrogen-only phase, but increased during the
      E2 plus NETA phase. The present study supports our previous suggestion that NETA
      stimulates bone formation in early postmenopausal women.

PMID- 2233272
TI  - Repeated pregnancy without lactation: effects on maternal glycemic control,
      pregnancy outcome, carcass composition, and fat distribution in rats.
AB  - Repeated pregnancy without lactation in rats has been reported to produce
      permanently elevated carcass fat mass and hyperplasia in subcutaneous fat depot.
      In the present study, the pregnancy outcome, intravenous glucose tolerance
      ability (IVGTT), and carcass composition were further examined in Osborne-Mendel
      rats. Female rats were divided into pregnancy-lactation (PL), pregnancy-no
      lactation (PNL), and control (CON) groups. Half of the rats were killed after
      three pregnancy/lactation cycles, whereas the rest were given a 12-week rest
      period before killing. It was found that rats in PNL group had fasting
      hyperglycemia and insulin insensitivity during the third pregnancy (P less than
      or equal to .05), elevated spontaneous abortion rate (P less than or equal to
      .05), and elevated subcutaneous fat content (P less than or equal to .01)
      relative to that of PL rats or CON rats. After a 12-week rest period, a
      significant increase in subcutaneous fat cell number was also observed in PNL
      rats. PL rats, on the other hand, have significantly elevated
      internal/subcutaneous fat ratios (P less than or equal to .05), both immediately
      after weaning and after the 12-week rest period. The significance of this change
      is not yet known.

PMID- 2233273
TI  - Sources of propionate in inborn errors of propionate metabolism.
AB  - Amino acids are widely regarded as the most important sources of propionate in
      disorders of propionate metabolism. Propionate production was measured in the
      fasting state by continuous infusion of sodium [1-13C]propionate in three
      children with methylmalonic acidemia (MMA) and three with propionic acidemia
      (PA). The contribution of isoleucine, valine, threonine, and methionine
      catabolism to total propionate production was estimated by extrapolation from the
      hydroxylation of phenylalanine determined by a continuous-infusion
      [2H5]phenylalanine technique. The contribution of gut bacterial propionate
      production was determined by measuring total propionate production before and
      after treatment with oral metronidazole (10 to 20 mg/kg/d for 1 week). Amino acid
      catabolism accounted for a mean of 51.7% (range, 24.5% to 66.4%) of total
      propionate production. The mean decrease in propionate production after
      metronidazole was 22.2% +/- 8.5 (P less than .02); this percentage is likely to
      represent the minimum propionate production attributable to gut bacteria.
      Approximately 30% of total propionate production was unaccounted for, and is
      likely to arise primarily from odd-chain fatty acid catabolism in the fasting
      state. These results indicate that sources of propionate other than from protein
      catabolism are important in disorders of propionate metabolism, and explain the
      generally disappointing response to dietary protein restriction.

PMID- 2233274
TI  - Counterregulatory response to insulin-induced hypoglycemia in trained and
      nontrained humans.
AB  - The aim of the present series of experiments was to investigate the hormonal
      counterregulatory response to insulin-induced hypoglycemia in trained and
      nontrained healthy individuals. Five endurance athletes and six controls were
      administered intravenous insulin infusion at a rate of 0.15 U/kg/h until plasma
      glucose reached 50 mg/dL. The mean duration of the infusion in the trained and
      nontrained subjects corresponded to 18.6 and 26.3 minutes (P less than .01),
      suggesting that the former were characterized by an increased insulin
      sensitivity. Plasma glucose levels were similar in the two groups at the end of
      the insulin infusion, as well as during the postinfusion recovery period. Forty
      five minutes after the end of the infusion, plasma glucose levels were not
      significantly different from the preinfusion levels in the two groups. During
      this period of glycemia recovery, the increases in plasma glucagon, epinephrine,
      norepinephrine, and growth hormone were at least 50% lower in the trained than in
      the nontrained subjects. The increase in heart rate and oxygen uptake during the
      same period of time was significantly higher in the trained subjects. To
      determine whether this reduced hormonal response to hypoglycemia was due to
      reduced insulin levels or to an increased sensitivity to counterregulatory
      hormones, we investigated the effect of epinephrine on plasma glucose in two
      other groups of trained and nontrained subjects. In response to a constant
      epinephrine infusion of 0.01 or 0.1 micrograms/kg fat-free mass (FFM)/min, plasma
      glucose levels increased similarly in the two groups. In conclusion, these
      results indicate that trained subjects are characterized by a normal recovery
      from hypoglycemia despite a reduced response of counterregulatory
      factors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233275
TI  - Aging bone loss from the femur, spine, radius, and total skeleton.
AB  - In order to establish a comprehensive model for involutional bone loss, the
      following measurements were made of healthy white women: total body calcium by
      neutron activation analysis, bone density of the distal radius by single-photon
      absorptiometry, and dual-photon absorptiometry of the lumbar spine and femur
      (neck, Ward's triangle, and intertrochanteric areas). Longitudinal measurements
      were made for each of these skeletal sites except the femur. Evidence for a
      curvilinear component to the pattern of bone loss with aging was found for total
      body calcium and bone density of the radius, but not for the other measurements
      on analysis of cross-sectional data. Longitudinal studies confirmed that
      substantial bone loss begins only after menopause for the radius, whereas there
      is substantial premenopausal loss of bone from the lumbar spine. Prevention of
      vertebral osteoporosis requires maximizing bone mass before menopause. If
      longitudinal data confirm the model of linear rates of bone loss for the femur,
      there will be important implications for prevention of hip fractures.

PMID- 2233276
TI  - Altered ketone body metabolism during gram-negative sepsis in the rat.
AB  - To investigate why blood ketone bodies are depressed during sepsis, the
      production and utilization of ketone bodies was studied in fasted control,
      fasted, Escherichia coli-treated, fed control, and fed E coli-treated rats. Gram
      negative sepsis was induced by intravenous (IV) injection of 8 x 10(7) live
      colonies of E coli per 100 g body weight. Food was removed from the fasted rats
      after E coli injection. Fed rats were infused intragastrically with a
      nutritionally adequate diet for 5 days before inducing sepsis. Twenty-four hours
      after E coli injection, blood ketone bodies were reduced in fasted septic rats
      and fed septic rats compared with their respective control rats. Ketogenesis and
      oxidation of labeled palmitate was not altered in hepatocytes from fasted E coli
      treated rats. Yet, ketogenesis declined significantly in hepatocytes from fed E
      coli-treated rats. Oxidation of labeled palmitate was also significantly reduced
      in hepatocytes from fed E coli-treated rats. Utilization of ketone bodies as
      measured by the incorporation of [3-14C]beta-hydroxybutyrate into CO2, increased
      over threefold in the diaphragm, 12% in the heart, and 19% in the kidneys from
      the fasted E coli-treated rats. In the fed state, incorporation of [3-14C]beta
      hydroxybutyrate into CO2 was elevated fivefold in the heart, fourfold in the
      diaphragm, and over threefold in the kidneys from the septic rats. These results
      suggest that in the fasted state, plasma ketone bodies remain low during gram
      negative sepsis because peripheral tissues use more ketone bodies and because
      liver ketogenesis is not increased to compensate for the increased utilization.
      In the fed state, the reduction in blood ketone bodies appears to be attributed
      to both impaired ketogenic capacity and increased peripheral utilization.

PMID- 2233277
TI  - Unique alterations of neuropeptide content in median eminence, amygdala, and
      dorsal vagal complex of 3- and 6-week-old diabetes mutant mice.
AB  - The nature of the genetic defects which define the obese (ob) and diabetes (db)
      loci in mice remain unknown, but both produce similar syndromes when maintained
      in the same strain of mice. There is some evidence suggesting a lesion in the
      central nervous system (CNS) in db/db mice, while ob/ob mice appear to have a
      primary lesion outside the CNS. In a search for further evidence of a unique
      central lesion in db/db mice, we have examined neuropeptide content in selected,
      microdissected brain areas in both of these mutants and lean controls. In order
      to rule out possible interactions of the db mutation with the genetic background,
      diabetes mice of both C57BL/KsJ and C57BL/6J strains were studied. When
      concentrations of nine neuropeptide immunoreactivities were examined in up to
      seven microdissected areas of the brain, C57BL/6J ob/ob mice showed only one
      reproducible alteration, a lower content of beta-endorphin-like immunoreactivity
      (LI) in the preoptic area at both 3 and 6 weeks of age as compared with lean
      littermates. In contrast, db/db mice of both C57BL/6J and C57BL/KsJ strains
      exhibited alterations in a total of four peptides in three brain areas: lower
      concentration of somatostatin-LI in median eminence, higher Met-enkephalin-LI in
      dorsal vagal complex of the medulla oblongata, higher substance P-LI and lower
      vasoactive intestinal polypeptide (VIP)-LI in amygdala. The concentrations of the
      peptides studied in medial basal hypothalamus, lateral hypothalamus, substantia
      nigra, and preoptic area were not reproducibly altered in db/db mice. These data
      provide preliminary evidence for unique brain abnormalities in db/db mice in
      specific areas that are involved in processing of neural signals that can affect
      the islets of Langerhans, gonadotrophin secretory patterns, and many other
      visceral functions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233278
TI  - Collagen synthesis in postmenopausal women during therapy with anabolic steroid
      or female sex hormones.
AB  - The effect of anabolic steroid therapy and estrogen-progestogen substitution
      therapy on serum concentration of procollagen type III aminoterminal peptide
      (PIIINP), a measure of collagen synthesis, in postmenopausal women was studied in
      two double-blind studies: (1) 39 women allocated to treatment with either 50 mg
      nandrolone decanoate as an intramuscular depot or placebo injections every third
      week for 1 year, and (2) 40 women allocated to receive either 2 mg 17 beta
      estradiol plus 1 mg norethisterone acetate daily or placebo tablets for 1 year.
      Serum PIIINP was measured every 3 months during the study. Anabolic steroid
      therapy resulted in a more than 50% increase (P less than .001) in serum PIIINP
      at 3 months, which thereafter decayed but remained significantly increased
      throughout the study period. Serum PIIINP showed the same pattern during estrogen
      progestogen therapy, but to a lesser degree. We conclude that anabolic steroids
      stimulate type III collagen synthesis in postmenopausal women, while estrogen
      progestogen therapy may have such an effect, but only to a lesser degree.

PMID- 2233279
TI  - Protein kinase C inhibitors block insulin and PMA-stimulated hexose transport in
      isolated rat adipocytes and BC3H-1 myocytes.
AB  - Effects of protein kinase C (PKC) inhibitors and "down-regulation" on insulin and
      PMA-stimulated 2-deoxyglucose transport were determined in isolated rat
      adipocytes or BC3H-1 myocytes. In both model systems, H-7, sangivamycin, and
      staurosporine, inhibitors of the catalytic domain of PKC, each effectively
      blocked insulin and PMA-stimulated hexose uptake at similar concentrations. In
      the myocytes, staurosporine completely blocked the insulin effect retained post
      chronic phorbol myristate acetate (PMA)-induced "down-regulation." These findings
      indicate (1) that chronic pretreatment with PMA may not lead to a complete loss
      of PKC activity in the myocyte, and (2) that PKC is involved in insulin
      stimulated hexose transport in both isolated rat adipocytes and BC3H-1 myocytes.

PMID- 2233280
TI  - Increased resting energy expenditure in human immunodeficiency virus-infected
      men.
AB  - Even in the absence of anorexia and malabsorption, weight loss is frequently
      observed in patients with acquired immunodeficiency syndrome (AIDS) or AIDS
      related complex (ARC). To investigate whether increased resting energy
      expenditure (REE) might be responsible for this weight loss, indirect calorimetry
      was performed in 18 human immunodeficiency virus (HIV)-infected men free of
      clinically active opportunistic infections for at least 2 months. Patients with
      AIDS (n = 11) or ARC (n = 7) had 9% higher rates of REE when compared with 11
      healthy volunteers (P less than .05) with similar food intake and of the same
      body composition. The results obtained from patients with AIDS or ARC were
      identical. As no differences were found between patients and controls in plasma
      concentrations of catecholamines, thyroid hormones, cortisol, or tumor necrosis
      factor, except for lower concentrations of norepinephrine in the patients (mean
      +/- SD, 233 +/- 111 v 367 +/- 125 ng/L, patients v controls, P less than .01),
      this hypermetabolism is not explained by higher levels of these catabolic
      hormones. The results indicate that even in the absence of acute concomitant
      infections, increased REE may contribute to the weight loss in patients with AIDS
      or ARC.

PMID- 2233281
TI  - Early signs of vascular disease in homocystinuria: a noninvasive study by
      ultrasound methods in eight families with cystathionine-beta-synthase deficiency.
AB  - Fourteen patients (six males, eight females; mean age, 20 years) with
      homocystinuria due to homozygous cystathionine-beta-synthase (CBS) deficiency,
      underwent a vascular examination. Fourteen heterozygotes (seven males, seven
      females; mean age, 46 years), including 12 parents and one daughter of
      homozygotes (obligate heterozygotes), and one sister of a homozygote (with low
      enzyme activity as evaluated in vitro), were also examined. Homozygotes and
      heterozygotes were compared with two separate control groups of different age
      (mean age, 20 and 43 years, respectively). Ankle/arm systolic pressure index (by
      continuous-wave Doppler) was, on average, lower in homozygotes (P less than .01)
      and heterozygotes (P less than .05) as compared with the controls. An ankle/arm
      index less than 0.97 and suggesting flow-reducing arterial lesions was found in
      six (21%) lower limbs of homozygotes versus zero in controls (P less than .05).
      Echo Doppler (Duplex Scanner) abnormalities, indicating early, non-flow-reducing
      lesions of iliac arteries were more frequent in homozygotes (seven wall
      abnormalities or stenoses less than 15%) than in young controls (P less than
      .05). The corresponding figures for heterozygotes were seven wall abnormalities
      or stenoses (1% to 15% and one stenosis 16% to 50%) (P less than .01 v middle
      aged controls). Early lesions (three wall abnormalities or stenoses less than
      15%, three stenoses 16% to 50%) were detected in six (23%) internal carotids of
      heterozygotes versus three (3%) of corresponding controls (P less than .05).
      Technical limitations precluded the accurate detection of early lesions in the
      internal carotid arteries of young homozygotes and controls.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2233282
TI  - Type III hyperlipoproteinemia in a child with hemolytic uremic syndrome.
AB  - The case of a 6-year-old girl with severe hyperlipoproteinemia and chronic renal
      failure that developed after hemolytic uremic syndrome (HUS) is reported. The
      patient was homozygous for apolipoprotein (apo) E2, and her very-low-density
      lipoprotein (VLDL)-cholesterol/serum-triglyceride (TG) ratio of 0.63 was
      unusually high. She was consistently diagnosed to have type III
      hyperlipoproteinemia (HLP). This is the first report of type III HLP in a child
      with chronic renal disease.

PMID- 2233283
TI  - Bioavailability of phenylalanine and aspartate from aspartame (20 mg/kg) in
      capsules and solution.
AB  - Aspartame (L-aspartyl-L-phenylalanine methyl ester) was given in capsules or
      solution to compare the bioavailability of its constituent amino acids, aspartate
      and phenylalanine. Twenty healthy subjects received a single 20 mg/kg dose of
      aspartame in capsules or solution in a randomized, crossover design. Plasma amino
      acid concentrations and the phenylalanine to large neutral amino acid ratios
      (Phe/LNAA) were determined. Plasma aspartate concentrations did not increase with
      either treatment. For plasma phenylalanine following capsule ingestion, there was
      a smaller peak plasma concentration (Cmax; 103.3 v 126.6 mumol/L), a longer time
      to peak concentration (tmax; 108.6 v 36.6 minutes), but no significant difference
      in the area under the plasma concentration-time curve (AUC) (7,656 v 7,200
      mumol.min/L) when compared with solution ingestion. The maximum plasma Phe/LNAA
      ratio was smaller (0.16 v 0.19) with capsules. The changes for plasma tyrosine
      were similar to those seen with phenylalanine. There were no significant
      differences in the plasma concentrations of the other LNAAs between capsule and
      solution ingestion. Thus, given the small effect on phenylalanine Cmax and
      Phe/LNAA and no effect on the extent of absorption of phenylalanine, aspartame
      ingested in capsules at doses up to 20 mg/kg is a suitable dosage form for
      blinded clinical studies, provided that the slower rate of absorption of
      phenylalanine from capsules is taken into account.

PMID- 2233284
TI  - Influence of cold exposure on plasma triglyceride clearance in humans.
AB  - Recent human studies have shown that cold exposure increases lipid oxidation,
      even when the oxidation of circulating free fatty acid (FFA) is markedly reduced
      by the ingestion of nicotinic acid, thus seriously questioning the importance of
      FFA for lipid oxidation in the cold-exposed humans. It was therefore hypothesized
      that similarly to prolonged exercise, fatty acids from plasma triglycerides (TG)
      are important energy substrates for oxidation during prolonged cold exposure in
      man. The goal of this study was to determine the influence of cold exposure on an
      index of plasma TG utilization, the intravenous fat tolerance test (IVFTT). To
      evaluate the possibility of a delayed increase in fat tolerance, a second cold
      exposure and an IVFTT were also performed 24 hours after the first cold exposure.
      Seven healthy males (fasting, seminude) were subjected to an IVFTT (1 mL/kg 10%
      Intralipid) on three occasions while resting for 160 minutes: (1) at 29 degrees
      C, (2) in the cold (10 degrees C, 1 m/s wind), and (3) at 10 degrees C 24 hours
      after the first cold test. One week separated the warm test from the cold tests.
      Cold exposure reduced mean body temperature by 3.4 +/- 0.1 degree C and increased
      energy expenditure 2.5 times in comparison to warm values (P less than .01). It
      also increased fat oxidation by 70% (P less than .05) and plasma glycerol levels
      (P less than .05), but did not alter fat tolerance.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2233285
TI  - Methods in enzymology. Cumulative subject index.

PMID- 2233286
TI  - Oxygen radicals in biological systems. Part B: Oxygen radicals and antioxidants.

PMID- 2233287
TI  - Free radical initiators as source of water- or lipid-soluble peroxyl radicals.

PMID- 2233288
TI  - Generation of iron(IV) and iron(V) complexes in aqueous solutions.

PMID- 2233289
TI  - Use of ascorbate as test for catalytic metals in simple buffers.

PMID- 2233290
TI  - Detection of singlet molecular oxygen during chloride peroxidase-catalyzed
      decomposition of ethyl hydroperoxide.

PMID- 2233291
TI  - Determination of hydroperoxides with fluorometric reagent diphenyl-1
      pyrenylphosphine.

PMID- 2233292
TI  - Phycoerythrin fluorescence-based assay for reactive oxygen species.

PMID- 2233293
TI  - Determination of superoxide dismutase activity by purely chemical system based on
      NAD(P)H oxidation.

PMID- 2233294
TI  - Assay for superoxide dismutase based on chemiluminescence of luciferin analog.

PMID- 2233295
TI  - Automated assay of superoxide dismutase in blood.

PMID- 2233296
TI  - Assay of superoxide dismutase applicable to whole bacterial cells.

PMID- 2233297
TI  - Superoxide dismutase mimic prepared from desferrioxamine and manganese dioxide.

PMID- 2233298
TI  - Analysis of extracellular superoxide dismutase in tissue homogenates and
      extracellular fluids.

PMID- 2233299
TI  - Assays for cytochrome P-450 peroxygenase activity.

PMID- 2233300
TI  - Reductive cleavage of hydroperoxides by cytochrome P-450.

PMID- 2233301
TI  - DT-diaphorase: purification, properties, and function.

PMID- 2233302
TI  - Antioxidant activities of bile pigments: biliverdin and bilirubin.

PMID- 2233303
TI  - Fluorescence measurements of incorporation and hydrolysis of tocopherol and
      tocopheryl esters in biomembranes.

PMID- 2233304
TI  - Assay of lipid hydroperoxides using high-performance liquid chromatography with
      isoluminal chemiluminescence detection.

PMID- 2233305
TI  - Determination of methyl linoleate hydroperoxides by 13C nuclear magnetic
      resonance spectroscopy.

PMID- 2233306
TI  - Gas chromatography-mass spectrometry assays for lipid peroxides.

PMID- 2233307
TI  - Gas chromatography-mass spectrometry of 4-hydroxynonenal in tissues.

PMID- 2233308
TI  - Determination of aldehydic lipid peroxidation products: malonaldehyde and 4
      hydroxynonenal.

PMID- 2233309
TI  - Malondialdehyde determination as index of lipid peroxidation.

PMID- 2233310
TI  - Cholesterol epoxides: formation and measurement.

PMID- 2233311
TI  - Oxystat technique in study of reactive oxygen species.

PMID- 2233313
TI  - Iron redox reactions and lipid peroxidation.

PMID- 2233312
TI  - Phospholipid hydroperoxide glutathione peroxidase.

PMID- 2233314
TI  - Protein that prevents mercaptan-mediated protein oxidation.

PMID- 2233316
TI  - Photodynamic methods for oxy radical-induced DNA damage.

PMID- 2233315
TI  - Protein degradation as an index of oxidative stress.

PMID- 2233317
TI  - In vivo oxidative DNA damage: measurement of 8-hydroxy-2'-deoxyguanosine in DNA
      and urine by high-performance liquid chromatography with electrochemical
      detection.
AB  - HPLC with electrochemical detection is a highly sensitive and selective method
      for detecting the oxidatively modified DNA residue oh8dG. By this method, the
      detection of oh8dG from DNA and urine offers a powerful approach for assessing in
      vivo oxidative damage. Application of this technique to the detection of oh8dG
      from DNA permits the quantitation of the steady-state levels of this oxidatively
      modified deoxynucleoside and overcomes the detection problems associated with the
      extremely low levels present in DNA. In addition, the selectivity gained by this
      detection method eliminates the problem of separating the signal for oh8dG from
      normal deoxynucleosides. The quantitation of oh8dG in urine complements the
      measurement of oh8dG in DNA by estimating cumulative oxidative DNA damage in the
      body. In addition, the urinary assay provides a noninvasive means of measuring
      this type of damage in laboratory animals and human populations. Thus, an
      individual animal or human subject may be monitored over time, possibly under
      various prooxidant conditions, using oh8dG as a sensitive marker for oxidative
      DNA damage. This analytical approach may allow one to estimate the exposure of an
      individual to prooxidant conditions associated with lifestyle, genetic
      predisposition, degenerative diseases, and environmental toxins.

PMID- 2233318
TI  - Fluorometric analysis of DNA unwinding to study strand breaks and repair in
      mammalian cells.

PMID- 2233320
TI  - Measurement of oxidized proteins in systems involving activated neutrophils or HL
      60 cells.

PMID- 2233319
TI  - Clastogenic factors: detection and assay.

PMID- 2233321
TI  - Visible-range low-level chemiluminescence in biological systems.

PMID- 2233322
TI  - Modulation of cellular glutathione and protein thiol status during quinone
      metabolism.

PMID- 2233323
TI  - Measurement of xanthine oxidase in biological tissues.

PMID- 2233324
TI  - Oxy radicals in disseminated intravascular coagulation.

PMID- 2233325
TI  - Oxy radicals in endotoxin shock.

PMID- 2233326
TI  - Biochemical pharmacology of inflammatory liver injury in mice.

PMID- 2233327
TI  - Measurement of oxidant stress in vivo.

PMID- 2233328
TI  - Oxygen-derived free radicals in reperfusion injury.

PMID- 2233329
TI  - Noninvasive fluorometric measurement of mitochondrial membrane potential in
      isolated working rat hearts during ischemia and reperfusion.

PMID- 2233330
TI  - Oxygen scavengers in myocardial preservation during transplantation.

PMID- 2233331
TI  - Quantitation of free radical-mediated reperfusion injury in renal
      transplantation.

PMID- 2233334
TI  - Arachidonate related lipid mediators.

PMID- 2233333
TI  - Use of perfused organs in measurement of drug-induced oxidant stress.

PMID- 2233332
TI  - Use of isolated perfused organs in hypoxia and ischemia/reperfusion oxidant
      stress.

PMID- 2233335
TI  - Nomenclature.

PMID- 2233336
TI  - Bioassay of paf-acether by rabbit platelet aggregation.

PMID- 2233337
TI  - Electron-capture negative-ion chemical ionization mass spectrometry of lipid
      mediators.

PMID- 2233338
TI  - Bioassay of platelet-activating factor by release of [3H]serotonin.

PMID- 2233339
TI  - Quantitation of platelet-activating factor by gas chromatography-mass
      spectrometry.

PMID- 2233340
TI  - Quantitative analysis of platelet-activating factor by gas chromatography
      negative-ion chemical ionization mass spectrometry.

PMID- 2233341
TI  - Isolation of platelet-activating factor and purification by thin-layer
      chromatography.
AB  - Isolation and purification of platelet-activating factor can be accomplished with
      reasonable ease and effectiveness given the precautions and suggestions outlined
      above. These experimental approaches represent a composite of those practiced in
      the author's laboratory combined with selected observations reported in the
      literature.

PMID- 2233343
TI  - High-performance liquid chromatography separation and determination of lipoxins.

PMID- 2233342
TI  - Separation and characterization of arachidonate-containing phosphoglycerides.

PMID- 2233344
TI  - Quantitation of epoxy- and dihydroxyeicosatrienoic acids by stable isotope
      dilution mass spectrometry.

PMID- 2233345
TI  - High-performance liquid chromatography for chiral analysis of eicosanoids.

PMID- 2233347
TI  - Enzyme immunoassays of eicosanoids using acetylcholinesterase.

PMID- 2233346
TI  - Extraction of phospholipids and analysis of phospholipid molecular species.

PMID- 2233349
TI  - Purification of arachidonate 5-lipoxygenase from potato tubers.

PMID- 2233348
TI  - Preparation of prostaglandin H2: extended purification/analysis scheme.

PMID- 2233351
TI  - Immunoaffinity purification of arachidonate 5-lipoxygenase from porcine
      leukocytes.

PMID- 2233350
TI  - Potato arachidonate 5-lipoxygenase: purification, characterization, and
      preparation of 5(S)-hydroperoxyeicosatetraenoic acid.

PMID- 2233353
TI  - Synthesis of epoxyeicosatrienoic acids and heteroatom analogs.

PMID- 2233352
TI  - Radioimmunoassay of 11-dehydrothromboxane B2.

PMID- 2233354
TI  - Isolation of rabbit renomedullary cells and arachidonate metabolism.

PMID- 2233355
TI  - Cytochrome P-450 arachidonate oxygenase.

PMID- 2233356
TI  - Measurement of thromboxane metabolites by gas chromatography-mass spectrometry.

PMID- 2233357
TI  - Use of WEB 2086 and WEB 2170 as platelet-activating factor antagonists.

PMID- 2233359
TI  - Culture of bone marrow-derived mast cells: a model for studying oxidative
      metabolism of arachidonic acid and synthesis of other molecules derived from
      membrane phospholipids.

PMID- 2233358
TI  - Cloning of leukotriene A4 hydrolase cDNA.

PMID- 2233360
TI  - Endothelial cells for studies of platelet-activating factor and arachidonate
      metabolites.

PMID- 2233361
TI  - Use of cultured cells to study arachidonic acid metabolism.

PMID- 2233362
TI  - Eicosanoid biochemistry in cultured glomerular mesangial cells.

PMID- 2233363
TI  - Interaction between platelets and lymphocytes in biosynthesis of prostacyclin.

PMID- 2233364
TI  - Eicosanoid interactions between platelets, endothelial cells, and neutrophils.

PMID- 2233365
TI  - Isolated perfused rat lung in arachidonate studies.

PMID- 2233367
TI  - Immunoaffinity purification-chromatographic quantitative analysis of arachidonic
      acid metabolites.

PMID- 2233366
TI  - Isolated coronary-perfused mammalian heart: assessment of eicosanoid and platelet
      activating factor release and effects.

PMID- 2233368
TI  - Preparation of human and animal lung tissue for eicosanoid research.

PMID- 2233369
TI  - Preparation of tetradeuterated leukotriene A4 methyl ester: methyl-[11,12,14,15
      2H4]-(5S,6S)-oxido-(7E,9E,11Z, 14Z)-eicosatetraenoat e.

PMID- 2233370
TI  - Quantitation of sulfidopeptide leukotrienes in biological fluids by gas
      chromatography-mass spectrometry.

PMID- 2233371
TI  - Standardization and validation of medical decision-support systems: the CSE
      project.

PMID- 2233373
TI  - A brief history of computer-assisted electrocardiography.
AB  - This paper reviews the history of the development of computer methods for ECG
      interpretation. Selected highlights are presented which indicate how
      technological advances have paralleled the growth of the application of the
      technique to a point where globally over 100 million ECGs per annum are now
      interpreted by computer.

PMID- 2233372
TI  - Common standards for quantitative electrocardiography: goals and main results.
      CSE Working Party.
AB  - Computer processing of electrocardiograms (ECGs) has over the last 15 years
      increased rapidly. Still, there are at present no standards for computer ECG
      interpretation. Different techniques are used not only for measurement and
      interpretation, but also for transmission and storage of data. In order to fill
      these gaps, a large international project, sponsored by the European Commission,
      was launched in 1980 to develop "Common Standards for Quantitative
      Electrocardiography (CSE)". The main objective of the first CSE study was to
      reduce the wide variation in wave measurements currently obtained by ECG computer
      programs. The second study was started in 1985 and aimed at the assessment and
      improvement of diagnostic classification of ECG interpretation programs. To this
      end reference libraries of well documented ECGs have been developed and
      comprehensive reviewing schemes devised for the visual and computer analysis of
      ECGs. This task was performed by a board of cardiologists in a Delphi review
      process, and by 9 VCG and 10 standard 12-lead programs developed by university
      research groups and by industry. A third action was started in June 1989 to
      harmonize acquisition, encoding, interchange and storing of digital ECG data. The
      action thus performed have become internationally recognized milestones for the
      standardization of quantitative electrocardiography.

PMID- 2233374
TI  - The role of computer modeling in electrocardiography.
AB  - This paper introduces some levels at which the computer has been incorporated in
      the research into the basis of electrocardiography. The emphasis lies on the
      modeling of the heart as an electrical current generator and of the properties of
      the body as a volume conductor, both playing a major role in the shaping of the
      electrocardiographic waveforms recorded at the body surface. It is claimed that
      the Forward-Problem of electrocardiography is no longer a problem. Several source
      models of cardiac electrical activity are considered, one of which can be
      directly interpreted in terms of the underlying electrophysiology (the
      depolarization sequence of the ventricles). The importance of using tailored
      rather than textbook geometry in inverse procedures is stressed.

PMID- 2233375
TI  - Reference standards for software evaluation.
AB  - The field of automated ECG analysis was one of the earliest topics in Medical
      Informatics and may be regarded as a model both for computer-assisted medical
      diagnosis and for evaluating medical diagnostic programs. The CSE project has set
      reference standards of two kinds: In a broad sense, a standard how to perform a
      comprehensive evaluation study, in a narrow sense, standards as specific
      references for evaluating computer ECG programs. The evaluation methodology used
      within the CSE project is described as a basis for presentation of results which
      are published elsewhere in this issue.

PMID- 2233376
TI  - Evaluation of ECG interpretation systems: signal analysis.
AB  - Performance analysis of biosignal processing systems which provide diagnostic
      statements requires particular care. Besides general accuracy requirements,
      psychological and legal implications for patient and physician have to be
      considered on both the development and the user sites. Cybernetics and control
      engineering have provided the basic methodology for performance analysis of
      systems: in technical systems often mathematically defined functions and signals
      can be fed into the system to be tested and its response and output provide the
      necessary performance characteristics after adequate mathematical analysis. For
      systems which process biosignals, as for example ECG analysis systems, instead of
      analytically given signals learning and test sets of data derived from patients
      have to be applied. The performance analysis is done on a statistical basis. In
      this paper construction and composition of learning and test data sets as well as
      methods for performance evaluation of the signal processing part of ECG programs
      are described. Specific reference is made to the European project Common
      Standards for Quantitative Electrocardiography (CSE) where ten ECG- and nine VCG
      programs have been tested. The results of these tests provide reference data and
      standards for further program development as well as for independent system
      performance evaluation.

PMID- 2233377
TI  - Evaluation of ECG interpretation results obtained by computer and cardiologists.
AB  - In an international project investigators from 25 institutes are trying to
      establish a common reference library and evaluation methods for testing the
      diagnostic performance of various ECG computer programs and of cardiologists,
      based on ECG-independent clinical information. A first set of 500 validated ECGs
      was collected and analyzed by fifteen different computer programs and nine
      cardiologists, seven of who analysed the ECG and five the VCG. A coding scheme
      was used to map individual diagnostic statements onto a common set. Combined
      program and referee results were obtained by weighted averaging. Preliminary
      results indicate that the classification accuracy of several programs can still
      be improved. However, it was also apparent that the results of the best 12-lead
      ECG computer programs proved to be almost as accurate as the best of seven
      cardiologists in classifying seven main disease categories, i.e., normal, left,
      right and biventricular hypertrophy, anterior, inferior and combined myocardial
      infarction. Evaluation of rhythm statements and conduction disturbances was not
      included in the study. The data collection is still being pursued in order to
      reach over 1,000 cases. In this way a common diagnostic database is being
      established for comparative testing of diagnostic computer programs. This should
      lead to consumer protection and improve the accuracy and reliability of
      computerized electrocardiography.

PMID- 2233378
TI  - Signal analysis for ECG interpretation.
AB  - In ECG interpretation usually two main areas are discerned: the signal analysis
      and the diagnostic classification. This article reviews the major developments in
      the first area. ECG signal analysis itself is subdivided into the stages data
      acquisition, data transformation, feature selection, and data reduction. These
      stages are consecutively reviewed, while in the data transformation stage digital
      filtering, detection, wave typing, beat selection, and boundary recognition are
      discussed.

PMID- 2233379
TI  - Classification methods for computerized interpretation of the electrocardiogram.
AB  - Two methods for diagnostic classification of the electrocardiogram are described:
      a heuristic one and a statistical one. In the heuristic approach, the
      cardiologist provides the knowledge to construct a classifier, usually a decision
      tree. In the statistical approach, probability densities of diagnostic features
      are estimated from a learning set of ECGs and multivariate techniques are used to
      attain diagnostic classification. The relative merits of both approaches with
      respect to criteria selection, comprehensibility, flexibility, combined diseases,
      and performance are described. Optimization of heuristic classifiers is
      discussed. It is concluded that heuristic classifiers are more comprehensible
      than statistical ones; encounter less difficulties in dealing with combined
      categories; are flexible in the sense that new categories may readily be added or
      that existing ones may be refined stepwise. Statistical classifiers, on the other
      hand, are more easily adapted to another operating environment and require less
      involvement of cardiologists. Further research is needed to establish differences
      in performance between both methods. In relation to performance testing the issue
      is raised whether the ECG should be classified using as much prior information as
      possible, or whether it should be classified on itself, explicitly discarding
      information other than age and sex, while only afterwards other information will
      be used to reach a final diagnosis. Consequences of taking one of both positions
      are discussed.

PMID- 2233380
TI  - Methodology of ECG interpretation in the AVA program.
AB  - The AVA program combines a thirty-year history with an approach that remains
      innovative; namely: multivariate statistical analysis on orthogonal ECG leads.
      Its diagnostic reference base includes only diagnoses independently verified by
      non-ECG criteria. The diagnostic module assesses probabilities of nine
      alternative disease categories, based on QRS-T parameters; or four other
      categories in case of conduction defects. Probabilities of left or right atrial
      overload are also computed. The program also recognizes wall injury, T-wave
      abnormalities, electrolyte disturbances, myocardial ischemia, and makes
      differential diagnoses between strain and digitalis effects. An arrhythmia
      classification module can generate any of 40 rhythm statements. Signal
      recognition is based on the spatial velocity function. The program has been
      translated to a microcomputer version.

PMID- 2233381
TI  - Methodology of ECG interpretation in the Nagoya program.
AB  - The outline of the Nagoya Program, the most representative software package for
      computerized electrocardiography in Japan, is described. First, the history and
      current status of research and its transfer to commercial products for
      computerized interpretation of electrocardiograms is briefly reviewed. Second,
      development and testing of the Nagoya Program is depicted, referring to a gold
      standard for evaluation and the database being used for this purpose, and to its
      participation in the CSE study. Third, a description of signal acquisition and
      wave identification is given, followed by the detection of rhythm disturbances.
      Next, algorithms for contour classification, which consist of decision-tree logic
      established through trial and error and making use of the database of ECGs, are
      described. Finally, special features and future plans of the Nagoya Program are
      mentioned.

PMID- 2233382
TI  - Methodology of the modular ECG analysis system MEANS.
AB  - The methodology, used in the Modular ECG Analysis System (MEANS) is described.
      MEANS consists of modules for signal analysis and diagnostic classification. The
      basic structure of the modular interpretation system remained intact over a
      period of 20 years, while all modules underwent many changes as a function of
      experience and insight, and the continuously changing information technology. The
      article describes the advantages of a modular approach to decision-support
      systems, the most important ones being easier maintenance of the software package
      and separate optimization and testing of each module. The overall evaluation of
      MEANS was done in the CSE study. Evaluation results for modules and for the
      entire system are presented.

PMID- 2233383
TI  - Methodology of ECG interpretation in the Glasgow program.
AB  - This paper describes the methods currently used in Glasgow Royal Infirmary for
      computer analysis of electrocardiograms. The software is designed to analyse from
      3 to 15 simultaneously recorded leads, with facilities for analysis of rhythm and
      serial changes. Options for Minnesota Code (with serial comparison) and XYZ lead
      interpretation are available.

PMID- 2233384
TI  - Methodology of ECG interpretation in the Dalhousie program; NOVACODE ECG
      classification procedures for clinical trials and population health surveys.
AB  - The Dalhousie ECG Program was designed specifically for the needs of
      epidemiologic studies, health surveys, and clinical trials. The program logic is
      dynamic in that it can accommodate any combination of ECG leads, record length
      and sampling rate. The NOVACODE module of the program classifies ECGs according
      to the Minnesota Code, supplemented with new sets of logic criteria for
      conduction defects, acute myocardial infarction, and serial ECG changes. Improved
      statistical models are incorporated for enhanced detection of myocardial
      infarction using the Cardiac Infarction Injury Score, and for quantification of
      left ventricular mass estimation. It is anticipated that these program
      improvements will enhance its utility particularly in monitoring progression and
      regression of cardiac involvement in hypertensive and ischemic heart disease, and
      in the assessment of the effectiveness of intervention on cardiovascular disease
      risk factors.

PMID- 2233385
TI  - Methodology of ECG interpretation in the Hannover program.
AB  - The Hannover ECG program HES has been designed for measurement and interpretation
      of resting and (moderate) exercise electrocardiograms. In the signal analysis
      part the program follows an averaging strategy. For diagnostic classification a
      hybrid model with decision trees and scoring algorithms, and with multivariate
      probabilistic tests for derivation of category A statements is applied. The
      multivariate classification technique allows to adjust sensitivity and
      specificity for specific application areas without changing the diagnostic
      criteria.

PMID- 2233386
TI  - Methodology of ECG interpretation in the Padova program.
AB  - The main lines of the program designed for the interpretation of ECGs, developed
      in Padova by LADSEB-CNR with the cooperation of the Medical School of the
      University of Padova are described. In particular, the strategies used for (i)
      morphology recognition, (ii) measurement evaluation, and (iii) linguistic
      decision making are illustrated. The main aspect which discerns this program in
      comparison with other approaches to computerized electrocardiography is its
      ability of managing the imprecision in both the measurements and the medical
      knowledge through the use of fuzzy-set methodologies. So-called possibility
      distributions are used to represent ill-defined parameters as well as threshold
      limits for diagnostic criteria. In this way, smooth conclusions are derived when
      the evidence does not support a crisp decision. The influence of the CSE project
      on the evolution of the Padova program is illustrated.

PMID- 2233387
TI  - Methodology of ECG interpretation in the Lyon program.
AB  - To provide an in-depth interpretation of the spatial QRS-T contour, we
      established a set of vectorcardiographic parameters computed octant by octant.
      For each statement the criteria constitute a model which is closely related to
      pathophysiological patterns. The diagnostic strategy is of the heuristic type.
      For each diagnosis a table lists several criteria providing both specific and
      differential diagnostic information. Inter-table competition is handled by
      specific logic. The program classifies diagnoses according to the number of non
      satisfied criteria. Three versions are available including 124, 51 and 7
      diagnoses, respectively. The first, intended for interpretation of complex
      situations, has given satisfactory results in such situations. Rhythm analysis is
      performed from 8-second recordings. All functions--acquisition, quality control,
      choice of a dominant complex, wave recognition, parameter extraction,
      interpretation, editing, storage--are integrated into a mobile cart. A
      complementary program performs serial analysis of successive tracings. It
      highlights with great precision morphological changes in the spatial loops and
      interval variations.

PMID- 2233389
TI  - Interpretation of short ECGs with a personal computer: the Porto program.
AB  - A computer program for ECG analysis and interpretation developed at the
      University of Porto, Portugal is presented. The program runs on a microcomputer
      and employs the three-lead Frank VCG. The signals are sampled at 250 Hz with 8
      bit precision during 5.5 s. Details on signal conditioning and wave recognition
      and measurement techniques are given. The diagnostic part of the program uses
      decision-tree logic. The decision rules are mainly derived from the Washington
      Code. The diagnostic accuracy of four classes (normal, left and right ventricular
      hypertrophies and myocardial infarction), evaluated in a sample of 1,075
      pediatric and adult patients and classified by ECG-independent means was 76%. The
      program is currently being evaluated on the CSE database.

PMID- 2233390
TI  - Value of scatter-graphs for the assessment of ECG computer measurement results.
AB  - A new method is presented, different from usual methods, for the discussion of
      the results of computer ECG measurement programs, based on a new graphical
      evaluation method. The proposed "scatter-graphs" both highlight the main program
      results and facilitate the comparison between various wave-recognition
      algorithms. They allow the distinction between the reliability of an algorithm,
      which is its capacity to provide a maximum of measurements with a minimum amount
      of errors, and its precision, i.e., the standard deviation of the differences
      between its point estimates and the reference. The method proves to be a powerful
      tool for the discussion of individual, as well as the median program results in
      CSE Measurement Study. It allows to highlight limitations induced in performance
      assessment by the variability of the reference itself, and to state that the
      median program is at least as close to the "Gold Standard" as the median of the
      referees.

PMID- 2233388
TI  - Methodology of ECG interpretation in the Louvain program.
AB  - The Louvain program performs the analysis and interpretation of the
      vectorcardiogram (VCG) to increase the clinical utility of ECG analysis. Among
      its original features, there are (1) a high-resolution vector-loop display for
      visual analysis, (2) quantitative analysis of the spatial VCG using age-sex
      stratified limits, (3) separate software for adult and pediatric series and (4)
      complementary deterministic and statistical methods of diagnostic classification.
      Using objective, ECG-independent evidence as a reference standard, the Louvain
      program has shown satisfactory levels of diagnostic accuracy in most basic
      categories. However, its usefulness is especially marked in "borderline" or
      "complex" situations, where the 12-lead ECG cannot provide a clear answer. It
      corresponds to the concept of "computer-assisted ECG interpretation" as opposed
      to "computer ECG analysis".

PMID- 2233391
TI  - Do we really value the health of the world's babies and children?

PMID- 2233392
TI  - Private midwives: a new approach to family planning service delivery in Ghana.
AB  - Data on 134 private sector midwives who were educated and trained in family
      planning service delivery by the Ghana Registered Midwives' Association (GRMA)
      showed that, for most, the course was the first they had received since
      qualifying as a midwife. Four out of five of the new family planning clients
      served by these midwives were first time contraceptive users. Approximately 9% of
      the clients were men, most of whom requested condoms. While delivering women is
      still the main function of the maternity homes, it is clear that family planning
      services have come to represent an important element of the health care the
      midwives provide. A follow-up study of family planning acceptors found extremely
      encouraging continuation rates. In addition, a survey of the women that the
      midwives had delivered showed that the contraceptive prevalence rate among these
      women was higher than the national rate. Providing family planning services
      through private sector midwives has been shown to be a very successful approach
      in Ghana, and one that has the potential to become a pillar of the nation's
      overall family planning delivery programme. As several other countries in Africa
      also have active private sector health networks, this approach holds promise far
      beyond its initial success in Ghana.

PMID- 2233393
TI  - Stereotypes of childbearing women: a look at some evidence.
AB  - We all use stereotypes to help us to behave in what we hope will be appropriate
      ways towards people that we have not met before. On the labour ward midwives are
      likely to use such stereotypes to make assumptions about what a particular woman
      is likely to want during labour and delivery. Two commonly encountered
      stereotypes are those of the 'well educated, middle-class NCT type' and the
      'uneducated working class woman'. This paper explores evidence for these two
      stereotypes drawing on data from a large scale prospective survey of women's
      expectations of childbirth. The stereotypes were not supported in a number of
      important respects. In particular: women of different levels of education were
      equally likely to subscribe to the ideal of avoiding drugs during labour; the
      less educated women did not want to hand over all control to the staff; it was
      less educated women who had the highest expectations that birth would be a
      fulfilling experience.

PMID- 2233395
TI  - Nutritional requirements in pregnancy. What happens if they are not met?
AB  - In a previous paper (Hytten, 1990) the specific extra nutritional needs of
      pregnancy were described. This paper examines what happens if these needs are not
      met.

PMID- 2233394
TI  - Childbirth expectations: a qualitative analysis.
AB  - Maternal childbirth expectations play an important role in determining a woman's
      response to her childbirth experience. As part of the initial phase in the
      development of a research tool to investigate maternal childbirth expectations,
      in-depth interviews were conducted with a sample of eleven urban Canadian women
      in their third trimester of pregnancy. Content analysis of interview data
      indicated that the women had developed detailed expectations of the childbirth
      experience as well as for the roles of support persons and health care personnel.
      Exploration of women's childbirth expectations is discussed as an important
      component of childbirth education.

PMID- 2233396
TI  - Awareness among pregnant women of the effect on the fetus of commonly used drugs.
AB  - Epidemiological studies have shown that pregnant women continue to take
      substantial quantities of drugs, particularly those readily available to them
      without prescription. Little is known of the attitudes and knowledge among
      pregnant women of the effects of these substances on the fetus. Awareness of the
      effects on the fetus of commonly used drugs, cigarettes and alcohol among 514
      women in the postnatal wards of two maternity units in Glasgow was assessed by
      self completion questionnaire between October 1987 and April 1988. Most of the
      women recognised that the fetus is most at risk of being harmed by drugs during
      the first 3 months of pregnancy. The majority felt it was safest not to smoke
      cigarettes and were aware of the adverse effects of smoking on fetal growth. Over
      half thought smoking was harmful while breastfeeding. Over half thought that
      alcohol should be avoided altogether in pregnancy and that drinking could harm
      the fetus. Most women considered alcohol harmful to the breast feeding baby. The
      majority of the women would opt for paracetamol containing analgesics only and
      only a small proportion would take one containing aspirin. Only half the study
      population would take a prescribed antibiotic. A generally high level of
      awareness of commonly used drugs was demonstrated although there are areas where
      further health education could be directed. The study has highlighted areas
      worthy of further research.

PMID- 2233397
TI  - Risk factors for birth asphyxia and brain damage in pregnancy and labour.
AB  - In this review the patho-physiology and risk factors of birth asphyxia are
      discussed. Simple and appropriate, but scientifically sound, technology for the
      prevention of birth asphyxia is described. This can be used at home, in the
      community, in health sub-centres and health centres to identify and assess risk
      factors so that appropriate referral can be made. Based on experience in
      developing countries, actions which can be performed by the mother, relatives,
      neighbours, traditional birth attendants and nurses and midwives are described.

PMID- 2233398
TI  - Surface hydrophobicity and surface free energy of Actinobacillus
      actinomycetemcomitans strains from human periodontitis.
AB  - The surface properties of five freshly isolated clinical strains of
      Actinobacillus actinomycetemcomitans and a non-sticky, non-cohesive colonial
      variant were characterized. On growth in serum-containing and serum-free media,
      the primary isolates had a high surface free energy, corresponding with the low
      hydrophobicity observed, using as assay adsorption to hexadecane. The dispersion
      component of the surface free energy was significantly lower upon growth in serum
      free medium. In the electron microscope the cells appeared covered with vesicles.
      In sharp contrast, the colonial variant had a very low surface free energy but
      still showed a low hydrophobicity in the hexadecane assay. Expression of the
      surface free energy characteristics in serum-grown cultures appeared strongly
      dependent on cell treatment, suggesting a significant influence of an adsorbed
      proteinaceous layer. The cells of the variant strain generally carried fewer
      surface vesicles. No major difference was observed in the outer membrane protein
      composition between parent and variant strain.

PMID- 2233399
TI  - Naphthoquinone pigments related to fusarubin from the fungus Fusarium solani
      (Mart.) Sacc.
AB  - A review is presented on the naphthoquinone pigments produced by the filamentous
      fungus Fusarium solani (Mart.) Sacc., and related species. After description of
      the naphthoquinone structures and biogenesis, the physiological and genetical
      controls of pigment production are discussed. The biological properties of the
      main naphthoquinone pigments so far investigated are described. Many problems
      still remain to be resolved in these fields, where Nectria haematococca (Berk.
      and Br.) Wr., the sexual state of Fusarium solani, is used as an experimental
      model.

PMID- 2233402
TI  - The race is on. A look at Michigan's gubernatorial candidates.

PMID- 2233400
TI  - Effect of ciprofloxacin on experimental osteomyelitis in the rabbit tibia,
      induced with a mixed infection of Staphylococcus epidermidis and Bacteroides
      thetaiotaomicron.
AB  - After induction of experimental polymicrobic osteomyelitis with Staphylococcus
      epidermidis and Bacteroides thetaiotaomicron (ciprofloxacin MIC, 0.5
      micrograms/ml and 4.0 micrograms/ml, respectively), in the presence of a foreign
      body implant, in a rabbit tibia model, ciprofloxacin was administered to infected
      animals for 2- and 4-week periods. At necropsy, rabbits in the 2-weeks-treated
      group had mean ciprofloxacin levels of 5.94 micrograms/ml in serum, 3.63
      micrograms/g in marrow, and 1.88 micrograms/g in bone. Rabbits in the 4-weeks
      treated group had mean ciprofloxacin levels of 7.77 micrograms/ml in serum, 5.84
      micrograms/g in marrow, and 2.01 micrograms/g in bone. Quantitative bacterial
      plate counts were conducted on weighed samples of infected bone, marrow, and the
      catheter implant, taken at necropsy from treated and control rabbits. Variable
      reduction of bacterial numbers was observed in samples from treated animals, as
      compared to untreated controls. Samples of infected bone, marrow and catheter,
      showed comparable evidence of osteomyelitis and bacterial colonization in both
      treated and control animals. Although relatively high tissue levels of
      ciprofloxacin were attained, little therapeutic effect was observed.

PMID- 2233401
TI  - Growth of Mycobacterium leprae under low oxygen tension.
AB  - Despite numerous attempts, Mycobacterium leprae has yet to be cultivated in
      vitro. This organism has been considered as microaerophilic. The effects of
      various known gas mixtures on the in vitro growth of M. leprae were investigated.
      A gas mixture containing 2.5% O2 and 10% CO2 was found to be more favourable for
      the growth of this mycobacterium on artificial medium. Growth was evaluated by
      three parameters namely cell counts, bacterial ATP and DNA. An optimal growth of
      M. leprae, as determined by all three parameters, on both liquid and solid media
      was obtained between 18 and 24 weeks of incubation under optimal gas mixture.
      Solid medium which contained egg-yolk was relatively more beneficial for in vitro
      growth than the liquid medium. The cultivated bacilli exhibited some important
      characteristics specific for M. leprae, including growth in mouse foot-pads. The
      bacilli gradually lost their power of adaptation to grow on artificial media and
      did not show any ATP or DNA after about 36 weeks of incubation.

PMID- 2233403
TI  - Attorney/physician. Guidelines for inter-professional conduct.
AB  - It has come to our attention that many attorneys are causing record copy
      companies to subpoena medical records without attaching an authorization or
      consent signed by the patient. This is unacceptable. Physicians should never
      honor a third-party request or subpoena for records without a properly executed
      authorization signed by the patient. The power of a subpoena should never be used
      to put a physician in the position of violating patient confidentiality through
      lack of understanding or intimidation. The attorney should be responsible to see
      that a proper authorization is submitted with the records request or subpoena. A
      physician who receives a records request or subpoena without such an
      authorization should immediately communicate refusal to comply and the reason to
      the initiating attorney. The medical and legal professions have established an
      attorney/physician code covering this and related issues. The code is set forth
      verbatim.

PMID- 2233404
TI  - Michigan Health Care Data Corporation. The first and only statewide voluntary
      health data system in the US.
AB  - To continue its mission of providing information to improve understanding of
      health care in Michigan and to aid in planning and decisionmaking, the Michigan
      Health Care Data Corporation needs to achieve several things. The following is a
      look at its history and structure, MSMS participation, public reports, and future
      expectations.

PMID- 2233405
TI  - Disposition of a medical practice.

PMID- 2233406
TI  - Graduate medical education and state law.

PMID- 2233407
TI  - A creative partnership between practicing physicians and local health departments
      could help everyone.

PMID- 2233408
TI  - Midwifery education in Japan.

PMID- 2233409
TI  - Why education?

PMID- 2233410
TI  - Breast-feeding practices in Japan.

PMID- 2233411
TI  - Japan's Maternal and Child Health Handbook.

PMID- 2233412
TI  - [Changes in the energy indices of Escherichia coli during exhaustion and renewal
      of glucose and ammonia supply as a factor responsible for the coupling of energy
      and constructive types of metabolism].
AB  - The shift down of glucose in the growth medium lowered the energetic status of
      cells whereas that of ammonium elevated it, which was indicative of their
      specific effect on metabolism. The shift up of glucose within the first four
      seconds promptly increased the intracellular ATP pool, the energy charge and the
      ATP/ADP ratio up to values characteristic of growth, while the addition of
      ammonium after its exhaustion resulted in the opposite effect. The described
      changes are typical of an incomplete coupling between energetic and constructive
      metabolic types in E. coli.

PMID- 2233413
TI  - No correlation between tumor markers and prognosis under polygenic control
      systems.
AB  - Tumor markers in serum should not be correlated with the prognosis of patients
      with malignant tumors, although the markers indicate the presence of tumors,
      since marker levels and prognosis are controlled independently by poly-genes.
      Furthermore, prognostic factors, including incidence of pulmonary metastasis,
      tumor growth rate, tumor drug sensitivity and host response, vary among patients.
      In general, tumor markers may be used to demonstrate response of tumor to
      treatments only when expression of the markers does not change in a time
      dependent manner.

PMID- 2233414
TI  - Pickles, peptide hormones and pregnancy: a hypothesis.
AB  - In western societies a high frequency of heartburn, nausea and vomiting occur
      during pregnancy. The causes and mechanisms of these clinical symptoms remain
      poorly understood. Evidence suggests steroid hormones modulate gastrointestinal
      transit time and plasma peptide hormones, while peptide hormone modulated food
      intake and preferences. Since diurnal and episodic release of steroid and peptide
      hormones occur, it is postulated that heartburn and other digestive dysfunction
      during pregnancy are associated with elevated steroid and peptide (beta
      endorphin, NPY) hormone interaction with innate biological rhythms controlling
      the gastrointestinal tract.

PMID- 2233415
TI  - Alcohol withdrawal syndrome--an auto-immune disease? A neuroimmunologic model for
      pathogenesis of alcohol withdrawal symptoms.
AB  - A neuroimmunologic model of alcohol withdrawal symptoms is developed according to
      which these may be considered as an idiopathic auto-immune disease. During the
      alcohol abuse period of non-addicts, homeostasis may alter pathologically by
      gradual adaptation of the organism: auto-sensitisation develops and finally leads
      to the breakdown of auto-immune tolerance of the structural modifications set by
      alcohol withdrawal. The immunosystem regards the existing assimilation of alcohol
      as self, the withdrawal of alcohol as non-self. Alcohol withdrawal may be
      considered as an acknowledged physical stressor, and physical stressors as
      potential triggers of auto-immune diseases. Some so-called alcohol-induced
      diseases may originate in the pathogenic effects of preceding auto-immune
      responses to repeated alcohol withdrawals. Neuroimmunologic preconditions of
      potential auto-immune diseases exactly fit the alcohol withdrawal situation.
      Neuroimmunologic diseases themselves show close analogies respectively to alcohol
      withdrawal symptoms as well as to some alcohol-induced diseases. The myelin basis
      protein is assumed to be a potential auto-allergen. Finally withdrawal symptoms
      being the expression of physical dependence on alcohol, the model may highlight
      the very nature of physical dependence.

PMID- 2233416
TI  - The 'hyperprosexia phenomenon' in traumatic brain injured patients (a forgotten
      term for an old problem).
AB  - In traumatic brain injured patients the basic functions of the cognitive,
      behavioral, emotional and intellectual systems are disturbed. The patients'
      ability to regulate the interaction between the ego and the external world is
      diminished and they present inflexible, concrete and sometimes inappropriate
      behavior. We have not observed anosognostic phenomena in these patients. Most of
      them are preoccupied with their physical impairments and unaware of their
      intellectual deficits. We hypothesize that this preoccupation or 'hyperprosexia
      phenomenon' may be observed in traumatic brain injured patients. The various
      neuropsychological, medical and philological aspects of these terms are
      discussed.

PMID- 2233417
TI  - Potential role of acute hypophosphatemia during hypokalemic periodic paralysis
      attack.
AB  - A paralysis attack was induced by glucose load in a patient with hypokalemic
      periodic paralysis. A profound drop in serum phosphorus was observed (from 3.0 to
      0.8 mg/dl) in parallel to the serum potassium decrease. The potential role of
      phosphorus metabolism in the pathophysiology of muscle weakness in this disease
      is discussed.

PMID- 2233418
TI  - Parkinson's disease and cytochrome P450: a possible link?
AB  - The possibility that idiopathic Parkinson's disease may be linked to a deficiency
      of an important detoxifying enzyme such as the cytochrome P450 enzyme bufuralol
      hydroxylase is examined. A hypothetical model of how this might operate to
      produce early onset Parkinson's disease is suggested.

PMID- 2233419
TI  - Competing antagonists to energy production in space and their effect on calcium
      metabolism.
AB  - In microgravity, energy demand and its production are impressively decreased
      resulting in the clinical consequences of negative calcium balance and inhibited
      biosynthesis. Increased concentration of the underutilized ATP inhibits
      phosphorylation and decarboxylation resulting in increased tricarboxylates.
      Citrates mobilize calcium resulting in diseases mediated by the withdrawal of the
      citrate complexed calcium from hard and soft tissues. If man is to live in space
      for extended periods of time, he must dramatically reduce antagonists to energy
      production and substitute measures that enhance metabolic respiration.

PMID- 2233420
TI  - Space adaptation syndrome is caused by elevated intracranial pressure.
AB  - Space adaptation syndrome (SAS) incapacitates about 50% of the astronauts with
      symptoms of headache, malaise, vomiting, vertigo, etc. A hypothesis that SAS is
      caused by elevated intracranial pressure secondary to the cephalad fluid shift in
      zero G is proposed. A mechanism of how the cephalad fluid shift could cause
      elevated intracranial pressure is discussed. Factors known to alleviate and
      exacerbate SAS are interpreted in light of the elevated intracranial pressure
      mechanism.

PMID- 2233421
TI  - Stress-adaptation failure hypothesis of Alzheimer's disease.
AB  - It is proposed that the higher incidence of chronic stress-adaptation failure in
      patients with Alzheimer's disease is of specific etiopathological significance.
      Such chronic stress-adaptation failure leads to a vicious circular reaction,
      namely: intense, stressful stimuli----neocortico-limbic excitation----hypothalamo
      pituitary-adrenocortical (HPA) axis activation----excessive secretion of
      neurohormones including cortisol----stimulation of inhibitory glucocorticoid
      sensitive hippocampal neurons----failure to terminate the HPA axis response---
      chronic excessive secretion of neurohormones including cortisol---
      overstimulation degeneration of glucocorticoid sensitive hippocampal inhibitory
      neurons----progressive cognitive-affective behavioral disorganizational failure
      which is typical of dementia of the Alzheimer's type. Possibilities of
      neuropharmacological corrections and neurobehavioral re-education are suggested.

PMID- 2233422
TI  - The integration of the cerebral and coronary circulations with the dynamic system
      structure of brain and myocardium and the form of the cerebral and coronary
      artery trees.
AB  - Cerebral and coronary arterial trees lack functional anastomoses and are 'non
      redundant' in the number of arteries. These two morphological characteristics
      expose brain and myocardium to vascular pathologies. An elementary model common
      to the cerebral and myocardial blood supply permits an explanation of the two
      characteristics. On the ground of this model the brain and the myocardium are
      represented as dynamic systems--organ-systems--made up of units, these
      corresponding to neurons and to cardiac cells. A flow of information between the
      units determines variations of state of the units. The whole of the variations of
      state of the units gives the organ-system function. The artery tree is considered
      as an information channel--tree-channel--that conveys information to the units.
      This artery-transmitted information determines the way the units function. The
      tree-channel always emits the same message. Therefore the artery-transmitted
      information does not cause local or temporal variations in the functioning of the
      units. On the contrary, if the tree-channel is noised the ending branches will
      emit randomly varied messages. Such random emission--disorder--will cause random
      loco-temporal variations in the functioning of the units. Consequently the
      functioning of the organ-system will be disturbed. It is shown that a low number
      of branches lowers the quantity of disorder that a noised tree-channel can emit.
      The absence of anastomoses avoids combinatory phenomena between the diverse
      messages that would increase the disorder. Biological and pathological evidence
      supports the model and the explanation.

PMID- 2233423
TI  - Popperian everyday diagnostics--the growth of diagnostic knowledge in the
      particular case.
AB  - In an earlier paper the Bayesian model for everyday diagnostics of disease in the
      particular patient and the Bayesian decision model was criticized. Here a
      Popperian model is applied and its presumptions and consequences are
      investigated. Abandoning calculable probabilities as Popper suggests in science,
      and substituting them with degrees of corroboration, is realistic.

PMID- 2233424
TI  - Bovine spongiform encephalopathy--a new disease transmissable to humans?
AB  - Current concerns about the cattle disease bovine spongiform encephalopathy do not
      appear to take cognisance of the parallel with scrapie, the similar/identical
      disease of sheep/goats. This has existed for 200 years, and clearly involved a
      longstanding consumption of meat/offal from affected animals, but apparently
      without consequential human disease. A summary is given of the characteristics of
      the human and animal spongiform encephalopathy diseases and their causative
      agents. The conclusion of the official Southwood Report that the bovine disease
      is caused by the inclusion of sheep scrapie material in cattle fodder is
      critically discussed: an alternative mechanism is proposed for its emergence.

PMID- 2233425
TI  - Transcutaneal suture ligations of varicose veins.

PMID- 2233426
TI  - Male sex and heart disease--iron loss in semen?

PMID- 2233427
TI  - Bone marrow transplantation.

PMID- 2233428
TI  - An NHMRC code for the conduct of science.

PMID- 2233429
TI  - Chemonucleolysis: a further look at a contentious issue.

PMID- 2233430
TI  - The perinatal autopsy.

PMID- 2233432
TI  - Leg ulcers in rheumatoid arthritis.
AB  - A retrospective study over an eight-year period of 33 episodes of leg ulceration
      in 26 patients with rheumatoid arthritis requiring inpatient management is
      reported. the aetiology of the ulcers was found to be multifactorial. The most
      common factors were venous insufficiency (45.5%), trauma or pressure (45.5%) and
      arterial insufficiency (36.4%). Vasculitis (18.2%) and Felty's syndrome (12.1%)
      were less frequent causes, and pyoderma gangrenosum was rare. Most patients had
      seropositive erosive disease with high rheumatoid factor titres and significant
      functional impairment; over half were on maintenance corticosteroids.
      Colonisation of the ulcers by organisms, predominantly Staphylococcus aureus, was
      common (69.7%). Skin grafting was required in 63.3%, but the rate of complete
      take was only 42.9% despite multiple attempts. Hospitalisation was prolonged
      (mean 47.9 days) and the recurrence rate requiring further hospitalisation was
      26.9%. The diagnosis of vasculitis and the limited role of biopsy in establishing
      its presence are discussed.

PMID- 2233431
TI  - Bone marrow transplantation: a review of a programme and its first 100 patients.
AB  - We review the first 100 patients receiving a bone marrow transplant as definitive
      therapy for their underlying disease. These patients were treated between May
      1975 and June 1988. Median age was 8 years (range, 1 month to 43 years).
      Initially, patients were given transplants late in their disease but, as the
      programme progressed, patients were given transplants earlier and while in
      remission from their disease. The types of disease considered for treatment by
      bone marrow transplantation (BMT) expanded from leukaemia, and aplastic anaemia
      to include neuroblastoma, thalassaemia and immune deficiency. Initially matched
      donors were used but the source of marrow broadened to include mismatched family
      members, matched unrelated donors and autologous marrow. Problems after BMT were
      rejection (11%), acute graft-versus-host disease (GVHD) (45%), interstitial
      pneumonitis (22%) and relapse (36%). Recurrence of disease was the cause of half
      the deaths. GVHD was less frequent with the use of methotrexate and cyclosporin,
      T-cell depleted marrow or matched donors. Interstitial pneumonitis was more
      commonly associated with the use of mismatched donors and the development of
      GHVD. Relapse was less likely when BMT was undertaken in the first remission. At
      least one long-term side effect was seen in all patients treated with total body
      irradiation whereas no patient treated without irradiation had long-term side
      effects. The rate of disease free survival of patients at 24 months was 56% for
      matched, 48% for closely matched, 46% for autologous and 29% for mismatched
      transplants. For matched transplants mortality within the first 6 months after
      transplantation decreased from 28% before 1984 to 5% since 1984. Fifty-one
      patients have survived to June 1989, 49 of them disease free, for periods ranging
      from 12 to 123 months (median 29 months).

PMID- 2233433
TI  - Hypertension control and the risk of myocardial infarction and stroke: a
      population-based study.
AB  - A population-based case-control study was performed to determine the importance
      of the presence of hypertension and the control of blood pressure level during
      treatment for hypertension on the occurrence of acute myocardial infarction (AMI)
      and stroke in persons aged 35-69 years in the Hunter Region community. Patients
      with a first episode of AMI or stroke were identified from community-based heart
      attack and stroke registers and compared with control subjects obtained from a
      random population sample from the same community. Twenty per cent of control
      subjects were currently receiving treatment for hypertension compared with 37% of
      patients with myocardial infarction (odds ratio adjusted for age, sex and several
      other possible confounding variables, 2.6; 95% confidence interval (CI), 1.9-3.4)
      and 51% of patients with stroke (adjusted odds ratio, 3.5; 95% CI, 2.3-54). Among
      those who had ever been told they had hypertension, 71%, 73% and 59% of patients
      with AMI, patients with stroke and control subjects, respectively, were receiving
      treatment at the time of the AMI or the stroke or at the time of the survey
      (control subjects). For those receiving treatment for hypertension, blood
      pressure levels were obtained from the records of their general practitioner.
      Despite similar pretreatment levels the last recorded blood pressure level
      (either before the survey of the development of AMI or stroke) was higher among
      those who developed AMI or stroke than those in the control group. Those with a
      treated diastolic blood pressure of less than 80 mmHg appeared to be at a higher
      risk of both AMI and stroke than those with a treated diastolic blood pressure
      level of 80-89 mmHg, but the difference was not statistically significant.
      Randomised controlled trials do not show a reduction in rates of AMI in response
      to a reduction of blood pressure. Nevertheless our findings suggest that the
      presence of hypertension and poor control of blood pressure levels despite
      treatment may be important aetiologically both for AMI and stroke occurrence.

PMID- 2233434
TI  - Psychotropic drugs in Australia: consumption patterns.
AB  - This paper reviews studies of psychotropic drug use in Australia, analyses
      results from the Australian Health Surveys and compares the findings with those
      from other countries. It identifies subpopulations with high rates of drug use,
      which may consequently be at greater risk of drug-related harm. The levels of
      consumption of psychotropic agents in Australia were estimated from the results
      of studies conducted in community and institutional settings between 1970 and
      1986. In the absence of more recent data national prevalence rates were derived
      from analysis of data provided by the Australian Health Surveys (AHS) of 1977
      1978 and 1983-1984, and comparisons were made with rates available from other
      countries. While the prevalence of current and frequent use of drugs for nervous
      conditions was found to have decreased in most age groups over this period, it
      was consistently higher in females than in males, and increased with age. An
      analysis of the 1983-1984 AHS data revealed that the consumption of "medicines
      for nervous conditions" fell by 35% but that no change occurred in the prevalence
      of persons taking sleeping medicines. This fall appeared to occur in both rural
      and urban populations. Further analysis of data relating to the consumption of
      hypnotic agents revealed that changes occurred in the patterns of use within age
      and gender subgroups. Significant differences were observed between Australian
      States in consumption rates of sleeping medicines (chi 2 = 282.2; df = 7; P less
      than 0.01) and of medicines for nervous conditions (chi 2 = 289.7; df = 7; P less
      than 0.01). There were high rates of use of medicines for sleep in South
      Australia and of medicines for nervous conditions in Queensland. The prevalence
      of use of both drugs for sleep (rs = 0.71; P less than 0.05) and drugs for
      nervous conditions (rs = 0.77; P less than 0.05) was related to the rate of
      consultations with doctors. Preliminary surveys of various non-British
      subpopulations including Aborigines were inconclusive. These results have
      implications for reducing the harm associated with the use of psychotropic
      agents, particularly hypnotics and drugs for nervous conditions, in Australia.

PMID- 2233435
TI  - The pivot: the First Australian Casualty Clearing Hospital at the Gallipoli
      beachhead--the first seven days.
AB  - In October 1914, a new type of medical unit was added to the order of battle of
      the Australian Army's casualty evacuation chain. Designated the casualty clearing
      hospital, it was called a Casualty Clearing Station on the beach at Anzac Cove in
      the Gallipoli campaign. This unit was established as the most forward unit to
      provide emergency surgery, freeing the forward field ambulances from the
      necessity of holding wounded soldiers, a task which compromised their mobility
      and prevented them from moving with the brigades they supported. The Casualty
      Clearing Station was to be the most forward unit where specialist surgeons,
      anaesthetists, nurses, radiologists and a dentist were to be found. The 1st
      Australian Casualty Clearing Station (1ACCS) was raised in Hobart and consisted
      of 93 men including 7 doctors. After some seven weeks of training in camp, the
      new unit embarked for Egypt and the Gallipoli offensive. They landed on the beach
      at Anzac Cove at 11 a.m. on 25th April 1915, and remained on a 20 metre stretch
      of beach through eight months of the Gallipoli campaign. This paper reviews the
      first seven days of the Station's role at Anzac Cove, during which time this
      essentially inexperienced medical unit treated and evacuated an estimated 2700
      wounded Australian and New Zealand soldiers. This paper also reviews the
      Commanding Officer's hitherto unpublished war diary and other archival and family
      records which add to the medical story of Anzac. This frightful baptism of mass
      casualty evacuation, undergone by the Australian Army Medical Corps, brings a
      perspective to the problems of mass disasters today.

PMID- 2233436
TI  - The final assault--Gallipoli 1990.

PMID- 2233437
TI  - Stress and hypertension--a critical review.
AB  - Recurrent psychosomatic stress has been popularly thought to cause permanent
      hypertension by repeated reactive blood pressure elevations. These are considered
      by some to be caused by various mechanisms, including an increased sympathetic
      outflow and a decreased parasympathetic inhibition, or possibly an inborn
      functional abnormality in the walls of the resistance vessels, which becomes a
      structural abnormality as a result of the elevated pressure. Recent work,
      however, has questioned some of these concepts. Many of the assumptions in the
      past concerning the ill-effects of elevated blood pressure have been based on
      clinic or office readings. With the more widespread use of ambulatory monitoring,
      first developed in the 1960s, information has accumulated which has helped to
      clarify the predictive value of such office readings. Ambulatory monitoring has
      also given much information about the relationship between daily activities,
      blood pressure reactivity and the mean daily blood pressure level. It appears
      that only the mean daily level is related to cardiovascular morbidity and
      mortality. Variations in blood pressure in response to bodily and mental activity
      are not so related. Nor has it been shown that variability is a precursor of
      fixed hypertension. The role of laboratory stressors is discussed to see whether
      they are predictive of future hypertension and whether they reflect real life
      situations. Clinical studies of the relationship between stress and hypertension
      and, in particular, specific causes of stress such as anxiety and hostility are
      considered. It is concluded that there is no satisfactory evidence that
      psychosocial stress leads to the elevation of the mean daily blood pressure with
      its pathogenic connotations.

PMID- 2233438
TI  - Sarcomatous mesothelioma of the pleura with cerebral metastases.
AB  - A case of sarcomatous pleural mesothelioma in a 22-year-old woman is presented.
      There was no history of occupational exposure to asbestos. Twenty months after
      the first symptoms occurred the patient noticed weakness in the right arm. A
      computed tomography scan of the brain showed multiple metastases. The patient
      died 10 days later.

PMID- 2233439
TI  - Use of tranexamic acid mouthwash in dental procedures in patients taking oral
      anticoagulants.

PMID- 2233441
TI  - Pap smear rates in New South Wales--1984 to 1988.

PMID- 2233440
TI  - Evening primrose oil and premenstrual syndrome.

PMID- 2233442
TI  - Side effects of rubella immunisation in teenage girls.

PMID- 2233443
TI  - Eritrean medicine.

PMID- 2233444
TI  - Lymphoedema: a vascular problem.

PMID- 2233445
TI  - Osteomyelitis: approaching the 1990s.

PMID- 2233446
TI  - Training aboriginal doctors.

PMID- 2233447
TI  - Screening: the need for a population register.

PMID- 2233448
TI  - Diabetes among aboriginal people in central Australia: a high prevalence based on
      health service attendance.
AB  - The prevalence of diagnosed diabetes in Aboriginal people living in central
      Australia (population, 9983) was determined by collating data from the hospital,
      rural and urban health services, nursing homes and death registers. A total of 98
      male and 183 female Aboriginal residents with diabetes attended health services
      in central Australia between January 1984 and December 1986. The point prevalence
      of diagnosed diabetes at the end of 1986 in the age group 25-34 years was 1.6% in
      men and 3.1% in women, and in those over 35 years, 8.8% and 14.1%, respectively.
      The true prevalence of diabetes (diagnosed and undetected) is likely to be at
      least twice this rate, and constitutes a major public health problem in central
      Australia. Diabetes and other disorders such as obesity, hypertension and
      ischaemic heart disease have common antecedents and outcomes. The control of
      these non-communicable diseases requires integrated and culturally appropriate
      educational, social and medical strategies.

PMID- 2233450
TI  - A prospective study to assess the efficacy of ketoconazole in the treatment of
      recurrent vaginal candidiasis.
AB  - A prospective study of oral ketoconazole therapy was undertaken in 40 women who
      suffered from recurrent thrush. Symptoms were relieved within three days for half
      the women, and two-thirds of the women maintained an absence of symptoms for a
      period of at least a month. Over 80% of the patients assessed the treatment as
      being effective, with 90% preferring oral to topical therapy.

PMID- 2233449
TI  - Trends in caesarean section in Western Australia, 1980-1987.
AB  - During the 1980s the incidence of both emergency and elective caesarean section
      in Western Australia increased, accompanied by a decrease in that of all other
      delivery methods. The proportion of emergency caesarean sections increased from
      5.9%. of all deliveries in 1980 to 8.2% in 1987 and that of elective sections
      from 5.3% to 8.7%. For each year studied less than 50% of primiparous women
      delivering singletons had a normal vaginal delivery. Emergency caesarean sections
      were more common in primiparas and at the teaching hospital and elective sections
      in multiparas and at the metropolitan private hospitals. The proportion of
      primiparas having either emergency or elective caesarean sections rose with
      maternal age, but for multiparas the proportion having elective sections rose,
      but there were few differences in emergency sections with increasing age. Repeat
      caesarean sections, which made up 28.8% of the total in 1987, have contributed
      increasingly to the rising proportion of caesarean section deliveries. Unless the
      number of emergency sections in primiparous women falls and the challenge of
      vaginal birth after caesarean section is met, it is likely that the caesarean
      section rate in Western Australia will continue to increase over the next decade.

PMID- 2233451
TI  - Invasive disease due to Salmonella virchow: a north Queensland problem.
AB  - Salmonella virchow is the second most commonly isolated salmonella serotype from
      human sources in Australia, and overseas studies indicate that S. virchow is a
      significant cause of extraintestinal salmonellosis. The successful management of
      three infants, two with septicaemia and one with leptomeningitis and septicaemia
      due to S. virchow, is described. A review of the Townsville General Hospital
      laboratory records (1978-1988) showed that, among other aspects, S. virchow
      accounted for 46% of all salmonella septicaemias, further exemplifying the
      invasive propensity of this serotype. Information obtained from various sources,
      after crude analyses, demonstrates that more than 90% of S. virchow infections in
      humans in Australia occur in Queensland, and that most (greater than 78% in 1987)
      of those infections in Queensland come from a coastal zone north of Bundaberg,
      with the highest concentration (0.4 per 1000 persons) occurring in the Cairns
      region.

PMID- 2233452
TI  - Acute rheumatic fever and rheumatic heart disease in a rural central Australian
      aboriginal community.
AB  - A retrospective study of clinical case records was conducted at the health centre
      of a rural central Australian Aboriginal community to determine the frequency of
      acute rheumatic fever and of rheumatic heart disease between 1978 and 1987. The
      case records of 976 residents over 5 years of age were examined for evidence of
      the clinical indicators of acute rheumatic fever or rheumatic heart disease;
      together they contributed 8015 person-years of study. During the 10-year study
      period, 18 patients developed acute rheumatic fever and 12 patients had rheumatic
      heart disease. The annual incidence of acute rheumatic fever (first and recurrent
      attacks) for children aged 5-14 years was 815 per 100,000 person-years. For the
      residents aged 5 years and over, the point prevalence for rheumatic heart disease
      at the end of 1987 was between 7.9 and 12.3 per 1000 persons, according to health
      clinic records and the official population census, respectively. These rates are
      similar to those reported for Third World countries. Preventive measures must
      include efforts by health professionals to help to alleviate the adverse living
      conditions in Aboriginal communities.

PMID- 2233453
TI  - Obstetrics and litigation: a consumer perspective.

PMID- 2233454
TI  - Abnormal illness behaviours and their treatments.

PMID- 2233455
TI  - A unique mental health network for Victorian aboriginal people.
AB  - The Victorian Aboriginal Mental Health Network (VAMHN) is a unique mental health
      programme for Aboriginal people in Australia. The network was set up in 1987. The
      services and programmes developed include a community consultation service, a
      psychiatric inpatient unit; and educational, evaluative and research programmes.
      Utilisation of the network has steadily increased and the demand for both primary
      and secondary consultations continues to grow.

PMID- 2233456
TI  - Aerosol delivery in lung disease.
AB  - Metered-dose inhalers are the preferred method of aerosol delivery under normal
      circumstances because of their convenient size, ease of use and better patient
      compliance. Where poor coordination exists a spacer device, breath-activated
      inhaler or powder inhalation should be used and if muscular weakness presents a
      problem a Haleraid should be tried. A clinical air pump with jet nebuliser is
      appropriate if these methods prove unsatisfactory; where wet aerosol has been
      shown to result in clearly superior effects; for very small children; and for the
      "brittle" asthmatic prone to sudden life-threatening attacks, especially patients
      living in isolated conditions. Regular checks on aerosol techniques and efficacy
      of therapy are important aspects of follow up and education of all patients with
      airflow obstruction.

PMID- 2233457
TI  - "Stockpiling" psychotropic drugs and HIV infection.

PMID- 2233458
TI  - Notification of HIV infection.

PMID- 2233459
TI  - Tropical arthritis in Papua New Guinea: a reactive arthritis.

PMID- 2233461
TI  - The self-seeking syringe.

PMID- 2233460
TI  - The diagnosis of breast cancer.

PMID- 2233463
TI  - Drug company representative.

PMID- 2233462
TI  - HDL-cholesterol testing.

PMID- 2233464
TI  - The health effects of chemical waste in an urban community.

PMID- 2233465
TI  - Trends in asthma mortality in Australia, 1911-1986.

PMID- 2233466
TI  - Dangers of immunotherapy for the treatment of asthma in children.

PMID- 2233467
TI  - Which waist-hip ratio?

PMID- 2233468
TI  - Are blackflies in Australia?

PMID- 2233469
TI  - Methylprednisolone in the management of acute spinal cord injuries.

PMID- 2233470
TI  - Liver transplantation in children.

PMID- 2233471
TI  - Patterns of treated non-melanoma skin cancer in Queensland--the region with the
      highest incidence rates in the world.
AB  - The incidence of non-melanoma skin cancer, comprising basal cell carcinoma and
      squamous cell carcinoma, was studied in Queensland during 1984. The world
      standardised annual incidence rates (per 100,000 population) for the number of
      persons with non-melanoma skin cancer were estimated to be 1372 for men and 702
      for women, the highest recorded incidence rates in the world. Rates in men were
      nearly double the rates in women and age-specific incidence rates increased
      curvilinearly with age. There were, on average, 1.4 skin cancers per person with
      non-melanoma skin cancer and the ratio of basal cell carcinomas to squamous cell
      carcinomas was approximately three to one. The age-standardised annual incidence
      rate (per 100,000 population) of basal cell carcinoma for residents of the Gold
      Coast was 1.83 times the Brisbane rate for men and 1.57 times that for women,
      indicating significant differences between the two regions. For squamous cell
      carcinoma the regional differences were not statistically significant. The
      average potential number of non-melanoma skin cancers (per person) treated during
      the lifetime of a cohort of 100,000 was estimated to be 0.014 for men and 0.009
      for women by age 40. By age 65, these numbers increased to 0.22 for men and 0.11
      for women. At age 90, these average numbers were 1.09 and 0.42, respectively.
      Although the incidence of non-melanoma skin cancer is much higher in the older
      age groups, it should be kept in mind that it also affects the younger
      population; 1028 Queenslanders under 40 required treatment for 2300 non-melanoma
      skin cancers in 1984. This study which provides baseline information about the
      occurrence of non-melanoma skin cancer in Queensland emphasises the importance of
      developing safe sun-exposure habits, detecting non-melanoma skin cancer early and
      protecting and restoring the atmosphere.

PMID- 2233472
TI  - Cost comparison of intravenous antibiotic administration.
AB  - The cost of preparing and administering intravenous antibiotics in an Australian
      teaching hospital was determined. The costs associated with acquisition, delivery
      (administration system, ancillary equipment, labour), and laboratory monitoring
      for potential toxicity were calculated. Standard regimens based on antibiotic
      guidelines were used to compile the daily total cost. The results indicate that
      these components affect the daily total cost of individual antibiotics in
      different ways. Acquisition cost is often a poor predictor of total cost, which
      ranges from 1.2 times to almost eight times the acquisition cost. Less frequent
      administration reduces total costs substantially, as does slow injection compared
      with infusion. Laboratory costs constitute between 3.6% and 23% of the daily
      total cost and are most pronounced with antibiotics that have low acquisition
      costs. Antibiotic cost containment should not focus on acquisition cost alone.
      Daily total cost to administer antibiotics is a more appropriate and accurate
      costing method. Hospitals must acknowledge the need for innovative resource
      allocation methods which recognise this fact.

PMID- 2233473
TI  - Suicide and related deaths in Victorian doctors.
AB  - A cohort of University of Melbourne medical graduates (1950-1959 graduates
      inclusive) was followed up until December 31, 1986. Vital status at the end of
      the study period was ascertained and, for those who had died, cause of death was
      determined. The cohort consisted of 1453 members (1279 men and 174 women). One
      hundred and twenty-six of the group had died (115 men and 11 women) and 68 (4.7%;
      57 men and 11 women) were lost to follow-up. The major causes of death were
      cardiovascular disease and malignant neoplasms. The standardised mortality ratios
      (SMRs) for all-cause mortality were low (59 for the male doctors and 84 for the
      female doctors) indicating that male doctors experience a "force of mortality"
      59% that of the general population and female doctors 84%. For the male doctors,
      the SMR for suicide was 113 (95% confidence interval [CI], 54-207) (10 of 115
      deaths in male doctors) about double the SMR for mortality from all causes. For
      the female doctors, the SMR for suicide was 501 (95% CI, 103-1500) (3 of 11
      deaths in female doctors). For deaths resulting from all accidents the SMR was
      low for the males (29) and higher for the females (126). The SMR for mental
      disorders for the male doctors was marginally raised (132). This study reveals
      some indication of a problem in doctors in regard to deaths by suicide, other
      violent deaths and mental disorders. A larger study involving a control group of
      equivalent social class is required to confirm the findings of this study.

PMID- 2233474
TI  - Prevalence of chronic fatigue syndrome in an Australian population.
AB  - An epidemiological study was undertaken to provide the first reported estimate of
      the point prevalence of chronic fatigue syndrome in an Australian community.
      After a pilot study in a separate location, the population of the Richmond
      Valley, New South Wales, was sampled using a structured case-finding technique,
      which included notification from local medical practitioners, the use of a
      screening questionnaire and standardised interviews conducted by a physician and
      psychiatrist. In addition, investigations were performed to exclude alternative
      diagnoses and to assess cell-mediated immunity. Forty-two patients with chronic
      fatigue syndrome, with a female:male ratio of 1.3:1.0, were detected in a
      population of 114,000. The mean age at onset of symptoms was 28.6 years (SD, 12.3
      years), and the median duration of symptoms from onset to sampling date was 30
      months. The social status of the patients was distributed in accordance with that
      of the remainder of the population sampled, with no bias towards the middle or
      upper social classes. The disorder was causing considerable incapacity, with 43%
      of patients unable to attend school or work. The conservative estimate from this
      study suggests a prevalence on June 30 1988 of 37.1 cases per 100,000 (95%
      confidence interval [CI], 26.8-50.2). Chronic fatigue syndrome is an important
      disorder in this Australian community that affects young individuals from all
      social classes and causes considerable ill health and disability.

PMID- 2233475
TI  - Muscle versus brain: chronic fatigue syndrome.

PMID- 2233476
TI  - Pharmacokinetics in acute illness.
AB  - Severe illness at any age is accompanied by organ dysfunction, the administration
      of numerous drugs and complex changes in drug absorption, disposition and action.
      The clinician faced with a seriously ill patient should be aware of the important
      principles of drug treatment in critical illness. With acute illness of all
      types, the premature infant and the octogenarian lie at opposite ends of an age
      spectrum which encompasses the gamut of human disease and changeable organ
      pathophysiology. The common requirement of this host of variables is a flexible
      management plan, and careful observation of the patient's response to a
      therapeutic regimen which has been based on a sound knowledge of drug
      pharmacokinetics.

PMID- 2233477
TI  - The accreditation of undergraduate medical education in Australia.
AB  - The Australian Medical Council was established in 1985 with one of its three
      functions being the accreditation of medical schools and of courses leading to
      basic medical qualifications. The Accreditation (Standing) Committee has
      developed guidelines for assessment and accreditation in Australia, and commenced
      its programme of visits to Australian medical faculties in March 1988, with the
      tenth faculty scheduled to be visited in September 1993. This article describes
      the process of assessment and accreditation developed in Australia by the
      Australian Medical Council. A later article will discuss the issues in medical
      education that have been identified during the process of accreditation.

PMID- 2233478
TI  - A training programme for rural general practice.
AB  - An improvement in methods of training graduates for general practice has been
      recommended as a result of several investigations into the problems faced by
      rural medical practitioners. This paper describes a rural vocational training
      programme conducted by the Family Medicine Programme in North Queensland. The
      programme combines educational support, professional support and mentorship with
      a medical educator experienced in rural practice. The educational support is
      partly chosen by members of the rural group, and is designed to meet needs of
      group members and the communities they serve. The cost of such a programme is
      high, due to travel and communication over long distances, but is justifiable if
      it improves recruitment and retention of rural practitioners.

PMID- 2233479
TI  - Communication and health--health as an ecosystem.
AB  - The importance of communication in public health is described with reference to
      recent experiences in Australia where good progress has been made with certain
      major public health problems. There has been a 30% fall in road accident deaths
      and a 40% fall in deaths from coronary heart disease, and a smoke free
      environment has been established in public places and in the work place. These
      successes depended on effective communication based on appropriate data.
      Evaluation data have also been used to keep the public informed and to reinforce
      the message. The cooperation of the media has been most important in stimulating
      a new awareness of health and the opportunities for self help and community
      initiatives. In central Australia, new initiatives involving the Central
      Australian Aboriginal Congress have led to an improvement in the health of
      Aborigines, the training of Aborigines as health workers and the development of a
      Centre for Appropriate Technology at the Alice Springs College of Technical and
      Further Education. At the international level, Australia sponsored a World Health
      Assembly resolution in 1986 calling for the elimination of iodine deficiency
      disorders. With the support of the Australian International Development
      Assistance Bureau and the United Nations Children's Fund (UNICEF), an
      international expert group of scientists and public health professionals, the
      International Council for Control of Iodine Deficiency Disorders (ICCIDD), based
      in Adelaide, has been able to work with the World Health Organization (WHO) and
      UNICEF in the development of an international public health programme aimed at
      eliminating iodine deficiency disorders by the year 2000. The ICCIDD is a new
      model for communication and action in international health which is now being
      advocated for other areas.

PMID- 2233480
TI  - The prediction of suicide.
AB  - The prediction of suicide remains a major challenge for health professionals.
      Sociodemographic predictors of the risk of suicide lack specificity: factors such
      as living alone, being unemployed, or having a physical or mental illness are
      common, separately or in combination, but suicide is rare. Psychiatric
      conditions, such as depression, alcohol dependence, schizophrenia and personality
      disorders, are strongly associated with suicide, but most psychiatrically ill
      patients do not suicide. Most suicidal patients consult a helping agency within a
      month of their act and, in practice, successful assessment of the risk of suicide
      and intervention to prevent it depend on gaining an understanding of the
      individual patient and developing a therapeutic relationship. More research into
      the biological, psychological and social factors that distinguish suicidal from
      non-suicidal individuals is needed. We review key studies that have addressed the
      issue of suicide prediction, outline the clinician's role in evaluating the risk
      of suicide in the individual, and suggest directions for future research.

PMID- 2233481
TI  - Diaphragmatic paralysis following cervical herpes zoster.
AB  - A 74-year-old man was found to have a paralysed left hemidiaphragm within four
      months of the appearance of a typical herpes zoster rash involving his left
      shoulder and neck. Investigations, including bronchoscopy and computed tomography
      of the chest, failed to detect a cause for the diaphragmatic paralysis. We
      believe that the cervical zoster and diaphragmatic paralysis were causally
      related, a rare but recognised association.

PMID- 2233482
TI  - An unusual presentation of herpes zoster.

PMID- 2233483
TI  - Muscle side effects associated with simvastatin therapy.

PMID- 2233484
TI  - Guns and violence in Australia.

PMID- 2233485
TI  - Hand dermatitis caused by Peruvian lily.

PMID- 2233486
TI  - Alzheimer's disease and omega-3 fatty acids: hypothesis.

PMID- 2233487
TI  - Colorectal cancer.

PMID- 2233488
TI  - Risk of HTLV-1 transmission in renal transplantation among aborigines.

PMID- 2233489
TI  - Severe heat stroke in an experienced athlete.

PMID- 2233490
TI  - Cricopharyngeal myotomy.

PMID- 2233491
TI  - Variation in cholesterol levels.

PMID- 2233492
TI  - Hyper IgE syndrome? A new disease.

PMID- 2233493
TI  - Endometriosis and social class.

PMID- 2233494
TI  - Thiamine in our bread and wine.

PMID- 2233495
TI  - Introduction or artificial limbs scheme.

PMID- 2233496
TI  - True and false contraindications to pertussis vaccine.

PMID- 2233497
TI  - Skateboard injuries.

PMID- 2233499
TI  - Confidentiality ad absurdum.

PMID- 2233498
TI  - Foreign medical graduates.

PMID- 2233500
TI  - Snake venom allergy.

PMID- 2233501
TI  - Marbled beef.

PMID- 2233502
TI  - Residential care for Australians with dementia.

PMID- 2233503
TI  - Seatbelts save lives.

PMID- 2233504
TI  - Nuts and iron deficiency.

PMID- 2233505
TI  - [Iodide instead of L-thyroxine].

PMID- 2233506
TI  - [Postural problems at the work site. Prevention of pain and physical damage by
      proper sitting, standing, gait and lifting].

PMID- 2233508
TI  - Desk-top systems for office chemistries.

PMID- 2233507
TI  - [Drug information. Instructions for storage and administration. Drugs for use in
      the nose and ear].

PMID- 2233509
TI  - Botulinum toxin for ocular muscle disorders.

PMID- 2233510
TI  - Moricizine for cardiac arrhythmias.

PMID- 2233511
TI  - Prevention and treatment of nerve gas poisoning.

PMID- 2233512
TI  - Olsalazine for ulcerative colitis.

PMID- 2233513
TI  - Impact of political change on the psychological stress process among West Bank
      Palestinian women.
AB  - This article reports the relationships between political change, personal factors
      and the psychological stress process among 40 West Bank Palestinian women. The
      women were tested in spring 1982 and in autumn 1985. The stress process assessed
      consists of exposure to stressful life events, the way that women perceive the
      severity of stress (worry) and appraise their own resources to cope with it
      (locus of control), as well as actual coping modes, and mental health problems.
      The results show that the Palestinian women had more personal and political
      worries, and showed more personal helplessness (external locus of control) after
      the Lebanon war in 1985 than in 1982. The results further show that women
      employed less avoidance and retreat, and less denial as coping modes in 1985 than
      in 1982. No changes between these years were found in the women's mental health,
      their locus of control on the Palestinian issue, and coping modes of aggressive
      action and social-political activity. The results on the roles of personal
      factors in the stress process show that younger women expressed more political
      worries and initiative (internal locus of control) on the Palestinian issue.
      Furthermore, women who had many children had fewer political worries and more
      personal worries, and were less external in their locus of control on the
      Palestinian issue than women with few children.

PMID- 2233514
TI  - Review of some studies of group behaviour relevant to global security.
AB  - Since the publication of Lionel Penrose's On the Objective Study of Crowd
      Behaviour, significant advances have been made in the understanding of intragroup
      and intergroup behaviour relevant to world security and peace. Some of these are
      reviewed in this article. Rational decisions in the complex and dangerous modern
      world may require understanding of the constraints and influence of both the
      cultural and biological backgrounds of human social existence.

PMID- 2233515
TI  - Security through co-operation.

PMID- 2233516
TI  - Clinical trial and pharmacokinetics of carboplatin 560 mg/m2 in children.
AB  - We report a clinical trial with carboplatin (CBDCA) in 15 children with malignant
      solid tumors recurrent after or resistant to conventional treatment. Based on
      previous phase I clinical trials, these children were given a dose of CBDCA 560
      mg/m2 by intravenous infusion every 4 weeks. The study includes a pharmacokinetic
      analysis of CBDCA in three patients. This clinical trial shows the feasibility of
      this CB-DCA schedule, even after high cumulative doses of previous chemotherapy.
      As expected the main toxicity was hematologic but the risk of renal and
      ototoxicity is not excluded and these functions have still to be monitored when
      this relatively high dose of CBDCA chemotherapy is used.

PMID- 2233517
TI  - Prognostic significance of regional lymph node involvement in childhood extremity
      rhabdomyosarcoma.
AB  - Thirty-four patients with extremity rhabdomyosarcoma were treated at Memorial
      Sloan-Kettering Cancer Center during the years 1970 to 1987. The regional lymph
      node status at diagnosis was histologically confirmed in 27 patients. Of these 27
      patients, there were 20 males and 7 females, ranging in age from 6 months to 22
      years (median 10 years). The primary tumor was located in the upper and lower
      extremity in 11 and 16 patients, respectively. The histologic subtypes included
      embryonal in 13 patients and alveolar in 14 patients. Fourteen patients had no
      evidence of regional lymph node involvement (N0) and 13 patients had lymphatic
      metastases (N1). All patients were further staged according to the extent of
      surgical resection, the local invasiveness and size of the primary tumor, and the
      presence (M1) or absence (M0) of distant metastases. With a median follow-up time
      from diagnosis of 9.2 years (minimum 5.3 years), the overall survival was 48%
      (13/27): N0, 12/14 and N1, 1/13 (P = .0002). Excluding those patients with M1
      disease, the survival rate was: N0, 11/12; N1, 1/10 (P = .0001). The first site
      of relapse in the M0 patients was distant metastases in 8/10 cases. Our results
      suggest that regional lymph node involvement at diagnosis is an important
      prognostic factor in extremity RMS. Its presence appears to be associated with a
      high incidence of relapse in metastatic sites and poor survival outcome.

PMID- 2233518
TI  - Decrease in childhood neuroblastoma death in Japan.
AB  - Death statistics cards under 15 years of age submitted between 1979 and 1987 and
      coded as malignant neoplasms of organs or sites, in which neuroblastoma might
      affect, were inspected. A total of 1,037 cases of neuroblastoma death were
      identified. Total number of neuroblastoma deaths among those under 15 years of
      age ranged between 118 and 145 from 1979 to 1984. However, after 1985 the number
      of deaths showed a declining tendency, down to 89 in both 1985 and 1986 and
      totalling only 93 in 1987. This declining tendency was mostly-seen among children
      between 1 to 4 years of age. In this age group, the rate of death in 1987 was
      about one half of that in 1979; In the other age groups no declining tendency of
      neuroblastoma death was found. The reason for the decrease in neuroblastoma death
      among children in Japan may be a result of widespread mass-screening for
      neuroblastoma. However, further study is necessary before any final conclusions
      can be drawn.

PMID- 2233519
TI  - Superior vena cava syndrome associated with childhood malignancy: analysis of 24
      cases.
AB  - Twenty-four children with superior vena cava obstruction at initial presentation
      or associated with disease recurrence were treated at St. Jude Children's
      Research Hospital from 1973 to 1988. Of the 16 patients with superior vena cava
      syndrome at presentation, eight had non-Hodgkin's lymphoma, four had acute
      lymphoblastic leukemia, two had Hodgkin's disease, one had neuroblastoma, and one
      had a yolk sac tumor. Their clinical condition at presentation was often critical
      and required rapid treatment. In all cases, histopathologic diagnosis was
      obtained without complication by either bone marrow aspiration, lymph node
      biopsy, thoracentesis, or thoracotomy prior to the initiation of definitive
      therapy. Eight children had superior vena cava syndrome as a late complication
      during the course of their therapy. None had an antecedent history of superior
      vena cava obstruction. In contrast to the patients with superior vena cava
      obstruction at presentation, this group was composed predominantly of patients
      with recurrent solid tumors. Other causes included disseminated candidiasis and
      superior vena cava thrombosis, thus underscoring the importance of recognizing
      the etiology of superior vena cava syndrome to facilitate proper treatment.

PMID- 2233520
TI  - Phase II study of MOPLACE chemotherapy for patients with previously treated
      Hodgkin's disease: a CALGB study.
AB  - To further evaluate possible non-cross-resistant regimens in Hodgkin's disease, a
      phase II trial utilizing antimetabolites and etoposide was initiated by the
      Cancer and Leukemia Group B (CALGB). Etoposide was included because of its known
      efficacy in relapsed Hodgkin's disease and to evaluate for synergy with an
      alkylating agent and vincristine. Cytosine arabinoside and methotrexate were
      included to evaluate their effectiveness in rapidly growing resistant disease.
      Forty-two patients with previously treated Hodgkin's disease were entered, of
      which 37 are evaluable for response and toxicity. All patients had at least 2
      prior regimens of chemotherapy and 59% had additional radiation therapy. Complete
      and partial response was observed in 61%; there were 32% complete responders.
      Duration of complete response was a median of 8 months (range 2-28+ months).
      Duration of partial response was 7 months (range 1-17 months). Three patients
      remain in complete remission at 19, 19, and 28 months. Major toxicity was
      hematologic with severe or life-threatening toxicity in 54%. There was one
      patient with a fatal infection. Non-hematologic toxicity, save for nausea and
      vomiting, was mild and uncommon. There were two fatal and one severe pulmonary
      toxicities reported in patients who had previous exposure to bleomycin and
      mediastinal radiation. Three had interstitial pneumonitis and one pulmonary
      emboli. The interstitial pneumonitis was thought to be drug related. Survival of
      the entire group is estimated at 61% at 12 months. We conclude that MOPLACE is an
      effective regimen with an appreciable complete response rate in this heavily
      pretreated group of patients. Hematologic and pulmonary toxicities are severe and
      may necessitate dose modifications. The use of etoposide containing combinations
      requires further study as primary therapy in untreated patients.

PMID- 2233521
TI  - Phase II trial of etoposide and doxorubicin in advanced head and neck cancer.
AB  - In an effort to improve the response rate of patients with advanced head and neck
      cancer, a clinical trial combining two infrequently studied drugs was conducted.
      Twelve patients with squamous cell carcinoma of the head and neck were treated
      with 3-day continuous infusions of etoposide (90 mg/m2/day) and doxorubicin (15
      mg/m2/day). All patients had been heavily pre-treated with surgery, radiation
      therapy, and/or chemotherapy. No objective responses were observed in 9 evaluable
      patients. One patient maintained stable disease state for 4 months. The major
      toxicity was Grade 3 or 4 myelosuppression which occurred in 42% of administered
      cycles. Although single-agent etoposide and doxorubicin have shown response rates
      of 10%-40% in patients with squamous cell carcinoma of the head and neck, we were
      disappointed to find that the combination of etoposide and doxorubicin has little
      or no activity in patients with advanced head and neck cancer. The toxicity
      encountered with this combination was significant.

PMID- 2233522
TI  - Histological, immunohistochemical, and chromosomal studies on non-adrenal
      neuroblastomas without increased excretion of catecholamines and their
      metabolites in urine.
AB  - We reviewed our records for the last 10 years and found three of the 36 patients
      with neuroblastoma did not excrete significantly increased quantities of
      catecholamine metabolites in urine. All of these tumors were histologically
      characterized by small round cells and possessed a few dense core granules on the
      electron microscopic examination. All of them were reacted with anti-neuron
      specific enolase (NSE) antibodies, OKB2, PI153/3 monoclonal antibodies (MoAbs).
      The HNK-1, BA-1, and SJ-9A4 MoAbs reacted with two out of three. One of them
      demonstrated a reciprocal translocation involving the short arm deletion of
      chromosome 1. This multidisciplinary study has been helpful in making more
      accurate diagnoses for neuroblastoma without classical clinical characters.

PMID- 2233523
TI  - Non-randomised study comparing toxicity of Escherichia coli and Erwinia
      asparaginase in children with leukaemia.
AB  - Seven hundred fifty-eight unselected children entered into the United Kingdom
      Medical Research Council acute lymphoblastic leukaemia UKALL VIII Study and Trial
      were studied for differences in early treatment-related toxicity according to the
      type of intramuscular L-asparaginase received. Two hundred seventy-five received
      a product obtained from Escherichia coli and 483 the enzyme from Erwinia
      chrysanthemi. The E. coli patients had a significantly higher incidence of
      neurotoxicity, pancreatitis, and life-threatening sepsis (4%, 2%, and 20%,
      respectively) when compared with the Erwinia group (2%, 0%, and 18%). Severe
      hypersensitivity was seen in one patient from both groups and the incidence of
      glucose intolerance was not significantly different. These findings indicate that
      E. coli asparaginase may be more toxic. With a minimum follow up of 4 1/2 years
      there is no evidence that either product has made a significantly different
      contribution to disease-free survival.

PMID- 2233524
TI  - Non-Hodgkin's lymphoma in a cardiac transplant patient--successful management
      without chemotherapy.

PMID- 2233525
TI  - Breast nodules as the initial site of relapse in childhood leukemia.
AB  - Two children with acute monoblastic leukemia in remission developed breast
      nodules that were the initial sites of disease relapse. Shortly after the
      appearance of disease in this site, the children developed marrow recurrence and,
      despite additional treatment, rapidly deteriorated and died from pancytopenia
      related complications. The importance of careful breast examination is stressed
      as part of the surveillance physical examination for children with monoblastic
      leukemia.

PMID- 2233526
TI  - Gastric tumor and hematemesis in a patient with chronic lymphocytic leukemia.

PMID- 2233527
TI  - [Data on the epidemiology of Lyme disease in Bulgaria].
AB  - 134 patients with clinically, epidemiologically and serologically confirmed
      Lyme's disease have been examined. 89.5% of them had erythema chronicum migrans,
      112 patients (83.6%) were known to have had tick bites. The majority of patients
      were white-collar workers and townspeople. Hungry ticks collected from plants
      were shown to contain B. burgdorferi. 497 foresters and animal farmers have been
      serologically examined, using an indirect immunofluorescence test. Antibodies to
      B. burgdorferi in diagnostic titres have been revealed in 15.3% of foresters and
      17.8% of animal farmers.

PMID- 2233528
TI  - [Data on the typing of natural foci of tick-borne rickettsiosis in Siberia and
      the Far East].
AB  - The studies of the level of Ixodidae ticks infestation and seroepidemiological
      parameters made it possible to characterize specific features of the epidemic
      process in foci with different tick species. A working principle for the typing
      of the natural foci of tick-borne rickettsiosis has been suggested. According to
      the number of tick species 3 types of foci have been identified: monovector,
      divector and polyvector foci.

PMID- 2233529
TI  - [An analysis of the multiyear dynamics of ascariasis morbidity in the USSR].

PMID- 2233530
TI  - [The current situation with strongyloidiasis in the USSR].
AB  - The literary data available and our own observations served the basis for
      characterization on strongyloidiasis distribution areas in the USSR. They embrace
      the Caucasus, Middle Asia, the European part of the country up to latitude 55-56
      degrees north in the Maritime Territory and the southern part of the Khabarovsk
      Territory. Intensive invasion foci in specialized hostel-type institutions,
      invasion importation from the tropics to moderate climatic zones and their role
      in the epidemic process are discussed.

PMID- 2233531
TI  - [Opisthorchiasis in Chernigov Province (the situation and control and prevention
      measures)].
AB  - The results of planned population surveys for opisthorchiasis performed by teams
      of epidemiologists in 11 districts of Chernigov Province have been reviewed.
      130,067 individuals in 156 communities have been examined. All the communities
      were situated not more than 5 km from the main water artery of the area--the
      Desna River and its main tributaries--the Seim, the Ubed', the Doch', the Borzna.
      713 cases of opisthorchiasis have been identified in 96 villages. 1.0 +/- 0.2%
      (out of 3,180) of mollusks C. inflata and 0.9 +/- 0.4% of carps from the river
      basins in 8 districts of the region proved to be invaded with Opisthorchis
      larvae.

PMID- 2233532
TI  - [The characteristics of the circulation of the causative agent of opisthorchiasis
      in the tributaries of the Ob].
AB  - Opisthorchiasis morbidity is reviewed in the area of the Vasyugan River, an Ob
      tributary. Intermediate hosts have been found in 3 settlements situated at
      various distances from the ostium. The infestation of intermediate and additional
      hosts with Opisthorchis larvae is investigated. The above data and the results of
      previous population surveys (establishing infestation and contamination) served
      the basis for elucidating the nature of helminth circulation on the territory
      along the Vasyugan River. The role of infected fish migration is discussed as a
      source of human infection in areas where helminth circulation is altogether
      absent or is at an extremely low level.

PMID- 2233533
TI  - [Alveolar hydatid disease in the Koryak Autonomous Okrug].

PMID- 2233534
TI  - [The serum immunoglobulin E level and the endocrine activity of the stomach,
      duodenum and pancreas after recovery from opisthorchiasis].
AB  - Serum IgE level and blood levels of gastrin, insulin, C peptide and glucagon have
      been studied in 34 patients with chronic opisthorchiasis (18 females and 16 males
      aged 36.5 +/- 2.6 years) prior to treatment and 10 days, 6 months and 12 months
      after recovery from the invasion. Blood levels of gastrin, insulin and C peptide
      remained unchanged. A trend towards normalization of glucagon levels about a year
      after recovery from opisthorchiasis has been observed. Serum IgE level a year
      after recovery was normal.

PMID- 2233536
TI  - [The decreased susceptibility of Syrian hamsters to Opisthorchis felineus
      invasion after its repeated administration].
AB  - The investigations conducted on Syrian hamsters have revealed that multiple
      enteral infusions of cold inactivated (t = -10 degrees C) O. felineus
      metacercariae resulted in the formation of immunocompetent cell and fibroblast
      infiltrations around the branches of the portal vein. The infestation of animals
      by viable pathogens led to reduced accommodation of helminths and suppressed cell
      infiltration in the liver. It is assumed that the native population of the foci
      become tolerant to the disease with the penetration of noninvasive Opisthorchis
      larvae into their body and the development of latent forms of helminthiasis.

PMID- 2233535
TI  - [Cross-reacting antigens of Opisthorchis felineus and Salmonella typhi and their
      possible effect on the clinical course of typhoid fever].
AB  - The experiments on rabbits immunized with a complex O. felineus antigen and
      spirit abdominal typhoid vaccine enriched with Vi-antigen, as well as studies on
      patients with chronic opisthorchiasis and bacterial carriers of S. typhi have
      established the presence of cross-reacting antigens in abdominal typhoid and
      opisthorchiasis pathogens. It is suggested that these antigens play an essential
      role in the development and outcome of abdominal typhoid secondary to chronic
      opisthorchiasis invasion.

PMID- 2233537
TI  - [A comparative study of the efficacy of praziquantel and its liposomal form in
      experimental opisthorchiasis].
AB  - Intensive and extensive efficacy of praziquantel pure and that included in
      multilamellar liposomes was studied. As a result, a high anti-helminthic activity
      of liposomal praziquantel has been established. Negative effect of praziquantel
      on protein synthetic and enzymatic function of the liver has been revealed in
      normal animals. The treatment with liposomal praziquantel led to a rapid
      normalization of total lipid and bilirubin levels, thymol turbidity test,
      transaminase indices and also to a decrease in dystrophic liver changes.

PMID- 2233538
TI  - [The effectiveness of 2 immunoenzyme analysis test systems in the diagnosis of
      human trichinelliasis].
AB  - The efficacy of 2 test systems for enzyme immunoassay using various ingredients
      (produced in the E. I. Martsinovskii Institute of Medical Parasitology and
      Tropical Medicine, USSR Ministry of Public Health and Institute of Advanced
      Medical and Pharmaceutical Training, Prague) has been assessed on blood sera of
      122 patients with trichinellosis, 200 patients with other parasitic diseases and
      300 healthy donors. No considerable differences in the efficacy of 2 test systems
      have been revealed. The test sensitivity is higher with the use of somatic than
      secretory-excretory antigens of identical specificity.

PMID- 2233539
TI  - [Antigenic preparations from Opisthorchis and their use in immunodiagnosis. 2.
      The effectiveness of antibody detection in infected patients].
AB  - Serological studies using opisthorchis immunoreagents of various specificity
      (metabolic, somatic and from eggs) have shown that metabolic antigen preparations
      were the most effective. Simultaneous use of 3 immunoreagents of various
      specificity ensures higher percentage of opisthorchiasis patients'
      identification. Passive hemagglutination test and enzyme immunoassay are
      practically identically effective for the antibody determination.

PMID- 2233541
TI  - [The ultrastructure of sterile larvocysts of Echinococcus granulosus from
      different hosts].
AB  - The sterile larvocysts of Echinococcus granulosus are characterized by host
      dependent morphological variability. The distinctions reside in the intensity of
      germinative layer development, glycogen and lipid content, ultrastructure of the
      tegument distal cytoplasm. The larvocysts obtained from one host species in
      different geographic zones of the country are morphologically similar. The
      sterile Echinococcus granulosus larvocysts obtained upon experimental infection
      of mice demonstrate typical morphological signs of the strain used for infection.

PMID- 2233540
TI  - [The clinical picture of tropical malaria in nonimmune newcomers in endemic foci
      in Africa].
AB  - 415 nonimmune patients with acute signs and symptoms of falciparum malaria have
      been examined. The study has shown that 2/3 of patients had a moderate form of
      the disease, a severe form was noted only in 4.57% of patients. Classical
      symptoms of malaria--chill, body ache, headache--were observed only in half of
      the patients, 1/3 of patients had so-called masks of malaria--respiratory
      catarrh, pharyngitis, allergy, symptoms of enterocolitis. Early diagnosis and
      complex treatment with chloroquine or chloroquine combined with fansidar (1.16%
      of patients) promoted to a rapid improvement of the clinical symptoms and to
      favourable outcome. No fatal outcomes or severe complications have been observed.
      The mean duration of the disability period was 8.9 days. The first-degree
      resistance to chloroquine (clinical data) was noted in 11 patients, repeated
      manifestations of malaria occurred in 8.12% of patients and were more severe.

PMID- 2233542
TI  - [The Wilcoxon nonparametric statistical criterion in the Mann-Whitney
      modification in evaluating the results of parasitological health research].

PMID- 2233543
TI  - [Invention activities and the structure of conducting patent research at the E.
      I. Martsinovskii Institute of Medical Parasitology and Tropical Medicine. The
      tasks of the Patent Service of the Institute].

PMID- 2233544
TI  - [The first Russian expedition to Brazil in 1821-1829 (the medical parasitological
      aspects)].

PMID- 2233546
TI  - [Ecology and health].
AB  - The World Health Organization (WHO) has proclaimed 1990 as the year of human
      environment protection. A tight bond between ecology as a science, and preventive
      medicine has been observed. The paper presents the basic facts about ground,
      water and air pollution, as well as the effects of ecological disorders on human
      health. Noted are the basic pointers for the improvement of the conditions in our
      environment and the role that society and the individual, especially a physician
      has to carry. Everybody should act accordingly with the proclaimed slogan: Think
      global--Act local.

PMID- 2233545
TI  - [The efficacy of and tolerance for fansimef in the treatment of tropical malaria
      in the south of the Socialist Republic of Vietnam].
AB  - The efficacy of and tolerance to fancimef in 49 patients was compared to the
      efficacy of and tolerance to quinine in combination with fansidar in 33 patients
      with moderate P. falciparum malaria. A good tolerance to and a high efficacy of
      fancimef have been shown, which was manifested in rapid fever arrest,
      disappearance of parasitemia, absence of the disease relapses, which were
      observed in 2 patients on quinine combined with fansidar. The advantage of
      fansimef is one-time administration of the total course dose.

PMID- 2233548
TI  - [The importance of monitoring with the Swan-Ganz catheter in cardiac surgery-
      personal experience].
AB  - In our paper we will present the advantages of the modern hemodynamic monitoring
      system in open heart surgery, especially in high risk patients. The Swan-Ganz
      monitoring system, with great possibilities for measuring and calculating a large
      number of parameters, is necessary for the postoperative treatment, for regular
      diagnosis and therapy of heart insufficiency, as well as the low cardiac output
      syndrome. There is no correlation between pulmonary capillary wedge pressure and
      central venous pressure, and central venous pressure isn't significant for heart
      insufficiency estimation, more exactly left heart insufficiency estimation.
      Pulmonary capillary wedge pressure is significant in the prevention and therapy
      of the low cardiac output syndrome.

PMID- 2233547
TI  - [Ecological characteristics of viral hepatitis. III. Hepatitis B in Vojvodina].
AB  - The significance of particular risk factors for hepatitis B virus infection in
      persons of various ages was analyzed by active epidemiological investigation.
      Among the diseased children, the largest number of them were mentally retarded
      and accommodated in special institutions. Sexual and professional exposure to the
      hepatitis B virus is responsible for a considerable percentage of diseased
      adults, aged 20-49. In persons over 50 years of age, parenteral medical
      interventions are the most frequent risk factor. By carrying out proper
      sterilization in medical practice and vaccination of the exposed categories of
      the population, a significant reduction of the hepatitis B morbidity rates can be
      achieved.

PMID- 2233549
TI  - [Morphometric analysis of the vascular network of the suprachiasmatic and
      paraventricular nucleus in the human brain].
AB  - The aim of the study is to discover, the sources of vascularization, vascular
      areas, the size and density of the capillary network in the suprachiasmatic and
      the paraventricular nuclei of postnatal human brains of both sexes. The brain
      blood vessels under examination were filled with a mixture of India ink and
      gelatin. The serial paraffin sections of 200 microns cleared after Spalteholz. In
      the vascularization of the suprachiasmatic and the paraventricular nuclei, two
      arterial stems, take part with their branches (a. cerebri anterior and a.
      communicans anterior). In order to quantify the density of the capillary network,
      the authors used the standard stereologic parameters - volume density, surface
      density and mean radius of blood vessels. The comparative testing of the mean
      values obtained in male and female subjects did not reveal any significant sex -
      dependent differences regarding the size and density of the capillary network in
      the suprachiasmatic and the paraventricular nuclei of the human brain.

PMID- 2233550
TI  - [Psychological changes in diabetic patients with polyneuropathy].
AB  - The study has multi-sidedly examined and considered the possible relations
      between psychic, especially unsuitable emotional charges and the most frequent
      peripheral nerve complications in diabetes mellitus patients. By the comparative
      method of researching the psychic status and electro-physiological
      characteristics in patients with diabetic polyneuropathy, it has not been
      determined that distinct psychic disorders exist in patients with roughly
      expressed nervous complications in relation to the control group on condition,
      which consists of patients with complications of a lighter form. The results of
      this research lead the assumptions, of a possible psychic induction of nervous
      complications in the course of diabetes mellitus, to a doubt.

PMID- 2233551
TI  - [Social tension--a factor in conversion. Case report].
AB  - Presented is a case of a girl of Albanian nationality, an adolescent, one of the
      ill in the group of "mass poisoned" in Kosovo, at the beginning of 1990. The up
      to then, completely healthy girl had repeated crises of the same type four times,
      with functional disorders. She was hospitalized at the request of her father in
      Novi Sad, at the Institute for Neurology and Psychiatry of the Developmental Age.
      The somatic and laboratory findings were within the average limits. The
      psychological tests indicated a person prone to conversive reacting in situations
      which she does not succeed to process emotionally in an adequate manner. Such a
      personality structure had the role of inducing a conversive atmosphere in the
      immediate school environment. The presented case has suggested that a low level
      of general culture and expected school knowledge primarily creates favorable
      grounds for massive hysterical occurrences.

PMID- 2233553
TI  - [Fluoridation of drinking water in Pancevo].
AB  - In Pancevo on May 12, 1988 the continual fluoridation of water was started.
      Fluoridation is conducted with 2% silicofluoride acid. Up to now, controls on
      fluoride content in drinking water, which are conducted on eight places in the
      city, show that the concentration of fluoride is about 1 mg of fluoride per liter
      of drinking water. There are very little deviations during measurement, so the
      system can be considered as safe. The analysis of costs of water fluoridation in
      October 1988 was 250 dinars per inhabitant. In this way we achieved the most
      efficient and at the same time cheap method of dental health protection as well
      as the protection of the whole human organism, in accordance with the opinions of
      the World Health Organization concerning that subject.

PMID- 2233552
TI  - [Acute gastrointestinal hemorrhage after placement of a peritoneojugular shunt].
AB  - Since 1984 the peritoneovenous (LeVeen) shunt has been installed in 33 patients
      (10 females 30.3%, and 23 males 69.7%), with the average age of 54 +/- 8 years
      all in the oedema--ascitic decompensation phase of their primary illness. The
      control group consisted of 39 patients with identical etiology and primary
      illness stadium, sex and age structure and duration of primary illness, all
      treated with medicament - diet therapy. All the operated patients and those
      treated with medicament--diet regime died. Their autopsy findings were
      confronted. The aim of this study was to indicate the type and frequency of
      digestive hemorrhage in this population on our own clinical--patient material.
      Gastrointestinal hemorrhage was the cause of death in 8 (24.24%) patients out of
      the group operated on, and 6 (15.3%) from the control group. The isolated rupture
      of esophageal varices was the cause of death in one (3.03%) patient out of the
      group operated on, and in 5 (12.12%) patients from the control group, the rupture
      of esophageal varices with toxic vasculitis in 3 (0.09%) patients from the group
      operated on, and not in one out of the control group; rupture of esophageal
      varices associated with toxic vasculitis and disorders of the hemostatic
      mechanism appeared in 4 (12.12%) of patients from the group operated on, and in 1
      (2.56%) of the control group. On the basis of the presented it can be concluded
      that gastrointestinal hemorrhage is a significantly more frequent cause of death
      in the group operated on than in the control group, and that hemorrhages are of
      an all the more complex etiology when the flow-in of ascites into circulation is
      greater. Hemodilution and endotoxins are to blame for their occurrence and it is
      necessary to preoperatively conduct, beside the control of the hemostatic
      mechanism, also the test of ones own ascitic burdening and to determine the level
      of endotoxin in the ascites.

PMID- 2233554
TI  - [Analysis of the causes of suicide attempts in women].
AB  - In suicidological literature and practice there is a repeated confirmation of the
      presence of the appeal function as an unconscious motive in the suicide attempt.
      In the basis of the appeal is the attempt of the suicidant to restore disturbed
      relations with surroundings, and according to this, in this case, the suicide
      attempt is directed more to life than death. In the researched material an
      analysis was conducted of the cause of death in 319 women with the aim to evident
      the possible presence of unwanted pregnancy and to give light to the causes and
      motives of the act of suicide.

PMID- 2233555
TI  - [Hypoglycemia in childhood. I. Physiology, pathophysiology and the classification
      of hypoglycemia].
AB  - Regardless of age and body mass, hypoglycemia is defined as the glycemia value
      below 2.6 mmol/l. This is the borderline glycemia value, below which the
      suffering begins which directly endangers the CNS development in the newborn
      period. The fact that we registered hypoglycemias in 2/3 of premature infants and
      in 3/4 of low birth weight infants at registration on the ward for premature
      infants at the Institute for Mother and Child Health Protection, in the course of
      1988, tells of the complexity and seriousness of the situation with which we meet
      during the depopulation of the inhabitants. The paper gives physiological basics
      for the understanding of glucose homeostasis in the organism, as the most
      frequent forms of hypoglycemia with which the physician meets in practice. A
      diagnosing and hypoglycemia treatment algorithm is given.

PMID- 2233556
TI  - [Rehabilitation of the rheumatoid hand].
AB  - Treatment of patients suffering from rheumatoid arthritis is complicated and it
      consists mainly of applying general measures, medical therapy, physical therapy
      and rehabilitation, and, if necessary, surgical - orthopedic measures. The
      treatment is conducted as team work and it lasts for years. The chronic and
      evolutionary character of the disease requires a rather dynamic effort against
      the onset of joint deformation as well as the constant follow up of the evolution
      of the disease, and the local condition of the joints. Within the examined group
      of a hundred patients with classical and definitive rheumatoid arthritis, formed
      deformations of hand joints were registered in 72% of patients by means of
      clinical examination. Preventive measures against joint deformation make an
      integral part of rheumatoid arthritis patient treatment. Their application starts
      from the moment when the diagnosis is made and lasts as long as the disease does.

PMID- 2233558
TI  - [Regulation of muscle tonus].
AB  - The regulation of muscle tonus takes place at least at six levels of the central
      nervous system: the spinal cord, vestibular nuclei, the cerebellum, the reticular
      formation, extrapyramidal system and the motor cortex. A multiple complexity of
      the connections of these systems in the regulation of muscle tonus is presented,
      so that therapy can be usefully applied in states of muscle tonus disorders.

PMID- 2233557
TI  - [Clinical and radiologic status of the hip joint in adolescents and children with
      late detection of anomalies of the hip joint].
AB  - The study analyzed 35 questionnaires (70 hips) with an overdue discovered anomaly
      of the hip joint. 32 cases (91.5%) were girls, 3 cases (8.5%) boys, while the
      relation of girls to boys was 10.6:1. The average age at the moment of discovery
      of the defect was 3.9 months and in the period of control 12-13 years. All the
      questionnaires were conservatively treated but it was not observed that the
      method of treatment had any influence on the final result. According to analysis
      of clinical and radiological parameters the authors accepted the thought that
      these hips should be followed up until the end of their growth, and when an
      indication for operative treatment has been set it should take care about the
      development of the acetabulum as well as the shape of the proximal edge of the
      femur and the orientation of the ilium bone.

PMID- 2233559
TI  - [Organic factors in behavior disorders in the developmental age].
AB  - The problem of bad behavior in the young is as old as the written history of
      mankind. It is always a current problem in a practical and theoretical sense as
      well. While everyday life is filled with various forms of criminal offense, drug
      addiction, the forming of gangs-especially in dynamic societies, theoretical
      opinions tend to oscillate between biological factors and the psychological
      social ones which are always unsuitable for a person in the course of its
      development. The authors have presented a review of the basic theoretical
      directions, and after that the results of their own research. Children with
      behavior disorders were investigated: parallely by psychological-psychiatric
      investigation as well as with an up-to-date biological approach, examining
      subclinical semiotics, EEG and REG. On the basis of these comparisons we have
      come to the following principal opinions: the suggested psycho-neuro-vegetative
      subclinical syndrome, recommended by the same authors, does not take the behavior
      disorder upon itself. Also, not every behavior disorder includes the obligatory
      psycho-neuro-vegetative subclinical syndrome (PNVSS). Nevertheless, PNVSS
      presents a risk factor for behavior disorder, in the case that the personality in
      development is growing up under unfavorable psycho-social conditions. Finally, in
      the younger ages PNVSS, by its primary features, determines the behavior disorder
      also, while at an older age (after 11) behavior has all the more of an asocial
      and antisocial character.

PMID- 2233560
TI  - [The 88th anniversary of the Novi Sad Iodine Spa].

PMID- 2233561
TI  - Random sampling for evaluating treatment plans.
AB  - We analyze the influence of sampling technique on the accuracy of estimating
      irradiated volumes, dose-volume histograms and tumor control and normal tissue
      complication probabilities. The sampling techniques we consider are uniform
      distribution of points on a regular Cartesian grid and random selection of
      points. For three-dimensional treatment planning, random sampling leads to a
      significant reduction in estimation error and/or in the number of calculation
      points necessary to achieve a required accuracy. We discuss advantages and
      drawbacks of random sampling, as compared to sampling on a regular grid. It is
      suggested that, in practical situations, at least 50 times fewer randomly sampled
      points per organ/volume of interest are needed for fast estimation of
      complication probability with the same accuracy, i.e., not exceeding 5% (within
      95% confidence limits) in the worst case.

PMID- 2233562
TI  - Therapy imaging: a signal-to-noise analysis of a fluoroscopic imaging system for
      radiotherapy localization.
AB  - We have been developing a digital fluoroscopic imaging system to replace the
      portal films that are currently used to verify patient positioning during
      radiotherapy treatments. Our system differs from previously reported devices in
      the construction of the detector and in the operation of the TV camera. The
      signal, noise, and signal-to-noise properties of this system have been determined
      by measuring the modulation transfer function [MTF(f)], the noise power spectra
      [NPS(f)], and by calculating the detective quantum efficiency [DQE(f)] of the
      system. The results show: (i) that the spatial resolution of the system is
      determined largely by the lens of the TV camera and by frame grabber; and (ii)
      that the noise in the system is dominated by the secondary light quanta, due to
      the poor light collection efficiency of the optical chain. Despite these physical
      limitations, a contrast-detail study shows that the fluoroscopic system is better
      at detecting large, low contrast objects than portal films. Therefore the system
      is already a reasonable alternative to portal films and modifications to the
      metal plate/phosphor detector, lens, TV camera, and frame grabber should improve
      the performance of the system further.

PMID- 2233563
TI  - Forward-directed bremsstrahlung of 10- to 30-MeV electrons incident on thick
      targets of Al and Pb.
AB  - Bremsstrahlung spectra from thick targets of Al and Pb have been measured
      absolutely (photons per incident electron) along the beam axis for electrons of
      10-, 15-, 20-, 25-, and 30-MeV incident energy. The spectra have a 220-keV low
      energy cutoff. The targets were cylinders with nominal thicknesses of 110% of the
      electron CSDA range. A thin transmission detector, calibrated against a toroidal
      current monitor, was placed upstream of the target to measure the beam current.
      The spectrometer was a 20-cm diameter by 25-cm-long cylindrical NaI detector.
      Measured spectra were corrected for pile-up, background, detector response,
      detector efficiency, attenuation in materials between the target and detector and
      the collimator effect. Spectra were calculated using the EGS4 Monte Carlo system
      for simulating the radiation transport. The simulation model included the small
      amount of material upstream of the target. This material contributed about 40% of
      the spectrum, but its presence or absence had little effect on the calculated
      bremsstrahlung yield. The shapes of the measured and calculated spectra were in
      excellent agreement. The ratio of the total number of photons in each measured
      spectrum to those in the corresponding calculated spectrum varied from 0.97 +/-
      0.06 to 1.12 +/- 0.06, depending largely on the atomic number of the target.
      Absolute spectral measurements in the literature agreed with our calculations of
      spectral shape but showed a range of +/- 30% in the number of photons per
      incident electron relative to the calculated values, which is contrary to our
      result.

PMID- 2233564
TI  - Effect of tissue inhomogeneity on dose distribution of point sources of low
      energy electrons.
AB  - Perturbation in dose distributions of point sources of low-energy electrons at
      planar interfaces of cortical bone (CB) and red marrow (RM) was investigated
      experimentally and by Monte Carlo codes EGS and the TIGER series. Ultrathin LiF
      thermoluminescent dosimeters were used to measure the dose distributions of point
      sources of 204Tl and 147Pm in RM. When the point sources were at 12 mg/cm2 from a
      planar interface of CB and RM equivalent plastics, dose enhancement ratios in RM
      averaged over the region 0-12 mg/cm2 from the interface were measured to be 1.08
      +/- 0.03 (SE) and 1.03 +/- 0.03 (SE) for 204Tl and 147Pm, respectively. The Monte
      Carlo codes predicted 1.05 +/- 0.02 and 1.01 +/- 0.02 for the two nuclides,
      respectively. However, EGS gave consistently 3% higher dose in the dose scoring
      region than the TIGER series when point sources of monoenergetic electrons up to
      0.75 MeV energy were considered in the homogeneous RM situation or in the CB and
      RM heterogeneous situation. By means of the TIGER series, it was demonstrated
      that aluminum, which is normally assumed to be equivalent to CB in radiation
      dosimetry, leads to an overestimation of backscattering of low-energy electrons
      in soft tissue at a CB-soft-tissue interface by as much as a factor of 2.

PMID- 2233565
TI  - Anthropomorphic radiation therapy phantoms: a quantitative assessment of tissue
      substitutes.
AB  - Compositional analyses of samples of soft tissue and lung substitutes used in the
      construction of anthropomorphic radiotherapy phantoms were performed for products
      from Alderson Research Laboratories Inc., Kyoto Scientific Specimens
      Company/Capintec Inc., Humanoid Systems Inc., Radiology Support Devices Inc., and
      The Phantom Laboratory Inc. To assess quality control in the manufacture process,
      the results of these compositional analyses were compared with individual
      manufacturer's design specifications and electron densities measured by computed
      tomography analysis of actual phantom slices. A comparison of the manufacturers
      design specifications against reference tissue parameters from Tissue Substitutes
      in Radiation Dosimetry and Measurement (International Commission on Radiation
      Units and Measurements) indicates marked differences in the basic design of
      commercially available anthropomorphic phantoms.

PMID- 2233566
TI  - On methods of inhomogeneity corrections for photon transport.
AB  - Eight methods of photon inhomogeneity correction were examined for their photon
      transport approximations. The methods were categorized according to the different
      approaches used to model scatter photon dose contribution. They were the ratio of
      TAR (RTAR) and the modified Batho power law which utilized only the 1-D density
      information along the primary photon path; the equivalent TAR (ETAR) and the FFT
      convolution methods which incorporated the 3-D density information of the medium
      for empirical scatter dose calculation; the differential SAR (DSAR), the delta
      volume (DV), dose spread array (DSA), and differential pencil beam (DPB) methods
      which employed explicit 3-D scatter ray-trace calculation. Cobalt-60 measurements
      in horizontal slab phantoms were used to allow simpler data analysis. RTAR
      consistently overestimated lung corrections by approximately 10%. The scatter ray
      trace approach was not always better as the DSAR calculations were inferior to
      those using the Batho method. The ray-tracing DV, DPB, and DSA methods agreed
      with measurements mostly to within 2%, at the expense of long computation time.
      The nonscatter ray-tracing ETAR and FFT convolution calculations were only
      slightly inferior in the same geometries. These methods improve on the current 1
      D methods and should be seriously considered for fast optimization purposes in
      practical 3-D treatment planning.

PMID- 2233567
TI  - Dose rate determination for 125I seeds.
AB  - Dose rates in water have been determined for the two types of 125I seed currently
      used in brachytherapy. The need for such determinations became evident when
      water/air ratios measured with a silicon diode were found to be lower than
      expected. Extensive measurements using lithium fluoride thermoluminescent
      dosimeters (TLD's) have been performed in a solid water phantom, at distances
      from 0.1 to 10 cm from the seed center and at angular increments of 10 degrees,
      15 degrees, or 30 degrees within a plane through the seed axis. Dose calibration
      of the TLD's was accomplished by irradiation in air with 125I seeds of the same
      type and of strengths traceable to a calibration at the National Institute of
      Standards and Technology (NIST). Relative calibration of TLD's was monitored by
      irradiation, in an oven-type x-ray machine, of control dosimeters simultaneously
      and all dosimeters intercurrently with the 125I irradiations. Values obtained for
      the dose rate constant, i.e., dose rate per unit air-kerma strength at 1 cm on
      the transverse axis, were 0.853 and 0.932 cGy h-1 U-1 (1.08 and 1.18 cGy h-1 mCi
      1) for the 6711 and 6702 seeds, respectively. Measured data were supplemented
      with Monte Carlo-calculated relative dose rate data generated using the MORSE
      code. These calculations used 100 energy groups from 10 to 35.4 keV and involved
      energy collection bins ranging from 0.025 to 1.2 cm on an edge. Normalized at 1
      cm, transverse axis calculated data are not significantly different from measured
      data (ours or cited literature) at distances either less than 2.5 or greater than
      8 cm. Normalized at different distances along the transverse axis, our off-axis
      calculated and measured distributions agree closely at all angles but differ from
      literature measured distributions at small (less than or equal to 1 cm) distances
      and, for small angles, increasingly at larger distances (greater than or equal to
      5 cm).

PMID- 2233568
TI  - Dose distribution of 125I sources in different tissues.
AB  - The low-energy photons of 125I deposit energy in tissues primarily by the
      photoelectric effect, which is strongly dependent on the atomic number Z. Thus
      dose distributions of 125I sources in media of different Z are not the same. LiF
      and CaF2 thermoluminescent dosimeters were used for relative dose distribution
      measurements in materials that are equivalent to muscle, breast, and bone. The
      experimental data are in good agreement with published results for muscle, and in
      reasonable agreement with Monte Carlo calculations for all the tissues tested.
      These measured data provide the basis for dose distribution calculations when
      125I seeds are implanted in or near inhomogeneous tissues.

PMID- 2233570
TI  - Film dosimetry analyses on the effect of gold shielding for iodine-125 eye plaque
      therapy for choroidal melanoma.
AB  - One of the methods currently being used to treat choroidal melanoma employs an
      episcleral plaque containing I-125 radioactive seeds. However, comprehensive
      dosimetry studies on the plaque are scarce and controversial. For this work, we
      use film to study the dosimetry outside the lip of the gold shield of the eye
      plaque. This lip around the gold shield was made to protect the critical
      structures behind and adjacent to the lesion. Since the changes of energy
      spectrum of I-125 in tissue are negligible, film dosimetry seems to be a logical
      choice because of high spatial resolution required around the lip of the gold
      plaque. For this study, we first established an H and D curve with dose expressed
      in a unit of specific dose rate constant. This avoids absolute dose measurements.
      All film density measurements are made with a 1-mm aperture scan, normalized to
      the density at the prescription point for tumor of 3-5-mm apical height, i.e., 5
      mm from the interior surface of sclera, and converted to percentage isodose
      curves. With a gold shield, it is found that when the plaque is placed against
      the optical nerve, the optical disk and macula, located at 2 mm outside the lip,
      on the exterior surface of sclera, may receive 85% of the prescription dose for a
      12-mm plaque and 58% for a 16-mm plaque. For tumors of 8-mm apical height, the
      optical nerve would receive more than the prescription dose.

PMID- 2233569
TI  - A dose computation model for 241Am vaginal applicators including the source-to
      source shielding effects.
AB  - A dose computation model has been developed for the determination of dose
      distributions around vaginal plaque applicators containing encapsulated 241Am
      sources. Encapsulated sources of 241Am emit primarily 60-keV photons which have a
      half-value layer thickness of 1/8 mm of lead. This makes possible highly
      effective in vivo shielding of normal tissues at risk, by placing thin lead
      shields at appropriate places on the applicator. However, self-absorption of
      photons in the source material itself is intense, requiring bulky sources of
      about 1 cm diameter. These sources also produce considerable source-to-source
      shielding which must be taken into account in dose calculations. Our dose
      computation model for a single source employs three-dimensional integration of
      dose contributions from volume elements of the source including the effects of
      absorption and scattering of photons in the source material, titanium
      encapsulation, and water. An empirical correction to Berger's data on buildup
      factors of point, isotropic sources is made to account for the effects of
      anisotropic photon emission by cylindrical 241Am sources. The second part of our
      dose computation model takes into account source-to-source shielding effects on
      both primary and scattered photons for the vaginal plaque geometry. The results
      of the model have been verified for accuracy by comparisons with extensive
      dosimetry measurements using lithium fluoride thermoluminescent dosimeters.

PMID- 2233571
TI  - Line and slice selection for moving spins.
AB  - The Bloch equations are solved numerically for spins moving at constant velocity
      for the case of 90 degrees slice selection, and for subsequent 180 degrees spin
      echo line selection. The calculations use the comoving, rotating reference frame
      which is shown to be valid for general accelerated motions. Magnetization
      profiles and phase shifts are presented for slice selection for both plug and
      laminar flow. Line selection is studied for the case of plug flow, where a "local
      vector sum" is introduced to demonstrate effective localization of activated
      spins. In addition to local magnetization densities, the spatially integrated
      signals seen by a nonselective antenna are calculated. The relation between net
      phase shift and flow rate is examined and deviations from the predictions of
      simple analytic models are discussed.

PMID- 2233572
TI  - Hyperthermia system combined with a magnetic resonance imaging unit.
AB  - Magnetic resonance imaging (MRI) has recently been proposed as a method to
      monitor, noninvasively, temperature, blood flow, and cell metabolism during
      oncologic hyperthermia (HT). To heat and "image" simultaneously, it is necessary
      to combine a HT device and a MRI unit. As a demonstrative example of the problems
      associated with implementing such a system, a mini-annular phased array
      hyperthermia applicator was combined with a 0.5-T whole body MRI unit. With the
      aid of filters, baluns, and switches, the HT applicator and the MRI unit were
      made compatible. The overall system was tested using a muscle-equivalent,
      cylindrically shaped polyacrylamide gel phantom. No interference between the HT
      device and the MRI unit was observed. Noninvasive temperature images, with a
      resolution better than 1 degree C/cm, were obtained from images of molecular
      diffusion recorded before and during heating.

PMID- 2233573
TI  - Computerized detection of pulmonary nodules in digital chest images: use of
      morphological filters in reducing false-positive detections.
AB  - Currently, radiologists can fail to detect lung nodules in up to 30% of actually
      positive cases. If a computerized scheme could alert the radiologist to locations
      of suspected nodules, then potentially the number of missed nodules could be
      reduced. We are developing such a computerized scheme that involves a difference
      image approach and various feature-extraction techniques. In this paper, we
      describe our use of digital morphological processing in the reduction of computer
      identified false-positive detections. A feature-extraction technique, which
      includes the sequential application of nonlinear filters of erosion and dilation,
      is employed to reduce the camouflaging effect of ribs and vessels on nodule
      detection. This additional feature-extraction technique reduced the true-positive
      rate of the computerized scheme by 13% and the false-positive rate by 50%. In a
      comparison of the scheme with and without the additional feature-extraction
      technique, inclusion of the additional technique increased the detection
      sensitivity by about half at the level of three to four false-positive detections
      per chest image.

PMID- 2233574
TI  - Single-exposure dual-energy computed radiography.
AB  - This paper focuses on analysis and development of a single-exposure dual-energy
      digital radiographic method using computed radiography (Fuji FCR-101 storage
      phosphor system). A detector sandwich consisting of storage phosphor imaging
      plates and an interdetector filter is used. The goal of this process is to
      provide a simple dual-energy method using typical plane-projection radiographic
      equipment and techniques. This approach exploits the transparency of the storage
      phosphor plates, using radiographic information that would be otherwise lost, to
      provide energy selective information essentially as a by-product of the
      radiographic examination. In order to effectively make use of the large dynamic
      range of the storage phosphor imaging plates (10,000:1), a computed radiography
      image reading mode of fixed analog-to-digital converter gain and variable
      photomultiplier sensitivity provides image data which can be related to relative
      incident exposure for export to the decomposition algorithm. Scatter rejection
      requirements necessitated crossed 12:1 grids for a field size of 36 x 36 cm.
      Optimal technique parameters obtained from computer simulation through
      minimization of the aluminum and Plexiglas equivalent image uncertainty under
      conditions of constant absorbed does resulted as: 100 kVp using a 0.15-mm-thick
      tin (Sn) interdetector filter for the lung field. This yields a surface exposure
      of 23 mR and a surface absorbed dose of 0.26 mGy for a 23-cm-thick chest.
      Clinical application in evaluation of the solitary pulmonary nodule is discussed,
      along with an image set demonstrating this application.

PMID- 2233575
TI  - A time-delay integration charge-coupled device camera for slot-scanned digital
      radiography.
AB  - We have developed a low-noise digital camera based on a 512 x 96 element CCD
      operating in the time-delay integration mode. This camera has been combined with
      an x-ray image intensifier to record radiographic images produced by a scanning
      slot beam of radiation. This results in the rejection of a large fraction of
      scattered radiation, without a significant increase in x-ray tube heat loading or
      image acquisition time. Here we describe the design of our CCD camera and the
      results of our investigations of camera resolution, linearity, noise, and quantum
      efficiency. We have found that both the resolution limit (50 mm-1) and the
      dynamic range (2100) of this novel camera are greater than reported values for
      conventional video cameras. Applications of this system in digital angiography
      and mammography are discussed.

PMID- 2233576
TI  - Effect of various noise sources on the detective quantum efficiency of phosphor
      screens.
AB  - We have examined the effect of screen-structure, optical-detector, and secondary
      quantum noise sources on detective quantum efficiency, DQE(f). This was done by
      using experimental measurements of screen-structure and optical-detector noise in
      combination with a theoretical model which predicts x-ray quantum and secondary
      quantum noise for different optical and physical properties of a phosphor screen.
      The reduction in DQE(f) from noise sources other than x-ray quantum noise depends
      on the noise power spectra (NPS) of these other sources relative to the x-ray
      quantum NPS. Even though x-ray quantum noise may be the dominant noise source at
      low spatial frequencies, it decreases relatively rapidly with increasing
      frequency so that other noise sources, which may be small at low frequencies,
      dominate. Our model predicts that DQE(f) can be increased, at spatial frequencies
      less than 4 mm-1, by changing the optical properties of the screen even though
      modulation transfer function MTF(f) may decrease. Furthermore, if screen and
      optical-detector noise decrease with increasing frequency and secondary-quantum
      noise sufficiently small, then DQE(f) will also be improved at frequencies
      greater than 4 mm-1.

PMID- 2233578
TI  - Effects of nonmineral tissues on measurement of bone mineral content by dual
      photon absorptiometry.
AB  - Computer simulations were performed to investigate the effects of nonmineral
      tissue (overlying soft tissue and nonmineral components of bone) on the
      measurement of bone mineral content by dual-photon absorptiometry (DPA). Selected
      experimental studies were performed to test the predictions of the simulations.
      The results indicate that variations in the composition of nonmineral tissue can
      significantly affect measurement precision and accuracy at the levels achievable
      with modern x-ray based absorptiometry systems (0.5%). Thus biological variables
      may limit further improvements in measurement precision and accuracy. Biological
      variables also can affect intercalibration of systems that use different
      radiation sources and/or calibration techniques.

PMID- 2233577
TI  - Model of the spatial-frequency-dependent detective quantum efficiency of phosphor
      screens.
AB  - We have developed a theoretical model to predict the modulation transfer function
      (MTF), the shape of the x-ray quantum noise power spectrum (NPS), and the spatial
      frequency-dependent detective quantum efficiency (DQE) of an x-ray phosphor
      screen. The transfer of energy through the screen is modelled as a series of
      cascaded stochastic processes assuming that the screen consists of many thin
      phosphor layers. In this way, the model is able to account for the possibility of
      secondary-quantum noise and the difference in shape between MTF2 and the x-ray
      quantum NPS. Modelling a Kodak Min-R screen we were able to predict both the
      number of light quanta emitted per absorbed x-ray and MTF(f) to better than +/-
      5%, and the scintillation efficiency to within 10% of experimentally measured
      values. The shape of the x-ray quantum NPS is predicted to within +/- 5% for
      spatial frequencies less than about 6 mm-1 and to within +/- 20% for higher
      frequencies.

PMID- 2233579
TI  - Origins of flare in x-ray image intensifiers.
AB  - The disk spread function of flare of an x-ray image intensifier (XRII) was
      measured using monoenergetic x rays. The signal-to-noise ratio at the center of
      the disks and the pulse height spectrum of the flare are also measured. These
      measurements are correlated with the physical construction of the XRII. A simple
      model of the XRII is developed which is used to identify the various sources of
      flare.

PMID- 2233580
TI  - Some possible effects of a catheter on the arterial wall.
AB  - When a catheter is inserted through an artery, the wall shear stress increases
      and the secondary flow exhibits an increased number of instantaneous vortices.
      These effects become more evident when the annular gap between the catheter and
      the artery becomes more narrow. Accordingly it is suggested that these factors
      may affect the preferential distribution of the atheromatous plaques at the sites
      of the wall with an increased permeability.

PMID- 2233581
TI  - Lesion detection in radiologic images using an autoassociative paradigm:
      preliminary results.
AB  - An area of artificial intelligence that has gained recent attention is the neural
      network approach to pattern recognition and classification. The use of neural
      networks in radiologic lesion detection is explored by employing what is known in
      the literature as the "novelty filter." This filter uses a linear algebraic
      model, whereupon in neural network terms, images of normal patterns become
      "training vectors" and are stored as columns of a matrix. An image of an abnormal
      pattern is introduced and the abnormality or the "novelty" is extracted. A
      noniterative technique has been applied. In a preliminary experiment,
      autoassociative recall was tested using alphabetic characters as training
      vectors. The second experiment used sections of transverse magnetic resonance
      (MR) images (TR = 3000 ms, TE = 40 ms) of normal patients as the training
      vectors. A section of a transverse MR brain image with multiple sclerosis lesions
      was introduced to the filter and the abnormalities were extracted. In conclusion,
      a neural network based lesion detector may have great promise in medical pattern
      recognition.

PMID- 2233582
TI  - Improving precision and safety in the use of beam modifying devices in radiation
      therapy.
AB  - Reliable and safe implementation of beam modifying devices such as wedges and
      block trays requires careful design and construction. Inappropriate design may
      pose problems ranging from user-hostile operation to hard-to-track, but
      significant variations in actual position in a beam. This may cause variation in
      actual wedge output factors, or variation in the position of a block tray. In
      case of simple mechanical failure or personnel mistake, design related mechanical
      conditions may result in injury to either a patient or a staff member. This paper
      is based on experience with linear accelerators from one manufacturer, but
      similar conditions are likely to exist with other radiation machines. A simple
      technical modification is offered which improves both accuracy and
      reproducibility in the placement of wedge-type filters. For our machines the
      solution also provides improved safety in the use of both wedge trays and block
      trays.

PMID- 2233583
TI  - A proposal for the calibration of plane-parallel ion chambers by accredited
      dosimetry calibration laboratories.
AB  - A procedure is described by which the AAPM-accredited dosimetry calibration
      laboratories could offer calibrations of plane-parallel ionization chambers for
      radiotherapy dosimetry applications, by comparison with a cylindrical ion chamber
      in a phantom irradiated by 60Co gamma rays. Ngas can thus be determined for the
      plane-parallel chamber under uniform conditions of photon scatter, and without
      the need for an electron fluence correction.

PMID- 2233584
TI  - Problems with the Radiation Measurements Incorporated/American College of
      Radiology mammography accreditation phantom.

PMID- 2233585
TI  - Assessment of 125I clinical dose specification from recent dose rate evaluations.

PMID- 2233586
TI  - Evaluation of the Crohn's Disease Activity Index (CDAI) and the Dutch Index for
      severity and activity of Crohn's disease. An analysis of the data from the
      European Cooperative Crohn's Disease Study.
AB  - In the European Cooperative Crohn's Disease Study a general documentation of
      clinical and laboratory data was made at the entry into the study in 452
      patients. These patients were in different states of their disease from quiescent
      to very active. In all patients the Crohn's Disease Activity Index of Best (CDAI)
      and the Dutch Index of van Hees was calculated. Three gastroenterologists did a
      global clinical rating and a separate laboratory rating without knowledge of the
      indices. The ratings were then correlated with the indices in the individual
      patients. The clinical rating correlated well with the CDAI (r = 0.88) and less
      with the Dutch Index (r = 0.672). On the other hand the laboratory rating showed
      a better correlation with the Dutch Index (r = 0.742) than with the CDAI (r =
      0.573). This demonstrates that the CDAI preferably is an estimate of the clinical
      severity of the disease and not of the activity of inflammation. Vice versa the
      Dutch Index is mainly reflecting the activity of the inflammatory process.

PMID- 2233587
TI  - [Sonographic percutaneous drainage of liver abscesses].
AB  - 13 patients with pyogenic liver abscess and five patients with amoebic abscess
      underwent percutaneous drainage of the abscesses using the Seldinger (n = 8) or
      trocar technique (n = 11). The results showed that the trocar method was easier
      and faster to perform and well tolerated by the patients. No complications were
      observed despite of one case of transient peritonitis caused by a dislocated
      catheter. One patient with pyogenic liver abscess died of septic shock. All other
      patients were successfully treated, using local drainage and systemic antibiotic
      therapy.

PMID- 2233588
TI  - [Bowel cleansing prior to colonoscopy. A prospective, randomized, blind
      comparative study].
AB  - A randomized, prospective, single blind study was performed in 90 hospital
      inpatients to compare the effect of three different bowel preparatory regimens
      prior to total colonoscopy. The extend of bowel cleansing, acceptance by the
      patients, side effects as well as body weight, blood pressure, pulse rate and
      various laboratory parameters served as major assessment criteria. Peroral
      colonic lavage was superior to a senna preparation and a combined laxative agent
      with regard to the extend of bowel cleansing (p less than 0.001). The study
      failed to detect significant differences in terms of acceptance by the patients
      between the three study groups. Minor deviations were found after the combination
      laxative (slight decrease of serum potassium levels by 0.32 mmol/l), after the
      senna preparation (minimal decrease of the heart rate), and after peroral lavage
      (slightly less weight reduction) as compared with the other study groups,
      respectively. We conclude that peroral lavage is significantly more effective
      with regard to the extend of bowel cleansing, when compared with two other bowel
      preparatory regimens, which use a senna preparation or a laxative combination,
      respectively. Likewise, this study failed to detect significant differences in
      terms of acceptance by the patients.

PMID- 2233589
TI  - [The effect of age and sex on localization, tumor stage and prognosis of
      colorectal carcinoma].
AB  - In a retrospective study including 946 cases with colorectal cancer we analysed
      age, sex, distribution and stage. There was a significant higher prevalence in
      women and in all tumor stages women were older than men. The frequencies of Dukes
      C and proximal colon cancer was significantly higher in women. In older patients
      we found an increasing incidence of proximal cancer. Instead of tumor stage the
      age, sex and distribution showed no influence on the outcome.

PMID- 2233590
TI  - [Imitation of primary sclerosing cholangitis by an infiltrating growing
      adenocarcinoma originating from the gallbladder].

PMID- 2233592
TI  - [Hepatobiliary complications of chronic inflammatory bowel diseases].

PMID- 2233591
TI  - [Indications for and efficacy of endoscopic sclerosing treatment of esophageal
      varices in liver cirrhosis].

PMID- 2233593
TI  - [Postgastrectomy syndrome].

PMID- 2233594
TI  - [Secondary esophageal perforation following sclerosing of varices--healing with
      conservative therapy].

PMID- 2233595
TI  - [Clinical aspects and therapy of achalasia exemplified by a case of dolicho
      esophagus].

PMID- 2233596
TI  - [Vascular risk factors in patients with ophthalmoplegia].
AB  - The occurrence of high-risk factors for vascular disorders was analysed in a
      group of 43 patients suffering from diplopia of unknown aetiology. The subjects
      (25 men and 18 women) were aged between 17 and 78 years. Previously excluded were
      patients with intracranial or orbital tumors, ocular myositis or myasthenia,
      multiple sclerosis, endocrine orbitopathy, head trauma, cerebral hemorrhage or
      aneurysms, leucaemic infiltrates or metastasising tumors. Compared to the control
      groups of extensive epidemiological studies, the patients showed a higher
      prevalence of arterial hypertension and diabetes mellitus. Adipositas,
      lipometabolic disturbance and cigarette smoking were also more frequent. The
      findings support the hypothesis of a vascular origin of eye-muscle paresis.

PMID- 2233597
TI  - [Serology and culture diagnosis of Campylobacter jejuni infections].
AB  - Campylobacter jejuni is known today as one of the most common pathogens in acute
      infectious enteritis. In 77 patients serological testing by complement fixation
      as well as stool cultures were performed. A campylobacter jejuni infection was
      identified in 53% by culture and in 64% by serology, only in 17% the diagnosis
      was made with both methods. We conclude, that because of these data stool culture
      and serological testing should be used simultaneously. The complement fixation
      technique shows an increase in serum titer one to three weeks after beginning of
      the illness and a decrease in serum titer after four to eight weeks. For this
      reason it is an appropriate method for the identification of acute infections.

PMID- 2233599
TI  - [Effect of nitrendipine on the function of the upper gastrointestinal tract].
AB  - A double-blind crossover-trial comparing the influence of orally administered
      nitrendipine and placebo on the function of the upper gastrointestinal tract was
      carried out in ten healthy volunteers. Esophageal motility, intestinal transit
      time, size and motility of the gallbladder, serum gastrin levels and gastric
      secretion (basal and after stimulation with pentagastrin) were determined. No
      statistically significant differences between nitrendipine and placebo could be
      observed. Most parameters remained unchanged in both groups. Serum gastrin levels
      slightly increased after nitrendipine but did not exceed the normal range. The
      results demonstrate that nitrendipine given in an antihypertensive dosage, in
      contrast to other calcium antagonists, does not influence the function of the
      upper gastrointestinal tract.

PMID- 2233598
TI  - [Therapy of moderate hypertension with the calcium antagonist nitrendipine in
      combination with beta receptor blocker or diuretic].
AB  - The efficacy of the calcium channel blocker nitrendipine alone and in combination
      with the beta blocking agent acebutolol or hydrochlorothiazide was tested in 34
      patients with moderate essential hypertension. After a wash out period of three
      to four weeks, all patients received placebo for two weeks, thereafter 20 mg of
      nitrendipine per day for four weeks. When diastolic blood pressure remained above
      95 mmHg with nitrendipine, acebutolol (200 mg/d) or the thiazide (25 mg/d) was
      added in a randomised double-blind fashion. With nitrendipine alone, blood
      pressure could be normalized in nine patients with a drop in pressure from
      168/108 to 152/89 mmHg. The other patients showed a fall in blood pressure from
      164/110 to 152/102 mmHg. In these patients, the addition of acebutolol or
      thiazide was followed by a further fall in blood pressure which was similar with
      both drugs. With acebutolol blood pressure decreased from 154/102 to 146/94 mmHg
      and with the thiazide from 152/102 to 147/95 mmHg, respectively. Minor and mostly
      transient side effects were predominantly seen during therapy with nitrendipine
      alone. The fall in diastolic but not systolic blood pressure with nitrendipine
      was correlated with age. The blood pressure lowering effect of nitrendipine was
      independent of plasma renin activity and intracellular electrolyte
      concentrations. In the therapy of moderate hypertension, nitrendipine given in
      combination with a betablocker or a thiazide diuretic is effective and well
      tolerated.

PMID- 2233601
TI  - [Therapy of bullous pemphigoid with erythromycin].
AB  - Bullous pemphigoid is the most common autoimmune mediated bullous disease in men.
      Erythromycin combined with a low dose methylprednisolone was tested in eleven
      patients in a prospective study. A historical collective of the last 33 patients
      treated before this study was started served as the control group. The duration
      of hospitalization as an expression of therapeutic response, but also of lowered
      side effects dropped down from 43 to 33 days in the erythromycin treated group.
      The study further shows a responder rate of about two thirds of the patients, one
      third, however, required a high dose regimen of corticosteroids in order to
      ameliorate. From this could be concluded, that two different subtypes of bullous
      pemphigoid exist concerning their therapeutic response.

PMID- 2233600
TI  - [Compliance problems in therapy with levothyroxine].
AB  - In order to evaluate problems with long-term levothyroxine therapy, the course of
      treatment in 185 patients of an endocrinological outpatient ward (88 with
      euthyroid goiter, 41 with overt or latent hypothyroidism, ten with Hashimoto's
      thyroiditis, 46 after resection of goiter) was analyzed retrospectively. Duration
      of therapy ranged from one to 28 years. Suppressive therapy of euthyroid goiter
      was stopped by the treating physician in eleven patients (11%), in five
      permanently. To the contrary, 30 patients (34%) stopped medication by themselves
      31 times, 29 times, however, levothyroxine was restarted again. Observations in
      the group with latent hypothyroidism were similar. After operation levothyroxine
      therapy was stopped by the physician eight times, six times only for a limited
      time period. Eight patients (17%) decided to stop therapy without knowledge of
      the treating physician, but in all it was restarted later. The presented results
      show that the success of levothyroxine therapy of euthyroid goiter as well as of
      prophylaxis of goiter relapse after operation is threatened by dyscompliance of
      the patients. In goiter suppression therapy compliance is further challenged by a
      lack of consequence in therapy planning and guidance.

PMID- 2233603
TI  - [Radiologic skeletal diagnosis in dialysis patients].

PMID- 2233602
TI  - [Syncope in coin lesion of the liver and anemia. Freiburg gastroenterology
      conference].

PMID- 2233605
TI  - [Quality assurance in medicine].

PMID- 2233604
TI  - [Prevention of obliterating arterial diseases with acetylsalicylic acid].

PMID- 2233606
TI  - [Post-primary multifocal soft tissue and bone tuberculosis].

PMID- 2233607
TI  - [Tongue necrosis in temporal arteritis].

PMID- 2233608
TI  - [Myelodysplastic syndrome--a retrospective study of 38 patients].
AB  - 38 patients diagnosed as myelodysplastic syndrome (MDS) were retrospectively
      evaluated for clinical course, prognostic factors, diagnostical power of cytology
      and histology and relevance of hypoplastic myelodysplastic syndrome. Median
      observation time was 14.5 (0 to 104) months. 15 patients (40%) developed an acute
      myelogenous leukemia after two to 67 (median eleven) months. Prognosis was
      negatively influenced by age, suggested myelotoxic agents in prior history and
      leukemia in first-grade relatives as well as ESR greater than or equal to 30 mm
      Hg (first hour). FAB-classification and Bournemouth-score reflected prognosis in
      respect to survival time and development of an acute leukemia. Cytology and
      histology revealed contradictory results in four of 14 comparable cases (28.6%).
      Hypoplastic myelodysplastic syndrome was diagnosed by histology in seven out of
      eight cases. This entity showed significantly lower WBC-values and a considerable
      longer survival time.

PMID- 2233609
TI  - [Prevalence, causes and effects of increased iron storage in patients with kidney
      transplantation].
AB  - Patients on chronic hemodialysis often need blood transfusions due to
      erythropoietin deficiency. Even after successful kidney transplantation iron
      overload may persist. Former histological studies have revealed siderosis of the
      liver in 69% of all patients whose serum ferritin was above 1100 ng/ml. The aim
      of the present study was to evaluate the influence of iron overload on liver
      function. In 146 symptom free patients with renal allografts serum ferritin was
      determined to detect possible iron overload. Serum ferritin between 4 and 5480
      ng/ml were found (women: 358.7 +/- 105.3; men 282.4 +/- 63.3 ng/ml; x +/- SEM).
      Twelve patients (8.1%) had ferritin levels higher than 1100 ng/ml. These twelve
      patients as well as another group of eight patients with renal allografts whose
      serum ferritin was known to be higher than 1100 ng/ml were included for further
      evaluation. Their data were matched and compared with those of a control group
      also patients with renal allograft (same age and sex) whose serum ferritin was
      lower than 1100 ng/ml. Transaminases (SGPT 22.6 +/- 3.6 vs. 15.4 +/- 6.0 U/l;
      SGOT 14.7 +/- 2.0 vs. 13.0 +/- 4.8 U/l) and plasma glucose (90.5 +/- 7.1 vs. 76.8
      +/- 3.7 mg/dl) were found to be significantly higher (p less than 0.05) in
      patients with serum ferritin levels above 1100 ng/ml. Elevated transaminases were
      significantly more frequent in patients with high serum ferritin (9 vs. 2; p less
      than 0.02) as compared with the control. Ferritin levels significantly correlated
      with the number of preceding blood transfusions (p less than 0.002). Hbs
      persistence was detected in six out of 20 patients with high ferritin levels but
      only in one out of 20 in the control group (p less than 0.05) whereas anti-Hbs
      prevalence was not different in the two groups. These data indicate that chronic
      iron overload should be considered as a possible cause of chronic liver disease
      in patients with renal allografts.

PMID- 2233610
TI  - [Long-term therapy of tumor pain using morphine-retard tablets].
AB  - We analysed the effect of sustained-release morphine tablets in 174 patients with
      severe cancer pain. A good relief of pain could be obtained in 65% of the
      patients within the first week and in 80% of the patients at the end of therapy.
      The mean daily dose was at 178 mg morphine, six patients needed more than 1000 mg
      per day. The sustained-release morphine was given at fixed intervals, in 80% of
      the cases every eight hours. No severe side-effects were associated with long
      term morphine therapy. We often saw nausea and vomiting, constipation and
      drowsiness, but these side-effects decreased after the first weeks of treatment.
      Only in ten patients we had to stop therapy because of side-effects. Morphine can
      be used successfully in the treatment of cancer pain for long periods without
      concern about tolerance.

PMID- 2233611
TI  - [Ascites and splenomegaly in childhood. Freiburger gastroenterology discussions].

PMID- 2233612
TI  - [Immunocytological phenotyping of leukemias and lymphomas. Methods, results,
      indications and significance].

PMID- 2233613
TI  - [Plasmocytoma: immunology and molecular genetics].

PMID- 2233615
TI  - [Immunotherapy of malignant diseases using interleukin 2. Bases, results,
      trends].

PMID- 2233614
TI  - [Immunotoxin: from the idea of "magic bullets" to clinical applications].

PMID- 2233616
TI  - [Motivation for and problems in the cooperation of psychosomatic medicine and
      oncology].

PMID- 2233617
TI  - [Therapy and prevention of malaria].

PMID- 2233618
TI  - Nicholas M. Greene, M.D. to receive ASA Distinguished Service Award.

PMID- 2233619
TI  - Ventilation of the newborn with tracheoesophageal fistula.

PMID- 2233620
TI  - Recolonization of anesthetic instruments after regular treatment with potentially
      pathogenic organisms.
AB  - Anesthetic instruments are classified as classes B with regard to sterilization
      status. This means that washing with soap and water or other detergents is
      sufficient for reuse. A prospective study was conducted over a 6 month period in
      the operating (rooms) theatres at Princess Basma Teaching Hospital on anesthetic
      instruments including laryngoscopes, oxygen masks, airways, tracheal tubes and
      suction catheters. Fifteen different samples were taken randomly at different
      sites on these instruments after they had been prepared conventionally for use,
      and these samples were cultured for bacterial contamination (e.g. P. Aeruginosa).
      The results showed that potentially pathogenic bacteria were colonizing these
      instruments. It was concluded that these instruments are important vehicles for
      transmitting various agents of infection and play an important role in causing
      nosocomial infections. It is recommended that more effective methods be used for
      sterilizing these instruments.

PMID- 2233621
TI  - Cardiopulmonary resuscitation in Saudi Arabia--past, present and future.

PMID- 2233622
TI  - Influence of head-up versus head-down position on intracardiac pressures during
      pulmonary artery catheterization.

PMID- 2233623
TI  - Dysrhythmias during oral surgery--effect of combined local and general
      anesthesia.
AB  - In two groups, each of 50 patients undergoing pulpectomy or multiple extractions,
      effects of combining xylocaine nerve block with halothane general anesthesia were
      studied. Local blockade of surgical stimuli reduced markedly the incidence of
      dysrhythmias occurring during halothane anesthesia. Recovery was faster and
      postoperative analgesia was enhanced.

PMID- 2233624
TI  - Hypotensive anesthesia for microsurgery of the middle ear--a review.

PMID- 2233625
TI  - Intraoperative one-lung ventilation for total laryngotracheoesophageal cleft.
AB  - A case of complete laryngotracheoesophageal cleft, diagnosed as an esophageal
      atresia with tracheoesophageal fistula, was successfully managed with one-lung
      ventilation during surgery, although some complications have occurred during
      surgery. Higher positive end-expiratory pressure (PEEP) was required to produce
      adequate expansion of the independent lung postoperatively.

PMID- 2233626
TI  - Droperidol-induced extrapyramidal symptoms in an adolescent following strabismus
      surgery.

PMID- 2233627
TI  - Disseminated intravascular coagulopathy diagnosed by computed tomography.
AB  - A 24-year-old man was brought to casualty after a fall. He suffered from head
      injury and multiple fractures. On arrival he was apneic and the heart was at a
      standstill. Resuscitation was successful and the patient was taken to the CT room
      to assess the extent of his head trauma. At the end of the procedure, maintaining
      adequate ventilation proved to be very difficult; the blood pressure was rapidly
      falling and the ECG showed severe bradycardia. Asystole followed and
      resuscitation was unsuccessful. Postmortem CT scanning of the chest revealed that
      the tracheobronchial tree was flooded with blood and coagulation profile showed
      the picture of disseminated intravascular coagulopathy. CT may be useful in the
      diagnosis of some pathological conditions when autopsy is difficult to perform.

PMID- 2233628
TI  - Ventricular fibrillation in a normokalemic hemiplegic patient during induction of
      anesthesia.

PMID- 2233629
TI  - The use of anencephalic organs: historical and ethical dimensions.
AB  - The condition of newborn infants with anencephaly, a neural tube defect, is
      incurable and uniformly fatal. Although physicians reached a consensus two
      decades ago on the appropriateness of using these infants' organs, ethical and
      legal questioning has since challenged the grounds on which medical authorities
      justified transplantation. Advocates have proposed three conceptual strategies to
      warrant procuring anencephalics' organs: redefining death, excluding the infants
      from possessing personhood, and intubating and ventilating them while keeping a
      vigil for brain death. Each of these conceptual schemes has arguable shortcomings
      in its construction, however; as such, the case for using anencephalic infants as
      sources of organs has yet to be conclusively demonstrated.

PMID- 2233630
TI  - Recall strategies and memory for health-care visits.
AB  - Complex questions in health surveys place heavy cognitive demands on respondents,
      prompting researchers to appraise how specific cognitive interventions may
      improve the accuracy of people's answers. Investigators in one experiment asked
      participants to recall visits to medical providers in forward, backward, or no
      particular order, and matched results with providers' records. "Free" recall
      proved marginally superior to forward or backward ordering, although overall
      respondents underreported the number of visits by 20 percent; participants'
      gender and self-reported health status, among other factors, also affected
      quality of recall. The experiment lends support to contentions that the methods
      of cognitive science applied to survey research better the accuracy of population
      survey data.

PMID- 2233631
TI  - Toward new typologies for HMOs.
AB  - The evolution of health maintenance organizations (HMOs) has entailed changes in
      both their structural characteristics and incentives to attract physicians'
      participation. Previous classifications of HMOs have failed to capture explicitly
      key features of these changes. Two alternative typologies based on incentives or
      organizational structures may be constructed by examining precise forms of two-
      or three-tiered contractual arrangements, physicians' payment methods, clienteles
      served, and means of pooling risks. Classifications of these kinds may represent
      or aid in generating a valid typology to help managers, consumers, providers, and
      analysts understand better how HMOs operate and which factors are critical in the
      dynamic managed-care industry.

PMID- 2233632
TI  - Estimated prevalence of Alzheimer's disease in the United States.
AB  - Although awareness of Alzheimer's disease has increased strikingly among
      professional and lay audiences, precise means do not exist to calculate how many
      Americans the disease affects. Projecting data from a cohort of 32,000
      individuals in a defined community in the United States, however, suggests that
      there were 2.88 million persons aged 65 or older with probable Alzheimer's
      disease in 1980. Using U.S. Census Bureau middle series projections yields an
      estimated total of 10.3 million persons with the disease for the year 2050.
      Limitations on these estimates notwithstanding, the projections indicate that
      more studies are needed to identify the etiology of Alzheimer's disease, its
      incidence, and the future costs of relevant institutional and community care.

PMID- 2233634
TI  - Informed consent. Opening the doors to physician-patient communication (1).

PMID- 2233633
TI  - Intracranial aneurysms. A review.
AB  - Intracranial aneurysms are common, and their rupture carries a grave prognosis.
      There is no effective way of preventing the development of intracranial
      aneurysms, but noninvasive means of detection are becoming increasingly practical
      and, at present, should be used routinely--at least in populations at high risk.
      SAH is frequently preceded by warning signs that, when recognized by the primary
      care or the emergency room physician, can lead to prompt and safe surgical
      intervention. About half the patients who suffer a major rupture either die or
      remain in poor condition as a result of the hemorrhage. In the rest, surgical
      intervention has become safer and very effective in preventing subsequent
      hemorrhage, which occurs in about 50% of patients if the aneurysm is left
      untreated. Since early surgery should be at least considered in the majority of
      these patients and since the early treatment of a patient after SAH is so
      specialized, it appears prudent to manage patients with SAH in units where the
      necessary neurological and neurosurgical specialized intensive care is available.

PMID- 2233635
TI  - Beware the UBIT--taxes on qualified plan investments can bite.

PMID- 2233636
TI  - Promising AIDS drug.

PMID- 2233637
TI  - AZT-cancer link.

PMID- 2233638
TI  - Changes in the practice of pathology.

PMID- 2233639
TI  - Listening to patients and to physicians.

PMID- 2233641
TI  - Medical charity in the 1990s.

PMID- 2233640
TI  - Score one for physicians as business people. Minnesota Medicine interviews George
      V. Tangen, M.D.

PMID- 2233642
TI  - Cholecystectomy in two small community hospitals.
AB  - From 1958 to 1988, the author performed 981 cholecystectomies for nonmalignant
      gallbladder disease in two small southeastern Minnesota hospitals. Of the 981
      patients treated, 708 were women. Among patients under age 40, the proportion of
      women was even higher, about 9 to 1. The peak age for cholecystectomy in both
      sexes was between 50 and 70. A normal gallbladder was found in 0.5% of patients,
      and 0.4% had cholecystitis without stones. The complication rate was 9.7%, and
      the mortality rate was 0.6%. All of those who died were 70 years old or older.
      These results compare favorably with those published from large institutions and
      indicate gallbladder surgery can be performed safely and effectively in small
      hospitals.

PMID- 2233644
TI  - The National Practitioner Data Bank. From the physician's perspective.

PMID- 2233643
TI  - The urethral syndrome: myth or reality? A commentary.
AB  - Although most urologists will agree that dealing with patients suffering from the
      multiple symptom complex commonly called the urethral syndrome is often time
      consuming, its origin and treatment continue to generate debate. This essay
      proposes that entrapment of sensory nerves in the wall of the urethra by fibrosis
      leads to an abnormal response of Barrington's reflex II, which, in turn, leads to
      the urethral syndrome. Periurethral fibrosis occurs following trauma, infections,
      and pelvic irradiation therapy. The urethral syndrome, the author concludes, is
      therefore based on recognized anatomical factors. The recommended treatment is
      urethral dilation accompanied by hot sits baths and short courses of
      Sulfamethoxazole-Trimethoprim. Long-term drug therapy is to be avoided.

PMID- 2233645
TI  - Successful long-term investing.

PMID- 2233646
TI  - MMA urges postponement of balance billing cap.

PMID- 2233648
TI  - Nutrition and immunology: challenge for the 1990s.

PMID- 2233647
TI  - Proposed modifications to the JCAHO Accreditation Manual For Hospitals by the
      National Committee for Nutrition Standards.

PMID- 2233649
TI  - A key to the literature of nutrition and immunology.

PMID- 2233650
TI  - Part II: Federal involvement in clinical nutrition.

PMID- 2233651
TI  - Psycho-motor skills in hemiplegic patients: reaction time differences related to
      hemispheric lesion side.
AB  - Psychomotor performances are frequently impaired in patients with cerebral
      lesion. The locus of lesion seems to play an important role: patients with right
      hemispheric lesion (RHL) frequently show a more important impairment in reaction
      to external stimuli than patients with left hemispheric lesion (LRH). The aim of
      this work was to study simple and choice visual reaction times in 2 groups of
      hemiplegic patients, with different hemispheric lesion side. Results confirm that
      patients with RHL have significantly more prolonged reaction times. No
      differences were found in a time we called choice time, related to "central
      delay" confirming that the more important psychomotor performances deficit in RHL
      patients is mainly related to impairment of attention, alertness, arousal
      systems.

PMID- 2233652
TI  - [Prolonged confusion syndrome in the course of cyclosporine treatment: a state of
      confusion?].
AB  - Cyclosporine is a potent immunosuppressant that is more and more widely used,
      particularly after organ transplantations. Many neurological side effects,
      including convulsions, that could be related to this drug, have been previously
      observed, most often with high blood concentrations. We report, for the first
      time, a case of prolonged confusion where a non convulsive status epilepticus may
      be discussed. It occurred in a 64-year-old woman, 17 days after a liver
      transplantation. The whole blood cyclosporine value was 230 micrograms/l (normal
      range: 100-200 micrograms/l) at the beginning of the status epilepticus. The
      cyclosporine imputability and the part of other factors that could have facilite
      are discussed.

PMID- 2233653
TI  - Nocturnal paroxysmal dystonia with atypical short-lasting attacks.

PMID- 2233654
TI  - [Clinico-pathological study of xanthogranulomatous cholecystitis].
AB  - Xanthogranulomatous cholecystitis (XGC) is an uncommon lesion which may form a
      tumor-like mass in inflamed gallbladders. In a review of 44 cases there were 40
      associated with gallstones which had been incarcerated in the neck of the
      gallbladder, 10 with past histories of abdominal surgeries, 15 with diabetes
      mellitus, three with carcinomas in the neck of the gallbladder and four with
      carcinomas in the other organs. Radiologically the differential diagnosis of
      gallbladder cancer and XGC was difficult in several cases. Thirty five cases of
      XGC have been diagnosed as chronic cholecystitis and 7 have been mistaken for
      feature of XGC in the contrast enhancement CT that is, detection of an intramural
      low density mass with continuously enhanced internal membraneous layer of the
      gallbladder wall. In view of the clinico-pathological findings of XGC, the
      lesions appear to result from intramural extravasation of bile and subsequent
      xanthogranulomatous reaction under obstructive conditions in the neck of the
      gallbladder. We conclude that XGC is not an uncommon special type of
      cholecystitis but an accompanied lesion sometimes seen in a kind of
      cholecystitis.

PMID- 2233655
TI  - [A clinical study of cerebral perfusion during pulsatile and nonpulsatile
      cardiopulmonary bypass].
AB  - The purpose of this study was to determine the effect of pulsatile flow on
      cerebral perfusion under cardiopulmonary bypass (CPB). Twenty-three patients who
      underwent cardiac operations were divided into two comparable groups: Group A (N
      = 11) had standard nonpulsatile flow, while in Group B (N = 12), a pulsatile pump
      was used. The blood flow of left common carotid artery and radial arterial
      pressure were continuously monitored during cardiac operation in both groups and
      cerebral vascular resistance was calculated. In Group B, the perfusion pressure
      of left common carotid artery was monitored and compared with that of radial
      artery. Arterial and internal jugular venous blood were sampled and the
      difference of cerebral A.V O2 contents and cerebral oxygen consumption was
      calculated. Cerebral vascular resistance in Group B (54.0 +/- 11.2% of the value
      of before-CPB) significantly decreased compared to that in Group A (72.2 +/- 11%)
      at the end of CPB (p less than 0.05). Pulse pressure following pulsatile CPB flow
      was 15.1 +/- 5.8 mmHg monitored in radial artery and it reduced to 8.5 +/- 5 mmHg
      in left common carotid artery. Although there was no significant difference in
      cerebral oxygen consumption of both groups during and just after CPB, the
      difference of cerebral A-V O2 contents of Group B was greater than Group A just
      after CPB. These data suggest that pulsatile flow may minimize the cerebral
      microcirculatory shunt during CPB, resulting from the reduction of cerebral
      vascular resistance.

PMID- 2233656
TI  - [The effect of peripheral blood leukocyte depletion on reperfusion injury of warm
      ischemic lung].
AB  - To clarify the role of leukocytes in reperfusion injury of preserved lung for
      lung transplantation, leukocyte depletion was performed and lung tissue
      generation of oxygen metabolites and histological evaluation were investigated.
      METHOD: 12 mongrel dogs were utilized, divided into 2 groups. In group A, hilar
      stripped left lung was submitted to 2 hour warm ischemia and 2 hour reperfusion.
      Blood filtration was performed three times using leukocyte filter. In group B,
      warm ischemia and reperfusion were performed without filtration. Lipid
      peroxidation products of lung tissue were measured by thiobarbituric acid assay.
      Tissue damage was estimated by wet/dry ratio and histological analysis. Results
      1). Peripheral blood counts revealed that effective leukocyte depletion was
      obtained and leukocyte efflux from reperfused lung was observed in group A. 2)
      Significant increase of lung tissue oxygen metabolite generation after
      reperfusion was observed in group B, while no significant fluctuate of tissue MDA
      titers was noted in group A. Tissue damage estimated by histological analysis and
      wet/dry ratio were considered to be controlled in group A compared with group B.
      In conclusion, leukocyte depletion by in vivo use of leukocyte filter was
      effective for reperfusion injury of warm ischemic lung and oxygen metabolites may
      play a role in these process.

PMID- 2233657
TI  - [An experimental study of the influence of positive end-expiratory pressure for a
      bidirectional cavopulmonary shunt].
AB  - In 8 mongrel dogs (weight 9-13 kg), we created a bidirectional cavopulmonary
      shunt through 4th intercostal thoracotomy. Positive end-expiratory pressure
      (PEEP) was added from 0cmH2O to 16cmH2O at the steps of 2cmH2O. The heart rate
      (HR), central venous pressure (CVP), pulmonary artery pressure (PAP), femoral
      artery pressure (FAP), pulmonary vascular resistance index (PVRI), and systemic
      vascular resistance index (SVRI) were measured as parameters of hemodynamics.
      Cardiac output (CO), pulmonary artery flow at proximal and distal site of this
      shunt (D-SF, P-SF) were measured using a magnetic flow meter. Blood gas analysis
      (PH, PaO2, PaCO2, HCO3-) were performed at the same time. HR had no significant
      change. CVP, PAP, PVRI, SVRI increased significantly (p less than 0.05, p less
      than 0.05, p less than 0.05, p less than 0.05) at 2cmH2O (9.2 +/- 2.5 mmHg),
      10cmH2O), (29.3 +/- 5.5 mmHg), 4cmH2O (287 +2- 56 dyne.sec.cm-5.m2), and 8cmH2O
      (1298 +/- 156 dyne.sec.cm-5.m2) compared with 0cmH2O (87.3 +/- 2.6 mmHg, 26.8 +/-
      3.4 mmHg, 240 +/- 29 dyne.sec.cm-5.m2, 1136 +/- 176 dyne.sec.cm-5.m2). FAP, CO, D
      SF, P-SF decreased significantly (p less than 0.01, p less than 0.05, p less than
      0.01, p less than 0.05) at 6cmH2O (129 +/- 7 mmHg), 2cmH2O(0.44 +/- 0.05 L/min),
      2cmH2O(449 +/- 47 ml/min), and 8cmH2O(105 +/- 17 ml/min) compared with 0cmH2O(148
      +/- 11 mmHg, 048 +/- 0.06 L/min, 471 +/- 44 ml/min, 132 +/- 19 ml/min). On blood
      gas analysis, PaO2 increased significantly (p less than 0.05) from 2cmH2O PEEP
      except PH, PaCO2, HCO3-. A mechanism for decline in D-SF was considered of being
      a secondary effect due to increase in CVP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233658
TI  - [A case of fatal graft-versus-host disease following blood transfusion in
      esophageal cancer documented by homozygous changes of HLA typing].
AB  - A 72 year-old Japanese male with esophageal cancer underwent esophagectomy. After
      seemingly uneventful recovery, he developed high fever on 11 post-operative day
      (POD), rashes over the whole body on 13 POD and leukopenia on 15 POD. On 22 POD,
      thrombopenia and parenchymal bleeding of lungs were noted. He died on 26 POD
      after progressive hypoxia and hypotension. HLA type of peripheral lymphocytes on
      him changed homozygously to that of the transfused fresh blood. Skin biopsy
      showed mild leukocyte infiltration in the epidermis and the dyskeratotic
      keratinocytes were associated with a contiguous lymphocyte, the so-called
      satellite cell necrosis. In the findings of autopsy, aplastic bone marrow and
      atrophied spleen, whose weight was 14g, were noted. Based on the clinical
      picture, skin biopsy and HLA study findings, we diagnosed this case as post
      transfusion GVHD. We think that high age, operative injury and preoperative
      irradiation might be inducement to reveal post-transfusion GVHD in this case.

PMID- 2233659
TI  - [A clinical case of ABO-incompatible living renal transplantation].
AB  - We successfully made ABO-incompatible renal transplantation, of which report is
      methodologically the first in Japan and probably the second in the world to our
      knowledge. Sixty year-old-female (mother) with B-blood type donated her right
      kidney to 36 years-old male (son) with O-blood type. Pretransplant removal of
      plasma isoagglutinin of the recipient through plasma exchange with albumin
      solution followed by hemodialysis with administration of fresh frozen B-type
      plasma effectively reduced the anti-BIgM-antibody titre of x256 to x8 and the
      anti-IgG-antibody titre of x512 to x16. Splenectomy was performed at the time of
      transplantation. On the 10th POD, the anti-B antibody titres were more decreased
      to IgM antibody x2 and IgG antibody x8. Patient is doing well without any sign of
      rejection as of 4 months postoperatively.

PMID- 2233660
TI  - [Human erythrocyte polyamine levels after partial hepatectomy: preliminary
      report].

PMID- 2233661
TI  - [Effect of tamoxifen on estrogen-stimulated growth of MCF-7 tumors in athymic
      mice: preliminary report].

PMID- 2233662
TI  - [Evaluation of in vitro prostaglandin production in human peripheral macrophage
      derived from healthy subjects and patients with cancer: preliminary report].

PMID- 2233663
TI  - [Intravenous administration of vancomycin for postoperative MRSA infection and
      its pharmacokinetics: preliminary report].

PMID- 2233664
TI  - [Intramural pH monitoring: early diagnosis of intestinal ischemia: preliminary
      report].

PMID- 2233665
TI  - [Meaning in measurement of bone mineral content as preoperative evaluation of
      aged patients].
AB  - Recently, mean span of life has been prolonged, and extensive operations are
      performed on aged patients. However, there are cases which have a difference
      between their chronological and actual ages. Bone mineral content (BMC) decreases
      with age and the decrease in BMC might suggest deterioration of immunological
      competence as observed in osteoporosis. Whether BMC can be an index for
      evaluation of geriatric patients' actual age from the aspect of immunological
      competence was investigated. Subjects were 54 cases aged more than 60. Twenty-one
      healthy young males and females were enrolled as the control group. Quantitative
      CT is used for assessment of BMC. The value obtained by dividing BMC by the
      standard BMC of the same age and sex, was defined as BMC index. BMC indices of
      normal BMC group were more than 0.8 and those of decreased BMC group were less
      than 0.8. Some immunological markers were investigated. Lymphocyte subset OKT3+
      was reduced and juvenile lymphocytes expressed by OKT6+ and OKT3+-(OKT4+ + OKT8+)
      increased (corrected). Increased in juvenile lymphocyte and decrease in
      lymphocyte blast transformation and competence of generating interleukin 2 were
      observed in decreased BMC group. BMC is useful as preoperative evaluation for
      geriatric operative cases and patients of BMC index below 0.8 need to be paid
      attention to postoperative infection.

PMID- 2233666
TI  - [Effect of postoperative hypertonic sodium infusion in the patients with total
      gastrectomy for gastric cancer].
AB  - In 17 patients with gastric cancer undergoing total gastrectomy, the effect of
      postoperative hypertonic sodium infusion were studied. The subjects were divided
      into 2 groups by concentration in the postoperative infusions. Group 1(Na group):
      over 5.0 mEq/Kg/day of sodium were infused in the postoperative days (POD). (End
      of operation to POD-4), Group 2 (Control group): 2.0-2.5 mEq/Kg/day of sodium
      (End of Op. to POD-1), 1.5-2.0 mEq/Kg/day (POD-2-4). 2.0-2.5 mEq/Kg/day were
      infused after POD-5 in both groups. In the Na group, NAG-Index, FENa and BUN were
      higher than those of control group. And cumulative primary Na balance (from end
      of operation to POD-5) indicated positive balance in Na group, and negative in
      control group. Furthermore, the cumulative infused sodium dose correlated with
      cumulated urinary sodium dose, potassium dose and cumulative NAG dose (from end
      of operation to POD-5). Significant difference was observed between two groups in
      urinary nitrogen. These findings suggest that the sodium dose in the
      postoperative infusion were suitable with 2.0-2.5 mEq/Kg/day.

PMID- 2233667
TI  - [Selective conservatism in the management of abdominal stab wounds].
AB  - Two hundred and two consecutive patients with abdominal stab wounds in a 14-year
      period were analysed as follows: (1) The patients were classified into 4
      categories; type I (no peritoneal penetration) 12%, type IIa (peritoneal
      penetration, no organ injury) plus type IIb (organ injury, no repair required)
      26% and type III (organ injury, repair required) 62%. Injuries caused by kitchen
      knife or violence, wounds in the lower chest or epigastrium, and harakiri
      injuries (Japanese traditional method of suicide) resulted in high frequencies of
      type III injury. (2) Hematoemesis, hematuria, unstable hemodynamics, and signs of
      peritonitis were reliable indications for immediate laparotomy. Both stabography
      and diagnostic peritoneal lavage were unuseful as adjunctive diagnostic methods.
      (3) A policy of selective management in 126 patients (1981-1988), comparing with
      a policy of mandatory exploration in 76 patients (1975-1980), reduced unnecessary
      laparotomy rate from 32% to 14% (p less than 0.01). (4) Injury patterns, observed
      in this series and the reported series from Japanese emergency centers, were
      strikingly different from the American series. The author emphasize the threat of
      morbidity caused by delayed diagnosis in the application of selective
      conservatism and propose the acceptable rate of unnecessary laparotomy; less than
      15%.

PMID- 2233668
TI  - [Characterization of a liver metastatic cell line derived from a human gastric
      cancer cell line].
AB  - This study was carried out to investigate whether there is any difference of
      biological characteristics between a gastric cancer cell line (KATOIII) and
      another cell line derived from liver metastasis of the same cell line (KATOIII
      H2). The liver metastasis was produced by intrasplenic injection of the fluid
      containing of KATOIII in nude mouse and new cell line was established using the
      cells of metastatic site. The results are as follows. 1) Inoculation of KATOIII
      H2 into the spleen produced liver metastases in all of the experimental animals,
      whereas the same procedure with KATOIII produced metastasis only in 30% of the
      animals. 2) KATOIII-H2 exhibited more prominent platelet-aggregating activity
      than KATOIII. 3) There is no difference between two cell lines on doubling time,
      histological findings of the xenografts and chromosomal number. 4) DNA index of
      KATOIII-H2 is lower than KATOIII and the trisomy in NO. 20 chromosome of KATOIII
      H2 was noted. The results indicate that metastatic potential is different between
      two cell lines and this fact is probably in a part because of the different
      platelet-aggregating activity of each cell line.

PMID- 2233669
TI  - [Serorrhaphy prevents regeneration of vagus nerve fibers after proximal gastric
      vagotomy].
AB  - Spouting or regeneration of vagus fibers occurs after vagotomy. An axonal tracing
      method was used to see the long-term effect of serorrhaphy in the prevention of
      axonal regeneration after proximal gastric vagotomy (PGV) in ferrets. METHODS: A
      neurotracer, wheat-germ agglutinin-horseradish peroxidase (0.5 mg), was injected
      subserosally at the corpus of the anterior stomach (1) without PGV (n = 4), (2)
      immediately after PGV (n = 2), (3) one year after PGV with serorrhaphy (n = 3),
      and (4) one year after PGV without serorrhaphy (n = 3). The ferrets were killed
      by perfusion-fixation. The brainstem was processed histochemically. Numbers of
      labeled cells in the dorsal motor nucleus of the vagus were statistically
      analyzed using square-root transformation. RESULTS: Numbers of labeled cells were
      348 for (1), 13 for (2), 2 for (3), and 43 for (4). Multiple comparisons revealed
      significant differences in (1) vs. (2), (3), (4) and (3) vs. (4). DISCUSSION: The
      number of preganglionic efferent vagus cells decreased acutely after PGV, which
      persisted one year. Regenerated vagus axons were less in the chronic group with
      serorrhaphy than in the group without one. Thus time factor did not influence the
      regeneration, but serorrhaphy was important in preventing vagal regeneration.
      CONCLUSION: Serorrhaphy during PGV prevents the regeneration of preganglionic
      efferent vagus fibers.

PMID- 2233670
TI  - [Preoperative oral antimicrobial bowel preparations in elective colorectal
      surgery].
AB  - Colorectal surgery is associated with high incidence of postoperative wound
      infection due to contamination of the field of operation by organisms from the
      intestine. A consecutive series of 300 patients undergoing elective operations on
      the colon and rectum, was studied to determine the efficacy of oral antibacterial
      preparations on the influence of intestinal organisms at operation and the
      incidence of postoperative wound infection. The patients were divided into four
      groups as their preoperative bowel preparations as follows; 1st group: mechanical
      preparation alone, 2nd group: mechanical preparation and oral kanamycin, 3rd
      group: mechanical preparation and oral kanamycin and metronidazole, and 4th
      group: mechanical preparation and oral polymyxin B and metronidazole. The results
      of bacteriological studies on specimens taken by swab from colonic lumen and
      wound at operation showed effectiveness of kanamycin and polymyxin B against
      aerobic gram-negative rods and metronidazole against anaerobes. The rates of
      postoperative wound infection were 47.5% in 1st group, 27% in 2nd group, 12% 3rd
      group, and 2.7% in 4th group, respectively.

PMID- 2233671
TI  - [Clinical significance of DNA content of rectal cancer measured by flow
      cytometory].
AB  - DNA content of 369 rectal cancers was measured by flow cytometry. One hundred and
      four (28.2%) were diploid, 252 (68.3%) were aneuploid and 13 (3.5%) were
      tetraploid. Diploid cancers were associated with an improved 5 year survival (p
      less than 0.001) and were more likely to be diagnosed at an early stage. However
      DNA content did not confer independent prognostic information in a Cox model
      based on four discrete pathological variables. Patients were classified by a new
      system of prognostic grouping and those with a very good or a very poor outlook
      were removed leaving 137 prognostic group 3 patients. No further
      substratification of this group by DNA content or by four additional pathological
      variables could be achieved. As the new prognostic system is not improved by the
      additional of ploidy, routine adoption of flow cytometry in the assessment of
      rectal cancer can not be recommended.

PMID- 2233672
TI  - [Evaluation of correlation between the disappearance rate of indocyanine green
      and the maximum removal rate].
AB  - The disappearance rate of indocyanine green (K.ICG) and the maximum removal rate
      (Rmax) usually correlate with each other. However, in some cases it was shown
      there was a dissociation between them. We investigated the relationship between
      the two rates in 146 subjects. K.ICG and Rmax correlated strongly with a
      correlation coefficient of 0.749 (p less than 0.001). Sixty-six cases were
      included in the limits of 95% confidence, and the other 80 cases outside the
      limits were defined as dissociated cases. Among them a lower Rmax rate as
      compared to the K.ICG rate was found in many cases of obstructive jaundice.
      Particularly a lower K.ICG rate compared to the Rmax rate was found in many cases
      of liver cirrhosis accompanied by esophageal varices and idiopathic portal
      hypertension. On the other hands, we performed multiple regression analysis on 12
      other liver function tests. K.ICG was strongly related to platelet count,
      circulatory blood volume, and albumin, all factors relating to portal
      hypertension. Rmax largely depended on LCAT, A/G ratio, and cholinesterase, which
      are Therefore, the dissociation between K.ICG and Rmax was caused by differences
      in the characteristic of each disease.

PMID- 2233673
TI  - Nitrate reductases of Escherichia coli: sequence of the second nitrate reductase
      and comparison with that encoded by the narGHJI operon.
AB  - The structural genes for NRZ, the second nitrate reductase of Escherichia coli,
      have been sequenced. They are organized in a transcription unit, narZYWV,
      encoding four subunits, NarZ, NarY, NarW and NarV. The transcription unit is
      homologous (73% identity) to the narGHJI operon which encodes the genes for NRA,
      the better characterized nitrate reductase of this organism. The level of
      homology between the corresponding polypeptides ranges from 69% for the NarW/NarJ
      pair to 86% for the NarV/NarI pair. The NarZ polypeptide contains the five
      conserved regions present in all other known molybdoproteins of E. coli and their
      relative order is the same. The NarY polypeptide, which contains the same four
      cysteine clusters in the same order as NarH, is probably an electron transfer
      unit of the complex. Upstream of narZ, an open reading frame, ORFA, is present
      which could encode a product which has homology (73% identity) with the COOH
      terminal end of NarK. The ORFA-narZ intergenic region, however, is about 80
      nucleotides long and does not contain the cis-acting elements, NarL and Fnr
      boxes, nor the terC4 terminator sequence present in the 500 nucleotide narK-narG
      intergenic region. This might explain why the narZYWV and the narGHJI operons are
      regulated differently. Our results tend to support the hypothesis that a DNA
      fragment larger than that encompassing the narGHJI genes has been duplicated.

PMID- 2233674
TI  - Paternal inheritance of mitochondria in rapeseed (Brassica napus).
AB  - Transfer of a mitochondrially associated plasmid following sexual crosses in
      Brassica napus rapeseed suggested that paternal mitochondria were being
      transferred to the cytoplasm of the egg. To examine this possibility further,
      plants carrying the chloroplast (cp) marker of triazine resistance, but which had
      lost the plasmid associated with the mitochondria of this cytoplasm, were crossed
      as females to males carrying the polima cytoplasm. The males carried a nuclear
      fertility restorer gene on an extra chromosome to overcome the male sterility
      marker conferred by the mitochondria of this cytoplasm. Approximately 10% of the
      F1 progeny displayed the male sterility and flower morphology of the male parent.
      Mitochondrial (mt) DNA from the progeny showed the combined restriction patterns
      of both parents, but this mt heterogeneity did not continue into subsequent
      generations. All progeny retained the cp DNA restriction patterns of the maternal
      plant as well as resistance to the herbicide atrazine. To date, sexually mediated
      cybrid plants have shown no morphological abnormalities and have maintained their
      unique combination of cp and mt traits through several sexual generations.

PMID- 2233675
TI  - Use of oligonucleotide probes to identify members of two-component regulatory
      systems in Xanthomonas campestris pathovar campestris.
AB  - Two-component regulatory systems comprising a sensor and a regulator protein,
      both with highly conserved amino acid domains, and commonly genetically linked,
      have been described in a range of bacterial species and are involved in sensing
      environmental stimuli. We used two oligonucleotide probes matching the postulated
      coding regions for domains of sensor and regulator proteins respectively in
      Xanthomonas campestris pathovar campestris (Xcc) to identify possible two
      component regulatory systems in Xcc. Two different fragments of Xcc DNA with
      homology to both of these probes were cloned. The DNA sequence of part of one of
      these fragments encompassed a potential open reading frame (ORF), the predicted
      amino acid sequence of which had extensive homology with regulator proteins of
      two-component regulatory systems. Analysis of the predicted amino acid sequence
      for the 3' end of an adjacent ORF revealed a very high level of homology with the
      C-terminal end of sensor proteins. Strains of Xcc with Tn5-induced mutations in
      the regulator gene were affected in extracellular polysaccharide production, and
      also in resistance to salt and chloramphenicol. No effects of mutation in the
      second clone were observed.

PMID- 2233676
TI  - T-T cyclobutane dimers are misinstructive, rather than non-instructive, mutagenic
      lesions.
AB  - The lesions produced by SOS-dependent mutagens in Escherichia coli are commonly
      referred to as nonpairing or non-instructive. Although these terms are likely to
      be appropriate for some lesions, particularly the abasic site, for others, such
      as the cyclobutane dimer, their suitability is open to question. To address this
      question, we have compared the error frequencies and spectra that result when a
      uniquely located T-T sequence, carried in a single-stranded vector, contains
      either a cis-syn or a trans-syn cyclobutane dimer, or when either the 5'T or 3'T
      is converted to an abasic site. The data suggest that the high accuracy with
      which the dimer-containing templates are replicated is unlikely to be the
      consequence of polymerase preference for the non-instructive insertion of dAMP.
      Similarly, mispairing, rather than non-pairing, is likely to cause mutations.
      Cyclobutane dimers seem therefore to be misinstructive rather than non
      instructive lesions, and the common feature shared by SOS-inducing lesions is
      more their ability to block replication than inability to form correct base
      pairs.

PMID- 2233677
TI  - Interchromosomal and intrachromosomal recombination in rad 18 mutants of
      Saccharomyces cerevisiae.
AB  - The frequency of intra- and interchromosomal recombination was determined in
      RAD18 and rad18 deletion and rad18-3 mutant strains. It was found that
      spontaneous interchromosomal recombination at trp5, his1, ade2, and MAT was
      elevated 10- to 70-fold in the rad18-3 and rad18 delta mutants as compared to the
      RAD+ strains. On the other hand the frequencies of spontaneous intrachromosomal
      recombination for the his3 delta 3', his3 delta 5' and the his4C-, his4A-
      duplications and for heterothallic mating type switching were only marginally
      elevated in the rad18 deletion mutant, and recombination between ribosomal DNA
      repeats was only 2-fold elevated in the rad18-3 mutant. These differences may be
      due to a haploid versus diploid specific difference. However interchromosomal
      recombination was elevated 40-fold and intrachromosomal recombination was only
      marginally (1.5-fold) elevated in a diploid homozygous for rad18 delta, arguing
      against a haploid versus diploid specific difference. Possible explanations for
      the difference in the elevated levels of intra- versus interchromosomal
      spontaneous recombination are discussed.

PMID- 2233678
TI  - Cellular localization of the MalG protein from the maltose transport system in
      Escherichia coli K12.
AB  - In Escherichia coli five proteins are directly involved in the high affinity
      transport system for maltose and maltodextrins. Sequence data and genetic
      evidence indicate that three of them, MalF, MalG and MalK, are associated with
      the inner membrane. In order to characterize the MalG protein more thoroughly and
      to determine its subcellular localization under physiological conditions, we
      generated well-defined mutations induced in vitro that affect the size and the
      function of the malG gene product. Wild-type and mutant proteins were detected in
      total bacterial extracts and on purified subcellular fractions with the help of
      an antibody prepared against a synthetic peptide based on the predicted N
      terminal sequence of MalG. The protein was solubilized from crude membranes by
      the detergent Triton X-100, indicating that it was localized in the inner
      membrane. A mutant carrying an in-phase insertion of four amino acids into a
      region conserved in several inner membrane proteins from periplasmic transport
      systems displayed a maltose-negative phenotype. This suggested that this region
      is very probably essential for MalG function.

PMID- 2233679
TI  - Colicin M is only bactericidal when provided from outside the cell.
AB  - The colicin M structural gene, cma, was subcloned in a vector which allowed
      temperature-inducible control of its expression. Induction of expression of cma
      in colicin M uptake proficient strains was lethal for the host cell when the
      colicin M immunity protein was not present. In liquid culture cells lysed, and no
      colonies were formed on solid media. These effects were not observed in mutants
      defective in the colicin receptor (FhuA) or uptake functions (TonB, TolM), nor in
      wild-type cells treated with trypsin prior to induction of cma expression. It was
      concluded that cytoplasmic colicin M is not toxic for the producing cell. To
      exert a lethal effect the colicin has to enter the cell from outside. Cells
      expressing cma released small amounts of colicin M.

PMID- 2233680
TI  - Developmentally regulated expression of a sunflower 11S seed protein gene in
      transgenic tobacco.
AB  - Helianthinin is the major 11S seed storage protein of sunflower (Helianthus
      annuus). Like most seed proteins, helianthinin is encoded by a small gene family;
      two members of this gene family, HaG3-A and HaG3-D, have been isolated and
      characterized. Tobacco was transformed with a 6 kb fragment of HaG3-A containing
      the helianthinin coding region flanked by 3.8 kb upstream and 0.4 kb downstream
      sequence. Expression of helianthinin was developmentally regulated in seeds of
      transgenic tobacco plants; furthermore, helianthinin polypeptides were
      proteolytically processed and targeted to the protein bodies of transgenic
      tobacco. A fragment of HaG3-A from -2376 to +24 was fused to the beta
      glucuronidase (GUS) reporter gene and transferred to tobacco. GUS expression
      driven by this helianthinin upstream region was developmentally regulated in
      seeds. Germinating seedlings of the same transformant exhibited a time-dependent
      decrease in GUS activity with none detected by 6 days post imbibition (DPI).
      Histochemical analysis of GUS activity in embryos and 2 to 5 DPI seedlings showed
      expression restricted to the cotyledons and upper embryonic axis with none
      detected at the radicle end. No GUS activity was found in cotyledons, hypocotyls,
      leaves, and roots of 18 day seedlings or in leaves of an 8 week F1 plant. These
      results indicate that the cis-regulatory elements required for developmental
      control of the HaG3-A helianthinin gene are located in a 2.4 kb upstream region
      of this gene. This region was sequenced together with the upstream region of the
      HaG3-D helianthinin gene.

PMID- 2233681
TI  - A repeated chromosomal DNA sequence is amplified as a circular extrachromosomal
      molecule in rice (Oryza sativa L.).
AB  - The plasmid pE10 is a pBR322-derived plasmid carrying a 4.5 kb rice (Oryza sativa
      L.) repeated DNA sequence. The cloned sequence has been shown to be amplified in
      cultured rice cells. The analysis of practically intact chromosomal rice DNA
      molecules by pulsed field gel electrophoresis has now shown that the
      amplification is associated with the appearance of extrachromosomal molecules. In
      fact, pE10 hybridizes exclusively with unfractionated DNA from leaf protoplasts,
      while it recognizes predominantly an extrachromosomal DNA molecule (ECD) of about
      45 kb and its multiples in the case of protoplasts from cultured cells.
      Insensitivity to the action of the exonuclease Bal31 suggests that the molecule
      is circular. Analysis of restriction endonuclease products with both standard
      horizontal and pulsed field gel electrophoresis suggest that the extrachromosomal
      DNA, and its chromosomal counterpart, is composed of tandemly repeated units of
      about 7 kb. Thus, the smaller extrachromosomal circle should contain 6-7 repeats,
      while the sequence cloned in pE10 is a subset of this repeat. The
      extrachromosomal DNA represents about 1% of total rice DNA and its level of
      amplification is not affected by the different phases of growth in culture.

PMID- 2233682
TI  - Par site of the ColN plasmid: structural and functional organization.
AB  - A par site involved in the resolution of multimeric plasmid DNA forms was
      localized in a 679 bp SalI-KpnI fragment of the small colicinogenic plasmid ColN.
      It was shown that replication of the monomeric pUC19 recombinant plasmid carrying
      the par region of ColN does not result in the formation of significant numbers of
      multimers. In order to function properly, the ColN multimer resolution mechanism
      requires the product of the xerA gene, just as in the case of ColE1. Nucleotide
      sequence analysis of the par region of ColN revealed substantial homology with
      the par locus of the ColE1 plasmid. The results of this study and data from the
      literature indicate that the par sites of ColE1-type plasmids have substantial
      homology and the same mechanism of action, and in fact represent a universal
      stability module for small multicopy colicinogenic plasmids.

PMID- 2233683
TI  - Either of two nod gene loci can complement the nodulation defect of a nod
      deletion mutant of Rhizobium leguminosarum bv viciae.
AB  - A deletion mutant of Rhizobium leguminosarum biovar viciae lacking the host
      specific nodulation (nod) gene region (nodFEL nodMNT and nodO) but retaining the
      other nod genes (nodD nodABCIJ) was unable to nodulate peas or Vicia hirsuta,
      although it did induce root hair deformation. The mutant appeared to be blocked
      in its ability to induce infection threads and could be rescued for nodulation of
      V. hirsuta in mixed inoculation experiments with an exopolysaccharide deficient
      mutant (which is also Nod-). The nodulation deficiency of the deletion mutant
      strain could be partially restored by plasmids carrying the nodFE, nodFEL or
      nodFELMNT genes but not by nodLMN. Surprisingly, the mutant strain could also be
      complemented with a plasmid that did not carry any of the nodFELMNT genes but
      which did carry the nodO gene on a 30 kb cloned region of DNA. Using appropriate
      mutations it was established that nodO is essential for nodulation in the absence
      of nodFE. Thus, either of two independent nod gene regions can complement the
      deletion mutant for nodulation of V. hirsuta. Similar observations were made for
      pea nodulation except that nodL was required in addition to nodO for nodulation
      in the absence of the nodFE genes. These observations show that nodulation can
      occur via either of two pathways encoded by non-homologous genes.

PMID- 2233685
TI  - Identification and characterization of stamen- and tapetum-specific genes from
      tomato.
AB  - Differential screening of a tomato cDNA library produced from pre-anthesis
      stamens resulted in the isolation of 25 cDNA clones that hybridized to probes
      made from stamen RNA and showed no hybridization to probes made from RNA of
      vegetative organs. The 25 clones were found to represent 11 noncross-hybridizing
      classes. The majority of these clones were derived from genes that were single or
      low copy in the tomato genome. Northern RNA blotting experiments of vegetative
      and floral organs at several stages of development demonstrated that expression
      in all 11 classes was confined to floral organs. Of the 11 classes 9 were found
      to be expressed exclusively in stamens prior to anthesis. Two classes showed
      expression in immature stamens and in petals, with one of these two additionally
      being expressed in mature stamens at anthesis. Clones from three of the classes
      that were expressed exclusively in stamens were used as probes for in situ
      localization of RNA in floral organs. These experiments demonstrated that
      expression of the genes corresponding to these clones was confined to the tapetal
      cells of the anthers. Expression of one of the three genes was found to be
      limited to a single cell type during the 5-6 day period from late meiosis to
      immature pollen formation.

PMID- 2233686
TI  - Differentiated induction of cytochrome P450b/e and P450p mRNAs by dose of
      phenobarbital in primary cultures of adult rat hepatocytes.
AB  - Phenobarbital induces cytochromes P450 (P450s) of not only the class IIB gene
      subfamily (i.e., P450b and P450e) but also the class IIIA gene subfamily (P450p
      and P450pcn2). To determine whether coinduction of these structurally dissimilar
      gene products involves the same mechanism, we examined the dose dependency of
      phenobarbital induction of the mRNAs for these four P450s in a new responsive
      system for primary monolayer cultures of adult rat hepatocytes on Matrigel, a
      reconstituted basement membrane. Two-day treatments of the cultures with
      phenobarbital produced marked dose-dependent increases in the levels of P450b,
      P450e, and P450p mRNAs, which reached maximal inductions ranging from 11- to
      greater than 193-fold. Although the dose-response relationships for the
      inductions of P450b and P450e mRNAs by phenobarbital were similar (ED50 = 1.5 x
      10(-5) and 5.7 x 10(-6) M, respectively), the dose-response curve for the
      induction of P450p mRNA was positioned distinctly to the right (ED50 = 3.0 x 10(
      4) M). This difference reflects a potency ratio of 20-fold for P450p/P450b mRNA
      induction. Phenobarbital also produced a weak dose-dependent induction of
      P450pcn2 mRNA, with a potency (ED50 = 3.4 x 10(-5) M) intermediate between those
      for P450b/e and P450p. In a similar experiment using two phenobarbital-like
      inducers, (trans)nonachlor and clotrimazole, the relative inductions of P450b,
      P450e, P450p, and P450pcn2 mRNAs proved to be similar to those produced by
      phenobarbital (P450p/P450b potency ratios = 14- and 16-fold, respectively). These
      findings provide strong further evidence in support of the newly emerging concept
      that "phenobarbital" induction of the responsive class IIB and class IIIA P450
      isozymes likely reflects multiple mechanisms.

PMID- 2233684
TI  - Differential regulation of STA genes of Saccharomyces cerevisiae.
AB  - The single glucoamylase gene (SGA1) of the yeast Saccharomyces cerevisiae is
      expressed exclusively during the sporulation phase of the life cycle. Enzymatic
      studies and nucleic acid sequence comparisons have shown that the SGA1
      glucoamylase is closely related to the secreted enzymes of S. cerevisiae var.
      diastaticus. The latter are encoded by any of three unlinked STA genes, which
      have been proposed to derive from the ancestral SGA1 form by genomic
      rearrangement. We show that the regulation of SGA1 is distinct from that of the
      other members of the STA gene family. SGA1 expression did not respond to STA10,
      the primary determinant of glucoamylase expression from STA2. Unlike STA2, SGA1
      was not regulated directly by the mating type locus. Expression of SGA1 depended
      on the function of the MAT products in supporting sporulation and not on the
      formation of haploid progeny spores or on the composition of the mating type
      locus per se. We conclude that the STA genes acquired regulation by STA10 and MAT
      by the genomic rearrangements that led to their formation. This regulation is
      thus distinct from that of the ancestral SGA1 gene.

PMID- 2233687
TI  - Perturbations of intracellular calcium distribution in kidney cells by
      nephrotoxic haloalkenyl cysteine S-conjugates.
AB  - The Ca2(+)-sensitive dye fura-2 was used to investigate the disturbances in
      intracellular Ca2+ concentration [( Ca2+]i) and distribution induced by the
      nephrotoxic cysteine S-conjugate S-(1,2-dichlorovinyl)-L-cysteine (DCVC) and its
      homocysteine analog S-(1,2-dichlorovinyl)-L-homocysteine (DCVHC) in LLC-PK1
      cells. After 24-hr treatment with DCVC, the average [Ca2+]i increased from 88 +/-
      23 nM to 415 +/- 92 nM. Digital image analysis revealed that the mitochondrial
      region, which was stained with rhodamine-123, contained lower Ca2+ concentration
      ([Ca2+]) than other cell areas. This distribution was different from the higher
      [Ca2+] in the nuclear and mitochondrial regions observed in control cells. In
      DCVHC-treated cells, there was also an increase in [Ca2+]i to 355 +/- 85 nM, but
      the increase in [Ca2+] was greater in the mitochondrial region, compared with the
      rest of the cell. After 72-hr treatment with DCVC or DCVHC, the average [Ca2+]i
      was 410 +/- 85 nM and 340 +/- 90 nM, respectively, and blebs with markedly higher
      [Ca2+] (600-1000 nM) than the rest of the cell appeared in both DCVC- and DCVHC
      treated cells. Moreover, in DCVC-treated cells the mitochondria could not be
      stained with rhodamine-123, indicating severe mitochondrial damage and loss of
      membrane potential. All changes described above took place in viable (propidium
      iodide-negative) cells. The experiments demonstrate that severe perturbations of
      intracellular Ca2+ distribution, particularly in the mitochondrial region,
      precede bleb formation and cell death in the course of development of toxicity by
      DCVC and DCVHC.

PMID- 2233688
TI  - Developmental expression and in situ localization of the phenobarbital-inducible
      rat hepatic mRNAs for cytochromes CYP2B1, CYP2B2, CYP2C6, and CYP3A1.
AB  - In this study we examined the differential hepatic expression of four
      phenobarbital (PB)-inducible rat cytochrome P450 genes, CYP2B1, CYP2B2, CYP2C6,
      and CYP3A1. The mRNAs encoding these cytochromes were analyzed in the liver with
      respect to PB responsiveness, developmental expression, and in situ localization.
      Utilization of the polymerase chain reaction enabled assessment of specific
      hepatic mRNA expression patterns during early development that were not
      detectable with standard Northern blot or slot-blot procedures. The polymerase
      chain reaction data demonstrated that fetal liver from day 15 of gestation was
      responsive to the inductive effects of transplacental PB administration. Both
      constitutive and PB-induced levels of each mRNA increased with increasing
      developmental age, reaching maximal levels approximately 3 weeks postpartum. An
      exception to this trend was observed for rats of gestational day 22, which
      exhibited transiently increased constitutive levels of CYP2B1, CYP2B2, and CYP3A1
      mRNAs, such that PB-induced levels were not elevated over those observed in
      untreated animals. In situ hybridization data, obtained with livers form 6-week
      postpartum animals, revealed striking differences in regional distributions among
      the cytochrome P450 transcripts. Whereas patterns of PB-induced expression of
      CYP2C6 mRNAs were relatively homogeneous across the hepatic lobule, CYP3A1 mRNAs
      in PB-treated livers demonstrated marked centrilobular localization. These
      results were in contrast to data obtained previously for PB-inducible CYP2B1 and
      CYP2B2 mRNAs, which were distributed homogeneously across the hepatic lobule
      except for cells in the immediate vicinity of the periportal tract.

PMID- 2233689
TI  - Multiple forms of biliverdin reductase: age-related change in pattern of
      expression in rat liver and brain.
AB  - Biliverdin reductase is the dual nucleotide-dependent cytosolic enzyme that
      converts biliverdin to the bile pigment, bilirubin, and displays extensive
      microheterogeneity in rat organs. The enzyme is unique in having two pH optima.
      The present study reports on the tissue-dependent pattern of developmental
      expression of the reductase in rat liver and brain. When analyzed by Western
      immunoblotting, two closely migrating immunoreactive proteins were detected in
      the liver cytosol during the first 2-3 weeks after birth; the protein with
      greater mobility was not detected in the liver of adult aged animals (6 months
      old) and was present at low levels in rats during the first week of life. The
      faster migrating protein was not detected in the brain cytosol at any stage of
      development. Furthermore, in the brain the total amount of enzyme protein
      increased as the animal matured, whereas in the liver the enzyme protein level
      decreased with age. When the purified enzyme was analyzed, age-related changes in
      the variant composition of the enzyme in the liver were noted. Although in both
      adult and newborn animals (14 days old) the purified enzyme, when subjected to
      isoelectric focusing, separates into five net charge forms (pl 6.23, 5.91, 5.76,
      5.61, and 5.48), the relative abundance of the variants notably differed in the
      two preparations. In addition, when the purified preparations were subjected to
      two-dimensional electrophoresis, although both purified preparations separate
      into three molecular weight forms (Mr 30,400, 30,700, and 31,400) one species (Mr
      31,400, pl = 5.77), which was very prominently expressed in the newborn, was
      essentially absent in the adult. Biliverdin reductase activity of the liver
      cytosol with both NADPH (pH 8.7) and NADH (pH 6.7) exhibited developmental
      changes, with the activity increasing after birth, reaching a peak on day 14, and
      decreasing to low levels in the adult. The existence of a close correlation
      between development of biliverdin reductase activity in the brain and liver and
      that of heme oxygenase in these organs is noted. The suggestion is made that the
      reductase is not a passive component of the heme degradation pathway; rather, its
      activity could become limiting in the elimination of heme degradation products.

PMID- 2233690
TI  - Hemin administration to rats reduces levels of hepatic mRNAs for phenobarbitone
      inducible enzymes.
AB  - The levels of hepatic mRNAs for several enzymes involved in drug metabolism were
      measured following administration to rats of either phenobarbitone or 2-allyl-2
      isopropylacetamide. There was a substantial elevation in the mRNA levels for
      cytochromes P450 IIB1, IIB2, and IIIA1, epoxide hydrolase, glutathione-S
      transferase Ya/Yc subunit, UDP-glucuronosyltransferase isoenzyme (UDPGTr-2),
      NADPH-cytochrome P450 oxidoreductase, and 5-aminolevulinate synthase. When rats
      were treated with hemin, together with inducing drug, there was a marked
      reduction in the induced levels of these mRNAs, with decreases in the range of 55
      95%. Basal levels of these mRNAs in the noninduced rat liver were also lowered by
      hemin administration. Nuclear run-on transcriptional experiments showed that
      hemin administration substantially lowered both the basal and drug-induced
      transcriptional activities of the genes for cytochrome P450IIB1/IIB2 and 5
      aminolevulinate synthase. In contrast, the mRNA for heme oxygenase was elevated
      by hemin treatment, whereas the mRNA levels of beta-actin, albumin, and ornithine
      transcarbamylase, used as controls, were not affected. Treatment of rats with
      clofibrate resulted in increased levels of mRNA for cytochrome IVA1 and, in
      addition, those for cytochromes P450IIB1 and P450IIB2. Hemin administration
      repressed the induction of mRNA levels for cytochromes P450IIB1 and IIB2 but not
      that for cytochrome P450 IVA1. Additionally, the induction of P450IAI by beta
      naphthoflavone was not affected by hemin. The results suggest that heme may
      negatively control the induction of cytochromes P450IIB1 and IIB2 and other
      hepatic enzymes by phenobarbitone and phenobarbitone-like drugs and perhaps play
      a role in regulating drug metabolism. There is, however, no evidence at present
      as to whether heme has a direct role in such a mechanism or whether injected
      hemin promotes a secondary response.

PMID- 2233691
TI  - Epidermal growth factor stimulates linoleic acid metabolism in BALB/c 3T3
      fibroblasts.
AB  - One response of BALB/c 3T3 cells to epidermal growth factor (EGF) is the release
      and subsequent metabolism of arachidonic acid. Prostaglandins generated from EGF
      treatment appear to play a role in the mitogenic signal. Lipoxygenase inhibitors
      (nordihydroguaiaretic acid and 5,8,11,14-eicosatetraynoic acid) were previously
      shown to be very effective in blocking EGF-stimulated DNA synthesis; however,
      only low levels of lipoxygenase-derived arachidonate metabolites were detected.
      In an extension of these investigations, we have now found that EGF stimulates
      lipoxygenase metabolites of linoleic acid in BALB/c 3T3 fibroblasts. In the
      presence of EGF (10 ng/ml), the cells converted 10-15% of exogenous linoleic acid
      (10 microM) to hydroxy fatty acids that were isolated on reverse phase high
      performance liquid chromatography. No linoleate metabolites were detected in the
      absence of EGF. The isolated compounds were characterized further by straight
      phase high performance liquid chromatography, UV spectroscopy, and gas
      chromatography-mass spectrometry analyses, and they were identified as 13
      hydroxyoctadecadienoic acid and 9-hydroxyoctadecadienoic acid. The hydroxy
      metabolites and their hydroperoxy precursors produced a 2- to 4-fold potentiation
      of EGF-stimulated [3H]thymidine incorporation in BALB/c 3T3 cells. These
      linoleate derivatives stimulated DNA synthesis at concentration ranges of 10(-8)
      to 10(-6) M. Thus, linoleic acid metabolism might be an important element in the
      EGF-regulated cascade of biochemical events leading to fibroblast mitogenesis.

PMID- 2233692
TI  - Quantitative molecular analysis predicts 5-hydroxytryptamine3 receptor binding
      affinity.
AB  - A quantitative molecular model was derived to predict drug affinities for 5
      hydroxytryptamine3 (5-HT3) receptors. The model was based on the molecular
      characteristics of a "learning set" of 40 pharmacological agents that had been
      analyzed previously in radioligand binding studies. Molecules were analyzed for
      various structural features, i.e., the presence of a benzenoid ring and nitrogen
      atom, substitutions on the benzenoid ring, the location of the substitutions on
      the nitrogen, and the molecular characteristics of the most direct pathway from
      the benzenoid ring to the nitrogen. Weighting factors, based on published 5-HT3
      receptor affinity data, were then assigned to each of 10 molecular
      characteristics. The derived computational model predicts accurately the
      affinities of the learning set for the 5-HT3 receptor (r = 0.98; p less than
      0.001). The computational model was then used to predict the receptor affinities
      of a "test set" of 40 pharmacological agents. The predicted values for these
      agents also correlate significantly (r = 0.83; p less than 0.001) with drug
      affinities for the 5-HT3 receptor, as determined by radioligand binding assays.
      This first line screening approach allows for the accurate prediction of drug
      affinities based on molecular characteristics with minimal dependence upon animal
      tissues or radioactivity.

PMID- 2233693
TI  - Inhibition of ribonucleotide reduction in CCRF-CEM cells by 2',2'
      difluorodeoxycytidine.
AB  - The new deoxycytidine analogue 2',2'-difluorodeoxycytidine (dFdC) is a specific
      inhibitor of DNA synthesis that has marked cytotoxicity and therapeutic activity.
      A 2-hr incubation with 0.1-10 microM dFdC decreased cellular viability 78-97%.
      This treatment reduced deoxynucleoside triphosphate pools, similar to the action
      of the ribonucleotide reductase inhibitor hydroxyurea. The most pronounced
      decrease occurred in the dCTP pool, quantitatively followed by the decrease of
      dATP, dGTP, and dTTP. In contrast, inhibition of DNA synthesis by
      arabinosylcytosine did not affect the dCTP level, whereas dATP, dGTP, and dTTP
      pools increased, but less than 2-fold. The incorporation of [5-3H]cytidine into
      the dCTP pool, a measure of ribonucleotide reductase activity in whole cells, was
      reduced to 3% of controls by 0.1 microM dFdC, but to only 40% by 0.1 microM ara
      C. Each drug decreased incorporation of [5-3H]cytidine into DNA to a similar
      extent (greater than 94%), suggesting limitation by a reaction proximal to this
      step. The cellular concentration of dFdC 5'-diphosphate was 0.3 microM at 50%
      inhibition of the in situ activity of ribonucleotide reductase. Direct assays of
      partially purified ribonucleoside diphosphate reductase (EC 1.17.4.1)
      demonstrated 50% inhibition by 4 microM dFdC 5'-diphosphate; dFdC 5'-triphosphate
      was much less inhibitory. We conclude that dFdC 5'-diphosphate acts as an
      inhibitor of ribonucleoside diphosphate reductase.

PMID- 2233694
TI  - Stereoselective S-oxygenation of 2-aryl-1,3-dithiolanes by the flavin-containing
      and cytochrome P-450 monooxygenases.
AB  - The reaction of NalO4, highly purified flavin-containing monooxygenase (EC
      1.14.13.8), and microsomes from hog liver with 2-aryl-1,3-dithiolanes and 2-aryl
      1,3-dithiolane S-oxides was investigated. The initial rates determined for the
      microsome- and purified flavin-containing monooxygenase-catalyzed rate of S
      oxidation of para-substituted 2-aryl-1,3-dithiolanes were similar, demonstrating
      that S-oxidation of these substrates occurred with similar velocities at
      saturating concentrations of substrate and, at least for the first S-oxidation,
      the reaction was insensitive to the nature of the para-substituent. The
      diastereoselectivity of S-oxygenation of 2-aryl-1,3-dithiolanes was determined
      and, in general, a marked preference for addition of oxygen to the sulfide sulfur
      atom was observed to occur trans to the aryl groups. In all cases examined,
      enantioselective enzymatic S-oxidation was observed. For S-oxide formation in
      microsomes, the data provided evidence for a minor role of cytochrome P-450 in S
      oxide formation, but the flavin-containing monooxygenase was mainly responsible
      for production of S-oxide. In contrast to previous reports, the
      enantioselectivity of S-oxidation catalyzed by highly purified cytochrome P
      450IIB-1 and cytochrome P-450IIB-10 was not always opposite to that catalyzed by
      hog liver flavin-containing monooxygenase activity. 2-Aryl-1,3-dithiolane S
      oxides were also oxidized a second time by NalO4, microsomes, or highly purified
      flavin-containing monooxygenase from hog liver but not cytochrome P-450IIB-1 or P
      450IIB-10. The rate of the second oxidation was 10-15-fold slower than the
      corresponding first S-oxidation and S,S'-dioxide formation was markedly dependent
      on the electronic nature of the para-substituent (Hammett correlation rho value
      of -1.3 and -1.1 for microsomes and highly purified flavin-containing
      monooxygenase from hog liver, respectively). The large dependence of the rate of
      S,S'-dioxide formation on the nature of the para-substituent demonstrates that
      velocity values at saturating concentrations of S-oxide were not the same for all
      2-aryl-1,3-dithiolane S-oxides and suggests that the chemical nature of the 2
      aryl-1,3-dithiolane S-oxide contributes to the rate-determining step of this
      enzymatic reaction.

PMID- 2233695
TI  - Cross-reactivity of antibodies raised against acetaldehyde adducts of protein
      with acetaldehyde adducts of phosphatidyl-ethanolamine: possible role in
      alcoholic cirrhosis.
AB  - This study measured the possible cross-reactivity of hapten-specific IgG
      antibodies purified from the sera of rabbits sensitized to an albumin
      acetaldehyde conjugate [N-ethyl-rabbit serum albumin (N-ethyl-RSA)] with
      acetaldehyde-phosphatidylethanolamine adducts. The N-ethyl-RSA was coupled to an
      Affigel-10 column to affinity purify the IgG (anti-N-ethyl-RSA IgG). Dioleoyl
      phosphatidylethanolamine (DOPE) was reacted with acetaldehyde to form a Schiff
      base, which was reduced to N-ethyl-DOPE, purified by high pressure liquid
      chromatography, and analyzed with direct chemical ionization mass spectrometry.
      Lamellar liposomes containing either 5% by weight N-ethyl-DOPE and 95% egg
      phosphatidylcholine or a mixture of 5% N-ethyl-DOPE, 71% DOPE, and 24%
      dioleoylphosphatidylcholine, as well as hexagonal phase micelles containing 5% N
      ethyl-DOPE and 95% DOPE, were prepared by sonication. Anti-N-ethyl-RSA IgG was
      then incubated with each of these lipid mixtures for 30 min, a fluorescein
      conjugated goat anti-rabbit IgG was added for an additional 30 min, and then
      binding of anti-N-ethyl-RSA IgG to N-ethyl-DOPE in the liposomes or micelles was
      measured by flow cytometry. Anti-N-ethyl-RSA IgG bound to N-ethyl-DOPE in both
      vesicles and hexagonal phase micelles, but the affinity was 16 times greater for
      the hapten in the hexagonal phase. This result demonstrates that physical
      presentation of the hapten can affect antibody recognition and that antibodies
      raised against N-ethyl-RSA can cross-react with acetaldehyde-phospholipid
      adducts.

PMID- 2233697
TI  - [3H]-DOB(4-bromo-2,5-dimethoxyphenylisopropylamine) and [3H] ketanserin label two
      affinity states of the cloned human 5-hydroxytryptamine2 receptor.
AB  - The binding properties of the 5-hydroxytryptamine2 (5-HT2) receptor have been the
      subject of much interest and debate in recent years. The hallucinogenic
      amphetamine derivative 4-bromo-2,5-dimethoxyphenylisopropylamine (DOB) has been
      shown to bind to a small number of binding sites with properties very similar to
      [3H]ketanserin-labeled 5-HT2 receptors, but with much higher agonist affinities.
      Some researchers have interpreted this as evidence for the existence of a new
      subtype of 5-HT2 receptor (termed 5-HT2A), whereas others have interpreted these
      data as indicative of agonist high affinity and agonist low affinity states for
      the 5-HT2 receptor. In this investigation, a cDNA clone encoding the serotonin 5
      HT2 receptor was transiently transfected into monkey kidney Cos-7 cells and
      stably transfected into mouse fibroblast L-M(TK-) cells. In both systems,
      expression of this single serotonin receptor cDNA led to the appearance of both
      [3H]DOB and [3H]ketanserin binding sites with properties that matched their
      binding characteristics in mammalian brain homogenates. Addition of guanosine 5'
      (beta, gamma-imido) triphosphate [Gpp(NH)p] to this system caused a rightward
      shift and steepening of agonist competition curves for [3H] ketanserin binding,
      converting a two-site binding curve to a single low affinity binding state.
      Gpp(NH)p addition also caused a 50% decrease in the number of high affinity
      [3H]DOB binding sites, with no change in the dissociation constant of the
      remaining high affinity states. These data on a single human 5-HT2 receptor cDNA
      expressed in two different transfection host cells indicate that [3H]DOB and
      [3H]ketanserin binding reside on the same gene product, apparently interacting
      with agonist and antagonist conformations of a single human 5-HT2 receptor
      protein. These observations are consistent with the classical view of
      interconvertible agonist affinity states of GTP-binding protein-coupled receptors
      and strongly support the "two state" over the "two receptor" model for DOB
      binding to the 5-HT2 receptor.

PMID- 2233696
TI  - 4-[125I]iodo-(2,5-dimethoxy)phenylisopropylamine and [3H]ketanserin labeling of 5
      hydroxytryptamine2 (5HT2) receptors in mammalian cells transfected with a rat
      5HT2 cDNA: evidence for multiple states and not multiple 5HT2 receptor subtypes.
AB  - Evidence has accumulated indicating that the radioactive hallucinogens 4-bromo
      [3H](2,5-dimethoxy)phenylisopropylamine ([3H]DOB) and 4-[125I]iodo-(2,5
      dimethoxy)phenylisopropylamine ([125I]DOI) label an agonist high affinity state
      of the 5-hydroxytryptamine2 (5HT2) receptor and [3H]ketanserin labels both
      agonist high and low affinity states. Recently, an alternative hypothesis has
      been put forward proposing that the radioactive hallucinogens are labeling a 5HT2
      receptor subtype distinct from the receptor labeled by [3H]ketanserin. In order
      to provide definitive evidence as to which of these hypotheses is correct, the
      rat 5HT2 receptor gene was transfected into NIH-3T3 (mammalian fibroblast) cells
      and COS (green monkey kidney) cells. Neither nontransfected cell type expresses
      5HT2 receptors; the transfected cells expressed high affinity binding sites for
      both [125I] DOI (KD = 0.8 nM and Bmax = 363 fmol/mg in NIH-3T3 cells; KD = 0.2 nM
      and Bmax = 26 fmol/mg in COS cells) and [3H]ketanserin (KD = 0.4 nM and Bmax =
      5034 fmol/mg in NIH-3T3 cells; KD = 1.0 nM and Bmax = 432 fmol/mg in COS cells).
      The affinities of agonists and antagonists for the [125I]DOI-labeled receptor
      were significantly higher than for the [3H]ketanserin-labeled receptor. The
      affinities of agonists and antagonists for these binding sites were essentially
      identical to their affinities for the sites radiolabeled by these radioligands in
      mammalian brain homogenates. The [125I]DOI binding was guanyl nucleotide
      sensitive, indicating a coupling to a GTP-binding protein. These data indicate
      that the 5HT2 receptor gene product contains both the guanyl nucleotide-sensitive
      [125I]DOI binding site and the [3H]ketanserin binding site. Therefore, these data
      indicate that the 5HT2 receptor gene product can produce a high affinity binding
      site for the phenylisopropylamine hallucinogen agonists as well as for the 5HT2
      receptor antagonists. These results strongly support the two-state hypothesis for
      the 5HT2 receptor and do not support the multiple 5HT2 receptor subtype
      hypothesis.

PMID- 2233698
TI  - Long lasting increase in neuropeptide Y gene expression in rat adrenal gland with
      reserpine treatment: positive regulation of transsynaptic activation and membrane
      depolarization.
AB  - To elucidate how the neuropeptide Y (NPY) gene is regulated by
      physiological/pharmacological changes in neural functions, the expression and
      regulation of the NPY gene were studied by measuring changes in the abundances of
      NPY and NPY mRNA in the adrenal gland and brain regions of rats in vivo and in
      PC12 rat pheochromocytoma cells after reserpine treatment. Long term treatment
      with reserpine in vivo, which causes hypotension and increased splanchnic nerve
      activity, induced prolonged increases in the abundance of NPY mRNA and putative
      NPY pre-mRNA, with concomitant increases in NPY, in the adrenal gland in a tissue
      dependent manner but caused no changes in the abundance of beta-actin mRNA.
      Transection of the splanchnic nerves almost completely (76%) prevented the
      reserpine-induced increases in the abundance of NPY mRNA and NPY pre-mRNA, but
      denervation alone did not affect their steady state levels. These results
      suggested that increased activity of the splanchnic nerves regulates NPY gene
      expression positively in the adrenal gland, probably at the level of
      transcription. In PC12 cells, reserpine decreased the abundance of NPY mRNA
      directly, but nicotinic receptor activation increased its abundance transiently
      and the persistent membrane depolarization increased its abundance markedly.
      Thus, NPY gene expression is positively regulated by membrane depolarization via
      increased transsynaptic activation with reserpine.

PMID- 2233699
TI  - Immunochemical analysis of a cytochrome P-450IA1 homologue in human lung
      microsomes.
AB  - The monoclonal antibody MAb 1-7-1, which specifically binds to cytochromes P
      450IA1 and P-450IA2 in 3-methylcholanthrene-induced rat liver microsomes, was
      used to identify a cytochrome P-450IA1 homologue in human lung microsomes.
      Although MAb 1-7-1 had similar affinity constants for human and rat microsomes,
      the amount bound to human lung microsomes was severalfold lower than that bound
      to microsomes from untreated rat or rabbit lung and much lower than the amount
      bound to 3-methylcholanthrene-induced rat lung or liver microsomes. The amount
      bound to untreated baboon lung microsomes was similar to that bound to human lung
      microsomes. Three cytochrome P-450IA1-catalyzed activities, 7-ethoxyresorufin O
      deethylase, 7-ethoxycoumarin, O-deethylase, and aryl hydrocarbon hydroxylase,
      were measurable in human lung microsomes, but the cytochrome P-450IA2-dependent
      activity acetanilide 4-hydroxylase was not. MAb 1-7-1 inhibited, and its binding
      correlated strongly with, 7-ethoxyresorufin O-deethylase activity (r = 0.92, p
      less than 0.01) in human lung microsomes. 7-Ethoxyresorufin O-deethylase
      activities in human lung were similar to those measured in untreated baboon lung
      but considerably lower than those present in untreated rabbit lung, untreated or
      3-methylcholanthrene-induced rat lung and liver, or human liver. We conclude that
      MAb 1-7-1 recognizes a cytochrome P-450IA1 homologue in human lung and that no
      cytochrome P-450IA2 homologue is detected. Cytochrome P-450IA1 is expressed in
      human lung at relatively low levels, similar to those observed in untreated
      primate (baboon) lung. The majority of the 19 human lung samples examined do not
      exhibit a permanent polycyclic aromatic hydrocarbon-induced state with respect to
      this isozyme.

PMID- 2233700
TI  - Positive cooperativity in the binding of alcuronium and N-methylscopolamine to
      muscarinic acetylcholine receptors.
AB  - The effect of the neuromuscular blocker alcuronium on the binding of N-[3H]
      methylscopolamine [( 3H]NMS) and l-[3H]quinuclidinylbenzilate ([3H]QNB) to
      muscarinic binding sites in rat heart atria, longitudinal smooth muscle of the
      ileum, cerebral cortex, cerebellum, and submaxillary glands was measured using
      filtration techniques. In the presence of 10(-5) M alcuronium, the binding of
      [3H]NMS (which was present at a subsaturating concentration of 2 x 10(-10) M) was
      increased 5.3-fold in the atria and smooth muscle and 3-fold in the cerebellum;
      no increase was observed in the brain cortex and salivary glands. The binding of
      [3H]NMS was inhibited at 10(-3) M and higher concentrations of alcuronium. The
      rates of [3H]NMS association to and dissociation from muscarinic binding sites in
      the atria were diminished by 10(-5) M alcuronium. Scatchard plots of [3H]NMS
      binding data obtained with and without 10(-5) M alcuronium indicated that the
      maximum number of binding sites was not altered by the drug, whereas the apparent
      Kd for [3H]NMS was diminished. In contrast to [3H] NMS, the effects of alcuronium
      on the binding of [3H]QNB were only inhibitory. The concentration of alcuronium
      required to diminish the binding of [3H]QNB by 50% (IC50) was 4-7 microM in the
      atria, ileal smooth muscle, and the cerebellum, 140 microM in the brain cortex,
      and 1200 microM in the parotid gland. The results suggest that the binding of low
      concentrations of alcuronium to muscarinic receptors in the heart, ileal smooth
      muscle, and cerebellum allosterically increases the affinity of muscarinic
      receptors towards [3H]NMS, although not [3H]QNB. At high concentrations,
      alcuronium inhibits the binding of muscarinic ligands, presumably by competition
      for the classical muscarinic binding site. Positive cooperativity induced by
      alcuronium appears to be specific for the m2 (cardiac) subtype of muscarinic
      receptors.

PMID- 2233701
TI  - Structure-function relationships of hydroxylated metabolites of tamoxifen that
      control the proliferation of estrogen-responsive T47D breast cancer cells in
      vitro.
AB  - Several hydroxylated derivatives of tamoxifen were tested for their effects on
      the growth of T47D human breast cancer cells in vitro. Compounds containing a
      fused seven-membered ring were used to prevent isomerization of the triphenyl
      ethylenes at the double bond. This stable structure permitted the determination
      of the activity of the cis and trans forms of tamoxifen and the true activity of
      two of its metabolites, 4-hydroxytamoxifen and metabolite E. Estradiol stimulates
      the growth of T47D cells 3-4-fold over control after 6 days of treatment (EC50 =
      congruent to 3 x 10(-12) to 3 x 10(-11) M, depending upon the particular
      experiment). The fixed ring form of the trans isomer of tamoxifen is an
      antiestrogen, whereas the cis isomer is estrogenic. Fixed ring-trans-4
      hydroxytamoxifen is a potent antiestrogen, and its cis isomer is a weak
      antiestrogen (IC50 congruent to 4 x 10(-8) to 2 x 10(-7) M). The fixed ring form
      of trans-metabolite E (tamoxifen without the dimethylaminoethane side chain) is
      only a weak partial estrogen agonist, whereas the fixed ring derivative of its
      cis isomer is a potent estrogen agonist (EC50 congruent to 4 x 10(-12) to 1 x 10(
      11) M). These studies have determined the true biological activities of the
      hydroxylated derivatives of tamoxifen. This information will be valuable for the
      development of drug receptor models and will be particularly useful when the
      three-dimensional structure of the receptor complex is determined.

PMID- 2233703
TI  - Regulatory volume decrease of pancreatic beta-cells involving activation of
      tetraethylammonium-sensitive K+ conductance.
AB  - Beta-cell-rich pancreatic islets from ob/ob-mice were used for evaluating the
      early effects of hypotonic stress. The beta-cells responded to an abrupt lowering
      of the osmotic pressure by 102 mOsm with both a transient stimulation of insulin
      release (peak value 25 times above basal) and a loss of potassium without major
      effects on sodium. The secretory response was obtained also in the presence of
      100 microM quinine or 20 mM tetraethylammonium+. The loss of potassium was not
      affected by 20 mM glucose or 10 microM bumetanide, but became less apparent in
      the presence of 100 microM quinine and disappeared when the islets were exposed
      to 20 mM tetraethylammonium+. Amiloride and high concentrations of the
      hypoglycemic sulfonylureas tolbutamide and glibenclamide had only a slight
      suppressive action on potassium mobilization. Patch clamp analyses revealed an
      increased frequency of small channel openings after exposure to the hypotonic
      medium. It is concluded that the pancreatic beta-cells have the ability for a
      regulatory volume decrease involving activation of tetraethylammonium-sensitive
      K+ conductance. The stimulation of insulin release obtained by lowering the
      osmotic pressure seems to be related to the entry of water rather than to the ion
      movements responsible for the readjustment of the beta-cell volume.

PMID- 2233702
TI  - Molecular events regulating messenger RNA stability in eukaryotes.
AB  - The regulation of mRNA turnover plays a major role in the overall control of gene
      expression. Transcriptional control of eukaryotic gene regulation by external
      and/or internal stimuli has received considerable attention and the purpose of
      this review is to highlight recent work elucidating the mechanisms underlying the
      steady-state levels of mRNAs in the cytoplasm. Protection of mRNA from the action
      of nucleases as it passes from the nucleus to the ribosomes for translation is
      achieved, at least in part, by its union with mRNA binding proteins and the
      presence of poly(A) tail. The half-life of a message represents a balance between
      the transcriptional activity and intracellular degradative processes. These
      properties can be modulated by the presence of specific nucleotide sequences in a
      mRNA along with cis- and trans-acting elements and accompanied by post
      translational feed back mechanisms. Presently, various regulatory mechanisms
      involved in the mRNA decay process are ill-defined. The work described here
      illustrates the complexity of this emerging field of study and outlines its
      contribution to our understanding of gene regulation in eukaryotes.

PMID- 2233704
TI  - Characterization and analysis of the subclasses and molecular species of choline
      phosphoglycerides from porcine heart by successive chemical hydrolyses and
      reverse phase high-performance liquid chromatography.
AB  - Choline phosphoglycerides (CPG) represent the major fraction of heart
      phospholipids. Since depletion of membrane phospholipids and accumulation of lyso
      compounds, particularly lysophosphatidylcholines, have been implicated in
      arrhythmogenesis, it was of great interest to study the composition of this major
      phospholipid fraction of the heart at a molecular level in an established animal
      model. The data presented here describe the first report on the detailed chemical
      examination of CPG and resolution, characterization and quantitative analysis of
      the molecular species of this phospholipid fraction from porcine heart by high
      performance liquid chromatography (HPLC). This fraction constitutes 37.5 +/- 0.7%
      (n = 21) of the total phospholipids and upon successive mild acid and alkaline
      hydrolyses revealed the presence of essentially three subclasses: diacyl-,
      alkenylacyl-, and alkylacyl glycerophosphorylcholines, in a relative abundance of
      57.7 +/- 2.2% (n = 8), 37.3 +/- 1.3% (n = 8) and 4.6 +/- 0.2% (n = 8),
      respectively. The fourth subclass, dialkyl CPG was found only in minute amounts
      (0.43 +/- 0.05%, n = 8) and the presence of dialkenyl and alkenylalkyl analogues
      could not be detected. Alternatively, by converting the CPG fraction to benzoate
      derivatives after phospholipase C digestion, it was possible to isolate and
      quantitate subclass composition by TLC/spectroscopy or both subclass compositions
      and molecular species analysis by HPLC directly by a UV detector online with the
      column. By these techniques, subclass composition was found to be very similar to
      that obtained by the chemical hydrolysis technique. By HPLC, up to 25 species can
      be identified and quantitated in each subclass, their identity being confirmed by
      gas-liquid chromatography, after their isolation from the column. The analyses
      showed that up to 74% of the diacyl moiety consisted of 16:0-18:2 (34%), 16:0
      18:1 (27%), and 18:0-18:2 (13%) species, while the major species of the
      alkenylacyl moiety were 16:0-18:2 (44%) 16:0-18:1 (13%), 16:0-20:4 (12%) and 18:1
      18:2 (9%) making up more than 75% of the total mass of this subclass. The major
      molecular species of the alkylacyl moiety was 16:0-18:2, constituting up to 47%
      of this fraction, while others constituted about 10% (16:0-18:1), 9% (18:1-18:2),
      8% (16:0-20:4) and 6% (18:0-18:2), making up 80% of the total mass. The ether
      chain composition of akylacyl CPG whether determined after isolation of this
      fraction by the chemical hydrolysis technique or by HPLC was
      indistinguishable.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2233705
TI  - The kinetics of fibronectin synthesis and release in normal and tumor promoter
      treated human lung fibroblasts.
AB  - The present study is a detailed kinetic analysis of the synthesis, release and
      multimerization of fibronectin (FN) in normal and tumor promoter-treated human
      lung fibroblasts. Pulse/chase and surface labeling experiments were performed to
      follow the fate of both newly synthesized and preexisting cell-surface FN over
      time. The majority of FN (80%) left the intracellular compartment within one hour
      of synthesis. However, the rate of direct secretion was very low and after one
      hour, 70% of newly synthesized FN was still at the cell surface. This material
      was primarily dimeric. Dimeric and multimeric (very high molecular weight) FN was
      detectable at the cell surface and in the medium 4 hours after synthesis. Pulse
      labeled FN multimer levels peaked at 12 hours and declined thereafter. After 24
      hours, 85% of pulse-labeled FN had been shed into the medium and the labeled FN
      remaining at the cell surface was primarily multimeric. Surface labeling
      experiments confirmed that the majority of FN resides at the cell surface prior
      to release into the medium. One hour treatment with the phorbol ester tumor
      promoter, 12-0-tetradecanoyl phorbol-13-acetate (TPA), stimulated a nine-fold
      increase in release of preexisting, dimeric cell-surface FN (125I-labeled). The
      major effect of longer term TPA treatment up to nine hours was continued
      depletion of dimeric cell-surface FN. Increased release of cell-surface
      multimeric FN was also stimulated by TPA, but to a much lesser extent. Release of
      newly synthesized (pulse-labeled) dimeric FN was also stimulated by TPA though
      much less than pre-existing FN, and TPA treatment produced a small decrease in
      the steady-state level of multimeric FN. Thus, preexisting cell-surface FN and
      newly synthesized FN differ dramatically in their susceptibility to TPA
      treatment.

PMID- 2233706
TI  - Protein kinase C does not regulate diacylglycerol metabolism in aortic smooth
      muscle cells.
AB  - The effect of a reduction in protein kinase C activity on the metabolism of
      exogenous [3H]diC8 by freshly isolated smooth muscle cells from rabbit aorta and
      cultured A10 smooth muscle cells was determined. The metabolism of [3H]diC8 by
      both smooth muscle cell preparations was predominantly by hydrolysis to yield
      monoC8 and glycerol (lipase pathway); very little radioactivity was incorporated
      into phospholipids. Diacylglycerol lipase activity measured in vitro with A10
      cell homogenates was much greater than diacylglycerol kinase activity. The
      addition of the protein kinase C inhibitor H-7 to incubations of isolated aortic
      smooth muscle cells and cultured A10 cells had no significant effect on the
      metabolism of [3H]diC8. Protein kinase C activity in cultured A10 cells
      preincubated for 20 h with a phorbol ester was reduced to 14% of control as a
      consequence of down-regulation, but diC8 metabolism was not changed. Therefore,
      protein kinase C does not regulate the metabolism of diacylglycerols in aortic
      smooth muscle cells.

PMID- 2233707
TI  - Lymphocyte calcium extrusion: kinetic and thermodynamic measurements using
      ratiometric dual-emission spectrofluorometry.
AB  - A method is described for monitoring intracellular ionized calcium (Ca2+) and
      determining kinetic and thermodynamic parameters of Ca2(+)-extrusion from intact
      lymphocytes. The method uses ratiometric spectrofluorometry and the fluorescent
      Ca2+ dye indo-1. Lymphocytes were loaded with calcium and placed in a low calcium
      medium. A novel formula for calculation of intracellular Ca2+ that corrects for
      background fluorescence and fluorescence quenching was used. Calcium extrusion
      resulted in exponential decrease in cytoplasmic Ca2+ with a rate constant of
      0.031 +/- 0.003 sec-1, maximal rate of 23 +/- 7 nM/sec, dissociation constant of
      366 +/- 63 nM, Hill coefficient of 2.3 +/- 0.4, Q10 of 2.58 +/- 0.28, and
      activation energy of 18.3 Kcal/mol. This method should allow for characterization
      of the Ca2(+)-extrusion system of lymphocytes and may be applicable to other
      blood cell types.

PMID- 2233709
TI  - Tissue-specific expression from a compound TATA-dependent and TATA-independent
      promoter.
AB  - We have found that the mouse metallothionein-I (MT-I) gene promoter functions in
      an unusual, compound manner. It directs both TATA-dependent and TATA-independent
      modes of transcription in vivo. The TATA-dependent message is initiated at the
      previously characterized +1 transcription start site and is the predominant
      species in most tissues. In many cell types it is metal inducible. The TATA
      independent initiation sites are distributed over the 160 bp upstream of the
      previously characterized +1 start site, and the RNA products are present in all
      tissues examined. Only in testis, however, do the TATA-independent transcripts
      predominate, accumulating to highest levels in pachytene-stage meiotic cells and
      early spermatids. Unlike the TATA-dependent +1 transcript, these RNAs are not
      induced by metal, even in cultured cells in which the +1 species is induced.
      Transfection studies of site-directed mutants show that destruction of the TATA
      element drastically alters the ratio of the two RNA classes in cells in which the
      +1 transcripts normally dominates. In TATA-minus mutants, the TATA-independent
      RNAs become the most prevalent, although they remain refractory to metal
      induction. Thus, the MT-I promoter utilizes two different types of core promoter
      function within a single cell population. The two different types of core
      promoter respond very differently to environmental stimuli, and the choice
      between them appears to be regulated in a tissue-specific fashion.

PMID- 2233708
TI  - The SNF5 protein of Saccharomyces cerevisiae is a glutamine- and proline-rich
      transcriptional activator that affects expression of a broad spectrum of genes.
AB  - The Saccharomyces cerevisiae SNF5 gene affects expression of both glucose- and
      phosphate-regulated genes and appears to function in transcription. We report the
      nucleotide sequence, which predicts that SNF5 encodes a 102,536-dalton protein.
      The N-terminal third of the protein is extremely rich in glutamine and proline.
      Mutants carrying a deletion of the coding sequence were viable but grew slowly,
      indicating that the SNF5 gene is important but not essential. Evidence that SNF5
      affects expression of the cell type-specific genes MF alpha 1 and BAR1 at the RNA
      level extends the known range of SNF5 function. SNF5 is apparently required for
      expression of a wide variety of differently regulated genes. A bifunctional SNF5
      beta-galactosidase fusion protein was localized in the nucleus by
      immunofluorescence. No DNA-binding activity was detected for SNF5. A LexA-SNF5
      fusion protein, when bound to a lexA operator, functioned as a transcriptional
      activator.

PMID- 2233710
TI  - Transcriptional activation of the human cytotoxic serine protease gene CSP-B in T
      lymphocytes.
AB  - The cytotoxic serine protease B (CSP-B) gene is activated during cytotoxic T
      lymphocyte maturation. In this report, we demonstrate that the PEER T-cell line
      (bearing gamma/delta T-cell receptors) accumulates CSP-B mRNA following exposure
      to 12-O-tetradecanoylphorbol-13-acetate (TPA) and N6-2'-O-dibutyryladenosine
      3',5'-cyclic monophosphate (bt2cAMP) because of transcriptional activation of the
      CSP-B gene. TPA and bt2cAMP act synergistically to induce CSP-B expression, since
      neither agent alone causes activation of CSP-B transcription or mRNA
      accumulation. Chromatin upstream from the CSP-B gene is resistant to DNase I
      digestion in untreated PEER cells, but becomes sensitive following TPA-bt2cAMP
      treatment. Upon activation of PEER cells, a DNase I-hypersensitive site forms
      upstream from the CSP-B gene within a region that is highly conserved in the
      mouse. Transient transfection of CSP-B promoter constructs identified two
      regulatory regions in the CSP-B 5'-flanking sequence, located at positions -609
      to -202 and positions -202 to -80. The region from -615 to -63 is sufficient to
      activate a heterologous promoter in activated PEER cells, but activation is
      orientation specific, suggesting that this region behaves as an upstream promoter
      element rather than a classical enhancer. Consensus AP-1, AP-2, and cAMP response
      elements are found upstream from the CSP-B gene (as are several T-cell-specific
      consensus elements), but the roles of these elements in CSP-B gene activation
      have yet to be determined.

PMID- 2233711
TI  - Molecular genetic analysis of Saccharomyces cerevisiae C1-tetrahydrofolate
      synthase mutants reveals a noncatalytic function of the ADE3 gene product and an
      additional folate-dependent enzyme.
AB  - In eucaryotes, 10-formyltetrahydrofolate (formyl-THF) synthetase, 5,10-methenyl
      THF cyclohydrolase, and NADP(+)-dependent 5,10-methylene-THF dehydrogenase
      activities are present on a single polypeptide termed C1-THF synthase. This
      trifunctional enzyme, encoded by the ADE3 gene in the yeast Saccharomyces
      cerevisiae, is thought to be responsible for the synthesis of the one-carbon
      donor 10-formyl-THF for de novo purine synthesis. Deletion of the ADE3 gene
      causes adenine auxotrophy, presumably as a result of the lack of cytoplasmic 10
      formyl-THF. In this report, defined point mutations that affected one or more of
      the catalytic activities of yeast C1-THF synthase were generated in vitro and
      transferred to the chromosomal ADE3 locus by gene replacement. In contrast to
      ADE3 deletions, point mutations that inactivated all three activities of C1-THF
      synthase did not result in an adenine requirement. Heterologous expression of the
      Clostridium acidiurici gene encoding a monofunctional 10-formyl-THF synthetase in
      an ade3 deletion strain did not restore growth in the absence of adenine, even
      though the monofunctional synthetase was catalytically competent in vivo. These
      results indicate that adequate cytoplasmic 10-formyl-THF can be produced by an
      enzyme(s) other than C1-THF synthase, but efficient utilization of that 10-formyl
      THF for purine synthesis requires a nonenzymatic function of C1-THF synthase. A
      monofunctional 5,10-methylene-THF dehydrogenase, dependent on NAD+ for catalysis,
      has been identified and purified from yeast cells (C. K. Barlowe and D. R.
      Appling, Biochemistry 29:7089-7094, 1990). We propose that the characteristics of
      strains expressing full-length but catalytically inactive C1-THF synthase could
      result from the formation of a purine-synthesizing multienzyme complex involving
      the structurally unchanged C1-THF synthase and that production of the necessary
      one-carbon units in these strains is accomplished by an NAD+ -dependent 5,10
      methylene-THF dehydrogenase.

PMID- 2233712
TI  - Temperature-sensitive DNA mutant of Chinese hamster ovary cells with a
      thermolabile ribonucleotide reductase activity.
AB  - JB3-B is a Chinese hamster ovary cell mutant previously shown to be temperature
      sensitive for DNA replication (J. J. Dermody, B. E. Wojcik, H. Du, and H. L.
      Ozer, Mol. Cell. Biol. 6:4594-4601, 1986). It was chosen for detailed study
      because of its novel property of inhibiting both polyomavirus and adenovirus DNA
      synthesis in a temperature-dependent manner. Pulse-labeling studies demonstrated
      a defect in the rate of adenovirus DNA synthesis. Measurement of
      deoxyribonucleoside triphosphate (dNTP) pools as a function of time after shift
      of uninfected cultures from 33 to 39 degrees C revealed that all four dNTP pools
      declined at similar rates in extracts prepared either from whole cells or from
      rapidly isolated nuclei. Ribonucleoside triphosphate pools were unaffected by a
      temperature shift, ruling out the possibility that the mutation affects
      nucleoside diphosphokinase. However, ribonucleotide reductase activity, as
      measured in extracts, declined after cell cultures underwent a temperature shift,
      in parallel with the decline in dNTP pool sizes. Moreover, the activity of cell
      extracts was thermolabile in vitro, consistent with the model that the JB3-B
      mutation affects the structural gene for one of the ribonucleotide reductase
      subunits. The kinetics of dNTP pool size changes after temperature shift are
      quite distinct from those reported after inhibition of ribonucleotide reductase
      with hydroxyurea. An indirect effect on ribonucleotide reductase activity in JB3
      B has not been excluded since human sequences other than those encoding the
      enzyme subunits can correct the temperature-sensitive growth defect in the
      mutant.

PMID- 2233713
TI  - The phenotype of the minichromosome maintenance mutant mcm3 is characteristic of
      mutants defective in DNA replication.
AB  - MCM3 is an essential gene involved in the maintenance of minichromosomes in yeast
      cells. It encodes a protein of 971 amino acids that shows striking homology to
      the Mcm2 protein. We have mapped the mcm3-1 mutation of the left arm of
      chromosome V approximately 3 kb centromere proximal of anp1. The mcm3-1 mutant
      was found to be thermosensitive for growth. Under permissive growth conditions,
      it was defective in minichromosome maintenance in an autonomously replicating
      sequence-specific manner and showed an increase in chromosome loss and
      recombination. Under nonpermissive conditions, mcm3-1 exhibited a cell cycle
      arrest phenotype, arresting at the large-bud stage with an undivided nucleus that
      had a DNA content of nearly 2n. These phenotypes are consistent with incomplete
      replication of the genome of the mcm3-1 mutant, possibly as a result of limited
      replication initiation at selective autonomously replicating sequences leading to
      cell cycle arrest before mitosis. The phenotype exhibited by the mcm3 mutant is
      very similar to that of mcm2, suggesting that the Mcm2 and Mcm3 protein may play
      interacting roles in DNA replication.

PMID- 2233714
TI  - Nucleosome depletion alters the chromatin structure of Saccharomyces cerevisiae
      centromeres.
AB  - Saccharomyces cerevisiae centromeric DNA is packaged into a highly nuclease
      resistant chromatin core of approximately 200 base pairs of DNA. The structure of
      the centromere in chromosome III is somewhat larger than a 160-base-pair
      nucleosomal core and encompasses the conserved centromere DNA elements (CDE I,
      II, and III). Extensive mutational analysis has revealed the sequence
      requirements for centromere function. Mutations affecting the segregation
      properties of centromeres also exhibit altered chromatin structures in vivo. Thus
      the structure, as delineated by nuclease digestion, correlated with functional
      centromeres. We have determined the contribution of histone proteins to this
      unique structural organization. Nucleosome depletion by repression of either
      histone H2B or H4 rendered the cell incapable of chromosome segregation. Histone
      repression resulted in increased nuclease sensitivity of centromere DNA, with up
      to 40% of CEN3 DNA molecules becoming accessible to nucleolytic attack.
      Nucleosome depletion also resulted in an alteration in the distribution of
      nuclease cutting sites in the DNA surrounding CEN3. These data provide the first
      indication that authentic nucleosomal subunits flank the centromere and suggest
      that nucleosomes may be the central core of the centromere itself.

PMID- 2233715
TI  - On the mechanism for efficient repression of the interleukin-6 promoter by
      glucocorticoids: enhancer, TATA box, and RNA start site (Inr motif) occlusion.
AB  - The feedback inhibition of interleukin-6 (IL-6) gene expression by
      glucocorticoids represents a regulatory link between the endocrine and immune
      systems. The mechanism of the efficient repression of the IL-6 promoter by
      dexamethasone (Dex) was investigated in HeLa cells transiently transfected with
      plasmid constructs containing different IL-6 promoter elements linked to the
      herpesvirus thymidine kinase gene (tk) promoter and the bacterial chloramphenicol
      acetyltransferase gene (cat) and cotransfected with cDNA vectors constitutively
      expressing either the active wild-type or inactive mutant human glucocorticoid
      receptor (GR). The induction by interleukin-1, tumor necrosis factor, phorbol
      ester, or forskolin of IL-6-tk-cat chimeric constructs containing a single copy
      of the IL-6 DNA segment from -173 to -151 (MRE I) or from -158 to -145 (MRE II),
      which derive from within the multiple cytokine- and second-messenger-responsive
      enhancer (MRE) region, was strongly repressed by Dex in a wild-type GR-dependent
      fashion irrespective of the inducer used. The induction by pseudorabies virus of
      an IL-6 construct containing the IL-6 TATA box and the RNA start site
      ("initiator" or Inr element) but not the MRE region was also repressed by Dex in
      the presence of wild-type GR. DNase I footprinting showed that the purified DNA
      binding fragment of GR bound across the MRE, the TATA box, and the Inr site in
      the IL-6 promoter; this footprint overlapped that produced by proteins present in
      nuclear extracts from uninduced or induced HeLa cells. Imperfect palindromic
      nucleotide sequence motifs moderately related to the consensus GR-responsive
      element (GRE) motif were present at the Inr, the TATA box, and the MRE II site in
      the IL-6 promoter; although MRE I and a GR-binding site between -201 and -210 in
      IL-6 both lacked a discernible inverted repeat motif, their sequences showed
      considerable similarity with negative GRE sequences in other Dex-repressed genes.
      Surprisingly, chimeric genes containing MRE II, which lacks a recognizable
      GACGTCA cyclic AMP- and phorbol ester-responsive motif, were strongly induced by
      both phorbol ester and forskolin, suggesting that MRE II (ACATTGCACAATCT) may be
      the prototype of a novel cyclic AMP- and phorbol ester-responsive element. Taken
      together, these observations suggest that ligand-activated GR represses the IL-6
      gene by occlusion not only of the inducible IL-6 MRE enhancer region but also of
      the basal IL-6 promoter elements.

PMID- 2233716
TI  - Functional analysis of c-Myb protein in T-lymphocytic cell lines shows that it
      trans-activates the c-myc promoter.
AB  - The function of c-Myb protein was revealed by transfecting an expression vector
      containing the entire c-Myb protein-coding sequence into the murine CTLL-2 T-cell
      line. Expressions of high levels of c-Myb protein did not alter the expression of
      several T-cell markers, c-fos mRNA expression, responses to interleukin-2, and
      growth characteristics of these cells. Interestingly, expression of the c-myc
      gene was drastically increased in this clone. Further, the c-myb expression
      plasmid, but not a frameshift mutant of c-myb, enhanced the expression of a
      hybrid construct of c-myc promoter linked to a reporter gene by 8- to 14-fold.
      These results demonstrate a role of c-Myb protein in c-myc gene expression.

PMID- 2233717
TI  - p53 functions as a cell cycle control protein in osteosarcomas.
AB  - Mutations in the p53 gene have been associated with a wide range of human tumors,
      including osteosarcomas. Although it has been shown that wild-type p53 can block
      the ability of E1a and ras to cotransform primary rodent cells, it is poorly
      understood why inactivation of the p53 gene is important for tumor formation. We
      show that overexpression of the gene encoding wild-type p53 blocks the growth of
      osteosarcoma cells. The growth arrest was determined to be due to an inability of
      the transfected cells to progress into S phase. This suggests that the role of
      the p53 gene as an antioncogene may be in controlling the cell cycle in a fashion
      analogous to the check-point control genes in Saccharomyces cerevisiae.

PMID- 2233718
TI  - In vitro analysis of a transcription termination site for RNA polymerase II.
AB  - Transcription from the adenovirus major late (ML) promoter has previously been
      shown to pause or terminate prematurely in vivo and in vitro at a site within the
      first intron of the major late transcription unit. We are studying the mechanism
      of elongation arrest at this site in vitro to define the DNA sequences and
      proteins that determine the elongation behavior of RNA polymerase II. Our assay
      system consists of a nuclear extract prepared from cultured human cells. With
      standard reaction conditions, termination is not observed downstream of the ML
      promoter. However, in the presence of Sarkosyl, up to 80% of the transcripts
      terminate 186 nucleotides downstream of the start site. Using this assay, we
      showed that the DNA sequences required to promote maximal levels of termination
      downstream of the ML promoter reside within a 65-base-pair region and function in
      an orientation-dependent manner. To test whether elongation complexes from the ML
      promoter were functionally homogeneous, we determined the termination efficiency
      at each of two termination sites placed in tandem. We found that the behavior of
      the elongation complexes was different at these sites, with termination being
      greater at the downstream site over a wide range of Sarkosyl concentrations. This
      result ruled out a model in which the polymerases that read through the first
      site were stably modified to antiterminate. We also demonstrated that the ability
      of the elongation complexes to respond to the ML termination site was promoter
      specific, as the site did not function efficiently downstream of a heterologous
      promoter. Taken together, the results presented here are not consistent with the
      simplest class of models that have been proposed previously for the mechanism of
      Sarkosyl-induced termination.

PMID- 2233719
TI  - A novel immediate-early response gene of endothelium is induced by cytokines and
      encodes a secreted protein.
AB  - We have previously described the cloning of a group of novel cellular immediate
      early response genes whose expression in human umbilical vein endothelial cells
      is induced by tumor necrosis factor alpha in the presence of cycloheximide. These
      genes are likely to participate in mediating the response of the vascular
      endothelium to proinflammatory cytokines. In this study, we further characterized
      one of these novel gene products named B61. Sequence analysis of cDNA clones
      encoding B61 revealed that its protein product has no significant homology to
      previously described proteins. Southern analysis suggested that B61 is an
      evolutionarily conserved single-copy gene. B61 is primarily a hydrophilic
      molecule but contains both a hydrophobic N-terminal and a hydrophobic C-terminal
      region. The N-terminal region is typical of a signal peptide, which is consistent
      with the secreted nature of the protein. The mature form of the predicted protein
      consists of 187 amino acid residues and has a molecular weight of 22,000.
      Immunoprecipitation of metabolically labeled human umbilical vein endothelial
      cell preparations revealed that B61 is a 25-kilodalton secreted protein which is
      markedly induced by tumor necrosis factor.

PMID- 2233720
TI  - Repair and recombination of X-irradiated plasmids in Xenopus laevis oocytes.
AB  - Plasmid DNA substrates were X-irradiated and injected into the nuclei of Xenopus
      laevis oocytes. After incubation for 20 h, DNA was recovered from the oocytes and
      analyzed simultaneously for repair and for intermolecular homologous
      recombination by electrophoresis and bacterial transformation. Oocyte-mediated
      repair of DNA strand breaks was observed with both methods. Using a repair
      deficient mutant Escherichia coli strain and its repair-proficient parent as
      hosts for the transformation assay, we also demonstrated that oocytes repaired
      oxidative-type DNA base damage induced by X-rays. X-irradiation of a circular DNA
      stimulated its potential to recombine with a homologous linear partner.
      Recombination products were detected directly by Southern blot hybridization and
      as bacterial transformant clones expressing two antibiotic resistance markers
      originally carried separately on the two substrates. The increase in
      recombination was dependent on X-ray dose. There is some suggestion that lesions
      other than double-strand breaks contribute to the stimulation of oocyte-mediated
      homologous recombination. In summary, oocytes have considerable capacity to
      repair X-ray-induced damage, and some X-ray lesions stimulate homologous
      recombination in these cells.

PMID- 2233721
TI  - Structure and evolution of the U2 small nuclear RNA multigene family in primates:
      gene amplification under natural selection?
AB  - The organization of U2 genes was compared in apes, Old World monkeys, and the
      prosimian galago. In humans and all apes (gibbon, orangutan, gorilla, and
      chimpanzee), the U2 genes were organized as a tandem repeat of a 6-kb element;
      however, the restriction maps of the 6-kb elements in these divergent species
      differed slightly, demonstrating that mechanisms must exist for maintaining
      sequence homogeneity within this tandem array. In Old World monkeys, the U2 genes
      were organized as a tandem repeat of an 11-kb element; the restriction maps of
      the 11-kb elements in baboon and two closely related macaques, bonnet and rhesus
      monkeys, also differed slightly, confirming that efficient sequence
      homogenization is an intrinsic property of the U2 tandem array. Interestingly,
      the 11-kb monkey repeat unit differed from the 6-kb hominid repeat unit by a 5-kb
      block of monkey-specific sequence. Finally, we found that the U2 genes of the
      prosimian galago were dispersed rather than tandemly repeated, suggesting that
      the hominid and Old World monkey U2 tandem arrays resulted from independent
      amplifications of a common ancestral U2 gene. Alternatively, the 5-kb monkey
      specific sequence could have been inserted into the 6-kb array or deleted from
      the 11-kb array soon after divergence of the hominid and Old World monkey
      lineages.

PMID- 2233723
TI  - An amino-terminal c-myc domain required for neoplastic transformation activates
      transcription.
AB  - The product of the c-myc proto-oncogene is a nuclear phosphoprotein whose normal
      cellular function has not yet been defined. c-Myc has a number of biochemical
      properties, however, that suggest that it may function as a potential regulator
      of gene transcription. Specifically, it is a nuclear DNA-binding protein with a
      short half-life, a high proline content, segments that are rich in glutamine and
      acidic residues, and a carboxyl-terminal oligomerization domain containing the
      leucine zipper and helix-loop-helix motifs that serve as oligomerization domains
      in known regulators of transcription, such as C/EBP, Jun, Fos, GCN4, MyoD, E12,
      and E47. In an effort to establish that c-Myc might regulate transcription in
      vivo, we sought to determine whether regions of the c-Myc protein could activate
      transcription in an in vitro system. We report here that fusion proteins in which
      segments of human c-Myc are linked to the DNA-binding domain of the yeast
      transcriptional activator GAL4 can activate transcription from a reporter gene
      linked to GAL4-binding sites. Three independent activation regions are located
      between amino acids 1 and 143, a region that has been shown to be required for
      neoplastic transformation of primary rat embryo cells in cooperation with a
      mutated ras gene. These results demonstrate that domains of the c-Myc protein can
      function to regulate transcription in a model system and suggest that alterations
      of Myc transcriptional regulatory function may lead to neoplastic transformation.

PMID- 2233722
TI  - The HXT2 gene of Saccharomyces cerevisiae is required for high-affinity glucose
      transport.
AB  - The HXT2 gene of the yeast Saccharomyces cerevisiae was identified on the basis
      of its ability to complement the defect in glucose transport of a snf3 mutant
      when present on the multicopy plasmid pSC2. Analysis of the DNA sequence of HXT2
      revealed an open reading frame of 541 codons, capable of encoding a protein of Mr
      59,840. The predicted protein displayed high sequence and structural homology to
      a large family of procaryotic and eucaryotic sugar transporters. These proteins
      have 12 highly hydrophobic regions that could form transmembrane domains; the
      spacing of these putative transmembrane domains is also highly conserved. Several
      amino acid motifs characteristic of this sugar transporter family are also
      present in the HXT2 protein. An hxt2 null mutant strain lacked a significant
      component of high-affinity glucose transport when under derepressing (low
      glucose) conditions. However, the hxt2 null mutation did not incur a major growth
      defect on glucose-containing media. Genetic and biochemical analyses suggest that
      wild-type levels of high-affinity glucose transport require the products of both
      the HXT2 and SNF3 genes; these genes are not linked. Low-stringency Southern blot
      analysis revealed a number of other sequences that cross-hybridize with HXT2,
      suggesting that S. cerevisiae possesses a large family of sugar transporter
      genes.

PMID- 2233724
TI  - A hypoxic consensus operator and a constitutive activation region regulate the
      ANB1 gene of Saccharomyces cerevisiae.
AB  - We have identified a consensus operator sequence, YYYATTGTTCTC, which mediates
      the repression imposed by the ROX1 factor upon the members of the hypoxic gene
      regulon, which includes ANB1, HEM13, COX5b, and CYC7. The members of the regulon
      were repressed with widely varying stringency, and the variation was correlated
      with the number and fidelity of operator sequences observed. ANB1 had two
      operators operating with unequal efficiency, each containing two copies of the
      operator sequence. Synthetic operator sequences introduced into an operator
      deletion were effective as monomers but much more so as dimers, consistent with
      cooperativity. The native operators both imposed ROX1 repression on the GAL1
      gene, in either orientation, but the synthetic operators did not, indicating that
      the sequence context may be important. The repression and activation of ANB1 are
      independent spatially and functionally, since deletion of the operators did not
      reduce expression and since both the operator and activation regions functioned
      separately in the GAL1 UAS. The ANB1 UAS was constitutive, containing several
      elements distributed over a 300-bp region. There were two dT-rich segments, one
      of 51 bp and one of 165 bp, the latter capable of activating transcription by
      itself. Flanking segments containing GRF2 (REB1) and ABF1 (GF1) sites may
      contribute to activation but were not essential. The UAS showed a strongly
      preferred orientation.

PMID- 2233725
TI  - The Saccharomyces cerevisiae SIN3 gene, a negative regulator of HO, contains four
      paired amphipathic helix motifs.
AB  - The SIN3 gene (also known as SDI1) is a negative regulator of the yeast HO gene.
      Mutations in SIN3 suppress the requirement for the SWI5 activator for expression
      of the yeast HO gene and change the normal asymmetric pattern of HO expression in
      mother and daughter cells. Furthermore, the in vitro DNA-binding activity of
      several DNA-binding proteins is reduced in extracts prepared from sin3 mutants.
      We have cloned the SIN3 gene and determined that a haploid strain with a SIN3
      gene disruption is viable. We determined the sequence of the SIN3 gene, which is
      predicted to encode a 175-kDa polypeptide with four paired amphipathic helix
      motifs. These motifs have been identified in the myc family of helix-loop-helix
      DNA-binding proteins and in the TPR family of regulatory proteins. The SIN3
      transcript was mapped, and it was determined that the SIN3 transcript was absent
      in stationary-phase cells. Immunofluorescence microscopy with anti-SIN3 antibody
      demonstrated that SIN3 protein was present in nuclei. A comparison of restriction
      map and sequence data revealed that SIN3 is the same as regulatory genes UME4 and
      RPD1.

PMID- 2233726
TI  - Prenylation of mammalian Ras protein in Xenopus oocytes.
AB  - Ras protein requires an intermediate of the cholesterol biosynthetic pathway for
      posttranslational modification and membrane anchorage. This step is necessary for
      biological activity. Maturation of Xenopus laevis oocytes induced by an oncogenic
      human Ras protein can be inhibited by lovastatin or compactin, inhibitors of the
      synthesis of mevalonate, an intermediate of cholesterol biosynthesis. This
      inhibition can be overcome by mevalonic acid or farnesyl diphosphate, a
      cholesterol biosynthetic intermediate downstream of mevalonate, but not by
      squalene, an intermediate after farnesyl pyrophosphate in the pathway. This study
      supports the idea that in Xenopus oocytes, the Ras protein is modified by a
      farnesyl moiety or its derivative. Furthermore, an octapeptide with the sequence
      similar to the C-terminus of the c-H-ras protein inhibits the biological activity
      of Ras proteins in vivo, suggesting that it competes for the enzyme or enzymes
      responsible for transferring the isoprenoid moiety (prenylation) in the oocytes.
      This inhibition of Ras prenylation by the peptide was also observed in vitro,
      using both Saccharomyces cerevisiae and Xenopus oocyte extracts. These
      observations show that Xenopus oocytes provide a convenient in vivo system for
      studies of inhibitors of the posttranslational modification of the Ras protein,
      especially for inhibitors such as peptides that do not penetrate cell membranes.

PMID- 2233727
TI  - Promoter elements and erythroid cell nuclear factors that regulate alpha-globin
      gene transcription in vitro.
AB  - We have previously purified four factors (alpha-IRP, alpha-CP1, alpha-CP2, and NF
      E1) that interact with the promoter of the alpha-globin gene. One of these (NF
      E1) is a tissue-restricted factor that has recently been cloned. The binding
      sites of these factors identify DNA sequence elements that might mediate the
      tissue-specific and inducible transcription of the alpha-globin gene. This
      possibility was tested in a series of in vitro transcription experiments. An
      examination of 5' truncated templates and synthetic promoters constituted from
      individual factor-binding sites apposed to the alpha-TATAA box showed that the
      binding elements of three factors (alpha-CP1, alpha-IRP, and NF-E1) mediate four-
      to sixfold activation of transcription in vitro. In contrast, one element (alpha
      CP2) stimulated transcription less than twofold. The 5- to 10-fold stimulation of
      these latter templates upon addition of a DNA sequence affinity-purified factor
      suggests that alpha-CP2 is functionally limiting in nuclear extracts. Additional
      experiments further tested the effect of supplementing extracts with factors
      purified from erythroid cell nuclear extracts or, in the case of NF-E1, enriched
      from a bacterial cDNA expression system. Each factor tested stimulated
      transcription in vitro in a binding-site-dependent manner. Our results provide a
      comprehensive functional view of the murine alpha-globin promoter and suggest
      possible mechanisms for activation of alpha-globin gene transcription during
      induced differentiation of murine erythroleukemia cells.

PMID- 2233728
TI  - A phorbol ester-regulated ribonuclease system controlling transforming growth
      factor beta 1 gene expression in hematopoietic cells.
AB  - 12-Tetradecanoylphorbol-13-acetate (TPA)-induced differentiation of U937
      promonocytes leads to a 30-fold increase in transforming growth factor beta 1
      (TGF-beta 1) gene expression, and this effect results from a stabilized mRNA.
      Similar up-regulation was detected in TPA-treated K562 erythroblasts but was
      absent from cell lines that do not differentiate in response to TPA. Related
      studies in vitro showed that postnuclear extracts of U937 promonocytes contain a
      ribonuclease system that degrades TGF-beta 1 mRNA selectively and that this
      system is completely blocked by prior treatment of the cells with TPA. These data
      identify a new mechanism for regulating TGF-beta 1 mRNA levels and allow us to
      establish the overall basis for control of TGF-beta 1 gene expression by
      activation of protein kinase C. Our results also provide a new basis for
      understanding the long-term up-regulation of TGF-beta 1 gene expression that can
      accompany hematopoietic cell differentiation.

PMID- 2233729
TI  - Analysis of the mouse Dhfr/Rep-3 major promoter region by using linker-scanning
      and internal deletion mutations and DNase I footprinting.
AB  - The mouse dihydrofolate reductase (Dhfr) promoter region is buried within a CpG
      island (a region rich in unmethylated CpG dinucleotides), has a high G+C content,
      and lacks CAAT and TATA elements. The region contains four 48-bp repeats, each of
      which contains an Sp1-binding site. Another gene, Rep-3 (formerly designated Rep
      1), shares the same general promoter region with Dhfr, being transcribed in the
      direction opposite that of Dhfr. Both genes appear to be housekeeping genes and
      are expressed at relatively low levels in all tissues. The 5' termini of the
      major Dhfr transcripts are separated from the 5' termini of the Rep-3 transcripts
      by approximately 140 bp. This curious structural arrangement suggested that the
      two genes might share common regulatory elements. To investigate the promoter
      sequences driving bidirectional transcription, a series of promoter mutations was
      constructed. These mutations were assayed by a replicating minigene system and by
      promoter fusions to the chloramphenicol acetyltransferase gene. Linker-scanning
      mutations that spanned the four repeats produced a variety of mRNA transcript
      phenotypes. The effects were primarily quantitative, generally reducing the
      abundance of transcripts for one or both genes. Some mutations affected Dhfr in a
      qualitative manner, such as by changing the startpoint of one of the major Dhfr
      transcripts or changing the relative abundance of the two major Dhfr transcripts.
      Additionally, protein transcription factors that bind to sequences in the mouse
      Dhfr/Rep-3 major promoter region, potentially affecting expression of either or
      both genes, were investigated by DNase I footprinting. The results indicate that
      multiple protein-DNA interactions occur in this region, reflecting potentially
      complex transcriptional control mechanisms that might modulate expression of
      either or both genes under different physiological conditions.

PMID- 2233730
TI  - Structural and functional dissection of Sec62p, a membrane-bound component of the
      yeast endoplasmic reticulum protein import machinery.
AB  - SEC62 is required for the import of secretory protein precursors into the
      endoplasmic reticulum (ER) of Saccharomyces cerevisiae. The DNA sequence of SEC62
      predicts a 32-kDa polypeptide with two potential membrane-spanning segments. Two
      antisera directed against different portions of the SEC62 coding region
      specifically detected a 30-kDa polypeptide in cell extracts. A combination of
      subcellular fractionation, detergent and alkali extraction, and indirect
      immunofluorescence studies indicated that Sec62p is intimately associated with
      the ER membrane. Protease digestion of intact microsomes and analysis of the
      oligosaccharide content of a set of Sec62p-invertase hybrid proteins suggested
      that Sec62p spans the ER membrane twice, displaying hydrophilic amino- and
      carboxy-terminal domains towards the cytosol. Sec62p-invertase hybrid proteins
      that lack the Sec62p C terminus failed to complement the sec62-l mutation and
      dramatically inhibited the growth of sec62-l cells at a normally permissive
      temperature. The inhibitory action of toxic Sec62p-invertase hybrids was
      partially counteracted by the overexpression of Sec63p. Taken together, these
      data suggest that the C-terminal domain of Sec62p performs an essential function
      and that the N-terminal domain associates with other components of the
      translocation machinery, including Sec63p.

PMID- 2233731
TI  - Manipulations of cholinesterase gene expression modulate murine
      megakaryocytopoiesis in vitro.
AB  - Megakaryocytopoiesis was selectively inhibited in cultured murine bone marrow
      cells by a 15-mer oligodeoxynucleotide complementary to the initiator AUG region
      in butyrylcholinesterase mRNA. Furthermore, conditioned medium from Xenopus
      oocytes producing recombinant butyrylcholinesterase stimulated
      megakaryocytopoiesis. These observations implicate butyrylcholinesterase in
      megakaryocytopoiesis and suggest application of oligodeoxynucleotides for
      modulating bone marrow development.

PMID- 2233732
TI  - Alternatively spliced platelet-derived growth factor A-chain transcripts are not
      tumor specific but encode normal cellular proteins.
AB  - Two platelet-derived growth factor A-chain proteins, termed short and long A
      chains, are generated as a result of alternative mRNA splicing of exon 6 of the A
      chain gene. S1 nuclease mapping and polymerase chain reaction analyses
      demonstrate that both short and long A-chain transcripts are expressed in a
      variety of normal tissues. In addition, immunohistochemical localization of long
      A-chain protein reveals a cellular distribution identical to that observed with
      platelet-derived growth factor heteroserum.

PMID- 2233733
TI  - Chromosome organization of the protozoan Trypanosoma brucei.
AB  - The genome of the protozoan Trypanosoma brucei is known to be diploid. Karyotype
      analysis has, however, failed to identify homologous chromosomes. Having refined
      the technique for separating trypanosome chromosomes (L. H. T. Van der Ploeg, C.
      L. Smith, R. I. Polvere, and K. Gottesdiener, Nucleic Acids Res. 17:3217-3227,
      1989), we can now provide evidence for the presence of homologous chromosomes. By
      determining the chromosomal location of different genetic markers, most of the
      chromosomes (14, excluding the minichromosomes), could be organized into seven
      chromosome pairs. In most instances, the putative homologs of a pair differed in
      size by about 20%. Restriction enzyme analysis of chromosome-sized DNA showed
      that these chromosome pairs contained large stretches of homologous DNA
      sequences. From these data, we infer that the chromosome pairs represent
      homologs. The identification of homologous chromosomes gives valuable insight
      into the organization of the trypanosome genome, will facilitate the genetic
      analysis of T. brucei, and suggests the presence of haploid gametes.

PMID- 2233734
TI  - The repeated sequence CATT(A/T) is required for granulocyte-macrophage colony
      stimulating factor promoter activity.
AB  - The hematopoietic growth factor GM-CSF (granulocyte-macrophage colony-stimulating
      factor) is expressed by activated but not resting T lymphocytes. Previously, we
      localized GM-CSF-inducible promoter activity to a 90-bp region of GM-CSF 5'
      flanking sequences extending from bp -53 to +37. To more precisely identify the
      GM-CSF DNA sequences required for inducible promoter activity in T lymphocytes,
      we have performed mutagenesis within a region of GM-CSF 5'-flanking sequences (bp
      -57 to -24) that contains the repeated sequence CATT(A/T). Mutations that do not
      alter the repeated CATT(A/T) sequence do not eliminate inducible promoter
      activity, whereas mutation or deletion of either of the CATT(A/T) repeats
      eliminates all inducible promoter activity in T-cell lines and in primary human T
      lymphocytes. Thus, both copies of the direct repeat CATT(A/T) are required for
      mitogen-inducible expression of GM-CSF in T cells.

PMID- 2233735
TI  - Molecular characterization of SerH3, a Tetrahymena thermophila gene encoding a
      temperature-regulated surface antigen.
AB  - The DNA sequences of a cDNA clone and the macronuclear genomic fragment
      corresponding to the functional copy of the SerH3 surface antigen gene of
      Tetrahymena thermophila were determined. Primer extension and nuclease protection
      assays show that the SerH3 transcription unit is 1,425 nucleotides long and
      contains no introns. The predicted polypeptide encoded by the SerH3 gene has a
      molecular mass of 44,415 daltons; one-third of its 439 residues are either
      cysteine, serine, or threonine. The central half of the polypeptide consists of
      three homologous domains in tandem array; within these domains, the cysteine,
      proline, and tryptophan residues occur in highly regular patterns.

PMID- 2233736
TI  - Functional analysis of a duplicated linked pair of ribosomal protein genes in
      Saccharomyces cerevisiae.
AB  - Ribosomal protein genes RP28 and S16A (RP55) are closely linked. Another set of
      this pair of genes exists in the genome (copy 2), genetically unlinked to copy 1.
      By using gene replacement techniques, we have shown that RP28 from copy 1 is
      required for vegetative growth and that the cells need S16A from copy 2 to
      achieve maximum growth rate.

PMID- 2233737
TI  - An abnormal splice donor site in one allele of the thyroid peroxidase gene in
      FRTL5 rat thyroid cells introduces a premature stop codon: association with the
      absence of functional enzymatic activity.
AB  - Low stringency screening of an FRTL5 cDNA library with a human thyroid peroxidase
      (TPO) cDNA probe yielded two different types of TPO cDNA clones. One type
      contained the full-length structural gene, but there was an A at the first
      nucleotide of an intronic splice donor site that leads to alternate splicing,
      with the retention of part of an intron. This 54-basepair retained intron
      fragment contains a premature inframe stop codon that would truncate the protein
      at its carboxyl-terminus by 71% with the loss of enzymatic activity. The second
      type of TPO cDNA does not contain the retained intron fragment and premature stop
      codon, but it is not full-length and lacks 580-680 basepairs at its 5' end.
      However, Northern blot analysis reveals only full-length copies (3.2 kilobases)
      of TPO mRNA in FRTL5 cells, and this 5' truncation is, therefore, an artifact of
      library construction. The relative proportions of the two types of TPO mRNA in
      FRTL5 cells was determined by the polymerase chain reaction, using as template
      single stranded cDNA generated by reverse transcription of FRTL5 mRNA. Slightly
      more than half of the TPO mRNA in the FRTL5 cells represented the form with the
      abnormal splice donor site. The relative proportions of the two TPO mRNA forms
      was not influenced by TSH stimulation of the FRTL5 cells, and the proportion
      remained unaltered even after the FRTL5 cells were subcloned by limiting
      dilution. At the genomic level, we used allele-specific oligonucleotides for the
      mutant and normal forms of TPO, and found FRTL5 cells to have both normal and
      abnormal TPO alleles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233738
TI  - Glucagon gene 3'-flanking sequences direct formation of proglucagon messenger RNA
      3'-ends in islet and nonislet cells lines.
AB  - Glucagon and the glucagon-like peptides are encoded within a larger precursor,
      proglucagon. Transcription of the glucagon gene in pancreas, intestine, and brain
      gives rise to identical proglucagon mRNA transcripts, after which tissue-specific
      post-translational processing produces different profiles of proglucagon-derived
      peptides in each tissue. The importance of glucagon gene 3'-untranslated and 3'
      flanking sequences in the control of glucagon mRNA production was studied by
      transfecting a series of 3'-deleted glucagon genes into fibroblast and islet cell
      lines. Glucagon genes containing 2 kilobases of 3'-flanking sequences gave rise
      to accurately processed mRNA transcripts in both baby hamster kidney fibroblasts
      and InR1-G9 islet cell lines. Deletion of all but 50 basepairs of 3'-flanking
      sequence had no effect on glucagon mRNA 3'-end formation. In contrast, additional
      deletion of 3'-flanking and 3'-untranslated sequences resulted in the production
      of read-through mRNA transcripts with aberrant 3'-ends. The results of these
      studies define a 50-basepair region in the 3'-flanking sequence of the glucagon
      gene important for the accurate processing of proglucagon mRNA transcripts.

PMID- 2233739
TI  - High concentrations of estrogen stabilize vitellogenin mRNA against cytoplasmic
      degradation but physiological concentrations do not.
AB  - Using DNA excess filter hybridization to pulse-labeled cellular RNA, we examined
      the stability of vitellogenin mRNA in Xenopus liver in relation to estrogen
      concentration. We showed that pharmacological concentrations of estrogen
      stabilize vitellogenin mRNA against degradation but that physiological
      concentrations do not. We concluded that there is little foundation for the
      common belief that estrogen stabilizes vitellogenin mRNA in normal liver cells
      and that such stabilization contributes to the normal expression of vitellogenin
      genes. We also discuss the importance of steroid concentration in other contexts,
      and show that the widespread tendency to use artificially high concentrations may
      lead to questionable conclusions.

PMID- 2233740
TI  - Developmental changes in levels of proopiomelanocortin intron A-containing
      heterogeneous nuclear RNA and mature messenger RNA in the anterior and
      neurointermediate lobes of the rat pituitary.
AB  - The POMC cells of the rat pituitary undergo dynamic phenotypic changes during
      differentiation. Here we have determined that alterations in the relative levels
      of a POMC precursor RNA species and POMC mRNA occur during development and may
      represent another level at which the POMC phenotype is developmentally regulated.
      We performed solution hybridization/nuclease protection assays using a POMC exon
      1/intron A splice junction probe to quantitate levels of both intron A-containing
      POMC heterogeneous nuclear (hnRNA) and fully processed POMC mRNA in separated
      anterior and neurointermediate lobes of the fetal, neonatal, and adult pituitary.
      The levels of POMC hnRNA per anterior lobe increased 7-fold from embryonic day 15
      to adulthood (0.022 to 0.159 fmol/lobe), while POMC mRNA levels increased 121
      fold (0.15 to 18.2 fmol/lobe). POMC hnRNA levels per neurointermediate lobe
      increased 23-fold from embryonic day 18 to adulthood (0.024 to 0.54 fmol/lobe),
      while POMC mRNA levels increased 69-fold (0.65 to 44.6 fmol/lobe). Thus, both
      anterior and neurointermediate lobes contain higher relative abundances of POMC
      hnRNA compared to mRNA during early development. These subsequently decrease
      (from 1:7 to 1: approximately 110 in the anterior lobe and from 1:27 to 1:83 in
      the intermediate lobe over the ages examined) as the levels of POMC mRNA in both
      anterior and neurointermediate lobe increase at a greater rate than POMC hnRNA as
      development progresses. These results provide the first measurements of POMC mRNA
      and hnRNA levels during ontogeny and suggest that there may be a developmental
      change in the regulation of POMC primary transcript processing.

PMID- 2233741
TI  - Progestin regulation of estrogen receptor messenger RNA in human breast cancer
      cells.
AB  - Progestin antagonism of estrogen action is thought to be due, at least in part,
      to progestin down-regulation of the estrogen receptor (ER). The molecular
      mechanisms subserving this effect, and the functional consequences in terms of
      target cell sensitivity to estrogens, are poorly understood. The present study
      was undertaken to address these issues with particular emphasis on progestin
      regulation of ER gene expression at the mRNA level. The T-47D human breast cancer
      cell line was treated with the synthetic progestin, ORG 2058, and the resultant
      changes in ER mRNA and ER levels determined by Northern analysis and radioligand
      binding, respectively. Treatment of T-47D cells with ORG 2058 resulted in rapid
      down-regulation of ER mRNA levels to a nadir of 35-40% of control by 6 h. This
      fall in ER mRNA levels was accompanied by a slower but more sustained fall in ER
      binding to a nadir of 20% of control at 24 h. Between 12 and 24 h ER mRNA levels
      recovered partially while ER ligand binding continued to fall. At 48 h both ER
      mRNA and ER concentrations remained depressed, although the latter to a greater
      extent. ER mRNA half-life was determined by [3H]uridine incorporation to be
      approximately 60 min and was unaffected by progestin treatment during the early
      rapid phase of ER mRNA down-regulation. These data demonstrate that progestins
      cause rapid down-regulation of the ER mRNA and suggest that during the early
      rapid phase of this effect, reduced transcription of the ER gene rather than
      altered ER mRNA half-life mediate this effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233742
TI  - Identification and characterization of two upstream elements that regulate
      adrenocortical expression of steroid 11 beta-hydroxylase.
AB  - We have studied the mechanisms that regulate the expression of the mouse gene
      encoding steroid 11 beta-hydroxylase (11 beta-OHase), a steroidogenic cytochrome
      P450 enzyme that is expressed only in the adrenal cortex. DNase I footprinting
      and gel-mobility shift analyses revealed potential regulatory elements at -370
      and -310 in the 11 beta-OHase promoter region. To determine the contributions of
      these elements to expression, we altered their sequences by site-selected
      mutagenesis and studied promoter activity after transfection into Y1 mouse
      adrenocortical tumor cells. Mutation of either element markedly decreased basal
      promoter activity but did not affect the response to treatment with 8-bromo cAMP.
      These experiments thus document the functional roles of these elements, within
      the context of the intact promoter, in constitutive expression of 11 beta-OHase.
      Moreover, addition of either of these elements to p-40GH, a 5'-deletion plasmid
      containing 11 beta-OHase sequences from -40 to +8 upstream of a growth hormone
      reporter gene, significantly increased promoter activity but did not confer cAMP
      responsiveness. Finally, increased expression was seen after transfection of Y1
      derivatives deficient in cAMP-dependent protein kinase, indicating that neither
      element required cAMP-dependent protein kinase activity. These studies thus
      define two regulatory elements that play important roles in 11 beta-OHase
      expression.

PMID- 2233743
TI  - Identification of an up-stream promoter of the human parathyroid hormone-related
      peptide gene.
AB  - Previous evidence has suggested that the human PTH-related peptide (PTHRP) gene
      uses two promoters, one a short down-stream element lying immediately between two
      5' exons (1 and 2) and a second lying in an unknown up-stream location. We
      approached identification of the up-stream element in three steps. First,
      Northern analysis carried out using progressively 5' fragments of the gene as
      probes identified a candidate region some 2.5 kilobases up-stream of exon 1.
      Second, a battery of overlapping 5' cRNA probes was used in RNase protection
      experiments to identify two previously unrecognized exons, 212 and 93 basepairs
      in length (termed exons 1A and 1B to distinguish them from the previously
      designated exon 1, which was termed exon 1C). Third, primer extension experiments
      were performed with oligonucleotides complementary to each of the 5' exonic
      sequences. These experiments identified a transcription start site up-stream of
      exon 1A and also demonstrated that the 5' exons of the PTHRP gene could be
      spliced together in several combinations. The up-stream promoter element contains
      a TATA box, but does not otherwise resemble the down-stream PTHRP gene promoter
      or the PTH gene promoter. We conclude that the human PTHRP gene contains eight
      exons spanning more than 15 kilobases of genomic DNA, with promoter elements
      lying immediately up-stream of exons 1A and 2. The identification of these
      elements will permit functional analysis of their roles in mediating tissue- and
      tumor-specific PTHRP gene expression.

PMID- 2233744
TI  - Molecular modeling of residues 38-57 of the beta-subunit of human lutropin.
AB  - Several regions on both the alpha- and beta-subunits of human LH comprise the
      receptor-binding domain of the hormone. One of these, a disulfide loop peptide
      containing residues 38-57 on the beta-subunit, also stimulated steroidogenesis in
      rat Leydig cells. Circular dichroism analysis and a Schiffer-Edmundson helical
      wheel projection of beta-(38-57) revealed the possibility of an amphipathic alpha
      helical structure through its N-terminal region. Secondary structure prediction
      algorithms do not predict alpha-helix in beta-(38-57), but, rather, suggest a
      sheet-coil-sheet topology. Homology searches between this peptide and proteins
      with known structure revealed that the two best matches are with prealbumin-(10
      30) and melittin-(1-26). Based on hydrophobic moment calculations, we suggest
      that beta-(38-57) more closely resembles melittin, a known example of an
      amphipathic helix. Molecular models were constructed that included an alpha-helix
      between Pro-39 and Pro-50 producing a hydrophilic face involving Thr-40, Arg-43,
      and Gin-46. Loop closure was performed either visually or by an incremental
      minimization procedure, using distance constraints to patch in a disulfide bond.
      Molecular dynamics at 300, 360, and 1000 K were used to explore the local
      conformational space, and dynamic structures were minimized. The most reasonable
      structures were found with the 300 and 360 K simulations, with those at 360 K
      consistently producing structures with lower conformational energies. In each of
      these simulations, the N-terminus of the alpha-helix unraveled to form a reverse
      turn (predicted by the GOR algorithm) which include Cys-38, Pro-39, Thr-40, and
      Met-41. Simulations at 1000 K produced the most variation in structure, but these
      were deemed unreasonable. Although not all possible conformations were explored,
      several models were found that comply with the assumption of an amphipathic helix
      in the N-terminal half of the peptide.

PMID- 2233745
TI  - Diurnal pattern of proopiomelanocortin gene expression in the arcuate nucleus of
      proestrous, ovariectomized, and steroid-treated rats: a possible role in cyclic
      luteinizing hormone secretion.
AB  - Opiate peptides are thought to modulate the pattern of LH release in female rats.
      We tested the hypothesis that changes in proopiomelanocortin (POMC) gene
      expression occur in proestrous (PRO) and ovariectomized (OVX) steroid-treated
      rats which may explain their unique patterns of LH secretion. Using in situ
      hybridization, we examined whether diurnal changes in POMC gene expression occur
      in the arcuate nucleus. Four groups of rats were used in this study. 1) PRO rats
      were used after exhibiting at least two consecutive 4-day estrous cycles; 2) OVX
      rats were killed 9 days after ovariectomy; 3) estradiol (E2)-treated rats were
      OVX for 7 days and then treated for 2 days; and 4) E2-progesterone (P4)-treated
      rats were treated with E2 as described above, and on day 9 at 1030 h, P4 was
      administered. Rats were killed at 2300, 0300, 1000, 1300, 1500, 1800, or 2300 h,
      beginning on the evening of diestrous day 2 or day 8 after ovariectomy. POMC gene
      expression exhibited a diurnal rhythm on PRO. Levels of mRNA rose during the
      morning, peaked between 0300-1000 h, and decreased by 2300 h. In E2-treated rats,
      which exhibited a LH surge similar in timing to the PRO surge, POMC mRNA levels
      exhibited a diurnal rhythm strikingly similar to that observed in PRO animals.
      OVX abolished the rhythm; however, average POMC mRNA levels across the 24-h
      period were not significantly different from those in PRO or E2-treated rats. P4
      treatment increased POMC mRNA levels by 2300 h compared to those in all other
      experimental groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233746
TI  - Expression of human 21-hydroxylase (P450c21) in bacterial and mammalian cells: a
      system to characterize normal and mutant enzymes.
AB  - Cytochrome P450c21 (steroid 21-hydroxylase) is a key enzyme in the synthesis of
      cortisol, whose deficiency is the cause of a common genetic disease, congenital
      adrenal hyperplasia. We have expressed P450c21 (steroid 21-hydroxylase) in E.
      coli and mammalian cells. In E. coli, P450c21 cDNA was cloned into a T7
      expression vector to produce a large amount of P450c21 fusion protein, which
      enabled antiserum production. In mammalian cells, a plasmid containing full
      length P450c21 cDNA (phc21) was constructed and transfected into COS-1 cells to
      produce active P450c21, which was detected by immunoblotting and 21-hydroxylase
      activity assay. This system was used to assay mutations involved in the disease.
      Ile172 of phc21 corresponding to the site of mutation in some cases of the
      disease was mutagenized to become Asn, Leu, His, or Gln. Mutant as well as normal
      P450c21 was produced when their cDNAs were transfected into COS-1 cells. The
      mutant proteins, however, had greatly reduced 21-hydroxylase activities.
      Therefore, missense mutation at Ile172 resulted in inactivation of the enzyme,
      but not in repression of enzyme synthesis. The Leu for Ile substitution at amino
      acid 172 did not result in partial restoration of enzymatic activity, indicating
      that hydrophobicity at this residue may not play a role in its function.

PMID- 2233747
TI  - Alternative splicing produces messenger RNAs encoding insulin-like growth factor
      I prohormones that are differentially glycosylated in vitro.
AB  - Rat insulin-like growth factor-I (IGF-I) cDNA sequences predict two prohormones
      that differ in the carboxy-terminal extension peptide (E-peptide) as a result of
      the inclusion or exclusion of the 52-basepair exon 4 sequence. In the absence of
      exon 4, the sequence codes for the IGF-Ia prohormone, whose E region contains two
      potential N-glycosylation sites. With differential splicing and the inclusion of
      exon 4, the resultant mRNA codes for IGF-Ib, with a longer E-region sequence. In
      addition, as a consequence of a frame shift, both potential glycosylation sites
      are lost in the IGF-Ib peptide. We used an in vitro translation system
      supplemented with canine pancreatic microsomal membranes to analyze
      cotranslational processing of the IGF-I propeptides. We have demonstrated that
      IGF-Ia prohormone, which contains two potential N-glycosylation sites in the E
      region, can be N-glycosylated in vitro, and that both glycosylation sites are
      probably used. As expected, the IGF-Ib preprohormone is processed by microsomes,
      but is not glycosylated.

PMID- 2233748
TI  - Cellular localization of ovarian proopiomelanocortin messenger RNA during
      follicular and luteal development in the rat.
AB  - Opioid peptides are expressed in the reproductive system and have been reported
      to regulate reproductive function. The present study used in situ hybridization
      to selectively localize ovarian cells containing high levels of
      proopiomelanocortin (POMC) mRNA, an opioid precursor, during different stages of
      ovarian development. Prepubertal rats were primed with PMSG to stimulate
      follicular development, followed by hCG to induce ovulation. Treatment groups
      consisted of control (no treatment), PMSG (2 days post-PMSG), 1 day corpus luteum
      (CL; 1 day post-hCG), and 8 day CL (8 days post-hCG). POMC mRNA-containing cells
      were present in antral follicles, CL, and the interstitial compartment. With
      gonadotropin treatment, the percentage of follicles containing heavily labeled
      cells increased in the PMSG and 1 day CL groups. The number of POMC mRNA
      containing cells per follicle also increased in the 1 day CL group. In the CL, no
      difference was observed in the percentage of CL exhibiting labeled cells between
      the 1 day CL and 8 day CL groups; however, more labeled luteal cells per CL were
      present in the 1 day CL group. A marked increase in POMC mRNA-containing cells
      was observed in the interstitial compartment of the 1 day CL group. These results
      indicate that the number of POMC mRNA-containing cells increases with follicular
      development and CL formation; however, the ovarian distribution suggests that the
      labeled cells could be nonendocrine cells, possibly white blood cells. The in
      situ hybridization findings are indicative of low total concentrations of ovarian
      POMC mRNA, suggesting mainly an autocrine or paracrine role for POMC or POMC
      derived peptides.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233749
TI  - Tissue specificity of the hormonal response in sex accessory tissues is
      associated with nuclear matrix protein patterns.
AB  - The DNA of interphase nuclei have very specific three-dimensional organizations
      that are different in different cell types, and it is possible that this varying
      DNA organization is responsible for the tissue specificity of gene expression.
      The nuclear matrix organizes the three-dimensional structure of the DNA and is
      believed to be involved in the control of gene expression. This study compares
      the nuclear structural proteins between two sex accessory tissues in the same
      animal responding to the same androgen stimulation by the differential expression
      of major tissue-specific secretory proteins. We demonstrate here that the nuclear
      matrix is tissue specific in the rat ventral prostate and seminal vesicle, and
      undergoes characteristic alterations in its protein composition upon androgen
      withdrawal. Three types of nuclear matrix proteins were observed: 1) nuclear
      matrix proteins that are different and tissue specific in the rat ventral
      prostate and seminal vesicle, 2) a set of nuclear matrix proteins that either
      appear or disappear upon androgen withdrawal, and 3) a set of proteins that are
      common to both the ventral prostate and seminal vesicle and do not change with
      the hormonal state of the animal. Since the nuclear matrix is known to bind
      androgen receptors in a tissue- and steroid-specific manner, we propose that the
      tissue specificity of the nuclear matrix arranges the DNA in a unique
      conformation, which may be involved in the specific interaction of transcription
      factors with DNA sequences, resulting in tissue-specific patterns of secretory
      protein expression.

PMID- 2233750
TI  - Selective expression and developmental regulation of the ancestral rat insulin II
      gene in fetal liver.
AB  - Previous studies have indicated that high levels of insulin synthesis occur in
      the yolk sac of fetal rats. Because the yolk sac is an early site for synthesis
      of several tissue-specific proteins synthesized by liver later in development,
      these studies were performed to determine whether insulin gene expression also
      occurs in fetal liver. To this purpose, liver RNA obtained on consecutive days of
      rat fetal development from embryo day (E) 13 to E21 was evaluated for the
      presence of insulin or insulin-like mRNA species using Northern hybridization
      with a uniformly labelled rat insulin II genomic antisense RNA probe. Two species
      were detected. The larger was approximately 2.4 kilobases in length, was very low
      in abundance, and was present only during the earliest days studied (E13-15). The
      second species was approximately 720 bases in length, increased in abundance
      between days E13-16, and decreased between days E16-21. Maximum abundance of this
      mRNA was 0.3 pg/microgram total liver RNA, or 1/10th to 1/20th the abundance of
      total insulin mRNA in adult rat pancreas. Sequencing of multiple cloned products
      of E15 rat liver cDNA amplified by polymerase chain reaction using insulin I or
      II gene-specific primers indicated that the bands detected on Northern
      hybridization were (ancestral) rat insulin II gene transcripts. Analysis of
      products of polymerase chain reactions also indicated that the duplicated rat
      insulin I gene was not expressed in fetal liver. The content of insulin mRNA in
      fetal liver is sufficient to suggest that the liver may be a significant source
      for insulin at specific times during fetal development.

PMID- 2233751
TI  - Association of proenkephalin transcripts with polyribosomes in the heart.
AB  - Previous results have shown that the relative abundance of proenkephalin mRNA in
      the rat heart is comparable to the levels found in the brain; however, the
      extractable enkephalin-containing peptide levels are much lower in the heart.
      This lack of correspondence between the levels of transcript and peptide could
      arise from either the inefficient translation of proenkephalin transcripts or the
      translation of proenkephalin transcripts into peptides that are rapidly secreted
      or degraded. To distinguish between these possibilities, the translational status
      of proenkephalin mRNA in the rat heart was established by Northern blot analysis
      of sucrose density gradient-sedimented polysomal fractions and compared to the
      striatum, which is known to efficiently translate proenkephalin transcripts. In
      both tissues, we detected 1.5-kilobase transcripts, but an additional larger
      transcript of approximately 3.6 kilobases was detected in the heart. Both
      transcripts were associated primarily with polyribosomes, suggesting active
      translation of proenkephalin mRNA in the rat heart. RIA of the culture media and
      extracts from primary cultures of neonatal rat cardiomyocytes indicated the
      presence of immunoreactive Met-enkephalin-Arg6-Phe7, which was stimulated by 8-(4
      chlorophenylthio)cAMP. These results suggest that proenkephalin transcripts are
      translated in the heart and that detectable levels of immunoreactive Met
      enkephalin-Arg6-Phe7 are present in the media and cell extracts of primary
      cultures of neonatal rat cardiomyocytes.

PMID- 2233752
TI  - Lipoprotein lipase gene expression in rat adipocytes is regulated by
      isoproterenol and insulin through different mechanisms.
AB  - Lipoprotein lipase (LPL) is highly regulated by catecholamines and insulin in
      adipocytes. Isoproterenol, a beta-adrenergic agonist, decreases LPL enzyme
      activity, whereas insulin increases LPL activity. We have isolated an 868
      basepair rat LPL cDNA clone to assess hormone-mediated changes in LPL steady
      state mRNA levels and LPL gene transcription rates in adipocytes. Northern blot
      analysis of isoproterenol-treated (10(-6) M) adipocytes showed that LPL steady
      state mRNA decreased by 15 min. Nuclear run-on transcription assays in
      isoproterenol-treated cells indicated that LPL gene transcription was also
      decreased at 15 min compared to that in control cells. Conversely, insulin (6.7 x
      10(-8) M) mediated an increase in LPL steady state mRNA in treated adipocytes,
      yet LPL gene transcription was not different from that in control cells. Thus,
      the isoproterenol-mediated decrease in LPL enzyme activity and steady state mRNA
      levels in adipocytes is associated with decreases in LPL gene transcription.
      Insulin, which does not affect LPL gene transcription, increases LPL enzyme
      activity and steady state mRNA levels. The effect of insulin on LPL mRNA is
      probably due to insulin-induced changes in mRNA stability.

PMID- 2233754
TI  - Immunoassays employing substituted ammonium compounds other than neuromuscular
      blocking drugs to increase the detection of IgE antibodies to these drugs.
AB  - Subjects who experience life-threatening anaphylactic reactions to neuromuscular
      blocking drugs frequently have serum IgE antibodies that react with substituted
      ammonium groups on the drugs. Failure to detect drug-reactive antibodies may be
      due to the nature of the drug-solid support used for testing sera. With this in
      mind, solid phases of some selected compounds containing substituted ammonium
      groups, in particular triethylamine and morphine, were prepared and used to
      screen sera in an attempt to increase the frequency of detection of IgE
      antibodies complementary to tertiary and/or quaternary ammonium groups. For
      subjects who experienced an anaphylactic reaction to succinylcholine or
      gallamine, use of the supplementary assays increased the frequency of detection
      from 83 to 100%. For d-tubocurarine and alcuronium, detections increased from 92
      to 100% and from 67 to 88%, respectively. Molecular models revealed a clear
      structural similarity between the conformations of the trialkylammonium groups on
      one face of the molecules of morphine and d-tubocurarine.

PMID- 2233753
TI  - Comparison of three related methods to select T cell-presented sequences of
      protein antigens.
AB  - A comparison of three methods to predict T cell-presented sequences within
      antigenic proteins led to the view that recurrent hydrophobic residues might
      nucleate excised peptides as alpha-helices against hydrophobic surfaces. Such
      helices could be protease-protected structures on their way to desetope binding.
      The compared methods were: the amphipathicity algorithm of DeLisi and Berzofsky
      [Proc. natn. Acad. Sci. U.S.A. 82, 7048-7052. (1985)] as modified by Margalit et
      al. [J. Immun. 138, 2213-2229. (1987)] the strip of-helix hydrophobicity
      algorithm (SOHHA) of Stille et al. [Molec. Immun. 24, 1021-1027. (1987)] and the
      motifs algorithm of Rothbard and Taylor [EMBO J. 7, 93-100. (1988)]. Correct
      prediction was defined at two levels of stringency: (1) the predicted sequence
      overlapped the experimentally reported sequence when the ratio of the
      intersection of both to the union of both greater than or equal to 0.5 or (2) the
      sequences touched when there was a non-empty intersection of both sequences. We
      determined the sensitivity (correct predictions/number of reported T cell
      presented sequences) and efficiency (correct predictions/number of predictions)
      at each level of stringency. In terms of overlap, the SOHHA was more sensitive
      (0.43) than the amphipathicity (0.29) (not significant) and motifs (0.0, 0.0) (p
      less than 0.05) predictions and more efficient (0.35) than the amphipathicity
      (0.14) and motifs (0.0, 0.0) predictions. At the less stringent criterion
      touching, the amphipathicity method (0.71) was as sensitive as motif Rothbard-4
      (0.79) and more sensitive than SOHHA (0.57) and motif Rothbard-5 (0.43). At that
      criterion, the SOHHA was more efficient (0.47) than the amphipathicity (0.36) and
      motifs (0.25, 0.40) methods. We hypothesize that the comparability of these
      approaches reflected the common, predominant influence of recurrent
      hydrophobicity in their predictions.

PMID- 2233755
TI  - Isolation and characterization of a glycoprotein allergen, Art v II, from pollen
      of mugwort (Artemisia vulgaris L.).
AB  - A glycoprotein allergen, Art v II, was isolated from pollen of mugwort by two
      different isolation procedures. Art v II-A was isolated by a combination of ion
      exchange chromatography on DEAE-Sepharose, affinity chromatography on Con A
      Sepharose and ion-exchange chromatography on Mono P. Art v II-B was isolated by a
      combination of preparative IEF in Ultrodex granulated gel, affinity
      chromatography on Con A-Sepharose and HPLC size exclusion on Ultropac TSK
      G2000SW. Art v II-A and Art v II-B were shown to be antigenically identical with
      the allergen we have formerly denoted Ag7. The MW of Art v II A/B was determined
      to be 34,000-38,000 by HPLC size exclusion, and 35,000 and 20,000 by SDS-PAGE
      under non-reducing and reducing conditions, respectively. Art v II was found to
      consist of 6(7) isoforms with pI 4.10, 4.20 (major component), 4.35, 4.45, 4.55,
      4.65, (4.80). The glycoprotein allergen had a protein to carbohydrate ratio of
      10:1 and the carbohydrate part contained mannose (70.7%), N-acetyl-glucosamine
      (17.0%), glucose (7.0%) and galactose (5.3%). In R(R)IE the purified allergen
      bound IgE from 5 (33%) of 15 sera from patients with clinical allergy against
      mugwort pollen and from 13 (52%) of 25 sera from patients selected only on the
      basis of a RAST-class 4 against mugwort pollen.

PMID- 2233756
TI  - Confirmation by peptide sequence and co-expression on various cell types of the
      identity of CD44 and P85 glycoprotein.
AB  - The p85 glycoprotein expressed on a variety of human cell types including
      astrocytes and lymphocytes has not been associated with the CD44 cluster. The
      recent demonstration that Hermes, a glycoprotein implicated in the adhesion of
      lymphocytes to endothelium, belongs to the CD44 cluster raises interesting
      questions concerning the role of this molecule on astrocytes and on non-lymphoid
      cells. To obtain confirmation of the identity of p85 glycoprotein and CD44, p85
      glycoprotein was purified from B-chronic lymphocytic leukemia cells by affinity
      to monolonal 50B4-IgG and electrophoretic elution, digested with trypsin or CNBr
      and fractionated by reversed-phase HPLC. The sequences of three peptides were
      obtained which could be aligned with the amino acid sequence deduced from the
      CD44 cDNA at residues 49-54, 59-66 and 309-323. These constitute the first
      reported peptide sequences for antigens of the CD44 cluster and confirm that p85
      glycoprotein is indeed the product of the CD44 gene. Since two different cDNA
      clones encoding molecules with cytoplasmic tails of 72 and 5 amino acids have
      been isolated, the isolation of peptide 309-323 confirms the existence of a
      processed protein with the longer cytoplasmic domain. Using a cDNA probe, we have
      characterized the expression of CD44 in several normal and malignant cell types.
      The level of CD44 mRNA was correlated with the surface expression of CD44
      antigens (50B4) in several leukemic cell lines, in astrocytoma lines and in
      normal granulocytes. Negative cells included the Y79 retinoblastoma line, the
      NALM-6 leukemic line and endothelial cells. Identical mRNA species of 5.0, 2.3
      and 1.7 kb were present in all CD44-positive samples, including normal
      granulocytes, astrocytoma, melanoma and leukemia cell lines and leukemic cells
      from patients. The highest level of expression of CD44 was observed on
      astrocytoma lines and on acute lymphoblastic leukemia cells of immature
      phenotype. The presence of high levels of CD44 on malignant cells could increase
      the ability of these cells to adhere to matrix proteins and/or to interact with
      endothelium, thus potentially altering their capacity for invasiveness and
      metastasis.

PMID- 2233757
TI  - Complement killing of human neuroblastoma cells: a cytotoxic monoclonal antibody
      and its F(ab')2-cobra venom factor conjugate are equally cytotoxic.
AB  - Only a few monoclonal antibodies mediate complement lysis of tumor cells, but for
      several antibodies it has been demonstrated that a complement-activating function
      can be introduced by covalent coupling of cobra venom factor (CVF), a non-toxic
      glycoprotein which is a structural and functional homologue of human complement
      component C3. In this study we compared the efficacy of complement killing of
      human neuroblastoma cells by the complement-activating monoclonal antibody 3F8
      directed against the GD2 ganglioside antigen with that of its F(ab')2-CVF
      conjugate. At equal numbers bound per cell the 3F8 antibody and the 3F8 F(ab')2
      CVF conjugate were found to be equally cytotoxic in the presence of complement
      from several species including human. Maximal killing reached up to 98%. The
      kinetics of killing and the bivalent metal requirement confirmed that the
      cytotoxic activity of the 3F8 antibody is mediated via the classical pathway and
      that of the 3F8 F(ab')2-CVF conjugate via the alternative pathway. To achieve a
      comparable degree of killing, an approximately eight-fold higher concentration of
      the 3F8 F(ab')2-CVF conjugate was required which appears to be a consequence of
      the approximately eight-fold lower binding activity of the 3F8 F(ab')2-CVF
      conjugate compared to the intact 3F8 antibody. Our data suggest that the coupling
      of CVF to non-cytotoxic antibodies allows the generation of conjugates with a
      cytotoxic activity similar to that of inherently cytotoxic antibodies.

PMID- 2233758
TI  - Polyvalent interaction of antibodies with bacterial cells.
AB  - We have studied the physical-chemical characteristics of the interaction of
      peroxidase-labelled rabbit antibodies with Bacillus sp. bacterial cells. The
      antibodies are able to bind bivalently with two antigen sites on the bacterial
      cells with the formation of intramolecular "cyclic" complexes. A kinetic model is
      proposed suggesting the existence of monovalent and bivalent cell surface
      antigens. The equilibrium constant of the bivalent IgG binding to the bacterial
      cell is by two orders of magnitude higher as compared to monovalent Fab
      fragments. The intramolecular reaction between the free active site of the
      monovalently bound antibody and a free antigen site on the cell surface is the
      rate limiting step of the polyvalent interaction. Formation of the cyclic
      complexes seems to be accompanied by essential tension of bonds and deformation
      of the IgG molecule. Agglutination of bacterial cells was also studied. The cell
      agglomerate size dependence on the antibody concn has a threshold. Agglutination
      proceeds under conditions where the antigen-antibody binding on the cell surface
      is far from equilibrium.

PMID- 2233759
TI  - Recognition of imidazole and histamine derivatives by monoclonal antibodies.
AB  - The different ways of raising antibodies to histamine are reviewed. High affinity
      monoclonal antibodies could be raised only against derivatized histamine.
      Succinyl glycinamide derivatization provided the basis of an efficient
      radioimmunoassay. In this paper the molecular pattern and the thermodynamical
      properties of histamine recognition were thoroughly investigated. Only the
      neutral form and not the cationic form of imidazole was recognized. As expected,
      the ligand recognition increased, with improved structural homology to the
      immunogen. However, a detailed analysis revealed a zwitterionic effect whenever a
      carboxylic group was present on the side chain of the ligand.

PMID- 2233760
TI  - [Treatment of acute bronchial obstruction in childhood].

PMID- 2233762
TI  - [Acute bronchial obstruction in infancy--therapeutic concepts].
AB  - Acute wheezing in infancy is a very common problem in pediatric practice. One
      diagnosis is RSV-bronchiolitis in the very young infant, but more often acute
      wheezy bronchitis will be diagnosed, which is also induced by viral infection and
      may be the first exacerbation of asthma. Both require the same basic therapy, but
      there ist no agreement about the therapy with bronchodilators. Similarly their is
      controversy about the use of antiviral agents for RSV-bronchiolitis. The most
      important strategies for the acute, and not the long term therapy, will be
      reviewed and discussed.

PMID- 2233761
TI  - [Bronchial asthma: allergy and inflammation. Principles of rational asthma
      therapy].
AB  - Improved concepts concerning the pathogenesis of chronic bronchial asthma, the
      role of air pollutants, infections, and allergic reactions are the basis of
      established therapeutic principles and the development of new drugs: Allergens
      initiate long lasting inflammatory processes ("late phase reactions") in the
      bronchial system. This inflammation causes bronchial hyperreactivity and altered
      lung function. A large number of inflammatory cells and mediators are involved.
      Air pollutants and infections can act in the same way. Asthma treatment should
      focus in the inflammatory process, start early and prevent and treat both chronic
      inflammation and acute bronchospasm.

PMID- 2233763
TI  - [Miller-Dieker syndrome (type I lissencephaly) with specific EEG changes].
AB  - We present the case report of a girl with a subtype of Lissencephaly syndrome,
      type I, "Miller-Dieker syndrome", pointing out the specific EEG features in
      infancy and early childhood. The following pathognomonic EEG manifestations may
      confirm the diagnosis of an lissencephalic syndrome: abnormally fast background
      activity of an extraordinary high voltage increasing with age, missing
      topographic structuring, no reactivity to sleep or medication, unusually high
      voltaged sharp-slow-wave complexes.

PMID- 2233764
TI  - [Subsepsis allergica in a patient with type I polyglandular autoimmune syndrome].
AB  - A 10.6 year old Turkish girl developed + the signs of a polyglandular autoimmune
      syndrome (PGA) type I since her first year of age. Apart from the endocrine and
      non-endocrine symptoms of PGA, she suffered from an acute state of illness with
      therapy-resistant fever and multiform exanthemas in the early course of disease.
      All included the criteria of Wissler-Fanconi syndrome became clear which has not
      yet been reported in association with PGA. Although this syndrome generally is
      considered an equivalent of Still's syndrome, rheumatoid symptoms could not be
      ascertained during the following 9-year-course of PGA.

PMID- 2233765
TI  - [Cystic fibrosis and celiac disease. Report of two cases].
AB  - Two patients with cystic fibrosis who subsequently developed celiac disease are
      described. Difficulties in the diagnosis of coexistence of both diseases are
      discussed.

PMID- 2233766
TI  - [Congenital intracranial teratoma with exophthalmos].
AB  - We report the rare case of a term newborn with an excessively large congenital,
      intracranial teratoma expanding into the right orbita and maxilla. The main
      symptoms were a total unilateral exophthalmos, a tumorous mass in the right
      cheek, macrocephaly with wide sutures, and a bulging fontanel. The diagnosis was
      confirmed by sonography, computed tomography and an exploratory excision from the
      retromaxillary region.

PMID- 2233767
TI  - [Bilateral adrenal pheochromocytoma. Diagnosis and follow-up using the clonidine
      test and measurement of plasma neuropeptide Y concentration].
AB  - The role of the clonidine suppression test and determination of the plasma
      concentration of noradrenaline and of neuropeptide Y (NPY) for the diagnosis and
      monitoring of bilateral pheochromocytoma was studied in a ten year old girl.
      Prior to tumor removal plasma concentration of noradrenaline (25.9 nmol/l) and
      NPY (14 pmol/l) were markedly elevated. Inhibition of central sympathetic
      activity by clonidine (150 micrograms orally) did not lower the plasma
      concentration of noradrenaline (70.4 nmol/l) and NPY (52.6 pmol/l). However in an
      adolescent boy with renal hypertension plasma concentration of noradrenaline and
      NPY fell following clonidine application (noradrenaline from 1.9 to 1.3 nmol/l,
      NPY from 3.6 to 2.4 pmol/l). After complete removal of the pheochromocytoma
      noradrenaline and NPY fell back to normal.

PMID- 2233768
TI  - [Models for management of premature and sick newborn infants--a structural
      analysis].

PMID- 2233769
TI  - [The effect of D-penicillamine on experimental liver cirrhosis induced by CCl4].
AB  - Authors examined the effect of D-penicillamin (Pw) on liver cirrhosis induced by
      chronic CCl4 and phenobarbital (Pb) treatment in Fischer 344 rats. Morphometric
      analysis of quantity of connective tissue fibres did not show decrease on the
      effect of Pe treatment. Quantity of hydroxiproline, which is one of the
      parameters of coll ahen decrease, did not change significantly on effect of drug,
      but only compared to CCl4 and Pb treated control. Quantity of glycosaminoglycan
      showed increase following Pe treatment. Lymphocyte stimulation by Con-A was
      different in CCl4 and Pb and Pe treated groups, respectively. According to our
      examinations in case of liver fibrosis cirrhosis induced by CCL4-PB treatment in
      rats the Pe treatment proved to be unsuccessful. It seems that Pe is effective
      only in forms of cirrhosis accompanied by significant copper accumulation, by
      decrease of toxic effects of copper.

PMID- 2233770
TI  - [Changes in the femoral vein in dogs as an effect of experimental lymphedema].
AB  - Authors studied changes of femoral vein developed by the effect of examinations
      experimental lymphoedema in dogs. Light and electronmicroscopic were performed
      from femoral vein of animals killed on 3rd and 14th postoperative day, and
      biomechanical examinations were done too from dogs killed on 14th postoperative
      day. In vessel wall edema, fibrosis, and in valves infiltration consisting of
      macrophages, neutrophilic granulocytes and of mesenchymal cells were observed.
      Biomechanical examinations did not show significant deviation. Their results
      suggest the possibility that extremital lymphoedema also in man may contribute to
      development of varicosity or to its aggravation. Experimental lymphoedema of
      lower limb of dog can be proposed as model experiment to the complex study of
      pathogenesis of development of varix.

PMID- 2233771
TI  - [Morphological of biological effects of progestagens].
AB  - During their clinical studies on human endometric tissue in normal and pathologic
      condition authors attempt to determine morphologic changes occurring to the
      effect of progestagens. Klt is established that progestagens cause typical
      morphologic changes which are manifested in regression of endometrium on varying
      scale. The most striking effect is exerted on mitochondria among respective cell
      organelles; it means the damage of these structures. Decrease of enzymatic
      processes linked to mitochondrea, caused by effect of progestagens, presumably
      inhibits cell proliferation. Inhibition of cellular oxidation in pathologic
      conditions, like in endometric hyperplasia and in highly differentiated cases of
      endometric cancer, can be of therapeutic effect. Their studies provide
      opportunity to interpretation of morphologic changes performed in hormone
      dependent tissues and to better understanding of its role in carcinogenesis of
      sexual hormones.

PMID- 2233773
TI  - [Methods of informatics in pathology].
AB  - Author surveys literature of pathology and medical informatics of last 25 years
      regarding pathological information systems. He studies changes of used hardware
      and software means related to development of computer technique. Some issues of
      use of pathological informatics in Hungary are also touched on basis of
      literature.

PMID- 2233772
TI  - [Immunohistology of Hodgkin's disease. Use of monoclonal antibodies in the
      analysis of the pathomorphology of Hodgkin's disease].
AB  - Author studied cryostatic sections of lymph node biopsy of 45 untreated patients
      suffering in lymphogranulomatosis by known T and B lymphocyte, macrophage
      histiocyte, Ia and HLA-DR and transferrine receptor specific monoclonal
      antibodies (moats). In HK-LP, HK-NS, HK-MC and HK-LD the infiltrations were
      formed by phenotyped lymphocytes contrary to HK-NP, where HK nodules were
      composed of B-cells. In HK-LPs T lymphocytes were of T-helper phenotypes, and
      these T-cells were observed in cases of HH-NS and HK-MC, abounding in
      lymphocytes, besides a few T-suppressor cells. The number of lymphocyte of latter
      type increased in HK-NS and and HK-MC, poor in lymphocytes and in HK-LD. The
      giant cells had positive reaction with Leu3a, Leu5, OKIa, HLA-DR and transferrine
      receptor specific moats. SR cells are such anaplasic cells or probably tumorous
      cells developed by cell hybridization, which are able to antigen expression
      characteristic of various hemopoietic cell line and of activated cells,
      respectively.

PMID- 2233774
TI  - [Adenomatoid tumor of the uterus: report of 3 cases].
AB  - Adenomatoide tumor of uterine is reported on the basis of study of three surgical
      preparations. Tumors were detected as causal finding in uterines removed for
      other changes. The tumor can be a histopathologic diagnostic problem. It is
      likely considered to be of mesothelial origin. Its two forms are separated; in
      one also smooth muscle cells take part in growth.

PMID- 2233775
TI  - [Morphologic and morphometric analysis of atheromatous changes in the aorta in
      silibinin-treated cholesterin-fed rabbits].
AB  - Authors studied the effect of Silibinin of antioxidative effect on cholesterin
      sclerosis of rabbits. Qualitative analysis of aorta sections, macroscopic and
      microscopic morphometric examination of aorta were the applied methods. Their
      results seem to show that Silibinin has a favourable influence on cholesterin
      sclerosis. According to their opinion only joint use of qualitative and
      quantitative macroscopic and microscopic methods can provide basis for really
      accurate judgment of any atheromatose change.

PMID- 2233776
TI  - [Pathomechanism of the development of chronic obliterative transplantation
      arteriopathy in human kidney allografts].
AB  - Authors examined cells participating in intimaproliferation in transplantation
      arteriopathy ultrastructurally in needle and wedge biopsy material from 40
      transplanted kidneys, and immunohistochemically in 10 cases. In early biopsies-
      even in two control kidneys--it could be observed that the smooth muscle cells of
      media are in direct contact with endothel cells by their small processes.
      Processes can fulfil a receptor function and can transmit endothel noxa to smooth
      muscle cells. Smooth muscle cells of media react to endothel damage caused by
      rejection with migration to intima and during this period they are transformed to
      myofibroblasts (myointimal cells). In the mean time inflammatory cells (mainly
      macrophages, helper and cytotoxic cells in lower number) from the lumen
      infiltrate the intima, and mediators, enzymes released from them can inspire
      smooth muscle cells to further proliferation, migration to intima and
      transformation to myofibroblast. To effect of mediators (gamma interferon)
      released from inflammatory cells, the myointimal cells during rejection will
      press out 2nd class transplantation antigens (HLA-DR), and as vicious circle it
      further aggravates immune reply to graft, causing vascular damage,
      intimaproliferation.

PMID- 2233777
TI  - [Clinico-pathological observations in myocardial rupture].
AB  - In their material of 10 years authors describe 42 myocardial ruptures developed
      as complication of acute myocardial infarct. The rupture developed in the acute
      stage of infarct. Rupture of anterior wall infarct is the most frequent. The most
      decisive clinical factor in development of rupture is the loading in acute stage,
      from pathologic aspect the strongly infiltrated, transmural infarct is considered
      the most decisive pathologic factor. Diabetes mellitus and hypertonia can
      predispose to myocardial rupture.

PMID- 2233778
TI  - [Histological changes in the appendix in the prodromal stage of measles].
AB  - Morphological changes of adenoid tissue associated with morbilli are known.
      However, it is less known that the disease may start with symptoms of acute
      appendicitis and on the basis of histological picture morbilli can be raised or
      rendered probable, respectively, before appearance of typical clinical symptoms.
      Among morbilli cases of recently increased number the later developed morbilli
      was diagnosed from appendix in an appendectomy performed on a patient being in
      prodormal stage.

PMID- 2233779
TI  - [Localization of the structural gene for botulinum neurotoxin type A using
      synthetic DNA probe for neurotoxin light chain].
AB  - To obtain the information on the genetic control of toxin production in the
      botulism causative agents, the oligonucleotides were synthesized as the molecular
      probes by translation of the amino acid sequence of the botulinic type A
      neurotoxin. The optimal conditions for hybridization of botulinic DNA with the
      synthetic DNA probes were determined and the probes specificity was demonstrated.
      The DNA fragments homologous to the probes used were shown to belong to bacterial
      genome, but not to bacteriophage one.

PMID- 2233780
TI  - [Isolation of transmissible cointegrates of Yersinia pestis plasmids pYV and pYT
      with the plasmid RP4::Mu cts 62, IncP1].
AB  - The transmissible cointegrates of the Yersinia pestis plasmids pYV and pYT with
      the broad host range plasmid RP4::Mu cts62 of the incompatibility group IncP have
      been constructed by the in vivo recombination. The cointegrative plasmid pKR14
      (pYV76 omega RP4::Mu cts62) conferred on the transconjugants the properties of
      Ca2(+)-dependence at 37 degrees C, V-antigen synthesis, RP4 plasmid markers (ApR,
      KmR, TcR), immunity to the lysis by the bacteriophage Mu cts62 and
      incompatibility with the homologous replicon pYV76. Cointegrates pKR103 and
      pKR106 (pYT omega RP4::Mu cts62) conferred on the transconjugant clones the
      ability to synthesize the "mouse" toxin and fraction I. The capability of
      Escherichia coli cells to synthesize the latter products has been demonstrated
      together with the deficiency of these cells to transport the synthesized fraction
      I to the cell surface.

PMID- 2233781
TI  - [Expression of Yersinia pestis antigens encoded by the Ca2+-dependence plasmid].
AB  - Antigens coded by the Ca2(+)-dependance plasmid were found in the cultural
      medium, cytoplasm and outer membranes of the three monoplasmid (pCadV) strains of
      Yersinia pestis with the different basic properties. The presence of 20 mM of
      Mg2+ at least in the medium is necessary for optimal expression of these
      proteins. The existence of strain differences in the bacterial cells reaction to
      temperature, cultivation medium has been demonstrated. No difference in the pCad
      dependent proteins was found in Yersinia pestis and the causative agents of
      pseudotuberculosis, enterocolitis.

PMID- 2233782
TI  - [Covalent-bound aggregates of equine venezuelan encephalomyelitis virus induced
      by UV-irradiation].
AB  - Formation of Venecuelan equine encephalomyelitis virus (VEE) aggregates induced
      by UV-light has been studied. The high doses of UV-irradiation induced the
      protein-protein cross-links resulting in formation of fast sedimenting viral
      structures. The latter structures are supposed to be presented by the aggregates
      of several virions linked by the UV-light induced RNA-protein and protein-protein
      covalent bonds. The lesions in the fine structure of virion envelope was
      registered by the electron microscopy technique.

PMID- 2233783
TI  - [Polypeptides of African swine fever virus].
AB  - The published data on the characteristics and properties of structural and
      nonstructural polypeptides of the African porcine virus are reviewed.
      Localization of the viral proteins in virions and infected cells, kinetics of
      biosynthesis, glycosylation, phosphorylation and the antigenicity of the proteins
      are discussed.

PMID- 2233784
TI  - [New shuttle-type vectors for cloning in Escherichia coli and Agrobacterium
      tumefaciens].
AB  - The vectors capable of replication in Escherichia coli and Agrobacterium
      tumefaciens have been constructed on the basis of the plasmid pUB5502. The
      constructed vectors pVA12, pVA12-2, pVA12-4 contain the mini-replicon and
      trimethoprim resistance gene (Tp) of a broad host-range plasmid R388 (IncW). The
      pVA12 vector (8.8 kb) has been constructed by insertion of a kanamycin resistance
      gene (Km) from the plasmid pUC-4K into a Psti site. It possesses 7 unique
      restriction sites for XhoI, SmaI, PvuI, PvuII, HindIII, EcoRI, BamHI and the
      markers for kanamycin and trimethoprim resistance (Km and Tp). The pVA12-2 and
      pVA12-4 vectors were obtained as a result of changing of the PvuII-EcoI fragment
      of pVA12 carrying the Tp gene for the PvuII-EcoRI fragment of pBR322 carrying the
      Tc gene. These plasmids have the same size of 9.7 kb and 8 unique sites for
      restriction endonucleases XhoI, SmaI, PvuI, PvuII, EcoRI, EcoRV, SalI, BalI and
      Km and Tc genes. No difference has been registered between the two plasmids by
      restriction analysis, but pVA12-4 has the dramatically increased copy number in
      Escherichia coli cells. All three vectors are transferable to Agrobacterium
      tumefaciens with the same frequencies by transformation or conjugation and do not
      affect the oncogenicity of pTi.

PMID- 2233785
TI  - [Relation between the Yersinia phage and bacteriophages isolated from the
      environment].
AB  - The bacteriophage designated RD2 has been isolated from the sewage in Rostov-on
      Don city and studied. The morphology of bacteriophage particles and the
      biological properties of the bacteriophage make it related to the plague
      bacteriophage isolated by D'Errel. The molecular masses of the compared
      bacteriophages are almost identical being 26.4 +/- 0.4 Md for RD2 and 24.7 +/-
      0.2 Md for D'Errel bacteriophage. The DNAs of the bacteriophages share 80% of
      homology and possess 15 nonhomologous regions scattered along the genomes. The
      phages are serologically related. The DNAs of both bacteriophages give the
      similar pattern of hydrolysis by restriction endonuclease EcoRV, but have the
      different sensitivity to many other restriction endonucleases. The protein
      specter of bacteriophage RD2 contains 18 polypeptides (11 minor ones), while the
      one of D'Errel bacteriophage contains 7 polypeptides similar in molecular mass
      with the polypeptides of RD2. The bacteriophage RD2 cannot be considered one of
      the plague causative agents of bacteriophages since the region where it has been
      isolated has a long epidemiological and epizootical record of absence of plague.

PMID- 2233786
TI  - [The effect of recombinant plasmids containing the antisense sequence of E. coli
      gene rplJ on the expression of tester gene rplJ-lacZ].

PMID- 2233787
TI  - [Inactivation of bacteriophage PM2 during storage].
AB  - The kinetics of bacteriophage inactivation in the medium that is optimal for its
      storage has been studied at temperatures from 4 to 55 degrees C. The plot of
      Arrhenius dependence of the constant of inactivation rate consists of the two
      linear parts with the energies of activation Ea = 25 kcal/mol for 4-37 degrees C
      and Ea = 91 kcal/mol for 37-55 degrees C. The DNA of inactivated bacteriophage
      remained mostly in superspiralized form and completely preserved its biological
      activity as tested by transfection in spheroplasts. The analysis of inactivation
      kinetics suggests ageing of virions cultivated at 4 degrees C. The addition of
      watersoluble antioxidant amoxipin did not change the inactivation kinetics. The
      addition of antioxidant ionol with twin-80 increased the inactivation that was
      paralleled by the bacteriophage DNA degradation.

PMID- 2233788
TI  - [Antisense RNA in transgenic plants].
AB  - The data on the effects of antisense RNA in plants is reviewed. Results of
      expression of the genes for selective markers, antisense reporter genes,
      functioning and viral genes are analyzed. The molecular mechanisms for inhibiting
      effects of antisense RNA and the potential use of the phenomenon in the plants
      biotechnology are discussed. The formation of long duplexes between the antisense
      RNA and messenger RNA are supposed to be irrelevant to suppression of gene
      expression in plants by the antisense RNA.

PMID- 2233789
TI  - [Interaction of staphylococcal alpha-toxin with biomembranes].
AB  - The recent data on staphylococcal alpha-toxin, its functions, methods for its
      purification, forms are presented in the review. The problem of a target for
      toxin molecule is discussed.

PMID- 2233790
TI  - [Directed cloning of the HLA-B27 gene isolated from a patient with ankylosing
      spondylitis (Bechterew's disease)].
AB  - The authors have used the modified method of the direct gene cloning suggested by
      Nichols et al to isolate HLA-B27 gene from a patient suffering from ankylosing
      spondylitis. Five restriction enzymes (ClaI, HindIII, SnaBI, PvuI, SalGI) which
      had no recognition sites within the 6.0 kb EcoRI-BamHI-DNA fragment supposedly
      containing the HLA-B27 gene have been chosen by blotting-hybridization of the
      restriction fragments of the patients DNA with HLA-B27-specific probe. The 6.0 +/
      0.5 kb DNA fragments were isolated and cloned after the DNA treatment by 300
      micrograms of all of these restriction enzymes. The obtained mini-library
      containing 280 recombinants has been screened with the use of HLA-B27 specific
      oligonucleotide probe. The clone PB27-2 has been isolated the restriction map of
      which is identical to HLA-B27k. The authors are planning to determine the
      sequence of the isolated gene in order to find a possible structural defect in
      it.

PMID- 2233791
TI  - Alkylation, mutagenesis and repair.

PMID- 2233792
TI  - Role of DNA methylation in the activation of proto-oncogenes and the induction of
      pulmonary neoplasia by nitrosamines.
AB  - The relationships between DNA methylation and repair induced by the tobacco
      specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) to the
      activation of proto-oncogenes and the induction of pulmonary neoplasia by this
      carcinogen is described. The formation of the O6-methylguanine (O6MG) adduct
      following metabolic activation of NNK appears to be a major factor in the
      induction of lung tumors in both rats and mice and in the activation of the K-ras
      oncogene in lung tumors from A/J mouse. The potent carcinogenicity of NNK in the
      rat lung correlated strongly with cell specificity for formation and persistence
      of the O6MG adduct in the Clara cells. This conclusion was supported by studies
      with nitrosodimethylamine (NDMA), a weak carcinogen in the rodent lung. Treatment
      with NDMA was not associated with any pulmonary cell specificity for DNA
      methylation. The high affinity for activation of NNK compared to NDMA was
      ascribed to a difference in cytochrome P-450 isozymes involved in the activation
      of these two nitrosamines. In the A/J mouse, the induction of pulmonary
      tumorigenesis involved direct genotoxic activation of the K-ras proto-oncogene as
      a result of the base mispairing produced by formation of the O6MG adduct. In
      contrast, the induction of pulmonary tumors in the rat by NNK does not appear to
      involve the ras pathway. It is apparent that different molecular mechanisms are
      involved in the development of pulmonary tumors by NNK in the mouse and rat. The
      studies described in this paper illustrate the utility of performing dose
      response experiments and the quantitation of DNA methylation and repair in not
      only target tissues but also target cell types. The fundamental knowledge gained
      from unraveling the mechanism of carcinogenesis by NNK could lead ultimately to
      the identification of factors important in the development of human lung cancer.

PMID- 2233793
TI  - DNA alkylation by the haloethylnitrosoureas: nature of modifications produced and
      their enzymatic repair or removal.

PMID- 2233794
TI  - Sequence-dependent formation of alkyl DNA adducts: a review of methods, results,
      and biological correlates.
AB  - Understanding the influence of the DNA sequence on chemical-DNA interactions may
      provide insight into the processes of chemical carcinogenesis and mutagenesis.
      This article provides a brief overview of studies and methods devoted to
      examining the distribution of DNA adducts produced by alkylating agents.
      Particular emphasis is placed on discussion of DNA adducts generated by simple
      alkylating agents and the role that their distribution may play in the generation
      of mutational hotspots.

PMID- 2233795
TI  - The control of O6-methylguanine-DNA methyltransferase (MGMT) activity in
      mammalian cells: a pre-molecular view.
AB  - Human peripheral blood lymphocytes (PBLs) can have a range of O6-methylguanine
      DNA methyltransferase (MGMT) activities. PBLs from some individuals may have
      almost no MGMT activity. Such individuals have most often been subject to
      malignancy or to immunodeficiency disease. Long-term lymphoblastoid lines (LCLs)
      prepared from PBLs of normal subjects by Epstein-Barr virus (EBV) transformation
      have MGMT activities which are in general somewhat higher than the PBLs from
      which they derive. Such cultures are therefore generally MGMT-positive. Only in
      rare cases, and generally from patients with low MGMT activity, are freshly
      obtained lines with very low activity obtained. There is however a 4-fold range
      of MGMT activity over which multiple lines derived from the same PBL sample can
      be found. Long-term cultivation can lead to LCLs with low activity as well as to
      lines of high activity. On rare occasions an MGMT-positive line may, within a few
      divisions, give a negative line. Some (but not all) MGMT-negative (or very low)
      lines have been known to gain (some) activity. Chinese hamster ovary (CHO) cell
      lines are in general very low in MGMT activity. Lines of higher activity can be
      selected by treatment with mutagenic crosslinking alkylating agents. Chinese
      hamster lines with high MGMT activity can be obtained by transfection with human
      DNA from MGMT-positive cells. Lines with significant activity can also be
      obtained by transfection of CHO cells with human DNA from MGMT-negative (or very
      low) cells. Resistance to MNNG treatment can be acquired without the acquisition
      of significant MGMT activity. Crosses of lines of high and low MGMT activity give
      equivocal results. Hybrids of low x low activity have no activity. Crosses of
      positive x positive strains give varied results. It has not been possible to
      identify MGMT-positive hybrids as including one particular chromosome by this
      type of experiment. There is no evidence for a general adaptive effect on MGMT
      synthesis greater than the variation within the cell cycle.

PMID- 2233796
TI  - The E. coli ogt gene.

PMID- 2233797
TI  - Macromolecular adducts of ethylene oxide: a literature review and a time-course
      study on the formation of 7-(2-hydroxyethyl)guanine following exposures of rats
      by inhalation.
AB  - The results of efforts to identify and quantify macromolecular adducts of
      ethylene oxide (ETO), to determine the source and significance of background
      levels of these adducts, and to generate molecular dosimetry data on these
      adducts are reviewed. A time-course study was conducted to investigate the
      formation and persistence of 7-(2-hydroxyethyl)guanine (7-HEG; Fig. 1) in various
      tissues of rats exposed to ETO by inhalation, providing information necessary for
      designing investigations on the molecular dosimetry of adducts of ETO. Male F344
      rats were exposed 6 h/day for up to 4 weeks (5 days/wk) to 300 ppm ETO by
      inhalation. Another set of rats was exposed for 4 weeks to 300 ppm ETO, and then
      killed 1-10 days after cessation of exposures. DNA samples from control and
      treated rats were analyzed for 7-HEG using neutral thermal hydrolysis, HPLC
      separation, and fluorescence detection. The adduct was detectable in all tissues
      of treated rats following 1 day of ETO exposure and increased approximately
      linearly for 3-5 days before the rate of increase began to level off.
      Concentrations of 7-HEG were greatest in brain, but the extent of formation was
      similar in all tissues studied. The adduct disappeared slowly from DNA, with an
      apparent half-life of approx. 7 days. The shape of the formation curve and the in
      vivo half-life indicate that 7-HEG will approach steady-state concentrations in
      rat DNA by 28 days of ETO exposure. The similarity in 7-HEG formation in target
      and nontarget tissues indicates that the tissue specificity for tumor induction
      is due to factors in addition to DNA-adduct formation.

PMID- 2233798
TI  - Properties of mammalian O6-alkylguanine-DNA transferases.

PMID- 2233799
TI  - Mutagenesis by N-nitroso compounds: relationships to DNA adducts, DNA repair, and
      mutational efficiencies.
AB  - The relationships between DNA alkylation, DNA repair and mutagenesis by N-nitroso
      compounds in Salmonella were examined. DNA adducts formed by treatment of the
      bacteria with N-nitroso compounds were monitored. Critical to the study was
      establishing which adducts led to mutations. Two methods were employed. In one,
      correlations in the dose-responses for adducts and mutagenesis were sought. For
      instance O6-methyl- and -ethyl-guanine, in contrast to other adducts, exhibited
      thresholds in their accumulation in Salmonella DNA, and mutagenesis at GC base
      pairs also exhibited the same threshold, suggesting a dependence of mutagenesis
      on the O6-alkylguanines. In the second method, mutagenesis induced by different
      mutagens with overlapping adduct spectra was compared. For example, EMS and ENU
      generate similar ratios of adenine adducts, but only ENU produces thymine
      adducts, and only ENU induced AT-GC and AT-CG base changes. These observations
      suggested that ethylthymines led to these mutations. Furthermore, it was found
      that these mutations were largely dependent on the presence of the plasmid,
      pKM101, indicating that error-prone repair activity contributes importantly in
      their processing to mutations. When DNA adducts by N-nitrosopyrrolidine were
      examined it was found that only one major adduct was detected in an excision
      repair-deficient strain, and that this adduct was not present in a repair
      proficient strain. Mutagenesis was also greatly reduced in the proficient strain,
      suggesting that mutagenesis was dependent on this adduct. From the relationships
      between premutagenic adduct levels and mutagenesis it was possible to calculate
      estimated values for the mutational efficiencies for several adducts. This
      calculation assumed an average distribution of adducts and mutations and required
      knowledge of the target size and the types of mutations that could lead to
      phenotypic changes. For the unrepaired O6-methyl- and -ethyl-guanines, and the O
      ethylthymines the mutational efficiencies were high (ca. 30-70%), but for the N
      nitrosopyrrolidine adduct it was low (ca. 1%). Initial studies were carried out
      on the mutational specificities of two higher homologue N-nitroso compounds (the
      N-nitroso-N-propyl- and N-butyl-nitroguanidines) in uvrB/pKM101 strains. This
      class of nitroso compounds is known to form similar DNA adducts as ENU. Their
      specificities were similar to that of N-nitroso-N-ethylurea at a high dose except
      the fraction of mutations at AT base pairs was reduced. The fraction of GC-CG
      transversions was although low, increased. The mutational specificities of N
      nitroso-N-methylurea and N-nitrosopyrrolidine were significantly different from
      the specificity of E

PMID- 2233800
TI  - Site-specifically alkylated oligodeoxynucleotides: probes for mutagenesis, DNA
      repair and the structural effects of DNA damage.

PMID- 2233801
TI  - Molecular dosimetry for sister-chromatid exchange induction and cytotoxicity by
      monofunctional and bifunctional alkylating agents.
AB  - The induction of sister-chromatid exchanges (SCEs) and cytotoxicity in 9L cells
      treated with monofunctional and bifunctional alkylating agents has been
      investigated. Three classes of monofunctional and bifunctional agents were
      studied: nitrosoureas, mustards and epoxides. Independent of class the
      bifunctional agents were 55-630-fold more effective at inducing SCEs and 300-2400
      fold more effective at inducing cellular cytotoxicity than the corresponding
      monofunctional agents. Comparing the induction of SCEs and cytotoxicity by these
      agents showed that these two cellular responses to DNA damage are highly
      correlated. The extent of DNA alkylation in cells treated with 1-ethyl-1
      nitrosourea (ENU) or 1-(2-chloro-ethyl)-1-nitrosourea (CNU) was similar
      indicating that the increased effectiveness of CNU to induce SCEs and
      cytotoxicity was not due to increased DNA alkylation. Molecular dosimetry
      calculations indicate that for CNU and ENU treatment of 9L cells there are 116
      and 8500 alkylations per SCE induced and 2.6 x 10(4) and 4.6 x 10(6) alkylations
      at the dose required to reduce survival of 9L cells by 90%. Comparison of the DNA
      alkylation products produced by CNU and ENU treatment of 9L cells suggests that
      the formation of the intrastrand crosslink N7-bis(guanyl)ethane and the
      interstrand crosslink 1-(3-deoxycytidyl)-2-(1-deoxyguanosinyl)ethane by CNU is
      responsible for the increased effectiveness of CNU treatment at both induction of
      SCEs and cytotoxicity.

PMID- 2233803
TI  - Antibodies to DNA alkylation adducts as analytical tools in chemical
      carcinogenesis.

PMID- 2233802
TI  - Induction of proteins involved in the repair of alkylated bases in mammalian
      cells by DNA-damaging agents.

PMID- 2233804
TI  - Regulation of O6-methylguanine-DNA methyltransferase expression in the Burkitt's
      lymphoma cell line Raji.
AB  - We have investigated the expression of the DNA-repair enzyme O6-methylguanine-DNA
      methyltransferase in the Burkitt's lymphoma cell line Raji. An existing mutant
      Raji cell line which lacks thymidine kinase activity had previously been shown to
      be Mex- and to no longer express O6-methylguanine-DNA methyltransferase. We
      report here that in addition to the methyltransferase and thymidine kinase, a
      third enzyme with an unrelated function, galactokinase, is also not expressed in
      Raji cells. The control of thymidine kinase expression is post-transcriptional
      and it is possible that galactokinase and methyltransferase can share a common
      post-transcriptional regulation with thymidine kinase.

PMID- 2233805
TI  - Alkylation damage, DNA repair and mutagenesis in human cells.
AB  - 17 human cell lines that differ significantly in level of O6-alkylguanine-DNA
      alkyltransferase (AGT) activity were identified by comparing their sensitivity to
      the cytotoxic effect of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and
      determining the level of AGT activity in cell extracts from the various lines by
      measuring the decrease in radiolabeled O6-methylguanine from DNA, using high
      performance liquid chromatography. 9 lines exhibited high levels of AGT activity,
      2 showed an intermediate level (25-50% of the mean of those with the higher
      levels), and 6 exhibited very low or virtually undetectable levels of AGT.
      Included were several lines that are very deficient in capacity for nucleotide
      excision repair. When representatives from the 3 categories of cell lines defined
      by the level of AGT activity were compared for sensitivity to the cytotoxic and
      mutagenic effect of MNNG, they showed an inverse correlation between the degree
      of cell killing and frequency of mutants induced and the level of AGT activity.
      The cells' capacity for nucleotide excision repair did not affect these results.
      Exposure of cells with a high level of AGT activity to O6-methylguanine in the
      medium reduced the AGT activity 60-80%. These pre-treated cells exhibited a
      significantly higher frequency of MNNG-induced mutants than did cells that were
      not pre-treated, suggesting that the O6-methylguanine lesion in DNA is
      responsible for a significant proportion of the mutations induced. Cell strains
      containing substrates for assaying intrachromosomal homologous recombination were
      constructed using parental cell lines from each of the 3 categories of AGT
      activity. These strains showed an inverse correlation between the level of AGT
      activity and the frequency of MNNG-induced recombination. When various cell lines
      representing the 3 categories of AGT activity were compared for sensitivity to
      ethylnitrosourea, the results were consistent with AGT and nucleotide excision
      repair playing a role in preventing cell killing and mutation induction by this
      agent.

PMID- 2233806
TI  - DNA alkylation damage: consequences and relevance to tumour production.

PMID- 2233807
TI  - Properties of mer- HeLa cells sensitive or resistant to the cytotoxic effects of
      MNU; effects on DNA synthesis and of post treatment with caffeine.
AB  - A line of HeLa cells was shown to be particularly sensitive to N-methyl-N
      nitrosurea (MNU) and N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), but not to a
      variety of other cytotoxic agents. A resistant line (designated HeLa/A22), was
      derived by treating HeLa cells repeatedly with MNU. Both the sensitive (HeLa) and
      resistant (HeLa/A22) cells have a mer- phenotype based both on their reduced
      rates of loss of O6-methylguanine (O6-MeG) from DNA and their low levels of the
      enzyme O6-methylguanine methyltransferase (MT). HeLa cells are therefore
      sensitive to unrepaired O6-MeG in DNA while the HeLa/A22 cells are resistant to
      unexcised O6-MeG and thus the A22 cells have the mer-rem+ phenotype. MNU produced
      an immediate dose-dependent inhibition of DNA synthesis in cultures of both
      sensitive and resistant cells which increased with time until about 4 h after
      treatment. DNA synthesis then recovered to near control rates in both sensitive
      and resistant cells before then exhibiting a progressive decrease after about 24
      h. DNA synthesis was more depressed at these late times after treatment in
      cultures of sensitive cells than in those of similarly-treated resistant cells.
      DNA synthesis remained depressed in sensitive cells but recovered 3 days after
      treatment in resistant cells. Post treatment incubation of MNU-treated HeLa cells
      with caffeine did not increase the toxic action of MNU. In contrast, post
      treatment of the resistant HeLa/A22 cells with caffeine resulted in a dramatic
      increase in the toxic effects of a higher equitoxic dose of MNU. The depressed
      rate of DNA synthesis observed in both cell lines after high doses of MNU was
      partially reversed by post treatment with caffeine in both sensitive and
      resistant cells. These observations can be interpreted in terms of the effects of
      caffeine on DNA replication in treated cells.

PMID- 2233808
TI  - Immunocytochemical analysis of in vivo DNA modification.
AB  - In the past decades a large number of DNA adducts induced in the intact animal by
      alkylating agents have been identified. The formation and repair of these adducts
      are important determinants, not only of mutagenesis, tumor initiation and DNA
      mediated toxicity but probably also of tumor progression. Most studies on in vivo
      DNA modification have been performed on isolated bulk DNA. More recently, methods
      have been developed to study the distribution of DNA adducts at the level of
      either the individual gene or the individual cell. This paper reviews
      immunocytochemical methods to study the formation and repair of DNA adducts and
      other DNA modifications at the level of the individual cell. DNA modifications
      induced by alkylating agents and a variety of other agents including ultraviolet
      radiation, aromatic amines, polycyclic aromatic hydrocarbons and platinum anti
      cancer drugs will be discussed. Up to now, immunocytochemical analysis of in vivo
      modified DNA has largely concentrated on experimental animals. These studies have
      revealed striking heterogeneities with regard to formation and/or repair of DNA
      adducts in tissues from rat, hamster and mouse. Immunocytochemical adduct
      analysis can be used to identify in a convenient, fast and detailed way cell
      types, cell stages and sites in which biological effects of the adducts might be
      expressed. More recently, immunocytochemical analysis of DNA adducts also proved
      to be feasible on in situ exposed human samples. A number of existing and
      potential applications in the field of chemical carcinogenesis, experimental
      chemotherapy and molecular epidemiology are discussed.

PMID- 2233809
TI  - The early history of the biological alkylating agents, 1918-1968.

PMID- 2233811
TI  - Molecular modeling studies of O2-alkylthymines and O4-alkylthymines in DNA:
      structures that may be pertinent to the incorporation of the corresponding
      dAlkTTP into DNA by DNA polymerases in vitro.

PMID- 2233810
TI  - Lack of sequence-specific removal of N-methylpurines from cellular DNA.
AB  - The removal of N-methylpurines from the DHFR gene and an unexpressed adjacent
      locus located downstream occurs at similar rates and to a similar extent in
      dimethyl sulfate treated Chinese hamster ovary B11 cells. Furthermore, no
      significant differences in repair rates are observed between the strands of the
      active gene. These data primarily reflect the removal of the most abundant lesion
      produced by dimethyl sulfate, 7-methylguanine, and are in contrast to the results
      obtained for the removal of ultraviolet-induced cyclobutane pyrimidine dimers
      from the same region of the genome. Pyrimidine dimers are cleared preferentially
      from the transcribed strand of the DHFR gene and are removed poorly from the non
      transcribed complementary strand and unexpressed adjacent regions. The results
      suggest that DNA lesions such as dimers that block transcription are removed
      preferentially from active genes, whereas lesions that do not interfere with
      nucleic acid synthesis (i.e. 7-methylguanine) are removed at similar rates from
      expressed and silent loci.

PMID- 2233812
TI  - Site-directed mutagenesis for quantitation of base-base interactions at defined
      sites.
AB  - Two alkylation products implicated in initiation of carcinogenesis are O6
      alkylguanine (m6G) and O4-alkylthymine (m4T). We have used site-specific
      insertion of these derivatives into oligonucleotides and measured the kinetic
      constants of various pairings, using both prokaryotic and eukaryotic polymerases
      for replication. Preliminary data are also reported for another carcinogen
      product, N2,3-ethenodeoxyguanosine ( epsilon G). The immediate neighbor bases
      play an important role in determining the frequency of specific changed
      basepairing and subsequent elongation of the annealed primer. However, both m4T
      and m6G prefer to form a type of G.T pairing which would lead to the transitions:
      G.C----A.T or T.A----C.G. The enzymes were the Klenow fragment of E. coli DNA
      polymerase I (Kf), engineered 3'----5' exonuclease-free Kf (exo-free Kf),
      polymerase alpha-primase complex from Drosophila melanogaster or calf thymus, and
      human immunodeficient virus-I reverse transcriptase (HIV-I RT). All enzymes led
      to approximately the same frequency of transitions. It is postulated that the
      mutation frequency at a given site is primarily a function of the structure of
      the sequence around the target site.

PMID- 2233813
TI  - Resistance to alkylation damage in Escherichia coli: role of the Ada protein in
      induction of the adaptive response.

PMID- 2233814
TI  - Physiological properties and repair of apurinic/apyrimidinic sites and imidazole
      ring-opened guanines in DNA.

PMID- 2233815
TI  - Why do O6-alkylguanine and O4-alkylthymine miscode? The relationship between the
      structure of DNA containing O6-alkylguanine and O4-alkylthymine and the mutagenic
      properties of these bases.
AB  - The carcinogenic and mutagenic N-nitroso compounds produce GC to AT and TA to GC
      transition mutations because they alkylate O6 of guanine and O4 of thymine. It
      has been generally assumed that these mutations occur because O6-alkylguanine
      forms a stable mispair with thymine and O4-alkylthymine forms a mispair with
      guanine. Recent studies have shown that this view is mistaken and that the
      alkylG.T and alkylT.G mispairs are not more stable than their alkylG.C or
      alkylT.A counterparts. Two possible explanations based on recent structural
      studies are put forward to account for the miscoding. The first possibility is
      that the DNA polymerase might mistake O6-alkylguanine for adenine, and O4
      alkylthymine for cytosine, because of the physical similarity of these bases. O6
      Methylguanine and adenine are similarly lipophilic and X-ray crystallography of
      the nucleosides has shown a close similarity in bond angles and lengths between
      O6-methylguanine and adenine, and between O4-methylthymine and cytosine. The
      second possible explanation is that the important factor in the miscoding is that
      the alkylG.T and alkylT.G mispairs retain the Watson-Crick alignment with N1 of
      the purine juxtaposed to N3 of the pyrimidine while the alkylG.C and alkylT.A
      pairs adopt a wobble conformation. 31P NMR of DNA duplexes show that the
      phosphodiester links both 3' and 5' to the C have to be distorted to accommodate
      the O6-ethylguanine:C pair, whereas there is less distortion of the
      phosphodiesters 3' and 5' to the T in an ethylG.T pair. Recent kinetic
      measurements show that the essential aspect of base selection in DNA synthesis is
      the ease of formation of the phosphodiester links on both the 3' and 5' side of
      the incoming base. The Watson-Crick alignment of the alkylG.T and alkylT.G
      mispairs may facilitate formation of these phosphodiester links, and this
      alignment rather than the strength of the base pairs and the extent of hydrogen
      bonding between them may be the crucial factor in the miscoding. If either
      hypothesis is correct it suggests that previously too much emphasis has been
      placed on the stability of the normal pairs in the replication of DNA.

PMID- 2233816
TI  - N-methyl-N'-nitro-N-nitrosoguanidine induced DNA sequence alteration; non-random
      components in alkylation mutagenesis.
AB  - Our approach to the study of how the molecular nature of DNA modulates the
      behavior of mutational sites involves the characterisation of distributions of
      mutations. The Escherichia coli lacI genetic/M13 cloning system allows the
      comparison of base substitution frequencies at a large number of sites. The
      observed distribution of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced G:C-
      --A:T transition (the predominant event), and A:T----G:C transition (a relatively
      rare event), is strikingly non-random. Some sites of G:C----A:T mutation are
      almost 100 times more often mutated by MNNG than the least susceptible sites.
      Sites of mutation, however, do not display a continuum of mutability, but rather
      can be strictly demarcated by their 5' flanking base. Sites with a high frequency
      of occurrence share a common sequence motif, namely 5'-R-G-N-3', which is the
      sole apparent feature that distinguishes them from sites less commonly mutated
      (i.e. 5'-Y-G-N-3'). A corollary of this defined site specificity is the absence
      of a strand bias in MNNG-induced lacI-d mutation. The availability of specific or
      non-specific alkylation-repair systems does not appear to alter the distribution
      of mutation, which suggests that the observed mutational distribution is a direct
      reflection of the initial damage distribution. MNNG does not belong to that class
      of compounds typified by ultraviolet light or 4-nitroquinoline-N-oxide which
      exhibit both random and non-random components of mutagenesis.

PMID- 2233817
TI  - The influence of age on the inducibility of rat liver cytochrome P450IA1 (CYPIA1)
      and P450IA2 (CYPIA2) mRNAs.
AB  - The levels of the messenger RNAs for the cytochromes P450IA1 (CYPIA1) and P450IA2
      (CYPIA2) were determined in liver cytoplasmic RNA of rats of various ages after
      maximal induction with either 3-methylcholanthrene or isosafrole and in untreated
      rats. An increase in the CYPIA1 mRNA levels was observed only after treatment
      with 3-methylcholanthrene, whereas both 3-methylcholanthrene and isosafrole were
      able to induce the levels of CYPIA2 mRNA. The study presented here shows that the
      maximal induction of these 2 mRNAs did not change with age when 3
      methylcholanthrene was used as the inducing agent. Isosafrole induction did not
      yield higher CYPIA1 mRNA levels in young rats but reduced the amount of this mRNA
      in old animals to levels below the detection limit of our assay. After induction
      with isosafrole the levels of the CYPIA2 mRNAs in the older age groups were lower
      than those observed in young rats. It is concluded that with age the
      responsiveness to cytochrome P450 inducers may change. This change is different
      for the various cytochrome P450 enzymes and depends on which inducer is used.

PMID- 2233818
TI  - DNA damage and repair with age in individual human lymphocytes.
AB  - Previous biochemical studies on DNA repair competence and aging have been limited
      to techniques, such as alkaline elution or nucleoid sedimentation, involving mass
      cell populations. These techniques provide no information about the distribution
      of DNA damage and repair among individual cells and are unlikely to detect age
      dependent changes affecting a minor fraction of the cell population. We have
      recently described a microgel electrophoretic assay (Singh et al., 1988) that
      measures, at the level of the individual cell, single-strand DNA breaks and
      alkali-sensitive sites. Here, we employ this method to analyze DNA damage and
      repair in lymphocytes isolated from the peripheral blood of 31 subjects (23 males
      and 8 females aged 25-91 years) and exposed in vitro to 200 rads of X
      irradiation. While basal (pre-irradiation) levels of damage were independent of
      the age of the donor, an age-dependent increase in DNA damage was observed
      immediately following irradiation. For all subjects, the mean level of DNA damage
      was restored to pre-irradiation control levels within 2 h of incubation at 37
      degrees C. However, a distribution analysis of DNA damage among cells within each
      sample indicated the presence of a few highly damaged cells (4-16%) in the 2-h
      sample, the occurrence of which was significantly more common among aged
      individuals. These data indicate an age-related decline in DNA repair competence
      among a small subpopulation of lymphocytes.

PMID- 2233820
TI  - A methyl viologen-sensitive mutant of the nematode Caenorhabditis elegans.
AB  - A methyl viologen (paraquat)-sensitive mutant, mev-1 (LG III), in Caenorhabditis
      elegans was about 4 times more sensitive to methyl viologen than the wild type.
      This mutant was also hypersensitive to oxygen. The brood size was about 1/4 that
      of the wild type. The average life span was determined to be 9.3 days as compared
      to 14.3 days for the wild type. The activity of superoxide dismutase (SOD), a
      scavenging enzyme for superoxide anion, was about half the wild-type level. We
      suggest that oxygen radicals may be involved in the normal aging mechanism in C.
      elegans.

PMID- 2233819
TI  - The relationship between DNA repair after alkylation damage and in vitro aging in
      human T-lymphocytes.
AB  - In vitro cultures of human peripheral blood lymphocytes, both unstimulated G0
      cells as well as phytohemagglutinin (PHA) stimulated cells, have been used in the
      investigation of DNA repair following different types of damage, including that
      induced by ultraviolet light, ionizing radiation, and chemical agents. We report
      here repair of DNA damage in cultured normal human T-lymphocytes after treatment
      with the alkylating agents, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) or
      methanesulfonate (MMS), as measured by the alkaline elution technique. T
      lymphocytes cultured with different sources of T-cell growth factors (TCGFs) were
      shown to have similar repair levels, as measured by loss of single-strand breaks.
      However, diminished repair was observed with in vitro culture age when T-cells
      were cultured with PHA and TCGF for a 3-week period. Cell-cycle analysis
      performed on asynchronously growing cultures indicated that differential repair
      with in vitro aging was not cell-cycle-related. Fluorescence Activated Cell
      Sorting (FACS) was used to determine the percentages of CD4+ and CD8+ T-cell
      subsets present during the in vitro culture periods. Cultures consisted primarily
      of CD4+ cells until day 20 when the percentage of CD8+ cells increased to
      approximately 50% of the T-cell population. Neither the absolute percentages of
      CD4+ and CD8+ cells not the CD4+/CD8+ ratios correlated with repair rates of
      cultured T-cells. Therefore, the observed decreases in the repair of alkylating
      agent-induced damage are not due solely to the change in the CD4+/CD8+ ratio.

PMID- 2233821
TI  - Hyperoxia-induced clonogenic killing of HeLa cells associated with respiratory
      failure and selective inactivation of Krebs cycle enzymes.
AB  - Cellular intoxication by elevated concentrations of O2 may be considered as a
      model for accelerated cellular aging processes resulting from excessive free
      radical production by normal metabolic pathways. We describe here that exposure
      of HeLa cell cultures to 80% O2 for 2 days causes progressive growth inhibition
      and loss of reproductive capacity. This intoxication was correlated with
      inhibition of cellular O2 consumption and inactivation of 3 mitochondrial
      flavoproteins, i.e., partial inactivation of NADH and succinate dehydrogenases
      and total inactivation of alpha-ketoglutarate dehydrogenase. As alpha
      ketoglutarate dehydrogenase controls the influx of glutamine/glutamate into the
      Krebs cycle, which is the major pathway for oxidative ATP generation in HeLa
      cells, the inactivation of alpha-ketoglutarate dehydrogenase was expectedly
      correlated with a net fall in glutamine/glutamate utilization. Furthermore, a
      simultaneous increase in glucose consumption and lactate production was observed,
      indicating that the cellular response to respiratory failure is to generate more
      ATP from glycolysis. In spite of this response, extensive depletion of ATP was
      observed. Thus, hyperoxia-induced growth inhibition and loss of clonogenicity
      seem to be due primarily to an impairment of mitochondrial energy metabolism
      resulting from inactivation of SH-group-containing flavoprotein enzymes localized
      at or near the inner mitochondrial membrane. These observations may be relevant
      for theories implicating loss of mitochondrial function as a prime factor in the
      aging process.

PMID- 2233822
TI  - The aging genome: determinant or target? Report of the EURAGE meeting on 'Genomic
      Instability and Aging', Nerja (Spain).

PMID- 2233823
TI  - International Commission for Protection Against Environmental Mutagens and
      Carcinogens. The possible involvement of somatic mutations in the development of
      atherosclerotic plaques. Report of ICPEMC Subcommittee 7/1. Conclusions and
      recommendations.

PMID- 2233824
TI  - International Commission for Protection Against Environmental Mutagens and
      Carcinogens. ICPEMC Working Paper 7/1/2. Shared risk factors for cancer and
      atherosclerosis--a review of the epidemiological evidence.
AB  - This paper reviews the epidemiological literature of relevance for the hypothesis
      that somatic mutation is involved in the formation of the atherosclerotic plaque.
      Assuming that somatic mutations are involved in atherogenesis, one would expect
      at least some of the risk factors for cancer and for atherosclerosis to be
      identical. Therefore, the review covers the correlated occurrence of cancer and
      atherosclerotic disease. Special interest is given to populations at high risk of
      cancer, including subpopulations with certain genetic diseases, and populations
      exposed to certain carcinogenic environmental agents including ionizing
      radiation, vinyl chloride monomer (VCM), arsenic, tobacco, and various industrial
      combustion effluents containing polycyclic aromatic hydrocarbons (PAHs). Exposure
      to combustion effluents from burning of tobacco or fuel is associated with an
      increased risk of cancer and atherosclerotic disease. Combustion effluents
      constitute a complex mixture of potentially hazardous agents, however, and the
      observed correlation of cancer and atherosclerosis among exposed persons cannot
      be unambiguously interpreted as evidence of a common etiology of the two groups
      of diseases. For ionizing radiation, arsenic, and VCM there is suggestive
      evidence that these agents possess an atherogenic effect beside their well-known
      carcinogenic properties. Both arsenic and VCM seem to have a specific affinity to
      the vascular bed causing various lesions including angiosarcomas and
      atherosclerotic plaques. Regarding ionizing radiation, the atherogenic effects
      seem to be localized to heavily irradiated fields. Beside the carcinogenic and
      atherogenic effects, exposure to arsenic, VCM, and ionizing radiation brings
      about an increase in the incidence of mutations and chromosomal aberrations. A
      theory involving somatic mutation in the pathogenesis of the atherosclerotic
      plaque could be consistent with the observed biological effects of ionizing
      radiation, arsenic, and VCM. The scant data from families with certain inherited
      diseases may also be consistent with an involvement of the genome in the
      pathogenesis of atherosclerosis. In conclusion, there is strong epidemiological
      evidence that several factors associated with an increased risk of cancer are
      also associated with an increased risk of atherosclerosis.

PMID- 2233825
TI  - International Commission for Protection Against Environmental Mutagens and
      Carcinogens. ICPEMC Working Paper 7/1/3. Animal studies suggesting involvement of
      mutagen/carcinogen exposure in atherosclerosis.
AB  - It is very important to elucidate the causative agents of atherosclerosis because
      coronary heart disease and cerebrovascular disease are the main causes of death
      in the developed countries. The evidence for a monoclonal origin of
      atherosclerotic plaques in humans prompted the study of the involvement of
      mutagens/carcinogens in the development of atherosclerosis. Polycyclic
      hydrocarbons, including 7,12-dimethylbenz[a]anthracene and benzo[a]pyrene, were
      shown to act as initiators and/or accelerators in atherosclerotic plaque
      formation in the chicken, pigeon and mouse. Radiation and oxygen radicals were
      also demonstrated to be involved in the development of atherosclerosis in
      animals.

PMID- 2233826
TI  - Evidence for an acetoxyarylamine as the ultimate mutagenic reactive intermediate
      of the carcinogenic aromatic amine 2,4-diaminotoluene.
AB  - 2,4-Diaminotoluene (2,4-DAT) is a mutagenic and hepatocarcinogenic aromatic
      amine, requiring metabolic activation. We have found that the mutagenic potency
      of 2,4-DAT in Salmonella TA98 is similar when activated by either Aroclor-1254
      induced rat primary hepatocytes or 9000 x g supernatant. Previous work has
      demonstrated that 2,4-DAT is activated by cytochrome P450. The present report
      describes an investigation of the role of acetyltransferase in 2,4-DAT
      activation. Substitution of TA98 with the acetyltransferase-deficient strain
      TA98/1,8-DNP6 resulted in an approximately 90% decrease in the mutagenic potency
      for 2,4-DAT using S9 activation. The newly engineered acetyltransferase-enhanced
      Salmonella tester strain YG1024 (TA98(pYG219] demonstrated greatly enhanced
      sensitivity to the mutagenicity of 2,4-DAT. Inhibition of O-acetyltransferase
      activity, either with the selective acetyltransferase inhibitor thiolactomycin,
      or by competitive inhibition with an alternative substrate for the enzyme,
      reduced the mutagenicity of 2,4-DAT in this acetyltransferase-enhanced bacterial
      strain. From these data we conclude that following 2,4-DAT activation by N
      hydroxylation by cytochrome P450, the resulting hydroxylamino intermediate is
      further activated in the bacteria via O-acetylation to form the ultimate reactive
      intermediate, which is postulated to be 4-acetoxyamino-2-aminotoluene.

PMID- 2233827
TI  - Acute and subacute cytogenetic effects of the trihalomethanes on rat bone marrow
      cells in vivo.
AB  - The mutagenic effects of the trihalomethanes (THMs: chloroform, CHCl3;
      dichlorobromomethane, CHCl2Br; dibromochloromethane, CHClBr2; bromoform, CHBr3),
      found in chlorinated drinking water have been studied for their ability to induce
      chromosome aberrations (CA) in vivo in rat bone marrow cells. THMs were
      administered intraperitoneally (i.p. acute) and orally (subacute). Using a
      maximal dose of 1 mmole/kg body weight, positive results were noted for CHCl3,
      CHCl2Br, CHClBr2 and CHBr3 with i.p. treatment, and for CHCl3 and CHBr3 with oral
      treatment. The time-dependent increase in CA showed a maximum level at 12 h after
      i.p. injection and at 18 h after the fifth and last day of oral treatment.

PMID- 2233828
TI  - Evaluation of the mutagenic potential of endosulfan using the
      Salmonella/mammalian microsome assay.
AB  - The mutagenic potential of endosulfan, a polychlorinated insecticide, was
      assessed using the highly sensitive Salmonella tester strains TA97(a), TA98,
      TA100 and TA102. It exhibited a toxic effect at dose levels of 50
      micrograms/plate and higher. Plate incorporation studies did not show mutagenic
      response with any of the tester strains used. A modification of the assay using a
      preincubation procedure showed mutagenic activity with and without metabolic
      activation with TA97(a) only. Increased toxicity was observed after addition of
      phenobarbital-induced S9 mix.

PMID- 2233829
TI  - Inhibitory effect of theophylline on repair of potentially lethal MMS-induced
      damages to DNA in V79 cells.
AB  - In a study of Chinese hamster V79 cells growing in the presence of sublethal
      concentrations of theophylline, we followed both the nature of DNA replication
      and the cells' response to toxic and DNA-damaging effects of methyl
      methanesulfonate (MMS). We found that cells cultured at low concentrations of
      theophylline (less than or equal to 0.3 mg/ml medium) showed deviations in the
      rate of DNA replication which, however, did not depress either the growth
      activity of the cells or their colony-forming ability. Considerable differences
      as against the controls appear in theophylline-cultured cells after treatment
      with MMS. Not only are they more sensitive to the toxic effects of this
      alkylating agent, but also their DNA synthesis is strikingly inhibited. More
      unrepaired lesions remain in parental DNA, and short fragments of daughter DNA,
      synthesized following cell treatment with MMS, are not elongated during a 2-h
      post-MMS treatment. Theophylline obviously belongs among agents inhibiting repair
      of potentially lethal MMS-induced DNA damages in Chinese hamster V79 cells.

PMID- 2233830
TI  - Absence of genotoxic activity of penbutolol in bacterial and mammalian cell
      screening systems.
AB  - The genotoxic potential of the beta-adrenergic blocker penbutolol was assessed
      using the Ames and HGPRT tests, unscheduled DNA synthesis (UDS) and alkaline
      elution assays. In the Ames test, penbutolol was tested for cytotoxicity and
      genotoxic activity in concentration ranges of 0.8-500 micrograms/plate and 0.1
      125 micrograms/ml in the HGPRT, UDS and alkaline elution assays. In the Ames test
      penbutolol showed significant toxicity above 500 micrograms/plate. In the
      mammalian cells (V79) used for the HGPRT test and A459 cells used for alkaline
      elution and UDS assays, penbutolol was cytotoxic at concentrations above 30
      micrograms/ml. In another series of experiments, male Wistar rats were treated
      i.p. with penbutolol (1, 10 and 100 mg/kg) and after 2 h liver nuclei were
      isolated and formation of single DNA-strand breaks was measured. The results of
      the present study demonstrate the absence of genotoxic activity of penbutolol in
      the 5 strains of Salmonella typhimurium (TA98, TA100, TA1535, TA1537 and TA1538)
      and in the strain of Escherichia coli WP2 uvrA in the presence or absence of
      metabolic activation. In V79 cells, penbutolol showed no mutagenic effects at the
      HGPRT locus in the presence or absence of metabolic activation. Additionally, no
      significant incorporation of [3H]thymidine into the DNA in the UDS test or
      formation of DNA-strand breaks in the alkaline elution assay was detected in the
      non-toxic concentration range of penbutolol with or without metabolic activation.
      Furthermore, penbutolol did not cause DNA damage in liver nuclei isolated from
      penbutolol-treated rats.

PMID- 2233831
TI  - Effect of alcohol sulfate, linear alkylbenzene sulfonate and natural soap on the
      development of fertilized eggs of the mouse in vitro.
AB  - Eggs from B6 x C3F1 female mice, which were fertilized in vitro with sperm from
      C3 x 101F1 male mice, were treated with synthetic surfactants, alcohol sulfate
      (AS) and linear alkylbenzene sulfonate (LAS), and natural soap for 1 h at the
      pronucleus stage, and then cultivated for 5 days. Eggs treated with AS or LAS at
      concentrations of less than 0.025% developed to the blastocyst stage as well as
      the untreated ones. At concentrations of AS or LAS higher than 0.03% no egg
      developed beyond the 1-cell stage. There appeared to be a threshold concentration
      between 0.025% and 0.03% of AS or LAS on the development of the mouse egg.
      However, natural soap had no effect on the development of the mouse egg up to
      0.05%. When AS or LAS was applied to the culture medium throughout the
      cultivation of fertilized eggs for 5 days, there also appeared to be a threshold
      concentration between 0.01% and 0.025%, but not in the case of natural soap. The
      results provide additional support to our previous observations that AS and LAS
      can interrupt mouse pregnancy by killing fertilized eggs.

PMID- 2233832
TI  - Comparison of different plants in screening for Mn clastogenicity.
AB  - Cationic (MnSO4.H2O) and anionic (KMnO4) manganese salts in aqueous solutions
      enhanced the frequency of chromosomal aberrations including both chromosome- and
      chromatid-type breaks, gaps, translocations and spindle disturbances in different
      plant systems in vivo to a statistically significant level. The activity of the
      cationic salt was more drastic, particularly on the submerged plant studied
      (Vallisneria spiralis L.), on prolonged exposure, when compared with bulbs of
      Allium cepa L. and seeds of Pisum sativum L.

PMID- 2233833
TI  - Cytogenetic study for possible mutagenic activity induced by ice-nucleation
      bacteria or their metabolic products in human lymphocytes in vitro.
AB  - A means for eliminating ice-nucleation-active (INA) bacteria, the microorganisms
      responsible for frost damage to plants at mild freezing temperatures, is the use
      as competitors of other naturally occurring, non-nucleating strains. Inactive
      mutants (INA-) of INA bacteria have been produced by genetic or chemical methods
      and proposed for biological control of INA populations. Since, however, the
      application of these INA- mutants in the field may create health hazards to
      animals, we have studied the possible mutagenic activity of the INA- mutants by
      examining chromosome aberrations, sister-chromatid exchange (SCE) frequencies,
      and proliferation kinetics of human lymphocyte cultures. These cultures were
      treated with: (a) a naturally occurring INA- bacterium (p 767), (b) 2 parental
      strains (cit 7 and cit 13) of INA bacteria isolated from Citrus orchards, and (c)
      2 INA- mutant strains (cit 7 del 1b and cit 13-12), produced, respectively, by
      chemical modification and by deletion of the corresponding parental strains.
      Neither whole bacteria nor infiltrates of bacterial growth media, in which toxic
      metabolic bacterial products might have been released, induced elevation of
      either chromosome aberrations and SCEs or a cell-division delay. Negative results
      were also obtained when sonicated bacteria were tested for possible intracellular
      mutagenic components.

PMID- 2233834
TI  - Cytogenetic analysis of mouse oocytes and one-cell zygotes as a potential assay
      for heritable germ cell aneuploidy.
AB  - Assays are needed for detecting chemically-induced aneuploidy, for investigating
      the mechanisms of aneuploidy production, and for obtaining heritable germ cell
      data that can be used to formulate human risk estimates. In this report, we
      describe the results of experiments designed to study aneuploidy in metaphase II
      (MII) oocytes induced by intraperitoneal (i.p.) or oral dosages of colchicine,
      and to investigate the proportion of aneuploid oocytes transmitted to one-cell
      (1C) zygotes following oral administration of colchicine immediately following
      HCG. The proportions (and percentages) of hyperploid MII oocytes were: 1/606
      (0.2), 37/504 (7.3), 152/731 (20.8) and 75/319 (23.5) for control, 0.2, 0.3 and
      0.4 mg/kg, respectively for i.p. administration of colchicine; and 3/216 (1.4),
      8/539 (1.5), 81/511 (15.9), 71/398 (17.8) and 98/391 (25.1) for control, 1.0,
      2.0, 3.0 and 4.0 mg/kg, respectively for oral administration of colchicine. The
      proportions of hyperploid 1C zygotes were 2/327 (0.6), 21/389 (5.4), 62/435
      (14.3) and 69/438 (15.8) for control, 2.0, 3.0 and 4.0 mg/kg, respectively for
      oral colchicine. The proportions of hyperploid MII oocytes and 1C zygotes were
      significantly higher (Chi-square, P less than 0.01) at each i.p. or oral dose
      (except 1.0 mg/kg oral) than in the controls. The frequencies of hyperploidy
      induced by oral doses of colchicine were greater in MII oocytes than in 1C
      zygotes. We also found that the frequency of developmentally delayed and
      polyploid 1C zygotes increased with the dose of oral colchicine. Developmentally
      delayed zygotes contained male-derived chromosomes and female-derived fragmented
      pronuclei and pronuclei with decondensed chromosomes. These results indicate that
      higher doses of oral colchicine are needed to induce comparable levels of
      aneuploidy found after i.p. administration, and that aneuploid oocytes are
      fertilized and reach first cleavage metaphase. In addition, colchicine induces a
      spectrum of events including aneuploidy, polyploidy and developmentally delayed
      oocytes and zygotes.

PMID- 2233835
TI  - The effect of sampling time on radiation-induced translocation yield in
      spermatogonial stem cells of male mice, differing in chromosomal constitution and
      sexual activity.
AB  - We have investigated the frequency of reciprocal translocations in the first
      differentiating spermatogonia entering the first meiotic division after 2 x 2.5
      Gy X-rays, given 24 h apart, as well as the development of this parameter in
      later stem-cell generations by studying multivalent configurations at the first
      meiotic division. Diakinesis-metaphase I cells were found for the first time
      between 30 and 40 days after irradiation. Subsequently, meiotic stages were
      sampled at 120, 180 and 280 days post irradiation. From day 40 post irradiation
      on, half of the males were allowed to impregnate females which enabled us to
      estimate the length of the post-irradiation sterile period, the development of
      litter size and the possible effect of sexual activity on the development of
      reciprocal translocation-containing stem cells. Half of the males were
      karyologically normal, the other half were homozygous for a reciprocal
      translocation (T/T) that affects testis weight and about halves sperm production.
      Irrespective of male karyotype, the first meiocytes had an induced translocation
      frequency of 9.00 +/- 2.56% (n = 8 males), followed by frequencies of 20.70 +/-
      4.87% (n = 15) at 180 days and 20.20 +/- 4.30% (n = 20) at 280 days (males with
      and without mating behavior showing no difference). At 120 days post irradiation,
      +/+ males had a frequency of 14.59 +/- 2.97% irrespective of sexual activity. T/T
      males (120 days post irradiation) that had mated showed a frequency of 18.63 +/-
      0.85% (n = 4) compared with 13.64 +/- 2.36% (n = 7) for those that had not. The
      observed rise of multivalent-carrying spermatocytes in time was highly
      significant. Notwithstanding the differences in testis weight and epididymal
      sperm count between the karyotypes, fertile matings occurred on average 72 days
      after irradiation, though with relatively wide margins. For the T/T karyotype,
      the first litter was statistically smaller than the subsequent litters. At 78
      days post irradiation, testis weights were back in the subnormal range for both
      karyotypes and hardly improved in time. Restoration of fertility thus coincided
      with the period just prior to the return to subnormal testis weights. The first
      diakinesis-metaphase I cells precede those that are numerous enough to accomplish
      'return to fertility' by about 2 weeks. Thus differentiation of stem-cell
      spermatogonia already follows a few days after irradiation. A pattern of
      spermatogonial cell divisions compatible with 'return to fertility' is only
      established some 2 weeks later.

PMID- 2233836
TI  - Induction of DNA-repair synthesis in primary rat hepatocytes by epoxides.
AB  - The genotoxicity of 10 epoxides was investigated in the UDS test with primary rat
      hepatocytes. The sensitivity of the assay was demonstrated using 2
      acetylaminofluorence. The epoxides 1,2-epoxyoctane, 1,2-epoxydecane,
      epoxycyclooctane, epoxycyclododecane, (+)-limoneoxide, alpha-pinaneoxide,
      transstilbeneoxide, and cis-2,3-epoxysuccinic acid, which are known to be non
      mutagenic in the Ames test, as well as the bacterial mutagen, 1,2
      epoxyphenoxypropane did not induce UDS in primary hepatocytes of the rat.
      However, a positive UDS response obtained with glycidyltrimethylammonium chloride
      showed that metabolic inactivation of the oxirane ring in hepatocytes is
      influenced by further structural substituents.

PMID- 2233837
TI  - Chirality-dependent DNA reactivity as the possible cause of the differential
      mutagenicity of the two components in an enantiomeric pair of epoxides.
AB  - Chemical compounds containing an epoxy group are very reactive substances and, in
      many cases, they therefore exhibit strong mutagenic properties. Very often such
      epoxides contain an asymmetric C atom and thus exist as racemic mixtures of
      optical isomers, the so-called R- and S-enantiomers. It is well known that in
      many cases a biological activity resides completely in one of the two
      enantiomeric forms of a molecule. Also, the R- and S-enantiomeric forms of
      epoxystyrene exhibit different mutagenic activities in Salmonella typhimurium
      TA100, although their chemical reactivity does not differ to a recognizable
      extent. Neither could the higher mutagenic activity of the R-epoxystyrene be
      attributed to a slower enzymatic hydrolysis reaction. Thus, the intrinsic
      potential for eliciting mutagenic responses may not be the same for the two
      enantiomers, as there is evidence of qualitative differences in the binding to
      DNA, pointing strongly to an intrinsic difference in mutagenic activity of the
      two enantiomers.

PMID- 2233838
TI  - Evaluation of the mutagenicity of combustion particles from several common
      biomass fuels in the Ames/Salmonella microsome test.
AB  - We have evaluated the mutagenicity of dichloromethane extracts of combustion
      particles from several biomass fuels that are commonly used in developing
      countries in Salmonella strains TA98 +/- S9 and TA100 +/- S9. Combustion-particle
      extracts from dried cow dung and crop residue exhibited mutagenic potencies
      similar to wood-smoke extracts (0.0-1.0 rev./microgram extract). However,
      extracts from coconut-shell-smoke particles showed relatively potent direct
      acting mutagenicity (1.6 rev./micrograms, TA98-S9). Results from testing this
      sample in nitroreductase- and acetylase- deficient strains TA98NR and TA98 (1,8
      DNP-6) revealed no contribution from nitroarenes.

PMID- 2233840
TI  - Methyl vinyl sulphone: a new class of Michael-type genotoxin.
AB  - Methyl vinyl sulphone (MVS) is a labile, Michael-reactive chemical, similar in
      structure to acrylamide (AA). Given that acrylamide is a reference mammalian
      mutagen and a rodent carcinogen, studies were undertaken to evaluate the
      potential genotoxicity of MVS. In common with AA, MVS was non-mutagenic to
      Salmonella but active as an aneugen to cultured mammalian cells. It is concluded
      that vinyl sulphones should be regarded as representative of a new class of
      genotoxic chemical whose mode of action is probably primarily dependent upon
      Michael reactivity to proteins.

PMID- 2233839
TI  - Role of sulfation and acetylation in the activation of 2-hydroxyamino-1-methyl-6
      phenylimidazo[4,5-b]pyridine to intermediates which bind DNA.
AB  - Mutagenic activity associated with amino-imidazoazaarene food-derived mutagens
      such as 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) appears to be
      dependent upon N-hydroxylation, though additional metabolic pathways may be
      involved in the production of the ultimate reactive intermediate which covalently
      binds DNA. We have evaluated the ability of 2-hydroxyamino-1-methyl-6
      phenylimidazo[4,5-b]pyridine (N-hydroxy-PhIP) to bind DNA in vitro and have
      determined which secondary metabolic pathways are involved in the production of
      electrophilic intermediates. Incubation of DNA with 10 microM N-hydroxy-PhIP
      alone or with mouse-liver cytosol did not result in detectable adduct formation.
      Addition of 3'-phosphoadenosine 5'-phosphosulfate or acetyl coenzyme A to
      cytosolic incubations containing N-hydroxy-PhIP resulted in DNA adducts which
      could be detected by 32P-postlabeling at levels of 594 and 30 fmoles/micrograms
      DNA, respectively. Addition of 3'-phosphoadenosine 5'-phosphosulfate and to a
      lesser extent acetyl coenzyme A to cytosolic incubations also increased the rate
      of degradation of the unstable N-hydroxy-PhIP intermediate. These data suggest
      that both sulfation- and acetylation-dependent metabolic pathways may be
      important in the mammalian genotoxic actions of PhIP.

PMID- 2233841
TI  - Growth delay and filamentation of Escherichia coli wild-type and Rec A cells in
      response to hexavalent chromium and other metal compounds.

PMID- 2233842
TI  - Severe chromosomal damage in mammalian cells induced by pulse labeling with small
      amounts of [3H]thymidine.
AB  - Pulse labeling of cultured mammalian cells with tritiated thymidine ([3H]TdR;
      different specific activities, 2-47 Ci/mmole) for 30 min at low concentrations of
      radioactivity (0.2-2 microCi/ml) causes an unusually high degree of chromosomal
      aberrations which becomes fully evident in the cohort of cells analyzed 8 h
      later. The effect depends on the total amount of radioactivity. In HeLa cells up
      to 93% aberrant metaphases with up to 3.6 aberrations per metaphase were
      observed; in CHO cells the corresponding figures are 62% aberrant metaphases with
      1 aberration per metaphase. The results may be valuable (i) for users of the
      pulse-labeling technique for analysis of cell-cycle kinetics, as this shows the
      technique as such may delay the labeled cohort of cells and therefore interferes
      with the matter under study and (ii) for risk assessment.

PMID- 2233843
TI  - Effects of in vivo exposure to antineoplastic drugs on DNA repair and replication
      in human lymphocytes.
AB  - In peripheral blood lymphocytes of 12 nurses and 3 patients exposed to
      antineoplastic drugs we determined the ability to repair DNA after UV irradiation
      and DNA replicative synthesis after stimulation by PHA. In nurses the levels of
      unscheduled DNA synthesis and DNA replication were not different than in a
      control group, whereas in patients significant changes were observed during and
      after chemotherapy in the level of both types of DNA synthesis.

PMID- 2233844
TI  - Inactivity of copper sulphate in a mouse bone-marrow micronucleus assay.

PMID- 2233845
TI  - Activity of urethane and N,N-dimethylurethane in the mouse bone-marrow
      micronucleus assay: equivalence of oral and intraperitoneal routes of exposure.
AB  - Urethane is shown to be active in the mouse bone-marrow micronucleus assay when
      administered as a single dose by either gavage or intraperitoneal injection. The
      magnitude of the response using the two routes was not statistically
      significantly different. N,N-Dimethylurethane (DMU) is shown to be mutagenic to
      Salmonella and active in the bone-marrow micronucleus assay by both routes of
      administration. The activity of DMU in the bone marrow precludes elimination of
      ethanol, yielding cyanate ion, as an explanation for the micronucleus-inducing
      activity of urethane.

PMID- 2233846
TI  - Multiple-pulse stimulation and dantrolene in malignant hyperthermia.
AB  - A potentially fatal condition, yet preventable, malignant hyperthermia (MH) lacks
      a satisfactory noninvasive diagnostic test. Studying the effects of intravenous
      dantrolene (3 mg/kg) on electrically stimulated skeletal muscle, we found that
      this approach does not conclusively distinguish between normal humans and those
      susceptible to malignant hyperthermia but nonetheless yielded important
      information about the action of dantrolene in man and in MH. Supramaximal single-
      and multiple-pulse stimulation of the common peroneal nerve produced stable
      torque responses of the dorsiflexor muscles (monitored in vivo), which dantrolene
      suppressed. With the multiple-pulse stimulation (5-6 pulses) this torque
      suppression was significantly less in MH-susceptible subjects than in control
      subjects. This distinction, also observed in MH swine, confirms this animal as a
      good model for human MH. That dantrolene's effect in MH can be more completely
      reversed with high frequency stimulation is intriguing; presumably, excitation
      contraction coupling differs in MH and normal muscle.

PMID- 2233847
TI  - Recording and physical characteristics of disposable concentric needle EMG
      electrodes.
AB  - There is currently considerable interest in using disposable concentric needle
      (CN) electrodes for clinical electromyography (EMG). To determine how these
      electrodes compare with reusable CN electrodes, we have compared signals recorded
      by these two electrode types from the same muscle in normal subjects. We also
      made similar recordings with two groups of reusable electrodes. There was no
      difference in the features of motor unit action potentials (MUAPs) recorded by
      the two groups of reusable electrodes. Disposable electrodes performed
      satisfactorily in conventional EMG examination. However, compared to reusable
      electrodes, the disposable electrodes recorded MUAPs with smaller amplitude and
      area but with the same area:amplitude ratio and MUAP duration. The physical and
      electrical properties of the CNE groups were also investigated. Disposable
      electrodes had lower electrical resistance and greater capacitance than reusable
      electrodes when measurements were made in saline. Photomicrographs showed that
      the disposable electrodes had smaller recording surfaces and that the central
      wire was frequently eccentric in the cannula. The differences in electrical
      recording characteristics could be due to differences in the size of the
      recording surface, eccentric placement of the central wire in the cannula or
      differences in the metal used for the central wire. We conclude that electrical
      and physical testing may not predict the recording characteristics of needle
      electrodes. Electrophysiologic testing is necessary to determine how EMG signals
      recorded by new types of electrodes compare with those recorded by currently used
      electrodes.

PMID- 2233848
TI  - Concurrence of malignant hyperthermia and congenital abnormalities.
AB  - Two children about to undergo corrective surgery were required to be investigated
      for malignant hyperthermia (MH). These investigations arose out of concern by the
      anesthetist who had obtained a history of unexplained pyrexial reactions to
      anaesthetic in other members of the family. Because over the years we have
      encountered several children with multiple congenital abnormalities who have been
      found to be susceptible to MH, we stressed the advisability of biopsying not only
      the patient but also the patient's parents. Positive responses for MH were
      obtained in the patients and in one of the parents on each occasion. The
      hypothesis of intrauterine MH with its pharmacogenetic propensity for heat
      production is considered as a possible etiological factor which may cause
      abnormalities of a congenital nature.

PMID- 2233849
TI  - Isometric features of orthostatic tremor: an electromyographic analysis.
AB  - A patient is described with "orthostatic" tremor. Electromyography revealed
      tremor bursts of 15 Hz in the lower extremities while standing and with isometric
      activation of the muscles, but the bursts disappeared with isotonic activation of
      muscles. Similar tremor was recorded in the arms with isometric, but not isotonic
      activation. Review of previously reported cases confirms these findings. The
      clinical and electrophysiologic features of this tremor distinguish it from other
      recognized forms of tremor.

PMID- 2233850
TI  - Soleus-specific myopathy induced by passive stretching under local tetanus.
AB  - Twenty-four adult albino rats were injected with tetanus toxin into the right
      gastrocnemius muscle and then subjected to sustained dorsiflexion of the right
      ankle joint for 2 to 14 days. Histologic examinations of the soleus after this
      procedure showed myopathic changes, characterized by variations in fiber
      diameters, myonecrosis with opaque fibers, interstitial fibrosis, and small
      groups of regenerated fibers. Electron microscopy revealed derangement of T
      tubules immediately adjacent to the sarcolemma in the early degenerative stage.
      The size and wet weight of soleus increased compared to that of the control side
      between 2 and 5 days post-tetanus. Serum GOT, LDH, and creatine kinase (CK)
      levels were elevated especially in the early degenerative stages. Peri- and
      endomysial fibrosis developed gradually from about 3 days post-tetanus.
      Pathomechanisms inducing these changes were discussed.

PMID- 2233851
TI  - Measurement of the amplitude of the EMG envelope.
AB  - When the force of muscle contraction is increased, the amplitude of the EMG
      envelope (ENAMP) increases. The ENAMP is usually assessed subjectively and its
      value in EMG analysis has been established. In this article we describe a method
      to make automatic measurements of the ENAMP. This method was tested on recordings
      of the EMG interference pattern (IP) from the biceps muscle of normal subjects.
      Normal values of this feature in the biceps muscle are described. There was a
      good concordance between the ENAMP measurements made by subjective assessment and
      by automatic analysis and the ENAMP values correlated strongly with a previously
      described feature of the IP called the upper centile amplitude. We infer that
      ENAMP is a robust feature of the IP that reflects the amplitude of the largest
      MUAP in the IP.

PMID- 2233852
TI  - Central changes in hypothyroid myopathy: a case report.
AB  - A muscle biopsy from a patient with hypothyroid myopathy showed striking central
      changes. "Cores" were seen in most type 1 fibers with oxidative enzyme
      preparations. Electron microscopy of these areas revealed Z disc streaming,
      myofilament disruption, and absent mitochondria. The myopathy rapidly improved
      with thyroxine treatment. This biopsy is of interest, as numerous "cores" have
      not previously been reported in hypothyroid myopathy.

PMID- 2233853
TI  - A comparison of magnetic and electrical stimulation of peripheral nerves.
AB  - We compared magnetic stimulation using different coil designs (2 rounded coils
      and a butterfly-prototype coil) with electrical stimulation of the median and
      ulnar nerves in 5 normal subjects. Using magnetic stimulation we were able to
      record technically satisfactory maximal sensory and motor responses only with the
      butterfly coil. Submaximal electrical stimuli preferentially activated sensory
      rather than motor axons, but submaximal magnetic stimuli did not. The onset
      latency, amplitude, area and duration of responses elicited electrically or
      magnetically with the butterfly coil during routine sensory and motor nerve
      conduction studies were similar, and motor and sensory conduction velocities were
      comparable when studied over long segments of nerve. However, the motor
      conduction velocities with magnetic and electrical stimulation differed by as
      much as 18 m/sec in the across-elbow segment of ulnar nerve. Thus, recent
      developments in magnetic stimulator design have improved the focality of the
      stimulus, but the present butterfly coil design cannot replace electrical
      stimulation for the detection of focal changes in nerve conduction velocity at
      common entrapment sites, such as in the across-elbow segment of the ulnar nerve.

PMID- 2233854
TI  - Quantitative electromyography in polymyositis: a reappraisal.
AB  - Manual analysis of motor unit action potentials (MUAPs) was performed in 33
      patients with polymyositis of whom 16 were studied in the acute stage and 17 in
      the chronic stage. Contrary to common description of "myopathic potentials" as
      being of low amplitude, short duration, and polyphasic shape, the quantitated
      study revealed no difference as to amplitude of short duration MUAPs in patients
      and normal subjects though short-duration MUAP and short duration polyphasic
      potentials were 4 and 3 times, respectively, more common in patients than in
      controls. Although the mean duration of MUAPs usually was significantly shorter
      in polymyositis than in controls, the average scatter of MUAPs duration was the
      same in the 2 groups. The average incidence of polyphasic MUAPs was 4 times
      higher in patients than in controls, as was the incidence of those of long
      duration. To avoid misinterpretation of EMG findings due to an excess of
      polyphasic MUAPs, a greater number of individual potentials than usually
      recommended should be collected allowing a valid estimate of the mean duration of
      MUAPs of simple configuration.

PMID- 2233855
TI  - Abstracts of poster and platform presentations: Fourth International Conference
      on Computerized and Quantitative EMG. Mainz, Germany, September 13-15, 1990.

PMID- 2233856
TI  - Fibrillation potentials and muscle fiber types.

PMID- 2233857
TI  - Myoclonus (nocturnus)

PMID- 2233858
TI  - Sensitivity for detecting fibrillation potentials: a comparison between
      concentric and monopolar needle electrodes.
AB  - The sensitivity of monopolar and concentric electrodes for detecting fibrillation
      potentials (FP) has never been formally compared. We studied 35 muscles with FP,
      sampling 20 sites each with concentric and monopolar needles. The concentric
      needle identified 0.88 +/- 3.44 (mean +/- standard deviation) more sites with
      spontaneous activity. Although statistically significant (Wilcoxon signed rank
      test P less than .03), this difference in sensitivity did not appreciably affect
      diagnostic interpretation. Subjects described the concentric needles as more
      painful. Needle insertions in 25 other muscles demonstrated that needle movement
      generated the majority of FP. We suggest that the increased tissue injury caused
      by concentric needles may account for both their increased sensitivity and
      discomfort.

PMID- 2233859
TI  - Time course of sprouting during muscle reinnervation in vitamin E-deficient rats.
AB  - A typical aspect of motoneuron plasticity is the sprouting which occurs during
      muscle reinnervation, resulting in a transitory multiple innervation of the
      muscle cells. In order to verify the effect of a decreased protection from free
      radical attack on the sprouting, the multiple innervation in the extensor
      digitorum longus muscle, following sciatic nerve crush and regeneration, was
      studied in vitamin E-deficient rats. Thus, the innervated end-plates and the end
      plates with multiple innervation were studied with histochemical and
      electrophysiological techniques. The percentage of innervated end-plates was
      similar in both groups at 30 as well as at 60 days after nerve crush.
      Nevertheless, multiple innervation was found in a larger part of the muscle and
      it lasted longer in the deficient rats. This finding is discussed in relation to
      some of the major hypotheses of sprouting; it may be relevant in the treatment of
      some lesions of peripheral nerve.

PMID- 2233860
TI  - A review of techniques employed to estimate the number of motor units in a
      muscle.
AB  - Being the smallest functional units under neural control, motor units play an
      integral role in muscle physiology. However, at the present time, there does not
      exist any widely accepted technique for quantifying or estimating the number of
      motor units in a muscle. Specifically, the existing techniques are the increment
      counting technique, a technique based on spike-triggered averaging, and a macro
      EMG based technique which vary in invasiveness from noninvasive to highly
      invasive, respectively. We discuss each of these techniques, along with their
      associated shortcomings, in detail.

PMID- 2233861
TI  - Spatial dispersion of magnetic stimulation in peripheral nerves.
AB  - To assess the longitudinal dispersion of the stimulus induced by the magnetic
      coil, collision experiments were performed in seven normal ulnar nerves. A
      supramaximal electrical stimulus S1 was delivered at the wrist, and followed by a
      supramaximal stimulus S2 in the upper arm, which was either electrical
      (electrical collision studies), or magnetic (magnetic collision studies). The
      interstimulus interval was varied by 0.2 msec increments from the time of
      complete cancellation of the S2 evoked motor response onwards, to include the
      entire span of recovery of that compound motor action potential. Collision curves
      were obtained for both magnetic and electrical stimuli by plotting the amplitude
      of the motor response elicited by S2 as a function of the interstimulus interval.
      In all seven normal ulnar nerves, comparison of the collision curves showed that
      the S2 evoked motor response is restored significantly more slowly when magnetic
      stimulation is used. This finding is best explained by longitudinal dispersion of
      the stimulus induced by the magnetic coil relative to conventional electrical
      stimulation, the large fibers being stimulated further away from the coil than
      the small ones. This interpretation is confirmed by the findings obtained with
      the same method in two cases of ulnar neuropathy, and by comparison of different
      intensities of magnetic stimulation.

PMID- 2233863
TI  - International symposium on peripheral nerve regeneration. Washington, DC,
      September 17, 1989. Proceedings.

PMID- 2233862
TI  - AAEM minimonograph #35: Clinical experience with transcranial magnetic
      stimulation.
AB  - We elicited motor evoked potentials (MEPs) using transcortical magnetic
      stimulation in 150 control subjects aged 14 to 85 years and 275 patients with a
      variety of diseases. There were no significant side effects. Cortex-to-target
      muscle latencies measured 20.2 +/- 1.6 ms (thenar), 14.2 +/- 1.7 ms (extensor
      digitorum communis), 9.4 +/- 1.7 ms (biceps), and 27.2 +/- 2.9 ms (tibialis
      anterior). Central motor delay between the cortex and the C-7 and L-5 measured
      6.7 +/- 1.2 ms and 13.1 +/- 3.8 ms, respectively. Mean spinal cord motor
      conduction velocity measured 65.4 m/s. MEP amplitude expressed as a percentage of
      the maximum M wave was never less than 20% of the M wave. A value of less than
      10% is considered abnormal. MEP latency increases linearly with age and central
      motor delay is longer in older subjects. Compound muscle action potentials and
      absolute MEP amplitudes decreased linearly with age. In multiple sclerosis (MS),
      MEP latency and central delay were often very prolonged. The MEP was more
      sensitive than the SEP in MS. In amyotrophic lateral sclerosis, MEP latencies
      were only modestly prolonged; the characteristic abnormality was reduced
      amplitude. When pseudobulbar features predominated MEPs were often absent. The
      MEP was of normal latency in Parkinson's disease, but age-related amplitude was
      often increased. MEP latency and amplitude were normal in Huntington's disease.
      Abnormal MEPs persisted several months after stroke despite good functional
      recovery. The MEP could be used to advantage to demonstrate proximal conduction
      slowing and block in demyelinating neuropathies. In plexopathy, ability to elicit
      an MEP several days after onset of paresis was good evidence of neuronal
      continuity in motor fibers.

PMID- 2233864
TI  - The anatomy and physiology of nerve injury.
AB  - Nerves have a structure of considerable complexity with features of special
      relevance to nerve injury and nerve regeneration. These include variations in the
      cross-sectional areas devoted to fascicular and epineurial tissue, the fascicular
      redistribution and mixing of different branch fibers brought about by fascicular
      plexuses, and the numbers of nerve fibers representing individual branches. The
      elasticity and tensile strength of nerve trunks and their capacity to resist
      traction deformation reside in the fascicular tissue, while the epineurium
      provides a protective cushion against compression. The microstructure of nerve
      trunks provides the basis for a classification of nerve injuries into five
      degrees of severity with partial and mixed types--each with a clearly defined
      pathology and distinguishing clinical features. Following a transection injury,
      changes occur in the severed axons, endoneurial tubes, fasciculi, and nerve
      trunk. The type of injury and the nature of these changes determine the outcome
      of axon regeneration.

PMID- 2233865
TI  - Enhancement of peripheral nerve regeneration.
AB  - Numerous factors external to the nerve cell can support and enhance nerve
      regeneration after injury. The definition of these factors and the elucidation of
      their mechanisms of action are the central goals of much contemporary
      neurobiologic research. This research will hopefully lead to the discovery of
      factors that will prove to be therapeutically beneficial for patients with either
      peripheral nervous system (PNS) injury or central nervous system (CNS) injury.
      This article reviews the biology of the regeneration response of the nerve to
      injury and discusses many of the factors that enhance nerve growth. Finally, the
      nerve guide or nerve regeneration chamber model for the evaluation of putative
      nerve regeneration enhancing agents in vivo is also discussed.

PMID- 2233866
TI  - Aberrant reinnervation.
AB  - Although great emphasis is placed on providing a satisfactory conduit for
      regeneration of peripheral axons after nerve repair, the quality of functional
      restoration is influenced as much by the quality as the quantity of axonal
      regeneration. Misdirected regeneration is so commonly encountered that motor
      axons appear to enter and regenerate to muscles in an almost random manner. Thus,
      when there are several choices, as usually is the case with more proximal nerve
      or plexus repairs, misdirected reinnervation accounts in many incidences for a
      poor quality of functional restoration. The regenerative capacities of type I and
      type II motor axons appear to differ. Proprioceptors and other sensory axons have
      been shown to reinnervate inappropriate end organs. Consequently, deranged
      central reflex modulation and disturbed orderly recruitment of motor units
      according to the size principle also contributes to this problem. Central re
      education or adaptation to misdirected regeneration does not occur to any
      appreciable extent.

PMID- 2233867
TI  - Fibrillation potential amplitude and muscle atrophy following peripheral nerve
      injury.
AB  - Maximum peak-to-peak fibrillation potential amplitude was measured in 69 subjects
      between 7 days and 10 1/2 years post complete or partial peripheral nerve injury.
      Mean amplitude during the first 2 months was 612 muV; third and fourth months 512
      muV, fifth and sixth months 320 muV. After the first year, no population of
      fibrillation potentials greater than 100 muV was recorded. The sciatic nerve was
      sectioned in 13 guinea pigs and animals studied up to 17 weeks. Fibrillation
      potential amplitude in gastrocnemius muscles declined paralleling that in humans.
      By the end of the study, type I fibers had lost almost half of their initial
      diameter and type II fibers had atrophied more than twice this amount.
      Fibrillation potential amplitude may be useful in estimating the time post nerve
      injury and appears to correlate with the surface area and fiber diameter of a
      type I muscle fiber.

PMID- 2233868
TI  - Quantitative clinical electrophysiology in the evaluation of nerve injury and
      regeneration.
AB  - Neuromuscular electrophysiological techniques can provide clinically important
      information about the localization, severity, and pathophysiology of peripheral
      nerve injuries, and about the progress of reinnervation. The relevant variables
      for study are compound nerve and muscle action potentials, motor unit action
      potentials, and denervation potentials. Available methods do not permit
      meaningful quantitation of regeneration. Newer methods under development attempt
      to estimate the number of motor units in a muscle and the number of axons in a
      nerve.

PMID- 2233869
TI  - Single fiber EMG evaluation in denervation and reinnervation.
AB  - SFEMG can be used to follow the course of reinnervation. The parameters of fiber
      density, mean jitter and percent blocking must each be followed and related to
      the type of injury to determine the stage of reinnervation. The few reported
      cases in the literature of SFEMG recordings followed over time after nerve
      compromise are reviewed and an additional case is presented by the author. Mean
      jitter values can return to normal approximately 1 1/2 years postonset of
      reinnervation. Some individual recordings may remain abnormal permanently.

PMID- 2233870
TI  - Critical review of gangliosides and thyrotropin-releasing hormone in peripheral
      neuromuscular diseases.
AB  - The lack of effective therapy for many of the chronic neuromuscular diseases such
      as amyotrophic lateral sclerosis, hereditary motor sensory neuropathy (Charcot
      Marie-Tooth disease), spinocerebellar degenerations and idiopathic polyneuropathy
      has led to a search for substances that may stimulate peripheral nerve
      regeneration. Two such agents that have been proposed are gangliosides (mixed
      purified bovine brain gangliosides, Cronassial) and thyrotropin releasing factor
      (TRH). Studies on both of these agents were initially reported with enthusiasm to
      be successful, but later double-blind controlled studies have failed to confirm
      these findings. This review provides critical analysis of the designs of studies
      of potentially effective agents in chronic neuromuscular diseases, and emphasizes
      the power of the placebo response, and the importance of designing placebos which
      are indistinguishable from the trial medication other than in the active effect.

PMID- 2233871
TI  - Surgical repair of peripheral nerve injury.
AB  - Magnification, use of fine interfascicular grafts for repair, and development of
      intraoperative electrophysiologic measurements of function have had a substantial
      impact on this field in the last 10 to 20 years. Basic surgical principles
      established during and since World War II remain the foundation for surgical
      repair of peripheral nerve injury but have been complemented nicely by these more
      recent advances. Selection of patients for surgery, as well as the timing of
      such, has been reviewed with emphasis on the differences between suspected
      transections and lesions in continuity, as well as comments on serious peripheral
      entrapments and tumors affecting nerve. The importance of not only preoperative
      electromyographic studies but also the intraoperative use of stimulation and
      stimulation and recording of nerve action potentials (NAPs) for lesions in
      continuity has been stressed. Operative techniques such as neurolysis, NAP
      recordings, suture, split repair, and interfascicular graft repair have been
      reviewed and some commentary on results provided. There has been a gradual
      evolution of centers in this country and abroad for care of the more serious
      surgical nerve problems. It is anticipated that in the future, such centers will
      be able to provide improved data concerning results with civilian nerve injuries.

PMID- 2233872
TI  - Abstracts of poster and platform presentations: 37th annual meeting. American
      Association of Electrodiagnostic Medicine. Chicago, Illinois, September 7-8,
      1990.

PMID- 2233873
TI  - Testing of therapeutic interventions in humans.

PMID- 2233874
TI  - Evaluating muscle strength and function. Proceedings of a workshop. Nashville,
      Tennessee, April 27-28, 1989.

PMID- 2233875
TI  - Preliminary observations on the reliability of the DCN-SMA Study Group
      methodology. Dallas-Cincinnati-Newington Spinal Muscular Atrophy (DCN-SMA) Study
      Group.

PMID- 2233876
TI  - Sensitivity of the DCN-SMA Study Group methodology. Dallas-Cincinnati-Newington
      Spinal Muscular Atrophy (DCN-SMA) Study Group.

PMID- 2233877
TI  - Manual muscle testing.

PMID- 2233878
TI  - Biomechanical muscle performance.

PMID- 2233879
TI  - Functional testing.
AB  - Functional testing is useful to monitor the natural history of several
      neuromuscular disorders, and to measure the efficacy of therapeutic agents in
      clinical trials. A major limitation of functional testing is that a single test
      is often not appropriate throughout all stages of disease. The same limitation
      holds true for other measurements of disease progression. MMT and quantitative
      myometry become technically difficult to perform and lack sensitivity to disease
      progression at some stages in the course of DMD, ALS, and spinal muscular
      atrophy. Other limitations of functional testing are its lack of sensitivity to
      detect a subtle improvement or decline in muscle strength, and the difficulty of
      applying standard statistical methods to analyze disease progression or
      therapeutic efficacy. The advantages of functional testing outweigh the
      limitations. Function testing uses daily activities to monitor disease
      progression. Patient's appreciate improvements in function more readily than
      improvements in muscle strength. Functional testing is easily standardized and is
      reliable. It can be performed, with little or no expense, in almost any clinical
      setting. The primary challenge for investigators who wish to incorporate
      functional tests is to identify functional tests that best measure the natural
      history of the specific disease under investigation. Further, functional testing
      allows the clinician to provide an educated guess on the likely future course of
      disease.

PMID- 2233880
TI  - Clinical trials in neuromuscular disease.

PMID- 2233881
TI  - The use of pulmonary function testing as a quantitative measurement for
      therapeutic trials.

PMID- 2233882
TI  - Fatigue testing.

PMID- 2233883
TI  - Introductory comments on disease-specific tests.

PMID- 2233884
TI  - Specific tests for polymyositis.

PMID- 2233885
TI  - Statistical considerations in clinical trials.

PMID- 2233887
TI  - Modeling of time-strength relationships.

PMID- 2233886
TI  - Statistical considerations in the study of spinal muscular atrophy. Dallas
      Cincinnati-Newington Spinal Muscular Atrophy (DCN-SMA) Study Group.

PMID- 2233888
TI  - Isokinetic dynamometry.
AB  - Quantitative muscle performance assessments require standardized protocols and
      logical explication of raw scores, regardless of technique used. A very expensive
      dynamometer is not a substitute for competent personnel carrying out strength
      assessments, and well-thought-out interpretations of the data.

PMID- 2233889
TI  - A methodology to measure the strength of SMA patients. Dallas-Cincinnati
      Newington Spinal Muscular Atrophy (DCN-SMA) Study Group.

PMID- 2233890
TI  - Osteomyelitis due to Cryptococcus neoformans in advanced age. Case report and
      review of literature.
AB  - In an 84-year-old man cryptococcosis with a pronounced osteomyelitic course
      (involvement of a rib, two thoracic vertebrae, the sacrum and a femur) was
      diagnosed histologically post mortem, thus directing attention to cryptococcosis
      in advanced age. The presumptive chronic course of the Cryptococcus neoformans
      (Cr. n.) infection in this patient was ascribed to chronic kidney failure,
      diabetes mellitus and chronic obstructive lung disease. Special reference is made
      to the mycological and radiological diagnosis of cryptococcosis of the bones as
      well as to its pathogenesis, therapy and epidemiology.

PMID- 2233891
TI  - Experimental dermatophytosis in nude guinea pigs compared with infections in
      Pirbright White animals.
AB  - With this investigation we wanted to compare the suitability of two different
      strains of guinea pigs to evaluate topical antifungals after experimental
      Trichophyton mentagrophytes infection. The "hairless"-strain was compared with
      the hairy Pirbright White strain. The infection areas were treated with a skin
      retention test (application before infection) and two sets of therapy tests
      (application after infection). In the retention test the different antimycotic
      compounds led to better gradations. Also, in the two sets of therapy tests the
      gradations among the compounds were more clearly and more comparable to published
      results of clinical trials. In the histological investigations the infections in
      the "hairless" animals developed in a way which is known from dermatophytoses in
      human skin. In the Pirbright White strain, however, due to the adjacent hair
      roots, a marked inflammatory reaction of the tissue persisted for 3 weeks which
      is not observed on human skin of the trunk and extremities. We, therefore,
      consider the "hairless" strain of guinea pigs to be more suitable than hairy
      animals for the comparison of topical antimycotics.

PMID- 2233892
TI  - Rilopirox--a new hydroxypyridone antifungal with fungicidal properties.
AB  - Rilopirox, 6-[[p-chlorophenoxy)phenoxy]methyl]-1hydroxy-4-methyl-2(1H)-pyrido ne,
      is a new fungicidal antimycotic with very low water solubility. It was designed
      to meet the demand for an intravaginal antifungal with a long skin retention time
      and a strong killing effect on pathogenic yeasts. In addition, it inhibits all
      common fungal pathogens in the range 0.98 to 15.6 micrograms/ml. Fungicidal rates
      vis-a-vis Trichophyton mentagrophytes and Candida albicans under proliferative
      and non-proliferative conditions are higher than those achieved with common azole
      and allylamine antifungals. Rilopirox is affected by Fe3+ ions and high
      concentrations of human serum owing to its chelating activity. The peptone source
      is of utmost importance to the inhibitory activity of rilopirox whereas the pH
      value seems to be unimportant so long as it is within the range 5-8.5. Rilopirox
      appears to meet the demand for an intravaginal antifungal as a result of its very
      low water solubility of 50 ng/ml and its immediate fungicidal action even under
      non-proliferative conditions.

PMID- 2233893
TI  - In vitro activities of polyene and imidazole antifungal agents against unusual
      opportunistic fungal pathogens.
AB  - Guidelines for the treatment of infections caused by unusual opportunistic fungi
      are limited and available in vitro data are scanty. In vitro susceptibility
      tests, employing an agar dilution procedure, were performed with amphotericin B
      (AMB), natamycin (NTC), itraconazole (ICZ), and ketoconazole (KTZ). Two media
      were used: Kimmig's agar (KA) and Yeast Morphology Agar (YMA). Fungi tested
      included isolates (n) of Acremonium spp. (10), Cunninghamella spp. (6), Fusarium
      spp. (18), Pseudallescheria boydii (14), and Trichosporon beigelii (5). All
      Acremonium and Cunninghamella isolates were susceptible to NTC (MIC less than or
      equal to 4 micrograms/ml) but many appeared to be resistant to AMB, (MIC greater
      than or equal to 32 micrograms/ml), KTZ and ICZ (MIC greater than or equal to 128
      micrograms/ml). Most isolates of Fusarium spp. were susceptible to both AMB and
      NTC (MIC90 = 4 micrograms/ml); one isolate was cross-resistant to both polyenes
      (MIC greater than 32 micrograms/ml). Only two of 18 Fusarium isolates appeared
      susceptible to the imidazoles (MIC less than or equal to 4 micrograms/ml); the
      remaining isolates exhibited high MICs (greater than or equal to 64
      micrograms/ml). All 14 isolates of P. boydii were susceptible to NTC (MIC less
      than or equal to 4 micrograms/ml) but four appeared to be resistant to AMB (MIC
      greater than or equal to 32 micrograms/ml). Most isolates of P. boydii were
      susceptible to both KTZ (MIC less than or equal to 4 micrograms/ml) and ICZ (MIC
      less than or equal to 16 micrograms/ml) but two isolates appeared to be resistant
      (MIC greater than or equal to 16 micrograms/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2233894
TI  - Structure of a telomeric expression site for variant specific surface antigens in
      Trypanosoma brucei.
AB  - We have studied the organization of the expression site, in which most chromosome
      internal variant-specific surface glycoprotein (VSG) genes of Trypanosoma brucei
      strain 427 are expressed (the dominant expression site) and compared it to the
      previously characterized VSG 221 expression site. With the exception of a 500 bp
      segment and a VSG pseudogene, which are absent from the dominant expression site,
      overall all major sequence elements of the two sites are organized similarly, as
      judged from their relative mapping positions by UV inactivation of transcription.
      Transcription is insensitive to 1 mg alpha-amanitin per ml, a characteristic
      property of VSG gene expression sites analyzed thus far. The sequence elements of
      the dominant expression site include at least one other expressed gene of unknown
      function and homologues of at least two other open reading frames. The large
      internal duplication of the 60-kb 221 expression site appear to be missing from
      the dominant site, resulting in a shorter, 40-kb transcription unit. As judged
      from its relative sensitivity to UV inactivation of transcription, a subsidiary
      promoter, identified by other methods in the dominant expression site appears
      fully dependent for its activity on the promoter located 40 kb upstream of the
      VSG gene. We conclude that all VSG gene expression sites may be similarly
      organized as large polygenic transcription units.

PMID- 2233895
TI  - A 31P nuclear magnetic resonance study of Crithidia luciliae.
AB  - 31P NMR has been used to observe phosphorus-containing compounds in both
      perchloric acid and KOH extracts and in whole cell suspensions of Crithidia
      luciliae. Cells were grown in Bone and Steinert medium, or in a modified RPMI
      culture medium and harvested after about 72 h in mid- to late log phase. 31P NMR
      spectra of the perchloric acid extracts indicated that 3-phosphoglycerate, which
      is normally at low concentrations in most cells, was the dominant phosphorus
      containing compound in the sugar phosphate region. 3-Phosphoglycerate is the end
      product of glycosomal glycolysis and our finding is consistent with previous
      observations of the failure to detect prior glycolytic intermediates. Other
      metabolites observed were ATP, ADP, NAD(P)+, phosphoenolpyruvate and low
      molecular weight polyphosphates (PPn, n less than 20). The presence of high
      molecular-weight polyphosphates was established by spectra recorded on extracts
      obtained through subsequent treatment of the insoluble fraction with KOH. 31P NMR
      experiments on whole cells indicated that the average main internal pH of cells
      in late-log growth phase was approx. pH 7.2 +/- 0.1, using the orthophosphate
      resonance as an indicator. The cells responded to the addition of glucose (final
      concentration approx. 35 mM) with a decrease in pH, both internal (delta pH = 
      0.9 (55 min)-1) and external (delta pH = -1.3 (15 min)-1). Polyphosphates and ATP
      could not be observed in whole cell experiments, although perchloric acid
      extracts of identically treated cells showed no significant depletion of these
      compounds.

PMID- 2233896
TI  - Ca2+ transport in digitonin-permeabilized trypanosomatids.
AB  - The use of digitonin to permeabilize Leishmania mexicana mexicana, Leishmania
      agamae, and Crithidia fasciculata plasma membranes enabled us to study Ca2+
      transport in situ. The present results show that the mitochondria of these
      trypanosomatids are able to build up and retain a membrane potential as indicated
      by a tetraphenylphosphonium-sensitive electrode. Ca2+ uptake caused membrane
      depolarization compatible with the existence of an electrogenically mediated Ca2+
      transport mechanism in these mitochondria. Ca2+ uptake was partially inhibited by
      ruthenium red, almost totally inhibited by carbonyl cyanide p
      trifluoromethoxyphenylhydrazone, and stimulated by inorganic phosphate. Large
      amounts of Ca2+ were retained by C. fasciculata mitochondria even after addition
      of thiols and NAD(P)H oxidants such as t-butylhydroperoxide and diamide. In
      contrast, Ca2+ was not retained in the matrix of Leishmania sp. mitochondria for
      long periods of time. In addition to the mitochondrial Ca2+ uptake, a vanadate
      sensitive Ca2(+)-transporting system was also detectable in these
      trypanosomatids.

PMID- 2233897
TI  - Recurrent de novo appearance of small linear DNAs in Leishmania major and
      relationship to extra-chromosomal DNAs in other species.
AB  - We have detected several new chromosome-sized DNAs in lines derived from the
      LT252 isolate of Leishmania major. These DNAs appeared de novo in two clonal
      lines undergoing methotrexate (MTX) selection (clone 7-R50, clone 15-R50), in a
      stably MTX-resistant population reverting from MTX pressure (R1000-11-P55rev),
      and spontaneously during routine serial passage of the wild-type LT252 line in
      vitro (LT252+). No association of these new DNAs with drug resistance was
      detected. The new chromosomes were present in multiple copies, stably maintained,
      linear, and hybridized to a telomere-specific probe, and ranged in size from 180
      to 220 kb. Southern blot hybridization revealed that all four new DNAs were
      related, and the family was designated the 715 class of small linear DNAs (SLDs).
      A 715-class SLD hybridization probe also identified small chromosomes described
      previously in Leishmania donovani (LD-1, HU-3 minichromosome) and Leishmania
      braziliensis (LD-1); LD-1 is known to be related to a smaller circular DNA, CD-1.
      A cloned probe derived from CD-1 (from K. Stuart and C. Tripp) identified two of
      the four L. major 715 class of SLDs in addition to the LD-1 DNAs of L. donovani
      and L. braziliensis, however the 715-class SLD probe did not identify CD-1
      itself. L. major and L. donovani possess a homologous 1.5 Mb chromosome
      containing both the CD-1 and 715 sequences within a 40-kb region, whose size
      remained unaltered following appearance of the SLDs. These data suggest that SLDs
      and CD-1 may arise from an evolutionarily conserved chromosomal reservoir.

PMID- 2233898
TI  - Chromosomal rearrangements and point mutations in the DHFR-TS gene of Plasmodium
      chabaudi under antifolate selection.
AB  - Selection of the rodent malaria Plasmodium chabaudi with low levels of the
      antifolate drug pyrimethamine has previously been shown by us to result in
      duplication of the dihydrofolate reductase-thymidylate synthase (DHFR-TS) gene by
      a duplication of chromosome 7 and subsequent rearrangements. We have selected
      this resultant parasite line with large doses of pyrimethamine and analysed the
      DHFR-TS gene and chromosomes for any changes. Increased drug pressure has
      resulted in reappearance of a chromosome with the same structure as chromosome 7
      from DS the parent line. Sequencing of the DHFR gene from each of the chromosomes
      has identified a single point mutation that results in a serine to asparagine
      change at position 106. This is the equivalent mutation that has been identified
      as the key residue in the mechanism of resistance to pyrimethamine in Plasmodium
      falciparum. There is no apparent increase in transcription of the DHFR-TS gene
      and the large increase in resistance is most likely a result of the mutation in
      the DHFR gene.

PMID- 2233900
TI  - Analysis of the sequences flanking the translational start sites of Plasmodium
      falciparum.
AB  - The 5' and 3' regions adjacent to the initiation codon in 22 Plasmodium
      falciparum sequences were examined. A 5' consensus sequence (AAAA/ATG) was found.
      Although P. falciparum non-translated DNA is A-rich, A occurred significantly
      more frequently in the 4 positions preceding the initiation ATG than in adjacent
      non-translated DNA, suggesting that this consensus sequence has functional
      significance in the initiation of translation. This region has similarities with
      the equivalent sequences in yeast and Drosophila but differs markedly from that
      in vertebrates. No significant bias in nucleotide frequencies was found 3' to the
      initiation codon.

PMID- 2233899
TI  - Kinetoplast DNA minicircles are inherited from both parents in genetic hybrids of
      Trypanosoma brucei.
AB  - We have examined the inheritance of kinetoplast DNA (kDNA) in gentic crosses of
      trypanosomes. In 2 independent crosses of Trypanosoma brucei spp. trypanosomes,
      the kDNA maxicircles which carry the genes for mitochondrial biogenesis, were
      inherited from one parent only, as already found by other workers. However, the
      other component of kDNA, the minicircles, were inherited from both parents. This
      was demonstrated by Southern analysis using cloned minicircle probes. The
      inheritance of kDNA is therefore not uniparental. Our data point to fusion of the
      parental kinetoplast DNA networks during genetic exchange, with gradual loss of
      one or other parental maxicircle type due to random segregation of maxicircles at
      subsequent mitotic divisions. We infer that the first event of genetic exchange
      is fusion of parental trypanosomes (either haploid or diploid), followed at some
      point by fusion of the parental mitochondria.

PMID- 2233902
TI  - Cerebral glucose metabolism in adults with hyperactivity of childhood onset.
AB  - BACKGROUND AND METHODS: The cause of childhood hyperactivity (attention deficit
      hyperactivity disorder) is unknown. We investigated the hypothesis that cerebral
      glucose metabolism might differ between normal adults (controls) and adults with
      histories of hyperactivity in childhood who continued to have symptoms. Each
      patient was also the biologic parent of a hyperactive child. None of the adults
      had ever been treated with stimulant medication. To measure cerebral glucose
      metabolism, we administered 148 to 185 MBq (4 to 5 mCi) of [18F]fluoro-2-deoxy-D
      glucose intravenously to 50 normal adults and 25 hyperactive adults while they
      performed an auditory-attention task. Images were obtained for 30 minutes with a
      Scanditronix positron-emission tomograph with a resolution of 5 to 6 mm. Whole
      brain and regional rates of glucose metabolism were measured with computer
      assistance by two trained research assistants, working independently, who were
      blinded to the subjects' status (control or hyperactive). RESULTS: Global
      cerebral glucose metabolism was 8.1 percent lower in the adults with
      hyperactivity than in the normal controls (mean +/- SD, 9.05 +/- 1.20 mg per
      minute per 100 g vs. 9.85 +/- 1.68 mg per minute per 100 g; P = 0.034). In the
      adults with hyperactivity, glucose metabolism was significantly reduced, as
      compared with the values for the controls, in 30 of 60 specific regions of the
      brain (P less than 0.05). Among the regions of the brain with the greatest
      reductions in glucose metabolism were the premotor cortex and the superior
      prefrontal cortex. When the seven women with hyperactivity or the six patients
      with learning disabilities were omitted from the analysis, the results were
      similar. CONCLUSIONS: Glucose metabolism, both global and regional, was reduced
      in adults who had been hyperactive since childhood. The largest reductions were
      in the premotor cortex and the superior prefrontal cortex--areas earlier shown to
      be involved in the control of attention and motor activity.

PMID- 2233901
TI  - Mutant dihydrofolate reductase-thymidylate synthase genes in pyrimethamine
      resistant Plasmodium falciparum with polymorphic chromosome duplications.
AB  - We have identified dihydrofolate reductase (DHFR) gene point mutations and
      chromosomal changes in pyrimethamine-resistant mutants selected in vitro of
      Plasmodium falciparum strain FCR3. A pyrimethamine-resistant derivative of the
      pyrimethamine-sensitive strain FCR3, FCR3-D8, that had been grown in the absence
      of pyrimethamine for an extended time, was grown in two concentrations of
      pyrimethamine, and surviving drug-resistant parasites were subcloned. One
      selected mutant, FCR3-D81, that grew at 1 X 10(-6) M pyrimethamine, contained a
      single point mutation in the DHFR domain which caused an amino acid change (Phe
      to Ser) at amino acid 223, whereas another mutant, FCR3-D85, that grew at 5 X 10(
      6) M pyrimethamine had that same mutation and an additional point mutation that
      changed amino acid 54 (Asp to Asn). The selection of FCR3-D85, whose nucleotide
      sequence was identical to that previously reported for FCR3-D8, confirmed that
      the original FCR3-D8 parasite population had changed during extended growth in
      vitro in the absence of drug pressure. FCR3-D81 and FCR3-D85 cells contained
      different pairs of polymorphic chromosomes that hybridized to a DHFR-TS probe as
      well as to three other chromosome 4 specific DNAs, indicating that at least part
      of chromosome 4 had been duplicated and that these parasites were aneuploid with
      15 rather than 14 chromosomes. The mutant DHFR-TS genes were diploid. We consider
      the roles of the polymorphic chromosome duplications and DHFR point mutation(s)
      as causes of pyrimethamine resistance.

PMID- 2233903
TI  - The little women of Loja--growth hormone-receptor deficiency in an inbred
      population of southern Ecuador.
AB  - BACKGROUND AND METHODS: Laron-type dwarfism, which is characterized by the
      clinical appearance of isolated growth hormone deficiency with elevated serum
      levels of growth hormone and decreased serum levels of insulin-like growth factor
      I (IGF-I), has been described in approximately 50 patients. This condition is
      caused by a deficiency of the cellular receptor for growth hormone, and it is
      transmitted as an autosomal recessive trait, as indicated by an equal sex
      distribution and a high rate of consanguinity in affected families. We studied 20
      patients (19 females and 1 male, 2 to 49 years of age), from an inbred Spanish
      population in southern Ecuador, who had the clinical features of Laron-type
      dwarfism. RESULTS: Seventeen patients were members of two large pedigrees. Among
      the 13 affected sibships, there were 19 affected and 24 unaffected female
      siblings and 1 affected and 21 unaffected male siblings. The patients' heights
      ranged from 10.0 to 6.7 SD below the normal mean height for age in the United
      States. In addition to the previously described features, 15 patients had limited
      elbow extensibility, all had blue scleras, affected adults had relatively short
      extremities, and all four affected women over 30 years of age had hip
      degeneration. Basal serum concentrations of growth hormone were elevated in all
      affected children (30 to 160 micrograms per liter) and normal to moderately
      elevated in the adults. The serum level of growth hormone-binding protein ranged
      from 1 to 30 percent of normal; IGF-I concentrations were low--less than or equal
      to 7 micrograms per liter in the children and less than or equal to 66 micrograms
      per liter in the adults (normal for Ecuadorean women, 98 to 238). Serum levels of
      IGF-II and growth hormone-dependent IGF-binding protein-3 were also low.
      CONCLUSIONS: We describe an inbred population with a high incidence of growth
      hormone-receptor deficiency resulting in a clinical picture resembling Laron-type
      dwarfism but differing principally in showing a marked predominance of affected
      females. This population, of Mediterranean origin, may be genetically related to
      other reported populations with Laron-type dwarfism, but with the genetic defect
      linked to a trait resulting in the early fetal death of most affected males.

PMID- 2233904
TI  - A randomized, prospective field trial of a conjugate vaccine in the protection of
      infants and young children against invasive Haemophilus influenzae type b
      disease.
AB  - BACKGROUND: Haemophilus influenzae type b is the leading cause of invasive
      bacterial disease in young children. The capsular polysaccharide vaccine does not
      protect children at greatest risk (those under the age of 18 months), but a
      polysaccharide-protein conjugate vaccine has proved to be more immunogenic in
      this age group. METHODS: We enrolled 114,000 infants in Finland in an open,
      prospective, randomized trial of a H. influenzae type b capsular polysaccharide
      diphtheria toxoid conjugate vaccine (polyribosylribitol phosphate-diphtheria
      toxoid [PRP-D]). Children born on odd-numbered days were vaccinated at the ages
      of 3, 4, 6, and 14 to 18 months; those born on even-numbered days formed the
      control group and received the same vaccine at the age of 24 months. RESULTS:
      After three doses of the vaccine there were 4 cases of verified bacteremic H.
      influenzae type b disease in the group receiving early vaccination, as compared
      with 64 cases in the control group, between the ages of approximately 7 and 24
      months. The protective efficacy of the vaccine was thus 94 percent (95 percent
      confidence interval, 83 to 98). No serious adverse effects were reported. The
      immune response to the conjugate vaccine was characteristic of a T-cell-dependent
      response when studied in a cohort of 120 infants. The primary immunization series
      resulted in a geometric mean concentration of anticapsular antibody of 0.53
      micrograms per milliliter at the age of seven months, and the fourth dose evoked
      an anamnestic response, with a mean antibody concentration of 45.22 micrograms
      per milliliter. CONCLUSIONS: A new conjugate vaccine consisting of the capsular
      polysaccharide of H. influenzae type b covalently linked to a protein carrier
      (PRP-D), administered to infants beginning at the age of 3 months, is highly
      effective in protecting young Finnish children (7 to 24 months old) against
      invasive H. influenzae type b infections.

PMID- 2233905
TI  - Impaired antibody response to Haemophilus influenzae type b polysaccharide and
      low IgG2 and IgG4 concentrations in Apache children.
AB  - BACKGROUND AND METHODS: Because Native American children are at much higher risk
      for invasive Haemophilus influenzae type b infection than white children, we
      compared the antibody responses to H. influenzae type b polysaccharide vaccine in
      healthy Apache and white children. RESULTS: The concentrations of H. influenzae
      type b antibody after immunization with polysaccharide vaccine were approximately
      10-fold lower in 24-month-old Apache children than in whites of a similar age (P
      less than 0.01). The decreased response involved H. influenzae type b antibodies
      of the IgG, IgM, and IgA classes. Concentrations of IgG antibody to tetanus
      toxoid did not differ significantly, and IgG antibodies to diphtheria toxoid were
      only twofold lower (P = 0.028). Although total IgG, IgM, and IgA levels were
      higher in two-year-old Apaches than in whites (all P less than 0.001), IgG2 and
      IgG4 subclasses were lower (both P less than 0.001). Among the Apaches,
      individual immunoglobulin levels and allotypes were not significantly correlated
      with their antibody responses to H. influenzae type b polysaccharide.
      CONCLUSIONS: Apache children have significant impairment of their antibody
      response to H. influenzae type b polysaccharide and little or no impairment of
      their antibody responses to protein toxoids. This immunodeficiency may explain
      the high incidence of H. influenzae type b infection in this population.

PMID- 2233906
TI  - Limited efficacy of a Haemophilus influenzae type b conjugate vaccine in Alaska
      Native infants. The Alaska H. influenzae Vaccine Study Group.
AB  - BACKGROUND: The prevention of invasive Haemophilus influenzae type b disease
      requires a vaccine that is effective when administered during the first six
      months of life. The infants of Alaska Natives are at particularly high risk of
      invasive H. influenzae type b disease. METHODS: To evaluate the protective
      efficacy of a H. influenzae type b polysaccharide-diphtheria toxoid conjugate
      vaccine (polyribosylribitol phosphate-diphtheria toxoid [PRP-D]), we enrolled
      2102 Alaska Native infants in a randomized, double-blind, placebo-controlled
      trial in which either the vaccine or a saline placebo was administered at
      approximately two, four, and six months of age. RESULTS: After 3969 subject-years
      of follow-up and 32 episodes of H. influenzae type b disease, the overall
      incidence of invasive disease was not reduced significantly in the vaccinated
      subjects (6.0 cases per 1000 patient-years), as compared with the placebo
      controls (9.6) or with other Alaska Native infants (6.0). After one, two, or
      three doses there was no significant protective efficacy with the vaccine; after
      three doses the efficacy was only 35 percent (95 percent confidence interval, -57
      to 73). The lack of efficacy was not related to the age at onset of disease, age
      at immunization, type of disease, degree of Alaska Native heritage, time after
      immunization, or year of the study. Levels of H. influenzae type b anticapsular
      antibody in recipients of the vaccine became significantly higher than levels in
      those who received placebo only after the second and third doses. Even after the
      third dose, only 48 percent of the vaccinated infants had antibody levels of more
      than 0.1 microgram per milliliter (geometric mean titer, 0.18). Antibody
      responses did not vary with the level of maternally acquired antibody, degree of
      Alaska Native ancestry, or age at time of the first or second immunizations, but
      they increased with increasing age at time of the third dose (P less than 0.001).
      CONCLUSIONS: We found no evidence that the PRP-D vaccine provides significant
      protection, at least for Alaska Native infants, against invasive diseases caused
      by H. influenzae type b. The ineffectiveness of the vaccine paralleled its
      limited immunogenicity.

PMID- 2233907
TI  - Hormonal evaluation of the patient with an incidentally discovered adrenal mass.

PMID- 2233908
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 46-1990. A 63-year-old woman with diarrhea and bullous lesions of
      the buttock.

PMID- 2233909
TI  - Hyperactivity in childhood.

PMID- 2233910
TI  - Evaluating the Haemophilus influenzae type b conjugate vaccine PRP-D.

PMID- 2233911
TI  - Prevention of coronary artery disease. A medical imperative.

PMID- 2233912
TI  - Transfusion of racially unmatched blood.

PMID- 2233913
TI  - Prevalence of lymphocytopenia in severe combined immunodeficiency.

PMID- 2233915
TI  - Another cause of tennis elbow.

PMID- 2233914
TI  - Acute response to recombinant insulin-like growth factor I in a patient with
      Mendenhall's syndrome.

PMID- 2233916
TI  - Corticosteroids as adjunctive therapy for severe Pneumocystis carinii pneumonia
      in the acquired immunodeficiency syndrome. A double-blind, placebo-controlled
      trial.
AB  - BACKGROUND: Preliminary reports suggest that patients with the acquired
      immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia may benefit
      from the addition of corticosteroid treatment to antibiotic therapy. METHODS: We
      conducted a double-blind, placebo-controlled trial to assess the efficacy of
      adjunctive corticosteroids in patients with AIDS and severe P. carinii pneumonia.
      Patients with marked abnormalities in gas exchange who had been treated with
      antibiotics for less than 72 hours were randomly assigned to receive either
      methylprednisolone (40 mg) or placebo every 6 hours for 7 days, in addition to
      treatment for 21 days with trimethoprim-sulfamethoxazole. The primary outcome
      measures were survival until hospital discharge and the development of
      respiratory failure. RESULTS: Twenty-three patients were enrolled in the study;
      there were no significant differences in base-line clinical or laboratory
      measures between the two treatment groups. Of 12 patients treated with
      corticosteroids, 9 (75 percent) survived until hospital discharge, as compared
      with only 2 of 11 placebo recipients (18 percent) (P less than 0.008).
      Respiratory failure developed in nine placebo recipients, as compared with only
      three patients treated with corticosteroids (P less than 0.008). No patient
      required the interruption or discontinuation of corticosteroid or antibiotic
      treatment because of toxicity or a complicating event. Because of the marked
      difference in survival, it was deemed unethical to continue the trial, and the
      study was terminated. CONCLUSIONS: Early adjunctive corticosteroid therapy can
      improve survival and decrease the occurrence of respiratory failure in patients
      with AIDS and severe P. carinii pneumonia.

PMID- 2233917
TI  - A controlled trial of early adjunctive treatment with corticosteroids for
      Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome.
      California Collaborative Treatment Group.
AB  - BACKGROUND: Pneumocystis carinii pneumonia remains a common cause of serious
      morbidity and mortality in patients with the acquired immunodeficiency syndrome
      (AIDS). The extensive lung injury that accompanies pneumocystis-associated
      respiratory failure and the reports of clinical benefit from the use of
      adjunctive corticosteroids provided the rationale for this prospective
      multicenter trial. METHODS: A total of 333 patients with AIDS and pneumocystis
      pneumonia received standard treatment and were randomly assigned to receive
      either corticosteroids (beginning with the equivalent of 40 mg of prednisone
      twice daily) or no additional therapy. The primary end points in this unblinded
      trial were the occurrence of respiratory failure (hypoxemia ratio [partial
      pressure of arterial oxygen divided by fraction of inspired oxygen] less than 75,
      intubation, or death), death, and dose-limiting toxicity of the initial standard
      therapy. RESULTS: Of the patients with confirmed or presumed pneumocystis
      pneumonia (n = 225 and n = 26, respectively), those assigned to treatment with
      corticosteroids had a lower cumulative risk at 31 days of respiratory failure
      (0.14 vs. 0.30, P = 0.004) and of death (0.11 vs. 0.23, P = 0.009), as well as a
      lower risk of death within 84 days (0.16 vs. 0.26, P = 0.026). The frequency of
      dose-limiting toxicity of the standard therapy was similar in the two treatment
      groups. Intention-to-treat analyses of the entire cohort confirmed these
      findings. Clinical benefit could not be demonstrated, however, for patients with
      mild disease (hypoxemia ratio, greater than 350), equivalent to a partial
      pressure of oxygen greater than 75 torr on room air. The patients assigned to
      corticosteroid treatment had an excess of localized herpetic lesions (26 percent
      vs. 15 percent, P = 0.04) but not of other infections or of neoplasms.
      CONCLUSIONS: Early adjunctive treatment with corticosteroids reduces the risks of
      respiratory failure and death in patients with AIDS and moderate-to-severe
      pneumocystis pneumonia. Because the adverse effects are few, corticosteroids
      should be included as part of the initial treatment for persons with AIDS who
      have moderate-to-severe pneumocystis pneumonia.

PMID- 2233919
TI  - The evaluation and treatment of seizures.

PMID- 2233918
TI  - Altered expression of the retinoblastoma gene product in human sarcomas.
AB  - BACKGROUND: The retinoblastoma-susceptibility (Rb) gene is a prototype tumor
      suppressor gene originally isolated from patients with heritable retinoblastoma.
      This gene encodes a nuclear phosphoprotein whose expression is altered in several
      types of human tumors. METHODS: We studied the expression of the Rb protein in 44
      primary and 12 metastatic high-grade human sarcomas by means of
      immunohistochemical methods and Western blotting. Computerized image analysis was
      used to quantify the level of Rb gene product in individual tumor cells. The
      expression of the Rb gene was then correlated with clinical outcome in the
      patients with primary tumors. RESULTS: Of the 44 patients with primary sarcomas,
      13 (30 percent) had tumors with normal, homogeneous expression of the Rb protein
      in essentially all tumor cells. Thirty-one patients with primary tumors (70
      percent) had altered Rb expression; in 18 (40 percent) the Rb protein was
      heterogeneously expressed, and in 13 (30 percent) it was detected in fewer than
      20 percent of the tumor cells. All 12 of the patients with metastatic sarcomas
      had altered expression of the Rb protein. When the findings in the patients with
      primary tumors were correlated with clinical outcome, survival was found to be
      significantly increased in the patients whose tumors had homogeneous Rb
      expression, as compared with those with either heterogeneous expression (P =
      0.026) or no expression (P = 0.012). CONCLUSIONS: Tumors in which the expression
      of Rb gene product was decreased were more aggressive than tumors in which this
      protein was expressed by nearly all cells. The Rb gene product may be an
      important prognostic variable in patients with these tumors.

PMID- 2233920
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 47-1990. A 51-year-old man with hemoptysis and cavitary lesions
      of the left lung.

PMID- 2233921
TI  - An error corrected, a conclusion withdrawn, and a lesson learned.

PMID- 2233922
TI  - Conjunctive antithrombotic and thrombolytic therapy for coronary-artery
      occlusion.

PMID- 2233923
TI  - Plasma endothelin-1 levels in patients with pregnancy-induced hypertension.

PMID- 2233924
TI  - Ticlopidine and thrombocytopenia.

PMID- 2233925
TI  - Prevalence and predictors of rhabdomyolysis in patients with hypokalemia.

PMID- 2233926
TI  - Improved molecular-genetic diagnosis of Leber's hereditary optic neuropathy.

PMID- 2233928
TI  - Health insurers and medical directives.

PMID- 2233927
TI  - The role of Veterans Affairs hospitals in the health care system.

PMID- 2233929
TI  - Immigrants, international travelers, and HIV.

PMID- 2233930
TI  - Organ transplantation in HIV-positive patients.

PMID- 2233931
TI  - The effect of low-dose warfarin on the risk of stroke in patients with
      nonrheumatic atrial fibrillation.
AB  - BACKGROUND: Nonrheumatic atrial fibrillation increases the risk of stroke,
      presumably from atrial thromboemboli. There is uncertainty about the efficacy and
      risks of long-term warfarin therapy to prevent stroke. METHODS: We conducted an
      unblinded, randomized, controlled trial of long-term, low-dose warfarin therapy
      (target prothrombin-time ratio, 1.2 to 1.5) in patients with nonrheumatic atrial
      fibrillation. The control group was not given warfarin but could choose to take
      aspirin. RESULTS: A total of 420 patients entered the trial (212 in the warfarin
      group and 208 in the control group) and were followed for an average of 2.2
      years. Prothrombin times in the warfarin group were in the target range 83
      percent of the time. Only 10 percent of the patients assigned to receive warfarin
      discontinued the drug permanently. There were 2 strokes in the warfarin group
      (incidence, 0.41 percent per year) as compared with 13 strokes in the control
      group (incidence, 2.98 percent per year), for a reduction of 86 percent in the
      risk of stroke (warfarin:control incidence ratio = 0.14; 95 percent confidence
      interval, 0.04 to 0.49; P = 0.0022). There were 37 deaths altogether. The death
      rate was markedly lower in the warfarin group than in the control group: 2.25
      percent as compared with 5.97 percent per year, for an incidence ratio of 0.38
      (95 percent confidence interval, 0.17 to 0.82; P = 0.005). There was one fatal
      hemorrhage in each group. The frequency of bleeding events that led to
      hospitalization or transfusion was essentially the same in both groups. The
      warfarin group had a higher rate of minor hemorrhage than the control group (38
      vs. 21 patients). CONCLUSIONS: Long-term low-dose warfarin therapy is highly
      effective in preventing stroke in patients with non-rheumatic atrial
      fibrillation, and can be quite safe with careful monitoring.

PMID- 2233933
TI  - Prevalence of the human immunodeficiency virus among university students.
AB  - BACKGROUND AND METHODS: To estimate the magnitude of the human immunodeficiency
      virus (HIV) epidemic among university students, we conducted a blinded HIV
      seroprevalence survey at 19 universities throughout the United States. HIV
      antibody testing was performed on blood collected for routine medical purposes at
      the student health centers of the participating institutions. At each campus,
      from 250 to 1000 blood specimens were collected consecutively and tested for HIV
      antibodies by enzyme-linked immunosorbent assay and Western blot analysis.
      Nonidentifying demographic data were linked with the test results. RESULTS: Of
      16,863 specimens in the sample, 30 (0.2 percent) were positive for antibodies to
      HIV. Positive specimens were found at 9 of the 19 schools. All were from students
      over 18 years old; 19 (63 percent) were from students over 24. All but 2 of the
      30 infected students were men. The seroprevalence rate for men was 0.5 percent
      (95 percent confidence interval, 0.3 to 0.7), and for women it was 0.02 percent
      (95 percent confidence interval, 0.002 to 0.066). Seroprevalence increased with
      age--from 0.08 percent (95 percent confidence interval, 0.04 to 0.15) for
      students 18 to 24 years old to 1.0 percent (95 percent confidence interval, 0.2
      to 2.9) for those 40 or older. CONCLUSIONS: HIV infection is present on U.S.
      university campuses, although the rate appears to be far lower than that of
      populations known to be at high risk. The potential clearly exists, however, for
      the further spread of HIV infection in this population, and preventive measures
      are needed.

PMID- 2233932
TI  - The relation between genotype and phenotype in cystic fibrosis--analysis of the
      most common mutation (delta F508).
AB  - BACKGROUND AND METHODS: Both the clinical manifestations of cystic fibrosis and
      the genotypes of patients are heterogeneous, but the associations between the two
      are not known. We therefore studied blood samples from 293 patients with cystic
      fibrosis for the presence of the most common disease-causing mutation (delta
      F508) on chromosome 7 and compared the results with the clinical manifestations
      of the disease. RESULTS: The prevalence of the delta F508 allele in the cohort
      was 71 percent; 52 percent of the patients were homozygous for the mutation, 40
      percent were heterozygous, and 8 percent had other, undefined mutations. The
      patients who were homozygous for the mutation had received a diagnosis of cystic
      fibrosis at an earlier age and had a greater frequency of pancreatic
      insufficiency; pancreatic insufficiency was present in 99 percent of the
      homozygous patients, but in 72 percent of the heterozygous patients and only 36
      percent of the patients with other genotypes. The patients with pancreatic
      insufficiency in all three genotype groups had similar clinical characteristics,
      reflected by an early age at diagnosis, similar sweat chloride values at
      diagnosis, similar severity of pulmonary disease, and similar percentiles for
      weight. In contrast, the patients in the heterozygous-genotype and other-genotype
      groups who did not have pancreatic insufficiency were older and had milder
      disease. They had lower sweat chloride values at diagnosis, normal nutritional
      status, and better pulmonary function after adjustment for age. CONCLUSIONS: The
      variable clinical course in patients with cystic fibrosis can be attributed at
      least in part to specific genotypes at the locus of the cystic fibrosis gene.

PMID- 2233934
TI  - Cardiac localization of eosinophil-granule major basic protein in acute
      necrotizing myocarditis.

PMID- 2233935
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 48-1990. A 65-year-old man with pulmonary infiltrates after
      treatment for Wegener's granulomatosis.

PMID- 2233936
TI  - Atrial fibrillation--risk marker for stroke.

PMID- 2233937
TI  - Red-cell cytoskeletal abnormalities--implications for malaria.

PMID- 2233938
TI  - Heart disease and the eosinophil.

PMID- 2233939
TI  - Effects of human growth hormone in men over 60 years old.

PMID- 2233940
TI  - Differences in the quality of semen in outdoor workers during summer and winter.

PMID- 2233942
TI  - Evaluation of acute aortic dissection by intravascular ultrasonography.

PMID- 2233941
TI  - Pharmacokinetics of mercaptopurine in children with acute lymphocytic leukemia.

PMID- 2233943
TI  - New editorial policy on conflicts of interest.

PMID- 2233944
TI  - When doctors question kids.

PMID- 2233945
TI  - The agent of bacillary angiomatosis. An approach to the identification of
      uncultured pathogens.
AB  - BACKGROUND: Bacillary angiomatosis is an infectious disease causing proliferation
      of small blood vessels in the skin and visceral organs of patients with human
      immunodeficiency virus infection and other immunocompromised hosts. The agent is
      often visualized in tissue sections of lesions with Warthin-Starry staining, but
      the bacillus has not been successfully cultured or identified. This bacillus may
      also cause cat scratch disease. METHODS: In attempting to identify this organism,
      we used the polymerase chain reaction. We used oligonucleotide primers
      complementary to the 16S ribosomal RNA genes of eubacteria to amplify 16S
      ribosomal gene fragments directly from tissue samples of bacillary angiomatosis.
      The DNA sequence of these fragments was determined and analyzed for phylogenetic
      relatedness to other known organisms. Normal tissues were studied in parallel.
      RESULTS: Tissue from three unrelated patients with bacillary angiomatosis yielded
      a unique 16S gene sequence. A sequence obtained from a fourth patient with
      bacillary angiomatosis differed from the sequence found in the other three
      patients at only 4 of 241 base positions. No related 16S gene fragment was
      detected in the normal tissues. These 16S sequences associated with bacillary
      angiomatosis belong to a previously uncharacterized microorganism, most closely
      related to Rochalimaea quintana. CONCLUSIONS: The cause of bacillary angiomatosis
      is a previously uncharacterized rickettsia-like organism, closely related to R.
      quintana. This method for the identification of an uncultured pathogen may be
      applicable to other infectious diseases of unknown cause.

PMID- 2233946
TI  - Clinical and pathological features of bacillary peliosis hepatis in association
      with human immunodeficiency virus infection.
AB  - BACKGROUND: Peliosis hepatis is characterized by cystic, blood-filled spaces in
      the liver and is seen in patients with chronic infections or advanced cancer and
      as a consequence of therapy with anabolic steroids. Cutaneous bacillary
      angiomatosis is a bacterial infection that occurs in patients with human
      immunodeficiency virus (HIV) infection; its histologic appearance is that of a
      pseudoneoplastic vascular proliferation. METHODS: We studied liver tissue from
      eight HIV-infected patients with peliosis hepatis, two of whom also had cutaneous
      bacillary angiomatosis. For comparison we examined tissue from four patients who
      had peliosis hepatis without HIV infection. Tissues were examined histologically
      on routine sections and with special stains and electron microscopy. RESULTS: The
      histologic features seen in peliosis hepatis associated with HIV infection, but
      not in the four cases unrelated to HIV infection, were myxoid stroma and clumps
      of a granular purple material that on Warthin-Starry staining and electron
      microscopy proved to be bacilli. The bacilli, which could not be cultured, were
      morphologically identical to those found in the skin lesions of cutaneous
      bacillary angiomatosis. The clinical courses of two of the patients with this
      "bacillary peliosis hepatis" indicate that it responds to antibiotic treatment.
      CONCLUSIONS: HIV-associated bacillary peliosis hepatis is an unusual, treatable
      opportunistic infection, probably caused by the same organism that causes
      cutaneous bacillary angiomatosis. Our failure to find bacilli in non-HIV
      associated cases implies that other pathogenetic mechanisms may also be
      responsible for peliosis hepatis.

PMID- 2233948
TI  - Regional myocardial metabolism of high-energy phosphates during isometric
      exercise in patients with coronary artery disease.
AB  - BACKGROUND: The maintenance of cellular levels of high-energy phosphates is
      required for myocardial function and preservation. In animals, severe myocardial
      ischemia is characterized by the rapid loss of phosphocreatine and a decrease in
      the ratio of phosphocreatine to ATP. METHODS: To determine whether ischemic
      metabolic changes are detectable in humans, we recorded spatially localized
      phosphorus-31 nuclear-magnetic-resonance (31P NMR) spectra from the anterior
      myocardium before, during, and after isometric hand-grip exercise. RESULTS: The
      mean (+/- SD) ratio of phosphocreatine to ATP in the left ventricular wall when
      subjects were at rest was 1.72 +/- 0.15 in normal subjects (n = 11) and 1.59 +/-
      0.31 in patients with nonischemic heart disease (n = 9), and the ratio did not
      change during hand-grip exercise in either group. However, in patients with
      coronary heart disease and ischemia due to severe stenosis (greater than or equal
      to 70 percent) of the left anterior descending or left main coronary arteries (n
      = 16), the ratio decreased from 1.45 +/- 0.31 at rest to 0.91 +/- 0.24 during
      exercise (P less than 0.001) and recovered to 1.27 +/- 0.38 two minutes after
      exercise. Only three patients with coronary heart disease had clinical symptoms
      of ischemia during exercise. Repeat exercise testing in five patients after
      revascularization yielded values of 1.60 +/- 0.20 at rest and 1.62 +/- 0.18
      during exercise (P not significant), as compared with 1.51 +/- 0.19 at rest and
      1.02 +/- 0.26 during exercise before revascularization (P less than 0.02).
      CONCLUSIONS: The decrease in the ratio of phosphocreatine to ATP during hand-grip
      exercise in patients with myocardial ischemia reflects a transient imbalance
      between oxygen supply and demand in myocardium with compromised blood flow.
      Exercise testing with 31P NMR is a useful method of assessing the effect of
      ischemia on myocardial metabolism of high-energy phosphates and of monitoring the
      response to treatment.

PMID- 2233947
TI  - A newly recognized fastidious gram-negative pathogen as a cause of fever and
      bacteremia.
AB  - BACKGROUND: We identified a motile, curved, gram-negative bacillus as the cause
      of persistent fever and bacteremia in two patients with symptomatic human
      immunodeficiency virus infection. The same organism was subsequently recovered
      from a bone marrow-transplant recipient with septicemia and from two
      immunocompetent persons with week-long febrile illnesses. All the patients
      recovered after antimicrobial therapy. METHODS AND RESULTS: Primary cultures of
      blood processed by centrifugation after blood-cell lysis yielded adherent, white,
      iridescent, morphologically heterogeneous colonies in 5 to 15 days. Subcultures
      grew in four days on chocolate, charcoal-yeast extract, or blood agar. The
      organisms stained weakly with safranin and were not acid-fast. Fluorescent
      antibody tests for legionella and francisella were negative. Biochemical
      reactivity was minimal and difficult to ascertain. Agar-dilution testing revealed
      in vitro susceptibility to most antimicrobial agents tested. The cellular fatty
      acid composition of the isolates was similar, resembling that of Rochalimaea
      quintana or brucella species, but not Helicobacter pylori or species of
      campylobacter or legionella. As resolved by gel electrophoresis, cell-membrane
      preparations of all isolates contained similar proteins, with patterns that
      differed from that of R. quintana. Patterns of digestion of DNA from all isolates
      by EcoRV restriction endonuclease were virtually identical and also differed from
      that of R. quintana. On immunodiffusion, serum from one convalescent patient
      produced a line of identity with sonicates of all five isolates. CONCLUSIONS:
      This pathogen may have been unidentified until now because of its slow growth,
      broad susceptibility to antimicrobial agents, and possible requirement of blood
      cell lysis for recovery in culture. It should be sought as a cause of unexplained
      fever, especially in persons with defective cell-mediated immunity.

PMID- 2233949
TI  - Frequency and costs of diagnostic imaging in office practice--a comparison of
      self-referring and radiologist-referring physicians.
AB  - BACKGROUND: To assess possible differences in physicians' practices with respect
      to diagnostic imaging, we compared the frequency and costs of imaging
      examinations as performed by primary physicians who used imaging equipment in
      their offices (self-referring) and as ordered by physicians who always referred
      patients to radiologists (radiologist-referring). METHODS: Using a large, private
      insurance-claims data base, we analyzed 65,517 episodes of outpatient care by
      6419 physicians for acute upper respiratory symptoms, pregnancy, low back pain,
      or (in men) difficulty urinating. The respective imaging procedures studied were
      chest radiography, obstetrical ultrasonography, radiography of the lumbar spine,
      and excretory urography, cystography, or ultrasonography. RESULTS: For all four
      clinical presentations, the self-referring physicians obtained imaging
      examinations 4.0 to 4.5 times more often than the radiologist-referring
      physicians (P less than 0.0001 for all four). For chest radiography, obstetrical
      ultrasonography, and lumbar spine radiography, the self-referring physicians
      charged significantly more than the radiologists for imaging examinations of
      similar complexity (P less than 0.0001 for all three). The combination of more
      frequent imaging and higher charges resulted in mean imaging charges per episode
      of care that were 4.4 to 7.5 times higher for the self-referring physicians (P
      less than 0.0001). These results were confirmed in a separate analysis that
      controlled for the specialty of the physician. CONCLUSIONS: Physicians who do not
      refer their patients to radiologists for medical imaging use imaging examinations
      more frequently than do physicians who refer their patients to radiologists, and
      the charges are usually higher when the imaging is done by the self-referring
      physician. From our results it is not possible to determine which group of
      physicians uses imaging more appropriately.

PMID- 2233950
TI  - Blunt trauma during pregnancy.

PMID- 2233952
TI  - New opportunistic infections--more opportunities.

PMID- 2233951
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 49-1990. A 47-year-old Cape Verdean man with pericardial disease.

PMID- 2233953
TI  - Immunotherapy for allergy to insect stings.

PMID- 2233955
TI  - High-impact aerobic exercises and vertigo--a possible cause of bilateral
      vestibulopathy.

PMID- 2233954
TI  - Protecting severely abused and neglected children. An unkept promise.

PMID- 2233956
TI  - Theophylline for erythrocytosis after renal transplantation.

PMID- 2233957
TI  - Infection with a novel, unidentified mycobacterium.

PMID- 2233958
TI  - Stereotactic radiation for intracranial arteriovenous malformations.

PMID- 2233959
TI  - Postgraduate experience--the great sex divide in health sciences.

PMID- 2233960
TI  - Sudden death caused by inhalation of butane and propane.

PMID- 2233962
TI  - Seizures and other neurologic sequelae of bacterial meningitis in children.
AB  - BACKGROUND: Although the mortality rate among children with bacterial meningitis
      has decreased dramatically in recent decades, some patients are left with
      neurologic sequelae. It has not been clearly established which features of the
      acute illness predict the chronic neurologic sequelae, including late seizures or
      epilepsy. METHODS: We followed 185 infants and children prospectively during and
      after acute bacterial meningitis. The mean duration of follow-up was 8.9 years
      (range, 0.1 to 15.5). During the first six years standard neurologic examinations
      were performed; telephone interviews were conducted thereafter. RESULTS: One
      month after meningitis, 69 children (37 percent) had neurologic abnormalities.
      Many of these signs resolved within a year, leaving only 26 children (14 percent)
      with persistent deficits: 18 (10 percent) had only sensorineural hearing loss,
      and 8 (4 percent) had multiple neurologic deficits. Thirteen children (7 percent)
      had one or more late seizures not associated with fever. The presence of
      persistent neurologic deficits indicative of cerebral injury was the only
      independent predictor of late afebrile seizures (P less than 0.001). CONCLUSIONS:
      After bacterial meningitis only children with permanent neurologic deficits are
      at high risk for epilepsy. Those with normal examinations after the acute illness
      have an excellent change of escaping serious neurologic sequelae, including
      epilepsy.

PMID- 2233961
TI  - Long-term outcome after surgical repair of isolated atrial septal defect. Follow
      up at 27 to 32 years.
AB  - BACKGROUND: Atrial septal defects have been surgically correctable for more than
      30 years. The long-term survival rates among patients treated in the early era of
      cardiac surgery are poorly documented, but such data are of critical importance
      to the future medical care, employability, and insurability of these patients.
      METHODS: To determine the natural history of surgically corrected atrial septal
      defects, we studied all 123 patients who underwent repair of an isolated defect
      (ostium secundum or sinus venosus) at the Mayo Clinic between 1956 and 1960, 27
      to 32 years after the procedure. The follow-up status of all patients was
      determined by written questionnaires and telephone interviews. Hospital records
      and death certificates were obtained if interim hospitalization or death had
      occurred. RESULTS: The overall 30-year actuarial survival rate among survivors of
      the perioperative period was 74 percent, as compared with 85 percent among
      controls matched for age and sex. The perioperative mortality was 3.3 percent
      (four deaths). Actuarial 27-year survival rates among patients in the younger two
      quartiles according to age at operation (less than or equal to 11 years and 12 to
      24 years) were no different from rates among controls--97 percent and 93 percent,
      respectively. In the two older quartiles (25 to 41 years and greater than 41
      years), 27-year survival rates were significantly less (P less than 0.001)--84
      percent and 40 percent, respectively--than in controls (91 and 59 percent).
      Independent predictors of long-term survival according to multivariate analysis
      were age at operation (P less than 0.0001) and systolic pressure in the main
      pulmonary artery before operation (P less than 0.0027). When repair was performed
      in older patients, late cardiac failure, stroke, and atrial fibrillation were
      significantly more frequent. CONCLUSIONS: Among patients with surgically repaired
      atrial septal defects, those operated on before the age of 25 have an excellent
      prognosis, but older patients require careful, regular supervision.

PMID- 2233963
TI  - The sequelae of Haemophilus influenzae meningitis in school-age children.
AB  - BACKGROUND: Previous data on the consequences of Haemophilus influenzae type b
      meningitis for school-age children have been inconsistent, and much of the
      information on risk factors has been inconclusive. The present study was designed
      to evaluate the sequelae of this disease with a protocol for the comprehensive
      assessment of neuropsychological function. METHODS: Ninety-seven school-age
      children (mean age, 9.6 years), each of whom had a school-age sibling, were
      recruited from a survey of the medical records of 519 children treated for H.
      influenzae type b meningitis between 1972 and 1984 (at a mean age of 17 months)
      at the children's hospitals of Toronto, Ottawa, and Montreal. Of the 97 children,
      41 had had an acute neurologic complication. Sequelae were assessed by comparing
      the index children with their nearest siblings on the basis of standardized
      measures of cognitive, academic, and behavioral status. RESULTS: Only 14 children
      (14 percent) had persisting neurologic sequelae: sensorineural hearing loss in 11
      (unilateral in 6 and bilateral in 5), seizure disorder in 2, and hemiplegia and
      mental retardation in 1. Although the total sample of index children scored
      slightly below the siblings in reading ability, the 56 children without acute
      phase neurologic complications (58 percent) were indistinguishable from their
      siblings on all measures. The differences between the groups were small even for
      the 41 pairs in which the index child had had an acute neurologic complication
      (mean full-scale IQ, 102 for the index children vs. 109 for the siblings).
      Sequelae were also associated with lower socioeconomic status and a lower ratio
      of glucose in cerebrospinal fluid to that in blood at the time of the meningitis.
      Behavioral problems were more prominent in index boys than index girls and in
      those who were older at the time of testing, but sex and age were not related to
      cognitive or academic sequelae. CONCLUSIONS: We find a favorable prognosis for
      the majority of children who are treated for meningitis caused by H. influenzae
      type b.

PMID- 2233964
TI  - Random ciliary orientation. A cause of respiratory tract disease.

PMID- 2233966
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 50-1990. A 65-year-old man with pharyngitis, upper-airway
      obstruction, and a rash.

PMID- 2233965
TI  - Two patients with cystic fibrosis, nonsense mutations in each cystic fibrosis
      gene, and mild pulmonary disease.

PMID- 2233967
TI  - Atrial septal defect--lessons from the past, directions for the future.

PMID- 2233968
TI  - Ciliary dysmorphology and dysfunction--primary or acquired?

PMID- 2233969
TI  - Defining experimental therapy--a third-party payer's dilemma.

PMID- 2233970
TI  - Platelet hyperreactivity and prognosis in survivors of myocardial infarction.

PMID- 2233971
TI  - Case 47-1989--sexual precocity.

PMID- 2233972
TI  - Transmission of HIV by transfusion of screened blood.

PMID- 2233973
TI  - Finder's fees for research subjects.

PMID- 2233974
TI  - Legally required disclosure of conflicts of interest.

PMID- 2233975
TI  - Coelomomyces psorophorae var tasmaniensis Couch + Laird (1988)
      (Coelomomycetaeceae: Blastocladiales), a fungal pathogen of the mosquito Aedes
      australis. I: Structural changes in the outer walls of sporangia during
      germination.
AB  - The germination of sporangia in Coelomomyces psorophorae var tasmaniensis (C. p.
      tas.) is uncoordinated and thus there is a mixture of developmental stages in any
      given population. Continuous urografin gradients separated out the critical
      stages of germinating sporangia giving four bands, each band representing a
      consecutive stage of germination. These stages were investigated for changes in
      the sporangial wall using Transmission Electron Microscopy (TEM). The sporangia
      have a typical two-layered wall, an electron dense outer layer which can be
      divided into three distinct sub-layers D1, D2, and D3 and an inner electron
      transparent secondary wall. Stage 3 sporangia have an intact D1 layer on their
      outer wall. In the subsequent stages (4 & 4b) there is a progressive breakdown of
      this layer.

PMID- 2233976
TI  - Pityriasis versicolor: unicity or duality?

PMID- 2233977
TI  - Coelomomyces psorophorae var tasmaniensis Couch + Laird (1988)
      (Coelomomycetaeceae: Blastocladiales), a fungal pathogen of the mosquito Aedes
      australis. II: Nuclear changes during meiospore formation.
AB  - The presence of synaptonemal complexes were checked in dividing chromosomes as
      evidence for meiotic division in germinating sporangia. Continuous urografin
      gradients were used to separate out the various phases of germinating sporangia,
      the nuclei were removed and embedded for ultrastructural studies. Meiotic
      inhibitors were applied to germinating sporangia to retard meiotic division to
      highlight the synaptonemal complexes. At an early phase of sporangial
      differentiation dividing nuclei developed with synaptonemal complexes. Meiotic
      inhibitors and stimulators may be used to control sporangial germination for an
      induction of a high meiospore count. This may be of crucial importance in the
      utilization of Coelomomyces spp. as a biological control agent of mosquito
      species.

PMID- 2233978
TI  - Versicolorin A hemiacetal, hydroxydihydrosterigmatocystin, and aflatoxin G2 alpha
      reductase activity in extracts from Aspergillus parasiticus.
AB  - Versicolorin A hemiacetal was converted to versicolorin C in cell-free systems
      from Aspergillus parasiticus. The rate of reaction catalyzed by the 35-70%
      ammonium sulfate fraction was 0.43 nmol min-1 mg-1 with NADPH as cosubstrate and
      0.17 nmol min-1 mg-1 with NADH at 25 degrees C at pH 7.4. The product from
      incubation of 17-hydroxy-16,17-dihydrosterigmatocystin with the 35-70% ammonium
      sulfate fraction and NADPH was a polar compound which was converted to
      dihydrosterigmatocystin by 0.4 M HCl. The polar compound is proposed to be the
      14,17-hydrated open-chain derivative of dihydrosterigmatocystin. Aflatoxin G2
      alpha was also reduced in this system to a polar product tentatively identified
      as the 13,16-hydrated open-chain derivative of AFG2. The reductase activity may
      be involved in the formation of reduced intermediates and aflatoxins in cultures
      of A. parasiticus.

PMID- 2233979
TI  - Pulmonary aspergillosis due to Aspergillus terreus combined with staphylococcal
      pneumonia and hepatic candidiasis.
AB  - A female patient with systemic lupus erythematosus (SLE) developed pulmonary
      aspergillosis with staphylococcal pneumonia and hepatic candidiasis. Aspergillus
      terreus, which is a rare causative organism of pulmonary aspergillosis, was
      identified from a pulmonary lesion by culture. The aleurioconidium production, a
      characteristic of the genus Aspergillus sect. terrei, was demonstrated on short
      and irregular hyphal features in tissue sections. This report is the first of a
      combined case of pulmonary aspergillosis due to A. terreus with infections caused
      by other microorganisms.

PMID- 2233981
TI  - Fungi associated with dried fish in Sri Lanka.
AB  - The mycoflora of dried-salted fish from markets in Kandy, Sri Lanka was studied
      with emphasis on visibly spoiled dried fish. A total of 61 fungal isolates from
      25 dried-fish were isolated and identified. The most prevalent fungus was
      Aspergillus niger. Species of Aspergillus flavus, A. fumigatus, A. glaucus, A.
      restrictus, Aureobasidium spp. Basipetospora halophila (a genuinely halophilic
      fungus) Cladosporium herbarum, Gliomastix, spp., Penicillium chalybeum and
      Penicillium expansum were present. The isolated fungi did not grow in synthetic
      media containing more than 30% sodium chloride. Aureobasidium spp. and Gliomastix
      spp. did not grow on dried-fish under laboratory conditions. The protective
      exoskeleton appeared to prevent fungal growth on dried shrimp. The A. flavus
      strains isolated were not aflatoxigenic.

PMID- 2233980
TI  - Ocular rhinosporidiosis in Tamil Nadu, India.
AB  - A high incidence of ocular rhinosporidiosis in Kanyakumari district of Tamil
      Nadu, India is reported. Among the four taluks (sub-division for administration),
      highest occurrence was found in Agastheeswaram taluk (51.2%) followed by Kalkulam
      (24.4%), Thovalai (22%) and Vilavancode (2.4%). The disease occurred among both
      sexes equally and preponderance of a particular sex was not observed. The young
      adolescents were found to be more susceptible. The disease was found in all socio
      economic strata and among all communities and persons belonging to different
      religious groups. Most of the patients gave a history of bathing in muddy
      stagnant pools of water.

PMID- 2233982
TI  - Initial attachment of Candida albicans cells to buccal epithelial cells.
      Demonstration of ultrastructure with the rapid-freezing technique.
AB  - The rapid-freezing technique was applied in association with scanning and
      transmission electron microscopy to observe the initial attachment (or contact)
      of Candida albicans cells to exfoliated human buccal epithelial cells. Low
      temperature scanning electron microscopy provided detailed three-dimensional
      morphological features of the yeast-epithelial cell association; adhesion of C.
      albicans cells to host cells was primarily owing to an interaction between
      fibrillar layer of the yeast cell wall and the membrane interdigitations of the
      epithelial cells. Such a particular interconnection between the two cells was
      confirmed by the freeze-substitution fixation for transmission electron
      microscopy. These results clearly demonstrate the outermost fibrillar cell wall
      layer of C. albicans responsible for adhesion to host cells.

PMID- 2233983
TI  - Antimicrobial activity of naphthoquinones from fusaria.
AB  - Twenty-two naphthoquinone compounds isolated or derived synthetically from
      culture extracts of Fusarium solani and F. oxysporum were examined for
      antimicrobial activity. Fifteen exhibited antibiotic activity against
      Staphylococcus aureus, and 12 were active against Streptococcus pyogenes, but
      none were active at the highest rate of 128 micrograms/ml against Escherichia
      coli, Klebsiella pneumoniae, Salmonella typhi, Proteus vulgaris, Serratia
      marcescens, or Pseudomonas aeruginosa. Of 8 plant pathogenic bacteria tested
      against 11 naphthoquinones, Corynebacterium poinsettiae was inhibited by 6
      compounds, and Pseudomonas viridiflava was weakly inhibited by one. Only one of a
      group of 6 fluorescent soil pseudomonads was inhibited by one naphthoquinone.
      Antifungal activity of 10 compounds against 8 fungal plant pathogens was limited
      to inhibition of Phytophthora parasitica by one naphthopyran.

PMID- 2233985
TI  - The effect of mycophenolic acid on the cell cycle of Candida albicans.
AB  - Mycophenolic acid inhibited the growth of Candida albicans. Cultures exposed to a
      concentration of 8.4 micrograms ml-1 mycophenolic acid were found to exhibit cell
      cycle arrest with two or more buds. Nuclear staining revealed that these were
      nucleate implying a possible defect in cytokinesis. The results are discussed in
      relation to the possible mode of action of mycophenolic acid.

PMID- 2233986
TI  - Alterations in the pathogenicity of one Paracoccidioides brasiliensis isolate do
      not correlative with its in vitro growth.
AB  - The in vitro subcultivation of some microorganisms for long periods causes
      measurable loss of their pathogenicity, which can be reverted by reisolation from
      infected hosts. We compared the pathogenicity and the in vitro growth pattern of
      one P. brasiliensis isolate (Pb 18) in its yeast phase, using the following
      samples: 1) The original pathogenic Pb 18 (OP). 2) Pb 18 attenuated by continuous
      in vitro subcultivation (AT). 3) Pb 18 (AT) reisolated from susceptible B10.A
      mice (RS). 4) Pb 18 (AT) reisolated from resistant A/SN mice (RR). Pathogenicity
      was evaluated by anatomopathology and mortality of mice infected i.p. with 5 x
      10(6) fungi. Median survival times of mice infected with OP ranged from 74 to 117
      days during the first 51 months of subculturing; with more cycles of subculturing
      the median survival time increased, reaching 250 days at the 64th month. This
      indicated decreasing virulence of OP during this period of subculturing. Survival
      of mice infected with RS and RR was respectively 112 and 123 days, which is
      similar to the behavior of the OP variant. The in vitro growth curve profile of
      RR showed significantly higher numbers of total and viable yeasts than the other
      studied variant. These results show that: 1) Pb 18 isolate loses its
      pathogenicity by continuous subcultivation. This phenomenon is reverted by
      reisolation from mice, independently from their susceptibility to the fungus; 2)
      the in vitro growth patterns of Pb 18 do not correlate with alterations in
      pathogenicity but are influenced by the host's environment.

PMID- 2233988
TI  - [The characterization of microbial lipases. 1. The determination of lipase
      activity].
AB  - In the selection of an appropriate method for activity determination of lipases
      existing technical equipment, kind of enzymes, number of samples investigated
      (e.g. in routine analysis), and expected sensitivity range have to be taken into
      account. Titrimetric methods and above all copper salt methods with their high
      detection sensitivity are the most suitable procedures for activity determination
      of lipases used in laboratories and institutions without equipment for
      radiochemical analysis.

PMID- 2233989
TI  - Drugs of abuse: chemistry, pharmacology, immunology, and AIDS. Introduction.

PMID- 2233987
TI  - Effect of the ingestion of an extract from Bauhinia monandra seeds on rats.
AB  - Bauhinia monandra is a leguminous plant that would be used in human nutrition,
      however it shows a high hemagglutinating activity against trypsin-treated
      erythrocytes of rabbit, 2 ml of a NaCl-solution extract of the seeds was given to
      a group of rats for 10 days. Intestinal disaccharidase activity was determined.
      Histopathological and histochemical examinations were also performed. Lectins
      from Bauhinia monandra seeds did not cause any visible intestinal damage even
      when they seem to be able to bind to the enterocyte brush border. The low
      disaccharidase activity in the membrane and enterocyte fractions, which represent
      the enzyme synthesis level, indicates that lectins could reduce the synthesis of
      these enzymes rather than inhibit the active sites of the enzymes. This effect
      could be in turn related with the binding action of lectins, because no effect of
      the autoclaved extract on the disaccharidase activity was observed.

PMID- 2233984
TI  - Review of animal mycoses in Australia.
AB  - This review covers the available literature on the mycoses of animals in
      Australia since the last review published in 1967. Of the cutaneous infections,
      dermatophytoses have been recorded in a wide range of animals: cattle, horses,
      goats, pigs, sheep, cats, dogs, mice, guinea-pigs, rabbits, a lion, kangaroos, a
      camel, koalas and wallabies. These infections were caused by several species and
      varieties of the genera, Microsporum and Trichophyton. Eight agents of ringworms
      have been recorded in the horse. Two subcutaneous mycoses, phaeohyphomycosis and
      sporotrichosis have been reported. Phaeohyphomycosis is becoming more common but
      sporotrichosis is rare having been recorded only once in a cat. The following
      systemic mycoses have been recorded: adiaspiromycosis, aspergillosis,
      candidiasis, cryptococcosis, dactylariosis, fusariomycosis, histoplasmosis,
      miscellaneous mycoses, mycotic abortion and related conditions, zygomycosis,
      pythiosis, protothecosis and green algal infections. Cryptococcosis has affected
      11 different animal species. Mycotic abortion is a serious disease in Victoria.
      Pythiosis of horses has been extensively studied in northern Australia.

PMID- 2233990
TI  - Drugs of abuse: chemistry, pharmacology, immunology, and AIDS. A technical
      review. October 31-November 2, 1988, Rockville, MD. Proceedings.

PMID- 2233991
TI  - Cocaine receptor--design of ligands.

PMID- 2233992
TI  - Immunomodulatory effects of chronic morphine treatment: pharmacologic and
      mechanistic studies.

PMID- 2233993
TI  - Morphine-induced immune modulation: does it predispose to HIV infection?

PMID- 2233994
TI  - A murine retrovirus model for studies of the role of cofactors and ethanol in
      AIDS development.

PMID- 2233995
TI  - Drug abuse and AIDS: causes for the connection.

PMID- 2233997
TI  - Novel thebainelike morphinandienes and their Diels-Alder adducts.

PMID- 2233996
TI  - Immune function in heroin addicts and former heroin addicts in treatment: pre-
      and post-AIDS epidemic.
AB  - These studies suggest that specific opiate receptors are not involved
      significantly in modulating NK-cell activity by any direct effect. The role
      normally played by the endogenous opioids in directly modulating NK-cell
      cytotoxic activity may be minimal and certainly is not a clinically relevant
      controlling factor. These findings also suggest that the repeatedly observed
      lowering of NK-cell activity in untreated heroin addicts is not due to a direct
      drug effect. It may be due, however, to an indirect drug effect, possibly by way
      of altering neuroendocrine function, which we and others have shown predictably
      occurs during cycles of heroin addiction, and which, as discussed above, has been
      shown to become normalized during steady-dose, long-term, methadone-maintenance
      treatment. The lowering of NK-cell activity in heroin addicts may also be due
      primarily to the use of unsterile needles, with exposure to and infection with
      multiple diseases as well as injection of many foreign substances. Clinical
      studies of all the important immunological indices will have to be carried out in
      well-characterized human populations, including normal healthy control subjects,
      drug abusers, drug addicts, and former drug addicts in defined treatment status,
      before the actual roles of drugs of abuse or drugs used to treat drug abuse in
      immune function in humans will be fully understood.

PMID- 2233999
TI  - Opiate antagonists and anti-HIV agents.

PMID- 2233998
TI  - Effect of fluorine substitution on the anti-HIV activity of dideoxynucleosides.

PMID- 2234000
TI  - Recovery from opiate addiction without treatment: a summary.

PMID- 2234001
TI  - The role of ethnography in substance abuse research and public policy: historical
      precedent and future prospects.

PMID- 2234002
TI  - Women and addiction: process, treatment, and outcome.

PMID- 2234003
TI  - Chicano intravenous drug users.

PMID- 2234004
TI  - The German Bridge: a street hookers' strip in the Amsterdam Red Light District.

PMID- 2234005
TI  - Methodological and design issues: techniques for assessing the representatives of
      snowball samples.

PMID- 2234007
TI  - Requirements for inductive analysis.

PMID- 2234006
TI  - Identifying and gaining access to hidden populations.

PMID- 2234008
TI  - Computer analysis of qualitative data.

PMID- 2234009
TI  - Ethnographic field stations.
AB  - Ethnographic field stations are not a substitute for traditional ethnography,
      because they provide an "unnatural" setting for research interaction and
      observation to take place. However, they do provide perhaps the optimal setting
      for qualitative and quantitative methodologies to be undertaken in a single
      research effort. In this sense, they are critically important for advancing our
      knowledge about drug abusers and their behaviors.

PMID- 2234010
TI  - Ethnographic research on hidden populations: penetrating the drug world.

PMID- 2234011
TI  - Building blocks.

PMID- 2234012
TI  - Which dressing?

PMID- 2234013
TI  - A trialist's perspective of conducting research in ICU.

PMID- 2234014
TI  - The role of cancer nursing societies in cancer programmes.

PMID- 2234016
TI  - Copying and copyright.

PMID- 2234015
TI  - The planning of hospitals. Part III: Planning the New Durban Academic Hospital.

PMID- 2234017
TI  - AIDS scan.

PMID- 2234018
TI  - Malaria the forgotten disease?

PMID- 2234020
TI  - AIDS scan.

PMID- 2234019
TI  - The victims of violence.

PMID- 2234021
TI  - A strange caesarean section.

PMID- 2234023
TI  - The menopause.

PMID- 2234022
TI  - The nursing care of AIDS patients: caring, not curing.
AB  - In sum, examination of the complex issues surrounding AIDS brings the disease
      into clearer focus for the individual health care professional. One of the
      benefits is that AIDS is causing the nursing profession to re-examine its role in
      health care. Absence of a cure is not tantamount to having nothing more to offer.
      In fact, care rather than cure, becomes imperative. The highest quality care
      possible for all patients irrespective of their background, colour, religion,
      sexual orientation, diagnosis and prognosis, is a priority. Hopefully everyone in
      health care and society at large will learn valuable lessons from the AIDS
      experience. In this context, the role of health care professionals should be that
      of student learning from the patient.

PMID- 2234024
TI  - Leadership and the professional nurse.

PMID- 2234025
TI  - Suntanning? Don't take a chance--take care.

PMID- 2234026
TI  - The critical care nursing issue: an update.

PMID- 2234027
TI  - Transcultural nursing.

PMID- 2234028
TI  - [Health services in the Homelands of the East Transvaal].

PMID- 2234029
TI  - Cross-cultural perspectives in breast-feeding.

PMID- 2234030
TI  - Labour pains.

PMID- 2234031
TI  - Re-examining the nursing process: Part 1.

PMID- 2234032
TI  - Electrosurgery--Part 3. Uses of electrosurgery.

PMID- 2234033
TI  - A gift.

PMID- 2234034
TI  - Day surgery.

PMID- 2234035
TI  - Shared experience: post-registration theatre courses and common core learning.

PMID- 2234036
TI  - Respiration monitoring in the recovery unit.

PMID- 2234037
TI  - Life without swab racks.

PMID- 2234038
TI  - Ethics--a proper study for the nurse.

PMID- 2234039
TI  - Some important medical law cases of interest to theatre nurses.

PMID- 2234040
TI  - Surgical cement friend or foe?

PMID- 2234041
TI  - Electrosurgery--Part II. The principles of electrosurgery.

PMID- 2234042
TI  - Science defeats all odds in US budget.

PMID- 2234043
TI  - AIDS research. NIH digging in.

PMID- 2234044
TI  - Research quality. David, meet Goliath.

PMID- 2234045
TI  - Contraception. Equality for the sexes?

PMID- 2234046
TI  - Human genome. A different approach.

PMID- 2234047
TI  - Cancer research. Uncharitable actions.

PMID- 2234048
TI  - Recipe for safer sauces.

PMID- 2234049
TI  - Overall mortality and cancer mortality around French nuclear sites.
AB  - Higher than expected mortality from leukaemia has been observed in the population
      under age 25 living around Sellafield and Dounreay, nuclear reprocessing plants
      in the United Kingdom. We report the results of a similar study for the
      population residing around nuclear sites in France. The number of leukaemia
      deaths was 58, comparable to the 62 in control areas, and slightly less than the
      67 expected from national mortality statistics. Twelve deaths due to Hodgkin's
      disease were observed around nuclear sites; this is about twice the number of
      Hodgkin's deaths observed in control areas and twice the number expected from
      national mortality statistics. This observation must, however, be interpreted in
      light of the fact that several causes of deaths were studied, increasing the play
      of chance.

PMID- 2234050
TI  - X-ray analysis of beta B2-crystallin and evolution of oligomeric lens proteins.
AB  - The beta, gamma-crystallins form a class of homologous proteins in the eye lens.
      Each gamma-crystallin comprises four topologically equivalent, Greek key motifs;
      pairs of motifs are organized around a local dyad to give domains and two similar
      domains are in turn related by a further local dyad. Sequence comparisons and
      model building predicted that hetero-oligomeric beta-crystallins also had
      internally quadruplicated subunits, but with extensions at the N and C termini,
      indicating that beta, gamma-crystallins evolved in two duplication steps from an
      ancestral protein folded as a Greek key. We report here the X-ray analysis at 2.1
      A resolution of beta B2-crystallin homodimer which shows that the connecting
      peptide is extended and the two domains separated in a way quite unlike gamma
      crystallin. Domain interactions analogous to those within monomeric gamma
      crystallin are intermolecular and related by a crystallographic dyad in the beta
      B2-crystallin dimer. This shows how oligomers can evolve by conserving an
      interface rather than connectivity. A further interaction between dimers suggests
      a model for more complex aggregates of beta-crystallin in the lens.

PMID- 2234051
TI  - Computer modelling at the single-neuron level.

PMID- 2234052
TI  - Xeroderma pigmentosum. A gene for tumour prevention.

PMID- 2234053
TI  - Mitosis. The kinetochore in captivity.

PMID- 2234054
TI  - Human genetics. Bone disease cracks genetics.

PMID- 2234056
TI  - Differences in hair and fleece loss.

PMID- 2234055
TI  - Morbillivirus in dolphins.

PMID- 2234058
TI  - UK Research Councils. Storm over funding policy.

PMID- 2234057
TI  - Invariant chain distinguishes between the exogenous and endogenous antigen
      presentation pathways.
AB  - Class I MHC molecules acquire peptides from endogenously synthesized proteins,
      whereas class II antigens present peptides derived from extracellular compartment
      molecules. This dichotomy is due to the fact that the invariant chain associates
      with class II molecules in the endoplasmic reticulum, preventing binding of
      endogenous peptides. The mutually exclusive binding of peptide and invariant
      chain to class II molecules suggests that the invariant chain might play a part
      in autoimmune disease.

PMID- 2234060
TI  - Genetic testing. Still over the horizon.

PMID- 2234059
TI  - Stimulation of the phosphatidylinositol pathway can induce T-cell activation.
AB  - The T-cell antigen receptor (TCR) regulates two signal transduction pathways: the
      phosphatidylinositol (PtdIns) and tyrosine kinase pathways. Stimulation of T
      cells with antigen or anti-TCR monoclonal antibodies induces an increase in
      inositol phosphates and diacylglycerol, the second messengers responsible for the
      mobilization of cytoplasmic free calcium and activation of protein kinase C-4.
      The TCR also activates a tyrosine kinase that is not intrinsic to the TCR. The
      relationship between these two signal transduction pathways and their
      contribution to later T-cell responses is unclear. Studies using variants of a
      murine hybridoma suggested that the PtdIns pathway might not be necessary for or
      be involved in regulating interleukin-2 (IL-2) production. To address the
      relationship between later T-cell responses and the early biochemical signals, we
      investigated the ability of a heterologous receptor with defined signal
      transduction function to induce T-cell activation. The human muscarinic subtype-1
      receptor (HM1), which elicits PtdIns metabolism in neuronal cells through a G
      protein-coupled mechanism, also functionally activates this pathway when
      expressed in the T-cell line Jurkat-derived host, J-HM1-2.2 (ref.8). We show here
      that stimulation of HM1 alone induced IL-2 production and IL-2 receptor alpha
      chain expression. HM1 does not induce the tyrosine kinase pathway, suggesting
      that this pathway does not directly influence later T cell-activation responses.
      Instead, our studies indicate that activation of the PtdIns pathway is probably
      sufficient to induce later T-cell responses.

PMID- 2234061
TI  - Analysis of a human DNA excision repair gene involved in group A xeroderma
      pigmentosum and containing a zinc-finger domain.
AB  - Xeroderma pigmentosum (XP) is an autosomal recessive disease, characterized by a
      high incidence of sunlight-induced skin cancer. Cells from people with this
      condition are hypersensitive to ultraviolet because of a defect in DNA repair.
      There are nine genetic complementation groups of XP, groups A-H and a variant. We
      have cloned the mouse DNA repair gene that complements the defect of group A, the
      XPAC gene. Here we report molecular cloning of human and mouse XPAC complementary
      DNAs. Expression of XPAC cDNA confers ultraviolet-resistance on several group A
      cell lines, but not on lines of other XP groups. Almost all group A lines tested
      showed abnormality or absence of XPAC messenger RNAs. These results indicate that
      a defective XPAC gene causes group A XP. The human and mouse XPAC genes are
      located on chromosome 9q34.1 and chromosome 4C2, respectively. Human XPAC cDNA
      encodes a protein of 273 amino acids with a zinc-finger motif.

PMID- 2234062
TI  - Cloning of a mitogen-inducible gene encoding a kappa B DNA-binding protein with
      homology to the rel oncogene and to cell-cycle motifs.
AB  - We have cloned and characterized a mitogen-inducible gene isolated from human T
      cells that predicts a protein of 968 amino acids. The amino-terminal domain has
      regions homologous to the oncogene rel and to the developmentally important gene
      dorsal of Drosophila. The carboxy-terminal domain contains repeat structures
      found in a variety of proteins that are involved in cell-cycle control of yeast
      and in tissue differentiation in Drosophila and Ceanorhabditis elegans, as well
      as in the putative human oncogene bcl-3 and in the ankyrin protein. A truncated
      form of the product of this gene translated in vitro is a DNA-binding protein
      which interacts specifically with the kappa B binding site found in many
      inducible genes, including the enhancer in human immunodeficiency virus. This
      gene is yet another in a growing list of important regulatory molecules whose
      expression is transcriptionally induced upon cellular activation.

PMID- 2234063
TI  - Embryo research. Germany turns clock back.

PMID- 2234064
TI  - EMBO. Fellowships for East.

PMID- 2234065
TI  - Scientific misconduct. Chained to the bench.

PMID- 2234066
TI  - TATA-dependent and TATA-independent transcription at the HIS4 gene of yeast.
AB  - Two systems of transcription factors stimulate expression of the HIS4 gene of
      Saccharomyces cerevisiae. High-level transcription induced by amino-acid
      starvation is mediated by Gcn4(ref.1) and basal transcription is mediated jointly
      by the factors Bas1 and Bas2 (Pho2). We now show that wild-type Gcn4 requires the
      TATA element for correct messenger RNA start-site selection, but Gcn4 derivatives
      with deletions in the activation domain activate HIS4 transcription at the
      correct mRNA start site (I) in the absence of the TATA element. Gcn4 derivatives
      that activate TATA-independent transcription show low levels of activation.
      Similarly, we find that low levels of transcription by Bas1/Bas2 are TATA
      independent, whereas high levels are TATA-dependent. These results show that the
      HIS4 TATA element is required for mRNA start-site selection only under conditions
      of high-level transcription.

PMID- 2234067
TI  - A downstream initiation element required for efficient TATA box binding and in
      vitro function of TFIID.
AB  - The gfa gene encodes glial fibrillary acidic protein, an intermediate filament
      protein expressed in glial cells. In vitro transcription analysis has shown that
      the human gfa promoter contains two initiation elements that can independently
      specify the transcription startpoint. One of the elements is a TATA box 25 base
      pairs (bp) upstream from the transcription startpoint; the other is located
      between 10 and 50 bp downstream from the transcription initiation site. We have
      now shown by transfection that both elements are required for efficient
      transcription in cultured cells. A partially purified natural human TATA box
      binding factor (TFIID) from HeLa cells gave footprints that extended from
      upstream of the TATA box through the downstream initiator. Deletion of the
      downstream initiator inhibited both TFIID binding to the TATA box and
      transcription in vitro. In contrast to natural human TFIID, clone human and yeast
      TFIIDs expressed in bacteria gave footprints covering only the TATA box region,
      although hypersensitive sites were observed in the downstream region. The cloned
      TFIIDs also showed less dependence than natural human TFIID on the downstream
      initiator for both TATA box binding and in vitro transcription. These results
      suggest that natural human TFIID contains an additional component(s) that
      contribute(s) to stable TFIID binding and effective transcription by interacting
      with the downstream initiator.

PMID- 2234069
TI  - Bills pass at last minute.

PMID- 2234068
TI  - Product review. New mammalian expression vectors.

PMID- 2234071
TI  - Public health in Italy.

PMID- 2234070
TI  - Battle over censorship.

PMID- 2234072
TI  - Gene targeting. How efficient can you get?

PMID- 2234073
TI  - Vision. Knowing where you're going.

PMID- 2234074
TI  - Parasites in Drosophila embryos.

PMID- 2234075
TI  - Role of nerves in hypertension.

PMID- 2234076
TI  - When are parasites clonal?

PMID- 2234077
TI  - Requirement for hsp70 in the mitochondrial matrix for translocation and folding
      of precursor proteins.
AB  - By analysis of a temperature-sensitive yeast mutant, a heat-shock protein in the
      matrix of mitochondria, mitochondrial hsp70 (Ssc1p), is found to be involved both
      in translocation of nuclear-encoded precursor proteins across the mitochondrial
      membranes and in (re)folding of imported proteins in the matrix.

PMID- 2234078
TI  - The role of disparity-sensitive cortical neurons in signalling the direction of
      self-motion.
AB  - Movement of an observer through the environment generates motion on the retina.
      This optic flow provides information about the direction of self-motion, but only
      if it contains differential motion of elements at different depths. If the
      observer tracks a stationary object while moving in a direction different from
      his line of sight, the images of objects in the foreground and in the background
      move in opposite directions. We have found neurons in the cerebral cortex of
      monkeys that prefer one direction of motion when the disparity of a stimulus
      corresponds to foreground motion and prefer the opposite direction when the
      disparity corresponds to background motion. We propose that these neurons
      contribute a signal about the direction of self-motion.

PMID- 2234079
TI  - Reduced levels of hsp90 compromise steroid receptor action in vivo.
AB  - Signalling by steroid hormones is mediated by receptor proteins that bind
      hormonal ligands and regulate the transcription of specific genes. The heat-shock
      protein hsp90 seems to associate selectively with unliganded receptors
      (aporeceptors), but it has not been determined whether this interaction affects
      receptor function in vivo. To address the role of hsp90, we have taken advantage
      of the capacity of mammalian steroid receptors to function in yeast. We
      constructed a strain of Saccharomyces cerevisiae in which hsp90 expression was
      regulatable and could be reduced more than 20-fold relative to wild type. At low
      levels of hsp90, aporeceptors seem to be mostly hsp90-free, yet fail to enhance
      transcription; on hormone addition, the receptors are activated but with markedly
      reduced efficiency. Thus hsp90 does not inhibit receptor function solely by
      steric interference; rather, hsp90 seems to facilitate the subsequent response of
      the aporeceptor to the hormonal signal. This is the first biological evidence
      that hsp90 acts in the signal transduction pathway for steroid receptors.

PMID- 2234080
TI  - Limitation of the size of the vulval primordium of Caenorhabditis elegans by lin
      15 expression in surrounding hypodermis.
AB  - In the nematode Caenorhabditis elegans six hypodermal cells, the vulval precursor
      cells, are each competent to generate vulval cells. Normally only the three
      nearest precursor cells to the uterine anchor cell generate the vulva (22
      nuclei), while the three others fuse with the non-specialized hypodermal
      syncytium (hyp7) surrounding each precursor cell and covering the body. Without
      an inductive signal from the anchor cell, all six vulval precursor cells fuse
      with hyp7 and no vulva is formed. But without activity of the vulval
      determination gene lin-15(+), all six cells undergo vulval divisions whether the
      anchor cell is present or not. Using mosaic analysis, we demonstrate here that
      lin-15(+) expression is necessary in cells other than the vulval precursor cells
      or the anchor cell, most probably in the hyp7 syncytium. We propose that lin
      15(+) is active in hyp7 in order to repress an intrinsic vulval program in the
      precursor cells. The inductive signal from the anchor cell counteracts this
      repression for three precursor cells, allowing them to generate vulval cells.
      Such a two-signal (repressor/derepressor) mechanism may operate in other cases of
      tissue induction.

PMID- 2234081
TI  - Gene replacement in parasitic protozoa.
AB  - Trypanosomatid protozoa frequently cause severe diseases in humans. Many
      molecules likely to have a role during the infectious cycle have been identified,
      yet proof of their function is often lacking. We describe studies in Leishmania
      major of homologous gene targeting, a powerful method for testing gene function
      in other organisms. Following introduction of a construct containing
      dihydrofolate reductase-thymidylate synthase (dhfr-ts) flanking sequences fused
      to neomycin phosphotransferase, 45% of the colonies contained the planned
      homologous replacement; this frequency rose to nearly 100% in transfections using
      low amounts of DNA. Integrative transfection in Leishmania thus resembles that of
      Saccharomyces cerevisiae in giving predominantly homologous events. To facilitate
      studies of folate metabolism and chemotherapy the sole dhfr-ts copy in a
      heterozygous deletion line was replaced, yielding lines that were functionally
      DHFR-TS-. Although most genes are diploid in trypanosomatids, methods exploiting
      the high frequency of homologous recombination should permit complete replacement
      of any parasite gene.

PMID- 2234082
TI  - An unusually large multifunctional polypeptide in the erythromycin-producing
      polyketide synthase of Saccharopolyspora erythraea.
AB  - Erythromycin A, a clinically important polyketide antibiotic, is produced by the
      Gram-positive bacterium Saccharopolyspora erythraea. In an arrangement that seems
      to be generally true of antibiotic biosynthetic genes in Streptomyces and related
      bacteria like S. erythraea, the ery genes encoding the biosynthetic pathway to
      erythromycin are clustered around the gene (ermE) that confers self-resistance on
      S. erythraea. The aglycone core of erythromycin A is derived from one propionyl
      CoA and six methylmalonyl-CoA units, which are incorporated head-to-tail into the
      growing polyketide chain, in a process similar to that of fatty-acid
      biosynthesis, to generate a macrolide intermediate, 6-deoxyerythronolide B. 6
      Deoxyerythronolide B is converted into erythromycin A through the action of
      specific hydroxylases, glycosyltransferases and a methyltransferase. We report
      here the analysis of about 10 kilobases of DNA from S. erythraea, cloned by
      chromosome 'walking' outwards from the erythromycin-resistance determinant ermE,
      and previously shown to be essential for erythromycin biosynthesis. Partial
      sequencing of this region indicates that it encodes the synthase. Our results
      confirm this, and reveal a novel organization of the erythromycin-producing
      polyketide synthase, which provides further insight into the mechanism of chain
      assembly.

PMID- 2234083
TI  - Bidirectional incompatibility between conspecific populations of Drosophila
      simulans.
AB  - Cytoplasmic incompatibility (CI) describes the phenomenon whereby eggs fertilized
      by sperm from insects infected with a rickettsial endosymbiont fail to hatch.
      Unidirectional CI between conspecific populations of insects is a well documented
      phenomenon. Bidirectional CI has, however, only been described in mosquito
      populations, and recently between closely related species of parasitic wasps,
      where it is of interest as both an unusual form of reproductive isolation and as
      a potential means of insect population suppression. Here we report on the first
      known example of bidirectional CI between conspecific populations of Drosophila
      simulans. Further, we show that defects as early as the first cleavage division
      are associated with CI. This observation suggests that the cellular basis of CI
      involves disruption of processes before or during zygote formation and that CI
      arises from defects in the structure and/or function of the sperm during
      fertilization.

PMID- 2234084
TI  - French research. Pleas made for science spy.

PMID- 2234086
TI  - Bush veto fuels orphan drug act uncertainties.

PMID- 2234085
TI  - Belt-tightening at MRC.

PMID- 2234087
TI  - The buck stops with government.

PMID- 2234088
TI  - Protein conformation. Hinge-bending and folding.

PMID- 2234089
TI  - Dental caution.

PMID- 2234090
TI  - Molecular structure of F-actin and location of surface binding sites.
AB  - Comparisons of three-dimensional maps of vertebrate muscle thin filaments
      obtained by cryo-electron microscopy and image analysis, reveal the molecular
      structure of F-actin, the location of the C terminus of the monomer and the
      positions of the binding sites of tropomyosin, the myosin head and the N-terminal
      portion of the myosin A1 light chain on the filament. These data provide strong
      constraints for evaluating models built from the atomic structure of the monomer
      and the subsequent identification of molecular contacts.

PMID- 2234091
TI  - New Sivapithecus humeri from Pakistan and the relationship of Sivapithecus and
      Pongo.
AB  - New humeri of two species of the Miocene hominoid Sivapithecus are described from
      near Chinji in Pakistan from between approximately 9 and 11 Myr ago.
      Sivapithecus, a middle and late Miocene hominoid from Turkey and Indo-Pakistan,
      is overall unlike any living hominoid, although facial-palatal similarities to
      the extant orangoutan, Pongo, have been used to support a hypothesis of close
      relationship. Living hominoids have postcranial similarities assumed to be shared
      derived, among them features of the proximal humerus. However, the new
      Sivapithecus proximal humeri differ from those of living hominoids, supporting an
      alternative hypothesis in which Sivapithecus and Pongo are not closely related.
      It is not clear how to choose between these incompatible hypotheses.

PMID- 2234092
TI  - Cellular peptide composition governed by major histocompatibility complex class I
      molecules.
AB  - Major histocompatibility complex (MHC) class I molecules present peptides derived
      from cellular proteins to cytotoxic T lymphocytes (CTLs), which check these
      peptides for abnormal features. How such peptides arise in the cell is not known.
      Here we show that the MHC molecules themselves are substantially involved in
      determining which peptides occur intracellularly: normal mouse spleen cells
      identical at all genes but MHC class I express different patterns of peptides
      derived from cellular non-MHC proteins. We suggest several models to explain this
      influence of MHC class I molecules on cellular peptide composition.

PMID- 2234093
TI  - Structure, expression and function of a schwannoma-derived growth factor.
AB  - During the development of the nervous system, cells require growth factors that
      regulate their division and survival. To identify new growth factors, serum-free
      growth-conditioned media from many clonal cell lines were screened for the
      presence of mitogens for central nervous system glial cells. A cell line
      secreting a potent glial mitogen was established from a tumour (or 'schwannoma')
      derived from the sheath of the sciatic nerve. The cells of the tumour, named JS1
      cells, were adapted to clonal culture and identified as Schwann cells. Schwann
      cells secrete an autocrine mitogen and human schwannoma extracts have mitogenic
      activity on glial cells. Until now, neither mitogen has been purified. Here we
      report the purification and characterization of a mitogenic molecule, designated
      schwannoma-derived growth factor (SDGF), from the growth-conditioned medium of
      the JS1 Schwann cell line. SDGF belongs to the epidermal growth factor family,
      and is an autocrine growth factor as well as a mitogen for astrocytes, Schwann
      cells and fibroblasts.

PMID- 2234094
TI  - A mutant T4 lysozyme displays five different crystal conformations.
AB  - Phage T4 lysozyme consists of two domains between which is formed the active-site
      cleft of the enzyme. The crystallographically determined thermal displacement
      parameters for the protein suggested that the amino terminal of the two domains
      undergoes 'hinge-bending' motion about an axis passing through the waist of the
      molecule. Such conformational mobility may be important in allowing access of
      substrates to the active site of the enzyme. We report here a crystallographic
      study of a mutant T4 lysozyme which demonstrates further the conformational
      flexibility of the protein. A mutant form of the enzyme with a methionine residue
      (Met 6) replaced by isoleucine crystallizes with four independent molecules in
      the crystal lattice. These four molecules have distinctly different
      conformations. The mutant protein can also crystallize in standard form with a
      structure very similar to the wild-type protein. Thus the mutant protein can
      adopt five different crystal conformations. The isoleucine for methionine
      substitution at the intersection of the two domains of T4 lysozyme apparently
      enhances the hinge-bending motion presumed to occur in the wild-type protein,
      without significantly affecting the catalytic activity or thermal stability of
      the protein.

PMID- 2234095
TI  - Analysis of the 5-HT receptor in rabbit saphenous vein exemplifies the problems
      of using exclusion criteria for receptor classification.
AB  - 5-Hydroxytryptamine (5-HT) contracts ring preparations of rabbit saphenous vein
      via direct and indirect components, the latter being compatible with a "tyramine
      like" action at sympathetic nerve terminals. Here an attempt was made to
      establish the identity of the receptor mediating contraction directly, in terms
      of the currently accepted proposals (Bradley et al. 1986). Results with agonists
      suggested 5-HT1-like receptor activation: methylsergide behaved as a partial
      agonist with microcolar affinity and 5-HT effects were mimicked by 5
      carboxamidotryptamine (5-CT) and GR43175. The agonist potency order was 5-CT
      greater than 5-HT greater than methysergide greater than or equal to GR43175, the
      same as that reported at the 5-HT1-like receptor in dog saphenous vein (Feniuk et
      al. 1985; Humphrey et al. 1988). Consistent with this, 5-HT effects were
      resistant to blockade by the selective 5-HT3 receptor antagonist MDL72222 (1.0
      mumol/l). In contrast, methiothepin (0.01-0.3 mumol/l), ketanserin (0.3-30.0
      mumol/l) and spiperone (0.3-30.0 mumol/l) each produced surmountable antagonism
      which, although competitive in nature only for methiothepin (pKB = 9.45 +/- 0.09,
      17 d.f.), implied 5-HT2 receptor involvement. The possibility that these
      discrepancies resulted from mixed populations of 5-HT1-like and 5-HT2 receptors
      can be excluded because; 1). Ketanserin and spiperone blocked the actions of 5-HT
      and the selective 5-HT1-like receptor agonist GR43175 with equal facility and 2).
      Responses to all of the agonists studied were similarly antagonised by flesinoxan
      (pKB approximately 6.4), a simple competitive antagonist at the receptor in
      rabbit saphenous vein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234096
TI  - Actions of non-peptide ergot alkaloids at 5-HT1-like and 5-HT2 receptors
      mediating vascular smooth muscle contraction.
AB  - This report describes the actions of the non-peptide ergot alkaloids
      methysergide, methylergometrine and ergometrine at two types of 5-HT receptor
      mediating vascular contraction; the well established 5-HT2 receptor in rabbit
      aorta and a non-5-HT2 receptor in rabbit saphenous vein which resembles the 5-HT1
      like receptor in dog saphenous vein. In the rabbit aorta ergometrine (1 mumol/l)
      and methylergometrine (0.3 mumol/l), but not methysergide, produced small
      contractions (14% and 7% respectively of the maximal response to 5-HT). This
      contraction was not related to activation of 5-HT2 receptors since it was
      resistant to blockade by ketanserin (0.3 mumol/l). When examined as antagonists
      of 5-HT-induced contractions of rabbit aorta, each ergot displayed nanomolar
      affinity at the 5-HT2 receptor but only methysergide behaved as a simple
      competitive antagonist (pKB = 8.25). Methylergometrine and ergometrine produced
      surmountable blockade which was accompanied by a non-parallel displacement of the
      5-HT concentration-effect curves. The selective 5-HT1-like receptor agonist
      GR43175 (less than or equal to 30 mumol/l) was devoid of affinity at the 5-HT2
      receptor in rabbit aorta. In the rabbit saphenous vein each of the ergots
      produced concentration-dependent contractions which resulted in overtly biphasic
      concentration-effect curves. Only the first phase of contraction mimicked the
      effects of 5-HT and GR43175 since contractions were not blocked by MDL 72222 (1
      mumol/l), but were surmountably antagonised by methiothepin (10 nmol/l),
      ketanserin (0.3 mumol/l) and spiperone (0.3 mumol/l).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2234097
TI  - The effects of ageing on prejunctional 5-hydroxytryptamine receptors in the rat
      vas deferens.
AB  - The prejunctional inhibitory effects of a series of 5-HT1 receptor agonists were
      examined against the isometric contraction of epididymal portions of rat vas
      deferens evoked by single stimulus pulses in the presence of nifedipine (10
      mumol/l). The 5-HT1A ligand flesinoxan produced inhibition of contractions which
      was not inhibited by cyanopindolol or yohimbine. However, the prejunctional
      inhibitory concentration response curve for the 5-HT1 agonist 5
      carboxamidotryptamine (5-CT) was biphasic in tissues from 1.5 month old animals
      but monophasic in tissues from 24 months animals. Cyanopindolol (1 mumol/l)
      antagonised the inhibitory effects of 5-CT in tissues from 1.5 and 3 month
      animals but not in tissues from 8 or 24 months animals. Inhibitory actions of 5
      CT were not prevented by pretreating animals with pertussis toxin (6
      micrograms/kg i.v.), a dose which abolished the negative inotropic response to
      acetylcholine in rat left atria. It is concluded that the nerve terminals of vas
      deferens from 1.5 month old animals contain both 5-HT1B and other as yet
      unclassified 5-HT1 receptors, but that this 5-HT1B-mediated response is lost in
      maturation and ageing.

PMID- 2234098
TI  - Muscarinic inhibition of acetylcholine release from a novel in vitro preparation
      of the guinea-pig trachea.
AB  - An isolated preparation of the guinea-pig trachea is described which allows the
      simultaneous measurement of acetylcholine release and smooth muscle contraction.
      Incubation of the epithelium-free preparation with [3H]choline resulted in the
      formation of [3H]acetylcholine. Electrical stimulation caused the release of
      [3H]acetylcholine and a contractile response. Tetrodotoxin and omission of
      calcium from the medium abolished both the evoked release and contractions. The
      muscarinic agonists oxotremorine, carbachol and pilocarpine concentration
      dependently inhibited the electrically evoked acetylcholine release and
      contracted the tracheal smooth muscle. Pre- and postsynaptic EC50 values for a
      given agonist were not different. Atropine (100 nmol/l) significantly facilitated
      the evoked acetylcholine release. A concentration of 10 nmol/l atropine did not
      change the evoked release but antagonized the inhibitory effect of oxotremorine.
      It is concluded that presynaptic muscarine autoreceptors inhibit the release of
      acetylcholine from parasympathetic nerves of the guinea-pig trachea.

PMID- 2234099
TI  - Pharmacokinetic properties of the antimuscarinic drug [3H]-hexahydro-sila
      difenidol in the rat.
AB  - The pharmacokinetics of tritiated hexahydro-sila-difenidol [( 3H]-HHSiD) were
      examined in rats. Furthermore, the distribution of radioactivity was studied by
      means of whole body autoradiography. After i.v. administration of 2.9 mg/kg HHSiD
      plus [3H]-HHSiD to anaesthetized rats bearing a catheter implanted in the ductus
      choledochus and receiving a mannitol infusion, HHSiD was rapidly distributed and
      metabolized. Only 5% of the radioactivity was recovered in blood after 23 s and
      0.4% after 2.5 h. 64% of the plasma radioactivity could be extracted with hexane
      from the samples taken 23 s after administration. 52% of the radioactivity was
      eliminated within 2.5 h, 13% by urinary and 39% by biliary excretion. Following
      oral administration of 8.6 mg/kg HHSiD plus [3H]-HHSiD there was an absorption of
      approximately one fourth of the administered radioactivity within 4 h. By means
      of whole body autoradiography (i.v. injection) as well as by tissue distribution
      measurement the highest levels of radioactivity were found in bile, urine, lung,
      kidney, adrenals, liver and pancreas. Thus, after i.v. administration to rats
      HHSiD is rather quickly distributed, metabolized and excreted. This explains its
      low antimuscarinic potency in vivo.

PMID- 2234100
TI  - Differential distribution in, and release from, sympathetic nerve endings of
      endogenous noradrenaline and recently incorporated catecholamines.
AB  - Guinea-pig vasa deferentia or hypogastric nerve-vas deferens preparations,
      preincubated with pargyline (to irreversibly inhibit monoamine oxidase), were
      exposed to 2.3 mumol/l of unlabelled adrenaline or of 3H-7-(-)-noradrenaline in
      the presence of hydrocortisone (to inhibit extraneuronal uptake). The vasa
      deferentia were then mounted in perifusion chambers and subjected to transmural
      electrical stimulation, electrical stimulation of the nerve, depolarization by
      potassium (50 mmol/l), or addition of tyramine (40 mumol/l). The evoked overflow
      of tritium and of unlabelled catecholamines was expressed as a fraction of their
      tissue content. For all stimuli, the fractional release of the exogenous amines
      was higher than that of endogenous noradrenaline. Thus, recently incorporated
      amines are preferentially mobilized irrespective of the particular type of
      releasing mechanism or the chemical nature of the amine. In vasa deferentia which
      had been loaded with increasing amounts of adrenaline (by incubating the tissues
      with adrenaline at concentrations ranging from 0.6 to 160 mumol/l), the
      fractional release of adrenaline decreased and became closer to that of
      endogenous noradrenaline. Hence, the access of exogenous catecholamines to the
      deepest storage sites requires higher concentrations of amines than those needed
      to reach the more easily releasable pools. Light microscope autoradiographs
      obtained from slices of vasa deferentia previously loaded with 2.3 mumol/l 3H-(-)
      noradrenaline showed that the outer layers were strongly labelled with silver
      grains whereas the inner layers were poorly marked. It is concluded that recently
      incorporated amines are preferentially stored in varicosities close to the
      surface of the tissue and, in comparison with endogenous noradrenaline, are
      preferentially released from sympathetically innervated organs.

PMID- 2234102
TI  - Central, naloxone-reversible antinociception by diclofenac in the rat.
AB  - The antinociceptive effect of subcutaneously (s.c.), intracerebroventricularly
      (i.c.v.) or intrathecally (i.t.) administered diclofenac was studied in a series
      of experiments employing the tail-flick (0.01-10.0 mg/kg body weight i.p., 1-50
      micrograms i.c.v., 1-10 micrograms i.t.) and hot-plate (0.01-50 mg/kg body weight
      i.p., 1-50 micrograms i.c.v., 1-10 micrograms i.t.) models representing
      somatosensory stimuli and the writhing test (0.001 mg-10 mg s.c., 0.1-200
      micrograms i.c.v., 0.1-100 micrograms i.t.) and colorectal distension (1-200
      micrograms i.c.v.) models representing noxious visceral stimuli. Diclofenac did
      not exert any antinociceptive effects in the tail-flick or hot-plate models. In
      the writhing test, diclofenac dose-dependently inhibited the number of writhings
      after s.c. administration (0.001-10.0 mg/kg body weight) with an ED50 of 1 mg/kg.
      A similar dose-dependent action of diclofenac was seen after i.c.v. (0.1-200
      micrograms) and i.t. (0.1-100 micrograms) administration with an ED50 of 3
      micrograms in both cases. The antinociceptive effect of diclofenac administered
      s.c., i.c.v. or i.t. was almost completely reversed by pretreatment with
      naloxone, (1 mg/kg body weight s.c.). In the colorectal distension model, the
      i.c.v. administration of diclofenac (1-200 micrograms), which attenuated the
      cardiovascular response to colorectal distension, was reversed by naloxone. The
      pressor and tachycardia response to a 20 s, 80 mmHg colorectal distension was
      inhibited by diclofenac 100 micrograms i.c.v. (16.1 +/- 1.7 mmHg or 58% and 39.4
      +/- 0.4 bpm or 70% versus control, respectively). It is concluded that diclofenac
      exerts a central, naloxone-reversible antinociceptive action in experimental
      animals after noxious visceral stimuli but not after somatosensory stimuli.

PMID- 2234101
TI  - The heterogeneity of the neuronal distribution of exogenous noradrenaline in the
      rat vas deferens.
AB  - After loading of the incubated rat vas deferens with 0.2 mumol/l 3H-noradrenaline
      (followed by 100 min of wash-out with amine-free solution), the efflux of
      endogenous and exogenous compounds was determined by HPLC with electrochemical
      detection and by column chromatography with scintillation counting. Two different
      types of heterogeneity of labelling were found. The first one is due to the
      preferential labelling of varicosities close to the surface of the tissue, the
      second one to the preferential labelling of vesicles close to the surface of
      loaded varicosities. As diffusion distances within the tissue and within
      varicosities are then longer for endogenous than for exogenous amine and
      metabolites, the composition of spontaneous efflux of exogenous compounds
      differed from that for endogenous compounds. Because of preferential neuronal and
      vesicular re-uptake of endogenous noradrenaline, the percentage contribution by
      noradrenaline to overall efflux was: endogenous less than exogenous. While 3H
      DOPEG was the predominant exogenous metabolite, DOPEG and MOPEG equally
      contributed to the "endogenous" efflux. Desipramine abolished the consequences of
      the first heterogeneity of labelling, i.e., it increased the efflux more for
      endogenous than for exogenous noradrenaline; moreover it decreased the efflux of
      3H-DOPEG, but increased that of 3H-MOPEG. The reserpine-like compound Ro 4-1284,
      on the other hand, abolished the consequences of the second type of
      heterogeneity; it reduced the specific activity of "total efflux" (i.e., of the
      sum of noradrenaline + DOPEG + MOPEG) to the specific activity of the tissue
      noradrenaline. The degree of heterogeneity of labelling was reduced after
      inhibition of monoamine oxidase and also when the tissues were loaded with 2 or
      20 mumol/l 3H-noradrenaline. It is proposed that the various "compartments" and
      "pools" of noradrenaline described in the literature reflect the two
      heterogeneities described here.

PMID- 2234103
TI  - A bradykinin antagonist inhibits carrageenan edema in rats.
AB  - Bradykinin has been implicated in acute inflammatory reactions. Intradermal
      injection elicits increased vascular permeability and hyperalgesia, and bioassays
      have suggested increased bradykinin concentration in inflammatory exudates.
      Poorly specific inhibitors of kallikrein, the enzyme catalyzing formation of
      bradykinin, inhibit certain acute inflammatory reactions. However, the lack of a
      specific bradykinin receptor antagonist has made proof of the hypothesis
      difficult. In this study, we have used the potent, specific bradykinin antagonist
      DArg[Hyp3DPhe7] bradykinin (NPC 567) as a probe to examine the role of bradykinin
      in carrageenan-induced edema in the paws of rats. Subplantar injection of
      carrageenan led to an increase in immunoreactive bradykinin and metabolic
      product, desArg9bradykinin. NPC 567 inhibited the development of edema in
      response to carrageenan, to a maximum 65%. Thus, bradykinin appears to be a major
      mediator of increased vascular permeability in response to carrageenan.

PMID- 2234104
TI  - Interaction of adenine nucleotides, UTP and suramin in mouse vas deferens:
      suramin-sensitive and suramin-insensitive components in the contractile effect of
      ATP.
AB  - Effects of various nucleotides, nucleosides and noradrenaline on smooth muscle
      tension were studied in the isolated mouse vas deferens. alpha, beta-Methylene
      ATP, ATP gamma S, noradrenaline, ATP and UTP elicited contraction, with potency
      decreasing in that order; there was no contractile response to adenosine or
      uridine (up to 100 mumol/l). Prolonged incubation with alpha, beta-methylene-ATP
      (concentration increased stepwise from 0 to 15 mumol/l) selectively reduced
      contractions induced by ATP and UTP but not those induced by noradrenaline, and
      there was cross-tachyphylaxis between ATP and UTP. Suramin (10-300 mumol/l) did
      not alter the response to noradrenaline but shifted the concentration-response
      curves for alpha, beta-methylene-ATP, ATP gamma S, UTP and lower concentrations
      of ATP (0.1-1 mumol/l) to the right. The pA2-values of suramin were 5.2 against
      alpha, beta-methylene-ATP, 4.8 against ATP gamma S, 5.1 against UTP and 5.4
      against lower concentrations of ATP. The effects of higher concentrations of ATP
      were largely resistant to suramin. The results indicate that the mouse vas
      deferens possesses contraction-mediating smooth muscle P2x-receptors. UTP also
      acts at this receptor, and there is no evidence for a separate UTP receptor. The
      selective inhibition of nucleotide- but not noradrenaline-induced contractions by
      suramin confirms the view that suramin is a selective P2-antagonist. The
      resistance against suramin of part of the effect of ATP suggests that ATP
      activates a suramin-insensitive site in addition to the P2x-receptor.

PMID- 2234105
TI  - Absorption and metabolism of procaine by the rat small intestine.
AB  - The aim of this study was to obtain information about the absorption of procaine
      in the rat small intestine (Fisher-Parsons preparation). In the range from 0.25
      10 mmol.l-1 procaine in the luminal perfusate, much more of the unchanged drug
      was absorbed in segments of the ileum than of the duodenum and jejunum. Besides
      procaine, two metabolites, p-aminobenzoic acid (PABA) and acetylated p
      aminobenzoic acid (AABA), formed in the intestinal mucosa, appeared in the
      absorbate. With increasing substrate concentration in the perfusate the PABA in
      the absorbate increased considerably in all three segments; from 0.75 mmol.l-1
      procaine upwards the PABA produced was highest in the jejunum. AABA formed in the
      mucosa and measured in the absorbate did not increase in the same manner with
      increasing substrate concentration; in the absorbate of jejunal segments the
      amount of AABA was significantly higher than in duodenal and ileal segments.
      Taking into account that in rats the microclimate of the ileum differs
      considerably from that of the upper part of the small intestine, the marked
      difference observed in the absorption of procaine between ileal segments on the
      one side, and duodenal and jejunal segments on the other, can be explained on the
      basis of the "non-ionic diffusion" theory.

PMID- 2234106
TI  - Alteration of cytochrome P-450 by prolonged administration of imipramine and/or
      lithium to rats.
AB  - The aim of this study was to investigate imipramine-induced alterations of
      cytochrome P-450 and to determine whether prolonged concomitant administration of
      imipramine and lithium results in a pharmacokinetic interaction. Male Wistar rats
      received imipramine (10 mg/kg i.p.) at 12 h intervals or lithium chloride (100
      mg/kg in drinking water) or they were treated with the combination of these drugs
      for 2 weeks. The long term treatment with imipramine produced a very complex
      alteration of cytochrome P-450: imipramine increased the level of the cytochrome,
      but it decreased the rate of its own aromatic hydroxylation in position 2. The
      rate of N-demethylation in the side chain was not changed. Consequently, in the
      case of both hydroxylation and demethylation, calculated molecular activities
      were decreased to 48% and 70% respectively. This differential change in
      activities corresponded well to the observed decrease of absorption in difference
      spectra (type I) produced in microsomes by imipramine. Carbamazepine-induced type
      I difference spectra were also decreased by imipramine pretreatment, but to a
      lesser extent. In contrast, hexobarbital type I binding was increased by
      imipramine treatment while type II difference spectra produced by metyrapone were
      not affected. The preliminary SDS-PAGE analysis of cytochrome P-450 isoenzymes of
      control and imipramine treated rats showed that the investigated antidepressant
      markedly intensified a protein band at 50.11 kD while bands at 51.28 kD, 56.20 kD
      and 56.88 kD were less intensive. These results indicate that the alteration of
      cytochrome P-450 by imipramine treatment is not only of quantitative but also of
      qualitative character. Lithium alone given to rats affected neither the
      concentration of cytochrome P-450 in microsomal protein nor the rate of
      imipramine metabolism in vitro. Lithium given jointly with imipramine reduced
      imipramine-induced elevation of cytochrome P-450.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2234107
TI  - Autoradiographic study of the rat vas deferens incubated with 3H-noradrenaline.
AB  - Rat vasa deferentia were incubated with 0.2 mumol/l 3H-noradrenaline for 60 min
      and then washed out with amine-free solution for 100 min. Autoradiography then
      revealed a preferential labelling of the varicosities in the immediate vicinity
      of the surface of the tissue. However, when tissues were obtained from reserpine-
      and pargyline-pretreated rats (to block vesicular uptake and monoamine oxidase),
      3H-noradrenaline was able to penetrate more deeply into the tissue. These
      differences are in accordance with the view that the autoradiographs reflect the
      3H-noradrenaline concentration gradient (within the extracellular space)
      generated by the neuronal uptake of the 3H-amine; the concentration gradient is
      steeper (and the heterogeneity of labelling is more pronounced) in tissues with
      intact vesicular uptake and monoamine oxidase than in tissues in which these
      mechanisms had been inhibited.

PMID- 2234108
TI  - Black stool. Some light on a dark subject.

PMID- 2234109
TI  - Hemochromatosis discovered through blood donor screening for alanine
      aminotransferase.

PMID- 2234110
TI  - A rationale for evaluation of byssinosis.

PMID- 2234111
TI  - This here and that there. The night I wrote a prescription on a piece of wood.

PMID- 2234112
TI  - Recreational safety.

PMID- 2234113
TI  - Trauma care in North Carolina: an update.

PMID- 2234114
TI  - David Tillerson Smith.

PMID- 2234115
TI  - On the AHEC airplanes: Response to Dr. Sedwitz's letter (1990;51:246)

PMID- 2234116
TI  - A followup to the article on maternal-fetal consultative services.

PMID- 2234117
TI  - A comment on Dr. Tyor's article, "Nancy Slater's Saga".

PMID- 2234118
TI  - The importance of maintaining water quality in the dialysis unit. A case study.

PMID- 2234120
TI  - Negative view of dialysis nurses.

PMID- 2234119
TI  - Bringing the nurse-tech turf war to an end: a priority for both professions.

PMID- 2234121
TI  - Quality care and cost containment--a practical approach.

PMID- 2234122
TI  - Dwindling donations make presumed consent a proposal worthy of consideration.

PMID- 2234123
TI  - Reporting device-related problems and incidences to the FDA.

PMID- 2234124
TI  - Guilty until proven innocent?

PMID- 2234126
TI  - The student practicum: 1990.

PMID- 2234125
TI  - Who's that knocking at my door?

PMID- 2234127
TI  - Facilitating expert practice in gerontological nursing.
AB  - Educators and clinical specialists can collaborate to develop experts in
      gerontological nursing. The authors use Loevinger's theory of ego development and
      Benner's model to guide their work. Their teaching strategies are designed to
      increase self-awareness, add conceptual contexts, broden practice perspectives,
      and promote professional esteem.

PMID- 2234128
TI  - Strategic planning: collaboration and empowerment.
AB  - This article describes a strategic planning process for the redesign of patient
      care delivery based on a systems approach. The process included an assessment of
      internal hospital strengths and weaknesses matched with external opportunities
      and threats in the community that the hospital serves. An essential component of
      the strategic planning process was collaboration. Two types of collaboration
      emerged, interdisciplinary and intradisciplinary. The outcome of involving all
      disciplines in the hospital as well as multiple levels and roles within nursing
      was a comprehensive implementation plan based on the empowerment of the health
      care provider, health care recipient, and the health care system.

PMID- 2234129
TI  - Ethical issues. Least restrictive conditions.

PMID- 2234130
TI  - Enhancing the success of NCLEX-RN retesters.
AB  - The widely recognized shortage of nurses, together with uncertain trends in
      nursing school enrollments, poses a dilemma for the health care industry. This
      dilemma is aggravated by the loss from the work force of graduate nurses who fail
      the registered nurse licensure examination. Employer institutions fail to reap
      the benefits of expensive recruiting and orientation, the graduate nurses face a
      personal and professional crisis, and a shadow is cast over their nursing school.
      Out of mutual concern, a tertiary care hospital and its affiliated university
      school of nursing collaborated to develop a model for a clinically based remedial
      program to increase the likelihood of passing a licensure retest. Developmental
      aspects and advantages of this model are described. Issues for consideration
      prior to implementation of such a program are discussed.

PMID- 2234131
TI  - Managers' ability to perform: individual and collective assessment findings.
AB  - Changes in role responsibilities, organizational relationships and mix of
      professional and non-licensed personnel have increased the need for well prepared
      managers who can be effective in new work environments. Because such individuals
      are not readily available, identification of potential managers and development
      of incumbents are crucial. This article describes how four hospitals used the
      same unique assessment system to identify the strengths and limitations of 116
      managers, the implications of their findings, and subsequent interventions.
      Suggested also are activities with potential for meeting hospitals' future needs
      for effective managers.

PMID- 2234132
TI  - The house of collaboration.

PMID- 2234133
TI  - A career mobility program for skilled nursing facilities.
AB  - This article reports the results of a 3-year demonstration project in career
      mobility for nursing personnel in skilled nursing facilities. The goal of the
      project was to demonstrate the effectiveness of a career mobility program in
      addressing service delivery challenges such as recruitment, retention, and
      satisfaction of nursing personnel in skilled nursing facilities. The project was
      a joint effort between an educational department of a large university and a
      major long-term care corporation. The project evaluation addressed the
      effectiveness of this career mobility program in attracting and retaining nursing
      personnel, the satisfaction of nursing personnel with their jobs, and whether the
      additional training affected the quality of care. Five pilot and three comparison
      sites were designated in Southern California. Survey, self-report, and interview
      data were collected at yearly intervals and at the completion of the project.
      Descriptive statistics and analysis of variance formed the basis for data
      analysis and interpretation. Overall, the findings suggested that the career
      mobility program has the potential to retain staff who benefit from a career
      development program. The career mobility program was a valuable strategy, but its
      success was only as good as the management team's authority to support the
      program and emphasize its goals.

PMID- 2234134
TI  - Political issues. Opportunities to share and learn.

PMID- 2234135
TI  - An interview with Gail R. Wilensky. Interview by Carmella A. Bocchino.
AB  - In this interview, conducted just 4 months after assuming her new position as
      Administrator of HCFA, Dr. Wilensky discusses her goals for the agency, the
      emergence of Medicaid as a separate bureau, Medicare reimbursement policies, and
      nurses' potential as recognized health care providers.

PMID- 2234136
TI  - Are nurses less satisfied than other workers?
AB  - Are nurses less satisfied than other workers? In this study comparing job
      satisfaction of baccalaureate nurses with elementary teachers and accountants,
      the three groups rated many aspects of their jobs similarly. Nurses were not
      comparatively or pervasively less satisfied with their jobs than these other
      professionals except in the areas of salary, chance for administrative
      participation, and job security.

PMID- 2234138
TI  - Shopping for quality: the Greater Cleveland Health Quality Choice Project.
AB  - The Greater Cleveland Health Quality Choice Project, a competitive strategy for
      reforming the delivery and reimbursement of health care, can be a model for
      national health care reform.

PMID- 2234137
TI  - Staffing accommodations to hospital unit admissions.
AB  - This study of the flow of patients through five general medical units in a 750
      bed medical center described the relentless and unpredictable demand for nursing
      services (with 80% of the admissions coming from the emergency department) and
      the resulting costs in terms of supplementary staffing and overtime usage.

PMID- 2234140
TI  - Economic considerations for epidural anesthesia in childbirth.
AB  - The relationships between epidural anesthesia and selected intrapartum outcomes
      was examined in 140 first-term pregnancies. Significant relationships were found
      with four outcomes: increased use of forceps or vacuum extractor, increased
      length of second stage labor, increased incidence of Cesarean birth, and
      increased need for oxytocin augmentation. These findings have significant
      implications for staffing on labor units and costs.

PMID- 2234139
TI  - Analysis of ambulatory nursing practice.
AB  - A nursing patient classification system can be used in ambulatory care to
      facilitate decision making relative to staffing assignments and to begin
      examining differences in patients' nursing care requirements according to medical
      diagnosis or other patient characteristics.

PMID- 2234141
TI  - The roar of the Titans.

PMID- 2234142
TI  - Technology administration in the hospital.

PMID- 2234143
TI  - Patient care automation: the future is now. Part 3. The five rules of automation.
AB  - Five key principles for creating effective operations optimization-based patient
      care automation have now been established: (a) The old system architectures did
      not provide operations optimization; (b) primary patient care optimization
      (nurses and doctors) must be the central focus of any effective system; (c) the
      system must provide a platform that allows for eliminating both the retrospective
      and prospective (subterranean) paper records; (d) point-of-care data capture,
      including at the bedside, must be provided; and (e) integration around the
      patient is critical to success. Systems that ignore these principles will
      ultimately be doomed to repeat the problems of the manual system. Adherence to
      these principles opens a myriad of possibilities and provides a road map for how
      such a system should function. The next installment in this series of articles
      will address the ramifications of integration in system design and system use.
      The positive effects that such system designs can have on the realization of
      demonstrable benefits from system technology will also be reviewed.

PMID- 2234144
TI  - Political involvement: a nursing necessity.

PMID- 2234145
TI  - Managing cultural diversity: turning demographic factors into a competitive
      advantage.

PMID- 2234146
TI  - [Psychiatric is not always psychogenic, especially in the general hospital].

PMID- 2234147
TI  - [Vitamin D poisoning; real and spurious].
AB  - Vitamin D in large doses is a proper therapy in hypoparathyroidism, osteomalacia,
      vitamin D-resistant rickets and also in chronic renal failure although in those
      cases the active metabolite of vitamin D is preferred because of the much shorter
      biologic halflife. Apart from these disorders there are no good reasons for using
      megadoses of vitamin D. Pseudo-vitamin D intoxication is caused by granulomatous
      diseases as a so-called inappropriate calcitriol secretion. In cases of vitamin D
      intoxication the 25-OHD3 content in the serum is much too high, the parathyroid
      hormone concentration is suppressed and the I,25-(OH)2D3 level is low, whereas in
      pseudo-vitamin D intoxication the 25-OHD3 content in the serum is normal and the
      I,25-(OH)2D3 is seriously elevated. Cultured alveolar macrophages of patients
      with sarcoidosis can produce I,25-(OH)2D3 as can sarcoid lymph node homogenate.
      I,25-(OH)2D3 proved to promote the fusion of alveolar macrophages to form
      polykaryons. Local concentrations of I,25-(OH)2D3 may be higher at sites of
      granulomatous tissue and can act in a paracrine or autocrine fashion to enhance
      granuloma formation. The action of glucocorticoids and chloroquine in patients
      with sarcoidosis and hypercalcaemia is presumably an interruption of the
      described vicious circle.

PMID- 2234148
TI  - [The older worker: a medical problem or not?].

PMID- 2234149
TI  - [Family practitioner's and specialist's role in the care of the patient with
      epilepsy].
AB  - Differences of opinion between GPs and medical specialists about their roles in
      the care of patients with epilepsy make it difficult to improve this care. To
      assess the roles of GP and specialist care a random sample of 500 GPs and all
      clinical neurologists in The Netherlands were sent a questionnaire about their
      attitude and actual behaviour towards tasks concerning epilepsy. The response was
      54%. Non-response analysis did not bring forward statistically significant
      differences. Both GPs and specialists considered further diagnosis and starting
      antiepileptic drug regimens tasks for the specialist. The treatment of attacks in
      the patient's home situation was considered by both groups as a task for the GP.
      About other tasks opinions were that they ought to be shared or opinions appeared
      to be divided. According to the authors tasks about which consensus exists as
      well as tasks about which opinions differ should be considered carefully: on
      management level by the Epilepsy consultation group of the Dutch Society of
      General Practitioners and the Dutch Epilepsy Federation, on care level by
      introducing a patient information card.

PMID- 2234151
TI  - [The sickness impact profile; results of an evaluation study of the Dutch
      version].
AB  - The U.S. clinimetric instrument, the sickness impact profile (SIP), was validated
      for The Netherlands. The SIP is a standardized list of 136 statements aimed at
      measuring changes of conduct in everyday activities due to sickness, and may be
      used as a measure of outcome in clinical studies. Three necessary stages of a
      validation study were performed: translation, assignment of weighing factors to
      the statements and comparison of SIP measurements in a Dutch and an U.S. open
      population. The findings were that a good Dutch version of the SIP is available,
      that there is a strong correlation between the weighing factors assigned to the
      statements of the Dutch and of the U.S. version, and that the SIP scores of open
      populations of the two countries are in agreement. The findings for the Dutch
      open population may be used as reference values in other studies.

PMID- 2234150
TI  - [Extracardial manifestations in constrictive pericarditis].
AB  - Constrictive pericarditis is a slowly progressive disabling disease. The
      diagnosis is easily overlooked because of the striking extracardial signs and
      symptoms such as abdominal discomfort, general fatigue, cachexia, ascites and
      oedema. We describe 7 patients with these symptoms in whom the diagnosis was
      missed during 0.5-17 years. The decisive clue for correct diagnosis appeared to
      be the raised central venous pressure. This proves the importance of an accurate
      physical examination. Other findings were: ascites (7/7), hepatomegaly (7/7),
      oedema (6/7), narrow pulse pressure (less than or equal to 35 mmHg) (5/7), ECG
      abnormalities (7/7) and pericardial calcifications on the chest X-ray (5/7). In
      addition we found slightly raised liver enzymes and a protein-losing enteropathy
      leading to low serum protein levels. These abnormalities are all explained by the
      alterations in haemodynamics and lymph flow. The only curative therapy is
      surgical decortication of the heart.

PMID- 2234153
TI  - [Tracheotomy and intubation].

PMID- 2234152
TI  - [Mega-dosages vitamin D: progressive medicine?].
AB  - Although the risk of vitamin intoxication is well recognised, massive doses of
      these preparations continue to be prescribed, especially in the so-called
      'alternative' medical sector. We describe a patient with hypervitaminosis D due
      to administration of megadoses of vitamin D in the absence of an obvious
      indication. Mode of action and symptoms of vitamin D intoxication are discussed.
      It is emphasized that vitamin preparations should only be used when strictly
      indicated and that close clinical and biochemical supervision is necessary.

PMID- 2234154
TI  - [Medical therapy in patients with chronic coma; a contribution from nursing home
      medicine].

PMID- 2234155
TI  - [Emergency medicine; a very necessary new discipline].

PMID- 2234156
TI  - [Diagnosis and treatment of chronic polymorph light dermatoses].

PMID- 2234157
TI  - [Organ donation in a general hospital].

PMID- 2234158
TI  - [A misunderstood peripheral facial nerve paralysis and yet not Bell's palsy].

PMID- 2234159
TI  - [Heredity: science and society; advice from the Public Health Council].

PMID- 2234160
TI  - [Long-term anticoagulant treatment following an acute myocardial infarction].

PMID- 2234161
TI  - [Heart aneurysm: pathophysiology, complications and treatment].

PMID- 2234162
TI  - [The average costs of an admission to the hospital].
AB  - The mean cost of the hospital admission has increased considerably in the last 12
      years, to an amount of Dfl. 7,415,- in 1988. However, if the greying of the
      patient population is taken into account (the elderly on average stay long in
      hospital), together with the devaluation of the guilder, a clear rise of the mean
      costs per hospitalization is no longer demonstrable. On the contrary, there is
      firm evidence to support the view that the cost per hospitalization has actually
      been decreasing since 1982, the last year before the beginning of budgeting. In
      addition, a very large amount has been saved due to a considerable decrease of
      the number of admissions.

PMID- 2234163
TI  - [Revised guidelines for the treatment of patients with severe traumatic brain
      injury].
AB  - The early assessment and acute treatment of patients with severe traumatic brain
      injury require a well structured and organized policy. This policy should include
      rapid transport to, and effective first aid in trauma centres especially equipped
      for this purpose, adequate communication of information between the (para
      )medical workers successively involved and a multidisciplinary handling of
      diagnostics and treatment of the various traumatic and posttraumatic conditions.
      This requires the imposition of unequivocal priorities known to all concerned. In
      this paper, which was written in cooperation with the different medical
      disciplines concerned, the main features of the acute treatment of severe head
      injury, about which a wide agreement was reached, are worked out in 18 theses.
      The guidelines regard the admission and first aid, the diagnostic procedures and
      the conservative and surgical treatment of patients with severe head injury.
      These guidelines can be developed in the different hospitals into detailed
      blueprints for the treatment, in accordance with the local situation.

PMID- 2234164
TI  - [The watermelon stomach; linear convolutions of vascular ectasias in the antrum].
AB  - The watermelon stomach or 'gastric antral vascular ectasia' is a rare clinical
      entity. It may cause persistent blood loss. The endoscopic picture is highly
      characteristic and consists of parallel erythematous folds in the antrum.
      Histological characteristics are: dilated mucosal capillaries and venules,
      containing fibrin thrombi, along with fibromuscular hyperplasia in the lamina
      propria. In case of severe blood loss partial resection of the stomach or laser
      photocoagulation is often necessary.

PMID- 2234165
TI  - [When latex disintegrates, or a mechanical pyloric ulcer].
AB  - Complications of Celestin oesophageal tube disintegration are discussed with
      reference to the case of a patient with a tube inserted because of extrinsic
      stenosis presenting with upper abdominal complaints.

PMID- 2234166
TI  - [Biceps tendon rupture].

PMID- 2234167
TI  - [Abuse of anticholinergic agents].

PMID- 2234168
TI  - [Smoking behavior among family physicians, specialists and students in Rotterdam,
      1989].

PMID- 2234169
TI  - [Liability for professional mistakes--breakthrough of a taboo?].

PMID- 2234170
TI  - [Small intestinal perforation as a complication of treatment with loperamide in a
      Salmonella typhimurium infection].

PMID- 2234171
TI  - [Deep frozen, deeply regretted].

PMID- 2234172
TI  - [The melanoma problem in The Netherlands].

PMID- 2234173
TI  - [Should congenital melanocytic nevi be removed?].

PMID- 2234174
TI  - [Revised consensus melanoma of the skin].
AB  - A second consensus meeting on cutaneous melanoma was held on June 15, 1990. The
      present report concisely discusses the recommended policy concerning the
      diagnosis and treatment of melanoma. The changes in melanoma management in
      comparison with the first consensus meeting in 1984 are emphasized.

PMID- 2234176
TI  - [Epidemiology of melanoma of the skin in The Netherlands: a descriptive study].
AB  - A study of the mortality rates of cutaneous malignant melanoma over the period
      1950-1985 in The Netherlands showed a fourfold increase of mortality. An analysis
      by birth cohort suggests a cohort effect: age-specific mortality rates increase
      with successively younger generations. To determine the incidence of malignant
      melanoma of the skin data were derived from a registration of histological
      diagnoses of diseases (PALGA). The estimated numbers of new cases of melanoma of
      the skin were 1270 and 1372 in the years 1986 and 1987 respectively. Data on the
      trend in incidence are restricted, but indicate an increase. This descriptive
      study allows no conclusions about the cause of the rise in incidence and
      mortality rates.

PMID- 2234175
TI  - [Melanoma of the skin in the national cause-of-death statistics and in the
      hospital statistics].
AB  - In the last 40 years the national mortality from melanoma of the skin, corrected
      for age, has increased by over 300%. Figures for males are always higher than
      those for females and this difference tends to grow larger. Since 1960 it has
      mostly been the mortality in the age groups 30-69 years that increased. The rise
      in mortality of older persons has been relatively small. Among the patients
      treated clinically, females are in the majority and increasingly so from year to
      year. Probability of survival is better for females than for males. Major shifts
      seem to occur in the localization of the lesion. Lesions are localized relatively
      less often in the skin of the head. In males, it is the frequency of melanomas of
      the trunk that is rising, while melanomas of the extremities are markedly
      increasing in frequency in both males and females.

PMID- 2234177
TI  - [Adjuvant regional isolation perfusion of the extremities of patients with stage
      I melanoma thicker than 1.5 mm].
AB  - The use of isolated regional perfusion with melphalan as an adjuvant treatment
      for stage I melanoma of the extremity continues to be controversial. The present
      retrospective study evaluates the past 25 years' experience by comparing 227
      perfused patients from Groningen with 238 matched controls from five hospitals in
      The Netherlands and Westphalia (West Germany). All patients underwent wide local
      excision for a primary extremity melanoma of 1.5 mm or greater in thickness. A
      proportional hazards regression analysis for recurrence of disease and survival
      identified the significant prognostic factors, of which, besides level of
      infiltration, ulceration, age and sex, tumour thickness was found to be the most
      important. Corrected for these factors, it was not possible to demonstrate a
      statistically significant effect for perfusion in terms of time to limb
      recurrence (p = 0.61), time to regional lymph node metastasis (p = 0.11), time to
      distant metastasis (p = 0.73), disease-free interval (p = 0.42), and survival (p
      = 0.90). No statistically significant differences were seen for adjuvant
      perfusion in any of the subgroups.

PMID- 2234178
TI  - [The 'freckle bus' campaign; an unhealthy phenomenon or a sensible experiment?].
AB  - In the summer of 1989 a screening campaign for skin cancer was organized in four
      seaside resorts of The Netherlands using a mobile examination room. On 4
      consecutive Saturdays 3069 individuals were examined. A total of 65 individuals
      with a suspected lesion were found. Histological reports were obtained on 46
      suspected lesions and showed: 6 melanomas (all with a thickness less than 1 mm),
      2 squamous cell carcinomas, 23 basal cell carcinomas, 5 dysplastic naevi and 10
      benign skin lesions. The positive predictive value of the clinical examination
      appeared to be 83%. Much publicity was given to the campaign by the
      (inter)national media. The effects of this publicity were measured by a
      questionnaire sent to the general practitioners (856) and dermatologists (25) in
      the region, of whom 44% and 84%, respectively, responded. It appeared that during
      and after the campaign there had been an increase in the number of consultations
      for skin lesions, and an increase in the diagnoses of malignant lesions.

PMID- 2234179
TI  - [Malignant melanoma in a primary care pathologico-anatomical laboratory in 1988
      and the freckle bus year].
AB  - Our laboratory is specialized in pathology and cytology service to general
      practitioners (GPs). In 1988 we received approx. 1600 skin biopsies from GPs, two
      were melanomas. In 1989, when some 3200 biopsies were examined, the number of
      melanomas increased to 15. In that year a screening service was provided in the
      summer months using a 'freckle bus'. Only one melanoma patient was sent to the GP
      for further investigation through this screening service. We presume that the
      concomitant publicity in the mass media was more important for melanoma
      detection. The characteristics of the 17 melanomas detected by the GPs were in
      accordance with published epidemiological data. They were, however, very small
      with a median diameter of 5 mm. More than 70% of the melanomas had a thickness
      less than 1 mm. The task of the GP in detecting melanomas is discussed. In our
      study the GPs act in accordance with the proposed guidelines: they only excise
      lesions with a low suspicion, the margin being at least 1 mm and all biopsies are
      verified histologically.

PMID- 2234180
TI  - [Scintigraphy using I 131 iodobenzylguanidine and malignant melanomas].
AB  - The successful use of iodine-131-meta-iodobenzylguanidine (I-131-MIBG)
      scintigraphy for diagnosis of phaeochromocytoma and neuroblastoma stimulated
      investigation into its diagnostic and therapeutic usefulness in other neural
      crest tumours. It appears that there is a difference in capacity to absorb I-131
      MIBG between the different tumour types. In I-131-MIBG scintigraphy of carcinoids
      there are more false negative results in comparison with phaeochromocytomas and
      neuroblastomas. Melanoma, also a neural crest tumor, turned out to be false
      negative in 100% of the cases reported until 1989. The authors present a case of
      a malignant melanoma with metastases in liver and stomach, concentrating I-131
      MIBG. Biochemical examination demonstrated that this particular tumour was
      metabolically very active. It is suggested that the I-131-MIBG-positive
      scintigram of the melanoma may be related to the level of metabolic activity. By
      biochemical screening in proven cases of malignant melanoma it may be possible to
      select cases in which I-131-MIBG scintigraphy is worthwhile with a view to
      therapeutic application of I-131-MIBG.

PMID- 2234181
TI  - [Mass screening for skin cancer; experiences in Oss].

PMID- 2234182
TI  - [Eurothemes. Physicians and patients without borders].

PMID- 2234183
TI  - [The treatment of ankle edema in the elderly in family practice; when and how
      often are diuretics used?].

PMID- 2234184
TI  - [The unborn child as patient; advice from the Public Health Council].

PMID- 2234185
TI  - [In-vitro fertilization in The Netherlands].

PMID- 2234186
TI  - [Invasive diagnosis and treatment of the urinary tract in the fetus].

PMID- 2234187
TI  - [Tubes, cuffs and cannulas].

PMID- 2234188
TI  - [Hypertension consensus in The Netherlands].
AB  - It is known that mild hypertension is a common disorder and there is increasing
      evidence that it is possible to decrease the incidence of cardiovascular damage
      by antihypertensive treatment. Stimulated by the controversy on the
      identification and treatment of patients with mild hypertension, a Dutch
      hypertension consensus meeting was held on March 16th 1990. Consensus was reached
      that the decision to treat should be taken on the basis of both the blood
      pressure level and the individual risk profile, including hypercholesterolaemia,
      history of smoking, diabetes, or a family history of cardiovascular disease.
      Subjects at risk should be identified by selective case finding (persons with
      known additional risk factors) and screening restricted to men aged 55 to 65
      years. All patients should be started on non-pharmacological treatment by
      decreasing sodium intake, and where necessary reducing body weight and alcohol
      consumption, and stopping smoking. If antihypertensive drugs are to be given,
      diuretics, beta-blockers, ACE-inhibitors, and (or) calcium antagonists are the
      drugs of choice.

PMID- 2234189
TI  - [An unusual hospital infection: Aeromonas hydrophila infection due to the use of
      leeches].
AB  - A patient is described with an infection with Aeromonas hydrophila after the use
      of medical leeches to improve the circulation of a congested region of surgery.
      The use of medical leeches and the treatment of a leech-related infection are
      discussed.

PMID- 2234190
TI  - [Valproic acid and stupor].
AB  - A patient treated with valproic acid and phenytoin for complex partial epilepsy
      developed a stupor at therapeutic serum levels of the anti-epileptic agents. A
      few days after discontinuation of valproic acid, complete recovery occurred. The
      pathogenic mechanism involved is still obscure.

PMID- 2234191
TI  - [Eurothemes. Eastern Europe AIDS prevention; a lot of 'policy' but few condoms].

PMID- 2234192
TI  - [Treatment of unstable wrist fractures using the external fixator].

PMID- 2234193
TI  - [The long-term prognosis of hangman's fractures].

PMID- 2234194
TI  - [The risks of diazepam in newborn infants].

PMID- 2234195
TI  - Brain brachytherapy for malignant gliomas at Creighton University.

PMID- 2234196
TI  - Leptomeningeal carcinomatosis: CT and MRI appearances.

PMID- 2234197
TI  - Health managed care.

PMID- 2234198
TI  - Medicaid update.

PMID- 2234199
TI  - Some electrochemical characteristics of synthetic analogs of nucleic acid
      components. I. Derivatives of cytidine and arabinosylcytosine. An attempt to find
      correlation among some of their properties.
AB  - The polarographic reduction and parameter tg alpha of a series of natural and
      synthetic pyrimidine nucleosides, cytidine derivatives, and the cancerostatic
      agent arabinosylcytosine were studied. Correlations were found between these
      newly determined characteristics and capacity factor kappa from HPLC analysis,
      growth inhibition of E. coli B bacteria, deamination of nucleosides by cytidine
      deaminase, DNA synthesis, and rate of biotransformation and lipophilicity
      expressed as log P. It was confirmed that the molecule of nucleosides is complex
      to such an extent that no linear correlation could be revealed among the
      respective parameters. Linear correlation was found only in smaller, structurally
      similar groups of derivatives.

PMID- 2234200
TI  - Tumor inhibition and hematological improvements by dopamine analog 3,4
      dihydroxybenzylamine in mice bearing transplantable carcinoma.
AB  - The cancer chemotherapeutic efficacy of 3,4-dihydroxybenzylamine (DHBA), a
      dopamine analog with reduced neurotoxic effects, was evaluated in strain A mice
      bearing transplantable Ehrlich's ascites carcinoma. The analog was administered
      intraperitoneally on day 1 post-transplantation at dose schedules of 50, 100 and
      200 mg/kg/day for 7 consecutive days. The results demonstrated a significant
      inhibition of tumor growth and prolongation of the survival time of EAC tumor
      bearing mice following DHBA treatment. Diminished activity of the growth-related
      respiratory enzyme succinate dehydrogenase along with the stimulated activity of
      the lysosomal enzyme beta-glucuronidase in the DHBA-treated tumor cells indicated
      inhibition of tumor growth as well as active lysis of the tumor cells. Tumor
      inhibition was accompanied by marked improvements in hemoglobin concentration.
      RBC count and bone marrow cellularity. The results demonstrated that DHBA did not
      adversely affect hematological profile of the host while it inhibited the growth
      of Ehrlich's ascites carcinoma.

PMID- 2234201
TI  - HPLC determination of methotrexate and its metabolite in serum.
AB  - Determination of methotrexate (MTX) residues in biological samples (serum,
      cerebrospinal fluid) was worked out using liquid-liquid and solid-phase
      extractions and high performance liquid chromatography (HPLC) with UV detection.
      Clinical samples from patients treated by low and high doses of MTX were analyzed
      using reversed-phase and ion-pair liquid chromatography, and buffer-methanolic
      mobile phases. Chromatographic conditions were optimized for the simultaneous
      determination of MTX and its metabolite and the minimal analysis time was
      recommended. The results were statistically evaluated, elimination curves and
      chromatograms have been demonstrated. Solid-phase extraction recovery was 93.1 +/
      1.5% and the determination limit for methotrexate in serum samples was 5.10(-7)
      mol/l and after the preconcentration of samples 5.10(-8) mol/l.

PMID- 2234203
TI  - Inhibition of proliferation of HeLa cells by cocultivation with early mouse
      embryos (preliminary report).
AB  - Eight- to 16-cell zona-free mouse embryos were cocultivated with 5 to 10 HeLa
      cells in cultivation drops of 0.1 microliter containing D-PBS medium supplemented
      with 20% fetal bovine serum. The control group included HeLa cells alone
      cultivated in the same medium under the same culture conditions. The two cultures
      were evaluated after 72 hours. The control group showed 147 out of 181 cases of
      proliferation of HeLa cells (81.22%), whereas HeLa cells cocultivated with zona
      free mouse embryos only proliferated in 2 out of 156 cases (1.28%). Proliferation
      of HeLa cells was inhibited even though these were not in direct contact with the
      embryos. The experiments suggest that the secretory activity of early embryos in
      culture medium inhibits proliferation of transformed cells via a special agent.

PMID- 2234202
TI  - In vitro activation of tumoricidal properties of rat peritoneal macrophages using
      lipopolysaccharide.
AB  - The peritoneal macrophages from normal Lewis rats were characterized by their
      capacity to phagocytose, by the presence of nonspecific esterase and Fc
      receptors. In vitro, these macrophages were maintained in culture 7 and/or 21
      days, respectively, and for the last 24 h (activation period) were cultured with
      0.1-4.0 micrograms/ml of lipopolysaccharide (LPS) and were found tumoricidal
      against different rat fibrosarcomas, at a ratio of 50:1 (BP6-Tu2, MC-1 and B77).
      Macrophage-mediated tumor cytolysis was determined using 51Cr-release assay. The
      sensitivity of used tumors to macrophage-mediated cyto-toxicity was different. In
      vivo the transfer of the activated macrophages together with the mentioned tumor
      cells to rats inhibited the growth of tumors. The adoptive transfer of
      macrophages activated with "activators" might lead to a new kind of immunotherapy
      of neoplastic diseases.

PMID- 2234204
TI  - Hairy cell leukemia and other "hairy-cell" lymphoproliferative disorders (LPD
      HC): the significance of morphologic, histologic and immunologic studies.
AB  - In this report the clinical, morphologic, histologic and immunologic findings of
      41 patients with hairy lymphoid cells in peripheral blood and/or bone marrow are
      analyzed. In 27 patients the diagnosis of hairy cell leukemia was established. 14
      patients had other variants of lymphoproliferative disorders: malignant lymphoma
      with hairy cells--7, chronic lymphocytic leukemia with hairy cells--5, and T cell
      lymphoproliferative disorder with hairy cells--2 patients, respectively. Several
      variants of malignant lymphoma with hairy cells were defined: lymphocytic,
      centrocytic and lymphoplasmacytic. The importance of combined use of bone marrow
      biopsy and immunophenotyping for the correct diagnosis of hairy cell leukemia and
      other "hairy-cell" lymphoproliferative disorders is stressed. The obtained data
      suggest relationship between characteristic clinical manifestation (isolated
      splenomegaly), presence of hairy cells and CD11c-antigen expression.

PMID- 2234205
TI  - Expression of blood group A and B antigens in gastric cancer examined by
      monoclonal antibodies.
AB  - Fourty-eight patients with gastric carcinoma were histologically examined and
      classified according to Lauren as intestinal or diffuse type. Employing
      monoclonal antibodies, in all samples the expression of blood group A and B
      antigens was studied using the method of indirect immunoperoxidase reaction. In
      patients with blood groups A and AB the comparison of expression revealed marked
      differences between the intestinal and diffuse type carcinomas. In the intestinal
      type, the expression of the blood group antigens was highly heterogenous, while
      diffuse type carcinomas displayed a homogenous expression. The obtained
      differences support Lauren's classification. The staining of supranuclear regions
      of tumor cells by the monoclonal antibody HE 10 (which reacts with antigenic
      determinants A and H of type 3 and 4) was found more frequently in intestinal
      type carcinomas. The possible prognostic significance of these findings is
      discussed.

PMID- 2234206
TI  - Sonography in the evaluation of treatment of differentiated thyroid cancer. First
      results in 158 patients.
AB  - Sonographic examination of soft tissues of the neck was used to search for
      recurrent thyroid cancer in 158 patients. Two hundred and thirty-six sonographic
      findings were evaluated. Specificity of the method, regardless of the type of
      recurrence, was 0.96, sensitivity 0.66, precision 0.81, predictive value of
      negative finding 0.72. This compares favorably with the results of examination by
      palpation (sensitivity 0.32 to 0.52, according to the type of recurrence), or
      with those of palpation combined with thyroglobulin estimation (sensitivity 0.50
      to 0.60). Most important was the possibility of early detection of unpalpable
      recurrent lesions showing no radioiodine uptake, or relapses with low
      thyroglobulin production. Systematic evaluation of out-patients using sonography
      could lower the need for radioiodine scans that are necessarily connected with
      thyroid hormone therapy withdrawal and that are usually performed in in-patients.

PMID- 2234207
TI  - Survival and mortality in a randomized study of lung cancer detection.
AB  - In a randomized prospective study of lung cancer detection in a high-risk
      population of over 6000 heavy smokers semiannual screening by X-ray and sputum
      cytology was compared to screening at a 3-year interval. The comparison of Kaplan
      Meier estimates of survival curves done without and with correcting for lead-time
      bias disclosed a rather important impact of lead-time bias on survival
      comparisons. On the contrary, controlling for possible length bias had no obvious
      effect on the shape of survival curves. The evaluation of mortality from lung
      cancer, being used as a basic criterion, indicated no traceable benefit from
      semiannual screening. The higher incidence of lung cancer in the frequently
      screened group was paralleled by a higher mortality. It is concluded that
      currently available screening techniques will not solve the problem of lung
      cancer mortality in smokers. The results underline the importance of primary
      prevention for lung cancer.

PMID- 2234208
TI  - Occupational risk factors for cancer of the larynx in Spain.
AB  - Spain is one of the countries with the highest incidence of laryngeal cancer and,
      together with France, is the country with the lowest percentage of women with
      this disease. In order to identify the occupational risk factors associated with
      laryngeal cancer in this country a case-control study was performed. Cases
      included 85 patients with epidermoid carcinoma of the larynx diagnosed in "La
      Paz" Hospital, Madrid, between 1985 and 1987. A sample of 170 patients from the
      same hospital was used as control. The results of the study revealed that 56.5%
      of larynx cancer patients had a sedentary occupation working in the service
      sector. Exposure to insecticides or silica were strongest risk factors for
      laryngeal cancer. An association between laryngeal cancer and exposure to fumes,
      chemical products, mineral dust, or wood dust was not found.

PMID- 2234209
TI  - Risk for development of cancer in three urban areas of India.
AB  - The probability of developing cancer by using life table approach has been
      computed for the population of three metropolitan cities of India based on data
      of population based cancer registries located at Bangalore, Bombay and Madras. It
      was observed that the risk for development of malignancy of all sites from 20 to
      64 years ranged from 4.73% to 5.28% in males, whereas it was 6.76% to 9.18% in
      females. The increased risk in females was mainly due to the high risk of
      development of cancer of the uterine cervix and breast. The available morbidity
      indices such as cumulative incidence rate and cumulative risk do not account for
      the mortality experiences of population. The present exercise will be useful in
      evaluating the changes in the disease spectrum as a result of change in the
      mortality experiences and population structure.

PMID- 2234210
TI  - Flow cytometry (FCM) analysis of endometrial hyperplasia and carcinoma.
AB  - In a series of 52 biopsy specimens (31 endometrial carcinomas, 10 atypical
      endometrial hyperplasias, and 11 cases of normal endometrium), DNA ploidy and S
      phase cell fraction were estimated in paraffin-embedded material. DNA aneuploidy
      was detected in 2 of the 10 atypical endometrial hyperplasias and 7 of the 31
      endometrial carcinomas. The majority of aneuploidy was found to be connected with
      the loss of tumor differentiation. No ploidy disturbances were found in normal
      endometrium. The S-phase cell fraction value of normal endometrium was
      significantly lower when compared with that of endometrial carcinoma. The broad
      variation in S-phase cell fraction values of the endometrial carcinomas and
      atypical endometrial hyperplasias was in contrast with the low variability of S
      phase cell values of normal endometrium. Very low incidence of aneuploidy in the
      group of well differentiated endometrial carcinomas (Grade I) enables the
      suggestion that the presence of aneuploidy predicts a more aggressive disease and
      that the detection of an aneuploid stemline in atypical endometrial hyperplasia
      may already indicate the neoplastic transformation.

PMID- 2234211
TI  - Microphotometric nuclear DNA analysis in cervical dysplasia of the uterine
      cervix: its relation to the progression to malignancy and regression to normalcy.
AB  - The present study was attempted to reveal the predictive value of DNA ploidy
      pattern of uterine cervical dysplasia cases in relation to cervical
      carcinogenesis. Microphotometric nuclear DNA analysis using Feulgen stain was
      carried out in 310 cervical smears of 80 dysplasia cases consisting of 53 cases
      which progressed to malignancy and 27 cases which regressed to inflammation or
      normalcy during their follow-up periods. Aneuploid DNA pattern was observed in
      initial as well as follow-up smears in 69.8% of cases of the progressive group,
      and in 7.4% of cases of the regressive group. This difference is statistically
      highly significant (chi 2 27.88, p less than 0.001). In the progressive group, an
      aneuploid DNA value was observed in 40.0% of mild dysplasia, 71.9% of moderate
      dysplasia and 90.9% of severe dysplasia. In the regressive group, DNA aneuploidy
      was observed in only 9.1% of moderate dysplasia. This difference is statistically
      significant. These findings indicate that an aneuploid DNA value is a risk
      indicator for malignant potential of dysplasia cases.

PMID- 2234212
TI  - Modulation of glycoconjugate biosynthesis by 5-hexyl-2'-deoxyuridine in highly
      metastatic Lewis lung carcinoma cells.
AB  - The mechanism of action of 5-hexyl-2-'deoxyuridine (HUdR), a compound with
      antitumor activity, has been investigated in the HM cell lines derived from the
      highly metastatic variant of Lewis lung carcinoma (3LL-HH). It was shown that
      this pyrimidine analog did not inhibit the biosynthesis of nucleotides but
      modified the biosynthesis of glycoconjugates. The incorporation of [14C]
      glucosamine into cytoplasmic glycoconjugates [glycosaminoglycan (GAG), glycolipid
      (GL), glycoprotein (GP), neutral polysaccharide (NP)] decreased to a similar
      level. The [14C]-glucosamine derived radioactivity was reduced to about 60-70% of
      the untreated controls in the presence of 15 micrograms/ml HUdR, which caused no
      inhibition of cell proliferation. These results might be explained by the reduced
      conversion of glucosamine into uridine-5'-diphospho-hexosamine. As more reduction
      was observed in the glucosamine labeling of glycoconjugates in nuclei and
      extracellular compartment, it may be conceivable that the intracellular transport
      of certain glycoconjugates (GAG, GP) is also affected by HUdR. In the
      extracellular compartment the reduced level of GAG labeling was the most apparent
      change. However, at a higher concentration of HUdR (75 micrograms/ml) there was a
      higher radioactivity in the combined GL + GP fraction. Using [35S]-labeling, the
      GAG fractions also showed a decreased radioactivity but only at the concentration
      of 75 micrograms/ml HUdR.

PMID- 2234213
TI  - The role of polyamines as a marker of tumor progression and regression in
      experimental tumors.
AB  - The pattern of changes in the polyamine spectrum has been studied under the
      stress of Sarcoma 180, a transplanted tumor growing in the peritoneal cavity of
      mice. Retinol, a known inhibitor of ornithine decarboxylase, was used to modulate
      tumor growth pattern and subsequent changes in the level of polyamines. The
      polyamine levels showed an increase during tumor proliferation. In the treated
      group, however, the enhanced levels exhibited a tendency to decrease, along with
      tumor inhibition, indicating that a positive correlation exists between the
      polyamine content in the red blood cells of mice and the tumor growth pattern.

PMID- 2234214
TI  - Stimulating effect of blood serums from tumor-bearing rats on cholesteryl ester
      synthesis in normal rat liver cytosol in vitro.
AB  - Addition of diluted blood serum from tumor-bearing rats stimulated significantly
      the synthesis of cholesteryl esters from labeled cholesterol and endogenous fatty
      acids in the cytosol derived from normal rat liver. With both Zajdela and Walker
      transplantable tumors this effect was found to be associated with the most
      intensive period of tumor growth. During chemical carcinogenesis induced by a
      single subcutaneous administration of benzo(a)pyrene the stimulating effect of
      sera was found to precede several weeks the appearance of palpable tumors and
      persisted during the period of progressive tumor growth. With all tumors used,
      sera in ultimate stages of tumor growth failed to show a stimulating effect. The
      stimulating effect was due to the presence of a yet unidentified lipid. Higher
      quantities of this substance may appear in the serum of tumor-bearing animals to
      meet higher requirements for cholesteryl esters during tumor growth. The
      stimulating effect of the blood serum on cholesteryl esters may be a useful
      marker of malignant tumors in humans.

PMID- 2234215
TI  - Long-term carcinogenicity bioassay of the herbicide atrazine in F344 rats.
AB  - In Fischer F344/LATI rats of both sexes the herbicide atrazine was given in the
      diet at concentrations of 0, 375 and 750 ppm for 126 weeks. Food and water
      consumption was similar in the treated and control groups. Feeding of atrazine
      resulted in dose-dependent depression of body weight gain in both sexes. There
      was no difference in the survival among the females. The males in the treated
      groups lived significantly longer than the controls. Exposure to atrazine
      resulted in significantly increased incidence of mammary tumors in the high dose
      male group. Uterine carcinomas were observed at a dose-related, significantly
      increased incidence. The number of combined leukemias/lymphomas increased in the
      treated males and females, but it was statistically significant only for females.
      The total number of malignant tumors showed a dose-related increase in both
      sexes. Other tumors and nontumorous lesions occurred at background level and were
      not influenced by treatment.

PMID- 2234216
TI  - Some electrochemical characteristics of synthetic analogs of nucleic acid
      components. II. Derivatives of uridine and arabinosyluracil. An attempt to find
      correlation between some of their properties.
AB  - The relation between half-wave potentials E1/2, parameter tg alpha, and chemical
      structure of a series of natural and synthetic compounds of nucleic acids were
      studied. This series included the pyrimidine nucleobase uracil, the natural
      pyrimidine nucleoside uridine and its deoxy-derivatives, the synthetic analog
      arabinosyluracil, its deoxy- and thio-analogs, and some cyclonucleosides. It was
      confirmed that the value of tg alpha, which may suggest a potential carcinogenic
      activity of the compounds studied, is dependent upon lipophilicity and rate of
      biotransformation of these compounds. Generally, it was shown that the complexity
      of nucleoside molecules makes it impossible to find parameters showing
      correlation. Linear correlation was found only in small, structurally similar
      groups of derivatives.

PMID- 2234217
TI  - Treatment of murine EL4 leukemia in ascitic form with anti-Thy 1.2 specific
      immunotoxins.
AB  - C57BL/6 mice with EL4 leukemia cells in ascitic form were intraperitoneally
      treated with ricin A chain-multivalent antibody immunotoxins. The immunotoxins
      containing rabbit IgG anti-Thy 1.2 antibodies complemented by protein A of
      Staphylococcus aureus were able to interact specifically with the target cells
      and to induce an antitumor effect as revealed by an increase in survival time of
      the mice. No apparent secondary effects consecutive to a cytotoxic action on the
      normal Thy 1.2 antigen bearing cells were observed with the immunotoxin doses
      used.

PMID- 2234219
TI  - Antitumor activity of Borrelia burgdorferi cultures.
AB  - Cultures of B. burgdorferi, their supernatants as well as washed cells revealed
      in vitro a considerable antitumor activity against cells of Gardner lymphoma.
      Nemeth-Kellner lymphoma and LP-2 plasmacytoma. In in vivo tests an inhibition of
      tumor growth was evident, even if the treatment was started on day 4 after
      implantation of the tumor. The best results were obtained with the supernatants
      of the cultures.

PMID- 2234220
TI  - Management of patients with brain metastases of unknown origin.
AB  - During the years 1973-1987, 75 patients were irradiated for brain metastases of
      unknown origin at the Institute of Oncology in Ljubljana. Of these, 35 (47%) were
      previously treated by surgery: Metastases were completely removed in 22 patients
      and partially in 7, whereas biopsy alone was performed in 6 patients. Based on
      the examinations carried out during radiation therapy and at the time of follow
      up, the primary sites of tumor were established as follows: The lung in 40
      patients, the breast in 2, melanoma in 2, and the esophagus, kidney, and parotid
      gland in one patient, respectively. Primary tumor could not be detected in 28
      (37%) patients. Metastases were microscopically verified in 48 cases in which
      anaplastic carcinoma and adenocarcinoma were most frequent. All the patients were
      irradiated on a cobalt unit, generally with doses of 10 x 300 cGy in 2 weeks.
      Median survival of the 22 patients with total removal of brain metastases was 9.5
      months, one-year survival being achieved in 41% of cases. In the remaining
      patients median survival was 3 months, whereas only 12% of the patients survived
      one year. The cause of death were most frequently, i.e. in 45 patients, brain
      metastases.

PMID- 2234218
TI  - On the background of differences in survival of female breast cancer patients in
      the German Democratic Republic and the Estonian SSR.
AB  - The aim of this study was to describe the age-specific survival patterns and to
      analyse the differences between the survival rates of female breast cancer
      patients in the German Democratic Republic in 1976-1977 and the Estonian SSR in
      1968-1981. The estimated 5-year relative survival rate (RSR) was 64.1% in the GDR
      and 55.9% in Estonia. Patients aged 55 years or older at diagnosis had higher
      survival in the GDR (5-year RSR 62.6%) than in Estonia (49.5%). That result was
      clearly connected with higher proportion of advanced tumors among older patients
      in Estonia. For patients younger than 55 years the difference of the 5-year RSR
      between the both countries was not statistically significant (GDR 65.3%, Estonia
      63.4%). The standardization of overall 5-year RSR by stage and age, but also only
      by stage of the disease produced virtually equal results for the GDR and Estonia.
      It means that the main source of the differences in overall breast cancer
      survival rates between the GDR and Estonia are the discrepancies in stage
      distribution, particularly in older age groups.

PMID- 2234221
TI  - [Recent developments in ultrasound study of cerebral arteries and their clinical
      value].

PMID- 2234222
TI  - [Pattern of cerebral infarct in computerized tomography. Pathophysiologic
      concepts, validation and clinical relevance].
AB  - Our pathogenetically oriented classification system of hemispheric brain
      infarctions is reviewed. New data are presented to validate this classification
      from various points of view. A retrospective analysis of 73 patients with large
      striato-capsular infarcts demonstrated that two-thirds of them had a source of
      embolism either in the carotid bifurcation or in the heart. SPECT-imaging in
      patients with hemispheric brain infarctions of various origin revealed that the
      area of exhausted cerebral perfusion reserve largely exceeds the area of the
      infarct visible on CT if a hemodynamically caused low-flow infarction is present.
      This is not the case in the territorial type. Measurement of the hemispheric
      vasomotor reactivity to capnic stimuli confirmed this finding by demonstrating a
      severely reduced VMR in low-flow infarctions, but not in thrombo-embolically
      caused territorial infarctions. Lacunar infarctions due to occlusion of single
      long penetrating arteries should be judged as either "unequivocal", "probable" or
      "possible lacunae" and should be differentiated from small lacunar-like
      infarctions in the cortex ("non-lacunae") which represent small territorial
      infarctions due to thromboembolism of small pial arteries. Infarctions in the
      temporo-parieto-occipital watershed area are difficult to distinguish from
      territorial infarctions within the posterior part of the middle cerebral artery
      distribution. For research purposes, such patients should be excluded in order to
      keep the subgroups homogeneous. Consequences of this classification system for
      diagnostic and therapeutic strategies in stroke patients are discussed.

PMID- 2234223
TI  - [Cerebral ischemia in young adults. Typical causes and diagnostic problems].

PMID- 2234224
TI  - [Diagnosis and prognosis of acute cerebellar infarcts. A retrospective study].
AB  - 37 patients with acute cerebellar infarction were analysed retrospectively.
      Diagnosis of cerebellar infarction cannot be made by clinical symptoms alone
      rather together with CT and MRT displaying the localisation and size of the
      lesion. Evoked potentials do predict clinical outcome more accurately than EEG or
      doppler sonography do.

PMID- 2234226
TI  - [Measuring premorbid performance capacity].

PMID- 2234225
TI  - [Orthostatic dysregulation in Parkinson syndrome. Results of a study of 250
      patients].

PMID- 2234227
TI  - [Aneurysms of the anterior inferior cerebellar artery. A case report and review
      of the literature].
AB  - A case of an anterior inferior cerebellar artery (AICA) aneurysm in a 63-year-old
      female who had suffered from subarachnoid hemorrhage and died after repeated
      bleeding is presented. A review of 26 cases available from literature is given.
      Clinical symptomatology and diagnostic procedures are discussed.

PMID- 2234228
TI  - [Traumatic rupture of the inferior petrous sinus with fatal subarachnoid
      hemorrhage after a fall on the back of the head].

PMID- 2234229
TI  - [Familial paroxysmal dystonic choreoathetosis].

PMID- 2234230
TI  - [Hemiballism as the primary symptom of AIDS].

PMID- 2234231
TI  - Anatomy and physiology of the mechanism of continence.

PMID- 2234232
TI  - Anal hemorrhoids.

PMID- 2234233
TI  - Proctitis.
AB  - An overview is given of the various aspects of idiopathic proctitis. Special
      emphasis is given on the diagnostic possibilities especially the endoscopic
      appearances. The list of other inflammatory conditions to be considered in the
      differential diagnosis is long and includes especially infectious disorders,
      Crohn's disease, post-radiation abnormalities, caustic damage and ischaemic
      damage. The mainstay of therapy is topical application of measalazine and
      corticosteroids. In general measalazine appears to be equally effective as
      corticosteroids.

PMID- 2234234
TI  - General perianal skin problems.
AB  - In this paper attention is focused on the following conditions: perianal skin
      problems such as pruritus in the perianal area, the eczemas, psoriasis,
      premalignant and malignant tumours such as Bowen's disease and Bowenoid
      papulosis, squamous cell carcinoma, dermatophyte and yeast infections and
      sexually transmitted diseases such as syphilis, condylomata acuminata (warts) and
      genital herpes. Principles of clinical, bacteriological and histopathological
      diagnosis will be discussed briefly for each of the above-mentioned diseases. For
      some of these, therapeutic effectiveness and particular side effects due to the
      use of topically applied drugs containing corticosteroids, anaesthetics,
      antibiotics and preservatives will also be considered.

PMID- 2234235
TI  - Perianal complications in Crohn's disease.

PMID- 2234236
TI  - Extra-ordinary forms of proctitis.

PMID- 2234238
TI  - Abstracts of The Netherlands Society of Gastroenterology. 1988 and 1989.

PMID- 2234237
TI  - Radiology of anorectal diseases.

PMID- 2234239
TI  - Treatment of renal failure in the primary hyperoxalurias.

PMID- 2234241
TI  - Radical esophagectomy on a maintenance hemodialysis patient.

PMID- 2234240
TI  - Aortobronchial fistula complicated with an aortic aneurysm in hemodialysis
      patient.

PMID- 2234242
TI  - Cardiac risk score for coronary artery disease and preparation for kidney
      transplantation.

PMID- 2234243
TI  - Intraperitoneal cisapride for the treatment of diabetics with gastroparesis and
      end-stage renal disease.

PMID- 2234244
TI  - In vitro production of 'glomerular red cells': role of pH and osmolality.
AB  - We used an in vitro model consisting of a polycarbonate filter with pore
      diameters of 3 microns, through which red cells suspended in urine or buffer were
      pumped at a flow rate of 0.5 ml/min. pH and osmolality of the suspension were
      systematically changed within a range of pH 5-8 and 200-800 mosm/kg H2O. It was
      found that: (1) glomerular shapes could be produced by this filtration technique;
      (2) urine facilitated the production of glomerular shapes; (3) certain shapes
      occurred predominantly, at specific conditions of pH and osmolality and (4)
      hemolysis decreased with increasing osmolality or very low pH. These observations
      shed light on the mechanism by which glomerular red cell shapes are formed.

PMID- 2234245
TI  - Ocular and auditory toxicity in hemodialyzed patients receiving desferrioxamine.
AB  - During an 18-month period of study 41 hemodialyzed patients receiving
      desferrioxamine (10-40 mg/kg BW/3 times weekly) for the first time were monitored
      for detection of audiovisual toxicity. 6 patients presented clinical symptoms of
      visual or auditory toxicity. Moreover, detailed ophthalmologic and audiologic
      studies disclosed abnormalities in 7 more asymptomatic patients. Visual toxicity
      was of retinal origin and was characterized by a tritan-type dyschromatopsy,
      sometimes associated with a loss of visual acuity and pigmentary retinal
      deposits. Auditory toxicity was characterized by a mid- to high-frequency
      neurosensorial hearing loss and the lesion was of the cochlear type.
      Desferrioxamine withdrawal resulted in a complete recovery of visual function in
      1 patient and partial recovery in 3, and a complete reversal of hearing loss in 3
      patients and partial recovery in 3. This toxicity appeared in patients receiving
      the higher doses of desferrioxamine or coincided with the normalization of
      ferritin or aluminium serum levels. The data indicate that audiovisual toxicity
      is not an infrequent complication in hemodialyzed patients receiving
      desferrioxamine. Periodical audiovisual monitoring should be performed on
      hemodialyzed patients receiving the drug in order to detect adverse effects as
      early as possible.

PMID- 2234246
TI  - Urinary excretion of apolipoproteins bound to HDL-like particles in rat nephrotic
      syndrome and their relation to plasma HDL.
AB  - Lipoprotein excretion was investigated in the urine of hyperlipidemic rats with
      nephrotic syndrome induced by aminonucleoside of puromycin. Incubation with
      phosphatidylcholine liposomes was employed to float apoproteins not bound to
      lipids, by ultracentrifugation at d = 1.21 g/ml. On ultracentrifugation of whole,
      untreated urine, the amount of protein floated was 6-fold greater in nephrotic
      vs. control rats and consisted mainly of HDL-like particles. Sodium
      dodecylsulfate-polyacrylamide gel electrophoresis showed that control urine
      contained apoproteins A-I, A-II, E and traces of C, whereas in the nephrotic
      urine apo-E and a large amount of apo-C was found. Addition of liposomes to the
      ultracentrifugal d = 1.21 g/ml infranate and reflotation at the same density
      resulted only in slight increment in the floated apoproteins, mainly C and A-I.
      Addition of liposomes to the whole urine and centrifugation at d = 1.21 g/ml also
      did not produce a greater yield in the floated apoproteins of control or
      nephrotic urine. These results indicated that the urine is virtually devoid of
      lipid-free apoproteins and those floated from both the nephrotic and control
      urine are complexed with lipids. The plasma VLDL + LDL fraction of nephrotic
      rats, though increased in quantity, did not differ markedly in composition from
      that of control rats. The HDL, approximately 3-fold elevated in nephrotic rats,
      were poorer in esterified cholesterol and richer in phospholipids. Relative to
      plasma HDL, the nephrotic urine HDL were protein-rich and phospholipid-poor and
      appeared to be larger in particle size as suggested by the lower estimated
      specific volume. The modified plasma HDL in nephrosis may have a
      pathophysiological implication.

PMID- 2234247
TI  - Serum immunoglobulin levels and natural antibodies to Haemophilus influenzae in
      hemodialysis patients: evidence for IgG subclass imbalances.
AB  - Humoral immune parameters were studied in 13 patients with end-stage renal
      failure on maintenance hemodialysis. Serum IgA, IgM and IgG concentrations were
      comparable to control values from 14 healthy blood donors. IgG subclass analysis
      revealed significantly increased IgG1 levels in the patients when compared to
      controls (p less than 0.01). In 3 patients, IgG2 deficiency was found, in one
      case associated with low IgG3 level. Concentrations and subclass composition of
      naturally occurring antibodies to Haemophilus influenzae type b (Hib)
      polysaccharide (PS) were measured using an indirect ELISA. In patients IgM and
      IgG, including IgG1 and IgG2 antibodies to Hib, presented no difference from
      controls. Subclass analysis of Hib specific IgG antibodies revealed that IgG2
      accounted for a substantial amount of the anti-Hib PS antibody response in
      controls as well as in patients. We conclude that patients on maintenance
      hemodialysis present imbalances of immunoglobulin levels. However, the antibody
      response to certain PS antigens could remain unaffected by renal failure.

PMID- 2234248
TI  - Endotoxemia in patients on hemodialysis.
AB  - We examined endotoxins and limulus amebocyte lysate-reactive material (LAL-RM) in
      serum from 87 patients on hemodialysis, using the conventional chromogenic
      limulus test (CCLT) and a new specific endotoxin assay with factor G-free LAL
      (endotoxin-specific test: EST). All patients with regenerated cellulose dialyzers
      had increased CCLT values, whereas the EST values were not higher than in
      controls. This discrepancy can be explained by the LAL-RM which is cellulose
      derived and cross-reacts with LAL via factor G. Using EST for measurements of
      endotoxin, 6 patients out of 87 had pathological endotoxemia and all of these
      patients were associated with either cirrhosis, infection, or malignancy. Some
      patients who had no complications showed fever before or during dialysis, but
      they did not have high endotoxin levels. EST is useful for the diagnosis of
      endotoxemia in patients on hemodialysis because of the presence of LAL-RM in
      serum. Endotoxemia is rare in patients on hemodialysis, if they are not
      associated with infection, cirrhosis, or other complications.

PMID- 2234249
TI  - Urinary IgA, secretory IgA and secretory component in women with recurrent
      urinary tract infections.
AB  - Urinary secretory IgA (sIgA), consisting of free secretory component (FSC) and
      dimeric IgA, is involved in the defense against urinary tract infections (UTI).
      Recurrent UTIs (rUTI) have been suggested to be associated with a defective
      excretion of sIgA. Therefore urinary sIgA, FSC and serum-type IgA concentrations
      were measured by ELISA in 68 normal women, 10 asymptomatic women with rUTIs and
      no urological abnormality (group A), 8 asymptomatic women with rUTIs and a
      urological abnormality (B), 4 women with acute UTI (C) and 5 women with a
      selective serum IgA deficiency (D). Annual UTI rates were increased in groups A,
      B and C, but normal in group D. In no patient group urinary FSC concentration was
      different from the normals, while sIgA concentrations were increased in group C,
      markedly reduced in group D, but normal in groups A and B. Urinary serum-type IgA
      concentrations were significantly increased in group A and C, markedly reduced in
      group D and normal in group B. These results demonstrate that the urinary sIgA
      system participates in the immune response to bacterial infections, but that even
      a complete failure of the sIgA system does not lead to an increased UTI rate.
      Furthermore, no association of recurrent UTIs with disturbances of the urinary
      sIgA excretion could be demonstrated.

PMID- 2234250
TI  - Sustained-release bezafibrate corrects lipid abnormalities in patients on
      continuous ambulatory peritoneal dialysis.
AB  - A study was undertaken in 24 Chinese patients on maintenance continuous
      ambulatory peritoneal dialysis, using bezafibrate in its sustained-release form
      to correct lipid abnormalities. Six patients who received 400 mg/day developed
      severe muscle weakness with grossly elevated creatine phosphokinase activities
      within 3 weeks. The drug was discontinued and the symptoms disappeared. The
      remaining 18 patients received 400 mg/week for 8 weeks. There was a significant
      decrease in serum triglyceride (2.74 +/- 0.33 to 1.86 +/- 0.17 mmol/l at the 4th
      week and 1.65 +/- 0.4 mmol/l at the 8th week). Concomitantly, serum total
      cholesterol decreased. Serum high-density lipoprotein cholesterol increased
      significantly (from 1.18 +/- 0.082 to 1.36 +/- 0.060 mmol/l at the 4th week and
      1.40 +/- 0.103 mmol/l at the 8th week). Post-heparin lipoprotein and hepatic
      lipases were measured by a substrate-specific method. The former increased
      significantly (p = 0.000) after bezafibrate treatment while the latter did not
      change. All parameters of lipid metabolism returned towards baseline 4 weeks
      after discontinuation of therapy. The drug was well tolerated at 400 mg/week and
      there was no significant rise in serum creatine phosphokinase.

PMID- 2234251
TI  - Oxyphil cells of parathyroid glands in chronic renal failure may not secrete
      parathyroid hormone.
AB  - To evaluate the function of parathyroid oxyphil cell in chronic renal failure, we
      studied the histopathological findings of 148 parathyroid glands of 42 patients
      (29 males, 13 females) on maintenance hemodialysis. The individual and total
      weights of resected parathyroid specimens in each patient were recorded. Using
      the morphometrical analyzing system, we measured the oxyphil cell area and total
      area in each excised section taken through the maximum diameter, to estimate them
      in each patients. According to the fractional ratio (R:oxyphil cell area/total
      area), patients were divided into four groups: group I (R less than 1%), group II
      (1% less than or equal to 5%), group III (5% less than or equal to R less than
      10%) and group IV (10% less than or equal to R). There were no differences in
      age, duration of hemodialysis and serum C-PTH level among the different groups.
      There was a positive correlation not only between total glandular weight and
      serum C-PTH level, but also between total glandular weight and total area, and
      also a positive correlation was found between serum C-PTH level and total area.
      No tendency was found between oxyphil cell area and serum C-PTH level. However,
      in 15 patients whose oxyphil cell area was more than 10 mm2, there was a negative
      correlation between the area and serum C-PTH level. Also, in 16 patients whose R
      was more than 5%, there was a negative correlation between the rate and serum C
      PTH level. These results suggested that oxyphil cell in chronic renal failure
      might not secrete PTH.

PMID- 2234252
TI  - Pattern of double glomerulopathies. A clinicopathologic study in nine nondiabetic
      patients.
AB  - Nine new cases of double glomerulopathies (GP) were found among 1,715 renal
      biopsies. Immunofluorescence and electron microscopy were needed to achieve a
      correct diagnosis and the prevailing relevance of these techniques in single
      cases was stressed. IgA nephropathy was the most commonly found GP, being
      associated with membranous glomerulonephritis (GN) (2 patients), minimal change
      disease (3 patients), and focal segmental glomerulosclerosis (1 patient). In
      addition, single cases of membranous GN plus crescentic GN and acute GN plus
      cryoglobulinemic GN were recorded. Possible factors involved in the pathogenesis
      and clinical significance of double glomerulopathies are discussed.

PMID- 2234253
TI  - Elimination of iohexol, a low osmolar nonionic contrast medium, by hemodialysis
      in patients with chronic renal failure.
AB  - The dialyzability of iohexol was examined in patients with chronic renal failure
      on long-term hemodialysis treatment. Eight patients had iohexol (Omnipaque 240 or
      350 mg I/ml) injected in doses between 98 and 1,493 mg I/kg body weight (BW) 25 h
      (mean time) before start of hemodialysis. Dialysance of iohexol was 81 +/- 15
      ml/min (mean +/- SD) compared to 120 +/- 16.8 ml/min for creatinine. Elimination
      half-life for iohexol during hemodialysis was 3.9 +/- 1.1 h while plasma
      clearance was 64 +/- 17 ml/min. The distribution volume calculated (0.25 +/- 0.05
      liters/kg BW) confirms previous observations with distribution in the
      extracellular fluid only. Before the start of hemodialysis 36 +/- 28% of the dose
      injected was eliminated, indicating some extrarenal elimination. After 4 h of
      hemodialysis 72 +/- 11% of the dose was removed.

PMID- 2234254
TI  - Dynamic pulmonary accumulation of labelled neutrophils by blood membrane contact
      in the pig.
AB  - Nine anesthetized pigs were subjected to short (90 min) sham dialysis with blood
      membrane contact with the aim to select effects of the artificial surface during
      dialysis. The importance of the neutrophil (PMN) was investigated by the
      selective isotope labelling, dynamically followed by gamma-camera imaging and
      biochemical assays specifically oriented for PMN function. These assays included
      cell count, PMN aggregation, PMN luminescence, fibronectin and catalase activity.
      Additionally, pulmonary and systemic hemodynamics and acid base balance were
      monitored. Sham dialysis induced an accumulation of labelled PMN attaining a
      maximum between 15 and 17 min. This was coupled with a time-related neutropenia,
      pulmonary vasoconstriction, increased in vitro PMN aggregation and luminescence
      response. The neutrophil response abated by the end of dialysis. Cardiac output
      and arterial blood pressure declined to a steady level after 30 min of sham
      dialysis. There was an insignificant decrease in catalase activity. All other
      parameters remained unaltered. The results indicate that PMN accumulates in the
      pulmonary vessels, in association with neutropenia and activation. The transience
      of the event points to a protective mechanisms of humoral and/or cellular
      character.

PMID- 2234255
TI  - Acute renal failure of renovascular origin: cure by aortorenal reconstruction
      after 25 days of anuria.
AB  - A case of dialysis-dependent acute renal failure due to bilateral renal artery
      occlusion is described. Renal function was improved dramatically by
      revascularization after 25 days of anuria and no further dialysis was required.

PMID- 2234256
TI  - Uric acid handling, pregnancy and cyclosporin in renal transplant women.

PMID- 2234257
TI  - [Harvey Cushing: neurosurgeon and artist].
AB  - Harvey Cushing was a man of many talents. He was a skilled, surgeon, scientist,
      author and bibliophile. In addition, he was an accomplished artist for both
      medical non-medical subjects. In this paper, we present three surgical drawings
      of Dr Cushing's that are representative of the nearly one hundred drawings we
      have thus far found with his operative notes in the Peter Bent Brigham Archives.
      We will also discuss Cushing's non-medical art, some of the best of which is of
      the French countryside.

PMID- 2234258
TI  - [The retrolabyrinthine approach. Its value in the treatment of lesions of the
      lateral sinus].
AB  - The Authors conceive the petrous bone as made of four segments bounded by two
      vertical plans, one passing through the anterior wall of the internal auditory
      canal and the posterior wall of the external auditory canal, the other passing
      through the inner aspect of the tympanic cavity and the outer aspect of the
      labyrinthe. Drilling away one or several segments realizes a trans-petrous
      approach which always begins by drilling away the posterior-external segment, the
      retro-labyrinthine segment. Drilling away only the retro-labyrinthine segment
      realizes retro-labyrinthine approach which entirely put into sight the
      circumference of the bending of the lateral sinus. Thus, it is possible to
      perfectly and more easily deal with lesions localized in this region. The skin
      incision is made two fingerbreadths above and behind the external ear. The scalp
      uncovers the mastoid as far as the posterior ring of the external auditory canal.
      The superficial drilling uncovers the temporal dura, the lateral sinus and the
      occipital dura and between them the sinuso-dural angle. Then the mastoid is
      drilled away as far as the antrum is opened. Its aditus internally sided by the
      loop of the external semi-circular canal serves to localize the external surface
      of the labyrinthe. Finally, the retro-labyrinthine approach is bounded by the
      posterior wall of the external auditory canal anteriorly, by the external surface
      of the labyrinthe internally, by the dura of the superior surface of the petrous
      bone superiorly and by the bended part of the lateral sinus and the dura of the
      posterior surface of the petrous bone posteriorly. The closure is made with a
      dural graft then with bony dust mixed with biologic glue, then the petrectomy is
      plugged with under-skin fat and then the superficial planes are carefully
      stitched. The authors report 5 cases of meningiomas of the lateral sinus, 1 case
      of hemangiopericytoma and 2 dural arteriovenous fistulas which demonstrate the
      interest of this approach to lesions developed on this part of the lateral sinus.

PMID- 2234259
TI  - [Cell proliferation in human cerebral tumors. In vivo study of 45 cases by
      incorporation of 5-iododesoxyuridine].
AB  - A method to study the proliferation of human brain tumors, is presented. Non
      radioactive 5-Iododeoxyuridine (2.4 gr) infused over a 24 hours period is
      detected in situ on histologic section by an immunological technique (peroxidase
      anti-peroxidase) using a specific anti-Iododeoxyuridine antibody. This
      exploration utilised in 45 patients is easy, reliable and harmless. All cells
      which enter in S phase of cellular cycle during the infusion are labelled. So the
      cellular kinetics of all the brain tumor cells (malignant cells, inflammatory
      stroma reaction cells, reactive astrocytes, endothelial and muscular cells of the
      vessels) are detected on the same histological section, as well as all the others
      proliferative cells of the body (leukocytes, primitive tumor of the metastatic
      brain localisation...) if multiples biopsies are done. 8 of 9 gliomas of low
      histological malignancy (grade I and II) have a slow cellular kinetic. The 23
      astrocytomas of different histological malignancy (grade III and IV) have
      variable proliferative speed (7 very fast, 8 fast and 8 slow). Only the large
      cells of the pinealoma are very proliferative, the lymphoid stroma is quiescent.
      The 5 metastasis have a slow to very fast kinetic without correlation with the
      cellular differentiation except in one case (important differentiation and slow
      cellular proliferation). The 5 lymphoma cells kinetics are well correlated with
      the histologic differentiation (3 large cells poor differentiated lymphomas and
      very fast kinetic, 2 better differentiated and slower proliferation). The 2
      meningiomas proliferate slowly. The biochemical and histopathological grounds of
      the presented method and the limits of quantification are discussed. This method
      is compared with this using Bromodeoxyuridine. The correlation between
      proliferation and histologic malignancy is analysed. The use of cytokinetic
      results for therapeutic and prognosis need further statistical anatomoclinical
      studies.

PMID- 2234260
TI  - [Laitinen's stereo-adapter: application to the fractionated cerebral irradiation
      under stereotaxic conditions].
AB  - Radiosurgery is a technique which provides a single high dose of radiation very
      precisely to an intracranial lesion. The volume of tissue treated is small enough
      to avoid undue biological damage. This treatment requires very sophisticated
      apparatus and often considerable modifications in the treatment apparatus. The
      authors have closen to elaborate a system which makes it possible to deliver
      conventional fractionated irradiation, using a non-invasive stereotactic head
      frame called "Laitinen stereo-adapter". By fractionating the dose, most benign or
      low-grade malignant brain tumours can be treated, whatever their volume. The
      stereo-adapter and the target localization process are described. It can be used
      with C.T. scanning, angiography or M.R.I. The treatment apparatus is a linear
      accelerator delivering a 10 M.V. photon beam and treatment is made in the precise
      positioning of the target localization. The geometrical accuracy of the repeated
      mountings was studied in a preliminary study, showing a mean discrepancy of less
      than 1 mm in the three space planes. The geometrical accuracy of the radiation
      treatment was also studied on a phantom and the precision evaluated at less than
      1 mm. The addition of extra collimators with a precollimation system decreased
      the lateral penumbra to 2-3 mm. Careful dosimetry was performed for each
      collimator. The use of non-coplanar arcs makes it possible to obtain a steep dose
      fall off outside the target volume. The dose planning calculations were compared
      to photodensitometry and thermoluminescent measurements, showing a good
      correlation. Each technical point will be discussed.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2234261
TI  - [Multiple intracranial aneurysms: discussion of the therapeutic management of a
      case].
AB  - The authors report the case of a 57-year-old, right-handed female who experienced
      a sudden acute headache, followed by a period of confusion and fever. Over the
      next week she developed language disturbances. No diagnosis was established.
      Three weeks later she was referred to the neurologist, complaining of a right
      frontal headache. The C.T. scans with and without contrast enhancement were
      suggestive of an aneurysm in each sylvian fissure. The angiography disclosed the
      presence of four aneurysms: a large left M.C.A. aneurysm, a larger right M.C.A.
      aneurysm, an aneurysm on the anterior communicating aneurysm and a small right
      M.C.A. aneurysm located more distally. The left M.C.A. aneurysm was presumably
      ruptured and responsible for the initial symptoms. The right M.C.A. aneurysms was
      apparently unruptured, but accounted for the persistent right headache. The other
      two aneurysms were thought to be asymptomatic. The left M.C.A. was operated
      first. Blood in the sylvian fissure confirmed the earlier rupture. Two weeks
      later, the three other aneurysms were surgically treated, via the same right
      pterional approach. No sign of hemorrhage was found on the right side. The post
      operative angiogram demonstrated the disappearance of all four aneurysms. Three
      months later, the patient was able to resume her previous occupations and
      clinically, she demonstrated no sign of psychological or intellectual
      disturbances. The management of multiple and bilateral cerebral aneurysms is
      discussed, as well as the management of asymptomatic aneurysms.

PMID- 2234262
TI  - [Mature lumbar multi-tissue dysembryoma of the spinal cord with sacral spina
      bifida occulta].
AB  - The authors report the case of a 28-year-old woman who presented with L5
      bilateral sciatica associated with perineal sensory disorders. During surgery, a
      mature pluritissular dysembryoma originating in a tethered spinal cord was
      discovered at the level of the L2-L3 intervertebral space. Following removal of
      the lesion, all symptoms disappeared. Mature pluritissular dysembryomas of the
      spinal cord result from the inclusion of neuroectodermal and mesodermal tissue
      which has not followed normal evolutive embryonic organization.

PMID- 2234263
TI  - [Hydrocephalus and cerebral cysticercosis. A case report. Review of the
      literature].
AB  - A case of intraventricular and cisternal cerebral cysticercosis with no
      intraparenchymatous involvement is reported. The clinical features were
      characterized by episodes of blockage of the C.S.F. pathways producing acute
      hydrocephalus. On three occasions surgical treatment was required: two
      ventriculoperitoneal shunts and a ventriculocisternostomy were performed. The
      intraventricular cystic membranes found during the third operation suggested the
      diagnosis. Epidemiological arguments, the pathogenesis of hydrocephalus and
      diagnostic and therapeutic aspects are discussed in the light of the literature
      data.

PMID- 2234264
TI  - [Hydatidosis of the cranial vault. Two case reports].
AB  - The authors report 2 cases of echinococcosis of the cranial vault, an extremely
      rare localization of hydatid disease. The parietal bone was involved in one case
      and the occipital bone in the other. The authors discuss the mechanism and
      classification of cranial vault echinococcosis. The clinical signs of the disease
      as well as its radiological appearances and especially its very characteristic CT
      scan appearances are studied in relation to the literature.

PMID- 2234265
TI  - [New strategies for the treatment of acute renal insufficiency].

PMID- 2234266
TI  - [Continuous hemodialysis with low blood flow and low dialysate flow in the
      treatment of acute renal insufficiency].
AB  - Slow continuous hemodialysis (SCHD) was performed in 9 patients with oliguric
      acute renal failure and cardiovascular instability. The vascular access was a
      Scribner's shunt in 7 patients and a double lumen venous catheter with a BSM22
      blood system in 2 patients. Three different dialyzers were tested. The mean urea
      clearance was 10.8 +/- 1.5 ml/min with the 0.2 m2 polysulfone hollow fiber
      dialyzer, 14.3 +/- 2.7 ml/min with the 0.5 m2 AN 69 S parallel plate dialyzer and
      13.8 +/- 1.8 ml/min with the 0.6 m2 AN 69 hollow fiber dialyzer. The mean
      dialysate flow rate was 15.6 +/- 1.9 ml/min, 15.2 +/- 0.7 ml/min and 15.1 +/- 1.6
      ml/min for the three dialyzers, respectively. A linear relationship was
      documented for blood urea clearance and dialysate flow rate indicating clearly
      that low blood flow from 60 to 100 ml per min was appropriate for optimal
      diffusive transfer. The technic required continuous heparin anticoagulation.
      Three patients died of causes not related to the SCHD technic. When used in
      critically ill patients, SCHD is a simple method, suitable for intensive care
      unit staff with no trained dialysis nurses and allows an adequate control of
      uremia, fluid removal, acid base homeostasis and parenteral nutrition.

PMID- 2234268
TI  - [Daily hemodialysis of ultra-short duration with non-traumatic vascular access.
      Two cases].
AB  - The authors report their experience on treating two patients, suffering end-stage
      renal disease, by daily hemodialysis of ultra-short duration with a non-traumatic
      vascular access. 90 minutes dialysis are realized 6 days a week. Clinical
      tolerance is excellent and patients' adhesion is satisfactory. However, despite
      reutilization of the dialyzer, the method remains costly.

PMID- 2234267
TI  - [Continuous veno-venous hemofiltration in acute renal insufficiency].
AB  - A fully pump-assisted continuous veno-venous hemodiafiltration system (CVVHDF)
      was studied in 10 acute renal failure patients. A counter current pump system
      ensured slow dialysis at a mean flow rate of 24.6 +/- 0.6 ml/min (single pass)
      and guaranteed recovery of 97% of dialysate. Ultrafiltration rates were
      controlled by a separate occlusive pump, connected to the dialysate compartment.
      Blood was circulated by mean of a third pump at flow rates ranging form 100 to
      150 ml/min. Mean duration of CVVHDF was 197 +/- 32 h (range 96-336). Mean serum
      creatinine and urea before initiation of CVVHDF were 525 +/- 52 mumol/l and 36 +/
      14 mmol/l and stabilized after 4-7 days of CVVHDF at 280 +/- 27 mumol/l and 14
      +/- 3 mmol/l. Hemodynamic parameters remained stable. Glucose and phosphate
      removal by CVVHDF was 296 +/- 42 mmol/day and 33 +/- 6 mmol/day respectively.
      Fractional losses of aminoacids given by parenteral nutriton averaged 8 +/- 1%.
      An 69 filters induced no significant changes in leucocyte and thrombocyte counts
      and only a slight decrease in pO2 (-0.78 +/- 0.30 K Pa at 60 min). We conclude
      that CVVHDF is a safe, efficient and reliable treatment modality, allowing a good
      control of the fluid balance.

PMID- 2234269
TI  - [Rapid development of mitral and aortic stenoses with chronic hemodialysis. A
      report of 2 cases].
AB  - Chronic renal failure is associated with a high incidence of calcifications of
      the mitral anulus, which if severe enough may result in mitral stenosis or
      regurgitation. Aortic valve calcifications, though less frequent, may also occur
      and cause aortic valve stenosis, as observed in two patients. In hemodialysed
      patients, identification of valvular aortic stenosis might be difficult on a
      clinical basis since the systolic ejection murmur might be attributed to aortic
      sclerosis or a high output state and left ventricular hypertrophy to previous
      hypertensive disease. Calcific aortic stenosis may easily be detected using
      echocardiography combined with the continuous Doppler technique.

PMID- 2234270
TI  - [Parameters of hemostasis during treatments associating fractionated heparin
      administered subcutaneously to standard and fractionated heparin administered
      intravenously in the chronic hemodialysis patient].
AB  - The hemorrhagic risk of an association of fractioned heparin (Fraxiparine)
      injected intravenously at the dose of 7500 AXaICU or of unfractionned heparin
      (UFH) injected intravenously at the usual dose used for a priming dose for
      hemodialysis (3750 +/- 1280 IU + 1000 IU after 2 hours of dialysis) to the
      subcutaneous administration of a thrombo-embolism preventive dose of Fraxiparine
      (7500 AXaICU) was evaluated on the modifications of the following hemostasis
      parameters: thrombin time, Activated Partial Thrombin Time (APTT), prothrombin
      time, anti Xa activity in 13 uremic patients on hemodialysis. The association of
      intravenous and subcutaneous Fraxiparine prevents efficiently the clotting of the
      extracorporeal circulation without inducing a detectable antithrombinic activity.
      In contrast, the association of I.V. UFH to subcutaneous Fraxiparine induces a
      significant increase of the thrombin time and of the APTT. This latter is
      exclusively explained by the activity of UFH. It is concluded that subcutaneous
      Fraxiparine at the thromboembolism preventive dose can be associated as well to
      I.V. Fraxiparine as to UFH without increasing the antithrombinic activity of the
      plasma.

PMID- 2234271
TI  - [Financial impact of anemia in patients with chronic renal insufficiency
      undergoing hemodialysis at centers].
AB  - The aim of this study was to evaluate the financial impact of anemia and
      transfusions in patients undergoing hemodialysis. Among a total population of 309
      patients treated in 6 French hemodialysis centers, 30 have been selected to enter
      in a detailed evaluation: 15 (Group 2) having received in 1987 eight blood units
      or more, and 15 (Group 1) not transfused during the period of study. The
      expenditures were calculated for both groups in each category, excluding the
      direct cost of dialysis sessions. The analysis shows that transfused patients
      cost roughly 28542 FF more per capita and per year than nontransfused patients.
      The most important causes of increasing expenditure were not only the cost of
      blood units (10140 FF per patient and per year), but also direct and indirect
      costs of medical and biologic follow-up of transfused dialysis patients, such as
      outpatient visits, surgery and hospitalizations (19061 FF per capita and per
      year). A major center effect was evidenced, the center variation being influenced
      by the variation in inpatient enrollment, and variation in medical policies.
      Since the cost of the end-stage renal failure would be strongly affected by the
      costly addition of human recombinant erythropoietin to the therapeutic
      armamentorium, it would be advisable to take into account in economic outcomes
      for dialysis patients savings through reduced need for blood transfusions and
      perhaps fewer hospitalizations.

PMID- 2234272
TI  - [Continuous ambulatory peritoneal dialysis in Tunisia].
AB  - CAPD covers about 4% of renal replacement therapy patients in Tunisia. From
      February 1983 to 1988, 47 patients, 21 males and 26 females whose mean age was
      36, 14 +/- 15 were treated. Their socio-cultural level was variable. The mean
      duration of therapy was 14.5 months/patient/year. The five years patient survival
      rate was 46% and the technique survival rate 21%. Most patients had a good
      general condition and were professionally rehabilitated. Peritonitis was the main
      complication: its incidence was 1.8 episodes/patient/year. Yeasts peritonitis
      were relatively frequent, specially in patients who had previously been treated
      with antibiotics. Peritonitis was often cured with a local and general treatment.
      Yearly CAPD cost was 1/3 lower than center hemodialysis and a better management
      allowed to decrease the expenses due to laboratory and X ray investigations and
      to hospitalization. On the basis of this clinical experience, we believe that
      CAPD is an efficient and valid therapeutic modality, less expensive than
      hemodialysis. It is probably a suitable renal replacement therapy in other
      centers in Tunisia and in other developing countries.

PMID- 2234273
TI  - [The first thirty months of kidney transplantation in Tunisia].
AB  - Kidney transplantation is actually the best replacement therapy for the end stage
      renal failure. It sets free the hemodialysed patient from the hemodialysis
      restraint and contributes to solve the socio-economic problems risen by chronic
      hemodialysis. The authors report the results of this technic during the first 30
      months of kidney transplantation in the "Hopital Charles Nicolle" of Tunis. They
      describe the first steps which led to kidney transplantation, the therapeutic
      regimens, the medico-legal problems and the specific complications observed
      during this start period.

PMID- 2234275
TI  - [Recurring arterial thrombosis in the adult during a nephrotic syndrome. Report
      of a case and review of the literature].
AB  - A 55 year old male with idiopathic nephrotic syndrome (minimal glomerular changes
      at light microscopy) developed recurrent arterial thrombosis (aortic, popliteal
      and prosthetic) combined with recurrent proteinuria. Fourty nine cases of adult
      arterial thrombosis associated with nephrotic syndrome are reviewed. This
      complication mainly affects the coronary, iliac and femoral, renal and cerebral
      arteries. Any type of nephrotic syndrome can be involved. The hypercoagulable
      state predisposes to thromboembolic events. Corticosteroid induced thrombotic
      episodes have been described during nephrotic syndrome. Therefore anticoagulant
      therapy is mandatory when steroid therapy is used.

PMID- 2234274
TI  - [Evaluation of nutritional status in chronic renal insufficiency].
AB  - No nutritional criteria have been validated in uremic patients. Chronic renal
      failure directly alters biological nutritional criteria. Anthropometric criteria
      are inadequate to routine follow up, but advisable to compare groups of patients.
      Quantitative evaluation of nitrogen ingestion and excretion allows to control
      dietetic compliance. They can not be used to check long term nitrogen balance.
      Nutritional criteria fail to diagnose mild undernutrition in uremic patients but
      they help to detect patients at risk to develop undernutrition when ascribed to
      low protein diets. Food inquiries, conducted by well trained dietitians are quite
      advisable, and helpful to the patients.

PMID- 2234276
TI  - [Fetal and maternal risks in pregnant women with primitive chronic
      glomerulonephritis].

PMID- 2234277
TI  - [Concentration of calcium in the dialysate and in the reinjection liquid in "on
      line" hemofiltration].

PMID- 2234278
TI  - [Hyperkalemia induced by heparin. A case].

PMID- 2234279
TI  - Acetyl-1-carnitine. 1: Effects on mortality, pathology and sensory-motor
      performance in aging rats.
AB  - Three different test sites assessed the effects of acetyl-1-carnitine (AC) on age
      related changes in general health, sensory-motor skills, learning, and memory.
      Two groups of rats began the experiments at 16 months of age. One group (OLD-AC)
      was given AC, 75 mg/kg/day, beginning at 16 months. The other group (OLD-CON) was
      treated identically except it was not given the drug. Beginning at 22 months of
      age, these rats and a group of young (3-4 months old) rats (YG-CON) were given a
      series of sensory-motor tasks. AC decreased mortality, and had no reliable effect
      on body weight, fluid intake, or the general health of the rats. These data
      indicate that a chronic dose of AC does not interfere with food and water intake,
      and may increase longevity. An age-related decline of performance occurred in
      most of the sensory-motor tasks; locomotor activity was reduced in a novel
      environment and in a runwheel, and the ability to prevent falling was reduced in
      tests on a taut wire, rotorod, inclined screen, and several types of elevated
      bridges. An age-related decline of performance did not occur in grooming, or in
      the latency to initiate several different behaviors. AC had no effect on
      performance in any sensory-motor task. These data indicate that the improvements
      produced by AC in some tests of spatial memory may be due to the effects of AC on
      cognitive abilities rather than on sensory-motor skills.

PMID- 2234280
TI  - Acetyl-1-carnitine. 2: Effects on learning and memory performance of aged rats in
      simple and complex mazes.
AB  - Acetyl-1-carnitine (AC) was administered via drinking water for six months to one
      group (OLD-AC) of male F-344 rats beginning at 16 months of age, while another
      group (OLD-CON) of rats was given water only during that period. The rats were
      maintained on this treatment throughout behavioral testing, which began at 22
      months of age. Performance of the OLD-AC and OLD-CON rats was compared to that of
      young control (YG-CON) rats on the following set of tasks: spontaneous
      alternation in the arms of a T-maze, two-choice simultaneous discrimination in
      the stem of a T-maze, rewarded alternation in the arms of a T-maze, spatial
      discrimination and reversal on a circular platform, spatial working memory in the
      radial 8-arm maze, long-term memory in the 14-unit T-maze, and for preference of
      the light or dark chamber of a two-compartment box. AC improved the long-term
      memory performance in the split-stem T-maze and on the circular platform but had
      no discernable effects on performance of aged rats in the other tasks. Possible
      reasons for the selectivity of this agent's action on behavior are suggested.

PMID- 2234282
TI  - A comparison of the working memory performances of young and aged mice combined
      with parallel measures of testing and drug-induced activations of septo
      hippocampal and nbm-cortical cholinergic neurones.
AB  - The spatial working memory performances of young (2 months) and aged (24-26
      months) mice of the C57BL/6 strain were compared using a delayed nonmatching to
      place (DNMTP) protocol in an automated 8-arm radial maze. The aged mice were
      observed to exhibit a selective and interference-related memory deficit. Parallel
      neurochemical analysis of the activity of septo-hippocampal and nbm-cortical
      cholinergic neurones in vivo was conducted using measures of sodium-dependent
      high-affinity choline uptake. Results showed that whereas the level of
      cholinergic activity in both brain regions varied less than 10% between young and
      aged mice in quiet conditions (basal) the activation usually observed at 30-sec
      posttest (+20-25%) in young mice was greatly attenuated in the frontal cortex and
      almost totally absent in the hippocampus of aged mice. In view of these results a
      complementary experiment was carried out in order to test the intrinsic ability
      of septo-hippocampal cholinergic neurones to activate using acute injection of
      scopolamine (1 mg/kg IP 20 min) to both young and aged mice in quiet conditions.
      The drug injection resulted in a very large (+70%) increase in hippocampal high
      affinity choline uptake and with amplitudes which did not vary significantly
      between young and aged subjects. These observations attest to a relatively well
      preserved state of central cholinergic neurones and an intact capacity to
      activate normally when challenged pharmacologically in aged mice. The results
      strongly suggest that the loss of cholinergic activation and associated memory
      deficit in aged mice might rather be related to a hypofunction of phasically
      active transsynaptic processes which normally mediate the activation of these
      cholinergic pathways during memory testing.

PMID- 2234281
TI  - Markers for biogenic amines in the aged rat brain: relationship to decline in
      spatial learning ability.
AB  - The major goal of the study was to evaluate the relationship of brain aging to
      individual differences in functional decline in rats. Forebrain choline
      acetyltransferase (ChAT) and monoamines, including their metabolites, were
      examined in young and aged male Long-Evans rats in relation to their spatial
      learning ability. Aged rats that were unimpaired on a spatial learning task
      exhibited few changes in neurochemistry relative to the young group: each change
      in this subgroup was also evident in the remaining aged animals that were
      behaviorally impaired. Additional changes in neurochemical measures only found in
      the behaviorally impaired aged animals included decreased ChAT in the basal
      forebrain, striatum, and frontal cortex. A cluster analysis using the 15
      neurochemical measures that were sensitive to aging yielded groupings of aged
      animals that differed with respect to their spatial learning ability, but not in
      their cue learning latencies. In this analysis the activity of ChAT in the basal
      forebrain and striatum appeared to be the best predictors of spatial learning
      impairment.

PMID- 2234283
TI  - Disrupted retention of the classically conditioned nictitating membrane response
      in the aluminum-intoxicated rabbit using electrical stimulation of the brain as a
      conditioned stimulus.
AB  - Rabbits were classically conditioned to emit an eyeblink conditioned response
      (CR) to electrical stimulation (ESB) of the medial geniculate nucleus (MGN)
      paired with a corneal air puff until they attained a criterion of two consecutive
      days of greater than 90% CRs. They then received intraventricular injections of
      1% AlCl3, HCL, or normal saline. Ten days postinjection, each animal underwent a
      retention test consisting of 50 ESB alone presentations. Whereas all saline and
      HCL animals gave at least 90% CRs during retention, no aluminum rabbit emitted
      more than 30% CRs. Considered with the results of previous work, these data
      suggest that aluminum-induced neurofibrillary degeneration disrupts retention of
      the CR by affecting central associative processes.

PMID- 2234284
TI  - The supraoptic and paraventricular nuclei of the human hypothalamus in relation
      to sex, age and Alzheimer's disease.
AB  - Volume and total cell number were determined in the supraoptic (SON) and
      paraventricular (PVN) nuclei of 14 male and 16 female subjects ranging in age
      from 10 to 93 years. In addition, 4 male and 6 female subjects suffering from
      Alzheimer's disease (AD) and ranging in age from 46 to 97 years were studied.
      Subjects were divided into two age groups, viz., "young" for subjects up to 60
      years, and "old" for subjects older than 60. No sex differences in volume and in
      total cell number were observed in the SON and PVN in either age group. In
      addition, no significant correlation was found between total cell number in the
      SON and PVN and brain weight. No significant differences in volume and total cell
      number were found in either the SON or PVN between young and old control subjects
      or between AD cases and controls, indicating that these nuclei are spared from
      degenerative changes in senescence and AD. Determination of neuron numbers in the
      SON supported this view. In contrast, volume and total cell counts in the
      suprachiasmatic decreased in senescence and were dramatically reduced in AD. The
      present results indicate the occurrence of differential patterns of cell loss
      within the human hypothalamus with aging and in AD, which are proposed to be
      related to functional differences between the hypothalamic nuclei.

PMID- 2234285
TI  - Quantitative analysis of age-related dendritic changes in medium spiny I (MSI)
      striatal neurons of C57BL/6N mice.
AB  - Our study used quantitative morphometric analysis and Golgi staining methods to
      evaluate postnatal changes in the dendritic architecture of MSI neurons of the
      striatum between 1 and 30 months of age. Morphological changes and chronological
      age were also correlated with functional testing in order to identify
      subpopulations of aged mice with dendritic alterations that may be more
      characteristic of a motor deficit rather than the normal aging process. We found
      that the overall size of the dendritic arbor of MSI neurons in the rostral
      striatum remained stable with age, while caudal MSI neurons exhibited a
      significant elongation of terminal dendritic segments between 25 and 30 months of
      age. In addition, our correlation analysis of motor performance and chronological
      age found that neither striatal-motor deficits nor their associated anatomical
      correlates were inevitable consequences of senescence but were characteristic for
      a select subpopulation of aged mice with striatal-motor deficits. We found that
      mice that tested poorly on the balance rod had a significant increase in the
      number of MSI neurons with small dendritic arbors in various stages of atrophic
      degeneration. Conversely, 30-month-old mice that had no functional impairment
      showed no significant change in the number of neurons with atrophic dendrites.
      These data reinforce the premise that the correlation of structure and function
      plays an important role in the analysis of an aging population since data may
      vary based on the number of functionally impaired or unimpaired mice that make up
      an experimental group.

PMID- 2234286
TI  - The indusium griseum: is it involved in Alzheimer's disease?
AB  - The histopathology of the indusium griseum (IG), a displaced hippocampal anlage,
      was studied in five patients with Alzheimer's disease (AD) and five controls. In
      the AD group, the IG had occasional neurons with granulovacuolar change (GVD) and
      rare Hirano bodies (HB), but no senile plaques (SP), neurofibrillary tangles
      (NFT), or neurons staining for phosphorylated neurofilament antigen. There was a
      slight but not statistically significant diminution of neurons within the IG. In
      all AD cases, the hippocampus showed abundant AD-associated histopathology. In
      the control cases, only rare neurons with GVD were present in the IG. These
      findings indicate that although single neurons within the IG may show some of the
      cytologic changes seen in the hippocampal neurons in normal aging and AD, IG
      neurons do not express the full range and severity of histopathologic
      abnormalities characteristic of AD. This suggests that factors other than
      selective vulnerability of neurons of hippocampal origin might be operating to
      induce the neuropathologic picture of AD.

PMID- 2234287
TI  - Effect of exercise on physiological age-related change at mouse neuromuscular
      junctions.
AB  - To determine the effect of endurance exercise on physiological age-related change
      at the mouse neuromuscular junction (NMJ), synaptic function was studied for
      extensor digitorum longus (EDL) and soleus muscles of three C57BL/6J mouse
      groups, 1) young adult control (YC: 10 months), 2) old control (OC: 20 months),
      and 3) old mice which exercised (OE: 20 months) since young-adulthood.
      Electrophysiological properties were studied with intracellular recording
      techniques. Safety margin was studied by measuring indirect isometric twitch
      tension in different calcium concentrations. With sedentary aging, EDL and soleus
      quantal contents increased. Following aging combined with 10 months of exercise,
      the EDL quantal contents in OE and YC animals were similar. In contrast, soleus
      quantal content was greater in OE than in YC animals. Determined safety margins
      were OC greater than YC = OE for EDL, and OC = YC = OE for soleus. This is the
      first study to indicate that physiological age-related changes at NMJs of EDL and
      soleus muscles are affected differently by endurance exercise. Exercise prevented
      all physiological age-related changes in EDL NMJs but not in soleus NMJs, this
      suggests that EDL changes are associated with inactivity during aging, while
      soleus changes are "fundamental" age changes.

PMID- 2234288
TI  - Regulation of phorbol ester binding and protein kinase C activity in aged rat
      brain.
AB  - Protein kinase C (PKC) function was analyzed in aged male Sprague-Dawley rat
      brain using two different approaches: the binding of [3H]-phorbol-12,13
      dibutyrate and the in vitro phosphorylation of histone H1. In cortex the binding
      was decreased while in cerebellum no age-related modifications were observed. In
      hippocampus the binding capacity was increased in old animals and the affinity
      decreased. The kinase activity in both soluble and particulate fractions was
      decreased in cortex, increased in hippocampus and unmodified in cerebellum. The
      area selective, age-dependent modifications in neuronal PKC may sustain short-
      and long-term regional changes of neuronal excitability.

PMID- 2234289
TI  - Aging and cognition: facilitation of recent memory in aged nonhuman primates by
      nimodipine.
AB  - Impairments of recent memory are a common complaint associated with aging and
      especially with respect to certain neural pathological conditions that may
      accompany aging. While this is well recognized, there is little clear evidence
      for a viable therapeutic treatment. Recently, however, certain investigations
      have suggested that blocking neuronal calcium channels may be an effective
      treatment for the memory impairments that are associated with brain injury as
      well as the memory failures that may occur during aging. The present research
      supports this suggestion by demonstrating that the dihydropyridine calcium
      channel blocker, nimodipine, will significantly improve the stabilized
      performance of 28-29-year-old rhesus monkeys when they are tested on a delayed
      response task which depends upon trial-specific, or recent, memory.

PMID- 2234291
TI  - [Combination of serial transcranial Doppler examinations and cerebral blood flow
      studies in the management of cerebral vasospasm after subarachnoid hemorrhage].
AB  - In 13 patients who had ruptured intracranial aneurysms, serial transcranial
      Doppler (TCD) and cerebral blood flow (CBF) examinations were performed in order
      to evaluate the degree of cerebral vasospasm. All patients showed some extent of
      vasospasm on angiography, which was performed between Day 7 and 10. The flow
      velocities of either the middle cerebral arteries or the anterior cerebral
      arteries, measured by TCD, began to increase on post hemorrhage Day 5, and
      maximum flow velocities were recorded between Day 9 and 13, with normalization
      occurring within the following 2 weeks. In 5 cases of symptomatic vasospasm, a
      rapid increase of flow velocities preceded clinical manifestation of the
      vasospasm. Maximum flow velocities of the 5 cases were at a higher level in the
      range of 119-184cm/sec (mean 149cm/sec) that the cases where there were no
      symptoms. Consequently, serial TCD examinations were very useful for the early
      detection of vasospasm after subarachnoid hemorrhage. And it was confirmed that
      the change of flow velocities was more important than the value itself, and that
      the rapid increase of flow velocities indicated severe ischemia. However, for
      judging when vessel narrowing was resolving, the usefulness of the TCD
      examinations were doubtful. This is because flow velocities measured by TCD are
      thought to be fairly much influenced by multiple factors such as the change of
      blood pressure, blood volume, which were caused by the active treatment for the
      vasospasm. Serial measurements of CBF were also made 2-7 times (mean 3.1 times)
      during the first two weeks following subarachnoid hemorrhage using the 133Xe
      intravenous injection method.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234290
TI  - [Histological diagnosis of brain tumors (14): Histiocytosis X].

PMID- 2234292
TI  - [Computed tomography in diagnosis of diffuse axonal injury].
AB  - Diffuse axonal injury (DAI) has been described in instances of prolonged
      traumatic coma on the basis of the neuropathological findings, but the same
      findings are also found in patients with cerebral concussion. Experimental
      studies confirm that the quality of survivors following trauma is directly
      proportional to the amount of primarily injured-axon. When the injured axon lies
      in a widespread area of the brain, outcome for the patient is always poor. In a
      series of 260 severely head-injured patients, based on their poor outcome, 69
      (27%) were diagnosed as DAI. Because of their relatively good outcome, eighty-two
      patients (32%) were classified into non-DAI group. The predominant CT finding of
      DAI patients was intraparenchymal deep-seated hemorrhagic lesion. This was
      observed in 28 patients (41%). Normal CT was also observed in 11 patients (16%).
      On the other hand, 8 of the non-DAI group (10%) manifested deep-seated lesions.
      Diffuse cerebral swelling (DCS) appeared in both groups in the same incidence.
      Subarachnoid hematoma in the perimesencephalic cistern (SAH (PMC] and
      intraventricular hematoma (IVH) were observed in 64% of the DAI group, and in 23%
      of the non-DAI group. The available evidence indicates that various types of
      hematoma seen in the deep-seated structures of the brain do not have an absolute
      diagnostic value, but the frequency of hematoma is thought to increase in
      proportion to the amount of injured-axon.

PMID- 2234293
TI  - [Postoperative MR findings in acoustic neuromas: nerve edema within the internal
      auditory canal].
AB  - Postoperative MR findings of eleven acoustic neuromas were analyzed. MRI's were
      able to clearly visualize residual tumor around the 7th and 8th cranial nerves
      that were left to preserve cranial nerve function, although conventional X ray CT
      scans often failed to detect it due to artifacts in the parapetrous area. The
      facial nerves preserved during operations were also visualized from their
      brainstem portion to the internal auditory meatus. These findings indicate that
      MRI is excellent in delineating soft tissue in the CP angle that would be
      overlooked by conventional X ray CT scan. It was also found that the nerve
      bundles within the internal auditory canal gained increased signal intensity on
      the T1 and proton weighted images after surgical interventions and that this
      effect extended into the most distal end of the nerve bundles and even into the
      intracochlear portion of the cochlear nerve. The nerve bundles with increased
      signal intensity were conspicuously enhanced after intravenous administration of
      Gd-DTPA. This indicated that the blood nerve barrier of the nerves within the
      internal auditory canal were disrupted due to the surgical manipulations in
      excising tumors. Following such surgical manipulations, nerve edema ensued,
      although manipulations in the cerebello-pontine angle were done carefully and
      protectively under a surgical microscope. The clinical significance of disruption
      of the blood nerve barrier and following nerve edema were discussed from the
      standpoint of preservation of the 7th and 8th cranial nerve functions.

PMID- 2234294
TI  - [Treatment of metastatic brain tumor from renal cell carcinoma].
AB  - Twenty-eight patients with metastatic brain tumor from renal cell carcinoma were
      treated at the National Cancer Hospital, Tokyo, between 1962 and March 1989. In
      13 patients, the median time interval between the initial diagnosis and pulmonary
      metastasis was 18 months, and the interval between pulmonary metastasis and brain
      metastasis was 13 months. In 10 patients, whose initial diagnosis was pulmonary
      metastasis, the median interval between pulmonary metastasis and brain metastasis
      was also 13 months. There were 2 patients who presented brain metastasis
      initially. The median survival time from the diagnosis of brain metastasis was 17
      months for the patients whose brain tumors were surgically resected, but only 4
      months for the patients who didn't receive surgery. The median survival time of
      the patients who received postoperative radiation was 20 months, while it was
      10.5 months for the patients who received radiation therapy alone. Repeated
      serial CT scans of 7 patients with measurable brain metastases revealed partial
      response (PR) to radiotherapy in 2 patients (28.6%), no change (NC) in 4 patients
      (57.2%), and progressive disease (PD) in one patient (14.3%). BrdU labeling
      indices of resected brain metastases were about 2%, and the doubling time
      calculated on repeated serial CT scans was about 20 days. As these lesions are
      rather resistant to radiotherapy and grow relatively slowly they should be
      resected as much as possible.

PMID- 2234295
TI  - [Clinical analysis of malignant meningiomas].
AB  - It seems generally accepted that meningiomas are benign tumors, and that
      malignant meningiomas are not common. The pathological criteria for judging
      whether meningiomas are malignant or not are controversial. Hemangiopericytic
      type, high cellularity, brain invasion, high mitotic rate, necrotic foci, and
      papillary type are regarded as histological characteristics of malignant
      meningiomas. Of a series of 105 patients with surgically treated meningioma, 25
      patients demonstrated malignant characteristics (24%). The overall recurrence
      rate in our patients was 14%. The incidence of recurrence in 25 patients with
      pathologically malignant characteristics, and recurrence in 80 patients with
      pathologically benign characteristics were 32% and 9%, respectively. In
      comparison with benign meningiomas, recurrent factors in malignant ones included
      Simpson grade II operation, attachment of skull base, and no radiation-therapy.
      In conclusion, our criteria for malignant meningiomas have proved to be
      acceptable, and these cases should be treated with radiation therapy after
      surgery.

PMID- 2234296
TI  - [A case of giant osteoma in the occipital bone].
AB  - A 51-year-old female patient, admitted with a chief complaint of dizziness, had
      bulging of the occipital area, which had started insidiously. On admission, a
      bony hard swelling with a smooth surface was noted in the left occipital region,
      extending over the midline of the skull. Plain X ray films revealed a uniform
      shadow of an osteoid mass inside the occipital bone. A tomogram indicated that
      the mass originated in the diploe or outer table of the skull, although there was
      no evidence of destruction of the inner table. CT scan revealed mixed density
      mass with high density of bone and an irregularly shaped low density area. In the
      T1-weighted images of MRI, the entire mass showed a low intensity, while in the
      T2-weighted image the mass showed 3 areas with different intensities. Bone
      scintigraphy was performed with 99mTc-MDP and revealed an image of accumulation
      in the mass. Carotid and vertebral angiograms were negative for evidence of
      feeding arteries to the mass, for tumor stain, and for occlusion of either
      sigmoid sinus or transverse sinus. The mass was diagnosed as a giant osteoma, and
      was totally removed. The excised tumor measured 10 x 9 x 5 cm, and inspection at
      operation revealed it to be composed of a fragile osteoid portion and a
      comparatively soft connective tissue portion. The histological diagnosis of the
      mass was that it was a spongy osteoma including a comparatively large amount of
      connective tissue. The postoperative recovery of the patient was satisfactory and
      her dizziness disappeared.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234297
TI  - [A case of arteriovenous malformation in a neonate].
AB  - Although arteriovenous malformation (AVM) is considered a congenital disease, few
      cases of AVM are manifested clinically in the neonatal period. In this paper a
      neonatal case of AVM manifested as intracranial hemorrhage is reported. A newborn
      female infant 12 days after birth, was admitted to a hospital with the chief
      complaint of sudden onset of vomiting and fever. Neurological examination
      revealed left hemiparesis with bulging of the anterior fontanel. CT examination
      demonstrated a large mass lesion with hemorrhage in the right parietal lobe. The
      lesion was enhanced with contrast medium. Consent for surgery was not able to be
      obtained from her family, so she was treated conservatively. A gradually
      enlarging cyst surrounding the mass appeared in follow-up CT examination. Her
      left hemiparesis and bulging of the anterior fontanel remained unchanged, and a
      rather good general health condition was maintained. Consent for surgery was
      finally obtained from her parents and the patient was transferred to our hospital
      three months after the onset of the symptoms. Cerebral angiogram showed AVM with
      a big aneurysmal sac. The feeder arteries of the AVM arose from the right middle
      cerebral artery and the anterior cerebral artery. The drainers poured into the
      superior sagittal sinus. AVM was removed totally by right parietal craniotomy on
      the 24th January, 1989. Postoperatively, her left hemiparesis started to improve
      gradually. Her general condition was also good, and she showed no neurological
      deficits at the age of 8 months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234298
TI  - [Anterolateral approach to giant cell tumor in T4 vertebral body].
AB  - A case of giant cell tumor involving the Th4 vertebral body is reported. A 27
      year-old man, who had a 2 month history of back pain and paraparesis, was
      admitted to our department in August, 1986. On the first admission, he manifested
      severe paraparesis and sensory disturbance below the Th5 dermatome level.
      Neuroradiological examination demonstrated an epidural tumor involving the Th4
      vertebral body and compressing the spinal cord. Emergency laminectomy for
      decompression and biopsy was performed. The surgical specimen was a giant-cell
      tumor. 6 weeks after the first operation, total removal of the tumor and anterior
      fusion of the Th 3-5 with iliac bone graft was performed through the
      anterolateral transthoracic approach. Postoperative course was uneventful. A
      curative resection and immediate stabilization was thus able to be undertaken
      through the anterolateral transthoracic approach, when the epidural tumor was
      confined to the thoracic vertebral body.

PMID- 2234299
TI  - [A case of intracranial hypoglossal neurinoma with no preoperative hypoglossal
      nerve palsy].
AB  - A case of intracranial hypoglossal neurinoma without hypoglossal nerve palsy is
      reported. A 43-year-old housewife was admitted to our hospital with vertigo and
      left occipital headache. Neurologically, no cranial nerve deficits were present.
      CT scan and cerebral angiography showed a mass in the lower left posterior fossa.
      MRI also revealed a well circumscribed extra-axial mass compressing brain stem
      and cerebellum to the right. Left suboccipital craniotomy was performed and the
      tumor was removed subtotally. From the operative findings, the 8th to 11th
      cranial nerves were not related to the tumor, however, the origin of the tumor
      was not confirmed. The histology showed Antoni A type neurinoma mixed partially
      with Antoni B type. After the operation, the tongue deviation appeared to the
      left, but no other cranial nerve deficit was noticed. Post-operative
      neuroradiological reexaminations defined slight enlargement of the hypoglossal
      canal. Then, we concluded that the origin of the tumor must have been the
      hypoglossal nerve. Most intracranial hypoglossal neurinoma grow in the
      hypoglossal canal followed by enlargement or erosion of the hypoglossal canal.
      The author thought that this case suggests that this hypoglossal neurinoma
      originated from a few rootlets of hypoglossal nerve and grew mainly between the
      medulla and the hypoglossal canal.

PMID- 2234300
TI  - [Disproportionately large communicating fourth ventricle with bilateral
      exotropia: report of two cases].
AB  - Two cases of disproportionately large communicating fourth ventricle (DLCFV)
      accompanied by consciousness disturbance and bilateral exotropia are reported.
      Case #1 was a 21-year-old male who suffered from consciousness disturbance and
      bilateral exotropia due to malfunction of the ventriculoperitoneal shunt (VPS)
      which had previously been operated on twice for a left parietal arteriovenous
      malformation, which had caused ventricular hemorrhage several times. The last
      hemorrhage was massive and made ventricular casting, including the fourth
      ventricle. Both bilateral exotropia and the fourth ventricular dilatation were
      well controlled by the reconstruction of the VPS. Case #2 was a 66-year-old
      female, semicomatous because of massive subarachnoid hemorrhage with ventricular
      casting hematoma due to rupture of the right middle cerebral aneurysm. Though an
      improvement of the consciousness disturbance was obtained by continuous
      ventricular drainage (CVD), bilateral exotropia and consciousness deterioration
      appeared after lumboperitoneal shunt followed by the removal of the CVD. Another
      CVD was then carried out and some improvement was obtained again. However, the
      same symptoms appeared again after the VPS, followed by the removal of the CVD.
      The patient finally died despite a third CVD. Autopsy revealed a markedly dilated
      fourth ventricle and massive subarachnoid clots particularly around the foramen
      of Magendie and Luschka. The pathogenesis of DLCFV and bilateral exotropia are
      also discussed.

PMID- 2234301
TI  - [Clinical study of pseudomembranous colitis: a neurosurgical viewpoint].
AB  - In many instances patients who have undergone neurosurgery are given antibiotics.
      Some of these patients, however, run the risk of developing pseudomembranous
      colitis. In our department over the past three years, 239 patients, whose
      hospitalization period exceeded two weeks, were given antibiotics. Of this total
      number, 6 patients (2.5%) contacted pseudomembranous colitis and a clinical study
      of these 6 cases was conducted from a neurosurgical viewpoint. This study
      concentrated on diarrhea, the primary symptom, and the 6 patients consisted of 1
      male and 5 females whose ages ranged from 61 to 75 years. All had undergone
      surgery, and a breakdown of their diseases is as follows: 2 cases of a
      subarachnoid hemorrhage, 2 cases of an intracerebral hemorrhage, 1 case involving
      a glioblastoma multiforme, and a case of normal pressure hydrocephalus. Diarrhea
      was present in all 6 cases and, additionally, pyrexia, abdominal pains, and
      leukocytosis were seen. On colonoscopic examination, 5 patients were diagnosed as
      having developed pseudomembranous colitis, and were treated by oral
      administrations of Vancomycin. In the remaining cases, in which a colonoscopic
      examination had not been performed, a diagnosis of pseudomembranous colitis had
      not been achieved and, subsequently, one patient died of multiple organ failure.
      On autopsy, however, it was determined that the patient had had pseudomembranous
      colitis. Thus, if symptoms of diarrhea occur during or after administrations of
      antibiotics, the possibility of pseudomembranous colitis must be assumed, and a
      colonoscopic examination should be performed immediately, so as to detect the
      disease at an early stage. This condition can be transmitted within a hospital
      and, therefore, great emphasis must be placed on preventing secondary infections.

PMID- 2234302
TI  - [Diagnostic value of short latency somatosensory evoked potentials for various
      intracranial lesions].
AB  - Diagnostic value of short latency somatosensory evoked potentials (SSEP) was
      studied in 124 patients with various intracranial lesions. Abnormal SSEPs were
      recorded in 58 of 124 patients (46.8%) and were classified into three types. Type
      I (6 cases) showed abnormality of late components with N18 being preserved. All
      patients with type I abnormality had cortical or subcortical lesions in the
      parietal lobe. Type II (20 cases) was characterized by abnormality of N18 and
      late components with N16 being preserved, and mainly seen in patients with a
      lesion involving thalamus and internal capsule. Type III (31 cases) showed
      abnormality of N16 and N18 which was elicited by unilateral stimulation (IIIa: 11
      cases), or bilateral stimulation (IIIb: 21 cases), and this indicated brainstem
      impairment. The incidence of SSEP abnormality was as high as 93.1% in patients
      with sensory disturbance, and 23.1% in patients without such disturbance, and it
      was suggested that SSEP is useful to detect subclinical dysfunction in the
      somatosensory pathway. The SSEP grades defined by Anderson et al were found to be
      well correlated with the outcome of patients with severe head injury, and the
      SSEP was more reliable for predicting the outcome of patients than the auditory
      brainstem evoked responses. The SSEP grades were also fairly well correlated with
      the outcome of patients with cerebrovascular accidents, although the outcome was
      not consistent in patients with moderately abnormal SSEP.

PMID- 2234303
TI  - [Cerebellar infarction: analysis of 33 cases].
AB  - During the past 9 years and 2 months we have encountered 33 cases with cerebellar
      infarction. These patients were classified into 3 types according to their
      clinical course. Type 1 (18 cases); The course was benign, and symptoms and signs
      improved without surgical treatment. Type 2 (11 cases); The course was
      progressive with deterioration of consciousness between 24-72 hours after the
      onset. Type 3 (4 cases); The course was rapid resulting in lapse into coma within
      a few hours. Also, its prognosis was fatal due to coexisting brain-stem
      infarction regardless of any treatment. Surgical intervention was required for
      Type 2 in which the lesion included the region of the vermis or occupied more
      than one-third of the cerebellar hemisphere, and had subsequently compressed the
      brain-stem and caused obstructive hydrocephalus. In 9 cases out of Type 2,
      ventricular drainage alone was performed and prompt improvement of consciousness
      level was detected except in one case. We consider that ventricular drainage is
      not so invasive a method, and it is beneficial. However, in 2 cases of Type 1 and
      4 cases of Type 2, hemorrhagic infarction occurred. Thus, one should be aware of
      the possibility of hemorrhagic infarction, even though it may be asymptomatic
      infarction. If prompt improvement of consciousness is not detected after
      ventricular drainage, suboccipital craniectomy should be recommended.

PMID- 2234304
TI  - [Regional effects of craniotomy on cerebral circulation and metabolism: PET study
      on the un-ruptured aneurysmal surgery].
AB  - Regional effects of craniotomy on cerebral circulation and metabolism, such as
      regional cerebral blood flow (rCBF), regional cerebral oxygen consumption
      (rCMRO2), regional oxygen extraction fraction (rOEF), and regional cerebral blood
      volume (rCBV) were examined by a PET (positron emission tomography) study
      concerning surgery that was performed on unruptured aneurysm patients. Eight
      patients with intracranial un-ruptured aneurysms were studied pre- and post
      operatively by the 15O labelled-gas steady-state method, using HEADTOME-III. All
      patients underwent aneurysmal surgery performed by the transsylvian approach.
      There was a significant increase in the mean OEF values taken from the whole
      brains of 8 patients, but there was not a significant change in CBF, CMRO2 or
      CBV. The increase in OEF was caused by decrease of O2 content, which was caused
      by post-operative decrease in the Hb value. So, this OEF increase was not the
      direct effect of craniotomy. In 2 patients, the rCBF and rCMRO2, in the fronto
      temporal region (where craniotomy was performed) increased post-operatively. This
      regional effect suggests transient reactive hyperemia following compressive
      ischemia during the operative procedure, and metabolic demands for recovery of
      brain function. In 2 other patients, who had relatively low rCBFs during the pre
      operative study, rCBF and rCMRO2 in the bi-frontal region had decreased more at
      the post-operative study. This change appears to have been caused by removal of
      cerebrospinal fluid and depression of the frontal lobe. From this study, it
      becomes evident that the regional effect of craniotomy on cerebral circulation
      and metabolism is not so great, when adequate microsurgical techniques are used.

PMID- 2234305
TI  - [A case of pineocytoma totally removed].
AB  - A case of pineocytoma which is thought to be uncommon is reported. A 50-year-old
      man complaining of occasional dizziness and tinnitus of the left ear was referred
      to our Center on Feb. 10, 1989. No noteworthy signs were detected out
      neurologically. Plain CT scan disclosed a homogeneous iso- to high-density area
      in the pineal region, which was markedly enhanced on the post-contrast study. On
      the T1 MRI, that pineal tumor appeared as a low intensity area and on the T2, a
      high intensity area with intratumoral low signal intensity suggesting
      calcification. The tumor was conspicuously enhanced by Gd-DTPA. Left vertebral
      angiography demonstrated a faint tumor blush which was confirmed to be fed by the
      medial and the lateral posterior choroidal and the thalamo-perforating arteries
      bilaterally. The superior thalamic and the internal cerebral veins were displaced
      upwardly and the precentral cerebellar vein posteriorly. On Feb. 20, the tumor
      was totally removed via infratentorial-supracerebellar approach. Histological
      examination of the removed tumor disclosed that it was a "true" pineocytoma. The
      patient was discharged on Mar. 15 and has been free from signs and symptoms by
      the 4th postoperative month. Neither irradiation nor chemotherapy was added.
      Literature concerned are reviewed and brief discussion on pineocytoma done.

PMID- 2234306
TI  - [A case of traumatic syringomyelia which disappeared after anterior
      decompression: a suggestion for surgical treatment of syringomyelia].
AB  - A 37-year-old man had received cervical spinal-cord injury 20 years previously.
      Recently, he complained of progressive spastic gait and was shown to have
      fracture dislocation of the C5 vertebral body which compressed the spinal cord
      posteriorly. He also had a syrinx from the C5 to C2 vertebral level.
      Postoperatively, this syrinx disappeared after anterior decompression of the C4
      and C5 vertebral bodies. Such a case as this has never been reported, and this
      case may give a suggestion for surgical treatment of syringomyelia, because it is
      very natural that the most reasonable treatment of any disease is removal of the
      cause.

PMID- 2234307
TI  - [Complete occlusion of right middle cerebral artery by radiation therapy after
      removal of pituitary adenoma: case report].
AB  - Radiation angiopathy is a well-known complication accompanying irradiation. But
      the majority of effected vessels are small vessels. Cases of intracranial major
      arteries being effected are not so numerous. We report the case of a 47-year-old
      female patient. The removal of pituitary adenoma was carried out on her in 1982.
      After that, 4500rad irradiation was performed. It was about six years after
      irradiation that the first angiography was made. Right MCA occlusion, multiple
      stenosis of both ACAs and Moya-Moya like vessels were discovered. On admission
      light paresis on her left lower extremity was recognized and hyperlipidemia was
      noted. It was interesting that the multiple stenosis was found in an area outside
      the irradiation field. MCA-STA anastomosis was performed and the prognosis was
      good. The authors described this case and reviewed the pertinent literature.

PMID- 2234308
TI  - [Cerebellar ganglioglioma: a case report].
AB  - A case of cerebellar ganglioglioma in a 5 year-old girl is presented. She came to
      our hospital on January 30, 1989 with complaints of headache of one year
      duration. CT scans disclosed a low density lesion suggesting a cystic tumor in
      the left cerebellar hemisphere with moderate hydrocephalus. Preoperative MRI
      demonstrated more clearly the location and extent of the tumor. She was operated
      on using suboccipital craniotomy, on March 3. Subtotal removal of the tumor was
      performed because the tumor had invaded the brain stem. She made an uneventful
      recovery without any neurological deficits. Histologically, the tumor was
      composed of ganglion cells and astrocytic cells, so it was diagnosed as
      ganglioglioma. Cerebellar ganglioglioma is a rare tumor, and only 17 cases have
      been reported including the present case. Clinical and radiological study of
      these cases revealed that there are no specific findings to indicate cerebellar
      ganglioglioma and preoperative diagnosis is impossible. But practically, MRI is
      the most sensitive method for identifying the extent of the lesion and, thus, is
      of benefit for deciding operative strategy.

PMID- 2234309
TI  - [Aneurysm arising from the cortical branch of the superior cerebellar artery:
      case report].
AB  - We reported a case of a 64-year-old man who presented a subarachnoid hemorrhage
      due to rupture of an aneurysm arising from the cortical branch of the superior
      cerebellar artery (SCA) at the junction of the superior vermian branch and the
      hemispheric branch. Eight days after the rupture, neck clipping of the aneurysm
      was performed successfully using the occipital transtentorial approach in a prone
      position, and the patient's postoperative course was uneventful. This rare case
      of aneurysm arising from the cortical branch of SCA was discussed with a review
      of literature.

PMID- 2234310
TI  - [A case of large basal ganglia AVM totally removed by staged operation].
AB  - Large basal ganglia AVMs have been deemed inoperable because of their location in
      critical structures. Nonetheless, the unfavorable natural history of an untreated
      ruptured AVM in a young patient induced us to approach these lesions. We
      presented a case of a large basal ganglia AVM totally removed by a three-staged
      operation. A 26-year-old man who had twice experienced intracranial hemorrhage
      was admitted for examination. On admission, mild left hemiparesis, hypesthesia
      and left hemianopsia were disclosed. CT scan showed the AVM was located in the
      posterior thalamus with the hematoma cavity laterally. Right carotid and
      vertebral angiograms demonstrated a large AVM, 5cm in diameter, supplied by the
      anterior choroidal artery (AchoA), the lateral lenticulostriate arteries (I
      LSAs), the lateral posterior choroidal artery (LPchoA) and the thalamo
      perforating artery. Drainage was via the internal cerebral vein and the basal
      vein of Rosenthal. MRI demonstrated more clearly the anatomical relationship of
      the nidus and surrounding structures. The patient underwent a three staged
      operation. At the first operation AchoA was interrupted in the inferior horn of
      the lateral ventricle (IHL) via the hematoma cavity using the trans-sylvian
      approach. The anterior part of the nidus was dissected with all except one of the
      I-LSAs being disconnected. At the next operation by occipital interhemispheric
      approach, some feeders from the posterior cerebral artery were coagulated and
      disconnected. The medial and posterior part of the nidus was dissected from the
      thalamus along with the choroid plexus of the trigone of the lateral
      ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234311
TI  - Glutathione S-transferase in human brain.
AB  - The glutathione S-transferases are a complex group of multifunctional enzymes
      which may detoxify a wide range of toxic substances including drugs and
      carcinogens. Different isoenzymes vary in substrate specificity, tissue
      distribution and level of expression during development. Following reports of
      cell-specific and age-dependent expression in rat brain we have studied,
      immunohistochemically, expression of the Pi and Alpha class isoenzymes in 10
      adult and 21 human fetal brains. Whilst Alpha isoenzyme is expressed only in
      adult brain, and then only focally, Pi isoenzyme is strongly expressed from as
      early as 12 weeks gestation. In the adult, expression is localized to choroid
      plexus, vascular endothelium, ventricular lining cells, pia-arachnoid and
      astrocytes. In fetal brain, expression is also strong in cells with the
      morphology of tanycytes and in the cell bodies of radial glia. Neurons are
      consistently negative. Pi isoenzyme thus localizes to the sites of the blood-CSF
      barrier, blood-brain barrier, CSF-brain barrier and pia-arachnoid-brain barrier.
      It is ideally placed to regulate neuronal exposure to potentially toxic
      substances derived from blood or cerebrospinal fluid. Expression so early in
      gestation is of significance and may imply a role in protection of the developing
      human brain.

PMID- 2234312
TI  - Spinal cord disease in children with HIV-1 infection: a combined molecular
      biological and neuropathological study.
AB  - An autopsy study was performed on spinal cords from 18 children who died with HIV
      1 infection, using standard histopathologic techniques as well as in situ
      hybridization and immunocytochemistry for HIV-1. Of 16 spinal cords examined by
      histology, nine had inflammatory cell infiltrates and six had multinucleated
      cells; both types of lesion are associated with the presence of HIV-1 in central
      nervous system tissue. HIV-1 type lesions were often present in the spinal cord
      and brain from the same patient. Pallor of myelin in corticospinal tracts in the
      cord was present in half of the cases; this change correlated with diffuse myelin
      pallor in the corresponding brains, but not with the HIV-1 associated changes in
      the cords. In situ hybridization for HIV-1 nucleic acid sequences gave positive
      results in seven of 18 spinal cords, with hybridizing signal usually localized to
      inflammatory cell infiltrates and multinucleated cells. Positive in situ
      hybridization, on frozen sections, correlated with the presence of HIV-1
      associated changes on paraffin sections from the same cases. Immunocytochemistry
      for p25 core protein of HIV-1, using a monoclonal antibody on frozen sections,
      was positive in multinucleated cells, macrophages, and microglia. In this series
      there were two cases of vacuolar myelopathy, one a 30-month-old boy who had
      concomitant measles virus in the spinal cord grey matter, and the other nine-year
      old girl who had severe HIV-1 infection of the cord. Other than the single case
      of measles virus, there were no opportunistic infections in the cords in this
      series. HIV-1 frequently involves the spinal cord in children with AIDS, while
      opportunistic infections are rare. Vacuolar myelopathy occurs in children with
      HIV-1 infection, although its occurrence is much less frequent than in adults
      with AIDS.

PMID- 2234313
TI  - Pathology of Streptococcal meningitis following intravenous intracisternal and
      natural routes of infection.
AB  - The distribution of pathological lesions present in 20 cases of naturally
      occurring Streptococcus suis type 2 meningitis and 20 cases of the disease
      induced experimentally by intravenous or intracisternal inoculation was examined.
      It was found that the distribution of lesions was similar; mild lesions were
      present at the choroid plexuses whilst the most dense cellular accumulations were
      found at sites of cerebrospinal fluid (CSF) efflux, such as arachnoid villi and
      olfactory nerve sheaths. The distribution of changes was considered to reflect
      the dynamics of CSF flow rather than indicate the site of entry of the organisms
      into the CSF compartment.

PMID- 2234314
TI  - Brainstem auditory evoked potentials in icteric fullterm newborns: alterations
      after exchange transfusion.
AB  - Brainstem auditory evoked potentials (BAEP) were studied in five fullterm
      newborns before and during an exchange transfusion (ET) for hyperbilirubinemia
      and 1, 24, 48 hours after, in order to evaluate the changes of BAEP following
      acute decreases in bilirubinemia. Hyperbilirubinemia was due to ABO
      incompatibility. The newborns were free of other risk factors known to alter
      BAEP. In comparison with our normal laboratory data, we observed significant
      differences in pre-ET recordings for latencies I and V (p less than 0.01), and
      for interpeak latency V-III (p less than 0.01). After ET, there was a tendency
      towards shortening of all mean latencies and interpeak latencies in correlation
      with the acute decrease in bilirubinemia, but post-ET BAEP alterations consisted
      predominantly of a wave V latency and of a wave V-I interval shortening (p less
      than 0.01). In four patients, during the 48 hours post-ET we observed
      modifications of the wave V-I interval related to variations of bilirubinemia. At
      12 months, BAEP were normal. Even acceptable increase of bilirubinemia in
      otherwise normal newborns may have a deleterious influence on BAEP and this could
      have implications for the determination of a so-called threshold of bilirubin
      neurotoxicity. Our results suggest that bilirubin neurotoxicity is rapidly
      reversed by ET, but it seems important to verify BAEP in the follow-up of
      hyperbilirubinemic newborns.

PMID- 2234315
TI  - Analysis of very long-chain fatty acids and plasmalogen in the erythrocyte
      membrane: a simple method for the detection of peroxisomal disorders and
      discrimination between adrenoleukodystrophy and Zellweger syndrome.
AB  - We analyzed the sphingomyelin very long-chain fatty acids (VLCFAs) and
      phosphatidylethanolamine (PE) plasmalogen contents of the erythrocyte membrane in
      patients suffering from peroxisomal disorders. In a patient with Zellweger
      syndrome, both a decrease in the PE plasmalogen content and an increase in the
      sphingomyelin VLCFAs content of the erythrocyte membrane were noted. In patients
      with adrenoleukodystrophy, however, there was no decrease in PE plasmalogen,
      although the sphingomyelin VLCFAs content of the membrane was significantly
      increased in comparison with control values. Analyses of both sphingomyelin
      VLCFAs and PE plasmalogen were carried out simultaneously, using both the same
      process and the same sample.

PMID- 2234316
TI  - Fetal ventriculomegaly due to isolated brain malformations.
AB  - Management of 32 consecutive cases of fetal hydrocephalus diagnosed prenatally
      during a five years period is presented. Thirteen cases (40%) being patients with
      ventriculomegaly due to isolated brain malformation are the topic of this paper.
      In this group, management was conservative and consisted of termination of
      pregnancy by elective cesarean section after prenatal fetal assessment. Agenesis
      of corpus callosum (6 cases) and Dandy-Walker malformation (7 cases) were the
      most common observed forms. Antenatal sonography improved intrauterine follow-up.
      Skillful perinatal management and support facilities after birth have been found
      a reliable approach to conservative management of fetal hydrocephalus by lacking
      of satisfactory techniques for in utero permanent cerebrospinal fluid shunting.

PMID- 2234317
TI  - Acute hemiparesis as the presenting sign in a heterozygote for ornithine
      transcarbamylase deficiency.
AB  - Strokes in children occur in conjunction with cardiac disease, hematological
      disorders, trauma, intracranial infections and migraine. Recently several inborn
      errors of metabolism have been recognized as possible causes of stroke-like
      symptoms. We describe a female heterozygote of ornithine transcarbamylase
      deficiency, who presented with convulsions and right sided hemiplegia. MR-imaging
      of the brain demonstrated an acute ischemic lesion in the left hemisphere. In
      addition to other known metabolic causes of stroke like attacks urea cycle
      defects should be considered in the differential diagnosis of acute hemiplegia in
      childhood.

PMID- 2234318
TI  - The role of short latency somatosensory evoked responses in infants with rapidly
      progressive ventricular dilatation.
AB  - The effect of hydrocephalus on somatosensory evoked potentials was studied in
      nine infants. An increase in N1 latency was found in five infants studied
      longitudinally during a period of progressive ventricular dilatation. A marked
      decrease in N1 latency was noted in 7 infants, within one week following shunt
      insertion and in two infants who showed spontaneous arrest of ventricular growth.
      A correlation was found between cerebrospinal fluid pressure and the delay in N1
      latency, but the number of infants studied is still small. SEPs appear to be a
      useful additional test when assessing infants with progressive ventricular
      dilatation. Once a baseline value for N1 has been obtained following shunt
      insertion, SEPs may subsequently be useful when assessing a child with possible
      shunt dysfunction.

PMID- 2234319
TI  - N-acetylaspartic aciduria in Canavan disease: another proof in two infants.
AB  - Increased amounts of urinary N-acetyl-aspartic acid was found in two infants with
      biopsy proven Canavan disease. The aspartoacylase assay is a new tool for
      determining both the prenatal and antenatal diagnosis of Canavan disease. This
      assay should be screened in patients with early onset of psychomotor
      deterioration, macrocephaly, spasticity/hypotonia and white matter hyperleucency
      at CT scan.

PMID- 2234320
TI  - MR-imaging findings in children with Sturge-Weber syndrome.
AB  - Intracranial extent and distribution of leptomeningeal angiomatosis, visualized
      by magnetic resonance imaging (MRI) with Gadolinium-DTPA (Gd-DTPA) enhancement,
      is demonstrated in four children with Sturge-Weber syndrome (SWS). Aged 7, 9, 11
      and 19 months, they presented with cutaneous, neurologic and ocular symptoms at
      the time of MRI examination. Angiomatous alteration of the skull, atypically
      located and congested intracerebral and basal veins as well as intracerebral
      changes secondary to the leptomeningeal angiomatosis are demonstrated with T2
      weighted images. Gd-DTPA enhanced T1 weighted images exhibit clearly the regional
      distribution of angiomatosis in the skull, meninges and within the brain. Before
      calcifications in children with SWS are detectable by CT, MRI is the method of
      choice to detect intracranial involvement. Enhancement with Gd-DTPA improves the
      diagnostic value of MRI, before neurological symptoms appear. Follow-up studies
      with Gd-DTPA enhanced MRI can be applied to recognize thrombotic changes of
      leptomeningeal angiomatosis as well as subsequent intracerebral impairment.

PMID- 2234321
TI  - An incident case-referent study of febrile convulsions in children: genetical and
      social aspects.
AB  - In a prospective community-based study of 103 children with febrile convulsions
      (FC), social and genetical factors were compared with 193 age and sex matched
      referents sampled from the community. FC were found more often among parents of
      cases than referents (odds ratio 21.0; p less than 0.001). A history of FC in any
      type of relative was found in 39.8% of cases and 10.4% of referents (odds ratio
      5.8; p less than 0.001). The familial occurrence of FC is best described by a
      multifactorial (polygenic) model. No difference was found between groups in the
      occurrence of other diseases than FC affecting the central nervous system and
      only one case was mentally retarded. No difference was found between cases and
      referents in the age of independent walking and ability to speak at age 18
      months. Children with FC more often had infectious diseases than referents (odds
      ratio 2.84; p = 0.002). Children with FC more often lived in apartments and spent
      their time in day by day care institutions (odds ratio 2.91; p = 0.02). Parents'
      occupation did not differ between groups. Mothers of children with FC more often
      had compulsory education only compared with mothers of referents.

PMID- 2234322
TI  - Cutaneomeningo-spinal angiomatosis: the syndrome of Cobb. A case report.
AB  - We present the case of a young patient with Cobb's syndrome who presented with an
      acute paraplegia. A review of the literature indicates that this condition is
      rare. The coexistence of cutaneous naevi in a dermatomal pattern and neurological
      signs of a spinal cord lesion is significant and should always be considered as
      the excision of spinal arteriovenous malformations can be accomplished safely.

PMID- 2234323
TI  - Moya-Moya syndrome and primary pulmonary hypertension in childhood.
AB  - A child is described with Moya-Moya disease and a primary pulmonary hypertension.
      This association has never been reported until now. It is attempting to consider
      a common vascular denominator for both diseases although we were not able to
      prove this hypothesis.

PMID- 2234324
TI  - Megalencephaly with dysmyelination, spasticity, ataxia, seizures and distinctive
      neurophysiological findings in two siblings.
AB  - A progressive neurological condition characterised by megalencephaly, spasticity,
      ataxia and seizures in two siblings of consanguineous parents is described. The
      electroencephalogram showed posterior discharges and an unusual photoparoxysmal
      response whereas brainstem auditory evoked potential findings were consistent
      with a white matter disorder. Computerized tomography scans revealed diffuse
      hypodensity of the white matter and a brain biopsy on one sibling showed features
      of dysmyelination without evidence of demyelination, Rosenthal fibres or the
      spongy changes characteristic of Canavan's disease. There was no detectable
      biochemical abnormality. This combination of clinical, neurophysiological and
      neuropathological abnormalities has not previously been described.

PMID- 2234325
TI  - Thickness of carotid artery atherosclerotic plaque and ischemic risk.
AB  - Noninvasive duplex scanning of carotid artery atherosclerotic plaque was
      performed in 286 consecutive patients referred to a cerebrovascular diagnostic
      laboratory. The presence and thickness of such plaque in the region of the
      carotid bifurcation were examined for association with the degree of vessel
      stenosis, age, sex, smoking history, history of prior transient ischemic attack
      or stroke, and systemic manifestations of atherosclerotic disease.
      Atherosclerotic plaque thickness was positively correlated with degree of vessel
      stenosis (P less than 0.0001). Both parameters were independent predictors of
      cerebrovascular events but plaque thickness was a better predictor of prior
      transient ischemic attacks (P less than 0.05), and vessel stenosis was a better
      predictor of prior stroke (P less than 0.005). Patient age (P less than 0.001)
      and pack-years of cigarette use (P less than 0.001) were independent positive
      predictors of carotid atherosclerotic plaque thickness. The greatest effect of
      smoking and atherosclerotic plaque thickness was seen in heavy smokers younger
      than age 55. Both carotid artery plaque thickness and pack-years of smoking were
      significant independent predictors of other systemic manifestations of
      atherosclerotic disease (P less than 0.05). Such noninvasive scanning of carotid
      artery atherosclerotic plaque demonstrates the significant role of age and
      smoking in the progression of disease. It also suggests a significant role for
      carotid atherosclerotic artery plaque in the pathophysiology of cerebrovascular
      events, especially transient ischemic attacks, even prior to the production of a
      flow-limiting stenosis. Finally, noninvasive screening of carotid artery plaque
      may provide a useful marker for the patient at risk for systemic atherosclerotic
      disease and identify the patient for whom maximal atherosclerotic risk factor
      modification is needed.

PMID- 2234326
TI  - A rat femoral artery model for vasospasm.
AB  - A new animal model for vasospasm using rat femoral artery has been developed.
      Whole blood, washed erythrocytes, or leukocytes in platelet-rich plasma were
      selectively applied to the adventitial surface of the femoral artery for 7 days
      in 15 rats, after which the vessels were perfusion-fixed and examined by light
      and transmission electron microscopy and immunohistochemistry. As compared with
      matched control arteries, there was a prominent reduction in luminal cross
      sectional area after 7 days in vessels exposed to whole blood or washed
      erythrocytes, but not in those exposed to leukocytes in platelet-rich plasma. In
      arteries with luminal narrowing, light and transmission electron microscopy
      demonstrated marked morphological changes throughout the vessel wall similar to
      those seen in cerebral vasospasm after subarachnoid hemorrhage.
      Immunohistochemistry disclosed a prominent loss of immunoreactive actin in smooth
      muscle cells of arteries exposed to whole blood or erythrocytes. To assess the
      time course of arterial narrowing in this model, whole blood was selectively
      applied to the adventitial surface of femoral arteries in 23 rats for periods
      from 2 to 20 days. As compared with control arteries, arterial narrowing was
      variably present at 2 days, progressively increased by 5 days, was maximal at 7
      to 10 days, and returned to near control levels by 20 days. The presence and
      severity of ultrastructural changes in vessel wall corresponded to the degree of
      arterial narrowing over time. These results suggest that chronic narrowing in rat
      femoral artery exposed to periadventitial blood is analogous to that observed in
      cerebral arterial vasospasm after subarachnoid hemorrhage. This new model
      represents a simple and reliable means to investigate pathogenic mechanisms and
      potential therapies for vasospasm.

PMID- 2234327
TI  - Effect of endothelin on the canine basilar artery.
AB  - Endothelin, a recently discovered peptide produced by endothelial cells, has been
      shown to have potent constrictor effects on major arteries in vitro. This
      experiment was performed to determine whether endothelin plays a physiological
      role in cerebral vasospasm after subarachnoid hemorrhage. A cisternal injection
      of endothelin (10(-8) mol or 10(-9) mol) caused severe vasoconstriction of the
      canine basilar artery. The degree of vasoconstriction was dose related and long
      lasting, persisting for more than 24 hours. This constriction was prevented
      completely by pretreatment with nicardipine (10(-8) mol). Endothelin produced a
      marked and transient elevation in blood pressure and might play an important role
      in cerebral vasospasm. Further investigation will be needed to determine the role
      of endothelin in the pathogenesis of vasospasm.

PMID- 2234329
TI  - Acute changes in the dynamics of the cerebrospinal fluid system during
      experimental subarachnoid hemorrhage.
AB  - Early changes in intracranial pressure (ICP), ICP volume index, and resistance to
      absorption of cerebrospinal fluid induced by experimental subarachnoid hemorrhage
      were studied in cats. After SAH, the ICP was slightly elevated, and there was a
      decrease in the buffering capacity of the intracranial space and a sharp rise in
      outflow resistance. During infusion of blood into the cisterna magna with a
      constant infusion rate, an extensive increase in ICP could be demonstrated in
      contrast to the infusion of saline, which caused only slight elevation of ICP.
      Furthermore, during blood infusion, the ICP level did not reach a plateau phase
      of pressure, as was demonstrated during infusion of saline. It is suggested that
      the marked increase in ICP during blood infusion into the subarachnoid space is
      caused by intracranial volume loading and the simultaneous increase in
      cerebrospinal fluid outflow resistance. It is concluded that the reported
      relationship between increased cerebrospinal fluid outflow resistance and
      increased ICP supports the hypothesis of a strong increase in ICP during
      subarachnoid hemorrhage in human subjects.

PMID- 2234328
TI  - The frequency-dependent behavior of cerebral autoregulation.
AB  - Cerebral autoregulation is a complex physiological process composed of both fast
      and slow components that may respond differently to different rates and patterns
      of blood pressure variation. To assess the temporal nature of autoregulation,
      transcranial Doppler velocity recordings of the middle cerebral artery obtained
      over prolonged periods were compared with blood pressure recordings in 5 patients
      without cerebral disease and in 13 patients with intracranial pathological
      changes. Correlations between the velocity and pressure wave forms at various
      frequencies of variation were measured with systems analysis techniques. Patients
      with aneurysmal subarachnoid hemorrhage had high correlations indicating pressure
      dependent flow and impaired autoregulation. Patients without cerebral disease had
      significantly lower correlations (P less than 0.01), indicating intact
      autoregulation. Examples of increasing correlations and correlations at new
      frequencies emerging as the clinical condition worsened are given. These
      preliminary examples suggest that the application of systems analysis techniques
      to velocity and pressure data allow measurement of the temporal nature of
      cerebral autoregulation.

PMID- 2234330
TI  - Inhibition of tumor growth in a glioma model treated with boron neutron capture
      therapy.
AB  - This investigation attempts to determine whether increased survival time seen
      when the F98 glioma model is treated with boron neutron capture therapy (BNCT) is
      a result of inhibition of tumor growth caused by radiation-induced alterations in
      endothelial cells and normal tissue components. This indirect effect of radiation
      has been called the tumor bed effect. A series of tumor-bearing rats was studied,
      using a standardized investigational BNCT protocol consisting of 50 mg/kg of
      Na2B12H11SH injected intravenously 14 to 17 hours before neutron irradiation at 4
      x 10(12) n/cm2. Ten rats, serving as controls, received no treatment either
      before or after tumor implantation. A second group of 10 rats was treated with
      BNCT 4 days before tumor implantation; these animals received no further
      treatment. The remaining group of 10 rats received no pretreatment but was
      treated with BNCT 10 days after implantation. Histological and ultrastructural
      analyses were performed in 2 animals from each group 17 days after implantation.
      Survival times of the untreated control animals (mean, 25.8 days) did not differ
      statistically from the survival times of the rats in the pretreated group (mean,
      25.5 days). The rats treated with BNCT after implantation survived significantly
      longer (P less than 0.02; mean, 33.2 days) than the controls and the
      preirradiated animals. Tumor size indices calculated from measurements taken at
      the time of death were similar in all groups. These results indicate that, with
      this tumor model, BNCT does not cause a tumor bed effect in cerebral tissue. The
      therapeutic gains observed with BNCT result from direct effects on tumor cells or
      on the peritumoral neovascularity.

PMID- 2234331
TI  - Characterization of a newly established malignant meningioma cell line of the
      human brain: IOMM-Lee.
AB  - A permanent malignant meningioma (MM) cell line of the human brain designated
      "IOMM-Lee" is reported. This cell line was successfully established from the
      tumor of a 61-year-old Chinese man with repeated recurrent primary intraosseous
      malignant meningioma of the skull. It has been subcultured for more than 60
      passages during the past 30 months. The doubling time of cultured cells is
      approximately 62 hours. Tumorigenicity in athymic nude mice (Balb/c-nu/nu) who
      develop multiple pulmonary metastases was observed; the doubling time of tumor
      volume in vivo is approximately 5 days. Karyotypic analysis revealed this cell
      line to be of human origin and near-diploid, with a modal chromosome number of
      49. The mesenchymal tumor marker vimentin and intracytoplasmic microfilaments
      were identified in the cytoplasm of tumor cells by indirect immunohistochemical
      peroxidase-anti-peroxidase assays and immunogold ultrastructural localization by
      transmission electron microscopy, respectively. Scanning electron microscopy of
      cultured cells and xenografted tumors revealed ellipsoidal or carrot-shaped tumor
      cells presenting a wrinkled surface with short sparse microvilli. Potential
      proliferating activity was determined by Ki-67 monoclonal antibody; the Ki-67
      labeling index of cultured cells and xenografted tumors was approximately 36% and
      30%, respectively. This newly established malignant meningioma cell line of the
      human brain may prove useful as a research model.

PMID- 2234332
TI  - Repair of isolated axillary nerve lesions after infraclavicular brachial plexus
      injuries: case reports.
AB  - Stretch injuries of the infraclavicular brachial plexus have a much better
      prognosis for spontaneous recovery than do their supraclavicular counterparts. We
      present three patients with stretch injuries of the infraclavicular brachial
      plexus who had spontaneous restoration of function in all muscles except the
      deltoid. Decreased shoulder abduction was a serious handicap to these
      individuals. At surgical exploration, each patient had an isolated, complete
      axillary nerve disruption at the quadrilateral space. Deltoid muscle function was
      restored in all three patients by repair of the axillary nerve with sural nerve
      grafts across the quadrilateral space.

PMID- 2234333
TI  - Functional results of facial nerve suture after removal of acoustic neurinoma:
      analysis of 25 cases.
AB  - The facial nerve is sometimes severed during the removal of acoustic neurinomas,
      either intentionally to ensure complete removal, or unintentionally because of
      difficulties in identification. In such cases we have, if possible, sutured the
      nerve stumps microsurgically, either end to end or by use of an intervening nerve
      graft. We analyzed the outcome of 25 instances of facial nerve suturing in a
      series of 219 patients operated on for acoustic neurinoma from 1979 to 1987. The
      first signs of recovery appeared at an average of 12 months, and there was
      continued improvement for several years. Recovery was graded from 1 to 6. The
      anastomosis was successful in 24 of the 25 sutured nerves, in that at least some
      facial movement and tone were restored (Grade 5 or higher). In 11 of the 25
      cases, facial appearance at rest and with movement was moderately good (Grade 2
      or 3). A Grade 1 result, with no perceivable facial dysfunction, was never
      achieved. Typically, oral muscles showed the most improvement and frontal muscles
      the least. Facial appearance was better at rest than with movement, which was
      always complicated by some degree of synkinesis. Closure of the eye was so good
      in 13 of the 25 cases that neither tarsorrhaphy nor an eyelid spring was
      necessary. When the facial nerve is severed, intraoperative suture is
      recommended, because it provides a chance for moderately good restoration of
      facial appearance.

PMID- 2234334
TI  - Extracranial repair of cerebrospinal fluid fistulas: technique and results in 37
      patients.
AB  - Although neurosurgeons have traditionally preferred intracranial repair for the
      management of cerebrospinal fluid (CSF) fistulas, this approach is associated
      with the complications of a craniotomy, anosmia, and a high incidence of
      recurrent fistulas. Extracranial repair, on the other hand, produces no central
      nervous system morbidity, preserves olfaction, and is associated with a low
      incidence of recurrence. Although there have been several reports of extracranial
      repair of CSF fistulas by otorhinolaryngologists, this approach has received
      scant mention in the neurosurgical literature. We report here our experience with
      37 patients with CSF rhinorrhea or otorrhea who underwent extracranial repair.
      The etiology of the fistula was postoperative in 22, traumatic in 6, and
      spontaneous in 9. The fistulas were repaired using one of four techniques:
      external ethmoid-sphenoid in 18 patients, transmastoid in 9, transseptosphenoid
      in 7, and osteoplastic frontal sinusotomy in 3. In 32 of the 37 patients (86%)
      the fistulas were successfully repaired with the initial procedure. Of the 5
      patients requiring a second operation, the fistula was successfully closed in 4
      for an overall success rate of 97%. Complications were few and consisted of a
      transient facial paresis in a patient undergoing transmastoid repair and one
      death from meningitis. The authors conclude that because of low morbidity and
      mortality and a high success rate in closing fistulas, extracranial repair is the
      preferred technique for the operative management of CSF rhinorrhea and otorrhea.

PMID- 2234335
TI  - Whither short-course chemotherapy for tuberculous meningitis?
AB  - Short-course chemotherapy is well established for the treatment of pulmonary
      tuberculosis but not for extrapulmonary disease. We present a series of 35 cases
      in which chemotherapy for tuberculous meningitis was given for a period of less
      than 2 years. Short-term therapy was associated with recrudescence of tuberculous
      meningitis and, in some cases, with the development of deep cerebral infarcts and
      permanent neurological deficits. We think short-term chemotherapy for
      tuberculosis of the central nervous system is inadequate.

PMID- 2234336
TI  - Mild head injury classification.
AB  - Inconsistencies across studies concerning outcome after mild head injury may
      reflect differences in the diagnostic criteria used for selection of patients.
      Consequently, we compared the neurobehavioral outcome in three groups of
      consecutively hospitalized patients (aged 16 to 50 years) who sustained a closed
      head injury (CHI) and had a Glasgow Coma Scale (GCS) score in the 9 to 15 range.
      These groups included patients with uncomplicated CHI with mild impairment of
      consciousness as reflected by a GCS score in the 13 to 15 range (n = 78),
      patients with initially mild impairment of consciousness complicated by brain
      lesion or depressed skull fracture (n = 77), and patients with moderate CHI (n =
      60). Tests of memory, information processing, and verbal fluency were
      administered within 1 to 3 months after injury, and the Glasgow Outcome Scale was
      completed at 6 months. Neurobehavioral functioning was impaired in the groups
      with complicated mild CHI and moderate CHI as compared to the group with
      uncomplicated mild CHI. Although moderate CHI produced longer durations of
      impaired consciousness and posttraumatic amnesia than complicated mild head
      injury, patients in these groups did not differ in neurobehavioral performance.
      Global outcome at 6 months was better in the patients with mild CHI than in
      patients with complicated mild and moderate injuries. Analysis of the various
      complications of mild CHI revealed that the presence of an intracranial lesion
      was related to more severe neurobehavioral sequelae than injuries complicated by
      a depressed fracture.

PMID- 2234337
TI  - Diffuse axonal injury: analysis of 100 patients with radiological signs.
AB  - One hundred patients with head injuries who showed diffuse axonal injury on
      computed tomographic scans are reported. Evaluation of the Glasgow Coma Score,
      pupillary signs, and computed tomographic findings on admission led to an
      improved ability to forecast outcomes. Our relatively good results as compared
      with other series, can be explained by the high proportion of children and by the
      liberal use of computed tomography to evaluate head injuries, thus revealing that
      concussion may sometimes be regarded as an early form of diffuse axonal injury.

PMID- 2234338
TI  - Ischemic brain damage in a model of acute subdural hematoma.
AB  - Ischemic brain damage is the most important neuropathological finding in humans
      who die after acute subdural hematoma; however, its causes are poorly understood.
      We have produced acute subdural hematoma in the rat by injecting 400 microliters
      of autologous blood (approximately 20% of intracranial volume) into the subdural
      space. Extensive areas of ischemic damage, involving 14 to 16% of the volume of
      the hemisphere, developed in this model at 4 and 24 hours after the lesion. The
      hematomas were associated with a brief peak in intracranial pressure (51 mm Hg),
      which remained at three times normal levels (14 mm Hg) for 3 hours. In this
      model, therefore, ischemic damage appears to be due to the local effects of blood
      overlying the cortex at 4 hours after the ictus, rather than to globally raised
      intracranial pressure. The implications for the pathophysiology of acute subdural
      hematomas in humans are discussed.

PMID- 2234339
TI  - Stroke: a selective history.

PMID- 2234340
TI  - Chronic Lyme disease with an expansive granulomatous lesion in the
      cerebellopontine angle.
AB  - Expansive granulomatous lesions in the posterior cranial fossa are rare and have
      not been reported in conjunction with Lyme disease. We report a patient with
      verified Borrelia burgdorferi infection who developed a tumor in the
      cerebellopontine angle. Rapid growth of the tumor led to signs of cerebral
      compression and to hydrocephalus. Surgical intervention was required despite
      florid meningitis. The histological examination showed inflammatory, nonspecific
      granulation tissue. The origin of this tissue is almost certainly causally
      related to the B. burgdorferi infection. Signs of inflammation resolved rapidly
      after subtotal resection. The clinical, radiological, and biochemical course is
      documented. This is the first report of an expansive cerebral lesion in the
      chronic phase of Lyme disease.

PMID- 2234341
TI  - Symptomatic pineal cyst: case report.
AB  - Pineal cysts are being described with increasing frequency since the advent of
      magnetic resonance imaging. Although pineal cysts are incidental findings in as
      many as 4% of magnetic resonance imaging studies, symptomatic pineal cysts are
      quite rare. We present a case of pineal cyst causing aqueductal obstruction with
      symptomatic hydrocephalus and resultant headache and syncope, which was treated
      by surgical resection. A review of the relevant literature and discussion follow.

PMID- 2234342
TI  - Vagal schwannoma associated with syncopal attacks and postural hypotension: a
      case report.
AB  - A case of vagal schwannoma in the cerebellomedullary angle is reported.
      Preoperatively, the patient had paroxysmal episodes of postural hypotension with
      syncope. After total removal of the vagal tumor, her systemic blood pressure
      returned to normal.

PMID- 2234343
TI  - Multiple intracranial tumors of different cell types.
AB  - Multiple intracranial tumors of different cell types are rare. We report nine
      patients with multiple intracranial tumors, who did not have a history of trauma,
      irradiation, or phacomatosis. The clinical, radiological, and histopathological
      findings as well as indications for operations in patients with asymptomatic
      second tumors are discussed.

PMID- 2234344
TI  - Occult vascular malformations of the optic chiasm: magnetic resonance imaging
      diagnosis and surgical laser resection.
AB  - Angiographically occult vascular malformations of the optic nerve and chiasm are
      extremely rare. Before the advent of magnetic resonance imaging (MRI), it was
      difficult to diagnose these lesions preoperatively. We report MRI scan findings
      of optic chiasm cavernous angiomas in two patients with chiasmal syndrome. MRI
      was useful in localizing the vascular malformation and delineating its
      characteristics, especially chronic hemorrhage. One patient underwent biopsy of
      the lesion. The other patient underwent complete microsurgical resection of the
      malformation with the carbon dioxide laser with preservation of vision. Occult
      vascular malformations of the optic nerve and chiasm may be a more common cause
      of visual deterioration than previously recognized. The MRI scan is the imaging
      modality of choice for diagnosing and following these lesions. In certain
      patients, these vascular malformations may be amenable to complete surgical
      removal with stabilization or improvement of visual function.

PMID- 2234345
TI  - Cyst of the choroid plexus in the lateral ventricle: case report and review of
      the literature.
AB  - We report an intraventricular cyst in a 2-year-old boy who had myoclonic jerks of
      the extremities. The cyst had no communication with the ventricular system or
      subarachnoid space. Total removal of the cyst adhering to the choroid plexus was
      accomplished. The glial cyst wall was lined in part by flattened or cuboidal
      epithelium. The preoperative and postoperative computed tomographic scans and
      magnetic resonance images are presented, and congenital benign cysts in the
      lateral ventricle are reviewed and discussed.

PMID- 2234346
TI  - Traumatic aneurysm of the superior cerebellar artery: case report and review of
      the literature.
AB  - Less than 10% of the 250 reported cases of traumatic intracranial aneurysms have
      involved the posterior circulation. Traumatic aneurysms of the superior
      cerebellar artery are extremely rare, with only three cases previously reported.
      This is the first report of a traumatic superior cerebellar artery aneurysm in
      which the diagnosis was suggested by computed tomographic scan. The potential for
      a good outcome suggests the value of early angiography when the history and
      diagnostic imaging studies suggest the possibility of a traumatic aneurysm.

PMID- 2234347
TI  - Intradural herniation of a thoracic disc presenting as flaccid paraplegia: case
      report.
AB  - A case of intradural herniation of a thoracic disc in a patient with a flaccid
      paraplegia is described. Intradural herniation of a thoracic disc is considered a
      rare event. A review of the relevant patient literature revealed 14 other reports
      involving 28 patients. No other report has described a patient with an intradural
      thoracic disc herniation who developed a flaccid paraplegia.

PMID- 2234348
TI  - A case of dyschondroplasia associated with brain stem glioma: diagnosis by
      stereotactic biopsy.
AB  - We present a 24-year-old patient with multiple chondromas of both hands, the
      pelvis, the left leg, and an associated brain stem glioma. There was no evidence
      of hemangioma or dyschromia, and the condition was diagnosed as Ollier's disease,
      a special type of dyschondroplasia like Maffucci's syndrome and Kast's disease.
      An increased overall risk for development of malignant skeletal and nonskeletal
      tumors is associated with Maffucci's syndrome. The risk of malignant degeneration
      is lower in Ollier's disease. A glioma in the pons and the right lobe of the
      cerebellum was found in this patient. The literature describes an association
      with gliomas in only 12 cases of dyschondroplasia and an infratentorial
      localization in just one case. Signs of malignancy were histologically confirmed
      in 7 cases without significant preponderance of any one type. Our patient had a
      low-grade brain stem astrocytoma with fibrillar and gemistocytic components. A
      stereotactic serial biopsy made it possible to rule out malignant degeneration.
      Stereotactic brain tumor biopsy as a routine neurosurgical procedure is
      particularly valuable for deep space-occupying processes and forms the basis for
      therapy. In the present case, irradiation was not recommended.

PMID- 2234349
TI  - An unusual complication of silastic dural substitute: case report.
AB  - A case is presented in which a patient developed an unusual complication after
      the use of Silastic dural substitute. In 1983, the patient underwent removal of a
      meningioma with the involved dura. Five years later, he developed around the
      graft material a very thick connective tissue capsule, which simulated a
      recurrent meningioma clinically and radiologically.

PMID- 2234350
TI  - Decompression of lumbar spinal stenosis.

PMID- 2234351
TI  - Prediction of outcome of shunt procedures for communicating hydrocephalus.

PMID- 2234352
TI  - Ultrastructural evidence for differentiation in a human glioblastoma cell line
      treated with inhibitors of eicosanoid metabolism.
AB  - Human glioblastoma cells incubated in the presence of inhibitors of eicosanoid
      biosynthesis show decreased cellular proliferation without cytotoxicity. We
      studied the ultrastructural morphology of a human glioblastoma cell line cultured
      with nordihydroguaiaretic acid (NDGA), a lipoxygenase inhibitor, or 5,8,11,14
      eicosatetraynoic acid, a cyclooxygenase and lipoxygenase inhibitor. When
      glioblastoma cells were treated for 3 days with antiproliferative concentrations
      of either agent, they shared many morphological characteristics, including
      evidence for increased astrocytic differentiation with only limited signs of
      toxicity. The inhibited glioma cells demonstrated an increase in the number and
      length of astrocytic processes containing greater numbers of glial filaments, and
      the NDGA-treated cells also demonstrated extensive lateral pseudopod formation
      along the processes. The glioblastoma cell shape also became more elongated,
      losing the usual nuclear lobularity and nuclear inclusions, especially in NDGA
      treated cells. Many cytoplasmic organelles packed the cytosol of the inhibited
      glioma cells, including prominent Golgi apparatus, dilated smooth endoplasmic
      reticulum evolving into dilated vesicles, cytoplasmic vacuoles, and numerous
      concentric laminations. There was limited evidence for toxicity, however, as the
      mitochondria were more pleomorphic with some mitochondrial distention and
      disruption of the cristae along with an increase in cytoplasmic vacuolization. We
      conclude that the inhibitors of eicosanoid biosynthesis, NDGA and 5,8,11,14
      eicosatetraynoic acid, not only suppress glioblastoma cell proliferation, but
      also induce increased astrocytic differentiation.

PMID- 2234353
TI  - Epidermoid tumors of the 4th ventricle: report of seven cases.
AB  - Epidermoid tumors occur very rarely in the 4th ventricle. We discuss the history,
      clinical course, and the surgical results for seven patients. One patient had a
      remittal of symptoms, probably due to the emergence of the tumor from the 4th
      ventricle into the cisterna magna. Total removal of the capsule was possible only
      in the youngest patient. At present, four patients (mean follow-up, 6 years)
      enjoy good general and neurological health.

PMID- 2234354
TI  - Limited selective posterior rhizotomy for the treatment of spasticity secondary
      to infantile cerebral palsy: a preliminary report.
AB  - A limited selective posterior rhizotomy was performed on 30 children suffering
      from spasticity secondary to infantile cerebral palsy. As opposed to standard
      techniques that stimulate and divide the dorsal rootlets from L2 to S1, we
      dissected L4, L5, and S1 dorsal roots through an L5 to S1 laminectomy. Eight to
      12 rootlets from each root were electrically stimulated with two unipolar
      electrodes (pulse width, 50 microseconds; 10-50 V). The muscle responses were
      observed visually and registered by electromyography. Those rootlets associated
      with an abnormal motor response as evidenced by sustained muscular contraction or
      by prolonged electromyographic response were divided. Spasticity was scored from
      0 to +. The muscular groups assessed were those involved in the flexion of the
      shoulder, elbow and wrist in the upper limbs, and those involved in flexion and
      adduction of the hip, flexion of the leg, and plantar flexion in the lower limbs.
      The patients were assessed 1 week before and 6 months after the operation.
      Reduction of spasticity was observed in all the muscular groups, and all the
      patients presented functional improvement of motor abilities. These preliminary
      results indicate that a limited procedure that reduces the extension of the
      laminectomy and the length of the operation could be effective for treating
      spasticity secondary to infantile cerebral palsy.

PMID- 2234355
TI  - Radical osteoclastic craniectomy in sagittal synostosis.
AB  - We report our experience in the surgical treatment of sagittal synostosis using
      radical osteoclastic craniectomy in 60 consecutive patients. After surgery in
      children aged 6 months or younger (Group I), reossification usually started 2
      weeks postoperatively and was complete within 6 months, resulting in an optimal
      skull contour. In children aged 7 to 12 months (Group II), reossification was
      prolonged and lasted for 12 months or longer. The skull contour normalized in its
      biparietal width and improved in sagittal diameter, remaining, however, slightly
      abnormal. In children older than 12 months (Group III), the skull contour partly
      improved in the biparietal diameter but did not change in the sagittal direction.
      Reossification was incomplete with persistent pseudosutures. Enlarged frontal
      subarachnoid spaces were reversible or improved in all patients independent of
      age at the time of surgery. We encountered no complications in our series. In our
      opinion, radical osteoclastic craniectomy is the simplest, most efficient, and
      most physiologically sound method for the treatment of sagittal synostosis in
      patients up to 6 months of age. This procedure allows the rapidly growing brain
      to form its skull vault, thus providing optimal cosmetic results. In older
      children, osteoplastic morcellation procedures should be the treatment of choice.

PMID- 2234356
TI  - Serial ultrasonographic evaluation of neonatal vein of Galen malformations to
      assess the efficacy of interventional neuroradiological procedures.
AB  - Two-dimensional echocardiography complemented with color-flow imaging and pulsed
      Doppler ultrasound was used to evaluate one fetus and five neonates with a vein
      of Galen malformation who had severe high-output congestive heart failure and
      cranial bruits at birth. Intracranial blood flow through the vein of Galen
      malformations, cardiac status, and direction of aortic blood flow were assessed
      before and after staged interventional neuroradiological treatment with
      transarterial and transvenous embolization procedures. Color-flow imaging in each
      infant displayed the major vascular anatomy including feeding vessels and the
      patterns of filling of the vein of Galen malformations. Pulsed Doppler ultrasound
      performed on the descending aorta above the diaphragm showed the degree of
      diastolic flow reversal indicative of runoff into the vein of Galen
      malformations. A reduction in blood flow through the vein of Galen malformation
      was seen on color-flow imaging in four patients treated successfully by embolic
      procedures. The ratio of diastolic retrograde flow velocity in the descending
      aorta to systolic antegrade velocity decreased from 0.51 +/- 0.15 (mean +/-
      standard deviation) to 0.15 +/- 0.20 (P less than 0.05). Color-flow imaging and
      pulsed Doppler ultrasonography provided anatomical and pathophysiological
      information regarding cardiac hemodynamics and intracranial blood flow; with the
      patient's clinical status, these methods provided a reliable, noninvasive means
      to evaluate the effectiveness of therapy and the need for further treatment in
      neonates with vein of Galen malformations.

PMID- 2234357
TI  - Spinal cord thromboplastin-induced coagulopathy in a rabbit model.
AB  - Coagulopathy results from many diverse events, including several neurogenic
      causes. Using a rabbit model, we produced coagulopathy by injecting autologous
      spinal cord and extracted thromboplastin intravenously. Serial coagulation panels
      were performed to evaluate the activation of the thrombotic and fibrinolytic
      pathways. Group 1 animals (n = 4) received intravenous injections of homogenized
      spinal cord tissue. Coagulopathy was not produced with 36 mg of homogenized
      spinal cord tissue, but 50 mg or more resulted in death. Group 2 animals (n = 12)
      received intravenous injections of extracted rabbit cord thromboplastin, which
      contained approximately 60% activity of a commercially purified rabbit brain
      thromboplastin. Five animals receiving 2.5 to 5.5 mg of thromboplastin per
      kilogram of body weight survived with evidence of coagulopathy. Seven animals
      receiving 2.5 to 100 mg of thromboplastin per kilogram of body weight died. Group
      3 (4 control animals) received normal saline injections without changes in
      clinical or laboratory status. The thrombotic pathway was activated in all
      animals as evidenced by decreased platelet counts and fibrinogen levels.
      Activation of the fibrinolytic system was demonstrated by increased
      concentrations of protamine sulfate and abnormal euglobulin clot lysis times. The
      most sensitive parameters were the platelet count, protamine sulfate
      concentration, and white cell count (margination), which became abnormal within
      15 minutes after the injections and returned to normal within 1 hour.

PMID- 2234358
TI  - Xenon-enhanced computed tomographic measurement of cerebral blood flow in
      patients with chronic subdural hematomas.
AB  - We compared clinical symptoms with extent of brain shift on computed tomographic
      (CT) scans and quantitative and three-dimensional measurements of cerebral blood
      flow (CBF) on xenon-enhanced CT scans in 10 patients with chronic subdural
      hematomas. Five patients had only headache and minimal or no brain shift on a CT
      scan. The other five had hemiparesis and/or mental disturbance in addition to
      headache and moderate or severe brain shift on a CT scan. The mean hemispheric
      CBF decreased about 7% in patients with headache and about 35% in patients with
      hemiparesis and/or mental disturbance. It decreased also on the side without the
      hematoma. The CBF reduction was always more pronounced in the putamen and
      thalamus than in the cortex. On the contrary, the cortex CBF was mostly preserved
      or even elevated in both groups of patients. We speculate that CBF reduction in
      patients with a chronic subdural hematoma occurs initially in central cerebral
      areas like the basal ganglia and thalamus, and then extends to the entire
      hemisphere including the cortex as brain compression and displacement progress.
      Central cerebral area involvement might be more responsible for clinical symptoms
      than the cortex.

PMID- 2234359
TI  - Infectious intracranial aneurysms: comparison of groups with and without
      endocarditis.
AB  - A series of 12 patients with infectious intracranial aneurysms is presented, and
      a number of unusual features of the disorder are emphasized. A comparison of
      characteristics of the aneurysms and clinical course is made between patients
      with and without infective endocarditis. Most of the unusual characteristics of
      infectious aneurysms, including rare locations, causative organisms, and
      predisposing medical conditions, occurred in the group without endocarditis. The
      relationship of atypical features of infectious aneurysms to the etiology of
      aneurysm formation is discussed, and an approach to treatment is presented.

PMID- 2234360
TI  - Distribution of angiographic vasospasm after subarachnoid hemorrhage:
      implications for diagnosis by transcranial Doppler ultrasonography.
AB  - A study was undertaken to determine how frequently angiographic vasospasm occurs
      outside the normal access range of transcranial Doppler ultrasound in patients
      who have suffered a subarachnoid hemorrhage. Vasospasm located in the basal
      vessels is readily identifiable using transcranial Doppler ultrasound whereas
      spasm affecting the more distal, vertically oriented arteries is outside the
      standard detection range. It is therefore speculated that the sensitivity of the
      technique would be adversely affected by a high incidence of distal vasospasm. A
      total of 136 angiograms performed on 68 patients after a subarachnoid hemorrhage
      from anterior circulation aneurysms were reviewed to determine the typical
      distribution of vasospasm. Of the 40 cases that showed greater than or equal to
      25% vessel narrowing, 50.0% had spasm restricted to the basal vessels, 42.5% had
      spasm involving both basal and distal segments, and 7.5% had spasm of the distal
      segments only. None of the patients with distal vasospasm alone developed delayed
      ischemic deficits. It is concluded that most patients with anterior circulation
      aneurysms who develop vasospasm will have involvement of the basal vessels, but a
      small number of patients may develop vasospasm only in distal vessels.

PMID- 2234361
TI  - Hypertension as a risk factor for epilepsy after aneurysmal subarachnoid
      hemorrhage and surgery.
AB  - A prospective, consecutive series of 307 patients with aneurysmal subarachnoid
      hemorrhage ranging from Grades 1 to V according to the classification of Hunt and
      Hess on admission were evaluated to determine the incidence of epilepsy 1 to 3
      years (mean, 1.4 years) after aneurysmal subarachnoid hemorrhage (SAH) and
      surgery. Sixty-three patients had died and one patient was lost to follow-up.
      Twenty-nine patients developed epileptic seizures after the SAH and surgery. The
      mean time from the SAH to epileptic seizure varied from 0 days (day of the SAH)
      to 2 years (mean, 6.7 months). The seizures were classified as focal in 9
      patients (31%) and as generalized in 20 patients (69%). All patients received
      anticonvulsant medication after more than one seizure. The risk factors for
      development of posthemorrhagic/postoperative epilepsy were, in order of
      importance: a history of hypertension; an infarct on late computed tomographic
      scan; and the duration of coma after the ictus. Of the 85 patients with histories
      of hypertension, 17 (20.0%) developed epilepsy. Only 12 (5.4%) of the 222
      nonhypertensive patients developed epileptic seizures. The difference between the
      groups was significant (P = 0.0001). Computed tomographic scans were undertaken
      in 237 patients 1 to 3 years (mean, 1.4 years) after the SAH and surgery.
      Postoperative epilepsy was significantly associated with infarcts visualized on
      computed tomographic scan (P = 0.0005).

PMID- 2234362
TI  - Pharmacological reversibility of experimental cerebral vasospasm.
AB  - Using a morphometric technique, the pharmacological reversibility of luminal
      narrowing after experimental subarachnoid hemorrhage (SAH) was investigated. For
      vasodilation, a "cocktail" consisting of 10(-4) M papaverine, 2 x 10(-4) M sodium
      nitroprusside, and 10(-5) M adenosine was administered intra-arterially. Forty
      two rabbits were divided into six groups: control (normal animals); control plus
      cocktail (normal animals perfused with the cocktail before fixation); SAH
      (animals sacrificed 48 hours subsequent to intracisternal injection of 1.5 ml/kg
      of arterial blood); SAH plus cocktail (SAH plus perfusion with the cocktail);
      BaCl2 (animals sacrificed 10 minutes after intracisternal injection of 2 ml of 3
      x 10(-3) M BaCl2); and BaCl2 plus cocktail (BaCl2 animals perfused with the
      cocktail). The diameter of the basilar arteries in the control and the control
      plus cocktail groups was not significantly different. BaCl2 reduced the diameter
      44% and SAH reduced the diameter 27%. There were no significant differences
      between the diameter of the BaCl2 plus cocktail group and SAH plus cocktail group
      when compared with the control or the control plus cocktail group. Morphological
      examination by light and transmission electron microscopy showed luminal
      narrowing and corrugation of the elastic lamina with few degenerative or
      proliferative changes of the vessel wall in animals with SAH. These results
      suggest that cerebral vasospasm is caused initially by smooth muscle contraction
      rather than by proliferative vasculopathy and that it is not an irreversible
      process.

PMID- 2234363
TI  - Changes in intracochlear and intracanalicular nerves after acoustic neurinoma
      excision confirmed by magnetic resonance imaging.
AB  - Postoperative magnetic resonance imaging findings related to the
      vestibulocochlear and facial nerves within the internal auditory canal were
      analyzed in acoustic neurinomas. T1- and proton-weighted magnetic resonance
      images showed that the vestibulocochlear nerves distal to the internal auditory
      meatus increased in signal intensity after surgical intervention. These nerves
      were conspicuously enhanced after intravenous administration of gadolinium
      diethylene-triamine-pentaacetic acid. The preserved facial nerves were also
      markedly enhanced postoperatively. As a possible cause of these findings, we
      suggest operative disruption of the blood-nerve barrier with ensuing nerve edema,
      although the operative procedures were carefully carried out using a surgical
      microscope. The clinical significance of traumatic disruption of the blood-nerve
      barrier and subsequent nerve edema are discussed from the standpoint of
      preservation of cochlear nerve function.

PMID- 2234364
TI  - Fractures of the clivus: classification and clinical features.
AB  - Fractures of the clival complex were diagnosed in a series of 17 patients
      admitted to the Maryland Institute for Emergency Medical Services System and the
      University of Maryland Medical System over a 30-month period. These fractures
      were divided pathologically into three types based upon their appearance on
      computed tomography: longitudinal, transverse, and oblique. The mechanisms of
      injury were similar in all groups, and the Glasgow Coma Scale scores at admission
      were comparable, regardless of fracture type, in survivors and nonsurvivors.
      Longitudinal fractures were associated with severe injury to the central nervous
      system and with brain stem infarction, and 4 of 6 (67%) of these patients died.
      Transverse fractures of the clival complex were found in 6 patients, 3 of whom
      (50%) died. All of these patients had fractures of the petrous ridge; 2 of the 3
      survivors had multiple cranial nerve deficits, and one patient developed a
      carotid-cavernous fistula. Of the 5 patients with oblique clival fractures, 2
      survived (40%), both of whom had multiple cranial nerve palsies; in addition, one
      of these patients developed a carotid-cavernous fistula. Using the present
      generation of computed tomographic scanners, fractures of the clival complex can
      be reliably diagnosed; they are probably more common than previously believed and
      can be separated into three groups based on the characteristics on computed
      tomographic scans and clinical findings.

PMID- 2234365
TI  - Effect of dosage and timing of administration of naloxone on outcome in the rat
      ventral compression model of spinal cord injury.
AB  - The effect of the dosage and timing of administration of naloxone after spinal
      cord injury in rats via the ventral compression technique is presented. The rat
      ventral compression technique allows for a ventral compression of the spinal cord
      without the requirement of a previous laminectomy. It therefore facilitates the
      creation of an experimental lesion that is similar to that observed in the human
      clinicopathological situation. The first part of the two-part study presented
      herein involved the determination of the optimal dose of naloxone, administered
      intraperitoneally 45 minutes after the creation of the lesion. Of the groups
      studied (control group through 10.0 mg/kg group), 2.0 mg/kg of naloxone proved to
      be superior to both lesser and greater dosages. The second part of the study
      involved the administration of a 2.0 mg/kg dose of naloxone at varying intervals
      ranging from 10 minutes before lesioning to 24 hours after lesioning. A
      multiphasic response was again demonstrated, with an optimal time of
      administration occurring 45 minutes after the creation of the lesion. A
      significant effect was offered by a midrange dose of naloxone (2.0 mg/kg),
      administered at 45 minutes after injury (P less than 0.02 by analysis of variance
      and Duncan's multiple range test). These findings are discussed with respect to
      recent evidence regarding the effects of narcotic antagonists on both mu and
      kappa narcotic receptors. Past and future experiments must account for these
      responses to multiphasic dosage and timing of administration. Failure to do so
      may lead to erroneous conclusions.

PMID- 2234366
TI  - Harvey Cushing and pediatric neurosurgery.
AB  - Harvey Cushing made fundamental and seminal contributions to pediatric
      neurosurgery. Early in his surgical career, he described the diagnosis and
      treatment of subdural hematomas in newborn infants. Important investigations on
      the cerebrospinal fluid and the nature of hydrocephalus were carried out under
      his direction, first by Walter Dandy and Kenneth Blackfan in the Hunterian
      Laboratory at the Johns Hopkins School of Medicine, and shortly afterward by
      Lewis Weed at the Laboratory of Surgical Research at Harvard. Cushing's principle
      interest throughout his professional career was the surgical treatment of brain
      tumors. By his careful clinical examination of patients. Cushing described for
      the first time a typical and composite picture of the more common tumors of the
      posterior fossa in children, particularly the cerebellar astrocytomas and
      medulloblastomas. Percival Bailey, working under Cushing's supervision at
      Harvard, studied and classified the glioma group of brain tumors. This
      contribution by Bailey was a major factor in the understanding of the
      characteristics and natural history of these tumors. In the closing years of
      Cushing's surgical practice, he published three major papers summarizing the
      characteristics, clinical picture, and treatment of the more common brain tumors
      in the pediatric age group. As a result of his exceptional surgical skill and
      innovations, he was able to achieve a surgical mortality of only 4% in operations
      on brain tumors in children. These landmark papers secured Cushing's place as a
      pioneer in pediatric neurosurgery.

PMID- 2234367
TI  - Clinicopathological experience with pineocytomas: report of five surgically
      treated cases.
AB  - The clinicopathological experience associated with five cases of pineocytoma is
      presented. All patients were treated by surgical removal without postoperative
      radiotherapy. In three individuals, 2000 cGy was administered to the tumor as a
      presurgical diagnostic test, with no evidence of response. All cases demonstrated
      histological features of pineocytoma, according to the criteria of Borit et al.,
      and of the so-called "pineocytoma with neuronal differentiation," according to
      the criteria of Rubinstein. The experience obtained from the present series
      reveals that these tumors can occur in the initial decades of life, that a cystic
      appearance and the presence of calcifications are distinctive features of their
      radiological evaluation, and that they have a good prognosis after surgical
      removal, even when the histological data indicate local invasion. The convenience
      of reserving the term "pineocytoma" for these tumors, and of including the so
      called "pineocytomas without further differentiation" within the group of
      pineoblastomas, is suggested in order to achieve a practical clinicopathological
      assessment of parenchymatous pineal tumors.

PMID- 2234368
TI  - Maffucci's syndrome with bilateral cartilaginous tumors of the cerebellopontine
      angle.
AB  - Maffucci's syndrome is characterized by the combination of multiple enchondromas
      (Ollier's disease) and hemangiomatosis. These hemangiomas develop in the
      subcutaneous tissue and form red-blue tumors dispersed over the whole body.
      Intracranial involvement is rare, making a preoperative radiological diagnosis
      and differentiation from other tumors rather difficult. The radiological
      characteristics and successful removal of the intracranial part of a
      chondrosarcoma of the cerebellopontine angle in a case of Maffucci's syndrome are
      reported in this paper.

PMID- 2234369
TI  - Concurrent intradural and extradural meningiomas of the cervical spine.
AB  - A case of an extradural spinal meningioma presenting with a separate intradural
      meningioma at the same cord level is reported. Review of the English literature
      on spinal epidural meningiomas reveals a high incidence of concurrent intradural
      tumors in patients with epidural meningiomas. This leads to the conclusion that
      the intradural space should be evaluated carefully when an epidural meningioma is
      encountered.

PMID- 2234370
TI  - Intradural spinal cord tumor presenting as a subarachnoid hemorrhage: magnetic
      resonance imaging diagnosis.
AB  - Negative findings on four-vessel angiography after a subarachnoid hemorrhage are
      seen in 5 to 30% of patients. A previously silent lesion in the spinal canal may
      be responsible for the ictus in a small percentage of this group. The etiological
      factors include tumors and arteriovenous malformations; however, investigations
      of such lesions have been limited to patients with signs and symptoms of spinal
      cord or nerve root pathological processes. This report describes the management
      of a 56-year-old woman with clinical findings typical of an aneurysmal
      subarachnoid hemorrhage and negative findings on cerebral angiography, in whom
      magnetic resonance imaging with gadolinium enhancement revealed an intradural
      extramedullary cervical schwannoma. For this reason, cervicothoracic magnetic
      resonance imaging with gadolinium enhancement should be considered as an
      adjunctive scanning examination in all patients with a subarachnoid hemorrhage
      and negative findings on angiography.

PMID- 2234371
TI  - Myelopathy presenting decades after surgery for congenital cervical cutaneous
      lesions.
AB  - We report on two patients in whom cervical myelopathy developed decades after
      they had undergone surgery for congenital cervical cutaneous lesions.
      Preoperative magnetic resonance imaging demonstrated dorsal tethering and
      cavitation of the cervical cord in the area of the previous surgery and was
      helpful in decision making regarding surgical exploration and in planning for it.
      We stress the importance of long-term follow-up by both clinical examination and
      magnetic resonance imaging in children who have been operated on for cervical
      cutaneous masses that may have central connections.

PMID- 2234372
TI  - Paraplegia after a routine lumbar laminectomy: report of a rare complication and
      successful management.
AB  - Arachnoid cysts of the spinal canal are relatively common lesions that may be
      either intra- or extradural. These cysts are usually asymptomatic but may produce
      symptoms by compressing the spinal cord or nerve roots. We report a case in which
      an intradural thoracic arachnoid cyst became symptomatic after a routine
      decompressive lumbar laminectomy for spinal stenosis. Myelography revealed no
      abnormality, although magnetic resonance imaging and computed tomography after
      myelography demonstrated a mass within the posterior aspect of the thoracic
      spinal canal associated with anterior displacement and compression of the spinal
      cord. A change in the flow dynamics of the cerebrospinal fluid probably allowed
      the development of spinal cord compression due to one of the following: expansion
      of the cyst, decreased cerebrospinal fluid buffer between the cord and the cyst,
      or epidural venous engorgement. A concomitant and more cephalad lesion such as an
      arachnoid cyst should be considered when myelopathic complications arise after
      lumbar surgery. Magnetic resonance imaging and computed tomography after
      myelography are useful to demonstrate the additional pathological processes.

PMID- 2234373
TI  - Radiation necrosis of the optic chiasm, optic tract, hypothalamus, and upper pons
      after radiotherapy for pituitary adenoma, detected by gadolinium-enhanced, T1
      weighted magnetic resonance imaging: case report.
AB  - A 26-year-old woman was treated for a prolactin secreting pituitary adenoma by
      surgery and radiotherapy (5860 rads). Fourteen months later, she developed right
      hemiparesis and dysarthria. A T1-weighted magnetic resonance imaging scan using
      gadolinium contrast showed a small, enhanced lesion in the upper pons. Seven
      months later, she had a sudden onset of loss of vision, and radiation optic
      neuropathy was diagnosed. A T1-weighted magnetic resonance imaging scan showed
      widespread gadolinium-enhanced lesions in the optic chiasm, optic tract, and
      hypothalamus. Magnetic resonance imaging is indispensable for the early diagnosis
      of radiation necrosis, which is not visualized by radiography or computed
      tomography.

PMID- 2234375
TI  - Suprasellar pituitary adenoma arising from the pars tuberalis: case report.
AB  - A rare case of suprasellar pituitary adenoma arising from the pars tuberalis in a
      53-year-old woman is presented. The tumor was located exclusively above the
      diaphragma sellae, and no invasion into the sella turcica was noted.

PMID- 2234374
TI  - Pituitary hemorrhage into a Rathke's cleft cyst.
AB  - This report describes a case of symptomatic pituitary hemorrhage into a Rathke's
      cleft cyst in a 25-year-old woman. The literature on pituitary hemorrhage in
      nonadenomatous sellar tumors is reviewed.

PMID- 2234376
TI  - An operative complication in a patient with a true posterior communicating artery
      aneurysm: case report and review of the literature.
AB  - Intraoperative oculomotor nerve injury in a patient with a true posterior
      communicating artery aneurysm is reported in detail. A comparison of internal
      carotid artery aneurysms at the posterior communicating artery junction with true
      posterior communicating artery aneurysms deserves special attention, because the
      vascular relationships of the aneurysm are more complex. A clip along the
      internal carotid artery does not occlude blood flow to the aneurysm, and the
      aneurysmal neck and the distal posterior communicating artery are closer to the
      oculomotor nerve. This is the 27th reported case of a true posterior
      communicating artery aneurysm. The incidence of true posterior communicating
      artery aneurysms ranges from 0.1 to 2.8% of all aneurysm patients. Such aneurysms
      constitute 4.6 and 11% of so-called posterior communicating aneurysms in two
      series. Difficulty associated with a preoperative diagnosis has been documented
      in at least 4 cases. An awareness of this rare aneurysm is stressed in order to
      avoid operative complications.

PMID- 2234377
TI  - A method for monitoring intracerebral temperature in neurosurgical patients.
AB  - Current interest in brain temperature and selective brain cooling makes a method
      allowing for continuous monitoring of intracerebral temperature in humans
      desirable. The authors describe a safe, simple, and reliable technique using a
      thermocouple of copper and constantan in combination with intraventricular
      monitoring of intracranial pressure for measurement of brain temperature in
      neurosurgical patients.

PMID- 2234378
TI  - Adult hydrocephalus and shunting.

PMID- 2234379
TI  - Spinal epidural hematoma and garlic ingestion.

PMID- 2234380
TI  - Osteochondroma of the vertebral column.

PMID- 2234381
TI  - Indomethacin in severe head injury.

PMID- 2234382
TI  - Clinical utility of partial flip angle T2-weighted spin-echo imaging of the
      brain.
AB  - To assess the clinical usefulness of partial flip angle (PFA) spin-echo (SE)
      brain imaging, a total of eighty patients were examined with both conventional
      double echo T2-weighted SE (2500/30, 80/90 degrees/one excitation) and PFA double
      echo SE (1200/30, 70/45 degrees/two excitations) on 2.0T system. Two comparative
      studies were performed: (1) in 65 patients PFA SE technique was compared with
      conventional SE without flow compensating gradients, and (2) in 15 patients the
      former was compared with the latter with flow compensating gradients. Imaging
      time was nearly identical in each sequence. In both studies we found that PFA T2
      weighted SE images were almost identical to those obtained with the conventional
      SE technique in the contrast characteristics and the detection rate of the
      abnormalities (100%, 85/85 lesions), and more importantly, PFA SE revealed few
      flow artifacts in the brain stem, temporal lobes and basal ganglia which were
      frequently seen on conventional SE without flow compensating gradients.
      Additionally, PFA SE images demonstrated no suppression of CSF flow void in the
      aqueduct which was commonly seen on conventional SE with flow compensating
      gradients. In overall image quality, the PFA SE images, particularly the second
      echo images, were almost comparable with those of conventional SE with flow
      compensating gradients. A flip angle of 45 degrees seems to be close to Ernst
      angle, the angle at which maximum signal occurs, for a given TR of 1200 msec for
      CSF and most of the abnormalities containing higher water content.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2234383
TI  - Value of contrast enhanced CT scanning in the non-trauma emergency room patient.
AB  - To determine the value of performing contrast CT in addition to non-contrast CT
      in the evaluation of acute non-traumatic central nervous system disorders, we
      retrospectively reviewed 322 cases originating from the emergency room at our
      institution. The most common indication for scanning was seizure activity (34% of
      total), followed by headache (30%), focal neurological deficit (10%), and altered
      mental status (8%). 75% of the non-contrast scans were normal. The contrast
      enhanced scan revealed abnormalities not evident on the non-contrast scan in only
      three of these cases, and the information did not alter patient management. We
      conclude that in the acute setting, if a non-contrast CT is normal, a contrast
      study is usually unnecessary. Therefore, given the additional risks of contrast
      infusion, the contrast study, if needed, is generally best obtained at a later
      date, after more careful evaluation of the patient's history and medical records.
      If the non-contrast CT scan is abnormal, a contrast enhanced CT scan may be
      beneficial, but, again, is often not needed to direct acute patient management.

PMID- 2234385
TI  - Dissecting and fusiform aneurysms of vertebro-basilar systems. MR imaging.
AB  - The magnetic resonance (MR) findings of three cases with vertebro-basilar
      dissecting aneurysms (DA) were compared with those of two cases with vertebro
      basilar fusiform aneurysms (FA). No abnormal findings, excepting a dilatation of
      a signal-void area corresponding to the arterial blood flow, were shown on the MR
      images in the patients with a FA. In contrast to the FA cases, various
      abnormalities were detected by the MR studies in all three DA cases. An intimal
      flap and a double lumen were demonstrated in one case. An intra-mural hematoma
      was shown in one case. A hematoma neighboring the parent artery was demonstrated
      in two cases. MR imaging was thought to be useful for detecting intracranial
      vascular lesions, such as a DA, and for discriminating between a DA and a FA.

PMID- 2234384
TI  - Pediatric brainstem glioma. Post-radiation clinical and MR follow-up.
AB  - Thirty-four pediatric patients, twenty with presumed and fourteen with biopsy or
      autopsy proven brainstem gliomas were imaged by CT and MR before radiation
      therapy. Twenty-eight patients received radiotherapy. Of these, eighteen fit the
      protocol for combined clinical and MR post-treatment evaluation. No cases of
      radionecrosis were seen at autopsy. This study shows that MR can demonstrate
      tumor response to radiation therapy, tumor progression prior to clinical
      deterioration, post-treatment cyst formation and hemorrhage. Although MR clinical
      correlation was not optimal on six week post-treatment evaluation, 4-10 month
      post-treatment MR scanning correlated well with clinical evaluation. MR appears
      useful in post-therapeutic monitoring of tumor response.

PMID- 2234386
TI  - Imaging of cerebral arterio-venous malformations by transcranial colour-coded
      real-time sonography.
AB  - Transcranial color-coded real-time sonography (TCCS) is a new diagnostic method
      allowing the non-invasive imaging of parenchymal and vascular structures of the
      adult brain through the intact skull. A description of the sonographic findings
      in two patients presenting with a radiologically ascertained arterio-venous
      malformation is provided. The AVM's can be depicted in the two-dimensional B-mode
      image as echodense areas interspersed with zones of lower echodensity. Their
      extension correlated with corresponding MRI images. The color-coded illustration
      of intravascular flow phenomena allowed the distinct identification of the major
      afferent feeding vessels, the venous drainage and of the vascular convolution of
      both AVM's. Information on hemodynamics, as e.g. the blood supply of the angioma
      by the contralateral internal carotid artery, are obtained by color-coded
      identification of intravascular flow direction including analysis of the Doppler
      frequency spectrum. All findings obtained by TCCS complied with those established
      by angiography. We conclude, that TCCS is a suitable method for early diagnosis
      and long term follow up of cerebral AVM's.

PMID- 2234387
TI  - Cerebral blood flow mapping using stable xenon-enhanced CT in sickle cell
      cerebrovascular disease.
AB  - The cerebral blood flow (CBF) of 25 patients with sickle cell cerebrovascular
      disease (SCCVD) was examined using a Xenon-CT flow mapping method. Brain CT and
      MR findings were correlated with those of the Xenon-CT flow studies. CBF defects
      on Xenon-CT correlated reasonably well with the areas of cortical infarctions on
      the MR images, but in 27% of the cases, flow defects were slightly larger than
      the areas of infarctions on the MR images. In deep watershed or basal ganglia
      infarctions, abnormal CBF was noted about the cerebral cortex near infarctions in
      72% of the patients, regardless of infarction sizes on the MR images. However,
      decreased CBF was recognized in 4 of the 9 children whose MR images were
      virtually normal. Thus, the extent of flow depletion cannot be predicted
      accurately by MR imaging alone. Xenon-CT flow mapping proved a safe and reliable
      procedure for evaluation of the CBF of patients with SCCVD. Although this study
      is preliminary, it may have a potential in selecting patients for
      hypertransfusion therapy, as a noninvasive test and for following children with
      SCCVD during their therapy. Careful correlation of results of CBF with those of
      MR imaging or of CT is important for objective interpretations of flow mapping
      images.

PMID- 2234389
TI  - Volumetric quantification of brain volume in children using sequential CT scans.
AB  - We devised a three dimensional method for the accurate measurement of brain
      volume and applied it to 32 neurologically normal children, 7 children with only
      mental retardation and 15 children with both mental retardation and motor
      disturbance. In the group of neurologically normal children, the total brain
      volume increased from 723 cm3 to 1407 cm3 in order of age. The correlation ratio
      between the total brain volume and age was significant (P less than 0.0001). The
      values of the total brain volume and the developmental curve were similar to
      those of the total brain weight of normal children previously reported. The
      combined volume of the cerebellum, the midbrain, the pons and the medulla also
      increased from 76 cm3 to 200 cm3 in a manner similar to that of the total brain.
      The correlation between total brain volume and head circumference was significant
      (P less than 0.0001). In the group of children with mental retardation, the total
      brain volume was relatively smaller than that of neurologically normal children.
      In the group of the children with mental retardation and motor disturbance, 10
      out of 15 cases showed values below -2 SD of those of neurologically normal
      children. The values of the total brain volume were each less than -3 SD in 3
      cases whose head circumferences were each more than -3 SD. Our method for the
      direct measurement of brain volume based on serial CT scans may be useful for the
      accurate examination of brain development.

PMID- 2234388
TI  - Selective cerebral intraarterial DSA. Complication rate and control of risk
      factors.
AB  - In 1095 patients 2770 brain supplying arteries have been studied by i.a.-DSA.
      Definitive neurological deficits occurred in 0.09%, transient deficits were
      observed in 0.45%. The reduced complication rate in comparison to former studies
      seems to be a continued effect of technical progress (DSA) and the use of new
      isoosmotic contrast media. In order to reduce the "training hospital effect" as
      to complication rate careful supervision of trainees is necessary. The average
      fluoroscopy time per vessel is proposed as an objective measure of the
      investigational skill of a neuroradiologist.

PMID- 2234390
TI  - Use of a new mixture for embolization of intracranial vascular malformations.
      Preliminary experimental experience.
AB  - The internal carotid artery system in swine has a special anatomic configuration
      similar to a brain "arterial-arterial malformation." The internal carotid artery
      breaks up into a multitude of fine channels (rete mirabile) situated at the base
      of the skull on the side of the hypophysis. This anatomic arterial model was used
      to analyze acute and chronic angiographic and histological changes after
      occlusion of the rete mirabile with I) avitene, II) avitene, and 50% ethanol,
      III) avitene, 30% ethanol and Polyvinyl alcohol, IV) avitene 50% ethanol and
      Polyvinyl alcohol, V) IBCA and VI) silk. Histopathological changes observed in
      the rete mirabile six weeks following occlusion demonstrated that a mixture of
      avitene, 30% ethanol and Polyvinyl alcohol and IBCA produced the best anatomic
      results. Embolization with avitene, PVA and ethanol induced a more bland
      histological reaction than the one observed with IBCA. Preliminary clinical
      experience with this mixture is reassuring in those cases in which the AVM was
      surgically resected. The partially thrombosed AVM was easily depressed and
      compressed by the neurosurgeon allowing for satisfactory hemostasis in and around
      the nidus of the AVM.

PMID- 2234391
TI  - (D, L) polylactide microspheres as embolic agent. A preliminary study.
AB  - Owing to their shape, accurately calibrated microspheres appear to be very
      suitable material for distal embolization. Moreover, the biocompatible (D, L)
      polyactide (PLA) microspheres possess two other valuable advantages: easy
      adjustment of their biodegradation rate, and incorporation of chemotherapeutic
      agents during their production. The authors describe the preparation of these (D,
      L) PLA microspheres and their clinical applications as a preliminary step to
      arterial chemoembolization.

PMID- 2234392
TI  - Neurography using the intramuscular injection of ionic iodine contrast media.
AB  - Our report presents a new method of neurography. Sciatic nerve and lumbosacral
      plexuses in frogs have been visualized after the intramuscular injection of water
      and lipid soluble ionic iodine contrast media (Telebrix 300, Potassium Iodide 30%
      and Lipiodol Ultra Fluid). The ascendant flow of the iodine ions (anions) has
      been achieved by establishing the electrical potential difference between the
      injection site and the proximal part of the sciatic nerve and lumbosacral plexus.
      The application of DC current ensued immediately after the injection. Several
      minutes later the proximal segments of tibial and peroneal common nerves, as well
      as the sciatic nerve in its full length, have been visualized on X-Ray film.
      Lumbosacral plexuses became radioopaque after 20 plus minutes.

PMID- 2234394
TI  - Intracavernous aneurysm. Superior demonstration by magnetic resonance
      angiography.
AB  - A case of intracavernous aneurysm in a 56-year-old woman is reported. The
      superiority of MRI and MRA in the diagnosis is shown.

PMID- 2234393
TI  - MRI demonstration of cortical laminar necrosis and delayed white matter injury in
      anoxic encephalopathy.
AB  - We performed serial radiological examinations on a patient with anoxic
      encephalopathy. In the early term after the anoxic insult, T1-weighted MRI
      revealed high signal intensity areas distributed laminarly in the cerebral cortex
      and diffusely in the putamen, which were thought to reflect the cortical necrosis
      and necrosis in the putamen. Single photon emission computed tomography using I
      123 isopropylamphetamine showed persistent hypoperfusion in the arterial
      watershed zones. T2-weighted MRI performed several months after the anoxic
      episode revealed diffuse high-intensity lesions in the arterial water-shed zones.
      These delayed-onset white matter lesions continued to extend over several months.

PMID- 2234395
TI  - High field MR imaging of the brain in pseudohypoparathyroidism.
AB  - Two cases of pseudohypoparathyroidism were examined with a superconductive 1.5 T
      MR imaging system. High signal intensities were seen in both putamina, pulvinars
      and dentate nuclei on T1-weighted images.

PMID- 2234396
TI  - MRI of radiation induced spinal cord glioma.
AB  - Radiation induced neoplasms of the spinal cord are rare lesions. This report
      details the MR evaluation of a patient with radiation induced astrocytoma of the
      cervical cord. The diagnosis of second primary neoplasm should be considered in
      patients with prior radiation therapy when MRI demonstrates an intramedullary
      lesion.

PMID- 2234397
TI  - Amyloidosis of the spine in a patient on long-term hemodialysis.
AB  - A 54-year-old man with a history of renal failure treated with hemodialysis for
      over 10 years presented with clinical signs and symptoms and plain radiographic,
      computed tomographic and magnetic resonance imaging features of cervical
      vertebral osteomyelitis with spinal cord compression. Decompressive surgery
      revealed amyloid deposition. In the setting of chronic hemodialysis,
      differentiation between amyloid deposition and osteomyelitis may not be possible
      on an imaging basis necessitating biopsy for diagnosis.

PMID- 2234398
TI  - Spiculated vertebral metastases from prostatic carcinoma. Report of first two
      cases.
AB  - Periosteal reaction with spicule formation is very rare in metastatic bone
      disease, as only 75 cases are reported in the literature. Although prostatic
      cancer often metastasizes to the spine, spiculation here has not been reported.
      We present the first two cases of vertebral metastases from prostatic carcinoma
      with spicule formation giving rise to osseous spinal stenosis and neurological
      deficits, best demonstrated by CT.

PMID- 2234399
TI  - MR demonstration of a unilateral olivary hypertrophy caused by pontine tegmental
      hematoma.
AB  - Two patients with unilateral olivary hypertrophy (OH) following a pontine
      tegmental hematoma are presented. Both showed palatal myoclonus and one patient
      showed an extremity myorhythmia on the opposite side of OH. The magnetic
      resonance (MR) examination demonstrated an abnormal unilateral hyperintense
      lesion in the ventral part of medulla oblongata on T2-weighted images. The MR
      findings were highly suggestive of the pathological nature of the lesion, showing
      the value of MR.

PMID- 2234400
TI  - Brown tumor in secondary hyperparathyroidism, causing progressive paraplegia.

PMID- 2234401
TI  - Bilateral aberrant jugular bulbs.

PMID- 2234403
TI  - Submicromolar concentrations of zinc irreversibly reduce a calcium-dependent
      potassium current in rat hippocampal neurons in vitro.
AB  - The action of the endogenous divalent cation zinc on Ca2+ and Ca2(+)-dependent
      currents was studied in rat hippocampal CA1 and CA3 neurons in vitro, by means of
      a single electrode voltage clamp technique. Bath application of zinc (0.5-1
      microM) produced a small membrane depolarization associated with an increase in
      synaptic noise and cell excitability and a depression of the
      afterhyperpolarization following a train of action potentials. The effects on the
      afterhyperpolarization, could not be reversed on washout. In voltage-clamped
      neurons, zinc induced a steady inward current and reduced, at resting membrane
      potential, the peak amplitude of the outward current underlying the
      afterhyperpolarization, IAHP. In caesium loaded neurons (in the presence of
      tetrodotoxin and tetraethylammonium), zinc reduced the slow inactivating Ca2+
      current activated from a holding potential of -40 mV. Similar results were
      observed with nickel and cobalt at comparable concentrations, with Zn2+ greater
      than Ni2+ greater than Co2+, in their order of potency. In contrast to nickel and
      cobalt the effects of zinc did not reverse on washout. These results suggest that
      low concentrations of zinc enhance cell excitability by reducing IAHP. In
      addition, zinc reduces the slow inactivating voltage-dependent Ca2+ current. The
      irreversible effect of this metal ion is compatible with a toxic, intracellular
      site of action.

PMID- 2234402
TI  - Systemic administration of MK-801 protects against N-methyl-D-aspartate- and
      quisqualate-mediated neurotoxicity in perinatal rats.
AB  - MK-801, a non-competitive antagonist of N-methyl-D-aspartate-type glutamate
      receptors, was tested for its ability to antagonize excitotoxic actions of N
      methyl-D-aspartate or quisqualic acid injected into the brains of seven-day-old
      rats. Stereotaxic injection of N-methyl-D-aspartate (25 nmol/0.5 microliters) or
      quisqualic acid (100 nmol/1.0 microliter) into the corpus striatum under ether
      anesthesia consistently produced severe unilateral neuronal necrosis in the basal
      ganglia, dorsal hippocampus and overlying neocortex. The distribution of the
      damage corresponded to the topography of glutamate receptors in the vulnerable
      regions demonstrated by previous autoradiographic studies. N-Methyl-D-aspartate
      produced severe, confluent neuronal destruction while quisqualic acid typically
      caused more selective neuronal necrosis. Intraperitoneal administration of MK-801
      (0.1-1.0 mg/kg) 30 min before N-methyl-D-aspartate injection had a prominent dose
      dependent neuroprotective effects as assessed morphometrically by comparison of
      bilateral striatal, hippocampal and cerebral hemisphere cross-sectional areas
      five days later. A 1 mg/kg dose of MK-801 given as pre-treatment completely
      protected the infant brain. The same dose of MK-801 was also completely
      protective when administered 30 or 40 min after N-methyl-D-aspartate and afforded
      partial protection when given 2 h later. MK-801 pre-treatment also prevented the
      electrically confirmed behavioral seizures induced by N-methyl-D-aspartate. The
      drug significantly reduced striatal but not hippocampal or neocortical injury
      when given as two doses (1 mg/kg) 30 min prior to and immediately following
      quisqualic acid injection. The data indicate that systemic administration of MK
      801 can prevent N-methyl-D-aspartate-induced neuronal injury in perinatal rat
      brain even when administered after the initial insult. MK-801 also partially
      antagonized quisqualic acid-mediated neurotoxicity, suggesting that quisqualic
      acid-induced toxicity is, in part, mediated through N-methyl-D-aspartate receptor
      activation. The sensitivity of the developing brain to the toxicity of N-methyl-D
      aspartate provides a sensitive and reproducible in vivo model for exploring these
      issues and for screening prospective neuroprotective drugs that act at the N
      methyl-D-aspartate receptor-channel complex.

PMID- 2234404
TI  - Serotonin attenuates a slow inhibitory postsynaptic potential in rat hippocampal
      neurons.
AB  - Activity of hippocampal neurons was recorded in an in vitro slice preparation.
      Topical application of serotonin produced hyperpolarization, blockade of a slow
      afterhyperpolarization which follows a burst discharge and blockade of a slow
      inhibitory postsynaptic potential. The slow inhibitory postsynaptic potential
      evoked by stimulation of the apical dendritic region of the hippocampus is more
      sensitive to serotonin than the membrane potential or conductance. The effects of
      serotonin on the inhibitory postsynaptic potentials are blocked by the 5-HT1a
      antagonist spiperone, and not by mianserin, a 5-HT2 antagonist. The attenuation
      of the inhibitory postsynaptic potentials is not accompanied by a change in
      postsynaptic reactivity to GABA or baclofen. Serotonin blocks repetitive large
      inhibitory postsynaptic potentials evoked in hippocampal neurons by topical
      application of 4-aminopyridine. Putative interneurons are more sensitive to
      topical application of serotonin than pyramidal neurons. Fenfluramine, a
      serotonin releaser mimics the effects of topical application of serotonin
      indicating that synaptically released serotonin can produce the changes in
      membrane potential and reactivity to afferent stimulation. It is suggested that
      serotonin attenuates slow inhibitory postsynaptic potentials by inhibiting feed
      forward inhibitory interneurons which impinge upon the recorded pyramidal
      neurons.

PMID- 2234405
TI  - Characterization of dopamine release in the rat medial prefrontal cortex as
      assessed by in vivo microdialysis: comparison to the striatum.
AB  - Using the technique of perfusion microdialysis combined with a small-bore liquid
      chromatography system we have measured the basal and drug-induced fluxes of
      extracellular dopamine in the medial prefrontal cortex of chloral hydrate
      anesthetized rats and have compared our findings in the cortex to that observed
      in the striatum. The results were as follows. (1) At a flow rate of 2
      microliter/min, the basal level of dopamine in the medial prefrontal cortex was
      0.28 +/- 0.1 (n = 32) fmol/microliter perfusate, which was nearly an order of
      magnitude less than that obtained from the striatum. (2) alpha-Methyl-para
      tyrosine (150 mg/kg i.v.) significantly decreased the extracellular levels of
      striatal and cortical dopamine. The magnitude and duration of the responses were
      similar in both regions. (3) Local perfusion with 30 mM K+ had a more profound
      effect on dopamine release in the striatum than in the medial prefrontal cortex.
      The K(+)-induced release in both regions was significantly attenuated in the
      absence of Ca2+. (4) The anxiogenic beta carboline FG 7142 (15 mg/kg, i.p.)
      enhanced the release of cortical dopamine by about 50% while it was without an
      effect in the striatum. (5) Amphetamine (1 mg/kg, i.v.) significantly elevated,
      while reserpine (5 mg/kg, i.p.) rapidly attenuated, the dopamine level in the
      medial prefrontal cortex. These studies demonstrate that perfusion microdialysis,
      in conjunction with small-bore liquid chromatography with electrochemical
      detection, can be used to measure the basal release of dopamine in the rat medial
      prefrontal cortex and that the dopamine release process in this region, as has
      been shown in the striatum, is sensitive to stimulation conditions and
      pharmacological manipulations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234406
TI  - Nerve growth factor in the primate central nervous system: regional distribution
      and ontogeny.
AB  - An enzyme immunoassay for nerve growth factor was developed to determine the
      regional distribution and ontogenic change in the macaque (Macaca fascicularis)
      CNS. The standard curve of mouse nerve growth factor paralleled the dilution
      curves of extracts from the primate CNS at the adult and pre-natal stages.
      Furthermore, the nerve growth factor immunoreactive material comigrated with
      mouse nerve growth factor by means of carboxy methyl cellulose chromatography.
      These findings suggest that the immunoreactive material extracted from the
      primate CNS is mouse nerve growth factor-like molecules. At the adult stage, the
      highest level of nerve growth factor was in the hippocampus, with relatively high
      levels also in the hypothalamus, the cerebral cortex, the amygdala, the basal
      nucleus of Meynert, the septal nucleus, the cerebellum and the caudate nucleus.
      No detectable amounts were observed in the spinal cord, the substantia nigra or
      the dentate nucleus. In addition to the CNS, the pituitary gland contained about
      four times the level found in the hippocampus. At embryonic day 120, a high level
      of nerve growth factor already existed in the occipital cortex (80% of the level
      at the adult stage) and in the hippocampus (70% of the level at the adult stage).
      Between embryonic day 120 and the newborn stage in the occipital cortex and
      between embryonic day 120 and postnatal day 60 in the hippocampus, nerve growth
      factor levels increased about 1.7-fold, and after that, they gradually decreased
      until the adult stage was reached. In contrast, in the cerebellum, the level was
      quite high during the pre-natal period and declined to one-third at postnatal day
      60. The developmental changes in nerve growth factor and choline
      acetyltransferase activity in the hippocampus were well correlated (r = 0.963)
      between embryonic day 120 and postnatal day 60. Our studies reveal that nerve
      growth factor is present in the primate CNS. The high level of nerve growth
      factor during embryonic stages and the good correlation with choline
      acetyltransferase activity suggest a physiological role for nerve growth factor
      in the development of the primate CNS.

PMID- 2234408
TI  - Calcitonin gene-related peptide in primary afferent neurons of rat: co-existence
      with fluoride-resistant acid phosphatase and depletion by neonatal capsaicin.
AB  - Immunohistochemical and histochemical techniques were used to re-examine the
      extent to which neonatal capsaicin treatment depletes calcitonin gene-related
      peptide in the dorsal horn of the spinal cord, to determine the localization of
      calcitonin gene-related peptide in relation to that of fluoride-resistant acid
      phosphatase in lumbar dorsal root ganglia, and to compare the distribution of
      these primary afferent markers in the dorsal horn. A substantial depletion of
      calcitonin gene-related peptide was observed in the dorsal horn of adult rats
      treated neonatally with capsaicin suggesting that a large proportion of this
      peptide in the dorsal horn is contained within capsaicin-sensitive primary
      afferent fibers. In dorsal root ganglia 30% of all or 44% of small- and medium
      sized calcitonin gene-related peptide-immunoreactive cells were positive for
      fluoride-resistant acid phosphatase. Conversely, 50% of cells positive for the
      phosphatase enzyme also displayed immunoreactivity for the peptide. In lamina II
      of the dorsal horn calcitonin gene-related peptide and fluoride-resistant acid
      phosphatase were found to have an overlapping distribution. The presence of
      fluoride-resistant acid phosphatase in a substantial proportion of neuropeptide
      containing primary sensory neurons suggests a lack of segregation of sensory
      neuronal populations into peptide- and non-peptide-containing subgroups at least
      on the basis of non-peptide neurons defined as those containing fluoride
      resistant acid phosphatase.

PMID- 2234409
TI  - Neural mechanisms underlying the action of primer pheromones in mice.
AB  - Our electrophysiological experiments in female mice have provided evidence that
      electrical stimulation of the accessory olfactory bulb orthodromically excites a
      subpopulation of tuberoinfundibular arcuate neurons by way of the amygdala. The
      present study shows that half of such neurons are identified as dopaminergic by
      examining the effectiveness of infusing 6-hydroxydopamine and 5,7
      dihydroxytryptamine locally into the median eminence in blocking their antidromic
      response. Further attention is focused on excitatory amino acid receptors within
      the amygdala and the amygdaloid pathway that mediate the accessory bulb-induced
      excitation of tuberoinfundibular arcuate neurons. The excitatory transmission was
      reversibly blocked by intra-amygdala infusion (3 nmol) of the excitatory amino
      acid antagonists kynurenic acid, D,L-2-amino-5-phosphonovalerate, gamma-D
      glutamylaminomethylsulphonate and D,L-2-amino-4-phosphonobutyrate. Intra-amygdala
      infusions (3 nmol) of N-methyl-D-aspartate and kainate markedly enhanced the
      firing activity of tuberoinfundibular arcuate neurons with excitatory inputs from
      the accessory bulb, whereas similar infusions of quisqualate were without effect
      Intra-stria terminalis infusions of the local anaesthetic lignocaine completely
      abolished the excitatory transmission in all the cells tested. Furthermore,
      tuberoinfundibular arcuate neurons stimulated from the accessory bulb were also
      orthodromically stimulated from the stria terminalis with a shorter latency.
      These studies demonstrate that the projections of the accessory olfactory bulb
      activate excitatory amino acid receptors within the amygdala and subsequently the
      stria terminalis route, thereby causing excitation of tuberoinfundibular
      dopaminergic arcuate neurons. This functional pathway can account for the
      reproductive effects so far described as a consequence of vomeronasal
      chemoreception.

PMID- 2234407
TI  - Early accumulation of serotonin in rat spinal cord subjected to traumatic injury.
      Relation to edema and blood flow changes.
AB  - Changes in the concentration of serotonin (5-hydroxytryptamine) in the early
      period after a focal traumatic injury to rat spinal cord were determined and
      related to the formation of edema and alterations in blood flow. A unilateral, 5
      mm-long and 3-mm-deep traumatic injury located 2 mm from the midline was created
      in the T10-11 segment of the cord. Five hours after the injury the serotonin
      concentration in the traumatized segment had increased more than 100% compared
      with controls. There was also a progressive increase in water content of the
      traumatized segment measured 1-5 h after the injury. On the other hand, the
      spinal cord blood flow showed a progressive decrease to about 35% of its initial
      value at 5 h. Pretreatment with p-chlorophenylalanine, a serotonin synthesis
      inhibitor, impeded the elevation in water content measured 5 h after the trauma.
      The spinal cord blood flow remained close to normal values and the increase in
      serotonin was absent. Our results show that trauma to the rat spinal cord will
      induce changes in the serotonin concentration of the tissue and that the
      associated formation of edema and blood flow alterations can be alleviated in
      serotonin depleted rats. Obviously, serotonin plays a significant role in the
      pathophysiology of traumatic injury of rat spinal cord.

PMID- 2234410
TI  - Reflex responses of fusimotoneurons to sinusoidal muscle stretching.
AB  - Reflex response of fusimotoneurons to sinusoidal muscle stretching were
      investigated in decerebrated cats. Nerve impulses of single fusimotoneurons were
      recorded from thin filaments dissected from otherwise intact nerves to triceps
      surae muscles. Amplitude of the sinusoidal stretching of these muscles was 3 mm
      peak-to-peak and the frequencies 0.1-10 Hz. Electric muscle activity was also
      recorded in some experiments. Fusimotor responses were similar to those of the
      skeletomotoneurons in that both were advanced in phase with respect to muscle
      length changes, while their amplitude increased with increase in stretching
      frequency. Modulation at the frequency corresponding to the second harmonic of
      the input signal was predominant in fusimotor responses. It is supposed to appear
      mainly due to the convergence to fusimotoneurons of afferent impulses from
      different muscle receptors arriving after different delays. Its functional role
      is discussed.

PMID- 2234411
TI  - Synaptic efficacy of inhibitory synapses and repetitive firing in the
      reinnervating trigeminal and hypoglossal motoneurons.
AB  - The synaptic efficacy and repetitive firing in masseteric motoneurons after the
      self-union operation and in tongue protruder motoneurons after their cut axons
      were reunited to tongue retractor muscles, the styloglossus muscle, were studied
      in cats. To ensure the correct identification of reinnervating motoneurons, the
      muscle response produce by an induced spike in a motoneuron by intracellularly
      injected depolarizing current was recorded. In both masseteric and tongue
      protruder motoneurons there were no differences on the patterns of postsynaptic
      potentials produced in reinnervating and non-reinnervating motoneurons by
      peripheral nerve stimulation, suggesting that the recovery of the synaptic
      efficacy of inhibitory synapses is time-dependent rather than muscle
      reinnervation. However, the present study demonstrated that the recovery of
      processes that control rhythmical firing of motoneurons is probably dependent on
      muscle reinnervation.

PMID- 2234412
TI  - Involvement of a cholinergic mechanism in the sustained depolarization and
      contraction of the lower oesophageal sphincter muscle cells in the cat.
AB  - Membrane potentials were recorded in vitro with intracellular electrodes from the
      circular muscle cells of the cat lower oesophageal sphincter and oesophageal
      body. In addition, the tension of lower oesophageal sphincter and oesophageal
      body strips was recorded isotonically. Under the experimental conditions, no
      spontaneous electrical activity or variation in the tension of the strips
      occurred. The resting membrane potential of the circular muscle cells was
      significantly lower in the lower oesophageal sphincter (-51.0 +/- 0.3 mV) than in
      the circular muscle cells of the oesophageal body (-57.1 +/- 0.4 mV). These
      values were not affected by infusion of tetrodotoxin 3.1 x 10(-6) M. In the
      presence of atropine (3.5 x 10(-7) M), the resting membrane potential of the
      circular muscle cells of the lower oesophageal sphincter increased significantly
      (-57.6 +/- 0.4 mV), whereas the resting membrane potential of the circular muscle
      cells of the oesophageal body was not significantly affected (-57.8 +/- 0.6 mV).
      In the presence of atropine, no significant difference in the values of the
      resting membrane potential of the circular muscle cells was observed between the
      lower oesophageal sphincter and the oesophageal body. Hyoscine (2.9 x 10(-7) M)
      significantly increased the resting membrane potential of the circular muscle
      cells of the lower oesophageal sphincter, whereas eserine (3.6 x 10(-6) M)
      significantly decreased it. Atropine induced a significant decrease in the
      membrane resistance of the circular muscle cells of the lower oesophageal
      sphincter. Atropine decreased the resting tension of lower oesophageal sphincter
      strips whereas eserine increased it, but no such effects were recorded on
      oesophageal body strips.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234413
TI  - Electrophysiological properties of subpopulations of rat dorsal root ganglion
      neurons in vitro.
AB  - Intracellular recordings were made from rat dorsal root ganglion neurons in
      vitro. Action potentials with an inflection on the falling phase occurred in all
      cells conducting up to 5.2 m/s and in a proportion of faster conducting cells
      which decreased with increasing conduction velocity, until no cells conducting
      faster than 31 m/s had an inflection. Overall, all C-cells (less than 1.3 m/s),
      61% of A delta-cells (1.3-12 m/s) and 23% of A alpha/beta-cells (greater than 12
      m/s) had inflections. A-cells with inflections were found to be
      electrophysiologically distinct from those without as they differed in the mean
      and distribution of every action potential and afterhyperpolarization parameter
      measured. C-cells differed from all A-cell groups, but the means and
      distributions of most parameters were closer to those of A-cells with inflections
      than of A-cells without. In addition, all A- and C-cell action potentials with
      inflections were tetrodotoxin resistant, while all those without were sensitive.
      The only parameters whose means differed between A alpha/beta- and A delta
      neurons were ones which correlated with conduction velocity (action potential
      duration, overshoot and maximum rate of rise and fall). The response pattern to
      prolonged current injection did not correlate with conduction velocity, but
      slightly more A-cells with inflections were single firing. A-cells with long
      afterhyperpolarizations always fired singly, while those with shorter durations
      fired singly or multiply. Somatic following frequency was most strongly limited
      by long afterhyperpolarization duration; it was also slightly lower in A delta-
      than in A alpha/beta-cells, and lower in A-cells with inflections than in those
      without. Fibre following frequencies were highest in the fastest conduction
      neurons.

PMID- 2234414
TI  - Selective uptake of C-fragment of tetanus toxin by sympathetic preganglionic
      nerve terminals.
AB  - Immunohistochemical techniques have shown that the C-fragment of tetanus toxin
      injected into medial gastrocnemius muscle in the guinea-pig and rat, in addition
      to its retrograde transport in the axons of the somatomotor, sympathetic and
      sensory neurons supplying this muscle, is taken up and concentrated by terminal
      varicosities within pre- and paravertebral sympathetic ganglia at all
      thoracolumbar levels. Staining was absent in chronically denervated ganglia,
      demonstrating the specific association of the antigen with preganglionic
      varicosities. Preganglionic varicosities at all levels were also labelled after C
      fragment injection into the peritoneal cavity or into denervated medial
      gastrocnemius; both of these procedures failed to label somatomotor or sensory
      neurons. Although retrograde trans-synaptic transport could be demonstrated,
      sympathetic labelling was sparse and non-specific, so that the C-fragment of
      tetanus toxin is unsuitable for the identification of sympathetic pathways. The
      selective and widespread uptake of tetanus toxin by sympathetic preganglionic
      terminals could explain the diverse autonomic symptoms observed in tetanus
      intoxication.

PMID- 2234415
TI  - Neural control of ectopic filiform spines in adult tongue.
AB  - The tongue surface directly above a fungiform taste bud is flat, thinly
      keratinized, and free of filiform spines. We examined fungiform papillae in
      serial sections of rat and gerbil tongues after unilateral transection of the
      chorda-lingual nerve had caused many fungiform taste buds to degenerate. Such
      empty fungiform papillae often formed a solitary keratinized outgrowth that
      closely resembled the spine of an ordinary filiform papilla. By six months an
      ectopic spine was found on 61% of empty fungiform papillae, but never on
      fungiform papillae that contained a taste bud. Experimental innervation of the
      tongue reduced the incidence of ectopic filiform spines in proportion to the
      cross-sectional area of the trigeminal nerve branches tested (the mylohyoid
      nerve, the lingual nerve, lingual + mylohyoid or lingual + auriculotemporal
      nerves). The chorda tympani nerve was 60 times more effective than trigeminal
      nerves in preventing ectopic filiform spines. We suggest that positive and
      negative trophic actions are normal characteristics of taste axons, for they
      promote the formation of taste buds and prevent the expression of ectopic
      filiform spines. By preventing the outgrowth of ectopic spines on fungiform
      papillae, taste axons maintain a thinly keratinized apical surface that can be
      breached by the taste receptor cells.

PMID- 2234416
TI  - Cajal-Retzius cell ontogenesis and death in mouse brain visualized with
      horseradish peroxidase and electron microscopy.
AB  - The ontogenetic development of Cajal-Retzius cells was studied in mouse by local
      application of horseradish peroxidase over the developing neocortex, revelation
      with 3,3'-diaminobenzidene and examination from horizontal thick sections. Cajal
      Retzius cells were completely stained in Golgi-like fashion. The Cajal-Retzius
      cells were seen to be elongated spindle-shaped bipolar neurons with their main
      processes horizontally oriented. They were exclusively located in the first
      cortical layer and were connected to the cortex surface by the numerous vertical
      appendages. Except for these appendages, the Cajal-Retzius cells were two
      dimensional, with an immature structure at their tips resembling a growth cone.
      Cajal-Retzius cell dendrites were up to 400-microns-long and reached their
      maximal length prenatally. Their axon and its collaterals were very fine and
      sometimes measured several millimetres. It followed a random but planar
      trajectory confined to the first layer. Healthy Cajal-Retzius bearing growth
      cones were seen until one week after birth when signs of Cajal-Retzius cell
      degeneration began to occur and intensified in the days that followed. Rough
      endoplasmic reticulum and Golgi complex swelling along with a progressive
      darkening of the Cajal-Retzius cells were revealed by electron microscopy,
      strongly suggesting that most Cajal-Retzius cells disappear from the first
      cortical layer. Usually neuronal death is the result of cell deafferentation
      following synapse retraction; however, this effect does not seem to apply to
      Cajal-Retzius cells engaged in the process of death since normal synaptic
      junctions were seen on them. No signs of the morphological transformation of
      Cajal-Retzius cells into persisting horizontal first layer cells were observed.
      The concept of dual origin of neocortex is discussed in light of the similar fate
      of Cajal-Retzius cells and subplate neurons which both are transient neurons.

PMID- 2234417
TI  - Assessment: generic substitution for antiepileptic medication. Report of the
      Therapeutics and Technology Assessment Subcommittee of the American Academy of
      Neurology.

PMID- 2234418
TI  - Assessment: intraoperative neurophysiology. Report of the Therapeutics and
      Technology Assessment Subcommittee of the American Academy of Neurology.
AB  - Experience to date in both humans and controlled animal research studies
      substantiates that several electrophysiology tests and monitoring techniques are
      safe and efficacious, to a variable degree, as commonly applied in the operating
      room for the following procedures: EEG or SEP to monitor for cerebral ischemia;
      ECoG and SEP sensory cortex identification to define the limits of cortical
      resection; SEP spinal cord monitoring; BAEP and cranial nerve EMG monitoring
      during posterior fossa procedures; functional localization of cortex with direct
      cortical stimulation in expert hands; and EMG and compound muscle and nerve
      action potential measurements of various peripheral nervous system structures.
      All these techniques need to be applied by a well-trained, knowledgeable
      physician-neurophysiologist or personnel directly under his or her supervision.
      Clinical situations need to be chosen carefully, avoiding those in which the
      nervous system is only at low risk.

PMID- 2234419
TI  - Generic substitutions for antiepileptic drugs.

PMID- 2234421
TI  - The mesoneocortical dopamine neuron system.

PMID- 2234420
TI  - How acute brain failure becomes chronic: a view of the mechanisms of dementia
      related to stroke.

PMID- 2234422
TI  - Aspiration in bilateral stroke patients.
AB  - Seventy patients with bilateral strokes underwent neurologic and
      videofluoroscopic barium swallowing examinations; 34 (48.6%) aspirated. Patients
      with aspiration were more likely to have posterior circulation strokes, abnormal
      cough, abnormal gag, and dysphonia. However, patients likely to aspirate can be
      identified best by the presence of an abnormal voluntary cough, an abnormal gag
      reflex, or both. The prediction of patients at risk for aspiration was not
      improved by additional clinical information (ie, presence of dysphonia or
      bilateral neurologic signs).

PMID- 2234423
TI  - Prolonged confusion following convulsions due to generalized nonconvulsive status
      epilepticus.
AB  - Among patients with a prolonged confusional state after convulsive seizure, we
      diagnosed 8 cases as generalized nonconvulsive status epilepticus. Six had a
      history of seizures, and 2 had new onset. The convulsive seizures were
      generalized in 6 and focal in two. The postictal confusion lasted up to 36 hours
      in the most prolonged case, and a delayed response to anticonvulsant medications
      occurred in all cases. The clinical symptoms ranged from mild confusion to coma.
      Psychiatric manifestations or automatisms were rare. The presumed etiology was
      due to diverse causes, but a withdrawal state was the most common. EEG
      demonstrated continuous or nearly continuous generalized ictal discharges of
      variable morphology. These cases call attention to the fact that some prolonged
      confusional states following convulsive seizures are in fact due to persistent
      seizure activity that can be diagnosed by EEG.

PMID- 2234424
TI  - Verbal memory impairment correlates with hippocampal pyramidal cell density.
AB  - Thirty-five patients with medically refractory epilepsy localized to the temporal
      lobe (18 left, 17 right) completed the verbal Selective Reminding Test before
      surgery. Verbal memory impairments existed before surgery regardless of the
      lateralization of the seizure focus, but patients with left temporal seizure foci
      were significantly more impaired. After surgical removal of the mesial temporal
      lobe structures, 2 blinded observers established volumetric cell densities for
      hippocampal subfields CA1, CA2, CA3, the hilar area, and the granule cell layer
      of the area dentata. Statistically significant correlations existed between
      presurgical memory impairment and cell counts (in CA3 and the hilar area, only)
      for patients with left temporal seizure foci. These findings support the
      hippocampal model of memory and complement prior research documenting the memory
      impairments present after surgical removal of the mesial temporal structures.

PMID- 2234425
TI  - The opposite pupil in herniation.
AB  - I serially examined the pupil opposite the one already enlarged from
      transtentorial herniation in 13 patients. The main abnormalities, stereotyped in
      most patients, were an initially diminished light reaction with a 2.5- to 4-mm
      diameter pupil, followed by slight reduction in size, and then reenlargement to
      greater than original size, all with preserved roundness. Subsequent
      deterioration varied among patients, but a transitional oval shape was infrequent
      and oculomotor function was preserved until both pupils were enlarged and fixed.
      Once the pupil on the side of a mass enlarges, heralding herniation, subsequent
      deterioration can be appreciated through changes in reactivity and size of the
      opposite pupil.

PMID- 2234426
TI  - Spatiotemporal contrast sensitivity differs in normal aging and Parkinson's
      disease.
AB  - We measured contrast sensitivity for static and laterally drifting vertical
      gratings in 12 young adults, 7 normal elderly adults, and 8 patients with
      Parkinson's disease (PD). We compared static and motion contrast sensitivity for
      spatial frequencies of 0.25, 1, and 4 cycles per degree (cpd), and temporal
      frequencies of 1, 3, and 9 Hz. Results show that normal aging leads to a
      reduction of motion sensitivity for the spatial frequency of 0.25 cpd. Compared
      with elderly controls, PD patients do not present specific abnormalities in this
      domain. However, for spatial frequencies of 1 and 4 cpd and temporal frequencies
      of 1 and 3 Hz, motion sensitivity is worse than static sensitivity in PD patients
      and not in elderly controls. These findings suggest a specific deficit of motion
      perception in PD, and possible dopaminergic involvement in the control of
      visuospatial behavior.

PMID- 2234427
TI  - Central neurogenic hyperventilation: pharmacologic intervention with morphine
      sulfate and correlative analysis of respiratory, sleep, and ocular motor
      dysfunction.
AB  - Central neurogenic hyperventilation (CNH), for which there is no effective
      therapy, can eventually result in respiratory fatigue and death. This report
      describes a patient with CNH due to a brainstem anaplastic astrocytoma who also
      exhibited disturbances of sleep and ocular motor function. The CNH responded
      clinically to morphine sulfate and methadone. Analysis of ventilatory response to
      CO2 before and after morphine demonstrated a depression of ventilatory response
      (49 to 53% of baseline) and occlusion pressure response (35 to 50% of baseline)
      to CO2, with a requirement for high doses of naloxone (10 mg IV) to reverse the
      effect. Polysomnography revealed sustained hyperventilation, elevated O2
      saturation, and low end-tidal CO2 throughout all stages of non-rapid eye movement
      (NREM) sleep, and absence of rapid eye movement (REM) sleep. Ocular motor
      evaluation disclosed absence of horizontal and reflexive saccades with
      compensatory head thrusts. Correlation of the clinical and physiologic data with
      the MRI abnormalities suggested that the lesion responsible for CNH in this
      patient might reside in the medial tegmental parapontine reticular formation.
      Since recurrent episodes of hyperventilation responded in a sustained fashion to
      IV and oral opiates, this treatment may warrant consideration in other patients
      with CNH.

PMID- 2234428
TI  - Memory-related neural systems in Alzheimer's disease: an anatomic study.
AB  - In the primate brain, there are strong connections among the entorhinal cortex,
      the hippocampal formation, and the amygdala, 3 structures of the ventromedial
      temporal lobe that are related to memory function. Because memory impairment is a
      central feature of Alzheimer's disease, we examined the probable cells of origin
      and terminal zones of these connections in the brains of humans affected by the
      disease, using thioflavine S, Alz-50, and anti-A4 amyloid protein
      immunocytochemistry. Specific cytoarchitectural areas and lamina that give rise
      to projections from the entorhinal cortex, the hippocampal formation, and the
      amygdala consistently contained neurofibrillary tangles. The terminal zones of
      many of these projections contained neuritic plaques, Alz-50-positive neuritic
      alterations, and A4 deposition. Other cytoarchitectural areas and lamina,
      sometimes immediately adjacent, were consistently spared from these Alzheimer
      changes. This pattern of Alzheimer-related alterations would disrupt projections
      among the entorhinal cortex, hippocampal formation, and amygdala at multiple
      sites, and also disrupt projections between these structures and cortical and
      subcortical targets. In functional terms, this pattern of structural damage is
      likely to be as devastating as bilateral destruction of the ventromedial temporal
      lobe, and thus contribute substantially to the memory disorder seen in this
      condition.

PMID- 2234429
TI  - Hemiparkinsonism-hemiatrophy syndrome: clinical and neuroradiologic features.
AB  - We evaluated 11 patients with hemiparkinson-hemiatrophy syndrome, 6 with body and
      contralateral cerebral hemispheric hemiatrophy, 4 with only body hemiatrophy, and
      1 with just brain hemiatrophy. The mean age of symptom onset was 38.1 years
      (range, 18 to 54) with 5.2 +/- 3.1 (mean +/- SD) years of illness until the last
      follow-up visit. The presenting symptom was unilateral tremor in 6 patients, hand
      dystonia in 2, bradykinesia in 2, and abnormal gait in 1 patient. Three patients
      had a good response to levodopa, 4 had moderate response, and 2 patients had a
      poor response. During a mean follow-up period of 1.7 years (range, 4 months to 5
      years), the Hoehn and Yahr score changed in only 3 patients: 2 gained 1.5 points
      and 1 gained 3 points over 2.5 years. We discuss the association between
      hemiparkinsonism-body hemiatrophy and contralateral hemispheric hemiatrophy, and
      raise the possibility of early childhood brain insult with delayed-onset
      parkinsonism.

PMID- 2234430
TI  - Cytokine accumulations in CSF of multiple sclerosis patients: frequent detection
      of interleukin-1 and tumor necrosis factor but not interleukin-6.
AB  - We identified the cytokines interleukin-1 beta (IL-1 beta), tumor necrosis factor
      (TNF), and interleukin-6 (IL-6) by specific radioimmunoassays in the CSF of
      patients with multiple sclerosis (MS) and other neurologic diseases (OND). There
      was a high incidence of detectable IL-1 beta in patients with active MS compared
      with inactive MS or OND patients. TNF was also more frequently present in active
      MS than in OND CSF. By contrast, most MS CSF did not contain detectable IL-6.
      There was no correlation between the degree of CSF pleocytosis and the level of
      individual cytokines, suggesting that cytokine accumulations may be derived from
      CNS, and not CSF, cells. As IL-1 beta and TNF experimentally induce astrogliosis,
      demyelination, temperature elevation, lassitude, and sleep, and results raise the
      possibility that these cytokines may contribute to a variety of manifestations in
      MS and in other disease states.

PMID- 2234431
TI  - Anti-GM1 IgM antibodies in motor neuron disease and neuropathy.
AB  - We found anti-GM1 IgM antibodies in 23% of 56 patients with motor neuron disease
      (MND), in 19% of 69 patients with neuropathy, and in 7% of 107 controls with
      other neurologic and nonneurologic diseases. Most of these patients had anti-GM1
      IgM antibody titers of 1:80 or less; slightly higher antibody titers (up to
      1:640) were found in 3 patients, 1 with MND and 2 with neuropathy, and very high
      titers (1:20,480) in a patient with MND and an IgM kappa M protein that reacted
      with GM1, GD1b, and asialo GM1. Six other patients with anti-GM1 IgM that also
      bound to GD1b. Reactivity with GD1b did not correlate with anti-GM1 titers but
      was only present in patients with MND or neuropathy. Anti-GM1 IgM antibodies may
      be a normal constituent of the human antibody repertoire but their frequency and,
      in some cases, their levels are higher in patients with MND and neuropathy. The
      origin and the pathogenetic role of these antibodies in neural impairment remain
      to be established.

PMID- 2234432
TI  - Cervical magnetic stimulation.
AB  - We stimulated the cervical region with a 9-cm-diameter magnetic coil on centered
      on the spinous processes in 21 normal subjects. We obtained maximal amplitudes
      with clockwise coil current in right-sided upper extremity muscles and
      counterclockwise coil current in left-sided upper extremity muscles. Optimal
      stimulation sites for biceps, triceps, and abductor digiti minimi were C-3 or C
      4, C-4 or C-5, and C-4, C-5, or C-6, respectively. The latencies of the muscle
      responses varied little in the same subject in spite of marked amplitude changes
      due to suboptimal position of the coil or submaximal stimulator output. In
      abductor digiti minimi, the amplitude of the muscle response on cervical magnetic
      stimulation was 9 to 100% of the supramaximal amplitude on wrist electrical
      stimulation. We established normal values for latency, amplitude, and interside
      differences for the above 3 upper extremity muscles. The findings were
      reproducible, and the latencies obtained with large coils from different
      manufacturers in the same subjects were comparable. We found no advantage in
      bipolar recording over tendon-belly montage. Comparison of magnetic and
      electrical needle root stimulation in the same subjects showed that the magnetic
      stimulus was more proximal in biceps and triceps, and that the site of excitation
      was approximately the same in abductor digiti minimi. Indirect assessment of the
      longitudinal site of excitation based on F-wave minimal latency indicated that
      excitation occurred within millimeters of the emergence of axon of the peripheral
      motor neuron.

PMID- 2234433
TI  - Neuronal injury due to HIV-1 envelope protein is blocked by anti-gp120 antibodies
      but not by anti-CD4 antibodies.
AB  - Picomolar concentrations of native or recombinant coat protein gp120, from the
      human immunodeficiency virus type 1 (HIV-1), injured rat retinal ganglion cell
      neurons in culture. This form of neurotoxicity could be completely abrogated by
      anti-gp120 but not by control preimmune serum, suggesting that the lethal effects
      of the purified preparations of the envelope protein were due to gp120 and not to
      a contaminant. Entry of HIV-1 is mediated by gp120 binding to a surface protein,
      designated "CD4," which is located, for example, on T lymphocytes. However, in
      the present study, specific anti-CD4 antibodies, at concentrations known to block
      effects mediated by high-affinity binding to CD4 on the surface of rat T cells,
      did not prevent neuronal injury induced by gp120. These findings suggest that
      injury of central neurons engendered by gp120 may be responsible, at least in
      part, for the neurologic manifestations observed in as many as 2/3 of the
      patients with acquired immunodeficiency syndrome, such as dementia, myelopathy,
      and visual loss, even in the absence of superinfection. In contrast with previous
      studies, however, this report suggests that the deleterious effects of gp120 on
      neurons may not be mediated via binding to the CD4 molecule.

PMID- 2234435
TI  - Antibodies to synthetic peptide (125-148) of the alpha-subunit of human nicotinic
      acetylcholine receptor in sera from patients with myasthenia gravis.
AB  - We measured the amount of antibodies to a synthetic peptide that corresponds to
      the alpha-subunit residues Lys125-Thr148 of human acetylcholine receptor (AChR)
      in myasthenic sera. We detected anti-peptide antibodies in 52% (89/171) of the
      patients with myasthenia gravis (MG), but none in any of the healthy controls.
      Anti-peptide antibodies should provide a valuable immunologic parameter for the
      clinical evaluation of MG, but no apparent correlation was observed between the
      titers of anti-peptide and anti-AChR antibodies.

PMID- 2234434
TI  - Kearns-Sayre syndrome presenting as renal tubular acidosis.
AB  - Renal tubular acidosis and tetany were the 1st manifestations of Kearns-Sayre
      syndrome in a 5-year-old child. Subsequently, he developed progressive external
      ophthalmoplegia, ptosis, retinopathy, heart block, and endocrinopathy. There was
      a 7.5-kb deletion of mitochondrial DNA documented in muscle, kidney, skin
      fibroblasts, and leukocytes, providing evidence for a multisystem mitochondrial
      cytopathy.

PMID- 2234436
TI  - Electron transfer flavoprotein: ubiquinone oxidoreductase (ETF:QO) deficiency in
      an adult.
AB  - A 19-year-old woman with mild myopathic symptoms from age 6 and fasting
      intolerance presented with a Reye-like syndrome and a myopathy. Investigations
      disclosed a lipid storage myopathy, type II glutaric acidemia, and carnitine
      deficiency in skeletal muscle. Riboflavin and carnitine treatment corrected the
      metabolic abnormalities and she improved clinically. She later died from
      pulmonary complications secondary to aspiration. Subsequent studies established
      electron transfer flavoprotein: ubiquinone oxidoreductase (ETF:QO) deficiency
      (fibroblast ETF:QO activity was 2.9 mU/mg, normal range is 14.1 +/- 3.8 mU/mg) as
      the cause of her illness. This is the first documented case of ETF:QO diagnosed
      in an adult.

PMID- 2234437
TI  - Streptococcus bovis meningitis: report of 2 cases.
AB  - We describe 2 cases of Streptococcus bovis meningitis and review the 9 cases
      previously reported. This microorganism is a rare cause of meningitis in which
      there are no distinctive clinical or laboratory features. The Gram stain of the
      CSF is usually negative. Ten of the 11 cases had some underlying disease or
      comorbid condition that predisposed to S bovis infection: gastrointestinal
      disorder, endocarditis, CSF leak, polymyalgia rheumatica, and mandibular block.
      Treatment with high-dose penicillin is usually adequate.

PMID- 2234438
TI  - Cavernous hemangioma of the spinal cord: report of 2 unusual cases.
AB  - We present 2 cases of spinal cord intramedullary cavernous hemangioma; 1 patient
      is the 1st reported case of multiple spinal cord lesions. Diagnosis is greatly
      enhanced by the use of MRI.

PMID- 2234439
TI  - Eosinophilia-myalgia syndrome (L-tryptophan-associated neuromyopathy).
AB  - Histopathologic study of skeletal muscle biopsy in a patient with eosinophilia
      myalgia syndrome following L-tryptophan use showed prominent lymphocytic
      perineuritis, neuritis, and perimysial fasciitis. The presence of perineuritis
      and neuritis provides a histopathologic basis for clinical features of neuropathy
      in eosinophilia-myalgia syndrome and occurred in conjunction with a fasciitis or
      interstitial myositis that was predominantly perimysial and focally endomysial.

PMID- 2234440
TI  - Neuroleptic malignant syndrome: a unique association with a tricyclic
      antidepressant.
AB  - We report the lst case of neuroleptic malignant syndrome occurring in a patient
      receiving desipramine, a tricyclic antidepressant, with no exposure to
      neuroleptics. Our case suggests that this syndrome may be caused by a central
      imbalance between norepinephrine and dopamine, and not by dopamine depletion
      alone.

PMID- 2234441
TI  - Selective involvement of the pyramidal tract on magnetic resonance imaging in
      primary lateral sclerosis.

PMID- 2234442
TI  - Cerebellar atrophy following acute intoxication with phenytoin.

PMID- 2234443
TI  - Intracerebral hemorrhage following scorpion bite.

PMID- 2234444
TI  - Primary CNS lymphoma.

PMID- 2234445
TI  - Rett's syndrome.

PMID- 2234446
TI  - Antineuronal antibodies.

PMID- 2234447
TI  - [The aorto-coronary bypass in the elderly patient].
AB  - In the FRG one person every ten is more than 70-years old; the average life
      expectancy, often underestimated, is about 11 years for the 70-years old and 6
      years for 80-years old. The modern approach to coronary disease has broadened the
      indications for coronary artery bypass grafting in the elderly. The present
      report, studying 152 patients more than 70-years old, suggests the usefulness of
      a myocardial revascularization in the elderly; it remains to define the relative
      contraindications (renal failure, high LVEDP, valve replacement). However, the
      symptomatic improvement we could achieve (95.45%) seems to be a good result,
      considering the low CABG-related postoperative lethality (1.9%). The trend of our
      results regardless of 5 years survival is also encouraging (85.1%).

PMID- 2234448
TI  - [Hyperkinetic ventricular arrhythmia during the treadmill test in chronic
      ischemic heart disease].
AB  - Aim of this study was to evaluate the pattern of onset and the characteristics of
      ventricular arrhythmias (VA) observed during treadmill test (TT) in patients with
      chronic ischemic heart disease (CIHD). Two groups of patients with CIHD were
      retrospectively compared: group A consisted of 120 consecutive patients with
      premature ventricular beats (PVBs) either isolated (greater than 2/min) or
      repetitive during exercise, or maximal exercise, or recovery; group B consisted
      of 140 consecutive patients without PVBs during TT. The two groups were
      comparable in mean age, male/female ratio, incidence of previous myocardial
      infarction, of previous coronary artery by-pass graft or of percutaneous
      transluminal coronary angioplasty. There were no significant differences between
      the two groups regarding the parameters evaluated during TT: duration of
      exercise, maximal heart rate, heart rate-systolic blood pressure product as well
      as in the percentage of positive tests for acute myocardial ischemia (51.6% vs
      40.7%). In the two subgroups of patients who underwent coronary arteriography and
      left ventricular angiography (24/120 and 23/140 patients respectively) no
      differences were found in the number and distribution of critical coronary
      stenosis and of dyskinetic or akinetic areas. In both groups A and B the QTc
      interval at maximal exercise was significantly longer than its value at rest (p
      less than 0.001), but there was no relevant difference between the two groups. In
      group A patients with VA during maximal exercise (n = 60) showed a higher
      prevalence of complex VA (class Lown greater than or equal to 3) compared to the
      others (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234449
TI  - [Surgical risk in patients with heart valve disease in non-cardiac surgery].
AB  - Our purpose was to retrospectively evaluate major risk of non cardiac surgery in
      patients with valvular heart disease. We studied retrospectively 136 patients, 44
      affected by aortic, 81 by mitral and 11 by mitroaortic valve disease. NYHA class
      was I-II in 130 and III in 6 patients. Sixty four patients underwent orthopedic
      surgery, 57 patients occulistic surgery and 5 patients urological surgery. There
      were no hospital deaths. Fifteen patients developed major perioperative
      complication: 7 serious ventricular arrhythmias, 6 hypotension, 2 "hypertensive
      attacks". We conclude that non cardiac surgery is safe in patients with valvular
      heart disease.

PMID- 2234450
TI  - [The use of dynamic electrocardiographic monitoring in scleroderma patients].
AB  - A comparative analysis of arrhythmias by "basal" electrocardiogram (ECG) and by
      continuous 24-hour Holter electrocardiogram monitoring was performed in 17
      patients with systemic sclerosis (16 women and one man). Our study confirms that
      rhythm disturbances are better detectable using Holter monitoring. In fact, no
      patients had ventricular arrhythmias detected by ECG; on the contrary, Holter
      monitoring revealed ventricular arrhythmias in nine patients (53.3%). This method
      also revealed a ventricular tachycardia, not detected by ECG. In two patients
      ventricular repolarisation abnormalities without symptoms was revealed.

PMID- 2234452
TI  - [Peripheral nerve injuries during carotid endarterectomy].
AB  - Our experience with patients undergoing carotid endoarteriectomy over a 10 year
      period has been retrospectively reviewed. Nerve injuries were detected by
      reviewing postoperative progress and clinical notes. One hundred thirty-four
      procedures were performed on 120 patients, to 15 of whom (9%) occurred major
      nerve injuries. These included seven vagal nerve injuries causing ipsilateral
      vocal cord paralysis and hoarseness, five injuries of the marginal mandibular
      nerve and three injuries of the hypoglossal nerve. None of the patients with
      nerve injury had a stroke as a result of carotid operation. Vocal cord paralysis
      was documented by laryngoscopy. The incidence of cranial nerve injury during
      carotid endoarteriectomy appears to be higher than expected, particularly if
      asymptomatic patients are controlled.

PMID- 2234451
TI  - [A study of the distribution of some risk factors in patients with myocardial
      infarct. Different cardiovascular prevention methods in relation to age].
AB  - In order to evaluate whether a different method of preventive approach to
      ischemic cardiopathy is appropriate in relation to age, the distribution of some
      classic cardiovascular risk factors (cigarette smoke, cholesterol) and a stress
      related risk factor (type of work) was studied in two groups of patients, aged
      respectively over and under 60, admitted to hospital for acute myocardial
      infarction. The most significant data were: blood cholesterol values less than
      220 mg/ml, found mainly in older patients; a larger number of heavy smokers in
      the group of patients aged under 60; the majority of patients were employees. In
      the light of these results, the paper discussed the need for different forms of
      preventive intervention, both clinical and epidemiological, for Ischemic
      cardiopathy in relation to age.

PMID- 2234453
TI  - [Follow-up in femoral artery embolectomy].
AB  - The results of 112 femoral embolectomies performed on 100 patients were reviewed.
      Operative mortality rate was 15% and early amputation (within 30 day-after the
      procedure) 18%. The role of early amputation was closely related to the time of
      leg ischemia. Current follow-up as established for 86 patients. 5 years and 10
      years survival rates for the group were 49% and 40%. Although early survival is
      decreased after femoral embolectomy long term survivors can be expected to live
      independently with excellent limb salvage and function.

PMID- 2234454
TI  - [Popliteal aneurysm. Our experience in 65 cases].
AB  - Fifty patients with 65 popliteal aneurysms underwent reconstructive procedures
      (mean age 64). Atherosclerosis is almost the exclusive cause of popliteal
      aneurysms. Most of the cases showed an acute ischemia, while he others were
      asymptomatic or presented a complication of venous occlusion or neural
      compression. Numerous cases were found incidentally at amputations (these were
      not included). The best operational method is ligation of the aneurysm sometimes
      with partial resection and autologous venous graft bypass. The immediate results
      were excellent in all cases, loss of limb was observed in only three.

PMID- 2234455
TI  - [Evaluation of acute cardiotoxicity from the combination cyclophosphamide
      mitoxantrone-5-fluorouracil (CMF) with Holter ECG].
AB  - By making use of a twenty-four hour Holter monitoring, it as been possible to
      compute the acute cardiotoxicity of the cyclophosphamide + mitoxantrone + 5
      fluorouracil (CNF) association in twenty oncologic patients (pts) each of whom
      being immune from organic cardiopathy emerging clinically and at their first
      cycle of chemotherapy. The following parameters have been computed: meaningful
      changes in the heart frequency; premature atrial and ventricular depolarizations,
      both as a first appearance and as a clear growth in the number; the ST
      dislocation entity; malignant ventricular arrhythmias. The administration of CNF
      at the doses of: 600 mg/m2 of cyclophosphamide, 12 mg/m2 of mitoxantrone and 600
      mg/m2 of 5-fluorouracil , has caused a meaningful increase in the heart frequency
      on 6 pts (30%), an increase of premature atrial depolarization on 4 pts (20%)
      with an appearance ex novo on 2 pts (10%), an increase of premature ventricular
      depolarization, without any passing to superior Lown classes, on 2 pts (10%) with
      an appearance ex novo on 3 pts (15%). Although the results in the study point out
      a frequency percentage of simple hyperkinetic arrhythmias equal to the 55%, the
      lack of more serious hyperkinetic arrhythmias and of intense disorders of
      ventricular repolarization testified to a synergic effect as a determining factor
      on the acute cardiotoxicity of the previously discussed association, in our
      opinion.

PMID- 2234456
TI  - [Pharmacologic effects and safety profile of bethanechol in the differential
      diagnosis of pseudo-anginal thoracic pain].
AB  - The use of bethanecol has recently been proposed to improve the diagnostic
      accuracy of esophageal manometry in identifying the origin of symptoms in
      patients with non cardiac chest pain. In this study we report our experience in
      30 patients who underwent esophageal functional studies. Despite its low
      diagnostic value, bethanecol test (two subsequential doses of 50 micrograms/kg)
      demonstrated an excellent safety profile, there were few side effects, and
      patients tolerance was good. The Holter electrocardiographic study showed an
      isolated case of transient atrioventricular block.

PMID- 2234458
TI  - [AIDS: Mycoplasma and/or HIV?].

PMID- 2234457
TI  - [Dilated cardiomyopathy and visceral anomalies in myotonic dystrophy].
AB  - In dystrophia myotonica clinical evidence of cardiac involvement usually appears
      several years after the onset of neuromuscular symptoms. In more than 90% of
      cases there is damage to the specialized cardiac tissues and in about 7% of cases
      there are alterations to the myocardium. We report a case characterized by early
      and spread deterioration of the pump function developing into refractory
      congestive heart failure. The contemporary involvement of the smooth muscle of
      gallbladder and colon confirms the hypothesis that dystrophia myotonica is a pan
      muscle disease.

PMID- 2234459
TI  - [Anatomo-functional consequences of the radical surgery of the cervico-cephalic
      region in oncologic patients].
AB  - The role of surgery in head and neck cancer treatment is now well established, as
      it appears the most effective approach to such patients, while other therapies
      (i.e. chemotherapy, radiotherapy) can be of some help as second choice
      procedures. Surgery demonstrates however its own pitfalls, as it can often cause
      secondary anatomo-functional defects. The main problems appear to be related to
      the impossibility of physiological feeding following composite resection for oral
      cancer. An immediate reconstruction by transposition of myocutaneous flaps is of
      the utmost importance, as it reestablishes the preoperative condition lessening
      hospitalization time and postoperative disabilities. Neurological lesions, an
      unfrequent major complication of cervical lymphadenectomy, can cover a wide range
      of seriousness, from hardly detectable sensorial deficits to the impossibility of
      spontaneous ventilation. In this paper the Authors, on the basis of their
      experience, describe the measures to be taken in order to avoid secondary lesions
      (or to minimize their effects) in head and neck cancer surgery.

PMID- 2234460
TI  - [Osteo-articular amyloidosis caused by dialysis. Clinical and radiologic
      aspects].
AB  - Twenty-nine patients who had received chronic hemodialysis for more than 5 years
      provided the material for the present study. In 12 of them (41%) there were
      radiological findings of dialysis related amyloidosis, mainly destructive
      spondyloarthropathy of the cervical spine (n = 11) and geodes of the shoulder (n
      = 5). When compared with negative patients, these patients were significantly
      older (p less than 0.001 and had been dialyzed for longer periods of time (p less
      than 0.01). Moreover, in such patients there was an higher incidence of carpal
      tunnel syndrome (p less than 0.025) and shoulder pain (p less than 0.001). Our
      results confirm that osteoarticular amyloidosis is a frequent long-term
      complication of chronic hemodialysis and underline the correlation between
      clinical and radiological findings.

PMID- 2234461
TI  - [Behavior of ionized calcium in hypertensive and normotensive patients].
AB  - Serum concentrations of ionized calcium have been measured in a group of 38
      patients with essential hypertension (26 women and 12 men with mean age 61 +/- 12
      years) and in a group of 19 normotensives (14 women and 5 men with mean age 70 +/
      12 years). Serum Ca++ levels were significantly lower in hypertensives than in
      normotensives (4.16 +/- 0.43 mg/dl and 4.46 +/- 0.38 mg/dl respectively, with p
      less than 0.05). The lower serum concentrations found in hypertensives may be due
      ions in arterial smooth muscle cells may cause an increase of vascular tone and
      peripheral resistances. Our results support, in agreement with other Authors, the
      possible role of ionized calcium in the pathogenesis of essential hypertension.

PMID- 2234462
TI  - [Occult blood in the feces for the early diagnosis of tumors of the digestive
      system].
AB  - Mortality from colon-rectal cancer is rising steadily in Italy; of malignant
      tumours, those of the nitestine come second after those of the lung. Hence the
      ned for early diagnosis based on the search for occult blood in the stools. This
      test takes on important significance for screening purposes in subjects at risk.
      Alongside diagnosis it is important to effect primary prevention diet, food and
      environmental factors). A negative result of the identification of occult blood
      in the stools absolutely does not exclude tumour of the intestinal tract. A
      positive finding, on the other hand, does not necessarily confirm the presence of
      a tumour. Such an investigation was carried out at the Analysis Laboratory of the
      Sant'Antonio di Ovada Hospital, Health Unit 74, in the period between October '87
      and June '88. The samples were taken from hospitalised patients and from out
      patients. The samples from hospitalised patients totalled 324 and 20 proved
      positive for occult blood; of the out-patient samples (176), positivity was
      observed in 12. Hospitalised patients were recontrolled and results were
      confirmed positive. The out-patients did not present for further controls.

PMID- 2234463
TI  - [Plasma beta-endorphin and caffeine consumption in chronic hemicrania].
AB  - Thanks to recent biochemical and neuroendocrine findings, migraine belonging to
      the group of primary headaches appears as a pathology of the antinociceptive
      system with evolutive character. It has been demonstrated, in fact, that right at
      the early stage of migraine, there is a significant reduction in liquoral
      concentrations of beta-endorphin (beta-E), endogenous opioid peptide followed by
      a similar change in the plasma opioid system. The opioid system deficiency is
      even more evident after stimulation tests that point to reduced reactivity of the
      hypothalamo-hypophyseal system with respect to stimuli that in normal subjects
      trigger hypophyseal beta-E incretion. Caffeine, a member of the methyl-xanthine
      group, is an interesting molecule in the study of migraine patients because the
      chronic intake of this substance, contained in numerous analgesics, has been
      related to the chronic nature of the pain. The purpose of the present study is to
      assess the relationship between caffeine consumption and plasma opioid system.
      With the administration of a single oral dose of caffeine, normal subjects
      present an increase in plasma concentrations of beta-E, while in patients with
      chronic migraine, the response is significantly lower. These data confirm the
      poor reactivity of the plasma opioid system to pharmacological stimuli in
      migraine. Average daily consumption of caffeine has also been determined. It was
      not possible to establish a correlation between consumption of caffeine and
      plasma concentrations of beta-E whether basal or after stimulus with caffeine.

PMID- 2234464
TI  - [Cardiac effects of prostacyclin infusion].
AB  - The purpose of this investigation is the evaluation of cardiac effects of short
      term prostacyclin intravenous infusion. Prostaglandin I2 has been administered at
      rate of 5 ng/kg/min. Systolic blood pressure (mmHg) remains unchanged, heart rate
      (beats/min) significantly increases (p less than 0.01). Diastolic blood pressure
      (mmHg) significantly decreases (p less than 0.01) during the first hour: this
      decrease is not significant during the second and third hour. The QTc shortens
      during the first and third hour and returns to normal values during 60-90 minutes
      of infusion. This preliminary study suggests that cardiac effects of prostacyclin
      infusion are indirect.

PMID- 2234465
TI  - [Clinical experience with piperacillin in the prophylaxis of post-operative
      infections].
AB  - Ninety patients who had undergone surgery have been treated with piperacillin as
      a prophylaxis for hospital infections. Twenty-two (24.4%) emergency operations
      and sixty-eight (75.6%) elective ones have been performed. Thirty-five open
      drainages, seven vacuum drainages and fifty-five urinary catheters have been
      placed. Post-operative infections occurred in 18 patients (20%), five of them
      submitted to emergency operations and thirteen submitted to elective operations.
      In eight cases an open drainage had been placed and in three cases a vacuum rate.
      The Author concludes that the hospital infections rate agrees with that occurring
      in the quoted sources; that open drainages, especially if placed through surgical
      wound, have main responsibilities for infections, and that piperacillin acted as
      a very well tolerated antibiotic and a highly manageable and effective one,
      offering therefore a good prophylaxis for hospital infections.

PMID- 2234466
TI  - [Netilmicin in a single daily dose for treatment of systemic infections].
AB  - The Authors report the results obtained in 35 patients of either sex suffering
      from various systemic infections and treated with netilmicin. Netilmicin has been
      intramuscularly administered in once daily dose of 4.5 mg/kg (mean daily dose
      294.3 mg) for a mean duration of 17.8 days. The clinical resolution of the
      infections has been achieved in 97.1% (34 patients) of the study population; only
      one patient showed failure. Thirty-three of the 35 baseline causative pathogens
      have been eradicated. The local and systemic tolerability was good. The serum
      pharmacokinetics showed bactericidal levels of netilmicin and no serum
      accumulation.

PMID- 2234467
TI  - [Socioeconomic status and survival in multiple myeloma].
AB  - In order to investigate the relationship between socioeconomic status and
      survival in multiple myeloma, a group of 121 patients, followed from first
      diagnosis to their demise, was subdivided into three social classes: high,
      medium, and low. Social class subdivision was performed taking into account the
      degree of education, occupation, and income. Significant differences (p less than
      0.05) exist regarding mean survivals, survival curves, clinical stages, and
      responses to therapy between the three considered classes. A low socioeconomic
      status is associated with shorter survival, higher frequence in poor clinical
      stage, and less percentage of positive responses to chemotherapy. In conclusion,
      the socioeconomic status is an important prognostic factor in patients with
      multiple myeloma, to be considered with other clinical and laboratory data.

PMID- 2234468
TI  - [Anatomo-clinical considerations on early gastric cancer].
AB  - The morphological features of early gastric carcinoma and its differences with
      respect to advanced gastric cancer are discussed on the basis of reported data.
      In particular, prognostic morphological implications and therapeutic
      possibilities are discussed. Study of recurrences suggest factors to improve
      prognostic productivity.

PMID- 2234469
TI  - [Scientific institutions for treatment and care: purpose, characteristics and
      specific role in the oncologic sector].
AB  - The qualities of Comprehensive Health Care Institutes facilities established to
      foster, carry out and coordinate activities of scientific research and assistance
      in the field of biomedicine are described. At present there are 23 centers, their
      activity being based on two fundamental features: 1) topical research in specific
      themes characterizing the role these Institutes continuously play; 2) specialized
      research concerning subjects of particular interest and/or urgency suggested by
      the Ministry of Health.

PMID- 2234470
TI  - [Peculiar clinical pictures of Guillain-Barre-Strohl syndrome. Description of 2
      clinical cases].
AB  - A clinical of 37 patients suffering form Guillain-Bare syndrome has been carried
      out. Because of their unusual onset and clinical course, two of the cases are
      reported in full. The first case presented atypical onset modalities
      characterised by dysarthria, dysphonia and dysphagia with subsequent diplegia of
      the facial nerve and motor involvement of all four extremities; the second was
      difficult to diagnose and over time it turned out to be disimmune chronic
      recurrent polyneuropathy. The clinic instrumental diagnostic and therapeutic
      course of this case, which was characterised by the poor response to
      corticosteroid therapy as a result of which use of immunosuppressor (azatioprine)
      and plasma-feresis were employed with a reaosable improvement, is described in
      detail. The differential diagnosis and nosologica classification are discussed.

PMID- 2234471
TI  - [Unilateral cavernous angioma of the thalamus disclosed by transitional disorders
      in the upward gaze].
AB  - We describe a case of a cavernous angioma of the right thalamus, identified by
      MRI, showing transient vertical diplopia in the upward gaze, present only in
      protracted recumbency. We consider possible pathogenetic mechanisms in an attempt
      to explain this peculiar disturbances. In addition we emphasize that MRI is the
      most sensitive procedure for detection of the cavernous angioma.

PMID- 2234472
TI  - [Eosinophilic gastritis. Clinico-pathologic considerations on a case and review
      of the literature].
AB  - The clinical, radiographic and histological features of a case of eosinophilic
      gastritis in a 26 year old-man without personal or familial signs of allergy are
      reported. The Authors pointed out the importance of radiographic and histological
      aspects of the case studied. Therefore they represent essential methods for a
      correct diagnosis and an appropriate management that in this case is only
      pharmacological. The diagnosis of eosinophilic gastritis is, however, important
      for the recognition of specific allergens.

PMID- 2234473
TI  - [Myocardial damage and pheochromocytoma. Description of 2 cases and review of the
      literature].
AB  - The usual presentation of phaeochromocytoma is well known. It is a catecholamine
      producing tumor of the sympathochromaffin system that typically cause sustained
      hypertension or hypertensive crisis. Rarely it has an uncommon clinical
      presentation with or without arterial hypertension and so the most significant
      symptoms are episodes of left ventricular failure, arrhythmias, ischemic ECG
      changes, angina pectoris, myocardial infarction, hypertrophic or dilated
      cardiomyopathy. On report two cases of uncommon presentation of phaeochromocytoma
      and a few cases of myocardial damage from the literature are reviewed.

PMID- 2234474
TI  - [Serum paraprotein in a patient with chronic lymphatic leukemia].
AB  - We report a case of chronic lymphocytic leukemia associated with paraproteinemia
      which proved to be a complete immunoglobulin IgM lambda. This case is reported
      because the process of cellular differentiation exposed to intrinsic or extrinsic
      stimulation may undergo morphofunctional variations which lead to the formation
      of plasma cells with extremely high secretionary capacities during the course of
      chronic lymphocytic leukemia.

PMID- 2234475
TI  - [Andersson's phenomenon in HLA-B27 negative ankylosing spondylitis].
AB  - A computed tomography (CT) and conventional radiography study is reported in a
      case of HLA-B27 negative ankylosing spondylitis. The value of CT in comparison
      with conventional radiography in evaluation of anatomic alterations is
      determined.

PMID- 2234476
TI  - [Cardiovascular involvement and relative risk factors in systemic sclerosis.
      Personal contribution].
AB  - In systemic sclerosis (SS), cardiovascular commitment was recorded in an autopsy
      series, in widely different percentages, from 12 to 81%. On the other hand,
      clinical diagnosis of cardiopathy is made in far fewer cases. In addition, the
      coexistence of renal and/or pulmonary commitment makes difficult separation
      between primary and secondary heart damage. In 22 patients (2 m, 20 f) aged
      between 34 and 75 (average 55 +/- 11) with SS, a study has been made of the a)
      prevalence of cardiovascular commitment; b) the significance of the classic risk
      factors; c) the erythrocyte filtration time or TF (index of microangiopathic
      damage). Metabolic stability, fibrinogen, haematocrit and TF (Reid et al. method)
      were assessed in each patient. Nine patients (40.9%) presented ischaemic
      cardiopathy (myocardial infarction in three and effort angina in six), one (4.5%)
      presented hypertensive cardiopathy. Conduction disturbances were observed in five
      patients (22.7%). Whereas a statistically significant increase in TF was observed
      in cardiopaths, no differences in plasma levels of glucose, cholesterol or
      fibrinogen were observed. The incidence of smoking and the familial factor were
      also insignificant.

PMID- 2234477
TI  - [Regulation mechanisms in prolactin secretion. Possible role of the hypophyseal
      renin-angiotensin system].
AB  - Recent studies have shown a possible role of different factors in the regulation
      of prolactin secretion. In fact many neurotransmitters (dopamine) and peptides
      can modulate prolactin release from anterior pituitary lactotrophs. In vitro and
      in vivo studies, Angiotensin II has been shown to increase prolactin release. On
      the basis of these data we have studied the effects of enalapril (ACE-Inhibitor)
      on baseline plasma prolactin in nine hypertensive post-menopausal women. The
      results indicate that 15-day inhibition of angiotensin-converting enzyme by
      enalapril significantly reduced serum prolactin levels. These data suggest that
      the Angiotensin II may play a role in the control of prolactin secretion in
      hypertensive women.

PMID- 2234478
TI  - [Hyponatremia in cirrhosis with ascites].
AB  - Hyponatremia complicates ascitic hepatic cirrhosis with frequency and gravity
      related to the gravity of the cirrhosis itself. When hyponatremia develops, it
      worsens the already present secondary hyperaldosteronism and makes therapy with
      spironolactone inefficacious. From a pathophysiologic viewpoint a pathogenetic
      role in determining hyponatremia is attributable to the reduced plasmatic renal
      perfusion; in several patients a syndrome of inappropriate ADH secretion
      develops. Other neurohormonal systems (catecholamines, prostaglandins,
      natriuretic hormones) are probably very important in modifying renal hemodynamics
      and renal tubular function. In some patients a causative role for hyponatremia is
      attributable to iatrogenic factors (e.g.: diuretics). From a therapeutic
      viewpoint, we examine some schedules, pharmacologic or not, that, however, are
      far from being useful for all patients. We discuss, mainly, water restriction,
      osmotic diuretics with or without loop diuretics, loop diuretics followed by
      sodium reintegration and concentration-reinfusion of ascites or application of
      peritoneovenous shunt.

PMID- 2234479
TI  - [Chronic gastritis. A study of 151 cases diagnosed using gastric biopsy].
AB  - With the aim to detect a correlation between endoscopic aspects and histological
      features of chronic gastritis, the Authors have analysed retrospectively a series
      of 151 cases where endoscopic alterations were likely due to chronic gastritis
      and in all cases multiple biopsies were performed. A possible correlation between
      endoscopy, histology and occurrence of intestinal metaplasia has been carefully
      evaluated. Only in chronic atrophic gastritis a certain relationship between
      endoscopic features and histologic diagnosis was detectable: in the same cases a
      high incidence of intestinal metaplasia was found as well, independently from the
      severity of endoscopic and/or histologic aspects. The Authors discuss the
      controversial problems in terminology and endoscopic definition of chronic
      gastritis.

PMID- 2234480
TI  - [Campylobacter pylori infection. Results of an investigation of 130 patients].
AB  - After recalling the main data on diagnosis, pathogenesis and treatment of CP
      infection, the results of a study on 130 patients are presented.

PMID- 2234481
TI  - [Echocardiographic analysis of the left ventricular mass in smokers].
AB  - A morphometric echocardiographic analysis of left ventricular mass was performed
      in 110 heavy smokers and 110 controls aged 20-60. Taken as a whole, the smoker
      group revealed a higher ventricular mass index (88.4 +/- 19.5 v 78.3 +/- 16.8
      g/sq m; p less than 0.01). The difference was not significant in the 20-40 age
      group (78.1 +/- 18.3 v 76.7 +/- 18.1 g/sq m) but was highly significant (p less
      than 0.001) in the 41-60 age group (96.0 +/- 18.8 v 80.7 +/- 15.8 g/sq m). The
      increase in mass may be related to increased catecholamine incretion, raised
      blood viscosity due to increased fibrinogen and haemocrite and to transitory but
      repeated increases in telesystolic stress caused by the cigarette smoke. The
      increase in myocardial mass together with other well-known coronary alterations
      induced by smoking might explain the greater incidence an severity of ischaemic
      heart disease, not to mention sudden death among heavy smokers.

PMID- 2234482
TI  - [Epidemiologic observations on the subject of phlebopathy of the legs and its
      dermatologic complications].
AB  - The authors carried out an epidemiological study on a group of 10032 patients
      with chronic venous insufficiency, composed of 2686 males (26.77%) and 7346
      females (73.23%). The case report is divided into varicose diseases (83.30%) and
      sequelae of deep vein thrombosis (16.70%). As well as the relationship between
      sex and age is considered rate of dermatological complications, with regard both
      to the type of venous diseases (65.54% varicose and 34.46% post-thrombotic) and
      to their clinical manifestations. As well as any family connection, various
      environmental factors are taken into account such as the patient's work, noxae
      iatrogenic, pregnancy and obesity.

PMID- 2234483
TI  - [The use of weight and height data reported in surveys for screening for obesity
      and juvenile arterial hypertension].
AB  - The surveying of weight and height allows to measure for every subject the body
      mass index which is a risk indicator both for obesity and for juvenile blood
      hypertension. The A. have verified and demonstrated that the surveying of weight
      and height orally told by teen-agers can be a rapid and economic instrument to
      execute a first screening for such pathologies.

PMID- 2234484
TI  - [Study of a population sample conducted using the bioenergy gold test].
AB  - Experiments carried out using the bioenergy gold test showed that a bioradiant
      subject working on water without touching, is able to modify the evolution of the
      gold colloid generated by chemical reaction in the treated water sample. To
      complete these researches, experiments were carried out on 50 pranotherapeutic
      practitioners and on 50 normal subjects. Statistical analysis shows that the
      results in normal subjects differ from those in the pranotherapeutic
      practitioners. These observations confirm that pranotherapeutists act physically
      on the water, modifying the structure of the liquid and the chemical gold test is
      able to reveal these changes.

PMID- 2234485
TI  - [A systematic approach to the prediction of psychosomatic disease].
AB  - This paper is an introduction to the "philosophy" adopted in research on the
      influence of mental factors in the onset of psychosomatic diseases. The research
      is oriented to the construction and implementation on a computer of a model that
      makes it possible to formulate predictions regarding the onset and possibly the
      classification of the "type" of psychosomatic disease so as to be able to
      activate an appropriate prophylaxis.

PMID- 2234486
TI  - [Additional contribution to the epidemiology of fractures of the proximal end of
      the femur in the elderly (1965-1985)].
AB  - The seasonal incidence of hip fractures was studied in the Department of
      Orthopaedics of the University of Siena in a 22 year period (1965-1985). The
      fracture incidence rate per 100,000 individuals in the population at risk was
      calculated. The incidence rate of fracture increased significantly in women
      during the period studied, whereas there was no significant increase in men.

PMID- 2234487
TI  - [Survey on goiter in elementary school children in the Bisagno and Trebbia
      valleys (Liguro-Emilian Apennines)].
AB  - The authors have made an inquiry about school-children of two villages of
      Northern Appennines: Bargagli and Ottone, formerly seats of endemic goiter. The
      disappearance of endemic goiter in the younger generations of these villages, is
      in accordance with previous observations by one of the writers suggesting that
      sheep represent an important ecologic factor in endemic areas.

PMID- 2234488
TI  - [Role of the cerebral CAT examination in the diagnosis of neurotoxoplasmosis].
AB  - A case of central nervous system toxoplasmosis is reported. Attention is called
      to the diagnosis of this infection; moreover, the authors emphasize the
      importance of the TAC brain for the diagnosis and evaluation of the clinical
      evolution and response to the therapy.

PMID- 2234489
TI  - [Clonidine abstinence syndrome. A clinical case].
AB  - During hospitalization a patient with acute pulmonary oedema caused by myocardial
      dilation and chronic kidney failure presented high blood pressure and repeated
      episodes of supraventricular tachycardia. The complication was attributed to the
      withdrawal of clonidine and was treated by reintroduction of the drug combined
      with nifedipine, nitroderivates and antiarrhythmic drugs.

PMID- 2234490
TI  - [Hereditary spherocytosis and splenectomy].
AB  - The case of a sixteen year old girl with hereditary spherocytosis, submitted to
      splenectomy, is presented. After operation the patient had four serious
      infections; for this reason she is now treated by antibiotic prophylaxis.

PMID- 2234491
TI  - [AIDS in Italy: update to March 31, 1990].

PMID- 2234492
TI  - Immunohistochemical evidence for the presence of protein kinase C beta-subtype in
      rat motoneurons and myoneural junctions.
AB  - The localization of protein kinase C beta-subtype-like immunoreactivity (PKC-beta
      LI) was studied in the spinal cord and in different striated muscles of rat. In
      the spinal cord, large motoneurons in the ventral horn were PKC-beta
      immunoreactive (IR). Strong immunoreactivity to PKC-beta was found in large nerve
      bundles between muscles, and in smaller nerves among muscle fibers. Myoneural
      junctions, which showed weaker immunoreactivity to PKC-beta, were also
      demonstrated in all muscles studied; the external ocular muscles, the diaphragma
      and the triceps surae muscle. Muscle cells were not labelled.

PMID- 2234493
TI  - Differential control of operant and consummatory licking in rats.
AB  - The failure of rats to optimize their behavior when drinking from two retractable
      spouts available for single licks was analyzed. The rats were trained in an
      apparatus where the contacted spout was withdrawn after completion of a lick and
      the other spout was presented. After 5 days of such forced spout alternation
      training the animals continued to emit 2.7 instead of the optimum 1.0 lick per
      spout presentation (LPSP). With water available in one spout only the average
      LPSP at the empty spout dropped to 1.2 and increased to 3.6 at the water
      containing spout. It is argued that the operant licks at the dry spout approach
      the ideal value of 1.0 LPSP whereas the number of LPSPs at the water spout is
      increased by the consummatory nature of licking triggered by the presence of
      water in the oral cavity.

PMID- 2234494
TI  - Changes in calcitonin gene-related peptide immunoreactivity in the rat dorsal
      horn following electrical stimulation of the sciatic nerve.
AB  - Immunoreactive staining for calcitonin gene-related peptide (CGRP) in the rat
      superficial dorsal horn (L4-L5 segments) was examined following electrical
      stimulation of the sciatic nerve. Electrical stimulation for twenty minutes at an
      intensity to elicit both A and C fiber volleys resulted in a significant decrease
      in CGRP immunoreactivity in the medial two-thirds of the dorsal horn on the
      stimulated side as compared to the non-stimulated side of the spinal cord. The
      change was most pronounced in the medial area of the dorsal horn, with a 54%
      decrease in immunostaining density compared to the non-stimulated side. In
      contrast, when the sciatic nerve was stimulated for the same period at an
      intensity that stimulates only A fibers, there was no significant difference in
      the density of immunoreactive staining in the dorsal horn between the non
      stimulated and stimulated sides of the spinal cord. These results suggest that
      activity in a specific population of primary afferent fibers causes a dramatic
      depletion of CGRP in the dorsal horn.

PMID- 2234495
TI  - Progressive loss of messenger RNA and delayed neuronal death following transient
      cerebral ischemia in gerbils.
AB  - We examined mRNA, cytoplasmic RNA and structural damage in the hippocampus of the
      gerbil brain after transient ischemia by in situ hybridization, Acridine orange
      histochemistry and immunohistochemistry. Progressive decline of mRNA became
      visible in the CA1 region after reperfusion for 3 h and loss of cytoplasmic RNA
      and emergence of structural damage in 3 days. Reduction of mRNA in the CA3-CA4
      region was transient. The findings suggested positive correlation between
      progressive loss of mRNA and delayed neuronal death.

PMID- 2234496
TI  - Influence of the nervous system on experimentally induced urethral inflammation.
AB  - We have studied the contribution of the nervous system on experimentally induced
      urethral inflammation in the rat. Urethral inflammation was induced by inserting
      latex strips into the urethra. The effects of different experimental procedures
      was assessed by using a 4-graded inflammation scale based on the histological
      findings. Attenuation of urethral inflammation was produced by administration of
      capsaicin at birth. A more complete attenuation was produced by sympathectomy
      prior to application of the latex strip. Urethral inflammation was also severe in
      the spontaneous hypertensive rat. Injection of morphine into the third ventricle
      of the brain significantly reduced the experimentally induced urethral
      inflammation. These data taken together indicate that the sensory and
      postganglionic innervation of the urethral mucosa as well as the central nervous
      system is critically involved in the inflammatory reaction of the urethra
      following exposure to latex strips.

PMID- 2234497
TI  - The regional difference of neuronal susceptibility in the dentate gyrus to
      hypoxia.
AB  - The effects of hypoxia on neuronal activity in dentate gyrus granule cells were
      studied in submerged guinea pig hippocampal slices. In all regions of the dentate
      gyrus granule, the amplitude of the population spike recorded from the dentate
      granule cell layers, in response to electrical stimulation of the perforant path,
      decreased during hypoxia and recovered during reoxygenation. However, the ventral
      dentate gyrus granule cells (upper blade) were more susceptible to hypoxia than
      the dorsal ones (lower blade), indicating regional differences of neuronal
      susceptibility to hypoxia in the dentate gyrus.

PMID- 2234498
TI  - Potassium channel activators abolish excitotoxicity in cultured hippocampal
      pyramidal neurons.
AB  - When hippocampal pyramidal neurons are grown in culture they develop excitatory
      synaptic contacts. If these cultures are perfused with Mg2(+)-free, glycine
      supplemented medium the neurons exhibit fluctuations in [Ca2+]i and associated
      cell death ('excitotoxicity'). These phenomena involve the activation of NMDA
      receptors. When cultures are treated with the K(+)-channel activators cromakalim
      and diazoxide both the [Ca2+]i fluctuations and the neuronal death are abolished.
      These effects are reversed by the sulfonylurea glyburide. It thus appears that
      K(+)-channel activators may be a novel therapeutic intervention in epilepsy and
      associated disorders.

PMID- 2234499
TI  - Intradermal injections of bradykinin or histamine cause a flare-like
      vasodilatation in monkey. Evidence from laser Doppler studies.
AB  - The spreading cutaneous vasodilatation (flare) that follows a cutaneous injury is
      readily visible in humans but cannot be visualized in monkey. To determine if
      monkeys exhibit this neurally mediated reaction, cutaneous blood flow changes
      after intradermal injections of bradykinin and of histamine were monitored in the
      hairy skin of pentobarbital anesthetized monkeys. Using a laser Doppler device,
      recordings of cutaneous blood flow were made at distances of 15 and 25 mm from
      the injection of 50 microliters of saline, bradykinin (10(-3) M) and histamine
      (10(-3) M). These sites were beyond the radius of the wheal caused by bradykinin
      (6.3 mm) or histamine (6.8 mm). At both recording sites, both drugs caused an
      increase in blood flow that was significantly larger than that caused by the
      injection of the same volume of saline. These results provide evidence that
      although a flare is not visible in monkey skin, a flare-like vasodilatation does
      occur over an area of at least 50 mm diameter.

PMID- 2234500
TI  - Respiratory patterning of the rat olfactory bulb unit activity: nasal versus
      tracheal breathing.
AB  - To assess the role of nasal/tracheal (N/T) breathing in the respiratory
      patterning of the olfactory bulb (OB) neurons, the activity of 21 units was
      recorded in 6 anesthetized rats set with a cannula enabling reversible
      tracheotomy: the rats could inhalate either through nasal pathways or through
      trachea directly. Shift from tracheal to nasal breathing induced respiratory
      patterning in 7 units. The changes were steady, reversible and reproducible. The
      present data, matched with previous ones, indicate that tracheotomy and
      anesthesia decrease the occurrence of respiratory patterning in OB neurons. The
      experiments also suggest that peripheral as well as central structures may be a
      source of respiratory modulation in the olfactory bulb.

PMID- 2234501
TI  - Extracellular tumor necrosis factor induces a decreased K+ conductance in an
      identified neuron of Aplysia kurodai.
AB  - Recombinant human tumor necrosis factor (rhTNF) was pressure-applied onto the the
      soma of identified neuron R12 in the Aplysia abdominal ganglion. rhTNF induced a
      slow inward current (ITNF, 80-100 s in duration, 5-10 nA in amplitude) associated
      with a conductance decrease. ITNF begins 1-2 s after applying rhTNF and peaks in
      5-6 s. ITNF was decreased by hyperpolarization and had a reversal potential of
      approximately -87 mV (close to the K+ equilibrium potential). Ion substitution
      and pharmacological experiments suggest that ITNF is due to a decreased K+
      conductance and that TNF, a product of macrophages, may form an important link in
      communications between nervous and immune systems.

PMID- 2234502
TI  - Catalepsy induced by carbachol microinjected into the pontine reticular formation
      of rats.
AB  - Rats were implanted stereotaxically with permanent guide tubes aimed at the
      pontine reticular formation. Carbachol was microinjected in the awake, freely
      moving rats. Catalepsy was evaluated with the horizontal bar test. Intense and
      long-lasting, dose-dependent catalepsy was observed following microinjections of
      2-8 micrograms of carbachol. Pretreatment with intraperitoneally administered
      scopolamine significantly reduced the cataleptogenic effect of carbachol. These
      results show that the pontine reticular formation is part of the neuroanatomical
      substrate of catalepsy induced by cholinergic drugs.

PMID- 2234503
TI  - The proton-activated inward current of rat sensory neurons includes a calcium
      component.
AB  - Many neurons possess a proton-activated conductance, IH, which supports a large
      transient inward current at negative potentials and thereby depolarizes cells
      during rapid drops in external pH. The channels underlying this conductance are
      permeant to monovalent cations, with a clear preference for sodium. In earlier
      experiments, it appeared that divalent cations were impermeant: increasing
      concentrations of extracellular Ca2+ actually decreased the current amplitude.
      Using whole-cell patch clamp recording techniques, we find that the proton
      activated channel is permeant to Ca2+ ions. In the absence of monovalent cations,
      a substantial current is supported by divalent cations. The previously reported
      block results from competition between divalents and monovalents. This finding
      suggests that IH may provide a pathway for Ca2+ entry during the acidification
      that accompanies normal synaptic transmission, excessive electrical activity, and
      tissue ischemia.

PMID- 2234505
TI  - Tetrahydroaminoacridine increases acetylcholine synthesis and glucose oxidation
      by mouse brain slices in vitro.
AB  - 1,2,3,4-Tetrahydro-5-aminoacridine (THA; tacrine) reportedly improves cognitive
      deficits in certain individuals with Alzheimer's disease. The present study
      describes increased glucose oxidation and acetylcholine (ACh) synthesis by mouse
      brain slices after THA treatment. THA increased [U-14C]glucose decarboxylation
      and ACh formation in a concentration-dependent manner in hippocampal slices (50
      nM less than 50 microM less than microM). In striatal and cortical slices, 50
      microM THA effectively elevated the oxidation of glucose and its incorporation
      into ACh. Thus the efficacy of THA treatment on Alzheimer patients may be
      partially related to increased ACh synthesis and oxidative metabolism.

PMID- 2234504
TI  - Microinjections of nicotine in the medial pontine reticular formation elicits REM
      sleep.
AB  - Microinfusion of non-specific cholinergic muscarinic-nicotinic agonists, such as
      carbachol, into the medial pontine reticular formation readily elicits REM sleep.
      It has generally been assumed that muscarinic receptors mediate the action of
      cholinergic agonists in triggering rapid eye movement (REM) sleep. Very little is
      known, however, about the role of nicotinic mechanisms in REM sleep generation.
      In this study, we administered nicotine and Ringer's solution into the medial
      pontine reticular formation of freely moving cats. Compared to control Ringer's
      injections, nicotine increased REM sleep and decreased wake and slow wave sleep
      (SWS) I percentage. Nicotine also shortened the time to REM sleep onset. These
      findings suggest a role of nicotinic mechanisms in REM sleep generation.

PMID- 2234506
TI  - Effects of hyperinsulinemia on local cerebral insulin binding and glucose
      utilization in normoglycemic awake rats.
AB  - The present study was carried out to characterize the effects of insulin, using
      the euglycemic hyperinsulinemic clamp, on insulin binding and glucose utilization
      in specific areas of rat brain, by autoradiographic methods. Binding of
      [125I]Insulin was significantly higher in the hippocampus CA1, the ventromedial
      and lateral hypothalamus nuclei of the hyperinsulinemic rats than in control
      rats. Glucose utilization was slightly but not significantly decreased in the
      hippocampus CA1, the ventromedial and lateral hypothalamus of hyperinsulinemic
      rats. These data suggest that insulin, via its specific receptors, may exert its
      central actions by affecting glucose utilization.

PMID- 2234507
TI  - Effects of polyvalent cations and dihydropyridine calcium channel blockers on
      recovery of CNS white matter from anoxia.
AB  - The effects of anoxic injury on the functional integrity of mammalian central
      white matter were studied electrophysiologically using the rat optic nerve model.
      Previous studies on this model have shown that extracellular Ca2+ is critical to
      the production of irreversible anoxic injury, and suggest that during anoxia Ca2+
      crosses the membrane to enter the intracellular compartment. We attempted to
      elucidate the mechanism by which this damaging Ca2+ influx occurs. The inorganic
      Ca2+ channel blockers Mn2+ (1 mM), Co2+ (1 mM) or La3+ (0.1 mM) had no effect on
      recovery of the area under the compound action potential after a standard 60 min
      period of anoxia; only Mg2+ (10 mM) significantly improved recovery (54.9 +/-
      8.9% vs. 28.7 +/- 10.1%, P less than 0.005). Treatment with organic Ca2+ channel
      blockers of the dihydropyridine class, nifedipine (1-10 microM) or nimodipine (1
      40 microM), also had no effect on recovery from anoxia. We conclude that Ca2+
      influx during anoxia does not occur via conventional Ca2+ channels sensitive to
      polyvalent cations or dihydropyridines.

PMID- 2234509
TI  - Distribution of Alzheimer's disease amyloid A4-generating enzymes in rat brain
      tissue.
AB  - To screen for putative amyloid A4-splitting proteinases, model peptide substrates
      homologous to the N- and C-terminal portions of the A4 protein were synthesized.
      The N-terminal A4-splitting enzyme activity was found to be higher in the
      hypothalamus and limbic area, compared with in the cerebral cortex and cerebellum
      in 2-month-old rat. The activity decreased throughout the brain in 20-month-old
      rat. On the other hand, the activity of the putative C-terminal A4-splitting
      enzyme was significantly higher, 1.4-fold, in the hippocampus than in the
      cerebral cortex in the young rat. The activity also significantly decreased in
      the brain of 20-month-old rat, but was still higher in the cerebral cortex,
      hippocampus and cerebellum.

PMID- 2234508
TI  - Inhibitory influences of mammalian FMRFamide (Phe-Met-Arg-Phe-amide)-related
      peptides on nociception and morphine- and stress-induced analgesia in mice.
AB  - The effects of two endogenous mammalian FMRFamide (Phe-Met-Arg-Phe-NH2)-related
      peptides, an octapeptide F8Fa (Phe-Leu-Phe-Gln-Pro-Gln-Arg-Phe-NH2) and an
      octadecapeptide A18Fa (Ala-Gly-Glu-Gly-Leu-Ser-Ser-Pro-Phe-Trp-Ser-Leu-Ala-Ala
      Pro-Gln-Arg-Phe -NH2) on morphine- and restraint stress-induced analgesia and
      basal nociceptive sensitivity, as measured by the latency of a foot-lifting
      response to a warmed surface, were examined in male mice. Intracerebroventricular
      (i.c.v.) administrations of F8Fa and A18Fa (0.10-10 micrograms) during the day
      time significantly reduced morphine (10 mg/kg) and restraint-induced analgesia at
      30 min after administration, with F8Fa having a greater inhibitory effect than
      A18Fa. At night during the dark period i.c.v. F8Fa also significantly reduced the
      elevated nocturnal thermal response latency, while not affecting the shorter day
      time nociceptive responses. Peripheral administrations of the prototypic opiate
      antagonist, naloxone (1.0 mg/kg), had similar inhibitory effects on morphine- and
      stress-induced analgesia, and the day-night rhythm of nociceptive sensitivity.
      These results indicate that F8Fa and A18Fa are involved in the modulation of
      opioid analgesia and suggest that these endogenous FMRFamide-related peptides may
      be associated with the expression of the day-night rhythm of opioid-mediated
      nociceptive sensitivity.

PMID- 2234510
TI  - Cycles of nursing.

PMID- 2234511
TI  - An interview with Lucille Joel. Interview by Barbara J. Barnum.

PMID- 2234512
TI  - Inside ICN headquarters with Constance Holleran. Interview by Craig Little.

PMID- 2234513
TI  - A national health insurance program: a nursing perspective.

PMID- 2234514
TI  - International credentials review: crucial and complex.

PMID- 2234515
TI  - Baccalaureate and master's degree programs in nursing accredited by the NLN 1990
      91.

PMID- 2234516
TI  - Standard of care: the honest error of judgment rule.

PMID- 2234517
TI  - Legal implications of routine screening for asymptomatic silent myocardial
      ischemia.
AB  - A recent case in California raises legitimate concern about the risks of a
      lawsuit arising out of a routine physical examination. This ruling has an ominous
      portent for many physicians who either are not current or are not comfortable
      with the available testing procedures for screening asymptomatic patients for
      silent myocardial ischemia.

PMID- 2234518
TI  - Carotid endarterectomy under local anesthesia.
AB  - Carotid endarterectomy has been used increasingly in the management of
      cerebrovascular disease. However, morbidity and mortality statistics for this
      procedure have caused criticism. The authors believe neurologic and medical
      complications can be reduced with the use of regional anesthesia for carotid
      endarterectomy.

PMID- 2234519
TI  - Maintaining an office laboratory.
AB  - The author discusses the need to have a complete, up-to-date procedure manual
      available at all times; information on ways to investigate reference laboratories
      is included.

PMID- 2234520
TI  - Carcinoma of the male breast.
AB  - Carcinoma of the male breast remains an unusual entity. Because of this, large
      series of patients are infrequent and a standard of care has not been
      established. In this study, 31 male patients with mammary carcinoma were treated
      over a 29-year interval. The course of these individuals was examined and
      comparisons were made with the existing literature.

PMID- 2234521
TI  - Squamous cell cancer of the larynx in an intravenous drug user with AIDS.
AB  - We present the case of a 29-year-old intravenous drug user with AIDS and squamous
      cell cancer of the larynx. Profound immunosuppression was evident by an OKT4:OKT8
      ratio of 0.1. Simultaneous treatment of the laryngeal cancer by laser
      vaporization and treatment of immunosuppression with zidovudine resulted in no
      tumor recurrence after one year.

PMID- 2234522
TI  - Parathyroid adenoma with conflicting parathyroid hormone levels.
AB  - For discrepant diagnoses in a patient with hypercalcemia, the authors utilized
      three different parathyroid hormone assays. The new two-site immunoradiometric
      assay (IRMA) proved to be the most accurate and is recommended in the
      differential diagnosis of hypercalcemia.

PMID- 2234523
TI  - Pediatric cancer mortality rates in New Jersey and the United States.
AB  - The authors studied pediatric mortality rates for four major categories of
      neoplasms for the years 1950 to 1985. This report indicates differences in trends
      between the rates of the New Jersey population and of the United States
      population, for males and females, and whites and nonwhites.

PMID- 2234524
TI  - Intussusception in childhood.
AB  - We present our experiences with 41 consecutive cases of intussusception. Most
      cases had a preliminary barium enema performed that successfully reduced the
      intussusception in 12 cases. Twenty-nine patients were explored surgically; bowel
      resection was carried out in 6 patients, and surgical reduction was carried out
      in 23 cases.

PMID- 2234525
TI  - Physicians' office laboratories.
AB  - The number of physicians' office laboratories (POLs) is increasing. Formal
      technical education and certification for physician office laboratory personnel
      assure more accurate results.

PMID- 2234526
TI  - Focal Candida hepatitis in a patient with Richter's syndrome.

PMID- 2234527
TI  - Contemporary leadership begins with mentoring.

PMID- 2234528
TI  - Contemporary leadership: mentors and stewards.

PMID- 2234530
TI  - Modern mentoring: strategies for developing contemporary nursing leadership.

PMID- 2234529
TI  - Nurse executive profile of excellent nursing leadership.

PMID- 2234531
TI  - The mentor perspective.

PMID- 2234532
TI  - The mentee perspective.

PMID- 2234533
TI  - An interactive model of leadership.

PMID- 2234534
TI  - Nursing leaders as mentors: how are we doing?

PMID- 2234535
TI  - The influence of gender on communication for nurse leaders.

PMID- 2234536
TI  - Toward achievement of mentoring for nurses.

PMID- 2234537
TI  - The most important characteristics of nursing leaders.

PMID- 2234538
TI  - Mentoring: a concept analysis.

PMID- 2234539
TI  - The importance of risk assessment to the nation's health and economy.
AB  - The global marketplace is changing rapidly. Never in history has the opportunity
      to capture new markets with new products and new generations of products been
      greater. However, never has the chance of losing established markets been higher.
      We are failing to develop new products despite the fact that Americans have paid
      for the science from which the world's new technologies were developed. There are
      many reasons for our failure to turn scientific leads into products. One of the
      most obvious is that we overestimate the risk of new technologies. Present policy
      uses a conservatively biased risk assessment process to estimate risk. This
      process uses many assumptions to bridge gaps in our scientific knowledge about
      risk. If we wish to be competitive, we must bring safe, inexpensive new products
      to the marketplace faster. We must seek ways of making our policies more
      effective while still protecting public health. Risk assessment sets the
      standards for product development, product approval, and environmental release. A
      slight miscalculation in "safety levels" can result in tens of billions of
      dollars in cost added to products. These added costs have a major and direct
      impact on the competitiveness of U.S. products in the global marketplace where
      differences in consumer acceptance can be calculated in a few percentage points
      difference in price.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2234540
TI  - Quantitative approaches to human risk assessment for noncancer health effects.
AB  - The estimation of risk for health effects due to chemical exposure is important
      to the development of standards for regulating the manufacture, use and release
      of chemicals into the environment. The quantitative data used to develop risk
      estimates usually come from laboratory animal studies employing relatively high
      dose levels. Thus, both interpolation from high to low dose levels and
      extrapolation from laboratory animals to humans are required. The approach most
      widely used for noncancer end points is to determine the no-observed-adverse
      effect level (NOAEL) for the critical effect and then apply uncertainty factors
      (UFs) to account for scientific uncertainties in the total data base, such as
      response variability within and between species, the lack of chronic exposure
      data, the lack of a NOAEL, etc. The resulting value is a reference dose (RfD),
      i.e., the dose at or below which there is unlikely to be any excess risk. One
      difficulty with the NOAEL/UF approach is that it does not provide a basis for
      estimating risk at doses above the RfD; thus, if the exposure assessment
      indicates that human exposure is above the RfD, there is no way to judge the risk
      of that exposure. Alternative quantitative approaches for risk estimation of
      noncancer end points have been proposed and include both statistical and
      biologically-based dose-response modeling. Research is currently underway to
      further develop and explore the application of such approaches.

PMID- 2234541
TI  - Towards quantitative risk assessment for neurotoxicity.
AB  - Methods for quantitative risk assessment have been developed in some detail for
      carcinogens. These methods attempt to be consistent with current knowledge about
      the mechanism of carcinogenesis and are probably not applicable to neurotoxicity
      endpoints. The traditional approach for neurotoxicants has been to define the
      NOAEL (No Observed Adverse Effects Level) or LOAEL (Lowest Observed Adverse
      Effects Level) and to divide by a safety factor. One of the weaknesses of this
      approach is that it does not yield a risk estimate; however, this approach has
      been widely used, and it is consistent with very limited data. Alternative
      methods to assess risk are available and have been applied to existing data.
      These methods are very much dependent upon the nature of the data analyzed, but
      current data are often limited and do not allow good and comprehensive risk
      assessments of neurotoxic endpoints. Additional experiments and expanded
      experimental designs can facilitate improved and more precise risk assessments.
      Experiments should consider dose ranges which encompass conceivable environmental
      exposures. Experiments should measure and report individual, as well as group
      response, and indices of exposure. Finally, more work needs to be done to compare
      responses across several species. More comprehensive experiments can only lead to
      more comprehensive risk assessments.

PMID- 2234542
TI  - Analysis of dose/time/response relationships for chronic toxic effects: the case
      of acrylamide.
AB  - This case study illustrates how a very simple dynamic modeling approach can
      extract information of interest for both toxic mechanism research and risk
      assessment from a series of dose/time/response data. The technique is applicable
      for effects that are thought to result from damage processes that are reversible,
      at least at low doses and times of exposure. The data sets analyzed provided
      information on some specific manifestation of acrylamide neurotoxicity produced
      by different combinations of acrylamide dose rate and duration of exposure.
      Assuming that responses occur when a specific amount of axonal damage
      accumulates, and that the repair of damage depends directly on the amount of
      damage present, the dose-related change in the time required to produce a
      specific type of effect can be used to estimate: (1) The rate of repair of the
      incipient damage - and differences in repair rates for different individuals
      within species, and among different species, and (2) The dose of acrylamide that
      would be just barely able to produce each effect in each species, if the
      experiment were conducted over the animal's entire lifespan. Information of the
      first type may also be helpful in neurotoxicology research. Specific biomarkers
      for the main process causing a particular response should be repaired in
      different locations and in different species with the dynamics that are
      consistent with the repair rates calculated from the dose vs. time-of-effect
      data.

PMID- 2234543
TI  - Neurotoxicology dose/response assessment for several cholinesterase inhibitors:
      use of uncertainty factors.
AB  - Dose/response assessment for non-carcinogenic endpoints typically uses the
      Acceptable Daily Intake (ADI) or Reference Dose (RfD) approach, in which a dose
      believed to cause no toxic effect is divided by a number of safety or uncertainty
      factors (e.g., to control for variability and cross-species extrapolation), in
      order to estimate a dose presumed to have no adverse effects in humans. With the
      establishment of neurotoxicology testing guidelines, routine use of uncertainty
      factors to undertake neurotoxicity dose/response assessment procedures is likely.
      This approach to dose/response assessment has not yet been widely applied to
      neurotoxicity data. The purpose of this study was to assess the use of
      uncertainty factors and the assumptions underlying the use of the uncertainty
      factor method in assessing risk for several known human neurotoxicants. Because
      of the availability of a large neurotoxicity data base which included human
      exposure data, parathion, diisopropylfluorophosphate, physostigmine and
      acrylamide were chosen for this analysis. Literature searches were conducted for
      both human and animal data. The resulting data were assigned to one of five end
      point categories: Neurochemistry/neuropathology, physiology/consummatory
      behavior, sensory/motor, electrophysiology, and learning/memory behavior. No
      observed-adverse-effect levels (NOAELs) and/or lowest-observed-adverse-effect
      levels (LOAELs) were determined when possible for each end point and for several
      species. Reference doses (RfDs) were calculated and compared across species. A
      number of issues and critical assumptions were identified.

PMID- 2234544
TI  - Effects of exposure period and nutrition on the developmental neurotoxicity of
      anticonvulsants in rats: short and long-term effects.
AB  - The results of three experiments on the functional neuroteratogenicity of
      anticonvulsants in rats are presented. Two of the experiments have been reported
      previously and are reviewed here, while the third experiment is presented here
      for the first time. The first experiment examined prenatal phenytoin (200 mg/kg),
      trimethadione (250 mg/kg), and phenobarbital (80 mg/kg) for critical period
      effects by exposing separate groups of rats to the drugs or to vehicle on
      embryonic (E) days 7-10, 11-14, or 15-18. Phenytoin produced effects in the E11
      14 offspring, but few effects in the E15-18 offspring, and almost no effects in
      the E7-10 offspring. Phenytoin's E11-14 effects in the offspring were increased
      pivoting, delayed swimming ontogeny, hyperactivity, impaired water maze learning,
      and impaired passive avoidance retention. The second experiment looked for
      phenytoin's long-term effects. Phenytoin-exposed offspring administered 200 mg/kg
      on E7-18 exhibited numerous postnatal dysfunctions, including water maze learning
      deficits that persisted to beyond 501 days of age. The learning deficits were
      neither increased nor decreased in severity at this age compared to those seen in
      littermates tested at 50 days of age. The third experiment assessed the role of
      manganese in counteracting phenytoin-induced postnatal dysfunction and the
      possible confounding effects of maternal undernutrition associated with the
      drug's administration. The typical pattern of phenytoin-induced behavioral
      effects was observed in rat offspring. The results demonstrated that
      undernutrition was not a confound, since pair-feeding and pair-watering controls
      did not diminish the phenytoin-induced dysfunction in the offspring. Also,
      administration of a manganese supplementation (200 ppm in the drinking water)
      during gestation did not significantly alter the pattern of phenytoin-induced
      postnatal effects.

PMID- 2234545
TI  - Risk assessment of the developmental neurotoxicity of lead.
AB  - Lead has long been recognized as a developmental neurotoxicant. Although no
      reasonable doubt exists about this qualitative characterization, quantitative
      aspects of the developmental neurotoxicity of lead have been more difficult to
      resolve. This paper focuses on two key issues in a risk assessment of lead: the
      blood lead level of concern, i.e., the lowest level of exposure associated with
      neurotoxic effects in children, and the magnitude and implications of such
      effects. The distinction between a threshold and a level of concern is also
      discussed, along with the issue of whether a threshold exists for lead-induced
      health effects.

PMID- 2234546
TI  - Polypeptide growth factors in mammalian development: some issues for
      neurotoxicology and behavioral teratology.
AB  - Protein molecules known as Growth Factors (GFs) appear to play an important
      regulatory role in a number of CNS functions. In particular Nerve Growth Factor
      (NGF), the best characterized among about 30 GF molecules, is endowed with
      specific activities on cholinergic and peptidergic CNS neurons. Indexes of
      neurobehavioral maturation are accelerated in the mouse by neonatal NGF exposure,
      while a similar treatment with EGF exerts both growth-promoting and growth
      inhibiting effects on somatic and behavioral development. Scopolamine
      hyperactivity is enhanced around weaning by NGF pretreatment. Data are discussed
      along with (a) NGF prevention of cholinergic system damage and (b) the molecular
      mechanism of endogenously-triggered CNS repair processes.

PMID- 2234547
TI  - Risk assessment: the insidious nature of neurotoxicity and the aging brain.
AB  - Neurotoxicology is a fertile source of ambiguities. They complicate the
      conventional risk assessment process, whose current procedures and models were
      designed to accommodate a unitary endpoint and mechanism. All of these
      ambiguities are multiplied by their interaction with aging because many
      manifestations of neurotoxicity, such as impaired sensory acuity, mimic the
      natural course of aging. With aging as a model, modifications of the risk
      assessment paradigm have been designed. These modifications take the form of
      adaptations able to accommodate the unique properties of neurotoxicity.
      Properties such as progressive declines in function, the late impact of prenatal
      damage, multiple endpoints, variations in exposure pattern, reversibility, and
      population shifts in performance are explicitly recognized by these adaptations.

PMID- 2234548
TI  - Memory, synaptic plasticity and neurotoxins.
AB  - Most neurotoxins induce serious impairments in cognitive or intellectual
      functioning; therefore, the ability of the individual to learn and remember forms
      a critical component of neurotoxin assessment. In depth investigations of
      neurotoxin-induced cognitive deficits have assisted in pinpointing the neural
      site of toxin activity. However, specific impairments in learning and memory can
      depend on the developmental stage at which the individual is exposed to the
      toxin, and certain neurotoxins show cognitive lifespan selectivity. There appears
      to be a basic sequence of events underlying neural development and information
      storage, and neurotoxins may disrupt this neuronal sequel critical for the
      storage or expression of "ancestral" or "environmental" memories. Certain primary
      rules govern the orderly development of the nervous system; these rules or
      mechanisms allow the expression of "ancestral memories" concerning neuronal
      differentiation and primitive behaviors. Following birth, these same mechanisms
      have been retained in a less robust form to allow learning and information
      storage, or the retention of "environmental memories." Neurotoxins which disrupt
      learning and memory capacities appear to interfere in this basic sequence of
      events, with the specific outcome depending on when during lifespan development
      the neurotoxin intervenes.

PMID- 2234549
TI  - Comparative sensitivity of neurobehavioral tests for chemical screening.
AB  - Guidelines for conducting neurobehavioral tests of motor activity, schedule
      controlled operant performance, and a functional observational battery (FOB) were
      published by the U.S. EPA Office of Toxic Substances (1985). We have utilized a
      specific FOB protocol in conjunction with motor activity measured in a figure
      eight maze and performance maintained under a fixed-interval schedule of
      reinforcement to determine the acute effects of chemicals which produce different
      syndromes of intoxication in rats (chlordimeform, carbaryl, pentobarbital,
      triadimefon, nicotine, and 3-acetyl pyridine). The results showed that for each
      compound there was a substantial degree of overlap in the dose range of
      effectiveness across the different tests. In all cases, however, the lowest
      effective dose identified using the FOB was equal to or less than that provided
      by motor activity and operant tests. For most compounds, motor activity and
      operant performance were equally sensitive. Nicotine and triadimefon, however,
      increased the rate of operant responding at lower doses than those that affected
      motor activity. The time course of each chemical appeared similar across tests
      with one exception. 3-Acetyl pyridine produced clear effects in the FOB
      throughout testing (up to three weeks) whereas recovery was evident within one
      week using motor activity and operant performance. FOB and motor activity testing
      can be easily integrated into ongoing toxicity studies. On the other hand, the
      traditional approach to testing the effects of chemicals on operant performance
      requires prior food or water deprivation, and time for training the animals and
      establishing a stable level of performance. In the context of hazard
      identification (i.e., testing for the effects of unknown chemicals) the FOB and
      motor activity may be expected to adequately detect neurotoxicity. Operant
      performance may be more valuable in characterizing the actions of identified
      neurotoxicants.

PMID- 2234550
TI  - Neonatal exposure to DDT and its fatty acid conjugate: effects on cholinergic and
      behavioural variables in the adult mouse.
AB  - We have recently observed that DDT and a DDT metabolite, DDOH, conjugated to a
      fatty acid, palmitic acid, DDOH-PA, affects muscarinic cholinergic receptors
      (MAChR) in the neonatal mouse brain when given to suckling mice during rapid
      brain growth. This early exposure of the neonatal mouse also affects the
      behaviour of the animals as adults. When DDT and DDOH-PA was given as a single
      low oral dose of 1.4 mumol/kg body weight, DDT (0.5 mg), DDOH-PA (0.7 mg) and a
      20% fat emulsion vehicle (10 ml) per kg body weight to 10-day-old NMRI mice,
      behavioural tests at adult age of four months, indicated disruption of a simple,
      non-associative learning process, i.e. habituation, in both DDT and DDOH-PA
      treated mice. There was also a significant increase in the potassium evoked
      release of ACh from slices of cerebral cortex and a tendency towards a decrease
      in the density of MAChR in mice receiving DDT. These effects in the adult mice
      could not be correlated to the concentration of DDT in the adult brain since DDT
      one month after its administration to the 10-day-old mouse no longer is present
      in the brain.

PMID- 2234552
TI  - Toxic effects of cocaine to the cardiovascular system in conscious and
      anesthetized rats and rabbits: evidence for a direct effect on the myocardium.
AB  - The cardiovascular toxicity of cocaine is complex because it has local anesthetic
      properties, central nervous system stimulatory effects, as well as cardiac
      effects. Recreational use of this drug has increased recently, but the precise
      mechanism of sudden cardiac death induced by cocaine is not known. The primary
      objective of this work was to test for a direct cardiovascular toxicity of
      cocaine. Rats and rabbits were anesthetized, and the femoral vein and artery were
      cannulated for drug infusion and blood pressure monitoring. Different doses of
      cocaine (0.3, 1, 3, 10 mg/kg) were infused. For conscious animal experiments, the
      animals were allowed to recover from the anesthesia and then were subjected to
      cocaine. Low doses of cocaine (0.3 and 1 mg/kg) increased systolic as well as
      diastolic pressure in conscious rats and rabbits. In anesthetized rats and
      rabbits, the same dose of cocaine increased blood pressure with a decrease in
      heart rate. With the high doses of cocaine (3 and 10 mg/kg), all cardiac
      parameters were reduced in both rats and rabbits. In isolated rabbit hearts,
      cocaine decreased all cardiac parameters. Based on the fact that high doses of
      cocaine severely depressed all cardiac parameters and its effect on the isolated
      heart, cocaine-induced sudden cardiac death appears to be due to a primary effect
      on the myocardium.

PMID- 2234551
TI  - Acute cardiovascular toxic effects of copper in anesthetized rabbits.
AB  - Copper deficiency is linked to many types of cardiovascular diseases. Copper
      toxicity may not be common, but it produces cardiac problems and even lethality.
      However, little is known about the precise mechanism of cardiotoxic action of
      copper in mammals. In an effort to characterize the cardiovascular effects and
      potential toxic action of copper, white New Zealand rabbits were instrumented for
      the measurement of cardiovascular parameters under urethane anesthesia. Left
      ventricular pressure and its dP/dt as well as the sympathetic efferent renal
      nerve activity were also monitored continuously before, during and after the
      injection of various doses of copper. Low doses of copper (3 mg/kg or less)
      increased blood pressure with a slight reduction in heart rate. There was also a
      transient increase in cardiac contractile force as shown by an increase of dP/dt
      with a reduction in sympathetic renal efferent nerve activity. However, high
      doses of copper (10 mg/kg or higher) decreased these cardiac parameters, which
      led to a state of shock, 90 seconds after the copper treatment. There was a
      compensatory increase in respiration rate and renal nerve activity during the
      shock. Thus, the data suggest that copper initially activates peripheral organs
      such as the heart and subsequently produces a distinct inhibitory action on
      sympathetic outflow, which is related to the toxic action of this metal.

PMID- 2234553
TI  - Ethanol inhibition of spontaneous calcium release from isolated sarcoplasmic
      reticulum of alcoholic rats.
AB  - Ethanol is a well-recognized cause of muscle damage in humans. In vitro, ethanol
      decreases muscle fiber twitch tension by a mechanism unrelated to the electrical
      events of the motor endplates or muscle surface membranes. One possible
      explanation for this effect is a primary ethanol effect on calcium release from
      the sarcoplasmic reticulum (SR). Ethanol has been shown to progressively decrease
      a form of calcium release from isolated SR vesicles seen in vitro in the presence
      of high phosphate concentrations ("spontaneous calcium release"). In this study,
      ethanol is shown to have similar inhibiting effects on spontaneous calcium
      release from sarcoplasmic reticulum isolated from alcoholic rats and from pair
      fed controls. This suggests that membrane adaptation to chronic ethanol exposure,
      such as has been described for brain and liver membranes, does not produce
      tolerance to ethanol effects on spontaneous calcium release in sarcoplasmic
      reticulum.

PMID- 2234554
TI  - Zinc nutrition in fetal alcohol syndrome.
AB  - Because alcohol has an adverse effect on zinc homeostasis, this study was
      designed to study if zinc content of the diet modifies the severity of fetal
      alcohol syndrome in a mouse model. The effect of varying zinc intake on the
      progeny of pregnant mice fed a liquid diet containing 15% of the calories as
      ethanol was studied. Prenatal mortality was higher when the mothers consumed
      alcohol with inadequate zinc intake. Because of the adverse effect of alcohol on
      zinc homeostasis and because zinc deficiency has been shown to potentiate alcohol
      embryopathy, one group was given zinc supplementation to four times the
      Recommended Dietary Allowance. Supplemental zinc above the Recommended Dietary
      Allowance was not protective and appeared to have an adverse effect on fetal
      weight and prenatal mortality. These results suggest that zinc intake should be
      optimized during pregnancy but that zinc supplementation above the Recommended
      Dietary Allowance does not reduce the incidence or severity of fetal alcohol
      syndrome.

PMID- 2234556
TI  - Assessment and management of cervical intraepithelial neoplasia.
AB  - Although cervical intraepithelial neoplasia (CIN) once was thought to be a
      clinical problem primarily for older women, data reveal an alarming rise of this
      condition among younger women. The gains made in decreasing the incidence of
      cervical cancer have been tempered by the steadily increasing incidence of its
      precursor state, CIN. Because of increasing evidence of the association of the
      human papillomavirus (HPV) with cervical cancer and CIN, this virus is of
      particular concern. Colposcopy is a valuable method for evaluating CIN that has
      been indicated on Pap, as well as for identifying HPV. Since having an abnormal
      Pap and undergoing colposcopic examination may be stressful, the clinician can
      play a significant role in helping the client cope with the process of evaluation
      and treatment of abnormal Paps in addition to controlling cervical cancer.

PMID- 2234555
TI  - Otitis media: an overview of acute and chronic disease.
AB  - Otitis media is the most prevalent illness affecting the pediatric population.
      Each year in the United States there are 30 million visits to pediatricians for
      the treatment of otitis media infections and their sequelae, at a cost of $1
      billion in health care dollars. This article offers a discussion of the factors
      that predispose children to otitis media, with emphasis on diagnosis and
      treatment. The clinical presentation, disposition and associated morbidity of
      common complications are also discussed.

PMID- 2234557
TI  - Diagnosis and management of cluster headaches.
AB  - Cluster headaches are vascular headaches that predominantly affect males and
      occur frequently, with cyclic regularity. Treatment is predominantly
      pharmacological in nature and is divided into symptomatic and prophylactic
      relief. This article discusses the pathogenesis, clinical features, and current
      prophylactic and symptomatic treatments used with cluster headaches.

PMID- 2234558
TI  - Antibiotic therapy for epididymitis clarified.

PMID- 2234560
TI  - Furosemide for pulmonary edema.

PMID- 2234559
TI  - A tragic breach in the standard of care.

PMID- 2234561
TI  - Making it better.

PMID- 2234562
TI  - Improving nurse/doctor communications.

PMID- 2234563
TI  - The mouth organ.

PMID- 2234564
TI  - Complying with vaccine law will help prevent errors.

PMID- 2234565
TI  - The need to laugh.

PMID- 2234566
TI  - Consent for treatment. Lover's rights.

PMID- 2234567
TI  - Caring for patients with intracranial tumors.

PMID- 2234568
TI  - Managing C.H.F. at home.

PMID- 2234569
TI  - Working with a transhepatic biliary catheter.

PMID- 2234570
TI  - Choosing a leadership style that fits.

PMID- 2234571
TI  - Action stat! Tetanus.

PMID- 2234573
TI  - Fast facts about Fax.

PMID- 2234572
TI  - Today's insulins. What you and your patient need to know.

PMID- 2234574
TI  - David had all but surrendered to death ... until a nurse stepped in.

PMID- 2234576
TI  - Assessing cardiac emergencies.

PMID- 2234575
TI  - Working with kids who have cancer.

PMID- 2234577
TI  - When nurses are addicted to drugs. Confronting an impaired co-worker.

PMID- 2234578
TI  - Get on the right track with Z-track injections.

PMID- 2234579
TI  - Respiratory alkalosis. Pathophysiology, signs, and symptoms.

PMID- 2234580
TI  - How to assess deep tendon reflexes.

PMID- 2234581
TI  - Controlling the flow. Electronic infusion devices.

PMID- 2234582
TI  - Making room for love.

PMID- 2234583
TI  - Determining the cause of postoperative fever.

PMID- 2234584
TI  - Reviewing A.I.D.S.

PMID- 2234585
TI  - Research in nurse education.

PMID- 2234586
TI  - Cancer nursing: learning to cope with an artificial limb.

PMID- 2234587
TI  - Cancer nursing: biological therapy.

PMID- 2234588
TI  - Cancer nursing: management of constipation.

PMID- 2234591
TI  - Racism: just a hue and cry?

PMID- 2234590
TI  - The Edinburgh experience.

PMID- 2234589
TI  - Cancer nursing: a history of pain.

PMID- 2234592
TI  - Project 2000 Australian style.

PMID- 2234593
TI  - Patient care--or repression?

PMID- 2234594
TI  - Homes fit for nurses.

PMID- 2234595
TI  - PREPP: what it will mean.

PMID- 2234596
TI  - Theatre nursing. Involving the parents.

PMID- 2234597
TI  - Theatre nursing. Pre-op visits: why they don't happen.

PMID- 2234598
TI  - Theatre nursing. Operation Green.

PMID- 2234599
TI  - Returning to nursing.

PMID- 2234601
TI  - Central Birmingham: the personal touch.

PMID- 2234602
TI  - I thought I was discharged.

PMID- 2234600
TI  - Creative arts as therapy.

PMID- 2234603
TI  - Identity crisis.

PMID- 2234604
TI  - Theatre nursing. Developing the role of the nurse.

PMID- 2234605
TI  - Pharmacologic control of aberrant behavior in the mentally retarded: toward a
      more rational approach.
AB  - Drugs are frequently used to control aberrant behavior in the mentally retarded.
      However, despite decades of research, this approach to behavioral management has
      had very limited success. Slow progress in this area can be attributed, in part,
      to the lack of a theoretical framework to guide research. The main purpose of
      this review is to integrate clinical research in this area with evidence
      concerning the neurochemical mechanisms that mediate aberrant behaviors. It is
      concluded that a theoretical framework that takes into account the biological
      mechanisms that underlie disordered behavior and the actions of drugs provides
      the basis for a more rational approach to the development of pharmacological
      therapies in the mentally retarded.

PMID- 2234606
TI  - Central effects of CRF on metabolism and energy balance.
AB  - CRF is recognised for its actions on pituitary ACTH release, but also has direct
      effects within the brain which are important in mediating physiological responses
      to stress. Behavioral effects of CRF include increased locomotor activity and
      inhibition of food intake and its actions on metabolism are mediated mainly by
      activation of the sympathetic nervous system. CRF appears to be important in the
      regulation of energy balance and body weight, influencing both food intake and
      sympathetically-mediated thermogenesis. A defect in the synthesis or release of
      CRF has been implicated in the development of obesity in laboratory animals,
      since the condition is alleviated by adrenalectomy, hypophysectomy or exogenous
      CRF treatment. Recent data have revealed an additional role for CRF as a mediator
      of the neuroendocrine and metabolic responses to immune signals, particularly
      cytokines. The central actions of CRF are independent of the pituitary but may
      involve release of proopiomelanocortin products within the brain. CRF is thus
      emerging as an important integrator of the physiological responses to stress,
      infection and immunity, a finding which may have important implications for
      future therapies.

PMID- 2234607
TI  - Behavioral adaptations to pathogens and parasites: five strategies.
AB  - The ever present threat of viral, bacterial, protozoan and metazoan parasites in
      the environment of wild animals is viewed as responsible for the natural
      selection of a variety of behavioral patterns that enable animals to survive and
      reproduce in this type of environment. Several lines of research, some quite
      recent, point to five behavioral strategies that vertebrates utilize to increase
      their personal or inclusive fitness in the face of parasites (broadly defined to
      include pathogens). These are: 1) avoidance of parasites; 2) controlled exposure
      to parasites to potentiate the immune system; 3) behavior of sick animals
      including anorexia and depression to overcome systemic febrile infections; 4)
      helping sick animals; 5) sexual selection for mating partners with the genetic
      endowment for resistance to parasites. The point is made that to consider a
      behavioral pattern as having evolved to serve a parasite control function the
      parasite or causative agent should be shown to adversely impact the animal's
      fitness and the behavior in question must be shown to help animals, or their
      offspring or group mates, in combating their exposure, or reducing their
      vulnerability, to the parasite.

PMID- 2234608
TI  - The neural mechanism of declarative memory consolidation and retrieval: a
      hypothesis.
AB  - This paper proposes a new theory addressing the neural mechanism of declarative
      memory consolidation and retrieval. The premise of the theory is that the cortex
      is responsible for the storage of declarative memory while the medial temporal
      lobe is responsible for the consolidation and retrieval of declarative memory.
      The theory suggests that the medial temporal lobe can only accomplish its
      functions related to memory by hierarchically and cooperatively regulating the
      descending limbic system, including the hypothalamus, epithalamus, septum,
      mammillary bodies and the bed nucleus of the stria terminalis. These descending
      limbic structures, together with the amygdala, further send efferents to the four
      ascending NA, 5-HT, DA and ACh systems. It is these four ascending extrathalamic
      regulatory systems that provide the feedback neural pathways to the cortex and
      regulate the processes of memory consolidation and retrieval in the cortex.
      Therefore, the coupling of these descending limbic structures to the ascending
      NA, 5-HT, DA and ACh systems completes the neural circuits responsible for the
      consolidation and retrieval of new declarative memories. This neural mechanism of
      declarative memory consolidation and retrieval is universal to all species in
      higher mammals.

PMID- 2234609
TI  - Neuroendocrine mechanisms involved in regulation of body weight, food intake and
      metabolism.
AB  - Body weight regulation is the result of food intake and energy expenditure. The
      central nervous system (CNS), and in particular, the hypothalamus, controls food
      intake as well as metabolism, the latter mainly by autonomic effects on the islet
      of Langerhans, hepatocytes and adipocytes. Body weight, more precisely body fat
      content, is probably controlled by a feedback mechanism in which insulin,
      released from the B cell of the islet of Langerhans, plays a key role. The islet
      of Langerhans is an intricate neuroendocrine unit in which the release of
      glucagon, insulin, and somatostatin from A, B, and D cells, respectively, is
      controlled by the CNS via a rich autonomic innervation. In addition, the
      endocrine cells of the pancreas influence each other by paracrine actions. The
      CNS control of the islets shapes the plasma insulin and blood glucose profiles
      during the circadian cycle and thereby regulates the nutrient flow to the
      different tissues in the body. Thus, the CNS structures involved in regulation of
      body weight and food intake control also metabolism. The mechanisms contributing
      to match food intake and the needs of metabolism are discussed.

PMID- 2234610
TI  - Pancreatic glucagon signals postprandial satiety.
AB  - The hypothesis that prandial increases in circulating pancreatic glucagon
      initiates an important peripheral satiety signal is reviewed. Glucagon
      administration at the beginning of meals reduces the size of test meals in
      animals and humans and reduces the size of spontaneous meals in rats. Exogenous
      glucagon may also interact synergistically with cholecystokinin to inhibit
      feeding. These appear to be satiety effects because they are behaviorally
      specific in rats and subjectively specific in humans. Glucagon's pharmacological
      satiety effect is complemented by compelling evidence for a necessary
      contribution of endogenous glucagon to the control of meal size: administration
      of glucagon antibodies increases both test and spontaneous meal size in rats.
      Under many, but not all, conditions exogenous glucagon's satiety effect appears
      to originate in the liver and to be relayed to the brain via hepatic vagal
      afferents. Analysis of the central processing of this signal, however, has barely
      begun. How glucagon changes are transduced into neural afferent signals also
      remains an open question. The only hypothesis that has been extensively tested is
      that stimulation of hepatic glucose production initiates the satiety signal, but
      this is neither convincingly supported nor clearly rejected by currently
      available data. It is also not yet clear whether glucagon contributes to some
      forms of obesity or has potential use as a therapeutic tool in the control of
      eating disorders. Of the several proposed controls of hunger and satiety,
      glucagon appears to be one of the most likely to be physiologically relevant.
      This encourages further analysis of its behavioral characteristics, its neural
      mechanisms, and its clinical potential.

PMID- 2234611
TI  - A review of the physiological bases of the anorexic action of phenylpropanolamine
      (d,1-norephedrine).
AB  - Phenylpropanolamine (PPA) is a phenethylamine that induces a variety of effects
      including anorexia and weight loss. The present review compares the acute
      anorexic effects of PPA with those of amphetamine in animals and humans,
      describes the persistent chronic effects of PPA on feeding as well as differences
      in anorexic potency between the norephedrine enantiomers (d-norephedrine less
      than 1-norephedrine) and summarizes the generality of PPA anorexia. The review
      also describes the putative mechanisms by which PPA is thought to reduce feeding
      behavior including alteration of gastric emptying and interaction with central
      nervous system neurons.

PMID- 2234612
TI  - The rising incidence of congenital syphilis: back to the future.

PMID- 2234613
TI  - Crack cocaine: ripples of a rock in a pond.

PMID- 2234614
TI  - Syphilis among parturients at an inner city hospital: association with cocaine
      use and implications for congenital syphilis rates.
AB  - The frequency of positive cord blood rapid plasma reagin (RPR) tests among
      newborns at an inner city hospital and associations with maternal cocaine use,
      prenatal care, and adequacy of syphilis therapy were retrospectively assessed.
      The incidence of positive cord blood RPRs increased from 1.1% of all live births
      in 1985 to 3.4% in 1988. In 1987, 98 babies were born with positive cord blood
      RPRs; 86 of their charts were available for review. Four infants had false
      positive RPRs, and one patient delivered twins, leaving 81 mothers who could be
      evaluated. Almost 37% of these patients had had no prenatal care. More than 55%
      had inadequate or not therapy for syphilis. Of these, only 17.4% had prenatal
      care. Slightly more than 40% of patients acknowledged using drugs during
      pregnancy, 87.9% of whom used cocaine. Among the patients who used drugs, 75.8%
      received no prenatal care, in contrast to 10.4% of mothers who did not use drugs
      (p less than 0.001). It appears that drug use, particularly use of cocaine, is
      associated with low levels of utilization of prenatal services and inadequate
      therapy for syphilis. This may lead to increased risk of congenital syphilis in
      newborns.

PMID- 2234615
TI  - The prevalence of marijuana (cannabis) use and dependence in cocaine dependence.
AB  - In a retrospective and prospective study using DSM-III-R criteria for substance
      dependence in 232 inpatients and 51 outpatients, the clinical suspicion that
      cocaine addicts use other drugs including marijuana was confirmed. As many as 53%
      of cocaine addicts diagnosed by DSM-III-R criteria for cocaine dependence
      qualified for a diagnosis of cannabis dependence. The reports regarding marijuana
      and other drug dependence among cocaine addicts have been few and inconclusive.
      The diagnosis of other drug use and dependence in cocaine dependence has
      importance with regard to prognosis and treatment. This study found a high
      prevalence of marijuana (cannabis) dependence in patients with cocaine
      dependence.

PMID- 2234616
TI  - The public health consequences of crack cocaine.

PMID- 2234617
TI  - Position paper of the Associated Medical Schools of New York on HIV testing and
      access to treatment.

PMID- 2234618
TI  - Gas warfare: military-medical responsiveness of the Allies in the Great War, 1914
      1918.

PMID- 2234620
TI  - Eosinophilia-myalgia syndrome and L-tryptophan.

PMID- 2234619
TI  - Crack abuse and asthma: a fatal combination.

PMID- 2234621
TI  - Neurocutaneous manifestations of neurofibromatosis-2.

PMID- 2234622
TI  - Defining brain death.

PMID- 2234623
TI  - Trade and generic names of drugs.

PMID- 2234624
TI  - A neglected resource.

PMID- 2234626
TI  - The community health worker program.

PMID- 2234625
TI  - Reversible hypoxic cerebral edema in severe hemolytic crisis.

PMID- 2234627
TI  - Skin cancer prevention.

PMID- 2234628
TI  - Cervical cancer in New York State.

PMID- 2234629
TI  - [General supervision of practice and agency placement nurses].

PMID- 2234630
TI  - [Choose a theoretical framework--choose Orem].

PMID- 2234631
TI  - [Dying a little each day].

PMID- 2234632
TI  - [Pakistan. The beginning of a new time for the nursing profession].

PMID- 2234633
TI  - [What do you know about prostate cancer?].

PMID- 2234634
TI  - [Alcohol and community action].

PMID- 2234636
TI  - [To stop conjugal violence].

PMID- 2234635
TI  - [Psychiatric day hospitals].

PMID- 2234637
TI  - An illustrious past, but our future needs rethinking.

PMID- 2234638
TI  - [Career plans in the clinical milieu].

PMID- 2234639
TI  - [Drug-food interactions].

PMID- 2234640
TI  - Evaluation of standards of practice for general practitioners using eight
      hypothetical cases.
AB  - Concerns about the quality of primary care in New Zealand have increased over
      recent years as the scarcity of research in this field has become more apparent.
      A survey was undertaken among 132 general practitioners in Otago and Southland to
      gauge the degree of consensus of care for eight hypothetical cases. An 87.3%
      response rate was obtained. The year of graduation of the respondents was a
      significant factor in determining the response to the choice of management
      options for the paediatric sore throat and the benign hypertension cases. A
      variation in treatment of a 65 year old with epigastric pain was seen between
      rural and urban practitioners, with the cluster containing the most rural
      practitioners being least likely to undertake detailed diagnostic procedures.

PMID- 2234641
TI  - Dependency levels of people in aged care institutions in Auckland.
AB  - Between January and June 1988, a survey of 7516 people in aged care facilities in
      the Auckland region (99.4% response rate) was undertaken to ascertain the extent
      and provision of care for elderly people requiring ongoing care in order to make
      comparisons with other centres in New Zealand. Information was gathered about
      their ability to perform various activities of daily living by staff members who
      completed a structured precoded and pretested questionnaire for each resident or
      patient. Overall levels of dependency were also assessed as part of the
      questionnaire: 13% were assessed as requiring long stay hospital care, 48% had
      moderate or appreciable dependency, and the remainder had some dependency (23%)
      or none at all (16%). Almost one quarter (23%) of the 5213 residents in old
      people's homes were rated as apparently independent. Of people in religious and
      welfare residential homes, 38% were rated as independent whereas in commercial
      rest homes 12% of people were classified in this way. This high level of apparent
      independence in religious and welfare homes is the main aspect in which the
      Auckland long term care scene is distinct from other regions in the country.

PMID- 2234642
TI  - Silent myocardial ischaemia.

PMID- 2234643
TI  - The spectrum of systemic candidiasis at Auckland Hospital.
AB  - Systemic candidiasis is uncommon. We reviewed our experience with this disease
      from the infectious disease unit, Auckland Hospital, between 1982 and 1988,
      because many of these patients are referred to us. We then selected 11 of them to
      highlight particular presentations, diagnostic or management issues. We included
      both compromised and noncompromised patients from medical and surgical services.
      Candida albicans was the most common cause, but we also saw patients infected
      with C glabrata, C parapsilosis, and C tropicalis and present them to exemplify
      their different clinical presentations. Demonstrable fungaemia is uncommon in
      patients with systemic candidiasis, serological techniques are both insensitive
      and nonspecific and patients are often too ill from underlying disease to allow
      for invasive diagnostic procedures. Thus diagnosis is often difficult. Parenteral
      amphotericin B with or without 5-fluorocytosine is still the main antifungal
      treatment. Triazole antifungals may change that in the future. Systemic
      candidiasis retains a high mortality: careful individualised management of
      patients may improve mortality and morbidity.

PMID- 2234644
TI  - Asthma and its management at a student health service.
AB  - Of 96 asthmatic students 62 said their asthma had not required them to give up
      any activity but only seven said it had not interfered in some way with their
      sport. Thirty-nine regarded their asthma as an annoyance and 13 of these were
      angered by it. Fifty-seven respondents took treatment continuously and the most
      favoured agent in attacks was salbutamol. Peak flow meters were not used
      regularly except by six students. About two-thirds had significant deficiencies
      in their knowledge of asthma and the most popular source of information was the
      general practitioner. Only 30 had read the Asthma Foundation pamphlets.

PMID- 2234645
TI  - Acute transfusion reactions.
AB  - We reviewed 1500 acute transfusion reactions that were reported to the Auckland
      Regional Blood centre over a 7 year period, from approximately 440,000
      transfusions. The majority of reactions were to red cells, and these had the
      highest reaction incidence per unit (0.73%) of all blood products. The reaction
      incidence per unit transfused for plasma was 0.1%, for stable plasma protein
      solution 0.01%, and for platelets 0.04%. The majority of symptoms reported were
      mild and transient. The commonest were fever (72%), rigors (33%), and rash or
      urticaria (30%). Although more serious reactions were reported such as
      angioedema, hypotension and pulmonary oedema, none of these were severe, as
      judged from the data reported to the centre. There were two transfusion related
      deaths during the study period, one due to an ABO incompatible transfusion, the
      other due to bacterial contamination of a unit of blood. Leucocyte agglutinins or
      antibodies were detected in 29% of those with a febrile reaction, but were also
      detected in 22% of those who remained afebrile. Serological abnormalities that
      may have accounted for the reaction were only detected in 12 patients six of whom
      had autoantibodies. As laboratory investigation reveals little that accurately
      defines the aetiology of a reaction, a rationalisation of the investigation into
      acute transfusion reactions is suggested.

PMID- 2234646
TI  - Poor participation of nulliparous women in a low dose aspirin study to prevent
      preeclampsia.
AB  - Only four of 39 nulliparous women agreed to participate in a placebo controlled
      study of low dose aspirin therapy to prevent preeclampsia. The major reason for
      nonparticipation was fear the aspirin would harm the fetus (30 of 35 women).
      Twenty-four women felt public promotion of a healthy lifestyle influenced their
      nonparticipation. No woman felt any practical problems related to the study
      impeded their recruitment and all but one woman felt the study was important and
      worthwhile. Eleven women considered any drug therapy or research in pregnancy was
      anathema. As a result of the low response rate a multicentered study was not
      feasible. Unless new approaches to research are developed, scientific advances in
      obstetric practice in New Zealand may depend only on research conducted overseas.

PMID- 2234647
TI  - The Cartwright inquiry.

PMID- 2234648
TI  - Tobacco advertising and consumption.

PMID- 2234649
TI  - Indentured slavery.

PMID- 2234650
TI  - HIV testing.

PMID- 2234651
TI  - Melanoma and polyunsaturated fat; cancer and diet.

PMID- 2234652
TI  - Strategic ethics.

PMID- 2234653
TI  - Thin membrane nephropathy.

PMID- 2234654
TI  - Doxorubicin-associated hyperpigmentation.

PMID- 2234655
TI  - Fluoridation and caries.

PMID- 2234656
TI  - Does a low serum potassium predispose to admission to coronary care?

PMID- 2234657
TI  - Double gloving during surgery: a technical tip.

PMID- 2234658
TI  - Treatment of cutaneous larva migrans.

PMID- 2234660
TI  - Auckland revisited. Busy, busy, busy.

PMID- 2234659
TI  - Letters from Romania.

PMID- 2234662
TI  - Auckland revisited. Bureaus in business.

PMID- 2234661
TI  - Auckland revisited. Baby boom.

PMID- 2234663
TI  - Nursing, mental health and the community.

PMID- 2234664
TI  - The price of participation.

PMID- 2234666
TI  - After the act.

PMID- 2234665
TI  - Professional? Industrial? Closing the gap.

PMID- 2234667
TI  - Care of the elderly: sound sleep.

PMID- 2234669
TI  - Save time and money on new products.

PMID- 2234668
TI  - The decision wasn't made alone...

PMID- 2234671
TI  - Emergency department liability: general legal issues for nurses.

PMID- 2234670
TI  - Closing the gap between school and service.

PMID- 2234672
TI  - National practice guidelines: what do they mean for nurses?

PMID- 2234674
TI  - Trust: essential for delegation.

PMID- 2234673
TI  - Model Medicare physician fee schedule published.

PMID- 2234675
TI  - Peer interviews: sharing the hiring process.

PMID- 2234676
TI  - Health patterns as DRG outlier predictors.

PMID- 2234677
TI  - A study of nursing documentation.

PMID- 2234678
TI  - Daily nursing documentation can be quick and thorough!

PMID- 2234679
TI  - Charting for accountability.

PMID- 2234681
TI  - Home health challenges: paperwork vs. peoplework.

PMID- 2234680
TI  - New nurse managers: Part I--Orientation for the 1990s.

PMID- 2234682
TI  - What keeps nurses in nursing?

PMID- 2234683
TI  - MBO theory versus the real world.

PMID- 2234684
TI  - Patient classification interrater reliability.

PMID- 2234685
TI  - Attitude: the new posture for the nineties.

PMID- 2234686
TI  - Power: from commanding turf to generating excellence.

PMID- 2234687
TI  - Iconodontalgia VI.

PMID- 2234688
TI  - Computers?

PMID- 2234689
TI  - Autologous blood: the safest alternative.

PMID- 2234691
TI  - Albany, where the action is.

PMID- 2234690
TI  - Decreasing the density of dark radiographs--a lost art.
AB  - The purpose of this paper is to describe a procedure that appears to have been
      lost with time and that reduces excess density [immaterial of the cause] on
      radiographs. This results in radiographs of greatly improved diagnostic quality.
      This procedure results in avoiding retakes resulting in a lower radiation dose to
      the patient and a saving of time. This procedure should not be considered as a
      substitute for poor radiological or processing techniques.

PMID- 2234692
TI  - Clarifying "managed care".

PMID- 2234693
TI  - International Commission on Radiation Protection.

PMID- 2234694
TI  - Technetium-99m antimony sulphide colloid lymphoscintigraphy of the prostate by
      direct transrectal injection.
AB  - Laterality of prostatic lymphatic drainage was successfully assessed in nine
      patients with prostatic carcinoma after direct unilateral transrectal injections
      of 99Tcm-antimony sulphide colloid by Franzen needle. Pelvic lymphatic drainage
      was equally divided between ipsilateral, contralateral and bilateral patterns.
      The frequent observation of radiocolloid migration to contralateral lymph node
      groups in patients with prostate carcinoma, including those with primary disease
      localized clinically to a single lobe of the prostate, indicates the potential
      for contralateral pelvic lymph node metastases in this population. This finding
      may be important in determining the appropriate surgical staging and treatment of
      patients with prostate carcinoma. The clinical applicability of
      lymphoscintigraphy in the evaluation of metastatic spread and in lymph node
      biopsy planning requires further study.

PMID- 2234695
TI  - Anti-melanoma antibodies bind preferentially to diploid metastases in
      immunoscintigraphy.
AB  - Immunoscintigraphy with 99Tcm-labelled anti-melanoma monoclonal antibody F(ab')2-
      fragments was performed in 23 patients with histologically verified metastatic
      melanoma. Immunoscintigraphy was positive in 14 patients and all known metastases
      were detected in eight patients, five of whom had only one lesion. Lesion
      localization and detectability were as follows: 12/13 (92%) cutaneous and
      subcutaneous, 11/14 (79%) lymph node, 5/7 (71%) bone, 3/6 (50%) lung and 1/5
      (20%) abdominal metastases were visualized. Despite its high specificity--no
      false positive immunoscintigrams--the low sensitivity of this method in detecting
      deep metastases hampers its usability. The false negative results were not due to
      lack of antigen expression as positive immunostaining results were observed also
      in specimens from patients with negative immunoscintigrams. Flow cytometric
      analysis of the metastases revealed that in 7/8 (88%) patients with diploid
      tumours had positive immunoscintigrams but only 7/15 (47%) patients with
      aneuploid tumours. These results show that the diagnostic accuracy of melanoma
      immunoscintigraphy can be improved by selecting patients not only by testing for
      the antigen but also on the basis of DNA analysis of an accessible lesion.

PMID- 2234697
TI  - Cortical cerebral blood flow in HIV-1-related dementia complex.
AB  - Dementia complex is a syndrome that affects a high percentage of AIDS patients.
      Neuroradiological findings may be non-specific and the diagnosis can be difficult
      in its earlier stages. Preliminary radionuclide studies have recently reported
      derangements of regional cerebral blood flow (CBF) which may be present before
      overt anatomical injury. This study reports on cortical and cerebellar CBF
      changes in 26 patients studied with 99Tcm-HM-PAO and single photon emission
      computed tomography (SPECT). Extensive cortical CBF derangements were observed in
      all patients and an evident cerebellar hypoperfusion was also present in three.
      The prevalence of hypoperfusion was highest in the frontal and parietal lobes.
      The extension of the hypoperfusion showed a highly significant correlation with
      the severity of the dementia complex (P less than 0.01 by chi 2 test). The SPECT
      also showed hypoperfused areas in three patients with normal CT scans and in two
      patients with normal MRI scans. These results confirm previous preliminary
      reports on the high prevalence of cortical hypoperfusion in dementia complex and
      suggest the use of this radionuclide technique to assist in the early diagnosis
      and follow-up of AIDS patients, especially when CT and MRI are still normal.

PMID- 2234696
TI  - Radionuclide studies of left ventricular function in normal subjects.
AB  - The effects of age and exercise on cardiac function in a normal male population
      have been assessed by ECG-gated radionuclide ventriculography. Fifty-nine
      subjects aged from 25 to 54 years were studied (mean 44 +/- 10 S.D. years).
      Resting left ventricular ejection fraction (LVEF) was 0.54 +/- 0.07 and this
      increased by 0.07 +/- 0.05 during supine submaximal exercise at 75 watts. The
      mean increase in cardiac output on exercise was 93 +/- 30%. Stroke volume
      increased on exercise by 23 +/- 13% and end-systolic volume decreased by 10 +/-
      16%. There was a weak correlation (P less than 0.05) between age and change in
      LVEF on exercise but the increase in cardiac output on exercise was not age
      dependent. It is important to use an age matched control population in any study
      of cardiac function.

PMID- 2234699
TI  - Difficulties in detecting osteitis in the diabetic foot.

PMID- 2234698
TI  - 67Ga-scintigraphy for evaluation of AIDS-related intestinal infections.
AB  - This study was designed to evaluate the role of 67Ga-scintigraphy in AIDS-related
      intestinal infections. Seventeen out of twenty-five HIV-positive patients (68%)
      primarily investigated with 67Ga-scans to screen for opportunistic pneumonia
      presented pathologic abdominal 67Ga-uptake which was, in most cases, due to
      proven opportunistic intestinal infection (cytomegalovirus, atypical
      mycobacteria, cryptosporidiosis etc.). The correlation of abdominal with
      pulmonary findings has shown that AIDS-related intestinal infections and
      opportunistic pneumonia may occur concomitantly in the majority cases (11/17). In
      6/17 patients positive abdominal findings were observed without opportunistic
      pneumonia at the same time. Gallium imaging of the abdomen has shown to identify
      successfully the most common extrapulmonary sites of HIV-related infections.
      Thus, abdominal imaging or whole body scintigraphy should be a mandatory part of
      each 67Ga-scan in patients with HIV infection, even if it was primarily performed
      to screen for opportunistic pneumonia only. Knowledge of multilocular
      opportunistic infections, usually caused by different pathogens, is clinically
      important for further diagnostic and therapeutic management.

PMID- 2234700
TI  - Prenatal diagnosis of fetal tumors by ultrasonography.
AB  - Fetal tumors lead to serious illness or even death in the fetal or neonatal
      period. Problems vary from severe hydrops to underdevelopment of fetal organs. In
      some instances a tumor may cause mechanical obstruction during the birth process.
      Polyhydramnios frequently develops. Adequate prenatal diagnosis is of utmost
      importance. Timely detection of the fetal tumor prevents traumatic birth and
      postnatal care and treatment can be scheduled. This report is a review of the
      relevant recent literature and the tumors detected in our ultrasound unit between
      1982 and 1988. The ultrasonographic appearance, clinical course, and differential
      diagnosis of the tumors are discussed.

PMID- 2234701
TI  - Recurrent miscarriage: a review of current concepts, immune mechanisms, and
      results of treatment.

PMID- 2234702
TI  - Retroperitoneal soft tissue sarcomas: a review of the literature.
AB  - The English language literature on retroperitoneal sarcomas published between
      1981 and 1988 has been reviewed. The histology, different prognostic factors,
      value of imaging techniques, and need for multidisciplinary management are
      discussed. Complete surgical excision with tumor-free margins confirmed by
      histology is essential if long-term survival and local control are to be
      achieved. In many cases resection of adjacent organs is required as most patients
      present with advanced, aggressive local disease. The roles of adjuvant
      radiotherapy and chemotherapy in the treatment of retroperitoneal sarcomas are
      uncertain and must await further controlled, randomized, prospective studies.

PMID- 2234703
TI  - Sexuality and reproduction in spinal cord injured women.
AB  - Sexuality, reproduction, and childbearing are essential issues for the spinal
      cord injured women. The medical complications, including urinary tract
      infections, anemia, pressure sores, sepsis, and autonomic hyperreflexia are
      significant in each of these areas with both physical as well as emotional
      ramifications. Patient and family education is of primary importance in both
      anticipating as well as dealing with the potentially serious consequences. A
      consultant knowledgeable in the problems of the spinal cord injured can be of
      utmost benefit especially in the labor and delivery process.

PMID- 2234704
TI  - Primary malignant melanoma of the uterine cervix: two case reports and a
      century's review.
AB  - Primary malignant cervical melanoma is diagnosed by the presence of junctional
      melanocytic abnormality and the absence of distant metastasis. Amelanotic and
      poorly differentiated tumors can often be diagnosed with the HMB-45
      immunoperoxidase stain which is very specific for melanoma. Early reported cases
      were treated with simple excision followed many times by radiation therapy.
      Radical hysterectomy, pelvic lymphadenectomy, and partial vaginectomy have been
      advocated by some contemporary investigators. Radiation can be used as adjuvant
      or palliative treatment; its efficacy is not well established. Few patients have
      been treated with modern chemotherapy. No patient has been treated with
      immunotherapy. Primary malignant cervical melanoma carries a very poor prognosis.
      Most patients succumb from their disease within 2 years. One patient has survived
      14 years. The small number of reported cases makes it difficult to evaluate the
      efficacy of any treatment modality.

PMID- 2234705
TI  - Pulmonary hypoplasia: a review.

PMID- 2234706
TI  - Classification of endometrial cells on cervical cytology.
AB  - One hundred eighty-eight women who had endometrial cells on cervical cytologic
      specimens during the secretory phase or in the postmenopausal period were studied
      retrospectively. Each had undergone hysterectomy or endometrial biopsy within 12
      months of the original smear. The endometrial cells were classified as typical,
      atypical, or suspicious for carcinoma. Among premenopausal subjects, three of 57
      with typical cells had endometrial hyperplasia, one of two with atypical cells
      had endometrial polyps, and both with cells suspicious for carcinoma had
      endometrial carcinoma. In the postmenopausal group, ten (13.5%) of 74 with
      typical endometrial cells had either hyperplasia or carcinoma, and five (22.7%)
      of 22 with atypical cells and 24 77.4%) of 31 patients with suspicious cells had
      either hyperplasia or carcinoma. The present findings and a review of the
      pertinent literature demonstrate that the classification system used is helpful
      in predicting the risk for endometrial disease in patients with endometrial cells
      seen on cervical cytologic smears during the secretory phase or in the
      postmenopausal period.

PMID- 2234707
TI  - Observer variability in the scoring of colpophotographs.
AB  - Colposcopy and cervicography are accepted tools for assessing the cervix for an
      atypical transformation zone. We studied the validity of the colpophotograph as a
      measurement tool by determining the agreement of experienced colposcopists using
      colpophotographs of 50 women. Interobserver agreement was generally fair to good
      (kappa greater than or equal to 0.40) for the presence of the squamocolumnar
      junction and the area of ectopia but it was poor (kappa less than 0.40) for the
      area, border, and color characteristics of an atypical transformation zone. Intra
      observer agreement was fair to good for the color characteristics of an atypical
      transformation zone, but it was poor for the area and border characteristics. We
      conclude that observer agreement studies should play a role in the validation of
      methods used in the visual diagnosis of cervical intraepithelial neoplasia.
      Considerable lack of agreement in reporting cytologic findings is a well-known
      problem, and lack of agreement might be an even bigger problem in reporting
      colposcopic findings.

PMID- 2234708
TI  - A randomized trial comparing two methods of cold knife conization with laser
      conization.
AB  - In a randomized study, 62 women were submitted to cold knife conization with
      application of Sturmdorf sutures, 60 to cold knife conization without sutures,
      and 61 to laser conization. Early hemorrhage occurred in 1.6, 13.3, and 6.6% of
      women, respectively (P less than .05), and late hemorrhage in 15.3, 3.6, and
      11.7%, respectively. Considering early and late hemorrhage together, there was no
      significant difference among the three treatment groups. Dysmenorrhea tended to
      be more common after application of Sturmdorf sutures, as it was reported by
      27.8, 13.2, and 14.3% of patients, respectively, but the difference was not
      statistically significant. Dysmenorrhea occurred in 13% of the cases with a cone
      height of 20 mm or less and in 26% of the cases with a cone height greater than
      20 mm (P less than .05). Endocervical cells were present significantly more often
      after sampling with a cytobrush than with a cotton swab (P less than .0001),
      whereas the method of conization had no influence. In smears obtained with a
      cytobrush, endocervical cells were present in 88.0, 84.9, and 82.5% of the cases;
      in smears obtained with a cotton swab, endocervical cells were present in 46.6,
      57.7, and 54.5%, respectively. We conclude that cold knife conization without
      Sturmdorf sutures is about equal to laser conization in overall complications,
      but the laser is preferable for outpatient treatment because of a lower frequency
      of early hemorrhage. Sturmdorf sutures should be avoided. Smears at follow-up
      should be taken with a cytobrush and a wooden spatula.

PMID- 2234709
TI  - Basement membrane of cervical adenocarcinoma: an immunoperoxidase study of
      laminin and type IV collagen.
AB  - The basement membrane components type IV collagen and laminin were examined
      immunohistochemically in 14 cases of adenocarcinoma of the cervix. The patterns
      of staining in adenocarcinoma in situ, invasive adenocarcinoma, and early
      invasive adenocarcinoma were compared to see whether characteristic patterns
      could be delineated. Adenocarcinoma in situ had a uniform intact basement
      membrane, whereas the basement membrane of invasive adenocarcinoma was fragmented
      and irregular. Cases of early stromal invasion showed early gland buds and
      outpouchings with defective basement membrane staining. The degree of histologic
      differentiation of the tumor was not clearly related to the amount of basement
      membrane component staining. The concept of early stromal invasion in cervical
      adenocarcinoma, as supported by our immunohistochemical studies, is discussed as
      it relates to a possible pathogenic mechanism in early invasion and infiltration
      of adenocarcinoma of the cervix.

PMID- 2234710
TI  - Treatment of fallopian tube carcinoma with cisplatin, doxorubicin, and
      cyclophosphamide.
AB  - Primary carcinoma of the fallopian tube is uncommon and is often treated using
      regimens active in ovarian carcinoma. Evidence is scant that such therapies
      benefit patients with fallopian tube carcinoma. Between December 1979 and July
      1988, we treated 18 patients who had adenocarcinoma of the fallopian tube with
      the combination of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), and
      cyclophosphamide (500 mg/m2) administered intravenously on 1 day every 28 days.
      Histologic confirmation of fallopian tube carcinoma was obtained before entry in
      the study. Three patients had stage I disease, five had stage II, nine had stage
      III, and one had stage IV. Sixteen patients received the combination therapy as
      first-line treatment after cytoreductive surgery, and two patients received it
      for recurrent carcinoma. Seven patients had clinically measurable disease at the
      start of therapy. Two of these patients had a complete clinical response, two had
      stable disease, and three had progressive disease. Eight of the 15 patients with
      stages II-IV disease underwent second-look laparotomy; four had a complete
      response to therapy and four had a partial response, making the overall response
      rate 53%. The toxicity of the regimen was moderate. The median survival was 81
      months. Patients with stages II-IV disease had a median survival of 43.9 months
      and a progression-free survival of 22.5 months. This regimen appears to be active
      in fallopian tube carcinoma and can result in response rates comparable to those
      reported for epithelial ovarian cancer.

PMID- 2234711
TI  - Early amniocentesis: report of 407 cases with neonatal follow-up.
AB  - Amniocentesis was performed for prenatal diagnosis in 407 pregnancies between the
      gestational ages of 11-14 weeks. The safety and accuracy of the procedure were
      compared with data obtained from collaborative studies of amniocentesis performed
      later in the second trimester. There were no differences observed with respect to
      accuracy, pseudomosaicism, or maternal-cell contamination related to the timing
      of the procedure. The fetal loss rate within 4 weeks of the procedure was 2.3%.
      Fetal losses appeared to be related to maternal complications such as bleeding
      and leakage of fluid that occurred within a day of the procedure. No major
      maternal complications were noted. Information regarding neonatal outcome,
      including pulmonary complications and congenital orthopedic postural deformities,
      was found to be similar to that in previous reports.

PMID- 2234712
TI  - Effect of maternal smoking and age on congenital anomalies.
AB  - The incidence of congenital anomalies was examined by the level of maternal and
      paternal smoking during pregnancy for 17,152 infants. A multiple regression
      analysis was used to control for the possible confounding effects of maternal
      age, formal education, ethnic origin, religion, marital status, parity, social
      class, and work outside the home. Neither maternal nor paternal smoking habits
      were significantly associated with the occurrence of congenital malformations.
      Maternal age was significantly (P less than .005) related to the incidence of
      major anomalies. Mothers aged 35 years and older who smoked were found to have a
      significantly (P less than .002) higher risk for minor malformations and a
      nonsignificantly increased rate of major malformations. Maternal cigarette
      smoking may be an important preventable risk factor for congenital anomalies
      among mothers aged 35 years or older.

PMID- 2234713
TI  - Maternal mortality in the United States, 1979-1986.
AB  - To understand better the epidemiology and to describe the causes of maternal
      death, we reviewed all identified maternal deaths in the United States and Puerto
      Rico for 1979-1986. The overall maternal mortality ratio for the period was 9.1
      deaths per 100,000 live births. The ratios increased with age and were higher
      among women of black and other minority races than among white women for all age
      groups. The causes of death varied for different outcomes of pregnancy; pulmonary
      embolism was the leading cause of death after a live birth. Unmarried women had a
      higher risk of death than married women. The risk of death increased with
      increasing live-birth order, except for primiparas. In order to develop
      strategies to reduce the risk of maternal death in the United States, future
      studies should include expanded information about each death, which will allow
      better understanding of factors associated with maternal mortality.

PMID- 2234714
TI  - Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal
      study.
AB  - Preeclampsia is a disease unique to pregnancy that contributes substantially to
      maternal and fetal morbidity and mortality. The condition has been thought to be
      one of hypoperfusion in which increased vascular resistance characterizes the
      associated hypertension. This study was designed to test an alternative
      hypothesis, that preeclampsia is characterized by high cardiac output. In a
      blinded longitudinal study of nulliparas with uncomplicated pregnancies, cardiac
      output was measured serially by Doppler technique. Cardiac output was elevated
      throughout pregnancy in patients who became preeclamptic (P = .006). Six weeks
      postpartum, the hypertension of the preeclamptic subjects had resolved but
      cardiac output remained elevated (P = .001) and peripheral resistance remained
      lower than in the normotensive subjects (P = .001). This study demonstrates that
      preeclampsia is not a disease of systemic hypoperfusion and challenges most
      current models of the disease based on that assumption.

PMID- 2234715
TI  - Aggressive or expectant management for patients with severe preeclampsia between
      28-34 weeks' gestation: a randomized controlled trial.
AB  - Fifty-eight women with severe preeclampsia between 28-34 weeks' gestation
      qualified for a randomized controlled trial to establish whether elective
      delivery 48 hours after administration of betamethasone (aggressive-management
      group) or delivery later as indicated by maternal or fetal condition (expectant
      management group) was more beneficial to maternal and fetal outcome. Twenty women
      who qualified were not randomized because they developed maternal or fetal
      indications necessitating delivery within 48 hours; these newborns developed most
      of the complications. Expectant management was not associated with an increase in
      maternal complications, but it significantly prolonged the gestational age (mean
      7.1 days; P less than .05), reduced the number of neonates requiring ventilation
      (P less than .05), and reduced the number of neonatal complications (P less than
      .05).

PMID- 2234716
TI  - Does indomethacin alter the hemodynamic response to magnesium sulfate infusion
      and hemorrhage in gravid ewes?
AB  - The purpose of this study was to determine whether indomethacin alters the
      maternal and fetal hemodynamic response to magnesium sulfate (MgSO4) infusion and
      hemorrhage in gravid ewes. We studied seven chronically instrumented animals
      between 0.8 and 0.9 of timed gestation. The experimental sequence included: 1) at
      time 0, indomethacin, 2 mg/kg, or vehicle only intravenously (IV) over 5 minutes;
      2) at 60 minutes, MgSO4 4 g IV over 5 minutes; 3) at 65 minutes, MgSO4 infusion
      at 4 g/hour; 4) at 150 minutes, maternal hemorrhage, 20 mL/kg, over 60 minutes;
      and 5) at 215 minutes, reinfusion of maternal blood over 60 minutes. Each animal
      was studied with and without indomethacin. Indomethacin, but not vehicle only,
      transiently increased maternal and fetal mean arterial pressure (MAP), decreased
      maternal and fetal heart rate, and decreased maternal cardiac output. Magnesium
      sulfate significantly decreased uterine vascular resistance and increased uterine
      blood flow both with and without indomethacin. Hemorrhage significantly decreased
      maternal MAP, heart rate, cardiac output, and uterine blood flow in both groups.
      The magnitude of each change was similar between the groups. For example, at the
      end of hemorrhage, maternal MAP was 36 +/- 7% below baseline (P = .0001) with
      indomethacin and 41 +/- 2% below baseline (P = .0001) in the vehicle-only group
      (P = not significant between groups). Hemorrhage significantly decreased fetal
      heart rate, pH, and PO2, and increased fetal MAP and PCO2 in both groups. We
      conclude that indomethacin did not alter the maternal or fetal hemodynamic
      response to MgSO4 infusion and hemorrhage in gravid ewes.

PMID- 2234717
TI  - Pregnancy and liver transplantation.
AB  - To define the risks and outcomes associated with pregnancy and liver
      transplantation, we reviewed our experience in managing eight pregnant women who
      had undergone orthotopic liver transplantation. Seven patients conceived after
      transplantation; the interval from transplantation to conception ranged from 3
      weeks to 24 months. One patient received an allograft at 26 weeks' gestation for
      hepatic failure secondary to acute fulminant hepatitis B. Of the seven patients
      who conceived after transplantation, six had live births and one electively
      terminated her pregnancy. Five patients developed worsening hypertension and/or
      preeclampsia. Three patients developed severe preeclampsia and required delivery.
      One patient suffered acute allograft rejection during pregnancy which was
      successfully treated with corticosteroids. Two patients had persistent elevation
      of serum transaminases and two had severe anemia. The mean gestational age at
      delivery was 32.8 weeks. Of the six live births to women who conceived after
      transplantation, five infants survived and are well and one infant died. There
      were no congenital anomalies. All mothers are alive at this time. Pregnancy in
      recipients of hepatic allografts is associated with good perinatal outcome, but
      there is an increased risk of preeclampsia, worsening hypertension, and preterm
      delivery. Pregnancy does not appear to have a deleterious effect on hepatic graft
      function or survival. Joint management of these patients by a transplant
      specialist and a perinatologist is essential.

PMID- 2234718
TI  - Objective tocodynamometry identifies labor onset earlier than subjective maternal
      perception.
AB  - The ability of women instructed in self-detection of uterine contractions to
      identify the abrupt rise in uterine activity known to precede the onset of labor
      has not been evaluated. This study was designed to assess the temporal
      relationship between objective uterine activity monitoring, subjective maternal
      perception of uterine activity above a commonly used threshold value (four or
      more contractions per hour), and progressive cervical change. Daily
      tocodynamometry (7-9 AM) was recorded in 79 women with preterm premature rupture
      of the membranes from admission until the onset of spontaneous labor (5.3 +/- 6.3
      days). The subjects were at bed rest, received no tocolytic therapy, and were
      instructed in the signs of labor and uterine self-palpation. Patients
      simultaneously provided a subjective assessment of uterine activity (four or more
      contractions per hour). The majority of uterine activity recordings (78%)
      revealed fewer than four contractions per hour, and the patients' subjective
      reports agreed in almost all instances (97.6%). On 91 days, four or more
      contractions per hour were recorded objectively, but the patients' subjective
      reports agreed in only 25 instances (27%). On the day of labor onset,
      significantly more women had an objective assessment (32%) (P less than or equal
      to .01). Patients subjectively identified labor onset 10.6 +/- 6.7 hours after
      objective monitoring indicated increased uterine activity, and when subjectively
      identified, both cervical dilatation (4.9 +/- 2.5 cm) and effacement (85 +/- 30%)
      were significantly advanced (P less than or equal to .001) compared with the
      admission examination (1.1 +/- 1.2 cm; 20 +/- 30%).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2234720
TI  - Doppler umbilical artery studies in the twin-twin transfusion syndrome.
AB  - Eleven patients with twin pregnancies were identified as having twin-twin
      transfusion syndrome on the basis of like-sex twins with monochorionic
      placentation and umbilical venous blood hemoglobin differences exceeding 50 g/L
      at delivery. Umbilical artery velocity-time waveform studies had been performed
      in these pregnancies as part of a large series of 456 twin pregnancies. In all 11
      cases, the systolic-diastolic (S-D) ratio differences between the twins were less
      than 1 unit (mean 0.4 +/- 0.2), indicating that in twin-twin transfusion,
      umbilical artery S-D ratios are concordant even in the presence of discordancy in
      fetal size.

PMID- 2234719
TI  - Effect of angiotensin II infusion during normal pregnancy on flow velocity
      waveforms in the uteroplacental and umbilical circulations.
AB  - Women destined to develop preeclampsia show an increased systemic pressor
      response to infused angiotensin II, and the angiotensin sensitivity test has been
      accepted as an appropriate means of identifying these women. However, the effect
      of angiotensin II infusion on uteroplacental blood flow is unknown and may be
      deleterious. Patients undergoing angiotensin sensitivity tests as part of a
      protocol examining the effect of aspirin on the incidence of preeclampsia were
      studied with Doppler velocimetry performed before and during the angiotensin II
      infusion. Fetal well-being was documented with biophysical profiles performed
      before and after the infusions. Neither the systolic-diastolic ratios in the
      uterine and umbilical arteries nor the biophysical profile scores were altered
      significantly (P = .43, P = .23, Wilcoxon signed-rank median test, and P = .35,
      Fisher exact test, respectively). These findings suggest that the angiotensin
      sensitivity test does not increase resistance to flow in the uterine or umbilical
      circulation, and therefore may be used safely in screening for preeclampsia.

PMID- 2234721
TI  - The association between oligohydramnios and intrauterine growth retardation.
AB  - Among 147 cases of suspected intrauterine growth retardation (IUGR) identified
      based upon ultrasonic abdominal circumference below the tenth percentile, 56 were
      confirmed IUGR infants at birth and 91 were non-IUGR infants. Eight of 316
      control fetuses with abdominal circumference above the tenth percentile turned
      out to be IUGR infants at birth. The incidence of oligohydramnios was strikingly
      different among the three groups: 29% for the IUGR group, 9% for the non-IUGR
      group, and 0.6% for the controls (P less than .001). When the criteria of
      abdominal circumference below the tenth percentile and presence of
      oligohydramnios were used together, the positive predictive value doubled (from
      38.1 to 66.7%; P less than .01). Oligohydramnios developed some time after the
      somatic evidence of fetal growth retardation in all cases in this study. Finally,
      there were no significant differences between fetal growth retardation with or
      without oligohydramnios with respect to maternal risk factors or fetal outcome.
      We conclude that in fetal growth retardation, the occurrence of oligohydramnios
      during the third trimester of pregnancy is not associated with worse fetal
      outcome.

PMID- 2234722
TI  - Obstetric practice patterns in Washington state after tort reform: has the access
      problem been solved?
AB  - We surveyed all potential obstetric providers in Washington state in the spring
      of 1989 to determine whether the passage of tort reform in 1986 had improved
      access to care for rural and medically indigent women. We found that, although
      the exodus of family physicians from obstetric practice that had been observed
      between 1985-1986 appears to have slowed, there is still substantial net
      attrition among family physicians. As a result, rural patients are having
      increasing difficulty obtaining local access to obstetric care. By contrast, the
      supply of obstetricians and midwives seems to be stable. All three groups of
      providers are increasingly reluctant to provide care to the growing number of
      Medicaid patients. Although tort reform may have slowed the rate at which
      providers are quitting obstetrics, equilibrium has not yet been achieved.
      Shortages of rural physicians and inadequate Medicaid reimbursement rates must be
      addressed to improve obstetric access for underserved groups.

PMID- 2234723
TI  - Early age at menopause among left-handed women.
AB  - Associations have been suggested between handedness, autoimmune disorders, and
      reproductive hormonal changes. The purpose of this study was to test a proposed
      relationship between handedness and age at menopause. Two national survey data
      sets were used to compare recalled ages at menopause. Mexican-American women,
      ages 35-74, naturally postmenopausal for at least 1 year, were selected from the
      Hispanic Health and Nutrition Examination Survey (HHANES). White and black women
      were selected from the National Health and Nutrition Examination Survey (NHANES
      I) using similar criteria. The mean age at menopause was found to be earlier
      among left-handed women than right-handed women from the NHANES-I data set. In
      the HHANES data set, the mean age at menopause was significantly earlier among
      left-handed women than in right-handed women (t = 2.35, P less than .05). Early
      age at menopause among left-handed women may result from misclassification of
      handedness among older women or differential mortality among left-handed
      individuals. Alternatively, the association may be related to possible
      correlations between left-handedness and autoimmune disorders, which may include
      reactions against hormone receptor sites and oocytes.

PMID- 2234724
TI  - Whither electronic fetal monitoring?
AB  - Largely based on promising animal studies, continuous electronic fetal monitoring
      (EFM) was introduced into clinical practice in the early 1970s. After almost 20
      years of experience, it is now apparent that the anticipated benefits of this
      technology have not materialized. Undesirable side effects of EFM include
      inappropriate operative intervention for some patients and increased liability
      for physicians and hospitals, resulting in an increase in the costs of obstetric
      services. After reviewing several research studies, The American College of
      Obstetricians and Gynecologists concluded that EFM and intermittent auscultation
      are equivalent methods for intrapartum assessment. We have developed a protocol
      for the performance of intermittent auscultation, including indicated responses
      to different levels of bradycardia. This protocol has allowed us to substitute
      auscultation for EFM in a high percentage of patients using existing nursing
      personnel. Laboring patients should, at a minimum, receive information on both
      intermittent auscultation and EFM to enable them to make an informed choice of
      method for intrapartum fetal assessment.

PMID- 2234725
TI  - Debulking of pelvic and para-aortic lymph node metastases in ovarian cancer with
      the cavitron ultrasonic surgical aspirator.
AB  - Six patients with metastatic ovarian cancer with extensive involvement of the
      pelvic and/or para-aortic lymph nodes underwent surgical debulking with the
      Cavitron Ultrasonic Surgical Aspirator. Intraoperative and postoperative
      morbidity was minimal. It is suggested that this technique may be used for
      cytoreductive surgery in combination with standard surgical techniques.

PMID- 2234726
TI  - Objective assessment of meconium content of amniotic fluid.
AB  - The amount of meconium in amniotic fluid is subjectively estimated by visual
      inspection and classified as thin (light), moderate, or thick (heavy). This
      estimate may be important for assessing the neonatal risk of perinatal asphyxia
      and meconium aspiration syndrome. This study reports on the "meconium-crit," a
      simple, rapid, inexpensive, and reproducible method of quantifying meconium
      concentration in amniotic fluid. The purpose of the study was to determine the
      relationship between the meconium-crit and meconium concentration. Specimens were
      prepared by placing 3.0 g of fresh neonatal meconium into clear amniotic fluid
      and vortexing for 15 minutes to obtain a stock solution of 15.0 g meconium/100 mL
      amniotic fluid. Stock solutions were then diluted with clear amniotic fluid to
      obtain concentrations of 10.0, 7.5, 5.0, 3.0, and 1.5 g/100 mL. One-tenth
      milliliter of the amniotic fluid/meconium mixture was drawn into a standard
      hematocrit tube and centrifuged. The meconium-crit was then measured directly as
      with a hematocrit. Regression analysis indicated that meconium-crit values were
      linearly related to meconium concentration (r = 0.901-0.995). This method
      provides a reproducible means of quantifying meconium in amniotic fluid.

PMID- 2234727
TI  - Terms of confinement.

PMID- 2234728
TI  - Complications of first-trimester abortion: a report of 170,000 cases.

PMID- 2234729
TI  - Oral contraceptives and breast cancer: a case-control study with hospital and
      community controls.

PMID- 2234730
TI  - Pregnancy outcome of patients with uncorrected uterine anomalies managed in a
      high-risk obstetric setting.

PMID- 2234732
TI  - Stress in life and work. Part 1: How it affects the individual.

PMID- 2234731
TI  - The significance of moderate and severe inflammation on class I Papanicolaou
      smear.
AB  - The significance of a cytologic diagnosis of moderate and severe inflammation
      with a normal (class I) Papanicolaou smear has not been addressed. A
      retrospective review of 596 consecutive cervical smears performed over 13 months
      revealed 85 women who had a class I cytologic smear with moderate to severe
      inflammation. Seventy-eight patients had colposcopic examinations and were
      considered for this study. Fifty-nine (75.6%) had cervical punch biopsies and/or
      endocervical biopsies. Of the 78, 19 (24.4%) had cervical condylomata and nine
      (11.5%) had cervical intraepithelial neoplasia. We conclude that class I
      cytologic smears with moderate to severe inflammation may be associated with
      findings of condylomata and cervical dysplasia.

PMID- 2234733
TI  - Does sex sell safety?

PMID- 2234734
TI  - The end justifies the means.

PMID- 2234735
TI  - Psychotherapy: a counselling success.

PMID- 2234736
TI  - Advising early retirement on medical grounds.

PMID- 2234737
TI  - Building inspection crucial part of effective asbestos management.

PMID- 2234738
TI  - Asbestos in place may present immeasurable risks in buildings.

PMID- 2234739
TI  - Asbestos warrants care, management but society must resist urge to panic.

PMID- 2234740
TI  - Respirator innovation.

PMID- 2234741
TI  - Industrial hygienists take the field with new gas-detection technology.

PMID- 2234742
TI  - Preventing employee drug abuse starts with firm policy, awareness.

PMID- 2234743
TI  - Menstrual cycle disorders.

PMID- 2234744
TI  - Characteristics and control of the normal menstrual cycle.
AB  - The most important activity during the follicular phase of the cycle is the
      secretion of gonadotropins, which control folliculogenesis and influence uterine
      proliferation. The dominant events of the periovulatory phase are the LH surge
      and ovulation. The significant change during the luteal phase is the production
      of a nutritive mucus by the endometrial glands in preparation for an embryonic
      blastocyst. The cardinal passage of the menstrual phase is the menstrual flow
      itself. These different events (and the metabolic processes that regulate them)
      have wide-ranging effects on the integrity of the body. As Havelock Ellis, the
      eminent English psychologist, stated at the turn of this century, "the
      omnipresent process of sex, as it is woven into the whole texture of our body, is
      the pattern of all the process of our life" (source unknown). The sweeping
      influences of the menstrual cycle illustrate the extent to which the process of
      reproduction is indeed woven into the whole of the human body.

PMID- 2234745
TI  - Clinical manifestations of hormonal changes in the menstrual cycle.
AB  - The human female reproductive cycle is the result of repeated interactions-
      giving positive and negative feedback--of pituitary gonadotropic hormones and
      ovarian sex steroid hormones. If any of the pituitary or ovarian hormones becomes
      tonically elevated or suppressed, ovulation will cease. The charge to the
      clinician in evaluating disorders of ovulation is to determine which hormone(s)
      is tonically elevated or suppressed. Sex steroid hormones exert effects on their
      target tissues that can be observed directly. These changes aid the clinician in
      evaluating disorders of ovulation and establishing which hormone(s) is tonically
      elevated or suppressed. Changes in thermoregulation can be detected by the basal
      body temperature record. Changes in the vagina can be detected by cytologic
      examination. Changes in the endometrium can be observed by obtaining a biopsy
      specimen for histologic examination. Premenstrual molimina suggest to the woman
      and her clinician that ovulation has occurred. Utilization of these changes in
      clinical practice aids the clinician in making a specific diagnosis of the cause
      of anovulation and in developing a treatment plan. Moreover, when the woman is
      aware of these clinical changes, it makes her a more involved participant in her
      health care.

PMID- 2234746
TI  - Systemic illness and menstrual dysfunction.
AB  - Menstrual dysfunction can be associated with a number of systemic illnesses.
      Whereas the effects of some diseases on the reproductive system are simply a
      result of the pathophysiology of the disorders, in other cases, temporary
      cessation of reproductive function conserves energy for other tasks related to
      survival and well being.

PMID- 2234747
TI  - Influence of the menstrual cycle on systemic diseases.
AB  - Physiological changes associated with the menstrual cycle influence the clinical
      course of some diseases such as bronchial asthma, allergies, anaphylaxis,
      epilepsy, migraine, dermatoses, and porphyria. Hormonal manipulation can be
      beneficial in some patients.

PMID- 2234748
TI  - Menorrhagia.
AB  - Excessive vaginal bleeding, or menorrhagia, is one of the most common presenting
      symptoms for gynecologic patients. Although this disorder has many possible
      etiologies, it is generally possible to approach its diagnosis and management in
      an orderly fashion. When evaluating the menorrhagic patient, it important to gear
      the work-up toward a differential diagnosis that includes pregnancy-related
      causes, hormonal problems, iatrogenic etiologies, mechanical intrauterine
      disorders, infections of the lower genital tract, and gynecologic cancers
      (PHIMIC). This differential approach can guide the types of historical data
      obtained from the patient, focus the physical examination, and alert the
      practitioner to the most appropriate laboratory and radiologic evaluation.
      Therapy can differ widely, depending on the cause of the bleeding. Most types of
      menorrhagia respond to medical therapy with oral contraceptives, oral synthetic
      estrogens or progestins, and long-acting intramuscular progestins or GnRH
      agonists. Surgical approaches, such as dilatation and curettage or hysterectomy,
      are less and less a first-line therapy; but innovative surgical techniques such
      as hysteroscopy and laparoscopic surgery are becoming increasingly important.
      With rapid, goal-directed diagnosis and specific therapy, the medical
      complications, anxiety, and discomfort suffered by the woman with menorrhagia can
      be alleviated quickly.

PMID- 2234749
TI  - Amenorrhea.
AB  - Amenorrhea, the lack of menstruation, is a gynecologic disorder that may arise
      from a variety of causes. If a logical and orderly schema is followed, the
      correct diagnosis and appropriate management plan can be formulated.

PMID- 2234750
TI  - Vaginal bleeding in childhood and adolescence.
AB  - Vaginal bleeding in early childhood, regardless of its duration and quantity, is
      always of clinical importance. This article discusses the examination of the
      child and adolescent and reviews the various causes of vaginal bleeding in these
      patient groups.

PMID- 2234751
TI  - Abnormal bleeding in the climacteric.
AB  - In the perimenopausal years, we encounter a situation where the normal diminution
      in reproductive capacity, with its resulting disruption of the normal menstrual
      hormonal pattern, coincides with a very real risk of pelvic pathology. Limitation
      in the ability to diagnose and to treat these patients conservatively has in the
      past resulted in a high rate of hysterectomy. With increased understanding of the
      normal physiology of this stage of transition and with improved diagnostic tools,
      we are now able to come to a definitive diagnosis in most patients. This ability
      to assure the diagnosis has made it much easier to counsel the patient
      confidently about the appropriate course of action. We will continue to encounter
      the problem of hysterectomy for bleeding with no histologic lesion being found.
      Although reviewers' letters may be considered an unnecessary thorn in the side,
      the improved practice that has resulted from these efforts gives strong support
      to their continued activities. We can have confidence that our treatment plan
      evolved in a logical manner and offers our patients a high probability of benefit
      at justifiable risk.

PMID- 2234752
TI  - Cyclic pelvic pain.
AB  - Cyclic pelvic pain is a common gynecologic problem caused by relatively few
      diseases, which usually can be diagnosed and remedied quickly. Some complaints
      reflect normal physiologic aspects of the menstrual cycle (mittelschmerz,
      menstrual awareness). Premenstrual syndrome can be diagnosed, but an effective
      and convenient treatment is lacking. Dysmenorrhea is the commonest source of
      cyclic pain, diagnosed by its characteristic history and rapid relief on
      administration of antiprostaglandin agents. Endometriosis is diagnosed surgically
      and best treated either surgically then, or medically by danazol or GnRH
      agonists. In contrast, adenomyosis is a problem commonly encountered in later
      life, and hysterectomy is usually needed for both definitive diagnosis and
      treatment.

PMID- 2234753
TI  - Pelvic pain and infections.
AB  - Infectious etiologies of both acute and chronic pelvic pain are common and may
      involve multiple organ systems. In the evaluation of the acute pain, it is
      important to remember that rapidity of diagnosis is important because of the
      possibility of significant morbidity and even death if a condition is not
      attended to rapidly. In recent years, laparoscopic evaluation of the pelvis has
      provided a better understanding of the pathophysiology of some of these
      infections, as well as possible therapeutic maneuvers. The evaluation of chronic
      pelvic pain requires a thorough attempt at careful diagnosis with minds open to
      the possibility that other organ systems besides the genital tract may be
      involved. Laparoscopy also may be an important diagnostic and therapeutic tool in
      the evaluation of the sequelae of pelvic inflammation leading to chronic pelvic
      pain. All therapeutic modalities that are instituted on the basis of the
      diagnostic evaluation must take into consideration that a strong emotional
      component is generally associated with chronic pelvic pain. Such components must
      be addressed in order to achieve the best possible results for the patient.

PMID- 2234754
TI  - Premenstrual syndrome: an update for the clinician.
AB  - Premenstrual syndrome is a complex disorder in which a variety of symptoms can
      occur in the luteal phase of the menstrual cycle. The symptoms should occur each
      cycle only from the time near ovulation to soon after the onset of menses. There
      should be at least 1 week in follicular phase that is symptom-free. Symptoms
      should be severe enough to significantly interfere with the ability of the
      patient to function within her normal lifestyle. Diagnosis is based on clinical
      information from prospective charting of symptoms. Up to 50 per cent of patients
      who think they have PMS really suffer from another type of mental illness,
      usually a depressive disorder. Laboratory tests are not generally helpful in the
      diagnosis. Treatment is based on the type(s) of symptom(s). Available treatments
      are reviewed with documentation of results from double-blind placebo-controlled
      experimental designs. The etiology of PMS is not known. However, there are good
      empiric therapies available that can help most PMS patients.

PMID- 2234755
TI  - Hypnosis modality defended.

PMID- 2234756
TI  - The difference between ethical and unethical "marketeering". Another big
      fish/little fish scenario?

PMID- 2234757
TI  - The National Practitioner Data Bank.

PMID- 2234759
TI  - Perceptions realigned.

PMID- 2234758
TI  - Beyond instructions for use: how to counsel your patients about their
      prescriptions.

PMID- 2234760
TI  - "How far should physicians go to facilitate a patient's death?".

PMID- 2234761
TI  - What you need to know about disposing of infectious waste.

PMID- 2234762
TI  - What is infectious waste (and how do I get rid of it?).

PMID- 2234763
TI  - The State Health Insurance Task Force: progress notes from OSMA representative
      Owen Johnson, MD.

PMID- 2234765
TI  - Job's syndrome (granulomatous disease variant).

PMID- 2234764
TI  - Failure to diagnose: a key element in malpractice.

PMID- 2234767
TI  - The "longer view" of health care.

PMID- 2234766
TI  - Skin cancer: a review with consideration of treatment options including Mohs
      micrographic surgery.
AB  - A review of basal and squamous cell carcinoma of the skin is presented with
      emphasis on treatment modalities. A series of 312 cases of skin cancer is
      presented in which Mohs micrographic surgery was the treatment. This technique is
      indicated for tumors that are 1) recurrent; 2) on anatomic sites with a high risk
      for recurrence; 3) of large size; 4) of aggressive histologic type; 5)
      incompletely excised; or 6) present on important functional or asthetic areas.

PMID- 2234768
TI  - Anabolic steroids and the Ohio State Medical Board.

PMID- 2234769
TI  - Medical students take a fantastic voyage.

PMID- 2234770
TI  - New crop of medical students is on the 'horizon'.

PMID- 2234771
TI  - Cancer hospital dream becomes reality.

PMID- 2234772
TI  - How to find your way through the yellow pages maze.

PMID- 2234773
TI  - They tell us medicine is changing.

PMID- 2234774
TI  - Janiceps twins.

PMID- 2234775
TI  - Contraceptive use and counseling before and after an abortion in Ohio, 1981 and
      1986.

PMID- 2234776
TI  - Therapeutic aspects of low-risk breast cancer.
AB  - Attempts to treat patients suffering from metastasizing or primary operable
      breast cancer in a risk adapted fashion have always been dependent on the
      detection and clinically relevant ranking of prognostic parameters. Despite a
      variety of assumed prognostic parameters and description of prognostic indices no
      generally accepted definition of low or high risk breast cancer has been
      established as yet. Nevertheless, attempts have been successful to accomplish
      risk adapted treatment strategies that resulted in a substantial reduction in
      treatment related morbidity. Thus, replacement of surgical ablation procedures by
      drugs manipulating hormonal feedback regulation has yielded less side effects.
      Furthermore, new antiestrogens and antigestagens are aiming at a reduction in the
      rate and degree of toxicity. In addition, chemotherapy of metastasizing disease
      as well as adjuvant systemic therapy is being investigated with consideration of
      the concept of a maximum in efficacy and a minimum in toxicity.

PMID- 2234777
TI  - Ether lipids and derivatives as investigational anticancer drugs. A brief review.
AB  - There is considerable evidence that certain ether lipids represent a new class of
      antineoplastic agents. The activity of some of these structures is partially
      mediated through non-specific host resistance cells. In addition, more
      importantly, these ether lipids have been shown to be cytotoxic for cells from a
      wide variety of tumors and leukemias. The site of the cytotoxic action of ether
      lipids appears to be the cell membrane. They inhibit the biosynthesis of
      phosphatidylcholine as well as the activity of protein kinase C and might
      interfere with some growth factor receptors. Higher concentrations of some of
      these compounds are not compatible with the lipid bilayer matrix of the membrane.
      However, it remains uncertain whether or not these effects represent the only
      mechanisms for the cytotoxic action of this material. Further experiments
      elucidating the molecular mechanisms in the cytotoxicity of these compounds are
      necessary. In vivo a wide variety of mouse and rat tumors have been found to be
      sensitive to the therapeutic activity of ether lipids, with other tumor and
      leukemia models, however, being resistant to this material. Clinical phase I
      pilot trials have been completed, showing tumor response in a small number of
      patients treated, and 3 drugs are currently in phase II studies. Some of these
      ether lipids are preferentially cytotoxic to leukemic cells in comparison with
      normal bone marrow cells within a certain dose range. Thus, they are suitable for
      purging residual leukemic cells from remission bone marrow used for autologous
      bone marrow transplantation. A phase I/II study of autologous bone marrow
      transplantation in acute leukemia using bone marrow cells treated with ether
      lipids is in progress.

PMID- 2234778
TI  - [Postoperative adjuvant whole abdomen irradiation in ovarian cancer].
AB  - Seventy-nine patients with ovarian carcinoma stage I-III postoperatively received
      a whole abdominal irradiation (median dose: 22.5 Gy) followed by pelvic boost
      irradiation (median pelvic dose: 45 Gy) as the sole adjuvant therapy. Surgery
      preceding the irradiation was radical only in 59 percent of the patients. Whole
      abdominal irradiation was performed either in the moving-strip-technique or the
      open-field-technique. The median follow-up time was 57 months. The overall and
      the progression-free five-year survival rate of the whole group is 66 +/- 6% and
      63 +/- 6%, respectively. We have not seen a clear-cut dependence of the survival
      rates on the completeness of the surgery, on tumor histology or grading. In a
      statistically significant way, the survival rates depend on the stage, the
      presence of tumor rests, and, above all, on the risk group. The overall five-year
      survival rate for the intermediate-risk patients is 78 +/- 7% and 22 +/- 11% for
      high risk patients. There aren't any randomized studies concerning the optimal
      adjuvant therapy for intermediate-risk patients. Because of the reproduceable
      results and the infrequent toxicity, whole abdominal irradiation seems to be a
      treatment equivalent to other adjuvant therapies for these patients.

PMID- 2234780
TI  - High-dose epirubicin in combination with cyclophosphamide (HD-EC) in advanced
      breast cancer: final results of a dose finding study and phase II trial.
AB  - In the dose finding study we were able to demonstrate that an increase of the
      epirubicin dose to 120 mg/m2 in combination with cyclophosphamide (600 mg/m2) is
      possible. The phase II trial had to check the efficacy and the toxicity of this
      combination with a therapy interval of 21 days. 34 patients with metastatic
      breast cancer previously not treated with chemotherapy for metastatic disease
      entered this phase II trial, which tested the efficacy and toxicity of the
      chemotherapy combination epirubicin 120 mg/m2 and cyclophosphamide 600 mg/m2 (HD
      EC regimen) i.v. every three weeks. Excluded from the trial were patients at risk
      of anthracycline toxicity and those with bone or brain metastases. Results
      compare favourably with best data reported in the literature for chemotherapy of
      metastatic breast cancer: overall remission rates of 73% (35% CR, 38% PR), median
      TTP of 58 weeks for CR (range 32-168 weeks) and 52 weeks for the PR group (range
      24-110 weeks); median survival time for CR 71+ weeks (range 52-196+), for PR 74+
      weeks (range 40-134+ weeks). No therapy was given for remission maintenance after
      a stable remission was obtained. This results in a very favourable ratio of time
      with chemotherapy to maintenance time without chemotherapy, which is 10 weeks/62
      weeks for CR and 12 weeks/49 weeks for PR. Evidence of tumor remission was found
      in 80% of the patients who already responded to chemotherapy after the first
      cycle. The early onset of tumor response as well as the short induction
      chemotherapy period necessary to obtain best response are considered major
      advantages of the HD-EC regimen.

PMID- 2234779
TI  - [Vaginal ultrasound as a screening method for detection of adnexa tumors in
      postmenopause?].
AB  - 424 ovaries of 212 postmenopausal women not on hormone treatment were examined by
      vaginal ultrasound. 155 patients had no clinical complaints, 57 patients showed
      atypical uterine bleeding. 48 pathological findings could be detected
      sonographically (11.3%). Among the histologically clarified cases were 2
      asymptomatic ovarian cancers. Altogether, the vaginosonography proved to be a
      very simple and effective method to detect ovarian tumors in postmenopausal
      women.

PMID- 2234782
TI  - [Dialysability of cytostatic drugs. Experimental studies in vitro].
AB  - There are no established guidelines for detoxification for most cases of
      overdosage or intoxication with cytostatic drugs. Little is known about the
      dialysability of cytostatic drugs. To obtain further information on the
      dialysability of cytostatic drugs, human plasma was incubated with cytostatic
      drugs and dialysed in vitro using "mini-modules" with capillaries identical to
      clinical use. Cytotoxicity before and after dialysis was measured in a biological
      test system using permanent human lymphoblast cultures (LS2). The 20 cytostatic
      drugs studied could be categorised as follows: Good dialysability in vitro:
      methotrexate, 5-fluorouracil, cytarabine, actinomycin D, mitomycin C, 4-OH
      cyclophosphamide, ifosfamide, melphalan, dacarbazine, cisplatin. Intermediate
      dialysability in vitro: adriamycin, epirubicin, carmustine. Ineffective
      dialysability in vitro: daunorubicin, vincristine, vinblastine, vindesine,
      etoposide, teniposide, mitoxantrone. These in vitro results cannot be transferred
      automatically into the in vivo situation because of specific drug distribution
      and metabolic rates. Considering pharmacokinetic data, the following
      recommendations can be made for practical clinical purposes: Detoxification by
      hemodialysis in vivo: Possibly effective: Methotrexate, 5-fluorouracil, mytomicin
      C, cyclophosphamide, ifosfamide, melphalan, carmustine, dacarbazine. Ineffective:
      Adriamycin, epirubicin, daunorubicin, mitoxantrone, actinomycin D, etoposide,
      teniposide, vincristine, vinblastine, vindesine, cytarabine, cisplatin.

PMID- 2234781
TI  - Results and prognosis of acute non-lymphocytic leukemia in adults. A
      retrospective study of 319 patients between 1977-1987.
AB  - Between 1977-87, 319 patients with AML were admitted to Hannover Medical School.
      At all 41 of these patients were not treated (median duration of survival 0.6
      months). Among the 278 treated patients, there was a CR rate of 53.6%, the median
      duration of remission was 10.1 months and the median duration of survival 7.0
      months. The patients with FAB-classification M4-M5 had a worse prognosis than
      those with M1-M3. Patients under 50 years of age had a significant higher
      remission rate and survival time than those over 50 years. In the last 10 years,
      the remission rate rose from 37.3% to 61.0% (p = 0.1776). There was a rise in
      median duration of survival from 5.9 months (1977-79) to 8.0 months (1984-85) (p
      less than 0.001). The median remission time decreased from 15.8 months (1977-79)
      to 12.0 months (1984-85) (p less than 0.001). After the first reinduction
      therapy, the remission rate (46.6%), duration of remission (5.3 months), and
      duration of survival (4.1 months) was lower than after primary therapy. After the
      second reinduction therapy the CR rate was 69.2%, and the remission time 2.9
      months. The CR rate after the third reinduction therapy was 22.2%.

PMID- 2234783
TI  - Cytotoxic activity of lysophosphatidylcholine analogues on human lymphoma Raji
      cells.
AB  - The cytotoxic activity of 21 lysophosphocholine analogues was tested on human
      lymphoma Raji cells. Structure-activity investigations revealed a more than 50
      fold difference in the cytotoxicity between the different compounds. Whereas
      acyllysophosphocholines showed only borderline effects, the most pronounced toxic
      activity was observed with compounds which have an etherbond in the sn-1 position
      and a hydrogen, a methoxy or a methoxymethylgroup in position sn-2. Elongation of
      the phosphorous-nitrogen distance in the choline group markedly reduced the
      cytotoxicity of the compounds. From the results obtained it was concluded that a
      long chain fatty alcohol adjacent to a phosphocholine headgroup represents the
      minimal requirement for antineoplastic activity. Thus, a new group of
      antineoplastic compounds, the alkylphosphocholines, was developed in our
      laboratory, with in vitro cytotoxic activities just as effective as the most
      toxic alkyllysophosphocholines.

PMID- 2234784
TI  - Characterization of human glioblastoma cell lines in vitro and their xenografts
      in nude mice by DNA fingerprinting.
AB  - Human gliomas were grown as permanent tissue cultures and xenografts in nude
      mice. DNA fingerprint patterns from two human gliomas were established using two
      different hypervariable multilocus probes [( GTG]5 and 33.15). In general the
      cell lines investigated showed an overall stability in the DNA fingerprint
      pattern. However, differences in the DNA fingerprint patterns were shown to occur
      depending upon the above mentioned parameters.

PMID- 2234785
TI  - [Cisplatin, vindesine and hyaluronidase combined with simultaneous radiotherapy
      of advanced head and neck tumors].
AB  - In a prospective pilot study 21 patients with advanced squamous cell carcinoma of
      the head and neck were treated with polychemotherapy and Hyaluronidase combined
      with radiation. With the exception of one patient, who refused laryngectomy, all
      patients were inoperable. Chemotherapy consisted of 5 mg Vindesine on day 1 and
      80 mg/m2 Cisplatin on day 2. 200,000 U Hyaluronidase were given by infusion over
      20 min prior to Vindesine and Cisplatin. Radiation in fractions of 2 Gy a day was
      administered 12 times per cycle (day 3-5, 8-12 and 15-18). Treatment was repeated
      on day 22 and 43. Total radiation dose was 72 Gy. Side-effects were mainly of
      local character (moderate severe mucositis in 7, mild mucositis in 14 patients).
      No severe systemic toxicity was seen. Complete remission was noted in 17 out of
      21 patients. 16 patients are now a life without progression. 1 patient in
      complete remission died 5 months after therapy due to pneumonia without evidence
      of tumor. The mean time of follow up is 16 months (range 3-42). The preliminary
      results suggest that combined therapy with Vindesine, Cisplatin, Hyaluronidase
      and Radiation is well tolerable and highly effective against advanced squamous
      cell carcinoma of the head and neck.

PMID- 2234786
TI  - [Requirements in clinical evaluation of drugs in oncology. Guidelines of the
      phase I/II study group of the Professional Society of Internal Oncology of the
      German Cancer Society].

PMID- 2234787
TI  - [The role of the myoblasts and connective tissue in the regeneration of the limbs
      in amphibians].
AB  - A possibility of tissue metaplasia (transformation of one cell type into another)
      during limb regeneration in lower vertebrates has been a matter of vivid
      arguments over the last decades. These discussions are rather irreconcilable in
      character mainly due to the lack of reliable cell markers which permit to follow
      all the stages of cell transformation during metaplasia. The final conclusions
      can be made only if any artifacts of cell labelling are excluded. Latest findings
      obtained using nuclear and cytoplasmic markers are presented which suggest that
      many data interpreted previously as a convincing proof of metaplasia may be a
      consequence of the involvement of nondifferentiated cells in regeneration.
      Molecular biological approaches are believed to be most promising for the
      solution of disputable problems of tissue metaplasia. However, recent findings
      about actin gene hypomethylation are insufficient for any final conclusions about
      the possibility of metaplasia during limb regeneration. The answer to many
      unsolved questions of developmental biology can be made only when combined use is
      made of modern methods of cell and molecular biology.

PMID- 2234788
TI  - [The molecular factors of the cell adhesion of neural tissues and the Ca2+
      independent adhesion system].
AB  - The review discusses various technical approaches to identification of plasma
      membrane and extracellular matrix proteins involved in cell adhesion.
      Physicochemical characteristics of macromolecular factors of the Ca2(+)
      independent adhesion system in neural tissue cells are discussed alongside with
      the findings on their biosynthesis and expression on the cell surface at
      different stages of embryogenesis.

PMID- 2234789
TI  - [Changes in the activity of different classes of enzymes in the cerebral cortex
      of rats in ontogeny and after the transplantation of embryonic nerve tissue].
AB  - The activity of lactate dehydrogenase (LDH), indophenol oxidase, aspartate
      aminotransferase (AsAT), alkaline phosphatase, acid phosphatase and aldolase at
      different stages of rat development was measured. We have also determined changes
      in the activity of these enzymes resulting from transplantation of embryonic
      nerve tissue (ENT) into the brain of adult animals. During development from the
      embryo to the adult animal, LDH and AsAT activities increased, while alkaline
      phosphatase activity diminished. After ENT transplantation, the most prominent
      changes were in the alkaline phosphatase activity whereas the activity of LDH,
      AsAT and acid phosphatase remained unchanged and similar to that in the brain
      cortex of intact adult animals. Changes in the enzyme activity resulting from ENT
      transplantation changed in a manner characteristic of the transplant. Local brain
      damage did not change the activity of the studied enzymes fifty days after
      surgery.

PMID- 2234790
TI  - [Astrocyte death in organotypic cultures of fetal spinal cord from rats with
      unilateral micromelia].
AB  - Growth and differentiation of neurons and glia in spinal cord explants of 16 days
      old rat fetuses with teratogen-induced left-sided micromelia were studied.
      Progressive destruction of astrocytes that differentiate in interstitial zone of
      cultures was observed in 37% of explants of the left side, while the development
      was normal in cultures of the right side. Possible mechanisms leading to
      destruction of astrocytes in cultures of spinal cord regions that innervate
      anomalous limbs are discussed.

PMID- 2234792
TI  - [The ultrastructure of the neurons of a graft developing in the brain of rats
      experiencing hypoxia].
AB  - Fragments of the brain cortex of 17- or 18-day-old rat embryos were
      allotransplanted into the brain cortex of rats subjected to hypoxia. Four days
      later the graft consisted of mixed differentiating neuroblasts. By the 100th to
      130th day after transplantation the graft contained mature neurons,
      differentiating neurons and neuroblasts. Hypochromic neurons showing the signs of
      intracellular reparation were also detected. A well-developed neuropile was
      localized inside the graft. In contrast to the normal brain, neurons in the graft
      were not organized in layers.

PMID- 2234791
TI  - [The differentiation of the nerve and glial cells of neocortical transplants
      placed into the brain of adult rats].
AB  - Embryonal neural tissue of 17-day-old rat embryos was transplanted into the brain
      of adult Wistar rats to test the differentiation of transplants with reference to
      the normal cerebral cortex development. The control and the experimental rats
      were decapitated 2, 5, 7, 10, 15, 20, 25, and 35 days after the transplantation.
      Differentiation of neural tissue was studied using monoclonal antibodies against
      neurofilaments as well as by counting the proportion of differentiated neurons.
      The glial differentiation was studied by immunohistochemical method using
      monoclonal antibodies against acid glial fibrillar protein and vimentin. The
      differentiation of neural cells of transplants proved to be synchronous with the
      normal ones while the differentiation of glial cells accelerates.

PMID- 2234793
TI  - [Fibronectin distribution during the transdifferentiation and proliferation of
      eye cells after retinal detachment and removal of the crystalline lens in
      tritons].
AB  - Expression of fibronectin (Fn) during eye tissue regeneration in the newt after
      retinal detachment and lens removal was studied by immunohistochemistry.
      Proliferation of cells involved in eye tissue regeneration was studied using
      autoradiography. Fn was detected around the cell membranes of undifferentiated
      proliferating and migrating cells in ciliary body of the iris and growth zone of
      the retina. Redistribution of Fn was observed in proliferating cells of the
      dorsal iris participating in lens regeneration. Fn appeared on the apical surface
      of proliferating redifferentiating pigment epithelium (PE) cells at the periphery
      of the eye and over the whole surface of proliferating PE cells in the central
      part of the eye. The Fn level in the Bruch's membrane decreased in the area of
      transdifferentiating cells detachment from PE layer (in the lower part of the
      eye) but continued to be stable in the area of PE cell redifferentiation (at the
      periphery of the eye). The role of Fn is discussed in relation to
      transdifferentiation, proliferation and migration of cells in the regenerating
      eye.

PMID- 2234794
TI  - [The capacity for regeneration of the myocardium in rat fetuses].
AB  - A reproducible model of heart injury in 16-days old rat fetuses has been
      developed. 30 days after the injury a 4-fold increase of the damaged area was
      observed. Decrease of reparative capacity of myocardium in fetuses as compared
      with the adults is due to the functional immaturity of the connective tissue
      cells.

PMID- 2234796
TI  - [The parthenogenetic activation under the action of cycloheximide of mouse
      oocytes matured in vivo].
AB  - Treatment of mouse oocytes matured in vivo by cycloheximide at a concentration 25
      micrograms/ml for 2 h induced female pronucleus formation. In all activated
      oocytes the formation of the female nucleus was completed 5-6 h after the
      beginning of cycloheximide treatment. When cycloheximide concentration was
      decreased down to 5 micrograms/ml, its effect was detected 1 h later as compared
      with that at a concentration of 25 micrograms/ml.

PMID- 2234795
TI  - [The enzymes of fructose metabolism in the liver of chick embryos].
AB  - The activity of fructose cycle enzymes remains practically constant in chick
      embryonic liver during ontogenesis. Change in ratio of aldolase A to B activities
      was detected. It is suggested that fructose enters the cycle via the sorbitol
      pathway in which aldose reductase and sorbitol dehydrogenase are involved.

PMID- 2234797
TI  - [Sexual dimorphism in the development of the neuronal populations of tractus
      solitarius nuclei in rats].
AB  - Using light microscopy, we performed morphometric analysis of various cell
      populations of brain solitary tract nuclei at various stages of ontogenesis in
      rats. Sex-related dimorphism of development was observed in eight neuronal
      populations. Sex-related differences in the structure of these neurons persist in
      adult rats. The data obtained suggest that solitary tract nuclei participate in
      brain sexual differentiation.

PMID- 2234799
TI  - Laser madness in medicine.

PMID- 2234798
TI  - [Positional information and finger growth in man].

PMID- 2234800
TI  - Overnight admission of outpatient strabismus patients.
AB  - The trend to outpatient strabismus surgery prompted us to determine the frequency
      of, and the reasons for, postoperative overnight hospital admission following
      such surgery. In one year, 303 outpatient strabotomies were performed at the
      Jules Stein Eye Institute on patients over 15 months old. Twenty-four (7.9%) were
      admitted overnight postoperatively. Compared with controls, those admitted were
      older (37 vs 20.5 years), and had a longer duration of anesthesia (145 vs 116
      minutes) and surgery (104 vs 75 minutes) (P less than .01 for each). The time
      that surgery commenced and the use of perioperative medications were not
      significant factors. The most frequent reasons for overnight admission were
      nausea (38%) despite prophylaxis and the use of bilateral patches (16%). To
      minimize postoperative admissions, better strategies should be developed to
      decrease the frequency of significant postoperative nausea, the duration of
      surgery and anesthesia, and, if possible, the use of bilateral patches.

PMID- 2234801
TI  - Vitreous changes and macular edema in central retinal vein occlusion.
AB  - The condition of the posterior vitreous was determined in 56 eyes with central
      retinal vein occlusion (CRVO). Using a life-table analysis, it was studied in 56
      eyes. The incidence of posterior vitreous detachment (PVD) in the CRVO eyes at
      the first vitreous examination did not differ significantly from that in 64 age
      matched control eyes. However, the incidence of PVD in CRVO eyes increased from
      39.3% at the first vitreous examination to 58.5% after 6 months, and to 69.6% 1
      year from the examination. The incidence of PVD in CRVO eyes during follow-up was
      statistically higher than that of the controls (P = .009). The incidence of PVD
      after the first vitreous examination was significantly higher in eyes with
      hemorrhagic retinopathy than in eyes with venous stasis retinopathy (P = .04). In
      the 34 eyes with macular edema, the edema lasted significantly longer in those
      with vitreomacular attachment (VMA) at the first examination than in those
      without VMA at this time (P = .02). VMA may play an important role in the
      pathogenesis and chronicity of macular edema in CRVO.

PMID- 2234802
TI  - Management of macular puckers associated with retinal angiomas.
AB  - Monocular visual loss in four patients was caused by epiretinal macular membranes
      associated with peripheral retinal capillary angiomas or angioma-like lesions.
      Three patients had solitary vascular lesions and one had two discrete vascular
      lesions. All patients were in good health, with no evidence of the von Hippel
      Lindau syndrome. In three patients, spontaneous peeling of the macular membranes
      and visual improvement occurred 2 to 6 months after obliteration of the angioma
      like lesions with cryotherapy (two patients), or cryotherapy combined with argon
      laser (one patient). The fourth patient underwent a vitrectomy 8 months after the
      macular pucker had failed to respond to treatment of the vascular lesion.

PMID- 2234803
TI  - Pupillary dilatation during cataract surgery--relative efficacy of indomethacin
      and flurbiprofen.
AB  - In a prospective, randomized, double-blind trial, we evaluated the relative
      efficacy of indomethacin and flurbiprofen when used as adjuvants to routinely
      used mydriatics for maintenance of pupillary dilatation in patients with heavily
      pigmented iris undergoing extracapsular cataract extraction. The drugs were
      administered orally as well as topically according to a fixed regimen. The
      pupillary diameters, measured with calipers at various surgical steps, were
      significantly larger at every step in the study groups in which either of the
      adjuvants had been used than they were in the control group (P less than .001).
      Flurbiprofen tended to help maintain a larger pupillary diameter in the later
      stages of surgery than indomethacin, but this difference was not statistically
      significant. We conclude that it is important to use prostaglandin synthetase
      inhibitors as adjuvants to routine mydriatics, and that flurbiprofen may be
      somewhat more effective than indomethacin in this capacity.

PMID- 2234804
TI  - Management of postoperative inflammation: dexamethasone versus flurbiprofen, a
      quantitative study using the new Flare Cell Meter.
AB  - A consecutive, random, prospective study was conducted to compare the effect of
      topical dexamethasone and flurbiprofen drops on postoperative inflammation in
      patients undergoing extracapsular cataract extraction with lens implantation.
      Objective, quantitative measurements were made postoperatively, using the Kowa FC
      1000 Flare Cell Meter. The two treatments were equally effective.

PMID- 2234805
TI  - Retinal toxicity of intravitreal ticarcillin.
AB  - The retinal toxicity of the penicillin derivative, ticarcillin, was tested in
      albino rabbits by injecting the animals intravitreally with doses ranging from 50
      to 3,000 micrograms, and monitoring them for 4 weeks. A second confirmatory study
      was performed by repeating the high-dose injections in a different set of rabbits
      and monitoring them for 3 weeks. Histologic examination and electroretinography
      of both groups showed that dosages up to 3000 micrograms produced no detectable
      damage to the retina. A dosage of 3000 micrograms of ticarcillin, which is 38
      times the minimal inhibitory concentration for Pseudomonas aeruginosa, appears
      safe.

PMID- 2234806
TI  - Evaluation of peribulbar anesthesia in eye camps.
AB  - Modified peribulbar anesthesia was administered with a 26-gauge, half-inch,
      insulin needle to 367 eyes of 360 patients in three eye camps in India. The
      intraocular procedures consisted of cataract extraction in 349 eyes,
      trabeculectomy in 11 eyes, and combined cataract extraction and trabeculectomy in
      seven eyes. The overall success rate of the anesthesia technique was 90.2%
      (supplemental anesthesia was required in 36 eyes). There was good lid and globe
      akinesia and anesthesia, adequate pupillary dilatation for intracapsular cataract
      extraction, and excellent hypotony. No significant local or systemic
      complications were observed, except for mild to moderate chemosis in some eyes,
      which did not produce any intraoperative or postoperative problems. We found this
      technique easy to learn, relatively safe, effective, and well tolerated by our
      patients.

PMID- 2234807
TI  - Experience with photocoagulation in Behcet's disease.
AB  - Between 1973 and 1987 we examined both eyes of 300 patients with the
      uveoretinitis-type lesions characteristic of Behcet's disease. Of the 556 eyes
      whose fundus could be examined, 38 eyes (6.8%) in 33 patients (11%) had developed
      retinal capillary nonperfusion, branch retinal vein occlusion, or retinal or disc
      neovascularization. These eyes were treated by photocoagulation, primarily to
      forestall vitreous hemorrhage and the development of neovascular glaucoma, as
      well as to decrease the macular edema resulting from vein occlusion. The
      treatment, which was well tolerated, was successful in closing retinal capillary
      nonperfusion areas and eliminating retinal neovascularization. Disc
      neovascularization was resolved completely in some cases, and partially in
      others.

PMID- 2234808
TI  - Flexible endoscopy in primary dye testing of the lacrimal system.
AB  - The Olympus PF-22 angioscope was used to examine the inferior meatus during
      primary dye testing in 80 lacrimal systems in 48 patients. Dye testing was done
      bilaterally in 32 subjects with no known abnormalities of lacrimal excretory
      function; it also was performed on the apparently normal contralateral side of 16
      patients with unilateral epiphora. Dye was observed in the nose in 79 of 80
      lacrimal systems (99%). Dye was not observed in one patient, who appeared to have
      a dysfunctional lacrimal excretory system. Primary dye testing of the lacrimal
      system is reliable when the Olympus PF-22 angioscope is used to examine the
      inferior meatus.

PMID- 2234809
TI  - Increase of neuroretinal rim area after surgical intraocular pressure reduction.
AB  - The Optic Nerve Head Analyzer was used to measure the optic disc structure of 18
      eyes (13 adult glaucoma patients) before and after surgical intraocular pressure
      reduction. Neuroretinal rim area markedly increased (from +0.15 mm2 to +0.45 mm2)
      in eight eyes, but changed either very little (less than +/- 0.1 mm2) or not at
      all in the remaining 10 eyes. The mean increase was from 0.75 +/- 0.26 mm2 to
      0.92 +/- 0.36 mm2. The increased neuroretinal rim area found at this time
      remained in all eyes reexamined 1 to 3 years after surgery. Our data support
      previous findings that glaucomatous disc cupping may be reversed even in adult
      eyes, perhaps as the result of adequate pressure reduction.

PMID- 2234811
TI  - Monocanalicular intubation.

PMID- 2234810
TI  - Subconjunctival THC: YAG laser limbal sclerostomy Ab externo in the rabbit.
AB  - A chromium-sensitized, and thulium and holmium-doped YAG laser (THC:YAG laser)
      was used to create bilateral limbal sclerostomies in six Dutch pigmented rabbits.
      The laser is a long-pulsed (300 microseconds) [corrected], compact, self
      contained, solid-state laser operating in the near infrared (2.1 microns). A 1-mm
      conjunctival stab incision was made 12 mm away from the sclerostomy site to allow
      entry of a specially designed 26-gauge (480 microns) optic probe that delivers
      energy at right angles to the long axis of the fiber. Probe insertion minimally
      disturbed the conjunctiva. Pulse energies of 60 to 150 mJ were used with a
      repetition rate of 5 pulses/s. Energy levels ranging from 1.35 to 6.6 J produced
      full-thickness sclerostomies. Histopathology showed a sharply defined perforating
      limbal wound at all energy levels. The overlying conjunctiva was intact, with
      swelling of the adjacent cornea. A peripheral iridectomy was intentionally
      created with the laser through the peripheral limbus, resulting in a sharply
      defined perforating tract through the iris/ciliary body. This technique may
      simplify filtering sclerostomy surgery, without anterior chamber instrumentation
      and with minimal conjunctival trauma.

PMID- 2234812
TI  - Postkeratoplasty suture removal.

PMID- 2234813
TI  - In vivo intraocular lens failure.

PMID- 2234814
TI  - Polypropylene ligatures with Molteno implants.

PMID- 2234815
TI  - Evaluation of visual fields by ophthalmologists and by OCTOSMART program.
AB  - The introduction of Goldmann perimetry standardized measuring conditions as much
      as possible. In spite of this, it had been possible for the perimetrist to
      influence the results of perimeter measurements. The introduction of computer
      controlled perimetry, however, has largely eliminated the influence of the
      investigator on perimetry results. Nevertheless, the interpretation of a
      perimetric result in the everyday clinical situation is still extensively
      subjectively coloured and is liable to vary, depending on the doctor carrying it
      out. The OCTOPUS Program G1 was introduced a few years ago and used above all for
      glaucoma. This program greatly simplified visual field assessment thanks to its
      visual field indices. The indices make it possible to compare visual field
      results with those of a normal population. The present introduction of the
      OCTOSMART program represents a further step forward. This program analyses
      measured visual fields with the aid of standardized, statistical criteria based
      on a large, normal value study. This analysis standardizes and thereby simplifies
      the interpretation of visual field results. This study compares the outcome of
      the OCTOSMART program with visual field interpretations by eye doctors.

PMID- 2234816
TI  - Fluorescein angiography in ciliary body melanomas.
AB  - We retrospectively studied the value of iris fluorescein angiography in
      predicitng benignity or malignancy in 10 cases of ciliary body melanoma with iris
      extension. No correlation between fluorescein-angiographic appearance and
      histopathologic features was observed. Fluorescein angiography adds little to the
      management of ciliary body melanomas with iris extension.

PMID- 2234817
TI  - Argon versus krypton panretinal photocoagulation side effects on the anterior
      segment.
AB  - The modification of corneal sensitivity, accommodation, pupillary diameter and
      endothelial cell density after argon versus krypton panretinal photocoagulation
      were studied prospectively in 88 eyes of 64 diabetic patients with proliferative
      diabetic retinopathy, randomized for one of the two laser treatments. In both
      groups a marked internal ophthalmoplegia and reduction of corneal sensitivity
      occurred after laser photocoagulation. At no time, 2, 90 and 180 days after PRP,
      were these parameters significantly different. Endothelial cell loss was non
      significantly greater in the krypton group. The results indicated that the side
      effects commonly observed on the anterior segment after PRP are comparable using
      argon or krypton lasers.

PMID- 2234818
TI  - Central visual field changes after panretinal photocoagulation in proliferative
      diabetic retinopathy.
AB  - This study comprises 53 eyes, divided into two groups A and B, with proliferative
      diabetic retinopathy which were treated with panretinal photocoagulation (PRP).
      Its purpose is to investigate the alterations in the central 15 degrees and 30
      degrees of the visual field and in each quadrant separately. In both groups A and
      B, PRP covered the periphery and mid-periphery. In group A, it stopped 2 disc
      diameters (DD) from the upper temporal and lower margin of the fovea including
      the papillomacular bundle, while in group B, PRP stopped 3 DD from the upper
      temporal and lower margin of the fovea and 1 DD of the nasal margin of the optic
      disc. The investigation revealed, in group B after PRP, an improvement of the
      retinal sensitivity in the central 15 degrees of the visual field (p less than
      0.01). In the 30 degrees of the visual field a deterioration after PRP was noted
      in both groups A and B, the deterioration being however much more prominent in
      group A. Comparing the results between groups B and A after PRP, a difference in
      the retinal sensitivity in favour of group B at 15 degrees and 30 degrees of the
      visual field was found. As regards regression of neovascularization and visual
      acuity, no statistically significant difference has been observed between the two
      groups.

PMID- 2234819
TI  - Unusual exudative retinal detachment 9 months after scleral buckling surgery.
AB  - A 49-year-old man developed exudative retinal detachment 9 months after
      uncomplicated scleral buckling surgery in the left eye. The subretinal exudates
      were strictly localized along the buckle and showed remarkable response to
      steroid. The cause would be noninfectious inflammation like posterior scleritis,
      triggered by the buckle itself or its associated factors. It is important to note
      that subretinal exudates long after scleral buckling can occur in consequence of
      steroid-responsive inflammation as well as insidious bacterial or fungal
      infection described previously.

PMID- 2234820
TI  - Comparative study of different techniques of intraocular gas tamponade in the
      treatment of retinal detachment due to macular hole.
AB  - The injection of sulfur hexafluoride (SF6) or perfluoropropane (C3F8) was used as
      a method of internal tamponade in 43 eyes affected by retinal detachment due to
      macular hole. The technique of ocular hypotension prior to gas injection varied
      according to the characteristics of each case, using vitrectomy and SF6 30% in 8
      cases (group 1), fluid-gas (SF6) exchange through the pars plana in 10 cases
      (group 2), paracentesis of the anterior chamber prior to injection of SF6 in 12
      cases (group 3) and injection of C3F8 without drainage in 13 cases (group 4).
      Retinal reattachment was initially achieved in 87 (group 1), 83.3 (group 2), 100
      (group 3) and 92.3% (group 4), but 4 recurrences yielded a 6-month follow-up cure
      of 75 (group 1), 75 (group 2), 91 (group 3) and 84% (group 4). Postoperative
      complications included proliferative vitreoretinopathy (7%), endophthalmitis
      (2.3%) and subretinal hemorrhage (2.3%). The use of intraocular gas tamponade
      appears to be a procedure with an acceptable complication rate in the treatment
      of retinal detachment due to macular hole. This study suggests the use of
      paracentesis and SF6 in phakic eyes, C3F8 in aphakic eyes and vitrectomy plus 30%
      SF6 in eyes with proliferative vitreoretinopathy or vitreoretinal traction
      adjacent to the macular hole.

PMID- 2234821
TI  - Visual disturbance in patients with melanocytoma of the optic disk.
AB  - Visual disturbance in 11 patients with melanocytoma of the optic disk was
      analyzed. Goldmann visual field examination showed enlargement of Mariotte's
      blind spot in 7 of 10 patients (70%) and visual field defect or depression in 7
      patients (70%). In 6 of the 7 patients with visual field defect of depression
      (86%), the portion of visual field damage corresponded with the location of the
      tumor and retinal nerve fiber bundle defect. In 1 patient, sudden loss of visual
      acuity occurred, presumably due to anterior ischemic optic neuropathy induced by
      melanocytoma.

PMID- 2234823
TI  - Distance heterophoria and tonic vergence.
AB  - It has previously been suggested that the difference between tonic vergence (TV)
      and distance heterophoria may relate either to proximally induced vergence or
      accommodative divergence. To identify which of these components was responsible
      for this difference, the present study compared TV and distance heterophoria in a
      population of 20 subjects. However, distance heterophoria was now assessed with
      open-loop accommodation. No significant difference was observed between these two
      measures. This suggests that the previously observed variations between TV and
      distance heterophoria (with accommodation closed-loop) were produced by
      accommodative divergence. However, in a subgroup of 7 subjects, measurements of
      TV were more convergent (greater than 2 delta) than the distance heterophoria. In
      these subjects, proximally induced vergence may have accounted for the difference
      in response.

PMID- 2234822
TI  - Retinal sensitivity in acute hypoglycemia.
AB  - We measured retinal threshold sensitivity via automated computerized static
      perimetry in predetermined meridians in euglycemic diabetic subjects and in the
      same subjects during insulin-induced hypoglycemia. During periods of reduced
      blood glucose levels, decreased retinal sensitivity, most marked in temporal
      meridians, was observed.

PMID- 2234824
TI  - Changes in corneal thickness under four different rigid gas permeable contact
      lenses for daily wear.
AB  - The relation between corneal thickness changes and the Dk value of rigid contact
      lenses was investigated in 42 patients who were fitted with contact lenses for
      the first time. These 42 patients were divided into 4 groups that were fitted
      with contact lenses of different Dk values. Corneal thickness in the open-eye
      state was measured (mid-afternoon) before contact lens fitting and after 6 weeks
      of daily contact lens wear. The changes in corneal thickness were not
      significantly different among the 4 contact lens materials (Dk values 8, 26, 54,
      and 92). We conclude that for daily wear use the lower Dk materials meet corneal
      requirements. However, there is a significant trend; the higher Dk values result
      in a thinner cornea. Causes for this phenomenon are discussed.

PMID- 2234825
TI  - Clinician interpersonal communication skills and contact lens wearers'
      motivation, satisfaction, and compliance.
AB  - The relation between the practitioner and patient may have important effects upon
      the safety and success of contact lens wear. In this study we investigated the
      interrelations among clinicians' interpersonal communication skills and patients'
      motivation, satisfaction, and compliance with care and maintenance instructions.
      These variables were measured through questionnaires and interviews. Significant
      associations were found among many aspects of the clinicians' interpersonal
      skills and aspects of the patients' motivation and satisfaction. These findings
      are consistent with those from other health care settings and indicate that the
      quality of the contact lens practitioner's interpersonal skills can substantially
      influence patient outcomes and perceptions.

PMID- 2234827
TI  - A simple method for improving stereopsis.
AB  - Presented here is a method for the improvement of stereopsis. It is based on
      covering and uncovering one eye in a particular way. A complete program for the
      improvement of stereopsis is described. This includes an uncovering technique,
      the use of an Orthofuser, and the observation of specular reflections. Examples
      are given which demonstrate the effectiveness of the method. Persons who are
      capable of stereopsis but who use it selectively or not at all in everyday life
      (paradoxical stereopsis) are particularly easy to cure.

PMID- 2234826
TI  - Soft contact lens-induced longitudinal spherical aberration and its effect on
      contrast sensitivity.
AB  - Some investigators have suggested that the poor quality of vision which some
      spherical, single vision, soft lens-wearing patients report may be a result of
      spherical aberration induced in the ocular system when a soft lens is placed on
      the eye. In this study, the longitudinal spherical aberration of spherical soft
      lenses, both on and off the eye, was calculated using an aspheric corneal model
      and two-dimensional ray tracing program. Specifically designed front-surface
      aspheric, soft lenses were produced which demonstrated levels of in-air power
      variation similar to that calculated for similar-parameter spherically surface
      lenses. The effect of these lenses on the visual performance of nine subjects was
      assessed by measuring changes in contrast sensitivity and high contrast visual
      acuity through 3- and 6-mm artificial pupils. Significant losses of contrast
      sensitivity were recorded for the spherically aberrated lenses with the 6-mm
      pupil but not with the 3-mm pupil. High contrast acuity was not affected by any
      of the aberrated lenses with either the 3- or 6-mm pupils. Theoretical
      calculations and the contrast sensitivity results indicate that negatively
      powered lenses produce significantly less spherical aberration in situ than
      positively powered lenses. Because the majority of the prepresbyopic soft lens
      wearing population have low to moderate amounts of myopia, it would appear that
      soft lens-induced spherical aberration is unlikely to be responsible for the
      reduction in visual performance which some patients report when corrected with
      single vision soft lenses.

PMID- 2234829
TI  - Comparison of two clinical methods for measuring tonic accommodation in children.
AB  - Two methods have been described for measuring tonic accommodation (TA) under
      clinical conditions. One is the near retinoscopy (NEAR) method; the other uses
      Nott retinoscopy as the patient views a low spatial frequency difference of
      Gaussian (DOG) target. The purpose of this study was to compare the TA measures
      made by these two procedures on a group of 6- to 14-year-old children. The data
      indicate that the procedures yield significantly different information.

PMID- 2234828
TI  - Binocular inhibition: psychophysical and electrophysiological evidence.
AB  - Binocular summation, defined as an increase in the binocular response compared
      with the monocular, occurs when the sensitivities of the two eyes are equal. We
      investigated the psychophysical and electrophysiological binocular response to a
      difference in monocular retinal illuminance. Different levels of unequal
      monocular sensitivities were induced by means of neutral density filters placed
      in front of one eye. Both studies produced similar results. In the absence of
      filters, maximum binocular summation was produced. With increasing difference in
      monocular illuminance, the binocular response decreased steadily until it reached
      a level below the monocular. The clinical implications of binocular inhibition, a
      perceptual phenomenon similar to Fechner's Paradox, are discussed.

PMID- 2234830
TI  - Visual neural performance for chromatic displays.
AB  - Various subjective procedures have been used in the past to examine the visual
      disorders and ocular symptoms often associated with prolonged usage of Video
      Display Units (VDU's). We examined visual neural performance for VDU stimuli
      which differed in size (14, 21, or 28 min arc), chromaticity (white, red, green,
      or blue), and retinal clarity, by transient pattern visually evoked potentials (t
      p VEP's). Such information could prove useful in the design of electro-optical
      display systems that optimize visual neural performance and minimize ocular
      fatigue. Stimuli consisted of "monochromatic" (W, R, G, or Blue on black) and
      "multichromatic" (Blue/R, Blue/G, and R/G) checkerboards with brightness-matched
      chromatic elements displayed on a high resolution RGB monitor at 40 and 80 cm.
      The ambient lighting level was 54 lux. Group-averaged amplitudes and implicit
      times of t-p VEP's from 20 visually normal subjects indicated a differential
      neural response across target colors and three experimentally induced levels of
      blur. For monochromatic stimuli, the Blue/Black targets elicited t-p VEP's with
      the lowest amplitude, longest implicit time, and greatest sensitivity to optical
      defocus. Increasing the target element size reduced the VEP sensitivity to
      defocus across all colors except red. For multichromatic targets, Red/Green
      targets elicited the most vulnerable t-p VEP's. Several optical and neural
      explanations are given to explain these results. Implications for VDU designs are
      presented.

PMID- 2234831
TI  - Prevalence of Meibomian gland dysfunction.
AB  - This study was performed to determine the prevalence of Meibomian gland
      dysfunction (MGD) and to determine which patient profile factors might be
      associated with the syndrome. Patients were randomly selected, apparently normal
      patients presenting for routine vision examinations. Of the 398 patients for whom
      Meibomian gland expression was performed and a detailed history obtained, 155
      patients or 38.9% exhibited MGD based on the principal clinical criterion of an
      absent or cloudy Meibomian gland secretion upon expression. Patient profile
      factors of gender, age, allergy occurrence, and contact lens wear were analyzed
      for correlation with MGD. Age was found to be the only significant correlating
      factor (positive correlation, p less than 0.0001).

PMID- 2234832
TI  - Visual acuity assessment from birth to three years using the acuity card
      procedure: cross-sectional and longitudinal samples.
AB  - We used the Teller Acuity Cards (TAC) to test 7 groups of 20 healthy infants and
      children ranging in age from 1 week to 36 months. We also tested 27 of these
      children at least twice within their first year. We had two primary goals: (1) to
      provide normative data on the development of visual acuity as assessed with the
      new version of the TAC (Vistech, Inc.) and (2) to investigate the predictive
      value of the TAC. The results from the cross-sectional samples show that our
      estimates of visual acuity are consistent with those reported by other
      researchers who used earlier versions of the TAC. The longitudinal data indicate
      that, on the average, an early estimate of visual acuity was not predictive of a
      later estimate, at least within the first year. The results are discussed in
      terms of the usefulness of the TAC for testing normal and clinical populations.

PMID- 2234833
TI  - Current methods of treating and preventing myopia.
AB  - In this review, we discuss and compare current methods of treating and preventing
      myopia including radial keratotomy, keratomileusis, keratophakia,
      epikeratoplasty, keratokyphosis, scleral reinforcement, phakoemulsification, and
      heat application. Among the visual training methods are such procedures as
      biofeedback and behavior modification. The use of drugs, orthokeratology,
      spectacles, bifocals, prisms, intraocular lenses, contact lenses, and ultrasound
      are described.

PMID- 2234834
TI  - Observations relating to paradoxical stereopsis.

PMID- 2234835
TI  - A possible reason for the lack of symptoms in aged eyes with low tear stability.

PMID- 2234836
TI  - Toxic ulcerative keratopathy.

PMID- 2234837
TI  - Penetrating keratoplasty in the management of posterior amorphous corneal
      dystrophy.

PMID- 2234838
TI  - More about advertising.

PMID- 2234839
TI  - Paying bounty for patients.

PMID- 2234840
TI  - Argon green (514 nm) versus krypton red (647 nm) modified grid laser
      photocoagulation for diffuse diabetic macular edema.
AB  - Between 1984 and 1988, 225 eyes of 132 patients were entered in a prospective,
      randomized clinical trial to determine if any significant differences exist
      between treatment with argon green (514 nm) and krypton red (647 nm) modified
      grid laser photocoagulation for patients with diffuse diabetic maculopathy with
      or without cystoid macular edema. At the 12- and 24-month follow-up visits, no
      statistically significant difference was found between the two groups with
      respect to all of the following: reduction or elimination of macular edema,
      improvement in visual acuity, worsening of visual acuity, number of treatments
      per eye, and effect on the visual field. At the 12-month follow-up visit, none of
      the following factors statistically affected the visual outcome in either of the
      two groups: a history of systemic hypertension, systemic vascular disease,
      cystoid macular edema, or initial poor visual acuity.

PMID- 2234841
TI  - Intraoperative massive suprachoroidal hemorrhage during pars plana vitrectomy.
AB  - Seven eyes (7 patients) developed massive suprachoroidal hemorrhage (MSCH) during
      pars plana vitrectomy (PPV) for complicated retinal detachments. The MSCH
      developed late in the procedure following PPV, air fluid exchange, endolaser,
      cryopexy, and scleral buckling in five of seven eyes. In two eyes, mild
      hemorrhagic choroidal detachments noted intraoperatively progressed to MSCH
      within 72 hours postoperatively. Diagnosis of MSCH was confirmed by echography
      and CT scan. Multiple scleral buckling surgeries, high myopia, aphakia, and
      intraocular inflammation were the main risk factors. Placement of a broad
      posterior scleral buckle with intraoperative hypotony and cryopexy were important
      precipitating factors. Visual results were poor, with six of seven eyes showing
      no light perception. The mean follow-up time was 12.8 months. Once acute MSCH is
      recognized intraoperatively, surgical decompression at that time should be
      avoided as MSCH itself may tamponade the choroidal bleed. Details of prevention
      and management are discussed.

PMID- 2234842
TI  - Autosomal dominant neovascular inflammatory vitreoretinopathy.
AB  - Twenty-eight of 61 members of a six-generation family are affected by an
      autosomal dominant eye disease which has not been described previously. Affected
      patients are asymptomatic in early adulthood, but have vitreous cells and the
      selective loss of the b-wave on the electroretinogram. Later, peripheral retinal
      scarring and pigmentation, peripheral arteriolar closure, and neovascularization
      of the peripheral retina at the ora serrata or occasionally neovascularization of
      the optic disc develop. Cystoid macular edema, vitreous hemorrhage, tractional
      retinal detachment, and neovascular glaucoma can cause profound visual loss.
      Vitrectomy reduces traction on the retina and allows for retinal reattachment.
      The role of argon laser photocoagulation or cryopexy in reducing the neovascular
      complications remains uncertain.

PMID- 2234843
TI  - HLA associations and ancestry in Vogt-Koyanagi-Harada disease and sympathetic
      ophthalmia.
AB  - A strong association with HLA antigens DR4, DRw53, and Bw54 has previously been
      reported among Japanese patients with Vogt-Koyanagi-Harada disease (VKH) and
      sympathetic ophthalmia (SO). In the United States, no firm association between
      HLA-A or -B loci and VKH has been found previously; testing for HLA-DR loci has
      not been performed to date. The authors performed HLA typing of 23 American
      patients with VKH and 8 patients with SO. When VKH patients were compared with
      racially matched controls without disease and patients with other types of
      uveitis, strong associations with HLA-DR4 and HLA-DRw53 were found. The strongest
      associations observed in this sample were with HLA-DQw3, an antigen which is in
      positive linkage disequilibrium with DR4, and with the HLA-DR4/DQw3 haplotype.
      The small number of patients with SO precluded statistical analysis; however,
      similar HLA associations were noted. The patients also were questioned regarding
      their ancestry. The anecdotal association of VKH with American Indian ancestry
      was confirmed. It appears that the ethnoracial association may be explained by
      HLA type. One possible explanation for identical HLA associations in two diseases
      with different precipitating events yet similar ocular manifestations is
      development of an altered immune response to exogenous microbial antigen with
      subsequent autoimmunity. Further definition of the genetic susceptibility to VKH
      and SO may help define the pathophysiology of both diseases and allow the
      prediction of which patients are at increased risk for SO.

PMID- 2234844
TI  - The epidemiology of ophthalmic malignancies in New York State.
AB  - The epidemiologic characteristics of more than 1400 primary eye cancers (ICD-9,
      site 190) diagnosed among New York State (NYS) residents between 1975 and 1986
      are described. Among NYS male residents, the average annual age-adjusted
      incidence rate was 7.5 per 1,000,000, and among NYS female residents, the rate
      was 5.4 per 1,000,000 (male:female rate ratio, 1.39). The majority of ophthalmic
      malignancies were included within three histologic groupings: melanomas (70.4%),
      retinoblastomas (9.8%), and squamous cell carcinomas (9.2%). The average annual
      incidence of retinoblastoma among persons in NYS who were less than 5 years of
      age was 9.5 per 1,000,000 for boys and 8.7 per 1,000,000 for girls (male:female
      rate ratio, 1.09). The average annual incidence (age-adjusted) of ocular
      melanomas was 4.9 per 1,000,000 among men and 3.7 per 1,000,000 among women in
      NYS (male:female rate ratio, 1.32). Expanded knowledge of the epidemiology of
      ophthalmic cancers can help to develop a foundation on which to monitor disease
      patterns and can serve to stimulate further etiologic research involving these
      rare malignancies.

PMID- 2234845
TI  - Acquired retinal arteriovenous communications in occlusive disease of the carotid
      artery.
AB  - Retinal arteriovenous communications proximal to extensive areas of complete
      vascular closure developed in three patients with occlusive disease of the
      carotid arteries. In one case, the authors document the development of the
      arteriovenous communications through successive enlargement of small retinal
      vessels after progressive signs of retinal ischemia in the form of narrowed
      retinal arteries, venous dilation and beading, microaneurysms, retinal dot and
      blot hemorrhages, cotton-wool spots, and capillary nonperfusion. The development
      of arteriovenous communications in carotid occlusive disease has not been
      described previously.

PMID- 2234846
TI  - Serum and aqueous humor sialic acid levels in Behcet's disease.
AB  - Serum and aqueous humor sialic acid (SA) levels were determined in 27 patients
      with Behcet's disease (Bd). Serum SA levels were elevated significantly during
      the active episode (mean, 113.4 +/- 4.12 mg/dl) and in the remission stages
      (mean, 85.4 +/- 4.79 mg/dl; P less than 0.001). A significant increase was also
      detected in active episodes when compared to chronic stages (P less than 0.02).
      Aqueous humor levels were also evaluated but could only be determined in the six
      eyes at the end-stage of the disease (mean, 2.65 +/- 0.60 mg/dl; P less than
      0.05).

PMID- 2234847
TI  - Clinical spectrum of leber's congenital amaurosis in the second to fourth decades
      of life.
AB  - Leber's congenital amaurosis is a type of congenital retinitis pigmentosa in
      which the fundus abnormalities are extremely variable and to some extent age
      dependent. Most cases are seen in infancy. The retinal, electroretinogram, and
      fluorescein angiographic findings are described in ten patients with Leber's
      congenital amaurosis who ranged in age from 13 to 36 years when first seen. All
      of the patients were from Honduras and were unrelated except for one pair (a
      brother and sister). The polymorphic appearance of the fundus is emphasized and
      is particularly striking in the siblings. A macular lesion (a bull's-eye
      maculopathy) not previously associated with Leber's congenital amaurosis is
      reported as a variant fundus appearance in this entity.

PMID- 2234848
TI  - Early magnetic resonance imaging in acute traumatic internuclear ophthalmoplegia.
AB  - Adduction deficiency following acute head trauma may result not only from orbital
      damage but also from internuclear ophthalmoplegia, and in most instances this
      resolves over weeks to months. To date, noninvasive imaging studies during the
      acute phase following injury have not been definitive in localizing the
      pathology. Three cases of adduction deficiency following head trauma that were
      caused by internuclear ophthalmoplegia are reported. A lesion in the brain stem
      was found in all three cases by magnetic resonance imaging in the subacute post
      traumatic period. These lesions were not visible on routine x-ray computed
      tomography obtained at the time of injury.

PMID- 2234849
TI  - Signs distinguishing spasmus nutans (with and without central nervous system
      lesions) from infantile nystagmus.
AB  - Clinical findings as well as eye and head movement recordings were analyzed from
      23 patients with spasmus nutans without central nervous system (CNS) changes, 10
      patients with spasmus nutans-like disease (head nodding, intermittent nystagmus
      associated with intracranial anomalies or visual pathway disorders), and 25
      patients with infantile nystagmus. Ten diagnostic signs were established to
      differentiate between the patient groups. Although they were helpful in
      separating patients with infantile nystagmus from those with spasmus nutans, no
      difference was found between the patients with spasmus nutans with and without
      CNS lesions. This study indicates that eye and head movement recordings do not
      allow differentiation between benign spasmus nutans and spasmus nutans-like
      disease. The differentiation must be made on the basis of neuroimaging.

PMID- 2234850
TI  - Late juvenile-onset Krabbe's disease.
AB  - Krabbe's disease is an autosomal recessive leukodystrophy characterized by a lack
      of galactocerebroside beta-galactosidase activity. In contrast to the classic
      early infantile-onset form of Krabbe's disease, less recognized, late-onset
      variants exist. The authors present a case of late juvenile-onset Krabbe's
      disease, including the associated magnetic resonance imaging (MRI) findings. Most
      patients with late-onset Krabbe's disease present with visual loss due to optic
      atrophy. Associated gait abnormalities and parental consanguinity should increase
      the clinician's suspicion that a child may have late-onset Krabbe's disease.
      Because of the prolonged survival in late-onset Krabbe's disease, the recent
      development of bone marrow transplantation for these patient makes diagnosis of
      this disorder particularly important.

PMID- 2234851
TI  - Crystalline cataract and uncombable hair. Ultrastructural and biochemical
      findings.
AB  - A 7-year-old girl was found to have a progressive axial crystalline cataract
      located in the embryonal, fetal, and infantile nucleus. She also had the unknown
      association of crystalline cataract with uncombable hair. Samples of the aspirate
      after extracapsular cataract extraction (ECCE) showed elongated, trigonal
      crystals on scanning electron microscopy. On transmission electron microscopy,
      the crystals were surrounded by a membrane sometimes consisting of up to 30
      concentric layers. The crystals were found to contain carbon, oxygen, nitrogen,
      sulfur, and disulfide bonds. The findings suggest that a major constituent of the
      crystals was a sulfur-containing aminoacid, probably cystine. Protein analysis of
      the remaining lens material showed elevated alpha-, beta 2-, and gamma 2-
      crystallin levels. Analysis of the hair root status showed hair loss in the
      resting phase of the hair cycle with abnormal sheathing in most hairs that were
      in the growth phase.

PMID- 2234852
TI  - Bilateral keloid-like myofibroblastic proliferations of the cornea in children.
AB  - Two 6-month-old white boys developed localized multifocal white nodules of the
      anterior corneal stroma without evidence of antecedent trauma, inflammatory
      disease, or familial occurrence. The first patient had bilateral lesions
      initially; the second patient initially had unilateral involvement followed by a
      corneal nodule in the second eye at 11 years of age. Light and electron
      microscopic studies of the lesions in both patients were similar and disclosed
      stromal nodules composed of proliferating myofibroblasts, activated fibroblasts,
      and haphazardly arranged fascicles of collagen. Immunohistochemical studies
      revealed that the spindle cells within the nodules expressed immunoreactivity for
      vimentin and alpha-smooth muscle actin. Management options for these slowly
      progressive corneal lesions include lamellar versus penetrating keratoplasty and
      topical corticosteroids.

PMID- 2234853
TI  - Macular dystrophy of the cornea. A systemic disorder of keratan sulfate
      metabolism.
AB  - The serum of most patients with type 1 macular corneal dystrophy (MCD), the most
      prevalent subtype, lacks detectable antigenic keratan sulfate (KS), and it has
      been postulated that such individuals may lack antigenic KS in their cartilage as
      well. To test this hypothesis, we studied the cornea, serum, and nasal cartilage
      from an MCD patient using light and electron microscopy, immunohistochemistry,
      and a quantitative enzyme-linked immunosorbent assay (ELISA) which uses a
      monoclonal antibody against a sulfated epitope on the KS chain to measure KS
      content. Histologically, corneal deposits seen were characteristic of MCD. No
      abnormal deposits were noted in the cartilage. The lack of immunoreactivity in
      corneal sections with antibodies against sulfated epitope on KS and the absence
      of this epitope in serum showed that the patient had type 1 MCD. The cartilage
      specimen showed no immunoreactivity in the chondrocytes or extracellular matrix.
      Quantitative analysis by ELISA demonstrated that the antigenic KS content of the
      cornea and cartilage was at least 800 times lower than that in normal controls.
      This provided direct evidence that the abnormality in the sulfation of keratan in
      type 1 MCD involves the cornea and cartilage.

PMID- 2234855
TI  - Glaucomatous optic nerve atrophy in small discs with low cup-to-disc ratios.
AB  - Glaucomatous optic nerve damage has generally been associated with high cup-to
      disc ratios. Fifteen eyes of nine patients with increased intraocular pressure
      and glaucomatous visual field loss but low cup-to-disc ratios are reported. The
      optic disc area was significantly (P less than 0.01) smaller than in 429 normal
      subjects and 556 glaucoma patients with high cup-to-disc ratios. Parapapillary
      chorioretinal atrophy was significantly larger and retinal nerve fiber bundles
      were significantly less visible than in the normal group. The latter two
      parameters were not significantly different in the glaucoma groups with low and
      high cup-to-disc ratios when the groups were matched for mean perimetric loss.
      The authors conclude that in eyes with small optic discs, glaucomatous optic
      nerve damage may be indicated more sensitively by parapapillary changes than by
      cup-to-disc ratios. Glaucomatous eyes with small optic nerve heads can have
      misleadingly low cup-to-disc ratios.

PMID- 2234854
TI  - Delivery of fluorescein to the anterior chamber using the corneal collagen
      shield.
AB  - Collagen corneal shields show promise as an alternative method of drug delivery
      to the eye. The authors quantified collagen shield delivery of sodium fluorescein
      to the aqueous humor in human volunteers using fluorophotometry. Collagen shields
      that had been immersed in 0.01% sodium fluorescein were applied to eyes of human
      volunteers. The shields delivered significantly more fluorescein to the aqueous
      humor at 2 and 4 hours compared with drops of the same concentration instilled
      every 30 minutes for 4 hours (P less than 0.0001 and P = 0.0003, respectively) or
      daily wear soft contact lenses presoaked in 0.01% fluorescein (P less than 0.0001
      and P less than 0.0025, respectively). Collagen shields did not induce damage to
      the corneal epithelium over a 2-hour wearing period. These results suggest that
      the collagen shield may be superior to topical drops in delivering water-soluble
      compounds to the cornea and aqueous humor.

PMID- 2234857
TI  - Epikeratoplasty. American Academy of Ophthalmology.

PMID- 2234858
TI  - Contrast sensitivity and glare testing in the evaluation of anterior segment
      disease. American Academy of Ophthalmology.

PMID- 2234856
TI  - Cellular reactions on heparin surface-modified versus regular PMMA lenses during
      the first postoperative month. A double-masked and randomized study using
      specular microphotography.
AB  - Specular microscopy was used for investigation of cellular reactions on the
      intraocular lens (IOL) anterior surface of Heparin surface-modified (HSM) versus
      regular polymethylmethacrylate (PMMA) lenses (Pharmacia types 700C versus 700B,
      respectively). The double-masked randomized study included 53 patients
      investigated at 1 and 4 weeks postoperatively. Giant cells were only found on
      control lenses and more frequently at 4 weeks. Small cells were found on both
      lens types, but in a higher frequency on the control lenses. The number of small
      cells decreased during the first 4 weeks on both the control and HSM lenses.
      However, those control lenses that had giant cells on their surface showed an
      increase in the number of small cells during the same time. The results of the
      current study show that HSM lenses give rise to less postoperative inflammatory
      cellular reactions than regular PMMA lenses.

PMID- 2234859
TI  - The freeze-drying of Cowdria ruminantium.
AB  - Lyophilized tissues of mice and blood of sheep, infected with either the Kumm,
      the Welgevonden or the Ball 3 stock of Cowdria ruminantium, remain infective to
      mice and sheep after storage at 4 degree C for 90 days. Freeze-dried tissues
      stored at -18 degrees C and -28 degrees C are still infective after 6 months and
      2 years, respectively.

PMID- 2234860
TI  - Concurrent babesiosis and ehrlichiosis in the dog: blood smear examination
      supplemented by the indirect fluorescent antibody test, using Cowdria ruminantium
      as antigen.
AB  - Giemsa-stained, peripheral blood smears of 67 dogs, showing clinical signs
      typical of babesiosis or reminiscent of concurrent babesiosis and ehrlichiosis,
      were examined for the presence of Babesia canis and Ehrlichia canis. Since
      Cowdria ruminantium cross-reacts with Ehrlichia, the sera of these dogs were also
      subjected to the indirect fluorescent antibody (IFA) test in which C. ruminantium
      was used as antigen. Fifty-five per cent of these dogs had mixed infections of B.
      canis and E. canis, as judged by blood smear examination and serology. The serum
      of 32% of these dogs with mixed infections reacted positively in the IFA test.
      Six out of 9 dogs, the blood smears of which were negative for both B. canis and
      E. canis, were serologically positive for E. canis. Furthermore, sero-conversion
      from a negative in the initial serum sample to titres of up to 1:160 in a
      subsequent sample was recorded in 9 out of 13 dogs with suspected mixed infection
      on blood smear.

PMID- 2234861
TI  - A comparison of haemodynamic and vasoconstrictory responses in sheep with a toxic
      fraction from Pachystigma pygmaeum and with the plant material.
AB  - ST-segment changes in the ECG, which are an indication of acute myocardial
      ischaemia, are obtained when a small quantity of an extract from dried
      Pachystigma pygmaeum is injected intravenously in sheep. When the fraction was
      injected subcutaneously, animals reached a crisis after about 5 h, with low
      values of stroke volumes and high values for pulmonary arterial pressures,
      pulmonary vascular resistances and heart rates. The haemodynamic changes are an
      indication of the development of pump failure of the heart. In sheep, injected
      subcutaneously with the toxic fraction, as well as for sheep dosed with plant
      material through rumen fistula, increased serum levels for thromboxane and
      increased or decreased levels for prostacycline were observed. The experimental
      results are interpreted as being an indication that these prostaglandines may be
      involved in the development of gousiekte by impeding cardiopulmonary function as
      a result of coronary and pulmonary vasoconstriction. The sudden death observed in
      some gousiekte sheep may be due to myocardial ischaemia and associated
      arrhythmias.

PMID- 2234862
TI  - The detection and isolation of a paralysis toxin present in Argas (Persicargas)
      walkerae.
AB  - One-day-old leghorn chickens were used in a laboratory assay to determine the
      toxicity of crude extracts of the tick Argas (Persicargas) walkerae and of
      fractions obtained during the isolation procedure. Extracts of unfed and engorged
      larvae, nymphae and females were tested using this in vivo test system. Only
      extracts of replete A. (P.) walkerae larvae produced paralysis. A toxic fraction
      was isolated from replete larval extracts by gel-permeation and ion-exchange
      chromatography. This fraction with a pI of 4,5, showed 2 major bands
      corresponding to a Mr of 32 kDa and 60 kDa after SDS-polyacrylamide gel
      electrophoresis.

PMID- 2234863
TI  - Parasites of South African wildlife. V. A. description of the males of
      Oesophagostomum mocambiquei Ortlepp, 1964 from warthogs, Phacochoerus aethiopicus
      (Pallas, 1766).
AB  - Oesophagostomum mocambiquei Ortlepp, 1964 was described from 9 females recovered
      from a warthog, Phacochoerus aethiopicus (Pallas, 1766), from northern
      Mozambique. Large numbers of O. mocambiquei were recovered during subsequent
      surveys of the parasites of warthogs from the Kruger National Park and the
      Hoedspruit Nature Reserve. The males, which have not yet been described, resemble
      those of Oesophagostomum santosdiasi Ortlepp, 1964 in the principal measurements.
      They can, however, be differentiated by the shape of the mouth capsule, which is
      round in O. mocambiquei and oval in O. santosdiasi. A simplified key for the
      identification of the Oesophagostomum species that occur in warthogs in South
      Africa and Namibia is provided and the differences between them tabulated. The
      names Oesophagostomum mocambiquei and Oesophagostomum santos-diasi are corrected
      to O. mocambiquei and O. santosdiasi respectively, since diacritic marks are not
      allowed under the Code of International Zoological Nomenclature.

PMID- 2234864
TI  - Salmonella isolated from feeds and feed ingredients during the period 1982-1988:
      animal and public health implications.
AB  - The prevalence of Salmonella in southern Africa in farm feeds and by-products of
      animal origin during 1982-1988 was determined. Salmonella occurred in 5.18% of
      the farm feed samples and in 9.54% of the by-product samples. Different serovars
      were isolated, some only once. The findings underestimate the true prevalence of
      Salmonella in farm feeds and by-products, and is representative of only the most
      severely contaminated products. The epidemiology of salmonellosis is discussed
      with special reference to the importance of multiple resistance to antibiotics,
      the increase in the number of cases of salmonellosis worldwide and "Salmonella
      free" feeds and foods. More detailed research on the role of farm feeds in the
      epidemiology of salmonellosis is required. Efforts should be made to increase
      awareness of the problem, to improve quality management at farm feed production
      plants and to develop efficient systems to monitor the hygienic safety of feeds
      and foods.

PMID- 2234865
TI  - Heat stress in dairy cattle under southern African conditions. II. Identification
      of areas of potential heat stress during summer by means of observed true and
      predicted temperature-humidity index values.
AB  - November-March are the hottest months of the year with the highest monthly mean
      "temperature-humidity index" (THI) in South Africa and Namibia. These 5 months
      are associated with severe heat stress in dairy cattle, are of critical
      importance for their performance and may have great economic implications for the
      owner as well as for the dairy industry. Firstly, compared with the existing
      Livestock Weather Safety index (LWSI), more relevant meteorological data can be
      generated when mapping South Africa and Namibia according to the LWSI modified
      for lactating dairy cattle (LDC). Secondly, compared with the observed true THI
      values alone, more relevant data on heat stress and its deleterious effects on
      dairy cattle performance, become available when mapping South Africa and Namibia
      according to the combined observed true and predicted THI values. Minimum
      precautions against heat stress in dairy cattle are recommended depending on THI
      values as classified by the LWSI for LDC.

PMID- 2234866
TI  - A survey of annoyance of livestock by Simulium chutteri Lewis along the Orange
      River, South Africa (Diptera: Simuliidae).
AB  - A survey by means of questionnaires was conducted along the Orange River to
      determine the extent of blackfly annoyance to livestock during 1984-1988. Severe
      annoyance reached peaks during September-November and increased over the years.
      Annoyance levels decreased with distance from the river with occasional severe
      annoyance as far away as 76 km. Annoyance levels increased with distance
      downstream from the P. K. le Roux dam to Augrabies (750 km). Greater water
      releases for increased irrigation and electricity generation may be an important
      reason for the higher annoyance levels. Present day high and increasing
      irrigation water requirements and the great length of the river probably render
      control by water level fluctuations impractical. Loss of condition of especially
      small livestock is the main consequence of annoyance by female blackflies.
      Decreased percentage lambing and occasional deaths were also reported.

PMID- 2234867
TI  - The use of filter paper discs impregnated with thionin acetate, basic fuchsin and
      thionin blue in the identification of Brucella species.
AB  - Filter paper discs impregnated with solutions containing 0.25, 0.5 and 1
      mg/milliliter of thionin acetate, 0.75 and 1.5 mg/milliliter of basic fuchsin and
      0.5 mg/milliliter of thionin blue were used in the typing of Brucella species.
      All the strains used reacted as expected, proving this new technique to be
      reliable in the identification of Brucella species. The method is less expensive
      and the results easier to interpret than those obtained with methods previously
      used.

PMID- 2234868
TI  - Epizootology of wildebeest-derived malignant catarrhal fever: possible
      transmission among cows and their calves in the north-western Transvaal.
AB  - The investigation involved 52 cases of wildebeest-derived malignant catarrhal
      fever in 1986 and 1989 in a herd of cattle kept in camps adjacent to a game farm
      harbouring a herd of approximately 330 blue wildebeest (Connochaetes taurinus).
      In the outbreaks, 34 cows and 18 calves died as result of the disease. The
      exceptionally high incidence of the disease in both cows and their calves, the
      low incidence in calves of unaffected cows, the relatively short period between
      the death of cows and their calves as well as the occurrence of the disease in 2
      calves born after their mothers had been moved away from wildebeest, are
      indicative of transmission among cows and calves. The death of at least 6 calves
      within 6 weeks of birth is ascribed to intra-uterine infection while some calves
      that survived longer may have acquired the infection from other cattle or from
      wildebeest.

PMID- 2234869
TI  - An attempt to improve the immunization of sheep against heart-water by using
      different combinations of 3 stocks of Cowdria ruminantium.
AB  - Neither sheep immune to the Ball 3, the Kwanyanga or the Mara stocks of Cowdria
      ruminantium nor those immunized with combinations of these 3 stocks were
      protected against challenge with the Mali stock. Against challenge with the
      Welgevonden stock, however, immunization with each of the 3 combinations and with
      single stocks effected a protective immunity.

PMID- 2234870
TI  - An efficient medium for the isolation of Trichomonas foetus.
AB  - Trials were conducted to compare a modification of a commercial medium with the 2
      media currently used at the Veterinary Research Institute, Onderstepoort, for the
      isolation of Trichomonas foetus. An antifungal agent was also added to the
      medium. Results obtained proved the modified medium to be more reliable for the
      isolation of T. foetus than the other 2, and the addition of antifungal more
      efficient in the control of contaminants.

PMID- 2234871
TI  - Introducing the 'walk-up' flap.
AB  - Reconstructive oral and maxillofacial surgeons often find the need for additional
      soft tissue even when a myocutaneous flap has been previously placed. This
      article introduces the principles, technique, and results of 32 "walk-up" muscle
      flaps derived from existing myocutaneous flaps. The anastomotic vascular ingrowth
      at the original myocutaneous flap's distal end permits its proximal detachment
      and axial vessel ligation to rotate the proximal two thirds to a tissue-deficient
      site. In our experience at the University of Miami, these flaps have been
      predictable (97% viable transfer rate), have provided vascular soft tissue in
      deficient areas, and have been skin grafted at their surface to increase oral
      lining or skin cover, among several other uses.

PMID- 2234872
TI  - Cephalometric analysis of long-term airway space changes with maxillary
      osteotomies.
AB  - The cephalometric radiographs of 13 patients without sleep apnea who had
      undergone isolated maxillary surgery were studied. The authors found increases in
      both the nasopharyngeal and hypopharyngeal airway spaces 3 to 5 years after
      surgery. The results suggest that adaptive processes occur in both the upper and
      lower jaw, which contribute to an enlarged airway after surgery.

PMID- 2234873
TI  - Psoriatic arthropathy of the temporomandibular joint.
AB  - A case of psoriatic arthritis of both temporomandibular joints is described with
      a brief review of the literature and discussion on the management of this
      condition. To date, psoriatic arthritis has been successfully treated by
      conservative means. In the case reported, surgical replacement of the condyles
      became necessary to eliminate pain and restore function.

PMID- 2234874
TI  - A study of the comparative efficacy of four common analgesics in the control of
      postsurgical dental pain.
AB  - Four common oral analgesics were tested in a single-blind trial to determine
      their relative efficacy in the management of postsurgical pain in 103 patients
      who had their impacted third molars surgically removed under general anesthesia.
      The analgesics tested were acetylsalicylic acid (26 patients), ibuprofen (26
      patients), a paracetamol/codeine/caffeine combination (Solpadeine) (25 patients),
      and dihydrocodeine (26 patients). The paracetamol/codeine/caffeine combination,
      ibuprofen, and acetylsalicylic acid preparations produced equally effective
      analgesia. Dihydrocodeine was found to be a poor analgesic in this pain model.
      There were no adverse reactions to any of the preparations.

PMID- 2234875
TI  - Histologic evaluation of the width of soft tissue necrosis adjacent to carbon
      dioxide laser incisions.
AB  - This study evaluated the width of tissue necrosis lateral to carbon dioxide laser
      incisions on human intraoral excisional biopsy specimens. Measurements were made
      on specimens including epithelium, muscle, dense and loose connective tissue, and
      salivary gland. Results showed a mean width of tissue necrosis of 86 microns in
      epithelium, 85 microns in muscle, 51 microns in loose connective tissue, 96
      microns in dense connective tissue, and 41 microns in salivary gland. The range
      of thermal necrosis in different tissue types is probably based on the water
      content within each type. A cellular partially homogenized zone of reversible
      thermal damage up to 500 microns in width was visible adjacent to the zone of
      thermal necrosis. The relatively narrow width of tissue necrosis with this
      technique may account for the claimed superior properties of laser-induced wounds
      compared with those created by electrosurgery.

PMID- 2234876
TI  - Unilateral mydriasis caused by transdermal scopolamine.
AB  - Contamination of the eye after handling of a transdermal scopolamine patch may
      cause accidental mydriasis. A simple office test is discussed to identify this
      pharmacologic blockade and thereby avoid an extensive neurologic workup.

PMID- 2234877
TI  - Autogenous transplantation of impacted maxillary canines.

PMID- 2234878
TI  - Propolis allergy: a cause of oral mucositis with ulceration.
AB  - Propolis has been used since ancient times in folk medicine for its alleged
      beneficial effects. It is a potent sensitizer and is well recognized as a cause
      of occupational allergic eczematous contact dermatitis in apiarists. Recently,
      there has been an increase in allergic eczematous contact dermatitis because of
      nonoccupational exposure to propolis in "natural products" and biocosmetics. This
      report describes a patient who had acute oral mucositis with ulceration as a
      result of using propolis-containing lozenges.

PMID- 2234879
TI  - Multiple myeloma and bullous lichenoid lesions: an unusual association.
AB  - Many associations of lichenoid reactions have been described but this case
      appears to be a previously unreported association--with multiple myeloma. This
      case also demonstrates the necessity of a mucosal biopsy with adequate
      hematologic and serologic investigations to obtain a definitive diagnosis.

PMID- 2234880
TI  - Nitrendipine-induced gingival hyperplasia. First case report.
AB  - Drug-induced gingival hyperplasia is well documented within the literature. It
      has been associated with phenytoin, cyclosporine, and calcium channel blocking
      agents. Nitrendipine is an experimental calcium channel blocking agent that also
      appears to cause the side effect of drug-induced gingival hyperplasia. The
      clinical and histologic presentation of this side effect and possible biochemical
      mechanisms of pathogenesis are discussed.

PMID- 2234881
TI  - Thermally induced 'nicotine' stomatitis. A case report.
AB  - A palatal lesion resembling "nicotine" stomatitis was found in a woman who did
      not smoke. However, the patient frequently drank extremely hot beverages. After
      she was instructed to reduce the temperature of the beverages, the lesion almost
      completely resolved. This suggests that heat was the primary cause of this lesion
      and also implicates heat as the major cause of nicotine stomatitis.

PMID- 2234882
TI  - The cellular composition of basal cell adenoma of the parotid gland: an
      immunohistochemical analysis.
AB  - Four cases of basal cell adenoma of the parotid gland were examined
      immunohistochemically to characterize their cellular composition. In all cases
      epithelial membrane antigen and keratin were detected in the inner luminal cells;
      some cells also showed positive staining for secretory functional markers,
      indicating their differentiation toward secretory epithelium. In tubular and
      trabecular types the outer cells consistently displayed an intense staining for
      vimentin and some were also positive for actin, indicating their myoepithelial
      nature. In the solid type, most tumor cells resembled the ductal cells or basal
      cells of larger ducts in normal gland with regard to their immunoreactivity. Our
      results may suggest that the proportion and arrangement of heterogeneous tumor
      cells are responsible for different histologic patterns of the salivary basal
      cell adenoma.

PMID- 2234883
TI  - Primary malignant melanoma in the parotid gland.
AB  - Reports of primary malignant melanoma arising from the parotid salivary gland are
      extremely rare and, to date, have been sporadic. We report a pertinent case, and
      tabulate and correlate the clinical findings of the 13 cases reported thus far in
      the literature. The most common symptom is a progressively enlarging,
      asymptomatic, firm, and fixed mass. Total excision has been the established
      treatment of choice. The contribution of radiotherapy, chemotherapy, and
      immunotherapy remains unclear, and it is not possible at present to predict the
      outcome of treatment in individual patients. Although rare, primary malignant
      melanoma should be considered in the differential diagnosis of parotid tumors.
      The clinical significance of establishing the diagnosis of primary malignant
      melanoma of the parotid gland is emphasized.

PMID- 2234884
TI  - Oral histoplasmosis as a presenting disease in acquired immunodeficiency
      syndrome.
AB  - A 43-year-old homosexual man visited his dentist with painful, nodular, ulcerated
      lesions on the soft palate, right buccal mucosa, and right posterior maxillary
      gingiva. Serologic studies for exposure to human immunodeficiency virus,
      performed before biopsy, were positive. Biopsy of the maxillary gingiva
      demonstrated sheets of histiocytes containing small intracellular yeasts, which
      on culture were identified as Histoplasma capsulatum. Bilateral leukoplakic
      lesions with some vertical furrowing involving the lateral borders of the tongue
      were also noted. Histologically, hyperkeratosis and fungal hyphae were
      identified. The patient was treated for histoplasmosis with amphotericin B, which
      resulted in significant improvement of the oral lesions. He was subsequently
      hospitalized for fatigue and dyspnea and was found to have Pneumocystis carinii
      pneumonia. Pulmonary status deteriorated within a 3-week period, and the patient
      died. Autopsy findings were negative for histoplasmosis but positive for
      necrotizing and cavitary P. carinii pneumonia, pulmonary and hepatic herpes
      simplex infections, and pulmonary and intestinal cytomegalovirus infection.

PMID- 2234885
TI  - An SEM investigation of the mesiolingual canal in human maxillary first and
      second molars.
AB  - The mesiolingual orifices of 21 maxillary first molars and 37 maxillary second
      molars were examined with the scanning electron microscope. The mesiobuccal roots
      of these teeth were also typed by means of a clearing technique. The results
      demonstrated that 90% of first molars and 70% of second molars had two canals in
      the mesiobuccal root. Type 3 canal systems occurred in 33% of first molars and
      35% of second molars. Eighty-one percent of first molars and 59% of second molars
      had a separate mesiolingual canal orifice. The mean diameter of the mesiolingual
      orifice was 0.49 mm in first molars and 0.42 mm in second molars. The mean
      distance of the mesiolingual orifice from the mesiobuccal orifice was 2.31 mm in
      first molars and 2.06 mm in second molars. In type 3 roots, the average distance
      of the mesiolingual foramen to the anatomic apex was 2.0 mm for first molars and
      1.45 mm for second molars.

PMID- 2234886
TI  - Replantation: an analysis of 29 teeth.
AB  - The results of replantation of 29 teeth are described. Maxillary incisors
      constituted 85% of 27 permanent teeth. The period between avulsion and
      replantation ranged from within an hour to 86 days, but the actual extraoral
      period was within 5 hours in all but one case. Nineteen of the 27 permanent teeth
      were functioning for 7 months to 6 years and 7 months postoperatively. Root
      resorption was the cause of tooth loss in five cases. The incidence of root
      resorption seemed to increase with the increase of the extraoral period, but it
      was not affected by the period between avulsion and replantation, the condition
      of supporting tissues, the degree of root formation, and the type and period of
      splinting, indicating multiple factors involved in determining the prognosis of
      replanted teeth. In conclusion, every effort should be made to preserve avulsed
      teeth even in unfavorable conditions.

PMID- 2234887
TI  - Apical closure of mature molar roots with the use of calcium hydroxide.
AB  - Calcium hydroxide may induce apical root closure in affected mature teeth as well
      as in immature teeth. Once an apical hard tissue barrier is formed, a permanent
      root canal filling can be safely condensed. Two cases are described in which
      calcium hydroxide induced apical root closure in mature molar teeth where the
      apical constriction was lost because of chronic inflammatory process.

PMID- 2234888
TI  - Quantitative evaluation of digital dental radiograph imaging systems.
AB  - Two digital imaging systems, a video camera and analog-to-digital converter, and
      a charge-coupled device linear photodiode array slide scanner, were tested for
      their suitability in quantitative studies of periodontal disease. The information
      content in the original films was estimated, and digital systems were assessed
      according to these requirements. Radiometric and geometric performance criteria
      for the digital systems were estimated from measurements and observations. The
      scanner-based image acquisition (digitization) system had no detectable noise and
      had a modulation transfer function curve superior to that of the video-based
      system. The scanner-based system was equivalent to the video-based system in
      recording radiographic film densities and had more geometric distortion than the
      video-based system. The comparison demonstrated the superiority of the charge
      coupled device linear array system for the quantification of periodontal disease
      extent and activity.

PMID- 2234890
TI  - Unusually placed molars.

PMID- 2234889
TI  - Cross-sectional radiography for implant site assessment.
AB  - An accurate tomographic technique is described for acquisition of optimal cross
      sectional images of implant sites before implant surgery. The described technique
      is applicable to tomographic systems equipped with a cephalometric head
      positioner. This cross-sectional tomographic technique was performed on a series
      of patients and the images of the first 20 patients subsequently evaluated. The
      cross-sectional images allowed for the characterization of the alveolar crest and
      visualization of anatomic structures in a buccolingual dimension while providing
      an accurate estimation of available vertical space from the crest.

PMID- 2234891
TI  - Butterfly artifact in the oral cavity.

PMID- 2234893
TI  - Unusual calcareous bridge.

PMID- 2234894
TI  - Absence of all permanent second molars.

PMID- 2234892
TI  - Disturbance in lip sensation.

PMID- 2234895
TI  - Antrolith.

PMID- 2234896
TI  - Rupture of a mucous retention cyst.

PMID- 2234897
TI  - Reissner's membrane in aging, Meniere's disease, and profound sensorineural
      deafness.
AB  - The characteristics of Reissner's membrane from 47 human cochleae with mild
      endolymphatic hydrops, profound sensorineural deafness and normal ears were
      studied by light microscopy. The highest cell densities were observed in the
      zones adjacent to the limbus spiralis and the stria vascularis. The cell density
      of Reissner's in normal ears decreased with age concomitant with an increased
      formation of epithelial cell clusters. In hydrops, the density increased with the
      exception of the apical turn. However, sporadic loss of the cells in isolated
      areas of the membrane was observed. The ears with profound deafness showed no
      significant changes compared with age-related controls. No definite relationship
      between Reissner's cell density and hair cell loss or strial atrophy was
      observed.

PMID- 2234898
TI  - Relationship between results of electrocochleography and caloric test in
      Meniere's disease.
AB  - The relationship between an increase in the negative summating potential (-SP)
      and the results of caloric tests was examined in 35 patients with unilateral
      Meniere's disease. The -SP was recorded by extratympanic electrocochleography.
      The quantitative bithermal caloric test was performed by irrigating with cool (30
      degrees C) and hot (44 degrees C) water. An increased -SP was recorded in 20 of
      35 patients (57%). Abnormal unilateral weakness (UW) on the involved side and
      abnormal directional preponderance (DP) to the involved side were observed in 16
      of 35 (46%) and in 4 of 35 patients (11%), respectively. No significant
      correlation was found between an increased -SP and an abnormal UW and DP in
      Meniere's disease.

PMID- 2234899
TI  - Effect of mechanical trauma on the stapedial footplate after stapedectomy. A
      scanning electron microscopic study.
AB  - The possible occurrence of inner-ear trauma linked to stapedectomy was studied by
      scanning electron microscopy of the medial (or labyrinthine) side of human
      stapedial footplates after performing a hole with different instruments. The
      anatomic variations induced experimentally by the different procedures are
      presented in detail and discussed. Manual instruments were shown to induce
      irregularities on the rim of the hole, whilst the utilization of either electric
      or pneumatic drills produced more regular margins. Finally, laser-produced holes
      were also examined. Rather neat rims were observed, but the thermal effect
      produced by this device has to be considered the major parameter involved in a
      possible inner-ear postoperative trauma.

PMID- 2234900
TI  - Tympanic neurectomy: its effects on the seromucinous glands of the middle ear of
      cats.
AB  - The effect of tympanic neurectomy on the seromucinous glands of the middle ear
      was evaluated experimentally in cats. The operation suppressed the secretory
      activity of the glands and induced their atrophy, and glandular suppression was
      still evident 1 year postoperatively. This work points to the possibility of
      employing tympanic neurectomy in the treatment of refractory cases of otitis
      media with effusion. The operation is easy to perform, and, theoretically, it
      should allow drainage of the effusion and inspection of the ossicles. However,
      neurectomy should be carried out as completely as possible in order to achieve
      optimum and long-lasting effects.

PMID- 2234901
TI  - Cisplatin reduces epidermal growth factor receptors in squamous-cell carcinoma in
      vitro. Preliminary results.
AB  - A radioreceptor assay was used to determine the number and affinity of epidermal
      growth factor (EGF) receptors in a human squamous carcinoma cell line of the
      larynx (HLac 79) after exposure to cisplatin (DDP). Cells exposed to high
      concentrations of cisplatin showed about 30% fewer receptors compared to
      untreated and low-dose-treated cells. This reduction in the number of receptors
      might be responsible for the decreased growth when stimulated by EGF. Cisplatin
      appears to lower the concentration of EGF receptors on carcinoma cells, which
      might result in additional antiproliferative activity especially in carcinomas
      with high EGF receptor expression.

PMID- 2234902
TI  - Laryngoplasty with vascularized and non-vascularized auricular mucochondral
      grafts. An experimental study in rabbits.
AB  - A composite graft from the rabbit ear, consisting of cartilage, perichondrium and
      oral mucosa, was transposed to reconstruct a defect in the thyroid cartilage of
      the larynx in 10 rabbits. Five grafts were transposed as an island on an intact
      neurovascular pedicle; the other 5 were performed as a free graft without
      vascularization. After 9 weeks all the rabbits with a vascularized cartilaginous
      graft survived, with no sign of respiratory distress. The internal lining of the
      newly formed larynx was composed of undifferentiated stratified squamous cell
      epithelium. The survival of an intact cartilage and mucosa prevented a serious
      scar reaction in the neo-larynx and maintained the patency of the restored lumen.
      In the rabbits with non-vascularized cartilaginous grafts, there was necrosis
      present within the mucosal grafts, with intensive formation of granulation tissue
      in the transplanted region and retraction of the lumen. The present study
      highlights the importance of using well-vascularized composite cartilaginous
      grafts in laryngeal reconstruction. The possibility of utilizing a vascularized
      cartilaginous graft in man is discussed.

PMID- 2234903
TI  - Nasal mucociliary clearance in patients with nasal polyposis.
AB  - We have studied 30 patients (13 males and 17 females) with nasal polyposis,
      measuring the nasal mucociliary clearance using the saccharin test. The results
      have been compared with those obtained in a control group of 20 healthy subjects.
      The values obtained in the group with nasal polyposis (mean +/- SD = 31.7 +/-
      13.4 min) were significantly higher than those of the healthy subjects (mean +/-
      SD = 12 +/- 6 min; p less than 0.002). These results suggest that there is a
      significant decrease in the nasal mucociliary clearance of patients with nasal
      polyposis.

PMID- 2234904
TI  - Laryngeal carcinoma showing multidirectional epithelial neuroendocrine and
      sarcomatous differentiation.

PMID- 2234905
TI  - Wegener's granulomatosis with otological disorders as primary symptoms.
AB  - Otological symptoms as initial manifestations of Wegener's granulomatosis have
      been observed in 3 patients. In one of them, symptoms consisted of a bilateral
      sensorineural hearing loss, improved by corticoid therapy. No other organ system
      was involved and laboratory tests remained within normal limits for 2 years after
      the onset of otological signs. In the other 2 patients, Wegener's granulomatosis
      manifested mainly as serous otitis media. Otologic involvement underscores the
      role of the otolaryngologist in the early diagnosis and treatment of this
      disease.

PMID- 2234906
TI  - Fluctuating hearing loss in lipoma of the cerebellopontine angle.
AB  - Two cases of lipoma of the cerebellopontine angle are presented. Both of them
      showed fluctuating hearing loss, and one case exhibited Meniere-like symptoms. In
      one of the cases, continued clinical surveillance is considered in view of a high
      chance of postoperative morbidity.

PMID- 2234907
TI  - [Effect of extra- and intra-cranial vascular anastomosis on regional blood flow,
      studied by SPECT using 99m-Tc HMPAO].
AB  - Thirty-two patients suffering from occlusive cerebrovascular disease were
      investigated by means of 99mTc-HMPAO brain SPECT before and one month after EC-IC
      bypass operation. The regional cerebral blood flow was unchanged postoperatively
      in 19 patients, increased in 7 cases, and deteriorated in 6 patients. One patient
      died in the postoperative period and in another no follow-up SPECT could be
      performed. It is concluded that the regional cerebral blood flow, even in the
      absence of a morphological deficit on CT, was not improved by the operation in
      the majority of cases.

PMID- 2234908
TI  - [Correlations between cardiorespiratory reflex impairment and distal neuropathy
      in diabetics free of clinical symptoms of autonomic neuropathy].
AB  - Signs of autonomic cardiac neuropathy and its association with distal symmetrical
      polyneuropathy were investigated in adult diabetic patients free from clinical
      symptoms of autonomic neuropathy. Cardiorespiratory reflexes were assessed by non
      invasive tests (deep-breathing, Valsalva manoeuvre and lying-to-standing)
      evaluating parasympathetic function of cardiac innervation. Measurement of motor
      nerve conduction velocity in both peroneal nerves and neurological physical
      examination were carried out for assessment of distal somatic neuropathy. Among
      64 diabetics, definitive signs of cardiac autonomic neuropathy were found in 28
      patients (44%), early signs of cardiac autonomic neuropathy were observed in 19
      patients (30%) while no alterations were documented in 17 patients (26%). The
      values of motor nerve conduction velocity in peroneal nerves (41.8 +/- 0.7 m/s)
      were significantly (p less than 0.01) lower in patients with definitive cardiac
      autonomic neuropathy (n = 28) than those (45.8 +/- 1.1 m/s) of patients without
      any signs of cardiac autonomic neuropathy (n = 17). These latter values were,
      however, significantly (p less than 0.001) lower than those (53.7 +/- 0.7 m/s) of
      control subjects (n = 50). Abnormal results of non-invasive tests for autonomic
      neuropathy, i.e. alterations of cardiorespiratory reflexes indicating
      parasympathetic impairment in cardiac innervation could be often found in
      diabetics without clinical signs of autonomic neuropathy. These alterations could
      be frequently observed in diabetics with distal symmetrical neuropathy as well as
      in diabetic patients with one or more late specific complications.

PMID- 2234909
TI  - [Normalization of ECG after right ventricular infarct].
AB  - 6-month ECG follow-up was carried out in 65 patients with right ventricular
      infarction accompanied by anterior (n = 17) and inferior (n = 48) left
      ventricular necrosis. QRS morphology and ST segment alterations were evaluated in
      the period of rehabilitation and 6 months later. By the end of the 6th month QRS
      in V3-4R returned to normal in 12 patients (18%) and there was no ST elevation in
      none case by this time. Normalization of QRS in V3-4R was about the same in the
      two groups and it was independent from the age of patients.

PMID- 2234912
TI  - [In memory of Janos Ambro--on the centenary of his death].

PMID- 2234910
TI  - [Imported food poisoning caused by fish toxins (ciguatoxin)].
AB  - Various types of fish-poisoning mainly occur in tropical areas. Saxitoxin,
      tetrodotoxin, scombrotoxin and clupeotoxin are heat labile while ciguatoxin, in
      contrast, is heat stable thus it may be the source of severe poisoning even in
      case of thorough cooking and baking. In December 1987 a mass alimentary poisoning
      occurred following ingestion of fish meat in a group returning from Cuba. The
      most severe case was admitted to our department with symptoms of extended
      paresis. Diagnosis of ciguatoxin poisoning was established based upon the
      history, clinical features and laboratory results. Nowadays exotic, remote "Fish
      poisoning" cases have to be taken into consideration even in our country.

PMID- 2234911
TI  - [Primary choriocarcinoma of the lung simulating tuberculosis].
AB  - The authors report the case of a young female patient in whose lung they found a
      hollow, infiltrating lesion characteristic of tuberculosis which was removed by
      operation. Histologically, the lesion proved to be choriocarcinoma. Elsewhere
      tumour could not be detected.

PMID- 2234913
TI  - [Physician-agronomist or agronomist-physician: Janos Karoly L ubeck (1776-1814)].

PMID- 2234914
TI  - [Perinatal serum lead levels].

PMID- 2234915
TI  - [Joint involvement in septic salmonellosis].

PMID- 2234916
TI  - [The practice of genetic counseling].
AB  - The most important practical application of medical genetics is the genetic
      counselling. It is based on the specific burden of potential offspring which
      involves severity and treatibility of expected disorder, possibility of prenatal
      diagnosis, risk, etc. The separation of specific and random burdens is also very
      important. In Hungary a new counselling method entitled "information guidance
      counselling" was introduced which means an intermediate position between
      directive and nondirective counselling because of the expectation of family
      planners.

PMID- 2234917
TI  - [Causes and management of local tumor recurrence after low resection of the
      rectum].
AB  - The postoperative course of 64 patients resected with EEA stapler because of
      their midrectal cancer have been followed. 13 (20.3%) local tumor recurrence have
      been observed in the first 24 postoperative months. 5 patients could be rectum
      exstirpated at the reexploration, only colostomy was performed in 8 cases. All
      the inoperabel patients have died in a year, but 3 of the exstirpated ones
      overlived this time. A direct connection have been observed between the Dukes
      stadium and the differentiation of the tumor, the distance of the distal
      resection line from the lower end of the tumor and the probability of the local
      recurrence. No connection has been found between the distance of the tumor from
      the linea dentata and the local tumor recurrence. On the basis of the oncological
      observations the deep rectal resection can be performed only by tumors in stadium
      Dukes A and B, if the tumor is well differentiated, there are no signs for local
      propagation or lymph node metastases, and more then 2 cm distal distance can be
      kept by the resection from the lower and of the tumor. In all other cases the
      rectum exstirpation must be the method of choice.

PMID- 2234919
TI  - [Melanoma screening in Debrecen].
AB  - Melanoma screening examination has been organized in Debrecen. The aid of it is
      the early detection and treatment of melanoma. Different methods (educational
      pamphlet, postgradual training of GP's, TV, radio) help the work of
      dermatologists.

PMID- 2234918
TI  - [Subglottic laryngitis treated with corticosteroid inhalation].
AB  - On basis of examinations the authors established that in case of a mild
      pseudocroup syndrome the inhalation of beclomethasone in itself, in more severe
      cases combined with racem epinephrine has a favourable effect; it shortens the
      period of symptoms, and effectively reduces the progress of laryngitis with
      resting dyspnoe. In 15 cases out of 18 patients treated without local steroids,
      airway stenosis increased, while in patients getting inhalative steroids only 15
      cases out of 29 worsend. In practice the use of beclomethasone makes possible the
      home treatment in mild cases of pseudocroup. It must be considered, however, that
      one hour is needed while its effect develops. The progress of laryngitis can be
      stopped by inhalative corticosteroids, but in most severe cases they must be
      combined with racem epinephrine.

PMID- 2234920
TI  - [Gentamycin concentration in the milk of a mother after treatment by implantation
      of a Septopal chain].
AB  - The author implanted 90 beads of Septopal into the osteomyelitic femur of a wet
      mother. The excretion of gentamycin in the mother's milk was continuously
      examined. The investigations revealed that the excretion of gentamycin with the
      mother's milk was so minimal that it did not signify any risk for the newborn
      baby.

PMID- 2234921
TI  - [Solitary ulcus recti simplex].

PMID- 2234922
TI  - [Abuses in alternative medicine].

PMID- 2234923
TI  - [Angiologic aspects of surgery of the extremities in diabetics].

PMID- 2234924
TI  - [Teratogenic effects of the workplace on pregnant women].

PMID- 2234925
TI  - [Surgical treatment of stomach cancer with extended removal of lymph nodes].
AB  - The authors evaluate the results of extensive lymph node dissection for gastric
      cancer at 50 patients. It has been found that the lymph node dissection did not
      increase the risk of operation. The mortality rate was 2%. The average number of
      removed and histologically examined lymph nodes was 26. The extensive lymph node
      dissection and the accurate histology provided opportunity for precise staging.
      Their first evaluation of survival showed an encouraging improvement of prognosis
      regard to that of patients survival treated by traditional surgical method.
      Besides it they reviewed the classification of Japanese Research Society for
      Gastric Cancer for the lymph drainage of the stomach and the surgical technique
      of the lymph node dissection.

PMID- 2234927
TI  - [Management of intussusception in infancy by hydrostatic desinvagination under
      ultrasonic monitoring].
AB  - The ultrasonographic diagnosis of intussusception may be a recent complementation
      of X-ray fluoroscopy controlled hydrostatic desinvagination. Ultrasound is also
      useful in follow-up of the effectiveness of conservative management. By
      presenting their experience gathered by successful treatment of one case, the
      authors' aim is to contribute to the spread of this method.

PMID- 2234926
TI  - [Early calcipenic osteopathy in the panoramic x-ray image of the maxillary and
      mandibular alveolar process of young adult alcoholics].
AB  - The authors have examined 220 maxillary and mandibular panoramic roentgenograms
      of 55-55, all 110, between 21-34 years of age alcohol addict males and females
      with a complete dentitions and intact parodontium. In 19 per cent of patients
      developed osteoporomalacia, cystic rarefications and multiple pathologic
      microfractures of the alveolar spongy bone tissues. The calcipenic osteopathia
      was verified by the routine laboratory disorders of calcium and phosphor
      metabolisms, besides by the diminution of roentgenmorphometrical index of right
      2nd metacarpus and tibia. The osteoporomalacia of alveolar parts preceded
      calcipenic osteopathia of all bones in 52 per cent of patients. A quantity of 25
      50 g alcohol consumed daily would be resulting the calcipenic osteopathia after 3
      5 years. Its development may be due to individual praedisposition influenced by
      nutritional, hormonal, genetic and hepatopancreatic factors.

PMID- 2234929
TI  - [The status of public health in Hungary 100 years ago].

PMID- 2234928
TI  - [Remembering Pal Bugat. "Every human thought yearns to be realized"].

PMID- 2234930
TI  - [Bohumil Eiselt--the Czech Markusovszky].

PMID- 2234931
TI  - [Contraceptive pills and congenital abnormalities].

PMID- 2234933
TI  - [Preoperative diagnosis of breast tumors in our clinic].
AB  - Between 1983 and 1988 197 patients underwent mammography and fine needle
      aspiration cytology procedure beside physical examination before operation for
      breast tumor in our clinic. The sensitivity of mammography and fine needle
      aspiration cytology were 81.9 and 66.1%, their specificities were 91.2 and 95%,
      the specificity of physical examination was 97.7%. When all three examinations
      indicated malignancy, this was confirmed by histology without exception. When the
      examinations showed benign lesion in concert, four of the 26 diagnoses were
      false, histology proved breast cancer smaller than 2 centimetres in diameter
      without lymph node metastases in each case. Those aspirations which were
      considered unsatisfactory because of the lack of cells supported the diagnosis of
      a benign tumor raised by physical examination and mammography. Our data indicate
      that the diagnosis yielded by the combination of the three examinations may
      support therapy more than it does in the present.

PMID- 2234932
TI  - [Surgical management of corrosive lesions of the esophagus].

PMID- 2234935
TI  - [Plasma fibronectin level in thyroid disease].
AB  - Fibronectins are widespread components of connective tissues and their production
      is partly under hormonal control. A study was undertaken to reveal the influence
      of thyroid diseases on plasma fibronectin level. It is stated that compared with
      a euthyroid control group (n = 33; 436 +/- 82 micrograms/ml) plasma fibronectin
      content is significantly higher in untreated, overt hyperthyroidism (n = 27; 1036
      +/- 389 micrograms/ml), while its plasma level is lower in hypothyroidism (n =
      18; 230 +/- 123 micrograms/ml). Data hint to the possibility that the measurement
      of plasma fibronectin level may yield a help to assess the effect of thyroid
      hormones at target organ (connective tissue) level.

PMID- 2234934
TI  - [Fetal diagnosis of Edwards syndrome].
AB  - Eight cases of Edward's syndrome were found prenatally by cytogenetical analysis
      of 1680 pregnant women. It has been estimated that after Down's syndrome
      Edwards's syndrome is the most frequently encountered chromosomal abnormality.
      This syndrome is associated with high rate of anomalies detectable by ultrasound
      (e.g. omphalocele, polyhydramnion, growth retardation). Here it is discussed in
      relation with sonographical findings related to Edwards's syndrome and
      representing clear indications for chromosomal analysis. The authors call
      attention to the importance of the diagnosis of Edward's syndrome at each
      gestational age.

PMID- 2234937
TI  - [Indications for ultrasonography in abdominal injuries, based on a 5-year case
      load].
AB  - The authors performed during 5 years 2620 emergency ultrasonographies of 34,873
      ultrasonographic examinations. In 640 cases the examinations were carried out
      with injured patients. The results were positive in 46 cases. The distribution of
      positive cases are presented and certain cases are described. On the basis of
      literary data and their own experiences the authors summarize the advantages and
      indications of ultrasonography and deal briefly with the order of sequence of
      image-forming diagnostics emphasizing the primary role of ultrasonography. It is
      stressed that with the joint evaluation of the clinical picture and
      ultrasonography no other intervention was required with 16 patients than a close
      observation whereas acute surgery had to be performed with 17 patients.

PMID- 2234936
TI  - [Recombinant human erythropoietin in the therapy of anemia in hemodialyzed
      patients].
AB  - The authors reported on a three month long EPREX (human recombinant
      erythropoietin) therapy of 5 hemodialysis patients for the treatment of their
      anemia. The drug was administered in bolus form 2 or 3 times a week after
      dialysis in a dose of 50 to 150 IU/bodyweight increased gradually in every (or
      every second) week. Hgb ad Htk values were determined once a week while
      erythrocyte, leukocyte, thrombocyte and reticulocyte count once a month. Serum
      iron, TIBC, serum ferritin, BUN, serum creatinine, urea, serum ions, liver
      function assays, serum lipids and amylase were also established. Hgb, Htk levels
      and reticulocyte count have significantly increased in the 4th week of treatment
      already, severe anemia ceased with improved appetite, general condition and
      physical strength. Serum urea and LDH levels significantly increased while SGOT
      decreased. No significant change in leukocyte and thrombocyte count, serum Na, K,
      Ca, P, Cl, BUN, creatinine, total protein level, serum albumin, bilirubin,
      alkaline phosphatase, GGT, GPT, amylase and blood sugar as well as serum lipid
      level were observed. No adverse reactions occurred during the treatment. After
      the three gradually decreased and within 6 weeks they had to be transfused again.
      In three patients the need for transfusion has significantly grown after the
      treatment. The authors consider EPREX a highly efficient drug in the treatment of
      anemia in dialysis patients.

PMID- 2234938
TI  - [Epidemiologic study of primary liver cancer in Vas County].
AB  - The incidence of primary liver carcinoma in the last twelve years was
      investigated retrospectively in the county Vas. A continuously increasing tumor
      frequency was found, by the end of the period the value had doubled. The
      phenomenon attained nearly exclusively the male population while no change could
      be seen in females. For further clarification comparative investigations into the
      association between chronic HBV infection and chronic alcohol abuse as well and
      hepatic carcinoma were performed. Changes in these factors cannot fully explain
      the gross increase in hepatic tumor incidence, the effect of other risk factors
      has to be suspected.

PMID- 2234939
TI  - [Quality assurance in clinical laboratory diagnosis].
AB  - Both the internal and the external quality controls are necessary to achieve
      reliable and comparable laboratory tests. The internal quality control includes
      preanalytical, analytical and postanalytical checking of factors to eliminate all
      interferences of laboratory tests. The use of reliable methods which result in a
      good accuracy and precision, however, can provide results which are not
      comparable to the results of other laboratories. The role of the external quality
      control is to check differences between the laboratories and to make the results
      as comparable as possible. The accuracy and precision of Hungarian laboratories
      improved during the past decade which can be attributed to the better technical
      conditions, on the one hand, and to the regular internal and external quality
      control, on the other hand. An increasing number of the small laboratories,
      mostly in the service of general practitioners, are unable to perform the same
      quality of laboratory tests as that of the central laboratories, since their
      technical conditions are old-fashioned and inadequate to use up-to-date methods.
      The urgency of improvement in technical condition of small laboratories is
      obvious from both professional and economical reasons.

PMID- 2234940
TI  - [Leukocyte migration inhibition test in celiac disease].
AB  - The leukocyte migration inhibition test is a method used to assess the cell
      mediated immune function. The authors examined 251 samples for a period of 3
      years; 169 samples from celiac patients and 82 were control. The sensitivity of
      this test was 34/35 (97%) in proved gluten sensitive patients, but this was found
      after repeating the test at different periods of time. According to these results
      the authors conclude that the efficacy of this test is less sensitive in the
      newly diagnosed celiac patients, which means that it is not suitable for
      screening purpose, but useful for detecting gliadin sensitivity during the
      diagnostic period of celiac disease (e. i. the 3 biopsies). LMT may be used to
      indicate the proper time for the 2nd and/or 3rd biopsy, and can also be used to
      reveal the gluten-free diet defaults. The authors agree with those who believe
      that this test cannot substitute the performance of the small intestinal biopsy.

PMID- 2234941
TI  - [The significance of hypocitruria in calcium oxalate induced nephrolithiasis].
AB  - The citrate concentration of the daily collected urine was measured by citrate
      lyase method in 25 untreated patients with recurrent calcium stone disease (10
      hypercalciuric and 15 normocalciuric) and in 11 patients with stone disease
      treated with hydrochlorothiazide and in 16 healthy controls. We found a great
      variancy of the results what rather looks like biological than methodic type. The
      concentration (1.99 +/- 1.33 mmol/l in normocalciuric and 2.77 +/- 1.62 in
      hypercalciuric stone formers but 5.06 +/- 2.81 in controls) and the daily output
      of the urinary citrate (2.74 +/- 1.38 mmol/d and 4.24 +/- 1.69 vs. 4.41 +/- 1.85)
      but not the citrate/creatinine ratio was significantly less in about the half of
      stone formers. The hypocitraturia was frequent in the normocalciuric and very
      rare in the hypercalciuric group of the renal stone patients. Measurement of the
      urine citrate concentration is more sensitive tool in the diagnosis of
      hypocitraturic state than daily citrate output while the latter is more
      characteristic for the patient, so common study of the two parameters is
      recommended.

PMID- 2234942
TI  - [Early results of balloon catheter dilatation in ilio-femoral-popliteal arterial
      occlusion].
AB  - Since 1981 intraoperative balloon dilatation has been performed in 78 patients
      suffering from occlusive arterial disease of the lower extremities. In 34
      patients the proximal iliac stenosis was dilated (common iliac artery: 15 and
      external iliac artery: 27) in association with a femoro-popliteal reconstruction.
      In 44 patients, the femoro-popliteal segment distal to an ilio-femoral
      reconstruction was dilated. In the early postoperative period (0-30 days) there
      was no reocclusion in the group of proximal dilation. In the other group, where
      the out-flow tract was dilated, in one case femoral amputation, while in another
      patient reoperation was necessary because of early reocclusion. The combining
      intraoperative balloon dilatation with surgical reconstruction may decrease the
      risk, and simplify the management of patients with multiple vascular lesions and
      it is valuable adjunct to vascular surgery to improve inflow or outflow.

PMID- 2234943
TI  - [Liver tumors caused by androgenic steroids].
AB  - 11 hepatocellular tumours associated with the long term use of androgenic
      steroids were reported. Three of the tumours were seen on the basis of diffuse
      peliosis hepatis. One of the 11 tumours was benign hepatocellular adenoma. In one
      case malignant transformation of an adenoma was observed. Nine tumours proved to
      be highly differentiated hepatocellular carcinomas. Metastases were observed in
      three cases. Histological and electron microscopical peculiarities of the tumours
      were the accumulation of glycogen in the cytoplasm of tumour cells, nuclear
      inclusions, and great number of peculiar formed vessels. The last case is a
      rarity. One year after the needle biopsy implantation of hepatocellular carcinoma
      was observed with several tumorous metastases at the site of the previous biopsy.
      The authors suggest regular hepatic control by ultrasound examinations of
      patients on sexual steroid hormones.

PMID- 2234945
TI  - [What innovations does the recent change in the nursing legislation cause?].

PMID- 2234944
TI  - [T gamma-lymphoproliferative disease].
AB  - The case of a rare type of T-cell malignant lymphomas, clinically with a
      relatively favorable course, a T gamma-lymphoproliferative disease (T gamma-cell
      chronic lymphocytic leukaemia) was presented. The cytomorphological,
      cytochemical, immuncytochemical and cytogenetical markers and functional tests of
      the peripheral blood lymphocytes from the patient were tested. The leukaemic
      cells with light- and electron microscopy showed the so called LGL (large
      granular lymphocyte) morphology with multifocal reactions of acid hydrolase
      enzymes. These cells also expressed IgG-Fc-receptor, CD 8 monoclonal antibody
      positivity and a monoclonally rearranged T-cell receptor gen expression.
      Functionally the patient's lymphocytes developed a blastic response to the T-cell
      mitogen Concanavalin A (ConA), they suppressed the immunoglobulin production of B
      lymphocytes in co-cultures and had a normal NK-activity but decreased ADCC
      values. The patient was diagnosed by blood, bone marrow and lymph node
      examination and does not need any therapy. This case was published because of
      it's diagnostic, immunological and prognostical interests.

PMID- 2234946
TI  - [Education in nursing--formation of the personality].

PMID- 2234947
TI  - [From custodian in a mental hospital to psychiatric nurse. A new profession is
      introduced].

PMID- 2234948
TI  - [Nursing care of patients with stroke].

PMID- 2234949
TI  - [5 years of Austrian AIDS assistance. AIDS knows no differences, no boundaries].

PMID- 2234950
TI  - [New ways for better understanding between family and nursing personnel].

PMID- 2234951
TI  - [Report on the inquiry on personnel procurement in Austrian health facilities].

PMID- 2234953
TI  - [15 years of toxoplasmosis surveillance of pregnant women in Austria. An
      exemplary results in the prevention of neonatal infection].

PMID- 2234952
TI  - [Chlamydia--only the name is beautiful].

PMID- 2234954
TI  - [Health care of tomorrow: synergies instead of hopelessness].

PMID- 2234955
TI  - [The Graz pediatric nursing school makes contact with Marburg nursing high school
      students].

PMID- 2234956
TI  - [Pelvic tilt and leg length discrepancy].
AB  - Pelvic obliquity caused by leg length discrepancy is a problem facing patients
      with a wide variety of conditions. It is the degree of discrepancy and the growth
      pattern of the legs that usually govern treatment decisions, with the cause of
      the discrepancy having little influence. We analyzed the results recorded in 345
      patients with pelvic obliquity caused by leg length inequality operated on
      between 1969 and 1989. In 146 patients a shortening procedure was done and in 199
      patients a lengthening procedure. Biological bone growth stimulation did not
      prove to be predictable and effective in 65 cases. In 134 patients and 138
      segments a distraction procedure was performed. In 26 segments the technique was
      according to Wagner; in 37 cases the Ilizarov fixator was used and in 75 the
      Orthofix device. Excellent results were obtained in 65% and good results in 23%;
      the condition became worse in 12%. Analysis of the results justifies the use of
      epiphysiodesis, shortening osteotomies and bone lengthening according to the
      biological principles investigated by Ilizarov in the presence of well-defined
      indications outlined in this report. Patients with a discrepancy of up to 2-3 cm
      are treated conservatively by shoe lift. For patients with a leg length
      inequality of 3-5 cm, epiphysiodesis or shortening osteotomy is still a good
      indication although lengthening procedures can also be performed. Discrepancies
      between 5 and 15 cm are treated mainly by lengthening operations. New lengthening
      techniques such as corticotomy and callus distraction, as well as new external
      fixation systems like Orthofix and Ilizarov, have made bone lengthening a less
      risky, easier, and more effective procedure. In a growing child, careful clinical
      and radiological assessment and repeated analysis of past growth in order to
      predict future growth can provide an exact plan for effective treatment, which
      often consists of bone lengthening, combined with shortening procedures on the
      contralateral side to establish leg length equality even in cases when there is
      20 cm difference. Surgical treatment can be especially gratifying when
      anatomical, cosmetic and functional symmetry is restored and a lifetime of shoe
      lifts, braces or prostheses can be avoided.

PMID- 2234958
TI  - [Pelvic tilt and leg length correction].
AB  - Pelvic tilt is often the consequence of a discrepancy in leg length and can be
      corrected either with orthotic devices or by operative equalization of the leg
      length. However, pelvic tilt can also occur independently of the leg length in
      cases of asymmetry of the pelvis, malposition of the hip joint or contracted
      scoliotic deviation of the spine. In such cases with complex deformities
      correction of the pelvic tilt should aim a balanced body posture rather than
      necessarily a symmetric level of the iliac crests.

PMID- 2234957
TI  - [Lower leg lengthening using the Ilizarov system. Presentation of the various
      surgical techniques and analysis of lower leg lengthening procedures performed
      1986-1989].
AB  - The technique of lengthening the tibia with the Ilisarov device is explained.
      Different variations (bifocal or simultaneous) of the method are demonstrated, as
      well as the results of 53 cases of tibia lengthening in 37 patients of our
      hospital between 1986 and 1989. In 14 patients, a second operative procedure was
      necessary during treatment. In no case was internal fixation or grafting
      necessary. The Ilisarov ring fixator is very efficient, especially in major
      lengthening procedures and for simultaneous correction of deformities.

PMID- 2234959
TI  - [Pelvic abnormalities affecting the statics of the vertebral column].
AB  - Of all the bony anomalies of the pelvis, unilateral developmental disturbances of
      the body of the iliac bone and the lateral parts of the os sacrum mainly affect
      the statics of the vertebral column. After a short description of the normal
      development of the os coxae and os sacrum, an attempt is made to systematize
      these anomalies and explain them from a developmental point of view. This is
      achieved by studying anatomical specimens and clinical cases. Primary
      disturbances concerning the growing of the cartilaginous epiphysis itself or
      secondary disturbances, which result from unilateral muscular palsy, can be
      responsible for retarded development of the body of the iliac bone. Unilateral
      dysplasia of the lateral part of the os sacrum could be based on disturbances of
      the precartilage. This is also thought to be the reason for asymmetrical
      formations of so-called transitional vertebrae.

PMID- 2234960
TI  - [Transiliac leg lengthening: experiences with a modified Salter osteotomy].
AB  - Transiliac limb lengthening osteotomy is a modified Salter innominate osteotomy
      which uses a trapezoidal interposition bone graft instead of the usual triangular
      graft to achieve up to 3 cm of intrapelvic lengthening. It allows correction of
      certain forms of postural imbalance and pelvic obliquity, as well as allowing an
      optimal and variable amount of acetabular redirection. This review of 105
      patients who have undergone the procedure at our institution revealed the
      following indications: decompensated scoliosis, 26 patients; acetabular dysplasia
      with ipsilateral femoral shortening, 34 patients; intrapelvic asymmetry, 7
      patients; pure limb length inequality, 38 patients. Intrapelvic lengthening
      averaged 2.5 cm. Correction of decompensated scoliotic curves averaged 7 degrees
      reduction in Cobb angle. Improvement in center-edge angle in patients with hip
      dysplasia averaged 17 degrees. Reduction in size of shoe lift required to balance
      the trunk in all cases was correlated closely with the intrapelvic lengthening
      achieved. Complications included two transient neurapraxias (one femoral, one
      femoral and sciatic), two cases of sacroiliac subluxation (one patient with
      myelodysplasia, and one patient with polio), three cases of partial graft
      collapse, and six instances of broken fixation pins, and three deep wound
      infections. No patient had chondrolysis or avascular necrosis of the femoral
      head. After average follow-up of nearly 5 years (minimum follow-up 2 years),
      patients who underwent transiliac limb lengthening osteotomy for correction of
      postural imbalance for various causes retained satisfactory correction.

PMID- 2234961
TI  - [Pelvic tilt in neuromuscular diseases].
AB  - On the basis of a study of the literature and observations in 53 of our own
      patients, we attempted to establish the cause and best treatment for neuropathic
      oblique pelvis. In addition, we tried to find out if certain kinds of neurologic
      dysfunctions coincide with certain kinds of oblique pelvis. It is highly probable
      that this pelvis malformation is the result of neuropathic spinal deformity.
      Severe oblique pelvis and scoliosis can be related to the severity of the
      neurologic dysfunction. Hip dislocation is not the reason for oblique pelvis. It
      can be assumed that hip dislocation, on the one hand, and oblique pelvis and
      scoliosis on the other can influence each other. To correct oblique pelvis, the
      neuropathic spinal deformity must be corrected. Anterior and posterior fusion,
      including the lumbosacral junction, give the best results.

PMID- 2234962
TI  - [CD instrumentation in pelvic tilt].
AB  - Our realistic definition of pelvic obliquity is: any fixed malalignment existing
      between the spinal and pelvic structure in the frontal, sagittal and horizontal
      plane. The pelvic unit--with rare exceptions--must be considered one unique
      vertebra, an intercalary bone between the trunk and lower limbs. Like a
      structural vertebra in a scoliotic spine, the pelvic unit can be distorted in
      structure. The etiologies of pelvic obliquity can be divided into three major
      levels: below, inside and above the pelvis. Preoperative surgical planning must
      consider the position of the pelvis in the three dimensions. The technical
      options of pelvic fixation are described: alar staples, sacral screws, the
      cannulated iliosacral screw and finally the Galveston technique. The surgical
      technique is described. The results are presented in about 80 cases of CD
      instrumentation with pelvic fixation. For preoperative hyperlordosis a mean
      correction of 40 degree was achieved and for preoperative hyperkyphosis a mean
      correction of 66 degree.

PMID- 2234963
TI  - [The Luque-Galveston operation in the treatment of neuropathic pelvic tilt].
AB  - A series of 17 patients with neuromuscular pelvic obliquity underwent Luque
      Galveston instrumentation. None of these patients had an increased neurologic
      deficit. One intraoperative death occurred due to pulmonary air embolism. It was
      possible to follow up 13 patients for an average of 2.7 years. The average
      correction achieved was from 97.6 degree to 38.8 degree for pronounce unbalanced
      lumbar or thoracolumbar curves: the correction loss averaged 3.6%. Combination
      with anterior correction or fusion in 38% is believed to be the factor that
      enabled us to reduce the incidence of pseudarthrosis and implant failure.

PMID- 2234965
TI  - [Cancer of the retrocricoid region].
AB  - Five cases of the postcricoid carcinoma surgically treated during the last 6
      years were described. During the same period 20 other patients with
      hypopharyngeal (piriform sinus) and 311 laryngeal cancer were operated upon.

PMID- 2234964
TI  - [Cryosurgery of precancerous conditions of the oral cavity and pharynx].
AB  - In ENT Clinic, II Faculty of Medical Academy in Warszawa 108 patients with
      precancerous lesions were treated by cryosurgery during the years 1975-84. In 43
      patients the lesions were in oral and in pharyngeal cavities, 33 out of 43 have
      had before the cryosurgery some form of therapy, conservative or radical without
      lasting effects. In all treated cryosurgically patients the positive results were
      obtained, which were consecutively verified during 3 to 9 years of observations.
      There were no malignant transformations, no other complications. The authors
      found, that the cryosurgery is a promising method of therapy in precancerous
      lesions.

PMID- 2234966
TI  - [A card for selective laryngeal examinations adapted for computerized data
      processing].

PMID- 2234968
TI  - [Autogeneic bone transplants in the treatment of nose deformities].
AB  - The late results of the nasal reconstruction by means of the autogenic osseous
      grafts from hip were described. 24 patients were described after being controlled
      3 to 15 years after surgery. The deteriorations of the cosmetic effects were
      observed, because of the graft resorption. The complications at the place of
      taking graft were also possible. However, the authors stressed the usefulness of
      this autogenic osseous graft method of surgery.

PMID- 2234967
TI  - [Pleomorphic adenoma of atypical localization].
AB  - The authors described 4 cases of multiform adenomata located in other than
      parotid gland sites. The diagnostic difficulties were stressed as well as the
      necessity of the histologic verification.

PMID- 2234969
TI  - [Various forms of mycoses of the oral cavity, pharynx, nasal cavity, paranasal
      sinuses, larynx and ear. II. Candidiasis and cryptococcosis].

PMID- 2234971
TI  - [Tonsillectomy. Analysis of the data for the 25-year period].
AB  - The author analysed the 38734 out of 39653 tonsillectomies performed in region of
      Gdansk during the years 1961-85. Age, sex and kind of intervention were evaluated
      (adenoidectomy, tonsillectomy, adenotonsillectomy and others). The frequency of
      above mentioned surgery was reduced during these 23 years by 32% (from 14.5 to
      9.8 for 10,000). The great majority of this surgery was performed in children
      aged 3 to 7 years. The rarest age was below 3 and over 40. Under the age of 11
      years prevailed boys, over 11 girls. Adenoidectomy represented 65% of cases,
      adenotonsillectomy only 6.6%. The tonsillotomy was also present. The author
      discussed the reason of decreasing number of tonsillectomy.

PMID- 2234970
TI  - [Cytological examination of nasal discharge before and after local administration
      of flunisolide (syntaris)].
AB  - The influence of syntaris therapy on nasal mucosa was testified by means of the
      cytologic examinations. After therapy the number of the cylindric multilayer
      epithelial and inflammatory cells was lowered. No cell damage was observed.

PMID- 2234972
TI  - [Directional hearing in relation to individual circadian biorhythm].
AB  - Acuity angle of the directional hearing was investigated in connection with the
      individual circadian rhythm. Two groups of 15 persons represented the morning and
      evening form of the circadian rhythm. Body temperature fixed the rhythm
      character. The evaluations of the angle acuity of the directional hearing were
      performed in the highest and the lowest point of body temperature as well as in
      the neutral point, which was determined in the morning group in the middle
      between the two extremes. The possibility of the sound localization in individual
      and linked with the body temperature circadian rhythm.

PMID- 2234973
TI  - [Problem of hereditary deafness].

PMID- 2234974
TI  - [Post-influenza parageusia].
AB  - A case of postinfluenzal qualitative taste disorders lasting over two years was
      described. After short treatment subjective symptoms subsided completely and the
      results of the gustometric tests normalized themselves.

PMID- 2234975
TI  - [Ludwik Guranowski (1853-1926)--otologist and co-founder of the Polish
      Otolaryngological Society].
AB  - The life, work and scientific activity of Ludwik Guranowski a known Warsaw Doctor
      were presented. The review of his scientific publications, practice, social and
      publishing activity was also described, specially in connection with the edition
      of "Polski Slownik Lekarski" by Stanislaw Kosminski. The personality traits of
      this appreciated man were also depicted.

PMID- 2234976
TI  - [Neonatal sepsis: bases and possibilities for immunotherapy and
      immunoprophylaxis. 1: Maturation of immune mechanisms in the fetus and in newborn
      infants].

PMID- 2234978
TI  - [Neonatal sepsis: bases and possibilities for immunotherapy and
      immunoprophylaxis. 3: Immunoprophylaxis].
AB  - This paper reviews several specific and nonspecific procedures for
      immunoprophylaxis to prevent bacteriological infections in preterm and term
      newborns. An active or passive immunization is limited necessarily by the wide
      range of organisms causing neonatal infections. There exist first experiences
      regarding the prophylactic use of intravenous gammaglobulins for high-risk
      neonates or pregnant women with symptoms of infection and at risk for preterm
      delivery. Bacterial polysaccharide vaccines are under development, but up to now
      far off any universal availability.

PMID- 2234977
TI  - [Neonatal sepsis: bases and possibilities for immunotherapy and
      immunoprophylaxis. 2: Immunotherapy].
AB  - The physiological immunodeficiency of preterm and term newborns is the major
      cause of their increased susceptibility to infections. Although nonspecific and
      specific host defence mechanisms are morphologically intact, there are functional
      and quantitative defects. Supportive immunotherapy is required to equalize these
      immunological defects. This article reviews topical possibilities for
      immunotherapy of neonatal sepsis (exchange transfusion, transfusion of fresh
      blood or fresh plasma, granulocyte transfusion, use of immunoglobulins,
      fibronectin, interferon and colony-stimulating factor).

PMID- 2234979
TI  - The effect of antibiotics on the function of the phagocytic system.
AB  - The present paper reviews the effect of various antibiotics (ATB) on the cells of
      the phagocytic system. The first part deals with an indirect mechanism of action
      of ATB, i.e. with changes induced in the bacterial cell which in turn renders
      these bacteria susceptible to phagocytosis. In the second part, the direct effect
      of ATB on phagocytic cells is discussed: binding of ATB to phagocytes,
      penetration into the cell, change in chemotactic (migratory) activity, effects on
      ingestion of particles, intracellular killing of bacteria and on phagocytosis
      associated metabolic changes (e.g. chemiluminescence).

PMID- 2234981
TI  - [Adrenaline and noradrenaline levels in 10-12-year-old boys during a mathematics
      test].
AB  - Blood plasma adrenaline and noradrenaline levels were measured using radio-enzyme
      techniques in 53 normally intelligent boys aged 10 to 12 years with and without
      Attention Deficit Disorders. The measurements were performed while the subjects
      were at rest and during a calculation load test. An anticipatory effect in the
      release of catecholamine and phasic phenomena were observed. Intelligence and
      mental lability are implicated in catecholamine release during load situations
      als well as genetic factors.

PMID- 2234980
TI  - [Neuromuscular diseases and respiratory insufficiency in newborn infants].
AB  - Myopathological examinations which served to gain information on the potential
      impact of neuromuscular disease on the syndrome of perinatal respiratory failure
      included 47 consecutively deceased premature infants and neonates. A definite
      muscular disease could not be safety diagnosed in any case. However, only a very
      small number of investigations and data on the initial (possibly prenatal)
      manifestations have been available up to now. We found a total of 11 cases with
      increased intrafibrillary fat deposits coupled with mitochondrial aggregations in
      three cases. In seven cases, we found a retarded maturation ranging from three to
      nine weeks. Focally manifest myopathic changes were recorded in three cases. In
      one case, a large-group atrophy was found which might indicate the existence of a
      defect in the region of the second motor neuron. Biochemical backup
      investigations are necessary to be able to assess the relatively high incidence
      of increased fat deposits. We consider myopathological examinations of premature
      infants who died of respiratory failure to be desirable because far more
      comprehensive studies are necessary to be able to assess the importance of
      perinatally occurring muscular changes for the diagnosis of neuromuscular
      diseases.

PMID- 2234982
TI  - Spontaneous growth in Turner's syndrome.
AB  - The natural course of growth in Turner's syndrome is demonstrated on the basis of
      growth data from untreated patients. The mean adult height was found to be 145.5
      cm (range 136-166 cm), the growth curve was similar to that in comparable
      studies. A decreased growth potency of skeletal (and other) cell populations
      seems to be the causal defect, beginning with intrauterine growth retardation.
      Special other causes like metabolic or endocrine changes could be excluded.

PMID- 2234983
TI  - [Grey value analysis of the ultrasonic image of the thyroid in children].
AB  - Simultaneously with the sonography of the infantile thyroid gland in addition to
      the description of the echo texture we tried to elaborate with the aid of a grey
      value analysis quantitatively comparable parameters for healthy thyroid glands.
      The thyroid gland of newborn showed by 17.4 the lowest mean grey-value. In
      schoolchildren it ranges between 25.5 and 31.0. Consequently the differences in
      grey-values objectively found out may be of use for diagnostics of thyroid
      diseases in infancy by the fact that before the rear of values dependent on age
      abnormalities will become better percentile.

PMID- 2234984
TI  - [75 years of Gottfried von Preyer's pediatric hospital of the city of Vienna].

PMID- 2234986
TI  - [Allergy diagnosis: indication and evaluation].
AB  - Allergy diagnosis is based on history, skin-test, RAST and lung functions test.
      For skin-test a modified PRICK-test is used. In allergic rhinitis and bronchial
      asthma the evaluation of this test is clear, in food-allergies however 50% false
      positive resp. negative results are seen. Very difficult is the diagnosis in drug
      allergies. In atopic dermatitis and contact-eczema a patch-test has to be done
      too.

PMID- 2234985
TI  - [Atopy: definition--pathogenesis].
AB  - After a short historical review about the detection of reagins by Coca and
      Prausnitz-Kustner 1921-1923 and about their physico-chemical characterisation as
      IgE-antibodies by Ishizaka and Johansson 1967-1968 the definition and the
      clinical relevance of atopy is discussed. The IgE-regulation by interleukins and
      the pathomechanism of IgE-mediated allergies is reviewed. Of special importance
      is the IgE-mediated inflammatory late-reaction and the--therefore caused-
      unspecific hyperreactivity of the stricken tissue, both characteristic features
      of asthma bronchiale as well as atopic dermatitis.

PMID- 2234987
TI  - [Antibody deficiency in obstructive lung diseases].
AB  - Severe chronic chest disease is the most serious complication in patients with
      antibody deficiency syndromes. IgG-subclass-deficiencies were a frequent finding
      in patients with obstructive lung disease and in patients with sinopulmonary
      infections. In the patient population referred to us for immunological
      investigation recurrent infection of the upper and lower respiratory tract was
      the most common reason to suspect undue susceptibility to infection. In 1034
      pediatric patients analyzed 299 were found to be deficient in one of several IgG
      subclasses. In a group of 30 children, all of whom had severe lung disease and
      normal concentrations of serum IgG, IgA and IgM, airway-obstruction has been
      diagnosed in 19. 20 of the 30 patients had IgG-subclass-deficiency. The large
      percentage of IgG-subclass-deficiencies in this group of patients indicates that
      immunological disregulation is likely to contribute to the pathogenesis of
      chronic lung disease.

PMID- 2234988
TI  - [Pollinosis and bronchial asthma: pathogenesis, immunology, clinical aspects].
AB  - Rhinoconjunctivitis induced by pollen exposure and bronchial asthma are generally
      easily recognizable clinically. In asthma a number of differential diagnoses such
      as ciliary dyskinesia, cystic fibrosis and gastro-oesophageal reflux must be
      considered. The predominant symptoms are coughing and wheezing. Investigations
      into the complex nature of mediator release and IgE synthesis have established a
      predominantly inflammatory pattern of reactions largely responsible for induction
      and maintenance of bronchial hyperresponsiveness due to both acute and chronic
      processes. Future therapeutic consequences may be derived from anti-inflammatory
      strategies. This has already lead to reassessment and upgrading of use of
      corticosteroids in paediatric asthma.

PMID- 2234989
TI  - [Pathogenesis and clinical aspects of atopic dermatitis].
AB  - Atopic dermatitis (a. D.) is a chronically relapsing inflammatory disease of the
      skin caused by a genetically transmitted hypersensitivity to environmental
      substances. Its pathogenesis is complex and multifactorial: heredity of atopic
      constitution, disturbances of humoral (hyperimmunoglobulinemia-E) and cellular
      (defect of suppressor-T-cells) immunity, abnormal vascular reactions and abnormal
      skin functions. A. D. shows different forms in different age groups: Eczema
      infantum in infancy, Eczema flexurarum in childhood and Neurodermatitis
      disseminata and pruriginosa while and after puberty. Typically for all forms is a
      pruritus and the status neurodermiticus. The healing of a. D. is spontaneously
      possible at any time, but not predictable for a special case.

PMID- 2234990
TI  - [Therapy of bronchial asthma].
AB  - Asthma stems from chronic inflammatory changes in the bronchial mucosa: its long
      term treatment is mainly based on the antiinflammatory action of the employed
      substances. Topical (aerosol) treatment is considered as the most effective route
      of medication; availability of new substances and new aerosols in Austria
      requires a revision of previously established treatment strategies. Such revised
      strategies are presented for schoolchildren, babies and toddlers respectively;
      they follow the same principles, but differ in respect to the preferred method of
      topical medication. In addition, coexistent allergy has to be evaluated and
      treated on an individualized basis; occasionally, so-called "tertiary strategies"
      of asthma treatment are employed as well.

PMID- 2234991
TI  - [Recommendations and guidelines for the treatment of atopic dermatitis].
AB  - Till now no causal and healing treatment of atopic dermatitis (a. D.) is known.
      About this fact and about the relapsing course of a. D. the parents of the atopic
      children have to be informed before starting treatment. The principles of
      treatment are avoiding of pruritus and scratching, keeping the skin cool and
      humid, and avoiding of bacterial superinfections. Topic steroid-treatment is very
      effective, dose and application however have to be strongly controlled. The
      nutrition of children with a. D. should be as normal as possible, extreme regimes
      of diet have to be avoided. Very essential is a consequent cure of the skin,
      especially in the symptom-free intervals, keeping the skin cool and humid and
      avoiding all mechanical and chemical irritants.

PMID- 2234992
TI  - Antinociception and cardiovascular responses produced by electrical stimulation
      in the nucleus tractus solitarius, nucleus reticularis ventralis, and the caudal
      medulla.
AB  - In experiment 1, quantitative regional comparisons of the antinociceptive and
      cardiovascular responses produced by electrical stimulation in the caudal
      medulla, including regions such as the nucleus tractus solitarius (NTS), nucleus
      reticularis ventralis (NRV), nucleus reticularis gigantocellularis (NRGC),
      nucleus reticularis paragigantocellularis (NRPGC), nucleus raphe obscurus (NRO),
      and medial portions of the lateral reticular nucleus (LRN), were made in the rat.
      Electrical stimulation in all of these regions resulted in inhibition of the
      nociceptive tail-flick reflex, although the threshold intensity for inhibition
      was greater for sites in NTS compared to many sites ventral to the NTS.
      Antinociception was generally accompanied by an increase in mean arterial blood
      pressure, with the exception of sites in the NRO, where depressor responses were
      evoked by stimulation. Detailed comparisons between the NTS and NRV revealed that
      greater intensities of electrical stimulation were required to produce
      antinociception for sites in the NTS as compared to the NRV. There were no
      significant differences in threshold intensities for antinociception as a
      function of rostrocaudal subdivisions of the NTS, but the lateral subdivision of
      the NTS was significantly more efficacious than the medial subdivision. This
      mediolateral difference within NTS was primarily due to stimulation in medial
      sites producing overt movements in some animals, probably due to stimulation of
      adjacent midline nuclei or pathways. Within the NRV, thresholds for inhibition of
      the tail-flick reflex were greater for sites in the dorsal subdivision as
      compared to the ventral subdivision, which contains spinopetal projections from
      the NRM. The slopes of the lines of recruitment for inhibition of the tail-flick
      reflex at stimulation sites in either the NTS or NRV were both very steep,
      similar to other forms of antinociception. In experiment 2, the pulse duration of
      electrical stimulation was varied for sites of stimulation in the lateral NTS and
      NRV to generate strength-duration curves. This experiment confirmed that
      stimulation sites in the lateral NTS required greater current intensities to
      inhibit the tail-flick reflex than sites in the NRV. However, the chronaxies
      derived from the strength-duration functions for the NTS or NRV were both
      approximately 170 microseconds, indicating that the antinociceptive effects in
      these regions may not be exclusively due to the stimulation of fibers of passage.
      These results are discussed in terms of the role of the NTS, NRV, and caudal
      medulla in the modulation of nociceptive responses and cardiovascular function.

PMID- 2234993
TI  - Leakage of fluid administered epidurally to rats into subcutaneous tissue.
AB  - Epidural catheters were implanted in rats under halothane/nitrous oxide
      anaesthesia. Contrast medium (Iopamidol) was injected via the catheter under
      fluoroscopic control 24-48 h after implantation. In 15 of 20 rats contrast could
      be seen leaking out of the epidural space, usually after only 25 microliters was
      administered. Leakage was associated with diminished antinociceptive response to
      morphine administered via the catheter. Both leakage and decreased response to
      morphine could be largely prevented by applying a drop of Supa-Glue over the site
      of entry of the catheter to the epidural space at the time of catheter
      implantation. Investigators using epidurally cannulated rats should document that
      leakage does not occur or discard results from rats showing evidence of leakage.

PMID- 2234994
TI  - Clinical judgments in pain management.
AB  - From research reports published over the last 20 years, it appears that moderate
      to severe uncontrolled pain may be the norm for hospitalized patients despite
      recent advances in the management of pain. Research on the extent of under
      management of pain and the factors associated with it is examined and summarized
      in this paper. Methodological imperfections of the research are identified.
      Several explanations for pain under-management have been proposed and these are
      reported. A clinical decision making model is also reviewed and it is suggested
      that this model could be applied to pain management problems. Further, it is
      suggested that this model may be very useful in developing educational
      interventions to improve health practitioners' clinical skills in pain
      management.

PMID- 2234995
TI  - Evaluating the efficacy of EMLA in alleviating pain associated with lumbar
      puncture; comparison of open and double-blinded protocols in children.
AB  - Potential benefit of the topical anesthetic EMLA prior to lumbar puncture was
      studied in children with cancer. Comparison was made between 2 types of study:
      the first one involved 10 children who were enrolled in a double-blind placebo
      controlled study and in the second, 18 children in an open crossover study.
      Although both studies suggested the favourable effects of EMLA in alleviating
      pain associated with LP, they illustrated the need to perform such studies in a
      controlled blinded fashion; the effect in the double-blind study was not apparent
      in some cases, whereas it was clear cut in all open cases.

PMID- 2234996
TI  - Low dose amitriptyline in chronic pain: the gain is modest.
AB  - In the double-blind placebo-controlled study presented here, the effects were
      investigated of a low dose of amitriptyline (75 mg) in patients with chronic pain
      of various origins. The active drug was superior to placebo in reducing pain
      intensity. The reduction was small. In the second treatment week, the
      amitriptyline treated patients slept longer. No differences between active drug
      and placebo were found with respect to daily activities or use of analgesics.
      Based on our data and those of other studies, it is concluded that amitriptyline
      (and other antidepressants) in low doses does have a positive effect on the
      intensity and some other aspects of chronic pain, but that the effect is modest.
      It must be kept in mind that chronic pain is a very treatment-resistant
      condition. Therefore, even modest positive effects may be worthwhile.

PMID- 2234998
TI  - A genetic factor in the reaction of rats to peripheral nerve injury.

PMID- 2234997
TI  - Pain relief achieved by transcutaneous electrical nerve stimulation and/or
      vibratory stimulation in a case of painful legs and moving toes.
AB  - A patient is described with painful legs and moving toes. The pain had been
      occurring for more than 15 years, and a variety of therapies had been attempted
      with only partial, if any, success. Only morphine had succeeded in relieving the
      pain, but it had to be discontinued to avoid tolerance and dependence. We devised
      a treatment consisting of transcutaneous electrical nerve stimulation (TENS),
      vibratory stimulation (VS), and a combination of the two methods (TENS + VS).
      TENS brought about partial pain relief, but was less effective than VS; dual
      stimulation (TENS + VS) led to complete alleviation of the pain. Four months
      later, the patient was applying dual stimulation himself at home and was thus
      able to maintain complete relief with 3 or 4 weekly sessions. We suggest that
      dual stimulation results in a large-scale recruitment of large-diameter afferent
      fibres and may thus set up a powerful inhibitory control of nociception in our
      patient.

PMID- 2234999
TI  - Heritability of symptoms in an experimental model of neuropathic pain.
AB  - Male and female rats underwent transection and ligation of the sciatic and
      saphenous nerves, and the development of autonomy was monitored. The deafferented
      animals were then interbred, always selecting males and females that expressed
      relatively high and, alternatively, relatively low levels of autotomy. Offspring
      were similarly operated and interbred. By the sixth generation of selective
      breeding, lines were achieved in which autotomy was consistently high (HA) or
      consistently low (LA). There was no indication of sex linkage. Thermal and
      mechanical nocifensive responsiveness co-selected with propensity to express
      autotomy following nerve injury: response thresholds were lower in HA than in LA
      rats. F1 hybrids formed by crossing homozygous HA and LA animals showed low
      levels of autotomy, similar to LA stock. This indicates recessive inheritance of
      the autotomy trait. Backcrossing F1 hybrids onto the LA line yielded a low
      autotomy phenotype in almost all cases; backcrossing F1 hybrids onto HA stock
      yielded about 50% high autotomy and 50% low autotomy. These ratios are consistent
      with simple mendelian inheritance of a single gene. Taken together, the data
      suggest that autotomy is inherited as a single-gene autosomal recessive trait.

PMID- 2235001
TI  - [Principles and histologic effects of the treatment of hypertension with focused
      high-intensity ultrasound].
AB  - Focused high-intensity ultra-sound is used to treat glaucoma. Histopathologic
      examinations of rabbit and pig eyes following therapeutic ultrasound demonstrated
      highly localized lesions including destruction of the ciliary epithelium and
      thinning of the sclera. The bond between the sclera and the ciliary epithelium is
      weakened. The conjunctiva remains intact. The histologic findings in human eye
      enucleated after ultra-sound therapy are identical. Three mechanisms for pressure
      reduction are proposed: transscleral outflow of aqueous humor can occur under the
      overlying conjunctiva; focal destruction of the ciliary epithelium can reduce
      aqueous production; scleral scarring produces the potential for separation of the
      ciliary body and the sclera.

PMID- 2235000
TI  - Adrenal medullary implants in the rat spinal cord reduce nociception in a chronic
      pain model.
AB  - Previous work in this laboratory has indicated that the transplantation of
      adrenal medullary tissue into the subarachnoid space of the rat spinal cord can
      reduce pain sensitivity to acute noxious stimuli, particularly following
      stimulation by nicotine. This most likely results from the stimulated release of
      opioid peptides and catecholamines from the transplanted chromaffin cells.
      However, chronic pain models may more closely resemble human clinical pain, and
      the arthritic rat model has been used for screening potential therapeutic
      strategies. The purpose of the present study was to assess the potential for
      adrenal medullary tissue implanted into the spinal subarachnoid space to
      alleviate chronic pain. Adrenal medullary tissue was implanted into adjuvant
      induced arthritic rats, and changes in body weight and vocalization responses
      were monitored over the 10 week course of the disease. Results indicate that the
      severe weight reduction normally associated with this inflammatory arthritis was
      attenuated by adrenal medullary, but not control, implants. In addition,
      vocalizations were reduced in animals implanted with adrenal medullary, but not
      control tissue following nicotine stimulation. This reduction was blocked by the
      opiate antagonist, naloxone, and partially attenuated by the alpha-adrenergic
      antagonist, phentolamine. Together, these results suggest that the
      transplantation of adrenal medullary tissue into the subarachnoid space of the
      spinal cord may provide a local source of opioid peptides and catecholamines for
      the reduction of chronic pain.

PMID- 2235003
TI  - [The treatment of failed trabecular surgery in glaucoma with ultrasound
      (Sonocare)].
AB  - We have treated 62 recently post-operative eyes with non functioning
      trabeculectomies at the site of the failed bleb with one to four ultrasound
      applications each of five seconds duration and at an intensity level of 10
      kw/cm2; 32 eyes were phakic, 7 aphakic, and 23 pseudophakic (anterior or
      posterior chamber). The two groups of patients showed the best response when the
      ultrasound treatment was performed three to twelve weeks after the last
      trabeculectomy; 82% are success in the phakic group, and 68% in the aphakic or
      pseudophakic group after three months. After the ultrasound treatment, 5FU
      subconjunctival injections seem to be effective in the very bad cases with a low
      rate of complications.

PMID- 2235002
TI  - [Indications and results of Sonocare (ultrasound) in the treatment of ocular
      hypertension. A preliminary study of 395 cases].
AB  - The Sonocare system CST 100 provides high-intensity focused ultrasound to lower
      the intraocular pressure by three different mechanisms: partial destruction of
      the ciliary epithelium, scleral thinning allowing transcleral outflow of aqueous
      humor, and mainly the ciliary body separation from the sclera. Initially it was
      used to treat blind eyes with painful elevated intraocular pressure; now the
      indications are gradually extended to eyes with good vision. This technique takes
      place between laser trabeculoplasty and filtering surgery. The first 395 cases
      which were treated with ultrasound these two last years in the Quinze-Vingts
      Hospital, are displayed in this report.

PMID- 2235004
TI  - [An anterior chamber-subtenonian drainage tube. A long-term study].
AB  - A drainage of aqueous humor from the anterior chamber to the subtenonian space
      using a tube and a scleral implant was performed in 22 eyes, previously
      unsuccessfully operated on for glaucoma. The results after a follow up of 12 to
      36 months were good, specially in cases with undissectable conjunctiva (a 73%
      rate of success). The small incidence of serious complications incites us to use
      this technique earlier in the surgical treatment of uncontrolled ocular
      hypertension.

PMID- 2235005
TI  - [The value of inferior trabeculectomy in combined cataract-glaucoma surgery.
      Apropos of 54 cases].
AB  - In 54 consecutive cases of glaucoma triple procedure, a trabeculectomy was
      systematically performed at six o'clock. By separating the order and the
      locations of the incisions as well as their placement in limbo-corneal sites,
      haemorrhages are minimized. A watertight, controlled running suture avoids post
      operative flat anterior chamber, and permits rapid tonometric normalisation. The
      results of these first cases are: a mean post-operative ocular pressure (O.P.):
      15.1 mmHg, mean drop of O.P.: 36%; tonometric normalisation and visual-functional
      improvement above 90%.

PMID- 2235006
TI  - [Early postoperative campimetric outcome after trabecular surgery of chronic
      advanced glaucoma].
AB  - The authors report about the results of a preliminary study concerning the
      changes of glaucomatous visual field just after glaucoma filtering surgery in
      patients with advanced glaucoma. The visual field was established preoperatively,
      then 7 and 30 days in post operative period. Mesopic campimetry had been selected
      because of its precision for central field defects. The results appear to be
      favourable with 13 improvements 14 stabilizations, and 7 aggravations without
      loss of central vision. The authors have tried to determine predictive risk
      factors. The most important one are preoperative campimetric shape, angle
      anatomy, refraction and cardiovascular diseases.

PMID- 2235007
TI  - [Aqueous humor flow measured by fluorophotometry. A comparative study of the
      effect of various beta-blocker eyedrops in patients with ocular hypertension].
AB  - A randomized double-blind study of aqueous humor flow and intraocular pressure
      measurements before and four hours after instillation of placebo and beta-blocker
      eyedrops, was carried out in 40 hypertensive patients. The treated and non
      treated patients either did or didn't show an optic disc excavation and a visual
      field defect. Hypertensive patients with a previous tension treatment will stop
      therapy on a 3-week period up to an increase of their own ocular tension value
      greater than or equal to 3 mmHg. The intraocular pressure statistically decreased
      of 20.8% four hours after topical placebo, the aqueous humor flow remaining
      unchanged. In this study, timolol eyedrops induced a greater decrease of the
      aqueous humor flow (39%), followed equally by betaxolol (23.8%) and carteolol
      (20.42%). Timolol and betaxolol eyedrops equally induced a significant decrease
      of the intraocular pressure. There was no effect of carteolol on the intraocular
      pressure. The outflow facility was independent of the instilled beta-blocker
      eyedrop.

PMID- 2235008
TI  - [2 fluorophotometric methods of measuring aqueous humor flow in hypertensive
      patients].
AB  - Two fluorophotometric methods, by instillation and oral route, allowed the
      aqueous humor flow measurement and apparent outflow resistance calculation in
      normal and hypertensive subjects. There was no statistically significant
      difference between the two methods in the aqueous humor flow of hypertensive
      patients and normal subjects. On the contrary, there was an increase of the
      outflow resistance in hypertensive patients in relation to normal subjects.
      Finally, oral route fluorophotometry allowed the individualization and
      calculation of a coefficient of aqueous humor production from the iris, which is
      statistically increased in hypertensive in comparison with normal subjects.
      Subsequent studies thanks to this fluorophotometric method by oral route, which
      interest is certain in treated hypertensive patients, should allow to determine
      the action site of the drug and to quantify its efficiency.

PMID- 2235010
TI  - [The value of electroretinography in uveitis].
AB  - The involvement of the retina in the inflammation being one important factor in
      severe uveitis, the authors have tested the "ganzfeld" electroretinogram (ERG) in
      various forms of uveitis, especially in cases having opaque media. In Fuchs'
      syndrome and chronic anterior uveitis, the ERG is normal or only slightly
      altered, while important reduction of the potentials can occur even in case of
      good vision in intermediate uveitis, probably indicating concomitant retinal
      vasculitis. In Behcet's disease, ERG is mostly useful in testing the efficacy of
      therapy. ERG can be rather deceiving in idiopathic vasculitis, where the
      potentials are not always as reduced as expected. On the contrary, this test
      seems to allow differential diagnosis between Harada's disease and acute
      multifocal placoid pigment epitheliopathy. However, one must bear in mind that
      concurrent steroid treatment can elevate the amplitude of the potentials, a
      phenomenon which has to be taken into account when interpreting ERG results.

PMID- 2235009
TI  - [Study of the postoperative uveal reaction using the laser flare-cell meter].
AB  - Aqueous flare and cells can be quantified by a new system, the laser flare-cell
      meter (KOWA FC 1000). Mydriasis does not influence the results, that can
      positively be compared to fluorophotometry. It is possible to precisely measure
      the surgical trauma, and inflammatory diseases of the eye.

PMID- 2235011
TI  - [Functional evaluation of the corneal endothelium using anterior segment
      fluorophotometry].
AB  - The AA have studied the permeability of the corneal endothelium by anterior
      segment fluorophotometry using instillation of fluorescein. The Fluorotron Master
      TM has been modified with the introduction of a new slit (58.4 microns) and of
      the voltage output (6.5 v) has also been increased. The resolution has been
      improved from 2.39 mm to 0.59 mm. Of this study, we have examined 20 patients
      submitted to extracapsular cataract extraction with intraocular lens implantation
      (ECCE + IOL). The patients have been divided in two groups, according to the
      surgical technic used: "can-open" and intracapsular. Each patient have been
      submitted before surgery and 1 week after to an ophthalmologic examination,
      paquimetry and anterior segment fluorophotometry. The permeability coefficient
      (PAC) increases with the duration of surgery and when using "can-opener" instead
      of endocapsular.

PMID- 2235012
TI  - [Intra-corneal lens implantation: an experimental study in rabbits].
AB  - After the theoretical analysis, the authors describe the experimental results of
      hydrogel intracorneal lenses in the rabbit stroma.

PMID- 2235013
TI  - [Epithelial and stromal healing after radial keratotomy. Scanning electron
      microscopy analysis].
AB  - A study of corneal healing after radial keratotomy was conducted under scanning
      electron microscopy in 28 papio-papio baboons. The appearance of the incisions
      after follow-ups ranging from one hour to three and a half years postoperatively
      permits to emit some hypotheses regarding the precise mechanisms of action of
      radial keratotomy, as well as those governing any functional or anatomical
      complications susceptible to occur after the operation.

PMID- 2235014
TI  - [A histologic study 7 months after radial keratotomy in a 32-year-old man].
AB  - A 32 years old patient died seven months after a radial keratotomy. The
      histologic study of one cornea is realized. The wound of anterior stroma varies
      from 0.08 to 0.13 mm; it is filled of epithelial cells with eosinophile cytoplasm
      and a round nucleus. Near this epithelial ingrowth Bowman's membrane is
      interrupted and the fibres of stroma lose their parallel direction in comparison
      with the epithelial plane. These histopathologic results are compared with the
      other publications; and in reference with the mechanism of the healing, an
      histogenesis of the corneal healing is proposed.

PMID- 2235015
TI  - [A comparative study of extra-capsular extraction and intra-capsular extraction
      with implants after 24 months' follow up].
AB  - This statistical study follows the one already made in 1987 on a series of 200
      patients, 150 of them have been properly analysed after 24 months. It shows that
      after this delay the ECCE gives an efficient protection against complications
      especially in regard of central and peripheral retina.

PMID- 2235016
TI  - [The examination of color vision using a 2 metameric equation method].
AB  - Modern anomaloscopes with four independent light channels (i.e. Besancon
      Anomalometer which was presented in 1979 at the SFO Congress) allow accurate
      examinations of color vision. In our routine clinical examination, we use two
      metameric equations: the red-green Rayleigh equation and the blue-green Moreland
      equation. This so called Two-Equation-Method enables the diagnosis of congenital
      and acquired color vision defects in a precise qualitative as well as
      quantitative way. For both equations the goal of the examination is to measure
      the absolute matching range. Abnormal color vision is diagnosed if the absolute
      matching range is shifted and/or enlarged in one or both of the two metameric
      equations. In congenital colour vision deficiencies, the results are similar to
      those obtained with the Nagel anomaloscop. The different types of acquired
      defects are compared with the types of Verriest's classification. A computer
      controlled clinical examination of color vision, which will make the procedure
      simplier and shorter for the patient is actually being developed.

PMID- 2235017
TI  - [500 visual acuity tests in infants with Teller acuity cards].
AB  - Assessment of visual resolution with Teller Acuity Cards is now routine procedure
      in infant visual check-up. A grating is printed on one end of a card on an
      homogeneous background of the same mean luminance. A series of spatial
      frequencies at an interval of one half octave covers the range of infant acuity.
      Binocular and monocular acuities have been measured on 517 infants between 100
      and 399 days of age. The cards can be used from a few weeks of age up to 18
      months at least. Then it gets more chancy to keep the child attentive. Binocular
      and two monocular tests take 6 minutes with a normal child. Binocular grating
      acuity normally reaches 6.5 cycles/degree at 4 months of age, and 12 c/deg at 12
      months. Monocular acuity is one half octave lower. From the level of acuity
      obtained and observation of the behaviour, amblyopia can be detected and low
      vision can be estimated easily in infants.

PMID- 2235018
TI  - [Aniseikonia. A clinical study of 51 unilateral pseudophakic patients and
      practical applications].
AB  - The subjective aniseiconia was measured with spatial eiconometer on 51
      isometropic and unilateral pseudophakic patients in relation with the post
      operative anisometropia. The median value of subjective aniseiconia is 2-3% for
      anisometropia minus or equal to 5 diopters, without statistic correlation,
      related to a probably "sensorial brain adaptation". So error of intra-ocular lens
      power calculation less than 7.5 diopters may be accepted.

PMID- 2235019
TI  - [A new evaluation system of 3D vision].
AB  - 3D vision assessment depends on monocular and binocular factors. In
      ophthalmology, it is clinically evaluated through the optometric examination
      which is not exhaustive according to the monocular elements and doesn't take on
      the visual stimulus quantification. The video and electro-optic displays can meet
      all these exigencies. The basic principles they share are exposed and then an
      illustration is given of their performance and their adaptation to the
      physiologic mechanisms. So is presented a study on the fusion area of
      heterophoric subjects depending on the stimulus spatial frequencies (the
      synthetic precisely quantified images shown were circular DOGs). This area is
      greatly modified following the variety of subject's heterophoria.

PMID- 2235020
TI  - Epidemiology of spinal cord lesions in Denmark.
AB  - Denmark has a population of about 5.2 million. The rehabilitation of spinal cord
      injured (SCI) takes place in two specialised rehabilitation hospitals. The
      incidence of new traumatic SCI admitted to these hospitals in the period 1975
      1984 was 9.2 per million per year. During this period 92 Danes with non-traumatic
      and 268 with newly sustained traumatic spinal cord lesions were admitted to the
      rehabilitation hospital in Hornboek, which uptake area corresponded to South and
      East Denmark and Greenland and the Faroe Islands. Among the traumatic SCI 47%
      were due to traffic accidents, 23% to falls to a level below, 8% to attempted
      suicides, 6% to shallow water diving, and 6% to sporting accidents. The number of
      SCI caused by traffic accidents was found to decrease coincidently with the
      introduction of general speed limits and compulsory seat belt wearing. The
      male/female ratio was for the traumatic SCI 3.3, which was significantly lower
      than in the preceding 10-year period. 40% of all traumatic SCI were sustained at
      15-24 years of age, and 51% had tetraplegia. Traffic accidents gave rise to more
      cervical, and falls to more caudal lesions. 41% of the traumatic SCI had an
      improvement in their neurological status after their admission to the
      neurosurgical department until the discharge from the rehabilitation hospital.
      Those with incomplete lesions showed greater improvement than those with complete
      lesions regardless of the level. Complete cervical lesions had significant better
      remissions than complete thoracic/lumbar lesions.

PMID- 2235021
TI  - Bone and soft tissue injuries in post-mortem lumbar spines.
AB  - A histological study of transverse sections of lumbar facet joints from 36 lumbar
      spines of subjects dying from serious trauma revealed injuries not visible on
      standard radiography, and in a high percentage of joints. They include fractures
      of the superior articular process, central infractions of the subchondral bone
      plate, and tears of the articular capsule, including the ligamentum flavum. The
      facet joint injuries in young subjects were almost entirely absent from the facet
      joints of a comparable group of young subjects with no recent history of major
      trauma. The injuries resemble some of the 'age changes' seen in older subjects
      dying non-violent deaths. It is suggested that such injuries may lead to early
      onset facetal arthritis in survivors of major trauma.

PMID- 2235022
TI  - A comparison of past and future leisure activity participation between spinal
      cord injured and non-disabled persons.
AB  - Leisure activity profiles of 81 male and 21 female SCI subjects were compared
      with profiles of 135 male and 151 female non-disabled individuals. These
      profiles, derived from the Leisure Activities Blank (McKechnie, 1985), revealed
      that SCI subjects had been more physically active (prior to injury) than those in
      a non-disabled comparison group; however, their post-injury expectations for
      future leisure activity involvement were considerably lower than a similar study
      of non-disabled individuals. These reduced expectations were found for both
      active and sedentary activity categories. It is suggested that awareness of pre
      morbid leisure activity profiles, plus recognition that post-injury expectations
      for leisure activity participation are often reduced, could assist medical
      personnel to prescribe treatment or offer programmes that enable SCI patients to
      maintain their pre-morbid lifestyles and enhance future leisure activity
      expectations.

PMID- 2235023
TI  - Late asystole in high cervical spinal cord injury: case report.
AB  - A patient with delayed episodes of extreme bradycardia, asystole and syncope
      occurring 5 to 9 weeks after traumatic high cervical spinal cord injury is
      described. Temporary transvenous ventricular pacing followed by oral
      propantheline was required to prevent further episodes. The investigation,
      physiology and treatment of this arrhythmia in tetraplegia are discussed.

PMID- 2235024
TI  - The locked-in syndrome and related states.

PMID- 2235025
TI  - Early intermittent self-catheterisation after spinal cord injury.
AB  - An evaluation has been made of intermittent self-catheterisation (ISC) carried
      out by 25 paraplegic patients early after injury. The results were compared with
      those of intermittent catheterisation (IC) done in another 48 paraplegic patients
      by a catheter team. No significant difference was found regarding the rate of
      urinary infection or the incidence of urethral trauma. The final outcome of
      bladder training did not differ significantly between the two groups. Patients on
      self-catheterisation went home earlier for the weekend. Most patients and their
      relatives found that self-catheterisation in the early stage was easy to perform
      and meant a more active participation in bladder training. Early self
      catheterisation may help to overcome a nursing staff shortage in a busy acute
      spinal cord injury ward.

PMID- 2235026
TI  - Respiratory function in patients with spinal cord injuries: effects of posture.
AB  - The purpose of this study was to evaluate the respiratory function of spinal cord
      injuries (SCI) during different postures. Measurements were performed with a
      Fukuda PM 80 spirometer on 31 chronic stable SCI and 22 normal controls. Among
      the SCI patients, there were 12 quadriplegics and 19 paraplegics. The respiratory
      parameters, including forced vital capacity (FVC) and forced expiratory volume
      during first second (FEV1.0) were collected in each subject during supine,
      sitting and standing postures. The results revealed that SCI patient had impaired
      FVCs (p less than 0.05), the degree of impairment depending upon the level of
      cord injury (r = 0.81). The FEV1.0/FVC ratio of SCI was normal. For
      quadriplegics, the FVC during sitting and standing fell on 30 to 50% of normal
      values. The FVCs of paraplegics during all postures were around 80% of the
      predicted values. The FVC in the control group was reduced by 5 to 7% when
      changing postures from erect to supine. This study concludes that respiratory
      impairment does occur in SCI. The results obtained display a typical pattern of
      restrictive pulmonary impairment. The severity of the impairment is affected by
      the level of cord damage and is posturally dependent.

PMID- 2235027
TI  - Relationship between heart rate and oxygen uptake in thoracic level paraplegics.
AB  - In able-bodied subjects heart rate and oxygen uptake have a linear relation up to
      submaximal workloads. Cardiac response to exercise or physical stress is
      described to be under the control of the sympathetic nervous system. Various
      workers have claimed that the sympathetic contribution to the cardiac plexus
      arises between thoracic spinal cord levels T1 and T6. Paraplegics are
      participating in various sporting activities in increasing numbers.
      Theoretically, assessing the progress of physical fitness of paraplegics with
      lesions above T6 by monitoring heart rate alone becomes unreliable because of
      damage to their sympathetic system. Forty-four paraplegics with lesion levels
      between T3 and T10 were put through an arm cranking exercise routine with
      increasing power levels. Their heart rate and oxygen uptake was measured for each
      power level. For analytical purposes the subjects were grouped into two groups
      according to their lesion level. All the subjects with the lesion at T6 or above
      were in one group and the other group consisted of lesion at T7 or below. Almost
      linear relation was found between the heart rate and oxygen uptake in all
      subjects of both groups. The findings of this study suggest that either the
      sympathetic contribution comes from above spinal level T3, or the cardiac
      response to an increased demand in physical exercise is controlled by some other
      mechanism.

PMID- 2235028
TI  - Quality of semen after repeated ejaculation treatment in spinal cord injury men.
AB  - The study was designed to document the effects of regular drainage after penile
      vibrator stimulation on the quality of semen in SCI men. Twenty three
      tetraplegics and 9 paraplegics, 18 to 40 years of age and with neurological
      levels ranging from C4 to L1, were examined between 1 and 23 years after injury
      (median 2 years). None had ejaculated after the injury. Penile vibrator
      stimulation was tried in patients with cervical or thoracic lesions who showed
      reflex hip flexion on scratching the soles of the feet, 29 out of 32, and rectal
      electrostimulation in the remaining 3 low lesions with no reflex function in
      lumbar and sacral segments. The stimulation yielded semen in 29 (91%) of the men;
      22 had antegrade and 7 retrograde ejaculation. Sixteen of the 22 patients with
      antegrade ejaculation entered a home programme of vibrator stimulation prescribed
      once weekly. Four to 6 months of stimulation resulted in a rise of semen volume
      and of fructose and acid phosphatase levels in the seminal plasma, suggesting
      improved function of the seminal vesicles and the prostate. The percentage of
      motile sperms was low both before and after the treatment period. Despite this,
      the total count of motile sperms per ejaculate was already high in the patient's
      first ejaculates compared to the laboratory normal standard, and further clearly
      increased after the stimulation period. A standardised functional test measuring
      sperm penetration capacity showed strong evidence of long term stimulation
      effect. It is suggested that the test is used in the assessment of fertility
      potential in SCI men.

PMID- 2235030
TI  - A new building for the oldest spinal cord unit in The Netherlands.

PMID- 2235029
TI  - The various types of neurogenic bladder dysfunction: an update of current
      therapeutic concepts.
AB  - Increased experience with treatment strategies developed during the last 10 years
      in the field of neurourology justifies an update of current therapeutic concepts.
      Based on a rather simple, but clinically useful, classification of detrusor
      sphincter dysfunction the therapeutic concepts now available for four prototypes
      of detrusor-sphincter dysfunction are discussed. (1) For the combination of a
      hyperreflexive detrusor with a hyperreflexive (spastic) sphincter, characteristic
      for the reflex- and the uninhibited neuropathic bladder, detrusor-sphincter
      dyssynergia (DSD) is still the greatest problem, and transurethral sphincterotomy
      is the method of choice if this situation cannot otherwise be managed. One
      concept is to convert detrusor hyperreflexia into hyporeflexia by adequate
      pharmacotherapy, which is nowadays available, and to assist or to accomplish
      bladder emptying by clean intermittent (self-) catheterisation (CIC) with the
      advantage of dry intervals in between. Japanese colleagues recommend bladder
      overdistension during the spinal shock phase to achieve detrusor hyporeflexia,
      but this procedure is rather decisive at an early stage of the disability,
      leaving the detrusor no chance for further rehabilitation. Another possibility is
      rhizotomy of the sacral posterior roots to eliminate detrusor hyperreflexia, and
      the simultaneous implantation of a sacral anterior root stimulator (Brindley) to
      achieve electrically induced micturition. From our personal experience with 12
      patients this concept is ideal for female patients with unbalanced reflex bladder
      and otherwise uncontrollable reflex incontinence. (2) The combination of a weak
      detrusor with a spastic sphincter is a clear indication for CIC, as the bladder
      is emptied regularly, and due to the spastic sphincter, the patient stays
      continent as long as controlled fluid intake prohibits overflow incontinence. The
      implantation of an anterior sacral root stimulator is an alternative approach
      provided that at least weak reflex detrusor contractions are present. (3) With
      the combination of an areflexive or hyporeflexive detrusor and a flaccid pelvic
      floor, passive voiding by abdominal straining or by the Crede manoeuvre is
      usually recommended, but should be replaced by CIC if this mechanism of bladder
      emptying creates unphysiological high and dangerous intravesical pressures, or if
      vesico-uretero-renal reflux is present. Neurogenic urinary stress incontinence is
      usually associated with this type of lesion and can be successfully treated by
      the implantation of an artificial urinary sphincter (Scott). However in two
      thirds of the patients with neurogenic bladder dysfunction, additional, usually
      operative treatment is necessary to meet the criteria for implantation. Moreover,
      a 30% rate of repair operations must be accepted by patients, but is becoming
      less frequently required with an improved design of the device.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2235031
TI  - Functional neuromuscular stimulation in 4 patients with complete paraplegia.
AB  - The effect of functional neuromuscular stimulation (FNS) on muscle strength and
      endurance was studied in 3 patients with long-standing complete injuries (T7-T12)
      and in 1 patient with a recent complete injury (T5). All 4 patients became strong
      enough to rise, stand and to walk a few steps within parallel bars. However, only
      1 patient was able to walk without parallel bars (60 m). The energy demand of FNS
      assisted walking was measured to be more than 60% of the maximal endurance
      capacity of this patient. This finding partly explains the low patient acceptance
      of FNS.

PMID- 2235032
TI  - Cisapride stimulates small intestinal motility and relieves constipation in
      myelopathy due to cervical spinal stenosis: case report.
AB  - A patient with progressive spinal stenosis, paraplegia, chronic pain syndrome and
      simultaneous severe chronic constipation is described. Treatment with cisapride
      10 mg, 4 times daily improved her condition, and this was associated with
      improved small intestinal motility during a 12-hour examination using a computer
      aided system.

PMID- 2235033
TI  - Wrestling causing paraplegia.
AB  - This report deals with 4 patients who had a spinal cord injury resulting from
      wrestling. The cause and the results are discussed.

PMID- 2235034
TI  - The use of a calcium alginate dressing in the management of decubitus ulcers in
      patients with spinal cord lesions.

PMID- 2235035
TI  - The right to die of a high quadriplegic in a developing country: case report.
AB  - In the north of Thailand a 21-year-old patient with a complete quadriplegia at C4
      level with respiratory insufficiency was treated, including assisted respiration.
      The patient felt that living held nothing for him and therefore he requested at
      his own free will to go home and die.

PMID- 2235036
TI  - Halo versus Minerva--which orthosis?

PMID- 2235037
TI  - Sexual ability, activity, attitudes and satisfaction as part of adjustment in
      spinal cord-injured subjects.
AB  - Changes in different aspects of sexuality were investigated and related to
      overall quality of life and physical, psychological and social adjustment in 73
      SCI subjects, who were sexually active both before and after injury. Items on
      sexual interest and satisfaction were treated as one composite variable, the SIS
      scale, measuring sexual adjustment after injury. Despite severe genital
      dysfunction, more than half of the subjects (57%) rated their sexual relations
      after injury as satisfying or at least rather satisfying. The majority continued
      having intercourse, although many of them more seldom than before, and about half
      experienced orgasm. Sexual adjustment after injury was closely and positively
      correlated to frequency of intercourse, willingness to experiment with
      alternative sexual expressions and young age at injury. Physical and social
      independence and a high mood level were further positive determinants of sexual
      adaptation after injury, whereas the neurological level and completeness of
      injury showed no significant correlation with sexuality. It is suggested that
      sexual information and counselling should be integrated in the total care of the
      SCI patient to reduce the negative effects on sexuality, caused by the injury.

PMID- 2235038
TI  - Post-traumatic syringomyelia, an update.
AB  - Post-traumatic and post-arachnoiditic syringomyelia is described in 31 patients
      from the Midland Centre for Neurosurgery and Neurology (MCNN). It is suggested
      that the mechanisms may be similar in the two groups and that treatment is best
      directed to disabling the likely filling mechanisms by opening up the
      cerebrospinal fluid (CSF) pathways and deliberately leaving the dura open to
      create an artificial meningocele. It is suggested that drainage on its own is
      inappropriate but that when drainage of the syrinx is chosen as an ancillary
      technique then syringopleural drainage may be the procedure of choice.

PMID- 2235039
TI  - The team approach to urinary bladder management in spinal cord injury patients: a
      26-year retrospective look at the Highland View Hospital Urinary Catheter Care
      Team.
AB  - The Highland View Hospital Urinary Catheter Care Team was organised in 1962,
      primarily in response to the problems of increasingly drug resistant urinary
      infections and their complications in a chronic disease population which included
      patients with strokes, renal and liver failure and heart disease as well as those
      with spinal cord injury (SCI). When the spinal cord injury centre was formed in
      1970 the team became an integral part of the service. The early problems in
      organising the team, its evolution into a valuable, economically viable, patient
      care service and its role in urological clinical research, are discussed.

PMID- 2235040
TI  - China's first total care unit for the spinal cord injured.
AB  - Before discussing China's first total care unit for the spinal cord injured, it
      is important, though difficult due to lack of an epidemiological study, to give
      the incidence of spinal cord injury in China. The only seriously conducted study
      of this kind was that from the Beijing Area (Spinal Cord Injury Investigating
      Group in Beijing, 1988). Some of the results will be presented below.

PMID- 2235041
TI  - Spinal cord injury care system: fifteen-year experience at the Rehabilitation
      Institute of Chicago.
AB  - A statistical study of 15 years of the spinal cord injury care system of the
      Rehabilitation Institute of Chicago is reported. The Rehabilitation Institute of
      Chicago (RIC) is the rehabilitation component of the Midwest Regional Spinal Cord
      Injury Care System, a collaborative programme with Northwestern Memorial Hospital
      and Northwestern University. Data are reported on 1382 patients, a representative
      sample of the over 2000 patients treated since the inception of the centre. The
      sample was predominantly male (83%, N = 1147) and caucasian (64%, N = 888). The
      most common aetiology was motor vehicle accidents (36%, N = 505). During the 15
      year period there were significant decreases in both acute and rehabilitation
      lengths of stay. Ninety three per cent of the patients were discharged home.
      Rehabilitation benefits were demonstrated by improvements in the Modified Barthel
      Index. The research, educational and clinical programmes are described.

PMID- 2235042
TI  - Surgical rehabilitation of the upper limb in tetraplegia.

PMID- 2235043
TI  - Injuries to elite wheelchair athletes.
AB  - The purpose of this project was to describe the nature, type, and frequency of
      athletic injuries incurred by the elite wheelchair athlete. Nineteen athletes
      participated in a 1-year injury recall study at an elite wheelchair training
      camp. An injury was defined as anything the athlete expressed concern about and
      (a) caused a loss of participation due to an injury or illness or (b) an injury
      in which a fracture, dislocation, or subluxation occurred and the athlete was
      able to continue participation. There were 10 male and 9 female subjects who
      reported their injuries from 1 June 1987 to 31 May 1988. Fifty injuries were
      reported, strains and muscular injuries accounted for almost half of the
      injuries. Physicians were the primary care provider for 37% of the injuries,
      followed by physical therapists and athletic trainers at 26% and 15%
      respectively. Slightly over 57% of the injuries were classified as minor, missing
      7 days or less of participation and 32% were classified as major, missing 22 days
      or more of participation. The upper extremity was the most frequently injured,
      followed by the lower extremity, head and spine, and illnesses. Conventional
      treatments of ice, heat, modalities, and medications, were the most common
      methods of treating these injuries. Flexibility and strength training programmes
      should be implemented throughout the competitive season. Careful consideration of
      the training programme and workout intensity should also be evaluated.

PMID- 2235044
TI  - Cotrel-Dubousset rods in spinal fractures.

PMID- 2235045
TI  - Intravesical electrical stimulation for the rehabilitation of the neuropathic
      bladder.

PMID- 2235047
TI  - Changes in ambulation parameters in spinal cord injury individuals following
      rehabilitation.
AB  - The energy cost and gait parameters of 10 spinal cord injury patients (mean age =
      21.7 +/- 2.3 years) were measured at discharge from initial rehabilitation and at
      1 year follow-up. At follow-up testing patients walked faster (59.5 m/minute vs
      40.4 m/minutes; p less than 0.001), more efficiently (0.26 ml O2/kg.m vs 0.40 ml
      O2/kg.m; p less than 0.05) had slower heart rates (115 beats/minute vs 133
      beats/minute; p less than 0.01), and required decreased axial load on upper
      extremity assistive devices (18% body weight vs 26% body weight; p less than
      0.03). At follow-up testing, those patients with remaining weakness in the lower
      limbs had greater conditioning effects (increased rate of oxygen consumption and
      oxygen pulse) than those patients with relatively stronger limbs. These findings
      indicate that clinicians can expect significant improvements in functional
      ambulation performance in the first year following initial rehabilitation due to
      improved strength and conditioning.

PMID- 2235046
TI  - Reciprocal aided gait in paraplegia.
AB  - A group of 9 male paraplegics, experienced in the use of walking aids for
      ambulation, were tested using an alternate four-point gait. Data were collected
      pertaining to the axial load transmitted through the crutches, the upper limb
      joint displacements and the moments about the elbow and shoulder joints during
      the period of contact of the walking aid with the ground. This gait was found to
      be slow with long periods of load transmission through the walking aids.
      Comparatively high values were calculated for the moments about the joints of the
      upper limb.

PMID- 2235048
TI  - The Spinal Cord Injuries Center Hamburg.

PMID- 2235049
TI  - Differences between rehabilitation disciplines in views of depression in spinal
      cord injury patients.
AB  - Reports based on clinical impressions have suggested that depression after spinal
      cord injury (SCI) is a near-universal phenomenon; however, studies using
      objective methods and strict criteria have not confirmed this. The aim of this
      study was to explore the experiences and opinions of rehabilitation clinicians
      with the depressed mood in their SCI patients. A questionnaire was completed by
      149 staff members of various disciplines working in four specialised SCI
      rehabilitation centres. We found that the disciplines vary in the symptomatology
      they observe (nurses most, physicians and mental health professionals least), and
      that these differences to some degree correspond to variations in the estimate of
      the frequency and intensity of depression in the average patient. The amount of
      staff experience was found not to be a factor. The implications of these findings
      for theories of staff expectations regarding patient mood states and the
      functioning of the clinical team are discussed.

PMID- 2235050
TI  - Obstructive disordered breathing during sleep in patients with spinal cord
      injury.
AB  - Little is known about respiration and sleep in spinal cord injured (SCI)
      patients, and yet they frequently have complaints related to sleep. Four SCI
      patients with various sleep complaints were evaluated with nocturnal
      polysomnography. All 4 had evidence of obstructive sleep apnea (disordered
      breathing). These findings suggest that obstructive sleep apnea may be
      contributing to disruptive sleep in SCI patients and may be responsible for many
      of their daytime symptoms.

PMID- 2235051
TI  - Neural stimulation for spinal spasticity.
AB  - The knowledge of neural plasticity is used to improve motor function of the
      spinal cord by chronic stimulation of the dorsal columns. We achieved this with
      an improvised technique. The electrodes are exteriorized and stimulated by using
      a Grass stimulator. Five paraplegic patients with different aetiologies causing
      their paraplegia were treated by this method, and the details are enumerated.
      Four had good improvement and relaxation was maintained for varying periods after
      cessation of the stimulation. Mode of action is discussed.

PMID- 2235052
TI  - Hip joint instability in an infant with paraplegia following aortic surgery.
AB  - A report on an infant with paraplegia following aortic surgery who suffered from
      coarctation of the aorta and a ventricular septum defect (VSD). The spinal
      paralysis was complete and flaccid. He was found to have paralytic bilateral
      dislocatable hip joints. Magnetic resonance image (MRI) of spinal cord showed no
      pathological findings. The hip joints were treated by a hip abduction brace.

PMID- 2235053
TI  - Techniques for lumbar discography and computed tomography/discography in clinical
      practice.
AB  - The technique for lumbar discography is not well standardized. To better
      understand lumbar pathology, we have developed a consistent, reproducible, and
      relatively simple procedure for lumbar discography. We describe our technique and
      discuss variables that may differ among individual lumbar discography procedures.

PMID- 2235054
TI  - Complications in primary total knee arthroplasty.
AB  - Total knee arthroplasty is one of the most popular and satisfying procedures in
      orthopaedic surgery. However, several perioperative and postoperative
      complications may follow total knee arthroplasty, leading to reconstruction
      failure. This article summarizes the issues of wound healing, infection,
      supracondylar fractures, thromboembolic disease, soft tissue balance, peroneal
      nerve palsy, and patellofemoral problems following primary total knee
      arthroplasty.

PMID- 2235055
TI  - Treatment of comminuted distal radial fractures with preliminary horizontal
      finger trap traction and a Roger-Anderson external fixation device.
AB  - Over a five-year period, 43 patients with comminuted distal radial fractures were
      treated with a Roger-Anderson external fixation device after the fracture was
      aligned in Strong's horizontal finger trap traction. Nineteen patients (21
      wrists) were available for personal interview and radiographic follow-up. A 0.5
      mm loss of radial height and an average loss of 2.4 degrees of palmar angulation
      presented. Range of motion (ROM) was excellent, stiffness was nonexistent or
      minimal in 81%, pain was nonexistent or minimal in 86%, and weakness of grasp was
      nonexistent or minimal in 81%. Complications were minimal; they included three
      pin tract infections, two of which required pin removal before they resolved. One
      patient fractured a pin that also required removal. Strong's horizontal finger
      trap traction and the Roger-Anderson external fixation device simplified the
      sometimes difficult treatment of this fracture. It seems to be most effective in
      young athletic individuals who have good bone stock and very comminuted
      fractures.

PMID- 2235058
TI  - Tips of the trade #28. Accurate tunnel placement using drill guides in knee
      ligament reconstruction.
AB  - Knee ligament reconstruction is optimized when intra-articular grafts are placed
      isometrically. Several drill guides have been designed to facilitate accurate
      tunnel placement. The use of an intra-articular keying hole, made with a burr,
      enhances proper and secure drill guide placement. Sterile mineral oil lubrication
      of the drill guide components will help prevent their distortion and will
      eliminate improper tunnel placement.

PMID- 2235057
TI  - Arthroscopy update #8. Auxiliary portal for assessing patellofemoral alignment.
AB  - An auxiliary arthroscopic portal may be used to improve visualization and
      evaluation of the patellofemoral joint. A reusable transquadriceps tendon portal,
      which assesses patellar alignment within a 0 degree to 90 degrees range of
      motion, is described.

PMID- 2235056
TI  - A technique of acetabular reconstruction for uncemented total hip replacement.
AB  - A technique for performing uncemented total hip replacement in the presence of
      osteoarthritis with proximal femoral migration is detailed. The femoral head is
      used as an autograft. The center of rotation of the hip is returned to its
      anatomic location, and subchondral bone is preserved. Rigid fixation of the graft
      is accomplished with matching reamers and AO lag screw fixation. Simultaneous
      reaming of graft and host bone produces a seamless transition to ensure graft
      loading. The goals of restoration of anatomic hip center, rigid press fit, and
      complete cup coverage are accomplished.

PMID- 2235059
TI  - Pediatric update #15. Florid reactive periostitis of the digits.
AB  - Benign fibrous lesions of the digits can present a considerable diagnostic
      challenge. Some lesions may resemble sarcomas, resulting in needless amputation.
      One such benign entity resembles myositis ossificans histologically but presents
      as an aggressive hand lesions. Unfortunately, this lesion has been given multiple
      names. It is most appropriately termed florid reactive periostitis. This paper
      reports a case of florid reactive periostitis in a 12-year-old girl.

PMID- 2235061
TI  - B-chromosomes: germ-line parasites which induced changes in host recombination.

PMID- 2235060
TI  - Selection and evolution of virulence in bacteria: an ecumenical excursion and
      modest suggestion.
AB  - Why do parasites kill their hosts? During this past decade, research in three
      different areas; evolutionary ecology, medical microbiology, and population
      genetics has provided theory and data that address this and related questions of
      selection and the evolution and maintenance of parasite virulence. A general
      theory of parasite-host coevolution and the conditions for selection to favour
      parasite virulence has been put forth. Considerable advances have been made in
      elucidating the mechanisms of pathogenicity and inheritance of virulence in
      bacteria. The population genetic structure and the relationship between
      pathogenic and non-pathogenic forms has been determined for a number of species
      of bacteria. We critically review these developments and their implications for
      questions of selection and the evolution and maintenance of virulence in
      bacteria. We postulate how selection may operate on specific types of bacterial
      virulence and present a general protocol to experimentally test hypotheses
      concerning selection and the evolution of virulence in bacteria.

PMID- 2235062
TI  - Virulence of lizard malaria: the evolutionary ecology of an ancient parasite-host
      association.
AB  - The negative consequences of parasitic infection (virulence) were examined for
      two lizard malaria parasite-host associations: Plasmodium agamae and P.
      giganteum, parasites of the rainbow lizard, Agama agama, in Sierra Leone, West
      Africa; and P. mexicanum in the western fence lizard, Sceloporus occidentalis, in
      northern California. These malaria species vary greatly in their reproductive
      characteristics: P. agamae produces only 8 merozoites per schizont, P. giganteum
      yields over 100, and P. mexicanum an intermediate number. All three parasites
      appear to have had an ancient association with their host. In fence lizards,
      infection with malaria is associated with increased numbers of immature
      erythrocytes, decreased haemoglobin levels, decreased maximal oxygen consumption,
      and decreased running stamina. Not affected were numbers of erythrocytes, resting
      metabolic rate, and sprint running speed which is supported by anaerobic means in
      lizards. Infected male fence lizards had smaller testes, stored less fat in
      preparation for winter dormancy, were more often socially submissive and,
      unexpectedly, were more extravagantly coloured on the ventral surface (a sexually
      dimorphic trait) than non-infected males. Females also stored less fat and
      produced smaller clutches of eggs, a directly observed reduction in fitness.
      Infected fence lizards do not develop behavioural fevers. P. mexicanum appears to
      have broad thermal buffering abilities and thermal tolerance; the parasite's
      population growth was unaffected by experimental alterations in the lizard's body
      temperature. The data are less complete for A. agama, but infected lizards
      suffered similar haematological and physiological effects. Infected animals may
      be socially submissive because they appear to gather less insect prey, possibly a
      result of being forced into inferior territories. Infection does not reduce
      clutch size in rainbow lizards, but may lengthen the time between clutches. These
      results are compared with predictions emerging from several models of the
      evolution of parasite virulence. The lack of behavioural fevers in fence lizards
      may represent a physiological constraint by the lizards in evolving a thermal
      tolerance large enough to allow elimination of the parasite via fever. Such
      constraints may be important in determining the outcome of parasite-host
      coevolution. Some theory predicts low virulence in old parasite-host systems and
      higher virulence in parasites with greater reproductive output. However, in
      conflict with this argument, all three malarial species exhibited similar high
      costs to their hosts.

PMID- 2235063
TI  - The evolution of inducible defence.
AB  - Defences against parasites are characterized by inducible, amplifiable responses,
      often with a memory component. Inducible defences with similar properties are
      common in a variety of other types of interactions, for example many aquatic
      invertebrates produce inducible structural defences against their predators and
      competitors. Most inducible defences have the following properties: (1) a
      threshold of activation; (2) an amplification of response with increasing
      stimulus; (3) a memory component. Specificity, amplification and memory are the
      basis for defining a defence as 'immune' (Klein, 1982), and these properties are
      present in both the vertebrate and invertebrate internal defence responses to
      pathogens. Invertebrates differ in the absence of immunoglobulins and therefore
      in reduced specificity. Although the reduced specificity of invertebrate internal
      defence systems is often viewed as proof of their 'primitiveness', the
      differences in defence systems of vertebrates and invertebrates may be more
      related to their respective selection regimes than to phylogeny. The syngeneic
      recognition system of vertebrates functions to recognize small departures from
      self, such as would arise from neoplasia. Are vertebrates under more intense
      selection from neoplasia, perhaps due to a greater incidence of hormonal
      imbalance or hypersensitivity reactions? The invertebrate internal defence
      systems are all less discriminating than the vertebrate, but there are marked
      differences in degree of discrimination depending on whether the group is
      colonial or not. Even the phyla of colonial animals with quite simple body plans,
      the sponges and cnidarians, have a more discriminating recognition system than
      the phyla of solitary animals with more complex body plans, such as the molluscs
      and arthropods. The primary effectors of all invertebrate responses to parasites
      are encapsulation and phagocytosis, although in some phyla there are specific
      antibacterial proteins than can also be induced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235064
TI  - Parasites, desiderata lists and the paradox of the organism.

PMID- 2235065
TI  - Genetic exchange and evolutionary relationships in protozoan and helminth
      parasites.
AB  - The study of genetic exchange systems and the use of genetic analysis has been
      relatively limited in parasites leading to considerable gaps in our basic
      knowledge. This lack of knowledge makes it difficult to draw firm conclusions as
      to how these systems evolved. An additional problem is also raised by the
      difficulties in defining evolutionary distances particularly with the unicellular
      protozoa, using classical ultrastructural and cytological criteria. While these
      difficulties have by no means been overcome, the use of rapid sequencing
      techniques applied to the ribosomal genes has allowed measurement of evolutionary
      distances, and considerable advances in our understanding of the genetic exchange
      systems in a few parasitic protozoa have recently been made. The conclusions from
      these recent sets of analyses are reviewed and then examined together in order to
      discuss the evolution of genetic exchange systems in parasitic protozoa. The
      evolutionary distances defined by ribosome sequence analysis show that parasites
      are an extremely divergent group, with distances which, in some cases, are orders
      of magnitude greater than the distances between mammals and fish; furthermore
      these studies suggest that the parasitic protozoa or their free-living ancestors
      are extremely ancient. These findings support the view that parasitism has
      occurred independently many times and that the parasitic life-style has been
      adopted by evolutionarily distinct groups. The recent observation of a non
      obligatory genetic system in the diploid but evolutionary ancient kinetoplastid
      Trypanosoma brucei suggests that diploidy and meiosis are extremely old. The
      observation, in parasitic protozoa and helminths, that selfing or non-obligatory
      mating is a common feature suggests that these processes may be strategies to
      overcome the cost of meiosis. In this context, the question of what selective
      forces maintain genetic exchange is discussed.

PMID- 2235066
TI  - Eimeria species: studies using rRNA and rDNA probes.
AB  - rRNA and a heterologous cloned rDNA probe have been used to detect the rRNA genes
      of Eimeria species which infect the chicken, and has allowed the isolation and
      preliminary characterization of cloned rDNA sequences from a genomic DNA library
      of Eimeria tenella. It is demonstrated that rRNA and rDNA probes can be used to
      identify individual Eimeria species by the restriction fragment patterns detected
      after Southern hybridization. In addition, studies have shown that the large and
      small subunit rRNAs are expressed throughout sporulation.

PMID- 2235067
TI  - Hymenolepis diminuta: changes in intestinal morphology and the enterochromaffin
      cell population associated with infection in male C57 mice.
AB  - Mean villus height, crypt depth and the number of 5-HT-positive enterochromaffin
      (EC) cells have been examined in two regions of the small intestine (20-30% and
      60-70% distance from the pylorus) of male, 6 to 8-week-old, C57 mice following a
      5-cysticercoid infection of the rat tapeworm, Hymenolepis diminuta. Test mice and
      sham-infected controls were autopsied 0, 4, 8, 10, 14 and 28 days post-primary
      infection (p-1 degree-i) and 2, 4, 5, 7 and 14 days post-secondary infection (p-2
      degrees-i), administered 28 days p-1 degree-i. Morphometric analysis revealed a
      statistically significant increase in crypt depth in the 60-70% intestine region
      in infected mice during both primary and secondary infections; no significant
      deviation from the control was observed for villus height in infected mice.
      Statistical analysis showed a significant increase in the number of 5-HT-positive
      EC cells in infected mice. This response occurred in the lower portion of the
      intestine on days 10-p-1 degree-i and 5-p-2 degrees-i, and was not due to
      increased mucosal surface area in this region. Results are discussed with
      reference to murine cestode rejection and the possible involvement therein of the
      neuroendocrine system.

PMID- 2235068
TI  - Molecular characterization of the surface and cyst fluid components of Taenia
      crassiceps.
AB  - Information relating to the characterization of cestode surface macromolecules is
      limited. This is especially the case with Taenia crassiceps, a well-recognized
      model for the study of larval cestodiasis. Here, the protein and glycoprotein
      composition of the tegumental surface and cyst fluid of the metacestode have been
      investigated using radio-isotope labelling, immunoprecipitation, SDS-PAGE and
      lectin affinity chromatography. A restricted number of surface proteins was
      labelled with the 125I/Iodogen method although the majority were immunogenic; in
      contrast an array of cyst fluid antigens were labelled. Host serum proteins,
      including immunoglobulins, were identified on the surface and in the cyst fluid.
      Some of the 125I-labelled surface proteins, including a 37 kDa molecule, have
      been shown to be glycoproteins and probably contain-D-mannose and/or D-glucose;
      there is limited or no N-acetylglucosamine and no terminal galactose present on
      these components. A 37 kDa surface molecule, possibly the same glycoprotein, was
      also precipitated by infection sera and this may endorse the theory that highly
      immunogenic carbohydrates are continuously shed by T. crassiceps as a mechanism
      for diverting the immune response of the host. Radio-iodinated and
      biosynthetically labelled T. crassiceps antigens were highly cross-reactive with
      antibody raised to other cestodes and not one antigen was identified as a
      possible candidate for use in specific immunodiagnosis of any of the important
      taeniid infections.

PMID- 2235070
TI  - Population dynamics in echinococcosis and cysticercosis: regulation of Taenia
      hydatigena and T. ovis in lambs through passively transferred immunity.
AB  - A comparison has been made of the interactions between passively transferred and
      actively acquired immunity in regulating populations of Taenia hydatigena and T.
      ovis. When ewes were grazed prior to parturition under a high infection pressure,
      immunity was transferred to their offspring for up to 8 weeks. A qualitative
      difference between the species was the destruction of larval T. ovis prior to
      their establishment ('pre-encystment immunity') and that of T. hydatigena after
      they had become established ('post-encystment immunity') in the challenged lambs.
      The major difference in terms of population regulation between the two parasites
      was that infection occurred with T. hydatigena but not with T. ovis in those
      lambs reared from birth for 16 weeks under high infection pressure. Passive, like
      active immunity, is a density-dependent constraint. It plays an important role in
      the population regulation of T. ovis, but not of T. hydatigena. This is discussed
      in terms of transmission in the natural environment, an hypothesis on humoral
      protection and the need to elucidate pathways of protection when immunization
      schedules are being evaluated for controlling the taeniid zoonoses.

PMID- 2235069
TI  - The relationship between the frequency distribution of Ascaris lumbricoides and
      the prevalence and intensity of infection in human communities.
AB  - Observed field data from a range of geographically distinct human communities
      suggest a consistent non-linear relationship between prevalence and mean
      intensity of Ascaris lumbricoides infection. Utilizing the negative binomial
      distribution as a description of observed aggregation, maximum-likelihood
      analysis reveals that the degree of aggregation is a negative linear function of
      mean worm burden. The factors responsible for this relationship in human
      populations require further study but may involve some combination of (i) density
      dependent reduction in worm numbers within individuals, (ii) density-dependent
      parasite-induced host mortality or (iii) self-treatment by heavily infected
      hosts. Variability in the degree of aggregation appears dependent on the level of
      infection in a community and independent of geographical differences in the host
      or parasite populations.

PMID- 2235071
TI  - The laboratory maintenance of Diphyllobothrium dendriticum (Nitzsch, 1824).
AB  - A protocol for the routine laboratory maintenance of the life-cycle of
      Diphyllobothrium dendriticum, using herring gulls (Larus argentatus), Cyclops
      abyssorum and rainbow trout Oncorhynchus mykiss ( = Salmo gairdneri) as the
      definitive, first and second intermediate hosts respectively, is described.

PMID- 2235072
TI  - Speciation of echinostomes: evidence for the existence of two sympatric sibling
      species in the complex Echinoparyphium recurvatum (von Linstow 1873) (Digenea:
      Echinostomatidae).
AB  - Evidence for the existence of 2 first intermediate host-specific sibling species
      of the 45 collar-spined echinostome Echinoparyphium recurvatum is presented.
      Experimental studies on their life-cycles were carried out under controlled
      laboratory conditions. The two entities were found to be morphologically
      indistinguishable in all major respects, yet they exhibited distinct biological
      characteristics. One of the sibling species utilizes the freshwater lymnaeid
      pulmonate snail Lymnaea peregra as first intermediate host, and the adults occur
      in the anterior small intestine of the wildfowl experimental definitive host Anas
      platyrhynchos. The other utilizes the freshwater mesogastropod prosobranch snail
      Valvata piscinalis as first intermediate host, and the adults occur in the
      posterior small intestine and rectum of A. platyrhynchos. The existence of the
      two sibling species in sympatry may be explained by the fact that the life-cycles
      of the two forms represent two distinct cycles of transmission serving to reduce
      excessive competition between them.

PMID- 2235073
TI  - The influence of second intermediate host dispersion pattern upon the
      transmission of cercariae of Echinoparyphium recurvatum (Digenea:
      Echinostomatidae).
AB  - Transmission of cercariae of the echinostome digenean Echinoparyphium recurvatum
      was observed in experimental populations of the second intermediate host snail
      Lymnaea peregra. Populations of 100 snails were distributed among plastic mesh
      cages in an infection arena to produce different patterns of host dispersion.
      Cercarial transmission was investigated in host populations showing three
      separate patterns of host dispersion; Ideal Regular, Random and Contagious
      ('Clumped'). Levels of cercarial transmission in populations showing each type of
      dispersion pattern were found to be significantly different. The highest rate of
      cercarial transmission occurred in the contagiously dispersed host population,
      and the lowest in the randomly dispersed population. Analysis of results from the
      randomly dispersed population also showed that both the mean percentage
      prevalence of infection, and also the mean number of cysts recovered per snail,
      increased significantly with the number of snails per cage. The positive
      relationship between the mean number of cysts per snail and the number of snails
      per cage was found to be best described by an exponential function. Chemosensory
      location of L. peregra snail hosts by E. recurvatum cercariae may provide an
      explanation for the patterns of cercarial transmission observed.

PMID- 2235074
TI  - A comparison of multiplication rates in primary and challenge infections of
      Trypanosoma brucei bloodstream forms.
AB  - The hypothesis that division of Trypanosoma brucei slender bloodstream forms is
      dependent upon the availability of a host-derived growth factor has been tested
      by superimposing challenge doses of slender-form trypanosomes onto preexisting
      infections at a time during the primary infection when stumpy forms predominated.
      The challenge populations grew in the doubly-infected mice indicating that
      depletion of a putative growth factor by the expanding population of the primary
      infection had not prevented division of the trypanosomes although slight
      reductions in multiplication rates were observed. This effect was independent of
      the variable antigen type (VAT) of the trypanosomes and of their stock of origin.

PMID- 2235075
TI  - Proteolytic activity in Tritrichomonas mobilensis.
AB  - Cell extracts of an entero-invasive protozoon of squirrel monkeys, Tritrichomonas
      mobilensis, contained relatively high proteolytic activity, measured on hide
      powder azure (HPA). Multiple proteinase forms, optimally active at pH 5-7, were
      detected by electrophoretic analysis in gelatin-containing polyacrylamide gels.
      Three major proteinase bands of apparent low molecular weights, Mr 18, 23 and 30
      kDa, were seen on gels. Inhibition-activation studies suggest that only cysteine
      proteinases were involved in HPAase and gelatinolytic activities of T. mobilensis
      cell extracts.

PMID- 2235076
TI  - The influence of genes mapping within the major histocompatibility complex on
      resistance to Trichuris muris infections in mice.
AB  - Two panels of H-2 recombinant strains of mice were used in an attempt to map the
      H-2-linked genes which control resistance to infection with Trichuris muris.
      Response phenotypes could be related to the presence of 'resistance' (q,b) or
      'susceptibility' (k,d) alleles at I-A. The influence of these genes was modulated
      by other alleles, particularly q or d alleles, at the D end of the H-2. Absence
      of I-E molecules correlated with resistance to infection in some but not all
      strains studied. Thus the (B10.BR x B10.G) F1 strain which expressed I-Ek gene
      products was resistant to infection. A study of the time-course of infection in
      strains of mice expressing q alleles throughout the H-2 on 4 different genetic
      backgrounds (NIH, SWR, DBA and B10) revealed that most strains were resistant to
      infection. However, the DBA/1 strain exhibited differential responsiveness, 4 out
      of 6 individuals harbouring mature adult parasites on day 35 post-infection.

PMID- 2235077
TI  - Immunogenetic correlates of susceptibility to infection with Heligmosomoides
      polygyrus in outbred mice.
AB  - Outbred MF1 mice were characterized with respect to their susceptibility to
      infection with Heligmosomoides polygyrus (Nematoda) on the basis of faecal egg
      counts after 8 weeks of repeated infection (50 larvae/week). Selective breeding
      for resistance and susceptibility was carried out over 3 generations. The H-2
      type of a sample of the mice was determined, and antigen recognition assessed on
      the basis of Western blots against adult and larval H. polygyrus homogenate. The
      selective breeding programme yielded very strong evidence for the heritability of
      susceptibility to infection. The results were consistent with a model of single
      gene control with resistance dominant over susceptibility. The presence of the H
      2k haplotype was significantly associated with susceptibility, as was the
      recognition of a 17 kDa antigen in blots against both larval and adult worm
      homogenate. The proportion of mice phenotypically susceptible to infection, the
      proportion bearing the H-2k haplotype, and the proportion recognizing the 17 kDa
      antigen, were all approximately 0.25.

PMID- 2235079
TI  - An experimental and theoretical study of the dynamics of a mouse-nematode
      (Heligmosomoides polygyrus) interaction.
AB  - The population dynamics of outbred laboratory mice in indoor enclosures in the
      absence and presence of a naturally transmitted direct life-cycle nematode
      Heligmosomoides polygyrus Dujardin 1845 were reported previously. This manuscript
      presents further information on the age and sex structure of the populations,
      results of experiments designed to estimate the density-dependent effect of the
      parasite on host survival and reproduction, and a mathematical model of both
      uninfected and infected mouse populations. In the uninfected mouse population,
      survival of female mice was age- and density-independent, survival of male mice
      was age-dependent and density-independent, and recruitment was density-dependent.
      Independent experiments revealed that the parasite had no density-dependent
      effect on mouse reproduction, but had density-dependent effects on both acute and
      chronic survival of mice. An age-structured Leslie matrix model captured the
      exponential growth and plateau of the uninfected mouse population. Modification
      of the model to incorporate the effects of the parasite provided a good fit to
      the data from the infected populations, supporting the hypothesis that density
      dependent effects of the parasite on host survival could lead to regulation of
      host abundance.

PMID- 2235078
TI  - Intracellular differentiation of Leishmania amazonensis promastigotes to
      amastigotes: presence of megasomes, cysteine proteinase activity and
      susceptibility to leucine-methyl ester.
AB  - Intracellular differentiation of Leishmania promastigotes to amastigotes is a
      critical step in the establishment of infection. In this report three related
      features of mexicana subspecies amastigotes were used to follow the
      differentiation of the parasites within macrophages. Early after infection, (a)
      parasites did not contain ultrastructurally recognizable megasomes, (b) cysteine
      proteinase activity of parasite lysates was not detected in gelatin-containing
      acrylamide gels, and (c) parasites were essentially resistant to L-leucine-methyl
      ester (Leu-OMe). Typical megasomes were first identified on the 5th day, were
      more prevalent on day 7, and underwent swelling in macrophages exposed to Leu
      OMe. Cysteine proteinase activity was first detected on day 3 and increased
      thereafter. Susceptibility to Leu-OMe of parasites studied in situ or isolated
      from infected macrophages increased with time of intracellular residence and by 7
      days approached that of amastigotes isolated from mouse lesions. In contrast,
      parasites derived from either promastigotes or amastigotes were equally
      susceptible to another leishmanicidal compound, tryptophanamide (Trp-NH2). The
      results provide additional support for the involvement of megasomes and their
      cysteine proteinases in parasite killing by Leu-OMe, and highlight the slow pace
      of the intracellular differentiation of L. amazonensis promastigotes to
      amastigotes.

PMID- 2235080
TI  - Capture and penetration processes of the free-living juveniles of
      Trichostrongylus colubriformis (Nematoda) by the nematophagous fungus,
      Arthrobotrys oligospora.
AB  - The nematode-trapping fungus Arthrobotrys oligospora traps and invades all the
      free-living juvenile stages of the trichostrongyle nematode Trichostrongylus
      colubriformis. The processes of capture and invasion of the 1st-stage juveniles
      are described using differential interference contrast optics and 3-D
      reconstruction techniques. The adhesive responsible for capture is well preserved
      using a freeze-substitution technique for scanning electron microscopy. The
      invasion process of the ensheathed 3rd-stage juvenile of T. colubriformis takes
      much longer than in the 1st- or 2nd-stage juvenile and involves the formation of
      secondary infection pegs between the sheath and the cuticle which appear to
      penetrate the cuticle by physical pressure.

PMID- 2235081
TI  - [Ataxia telangiectasia: a model of investigation of chromosomal translocations].

PMID- 2235082
TI  - [Platelet antibody activity in malaria thrombocytopenia].
AB  - To assess immune responses to malaria-induced thrombocytopenia, an haematologic
      and immunologic study was performed on 25 patients with imported malaria upon
      admission and 8 days after treatment. Thrombocytopenia (150 x 10(9)/litre) was
      detected in 19 cases (P. falciparum: 11 cases, P. ovale: 6 cases, P. vivax: 2
      cases). No laboratory evidence of disseminated intravascular coagulation
      impairment was found in any of the patients. Bone marrow examination performed in
      9 cases showed no abnormality in the megakaryocyte series. Platelet count was
      independent of circulating parasite levels (r = 0.27) and inversely related to
      the number of antibody binding sites (ABS) on platelets (r = -0.6, p. less than
      0.01). The indirect Coombs test (r = -0.54; p less than 0.01) and IgG and IgE
      levels (p less than 0.02) gave similar findings. A statistical correlation was
      observed between the level of circulating immune complex and the number of ABS (r
      = 0.525, p less than 0.01). Thus malaria-induced thrombocytopenia seems to mainly
      involve IgG type antiplatelet antibody activity. Although they may be implicated
      in the binding of antibodies to platelets, circulating immune complexes do not
      appear to mediate thrombocytopenia.

PMID- 2235083
TI  - [Hourly serum cortisol assay over 24hr by immunoenzymology in depression].
AB  - Enzymoimmunoassays have been developed as alternatives to radioimmunoassays
      because they obviate the need for labelled compounds yet offering comparable
      specificity. The authors used an enzymoimmunoassay to investigate hourly serum
      cortisol levels over 24 hours in 6 patients (aged over 40 years) with endogenous
      depression (4 unipolar depressions, under antidepressor treatment and 2 bipolar
      depressions, without medication) and in 2 controls, aged 20 and 47 years. In
      agreement with literature data, a clear circadian rhythm was observed in controls
      and in the depressed patients, and hypercorticism was noted in one depressed
      patient. A trend towards phase advance in depression was seen in both the treated
      and untreated patients.

PMID- 2235085
TI  - [Identification of Campylobacter jejuni by using a biotinylated probe].
AB  - A DNA biotinylated probe for the rapid identification of Campylobacter jejuni in
      culture (Enzo Biochem, New York) has been evaluated. The hybridized biotinylated
      DNA probe is detected by its interaction with streptavidin linked to horseradish
      peroxidase. Sixteen strains of C. jejuni, including type strain. 24 strains of
      other Campylobacter and Helicobacter species, and 59 strains of other general
      have been studied. The probe was highly sensitive (100%) and specific (100%
      inside the genera Campylobacter and Helicobacter). All Campylobacter strains gave
      strong signals, and only three weak signals have been observed with non
      Campylobacter strains. Our results indicate that specific recombinant DNA probe
      should offer a reliable and rapid method for routine diagnosis of Campylobacter
      jejuni enteritis.

PMID- 2235084
TI  - [Prevalence of hepatitis B (Hbs Ag, Hbe Ag, DNA) and delta virus markers, in
      about 10,000 pregnant women in Limoges (France)].
AB  - The risk of perinatal B virus transmission is well known, but is estimated in
      France on results obtained from blood donors or from urban populations. In the
      present study, the screening of HBs Ag was carried out during five years (1984
      1988), within a sample population of pregnant women (french women: 8,364,
      immigrant women: 1,206) seen in the university hospital of Limoges. Positive sera
      for HBs Ag were also tested for the other markers of B virus including specific
      DNA, and markers of the delta virus. The total seroprevalence of HBs Ag among
      these women was 0.54%, and was significantly higher in the immigrant women group
      (2.57%) when compared to that of french women (0.25%). During the same period
      (1984-1988), the seroprevalence among females blood donor was 0.03%. Among the
      HBs Ag chronic carrier pregnant women (n = 52), 27% were HBe Ag positive and four
      of them (31%) had viral DNA in their serum. Viral DNA was found in three women
      who were HBe Ag negative. Thirteen per cent of the HBs Ag positive pregnant women
      were infected by the delta virus.

PMID- 2235086
TI  - [Effect of ceftriaxone on aerobic fecal flora in children].
AB  - Counts of aerobic faecal flora were done using serial dilutions of stools
      cultured on selective media in order to estimate the ecological effects of
      ceftriaxone. Twenty children were studied (24 courses of treatment), 17 of them
      with post-chemotherapy agranulocytosis. Enterobacteriaceae disappeared in all
      cases. After treatment, they rose again, unless another antibiotic was
      administered. No Pseudomonas could be found, due to the protective isolation.
      Streptococci D disappeared in 6 children. Staphylococcus aureus was present
      transiently at a low level in one case. Candida persisted in two cases at the
      same level in spite of antifungal therapy.

PMID- 2235087
TI  - [In vitro antifungal activity of mercurobutol].
AB  - Mercurobutol, in its commercial form, exhibits fungistatic and fungicidal
      activities against both yeasts: Candida albicans, C. tropicalis, Torulopsis
      glabrata, Pityrosporum spp., and filamentous fungi: dermatophytes, Aspergillus
      fumigatus, mainly saprophytic or potentially pathogenic fungi of the cutaneo
      mucous flora. Minimal inhibitory concentrations on this antiseptic indicate a
      high susceptibility of the species tested, that could justify the enlargement of
      the indication of the drug to the complementary treatment of most cutaneous
      mycosis.

PMID- 2235088
TI  - [Proteinuria selectivity: description of a new index].
AB  - An improved simple method for determination of selectivity index has been
      described. This new index (Creteil index) has been compared to Cameron index. The
      correlation between both indexes has been 0.949 (R-squared). Creteil index is a
      less expensive method because only two determinations are requisited in serum and
      urine: albumin and IgG. In Cameron index, transferrin and IgG are detected and
      albumin has to be measured in addition in the blood to appreciate the nephrotic
      syndrome.

PMID- 2235089
TI  - [Cancer of the breast. Genetic alterations and prognostic factors].
AB  - The etiology of breast cancer is thought to involve a complex interplay of
      various factors, among them: genetic alterations. Multiple studies have been made
      to identify and characterize mutations that frequently occur during
      tumorigenesis. In human breast cancer, some of these alterations involve
      implication of proto-oncogenes (c-myc, c-erbB-2 and int-2) that have been shown
      to contribute to tumorigenesis by using the transgenic mouse model. Loss of
      heterozygoty represents the other important type of abnormalities that has been
      frequently observed in breast tumor DNAs; these specific genic deletions could
      inactivate or remove suppressor genes. In some studies, specific alterations have
      been associated with some clinical parameters, but have led to numerous
      controversies. Larger studies would be necessary to confirm some alterations as
      useful prognostic factors of the post-surgical course of the disease.

PMID- 2235090
TI  - [Norfloxacin: a broad-spectrum quinolone for superficial eye infections].
AB  - Norfloxacin is a synthetic antibiotic belonging to the fluoroquinolone class. At
      present, an oral formulation is available and indicated for the treatment of
      urinary tract infections. Because of the properties of norfloxacin, a 0.3%
      norfloxacin ophtalmic solution may be used by ophtalmologists. The molecular
      target of norfloxacin is DNA gyrase that regulates DNA replication. Norfloxacin
      is a broad spectrum antibiotic. A flurin atome in position 6 is responsible for
      the broad spectrum of activity as compared with the first generation quinolones.
      MICs of norfloxacin against Haemophilus influenzae, Neisseria gonorrhoeae,
      Staphylococcus aureus, Pseudomonas aeruginosa, and enterbacteriaceae are low or
      intermediate. Norfloxacin is a bactericidal drug of which MBCs are equivalent to
      or twice as high as MICs against the majority of organisms. The proportion of
      norfloxacin resistant strains is limited and, at present, no plasmid resistance
      has been observed. This explains the activity of norfloxacin against clinical
      isolates whose drug resistance is plasmid-mediated. Norfloxacin resistance is
      chromosomic, but the mutation rate is low. There is no cross-resistance between
      quinolones and other classes of drug, with the exception of drug resistance
      related to changes in the bacterial outer membrane proteins. A low decrease in
      norfloxacin susceptibility is observed in case of resistance to first generation
      quinolones. The above-mentioned properties make norfloxacin in ophtalmic solution
      a first line drug for treatment of superficial ocular infections and a second
      line drug for treatment of infections due to organisms resistant to other drugs.

PMID- 2235091
TI  - Evaluation of the white blood cell differential given by the new analyser Coulter
      STKS in both hematological and non-hematological patient groups.
AB  - The White Blood Cell differential given by the new analyser Coulter STKS was
      studied in a group of hospitalized patients originating from non-hematological
      departments (group 1; n = 290) and a group of patients suffering from an
      hematological disease (group 2; n = 106) with blood smear abnormalities. A good
      relationship between the reference method and the STKS results was shown in 200
      patients without hematological abnormalities. Both sensitivity and reliability of
      alarms were evaluated in both groups. In group 1, we noticed respectively: 208
      true negative, 40 true positive, 7 false negative, 35 false positive. Six of the
      seven false negative results were related to the presence of a slight myelemia
      without hematological significance, one to the presence of small quantity of
      circulating blasts with a leuconeutropenia. In group 2, all abnormalities seen on
      the blood smear were detected by the Coulter STKS either by an alarm message (93
      cases) or by an increase of the lymphocyte population (9 cases) in some chronic
      lymphocyte leukemias, or by an important leuconeutropenia (4 cases) in acute
      treated leukemias. The results of the White Blood Cell differential performed
      with the Coulter STKS exhibited a good relationship with the reference method for
      normal bloods and a good reliability for detection of abnormal cells.

PMID- 2235092
TI  - Follicular immunoblastic lymphoma: neoplastic counterpart of the intrafollicular
      immunoblast?
AB  - B-immunoblasts, the precursors of plasma cells, occur predominantly in the
      interfollicular regions of lymphoid tissue, but may also occur in small numbers
      in germinal centres (intrafollicular immunoblasts). We report an unusual case of
      de novo follicular lymphoma composed of immunoblasts with an appreciable amount
      of plasmacytoid cytoplasm. We postulate that follicular immunoblastic lymphoma
      probably represents the neoplastic counterpart of the intrafollicular
      immunoblast.

PMID- 2235093
TI  - Mycobacterium terrae tenosynovitis.
AB  - Atypical mycobacteria causing extra-pulmonary disease in man are well documented.
      These infections are manifested by the presence of ulcers, abscesses and
      lymphadenitis. Mycobacterium marinum is particularly noted for infections
      involving the synovium, tendon sheaths, bursae and bone. Of lesser note is
      Mycobacterium terrae (radish bacillus), a nonchromogen also associated with
      tenosynovitis. We are not aware of any previous report of the association of M.
      terrae with synovitis in Australia. This case report describes a culture-proven
      case of tenosynovitis caused by M. terrae.

PMID- 2235094
TI  - Angiosarcoma of the prostate. An immunohistochemical study of a case.
AB  - A rare case of angiosarcoma occurring in the prostate of a 35-year-old man and
      characterized by a classical histological appearance is presented. The diagnosis
      was confirmed by the demonstration of factor VIII-related antigen in the tumor
      cells. The case illustrates the aggressive nature of angiosarcoma of the
      prostate.

PMID- 2235095
TI  - Grossly elevated serum prostatic acid phosphatase in a patient with carcinoid.
AB  - We report a case of carcinoid, diagnosed histochemically and biochemically, which
      was associated with grossly elevated serum prostatic acid phosphatase and normal
      serum prostate specific antigen.

PMID- 2235096
TI  - Macromolecular lactate dehydrogenase: an innocent bystander.
AB  - Lactate dehydrogenase (LD) activity is often increased in malignancy, and may
      occasionally be a useful tumor marker. In the case reported here, a persistently
      increased LD activity led to an extensive search for a neoplasm. Results of
      routine investigations were normal, but LD electrophoresis followed by gel
      filtration and immunofixation confirmed the presence of a circulating
      macromolecular LD, comprising IgAK bound to LD. Altogether it may provoke
      unnecessary investigations, the LD-IgA complex currently has no diagnostic
      significance.

PMID- 2235097
TI  - Osteolytic skeletal lesions in chronic myeloid leukemia.

PMID- 2235098
TI  - Apolipoprotein localization in the human bile duct and gallbladder.
AB  - Apolipoproteins AI, AII and B were identified in the normal and pathological
      human bile duct and the gallbladder epithelium using an avidin-biotin
      immunoperoxidase technique. Small intestine and stomach sections served as
      positive and negative controls respectively. Staining was focal for
      apolipoproteins AI and AII, and continuous for apolipoprotein B. In addition to
      homogenous and granular cytoplasmic staining, foamy cytoplasmic staining,
      particularly for apolipoproteins AI and AII, was observed around lipid droplets
      in cells containing much lipid. No correlation between a particular pathological
      condition of the gallbladder (acute cholecystitis, mucocele, chronic
      cholecystitis, cholesterolosis) and staining pattern or intensity of staining was
      found for any of the apolipoproteins, although both apolipoproteins AI and AII
      stained more intensely than apolipoprotein B in each group. Positive staining was
      also found for all apolipoproteins in epithelial cells which had invaded the
      underlying connective tissue (gallbladder carcinoma), suggesting that the
      epithelial cells are capable of synthesizing apolipoproteins de novo. In this
      latter case, apolipoprotein B stained more intensely than for either AI or AII,
      and significantly (p less than 0.05) more strongly than that found in the other
      pathological groups. The identification of apolipoproteins in the gallbladder
      epithelium raises the interesting question of their origin and functional role.

PMID- 2235099
TI  - Human leucocyte differentiation antigens: review of the CD nomenclature.
AB  - In February 1989 the 4th International Workshop and Conference on Human Leucocyte
      Differentiation Antigens was held in Vienna. At this meeting the structure and
      function of recognized cellular antigens was reviewed and new antigens defined.
      In addition, information was obtained on the molecular genetics of antigens from
      gene cloning and sequencing. The CD (clusters of differentiation) nomenclature
      was extended, giving a total of 78 CD clusters, and some previously described CD
      groups revised and sub-divided. In this paper new information on the structure
      and function of leucocyte antigens presented at the meeting will be discussed. In
      addition, descriptions of the newly defined CD clusters and changes to
      established clusters will be outlined.

PMID- 2235100
TI  - Comparison of thromboplastins using the ISI and INR system.
AB  - Twelve thromboplastins were tested against a secondary reference thromboplastin
      (human brain CRM BCR No. 147) or a tertiary house standard (human brain
      thromboplastin) with plasmas from normal healthy individuals and patients on oral
      anticoagulant therapy. The relationship between the prothrombin ratios of the
      thromboplastins tested versus the reference reagent was either a straight or
      curved line. The International Sensitivity Index (ISI) was estimated for each of
      the test thromboplastins and these ranged from 0.98 to 2.24. Some ISIs stated by
      manufacturers were different from our results. Thromboplastins with a high ISI
      showed a loss of sensitivity in assessing the level of anticoagulation at the
      upper end of the therapeutic range. In addition, the 95% Confidence Interval (CI)
      of the ISI estimations were widest for thromboplastins with the highest ISIs.
      Conversion of the prothrombin ratio to International Normalized Ratio (INR) was
      most accurate with the Australasian Reference Thromboplastin (ART) and least
      accurate with reagents having an ISI of 2.00 and over. Thromboplastins with an
      ISI between 1.10 and 1.50 may be adequate for the control of oral anticoagulant
      therapy, but were less accurate than a thromboplastin with an ISI approximating
      1.00. Factors other than ISI should be considered in the choice of a
      thromboplastin, in particular a measurement of the accuracy of the ISI estimation
      such as the 95% confidence interval estimation used here.

PMID- 2235101
TI  - Ras gene product expression in blood and marrow smears of patients with acute
      leukemia: importance of fixation.
AB  - Activation of ras protooncogenes by any of several possible mutations in codons
      12, 13 or 61 has been demonstrated in a variety of human malignancies, including
      acute non-lymphoblastic leukemia (ANLL). In situ staining for the ras gene
      product, p21, has been demonstrated in carcinomas of several sites. High levels
      of p21 expression have been associated with histologic anaplasia in prostate
      cancer and regional lymph node metastasis in breast cancer. We examined 16 marrow
      aspirates and blood smears from patients with acute leukemia, predominantly ANLL,
      and eight controls. Marrow aspirates or blood were smeared on glass slides and
      fixed immediately in 10% buffered formalin. p21 was examined with avidin-biotin
      linked immunoperoxidase visualization. Particular attention must be paid to
      antibody selection and fixation protocol to demonstrate p21, owing to its rapid
      degradation ex vivo. Three of 16 patients exhibited occasional high p21
      expression primarily in leukemic blasts, but in no case were more than 10% of
      blast cells positive. Normal reticuloendothelial and myeloid cells occasionally
      exhibited mild to moderately heavy staining, but megakaryocytes, erythroid
      precursors, lymphocytes and plasma cells were consistently negative. Most
      patients, 5 normal volunteers and 3 patients with non-malignant disease,
      exhibited no reactivity, or only a faint blush. These data suggest that while
      point mutation and concomitant activation of c-N-ras occurs regularly in ANLL,
      high levels of ras p21 expression are rarely found with this technique.

PMID- 2235102
TI  - Red cell folate assays: some answers to current problems with radioassay
      variability.
AB  - Red cell folate specimens were added to the Quality Assurance Program (QAP) of
      the Royal College of Pathologists of Australasia in 1986. The interlaboratory
      variation in the results of these red cell folate surveys has been persistently
      unsatisfactory. This study reports an investigation into the factors contributing
      to the wide variation of results reported in QAP surveys. Survey results were
      studied, replies to a questionnaire regarding methods sent to all participants
      were assessed and some new experimental studies were performed. Factors
      contributing to the poor QAP results include variation in dilution and diluent,
      calculation errors, failure to freeze the hemolysate prior to assay and to follow
      the kit manufactorer's instructions, stability of dithiothreitol, and variations
      in kit methods, especially in the release of bound folate by "boil" and "no-boil"
      methods. Photodecomposition and the form and concentration of ascorbate may also
      be significant. Adequate preparation of the hemolysate sample should ensure
      release of all protein-bound red cell folate with the reduction of all folates to
      a single form. Kit manufactures, users and the QAP committee can all contribute
      in all attempt to rectify current sources of error.

PMID- 2235103
TI  - Neurotic and psychosomatic disorders. Interdependence in terms of the search
      activity concept.
AB  - There are no correlations between MMPI Hysteria (Hs) and Depression (D) scales in
      psychosomatic patients in contrast to other patients with somatic disturbances,
      neurotic disturbances, and in healthy subjects. The roles of depression and
      hypochondria in the dynamics of psychosomatic disturbances are discussed
      according to the search activity concept. It is suggested that hypochondriacal
      complaints are prognostically favorable in comparison with anxiety-depression
      complaints.

PMID- 2235104
TI  - Pavlov, psychoanalysis, and neuroses.
AB  - Pavlov's discovery of experiment neurosis was serendipitous, yet it was made
      under the influence of Breuer and Freud's case of Anna O. In 1914, Pavlov's
      disciple N. R. Shenger-Krestovnikova, exploring the limits of visual
      discrimination in dogs, noticed that when the discrimination was difficult, the
      dogs' behavior became disorganized. Pavlov drew an analogy between the condition
      of Shenger-Krestovnikova's dogs and their disorganized behavior with Anna O.'s
      situation and her neurotic reaction. Pavlov concluded that he had demonstrated in
      the laboratory the elements of neurosis in animals and human alike. Schilder's
      criticism of his position, his later study of human neuroses in clinical
      settings, and the views of Janet may have induced Pavlov to differentiate between
      animal and human neuroses.

PMID- 2235105
TI  - Locus of semantic generalization of the galvanic skin response and possible
      inhibitory influence of conditional stimuli upon unconditional response following
      conditioning with innocuous and noxious unconditional stimuli.
AB  - Two different problems were investigated using the GSR index of the orienting
      reflex (OR): 1) the locus of semantic generalization; and 2) a possible
      inhibitory influence of the CS upon the UCR. Two experiments were conducted. One
      experiment employed an innocuous USC, and a second similar experiment used a loud
      noise as the UCS. Unidirectional word associates were employed in the test of the
      direction of semantic generalization. Constant and varying CS words were used to
      test the possible inhibitory influence of the CS upon the UCR. Evidence was
      obtained of semantic generalization occurring in the training and in the test
      situation. There was no evidence of the CS developing inhibition over the UCR.
      Theoretical interpretation of both phenomena were considered. The need for
      developing theories of conditioning of the OR in humans was emphasized in
      contrast to current efforts to apply inappropriate cognitive animals learning
      theories which fail to consider biologic constraints.

PMID- 2235106
TI  - Reaction time task as unconditional stimulus. Comparing aversive and nonaversive
      unconditional stimuli.
AB  - Nonaversive unconditional stimuli (USs) are seldom used in human classic
      conditioning of autonomic responses. One major objection to their use is that
      they produce deficits in electrodermal (ED) second- and third-interval response
      conditioning. However, a nonaversive reaction time (RT) task that includes
      feedback of success has been shown to be an effective US while avoiding this
      disadvantage (Lipp and Vaitl 1988). The present study compared this new RT task
      (RT-new) with a traditional RT task (RT-old) and with a standard aversive US
      (shock) in differential classic conditioning of ED, heart rate (HR), and digital
      pulse volume (DPV) responses. Eight-second-delay differential conditioning was
      applied in three groups of 12 subjects each. Simple geometric features (square,
      cross) displayed on a television screen served as conditional stimuli (CS+ and CS
      ). In acquisition, there were no statistically significant differences among the
      groups; differential conditioning did occur in HR, first- and second-interval ED
      responses, and first-interval DPV responses. Separate analyses within each group,
      however, revealed that there was no second-interval ED conditioning in the RT-old
      group. During extinction, neither DPV nor second-interval ED conditioning could
      be obtained, whereas HR and first-interval ED conditioning occurred in each
      group. In third-interval omission ED responses, RT-old and shock groups exhibited
      extinction, while response differentiation was maintained in the RT-new group
      throughout extinction. The RT task including feedback proved to be as reliable a
      US as a standard aversive US, whereas application of a traditional RT task again
      yielded some weaknesses in second-interval ED conditioning.

PMID- 2235108
TI  - A pediatrician's view: some things old, some things new.

PMID- 2235107
TI  - Kupalov's concept of shortened conditional reflexes: psychophysiological and
      psychopharmacological implications.

PMID- 2235109
TI  - Viral otitis media.

PMID- 2235110
TI  - Measles vaccine and measles control.

PMID- 2235111
TI  - Developmental regulation of angiotensinogen gene expression in sheep.
AB  - It has been suggested that the liver is not the main source of angiotensinogen
      during fetal life in rats, but that the kidney is an important site of fetal
      angiotensinogen synthesis. In an effort to determine if this phenomenon is
      specific to the rat or applicable to other species, we compared the ontogenic
      changes in hepatic and renal angiotensinogen mRNA expression in fetal (60, 90,
      118, and 138 d of gestation, term being 145 d), newborn (7 d postnatal), and
      adult sheep. Total RNA was extracted, subjected to Northern blotting and
      hybridized using a full-length rat radiolabeled antisense RNA. Angiotensinogen
      mRNA sequences were detected in all fetal liver samples and appeared to increase
      3-fold from 60 to 138 d gestation and then to decrease after birth. In contrast,
      angiotensinogen mRNA could not be detected in renal cortical tissue of 118 or 138
      d fetuses, or newborn or adult sheep. We conclude that, unlike in the rat, liver
      angiotensinogen gene expression is detectable during the 2nd trimester of
      gestation in sheep and is developmentally regulated. Furthermore, in contrast to
      the fetal rat, angiotensinogen mRNA sequences were undetectable in fetal sheep
      kidney.

PMID- 2235112
TI  - The effect of maternal ethanol ingestion on fetal vitamin A in the rat.
AB  - The effect of maternal ethanol ingestion on fetal tissue vitamin A was
      investigated. Pregnant rats were pair-fed control diets or diets containing 36%
      of energy as ethanol. After 17 or 21 d gestation, fetuses were removed and fetal
      and maternal tissues were analyzed by HPLC for retinol and retinyl palmitate.
      Ethanol consumption resulted in fewer fetuses per pregnancy, increased number of
      resorptions, and increased numbers of gross fetal abnormalities. In maternal
      tissues, ethanol consumption resulted in greater lung and kidney vitamin A
      concentrations. In the fetuses of ethanol-consuming pregnancies, free retinol in
      liver was higher at d 17. However, fetal liver palmitate levels and total retinyl
      palmitate in liver, lung, and kidney were lower in ethanol-fed rats at d 21 of
      gestation. Fetal lung retinyl palmitate concentrations were greater at both d 17
      and d 21, and kidney levels were also greater at d 21. In conclusion, the
      ingestion of ethanol by pregnant rats is associated with a reduction in fetal
      liver vitamin A levels and an elevation in the levels of lung and kidney vitamin
      A, indicating possible altered vitamin A metabolism as a result of ethanol
      consumption.

PMID- 2235113
TI  - Effect of aminophylline on diaphragmatic contractility in the piglet.
AB  - Minute ventilation, arterial blood gases, arterial pH, cardiac output, and
      transdiaphragmatic force generation, both during spontaneous ventilation and in
      response to phrenic nerve stimulation during airway occlusion at end expiration,
      were measured in nine anesthetized, tracheostomized piglets before and 30 min
      after parenteral infusion of 20 mg/kg aminophylline. Serum theophylline levels
      averaged 109 +/- 21 mumol/L (19.7 +/- 3.7 micrograms/mL) at 30 min postinfusion.
      No significant changes were noted in pH, blood gases, blood pressure, or
      ventilatory measures after aminophylline. Aminophylline infusion also had no
      effect on transdiaphragmatic force generation at any frequency of phrenic nerve
      stimulation studied. It is concluded that aminophylline has no effect on
      diaphragmatic contractility in the quietly breathing, nonfatigued piglet.

PMID- 2235114
TI  - Biotin labeling of red cells in the measurement of red cell volume in preterm
      infants.
AB  - Determination of circulating red cell volume (RCV) in anemic preterm infants is,
      in theory, a better indicator of transfusion needs than Hb concentration. Our
      study reports the results of RCV measurement using biotin labeling of red cells
      on 40 occasions in preterm infants of 25-34 wk gestation. In 20 infants, who had
      estimations made within 24 h of birth, the RCV varied between 17.7 and 66 mL/kg.
      Twenty measurements were made at a later age at the time of a blood transfusion.
      RCV values were between 13.1 and 41.5 mL/kg before transfusion. In 13 infants,
      RCV was determined simultaneously using two methods, biotin and dilution of
      autologous HbF with donor HbA at transfusion. There was no significant difference
      between the results of RCV estimations using these two methods. Our study
      demonstrates that biotin labeling is an effective method for determining RCV in
      preterm infants.

PMID- 2235115
TI  - Placental transfer of glucose and amino acids in intrauterine growth retardation:
      studies with substrate analogs in the awake guinea pig.
AB  - After experimentally inducing growth retardation by unilateral uterine artery
      ligation in midpregnancy, placental blood flow (PBF) (microsphere technique) and
      placental transfer of 14C-aminoisobutyric acid (AIB) and 3H-methylglucose (MG)
      were studied at d 44, 50, or 63 of gestation in 19 chronically catheterized awake
      guinea pigs. At d 44, fetal wt (FW) and placental wt were reduced by 16 and 18%,
      respectively, in the ligated horn and FW/PBF was increased by 122%. Placental
      efficiency to transfer MG and AIB (fetal dpm/g placenta) was maintained in the
      ligated horn, feto-placental extraction (feto-placental dpm/PBF) was increased,
      and placental transfer of the substrate analogs (fetal dpm/g fetus) was
      unchanged. At d 50 and 63, placental wt and FW were reduced in proportion
      (approximately 40%) in the growth-retarded group and FW/PBF was increased by 80
      and 51%, respectively. Placental transfer of AIB was reduced by 33% at d 50 and
      by 18% at d 63. In addition, placental efficiency to transfer AIB was reduced by
      36% at d 50 and by 22% at d 63 in the growth-retarded group. Fetal uptake of MG
      per g fetus was slightly reduced (-6%) at d 50 of gestation, but unaffected at d
      63. Extraction of MG from the maternal PBF was increased, whereas the wt-specific
      transfer capacity of the placenta was unaltered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235116
TI  - Comparison of urinary growth hormone and IGF-I excretion in small- and
      appropriate-for-gestational-age infants and healthy children.
AB  - The output of urinary growth hormone (GH) and IGF-I were quantitated by RIA in 12
      h urine collections obtained from infants who were preterm, small for gestational
      age (PT-SGA, n = 13); preterm, appropriate for gestational age (PT-AGA, n = 27);
      full term, small for gestational age (FT-SGA, n = 13); and full term, appropriate
      for gestational age (FT-AGA, n = 29); and from normal children (n = 33). The
      amounts of GH and IGF-I (mean +/- SEM) excreted by the PT-SGA and FT-SGA infants
      were not significantly lower than those excreted by the PT-AGA and FT-AGA groups,
      respectively [GH (micrograms/kg): PT-SGA 13.7 +/- 3.1 versus PT-AGA 14.0 +/- 2.2,
      FT-SGA 7.8 +/- 2.4 versus FT-AGA 6.6 +/- 1.8; IGF-I (nmol/kg): PT-SGA 0.52 +/-
      0.09 versus PT-AGA 0.53 +/- 0.04, FT-SGA 0.31 +/- 0.05 versus FT-AGA 0.35 +/-
      0.04]. All infant groups exhibited significantly greater outputs of urinary GH
      and IGF-I compared with the children (p less than 0.01). The plasma
      concentrations of GH in all infant groups were high, whereas the plasma IGF-I
      levels were low. Microalbumin and beta-2 microglobulin excretion did not
      correlate with urinary GH and IGF-I output. Despite the higher microalbumin
      output in FT babies, urinary GH and IGF-I excretion was lower in these
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235118
TI  - Reversal of venous blood flow with atrial tachycardia and hydrops in fetal sheep.
AB  - The purpose of this project was to characterize the reversal of blood flow in the
      proximal inferior vena cava (IVC) seen in fetal sheep with pacing-induced atrial
      tachycardia and hydrops. We successfully operated on seven pregnant ewes at 118
      130 d gestation to attach ECG and pacing wires, insert vascular catheters, and
      place Doppler flow probes around the common aortic trunk and the IVC. We also
      performed two-dimensional and Doppler ultrasonographic exams at baseline, after
      initiation of pacing, and daily thereafter. All fetuses developed hydrops.
      Ultrasonographic appearance of ascites and pleural effusion occurred within 4 h
      in four fetuses and within 48 h in all fetuses. Atrial pacing did not affect
      arterial pH or arterial O2 tension, but arterial CO2 tension increased by a small
      amount. Mean IVC pressure increased 75%, whereas mean aortic pressure remained
      the same. Concentrations of plasma protein and albumin and the hematocrit did not
      change with atrial pacing. Doppler ultrasound examination and Doppler IVC flow
      tracings showed that flow reversal began immediately with atrial pacing and
      disappeared immediately with cessation of pacing. Reversed flow was 21% of
      forward flow. Inspection of simultaneous recordings of ECG, Doppler aortic and
      IVC flows, and aortic and IVC pressure tracings revealed that the reversed blood
      flow occurred in diastole in conjunction with atrial contraction and, therefore,
      could not be due to tricuspid insufficiency. Our findings of increased venous
      pressure and reversed venous blood flow suggest that ventricular function is
      impaired and further suggest that oxygen supply to the ventricles may not be
      sufficient for the increased demand.

PMID- 2235117
TI  - Effect of sleep on regional blood flow distribution in piglets.
AB  - The regional distribution of blood flow to the brain and to other major organs
      was studied during wakefulness and sleep in growing piglets. A young group was
      studied at 6.8 +/- 1.3 d of age and an older group at 33.5 +/- 5.5 d. Two d
      before the experiments, we instrumented the animals for measurement of blood flow
      by the microsphere technique. We determined sleep state using EEG and behavioral
      criteria. Although we did not find significant differences in blood gas tensions
      and cardiac output with changes in behavioral states, we did note a number of
      important changes in brain and muscle blood flow with sleep. 1) Although total
      brain blood flow changed little between wakefulness and sleep at both ages,
      regional differences existed. Indeed, at both ages, during rapid eye movement
      sleep (active sleep), blood flow to the thalamus-hypothalamus and brainstem was
      significantly higher than during wakefulness (p less than 0.025); in older
      piglets, blood flow to these two regions was significantly lower in quiet sleep
      than in wakefulness (p less than 0.05). 2) Blood flow to most skeletal muscle
      groups, and particularly to the diaphragm, was lower during sleep than during
      wakefulness. 3) Age did not have a significant effect on the regional
      distribution of blood flow during sleep. We conclude that behavioral states
      influence the regional distribution of blood flow in early life, but not in an
      age-dependent fashion. We speculate that, because no difference was observed in
      other hemodynamic variables, the regional changes in organ blood flow with sleep
      most probably reflect the differences in local metabolic needs.

PMID- 2235119
TI  - Early changes in the permeability of the blood-brain barrier produced by toxins
      associated with liver failure.
AB  - Our study was designed to determine whether substances that appear in the serum
      during the course of liver failure have a detrimental effect on the passive
      permeability of the blood-brain [blood-cerebrospinal fluid (CSF)] barrier. Lactic
      acid, octanoic acid, and ammonia were infused into rabbits for 4 h. The
      permeability changes of the blood-brain barrier were quantified by infusing
      polyethylene glycol 400 (PEG 400) and measuring the quantity and average mol wt
      of the PEG 400 that entered the CSF. The lipid solubility and effective
      diffusional radius of the PEG molecules were also quantified to provide greater
      precision for measurements using this probe. None of the animals receiving toxic
      infusions became seriously ill during the infusions. Low dose infusions of lactic
      acid, octanoic acid, and ammonia increased the effective pore diameter of the
      blood-brain barrier from 7.3 A to an average of 8.5 A. The amount of PEG entering
      the CSF increased from 1.7 to 4.0 (p less than 0.025), 4.7 (p less than 0.025),
      and 6.7 (p less than 0.001) mmol/L, respectively. Rabbits with galactosamine
      induced liver failure had 10.1 mmol/L PEG 400 in the CSF (P less than 0.001)
      before any evidence of cerebral edema. These changes occur soon after these
      toxins accumulate in the plasma and may alone or together with other toxins
      account for the permeability changes that allow neurotoxic substances to enter
      the brain during hepatic disease and encephalopathies such as Reye's syndrome.

PMID- 2235120
TI  - Effect of gentamicin on the auditory brainstem evoked response in term infants: a
      preliminary report.
AB  - Seven essentially healthy term infants who received gentamicin starting on the
      1st day of life for prolonged rupture of membranes and maternal fever were
      compared with nine healthy term infants to determine whether this drug induces
      alterations in the auditory pathway. The auditory pathway was studied on the 3rd
      day of life by analyzing brainstem auditory evoked potentials elicited by a click
      stimulus presented at the infant's ears. Latencies of components III and V,
      interval I-III, and interval I-V were significantly prolonged in the gentamicin
      group, indicating impairment of the central component of the auditory pathway.
      Peak and trough serum gentamicin levels all fell within the recommended
      therapeutic range. The study indicates that short course gentamicin therapy in
      healthy newborn infants can lead to abnormality of auditory function.

PMID- 2235121
TI  - Protein metabolism in phenylketonuria and Lesch-Nyhan syndrome.
AB  - Animal and in vitro studies have implicated decreased protein synthesis in the
      pathogenesis of tissue damage in phenylketonuria (PKU) and of growth failure in
      Lesch-Nyhan syndrome. Protein turnover was measured in vivo in ten young adult
      subjects with classical PKU, two subjects with hyperphenylalaninemia, and three
      children with Lesch-Nyhan syndrome using techniques based on continuous infusions
      of [13C]leucine and, in Lesch-Nyhan subjects, [2H5]phenylalanine. The PKU
      subjects had various degrees of dietary phenylalanine restriction and plasma
      phenylalanine levels at the time of study ranged from 450-1540 mumol/L (mean
      1106). Plasma phenylalanine in the two hyperphenylalaninemic subjects was 533 and
      402 mumol/L. Rates of protein synthesis in all PKU subjects (mean 3.71 g/kg/24 h,
      range 2.68-5.10, [13C]leucine as tracer) were in a range similar to or above
      control values (mean 2.97, range 2.78-3.22, n = 6), as were rates of protein
      catabolism (PKU mean 4.23 g/kg/24 h, range 3.15-5.45; controls 3.64, 3.50-3.91).
      Protein turnover values in hyperphenylalaninemia were also similar to those in
      controls. With [13C]leucine as tracer, both mean protein synthesis and catabolism
      values in Lesch-Nyhan subjects (mean 4.80 and 5.64 g/kg/24 h, respectively) were
      higher than values in control children matched for protein intake (synthesis 4.32
      +/- 0.74 (SD) and catabolism 4.85 +/- 0.57 (g/kg/24 h, n = 5). Similar results
      were obtained in Lesch-Nyhan subjects using [2H5]phenylalanine as tracer. These
      results suggest that protein turnover is not decreased in either PKU or Lesch
      Nyhan syndrome. This conclusion is inconsistent with the hypothesis that tissue
      damage in PKU results from impaired protein synthesis.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2235122
TI  - Impaired skin fibroblast carnitine uptake in primary systemic carnitine
      deficiency manifested by childhood carnitine-responsive cardiomyopathy.
AB  - Evidence is emerging that primary systemic carnitine deficiency, a potentially
      lethal but eminently treatable inborn error of fatty acid oxidation, involves a
      cellular defect in the uptake of carnitine. We present four unrelated children
      with primary carnitine-responsive cardiomyopathy, weakness (with or without
      hypoketotic hypoglycemic encephalopathy), low serum and/or tissue carnitine
      concentrations, and severe renal carnitine leak. Dicarboxylic acids were absent
      in the urine of three children who were tested, and all four had a rapid and
      dramatic improvement in cardiac function, strength, and somatic growth after
      carnitine therapy. We studied carnitine uptake in cultured skin fibroblasts from
      all four children and seven of the eight healthy nonconsanguinous parents. [3H]L
      carnitine uptake was evaluated in vitro under linear time kinetics. Substrate
      concentrations were varied from 0.1 to 1000 microM. Physiologic uptake was
      determined at carnitine concentrations between 0.1 and 50 microM. Nonspecific
      uptake was determined at a concentration of 10 mM. The four patients had
      negligible uptake throughout the physiologic range, implying a marked deficiency
      in the specific high-affinity, low-concentration, carrier-mediated uptake
      mechanism. At a concentration of 5 mumol/L, the mean velocity of uptake in the
      four patients was 2% of control values. Their parents showed intermediate maximal
      rates of carnitine uptake ranging from 13 to 44% of control Vmax values, but
      normal Km values, suggesting that the heterozygotes had a reduced number of
      normal functioning carnitine transporters. The observed reduction in Vmax values
      for the parents supports an autosomal recessive inheritance pattern and may be a
      more sensitive indicator of heterozygosity than serum carnitine
      concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235124
TI  - Development of ornithine metabolism in the mouse intestine.
AB  - Circulating arginine available for synthesis of protein is produced in the kidney
      of the adult mammal by the action of the last two enzymes of the urea cycle,
      argininosuccinate synthase and argininosuccinate lyase. In a previous
      publication, we reported the presence of a complete biosynthetic pathway for
      arginine in the intestine of the neonatal mouse at a time when no other
      endogenous sources of arginine were available. Our present study was aimed at the
      determination of the source of ornithine used by the intestine of the neonatal
      mouse for the synthesis of arginine. We established the developmental profile of
      the two intestinal mitochondrial enzymes, pyrroline 5-carboxylate synthase and
      ornithine aminotransferase, responsible for the conversion of glutamate to
      ornithine. Both enzymatic activities were found to be significantly elevated
      throughout the suckling period with a peak of activity during the 2nd wk of life.
      Glutamate dehydrogenase activity in the intestine did not appear to be
      developmentally regulated during the suckling and weaning periods; therefore,
      this enzyme was used as a convenient marker to quantify mitochondrial
      preparations. Ornithine decarboxylase activity was undetectable in the intestine
      of the mouse during the suckling period and was detected briefly at weaning,
      indicating that ornithine synthesized in the intestinal mitochondria is probably
      not diverted actively into the polyamine pathway and is available for synthesis
      of arginine by the enzymes of the urea cycle.

PMID- 2235123
TI  - Failure of L-carnitine to protect mice against hyperammonemia induced by ammonium
      acetate or urease injection.
AB  - Reports indicate that L-carnitine administration before 100% lethal dose of
      ammonium acetate suppresses the symptoms of ammonia toxicity and prevents death
      in mice. However, we have been unable to confirm this observation. The cause of
      discrepancy between our results and the results of others was investigated with
      two models of hyperammonemia in mice: 1) that induced by intraperitoneal
      injection of urease and 2) that induced by intraperitoneal injection of ammonium
      acetate. L-Carnitine administration failed to protect mice against ammonia
      toxicity induced by intraperitoneal injection of urease. Mortality in mice
      treated with L-carnitine 30 min before injection of ammonium acetate was similar
      to that of controls pretreated with saline. Ammonia and urea levels in plasma,
      liver, and brain were also similar in both groups. However, the values were
      significantly lower than those in mice denied either pretreatment before the
      ammonium acetate challenge. These results indicate that pretreatment acts to
      reduce blood and tissue ammonia simply by diminishing the rate of absorption of
      the challenge, owing to the dilution of ammonium acetate upon mixing with the
      contents of the peritoneal cavity. Thus, any protocol that does not compare
      results of a putative protective agent with those obtained with an equal volume
      of solvents or saline runs the risk of ascribing protective property to the agent
      when the protection may, in fact, have been afforded by the solvent.

PMID- 2235125
TI  - Transport of biotin in the ileum of suckling rats: characteristics and ontogeny.
AB  - Unlike adult rats, which transport biotin preferentially in the jejunum of the
      small intestine, suckling rats transport biotin preferentially in the ileum. The
      characteristics and kinetics of the transport process of biotin in the ileum of
      developing suckling rats and the subsequent maturation of the process in weanling
      and adult rats are not known and, therefore, are examined in this study.
      Transport studies were performed in suckling (16-d-old), weanling (25- to 27-d
      old), and adult (90-d-old) rats using the everted sac technique. Transport of
      biotin in the ileum of suckling rats was significantly higher (p less than 0.01)
      than that in weanling rats, and transport in weanling rats was in turn
      significantly higher (p less than 0.01) than that in adult rats. In all age
      groups examined, transport of biotin was found to be Na(+)-dependent and
      saturable as a function of concentration within the physiologic range (less than
      10 microM), but linear at high concentrations. However, the Vmax of the carrier
      mediated transport system of biotin showed progressive decrease with maturation
      (3290 +/- 363, 829 +/- 47, and 463 +/- 19 pmol/g tissue wet wt/15 min in
      suckling, weanling, and adult rats, respectively), whereas no significant changes
      were observed in the apparent Km (2.8 +/- 0.6, 2.6 +/- 0.4, and 3.4 +/- 0.4
      microM in suckling, weanling, and adult rats, respectively). These findings
      suggest that maturation is associated with a decrease in the number (and/or
      activity) but not the affinity of the ileal biotin transport carriers. Transport
      of biotin by the diffusion process was also found to decrease with maturation
      (diffusion rates of 144, 86.5, and 40 pmol/g tissue wt/15 min were found for
      suckling, weanling, and adult rats, respectively).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2235126
TI  - Mechanism of the unique susceptibility of deep cortical glomeruli of maturing
      kidneys to severe focal glomerular sclerosis.
AB  - The alterations in single glomerular hemodynamics, glomerular size, and
      development of glomerular sclerosis after subtotal nephrectomy were assessed in
      approximately 32-d-old young and greater than 3-mo-old adult Munich-Wistar rats.
      In 6 wk, young rats developed more pronounced glomerular sclerosis and more
      marked elevation in blood urea nitrogen. The deep (versus superficial) cortical
      region of young rats was characterized by having a greater number of glomeruli
      with advanced sclerosis. Single nephron glomerular filtration rate of superficial
      glomeruli of the young increased to a much greater extent than whole kidney
      glomerular filtration rate, whereas there were comparable post-subtotal
      nephrectomy increases in whole kidney glomerular filtration rate in these two age
      groups, indicating that the deep glomeruli were exposed to a lesser hemodynamic
      load than were the superficial. Since the remnant nephrons of young and adult
      rats achieved equally high glomerular pressures and comparably large glomerular
      size shortly after subtotal nephrectomy, the unique susceptibility of young
      glomeruli to sclerosis is attributed to the intrinsic property of these
      glomeruli, rather than the abnormal hemodynamics or stimuli promoting hypertrophy
      and mesangial matrix accumulation imposed upon the glomeruli.

PMID- 2235127
TI  - Society for Pediatric Research presidential address 1990: pediatric research-
      integrated evaluations to achieve insights into organ function.

PMID- 2235128
TI  - In vivo effect of interleukin-6 on cycling status of hematopoietic progenitors
      from adults and neonates.
AB  - In vitro, IL-6 can induce hematopoietic progenitors to progress from G0 into
      cycle, but a role for IL-6 in regulating cycling status of progenitors in vivo
      has not been established. In our studies, groups of five to six adult and newborn
      rats received i.v. injections of either IL-6 (1 ng/g body wt) or the vehicle
      (control), after which cycling of hematopoietic progenitors was evaluated by
      tritiated thymidine suicide. Progenitors from adult rats injected with the
      control had thymidine suicide rates of 7 +/- 1% (mean +/- SEM), compared with 23
      +/- 7% in the IL-6 recipients (p less than 0.02). Progenitors from newborn rats
      injected with the control had thymidine suicide rates of 19 +/- 2%, compared with
      29 +/- 1% in the IL-6 recipients (p less than 0.003). In addition, IL-6
      administration resulted in release of cells from the neutrophil storage pool into
      the circulation, as evidenced by fewer polymorphonuclear cells flushed from the
      long bones (neonates, p less than 0.001; adults, p less than 0.003), a rise in
      blood neutrophil concentration (neonates, p less than 0.001; adults, p less than
      0.05), and a leukocyte "left shift" (neonates, p less than 0.001; adults, p less
      than 0.01). Thus, the effects of IL-6 in vivo in newborn and adult rats include
      cycle induction of hematopoietic progenitors and release of neutrophils from the
      storage pool into the circulation.

PMID- 2235129
TI  - Discrimination between low dietary zinc and endotoxin exposure: a model study on
      weaning rats.
AB  - To establish a parameter for zinc status that is independent of the occurrence of
      infection, we studied the effects of low dietary zinc and endotoxin in weaning
      rats 21 d after 65Zn intubation. We monitored aspects of zinc status (tissue zinc
      content, 65Zn distribution, and specific 65Zn activity in tissue) and 65Zn
      metabolism (absorption, excretion, and biologic half-life), as well as weight
      gain, feed conversion, and dietary zinc use. The low zinc diet induced classical
      deficiency with losses of bone zinc, resulting in lower content (7.4 versus 19.6
      mumol) and higher spec act (17 versus 8 kBq/mumol). Other tissue-specific and
      plasma-specific activities were also higher (overall, 20 versus 8 kBq/mumol;
      plasma, 8 versus 4 kBq/mumol). Endotoxin caused lower total-plasma zinc (0.04
      versus 0.05 mumol) but did not affect spec act (4 kBq/mumol); combined endotoxin
      and low-zinc diet caused low total-plasma zinc (0.01 mumol) and high spec act, as
      did the low-zinc diet alone (12 kBq/mumol). We conclude that plasma-spec act (or
      stable isotope enrichment) can serve as an index for nutritional zinc status
      during recurrent infection.

PMID- 2235130
TI  - Response to calcium of skinned gallbladder smooth muscle from newborn and adult
      guinea pigs.
AB  - Guinea pig gallbladder smooth muscle contractility undergoes a period of
      postnatal maturation. Because tissues from adult animals contract more forcefully
      than tissues from newborn animals when stimulated with agonists that activate the
      contractile process through different mechanisms (receptor activation, membrane
      depolarization), we proposed that factors unrelated to the mechanism of action of
      the agonist may contribute to the difference in force development between the age
      groups. Our study tested this hypothesis by examining the in vitro contractile
      response to calcium of membrane skinned muscle preparations from newborn and
      adult guinea pigs. Cell membranes were permeabilized using a Triton X-100 (0.5%)
      skinning solution. The muscle strips were rinsed in relaxing solution then
      contracted with calcium. The contracting solution contained either 1, 5, 10, or
      20 microM calcium. Each muscle strip was stimulated with a single concentration
      of calcium. The results can be summarized as follows: 1) the maximal response of
      the skinned preparations did not differ from that of membrane intact
      preparations; 2) tissues from each age group contracted in a dose-response manner
      with the maximal response occurring at 10 microM calcium; and 3) at each calcium
      concentration, tissues from adult animals developed more active force than
      tissues from newborn animals. The data suggest that the postnatal maturation of
      gallbladder smooth muscle contractility includes factors involved in calcium
      activation of the excitation-contraction coupling process.

PMID- 2235131
TI  - Bile secretion of trace elements in rats with a congenital defect in
      hepatobiliary transport of glutathione.
AB  - Bile secretion of trace elements, analyzed by proton-induced x-ray emission, was
      studied in rats with a congenital defect in hepatobiliary transport of organic
      anions [Groningen Yellow (GY) rats], in which the process of bile secretion
      resembles that of the neonatal period. Bile flow (-41%) and biliary glutathione
      secretion (-99%) were drastically impaired in GY rats compared with controls.
      Plasma concentrations of all detectable trace elements (Fe, Cu, Zn, Mo, Br, and
      Se), as well as that of simultaneously determined Ca, were similar in GY and age
      matched control Wistar rats. Bile concentrations of Fe, Mo, Br, and Ca were also
      similar in both groups, resulting in a approximately 40% reduction of their
      secretion rates in GY rats. The concentrations of Zn (-62%) and Mn (-64%) were
      significantly lower in GY rats in contrast to that of Cu, which was 50% higher.
      Se could not be detected in bile of either group. Recovery in bile (% dose/3 h)
      after i.v. injection of MnCl2, CuSO4, or SeO2 (1 mg metal/kg) was lower in GY
      rats than in controls: Mn, 26 and 35%; Cu, 2.6 and 5%; and Se, 1.5 and 5%,
      respectively. Injection of ZnSO4 did not lead to increased Zn secretion in GY
      rats, and only 1.1% of the dose was recovered in controls. Thus, the hepatic
      handling of different endogenous and exogenously administered trace metals is
      affected to a variable extent in the GY rat. For a number of metals (e.g. Fe,
      Mo), this may be related to the reduced bile flow; for others (e.g. Zn, Mn, Cu),
      other regulatory factors appear to be responsible.

PMID- 2235132
TI  - Rat heart perfusion as model system for enzyme replacement therapy in
      glycogenosis type II.
AB  - Cardiac failure and skeletal muscle weakness are the main clinical features of
      glycogenosis type II, a lysosomal storage disorder caused by acid alpha
      glucosidase deficiency. In our study, we have investigated in a rat heart
      perfusion-recirculation system whether acid alpha-glucosidase can be taken up
      from the vascular system into cardiomyocytes. When rat hearts were perfused with
      mannose 6-phosphate-containing acid alpha-glucosidase purified from bovine
      testis, a 3- to 4-fold increase of enzyme activity was obtained. Perfusion with
      human placental acid alpha-glucosidase not containing the mannose 6-phosphate
      recognition marker did not have such an effect. The presence of bovine testis
      acid alpha-glucosidase in heart tissue was demonstrated by immunoblotting.
      Immunocytochemistry provides evidence for uptake of the exogenous enzyme in
      lysosomes of the cardiomyocytes. The relevance of these findings for enzyme
      therapy in glycogenosis type II is discussed.

PMID- 2235133
TI  - Interstitial transudate purines in normoxic and hypoxic immature and mature
      rabbit hearts.
AB  - Interstitial transudate and coronary venous concentrations of adenosine, inosine,
      and hypoxanthine were determined in isolated isovolumic immature and mature
      rabbit hearts during normoxia and hypoxia. During normoxia, interstitial
      transudate adenosine was lower in immature hearts compared with mature hearts.
      Interstitial transudate concentrations of adenosine, inosine, and hypoxanthine
      were 130 +/- 16 nM, 699 +/- 88 nM, and 392 +/- 80 nM, respectively, in immature
      rabbit hearts and 228 +/- 35 nM, 1154 +/- 126 nM, and 287 +/- 30 nM,
      respectively, in mature rabbit hearts. Interstitial transudate adenosine was
      significantly lower in the immature hearts. Coronary venous purine concentrations
      were 6- and 8-fold lower than their respective interstitial transudate
      concentrations during normoxia in both age groups. Hypoxia significantly
      increased interstitial transudate purines in both age groups. Interstitial
      transudate adenosine, inosine, and hypoxanthine increased to 1180 +/- 231 nM,
      4049 +/- 500 nM, and 1099 +/- 98 nM, respectively, in immature hearts and to 1225
      +/- 300 nM, 5220 +/- 1217 nM, and 876 +/- 147 nM, respectively, in mature hearts.
      The age-related difference in transudate adenosine levels present during normoxia
      was not detected during hypoxia. Venous purine levels increased during hypoxia
      and the gradient from interstitial transudate fluid to venous effluent was
      abolished for adenosine in both groups. In immature hearts, hypoxia led to higher
      venous effluent adenosine levels than in the mature hearts. Coronary resistance
      correlated with interstitial transudate adenosine in both groups, although
      immature hearts displayed lower resistances at all adenosine levels.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2235134
TI  - Regional cerebral blood flow after hemorrhagic hypotension in the preterm, near
      term, and newborn lamb.
AB  - Developmental changes in regional cerebral blood flow (CBF) responses to
      hemorrhagic hypotension during normoxia and normocapnia were determined using
      radioactively labeled microspheres to measure flow to the cortex, brainstem,
      cerebellum, white matter, caudate nucleus, and choroid plexus in three groups of
      chronically catheterized lambs: 90- to 100-d preterm fetal lambs (n = 9); 125- to
      136-d near-term fetal lambs (n = 9); and newborn lambs 5- to 35-d-old (n = 8).
      Heart rate, central venous pressure, and arterial blood pressure were monitored
      continuously and arterial blood gas tensions, pH, Hb, and oxygen saturation
      together with regional CBF were measured periodically. Hemorrhagic hypotension
      produced a mean decrease in arterial blood pressure of 27 +/- 4, 23 +/- 2, and 41
      +/- 4% in the three groups, respectively, whereas reinfusion of the lamb's blood
      resulted in a return to control blood pressure within 3% in all three groups. In
      the pre-term fetal lamb, CBF decreased significantly in all regions during
      hypotension. In the near-term fetal lamb, only blood flow to the cortex decreased
      significantly during hypotension. In the newborn lamb, only the choroid plexus
      demonstrated a significant decrease in blood flow during hypotension. The lower
      limit of regional CBF autoregulation was identical to the resting mean arterial
      pressure in fetal life but significantly lower in newborn lambs. These
      experiments demonstrate for the first time that vulnerability to hypotension
      decreases with increasing maturity and that the brainstem, the phylogenetically
      oldest region of the brain, is the least vulnerable to the effects of hypotension
      at any age in the lamb model.

PMID- 2235135
TI  - Proximal, tracheal, and alveolar pressures during high-frequency oscillatory
      ventilation in a normal rabbit model.
AB  - To study the effect of different high-frequency oscillatory ventilation
      parameters on airway pressure, we measured oscillatory pressure amplitude ([Paw[)
      and mean airway pressure (Paw) at three sites in open-chested normal rabbits:
      proximal, trachea, and alveolus. Five animals were studied to test a new pleural
      capsule design, which was then used in two groups of animals to measure right
      upper (n = 4) or middle (n = 5) lobe alveolar pressures. Animals were randomly
      sequenced through combinations of frequency (10, 15, and 20 Hz) and fractional
      inspiratory time (Ti) (0.3 and 0.5) while normoxic and eucapnic. During capsule
      testing, we noted that alveolar pressures increased (p less than 0.05) with
      increasing capsule mass, suggesting that compressive forces from the capsule may
      alter the capsule measurement. We thus used a low-mass (430 mg) transducer system
      in the rabbit high-frequency oscillatory ventilation experiments. Using
      multifactorial analysis of variance, we found significant main effects of Ti on
      Paw, and of measurement site on both [Paw[ and Paw (all p less than 0.009).
      Frequency did not influence variations in either [Paw[ or Paw. For both Ti
      settings, alveolar upper lobe Paw was lower compared with that of the middle lobe
      (p less than 0.0005). Lengthening Ti (0.3 to 0.5) increased tracheal Paw in each
      capsule group (p less than 0.0005). At Ti = 0.5, tracheal Paw exceeded Paw
      measured proximally (p less than 0.05). Our data support in vivo alveolar Paw
      inhomogeneity and demonstrate significant changes in pressures within the lung
      related to Ti during high-frequency oscillatory ventilation.

PMID- 2235136
TI  - Influence of carotid denervation on the arousal and cardiopulmonary responses to
      upper airway obstruction in lambs.
AB  - Experiments were done on five lambs to determine if carotid denervation
      influences the arousal and cardiopulmonary responses to upper airway obstruction
      during sleep. Each lamb was anesthetized and instrumented for recordings of
      electrocorticogram, electro-oculogram, nuchal and diaphragm electromyograms, and
      measurements of arterial blood pressure and arterial Hb oxygen saturation. A
      tracheotomy was done and a fenestrated tracheotomy tube placed in the trachea.
      During the study, a 5 F balloon-tipped catheter was inserted into the tracheotomy
      tube so that air flow could be obstructed by inflating the balloon. No sooner
      than 3 d after surgery, measurements were made in quiet sleep and active sleep
      during control periods when the animal was breathing room air and during
      experimental periods of upper airway obstruction. Carotid denervation
      significantly affected the arousal response to upper airway obstruction. Arousal
      occurred during 14 of 14 epochs in quiet sleep and during 12 of 13 epochs in
      active sleep before the arterial Hb oxygen saturation decreased to 30%. However,
      the time to arousal was increased and the arterial Hb oxygen saturation at
      arousal was decreased in carotid-denervated lambs compared with what we have
      previously observed in carotid-intact lambs. These data provide evidence that the
      carotid chemoreceptors and/or carotid baroreceptors play a major role in causing
      arousal from sleep during upper airway obstruction in lambs. Our results may have
      implications for sudden infant death syndrome, because it is possible that
      alterations in the arousal response to respiratory stimuli play a role in sudden
      infant death.

PMID- 2235137
TI  - Developmental changes of tropoelastin synthesis by rat pulmonary fibroblasts and
      effects of dexamethasone.
AB  - Lung elastin is an important extracellular structural protein and it has been
      postulated that it plays a regulatory role in alveolar formation. To study the
      developmental regulation of elastin gene expression, we examined the tropoelastin
      (TE) production in primary culture of rat pulmonary fibroblasts (RPF). We found
      that developmental changes in elastin production as assessed by TE synthesis and
      3.6-kb TE mRNA levels were similar for RPF and whole tissue except those results
      from late gestation animals, with peak elastin expression occurring 7 d
      postnatally with a decline out to 21 d. At late gestation (20 d), TE mRNA was
      barely detectable in RPF but clearly detectable TE mRNA in the whole tissue,
      indicating that there are elastogenic cells other than RPF in the tissue at this
      age. When TE-producing cells were treated with dexamethasone, there was a dose
      dependent stimulation of TE synthesis with the maximum response at 10(-9) to 10(
      7) M. Interestingly, dexamethasone had no stimulatory effect on cells from late
      gestation animals. The developmental window of elastin synthesis in this RPF
      model between late gestation and 21 d postnatal seems to correlate with the
      reported period of secondary alveolar formation, and thus we speculate that RPF
      elastogenic activity reflects that of the alveolar wall.

PMID- 2235138
TI  - Changes in placental blood flow in the normal human fetus with gestational age.
AB  - We assessed fetoplacental blood volume flow and placental resistance
      prospectively with Doppler sonography in 74 normal human fetuses of 19 to 42 wk
      gestation to determine the changes in placental perfusion with gestational age.
      Placental blood volume flow was assessed from the umbilical vein as the product
      of the mean flow velocity integral and the cross-sectional area of the umbilical
      vein. Placental resistance was assessed as the ratio of maximum systolic and
      minimum diastolic blood flow velocities from an umbilical artery. Umbilical vein
      blood volume flow increased exponentially (r = 0.86) with gestational age from 19
      wk to term, and did not decrease in postdate fetuses. Umbilical vein blood volume
      flow increased linearly with fetal weight (r = 0.77), although volume flow per
      unit body weight changed little with gestational age. Umbilical artery velocity
      ratio decreased progressively, indicating diminishing placental resistance with
      gestational age, but did not correlate closely with umbilical vein blood volume
      flow. We submit that fetoplacental blood volume flow can be readily calculated
      directly from the umbilical vein with Doppler ultrasound and may provide a better
      index of placental perfusion than the umbilical artery velocity ratio.

PMID- 2235139
TI  - Whole body nitrogen kinetics and their relationship to growth in short children
      treated with recombinant human growth hormone.
AB  - We studied the effects of growth hormone on retention of 15N-labeled amino acids
      in 34 short, prepubertal, growth hormone-sufficient children and three growth
      hormone-deficient subjects. All 34 non-growth hormone-deficient children had
      apparently normal circulating growth hormone molecules and no mutations were
      detected in the growth hormone or IGF-I genes of any subjects. Fibroblasts from
      34 children responded normally when challenged with recombinant human IGF-I.
      During the last 72 h of a 4-d challenge with recombinant human growth hormone (16
      micrograms/kg body wt), retention of a mixed 15N-amino acid dose varied between
      5.7 and 50.5%. Whole body protein synthesis, breakdown, and net anabolism
      calculated from the 15N kinetics were all increased by the acute growth hormone
      challenge. However, no routine clinical feature or laboratory determination
      correlated with the nitrogen retention response. After subsequent treatment (75
      micrograms/kg three times a week) with recombinant human growth hormone for 1 y,
      there was a significant increase in height velocity, but this increase was not
      related significantly to pretreatment variables other than inversely to
      pretreatment height velocity. There was a significant (p = 0.03) correlation
      between the change in height velocity Z score and the degree of nitrogen
      retention to acute challenge with growth hormone, but this correlation was too
      weak (r = 0.37) to be of practical value in predicting the treatment growth
      response in an individual child.

PMID- 2235141
TI  - Treatment considerations for children with human immunodeficiency virus
      infection.

PMID- 2235140
TI  - Howland award presentation to Julius B. Richmond.

PMID- 2235142
TI  - Serologic evidence of subclinical pertussis in immunized children.
AB  - Incidental to a vaccine study involving 783 immunized children conducted at two
      study sites, inner city children had significantly higher geometric mean
      pertussis agglutinin titers compared with suburban children just before the
      fourth dose of diphtheria-tetanus-whole cell pertussis vaccine (47 vs. 25; P less
      than 0.001). Higher titers in the inner city were correlated with residence in
      census tracts where cases of pertussis were reported. Three hundred thirty-two
      children in a placebo arm of the study who were clinically observed and had
      paired serum samples taken during a 2- to 4-month period were analyzed for
      evidence of natural Bordetella infection. Twelve (11%) inner city children and
      three (1.3%) suburban children had spontaneous 4-fold or greater rises in at
      least two different pertussis antibodies measured (agglutinin, antitoxin or
      enzyme-linked immunosorbent assay for IgG to pertussis toxin, IgG and IgA to
      filamentous hemagglutinin). Eighty percent of these children had IgA to
      filamentous hemagglutinin. Nine of 12 inner city children with serologic evidence
      of pertussis lived within 6 blocks of a case of pertussis reported within 1 month
      of the observed antibody rise in study subjects; none had a household member with
      pertussis and none had symptomatic disease.

PMID- 2235143
TI  - Current epidemiology of pertussis in Japan.
AB  - Since the introduction of whole cell pertussis vaccine into general use as part
      of the routine immunization in 1947 under the Preventive Immunization Law, a
      steady decrease in reported cases of pertussis was noted until 1974. At that time
      the number of reported cases reached an all time low and no deaths caused by
      pertussis were reported. The vaccine (diphtheria-tetanus-whole cell pertussis
      vaccine) had been given to infants 12 weeks old or older in a 0.5-ml dose by deep
      subcutaneous injection; three doses were given at intervals of 3 to 8 weeks and
      the fourth dose (booster) was given 12 to 18 months after the third dose. The
      immunization was completed with those four doses. Because whole cell vaccine
      appeared to be associated with severe neurologic illnesses, it was temporarily
      suspended in 1975. The vaccine was resumed soon thereafter but the age of
      administration was raised to 24 to 48 months. Under these circumstances
      acceptance rates of pertussis occurred, reaching a peak in 1979. Although whole
      cell vaccine was used even after temporary suspension, it was considered to be
      unacceptable by the public. As a result the acellular pertussis vaccine was
      developed and has totally replaced whole cell vaccine since 1981. A steady
      decrease in reported cases of pertussis as well as the number of deaths has been
      noted since 1979 in accordance with increase in vaccine acceptance rates. The
      national surveillance system begun in 1981 demonstrated also a steady decrease in
      the incidence of pertussis during the past 9 years.

PMID- 2235144
TI  - Nosocomial bacteremias in measles.
AB  - The purpose of this study was to determine whether nosocomial bacteremias
      occurred more frequently in patients admitted with severe measles compared with
      general pediatric admissions. In a retrospective survey of 977 blood culture
      reports during a 4-year period, 1985 to 1988, the incidence of nosocomial
      bacteremias in patients with measles was found to be on the average of 3.37/100
      admissions/year, approximately 6 times that of general pediatric patients (0.57).
      Gram-negative organisms (predominantly Klebsiella and Salmonella species)
      accounted for 86.5% of all isolates from measles patients, with 23% of these
      being multiply antibiotic-resistant. All the isolates from the general patients
      were fully susceptible to antibiotics. The duration of hospitalization was more
      than doubled in both groups of affected patients. The onset of hospital-acquired
      bacteremias occurred on an average of 11.2 days after admission in the patients
      with measles and 20.5 days in the general patients. Our findings revealed that
      nosocomial bacteremias occurred with greater frequency in patients with measles
      and contributed to the morbidity of these patients.

PMID- 2235145
TI  - Thrombocytosis after pneumonia with empyema and other bacterial infections in
      children.
AB  - Thrombocytosis is seen in association with many conditions, including infectious
      diseases. We studied thrombocytosis after severe bacterial infections,
      particularly pneumonia with empyema in children. A systematic survey of the
      phenomenon was conducted. Twenty-seven children admitted for pneumonia with
      empyema were studied. Thrombocytosis (platelet counts greater than 500 x
      10(3)/microliters) was present in 92.5%. Platelet counts reached their maximum at
      15.1 +/- 3.7 days (range, 7 to 25) and declined to normal after 3 weeks of
      illness. Compared with a healthy control group, significant thrombocytosis, but
      of lower incidence, was also noted in children with lobar pneumonia without
      pleural effusion, bacterial meningitis and osteomyelitis. Platelet functions were
      examined in seven of the children but no abnormalities were observed. Bone marrow
      aspiration of three children with pneumonia and empyema showed megakaryocytic
      hyperplasia. We found no correlation between thrombocytosis, neutrophilia, fever,
      the clinical course, complications, prognosis or treatment. Neither
      thromboembolic nor hemorrhagic phenomena were observed.

PMID- 2235146
TI  - Fatal varicella after a single course of corticosteroids.

PMID- 2235147
TI  - Aspergillus osteomyelitis in a child treated for acute lymphoblastic leukemia.

PMID- 2235148
TI  - Pseudallescheria boydii and brain abscesses.

PMID- 2235149
TI  - Diabetes insipidus as a complication of neonatal group B streptococcal
      meningitis.

PMID- 2235151
TI  - Histoplasmosis after multiple trauma.

PMID- 2235150
TI  - Dipylidium caninum, an underrecognized infection in infants and children.

PMID- 2235152
TI  - Hyperammonemia and neonatal herpes simplex pneumonitis.

PMID- 2235153
TI  - Use of antibiotics in neonates weighing less than 1200 g.

PMID- 2235154
TI  - Fatal adenovirus disease and human immunodeficiency virus infection.

PMID- 2235155
TI  - Diagnosis of Lyme arthritis.

PMID- 2235156
TI  - Antibiotics for respiratory syncytial virus infection.

PMID- 2235157
TI  - The tragedy of toxoplasmosis.

PMID- 2235158
TI  - Herpes simplex virus infections.

PMID- 2235159
TI  - Pediatric acquired immunodeficiency virus syndrome.

PMID- 2235160
TI  - Syphilis.

PMID- 2235161
TI  - Varicella in the womb and beyond.

PMID- 2235162
TI  - Subclinical infection as a cause of preterm delivery.

PMID- 2235163
TI  - Bacteriology of neonatal sepsis.

PMID- 2235164
TI  - Group B streptococcal infections.

PMID- 2235165
TI  - Adjuncts to the therapy of bacterial meningitis.

PMID- 2235166
TI  - Current antibacterial therapy for neonatal sepsis and meningitis.

PMID- 2235167
TI  - Management of chronic middle ear effusion with prednisone combined with
      trimethoprim-sulfamethoxazole.
AB  - Fifty-three patients were enrolled and evaluable in a randomized, double-blinded
      controlled clinical trial comparing prednisone for 7 days plus trimethoprim
      sulfamethoxazole (TMP/SMZ) for 30 days vs. TMP/SMZ alone in treating chronic
      middle ear effusion (MEE). Clearing of the effusion in both ears or in one when
      only one was involved was called complete resolution; clearing in one of two
      affected ears was called partial resolution. The outcomes 2 weeks after
      initiation of therapy of 26 patients initially treated with prednisone plus
      TMP/SMZ were complete resolution in 20, partial resolution in three, and
      unchanged in three. The outcomes in 27 patients initially treated with TMP/SMZ
      alone were complete resolution in eight, partial resolution in three, unchanged
      in 13 and development of acute otitis media in three (P less than 0.01 for
      complete resolution). Two weeks after initiation of therapy, patients with a MEE
      that failed to clear were crossed over to the alternative regimen. Overall 29 of
      41 patients (71%) who received oral prednisone plus TMP/SMZ initially or after
      the crossover had complete resolution of their middle ear effusion at 2 weeks
      after starting prednisone and TMP/SMZ. Five of 35 (14%) patients treated with
      prednisone plus TMP/SMZ and one of six (17%) patients treated with TMP/SMZ alone
      who had complete resolution at 4 weeks required subsequent referrals for
      tympanostomy tubes. A course of prednisone for 7 days plus TMP/SMZ for 30 days
      with monthly follow-up should be considered in children with MEE persisting
      beyond 6-8 weeks before referral for tympanostomy tube placement.

PMID- 2235168
TI  - Central nervous system tuberculosis in children: a review of 30 cases.
AB  - The medical records of 30 children with central nervous system tuberculosis (CNS
      tuberculosis) who were treated between March, 1976, and February, 1989, were
      reviewed. All had cranial computerized tomography scans at presentation. The mean
      cerebrospinal fluid leukocyte count was 200/mm3, protein 239 mg/dl, glucose 25
      mg/dl and CSF/serum glucose ratio 21%. Mantoux skin tests with 5 tuberculin units
      were greater than or equal to 10 mm induration in 50%, and chest radiographs were
      positive in 40% of patients. Hydrocephalus was demonstrated by cranial
      computerized tomography in all 30 patients (100%). Cranial computerized
      tomography scan demonstrating hydrocephalus is a sensitive radiographic nervous
      system tuberculosis and should be part of the early evaluation of children with
      suspected central nervous system tuberculosis.

PMID- 2235169
TI  - Immunoglobulin G subclasses in serum and circulating immune complexes in patients
      with Kawasaki syndrome.
AB  - IgG subclass concentrations in sera of 17 patients with Kawasaki syndrome were
      determined. Significantly increased IgG1 (P less than 0.001) and IgG3 (P less
      than 0.001) were found in the patients compared with 22 age-matched healthy
      children, whereas IgG2 and IgG4 were normal or slightly decreased. IgG immune
      complexes were measured by protein A-enzyme-linked immunosorbent assay (ELISA)
      combined polyethylene glycol precipitations. Eight of 17 patients (47.1%) were
      found to have circulating immune complexes (CIC) values above the normal control
      range (geometric mean +2 SD). IgG subclass composition in CIC was analyzed. The
      subclasses in CIC were predominantly IgG1 and IgG3. Because the antibody
      responses to different antigens exhibit IgG subclass restriction, it would
      suggest that the change of serum and CIC IgG subclasses in Kawasaki syndrome may
      have relevance to the pathogenesis of the disease.

PMID- 2235170
TI  - The use of prophylactic furazolidone to control a nosocomial epidemic of multiply
      resistant Salmonella typhimurium in pediatric wards.
AB  - The nosocomial spread of enteric pathogens is often difficult to control in
      overcrowded pediatric wards. During 1983 and 1984, despite cohorting of patients
      and enforced hand washing, more than 200 cases of nosocomial multiply resistant
      Salmonella typhimurium phage type R-9 were observed on two adjacent pediatric
      wards. Most cases occurred during the summer months. After 19 new cases were
      detected early in the summer of 1985, oral administration of furazolidone
      throughout their entire hospital stay (2.5 mg/kg twice daily) was recommended for
      all subsequently hospitalized infants. Among the 114 (65%) infants who were
      appropriately treated, only one additional case (1%) was detected. In contrast 11
      (19%) cases occurred among the 59 infants who were inappropriately treated: 5 of
      35 (14%) of those who were not treated and 6 of 24 (25%) in whom treatment with
      furazolidone was delayed greater than 24 hours (P less than 0.001 between the
      appropriately and inappropriately treated groups). In pediatric wards where
      infection control measures cannot be optimally applied, prophylactic furazolidone
      administration may be helpful in preventing the spread of enteric pathogens.

PMID- 2235171
TI  - Safety evaluation of PRP-D Haemophilus influenzae type b conjugate vaccine in
      children immunized at 18 months of age and older: follow-up study of 30,000
      children.
AB  - We evaluated the safety of the PRP-D conjugate Hib vaccine (ProHIBit, Connaught)
      in 29,309 children vaccinated at 18-60 months of age in the Southern California
      Kaiser Permanente medical clinics during the period April 1, 1988, to July 31,
      1989. Surveillance for potential reactions involved postcard questionnaires,
      telephone surveys, reports of Kaiser staff and review of hospitalizations and
      covered two periods following immunization: (1) the first 48 hours and (2) days 2
      through 30. Surveillance for invasive Hib disease involved the above methods in
      addition to systematic reviews of laboratory and hospital records through January
      31, 1990. Rates of local and systemic reactions within 48 hours of vaccination
      with PRP-D alone were low (less than or equal to 2% for fever greater than 102
      degrees F, local redness or swelling) and similar to those previously reported
      after vaccination with PRP. Hospitalization and seizures (0.15% and 0.09% of
      vaccinated children, respectively) occurring within 1 month of immunization
      appeared to be unrelated to vaccination. One 29-month-old child had onset of a
      fatal episode of Hib sepsis/meningitis within 48 hours of vaccination. Also, a 30
      month-old child developed Hib meningitis 10 months after PRP-D vaccination. We
      conclude that PRP-D is safe when given alone or in combination with other
      childhood vaccines between 18 and 60 months of age.

PMID- 2235172
TI  - An epidemic outbreak of cryptosporidiosis: a prospective community study from
      Guinea Bissau.
AB  - In the first year of a prospective community study of childhood diarrhea
      conducted in a semiurban area in the capital of Guinea Bissau, Cryptosporidium
      sp. was found in 73 (6.0%) of 1216 episodes of diarrhea. The parasite was the
      second most prevalent intestinal parasite, and the only one significantly
      associated with diarrhea (OR = 2.79, P = 0.0006). The seasonal distribution was
      striking, with a peak prevalence in the beginning of the rainy season (May 17.6%)
      when an epidemic outbreak of diarrhea started. The prevalence was highest in
      children younger than 18 months, an age at which prevalences of other intestinal
      parasites were low. This reverse age pattern may possibly be explained by the
      small infective dose needed to create severe infections, by air-borne
      transmission and by the development of protective immunity.

PMID- 2235173
TI  - Pre-discharge immunization among hospitalized Filipino children.
AB  - Identifying opportunities to vaccinate eligible children is one way to boost
      rates of immunization especially in countries with low immunization coverage and
      where convalescence from infectious illness is a contraindication to vaccination.
      To determine the safety and immunogenicity of diphtheria-tetanus toxoid-pertussis
      and oral polio immunization, 210 convalescing infants and children and community
      controls, comparable image and nutritional status, were studied. Using the
      pertussis agglutination and poliovirus neutralization tests, quantitative
      serologic responses were compared in the two study groups. No significant
      differences in the incidence rates of febrile reactions (23% in controls; 28% in
      convalescents) of local reactions (92% in controls; 87% in convalescents) and of
      seroconversion (P greater than 0.05) were noted between the two groups. Our
      investigation suggests that infants and children convalescing from infectious
      illnesses can be safely and effectively vaccinated. This study further suggests
      that hospitalization provides an opportunity to vaccinate such children.

PMID- 2235174
TI  - Maternal immunization.

PMID- 2235176
TI  - A clue (tip-off) to urinary infection with Candida.

PMID- 2235175
TI  - Clostridium sordellii infection and toxin neutralization.

PMID- 2235178
TI  - Lyme disease presenting as hepatitis and jaundice in a child.

PMID- 2235177
TI  - Eustachian tube dysfunction in children with streptococcal pharyngitis.

PMID- 2235179
TI  - Bacteriology of retropharyngeal abscess in children.

PMID- 2235180
TI  - Haemophilus influenzae type B abscess after diphtheria-tetanus toxoids-pertussis
      immunization.

PMID- 2235181
TI  - Interstitial pneumonia and alpha-hemolytic Streptococcus sepsis in a child with
      malignancy who recently received cytosine arabinoside.

PMID- 2235182
TI  - False-positive Chlamydia immunoassays.

PMID- 2235183
TI  - Prophylactic zidovudine for a child after human immunodeficiency virus
      needlestick exposure.

PMID- 2235184
TI  - The Pediatric Infectious Diseases Society 1990 awards.

PMID- 2235185
TI  - Perinatally acquired human immunodeficiency virus infection.

PMID- 2235186
TI  - Case-control study of Cryptosporidium parvum infection in Peruvian children
      hospitalized for diarrhea: possible association with malnutrition and nosocomial
      infection.
AB  - A retrospective, hospital-based case-control study was used to investigate
      whether there were any clinical characteristics that could distinguish
      Cryptosporidium parvum-infected children with diarrhea from other non-C. parvum
      infected children with diarrhea. Ten percent (24 of 248) of children admitted to
      a rehydration ward at Cayetano Heredia University Hospital, Lima, Peru, were
      infected with C. parvum. The 24 patients infected with C. parvum (cases) were
      matched to an equal number of noninfected patients (controls). C. parvum-infected
      patients were more likely to be malnourished than were children without this
      infection (P less than 0.05). Also nosocomial infection caused by C. parvum
      occurred in three severely malnourished patients, two of whom died. No other
      clinical or laboratory characteristics were found that would distinguish children
      with diarrhea caused by C. parvum from other children with diarrhea. In children
      hospitalized for diarrhea C. parvum infection occurs most frequently in
      malnourished children.

PMID- 2235187
TI  - Immunogenicity of Haemophilus b conjugate vaccine (meningococcal protein
      conjugate) in children with prior invasive Haemophilus influenzae type b disease.
AB  - Children younger than 2 years of age with previous invasive Haemophilus
      influenzae (Hib) type b disease may not develop protective antibodies to antigens
      of Hib and may be at risk of developing a second episode of Hib disease. Twenty
      three children with prior Hib disease were immunized with Haemophilus b conjugate
      vaccine (meningococcal protein conjugate). Children 12 to 24 months of age were
      given one dose of vaccine and children younger than 12 months of age were given 2
      doses 2 months apart. Antibody to the polysaccharide capsule of Hib (PRP) was
      measured by radioimmunoassay. Eighteen children had preimmunization serum
      antibody concentrations less than 0.150 micrograms/ml. All 18 children responded
      with greater than 0.150 micrograms/ml of antibody after a single dose of vaccine.
      Only 1 of the 23 children had a preimmunization serum antibody concentration
      greater than 1.000 micrograms/ml. Seventeen children ultimately responded with
      greater than 1.000 micrograms/ml of antibody (P less than 0.0001), concentrations
      of antibody thought to correlate with protection. Haemophilus b conjugate vaccine
      (meningococcal protein conjugate) is immunogenic in children with invasive Hib
      disease. Children younger than 2 years of age with invasive Hib disease should be
      subsequently immunized with a Hib conjugate vaccine.

PMID- 2235188
TI  - Clinical features of adenovirus enteritis: a review of 127 cases.
AB  - We retrospectively analyzed the clinical features of 127 hospitalized pediatric
      patients whose fecal samples were positive for adenovirus (Ad) by electron
      microscopy during an 18-month period. Serotyping results obtained by
      microneutralization tests and restriction endonuclease analysis were available
      for 105 of 127 cases. There were 69 males and 58 females and 94% of patients were
      less than 4 years of age. The average body temperature was 38 degrees C rectal
      (range, 36.2-40.8 degrees C) with an average duration of fever of 1.6 days. The
      average duration of clinical illness was 8.8 days (range, 1 to 32 days). Although
      Ad 40 and Ad 41 were isolated in the majority of cases (59 of 105 (56%], Ad 31
      was associated with 18 of 105 cases (17%). Of the 18 cases associated with Ad 31,
      14 were nosocomial and associated with diarrhea. Our survey confirms the
      importance of fastidious enteric Ad in infantile diarrhea (Ad 40, Ad 41) and
      suggests that Ad 31 produces a clinical syndrome indistinguishable from that
      caused by Ad 40 and Ad 41. The occurrence of Ad enteritis in patients admitted
      for unrelated illnesses well after initial hospitalization suggests that Ad is
      also an important cause of nosocomial enteritis in our hospital.

PMID- 2235189
TI  - Pneumococcal endocarditis in infants and children: report of a case and review of
      the literature.

PMID- 2235190
TI  - Central nervous system melioidosis in children.

PMID- 2235191
TI  - Candida albicans placentitis and funisitis: early diagnosis of congenital
      candidemia by histopathologic examination of umbilical cord vessels.

PMID- 2235193
TI  - Limp as a presenting sign of meningitis.

PMID- 2235192
TI  - Campylobacter infection in the neonate: case report and review of the literature.

PMID- 2235194
TI  - External ophthalmomyiasis in an urban infant.

PMID- 2235195
TI  - Catheter-related sepsis refractory to antibiotics treated successfully with
      adjunctive urokinase infusion.

PMID- 2235196
TI  - Stomatococcus mucilaginosus infections in children with leukemia.

PMID- 2235197
TI  - Adverse reactions to ribavirin.

PMID- 2235198
TI  - Haemophilus influenzae type b resistant to ampicillin and chloramphenicol.

PMID- 2235199
TI  - Treatment of congenital toxoplasmosis.

PMID- 2235201
TI  - An industrial hygiene approach to controlling nonpatient exposure to ribavirin
      aerosol.

PMID- 2235200
TI  - Benzathine penicillin G for the treatment of infants and children with pneumonia.

PMID- 2235202
TI  - Reproductive risk assessment with occupational exposure to ribavirin aerosol.

PMID- 2235203
TI  - Studying the safety of ribavirin in human pregnancy.

PMID- 2235204
TI  - Pulmonary function testing in infants with respiratory syncytial virus
      bronchiolitis requiring mechanical ventilation.

PMID- 2235205
TI  - Safety of ribavirin with mechanical ventilation.

PMID- 2235206
TI  - Adverse drug reactions: United States experience. I.

PMID- 2235207
TI  - Prioritizing research questions on the safety of ribavirin in the treatment of
      respiratory syncytial virus infections.

PMID- 2235208
TI  - Clinical studies with ribavirin.

PMID- 2235209
TI  - Study design considerations for ribavirin: efficacy studies.
AB  - Five placebo-controlled double-blind studies, each including approximately 30
      subjects, have addressed the question of the effect of aerosolized ribavirin on
      the course of RSV lower respiratory infection in infancy. The fact that each was
      able to establish a beneficial effect despite the small number of subjects
      studied is convincing evidence that such an effect exists. The studies from
      Rochester using oximetry and an analog illness severity scale indicate that this
      effect is both statistically significant and clinically relevant. These tools are
      reliable and easily applicable measures for multicenter studies when illness
      severity is selected as an outcome measure. Characteristics that should be taken
      into consideration when assigning experimental groups include age, sex, a history
      of prematurity or underlying conditions and arterial oxygen saturation. Future
      studies will address additional questions about the efficacy of ribavirin, such
      as its role in critically ill children, the economic benefits of its use in terms
      of duration of hospitalization, the usefulness of early treatment of RSV disease
      in high risk infants, and the impact of treatment on long-term consequences of
      RSV infection. These studies may require outcome variables and subject selection
      strategies different from those used in earlier studies.

PMID- 2235210
TI  - New data on clinical efficacy of ribavirin.

PMID- 2235211
TI  - Early ribavirin aerosol treatment of respiratory syncytial virus infection in
      high-risk children.

PMID- 2235212
TI  - Clinical use of ribavirin in the future.

PMID- 2235213
TI  - Developmental toxicity and safety evaluations of ribavirin.

PMID- 2235214
TI  - Ribavirin pharmacokinetics.

PMID- 2235215
TI  - Hemodynamic alterations in patients treated with ribavirin.

PMID- 2235216
TI  - Environmental exposure to ribavirin aerosol.

PMID- 2235217
TI  - Primary care: the future for pediatric education.

PMID- 2235218
TI  - Prevalence of human immunodeficiency virus seropositivity in pediatric emergency
      room patients undergoing phlebotomy.
AB  - Information on the prevalence of human immunodeficiency virus (HIV) infection
      among children and adolescents requiring medical care is sparse. A small but
      significant risk of seroconversion occurs in health care workers who handle blood
      and body fluids of patients infected with HIV. The prevalence of HIV
      seropositivity in children who had phlebotomy as part of emergency care was
      measured. Of 749 blood samples, 21 (2.8%) tested positive for HIV antibody by
      enzyme-linked immunosorbent assay and Western Blot analysis: 14 samples from 6
      patients with hemophilia, 6 from 3 patients with acquired immunodeficiency
      syndrome/acquired immunodeficiency syndrome-related complex, and 1 from a patient
      with asthma. Of these 21 blood samples, 10 were from 4 children previously known
      to be HIV positive, 4 were from patients with a known parental risk factor, and
      16 were from patients with known history of blood transfusion. One sample was
      from a children with unknown HIV status and no documented risk factors.
      Procedures included 9 venipunctures, 17 intravenous line placements, 1 lumbar
      puncture, and 1 pelvic examination. Most patients with HIV seropositivity had
      been known to be HIV seropositive or at significant risk for HIV seropositivity.
      Although the potential risk to health care workers from children without known
      risk factors for HIV seropositivity was small in this population, the currently
      recommended infection-control precautions should always be observed.

PMID- 2235219
TI  - Access to medical care for children and adolescents in the United States.
AB  - To evaluate access to health care for American children and adolescents, a
      telephone survey of a national random sample of households was conducted in which
      2182 children 17 years or younger were studied. Approximately 10% had no medical
      insurance; 10% had no regular source of care; and 18% identified emergency rooms,
      community clinics, or hospital outpatient departments as their usual site of
      medical care. Children who were uninsured, poor, or nonwhite were less likely to
      have seen a physician in the past year (P less than .001), and uninsured children
      were less likely to have up-to-date immunizations. Logistic regression analyses
      revealed that poor, uninsured, or nonwhite children less frequently had a regular
      source of care; more frequently used emergency rooms, community clinics, and
      hospital outpatient departments as their regular providers; and more frequently
      encountered financial barriers to health care. Low-income or nonwhite children
      had much less access to care compared with children from more affluent or white
      families, independent of insurance status or health status.

PMID- 2235220
TI  - Children riding in the back of pickup trucks: a neglected safety issue.
AB  - Motor vehicle-related trauma is the leading cause of death in children in the
      United States. All states have pediatric restraint requirements for passenger
      vehicles to help prevent these deaths and injuries. Only a few states, however,
      possess safety laws or restrictions for passengers who ride in the back of pickup
      trucks. A retrospective review of medical records for a 40-month period revealed
      40 patients whose injuries were a direct result of being a passenger in the cargo
      area (bed) of a pickup truck. Their injuries and other pertinent data are
      discussed. Representatives from the Highway Safety Commission of each state were
      surveyed about their specific highway safety laws. The responses revealed that
      all states and the District of Columbia have child restraint requirements for
      passenger automobiles, 34 states have adult restraint laws, but only 17 states
      have any type of restriction for passengers riding in the back of pickup trucks.
      Seventy-one percent of the states with pickup truck regulations include only the
      preschool-age child. Data from the National Highway Traffic Safety Administration
      concerning pickup trucks and passenger fatality are presented and discussed.

PMID- 2235221
TI  - Hair dryer burns in children.
AB  - Three children with burn injuries caused by home hair dryers are described. In
      one patient the injury was believed to be accidental, and in the other two cases
      the injuries were deliberately caused by a caretaker. The lack of prior
      experience with hair dryer burns initially led to suspicion of other causes. The
      characteristics of each case aided in the final determination of accidental vs
      nonaccidental injury. These cases prompted testing of home hair dryers to
      determine their heat output. At the highest heat settings, the dryers rapidly
      generated temperatures in excess of 110 degrees C. After the dryers were turned
      off, the protective grills maintained sufficient temperatures to cause full
      thickness burns for up to 2 minutes. These cases and the results of testing
      demonstrate that hair dryers must be added to the list of known causes of
      accidental and nonaccidental burns in children.

PMID- 2235222
TI  - Transbronchial biopsies in children after heart-lung transplantation.
AB  - Sixty transbronchial biopsies have been performed in eight children after heart
      lung transplantation. The selection of fiber-optic bronchoscope or a small (4 mm;
      30 cm) rigid bronchoscope was made according to the size of endotracheal tube
      required at surgery. If the endotracheal tube was size 7.5 or greater, a fiber
      optic bronchoscope was used, whereas if the endotracheal tube size was below 7, a
      rigid bronchoscope was used. For the diagnosis of lung rejection, the histology
      of biopsies revealed a sensitivity of 91% and specificity of 69% (similar to the
      result in adults). The histology also distinguished lung infection from
      rejection. Complications included three pneumothoraces and two clinically
      significant episodes of hemorrhage, one of which led to a cardiorespiratory
      arrest, which may have been caused by hypoxia. As a result, arterial oxygen
      saturation is now monitored during the procedure using a pulse oximeter.

PMID- 2235223
TI  - Self-induced urinary tract infection in school-age boys.
AB  - This study focuses on a consecutive series of 31 boys, aged 5 years 3 months to
      14 years 9 months, who had a first diagnosed urinary tract infection. A
      questionnaire administered after diagnosis revealed that 10 of these boys
      injected water into their urethra while taking a bath in the few days preceding
      the onset of infection. Neither presenting symptoms nor urine tests can
      distinguish self-inflicted infections from infections occurring spontaneously.
      However, no urinary tract malformations were detected among the boys with a
      history of urethral manipulation whereas one third of the other 21 boys had
      anomalies. If these data are confirmed by other studies, complete imaging
      investigation could then be avoided in such cases. It could also become possible
      to prevent a number of urinary tract infections in school-age boys by warning
      parents and children of the serious risks of self-instrumentation.

PMID- 2235224
TI  - Impact of intrauterine growth retardation and body proportionality on fetal and
      neonatal outcome.
AB  - Previous prognostic studies of infants with intrauterine growth retardation
      (IUGR) have not adequately considered the heterogeneity of IUGR in terms of
      cause, severity, and body proportionality and have been prone to
      misclassification of IUGR because of errors in estimation of gestational age.
      Based on a cohort of 8719 infants with early-ultrasound-validated gestational
      ages and indexes of body proportionality standardized for birth weight, the
      consequences of severity and cause-specific IUGR and proportionality for fetal
      and neonatal morbidity and mortality were assessed. With progressive severity of
      IUGR, there were significant (all P less than .001) linear trends for increasing
      risks of stillbirth, fetal distress (abnormal electronic fetal heart tracings)O
      during parturition, neonatal hypoglycemia (minimum plasma glucose less than 40
      mg/dL), hypocalcemia (minimum Ca less than 7 mg/dL), polycythemia (maximum
      capillary hemoglobin greater than or equal to 21 g/dL), severe depression at
      birth (manual ventilation greater than 3 minutes), 1-minute and 5-minute Apgar
      scores less than or equal to 6, 1-minute Apgar score less than or equal to 3, and
      in-hospital death. These trends persisted for the more common outcomes even after
      restriction to term (37 to 42 weeks) births. There was no convincing evidence
      that outcome among infants with a given degree of growth retardation varied as a
      function of cause of that growth retardation. Among infants with IUGR, increased
      length-for-weight had significant crude associations with hypoglycemia and
      polycythemia, but these associations disappeared after adjustment for severity of
      growth retardation and gestational age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235225
TI  - Development and validation of an index for scoring baseline respiratory disease
      in the very low birth weight neonate. Severity Index Development and Validation
      Panels and Newborn Lung Project.
AB  - An accurate description of the population at risk for neonatal chronic lung
      disease is clearly of prime importance for comparative studies and the planning
      of interventions. Attempts to explain variations in chronic lung disease rates in
      such studies have been compromised by lack of a way of estimating the severity of
      the initial pulmonary disease as a risk factor. Therefore, a severity index was
      developed for use in very low birth weight (less than 1501 g) neonates. Special
      emphasis was placed on applicability of the index in the multicenter
      observational setting. Development followed a clinician panel approach, with the
      resulting index designed to capture clinical judgment of severity. The index was
      validated prospectively on neonates in a neonatal intensive care unit, and
      retrospectively using charts from nine hospitals nationwide. Correlations of the
      index with clinical judgment in the two samples were .95 and .93, respectively.
      In an additional validation the index combined with birth weight correctly
      predicted oxygen dependence status at 30 days in 36 of 42 neonates consecutively
      admitted to five neonatal intensive care units (P = .002). Birth weight and the
      severity index contributed about equally to the prediction, and therefore they
      seem to represent partly independent components of baseline propensity for
      prolonged oxygen dependence.

PMID- 2235226
TI  - Dexamethasone effects on the hospital course of infants with bronchopulmonary
      dysplasia who are dependent on artificial ventilation.
AB  - A randomized double-blind placebo-controlled trial was conducted to evaluate the
      effects of enterally administered dexamethasone on the hospital course of infants
      with bronchopulmonary dysplasia. A total of 23 infants with a birth weight less
      than 1500 g who were dependent on artificial ventilation 3 to 4 weeks of age
      received dexamethasone (n = 12) or saline placebo (n = 11). Dexamethasone (0.5
      mg/kg per day) was given in tapering doses for 7 days followed by hydrocortisone
      (8 mg/kg per day) which was progressively reduced for a total of 17 days of
      therapy. Infants who received dexamethasone required less oxygen on days 8 and 17
      (P less than .05) and were more likely to extubate 8 days after therapy than
      infants in the control group (respectively 8/12 vs 3/11 infants, P less than .05;
      P = .12 after Yates correction). The use of dexamethasone significantly shortened
      median duration of mechanical ventilation (4 vs 22 days, P less than .05) but had
      no effect on length of oxygen therapy, hospitalization, home oxygen therapy,
      occurrence and severity of retinopathy of prematurity, rate of growth, and
      mortality. No significant complications resulted from dexamethasone therapy.
      Measurements of plasma dexamethasone levels confirmed the absorption of drug from
      the gastrointestinal tract (23.7 ng/mL in dexamethasone vs 4.6 ng/mL in the
      control group, P less than .05). Dexamethasone administration resulted in short
      term improvements in pulmonary function but did not ameliorate the hospital
      course of infants with bronchopulmonary dysplasia.

PMID- 2235228
TI  - Prolonged maternal fluid supplementation in breast-feeding.
AB  - A randomized, crossover study design was used to evaluate the effect of prolonged
      maternal fluid supplementation on the milk supply of breast-feeding women. A
      total of 19 well-nourished women whose infants were solely breast-fed and
      thriving were enrolled when their infants were 90 to 120 days of age. Of this
      group, 15 women consumed at least a 25% increase in fluids above baseline for 7
      days. Mean daily milk production was 767 +/- 178 mL for the baseline period and
      744 +/- 138 mL for the increased fluid period. There was no significant change in
      milk production between baseline and increased fluid periods. No significant
      linear relationship between the percentage increase in fluid intake and
      percentage change in milk production was found.

PMID- 2235227
TI  - Predicting risk for bronchopulmonary dysplasia: selection criteria for clinical
      trials.
AB  - Early identification of neonates in whom bronchopulmonary dysplasia is most
      likely to develop permits appropriate enrollment into clinical trials testing
      early intervention therapies for the prevention or treatment of bronchopulmonary
      dysplasia. Analysis of 160 neonatal intensive care unit survivors to 28 days
      revealed that supplemental oxygen requirement at 28 days could be predicted by a
      logistic regression including (1) birth weight, gestational age, 5-minute Apgar
      score, and peak inspiratory pressure at 12 hours for 12-hour-old neonates and (2)
      birth weight, gestational age, peak inspiratory pressure at 12 hours, and mean
      airway pressure at 10 days for 10-day-old neonates. These two regression analyses
      were applied prospectively to three new data sets totaling 238 neonates to test
      their predictive ability. Neonates were classified into low-, moderate-, or high
      risk groups on the basis of their predicted probability of requiring oxygen
      supplementation at 28 days; low = probability of less than 25%, moderate =
      probability of 25% to 75%, and high = probability greater than 75%. Although
      these populations were demographically distinct from the original group, the
      regression analyses performed well. The regression analysis for 12 hours of age
      classified 125 neonates at low risk of whom 9% required supplemental oxygen at 28
      days, and the regression analysis for 10 days classified 141 neonates at low risk
      of whom 7% required supplemental oxygen. The 12-hour regression analysis
      classified 80 neonates at moderate risk of whom 33% required supplemental oxygen
      at 28 days and the 10-day regression analysis classified 49 neonates at moderate
      risk of whom 24% required supplemental oxygen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235229
TI  - Breast-feeding rates among black urban low-income women: effect of prenatal
      education.
AB  - Many factors are associated with low breast-feeding rates among black low-income
      women. This study examines whether, despite such factors, health professionals'
      prenatal education of black poor women is associated with increased breast
      feeding rates. Black women born in the United States who attended a midwives
      prenatal clinic (N = 159) were randomly assigned to two types of prenatal
      education or were followed up in a control group. All women were interviewed on
      entry into the study and after delivery of their infants. Women assigned to group
      classes attended at least one session discussing myths, problems, and benefits of
      breast-feeding. Women assigned to individual prenatal counseling spoke with a
      pediatrician or nurse practitioner, who discussed breast-feeding topics similar
      to those covered in the classes. Women in the control group received no
      additional prenatal education. The three study groups had significantly different
      percentages of women who breast-fed (controls 22%, classes 46%, individual
      sessions 53%). Higher percentages of women in the study groups carried out their
      prenatal plans to breast-feed (controls 50%, classes 86%, individual sessions
      62%) or breast-fed despite prenatal plans to bottle-feed (controls 10%, classes
      26%, individual sessions 48%). After multivariable analysis controlling for age,
      prenatal plans to breast-feed, prior breast-feeding experience, perceived support
      for breast-feeding, education, gravidity, and employment plans, women in
      intervention groups had a higher likelihood of breast-feeding than control
      subjects. These findings suggest that an increase in relatively simple, not-too
      time-consuming educational efforts in institutions and offices serving black low
      income women might yield significant narrowing of the gap in breast-feeding rates
      between white affluent women and black low-income women.

PMID- 2235230
TI  - Surfactant replacement therapy with a single postventilatory dose of a
      reconstituted bovine surfactant in preterm neonates with respiratory distress
      syndrome: final analysis of a multicenter, double-blind, randomized trial and
      comparison with similar trials. The Surfactant-TA Study Group.
AB  - The effects of a single dose of surfactant TA were assessed in premature neonates
      (birth weight 750 to 1749 g) with respiratory distress syndrome (RDS) in a
      multicenter, double-blind, randomized clinical trial. Only neonates with
      surfactant deficiency and without ultrasonographic evidence of intracranial
      hemorrhage greater than or equal to grade II were enrolled. Fifty-four patients
      received surfactant (100 mg of phospholipid per kilogram of body weight) and 46
      patients received an air placebo within 8 hours of life. Treatment with this
      surfactant resulted in a significant reduction in the severity of RDS with a
      concomitant increase in the proportion of neonates with mild disease. The
      frequency of pulmonary interstitial emphysema and of pneumothorax was
      significantly lower in treated neonates compared with control neonates (2% vs
      26%, P = .0008, and 7% vs 39%, P = .0004, respectively). The frequency of
      intracranial hemorrhage was significantly lower in the surfactant group compared
      with the control group (20% vs 54%, P = .0008) and was also reduced for the
      smallest neonates in the surfactant group (13% vs 73%, P = .00008). When
      categorized according to severity of intracranial hemorrhage and severity of
      bronchopulmonary dysplasia, the surfactant group was at a significant advantage
      (adjusted Cochran-Mantel-Haenszel X2 = 10.72, P less than .001 and X2 = 4.43, P =
      .036, respectively). The proportion of neonates surviving without intracranial
      hemorrhage and/or bronchopulmonary dysplasia was 63% in the surfactant group vs
      26% in the control group (P = .0004); as for the smallest neonates, it was 58% in
      the surfactant group vs 4% in the control group (P = .0002). There were no
      differences between the groups with respect to the frequency of patent ductus
      arteriosus (46% vs 37%), pulmonary hemorrhage (6% vs 7%), necrotizing
      enterocolitis (0% vs 2%), sepsis (4% vs 2%), retinopathy of prematurity (13% vs
      22%), or death (15% vs 22%). It is concluded that treatment with the single-dose
      surfactant regimen used in this study reduces the severity of respiratory
      distress during the 48 hours after treatment and decreases the major pulmonary
      morbidity and intracranial hemorrhage in premature neonates with RDS. Further
      studies are needed to determine whether (1) treatment at birth or as soon as
      after RDS is diagnosed and (2) the use of multiple dose of this surfactant would
      result in any additional benefits.

PMID- 2235231
TI  - Pediatric acquired immunodeficiency syndrome: an unusually high incidence of
      twinning.
AB  - Surveillance data on incidence of twins among reported cases of pediatric AIDS in
      New York City are presented. Most pairs are concordant for HIV infection. Three
      discordant pairs have been described elsewhere. Possible reasons for the
      association are discussed, including the most likely explanation that twins show
      symptoms early and are overrepresented in the early years of surveillance of
      pediatric AIDS.

PMID- 2235232
TI  - Failure of a nursing infant to thrive after the mother's gastric bypass for
      morbid obesity.

PMID- 2235233
TI  - Drug prescribing in pediatrics: challenges for quality improvement.

PMID- 2235234
TI  - Economy, convenience, and safety: can we have it all? Some thoughts on the
      occasion of the fortieth anniversary of the Committee on Injury and Poison
      Prevention.

PMID- 2235235
TI  - Predicting risk for bronchopulmonary dysplasia.

PMID- 2235236
TI  - Screening for neuroblastoma in infants: investigate or implement?

PMID- 2235237
TI  - American Academy of Pediatrics Committee on Infectious Diseases: Haemophilus
      influenzae type b conjugate vaccines: immunization of children at 15 months of
      age.

PMID- 2235238
TI  - American Academy of Pediatrics Committee on Sports Medicine: Risks in distance
      running for children.

PMID- 2235239
TI  - American Academy of Pediatrics Committee on Sports Medicine: Strength training,
      weight and power lifting, and body building by children and adolescents.

PMID- 2235240
TI  - Sports deficit disorder.

PMID- 2235241
TI  - Child abuse.

PMID- 2235242
TI  - Infant feeding and infectious disease.

PMID- 2235244
TI  - Pediatric emergencies.

PMID- 2235243
TI  - Fever and petechiae in children.

PMID- 2235245
TI  - The work of pediatric residents.

PMID- 2235246
TI  - Persistent pulmonary hypertension and ECMO.

PMID- 2235247
TI  - The NICHD phototherapy study.

PMID- 2235248
TI  - Identification of time-compressed sentential stimuli by good vs poor readers.
AB  - Ability of eight good and eight poor readers (in Grade 1, ages ranging from 6.7
      to 7.4 yr.) to discriminate phonemic contrasts presented in 50% time-compressed
      sentential stimuli (Subtest 13 of the Carrow-Auditory Visual Abilities Test) was
      measured. Good readers exhibited a significantly higher over-all mean performance
      than poor readers on the time-compressed task. Effects of time-compression on the
      perception of manner, place, voicing and frequency contrasts showed a similar
      pattern of errors for both groups of readers. Implications of the effects of
      auditory discrimination on reading abilities are discussed.

PMID- 2235249
TI  - A choice-reaction time task utilizing congruent and incongruent colour/word
      stimuli: another reaction to Stroop.
AB  - A choice reaction time task was devised, using incongruent colour/word (Stroop
      type) and congruent colour/word stimuli. A significant difference was found
      between reaction times to the two stimulus types with the Stroop-type stimuli
      eliciting longer reaction times. It is argued that traditional hypotheses about
      channel limitation can not explain this finding; the suggestion that the delay
      may lie in the decision-making process is put forward.

PMID- 2235250
TI  - Effect of the standard on size of the horizontal-vertical illusion.
AB  - 70 subjects participated in a study designed to replicate the 1968 claim of
      Gardner and Long that the horizontal-vertical illusion is larger with the
      vertical than with the horizontal as standard. The effect did not appear in Exp.
      1 when subjects made judgments under both the reproduction and graded-series
      methods but did in a pilot study and in Exp. 2, although more strongly with the
      method of reproduction.

PMID- 2235251
TI  - Perception of unilateral weightbearing during unilateral and bilateral upright
      stance.
AB  - To compare the effect of stance (unilateral vs bilateral) and of weightbearing
      target (25%, 50%, 75%) on error in weightbearing perception, two groups,
      unilateral and bilateral, of 30 comparable subjects were tested. Weightbearing
      was measured while subjects stood on digital scales; bilateral stance was
      accomplished using two scales, and unilateral stance was accomplished using a
      walker and a single scale. The subject's error in perceiving weightbearing at
      each target level was assessed by taking the absolute value of the target percent
      weightbearing minus the mean actual percent weightbearing. The mean errors at the
      25, 50 and 75% targets were 6.5, 3.2, 17.6% for the unilateral group and 3.1,
      1.4, 3.8% for the bilateral group. A two-way analysis of variance indicated the
      magnitude of error differed between groups and target levels, with a greater over
      all error displayed by the unilateral weightbearing group. Our results suggest
      that adults are less accurate in judging weightbearing while standing on one,
      rather than on two, lower extremities. Clinicians should not expect patients to
      follow accurately instructions to weightbear at a specific percentage of full
      weight, particularly when using an assistive device to adjust weightbearing.

PMID- 2235252
TI  - Effects of walking on reaction and movement times among elders.
AB  - The purpose of this study was to examine the effects of a 6-wk. walking program
      on reaction times and movement times among 52 elders. Twenty-seven elderly, whose
      mean age was 71.8 yr. comprised the experimental group, and 25 elderly whose mean
      age was 71.8 yr. comprised the comparison group. The former subjects walked for
      30 min. three times a week for 6 wk. while the latter maintained their normal
      activity. No significant differences in simple or choice reaction times and the
      associated movement times were found. To clarify the relationship of health and
      current and past physical activity, correlations of these with both simple and
      choice reaction times and movement times were examined. Except for the number of
      miles walked in a week, none of the correlations were significant. These results
      may not support previous findings that reaction and movement times were shorter
      with life-long participation in aerobic activity. However, the present study
      examined persons who were sedentary and were not involved in a life-long
      participation in aerobic exercise. Implications of these findings are discussed.

PMID- 2235253
TI  - Role of color in perception of attractiveness.
AB  - In this color study females reported a favorite color significantly more often
      than males. Males preferred bright colors significantly more than females, with a
      converse finding for preference for soft colors. The 276 subjects, when asked to
      evaluate the attractiveness of stimulus models in photographs, gave as the reason
      color significantly more often than style of clothing or facial expressions.
      Subjects significantly concurred with expert choices of recommended and
      nonrecommended colors in five of the six sets of photographs. This study lends
      credence that wearing recommended colors makes a difference in judgments of what
      looks best by subjects over the age of 12.

PMID- 2235254
TI  - Nonballistic coincident timing.
AB  - A nonballistic coincident timing task was used to assess to what extent retarded
      subjects could use spatial and temporal information to plan their movements.
      Subjects did not just respond to events but appeared able to modify/plan their
      responses, given sufficient time.

PMID- 2235255
TI  - Sex differences in severity of injury in attempted suicides who jump.

PMID- 2235256
TI  - Microgenetic patterns of adaptation on the Stroop task by patients with bronchial
      asthma and duodenal peptic ulcer.
AB  - Microgenetic patterns of adaptation on the Stroop task were assessed by means of
      the Serial Color-Word Test given 21 patients with bronchial asthma and 20 with
      duodenal peptic ulcer, who were compared with 41 normal controls matched for sex,
      age, and education. Two measures were calculated on each of the five trials of
      the test, one of linear change and one of nonlinear change in reading times. As
      predicted, patients presented more frequently patterns characterized by high
      nonlinear change and less frequently stabilized patterns (low linear and
      nonlinear change of reading speed). Linear and nonlinear change were then
      calculated on the five linear change scores and the five nonlinear change scores;
      again patients presented more frequently patterns characterized by high nonlinear
      change on both the linear change scores and nonlinear change scores and less
      frequently stabilized patterns. These findings indicate strong similarities
      between the adaptation patterns of patients with ulcer and asthma and the
      microgenetic patterns previously known to characterize neurotic and psychotic
      patients. Furthermore, scores on the Serial Color-Word Test also differentiated
      between ulcer and asthma groups.

PMID- 2235257
TI  - Responses of psychotic adolescents to PPVT-R items of human versus nonhuman
      content.

PMID- 2235258
TI  - Effect of orientation on visual and vibrotactile letter identification.
AB  - The effect of stimulus orientation of letters presented either visually or
      vibrotactually was examined to obtain basic information on sensory substitution
      using the tactile sense. The reaction time (RT) to identify the letters F and R
      presented in normal or mirror-image form at four orientations each was measured.
      In addition, conditions of 0 degree and 270 degrees of head rotation from
      vertical and arm rotation from the midline axis were employed. Data from 5
      trained subjects showed that vibrotactile RTs were always longer than visual RTs.
      Stimulus rotation away from normal orientation increased visual RTs significantly
      but not vibrotactile RTs. Visual orientation effect then seemed to be determined
      by the body-coordinate system but not the vibrotactile orientation. Although
      further studies are warranted, from the results of this experiment, any
      convenient and constant stimulus orientation could be used with a wearable
      vibrotactile display system to exploit passive touch.

PMID- 2235259
TI  - Sport activity and personality as elements in preventing cancer and coronary
      heart disease.
AB  - Results are reported for 3 groups of healthy male probands, 318 in each group,
      matched for age and personality type on the Personality-Stress Questionnaire. One
      group was actively engaged in sports, one had discontinued former sporting
      activities, and one group had never taken part in regular sports. Follow-up after
      13 yr. showed lowest mortality in those actively engaged in sport, highest
      mortality in those who had given up sport, with those who had never been engaged
      in sport intermediate. Prophylactic behaviour therapy was shown to reduce
      mortality of those who had given up sport to a significant extent but not to
      affect degree of retinal sclerosis.

PMID- 2235260
TI  - Encoding of colors in short-term memory.
AB  - A theory is proposed to explain results from prior experiments on release from
      proactive inhibition and the recall of colors or color names in short-term
      memory. It is assumed that colors are encoded in two ways, verbally and
      perceptually, while color names are encoded only verbally. Assuming that the
      release occurs when a new and different encoding is performed on changed
      material, it follows that release from proactive inhibition should occur with
      shifts from color names to colors but not with shifts in the opposite direction.
      These results were obtained in prior experiments. In the present experiment
      ambiguous colors were used to minimize the verbal encoding. As predicted, release
      from proactive inhibition was found with shifts from ambiguous colors to names as
      well as with shifts from names to the ambiguous colors.

PMID- 2235261
TI  - The prediction of death from cancer by means of personality/stress questionnaire:
      too good to be true?
AB  - Recent work by Grossarth-Maticek and Eysenck has suggested that there are
      personality traits which in combination can predict cancer in healthy probands
      with 81% accuracy. Many critics have considered this result "too good to be
      true." It is shown that earlier studies have given results not very different in
      accuracy, suggesting that such a criticism is unwarranted.

PMID- 2235262
TI  - Causal attributions of physical education majors and mentally retarded adults.
AB  - This exploratory study examined the causal attributions and expectancies of 51
      physical education majors and 25 mentally retarded adults. The majors completed a
      written questionnaire concerning their causal attributions and expectancies for
      motor performance of the adults. The adults responded through an interview
      procedure regarding causal attributions and expectancies for their own motor
      performance. Analysis did not support the hypothesis that people make stable
      attributions about the performance of mentally retarded populations and
      subsequently maintain low expectancies. Previous experiences of failure did not
      diminish the expectancies of the adults for their own future success.

PMID- 2235263
TI  - Validity of the Estimated Learning Potential and other measures of learning
      potential.
AB  - The validity of the Estimated Learning Potential from the System of Multicultural
      Pluralistic Assessment was estimated using other measures of learning potential
      as criteria. In addition, correlations of traditional IQs with the learning
      potential measures were examined. The correlations between the Estimated Learning
      Potential and the criterion measures were low to moderate. Further, the
      traditional IQ was more strongly related to the learning potential measures than
      to the Estimated Learning Potential. Implications of these results, including the
      finding that learning potential should not be considered a unitary construct,
      were discussed.

PMID- 2235264
TI  - Mortality from suicide in follow-up studies of psychiatric patients.

PMID- 2235265
TI  - Perceptual inequality between two physically equal constant velocities.
AB  - When an object moves with an equal constant velocity before and after passing
      through a tunnel (or before and after a sudden acceleration--or deceleration--in
      the central part of its trajectory), the two velocities (the one preceding and
      the one following the tunnel or the sudden acceleration or deceleration) are
      perceived as different even if actually physically equal. Four experiments were
      carried out to underestimation of the second velocity (i.e., the one following
      the tunnel) when the first one (i.e., the one preceding the tunnel) is low, and
      an overestimation of the second one when the values of the first velocity are
      higher. An interpretation of the results is proposed, suggesting that an
      appearance effect (i.e., an apparent higher velocity at the beginning of the
      movement) could be for the perceptual inequality between the two physically equal
      constant velocities.

PMID- 2235266
TI  - Menninger's motives for suicide in genuine, simulated and hoax suicide notes.

PMID- 2235267
TI  - Stroop phenomena in the Vietnamese language: the case of Quocngu, Chunom and
      Chinese characters.

PMID- 2235268
TI  - Socioemotional functioning of creative preschoolers.
AB  - This study investigated the relationship between original thinking and
      socioemotional characteristics of 40 preschoolers, ranging in age from 44 to 68
      mo. (M = 56.2 mo.). Socioemotional behavior was assessed by teachers on two
      ratings, the Kohn Social Competency and the Child's Behavior Traits scales.
      Creative potential was assessed by the Multidimensional Stimulus Fluency Measure
      which measures ideational fluency. Contrary to expectations, no statistically
      significant differences in psychosocial adjustment were found between the more
      and less creative preschoolers on a median split. A significant effect for sex
      was detected on six of seven socioemotional variables examined, with girls
      scoring higher than boys on over-all adjustment. Similarly, more positive
      attributes of preschool girls are indicated in areas of functioning that
      traditionally have been reported to be characteristic of boys.

PMID- 2235269
TI  - Overcrowding in prisons and rates of suicide and homicide.

PMID- 2235270
TI  - Relationship between academic placement and perception of abuse of the voice.
AB  - Informal polling of public school speech-language pathologists indicated that
      special education teachers referred more children for disorders of voice than did
      regular classroom educators. This study evaluated the effect of academic
      placement (regular or special education settings) upon children's and their
      teachers' ratings of abuse of the voice. Analysis showed the two groups of
      teachers' criteria for judging abusive vocal behaviors differed while the
      children's ratings from each setting did not differ. The special educators
      appeared to perceive their students' vocal behavior as more abusive possibly due
      to environmental constraints, training or the social affective interactions of
      their students.

PMID- 2235271
TI  - Anxiety, self-control and shooting performance.
AB  - 55 rifle shooters were administered state-trait anxiety and self-control
      questionnaires. Shooting performance was recorded on 7 competitive occasions.
      Analysis indicated shooting performance is dependent more on anxiety state than
      on anxiety trait and self-control. Highly skilled shooters were less anxious and
      performed better across all competitions than moderately skilled shooters but did
      not differ on self-control and anxiety trait. The assumption that increased
      anxiety negatively affects performance through the mediation of self-control
      should be further studied.

PMID- 2235272
TI  - Lack of sex differences with the Baldwin illusion.
AB  - Responses of college students (16 men and 16 women) to the Baldwin illusion
      showed a significant effect for size of square but not for sex. Findings are
      consistent with those reported previously by Porac, Coren, Girgus, and Verde for
      adults and for the oldest group of children tested by Pressey and Wilson.

PMID- 2235274
TI  - Effects of different attentional strategies and practice on motor efficiency.
AB  - The effect of different attentional strategies on motor efficiency, measured by
      reaction-response time components, has historically been based on memory-drum
      construct theory, which implied limited attention and motor-response processing.
      The present study contrasts these principles by using a recording system and
      automatic analysis of reaction-response parameters. A within-subject design
      allowed detailed observation of the frequency of each preparatory set within each
      parameter and with control of the effects of practice. Analysis indicates (a)
      practice changes the effects of the attentional strategies on the components of
      reaction response but not the actual movement; (b) the motor-set strategy
      produces shorter movement times and, inversely, higher motor reaction times; and
      (c) the motor-sensory set integrated strategy produces improvements on each
      component of the reaction response. These findings suggest the memory-drum
      construct theory needs revision and should be based on other attentional models.

PMID- 2235273
TI  - Syllogistic reasoning in Puerto Rican bilingual elementary school children.
AB  - The purpose of the present study was to measure the effects of language
      proficiency and grade (age) on the reasoning of Puerto Rican bilingual children
      in elementary school. 20 syllogisms were administered, 10 in English and 10 in
      Spanish, and accuracy of and strategy for solution were examined. Solutions were
      more often accurate, and the proportion of theoretical explanations given for
      them was higher in Spanish. Differences by grade were not significant except a
      higher proportion of theoretical explanations were given by children in Grade 5
      for syllogisms in Spanish.

PMID- 2235275
TI  - Color CRT characterization presented solely in terms of the CIE system.
AB  - Color CRT characterization provides a convenient means of producing colors
      specified in terms of their chromaticity coordinates and luminances. It also
      simplifies the inverse procedure by enabling the determination of the
      chromaticities and luminances of displayed colors without direct measurement.
      This paper presents the characterization procedure entirely within the context of
      the well-known CIE system, a brief description of which is provided as
      background. This presentation is intended for those with access to a spectral
      radiometer but little familiarity with color specification or measurement.

PMID- 2235276
TI  - An intercultural comparison of immediacy among Japanese and Americans.

PMID- 2235277
TI  - The diagnostic value of cerebellar-vestibular tests in detecting learning
      disabilities, dyslexia, and attention deficit disorder.
AB  - Neurological and optokinetic measures of cerebellar-vestibular (CV)
      dysfunctioning were shown to be of significant diagnostic value in
      differentiating between learning disabled subjects and controls matched for
      chronological age, sex, handedness, IQ, and background (ns = 35). Although
      traditionally used electronystagmographic positional and caloric parameters were
      not similarly discriminating, quantitative measures of vertical nystagmus in
      various eyes-closed positions appeared to have diagnostic potential and were
      related significantly to such CV-determined neurological signs as positive
      monopedal Romberg. As a substantial majority of learning disabled (82.9%)
      evidenced ADD-like symptoms and since learning disabled subsamples with and
      without Attention Deficit Disorder (ADD) shared similar coexisting symptoms and
      CV signs, it appeared probable that learning disabilities and ADD were
      reflections of the same underlying CV determinants.

PMID- 2235278
TI  - Insulin and dextrose effects on fixed-interval behavioral thermoregulation in
      albino rats.
AB  - This study is a systematic replication of the effects of insulin doses on operant
      behavior reinforced (in an earlier study) by fixed-ratio schedules of microwave
      (MW) reinforcement. In this study, insulin and dextrose doses were administered
      (ip) prior to fixed-interval 2-min. schedules of MW reinforcement in rats tested
      in a cold environment. Six Sprague-Dawley rats were conditioned to regulate their
      thermal environment with 5-sec. exposures of MW radiation (SAR = 0.34
      Watts/kg/(mW/cm2) under the FI-2' schedules. Humulin-regular insulin and 50%
      solutions of dextrose were administered (ip) alternately with saline control
      sessions for 8-hr. durations. A within-subjects, repeated-measures 4 x 8 x 3
      factorial analysis of variance design showed that insulin doses suppressed
      operant responding for heat, which confirmed the results of the earlier study
      under a different schedule. In addition, high doses of dextrose had similar
      suppressing effects on operant responding for heat. The data are interpreted in
      terms of the discriminative properties of increased thermogenesis produced by the
      insulin and dextrose doses. The suppressing effects were more pronounced for the
      first two hours, yet they persisted for approximately six hours of the 8-hr.
      sessions.

PMID- 2235279
TI  - Computerized interpretation of the Luria-Nebraska Neuropsychological Battery: a
      pilot study.
AB  - Programs for the computer analysis and interpretation of neuropsychological test
      data have been developed in recent years. In this paper, a new computer program,
      with initial validation data, is presented. Diagnostic hit rate for brain damage
      was 80% (52 of 65). For the extent of brain damage the hit rate was 60% (12 of
      20). When laterality was considered, the hit rate was 71% (10 of 14). These
      results are comparable with computer programs for data from the Halstead-Reitan
      Neuropsychology Test Battery.

PMID- 2235280
TI  - Subliminal stimulation and cognitive and motor performance.
AB  - The present experiment investigated whether subliminally exposed messages affect
      cognitive and motor performance and whether personality factors can explain
      interindividual differences in this respect. According to Silverman (1983),
      people have a symbiotic fantasy, that is, a need for symbiotic oneness with the
      mother figure. This need can temporarily be satisfied by a tachistoscopic
      exposure of the message "Mommy and I are one." By relieving the unconscious
      conflict, psychological tension is reduced. Using these notions, it was
      hypothesized that different measures of performance should be improved. The
      results indicate that both cognitive performance, in terms of the ability to
      interpret incomplete and fragmented pictures, and motor performance, in terms of
      the ability to follow a printed line with a stylus, is improved by this procedure
      compared to that of a control group exposed to the neutral message "People are
      walking." However, it was not possible to relate these changes to individual
      differences in terms of the individual's structure of his psychological defense
      system as measured by the Defense Mechanism Test (DMT). Other possible
      explanations are discussed.

PMID- 2235281
TI  - Effects of alcohol on cognitive performance measured with Stroop's Color Word
      Test.
AB  - An experiment was performed to test whether alcohol intoxication leads to
      cognitive disinhibition as measured by the Color Word Test. In psychoanalytic
      terms, it was hypothesized that alcohol would decrease secondary process
      functioning leading to disinhibition and so make it easier to perform a primary
      process function. 24 men and 24 women participated and were randomly assigned to
      an Alcohol group, a Placebo group or a Control group. The alcohol dose was 1.0 ml
      of 100% alcohol/kg body weight. No statistically significant differences were
      found on any of the three dependent measures, number of errors, number of
      hesitations and total time needed, except that men in the Alcohol group needed
      significantly longer time to complete the test. These results indicate that
      cognitive disinhibition is not valid as an explanation for alcohol-related
      changes in cognitive functioning.

PMID- 2235282
TI  - Cracks--of Kuhn and doom.

PMID- 2235283
TI  - Pigeon pattern perception: limits on perspective invariance.
AB  - Two experiments are reported in which the response of pigeons to perspective
      transformations of a pattern target was measured. In the first experiment an
      alphabet letter was taken as the pattern target (the 'positive') and the response
      to its perspective transforms was compared to the response to nontarget letters
      ('negatives') over the course of discrimination training. In the second
      experiment irregular quadrilaterals were used as positives and the responses to
      slight perspective deformations of the prototypes were compared to the responses
      to random transformations of the same magnitude under steady-state conditions.
      The amount of differential responding depended on the type of transformation.
      There was no differential response to targets rotated in the picture plane or
      around the horizontal axis in either experiment. There was differential response
      to small reductions and enlargements of the target. There was also differential
      response to translated targets, and this was seen irrespective of the amount of
      displacement. Results from targets rotated around the vertical axis were erratic,
      some target-plus-angle combinations elicited differential responding, but most
      did not. The erratic responses are attributed to symmetries in pattern elements
      that were abstracted as critical features. Pigeons therefore exhibit no true
      rotation invariance, limited size invariance, and complete shift invariance. It
      is argued that size invariance, but not position invariance, may depend on prior
      exposure to the alternatives.

PMID- 2235284
TI  - Stereo and motion cues in preattentive vision processing--some experiments with
      random-dot stereographic image sequences.
AB  - Low-level preattentive vision processing is of special interest since it seems
      the logical starting point of all vision processing. Exploration of the human
      visual processing system at this level is, however, extremely difficult, but can
      be facilitated by the use of stroboscopic presentation of sequences of random-dot
      stereograms, which contain only local spatial and temporal information and
      therefore limit the processing of these images to the low level. Four experiments
      are described in which such sequences were used to explore the relationships
      between various cues (optical flow, stereo disparity, and accretion and deletion
      of image points) at the low level. To study these relationships in more depth,
      especially the resolution of conflicting information among the cues, some of the
      image sequences presented information not usually encountered in 'natural'
      scenes. The results indicate that the processing of these cues is undertaken as a
      set of cooperative processes.

PMID- 2235285
TI  - Adaptation to optically-increased interocular separation under naturalistic
      viewing conditions.
AB  - Mirror spectacles which enhance binocular disparity by optically doubling the
      normal separation between the eyes were used to create conditions of combined
      perceptual and oculomotor conflict. Apparent depth and distance, as well as tonic
      accommodation, tonic vergence, and accommodative-vergence gain (response AC/A
      ratio), were assessed immediately before and after a 30 min exposure period of
      naturalistic viewing with the spectacles. Wearing the spectacles produced an
      increase in tonic vergence, and perceptual aftereffects consisting of increased
      apparent distance and depth. The results indicate that oculomotor conflict
      associated with enhanced interocular separation may be resolved through
      adaptation of tonic vergence, rather than through alteration of accommodative
      vergence gain. The results also demonstrate that perceptual conflict between
      disparity and multiple veridical depth cues does not necessarily produce adaptive
      modification of the relationship between binocular disparity and apparent depth.

PMID- 2235287
TI  - Perception of structure from two-, four-, or eight-dot oscillatory motion:
      restoration of rigidity with the aid of structural information.
AB  - The motion of two dots corresponding to the two endpoints of an oscillating rigid
      pendulum produces the perception of an elastic rod, not a rigid one. The
      possibility that structural information about a rigid object whose motion is
      simulated plays an important role in the perceptual restoration of the rigidity
      is examined. Two experiments are reported in which the motion of the endpoints of
      rigid objects (two endpoints for a rod, four for a sheet, and eight for a board)
      was displayed. Rigid structure was restored whenever structural information could
      be used to activate a knowledge data-base on the properties of the objects.

PMID- 2235286
TI  - How the visual system detects changes in the direction of moving targets.
AB  - To determine how the visual system represents information about change in target
      direction, we studied the detection of such change under conditions of varying
      stimulus certainty. Target direction was either held constant over trials or was
      allowed to vary randomly. When target direction was constant the observer could
      be certain about that stimulus characteristic; randomizing the target direction
      rendered the observer uncertain. We measured response times (RTs) to changes in
      target direction following initial trajectories of varying time and distance. In
      different conditions, the observer was uncertain about either the direction of
      the initial trajectory, or the direction of change or both. With brief initial
      trajectories in random directions, uncertainty about initial direction elevated
      RTs by 50 ms or more. When the initial trajectories were at least 500 ms, this
      directional uncertainty ceased to affect RTs; then, only uncertainty about the
      direction of change affected RTs. We discuss the implications of these results
      for (i) schemes by which the visual system might code directional change; (ii)
      the visual integration time for directional information; and (iii) adaptational
      processes in motion perception.

PMID- 2235288
TI  - Vernier acuity with opposite-contrast stimuli.
AB  - Vernier acuity has usually been tested with stimuli of the same contrast polarity
      (SC). This traditional vernier acuity was compared to that obtained with stimuli
      of opposite-contrast (OC) in which one target was brighter than the background
      and the other was darker. For both bar and dot targets vernier acuity with OC
      stimuli was about half as good as with SC stimuli. There were large individual
      differences in the size of the disadvantage with OC stimuli, although thresholds
      remained within the hyperacuity range. There were also individually-differing
      biases to see a dark vernier stimulus on one or the other side of a bright
      stimulus. Differences between OC and SC vernier acuities persisted over a wide
      range of interstimulus spacings, widths, and contrasts. At extremes of these
      spatial manipulations acuities became similar, but only because SC acuities were
      degraded to the level of OC acuities. Subjects showed little improvement in OC
      vernier acuity, even after 50,000 trials. It is concluded that finest judgements
      of spatial position arise in a level of the visual system at which light and dark
      stimuli are treated independently.

PMID- 2235289
TI  - Perceptual information for the timing of interceptive action.
AB  - Time-to-contact is an important quantity for controlling activities which involve
      the timing of interactions with objects and surfaces in motion relative to an
      observer. Two alternative means for obtaining perceptual information that might
      be used to obtain the time-to-contact required to correctly time an interaction
      have been contrasted: a method based on the perception of distance and velocity,
      and a method due to Lee involving a perceptual variable called tau. A monocular
      version of the first method is presented and shown to place a highly unrealistic
      and arbitrary limitation on the capabilities of the visual system. The second
      method is reviewed and its limitations discussed. Several means by which these
      limitations can be overcome are presented. Recently reported results from
      experiments which involved catching self-luminous balls in the dark are
      interpreted in terms of timing information available to the subject, and the
      notions of intermodal and multimodal timing information are introduced. Finally,
      the possibility that timing information is available to an observer which does
      not involve the variable tau is considered. It is concluded that many questions
      regarding the perception of time-to-contact remain unresolved and that much
      empirical research remains to be done.

PMID- 2235291
TI  - Perception and art: links with normal and abnormal brain function. Fifth
      international symposium of the Northern Eye Institute. Bristol, July 1989.
      Abstracts.

PMID- 2235290
TI  - Binaural and monaural localization of sound in two-dimensional space.
AB  - Two experiments were conducted. In experiment 1, part 1, binaural and monaural
      localization of sounds originating in the left hemifield was investigated. 104
      loudspeakers were arranged in a 13 x 8 matrix with 15 degrees separating adjacent
      loudspeakers in each column and in each row. In the horizontal plane (HP), the
      loudspeakers extended from 0 degrees to 180 degrees; in the vertical plane (VP),
      they extended from -45 degrees to 60 degrees with respect to the interaural axis.
      Findings of special interest were: (i) binaural listeners identified the VP
      coordinate of the sound source more accurately than did monaural listeners, and
      (ii) monaural listeners identified the VP coordinate of the sound source more
      accurately than its HP coordinate. In part 2, it was found that foreknowledge of
      the HP coordinate of the sound source aided monaural listeners in identifying its
      VP coordinate, but the converse did not hold. In experiment 2, part 1,
      localization performances were evaluated when the sound originated from
      consecutive 45 degrees segments of the HP, with the VP segments extending from 
      22.5 degrees to 22.5 degrees. Part 2 consisted of measuring, on the same
      subjects, head-related transfer functions by means of a miniature microphone
      placed at the entrance of their external ear canal. From these data, the 'covert'
      peaks (defined and illustrated in text) of the sound spectrum were extracted.
      This spectral cue was advanced to explain why monaural listeners in this study as
      well as in other studies performed better when locating VP-positioned sounds than
      when locating HP-positioned sounds. It is not claimed that there is inherent
      advantage for localizing sound in the VP; rather, monaural localization
      proficiency, whether in the VP or HP, depends on the availability of covert peaks
      which, in turn, rests on the spatial arrangement of the sound sources.

PMID- 2235292
TI  - Glucose utilization, blood flow and capillary density in the ventrolateral
      medulla of the rat.
AB  - A specific population of neurons in the ventrolateral medulla (VLM) acts as the
      main integration center for the regulation of the sympathetic outflow to the
      cardiovascular system. In order to investigate whether this nucleus can be
      distinguished from its surroundings in the reticular formation of the medulla
      with respect to functional and morphological variables, the present study
      investigates several of such variables in this area on a quantitative basis.
      Local medullary glucose utilization was measured by the 2-[14C]deoxyglucose
      method; local medullary blood flow was quantified using iodo[14C]-antipyrine, and
      the local density of perfused capillaries was calculated by counting the number
      of intravascular fluorescent spots in brain sections after i.v. infusion of a
      globulin-coupled fluorescent dye. The values obtained from the VLM were compared
      with the respective values found in a reference area of the same brain section
      (gigantocellular nucleus). The values for glucose utilization, blood flow and
      capillary density were significantly (P less than 0.05) higher in the VLM than in
      the reference area (gigantocellular nucleus). This difference was 44.7% for
      glucose utilization, 34.1% for blood flow and 19.7% for capillary density. These
      data support the hypothesis that neurons in the VLM are specifically well
      supplied for being directly regulated in their activity by the PCO2 and pH in the
      arterial blood.

PMID- 2235293
TI  - Dependence of intracellular free calcium and tension on membrane potential and
      intracellular pH in single crayfish muscle fibres.
AB  - The dependence of intracellular free calcium ([Ca2+]i) and tension on membrane
      potential and intracellular pH (pHi) was studied in single isolated fibres of the
      crayfish claw-opener muscle using ion-selective microelectrodes. Tension (T) was
      quantified as a percentage of the maximum force, or as force per cross-sectional
      area (N/cm2). In resting fibres, pHi had a mean value of 7.06. Contractions
      evoked by an increase extracellular potassium [( K+]0) produced a fall in pHi of
      0.01-0.05 units. The lowest measured levels of resting [Ca2+]i corresponded to a
      pCai (= -log [Ca2+]i) of 6.8. Intracellular Ca2+ transients recorded during K(+)
      induced contractions did not reveal any distinct threshold for force development.
      Both the resting [Ca2+]i and resting tension were decreased by an intracellular
      alkalosis and increased by an acidosis. The sensitivity of resting tension to a
      change in pHi (quantified as -dT/dpHi) showed a progressive increase during a
      fall in pHi within the range examined (pHi 6.2-7.5). The pHi/[Ca2+]i and
      pHi/tension relationships were monotonic throughout the multiphasic pHi change
      caused by NH4Cl. A fall of 0.5-0.6 units in pHi did not produce a detectable
      shift in the pCai/tension relationship at low levels of force development. The
      results indicate that resting [Ca2+]i is slightly higher than the level required
      for contractile activation. They also show that the dependence of tension on pHi
      in crayfish muscle fibres is attributable to a direct H+ and Ca2+ interaction at
      the level of Ca2+ sequestration and/or transport. Finally, the results suggest
      that in situ, the effect of pH on the Ca2+ sensitivity of the myofibrillar system
      is not as large as could be expected on the basis of previous work on skinned
      crustacean muscle fibres.

PMID- 2235294
TI  - Madin-Darby canine kidney cells. I. Aldosterone-induced domes and their
      evaluation as a model system.
AB  - Vectorial transport of salt and water in the Madin-Darby canine kidney (MDCK)
      cell line is indicated by the formation of domes when a monolayer is grown on an
      impermeable support. We investigated aldosterone-induced dome formation and
      evaluated the dome as an experimental model. Transepithelial dome resistance was
      about 80 omega cm2 and constant when dome size exceeded 2.10(-4) cm2. The
      relative ion conductances (expressed as transference numbers) across the dome
      epithelium were tNa:tCl:tk = 0.64:0.24:0.06. They reflect the permeability
      properties of the paracellular shunt pathway tested at physiological
      concentrations of the individual ions. Aldosterone accelerated dome formation in
      serum-deprived MDCK monolayers. Prostaglandin E1 and transferrin were supportive
      but not essential for aldosterone-induced dome formation. After 72 h dome density
      was equal in monolayers cultured in serum-supplemented medium either in the
      presence or absence of mineralocorticoids. We conclude that aldosterone induces
      cell polarization in MDCK monolayers, leading to the formation of domes. The dome
      epithelium appears to be electrically isolated from the adjacent monolayer and
      can be studied by microelectrode techniques.

PMID- 2235295
TI  - Autoregulation of the glomerular filtration rate and the single-nephron
      glomerular filtration rate despite inhibition of tubuloglomerular feedback in
      rats chronically volume-expanded by deoxycorticosterone acetate.
AB  - Tubuloglomerular feedback (TGF) function and autoregulation (renal blood flow
      RBF; glomerular filtration rate, GFR; single-nephron glomerular filtration rate,
      SNGFR) were examined in rats chronically treated with deoxycorticosterone acetate
      (DOCA) and given isotonic saline to drink. DOCA treatment depressed arterial
      plasma renin activity, expanded plasma volume by 25% and increased arterial blood
      pressure. Autoregulation of RBF and GFR was maintained in the DOCA animals above
      90 mm Hg and 110 mm Hg respectively, whereby both GFR and RBF were lower than in
      controls. Micropuncture experiments demonstrated the absence of TGF in the DOCA
      animals. There was no difference between SNGFR values measured in the distal and
      proximal tubules, nor was there a significant response of SNGFR when loops of
      Henle were perfused with Ringer's solution at 20 nl/min. Loop perfusion in
      control rats with tubular fluid collected in DOCA rats elicited a normal TGF
      response, showing that TGF inhibition in the DOCA animals is due to changes in
      the function of the juxtaglomerular apparatus. In contrast to control rats,
      proximal SNGFR was perfectly autoregulated. These results suggest that TGF is not
      primarily responsible for autoregulation and that the vasodilatation normally
      resulting from acute TGF interruption is therefore compensated by some other
      mechanism such that RBF and GFR are lower than in controls.

PMID- 2235296
TI  - Cholinergic agonists increase cell calcium in rat medullary collecting tubules. A
      fura-2 study.
AB  - The intracellular free calcium concentration [Ca2+]i of rat medullary collecting
      tubules was calculated from microscope fluorescence measurements in single pieces
      of fura-2-loaded tubules superfused at 37 degrees C. When carbachol (10(-4)-10(
      3) M) was added in the superfusate, a biphasic increase in [Ca2+]i was generally
      obtained, which included an early peak phase and a sustained plateau thereafter;
      sometimes, the peak phase was not apparent; the plateau was maintained as long as
      the agonist was applied. Several responses could be induced successively without
      a fall in responsiveness. From dose/response curves, K1/2 values of about 10(-5)
      M for carbachol and 10(-6) M for acetylcholine were obtained. The effects of the
      agonists were suppressed with 10(-4) M of atropine or pirenzepine, indicating the
      presence of muscarinic receptors of the M1 type. In the absence of external
      calcium, the peak phase of the response was preserved while the plateau phase was
      suppressed; thus, the peak involves the release of calcium stored in organelles,
      whereas the plateau involves the entry of external calcium through calcium
      channels which were voltage independent and insensitive to the usual calcium
      blockers.

PMID- 2235297
TI  - Role of voltage- and Ca2(+)-dependent K+ channels in the control of glucose
      induced electrical activity in pancreatic B-cells.
AB  - Low concentrations of tetraethylammonium chloride (TEA), which inhibit voltage-
      and Ca2(+)-sensitive K+ channels (K(+)-VCa channels), were used to investigate
      whether these channels play a role in the control of glucose-induced electrical
      activity (slow waves with spikes) in mouse pancreatic B-cells. Addition of 2 mM
      TEA to a medium containing 0, 3 or 6 mM glucose had no effect on the membrane
      potential of B-cells or on 86Rb+ efflux and insulin release from isolated islets.
      In 10 mM glucose, 0.5-2 mM TEA produced a concentration-dependent increase in
      spike amplitude without modifying slow-wave duration or frequency. Insulin
      release was only slightly increased under these conditions. In conclusion, K(+)
      VCa channels are not operative when the B-cell membrane is not depolarized (in
      low glucose). They appear to play a role in the repolarization of the spikes but
      not in that of the slow waves. In contrast to ATP-sensitive K+ channels, K(+)-VCa
      channels are not a target on which glucose acts to regulate electrical activity
      in B-cells and, hence, insulin release.

PMID- 2235299
TI  - Phrenic nerve responses to lung inflation and hypercapnia in decerebrate dogs.
AB  - The effects of changes in static airway pressure (Paw) and arterial PCO2 (PaCO2)
      on phrenic nerve activity were studied in unanesthetized, decerebrate dogs and
      compared with previous results from chloralose/urethane anesthetized dogs using
      the same experimental preparation (Mitchell et al. 1982; Mitchell and Selby
      1987). In ten mid-collicular decerebrate dogs, the lungs were independently
      ventilated while the left pulmonary artery was occluded and the right vagus nerve
      was transected. Changes in left lung Paw, therefore, exerted effects on pulmonary
      stretch receptors without altering blood gases; changes in the inspired gas
      ventilating the right lung controlled blood gas composition, without altering
      lung volume feedback. Phrenic burst frequency (f) and integrated amplitude (Phr)
      were monitored while Paw was varied between 2 and 12 cmH2O at various constant
      levels of PaCO2 between 31 and 69 mmHg. The major findings of this study are: (1)
      hypercapnia decreases the slope of the relationship between expiratory duration
      (tE) and Paw in both decerebrated and anesthetized dogs; (2) hypercapnia
      increases the inspiratory duration (tI) in decerebrated, but not anesthetized
      dogs; and (3) hypercapnia decreases the slope of the relationship between f and
      Paw due to these effects on tE and tI. These results support previous studies
      indicating that vagal and suprapontine mechanisms exert independent effects on
      respiratory timing. It is concluded that neither suprapontine influences nor
      anesthesia are necessary in the mechanism underlying interactions between stretch
      receptors and CO2-chemoreceptors in modulating tE. Furthermore, decerebration
      reveals a unique effect of CO2-chemoreceptors on tI, an effect found in
      anesthetized dogs only after carotid denervation.

PMID- 2235300
TI  - Long term comparison of some shock attenuating insoles.
AB  - The effect of one years general use on the performance of four shock attenuating
      insoles is reported. Testing was carried out using the JP Biomechanics Shock
      Meter on twelve volunteers on a timed oval course at eight intervals during the
      year. The results show that two of the insoles perform well (Viscolas and PPT)
      although deterioration does occur after 6-9 months use; the other two insoles
      (Plastazote and Gait Aid) perform poorly. It is suggested that manufacturers
      provide some information to the user or supplier regarding the effective life of
      their products.

PMID- 2235298
TI  - Aldosterone low-dose, short-term action in adrenalectomized glucocorticoid
      substituted rats: Na, K, Cl, HCO3, osmolyte, and water transport in proximal and
      rectal colon.
AB  - The short-term action of aldosterone in physiological concentration on net fluxes
      of Na, K, Cl, HCO3, osmolytes, and water was examined in the proximal colon and
      rectal colon of adrenalectomized (ADX) rats in vivo. The measuring time was 12 h,
      divided in eight periods of 90 min. (a) Aldosterone alone (6 nmol h-1 kg-1) did
      not stimulate transport in ADX rats. In these experiments plasma [K] increased to
      fatal values. A basal glucocorticoid substitution of 24 nmol h-1 kg-1
      corticosterone caused plasma K to stay constant throughout the experiment, so
      that epithelial transport was not handicapped by non-specific effects of ADX, but
      this also did not restore the decreased transport of ADX rats to control values.
      Under these conditions (absence of aldosterone) in the rectal colon Na and H2O
      transport was zero, whereas in the proximal colon flux rates were depressed by
      between 30% and 50%. In contrast, basal glucocorticoid substitution of 18 nmol h
      1 kg-1 corticosterone plus infusion of 6 nmol h-1 kg-1 aldosterone caused
      transport stimulation to values not significantly different from those of non-ADX
      controls. We conclude that after ADX, aldosterone at physiological concentrations
      increases transport if, as a prerequisite, a basal glucocorticoid substitution is
      provided. Transport of Na, K, and H2O is under the total control of aldosterone
      in the rectal colon but is only moderately altered in the proximal
      colon.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235301
TI  - Accelerations due to impact at heel strike using below-knee prosthesis.
AB  - The acceleration in the sagittal plane of the prosthetic tube at heel strike in
      normal walking was measured in five healthy amputees with their definitive below
      knee prosthesis, every subject using six different prosthetic feet, wearing sport
      shoes as well as leather shoes. The experiments were carried out in the
      rehabilitation centre "Het Roessingh", Enschede, The Netherlands. Maximum
      accelerations were extracted from the acceleration-time-signal. Mean acceleration
      maxima of all subjects were calculated for each foot-shoe combination to
      eliminate the individual influence of the subjects. In the axial direction the
      maximal accelerations demonstrate a clear difference among the prosthetic feet
      and the shoes, while in dorsoventral (tangential) direction the inter-individual
      variation in the acceleration extremes dominates the difference between the types
      of footwear. In comparison with non-amputees the magnitude of the maximal axial
      acceleration at heel strike does not differ significantly.

PMID- 2235302
TI  - An audit of amputation levels in patients referred for prosthetic rehabilitation.
AB  - Most lower limb amputations in the United Kingdom (UK) are carried out within
      general surgical, orthopaedic and plastic surgical units of district hospitals.
      This study of patients referred for rehabilitation was undertaken to determine
      the number and specialty interests of surgeons referring amputees, the numbers
      referred by each and, as one of several possible measures of appropriateness for
      rehabilitation, the amputation levels in patients referred for the first time to
      one sub-regional Disablement Services (limb fitting) Centre (DSC) over a 14 month
      period. Thirty nine surgeons, referred 263 amputees. The majority (61%) of
      surgeons referred 5 or fewer: a nucleus of 11 vascular surgeons (28%) referred
      64% of the patients. The underlying pathology, specialty interest of the surgeon
      or numbers referred by individual surgeons had no relation to final healed level
      which was below the knee in 55% of cases compared to national figures for all
      other DSC's ranging between 39% and 48% below-knee between 1981 and 1988. Since
      current practice in the UK is to refer all but the frailest patients for
      consideration of prosthetic rehabilitation, this study suggests that, nationally,
      more patients could be suited for the functionally superior below-knee level of
      amputation than are currently benefiting from it.

PMID- 2235303
TI  - A survey of amputations at Dodoma Regional Hospital, Tanzania.
AB  - A survey of 143 amputations performed at Dodoma Regional Hospital, Tanzania
      between 1983 and 1988 is presented. Consideration is given to indications for
      amputation, amputation levels, stump revision and supply of prostheses.

PMID- 2235304
TI  - Prosthetic use and functional and social outcome following major lower limb
      amputation.
AB  - A total of 175 consecutive below and above-knee amputees sent to the prosthetic
      workshop in Helsinki for prosthetic fitting from 32 hospitals were reviewed to
      determine their functional ambulation and social adaptation. The average age of
      the patients was 62.2 years at the time of the prosthetic fitting. The mortality
      was 11% (19) during the first postoperative year. One-year postoperative
      information was obtained for 141 of the surviving patients (90%) by personal
      contact. At the time of the review, 68% of the amputees (96 patients) who had
      been fitted with a prosthesis made extensive and regular use of it. Half of all
      the above-knee amputees and 79% of the below-knee amputees used their prosthesis
      throughout the day or over seven hours a day. A total of 72% of the above-knee
      amputees (33/46) and 85% of the below-knee amputees (67/79) had useful
      ambulation, at least indoors. Of the 141 patients contacted, 124 (88%) lived in
      their own homes. The remaining 16 patients (11%) lived in apartment houses for
      the aged or old people's homes. A total of 48 amputees (34%) needed a regular
      home help.

PMID- 2235305
TI  - Gait recovery pattern of unilateral lower limb amputees during rehabilitation.
AB  - The aim of this study was to determine the rate at which gait recovery as
      measured by temporal distance factors (velocity and symmetry) occurs in
      unilateral lower limb amputees. A microcomputer foot switch system was used to
      record the gait patterns of twenty subjects, mean age 65.1 years. The initial
      measurement was taken when the subject was capable of walking 6 metres with an
      interim prosthesis within the parallel bars. The patient sample as a whole was
      analyzed and subjects were further divided into four groups, depending on
      ambulatory aid required at discharge. Group A, n = 3 used no aid, Group B, n = 5
      used a single stick, Group C, n = 6 used 2 single sticks and Group D, n = 5
      required frames. A one way analysis of variance (F = 4.55, p = 0.02) showed a
      significant difference between the Groups, (A and D, B and D, C and D). The major
      velocity increase occurs within the first 30 days of the gait training programme.
      Overall about 55% increase in velocity can be expected within the first fifteen
      day period followed by an additional 30% between days 15-30. A moderately strong
      correlation (r = 0.78) was found between initial and discharge velocity. The
      correlation between initial and discharge symmetry was weaker (r = 0.50).

PMID- 2235306
TI  - Splinting for CDH: temporary splinting for the neonate.
AB  - A simple method of maintaining hip abduction in the neonate with suspected
      congenital hip instability is described. Clinical observations and parental
      impressions are initially favourable.

PMID- 2235307
TI  - [MR imaging of compressive cervical myelopathy after surgery--high signal
      intensity of the spinal cord on T2 weighted images].
AB  - We reviewed the MR images of 32 patients with cervical myelopathy, showing
      lesions of high signal intensity in the spinal cord on the sagittal T2 weighted
      images (T2WI) after surgery: 16 with OPLL; 9 with spondylosis; 4 with disc
      herniation and 3 with trauma. All images were obtained on a superconducting 1.5
      Tesla system. The lesions were classified into five groups, according to the
      shape and grade of signal intensity on the sagittal T2WI: (I) oval-shaped lesion
      of signal intensity less brighter than CSF with blurred margin, (II) longitudinal
      linear-shaped lesion of signal intensity similar to CSF, (III) spindle-shaped
      lesion of signal intensity similar to CSF, (IV) round-shaped lesion of signal
      intensity similar to CSF and (V) mixed-types lesions which consisted of group I
      and II. The present study was summarized as follows: 1) Oval-shaped lesions were
      seen in the cases of disc herniation and spondylosis with relatively short
      duration of the symptom, presumptively with relatively short duration of the
      symptom, presumptively indicative of edema. 2) Most cases of OPLL and spondylosis
      showed linear-shaped lesions, suggesting necrosis and/or cavitations of the
      central gray matter. 3) One case of spondylosis developed a spindle-shaped
      lesion, implicating syringomyelia. 4) Round-shaped lesions were seen in the cases
      of spinal trauma, suggesting posttraumatic cyst. 5) In a case of mixed-typed
      lesion examined pre- and postoperatively, only an oval-shaped lesion decreased in
      size after surgery.

PMID- 2235308
TI  - [MRI of splenomegaly].
AB  - Splenomegaly was evaluated by a 0.1 T MR system using multi-echo SE image. (TR =
      1500 msec., TE = 40, 80 and 120 msec.) Calculated measurement of T2 relaxation
      time was obtained. Material consists of 32 cases including 14 liver cirrhosis, 3
      chronic myelocytic leukemia, 1 malignant lymphoma and 14 normals. 1) T2 value of
      normal spleen measured 113.7 +/- 5.68 msec. 2) Splenomegaly due to congestion had
      the prolonged T2 value of 122.6 +/- 10.25 msec. 3) T2 value of splenomegaly with
      malignant cell infiltration such as leukemia and lymphoma were shorter than
      normal spleen. Good histological correlation was obtained in MRI findings of
      splenomegaly due to congestion and malignant cell infiltration.

PMID- 2235309
TI  - [Improved methods for transseptal left heart catheterization].
AB  - Although the transseptal approach is useful for evaluation of reliable
      hemodynamics, this technique is not used commonly for its invasive procedure. We
      report a new technique for transseptal left heart catheterization utilizing J
      shaped guide wire (0.018 inch). The guide wire is available for protecting the
      atrial wall from perforation by transseptal needle. Transseptal approach was
      performed by this technique in 58 patients with aortic valvular disease and
      mitral stenosis, including 6 cases of percutaneous transluminal mitral
      commissurotomy. We conclude that the J-shaped guide wire and the new technique
      make transseptal approach a safe and reliable procedure for even inexperienced
      hands.

PMID- 2235310
TI  - [Liver abscess as a complication of TAE--risk factors and prevention].
AB  - Transcatheter hepatic arterial embolization for not only hepatocellular carcinoma
      but metastatic liver cancers is nowadays prevalent. Gall bladder infarction,
      cholangitis, peptic ulcers, pancreatitis, and aneurysm are reported as
      complications of it. But the liver abscess following it is rare. We reviewed
      three cases of liver abscesses after transcatheter hepatic arterial embolization.
      Biliary tract congestion and inflammation, and iatrogenic contaminations are
      supposed to major factors that caused liver abscesses. We think we should refrain
      from the embolization until biliary tract disorders are resolved and take care
      not to contaminate the proceeding materials in addition to mixing antibiotics
      with embolus.

PMID- 2235311
TI  - [Self-expandable metallic stent for use in venous occlusions].
AB  - Expandable metallic stent was successfully introduced to 5 patients including
      idiopathic obstruction of the hepatic portion of the inferior vena cava (1 case),
      superior vena cava obstruction from metastatic lymphnodes swelling (2 cases) and
      IVC obstructions from liver metastases or lymphnodes metastases (2 cases). The
      obstructions were 4-14 cm long in the case of venous obstructions due to
      lymphnodes metastases and 2 cm long in the case of idiopathic hepatic IVC
      obstruction. In all cases, the stents were introduced by using 12-16 Fr catheter
      percutaneously without any complications. The stent used was connected up to 7
      pieces by using wire struts depending length of the obstructions. However the
      stents connected more than 5 pieces were difficult to advance through the
      catheter. The patients who had been treated with stents had been free from
      hazardous complications such as lower extremity swelling, and pain.

PMID- 2235312
TI  - [Evaluation of tiny abnormal mucosal findings on double contrast barium enema
      study].
AB  - Tiny abnormal mucosal findings on double contrast barium enema studies in 104
      cases were classified into 5 patterns, as follows 1) small elevation, 2)
      elevation with barium fleck, 3) spotty barium fleck, 4) ill defined barium fleck
      and 5) barium fleck with halo. Each mucosal pattern was correlated with age, sex
      and symptoms, as well as the coexistence of the fine network pattern. They were
      compared with those of 86 control cases. 44 histologically proven cases were
      reviewed in order to clarify the clinical significance of the above 5 patterns.
      Incidence of the tiny mucosal findings was 4.8% (104/2186). 1) small elevation,
      2) spotty barium fleck, 3) ill defined barium fleck and 4) barium fleck with halo
      were suggested the possibility of inflammatory bowel diseases.

PMID- 2235313
TI  - [Preliminary study and clinical evaluation method of ioversol in
      angiocardiography--establishment of safety evaluation parameters and reliability
      of radiographic quality evaluation].
AB  - A multi-center clinical study of a new nonionic iodinated contrast medium
      (ioversol) was performed in 26 patients undergoing left ventriculography (LVG)
      and coronary angiography (CAG) at four centers. The aims of this study were to
      try to establish a clinical evaluation method on contrast media in
      angiocardiography and to determine radiographic efficacy and safety of ioversol.
      The reliability of the method evaluating the radiographic quality of the contrast
      medium was also examined with statistical analysis. Excellent radiographic
      efficacy was observed with ioversol and morphological diagnosis was possible in
      all cases. The electrocardiograms (ST-segment deflection, T-wave amplitude, QT
      interval, corrected QT interval, arrhythmia and heart rate) and the hemodynamic
      parameters (left ventricular systolic and end diastolic pressures, left
      ventricular dp/dt max, aortic systolic and diastolic pressures) indicated no
      clinically significant changes. This study suggested that the monitoring of the
      ECGs and hemodynamic parameters for up to three minutes after injection of the
      contrast medium is sufficient for the evaluation in LVG and CAG, and that the
      monitoring in CAG during the first injection into each left and right coronary
      artery is also sufficient for the purpose. Heat sensation during injection was
      mild. A patient had a symptom of nausea after ioversol administration, but it was
      mild and transient and resolved spontaneously. There were no abnormal clinical
      laboratory data related to ioversol. The reliability of the radiographic quality
      evaluated by the individual clinical investigators was considered to be high and
      adaptable. However, the evaluation in the blinded cinefilms by the committee
      members involving all investigators would be more preferable for the higher
      objectivity. The study results suggest that ioversol is considered to be the
      efficacious and safe contrast medium for the cardiovascular angiography.

PMID- 2235314
TI  - [MR imaging of primary bone and soft tissue tumors].
AB  - MR imaging of 131 cases with pathologically confirmed primary bone and soft
      tissue tumors were studied. They included 44 bone tumors (25 benign tumors, 19
      malignant tumors) and 87 soft tissue tumors (55 benign tumors, 32 malignant
      tumors). MR imaging was performed on 0.5T, superconductive magnet system. All
      tumors were evaluated with T1-weighted, T2-weighted and STIR images. In some
      cases, contrast enhanced MR imaging with Gd-DTPA was applied. MR imaging was
      proving to be a valuable technique in the evaluation of patients with primary
      bone and soft tissue tumors. MR imaging was superior to the other modalities in
      delineating the extent of the tumor and their relation to surrounding structures
      in all cases. However, plain radiography and CT were more useful for evaluation
      of calcification, ossification, cortical destruction and endosteal/periosteal
      reaction than MR imaging. Direct sagittal and coronal images from MR imaging
      added accurate assessment for the relation between the tumor and their adjacent
      structures. MR imaging was of limited value in distinguishing benign from
      malignant tumors with the demonstration of tumor structures only, especially soft
      tissue tumors. But in bone and soft tissue tumors which have specific morphologic
      features and intensity patterns, MR imaging was very useful for diagnosis.

PMID- 2235315
TI  - [Clinical evaluation of radiotherapy for endocrine ophthalmopathy].
AB  - Ten patients with severe endocrine ophthalmopathy were treated by radiotherapy at
      Hyogo Medical Center for Adults from May 1984 to February 1988. All but one of
      the patients had poorly responded to previous systemic or topical corticosteroid
      therapy. The target of the radiotherapy was both retrobulbar tissues. The
      radiation field used was about 4 x 4 cm, excluding the pituitary gland and the
      brain, and was angled 5 degrees posteriorly to avoid the contralateral lens. A
      total of 2000 cGy was given to each patient over a 2 week-period. Eight of the
      ten patients showed some response, with 5 of them (50%) having a good to
      excellent response. Treatment was more effective for soft tissue changes,
      proptosis and keratopathy, while myopathy was less responsive. As for the
      duration of the eye signs and symptoms, those of a shorter duration (less then 12
      months) responded better. It was also noted that the degree of the eye muscle
      enlargement on the pre-treatment orbital CT scan was directly correlated to the
      results of the treatment. Although three of the patients experienced transient
      headache, there were no serious acute reactions or long term complications. In
      conclusion, retrobulbar radiotherapy is a well-tolerated, safe and effective
      treatment for severe endocrine ophthalmopathy.

PMID- 2235317
TI  - [Measurement of oxygen concentration in tumor cells by fluorescent probe
      (nitrocompound)].
AB  - The hypoxic cell fraction in tumors is considered to be responsible for
      radioresistance. Estimating the population of the hypoxic cell fraction in tumor
      could develop the effective means to predict radiosensitivity. In this study,
      nitroacridine (fluorescent dye) was tested to estimate hypoxic status in single
      cells and in spheroids. The oxygen concentration in the medium was measured by
      oxygen electrodes utilizing polarography method, mean while that in cells was
      calculated from the fluorescence intensity of the dye. The fluorescent spectra
      from cells showed the same pattern in spite of the changed oxygen concentration
      in medium, on the other hand its intensity was dependent upon the oxygen
      concentration. Using a fixed nitroacridine concentration and a fixed staining
      time, oxygen concentration of cells could be determined within range from 0.1 to
      1.0% values. These values are almost the same as the oxygen concentration of the
      radioresistant tumor cells. Thus, the fluorescent method we used in this study is
      considered to be useful to estimate radioresistance of tumor. However,
      fluorescent intensity would alter when used different cell lines, because of
      different cellular activity of nitroreductase.

PMID- 2235316
TI  - [Fever of unknown origin: re-evaluation of 67Ga scintigraphy in detecting causes
      of fever].
AB  - Radioactive gallium citrate has been known to accumulate not only in neoplasms
      but also in inflammatory foci, and thus widely used to find out pyrogenic lesions
      in cases of unexplainable prolonged fever. However, with developments and
      improvements of other imaging modalities, its diagnostic significance may have
      changed. To probe that issue, recent 65 scans for the patients with fever of
      unknown origin were reviewed retrospectively. Of these, 56 had sufficient
      clinical assessment and laboratory examinations to evaluate causative illnesses.
      Gallium images of 33 patients were interpreted as positive. Local inflammatory
      lesions were detected in 23 cases, with lung tuberculosis, urinary tract
      infection, and inflammatory joint diseases as prevalent final diagnoses. Pyogenic
      abscesses, though popular in the literatures on fever of unknown origin, were
      found in only 2 cases in our present series. This seemed to be due to earlier
      detection of affected sites by other imaging technics. Osteomyelitis, other major
      cause of fever in the past, was not found this time, probably owing to wide use
      of antibiotics. Besides localized diseases, seven cases of generalized disorders
      were found. There were 3 patients with hematological malignancies, 3 with
      systemic autoimmune diseases, and 1 with severe infectious mononucleosis. There
      were three false positive cases; intestinal gallium radioactivity in 2 cases and
      physiological pulmonary hilar accumulation in 1 were erroneously read as
      abnormal. Of 23 cases with negative gallium scan, no definite cause of fever were
      found in 19; twelve patients had spontaneous reduction of fever, 2 did so with
      antibiotics, and 5 with corticosteroids. False negative cases were; two with
      urinary tract infection on antibiotics, one with bacterial meningitis, and one
      with polyarteritis nodosa. Our results reconfirmed the excellent sensitivity and
      accuracy of gallium scan in the diagnosis of fever of unknown origin. In addition
      to the detection of focal inflammations, it may sometimes contribute to an early
      diagnosis of unexpected systemic diseases. From the results obtained, it is
      advisable that, in patients with fever of unknown origin, this test should be
      done early in diagnostic schedule and before administration of drugs that may
      mask potential sites of abnormal accumulation.

PMID- 2235318
TI  - [Stereoscopic MR angiography of the abdomen].
AB  - We have developed a new method of stereoscopic MR angiography of the abdomen
      using gradient echo images. Consecutive coronal scanning of the abdomen was
      performed by fast scan during breath hold. These images were overlapped by means
      of MR angiography. Then two slightly different views that can give a true
      stereoscopic effect were constructed. The more precise spatial relationship of
      the abdominal vessels can be visualized with our new method.

PMID- 2235319
TI  - [Usefulness of the percutaneous marking method with a coil (PMMC) for the
      localization of small pulmonary nodules].
AB  - We surgeons have always encountered difficulty in localizing small pulmonary
      nodules, measuring less than 5 mm in diameter, through palpation during
      operation. In order to solve such a problem, we devised a new method of
      localizing small pulmonary nodules by applying a technique of CT-guided needle
      biopsy; namely, metallic spring coil is implanted through a 16 G eraster needle,
      the tip of which has been placed near the lesion. Our method not only secures the
      resection of entire lesions, but reduces an amount of lung resection through a
      small incision (mini-thoracotomy) as well. Furthermore, this method is also
      thought to be useful for open lung biopsy of pulmonary nodules, measuring less
      than 1 cm in diameter, in saving time and reducing an amount of lung tissue
      collection. In case of cystic lesion which is thought to be difficult to palpate
      on operation, this method can also be useful for its resection.

PMID- 2235320
TI  - [A short TE gradient-echo sequence using asymmetric sampling].
AB  - We have developed a gradient-echo pulse sequence with a short TE less than 4 msec
      using a data set of asymmetric off-center sampling with a broad bandwidth. The
      use of such a short TE significantly reduces T2* de-phasing effect even in a two
      dimensional mode, and by collecting an off-center echo, motion-induced phase
      dispersion is also considerably decreased. High immunity of this sequence to
      these dephasing effects permits clear visualization of anatomical details near
      the skull base where large local field inhomogeneities and rapid blood flow such
      as in the internal carotid artery are present.

PMID- 2235321
TI  - [Ethanol injection for embolization of varicocele].
AB  - Five patients were treated for varicocele by embolization with the use of
      ethanol, which has not been used before. The ethanol was injected into the
      spermatic vein involved in the varicocele by the technique of spermatic
      venography. Embolization was successful in all five patients. During the follow
      up period, the varicocele became smaller or disappeared in four of the five
      patients. In one patient, catheterization was difficult, and the effect of
      ethanol was unsatisfactory because of the location of its release. The varicocele
      appeared again 13 months after embolization. Serious side effects were not found
      in all patients. Embolization therapy with ethanol is easily performed and is
      considered to be a safe and effective method.

PMID- 2235323
TI  - [Computer-aided diagnosis of interstitial lung diseases].
AB  - We are developing an automated method for determination of quantitative physical
      measures of lung textures in digital chest radiographs in order to detect and
      characterize interstitial lung disease. We describe a scheme of our approach for
      lung texture analysis, an automated classification method for distinction between
      normal and abnormal lungs with interstitial disease, and the effect of digital
      parameters on the accuracy of this computerized analysis, as well as applications
      of this method to the ILO pneumoconioses standard radiographs. The root-mean
      square (rms) variation and the first moment of the power spectrum of the lung
      texture were determined as quantitative texture measures based on a frequently
      analysis of lung textures, which represent the magnitude and coarseness (or
      fineness) of the lung textures, respectively. The computerized classification
      method is based on the analysis of these texture measures and on a data base
      derived from clinical cases. This classification method includes three
      independent tests, one for a definitely abnormal focal pattern, one for a
      relatively localized abnormal pattern, and one for a diffuse abnormal pattern. A
      comparison of receiver operating characteristic (ROC) curves obtained by
      radiologists and by means of the computerized classification method indicates
      that the computerized approach may provide performance similar to human observers
      in distinguishing lungs with mild interstitial disease from normal lungs. By
      investigating the effect of digital parameters such as pixel size, ROI size and
      the number of quantization levels on these texture measures obtained from the
      lung texture analysis and the performance of this computerized method, we
      attained a useful guide in the design of this computerized scheme. Texture
      measures obtained from computer analysis of the ILO pneumoconioses standard
      radiographs corresponded closely with the ILO classification categories for small
      opacities, though it was necessary for a qualified radiologist to identify
      representative areas in each ILO radiograph because of the inhomogeneous
      distribution of texture patterns in these standard radiographs. Our results
      suggest strongly that this computerized method can be a valuable aid to
      radiologists in their assessment of interstitial lung diseases.

PMID- 2235322
TI  - [Fundamental experiment of expansile force of expandable metallic stent].
AB  - So far expansile force of expandable metallic stent has been estimated by only
      wall-distending pressure P. We estimated expansile force of stent by not only P
      but also a force per one unit length of wire F. F corresponds to the degree of
      digging into the vessel wall. P and F were thought to be useful in selecting the
      best stent.

PMID- 2235324
TI  - [Transcatheter embolization therapy of pseudoaneurysms in patients with chronic
      pancreatitis].
AB  - Chronic pancreatitis is known to cause vascular disorders including
      pseudoaneurysm of peripancreatic arteries. Although the incidence of
      pseudoaneurysms due to pancreatitis detected by angiography has been reported as
      high as 10% in western literature, they are still considered rare in Japan. We
      reported two cases of pseudoaneurysm caused by chronic pancreatitis, one in
      splenic artery and the other in gastroduodenal artery, successfully treated by
      embolization. The embolizations were performed by occluding proximal splenic
      artery for splenic arterial aneurysm and gastroduodenal artery distal and
      proximal to the orifice for the aneurysm of gastroduodenal artery with stainless
      steel coils. Since the surgical therapy has high mortality rate, we consider
      transcatheter embolization is the treatment of choice for pseudoaneurysms caused
      by chronic pancreatitis.

PMID- 2235326
TI  - [Evaluation of axial multiplanar reconstruction CT for the diagnosis of small
      nodular lesions in the peripheral lung].
AB  - Our study investigated the relationships between tumors and surrounding
      structures, particularly vessels and bronchi within lesions in the periphery of
      the lung. We performed axial multiplanar reconstruction CT (AMPR-CT) with a
      Toshiba TCT-900S scanner, as well as conventional CT (Conv. CT) and CR tomography
      (CR tomo.). We examined 19 patients with pulmonary lesions who later underwent
      surgical resection (12 with lung cancer, 1 with metastatic tumor, 1 with
      hamartoma, 2 with tuberculoma, and 3 with pulmonary granuloma) of a total of 43
      patients with small nodular lesions less than 3 cm in diameter. AMPR-CT, Conv.
      CT, and CR tomo. were compared against resected specimens. The accuracy of each
      modality to detect involvement of bronchus, the pulmonary artery, and vein was
      AMPR-CT 50%:93%:91%, Conv. CT 47%:76%:55% and CR tomo. 37%:55%:42%, respectively.
      AMPR-CT was judged superior to both Conv. CT and CR tomo. In conclusions: 1) That
      AMPR-CT permits easier visualization of vessels and bronchi, and 2) That AMPR-CT
      is more effective than Conv. CT examinations in the morphological assessment of
      small nodular lesions. Thus, AMPR-CT is a useful new approach to the diagnosis of
      lesions in the lung.

PMID- 2235325
TI  - [High-field MR findings of multiple system atrophy].
AB  - Magnetic resonance images obtained at 1.5T were reviewed in 23 patients with
      clinically diagnosed multiple system atrophy (MSA). The patient group consisted
      of 13 cases with olivoponto-cerebellar atrophy (OPCA), three with striatonigral
      degeneration (SND), and seven with Shy-Drager syndrome (SDS). In each disorder
      group, hypointensity of the pars compacta of the substantia nigra was frequently
      demonstrated as well as the atrophy of the brain stem and cerebellum. Although T2
      weighted images depicted hypointensity of the putamen, which was prominent in its
      posterolateral part, in cases with SND and SDS, it was not encountered in cases
      with OPCA. Therefore, this finding was considered to facilitate differential
      diagnosis between OPCA and other two disorders. These hypointensities in the
      putamen and pars compacta of the substantia nigra may be due to excessive iron
      deposition and seem to correlate with extrapyramidal tract signs of MSA.

PMID- 2235327
TI  - [Right anterior caudo-cranial oblique (RACCO) view of portal branches].
AB  - The right caudocranial oblique (RACCO) view which is obtained by tilting the
      image intensifier 25 degrees caudally and 30 degrees to the right while the
      patients lie in supine position is proposed for improved depiction of the portal
      venous system. Transarterial portography with digital subtraction angiography was
      performed in the RACCO and posteroanterior (PA) views in 32 patients. Comparison
      of the two views revealed that the RACCO view was superior to the PA view of the
      left main branch in 25 patients (78%) and of the right posterior lobe branch in
      24 (75%) patients. Visibility of more distal portal branches, however, did not
      always improve by RACCO view. RACCO view will be useful for the evaluation of
      portal systems of primary and secondary hepatic neoplasms as a special view
      following portogram in PA projection when more detailed information is necessary
      on proximal portal branches.

PMID- 2235328
TI  - [Preliminary study of pelvic CT with air enema].
AB  - In pelvic CT, several techniques (appropriate preparations) have been reported
      for the optimal diagnostic imagings. We demonstrated the usefulness and
      limitations of "Air Enema", which is one of preparations for hollow viscera in
      pelvic CT examination. From Oct. 1986 to Mar. 1987, 38 patients with
      gynecological abnormalities were evaluated by consecutive pre and post "Air
      Enema" CT. The patients aged 26-75 years with mean of 44.6 years. All patients
      were examined in prone position with 100 ml of 2% iopamidol in the urinary
      bladder and medical tampon in the vagina. Two consecutive scans were performed
      from the level of pubic symphysis to the 5th lumbar vertebra at 10 mm-15 mm
      intervals. The first scan was pre "Air Enema" CT, in which the rectum, entire
      colon and terminal ileum were not distended. The second scan was post "Air Enema"
      CT, in which the hollow viscera was distended by 1000 ml-1500 ml of air. Two
      images, each from pre and post "Air Enema" CT were evaluated on the efficacy for
      imaging diagnosis. In "Air Enema" CT, main useful effect was "replacement
      effect", which was that intrapelvic masses and/or intrapelvic paravascular spaces
      were clearly delineated by distended bowels. Detection and location of
      intrapelvic masses were correctly diagnosed when the masses were relatively small
      (5.3 cm in average diameter), but there were no advantages in cases in which the
      pelvic masses were large enough to occupy the pelvic cavity (12.7 cm in average
      diameter). Abdominal pain was the most common adverse reaction to this technique.
      But complaints usually disappeared in few hours after examination. Thus, "Air
      Enema" seems to be useful preparation for pelvic CT examination to detect
      relatively small intrapelvic masses and abnormalities.

PMID- 2235329
TI  - [Treatment results of maxillary sinus carcinoma. A retrospective study].
AB  - The treatment results of a total of 617 cases with maxillary sinus carcinoma
      mainly treated by radiotherapy at the Department of Radiology, Osaka University
      Hospital between 1967 and 1983 were reviewed. The overall actuarial 5-year
      survival rate was 36.2%. The cases were divided into 3 groups by period of the
      treatment modalities corresponding each 5-year survival rate of 24.1% on 217
      patients for 1967 to 1971, 40.0% on 155 patients for 1972 to 1975, and 44.6% on
      245 patients for 1976 to 1983. The treatment results have improved in 5-year
      survival rate as modifying treatment modality. The actuarial 5-year local control
      rate was 60.0% for T1 on 9 patients, 43.1% for T2 on 181 patients, 31.7% for T3
      on 246 patients, and 19.2% for T4 on 181 patients, respectively. For more
      detailed analysis of the results, the cases were divided into 4 groups according
      to the initial treatment; the group 1 was treated by radiotherapy alone (RT), the
      group 2 by radiotherapy combined with intra-arterial infusion of 5-fluorouracil
      (RT + 5-FU), the group 3 by radiotherapy combined with surgical removal of the
      tumor mass through curettage under the general anesthesia (RT + OP) and the group
      4 by multidisciplinary procedure combined with radiotherapy, 5-FU regional
      infusion and curettage (RT + 5-FU + OP). In the T2 cases, the 5-year actuarial
      local control rate was 25.5% for RT on 51 patients, 45.0% for RT + 5-FU on 55
      patients, 58.2% for RT + OP on 23 patients and 51.5% for RT + 5-FU + OP on 52
      patients, respectively. In the T3 cases, the rate was 13.2% for RT on 85
      patients, 33.6% for RT + 5-FU on 78 patients, 52.3% for RT + OP on 31 patients
      and 45.9% for RT + 5-FU + OP on 52 patients, respectively. In the T4 cases, the
      rate was 7.6% for RT on 77 patients, 27.2% for RT + 5-FU on 52 patients, 17.8%
      for RT + OP on 20 patients and 31.5% for RT + 5-FU + OP on 32 patients,
      respectively. The combination therapy with 5-FU regional infusion and/or
      curettage had successfully improved the local control rate. On the T2 and T3
      cases of RT + OP, an additive effect of 5-FU infusion was not significant, and
      also on the T4 cases of RT + 5-FU, any usefulness of curettage could not be
      found.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2235330
TI  - [Differential diagnosis between nonhyperfunctioning adenoma and adrenal
      metastasis on adrenocortical scintigraphy].
AB  - Adrenocortical scintigraphy using I-131-adosterol was performed in six cases of
      nonhyperfunctioning adenoma incidentally discovered on CT scans and four cases of
      adrenal metastasis. In all six cases of nonhyperfunctioning adenoma, there was
      increased uptake of of the I-131-adosterol on the side of the adrenal mass
      discovered at CT. In three of four cases of adrenal metastasis, there was no
      uptake of the I-131-adosterol on the side of the mass detected at CT. Uptake was
      symmetrical in one case of adrenal metastasis. Adrenocortical scintigraphy is
      able to differentiate nonhyperfunctioning adenoma from adrenal metastasis in
      recognition of increased uptake of I-131-adosterol on the side of the adrenal
      mass discovered on CT scans.

PMID- 2235331
TI  - [Scrotal scintigraphy in the diagnosis and grading of varicocele].
AB  - Scrotal scintigraphy with 99mTc-red blood cells has been reported as a useful
      method for detecting varicocele. In this study we analysed the scintigraphy of
      251 infertile males with clinically diagnosed or suspected varicocele, in an
      attempt to establish a grading system of varicocele. Scintigraphically varicocele
      was diagnosed in 207 patients on the basis of pooling in hemiscrotum in static
      images and/or early flow through the spermatic cord vessels in dynamic images;
      physical examination overlooked 17 of them. Of the 207 patients, all had pooling
      (153 left-sided, 1 right-sided, and 53 bilateral pooling) and 52 had early flow.
      The early flow was a less sensitive sign for varicocele than the pooling and
      invariably accompanied by the intense pooling. The early flow may be related to
      increased shunt flow through varicocele. According to the scintigraphic findings,
      varicocele was classified as follows: Grade I (small varicocele with faint early
      flow or mild localized pooling, n = 103), Grade II (medium varicocele with
      obvious early flow or curvilinear mottled pooling, n = 67) and Grade III (large
      varicocele with marked early flow or pooling, n = 37). Clinical assessment (93
      small, 68 medium, and 54 large varicocele) supported the scintigraphic
      classification. Scrotal scintigraphy, therefore, facilitates precise evaluation
      of varicocele based on its morphology and hemodynamics.

PMID- 2235332
TI  - [Scrotal scintigraphy in varicocele compared with physical examination and
      venography].
AB  - Scrotal scintigraphy using a gamma-camera and 740 MBq of 99mTc-labeled human
      serum albumin was performed on 43 patients with suspected varicocele. In 39
      patients (37 left-sided, 2 bilateral) with proven varicoceles, sensitivities by
      the static and dynamic images were 92.3% and 51.3%, respectively. There were no
      false positive cases in either image (4 cases with no varicocele). It has been
      suggested that static images are useful for the detection of varicocele in
      infertile men. A comparison between the static and clinical grades showed that
      the static grades appeared to become higher in proportion to the clinical grades.
      A comparison between the static grades and the diameter of the internal spermatic
      vein (ISV) showed that the mean value of the diameter of the ISV in SG 1, SG 2
      and SG 3 was 4.1 +/- 0.66 mm, 5.1 +/- 0.68 mm, and 6.2 +/- 0.79 mm, respectively.
      Patients with higher static grades had ISVs of significantly larger diameter (SG
      1 vs SG 2; p less than 0.05, SG2 vs SG3; p less than 0.01, SG 1 vs SG 3; p less
      than 0.01, t-test). A comparison between the dynamic images and the degree of
      reflux in the ISV showed that patients with positive dynamic images had a
      significantly greater degree of reflux (p less than 0.01, Chi-square test). From
      these observations, scintigraphic findings would reflect the degree of reflux in
      the ISV, the diameter of ISV, and the size of the varicocele. Furthermore, from
      the remarkable changes between pre- and post-therapeutic findings on the
      scintigrams, therapeutic effects could be easily and objectively assessed by
      scintigraphy.

PMID- 2235333
TI  - [Determination of the point position from two orthogonal X-ray photographs using
      least squares method and geometrical solutions].
AB  - Six sets of solutions for calculating the position of an interest point were
      obtained geometrically using four measured image coordinates on two X-ray
      photographs orthogonally projected. When the image coordinates had no error, all
      the solutions gave the same position without error. When an error occurred, the
      calculated positions differed from each other due to the propagation of error.
      Some solutions could not be used for this determination owing to a large
      propagation of error. Under conditions similar to those of clinical practice, the
      ratio of maximum error of position calculated by the six geometrical solutions to
      minimum error was about 426. The least squares method that we proposed gave
      results with less error. When one of the image coordinates could not be measured
      for some reason, the least squares method became automatically equivalent to one
      of the six geometrical solutions.

PMID- 2235334
TI  - [Trial for improvement of image quality of chest tomography with computed
      radiography].
AB  - In conventional X-ray tomography, the presence of blurring which is caused by the
      object outside the focal plane reduces the image quality of the focal plane. With
      the application of computed radiography for the conventional chest tomography,
      two kinds of image processing techniques for the elimination of the blurring were
      examined. As a result, each image processing technique fairly succeeded in
      improving the image quality.

PMID- 2235335
TI  - [Clinical usefulness of 67Ga-citrate scintigraphy combined early image in
      malignant lymphoma--detection of abdominal lesions].
AB  - In order to improve the diagnostic accuracy in detecting abdominal lesions of
      malignant lymphoma, we studied prospectively the usefulness of 67Ga-citrate
      scintigraphy combined 5 to 6-hour early image with conventional 72-hour delayed
      image after injection. During the period from July 1986 to September 1988, total
      41 67Ga-citrate scintigrams performed on 28 patients with malignant lymphoma (3
      Hodgkin's disease, 25 non-Hodgkin lymphoma) were evaluated between early and
      delayed image regarding to such points as follows; 1) the physiologic bowel
      uptake of 67Ga-citrate, 2) detection of abdominal lesions indicated by other
      diagnostic modalities involving computed tomography, lymphography and
      ultrasonography. Following results were obtained: 1) Prominent bowel uptake of
      67Ga-citrate thought to be difficult to interpret the scintigram was observed in
      only 1 of 41 (2%) on early image versus 13 of 41 (32%) on delayed image. 2) Known
      lesion sites were detected in 24 of 31 (77%) on early image versus 21 of 31 (68%)
      on delayed image, resulting in 26 of 31 (84%) in combination with both images. 3)
      There were 2 false-positive and 5 false-negative lesions. Two false-positive
      lesions on early image were explained by physiologic hepatic uptake with ill
      defined outline and bladder uptake. On the other hand, all of 5 lesions on
      delayed image were explained by prominent bowel uptake. 4) Two patients were
      revealed higher splenic uptake comparing with hepatic uptake on both images,
      later proved to be diffuse splenic involvement without evidence of lesions on
      other diagnostic modalities. 5) The lesions less than 2 cm in diameter could not
      be detected in both images.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235336
TI  - [Late adverse reactions of non-ionic intravenous contrast media].
AB  - A prospective study of late adverse reactions of non-ionic intravenous contrast
      media was performed. Information was collected from questionnaires returned by
      the patients, and also from further interviews. The incidence of adverse
      reactions was 8.3% in all patients, and was higher in female (11.1%) than male
      (5.8%). They were more frequent in the patients with age ranging from 20 to 49
      than those older than 50. The most frequent symptom was headache, followed by
      itching, skin rashes, nausea, dizziness, and general fatigue. More than half of
      the reactions occurred within six hours after injection, but reactions a few days
      later were also reported.

PMID- 2235337
TI  - [Use of radiolabeled monoclonal antibodies for diagnostic imaging].
AB  - Monoclonal antibodies (MoAbs) are expected to carry radionuclides selectively to
      target tissues and to offer antigen-specific diagnosis. Indium (In)-111 has many
      favorable nuclear properties and is efficiently labeled with MoAbs using DTPA as
      a bifunctional chelating agent. In-111 labeled MoAbs are clinically employed for
      the diagnosis of malignant melanoma, colorectal cancer and acute myocardial
      infarction in Japan. Although non-specific deposit of In-111 was seen in liver
      and bone-marrow, scintigraphy using In-111 labeled MoAbs was encouraging, since
      it detected about 80% of tumors, tumors missed by conventional diagnostic methods
      such as CT, and tumors in patients with normal serum CEA values, and acute
      myocarditis as well as acute myocardial infarction was positive with In-11
      labeled Fab fraction of anti-myosin Ab. Acute or subacute toxicity was not
      observed. Human anti-murine antibody (HAMA) was detected in 53 of 64 (82.8%)
      patients who were intravenously administered with 20 to 42 mg of anti-melanoma or
      anti-CEA MoAbs (whole IgG). In contrast, only 5 of 406 (1.2%) patients had
      detectable levels of HAMA in their serum after receiving 0.5 mg of Fab fraction
      of MoAb. Recently mouse-human chimeric Ab has been produced by recombinant DNA
      techniques, which localized well in xenografted tumors and seems to be promising
      for clinical use. Investigations are under way to increase the tumor to non-tumor
      ratio by modifying chelating agents for coupling MoAbs with radionuclides.

PMID- 2235338
TI  - [Effects of sampling bandwidth in MR imaging].
AB  - Phantom and volunteer study was performed with spin-echo sequences of different
      sampling bandwidths to evaluate the narrow bandwidth signal acquisition
      technique. Our results demonstrated the characteristics of the narrow bandwidth
      sequence as follows: SNR improvement, sensitive to the field inhomogeneity and
      motion, loss of edge definition for short T2 tissues, and prominent chemical
      shift artifacts. Narrow bandwidth sequence with flow compensation was suitable
      for brain T2 weighted images because of its high SNR and less artifacts. In spite
      of the improvement of SNR, the narrow bandwidth technique may be inappropriate
      for short T2 tissues such as muscle, because of prominent chemical shift
      artifacts and loss of edge definition. Consequently, sampling bandwidth is one of
      the parameters which can be manipulated to improve MR image quality.

PMID- 2235339
TI  - [Analysis of cervical metastatic lymphadenopathy by ultrasonography].
AB  - One hundred and eight cervical lymph nodes of 37 patients were evaluated by
      ultrasonography. All lymph nodes were examined histologically, and among them 63
      lymph nodes were metastatic nodes. If submandibular, submental, mid and inferior
      internal jugular lymph nodes larger than 8 mm, and superior internal jugular
      lymph nodes larger than 9 mm had been regarded as metastasis, high sensitivity
      (92%) was demonstrated. All of 31 lymph nodes with unclear or irregular margin
      were metastatic. Eccentric hyperechoic area, which was considered to be the hilus
      of the lymph node, was observed in 20 nodes. Those were non-metastatic lymph
      nodes. Otherwise, all of 48 lymph nodes with inhomogeneous internal echoes or
      with central hyperechoic area and peripheral hypoechoic zone were metastatic. The
      in vivo and in vitro ultrasonograms of 25 lymph nodes were compared with
      histopathological findings. The metastatic region was not differentiated with the
      remaining area of the lymph node by ultrasonography. Necrosis showed an-, hypo-,
      iso-, or hyperechoic. Fibrosis showed iso- or hyperechoic. Inhomogeneous internal
      echoes were proved to be necrosis and fibrosis, and such a lymph node was
      metastatic. The eccentric hyperechoic area of the non-metastatic lymph node was
      attributed to fatty tissue. Ultrasonography was a useful examination for
      evaluating cervical lymph nodes.

PMID- 2235340
TI  - [Ewing sarcoma: changes after radiation and chemotherapy].
AB  - We retrospectively studied 52 cases of Ewing sarcoma to elucidate the pattern of
      healing and/or recurrence after radiation and chemotherapy. Persistent soft
      tissue mass was a sign of failure to respond to therapy. Repair or healing of
      lytic or blastic bone changes were slow and often minimal, and usually bone
      changes became gradually stable over 3 years. After bone changes became stable,
      localized new bone changes represented recurrence or secondary malignant
      neoplasms.

PMID- 2235341
TI  - [MR imaging of intracerebral hematomas: sequential changes of signal intensities
      on a 0.2T permanent magnetic system].
AB  - We performed 67 examinations in 27 patients with intracerebral hemorrhage on a
      0.2T permanent magnet system. MR appearance of the hematomas on T-1 weighted and
      T-2 weighted images (T1WIs, T2WIs) was carefully evaluated according to the
      chronological course of the lesions after the ictus. The signal intensity of each
      hematoma was classified into four stages in terms of the degradation process of
      hemoglobin. Four hematomas examined within 24 hours after the ictus (ultra-acute
      stage) appeared slightly hypointense or isointense relative to the normal brain
      tissue on T1WIs and markedly hyperintense on T2WIs. Three of those lesions became
      partially or totally hypointense on T2WIs at the acute stage (one to three days
      after the ictus), though all appeared in general isointense on T1WIs. The
      hematomas at the subacute stage (four days to two weeks after the ictus) were
      hyperintense on both T1WIs and T2WIs. At the chronic stage (more than two weeks
      after the ictus) the signal pattern of hematomas became variable: hyperintense on
      both T1WIs and T2WIs early at this stage; hypointense on T1WIs but mostly
      hyperintense on T2WIs latter. The results indicate the clinical feasibility of a
      low tesla system for MR evaluation of intracerebral hematomas.

PMID- 2235342
TI  - [MR imaging of mucocutaneous malignant melanoma in the head and neck].
AB  - MR imaging was performed in three patients with mucocutaneous malignant melanoma
      of the head and neck, and surgical specimens were investigated in MR-pathological
      correlation. Two of 3 cases were revealed to be melanotic melanoma; one arose in
      the maxillary sinus, and another in the bulbar conjunctiva. The remaining case
      was amelanotic melanoma originating in the nasal cavity. Two cases of melanotic
      melanoma showed different intensity on T1WI according to the melanin
      concentration; the more the melanin-producing process existed, the higher
      intensity in the tumor was shown. On T2WI there were also some differences in
      signal intensity; the case having more concentration of melanin changed lower
      partially in the areas where very high intensity was noted on T1WI, while another
      case remained unchanged. These findings are based on the inherent paramagnetic
      effect mostly compatible with the previous reports. On the other hand, the
      amelanotic melanoma was demonstrated as an intermediate intensity both on T1- and
      T2WI. Because of the higher incidence of hemorrhage in/around the tumor, it is an
      important diagnostic clue to this tumor, as in our case of amelanotic type. On
      reviewing the three cases, we consider that MR imaging offers a useful adjunct in
      the diagnosis of malignant melanoma.

PMID- 2235343
TI  - [The MR findings on the corpus callosum of normal young volunteers].
AB  - The size and shape of the corpus callosum of twenty-seven normal young volunteers
      (age 18-31 years, 17 men and 10 women) were investigated using a superconducting
      high field (1.5 T) MRI unit. The length of the corpus callosum was 71.1 +/- 5.1
      mm (mean +/- S.D.) and the height was 24.9 +/- 2.1 mm. The length ratio of the
      corpus callosum to the brain was 43.9 +/- 2.3% with the ratio of the height 25.0
      +/- 2.3%. The callosal index (height/length) was 35.4 +/- 2.9%. The area of the
      corpus callosum in the midsagittal plane was 681.4 +/- 93.6 mm2 (min. 563 mm2 to
      max. 902 mm2). We divided the corpus callosum into three segments: rostrum and
      genu; anterior and posterior trunks; splenium. Each part accounts for one third
      of the total area of the corpus callosum. The genu and splenium were generally
      equal in thickness. The minimal thickness of the trunk was 3 mm with the maximal
      one 9 mm. The posterior trunk was never thicker than the anterior one. The
      posterior part of the posterior trunk showed thinning and concavity in almost all
      cases. So-called impressio corporis callosi was observed in 12 cases (44.4%).
      Thirteen cases (48.1%) showed a shallow concave configuration at the anterior
      dorsal surface of the corpus callosum. Six cases of these were thought to be due
      to compression by the pericallosal artery. This finding was not detected in the
      posterior portion of the corpus callosum. This concavity was also seen in
      infants. The thinning of the posterior part of the posterior trunk was seen after
      the development of the splenium, but the concave configuration at the anterior
      dorsal surface of the corpus callosum may be encountered before the full
      development of the genu and splenium.

PMID- 2235344
TI  - [MRI diagnosis of the lung nodule--experimental and clinical studies regarding
      environmental effects on relaxation time measurement].
AB  - There have been several reports on MRI concerning the differential diagnosis of
      lung nodules by the measurement of relaxation time. Measuring the relaxation time
      has been reported to be of little value because of a lack of reliability in
      differentiating nodules, and may vary according to environmental effects such as
      tumor size, location and physical constitution as seen on CT. From this point of
      view, we have newly devised a phantom of the thorax containing simulated lung
      nodules in order to evaluate the environmental effects on the relaxation time,
      and investigated the fluctuation of the T1 and T2 values of lung nodules of the
      phantom. The experimental study using simulated lung nodules revealed that T1 and
      T2 values of the lung nodules shift according to various environmental factors
      such as tumor size, location, and blood flow. It is concluded that there are
      definite environmental effects on MRI measurements as seen on CT. In clinical
      studies with patients showing nodular shadows on chest radiography, we calculated
      the T1 and T2 relaxation times of lung nodules pre- and post-operatively. The T1
      and T2 relaxation times of resected tumors were measured approximately 2 hours
      after surgery. There was a tendency for the T1 values to decrease and T2 values
      to increase when compared to preoperative conditions. However it could not be
      proved that the changes of the relaxation times were solely due to environmental
      effects, because there were lots of valid causes which affect remained such as
      loss of blood flow and tissue degeneration after surgery.

PMID- 2235345
TI  - [Clinical efficacy of Z-100 for the treatment of leukopenia caused by
      radiotherapy--a multi-center double-blind comparative study with inosine].
AB  - The clinical usefulness and the optimal dose of Z-100 for the treatment of
      leukopenia caused by radiotherapy for malignant tumors was evaluated in a double
      blind study comparing 20 micrograms and 30 micrograms injections of Z-100 and
      inosine (Z-20, Z-30 and IN group, respectively). The effective rate according to
      the evaluation by the attending physicians was 67.4%, 79.1% and 48.9% in the Z
      30, Z-20 and IN groups, respectively, with a significantly higher efficacy rate
      for the Z-20 group than for the IN group. The frequency of adverse reactions was
      14.3%, 3.9% and 5.6% in the Z-30, Z-20 and IN groups, respectively, with the
      highest rate in the Z-30 group, but there was no significant difference among the
      three groups. The useful rate based on total evaluation considering the effective
      rate and the safety profile in each group was 60.8%, 77.3% and 46.8% in the Z-30,
      Z-20 and IN groups, respectively, with the highest rate in the Z-20 group showing
      significant difference from that in the IN group. The above data confirmed the
      clinical usefulness of Z-100 and suggested that the optimal dose was 20
      micrograms twice weekly for Z-100.

PMID- 2235347
TI  - Curriculum revolution: redefining the student-teacher relationship.

PMID- 2235348
TI  - Curriculum revolution: redefining the student-teacher relationship. Introduction.

PMID- 2235346
TI  - [Clinical efficacy of Z-100 for the treatment of leukopenia caused by
      radiotherapy--a multi-center double-blind comparative study with L-cysteine].
AB  - The clinical usefulness of Z-100 (Z group) for the treatment of leukopenia caused
      by radiotherapy for malignant tumors was evaluated by comparing it with that of L
      cysteine (L group) by the double-blind method. For 178 complete cases, there were
      no significant differences in the time-course of the WBC during radiotherapy
      between the two group. However, for cases with a large field of irradiation (15 X
      15 cm = 225 cm2), the mean WBC count in the L group decreased more than that in
      the Z group. The Z group showed comparable or superior efficacy for the treatment
      of leukopenia in the L group although there were no significant differences.
      Adverse reactions were observed in 5.66% and 2.94% in the Z and L groups,
      respectively, without any significant difference between the groups. The utility
      rate, useful or better, was 73.9% and 69.2% in the Z and L groups, respectively,
      showing a slightly higher rate in the Z group than in the L group, although the
      difference between the two groups was not significant. These results confirmed
      that Z-100 has comparable or superior efficacy to L-cysteine for the treatment of
      leukopenia caused by large field radiotherapy for malignant tumors.

PMID- 2235349
TI  - Transformation in nursing: bringing care back to health care.

PMID- 2235350
TI  - The two worlds of nursing: the one we teach about, the one that is.

PMID- 2235351
TI  - Our voices, our visions.

PMID- 2235352
TI  - Revolutionizing the student-teacher relationship.

PMID- 2235353
TI  - Curriculum revolution: a review.

PMID- 2235354
TI  - Has the revolution become the new religion?

PMID- 2235355
TI  - Critical social theory and nursing education.

PMID- 2235356
TI  - Clinical teaching: a shared adventure.

PMID- 2235357
TI  - State-approved schools of nursing L.P.N./L.V.N. 1990.

PMID- 2235358
TI  - Ethics in nursing: an anthology.

PMID- 2235359
TI  - Philosophical foundations of nursing practice.
AB  - This chapter examined how nursing has conceived itself historically and how this
      conception has changed. It is our contention, along with some of the authors
      discussed, that this issue is of paramount importance in structuring how a nurse
      responds to a moral dilemma and which obligations have primary or greater
      weighting. The empirical studies contained or referred to in Holfing et al. and
      Murphy substantiate that these conceptions do make a determinative difference in
      how nurses make ethical decisions. How nursing is viewed and its role
      relationships defined has been variously referred to as model, role conception,
      or philosophy of nursing. The significant point is that this forms the
      philosophical foundation of nursing and has profound ethical implications. The
      now dominant philosophy is that of client advocacy. However, as the articles
      indicate, ambiguity about just what advocacy entails and misgivings about the
      direction nursing has taken by those within and outside of nursing do exist. The
      next chapter presents still more conceptions of client advocacy and problems
      associated with it.

PMID- 2235360
TI  - A contrary view of the nurse as patient advocate.

PMID- 2235361
TI  - Patient advocacy: do nurses have the power and authority to act as patient
      advocate?

PMID- 2235362
TI  - The relation of the nurse to the doctor and the doctor to the nurse.

PMID- 2235363
TI  - Nursing advocacy of patients' rights: myth or reality?

PMID- 2235364
TI  - The nurse as advocate: a cantankerous critique.

PMID- 2235365
TI  - Nurses' rights.

PMID- 2235366
TI  - In defense of the traditional nurse.

PMID- 2235367
TI  - Nurses' rights.

PMID- 2235368
TI  - Do nurses have rights? No.

PMID- 2235369
TI  - Do nurses have rights? Yes.

PMID- 2235370
TI  - The human rights of patients, nurses, and other health professionals.

PMID- 2235372
TI  - The nurse-physician relationship: I. Sexism and hierarchy.

PMID- 2235371
TI  - A Bill of Rights for nurses.

PMID- 2235374
TI  - Sex discrimination: nursing's most pervasive problem.

PMID- 2235373
TI  - The doctor-nurse game.

PMID- 2235376
TI  - These men worry me.

PMID- 2235375
TI  - Dealing with sexism in nursing and medicine.

PMID- 2235377
TI  - The nurse-physician relationship: II. Somera and Tuma.

PMID- 2235379
TI  - The right to inform.

PMID- 2235378
TI  - The Somera case.

PMID- 2235381
TI  - Letters to the editor of Nursing Outlook: the Tuma case.

PMID- 2235380
TI  - Professional misconduct?

PMID- 2235382
TI  - Ethical reflections on the Tuma case: is it part of the nurse's role to advise on
      alternate forms of therapy or treatment?

PMID- 2235383
TI  - An experimental study in nurse-physician relationships.

PMID- 2235384
TI  - The nurse-physician relationship: III. Whistleblowing.

PMID- 2235385
TI  - Where does loyalty end?

PMID- 2235386
TI  - Dangerous doctors: what to do when the MD is wrong.

PMID- 2235387
TI  - Should nurses report negligence in medical treatment?

PMID- 2235388
TI  - "The 'joy' of telling a physician he's wrong".

PMID- 2235390
TI  - Thinking of blowing the whistle?

PMID- 2235389
TI  - The risks of blowing the whistle.

PMID- 2235391
TI  - Outrageous or outraged: a nurse advocate story.

PMID- 2235392
TI  - Notes of a whistleblower.

PMID- 2235393
TI  - Whistle-blower saved lives, lost everything else.

PMID- 2235395
TI  - The nurse-nurse relationship.

PMID- 2235394
TI  - Whistleblowing: disclosure and its consequences for the professional nurse and
      management.

PMID- 2235396
TI  - The nurse-nurse relationship.

PMID- 2235398
TI  - Guilt by association?

PMID- 2235397
TI  - Power brings out the worst in women.

PMID- 2235400
TI  - The commitment of nursing.

PMID- 2235399
TI  - Professional obligations of nurses.

PMID- 2235401
TI  - The nurse as a member of a profession.

PMID- 2235402
TI  - Engineers as moral heroes.

PMID- 2235403
TI  - The morality of cooperation.

PMID- 2235405
TI  - From loyalty to advocacy: a new metaphor for nursing.

PMID- 2235404
TI  - The nurse and the institution.

PMID- 2235406
TI  - The nurse as an employee.

PMID- 2235407
TI  - The conflicting demands of professionalism and unionism.

PMID- 2235408
TI  - Insubordination--patient load.

PMID- 2235410
TI  - The moral foundation of nursing.

PMID- 2235409
TI  - Rethinking the nurse's role in "do not resuscitate" orders: a clinical policy
      proposal in nursing ethics.

PMID- 2235411
TI  - Existential advocacy: philosophical foundations of nursing.

PMID- 2235412
TI  - A model for ethical decision making.

PMID- 2235413
TI  - The nurse as advocate.

PMID- 2235415
TI  - Let's stop calling ourselves "patient advocates".

PMID- 2235416
TI  - The nurse as advocate: concepts and controversy.

PMID- 2235414
TI  - The changing role of nurses in making ethical decisions.

PMID- 2235417
TI  - The patient rights advocate.

PMID- 2235419
TI  - Patient rights: an agenda for the '80s.

PMID- 2235418
TI  - The patient rights advocate: can nurses effectively fill the role?

PMID- 2235420
TI  - The role of the patient representative.

PMID- 2235421
TI  - The patient's representative: whose side is she on?

PMID- 2235422
TI  - Want some good advice? Think twice about being a patient advocate.

PMID- 2235423
TI  - Self-study report for home care organizations.

PMID- 2235425
TI  - Educational outcomes of associate degree nursing programs: roles and
      competencies.

PMID- 2235424
TI  - Self-study report for community health organizations.

PMID- 2235426
TI  - Taking nursing education to the streets.

PMID- 2235427
TI  - Community health advocacy: primary health care nurse-advocate teams in urban
      communities.
AB  - In summary, our health advocacy program uses PHC teams in urban, underserved
      communities to deal with the interaction of social and health factors in solving
      problems related to access to appropriate (as perceived by residents) and
      affordable health care. This approach encourages grass-roots participation in
      problem identification and solution, a fundamental ingredient of community
      empowerment. Further, this program facilitates community identification of nurses
      as resource persons who encourage collaboration to improve the community's health
      status and as health providers who enhance the authority and autonomy of
      community participation in the resolution of health issues.

PMID- 2235428
TI  - The community college-nursing home partnership: improving care through education.

PMID- 2235429
TI  - Lifting the veil of secrecy.

PMID- 2235430
TI  - Public disclosure: lifting the veil of secrecy on accreditation.

PMID- 2235431
TI  - Answering the question of whether success on the state boards be considered a
      significant outcome measure for educational programs.

PMID- 2235432
TI  - Should success on state boards be considered a significant outcome measure for
      educational programs? A regulatory perspective.

PMID- 2235433
TI  - An innovative method for developing a baccalaureate nursing program and providing
      placement credit for registered nurse students.

PMID- 2235434
TI  - Project L.I.N.C. (Ladders In Nursing Careers): an innovative model of educational
      mobility.

PMID- 2235436
TI  - Nurses in space.

PMID- 2235435
TI  - The S-S-S connection.

PMID- 2235437
TI  - A trajectory model for reorganizing the health care system.

PMID- 2235438
TI  - The many faces of the newly licensed nurse.

PMID- 2235439
TI  - Health policy issues toward the year 2000.

PMID- 2235440
TI  - Profile of hospital nursing personnel's contemporary nursing population: findings
      from the American Hospital Association's data.

PMID- 2235441
TI  - Profile of the contemporary nursing population: findings from 1988 sample survey
      of registered nurses data sources.

PMID- 2235442
TI  - Characteristics of newly licensed practical/vocational nurse practice.

PMID- 2235443
TI  - Costs and revenue sources for nursing centers.

PMID- 2235444
TI  - Nursing centers--state of the art and future initiatives: services and marketing
      strategies.

PMID- 2235445
TI  - Healing and wholeness: a case study of a nurse-managed AIDS center.

PMID- 2235446
TI  - A review of the state of the art of research on nursing centers.

PMID- 2235447
TI  - Career planning: a nurse's guide to career advancement.

PMID- 2235449
TI  - Nursing & health care: the supplement.

PMID- 2235448
TI  - Editor's notes for "Nursing in America: a History of Social Reform". A video
      documentary.

PMID- 2235450
TI  - Informatics: preparation for new nursing rules.

PMID- 2235451
TI  - Using simulation with RN-BSN students to challenge nursing credits.

PMID- 2235452
TI  - Discharge planning. Quality care: financial savings.

PMID- 2235453
TI  - The changing scene in baccalaureate nursing education.

PMID- 2235454
TI  - Nursing practice: cycles of development.

PMID- 2235455
TI  - Student nurse ambassadors spark interest in recruitment.

PMID- 2235456
TI  - Should regulatory agencies and legislative bodies dictate the curriculum of
      professional schools of nursing?

PMID- 2235457
TI  - Chemical dependency in the nursing profession.

PMID- 2235458
TI  - A survey of credit allocation for prior nursing education in BSN for RN programs.

PMID- 2235459
TI  - A theory of organizational structure for unifying nursing practice and education.

PMID- 2235460
TI  - The road map to a meaningful nurse preceptorship program.

PMID- 2235461
TI  - Nursing care shortage: strategies for resolving the crisis.

PMID- 2235462
TI  - Nurse empowerment: strengthening the role of research.

PMID- 2235463
TI  - Doctoral education for the nurse executive.

PMID- 2235464
TI  - Second-step versus competence-based RN baccalaureate education in a rural
      setting.

PMID- 2235465
TI  - Addressing the nursing shortage.

PMID- 2235466
TI  - [Bacterial meningitis in children].

PMID- 2235467
TI  - [Purulent meningitis in Denmark].
AB  - The epidemiology of meningococcal disease in Denmark has changed in recent years,
      with a rise in the number of cases in the 14-18 year age group. During the last
      decade 80 per cent of the meningococci belonged to Group B and 20 per cent to
      Group C. The treatment has followed the lines of the recommendations issued by
      the Rigshospitalet but some hospital departments have now chosen other
      preparations, as appears from the study presented in the article.

PMID- 2235468
TI  - [Treatment of bacterial meningitis in Finland].
AB  - The Finnish recommendations for treatment of bacterial meningitis are reported in
      this article. A new Finnish study is the only one to present a randomised
      comparison of the advantages and disadvantages inherent in four major drugs
      against meningitis.

PMID- 2235469
TI  - [Bacterial meningitis in Iceland].
AB  - The article reports on the number of patients in Iceland who in the last 30 years
      have been diagnosed as having bacterial meningitis, and on changes in the choice
      of medication during this period. The vaccination of Icelandic children against
      Haemophilus Influenzae B began in 1989.

PMID- 2235470
TI  - [Treatment of bacterial meningitis in Norway].
AB  - Infections with Group B meningococci have been a dominant infection problem in
      Norway in the last 15 years. The Norwegian recommendations as to treatment are
      reported in the article.

PMID- 2235471
TI  - [2 strategies in case of meningitis in Sweden].
AB  - In contrast to the other Nordic countries Sweden has long had a favourable
      position as regards meningococcal disease. In the last 10 year period the annual
      incidence has been only about one case per 100,000 inhabitants. The treatment
      once the cause is confirmed is conventional and no different from that in the
      other Nordic countries but varies somewhat in the event of unknown etiology.
      Cortisone therapy also seems to be more frequent in treatment of meningitis. Two
      strategies for antibiotic prophylaxis are used in Sweden.

PMID- 2235472
TI  - [Primary Sjogren's syndrome--more than a dry mouth and dry eyes].
AB  - Primary Sjogren's syndrome is an autoimmune disease mainly affecting exocrine
      glands. The cardinal symptoms are keratoconjunctivitis sicca and xerostomia, the
      sicca complex, in addition to extraglandular manifestations. The diverse clinical
      picture and the therapeutic aspect of the syndrome are discussed.

PMID- 2235473
TI  - [Malignant diseases in cause-of-death autopsies in forensic medicine].
AB  - The forensic examinations to determine cause of death allow study of the natural
      development of untreated diseases. In this study we retrospectively analysed
      malignant and/or intracranial tumours in a consecutive series of 7020 autopsies
      in northern Sweden. We found cancer in 171 cases in all, where sudden death was
      caused by previously undiscovered tumours in 41.

PMID- 2235474
TI  - [Oral temperature measurement using Craftemp].
AB  - The performance of oral, electronically measured body temperature with Craftemp
      (Astra Meditec) in routine use in medical wards was investigated. Rectal
      measurement with conventional Hg-thermometer was used as a reference method. The
      Craftemp method turned out to be unacceptably inaccurate: 30.8 per cent of the
      measurements of rectal-oral temperature difference were subject to a variation
      around the mean larger than +/- 0.4 degree C. The standard deviation of the
      rectal-oral temperature differences was 0.51 degree C, and the range -1.2 degrees
      C to +3.0 degrees C. Until an alternative method for measurement of body
      temperature is proven accurate in the clinical routine, the established method of
      rectal measurement should not be abandoned.

PMID- 2235475
TI  - [General medicine in the 1990s].

PMID- 2235476
TI  - [Statistical analysis of 2 x 2 tables:I. Controlled clinical studies].

PMID- 2235477
TI  - [Can prevention be hazardous to health?].
AB  - Health-promotion/disease-prevention may--despite the best intentions--have
      mischievous effects and overlooked ethical implications. This article describes
      some consequences of health promotion when initiated by the medical profession as
      medicalization of the modern human being, problems with false test-results,
      iatrogenic disease, and the risk of "victim blaming". The responsibility of the
      medical profession includes the well-being of healthy people as well as the
      actually or future sick. Therefore, health promotion has to be based on the
      values and informed consent of the healthy part of the population.

PMID- 2235478
TI  - [Surgery at high altitude--greetings from a hospital in the Himalayas. Tropical
      surgery--about typhoid perforation and tiger bites].

PMID- 2235479
TI  - Sequence analysis of two temperature-sensitive mutations in the alpha subunit
      gene (rpoA) of Escherichia coli RNA polymerase.
AB  - The rpoA gene of Escherichia coli encodes the alpha subunit of the DNA-dependent
      RNA polymerase. Two mutant alleles, rpoA101 and rpoA112, both of which produce
      RNA polymerase with altered thermostability and reduced fidelity of transcription
      in vitro (Ishihama et al. (1980) J. Mol. Biol. 137, 137-150), have been analyzed
      in details. The mutations were found to be responsible for the temperature
      sensitive growth by complementation test using a rpoA-expression plasmid. Each
      mutant allele was amplified from total cell DNA by PCR (polymerase chain
      reaction) and directly sequenced. Both the mutant rpoA genes were found to carry
      a single base transition which leads to a substitution of Cys for Arg at the
      position 191 (rpoA101) or 45 (rpoA112), respectively. Since the rpoA112 mutation
      causes the defect in RNA polymerase assembly (Kawakami & Ishihama (1980)
      Biochemistry 19, 3491-3495), the amino-terminal region of alpha including the
      position 45 was considered to play an important role in subunit assembly.

PMID- 2235480
TI  - 'Compensatory slippage' in the evolution of ribosomal RNA genes.
AB  - The distribution patterns of shared short repetitive motifs in the expansion
      segments of the large subunit rRNA genes of different species show that these
      segments are coevolving as a set and that in two examined vertebrate species the
      RNA secondary structures are conserved as a consequence of runs of motifs in one
      region being compensated by complementary motifs in another. These unusual
      processes, involving replication-slippage, have implications for the evolution of
      ribosomal RNA and for the use of the rDNA multigene family as a 'molecular clock'
      for assessing relationships between species.

PMID- 2235481
TI  - Identification and structural characterization of O-beta-ribosyl-(1"----2')
      adenosine-5"-phosphate in yeast methionine initiator tRNA.
AB  - We report in this paper on the complete structure determination of the modified
      nucleotide A*, now called Ar(p), that was previously identified in yeast
      methionine initiator tRNA as an isomeric form of O-ribosyl-adenosine bearing an
      additional phosphoryl-monoester group on its ribose2 moiety. By using the
      chemical procedure of periodate oxidation and subsequent beta-elimination with
      cyclohexylamine on mono- and dinucleotides containing Ar(p), we characterized the
      location of the phosphate group on the C-5" of the ribose2 moiety, and the
      linkage between the two riboses as a (1"----2')-glycosidic bond. Since the
      structural difference between phosphatase treated Ar(p) and authentic O-alpha
      ribosyl-(1"----2')-adenosine from poly(ADP-Ribose) was previously assigned to an
      isomeric difference in the ribose2-ribose1 linkage, the (1"----2')-glycosidic
      bond of Ar(p) was deduced to have a beta-spatial configuration. Thus, final
      chemical structure for Ar(p) at the position 64 in yeast initiator tRNA(Met) has
      been established as O-beta-ribosyl-(1"----2')-adenosine-5"-phosphate. This
      nucleotide is linked by a 3',5'-phosphodiester bond to G at the position 65.

PMID- 2235482
TI  - Control of mRNA stability in chloroplasts by 3' inverted repeats: effects of stem
      and loop mutations on degradation of psbA mRNA in vitro.
AB  - To investigate the role of mRNA 3' inverted repeats (IRs) in stabilizing plant
      chloroplast mRNAs, we have measured the processing and stability of wild-type and
      mutant RNAs corresponding to the 3' end of the spinach chloroplast psbA mRNA.
      wild-type and mutant 3' IR-RNA precursors were processed at similar rates in a
      homologous in vitro system, but RNAs with either a mutant loop sequence CUUCGG or
      a specific base substitution in the IR exhibited an enhanced accumulation of
      mature product. Incubation of mature products in the in vitro system demonstrated
      that this was due to an increased stability of the product. These mutant RNAs
      displayed the same order of stabilities when their decay was measured following
      electroporation into intact chloroplasts. We found that the in vitro system
      contains an endonuclease activity that cleaves the wild-type 3' IR-RNA within the
      loop and also in single-stranded regions, suggesting a possible role for the loop
      sequence in determining RNA longevity in vitro. Interestingly, the altered loop
      sequence CUUCGG, which enhances RNA stability in bacteria (1), prolonged the half
      life of psbA 3' IR-RNA in vitro and also resulted in an altered endonuclease
      cleavage pattern. Such nucleases could potentially play an important role in
      plastid mRNA decay in vivo.

PMID- 2235483
TI  - Inducibility of the HS II enhancer depends on binding of an erythroid specific
      nuclear protein.
AB  - An erythroid specific, inducible enhancer associated with hypersensitive site II
      (HS II) plays a central role in the function of the human beta globin dominant
      control region. The HS II enhancer consists of tandem AP-1 binding sites and has
      been shown to bind members of the ubiquitous jun and fos families of proteins.
      The same sites are now shown to bind the erythroid specific protein, NF-E2.
      Inducibility of the HS II enhancer depends on NF-E2 binding, even in the presence
      of another hypersensitive site. Further, increased activity of the enhancer in
      induced K562 cells correlates with the presence of NF-E2, which appears to be
      present in a modified form. NF-E2 is distinct from some enhancer binding proteins
      in K562 nuclear extracts, in that it does not contain Fos or Fra-1 protein. Thus,
      binding by NF-E2 may be the mechanism, whereby tandem AP-1 binding sites confer
      erythroid specificity on the HS II enhancer.

PMID- 2235484
TI  - Thiophosphate interference experiments locate phosphates important for the
      hammerhead RNA self-cleavage reaction.
AB  - A hammerhead domain of less than 50 nucleotides is responsible for a self
      cleavage reaction in the replication of plant RNA pathogens. The hammerhead is
      composed of three helices joining at a central conserved core of 11 single
      stranded nucleotides. The core is believed to fold into a tertiary structure that
      provides functional groups for catalysis and to coordinate one or more divalent
      metal ions. In this study we use a phosphorothioate substitution interference
      assay to identify four phosphates in the conserved core which also play a role in
      the self-cleavage reaction.

PMID- 2235485
TI  - Chromosomal footprinting of transcriptionally active and inactive oocyte-type 5S
      RNA genes of Xenopus laevis.
AB  - The chromatin structure of the Xenopus oocyte-specific 5S rRNA genes was examined
      at high resolution in immature oocyte and somatic cell chromosomes by DNase I
      footprinting. On oocyte chromatin, where the genes are active, the cleavage
      preferences over the entire gene region showed a periodic pattern of sensitivity
      and were dramatically different from the patterns obtained with deproteinized DNA
      or somatic cell chromatin. Further, the normal binding site for TFIIIA over the
      internal promoter region was preferentially sensitive to cleavage, indicating
      that TFIIIA was not bound in the manner predicted by in vitro experiments. In
      somatic cell chromatin, the oocyte-type 5S genes displayed a cleavage pattern
      largely similar to deproteinized DNA suggesting the absence of positioned
      nucleosomes on these inactive genes, although the presence of uncharacterized
      repressor complexes could not be ruled out. These data are discussed in terms of
      potential forms of the chromatin structure and alternative mechanisms of oocyte
      type gene activation.

PMID- 2235486
TI  - Host sequences flanking the HIV provirus.
AB  - A conserved property of retroviral proviruses is the presence of a direct repeat
      in the host DNA immediately flanking the viral sequence; each virus generates a
      repeat with a characteristic length. By sequencing the viral/host DNA junctions
      from five HIV-1 proviral clones, we have confirmed that integration of HIV
      results in the generation of a five basepair direct repeat. A target sequence in
      uninfected host DNA was analyzed to establish that the five basepair sequence
      flanking the provirus was present only once prior to integration. Of the five
      proviruses examined, two were found to have integrated in known repetitive
      sequence elements of the human genome; one in a Line-1 element and a second in
      satellite DNA.

PMID- 2235487
TI  - Metal-dependent binding of a nuclear factor to the rat metallothionein-I
      promoter.
AB  - Genomic footprinting studies in vivo and experiments using synthetic metal
      regulatory elements (MREs) in vitro suggest protein binding to the MREs of the
      mouse and rat metallothionein I (MT-I) genes. Using gel-retardation assays of
      promoter fragments, we observe a cadmium-dependent binding factor for the rat MT
      I promoter in rat hepatoma cells. This factor is present in extracts from both
      uninduced and cadmium-induced cells, but requires the presence of cadmium to bind
      to the promoter. The formation of a cadmium-dependent complex is competed by an
      oligonucleotide containing two MREs. This competition is lost when when one of
      the MREs is mutated, indicating a requirement for at least two MREs for binding
      of this factor. The cadmium-dependent factor dissociates more rapidly from the MT
      I promoter than does a factor that binds to a consensus Sp1 site present on the
      same DNA fragment. UV crosslinking analysis using nuclear extracts from cadmium
      induced cells, in the presence of an oligonucleotide probe containing both 5
      bromodeoxyuridine and 32P-deoxycytidine, identifies a 39 kDalton protein
      associated with the metal inducible complex.

PMID- 2235488
TI  - The stability of polypurine tetraplexes in the presence of mono- and divalent
      cations.
AB  - As with other guanine-rich sequences, poly[d(GGA)], poly[d(GA)] and poly[d(GAA)]
      probably form four-stranded or tetraplex structures. Thermal denaturation
      profiles were measured for these polymers at pH8 in the presence of Na+, NH4+,
      K+, Cs+, Mg2+, Ca2+ and Ba2+. For poly[d(GA)], Na+, NH4+, K+ stabilize the
      tetraplex to similar extents and the Tm increases with increasing ionic strength.
      In contrast the Tms with Mg2+, Ca2+ and Ba2+ are significantly different and
      reach maxima at about 5mM of cation. The tetraplex from poly [d(GAA)] behaves in
      a similar manner. Thermal denaturation profiles for poly[d(GGA)] yield
      transitions whose hyperchromicity depends both on the concentration and nature of
      the ion. A reversible cooperative transition is not observed at concentrations
      greater than 0.15M K+, 1mM Ca2+ or 0.3 mM Ba2+ and hysteresis is evident at some
      concentrations. These results are consistent with the idea that K+ and ions of a
      similar size can form a coordination complex with the 6-Keto group of eight
      guanines (G8-DNA). Unlike the tetraplex polymer this G8-DNA does not melt
      cooperatively.

PMID- 2235489
TI  - DNA sequences required for yeast actin gene transcription do not include
      conserved CCAAT motifs.
AB  - Sequences required for Saccharomyces cerevisiae actin gene transcription were
      mapped and compared to the regulatory region of the actin gene from a
      thermophilic fungus, Thermomyces lanuginosus. Two CCAAT motifs conserved in
      position in these two species could be mutated without affecting promoter
      activity, regardless of whether the yeast were grown in fermentable or non
      fermentable carbon sources. Two TATA-like sequences and an upstream activation
      sequence (UAS) composed of multiple elements were identified. The contribution of
      sequence motifs within these elements to UAS activity varied depending on the
      carbon source. The Thermomyces gene contains sequences highly homologous to this
      UAS, but in the opposite orientation.

PMID- 2235490
TI  - Ligation-independent cloning of PCR products (LIC-PCR).
AB  - A new procedure has been developed for the efficient cloning of complex PCR
      mixtures, resulting in libraries exclusively consisting of recombinant clones.
      Recombinants are generated between PCR products and a PCR-amplified plasmid
      vector. The procedure does not require the use of restriction enzymes, T4 DNA
      ligase or alkaline phosphatase. The 5'-ends of the primers used to generate the
      cloneable PCR fragments contain an additional 12 nucleotide (nt) sequence lacking
      dCMP. As a result, the amplification products include 12-nt sequences lacking
      dGMP at their 3'-ends. The 3'-terminal sequence can be removed by the action of
      the (3'----5') exonuclease activity of T4 DNA polymerase in the presence of dGTP,
      leading to fragments with 5'-extending single-stranded (ss) tails of a defined
      sequence and length. Similarly, the entire plasmid vector is amplified with
      primers homologous to sequences in the multiple cloning site. The vector oligos
      have additional 12-nt tails complementary to the tails used for fragment
      amplification, permitting the creation of ss-ends with T4 DNA polymerase in the
      presence of dCTP. Circularization can occur between vector molecules and PCR
      fragments as mediated by the 12-nt cohesive ends, but not in mixtures lacking
      insert fragments. The resulting circular recombinant molecules do not require in
      vitro ligation for efficient bacterial transformation. We have applied the
      procedure for the cloning of inter-ALU fragments from hybrid cell-lines and human
      cosmid clones.

PMID- 2235491
TI  - Synthesis of a gene for human serum albumin and its expression in Saccharomyces
      cerevisiae.
AB  - A 1761 base pairs long artificial gene coding for human serum albumin (HSA) has
      been prepared by a newly developed synthetic approach, resulting in the largest
      synthetic gene so far described. Oligonucleotides corresponding to only one
      strand of the HSA gene were prepared by chemical synthesis, while the
      complementary strand was obtained by a combination of enzymatic and cloning
      steps. 24 synthetic, 69-85 nucleotides long oligonucleotides covering the major
      part of the HSA gene (41-1761 nucleotides) were used as building blocks.
      Generally, four groups of 6-6 such oligonucleotides were successively cloned in
      pUC19 Escherichia coli vector to obtain about quarters of the gene as large
      fragments. Joining of these four fragments resulted in a cloned DNA coding for
      the 13-585 amino acid region of HSA, which was further supplemented with a double
      stranded linker sequence coding for the amino terminal 12 amino acids. The
      completed structural gene composed of frequently used codons in the highly
      expressed yeast genes was then supplied with yeast regulatory sequences and the
      HSA expression cassette so obtained was inserted into an Escherichia coli
      Saccharomyces cerevisiae shuttle vector. This vector was shown to direct the
      expression in Saccharomyces cerevisiae of correctly processed, mature HSA which
      was recognized by antiserum to HSA, and possessed the correct N-terminal amino
      acid sequence.

PMID- 2235492
TI  - Adenovirus infection of differentiated F9 cells results in a global shut-off of
      differentiation-induced gene expression.
AB  - Previous experiments have demonstrated a link between transcriptional regulatory
      mechanisms acting during F9 cell differentiation and transcription control by the
      adenovirus E1A gene. We have isolated a number of differentiation-specific genes
      by cDNA cloning to determine if E1A exerts a coordinated control over
      differentiation specific gene expression. The mRNAs encoded by these cDNAs were
      undetectable or only barely detectable in undifferentiated cells but then rose in
      concentration upon differentiation. Analysis of transcription rates in isolated
      nuclei revealed that all but one of the genes was transcriptionally regulated
      during differentiation. Interestingly, alpha 2-type IV collagen expression was
      activated by a post-transcriptional mechanism since the gene was transcribed in
      both undifferentiated and differentiated cells whereas the cytoplasmic mRNA was
      undetectable in undifferentiated cells but rose in abundance in parallel with
      other regulated transcripts. Adenovirus infection of differentiated F9 cells
      reduced the cytoplasmic mRNA levels of each of the differentiation specific genes
      to near that found in the undifferentiated cell. Of those genes that were
      transcriptionally activated by differentiation, adenovirus infection specifically
      inhibited transcription. In contrast, although the alpha 2 collagen mRNA levels
      were reduced by adenovirus infection similar to the other mRNAs, the control was
      post-transcriptional since transcription of the gene was unaffected. Thus, the
      mechanism for loss of gene expression mediated by E1A reflects the mechanism by
      which the gene was activated during differentiation. Based on these results we
      suggest that E1A controls the expression of the F9 cell phenotype by targeting a
      regulatory activity acting early in the differentiation program.

PMID- 2235493
TI  - Evidence for the frequent use of TTG as the translation initiation codon of
      mitochondrial protein genes in the nematodes, Ascaris suum and Caenorhabditis
      elegans.
AB  - Data obtained from alignments of nucleotide sequences of mitochondrial (mt) DNA
      molecules of the nematode worms Ascaris suum and Caenorhabditis elegans indicate
      that in six of the mt-protein genes of A. suum and three of the mt-protein genes
      of C. elegans TTG is used as the translation initiation codon. Also, GTT seems to
      be the translation initiation codon of the A. suum COIII gene. All of the five
      remaining A. suum mt-protein genes appear to begin with ATT and the remaining
      nine C. elegans mt-protein genes appear to begin with either ATT or ATA.
      Therefore, in contrast to all other metazoan mtDNAs sequenced so far, it is
      likely that none of the nematode mt-protein genes use the standard ATG
      translation initiation codon. Some A. suum and C. elegans mt-protein genes end in
      T or TA, suggesting that, as found in other metazoan mitochondria, 3'-terminal
      polyadenylation is occasionally necessary to generate complete translation
      termination codons in transcripts of nematode mt-protein genes.

PMID- 2235495
TI  - Conservation of the 3' terminal nucleotide sequence in five carlaviruses.

PMID- 2235494
TI  - Evidence for a new Z-type left-handed DNA helix: properties of Z(WC)-DNA.
AB  - The structure of Z-DNA, currently accepted as a model for all left-handed DNAs,
      fails to provide convincing explanations for at least four well established
      properties of left-handed DNA polymers in solution. However, the major
      discrepancies between theory and experiment are resolved by the structure
      presently proposed for Z[WC]-DNA, a new left-handed, zig-zag double helix with
      Watson-Crick-type backbone directions. Structural features of Z[WC]-DNA include
      the presence of an additional H-bond between each guanine N2-amino group and an
      adjacent phosphate oxygen, the capacity to form four-stranded, base-matched
      complexes that should readily precipitate from solution, and backbone
      progressions that are the same as B-DNA (opposite to Z-DNA). However, since Z[WC]
      DNA and Z-DNA have many parameters in common, they could be difficult to
      distinguish in a majority of existing experiments. In view of the close
      relationship of the new helix to B-DNA, which allows a relatively unhindered
      right-to-left transition in handedness, Z[WC]-DNA is theorized to be the left
      handed structure preferentially generated in vivo by the torque available in
      naturally occurring DNA supercoils.

PMID- 2235496
TI  - Nucleotide sequence of rfaI and rfaJ genes encoding lipopolysaccharide glycosyl
      transferases from Salmonella typhimurium.

PMID- 2235497
TI  - Nucleotide sequence of guinea-pig kappa-casein cDNA.

PMID- 2235498
TI  - The nucleotide sequence of the ferrochelatase and tRNA(val) gene region from
      Saccharomyces cerevisiae.

PMID- 2235499
TI  - Cloning and sequencing of POU-boxes expressed in Xenopus laevis neurula embryos.

PMID- 2235500
TI  - Nucleotide sequence of a radish cDNA clone coding for a late embryogenesis
      abundant (LEA) protein.

PMID- 2235501
TI  - Complete nucleotide sequence of the aroA gene from Salmonella typhi encoding 5
      enolpyruvylshikimate 3-phosphate synthase.

PMID- 2235502
TI  - Nucleotide sequence of two proline tRNA (AGG and CGG) genes from chicken.

PMID- 2235503
TI  - The nucleotide sequence of Xenopus laevis transferrin mRNA.

PMID- 2235504
TI  - Nucleotide sequence of the major outer membrane protein gene of Chlamydia
      trachomatis strain A/SA1/OT.

PMID- 2235505
TI  - Nucleotide sequence of the virion protein gene of belladonna mottle tymovirus.

PMID- 2235507
TI  - Complete nucleotide sequence of a German duck hepatitis B virus.

PMID- 2235506
TI  - Complete nucleotide sequence of a Chinese duck hepatitis B virus.

PMID- 2235508
TI  - Cloning and sequencing of the cysteine protease cDNA from Trypanosoma brucei
      rhodesiense.

PMID- 2235509
TI  - Nucleotide sequence of HIV-2D194, an isolate from a Gambian case of 'neuro-AIDS',
      which showed excellent growth in macrophages.

PMID- 2235510
TI  - Nucleotide sequence of rice 4-coumarate:CoA ligase gene, 4-CL.1.

PMID- 2235511
TI  - The complete sequence of the Bacillus amyloliquefaciens strain H, cellular BamHI
      methylase gene.

PMID- 2235512
TI  - The absence of adenine methylation increases the ligation efficiency of partially
      filled staggered DNA ends.

PMID- 2235513
TI  - Use of gamma irradiation to eliminate DNA contamination for PCR.

PMID- 2235514
TI  - A quick and efficient method for the recovery of plasmid or viral DNA from
      mammalian cells.

PMID- 2235515
TI  - DNA isolated from plastic embedded tissue is suitable for PCR.

PMID- 2235516
TI  - Stable and safe HIV provirus clones.

PMID- 2235517
TI  - Isolation and identification of restriction endonuclease Asp35HI from
      Acidiphilium species 35H.

PMID- 2235518
TI  - A simple method for generating single-stranded DNA probes labeled to high
      activities.

PMID- 2235519
TI  - A rapid and efficient method for transcript mapping.

PMID- 2235520
TI  - Direct single stranded sequencing from agarose of polymerase chain reaction
      products.

PMID- 2235521
TI  - Transferring plasmid DNA between different bacterial species with
      electroporation.

PMID- 2235522
TI  - A simple method for the direct use of total cosmid clones as hybridization
      probes.

PMID- 2235523
TI  - Ligated mycoplasma genomes as DNA size markers for PFGE.

PMID- 2235524
TI  - A rapid and highly efficient method for preparation of competent Escherichia coli
      cells.

PMID- 2235525
TI  - An STS in the human T cell receptor gamma locus (located at 7p14-15).

PMID- 2235526
TI  - G to A polymorphism in exon 31 of the COL3A1 gene.

PMID- 2235528
TI  - Retraction. Nucleotide sequences of mitochondrial ATPase subunit 9 genes from
      three lines of rice (Oryza Sativca L.)

PMID- 2235529
TI  - Questions the foundation of nursing education.

PMID- 2235530
TI  - Less caring and more self-caring.

PMID- 2235531
TI  - Military as model for caring?

PMID- 2235532
TI  - News for the passing parade.

PMID- 2235527
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 2235533
TI  - The aftermath of the Cruzan decision: dying in a twilight zone.

PMID- 2235534
TI  - The Oregon plan: increasing access to health care.
AB  - In 1989, a coalition of Oregon legislators, policymakers, and health care
      professionals created a new plan that attempts to ensure equitable and universal
      access to health care by prioritizing types of care. Critics call it unrealistic
      and a dangerous rationing scheme. Proponents argue it is better than the current
      system that denies thousands of citizens access to basic care.

PMID- 2235535
TI  - Nurses make high tech high touch.
AB  - Until nurses at St. Mary's Hospital took the lead in establishing an outpatient
      infusion unit, oncology patients had to travel up to 100 miles to receive
      chemotherapy. Today, they need travel only ten minutes to receive the best and
      latest of a variety of high-tech services.

PMID- 2235536
TI  - Assessment preparation for nurse practitioners.
AB  - Faced with primary care graduate students who were not adequately prepared to
      meet the demands of their clinical courses, faculty at the University of
      Pennsylvania conducted a three-year study to determine the effectiveness of
      physical assessment prerequisites. They concluded that graduate level assessment
      preparation was well worth the time and effort such courses require.

PMID- 2235537
TI  - An early 20th century view of nursing.
AB  - The novels of Dorothy Canfield Fisher reflect the esteem with which nursing was
      held in the first half of the 20th century. Though no longer widely read, these
      novels were, in their day, ranked with those of Willa Cather, Pearl Buck and
      Edith Wharton and are distinguished by their portrayal of nurses as strong,
      competent, independent, and compassionate role models for young women.

PMID- 2235538
TI  - Do patients understand written health information?
AB  - Long sentences, medical terms and small print make hospital information brochures
      and consent forms difficult for many patients to understand. There are, however,
      things nurses can do to make written information for patients more accessible.

PMID- 2235539
TI  - Should continuing education be public policy?
AB  - A survey of Illinois registered nurses reveals a striking relationship between
      employment setting and participation in continuing education programs. It
      suggests that public policy mandating CE participation may not be the best way to
      increase such participation among those nurses least inclined to do so.

PMID- 2235540
TI  - Ethical issues in research: scientific misconduct and fraud.

PMID- 2235541
TI  - AIDS support.

PMID- 2235542
TI  - Pay Review Body. The pay body snatchers.

PMID- 2235543
TI  - Pay Review Body. The cost of trusting.

PMID- 2235544
TI  - Pay Body Review. We don't want to fight, but ....

PMID- 2235546
TI  - Is stripe-itis curable?

PMID- 2235545
TI  - Pay Body Review. Breaking away.

PMID- 2235547
TI  - Alcoholism. To hell and back.

PMID- 2235548
TI  - Alcoholism. Small steps to progress.

PMID- 2235549
TI  - Eastern Europe. Training a new generation.

PMID- 2235550
TI  - Making sense of .... Endotracheal intubation.

PMID- 2235551
TI  - Stamping out inequality.

PMID- 2235553
TI  - Measuring quality in a psychiatric hospital.

PMID- 2235552
TI  - Alternative techniques.

PMID- 2235554
TI  - Nursing overseas. Operation Ontario.

PMID- 2235555
TI  - Her own brand of humour. Interview by Ian McMillan.

PMID- 2235556
TI  - Latchkey children.

PMID- 2235557
TI  - Investigating casual transmission of HIV.

PMID- 2235559
TI  - Women's health and nursing work.

PMID- 2235558
TI  - The measurement of symphyseal-fundal height.

PMID- 2235560
TI  - Primary nursing. An associate in care.

PMID- 2235562
TI  - Primary nursing. Collegiality is the key.

PMID- 2235561
TI  - Primary nursing. A role, not a title.

PMID- 2235563
TI  - Fewer than expected HIV children.

PMID- 2235564
TI  - Painful admission.

PMID- 2235565
TI  - Taking liberties.

PMID- 2235566
TI  - Widening horizons.

PMID- 2235567
TI  - Air of danger.

PMID- 2235568
TI  - Signals for support.

PMID- 2235569
TI  - Open learning. Into a new era.

PMID- 2235570
TI  - Open learning. The right stuff.

PMID- 2235571
TI  - Open learning. What the punters say.

PMID- 2235572
TI  - Thorns in their side?

PMID- 2235573
TI  - Making the game safer.

PMID- 2235574
TI  - Rehabilitation and the cancer patient.

PMID- 2235575
TI  - Seasonal affective disorder. Winter depression.

PMID- 2235576
TI  - Seasonal affective disorder. A sad situation.

PMID- 2235577
TI  - Farewell to the polyclinics?

PMID- 2235579
TI  - Drug administration. The view from the pharmacy.

PMID- 2235578
TI  - Drug administration. A prescription for self-help.

PMID- 2235581
TI  - Nurses and the law. Ethical ways.

PMID- 2235580
TI  - Professional conduct. Past imperfect.

PMID- 2235582
TI  - Intermittent self-catheterisation.

PMID- 2235583
TI  - Do we need to clamp catheters?

PMID- 2235584
TI  - Paediatrics needs to consider HIV.

PMID- 2235586
TI  - Open mind.

PMID- 2235585
TI  - Occupational hazards.

PMID- 2235587
TI  - Shifting ground.

PMID- 2235588
TI  - Child's play.

PMID- 2235589
TI  - Modern theatre.

PMID- 2235590
TI  - Undervalued support.

PMID- 2235591
TI  - Time to make doughnuts?

PMID- 2235592
TI  - Against the odds.

PMID- 2235593
TI  - Fair deal on appeal. A bottomless pit?

PMID- 2235594
TI  - Drug administration. Doing the round alone.

PMID- 2235595
TI  - Drug administration. Breaking the chain reaction.

PMID- 2235596
TI  - A jaundiced view.

PMID- 2235597
TI  - Improving social skills.

PMID- 2235598
TI  - HIV infection and community nursing staff in Scotland--1. Experience, practice
      and education.
AB  - To assess the effects of human immunodeficiency virus (HIV) for the work of
      community nursing staff, and to find out how community staff regard their
      contribution to the prevention of HIV infection, the care of people with AIDS and
      their preparation for this role was ascertained in a postal survey of one in five
      field staff carried out in Scotland. The 1,205 respondents represent an 85%
      response rate. While only 3% of respondents had experience of patients with AIDS,
      11% had been involved with known asymptomatic HIV infection and 30% had
      encountered those they considered to be at high risk of infection. While the
      workload generated by HIV-infected patients for individual nurses at this time
      was small, there were variations in the proportions of staff involved according
      to type of staff and employing health board. Only one-fifth of those who had
      encountered HIV-positive patients had offered them health education, and fewer
      had referred patients to their general practitioners or offered counselling.
      However, community nursing staff do consider that they have a role to play in
      health education, counselling and terminal care, but feel ill equipped to carry
      out this role. There is an urgent need for policies which clearly specify the
      roles that community nursing staff should be playing and for in-service education
      programmes which assist them to draw on the knowledge and skills that they have
      to enable them to apply them to help patients with HIV infection.

PMID- 2235599
TI  - Assessing methods of lipid measurement.

PMID- 2235600
TI  - Screening tests for sensorineural deafness.

PMID- 2235601
TI  - Essential hypertension in pregnancy.

PMID- 2235602
TI  - Management. A welcome return?

PMID- 2235604
TI  - Health visitors' supplement. Water, water everywhere....

PMID- 2235603
TI  - 'Donkeys' and dinner duty.

PMID- 2235606
TI  - Health visitors' supplement. Shouting it out.

PMID- 2235605
TI  - Health visitors' supplement. Business as usual.

PMID- 2235607
TI  - Health visitors' supplement. Bottom of the league?

PMID- 2235608
TI  - Health visitors' supplement. After the honeymoon.

PMID- 2235609
TI  - Reflex labelling of high-risk individuals does not limit HIV.

PMID- 2235610
TI  - Pink problems, blue solutions. Interview by Linda Davidson.

PMID- 2235611
TI  - Strengthening ties.

PMID- 2235612
TI  - Sanctuary in peril.

PMID- 2235614
TI  - Happily ever after?

PMID- 2235613
TI  - Vitamin alert.

PMID- 2235615
TI  - Nursing homes. Buyer beware.

PMID- 2235616
TI  - Nursing homes. Home truths.

PMID- 2235617
TI  - Nursing homes. Monitoring muddles.

PMID- 2235618
TI  - Sporting life.

PMID- 2235619
TI  - Making sense of .... hydrocolloid dressings.

PMID- 2235620
TI  - Nurses' homes. There's no place like home?

PMID- 2235621
TI  - Nurses' homes. Action plan for improvements.

PMID- 2235622
TI  - Fair deal on appeal. No way up.

PMID- 2235623
TI  - Facing the challenge.

PMID- 2235624
TI  - HIV infection and community nursing staff in Scotland--2. Knowledge and
      attitudes.
AB  - Findings from a survey of community nursing staff in Scotland reveal that there
      is limited knowledge about many aspects of HIV infection. Respondents were
      concerned about their lack of experience and knowledge as well as the in-service
      education that they had received. A substantial minority of community nursing
      staff felt that they should have the right to refuse to care for HIV-infected
      patients and those whose lifestyle put them at risk of HIV infection. A majority
      of staff felt that health professionals who are most at risk of contact with HIV
      infected materials should be informed of patients' HIV-antibody status without
      their consent. There were also some indications of a lack of confidence in
      service managers and recommendations are made regarding ways of increasing both
      the knowledge and confidence of front-line staff.

PMID- 2235625
TI  - 40 years on.

PMID- 2235626
TI  - Nurse education. Preaching what they practise.

PMID- 2235627
TI  - Nurse education. How to ... evaluate a short course.

PMID- 2235628
TI  - Mum's the word.

PMID- 2235629
TI  - Eliciting assessment data from the patient who is difficult to interview.
AB  - The patient interview is an essential part of the assessment phase of the nursing
      process. Ensuring a productive interview involves controlling, as much as
      possible, the interview environment as well as the nurse's verbal and nonverbal
      communication. Patients who are cognitively impaired, angry, anxious, depressed,
      manipulative, or seductive can make this interview process more challenging.
      Working individually with each of these possible patient dynamics in a calm,
      controlled, and knowledgeable way can help facilitate the interview process and
      pave the way for fewer problems in the future. Frequently, the interview may
      involve the discussion of sensitive topics such as terminal illness, suicide, or
      sexuality. Gathering information and developing a comfort level in broaching
      these issues with patients are important goals for nursing professionals.
      Reading, attending workshops, consultation with professionals, and most
      important, self-assessment of these sensitive topics are all useful tools in
      obtaining those goals.

PMID- 2235630
TI  - Assessment of patient laboratory data in the acutely ill.
AB  - Laboratory test results are a valuable source of information. Nurses need to
      assess laboratory test results as part of the physical assessment of their
      patients. Comparison of laboratory test results and changes with abnormal
      physical findings provides the basis for changes in the nursing care plan.
      Progressive monitoring of laboratory results and prompt interventions might
      lessen the seriousness of the health problem. In acute care units, the initial
      group of laboratory tests serves as a baseline for assessing additional test
      results. Several reference values should be remembered, particularly the
      electrolytes (potassium, sodium, and calcium), glucose, BUN, creatinine, and
      albumin. Specific group profiles assist in identifying and in monitoring the
      patient's health status. Incorporating laboratory test results into the plan and
      evaluation of care will result in safer and more effective patient care.
      Referring to laboratory test findings and comparing them with physical assessment
      findings are required for the delivery of professional nursing care.

PMID- 2235631
TI  - Pulmonary and acid-base assessment.
AB  - With increased technology, increased patient longevity, and burgeoning health
      care knowledge, pulmonary assessment of clients has become more complex, and
      nurses are now challenged to develop more comprehensive skills. These include a
      more focused patient history on selected clients as well as careful inspection,
      palpation, percussion, and auscultation. Additional techniques such as voice
      sounds provide the nurse with even more assessment data. An understanding of
      common pathologic pulmonary problems and their corresponding assessment findings
      as well as knowledge about acid-base imbalances will result in more effective
      professional nursing care.

PMID- 2235632
TI  - Advanced assessment of the abdomen and gastrointestinal problems.
AB  - There are many unique physical assessment findings that are associated with
      specific gastrointestinal disorders. The detection of these findings enables the
      nurse to manage gastrointestinal emergencies on the patient unit in a timely
      fashion, preventing deterioration and maintaining the safety of the patient.
      These skills build well on the traditional, detailed, and comprehensive
      assessments the nurse makes when using the nursing process. Specific abdominal
      assessments include detection of signs associated with appendicitis such as
      rebound tenderness and McBurney's, Rosvig's, and Aaron's signs. The nurse must
      always be alert to the possibility of peritonitis and the urgency of early
      detection and treatment. The patient with cirrhosis of the liver presents a
      distinct clinical picture. There is a need for subtle evaluation of mental status
      to detect early signs of hepatic coma. Another extra-abdominal assessment of this
      complication is asterixis. Finally, the assessment of the patient is enhanced
      when the nurse is able to help identify the location of bleeding. Improving
      abdominal and gastrointestinal system assessment leads to early detection of
      nursing problems and appropriate interventions.

PMID- 2235633
TI  - Peripheral vascular disorders. Assessment and intervention.
AB  - Peripheral vascular diseases are being seen with increased frequency in the
      health care setting today. It is imperative that nurses have a clear
      understanding of arterial, venous, and lymphatic circulatory mechanisms as well
      as the pathophysiologic changes that accompany common diseases of these systems.
      Providing the ongoing assessment to obtain a diagnosis, establish the acute
      versus chronic nature of findings, monitor progression, plan care, and assess the
      response to treatment is an important role for the nurse in order to preserve
      function, life, and limb in these patients.

PMID- 2235634
TI  - Neurologic assessment.
AB  - Neurologic nursing assessment requires the knowledge of anatomic and physiologic
      principles as well as the mastery of complex assessment skills. The nurse who is
      often the first and most consistent health team member interacting with clients
      may provide the key to the early recognition, prevention, and treatment of
      neurologic problems. The nurse, as the dynamic member of the health team, may
      then be the first line of defense in initiating cost-effective and perhaps life
      saving measures in neurologically impaired clients.

PMID- 2235635
TI  - Assessing acquired ocular diseases.
AB  - When assessing a patient's ocular complaint, one must listen carefully to the
      description of the symptoms. A decrease in vision is most frequently the symptom
      that prompts a person to seek attention. Pain in and around the eye is the next
      most frequent symptom complained about. Discomfort is often tolerated for long
      periods before professional attention is obtained. Visual acuity must be checked,
      for this is the vital sign by which exacerbation or improvement of many
      conditions is measured. We all take our eyes for granted until we suddenly cannot
      see, then the world takes on a completely different complexity, for loss of
      vision may mean loss of livelihood and independence.

PMID- 2235636
TI  - Health assessment of the early adolescent. Challenges and clinical issues.
AB  - Although early adolescence spans only 4 years, it is a critical time in the life
      of a young person in forming opinions and selecting options. Specific attention
      to the growing and changing needs of this population is imperative if their
      health status is to improve.

PMID- 2235637
TI  - The older adult. A comparative assessment.
AB  - Thorough assessment of older men and women is a complex but vital part of their
      health care. The ability to differentiate the changes owing to normal aging from
      those resulting from pathologic processes is necessary if their lives are to be
      as productive and enjoyable as they are prolonged. Each body system and function
      must be examined or tested with this difference in mind. Because aging occurs in
      different individuals at differing rates, a variety of functions may all be
      considered healthy or normal. Assessment findings must be viewed through the
      focus of the individual person as well as that of the population. The nurse will
      find opportunities to use assessment skills for older adults in many settings,
      ranging from independent living arrangements to institutional residential areas.
      In the community, social meeting places, day-care facilities, meal sites, and
      shopping areas are but a few of the places where older adults may be found, alone
      or in groups. Assessment opportunities can be identified or structured in any
      milieu. The setting itself, as well as the needs of the older adult(s), will help
      to determine the complexity of the assessment activities. The benefit to nursing
      of increased and expanded ability to assess the older adult is considerable. The
      organized concern of science and health care with aging is a relatively recent
      phenomenon. The older adults of today are unique--there are more of them than
      ever before, and they are living longer. Although their lives are not without
      health complications, they are, in a sense, role models for the rest of us:
      pathfinders in aging who can, if we observe them carefully, give us insight and
      direction for our own healthy aging processes and those of generations to come.
      Nursing is uniquely poised to use our caring methodology with the older adult.
      The elderly are interested in their health and willingly cooperate with those
      whose assessments are knowledgeable and realistic. Nursing is challenged to
      develop and implement advanced and specialized ways to identify and meet their
      needs.

PMID- 2235638
TI  - Acute pain relief.
AB  - Pain is a multidimensional psychophysiologic phenomenon. Systematic
      multidimensional assessment is an essential first component of an effective plan
      to relieve the pain. Nurses are key to effective pain management because of the
      close, 24-hour-a-day relationship with the hospitalized patient. It is the nurse
      who is most critical to the adequate assessment of pain, to the implementation of
      the treatment plan, and to the evaluation of efficacy. Nurses should continue to
      develop a better knowledge base about pain and pain therapies and assessment
      skills, be assertive in obtaining effective treatment for their patients, and
      perceive themselves as responsible for pain relief.

PMID- 2235639
TI  - Chronic pain.
AB  - Understanding of the etiology of chronic pain is growing rapidly as researchers
      seek to integrate physiologic and psychosocial mechanisms. When nurses assess
      clients with chronic pain, they should make their assessments using both verbal
      and nonverbal methods and realize that no one instrument is comprehensive enough
      to be used alone. The key to successful treatment of these difficult clients lies
      in the use of a comprehensive approach that takes the client seriously and
      integrates both physiologic and psychosocial approaches.

PMID- 2235640
TI  - Pain in children.
AB  - The assessment and management of children's pain is a topic that has received a
      great deal of attention since the late 1970s. Nurse researchers have played a
      dominant role in all areas of pediatric pain relief and likely will continue to
      do so. There are currently a number of pediatric pain assessment instruments
      developed that are used in selected practice settings, but their use should be
      extended to document the existence of pediatric pain and its relief.
      Pharmacologic interventions for pediatric pain relief have been hampered by
      incorrect beliefs about analgesic risks, prescribing and administrating habits,
      and a virtual explosion of information in the area of analgesics. Although nurses
      have traditionally used nonpharmacologic interventions for pain relief, these
      methods have not been well researched. Continued research efforts in this
      important area will result in improved diagnosis and management of pediatric
      pain.

PMID- 2235641
TI  - Nausea, vomiting, and retching.
AB  - Although nausea, vomiting, and retching have plagued mankind since antiquity,
      limited attention has been given to the three symptoms as separate entities.
      Although knowledge of symptom occurrence is essential to practice, nurses must
      focus on patients' response or distress to the occurrence of symptoms. The
      differentiation of symptom occurrence and symptom distress of nausea, vomiting,
      and retching is critical to the management and self-care demands of patients and
      the enhancement of their quality of life. Basic research on patterns of these
      individual symptoms and their components promises to provide a more progressive
      and fruitful approach to the patient response to these symptoms.

PMID- 2235642
TI  - Diarrhea.
AB  - Diarrhea is one manifestation of GI disturbance. Symptoms may be acute if caused
      by such things as infections, drug reactions, alterations in diet, heavy metal
      poisoning, or fecal impaction. Chronic diarrhea is a symptom of GI diseases such
      as irritable bowel syndrome, lactase deficiency, cancer of the colon,
      inflammatory bowel disease, and malabsorption diseases. Chronic diarrhea may also
      be associated with GI surgery, radiation therapy, laxative abuse, alcohol abuse,
      and chemotherapeutic agents. When interventions are required to deal with
      diarrhea, they may include such things as alteration in tube feeding products and
      methods of administration, fluid replacement by oral rehydration procedures, a
      rapid return to feeding, and education aimed at the health information clients
      need to prevent or control the symptom of diarrhea.

PMID- 2235643
TI  - Confusion.
AB  - The term confusion describes a plethora of possible cognitive deficits and
      behavioral manifestations. A subjective assessment of confusion must be followed
      by an objective systematic evaluation to develop the cognitive-behavior profile.
      Because of age-associated physiologic and pathologic changes, elderly patients
      are at high risk for developing acute confusion. The management of confusion
      presents a challenge to nursing. Nursing can play a significant role in the
      prevention and the early detection of acute confusion. Preventing or identifying
      confusion early will decrease the physical and psychological stress of the
      patient as well as decrease the cost of hospitalization by shortening length of
      stay. Additional research is needed to determine the efficacy of present nursing
      activities and to identify new approaches for management.

PMID- 2235644
TI  - Urinary incontinence.
AB  - Symptoms of urinary incontinence are distressing and disruptive to everyday life.
      They can also be indicative of more serious underlying disorders. Many methods of
      symptom management are available. Matching the affected person to the most
      effective and appropriate treatment method is a significant challenge for
      nursing. Just as pressing is the need to develop and test a cogent conceptual
      model for symptom management that includes primary prevention.

PMID- 2235645
TI  - Stress and anxiety.
AB  - Anxiety is the psychophysiologic signal that the stress response has been
      initiated. The stress response's by-product, stress, is difficult to define. The
      response has multiple dimensions that have yielded research with many foci. Most
      salient to nursing are investigations of psychobiologic variables, the influence
      of life events, and the interactional model of the stress response. The stress
      response can be viewed as an interactional process that causes psychophysiologic
      reactions that are immediate and can occur up to and including physiologic events
      3 weeks after confrontation with the stressor. The literature suggests that
      neuroendocrine alterations in response to confrontation with a stressor may
      influence immunocompetence. Intervention and prevention studies of stress focus
      on pharmacotherapy, psychotherapy, behavioral techniques, personality
      engineering, relaxation training, and biofeedback. Nursing research on stress has
      proliferated in the 1980s. Implications for nursing intervention include coping
      strategies that fall into four categories: behavioral, physical, cognitive, and
      emotional.

PMID- 2235646
TI  - Psychologic and physiologic aspects of depression.
AB  - Depression is a serious condition that will be encountered by most nurses
      regardless of their specialty area or practice setting. There is good empirical
      support for biologic and psychologic models of depression. This article discusses
      how symptom management is enhanced through a combination of psychotherapeutic and
      somatic treatments.

PMID- 2235647
TI  - Dyspnea.
AB  - A multidimensional model of dyspnea that includes sensation, perception,
      distress, response, and reporting components is presented. Assessment tools
      currently available are evaluated as are recent research findings for
      pharmacologic, oxygen, physical, and psychologic treatments. This article
      concludes by suggesting a role for the nurse in dyspnea amelioration.

PMID- 2235648
TI  - Fatigue.
AB  - Fatigue is a pervasive, protective phenomenon affecting the totality of the
      individual. Assessment and management involve a wide range of activities to
      address the total human being's physical, psychological, cognitive, and spiritual
      dimensions. When elimination or neutralization of the effect of an antecedent
      condition is not an option, redesigning one's life-style may be the primary
      avenue of fatigue management. This protective mechanism, fatigue, may in fact
      herald the return of quality and purpose to one's life.

PMID- 2235649
TI  - Shivering. A clinical nursing problem.
AB  - Shivering is a common but complex phenomenon that occurs in many patient care
      situations. Its metabolic costs and cardiorespiratory consequences should not be
      underestimated, particularly for the seriously ill, debilitated, or elderly
      patient. Using a conceptual frame of reference for assessment and action,
      independent and collaborative actions can be planned to reduce the energy
      expenditure, distress, and loss of control imposed by severe shivering.

PMID- 2235650
TI  - Nurse, are you a healer?
AB  - The concept of "nurse as healer" is in itself vague and illusive. It is, however,
      a concept that is beginning to emerge in practice and in the literature. To begin
      to develop an understanding of "nurse as healer", the following questions are
      addressed: Are nurses identified as healers in the nursing literature? In today's
      world of nursing practice, do nurses consider themselves to be healers? What
      healing practices do nurses engage in?

PMID- 2235651
TI  - Nursing students with learning disabilities: guidelines for fostering success.
AB  - Learning disabilities can be devastating for the nursing student, interfering
      with academic performance and with success on the NCLEX-RN. Within the past five
      to ten years, college educators are seeing an increasing number of students with
      learning disabilities diagnosed in the 1970s, who are now ready for higher
      education. This phenomenon is becoming apparent as well in schools of nursing in
      the United States. This article describes the problem, gives characteristics by
      which the student with a learning disability can be identified, and suggests
      methods for assisting the student to achieve success in school and on the
      national licensing examination following graduation.

PMID- 2235652
TI  - The role of nursing in the influenza epidemic of 1918-1919.
AB  - Just as the horrors of World War I were winding down, millions of people were
      stricken by an influenza epidemic that displaced war as the tragic focus of
      everyday life. The disease was known as the Spanish influenza and was pandemic in
      scope. Since the epidemic defied the capabilities of prevailing medicine, good
      nursing care was the best predictor of outcome. Nurses came to the rescue by
      working long, hard and tirelessly. One important outcome of the epidemic was a
      general recognition of the visiting nurse service and all nursing as a valuable
      and essential community service.

PMID- 2235654
TI  - The "martial law" theory of nursing.

PMID- 2235653
TI  - Sophomore high school students' perceptions of ideal and nursing career choices.
AB  - To increase the number of practicing nurses, high school students must be
      attracted to nursing as a career. This study compares sophomore high school
      students' perceptions of an ideal career with their perceptions of nursing as a
      career. Differences are identified and potential recruitment solutions suggested.

PMID- 2235655
TI  - Concept analysis of decision making.
AB  - Concept analysis allows us to examine the attributes and characteristics of a
      concept. The concept of decision making is central to the practice of nursing.
      Decision making occurs at all levels of human thought and action, so it has been
      explored in many disciplines. It is important to explore this concept from the
      perspective of the discipline of nursing, so that we can determine how
      definitions and theories apply to our practice. Investigating a concept adopted
      from other disciplines will eventually provide the profession with a basis for
      knowledge development.

PMID- 2235656
TI  - [Round-table: fetal echocardiography and ethical problems].

PMID- 2235657
TI  - [How and why is the diagnostic approach to celiac disease changing].
AB  - The first classic description of celiac disease (CD) was published in 1888. The
      introduction in the clinical practice of the jejunal biopsy, in 1957, offered a
      powerful tool for a more objective approach to the disease. The correct
      diagnostic procedure for CD was finally established by a document of the European
      Society for Pediatric Gastro-enterology and Nutrition (ESPGAN) in 1970, and the
      ESPGAN suggestions were rapidly adopted by the scientific community. During these
      years, alternative and non-invasive diagnostic approaches were developed such as
      non-immunological (tests of intestinal absorption and permeability) and
      immunological (anti-reticulin, anti-endomysium and anti-gliadin antibodies, HLA
      antigens) tests. Due to the increased reliability of some of these laboratory
      investigations and to the increased knowledge about CD, it has been recently
      proposed that a simplification of the usual ESPGAN protocol should be eventually
      adopted in well defined subjects suspected to have CD.

PMID- 2235658
TI  - [Phagocytic function of PMN granulocytes in a pediatric population with recurrent
      respiratory infections].
AB  - We have studied the Phagocytosis at 32 children who had recurrent respiratory
      tract infection (RRI). We used a easy method (Phagolux). The seventy-five percent
      (24/32) of children had a Phagocytosis and/or Opsonisation Deficit during or
      following the acute respiratory tract infection. All children (except for one who
      had a C3-deficit) reached normal parameters after (or al least) fourty-five days.

PMID- 2235659
TI  - [Cardiac involvement in food allergy. Study of cardiac activity by Holter
      monitoring in 12 allergic children during food challenge].
AB  - The authors have based their study on recent research of cardiac anaphylaxis in
      vitro and studied the cardiac involvement in vivo, by Holter trace in a group of
      12 children with food allergy in basal period (food allergens exclusion) and
      during food allergens reintroduction. In the same time the involvement of
      respiratory apparatus was followed by RAW's insp.esp. study. The results showed
      contemporaneously at the RAW's rise a mean increase of cardiac frequency of
      slight moment when the frequency was computed during 24 h, but evident in
      challenge phase. The cardiac frequency study in "late" phase of reply at the food
      allergens challenge showed a heavy and significant increase of cardiac frequency
      and extrasystole.

PMID- 2235660
TI  - [Validity and limitations of respiratory physiotherapy in children].

PMID- 2235661
TI  - [Thrombopenic purpura following measles vaccination].
AB  - A case of acute thrombocytopenic purpura complicating live measles vaccination is
      reported. Clinically and morphologically this case is identical to the
      postinfectious thrombocytopenic purpura. An immunological mechanism has been
      postulated to explain the thrombocytopenia.

PMID- 2235662
TI  - [Guillain-Barre syndrome in childhood: epidemiology and clinical aspects].
AB  - From 1980 to 1988, 25 cases of S.G.B. were diagnosed in children of ages between
      2 and 12 years old at the Pediatric Clinic of Catania University. No seasonal or
      sexual prevalence was observed and only 5 children were less than 5 years old at
      the beginning of the disease. The diagnosis was based on 2 principal points: 1)
      pain at the inferior limbs with motor, sensitive and autonomous disturbances; 2)
      an increase of the globulins in the cerebrospinal liquid without a quantitative
      variation of the cells. The disease had a medium length of duration of 20 to 30
      days; only in 2 children respiratory assistance was necessary, because of an
      ascending paresis, which included the respiratory muscles, while in 2 other aged
      11 and 12 years old the disease presented itself as being diphasic with a short
      intermittent intervals, which made us think of a complete remission. In one of
      these 2 patients, the disease manifested itself in an unusual manner, hitting
      initially the muscles of the upper limbs, the III cranial nerve and with marked
      cephalgia. The E.M.G. taken on 7 children presented itself as being frankly
      neuropathic.

PMID- 2235663
TI  - [Clinical efficacy of sodium diclofenac in chronic juvenile polyarthritis].
AB  - We refer the results of an open non-comparative study aimed to evaluate the
      clinical efficacy of Diclofenac sodium in the treatment of Polyarticular Juvenile
      Chronic Arthritis. We decided to use this drug to investigate if it exerts also
      in younger patients the anti-inflammatory and analgesic effects known in adults.
      We treated 26 patients (14 girls and 12 boys) aged 2-16 years; the disease
      duration ranged between 3 months and 14 years. Treatment was started only if
      previous anti-inflammatory drugs had been considered ineffective after a
      prolonged use (3-12 months). None was on basic therapy. No wash-out period was
      used for ethical reasons. During the trial period other additional symptomatic or
      anti-inflammatory drugs were not used. Diclofenac sodium was given by tablets
      and/or suppositories at the mean daily dosage of 2.4 mg/kg (min. 0.3-max. 5,
      according to disease activity) for a period of 2-52 months. Diclofenac sodium was
      particularly effective on joint pain and morning stiffness but also on joint
      swelling, and functional capacity. We noticed a tendency of JRA to improve during
      the trial period. The drug was well tolerated; one patient stopped because of
      headache, another continued the treatment only per os because of intolerance of
      rectal administration.

PMID- 2235664
TI  - [Dominant polycystic kidney disease in children. Clinical aspects related to age
      and problems of early diagnosis].
AB  - Two cases of Dominant Polycystic Kidney Disease (DPKD) are reported in newborns
      of two different affected families. One of two infants was prenatally diagnosed
      by ultrasound, few cases of in utero diagnosis being previously reported. The two
      infants had different course: one had no symptoms (14 months now), on the
      contrary the other one had abdominal mass at birth and oliguria in the first 48
      hours, then acute pyelonephritis at 15 months. The increasing incidence of DPKD
      diagnosed in infants and children by US screening in risk subjects is stressed
      and importance of precocious diagnosis for genetic counselling emphasized.

PMID- 2235665
TI  - [Primary intestinal lymphangiectasis. A case treated surgically].
AB  - The authors describe a rare case of primary intestinal lymphangiectasis resolved
      with surgical treatment. Usually the natural course of the disease is relatively
      mild and medical nutritional treatment can be sufficient. In this case the
      lymphatic intestinal anomaly was generalized to the entire small intestine but a
      distal ileal segment was particularly involved. The surgical resection of this
      intestinal tract resolved the symptomatology.

PMID- 2235666
TI  - [Sympathetic reflex dystrophy. Description of a pediatric case].
AB  - Reflex sympathetic dystrophy is a well known syndrome in adults, but often
      misdiagnosed in children. We describe a case occurred in a 12 years old girl.
      Psychological factors played a major role in the mechanism of the disease. Early
      recognition and prompt management allow complete recovery without sequelae.

PMID- 2235667
TI  - [Extrapyramidal syndrome caused by moderate overdosage of domperidone.
      Description of a case].
AB  - Domperidone is useful in the treatment of vomiting and gastroesophageal reflux in
      children. Its efficaciousness is due to the antagonist effect on gastrointestinal
      dopaminergic receptors. Contrary to the initial expectations, domperidone is able
      to penetrate into the hematoencephalic barrier and to cause adverse neurologic
      reactions. We report a case of extrapyramidal reaction in a child after moderate
      overdosage of domperidone.

PMID- 2235668
TI  - Pharmacokinetics and pharmacodynamics of anticancer agents: contributions to the
      therapy of childhood cancer.
AB  - Strategies for treating pediatric malignancies have not only been successful
      (i.e., curative) for several disseminated childhood cancers, they have also
      served as paradigms for the therapy of many adult cancers. Initial strategies
      included combined treatment modalities (chemotherapy, surgery, radiotherapy) and
      combinations of different pharmacologic classes of anticancer drugs given in the
      appropriate schedules. Despite the currently successful therapy for some
      malignancies (e.g., 70% 4-year disease-free survival in acute lymphocytic
      leukemia), many children die without known reason. Recent advances in the
      clinical pharmacology of anticancer drugs have identified relationships between
      dose intensity and response (efficacy, toxicity). Traditional methods of
      measuring dose intensity (prescribed dose) have evolved to more sophisticated
      approaches in maximizing the intensity of treatment, with good response rates.
      Other methods of optimizing chemotherapy for individual patients include bone
      marrow support procedures and therapy with biologic response modifiers.
      Relatively few clinically useful new anticancer drugs have been discovered in the
      past several years. Fortunately, the potential to improve therapy with currently
      available agents has come about through enhanced knowledge of the biochemical and
      clinical pharmacology of anticancer drugs and biologic response modifiers, as
      well as improved understanding drug resistance biology.

PMID- 2235669
TI  - Renal dysfunction associated with ciprofloxacin.
AB  - We cared for a 64-year-old woman who experienced increased serum creatinine
      levels after 8 days of ciprofloxacin therapy. She had previously received a
      course of several antibiotics, including gentamicin. Renal function returned to
      normal 18 days after the ciprofloxacin was discontinued. This is the eighth
      reported case of nephrotoxicity associated with this agent. The mechanism and
      predisposing factors have not been defined.

PMID- 2235670
TI  - Prospective surveillance of intravenous amphotericin B use patterns.
AB  - Information on amphotericin B use patterns and infusion-related adverse events
      were prospectively collected from 397 hospitalized adults. The methods of
      initiating amphotericin B varied greatly, with the majority of patients being
      gradually titrated to a full maintenance dose over 1-5 days. Overall, 71% of
      patients experienced at least one episode of an infusion-related adverse event
      (IRAE) during the first week of therapy. Fever and chills were most commonly
      observed, with peak frequency on days 1-3, followed by a subsequent decline. A
      wide variety of pretreatment medications were used to minimize IRAE; the most
      common regimens included some combination of diphenhydramine, acetaminophen, and
      corticosteroids, with or without heparin. The majority of patients (84.7%)
      received a test dose, and although none experienced a severe allergic reaction,
      one patient subsequently had an anaphylactic episode on the third day of
      amphotericin B therapy. The use of a test dose and the titration process are
      attempts to avoid the IRAE frequency associated with large initial doses of
      amphotericin B, but we observed that they provided little or no benefit. In
      addition, our study suggests that pretreatment regimens are frequently used in
      conjunction with the test dose. If the intent of the test dose is to identify
      patients sensitive to amphotericin B, pretreatment drugs may minimize these
      adverse events and prevent a complete evaluation of response to the test dose.

PMID- 2235671
TI  - Pharmacokinetics and pharmacodynamics of heparin during hemodialysis:
      interpatient and intrapatient variability.
AB  - Heparin pharmacokinetics and pharmacodynamics were studied in 17 patients
      undergoing hemodialysis, once a week for 4 weeks in order to evaluate
      intrapatient variability over time. A single bolus injection of heparin was
      administered directly into the circulation immediately prior to the start of
      hemodialysis in doses ranging from 3000 to 12,000 U. Blood samples were obtained
      to determine activated coagulation times (ACT) and heparin concentrations (HC).
      Combined zero- and first-order elimination was seen in each of the 4 weeks. The
      half-life of heparin decreased from beginning to end of hemodialysis during each
      week, with the percentage of decrease from the start of dialysis ranging from 70
      74%, indicating concentration-dependent elimination. Since the zero-order
      component did not appear to be clinically significant, first-order elimination
      was assumed. A linear decline in ACT over the time of the dialysis period was
      also seen during each week. A profile of ACT versus HC was generated for each
      patient as well as for the mean data to assess the relationship of HC to
      response. An excellent correlation was found for both individual patient data and
      mean data. In the third week the patients were randomized to receive standard
      treatment or an individualized dose. They were then crossed over to the opposite
      group in the fourth week to see if this relationship between ACT and HC would be
      useful in predicting heparin dose. These profiles were used to individualize the
      dose during either the third or fourth week of the study. No significant
      differences were noted between actual and predicted ACT. A significant degree of
      interpatient variability was demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235672
TI  - Effect of glycated albumin on phenytoin binding in elderly patients with type II
      diabetes mellitus.
AB  - We evaluated the effect of glycated albumin on phenytoin protein binding in 36
      elderly (age range 63-94 yrs) patients with type II diabetes mellitus (DM) under
      diet management. Serum was spiked with 15 mg/L phenytoin and incubated. A serum
      ultrafiltrate was obtained from each sample for determining total and free
      phenytoin concentrations. Glycated hemoglobin was determined by boronate-affinity
      chromatography, and glycated albumin was separated from nonglycated fractions
      with boronate-agarose gel. Glycated hemoglobin in the study group ranged from 4.3
      14.6% (mean 7.8 +/- SD 2.1%) and glycated albumin ranged from 3.7-12.5% (7.4 +/-
      SD 2.6%). We observed no correlation between glycated albumin and the percentage
      of free phenytoin (r2 = -0.14; p = 0.419). The concentration of nonglycated
      albumin ranged from 0.66-4.28 g/dl (mean 3.45 +/- 0.67 g/dl) and was calculated
      from measured total and glycated albumin concentrations. A correlation between
      the free fraction of phenytoin and nonglycated albumin was not demonstrated (r2 =
      0.22, p = 0.22). In addition, a correlation was not observed between total
      glycated albumin and the free fraction of phenytoin (r2 = -0.095; p = 0.58). We
      conclude that elderly patients with type II DM under diet control do not have
      significant alterations in phenytoin protein binding. The use of total serum
      phenytoin levels therefore appears appropriate for determining phenytoin dosages
      in elderly patients with well controlled type II DM.

PMID- 2235673
TI  - The osteogenic stimulating effect of neuroactive calcitonin gene-related peptide.
AB  - Silverman and Kruger (Somatosens. Res. 5(2):157-175; 1987) reported that sensory
      nerve fibers of the dental pulp secrete calcitonin gene-related peptide (CGRP).
      These are localized exactly where secondary or tertiary dentin calcification
      occurs. Recently we found that CGRP has an osteogenic stimulating effect by
      increasing the number and size of bone colonies in vitro. The purpose of this
      study is to test whether there is a relationship between the effects of different
      doses of CGRP and bone colony numbers and/or size. Rat CGRP in different dosages
      (0.4, 4 and 40 micrograms/ml in BGJb medium) was added daily to 3 million light
      density (LD) bone marrow white cells which were harvested from adult Sprague
      Dawley rats with the Ficoll-Paque density gradient separation method, then seeded
      onto a previously prepared feeder layer of fibroblasts in Petri dishes. Seven
      days after adding CGRP, in the controls without CGRP there were 2 bone colonies;
      with 0.4 microgram of CGRP there were 4 colonies; with 4 micrograms of CGRP there
      were 6 colonies; with 40 micrograms there were 9 colonies, indicating there was a
      significant increase in number of bone colonies with an increase in dose of CGRP
      between individual groups, respectively (p less than 0.0005 and p less than
      0.0001). In another experiment, intravenous injection of 10 micrograms of
      rCGRP/kg body weight was performed two hours before surgery. LD bone marrow white
      cells were collected and seeded onto a feeder layer in Petri dishes exactly as
      described above.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235674
TI  - Cysteinyl methyl ester of AVP(4-8), a potent agonist on the maintenance of
      passive avoidance in rats.
AB  - A series of short AVP analogs with D- or L-arginine forming the C-terminal was
      synthesized, and their peripheral effects, i.e., vasoconstrictor and antidiuretic
      activities, and behavioral effects in enhancing retention in passive avoidance in
      rats were evaluated. We found that: 1) AVP(4-8) and its cysteinyl methyl ester
      were more potent in the behavioral response than its D-Arg homologs; 2) the
      methyl ester derivative was the most effective analog in this behavioral test
      among the peptides we synthesized, with a potency 40 times as high as AVP; 3)
      neither the D- nor the L-Arg short derivatives of AVP showed any peripheral
      effects up to a dose thousands of times greater than AVP. The results support the
      contention that arginine in the short analogs plays an important role in their
      behavioral response associated with a relatively steady peptide conformation.

PMID- 2235675
TI  - Effect of avian neurotensin on motility of chicken (Gallus domesticus) lower gut
      in vivo and in vitro.
AB  - Mammalian neurotensin, originally isolated from bovine hypothalamus, differs from
      avian neurotensin (aNT) by 6 amino acid residues. Bovine neurotensin has been
      shown to affect motility of chicken crop and rectum and secretion of chicken
      ileum, but there have been no studies of the effects of aNT on avian intestinal
      function. This study was designed to characterize the effects of aNT on the
      motility of the chicken lower gut. Strain gauge transducers were used in vivo to
      measure contractions of chicken distal ileum, cecum, and distal colon in response
      to 30-min infusions of aNT at rates of 15, 30, 60 or 600 pmol.kg-1.min-1. In
      vitro experiments were conducted using segments of distal ileum, cecum or distal
      colon, stripped of mucosa, cut in either the longitudinal or circular plane, and
      suspended isometrically in isolated organ tissue baths at a resting tension of 1
      g. Avian neurotensin, substance P (SP), or carbamylcholine (CCH) were
      administered to the bath and the tension generated by each tissue was recorded
      via a force transducer. A relaxation of chicken ileum was observed in response to
      aNT infusion in vivo. Except for stimulation of excretation, colon and cecum were
      not affected by aNT infusion. Both aNT and SP stimulated motility of chicken
      ileum and cecum in vitro. SP had no consistent effect on colon and aNT only
      increased contractile force of colon circular muscle. It was concluded that both
      aNT and SP may have a role in the regulation of lower gut motility in avian
      species.

PMID- 2235676
TI  - Salmon pancreatic polypeptide exhibits neuropeptide Y-like activities in rats.
AB  - Salmon pancreatic polypeptide (sPP) is a 36 residue peptide amide isolated from
      salmon pancreas. It has 83% sequence identity with porcine neuropeptide Y (NPY).
      To confirm the sequence and obtain sufficient quantity of peptide for biological
      investigations, sPP was synthesized by automated t-Boc solid phase synthesis. The
      purified product had the expected amino acid composition, primary structure and
      mass, and was chemically and biologically indistinguishable from natural sPP.
      Investigation of its biological properties revealed that, like NPY, sPP increased
      blood pressure and decreased heart rate in anesthetized rats in a dose-dependent
      manner. There was no significant difference in the responses of NPY and sPP.
      Furthermore, administration of sPP directly into the hypothalamus of rats induced
      a feeding response comparable to that induced by NPY. Based on these
      investigations it may be suggested that synthetic and natural sPP are identical,
      and that sPP can express NPY-like activities in mammals presumably by interacting
      with the receptors of NPY.

PMID- 2235677
TI  - Synthetic domains of cystatins linked to enkephalins are novel inhibitors of
      brain cathepsins L/B.
AB  - Cystatin domains or homologous sequences were synthesized and tested as
      inhibitors of papain, and rat brain cathepsins B and L. These domains included:
      I, an enzyme substrate binding site containing a -GG- cleavage site (YGGFL); II,
      known cystatin consensus sequences (-QVVAG- or -QLVSG-); and III, the proposed
      ancillary site for binding of chicken cystatin to papain (-IPWLN-). A Domain II
      analog QVVAG(K-NH2) inhibited cathepsin L and papain with Ki 1-4 X 10(-4) M but
      was inactive towards cathepsin B. A peptide containing Domains I and II, YGGFL
      QVVAG(K-NH2), inhibited papain and cathepsin B with Ki 10(-4)-10(-5) M, and
      cathepsin L with Ki 10(-6) M. The presence of Domain III in the analog YGGFL
      QVVAG-IPWLN(K-NH2) resulted in a 10-fold increase in potency towards papain.
      These data demonstrated that putative cystatin domains are: 1) probably proximal
      in the intact cystatins; 2) can be linked directly to each other to yield smaller
      peptides active as inhibitors; 3) showed some specificity towards the three
      cysteine proteinases.

PMID- 2235678
TI  - Purification of peptide hormones from chinchilla pancreas by chemical assay.
AB  - Glucagon was purified from chinchilla pancreas and its biological activity
      determined. It was isolated using a chemical assay to identify peptides with a
      histidyl residue at the N-terminus. Chinchilla glucagon has the amino acid
      sequence HSQGTFTSDYSKHLDSRYAQEFVQWLMNT. It differs from the usual mammalian
      glucagon by amino acid substitutions at positions 13, 18 and 21 from the N
      terminus. Despite these sequence changes, its biological activity is conserved.
      Chinchilla glucagon has approximately the same potency as pig glucagon in
      stimulating liver membrane adenyl cyclase activity. Pancreatic polypeptide was
      also purified from chinchilla pancreas based on its Ala1 signal and has the
      sequence APLEPVYPGDNATPEQMAQYAAEMRRYINMLTRPRY#.

PMID- 2235679
TI  - Enkephalins interfere with early phases of voluntary ethanol drinking.
AB  - The relationship between the opiate peptides Leu-enkephalin and [D-Ala2
      Met5]enkephalinamide (DAME) and the initial expression and maintenance of ethanol
      preference was studied in male Wistar rats. Subcutaneous administration of both
      peptides prior to the first choice test between water and ethanol induced
      reductions on ethanol intake and subsequently on total fluid intake. Leu
      enkephalin treatment also diminished ethanol preference in the day of treatment
      and in consecutive days. Neither Leu-enkephalin nor DAME treatments modified rats
      sucrose preference or intake. The results suggest that the enkephalins studied,
      when administered in the early phases of ethanol preference, interfere with the
      mechanisms involved in the propensity to drink ethanol.

PMID- 2235680
TI  - Isolation and primary structure of VIP from sheep brain.
AB  - The amino acid sequence of the vasoactive intestinal polypeptide (VIP) is well
      conserved between species. Thus, all mammalian VIPs isolated so far, except that
      of the guinea pig, have the same amino acid sequence. This study describes the
      isolation and primary structure of sheep brain VIP. The purification was followed
      with a bioassay and a VIP receptor assay. The amino acid sequence of the isolated
      sheep VIP is identical to that of the pig, human, ox, rat, rabbit, goat and dog
      VIP.

PMID- 2235681
TI  - Isolation and sequence of canine xenopsin and an extended fragment from its
      precursor.
AB  - Canine xenopsin and a 27 residue segment of its precursor immediately surrounding
      the xenopsin moiety were isolated from acidic extracts of stomach. The six C
      terminal residues of canine xenopsin, H-Phe-His-Pro-Lys-Arg-Pro-Trp-Ile-Leu-OH,
      were identical to those in Xenopus xenopsin less than Glu-Gly-Lys-Arg-Pro-Trp-Ile
      Leu-OH. The amino acid sequence determined for the segment of the precursor was
      similar to the corresponding region of Xenopus pro-xenopsin (approximately 33%
      homology) and to the related Xenopus precursors, pro-levitide, pro-PGLa, pro
      magainin and pro-caerulein. These results, indicating evolutionary conservation
      of xenopsin and a portion of its precursor, suggest that this peptide has
      important biologic function(s).

PMID- 2235682
TI  - Endothelin-1 acutely stimulates the secretory activity of rat zona glomerulosa
      cells.
AB  - A bolus IV injection of endothelin-1 (ET-1) (0.5 microgram.kg-1) decreased PRA,
      without affecting plasma aldosterone (A) concentration. ET-1 exerted a dose
      dependent stimulation of basal secretion of A and corticosterone (B) by dispersed
      zona glomerulosa (ZG) cells, while it did not affect B production by inner
      adrenocortical cells. ET-1 notably enhanced the secretory response of dispersed
      ZG cells to a maximal effective concentration of ACTH, but not of either
      angiotensin II (ANG-II) or potassium. The conclusion is drawn that ET-1 acutely
      stimulates ZG in rats, by a mechanism probably similar to that underlying the
      adrenoglomerulotropic actions of ANG-II and potassium.

PMID- 2235683
TI  - Further observations on the mechanism of the cardiovascular reflexes caused by
      exposure of the peritoneum to neurotensin.
AB  - Intraperitoneal (IP) injections of either 1, 3 or 9 ml of neurotensin-containing
      solutions (NTCS) with 5.4, 54, 540 or 5400 nM of neurotensin (NT) were found to
      cause concentration-dependent, but volume-independent, increases of blood
      pressure (BP) and heart rate (HR) in anesthetized, close-abdomen guinea pigs. The
      duration of both effects varied between 15 to 30 min depending both on the NT
      concentration and volume of NTCS utilized. Indirect evidence suggested that NT
      inactivation within the peritoneal cavity contributed to shorten the duration of
      NT effects. Animal pretreatment with a ganglion blocker, adrenoceptor
      antagonists, clonidine or capsaicin, reduced the BP and HR increases caused by IP
      injection of NTCS whereas both effects were either unaffected or slightly
      potentiated by animal pretreatment with atropine, morphine or captopril. Addition
      of a local anesthetic to NTCS inhibited the hemodynamic effects of NT whereas
      acute bilateral cervical vagotomy was without significant effect. These results
      suggest that NT has the ability to trigger cardiovascular reflexes following its
      IP injection in guinea pigs. The activation of peritoneal, sympathetic, capsaicin
      sensitive primary afferents appears to be at the basis of these reflexes, the
      amplitudes of which seem poorly related to the volume of NTCS utilized (at least
      within the range of volume examined).

PMID- 2235684
TI  - A new peptide in the FMRFamide family isolated from the CNS of the hawkmoth,
      Manduca sexta.
AB  - We have purified a FMRFamide-like peptide from extracts of brain-subesophageal
      ganglion of the moth, Manduca sexta. The purification was monitored with a new,
      competitive ELISA, and accomplished with ion exchange and reverse-phase HPLC. The
      peptide structure was determined by a combination of tandem mass spectrometry and
      automated Edman degradation. The amino acid sequence of the peptide is less than
      Glu-Asp-Val-Val-His-Ser-Phe-Leu-Arg-Phe-amide (pEDVVHSFLRF-NH2). In a separate
      purification, an identical peptide was isolated from extracts of brain-associated
      neurohemal structures. We have named this peptide ManducaFLRFamide, to indicate
      its homology with other members of the "FMRFamide" family. In bioassays,
      chemically synthesized peptide increased the force of neurally evoked
      contractions in the major power-producing flight muscles, the dorsal longitudinal
      muscles. This observation suggests that hormonally released ManducaFLRFamide may
      play a role in sustaining or promoting the flight behavior necessary for mate
      seeking (in males) or oviposition (in females) in sphingid moths.

PMID- 2235685
TI  - Peptidergic innervation of the major salivary glands of the ferret.
AB  - In parotid, sublingual and submandibular glands of the ferret, morphological
      correlates were looked for, using immunocytochemistry, to previous physiological
      findings showing parasympathetic "atropine-resistant" salivary secretion and
      neuropeptide-evoked salivation in this species. Nerve fibers storing VIP were
      numerous in association with acini, ducts and blood vessels, while the number of
      fibers storing substance P was moderate and those containing CGRP and galanin
      few; also the number of NPY-containing fibers was low around acini and ducts but
      relatively high around vessels. Sympathectomy eliminated all NPY- and almost all
      dopamine beta-hydroxylase-containing fibers. Parasympathectomy of the parotid
      gland resulted in a total loss of the VIP-containing fibers, and a profound
      reduction in the number of substance P- and CGRP-containing fibers.

PMID- 2235687
TI  - Adolescence: psychopathology, normality, and creativity.

PMID- 2235686
TI  - Somatostatin inhibits neutrophil elastase release in vitro.
AB  - The influence of the long-acting somatostatin analogue, SMS 201-995, on FMLP
      induced neutrophil elastase release in vitro has been investigated. Doses from
      150 ng/ml upwards inhibited elastase release, with 100% inhibition by 2500 ng/ml.
      Inhibition was demonstrated both by an assay measuring elastase immunometrically
      and by an assay based on its enzyme activity. The demonstration that SMS 201-995
      inhibits protease release from polymorphonuclear leukocytes may have implications
      for the long-term clinical use of this somatostatin analogue.

PMID- 2235688
TI  - Normality and adolescence.
AB  - Diagnostic work with adolescents has always been difficult. The problem is to
      distinguish serious psychopathology from mild crisis. We can now say, however,
      that a severe identity crisis and emotional turmoil are just not part of normal
      growing up. Our belief is that we do not help adolescents who experience such
      crises or turmoil when we tell them not to worry about their problems because
      they are a normal part of adolescence and because they will "grow out of it." In
      summary, we have presented data on the self-image of a large number of
      adolescents. We have stressed three things. First, we used self-administered
      questionnaires to collect our data. Most important, our data are consistent, and
      they are congruent with results obtained from use of other psychologic
      instruments such as interviews or parents' evaluations of their children. Second,
      we found that the normal groups of adolescents we studied were characterized more
      by their similarities than by their differences. The continuity of values for all
      our samples over an 18-year period and across cultures was especially impressive.
      Third, we stressed the diversity of adolescents' view of their psychologic
      worlds. These youths define normal functioning and development. They reside in
      our communities, and before we can help their disturbed peers who need
      professional help, we need to know what the norm is. Only then can we correctly
      diagnose and successfully treat the adolescents who do seek our help.

PMID- 2235689
TI  - Personality status: changes through adolescence.
AB  - 1. Forty-two percent of a nonclinical sample of urban 18 year olds displayed some
      degree of personality dysfunction. This rate of disturbance is similar to a
      previously reported rate for 13 year olds, but higher than the prevalence rate
      for 16 year olds. Thus, early and late adolescence seem to represent "at risk
      periods" for the genesis of character pathology. 2. In late adolescence, the form
      of this disturbance is as follows: 40% fall into a histrionic, borderline,
      narcissistic cluster, whereas nearly 30% demonstrate an atypical or mixed
      picture. This differs markedly from the distribution of dysfunction in earlier
      subphases. 3. Thirty-eight percent of the disturbed sample showed evidence of
      dysfunction at all three subphases (early, middle, and late), whereas 62%
      fluctuated in or out of disturbance at one subphase or another. 4. There was a
      notable lack of consistency with respect to type of personality dysfunction from
      both a group and individual perspective, except for paranoid, schizoid, and
      schizotypal disturbance. This particular cluster retained both group and
      individual stability from age 13 to 18. 5. Two trends were evident however:
      teenagers who initially presented as avoidant, dependent, compulsive, or passive
      aggressive seemed to grow out of their dysfunction. By age 18, hardly any of the
      original subjects remained in this cluster, and most had become clear. Secondly,
      most of the adolescents identified as antisocial in early or middle adolescence
      migrated into the histrionic, narcissistic, borderline cluster in late
      adolescence. This latter group showed a steady increase throughout the time span
      studied, suggesting the importance of developmental factors.

PMID- 2235690
TI  - Psychosis and adolescence. The relation of intrapsychic structure formation and
      change to action and task.
AB  - This article is an exploration of intrapsychic structure formation and change
      from the point of view of a psychoanalytic concept of action. It compares the
      normal development of intrapsychic structure with that involved in psychotic
      disorganization as individuals encounter adolescence and its developmental tasks
      and requirements for action. The flexible complexity of intrapsychic structure
      and available action in a normally developing adolescent and the contrasting
      fixed simplicity of intrapsychic structure and its repertory of action in
      psychotic patients are highlighted. Four different environmental life occasions,
      all of which are associated with intrapsychic change, are examined against this
      background. The first of these involves little initial action on the part of the
      ego, although lasting change does occur. The last three involve both inner and
      outer developmental actions that can be central to growth and may be the occasion
      of psychosis. The first environmental life occasion is "trauma," in which the
      person's action, potentialities, and intrapsychic structure are disrupted by the
      world's destructive action and are thereby changed. The second is "intimacy," in
      which newly evolved actions and interaction are sought, often with little regard
      for or knowledge of the accompanying necessities of intrapsychic change. In the
      third --"success"--new intrapsychic change and altered necessities of action can
      surprisingly affect both the sense of continuity within one's inner world and the
      nature of one's relationship to the action of the outer world. The fourth
      occasion is "analytic" therapy, in which the regularities of one's intrapsychic
      structure and its stereotypies of action are often disrupted by the very
      "therapeutic" processes that allow these to be observed and examined in the
      course of promoting progressive development. All of these exciting and dangerous
      occasions mark out a separate, autonomous, individual, chosen act. The attempt to
      explicate the role of action in intrapsychic structural change during analytic
      work with a psychotic patient defines the analyst's actions as interferences and
      disruptions of that inner structure. His actions are noted, felt, represented,
      and organized into a part of that reformed, newly organized inner structure.
      Those analytic actions are represented by the patient as "having an impact" upon
      the patient and do indeed affect the patient. In that regard it is asserted that
      for a full, psychoanalytic conception of the ego, what is required is not only a
      central "body ego," but the integration of action in the formation and function
      of that ego's intrapsychic structure--an "action ego." Clarification of the
      complex relationship of conceptions of "fantasy" and action are re-examined in
      this context.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2235691
TI  - Creativity in adolescence.
AB  - Findings from an empirical research project on creativity, including controlled
      experimental assessment, indicate that the development of creative capacity
      occurs primarily during the adolescent period. Defined as the production of
      entities that are both new and valuable, creativity necessarily involves two
      specific types of cognition designated as the janusian and homospatial processes.
      Although there are precursors to the development of creativity during earlier
      childhood, both the motivation and the capacity to create appear first in the
      adolescent period. Important motivational factors derive from adolescent
      conflicts and developmental tasks such as the impetus to solve and consolidate
      issues relating to identity, the return of oedipal conflicts, and the pressures
      toward autonomy and independence. Engaging in creative types of fields and
      outlets helps generally to establish coherent identity during adolescence and
      beyond; the beginnings of a specific creative identity in adolescence are a
      necessary foundation for creative motivation and ability to create throughout
      life. The return of the oedipal conflict at the onset of puberty motivates the
      dual compliance and competition of the creatively disposed adolescent with his or
      her same-sex parent. The pressures toward autonomy and independence provide the
      motivational and affective substrate for the development of the homospatial and
      janusian processes. The homospatial process arises from the vacillating and
      concomitant experiences of autonomy (or separation) and connectedness. In the
      creatively disposed adolescent, one who activates and uses cognition to express
      and explore affect, the creative aspect of those experiences begins to be
      manifested in the concomitant cognitive separation and connection involved in
      superimposition of mental images. The janusian process arises from the
      experiences of rebellious oppositionality and intense emotional ambivalence. The
      creative cognitive aspect of these experiences is manifested in conscious
      conceptualization and use of simultaneous antitheses and oppositions. The use of
      simultaneous opposition in the janusian process at any age necessarily involves
      the capacity to grasp and manipulate abstract relations. Evidence for the first
      development of this capacity in adolescence comes from the research on formal
      operations reasoning and on understanding of the null class. Regarding the onset
      near that age period of capacity to use and comprehend the relational nature of
      opposition, supporting evidence derives from experimental data on the syntagmatic
      paradigmatic shift. With regard to the homospatial process, which is largely
      responsible for the creation of effective metaphors, both the late appearance of
      class inclusion behavior and the inability of younger children to comprehend and
      use relational metaphors preclude a preadolescent onset of this creative
      capacity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2235692
TI  - The drug abusing adolescent: clinical issues.
AB  - Clinical intervention with adolescent substance abusers is a complex issue.
      Disputes remain regarding the precise nature of the disorder. Treatment of the
      adolescent is complicated by the normal development tasks of this age,
      particularly denial of possible consequences and adoption of attendant risk
      taking behaviors. Treatment begins with a complete drug history and must not
      neglect the adolescent's family and other support system. The mental health
      professional, especially the psychiatrist, can make a unique contribution in this
      area, despite the "bad press" he has so often received by the rest of the
      (treatment) community.

PMID- 2235693
TI  - Feeling states during adolescence.
AB  - Adolescence is characterized by a wide variety of feeling states with certain
      stages in adolescence being associated with particularly strong affects, a result
      of the normative developmental process. Affective psychopathology during the
      adolescent years, particularly in the disorders of depression and
      mania/hypomania, is characterized by abnormalities in the quality and quantity of
      affective patterns and additionally by the appearance of feeling states, which
      may be historically uncharacteristic for the teen (i.e., out of keeping with his
      previous longitudinal pattern of personality development). Clinicians faced with
      assessing disturbances in feeling states during the adolescent years must
      carefully distinguish fluctuating developmental problems from clinical syndromes.
      A longitudinal assessment period is usually necessary before this distinction can
      be made with some certainty. The prescription of treatment, be it psychologic,
      biologic, or systems based, should await the completion of a careful clinical
      assessment prior to its institution.

PMID- 2235694
TI  - Adolescent problem behaviors: the influence of attachment and autonomy.
AB  - This article reviews current literature on adolescent problem behaviors and
      suggests that a model based on attachment theory and theories of adolescent
      autonomy and relatedness can help explain the development of these behaviors.
      When adolescents hold models of relationships with parents that are characterized
      by anger and insecurity and face increased pressures to seek autonomy, a high
      risk of problem behaviors ensues. Treatment implications flowing from this model
      are discussed.

PMID- 2235695
TI  - Adolescence and eating disorder: the obsessive-compulsive syndrome.
AB  - Although it is widely recognized that eating disorders primarily begin during the
      adolescent period, the centrality of obsessive-compulsive symptomatology and
      dynamisms and their relationship to adolescent conflict and development has not
      been generally accepted or understood. Social pressures toward conformity with
      the ideal of feminine thinness, which are especially influential during the
      adolescent period, combine with obsessive-compulsive predispositions to produce
      eating disorder symptoms and patterns of behavior. Obsessive preoccupation with
      images of food as well as ruminative calorie counting, and ritualistic behavior
      regarding food, use of laxatives, and vomiting, together with an underlying focus
      on control, undoing and other obsessive-compulsive defenses, and a sado
      masochistic orientation to the body all point to an essential obsessive
      compulsive disorder. The presence of dysphoric affect and the erratic success of
      antidepressant medication with eating disorder patients has led to a belief in an
      underlying affective disorder. However, careful assessment of eleven studies
      presenting differential diagnostic data regarding anorexia nervosa reveals that
      noneating related obsessive-compulsive patterns and symptoms are second overall
      in incidence to depressive patterns and symptoms. With critical re-evaluation of
      data presented, the obsessive-compulsive condition equals or supersedes the
      depressive one in many samples. Moreover, given the intense achievement
      orientation of persons with obsessive-compulsive illness, along with other
      psychodynamic factors, depressive symptoms could well be considered a secondary
      breakdown effect. If the all-pervasive obsessive-compulsive nature of eating
      related symptomatology discussed here is taken into consideration, depressive
      symptoms must be considered either secondary or incidental. As patients with
      eating disorders are notoriously secretive and oftentimes misleading about their
      symptoms and themselves, a diagnostic assessment of such patients in intensive
      treatment at a long-term hospital facility was carried out. Compared with a
      control group randomly selected from the remainder of the hospital patient
      population, obsessive-compulsive manifestations of rumination, ritualistic
      behavior, excessive cleanliness, excessive orderliness, perfectionism,
      miserliness, rigidity, and scrupulousness and self-righteousness were all
      significantly associated with the eating disorder patient group. The current
      eating disorder picture, therefore, appears to be a modern form of obsessive
      compulsive illness beginning during the adolescent period.

PMID- 2235697
TI  - Youth suicide: risk factors, assessment, and treatment of adolescent and young
      adult suicidal patients.
AB  - One of the most difficult clinical problems facing the mental health professional
      is the prediction and prevention of youth suicide. Suicide is currently the third
      leading cause of death for young people, ages 15 to 24, in the United States.
      This article presents several models for understanding youth suicidal behavior
      including psychologic, sociologic, and biomedical explanations. It summarize what
      is known about risk factors for adolescent and young adult suicide, including
      psychiatric diagnosis, personality traits, psychosocial factors, associated
      medical illnesses, biologic correlates, and family history and genetics.
      Knowledge about these risk factors will be translated into practical
      considerations for the treatment of adolescent and young adult suicidal patterns,
      including psychotherapeutic, psychopharmacologic, and environmental
      interventions.

PMID- 2235696
TI  - Paths of adolescent ego development: links with family life and individual
      adjustment.
AB  - In broad strokes, we have reviewed family contexts and adjustment of adolescent
      ego development. We concluded with group portraits, the salient family and
      individual characteristics of adolescents who followed six paths of ego
      development. There are strong differences in development--the profound arrests
      and the dramatic progressions. Although these composite pictures provide us with
      clearer ideas about each of the paths, we do not yet have a detailed
      understanding of how adolescents following the varied paths experience the world
      and relate in their families. Certain questions can only be pursued with this
      information. For instance, are there ways that parents of the steady conformist
      adolescents speak and behave that restrain their sons' and daughters' separation
      from the family? Or do the profoundly arrested teenagers provoke their parents to
      be less encouraging of their differences from other family members? These
      questions, touching on complex interactions flowing between parents and
      adolescents, require a closer look inside the families of teenagers following
      these paths of arrest and advance. In a work soon to be published, we listen
      closely to the voices of 13 adolescents and their parents, in solo and while
      together as a family. These narratives convey the message that paths of
      individual development are embedded within the intricate matrix of family
      relationships. The teenagers and their families closely and often poignantly
      illustrate the ways in which adolescents and parents handle the central dilemma
      posed during this phase of the life cycle: how to separate from the family and
      reaffirm one's place within it.

PMID- 2235698
TI  - Psychopathology, normality, and creativity in adolescence.

PMID- 2235699
TI  - [Neonatal complications in infants born to mothers with diabetes mellitus].
AB  - Health status of 53 babies delivered by diabetic mothers are discussed. Neonatal
      period was uncomplicated only in 12 cases. The remaining babies suffered from
      respiratory disorders, edema, neurological disturbances, prolonged jaundice,
      infections etc. Metabolic disorders in diabetic female are unfavourable for the
      development of pregnancy and neonate health. it may be improved by the proper
      diagnostico-therapeutical management prior to and during pregnancy and by
      intensive care of neonates after delivery. It requires, however, the
      establishment of health institution with highly qualified teams well equipped
      which will be able to carry out diagnosis and therapy of diabetes mellitus in
      females in the reproductive age, during pregnancy as well as proper care of the
      neonates.

PMID- 2235700
TI  - [Effects of drugs used in high-risk pregnancy on child development].
AB  - The study involved 60 children delivered by the mothers of risk group who were
      given gestagens and beta-adrenomimetics during pregnancy. Physical, motoric
      development and morbidity in this group of children with particular relation to
      respiratory diseases were subject to our study. Thirty eight children delivered
      by healthy mothers were used as a control group. It was found that there was no
      developmental abnormalities in children from pregnancies maintained with
      gestagens and beta-adrenomimetics. Morbidity rate was the same in the tested and
      control groups.

PMID- 2235701
TI  - [Blood flow in the umbilical artery in physiological pregnancy].
AB  - Fetal umbilical artery flow was measured with Doppler ultrasound technique in 206
      cases of the uncomplicated pregnancy. Indices A/B and R.I. were calculated. It
      was shown that vascular resistance in the umbilical artery is decreasing in the
      normal pregnancy parallel to its development and is manifested by the changes in
      A/B and R.I. values.

PMID- 2235702
TI  - [Symptoms of neonatal abstinence syndrome. Case report].
AB  - A case of the neonatal narcotic abuse syndrome is presented. A newborn baby
      additionally suffered from the congenital infection. Marked symptoms of narcotic
      withdrawal required an administration of the opiates and tranquillizers for three
      weeks.

PMID- 2235703
TI  - ["Munchausen syndrome by proxy" as an example of diagnostic error].
AB  - A case of the girl who underwent multiple hospitalizations is presented.
      Gastrointestinal disorders were seen in the infancy together with skin rash of
      allergic type, hypoglycaemia without any clear reason in the fourth year of age,
      and polyuria with hyponatremia and hypokalemia since the sixth year of age.
      Mother's lack of concern was unexplainable in view of the deteriorating child's
      health. Samples of the urine and faeces supplied by the mother have shown the
      laboratory findings suggesting that potassium chloride was added to the faeces
      and natrium hydrocarbonate--to the urine. Urine collected during polyuria
      contained large quantities of furosemide. Long-term follow-up, numerous
      examinations and performed tests have led to the diagnosis of the particular form
      of the ill-treated child syndrome, so-called "Munchausenn by proxy" syndrome.

PMID- 2235704
TI  - [2 cases of acute disseminated intravascular coagulation in normal pregnancy and
      as the first symptom of acute promyelocytic leukemia].
AB  - Two cases of the acute disseminated intravascular coagulation (DIC) are
      presented. DIC in the first case was diagnosed in healthy pregnant woman without
      any obstetric pathology. This patient recovered completely. The acute DIC in
      another patient preceded the acute promyelocytic leukemia. The patient died
      despite a control of DIC. DIC therapy included antifibrinolytic agents and
      additionally corticoids in pregnant patient. Heparin was not administered because
      of post partum period and foreseen cytostatic therapy in the leukemic patient.

PMID- 2235706
TI  - [Arterial hypertension in pregnant women].

PMID- 2235705
TI  - [A proposed model of the treatment of diabetes mellitus in pregnancy].
AB  - A model of management of pregnant diabetic patients is proposed. Such a model has
      been implemented at the Voivodeship Out-patient Clinic for Diabetics. Proposed
      model includes recent data on diabetes mellitus complications and the effect of
      coexisting diseases on the mother and fetus health. Management was adapted to the
      real and potential possibilities of health service in Poland. A decrease in the
      rate of mortality of fetuses under 7% was achieved. It is worth emphasizing
      despite higher value than those reported in the literature.

PMID- 2235707
TI  - [Actual views on the classification and results of surgical treatment of lung
      cancer].

PMID- 2235708
TI  - [Clinical picture of secondary pneumonia in our observations].
AB  - Hundred sixty four patients with the secondary pneumonia were analysed. The
      secondary pneumonia amounted to 65.8% of all cases of pneumonia treated within
      several years. Patients' sex, age, clinical symptoms, X-ray findings, coexisting
      diseases, sequence of the symptoms and the rate of their disappearance were
      analysed. It was found that the secondary pneumonia is prevailing in males over
      40 years of age and most frequently accompany cardiac failure and chronic
      unspecific respiratory diseases. It is characterized by slow onset and the lack
      of typical symptoms in the high percentage of patients. Radiological and clinical
      symptoms disappear more slowly. However, various ausculatory symptoms of
      pulmonary involvement often accompany the secondary pneumonia and are not
      directly related to the inflammatory lesion to the lungs.

PMID- 2235709
TI  - [Bronchial asthma in hay fever].
AB  - The author diagnosed cough, emphysema and the symptoms characteristic for the
      bronchial asthma in 43% of patients with seasonal allergy (rhinitis,
      conjunctivitis) to pollens. Such symptoms were more frequent (51% of cases) in
      patients allergic to the grass pollens with coexisting hypersensitivity to
      Compositae family. Asthmatic symptoms in patients allergic only to grass pollens
      were seen in 38%. The author suggests that prolonged exposition in the inhalatory
      allergens (from two to four-five months) plays an important role in asthma onset
      in such patients. It rather delays than accelerates admittance to allergic
      clinics.

PMID- 2235710
TI  - [Enzymatic reactivity of neutrophils in tobacco smokers].
AB  - Activity of 8 enzymes in neutrophils of tobacco smokers was assayed with
      histochemical semiquantitative technique. An increase in the activity of acid
      phosphatase and beta-glucuronidase was found in the short period of tobacco
      smoking lasting 6.5 years on the average. Low activity of beta-glucuronidase, N
      acetyl-beta-D-glucosaminidase, non-specific alpha-naphtolesterase and LAP was
      found in the individuals smoking tobacco for 18.5 years. The authors suggest that
      carcinogenic action of the tobacco smoke is also related to the disorders in
      neutrophils enzymes activity.

PMID- 2235711
TI  - [Respiratory insufficiency in patients with myasthenia gravis].
AB  - We evaluated 20 patients who required prolonged mechanical ventilation for
      respiratory failure associated with myasthenia gravis. All 20 patients survived
      and were weaned from the ventilator after 3 to 14 days (mean 6.5 days) of
      respiratory support. Progressing bulbar symptoms and respiratory infection were
      the most frequent causes of the myasthenic crisis. During a period of assisted
      mechanical ventilation, anticholinesterase medication was interrupted and the
      patients were treated with steroids and antibiotics. Plasmapheresis may be
      considered in the management of myasthenic crisis.

PMID- 2235712
TI  - [Effect of intravenous administration of aminophylline on the degree of
      saturation of urine with calcium phosphate].

PMID- 2235713
TI  - [Use of ceftriaxone in urinary and respiratory tract infections].
AB  - Efficiency of ceftriaxone (Rocephin Hoffman Laroche) was assessed in 16 children
      aged between 3 and 14 years and in 4 adults aged between 17 and 70 years with
      severe infections of the urinary and respiratory tracts caused by E. coli. S.
      pneumoniae, P. aeruginosa, P. mirabilis or enterococci. Pyelonephritis as a sole
      pathology was diagnosed in 10 patients whereas in further 8 patients it
      complicated other diseases (nephrotic syndrome, hepatitis, cholangitis,
      leukemia). Pneumonia complicated nephritis leukemia or lymphoma in 8 children.
      Peritonitis was diagnosed in 1 adult patient. Ceftriaxone was given in a single
      daily dose of 50 mg/kg to all children and 2.0 g to adult patients for 7-10 days.
      No adverse reactions were noted. Clinical improvement was achieved in all treated
      patients. Cultures became negative in 17 cases after the treatment. Significant
      bacteremia caused by P. aeruginosa persisted in 2 patients and by E. coli in 1
      patient. No toxic effects on liver, renal, pancreatic and bone marrow functioning
      were seen. Ceftriaxone may be safely and efficiently used for the treatment of
      the urinary and respiratory infections.

PMID- 2235714
TI  - [The role of aromatic hydrocarbon hydroxylase in the pathogenesis of lung
      cancer].
AB  - Aromatic hydrocarbons hydroxylase (AHH)--an enzyme of monooxydases group-
      catalyzes hydroxylation of polycyclic aromatic hydrocarbons yielding compounds of
      the direct cancerogenic properties. Inducibility determined genetically is a
      characteristic feature of AHH. Inducibility of AHH in patients with cancer of the
      lungs is higher than that in healthy population. According to some authors
      general population may be classified into three groups of : high, moderate, and
      low degree of AHH inducibility. A significant increase in the incidence of
      neoplasms related to an exposition to PAH was noted in patients with increased
      AHH inducibility. These neoplasms include: carcinoma of the lungs, mouth and
      larynx, cancer of the pharynx and leukoplakia. Moreover, the onset of these
      neoplasms is earlier than in subjects with moderate and low inducibility of AHH.

PMID- 2235715
TI  - [Health hazards of occupational exposure to asbestos dust].

PMID- 2235716
TI  - [Whole body plethysmography].

PMID- 2235717
TI  - [Primary biliary cirrhosis of the liver--current therapeutic possibilities].

PMID- 2235719
TI  - [Chronic active hepatitis in alcoholics].
AB  - In 42 chronic alcohol abusers liver biopsy was performed and chronic active
      hepatitis was diagnosed in 11 cases. In 4 cases etiology could be attributed to
      chronic HBV infection--they were positive for HBsAg in serum, three were positive
      for HBeAg and one case had anti-delta antibodies. In 7 cases etiology was
      obscure, at least in some of them alcohol could have been the underlying factor.
      Liver disease in these particular cases was clinically more severe than chronic
      active hepatitis due to infection with HBV and non-A, non-B viruses in non
      drinkers. Two cases progressed into liver decompensation despite 1 and 2 years of
      abstinence, respectively. Chronic active hepatitis in alcoholics constitutes a
      frequent pathology, its etiology is variable, in some cases obscure.

PMID- 2235718
TI  - [Procollagen Type III-N-terminal peptide as an indicator of hepatic
      fibrogenesis].
AB  - An assay of procollagen peptide III in blood serum enables non-invasive
      assessment of fibrogenesis in the liver. An increased level of this peptide has
      been shown in the chronic aggressive hepatitis and liver cirrhosis.

PMID- 2235720
TI  - [Ultrasonographic images of liver neoplasms--comparison with histopathological
      findings].
AB  - Ultrasound pictures taken in 100 patients with histologically confirmed primary
      of metastatic neoplasms of the liver were analysed retrospectively. The most
      frequent were hyperechogenic foci (43%). Hypoechogenic foci were found in 33% of
      the patients whereas mixed changes in the liver scans (hyper- and hypoechogenic)
      in 22%. Thirty seven per cent of the hyperechogenic foci were attributable to
      metastatic process. Hypoechogenic disorders were most frequently due to the
      primary cancer of the liver (20%). Mixed lesions were mainly produced by the
      cancer of large intestine and liver (41% and 27%, respectively). Metastases into
      the liver produced all three types of ultrasound pictures. The obtained results
      confirm the opinion that ultrasound picture of metastatic liver tumours is not
      suitable for the diagnosis of the type and origin of the neoplasm.

PMID- 2235722
TI  - [Evaluation of the capacity of the liver for phenazone biotransformation in
      patients with uremia on peritoneal dialysis].
AB  - This work aimed at establishing whether liver ability to biotransformation of
      drugs expressed by antipyrine kinetics is disturbed in peritoneally dialysed
      patients with end-stage renal failure. The investigations were carried out in 10
      uraemic patients using the antipyrine test and comparing antipyrine kinetics with
      those obtained in 13 healthy individuals. At the time of investigations, standard
      clinical tests of liver function were normal and HBs antigen was absent in all
      patients. It was shown that peritoneally dialysed patients with end-stage renal
      failure had not significantly changed antipyrine elimination as compared with the
      group of healthy controls: t0.5 = 13.2 +/- 6.8 v. 11.8 +/- 8.1 h, plasma
      clearance = 50 +/- 30 v. 34 +/- 21 ml/min (x +/- SD). The obtained results
      indicate that antipyrine kinetics is within normal range in uraemic patients
      regularly dialysed suggesting cytochrome P-450 in microsomes not being markedly
      reduced.

PMID- 2235721
TI  - [Plasma clearance of cholic acid in patients with chronic diseases of the liver].
AB  - The diagnostic value of 14C-cholic acid plasma clearance following oral
      administration was evaluated. 14C-cholic acid clearance was 1223 +/- 267 mL/min.
      per 1 square meter in the control group without liver disease. Significantly
      lower values (p less than 0.001) were obtained in the patients with chronic
      hepatitis (694 +/- 137 mL/min. per 1 square meter) and liver cirrhosis (332 +/-
      156 mL/min. per 1 square meter). Sensitivity of the 14C-cholic acid clearance
      test was 100% while specificity--80%. A 3-year follow-up has shown that this test
      is of high prognostic value in patients with liver cirrhosis.

PMID- 2235724
TI  - [Diagnostic difficulties in prajmaline-induced intrahepatic cholestasis].
AB  - A case of prajmalium-induced intrahepatic cholestasis is presented. A proper
      diagnosis was delayed because differential diagnosis did not include toxic liver
      damage. Pathogenetic considerations included immunological background of the
      disease which improved completely within one year. No clinical and biochemical
      complications were seen.

PMID- 2235723
TI  - [Effect of pyrazinoic acid on the transport function of the peritoneum-
      experimental studies].
AB  - Bidirectional transport of the urea, uric acid and albumin across parietal
      peritoneum was investigated in vitro under both normal conditions and following
      an administration of pyrazinoic acid. It was found that pyrazinoic acid decreased
      urea and uric acid transport from interstitial to mesothelial surface of the
      peritoneal membrane but did not affect the transport in reverse direction.
      Bidirectional transport of albumin remained unchanged. The obtained results are
      similar to those reported earlier and suggest that pyrazinamide actions are
      partially selective.

PMID- 2235725
TI  - [Development of autoimmune chronic active hepatitis after acute hepatitis B].
AB  - A case of the autoimmunological chronic active hepatitis following the acute HBV
      infection is presented. A 24-year female patient underwent HBV infection and was
      hospitalized one year later due to persistent abnormalities in the activity of
      aminotransferases. Immunosuppressive therapy improved the results of the liver
      functioning tests and histological picture of the liver. An appropriate diagnosis
      is of importance as the chronic autoimmunological hepatitis respond to the
      treatment with corticosteroids. Such a treatment produced an improvement in the
      presented case.

PMID- 2235726
TI  - [A peculiar form of portal hypertension--the Budd-Chiari syndrome].

PMID- 2235727
TI  - Role of calcium in the programmed death of rat prostatic glandular cells.
AB  - By using a newly developed and validated rat ventral prostatic organ culture
      system in which prostatic glandular cells can be induced to undergo programmed
      cell death, the role of an elevation in the intracellular free Ca2+ concentration
      in this death process was studied. By using this organ culture system, ventral
      prostatic glandular epithelial cells can be maintained in culture for a period of
      more than 14 days with a low daily rate of cell death (i.e., approximately 5% die
      per day) if androgen is included in the media. In contrast, if androgen is not
      included in the media, the daily rate of prostatic glandular cell death increases
      approximately 3-fold (i.e., approximately 15% die per day). With this organ
      culture system it has been demonstrated that the daily rate of programmed death
      of the glandular epithelial cells can be shifted from 5% to 15% of the cells
      dying per day when testosterone and 10 microM of the Ca2+ ionophore A23187 are
      both present in the media. Thus, when the intracellular free Ca2+ is elevated
      within prostatic cells by means of ionophore treatment, the daily rate of
      glandular cell death in the presence of testosterone is identical to that induced
      when testosterone is not present in the media. If the organ cultures are
      maintained in media lacking testosterone but containing 10 microM of the Ca2+
      channel blocker nifedipine to inhibit elevations in the intracellular free Ca2+
      derived from the extracellular pools, the rise in the daily rate of cell death
      from 5 to 15% of the cells dying per day induced by androgen ablation can be
      inhibited by approximately 70%. These results suggest that an increase within
      prostatic glandular cells in their intracellular free Ca2+ derived from
      extracellular Ca2+ pools is a critical early event involved in triggering the
      subsequent process of programmed cell death (i.e., specifically DNA
      fragmentation) in these cells following androgen ablation.

PMID- 2235728
TI  - Epidemiology of prostatic cancer: a case-control study.
AB  - A population-based case-control study of prostatic cancer in Alberta was
      undertaken to determine the risk factors associated with the disease. Cases were
      382 newly diagnosed prostatic cancer patients and 625 controls, group-matched to
      the anticipated age distribution of the cases, chosen at random from the health
      insurance roster. Subjects were interviewed in their homes by using a pre-tested
      questionnaire including questions related to ethnic group, education, puberty,
      marital history, family history, residence, water supply, smoking, and diet.
      Factors significantly related to the risk of developing prostatic cancer included
      ethnic group (British high, Ukrainian low), education (elementary high,
      university low), age at first marriage (early high, late low), family history
      (high risk for those with relatives with prostatic cancer), and increased
      masculinity among the children of cases. The results with respect to smoking,
      occupation, medical history, birthplace, residence, water supply, and diet were
      generally negative.

PMID- 2235729
TI  - Differences in growth requirements between epithelial and stromal cells derived
      from rat ventral prostate in serum-free primary culture.
AB  - Different procedures of enzymatic digestion of rat prostatic tissue and unique
      sets of mitogenic factors made it possible to culture practically pure
      populations of epithelial and stromal cells without previous separation of the
      two types of cells. Keratin-positive epithelial cells dissociated by trypsin and
      collagenase from adult rat ventral prostate proliferated in medium WAJC 404
      supplemented with epidermal growth factor, insulin, cholera toxin, and bovine
      pituitary extract. Proliferation of epithelial cells was completely inhibited by
      dexamethasone as low as 30 nM. On the other hand, fibroblast-like stromal cells
      released by trypsin digestion required a plastic substratum coated with calf
      serum or fibronectin, and proliferated in Eagle's minimum essential medium
      supplemented with cholera toxin, bovine pituitary extract, dexamethasone, and
      bovine serum albumin. Epidermal growth factor and insulin had negligible effect
      on proliferation of stromal cells. Physiological concentrations of
      dihydrotestosterone and estradiol showed no effect on proliferation of both types
      of cells.

PMID- 2235730
TI  - Experimental prostatitis in nonhuman primates: I. Bacterial adherence in the
      urethra.
AB  - Both man and monkey possess urothelial (transitional cell) receptors for P
      fimbriae of Escherichia coli; however, the male urethra has pseudostratified
      columnar cells. We studied adherence using scanning electron microscopy and found
      that P-fimbriae were the principal mediators of adherence to these cells as well.
      The monkey, therefore, should be a good model for the study of the ascending
      route of infection in prostatitis, the route thought to occur in man.

PMID- 2235731
TI  - Experimental prostatitis in nonhuman primates: II. Ascending acute prostatitis.
AB  - Bacterial prostatitis is a common cause of urinary tract infection in males, but
      little is known of its pathophysiology. To study this, we developed a nonhuman
      primate model using a wild-type clinical isolate of Escherichia coli. Primates
      have a prostatic anatomy that is similar to humans, which makes them ideal as an
      animal model of this disease. The monkeys had a urethral inoculation of this
      organism and were then followed with urine, blood, and semen cultures, white
      blood counts, and renal scans. They were sacrificed at from 10 days to 4 weeks,
      and their genitourinary tracts histologically examined. The prostatitis
      paralleled that reported in humans, and we conclude that the infection occurs by
      the ascending route. The organisms causing the infection in man do so in our
      primate model, and the histologic change is also the same. Thus, the primate
      model holds promise for studies to help us understand this disease.

PMID- 2235732
TI  - Effects of prolactin and androgens on the prostatic lipids of castrated mature
      bonnet monkeys.
AB  - The effects of prolactin (PRL), bromocriptine (Br), testosterone propionate (TP),
      dihydrotestosterone (DHT), and the combinations of these androgens with PRL/Br on
      total lipid, total cholesterol, total glyceride glycerols, and total phospholipid
      and their fractions in cranial and caudal prostates of castrated mature monkeys
      were studied. Glyceride glycerols formed the major portion of total lipids (50%)
      in normal monkeys. Cholesterol and phospholipids were of equal share (25%).
      Esterified cholesterol formed the major share (75%) of total cholesterol. Diacyl
      glycerol was the major (60%) glyceride glycerol and phosphatidyl choline and
      ethanolamine were the major phospholipid classes. Except triacyl glycerol
      castration markedly decreased all the lipid classes in both the lobes. PRL
      restored normal free and esterified cholesterol and phosphatidyl inositol but Br
      invariably decreased all the lipid classes. TP/DHT treatment stimulated the free
      and esterified cholesterol more than the control; it restored the normal
      glyceride glycerols in both the lobes. Phosphatidyl inositol, choline, and
      ethanolamine were stimulated by androgens and other phospholipid classes were
      brought to normal in both the lobes. Addition of PRL + TP/DHT markedly increased
      esterified cholesterol, phosphatidyl inositol, choline, ethanolamine, and
      phosphatidic acid in both the lobes. Br counteracted the effects of androgens and
      prolactin. In general, the influence of prolactin was more in the caudal lobe
      than cranial. The results are discussed in detail with available literature.

PMID- 2235733
TI  - Mitchell's bunionectomy and Wu's bunionectomy: a comparison of 100 cases of each
      procedure.

PMID- 2235734
TI  - Distal soft tissue procedure and proximal metatarsal osteotomy for correction of
      hallux valgus deformity.

PMID- 2235735
TI  - Metatarsocuneiform arthrodesis for treatment of hallux valgus and metatarsus
      primus varus.

PMID- 2235736
TI  - Arthrodesis of the first metatarsophalangeal joint with mini-fragment plate
      fixation.

PMID- 2235737
TI  - Keller resection arthroplasty.

PMID- 2235738
TI  - Complications of hallux valgus surgery and salvage.

PMID- 2235739
TI  - Cemented bipolar arthroplasty.

PMID- 2235740
TI  - Ethics in orthopedic residency.

PMID- 2235741
TI  - Treating hallux valgus deformities: versatility is required.

PMID- 2235742
TI  - Pathophysiology, anatomy, and biomechanics of hallux valgus.

PMID- 2235743
TI  - Bunion surgery: decision making.

PMID- 2235744
TI  - Simple bunionectomy.

PMID- 2235745
TI  - The Chevron procedure.

PMID- 2235746
TI  - The modified McBride procedure.

PMID- 2235747
TI  - Results of Akin type proximal phalangeal osteotomy for correction of hallux
      valgus deformity.
AB  - The results of 26 Akin proximal phalangeal osteotomies in 22 patients for hallux
      valgus deformities are reported. The average follow up was 53 months (range, 12
      to 97 months). Subjectively, 16 feet had a satisfactory result (61.5%).
      Objectively, 14 feet met the criteria for a satisfactory result (53.8%). The
      authors found that the Akin osteotomy was unpredictable as an isolated procedure,
      and not indicated in a hallux valgus deformity with an incongruent joint.

PMID- 2235749
TI  - [Sharpening technics for periodontal instruments].
AB  - Different approaches to sharpening are described by the Authors with particular
      emphasis upon periodontal curettes. Recent findings are also reported and
      discussed.

PMID- 2235748
TI  - [Caries in 6 to 12-year old children in 6 towns of Usl n. 16 of Modena].
AB  - A "screening" done by the "Servizio Materno Infantile" of Modena relative to
      children from 6 to 12 years old during 1988-89 is described. The research is
      referred to 1454 children 6 years old attending the second year of the secondary
      school. For the evaluation of the level of the dental health have been used the
      Oms Index. The results are very comforting: the 54% of the 6 years old children
      have sound teeth, but from the dmft Index with a value of 1.6 comes out the trend
      not to cure the caries of the deciduous teeth. Very few are the cases of 6 years
      old children with caries of the permanent teeth. At 12 years the percentage of
      children with sound teeth is lower (34%), however analyzing the DMFT Index (1.9)
      appears a very high degree of attention towards the dental care.

PMID- 2235750
TI  - [Prevention and school. Behavioral response of children and critical evaluation
      of teachers].
AB  - The Authors have examined the spontaneous attitude of the children of the first
      elementary class during a day spent at the department of Odontostomatology in a
      course programme for education and prevention of caries. It was shown an
      extremely positive behaviour, with images principally centered on the trip
      between school and Hospital (the bus, the sight of the town). The teachers based
      on a day by day diary have demonstrated a positive impression on the various
      aspects of the initiative, stressing the importance of continuative relationship
      between doctors-teachers-parents.

PMID- 2235751
TI  - [Intervention for integrated dento-periodontal prevention].
AB  - An epidemiological survey has been achieved on elementary and secondary
      schoolchildren of five different areas in the territory of Ussl no 16 in Lecco.
      The study, performed on a randomly sample of 458 children aged 6, 10, 12 years,
      used the epidemiological indexes DMFT/dmft and CPITN to monitor dental and
      periodontal status. The treatment needs of the subjects was monitored too and the
      amount of Streptococco mutans in 6 years old schoolchildren, using spittle
      drawning, was investigated. The results seem to show that the DMFT/dmft values
      are on a moderate level as regards the European goals, while the amount of dental
      and periodontal treatment performed is very low. The gingivitis prevalence is
      high, as well as scaling is required in many children. The analysis of the
      spittle samples drawned in 6 years old schoolchildren points out high levels of
      Streptococcus mutans as regard those collected in other similar studies achieved
      by our Department. According to the results analysis, two sorts of preventive
      intervention were planned to have the maximum preventive efficacy according to
      the disease level located in the different areas.

PMID- 2235752
TI  - [Assisting in endodontics].

PMID- 2235753
TI  - [Home oral hygiene instructions].

PMID- 2235754
TI  - [Epidemiological study of the incidence of dental caries].
AB  - The aim of this work is the evaluation of the results of an epidemiological
      survey on dental caries in schoolchildren in Arezzo and the province of Arezzo.
      The examined patients were 492, between the ages of 8 and 12, all of whom were at
      Primary School, in their third, fourth or fifth year. The evaluation of the data,
      which has been collected in other statistics in recent years, focussed on the
      measurement of caries in primary molars and upper incisors. The total occurrence
      of cases in which either the caries were present, or had already been cured,
      amounted to 62.4% of the total sample. It also seems as if there is a progressive
      increase in the instance of caries between the third year (45%) and the fifth
      year (68%) of Primary School. In addition it is worth noting that there is a
      higher incidence of caries among subjects in urban areas.

PMID- 2235755
TI  - [Sealants: indications, contraindications, technique].

PMID- 2235756
TI  - [Space analysis and treatment planning in the mixed dentition].
AB  - The maintaining of the space during mixed dentition, allows the patient to obtain
      a good occlusion, the right growth and facial development. The orthodontist can
      preserve the space, using simple appliances like the lip bumper and the lingual
      arch.

PMID- 2235757
TI  - Pulmonary elastic fibers in normal human development and in pathological
      conditions.
AB  - Normal human pulmonary elastic fiber development and development in some
      pathological conditions were examined using elastic stains by light microscopy,
      electron microscopy, and immunohistochemistry. In normal development elastic
      fibers, composed mainly of microfibrils, first appeared around primitive
      bronchioles at 10 weeks of gestation. As they matured, their appearance became
      more amorphous, and they extended into the peripheral alveolar walls. Development
      of elastic fibers was retarded in the hypoplastic lungs of the oligohydramnios
      syndrome, diaphragmatic hernia, and hydrops fetalis. Elastic development was also
      retarded in congenital pulmonary lymphangiectasia and in focal areas of lungs
      with pulmonary dysplasia. Distribution of well-developed elastic fibers was found
      around the dilated bronchioles and alveoli in cases of congenital cystic
      adenomatoid malformation and extralobar pulmonary sequestration. Elastic fibers
      were distributed irregularly and unevenly in the lungs of bronchopulmonary
      dysplasia and ventilated cases of Wilson Mikity syndrome. In addition, four very
      immature infants who had progressively deteriorating respiratory function showed
      an almost total lack of elastic fibers in their alveolar walls.

PMID- 2235758
TI  - Simple autopsy method for analysis of complex fetal cranial malformations.
AB  - A new radiography technique for examining second trimester abortions permits an
      accurate analysis of growth and maturation of the fetal skull. Reference material
      for normal development has been previously published. The potential of the method
      is demonstrated with three examples: thanatophoric dysplasia, Arnold-Chiari
      malformation, and anencephaly.

PMID- 2235759
TI  - Fatal malformations in Jamaica.
AB  - Babies with major malformations were identified during the Jamaica Perinatal
      Morbidity and Mortality Survey. They were found in 96 (8.6%) of 1112 perinatal
      and neonatal deaths coming to necropsy and in 28 (2.6%) of 1085 no so examined.
      The central nervous system was most commonly affected, followed by the renal,
      gastrointestinal, and cardiovascular systems in decreasing order of frequency.
      Many infants had abnormalities in more than one system and 10 malformation
      syndromes/sequences were identified. Although at the present time, major
      malformations make only a small contribution to perinatal and neonatal mortality
      in Jamaica, their importance will increase when deaths from other causes, such as
      birth asphyxia, decline. The type of malformation currently fatal in a particular
      population is relevant when planning diagnostic and surgical services for
      neonates and infants. It is also important to any discussions about provision of
      prenatal diagnostic services.

PMID- 2235760
TI  - Correlation between pathologic and ultrasound findings in first trimester
      spontaneous abortions.
AB  - We compared the pathologic and ultrasonographic findings of 31 first trimester
      spontaneous abortions to determine the benefits of such studies. The ultrasound
      diagnoses included empty gestational sac (n = 11), intrauterine fetal death (n =
      11), abortion in progress or incomplete abortion (n = 8), and live embryo (n =
      1). Two subgroups of empty sacs were identified by pathologic examination.
      Embryonic development appeared to be more advanced in one group as indicated by
      the presence of embryonic red blood cells (RBC's) in the placental vessels.
      Although an embryo or fetus was identified more frequently by sonar than by
      pathologic examination, we were able to diagnose developmental anomalies in small
      embryos that current ultrasound equipment cannot resolve. Such anomalies were
      identified even in the presence of fetal heart activity. Pathologic examination
      was also informative when heavy bleeding obscured the contents of the uterine
      cavity to sonar and was thus supplementary of a suboptimal ultrasound
      examination. Placental examination proved to be reliable in assessing gestational
      age at the time of embryonic/fetal death. There was a good correlation between
      RBC morphology and sonographic measurement of crown-rump length. First trimester
      ultrasound and pathologic examination of the embryo and placenta are informative
      and complement each other.

PMID- 2235761
TI  - Clinicopathological differences between early-onset and late-onset sepsis and
      pneumonia in very low birth weight infants.
AB  - We performed clinicopathological studies on early-onset sepsis (5 infants, less
      than 72 hours of life, EOS) and late-onset sepsis (15 infants, greater than 72
      hours, LOS) of very low birth weight, less than 1500 g (VLBW). In EOS, the
      clinical features mimic the respiratory distress syndrome and hematological
      changes were not observed. The lungs showed slight interstitial pneumonia with
      structural immaturity, hyaline membranes, hemorrhage, and minimal infiltration by
      polymorphonuclear neutrophils (PMNs). The pathogen was group B streptococcus or
      weakly gram-negative bacilli. In LOS, pneumonia proceeded to sepsis and
      neutropenia with elevated numbers of circulating immature neutrophils, and
      increased levels of C-reactive protein were observed at the onset of sepsis.
      Severe pneumonia with infiltration of numerous PMNs and bacterial colonies and
      polymicrobial infection by nosocomial pathogens such as Staphylococcus aureus and
      Pseudomonas aeruginosa were common. The thymus and spleen weights varied but
      retained normal structure in EOS. The thymus was depleted of lymphocytes, and the
      spleen was hypertrophic but poorly reactive against infection in LOS. The
      pathogenesis of EOS is regarded as being more closely correlated with lung
      immaturity and circulatory disorder in early life, whereas that of LOS is
      associated with immunological defenses of the host, potency of the pathogens, and
      terminal multiple organ failure.

PMID- 2235762
TI  - Sudden, unexpected, natural death in childhood.
AB  - One thousand nine hundred and fifty four autopsies performed at British
      Columbia's Children's Hospital during a 7-year period were reviewed to determine
      the causes of sudden unexpected natural death in the age group from birth to 17
      years. Of the 126 cases found, the largest group, 86 cases, was sudden infant
      death syndrome (SIDS). Nine deaths were the result of infection: 4 cases of H.
      influenza meningitis, 2 cases of meningococcemia, 2 cases of acute epiglottitis,
      and 1 case of necrotizing tracheobronchitis. Epilepsy, ruptured AV malformations,
      and brain tumors combined to make up an equally large group of 9 cases. Cardiac
      lesions were the third largest group, 6 cases. The three groups that posed the
      most difficulty in assigning a cause of death were (a) the group that were like
      SIDS yet had other confounding features, (b) the group in which metabolic death
      was suspected but not proven, and (c) death in epilepsy.

PMID- 2235763
TI  - Malignant mesenchymoma associated with a congenital lung cyst in a child: case
      report and review of the literature.
AB  - Primary lung tumors are uncommon in children, and malignant mesenchymal tumors
      form only a small proportion of these. Leiomyosarcomas occur more commonly than
      rhabdomyosarcomas, whereas malignant mesenchymomas are exceedingly rare. Of the
      total number of primary pulmonary rhabdomyosarcomas and malignant mesenchymomas
      of lung reported in children, 50% have occurred in association with congenital
      lung cysts. The relationship between abnormal morphogenesis and neoplasia is well
      documented in the kidney. A similar relationship may exist in the lung between
      cystic parenchymal maldevelopment and embryonal mesenchymal tumors. We report a 4
      year-old boy with a malignant mesenchymoma of lung arising within a congenital
      lung cyst; one similar case has previously been reported to our knowledge.

PMID- 2235764
TI  - Foregut choristoma of the ileum, (adenomyoma)--a case report.
AB  - An ileal adenomyoma in a 7-year-old boy who presented with jejunoileal
      intussusception is described and the term "foregut choristoma" is proposed for
      this and related conditions, such as ectopic pancreas or heterotopic Brunner's
      glands in the gastrointestinal tract. The polypoid mass in the ileum of this
      patient was composed of cystically dilated glandular structures lined by a tall
      columnar epithelium resembling hepatobiliary or pancreatic ductal epithelium,
      hypertrophic and irregular smooth muscle bundles surrounding the glandular
      elements, and small amount of fibrous stroma. Reported cases of this disorder in
      the gastrointestinal tract are generally confined to the antrum of the stomach.

PMID- 2235765
TI  - "Marden-Walker syndrome": neuropathologic findings in two siblings.
AB  - Neuropathologic examination of two siblings with phenotypic features consistent
      with Marden-Walker syndrome revealed central nervous system abnormalities which
      include reduction in the number of spinal anterior horn cells. The occurrence of
      these changes in a sibling pair provides strong evidence for a genetic etiology.
      The relationship between the neuropathologic changes and other phenotypic
      manifestations in this syndrome and in the closely related syndrome of Pena
      Shokeir are discussed.

PMID- 2235766
TI  - Pneumomyocardium: an unusual complication of barotrauma.
AB  - We report a 22-day-old infant who developed Staphylococcus aureus pneumonia with
      abscesses, pneumatoceles, and sepsis at 10 days of life. Mechanical ventilation
      was complicated by pneumothorax. At autopsy, a collection of air was found in the
      interventricular septum of the heart, a lesion we have termed pneumomyocardium.
      No hemorrhage, inflammatory infiltrate, organisms, or necrotic debris was found
      on the edge of the area of interstitial emphysema in the heart. We believe that
      the pneumomyocardium arose as a consequence of barotrauma.

PMID- 2235767
TI  - Combined true thymic hyperplasia and lymphoid hyperplasia in Graves' disease.
AB  - True thymic hyperplasia (enlarged gland composed of histologically unremarkable
      cortical and medullary parenchyma) and lymphoid hyperplasia (medullary lymphoid
      follicles in the clinical setting of autoimmunity) usually develop as independent
      pathologic processes. We reviewed the clinical features and gross and microscopic
      pathology of 2 hyperthyroid patients with features of both thymic hyperplasia and
      lymphoid hyperplasia. The diagnosis of thymic hyperplasia was supported by thymic
      weights greater than two standard deviations above the mean weight for age and
      histologic evidence of expanded cortical and medullary parenchyma. The diagnosis
      of lymphoid hyperplasia was supported by the increased number and size of
      medullary lymphoid follicles and the association with Graves' disease. This
      unusual combination results from two separate pathogenic mechanisms operating
      simultaneously in hyperthyroid patients. Elevated thyroid hormones directly
      stimulate the proliferation of thymic epithelium, producing thymic hyperplasia.
      The immune abnormalities underlying Graves' disease can also result in lymphoid
      hyperplasia of the thymus.

PMID- 2235769
TI  - The role of the pediatrician in school health.

PMID- 2235768
TI  - Sudden and unexpected death--a late effect of occult intraesophageal foreign
      body.
AB  - Acute upper airway obstruction in a 4-month-old male infant who presented as
      sudden infant death syndrome is described. At autopsy external tracheal
      compression and tracheobronchitis with plugging of the trachea and bronchi by an
      abundant mucopurulent exudate were found. The source of the inflammation was the
      adjacent esophagus where previous impaction of a coin had caused pressure
      necrosis with mucosal erosion and transmural granulation tissue formation. This
      case is reported to demonstrate that foreign bodies that remain in the esophagus,
      having by-passed the larynx, may still result in upper airway obstruction and
      death in early infancy by this unusual mechanism.

PMID- 2235770
TI  - Muscle disease in children: a practical approach.
AB  - This paper has given an overview of the complexity of childhood muscle disease.
      Fortunately, astute history-taking and physical examination, combined with
      readily available tests, will usually enable the clinician to formulate a
      diagnosis and plan of management.

PMID- 2235771
TI  - Lower gastrointestinal bleeding.
AB  - The differential diagnosis of lower gastrointestinal bleeding in children can be
      reduced markedly simply by taking into account the age of the child. The clinical
      condition of the patient can further help narrow the diagnostic possibilities.
      Newborns and infants who are clinically unstable are more likely to have diseases
      such as necrotizing enterocolitis, volvulus, Hirschprung disease,
      intussusception, or Meckel diverticulum. A baby who appears healthy should be
      examined for swallowed blood, allergic colitis, anal fissures, or lymphonodular
      hyperplasia. An older child of healthy appearance with bleeding is likely to have
      a juvenile polyp or infectious colitis, but a child who appears sick may have
      hemolytic uremic syndrome, Henoch-Schoenlein purpura, or inflammatory bowel
      disease. This information, along with that gleaned from the physical examination,
      can lead the pediatrician to determine the need for specific tests, such as
      abdominal radiographs, stool cultures, and an endoscopic evaluation. We have come
      a long way in our ability to diagnose the causes of lower gastrointestinal
      bleeding. With the availability of newer radiographic and nuclear medicine
      modalities and the ability to visualize the colon endoscopically, the need for
      exploratory laparotomy for diagnosis is rarer. While surgery may still be the
      therapy of choice, new diagnostic modalities give the surgeon much more
      preoperative information.

PMID- 2235772
TI  - Steroids: breakfast of champions.

PMID- 2235773
TI  - Diagnosis and management of upper gastrointestinal tract bleeding in the
      pediatric patient.

PMID- 2235774
TI  - Juvenile dermatomyositis: a clinical overview.
AB  - The child who develops the symptoms of the specific rash, proximal muscle
      weakness, and fatigue should seek medical care promptly. With the advances in
      physical and medical therapy, many of the consequences of the disease can now be
      ameliorated. There are suggestive data that JDMS and PM may each have a different
      pathophysiology, but more evidence is needed. The next few years should be
      exciting as there is increased effort to determine if there is, in fact, a causal
      relationship between Coxsackievirus B or other enterovirus and genetic factors
      that alter the susceptibility to or severity of the course of the disease.

PMID- 2235775
TI  - The satisfactions of pediatric practice.

PMID- 2235776
TI  - Let's stop the comeback of tuberculosis. Best drug regimens for prevention and
      treatment.
AB  - Tuberculosis has been on the increase in recent years, so physicians need to be
      aware of it once again. Very effective drugs are available to treat the disease.
      Pharmacokinetics, dosing schedule, and adverse reactions of each anti-tuberculous
      agent need to be considered. A short (6-month) course of therapy is now
      recommended: Isoniazid, rifampin (Rifadin, Rimactane), and pyrazinamide are given
      for the initial 2 months, followed by isoniazid and rifampin for 4 months. If
      drug resistance is a factor, a fourth drug is added to the initial regimen, and
      therapy may have to be extended. Chemoprophylaxis with isoniazid is very
      important to reduce the incidence of tuberculosis. It should be given to all high
      risk persons.

PMID- 2235777
TI  - Get Congress to kill the malpractice dragon.

PMID- 2235778
TI  - Why Nathan?

PMID- 2235779
TI  - Colonoscopy in critically ill patients. What conditions call for it?
AB  - Indications for colonoscopy in the intensive care unit include acute lower
      intestinal bleeding, sigmoid volvulus, pseudo-obstruction of the colon, and
      suspicion of pseudomembranous colitis. Although the incidence of
      cardiorespiratory complications may be higher in these critically ill patients,
      the procedure can be done safely with proper attention to detail. Because of
      colonic dilatation, endoscopy can often be done without bowel preparation.

PMID- 2235780
TI  - When epilepsy masquerades as heart disease. Awareness is key to avoiding
      misdiagnosis.
AB  - Autonomic neural impulses that accompany discharges during a seizure can cause a
      variety of cardiac manifestations, including cardiac arrhythmias, sudden death,
      anginal chest pain, neurogenic pulmonary edema, and symptoms of pheochromocytoma.
      Either generalized or focal seizures may generate such signs and symptoms. A
      better appreciation of cardiac problems caused by epilepsy is helpful in
      preventing misdiagnosis, because the clinical picture in such a patient may be
      confusing.

PMID- 2235781
TI  - When a patient with a bleeding disorder needs dental work. How you can work with
      the dentist to prevent a crisis.
AB  - Patients with bleeding disorders need close cooperation between their physician
      and their dental practitioner to receive safe, comprehensive dental care. When
      indicated, physicians must advise a compromised treatment plan to avoid deep
      injections or surgical procedures that may initiate a bleeding crisis in patients
      at risk. The conditions most commonly seen that require special consideration are
      long-term use of antithrombotic agents, platelet dysfunction caused by chronic
      renal failure, and congenital clotting factor deficiencies. Even these patients
      may undergo a high-risk procedure, such as periodontal surgery, with adequate
      precautions and preparation.

PMID- 2235782
TI  - Treating diabetes in the elderly. What are the special considerations?
AB  - Management of diabetes in elderly patients generally follows the same lines as in
      younger patients; that is, improvement of blood glucose status with diet, oral
      hypoglycemic, and insulin therapy as required. Older patients are more fragile,
      however, and more caution must be used with therapeutic interventions.

PMID- 2235783
TI  - Eosinophilia-myalgia syndrome linked to tryptophan.
AB  - Eosinophilia-myalgia syndrome has been linked to ingestion of tryptophan, but the
      exact cause of this recently recognized syndrome is unclear. As in other reported
      cases, the disease in the patient described here developed while she was taking
      tryptophan. Although eosinophilia resolved following glucocorticoid therapy, the
      disease in this patient continues to progress.

PMID- 2235784
TI  - Ketoconazole for prostate cancer.

PMID- 2235785
TI  - Toscanini's fumble.

PMID- 2235786
TI  - Tutorial approach to medical education.

PMID- 2235788
TI  - Potentially lethal ventricular arrhythmias. Minimizing the danger.
AB  - Patients with potentially lethal ventricular arrhythmias are at an increased risk
      of sudden death. Antiarrhythmic drugs, with the exception of beta blockers and
      possibly amiodarone, have not been particularly effective in reducing mortality.
      Beta blockers have been used successfully to treat survivors of myocardial
      infarction, including patients with significant impairment of ventricular
      function. Evidence to date suggests that use of low-dose amiodarone may be
      appropriate for selected patients with chronic heart failure and potentially
      lethal ventricular arrhythmias.

PMID- 2235787
TI  - Arrhythmias in patients with CHF. Should they be treated?
AB  - Ventricular arrhythmias are a major cause of death in patients with congestive
      heart failure. Dr Ellenbogen and his associates discuss the current thinking,
      based on recent studies, concerning use of antiarrhythmic agents to prevent
      sudden cardiac death in these patients. As they point out, the proper
      antiarrhythmic therapy may be crucial to long-term survival.

PMID- 2235789
TI  - Abdominal trauma in pregnancy. When is fetal monitoring necessary?
AB  - The type and duration of observation and monitoring of mother and fetus after
      abdominal trauma are dependent on gestational age and severity of trauma. Fetal
      monitoring is usually not required when the fetus is not viable; the primary
      consideration is the safety of the mother. When the fetus is viable, 24-hour
      inpatient fetal monitoring is indicated in cases of major trauma, even when no
      symptoms of injury are obvious.

PMID- 2235790
TI  - What to do about pruritus scroti.
AB  - Pruritus scroti is a common clinical disorder that is caused by various
      inflammatory disorders, infections, infestations, and neoplasms. Laboratory
      evaluation, including bacterial and fungal cultures, microscopic examination,
      skin biopsies, and measurement of blood glucose levels, is useful in establishing
      the diagnosis. Management of pruritus scroti includes avoidance of irritants,
      allergens, and restrictive clothing and use of topical and systemic agents that
      provide both symptomatic relief and specific treatment of the underlying cause.

PMID- 2235791
TI  - Summer heat illnesses.

PMID- 2235793
TI  - Viral pneumonias. A diagnostic and therapeutic challenge.
AB  - Viral pneumonias are both a diagnostic and a therapeutic challenge for primary
      care physicians. The illness should be suspected when an upper respiratory tract
      infection progresses to include dyspnea and cyanosis. Rapid diagnostic tests are
      now available to detect most of the viruses that cause pneumonias. Fortunately,
      viral pneumonias usually resolve without specific antiviral therapy; however,
      ribavirin is indicated for respiratory syncytial virus pneumonia in children and
      ganciclovir sodium (Cytovene) for cytomegalovirus pneumonia in immunocompromised
      patients. Acyclovir (Zovirax) is indicated for pneumonias due to herpes simplex
      virus and varicella-zoster virus infections. A high index of suspicion for
      bacterial superinfections is essential to reduce the risk of death from this
      complication.

PMID- 2235792
TI  - Pneumococcal pneumonia. Recognizing and treating this persistent disease.
AB  - Pneumococcal pneumonia remains a life-threatening disease despite the
      availability of many active antimicrobial agents and an effective vaccine. Dr
      Markowitz discusses why the disease persists, how it is diagnosed and treated,
      and what can be done to reduce its incidence.

PMID- 2235794
TI  - Mycoplasmal pneumonia. Are you thinking of atypical presentations?
AB  - The presentations of mycoplasmal pneumonia can be varied and sometimes
      complicated. The atypical nature of this illness, as opposed to the clear pattern
      of findings in classic bacterial pneumonias, leads the physician to the
      diagnosis. Appropriate therapy then allows quick improvement as a rule, with few
      sequelae.

PMID- 2235796
TI  - Why was this patient still in the hospital?

PMID- 2235795
TI  - What to do in case of an unthinkable chemical warfare attack or accident.
AB  - Successful management of casualties in a toxic chemical attack or accident
      depends on planning, preparation, and training. In many communities, physicians
      join other emergency rescue personnel to take part in periodic exercises and
      drills. In case of a large-scale attack or accident, all medical care providers
      will be needed to care for casualties. Chemical warfare agents are generally
      considered to be highly toxic, exotic materials, but most are not. Nerve agents
      are similar to, although more potent than, commonly used insecticides; cyanide
      and phosgene are widely available; the incapacitating agent BZ has effects
      identical to those of scopolamine; and most physicians with knowledge of
      chemotherapy are familiar with the effects of mustard. Although a chemical attack
      might be perceived as an uncontrollable disaster, the guidelines for successful
      management are the same as for any toxic chemical accident. Medical care of
      casualties depends on knowledge of the agent and timely intervention, and those
      responsible for such care must be ready.

PMID- 2235797
TI  - Mitral valve prolapse. When is it serious?
AB  - Mitral valve prolapse can best be diagnosed with careful clinical evaluation,
      including dynamic auscultation. Treatment consists of reassurance,
      pharmacotherapy for troublesome symptoms, and careful monitoring for signs of
      complications. Most complications can be either prevented or treated.

PMID- 2235798
TI  - The persistent vegetative state: time for caution?

PMID- 2235799
TI  - Psychiatry.

PMID- 2235800
TI  - Failure of thiazide diuretics to increase plasma calcium in mild primary
      hyperparathyroidism.
AB  - Thirteen patients with mild primary hyperparathyroidism who were taking thiazide
      diuretics intermittently for periods of up to 18 months were followed up for a
      mean of 5.3 years. No significant difference was found in either plasma total
      calcium corrected for albumin or whole blood ionized calcium in these patients
      between the periods on or off thiazides. We conclude that thiazide diuretics are
      not contraindicated in such patients.

PMID- 2235801
TI  - Do non-steroidal anti-inflammatory drugs or smoking predispose to Helicobacter
      pylori infection?
AB  - Susceptibility to Helicobacter pylori infection is a poorly understood
      phenomenon. This study was undertaken to establish whether either smoking or
      chronic non-steroidal anti-inflammatory drug (NSAID) consumption might in some
      way predispose to H. pylori infection and hence lead to peptic ulceration.
      Serological evidence of H. pylori infection was assessed in 100 consecutive
      subjects receiving NSAIDs without any evidence of gastrointestinal upset and 100
      matched controls. All subjects had a full assessment of their smoking habits.
      Sixty-three per cent of patients taking NSAIDs compared to 51% of controls had
      evidence of H. pylori infection (NS). Smoking habit also had no effect on H.
      pylori colonization. The ulcerogenic potential of NSAIDs and smoking does not
      appear to be mediated via a prediposition to H. pylori infection.

PMID- 2235802
TI  - Gastric antral vascular ectasia (watermelon stomach)--therapeutic options.
AB  - We have encountered five cases of chronic iron deficiency anaemia due to bleeding
      from gastric antral vascular ectasia (watermelon stomach). Two cases were
      associated with a lymphoma and in three cases there was evidence of portal
      hypertension. Two patients were treated conservatively by blood transfusions. The
      other patients required either surgery or tranexamic acid or endoscopic laser
      therapy to control the chronic haemorrhage.

PMID- 2235803
TI  - Relationship of urinary pH to symptoms of 'cystitis'.
AB  - The pH of urine samples from patients suffering symptoms suggesting urinary
      infection (e.g. dysuria, frequency, urgency) was measured while the patients were
      symptomatic and again when they had become asymptomatic. There was no correlation
      between the urine pH and the incidence or number of symptoms. No differences were
      observed between either the distribution or means of urine pH values in
      symptomatic and asymptomatic patients. There were also no significant differences
      in either symptomatology or urine pH between patients with significant
      bacteriuria and those without significant bacteriuria. These results cast doubt
      upon the traditional (but unproved) belief that alkalinizing the urine helps to
      reduce symptoms of dysuria and/or frequency, whether or not associated with
      urinary infection.

PMID- 2235804
TI  - Anicteric hepatitis and uveitis in a worker exposed to trichloroethylene.
AB  - A previously healthy woman developed acute anicteric hepatitis which slowly
      resolved, though bilateral anterior uveitis then appeared. No other cause than an
      occupational exposure to trichloroethylene was found, and rechallenge by resuming
      work has led to a transient increase in serum alkaline phosphatase. Both
      manifestations may constitute a rare systemic reaction to trichloroethylene.

PMID- 2235805
TI  - Reactivation of latent melioidosis.
AB  - Reports of melioidosis in residents of European countries are rare. We describe a
      case of reactivation of latent melioidosis in a United Kingdom resident. The case
      demonstrates the lack of clinical response to chemotherapy despite proven in
      vitro sensitivity of the organism to the drugs used. It is important to consider
      melioidosis as a cause of septicaemic illness in patients who have travelled to,
      or been resident in South-East Asia.

PMID- 2235806
TI  - Spreading sepsis by cystoscopy.
AB  - A healthy 54 year old man was investigated for haematuria. In spite of a proven
      urinary tract infection a cystoscopy was carried out with no antibiotic therapy.
      As a result he developed systemic infection leading to two independent, and
      potentially fatal, complications: vertebral osteomyelitis and a mycotic false
      aneurysm.

PMID- 2235807
TI  - Abdominal mass.

PMID- 2235808
TI  - Stress and stress counselling.
AB  - This is a report by the 1989 National Association of Clinical Tutors Wyeth
      Travelling Fellow to the United States of America. The stresses of postgraduate
      training and attempts to modify these are described, including stress
      counselling. The significance of stress and the relevance of the findings for
      postgraduate training in the United Kingdom are considered.

PMID- 2235809
TI  - Clinical hyperthyroidism due to non-neoplastic inappropriate thyrotrophin
      secretion.
AB  - We report a case of hyperthyroidism due to inappropriate thyrotrophin (TSH)
      secretion in a patient with selective pituitary resistance to thyroid hormone
      action. Symptoms of hyperthyroidism in patients with this disorder are usually
      mild, implying some peripheral tissue resistance to the metabolic effects of
      thyroid hormone. Our patient had unusually severe symptoms, including marked
      weight loss and cardiac arrythmias which required carbimazole and beta-blocker
      therapy for control. Somatostatin was ineffective in suppressing TSH secretion.
      The introduction of sensitive thyrotrophin assays should facilitate the accurate
      diagnosis of TSH-induced hyperthyroidism and avoid inappropriate treatment.

PMID- 2235810
TI  - Carotid artery stenoses and thrombosis secondary to cavernous sinus thromboses in
      Fusobacterium necrophorum meningitis.
AB  - We report the case of a young man with Fusobacterium necrophorum meningitis who
      developed bilateral carotid artery stenosis associated with thrombosis of the
      cavernous sinuses. Intraluminal clot was present in the region of the stenoses
      for which he was anticoagulated. The clinical presentation, problems with
      diagnosis, the use of anticoagulation and the need for prolonged treatment with
      metronidazole are discussed.

PMID- 2235811
TI  - Intermittent hypercalcaemia and vitamin D sensitivity in Hodgkin's disease.
AB  - A patient with Hodgkin's disease spontaneously developed steroid-responsive
      hypercalcaemia during two consecutive summers. Administration of 3000 U/day of
      vitamin D, while he was normocalcaemic, caused a sharp increase in serum
      1,25(OH)2D3 (from 59 pg/ml to 142 pg/ml) and subsequently hypercalcaemia while
      serum 25(OH)D3 rose moderately within the normal range (from 2.8 ng/ml to 10
      ng/ml). During a spontaneous episode of hypercalcaemia which was accompanied by
      increased circulating 1,25(OH)2D3 concentrations, administration of
      hydrocortisone decreased serum 1,25(OH)2D3 rapidly (from 115 pg/ml to 62 pg/ml)
      and eventually led to normocalcaemia while serum 25(OH)D3 remained unchanged.
      Thus the disturbances of mineral metabolism found in this patient with Hodgkin's
      disease are very similar to those previously described in sarcoidosis.

PMID- 2235812
TI  - A case of POEMS syndrome associated with essential thrombocythaemia and dermal
      mastocytosis.
AB  - We describe a case of POEMS syndrome presenting with the recognized features of
      polyneuropathy, organomegaly, endocrine abnormalities, monoclonal protein, skin
      changes and anasarca. The patient was found to have both a solitary sclerotic
      plasmacytoma of the pelvis and evidence of Castleman's disease of lymph nodes. A
      number of unusual and unique features are also documented. Histological
      examination of affected skin demonstrated changes similar to urticaria pigmentosa
      including local oedema and mast cell infiltration. There was marked
      thrombocythaemia which has been seen in only one previous case and in addition
      the patient developed diffuse vascular calcification in the absence of recognized
      aetiological factors. Radiotherapy of the pelvic lesion and chemotherapy to
      control the myeloproliferative disorder gave rise to significant improvement in
      neuropathy. Control of anasarca required steroid therapy in addition to
      diuretics. The significance of these observations is discussed in relation to
      previous reports.

PMID- 2235813
TI  - Erosive arthritis in relapsing polychondritis.
AB  - We report the case history of a 57 year old man who has suffered from typical
      deforming, relapsing polychondritis for 13 years. He has also developed erosive
      destructive seronegative polyarthritis involving some of his distal
      interphalangeal, proximal interphalangeal, metacarpophalangeal, intercarpal,
      wrist, intertarsal and metatarsophalangeal joints. The distribution of joint
      involvement in the small joints of the hands and feet is asymmetrical. Both hips
      and knee joints have also been involved necessitating bilateral total hip and
      right total knee replacement. The articular associations with relapsing
      polychondritis are discussed.

PMID- 2235814
TI  - Psoas abscess as a complication of subclavian venous catheterization.
AB  - A 76 year old woman developed a psoas abscess from vascular seeding of an
      infected subclavian venous catheter. The presentation was insidious and diagnosis
      delayed. Despite adequate surgical drainage, the case proved to be fatal. Venous
      catheters should be regarded as a potential source of septicaemia and occult
      abscess formation.

PMID- 2235815
TI  - Immunotactoid glomerulopathy associated with mycosis fungoides.
AB  - A patient with mycosis fungoides developed a nephrotic syndrome. Renal biopsy
      revealed deposits of a highly organized fibrillar material which did not stain
      with the typical amyloid stains; this picture was consistent with the diagnosis
      of non-amyloidotic fibrillary glomerulopathy or immunotactoid glomerulopathy. We
      believe this is the first case reported of immunotactoid glomerulopathy
      associated with mycosis fungoides. Possible pathogenetic implications are
      discussed with reference to previous publications.

PMID- 2235816
TI  - Cutaneous myiasis in an elderly debilitated patient.
AB  - A 77 year old woman, with chronic immobility, developed bed sores which became
      infested with maggots. This progressed to cutaneous myiasis which is an uncommon
      complication of this particular phenomenon.

PMID- 2235817
TI  - Synchronous adenocarcinoma and primary malignant lymphoma of the stomach.
AB  - A synchronous presentation of an adenocarcinoma and a primary low grade B cell
      lymphoma of the stomach is reported in a 79 year old man. Both diagnoses were
      made on endoscopic biopsies and immunocytochemistry was essential in confirming
      the lymphoma. The true incidence, aetiology and spatial relations of these
      tumours are unknown since only few cases of such synchronous gastric tumours have
      been reported in the literature.

PMID- 2235819
TI  - Conversation piece--the Medical Defence organisation doctor. Interview by P.D.
      Welsby.

PMID- 2235818
TI  - Ursodeoxycholic acid therapy in chronic active hepatitis.
AB  - A 41 year old woman developed chronic active hepatitis with prominent
      cholestasis. She was treated with prednisolone over 3 years with symptomatic
      benefit and improvement in serum biochemistry. However, various steroid-related
      side effects were encountered and steatorrhoea eventually occurred with very
      troublesome nocturnal diarrhoea. Therapy with ursodeoxycholic acid 750 mg daily
      was started. Serum alanine aminotransferase and gamma-glutamyl transferase
      normalized for the first time since her illness began. Steatorrhoea was
      abolished. There was good control of symptoms as prednisolone therapy was
      gradually reduced. However, when prednisolone was completely withdrawn there was
      a prompt biochemical deterioration. Addition of low-dose azathioprine has
      maintained normal blood tests over 24 months without return of the original
      symptoms. There are no side effects of ursodeoxycholic acid in subjects without
      gallstones and this agent may be effective treatment for cholestatic liver
      disease.

PMID- 2235820
TI  - Duodenal tuberculosis--a continuing diagnostic challenge.

PMID- 2235822
TI  - Snoring as the presenting feature of hypothyroidism.

PMID- 2235821
TI  - Brachial diplegia as a sequel to cardio-respiratory arrest: 'man-in-the-barrel
      syndrome'.

PMID- 2235823
TI  - Pneumococcal bacteraemia: a late complication following endoscopic variceal
      sclerotherapy.

PMID- 2235824
TI  - Borate G-banding technique applicable to in situ deoxyribonucleic
      acid/deoxyribonucleic acid hybridized chicken chromosomes.
AB  - The borate G-banding technique produced excellent longitudinal bands similar to
      trypsin G-bands on chicken chromosomes prepared from embryo material. Aged
      chromosome preparations on slides were pretreated in borate buffer (pH 9.2) for
      10 to 30 s at 37 C, then stained in Giemsa solution. This simple G-banding
      procedure gave high-resolution chromosome banding and permitted the visualization
      of silver grains that localized cloned gene sequences or cloned DNA fragments to
      specific regions by in situ hybridization.

PMID- 2235825
TI  - Divergent selection for body weight and yolk precursor in Coturnix coturnix
      japonica. 8. A summary of correlated responses.
AB  - Correlated response data accompanying 19 generations of selection for increased
      (HW) or decreased (LW) 4-wk BW and increased (HP) or decreased (LP) total plasma
      P were summarized. Similarly, 11 generations of selection of sublines derived
      from the original Lines HW and LP were also analyzed. Sublines were maintained
      through selection of males for increased 4-wk BW and females for the respective
      high or low plasma P. The randombred control (RBC1) was stable for BW early in
      egg production, BW change from early to late in production, wet and dry liver
      weights, 120-day egg production, and ova weight. A linear decrease in BW was
      found for the RBC1 line late in egg production, egg and respective component
      weights, and ova number. Body weight early and late in the production period for
      original Lines HW and LW was different from the RBC1 line. Wet liver weight
      increased for the HW line while dry liver weights declined in the original Lines
      LW, HP, and LP. Egg weights were greater in Line HW and lower in Lines LW, HP,
      and LP than in the RBC1 line. Yolk weight increased in Line HW and decreased in
      Lines LW and LP. Albumen weight was reduced in Line LP while shell weight was
      increased in Line HW and decreased in Line HP. Egg production, from onset to 120
      days, decreased in Lines HW and LW when compared to the RBC1 line. Line LP had
      more follicles in rapid development than Line RBC1. The sublines responded
      similarly to their line of origin differing only in the magnitude of response.
      This was a reflection of the mating scheme, which placed selection pressure on BW
      of males and plasma P in females.

PMID- 2235826
TI  - A comparison of flow cytometry and other techniques used for diagnosing
      Mycoplasma infections.
AB  - Mycoplasma isolates from chickens are usually identified by a fluorescent
      antibody (FA) technique that requires 7 to 10 days from sampling to the
      completion of identification. The FA procedure uses Mycoplasma-positive
      antibodies conjugated with fluoroisothiocyanate (FITC) to identify the colonies
      of the organism on agar. This paper describes a flow cytometric procedure that
      uses the same antibody-FITC conjugate and can be completed in 3 or 4 days.
      Broilers and egg-type hens inoculated with Mycoplasma gallisepticum and M.
      synoviae were swabbed from the choanal cleft and cultures were grown in broth.
      Broth aliquots were briefly incubated with polyclonal antisera to M.
      gallisepticum and M. synoviae conjugated with FITC, the same reagents routinely
      used in the FA technique. The sample was then analyzed by flow cytometry for the
      association of the fluorescent label and the organism. Samples from inoculated
      chickens incubated with the homologous antibody-FITC had greater fluorescent
      intensity than did those incubated with the heterologous antibody-FITC. Diagnosis
      by flow cytometry was consistent with that by the FA technique except that in one
      trial one sample was incorrectly identified by flow cytometry as positive for M.
      gallisepticum, although it was not inoculated with M. gallisepticum. Also, flow
      cytometry did not correctly identify M. synoviae organisms as readily when
      broilers were inoculated with both M. gallisepticum and M. synoviae.

PMID- 2235828
TI  - Locomotion of broiler chickens in floor pens.
AB  - Locomotion has a major effect on production and animal welfare as it relates to
      feed and water acquisition, feed utilization, carcass quality, health, and
      physical vigor. The locomotor abilities of the broiler are also important
      considerations in pen design and placement of feed and water dispensers. To study
      the locomotion of broiler chickens and the effect stocking density has on
      locomotion, eight groups of broiler chickens were observed in an experimental
      floor pen (1.2 by 1.7 m). A Videomex V Image Motion Computer was used to
      determine the distance traveled and the frame-by-frame (30 frames per s) location
      of a focal bird. Four densities (660, 790, 990, and 1320 cm2 per bird) were
      tested, one on each day of the 4-day recording period for each group of birds.
      Broiler chickens were active throughout the day and traveled an average distance
      of 8.8 m per h or 212 m per day. Increasing housing density reduced the distance
      traveled (10, 8.8, 8.5, and 8.1 m per h for 1,320, 990, 790, and 660 cm2 per
      bird, respectively) but did not affect the average number of visits to the
      feeders (4 per h) and water cups (2 per h). The focal birds used the total space
      provided during the day, indicating that they were not consistently socially
      restricted to certain areas of the pen.

PMID- 2235827
TI  - Efficacy of a hydrated sodium calcium aluminosilicate to reduce the toxicity of
      aflatoxin and T-2 toxin.
AB  - A hydrated sodium calcium aluminosilicate (HSCAS) was incorporated into diets
      (.5%) containing 3.5 mg of aflatoxin (AF) per kg and 8.0 mg of T-2 toxin (T-2)
      per kg, singly, and in combination. Male broiler chicks (n = 480) were provided
      with feed and water for ad libitum consumption from 1 to 21 days of age. Body
      weight gains were significantly depressed by AF and T-2, singly, and further
      decreased by the combination of the two toxins. Efficiency of feed utilization
      was not affected. The AF alone and the AF plus T-2 combination caused increases
      in relative liver, kidney, proventriculus, gizzard, spleen, and pancreas weights.
      Treatment-related changes in hematological and serum biochemical values and
      enzyme activities were observed. Oral lesions were observed only in chicks
      receiving the T-2 diets. The HSCAS fed singly did not alter any of the parameters
      measured but it did diminish the toxicity of AF for many parameters but did not
      appear to alter the toxicity of T-2. Addition of HSCAS to the AF plus T-2
      combination diet diminished some of the effects of the toxin combination. These
      findings indicate that HSCAS can diminish many of the adverse effects of dietary
      AF in the chicken, but it has no effect on T-2 toxicity.

PMID- 2235829
TI  - Immune responsiveness of neonatal chicks and immunocyte precursors from unprimed
      juvenile chicken donors.
AB  - The immune responsiveness of immunocyte precursors, obtained from peripheral
      blood of 4- to 6-wk-old unprimed chickens and assayed with the cell transfer
      model, was compared with that of neonatal chicks. Little if any splenic plaque
      forming cell (PFC) production was observed in the spleens of embryonic cell
      transfer hosts following a single antigen exposure to weak or moderate dosages of
      mammalian erythrocytes. However, modest to high PFC formation occurred
      consistently in the hosts following a second exposure to the same antigen when
      given 3 days later. Although a single immunization failed to elicit PFC formation
      in embryo hosts, a single injection of a wide range of antigen dosages into 8-day
      old chicks elicited PFC production consistently. When the double immunization
      protocol was used with 2- to 9-day-old neonatal chicks, the level of immune
      responses were indistinguishable from those elicited with a single antigen
      injection. The difference in the immune kinetics observed in embryo hosts may be
      related to the embryonic microenvironment, which is permissive, but may not be as
      immunosupportive as that of neonates.

PMID- 2235830
TI  - Effects of particle size on the biological availability of calcium and phosphorus
      in defluorinated phosphate for chicks.
AB  - A total of 576 d-old, male, broiler chicks were used in two trials 1) to
      determine the range of Ca and P levels over which the response in bone
      characteristics is linear and 2) to determine the influence of particle size of
      defluorinated rock phosphate (DFP) on the bioavailability of Ca and P in DFP. Six
      treatments were used in Experiment 1 in which varying percentages of added Ca
      (.00, .06, .12, .24, .36, and .48%) and added P (.00, .05, .10, .20, .30, and
      .40%) were evaluated in a corn-soybean meal diet containing 23% CP, .47% Ca, and
      .39% P (.14% available P). Weight gain, feed intake, and tibia breaking strength
      increased (P less than .001) with increasing levels of dietary Ca and P.
      Treatments in Experiment 2 consisted of: 1) Diet 1, a corn-soybean meal basal
      diet (23% CP, .50% Ca, .46% P, .21% available P), 2) Diet 1 with .12% added Ca
      from calcium carbonate (CC) and .07% added P from monosodium phosphate (MSP), 3)
      Diet 1 with .24% added Ca from CC and .14% added P from MSP; and 4 to 8), Diet 1
      with .24% added Ca and .14% added P from five particle sizes of DFP. Feed intake,
      weight gain, and tibia breaking strength and ash percentage increased linearly (P
      less than .01) and feed:gain ratio decreased quadratically (P less than .10) with
      increasing percentages of added Ca and P in Diets 1 to 3.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2235832
TI  - Effect of bambermycins (Flavomycin) in diets for growing turkeys.
AB  - Two experiments were conducted to investigate the response of turkeys to graded
      levels of bambermycins++ in wheat-based diets. In one, 960 Medium White poults
      were fed 0,2,3, or 4 mg bambermycins per kg from day-old to 12 wk of age. In the
      other, 264 male and 408 female Large White poults were fed 0,2,5, or 10 mg
      bambermycins per kg from day-old to 15 (females) or 18 (males) wk of age.
      Response of Medium White poults increased with age, with significantly greater
      weight gain from 8 to 12 wk of age as well as final weights when the diet was
      supplemented with bambermycins. Large White poults responded with highly
      significant increases in gains from 0 to 4 and 4 to 8 wk of age, and a highly
      significant linear response to bambermycins in final weights. Although feed
      efficiency of Large White poults from 0 to 4 wk of age increased with
      bambermycins, overall efficiency in both trials decreased when the diets were
      supplemented. The earlier and greater response of Large White poults in
      comparison with birds of a Medium White strain may be related to the differing
      growth characteristics of those strains. The difference may also be related to
      the re-use of litter in the former trial. However, the effect of neither strain
      nor litter was determined within the same experiment.

PMID- 2235831
TI  - Effect of body weight, feed allowance, and dietary protein intake during the
      prebreeder period on early reproductive performance of broiler breeder hens.
AB  - In Experiment 1, two groups (n = 180) of breeder pullets were selected at 16 wk
      from two larger groups with BW of either 1,591 +/- 43 (LBW) or 1,988 +/- 59 g
      (HBW). From 16 wk of age until a peak feed allotment of 159 g per bird per day,
      weekly feed allowances were increased in a low (LOW), medium (MED), or high
      (HIGH) manner. There were significant differences (P less than .05) in BW between
      the LBW and HBW treatments through 32 wk of age. Within each pullet weight class,
      the HIGH treatment was numerically heaviest through 32 wk. The HBW hens had
      significantly improved hen-day production from 24 to 28 (P less than .001) and 28
      to 32 wk (P less than .06). The LOW treatment resulted in significantly poorer
      production in both the LBW and HBW weight groups from 24 to 28 wk. There were no
      signficant treatment effects on egg weight at a given age. Within each pullet
      treatment, the HIGH treatment resulted in an increased percentage of double
      yolked (DY) eggs from 24 to 28 wk (P less than .05) and 28 to 32 wk (P less than
      .07). In experiment 2, pullets in each of two pullet treatments received
      approximately 12 kg of feed from 2 to 24 wk of age. One treatment received a
      greater quantity of feed early in the rearing period (HEAVY) while pullets in the
      other treatment received a greater quantity of feed later in the rearing period
      (LIGHT). One-half of the pullets from each rearing treatment were fed either a
      14% (LOWPRO) or 18% (HIGHPRO) protein diet during the prelay period (18 to 24
      wk). Pullets in the HEAVY treatment were significantly heavier (P less than .01)
      than those in the LIGHT treatment at 21 but not at 24 wk. The HIGHPRO treatment
      resulted in a significant improvement (P less than .05) in hen-day egg production
      from 24 to 28 and 28 to 32 wk. There were no treatment effects on egg weight, and
      the LOWPRO treatment resulted in a significant increase (P less than or equal to
      .01) in the number of DY eggs from 28 to 32 wk.

PMID- 2235833
TI  - Effects of feeding level during pullet-layer transition and of pretransition
      lighting on performance of broiler breeders.
AB  - Four feeding regimens were compared for the pullet-layer transition period and
      two light types, white and narrow-band green fluorescent, were compared in the
      grower period to determine their subsequent effects on reproductive performance
      of broiler breeder hens. Four limit-feeding treatments imposed from 18 wk (body
      weight of 1.8 kg) to "mature weight" of 2.8 kg at 27 (Treatment 1), 25 (Treatment
      2), 24 (Treatment 3) and 22.5 (Treatment 4) wk of age supported weight gains of,
      respectively, 15, 19, 23, and 27 g per day. Production of total and hatching eggs
      was similar among all dietary and lighting treatments. Hens given dietary
      Treatment 1 had a higher production from 224 to 252 days but had a lower
      production from 168 to 189 days associated with a 2.6-day later age at 50% egg
      production. Feeding regimen and lighting treatment had no effect on egg weight,
      and feeding did not affect mortality. Green lighting reduced mortality from 2.0
      to 1.4% at 70 to 126 days and from 5.7 to 4.0% from 126 to 280 days of age,
      compared with white lighting. Fertility was 5% lower for Treatment 4 versus
      Treatment 1 and 4% lower for white versus green lighting. The advantage of higher
      initial hatching egg production obtained with rapid growth, of greater than 15 g
      per day, during the transition period was outweighed by detrimental effects on
      production and fertility in later periods. Green light may increase chick
      production per hen housed by causing decreased pullet mortality and increased
      fertility.

PMID- 2235834
TI  - Effect of varying calcium and phosphorus level on manganese utilization.
AB  - Two experiments were conducted to evaluate the effect of varying levels of excess
      Ca and P on manganese (Mn) utilization. The criterion used to study the Mn
      antagonizing effects of excess Ca and P was the regression of total tibia Mn on
      supplemental Mn intake. In Experiment 1, high supplemental levels of Mn were fed
      (0, 500, and 1,000 mg Mn per kg); in Experiment 2, lower Mn levels were fed (0,
      50, and 100 mg Mn per kg). Supplements were added to a corn-soybean meal diet
      containing 1.1% Ca, .7% (.5% available) P, and 37 mg Mn per kg. In Experiment 1,
      a 3 x 3 x 3 factorial arrangement of treatments (four replicates) was used.
      Treatments were as follows: 0, .5, and 1.0% excess Ca as feed-grade ground
      limestone; 0, .4, and .8% excess P as KH2PO4; and 0, 500, and 1,000 mg Mn per kg
      as MnSO4.H2O. Total tibia Mn was depressed by P (P less than .0001) but not by Ca
      (P greater than .05). Compared with the standard (no added P), .4% P reduced Mn
      utilization by 22%, whereas .8% P reduced it by 38%. Manganese supplementation
      was found to ameliorate the growth-depressing effect of .8% supplemental P.
      Results of Experiment 2 agreed with the results in Experiment 1, providing
      evidence that bioavailability estimates obtained from experiments containing high
      levels of Mn can be extrapolated to diets containing lower levels. Results from
      Experiment 2 indicated that, relative to the standard (no added P), .22, .44 and
      .88% excess P reduced Mn utilization by 16, 22 and 31%, respectively.

PMID- 2235835
TI  - Lipid metabolism in liver of chicks: response to feeding.
AB  - Fatty-acid synthase is an enzyme complex responsible for the synthesis of the
      carbon chain of fatty acids. The hepatic activity of this enzyme increases
      rapidly during a refeeding period following a fast. The activity of fatty-acid
      synthase in liver of newly hatched chicks rises in parallel with the activities
      of other lipogenic enzymes at the initiation of feeding. Cycloheximide, an
      inhibitor of protein synthesis, prevents the feeding-associated rise of other
      lipogenic enzymes, but not of fatty-acid synthase. Evidence is reviewed that
      supports the hypothesis that in fasted chicks as well as in unfed, newly hatched
      chicks, fatty-acid synthase exists in a catalytically less-active form, one that
      is activated in response to feeding.

PMID- 2235836
TI  - Hepatic protein and amino-acid metabolism in poultry.
AB  - Two subjects are discussed: first, the regulation of hepatic protein synthesis;
      and second, the intermediary metabolism of methionine, particularly with respect
      to the role of 2-hydroxy-4-(methylthio)-butanoic acid (HMB, Alimet). In the first
      section, the regulation of albumin synthesis is reviewed in terms of molecular
      events associated with the changes in albumin synthesis during fasting and
      refeeding. The effect of infection or of inflammatory stress on both albumin and
      total protein synthesis in the liver is also discussed. In the second part,
      research results are presented which indicate that HMB is a naturally occurring
      compound in methionine intermediary metabolism. The HMB synthesis by chick liver
      enzymes is demonstrated, and its role in normal avian methionine metabolism is
      discussed.

PMID- 2235837
TI  - Effect of peptide histidine isoleucine on in vitro and in vivo prolactin
      secretion in the turkey.
AB  - Studies were conducted both in vitro, using monolayer cultures of turkey
      pituitary cells, and in vivo, using ovariectomized turkey hens, steroid-primed
      ovariectomized hens, and immature toms to compared the effectiveness of peptide
      histidine isoleucine (PHI) with that of vasoactive intestinal peptide (VIP) in
      stimulating prolactin (PRL) secretion. Vasoactive intestinal peptide, a putative
      PRL-releasing factor (PRF) in the turkey, was approximately 1000-fold more
      effective than PHI in stimulating PRL secretion in vitro. Prolactin secretion was
      significantly enhanced by the exposure of pituitary cells to 10(-7) M PHI and a
      similar stimulation was observed with 10(-10) M VIP. Injection of cannulated,
      unrestrained turkeys with PHI at doses up to 100 micrograms per kg of BW caused
      no significant change in circulating PRL concentrations, but injection of 10
      micrograms of VIP per kg resulted in a 7 to 22-fold increase in plasma PRL
      concentration within 10 to 30 min following injection. These results demonstrate
      a marked difference between the turkey and the rat in their response to a PRL
      stimulating neuropeptide. In contrast to what was observed in the turkey, PHI is
      a strong PRF in the rat, with a potency equal to or greater than that of VIP.
      Earlier studies have shown that thyrotropin-releasing hormone, another strong PRF
      in mammals, has little consistent PRF activity in the turkey. Thus, the present
      studies add additional evidence of major differences between mammals and birds in
      the control of PRL secretion by hypothalamic neuropeptides.

PMID- 2235838
TI  - The effect of tamoxifen on semen fertilization capacity in White Leghorn male
      chicks.
AB  - Tamoxifen (TAM) is an antiestrogen that advances sexual puberty in cockerels,
      turkey toms, and Muscovy drakes. The effect of TAM on semen-fertilization
      capacity in White Leghorn (WL) male chicks was assayed in the present study.
      Sixty, 2-wk-old, male chicks were divided into two equal groups. The chicks from
      one group were injected im with 1 mg of TAM per kg of BW every other day; those
      from the second group were vehicle-treated (with corn oil) and served as
      controls. Each chick was paired with a virgin, WL laying hen. When semen was
      produced, the paired female was inseminated twice a week. The results revealed
      that TAM administration caused the early production of fertile semen, which
      resulted in the first normal descendants as early as 8 wk of age and brought
      about 100% of parenthood by the age of 88 days.

PMID- 2235840
TI  - Head skeletal abnormalities associated with the throat tuft mutation (hfdTt) in
      the Japanese quail.
AB  - Hereditary abnormalities of head skeleton ascribed to embryonic visceral arch
      defects were investigated in Japanese quail homozygous for the throat tuft
      mutation (hfdTt). Differential staining for bone and cartilage of 15-day embryos
      revealed partial deletion or irregularity in the mandible, basiparasphenoid,
      hyoid apparatus, and quadratojugal bones, incidences of which were 84, 44, 40,
      and 18%, respectively. Incidence of the head-skeleton abnormality was 88% when
      individuals having at least one of the abnormalities mentioned were regarded as
      abnormal. Throat tuft (hfdTt) and ear tuft (hfd) homozygotes showed distinct
      differences between them, although both alleles are associated with visceral arch
      defects.

PMID- 2235839
TI  - Conditions necessary for a response by the commercial laying hen to supplemental
      choline and sulfate.
AB  - An experiment was conducted with commercial laying hens, 24 wk of age, to study
      the response from adding 440 mg of choline and sulfate as 2 g of K2SO4 per kg of
      a corn soybean-meal diet containing different levels of supplemental DL-Met. The
      basal diet was formulated to be deficient (.495%) in sulfur amino acids, and
      nonsulfate forms of trace minerals were used in all diets. The experiment was
      conducted for 22 wk; however, only the data from the last 12 wk were used as the
      measurement of response since the responses were greatest during this period. Egg
      production, egg weight, and feed efficiency were improved with each addition of
      Met from 0 to .2%. Choline supplementation of the diet containing added .033% Met
      significantly increased egg production. However, no response was obtained from
      choline supplementation of diets containing 0 or .067% added Met. Addition of
      sulfate improved egg production when it was added to the diet with choline but
      not when it was added to the diet with Met.

PMID- 2235841
TI  - Influence of dietary supplementation with Streptococcus faecium M-74 on broiler
      body weight, feed conversion, carcass characteristics, and intestinal microbial
      colonization.
AB  - Two experiments were conducted to determine the influence of Streptococcus
      faecium M-74 supplementation of broiler diets. Mixed-sex or male only chicks were
      used in the experiments. Both experiments consisted of six dietary treatments and
      four replicates per treatment in a randomized block design. The S. faecium was
      fed alone for 21, 36, or 44 days or for 44 days with S. faecium supplemented in
      the water for the first 14 days. In another treatment, S. faecium was fed for 44
      days, but the feed was restricted for Days 8 through 13. The S. faecium was also
      fed in combination with antibacterial products (AP) for 44 days. An additional
      diet was an unsupplemented basal, and another was supplemented only with AP. In
      Experiment 1, feed efficiency was significantly better with the basal and diets
      supplemented with S. faecium than with those diets supplemented with AP or AP and
      S. faecium. In Experiment 2, BW of broilers at 44 days of age were significantly
      heavier for broilers receiving S. faecium in the feed and also S. faecium in the
      water for the first 14 days as compared with broilers receiving AP or AP and S.
      faecium supplementation. There were no significant differences in carcass yield
      or composition characteristics. In Experiment 1, the scores representing S.
      faecium colonies found in the intestinal tract were not influenced by dietary
      treatment. The ceca had the highest S. faecium score of any of the intestinal
      tract locations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235842
TI  - Effects of feeding lasalocid on performance of broilers in moderate and hot
      temperature regimens.
AB  - Three trials were conducted in environmental chambers to study the effects of
      feeding lasalocid on broiler performance. Birds were randomly assigned at 31 or
      35 days of age to one of four treatment groups: hot cyclic (26.7 to 37.8 C and 90
      to 40% RH) with basal diet; hot cyclic with lasalocid diet (88 mg/kg); moderate
      constant (21 C and 50% RH) with basal diet; or moderate constant with lasalocid
      diet. All birds were killed and processed 2 wk after the start of each trial.
      Percentage of carcass yield and fat pad weight were determined. In the moderate
      temperature regimen, lasalocid feeding caused a depression in the 2nd wk gain
      (469 versus 486 g) but not in the final 2-wk gain. In the hot temperature
      regimen, birds fed lasalocid gained significantly more weight in the 2nd wk than
      those fed the basal diet (341 g versus 325 g) and had a significantly better feed
      conversion in the 2nd wk (2.04 versus 2.61) and overall (2.07 versus 2.32) than
      those fed the basal diet.

PMID- 2235843
TI  - Use of ivermectin to control the lesser mealworm (Coleoptera: Tenebrionidae) in a
      simulated poultry broiler house.
AB  - Broiler chickens were fed ivermectin at a level of 2 ppm for 5 wk to determine
      its efficacy against the lesser mealworm, Alphitobius diaperinus. This treatment
      essentially eliminated lesser mealworm larvae; no ivermectin residues were found
      in the livers of the treated chickens, even without a withdrawal period. However,
      the feeding of ivermectin may reduce body weights body weight gain and feed
      efficiency at older ages.

PMID- 2235844
TI  - Dietary and monensin effects on activity of hepatic microsomal mixed function
      oxidase system in chickens.
AB  - Four experiments were conducted to investigate if the degree of activation of the
      microsomal mixed-function oxidase (MFO) system was related to the degree of
      growth depression associated with the addition of monensin to the diet. The
      experiments were conducted with broiler chicks in battery brooders in which the
      chicks were fed diets of various composition and containing monensin at 0 to 160
      ppm. In all experiments, the activity of the MFO system was estimated by the
      change in the content of cytochrome P-450 in the hepatic microsomes. Activities
      of some microsomal enzymes were also measured in some of the experiments. Feeding
      a diet with 24% protein containing fish meal, alfalfa meal, and torula yeast
      significantly increased the activity of the MFO system in comparison with feeding
      an isonitrogenous and isoenergetic corn and soybean diet, but there was no
      difference between the diets in the toxicity of monensin as measured by growth
      rate. Supplementing a 16% protein but not a 24% protein diet with monensin
      significantly reduced growth rate. In none of the four experiments was there a
      statistically significant change in the hepatic content of cytochrome P-450 as a
      result of feeding monensin. Thus, variation in the magnitude of growth depression
      caused by monensin in diets of different protein concentration or ingredient
      composition does not appear to be explained on the relative degree of the
      activation of the MFO system.

PMID- 2235845
TI  - Glucocorticoid activation of deoxyribonucleic acid degradation in bursal
      lymphocytes.
AB  - Treatment of animals with exogenous adrenal steroids or elevation of endogenous
      glucocorticoids results in a profound involution of lymphoid tissue. In rodent
      species, this lymphoinvolution is accompanied by lymphocyte cell death and
      extensive degradation of the genome prior to lymphocytolysis. In the present
      study, this process was investigated in the bursa of Fabricius of domestic fowl.
      Four-wk-old chicks were treated with a single injection of dexamethasone, and
      bursal regression and cell viability were monitored over a 72-h period. Following
      hormone treatment, DNA was extracted from bursal lymphocytes and analyzed by
      agarose gel electrophoresis. Dexamethasone treatment resulted in a rapid
      regression of bursal tissue that could be detected as soon as 6 h posttreatment,
      but lymphocyte viability was not altered until 24 h afterward. The DNA isolated
      from bursal lymphocytes of glucocorticoid-treated birds appeared to be degraded
      at internucleosomal sites and generated a "ladder" of discrete DNA fragments when
      analyzed by agarose gel electrophoresis. This form of hormone-induced cell death,
      referred to as programmed cell death, may play a key role in glucocorticoid
      mediated immunosuppression.

PMID- 2235846
TI  - Effect of dietary protein source and cereal type on the incidence of sudden death
      syndrome in broiler chickens.
AB  - Three experiments were conducted to compare the incidence of Sudden Death
      Syndrome (SDS) in male Peterson by Arbor Acre broiler chickens fed diets with
      either corn or wheat as the grain type and meat meal or soybean meal as the main
      protein source. In the first two experiments, the broilers were raised in floor
      pens to 6 wk of age, and in the third experiment they were raised in battery
      brooder cages to 4 wk of age. In both floor pen studies, total mortality and the
      incidence of SDS were significantly higher for wheat-fed birds, while SDS as a
      percentage of total mortality was not affected by cereal type. In the brooder
      study, neither total mortality nor mortality from SDS was significantly affected
      by cereal type. In the floor pen studies, the incidence of SDS as a percentage of
      the birds housed, was reduced by the inclusion of meat meal in the diet. In the
      brooder study, total mortality and the incidence of SDS were not affected by
      protein source, but SDS as a percentage of total mortality was reduced with the
      inclusion of meat meal in the diet.

PMID- 2235847
TI  - Energy metabolism of broiler breeder hens. 1. The partition of dietary energy
      intake.
AB  - The partitioning of AME intake (MEI) and recovered energy (RE; defined as MEI
      minus heat production) was investigated on Hubbard broiler-breeder hens (BB) by
      using indirect calorimetry and energy balance. The regression of RE on MEI was
      linear (R2 = .96; P less than .01) with a slope of .817 +/- .024 (SE) and a y
      intercept of -238.3 +/- 10.7 (SE). The maintenance energy requirement was 292
      kilojoule (kJ) per kg per day (367 kJ per kg.75 per day). The regression of body
      RE, defined as RE minus egg energy, on MEI was linear (R2 = .96; P less than .01)
      with a slope of .799 +/- .045 (SE) and a y-intercept of -344.9 +/- 19.7 (SE).
      Therefore, an MEI of 432 kJ per kg per day was required by BB hens to maintain
      body energy equilibrium when they were laying at approximately 85% production. At
      an MEI of less than 432 kJ per kg per day, body energy was used for egg
      production. The AME cost of depositing 1 kJ of body, egg, protein, or fat energy
      was (mean +/- SE) 1.21 +/- .06, 91 +/- .32, 1.96 +/- .71, and 1.05 +/- .15 kJ,
      respectively. The results indicate that individually caged BB hens between 28 and
      36 wk of age in a thermal-neutral environment (21 C) require approximately 1.6
      megajoule (MJ) of AME per bird per day for normal growth (3 g/per day) and egg
      production (85%).

PMID- 2235848
TI  - Energy metabolism of broiler breeder hens. 2. Contribution of tissues to total
      heat production in fed and fasted hens.
AB  - In vitro rates of O2 consumption were investigated using excised biopsies from
      the liver, ileum, magnum, and latissimus dorsi muscle of Hubbard (H) broiler
      breeder hens fed four levels of ME intake. Diet had no effect on O2 consumption
      of any tissue. The overall mean initial O2 consumption (microL of O2 per mg of
      dry weight per h) for latissimus dorsi, liver, ileum, and magnum tissues were
      4.38, 13.33, 10.54, and 8.01, respectively. The Na+ and K(+)-adenosine
      triphosphatase-dependent respiration (ouabain-sensitive respiration) was 16% of
      the initial rate for latissimus dorsi, liver, and magnum tissues and 22% for
      ileum tissues. Fasting heat production of H and Arbor Acre (AA) meat-type hens
      measured over 3 days following an initial 24-h fast was 219 and 216 kilojoules
      (kJ) per kg per day (1 kJ = .239 kcal). There were no strain differences in the
      partitioning of O2 consumption into tissue components of fasted H and AA hens.
      Fasting metabolism accounted for 75% of the maintenance energy requirement in the
      hens. The liver, gut, and reproductive tract, which together make up 5 to 6% of
      BW, account for 26 and 30% of the total energy expenditure in fed and fasted
      hens, respectively.

PMID- 2235849
TI  - Riboflavin requirement of chicks fed purified amino acid and conventional corn
      soybean meal diets.
AB  - Three experiments were conducted to determine the riboflavin requirement for
      maximal growth of young chicks. Graded levels of crystalline riboflavin were
      added to either riboflavin-free, purified amino acid diets or corn-soybean meal
      diets. Chick growth responses were obtained upon adding riboflavin to both diets.
      Chicks fed the purified diet required 1.8 mg of riboflavin per kg of diet, but
      those fed the corn-soybean meal diet required 2.63 mg of riboflavin per kg of
      diet. Retarded growth and leg paralysis, rather than curled-toe paralysis, were
      the predominant signs of riboflavin deficiency. Calculations suggested that
      riboflavin bioavailability in the corn-soybean meal diet was 59.1%.

PMID- 2235850
TI  - High performance liquid chromatographic analysis of the malondialdehyde content
      of chicken liver.
AB  - An assay for the determination of malondialdehyde (MDA) levels in chicken liver
      is described. The method involves the extraction of the tissues with
      trichloracetic acid and reaction of the extract with TBA. The reaction mixture is
      then purified using reverse-phase cartridges and the TBA-MDA reaction products
      are separated from other TBA-reactive substances by reverse-phase HPLC. The
      method is rapid, reproducible, easy to perform, and is sensitive in the nanogram
      (10(-11) mol) range. Application of this technique may be useful to determine the
      extent of lipid peroxidation occurring in the liver as a result of degenerative
      liver diseases or poisoning with certain hepatotoxins.

PMID- 2235851
TI  - Arginine requirement of starting broiler chicks.
AB  - Three experiments were conducted to estimate the arginine requirement of male
      broiler chicks from 0 to 3 wk of age. The experiments were conducted in battery
      brooders with wires floors, and the birds received water and feed ad libitum. In
      the first experiment, chicks were fed a diet based on corn, soybean meal, casein,
      and corn-gluten meal containing 3,200 kcal ME per kg and either 20 or 23% crude
      protein. Regression analysis indicated an arginine requirement of 1.22% for
      maximum growth rate and feed efficiency with the 20% protein diet. For chicks fed
      the 23% protein diet, neither growth rate nor feed efficiency was significantly
      different among the diets containing arginine ranging from 1.13 to 1.43%. In the
      second experiment, a basal diet was used containing 17.5% casein and 22.5%
      protein with arginine ranging from 1.03 to 1.43%. An arginine requirement of
      1.18% for maximum body weight gain was estimated by regression analysis, but no
      significant response to arginine above the basal level was observed for feed
      efficiency. Performance of chicks fed the basal diet was somewhat reduced because
      of a difficulty with adherence of feed to the beaks. In a third experiment, three
      basal diets containing 21, 22, or 23% protein were formulated from practical
      ingredients without use of casein. The requirement for maximum growth rate and
      feed efficiency was estimated to be 1.24 to 1.28% for the three diets. The
      results of these investigations indicate that the arginine requirement for
      starting chicks suggested by the National Research Council in 1984 of 1.44% in
      diets containing 3,200 kcal ME per kg is too high for practical diets. The data
      presented here support an arginine requirement of 1.25%.

PMID- 2235852
TI  - The role of plasma thyroid hormones in the regulation of body weight of single
      comb White Leghorn and broiler embryos.
AB  - Studies were conducted to determine if sex differences in embryo weights existed
      in a light-weight breed of chickens (the Single Comb White Leghorn, SCWL) and in
      a heavy broiler strain of chickens. Plasma thyroid hormone concentration was
      measured to determine its relationship to embryo weight. Male SCWL embryos were
      heavier than females at 15 and 17 days of incubation, but not at 13 days. Male
      broiler embryos were heavier than females at 13 and 15 days of incubation, but
      not at 17 days. There was no sex difference in the levels of plasma
      triiodothyronine (T3) or of tetraiodothyronine (T4) of SCWL embryos at those
      respective ages. The plasma T4 in male broiler embryos was significantly lower
      than that in the females at 15 and 17 days of incubation, but not at 13 days.
      There was no relationship between plasma T3, and the weight of SCWL embryos.
      There were significant linear regressions of embryo weight on the plasma T4
      levels for SCWL males at 13 and 15 days of incubation and for SCWL females at 13
      and 17 days of incubation, respectively. A significant regression of embryo
      weight on plasma T4 was found in female broiler embryos at 13 days of age, but
      not in females at other ages or in males at any of the ages studied.

PMID- 2235853
TI  - The effect of age of breeder hens on residual yolk fat, and serum glucose and
      triglyceride concentrations of day-old broiler chicks.
AB  - The fat content and the concentrations of glucose and triglyceride in day-old
      chicks hatched from 27 and 60 wk-old broiler-breeder hens were determined from
      pooled samples of residual yolk and blood serum, respectively. Serum glucose and
      triglyceride levels were unaffected (P greater than .05) by breeder age, although
      there was a linear (P less than .001; r = .67) relationship between these
      characteristics and chick weight. Yolk fat, adjusted for chick weight, was on the
      average 13% greater (P less than .05) in chicks from old breeders than chicks
      from young breeder hens. Yolk wet weight was not affected (P greater than .05) by
      breeder age. Results indicate that breeder age may affect chick performance
      through alterations in the fat content of residual yolk.

PMID- 2235854
TI  - Effect of the sex-linked dwarfing gene (dw) upon skeletal development of young
      broiler chicks.
AB  - The influence of the sex-linked dwarfing gene (dw) on growth and skeletal
      development in young male broiler chicks was investigated. Chickens that were
      homozygous (dw/dw) for the dwarfing gene had significantly lower BW and
      tibiotarsus lengths when compared with the heterozygous (Dw/dw) or normal (Dw/Dw)
      genotypes. All genotypes exhibited similar incidences of tibial dyschondroplasia.
      In contrast to several other types of dwarfism, there was no effect of the dw
      gene on the width of the epiphyseal growth plate or the proteoglycan content of
      this tissue.

PMID- 2235855
TI  - A comparison of seven microbiological sampling procedures for hard-cooked eggs.
AB  - Seven microbiological sampling methods for hard-cooked eggs were evaluated and
      compared. Fresh eggs within 24 h of oviposition were cooked at 98 C for 22 min in
      water and then cooled in 31 C water. Eggs were dipped for 10 min in a
      physiological saline solution (.85% saline) 10 C cooler than the eggs and
      containing known numbers of bacteria. Eggs were then stored for 4 days at 6 C and
      sampled using one of seven rinse or blend procedures on whole eggs, shell,
      shelled egg contents, or shelled egg contents plus shell. Highest recoveries were
      made from the peeled egg plus shell rinse, shell rinse, whole egg blend, and
      shell blend. Lowest recoveries were found with the whole egg rinse, the peeled
      egg rinse, and the peeled egg blend. These results indicate that significant
      numbers of organisms are associated with the inner and outer shell surfaces as
      well as the egg contents surface (albumen). Satisfactory recoveries can be made
      with the peeled egg plus shell rinse or the whole egg blend. Whole egg rinsing of
      hard-cooked eggs does not appear to be satisfactory.

PMID- 2235856
TI  - Suspected child sexual abuse.

PMID- 2235857
TI  - Suspected keratoacanthoma--a wolf in sheep's clothing?

PMID- 2235859
TI  - Bleeding in pregnancy.

PMID- 2235858
TI  - The breathless child.

PMID- 2235860
TI  - Psychiatric night calls.

PMID- 2235861
TI  - The acute abdomen.

PMID- 2235862
TI  - Collapse--on the spot management.

PMID- 2235863
TI  - TWAR and changing respiratory infections.

PMID- 2235864
TI  - Dave's return.

PMID- 2235865
TI  - The care of hypertensive patients.

PMID- 2235866
TI  - Adolescent bone tumours.

PMID- 2235867
TI  - Revision strategies.

PMID- 2235868
TI  - The asthmatic child.

PMID- 2235869
TI  - The returning traveller.

PMID- 2235870
TI  - Management of travellers' diarrhoea.

PMID- 2235871
TI  - Imported malaria.

PMID- 2235872
TI  - Parasitic diseases.

PMID- 2235873
TI  - Sexually transmitted diseases.

PMID- 2235874
TI  - Pharmacists and GP prescribing.

PMID- 2235875
TI  - Chemical pathways of peptide degradation. III. Effect of primary sequence on the
      pathways of deamidation of asparaginyl residues in hexapeptides.
AB  - Deamidation of Asn residues can occur either by direct hydrolysis of the Asn
      residue or via a cyclic imide intermediate. The effects of primary sequence on
      the pathways of deamidation of Asn residues were studied using Val-Tyr-X-Asn-Y
      Ala hexapeptides with substitution on the C-terminal side (Y) and on the N
      terminal side (X) of the Asn residue. In acidic media the peptides deamidate by
      direct hydrolysis of the Asn residue to yield only Asp peptides, whereas under
      neutral or alkaline conditions, the peptides deamidate by formation of the cyclic
      imide intermediates which hydrolyze to yield both isoAsp and Asp peptides. At
      neutral to alkaline pH's the rate of deamidation was significantly affected by
      the size of the amino acid on the C-terminal side of the Asn residue. The amino
      acid on the C-terminal side of the Asn residue has no effect on the rate of
      deamidation at acidic pH. Changes in the structure of the amino acid on the N
      terminal side of the Asn residue had no significant effect on the rate of
      deamidation at all the pH's studied. For peptides that underwent deamidation
      slowly, a reaction involving the attack of the Asn side chain on the peptide
      carbonyl carbon resulting in peptide bond cleavage was also observed.

PMID- 2235876
TI  - Stereochemical characterization of the diastereomers of the amobarbital N
      glucosides excreted in human urine.
AB  - The stereochemistry associated with the amobarbital N-glucoside diastereomers (1a
      and 1b) that are excreted by humans in urine is unknown. Using X-ray
      crystallography, the absolute configuration of 1b was determined to be S (C-5
      position of the barbiturate ring). Following oral administration of amobarbital
      to Caucasians and Orientals, from 5 to 25% of the dose of amobarbital was
      excreted in the urine as 1b. The other diastereomer, 1a, accounted for less than
      0.1 to 0.2% of the dose in four individuals, with none detected in nine
      individuals. The rate constants, kf,1b, determined from the urinary excretion of
      1b were lower than those previously reported for unresolved amobarbital N
      glucosides. However, based on the urinary excretion of 1b, the rate constants, K,
      for elimination of amobarbital in Caucasians and Orientals were similar to those
      previously determined from the serum levels of amobarbital and the urinary
      excretion of unresolved amobarbital N-glucosides. In previous studies of the N
      glucosylation of amobarbital, it is likely that a single N-glucose diastereomer,
      1b, was being observed.

PMID- 2235877
TI  - An electrotopological-state index for atoms in molecules.
AB  - A new method for molecular structure description is presented in which both
      electronic and topological characteristics are combined. The method makes use of
      the hydrogen-suppressed graph to represent the structure. The focus of the method
      is on the individual atoms and hydride groups of the molecular skeleton. An
      intrinsic atom value is assigned to each atom as I = (delta v + 1)/delta, in
      which delta v and delta are the counts of valence and sigma electrons of atoms
      associated with the molecular skeleton. The electrotopological-state value, Si,
      for skeletal atom i is defined as Si = Ii + delta Ii, for second row atoms, where
      the influence of atom j on atom i, delta Ii, is given as sigma(Ii-Ij)/rij2; rij
      is the graph separation between atom i and atom j, counted as the number of
      atoms. The characteristics of the electrotopological state values are indicated
      by examples of various types of organic structures, including chain lengthening,
      branching, heteroatoms, and unsaturation. The relation of the E-state value to
      NMR chemical shift is investigated for a series of alkyl ethers. The E-state
      oxygen value gives an excellent correlation with the 17O NMR: r = 0.993 for 10
      ethers. A biological application of the E-state values in QSAR analysis is given
      for the binding of barbiturates to beta-cyclodextrin.

PMID- 2235878
TI  - The molecular weight dependence of nasal absorption: the effect of absorption
      enhancers.
AB  - A series of polyethylene glycols (PEGs) ranging in molecular weight from near 600
      to over 2000 daltons was used to study the effects of three absorption enhancers
      (sodium glycocholate, sodium lauryl sulfate, and polyoxyethylene 9 lauryl ether)
      on the molecular weight permeability profile of the nasal mucosa of the rat.
      Molecular weight-permeability properties were studied both by following changes
      in the excretion of the polyethylene glycols as a function of their molecular
      size and by examining the nasal mucosa for morphologic changes following exposure
      to the PEG/enhancer mixtures. Each absorption enhancer was found to affect the
      mucosa and its permeability in a unique manner. At a 1% concentration, sodium
      glycocholate only slightly affects tissue morphology and does not significantly
      alter the molecular weight permeability profile of the mucosa. In contrast, 1%
      sodium lauryl sulfate causes severe alteration of the mucosa and also greatly
      increases the absorption of both the PEG 600 and the PEG 2000 oligomers.
      Polyoxyethylene 9 lauryl ether was found to exert its action in a concentration
      dependent manner. At a concentration of 0.1%, few changes were seen in either
      mucosal integrity or permeability. At a 1% concentration, however, a significant
      alteration in the structure of the mucosal tissues as well as a profound increase
      in the permeability of the mucosa to the PEGs was observed. Correlation of
      mucosal integrity with the effectiveness of an enhancer indicates that some of
      these compounds appear to be acting by altering the structure of the
      mucosa.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235879
TI  - Biochemical and mechanical characterization of enzyme-digestible hydrogels.
AB  - Albumin-cross-linked hydrogels were prepared by free radical polymerization using
      1-vinyl-2-pyrrolidinone as a monomer and functionalized albumin as a crosslinking
      agent. The degree of chemical cross-linking was controlled by varying the degree
      of albumin functionality and the concentration of albumin. With emphasis placed
      on the potential use of these hydrogels for long-term oral drug delivery, gel
      characterization studies examined both the swelling and the mechanical properties
      in the absence and presence of pepsin. In the absence of pepsin, the equilibrium
      swelling ratio in simulated gastric fluid ranged from 17 to 55, depending on the
      degree of albumin functionality and the albumin concentration. Swelling was pH
      dependent at pH's greater than 7. The uptake of solvent into the dried hydrogels
      was determined to be Fickian. The integrity of swelling gels was dependent on the
      concentration of the functionalized albumin as well as on the degree of albumin
      functionality. In the presence of pepsin, a predominance of either surface or
      bulk degradation was observed, depending on the functionality of the albumin used
      as a cross-linker. Gel integrity during pepsin degradation also showed a marked
      dependence on the albumin functionality.

PMID- 2235880
TI  - Percutaneous penetration enhancement in vivo measured by attenuated total
      reflectance infrared spectroscopy.
AB  - A novel application of attenuated total reflectance IR spectroscopy (ATR-IR) was
      used to monitor the outer several microns of the stratum corneum (SC) and,
      thereby, demonstrate enhanced percutaneous absorption in vivo in man. 4
      Cyanophenol (CP) as a model permeant yielded a unique IR signal, distinct from
      those of the stratum corneum and the vehicle components. CP was administered for
      1, 2, or 3 hr as a 10% (w/v) solution either in propylene glycol or in propylene
      glycol containing 5% (v/v) oleic acid. The absorbance at 2230 cm-1, which
      corresponded to C identical to N bond stretching, diminished significantly faster
      when CP was codelivered with oleic acid. An IR absorbance due primarily to
      propylene glycol at 1040 cm-1 (C-O stretching) also disappeared more quickly
      following application of the enhancer-containing solution. In addition, only the
      formulations with oleic acid induced a higher wavenumber shift in the frequency
      of the asymmetric C-H bond stretching absorbance. This change indicates increased
      lipid-chain disorder, the mechanism by which oleic acid is believed to cause
      enhanced drug transport across the stratum corneum. Therefore, ATR-IR permits one
      to examine noninvasively the kinetics, extent, and mechanism of percutaneous
      penetration enhancement in vivo in human subjects.

PMID- 2235881
TI  - A method for quantifying particle absorption from the small intestine of the
      mouse.
AB  - We have developed a method for quantifying the absorption of model fluorescent
      latex particles from the mouse small intestine into Peyer's patches, mesenteric
      lymph nodes, and spleen. The procedure combines a simple and exhaustive particle
      recovery technique with a highly sensitive particle counting technique. Mice were
      orally gavaged with fluorescent polystyrene latex suspensions, and at various
      time points Peyer's patches, normal absorptive small intestinal tissue,
      mesenteric lymph nodes, and spleen were collected. The tissue samples were
      solubilized using an aqueous potassium hydroxide and surfactant solution and
      particles were counted using a flow cytometer. Using this method we were able to
      detect and quantify small numbers of particles, measure the course of uptake and
      clearance, and determine the tissue distribution of absorbed particles. Data
      generated using this technique indicate that particle absorption depends on the
      dose level, particle size, and fed state of the animals.

PMID- 2235882
TI  - Thermodynamics and mathematical modeling of the partitioning of chlorpromazine
      between n-octanol and aqueous buffer.
AB  - The distribution of chlorpromazine (CPZ) between aqueous buffer solutions and 1
      octanol was studied over a wide range of pH, buffer concentration, and
      temperature. A mathematical model was developed to simulate the distribution
      profiles. It is assumed that only monomers of CPZ exist in the organic phase,
      whereas in the aqueous phase, association equilibria were assumed to occur. The
      model predicted the formation of dimers and no higher aggregates over most of the
      concentration range covered in this study. Thermodynamic parameters for the
      partition equilibria were evaluated from the equilibrium partition coefficients
      measured as a function of temperature. Positive values of delta H and delta S
      were obtained for the transfer of CPZ from the aqueous to the organic phase. The
      process is entropy controlled indicative of a hydrophobic interaction between CPZ
      and the aqueous solvent.

PMID- 2235883
TI  - Absorption of polyethylene glycols 600 through 2000: the molecular weight
      dependence of gastrointestinal and nasal absorption.
AB  - Polyethylene glycols (PEGs) 600, 1000, and 2000 were used to study the molecular
      weight permeability dependence in the rat nasal and gastrointestinal mucosa.
      Absorption of the PEGs was measured by following their urinary excretion over a 6
      hr collection period. HPLC methods were used to separate and quantitate the
      individual oligomeric species present in the PEG samples. The permeabilities of
      both the gastrointestinal and the nasal mucosae exhibited similar molecular
      weight dependencies. The steepest absorption dependence for both mucosae occurs
      with the oligomers of PEG 600, where the extent of absorption decreases from
      approximately 60% to near 30% over a molecular weight range of less than 300
      daltons. Differences in the absorption characteristics between the two sites
      appear in the molecular weight range spanned by PEG 1000. For these oligomers,
      the mean absorption from the nasal cavity is approximately 14%, while that from
      the gastrointestinal tract is only 9%. For PEG 2000, mean absorption decreases to
      4% following intranasal application and below 2% following gastrointestinal
      administration. Within the PEG 1000 and 2000 samples, however, very little
      molecular weight dependency is seen among the oligomers. In the range studied, a
      distinct molecular weight cutoff was not apparent at either site.

PMID- 2235885
TI  - Performance of diltiazem tablet and multiparticulate osmotic formulations in the
      dog.
AB  - The in vivo performance of two extended-release (ER) osmotic formulations of
      diltiazem were evaluated in the beagle dog. Both ER formulations had similar
      bioavailabilities (F) as the diltiazem solution. Although F was somewhat variable
      following ER administration, this variability may be related to the drug entity
      since intra- and interanimal variability of orally administered diltiazem
      solutions was substantial. Deconvolution of the ER plasma diltiazem data with
      absorption data from the orally administered diltiazem solutions provided an
      estimate of the in vivo drug release from the ER formulations. The two ER
      formulations, designed with different in vitro release profiles, reflected these
      differences in vivo, with nearly identical respective in vivo and in vitro
      release profiles.

PMID- 2235884
TI  - Beta-cyclodextrin/steroid complexation: effect of steroid structure on
      association equilibria.
AB  - Molecular associations of beta-cyclodextrin (beta-CyD) with four steroids
      (cortisone, hydrocortisone, progesterone, and testosterone) have been studied
      using phase-solubility and spectroscopic techniques. Phase solubility diagrams
      could be categorized as B type. The complexes are formed at the stoichiometric
      ratios of 1:2 (drug:beta-CyD). A mathematical model has been proposed to
      calculate the apparent stability constants. The results suggest that the
      inclusion of a steroid molecule into the first beta-CyD cavity is
      thermodynamically more favorable over the association of 1:1 complex with the
      second beta-CyD molecule except for cortisone, which exhibits anomalous behavior.
      A mechanism of complexation has been proposed based on the apparent stability
      constants and chemical structures of the steroids and beta-CyD. It suggests that
      complexation is first brought about by inclusion of the five-member cyclopentane
      ring of the steroid molecule into the first beta-CyD cavity. The 1:1 complex
      subsequently binds with the second beta-CyD to form the 1:2 complex. The
      association constants of steroid/beta-CyD complexes are of the following order:
      progesterone greater than cortisone greater than testosterone greater than
      hydrocortisone. The order of aqueous solubilities of the complexes is
      hydrocortisone greater than cortisone greater than testosterone greater than
      progesterone.

PMID- 2235886
TI  - A redox-based system that enhances delivery of estradiol to the brain:
      pharmacokinetic evaluation in the dog.
AB  - The pharmacokinetics of a dihydropyridine-pyridinium salt-type chemical delivery
      system (CDS) for brain-targeted delivery of estradiol (E2) were examined in dogs.
      Parameters evaluated in vitro included stability in buffers and biological fluids
      and plasma protein binding. In vivo studies examined drug and metabolite
      concentrations in plasma, urine, and cerebrospinal fluid as well as in selected
      brain regions. The administered lipophilic E2-CDS disappeared very quickly from
      plasma and was not detected in urine. The oxidized drug form, E2-Q+, was excreted
      unchanged or as a conjugate in the urine for as long as 2 weeks. Plasma levels
      were below assay detection limits at later times. Pharmacokinetic analysis of
      urine E2-Q+ levels allowed estimation of a half-life of 2.2 days. Amounts of E2
      Q+ excreted into the urine were proportional to the dose but averaged only 13.9%
      of the dose, indicating that other routes of excretion must be considered. CSF
      levels were below the limit of detection for both E2-CDS and E2-Q+, however,
      brain tissue concentrations of E2-Q+ were similar in several brain regions of
      individual animals examined 1 or 3 days after drug dosing.

PMID- 2235887
TI  - Diffusion in porous materials above the percolation threshold.
AB  - The diffusion of water-soluble solutes in water-soaked porous media was studied
      by following the release of benzoic acid from poly(vinyl stearate) matrices. The
      results were analyzed using a pseudo-steady-state diffusion model coupled with
      the fundamental concepts of percolation theory. The results of the study
      indicated that the relationship between the bulk diffusion coefficient of benzoic
      acid in the polymer matrix and the porosity was well described by percolation
      scaling laws. A very low percolation threshold (0.07) was experimentally observed
      for this system.

PMID- 2235888
TI  - Caco-2 cell monolayers as a model for drug transport across the intestinal
      mucosa.
AB  - Human colon adenocarcinoma (Caco-2) cells, when grown on semipermeable filters,
      spontaneously differentiate in culture to form confluent monolayers which both
      structurally and functionally resemble the small intestinal epithelium. Because
      of this property they show promise as a simple, in vitro model for the study of
      drug absorption and metabolism during absorption in the intestinal mucosa. In the
      present study, the transport of several model solutes across Caco-2 cell
      monolayers grown in the Transwell diffusion cell system was examined. Maximum
      transport rates were found for the actively transported substance glucose and the
      lipophilic solutes testosterone and salicyclic acid. Slower rates were observed
      for urea, hippurate, and saliylate anions and were correlated with the apparent
      partition coefficient of the solute. These results are similar to what is found
      with the same compounds in other, in vivo absorption model systems. It is
      concluded that the Caco-2 cell system may give useful predictions concerning the
      oral absorption potential of new drug substances.

PMID- 2235889
TI  - Determination of solute-polymer interaction properties and their application to
      parenteral product container compatibility evaluations.
AB  - Kinetic and thermodynamic interaction properties between dialkyl phthalate test
      compounds and a polyolefin polymer were examined via a permeation-cell
      experimental design. Disappearance and appearance rates of solute in the receptor
      and donor solutions, as well as the equilibrium composition of the test system,
      are used to determine sorption and diffusion coefficients and the solute/polymer
      equilibrium binding constant. Sorption rate constants and diffusion coefficients
      exhibit Arrenhius-type behavior. The binding constants obtained correlate well
      with the solute's octanol-water partition coefficient. The kinetic and
      thermodynamic data generated combine with proposed interaction models to identify
      solute/polymer interactions (binding and leaching) pertinent to evaluating
      container/solution compatibility for parenteral products.

PMID- 2235890
TI  - Synthesis and calcium channel antagonist activity of 3-arylmethyl 5-isopropyl 1,4
      dihydro-2,6-dimethyl-4-(pyridyl)-3,5-pyridinedicarboxylates.
AB  - Unsymmetrical aryl(heteroaryl)methyl isopropyl ester analogues of nifedipine, in
      which the 2-nitrophenyl group at C-4 is replaced by a 2- or 3-pyridyl
      substituent, were synthesized and evaluated as calcium-channel antagonists using
      guinea pig ileal longitudinal smooth muscle. The point of attachment of the C-4
      pyridyl substituent was a determinant of activity where the relative potency
      order was 2-pyridyl greater than 3-pyridyl. Within the C-4 2-pyridyl series of
      compounds, and electronegative substituent such as a trifluoromethyl or bromo at
      the 4 position of the benzyl ester substituent or a nitrogen atom at the 1
      position of a 4-pyridylmethyl ester substituent, enhanced activity relative to
      the unsubstituted benzyl ester analogue. In contrast, in the C-4 3-pyridyl class
      of compounds, a variety of aryl(heteroaryl)methyl ester substituents did not
      alter potency to any significant extent. A number of compounds in the C-4 2
      pyridyl series possessing 4-pyridylmethyl, 4-trifluoromethylbenzyl, 4
      bromobenzyl, and 3-pyridylmethyl ester substituents were approximately equipotent
      to nifedipine. The aryl(heteroaryl)methyl ester and C-4 2-pyridyl substituents
      therefore appear to provide important interdependent contributions to calcium
      channel antagonist activity.

PMID- 2235891
TI  - Structure elucidation and thermospray high-performance liquid chromatography/mass
      spectroscopy (HPLC/MS) of the microbial and mammalian metabolites of the
      antimalarial arteether.
AB  - Microbial metabolism studies of the antimalarial drug arteether (1) have shown
      that arteether is metabolized to six new metabolites in addition to those
      previously reported (3). Large-scale fermentations with Cunninghamella elegans
      (ATCC 9245) and Streptomyces lavendulae (L-105) have resulted in the
      characterization of these metabolites primarily by two-dimensional nuclear
      magnetic resonance (2D-NMR) methods as 9 beta-hydroxyarteether (2), a ring
      rearrangement metabolite (3), 3 alpha-hydroxy-11-epi-deoxydihydroartemisinin (4),
      9 alpha-hydroxyarteether (5), 2 alpha-hydroxyarteether (6), and 14
      hydroxyarteether (7). Thermospray mass spectroscopy/high-performance liquid
      chromatographic analyses have shown that four of these metabolites (2, 5, 6, 7)
      are also present in rat liver microsome preparations.

PMID- 2235892
TI  - Influence of average molecular weights of poly(DL-lactic acid-co-glycolic acid)
      copolymers 50/50 on phase separation and in vitro drug release from microspheres.
AB  - The phase separation of fractionated poly(DL-lactic acid-co-glycolic acid)
      copolymers 50/50 was determined by silicone oil addition. Polymer fractionation
      by preparative size exclusion chromatography afforded five different microsphere
      batches. Average molecular weight determined the existence, width, and
      displacement of the "stability window" inside the phase diagrams, and also
      microsphere characteristics such as core loading and amount released over 6 hr.
      Further, the gyration and hydrodynamic radii were measured by light scattering.
      It is concluded that the polymer-solvent affinity is largely modified by the
      variation of average molecular weights owing to different levels of solubility.
      The lower the average molecular weight is, the better methylene chloride serves
      as a solvent for the coating material. However, a paradoxical effect due to an
      increase in free carboxyl and hydroxyl groups is noticed for polymers of 18,130
      and 31,030 SEC (size exclusion chromatography) Mw. For microencapsulation,
      polymers having an intermediate molecular weight (47,250) were the most
      appropriate in terms of core loading and release purposes.

PMID- 2235893
TI  - Physicochemical factors associated with binding and retention of compounds in
      ocular melanin of rats: correlations using data from whole-body autoradiography
      and molecular modeling for multiple linear regression analyses.
AB  - The relationship between the physicochemical characteristics of 27 new drug
      candidates and their distribution into the melanin-containing structure of the
      rat eye, the uveal tract, was examined. Tissue distribution data were obtained
      from whole-body autoradiograms of pigmented Long-Evans rats sacrificed at 5 min
      and 96 hr after dosing. The physicochemical parameters considered include
      molecular weight, pKa, degree of ionization, octanol/water partition coefficient
      (log Po/w), drug-melanin binding energy, and acid/base status of the functional
      groups within the molecule. Multiple linear regression analysis was used to
      describe the best model correlating physicochemical and/or biological
      characteristics of these compounds to their initial distribution at 5 min and to
      the retention of residual radioactivity in ocular melanin at 96 hr post
      injection. The early distribution was a function primarily of acid/base status,
      pKa, binding energy, and log P(o/w), whereas uveal tract retention in rats was a
      function of volume of distribution (V1), log P(o/w), pKa, and binding energy.
      Further, there was a relationship between the initial distribution of a compound
      into the uveal tract and its retention 96 hr later. More specifically, the
      structures most likely to be distributed and ultimately retained at high
      concentrations were those containing strongly basic functionalities, such as
      piperidine or piperazine moieties and other amines. Further, the more lipophilic
      and, hence, widely distributed the basic compound, the greater the likelihood
      that it interacts with ocular melanin. In summary, the use of multiple linear
      regression analysis was useful in distinguishing which physicochemical
      characteristics of a compound or group of compounds contributed to melanin
      binding in pigmented rats in vivo.

PMID- 2235894
TI  - Melting point, boiling point, and symmetry.
AB  - The relationship between the melting point of a compound and its chemical
      structure remains poorly understood. The melting point of a compound can be
      related to certain of its other physical chemical properties. The boiling point
      of a compound can be determined from additive constitutive properties, but the
      melting point can be estimated only with the aid of nonadditive constitutive
      parameters. The melting point of some non-hydrogen-bonding, rigid compounds can
      be estimated by the equation MP = 0.772 * BP + 110.8 * SIGMAL + 11.56 * ORTHO +
      31.9 * EXPAN - 240.7 where MP is the melting point of the compound in Kelvin, BP
      is the boiling point, SIGMAL is the logarithm of the symmetry number, EXPAN is
      the cube of the eccentricity of the compound, and ORTHO indicates the number of
      groups that are ortho to another group.

PMID- 2235895
TI  - Enhanced delivery of zidovudine through rat and human skin via ester prodrugs.
AB  - In an attempt to improve the skin delivery characteristics of Zidovudine (AZT,
      azidothymidine), five aliphatic esters (acetate, butyrate, hexanoate, octanoate,
      and decanoate) of AZT were synthesized and assessed as prodrugs of AZT. While the
      water solubility of the esters is lower than that of AZT, the solubilities in
      isopropylmyristate (IPM) and the partition coefficients (n-octanol:buffer) are
      higher. Susceptibility to enzymatic hydrolysis in the rat skin homogenate
      increases as the acyl chain of the ester is lengthened. Among the esters, acetate
      (C2-AZT) and hexanoate (C6-AZT) showed 2.4- and 4.8-fold enhanced permeation in
      human skin from an apolar vehicle (IPM) relative to application of AZT itself,
      respectively.

PMID- 2235896
TI  - Comparison of single-dose and steady-state nadolol plasma concentrations.
AB  - The pharmacokinetics of nadolol have been previously reported to be linear
      between single and steady-state dosing. Data from a study in our laboratory
      suggested greater than expected beta-blockade with nadolol at steady state.
      Because the early potency studies were single-dose studies, we hypothesized there
      was a nonlinearity in nadolol pharmacokinetics which produced higher than
      expected plasma concentrations at steady state. Six normal volunteers from the
      previous study (steady state) volunteered to participate in the single-dose
      study. Plasma concentrations were determined for 24 hr following a single dose of
      nadolol, 80 mg. A simple, inexpensive, and accurate method for determination of
      nadolol in plasma or serum by HPLC with fluorometric detection is described. The
      AUC0-tau at steady state was greater than the AUC0-infinity following a single
      dose in five of the six subjects. The mean ratio of AUCss/AUCsd was 2.54. This
      value would be unity in the presence of linear pharmacokinetics. We conclude that
      the principle of superposition is not applicable for nadolol.

PMID- 2235897
TI  - Solubilization of liposomes by weak electrolyte drugs. I. Propranolol.
AB  - The solubilization of dimyristoylphosphatidylcholine (DMPC) liposomes by a weak
      electrolyte drug, propranolol (PPL) hydrochloride, has been studied as a function
      of pH, [PPL], [DMPC], and temperature. The solubilization of liposomes at 40
      degrees C by 0.2 mM PPL occurred at different rates from 2.9 to 14.4 mM DMPC but
      converged at complete solubilization after 13 hr at pH 12.0. At the same [PPL],
      solubilization was complete after 18 days at pH 11.0, but incomplete
      solubilization occurred at pH 10.0 and not at all at lower pH's. In 14.4 mM DMPC
      liposomes, solubilization was gradual and proportional to the [PPL] from 0.001 to
      0.10 mM up to 95 hr, then rapid thereafter. The [PPL] at which the solubilization
      efficiency began to increase rapidly was determined to be 0.078 mM. The rate of
      solubilization was also influenced by the fluidity of the bilayers, a sevenfold
      increase in the time for complete solubilization being observed upon cooling from
      40 to 20 degrees C. Surface tension (st) data confirmed a low critical micelle
      concentration (CMC) and continued decrease in the st above the CMC. It is
      concluded that the critical ratio of PPL to DMPC for solubilization occurs in
      localized regions of the bilayers, with total solubilization at different rates
      depending on the [PPL] and the physical properties of the liposomes. The
      processes may be used advantageously to prepare small vesicles or to extract
      lipids or proteins, more efficiently than detergents, from biological membranes.

PMID- 2235898
TI  - Particle size and content uniformity.
AB  - The requirements of the USP Content Uniformity test are translated into physical
      and mathematical parameters. Assuming spherical particle sizes with a log normal
      distribution, the mean particle size and particle size distribution required to
      insure a high probability of passing the content uniformity test are calculated.
      On the basis of these calculations it is shown that satisfactory tablets of low
      doses cannot be manufactured from a drug that does not meet certain particle size
      distribution specifications. It is recommended that particle size specifications
      for low dose drugs include a requirement for a limit to size distribution.

PMID- 2235899
TI  - Influence of solute degradation on the accumulation of solutes migrating into
      solution from polymeric parenteral containers.
AB  - Solute stability in solution, in addition to solute-polymer interaction
      properties and the total solute available pool, impacts the interaction between a
      polymeric container and a parenteral product, specifically in terms of the
      migration of trace polymer components into the contained solution. A specific
      solute/polymer system has been studied with respect to properties impacting the
      magnitude and rate of solute migration from the polymer into solution. The
      solute, an alkyl ester, originates in a polyolefin composite packaging material.
      Solute degradation kinetics were studied as a function of solution temperature
      and pH. Solute-polymer interaction properties including the equilibrium binding
      constant and diffusion coefficient were obtained. An accumulation rate model is
      developed for the determination of the solution phase concentration of the
      liberated solute as a function of storage time and conditions. Coupling the model
      with the properties of the polymer-solute system studied provides a tool that
      accurately predicts solute accumulation behavior in a representative parenteral
      product configuration.

PMID- 2235900
TI  - The significance of trisomy 7 mosaicism in chorionic villus cultures.
AB  - Two cases of mosaic trisomy 7 confined to the cultured cells and not found in
      direct preparation were detected from 200 consecutive first-trimester chorionic
      villus samples (CVS) analysed. The mosaicism was similar in the two cases, but
      the pregnancy outcome was different. In both cases, the direct metaphases from
      the CVS were 46,XY. Culture metaphases were mos46,XY/47,XY, +7; the trisomy 7 was
      seen in 34 per cent of cells from case 1 and 53 per cent from case 2. A sonogram
      at 15 1/2 weeks revealed fetal death in utero in case 1, and the patient declined
      amniocentesis. The fetal tissue failed to grow in culture, but the placental
      cultured cells were 47,XY, +7 in 28 (100 per cent) cells analysed. In the second
      case, all the amniotic fluid cells were 46,XY and the pregnancy resulted in a
      normal male with a 46,XY karyotype in the cord blood and foreskin fibroblast
      cultures. The term placenta was mosaic with 13/163 (8 per cent) trisomy 7 cells.
      Extensive cytogenetic studies on the placenta for the first time confirmed
      trisomy 7 mosaicism confined to the villus cultures.

PMID- 2235901
TI  - The risks of early cordocentesis (12-21 weeks): analysis of 500 procedures.
AB  - Five hundred cordocenteses were performed between 12 and 21 weeks. The
      indications were thalassaemia (386), rapid karyotyping (97), feto-maternal allo
      immunization (10), rubella (6), and toxoplasmosis (1). One hundred and ten
      pregnancies underwent termination on the basis of the result, while 20 of the 370
      pregnancies intended to continue were lost to follow-up. Amongst these were 16
      fetal losses (4.3 per cent) and 22 premature deliveries (5.9 per cent); no other
      complications were reported. Four adverse prognostic factors were identified: (a)
      cord bleeding; (b) fetal bradycardia; (c) prolonged procedure time; and (d)
      anterior insertion of the placenta. There was no 'obvious' difference in fetal
      loss rate with advancing gestation until 19-21 weeks, when the risk of fetal loss
      decreased to 2.5 per cent.

PMID- 2235902
TI  - Holoprosencephaly: prenatal diagnosis by sonography and magnetic resonance
      imaging.
AB  - Magnetic resonance (MR) imaging was performed on two women at the 33rd and 34th
      pregnancy week, respectively, after ultrasonographic detection of a brain
      malformation. Fetal neuromuscular blockade was induced by pancuronium bromide
      injected into the umbilical vein under continuous ultrasound (US) guidance. MR
      images supported the echotomographic diagnosis of holoprosencephaly, improving
      the image quality and offering additional information in such cases of difficult
      differential fetal diagnosis. Holoprosencephaly was finally confirmed by neonatal
      US and autopsy (case 1), US, CT and MR (case 2).

PMID- 2235903
TI  - Limb reduction and chorion villus sampling.
AB  - Upper limb reduction was diagnosed by ultrasound scan at 17 weeks after chorion
      villus sampling at 9 weeks' gestation. Pregnancy was terminated and necropsy
      confirmed limb reduction in an otherwise normal fetus. The relationship of limb
      reduction to amniotic band syndrome is discussed.

PMID- 2235904
TI  - Ultrasound diagnostic features of twin reversed arterial perfusion sequence.
AB  - Two cases of twin reversed arterial perfusion (TRAP) sequence with relevant
      ultrasound features that would help an accurate diagnosis are described.
      Available management options are proposed and discussed.

PMID- 2235905
TI  - Risks of transabdominal chorionic villus sampling before the 12th week of
      amenorrhea.
AB  - The authors report on a series of 210 chorion villus sampling diagnoses made with
      a needle by the transabdominal route. The rate of fetal loss was 4.2 per cent.
      Placental localization was important: fetal losses were 8 per cent when the
      placenta was strictly posterior (transamniotic route), whereas it was only 1.6
      per cent when it was not posterior. Moreover, all fetal losses occurred (apart
      from one at 12.5 weeks of amenorrhea) before the 12th week of amenorrhea. The
      authors suggest that choriocentesis by the transabdominal route should not be
      performed before the 12th week of amenorrhea, and that the amniotic membrane
      should not be disturbed before the 13th week of amenorrhea.

PMID- 2235906
TI  - Mosaic isochromosome 20q found on amniocentesis with normal outcome.
AB  - A case of mosaic isochromosome 20q found on amniocentesis is described. A normal
      male infant was subsequently born.

PMID- 2235907
TI  - Successful intrauterine therapy of a large fetal ovarian cyst.
AB  - Fetal ovarian cysts can be managed in different ways, depending upon their size
      and clinical course: conservatively, by open surgery or by postnatal
      transabdominal puncture. However, in cases of large cysts detected antenatally
      and affecting the ongoing pregnancy, in utero transabdominal puncture can be
      undertaken, without increase of risk. A case of such a puncture at 30 weeks
      gestation is reported.

PMID- 2235908
TI  - Hematoma of the umbilical cord secondary to cordocentesis for intrauterine fetal
      transfusion.

PMID- 2235909
TI  - In utero resolution of a fetal cystic hygroma in a male with a 46,XY karyotype
      and normal development at one year.

PMID- 2235910
TI  - Supernumerary ribs and vertebrae in trisomy 9 syndrome.

PMID- 2235911
TI  - High-performance liquid chromatography of proteins on deformed nonporous agarose
      beads. Affinity chromatography of dehydrogenases based on cibacron blue
      derivatized agarose.
AB  - Nonporous agarose beads, prepared by shrinkage and cross-linking in organic
      solvents, were derivatized with Cibacron Blue F3G-A. A compressed bed of these
      beads was used for purification of dehydrogenases (glucose-6-phosphate
      dehydrogenase, lactate dehydrogenase and alcohol dehydrogenase). The
      chromatographic conditions for the purification of glucose-6-phosphate
      dehydrogenase were optimized by varying the pH of the buffer; the concentrations
      of eluting agents, i.e. NADP (specific elution) and sodium chloride (nonspecific
      elution); flow rate; residence time of the protein on the column bed; and protein
      load. Specific elution with NADP (2 mM in 0.025 M Tris-HCl, pH 8.0) gave the
      highest recovery (140%) and highest purification factor (200-fold) of the enzyme.
      The ability of the compressed bed of nonporous agarose beads to tolerate high
      flow rates was essential, since the recovery of the enzyme activity increased
      with an increase in flow rate.

PMID- 2235912
TI  - High-yield purification of glucokinase from rat liver.
AB  - A rapid and reliable method for the purification of rat liver glucokinase was
      developed. The procedure consists of DEAE-cellulose ion-exchange chromatography,
      Phenyl-Sepharose hydrophobic interaction chromatography, DEAE-Affi Gel Blue dye
      ligand chromatography, and duplicate steps of glucosamine-Sepharose affinity
      chromatography. Glucokinase was purified to a specific activity of 290 units/mg
      protein in a yield of 55% in 6 days. The final enzyme preparations were
      completely homogeneous in most experiments as assessed by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. The estimated molecular weight (51,000) and
      sigmoidal saturation function for glucose of purified glucokinase were in good
      agreement with published data.

PMID- 2235913
TI  - Biosynthetic preparation of [riboflavin-2-14C]flavin adenine dinucleotide using
      Clostridium kluyveri.
AB  - The biosynthetic preparation of [riboflavin-2-(14)C]flavin adenine dinucleotide
      from extracellular [2-(14)C]riboflavin by a growing culture of Clostridium
      kluyveri, first reported by Decker and coworkers, has been implemented using new
      media and more convenient isolation procedures.

PMID- 2235914
TI  - Expression of human placenta alkaline phosphatase in placenta during pregnancy.
AB  - To clarify the expression of PLAP during the course of pregnancy, the amount of
      PLAP mRNA and its activity in normal placental villi were measured. Both PLAP and
      its mRNA were found in placentae of as early as 7 weeks of gestation, and they
      continued to increase throughout pregnancy. But they showed different patterns of
      increase. The amount of PLAP mRNA began to increase dramatically around 13th week
      and probably continued to increase gradually until term. PLAP activity per gram
      of villi showed a gradual increase from around 13th week and a marked increase
      was observed after about 20th week. PLAP levels in sera from pregnant women were
      also measured, and they showed a pattern of increase imilar to that of PLAP
      activity per gram of villi. The continuous increase in the expression of PLAP
      throughout pregnancy suggests that PLAP may play a role in feto-maternal
      metabolism and placental differentiation.

PMID- 2235916
TI  - Human trophoblast-endometrial interactions in an in vitro suspension culture
      system.
AB  - We developed an in vitro suspension co-culture system to examine the interaction
      of 1st, 2nd and 3rd trimester purified cytotrophoblasts with human endometrium.
      Endometrium explants were added to cytotrophoblast cell suspensions and placed on
      an angled gyrating platform in a 37 degrees C incubator. When endometrium was
      cultured alone it was able to remain viable for up to 3 days. When trophoblasts
      were cultured alone, they formed small and large aggregates, and occasionally
      spherical shells with hollow centers. When trophoblasts and endometrium were
      cultured together, the trophoblasts adhered to the exposed stromal surfaces of
      the tissue fragments. The surface epithelium was not receptive to trophoblast
      attachment except in one experiment when day 19 endometrium was used for the co
      incubation, suggesting that surface attachment is usually restricted. A common
      finding was the presence of an acellular zone in the endometrium only adjacent to
      the attached trophoblasts. We speculate that this zone may be caused by
      proteolysis and resynthesis of ECM proteins by the trophoblasts. Based on our
      results, this in vitro suspension should prove useful for examining those factors
      which: (1) induce endometrial permissiveness, (2) promote paracrine effects on
      the endometrium, and (3) facilitate human trophoblast invasion.

PMID- 2235918
TI  - Community cholesterol screening: medical follow-up in subjects identified with
      high plasma cholesterol levels.
AB  - Population screening or plasma cholesterol is an effective method of detecting
      hypercholesterolemia; however, follow-up and treatment are essential components
      of such a program. After a city-wide screening in 1987 of more than 19,872
      persons, using a mailed survey with a response rate of 48%, we evaluated
      subsequent actions of 3,078 individuals with high plasma cholesterol levels.
      Slightly more than half the population was aware of high blood cholesterol levels
      prior to the time of screening and apparently used the program for follow-up.
      Overall, after the screening, 65% consulted a physician within 5 months of
      screening and blood cholesterol levels were remeasured in 80% of the sample.
      Procrastination and expense were cited as the primary reasons for failing to
      consult a physician. If screening is to be effectively utilized as a means of
      reducing the prevalence of high plasma cholesterol levels, diligent follow-up
      must be made of all individuals identified to be at increased risk on the basis
      of their initial values.

PMID- 2235915
TI  - Differential control of placental lactogen release and progesterone production by
      ovine placental tissue in vitro.
AB  - The hypothesis that placental secretion of progesterone (P4) and ovine placental
      lactogen (oPL) are controlled through different mechanisms was tested. Placental
      tissue was obtained at days 133-138 of pregnancy, and explant incubations were
      established using 200 mg tissue per flask in 5 ml O2-saturated DMEM containing 24
      mM HEPES and lacking phenol red (pH 7.4). Following a 30-min preincubation, and a
      15-min control period, test substances were added and incubations continued, with
      periodic gassing, for 4 h at 37 degrees C in a shaking water bath. Dopamine (DA),
      norepinephrine (NE) and epinephrine significantly stimulated P4 production (P
      less than 0.05). The enhancement of placental P4 production was mimicked by the
      addition of 8-bromo-cyclic adenosine monophosphate and forskolin (P less than
      0.05). The response to catecholamines was abolished by the addition of
      propranolol (P less than 0.05) but not by phentolamine (P greater than 0.05).
      Inclusion of a membrane-permeant substrate for P4 synthesis, 25
      hydroxycholesterol, increased basal (P less than 0.05) but did not enhance
      agonist-induced P4 production (P greater than 0.05). High performance liquid
      chromatographic analysis of placental tissue demonstrated the presence of DA
      (80.8 +/- 7.07 pg/mg) and NE (48.8 +/- 5.77 pg/mg), as well as catecholamine
      metabolites. Addition of 1,2-dioctanoyl-sn-glycerol (DAG) or phorbol 12-myristate
      13-acetate (PMA) enhanced oPL secretion (P less than 0.05) without affecting P4
      production. The response to DAG and PMA, representing the release of considerably
      more oPL than can be detected by extracting the tissue, was not influenced by
      treatment with cycloheximide (P greater than 0.05) indicating that secretion of
      preformed oPL is regulated by the protein kinase C pathway. These results support
      the hypothesis that the secretion of oPL and the production of P4 are controlled
      by different mechanisms.

PMID- 2235917
TI  - Routine pathological examination of placentae from abnormal pregnancies.

PMID- 2235919
TI  - Adherence to colorectal cancer screening in an HMO population.
AB  - This study aimed to determine factors that influence fecal occult blood test
      performance in colorectal cancer screening. A random sample was selected of men
      and women ages 50 to 74 years of age who had been mailed a fecal occult blood
      testing kit in a screening program in fall 1986. One year after initial test
      mailing, sample group members (n = 504) were surveyed by telephone. Four months
      later, the survey sample received a second fecal occult blood test mailing.
      Multivariable analysis for subjects with validated past fecal occult blood test
      status (n = 322) revealed the past testing was positively associated with
      physician encouragement of screening, age, the belief that cancer is curable,
      perceived test efficacy, and strong intention to do testing. It also was
      discovered that persons who felt that they had little control over their health
      were more likely to have done past testing. Preliminary analysis of prospective
      adherence showed that the strongest statistically significant independent
      predictor was past test performance. Prospective adherence among past nontesters
      (n = 121) was associated with expressed commitment to do fecal occult blood
      testing and reported presence of colorectal cancer risk factors. Analysis of
      adherence among past testers (n = 201) revealed that belief in colorectal cancer
      curability and age were significant predictors. The findings reported here
      indicate that factors influencing adherence among past nontesters differ from
      those for past testers. Overall, these results suggest that to increase
      participation in colorectal cancer screening, physicians and other health
      professionals should (a) deliver educational messages that increase awareness of
      risk factors for colorectal cancer and curability of the disease, and (b) elicit
      from potential screenees a commitment to engage in recommended preventive
      behaviors. It may also be well to consider "tailoring" messages for past
      nontesters and past testers, respectively, by emphasizing colorectal cancer risk
      factors and highlighting curability.

PMID- 2235920
TI  - Prevalence of lifestyle risk factors in a family practice.
AB  - The prevalence of eight adverse lifestyle risk factors which are linked to
      increased morbidity and mortality was determined. Smoking, excess alcohol use,
      obesity, lack of exercise, lack of seatbelt use, use of hazardous transportation
      vehicles, and inadequate rest were studied. A random sample of 147 patients from
      a private family practice were selected in a cross-sectional survey. Data were
      collected by mailed questionnaire. The most prevalent adverse habits were lack of
      seatbelt use (71%) and sedentary lifestyle (44%). Patients with multiple adverse
      health habits had poorer self-reported physical as well as emotional well-being.
      Using a factor analysis of the correlations among eight habits, no significant
      clustering of habits emerged as indicators of high risk. Thus, no abbreviated
      list of adverse lifestyle risk factors for clinical use was found that could
      replace a complete review of risk factors.

PMID- 2235921
TI  - Psychosocial predictors of physical activity in adolescents.
AB  - Regular physical activity consistently demonstrates an inverse relationship with
      coronary heart disease and has positive effects on quality of life and other
      psychological variables. Despite the benefits of exercise, many youth and adults
      maintain a sedentary lifestyle. Interventions are needed, particularly with
      youth, to increase levels of physical activity. A better understanding of the
      psychosocial predictors of physical activity will aid in structuring these
      interventions. Longitudinal data from a cohort of 743 10th-grade students from
      the control condition of the Stanford Adolescent Heart Health Program were
      analyzed. Regression analysis indicated that psychosocial variables were
      significantly related to physical activity after controlling for baseline levels
      of physical activity and BMI. Associations with physical activity were found for
      intention to exercise, self-efficacy, stress, and direct social influence. The
      designers of future interventions should consider including program components
      that target these variables.

PMID- 2235922
TI  - Trends in smoking by age and sex, United States, 1974-1987: the implications for
      disease impact.
AB  - Using data from the 1974-1987 National Health Interview Surveys, we report trends
      in current smoking prevalence and quit ratios (the proportion of those who have
      ever smoked who no longer smoke) for men and women in the age groups 20-24, 25
      44, 45-64, and 65 years and older. Current smoking prevalence decreased linearly
      for men in all age subgroups except 65 and older and for women ages 25-44 and 45
      64 years only. The quit ratios increased linearly within each age/sex subgroup
      except for men and women ages 20-24 years. Overall, there were about 1.4 million
      fewer male smokers and over 1 million more female smokers in 1987 than there were
      in 1974. Between 1974 and 1987, the population ages 25-44 years increased by
      approximately 47%, and the population 65 years and older increased by
      approximately 34%. As a result, between 1974 and 1987, the actual number of
      smokers increased among men ages 25-44 years (8% increase), women ages 25-44
      years (15% increase), and women ages 65 years and older (50% increase). These
      data suggest that even with favorable recent changes in the overall smoking
      prevalence of the U.S. population, the disease impact of smoking will increase
      for decades, especially among women. This scenario will be mitigated if increased
      attention is given to cessation among women in general and to the post-World War
      II generation of both male and female smokers.

PMID- 2235923
TI  - The knowledge and use of screening tests for colorectal and prostate cancer: data
      from the 1987 National Health Interview Survey.
AB  - Data based on the 1987 National Health Interview Survey are presented depicting
      factors associated with the knowledge and use of three tests for the early
      detection of colorectal and prostate cancer: digital rectal examination, fecal
      occult blood tests, and flexible sigmoidoscopy. The percentage of the at risk
      adult population who have ever heard of or had these tests is reported. The
      association of demographic, personal resource, and health system factors with
      knowledge of these tests is explored using multivariate logistic regression.
      Health system factors are most consistently associated with use of the tests and
      with knowledge. Family income, family size, education, knowledge of cancer early
      warning signs, and measures of encounters with the health care system are
      associated both with knowledge of and, independent of knowledge, with use of the
      tests. Residency in the non-South, being white or female, and having an
      optimistic attitude about cancer prevention are all factors associated with
      greater knowledge of the tests, but not greater use among those aware of the
      tests. Membership in a health maintenance organization is more strongly
      associated with knowledge and use of fecal occult blood tests than the other
      tests. No association was found between current smoking status and knowledge of
      or use of any of the tests.

PMID- 2235924
TI  - [Fibrinolytic properties of protease complex isolated from the culture fluid of
      Nocardia minima].
AB  - The protease complex isolated form the Nocardia minima culture liquid was studied
      in vitro. The preparation had two different activities (fibrinolytic and
      activating), i.e. it was able to convert plasminogen into plasmin. At a
      concentration of 250 micrograms/ml and above the preparation lysed experimental
      thrombi. The fibrinolytic activity of the preparation was completely inhibited
      with normal human plasma.

PMID- 2235925
TI  - [Characteristics of hydrolase biosynthesis in Bacillus mesentericus grown on
      various media].
AB  - The dynamics of the consumption of major carbon and nitrogen sources and the
      biosynthesis of hydrolytic enzymes were studied in Bacillus mesentericus grown on
      semisynthetic media. Conditions were chosen that provide the obtaining of the
      culture liquid with predominantly proteolytic or amylolytic activity. The
      replacement of maltose with native starch resulted in more intensive accumulation
      of the biomass and hydrolytic enzymes, and in more rapid (by 3-5 hr)
      transformation from the logarithmic to the stationary growth phase.

PMID- 2235926
TI  - [Comparative characteristics of the metabolism of E. coli cells with various
      activity of penicillin acylase].
AB  - A correlation between the synthesis and secretion of penicillin acylase (PA; EC
      3.5.1.11) and the membrane phospholipid composition was observed in three E. coli
      strains. In cells with overproduction of PA, the phospholipid/protein ratio
      decreases, while the cardiolipin/phosphatidylglycerol ratio increases. The
      differences in the functioning of the electron transport system were revealed in
      cells with different levels of PA synthesis and secretion. The O2 consumption
      rate was 3 times lower in the cells with overproduction of PA than in those of
      less productive strains. On the contrary, membrane particles isolated from the
      cells of PA producers had no significant differences in the O2-reduction rate.
      The sensitivity of the strains to the inhibitor of terminal oxidases, sodium
      cyanide, and to the uncoupler of redox phosphorylation, chlorocarbonyl
      phenylhydrazone, was different. Thus the E. coli cells with PA overproduction are
      characterized by significant changes in energetics and constructive metabolism.
      The interrelations between PA overproduction, phospholipid metabolism and the
      respiratory chain activity are discussed.

PMID- 2235927
TI  - [A new pathway for the central nervous regulation of carbohydrate homeostasis].

PMID- 2235928
TI  - [The functional role of membrane lipids in the mechanisms for realizing the
      effect of insulin].

PMID- 2235929
TI  - [Sex steroid metabolism in the hypothalamus and its role in the neuroendocrine
      regulation of reproduction].

PMID- 2235930
TI  - [The molecular genetic aspects of insulin-dependent diabetes mellitus].

PMID- 2235931
TI  - [The molecular polymorphism of the growth hormone and prolactin and its clinical
      significance].

PMID- 2235932
TI  - [The hormonal regulation of protein synthesis in liver cell cultures].

PMID- 2235933
TI  - [The problems of clinical diabetology].

PMID- 2235934
TI  - [The pathogenetic characteristics of diabetic nephropathy and its early
      diagnosis].

PMID- 2235935
TI  - [Insulin and its place in the therapy of diabetes mellitus types 1 and 2].

PMID- 2235937
TI  - [The hormonal-metabolic correlations in the generalized lipodystrophy syndrome].

PMID- 2235936
TI  - [The role of multiple insulin injections and self-monitoring of the disease in
      diabetes mellitus compensation in children].

PMID- 2235938
TI  - [The main trends in modern immunoendocrinology].

PMID- 2235939
TI  - [Disputable aspects of the definition, diagnosis and classification of
      respiratory insufficiency].

PMID- 2235940
TI  - [Concerning the article by T.N. Bodrova and F.F. Tetenev "Pathophysiological
      classification of external respiratory insufficiency"].

PMID- 2235941
TI  - [Improving the diagnosis and treatment of pulmonary tuberculosis among the
      inmates of reformatory institutions of the Ministry of Home Affairs].
AB  - According to the data given by the authors, the tuberculosis morbidity rate in
      the populations under surveillance of the Ministry of Home Affairs was over that
      in the general population. High morbidity of such persons is often contributed to
      their antisocial way of life, and alcohol and drug addiction. Full coverage of
      these groups by means of X-ray screening, when they are held prisoners during the
      investigation period, makes it possible to detect all cases with active
      tuberculosis, to prevent the admission of undetected patients to the reformatory
      schools and thereby to stop the transmission of tuberculous infection. The
      observations should be conducted twice a year since these imprisoned groups may
      be recognized as being at high risk for tuberculosis. The clinical pattern of
      pulmonary tuberculosis is unfavorable in the convicted persons. Appropriate three
      stage chemotherapy with the use of surgical interventions, if indicated permits
      one to achieve in the reformatory institutions of the Ministry of Home Affairs a
      high efficacy of treatment of ++newly-diagnosed pulmonary tuberculosis patients,
      which concurrently significantly decreases their epidemic danger for the general
      population when they are let free.

PMID- 2235942
TI  - [Intravitally undetected tuberculosis and non-registered foci od tuberculous
      infection].
AB  - Active pulmonary tuberculosis was revealed in 1.55% of the cases registered in
      11042 postmortem certificates representing forensic medical examination material
      accumulated at the archives for a period of 4 years. 66.35% of the cases had not
      been registered in a dispensary. Pulmonary tuberculosis was stated as a cause of
      death in 72.7% and as a concurrent condition in 27.3%. The basic activities of
      the antituberculosis service is to detect tuberculous infection and to rapidly
      eradicate its transmission. In addition, a close association and coordinated
      activities of forensic medical experts, phthisiologists and sanitary-and
      epidemiologists will ensure an improvement of the epidemiological situation.

PMID- 2235943
TI  - [Work capacity of patients with tuberculosis of a solitary kidney].
AB  - The material for this report is based on the examination data produced from 105
      patients with a single kidney who were operated on for contralateral kidney
      tuberculosis. The conducted clinical trial confirms the approach that the correct
      solution of the problems in medical labor examination depends on the nature of a
      pathologic process in the single kidney, clinical course of the disease and
      period of a pathologic process, degree of a chronic renal failure, arterial
      hypertension and severity of the pain syndrome. The role of social factors and
      the rehabilitation aspects of this type of the patients are considered.

PMID- 2235944
TI  - [Transbronchial biopsy of the lung and bronchoalveolar lavage in the diagnosis of
      sarcoidosis].
AB  - The outcomes of a complex study of sarcoidosis and other interstitial pulmonary
      diseases in 1325 patients are presented. An important role of intrapulmonary
      biopsy and bronchoalveolar lavage methods in defining the diagnosis and the
      process activity, especially when they are used in combination, is demonstrated.
      Complications in the form of bleedings and pneumothorax were registered in a
      limited number of the patients, mainly as a result of rigid bronchoscope
      procedures. Differential and diagnostic signs of sarcoidosis and some other
      disseminations in the lung, obtained by means of biopsy, bronchoalveolar lavage
      and clinical data studies, are given.

PMID- 2235945
TI  - [Variants of the course of fibrous-cavernous pulmonary tuberculosis].
AB  - Taking into account the presence of the process development symptoms or their
      absence (including a high rate of exacerbations, ongoing dissemination process,
      formation of new cavities in the affected foci, severe infiltration of the lung
      tissue and massive bacillary excretion), process development rate and the nature
      of complications, the following 4 versions of fibrous-cavernous pulmonary
      tuberculosis were identified: rapidly developing disease; slowly developing
      disease; fibrous-cavernous pulmonary tuberculosis whose clinical picture was
      determined by different complications; and relatively stable condition. ++Clinico
      roentgenological+ features of each version of the disease are described.
      Abnormalities in the ++clinico-roentgenological+ picture and laboratory findings
      are especially apparent in patients with rapidly developing fibrous-cavernous
      pulmonary tuberculosis.

PMID- 2235946
TI  - [Roentgenological diagnosis of acute lesions of the lungs with disorders of blood
      circulation and vascular permeability].
AB  - To specify differential and diagnostic criteria of hemodynamic and non
      hemodynamic pulmonary edema, canine experimental simulation (15 trials) of
      different types of abnormal hemodynamic and lung capillary permeability
      parameters was carried out. The X-ray pictures of 71 patients with and acute
      diffuse lesion of the pulmonary vascular channel (including 51 with adult
      respiratory distress and 20 with hemodynamic pulmonary edema) was analysed. The
      findings substantiated the possibility of making a differential diagnosis of
      pulmonary edema of various genesis. Symptom complexes, typical of predominantly
      higher permeability of the lung capillaries and hemodynamic disturbance, were
      formulated.

PMID- 2235947
TI  - [Effectiveness of chemotherapy of patients with newly detected destructive
      pulmonary tuberculosis living in rural areas].
AB  - The results of treating 333 new cases of destructive tuberculosis of the lungs
      were investigated in relation to the time of the disease detection and the
      chemotherapy regimens applied. When the disease was detected relatively early
      (not later than a month before registration of the pulmonary signs) the frequency
      of abacillation and cicatrization of the destructive cavities increased, the
      period of the main chemotherapy course decreased (including in- and outpatient
      stages) and the treatment expenditures appeared to be lower. The best results
      were observed with early use of the chemotherapy regimens including rifampicin,
      isoniazid, ethambutol and/or streptomycin at the first stage of the treatment
      especially when the disease was detected not later than a month before
      registration of the pulmonary signs.

PMID- 2235948
TI  - [Effect of acute respiratory viral infection on the indicators of immunity in
      patients with pulmonary tuberculosis].
AB  - To study the impact of acute respiratory viral infection (ARVI) on the course of
      pulmonary tuberculosis, 150 cases with this condition were under observation.
      These patients were divided into 2 groups: 88 subjects who had ARVI and 62
      persons who did not have it, being in hospital. In the both groups those
      suffering from infiltrative and focal pulmonary tuberculosis were predominant.
      ARVI is conducive to the aggravation of a specific process in the lungs, which
      was registered in 27.3% of the cases who had had ARVI, and impede the reactions
      of cellular immunity to restore, which can be observed during chemotherapy. Among
      those who had ARVI, 68.4% of the patients demonstrated a decrease in T-cells and
      blast transformation with PHA. A significant drop in the number of T-lymphocytes
      and their functional activity, as a consequence of ARVI, promotes the
      deterioration of the above specific process. ARVI affects the efficacy of the in
      patient treatment and decreases the proportion of patients with cavity closure.

PMID- 2235949
TI  - [Clinico-functional characteristics of the external respiratory system and
      central hemodynamics in patients with pulmonary tuberculosis].
AB  - Lung ventilation and central hemodynamics in the course of treatment of 43
      patients with pulmonary tuberculosis were studied. Registered ventilation and
      hemodynamic disturbances disappeared with an effectively conducted chemotherapy.

PMID- 2235951
TI  - [Tisamide in the complex treatment of tuberculosis].
AB  - The outcomes of tisamid treatment of newly diagnosed patients with bacillary
      pulmonary tuberculosis were analysed. To estimate the efficacy of tisamid and its
      administration indications, chemotherapy of the patients was performed with the
      use of two therapeutic regimens. Isoniazid, rifampicin and streptomycin (or
      ethambutol) were given to 73 patients, while other 72 ones were treated with the
      same drugs plus tisamid. The patients in each group were subdivided into slow,
      rapid and homozygotic (the most rapid) acetylators. Tisamid, when prescribed to
      newly-discovered patients with destructive tuberculosis, accelerates recovery, by
      excluding the risk of a hepatotoxic action. Tisamid in a combined treatment with
      isoniazid, rifampicin and streptomycin is mostly recommended for patients with a
      rapid acetylation phenotype, i.e. the cases for whom a short-term chemotherapy is
      possible.

PMID- 2235952
TI  - [The role of genetically determined haptoglobin phenotypes in patients with
      destructive pulmonary tuberculosis].
AB  - Haptoglobin (Hp) was phenotyped in 567 apparently healthy individuals and 223
      patients with destructive pulmonary tuberculosis, including 163 as newly-detected
      and 60 as recurrent cases. Three phenotypes of haptoglobin were identified, i.e.
      two homozygotic (Hp 1:1 and Hp 2:2) and one heterozygotic (Hp 2:1). It was
      revealed that among the pulmonary tuberculosis patients, both newly detected and
      recurrent cases, the number of Hp 2:2 carriers significantly increased, as
      compared to healthy individuals, while that of Ph 2:1 carriers decreased. A
      certain relation between the course of destructive pulmonary tuberculosis and
      genetically determined types of Hp was found. Sputum conversion and cavity
      closure in Hp 2:2 and Hp 1:1 phenotype carriers, as compared to Hp 2:1 ones,
      occurred more infrequently and in later periods. It is felt that the presence of
      the 2:2 phenotype is an adverse hereditary factor in relation to tuberculosis.

PMID- 2235950
TI  - [Prognostic value of functional methods of the study of respiration and blood
      circulation in surgery of tuberculous spondylitis].
AB  - Prognostic value of the basic indices of the external respiration function and
      central hemodynamics in view of predicting the nature of an early postoperative
      period in tuberculous spondylitis patients is demonstrated. Such indices, as
      vital capacity, ventilation and hemodynamic supply indices, and mean pressure in
      the pulmonary artery have the greatest prognostic value. One-dimensional analysis
      of variance of the functional examination data obtained from 209 patients with
      tuberculous spondylitis was used in this study.

PMID- 2235953
TI  - [Correction of protease-protease inhibitor imbalance by intrapulmonary
      administration of contrical in the treatment of patients with chronic nonspecific
      lung diseases].
AB  - The ratio of proteinases and their inhibitors in bronchoalveolar washings was
      studied in 38 patients with chronic nonspecific diseases of the lungs. A decrease
      in the inhibitor potential was detected. Contrical, an inhibitor of proteolytic
      enzymes, was used in the treatment of the patients. A new procedure for trans
      thoracic++ intrapulmonary administration of contrical with an ISI-1 needle jet
      injector was shown to be efficient. It provided delivery of the drug in optimal
      daily doses immediately into the inflammation focus.

PMID- 2235954
TI  - [Natural antibodies, homoreactants and R-proteins in patients with tuberculosis
      after effective and insufficiently effective chemotherapy].
AB  - The cellular receptor decay products R proteins and resultant product
      immunoglobulin complexes, homoreactants showing the properties of natural
      antibodies and natural anti-sheep erythrocyte antibodies were analysed in their
      dynamics in 116 patients with infiltrative pulmonary tuberculosis. It was found
      that small homoreactant levels and relatively low titers of R proteins and
      natural sheep anti-erythrocyte antibodies were typical of patients with a limited
      process and favorable course due to effective treatment, the parameters being
      gradually normalized in their dynamics. In patients with a disseminated
      destructive process running an unfavorable course, all the values were much
      higher before the treatment and slightly changed during an ineffective therapy.
      It is suggested that the findings may be useful in the clinical management of
      pulmonary tuberculosis to predict its course and outcomes and to evaluate the
      efficacy of chemotherapy.

PMID- 2235955
TI  - [Dynamics od reparative processes in bronchial stump after pneumonectomy in
      experimental animals].
AB  - Repair processes in the bronchus stump after pneumonectomy in 25 rats and 25
      guinea-pigs were analysed. The tests were conducted on 1, 3, 7, 14 and 30 days of
      the postoperative period using bronchus stump and its bottom material for
      semithin ++ slices and electron microscopy, respectively. At early stages,
      besides necrotic and necrobiotic changes in the bronchus stump, compensatory and
      adaptive reactions are also observed. 14 days after operation there was a
      restoration of epithelial lining and formation of granulation tissue around the
      stitches. By the 30-th day considerable degenerative and functional changes are
      detected in the lamina proper, including its cellular elements, as well as in the
      structure of collagenic, elastic and smooth muscular fibers. Basal cells,
      endotheliocytes and fibroblasts are the most active sources of regeneration.

PMID- 2235956
TI  - [Differential diagnosis of allergic pneumonia and tuberculosis].

PMID- 2235957
TI  - [Chemotherapy of newly detected destructive pulmonary tuberculosis in patients
      with pathology of the gastrointestinal tract and liver].

PMID- 2235958
TI  - [Treatment of patients with tuberculosis and alcoholism].

PMID- 2235959
TI  - [Causes of long-term disability of patients with tuberculosis].

PMID- 2235960
TI  - [A case of a generalized form of primary tuberculosis in a 3-year-old child].

PMID- 2235961
TI  - [Immediate and late results of surgical treatment of tuberculosis in patients
      with diabetes mellitus].

PMID- 2235962
TI  - [Rare complication of neurogenic tumor of the mediastinum].

PMID- 2235963
TI  - Pancreatic cancer and androgen metabolism: high androstenedione and low
      testosterone serum levels.
AB  - Serum androstenedione and testosterone levels were measured in 39 male patients
      with pancreatic cancer, and compared with the values obtained from 37 male
      patients with chronic pancreatitis or benign obstructive jaundice, and with those
      from 36 male patients with other gastrointestinal malignancies. Mean
      androstenedione values were significantly higher in the pancreatic cancer
      patients when compared to both control groups, and mean testosterone levels were
      significantly lower. The testosterone/androstenedione ratio was calculated and
      was also found to be significantly lower in the patients with pancreatic cancer.
      There was no difference in this ratio or in the androstenedione or testosterone
      levels when comparing both control groups. In two patients with stage I
      pancreatic cancer, serum androstenedione and testosterone levels were
      significantly altered, and returned to normal values after successful resection.
      These results confirm previous findings indicating that there is significant
      derangement in the androgen profile of patients with pancreatic cancer.

PMID- 2235964
TI  - Diameter of the main pancreatic duct in chronic calcifying pancreatitis.
      Measurement by ultrasonography versus pancreatography.
AB  - The aim of this study was to compare the diameter of the main pancreatic duct
      measured by ultrasonography (US) and endoscopic pancreatography (ERCP) in cases
      of chronic pancreatitis and to evaluate the ability of US to gauge the dilation
      of the main duct accurately enough to do a side-to-side wirsungo-jejunostomy.
      Sixty-one measurements were recorded in 50 patients (47 men and 3 women; age:
      43.7 +/- 10 years). In 11 cases, two measurements were made at an interval of
      more than one year. US always preceded ERCP. The measurements were compared in
      only 43 cases (71%), because evaluation by US was inaccurate in 14 cases (23%)
      and by ERCP in nine cases (15%). The mean value of the diameter measured by US
      was 4.30 +/- 3.01 mm, and by ERCP, 5.52 +/- 3.08 mm (mean +/- SD). When the
      diameter assessed by US (y) was greater than or equal to 3 mm, the diameter
      assessed by ERCP (x) was always greater than or equal to 4 mm. The value of x
      could be determined from y by the equation: x = y + 1.2 mm (r = 0.91, p less than
      0.05) The difference between x and y was constant and did not depend on the size
      of the duct. It could be owing to the hyperechogenicity of the duct walls. We
      conclude that US is a reliable way to assess the dilation of the main pancreatic
      duct and might be an acceptable method of judging whether a side-to-side wirsungo
      jejunostomy can be performed.

PMID- 2235965
TI  - Metal ions induce expression of metallothionein in pancreatic exocrine and
      endocrine cells.
AB  - Northern blot hybridization established that metallothionein (MT) mRNA levels
      were dramatically elevated in the rat pancreas following injection of Cd or Zn
      salts. To determine which pancreatic cell types express the MT gene, Northern
      blot hybridization analysis of RNA from preparations enriched for acini, in situ
      hybridization, and immunocytochemistry were used. RNA from pancreatic acini of Zn
      treated rats contained high levels of MT mRNA. In control rats, in situ
      hybridization suggested very low levels of MT mRNA in both exocrine and endocrine
      cells in the pancreas, but these levels were dramatically increased in both these
      cell populations following metal injection. In contrast, levels of insulin-I mRNA
      in the endocrine cells were not affected by metal injection. A similar result
      with MT mRNA was obtained in mouse and chicken pancreas using Northern blot and
      in situ hybridization. Immunocytochemistry detected MT in the rat acinar cell
      cytoplasm following metal injection. Although inconsistent with in situ
      hybridization studies and immunocytochemical analysis of exocrine cells,
      immunocytochemistry for MT indicated a uniform staining pattern of islet cells
      that was unaffected by metal treatment. These results establish that metal ion
      induction of the MT genes in pancreas occurs in both endocrine and exocrine
      cells, which suggests that this protein has diverse physiologic functions in this
      organ.

PMID- 2235966
TI  - Geranyl-geranyl acetone: a novel stimulant of secretin release in the dog.
AB  - Geranyl-geranyl acetone (GGA), a new acyclic polyisoprenoid, anti-ulcer drug
      appears to exert its beneficial effect by stimulating bicarbonate secretion from
      the stomach and pancreas. Its efficacy in stimulating pancreatic bicarbonate is
      particularly striking, and this study was designed to examine the mechanism for
      this action. Since it is structurally similar to the side chain of the
      prostaglandin molecule, its ability to stimulate bicarbonate secretion could be a
      direct one. On the other hand, the magnitude of pancreatic bicarbonate response
      (about 50% of maximal response to secretin) suggests it might act by releasing
      secretin. Two types of experiments were performed in dogs with pancreatic
      fistulas: first, secretagogue interactions were examined by studying the effect
      of intraduodenal GGA (8 mg/kg) or its carrier (control) on the dose-response
      curves to exogenous secretin and cholecystokinin octapeptide (CCK-8); second, the
      effect of graded doses of intraduodenal GGA on pancreatic bicarbonate and plasma
      secretin-like immunoreactivity (SLI) responses was tested directly. Pancreatic
      bicarbonate responses (micromoles per 30 min) were to secretin doses of 32, 125,
      and 500 ng/kg/h. Without and with GGA, responses were 74 +/- 27, 952 +/- 215, and
      2,000 +/- 425 and 599 +/- 110, 1,624 +/- 472, and 2,129 +/- 398 ng/kg/h,
      respectively. Similarly, the bicarbonate responses to CCK-8 were augmented. Basal
      plasma SLI was 1.5 +/- 0.6 pM/ml. Peak plasma SLI in response to 2, 4, and 8 mg
      of GGA intraduodenally were 6.8 +/- 0.7, 8.9 +/- 3.1, and 19.6 +/- 2.7 pM/ml,
      respectively. It is concluded that GGA is a potent stimulant of pancreatic
      bicarbonate secretion, and this action appears to be mediated by the release of
      duodenal secretin.

PMID- 2235967
TI  - Malabsorption of vitamin B12 in pancreatic insufficiency of the adult and of the
      child.
AB  - Vitamin B12 can bind two carrier proteins in the digestive tract, haptocorrin (R
      binder) and intrinsic factor, but only its binding to intrinsic factor allows its
      absorption. A malabsorption of vitamin B12 is observed in about 30% of adult
      patients with exocrine pancreatic insufficiency, using the Schilling test. None
      of the hypotheses that have tried to explain this malabsorption are entirely
      satisfactory. A failure to degrade haptocorrin can prevent the binding of vitamin
      B12 to intrinsic factor. It has also been suggested that pancreatic secretion
      could modify the structure of intrinsic factor, enabling the uptake of the
      vitamin B12-intrinsic factor complex by the ileum. Other factors can also affect
      the binding of vitamin B12 to intrinsic factor, such as the gastric pH and bile.
      The Schilling test is abnormal in nearly all cases of cystic fibrosis. One
      explanation could be the gastric hyperacidity observed in this disease. Despite
      the frequency of abnormal Schilling tests, vitamin B12 deficiency is very rare in
      cases of exocrine pancreatic dysfunction, in adults as well as in children with
      cystic fibrosis. The assimilation of this vitamin with a tracer included in food
      instead of the crystalline labeled cobalamin used in the Schilling test remains
      to be investigated.

PMID- 2235968
TI  - Treatment of acute alcoholic pancreatitis in cats.
AB  - We created acute pancreatitis in cats by instilling ethanol (20 ml of a 40%
      solution) into the stomach and then perfusing activated pancreatic enzymes
      through the main pancreatic duct. Edematous pancreatitis developed within 24 h as
      the enzymes leaked out of the duct into the surrounding pancreatic parenchyma. We
      tested the effects of a number of agents on the amelioration of the severity of
      the pancreatic inflammation. Cimetidine (an H2 receptor blocker) and Benadryl (an
      H1 receptor blocker) given in combination decreased the incidence of pancreatic
      hemorrhage but not the overall degree of inflammation. Indomethacin (a
      cyclooxygenase inhibitor) had a similar effect. Terbutaline (a beta-agonist)
      given alone decreased the overall degree of inflammation, including the incidence
      of hemorrhage. All of the drugs given together were no more effective than
      terbutaline alone. The combination was effective even when given up to 12 h after
      the onset of pancreatitis.

PMID- 2235969
TI  - Demonstration of a new resonance peak by proton NMR in rat pancreas stimulated
      with caerulein.
AB  - Low-resolution proton nuclear magnetic resonance (1H NMR) analysis of the
      pancreas of rats stimulated with caerulein, a cholecystokinin analog, was found
      to differ from that of control rats either fed ad libitum or fasted for two days.
      The hormonal stimulation induced (a) an increase in the longitudinal relaxation
      time T1; (b) a 1H NMR peak situated at 1.8 +/- 0.2 ppm from the resonance peak of
      tissular water. This resonance peak was not observed in the pancreas of fasted
      rats, although it could just be detected in the pancreas of rats fed ad libitum.
      These features were not observed after injection of lorglumide, an antagonist of
      cholecystokinin, followed by caerulein stimulation. On the other hand,
      stimulation with secretin induced a slight increase in T1 but did not lead to the
      appearance of the 1.8 +/- 0.2 ppm peak. The 1.8 +/- 0.2 ppm resonance peak thus
      appears to be related to the hormone-stimulated state of the exocrine pancreas
      and might be a useful indicator of the physiological state of exocrine pancreatic
      tissue. From ultrastructural examination of pancreatic cells and 1H NMR studies
      of solutions of the major membrane phospholipids in rat plasma, we concluded that
      the 1.8 +/- 0.2 ppm resonance peak stemmed from an alteration in the metabolism
      of membrane phospholipids and/or an increase in membrane fluidity after
      stimulation of acinar cells by caerulein.

PMID- 2235970
TI  - Manganese modulates protein phosphorylation in the rat pancreas: in vitro
      evidence for cation selective regulation.
AB  - The effects of manganese (Mn2+) on phosphorylation activity in the rat pancreas
      were examined in an in vitro phosphorylation assay and by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE) of endogenous proteins. Several
      histones were phosphorylated in the presence of pancreatic supernatant obtained
      following a 10-min centrifugation at 15,000 g. The histone preference for this
      reaction was VII-S greater than V-S or II-S greater than III-S greater than other
      histones. The Mn2+ (10 mM) enhanced the phosphorylation of some histones (II-A,
      III-S, VI-S, and VIII-S) but inhibited the phosphorylation of other histones (II
      S, V-S, and VII-S). The same concentration of Mn2+ also enhanced the
      incorporation of 32P into cytosolic proteins in the absence of exogenous
      histones. This effect was not mimicked by Ca2+, Mg2+, Ba2+, or Zn2+. Analysis of
      endogenous proteins by SDS-PAGE revealed Mn2(+)-dependent and time-dependent
      phosphorylation of high (98-200-kDa), intermediate (59-,52-,35-, and 30-kDa), and
      low-molecular weight proteins. The Mn2+ exerted similar effects in the presence
      of pancreatic cytosol obtained following a 60-min centrifugation at 100,000 g.
      However, the 35- and 30-kDa phosphoproteins and the low-molecular weight proteins
      were not readily visible. In both the 15,000- and the 100,000-g preparations,
      there was a dose-dependent increase in the phosphorylation of the Mr 98-kDa
      protein (p98) at concentrations ranging from 0.03 to 1.0 mM Mn2+ but a lesser
      stimulatory effect at 10.0 mM Mn2+.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235971
TI  - Effect of synthetic human cholecystokinin-33 on pancreatic blood flow in dogs.
AB  - We have examined the effect of synthetic human cholecystokinin (CCK-33 and CCK-8)
      on pancreatic blood flow and protein output in anesthetized dogs. Human CCK-33
      and CCK-8 increased pancreatic blood flow and protein output in a dose-related
      manner. There were no significant differences in increasing pancreatic blood flow
      between human CCK-33 and CCK-8, and increases in blood flow were closely related
      to the increase of the pancreatic enzyme secretion. L-364,718 (20 nmol/kg) caused
      a potent inhibition of CCK-stimulated pancreatic blood flow as well as protein
      output. The degree of inhibition by L-364,718 was dependent on the amount of CCK
      infused. This study demonstrates that increasing effect on pancreatic blood flow
      may be one of the biological actions of CCK mediated via CCK receptor. The CCK
      33, one of longer molecular forms of CCK, is an important biological stimulator
      of pancreatic blood flow as well as of exocrine pancreatic secretion.

PMID- 2235972
TI  - Atropine enhances food-stimulated CCK secretion in the rat.
AB  - The effect of atropine on plasma cholecystokinin (CCK) and pancreatic secretion
      during intraintestinal infusion of a conventional defined formula liquid diet
      (Ensure HN, Ross Laboratories, 1.06 kcal/ml) was studied in conscious rats. Rats
      were prepared with cannulae draining bile and pancreatic juice, which were
      returned to the duodenum at all times. Pancreatic secretion was monitored during
      intraduodenal infusion of 0.15 M NaCl for 2 h followed by Ensure HN, both infused
      at 4.62 ml/h. Rats were infused i.p. with atropine (500 micrograms/kg/h) or
      vehicle throughout the experiment, beginning 1 h before monitoring of basal
      pancreatic secretion. Basal and 15 min postprandial plasma CCK concentrations
      were determined by bioassay. Atropine inhibited basal pancreatic protein
      secretion by approximately 60%. However, protein secretion during infusion of the
      diet was not decreased by atropine, due to a larger incremental pancreatic
      protein secretory response in atropine-treated rats. Plasma CCK 15 min after
      beginning the diet infusion was significantly increased by atropine (8.09 +/-
      1.77 pM in atropine-treated rats versus 3.14 +/- 0.64 pM in controls). The
      results indicate that rats compensate for loss of cholinergic input to the
      pancreas by increasing CCK release in response to a meal. This is hypothesized to
      occur by virtue of reduced feedback inhibition of CCK release due to
      anticholinergic reduction of basal levels of intestinal protease activity.

PMID- 2235973
TI  - Increased body weight as a prognostic parameter for complications in the course
      of acute pancreatitis.
AB  - To evaluate whether obesity is a negative prognostic parameter in the course of
      acute pancreatitis, we examined 149 patients and divided them into four weight
      groups. Single (methemalbumin) and multiple (Ranson's signs) prognostic
      parameters were found to be independent of increased body weight in all groups,
      although the incidence of patients with more than six Ranson's signs or a
      positive methemalbumin test was highest in the most obese group. There was also
      no direct positive correlation between increased body weight and the incidence of
      mortality and late complications such as pseudocysts and abscesses. However, when
      compared with patients of normal weight, the obese groups showed a slight
      increase in the incidence of early complications such as shock and renal
      insufficiency and a significant increase in respiratory insufficiency
      necessitating artificial ventilation. Thus, increased body weight was associated
      with increased incidence of early extrapancreatic complications.

PMID- 2235974
TI  - Deduced amino acid sequence of heme binding region of chicken cholesterol side
      chain cleavage cytochrome P450.
AB  - The primary structure of the carboxy terminal 296 amino acids of chicken
      cholesterol side chain cleavage cytochrome P450 (P450scc) was deduced from a
      partial cDNA clone isolated from a chicken ovarian cDNA library. The sequence
      contained putative steroid binding and heme binding regions. Comparison of this
      sequence with the corresponding sequences of three mammalian forms of P450scc
      shows greater than 50% homology. The heme binding region of the avian P450scc
      shows 76% homology with the heme binding regions of rat and human P450scc and 81%
      homology with that of bovine P450scc.

PMID- 2235975
TI  - Reorganization and merging of the EMBL and GenBank keyword indexes in a tree
      structure for more efficient retrieval of nucleic acid sequences.
AB  - EMBL and GenBank keyword indexes have no hierarchical structure. In this paper we
      present a method for merging and reorganizing them in a tree structure whose
      primary roots are the keywords 'protein', 'DNA', 'RNA', and 'unclassified'.
      Synonymous keywords have been grouped together and erroneous keywords have been
      corrected. This taxonomic organization of keywords results in a more extensive
      and efficient retrieval which is further aided by "synonyms declaration". The
      tree has been produced using the computer programs GENPOINT and CREANET.

PMID- 2235976
TI  - Species comparison of calmodulin sequences.
AB  - No amino acid substitutions can be located when the calmodulin produced in
      various vertebrate species (human, rat, chicken, toad) are compared. However,
      multiple substitutions exist in calmodulin derived from non-vertebrates. Here, we
      have determined the residues for which no alterations in sequence are allowed.
      The protein from each species exhibits a sequence identity from residue 27 to
      residue 53, i.e., residues spanning a small part of the Ca2+ binding loop I and
      the adjacent interloop region. The analogous sequence (residues 100 to 129)
      abutting the Ca2+ binding loop III also exhibits only a few differences.
      Furthermore, negatively charged side chains at residues 82-84 in the central
      alpha-helix are conserved.

PMID- 2235977
TI  - The following protein sequences were reprinted from the protein sequence database
      of the Protein Identification Resource (PIR).

PMID- 2235978
TI  - The mutagen = carcinogen controversy.

PMID- 2235979
TI  - In memoriam Chapman H. Binford.

PMID- 2235980
TI  - Reversal by antrectomy of endocrine cell hyperplasia in the gastric body in
      pernicious anemia: a morphometric study.
AB  - Multifocal gastric carcinoid tumors occasionally develop in patients with
      pernicious anemia, associated with hyperplasia of endocrine cells in the atrophic
      and metaplastic gastric body mucosa. This constellation of findings probably
      requires a trophic drive from hypergastrinemia associated with antral G cell
      hyperplasia, a consequence of achlorhydria in these patients. We report a case in
      which antrectomy was performed on such a patient in order to abrogate the trophic
      stimulus. Antrectomy was followed by resolution of hypergastrinemia and a
      decrease in the size of polyps endoscopically. Nine months later, the gastric
      remnant was resected. Using morphometric techniques, endocrine cells in the
      initial antrectomy specimen (which included body mucosa at the resection line)
      were compared with those in the subsequently removed gastric body. Antrectomy
      resulted in striking decreases in number (137 versus 34/mm2; P = 0.0001) and size
      (93 versus 56 microns2; P = 0.0001) of endocrine cells of body mucosa. The
      findings suggest that antrectomy may be useful in the management of endocrine
      cell hyperplasia, and possibly also associated carcinoid tumors, in pernicious
      anemia.

PMID- 2235981
TI  - An autopsy study of the structure of the small vessels in biopsies from the
      lingula and upper and lower lobes: implications for vascular assessment.
AB  - We examined the structure of the muscular pulmonary arteries in the three lung
      sites most often used for lung biopsy. In a subset of cases, we also examined
      tissue from the central portion of the lower lobe. In each vessel we measured the
      area of intima and muscle media and expressed these data as a percentage of the
      total tissue area; vessel size was standardized by using the length of the
      internal elastic lamina. We found that no one biopsy site best represented the
      arterial structure of the central aspect of the lower lobe. The lingula had
      greater numbers of arteries which met the criteria for assessment from than did
      the other biopsy sites. The vessel structure was similar between the lingula and
      peripheral aspect of the upper lobe, but the lingula had a slightly increased
      area of muscle media and decreased intima when compared with the superior segment
      of the lower lobe. This was not a function of vessel size, since the overall
      cumulative distribution curve of percent muscle divided by length of internal
      elastic lamina was also shifted between lingula and lower lobe. We conclude that,
      in the assessment of arterial vascular structure, any of the standardly used
      biopsy sites can be representative of the lung. Although there may be differences
      in structure between the sites in individual patients depending on concurrent
      disease in any of the sites, there is no consistent site effect on vessel
      structure. If a formal morphometric evaluation of arterial structure is required,
      the lingula appears to have more vessels which fit the criteria for assessment.

PMID- 2235982
TI  - Comparison of fine-needle aspiration and frozen section of palpable mammary
      lesions.
AB  - We compared the results of 100 consecutive fine-needle aspirations of palpable
      mammary lesions in women with 100 consecutive frozen sections done on palpable
      suspicious nodules in the breasts of women who had had no prior aspiration. There
      were no false positive results in either group. The false negative rate of
      aspirations was 6%, compared with none for frozen section, suspicious cases
      excluded. In four of six patients with false negative aspirations, the specimen
      was nondiagnostic or unsatisfactory. (In this series, no repeat aspirations were
      performed for nondiagnostic or negative specimens, even when clinically
      suspicious.) We conclude that aspiration of a palpable mammary tumor is a
      definitive procedure with results equivalent to frozen section and equally
      suitable for choosing and undertaking definitive therapy, when positive. Negative
      results, viewed in an appropriate clinical context, also proved conclusive.
      Atypical or suspicious results at aspiration must be followed by repeat
      aspiration or excision, since these frequently prove positive; likewise,
      unsatisfactory or nonrepresentative aspirations must be investigated further, as
      indicated by the clinical evaluation.

PMID- 2235983
TI  - Medullary carcinoma of the thyroid gland: an encapsulated variant resembling the
      hyalinizing trabecular (paraganglioma-like) adenoma of thyroid.
AB  - Two encapsulated medullary carcinomas of the thyroid gland exhibiting an organoid
      and trabecular pattern with hyalinized stroma and composed of polyhedral to
      spindled tumor cells with hyaline-appearing cytoplasm are described and compared
      with three histologically indistinguishable adenomas of follicular cell
      derivation. Positive immunocytochemical staining for calcitonin and negative
      staining for thyroglobulin confirms the diagnosis of medullary carcinoma in these
      tumors, while positive staining for thyroglobulin confirms the follicular cell
      nature of the adenomas. The distinction between these tumor types is a crucial
      one, given the prognostic and potential genetic implications of medullary
      carcinoma.

PMID- 2235984
TI  - Carcinoembryonic antigen and carcinoids of the gastrointestinal tract.
AB  - We studied the prognostic significance of immunohistochemically localized
      carcinoembryonic antigen in 131 nonmetastasizing and 35 metastasizing
      gastrointestinal carcinoid tumors. The rate of positivity was lower with
      preabsorbed versus nonabsorbed polyclonal antiserum. Compared with generally used
      prognostic features (depth of invasion, tumor size, and mitotic rate) positivity
      for absorbed anticarcinoembryonic antigen was the most specific feature for
      metastatic tumors but was least sensitive. Although our results demonstrate that
      anticarcinoembryonic antigen, particularly when absorbed, is highly associated
      with metastatic disease, depth of invasion and tumor size are better predictors
      of behavior.

PMID- 2235985
TI  - Nucleolar organizer regions in human adrenocortical disorders.
AB  - A silver colloid technique to demonstrate nucleolar organizer region-associated
      proteins (AgNORs) was performed on sections of 39 human adrenal glands, including
      normal adrenal cortex, bilateral adrenocortical hyperplasia, adenoma, and
      carcinoma. In mineralocorticoid and glucocorticoid-producing adrenocortical
      cells, the mean number of AgNORs per nucleus was lowest in the normal adrenal
      gland and highest in adenoma, with statistically significant differences. The
      mean number of AgNORs in bilateral adrenocortical hyperplasia was placed between
      that of normal adrenal and adenoma. AgNOR numbers in morphologically and
      clinically verified adrenocortical carcinoma (12 cases) were not different from
      those in adenoma (17 cases). In adrenal cortex, AgNOR numbers may be correlated
      with increased steroid hormone production but appear to be of little value in
      discerning malignancy in adrenocortical neoplasms.

PMID- 2235986
TI  - Infundibulocystic basal cell carcinoma: a newly described variant.
AB  - A report by Tozawa and Ackerman (Am J Dermatopathol 9(6):474, 1987) upon a
      distinctive type of basal cell carcinoma with a particular type of follicular
      differentiation has stimulated lively correspondence in the literature of
      dermatopathology. The lesion in question presents itself clinically as a basal
      cell carcinoma on the face and histopathologically as a neoplasm typified by
      small size, sharp circumscription, and a unique combination of kinds of
      follicular differentiation, namely, follicular germs and infundibula. The
      principal point of contention concerning this neoplasm has been whether it is
      truly a special variant of basal cell carcinoma or whether it is actually a
      trichoepithelioma. More extensive studies of this singular neoplasm, including
      its occurrence in patients with nevoid basal cell carcinoma syndrome, and review
      of the very few portrayals of it in the literature, have consolidated our view
      that it is indeed a special variant of basal cell carcinoma. We now present (a)
      new information about an early stage in the evolution of the neoplasm in point,
      (b) evidence to validate classification of it as a basal cell carcinoma, and (c)
      a critical appraisal of other lesions that might pose problems in differential
      diagnosis. Finally, justification is provided for the designation
      "infundibulocystic basal cell carcinoma."

PMID- 2235987
TI  - Monoclonal anti-CEA antibodies in the discrimination between primary pulmonary
      adenocarcinoma and colon carcinoma metastatic to the lung.
AB  - Lung metastases from colon adenocarcinoma are often difficult to differentiate
      from primary lung adenocarcinoma. We studied the diagnostic value of a polyclonal
      anti-CEA antiserum and two monoclonal anti-CEA antibodies (B18, D14) which define
      antigens overexpressed in colon carcinoma. Autopsy material from 20 patients with
      colon carcinoma and lung metastases and 20 specimens from patients with primary
      lung adenocarcinoma were retrieved, stained, and interpreted without knowledge of
      the origin of the lung tumor. Colon carcinomas, lung metastases and lung
      primaries stained positively with polyclonal anti-CEA in 90-100% of cases. D14
      stained 75% of colonic metastases and 70% of primary lung adenocarcinomas,
      whereas 95% of colon primaries were positive. Sixty-five percent of colon
      primaries and 50% of their metastases were positive with B18, whereas 45% of lung
      primaries were positive. The frequency of B18 positivity was significantly
      greater in those colon primaries that were surgically derived (7/9, 78%) compared
      with their autopsy-derived lung metastases (2/9, 22%) (P less than 0.05).
      Similarly, D14 staining in surgically derived colon primaries (9/9, 100%) was
      significantly greater than their autopsy-derived lung metastases (5/9, 56%) (P
      less than 0.05). In surgical/biopsy-derived tissues 9/9 colonic primaries were
      D14-positive, whereas only 1 of 6 lung primaries was positive (P = 0.002). We
      conclude that D14 and polyclonal anti-CEA both stain the majority of colon
      adenocarcinomas and that changes associated with prolonged fixation may reduce
      the positivity rate with both B18 and D14 monoclonal antibodies. All three
      antibodies stain autopsy-derived tissue from primary lung cancer to a significant
      degree.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2235988
TI  - The histologic development of acid-induced esophagitis in the cat.
AB  - Acute reflux esophagitis in man is characterized histologically by infiltrates of
      segmented leukocytes, epithelial proliferation, and ulcers. Our feline model,
      which includes each of these features, is produced by the infusion of 0.1 N HCl
      at a rate of 1 ml per min into the distal esophagus of adult cats for varying
      periods of time. Our histologic scoring system includes both the intensity and
      the distribution of four morphologic features, namely basal cell hyperplasia
      (BCH), intraepithelial segmented leukocytes (IEL), subepithelial leukocytes
      (SEL), and ulcers. Each of these four categories are scored from 0 to 4, with a
      potential score of 16. We evaluated the effects of duration of acid exposure by
      infusing cats with HCl for 5 min (N = 4), 15 min (N = 12), 20 min (N = 12), and
      30 min (N = 6), followed by autopsy 24 h later. Mean scores (+/- SE) were as
      follows: 5 min, 3.0 (+/- 1.7); 15 min, 9.0 (+/- 1.0); 20 min, 11.17 (+/- 1.06);
      30 min, 15.17 (+/- 0.54). Differences between 5 and 15 min, 15 and 30 min, and 20
      and 30 min were significant (P less than 0.05). Basal cell hyperplasia appeared
      to be the most sensitive marker of acid injury; ulcers denoted severe injury
      associated with longer exposure periods. Although an occasional eosinophil was
      seen, the majority of the segmented leukocytes were neutrophils. We also studied
      healing histologically by examining cats at 1 d (N = 6), 2 d (N = 6), 3 d (N =
      11), and 4 d (N = 6) after a 30 min exposure to HCl.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2235989
TI  - Identification of human immunodeficiency virus in the heart of a patient with
      acquired immunodeficiency syndrome.
AB  - A 35-year-old homosexual white male diagnosed as having human immunodeficiency
      virus (HIV) infection presented with recurrent pericardial effusion, and HIV was
      isolated from the pericardial fluid. Autopsy revealed an extensive gross
      infiltrative lesion in the left ventricle of the heart. Microscopic examination
      of the myocardium demonstrated multifocal atypical lymphoid cell infiltrations
      associated with scattered foci of myocardial necrosis. The atypical lymphoid
      cells were immunoreactive to UCHL-1, a T cell antigen antibody. HIV was
      immunocytochemically identified in the cardiac lymphocytic infiltrate with anti
      p24 monoclonal antibodies. This finding was supported by ultrastructural
      examination and in situ hybridization study.

PMID- 2235990
TI  - Oligonucleotide probe for herpes virus: use in paraffin sections.
AB  - A method is described for in situ hybridization detection and typing of herpes
      simplex virus (HSV) using alkaline phosphatase-labeled synthetic oligonucleotide
      probes in paraffin tissue sections. Sections mounted on slides are prehybridized
      and denatured before the probe mixture is added. Hybridization proceeds for 1 h
      at 60 degrees C. Detection of the alkaline phosphatase label is performed using a
      nitro blue tetrazolium and 5-bromo-4-chloro-3-indolyl phosphate substrate.
      Specific hybridization with HSV type 1 DNA was found in sections of herpetic
      esophagitis and encephalitis. There was no discernible background staining.
      Hybridization with an oligonucleotide probe specific for HSV type 2 was negative.
      No hybridization occurred to sections of cytomegalovirus- or adenovirus-infected
      tissue. The development of this technique expands the utility of synthetic
      oligonucleotide probes to include hybridization reactions in routinely processed
      and paraffin-embedded tissue. The use of directly labeled oligonucleotide probes
      for tissue in situ hybridization overcomes problems of probe contamination with
      vector plasmid DNA, nonspecific avidin binding to tissue, and the danger and
      inconvenience of working with radioactive materials.

PMID- 2235991
TI  - Amphipathic helix motif: classes and properties.

PMID- 2235992
TI  - Crystal structure of a protein-toxin alpha 1-purothionin at 2.5A and a comparison
      with predicted models.
AB  - Alpha 1-Purothionin (alpha 1-P), a wheatgerm protein and lytic toxin, has a
      secondary and tertiary structure similar to that of crambin as revealed by CD and
      NMR studies. alpha 1-P crystallizes in the tetragonal space group 1422 with unit
      cell dimensions: a = b = 53.59 and c = 69.79 A. X-ray diffraction data have been
      measured to 2.5 A Bragg spacing. The crystal structure has been determined by
      molecular replacement methods, using an energy-minimized alpha 1-P model
      structure derived from crambin (Whitlow and Teeter: Journal of Biomolecular
      Structure and Dynamics 2:831-848, 1985, Journal of the American Chemical Society
      108:7163-7172, 1986). The energy-minimized model gives a slightly cleaner
      rotation solution and better refinement against the x-ray data than do the
      crambin or unminimized alpha 1-P structures. The final crystallographic residual
      with the data in the 10-2.5 A resolution range is 0.216. The refined alpha 1-P
      structure has a backbone rms difference of 0.74 A from crambin and 0.55 A from
      the energy-minimized alpha 1-P model. A low resolution NMR model of alpha 1-P
      calculated from metric matrix distance geometry and restrained molecular dynamics
      differs from crambin's backbone by 2.3 A rms deviation (Clore et al.: EMBO
      Journal 5:2729-2735, 1986). Backbone dihedral angles for our predicted model
      differ from the refined alpha 1-P structure in only one region (at a turn where
      there is a deletion relative to crambin). The NMR model had differences in four
      regions.

PMID- 2235993
TI  - Comparison of the structures of globins and phycocyanins: evidence for
      evolutionary relationship.
AB  - Globins and phycocyanins are two classes of proteins with different function,
      different ligands, and no substantial sequence similarity, yet the conformations
      of their polypeptide chains show very similar folding patterns. Does this arise
      from a genuine, albeit very distant, evolutionary relationship, or does it
      represent a common solution of a structural problem? We address this question by
      a very detailed comparison of the structures of the two protein families. An
      analysis of the helices and their interactions shows many features common to
      globins and phycocyanins, including some exceptional features of the globins such
      as a 3-10 C helix and the unusual "crossed-ridge" packing pattern at the B/E
      helix interfaces. We conclude that the evidence supports the hypothesis of
      distant evolutionary relationship between globins and phycocyanins.

PMID- 2235994
TI  - Conformational flexibility of a scorpion toxin active on mammals and insects: a
      circular dichroism study.
AB  - Three scorpion toxins have been analyzed by circular dichroism in water and in
      2,2,2-trifluoroethanol (TFE) solutions. These toxins were chosen because they are
      representative of three kinds of pharmacological activities: (1) toxin AaH IT2,
      an antiinsect toxin purified from the venom of Androctonus australis Hector,
      which is able to bind to insect nervous system preparation, (2) toxin Css II,
      from the venom of Centruroides suffusus suffusus, which is a beta-type antimammal
      toxin capable of binding to mammal nervous system preparation, and (3) the toxin
      Ts VII from the venom of Tityus serrulatus, which is able to bind to both types
      of nervous systems. In order to minimize bias, CD data were analyzed by a
      predictive algorithm to assess secondary structure content. Among the three
      molecules, Ts VII presented the most unordered secondary structure in water, but
      it gained in ordered forms when solubilized in TFE. These results indicated that
      the Ts VII backbone is the most flexible, which might result in a more pronounced
      tendency for this toxin molecule to undergo conformational changes. This is
      consistent with the fact that it competes with both antiinsect and beta-type
      antimammal toxins for the binding to the sodium channel.

PMID- 2235995
TI  - Distinct character in hydrophobicity of amino acid compositions of mitochondrial
      proteins.
AB  - A compact mitochondrial gene contains all essential information about the
      synthesis of mitochondrial proteins which play their roles in a small compartment
      of the mitochondrium. Almost no noncoding regions have been found through the
      gene, but a necessary set of tRNAs for the 20 amino acids is provided for
      biosynthesis, some of them coding different amino acids from those in a usual
      cell. Since the gene is so compact that the produced proteins would have some
      characteristic aspects for the mitochondrium, amino acid compositions of
      mitochondrial proteins (mt-proteins) were examined in the 20-dimensional
      composition space. The results show that compositions of proteins translated from
      the mitochondrial genes have a distinct character having more hydrophobic content
      than others, which is illustrated by a clustered distribution in the
      multidimensional composition space. The cluster is located at the tail edge of
      the global distribution pattern of a Gaussian shape for other various kinds of
      proteins in the space. The mt-proteins are rich in hydrophobic amino acids as is
      a membrane protein, but are different from other membrane proteins in a lesser
      content of Val. A good correlation found between the base and amino acid
      compositions for the mitochondria was examined in comparison to those of
      organisms such as thermophilic bacterium having an extreme G-C-rich base
      composition.

PMID- 2235996
TI  - Conformational and helicoidal analysis of the molecular dynamics of proteins:
      "curves," dials and windows for a 50 psec dynamic trajectory of BPTI.
AB  - A new procedure for the graphic analysis of molecular dynamics (MD) simulations
      on proteins is introduced, in which comprehensive visualization of results and
      pattern recognition is greatly facilitated. The method involves determining the
      conformational and helicoidal parameters for each structure entering the analysis
      via the method "Curves," developed for proteins by Sklenar, Etchebest, and Lavery
      (Proteins: Structure, Function Genet. 6:46-60, 1989) followed by a novel computer
      graphic display of the results. The graphic display is organized systematically
      using conformation wheels ("dials") for each torsional parameter and "windows" on
      the range values assumed by the linear and angular helicoidal parameters, and is
      present in a form isomorphous with the primary structure per se. The complete
      time evolution of dynamic structure can then be depicted in a set of four
      composite figures. Dynamic aspects of secondary and tertiary structure are also
      provided. The procedure is illustrated with an analysis of a 50 psec in vacuo
      simulation on the 58 residue protein, bovine pancreatic trypsin inhibitor (BPTI),
      in the vicinity of the local minimum on the energy surface corresponding to a
      high resolution crystal structure. The time evolution of 272 conformational and
      788 helicoidal parameters for BPTI is analyzed. A number of interesting features
      can be discerned in the analysis, including the dynamic range of conformational
      and helicoidal motions, the dynamic extent of 2 degrees structure motifs, and the
      calculated fluctuations in the helix axis. This approach is expected to be useful
      for a critical analysis of the effects of various assumptions about force field
      parameters, truncation of potentials, solvation, and electrostatic effects, and
      can thus contribute to the development of more reliable simulation protocols for
      proteins. Extensions of the analysis to present differential changes in
      conformational and helicoidal parameters is expected to be valuable in MD studies
      of protein complexes with substrates, inhibitors, and effectors and in
      determining the nature of structural changes in protein-protein interactions.

PMID- 2235998
TI  - A somatic gene rearrangement contributing to genetic diversity in maize.
AB  - We have discovered a somatic genomic rearrangement that occurs at high frequency
      at a duplicated zein locus in certain cultures of the maize inbred line A188. The
      rearranged allele arises from the duplication by a two-step process involving a
      homologous recombination and a second event, which may be a deletion, inversion,
      or insertion; both steps always occur together. The frequency of rearrangement is
      lower in homozygous states of the parental allele than in heterozygotes. In both
      cases, the rearrangement is shown to be mitotic. The rearranged product can be
      transmitted through meiosis, providing another mechanism for genome evolution in
      higher eukaryotes.

PMID- 2235997
TI  - Tension in secretory granule membranes causes extensive membrane transfer through
      the exocytotic fusion pore.
AB  - For fusion to occur the repulsive forces between two interacting phospholipid
      bilayers must be reduced. In model systems, this can be achieved by increasing
      the surface tension of at least one of the membranes. However, there has so far
      been no evidence that the secretory granule membrane is under tension. We have
      been studying exocytosis by using the patch-clamp technique to measure the
      surface area of the plasma membrane of degranulating mast cells. When a secretory
      granule fuses with the plasma membrane there is a step increase in the cell
      surface area. Some fusion events are reversible, in which case we have found that
      the backstep is larger than the initial step, indicating that there is a net
      decrease in the area of the plasma membrane. The decrease has the following
      properties: (i) the magnitude is strongly dependent on the lifetime of the fusion
      event and can be extensive, representing as much as 40% of the initial granule
      surface area; (ii) the rate of decrease is independent of granule size; and (iii)
      the decrease is not dependent on swelling of the secretory granule matrix. We
      conclude that the granule membrane is under tension and that this tension causes
      a net transfer of membrane from the plasma membrane to the secretory granule,
      while they are connected by the fusion pore. The high membrane tension in the
      secretory granule may be the critical stress necessary for bringing about
      exocytotic fusion.

PMID- 2235999
TI  - Structure of visual perception.
AB  - The response properties of a class of motion detectors (Reichardt detectors) are
      investigated extensively here. Since the outputs of the detectors, responding to
      an image undergoing two-dimensional rigid translation, are dependent on both the
      image velocity and the image intensity distribution, they are nonuniform across
      the entire image, even though the object is moving rigidly as a whole. To achieve
      perceptual "oneness" in the rigid motion, we are led to contend that visual
      perception must take place in a space that is non-Euclidean in nature. We then
      derive the affine connection and the metric of this perceptual space. The Riemann
      curvature tensor is identically zero, which means that the perceptual space is
      intrinsically flat. A geodesic in this space is composed of points of constant
      image intensity gradient along a certain direction. The deviation of geodesics
      (which are perceptually "straight") from physically straight lines may offer an
      explanation to the perceptual distortion of angular relationships such as the
      Hering illusion.

PMID- 2236000
TI  - Exogenous mRNA encoding tetanus or botulinum neurotoxins expressed in Aplysia
      neurons.
AB  - Injection of exogenous mRNA purified from various tissue preparations into
      cellular translation systems such as Xenopus oocytes has allowed expression of
      complex proteins (e.g., receptors for neurotransmitters). No evidence for
      expression of injected exogenous mRNA, however, has been reported in terminally
      differentiated neurons. If achieved, it would allow the study of long-lasting
      changes of properties of nerve cells in their functional context. To obtain
      evidence of such expression, we chose two proteins that produce a detectable
      effect even at very low intracellular concentrations. Tetanus toxin and botulinum
      neurotoxin fulfill this criterion, being the most potent neurotoxins known. Both
      toxins block neurotransmitter release at nanomolar intracellular concentrations.
      These di-chain proteins, consisting of a light chain and a heavy chain, have
      recently been sequenced. Their active sites are located (or partly located) on
      the light chain. mRNAs encoding the light chain of either toxin were transcribed
      in vitro from the cloned and specifically truncated genes of Clostridium tetani
      and Clostridium botulinum, respectively, and injected into presynaptic
      cholinergic neurons of the buccal ganglia of Aplysia californica. Depression of
      neurotransmitter release appeared in less than 1 hr, demonstrating successful
      expression of foreign mRNA injected into a neuron in situ.

PMID- 2236001
TI  - Isolated dystrophin molecules as seen by electron microscopy.
AB  - Dystrophin, the protein product of the Duchenne muscular dystrophy locus
      [Hoffman, E. P., Brown, R. H., Jr., & Kunkel, L. M. (1987) Cell 51, 919-928], is
      expressed in striated and smooth muscles as well as in non-muscle tissues.
      Examination of its primary structure has revealed that the molecule is composed
      of four domains, three of which share many features with the membrane
      cytoskeletal proteins spectrin and actinin. Dystrophin has thus been predicted to
      adopt a rod shape [Koenig, M., Monaco, A. P. & Kunkel, L. M. (1988) Cell 53, 219
      228]. In the present study, we describe its isolation from the chicken gizzard
      smooth muscle and present electron microscopic images of the molecule. Polyclonal
      antibodies were first prepared from a dystrophin fragment derived from the
      chicken skeletal muscle gene (residues 1173-1728). A dystrophin-enriched membrane
      preparation from chicken gizzard muscle was then purified by passing it through
      an affinity chromatography column made with the anti-dystrophin antibodies.
      Electron microscopy of isolated and rotatory-shadowed dystrophin molecules
      revealed that the lengths measured for the dystrophin monomers (175 +/- 15 nm)
      are compatible with a structural arrangement of the repeat sequence segments in
      triple-barrel alpha-helices connected by short-turn regions, as was earlier
      postulated for the repeat domains of spectrin and actinin. Electron microscopic
      images indicate that in addition the dystrophin molecules could present the same
      capacity of self-association in oligomeric structures as these cytoskeletal
      proteins and may thus be a part of a complex molecular meshwork essential to
      muscle cell function.

PMID- 2236002
TI  - Evolutionary conservation of antigen recognition: the chicken T-cell receptor
      beta chain.
AB  - T cells play important regulatory roles in the immune responses of vertebrates.
      Antigen-specific T-cell activation involves T-cell receptor (TCR) recognition of
      a peptide antigen presented by a major histocompatibility complex molecule, and
      much has been learned about this antigen-recognition process through structural
      and genetic studies of mammalian TCRs. Although previous studies have
      demonstrated that avian T cells express cell-surface molecules analogous to the
      mammalian TCR heterodimers, TCR genes have not been identified in nonmammalian
      species. We now report the cloning of a cDNA that encodes the beta chain of the
      chicken TCR. Southern blot analysis using this TCR beta cDNA probe demonstrated
      that the chicken TCR beta locus was clonally rear-ranged in chicken T-cell lines.
      TCR beta mRNA was expressed in cells isolated from the thymus but not in cells
      from the bursa of Fabricius where B cells are generated. Sequence analysis of six
      additional TCR beta cDNAs suggested the existence of at least two variable (V)
      region families, three joining (J) elements, and single diversity (D) and
      constant (C) elements. As in mammals, considerable nucleotide diversity was
      observed at the junctions of the variable, diversity, and joining elements in
      chicken TCR beta cDNAs. Genomic V beta and J beta elements were also cloned and
      sequenced. Both elements are flanked by classical heptamer/nonamer recombination
      signal sequences. Although the chicken and mammalian TCR beta chains displayed
      only 31% overall amino acid sequence identity, a number of conserved structural
      features were observed. These data indicate that (i) the chicken TCR beta
      repertoire is generated by combinatorial and junctional diversity and (ii)
      despite divergent evolution at the level of nucleotide sequence, important
      structural features of the TCR beta polypeptide are conserved between avian and
      mammalian species.

PMID- 2236004
TI  - Estrogen receptor level determines sex-specific in vitro transcription from the
      Xenopus vitellogenin promoter.
AB  - Female-specific expression of the Xenopus laevis vitellogenin gene was
      reconstituted in vitro by addition of recombinant vaccinia-virus-produced
      estrogen receptor to nuclear extracts from male livers, in which this gene is
      silent. Transcription enhancement was at least 30 times and was selectively
      restricted to vitellogenin templates containing the estrogen-responsive unit.
      Thus, in male hepatocytes, estrogen receptor is the limiting regulatory factor
      that in the female liver controls efficient and accurate sex-specific expression
      of the vitellogenin gene. Furthermore, the Xenopus liver factor B, which is
      essential in addition to the estrogen receptor for the activation of this gene,
      was successfully replaced in the Xenopus extract by purified human nuclear factor
      I, identifying factor B of Xenopus as a functional homolog of this well
      characterized human transcription factor.

PMID- 2236003
TI  - Aberrant splicing of androgen receptor mRNA results in synthesis of a
      nonfunctional receptor protein in a patient with androgen insensitivity.
AB  - Androgen insensitivity is a disorder in which the correct androgen response in an
      androgen target cell is impaired. The clinical symptoms of this X chromosome
      linked syndrome are presumed to be caused by mutations in the androgen receptor
      gene. We report a G----T mutation in the splice donor site of intron 4 of the
      androgen receptor gene of a 46,XY subject lacking detectable androgen binding to
      the receptor and with the complete form of androgen insensitivity. This point
      mutation completely abolishes normal RNA splicing at the exon 4/intron 4 boundary
      and results in the activation of a cryptic splice donor site in exon 4, which
      leads to the deletion of 123 nucleotides from the mRNA. Translation of the mutant
      mRNA results in an androgen receptor protein approximately 5 kDa smaller than the
      wild type. This mutated androgen receptor protein was unable to bind androgens
      and unable to activate transcription of an androgen-regulated reporter gene
      construct. This mutation in the human androgen receptor gene demonstrates the
      importance of an intact steroid-binding domain for proper androgen receptor
      functioning in vivo.

PMID- 2236006
TI  - Effect of specific mutations of tyrosine-(M)210 on the primary photosynthetic
      electron-transfer process in Rhodobacter sphaeroides.
AB  - We have measured the rate of the initial electron-transfer process as a function
      of temperature in reaction centers in a native strain of the photosynthetic
      bacterium Rhodobacter sphaeroides and two mutants generated by site-directed
      mutagenesis. In the mutants, a tyrosine residue in the vicinity of the primary
      electron donor and acceptor molecules was replaced by either phenylalanine or
      isoleucine. The electron-transfer reaction is slower in the mutants and has a
      qualitatively different dependence on temperature. In native reaction centers the
      rate increases as the temperature is reduced, in the phenylalanine mutant it is
      virtually independent of temperature, and in the isoleucine mutant it decreases
      with decreasing temperature. At 77 K, the electron-transfer reaction is
      approximately 30 times slower in the isoleucine mutant than in the native. These
      observations support the view that tyrosine-(M)210 plays an important role in the
      electron-transfer mechanism. In the isoleucine mutant at low temperatures, the
      stimulated emission from the excited reaction center undergoes a time-dependent
      shift to shorter wavelengths.

PMID- 2236005
TI  - DNA mismatch repair in Xenopus egg extracts: repair efficiency and DNA repair
      synthesis for all single base-pair mismatches.
AB  - Repair of all 12 single base-pair mismatches by Xenopus egg extracts was measured
      by a physical assay with a sequence containing four overlapping restriction
      sites. The heteroduplex substrates, derivatives of M13 phage DNA, differed in
      sequence at the mismatch position only and permitted measurement of repair to
      both strands. The efficiency of repair varied about 4-fold between the most and
      least effectively repaired mismatches. Repair was most active with C/A and T/C
      mismatches but the efficiency varied depending on the orientation of the
      mismatch. Mismatch-specific DNA repair synthesis was also observed but the extent
      of repair was not always predictive of the extent of synthesis, suggesting the
      presence of different repair systems or different modes of mismatch recognition.

PMID- 2236007
TI  - Steady-state force-velocity relation in the ATP-dependent sliding movement of
      myosin-coated beads on actin cables in vitro studied with a centrifuge
      microscope.
AB  - To eliminate the gap between the biochemistry of actomyosin in solution and the
      physiology of contracting muscle, we developed an in vitro force-movement assay
      system in which the steady-state force-velocity relation in the actin-myosin
      interaction can be studied. The assay system consists of the internodal cells of
      an alga, Nitellopsis obtusa, containing well-organized actin filament arrays
      (actin cables); tosyl-activated polystyrene beads (diameter, 2.8 microns;
      specific gravity, 1.3) coated with skeletal muscle myosin; and a centrifuge
      microscope equipped with a stroboscopic light source and a video system. The
      internodal cell preparation was mounted on the rotor of the centrifuge
      microscope, so that centrifugal forces were applied to the myosin-coated beads
      moving along the actin cables in the presence of ATP. Under constant centrifugal
      forces directed opposite to the bead movement ("positive" loads), the beads
      continued to move with constant velocities, which decreased with increasing
      centrifugal forces. The steady-state force-velocity curve thus obtained was
      analogous to the double-hyperbolic force-velocity curve of single muscle fibers.
      The unloaded velocity of bead movement was 1.6-3.6 microns/s (20-23 degrees C),
      while the maximum "isometric" force generated by the myosin molecules on the bead
      was 1.9-39 pN. If, on the other hand, the beads were subjected to constant
      centrifugal forces in the direction of bead movement ("negative" loads), the bead
      also moved with constant velocities. Unexpectedly, the velocity of bead movement
      did not increase with increasing negative loads but first decreased by 20-60% and
      then increased towards the initial unloaded velocity until the beads were
      eventually detached from the actin cables.

PMID- 2236008
TI  - Induction of verotoxin sensitivity in receptor-deficient cell lines using the
      receptor glycolipid globotriosylceramide.
AB  - Verotoxin 1 is an Escherichia coli-derived subunit toxin that specifically binds
      to the glycolipid globotriosylceramide and is cytotoxic for cells that contain
      this plasma membrane glycolipid. Glycolipid incorporation experiments have now
      been performed using human lymphoid cells of the B lineage that lack this
      receptor, to conclusively demonstrate that globotriosylceramide alone is a
      functional receptor for this toxin. Globotriosylceramide incorporated into the
      membrane of toxin-resistant cells provides intracellular access to verotoxin by
      receptor-mediated endocytosis. Protein synthesis is then inhibited and
      globotriosylceramide-containing cells are killed.

PMID- 2236009
TI  - Epithelins 1 and 2: isolation and characterization of two cysteine-rich growth
      modulating proteins.
AB  - Two proteins, termed epithelin 1 and epithelin 2, that inhibit the growth of A431
      cells, derived from a human epidermal carcinoma of the vulva, have been purified
      from rat kidney. Epithelin 1 stimulates the proliferation of murine
      keratinocytes, whereas epithelin 2 inhibits the epithelin 1-elicited growth of
      these cells. Thus epithelin 1 and 2 behave as agonist and antagonist,
      respectively, for normal epithelial cells. Epithelins are low molecular mass
      (approximately 6 kDa), acid- and heat-stable, single-chain proteins containing
      approximately 20% cysteine. Some of these cysteines form disulfide linkage(s)
      that are essential for biological activity. The amino-terminal amino acid
      sequences of epithelin 1 and epithelin 2 have been determined. The two proteins
      showed no substantial sequence homology with other proteins. However, a
      significant homology was seen between the amino-terminal sequences of epithelin 1
      and epithelin 2. Epithelins 1 and 2, therefore, appear to represent members of a
      distinct family of growth regulators.

PMID- 2236010
TI  - Parallel zippers formed by alpha-helical peptide columns in crystals of Boc-Aib
      Glu(OBzl)-Leu-Aib-Ala-Leu-Aib-Ala-Lys(Z)-Aib-OMe.
AB  - The crystal structure of the decapeptide Boc-Aib-Glu(OBzl)-Leu-Aib-Ala-Leu-Aib
      Ala-Lys(Z)-Aib-OMe (where Aib is alpha-aminoisobutyryl, Boc is t-butoxycarbonyl,
      OBzl is benzyl ester, and Z is benzyloxycarbonyl) illustrates a parallel zipper
      arrangement of interacting helical peptide columns. Head-to-tail NH...OC hydrogen
      bonding extends the alpha-helices formed by the decapeptide into long columns in
      the crystal. An additional NH...OC hydrogen bond in the head-to-tail region,
      between the extended side chains of Glu(OBzl), residue 2 in one molecule, and
      Lys(Z), residue 9 in another molecule, forms a "double tooth" on the side of the
      column. These double teeth are repeated regularly on the helical columns with
      spaces of six residues between them (approximately 10 A). The double teeth on a
      pair of parallel columns (all carbonyl groups pointed in the same direction)
      interdigitate in a zipper motif. All contacts in the zipper portion are of the
      van der Waals type. The peptide, with formula C66H103N11O17.H2O, crystallizes in
      space group P2(1)2(1)2(1) with a = 10.677(4) A, b = 16.452(6) A, and c =
      43.779(13) A; overall agreement R = 10.2% for 3527 observed reflections
      (magnitude of /F0/ greater than 3 sigma); resolution 0.9 A.

PMID- 2236011
TI  - Selection of gamma delta T cells with canonical T-cell antigen receptors in fetal
      thymus.
AB  - Two gamma delta T-cell subsets that are generated in the fetal thymus and
      selectively localize in epidermis and uterus-vagina-tongue epithelia exhibit
      remarkable homogeneity in their (T-cell) antigen receptors (TCR). In the present
      study, we show that cells expressing the canonical gamma delta TCR are also
      generated in fetal thymus organ cultures. Treatment of these cultures with anti
      gamma delta TCR antibodies did not prevent gamma delta T-cell development but led
      to a striking increase in the frequency of noncanonical in-frame sequences. We
      conclude from this finding that cells expressing the canonical TCR accumulate
      selectively as a result of TCR-mediated positive selection in the fetal thymus.

PMID- 2236013
TI  - Endogenous gibberellins in Arabidopsis thaliana and possible steps blocked in the
      biosynthetic pathways of the semidwarf ga4 and ga5 mutants.
AB  - Twenty gibberellins (GAs) have been identified in extracts from shoots of the
      Landsberg erecta line of Arabidopsis thaliana by full-scan gas chromatography
      mass spectrometry and Kovats retention indices. Eight of them are members of the
      early-13-hydroxylation pathway (GA53, GA44, GA19, GA17, GA20, GA1, GA29, and
      GA8), six are members of the early-3-hydroxylation pathway (GA37, GA27, GA36,
      GA13, GA4, and GA34), and the remaining six are members of the non-3,13
      hydroxylation pathway (GA12, GA15, GA24, GA25, GA9, and GA51). Seven of these GAs
      were quantified in the Landsberg erecta line of Arabidopsis and in the semidwarf
      ga4 and ga5 mutants by gas chromatography-selected ion monitoring (SIM) using
      internal standards. The relative levels of the remaining 13 GAs were compared by
      the use of ion intensities only. In comparison with the Landsberg erecta line,
      the ga4 mutant had reduced levels of the 3-hydroxy- and 3,13-dihydroxy-GAs, and
      it accumulated the 13-hydroxy-GAs, except GA53, and the non-3,13-hydroxy-GAs,
      except GA12. The GA4 gene encodes, therefore, a protein with 3 beta-hydroxylation
      activity. The ga5 mutant had reduced levels of the C19-GAs, which indicates that
      the product of the GA5 gene catalyzes the elimination of C-20 at the aldehyde
      level. The ga5 mutant also had increased levels of certain C20-GAs, which
      indicates existence of an additional control, possibly hydroxylation of C-20. The
      growth-response data, as well as the accumulation of GA9 in the ga4 mutant,
      indicate that GA9 is not active in Arabidopsis, but it must be 3 beta
      hydroxylated to GA4 to become bioactive. It is concluded that the reduced levels
      of the 3 beta-hydroxy-GAs, GA1 and GA4, are the cause of the semidwarf growth
      habit of both mutants.

PMID- 2236012
TI  - The general mitochondrial matrix processing protease from rat liver: structural
      characterization of the catalytic subunit.
AB  - A critical step in the import of nuclear-encoded precursor proteins into
      mitochondria involves proteolytic cleavage of their amino-terminal leader
      peptides by processing proteases found in the mitochondrial matrix. We report
      here the characterization of the general matrix processing protease from rat
      liver mitochondria. The final enzyme preparation consisted of two polypeptides, a
      catalytically active 55-kDa subunit and a 52-kDa one. To deduce the complete
      primary structure of the 55-kDa subunit, we first sequenced its mature amino
      terminus and several tryptic peptides derived from the pure protein. Next, using
      mixed oligonucleotide primers that had sequences based on two of these peptides,
      we synthesized a partial cDNA probe by selective amplification of liver RNA with
      the polymerase chain reaction. The amplified probe was then used to obtain a
      nearly full-length clone from a rat liver cDNA library. This cDNA codes for 508
      amino acid residues, including 16 residues of an amino-terminal leader peptide,
      the cleavage site of which is located two polypeptide bonds downstream from an
      arginine residue. The mature portion has a predicted molecular mass of 55.2 kDa;
      it shows 36% identity with the mitochondrial processing peptidases of
      Saccharomyces cerevisiae and Neurospora crassa. A conserved structural feature is
      a putative, negatively charged alpha-helix, located in the amino-terminal half of
      the subunit; this element might be important for the recognition of positively
      charged leader peptides characteristic of mitochondrial precursor proteins.

PMID- 2236014
TI  - Central prolactin infusions stimulate maternal behavior in steroid-treated,
      nulliparous female rats.
AB  - A series of experiments were conducted to determine whether and under what
      conditions central prolactin (PRL) administration would stimulate the onset of
      maternal behavior in female rats and to identify possible neural sites of PRL
      action. In each experiment ovariectomized, nulliparous rats whose endogenous PRL
      levels were suppressed with bromocriptine were tested for maternal behavior
      toward foster young. In experiments 1, 2, and 4, females were also exposed to
      pregnancy-like levels of progesterone (days 1-11) followed by estradiol (days 11
      17). In experiment 1 infusions (days 11-13) of four doses of ovine PRL (400 ng, 2
      micrograms, 10 micrograms, or 50 micrograms, but not 80 ng) into the lateral
      ventricle resulted in a rapid onset of maternal behavior (behavioral testing,
      days 12-17). The stimulatory action of these doses of PRL appears to be central,
      since subcutaneous injections of 50 micrograms of ovine PRL failed to affect
      maternal responsiveness (experiment 2). Experiment 3 indicated that the
      stimulatory effect of intracerebroventricularly administered PRL is steroid
      dependent. Infusions of either 10 micrograms of ovine PRL or 10 micrograms of rat
      PRL failed to induce maternal behavior in nonsteroid-treated animals. In the
      final experiment (no. 4) bilateral infusions of 40 ng of ovine PRL into the
      medial preoptic area of steroid-treated rats resulted in a pronounced stimulation
      of maternal behavior. These findings demonstrate a central site of PRL action in
      the stimulation of maternal responsiveness and point to the medial preoptic area
      as a key neural site for PRL regulation of maternal behavior.

PMID- 2236015
TI  - Location of the cis-acting auxin-responsive region in the promoter of the par
      gene from tobacco mesophyll protoplasts.
AB  - We have isolated a genomic clone of an auxin-regulated par gene, which is
      expressed during the transition from G0 phase to S phase in the early stage of
      tobacco mesophyll protoplasts cultured in vitro, from a tobacco genomic library
      using the par cDNA as a probe. When a chimeric gene, in which a reporter gene for
      bacterial beta-glucuronidase (GUS) was placed downstream of the 5' flanking
      sequences of the par gene, was introduced into tobacco mesophyll protoplasts by
      electroporation, the chimeric gene elicited auxin-regulated expression of GUS
      activity. Because deletion of a 111-base-pair (bp) direct repeat in the 5'
      flanking sequences of the par gene abolished the auxin-induced GUS activity, it
      is deduced that in the 111-bp direct repeat of the par gene promoter is localized
      an auxin-responsive region, which regulates auxin-mediated activation of
      transcription.

PMID- 2236016
TI  - Gangliosides normalize distorted single-cell intracellular free Ca2+ dynamics
      after toxic doses of glutamate in cerebellar granule cells.
AB  - Glutamate-induced delayed neurotoxicity after abusive and paroxismal activation
      of its receptors has been proposed to depend upon a sustained increase in
      intracellular free Ca2+ [( Ca2+]i). To elucidate the temporal and causal
      relationship between glutamate-induced changes in [Ca2+]i and neuronal death, we
      simultaneously studied the dynamics of [Ca2+]i changes in single neurons with the
      acetoxymethyl ester of fura-2 and the cell viability by imaging the nuclear
      penetration of propidium iodide. The main difference between toxic (50 microM)
      and nontoxic (5 microM) doses of glutamate is the lack of regulation in [Ca2+]i
      20 min after glutamate is removed. This protracted rise in [Ca2+]i in a single
      cell is correlated with (r = 0.87, P less than 0.01, Spearman's test), and
      consequently predictive of, the time of appearance of neuronal death, as measured
      by propidium iodide fluorescence. In addition, the glutamate receptor antagonists
      dibenzocyclohepteneimine (MK-801) and 3,3-(2-carboxypiperazine-4-yl)propyl 1
      phosphate reduce the acute increase of [Ca2+]i induced by glutamate but fail to
      revert the protracted increase of [Ca2+]i, elicited by toxic doses of glutamate.
      In contrast, the ganglioside GM1 and the semisynthetic lysoGM1 with N
      acetylsphingosine (LIGA-4) and lysoGM1 with N-dichloroacetylsphingosine (LIGA-20)
      failed to change the immediate rise of [Ca2+]i elicited by glutamate but
      prevented the protracted increase in [Ca2+]i after toxic doses of glutamate.
      Voltage-dependent Ca2+ channel blockers (nifedipine, etc.) did not change the
      initial or protracted responses to glutamate.

PMID- 2236017
TI  - Long-range movement and fibril association of type X collagen within embryonic
      cartilage matrix.
AB  - A recent immunoelectron microscopic study of type X collagen in developing
      cartilage gave results that could be explained by movement of the molecule from
      one region of the cartilage matrix to another, there becoming associated with
      preexisting collagen fibrils. In the present study, to test the feasibility of
      this model we incubated pieces of nonhypertrophic, embryonic chicken sternal
      cartilage (which has no endogenous type X collagen) in medium with type X
      collagen and then used immunofluorescence and immunoelectron microscopy to
      evaluate movement of the molecule through the matrix. The results show that type
      X collagen molecules can indeed pass through embryonic sternal cartilage matrix
      and subsequently become fibril-associated.

PMID- 2236018
TI  - Molecular cloning of a human gene that is a member of the nerve growth factor
      family.
AB  - Cell death within the developing vertebrate nervous system is regulated in part
      by interactions between neurons and their innervation targets that are mediated
      by neurotrophic factors. These factors also appear to have a role in the
      maintenance of the adult nervous system. Two neurotrophic factors, nerve growth
      factor and brain-derived neurotrophic factor, share substantial amino acid
      sequence identity. We have used a screen that combines polymerase chain reaction
      amplification of genomic DNA and low-stringency hybridization with degenerate
      oligonucleotides to isolate human BDNF and a human gene, neurotrophin-3, that is
      closely related to both nerve growth factor and brain-derived neurotrophic
      factor. mRNA products of the brain-derived neurotrophic factor and neurotrophin-3
      genes were detected in the adult human brain, suggesting that these proteins are
      involved in the maintenance of the adult nervous system. Neurotrophin-3 is also
      expected to function in embryonic neural development.

PMID- 2236019
TI  - Cleavage of the bacteriophage P1 packaging site (pac) is regulated by adenine
      methylation.
AB  - The packaging of bacteriophage PI DNA is initiated when the phage packaging site
      (pac) is recognized and cleaved and continues until the phage head is full. We
      have previously shown that pac is a 162-base-pair segment of P1 DNA that contains
      seven DNA adenine methyltransferase methylation sites (5'-GATC). We show here
      that cleavage of pac is methylation sensitive. Both in vivo and in vitro
      experiments indicate that methylated pac is cleavable, whereas unmethylated pac
      is not. Moreover, DNA isolated from P1 phage and containing an uncut pac site was
      a poor substrate for in vitro cleavage until it was methylated by the Escherichia
      coli DNA adenine methyltransferase. Comparison of that uncut pac DNA with other
      viral DNA fragments by digestion with methylation-sensitive restriction enzymes
      indicated that the uncut pac DNA was preferentially undermethylated. In contrast,
      virion DNA containing a cut pac site was not undermethylated. We believe these
      results indicate that pac cleavage is regulated by adenine methylation during the
      phage lytic cycle.

PMID- 2236020
TI  - The human immunodeficiency virus type 2 vpr gene is essential for productive
      infection of human macrophages.
AB  - The human immunodeficiency virus (HIV) genetic determinant(s) responsible for
      tropism in human T cells or macrophages are not well defined. We studied the role
      of the HIV type 2 (HIV-2) nef and vpr genes in viral tropism. HIV-2 mutants,
      lacking either vpr or nef genes, or both vpr and nef, were obtained by site
      specific mutagenesis of a biologically active HIV-2 proviral clone (HIV
      2sbl/isy), which is infectious in both human T cells and macrophages. Viral
      progeny carrying mutations of nef, vpr, or of both nef and vpr genes replicated
      more efficiently than the parental virus in primary human peripheral blood cells
      and in the human Hut 78 T-cell line. In contrast, the HIV-2 nef- mutant infected
      human macrophages as efficiently as the parental virus, whereas viruses lacking
      the vpr gene either alone or in conjunction with the lack of the nef gene did not
      replicate in macrophages. Thus, some lack of nef in HIV-2 enhances viral
      replication in T cells and does not interfere with viral replication in primary
      macrophages, whereas vpr is essential for replication of HIV-2 in human
      macrophages. Because the parental HIV-2sbl/isy cloned virus also infects rhesus
      macaques, the use in animal studies of these HIV-2 mutants with differences in
      cell tropism and rates of replication will be highly useful in understanding the
      mechanism of viral infectivity and possibly pathogenicity in vivo.

PMID- 2236021
TI  - Expression of CD4 by human megakaryocytes.
AB  - The CD4 antigen, which serves as the receptor for human immunodeficiency virus
      type 1 (HIV-1) on T cells, has been detected on human megakaryocytes. Recent
      evidence of impaired thrombopoiesis in HIV-1-related thrombocytopenia suggested
      that these cells could be directly infected by the virus and prompted a search
      for a receptor on megakaryocytes of normal subjects that could permit entry of
      HIV-1. Bone marrow specimens from uninfected normal control subjects were
      centrifuged over Ficoll-Hypaque (1.077 g/ml) and analyzed by three-color analysis
      with a flow cytometer utilizing monoclonal antibodies against CD4 and a
      glycoprotein present on the surface of megakaryocytes and platelets (GPIIb/IIIa;
      CD41), as well as 7-aminoactinomycin D, a stain for DNA. Cells presumed to be
      megakaryocytes were identified by having a DNA content greater than tetraploid
      and staining brightly with anti-CD41. Approximately 0.4% of the nucleated cells
      of the marrow met these criteria. Twenty-five percent of these megakaryocytes
      stained as brightly as CD4+ T cells. Several clones of antibody recognizing
      different epitopes of the CD4 molecule gave similar results. Platelets were CD4-.
      Staining of megakaryocytes with anti-CD4 was confirmed by direct microscopic
      examination of Percoll-gradient-enriched megakaryocytes employing two-color (CD4
      phycoerythrin and CD41-fluorescein) immunofluorescence analysis and phase
      contrast microscopy. The proportion of double-labeled cells among 112 phase
      contrast-identifiable megakaryocytes from five bone marrow specimens varied
      between 20% and 26% with a mean and SD of 22% +/- 2.5%. Thus some human
      megakaryocytes express CD4 on their surface that should be capable of binding the
      HIV-1 gp120 envelope protein. This could serve as a portal of entry for HIV-1.

PMID- 2236022
TI  - Myb protein binds to human immunodeficiency virus 1 long terminal repeat (LTR)
      sequences and transactivates LTR-mediated transcription.
AB  - The protooncogene c-myb encodes a nuclear transcription factor that binds to DNA
      in a sequence-specific manner and transactivates transcription of several viral
      and cellular genes. The expression of c-myb is induced in mitogen-stimulated
      peripheral blood lymphocytes and is constitutively expressed in several CD4+ T
      cell and myeloid cell lines, all of which constitute excellent targets for human
      immunodeficiency virus (HIV) infection and replication. We looked for the
      presence of Myb-binding motifs in human retroviral long terminal repeats (LTRs)
      and tested for Myb binding to HIV-1 LTR sequences by using a highly purified
      recombinant Myb protein. Our results show that HIV-1 LTR contains one high
      affinity Myb-binding site along with two or more low-affinity binding sites.
      DNase I protection analysis as well as oligonucleotide competition experiments
      indicate that this binding is sequence specific. Introduction of purified Myb
      protein directly into HeLa cells harboring HIV-1 LTR chloramphenicol
      acetyltransferase vectors indicates that Myb protein transactivates HIV-1 LTR
      mediated transcription. Thus, Myb protein binding to HIV LTR sequences may
      constitute one of the signals that regulates HIV-1 transcription.

PMID- 2236023
TI  - Steroids induce acetylcholine receptors on cultured human muscle: implications
      for myasthenia gravis.
AB  - Antibodies to the acetylcholine receptor (AChR), which are diagnostic of the
      human autoimmune disease myasthenia gravis, block AChR function and increase the
      rate of AChR degradation leading to impaired neuromuscular transmission. Steroids
      are frequently used to alleviate symptoms of muscle fatigue and weakness in
      patients with myasthenia gravis because of their well-documented
      immunosuppressive effects. We show here that the steroid dexamethasone
      significantly increases total surface AChRs on cultured human muscle exposed to
      myasthenia gravis sera. Our results suggest that the clinical improvement
      observed in myasthenic patients treated with steroids is due not only to an
      effect on the immune system but also to a direct effect on muscle. We propose
      that the identification and development of pharmacologic agents that augment
      receptors and other proteins that are reduced by human genetic or autoimmune
      disease will have broad therapeutic applications.

PMID- 2236024
TI  - Genetically engineered truncated myosin in Dictyostelium: the carboxyl-terminal
      regulatory domain is not required for the developmental cycle.
AB  - The study of engineered Dictyostelium mutants with altered or missing myosin has
      revealed the molecule to be essential both for cytokinesis and for completion of
      the complex Dictyostelium developmental cycle. To explore the biological role of
      the carboxyl-terminal portion of the myosin tail, we have created a Dictyostelium
      cell line bearing a mutation designated my delta C34 in the myosin (mhcA) locus.
      This cell line produces a truncated myosin protein lacking the 34-kDa carboxyl
      terminus of the wild-type tail. Southern blots of the mutant cells show that the
      myosin gene was disrupted by homologous recombination of the transforming plasmid
      into the myosin locus. Based on in vitro studies of myosin functional domains,
      the 200-kDa truncated myosin was designed to include a domain important for
      assembly but to eliminate a domain important for threonine phosphorylation. The
      mutant cells are defective in cytokinesis, similar to those mutants that are
      either devoid of myosin (null cells) or contain a truncated 140-kDa myosin (hmm
      cells). However, unlike previous mutants, the cells carrying the my delta C34
      mutation are able to complete the Dictyostelium developmental cycle to form
      fruiting bodies. Thus a truncated 200-kDa myosin can substitute for native myosin
      to function in developing cells. These results demonstrate that the 34-kDa
      carboxyl terminus of myosin, which contributes regulated phosphorylation sites
      and 20% of the total length of the rod, is not required for the developmental
      cycle of Dictyostelium.

PMID- 2236025
TI  - Interaction of epsilon-globin cis-acting control elements with erythroid-specific
      regulatory macromolecules.
AB  - We have used a competition assay to investigate the influence of erythroid
      specific cellular factors on transcription from the human epsilon-globin major
      cap site promoter and the minor promoter located 200 base pairs (bp) upstream
      from the epsilon-globin cap site. In the human erythroid cell line K562,
      competition of the epsilon-globin major cap site promoter linked to the
      chloramphenicol acetyltransferase (CAT) gene (epsilon P-CAT) with the same
      promoter fragment linked to a neomycin resistance gene (epsilon P-NEO) leads to a
      reduction in CAT activity. This indicates the specific presence of K562 cells of
      factor(s) which interact with the 200-bp promoter fragment (isolated from the
      gene body or flanking sequences) to activate transcription from the epsilon
      globin major cap site. Competition of the epsilon-globin major promoter (as
      epsilon P-CAT) with the upstream minor epsilon-globin promoter (as epsilon P2
      NEO) also leads to a reduction in CAT activity, indicating that both promoters
      share erythroid-specific trans-acting factors. The reverse competition (epsilon
      P2-CAT with epsilon P-NEO) leads to an increase in CAT activity, suggesting that
      the existence of erythroid-specific factor(s) which repress transcription from
      the 200-bp-upstream epsilon-globin promoter.

PMID- 2236026
TI  - Opal phytoliths found on the teeth of the extinct ape Gigantopithecus blacki:
      implications for paleodietary studies.
AB  - Identification of opal phytoliths bonded to the enamel surface of the teeth of
      Gigantopithecus blacki indicates that this extinct ape had a varied diet of
      grasses and fruits. By using the scanning electron microscope at magnifications
      of 2000-6000x specific opal phytoliths were observed and photographed on the
      fossilized teeth of an extinct species. Since opal phytoliths represent the
      inorganic remains of once-living plant cells, their documentation on the teeth of
      Gigantopithecus introduces a promising technique for the determination of diet in
      extinct mammalian species which should find numerous applications in the field of
      paleoanthropology as well as vertebrate paleontology.

PMID- 2236027
TI  - Human colorectal cancers display abnormal Fourier-transform infrared spectra.
AB  - Fourier-transform infrared spectroscopy (FT-IR) was applied to the study of
      tissue sections of human colorectal cancer. Pairs of tissue samples from
      colorectal cancer and histologically normal mucosa 5-10 cm away from the tumor
      were obtained from 11 patients who underwent partial colectomy. All cancer
      specimens displayed abnormal spectra compared with the corresponding normal
      tissues. These changes involved the phosphate and C-O stretching bands, the CH
      stretch region, and the pressure dependence of the CH2 bending and C = O
      stretching modes. Our findings indicate that in colonic malignant tissue, there
      are changes in the degree of hydrogen-bonding of (i) oxygen atoms of the backbone
      of nucleic acids (increased); (ii) OH groups of serine, tyrosine, and threonine
      residues (any or all of them) of cell proteins (decreased); and (iii) the C = O
      groups of the acyl chains of membrane lipids (increased). In addition, they
      indicate changes in the structure of proteins and membrane lipids (as judged by
      the changes in their ratio of methyl to methylene groups) and in the packing and
      the conformational structure of the methylene chains of membrane lipids. The
      cell(s) of the malignant colon tissues responsible for these spectral
      abnormalities is unknown. Cultured colon adenocarcinoma cell lines displayed
      similarly abnormal FT-IR spectra. The diagnostic potential of the observed
      changes is discussed.

PMID- 2236028
TI  - When is an inhibitory synapse effective?
AB  - Interactions between excitatory and inhibitory synaptic inputs on dendrites
      determine the level of activity in neurons. Models based on the cable equation
      predict that silent shunting inhibition can strongly veto the effect of an
      excitatory input. The cable model assumes that ionic concentrations do not change
      during the electrical activity, which may not be a valid assumption, especially
      for small structures such as dendritic spines. We present here an analysis and
      computer simulations to show that for large Cl- conductance changes, the more
      general Nernst-Planck electrodiffusion model predicts that shunting inhibition on
      spines should be much less effective than that predicted by the cable model. This
      is a consequence of the large changes in the intracellular ionic concentration of
      Cl- that can occur in small structures, which would alter the reversal potential
      and reduce the driving force for Cl-. Shunting inhibition should therefore not be
      effective on spines, but it could be significantly more effective on the
      dendritic shaft at the base of the spine. In contrast to shunting inhibition,
      hyperpolarizing synaptic inhibition mediated by K+ currents can be very effective
      in reducing the excitatory synaptic potentials on the same spine if the
      excitatory conductance change is less than 10 nS. We predict that if the
      inhibitory synapses found on cortical spines are to be effective, then they
      should be mediated by K+ through GABAB receptors.

PMID- 2236029
TI  - The C'-terminal interaction domain of the thyroid hormone receptor confers the
      ability of the DNA site to dictate positive or negative transcriptional activity.
AB  - To investigate mechanisms responsible for positive and negative transcriptional
      control, we have utilized two types of promoters that are differentially
      regulated by thyroid hormone (T3) receptors. Promoters containing the palindromic
      T3 response element TCAGGTCA TGACCTGA are positively regulated by the T3 receptor
      after the administration of T3, whereas otherwise identical promoters containing
      the estrogen response element TCAGGTCA CTG TGACCTGA can be regulated negatively;
      converse effects are observed with the estrogen receptor. We describe evidence
      that the transcriptional inhibitory effects of the T3 or estrogen receptors on
      the estrogen or T3 response elements, respectively, are imposed by amino acid
      sequences in the C'-terminal region that colocalize with dimerization and hormone
      binding domains and that these sequences can transfer inhibitory functions to
      other classes of transcription factors. Removal of the C'-terminal dimerization
      and hormone-binding domains of either the alpha T3 or estrogen receptors permits
      each receptor to act constitutively to enhance transcription on both T3 and
      estrogen response elements. It is, therefore, suggested that protein-protein
      interactions between receptor C' termini limit the subset of DNA binding sites on
      which transcriptional activation occurs.

PMID- 2236030
TI  - Direct measurement of oligonucleotide substrate binding to wild-type and mutant
      ribozymes from Tetrahymena.
AB  - Like protein enzymes, RNA enzymes (ribozymes) provide specific binding sites for
      their substrates. We now show that equilibrium dissociation constants for
      complexes between the Tetrahymena ribozyme and its RNA substrates and products
      can be directly measured by electrophoresis in polyacrylamide gels containing
      divalent cations. Binding is 10(3)- to 10(4)-fold tighter (4-5 kcal/mol at 42
      degrees C) than expected from base-pairing interactions alone, implying that
      tertiary interactions also contribute to energetic stabilization. Binding
      decreases with single base changes in the substrate, substitution of deoxyribose
      sugars, and lower Mg2+ concentration. Ca2+, which enables the ribozyme to fold
      but is unable to mediate efficient RNA cleavage, promotes weaker substrate
      binding than Mg2+. This indicates that Mg2+ has special roles in both substrate
      binding and catalysis. Mutagenesis of a region near the internal guide sequence
      disrupts substrate binding, whereas binding is not significantly affected by a
      mutation of the guanosine-binding site. This approach should be generally useful
      for analysis of ribozyme variants independent of their catalytic activities.

PMID- 2236031
TI  - Splicing of COB intron 5 requires pairing between the internal guide sequence and
      both flanking exons.
AB  - Group I introns are characterized by a set of conserved sequence elements and
      secondary structures. Evidence supporting the pairing of certain of these
      sequences has come from the comparison of intron sequences and from the analysis
      of mutations that disrupt splicing by interfering with pairing. One of the
      structures proposed for all group I introns is an internal guide sequence that
      base pairs with the upstream and the downstream exons, bringing them into
      alignment for ligation. We made specific mutations in the internal guide sequence
      and the flanking exons of the fifth intron in the yeast mitochondrial gene for
      apocytochrome b (COB). Mutations that disrupted the pairing between the internal
      guide sequence and the upstream exon (the P1 pairing) blocked addition of
      guanosine to the 5' end of the intron during autocatalytic reactions and
      prevented formation of the full-length circular intron. In contrast, transcripts
      containing mutations that disrupted the pairing between the guide sequence and
      the downstream exon (the P10 helix) initiated splicing but failed to ligate
      exons. Compensatory mutations that restored helices of normal stability mitigated
      the effects of the original mutations. These data provide direct evidence for the
      importance of the base pairing between the internal guide sequence and the
      downstream exon in the splicing of a wild-type group I intron.

PMID- 2236032
TI  - Early folding intermediate of ribonuclease A.
AB  - Pulsed hydrogen exchange (2H-1H) is used to characterize the folding process of
      ribonuclease A (disulfide bonds intact). The results show one principal early
      folding intermediate (I1), which is formed rapidly after the start of folding and
      whose proton-exchange properties change with the time of folding. All probes that
      are hydrogen bonded within the beta-sheet of native ribonuclease A are protected
      in I1. Thus, the results suggest that the beta-sheet is formed rapidly and
      cooperatively. The initial protection factors of probes in the beta-sheet are
      between 10 and 100, but they increase with time of folding and exceed 1000 at 400
      msec from the start of folding. Thus, the beta-sheet is only moderately stable
      when it is first formed, but subsequent events stabilize it, possibly through
      interactions involving hydrophobic side chains. The large protection factors of
      the beta-sheet probes in an early folding intermediate are unexpected and
      remarkable. Probes in the three alpha-helices are fewer in number and give less
      accurate data than the beta-strand probes. The folding kinetics expected for a
      simple sequential model of folding are outlined. An important difference between
      the observed and predicted behavior is that the early folding intermediate is not
      fully populated when it is first formed.

PMID- 2236033
TI  - Interchangeable RNA polymerase I and II enhancers.
AB  - The RNA polymerase I (pol I) enhancer of Saccharomyces cerevisiae contains at
      least three elements commonly associated with RNA polymerase II (pol II)
      enhancers, binding sites for the transcriptional activators general regulatory
      factor 2 and autonomously replicating sequence-binding factor I, and a thymidine
      rich element. When the particular form of the thymidine-rich element found in the
      pol I enhancer was placed in front of a pol II promoter, transcription was
      stimulated 43-fold, comparable to the effect of a powerful pol II activator such
      as Gal4. Conversely, when two copies of a thymidine-rich element from a pol II
      enhancer were placed upstream of a pol I promoter, transcription was stimulated
      38-fold. This functional reciprocity of pol I and II enhancers may reflect
      similarities in the mechanisms of transcriptional activation. The pol I enhancer
      also contains an element that appears to be pol I-specific and prevent the
      activation of pol II.

PMID- 2236034
TI  - Beta-globin locus activation regions: conservation of organization, structure,
      and function.
AB  - The human beta-globin locus activation region (LAR) comprises four erythroid
      specific DNase I hypersensitive sites (I-IV) thought to be largely responsible
      for activating the beta-globin domain and facilitating high-level erythroid
      specific globin gene expression. We identified the goat beta-globin LAR,
      determined 10.2 kilobases of its sequence, and demonstrated its function in
      transgenic mice. The human and goat LARs share 6.5 kilobases of homologous
      sequences that are as highly conserved as the epsilon-globin gene promoters.
      Furthermore, the overall spatial organization of the two LARs has been conserved.
      These results suggest that the functionally relevant regions of the LAR are large
      and that in addition to their primary structure, the spatial relationship of the
      conserved elements is important for LAR function.

PMID- 2236035
TI  - Chlamydomonas telomere sequences are A+T-rich but contain three consecutive G-C
      base pairs.
AB  - We have isolated telomeric DNA and telomere-associated sequences from
      Chlamydomonas reinhardtii. The terminal telomere sequences of the green alga
      Chlamydomonas are composed of (TTTTAGGG)n repeats that are similar, but not
      identical, to those of the higher plant Arabidopsis thaliana. We demonstrate that
      these repeats are telomeric by their preferential sensitivity to nuclease Bal-31
      digestion, their similarity to A. thaliana telomeres, their orientation relative
      to the end of the chromosome, and the methods used for their isolation. Five
      independent telomere clones were isolated, and three of these clones include
      closely related telomere-associated sequences. One of these telomere-associated
      sequences hybridizes to a number of genomic fragments sensitive to digestion with
      the exonuclease Bal-31. Like telomere sequences from other organisms, the C.
      reinhardtii telomeres display a bias for guanine and thymine nucleotides on the
      3'-end strand. However, the sequence of Chlamydomonas telomeres is more A + T
      rich than any other known telomere sequence. We propose that the common feature
      of all known telomere is the frequent occurrence of tracts of three or more
      adjacent guanine residues.

PMID- 2236036
TI  - Amplification of large artificial chromosomes.
AB  - Yeast artificial chromosome cloning is an attractive technology for genomic
      mapping studies because very large DNA segments can be readily propagated.
      However, detailed analyses often require the extensive application of blotting
      hybridization techniques because artificial chromosomes are normally present at
      only one copy per haploid genome. We have developed a cloning vector and host
      strain that alleviate this problem by permitting copy number amplification of
      artificial chromosomes. The vector includes a conditional centromere that can be
      turned on or off by changing the carbon source. Strong selective pressure for
      extra copies of the artificial chromosome can be applied by selecting for the
      expression of a heterologous thymidine kinase gene. When this system was used,
      artificial chromosomes ranging from about 100 to 600 kilobases in size were
      readily amplified 10- to 20-fold. The selective conditions did not induce obvious
      rearrangements in any of the clones tested. Reactivation of the centromere in
      amplified artificial chromosome clones resulted in stable maintenance of an
      elevated copy number for 20 generations. Applications of copy number control to
      various aspects of artificial chromosome analysis are addressed.

PMID- 2236037
TI  - Electrophoretic karyotype for Dictyostelium discoideum.
AB  - This paper reports on the separation of the Dictyostelium discoideum chromosomes
      by pulse-field electrophoresis and the correlation of the electrophoretic pattern
      with linkage groups established by classical genetic methods. In two commonly
      used laboratory strains, five chromosome-sized DNA molecules have been
      identified. Although the majority of the molecular probes used in this study can
      be unambiguously assigned to established linkage groups, the electrophoretic
      karyotype differs between the closely related strains AX3k and NC4, suggesting
      that chromosomal fragmentation may have occurred during their maintenance and
      growth. The largest chromosome identified in this study is approximately 9
      million base pairs. To achieve resolution with molecules of this size, programmed
      voltage gradients were used in addition to programmed pulse times.

PMID- 2236038
TI  - Polymerase chain reaction-aided genomic sequencing of an X chromosome-linked CpG
      island: methylation patterns suggest clonal inheritance, CpG site autonomy, and
      an explanation of activity state stability.
AB  - The 5' region of the gene encoding human X chromosome-linked phosphoglycerate
      kinase 1 (PGK1) is a promoter-containing CpG island known to be methylated at 119
      of 121 CpG dinucleotides in a 450-base-pair region on the inactive human X
      chromosome in the hamster-human cell line X8-6T2. Here we report the use of
      polymerase chain reaction-aided genomic sequencing to determine the complete
      methylation pattern of this region in clones derived from X8-6T2 cells after
      treatment with the methylation inhibitor 5-azacytidine. We find (i) a clone
      showing full expression of human phosphoglycerate kinase is fully unmethylated in
      this region; (ii) clones not expressing human phosphoglycerate kinase remain
      methylated at approximately 50% of CpG sites, with a pattern of interspersed
      methylated (M) and unmethylated (U) sites different for each clone; (iii)
      singles, defined as M-U-M or U-M-U, are common; and (iv) a few CpG sites are
      partially methylated. The data are interpreted according to a model of multiple,
      autonomous CpG sites, and estimates are made for two key parameters, maintenance
      efficiency (Em approximately 99.9% per site per generation) and de novo
      methylation efficiency (Ed approximately 5%). These parameter values and the
      hypothesis that several independent sites must be unmethylated for transcription
      can explain the stable maintenance of X chromosome inactivation. We also consider
      how the active region is kept free of methylation and suggest that transcription
      inhibits methylation by decreasing Em so that methylation cannot be maintained.
      Thus, multiple CpG sites, independent with respect to a dynamic methylation
      system, can stabilize two alternative states of methylation and transcription.

PMID- 2236039
TI  - A putative protein kinase gene (kin1+) is important for growth polarity in
      Schizosaccharomyces pombe.
AB  - Mixed synthetic oligonucleotides encoding a sequence conserved among tyrosine
      specific protein kinases were used to probe the genome of the fission yeast
      Schizosaccharomyces pombe. A single gene (kin1+) was isolated that encodes a
      putative protein kinase closely related to the KIN1- and KIN2-encoded
      serine/threonine-specific protein kinases of Saccharomyces cerevisiae. kin1+ is
      transcribed into a 3.5-kilobase mRNA that contains an uninterrupted open reading
      frame encoding a polypeptide of 98 kDa. In contrast to results obtained with kin
      mutants of S. cerevisiae, disruption of the Sc. pombe kin1+ gene resulted in
      recessive morphological and growth defects. kin1-disrupted cells grew slowly on
      enriched medium and grew as spheres, in contrast to wild-type Sc. pombe cells,
      which grow as rods. Relative to kin1+ cells, kin1-disrupted cells were
      differentially sensitive to lysis by treatment with alpha- and beta-glucanases,
      suggesting an alteration in either the composition or the organization of their
      cell walls.

PMID- 2236040
TI  - Size polymorphism of chicken major histocompatibility complex-encoded B-G
      molecules is due to length variation in the cytoplasmic heptad repeat region.
AB  - B-G antigens are cell-surface molecules encoded by a highly polymorphic multigene
      family located in the chicken major histocompatibility complex (MHC). Rabbit
      antisera to B-G molecules immunoprecipitate 3-6 bands from iodinated erythrocytes
      by sodium dodecyl sulfate (SDS) gels under reducing conditions. These are all B-G
      molecules because they all map to the B-G region of the chicken MHC in congenic
      and recombinant chickens, most are directly recognized by the antisera, most form
      disulfide-linked dimers, and none bear N-linked carbohydrate. Both apparent
      homodimers and heterodimers are found, which bear intrachain disulfide bonds. All
      3-6 bands have different mobilities in SDS gels between different haplotypes,
      ranging from 30 to 55 kDa. This size polymorphism is not affected by glycosidase
      treatment or addition of protease inhibitors. Partial proteolysis of cell surface
      iodinated B-G molecules generates extremely similar patterns of spots, both
      within and between haplotypes. These surface-iodinated peptides bear either
      interchain or intrachain disulfide bonds. Additional peptides are generated by
      proteolysis of B-G molecules iodinated after isolation. Thus, it appears that the
      extracellular regions of these molecules are very similar and that the length
      polymorphism is due to variations in the cytoplasmic regions. Inspection of the
      cDNA-derived protein sequence in this region shows many heptad repeats, which may
      allow variation in length by step deletion and alternative splicing. The repeats
      indicate an alpha-helical coiled-coil structure, which could form an interaction
      between subunits of the dimer or with the cytoskeleton or both.

PMID- 2236041
TI  - The recombinant immunotoxin anti-Tac(Fv)-Pseudomonas exotoxin 40 is cytotoxic
      toward peripheral blood malignant cells from patients with adult T-cell leukemia.
AB  - Anti-Tac(Fv)-PE40 is a recombinant single-chain immunotoxin containing the heavy
      and light variable regions of the anti-Tac monoclonal antibody fused to a mutant
      form of Pseudomonas exotoxin (PE). Anti-Tac binds to the p55 subunit of the human
      interleukin 2 (IL-2) receptor, and anti-Tac(Fv)-PE40 kills human or monkey cell
      lines that contain either the intact IL-2 receptor or its p55 subunit alone. To
      assess the usefulness of anti-Tac(Fv)-PE40 in treatment of IL-2 receptor-positive
      leukemia, we tested peripheral blood mononuclear cells from six patients with
      adult T-cell leukemia. In each of the six patients, anti-Tac(Fv)-PE40 was
      extremely cytotoxic to the malignant cells. Metabolic activity and sensitivity of
      the fresh cells improved when a small amount of IL-2 (10 units per ml) was
      present during incubation. The toxin concentration necessary to inhibit protein
      synthesis by 50% after 16-hr incubation of cells with immunotoxin varied from 1.6
      to 16 ng/ml (2.5-25 x 10(-11) M). In every case, binding was by means of the Tac
      antigen because anti-Tac(Fv)-PE40 cytotoxicity was prevented by adding excess
      anti-Tac antibody. Moreover, anti-Tac alone or an inactive mutant of anti-Tac(Fv)
      PE40 without ADP-ribosylation activity had very little cytotoxic activity.
      Peripheral blood mononuclear cells from normal controls, from a patient with Tac
      negative leukemia, and from adult T-cell leukemia patients without significant
      peripheral blood involvement were not sensitive to anti-Tac(Fv)-PE40. These
      results indicate that anti-Tac(Fv)-PE40 is a potent cytotoxin against adult T
      cell leukemia cells in vitro and warrants clinical testing.

PMID- 2236042
TI  - Downstream secondary structure facilitates recognition of initiator codons by
      eukaryotic ribosomes.
AB  - Recognition of an AUG initiator codon in a suboptimal context improves when a
      modest amount of secondary structure is introduced near the beginning of the
      protein-coding sequence. This facilitating effect depends on the position of the
      downstream stem-loop (hairpin) structure. The strongest facilitation is seen when
      the hairpin is separated from the preceding AUG codon by 14 nucleotides. Because
      14 nucleotides corresponds to the approximate distance between the leading edge
      of the ribosome and its AUG-recognition center as measured by ribonuclease
      protection experiments, a likely explanation for the enhancing effect of a
      downstream hairpin is that secondary structure slows scanning, thereby providing
      more time for recognition of the AUG codon, and the facilitation is greatest when
      the 40S ribosome stalls with its AUG-recognition center directly over the AUG.
      The variable ability of mammalian ribosomes to initiate at non-AUG codons in
      vitro is also explicable by the presence or absence of a stem-loop structure just
      downstream from the alternative initiator codon. This may be relevant to recent
      reports of adventitious upstream initiation events at non-AUG codons in some
      vertebrate mRNAs that have structure-prone, G + C-rich leader sequences.

PMID- 2236043
TI  - Fructose-induced aberration of metabolism in familial gout identified by 31P
      magnetic resonance spectroscopy.
AB  - The hyperuricemia responsible for the development of gouty arthritis results from
      a wide range of environmental factors and underlying genetically determined
      aberrations of metabolism. 31P magnetic resonance spectroscopy studies of
      children with hereditary fructose intolerance revealed a readily detectable rise
      in phosphomonoesters with a marked fall in inorganic phosphate in their liver in
      vivo and a rise in serum urate in response to very low doses of oral fructose.
      Parents and some family members heterozygous for this enzyme deficiency showed a
      similar pattern when given a substantially larger dose of fructose. Three of the
      nine heterozygotes thus identified also had clinical gout, suggesting the
      possibility of this defect being a fairly common cause of gout. In the present
      study this same noninvasive technology was used to identify the same spectral
      pattern in 2 of the 11 families studied with hereditary gout. In one family, the
      index patient's three brothers and his mother all showed the fructose-induced
      abnormality of metabolism, in agreement with the maternal inheritance of the gout
      in this family group. The test dose of fructose used produced a significantly
      larger increment in the concentration of serum urate in the patients showing the
      changes in 31P magnetic resonance spectra than in the other patients with
      familial gout or in nonaffected members, thus suggesting a simpler method for
      initial screening for the defect.

PMID- 2236044
TI  - Organ-specific and systemic autoimmune diseases originate from defects in
      hematopoietic stem cells.
AB  - Transplantation of bone marrow cells from nonobese diabetic (NOD) mice, a model
      for type 1 diabetes mellitus, to C3H/HeN mice, which express I-E alpha molecules
      and have aspartic acid at residue 57 of the I-A beta chain, induced insulitis
      followed by overt diabetes in the recipient C3H/HeN mice more than 40 weeks after
      bone marrow transplantation. When cyclosporin A, which perturbs T-cell functions,
      was injected intraperitoneally into [NOD----C3H/HeN] chimeric mice daily for 1
      month, the chimeric mice developed insulitis and overt diabetes within 20 weeks
      following bone marrow transplantation. Transplantation of bone marrow cells from
      (NZW x BXSB)F1 mice, which develop lupus nephritis, myocardial infarction, and
      idiopathic thrombocytopenic purpura, into C3H/HeN or C57BL/6J mice induced in the
      recipient strains both lupus nephritis and idiopathic thrombocytopenic purpura
      more than 3 months after transplantation. Transplantation of a stem-cell-enriched
      population from (NZW x BXSB)F1 mice into normal mice also induced autoimmune
      disease in the recipients. These results indicate that both systemic autoimmune
      disease and organ-specific autoimmune disease originate from defects that reside
      within the stem cells; the thymus and environmental factors such as sex hormones
      appear to act only as accelerating factors.

PMID- 2236045
TI  - A principle for the formation of the spatial structure of cortical feature maps.
AB  - Orientation-selective cells in the striate cortex of higher animals are organized
      as a hierarchical topographic map of two stimulus features: (i) position in
      visual space and (ii) orientation. We show that the observed structure of the
      topographic map can arise from a principle of continuous mapping. For the
      realization of this principle we use a mathematical model that can be interpreted
      as an adaptive process changing a set of synaptic weights, or synaptic connection
      strengths, between two layers of cells. The patterns of orientation preference
      and selectivity generated by the model are similar to the patterns seen in the
      visual cortex of macaque monkey and cat and correspond to a neural projection
      that maps a more than two-dimensional feature space onto a two-dimensional
      cortical surface under the constraint that shape and position of the receptive
      fields of the neurons very smoothly over the cortical surface.

PMID- 2236047
TI  - Molecular cloning and characterization of the immunologically protective surface
      glycoprotein GP46/M-2 of Leishmania amazonensis.
AB  - Immunization of mice with the GP46/M-2 membrane glycoprotein has been
      demonstrated to elicit protection against infection with the parasitic protozoan
      Leishmania amazonensis. As this molecule is important for future vaccine studies
      of leishmaniasis, the gene encoding the GP46/M-2 surface membrane glycoprotein of
      Leishmania amazonensis has been cloned and sequenced. The protein sequence
      derived from the DNA sequence data is consistent with the known biochemical and
      immunochemical properties of the protein and indicates a number of structural
      areas of interest. A repetitive sequence (24 amino acids repeated four times)
      occurs within the amino-terminal portion of the molecule and constitutes
      approximately 22% of the total mature protein. The protease-resistant
      immunodominant carboxyl-terminal domain of the protein comprises approximately
      half of the molecule and consists of proline-rich and cysteine-rich areas of
      sequence; the distribution of cysteine residues is suggestive of metal binding
      motifs. The sequence predicts a hydrophobic leader peptide, and a putative
      attachment site for a glycosyl-phosphatidylinositol anchor is indicated at the
      carboxyl terminus, consistent with the membrane location of the protein. Southern
      blot analyses also indicate the presence of a GP46/M-2 gene family.

PMID- 2236049
TI  - Odor types determined by the major histocompatibility complex in germfree mice.
AB  - The major histocompatibility complex (MHC) is the prime but not exclusive
      determinant of genetically specific constitutive body odors, termed odor types,
      represented strongly in urine of the mouse. Perception of MHC-determined odor
      types influences reproductive behavior in the contexts of mate choice and
      maintenance of early pregnancy, tending to favor the propagation of one MHC type
      over another. How MHC genotype determines MHC odor type is unknown. One possible
      explanation is that differential odorants are generated by populations of
      commensal microorganisms whose composition is somehow geared to MHC diversity.
      This hypothesis was tested in the Y-maze system in which mice are trained to
      distinguish the urinary odors of MHC-congenic mice. First, it was shown that mice
      could readily be trained to distinguish the urines of germfree MHC-congenic mice.
      Second, it was shown that mice trained to distinguish the urines of
      conventionally maintained MHC-congenic mice could as readily distinguish the
      urines of germfree MHC-congenic mice. These results imply that MHC-determined
      odor types do not depend on odorants generated by microorganisms.

PMID- 2236048
TI  - Renaturation of complementary DNA strands mediated by purified mammalian
      heterogeneous nuclear ribonucleoprotein A1 protein: implications for a mechanism
      for rapid molecular assembly.
AB  - Purified heterogeneous nuclear ribonucleoprotein (hnRNP) A1 protein, which is
      found in vivo associated with heterogeneous nuclear RNA (hnRNA), promotes the
      rapid renaturation of nucleic acid strands. Maximal renaturation activity
      requires the glycine-rich carboxyl-terminal one-third of the protein, although
      the amino-terminal two-thirds also has activity. The A1-mediated reaction is
      second-order with respect to complementary DNA concentration, and the
      renaturation rate constant at 37 degrees C with A1 is about 3000-fold greater
      than in the absence of the protein. At 60 degrees C, the A1-mediated renaturation
      rate is even faster, and is about 300-fold greater than protein-free reactions
      carried out at 68 degrees C in 1 M NaCl. Provided that sufficient A1 protein is
      present to coat all strands in solution, the presence of nonhomologous, single
      stranded DNA does not significantly inhibit the reaction. Moreover, renaturation
      of short strands to their complement contained in very long strands is nearly as
      efficient as between two short strands. These results indicate that A1 may be
      useful for procedures that rely on nucleic acid renaturation. We propose that A1
      promotes rapid renaturation primarily by reducing the entropic barrier of
      bimolecular strand association through relatively transient interactions between
      A1-coated strands. Such interactions, mediated by flexible repeating domains, may
      act generally to increase the association kinetics of highly specific molecular
      assemblies in processes such as RNA maturation, transcription, translation, and
      transport.

PMID- 2236046
TI  - Hypomutability in Fanconi anemia cells is associated with increased deletion
      frequency at the HPRT locus.
AB  - Fanconi anemia (FA) is an inherited human disorder associated with a
      predisposition to cancer and characterized by anomalies in the processing of DNA
      cross-links and certain monoadducts. We reported previously that the frequency of
      psoralen-photoinduced mutations at the HPRT locus is lower in FA cells than in
      normal cells. This hypomutability is shown here to be associated with an
      increased frequency of deletions in the HPRT gene when either a mixture of cross
      links and monoadducts or monoadducts alone are induced. Molecular analysis of
      mutants in the HPRT gene was carried out. In normal cells the majority of
      spontaneous and induced mutants are point mutations whereas in FA deletion
      mutations predominate. In that case a majority of mutants were found to lack
      individual exons or small clusters of exons whereas in normal cells large
      (complete or major gene loss) and small deletions are almost equally represented.
      Thus we propose that the FA defect lies in a mutagenic pathway that, in normal
      cells, involves bypassing lesions and subsequent gap filling by a recombinational
      process during replication.

PMID- 2236050
TI  - Autogenous suppression of an opal mutation in the gene encoding peptide chain
      release factor 2.
AB  - The peptide chain release factor 2 (RF2) gene, prfB, was cloned from Salmonella
      typhimurium by DNA hybridization using the Escherichia coli prfB probe. The
      nucleotide and amino acid sequences of prfB are 87.0% and 95.6% homologous
      between E. coli and S. typhimurium, respectively, including an in-frame premature
      UGA stop codon at position 26, the site of +1 frameshift for mature RF2
      synthesis. The supK584 mutation, which had been isolated as a recessive UGA
      suppressor in S. typhimurium, caused an opal (UGA) substitution at amino acid
      position 144 in the prfB gene. Complementation, reversion, and gene fusion
      analyses led to the conclusion that supK is a S. typhimurium RF2 mutation and
      this opal RF2 mutation generates a UGA suppressor activity, presumably because of
      inefficient translation termination due to the reduced cellular level of RF2. In
      fact, suppression of the supK opal mutation results from a form of autogenous
      control of RF2 synthesis.

PMID- 2236051
TI  - Temporary amelioration of hyperlipidemia in low density lipoprotein receptor
      deficient rabbits transplanted with genetically modified hepatocytes.
AB  - Familial hypercholesterolemia is an inherited disease in humans that is
      associated with coronary artery disease and is caused by a deficiency of the
      receptor that mediates the internalization of low density lipoprotein (LDL). We
      have used an animal model for familial hypercholesterolemia, the Watanabe
      heritable hyperlipidemic (WHHL) rabbit, to design a therapeutic approach for this
      disease, which attempts to correct the hepatic defect in LDL receptor expression.
      Hepatocytes were harvested from WHHL rabbits, plated in primary cultures, and
      exposed to recombinant retroviruses capable of efficiently transferring a
      functional human LDL receptor gene. Genetically modified cells were harvested and
      infused into the portal vein of WHHL recipients, who were analyzed for metabolic
      consequences of human LDL receptor expression. Each animal exhibited a
      statistically significant decrease in total serum cholesterol 2-6 days after
      transplantation, with an eventual return to pretreatment levels. Proviral DNA
      sequences and virus-directed transcripts were detected in liver tissue 24 hr
      after transplantation. In situ hybridization demonstrated provirus expression in
      a small population of hepatocytes distributed in periportal sections of the
      liver. This study illustrates the potential of somatic gene therapy in
      ameliorating hyperlipidemia associated with familial hypercholesterolemia.

PMID- 2236052
TI  - MyoD induces growth arrest independent of differentiation in normal and
      transformed cells.
AB  - MyoD is a gene involved in the control of muscle differentiation. We show that
      MyoD causes growth arrest when expressed in cell lines derived from tumors or
      transformed by different oncogenes. MyoD-induced growth inhibition was
      demonstrated by reduction in the efficiency of colony formation and at the single
      cell level. We further show that MyoD growth inhibition can occur in cells that
      are not induced to activate muscle differentiation markers. The inhibitory
      activity of MyoD was mapped to the same 68-amino acid segment necessary and
      sufficient for induction of muscle differentiation, the basic-helix-loop-helix
      motif. Mutants with alterations in the basic region of MyoD that fail to bind or
      do not activate a muscle-specific enhancer inhibited growth; mutants with
      deletions in the helix-loop-helix region failed to inhibit growth. Thus,
      inhibition of cell growth by MyoD seems to occur by means of a parallel pathway
      to the one that leads to myogenesis. We conclude that MyoD is a prototypic gene
      capable of functionally activating intracellular growth inhibitory pathways.

PMID- 2236053
TI  - Identification of mutations in regions corresponding to the two putative
      nucleotide (ATP)-binding folds of the cystic fibrosis gene.
AB  - Additional mutations in the cystic fibrosis (CF) gene were identified in the
      regions corresponding to the two putative nucleotide (ATP)-binding folds (NBFs)
      of the predicted polypeptide. The patient cohort included 46 Canadian CF families
      with well-characterized DNA marker haplotypes spanning the disease locus and
      several other families from Israel. Eleven mutations were found in the first NBF,
      2 were found in the second NBF, but none was found in the R-domain. Seven of the
      mutations were of the missense type affecting some of the highly conserved amino
      acid residues in the first NBF; 3 were nonsense mutations; 2 would probably
      affect mRNA splicing; 2 corresponded to small deletions, including another 3-base
      pair deletion different from the major mutation (delta F508), which could account
      for 70% of the CF chromosomes in the population. Nine of these mutations
      accounted for 12 of the 31 non-delta F508 CF chromosomes in the Canadian
      families. The highly heterogeneous nature of the remaining CF mutations provides
      important insights into the structure and function of the protein, but it also
      suggests that DNA-based genetic screening for CF carrier status will not be
      straightforward.

PMID- 2236055
TI  - Cell position and developmental fate in leech embryogenesis.
AB  - The o and p blast cell bandlets of the leech Theromyzon rude, which normally
      produce two different sets of identifiable cells designated the "O" and "P"
      fates, respectively, form an equivalence group: in embryos experimentally
      deprived of their p bandlet, the blast cells of the adjacent o bandlet may
      "transfate" and take on the P fate. Loss of the p bandlet is not, however, a
      sufficient condition for transfating of the o bandlet. Rather, loss of the p
      bandlet allows the o bandlet to shift into ectopic positions, and it is the
      ultimate position of the o bandlet that mandates which fate--O or P--the blast
      cells will take on. Therefore, the choice of the pluripotent o blast cells to
      follow either the O or P developmental pathway depends on their perception of
      positional cues provided by cells outside the equivalence group rather than on a
      direct interaction with p blast cell equivalence group members.

PMID- 2236054
TI  - Role of tryptophan repeats and flanking amino acids in Myb-DNA interactions.
AB  - The c-myb protooncogene codes for a sequence-specific DNA-binding protein that
      appears to act as a transcriptional regulator and is highly conserved through
      evolution. The DNA-binding domain of Myb has been shown to contain three
      imperfectly conserved repeats of 52 amino acids that constitute the amino
      terminal end. Within each repeat, there are three tryptophans that are separated
      by 18 or 19 amino acids and are flanked by basic amino acids. To determine the
      role of tryptophans and the flanking basic amino acids in the DNA-binding
      activity of Myb proteins, we have selectively mutagenized individual tryptophans
      as well as some of the amino acid residues that flank these tryptophans.
      Replacement of these tryptophans with glycine, proline, or arginine abolished the
      DNA-binding activity whereas replacement with other aromatic amino acids or
      leucine or alanine did not appreciably affect this activity. On the other hand
      the replacement of two amino acids, asparagine and lysine, that flank the last
      tryptophan with acidic amino acids completely abolished their DNA-binding
      activity. These results are consistent with a model we present in which the
      tryptophans form a hydrophobic scaffold that plays a crucial role in maintaining
      the helix-turn-helix structure of the DNA binding domain. Basic and polar amino
      acids adjacent to these tryptophans seem to participate directly in DNA binding.

PMID- 2236056
TI  - Architecture of ribosomal RNA: constraints on the sequence of "tetra-loops".
AB  - The four-base loops that cap many double-helical structures in rRNA (the so
      called "tetra-loops") exhibit highly invariant to highly variable sequences
      depending upon their location in the molecule. However, in the vast majority of
      these cases the sequence of a tetra-loop is independent of its location and
      conforms to one of three general motifs, GNRA, UNCG, and (more rarely) CUUG. For
      the most frequently varying of the 16S rRNA tetra-loops, that at position 83
      (Escherichia coli numbering), the three sequences CUUG, UUCG, and GCAA account
      for almost all examples encountered, and each of them has independently arisen at
      least a dozen times. The closing base pair of tetra-loop hairpins reflects the
      loop sequence, tending to be C.G for UUCG loops and G.C for CUUG loops.

PMID- 2236057
TI  - Free energy of sickling: A simulation analysis.
AB  - Molecular dynamics simulations were performed to calculate the difference between
      the dimerization free energies of normal human deoxyhemoglobin (HbA) and the
      mutant sickle-cell deoxyhemoglobin HbS (Glu-beta 6----Val) for one of the lateral
      contacts in the HbS x-ray structure. The simulations yield a value of--15
      kcal/mol. Although there is no quantitative experimental value for comparison,
      this is in qualitative agreement with the experimental result that HbS self
      assembles into multistranded fibers that are responsible for erythrocyte
      sickling, while HbA does not. The free-energy difference was decomposed into
      enthalpic and entropic terms, both of which are significant, and the
      contributions of individual protein residues and of the solvent were examined.
      Electrostatic effects play the dominant role in favoring dimerization of HbS
      compared with HbA; van der Waals interactions make a negligible contribution to
      the difference. Both differential solvation and protein-protein interactions are
      important. Interactions within the donor tetramer (i.e., that containing the Glu
      beta 6 mutation site), as well as those with the acceptor tetramer, contribute to
      the preferential free energy of dimerization of HbS.

PMID- 2236058
TI  - Genetic diversity and ecogeographical differentiation among ribosomal DNA alleles
      in wild and cultivated barley.
AB  - DNA from 267 accessions of wild barley from ecologically diverse habitats in
      Israel and Iran and from 92 accessions of cultivated barley from throughout the
      world were assayed for the 20 ribosomal DNA (rDNA) spacer-length variants that
      have been identified in the barley species. These 20 spacer-length variants,
      which are detectable by Southern blot hybridization, serve as markers of rDNA
      alleles of two Mendelian loci, Rrn1 and Rrn2. All of the populations of wild
      barley studied were polymorphic for both loci. In wild barley allele 112 (Rrn1)
      and allele 107 (Rrn2) behaved as widely adapted wild-type alleles; in our sample
      of cultivated barley allele 112 also behaved as a wild-type allele but allele 104
      was somewhat more frequent than allele 107 in Rrn2. A few other alleles were
      locally frequent in wild barley. However, most of the 20 alleles were infrequent
      or rare and such alleles were often associated as "hitchhikers" with one of the
      wild-type alleles in compound two-component alleles. Allelic and genotypic
      frequencies differed widely in different habitats in correlation with eight of
      nine factors of the physical environment. Discrete log-linear multivariate
      analyses revealed statistically significant associations among alleles of Rrn1
      and Rrn2. It was concluded that natural selection acting differentially on
      various rDNA alleles plays a major role in the development and maintenance of
      observed patterns of molecular and genetic organization of rDNA variability.

PMID- 2236059
TI  - Molecular cloning and amino acid sequence of brain L-glutamate decarboxylase.
AB  - We used specific polyclonal antibodies against L-glutamate decarboxylase (GAD) to
      screen a mouse brain cDNA library that was constructed in the expression vector
      lambda gt11. We obtained 1.5 x 10(6) recombinant DNA clones in the mouse brain
      cDNA library. One of the clones was positively identified as a GAD clone on the
      basis of the following results: (i) the clone and its secondary and tertiary
      clones all reacted strongly with anti-GAD antibodies; (ii) the fusion protein
      obtained from lambda GAD-Y1089 showed good GAD enzyme activity as determined by
      both CO2 and gamma-aminobutyric acid methods. The GAD clone thus obtained
      contains GAD cDNA of approximately 2.6 kilobases that has one internal EcoRI
      site. After GAD cDNA was cut at the EcoRI site, two DNA fragments of about 1.6
      and 1.0 kilobases were obtained at the 5' and 3' ends, respectively. The cDNA
      insert was found to be composed of 2632 base pairs, the translation initiation
      site was assigned to the methionine codon ATG, and the termination site was found
      to be TGA (positions 2216-2218). Furthermore, the coding region in 2169 base
      pairs was found to consist of 723 amino acids. The protein has a molecular weight
      of 83,207 and contains 83 strongly basic, 108 strongly acidic, 226 hydrophobic,
      and 221 polar amino acids with an isoelectric point of 5.355. The relationship of
      this GAD cDNA to other forms of GAD is discussed.

PMID- 2236060
TI  - Functional analysis of protein N-myristoylation: metabolic labeling studies using
      three oxygen-substituted analogs of myristic acid and cultured mammalian cells
      provide evidence for protein-sequence-specific incorporation and analog-specific
      redistribution.
AB  - Covalent attachment of myristic acid (C14:0) to the NH2-terminal glycine residue
      of a number of cellular, viral, and oncogene-encoded proteins is essential for
      full expression of their biological function. Substitution of oxygen for
      methylene groups in this fatty acid does not produce a significant change in
      chain length or stereochemistry but does result in a reduction in hydrophobicity.
      These heteroatom-containing analogs serve as alternative substrates for mammalian
      myristoyl-CoA:protein N-myristoyltransferase (EC 2.3.1.97) and offer the
      opportunity to explore structure/function relationships of myristate in N
      myristoyl proteins. We have synthesized three tritiated analogs of myristate with
      oxygen substituted for methylene groups at C6, C11, and C13. Metabolic labeling
      studies were performed with these compounds and (i) a murine myocyte cell line
      (BC3H1), (ii) a rat fibroblast cell that produces p60v-src (3Xsrc), or (iii) NIH
      3T3 cells that have been engineered to express a fusion protein consisting of an
      11-residue myristoylation signal from the Rasheed sarcoma virus (RaSV) gag
      protein linked to c-Ha-ras with a Cys----Ser-186 mutation. This latter mutation
      prevents isoprenylation and palmitoylation of ras. Two-dimensional gel
      electrophoresis of membrane and soluble fractions prepared from cell lysates
      revealed different patterns of incorporation of the analogs into cellular N
      myristoyl proteins (i.e., protein-sequence-specific incorporation). In addition,
      proteins were identified that underwent redistribution from membrane to soluble
      fractions after incorporating one but not another analog (analog-specific
      redistribution). Comparable studies using the model RaSV-ras chimeric protein
      also demonstrated analog-specific differences in incorporation, varying from
      approximately 25% of the total RaSV-ras chimeric protein with 5
      octyloxypentanoate to greater than 50% with 12-methoxydodecanoate. Modification
      by this latter compound was so extensive that the amount of membrane-associated N
      myristoylated protein was decreased. Incorporation of each of the analogs caused
      a dramatic redistribution to the soluble fraction, comparable to that seen when
      myristoylation was completely blocked by mutating the protein's site of myristate
      attachment (glycine) to an alanine residue. The demonstration that these analogs
      differ in the extent to which they are incorporated and in their ability to cause
      redistribution of any single protein suggests that they may also have sufficient
      selectivity to be of potential therapeutic value.

PMID- 2236061
TI  - Cloning and sequence of the human adrenodoxin reductase gene.
AB  - Adrenodoxin reductase (ferrodoxin:NADP+ oxidoreductase, EC 1.18.1.2) is a
      flavoprotein mediating electron transport to all mitochondrial forms of
      cytochrome P450. We cloned the human adrenodoxin reductase gene and characterized
      it by restriction endonuclease mapping and DNA sequencing. The entire gene is
      approximately 12 kilobases long and consists of 12 exons. The first exon encodes
      the first 26 of the 32 amino acids of the signal peptide, and the second exon
      encodes the remainder of signal peptide and the apparent FAD binding site. The
      remaining 10 exons are clustered in a region of only 4.3 kilobases, separated
      from the first two exons by a large intron of about 5.6 kilobases. Two forms of
      human adrenodoxin reductase mRNA, differing by the presence or absence of 18
      bases in the middle of the sequence, arise from alternate splicing at the 5' end
      of exon 7. This alternately spliced region is directly adjacent to the NADPH
      binding site, which is entirely contained in exon 6. The immediate 5' flanking
      region lacks TATA and CAAT boxes; however, this region is rich in G + C and
      contains six copies of the sequence GGGCGGG, resembling promoter sequences of
      "housekeeping" genes. RNase protection experiments show that transcription is
      initiated from multiple sites in the 5' flanking region, located about 21-91 base
      pairs upstream from the AUG translational initiation codon.

PMID- 2236062
TI  - Expression of fully functional tetrameric human hemoglobin in Escherichia coli.
AB  - Synthetic genes encoding the human alpha- and beta-globin polypeptides have been
      expressed from a single operon in Escherichia coli. The alpha- and beta-globin
      polypeptides associate into soluble tetramers, incorporate heme, and accumulate
      to greater than 5% of the total cellular protein. Purified recombinant hemoglobin
      has the correct stoichiometry of alpha- and beta-globin chains and contains a
      full complement of heme. Each globin chain also contains an additional methionine
      as an extension to the amino terminus. The recombinant hemoglobin has a C4
      reversed-phase HPLC profile essentially identical to that of human hemoglobin A0
      and comigrates with hemoglobin A0 on SDS/PAGE. The visible spectrum and oxygen
      affinity are similar to that of native human hemoglobin A0. The recombinant
      protein shows a reduction in Bohr and phosphate effects, which may be attributed
      to the presence of methionine at the amino termini of the alpha and beta chains.
      We have also expressed the alpha- and beta-globin genes separately and found that
      the expression of the alpha-globin gene alone results in a marked decrease in the
      accumulation of alpha-globin in the cell. Separate expression of the beta-globin
      gene results in high levels of insoluble beta-globin. These observations suggest
      that the presence of alpha- and beta-globin in the same cell stabilizes alpha
      globin and aids the correct folding of beta-globin. This system provides a simple
      method for expressing large quantities of recombinant hemoglobin and allows
      facile manipulation of the genes encoding hemoglobin to produce functionally
      altered forms of this protein.

PMID- 2236063
TI  - Rapid, nonradioactive detection of clonal T-cell receptor gene rearrangements in
      lymphoid neoplasms.
AB  - Southern blot hybridization analysis of clonal antigen receptor gene
      rearrangements has proved to be a valuable adjunct to conventional methods for
      diagnosing lymphoid neoplasia. However, Southern blot analysis suffers from a
      number of technical disadvantages, including the time necessary to obtain
      results, the use of radioactivity, and the susceptibility of the method to
      various artifacts. We have investigated an alternative approach for assessing the
      clonality of antigen receptor gene rearrangements in lymphoid tissue biopsy
      specimens. This approach involves the amplification of rearranged gamma T-cell
      receptor genes by the polymerase chain reaction and analysis of the polymerase
      chain reaction products by denaturing gradient gel electrophoresis. By use of
      this approach, clonal rearrangements from neoplastic lymphocytes constituting as
      little as 0.1-1% of the total cells in the tissue are detected as discrete bands
      in the denaturing gel after the gel is stained with ethidium bromide and viewed
      under ultraviolet light. In contrast, polyclonal rearrangements from reactive
      lymphocytes appear as a diffuse smear along the length of the gel. Our findings
      suggest that polymerase chain reaction combined with denaturing gradient gel
      electrophoresis may offer a rapid, nonradioactive, and sensitive alternative to
      Southern blot analysis for the diagnostic evaluation of lymphoid tissue biopsy
      specimens.

PMID- 2236064
TI  - Molecular structure of a major insulin/mitogen-activated 70-kDa S6 protein
      kinase.
AB  - The molecular structure of a rat hepatoma 70-kDa insulin/mitogen-stimulated S6
      protein kinase, obtained by molecular cloning, is compared to that of a rat
      homolog of the 85-kDa Xenopus S6 protein kinase alpha; both kinases were cloned
      from H4 hepatoma cDNA libraries. The 70-kDa S6 kinase (calculated molecular mass
      of 59,186 Da) exhibits a single catalytic domain that is most closely related in
      amino acid sequence (56% identity) to the amino-terminal, kinase C-like domain of
      the rat p85 S6 kinase (calculated molecular mass of 82,695 Da); strong similarity
      extends through a further 67 residues carboxyl-terminal to the catalytic domain
      (40% identity), corresponding to a region also conserved among the kinase C
      family. Outside of this segment of approximately 330 amino acids, the structures
      of the p70 and p85 S6 kinases diverge substantially. The p70 S6 kinase is known
      to be activated through serine/threonine phosphorylation by unidentified
      insulin/mitogen-activated protein kinases. A model for the regulation of p70 S6
      protein kinase activity is proposed wherein the low activity of the
      unphosphorylated enzyme results from the binding of a basic, inhibitory
      pseudosubstrate site (located carboxyl-terminal to the extended catalytic domain)
      to an acidic substrate binding region (located amino-terminal to the catalytic
      domain); substrate binding is thereby prevented. S6 kinase activation requires
      displacement of this inhibitory segment, which is proposed to occur consequent to
      its multiple phosphorylation. The putative autoinhibitory segment contains
      several serine and threonine residues, each followed directly by a proline
      residue. This motif may prevent autophosphorylation but permit
      transphosphorylation; two of these serine residues reside in a maturation
      promoting factor (MPF)/cdc-2 consensus motif. Thus, hormonal regulation of S6
      kinase may involve the action of MPF/cdc-2 or protein kinases with related
      substrate specificity.

PMID- 2236065
TI  - ISGF3, the transcriptional activator induced by interferon alpha, consists of
      multiple interacting polypeptide chains.
AB  - Interferon-stimulated gene factor 3 (ISGF3) is the ligand-dependent
      transcriptional activator that, in response to interferon treatment, is assembled
      in the cell cytoplasm, is translocated to the nucleus, and binds the consensus
      DNA site, the interferon-stimulated response element. We have purified ISGF3 and
      identified its constituent proteins: a DNA-binding protein of 48 kDa and three
      larger polypeptides (84, 91, and 113 kDa), which themselves do not have DNA
      binding activity. The multisubunit structure of ISGF3 most likely reflects its
      participation in receiving a ligand-dependent signal, translocating to the
      nucleus, and binding to DNA to activate transcription.

PMID- 2236066
TI  - Initiation of rolling-circle replication in pT181 plasmid: initiator protein
      enhances cruciform extrusion at the origin.
AB  - Plasmid pT181 DNA secondary structures have been analyzed in vitro by nuclease S1
      digestion and in vivo by bromoacetaldehyde treatment. A cruciform structure
      occurring at the pT181 replication origin in vitro is greatly enhanced by the
      binding of the plasmid-encoded initiator protein RepC. In vivo a DNA secondary
      structure also existed in the replication origin. Its frequency of formation was
      correlated with efficiency of RepC utilization. These data suggest that cruciform
      extrusion at the origin is involved in initiation of pT181 rolling-circle
      replication. A neighboring DNA structure influences the conformation of the
      origin in vivo.

PMID- 2236067
TI  - Imaging cytoskeleton--mitochondrial membrane attachments by embedment-free
      electron microscopy of saponin-extracted cells.
AB  - Embedment-free electron microscopy images the cytoskeleton and nuclear matrix,
      which are very difficult to visualize in conventional electron micrographs.
      However, to be effective, cell structures must be depleted of soluble proteins,
      which otherwise shroud cell architecture. Nonionic detergents effect this
      extraction, releasing soluble proteins but also destroying all membranes. Saponin
      can permeabilize plasma membranes, releasing soluble proteins while preserving
      many cytoplasmic membranes. Stereoscopic electron microscopy of resinless
      sections shows the many connections of the cytoskeleton to mitochondrial
      membranes.

PMID- 2236068
TI  - Volume-sensitive K-Cl cotransport in inside-out vesicles made from erythrocyte
      membranes from sheep of low-K phenotype.
AB  - Unidirectional K ion effluxes were measured from inside-out vesicles prepared
      from erythrocyte membranes from sheep of the low-K phenotype. Total K efflux was
      150 nmol per mg of protein per hr in a Cl medium of 295 mosmol/kg (with the Na/K
      pump inhibited). Cl-dependent K efflux (determined with methanesulfonate
      replacing Cl) was 54 nmol/(mg.hr). Cl-dependent K efflux (K-Cl cotransport)
      increased to 77 nmol/(mg.hr) with osmotic swelling of approximately 30% in 230
      mosmol/kg medium and decreased to 13 nmol/(mg.hr) after shrinkage of
      approximately 60% in 430-mosmol/kg medium. Osmotically induced changes in
      transport and vesicle volume were reversible. K-Cl cotransport was enhanced by
      ATP. Nonhydrolyzable ATP analogues failed to substitute for ATP, indicating that
      phosphorylation is involved. However, in the absence of added ATP there was
      significant K-Cl cotransport, suggesting that phosphorylation is not essential
      for function. The results provide clues about the nature of the signals detected
      by the sensor of cell volume changes and demonstrate that inside-out vesicles
      from sheep erythrocyte membranes provide an advantageous experimental system for
      investigation of the volume sensor.

PMID- 2236069
TI  - Duration of phasic electrical activity of the hypothalamic gonadotropin-releasing
      hormone pulse generator and dynamics of luteinizing hormone pulses in the rhesus
      monkey.
AB  - The secretion of luteinizing hormone (LH) by the pituitary gland is a pulsatile
      phenomenon. In the rhesus monkey, each pulse of LH in the peripheral circulation
      is associated with a characteristic increase in multiunit electrical activity
      (MUA) recorded from the medial basal hypothalamus. These "volleys" of electrical
      activity initiate the release of gonadotropin-releasing hormone (GnRH) into the
      pituitary portal circulation from the terminals of neurosecretory cells. Their
      duration varies from 1-3 min in normal, adult intact females to 10-25 min in long
      term ovariectomized monkeys. A variety of pharmacological interventions also
      modify volley duration. The purpose of this investigation was to determine the
      physiological significance of alterations in volley duration. The dynamics of LH
      pulses in ovariectomized animals were observed in a number of experimental
      circumstances in which MUA volley duration was reduced from a maximum of 23 min
      to a minimum of 4 min without significantly altering their frequency. The
      magnitude of each LH pulse was assessed by calculating the area under the curve
      delineated by the time course of LH above baseline. In eight experiments, a
      linear regression of these values on volley duration failed to reveal a
      significant correlation between MUA volley duration and the magnitude of LH
      pulses. These results suggest that all of the GnRH secreted per pulse is released
      at the onset of each MUA volley, the remainder of the increase in electrical
      activity having no further action on GnRH secretion, although effects on other
      systems cannot be excluded.

PMID- 2236070
TI  - Identical splicing of aberrant epidermal growth factor receptor transcripts from
      amplified rearranged genes in human glioblastomas.
AB  - The epidermal growth factor receptor gene has been found to be amplified and
      rearranged in human glioblastomas in vivo. Here we present the sequence across a
      splice junction of aberrant epidermal growth factor receptor transcripts derived
      from corresponding and uniquely rearranged genes that are coamplified and
      coexpressed with non-rearranged epidermal growth factor receptor genes in six
      primary human glioblastomas. Each of these six tumors contains aberrant
      transcripts derived from identical splicing of exon 1 to exon 8 as a consequence
      of a deletion-rearrangement of the amplified gene, the extent of which is
      variable among these tumors. In spite of this intertumoral variability, each
      intragenic rearrangement results in loss of the same 801 coding bases (exons 2-7)
      and creation of a new codon at the novel splice site in their corresponding
      transcripts. These rearrangements do not, however, affect the mRNA sequence for
      the signal peptide, the first five codons, or the reading frame downstream of the
      rearrangement.

PMID- 2236071
TI  - The metabolism of L-arginine and its significance for the biosynthesis of
      endothelium-derived relaxing factor: cultured endothelial cells recycle L
      citrulline to L-arginine.
AB  - We have investigated the mechanism by which cultured endothelial cells generate L
      arginine (L-Arg), the substrate for the biosynthesis of endothelium-derived
      relaxing factor. When Arg-depleted endothelial cells were incubated in Krebs'
      solution for 60 min, L-Arg levels were significantly (9.7-fold) elevated. The
      generation of L-Arg coincided with a substantial decrease (90%) in intracellular
      L-glutamine (L-Gln), whereas all other amino acids were virtually unaffected.
      Changes in calcium, pH, or oxygen tension had no effect on L-Arg generation,
      which was, however, prevented when the cells were incubated in culture medium
      containing L-Gln. L-Arg generated by endothelial cells labeled with L-[14C]Arg
      was derived from an unlabeled intracellular source, for the specific activity of
      the intracellular L-Arg pool decreased substantially (8.8-fold) over 60 min. Arg
      depleted endothelial cells did not form urea or metabolize L-ornithine but
      converted L-citrulline (L-Cit) to L-Arg possibly via formation of L
      argininosuccinic acid. Nondepleted cells stimulated with the calcium ionophore
      A23187 showed only a transient accumulation of L-Cit, indicating that L-Cit is
      recycled to L-Arg during the biosynthesis of endothelium-derived relaxing factor.
      The generation of L-Arg by Arg-depleted endothelial cells was partially (45%)
      blocked by protease inhibitors, and various Arg-containing dipeptides were
      rapidly cleaved to yield L-Arg. Thus, cultured endothelial cells recycle L-Cit to
      L-Arg and possibly liberate peptidyl L-Arg. The Arg-Cit cycle appears to be the
      equivalent in the endothelial cell to the formation of urea by the liver. The
      biosynthesis of endothelium-derived relaxing factor may, therefore, not only
      produce a powerful vasodilator but also relieve the endothelial cell of excess
      nitrogen.

PMID- 2236072
TI  - A 47-kDa human nuclear protein recognized by antikinetochore autoimmune sera is
      homologous with the protein encoded by RCC1, a gene implicated in onset of
      chromosome condensation.
AB  - Several autoimmune sera from patients with Raynaud phenomenon decorated mammalian
      kinetochores and bound to a 47-kDa protein on immunoblots of nuclear lysates.
      Antibody affinity-purified from immunoblots of the 47-kDa band recognized
      kinetochores, but due to crossreaction with an 18-kDa protein, localization
      remains elusive. We used one of these sera to purify the antigen from HeLa cells
      synchronized in mitosis as a noncovalent complex with a 25-kDa protein. The
      antigen was released from DNA by intercalation with 25 mM chloroquine. Ion
      exchange chromatography yielded the pure complex with an apparent molecular size
      of 68 kDa, which was separated into its components by gel filtration in 6 M
      guanidinium chloride. Upon two-dimensional gel electrophoresis the 47-kDa protein
      gave two main spots of pI 6.6 and 6.7, respectively. Posttranslational
      modification is indicated by additional antigenic spots, by lack of a free alpha
      amino group, and by chromatographic behavior of peptides on reversed-phase
      chromatography. The amino acid sequence for 205 residues of the 47-kDa protein
      has been established. This sequence is highly homologous with the translated
      reading frame of RCC1, a gene reportedly involved in regulating onset of
      mammalian chromosome condensation.

PMID- 2236073
TI  - Src homology region 2 domains direct protein-protein interactions in signal
      transduction.
AB  - Cytoplasmic proteins that regulate signal transduction or induce cellular
      transformation, including cytoplasmic protein-tyrosine kinases, p21ras GTPase
      activating protein (GAP), phospholipase C gamma, and the v-crk oncoprotein,
      possess one or two copies of a conserved noncatalytic domain, Src homology region
      2 (SH2). Here we provide direct evidence that SH2 domains can mediate the
      interactions of these diverse signaling proteins with a related set of
      phosphotyrosine ligands, including the epidermal growth factor (EGF) receptor. In
      src-transformed cells GAP forms heteromeric complexes, notably with a highly
      tyrosine phosphorylated 62-kDa protein (p62). The stable association between GAP
      and p62 can be specifically reconstituted in vitro by using a bacterial
      polypeptide containing only the N-terminal GAP SH2 domain. The efficient
      phosphorylation of p62 by the v-Src or v-Fps tyrosine kinases depends, in turn,
      on their SH2 domains and correlates with their transforming activity. In lysates
      of EGF-stimulated cells, the N-terminal GAP SH2 domain binds to both the EGF
      receptor and p62. Fusion proteins containing GAP or v-Crk SH2 domains complex
      with similar phosphotyrosine proteins from src-transformed or EGF-stimulated
      cells but with different efficiencies. SH2 sequences, therefore, form autonomous
      domains that direct signaling proteins, such as GAP, to bind specific
      phosphotyrosine-containing polypeptides. By promoting the formation of these
      complexes, SH2 domains are ideally suited to regulate the activation of
      intracellular signaling pathways by growth factors.

PMID- 2236075
TI  - Streamlined approach to creating yeast artificial chromosome libraries from
      specialized cell sources.
AB  - The study of tumor-specific chromosomal abnormalities has been severely impeded
      by an inability to link cytogenetic to molecular data. Restriction fragment
      length polymorphism mapping of any particular chromosomal rearrangement to the
      resolution limit of genetic methodology generates sets of probes that frequently
      are still too widely spaced to render the rearrangement breakpoints accessible to
      molecular isolation. The stable propagation of genomic fragments of up to one
      million base pairs in size as yeast artificial chromosomes (YACs) represents an
      important development in this regard. However, existing YAC libraries have been
      made from karyotypically normal sources making the localization and cloning of
      specific rearrangement breakpoints much more difficult. As a solution to this
      problem, we present an improved method for creating YAC libraries that can
      utilize specialized tumor-derived materials and that can be executed effectively
      in a small laboratory setting. Procedures that enabled more consistent DNA insert
      size selection and enhanced yeast transformation frequency were employed to
      generate a human YAC library from a neuroepithelioma cell line containing a
      characteristic t(11;22) chromosomal translocation. Approximately 40,000 colonies
      with an average insert size of 330 kilobase pairs were created. This library was
      screened with two single-copy probes that bracket the translocation breakpoint.
      YAC clones ranging from 370 to 550 kilobase pairs that were specific for each
      single-copy probe were identified. Specialized YAC libraries will make many more
      tumor-specific chromosomal abnormalities accessible to molecular isolation.

PMID- 2236074
TI  - Actin cores of hair-cell stereocilia support myosin motility.
AB  - The actin cores of hair-cell stereocilia were tested as a substrate for the
      movement of myosin-coated beads in an in vitro assay. Large numbers of
      stereocilia from bullfrog sacculi and semicircular canals were isolated by
      blotting onto coverglasses and were demembranated to expose the polar actin
      tracks of their cytoskeletal cores. Silica or polystyrene beads, coated with
      thick filaments of chicken skeletal muscle myosin, were added to this core
      preparation in the presence of ATP. Myosin-coated beads could reach some of the
      cores by diffusion alone, but the efficiency and precision of the assay were
      improved considerably by the use of "optical tweezers" (a gradient-force optical
      trap) to deposit the beads directly on the cores. Beads applied in this fashion
      bound and moved unidirectionally at 1-2 microns/s, escaping the retarding force
      of the trap. Actin filaments within the stereocilia are cross-linked by fimbrin,
      but this did not appear to interfere with the motility of myosin. Beads coated
      with optic-lobe kinesin were also tested for movement; these bound and moved
      unidirectionally at 0.1-0.2 microns/s when applied to microtubule-based
      kinociliary cores, but not when applied to actin-based stereociliary cores. Our
      results are consistent with, and lend support to, a model for hair cell
      adaptation in which a molecular motor such as myosin maintains tension on the
      mechanically gated transduction channels. Optical tweezers and video-enhanced
      differential interference contrast optics provide high efficiency and improved
      optical resolution for the in vitro analysis of myosin motility.

PMID- 2236076
TI  - Hypodense eosinophils and interleukin 5 activity in the blood of patients with
      the eosinophilia-myalgia syndrome.
AB  - The recent recognition of the eosinophilia-myalgia syndrome (EMS) associated with
      the ingestion of L-tryptophan prompted an analysis of the peripheral blood
      eosinophil phenotypes and of the serum eosinophil hematopoietins in this
      disorder. Five patients with an illness characterized by the abrupt onset of
      aching skeletal muscles, edema, thickening and induration of the skin, and marked
      blood eosinophilia associated with L-tryptophan ingestion provided eosinophils,
      serum, or both, for evaluation. Gradient sedimentation density analysis of the
      peripheral blood eosinophils from four of these patients revealed that 43 +/- 13%
      (mean +/- SEM) of the cells had converted to the abnormal (hypodense) sedimenting
      phenotype. When normodense eosinophils from the reference donors were cultured
      for 3 days in medium supplemented with increasing concentrations of serum from
      the patients with EMS, their viability increased in a dose-dependent manner to
      45%, which was significantly augmented over the effect of normal serum. This
      eosinophil viability-sustaining activity was inhibited by 76 +/- 7% (mean +/-
      SEM; n = 3) by the addition of anti-interleukin 5 (IL-5) but not by neutralizing
      antibodies monospecific for either granulocyte/macrophage colony-stimulating
      factor (GM-CSF) or IL-3. IL-5, an eosinophilopoietic factor, converts normodense
      peripheral blood eosinophils in vitro to a hypodense sedimenting form with
      extended viability and augmented biologic responses to activating stimuli. Thus,
      the presence of IL-5 in the sera of patients with EMS may contribute to the
      development and maintenance of the eosinophilia and may regulate the conversion
      of the peripheral blood eosinophils to the hypodense phenotype with augmented
      pathobiologic potential.

PMID- 2236077
TI  - Enzymatic aminoacylation of an eight-base-pair microhelix with histidine.
AB  - The major determinant for the identity of alanine tRNAs is a single base pair in
      the acceptor helix that is proximal to the site of amino acid attachment. A 7
      base-pair microhelix that recreates the acceptor helix can be charged with
      alanine. No other examples of charging of small helices with specific amino acids
      have been reported, to our knowledge. We show here that a 13-base-pair and an 8
      base-pair hairpin helix that reconstruct a domain and subdomain, respectively, of
      histidine tRNAs can be charged with histidine. We also show that transplantation
      of a base pair that is unique to histidine tRNAs is sufficient to consider
      histidine acceptance on a domain and subdomain of alanine tRNA. Both alanine and
      histidine aminoacyl-tRNA synthetases retain specificity for their cognate
      synthetic substrates. Alanine- and histidine-specific microhelices may resemble a
      system that arose early in the evolution of charging and coding.

PMID- 2236078
TI  - An essential arginine residue for initiation of protein-primed DNA replication.
AB  - A group of proteins that act as primers for initiation of linear DNA replication
      are called DNA-terminal proteins (terminal proteins). We have found a short
      stretch of conserved amino acid sequence among the terminal proteins from six
      different sources. The location of this sequence motif is also similar among the
      different terminal-proteins. To determine the functional role of this terminal
      protein domain in DNA replication, we have studied the bacteriophage PRD1 system.
      The PRD1 terminal protein and DNA polymerase genes were cloned into expression
      vectors, and the recombinant plasmids were used for constructing PRD1 terminal
      protein mutants. Site-directed mutagenesis and functional analysis showed that
      one of the two arginines (Arg-174) in the conserved sequence is critical for the
      initiation complex-forming activity of the PRD1 terminal protein. Replacement of
      Arg-174 by noncharged amino acids resulted in nonfunctional terminal protein.
      Phenylglyoxal, an alpha-dicarbonyl compound that reacts with the guanidino group
      of arginine, inhibits initiation complex formation between PRD1 terminal protein
      and dGMP. On the basis of these results, we propose that Arg-174 represents, at
      least in part, the binding site for phosphate groups of dGTP.

PMID- 2236080
TI  - Xenopus laevis alpha and beta thyroid hormone receptors.

PMID- 2236081
TI  - Boyd Orr memorial lecture. Early nutrition and later achievement.

PMID- 2236082
TI  - An overview of the epidemiological evidence linking diet and cancer.

PMID- 2236079
TI  - Mouse transgenes in human cells detect specific base substitutions.
AB  - We describe a system of transgenic human cell lines that detects and identifies
      specific point mutations at defined positions within a gene. The target
      transgenome is a mouse adenine phosphoribosyltransferase (APRT) gene rendered
      nonfunctional by introduction of a substitution at either of two bases that
      comprise a splice acceptor site. Reversion at a mutated site results in the
      expression of wild-type mouse APRT and consequent growth of APRT+ transgenic cell
      colonies. Site-specific reversion to wild-type sequence is confirmed by
      regeneration of a previously destroyed diagnostic Pst I site. Two independent
      cell clones, each with mutant transgenomes bearing an A----G transition,
      exhibited an up to 7500-fold, dose-dependent induction of reversion following
      treatment with ethyl methanesulfonate. Treatment of these clones with 2
      aminopurine resulted in no induction of revertants. In contrast, another
      transgenic cell clone, bearing a G----A transition, reverted as a consequence of
      2-aminopurine, but not ethyl methanesulfonate, treatment. These data confirm for
      human cells the proposed mechanisms of action of these mutagens and provide
      evidence for the utility of our site-specific reversion method for mutagenesis
      studies.

PMID- 2236083
TI  - Chemical food contaminants in the initiation of cancer.

PMID- 2236084
TI  - Alcohol and cancer.

PMID- 2236085
TI  - Inhibition of carcinogenesis by minor anutrient constituents of the diet.
AB  - A continuing study of chemopreventive agents has focused on several categories of
      naturally occurring compounds that inhibit carcinogen activation and are
      effective in preventing carcinogen-induced neoplasia when administered at short
      time-intervals before carcinogen challenge. The inhibitory compounds are:
      aromatic isothiocyanates found in cruciferous vegetables, monoterpenes present in
      citrus fruits and caraway-seed oil, and organosulphur compounds occurring in
      Allium species. Preliminary work indicates that glucobrassicin and indoles
      existing in cruciferous vegetables also have these attributes. Almost all
      carcinogens that are consumed in food require metabolic activation. Thus,
      inhibition of carcinogen activation reactions could be effective against this
      type of exposure. In addition, three naturally occurring compounds, i.e.
      phenethyl isothiocyanate, D-limonene and dipropyl sulphide inhibit activation of
      the tobacco-specific carcinogen NNK, and accordingly may have the capacity to
      diminish carcinogenic response to exposures to tobacco. The property of
      cruciferous vegetables, orange oil, benzyl isothiocyanate, and D-limonene, to act
      as both blocking and suppressing agents has been discussed. Two possible
      mechanisms for this multi-phase activity were presented. The first is that these
      inhibitory substances activate a complex integrated defence mechanism against
      toxic compounds which entails both blocking and suppressing components. The
      blocking component is the initial line of defence, and the suppressing component
      constitutes a 'fail-safe' backup to assure that if any of the toxic material
      attacks cellular constituents, its effects will be nullified. The second possible
      mechanism considered is that the inhibitors, because of high reactivity, have
      multiple biological effects that are separate and not part of a single,
      coordinated response. Inhibitors that have both blocking and suppressing effects
      could be particularly useful as chemopreventive agents. A simple interim
      classification of foods in terms of their potential impact on the occurrences of
      cancer has been proposed.

PMID- 2236086
TI  - Thyroid hormones and thermogenesis.

PMID- 2236087
TI  - Thermogenesis above maintenance in humans.

PMID- 2236088
TI  - Dietary-induced thermogenesis and feed evaluation in ruminants.

PMID- 2236090
TI  - Fatty acids, lipid peroxidation and diseases.

PMID- 2236089
TI  - Iron free radicals and arthritis.

PMID- 2236091
TI  - Cell lineage and differentiation during growth of the early mammalian embryo.

PMID- 2236092
TI  - Dietary methodology: implications of errors in the measurement.

PMID- 2236093
TI  - The Northern Ireland dietary survey and related studies.

PMID- 2236094
TI  - Dietary patterns in the Belfast MONICA Project.

PMID- 2236095
TI  - Nutrient intakes in socially disadvantaged groups in Ireland.

PMID- 2236096
TI  - Sodium and potassium intakes in Ireland.

PMID- 2236097
TI  - Nutritional surveillance in Ireland: theory and practice.

PMID- 2236098
TI  - Casein: a milk protein with diverse biologic consequences.
AB  - The consequences of bovine milk consumption are diverse, some of which are
      potentially deleterious. Although certain cultures shun cow's milk or milk-based
      products, Western societies consume large quantities of cow's milk. Although
      there are stronger similarities between bovine whey proteins and human whey
      proteins, the quantity and nature of casein in cow's milk differ markedly from
      human milk. We propose that the consequences of diets based on bovine casein
      should be more closely evaluated and certainly expanded beyond the simplistic
      approach of growth. What is good for the goose may be good for the gander, but
      what is good for the cow could be harmful to the human.

PMID- 2236100
TI  - Disintegrins: a family of integrin inhibitory proteins from viper venoms.
AB  - Disintegrins represent a new class of low molecular weight, RGD-containing,
      cysteine-rich peptides isolated from the venom of various snakes. They interact
      with the beta 1 and beta 3 families of integrins and their potency is at least
      500-2000 times higher than short RGDX peptides. Analysis of the amino acid
      sequences of 14 different disintegrins suggests that the RGD sequence, in the
      spatial configuration determined by the appropriate pairing of the cysteine
      residues, functions as a cell recognition site. However, certain nonconserved
      amino acids appear to modify the activity of disintegrins, their specificity for
      various receptors, and their ability to compete specifically with various
      ligands.

PMID- 2236099
TI  - The biology of mesangial cells in glomerulonephritis.
AB  - It is likely that a complex bidirectional interaction occurs between mesangial
      cells and the immune cells which infiltrate the mesangium during nephritis.
      Macrophages and other immune cells liberate a series of mediators, including
      substances such as IL-1, beta-endorphin, TNF, and PDGF--all of which promote the
      growth of mesangial cells. The end result is mesangial cell proliferation and
      increased matrix production, both of which are seen in nephritis. The
      proliferating mesangial cells liberate autocoids such as IL-1 and PDGF, thereby
      setting up an amplifying loop. Simultaneously, suppressive factors such as TGF
      beta are released which antagonize the actions of these growth-promoting
      substances. The proliferating mesangial cells also produce immunomodulatory
      peptides, which will in turn act on the infiltrating macrophages to stimulate
      their replication and activation. Such activated macrophages continue to amplify
      the inflammatory lesion and also promote the phagocytosis of localized antigen
      antibody complexes. The net effect of all of these interactions will depend on
      the dominance of substances which persist and override the roles of other
      molecules. Studies of the controls which regulate the production of these growth
      factors/immune modulators will yield insights into the fundamental mechanisms
      which determine the outcome in glomerulonephritis.

PMID- 2236101
TI  - Interleukin 6 in infection and cancer.

PMID- 2236102
TI  - Effects of recombinant human interleukins on food intake of previously food
      deprived rats.
AB  - The effects of intracerebroventricular injection of recombinant human interleukin
      1 beta (rhIL-1 beta), 1 alpha (rhIL-1 alpha), and 2 (rhIL-2) on feeding behavior
      were examined in previously food-deprived rats for 18 hr. At doses of 2-17
      ng/rat, rhIL-1 beta significantly reduced food intake in a dose-dependent manner
      and the feeding suppression continued about 4 hr later. Only 17 ng/rat rhIL-1
      beta reduced body weight gain for 8 hr after the injection. However, rhIL-1 alpha
      at dose of 17 ng/rat did not show any significant change of food intake and body
      weight gain during the whole observation period. At both doses of 8 and 40
      ng/rat, rhIL-2 also failed to suppress overfeeding after food deprivation. In
      adrenalectomized rats, feeding suppression by rhIL-1 beta appeared at the 1- to 2
      hr time period. The present studies suggest that rhIL-1 beta may be, at least in
      part, involved in feeding suppression on various inflammatory processes and that
      adrenal hormones may not play an important role in the induction of feeding
      suppression by rhIL-1 beta.

PMID- 2236103
TI  - Role of parathyroid hormone in the decreased motor nerve conduction velocity of
      chronic renal failure.
AB  - Certain data support the notion that chronic exposure to excess parathyroid
      hormone (PTH) is associated with decreased motor nerve conduction velocity, while
      other studies failed to confirm such an effect. Also, chronic renal failure of 4
      months duration in dogs did not elicit changes in MNCV or calcium content of
      nerve. These discrepancies may be due to differences in other metabolic
      parameters, such as degree of uremia, serum levels of calcium, phosphorus, or
      magnesium, and acid-base parameters, or in duration of chronic renal failure. To
      examine the effect of PTH on peripheral nerve function in renal failure in a more
      defined biochemical setting, we studied the changes in MNCV and nerve calcium
      content in dogs with and without excess PTH and with prolonged and similar
      duration of chronic renal failure (57 +/- 1.7 weeks) and comparable biochemical
      parameters. Dogs with chronic renal failure displayed a significant (P less than
      0.01) decrease in MNCV (before renal failure, 65 +/- 1.5 m/sec; after renal
      failure, 49 +/- 3.5 m/sec) and marked elevation in calcium content of peripheral
      nerve (444 +/- 45 mg/kg dry wt). These derangements were not observed in
      parathyroidectomized chronic renal failure animals; MNCV before renal failure was
      66 +/- 1.5 m/sec and after renal failure was 65 +/- 1.5 m/sec, and nerve calcium
      content after renal failure was 229 +/- 3 mg/kg dry wt. Also, parathyroidectomy
      of three dogs with preexisting chronic renal failure of 52 weeks was associated
      with reversal of the abnormalities in MNCV and calcium content of nerve despite
      an additional period of renal failure of 52 weeks in two of the dogs and 40 weeks
      in the third. Our data are consistent with the proposition that excess PTH plays
      a major role in the genesis of peripheral nerve dysfunction in chronic renal
      failure. This adverse effect of the hormone is most likely mediated by the PTH
      induced accumulation of calcium in peripheral nerve.

PMID- 2236104
TI  - Stimulation of radiation-impaired plasminogen activator release by phorbol ester
      in aortic endothelial cells.
AB  - Ionizing radiation has been reported to affect the fibrinolytic activity of
      exposed tissue. With cultured bovine aortic endothelial cells, radiation
      suppresses the release of plasminogen activator to the conditioned media, with a
      concomitant increase in intracellular plasminogen activator. Thus study was
      undertaken to determine whether radiation-impaired plasminogen activator release
      can be modified by phorbol ester. We exposed cultured bovine aortic endothelial
      cells to a sterilizing dose of 10 Gy of gamma-rays and found the treatment led to
      cell injury, as evidenced by an increased release of prelabeled chromium, and to
      a reduction of plasminogen activator in the conditioned media with elevated
      intracellular plasminogen activator in irradiated cells. Phorbol ester enhanced
      plasminogen activator activity in both sham-irradiated and irradiated endothelial
      cells. It was interesting to note that the increased plasminogen activator in
      phorbol ester-stimulated sham-irradiated cells was largely retained inside the
      cell, while it was released to the conditioned media in irradiated cells.
      Apparently, altered plasminogen activator activity of radiation-sterilized
      endothelial cells can be modified by exogenous stimuli.

PMID- 2236105
TI  - The effect of dietary protein source on manganese bioavailability to the rat.
AB  - Rats were fed diets containing 20% protein from casein, beef, chicken, tuna, or
      soybean. All diets contained 15% fat and were supplemented with limiting amino
      acids as necessary to meet National Research Council requirements. In Experiment
      1, the manganese content of all diets was the same; manganese content was 5
      mg/kg. In Experiment 2, a basal (adequate) level of minerals was provided in each
      diet but total mineral content varied depending on the contribution of the
      protein source; manganese was added to achieve a concentration of 5 mg/kg. In
      both experiments, 54Mn absorption was greatest from tuna (8.54% and 7.71%) and
      least from beef (4.57% and 4.14%) (P less than 0.0001). In both experiments,
      biologic half-life of 54Mn was longest in rats fed beef (18.5 and 26.9 days) and
      shortest in rats fed soy (14.5 and 16.2 days) (P less than 0.0002). Except for
      beef, biologic half-life was similar for dietary groups between the two
      experiments. In Experiment 1, only kidney manganese concentration was
      significantly affected by diet and was highest in soy-fed animals. In Experiment
      2, plasma, kidney, and liver manganese were all significantly affected by diet
      and were highest in soy-fed animals and lowest in beef-fed animals.

PMID- 2236106
TI  - Heparin mediates transmembrane potassium transfer in hyperkalemic dogs.
AB  - Unheparinized, ureter-ligated control dogs that are potassium loaded, i.e.,
      infused with 2 mEq of KCl/kg until prelethal electrocardiographic changes of
      hyperkalemic cardiotoxicity appear (end point), transfer 57 +/- 4% (1.7 +/- 0.1
      mEq/kg) of administered potassium to intracellular fluid. Heparinized controls
      transfer 73 +/- 1% (3.2 +/- 0.2 mEq/kg); with simultaneous alpha-adrenoreceptor
      blockade, that proportion increases to 81 +/- 2% (4.80 +/- 0.7 mEq/kg) and with
      simultaneous beta-receptor blockade it is 58 +/- 3% (1.1 +/- 0.1 mEq/kg). In
      potassium loaded, ureter-ligated dogs, heparin increases transmembrane potassium
      transfer as effectively as does a dosage of atropine large enough to cross the
      blood-brain barrier and its influence on potassium transfer, like that of
      atropine, is suppressed by beta-adrenoreceptor blockade.

PMID- 2236107
TI  - Relaxin, oxytocin, and prostaglandin effects on progesterone secretion from
      bovine luteal cells during different stages of gestation.
AB  - To determine the effects of relaxin, oxytocin, and prostaglandin F2 alpha on
      progesterone secretion, bovine luteal cells from different stages of gestation
      were dispersed in Medium 199 with 200 units/ml penicillin, 1.0% kanamycin, 0.5%
      bovine serum albumin, and 400 units/ml collagenase. Cells (10(5) were cultured in
      400 microliters of Dulbecco's modified Eagle's medium and Ham's F-12 medium
      containing fetal bovine serum and antibiotics, in Falcon multiwell plates, in a
      humidified environment of 95% O2 and 5% CO2 at 37 degrees C. Cells were cultured
      for 24 hr without treatment and thereafter with medium-hormone replacement every
      24 hr. Progesterone was quantified from unextracted media by radioimmunoassay.
      Basal progesterone secretion after 24 hr was 1.81 +/- 0.14, 1.76 +/- 0.17, 0.54
      +/- 0.49, and 0.57 +/- 0.21 pg/ml per viable luteal cell from 145-, 165-, 185-,
      and 240-day-old corpora lutea, respectively. Basal progesterone secretion
      increased (P less than 0.05) with time in culture. Relaxin induced a dose
      dependent (greater than 100 ng/ml) increase in progesterone release, compared
      with the controls. Oxytocin and prostaglandin F2 alpha induced greater release (P
      less than 0.05) of progesterone than relaxin at all stages of gestation, but
      progesterone release was dependent on the stage of gestation and the duration in
      culture. Luteinizing hormone (100 ng/ml) stimulated whereas 17 beta-estradiol (50
      ng/ml) inhibited progesterone secretion by luteal cells at all stages of
      gestation examined. Relaxin obliterated the prostaglandin- and oxytocin-induced
      progesterone secretion by bovine luteal cells from 145 to 214 days of gestation.
      Thus, relaxin, cloprostenol, and oxytocin regulate progesterone production by
      cultured bovine luteal cells, but hormone secretion was dependent on the stage of
      gestation.

PMID- 2236109
TI  - Bile acids in rat serum as indicators of hepatotoxicity by hornet venom.
AB  - The effect of hornet venom sac extract (VSE) on hepatic function in rats was
      evaluated by measurement of bile acid (BA) levels. A significant dose-dependent
      elevation of BA in rat serum upon repeated VSE administration was found. Rats
      envenomed for 2 weeks showed a significant rise of serum BA compared with the
      controls or with rats envenomed for 6 days. In rats envenomed for 1 week and
      killed after another week without envenomation, an improvement of the biochemical
      status was observed. These observations demonstrated that BA levels reflect the
      VSE-induced hepatic injury. They suggest that the cholestatic effects of VSE may
      be due to an impairment of bile acid excretion, but the elevations could also
      reflect parenchymal hepatic injury.

PMID- 2236108
TI  - Dietary palmitic acid (16:0) enhances high density lipoprotein cholesterol and
      low density lipoprotein receptor mRNA abundance in hamsters.
AB  - In order to examine the qualitative effect of different fats and specific fatty
      acids on plasma lipids and lipoprotein metabolism, six low fat, cholesterol-free
      diets were fed to young male hamsters (10/group) for a 4-week period. Fat blends
      were formulated with coconut oil, palm oil, soybean oil, high oleic acid
      safflower oil, butter, corn oil, and canola oil. Diets contained 13% energy as
      fat and dietary polyunsaturate/saturate ratios ranged from 0.12 to 1.04, one of
      which incorporated the American Heart Association-recommended concentrations of
      saturates, monoenes, and polyenes and another reflected the current American Fat
      Blend. In three diets the polyunsaturate/monounsaturate/saturate ratio was held
      constant while only the 12:0, 14:0, and 16:0 were varied. Plasma lipoproteins and
      apoproteins were assessed in conjunction with the abundance of specific hepatic
      and intestinal mRNA for the low density lipoproteins (LDL) receptor and various
      apolipoproteins associated with cholesterol metabolism. The plasma cholesterol
      response was lowest with the American Heart Association blend and equally
      elevated by the more saturated, low polyene diets (polyunsaturate/saturate, 0.12
      0.38). Replacing 12:0 plus 14:0 from coconut oil with 16:0 as palm oil induced a
      significant increase in high density lipoprotein (HDL) cholesterol with a trend
      toward decreased LDL. These shifts in lipoprotein cholesterol were corroborated
      by measures of the LDL/HDL ratio, the plasma apolipoprotein B/apolipoprotein A1
      ratio, and differences in the synthesis of apolipoproteins and the LDL receptor
      based on estimates of the mRNA for these proteins in the liver and gut, using
      specific cDNA probes for apolipoprotein A1, apolipoprotein B, apolipoprotein E,
      and the LDL receptor. Although it has been suggested that dietary polyenes lower
      total plasma cholesterol, including HDL, and that saturated fat increases both
      these pools of cholesterol, the current data represents the first evidence that a
      specific saturated fatty acid, i.e., palmitic acid, may enhance HDL production.

PMID- 2236111
TI  - Can hypoglycaemic attacks be avoided?

PMID- 2236112
TI  - A better life than before--quality of life in people with renal failure.
AB  - We take it for granted that one of the objectives of nursing is to improve
      patients' quality of life, but this is notoriously difficult to define. A surgery
      of renal patients revealed some surprising results of what they considered to
      constitute quality of life, with implications for the future of nursing care.

PMID- 2236113
TI  - A case for accuracy--monitoring blood pressure.

PMID- 2236110
TI  - Two separate differentiation inducing proteins for human myeloid leukemia cells
      and their isolation from normal lymphocytes.
AB  - Conditioned medium from mitogen stimulated normal peripheral blood lymphocytes
      (PBL) has been demonstrated to contain a maturation inducer activity mediating
      the differentiation of human myeloid leukemia cells to monocytes and macrophages.
      The maturation inducer activity was isolated by salt precipitation, Sepharose CL
      6B ion exchange and affinity chromatographies and electrophoresis. Two separate
      activities with M.W. ranges of 52-56 and 32-35 kDa capable of mediating the
      terminal differentiation of leukemic HL-60 promyelocytes to monocytes and
      macrophages were detected. The higher molecular weight species was determined to
      be a 54 kDa single polypeptide and was found to be distinct from IL-3 and IL-6 by
      ELISA and differentiation blocking assay. The inducing activity of the 32-35 kDa
      material was largely neutralized after treatment with anti-IL-3, but not with
      other antibodies. Employing the immunofluorescent antibody technique, the 54 kDa
      protein was detected on the surface membranes of PBL. The proportions and number
      of maturation inducer bearing lymphocytes in patients with acute myelogenous
      leukemia (0.4% and 35/mm3, respectively) were significantly lower than that of
      healthy donors (7.9% and 178/mm3) The role of these physiological factors in
      leukemia cell differentiation is discussed.

PMID- 2236114
TI  - Responding to a human need--lecturer-practitioner in human sexuality.
AB  - It is well known that illness can have a traumatic effect on sexuality. Lecturer
      practitioners in sexuality help people come to terms with this, and help nurses
      respond more effectively.

PMID- 2236115
TI  - Good food for long life--nutrition for elderly people.
AB  - As the body changes with age, elderly people can become vulnerable to the threat
      of malnutrition. Nurses can help point out any danger signs, showing them the way
      towards a healthy and accessible diet.

PMID- 2236116
TI  - Time to hand over the baby--parental care of the preterm infant.
AB  - Parents of babies in neonatal units often feel distanced from their baby, saying
      there is nothing they can do to help. Staff in NNUs must help involve parents in
      the care of their baby, to soothe qualms about discharge.

PMID- 2236117
TI  - If your baby is in a neonatal unit.

PMID- 2236118
TI  - Getting by without the poultices.

PMID- 2236119
TI  - Consider the mind as well as the body. Nursing care and support in multiple
      sclerosis.

PMID- 2236120
TI  - Spatial distribution of taurine in the teleost retina and its role in retinal
      tissue regeneration.

PMID- 2236121
TI  - Nervous tissue growth and differentiation: taurine effect on polyamine
      metabolism.

PMID- 2236122
TI  - Effect of glutamyltaurine on calcium influx in cultured cerebellar granule cells.

PMID- 2236123
TI  - Taurine interactions with ionic conductances in excitable membranes.

PMID- 2236124
TI  - Effects of taurine on mammalian skeletal muscle fiber during development.

PMID- 2236125
TI  - The interaction between taurine, calcium and phospholipids: further
      investigations of a trinitarian hypothesis.

PMID- 2236126
TI  - Inhibitory and stimulatory effects of structural and conformational analogues of
      taurine on ATP-dependent calcium ion uptake in the rat retina: deductions
      concerning the conformation of taurine.
AB  - A number of novel analogues of taurine were tested in a rat retinal preparation
      for their stimulatory or inhibitory activity in the ATP-dependent calcium ion
      uptake system at low calcium ion concentration. While the structural requirements
      for maintaining biological activity were quite limited, certain sulfone
      derivatives of taurine were observed to be more potent stimulators of calcium ion
      uptake than taurine. Utilization of multiple effectors in the uptake system was
      also analyzed. The effects of all combinations of taurine plus analogue that were
      tested were demonstrated to be mutually exclusive, that is, the compounds have
      similar modes of action. When two inhibitors, TAPS and THQS, were tested in
      combination, kinetic evaluation of the data suggested that both of these
      compounds also have a similar mode of action (mutually exclusive) with respect to
      each other. The inhibitors, TAPS and THQS, were also observed to be non
      competitive with respect to taurine thus suggesting that they do not bind to the
      same site as taurine.

PMID- 2236127
TI  - Modulation of cardiac Ca++ current by taurine.

PMID- 2236128
TI  - Immunocytochemical visualization of taurine-containing and taurine-synthesizing
      cells.

PMID- 2236129
TI  - Regulation of calcium homeostasis by taurine: role of calmodulin.

PMID- 2236130
TI  - Calciumdiacetylhomotaurinate (CA-AOTA) decreases the action of excitatory amino
      acids in the rat neocortex in vitro.

PMID- 2236131
TI  - Uptake and release of taurine--an overview.

PMID- 2236132
TI  - Taurine: uptake by platelets and plasma concentration of patients with Spielmeyer
      Vogt disease.

PMID- 2236133
TI  - Chloride-dependent amino acid transport in synaptic membrane vesicles.

PMID- 2236134
TI  - Taurine transport and cell volume regulation in a mammalian cell.

PMID- 2236135
TI  - A developmental and functional study on taurine-like immunoreactivity in the rat
      retina.

PMID- 2236136
TI  - Characteristics of taurine release from astroglial cells.

PMID- 2236137
TI  - Ionic and voltage requirements for tubular taurine transport.

PMID- 2236138
TI  - Taurine and mechanisms of cell volume regulation.

PMID- 2236139
TI  - Acclimation to hyper- and hypo-osmotic changes: the anomalous behavior of taurine
      in the nervous system and in the blood of vertebrates.

PMID- 2236140
TI  - Derangements in cerebral osmohomeostasis: a common denominator for stimulation of
      taurine and phosphoethanolamine release.

PMID- 2236141
TI  - Osmotic sensitivity of isoproterenol- and high-[K+]o-stimulated taurine release
      by cultured astroglia.

PMID- 2236142
TI  - Possible osmoregulatory role of taurine in the cellular swelling evoked by weak
      organic acids in the rat hippocampus.

PMID- 2236143
TI  - Taurine release associated to cell swelling in the nervous system.

PMID- 2236145
TI  - Taurine deficiency.

PMID- 2236146
TI  - Effects of taurine depletion on excitable tissues: recent studies.

PMID- 2236144
TI  - Is taurine involved in cerebral osmoregulation?

PMID- 2236148
TI  - Taurine deficiency myocardial failure in the domestic cat.

PMID- 2236147
TI  - Visual cortex development in rhesus monkeys deprived of dietary taurine.

PMID- 2236149
TI  - Evaluation of immunity in taurine-deficient cats.

PMID- 2236150
TI  - The effect of dietary taurine on feline reproduction and outcome.

PMID- 2236152
TI  - Taurine levels in brain nuclei of young adult and aging rats.

PMID- 2236151
TI  - Homeostatic and protective effects of taurine.

PMID- 2236153
TI  - Influence of dietary sulfur-containing amino acids on renal function and
      metabolism of calcium and taurine in chronic renal failure.

PMID- 2236154
TI  - Central antihypertensive effect of taurine.

PMID- 2236155
TI  - Tauret: further studies of the role of taurine in retina.

PMID- 2236157
TI  - Taurine and volume regulation in fish cells.

PMID- 2236156
TI  - Mitochondrial stability in taurine perfused, hypoxic bovine eye.

PMID- 2236158
TI  - Cysteine sulfinic acid decarboxylases (CSD) in the brain.

PMID- 2236159
TI  - Does taurine bind to the insulin binding site of the insulin receptor?

PMID- 2236160
TI  - Modelling the effect of chemotherapy intensity.

PMID- 2236161
TI  - Comments on kinetics and biology of the residual cancer, and on relevant
      therapeutic strategies based on these phenomena.

PMID- 2236162
TI  - Intraperitoneal chemotherapy for peritoneal carcinomatosis from colonic or
      appendiceal cystadenocarcinoma: rationale and results of treatment.
AB  - The natural history of cystadenocarcinoma of colonic or appendiceal origin was
      reviewed. This tumor represents a minimally invasive mucus producing tumor
      similar to what is commonly recognized within the bowel lumen as villous adenoma.
      This tumor is usually at an advanced stage at the time of presentation, and tends
      to recur at the site of tumor resection and on peritoneal surfaces. The fact that
      this tumor does not metastasize hematogenously or lymphatically nor does it
      invade locally was contrasted to its marked tendency to implant on all abdominal
      surfaces. The large variations in the efficiency of different types of tumor
      dissemination (metastases, invasion, and spread by implantation) need to be noted
      for this malignant process. The unique clinical features of cystadenocarcinoma
      were reviewed and the particular suitability of intraperitoneal chemotherapy for
      its treatment was discussed. Our treatment plan utilizing cytoreductive surgery
      and early plus delayed postoperative intraperitoneal chemotherapy was presented.
      The surprisingly good results of treatment was discussed. The effects of
      chemotherapy on tumor histology were presented in detain in six patients. Changes
      induced by intraperitoneal chemotherapy included a reduction in the number of
      foci of atypical adenomatous epithelium and marked cytologic atrophy. This plan
      of treatment is recommended for patients to prevent or to treat the spread of
      mucinous gastrointestinal cancer on peritoneal surfaces and within the resection
      site of the primary tumor.

PMID- 2236163
TI  - Autologous bone marrow transplantation for hematologic cancer.
AB  - In summary, autologous BMT is emerging as a way to deliver myeloablative therapy
      to patients with hematologic cancer ineligible for allogeneic BMT. Moreover,
      there are likely circumstances in which autologous is preferable to allogeneic
      BMT--most notably in Hodgkin's disease, but likely also in the older adult acute
      leukemia patient. Work is clearly required to produce upgraded conditioning
      regimens, and to define the need for and utility of marrow purification
      procedures. However, these pressing needs should not obscure the benefits of the
      current use of autologous BMT techniques for selected patients--nor prevent the
      realization that improved patient selection is the most immediate method to
      improve current results.

PMID- 2236164
TI  - Dose intensification using combination alkylating agents and autologous bone
      marrow support in the treatment of primary and metastatic breast cancer: a review
      of the Duke Bone Marrow Transplantation Program experience.

PMID- 2236165
TI  - Tumor treatment and cytokines.
AB  - In summary, molecular biology and advances in biochemical and biological
      techniques have led to the rapid characterization of a large number of cytokines.
      These are released in response to injury or invasion of the body and regulate the
      growth and function of a broad variety of cell types. Many cytokines are now in
      clinical trials and show promise in modulating the defence and repair responses
      of the body. The direct application of these cytokines to the killing of tumor
      cells remains problematic. However, it does seem likely that the use of these
      substances in a para-physiological mode i.e. in activating defence mechanisms and
      in particular stimulating hemopoetins may be a very important adjunct to more
      conventional means of tumor therapy such as chemotherapy or radiotherapy. The
      hemopoietic growth factors show particular promise here, although other
      substances such as IL-1 or IL-6 may find similar applications. In the future more
      information on the direct role of cytokines in the development of particular
      tumors may lead to the development and use of cytokine antagonists with effects
      directed at tumor cells or their environment.

PMID- 2236166
TI  - Dose intensity studies in breast cancer--autologous bone marrow transplantation.

PMID- 2236167
TI  - Use of granulocyte-macrophage colony stimulating factor (GM-CSF) to support
      intensive chemotherapy.

PMID- 2236168
TI  - Induction of secondary neoplasms by the treatment of malignant disease: lessons
      from Hodgkin's disease.

PMID- 2236169
TI  - Overview of adjuvant radiotherapy for breast cancer.

PMID- 2236170
TI  - Measuring quality of life.

PMID- 2236172
TI  - Comments on future developments of cancer therapy. Taking into consideration
      tumor biology and kinetics. Part II.

PMID- 2236171
TI  - Chemotherapy schedules: impact on treatment outcomes and quality of life.

PMID- 2236173
TI  - The biological basis for interleukin-2 anticancer therapy.

PMID- 2236174
TI  - The growth kinetics of clonogenic tumor cells that survive radiation therapy.

PMID- 2236175
TI  - Microenvironmental changes in irradiated tumors.

PMID- 2236176
TI  - The nature of tumour hypoxia: implications for therapy.

PMID- 2236177
TI  - Integrating the concept of dose intensity into a strategy for systemic therapy of
      malignant disease.

PMID- 2236179
TI  - Thin layer densitometry in the quantitative assay of drugs. Note V--Assay of
      reserpine and chlorthalidone in the presence of the potential impurities of their
      solid pharmaceutical forms.
AB  - Densitometric detection of compounds separated by thin layer was applied to the
      assay of a mixture of reserpine and chlorthalidone and their possible impurities.
      The method of analysis gave satisfactory results in the quality control of
      pharmaceutical preparations. Good results were obtained in urine tests for the
      detection of chlorthalidone, reserpine and methylreserpate. The times for the
      development of fluorescence in reserpine and methylreserpate directly in the
      chromatographic plate, are also described.

PMID- 2236178
TI  - [The effect of food intake on drug action].
AB  - Interactions between medicaments and food are only incompletely documented-
      despite their frequent occurrence. Food can influence the effect of medicaments
      in a variety of ways: the effect of the medicament can be delayed or weakened; in
      some cases the effect may also be increased. The interactions between the
      kinetics of medicaments and food are described in the present survey. The
      absorption conditions in the stomach and small intestine are influenced
      physiologically and chemically by food. In very rare cases the elimination of
      active ingredients too can be modified by the quality and quantity of the food.
      Detailed knowledge about the physical-chemical properties of the medicaments used
      help to optimize the pharmacotherapy in the individual case. For the patient, the
      easiest suggestion to follow would be to take the medicaments with plenty of
      water and always at the same time.

PMID- 2236180
TI  - [Synthesis and anticonvulsant properties of sugar triazene N-oxides].
AB  - In this paper we describe a high-yielding method leading to a novel family of
      sugars: the sugar triazene N-oxides. The anticonvulsant effect of one of these
      compounds was tested. It showed a promising activity indicating the potential
      therapeutic usefulness of this class of carbohydrate derivatives.

PMID- 2236181
TI  - Comparison of colourimetric methods for ammonia determination.
AB  - The precision of the Berthelot and Nessler methods of ammonia determination are
      compared at various ammonia concentrations. Recommendations are made regarding
      the most appropriate technique to use, dependent on the range of ammonia
      concentration expected. The effect of microdiffusion separation on the precision
      of ammonia determination is studied, together with an evaluation of a water
      soluble lid sealant and of the effect of a model amine contaminant.

PMID- 2236182
TI  - Effect of beta-cyclodextrin on the in vitro permeation rate and in vivo rectal
      absorption of acetaminophen hydrogel preparations.
AB  - The amounts of beta-cyclodextrin and hydroxyl propyl methyl cellulose (HPMC)
      affecting the in vitro permeation rate of acetaminophen containing in both
      aqueous solutions and HPMC hydrogel preparations through the dialyzer tubing and
      isolated rat rectum were investigated. The partition coefficient of acetaminophen
      with or without beta-cyclodextrin in water/n-octanol system was also studied. In
      vivo absorption experiments of these test formulations were carried out by rectal
      administration in rats. The results indicate that the concentrations of beta
      cyclodextrin and HPMC used decreased the amount permeated of acetaminophen from
      both test formulations. The more the amount of beta-cyclodextrin or HPMC the
      slower the permeation rate of acetaminophen. The permeation rate of acetaminophen
      through the dialyzer tubing was higher than that of acetaminophen through the
      isolated rat rectum. The result also shows beta-cyclodextrin and HPMC markedly
      reduced the in vivo bioavailability of acetaminophen from both test formulations.
      The lower partition coefficient and the higher hydrophilic properties of beta
      cyclodextrin inclusion complex, and the higher viscosity of HPMC hydrogel matrix
      might be responsible for decreasing the in vitro permeation rate and depression
      of in vivo rectal absorption of acetaminophen. The in vitro permeation data was
      well correlated with in vivo absorption results, suggesting that the in vitro
      permeation study regardless of the dialyzer tubing method or the isolated rat
      rectum method might be used to estimate the in vivo rectal absorption of
      acetaminophen.

PMID- 2236183
TI  - [Dietetic use of red sugarbeet pigment--effervescent tablets].

PMID- 2236184
TI  - [Spectrum analysis and thermal behavior of P.E.G. 6000 in the presence of
      antipyrine or pyramidon].

PMID- 2236185
TI  - [The Pharmaceutical Institute in Berlin. The development of pharmaceutical
      education to the present professional pharmacy].

PMID- 2236186
TI  - [Pharmacy history--a science with two histories].

PMID- 2236187
TI  - [Hermann Thoms and the pharmaceutical-chemical literature].

PMID- 2236188
TI  - [Pharmacy research by Schering: a good foundation for the next century].

PMID- 2236189
TI  - [Synthetic drugs of abuse of the second generation (so-called designer drugs). 2.
      Analysis of arylalkylamines (amphetamine)].

PMID- 2236190
TI  - [Platelet activating factor--a biologically active phospholipid].

PMID- 2236191
TI  - Nonsteroidal antiinflammatory agents. Part 20(3): Optically active thienyl
      biphenylyl-hydroxypropionic acids.
AB  - The optically active diastereometric erythro- and threo-3-thienyl-analogues 6a-d
      of 3-aryl-2-biphenylyl-3-hydroxy-propionic acids have been prepared. Some
      stereoisomers of 3-(3-thienyl)derivative 6b showed inhibition around 40% in the
      carrageenan-induced rat paw edema test.

PMID- 2236193
TI  - [Computer-aided differential thermal analysis of drugs].
AB  - An open-loop on-line computer connection to a DTA apparatus of high time constant
      and the developed software for data acquisition and utilization are described.
      The new system was calibrated thermomentrically and calorically. The main aim is
      a enhanced purity estimation, especially by using of the modified Van't Hoff
      equation based on DTA curves, which first must be transformed to process-power
      curves. Computer aided DTA provides utilization of higher quality and makes them
      faster and more exactly. Plotting of DTA curves which are baseline corrected and
      constructed as mean of equal curves as well as zooming are powerful and essential
      tools in optical comparison. The better estimation of the baseline under the peak
      and the computation of process-power-curve from DTA curve enable estimations
      based on curves of DTA apparatus' with high time constant as like as bases on DSC
      curves.

PMID- 2236192
TI  - Synthesis and pharmacological activity of 2-alkylthio substituted thieno[2,3
      d]pyrimidine-4-one and 5H-pyrimido [5,4-b]indol-4-one.
AB  - Quaternary salts of several 2-alkylthio substituted derivatives of thieno [2,3
      d]pyrimidin-4-one and 5H-pyrimido [5,4-b]indol-4-one with a basic group in
      position 2 of the alkyl chain were synthesized and screened for potential
      spasmolytic activity. These substances were prepared by condensation of the
      corresponding mercapto compounds with a 2-chloroalkyltertiary amine. The tertiary
      bases were quaternized with methyl iodide. Among the assayed compounds, the
      thieno [2-3-d]pyrimidin-4-one derivatives displayed a potent spasmolytic activity
      in the in vitro and in vivo assays.

PMID- 2236194
TI  - Percutaneous diffusion of cefalexin, sulfamethoxazole and diphenhydramine from
      ointments.
AB  - The effects of ointment base, drug concentration, and the presence of surfactant
      on the diffusion of cefalexin, sulfamethoxazole and diphenhydramine through
      excised mouse skin were studied. The total amount of diffused drug per ml against
      time and against the square root of time as plotted for the evaluation of
      results. As was expected from theory, a linear relationship was obtained for each
      drug when the square root of time was employed. The effect of the vehicle on the
      release of cefalexin was in the following decreasing order: o/w emulsion greater
      than water-soluble greater than hydrophilic greater than oleaginous greater than
      w/o emulsion base. That on the release of sulfamethoxazole was in the order:
      water-soluble greater than o/w emulsion greater than w/o emulsion = oleaginous =
      hydrophilic. The order in case of diphenhydramine was as follows: o/w emulsion
      greater than water-soluble greater than hydrophilic greater than oleaginous = w/o
      emulsion. The increase in drug concentration or the addition of a surfactant has
      caused an increase in the diffusion rate of each of the drugs.

PMID- 2236195
TI  - [Is the estimation of the activity of MTT-reduction suitable for the
      determination of basal cytotoxicity?].
AB  - The influence of 19 substances on the reduction of thiazolyl-blue (MTT) by
      cultivated calf aortic endothelial cells was studied. The substances tested could
      be classified into three groups. The first one includes drugs without significant
      effect on the reduction of MTT, the second one inhibits these reaction only
      weakly (less than 50%) and 10 substances of the third group showed an inhibition
      rate greater than 50%. There is no statistical reliability in the correlation
      between the IC50-values of the substances studied in the MTT-test and their LD50
      values (mouse, per os). The MTT-test does not permit the estimation of the basal
      cytotoxicity but only the inhibition of the activity of succinate dehydrogenase
      and the cytochrome c/c1-complex of the respiration chain of cultivated
      endothelial cells.

PMID- 2236196
TI  - [Judicial protection of monoclonal antibodies].
AB  - The possibility for GDR application for a patent of monoclonal antibodies are
      discussed in detail. Antibodies can be used advantageously as diagnostica. Basic
      suppositions for true patents in this field e.g. sufficient manifestation of the
      invention, newness and ingenious performance are referred. Possible algorithms
      for the formulation of the claims are given.

PMID- 2236197
TI  - [In vitro liberation of sulfadimidine from granulations and capsules].

PMID- 2236198
TI  - [Pharmaceutical and biopharmaceutical evaluation of
      acetylaminonitropopoxybenzolum (Falimint). 10. Biotransformation of the active
      substance in chick embryo and in in vitro systems].

PMID- 2236199
TI  - [Comparative study of serum levels of salicylic acid after oral administration of
      salicin and sodium salicylate in rats].

PMID- 2236200
TI  - [Comparative structure-activity and structure-toxicity of a series of 2,4
      oxazolidinediones].

PMID- 2236201
TI  - [Toxicity of Aethusa cynapium L., hundspetersilie].

PMID- 2236202
TI  - Effect of 2-mercapto-ethanol on some brain biochemical characteristics and
      behavioural changes in the ageing CBA/Ca mice.
AB  - Male CBA/Ca inbred mice were treated with a dose of 8 micrograms 2-mercapto
      ethanol per animal per day in the drinking water from the age of 5 months onwards
      up to the age of 24 months. Dopamine release was greatly decreased in old animals
      in contrast to the elevation of dopamine release in the treated mice. Similarly,
      an elevated malondialdehyde content in brain homogenates was also observed in the
      aged treated animals compared with their controls. No essential differences were
      observed in locomotor activity and learning between treated an control mice.

PMID- 2236203
TI  - Effect of diltiazem on experimental coronary artery thrombosis in dogs.
AB  - The effect of the calcium channel blocker diltiazem on arterial thrombosis was
      determined in anesthetized dogs subjected to continuous anodal stimulation of the
      intimal surface of the left circumflex coronary artery (LCCA). Infusion of saline
      (n = 6) or diltiazem (80 micrograms/kg plus 20 micrograms/kg/min i.v.; n = 6) was
      begun 15 min before electrical stimulation. Diltiazem prolonged the P-R interval
      by 28% and reduced mean arterial blood pressure (ABP) by 9%. All animals
      developed occlusive thrombosis. Saline- and diltiazem-treated dogs did not differ
      in the time to occlusion (204 +/- 30 and 153 +/- 27 min, respectively) and LCCA
      thrombus mass (25 +/- 4 and 24 +/- 3 mg, respectively). LCCA flows measured
      intermittently during thrombogenesis also did not differ between treatment
      groups, although the frequency of spontaneous flow increases which interrupted
      the flow declines was reduced 53% by diltiazem. In separate diltiazem-treated
      dogs (80 micrograms/kg plus 20 micrograms/kg/min i.v. for 2 h; n = 7) the ex vivo
      platelet aggregation response to platelet-activating factor (PAF) was inhibited (
      45%), but not the response to collagen. When 5 and 25 mumols/l diltiazem was
      tested in vitro, again the aggregation response to PAF was reduced (-25 and -81%,
      respectively) while that to collagen was unaffected. These results demonstrate
      that diltiazem does not impede thrombus formation in vivo when given at a dose
      that exerts threshold hemodynamic activity and significantly impairs platelet
      function.

PMID- 2236204
TI  - Physics of thermal processes in laser-tissue interaction.

PMID- 2236205
TI  - Monte Carlo calculation of conversion factors for the estimation of mean
      glandular breast dose.
AB  - The IPSM report on the commissioning and routine testing of mammographic x-ray
      systems recommends that breast dose be specified as the mean dose to the
      glandular tissues within the breast and gives the size and compositions of a
      standard breast phantom for the comparison of doses. The dose to this standard
      breast phantom can be determined by measuring the incident air kerma to a Perspex
      phantom and applying appropriate multiplicative conversion factors. These
      conversion factors have been evaluated by Monte Carlo calculations for a wide
      range of mammographic x-ray spectra. Some factors are provided for a range of
      breast thicknesses to supplement existing tabulations. Results are also given for
      equivalent thicknesses of Perspex and breast tissue.

PMID- 2236206
TI  - Measurement of backscatter factors for low energy radiotherapy (0.1-2.0 mm Al
      HVL) using thermoluminescence dosimetry.
AB  - Significant discrepancies of up to 10% exist between backscatter factors (BSF)
      recommended in a recent IAEA dosimetry Code of Practice (1987) compared with
      those published in Br. J. Radiol. Supplement 17 (1983), for the x-ray quality
      range 0.1-2.0 mm Al HVL. In an attempt to resolve this discrepancy, BSFs have
      been measured using thermoluminescence dosimetry (TLD) with small lithium borate
      chips, in order to minimise displacement effects associated with the use of
      larger volume ionisation chambers. Although subject to uncertainties inherent in
      the TLD calibration and readout process, the results indicate that the BJR (1983)
      data overestimate BSFs in this quality range. Broad agreement with the IAEA data
      is indicated, for the limited number of x-ray qualities and field sizes used.

PMID- 2236207
TI  - Cross sections and partial kerma factors for elastic and inelastic neutron
      scattering from nitrogen, oxygen and calcium at En = 21.6 MeV.
AB  - The Studsvik high-resolution, low-background time-of-flight facility has been
      used to measure differential neutron scattering cross sections for nitrogen,
      oxygen and calcium at a neutron energy of 21.6 MeV. Angular distributions in the
      range 10 degrees-160 degrees have been measured for both elastic and inelastic
      scattering from some low-lying levels in the three nuclei. Angle-integrated cross
      sections have been determined by fitting Legendre polynomial expansions to the
      differential data. Partial kerma factors for elastic and inelastic scattering
      have been deduced from these fits. Analyses in terms of the spherical optical
      model and the distorted-wave Born approximation have provided information on
      potential parameters and deformations, which have been used to calculate cross
      sections and partial kerma factors. Comparisons have been made with other recent
      data sets and model predictions, as well as with the evaluated neutron data file
      ENDF/B-V.

PMID- 2236208
TI  - Field dependence of 19F NMR in rat bone powders.
AB  - The 19F NMR properties of fluoridated rat bone powder samples have been studied
      in several external magnetic fields. The results show a characteristic field
      dependence, related to the strength of chemical shift interactions compared to
      dipole-dipole interactions. While the free induction decay shape is relatively
      insensitive to the 19F bone mineral concentration, the spin-lattice relaxation
      time decreases with increasing 19F concentration. Multi-exponential spin-lattice
      relaxation processes indicate that there are at least two chemically inequivalent
      incorporation sites for fluorine in bone mineral. Evidence for clustering of 19F
      fluoride impurities in bone mineral is seen in Hahn echo experiments. Sample
      preparation and handling methods are shown to affect the values of some of the
      observed NMR parameters.

PMID- 2236209
TI  - Calculations of displacement corrections for in-phantom measurements with
      ionisation chambers for mammography.
AB  - Displacement corrections for in-phantom measurements with ionisation chambers for
      the purpose of mammography are large and represent a major correction to consider
      for dose determinations. Experimental data on displacement corrections depend to
      a large degree on the model used to extrapolate to zero cavity radius.
      Calculations of displacement correction factors using a Monte Carlo code are
      presented for different cavity shapes, i.e. spherical, cylindrical and disc-like,
      in various phantom materials simulating the average breast and breast composing
      tissues. In addition, the influence of wall material and depth in-phantom are
      studied. Exponential extrapolation to zero cavity radius should be performed to
      obtain the dose in homogeneous phantoms. Displacement corrections for photons as
      used in mammography seem compatible with geometrical considerations made
      previously. A discrepancy is found between depth-dose data derived from
      calculations and those found in experiments.

PMID- 2236210
TI  - An investigation of factors affecting the accuracy of in vivo measurements of
      skin pigments by reflectance spectrophotometry.
AB  - Factors affecting the accuracy of the in vivo measurement of cutaneous pigments
      and blood oxygenation by reflectance spectrophotometry have been examined. It was
      found that stray light, the amounts of haemoglobin and melanin, and the level of
      blood oxygenation all contributed to the measured reflectance and had to be taken
      into account when calculating quantitative indices of skin pigments. Measurements
      on isolated sheets of epidermis demonstrated that over 50% of normally incident
      radiation is transmitted in a forward direction within 17 degrees of the incident
      direction and approximately 20% is backscattered between 90 degrees and 180
      degrees out of the sample, approximately 6.0% of it by specular reflection at the
      surface. The effective optical pathlength in suspensions of whole red cells was
      found to be 7% greater than in simple solutions containing the same concentration
      of haemoglobin.

PMID- 2236211
TI  - Optical properties of normal and diseased human breast tissues in the visible and
      near infrared.
AB  - The optical absorption and scattering coefficients have been determined for
      specimens of normal and diseased human breast tissues over the range of
      wavelengths from 500 to 1100 nm. Total attenuation coefficients were measured for
      thin slices of tissue cut on a microtome. The diffuse reflectance and
      transmittance were measured for 1.0 mm thick samples of these tissues, using
      standard integrating sphere techniques. Monte Carlo simulations were performed to
      derive the scattering and absorption coefficients, as well as the mean cosine of
      the scattering angle. The results indicate that scatter exceeds absorption by at
      least two orders of magnitude. Absorption is most significant at wavelengths
      below 600 nm. The scattering coefficients lie in the range 30-90 mm-1 at 500 nm,
      and fall smoothly with increasing wavelength to between 10 and 50 mm-1 at 1100
      nm. The scattering coefficient for adipose tissue differs, in that it is
      invariant with wavelength over this spectral range. For all tissues examined, the
      scattered light is highly forward peaked, with the mean cosine of the scattering
      angle in the range 0.945-0.985. Systematic differences between the optical
      properties of some tissue types are demonstrated.

PMID- 2236213
TI  - Breathing exercises for the medical patient: the art and the science.
AB  - The art of breathing exercises can be traced to the late 1800s. In the past 10
      years, the increased demand for treatment for respiratory muscle failure of
      dysfunction has resulted in numerous studies evaluating methods of treatment or
      training. This article provides an overview of research and practice, focused on
      treating the medical patient experiencing dyspnea or loss of respiratory muscle
      strength and endurance.

PMID- 2236212
TI  - Relationship between trunk muscle torque and bone mineral content of the lumbar
      spine and hip in healthy postmenopausal women.
AB  - The purpose of the study was to determine the relationship between trunk muscle
      strength and bone mineral density (BMD). Fifty-six postmenopausal women, aged 38
      to 73 years, were examined. The BMD of lumbar vertebrae L2-4, the femoral neck,
      the Ward's triangle, and the greater trochanter was measured with dual-photon
      absorptiometry. Isometric and isokinetic torque and work measurements obtained on
      a trunk testing unit were used to assess trunk flexor and extensor strength.
      Correlation analysis demonstrated a statistically significant relationship
      between most trunk torque and work measurements and BMD. The trunk extensors
      generally provided higher correlations with BMD than did the trunk flexors, and
      the isokinetic extension torque values demonstrated higher correlations than the
      isometric extension values in every case. Linear backward-regression models,
      based on the subjects' weight and trunk flexor and extensor torque and work
      measurements, demonstrated multiple-correlation coefficients of .67, .58, .43,
      and .65 in predicting the BMD of the L2-4 region, femoral neck, Ward's triangle,
      and greater trochanter region, respectively. Estrogen therapy status did not
      affect the linear regression models. These data suggest a positive relationship
      in postmenopausal women between flexor and extensor torque values and BMD at the
      lower lumbar spine and proximal femur.

PMID- 2236214
TI  - What is empathy, and can empathy be taught?
AB  - Empathy is a commonly used, but poorly understood, concept. It is often confused
      with related concepts such as sympathy, pity, identification, and self
      transposal. The purposes of this article are to clearly distinguish empathy from
      related terms and to suggest that the act of empathizing cannot be taught.
      According to Edith Stein, a German phenomenologist, empathy can be facilitated.
      It also can be interrupted and blocked, but it cannot be forced to occur. What
      makes empathy unique, according to Stein, is that it happens to us; it is
      indirectly given to us, "nonprimordially." When empathy occurs, we find ourselves
      experiencing it, rather than directly causing it to happen. This is the
      characteristic that makes the act of empathy unteachable. Instead, promoting
      attitudes and behaviors such as self-awareness, nonjudgmental positive regard for
      others, good listening skills, and self-confidence are suggested as important in
      the development of clinicians who will demonstrate an empathic willingness.

PMID- 2236215
TI  - Effects of electromyographic processing methods on computer-averaged surface
      electromyographic profiles for the gluteus medius muscle.
AB  - The objective of this study was to demonstrate how two different linear envelope
      detectors, as used in the quantification of surface electromyographic (EMG)
      signals, can lead to differences in the properties of observed computer-averaged
      EMG profiles. Eight healthy male subjects, aged 24 to 32 years, participated in
      the study. Computer-averaged EMG profiles for the gluteus medius muscle were
      recorded at a free-walking cadence and at stepping frequencies of 78 and 120
      steps/min, using detectors with 3- and 25-Hz cutoff frequencies simultaneously.
      The 3-Hz filtered EMG profiles proved to be smoother, to exhibit a significantly
      lower cycle-to-cycle variability, and to have a greater time lag with respect to
      the original unprocessed EMG signal than the 25-Hz filtered EMG profiles. The
      observed intersubject variability also was lower for the 3-Hz filtered EMG
      profiles than for the 25-Hz filtered EMG profiles. The results indicate that
      comparison of EMG profiles recorded with different detectors is difficult. A
      standard detector may solve this difficulty.

PMID- 2236216
TI  - Twenty-Fourth Mary McMillan lecture. Camelot revisited: legacy of the physical
      therapy education program at Case Western Reserve University.

PMID- 2236217
TI  - A new single-stage step test for the clinical assessment of maximal oxygen
      consumption.
AB  - Assessments of cardiorespiratory fitness are important in any health-assessment
      program or routine involving variables that may be influenced by an individual's
      level of physical fitness or ability to sustain an exercise program. Recently, a
      new single-stage step test was introduced that uses a height-adjustable platform
      to normalize the height of stepping for individuals of varying stature. This
      computer program is designed to simplify the use of this test and to facilitate
      the implementation in clinical environments where equipment or time is limited,
      yet accuracy and validity are essential.

PMID- 2236218
TI  - Stimulating clinical research.

PMID- 2236219
TI  - Movement science and its relevance to physical therapy.

PMID- 2236220
TI  - A dynamical systems approach to motor development.
AB  - The study of motor development has long influenced the clinical practice of
      physical therapy. We first review the contributions and deficiencies of two
      traditional maturational and reflex-based models of motor development. Second, we
      describe basic principles of kinematic and kinetic analyses of movement and show
      how we have applied these techniques to understand infant stepping and kicking.
      Third, we propose a theory of motor development based on a dynamical systems
      perspective that is consistent with our infant studies. Finally, we explore the
      implications of the model for physical therapists.

PMID- 2236221
TI  - Animal models offer the opportunity to acquire a new perspective on motor
      development.
AB  - During much of this century, our views of motor development were greatly
      influenced by speculations as to the role of reflexes in the control of movement.
      However, recent work casts a new view regarding the organization and control of
      movement. In this article, a review of recent studies of motor development in
      neonatal kittens and chick embryos is provided. The results of these studies
      suggest that very early in development there is considerable potential for
      coordinated movement. The potential for coordinated movement may also exist in
      early human development. Whether coordinated movement is observed appears to be
      dependent on a number of variables. For example, mechanical factors emerging
      during movement may impose demands that restrict the expression of coordinated
      movement. One possible implication for the practice of physical therapy is that
      researchers and clinicians will need to precisely characterize and quantify
      movement variables to advance our knowledge of the processes driving development
      and to establish effective means for addressing the movement problems of a
      pediatric population.

PMID- 2236222
TI  - Life-span development in functional tasks.
AB  - A life-span concept of motor development is presented as a framework for
      interpretation of a series of studies of righting tasks. Beginning with the task
      of rising from the floor, the use of a component approach for movement pattern
      description and for the identification of developmental sequences of motor
      patterns is reviewed. Studies applying this approach to a wide range of age
      groups and to various functional righting tasks are discussed. Recent studies
      investigating factors related to movement patterns used to perform one of the
      righting tasks are also reviewed. Suggestions concerning the ways in which this
      information could be applied to physical therapy practice are included.

PMID- 2236224
TI  - Motivational considerations in physical activity involvement.
AB  - The purpose of this article is to examine movement science research on personal
      and social-environmental motivational influences in physical activity contexts.
      Motivation is defined as a process in which internal and external factors direct
      and energize thoughts, feelings, and actions. Motivation is described as a
      consequence of meaning, which is derived from a combination of personal and
      social factors, including personal goals or incentives, expectations of personal
      efficacy, movement-related perceptual and affective experiences, and social and
      physical features of the environment. Recent literature from sport and exercise
      psychology is presented on these variables, their determinants, and their
      consequences for choice, effort, persistence, and performance behavior in
      exercise and sport contexts.

PMID- 2236223
TI  - Changes in posture control across the life span--a systems approach.
AB  - In this article, a systems approach to the development of posture control across
      the life span and its integration with voluntary tasks such as walking is
      described. Research shows a clear cephalocaudal gradient in the development of
      postural responses. Postural muscle synergies develop appropriate temporal
      organization through experience in each new level of postural skill development.
      Sensory inputs contributing to posture control influence postural responses very
      early in development, with responses being elicited by vision alone, or by
      somatosensory and vestibular cues in isolation. Studies of older adults indicate
      small, but significant, increases in onset latencies and disruptions in the
      temporal organization of postural muscle responses when subjects are given
      external threats to balance. In addition, older adults, like young children, use
      antagonist muscles more often in coactivation with agonist muscles. Older adults
      also have more difficulty balancing when sensory inputs are reduced
      experimentally or pathologically. Ankle dorsiflexor muscle weakness is also a
      factor in balance dysfunction in the older adult.

PMID- 2236226
TI  - Dynamic pattern theory--some implications for therapeutics.
AB  - This article introduces the Dynamic Pattern Theory of movement coordination and
      discusses possible implications of the theory for therapy. Basic constructs such
      as order parameters and control parameters, fluctuations, time-scale relations,
      and self-organization are discussed. Emphasis is given to their potential use to
      assess the coordination of functional motor acts. The theory's predictions about
      how motor acts are organized and the implications of its tenets for motor
      learning and the recovery of motor function are described briefly. A number of
      implications derived from the theory may support treatment strategies already in
      place and provide new insights for the future development of such strategies.

PMID- 2236225
TI  - Information processing for motor performance in aging adults.
AB  - Movement control systems are altered by the aging process. A growing body of
      research exists that explains the known changes that occur with aging, and many
      of those changes are related to central nervous system (CNS) effects. This
      article reviews motor control and learning issues related to CNS information
      processing effects of aging and the effects of practice and physical conditioning
      on reactive capacity. The extensive variability in motor-performance abilities of
      older people is addressed, and the significance of individual differences is
      emphasized.

PMID- 2236227
TI  - Controlling stability of a complex movement system.
AB  - Human movement systems have frequently been treated as one-dimensional, single
      axis, rigid bodies in order to simplify the gathering, analysis, and
      interpretation of data. The problem with this approach is that the results of
      such assumptions often lead to conclusions about the production and control of
      movement that do not relate to the control demands placed on the central nervous
      system. In order to truly understand how the central nervous system plans and
      produces movements to match environmental demands, we must take into account the
      many variations available within the body. The purpose of this article is to
      examine two movement systems that have the potential to act in multiple spatial
      dimensions with variable muscle action patterns when performing a stabilizing
      task. Methods of analyzing how the systems operate under differing task
      constraints and results of the experiments will be presented. Hypothetical models
      that have been proposed to explain how complex movement systems operate will also
      be discussed.

PMID- 2236228
TI  - Coordination of posture and movement.
AB  - Movement is performed against a background of subtle postural adjustments that
      counteract destabilizing forces imposed by the movement. Despite the importance
      of these postural adjustments to the safe and efficient performance of movement,
      little is known about the properties of these postural accompaniments. The
      purpose of this article is twofold. First, it provides a review of properties of
      postural adjustments that accompany a variety of limb and trunk movements.
      Second, a schema for the coordination of posture and movement is proposed. This
      schema suggests that a central nervous system model of body dynamics is essential
      to anticipatory control of posture during movement.

PMID- 2236229
TI  - Sensorimotor contributions of the basal ganglia: recent advances.
AB  - In the last decade, a great deal of research has been aimed at ascertaining the
      manner in which the basal ganglia (BG) contribute to the control of movement. The
      formation of workable hypotheses, however, has been limited by the great variety
      of putative roles reported in the literature. Reported functions have often been
      in direct conflict. Recent developments, however, provide new perspectives from
      which to view seemingly discordant functions. Data reviewed in this article
      suggest a distinct anatomical topography within the BG, allowing for highly
      specialized subfunctions. In parallel, BG cellular activity has been found
      primarily in association with specific sensory and task-related dimensions
      relevant to particular movements. The multiple sensorimotor contributions of the
      BG therefore are not contradictory, but represent BG contributions within
      different functional contexts. These multiple roles of the BG offer particular
      clinical insights.

PMID- 2236230
TI  - [Digital subtraction varicography].

PMID- 2236231
TI  - [Dynamic model of the calf muscular pump].

PMID- 2236232
TI  - [Rehabilitation in peripheral vascular pathology].

PMID- 2236233
TI  - [Repercussions of venous diseases on the osteoarticular system of the lower
      extremities].
AB  - Two centuries ago, a leading light of phlebology (J.-L. Petit) wrote, "When
      ulcers, located beside bones, have been present for more than one year, the bones
      rot". Today, on the basis of many anatomical and radiological studies, this
      statement can be modified as follows: bone lesions may occur even before the
      onset of an ulcer; their nature is very variable and they are certainly more
      extensive in long-standing phlebopathies. In legs presenting open ulcers for more
      than 5 years, bone lesions are nearly always present but may not coincide with
      the location of the ulcer; the changes occur in the same way and follow the same
      pattern in post-phlebitic ulcer and in essential varices. Within the legs,
      notable reciprocal potentially pathogenic relationships are set up between the
      joints and the veins. These are more marked in the distal section of the limb
      than in the proximal section. It is therefore essential that at the first
      phlebological consultation, particularly in the presence of serious cutaneous
      lesions, an in-depth investigation should be carried out of the functional state
      of the osteoarticular system in order to be able to combine treatment of the
      venous pathology with a correct restoration of the hemokinetic pump.

PMID- 2236234
TI  - [Pneumatic pressure therapy of lymphedema in the lower limbs].

PMID- 2236235
TI  - [Venous pathology].

PMID- 2236236
TI  - [Arterial pathology].

PMID- 2236238
TI  - [Investigations of function].

PMID- 2236237
TI  - [Lymphatic pathology].

PMID- 2236240
TI  - [Treatment of foot varices by ambulatory phlebectomy].

PMID- 2236241
TI  - [Doppler echography of the popliteal fossa and the calf, prior to ambulatory
      phlebectomy].

PMID- 2236242
TI  - [Venous endoscopy and ambulatory phlebectomy].

PMID- 2236239
TI  - [Local anesthesia in ambulatory phlebectomy by the method of R. Muller: risk
      assessment by lidocaine dosage].
AB  - Local anesthesia for ambulatory phlebectomy makes it necessary to inject a
      considerable quantity of lidocaine. This study involved 50 operations. The doses
      of lidocaine containing 1% adrenaline and injected after cooling (between 2 and 5
      degrees C) ranged from 200 mg to nearly 900 mg in a single administration. The
      assays of lidocaine in the peripheral venous blood were carried out by means of
      F.P.I.A. (Fluorescence Polarization Immuno Assay) at times 0, 30 min 60 min, 90
      min., 24 hours and 48 hours. The peak concentration obtained (1.8 micrograms/ml)
      for a dose of 700 mg in a subject weighting 65 kg, i.e. 10.9 mg/kg, was only one
      half the concentration considered to be neurologically toxic (4 to 12
      micrograms/ml) or one-twelfth of the toxic levels with regard to the
      cardiovascular system (24 micrograms/ml). The performance of local anesthesia in
      the physician's office is devoid of major risks, even though the doses used
      during AP are much higher than those usually administered in routine
      dematological surgery.

PMID- 2236244
TI  - [Personal experience with cryosurgery in varices].

PMID- 2236243
TI  - [The external pudendal veins. An anatomo-clinical study, their treatment by
      ambulatory phlebectomy (Muller method)].
AB  - Forty-one cases of E.P. varices (bilateral in 3 cases) were identified after
      examining 1371 patient histories followed up between 1985 and 1989 inclusive,
      i.e., 2.99 percent. Analysis of the history, clinical signs and Doppler and
      arguments based on the practice of ambulatory phlebectomy of the thighs made it
      possible to establish an accurate anatomical description of these somewhat poorly
      understood venous territories: simple or complex origin, principal or secondary
      saphenous ending and non-saphenous endings, supramelic, para-public, labial and
      perineal connections, extensions into other territories, defining major EP
      varicoses. Physical-pathological investigation can establish the frequently
      autonomous nature of these EP varicoses. The high incidence of primary reflux,
      their wide distribution along the varicose axes prolonged over 1 to 3 segments of
      the limbs, characterize the 37 cases of major EP varicosis. Therapeutic analysis
      reveals: the inadequacy of surgery and sclerosis in severe cases, the efficacy of
      ambulatory phlebectomy (A.P.) AP presents specific characteristics of method and
      bandaging related to the quality of the skin and venous tissue and the EP site.
      Thirty APs were carried out with very good anatomical, functional and aesthetic
      results.

PMID- 2236245
TI  - [The value of velocimetric investigation of the uterine arteries in retro
      placental hematoma. 3 cases].
AB  - Retro-placental hematoma is a sudden event with a serious prognosis which is
      aggravated by the very frequent absence of premonitory clinical, biological or
      ultrasonic signs. Does a velocimetric investigation of the uterine arteries have
      any predictive value in this disorder? The apparatus used was a continuous
      Doppler with spectral analysis and a 4 MHz probe no ultrasonic location. Each
      examination involved the exploration of 2 uterine arteries and of the umbilical
      flow. The method of recording the uterine arteries is described. Three cases of
      retro-placental hematoma are reported. In these three cases, an increase in the
      resistance index of one of the uterine arteries (the right artery in 2 cases and
      the left in 1 case) was detected with the presence of a protodiastolic notch on
      the trace, whereas the umbilical index itself was normal and no other sign was
      present which could predict the placental event. The value of the Doppler
      recording is already established in many obstetric indications, and these should
      be extended yet further, particularly if this preliminary study is confirmed on a
      larger scale.

PMID- 2236247
TI  - [Recommendations for standardizing the vocabulary and evaluation criteria in
      venous pathology (2nd part)].

PMID- 2236246
TI  - [Behavior of human endothelial cells in hyperoxia and hypoxia: effect of Ginkor
      Fort].
AB  - Recent discoveries have shown that venous diseases have a multifactorial
      etiology. One of the factors which is definitely involved in this pathologic
      process is the change in the concentration of oxygen. An increase in the
      concentration of oxygen, hyperoxia, or reoxygenation following hypoxia, damages
      the tissues by stepping up the production of free radicals. In addition, a
      reduction in oxygen concentration, or hypoxia, is also damaging, probably through
      a reduction in ATP synthesis. From a therapeutic standpoint, the veins, and more
      particularly the endothelium, must be protected against the impact on the tissue
      of these changes in oxygen concentration. In this study, the effects of Ginkor
      Fort were tested on cultured endothelial cells subjected to varying oxygen
      pressures. The results show that Ginkor Fort can provide good protection of
      endothelial cells against hyperoxia and hypoxia-reoxygenation. These beneficial
      effects are probably due to the presence of flavonoids in the Ginko biloba
      extract; these flavonoids have an anti-oxidant effect. In addition, this
      substance also protects the cells against hypoxia, possibly by increasing the
      availability of oxygen for ATP synthesis. This dual protective effect, which is
      produced by two different mechanisms, may account for the wide spectrum of Ginkor
      Fort in its use in venous diseases.

PMID- 2236248
TI  - In search of physiological principles: the use of animal diversity and novel
      technology. APS Specialty Meeting. Orlando, Florida, October 6-10, 1990.
      Abstracts.

PMID- 2236249
TI  - Role of integrative physiology in research programs of modern physiology
      departments.

PMID- 2236250
TI  - Minority recruitment physiology instruction on the Crow Indian Reservation.

PMID- 2236251
TI  - Salvation--it's just around the corner!

PMID- 2236252
TI  - Physiology in a South African homeland.

PMID- 2236253
TI  - Eric Liljencrantz Award.

PMID- 2236254
TI  - Effects of regional amygdaloid lesions on flight and defensive behaviors of wild
      black rats (Rattus rattus).
AB  - Flight and defensive behaviors of wild black rats (R. rattus) in response to
      nonpainful threatening stimuli were examined before and after regional amygdaloid
      lesions. Striking disruption of flight was found following damage to all major
      amygdaloid regions. In contrast, reduced defensiveness was most consistently
      associated with damage to cortical and, perhaps, central nuclei. The diffuse
      organization of flight behavior may result from extensive modality-specific
      cortical afferents to the amygdala and the varied provided by naturalistics
      threats. The more restricted representation of defensive attack may have resulted
      from diminished responsiveness to vibrissal stimulation mediated by medial and
      dorsomedial amygdaloid structures.

PMID- 2236255
TI  - The influence of maternal labels on dietary preferences of spiny mouse weanlings.
AB  - To assess the influence of conspecific chemical cues on the development of
      dietary preferences, spiny mouse (Acomys cahirinus) weanling were tested for
      their responses to food items that were partially eaten (thus, presumably
      labeled) by various categories of conspecifics. Consumption of a highly preferred
      novel food (fresh carrot) labeled by the pups' parents, or mother alone, was
      greater than that of a clean sample of the same food. The presence of labels
      emanating from the father or an alien mother had no effect on food consumption.
      Salient maternal labels that elicit preferential feeding by young appear to be
      individually unique, therefore allowing pups to recognize such cues emanating
      from their own mother. The attractive substance that mothers transfer to food
      items while eating (the maternal label per se) has not been identified, but
      saliva is a likely candidate.

PMID- 2236256
TI  - Brain structures important for solving a sawdust-digging problem in the rat.
AB  - Young rats subjected to bilateral lesions to one of 37 different brain sites were
      initially trained to traverse a narrow runway to reach a goal box containing
      water. The test involved blocking a portion of the runway with sawdust and
      determining whether the animals would burrow through the sawdust to gain access
      to the goal box. Lesions to 30 brain sites produced deficient performance on the
      sawdust-digging problem. This study, combined with earlier investigation of 11
      additional brain sites, shows that 41 of 48 total brain sites are involved in
      this task. These findings suggest that underlying brain mechanisms include a
      nonspecific mechanism and several specific mechanisms, such as visuospatial
      attentional, visual discrimination, vestibular-proprioceptive-kinesthetic
      discrimination, response flexibility, but much less place learning mechanisms.

PMID- 2236257
TI  - Learning and rhythmic human EMG in ecological perspective.
AB  - Previous evidence of strong interactions between learning and human treadmill
      locomotion led to a simplified system for studying learned rhythms in a framework
      of behavioral ecology. Motor control combined with instrumental conditioning in a
      rhythmic hand task with repeating trials, blocks, and complete regimens. Regimen
      contexts differed with respect to the pattern of stimulation before and after an
      electromyographic (EMG) response. Both an antecedent stimulus (a light flash) and
      a consequent stimulus (a tone indicating success or failure) were necessary for
      conditioning. Arguments were given for defining reinforcement as a composite of
      interdependent and size-scaled processes, some including knowledge of results,
      instead of as a single event after a response.

PMID- 2236258
TI  - Sleep and EEG spectra in the rabbit under baseline conditions and following sleep
      deprivation.
AB  - The 24-hr sleep-wake distribution and power spectra of the electroencephalogram
      were determined in rabbits that had been implanted with cortical and hippocampal
      electrodes. A diurnal preference for sleep was observed. The spectral power
      density in nonrapid eye movement sleep (NREM sleep) of the cortex showed a
      decreasing trend in most frequencies within the 12-hr light period. In the 12-hr
      dim period no clear trend was present. Most hippocampal EEG frequencies decreased
      in NREM sleep in the first two hours of the light period, and thereafter stayed
      on a constant level. Sleep deprivation elicited the following changes: a
      prolonged increase of NREM sleep and a short increase of REM sleep; in the
      cortex, an increase of slow-wave activity (SWA; power density in the 0.25-2.0 Hz
      frequency band) in NREM sleep, which declined in the course of recovery; an
      enhancement of slow-wave (1.25-3 Hz) and theta (6.25-7 Hz) activity in REM sleep.
      The hippocampus showed an increase in NREM sleep power density in almost all
      frequencies. In REM sleep the hippocampus exhibited an increase in power density
      in the 6.25-7 Hz and 12.25-13 Hz bands, whereas in the 7.25-8 Hz band the values
      were below baseline. The results show that SWA in NREM sleep and theta activity
      in REM sleep are enhanced by sleep deprivation, as has been observed in other
      mammalian species. The EEG changes in the hippocampus resembled those in the
      cortex.

PMID- 2236259
TI  - Startle-inducing acoustic stimuli evoke ultrasonic vocalization in the rat.
AB  - The present study demonstrates that acoustic stimuli which induce a startle
      response (ASR) also evoke ultrasonic vocalization in the rat. Sound recordings
      were done on three consecutive days of testing during sessions of 20 acoustic
      stimuli each and on the following day for three minutes following 5 acoustic
      stimuli (nonstimulus condition). Startle-inducing stimuli evoked continuous
      ultrasonic calling which was maintained throughout testing. Immediately following
      each acoustic stimulus, however, vocalization was interrupted by a period of
      silence (gap). The mean duration of sounds was reduced and the interpulse
      interval tended to increase during acoustic stimulation as compared to the
      nonstimulus condition. It is concluded that startle-eliciting stimuli induce a
      state of fear in the rat and that the acoustic-startle-elicited ultrasonic
      vocalization may provide a novel model in the study of anxiety.

PMID- 2236260
TI  - Differential effects of colchicine lesions of dentate granule cells on wet dog
      shakes and seizures elicited by direct hippocampal stimulation.
AB  - Direct electrical stimulation of either the dorsal or ventral hippocampal
      formation elicits wet dog shakes and overt seizures. Destruction of dentate
      granule cells in the dorsal hippocampal formation does not significantly reduce
      the number of wet dog shakes elicited by ventral hippocampal stimulation.
      However, destruction of dentate granule cells in the ventral hippocampus
      virtually eliminates wet dog shaking elicited by dorsal hippocampal stimulation.
      Destruction of either dorsal or ventral dentate granule cells lowers the
      threshold for eliciting forelimb clonus with rearing. These results suggest that
      dentate granule cells in the ventral hippocampus are essential for wet dog shakes
      elicited by intrahippocampal stimulation. However, dentate granule cells
      throughout the hippocampal formation appear to play an important inhibitory role
      in the spread of seizure activity within the hippocampus.

PMID- 2236261
TI  - Glycolysis in Anolis carolinensis during agonistic encounters.
AB  - We examined the influences of territorial status, encounter outcome, body mass
      difference, activity, and display on lactate accumulation in adult male Anolis
      carolinensis during agonistic interactions. Of the pairs of lizards frozen at the
      onset of an encounter, intruders had significantly higher lactate concentrations
      than residents. Lactate levels at the onset of an interaction were not
      significantly different from those at the conclusion, suggesting a limited role
      for glycolysis during such events. The outcome of an agonistic encounter was not
      based on fatigue. Individuals that were larger or changed sites had a lower
      relative lactate concentration at the conclusion of an interaction than smaller
      or sedentary animals. We consider the influence of autonomic arousal on
      glycolysis.

PMID- 2236262
TI  - Circadian rhythmicity and behavioral depression: I. Effects of stress.
AB  - Rats were exposed to repeated sessions of inescapable footshock, and behavioral
      depression was subsequently assessed by measuring escape performance during
      exposure to escapable shock in a different testing environment. Free-running
      circadian activity rhythms were assessed using running wheels for approximately
      three weeks before and after administration of inescapable shock. Several animals
      showed lengthening of free-running period and decreases in activity level
      following shock. Similar effects were also seen in rats that were removed from
      their running wheels, placed within the shock apparatus, and not given shock, but
      not in nonhandled control animals. Furthermore, period lengthening in shocked and
      handled rats was positively correlated with escape performance, suggesting that
      circadian rhythm alterations occurred in those animals that were best able to
      cope with shock or handling-related stressors. In contrast, individual
      differences in circadian period and activity level during baseline conditions
      were not predictive of either escape performance or circadian rhythm alterations.
      These results suggest that successful behavioral adaptation to stress may be
      associated with alterations of circadian rhythmicity.

PMID- 2236263
TI  - Circadian rhythmicity and behavioral depression: II. Effects of lighting
      schedules.
AB  - Two studies explore the relationship between rhythmicity and behavioral
      depression. Behavioral depression was induced using inescapable footshock, and
      assessed by measuring subsequent responses to escapable shock, in rats housed
      under different light-dark conditions. Experiment 1 compared escape performance
      in free-running and entrained animals following inescapable shock. Free-running
      and entrained animals did not exhibit differential vulnerability to the effects
      of inescapable shock. In addition, there were no systematic effects on phase
      following shock. However, several free-running animals showed increased circadian
      period following shock, and lengthening of period was significantly correlated
      with escape performance. Individual differences in baseline period or phase were
      not predictive of escape performance. In Experiment 2, "aftereffects" of
      entrainment to long or short light-dark cycles were utilized to create groups of
      animals with long or short free-running periods. After the administration of
      inescapable shock, escape performance was tested. There were no significant
      differences among experimental groups in escape performance. These results
      suggest that plasticity of circadian period, but not baseline period per se, may
      be associated with the ability to adapt to environmental challenges.

PMID- 2236264
TI  - Thyroparathyroidectomy produces a progressive escape deficit in rats.
AB  - Abnormal thyroid status and affective disorders have been associated in the human
      clinical literature. It has recently been shown that pretreatment with thyroid
      hormone can prevent escape deficits produced by inescapable shock in an animal
      analogue of depression. In this report we provide evidence that hypothyroid
      status can produce an escape deficit in rats. While sham-operated rats improved
      their performance on a simple escape task over three days of testing,
      thyroparathyroidectomized rats showed a pronounced decrease in their responses.
      Markov transition analysis was used to obtain conditional probabilities of
      escaping given a prior escape or failure to escape for the two groups. This
      analysis shows that the structure of the data set may be similar for the two
      groups. These results suggest that if intact rats learn to escape, then
      hypothyroid rats may learn not to escape.

PMID- 2236265
TI  - Habituation of the galvanic skin response in adult males as a function of age.
AB  - Habituation of the galvanic skin response (GSR) to electric shock was studied in
      28 male college students, 18-39 years old. A 60-Hz shock of 244.0-msec duration
      was presented every 1-3 min above the right ankle in a preprogrammed sequence.
      The GSR, measured as a change in palmar skin conductance to the shock, was
      examined over the first 17 shock trials. The habituation curve showed the typical
      large decrement over the first few trials followed by a smaller one over several
      more trials. The initial rate of habituation (percent decrement between shock
      trials 1 and 3) was shown to be age related even though none of the subjects
      would be considered old (18-39 years old). The younger the subject, the faster
      the initial habituation or, conversely, the older the subject the slower the rate
      (rs = -.50, N = 28, p less than 0.005). The asymptote did not vary with age. That
      such dramatic changes occur in the CNS of young males over a relatively few years
      is not unknown. PET studies of the caudate nucleus in normal males showed an
      exponential decrease in dopamine receptors with about half of the decrease
      occurring rapidly between the ages of 20 and 30 (Wagner, H.N., Jr. Diag. Imaging
      Nov.: 138-145; 1985). The usefulness of the GSR in detecting age effects in other
      kinds of learning, such as Pavlovian conditioning, is being explored, as well as
      its usefulness in detecting early learning/memory loss in aging and the
      dementias.

PMID- 2236266
TI  - The rat's right-left preference during free exploration of a multiple Y-maze.
AB  - The right-left preference of Wistar, Sprague-Dawley, and Long Evans rats of both
      sexes was investigated in a multiple Y-maze in which the animals had to perform
      three consecutive right-left choices in order to go from the common starting
      point to one of the eight goal arms. The rats were free to explore the maze
      without being subjected to punishments or rewards. Care was taken to minimize
      inhibitory influences on exploration (low illumination, no handling to return the
      rats to home cage). The statistical analysis of the total right-left choices
      performed by the rats showed that three groups (Wistar females, Sprague-Dawley
      females, and Long Evans males) exhibited a preference for the right. This
      preference was not related either to sex or strain, but was possibly a species
      characteristic.

PMID- 2236267
TI  - Behavioral effects of chronic imipramine treatment in genetically nervous pointer
      dogs.
AB  - The genetically nervous pointer dog has been proposed as a model for human
      anxiety disorders. In a double-blind placebo-controlled study, seventeen nervous
      pointer dogs were treated for four weeks with imipramine hydrochloride (10
      mg/kg), a potent antipanic agent in humans. Although three of the dogs
      demonstrated marked improvement to imipramine but not placebo treatment after
      short-term administration, chronic imipramine failed to modify the aberrant
      behavior in any of the dogs. These findings are discussed in the context of the
      nervous pointer dog as a model for human anxiety disorders.

PMID- 2236268
TI  - Computer analysis of the exploratory behavior of insects and mites in an
      olfactometer.
AB  - A method of quantification of the exploratory behavior of small animals
      stimulated by an odorant in a four-choice olfactometer, taking into account the
      interindividual variability of responses, was developed: individual tracks were
      time sampled according to the animal's walking speed and its positions were
      recorded according to the X-Y coordinates of the grid set underneath the device,
      the mesh of the grid suiting the animal's body size. A software, written in BASIC
      APPLESOFT on an APPLE IIe computer, allowed us to analyze the coordinates either
      of a single individual or of an experimental sample, leading to: a) the
      quantification of the insect distribution all over the experimental chamber,
      expressed in a table numbered according to the grid, where the percentage of
      position per square either for a given time fraction or the total observation
      period were reported, b) a graphic representation of the data according to
      several levels of greys, expressing the frequentation for each square for a given
      duration of observation. An analysis per time fraction allowed the chronological
      setup of events to appreciate. c) The collection of the positions among each flow
      field of the olfactometer for each individual of the experimental sample, for a
      given duration, was translated as the percentage of time spent in each flow
      field. Data files gathered these percentages for further statistical treatments.
      This computer method, which requires little equipment and appears to be easily
      adaptable to the study of biological models of various size and speed such as
      honeybees, trichogrammas and varroas mites, is a powerful tool for behavioral
      studies of small organisms tested in restricted areas.

PMID- 2236269
TI  - Computer-assisted analysis of behavior-brain damage relationships.
AB  - Experimental destruction of subcortical brain tissue by electrolytic, radio
      frequency, or excitotoxin lesions is commonly used in the study of the neural
      control of behavior. Relating variability in the locus and extent of brain damage
      to lesion-produced variability in behavior is essential to a complete analysis of
      the behavioral effects of brain damage. We describe the use of commercially
      available computer accessories and software for measuring the area of irregular
      polygons to accurately and rapidly estimate the amount of damage to any of a
      number of brain structures included within an area of experimental destruction.
      We then describe the use of statistical programs for correlation and multiple
      regression in calculating relationships between damage to particular structures
      and behavior. As an example, we show that excitotoxin (and presumably axon
      sparing) lesions of lateral hypothalamic tissue adjacent to the caudal zona
      incerta virtually eliminate male sexual behavior in rats. The use of multiple
      regression analysis, in conjunction with procedures for calculating destruction
      to different brain regions, provides a way of correlating brain damage and
      behavior that has widespread application in studies of the behavioral effects of
      brain lesions.

PMID- 2236270
TI  - Effects of drinks sweetened with sucrose or aspartame on hunger, thirst and food
      intake in men.
AB  - Forty-two nondieting adult males were given 8 or 16 oz of lemonade, sweetened to
      equal intensity with either aspartame or sucrose, or the same volumes of water,
      or no drink. Subjects were separated into three groups receiving the drinks at
      different times: with a self-selection lunch, or 30, or 60 min before lunch. Food
      intakes did not differ when subjects received the drinks with lunch; however,
      when the calories from the drinks were included, intake was significantly greater
      with the sucrose-sweetened lemonades than in the other conditions. When subjects
      received the drinks 30 or 60 min before lunch, food intakes were not
      significantly different. Appetite ratings were not different among the
      conditions. When the drinks were consumed with the meal, the 8-oz sucrose
      sweetened lemonade differed from the other drinks in that it did not
      significantly reduce thirst. The results indicate that in nondieting males,
      aspartame in concentrations similar to those in commercially available drinks did
      not increase hunger ratings or food intake. However, caloric drinks taken with
      lunch increased total energy intake in that meal. Also, sucrose-sweetened drinks
      may decrease thirst less than water or aspartame-sweetened drinks when taken with
      a meal.

PMID- 2236271
TI  - Anodal polarization in the substantia nigra increases rotational behavior in the
      rat.
AB  - Rotational behavior was examined in rats after unilateral application of an
      anodal direct current (3 microA, 30 min) to the substantia nigra pars compacta
      (SNC). The current application increased contralateral rotation in two stages.
      One was during the period immediately after the current application, in which the
      increase in rotation declined within 30 min. The other period was long lasting,
      in which rotation increased 2 hr after the application and persisted for 24 hr or
      more. These results suggest that anodal direct currents induce transient and long
      lasting activation of the SNC neurons, resulting in increases in rotational
      behavior.

PMID- 2236272
TI  - Experimental dissociation of behavioral and cardiovascular outcome in the
      borderline hypertensive rat.
AB  - F1 Offspring of hypertensive and normotensive rats (BHR) were reared with either
      hypertensive (SHR) or normotensive (WKY) cagemates, and observations were
      conducted at two developmental periods to assess the effects of rearing condition
      on the social environment and the behavior of BHR subjects. SHR displayed
      significantly more agonistic behavior during development than WKY, and BHR
      subjects reared with SHR were the targets of significantly more agonistic
      behavior than BHR subjects reared with WKY cagemates. BHR reared with SHR
      initiated twice as much agonistic behavior as BHR reared with WKY. When heart
      rate and blood pressure were assessed at 75-80 days of age, however, neither the
      alterations in developmental social environment nor the alterations in the
      behavioral characteristics of BHR were associated with differences in
      cardiovascular variables. The results do not support a causal connection between
      behavioral characteristics and cardiovascular outcome.

PMID- 2236273
TI  - A simple technique for localizing the primary auditory cortex in the rat.
AB  - A technique is described which will identify the skull position which directly
      overlies the sensory receiving area of the auditory cortex in the rat. This
      allows the recording of primary cortical auditory-evoked potentials with a high
      rate of success.

PMID- 2236274
TI  - Haloperidol-induced disruption of retrieval behavior and reversal with
      apomorphine in lactating rats.
AB  - Lactating rats were used in experiments to examine the role of the dopamine
      system in the regulation of ongoing maternal behavior. Administration of
      haloperidol disrupted retrieval behavior and nest building in a dose-dependent
      manner but not nursing behavior and pup licking. Feeding behavior including
      carrying of food pellets to the nest and general locomotor ability were not
      disrupted by haloperidol. Apomorphine effectively reversed the inhibition caused
      by dopaminergic blockade. These results indicate a role for dopamine in the
      motivational regulation of retrieval and nest building during the postpartum
      phase of maternal behavior.

PMID- 2236275
TI  - An open-field activity analysis of labyrinthectomized rats.
AB  - A detailed behavioral analysis was performed on rats that received bilateral
      labyrinthectomies. They were placed in a walled activity monitor (39 x 39 cm)
      that allowed the animal to move freely within the enclosure. Their behavioral
      activities were automatically recorded. These activities were placed into twelve
      different categories. The results show a lower rate of habituation for the
      labyrinthectomized animal as well as an overall increase in activity over all
      dimensions as compared to the control. This increase in behavior may be
      exploratory and a necessary feature in the formation of spatial maps.

PMID- 2236276
TI  - Rats with one olfactory bulb removed and the contralateral naris closed can
      detect odors.
AB  - Rats with one olfactory bulb removed were trained to detect 0.5%-0.005%
      concentrations of amyl acetate. These rats had only a slight decrement in
      performance when the naris ipsilateral to the intact olfactory bulb was closed.
      Thus, vapors inhaled through one naris can stimulate olfactory receptor neurons
      in the contralateral nasal vault. This internasal stimulation is probably
      mediated by the nasopharyngeal canal or nasopharynx.

PMID- 2236277
TI  - Gait topography in rat locomotion.
AB  - Gait topography has been quantified and normative data established for free,
      spontaneous locomotion in rats. The normal walking pattern has been compared for
      male and female rats and for three rat strains. The normal walking gait was found
      to be symmetrical, and measures of stride width (SW) and stride length (SL) were
      consistent, with coefficients of variability ranging between 10 and 21%. A study
      of gait ontogeny found that for both male and female rats, SL increased as a
      linear function of body weight, whereas SW increased curvilinearly. The results
      indicate that repeated measures of gait topography were not subject to
      interference from habituation. A sex difference in gait ontogeny was observed.
      The developmental pattern is similar for both sexes, but males increase both SL
      and SW faster than females. It is proposed that gait topography may yield
      valuable information in activity studies.

PMID- 2236278
TI  - Meal patterns of pygmy goats fed hay and concentrate ad lib.
AB  - The meal patterns of pygmy goats fed hay and pelleted concentrate ad lib were
      recorded and analyzed. The pygmy goats consumed 8 hay meals [6 during the light
      phase (= light)/2 during the dark phase (= dark)] and 10 concentrate meals (7
      during light/3 during dark) during 24 hr (12 hr light/12 hr dark). Sixty-two
      percent of hay and 74% of concentrate intake occurred during light. Total 24-hr
      hay (280 g) and concentrate (264 g) intakes were similar, but concentrate was
      preferred during dark. Concentrate meals were smaller during light than during
      dark. The mean feeding rate (g/min) within meals for both hay and concentrate was
      higher during dark than during light. Meal size and duration of postmeal interval
      were positively correlated for concentrate but not for hay. No significant
      positive correlation was found between meal size and duration of premeal
      interval. Separate analysis of diurnal and nocturnal meals indicated that the
      postmeal correlation for concentrate was evident primarily during dark. The
      results demonstrate that food intake in pygmy goats shows distinct diurnal
      variations and suggest that food intake in ruminants is regulated from meal to
      meal, with different factors prevailing during light and dark.

PMID- 2236279
TI  - Perinatal decortication impairs performance on an 8-arm radial maze task.
AB  - Two experiments evaluate the role of the neocortex in rodent spatial learning. In
      Experiment 1, perinatally decorticated rats and sham-operated controls began ten
      training sessions at day 200 on an 8-arm radial maze. Decorticated rats made more
      errors than controls, but showed improvement by the tenth session. In the second
      experiment, training was extended to determine whether decorticates could
      eventually match control performance levels if given sufficient training.
      Spontaneous activity levels were also recorded and compared to maze performance
      to investigate the relationship between poor performance on the radial maze and
      activity. More than half of the decorticates reached criterion performance.
      Decorticates had significantly elevated spontaneous activity levels when compared
      to controls, and the magnitude of this hyperactivity was related to performance
      deficits on the radial maze. These results suggest that with extended training
      decorticates can learn a spatial task. Performance deficits may reflect the
      hyperactive tendency of decorticates rather than a specific impairment of spatial
      learning abilities.

PMID- 2236280
TI  - Developmental changes in sugar and starch taste preferences in young rats.
AB  - Recent studies indicate that neonatal and adult rats are attracted to the taste
      of sugar as well as to starch-derived polysaccharides (e.g., Polycose). The
      present study investigated whether the relative preference for sweet and starchy
      tastes changes during the postweaning to adulthood period in male and female
      rats. This was accomplished by giving growing rats 24-hr/day one-solution
      (sucrose or Polycose vs. water) and two-solution (sucrose vs. Polycose)
      preference tests over a 9-week period (from 28 to 98 days of age). Acceptance
      (absolute intake) of sucrose and Polycose was also evaluated by comparing
      solution intakes during one-solution tests with water baseline intakes. Dilute
      solutions were used to minimize postingestive caloric and/or colligative effects.
      When tested with 2% saccharide solutions, the rats strongly preferred sucrose to
      Polycose with the preference increasing in magnitude from weeks 1 to 9 of
      testing. Sucrose acceptance also increased, relative to that of Polycose, after
      the third test week. When tested with 0.06 molar solutions, the rats initially
      consumed more Polycose (week 1) but by the fifth test week their sucrose
      preference and acceptance exceeded that of Polycose. These results indicate that
      the preference for sweet taste, relative to that for starchy taste, increases
      with age. Contrary to previous findings, the sweet taste preference was somewhat
      stronger in the male rats than in the female rats.

PMID- 2236281
TI  - High-fat diet preference in developing and adult rats.
AB  - Diet preference tests in rats have yielded equivocal results, as some
      investigators have reported a strong preference for diets high in fat over those
      containing less fat, while others have failed to see this preference. To further
      explore this unresolved problem, two diet preference experiments were conducted.
      In Experiment 1, adult rats were maintained for at least three months on one of
      three powdered diets (control, high-carbohydrate or high-fat). Rats were then
      given a preference test with all three diets available. Animals from each group
      overwhelmingly preferred the high-fat diet. To determine whether this preference
      was also present in younger, developing rats, in Experiment 2, weanling animals
      were tested with the same three diets as in Experiment 1. As observed with adult
      animals, weanling rats also showed a strong preference for the high-fat diet. The
      idea that rats prefer a diet with a relatively high level of fat is supported.
      Possible explanations for these findings are discussed.

PMID- 2236282
TI  - Salivary testosterone measurements: reliability across hours, days, and weeks.
AB  - Salivary testosterone measurements would appear to be useful in behavioral
      research, where subjects are often reluctant to provide serum samples. The
      usefulness of salivary measurements depends upon their reliability, however,
      which was the focus of the present investigation. In four studies, 270 male and
      175 female subjects collected saliva samples at times ranging from 30 min to 8
      weeks apart. Subjects collected samples on at least two days, at time of
      awakening, midmorning, late afternoon, and late evening. Mean testosterone
      concentration dropped about 50% from morning to evening for both sexes, with
      largest drops early in the day. Mean reliability was r = .64 across two days and
      r = .52 across seven-eight weeks. Menstrual cycle effects were negligible.
      Reliability can be increased by using more than one measurement, and it is
      probably desirable to combine measurements taken several weeks apart. Salivary
      assays offer a practical way of measuring testosterone in free-ranging subjects
      outside the laboratory.

PMID- 2236283
TI  - Responsiveness to olfactory stimuli presented in sleep.
AB  - Whether humans react to olfactory stimuli presented in sleep was assessed.
      Responses of ten participants (mean age = 22.8 years) were recorded to repeated
      three-minute periods of either air alone or to a peppermint odor (0.26 mg/liter)
      during stage 2 sleep. These responses included behavioral (awakening, microswitch
      closure), autonomic (heart rate, EMG, respiration), and central (EEG) components.
      An odor delivery system is described comprised of an aquarium pump, Teflon and
      TYGON tubing, oxygen mask, filtering, and air flow valves. The data indicate that
      humans react behaviorally, autonomically and centrally to olfactory stimuli
      presented while sleeping. Although the percentage of overall responsivity to
      olfactory stimuli was low, significant differences (ANOVA) in responsivity to
      odor periods vs. nonodor periods were found for microswitch closures, EEG, EMG,
      and heart rate. For these measures eight or more of the ten participants showed
      this pattern of differential responsivity during odor and nonodor periods (Sign
      test = p less than 0.05). A time-of-night effect was also observed in that
      responsivity tended to be greatest early in the night. The effect on responsivity
      of other durations, concentrations, and odors requires additional research.

PMID- 2236284
TI  - Pineal involvement in the alimentary behavior and taste preferences in the rat.
AB  - The purpose of this experiment was to explore the effects of pinealectomy or sham
      pinealectomy on circadian rhythms of taste preferences, food and fluid intake and
      body weight gain in rats. We compared the body weight gain, the amounts of food
      eaten and that of deionized water, total fluid, salt, sour, sweet and bitter near
      threshold solutions consumed by rats before all surgical manipulations and after
      pinealectomy or sham pinealectomy. The results showed that the pineal gland does
      not exert a major influence on circadian organization of taste preferences,
      drinking, feeding and body weight modifications in the rat. The failure of
      pinealectomy to modify light/dark rhythms of taste preferences and other related
      alimentary behaviors may be explained by the fact that pinealectomy does not
      completely eliminate circulating melatonin.

PMID- 2236285
TI  - Recent developments in the biosynthesis of the tropane alkaloids.
AB  - Recent work on the biosynthesis of the tropane moiety of cocaine, hyoscamine,
      scopolamine, and related alkaloids is reviewed. Revision of the generally
      accepted biosynthetic pathway to these alkaloids is now proposed in the light of
      new discoveries. New information on the biosynthesis of some of the acid moieties
      (benzoic, tiglic and tropic acid) of the tropane ester alkaloids is also
      discussed.

PMID- 2236286
TI  - Gardenia fruit extract stimulates the proliferation of bovine aortic endothelial
      cells in culture.
AB  - We previously reported that Gardenia fruit extract had a stimulatory effect on
      fibrolysis in vitro. In the present study, we describe that the hot water extract
      from Gardenia fruit (GFE) stimulates the proliferation of cultured endothelial
      cells from bovine aorta. The cells were cultured in RPMI1640 medium supplemented
      10% fetal bovine serum for up to 96 h in the presence of GFE (100 micrograms/ml
      and below). GFE at 25 and 50 micrograms/ml significantly increased the cell
      number after 48 h and above of the treatment. The incorporations of [3H]thymidine
      and [14C]leucine were significantly increased by 50 micrograms/ml GFE. The GFE
      stimulation of the proliferation was completely inhibited by 1 microM
      cycloheximide. The stimulatory activity of GFE was recognized in the low relative
      molecular mass (less than or equal to 10,000) fraction. In conclusion, it was
      demonstrated that a low molecular mass component of GFE stimulated endothelial
      cell proliferation and an increased protein synthesis was a essential component
      of this response. GFE may contain a useful compound to stimulate the
      proliferation of endothelial cells.

PMID- 2236287
TI  - Inhibitory effects of saponins from Tetrapleura tetraptera on the LH released by
      cultured rat pituitary cells.
AB  - Ethanolic extracts from stem bark of Tetrapleura tetraptera exerted an inhibitory
      effect on the luteinizing hormone (LH) released by cultured rat pituitary cells.
      These extracts contained triterpenic saponins, tannins, and flavonoids as
      estimated through phytochemical screening. Saponins were extracted. They
      apparently inhibited the luteinizing hormone-releasing hormone (LHRH)-induced LH
      release, the inhibition level being dose-dependent. Yet, the intracellular LH
      content remained constant whatever the saponin concentration, which demonstrated
      a lack of effect on the true release process. Accordingly, an interaction between
      saponins and LH released into the medium was demonstrated, which led to a
      decrease in the amount of immunoassayable hormone. This decrease was both time-
      and dose-dependent. It occurred even in the presence of serum in the medium,
      which suggests that the inactivation process may occur in vivo. Taken together,
      these results could explain the anti-gonadotrope properties of T. tetraptera
      extracts that are used as natural contraceptives in Ivory Coast pharmacopoeia.

PMID- 2236288
TI  - Growth, terpenoid production and antibacterial activity of an in vitro culture of
      the liverwort Fossombronia pusilla.
AB  - In vitro cultures of the liverwort, Fossombronia pusilla, have been ititiated
      from spores. They grew well on Gamborg B5 medium supplemented with 2% saccharose
      and 12.5 micrograms/l vitamin B12. Undifferentiated cultures were obtained on
      Knop mineral solution with 4% glucose. The cultures produced the same
      constituents as collected material. Perrottetianal A and B, known substances from
      liverworts were isolated and characterized by spectroscopic methods as well as
      alpha-(-)-santonin. A hitherto unknown diterpene dialdehyde-8-hydroxy-9
      hydroperrottetianal A--could also be characterized. Furthermore, 7 terpenes were
      identified by GC/MS. A petrol ether extract and the isolated terpenes exerted
      antibacterial activity.

PMID- 2236289
TI  - Antimalarial activity of Tanzanian medicinal plants.
AB  - Tanzanian medicinal plants were extracted and tested for in vitro antimalarial
      activity, using the multidrug resistant K1 strain of Plasmodium falciparum. Of 49
      plants investigated, extracts of three plants were found to have an IC50 between
      5-10 micrograms/ml, extracts of 18 other plants showed an IC50 between 10 and 50
      micrograms/ml, all others were less active. The three most active extracts were
      obtained from the tubers of Cyperus rotundus L. (Cyperaceae), the rootbark of
      Hoslundia opposita Vahl. (Labiatae), and the rootbark of Lantana camara L.
      (Verbenaceae).

PMID- 2236290
TI  - Antimalarial compounds containing an alpha,beta-unsaturated carbonyl moiety from
      Tanzanian medicinal plants.
AB  - Pure compounds were isolated from plant extracts with antimalarial activity. The
      extracts were obtained from the tubers of Cyperus rotundus L. (Cyperaceae), the
      rootbark of Zanthoxylum gilletii (De Wild) Waterm. (Rutaceae), and the rootbark
      of Margaritaria discoidea (Baill.) Webster (Euphorbiaceae). The most active
      compounds included (IC50 within brackets): alpha-cyperone (1) (5.5
      micrograms/ml), N-isobutyldeca-2,4-dienamide (2) (5.4 micrograms/ml), and
      securinine (3) (5.4 micrograms/ml). A mixture of autoxidation products of beta
      selinene was found to be the most active antimalarial substances obtained from C.
      rotundus (5.6 micrograms/ml.

PMID- 2236291
TI  - Molluscicidal and antischistosomal activities of Zingiber officinale.
AB  - Experiments were conducted to study the major constituents of Zingiber officinale
      responsible for its molluscicidal activity and the effect of the active component
      on different stages of Schistosoma mansoni. Gingerol and shogaol exhibited potent
      molluscicidal activity on Biomphalaria glabrata. Gingerol (5.0 ppm) completely
      abolished the infectivity of Schistosoma mansoni miracidia and cercariae in B.
      glabrata and mice, respectively, indicating that the molluscicide is capable of
      interrupting schistosome transmission at a concentration lower than its
      molluscicidal concentrations.

PMID- 2236292
TI  - Cytotoxic and antitumor constituents in pericarps of Mallotus japonicus.
AB  - A variety of phloroglucinol derivatives isolated from the pericarps of Mallotus
      japonicus were assessed for growth inhibiting activity against human larynx (HEp
      2) and lung (PC-13) carcinoma cells as well as mouse B16 melanoma, leukemia P388,
      and L5178Y cells. Most of these derivatives were proved to be significantly
      cytotoxic in culture. One of them, 3-(3,3-dimethylallyl)-5-(3-acetyl-2,4
      dihydroxy-5-methyl-6-methoxybenzyl )- phloracetophenone showed an excellent
      cytotoxicity against all target tumor cells and a marked prolongation of life
      span in mice bearing L5178Y leukemia.

PMID- 2236293
TI  - Spectral assignment and cytotoxicity of 22-hydroxytingenone from Glyptopetalum
      sclerocarpum.
AB  - 22-Hydroxytingenone was reisolated from a new source, Glyptopetalum sclerocarpum
      M. Laws and, for the first time, its unambiguous 13C-NMR assignments were
      accomplished through the use of APT, HETCOR, and selective INEPT spectroscopy.
      Intense, but nonspecific cytotoxic activity was observed when this substance was
      evaluated with a battery of cell lines comprised of the P-388 lymphocytic
      leukemia, KB carcinoma of the nasopharynx, and a number of human cancer cell
      types, i.e. HT-1080 fibrosarcoma, LU-1 lung cancer, COL-2 colon cancer, MEL-2
      melanoma, and BC-1 breast cancer.

PMID- 2236294
TI  - The cytotoxic principles of Pseudolarix kaempferi: pseudolaric acid-A and -B and
      related derivatives.
AB  - Pseudolaric acid-A and -B, the novel diterpene acids isolated from Pseudolarix
      kaempferi, and their related derivatives have been tested for cytotoxicity
      against KB, A-549, HCT-8, P-388, and L-1210 tumor cells. The results showed that
      pseudolaric acid-A and -B demonstrated potent cytotoxicity. The selectivity of
      pseudolaric acid-A and -B which inhibit the growth of particular cell types
      within the disease-oriented human cancer cell line panels is discussed.

PMID- 2236295
TI  - Fractionation and characterization of mitogenic and anti-complementary active
      fractions from kampo (Japanese Herbal) medicine "juzen-taiho-to".
AB  - "Juzen-Taiho-To" (TJ-48), which is a kampo (Japanese herbal) medicine prepared by
      decocting a prescription of ten kinds of herbs, has several immunostimulating
      activities. In order to characterize the active substances for anti-complementary
      and mitogenic activities, TJ-48 was fractionated. Anti-complementary activity was
      observed in the water- and methanol-insoluble fraction (F-2) and the crude
      polysaccharide fraction (F-5), whereas mitogenic activity was only found in F-5.
      However, other low molecular mass fractions did not show both activities.
      Methylation analysis indicated that F-2 mainly contained amylopectin-like
      polysaccharides. Both Pronase digestion and periodate oxidation decreased the
      anti-complementary activity of F-2, and the beta-amylase-resistant fraction of F
      2 still retained the potent anti-complementary activity. When F-5, which has the
      most potent of both activities, was further fractionated, only the major acidic
      polysaccharide fraction, F-5-2, showed potent mitogenic activity. Endo-alpha-(1--
      -4)-polygalacturonase digestion showed that F-5-2 mainly contained pectic
      polysaccharides, and the endo-polygalacturonase treatment of F-5-2 reduced the
      mitogenic activity but not the anti-complementary activity. F-2 and F-5 each
      activated the complement system by a different mode of action.

PMID- 2236296
TI  - [Triterpenoid sapogenins in the genus Grindelia].
AB  - A saponin fraction has been isolated from the ethanolic extract of Grindeliae
      herba. The saponin fraction showed strong haemolytic activity. The saponins were
      detected after separation on TLC by their color reactions and Rf values as well
      as by their haemolytic activity on blood agar. After hydrolysis, the chemical
      reactions and Rf values of the sapogenins were described. The main sapogenin was
      isolated by preparative chromatography and its structure was elucidated by mass,
      1H-NMR, 13C-NMR, IR, and UV spectra. The compound is a new natural triterpenoid
      sapogenin lactone and is named grindeliasapogenin D. Spectral evidence is
      presented to establish its structure as 2 beta,3 beta,16 alpha,23
      tetrahydroxyoleanan-28,13 beta-olide. Two further sapogenins present in small
      amounts were identified chromatographically as oleanolic acid and bayogenin using
      authentic reference substances. The aerial parts of Grindelia robusta Nutt, and
      G. lanceolata Nutt. (Asteraceae) (as well as two commercial extracts) were also
      investigated with respect to their saponin fraction. The 3 sapogenins mentioned
      above were detected in all samples. The antibiotic potency of the crude drug is
      not associated with the saponin fraction but is at least partially due to the
      resin fraction.

PMID- 2236298
TI  - Reconstruction of the vulva with V-Y advanced myocutaneous gracilis flap.
AB  - Reconstruction of the vulva with V-Y advanced triangular myocutaneous gracilis
      flap(s) is reported. Seven patients were treated with this technique following
      radical vulvectomy with two minimal complications. The reliability of this known
      flap and the usefulness of the V-Y advancement are stressed and make it a simple
      and successful technique.

PMID- 2236299
TI  - Surgical malpractice in the Renaissance and today.

PMID- 2236297
TI  - Structures of compounds with antigonadotropic activity obtained by in vitro
      oxidation of caffeic acid.
AB  - Two new cyclolignan derivatives were isolated by HPLC from the mixture of
      substances obtained after oxidation of caffeic acid with KMnO4. Their structures
      were elucidated by spectroscopic methods as 2,3-dicarboxy-6,7-dihydroxy-1-(3', 4'
      dihydroxy)-phenyl-1, 2-dihydronaphthalene (1) and 3-carboxy-6,7-dihydroxy-1-(3',
      4'-dihydroxy)-phenylnaphthalene (2). Compounds 1 and 2 exhibit antigonadotropic
      activity as do the extracts of crude drugs of Lycopus europaeus and Lithospermum
      officinale after oxidation by plant enzymes.

PMID- 2236300
TI  - Auriculomastoid tube pedicle for partial ear reconstruction.

PMID- 2236301
TI  - The medial plantar flap.

PMID- 2236302
TI  - Suitability of the rat femoral vessel as a microsurgical model.

PMID- 2236303
TI  - Defining the viability of avulsed skin flaps by the split-thickness skin excision
      (STSE) test.

PMID- 2236304
TI  - Prevention of arterial spasm with transcutaneous catheters.

PMID- 2236305
TI  - Nasotracheal intubation in the presence of facial fractures.

PMID- 2236306
TI  - The degloving technique in the correction of hypospadias.

PMID- 2236307
TI  - Feminizing genitoplasty and clitoroplasty.

PMID- 2236308
TI  - Long-term effects of tissue expansion on cranial and skeletal bone development in
      neonatal miniature swine: clinical findings and histomorphometric correlates.
AB  - Progressive tissue expansion induces significant gross, histologic, and bony
      changes in skulls and long bones of neonatal miniature swine. These bony changes
      consist of erosion underlying tissue expanders, with bony lipping and bone
      deposition at the periphery of the expander. Cranial suture lines underneath
      expanders appear effaced and convoluted. Serial CT scans reveal decreased bone
      thickness and volume (p less than 0.02) but identical bone density (p = 0.60)
      beneath expanders. Increased bone volume and thickness occur at the periphery of
      expanders (p less than 0.02). Bone density (CT number) is unaffected by tissue
      expansion in both cranial and long bones. These findings have histomorphometric
      correlates: Osteoclastic bone resorption occurs underneath expanders with
      periosteal reaction at the periphery of expanders. Cranial sutures are similarly
      affected, but no cranial synostosis results. No changes to the inner table of the
      skull or stigmata of increased intracranial pressure were observed either in CT
      scans or in behavioral changes in long-term animals. The pathophysiology of bony
      changes is a remodeling effect, not one of simple pressure deformation. Increased
      bone resorption and complete inhibition of bone formation occur until the
      pressure is removed. Cranial bone is significantly more affected than long bone.
      After removal of the expanders, reparative bone remodeling begins within 5 days
      and nearly complete healing of the cranial defects occurs within 2 months (p less
      than 0.02). No plagiocephaly results despite early coronal suture changes. On the
      basis of this study, we conclude that tissue expansion causes significant but
      reversible effects, readily monitored by high-resolution CT scans, on neonatal
      and infant cranial and long bones.

PMID- 2236309
TI  - Treatment of craniomaxillofacial fibrous dysplasia: how early and how extensive?
AB  - Twenty-eight craniomaxillofacial fibrous dysplasia patients were treated as early
      as the symptoms occurred. The principles of surgical treatment were based on the
      zones of involvement: total excision of dysplastic bone of fronto-orbital,
      zygoma, and upper maxillary origin (zone 1) and bone reconstruction primarily;
      conservative excision on hair-bearing skull (zone 2), central cranial base (zone
      3), and tooth-bearing bones (zone 4); and optic canal decompression on patients
      with orbital dysplasia and decreasing visual acuity. Patients were followed for 1
      to 11 years (average 5.3 years). No recurrence or invasion of the fibrous
      dysplasia into the grafted bone was seen. One patient had orthognathic maxillary
      osteotomy on the reconstructed maxilla 6 years after initial reconstruction. Five
      of 19 patients with alveolar dysplasia had a recurrence and were reshaped. One
      patient had mandibular sagittal osteotomies to set back the prognathic, fibrous
      dysplasic mandible after three attempts at conservative shaving. Another patient
      with mandibular fibrous dysplasia had recurrence with pain and a
      hemimandibulectomy with successful immediate free vascularized iliac bone graft
      reconstruction.

PMID- 2236310
TI  - Lamellar split osteotomy: a new craniofacial technique.
AB  - Craniofacial osteotomies have by convention been bilamellar translocations of the
      entire substance of the dysmorphic bone. This approach limits the surgeon by
      reducing the stable bone mass available for fixation, creating dependence on
      concave surfaces. Most important, it changes the bony topography that determines
      the preoperative plan. This paper presents a new craniofacial concept and
      technique used in 26 patients with various dysmorphic syndromes who were
      reconstructed by performing a lamellar split osteotomy. This technique maintains
      the internal lamella in its native position, thereby allowing it to act as a
      reference for the bony topography and providing a stable facial framework for
      rigid fixation. This interlamellar osteotomy has led to improved aesthetic
      results in the orthomorphic reconstructions of congenital and other deformities.
      It can be used in any aesthetic patient in whom contour changes or augmentation
      of form is desired. It is recommended as a preferred method for achieving
      quantitative contour improvement in patients over 3 years of age.

PMID- 2236311
TI  - Improved primary surgical and dental treatment of clefts.
AB  - The improved combination of surgical and dental teamwork in the primary treatment
      of clefts presented here is consistent with principles. In fact, this is a staged
      design for correction of classic clefts of the lip and palate that, based on
      biological principles, facilitates the continuance of the failed embryonic
      "migrations" toward a normal end point. Positioning of the alveolar segments,
      dissection of mucoperiosteum out of the cleft, and union of mucoperiosteum across
      the alveolar and anterior hard palate cleft make it possible to create a
      periosteal tunnel across the bony gap and set up a condition conducive to bone
      formation and eventual tooth eruption in the cleft area. Lip closure by adhesion
      reduces the tension of the primary lip closure and allows gentle molding until
      solidification of the arch occurs. Thus a complete cleft has been rendered an
      incomplete cleft. With a balanced, stabilized maxillary platform, the definitive
      lip and nose corrections can be carried to completion early (by 2 to 4 years of
      age). These planned actions bypass a persistent cleft, fistulas, raw areas,
      malposition of alveolar segments, and probably the necessity for later bone
      grafting. The only question not totally answered is the effect of this approach
      on final growth. Although most reports seem to indicate that growth has and will
      proceed within normal limits, another 10 years of careful follow-up is indicated
      and, in fact, is in progress.

PMID- 2236312
TI  - Experience with the functional cleft lip repair.
AB  - The first 12 functional cleft lip repairs performed on unselected consecutive
      patients immediately following the completion of training by the author are
      presented. Previous reports on this cleft lip repair have shown excellent results
      but have always been based on patients operated on by the originator of the
      procedure. This report gives credence to the ease with which a cleft lip repair
      that gives reproducible good results can be taught and learned even by plastic
      surgeons with limited experience. It reviews the technical steps of the
      procedure, which emphasizes wide undermining and release of the orbicularis oris
      muscle on the lateral side of the cleft to allow redraping and lengthening of the
      lip skin, step-by-step layered closure of the mucosa, muscle, and skin, and
      further vertical lengthening of the lip with a Z-plasty skin closure. Three
      elements that are difficult to achieve or restore with cleft lip revision are
      evaluated: (1) achievement of a good skin scar, (2) maintenance of the alar
      facial groove, and (3) achievement of adequate lip height without sacrificing
      horizontal lip length. Ten of the 12 patients had a satisfactory scar, 9 patients
      had a good alar-facial groove, and all patients had a normal-appearing horizontal
      lip length. Nine patients required secondary surgery; however, in six patients,
      this included correction of the nasal deformity that was not corrected at the
      time of cleft lip repair.

PMID- 2236313
TI  - Primary repair of the bilateral cleft lip nose: a 15-year review and a new
      treatment plan.
AB  - For 15 years a forked flap has been used for columella reconstruction in primary
      repair of the bilateral cleft lip nose. With the adolescent growth spurt, three
      unfavorable features have become apparent: (1) the columella may grow too long
      and the nostrils too large, (2) often the nasal tip remains broad, and (3) there
      is a drift of the columellar base and the lip-columellar angle is transgressed by
      scar. This procedure has therefore been discontinued. A new treatment plan is
      presented in which the columella is reconstructed from tissues in the splayed-out
      nasal tip.

PMID- 2236314
TI  - Nasal reconstruction with full-thickness cranial bone grafts and rigid internal
      skeleton fixation through a coronal incision.
AB  - The use of iliac and rib bone as onlay grafts to the nasal dorsum often fails
      because endochondral grafts resorb unpredictably. Membranous cranial bone grafts
      are less likely to resorb, especially when used with rigid internal fixation
      techniques. However, when split, they are often too thin and can be difficult to
      contour. Full-thickness cranial bone grafts were used to achieve nasal
      augmentation in 26 patients with end-stage nasal skeleton deficiency. All
      procedures were carried out using only a coronal incision. Grafts were harvested
      through a craniotomy, carved meticulously, and secured rigidly with miniplates or
      bicortical screws. Donor sites were reconstructed with split cranial grafts,
      leaving an intact cranial vault. No graft was lost to infection, and there was no
      significant donor-site morbidity. In carefully selected patients this method of
      full-thickness cranial bone graft reconstruction yields good results.

PMID- 2236315
TI  - Simultaneous reconstruction of cervical soft tissue and esophagus with a gastro
      omental free flap.
AB  - A microvascular transfer of gastric tube and omentum was used to simultaneously
      reconstruct cervical soft-tissue and esophageal defects in five patients. All
      patients had previous high-dose radiation and multiple flap reconstructions. The
      largest esophageal and soft-tissue defects were 10 cm and 160 cm2, respectively.
      All wounds healed primarily except for one orocutaneous fistula. There was one
      death from an intraoperative stroke. The gastro-omental flap is useful in cases
      where the reconstructive surgeon is faced with both esophageal and soft-tissue
      defects--particularly in heavily irradiated patients who have few reconstructive
      options.

PMID- 2236316
TI  - Sixty consecutive breast reconstructions with the inflatable expander: a critical
      appraisal.
AB  - Breast reconstruction using inflatable expanders has become an established and
      preferred technique. Although our knowledge of the biomechanical changes
      occurring in expanded skin has increased greatly, little information is available
      regarding average aesthetic results achieved with this technique. In order to
      eliminate the bias of best case selection reports, this study of 60 consecutive
      patients undergoing skin-expansion breast reconstruction was undertaken. Results
      of the study demonstrated a significant frequency and diversity of complications.
      In particular, immediate breast reconstruction with skin expanders was identified
      as a high-risk procedure because of its association with skin necrosis and
      delayed wound healing. Although two procedures--insertion and replacement--had
      been anticipated, patients from both the Boston and New York groups required
      approximately three operations to complete the expansion process. Average
      aesthetic results, often characterized by problems of symmetry, ptosis, and
      contour, need to be recognized and improved.

PMID- 2236317
TI  - The radial forearm flap for reconstruction of the upper extremity.
AB  - The radial forearm flap, owing to its good-caliber arteries of long length and
      equally well distributed venous system, has proved very reliable. It has not only
      earned its place and recognition in reconstructive hand surgery, but also has
      emerged as a workhorse for the microvascular surgeon. We have used 14 radial
      forearm flaps for upper extremity reconstruction, and we present herein our
      experience. The technique of extracorporeal tissue transfer, which has been
      published elsewhere, was used in two patients and is detailed. Four
      representative patients are presented.

PMID- 2236318
TI  - A prospective clinical evaluation of autogenous vein grafts used as a nerve
      conduit for distal sensory nerve defects of 3 cm or less.
AB  - The purpose of this study was to determine the efficacy of autogenous vein grafts
      as nerve grafts (AVNC) for bridging of small peripheral sensory nerve gaps as
      compared with direct repair and with conventional nerve grafting techniques
      (ANG). Patients with painful neuroma or segmental nerve injury of 3 cm were
      chosen as the test group. Those amenable to direct repair were classified as
      controls. Between 1982 to 1988, a total of 22 patients were enrolled in this
      study. A total of 34 nerves were repaired, 15 with a venous nerve conduit, 4 with
      a sural nerve graft, and 15 with direct repair. Significant symptom relief and
      satisfactory sensory function return were uniformly observed. The two-point
      discrimination measurements indicated superiority of direct repair and probably
      of conventional nerve grafting. However, the universally favorable patient
      acceptance and the return of measurable two-point discrimination indicates the
      effectiveness of autogenous vein grafts as nerve conduits when selectively
      applied to bridge a small nerve gap (less than or equal to 3 cm) on nonessential
      peripheral sensory nerves.

PMID- 2236319
TI  - Calcium carbonate gel therapy for hydrofluoric acid burns of the hand.
AB  - Hydrofluoric acid is used extensively as an industrial cleaning agent for metals
      and glass. Many workers are injured by cutaneous contact of the acid with exposed
      skin surfaces, particularly hands. Hydrofluoric acid burns are characterized by
      delayed onset of symptomatology with skin ulceration, and severe pain may be of
      extended duration. Treatment of hydrofluoric acid burns traditionally has
      consisted of local infiltration or intraarterial injections of calcium solutions.
      These injections are painful and frequently require retreatment. A new treatment
      utilizing a topical gel of calcium carbonate is described. Nine patients have
      been treated for hydrofluoric acid burns of the hand with calcium carbonate gel
      applied topically and covered with occlusive glove dressings. A gel slurry is
      compounded from calcium carbonate tablets and K-Y Jelly. Fingernails of the
      affected fingers are removed if a subungual burn is obvious. The gel is put into
      a surgeon's glove and placed over the burned hand. The patient replaces the glove
      and slurry every 4 hours for 24 hours. After the first day, the glove is
      discontinued unless there is resumption of painful symptoms. Full range of motion
      is encouraged during this interval. The calcium carbonate gel technique was
      successfully utilized in nine patients with no further need for injection
      therapy. In these patients, pain relief was obtained within 4 hours of treatment,
      with no further progression of skin ulceration. No reconstructive procedures were
      required in any patient, and only one patient did not return to full-duty work
      within 1 week. There were no long-term sequelae from burns treated with this
      topical therapy, except one patient, who presenting 24 hours after the burn,
      developed a digital tip neuroma that was excised.

PMID- 2236320
TI  - Direct monitoring of capillary perfusion following normovolemic hemodilution in
      an experimental skin-flap model.
AB  - The effects of normovolemic hemodilution on skin flap survival are studied in a
      recently developed skin-flap model (homozygous hairless mouse ear) in which
      nutritional capillary flow is monitored directly by means of intravital
      microscopy from the time of flap creation throughout the establishment of
      necrosis. Two diluting agents (dextran 60 and hydroxyethyl starch 200) are
      utilized. Our quantitative findings demonstrate that the amount of nonperfused
      tissue following flap creation in both the dextran (n = 23) and starch (n = 13)
      groups was significantly decreased as compared with controls (n = 19). Our
      qualitative observations suggest that improved hemorrheologic properties at the
      microcirculatory level are responsible for the observed decreased necrosis.
      Various mechanisms by which hemodilution may act to prevent necrosis are
      discussed.

PMID- 2236321
TI  - Achieving standardized photographs in aesthetic surgery.
AB  - The plastic surgeon who wishes to share clinical experience with colleagues is
      obligated to produce accurate data in the form of photographs. Moreover, accurate
      photographs are essential to enable an objective critical appraisal of one's own
      surgical skill and to display postoperative results to patients in an unbiased
      fashion. Change should not be a function of either the photograph or the
      photographer. The use of an acetate screen grid in conjunction with anatomic
      boundaries is described as a means to achieve accurate, reproducible standard
      photographs of the face and body in aesthetic surgical patients.

PMID- 2236323
TI  - Growing up.

PMID- 2236322
TI  - Consecutive patients.

PMID- 2236324
TI  - The use of conchal cartilage graft in involutional entropion.
AB  - A simple and stable technique for repairing involutional entropion is described.
      Through a transconjunctival incision between the lower border of tarsus and the
      lower lid retractor, the eyelid is divided between the tarsus and the orbicularis
      oculi muscle into external and internal layers. The internal layer is moved
      upward until the eyelashes turn outward, and then through-and-through sutures are
      placed to fix it in this corrected state. The resultant defect between the lower
      end of the tarsus and the retractor is filled with a conchal cartilage graft. The
      raw surface of the cartilage is epithelialized from the surrounding mucosa within
      1 to 2 weeks without shrinkage. This technique is more stable than any other
      technique that we have performed.

PMID- 2236325
TI  - Reduplication of the mouth and mandible.

PMID- 2236326
TI  - Controlled tissue expansion of a groin flap for upper extremity reconstruction.
AB  - A large upper extremity defect in an 8-year-old girl was resurfaced with an
      expanded groin flap. Tissue expansion allowed complete coverage of the defect
      while minimizing the donor deformity. Pretransfer expansion of pedicled flaps
      offers an alternative to free-flap reconstruction of complex upper extremity
      defects. This is especially valuable in the pediatric patient, in whom donor-site
      morbidity can be significant.

PMID- 2236327
TI  - Repair of a huge defect of the gluteal region by rotation of a combined tensor
      fasciae latae-sartorius myocutaneous flap.
AB  - Although the tensor fasciae latae myocutaneous flap is convenient for covering
      some defects in the gluteal region, it is not suitable to repair a huge defect
      because of its limited area. Based on the close relationship of the sartorius and
      the tensor fasciae latae at their origins and blood supply, the authors designed
      a myocutaneous flap containing both the tensor fasciae latae and the sartorius
      muscles and their skin territories with an area exceeding 800 cm2. Two
      successfully repaired patients are reported. The flaps provide normal
      sensitivity. The vascular pedicle has a reliable anatomy, being easily dissected,
      and averages 4.6 to 5.8 cm in length. Both muscles are expendable. There is
      little functional difficulty for hip joint after the operation.

PMID- 2236328
TI  - Secondary correction of the unilateral cleft lip nose using a conchal composite
      graft.
AB  - The secondary deformity of the unilateral cleft lip nose has many components. One
      is the dorsal dislocation of the lateral crus of the alar cartilage. We used a
      conchal composite graft positioned between the piriform aperture and the lateral
      crus and the upper lateral cartilage to correct this dislocation in nine
      patients. We believe that this graft is effective because it elevates the lateral
      crus of the alar cartilage off the depressed piriform aperture. This technique is
      very simple to perform, and it is easy to achieve nasal symmetry. Our results
      have been quite satisfactory, with no recurrence of dorsal dislocation. The donor
      site was covered by a subcutaneous pedicled flap from the cephaloauricular
      sulcus, leaving an inconspicuous deformity.

PMID- 2236329
TI  - The use of liposuction to contour cherubism.
AB  - Yet another application of suction lipectomy equipment is presented to remove the
      pathologic tissue in cherubism. Owing to the variations of consistency of the
      material in this condition, this technique may not be successful in all patients,
      but it is certainly recommended when indicated.

PMID- 2236330
TI  - Surgical correction of the inverted nipple with a tendon graft: hammock
      procedure.
AB  - Our procedure, in which the inverted nipple was suspended using autogenous tendon
      grafts, was easy to perform, and it was not necessary to cut the lactiferous
      ducts. There was no deformity of the nipple or areola after this procedure, and
      the surgical scars were inconspicuous. Three patients who were followed up for
      over 1 year after surgery were presented in this paper. In eight patients (13
      corrected inverted nipples), good results were obtained and there have been no
      complications to date.

PMID- 2236331
TI  - Pharmacotherapeutics for the primary care physician.

PMID- 2236332
TI  - Pharmacotherapy and the primary care physician.
AB  - Clinical pharmacy services and pharmacotherapy specialists did not begin in
      primary care settings. Rather, the initial interdisciplinary teams took root in
      large hospitals and tertiary medical center inpatient services during the middle
      1960s. By the early 1970s, however, numerous papers appeared that described a
      unique and exciting practice model that incorporated primary care physicians and
      clinical pharmacists. The sole purpose of the interdisciplinary concept was to
      allow each member to contribute their own expertise to improve patient care. In
      my experience, primary care physicians have been eager to consult clinical
      pharmacists and other health professionals. I believe that the reason for this is
      a fundamental philosophy that distinguishes these physicians from other medical
      specialists. Ingrained in their philosophy are concepts such as continuity of
      care and care of the entire patient. The latter relates, not only to multiple
      organ systems, but also the spiritual and behavioral characteristics of the
      person. The primary care physician is also viewed as the coordinator for all
      health care services required by their patients. Most primary care physicians
      welcome others' expertise as long as they continue to be the health care
      coordinator for the patient. The health care structure of the United States
      continues to shift to ambulatory care. This will provide additional opportunities
      for the types of group models described in this article. After 20 years, the
      positive impact that physician and pharmacotherapist teams can have on drug
      therapy is being recognized on a broader scale. These models should continue to
      move from the academic laboratory to private group practice.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2236333
TI  - Therapy for hypercholesterolemia.
AB  - For most patients, hypercholesterolemia can be effectively lowered with drug
      therapy but only after several issues have been considered. First, drug therapy
      should never be considered without adequate dietary intervention. Dietary therapy
      may be effective for many patients with mild to moderate elevations in
      cholesterol. None of the drugs used to treat lipid disorders are benign agents.
      There is still debate about the interpretations of recent studies, the ability to
      generalize from studies to the whole population, and the cost effectiveness of
      drug treatment. Within the framework of the AHA and NCEP guidelines, an
      individualized approach to therapy is prudent. This should be initiated with
      maximal patient education because drug therapy will be maintained for the long
      term or for life. The LDL and HDL levels, age, sex, other CHD risk factors, cost
      of treatment, patient awareness, and motivation must all be assessed when making
      treatment decisions. When drug therapy is considered for patients with isolated
      hypercholesterolemia, bile acid sequestrants are the drugs of choice.

PMID- 2236334
TI  - Antidiabetic agents.
AB  - Although either insulin or oral hypoglycemics may be used in conjunction with
      diet and exercise in the management of type II diabetes, drug therapy for type I
      diabetes involves only insulin. C-peptide levels can be tested to assess whether
      the patient has remaining pancreatic endocrine function. Patients being started
      on insulin for the first time should receive a single injection of an
      intermediate-acting insulin of "human" origin at a dose of approximately 0.5
      U/kg. Thereafter, fasting, mid-morning, mid-afternoon, bedtime, and possibly
      early morning blood sugars should be examined periodically to determine if the
      insulin dose needs to be increased, decreased, split, or if the patient needs to
      be on a two-insulin regimen. Intensive insulin therapy has become commonplace to
      control plasma glucose levels in the majority of patients receiving insulin
      therapy. Proper patient education regarding the insulin regimen, injection
      techniques, blood glucose monitoring, as well as diet, exercise, and foot care
      are essential if the patient's diabetes is to be controlled adequately.
      Guidelines for "adequate" glycemic control are outlined in Table 6. Recent
      evidence suggests that tight control of plasma glucose levels may decrease the
      macrovascular complications of diabetes. Although there is also evidence to
      suggest that the onset of microvascular complications might be delayed with
      strict glycemic control, the data are conflicting. The benefits of strict control
      must be weighted against the problems of hypoglycemia experienced by many
      patients who attempt tight control of their blood glucose levels. Biguanide
      compounds are available in Europe, but the sulfonylureas comprise the only class
      of oral agents in the United States commercially available for the treatment of
      type II diabetes. The two generations of these drugs reflect their potency and
      possible side-effect profiles. Of the first-generation agents, tolbutamide and
      chlorpropamide are the most widely prescribed. Tolbutamide is the weakest of the
      sulfonylureas, possibly making it a good drug for initiating oral therapy in the
      elderly. Chlorpropamide is becoming a less popular agent because of its long
      duration of action and its increased incidence of side effects. Of the second
      generation agents, glyburide offers a better dosing schedule (once daily compared
      with twice daily for glipizide); however, glyburide may produce a greater
      incidence of hypoglycemia, particularly in the elderly or in patients with
      significant renal impairment. There are few good studies comparing these two
      drugs so that recommending one over the other is difficult. Drug interactions are
      numerous with the first-generation drugs, but less so with the newer second
      generation agents.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2236335
TI  - Antibiotic therapy for common infections.
AB  - Several important points regarding the treatment of urinary tract infections
      should be made. Single-dose and short-course antibiotic therapy is appropriate
      only for women with acute bacterial cystitis due to E. coli. Studies comparing
      single-dose to full-course therapy have not been sufficiently designed to draw
      valid statistical conclusions, and only TMP/SMX is recommended at this time.
      Recurrent UTI in women is almost always due to reinfection, which is best managed
      by prophylactic antibiotics. Acute bronchitis and acute exacerbations of chronic
      bronchitis are often due to viral infections, and therefore antibiotic therapy is
      not always needed. In acute exacerbations of chronic bronchitis, the clearest
      success rates for antibiotic therapy have been in patients, who have all three of
      the following symptoms: increased dyspnea, increased sputum production, and
      sputum purulence. Mupirocin is an important addition to the agents used to treat
      bacterial skin infections due to streptococcal and staphylococcal strains. In
      impetigo, mupirocin has been demonstrated to be as effective or superior to oral
      erythromycin. In prostatitis, data on the fluoroquinolones appears impressive,
      but further comparative trials are needed. They may become first-line, empiric
      therapy. The newer oral antibiotics are not recommended as initial, empiric
      therapy in the outpatient management of common infections, with the possible
      exception of the treatment of prostatitis. These newer agents may be more
      important in the treatment of recurrent or resistant infections.

PMID- 2236336
TI  - Treatment of opportunistic infections associated with acquired immune deficiency
      syndrome.

PMID- 2236337
TI  - Therapy of affective disorders.
AB  - The key to the proper treatment of affective disorder is a correct diagnosis of
      the subtype of depressive illness. Thus, primary treatment recommendations
      include the TCAs for a depressive episode; ECT for a depressive episode with
      psychotic features; and MAOIs for dysthymic disorder and atypical depressive
      episodes. Nonresponding patients are treated with either lithium augmentation of
      TCA therapy, an MAOI, or ECT. Second-generation antidepressants are not usually
      indicated as initial treatments. They are recommended in situations in which
      their adverse-effect profiles offer significant advantages over TCAs in an
      individual patient. Second-generation antidepressants have not been extensively
      studied in patients who do not respond to TCAs. Maintenance antidepressant may be
      necessary to prevent recurrent depressive episodes. Lithium remains the mainstay
      of acute treatment of mania and for prophylaxis of subsequent affective episodes.
      In lithium-refractory or lithium-intolerant patients, carbamazepine is
      recommended. Valproic acid and verapamil have been useful, primarily in patients
      who do not respond to lithium and carbamazepine.

PMID- 2236338
TI  - Current issues in NSAID therapy.
AB  - More than a dozen NSAIDs are commercially available in the United States.
      Diclofenac may not be as effective for dysmenorrhea. Although most are equally
      efficacious, indomethacin is the preferred agent for hemicrania continua and
      chronic paroxysmal hemicrania. Although all NSAIDs should theoretically be
      beneficial in gout, the greatest experience is with indomethacin. Sulindac may be
      the preferred agent for diabetic neuropathy. Fenoprofen appears to be the most
      offensive NSAID in terms of nephrotoxicity. NSAIDs may antagonize
      antihypertensive therapy, although this effect may not persist beyond 1 month.
      Generally, use of NSAIDs in pediatric patients is limited to naproxen and
      tolmetin. Concomitant therapy with methotrexate, lithium, and AZT should be
      approached with caution. NSAIDs have similar propensities to cause
      gastrointestinal side effects. Sucralfate has consistently proved beneficial as
      cytoprotective therapy for use with NSAIDs without impairing absorption of the
      NSAID, NSAIDs generally should be avoided prior to surgery, although sulindac or
      nonacetylated salicylates have a negligible effect on platelet function and may
      be used if continued NSAID therapy is required. Hepatotoxicity, although rare
      with NSAIDs, is most common with phenylbutazone and least common with the
      fenamates.

PMID- 2236340
TI  - Drug use in pregnancy and lactation.
AB  - When prescribing drugs for patients who are pregnant or lactating, a clinician
      needs to ask the following questions: (1) Is pharmacotherapy necessary? (2) What
      drug can be used that has the lowest potential toxicity according to current
      knowledge? (3) What pharmacokinetic parameters does the drug follow during
      pregnancy? (4) What are the major risks inherent to this particular drug
      treatment? (5) Do the benefits outweight the risks? and (6) How can the risks be
      minimized by adjusting the drug dosage and duration? It is important to inform
      the patient of the possible risks and have her participate in making treatment
      decisions. If possible, the fetus or neonate should be monitored for adverse
      reactions during the course of treatment, and if any serious problems occur, the
      medication can be discontinued. Although it is true that no drug is totally
      without risk when used during pregnancy or lactation, if proper precautions are
      taken, then treatment can be rendered with minimal risks to both mother and
      child.

PMID- 2236339
TI  - Oral contraceptives.
AB  - Management of oral contraception requires an understanding of the relationships
      between the method's effectiveness, noncontraceptive benefits, and hormonal
      adverse effects. The new multiphasic combinations or OCs containing 35 micrograms
      of ethinyl estradiol and 0.5-1.0 mg of norethindrone or equivalent result in a
      maximum combination of efficacy and safety for the patient with minimal annoying
      problems for the patient and the prescriber. Patient education regarding early
      warning symptoms of adverse effects, breakthrough bleeding, and lack of
      withdrawal bleeding adds an additional margin of safety and reduces patient
      questions and uncertainties.

PMID- 2236341
TI  - Estrogen therapy during menopause and the treatment of osteoporosis.
AB  - Estrogen remains the single most effective agent in the treatment of menopausal
      symptoms and prevention of bone loss. This article focuses on the use of estrogen
      therapy during menopause and the pharmacotherapy of osteoporosis. Risks and
      benefits of hormonal therapy and regimen selection for menopausal women are
      discussed. The second section of the article focuses on current treatment
      strategies for osteoporosis.

PMID- 2236342
TI  - Chronic obstructive pulmonary disease.
AB  - Chronic obstructive pulmonary disease is indeed a multifaceted illness. The
      obstructive picture is the result of multiple pathologic processes. The most
      common cause is cigarette smoking. The key to decreasing the incidence of this
      disease is education to prevent people from starting to smoke and to educate
      those who do smoke to stop. The therapeutic management involves numerous
      medications, oxygen, and physiotherapy. Unfortunately, the pharmacologic
      management remains largely empiric with sympathomimetics, anticholinergics,
      methylxanthines, and corticosteroids. These agents, especially methylxanthines
      and corticosteroids, are not without considerable toxicity. Therefore, embarking
      on a pharmacologic plan requires weighing the risk to benefit ratio carefully and
      having a comprehensive plan to assess subjectively and objectively the efficacy
      and toxicity of the chosen therapy.

PMID- 2236343
TI  - Pharmacotherapy of asthma and allergic rhinitis.
AB  - It has become easier to treat and control the symptoms of asthma, while the
      treatment of allergies remains directed toward the prevention and blockade of
      histamine-induced symptoms. This article details treatment options, including
      beta-2 selective sympathomimetic agonists, methods of delivery, theophylline,
      cromolyn, corticosteroids, antihistamines, decongestants, and intranasal
      steroids.

PMID- 2236344
TI  - [Clinical study of postoperative delirium in the elderly].
AB  - It is said that the surgery is often followed by a delirious state (postoperative
      delirium) in the elderly, but there are few reports on detailed studies of this
      condition. To determine the frequency with which postoperative delirium occurs in
      the elderly, its main causes and clinical characteristics, etc., the author made
      a clinical study of 127 patients, aged 60 years and over, who were about to
      undergo operations. In this study, polygraphy was used in a postoperative
      electrophysiological study. Of the 127 patients, delirium was noted in 20
      (15.7%), there being little difference according to age or sex in the rate of
      occurrence, but in patients with malignancy, the rate was appreciably higher.
      Delirium became apparent between one day and two days after the operation and
      lasted for up to 6 days. We classified the types of delirium into the following
      three on the basis of clinical symptoms: hallucination type (5 cases), confusion
      type (8 cases) and hallucination-confusion type (7 cases). The possible causes of
      postoperative delirium include the patient's condition as shown in the pre and
      postoperative polygrams, the invasive effects of anesthesia and surgery (surgical
      procedures, length of time under anesthetic, time required for the operation,
      amount of blood lost and amount of blood received by transfusion, etc., the serum
      albumin before surgery, WBC after surgery, %delta PaO2, and whether ICU was used
      or not, and so on. Quite often in patients with postoperative delirium, the pre
      and postoperative polygrams show slow abnormality in the EEGs before surgery, and
      the eye movements of R(++)/RS pattern in the EOGs before and after surgery. Slow
      abnormality in the EEGs was much more frequently seen in the confusion type and
      hallucination-confusion type patients than in the hallucination type. In view of
      these results, we feel that any consideration of the occurrence of delirium must
      include the following factors. In cases where the effects of surgical invasion
      and metabolic disorder are greater, quite often consciousness is clouded
      following surgery. If the eye movements of R(++)/RS pattern is shown in the EOGs
      before surgery, as the clouding of consciousness is alleviated after the
      operation, considerable activity takes place in some of the brain's functions
      (those related to anxiety and tension, etc.) and a state of dissociation occurs
      in brain functions which would normally undergo integrated changes. It was
      thought that this dissociated state is manifested as the delirium.

PMID- 2236345
TI  - [Clinical study on depressive state following stroke].
AB  - A clinical study was made on depressive state following stroke using stroke
      patients in the chronic stage. There were 118 stroke patients in the present
      study and 25 patients (21.2%) satisfied the diagnostic criteria for major
      depressive syndrome of the Diagnostic and Statistical Manual of Mental Disorders,
      Third Edition Revised (DSM-III-R). As for dispositional, social, and somatic
      factors, a tendency was observed for depressive state to develop at a high
      frequency among patients with a past history of mental disorder prior to
      development of stroke, patients residing in suburban area, patients engaged in
      domestic and agricultural work, and patients with a frequent history of physical
      disorders. A tendency was observed for depressive state to develop at a high
      frequency among patients showing B type in YG test and patients presenting
      laterality in electroencephalography. Among the 49 right stroke patients,
      depressive state was observed in 10 cases (20.4%), while among the 43 left stroke
      patients, depressive state was seen in 10 cases (23.2%) with the incidence of
      depressive state showing no difference by hemisphere stroke. Study of the
      clinical characteristics of depressive state by hemisphere stroke with the use of
      symptom items of Zung scale and Hamilton scale showed that patients in depressive
      state with right hemisphere stroke had high values in symptom items considered
      close to the essence of endogenous depression such as depressed mood, suicide,
      diurnal variation, loss of weight, and paranoid symptoms, while patients in
      depressive state with left hemisphere stroke had high values in symptom items
      having a nuance of so-called neurotic depression such as psychic anxiety,
      hypochondriasis, and fatigue. Comparison with endogenous depression patients
      indicated that right stroke patients rather than left stroke patients showed a
      clinical picture suggestive of endogenous depression. Antidepressant was
      effective in 71.4% of the cases, but no difference in effectiveness could be
      observed by hemisphere stroke. In stroke patients in the chronic stage the
      incidence of clinical depressive state was higher than 20%, and involved in its
      onset were not only brain organ lesions but also dispositional, social, and
      somatic factors and integration dysfunction in the emotional activity of the left
      and right hemisphere functions. As for the clinical picture, a picture considered
      close to endogenous depression was observed in right stroke patients, while that
      considered close to so-called neurotic depression was seen in left stroke
      patients. The therapeutic effect of antidepressant was almost equivalent to that
      for endogenous depression.

PMID- 2236346
TI  - [Clinical and psychopathological study of delusional depression--relationship
      between the etiology and their personality].

PMID- 2236347
TI  - [Outcome of schizophrenia--extended observation (more than 20 years) of 129
      typical schizophrenic cases (II)].

PMID- 2236348
TI  - [A case of presenile dementia with peculiar speech-- palilalia].

PMID- 2236349
TI  - [Eye movements in schizophrenia--relationships among eye movements under three
      experimental conditions; closed-eye, pursuit, and exploratory].
AB  - In order to investigate the pathophysiology of schizophrenia using
      psychophysiological indicators of eye movements, this study was conducted to
      clarify relations among eye movements under three experimental conditions; closed
      eye, pursuit, and exploratory eye movements. Thirty-five chronic schizophrenic
      patients diagnosed by DSM-III-R criteria and 32 normal controls were examined.
      Horizontal eye movements were recorded electrooculographically with the subjects
      under two experimental conditions; one with eyes closed ("Closed-eye Eye
      Movement," Closed-eye EM), and the other with visually tracking a moving pendulum
      ("Pursuit Eye Movement," Pursuit EM). The closed-eye condition was further
      divided into two sub-conditions; one with the subjects awake and at rest, and the
      other with the subjects in the presence of a repetitive sound. Exploratory eye
      movements were recorded with an eye-mark recording system while the subjects
      viewing "S"-shaped geometric figures ("Exploratory Eye Movement," Exploratory
      EM). Indicators of eye movements under the three experimental conditions
      described above were measured and the correlations among them were investigated.
      Clinical symptoms in schizophrenics were assessed by BPRS, SANS and SADS and
      studied with the Factor Analysis method. In the Closed-eye EM, rapid eye
      movements appeared significantly more frequently and slow ones were less frequent
      in schizophrenics than in normals under both sub-conditions. The results for
      schizophrenics did not change significantly with the addition of sound stimuli.
      In the Pursuit EM, both the number and amplitude ratio of saccades were
      significantly larger in schizophrenics than in normals, although these indicators
      gradually decreased in both groups when tasks requiring concentration were
      demanded. In the Exploratory EM, the number of eye fixations, the total eye
      scanning length, and the "Responsive Search Score (RSS)," which is the total
      number of sections on which the eyes fixed during the response to the
      confirmative question, were all significantly smaller in schizophrenics than in
      normals. In schizophrenics, there were significant negative correlations between
      the RSS of the Exploratory EM and the number of rapid eye movements of the Closed
      eye EM, the RSS and the number, amplitude ratio of saccades of the Pursuit EM,
      respectively. On the contrary, in normals, significant positive correlations were
      found between the number of rapid eye movements and the number of
      saccades.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236350
TI  - [Performance-psychologic cross-sectional study of young schizophrenic patients
      with a subchronic and chronic disease course].
AB  - According to ICD-9 and DSM-III-R-criteria 14 subchronic schizophrenic male
      patients (duration of illness less than 2 years) and 17 chronically ill male
      schizophrenics (duration of illness between 5 to 12 years) matched for sex, age,
      education, type of illness, and medication were with the aid of 4 tests
      investigated with respect to time characteristics of performance parameters.
      Whereas subchronic patients revealed performance scores within the normal range
      of reference scores, chronically ill patients showed dissociative variations in
      performance (high scores in reasoning, low scores in speed factor). This can be
      interpreted as instability of brain functioning which characterizes
      schizophrenics suffering from a long duration of illness. Correlations between
      prolonged reactions to "crossmodal" choices and subjective basic symptoms in
      subchronic patients are hints at well established introspection ability of self
      regarded complaints.

PMID- 2236351
TI  - [Clinical and psychological test studies of the psychopathology of epilepsy].
AB  - 46 patients with generalised epilepsy and 67 patients with partial epilepsy were
      examined in respect of basic psychopathological symptoms in the stricter sense:
      rate reduction, viscosity, and perseveration. Comparison of the groups of
      patients classified pathologically with 34 healthy control subjects enabled
      psychopathological calibration of the battery of tests involved. This is turn
      resulted in differentiated the presentation of the influence on the basic psychic
      symptoms of epilepsy as such and the nature and frequency of attacks. The concept
      of different pathogenesis for the phenomenologically different symptoms viscosity
      and perseveration is discussed.

PMID- 2236352
TI  - [Magnetoencephalography--current trends].
AB  - The review deals with the method of magnet-encephalography. The physical
      principles and the most important technical conditions to put into practice this
      method are mentioned. Comparing with the electroencephalography this method shows
      various advantages, what leads to its intensive use for the localisation of
      components of evoked potentials, for the magnet-encephalographic record of the
      brain activity of the human fetus, and for the localisation of epileptic foci in
      therapy resistant epileptics.

PMID- 2236353
TI  - [Correlation of morphologic findings (CT) with clinical and relevant EEG findings
      in adult epileptics].
AB  - In the Brandenburg Epileptics' Center, 165 adult patients underwent computer
      tomography diagnosis in addition to the usual neuropsychiatric and EEG findings
      checklist. The findings were incorporated into the diagnosis of epilepsy. Results
      are discussed and it is suggested that the inclusion of cranial computer
      tomography in the diagnosis and the findings checklist would be an optimisation.

PMID- 2236354
TI  - [Experiences with psychosocial management of patients with multiple sclerosis in
      a discussion group].
AB  - Patients with multiple sclerosis must come to terms with their unpredictable
      chronic disease. Frequently, they want to establish contacts and exchange
      information with others sharing the same problems. Discussion groups of
      outpatients offer many opportunities to further the process of coping with the
      disease as an interlocking web of defensive and coping patterns. The patients can
      learn from each other to assess their disabilities and capabilities more
      realistically and to deal more openly with their fears, hopes and
      disappointments.

PMID- 2236356
TI  - The creative process: a functional model based on empirical studies from early
      childhood to middle age.

PMID- 2236355
TI  - [Acute tetraparesis in cervical spinal stenosis caused by chondrodystrophy].

PMID- 2236357
TI  - Obsessive compulsive disorder and basal ganglia dysfunction.

PMID- 2236358
TI  - Prospective role for adenosine and adenosinergic systems in psychiatric
      disorders.

PMID- 2236359
TI  - Ernst Kretschmer 1888-1964.
AB  - Until his retirement in 1959 Ernst Kretschmer was Professor of Psychiatry at the
      University of Tubingen. He published eight monographs, five of which were of
      eminent importance and at least two exerted considerable influence on European
      psychiatry for several decades, namely Der sensitive Beziehungswahn (1918) and
      Korperbau und Charakter (1921). His theory on constitutional body types and
      character became an integral part of German schoolbooks.

PMID- 2236360
TI  - Neuropsychological deficits and CT scan changes in elderly depressives.
AB  - A number of computerized tests were used to study visual attention, memory and
      learning in elderly depressed patients. Impairment was found in approximately 70%
      of depressed patients and was seen particularly in memory and in measures of
      latency. Depressed patients showed equivalent impairment in short-term memory but
      less impairment in conditional associative learning compared to a group of
      patients with early dementia of the Alzheimer-type (DAT), matched for age and pre
      morbid IQ. With respect to qualitative differences between depression and DAT,
      depressed patients showed a different pattern of errors and a consistently
      prolonged latency of response which was independent of delay in a delayed
      matching-to-sample test. On recovery from depression, although improvement was
      seen in most test scores, performance in measures of latency and in a number of
      tests of memory and learning failed to reach the level seen in a group of matched
      control subjects and approximately 35% of patients continued to show impairment.
      For the depressed patients, ventricular brain ratio (VBR) correlated with
      measures of slowing. In addition, in the 'recovered-depressives', VBR correlated
      with poor performance at high levels of task difficulty. These findings are
      discussed with respect to previous literature on the pattern of cognitive
      impairment and CT scan findings in depression.

PMID- 2236361
TI  - Neuroradiological and neuropsychological assessment in anorexia nervosa.
AB  - Seventeen patients with anorexia nervosa were examined by computed tomography
      (CT) and psychometry and compared with ten normal control subjects. The patients
      were found to have enlarged external cerebrospinal fluid spaces compared to
      controls. No differences were found in ventricular size and X-ray absorption
      density measurements between patients and controls. The patients performed
      abnormally on the symbol digit test, the scores of which displayed a significant
      negative correlation with the CT scan changes.

PMID- 2236362
TI  - Psychiatric consequences of temporal lobectomy for intractable seizures: a 20-30
      year follow-up of 14 cases.
AB  - Between 1958 and 1968, 14 patients from the epilepsy clinic at the University of
      Oregon Hospitals and Clinics with a diagnosis of temporal lobe epilepsy (TLE) had
      a temporal lobectomy for medically intractable seizures. Nine of the 14 patients
      operated on remained seizure-free over the 20-30-year period of follow-up.
      Between 6 months and one year following temporal lobectomy, two women, previously
      healthy from a psychiatric standpoint, developed psychoses, and the previous
      psychiatric problems of four other patients worsened. Two patients, one with
      incapacitating paranoid personality disorder and the other with explosive rage
      attacks preoperatively, had marked improvement in their psychiatric status
      following temporal lobectomy. The remaining six patients, all psychiatrically
      healthy prior to surgery, have had no change in psychiatric status following
      surgery. Development of psychosis or deterioration in psychiatric status after
      surgery was more common in patients with later age of onset, unreality or deja vu
      rather than epigastric aura, pre-operative evidence of bilateral brain damage,
      and persistence of EEG or clinical seizure activity. Development of a chronic
      psychosis in psychiatrically healthy individuals many months after temporal
      lobectomy, even when seizures are arrested or ameliorated, suggests that
      anomalous synaptic regeneration may follow the surgery in these cases. Careful
      analysis of histories and outcomes may contribute to better understanding of the
      pathophysiology and anatomical substrates of psychoses.

PMID- 2236363
TI  - Psychiatric aspects of HIV-1 infection and AIDS.
AB  - The literature on the psychiatric aspects of HIV-1 infection is reviewed. The
      whole range of psychiatric disorders described in HIV-1 infected subjects, from
      HIV-1 dementia to adjustment disorders, is covered, along with the AIDS-related
      psychopathology which may develop in subjects without HIV-1 infection.

PMID- 2236364
TI  - Psychological and physical determinants of premenstrual symptoms before and after
      hysterectomy.
AB  - The aim was to study women before and after hysterectomy (with conservation of
      the ovaries), in order to discover how far premenstrual symptoms are caused
      physically and how far psychologically. In such women both physical and
      psychological factors can influence premenstrual symptoms before hysterectomy;
      after the operation, in the absence of menstruation, only physical factors can do
      so. The subjects were 56 women awaiting hysterectomy for menorrhagia of benign
      origin. During three pre-operative months these women made daily self-ratings on
      a check-list in which typical premenstrual symptoms were interspersed with
      atypical symptoms; in this way their awareness of the premenstrual focus was
      minimized. Starting six months after hysterectomy, the women again kept daily
      check-lists for three months; over the same period their serum progesterone
      levels were measured to identify the premenstruum. After hysterectomy, levels of
      premenstrual symptoms fell significantly in the whole group, indicating that
      psychological factors were important determinants of such symptoms before
      hysterectomy.

PMID- 2236365
TI  - Sampling strategy in linkage studies of affective disorders.
AB  - Evidence of linkage in families of bipolar patients has so far been identified
      with genetic markers on chromosome X and 11. However, replications of these data
      have not consistently been reported in either case, which favours the hypothesis
      of genetic heterogeneity. Therefore, we have tried to outline a sampling strategy
      for linkage replication in affective disorders. We estimated the average number
      of nuclear families required to replicate X or 11 linkage as a function of the
      degree of heterogeneity as well as the number to prove heterogeneity given that
      linkage exists. The results are presented and discussed.

PMID- 2236366
TI  - Genetic and environmental determinants of the lability of trait neuroticism and
      the symptoms of anxiety and depression.
AB  - A genetic analysis was conducted on trait neuroticism and symptoms of anxiety and
      depression in a five-wave study of 462 twin pairs. Models that assessed the
      relative importance of genetic and environmental factors to the lability (within
      individual variability over time) of these measures were fitted to the data.
      Previous results concerning the substantial genetic involvement in the level of
      neuroticism and symptoms were confirmed. However, it was found that neither genes
      nor the shared environment of the twins was a significant cause of lability of
      these measures. An attempt was therefore made to identify aspects of individuals'
      environments that might be responsible for lability of neuroticism and symptoms.
      Adverse life events were found to predict variability of symptoms, but not of
      neuroticism. The availability of close social ties or having affectionless
      control in childhood did not contribute to lability.

PMID- 2236367
TI  - A contribution of fluorescent lighting to agoraphobia.
AB  - Under three types of artificial lighting 24 women with chronic agoraphobia and 24
      female control subjects assessed their mood and bodily symptoms, and their heart
      rate was measured. One of the three types of lighting was incandescent. The other
      two were fluorescent, one pulsating in the conventional manner 100 times per
      second and the other relatively steady. Both were provided by a single
      fluorescent lamp controlled from one of two circuits. When exposed to the
      conventional pulsating fluorescent light under double-blind conditions the
      agoraphobic group showed a higher heart rate and reported more anomalous visual
      effects in response to an epileptogenic pattern. Control subjects reported more
      bodily symptoms under the conventional fluorescent light than under the two other
      lighting conditions.

PMID- 2236368
TI  - Cognitive processing in post-trauma reactions: some preliminary findings.
AB  - The current study investigated a model of post-trauma reactions proposed
      initially by McFarlane (1988 a). Two separate data sets, one obtained following a
      multiple shooting and the other reported by McFarlane following a natural
      disaster, were examined. The findings of both studies provide support for a
      cognitive processing conceptualization of the development of post-trauma
      reactions.

PMID- 2236369
TI  - Psychological treatment for atypical non-cardiac chest pain: a controlled
      evaluation.
AB  - Thirty-one patients with atypical non-cardiac chest pain which had persisted
      despite negative medical investigation were treated in a controlled trial of
      cognitive-behavioural therapy. The average duration of pain was 4.7 years.
      Patients were randomized to either immediate treatment or as a control to
      assessment only. Treatment involved teaching patients how to anticipate and
      control symptoms, and modification of inappropriate health beliefs. The average
      number of sessions given was 7.2. There were significant reductions in chest
      pain. limitations and disruption of daily life, autonomic symptoms, distress and
      psychological morbidity in the treated group as compared with the control group
      who were unchanged. The assessment-only group were treated subsequently and
      showed comparable changes. Improvements were fully maintained by both treated
      groups at four- to six-months follow-up.

PMID- 2236370
TI  - Perceived parental rearing style, parental divorce and transsexualism: a
      controlled study.
AB  - The parental representations of male-to-female and female-to-male transsexuals
      were rated using the EMBU inventory. Scores on the measure were compared against
      ratings returned by controls of similar biological sex, matched on age,
      educational level and number of female siblings in an ANCOVA design. In line with
      previous findings by Parker & Barr (1982), who studied male-to-female
      transsexuals only, these patients were found not to differ from the male controls
      in their scoring of their mothers, but did score their fathers as less
      emotionally warm, more rejecting and more protective. Extending the findings by
      Parker & Barr (1982), female-to-male transsexuals rated both parents as more
      rejecting and less emotionally warm, but only their mothers as more protective
      than their female control equivalents rated theirs. Parental divorce
      distinguished both patient groups from controls, although further analyses
      revealed this not to imply more parental absence in patients than in controls.
      Male and female transsexuals differed from each other in some respects (e.g.
      lower scores on parental emotional warmth and higher scores on maternal rejection
      for the female patients), while being comparable in other respects (e.g. parental
      divorce).

PMID- 2236371
TI  - Obsessional states: anxiety disorders or schizotypes? An information processing
      and personality assessment.
AB  - This paper presents evidence that on an information processing task, designed to
      investigate putative inhibitory mechanisms in selective attention, obsessive
      compulsive disordered individuals can be clearly distinguished from other anxiety
      disorder clients and show significantly higher scores on questionnaire measures
      designed to detect schizotypy in the normal population. It is suggested that
      these results provide some support for the idea that obsessive-compulsive
      disorder may be misclassified as an anxiety disorder and may in fact be
      categorically more closely aligned to the schizophrenic constellation of
      disorders.

PMID- 2236372
TI  - Lycanthropy and demonomania: some psychopathological issues.
AB  - Modern reports on lycanthropy mainly concentrate on the content of patients'
      beliefs in being transformed into an animal. By contrast, an interest in the form
      of the symptomatology is usually minimal. This paper draws on Karl Jaspers'
      phenomenological views and focuses on some important albeit neglected
      psychopathological issues related to form which are relevant to any comprehensive
      consideration of lycanthropic phenomena.

PMID- 2236373
TI  - Hypertension labelling, life events and psychological well-being.
AB  - Almost all previous studies of the psychological sequelae of hypertension
      labelling have lacked a prospective, longitudinal design which could allow for
      causal interpretations. The present study relies on questionnaire data from a
      hypertension screening carried out on the entire adult population of a medium
      sized, Norwegian county (total number of participants = 74977). 'Labelled'
      individuals, i.e. previously unaware hypertensives (N = 173), false positives (N
      = 233), and patients in need of continued BP control (N = 474) have been followed
      up after 1-3 years, and comparisons are made with aware hypertensives (N = 206),
      patients previously treated for hypertension (N = 118), and a random sample of
      normotensives (N = 2326). 'Pre-labelling', baseline measures of subjective well
      being had been carried out on all comparison groups in connection with the
      screening. Changes in psychological well-being are not significantly related to
      labelling or BP-status. However, there is a deterioration in psychological well
      being among participants who have been subjected to one or more negative life
      events/stresses (other than labelling) in the preceding 12 months.

PMID- 2236374
TI  - Neurotic symptoms and subjective well-being in a community sample: different
      sides of the same coin?
AB  - Community survey data on neurotic symptoms and subjective well-being scales were
      examined with principal components analysis. The two types of scales were found
      to load on separate, but negatively correlated, factors. Furthermore, some
      differential correlates of the two types of scale were found, but the differences
      were not great. It was concluded that neurotic symptom and well-being scales do
      largely measure different ends of a single continuum, but well-being scales seem
      to have an extraversion component not shared by neurotic symptom scales.
      Subjective well-being measures may be useful in epidemiological surveys where it
      is desirable to discriminate among low symptom scorers.

PMID- 2236375
TI  - Life events and social stress in puerperal psychoses: absence of effect.
AB  - Thirty-three patients admitted to hospital with severe early onset puerperal
      psychiatric disorders were compared with matched normal puerperal controls.
      Interviews, which were administered after recovery, covered life events in the
      previous thirteen months and detailed assessment of previous and personal
      history, pregnancy and labour, other aspects of stress, social support, and
      marital relationships. No differences, except for previous history of psychiatric
      disorder, were found between patients and controls or between patients with
      depressive and with other diagnoses. These findings of absence of social stress
      contrast with previous studies of milder post-partum depression and of disorders
      with onset during pregnancy, and suggest that the aetiology of severe post-partum
      disorders is predominantly biological.

PMID- 2236376
TI  - Type A stress prone behaviour and breast cancer.
AB  - This quasi-prospective study of 2163 women attending breast-screening clinics
      (and controls), indicates that there is a link between personality factors and
      breast disease. Certain aspects of Type A behaviour seem to be associated with
      breast-disease states.

PMID- 2236377
TI  - Prevalence of three bulimia syndromes in the general population.
AB  - Prevalence of bulimia was estimated from a cross-sectional general population
      survey of 1498 adults, using the Diagnostic Interview Schedule (DIS) administered
      by trained lay interviewers. Lifetime prevalence of the DSM-III syndrome in
      adults aged 18-64 was 1.0% and this was concentrated in young women: in women
      aged 18-44 lifetime prevalence was 2.6%, and 1.0% currently had the disorder.
      Based on clinicians' reinterviews of random respondents and identified and
      marginal cases, the prevalence of current disorder using criteria for draft DSM
      III-R bulimia was 0.5%, for DSM-III it was 0.2%, and for Russell's Criteria
      bulimia nervosa 0.0%. A strong cohort effect was found, with higher lifetime
      prevalence among younger women, which is consistent with a growing incidence of
      the disorder among young women in recent years. Although elements of the
      syndromes were so common as to suggest that dysfunctional attitudes to eating and
      disturbed behaviour surrounding eating are widespread, there was little evidence
      of the bulimia syndrome having become an epidemic on the scale suggested by early
      reports.

PMID- 2236378
TI  - Mental health and medical consultation in primary care settings.
AB  - This paper examines the effect of psychiatric morbidity, as measured by the GHQ
      60, on the probability of being in contact with a primary care physician, and the
      socio-demographic factors which influenced this effect. We found that the
      presence of psychiatric morbidity emerged as a major determinant of primary care
      utilization in both sexes, and about one-sixth of consultations in men and one
      fifth of consultations in women could be attributed to it. Logistic modelling was
      used to investigate the joint effect on general practitioner consultation of
      psychiatric morbidity and seven socio-demographic variables. Sex, age, and
      psychiatric morbidity exerted independent, but not interactive, effects on
      consultation.

PMID- 2236379
TI  - Estimating psychiatric morbidity by logistic regression: application to post
      natal depression in a community sample.
AB  - The use of logistic regression to estimate the prevalence of psychiatric
      morbidity in community samples is illustrated here with data from a study of post
      natal depression in 702 primiparous Cambridge mothers. The method is also used to
      validate the primary screening instrument (in this case the Edinburgh Postnatal
      Depression Scale--EPDS), and to estimate the effects of cofactors, such as
      maternal age, previous psychiatric history and social class.

PMID- 2236380
TI  - Quality of life in chronically mentally ill patients in day treatment.
AB  - A structured assessment instrument, the Quality of Life Interview, was used to
      explain the quality of life of seventy patients with chronic psychiatric illness
      attending a day treatment programme. The interview was found to have acceptable
      psychometric properties. Factors that best predicted the quality of life of these
      patients included the number of re-admissions in the last year, frequency of
      family contacts, satisfaction with social life, psychiatric health and adult
      education. The theoretical implications and potential clinical benefits of these
      findings for chronic psychiatric patients are discussed.

PMID- 2236381
TI  - Psychiatric morbidity among Punjabi medical patients in England measured by
      General Health Questionnaire.
AB  - The 28-item GHQ was administered to 282 Punjabi and white British patients
      visiting two Health Centres in Bedford. We discovered that ethnicity is not
      significantly correlated with GHQ 'caseness', but that differences exist in
      somatic and depressive symptomatology. The discussion relates these findings to
      debates about the psychiatric morbidity of Asian immigrants and somatization.

PMID- 2236382
TI  - Do mental health surveys disturb?
AB  - We have tested the assumption that mental health surveys do not cause distress.
      At the end of a two-wave community survey of psychiatric symptoms and personality
      factors, respondents were asked specific questions about how the interviews
      affected them. Being interviewed was distressing for some individuals, but it was
      seen as beneficial by a larger number. Those reporting distress were more likely
      to have had neurotic symptoms prior to both interviews and to have personality
      characteristics which would indicate proneness to distress. Whether the distress
      lasted beyond the interview situation is unknown. These results suggest that
      surveys of mental health should tell intended respondents about the possible
      effects of the interview, both positive and negative. Some studies should try to
      estimate the duration of any distress reported to have been induced.

PMID- 2236383
TI  - A model of stability and change in minor psychiatric symptoms: results from three
      longitudinal studies.
AB  - A statistical model designed to estimate the contributions of stable and changing
      symptomatology to levels of minor psychiatric symptoms is developed. This model
      is fitted to data obtained from three longitudinal studies. These studies
      involved subjects from Canberra (Australia), Christchurch (New Zealand) and
      Groningen (Holland). Data from all three data sets were shown to fit the proposed
      model adequately. However, there were systematic differences in the findings of
      the study. The findings from the Canberra and Groningen studies suggested that a
      large amount (50-75%) of the variance in symptom levels could be attributed to
      between subject difference in stable levels of symptomatology. In contrast the
      Christchurch study suggested a smaller contribution of stable symptomatology.
      These differences may be explained by the nature of the samples studied. All
      three studies showed evidence of strong correlations (0.79-0.94) between stable
      levels of symptomatology and the measure of trait neuroticism. It is concluded on
      the basis of this evidence that the neuroticism may be little more than a way of
      measuring the subject's characteristic level of minor psychiatric symptoms. The
      model also made it possible to secure estimates of the extent to which measures
      of neuroticism were contaminated by short-term mental state. Estimates of
      contamination effects varied between studies. For the Canberra data contamination
      was negligible, for the Groningen data mild contamination effects were present
      but for the Christchurch data contamination was larger. These differences may be
      explained by differences in the nature of the samples studied.

PMID- 2236384
TI  - Marital conflict and children's adjustment: a cognitive-contextual framework.
AB  - Marital problems have been related to numerous indexes of maladjustment in
      children. Although several parameters of this association have been identified,
      the process by which exposure to interparental conflict gives rise to adjustment
      problems in children is largely unexplored. Research on the link between marital
      conflict and child maladjustment therefore is critically evaluated, and a
      framework is presented that organizes existing studies and suggests directions
      for future research on processes that may account for the association. According
      to the framework, the impact of marital conflict is mediated by children's
      understanding of the conflict, which is shaped by contextual, cognitive, and
      developmental factors. The implications of the framework for children's
      adjustment are discussed.

PMID- 2236385
TI  - Enhancement of social learning family interventions for childhood conduct
      disorder.
AB  - Social learning family intervention (SLFI) is the treatment of choice for young
      children exhibiting severe conduct disorder and antisocial behavior. Despite the
      reported success of this intervention, high levels of resistance, poor
      engagement, and inadequate maintenance of improvements are observed for a
      substantial proportion of distressed families. These obstacles have inspired
      enhancement efforts to improve basic social learning family-intervention models.
      The present review identifies promising approaches for maximizing treatment gains
      for the conduct-disordered child. Relevant studies were organized into 3
      approaches: enhancements and expansions (a) within a dyadic (parent-child)
      interaction model, (b) within a broad-based model that acknowledges a wider range
      of family influences, and (c) through a multisystems model. SLFI enhancements
      within the dyadic model have centered on either the strengthening of parental
      skills already included in the SLFI regimen or the adding of new interactional
      strategies. Some gains, but only partial success, have been achieved with the
      dyadic model supplements. SLFI expansions from a broad-based model have focused
      on parental adjustment, parental expectations during treatment, and social
      environmental stressors. The multisystems adjuncts to SLFI include cognitive
      behavioral interventions to affect peer relations and ecological approaches to
      sweep across domains. The broad-based and multisystems expansions have produced
      promising but undertested treatment regimens. Related areas of investigation
      included therapy process research, medication combined with SLFI, and the
      involvement of fathers in treatment. Recommendations are offered for improvement
      of SLFI research. The apparent theoretical crossroads for SLFI treatment of
      childhood conduct disorder are discussed.

PMID- 2236386
TI  - Burnout among Dutch psychotherapists.
AB  - The development of a Dutch adaptation of the Maslach Burnout Inventory is
      described. Preliminary results on burnout for 98 Dutch psychotherapists indicate
      that (on the average) young therapists and therapists who are employed in
      regional mental health services are more prone to burnout.

PMID- 2236387
TI  - Predicting alienation in a sample of Nigerian Igbo subjects.
AB  - Seeman in 1959 suggested that alienation is a multidimensional concept. Using two
      aspects of Seeman's concept of alienation, powerlessness and social alienation,
      and two concepts derived from Lachar's 1978 Minnesota Multiphasic Personality
      Inventory Cookbook, emotional and self-alienation, the present work was
      undertaken to ascertain which concept will more likely predict feelings of
      alienation. A stepwise multiple regression showed that among 160 Nigerian (Igbo)
      subjects the feeling of powerlessness predicted alienation more than did the
      other concept.

PMID- 2236388
TI  - What women think and what men think women think: perceptions of abuse and
      kindness in dating relationships.
AB  - The purpose of this study was to investigate how college women and their
      boyfriends viewed their relationships in terms of both abuse and kindness. The
      women filled out the Psychology Abuse-Kindness Relationship Inventory for
      themselves and their boyfriends responded to the questionnaire as they thought
      their girlfriends would. Several intriguing findings resulted: (1) Men thought
      their girlfriends would respond more negatively about the relationship than the
      women actually did. (2) Certain aspects of the relationship resulted in more
      discrepancies between the men's and women's perceptions. (3) Women distinguished
      present from past relationships by describing the former as more positive and the
      latter as more negative; men made no such distinction. Alternative explanations
      were offered to account for these results including projection, denial,
      projective identification, lack of psychological separation within couples, men's
      emotional upbringing and deeply rooted feelings towards women.

PMID- 2236389
TI  - Family satisfaction with medical care after traumatic brain injury.
AB  - Ratings during acute and follow-up care by 35 families having members with
      traumatic brain injury showed none of the medical facilities met families' needs
      though some aspects of patients' care were rated higher in hospitals. Findings
      suggest comprehensive surveys are needed.

PMID- 2236390
TI  - Beyond the psychiatric principle: a proposal for a psychological paradigm for the
      description and classification of psychopathology.
AB  - Dissatisfaction with the psychiatric system of classification of psychopathology
      has existed for decades. The many revisions have not rectified the many problems.
      An entirely different paradigm for the description and classification of
      psychopathology seemed necessary. Based on research, a proposal for a
      psychological system of classification of psychopathology is offered, one based
      on disorder in cognitive, emotional, and social functioning. A program of
      research to test the validity and heuristic value of this system is discussed.

PMID- 2236391
TI  - Individuation and adult children of alcoholics.
AB  - 42 adult male and 99 female volunteers from the Washington and Baltimore areas
      were administered the Psychological Separation Inventory, the Personal Authority
      in the Family System Questionnaire, the Adult Child of Alcoholics Screening Test,
      the Michigan Alcoholism Screening Test, and the Symptom-Checklist-90--R in a
      study of variables associated with the development of psychopathology of adult
      children of alcoholics. Individuation evolving from family dynamics rather than
      from intrapsychic individuation was more crucial to the development of
      psychopathology.

PMID- 2236392
TI  - Sibling variable correlates of children's academic achievement: family-group
      differences.
AB  - The study examined the proposition that relationships among sibling variables,
      intellectual ability, and academic achievement vary for children from different
      family-environment groups. Data were collected from 900 11-yr.-old Australian
      children and their parents. In the analysis, the children were classified into
      four family contexts that were defined conjointly by family social status and
      parents' academic socialization. Within each family group, regression surfaces
      were constructed from models that included terms to account for possible linear,
      interaction, and curvilinear associations among the variables. The results
      suggested the general proposition that within the family-environment groups,
      sibling variables were not related to academic achievement at different levels of
      children's ability. However, the findings indicated that there were variations to
      this general proposition. Indeed, there were a number of complex associations
      between the sibling variables and children's academic achievement in the
      different family-environment groups.

PMID- 2236393
TI  - Quantitative studies of responses elicited by selected TAT cards.
AB  - Quantitative differences in subjects' responses to selected TAT cards were
      studied. 70 white, female college students wrote stories in response to TAT Cards
      1, 2, 3BM, 12M, and 13MF. Stories were scored for several measures of drive
      intensity, defensive pattern, and object relational pattern. On all measures, the
      several cards were associated with different patterns of response. The use of the
      pattern of scores on several cards (as opposed to aggregate measures summing
      responses to several cards) for exploration of the ebb and flow of various
      aspects of intrapsychic functioning is discussed.

PMID- 2236394
TI  - The Ways of Coping instrument: reliability and temporal stability for a sample of
      employees.
AB  - Convergent support is demonstrated for the use of seven empirically derived
      scales of the Ways of Coping instrument developed by Lazarus and his colleagues.
      While the instrument is widely used, until now the internal consistency of the
      coping measures and stability of the factor structure have yet to be shown for a
      sample of employed adults. While type of job and type of coping incident reported
      are not dependent, analysis indicates that work and nonwork groups differ across
      several coping dimensions. Research implications and directions are addressed.

PMID- 2236395
TI  - Solution acceptance by common ravens (Corvus corax) given two-bottle preference
      tests.
AB  - Two-bottle tests of solution acceptance were conducted in an outdoor aviary with
      eight common ravens (Corvus corax). Aqueous concentrations of the following
      chemicals were used: five common sugars, three salts, two acids, quinine
      hydrochloride, and sodium saccharin. Solution acceptance, as recorded for the
      different ravens on each test, was the percentage of preference shown for a test
      solution over water (comparison solution). Mid-range saccharin concentrations
      (0.10% to 0.80% [w/w]) were preferred over water in the tests. The preference for
      saccharin contrasts with all other reports on avian response to the chemical in
      two-bottle tests. Nonetheless, the ravens nonpreferentially accepted lower
      concentrations or were averse at higher concentrations to drinking sugar
      solutions. Similar, though more sharply marked, shifts from indifference to
      aversion were noted in tests with the other chemicals. The possible relevance of
      these latter findings to the food habits of ravens is discussed.

PMID- 2236396
TI  - Night waking and temperament in early childhood.

PMID- 2236397
TI  - Association of country, sex, social class, and life cycle to locus of control in
      western European countries.
AB  - Relatively few studies have focused on causal factors in the development of locus
      of control. Here nine western European countries are studied to assess the
      hypothesis that the society in which one lives is important in the scores on
      locus of control. The data indicate greater variation resulting from country of
      residence on locus of control than that from the variables of life cycle, sex,
      and social class. Findings regarding these latter variables are congruent with
      previous research. In addition, being single was related to having an external
      locus of control.

PMID- 2236399
TI  - Recollecting events associated with victimization.
AB  - Subjects first completed social desirability and anxiety personality scales and
      then read a story about a woman meeting her brother for lunch. Some subjects were
      then told that the story involved sexual abuse. A week later all subjects took a
      multiple-choice memory test over the story. The results indicated that subjects
      categorized as repressors based on the personality scales had a lower proportion
      of negative than positive errors than did the nonrepressors, but only when they
      believed the story was about sexual abuse. However, repressors answered correctly
      as many items as did nonrepressors. The results were consistent with the idea
      that repressors remember as much about victimization experiences as do
      nonrepressors but are more likely to fill in the missing details of victimization
      experiences with positive reconstructions designed to reduce the over-all
      negative quality associated with victimization.

PMID- 2236400
TI  - Suicide and presidential elections in the USA.

PMID- 2236398
TI  - Felonious murder of police officers by ambush.

PMID- 2236401
TI  - Prevalence of smokeless tobacco consumption at a southwestern university.
AB  - 265 students attending a southwestern university were surveyed about their use of
      smokeless tobacco products. 27% of 84 male respondents indicated they consumed
      smokeless tobacco. The women did not report routine use of smokeless tobacco.

PMID- 2236402
TI  - Low scores on California Psychological Inventory as predictors of psychopathology
      in alcoholic patients.
AB  - This study concerned the use of generally low California Psychological Inventory
      (CPI) profiles to predict elevated MMPI scores. In a sample of 110 subjects, a
      CPI profile with T-scores of 25 or less reflects major psychopathology and there
      is a 79% chance of correct prediction of MMPI T-scores over 80. As a further
      validation, a Goldberg Individual Index was established with a cut-off score of
      70 to classify profiles as psychotic or nonpsychotic. It appears that the
      California Psychological Inventory can be expanded in making dual diagnoses for
      alcoholic patients. Scores can be used in treatment planning for alcoholic
      patients and to identify those individuals who should complete an MMPI for
      additional treatment planning and diagnoses.

PMID- 2236403
TI  - Adolescents' locus of control and compliance with contingency contracting and
      counseling interventions.
AB  - This study compared secondary school students' compliance with counseling or
      contingency contracting for truancy and disruptive behavior. Contracting was more
      effective than counseling with the 44 truants but not for those showing
      disruptive behavior (n = 52). Individuals with an internal locus of control were
      more responsive to counseling than those with external locus of control.

PMID- 2236404
TI  - Parental child-rearing attitudes associated with Type A behaviors in children.
AB  - The relation of Type A behaviors to parental child-rearing attitudes was assessed
      for 177 mothers, 153 fathers, and their children in preschools. Type A behaviors
      of children were measured on the Japanese version of the Matthews Youth Test for
      Health (MYTH), and parental child-rearing attitudes were measured on the Parents'
      Attitudes Test (PAT). Children were classified as Type A and Type B on the basis
      of their MYTH scores, and parental child-rearing attitudes in the two types were
      compared in a combination of parental sex (mothers vs fathers) and child's sex
      (boys vs girls). Analysis showed that especially mothers and fathers of Type A
      boys had less concern for their children than their peers whose boys were
      classified as Type B. The notion that boys showing Type A behaviors might develop
      Type A behavior patterns by striving to obtain more expression of concern or
      affection from their parents was presented.

PMID- 2236405
TI  - Citation patterns of the two social psychologies.

PMID- 2236406
TI  - Anger reactions of Iranian adolescents.
AB  - The purposes of this study were to examine the anger reactions of Iranian
      adolescents directed against their peer groups, parents, and teachers, or school
      faculties, and also to compare the results with Gesell's data from 1956. A
      questionnaire was developed according to Gesell's study to investigate the kinds
      of anger reactions 454 high school students (258 girls and 196 boys) expressed
      against their peer groups, parents and teachers, or school faculties. Adolescents
      used more crying against their fathers than mothers, peers, and teachers and more
      verbal aggression against their peers than their parents and teachers. For kind
      of anger reaction against parents and teachers or school faculties chi squared
      was significant across sex of adolescents. Finally, the kinds of anger reactions
      against mothers and stronger peers were significantly related to mothers'
      education.

PMID- 2236407
TI  - Effects of a forced institutional relocation on the mortality and morbidity of
      nursing home residents.
AB  - Residents of a county nursing home underwent a forced, mass relocation.
      Gerontologists advised on preparation of staff and residents. No increase in
      residents' mortality or morbidity was found after the relocation. The highest
      death rate was in the anticipatory period, the year prior to the move.

PMID- 2236408
TI  - Low self-esteem in eating disordered patients in the absence of depression.
AB  - Both low self-esteem and depression are well recognised as occurring in patients
      with eating disorders. 43 patients with eating disorders were studied to assess
      whether this low self-esteem occurred as part of an affective disorder or was
      independent of this. The patients, 23 with anorexia nervosa and 20 with bulimia
      nervosa, were assessed for low self-esteem, using the Rosenberg Self-esteem
      Questionnaire, and for depression, using the Hospital Anxiety and Depression
      Scale. The patients had low self-esteem, despite only a minority (33%) being
      depressed. This study demonstrates that low self-esteem occurs in patients with
      eating disorders in the absence of depression.

PMID- 2236409
TI  - Development and preliminary validation of a questionnaire assessment of expressed
      emotion.
AB  - A questionnaire for management of expressed emotion was constructed. It consisted
      of two scales, criticism and emotional overinvolvement. The questionnaire and the
      Camberwell Family Interview were then administered to relatives of schizophrenics
      and preliminary assessments of scale reliabilities and concurrent validities were
      done. Both questionnaire scales were reliable. With respect to validity the
      criticism scale correctly classified 88% of the subjects relative to the
      criticism scale of the interview. The emotional overinvolvement scale was less
      satisfactory (67%) but still assisted in classification of over-all expressed
      emotion. Expressed emotion, classification by the questionnaire, correctly
      identified 84% of the subjects with respect to the interview.

PMID- 2236410
TI  - Sources of meaning through the lifespan.
AB  - 185 men and women representing five developmental ages ranging from younger to
      older adulthood (17 to 96 yr) completed several measures to assess the amount and
      origins of most meaningful events in a person's life. As assessed by a
      modification of the Purpose-in-Life Test, the amount of purpose did not vary per
      se with age or sex. Similarly, the sources of meaning did not alter across time
      or sex. Themes of involvement emerged as the salient sources of meaning and
      included love, work, births of children, independent pursuits, accidents,
      illnesses, deaths, separations, or divorces, and to a lesser extent major
      purchases. The common sources and their timing are discussed within the context
      of a lifespan developmental model.

PMID- 2236411
TI  - Rational suicide: a test of the prescriptions of Epicurus concerning suicide.
AB  - The purpose of this research was to test the hypothesis that the individual who
      believes death is the end and who expects to experience more displeasure than
      pleasure over the remainder of his life will choose suicide. College students (N
      = 272) completed questionnaires measuring their beliefs about after-life,
      expectations of pleasure and displeasure should certain negative events happen to
      them, and expectations of suicide should these negative events happen to them.
      Support was not found for the hypothesis. The students who believed that death
      was the end stated that they would choose to live even if negative events
      promised them a life of greater displeasure than pleasure.

PMID- 2236412
TI  - Relating computer-associated stress to computerphobia.
AB  - The associations of computer-related stress, somatic complaints, and
      computerphobia were studied by administering questionnaires covering demographic
      data, exposure to computer information, computer-related stress, as measured by
      the Computer Technology Hassles Scale, somatic complaint items of the Hopkins
      Symptom Checklist, and Rosen, Sears, and Weil's measures of computerphobia:
      Computer Anxiety Rating Scale, Attitudes Toward Computers Scale, and Computer
      Thoughts Scale to 109 students. Correlations indicated scores on the Computer
      Technology Hassles Scale were significantly correlated .35 with somatic
      complaints, .27 with years used a computer, and .28 with self-rated computer
      knowledge. The Computer Technology Hassles Scale was not significantly correlated
      (.18, -.08, and -.05) with the three measures of computerphobia. Computer-related
      stress appears to be distinct from computerphobia.

PMID- 2236413
TI  - Therapeutic techniques vs therapeutic relationships in child behavior therapy.
AB  - The parents of 56 children who had received behavior therapy rated a number of
      variables, including the degree to which they viewed the therapeutic relationship
      versus the specific techniques used in treatment as important, the extent to
      which the child improved in therapy, and the child's present functioning.
      Therapists also provided ratings of clinical improvement. Even though parents
      gave the highest ratings for the importance of the relationship in therapy, the
      correlation between technique and clinical outcome was statistically significant
      while the correlations between the relationship and outcome was not. These
      statistical associations also held when therapists rated improvement. Also,
      therapists saw greater improvement in children than did the parents. Over-all,
      the results support the view that the relationship and techniques are interwoven
      and are both perceived as important factors in treatment.

PMID- 2236414
TI  - Relating locus of control to Machiavellianism and managerial achievement.
AB  - Rotter's Locus of Control Scale, Christie and Geis' Mach IV Scale, and Fineman's
      Work Preference Questionnaire were administered to a sample of 60 retail
      specialty store managers. While there were no significant correlations between
      locus of control and managerial achievement, there were significant correlations
      between locus of control and Machiavellianism for the over-all sample and for men
      but not for women. In addition, men possessed higher mean internal-control
      orientation than women.

PMID- 2236415
TI  - Medical resources and suicide prevention.

PMID- 2236417
TI  - Relationship between anxiety and premenstrual syndrome.
AB  - The relationship between symptoms of the premenstrual syndrome and anxiety was
      assessed for 68 women. The syndrome as measured by a modified version of the Moos
      Menstrual Distress Questionnaire, was correlated significantly with trait
      anxiety, as measured by Spielberger's State-Trait Anxiety Inventory. Trait
      anxiety was correlated with all three subtypes from the questionnaire:
      behavioral, psychological, and physical, most strongly for the psychological
      subtype. These findings suggest a role for stress-management training in the
      treatment of the premenstrual syndrome.

PMID- 2236416
TI  - Boredom proneness in pathological gambling.
AB  - To test the hypothesis that pathological gamblers seek stimulation as a means of
      reducing aversive under-aroused states of boredom and/or depression, the Beck
      Depression Inventory, Zuckerman's Sensation Seeking Scale and a Boredom Proneness
      Scale were administered to 48 diagnosed pathological gamblers and a control group
      of 40 family physician patients. Analyses of variance showed pathological
      gamblers obtained significantly higher boredom proneness and depression scores
      than those of controls. That the Boredom Proneness Scale failed to correlate with
      the Zuckerman Boredom Susceptibility subscale suggested the two measure differing
      dimensions. Results indicated the possible existence of three subtypes of
      pathological gamblers, one group characterized by boredom, another by depression,
      and a third by a mixture of both depression and boredom.

PMID- 2236418
TI  - Loneliness among Japanese and American college students.
AB  - Both Japanese and American college students (ns = 100), away from home at their
      first year in college, showed high scores in the Differential Loneliness Scale,
      with Japanese students scoring higher on all subscales.

PMID- 2236419
TI  - Differential effects of pet presence and pet-bonding on young children.
AB  - Pets have been shown to influence human development, but whether the effect is
      due to the presence of a pet or to the person's relationship with a pet is
      uncertain. Mothers rated their young children's companion animal bond
      (relationship) and social competence on a parental questionnaire, and a
      researcher assessed the children's empathy, cooperation, and intelligence during
      home visits. Significant correlations were noted between the children's bonds
      with their companion animals and their scores on the social competency scales as
      well as their empathy scores. The lack of similar significant pet presence
      ("ownership") correlations supports the hypothesis that the children's
      relationships with their pets are more important than just the presence of one or
      more pets in their homes.

PMID- 2236420
TI  - Relationship between scores on developing cognitive abilities test and scores on
      medical college admissions test for nontraditional premedical students.
AB  - The relationship of students' performance on the Developing Cognitive Abilities
      Test (DCAT), a test of scholastic aptitude, and their subsequent performance on
      the Medical College Admission Test (MCAT) were examined for 122 nontraditional
      premedical students who participated in a medical educational preparatory
      program. A stepwise multiple regression analysis produced moderate, though
      significant multiple correlations among subscores on the two tests. While there
      were a few exceptions, for the most part all of the subscores on the Developing
      Cognitive Abilities Test made a significant contribution to the regression
      equation in the prediction of scores on MCAT subtests. Implications for the value
      of the Developing Cognitive Abilities Test as an admissions tool as well as
      providing direction for possible intervention are discussed.

PMID- 2236421
TI  - Political behavior: voting participation of inner-city elderly blacks compared to
      other populations in a medium-sized city.
AB  - Voting participation was examined across nine elections in Omaha, Nebraska.
      Voting frequencies of all eligible voters in the city, all elderly eligible
      voters, and a random sample of inner-city elderly black voters were compared. The
      analysis shows that frequency of voting among inner-city elderly black
      individuals was the same as among all elderly persons in seven of the nine
      elections and significantly higher than that found among eligible voters of all
      ages in all nine of the elections.

PMID- 2236422
TI  - Educational needs of school personnel regarding child abuse and/or neglect.
AB  - From a review of literature a questionnaire was developed to identify problems
      related to child abuse/neglect in a rural school district. School administrators,
      regular and special education teachers, and counselors completed the survey to
      help establish more effective training programs. Analysis indicated that (1)
      school personnel need further assistance in dealing with problems pertaining to
      the maltreatment of students. (2) Formal, coordinated, workshop training for
      child abuse/neglect is needed. (3) Colleges and universities should offer
      instruction on abuse/neglect for persons preparing to work in schools. (4) School
      personnel need to be aware of and abide by the laws regarding reporting cases of
      abuse/neglect. (5) Improved communication among school, community, courts, and
      social service agencies is required for dealing wtih abuse cases. (6) School
      personnel should become more aware of what happens after abuse/neglect has been
      reported. Information from such analysis even for one school district can
      increase insight into problems.

PMID- 2236423
TI  - Attitudes toward autopsy refusal by young adults.
AB  - A survey of 158 18- to 24-yr. old college and 119 noncollege adults indicated
      that the latter were more reluctant to approve autopsies for spouses, children
      and distant relatives. Nonstudents also expressed more objections to autopsies
      than did students.

PMID- 2236424
TI  - Cognitive appraisal of daily hassles in college students showing Type A or Type B
      behavior patterns.
AB  - To test the hypothesized role of cognitive appraisal in Lazarus' model of life
      stress, 312 male and female undergraduate students completed the Hassles Scale
      and the Jenkins Activity Survey, Form C. Based upon their scores on the Type A
      scale of the Jenkins Activity Survey, subjects showing Type A behavior pattern
      differed significantly from subjects showing Type B behavior pattern on both
      reported frequencies of hassles (higher for Type A scoring subjects) and hassles
      content pattern. This is interpreted primarily as supportive of the cognitive
      appraisal variable in Lazarus' life stress model.

PMID- 2236425
TI  - Modification of the Word Association Test for assessing Posttraumatic Stress
      Disorders.
AB  - Suggestions for clinical modifications of the Word Association Test in assessing
      patients for Posttraumatic Stress Disorders are outlined. Two cases are briefly
      mentioned.

PMID- 2236426
TI  - MMPI comparisons of Hispanic- and white-American veterans seeking treatment for
      alcoholism.
AB  - Scores of 29 Hispanic- and 46 white-American alcoholics, who voluntarily sought
      psychiatric treatment for their alcoholism, were compared on the MMPI. It was
      hypothesized that Hispanic-American alcoholics would be better adjusted than
      white alcoholics on the validity and clinical scales of the MMPI. The hypothesis
      was supported, with Hispanic-Americans obtaining significantly lower scores than
      white veterans on the Pd, Mf, and Si scales. Hispanic and white patients did not
      differ on the remaining MMPI scales. The mean two-point code for Hispanic
      subjects was 2-8 (Depression-Schizophrenia) and for white patients 8-2
      (Schizophrenia-Depression).

PMID- 2236427
TI  - Alcohol-related expectancies reported by college women to a large dose of
      alcohol.
AB  - A sample of 50 college women taking part in a previous study about expected
      effects of moderate doses of alcohol were contacted a second time. Of the
      original 50 subjects 47 now reported their expectancies for a large dose of
      alcohol both for themselves and for others by simply stating the three most
      probable effects in terms of behavior and emotion. They primarily expected
      themselves to become happy and others generally to misbehave. When answers were
      coded as positive or negative, subjects expected positive or negative effects
      both for themselves and others on the first choice. On the second and third
      choices, the proportion of negative expectancies increased significantly,
      especially for others. Results from the previous and the present study were
      compared, and it was concluded that subjects seem to have very few but dominant
      expectancies.

PMID- 2236428
TI  - Psychophysiology at the interface of clinical science, cognitive science, and
      neuroscience.
AB  - Research in schizophrenia illustrates that the field of psychophysiology lies at
      the interface of clinical science, cognitive science, and neuroscience.
      Electrodermal abnormalities in schizophrenic patients have been found reliably
      across laboratories, and data reported here demonstrate that these abnormalities
      are at least partially dependent upon the clinical state of the patients. Both
      tonic and phasic electrodermal activity increased when schizophrenic patients
      entered into a psychotic episode, and preliminary evidence suggests that the
      increases may serve as early prodromal signs of an impending episode.
      Significance of the electrodermal abnormalities for understanding cognitive and
      attentional deficits is suggested by associations with secondary reaction time
      and startle blink probe findings. Neuroscience implications are highlighted by
      the correlation of the electrodermal abnormalities with regional brain metabolic
      activity indexed by positron emission tomography. An important task for the
      future is to interrelate measures from these various domains. The field of
      psychophysiology is particularly well positioned for this task.

PMID- 2236429
TI  - Cognitive determinants of the postimperative negative variation.
AB  - This study examined cognitive determinants of the postimperative negative
      variation (PINV), a slow brain potential observable after the onset of an
      imperative stimulus in a forewarned reaction time task. Controllability of the
      aversive imperative stimulus by a motor reaction and predictability of the
      contingency were varied in a factorial design. The exogenous portion of the slow
      negative wave was assessed in a passive listening condition using tones of the
      same quality as the imperative stimuli, but presented without forewarning.
      Results show that PINV not only occurs when control is absent but also during
      unpredictably gained control. Similarly, unpredictable lack of control yields a
      more negative potential than continual helplessness. Negativity elicited by the
      aversive tone alone was not significantly different from PINV during predictable
      lack of control. The order of conditions, which was manipulated between groups,
      did not affect amplitudes. It was concluded that contingency change is a crucial
      cognitive determinant of the PINV, whereas the effect of lack of control is
      difficult to differentiate from the sensory influence of the acoustic
      stimulation.

PMID- 2236430
TI  - Aerobic fitness, physical activity, and psychophysiological reactions to mental
      tasks.
AB  - The association between aerobic fitness, exercise, and psychophysiological
      reactivity was assessed in cross-sectional and prospective analyses. Seventy-five
      healthy but sedentary adults carried out a sub-maximal exercise test and easy and
      difficult problem solving tasks. Blood pressure, heart rate, skin conductance
      level, respiration rate, tidal volume, and oxygen consumption were monitored and
      additional heart rate was also computed. Differences between relatively fit and
      unfit individuals were found in respiration rate during tasks and in skin
      conductance level during post-task recovery periods, with a tendency toward
      diminished heart rate reactivity in fitter people. Subjects were subsequently
      allocated to four conditions: high intensity aerobic training, moderate intensity
      aerobic training, an undemanding strength and flexibility program (designed as an
      attention-placebo condition), and waiting list control. Training programs were
      conducted over a 10-week period, and were followed by a second laboratory
      session. Appropriate changes in aerobic performance over the training period were
      observed in the 12-min run/walk test. There were no important modifications in
      psychophysiological stress reactions associated with the different experimental
      conditions. These results are discussed in relation to the literature concerning
      the effects of fitness and physical activity on physiological response patterns.

PMID- 2236431
TI  - Effects of stimulus repetition, duration, and rise time on startle blink and
      automatically elicited P300.
AB  - Intense auditory stimuli of sudden onset evoke not only startle blinks but also
      an event-related potential component resembling classic P300, even when subjects
      have no assigned task. To more closely examine the relationship of this P300 to
      startle, event-related potentials and eyeblink were recorded from 16 young adults
      in three paradigms designed to produce wide variation in startle amplitude: an
      Habituation series of 30-ms, 105dBA white noise bursts, a Duration paradigm which
      presented 105dB noise bursts for 3, 10, 30, or 90 ms, and a Rise Time paradigm
      which varied the rise/fall times (3, 15, 30, and 45 ms) of 110dBA, 1000-Hz tone
      bursts. Subjects received two runs of each paradigm. Only on the final Duration
      and Rise Time runs were stimuli explicitly task relevant; on those runs subjects
      rated verbally, midway in each 8.4-s interstimulus interval, the disturbingness
      of the prior sound. Although even the briefest noise bursts evoked parietal P300
      as well as startle blink, P300 did not behave like startle. P300 habituated more
      slowly than did blink amplitude, was more responsive to sustained noise than were
      blink, N110, and P190, and most importantly, did not show the sensitivity to
      stimulus rise time manifested by these measures. These findings suggest that the
      amplitude of automatically elicited P300 is not governed by the same mechanisms
      as startle amplitude, but behaves more like a defense response.

PMID- 2236432
TI  - Maturation of startle facilitation by sustained prestimulation.
AB  - The startle response to a 104dB (SPL) 50-ms burst of white noise was facilitated
      by prestimulation with a nonstartling tone sustained for 2 s prior to the
      startling stimulus in 3, 4, 5, and 8 year old children and young adults. Both
      startle amplitude and onset latency showed significantly greater facilitation in
      the preschool children than in the 8-year-olds and adults. The results of this
      experiment, which used a fixed prestimulation interval, were compared to those of
      an earlier study in which the prestimulation interval was varied. The
      maturational changes in startle facilitation in response to the 2-s
      prestimulation interval were similar in the two experiments. Hence the
      maturational effect on startle facilitation was independent of the uncertainty
      (as to when the startling stimulus would be given), which might be associated
      with variable prestimulation intervals. These findings suggest that the neuronal
      mechanisms that mediate startle facilitation undergo development during early
      childhood and mature about 8 years of age, and that this maturational sequence is
      relatively independent of attentional effects.

PMID- 2236433
TI  - Do instructions modify effects of beta-adrenoceptor blockade on anxiety?
AB  - To study the interaction between physiological and cognitive factors in anxiety,
      44 subjects with public speaking anxiety were allocated to four different groups.
      Two groups received either beta-adrenoceptor blockade (100 mg of atenolol) or
      placebo orthogonally crossed with an instruction that heart rate would decrease
      or an instruction that did not mention cardiovascular effects. During the
      delivery of a speech, measures of heart rate, systolic and diastolic blood
      pressures, and self-reported anxiety were obtained. All variables increased
      during an anticipation period before speech, and heart rate, systolic blood
      pressure, and self-reported anxiety increased further during speech. Regardless
      of instructions, atenolol decreased heart rate and systolic blood pressure during
      both anticipation and speech, whereas no differences were found in self-reported
      anxiety. This lack of a relationship was seen in spite of the correctly perceived
      heart rate reduction in the atenolol-treated group receiving an instruction that
      heart rate would decrease. Cardiac aware subjects, according to the Autonomic
      Perception Questionnaire, showed higher levels of heart rate and self-reported
      anxiety at rest than did cardiac unaware subjects. During speech, even though
      heart rate was similar in atenolol treated groups, self-reported anxiety was
      higher in cardiac aware than in cardiac unaware subjects. The lack of a
      relationship between heart rate and self-reported anxiety is discussed in terms
      of primary and secondary emotions. It is suggested that the perception of
      external rather than internal cues determines situationally elicited anxiety.

PMID- 2236434
TI  - Event-related potentials to visual and language stimuli in normal and dyslexic
      children.
AB  - Event-related potentials (ERPs) were recorded in 31 normal and 21 dyslexic
      children, the latter with visual processing impairment, in three visual reading
      related tasks: a nonalphabetic, an alphabetic, and a lexical decision task (two
      levels of difficulty in each). ERPs were recorded from fifteen active electrodes
      for 1.5 s following stimulus presentation; analyses were done on difference
      waves. N2 and P3 components were usually longer in latency and P3 was lower in
      amplitude in the dyslexic than in the normal children. The P3 had a flatter,
      broader distribution in the dyslexics than in the controls, which was very
      similar to the effect of difficulty in the two easier tasks. The lack of Group X
      Age interactions is inconsistent with either a maturational lag between the
      groups of children, or with the dyslexic children catching up to normals in terms
      of their speed of processing. Thus, the dyslexic children required more time to
      process the visual information across tasks (with only their letter
      classification being equal to that of the normal controls) and approved to have a
      different developmental pattern in their ERPs from that of the normal children.

PMID- 2236435
TI  - Effects of methylphenidate on processing negativities in patients with attention
      deficit hyperactivity disorder.
AB  - This study compared the impact of methylphenidate on patients with Attention
      deficit Hyperactivity Disorder (ADHD) with and without aggressive/noncompliant
      features in an oddball test consisting of a randomly ordered series of loud
      (frequent) tones, soft (rare) tones, bright (frequent) lights, and dim (rare)
      lights. In alternate conditions, subjects were required to respond to either the
      rare tones or the rare lights. These tasks were administered in a drug-free
      baseline session and after a counterbalanced treatment of 14 days each of
      methylphenidate (0.3 mg/Kg b.i.d.) and placebo (lactose b.i.d.). In comparison
      with placebo, methylphenidate resulted in greater accuracy and speed of reactions
      to targets of both modalities. The amplitude of N1 to auditory nontargets was
      larger when the target was a rare tone as opposed to a rare light, and this
      attention-related effect was increased by methylphenidate. The same differential
      amplitude enhancement by stimulant treatment was found for an early area measure
      of difference ERPs. In contrast, for N1 to visual nontargets the effect of
      selective attention (larger amplitude when the target was a rare light vs. a rare
      tone) was not significant and was not affected by stimulant medication. All these
      findings were comparable for the three ADHD subgroups, a result attesting to the
      generality of stimulant effects on information processing.

PMID- 2236436
TI  - Parietal P3 response as an indicator of stimulus categorization: increased P3
      amplitude to categorically deviant target and nontarget stimuli.
AB  - Two experiments were performed in which we compared the effects of selected non
      deviant versus categorically deviant stimuli on parietal P3 under a variety of
      conditions in which one, both, or neither stimulus was a target of an
      experimental task. Subjects were repeatedly presented with series of 8 numeric
      stimuli and 1 alphabetic (Deviant) stimulus. P3 amplitudes to target and
      nontarget Deviant stimuli were consistently and significantly larger than to
      other, non-deviant targets and nontargets, respectively. Nontarget Deviant
      stimuli evoked P3 amplitudes comparable to those evoked by low-probability non
      deviant targets. The observed differences indicate that P3 amplitude is a
      sensitive indicator of perceived category differences, and that the effect of
      category deviance on parietal P3 amplitude is independent of task response
      classification (target or nontarget) and of response probability.

PMID- 2236437
TI  - What is "the vagal effect"? A rejoinder to Velden et al.'s interpretation of the
      cardiac cycle time effect.

PMID- 2236438
TI  - DMA-mode timing question for A/D converters.

PMID- 2236439
TI  - The power method for computing largest eigenvectors (principal components) of a
      dispersion matrix using minimal computer memory.

PMID- 2236440
TI  - Voluntary facial action generates emotion-specific autonomic nervous system
      activity.
AB  - Four experiments were conducted to determine whether voluntarily produced
      emotional facial configurations are associated with differentiated patterns of
      autonomic activity, and if so, how this might be mediated. Subjects received
      muscle-by-muscle instructions and coaching to produce facial configurations for
      anger, disgust, fear, happiness, sadness, and surprise while heart rate, skin
      conductance, finger temperature, and somatic activity were monitored. Results
      indicated that voluntary facial activity produced significant levels of
      subjective experience of the associated emotion, and that autonomic distinctions
      among emotions: (a) were found both between negative and positive emotions and
      among negative emotions, (b) were consistent between group and individual
      subjects' data, (c) were found in both male and female subjects, (d) were found
      in both specialized (actors, scientists) and nonspecialized populations, (e) were
      stronger when the voluntary facial configurations most closely resembled actual
      emotional expressions, and (f) were stronger when experience of the associated
      emotion was reported. The capacity of voluntary facial activity to generate
      emotion-specific autonomic activity: (a) did not require subjects to see facial
      expressions (either in a mirror or on an experimenter's face), and (b) could not
      be explained by differences in the difficulty of making the expressions or by
      differences in concomitant somatic activity.

PMID- 2236442
TI  - P300, probability, and interstimulus interval.
AB  - The relationship between target stimulus probability and interstimulus interval
      on the P300 (P3) component of the event-related potential was assessed in three
      experiments. In each study an auditory discrimination paradigm was employed
      wherein subjects indicated with a finger tap response the occurrence of a
      randomly presented 2000 Hz target tone embedded in a series of 1,000 Hz tones.
      Target stimuli were presented with a probability of either .20 or .80 in
      different conditions which were combined factorially with different interstimulus
      intervals. Experiment 1 presented stimuli at 2.0, 2.5, or 3.0 second intervals;
      Experiment 2 presented stimuli at 2.0, 3.0, or 4.0 second intervals; Experiment 3
      presented stimuli at 4.0, 6.0, or 10.0 second intervals. P3 amplitude was larger
      for the .20 relative to the .80 target probability conditions for the shorter
      interstimulus intervals but not for the longer intervals. P3 latency was
      consistently longer for the .20 relative to the .80 target probability
      conditions, with generally little effect observed for interstimulus interval
      changes. The results suggest that interstimulus interval affects component
      amplitude by determining the amount of processing resources available when the P3
      is produced.

PMID- 2236441
TI  - On the shift from anticipatory heart rate deceleration to acceleratory recovery:
      revisiting the role of response factors.
AB  - The influence of inducing motor responses of low and high force at different
      times in the cardiac cycle was examined. A handgrip response was used which
      allowed the separation of response initiation from response completion. Based on
      earlier work, we expected initiation, rather than completion, to initiate
      poststimulus cardiac acceleration. We also thought that preparation for a high
      force response might alter preparatory changes of interbeat interval differently
      from preparation for a low force response. Fifteen college-aged male subjects
      performed a warned reaction time task in which a visual stimulus signalled a
      handgrip requiring either a high or a low force to close. NoGo trials in which an
      inhibit signal was presented occurred on 12% of the trials. Stimuli occurred
      either on the R-wave of the electrocardiogram or 300 ms later. Reaction speed was
      varied in different trial blocks by rewarding response times of 200 ms (+/- 50
      ms), 300 ms, or 400 ms. Results based on the timing of response initiation were
      essentially identical to those based on the timing of response completion. High
      force relative to low force was associated with both earlier response initiation
      and earlier cardiac acceleration. Force did not alter preparatory cardiac
      deceleration. Force and response speed did, however, alter the level of heart
      rate after response occurrence. Thus, response initiation (or an earlier response
      process) appears to induce a cardiac acceleration whose level is influenced by
      the speed and force of the motor response.

PMID- 2236443
TI  - Event-related potentials and recognition memory for pictures and words: the
      effects of intentional and incidental learning.
AB  - Event-related potentials were recorded under conditions of intentional or
      incidental learning of pictures and words, and during the subsequent recognition
      memory test for these stimuli. Intentionally learned pictures were remembered
      better than incidentally learned pictures and intentionally learned words, which,
      in turn, were remembered better than incidentally learned words. In comparison to
      pictures that were ignored, the pictures that were attended were characterized by
      greater positive amplitude frontally at 250 ms and centro-parietally at 350 ms
      and by greater negativity at 450 ms at parietal and occipital sites. There were
      no effects of attention on the waveforms elicited by words. These results support
      the view that processing becomes automatic for words, whereas the processing of
      pictures involves additional effort or allocation of attentional resources. The
      N450 amplitude was greater for words than for pictures during both acquisition
      (intentional items) and recognition phases (hit and correct rejection categories
      for intentional items, hit category for incidental items). Because pictures are
      better remembered than words, the greater late positive wave (600 ms) elicited by
      the pictures than the words during the acquisition phase is also consistent with
      the association between P300 and better memory that has been reported.

PMID- 2236444
TI  - Interpersonal influence as active coping: effects of task difficulty on
      cardiovascular reactivity.
AB  - This study examined the effects of attempting social influence on cardiovascular
      reactivity. Subjects were randomly assigned to a noncontingent reward condition
      or one of three conditions in which receipt of a monetary reward was contingent
      on their ability to influence another individual through a persuasive
      communication. In the contingent conditions, the task was presented as either
      easy, difficult, or very difficult. Measures of systolic blood pressure,
      diastolic blood pressure, and heart rate were recorded while subjects prepared
      and delivered the persuasive communication (contingent conditions) or reviewed
      and read aloud the same statement without an incentive to influence. The
      contingent conditions produced significantly higher levels of systolic and
      diastolic blood pressure and heart rate reactivity during preparation and
      speaking. Further, reactivity was higher in the difficult condition than in the
      easy and very difficult conditions. The findings are discussed in terms of an
      interpersonal equivalent of traditional active coping tasks.

PMID- 2236445
TI  - Topographic quantitative EEG in elderly subjects with major depression.
AB  - Some previous quantitative EEG research indicates that depressed subjects show
      increased alpha and beta compared to controls. In this report, absolute and
      relative amplitude measures of topographic EEG were used to compare elderly
      subjects with major depression to sex and age matched control subjects. Elderly
      depressed subjects showed significantly higher absolute alpha amplitude than
      controls, but regional differences did not specifically distinguish them.
      Relative alpha amplitudes, and absolute and relative measures of beta, delta, and
      theta did not reliably distinguish depressed and control subjects. The results
      are discussed in the context of previous EEG research in depression and the
      elderly. Methodological features and the implications of these findings for state
      and trait dependent conceptualizations of depression are considered.

PMID- 2236446
TI  - Menstrual cycle phase is a potential confound in psychophysiology research.
AB  - Effects of menstrual cycle phase on physiological levels and reactivity were
      studied in a within-subject design with 20 women aged 18-30 years. Basal body
      temperature was monitored daily; follicular and luteal recording sessions
      occurred before and after the ovulatory temperature rise, respectively. The
      design consisted of task and rest periods, presented in counterbalanced order
      across phases. Half the subjects began during their follicular phase and half
      began during their luteal phase. Follicular and luteal phases were compared for
      differences between baseline resting levels, as well as for reactivity. The
      results showed menstrual phase differences in heart rate, pulse transit time, and
      EEG alpha, particularly during tasks, but no difference in reactivity.
      Habituation effects in the group that began during the follicular phase often
      masked luteal activation. In spite of the fact that not all statistical results
      achieved significance, the consistency of most trends supports the conclusion
      that physiological recording sessions with women might best be restricted to the
      follicular phase.

PMID- 2236447
TI  - Detection of colon distension in colonostomy patients.
AB  - Inborn and learned ability to detect mild, nonpainful distension of the sygmoid
      colon was examined in 22 patients who underwent colonostomy one year or more
      before the investigation. The colon was distended by a balloon inserted 10 cm
      below the orifice of the artificial anus. Each subject participated in three
      sessions on three consecutive weeks with several experimental tasks in each
      session. During each task, the patient received the colon stimulus (the "signal")
      25 times randomly paired with masking auditory or annular skin stimuli (around
      the stoma or 15 cm medially to it). The masking (warning) stimuli were
      administered in series of 50, representing the "noise," according to signal
      detection paradigms. The subjects had to indicate after each administration of
      the warning noise stimulus whether or not they thought the colon stimulus had
      been presented. In all three sessions, learning tasks were included using
      reinforcement of successful detection trials. Seven subjects out of 22 were
      considered good perceivers, 9 persons were considered medium perceivers, and the
      remaining 6 subjects were considered poor perceivers. According to the data of
      the first two groups, it can be hypothesized that most patients have some
      inherent sensitivity of colon distension, and that learning improves this initial
      ability. However, the role of skin, peritoneal, or interstitial receptors in
      colon distension detection cannot be excluded.

PMID- 2236448
TI  - Existing and training induced differences in aerobic fitness: their relationship
      to physiological response patterns during different types of stress.
AB  - Aerobic fitness has been associated with various desirable psychological and
      physiological characteristics. Recently, attenuation of physiological reactivity
      during stressful situations was added to this list, although comparison of the
      stress responses of sportsmen and sedentary subjects has yielded equivocal
      results. The present study examined cardiovascular patterns rather than single
      variables, and tried to clarify these matters. Tasks were used that were known to
      increase blood pressure through different combinations of changes in cardiac
      output and vascular resistance. Autonomic nervous system dynamics underlying
      these response patterns were studied using preejection period as an index of beta
      adrenergic activity, and respiratory sinus arrhythmia as an index of vagal
      activity. Pre-existing differences in aerobic fitness in a sample of sedentary
      subjects were related to their responses during the stressful tasks and the
      recovery periods afterwards. This approach prevented confounding of the
      relationship between fitness and stress-reactivity with the psychological effects
      of regular exercise. Furthermore, it excluded the bias in psychological makeup
      that is introduced when subjects spontaneously engaged in sports are compared to
      non-exercising persons. To rule out a third (hereditary?) factor underlying both
      stress-reactivity and fitness, physiological responses before and after a seven
      week training program were compared to those of subjects in a waiting list
      control group. Substantial individual differences in aerobic fitness were found
      in spite of the fact that all subjects reported low levels of habitual activity.
      During two active coping tasks, diastolic blood pressure reactivity and vagal
      withdrawal were negatively related to these pre-existing differences in fitness.
      No such relation was seen during a cold pressor test or during recovery from the
      tasks. Neither beta-adrenergic cardiac reactivity nor heart rate responses were
      related to fitness, but the absolute heart rate during the tasks was lower in the
      more fit subjects. Seven weeks of training were not effective in changing either
      reactivity or recovery of any of the variables. The discrepancy between cross
      sectional and longitudinal results in the present study suggests that training of
      longer duration is necessary to induce the psychological or physiological changes
      underlying reduced reactivity. The latter may include changes in cardiac
      vagal/sympathetic balance or in adrenoceptor sensitivity. Alternatively, both
      psychological and physiological determinants of stress-reactivity may be related
      to aerobic fitness at a dispositional level.

PMID- 2236450
TI  - The 29th annual meeting of the New Clinical Drug Evaluation Unit (NCDEU). May 30
      June 3, 1989, Key Biscayne, Florida. Proceedings.

PMID- 2236449
TI  - Stimulus control and response measurement in human psychophysiological research
      using the Macintosh computer.

PMID- 2236451
TI  - Plasma GABA in mood disorders.
AB  - Plasma levels of gamma-aminobutyric acid (GABA) were determined in 68 healthy
      controls and in 133 patients with mood disorder. Plasma GABA levels were
      significantly lower in the patients with mood disorder compared to controls.
      Levels of plasma GABA were similar among diagnostic groups (primary unipolar
      depression, bipolar depression, mania, and secondary depression). No differences
      in plasma GABA were found in patients classified according to family history, nor
      were any correlations found between plasma GABA levels and severity of depression
      as determined by the 17-item Hamilton Rating Scale for Depression. These findings
      support the notion that low plasma GABA may represent a biological marker for
      mood disorder.

PMID- 2236452
TI  - Buspirone in depressed outpatients: a controlled study.
AB  - One hundred fifty-five outpatients suffering from major depression with
      significant anxiety entered a double-blind study comparing 8 weeks of treatment
      with buspirone or placebo. Twenty-nine percent of buspirone and 40 percent of
      placebo patients discontinued treatment before 8 weeks. Major efficacy measures
      were the Hamilton Rating Scale for Depression (HAM-D) total score, the HAM-D
      retardation and anxiety factors, the HAM-D Rickels and Bech core depression
      clusters, the Clinical Global Impressions (CGI), and the Hopkins Symptom
      Checklist (HSCL). Results were consistent across all outcome measures, including
      the two core depression clusters, with treatment response to buspirone
      significantly better than to placebo at treatment endpoint. Seventy percent of
      buspirone and 35 percent of placebo patients (p less than .01) were rated
      moderately or markedly improved after 8 weeks of therapy. Buspirone was found to
      be safe and well-tolerated by patients with major depression and concomitant
      anxiety at doses of up to 90 mg/day.

PMID- 2236453
TI  - Pattern analysis shows beneficial effect of fluoxetine treatment in mild
      depression.
AB  - In a multicentered study, 372 patients with mild major depressive disorder with a
      Hamilton Rating Scale for Depression (HAM-D) score of 15 to 19 were randomly
      assigned to 6 weeks of treatment with placebo or 20 mg, 40 mg, or 60 mg/day of
      fluoxetine. Patients were rated weekly for improvement and the appearance of side
      effects. Pattern analysis of treatment response showed more patients in the
      active drug treatment groups having a persistent or a delayed persistent
      response, the types of response specifically associated with active treatment.
      Analyses of mean changes in treatment measures showed little difference among
      treatment groups. This may be explained in part by different distributions in
      outcome, placebo patients having had a higher frequency of mild improvement with
      fewer negative and very positive outcomes. Response rate analyses favor the
      active treatments numerically, but only one of the comparisons is statistically
      significant. These findings suggest a specific role for fluoxetine treatment in
      mildly depressed patients who do not respond promptly or who respond
      inconsistently to nonspecific treatment.

PMID- 2236454
TI  - Avoiding neurotoxicity with lithium-carbamazepine combinations.
AB  - A therapeutic synergism has been well documented with carbamazepine (CBZ) and
      lithium in some patients who do not respond adequately to either drug alone.
      Because both of these drugs can induce neurotoxicity, concern has been expressed
      about their safety when combined. The serum levels for effective and safe dosage
      have been determined when these drugs are used alone. Unfortunately, this
      information does not give us automatic insight into the range of safe serum
      levels for each drug when these drugs are combined. We do not know whether the
      contribution of each drug to the neurotoxicity is the same. We have plotted the
      paired serum levels on a two-dimensional graph and quantitatively determined the
      region where we begin to encounter neurotoxicity. When we examine the available
      data on this graph, we see no evidence for synergistic neurotoxicity.

PMID- 2236455
TI  - Mirtazapine vs. amitriptyline vs. placebo in the treatment of major depressive
      disorder.
AB  - Patients (n = 150) were randomized to a 6-week, double-blind study to evaluate
      the relative efficacy and safety of mirtazapine, amitriptyline, and placebo in
      the treatment of major depressive disorder symptoms. Average daily modal doses
      were mirtazapine, 18 mg; amitriptyline, 111 mg; and placebo, 4.6 capsules.
      Mirtazapine- and amitriptyline-treated patients had statistically significantly
      greater mean Hamilton Rating Scale for Depression (HAM-D) score reductions
      (weekly visits 1, 2, 4, and endpoint) compared to placebo. These findings were
      supported by the Montgomery-Asberg Depression Rating Scale (MADRS); the Zung Self
      rating Depression Scale (SDS); and the Clinical Global Impressions (CGI) scales.
      Somnolence and weight gain were the only adverse clinical experiences (ACEs)
      reported substantially more often by mirtazapine-treated patients than by those
      in the placebo group. However, more amitriptyline-treated patients reported
      decreased visual accommodation, dry mouth, dyspepsia, constipation, tachycardia,
      hypertension, hypotension, discoordination, dizziness, and tremor than
      mirtazapine- or placebo-treated patients. Results of this study indicate that
      mirtazapine is more effective than placebo in the treatment of these patients,
      and superior to amitriptyline in respect to anticholinergic and cardiovascular
      effects.

PMID- 2236456
TI  - Seasonal affective disorder: rapid resolution by low-dose alprazolam.
AB  - Seasonal affective disorder (SAD) has recently been recognized as a common
      psychiatric disorder, and treatment with bright artificial light has been shown
      to be effective in treating fall-winter SAD. However, many patients with SAD fail
      to respond or find phototherapy too inconvenient. We thus assessed the efficacy
      of alprazolam in 6 patients diagnosed with SAD during the course of ongoing
      clinical treatment. Alprazolam was administered in doses ranging from 0.5 mg to
      1.5 mg daily. This agent produced rapid and dramatic results in 4 patients, with
      remission of symptoms occurring in about 3 days. These patients initially became
      hypomanic or hyperthymic, and then settled into a state of euthymia about 2 weeks
      later. Two patients had a moderate response but were still symptomatic. Five
      subjects received continuous treatment for at least an entire season, and none
      experienced withdrawal symptoms upon discontinuation. Alprazolam may represent an
      effective and well-tolerated alternative treatment for SAD.

PMID- 2236457
TI  - A single estimate of separate within-individual correlations: applications in
      psychopharmacology.
AB  - Simple procedures are proposed to describe relationships between sets of repeated
      measures within study subjects. An example is the association between blood
      levels of prolactin and a drug (e.g., methylphenidate) measured at multiple time
      points across study subjects. These procedures consist of (a) estimating Pearson
      product moment correlation coefficients (rs) within individuals using all the
      observations available per individual; (b) estimating an average r that pools the
      information across study subjects; (c) testing whether these rs are homogenous
      using a simple chi-square test; and (d) testing the average r for statistical
      significance. If these individual rs are found to be homogeneous, the average r
      is taken as representative of the individual rs. Testing rs for homogeneity and
      pooling them across individuals are relatively old procedures (Snedecor 1956).
      Recent applications can be found in the meta-analytic literature (Rosenthal
      1983). Applications are demonstrated using actual data. We recommend using these
      procedures because they are simple and easily applied and interpreted.

PMID- 2236458
TI  - A clomipramine dosage reduction study in the course of long-term treatment of
      obsessive-compulsive disorder patients.
AB  - Ten patients with DSM-III-R obsessive-compulsive disorder (OCD) who were being
      treated chronically with clomipramine (270 +/- 20 mg/day) were studied to
      determine the minimum dose of clomipramine needed to maintain therapeutic
      benefit. These 10 patients were among the 17 of 18 patients recently reported to
      develop a return of OC symptoms following discontinuation of clomipramine under
      double-blind, placebo-controlled conditions. Each patient was rated twice--open
      and double-blind--at both initial and minimum doses of clomipramine, using the
      following three OC measures: the Yale-Brown Obsessive Compulsive Scale (YBOCS),
      the National Institute of Mental Health-Obsessive Compulsive Scale (NIMH-OC), and
      the National Institute of Mental Health Global Obsessive-Compulsive Scale (NIMH
      Global OC Scale). Gradual, open dosage reduction resulted in a mean dosage of 165
      +/- 19 mg/day, a reduction of 105 mg/day (approximately 40%, t = 5.55, p less
      than .001). This decrease in dose was accompanied by no significant change in the
      three OC measures, as determined by paired t-test. These results suggest that
      even though OCD patients were not able to discontinue medication completely, they
      were able to do well at lower doses than those used initially in treatment of the
      disorder.

PMID- 2236459
TI  - A placebo-controlled study of enciprazine in the treatment of generalized anxiety
      disorder: a preliminary report.
AB  - Enciprazine is a propanolamine derivative with a preclinical profile similar to
      buspirone but with less affinity for the postsynaptic dopamine receptor (Linden
      et al. 1988). We report on the outcome, using intent-to-treat data, of a 5-week,
      double-blind trial comparing three dose strengths of enciprazine (5 mg t.i.d., 10
      mg t.i.d., and 20 mg t.i.d.) to placebo. A dose escalation was permitted after 2
      weeks of active drug treatment, which 61 percent of patients overall took
      advantage of. A "last observation carried forward" (LOCF) analysis found a mean
      improvement in Hamilton Anxiety Scale (HAM-A) scores by Week 5 of -11.0 for the
      combined enciprazine treatment groups, and -4.4 for the placebo group (p less
      than .05). Fifty-two percent of enciprazine patients were judged to be "much" or
      "very much" improved, whereas none of the placebo patients were judged to have
      comparable improvement. Enciprazine was well-tolerated, with low levels of
      sedative and asthenic side effects reported. The compound appears to have promise
      as an anxiolytic agent.

PMID- 2236460
TI  - Behavioral response to methylphenidate and treatment outcome in first episode
      schizophrenia.
AB  - In order to examine the relationship of behavioral response to psychostimulants
      and acute treatment response, we administered methylphenidate (0.5 mg/kg i.v.),
      an indirect dopamine (DA) agonist, to 38 patients who met Research Diagnostic
      Criteria (RDC) for definite or probable schizophrenia or schizoaffective
      disorder, were experiencing their first acute episode of psychosis, and had
      received less than 12 weeks or no prior lifetime neuroleptic exposure. Following
      baseline methylphenidate infusions, patients received a standardized regimen of
      acute neuroleptic treatment. Methylphenidate produced an increase in
      psychopathology reflected by a worsening of both positive and negative symptoms.
      Using a priori criteria, 61 percent of patients exhibited psychotic symptom
      activation, and 39 percent showed no change. Activation during methylphenidate
      infusion during the initial acute phase of illness was not correlated with time
      to achieve antipsychotic treatment response but was associated with side-effect
      vulnerability.

PMID- 2236461
TI  - Steady-state pharmacokinetics of tacrine in patients with Alzheimer's disease.
AB  - Neurochemical studies of Alzheimer's disease (AD) suggest deficiencies in the
      cholinergic system. We evaluated the steady-state pharmacokinetics of tacrine
      (Cognex), an oral cholinesterase inhibitor, in 12 patients with AD. Patients
      sequentially received nine doses of 10 mg, 20 mg, and 30 mg of tacrine every 6
      hours. Blood samples were collected until 24 hours after the final dose. Plasma
      tacrine concentrations were measured using a validated high-performance liquid
      chromatographic method. Mean maximum plasma concentrations (Cmax) were 5.1 ng/ml,
      20.7 ng/ml, and 33.9 ng/ml following administration of 10 mg, 20 mg, and 30 mg
      doses, respectively. Corresponding mean values for steady-state area under the
      curve (AUC) were 19.7 ng/ml, 82.9 ng/ml, and 139 ng/ml.hr. Dose-normalized Cmax
      and AUC values after administration of the 20 mg and 30 mg doses of tacrine were
      comparable to each other but were significantly greater (p less than .05) than
      those after the 10 mg doses. The apparent elimination half-life was approximately
      3.4 hours for all dosing regimens. Dose-dependent increases in Cmax and AUC
      values in patients with AD were similar to those previously reported in normal
      volunteers. The mechanism of the nonlinearity in tacrine pharmacokinetics is
      unknown.

PMID- 2236462
TI  - The effect of concomitant disorders in childhood depression on predicting
      treatment response.
AB  - Children with pure depression or depression plus an anxiety-related disorder (n =
      14) had a higher drug response rate (57%) and a lower placebo response rate (20%)
      when compared to children with depression plus a concomitant conduct or
      oppositional disorder (n = 17) (33% drug response rate and 67% placebo response
      rate). These findings could explain why studies of prepubertal-onset depression
      found no differences between drug and placebo treatment assuming that a large
      percentage of the studies' subjects had concomitant conduct or oppositional
      disorders. The children with pure depression or depression plus an anxiety
      related disorder had different symptom clusters from those with depression plus a
      concomitant conduct or oppositional disorder. The former had more severe CDRS
      ratings on sleep, appetite disturbance, depressed feelings, and psychomotor
      retardation. In contrast, those with a concomitant conduct or oppositional
      disorder had shorter attention spans and were more likely to disturb other
      children (based on Conners scale scores).

PMID- 2236463
TI  - Saliva and serum lithium monitoring in hospitalized children.
AB  - Serum and saliva lithium levels are presented for 30 inpatients, ages 5.12 to
      11.95 years, diagnosed as having conduct disorder of the undersocialized
      aggressive type. Maintenance doses of lithium carbonate ranged from 600 mg to
      1,500 mg/day. Serum and saliva lithium levels were significantly correlated at
      optimal dose (r = .78, p less than .001) and overall (r = .83, p less than .001),
      lending support to the use of saliva lithium levels as an adjunct to serum
      lithium determinations. However, because saliva/serum lithium ratios reveal wide
      ranges between subjects, the use of saliva levels is limited, and laboratory
      assessments should be combined with careful clinical monitoring.

PMID- 2236464
TI  - Followup of adolescents initially treated for prepubertal-onset major depressive
      disorder with imipramine.
AB  - This preliminary followup of adolescents (n = 16) with prepubertal-onset major
      depressive disorder (MDD) suggests that a significant number continue to be
      depressed or possibly depressed (62%) and have moderate to severe ongoing
      psychosocial adjustment problems. A concomitant diagnosis of conduct or
      oppositional disorder at index assessment was a risk factor for an increased
      incidence of interim depressive episodes and more severe psychosocial adjustment
      problems including alcohol and drug abuse.

PMID- 2236465
TI  - S-adenosyl-L-methionine (SAM) in adults with ADHD, RS: preliminary results from
      an open trial.
AB  - The psychostimulants d-amphetamine and methylphenidate are thought to be the most
      effective treatment in children, adolescents, and adults with attention deficit
      hyperactivity disorder (ADHD) because they potentiate both dopamine (DA) and
      norepinephrine (NE) at the synaptic cleft. These medications are not free from
      side effects and controversy. Newer effective and safe treatments are needed. S
      Adenosyl-L-methionine (SAM), the active form of methionine, acts as a methyl
      donor and is involved in many metabolic pathways. It has beta adrenergic and DA
      receptor agonist activity. We have been using oral SAM in a sample of well
      diagnosed adults with ADHD, residual state (RS) in a 4-week open trial to
      establish SAM effectiveness and safety and in a 9-week, double-blind, placebo
      controlled crossover trial. Preliminary data from the open trial reveal that 75
      percent (6 out of 8 male) patients improve on it. The 2 who did not improve had
      not improved on methylphenidate trial. Improvement ranged from moderate to
      marked, with minimal and transient side effects that did not interfere with
      functioning.

PMID- 2236466
TI  - Therapeutic levels of valproate for psychosis.
AB  - Valproic acid was added to the treatment regimens of 21 psychiatric inpatients
      whose response to antipsychotic medications had been inadequate, and steady-state
      serum valproate levels were obtained on 15. The 7 patients who had unequivocal
      positive therapeutic responses to valproate improved at a mean serum level of 68,
      with a 95 percent confidence interval of 50 to 86. The 8 nonresponders had a mean
      serum level of 37.5 with a 95 percent confidence interval of 13 to 62. There was
      a weak relationship between oral dose and serum level. Two patients never reached
      therapeutic levels in spite of oral daily dosages of 5 g and 6 g respectively.
      Therapeutic levels could not be reached by 7 patients (47%) who were taking more
      than 1,250 mg daily. Our results suggest that the therapeutic serum range for
      seizures is valid for psychiatric patients but that the usual suggested oral
      dosage is often inadequate. Drug interactions may account for this.

PMID- 2236467
TI  - Fluphenazine plasma levels and clinical response.
AB  - We monitored fluphenazine plasma levels in 39 schizophrenic patients who
      participated in a 2-year double-blind comparison of 5 mg and 25 mg of
      fluphenazine decanoate (FD) administered every 14 days. We investigated the
      relationship between log-transformed plasma levels at 3, 6, and 9 months and
      subsequent psychotic exacerbations with logistic regression and survival
      analysis. Using logistic regression, the relationship was nonsignificant at 3
      months (chi-square = .21, df = 1, p = .65), but significant at 6 months (chi
      square = 4.38, df = 1, p = .04) and 9 months (chi-square = 8.98, df = 1, p =
      .003). Using survival analysis with fluphenazine levels as a covariate (Cox
      models), we also found significant relationships between the fluphenazine plasma
      level and the risk of exacerbations at 6 months (chi-square = 3.77, df = 1, p =
      .052) and 9 months (chi-square = 12.21, df = 1, p = .0005), but not at three
      months (chi-square = 0.87, df = 1, p = .65). These findings suggest that the
      measurement of fluphenazine plasma levels may be helpful in decision-making about
      the dosage of FD.

PMID- 2236468
TI  - Stereotypies and tardive dyskinesia: abnormal movements in autistic children.
AB  - Baseline stereotypic movements in 224 autistic children were studied as well as
      their relationship to certain demographic variables and measures of overall
      symptomatology and severity of illness. Prediction of haloperidol-related
      dyskinesias with measures of stereotypies and demographic variables was also
      attempted. Stereotypies were present in at least mild form in most children, with
      most showing moderate severity. Most stereotypies were in the orofacial area.
      I.Q. was found to be negatively related to stereotypies. Furthermore, across
      methods of assessment, severity and frequency of stereotypies were found to be
      positively related to overall symptomatology and severity of illness. No
      significant predictors of development of dyskinesias were found.

PMID- 2236470
TI  - [Psychophysiologic microperspective in the psychotherapy process--a sequential
      approach of investigation].
AB  - To Investigate the interpersonal psychophysiology in the psychotherapeutic
      process a sequential approach using single case analysis is presented. During 18
      psychoanalytic-psychosomatic initial interviews simultaneous recordings of heart
      periods (IBI) and arrhythmia scores (from ecg) and the psychotherapeutic dialogue
      were made from 10 patients with cardiac neurosis and their interviewers. The
      general finding is that therapists were able to forecast those segments better,
      in which their own physiological activity was involved than the segments of their
      patients. Consideration is given to the consequences which should be drawn from
      these results for psychophysiological psychotherapy research.

PMID- 2236469
TI  - [Bulimia with and without a history of anorexia--variants or entities?].
AB  - A group of bulimic women (n = 70) with (n = 23) and without (n = 47) a history of
      anorexia nervosa has been assessed concerning symptomatology, complaints and
      personality factors. Demographic variables were controlled for bias. As we had
      supposed, there was no difference for most of the variables analyzed. Some of the
      residual differences could be due to item formulation ("Oral Control"; EAT) or
      express the slight persisting underweight ("weight", "underweight") of the former
      anorexics. Nevertheless, this group unexpectedly seems to feel not equally
      disturbed concerning "Ineffectivity" (EDI), "Anancasm" (ANIS) and some
      personality factors ("Social Orientation", "Aggression", "Sorrows concerning
      health", "Neuroticism"; FPI-R). The similarity is even more impressive if the
      scores are seen in relation to population norms (Graph.). On demographic
      variables except weight both groups seem to be strikingly similar. The relative
      weight (or "underweight"), which was considered as a possible covariate, did not
      contribute significantly to most of the dimensions, so that the actual body shape
      cannot be viewed as significantly influencing personality and eating related
      factors. From the data analyzed we conclude that there are no reasons to consider
      bulimia with and without a former anorexia as distinct disorders.

PMID- 2236472
TI  - [Effect of the stress coping mechanisms of oncologic patients on their physical
      and psychological state in radiotherapy].
AB  - An empiric study was designed to investigate how patients cope with radiotherapy
      and its secondary effects. Subject of inquiry was the influence of variables such
      as age, sex and individual strategies of coping with stress on the extent of
      reported strain. 91 cancer patients (66 female, 25 male) undergoing radiotherapy
      with different diagnoses but comparable history and duration of disease were
      interviewed concerning physical complaints and impairment of psychic mood at four
      times: in the beginning, the middle and the end of a 6-week radiotherapy as well
      as 3 moths afterwards. Additionally general coping strategies were evaluated in
      the beginning. Results showed that reported impairment (only within the subgroup:
      women under 50) correlated significantly (p less than 0.01) with a coping
      behaviour that could be described as a "retreat and giving up".

PMID- 2236471
TI  - [Assessment of "coping with disease" in patients with amyotrophic lateral
      sclerosis (ALS): on the use of an interviewer assessment rating scale].
AB  - Theories on "Coping" try to explain which resources people use to master crises
      and conflict situations. Reactions to challenges of life are considered as
      "coping strategies". In psychosomatic research, the notion of "coping" serves to
      describe how patients can handle physical or mental illness. Myatrophic (or
      amyothrophic) lateral sclerosis (ALS) is a rare chronic progressive disease of
      the nervous system with a gradual loss of motor neurons, resulting in muscular
      atrophy, weakness and spasticity. Since the etiology is unknown and no curative
      treatment available, most patients die from respiratory failure within a few
      years. In a follow-up study on physical disability, medical care and social
      support in 21 patients with advanced ALS, we tried to address the question how
      patients get along with such a threatening condition. After semi-standardized
      clinical interviews with patients and close relatives, two investigators gave
      independent descriptions of reported or observed "coping strategies" (rated as
      "not at all-barely-possibly-probably-very probably present"). Considering 17
      patients assessed by both raters, significant agreement (Kendall's W) was
      achieved in three patients only. A comparison of aggregated answers (chi 2-Test)
      revealed different response sets, since one rater tended to choose extreme scale
      points, while the other preferred undecided answers. Differences of mean scores
      were observed in 8 out of 21 items, while significant correlations between
      investigators were obtained in another 8, including, though, only 2 of those 5
      items which both had rated as "probably present" in no less than 50% of the
      patient sample ("Dejection & Flight-Brooding-Keeping the Situation Open
      Distraction-Self-Isolation").(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236473
TI  - [Daily stress, coping with stress and metabolic control in insulin dependent
      adult diabetics].
AB  - In accordance with previous research investigating adult insulin-dependent
      diabetics the present study supports evidence for a weak correlation between
      psychosocial stress and metabolic control (HbA1c). This relation, however, is
      becoming more substantial, if specific patterns of stress-reactions are taken
      into account. This is especially the case for a pattern represented by a short
      form of the SVF-subscale "emotional irritability" (Janke et al., 1984), and even
      better by the (inversely scored) FPI-K-scale "calmness" (Fahrenberg et al.,
      1978). Contrary to our expectations a high amount of emotional irritability was
      leading to a more favorable metabolic control, especially in the case of high
      psychosocial stress. It is suggested that positive attention-directed and
      motivating functions of emotional stress-reactions may in the long run compensate
      or even exceed their short-lived debilitating metabolic effects.

PMID- 2236474
TI  - [Psychotherapy of sociopathic and objectively dangerous patients. Psychotherapy
      of sociopathic patients: prerequisites of the therapist and the environment.
      Parameters of therapeutic technics].
AB  - The author proposes that the environment involved in the treatment of sociopathic
      patients should not foster splitting mechanisms. Preconditions for the therapy
      and requirements for the capability of the psychotherapist are discussed,
      especially his attitudes, the cohesion of his own self and his emotional
      reactions towards his patients. Two case histories are presented to demonstrate
      the type and timing of the interventions. The therapeutic modality for the
      treatment of sociopathic disorders takes into consideration the superego
      distorsions and the defense mechanisms, specially acting out, regression and
      splitting.

PMID- 2236475
TI  - Asian rickets and osteomalacia.

PMID- 2236476
TI  - Factors determining success and energy requirements for cardioversion of atrial
      fibrillation.
AB  - Factors thought to affect the success of and energy requirements for
      cardioversion of atrial fibrillation were studied in 80 (49 male, 31 female)
      patients aged 21-88 (mean 61.5 years). Transthoracic impedance was measured in
      advance of the countershock using a 30 kHz low amplitude AC current passed
      through self-adhesive ECG/defibrillator pads (diameters 8-12 cm) applied to the
      chest in the antero-posterior (AP) position in 57 patients and the anteroapical
      (AA) position in 23 patients. Mean transthoracic impedance for all patients was
      69.3 +/- 16 (SD) ohms (range 39-131 ohms), but transthoracic impedance was
      significantly greater in the AA than the AP position (75.4 +/- 13 vs. 66.7 +/- 16
      ohms, p = 0.02). Initial energy was 50 J (delivered) and was gradually increased
      to a maximum of 360 J if required. Cardioversion was successful in 73 of 80 (91.2
      per cent), and low energy shocks (less than or equal to 200 J) were successful in
      45 of 80 (56.2 per cent) patients. Using single factor analysis, sex, left atrial
      enlargement, electrode pad positions, aetiology of atrial fibrillation, presence
      of left ventricular failure, and prior treatment with verapamil or beta
      adrenergic blockers were not significant determinants of cardioversion success or
      success of low energy shocks but prior treatment with digoxin was, both for
      cardioversion success and success at low energies. In patients with transthoracic
      impedance less than or equal to 70 ohms, low energy shocks were more often
      successful (33 or 50, 66 per cent) than in patients with transthoracic impedance
      greater than 70 ohms (12 of 30, 40 per cent), p = 0.04. Using univariate
      analysis, cardioversion success with low energy shocks was not only significantly
      associated with prior treatment with digoxin but also with the duration of atrial
      fibrillation (24 hours to one month and one month to three years) and for shocks
      of less than or equal to 100 J, with prior treatment with amiodarone.
      Multifactorial linear regression analysis selected, in rank order, only duration
      of atrial fibrillation of 24 hours to less than one month and one month to three
      years as significant predictors of both cardioversion success irrespective of
      shock strength, and success of low energy shocks.

PMID- 2236478
TI  - Clinical judgment analysis.
AB  - Judgement is central to the practice of medicine and occurs between making
      clinical observations and taking clinical decisions. Clinical judgment analysis
      has developed as a method of making statistically firm models of doctors'
      judgments. Computed models reveal the differential importance attached to items
      of clinical, social, or other data which are determinants of clinical decisions.
      These models can both reveal the causes of conflicts of judgment and may help
      resolve them in a way that unaided discussion cannot. Revealing experts' models
      to students speeds learning of diagnostic skills. Clinical judgment analysis
      offers a method of probing the judgments not just of students and doctors but
      also of patients who have shown systematic differences in their perceptions of
      risk and benefit. The power and relevance of clinical trials can be improved by
      the consistent application of judgment policies generated from both the trialists
      and those who will use their results.

PMID- 2236477
TI  - Adrenal dysfunction in patients with renal amyloid.
AB  - Amyloidosis is a multi-system disease. Renal involvement often leads to end-stage
      renal failure, which carries a poor prognosis. This paper reports the adrenal
      status of 22 patients with renal amyloid who were considered for or who had been
      commenced on renal replacement therapy. Twelve patients were considered or found
      to have AA amyloid and the remaining 10 had AL amyloid. Of 16 patients tested,
      seven demonstrated an abnormal response to a synacthen test. Four patients died
      at Addisonian crisis and hypo-adrenalism probably contributed to the deaths of a
      further two patients. Amyloid deposition was found in the adrenal glands in seven
      patients who died of systemic amyloidosis and renal failure. It is recommended
      that all patients with renal amyloid should have an assessment of adrenal
      function performed and if abnormal replacement steroid therapy should be
      commenced.

PMID- 2236479
TI  - Long-term results following 131I treatment for Graves' disease in Hong Kong
      Chinese--discriminant factors predicting hypothyroidism.
AB  - The clinical outcome of 1028 Hong Kong Chinese patients with Graves' disease
      treated with radioiodine therapy and followed for a mean of 9.85 +/- 4.84 years
      (range 2-20) was analysed. Retreatment was required by 413 patients (40.2 per
      cent), with 134 patients (13.0 per cent) requiring more than two 131I doses. One
      hundred and eighty-nine patients received carbimazole after 131I until
      euthyroidism was achieved. The cumulative incidence of hypothyroidism at one,
      five, 10 and 15 years was 9.6 per cent, 31.4 per cent, 53.8 per cent and 65.8 per
      cent, respectively. The average incidence of hypothyroidism after the first two
      years was 3.3 per cent per annum. Stepwise logistic regression analysis of
      pretreatment variables suggested that a combination of adjunctive carbimazole
      therapy, absence of ophthalmopathy and longer effective half-lives of 131I were
      of value in predicting which patients were less likely to develop permanent
      hypothyroidism. However, the probability of accurately predicting permanent
      hypothyroidism based on the present model was only 60 per cent. We believe that
      no single pretreatment variable, or combination of variables, predicts long-term
      hypothyroidism with sufficient confidence to justify the use of a 'formula'
      approach for prescribing 131I therapy for Graves' disease.

PMID- 2236480
TI  - Haemostatic changes in the loin pain and haematuria syndrome: secondary to renal
      vasospasm?
AB  - Twenty-five patients (seven male, 18 female) were diagnosed as having the loin
      pain and haematuria syndrome. Presenting symptoms were either loin pain alone or
      pain associated with macroscopic or microscopic haematuria, and were
      longstanding, having been present for mean of 9.3 years in males, and 10 years in
      females. Ten patients described symptoms of passing gravel or renal stones but
      these were only demonstrated radiologically in two patients. Investigation of all
      patients showed anatomically normal renal tracts, normal renal function, and no
      significant proteinuria. Phase-contrast microscopy during episodes of haematuria
      revealed dysmorphic red cells in all 10 patients studied. Renal biopsies were
      performed in 20 patients and showed no glomerular pathology, but arteriolar and
      arterial hyalinosis was seen in 13 of 20 (65 per cent), fibro-elastosis in larger
      vessels in eight of 20 (40 per cent) and red blood cells in tubules in 13 of 20
      (65 per cent) patients. The histological appearance in vessels was similar to
      that seen in cyclosporin A nephrotoxicity and would be consistent with the
      hypothesis that regional vasospasm occurs in the cortical circulation.
      Haematological studies in 22 patients, when compared with age and sex matched
      controls, showed the presence of circulating platelet aggregates, elevation of
      plasma beta-thromboglobulin (p less than 0.001), and increased platelet
      aggregation in response to serotonin and ADP (p less than 0.05 and p less than
      0.03, respectively). Plasma concentrations of D dimer (p less than 0.02) and C
      reactive protein (p less than 0.03) were also significantly elevated in the
      patient group. There was no deterioration of renal function during a mean
      observation period of 3.7 years and no patients developed proteinuria. Treatment
      was largely supportive; seven patients with intractable loin pain underwent
      surgical denervation with the relief of pain in four.

PMID- 2236481
TI  - In vitro colony culture and chromosomal studies in hepatic and portal vein
      thrombosis--possible evidence of an occult myeloproliferative state.
AB  - We have studied the prevalence of an underlying myeloproliferative state in 20
      patients with either hepatic or portal vein thrombosis. Using conventional
      clinical and laboratory criteria, an underlying myeloproliferative state was
      identified as the cause of the thrombosis in five patients (25%). A further 10 of
      the remaining 15 cases were found to have characteristic in vitro bone marrow
      culture studies and cytogenetic abnormalities suggestive of an underlying
      myeloproliferative disorder. Although none of these 10 cases have developed overt
      clinical and laboratory features of such a myeloproliferative disorder after a
      median observation period of two years, the presence of clonal karyotypic
      abnormalities in three cases, increased megakaryocyte colony growth in three
      cases and endogenous erythropoietin independent colony growth of the marrow
      erythroid progenitors in seven cases, argues strongly in favour of a primary
      haematological disorder. This has important therapeutic implications,
      particularly in cases being considered for orthotopic liver transplantation.

PMID- 2236482
TI  - The management of atypical non-cardiac chest pain.
AB  - Atypical, non-cardiac chest pain is common and disabling, and often persists
      despite negative medical investigations. Aetiology is disputed and management is
      difficult. A multi-causal model in which both psychological and physical factors
      play a part is helpful; a fundamental factor is continued misinterpretation of
      minor physical symptoms as evidence of heart disease. We report supportive
      evidence and describe a psychological treatment derived from the model. In a
      randomized trial, cognitive behavioural methods were effective in reducing chest
      pain, disability and use of medication, in patients both with and without
      psychiatric disorder. The clinical implications are discussed.

PMID- 2236483
TI  - The ecology and evolution of inducible defenses.
AB  - Inducible defenses are responses activated through a previous encounter with a
      consumer or competitor that confer some degree of resistance to subsequent
      attacks. While the importance of inducible resistance has long been known in host
      parasite interactions, it is only recently that its importance has emerged in
      other natural systems. Although the structural defenses produced by invertebrates
      to their competitors and predators are by no means the same as an immune response
      triggered by parasites, these responses all share the properties of (1)
      specificity, (2) amplification and (3) memory. This review discusses the
      following ecological consequences and evolutionary causes of inducible defenses:
      (1) Inducible defenses render historical factors important in biological
      interactions and can affect the probability of individual survival and growth, as
      well as affect population dynamics of consumers in some circumstances. (2)
      Although the benefits of inducible defenses are often balanced by fitness costs,
      including reduced growth, reproductive output and survivorship, the role of costs
      and benefits in the evolution of inducible defenses is by no means clear. A more
      integrated approach would involve a multivariate analysis of the role of natural
      selection on the inducible characters of interest, their norms of reaction and
      correlated fitness characters. (3) The disproportionate representation of
      inducible, morphological defenses among clonal organisms may be due to both a
      higher rate of origination and enhanced selection to maintain these defenses in
      clonal taxa. (4) Inducible defenses should be most common when reliable cues are
      available, attacks by biological agents are unpredictable, and the fitness gains
      of defenses are balanced by the costs. An integrated approach to studying
      inducible defenses would thus combine mechanistic estimates of costs, population
      level estimates of defense effectiveness, and genetic estimates of correlations
      between fitness and inducible characters. This will allow us to estimate rates of
      evolution in these phenotypically plastic threshold characters.

PMID- 2236484
TI  - [Basic concept for esthetic complete dentures (1)].

PMID- 2236485
TI  - [Swing-lock with milled lock tongue--guide for preparation].

PMID- 2236486
TI  - [Limits of manual crown margin formation (1)].

PMID- 2236487
TI  - [Clinical use of opal ceramic].

PMID- 2236488
TI  - [Children's prostheses--indications and dental technological preparation].

PMID- 2236489
TI  - [Introduction of new type of metal-free ceramic system].

PMID- 2236490
TI  - Phagocytic and bactericidal activities of leukocytes in whole blood from atomic
      bomb survivors.
AB  - This study evaluated the phagocytic and bactericidal activities of peripheral
      blood leukocytes from Hiroshima and Nagasaki atomic bomb survivors for
      Staphylococcus aureus. The data were analyzed by multiple linear regression for
      age, sex, radiation exposure, city of exposure, and neutrophil counts. No
      significant radiation effect was observed for either blood phagocytic or
      bactericidal activities. The only significant variable for these functions was
      the neutrophil count.

PMID- 2236491
TI  - Exogenous lactate modifies the repair of potentially lethal damage in three human
      tumor cell lines irradiated in vitro.
AB  - Lactate is one of several pathophysiological factors accumulating in the
      micromilieu of tumors under both hypoxic and well-oxygenized conditions, and thus
      may affect the recovery of irradiated tumor cells in vivo. In the present study,
      we investigated the effects of postirradiation incubation with exogenous lactate
      during confluent holding recovery on the repair of potentially lethal damage in
      three human tumor cell lines. Recovery was either unaffected or enhanced by low
      concentrations of exogenous lactate (2-5 mM), whereas it was suppressed by higher
      concentrations (10-50 mM). With high concentrations, survival in all three cell
      lines was lower at the end of the confluent holding period than at the beginning,
      yielding recovery ratios of less than 1.0. The effects differed quantitatively
      among the three tumor cell lines, and between the tumor cells and the normal
      diploid fibroblasts (AG 1522) studied previously.

PMID- 2236492
TI  - Drug sensitivity of heat-resistant mouse B16 melanoma variants.
AB  - Induction of transient thermotolerance by heat or other cytotoxic stressors has
      been reported to confer a moderate degree of drug resistance to tumor cells in
      vitro. In this study, a genetically stable, heat-resistant mouse B16 melanoma
      variant (W-H75) was tested for its sensitivity to various cytotoxic and
      antiproliferative agents. The heat-resistant W-H75 cells displayed a moderate two
      to threefold resistance to doxorubicin, VP-16, VM-26, colchicine, cis
      dichlorodiammineplatinum(II), HgCl2, and CdCl2. Marginal resistance to 4'(9
      acridinylamino)methanesulfon-m-anisidide vinblastine, 1,3-bis(2-chloroethyl)-1
      nitro-sourea, and NaAsO2 was observed, while no difference in sensitivity to the
      anticancer drugs, actinomycin D and camptothecin, was observed. Although W-H75
      cells were generally more resistant than the parental cells to most of the agents
      that were tested, they were collaterally sensitive to the antimetabolites
      methotrexate and 6-mercaptopurine. Resistance of the W-H75 cells to
      epipodophyllotoxins and anthracyclines was not due to differences in steady-state
      drug accumulation. For the epipodophyllotoxin VP-16, resistance may be related to
      a relative decrease in the number of drug-induced DNA strand breaks in W-H75
      cells. However, no difference in DNA strand breakage was observed between W-H75
      and parental cells which were treated with doxorubicin, suggesting that
      resistance to this drug occurred by a different mechanism. The possible
      involvement of glutathione and glutathione S-transferase in resistance was also
      investigated. The glutathione content in W-H75 cells was 35% higher than that in
      the parental line. However, glutathione S-transferase activity appeared to be
      identical in both cell lines. Two other heat-resistant B16 melanoma variants, B
      H103 and R-H92, were also tested for sensitivity to doxorubicin and VP-16. In
      contrast to the W-H75 cells, these two heat-resistant variants were
      hypersensitive to doxorubicin. The B-H103 cells were also hypersensitive to VP
      16. This study suggests that selection for cellular resistance to heat may result
      in cells that have an altered sensitivity to drugs.

PMID- 2236493
TI  - The persistence of lymphocytes with dicentric chromosomes following whole-body X
      irradiation of mice.
AB  - Thirty-six male C57B1/6 mice were X-irradiated whole body with 3 Gy to generate
      lymphocytes with dicentric chromosomes to study the persistence of these
      lymphocytes in the spleen and peripheral blood to estimate the life span of
      mature B- and T-cells. Peripheral blood and spleen were removed from groups of
      four mice immediately after radiation exposure and on Days 1, 3, 7, 14, 28, 56,
      and 112 thereafter. Peripheral blood lymphocytes were cultured with
      phytohemagglutinin to stimulate T-cell division, and splenic lymphocytes were
      cultured with either lipopolysaccharide or phytohemagglutinin to stimulate B- or
      T-cell division, respectively. The initial frequencies of dicentric chromosomes
      with accompanying fragments observed in splenic T-cells (0.44), splenic B-cells
      (0.43), and peripheral blood lymphocyte cultures (0.48) initiated on Day 0 were
      not significantly different. For both splenic and peripheral blood T-lymphocytes,
      the frequency of cells containing dicentric chromosomes declined in an
      exponential manner following irradiation, with a 50% reduction in frequency
      occurring 14 days after exposure. In contrast, the frequency of B-cells
      containing dicentric chromosomes remained stable through Day 7 but then declined
      precipitously between Day 7 and Day 14 and remained relatively stable, although
      slightly above baseline, through Day 112 post-exposure. For both B- and T-cells,
      less than 5% of the cells contained a dicentric chromosome with accompanying
      fragments at Day 112. These data indicate that B- and T-lymphocytes with
      dicentric chromosomes show different decay kinetics and suggest that they may
      possess different life spans.

PMID- 2236494
TI  - The effects of X irradiation on the metamorphosis and budding of Aurelia aurita.
AB  - With the aid of the Aurelia metamorphosis test system, the acute and subtle
      developmental and behavioral effects of X irradiation in the presence and absence
      of thyroxine on the Norfolk Aurelia aurita were described. Radiation doses were 0
      (control), 50, 100, 150, 200, and 400 Gy. Morphology of the ephyrae, and
      statolith and rhopalia numbers were recorded using the light microscope.
      Developmental abnormalities of the polyps and ephyrae were recorded with the
      scanning electron microscope and light microscope. Major findings from this
      investigation were the absence of rhopalia and statoliths in ephyrae at 150 and
      200 Gy, a reduction in pulses per minute in the ephyrae at 100, 150, and 200 Gy,
      a reduction in ephyrae released at 150, 200, and 400 Gy, and the development of
      polyp monsters. There was a significantly higher frequency of polyp monsters in
      the group exposed to thyroxine prior to radiation than in the thyroxine-free
      group prior to radiation.

PMID- 2236495
TI  - Affinity isolation of heat-shock and other calmodulin-binding proteins following
      hyperthermia.
AB  - The interaction of calmodulin (CaM) with heat-shock and other binding proteins
      was studied in rat adenocarcinoma cells. Cells were equilibrium-labeled for 48 h
      prior to heating for 1 h at 43 degrees C, or pulse-labeled for 2 h at 37 degrees
      C after heating, to monitor the effect of heat on the affinity of CaM-binding
      proteins synthesized under these conditions. A CaM antagonist shown to sensitize
      to heat killing, W-7 [N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide], was
      used in competition assays to help monitor any changes in affinity. We found that
      heating tended to reduce the CaM-binding of proteins synthesized before heating
      relative to their 37 degrees C controls and proteins synthesized after heating
      tended to have increased binding relative to their respective controls. Members
      of the heat-shock protein (hsp) 90-, 70-, and 26-kDa families were among the
      proteins that bound to CaM and were eluted by W-7. The peak elution fractions for
      the hsp's and other cellular proteins varied, but hsp-70 eluted in the early
      fractions. The hsp-70 family was also found to be among a number of W-7-binding
      proteins. We conclude that the assumption that CaM antagonists potentiate killing
      of heated cells solely by competing nonspecifically for CaM-binding protein sites
      on CaM does not explain the process completely. These antagonists could also act
      by competing for CaM-binding sites with specific proteins whose interaction with
      CaM is important for survival following heating, or by directly binding to other
      proteins whose function is important for survival and inhibiting their activity.
      We do not have sufficient data to discern the predominant mechanism among these
      possibilities, but we believe all are likely to occur in heated cells and
      speculate that inhibition of the functions of the hsp-70 family is important in
      several of these antagonist actions.

PMID- 2236496
TI  - Homologous recombination and mutagenesis of gamma-irradiated plasmid DNA in
      Escherichia coli host cells.
AB  - Plasmid DNA was used to study gamma-radiation-induced recombination and
      mutagenesis in Escherichia coli host cells. Plasmid pBRP1, a derivative of pBR322
      containing the lac operon of E. coli, was irradiated with 60Co gamma rays prior
      to transformation into E. coli strains of different recA and lac genotypes.
      Plasmid-chromosome recombination was assayed in lacY1 host cells, whereas plasmid
      mutagenesis was assayed in delta lac host cells lacking chromosomal sequences
      homologous to the plasmid. Both recombinant and mutant plasmids were identified
      by the phenotypic changes in lactose utilization, and confirmed by restriction
      analysis of isolated plasmids. Plasmid-chromosome recombination was induced to
      high levels (about 20% of survivors at 700 Gy) and was dependent on the host recA
      gene. Plasmid mutagenesis occurred at lower levels (about 1.5% of survivors at
      600 Gy) and was relatively independent of the recA gene. Plasmid survival was
      unaffected by the presence or absence of host recA mutations or the potential for
      plasmid-chromosome recombination.

PMID- 2236497
TI  - Repetitive pulsed-train "off" duration mitigates reductions in root growth rates
      of Pisum sativum L. induced by 60-Hz electric field.
AB  - An investigation was undertaken to define a 60-Hz electric field exposure system
      which would affect a eukaryotic cell system while mitigating a potential thermal
      rise. The biological effectiveness of pulsed 60-Hz electric fields on a cell
      system of defined sensitivity to continuous-wave 60-Hz electric fields was
      sought. Roots of garden pea (Pisum sativum L.) were exposed to pulsed trains of
      60-Hz, 430 V/m electric fields. The "on" time was constant at 1 s and the "off"
      time varied. The repetitive on:off regimens used were 1:20, 1:50, 1:100, 1:130,
      1:200, and 1:300. With continuous or 1:20 pulsed fields the growth response was
      equivalent (representing a 60% depression in root growth rate). The severity of
      the growth effect diminished as the off time increased; for the 1:100 regimen,
      the relative growth rate was depressed by about 30%; for the 1:300 regimen, the
      relative growth rate was equal to that of the controls.

PMID- 2236498
TI  - Radioprotective effects of dimethyl sulfoxide in golden hamster embryo cells
      exposed to gamma rays at 77 K. II. Protection from lethal, chromosomal, and DNA
      damage.
AB  - Golden hamster embryo cells were exposed to 137Cs gamma rays in the presence or
      absence of dimethyl sulfoxide at both 310 and 77 K. Dimethyl sulfoxide gave
      significant protection against cell killing at both 310 and 77 K. The extent of
      radioprotection with 1.28 M dimethyl sulfoxide at 77 K was 85-89% of the lethal
      effects observed in the absence of dimethyl sulfoxide at 310 K; the dose
      modifying factor was 5.7. Dimethyl sulfoxide also exerted protected against gamma
      ray-induced DNA single-strand breaks and chromosomal aberrations with a maximum
      protection of 80-100% at a dimethyl sulfoxide concentration of 1.28 M at 77 K. At
      77 K, H atoms, ion holes, and electrons can migrate through frozen cells but OH
      radicals cannot diffuse. Thus the protective effects of dimethyl sulfoxide
      against cell killing, chromosomal aberrations, and DNA single-strand breaks at 77
      K may be due to the scavenging of H atoms or other ions, rather than OH radicals.

PMID- 2236499
TI  - Pathological effects of the radiation protector WR-151327 in mice.
AB  - The systemic effects of the radiation protective agent, S-3-(3
      methylaminopropylamino) propylphosphorothioic acid (WR-151327), were studied in
      unirradiated B6CF1 male mice. Fifty mice were injected intraperitoneally with 540
      mg/kg WR-151327, and groups of five mice were sacrificed at 14-day intervals up
      to and including 140 days post-treatment. Ten mice served as sham-injected
      controls. A necropsy was performed and gross morphological abnormalities were
      noted. Tissues (brain, eyes, harderian gland, salivary glands, sternal bone
      marrow, thyroid, lung, thymus, esophagus, trachea, skeletal muscle, heart, liver,
      kidney, adrenal gland, spleen, small intestine, pancreas, and testes) were fixed
      in 10% formalin, embedded in paraffin, and sectioned. Slides were routinely
      stained with hematoxylin and eosin while Alizarin red stain was used to test
      specifically for the presence of calcium salts. Histopathological effects of WR
      151327 were restricted to the testes, salivary gland, and pancreas. The caudal
      pole of the testes was observed to undergo progressive changes from coagulation
      necrosis to dystrophic calcification. The cells of the submandibular salivary
      gland showed mainly hyperchromatic nuclei while the pancreas showed enlarged
      islets of Langerhans.

PMID- 2236500
TI  - Repair of radiation-induced DNA damage in thermotolerant and nonthermotolerant
      HeLa cells.
AB  - The effect of heat exposure on the repair of radiation-induced DNA damage which
      inhibits the ability of nuclear DNA to undergo supercoiling changes was studied
      using the fluorescent halo assay in thermotolerant and nonthermotolerant (normal)
      cells. The assay utilizes an intercalating, fluorescent dye to unwind and rewind
      endogenous DNA supercoils. When HeLa cells are exposed to 17.3 Gy radiation the
      ability of DNA to be rewound into supercoils is completely inhibited. However,
      the ability of DNA to rewind is 70% restored by 30 min after irradiation. Both
      thermotolerant and normal cells exposed to 45 degrees C for 30 min prior to
      irradiation had a rewinding ability intermediate between control and unheated
      cells, but there was no restoration of rewinding ability up to 3 h
      postirradiation. Thus, when irradiation immediately followed heating, there was
      no difference between thermotolerant and normal cells. However, when various time
      intervals were imposed between heating and irradiation, a difference in the
      ability of the cells to recover from heat-induced alterations became apparent. In
      normal cells after 6 h of postheat incubation the cells' ability to restore DNA
      supercoiling was approximately the same as that of control cells, while in
      thermotolerant cells only 2 h was required to repair the ability to restore
      supercoiling at the same rate. The rate of repair of DNA remained correlated with
      relative nuclear protein content as measured by fluorescein isothiocyanate
      staining in both thermotolerant and normal cells, indicating a possible
      relationship between the two.

PMID- 2236501
TI  - Measured intake and excretion patterns of naturally occurring 234U, 238U, and
      calcium in humans.
AB  - The normal dietary and fluid intake and urinary and fecal excretion of 234U and
      238U were determined in humans under strictly controlled conditions in the
      Metabolic Research Ward at Hines Hospital. These values formed the basis of the
      metabolic balances of these uranium isotopes. The major pathway of 234U and of
      238U excretion was via the intestine while the urinary 234U and 238U were very
      low, averaging 2% of the total excretion. The uranium balances were roughly in
      equilibrium. These data were used in combination with measurements of tissue
      concentrations of uranium from nonoccupationally exposed humans to calculate
      steady-state uptake factors for environmental exposure to uranium isotopes during
      baseline conditions of a normal dietary intake.

PMID- 2236502
TI  - Radiosensitivity of human natural killer cells: binding and cytotoxic activities
      of natural killer cell subsets.
AB  - The sensitivity of human natural killer (NK) cell activities (both binding and
      killing) after exposure of peripheral blood mononuclear cells to different doses
      of gamma radiation was studied. A panel of monoclonal antibodies was used to
      identify the NK and T-lymphocyte subsets and to evaluate their radiosensitivity.
      Peripheral blood mononuclear cells were irradiated with low (2-6 Gy) and high (10
      30 Gy) doses and NK cell binding and cytotoxic activity against K562 target cells
      were studied after 3 h and 48 h in culture. The primary damage to NK cell
      activity was identified at the postbinding level and affected mainly the lytic
      machinery. After 48 h culture postirradiation, an overall depression of cytotoxic
      activity was observed, but ionizing radiation produced either a selection of the
      more cytotoxic NK cell subsets, which therefore might be considered more
      resistant to radiation damage than the less cytotoxic NK cells, or a long-term
      stimulation of cytotoxic activity in surviving cells.

PMID- 2236503
TI  - 75 years of radiological research.

PMID- 2236504
TI  - 75th anniversary for the Center for Radiological Research.

PMID- 2236505
TI  - Microdosimetry and Katz's track structure theory. I. One-hit detectors.
AB  - A microdosimetric treatment of the response of one-hit detectors to radiation is
      formulated and compared with the model proposed by R. Katz, S. C. Sharma, and M.
      Homayoonfar (in Topics in Radiation Dosimetry, Suppl. I (F. H. Attix, Ed.), pp.
      317-383, Academic Press, New York, 1972) within the framework of their track
      structure theory. It is shown that radial dose distributions (on which the track
      structure theory is based) are generally poor substitutes for the exact
      microdosimetric distributions except when (a) the target is much larger than the
      radial extent of the track or (b) the "effective" specific energy in the target
      (alpha z, see text) is negligibly small. Since neither one of these conditions is
      generally satisfied, it is suggested that a meaningful search for one-hit
      detectors be based on a microdosimetric description of the stochastics of energy
      deposition. An analysis of the phi x-174 bacteriophage inactivation data is
      presented.

PMID- 2236506
TI  - Influence of microdosimetric quantities on observed dose-response relationships
      in radiation therapy.
AB  - The steepness of dose-response curves in radiation therapy depends to a large
      extent on the statistics of cell killing. This is so if the last few clonogenic
      tumor cells have to be hit or eradicated by other means to cure the patient. The
      steepness is dependent on the number of clonogenic cells in the tumor and the
      possible variation in their sensitivity. However, the uniformity of the dose
      distribution is also important and a decreased slope may result when the delivery
      of the dose is nonuniform or statistically uncertain. The variance in the energy
      imparted at the microdosimetric level to individual cell nuclei constitutes the
      ultimate limit of the variance in delivered dose at a given mean tumor dose.
      Considering all dosimetric variances it is shown that for low-LET beams the
      conventional microdosimetric variance will dominate, while in neutron and high
      LET beams in general the microdosimetric variance may contribute significantly to
      the observed dose-response relationship. As a result the normalized slope of the
      dose-response curve for tumor control and normal tissue complications with
      neutrons and other high-LET beams will be reduced compared to that with photons.
      This conclusion is found to be in quantitative agreement with available data from
      clinical trials with neutron therapy. Finally, it is pointed out that for beams
      with a very high RBE and LET it may be favorable to deliver a fraction of the
      total dose in the form of conventional low-LET radiation. This addition of low
      LET radiation may be desirable to ensure a dose to all clonogenic tumor cell
      nuclei that is sufficiently high and uniform to achieve a high probability of
      tumor control.

PMID- 2236507
TI  - Track structure, lesion development, and cell survival.
AB  - A stochastic track-structure-dependent model is presented based on DNA double
      strand breaks (DSBs) interacting in a time- and distance-dependent manner, and in
      competition with DSB repair, to form exchange-type chromosomal aberrations. Many
      models of cell survival involve estimation of mean numbers of lesions per cell,
      which is then related to cell survival. Unless this relationship is linear, this
      implies that a cell responds not to the number of lesions produced in it, but to
      the mean number of lesions in all the exposed cells; this is clearly unrealistic,
      particularly for phenomena such as saturation. In contrast to such deterministic
      approaches, we describe a stochastic model, in which individual cells are
      considered and exposed to Monte Carlo-generated tracks of various radiations. The
      elementary sublesions produced (DSBs) diffuse, repair, or interact, forming
      lesions (chromosomal exchange-type aberrations) in a time- and distance-dependent
      manner. Results agree well with experiments for survival of synchronous Chinese
      hamster V-79 cells exposed to X rays and radiations with LETs from 20 to 170
      keV/microns. Thus the main features of survival for low-, medium-, and high-LET
      radiation are understandable in terms of a single approach, the relative
      responses to different radiations being determined by their different energy
      deposition patterns.

PMID- 2236508
TI  - Dual-function 2-nitroimidazoles as hypoxic cell radiosensitizers and bioreductive
      cytotoxins: in vivo evaluation in KHT murine sarcomas.
AB  - The efficacies of a series of potential prodrugs of RSU-1069 and its alkyl
      aziridine analogues were assessed. These 1-(2-haloethylamino)-3-(2-nitro-1
      imidazolyl)-2-propanol compounds were designed to cyclize in vivo to generate 2
      nitro-imidazoles with aziridine (RSU-1069) or alkyl-substituted aziridine (RSU
      1164, RB-7040, or RSU-1150) functions. Maximum tolerated single, intraperitoneal
      doses (MTD) were determined in C3H/He mice bearing subcutaneous KHT sarcomas, and
      a drug dose-response relationship for radiosensitization was established for each
      compound administered at the optimum time (45-60 min) before local irradiation of
      tumors with a 10-Gy dose of X-rays. The potentials of the compounds as
      bioreductive cytotoxins were studied by administering them immediately after
      irradiation. Tumor cell survival was measured 18-24 h after treatment in an in
      vitro soft agar clonogenic assay. Results of toxicity, radiosensitization, and
      bioreductive cytotoxicity assays for each of the prodrugs (RB-6171, RB-6172, RB
      6173, RB-6174, and RB-6175) of the alkyl-substituted aziridines were entirely
      consistent with complete conversion to their respective target compounds. For
      example, RB-6171 (the prodrug form of RSU-1164) was only about four times less
      efficient than RSU-1069 as a radiosensitizer and bioreductive cytotoxin but had
      an MTD 7.5 times higher. In contrast, prodrugs of RSU-1069 (RB-6144 and RB-6145)
      were two- to threefold less toxic than their expected product. RB-6144 was a poor
      radiosensitizer and bioreductive agent compared with RSU-1069 and was similar to
      RB-6170, a nonalkylating nitroimidazole. This is consistent with the observation
      that there is limited conversion of RB-6144 to RSU-1069 in vitro. However,
      radiosensitization and bioreductive cytotoxicity produced by RB-6145 were only
      slightly less than the effects produced by RSU-1069; thus a therapeutic gain was
      achieved with RB-6145 in a murine tumor model.

PMID- 2236509
TI  - Studies with bifunctional bioreductive drugs. I. In vitro oncogenic transforming
      potential.
AB  - The oncogenic transforming potential of a series of bioreductive drugs including
      RSU-1069 and its various alkyl-substituted derivatives, RB-7040, RB-88716, RSU
      1164, and RB-88712, has been compared using the C3H 10T1/2 cell system. While the
      aziridine moiety at the terminal end of the side chain confers greater
      cytotoxicity to both the 2-nitroimidazole (RSU-1069) and the 5-nitrofuran (RB
      88716), it also increases the oncogenic transforming potential of the drugs
      correspondingly. By substituting the aziridine ring with methyl groups, the
      cytotoxicity and oncogenicity of these bioreductive drugs decrease in a way that
      is proportional to the degree of methylation. A clear structure-activity
      relationship can be demonstrated from these methyl-substituted derivatives such
      that a tetramethyl-substituent (RB-7040) is much less cytotoxic and oncogenic
      than a dimethyl-substituent (RSU-1164). RB-7040, which has in vitro and in vivo
      sensitizing efficiency comparable to the parental compound RSU-1069, is roughly
      tenfold less cytotoxic and, at concentrations that achieve an in vitro
      enhancement ratio of 2.9, induces a transforming frequency that is
      indistinguishable from the spontaneous rate.

PMID- 2236510
TI  - Microdosimetry at middle age: some old experimental problems and new aspirations.
AB  - The increasingly wider use of microdosimetry in fields other than pure
      radiobiological research, especially in "practical" domains such as radiation
      protection and medical physics, has created a number of new practitioners who are
      not fully acquainted with many of the experimental pitfalls which beset the
      aspiring microdosimetrist. This paper attempts to review some of the lesser known
      experimental obstacles. It also presents first results of measurements of single
      event spectra at nanometer site sizes, based on the use of a small (0.5 x 0.5 mm)
      counter. Some observations and a critique of the operation of this counter are
      also presented. It is shown that the counter produces spectra at 5 nm which can
      be compared with theoretical predictions grounded on fundamental avalanche theory
      for a cylindrical counter.

PMID- 2236511
TI  - Studies with bifunctional bioreductive drugs. II. Cytotoxicity assayed with A-549
      lung carcinoma cells of human origin.
AB  - A lung carcinoma cell line of human origin (A-549) cultured in vitro was used to
      investigate the cytotoxic effect of a range of bifunctional bioreductive drugs.
      The drugs tested consisted of nitroimidazoles or nitrofurans with terminal
      aziridine rings on the side chain and are designated RSU-1069, RSU-1164, RB-7040,
      RB-88716, and RB-88712. Measurements of the cytotoxicity in air demonstrated that
      methyl and alkyl addition to the aziridine ring reduced cell killing with
      progressive substitution of the alkylating moiety. A comparison was made of
      cytotoxicity in air and hypoxia with cells exposed to drugs for a 4-h period. A
      direct comparison of the aerobic and hypoxic cytotoxicity of RSU-1069 in human (A
      549) and rodent cells (V-79-379A) yielded similar results. The cytotoxicity
      factors, defined to be the ratio of drug concentrations under aerobic and hypoxic
      conditions which result in 10% cell survival, were found to be 40, 25, 18, and 8,
      respectively, for the four agents RSU-1069, RSU-1164, RB-88712, and RB-88716
      tested in A-549 cells. It has been suggested that under aerobic conditions the
      aziridine ring is primarily responsible for aerobic toxicity, whereas under
      hypoxic conditions, the aziridine moiety combined with a reduced 2-nitro moiety
      produces a bifunctional agent (I. J. Stratford et al., Br. J. Cancer 53, 339-344,
      1986).

PMID- 2236512
TI  - Micronuclei and clonogenicity following low- and high-dose-rate gamma irradiation
      of normal human fibroblasts.
AB  - Plateau-phase human fibroblasts were irradiated at either low dose rate
      (approximately 0.6 Gy/h) or high dose rate (78 Gy/h) with gamma rays and then
      released from contact inhibition. The frequency of cells containing micronuclei
      monitored at daily intervals showed that induction was dependent on both dose and
      dose rate with a peak incidence at 3 days postirradiation. Cumulative frequency
      distributions indicated a reduction by a factor of 4 when the dose was delivered
      chronically as opposed to acutely. Distributions also suggested that micronuclei
      containing cells persist over days, while the dose responses (different by a
      factor of 2.8) for both high and low dose rate indicated a plateau, particularly
      following higher doses at low dose rate. Data were not consistent with this
      response being due to cell cycle delay. Delayed plating resulted in both a
      reduced incidence of cells with micronuclei and enhanced survival following high-
      but not low-dose-rate irradiation, with the response being complete by 6 h. Cell
      surviving fraction and the fraction of cells with micronuclei were negatively
      correlated, but the relationships were different between the high- and low-dose
      rate irradiations. This divergence mitigates against using low-dose-rate
      responsiveness of the short-term micronucleus assay as an indicator of the
      initial slope of the acute dose-rate survival curve.

PMID- 2236513
TI  - The effects of the temporal distribution of dose on oncogenic transformation by
      neutrons and charged particles of intermediate LET.
AB  - The effects of dose rate and dose fractionation on high-LET radiation-induced
      oncogenic transformation of C3H 10T1/2 cells were examined. Cells were irradiated
      with graded doses of 5.9-MeV monoenergetic neutrons administered either in single
      acute exposures (30 mGy/min) or extended over an 8-h period at low dose rates
      (from 0.21 to 1 mGy/min). Although cell survival studies showed no difference in
      effect with a change in radiation delivery rate, enhancement of oncogenic
      transformation occurred when the dose rate was reduced. When the neutron dose was
      divided into three fractions over 8 h, the biological effect was intermediate
      between that for the acute and that for the low-dose-rate exposures. Further
      irradiations were made using deuterons with an LET of 40 keV/microns. The dose
      mean lineal energy was comparable to that measured for the 5.9-MeV monoenergetic
      neutrons. An inverse dose-rate/fractionation effect for the induction of
      transformation by high-LET deuterons was observed when the time between each of
      three fractions for a 0.3-Gy total dose was at least 45 min. No further
      enhancement was seen for longer dose fractionations, suggesting that very long
      protracted exposures of high-LET radiation would produce no additional
      enhancement.

PMID- 2236514
TI  - The reverse protraction factor in the induction of bone sarcomas in radium-224
      patients.
AB  - More than 50 bone sarcomas have occurred among a collective of about 800 patients
      who had been injected in Germany after World War II with large activities of
      radium-224 for the intended treatment of bone tuberculosis and ankylosing
      spondylitis. In an earlier analysis [H. Spiess and C. W. Mays, in Radiation
      Carcinogenesis. (C. L. Sanders et al., Eds.) pp. 437-450. USAEC Symposium Series
      29, CONF-720505, 1973] it was concluded that, at equal mean absorbed doses in the
      skeleton, patients with longer exposure time had a higher incidence of bone
      sarcomas. The previous analysis was based on approximations; in particular, it
      did not account for the varying times at risk of the individual patients. In view
      of the implications of a reverse protraction factor for basic considerations in
      radiation protection, the need was therefore felt to reevaluate the data from the
      continued follow-up by more rigorous statistical methods. A first step of the
      analysis demonstrates the existence of the reverse dose-rate effect in terms of a
      suitably constructed rank-order test. In a second step of the analysis it is
      concluded that the data are consistent with a linear no-threshold dose dependence
      under the condition of constant exposure time, while there is a steeper than
      linear dependence on dose when the exposure times increase proportionally to
      dose. A maximum likelihood fit of the data is then performed in terms of a
      proportional hazards model that includes the individual parameters, dose,
      treatment duration, and age at treatment. The fit indicates proportionality of
      the tumor rates to mean skeletal dose with an added factor (1 + 0.18.tau), where
      tau is the treatment time in months. This indicates that a protraction of the
      injections over 15 months instead of 5 months doubles the risk of bone sarcoma.

PMID- 2236515
TI  - Hyperthermia studies in polyamine-altered human lung carcinoma cells.
AB  - The effect of polyamine depletion on the survival response of human lung
      carcinoma cells (A-549) to acute heating at 45 degrees C and its effect on the
      induction and decay of thermotolerance were investigated in exponential and
      plateau-phase cells. A 48-h exposure to 1 mM alpha-difluoromethylornithine
      (DFMO), an irreversible inhibitor of ornithine decarboxylase, was used to deplete
      intracellular levels of putrescine and spermidine. Inhibition of polyamine
      synthesis had no effect on the survival of exponential cells to heating at 45
      degrees C, but slightly enhanced the killing of slowly proliferating plateau
      phase cells. While DFMO treatment did not inhibit the development of
      thermotolerance, it caused a reduction in the thermotolerance ratio of
      exponential cells from 2.6 to 1.80, and from 1.66 to 1.59 in plateau-phase cells.
      DFMO caused thermotolerance to decay more rapidly in polyamine-depleted cells as
      well. Flow cytometry demonstrated that DFMO did not alter the cell cycle
      distribution of plateau-phase cells (i.e., greater than 73% in G1/G0), but caused
      a block and time-dependent accumulation of exponential cells in G1/G0. The
      cytostatic properties of DFMO in exponential cells which favor its use with phase
      specific agents, and its ability to alter the magnitude and decay of
      thermotolerance in human carcinoma cells suggest a potential role for this
      nontoxic agent in clinically oriented hyperthermia studies.

PMID- 2236516
TI  - Alterations in specific and general protein synthesis after heat shock in heat
      sensitive mutants of CHO cells and their wild-type counterparts.
AB  - The rates of general and specific protein synthesis were studied in two heat
      sensitive strains of CHO cells (Harvey and Bedford, Radiat. Res. 113, 526-542,
      1988), both of which show a reduced ability to develop thermotolerance following
      an initial 45 degrees C heat shock. After various labeling periods with
      [35S]methionine, wild-type and mutant labeled proteins were separated by one- and
      two-dimensional polyacrylamide gel electrophoresis. Autoradiograms showed
      differences in levels of synthesis of several proteins after a 45 degrees C heat
      shock. In particular, these were in the hsp-70 group referred to as hsp-70a, b,
      and c, having molecular weights of 76, 73, and 72 kDa and isoelectric focusing pH
      values of 5.7, 5.5, and 5.7, respectively. Of particular note were changes in the
      hsp-70c region of the autoradiograms. We found that there was perhaps a low level
      of synthesis of hsp-70c in unheated wild-type cells but none was detectable in
      the mutant lines. After an isosurvival (approximately 10%) pulse of 45 degrees C
      heat there was a gradual increase in the synthesis of hsp-70c for wild-type but a
      smaller increase for the heat-sensitive strain 36 (HS-36) cells. In contrast, for
      HS-23 cells there was a very large initial increase by 5 to 7 h after the heat
      pulse and then a rapid decrease to undetectable levels by 11 to 13 h. The
      inhibition and recovery of general protein synthesis for both mutant and wild
      type cells was also measured following various heat treatments at 45 degrees C.
      We observed that inhibition and resumption to a "normal" rate of protein
      synthesis for HS-23 cells paralleled the same response observed for the wild-type
      10B2 cells. In sharp contrast, the time for recovery from the inhibition of
      protein synthesis for HS-36 cells was severely reduced for all heating times
      tested. Our results show that the period of delay before resumption of protein
      synthesis after heating does not always correlate with heat sensitivity or the
      degree of thermotolerance development. Several explanations for these
      observations are possible. One is that while synthesis of certain heat-shock
      proteins may indeed be responsible for the development of thermotolerance, the
      timing of the synthesis of these proteins in relation to the period of inhibition
      of general protein synthesis is crucial to such development.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 2236517
TI  - [The reaction of the heart to radiation. I. State of the knowledge based on
      animal experimental studies].
AB  - The aim of curative tumor therapy is healing without complications. Therefore the
      avoidance of undesirable side-effects in healthy tissue becomes more important to
      such a degree as the lifespan can be prolonged by therapy: In this review the
      experiences to cardiac reactions by ionizing radiations are represented from
      experiments on animals. The former conception of a marked radioresistance of the
      heart has to be revised to the hitherto presented investigations. Acute
      inflammatory reactions and late, often progressive alterations can develop in the
      heart like in other normal tissue. These late-effects especially are reflected at
      pericardium, myocardium and vessel system (microvessel system and coronaries) and
      not rarely cause functional injuries of the tissue. Actual investigations give
      special attention to pathogenesis of acute radioreaction. It is supposed that
      their explanation gives a better understanding for the process of independence
      and progress and with that a possibility for prophylactic or therapeutic
      measures.

PMID- 2236518
TI  - Radiobiological dose-response relationships by monitoring the ATP-concentration
      in L 1210 cells using 31P-NMR-spectroscopy.
AB  - In conventional radiobiology the survival fraction of cell cultures in the
      exponential phase is observed by the colony-forming ability, and the linear
      quadratic model represents an adequate frame of the numerical adaptation. The
      measurement of the ATP-concentration of L 1210 cells by 31P-NMR-spectroscopy in
      dependence of the applied radiation dose can also be used to evaluate dose
      response relationships. In particular, the beta-peak of the ATP is suitable to
      seize the chronological behavior of the cellular ATP-concentration. An access to
      RBE of a radiation quality is obtained by monitoring the ATP-concentration, and
      the combination treatment (irradiation and incubation of cisPlatinum) has also
      been studied with regard to the question of synergistic interactions.

PMID- 2236519
TI  - [Does the initial hemoglobin value modify the primary tumor reaction? A study of
      264 irradiated bronchial cancers].
AB  - In a retrospective investigation the remission rate was determined in roentgen
      picture for 264 male patients with bronchogenic carcinoma after intensive
      radiotherapy (target dose 56 Gy). Classification of roentgenologic remission was
      done in 3 groups (complete, partial, minimal/no remission). For each patient the
      pretherapeutic haemoglobin value was taken from casebook and clinical relevant
      limit concentrations for an anaemia were correlated with the classified
      remissions. The difference of regression frequency between complete and partial
      remission always can be secured statistically irrespectively of chosen limit,
      that is the anaemia has a provable influence on roentgenologic tumor reaction. To
      prove that the tumor value as a third variable is not responsible for that a
      covariant analysis was done. According to that the corrected mean haemoglobin
      values were 8.9 mmol/l for complete, 8.1 mmol/l for partial and 7.7 mmol/l for
      minimal/no remission. These differences of the mean values are significant in
      Newman-Keuls-test, the relation between initial haemoglobin value and remission
      type is provable independently of tumor volume. Also for bronchogenic carcinoma
      with that a dependence could be shown between haemoglobin concentration--and by
      this the oxygen supply of the tumor--and the reaction of the primary tumor after
      radiotherapy. From this we deduce the recommendation to treat anaemia before
      beginning of radiotherapy or to irradiate anaemic patients applying an effective
      sensitizer.

PMID- 2236520
TI  - Mitotic figures and pyknotic nuclei and necrotic cells in the mouse jejunum
      during injury and repair after whole-body gamma irradiation.
AB  - Radiation induced changes in the crypts of jejunum were studied in adult Swiss
      albino mice exposed to 4.5 Gy, 9.0 Gy and 12.0 Gy of 60Co gamma rays. Two
      parameters--mitotic figures and pyknotic nuclei and necrotic cells were studied
      quantitatively to assess the radiation damage and subsequent recovery. Their
      number in the crypt section was counted at 6 hours, 1, 2, 4, 6, 8 and 14 days
      after irradiation. In all the three exposure groups the minimum value for mitotic
      figures was obtained on day 1 when the pyknotic nuclei and necrotic cells were
      highest. On day 2 partial recovery was seen in both the parameters studied and by
      day 8 in mice exposed to 4.5 Gy and by day 14 in mice exposed to 9.0 Gy and
      recovery was complete. However, in mice exposed to 12.0 Gy no mice survived till
      the last autopsy interval and the normal values were never attained.

PMID- 2236521
TI  - Crypt cell population changes in the mouse jejunum during injury and repair after
      whole-body gamma irradiation.
AB  - Adult Swiss albino mice were exposed to 4.5 Gy, 9.0 Gy and 12.0 Gy of 60Co gamma
      rays and post-irradiation variations in the crypt cell population of jejunum were
      studied. In all the three exposure groups, a significant decrease in cellularity
      was observed on day 1. With the beginning of recovery crypt cell population
      tended to increase and gradually approached normal value by day 8 and 14 in mice
      exposed to 4.5 Gy and 9.0 Gy respectively. In mice exposed to 12.0 Gy normal
      value was never attained.

PMID- 2236522
TI  - [The functional efficiency of cardiac pacemakers as affected by ionizing
      radiation].
AB  - Influence of functions of cardiac pace-makers by ionizing radiation are
      represented, that is characterized in praxis relevant parameters as pulse
      duration and sensitivity in a special clear manner. For these parameters dose
      limits were defined in a phantom where tolerance ranges of pace-makers,
      guaranteed by producer, were over or underdosed. These dose values were different
      in dependence of installed electronic wiring diagrams. The radioresistance of
      pace-makers with Lewicki-wiring diagram (MCP 211 L) was higher than those with
      wiring diagram U 115. Measurings showed that the upper dose limits were greater
      than the known values with 60Co- and 9-MV-roentgen braking radiation and with
      that the complete programming and functional capacity of the pace-makers were
      conserved. The close cooperation of radiologists, physicists, cardiologists and
      technicians in the implantation clinic guarantees a good care for patients with
      pace-makers during radiotherapy without complications.

PMID- 2236523
TI  - [Shielded vaginal applicators for line-shaped 192Ir sources for use in the
      irradiation of cervix cancer].
AB  - The possibility is investigated to use shielded vaginal applicators for "line
      shaped" 192Ir-sources to irradiate cervical carcinoma. Using segment-shaped
      absorbers of heavy metal the dose can be reduced in ventro-dorsal direction in
      area of rectum and bladder with irradiation of cervical carcinoma up to a factor
      of 2 in dependence of rectum and bladder position. Selecting a suitable source
      position and source standing time a dose reduction can be realized in cranial
      direction up to two centimetres from the portio.

PMID- 2236524
TI  - [Initial experiences with radiation planning of combined teletherapy and
      brachytherapy of gynecologic tumors using CT tomograms].
AB  - Dose distributions of a combination from telecobalt-arc-therapy and afterloading
      therapy for radiation therapy of gynecological cancers were calculated, using a
      computer program developed in our institute. Taking as a basis CT-scans the bone
      structures were taken into consideration like inhomogeneities. Conclusions about
      the individual dose on sensitive organs into the irradiated area like bladder and
      rectum become possible. The influence of changing parameters such like distance
      of axis of arc-therapy can be shown clearly.

PMID- 2236525
TI  - Interventional radiology of the biliary tract.

PMID- 2236526
TI  - The history of interventional radiology of the biliary tract.

PMID- 2236527
TI  - Interventional radiologic alternatives to cholecystectomy.
AB  - It has been estimated that 20 million people in the United States have gallstone
      disease. The choice of the optimal management strategy for a patient with
      symptomatic gallstones in the 1990s will take into account the clinical status of
      the patient, the characteristics of the gallstones, and the patient's preference.
      Only patients whose doctors understand the advantages and disadvantages of the
      newer methods can make properly informed choices. When interventional radiologic
      alternatives to cholecystectomy are being contemplated, one approach is to first
      consider the patient's clinical presentation (acute or nonacute) and then their
      risk of death after cholecystectomy (low or high). Figure 5 shows an algorithmic
      approach to the management of gallbladder stones based on this concept. This
      algorithm also can be used as a framework for discussion of treatment options
      with any individual patient.

PMID- 2236528
TI  - Interventional radiology of the biliary tract. Transcholecystic intervention.
AB  - Diagnostic and therapeutic biliary intervention by percutaneous access to the
      gallbladder is an important new area in interventional radiology. The anatomy of
      the gallbladder, biliary tree, and surrounding viscera is reviewed in this
      article as a preliminary to discussion of the diagnostic techniques of
      aspiration, cholangiography, biopsy, and the therapeutic techniques of
      gallbladder drainage and cholelithotomy. Recently there has been a bewildering
      proliferation of procedures aimed at removal, fragmentation, and dissolution of
      gallbladder stones. Several of these are discussed in this article. Removal of
      common bile duct stones by percutaneous cholecystostomy also is discussed.

PMID- 2236529
TI  - Fine caliber cholangioscopy.
AB  - The miniaturized diameters of endoscopes (miniendoscopes) allow percutaneous
      access for endoscopic visualization of the extrahepatic and intrahepatic biliary
      system. Practical aspects of different miniendoscopes in an experimental model
      are described. Clinically, fine caliber cholangioscopy is helpful in detection of
      retained biliary stones. Nevertheless, discrimination of benign and malignant
      stenosis remains difficult, and simultaneous intervention under endoscopic
      guidance is compromised by the low steerability of the instruments.

PMID- 2236530
TI  - Interventional gallbladder procedures.
AB  - Interventional radiologic procedures in the gallbladder are influencing both the
      diagnosis and therapy of many gallbladder disorders. Current diagnostic and
      therapeutic percutaneous techniques offer important alternatives for their
      management. This article highlights the spectrum of interventional radiologic
      techniques available for gallbladder diseases.

PMID- 2236531
TI  - Percutaneous balloon dilatation of benign biliary strictures.
AB  - Percutaneous biliary dilatation is an effective alternative to surgical
      management of benign biliary strictures that has low morbidity and no reported
      mortality. Reported success rates for this procedure range from 40% to 90%
      depending on the size of the series, the type of patient being treated, and the
      length of follow-up period. The procedure is done in the fluoroscopy suite with
      an angioplasty balloon catheter. Transhepatic access is most common, but the
      procedure may be done via existing T-tube tracts or specially created jejunal
      loops. As the frequency of radical liver surgery such as liver transplant and
      radical trisegmentectomy rises, so too, the rate of biliary stricture is likely
      to rise, making percutaneous balloon dilatation an increasingly important tool in
      the interventional radiologist's armamentarium.

PMID- 2236532
TI  - Interventional radiology of the biliary tract. Metallic stents.
AB  - Biliary metallic stents were placed in 18 patients with bile duct obstruction.
      Six patients received Gianturco stents and 14 Wall-stents. Results of these tests
      are discussed.

PMID- 2236533
TI  - Biliary endoprostheses. Plastic versus metal stents.
AB  - Plastic biliary endoprostheses relieved malignant obstructive jaundice in 80% to
      90% of the patients. The comfort of a completely indwelling endoprosthesis should
      be offered to all palliatively treated tumor patients, and external-internal
      catheters should be reserved for the minority of patients who return with
      reoccluded endoprostheses. These patients have bacterial flora that rapidly
      contaminates the endoprosthesis and causes encrustations and reocclusions. Thus,
      a second endoprosthesis also would reocclude quickly. The mechanism of
      reocclusion of plastic and metal endoprostheses is completely different. In
      plastic endoprostheses, bacterial contamination causes decomposition of the bile
      and subsequent encrustation. In metal endoprostheses tumor ingrowths between the
      struts of the stent cause reocclusion. Tumor ingrowths were observed in only 6.5%
      of metal prostheses with a narrow woven mesh (Wallstent), whereas prostheses with
      large distances between the struts (Gianturco stent) had ingrowth rates of 19% to
      50%. This fact shows that tumor ingrowths can be reduced by narrowing the spaces
      between the metallic network, and, therefore, improvements in the design of the
      metal stents should reduce the occlusion rate to or below that of plastic
      endoprostheses, which currently have a lower encrustation rate. The major
      advantages of expandable metal prostheses are the relative ease and the minimal
      trauma of the implantation procedure. The Wallstent endoprosthesis, in
      particular, can be inserted through a 7-F introducer sheath and offers the chance
      of single-step placement. The 30-day mortality rate, therefore, was only 5%. This
      is significantly lower than the 30-day mortality rate after insertion of plastic
      prostheses (15% to 24%). Even simple external catheter drainage procedures have a
      higher reported 30-day mortality rate (27%). Expandable metal endoprostheses
      would be the most useful device if the occlusion rate could be kept under 10% in
      large series. Increasing the length of the endoprostheses to 10 cm in the
      expanded state could also improve the long-term patency rates.

PMID- 2236534
TI  - Intracorporeal biliary lithotripsy.
AB  - Most bile duct calculi can be removed with standard percutaneous or endoscopic
      techniques. Very large stones are the most common cause for failure.
      Intracorporeal lithotripsy, and EHL in particular, can be used safely in either
      the biliary tree or gallbladder to fragment these large stones and allow
      percutaneous removal or passage. Intracorporeal EHL requires direct vision to
      prevent damage to the bile duct mucosa. Intracorporeal laser lithotripsy may
      offer some safety advantages, but the laser requires much more expensive
      equipment than intracorporeal EHL. Additional studies are needed to determine the
      technique that is better in each circumstance.

PMID- 2236535
TI  - Technical aspects of biliary extracorporeal shock wave lithotripsy.
AB  - Radiologic imaging procedures play a major role in the evaluation of the
      potential patient for biliary extracorporeal shock wave lithotripsy, both during
      the procedure and in follow-up evaluation. The treating physician must have a
      thorough knowledge of ultrasonography techniques. Lithotripsy requires continual
      monitoring and frequent reassessment to optimize targeting and fragmentation of
      the gallstones while maintaining patient comfort.

PMID- 2236536
TI  - Clinical experience with biliary extracorporeal shock wave lithotripsy.
AB  - Biliary lithotripsy is a new and important development in the nonsurgical
      management of gallbladder, cystic duct, and bile duct stones. Most patients do
      not require general or epidural anesthesia with newer second-generation machines.
      Patient selection and the use of adjuvant therapy to aid fragment clearance are
      important issues that are discussed. Results from different centers are compared
      but few long-term results are yet available, i.e., longer than 18 months.

PMID- 2236537
TI  - Ablation of the cystic duct and the gallbladder. Experimental basis and initial
      clinical observations.
AB  - Bipolar radiofrequency electrocoagulation of the cystic duct by catheter can be
      performed safely and reproducibly using fluoroscopic control and induces
      endoluminal scar formation. The scar within the cystic duct forms a reliable
      barrier between the gallbladder and the biliary system and avoids recanalization
      of the cystic duct at a later date. Sclerotherapy of the isolated gallbladder
      with 95% ethanol and 3% STS can be performed without toxic or otherwise adverse
      effects and is suitable to ablate the porcine gallbladder. Initial clinical
      trials with this new technique on a small number of patients are promising and
      have demonstrated that the protocol can be applied safely to humans. The
      electrocoagulation technique by catheter appears suitable to ablate the human
      cystic duct. Follow-up evaluation of our first patients is under way and must
      determine whether our regimen is appropriate to ablate the human gallbladder on a
      long-term basis. Further development of this new approach may eventually enable
      definitive nonoperative treatment of cholecystolithiasis in selected patients.

PMID- 2236538
TI  - Combined radiologic and retrograde endoscopic and biliary interventions.
AB  - Methods of treating complex biliary duct problems by a team composed of an
      endoscopist and interventional radiologist are described. These procedures are of
      two types: Those in which all manipulations are performed through the endoscope
      and those in which an antegrade transhepatic and a retrograde endoscopic approach
      are combined.

PMID- 2236539
TI  - [Digital radiography].
AB  - Advantages of digital radiography: Improved low contrast imaging; Image
      processing capability (on line or post-processing); Lower radiation dose for
      certain applications ("Dose variation"); Digital storage and data transfer; Only
      one exposure for different imaging characteristics; Optimised real-time image,
      "digital fluoroscopy" (DBR); Shorter examination times (DBR); Advantages for
      technically complicated exposures (intensive care, superpositions in the chest
      region, pediatry) (DLR); High dynamic range, which eliminates over or under
      exposure; Real time image processing and display (DBR). Disadvantages of digital
      radiography; Lower spatial resolution is limiting fine structure (max.
      theoretical resolution is 31p/mm for 1000 and app. 5 lp/mm for 2000 pixels image
      matrix); Spatial resolution depends from image intensifier diameter or screen
      format; Lower SNR (Signal to Noise Ratio) for reduced dose, increased noise
      impression for edge enhancement; Information losses for monitor camera (DBR) 
      hardcopies; Diagnostic capabilities are reduced by noise and low spatial
      resolution caused by certain applications (mammography).

PMID- 2236540
TI  - [Diagnostic radiology--development and aspects].

PMID- 2236541
TI  - [Niobium powder--a new x-ray contrast medium for tracheobronchography].
AB  - In inhalation tracheobronchography with niobium powder in rabbits and a volunteer
      (physician), excellent contour bronchograms with detailed imaging of the
      structure of the mucosa were obtained. With methodically proper application the
      niobium particles of 20-40 microns do not penetrate into the alveoli and are
      quickly (within 1-5 days) eliminated from the bronchi. Investigations with mice
      have shown, that niobium powder is insoluble, does not irritate tissues and is
      not resorbed. It is also nontoxic.

PMID- 2236542
TI  - [Air or methylcellulose as a double contrast medium in x-ray studies of the small
      intestine?].
AB  - The value of enteroclysma in comparison to peroral roentgenologic imaging of the
      small bowel is beyond doubt. For the use of applicable double contrast media we
      carried out comparative investigations in 118 patients with inflammable diseases
      of the small bowel. 92 patients were investigated with air and 26 with 1%
      methylcellulose solution in double contrast. Advantages and shortcomings of both
      methods are discussed. For the diagnostic results as well as for the application
      of complementing techniques air seems to be better for double contrast studies
      than methylcellulose.

PMID- 2236543
TI  - [Angiodynographic detection of an arteriovenous fistula].

PMID- 2236544
TI  - [Quantitative flow determinations in the superior femoral artery and the
      popliteal artery using angiodynography (color-coded duplex sonography) before and
      after percutaneous transluminal laser angioplasty].
AB  - The primary angiographic PTLA-success correlates with the angiodynographically
      measured blood flow. 24 hours after the treatment the measured flow values in the
      AFS and AP allow prognoses: 1. Flow volumes in the AP less than 15 ml/min do not
      allow successful PLTA-therapy. 2. Slight clinical improvement can be expected for
      flow values greater than 50 ml/min in the AFS and between 20 and 30 ml/min in the
      AP. 3. AP-values greater than 30 ml/min correlate in this pilot investigations
      with an excellent clinical result 4 months after intervention.

PMID- 2236545
TI  - [Color Doppler sonography versus phlebography--a comparison in cases of suspected
      deep venous thromboses of the leg].

PMID- 2236546
TI  - [The application of 2-dimensional echocardiography to the control of the location
      of the electrode catheter during endocardial cardiography].
AB  - Modern methods for treatment of ventricular tachycardia require the exact
      knowledge of the position of the electrode catheter during intracardiac
      electrophysiological investigations. X-ray positioning in several projections
      facilitates the localisation of tachycardia with an accuracy of 4-8 cm2. From
      eight cadaver hearts schematic diagrams of the right ventricle for two
      dimensional echocardiography were derived. Endocardiac ventriculocartography
      under sonographic control was applied in 27 patients 45 times. With this method
      we were able to detect the electrode catheter in 42 of 45 (93%) patients
      effectively. Sonographic control facilitates not only the localisation of
      tachycardia without radiation burden but also its correlation with anatomic
      ventricular structure which is not possible by roentgenology. 3 negative results
      were due to negative echoes. In 3 of 5 cases the fulguration of the ventricular
      tachycardia focus under echo control was possible. Sonographic check up therefore
      is predilection method for endocardiac ventricular cardiography and can be
      recommended.

PMID- 2236547
TI  - [Magnet systems for magnetic resonance tomography].
AB  - In the past fifteen years, Magnetic Resonance Tomography (MRT) has become a
      valuable tool for medical diagnostics. At the same time, Magnetic Resonance
      Spectroscopy (MRS) has attracted more and more attention in medical and other
      related areas of investigations. For both methods it is necessary to provide a
      magnetic field, which can be generated by resistive magnets, by permanent magnets
      as well as by superconducting magnets. These three concepts are described and
      compared together with the advantages of each design and the considerations that
      must be addressed regarding the planned use and the availability of a suitable
      site. In addition to the main magnet important additions like gradient and shim
      coils, aspects of site planning and future problems are discussed.

PMID- 2236548
TI  - [Recent developments in x-ray luminescent imaging systems].
AB  - The paper is a survey on the latest developments in luminescent x-ray imaging
      systems. Special attention was given to two problems, the reduction of cross-over
      in screen-film-systems by variation of the spectrum of luminescence and the
      development of digital storage phosphor systems. Recent developments in the
      evaluation of x-ray luminescent screens are also discussed.

PMID- 2236549
TI  - [Difficulty in determining ultrasonic attenuation values from selective
      echograms].
AB  - The value of tomography is beyond all doubt. Custom systems allow the
      quantitative assessment of topographic and kinetic parameters of various organs
      and the blood. The assessment of tissue, however, is still qualitative and
      experimental methods for quantitative tissue characteristics are still expensive.
      We propose a method, that allows the determination of attenuation coefficients
      with little technical expense.

PMID- 2236550
TI  - [The use of imaging techniques in the diagnosis of pancreatic diseases].
AB  - The present paper discusses the use of modern imaging procedures in the diagnosis
      of various pancreatic diseases. Specific examination patterns are referred to
      their underlying pathological pancreatic processes to allow the best possible
      interpretation of the results of each technique. At present, magnetic resonance
      imaging does not play a decisive role in the diagnosis of either pancreatitis or
      pancreatic tumorous masses.

PMID- 2236551
TI  - [The diagnostic procedure in pancreatic diseases].
AB  - Once a diagnosis of acute pancreatitis is established it is necessary to
      discriminate between an edematous-interstitial and a necrotizing course of the
      disease, to determine the extent and location of necroses by contrast-enhanced CT
      and to detect early infection by ultrasound guided needle aspiration. In chronic
      pancreatitis it is imperative to ascertain the severity by ERCP, and to use
      imaging techniques to determine degree of functional impairment and the extent to
      which the inflammatory process has extended to the peripancreatic tissues by
      means of imaging techniques. Based on clinical data pancreatic carcinoma can not
      usually be detected until it is already in a late stage, but it can then be
      confirmed with great reliability by ERCP, contrast-enhanced CT, tumor marker
      tests and fine needle aspiration.

PMID- 2236552
TI  - [The place of ERCP in pancreatic diagnosis. The change caused by sonography and
      computed tomography].
AB  - Based on 1099 endoscopic retrograde cholangiopancreatograms (ERCP), 659
      examinations conducted in 1973-1980 prior to the introduction of computed
      tomography (CT) and 440 performed in 1988-1989, the impact of sonography and CT
      on ERCP is studied. The availability of CT did not cause any significant change
      in the frequency of and indications for ERCP. The rate of successful ERCP
      examinations increased from 73.6% to 92%. Complications occurred in 2.3%, and the
      mortality rate was 0.4% and was similar in both periods. ERCP was the third
      imaging procedure, being applied after sonography and CT, in most patients. The
      diagnostic value of ERCP in pancreatic disease is compared with that of
      sonography and CT in 116 patients with histologically or clinically proven
      diagnosis. The sensitivity is 79% for ERCP and 78% for CT. Indeterminate findings
      were recorded in 11% of the ERCP and 8% of the CT examinations; these rates can
      be decreased by complementary use of both imaging modalities.

PMID- 2236553
TI  - [A multiple stenosis syndrome of the visceral arteries following chronic
      pancreatitis?].
AB  - Multiple stenoses and occlusions of visceral arteries are documented by CT and
      angiographic findings in a case report. The possible etiology of pancreatitis is
      discussed and the differential diagnosis is outlined.

PMID- 2236554
TI  - [Focal peliosis of the adult liver in combination with glycogenosis type I
      (v.Gierke). A case report and review of the recent literature].
AB  - Peliosis hepatis is a condition characterized by blood-filled lesions in the
      liver that can be localized or diffuse in distribution. The predisposing factors
      for this condition include treatment with anabolic steroids, chemotherapeutic and
      oral contraceptive agents, catabolic metabolic conditions (e.g., hypoglycemia)
      and certain immunological disorders. This disease probably represents a non
      specific immunological response to a variety of noxious agents and has been
      successfully induced in experimental animals. The increased tendency towards
      liver rupture following blunt trauma and resuscitation procedures may have
      important medicolegal consequences. We present a case of peliosis hepatis in a
      patient with type I glycogen storage disease (von Gierke).

PMID- 2236555
TI  - [The feasibility of pretherapeutic diagnosis of malignant pharyngeal processes
      using high-frequency cineradiography].
AB  - The differentiation between stage T3 and stage T4 pharyngeal tumors is of crucial
      importance for the proper therapeutic approach (surgery, surgery with consecutive
      radio- or radiochemotherapy, chemotherapy). The clinical relevance of the
      additional information provided by cineradiography was evaluated in combination
      with the endoscopic and computed tomographic results. We performed static and
      dynamic pharyngography with mono- and double-contrast-methods in four planes,
      including pharyngeal distension (Valsalva's and Muller's maneuver) and phonation.
      For the dynamic study, high-speed cineradiography (35 mm film, 50 frames/s) was
      used. Twenty-three patients with histologically proven neoplasms were examined.
      It was determined that surgery was technically feasible in 4 out of 14 patients
      who were previously presumed to have inoperable tumors. In 2 cases, an extension
      of the tumor mass was seen by cineradiography (results proven intraoperatively).

PMID- 2236556
TI  - [Pancreatic pseudocyst? A pseudoaneurysm of the splenic artery].

PMID- 2236557
TI  - Nurses sued for "loss" of biopsy tissue.

PMID- 2236558
TI  - Nurse fails to disclose HIV test results: discrimination issue. Case in point:
      Leckelt v. Bd. of Com'rs. of Hosp. Dist. No. 1 (909 F. 2d 820--LA (1990)).

PMID- 2236559
TI  - Legal case briefs for nurses. TX.: nurse challenges Dr: retaliatory discharge;
      WA: nurses sue hospital & pension plan: ERISA.

PMID- 2236560
TI  - Pre-op enema perforated colon: Res Ipsa Loquitur. Case in point: Lucas v. St.
      Frances Cabrini Hospital (562 So. 2d 999--LA (1990)).

PMID- 2236561
TI  - Topics in cardiac transplantation. IV.

PMID- 2236562
TI  - Early postoperative care of the cardiac transplantation patient: routine
      considerations and immunosuppressive therapy.
AB  - The authors have attempted to outline the current state of the art with respect
      to the early postoperative management of the cardiac transplant recipient with
      special attention to immunosuppressive therapies. The commonly used agents, as
      well as the most successful combination regimens, have been described along with
      the current levels of expectation regarding rates of rejection and infection.
      Much has been learned regarding the management of these problems. Much remains to
      be learned to further decrease the incidence of postoperative infection and
      rejection and, equally if not more importantly, studies to investigate the
      etiology of transplant coronary artery disease need to be undertaken such that
      measures to delay or prevent its occurrence and/or arrest its progression can be
      instituted.

PMID- 2236563
TI  - Echocardiographic diagnosis of cardiac allograft rejection.

PMID- 2236564
TI  - Chest pain with normal coronary anatomy: a review of natural history and possible
      etiologic factors.

PMID- 2236565
TI  - Atypical causes of curable renovascular hypertension: a review.

PMID- 2236566
TI  - Oligosaccharide chains of glycoproteins.

PMID- 2236567
TI  - Bioactive peptide analogs: in vivo and in vitro production.

PMID- 2236568
TI  - Computer-assisted structure--antileukemic activity analysis of purines and their
      aza and deaza analogs.

PMID- 2236569
TI  - Medicinal chemistry: a support or a driving force in drug research?
AB  - The foregoing has demonstrated most emphatically the significant and central role
      which chemistry plays in modern and future drug research. It does not mean to
      diminish the important role of biology but it does serve to show that chemistry
      is not merely a support for the needs of biology but is a powerful driving force
      in itself. The two disciplines are essentially interdependent and each relies on
      the other for success in drug design, discovery and eventual delivery of a useful
      medicament to the patient. Finally, the medicinal chemist today is faced with as
      many if not more formidable challenges in medicinal research as his counterpart
      of a generation ago. The sciences of genetics, molecular biology, neuro
      pharmacology and electrophysiology have expanded the knowledge base of cellular
      function many fold. This new knowledge when coupled with the fundamental role of
      biochemistry in outlining in chemical terms both normal and abnormal cellular
      events offers the researcher a much more sophisticated appreciation of the cause
      of disease states. Knowing which enzymes or receptors are involved is a crucial
      step towards correcting the malfunctioning cellular conditions. With powerful new
      methods for determining the three-dimensional structure of molecules and computer
      graphics which give insight on rational drug design and modification, the
      medicinal chemist can explore with greater confidence than ever before the road
      to new drugs. The new biology, the new physical methodology and the computer have
      enhanced the role of chemistry in modern drug research and have given the
      medicinal chemist a more profound grasp of cellular aberrations leading to
      disease. This knowledge is a golden rod in the hands of an imaginative chemist in
      the search of innovative drugs.

PMID- 2236570
TI  - Neuroimmune axis as a basis of therapy in Alzheimer's disease.

PMID- 2236571
TI  - Fungal metabolites and Chinese herbal medicine as immunostimulants.

PMID- 2236572
TI  - Progress in the chemotherapy of leprosy: status, issues and prospects.

PMID- 2236573
TI  - Present status of Leishmaniasis.

PMID- 2236574
TI  - Systemic cancer therapy: four decades of progress and some personal perspectives.

PMID- 2236575
TI  - The use of quantum chemical methods to study molecular mechanisms of drug action.

PMID- 2236576
TI  - Polymyositis and dermatomyositis 1990--diagnosis, treatment and prognosis.

PMID- 2236577
TI  - Microdialysis--theory and application.

PMID- 2236578
TI  - Neuronal organization and information processing in the wind-sensitive cercal
      receptor/giant interneurone system of the locus and other orthopteroid insects.

PMID- 2236579
TI  - From phenomenon to mechanism: an investigational strategy.
AB  - 1. The author describes an investigational strategy useful in the field of
      psychopharmacology. 2. This strategy is based on the ability of a multi
      disciplinary team first to measure significant changes in a behavioral or
      physiological variable in response to an experimental manipulation. 3. This
      initial measurement allows investigators to identify a phenomenon but not its
      underlying mechanism. 4. Study then proceeds to assess the anatomical substratum
      essential to mediating the physiologic change and receptology. 5. Finally,
      changes in second messenger mechanisms are determined. 6. Study of the
      neurobiologic effects of bright light is used as an illustration.

PMID- 2236580
TI  - Clinical studies of 5-HT function using i.v. L-tryptophan.
AB  - 1. Preclinical studies reveal that long-term treatment with antidepressant drugs
      induces significant changes in serotonergic (5-HT) receptor sensitivity.
      Similarly, clinical studies suggest that brain 5-HT function is abnormal in
      depression. Of the available methodologies for conducting such clinical studies,
      the pharmacological challenge strategy has proven particularly useful. 2. I.v. L
      TRP has emerged as the most frequently used challenge agent in diagnostic and
      neuropsychopharmacological studies of 5-HT function. I.v. L-TRP increases serum
      prolactin (PRL) in humans, probably via 5-HT mechanisms. Under carefully
      standardized conditions, this PRL response to L-TRP appears to be a reasonably
      sensitive and valid measure of net 5-HT function. 3. The PRL response to L-TRP is
      blunted in depressed patients compared with healthy controls. Blunting has not
      been observed in panic disorder, obsessive compulsive disorder, or schizophrenia,
      although preliminary findings suggest it may occur in bulimia. 4. The PRL
      response to L-TRP is enhanced by certain classes of thymoleptic drugs (TCAs,
      MAOIs, 5-HT reuptake inhibitors, lithium) in a differentially time-dependent
      fashion. So-called "atypical" antidepressants (trazodone, mianserin) and
      benzodiazepines have no effect. Such findings are generally consistent with
      preclinical electrophysiological findings. 5. These clinical studies of the PRL
      response to L-TRP, in conjunction with emerging evidence that experimentally
      reduced plasma TRP can reverse the therapeutic effects of some antidepressants,
      suggest that antidepressant drug action may be more accurately conceptualized as
      5-HT dependent rather than 5-HT enhancing. The availability of more selective 5
      HT-active drugs promises to further clarify 5-HT mechanisms of neuropsychiatric
      disease and drug action at the clinical level.

PMID- 2236581
TI  - Nimodipine in the treatment of old age dementias.
AB  - 1. In a multicenter, placebo-controlled, double-blind clinical study in 178
      elderly patients with cognitive decline, nimodipine, a calcium antagonist was
      found to be a therapeutically effective agent in the treatment of old age
      dementias. 2. Treatment with 90 mg of nimodipine administered orally in divided
      doses for 12 weeks was significantly superior to an inactive placebo on all
      outcome measures including the Wechsler Memory Scale, the Mini Mental State
      Examination, the Global Deterioration Scale, the Sandoz Clinical Assessment
      Geriatric Scale, the Plutchik Geriatric Rating Scale, the Severity of Illness and
      Global Improvement Scales of Clinical Global Impression, and the Hamilton
      Psychiatric Rating Scale for Depression. 3. Adverse effects with nimodipine were
      few and mild. The drug was equally well tolerated and equally effective in the
      two major dementias of old age, i.e., primary degenerative and multi-infarct. The
      number of abnormal laboratory test readings remained essentially unchanged from
      pre-treatment to post-treatment.

PMID- 2236582
TI  - Influence of protein concentration on platelet 3H-imipramine binding.
AB  - 1. The effects of protein concentration in the assay mixture on platelet 3H
      imipramine binding were studied in normal controls. 2. Increasing protein
      concentrations (76-926 micrograms/ml) were found to alter estimates of binding
      affinity (Kd) but not the number of binding sites (Bmax). 3. Increasing Kd
      estimates were protein dependent at concentrations in excess of ca. 200
      micrograms/ml but were not protein dependent at lower concentrations. 4. A
      comparison of the present results with previous reports suggests that widespread
      interlaboratory differences in reported Bmax values for normal controls cannot be
      attributed to differences in the protein content of incubated samples. Rather
      these differences may be due to the inclusion of non-membrane protein in the
      assayed material.

PMID- 2236583
TI  - Light-induced plasma melatonin suppression in seasonal affective disorder.
AB  - 1. Subjects with seasonal affective disorder were exposed to 0, 500 and 1000 lux
      of white light for one hour beginning at 0300 hours. 2. Plasma samples were taken
      periodically and analysed for melatonin. 3. Plasma melatonin levels were
      suppressed by exposure to both 500 and 1000 lux light levels, suggesting that SAD
      patients show no neuroendocrine insensitivity to light but may show
      supersensitive responses to light.

PMID- 2236584
TI  - Treatment of winter depression with a portable, head-mounted phototherapy device.
AB  - 1. A portable, head-mounted device was developed for administration of light
      therapy. A randomized crossover protocol was used to test the therapeutic
      efficacy of this device, compared to a standard light box, for treatment of
      winter depression. 2. Depressive symptoms were significantly reduced by both the
      head-mounted device and the light box. 3. Therapeutic efficacy of the two devices
      was not significantly different. 4. The head-mounted device was rated by patients
      as significantly more convenient than the conventional light box; this may be
      important in improving patient compliance.

PMID- 2236585
TI  - Immobilization 12 days (but not one hour) earlier enhanced 2-deoxy-D-glucose
      induced immunosuppression: evidence for stressor-induced time-dependent
      sensitization of the immune system.
AB  - 1. Prior exposure to a stressor can either increase or decrease subsequent
      behavioral, neurochemical, and endocrine reactivity to stress, depending on the
      pattern of stress exposure. 2. Massed or frequent exposures typically induce a
      reduction in reactivity whereas intermittent or widely spaced exposures increase
      subsequent reactivity. 3. In the present study, the authors examined whether a
      single presentation of a temporally remote stressor would increase the
      immunosuppressive effects of a subsequent stressor. Specifically, the authors
      investigated the effectiveness of 2-deoxy-D-glucose (2-DG) in suppressing the
      responsiveness of splenic lymphocytes in male, Sprague-Dawley rats that received
      either no prior treatment, or immobilization either one hour or 12 days earlier.
      4. Splenic lymphocyte responsiveness to the T-cell mitogens, Concanavalin A (Con
      A) and phytohemagglutinin (PHA) was suppressed following a single injection of 2
      DG. 5. The group exposed to the stress of immobilization one hour prior to 2-DG
      demonstrated a comparable level of immune suppression. 6. In contrast, animals
      immobilized 12 days prior to the administration of 2-DG showed a more pronounced
      suppression of immune responsiveness which was significantly greater than the
      other groups injected with 2-DG. 7. Neither the stress-induced elevation in
      corticosterone, nor the suppression of blood lymphocyte reactivity to Con-A and
      PHA was enhanced by prior immobilization. 8. The results indicate that the
      immunosuppressive effects of an acute stressor can sensitize with the passage of
      time.

PMID- 2236586
TI  - Telemetric measurement of core temperature in pharmacological research: validity
      and reliability.
AB  - 1. The authors present data establishing the reliability and validity of a method
      for telemetrically measuring core temperature. 2. The method is designed to be of
      particular utility to psychobiological researchers.

PMID- 2236587
TI  - Indomethacin prevents increased catecholamine turnover in rat brain following
      systemic endotoxin challenge.
AB  - 1. Key features of the acute phase response to infection are replicated by
      systemic administrations of lipopolysaccharide and may be mediated via the
      production of lymphokines and cytokines, including interleukin-1. Inhibition of
      prostaglandin synthesis may attenuate certain features of the acute phase
      response. 2. In the present study, the effects of systemic administration of the
      lipopolysaccharide (LPS, 250 micrograms/rat) and interleukin-1 (IL-1, 10
      micrograms/rat) on catecholamine metabolism in different brain regions were
      compared and the effects of indomethacin, a cyclooxygenase inhibitor was
      determined. 3. The ratio of metabolite to parent amine was used as an index of
      turnover of catecholamines. 4. In hypothalamus, both epinephrine and
      norepinephrine concentrations were decreased and their major metabolite, 3
      methoxy,4-hydroxyphenylglycol (MHPG), was elevated at 4, 8 and 24 hr following
      LPS. The major metabolite of dopamine (homovanillic acid, HVA) was increased at 8
      hours in striatum, hypothalamus and medulla. LPS increased dopamine turnover at 8
      and 24 hr and norepinephrine turnover at 4, 8 and 24 hr. 5. In all regions
      examined, IL-1 produced effects similar to LPS on amine and metabolite contents
      and norepinephrine and dopamine turnover. 6. Significantly, co-administration of
      a single dose of indomethacin (50 mg/kg) completely blocked LPS-induced changes
      in hypothalamic catecholamines and metabolites and the increase in turnover at 4
      and 8 hr. Furthermore, the effects of IL-1 on hypothalamic MHPG content and
      norepinephrine turnover were also blocked by indomethacin, although the effects
      of IL-1 on regional catecholamines and HVA content and turnover were either not
      modified or partially antagonized by indomethacin. 7. The present results suggest
      that in the rat, activation of noradrenergic, dopaminergic and epinephrine
      containing neurons in hypothalamus, as well as dopaminergic neurons in other
      regions is associated with the acute phase response to endotoxin and that
      synthesis of prostaglandins plays a pivotal role in catecholamine responses in
      all brain regions examined.

PMID- 2236589
TI  - [Crossbridges in contracting muscle captured by rapid freezing].

PMID- 2236588
TI  - Decreased alcohol consumption by verapamil in alcohol preferring rats.
AB  - 1. Calcium channel blockers have been proposed, in addition to inhibiting the
      influx of Ca++ into the cells, to possess a wide variety of pharmacological
      effects, including interference with certain neurotransmitters involved in mood,
      mental disorders and alcohol craving. Further, it has been documented that
      certain neurotransmitters are involved in alcohol craving both in animals and
      humans. 2. To investigate the effects of Ca(++)-channel antagonist on alcohol
      preference, verapamil in three doses (5, 10 and 15 mg/kg) was injected (S.C.)
      twice daily over a period of one day in alcohol-preferring (P) and alcohol non
      preferring (NP) rats at 9:00 a.m. and 4:00 p.m. 3. Water, alcohol and food intake
      were monitored. 4. Our results show that verapamil in doses of 10 and 15 mg/kg
      significantly (p less than 0.02 and 0.01, respectively) reduced the intake of
      ethanol and increased the intake of water by P rats. However, injection of an
      equal volume of saline did not change the pattern of alcohol intake. 5. These
      results suggest that a (++(+)-channel blocker such as verapamil, could, at least
      partially, attenuate alcohol preference in alcohol preferring rats. It is
      possible that verapamil exerts an inhibitory effect on alcohol preference by
      interfering with Ca++ channels, blocking serotonin uptake or through another
      mechanism(s).

PMID- 2236590
TI  - [Cross-bridge movement in heart muscle during contraction].

PMID- 2236591
TI  - [Beating of myocardial cells and its regulation--fetal cardiomyocytes].

PMID- 2236592
TI  - [Intracellular Ca ion movement in cardiac muscles].

PMID- 2236593
TI  - [Regulation of vessel function and its disorder].

PMID- 2236594
TI  - [Coronary circulation in physiological and pathological states].

PMID- 2236595
TI  - [Energy metabolism and cell injury in ischemic heart].

PMID- 2236596
TI  - [Cellular basis of pathophysiology in stunned myocardium].

PMID- 2236597
TI  - [Morphological aspects of myocardial necrosis].

PMID- 2236598
TI  - [Calcium overload and myocardial injury].

PMID- 2236599
TI  - [Role of oxy-radicals in myocardial oxygen paradox].

PMID- 2236600
TI  - [Calcium-activated neutral proteases in cell injury].

PMID- 2236601
TI  - [Myocardial injury and phospholipases].

PMID- 2236602
TI  - [Immunopathogenesis of cardiomyopathy and myocarditis].

PMID- 2236603
TI  - [Arrhythmias due to myocardial injury].

PMID- 2236604
TI  - [Changes in intracellular anion-concentrations and cardio-active substances].

PMID- 2236605
TI  - [Cardiovascular disease and reactive oxygen toxicity--analysis by site-directed
      SOD derivatives].

PMID- 2236607
TI  - [Pathological findings of transplanted heart].

PMID- 2236606
TI  - [Myocardial protection during cardiac surgery; cardioplegia].

PMID- 2236608
TI  - [Development of new immunosuppressant and experimental cardiac transplantation].

PMID- 2236609
TI  - [Organ preservation].

PMID- 2236610
TI  - [Liposome chromatography: a new mode of separation using lipid bilayer].

PMID- 2236611
TI  - [Ultra-rapid Southern blotting of huge DNA: quantitative and simultaneous
      transfer method of nucleic acids in size from 0.07 to 2,000 kb].

PMID- 2236612
TI  - [Molecular biology of retroviral infection and the associated diseases].

PMID- 2236613
TI  - [An overview: what is the embryonic engineering].

PMID- 2236614
TI  - [Embryonic engineering].

PMID- 2236615
TI  - [Molecular biology of hepatitis B virus].

PMID- 2236616
TI  - [Hepatitis B virus and hepatocarcinogenesis].

PMID- 2236617
TI  - [Woodchuck hepatitis virus and enhancer].

PMID- 2236618
TI  - [Molecular biology of hepatitis delta virus].

PMID- 2236619
TI  - [The mechanism of EGF biosynthesis--physiological functions and pathological
      conditions].

PMID- 2236620
TI  - [Cell biological aspects of infectious diseases of human retrovirus: ATL and
      AIDS].

PMID- 2236621
TI  - [A historic, biographic, literary and clinical overview on the 50th anniversary
      of Freud's treatise, "Time-limited and extended analysis"].

PMID- 2236622
TI  - [Prostitution wishes and rescue fantasies--flight from the father. Sketches from
      the life of a woman ("Anna O."--"P. Berthold"--Bertha Pappenheim)].
AB  - Bertha Pappenheim, Breuer's famous patient "Anna O.," was a socially engaged,
      successful, Jewish women's rights advocate. The details of her biography
      presented here are not as well known--especially the subsequent course of her
      illness and treatment and her struggle against prostitution and the white slave
      trade, the latter carried on with special fascination. All of these show that
      "Anna O." left Breuer's treatment far from cured and that Bertha was entangled in
      a lifelong daughter-father conflict.

PMID- 2236623
TI  - [Dealing with (bypassing) the difference].
AB  - The author presents different psychoanalytic conceptualizations of gender
      difference. She reviews the controversy between Freud and Jones and discusses in
      detail the views put forward by Montrelay, a student of Lacan, who relates early
      linguistic development to gender-specific differences in closeness between the
      child and the "mother's body".

PMID- 2236624
TI  - [Selected problems of diagnosis, natural course and prognostic significance of
      borderline arterial hypertension. I. Long-term observations of borderline
      arterial hypertension in the population of working men].
AB  - Of 1236 men, aged 40-59 years, working in the same industrial plant borderline
      arterial hypertension (BH) was found in 253 (20.5%) subjects. The hypertensives
      and matched control normotensives (n = 237) were followed up for many years. At
      13 years 343 subjects i.e. 70% of the original population were reevaluated.
      Arterial hypertension developed in 79.1% of the subjects with initial BH, most
      frequently with systolic++-diastolic, less frequently with systolic and diastolic
      BH. In normotensives hypertension was diagnosed in 30% of the subjects (p less
      than 0.001). A negative correlation between blood pressure rise and its initial
      value was found in all subjects. Out of various risk factors such as overweight,
      family hypertension, smoking and tachycardia possibly contributing to the
      development of established hypertension genetic factors and overweight were shown
      to be predisposing. The results of the studies indicate the need of preventive
      measures in all men with borderline hypertension and normotensives with family
      hypertension and overweight.

PMID- 2236625
TI  - [Evaluation of the effectiveness of hemodialysis using only heparin or
      prostacyclin with heparin].
AB  - In ten patients treated by maintenance hemodialysis due to end-stage renal
      failure evaluation of dialysis efficiency was performed during the treatment with
      heparin alone as well as in the course of prostacyclin -heparin infusion.
      Statistically significant lower level of urea at the end of dialysis and
      significantly higher urea clearance were found during hemodialysis with
      prostacyclin -heparin infusion in comparison with infusion of heparin alone.

PMID- 2236626
TI  - [Bactericidal properties of granulocytes and plasma in patients with rheumatoid
      arthritis complicated by urinary tract infections].
AB  - 26 patients with rheumatoid arthritis complicate by infection of urinary tract,
      have been decreased bactericidal activity of granulocytes. No changes has been
      noted in the bactericidal activity of plasma. These results suggested that
      neutrophils in rheumatoid synovial membrane plays important role of inflammation
      processes.

PMID- 2236627
TI  - [Clinical and electrophysiological studies of the organ of hearing in newborn
      infants. II. Study of maturity of the auditory pathway by brain stem responses
      (ABR) in newborn infants].
AB  - In a group of 130 tested children, 102 of whom a property had evaluated on brain
      stem responses, we tested the influence of newborn maturation on values of
      response parameters, their configuration and threshold values. It was shown that
      newborn maturation lowers in a statistically significant way the threshold values
      of acoustic stimulus. Also, the configuration of the monitoring changes with age
      of child tested. Newborn maturation increases the frequency of occurrence of
      waves II, IV, V and VI though decreases of incidence IV/V complex. In the group
      of the youngest pre-term babies IV/V complex were present in 50% of cases,
      whereas in the group of newborns carried to term its present could be verified
      only in 5-11% of cases. Newborn maturity also influences in an essential way the
      average latent time consecutive waves as well as central conduction time
      determined by interpeak latency I-V. Coefficient correlation values for these
      parameters shows a negative statistical significance correlation. That is, a
      decreasing of average values of these parameters with maturation of the newborn.
      It was also shown that structures of the hearing pathway responsible for
      generation of early and late components of brain stem responses nature at
      different periods. Peripheral structures of the hearing pathway are significantly
      more mature at birth than are central structures.

PMID- 2236628
TI  - [Clinical analysis of 53 cases of septicemia caused by Streptococcus viridans in
      children].
AB  - The clinical analysis has been performed in 53 cases of sepsis induced by
      Streptococcus viridans. Among children with diagnosis of sepsis majority of cases
      in group of older infant and children up to 2 year age was due to above
      infection. The S. viridans strain isolated form the blood were in 90% percentage
      resistant to cloxacillin , the resistance to penicillin, ampicillin and
      gentamicin was equal to 70%, 50% and 34% respectively. The main symptoms of the
      S. viridans sepsis was most frequently localized in lung. Laboratory findings
      most frequently revealed anemia and toxic granulation in neutrophils . Four
      children died due to the infection (mortality index to 7.5%).

PMID- 2236629
TI  - [Proteinuria].

PMID- 2236630
TI  - Autobiographical and text recall in the elderly: an investigation of a processing
      resource deficit.
AB  - This study examined different explanations of age-related impairments in recall
      of details from text and autobiographical events. An interpretation of Central
      Executive Capacity Deficit was supported and explored further. This suggests that
      details are more demanding of capacity than main points, and that ability to
      appropriately integrate details with context is likely to be impaired. An
      implication was that irrelevant and false information may occur, and this was
      supported in both autobiographical and text recall. The effects were then
      examined in relation to various measures of ability. The aim was to determine
      whether declining capacity (as indicated by "Fluid Intelligence" measures)
      predicted ability to recall in a detailed manner. The difficulty with details was
      predicted independently by chronological age and by measures of fluid (e.g. AH4
      intelligence test) and the more crystallized verbal ability (Mill Hill vocabulary
      test). Only a measure of the specificity of autobiographical recall was predicted
      solely by measures of fluid intelligence. Decreased specificity was not a result
      of faster decay of memory for details, as there was little difference across the
      lifespan. The resource deficit appears to affect retrieval and appropriate
      implementation of detail. It was concluded that lower-ability elderly subjects
      have decreased Central Executive resources, which leads to poor (often
      inappropriate) integration of details with central thematic points, but that
      subjects' verbal ability, which does not decline with age, still has an important
      part to play.

PMID- 2236631
TI  - Age and prospective memory.
AB  - This paper reports an investigation into the effects of age, intelligence, and
      retrospective memory on performance in a prospective memory task in which
      subjects aged between 52 and 95 were required to telephone once a day either
      between two times or at an exact time. The most important influence on
      performance was how subjects chose to remember to make the telephone calls. The
      best performance was from subjects who telephoned either in conjunction with
      another routine event or engaged in some form of advanced planning of the daily
      schedule. The worst performance was from those who relied on internal cues from
      their own memory. Performance was intermediate from those who used external cues
      such as notes or diary entries. Subjects in the between condition were less
      likely to choose internal cues than those in the exact condition, possibly
      because the task appeared more difficult, and this resulted in their showing
      superior performance. The effect of age was influenced by the cue used. For
      subjects using internal cues, those who forgot were older than those who
      remembered, whereas for subjects using the other cues, those who forgot were
      younger than those who remembered. Regardless of cue, self-ratings of cognitive
      failures were related to performance such that those who reported more minor
      everyday mistakes were indeed more likely to forget to telephone. While there was
      some indirect effect of general intelligence on performance in the task, there
      was no relationship between retrospective memory scores and whether or not
      subjects remembered to telephone.

PMID- 2236632
TI  - Repetition priming and face processing: priming occurs within the system that
      responds to the identity of a face.
AB  - A familiar stimulus that has recently been recognized will be recognized a second
      time more quickly and more accurately than if it had not been primed by the
      earlier encounter. This is the phenomenon of "repetition priming". Four
      experiments on repetition priming of face recognition suggest that repetition
      priming is a consequence of changes within the system that responds to the
      familiarity of a stimulus. In Experiment 1, classifying familiar faces by
      occupation facilitated subsequent responses to the same faces in a familiarity
      decision task (Is this face familiar or unfamiliar?) but not in an expression
      decision task (Is this face smiling or unsmiling?) or a sex decision task (Is
      this face male or female?). In Experiment 2, familiar faces showed repetition
      priming in a familiarity decision task, regardless of whether a familiarity
      judgment or an expression judgment had been required when the faces were first
      encountered. Expression decisions to familiar faces again failed to show
      repetition priming. In Experiment 3, familiar faces showed repetition priming in
      a familiarity decision task, regardless of whether a familiarity judgment or a
      sex judgment had been asked for when the faces were first encountered. Sex
      decisions to familiar faces again failed to show repetition priming. In
      Experiment 4, familiarity decisions continued to show repetition priming when a
      brief presentation time with encouragement to respond while the face was
      displayed reduced response latencies to speeds comparable to those for sex and
      expression judgments in Experiments 1 to 3. The results are problematic for
      theories that propose that repetition priming is mediated by episodic records of
      previous acts of stimulus encoding.

PMID- 2236634
TI  - Contextual cueing effects in the remote memory of alcoholic Korsakoff patients
      and normal subjects.
AB  - This study examines the effects of contextual cueing on the remote memory of
      alcoholic Korsakoff patients and normal subjects. Naming of personalities who
      became famous in each of the five decades beginning 1935 was tested under two
      conditions: "no-context", in which minimal extraneous cues to identification were
      provided, and "context", where clear extraneous cues were available. Normal
      subjects performed better than Korsakoff patients, showed no evidence of a
      temporal gradient, and exhibited a contextual cueing advantage across all
      decades. In contrast, Korsakoff patients demonstrated a marked temporal gradient,
      and the contextual cueing advantage declined systematically as more recent
      decades were sampled. Further analyses demonstrated that the differential pattern
      of deficits shown by Korsakoffs and controls was not attributable to absolute
      differences in performance level. Theoretical implications of these data for
      explanations of Korsakoff retrograde amnesia are discussed.

PMID- 2236633
TI  - Episodic memory in dementia of the Alzheimer type and in normal ageing: similar
      impairment in automatic processing.
AB  - A perceptual identification task was used to provide an implicit measure for
      automatic memory processes. The facilitation of word identification on repeated
      presentation is taken as a measure of the automatic retrieval of an episode. In
      addition, recognition memory was tested. The recognition task is an explicit test
      of memory and relies mainly on controlled processing. In the first experiment 11
      patients suffering from probable Alzheimer disease and 11 normal age- and sex
      matched controls were tested. Both groups exhibited a rather small facilitation
      effect (ca 7%) but did not differ in the size of the effect. However, when tested
      explicitly, a difference in recognition memory existed between the two groups. In
      the second experiment the performance of 11 normal young subjects was compared to
      that of 11 normal elderly subjects. Whereas the elderly group showed a small
      facilitation effect similar to that observed in the first experiment, a
      considerable facilitation effect was found for the young group. Also, the elderly
      group had poorer recognition memory than the young group.

PMID- 2236635
TI  - The mediation of paired associate recall by representations of properties
      ascribed to objects in perception and imagination.
AB  - Any perceived or imagined object will have various properties: for example, it
      may be of a particular size, shape, and colour. In this paper it is argued that
      when two objects are perceived or imagined to be interacting, they are likely, as
      a result, to have properties that may, in part, mediate paired associate recall.
      In Experiments 1 and 2 it was shown that if the object to be named in recall has
      properties that are the same as the object named by the cue, then recall is
      greater than when the properties differ. In Experiment 3 it was shown that if the
      object to be named in recall has properties that are relevant to a relation
      between the two objects, then recall is enhanced, as compared with conditions in
      which this is not the case. In discussion, it is argued that, by means similar to
      those operating in these experiments, a representation of properties may
      contribute to recall in experiments in which subjects use interactive imagery.

PMID- 2236636
TI  - Performance on ratio and interval schedules with matched reinforcement rates.
AB  - In the first study, rats were trained to pull a chain on a schedule (RPI) that
      regulates the probability of reinforcement to maintain a constant average
      reinforcement rate without differentially reinforcing long inter-response times
      (IRTs). Although the response rate was sensitive to the overall rate of
      reinforcement, performance was unaffected by variations between 1 and 50 in the
      IRT memory size used in programming the schedule. In the second study, two groups
      of animals performed on either a random-interval (RI) schedule or a RPI schedule,
      with reinforcement rates determined by those generated by a third group
      performing on a random ratio (RR) 20 schedule. The RI group responded at a lower
      rate than the RPI group, which, in turn, responded at a lower rate than the RR
      group, even though the three groups experienced comparable rates of
      reinforcement. The fact that the RPI group responded at a lower rate than the RR
      group suggests that the standard response rate difference observed between ratio
      and interval schedules, which have been matched for reinforcement rate, cannot be
      attributed solely to the fact that conventional interval schedules differentially
      reinforce long IRTs.

PMID- 2236637
TI  - An investigation into blocking of filial imprinting in the chick during exposure
      to a compound stimulus.
AB  - The occurrence of "blocking" was investigated in jungle fowl chicks (Gallus
      gallus spadiceus B.) in an imprinting situation. In Experiment 1, chicks were
      simultaneously exposed to two stationary coloured cylinders, either two red
      cylinders (Group RR), a yellow and a red cylinder (YR), or two yellow cylinders
      (YY). After six days of exposure, the cylinders were removed from the cages and
      replaced by a yellow and a blue cylinder (i.e. YB) for each chick. This second
      phase of the experiment lasted for seven days. When the blue cylinder was
      presented alone during tests at different stages in Phase 2, the RR birds spent
      significantly more time with this cylinder and emitted fewer shrill calls than
      the chicks in the YR and YY groups. In Experiment 2, RR and YY birds were reared
      as in Experiment 1, except that in the second phase of the experiment they were
      exposed to a blue cylinder only. In this experiment the development of an
      attachment to the novel blue cylinder proceeded similarly in the RR and YY birds.
      In Experiment 3, it was found that chicks that were reared with a yellow and a
      red cylinder preferred the latter stimulus. Thus, although in the first phase of
      Experiment 1 the RR birds had been exposed to a more attractive stimulus, in
      tests during the second phase they spent more time with a novel stimulus (B) than
      the YY birds. These results are consistent with the suggestion that imprinting to
      a novel stimulus is "blocked" to some extent when that stimulus is presented in
      compound with another stimulus to which the animal has previously been exposed.

PMID- 2236638
TI  - Radiobiological aspects of continuous low dose-rate irradiation and fractionated
      high dose-rate irradiation.
AB  - The biological effects of continuous low dose-rate irradiation and fractionated
      high dose-rate irradiation in interstitial and intracavitary radiotherapy and
      total body irradiation are discussed in terms of dose-rate fractionation
      sensitivity for various tissues. A scaling between dose rate and fraction size
      was established for acute and late normal-tissue effects which can serve as a
      guideline for local treatment in the range of dose rates between 0.02 and 0.005
      Gy/min and fraction sizes between 8.5 and 2.5 Gy. This is valid provided cell
      cycle progression and proliferation can be ignored. Assuming that the acute and
      late tissue responses are characterised by alpha/beta values of about 10 and 3 Gy
      and a mono-exponential repair half-time of about 3 h, the same total doses given
      with either of the two methods are approximately equivalent. The equivalence for
      acute and late non-hemopoietic normal tissue damage is 0.02 Gy/min and 8.5 Gy per
      fraction; 0.01 Gy/min and 5.5 Gy per fraction; and 0.005 Gy/min and 2.5 Gy per
      fraction. A very low dose rate, below 0.005 Gy/min, is thus necessary to simulate
      high dose-rate radiotherapy with fraction sizes of about 2 Gy. The scaling factor
      is, however, dependent on the repair half-time of the tissue. A review of
      published data on dose-rate effects for normal-tissue response showed a
      significantly stronger dose-rate dependence for late than for acute effects below
      0.02 Gy/min. There was no significant difference in dose-rate dependence between
      various acute non-hemopoietic effects or between various late effects. The
      consistent dose-rate dependence, which justifies the use of a general scaling
      factor between fraction size and dose rate, contrasts with the wide range of
      values for repair half-time calculated for various normal-tissue effects. This
      indicates that the model currently used for repair kinetics is not satisfactory.
      There are also few experimental data in the clinical dose-rate range, below 0.02
      Gy/min. It is therefore necessary to verify further the presented scaling between
      fraction size and dose rate.

PMID- 2236640
TI  - Occupational health nursing.

PMID- 2236639
TI  - Quality assurance in radiotherapy by in vivo dosimetry. 2. Determination of the
      target absorbed dose.
AB  - Combined entrance and exit dose measurements were performed with semiconductor
      detectors on patients, treated for neck and oral cavity malignancies.
      Transmission measurements showed the important influence of contour inaccuracies
      and tissue inhomogeneities. In 39.6% (21/53) of the checked contours, the
      discrepancy between the contour diameter used for routine treatment planning and
      the actual patient diameter was 1 cm or more, and in this group a systematic
      tendency for patient diameter underestimation due to the procedure was detected.
      When the X-ray beam passed through important bone structures such as the
      mandibular bones or the vertebral body, large discrepancies of 10% and more
      between the measured and the expected transmission were found. The target
      absorbed dose was determined from the transmission and entrance dose measurement.
      A systematic underdosage of about 2% at midline level was found to be due to an
      inaccuracy in the algorithms of the treatment planning system. Underdosages of 5%
      or more at midline were detected in more than 20% (47/230) of the measurements.
      In all cases, the reason for erroneous dose delivery was identified. Entrance
      dose measurements were previously demonstrated to be useful for the assessment of
      uncertainties related to treatment machine, patient set-up and treatment planning
      system (part 1). Transmission measurements (the ratio of the exit to the entrance
      dose measurement) are shown to be very useful to evaluate uncertainties related
      to patient data such as contour errors and tissue inhomogeneities as well as to
      the algorithms of the planning system. The influence of these errors on the
      target absorbed dose can be estimated and corrections can be applied for each
      individual patient.

PMID- 2236641
TI  - A view of occupational health nursing practice: current trends and future
      prospects.

PMID- 2236642
TI  - Nursing advances in occupational injury prevention and control.

PMID- 2236643
TI  - Research in occupational health nursing.

PMID- 2236644
TI  - The education and training of occupational health nurses: current trends.

PMID- 2236645
TI  - Annotated bibliography.

PMID- 2236646
TI  - Twenty years of change and development in occupational health nursing in the UK.

PMID- 2236647
TI  - Occupational health nursing in developing countries.

PMID- 2236648
TI  - Holistic health care at the workplace.

PMID- 2236649
TI  - Communality in a scientific community.

PMID- 2236650
TI  - Pregnant moments: the process of conception in infertile couples.
AB  - This report is an explication of the process of conception in infertile couples
      as illuminated by 24 infertile couples and a comparison group of 6 couples with
      no fertility impairments. Employing techniques generic to grounded theory
      research, the investigators found that infertile couples lived conception as a
      series of biological and phenomenological moments. The process of biomedically
      assisted conception consisted of three components including: (a) forcing
      conception; (b) resolving conceptional ambiguity; and (c) reconciling conception
      as an idea and as an event. The findings suggest the need for a re-examination of
      current orientations to pregnancy time and space and appraisal of couples'
      interpretations of conception. In addition, the convergence of the conception
      experiences of infertile and fertile couples raises questions about the meaning
      of normal conception in the current technological context of reproduction.

PMID- 2236651
TI  - Depression, stress, mastery, and social resources in four ethnocultural women's
      groups.
AB  - This descriptive study was designed to examine the interrelationships of
      depression, stress, mastery, and social resources in four ethnocultural women's
      groups. The random sample (N = 212) was comprised of Chinese (n = 60), Vietnamese
      (n = 46), Portuguese (n = 56), and Latin American (n = 50) immigrant women. Using
      the CES-D, high depressive symptoms were reported by all groups. Collectively,
      the major correlates and predictors of depression were perceived stress and
      mastery. Group-specific analyses revealed different models for predicting
      depression in each ethnic group. The findings underscore the need for observation
      of the indicators of depression in immigrant women--regardless of their phase of
      resettlement--and a flexible, individualized approach to ethnic women's
      psychological health care.

PMID- 2236652
TI  - Factors that contribute to pressure sores in surgical patients.
AB  - In this prospective study examination was made of whether (a) time on the
      operating table, (b) proportion of intraoperative diastolic hypotensive episodes,
      (c) age, (d) preoperative serum albumin, (e) preoperative total protein levels,
      and (f) preoperative Braden scores could identify those patients who do and do
      not develop pressure sores during elective surgery. The stratified sample
      consisted of 125 adult patients. Fifteen patients (12%) developed a total of 23
      pressure sores. A discriminant function using time on the operating table,
      extracorporeal circulation, and age emerged as the best predictor correctly
      classifying 12 of 15 patients who developed pressure sores and 83 of 110 patients
      who remained pressure sore free.

PMID- 2236653
TI  - Self-care agency as a function of patient-environmental factors among nursing
      home residents.
AB  - The relationship between environmental and personal factors on self-appraised
      self-care agency of nursing home residents was examined. Data were collected from
      83 nursing home residents in relation to self-care abilities, environmental
      constraints, and selected demographic factors. Race and previous occupation were
      related to self-care agency with residents who were black or previously self
      employed evidencing higher scores. In addition, residents who viewed the home as
      overly restrictive or fostering dependence had lower perceptions of their self
      care abilities. The results are discussed in terms of Orem's theory of self-care,
      social learning theory, and implications for restructuring care within nursing
      homes.

PMID- 2236654
TI  - The process of rater training for observational instruments: implications for
      interrater reliability.
AB  - Although the process of rater training is important for establishing interrater
      reliability of observational instruments, there is little information available
      in current literature to guide the researcher. In this article, principles and
      procedures that can be used when rater performance is a critical element of
      reliability assessment are described. Three phases of the process of rater
      training are presented: (a) training raters to use the instrument; (b) evaluating
      rater performance at the end of training; and (c) determining the extent to which
      rater training is maintained during a reliability study. An example is presented
      to illustrate how these phases were incorporated in a study to examine the
      reliability of a measure of patient intensity called the Patient Intensity for
      Nursing Index (PINI).

PMID- 2236655
TI  - A validity study of four empathy instruments.
AB  - The construct validity of four empathy instruments were evaluated through
      examining group differences and correlations between tests. Subjects were 18
      registered nurses (RNs) and 32 nursing assistants (NAs). Instruments used were
      the Empathy Test (Layton, 1979), the Carkhuff (1969a, 1969b) Empathic
      Understanding in Interpersonal Processes Scale, the empathy subtest of the
      Barrett-Lennard (1962) Relationship Inventory, and LaMonica's (1981) Empathy
      Construct Rating Scale (ECRS). The first hypothesis, that RNs would score
      significantly higher than NAs on all empathy measures, was confirmed (p less than
      .0003 to p less than .027). The second hypothesis, that the various empathy
      measures would be positively related, was partially confirmed. The Carkhuff scale
      was significantly correlated with the ECRS (r = .25, p less than .05). The ECRS
      and the Barrett-Lennard also were correlated (r = .78, p less than .001). Results
      are interpreted using Barrett-Lennard's (1981) theory of empathy.

PMID- 2236656
TI  - Department of Health and Human Services, Public Health Service, National
      Institutes of Health. Human Gene Therapy Subcommittee, Minutes of Meeting, March
      30, 1990.

PMID- 2236657
TI  - Department of Health and Human Services, National Institutes of Health.
      Recombinant DNA research: proposed actions under guidelines.

PMID- 2236658
TI  - Department of Health and Human Services, Public Health Service, National
      Institutes of Health. Recombinant DNA Advisory Committee, Minutes of meeting,
      February 5, 1990.

PMID- 2236659
TI  - The influences of dexamethasone and indomethacin on 67Ga uptake by normal
      tissues.
AB  - Dexamethasone (DEX) increased 67Ga uptake by the liver and spleen at 4, 8, and
      even 24 h after the injection of 67Ga. These results showed that DEX influenced
      67Ga accumulation as well as the initial entry of 67Ga in the liver and spleen.
      On the other hand, indomethacin (IM) decreased 67Ga uptake by the liver and
      spleen at 4 h after the injection of 67Ga but did not influence the uptake at 8
      or 24 h after the injection of 67Ga. Moreover, DEX or IM little influenced 67Ga
      uptake by the kidney and muscle. These results suggest that the influence of DEX
      or IM on 67Ga uptake or accumulation is specific for the liver and spleen.

PMID- 2236660
TI  - [Evaluation of prognosis in patients with old myocardial infarction--using 201Tl
      myocardial scintigraphy and 99mTc cardiac scintigraphy].
AB  - To evaluate the prognosis in 57 patients with old myocardial infarctions, 201Tl
      myocardial scintigraphy and 99mTc-HSA gated blood pool scan had been done as a 5
      year follow up study. We subdivided into two groups; group I (over 60 years) and
      group II (under 60 years). Cardiac index (CI) and right ventricular ejection
      fraction (RVEF) did not change significantly, however left ventricular ejection
      fraction (LVEF) changed significantly (p less than 0.05). Correlationship between
      CAG score and delta LVEF by handgrip exercise test was y = -1.34 x +3.61 (n = 44,
      r = -0.400, p less than 0.01). Otherwise, Tl defect ratio between first and final
      examination did not show the significant change in two groups. In conclusion,
      nuclear examination (cardiac function and myocardial blood flow) is significant
      to evaluate the prognosis in patients with myocardial infarction.

PMID- 2236661
TI  - [Measurement of radiation energy and its application. V. Measurement of gamma-ray
      energy and its application. (1). Measurement of gamma-ray energy using Ge and
      NaI(Tl) detectors].

PMID- 2236662
TI  - [Investigation on thermal-neutron sensitivity of commercial BeO(Na)
      thermoluminescence dosimeter and development of thermal-neutron insensitive
      BeO(Na) phosphors encapsulated in quartz-capillary].
AB  - BeO(Na) TLD on the market, UD-170 L, gives thermoluminescence response equivalent
      to irradiation with 3.2 +/- 0.5 cGy of 60Co gamma-rays after irradiation with
      10(10) thermal neutrons per cm2. Because of this neutron sensitivity, UD-170 L is
      not suitable for measurement of gamma-rays in gamma-neutron mixed radiation from
      a nuclear reactor of Kinki University when we use it for radiobiological
      research. To reduce this troublesome sensitivity, we replaced the glass capillary
      used for UD-170 L with a quartz capillary. Quartz tube encapsulated BeO(Na)
      showed a markedly reduced response to thermal neutrons.

PMID- 2236663
TI  - [A new application of bull's-eye analysis to lung perfusion scintigraphy].
AB  - Technetium-99m macroaggregated albumin lung perfusion scintigraphy was performed
      and evaluated semiquantitatively by bull's-eye analysis in 24, including 7 with
      central pulmonary carcinoma, 3 with hypersensitivity pneumonitis (HP), 3 with
      diffuse panbronchiolitis (DPB) and 11 normal subjects. First, whole lung field
      was divided into three regions by three concentric circles. And then radial axes
      were projected from the center to define 36 sectors, 10 degree each. The counts
      of each sector was calculated and bull's-eye image and circumferential profile
      curve were displayed. The patient's map was compared with the lower limit of
      normal (mean-2 SD), and the extent score (ES) and the severity score (SS) were
      calculated. The ES was 0.25 +/- 0.12 in pulmonary carcinoma (n = 7), 0.08 +/-
      0.07 in HP (n = 3), 0.06 +/- 0.04 in DPB (n = 3). The SS was 26.39 +/- 15.17 in
      pulmonary carcinoma, 4.75 +/- 5.57 in HP, 4.29 +/- 3.67 in DPB. In one case of
      central pulmonary carcinoma, segmental perfusion defect was evaluated
      semiquantitatively by bull's-eye image and circumferential profile curve. And in
      one case of HP, the change of regional pulmonary blood flow could be followed
      easily using extent and severity map. This new application of Bull's eye analysis
      to lung perfusion scintigraphy might be useful to evaluate regional pulmonary
      blood flow.

PMID- 2236664
TI  - Immunoradiometric assay for prolactin in serum and tissue--comparison with
      radioimmunoassay.
AB  - Prolactin (PRL) concentrations in sera and tumors of patients with various
      pituitary tumors were measured by both immunoradiometric assay (IRMA) and
      radioimmunoassay (RIA). PRL concentrations in sera and tumor tissues measured by
      IRMA were well correlated with those measured by RIA. PRL concentrations in sera
      reflected those of tumors removed. This IRMA is a simple and useful method for
      PRL determination in serum and tissue.

PMID- 2236665
TI  - [Efficiencies of contamination source for flooring and some materials used in
      unencapsulated radioactivity handling facilities].
AB  - The efficiencies of contamination source, defined in ISO Report 7506-1, were
      experimentally determined for such materials as flooring, polyethylene, smear
      tested filter paper and stainless steel plate. 5 nuclides of 147Pm, 60Co, 137Cs,
      204Tl and 90Sr-Y were used to study beta-ray energy dependence of the efficiency,
      and 241Am as alpha-ray emitter. The charge-up effect in the measurement by a
      window-less 2 pi-proportional counter was evaluated to obtain reliable surface
      emission rate. The measured efficiencies for non-permeable materials, except for
      two cases, are more than 0.5 even for 147Pm. The ISO recommendations were shown
      to be conservative enough on the basis of present results.

PMID- 2236666
TI  - [Solid scintillator "Ready Cap" for measurement with a liquid scintillation
      counter--spectra and counting efficiencies for 15 different radionuclides].
AB  - "Ready Cap", a small plastic container coated with solid scintillator has
      recently been introduced (Beckman Instruments, Inc.). Pulse height spectra and
      counting efficiencies obtained with a liquid scintillator and Ready Cap using a
      liquid scintillator counter were compared for 15 different radionuclides. For
      radionuclides emitting low-energy beta-rays or characteristic X-rays, the spectra
      for Ready Cap shifted toward the higher energy side compared with the spectra for
      the liquid scintillator. This tendency was reversed for the nuclides emitting
      higher-energy beta-radiations (36Cl and 32P). Generally, counting efficiencies
      both in Ready Cap and in liquid scintillator increased with increase in the
      energy of beta- or X-rays. For some nuclides, Ready Cap gave higher counting
      efficiencies and for others it gave lower values than in the liquid scintillator.
      However, the differences were not large within each nuclide. The use of Ready Cap
      is recommended for measurements of radionuclides when liquid scintillation
      cocktails have no means of waste disposal under the present Japanese radioisotope
      regulation.

PMID- 2236667
TI  - [Shielding calculations for bremsstrahlung from beta-emitters].

PMID- 2236668
TI  - [Measurement of radiation energy and its application (13). V. Measurement of
      gamma-ray energy and its application (2). Analyses of gamma-ray spectrum data].

PMID- 2236669
TI  - A casebook in psychiatric ethics. Introduction.

PMID- 2236670
TI  - Valid consent and refusal.

PMID- 2236671
TI  - Paternalism in psychiatry.

PMID- 2236672
TI  - Relationships with colleagues.

PMID- 2236673
TI  - Sexual attraction toward patients.

PMID- 2236674
TI  - [From the pages of "La Radiologia Medica": nuclear medicine].

PMID- 2236675
TI  - [Magnetic resonance in the staging of bladder neoplasms: results of the use of
      JKA1, a ferrous contrast solution].
AB  - The authors report the results of the staging of urinary bladder cancers by means
      of MRI using a new ferrous contrastographic solution called JKA1. Eighteen
      patients with proved bladder neoplasms were examined by means of MRI: the bladder
      was filled with physiological solution first, and then with JKA1. Six patients
      were studied also after filling their bladders with Gd-DTPA solution (1:50). The
      results show that the use of JKA1, a T2-positive contrast medium, improved MR
      capabilities in the evaluation of small lesions (phi less than 1 cm) with minimal
      invasion of bladder wall; MR staging accuracy was 66.6% with the physiological
      solution and 77.8% with JKA1. The authors confirm the need for a wider MR study,
      in particular of T2 lesions (a critical subject for staging and surgical
      management) to assess MR diagnostic capabilities.

PMID- 2236676
TI  - [Magnetic resonance angiography of the neck vessels: technique and anatomy].
AB  - The authors identified the standard projections for studying neck vessels with
      magnetic resonance angiography. Sixty volunteers underwent angio-MR of the
      arterial neck vessels with FISP 3D FT sequences obtained on the coronal and
      sagittal planes. The gradient-echo sequence (FISP 3D FT) was acquired with TR =
      0.04-0.08 s and TE = 15 ms, with 25 degrees flip angle. Single excitated slices
      of thickness ranging from 1-2 mm were included in the acquisition volume. These
      sequences were subsequently processed by the maximum intensity projection method.
      Two radiologists examined our results to choose the optimal projections. We used
      a semiquantitative scale which allowed us to distinguish 3 different diagnostic
      levels for each projection: well-visualized vessels, poorly-visualized, and non
      visualized ones. For each section axial rotations were performed ranging from 0
      degree to 180 degrees, with 15 degrees intervals. On the coronal plane, rotations
      from -45 degrees to 45 degrees were the optimal ones to visualize the studied
      vessels. The 0 degree-15 degrees-30 degrees-45 degrees-135 degrees-165 degrees
      180 degrees projections allowed the common carotids to be clearly demonstrated
      together with the vertebral arteries. The other projections appeared to be
      useless for diagnostic purposes. On the sagittal plane, rotations from 60 degrees
      to 120 degrees were the optimal ones. The 90 degrees projection allowed the
      demonstration of all the big arterial vessels of the neck, including carotid
      bifurcation and internal and external carotids. The assessment of the optimal
      diagnostic projections for angio-MR of the neck vessels is helpful to reduce post
      processing time. As a matter of fact, the immediate visualization, during the
      examination, of the standard projections allows further acquisitions to be
      obtained--if needed--to try to solve specific diagnostic doubts.

PMID- 2236677
TI  - [Magnetic resonance in the diagnosis of bone infections].
AB  - Skeletal infections represent a variety of clinical and pathological conditions
      in which both an early diagnosis and the precise evaluation of disease extent are
      very important in planning proper therapy. To determine MRI capabilities and
      limitations in the evaluation of skeletal infections 21 patients--12 with a
      clinical diagnosis of osteomyelitis of the lower limbs and 9 with a clinical
      diagnosis of spondyloscitis--were studied with this technique. All patients were
      examined with conventional X-rays; conventional tomography was performed in 3
      cases, and CT in 6. Signal intensities and morphological aspects were then
      evaluated with MRI. MRI diagnoses were compared with surgical findings or
      clinical follow-up, after antibiotic therapy: 19 true-positives were observed,
      together with 1 true-negative, 1 false-positive, and no false-negatives. MRI
      findings were correlated with those of conventional radiology: MRI identified the
      lesions and their nature in 100% of cases, whereas conventional radiology did the
      same in 85% of cases; in 50% of cases only the latter was able to define the
      nature of the process. Four patients underwent MRI follow-up. MRI was highly
      sensitive in determining the presence of lesions in an early stage and in
      demonstrating lesion regression. Moreover, MRI was able to identify the
      complications occurring in some cases of osteomyelitis and spondyloscitis. In all
      cases MRI allowed the extent of the disease to be accurately determined and, in
      osteomyelitis of the lower limbs, it was extremely useful to differentiate soft
      tissue infections from bone marrow involvement.

PMID- 2236678
TI  - [Digital radiography in neonatal intensive care].
AB  - The authors report their experience with the routinary use of a computerized
      digital radiography system in Intensive Neonatal Care department. The
      conventional screen-film system is replaced by photostimulable imaging plates,
      which are scanned during processing by a laser providing the digital image. The
      latter is subsequently processable on high-resolution monitors. Over a 6-month
      period 86 examinations were performed with this method in Intensive Neonatal
      Care; good technical results were obtained. The use of digital radiography in
      intensive neonatal care is extremely promising for it allows high-quality images
      to be obtained, and radiation dose and number of acquisitions to be reduced.
      Finally, work stations allow both selective visualization of different body
      structures and their magnification.

PMID- 2236679
TI  - [Duplex-sonography in the preoperative evaluation of the small saphenous vein].
AB  - The authors analyze the results obtained by means of Doppler US, duplex
      examination and venography in the preoperative evaluation of venous vascular
      anatomy and flow dynamics in the popliteal fossa for short saphenous vein
      surgery. As a whole, 50 legs were examined in 34 patients who subsequently
      underwent surgery. The confluence of the short saphenous vein in the deep system
      proved to be very variable. Doppler results were compared with contrastographic
      ones: Doppler US had 10% accuracy in locating the confluence of the short
      saphenous vein and the figure rose to 62% with a +/- 2 cm tolerance. Duplex US
      had 30% and 98%, respectively. The latter always correctly demonstrated the
      reflux, while Doppler US in 5 cases (10%) ascribed gastrocnemius vein
      incompetence (4 cases) and Giacomini vein incompetence (1 case) to the short
      saphenous vein. The above findings demonstrate the total reliability of duplex US
      versus Doppler US and venography in recognizing the anatomic confluence and in
      allowing the fluximetric evaluation in a noninvasive, riskless and inexpensive
      way.

PMID- 2236680
TI  - [Echographic evaluation of abscess pathology in superficial soft tissue. Personal
      experience].
AB  - Sonography is currently considered a very useful technique for the study of
      inflammatory-abscess conditions in superficial soft tissues. The authors report
      their experience with US in the study of 22 patients. In 15 of them a comparison
      was made with X-ray findings, in 4 with fistulographic and in 2 with CT results.
      US allows the abscesses to be evaluated in both their morphological structure and
      anatomical topography. US has proven especially useful in correctly evaluating
      both complete and incomplete fistulas, as well as in revealing foreign bodies.
      The US pattern of an abscess often confirms clinical diagnosis for it supplies
      further and more accurate information. Moreover, US sometimes allows an abscess
      to be demonstrated even when the latter was missed at clinics. However, the
      differential diagnosis with malignant neoplasm is difficult and sometimes a
      decision can be made only by means of other diagnostic imaging modalities.

PMID- 2236681
TI  - [Synopsis of wrist pathology. Xeroradiography vs digital radiology].
AB  - Pathologic conditions of the wrist involve both musculoskeletal structures (bones
      and joints) and soft tissues, of which fat pads are an important diagnostic aid
      to recognize various disorders. The authors report their 5-year experience with
      Xeroradiography in the diagnosis of various pathologic conditions (e.g.,
      inflammatory, degenerative, and tumoral conditions) of the wrist. The importance
      of Xeroradiography was emphasized, in the past, because of its characteristic
      technical properties, especially in demonstrating lower-density tissues tumors.
      The main advantage of Xeroradiography is the physical phenomenon known as edge
      effect, which increases image contrast at the borders. Other differences between
      xeroradiography and conventional radiography are: broader recording latitude of
      the former, together with its higher resolution power (100 lines/mm), and high
      exposition power (which makes repeats useless). Thus, Xeroradiography allows the
      contemporary depiction of various and different structures and densities--e.g.,
      bones and soft tissues. Unfortunately, radiation dose to the patient is higher
      during Xeroradiography than during conventional radiography. That is why digital
      radiography has nowadays replaced Xeroradiography. In fact, the former provides
      images that are comparable with those obtained by means of conventional
      radiography and--sometimes--even with xeroradiographic images. Moreover, the use
      of digital radiography allows radiation dose to the patient to be markedly
      reduced, whereas recording latitude remains the same.

PMID- 2236683
TI  - [Echographic anatomy of the newborn hip and high-resolution equipment: internal
      capsular stria and perichondrial gap].
AB  - The use of high-resolution US equipment in the examination of the newborn hip
      allowed the evaluation of a thin echogenic stripe (the internal capsular stripe),
      which defines laterally the acetabular hyaline cartilage. By means of an anatomo
      histological preparation the echogenic stripe can be related to either the
      capsular circular fibres or the interface between the latter and the hyaline
      cartilage. The internal capsular stripe, together with the echogenic synovial
      stripe, precisely delimit the whole acetabular hyaline cartilage. Furthermore, in
      many babies high-resolution US sometimes fails to demonstrate Graf's
      "perichondral gap", so that an accurate anatomic knowledge of the hip becomes
      necessary in the evaluation of acetabular labrum.

PMID- 2236682
TI  - [Ultrasonography in the preoperative staging of carcinoma of the breast].
AB  - Data relative to 51 patients operated for breast carcinoma were retrospectively
      reviewed. All patients had undergone US and mammographic evaluation of max
      diameter of the neoplastic nodule. The above data were correlated with pathologic
      measurements of the surgical specimens. US-pathologic correlation coefficient was
      extremely high (r = 0.94). US proved especially helpful in those cases where
      mammography had failed to visualize the mass-namely in patients with dense
      breasts. Nearly all evaluated carcinomas had a typical US pattern: a hypoechoic
      lesion with irregular outline. US is recommended in evaluating tumor response to
      nonsurgical conservative treatment.

PMID- 2236684
TI  - [Radiologic changes in the pelvis of patients with chronic renal insufficiency
      undergoing periodic dialysis].
AB  - Bone alterations in the patients undergoing periodic dialysis represent a
      frequent and invalidating complication and cause the pattern called uremic
      osteodystrophy. In this study we have examined 173 pelvic X-rays of 73 patients
      affected with chronic renal insufficiency and undergoing periodic dialysis. The
      results indicate the presence of all the lesions characterizing uremic
      osteodystrophy. Arterial calcifications and osteoporosis are the most frequent
      patterns; with various incidence, osteomalacia, osteitis fibrosa, osteosclerosis
      and brown tumors are associated. In this group of patients, who were followed for
      many years, a non-univocal behavior was observed: next to patterns of progressive
      aggravation, such as vascular calcifications, phases of stabilization/improvement
      were observed, e.g., in case of brown tumors and osteitis fibrosa.

PMID- 2236685
TI  - [Echography and cytology in the study of spreading pathology of the salivary
      glands].
AB  - The contribution of the combined use of US and cytology is evaluated in the
      diagnosis of masses in the salivary glands and adjacent structures. US had 87.2%
      sensitivity in locating the mass; its accuracy in defining both physical
      structure and benign/malignant nature of the lesion was 91% and 74%,
      respectively. Thus US, after demonstrating a lesion, does not always allow the
      exact definition of its characteristic. In many of these cases, other imaging
      modalities do not help either. In our series of cases, cytology allowed an
      unquestionable diagnosis to be made in 87.2% of cases, and the combined use of US
      and cytology rose the figure to 97%. The only limitation is the evaluation of the
      deep extent of large masses: in such cases CT or, if available, MR imaging are
      recommended.

PMID- 2236686
TI  - [Multicentric reticulohistiocytosis (lipoid dermato-arthritis). A radiologic
      study of 3 cases].
AB  - The authors report their experience with 3 cases of multicentric
      reticulohistiocytosis observed over 6 years of outpatient radiological practice.
      The condition presents with the following radiological patterns: 1) clear-cut
      erosions of the articular surfaces, especially in the distal interphalangeal
      joints of the hands and in the metatarso-phalangeal joints of the feet, with
      symmetrical distribution (not necessarily); 2) osteolytic punched-out areas in
      the epiphyseal spongiosa, ranging in size from 1 mm to over 1 cm; 3) no
      osteoporosis, no osteo-proliferative or periosteal reactions, not even in the
      presence of large osteoarticular destructions; 4) frequent atlanto-epistropheal
      subluxation; 5) articular ankylosis at the sacroiliac joints only. The
      association of the above patterns and the relatively benign clinical course
      distinguish multicentric reticulohistiocytosis from rheumatoid arthritis,
      psoriasis arthritis, erosive osteoarthritis, and gout. A reliable diagnosis can
      be suggested on the basis of radiological findings alone, even before cutaneous
      or mucosal lesions appear--which are, at any rate, not sure to appear and typical
      of nails only. An unquestionable diagnosis can be made at histology of synovial
      and/or cutaneous nodules. Multicentric reticulohistiocytosis is considered an
      uncommon condition (nearly 100 cases in international literature to 1989); the
      authors believe it to be commoner though often misdiagnosed as a "variant of
      rheumatoid arthritis".

PMID- 2236687
TI  - [Pulmonary lymphangioleiomyomatosis. Radiologic aspects and the diagnostic role
      of computed tomography].
AB  - Lymphangioleiomyomatosis (LAM) is an uncommon disease affecting women of
      reproductive capacity. It is characterized by non-neoplastic proliferation of
      smooth muscle in the lungs and, occasionally, in lymph nodes and in the thoracic
      duct. The patients present with dyspnea, chylous pleural effusion, pnx, and
      hemoptysis. The authors evaluated 4 patients with biopsy-proven LAM, by means of
      CT. In all cases, CT revealed small well-defined cystic air spaces with smooth
      and thin walls, scattered in the lungs. CT was very useful because it was more
      sensitive and specific than conventional radiography. The CT appearance of LAM
      distinctly differed from that of other diseases than can produce cystic air
      spaces in the lungs, such as UIP, eosinophilic granuloma, centri-acinar
      emphysema, and bronchiectasis. Our experience confirms the clinical usefulness of
      CT in diagnosing LAM.

PMID- 2236688
TI  - [Pericardial liquid layer as an occasional finding in internal echography. Normal
      patterns and pathologic limits].
AB  - A small amount of fluid in the pericardial sac is often observed incidentally
      during upper abdomen US studies. In order to assess the normality range for this
      finding, 500 patients undergoing liver US were evaluated for the presence of
      pericardial fluid, the thickness of which was subsequently measured in positive
      cases. In a group of 20 patients with pericardial fluid thickness ranging 5-9 mm
      and in 6 cases with pericardial effusion greater than 10 mm, cardiologic
      evaluation was performed (clinical examination, ECG, echocardiography).
      Pericardial fluid was quite a common finding (20.8%) which had no clinical
      relevance when less than 10 mm. On the contrary, its clinical relevance was high
      when greater than 10 mm, and extending around the heart.

PMID- 2236689
TI  - [Correlation between the radiologic study of deglutition and the clinical picture
      in systemic sclerosis (scleroderma)].
AB  - Fifty-one patients with systemic sclerosis (scleroderma) were studied by means of
      videofluoroscopy in order to evaluate the abnormalities in the oropharyngeal and
      esophageal phases of deglutition and to correlate the radiological patterns with
      the clinical features of the disease. Thirteen patients (25.5%) exhibited
      swallowing disorders such as oral leakage, retention, penetration, mild or
      moderate aspiration and abnormal upper esophageal sphincter behavior. These
      dysfunctions were more evident in patients with esophageal motility
      abnormalities. A normal radiological pattern in the esophagus was not associated
      with swallowing alterations. Remarkably, patients with oral-pharyngeal disorders
      had a higher incidence of lung diseases. Forty-five patients (88%) exhibited
      disorders of the esophageal phase of deglutition, such as mild or severe motility
      abnormalities or hiatal hernia, gastro-esophageal reflux, reflux esophagitis, and
      stricture. Radiological findings in the esophagus can be abnormal in the early
      stages of the disease. On the other hand, the radiological pattern of esophageal
      motility can be occasionally negative in advanced or extensive disease. This
      indicates a discrepancy between clinical symptoms and radiological picture of the
      esophagus. The radiological examination of the oral-pharyngeal and esophageal
      phases of deglutition is important in patients with scleroderma in order to
      evaluate visceral involvement, motility disorders, and risk of aspiration. Such
      radiological information can be useful in preventing esophagitis and pulmonary
      complications.

PMID- 2236690
TI  - [Ultrasonography in the diagnosis of chronic inflammatory intestinal disease].
AB  - The accuracy of ultrasonography (US) in diagnosing active inflammatory bowel
      disease (IBD) is assessed on the basis of a randomized prospective study of 61
      patients. Twenty-six of the patients were affected with Crohn's disease (CD) and
      12 with ulcerative colitis, while the remaining 23 patients were control subjects
      with no specific chronic IBD. The US signs considered as significant for active
      CD and UC were: --visualization of a typical target image, that is a hyperechoic
      center corresponding to luminal bowel content, surrounded by a hypoechoic ring
      corresponding to loop walls; --at least 2 of the following: solid abdominal mass,
      distended loops, luminal narrowing, reduced peristalsis, stiff loops, and
      accumulation of fluid between the loops. US sensitivity and specificity for CD
      were 77% and 95.6%, respectively. As for UC, no significant results were
      obtained. In our experience, US is a reliable method for detecting alterations
      and, especially, complications typical of CD in its active phase. Considering the
      young age of the patients affected with CD and the number of exams they must
      undergo, US is considered as a useful tool in disease follow-up.

PMID- 2236691
TI  - [Tropical splenomegaly: echographic picture].
AB  - Tropical splenomegaly is a pathologic condition due to multiple causes, endemic
      malaria being the major one. Twenty-eight black patients, 10 males and 18
      females, residing in a tropical area, were investigated with US. The
      morphological features and major diameters of the spleen were studied and the
      splenic volumetric index (IVS) was calculated. Typical features were the presence
      of small intraparenchymal calcifications (46%) and the enlargement of splenic
      vessels, with US wall reinforcement (75%). No nodular lesions were detected, but
      increased frequency of organ lobulation was observed. A definite and uniform
      increase in splenic diameters was seen in all cases; IVS in particular was
      greater than the accepted confidence limit (21.5 +/- 6.5). This characteristic
      features should help the echographist to recognize this condition for they supply
      useful clinical information.

PMID- 2236692
TI  - [Invasive carcinoma of the cervix uteri (stage IB-IIB): evaluation using magnetic
      resonance].
AB  - In patients with cervical carcinoma the selection of the optimal therapy depends
      on the precise preoperative assessment of the extent of disease. Currently,
      decisions regarding the management of these patients are made on the basis of
      clinical (FIGO) staging that has 50% mean error rate. To investigate the value of
      MR imaging in staging patients with invasive cervical cancer, we performed 25 MR
      examinations on 23 patients with histologic diagnosis of cervical cancer. All
      patients were clinically considered as having stage IB or IIB disease and
      underwent radical hysterectomy, providing specimens for pathologic correlation.
      The overall accuracy of MR imaging in staging cervical carcinoma (stage IB-IIB)
      was 78.1%. MR imaging seems to be the most reliable preoperative modality for
      staging invasive cervical cancer.

PMID- 2236693
TI  - [Pure and diluted contrast media in the visualization of the portal venous system
      using digital angiography].
AB  - We report the results of intra-arterial digital subtraction angiography (DSA) in
      100 patients with portal hypertension. The portal venous system was evaluated;
      all patients underwent angiography of the celiac and superior mesenteric arteries
      before surgery. Forty-four of them were also examined after Warren splenorenal
      shunts. Therefore, a total of 144 exams was evaluated. The authors always
      employed low-osmolality ionic and non-ionic contrast media (iodine concentration:
      300-350 mg/ml). In 70 cases pure contrast medium was injected (20-25 ml); in the
      extant 74 cases it was diluted with an equal volume of saline solution
      (osmolality and iodine concentration reduced by 50%). Intra-arterial DSA always
      visualized portal venous system, collateral circulation, shunt location and
      postoperative changes. The major advantage of intra-arterial DSA is the smaller
      amount of contrast medium injected, so that local and systemic side effects are
      rare. According to our experience, it is best to dilute the contrast medium and
      inject the same amount as in conventional angiography, at the same rate. Other
      well-known advantages of intra-arterial DSA are quicker execution, less injury to
      arteries using smaller-caliber catheters, and low cost. The major disadvantage of
      intra-arterial DSA, as it appeared also in our study, is the field size of the
      intensifier, which in our case was limited to 6-9 inches. This is an insufficient
      coverage for the whole portal system to be studied, and some contrast medium
      injections become therefore necessary. An average of 3 injections were given to
      each patient. This problem reduces the advantage of less contrast medium per
      injection. At any rate, even though intra-arterial DSA exhibits this limitation,
      it can nevertheless yield important information in the pre- and postoperative
      evaluation of patients with portal hypertension.

PMID- 2236694
TI  - [Comparison of the results obtained using 99mTc HM-PAO tomoscintigraphy and
      computer tomography in ischemic lesions of the brain].
AB  - Fifty patients suffering from cerebral ischemic attacks, transient or not, were
      studied with both 99mTc HM-PAO single photon emission computed tomography (SPECT)
      and computed tomography (CT). In 31 patients both SPECT and CT showed pathologic
      areas, the max diameters of which were measured on CT images and SPECT
      orbitomeatal reconstructed sections, and then compared. We observed that: only
      SPECT images are positive for pathologic conditions in transient ischemic attacks
      and in the very early phases of infarctions; in recent infarctions (less than 15
      days earlier) both SPECT and CT scans are positive but SPECT lesion areas are
      greater than CT ones; pathologic areas, with clear-cut outlines, having the same
      dimensions on both CT and SPECT images, are supposed to result from old static
      infarctions. A persistent perilesional hypoactive area on SPECT images means, in
      our opinion, a hypoperfusional area liable to new vascular troubles; in which
      case, medical/surgical therapy seems necessary.

PMID- 2236695
TI  - [Simplified urographic technique using non-ionic contrast media].
AB  - Urography is not to be performed following a standard procedure. However, some
      key-films can be defined which are to be routinely employed. If needed,
      additional radiographs can be performed. We tried to optimize the urographic
      technique combining low X-ray exposure and adequate diagnostic assessment with
      the injection of 17.5 gI of a non-ionic agent. Two groups of 50 patients each
      were investigated. In the former, the technique we currently employ in our
      Institute was used: plain film, 2 nephrotomograms (1'), full-length view (7'),
      kidney view with ureteral compression (15'), and full-length or bladder view
      (20'). In the latter group, a more simplified technique was used: plain film, 2
      nephrotomograms (1'), kidney view (7'), and full-length view (15'). A compression
      device was positioned immediately before contrast medium injection and released
      immediately before the 15-minute exposure. Both urographic techniques allowed
      high scores to be reached (after the Kelsey Fry method), with no significant
      differences among the evaluated parameters. Thus, the technique employed on the
      second group is to be preferred, because it shortens examination time and reduces
      X-ray exposure. However, a simplified technique increases the radiologist's
      responsibility: it is thus essential for an experienced uroradiologist to
      accurately supervise the procedure and immediately decide what to do next.

PMID- 2236696
TI  - [Evaluation of the quality of screen-film radiographic systems: physical
      principles and methods of measurement].
AB  - Comparative evaluation of radiographic film-screen systems presents several
      problems from both the theoretical and the experimental point of view. From the
      theoretical point of view the main difficulties are related to the choice of the
      parameters best suited to express the "overall quality" of a system. From the
      practical point of view the main problem is that to measure some basic quantities
      (resolution and noise) sophisticated and expensive instruments are required. This
      paper deals with both these problems. To express image quality we have assumed
      the signal-to-noise power ratio: this index depends in a explicit way on
      contrast, resolution and noise of the system. The dependence on sensitivity is
      implicit and was derived using literature data. From a knowledge of the
      dependence of image quality on sensitivity it is possible to develop an "overall
      quality" index which is considered to express the "technological level" of the
      system. This index can be used in the comparative evaluation of the different
      systems. In this work some basic physical quantities (characteristic curve,
      sensitivity) were evaluated using standard instruments. To measure spatial
      resolution and noise an inexpensive, PC-based, TV-digitizer system was developed.
      As an example, both image and overall quality indices were evaluated on three
      mammographic systems which are typical of the three different "phases" of the
      development of this technique.

PMID- 2236697
TI  - [Intra-arterial regional chemotherapy and intensive loco-regional radiotherapy in
      the treatment of locally advanced cancer of the breast].
AB  - A multimodal treatment combining intra-arterial chemotherapy and intensive loco
      regional radiotherapy was administered to 55 patients with locally advanced
      breast cancer. Adjuvant polychemotherapy followed, and eventually endocrino
      therapy. Combined intra-arterial chemotherapy and intensive radiotherapy gave
      excellent results in both primary and lymph node lesions, with 90.9% and 92.2%
      complete/partial response rates. Three-year and 5-year actuarial survival rates
      were 69% and 59%, respectively. Patients showing better local responses to
      combined intra-arterial chemotherapy and intensive radiotherapy had longer
      survival and less frequent local recurrences. Combined intra-arterial
      chemotherapy and intensive loco-regional radiotherapy seems to be an effective
      modality for the treatment of locally advanced breast cancer.

PMID- 2236698
TI  - [Breast metastasis from melanoma. Description of a case].

PMID- 2236699
TI  - [Mammographic aspects of juvenile papillomatosis: 4 case reports].

PMID- 2236701
TI  - [Familial metaphyseal dysplasia (Pyle's disease) versus craniometaphyseal
      dysplasia. Presentation of a case].

PMID- 2236700
TI  - [Intracystic papilloma of the breast. 3 case reports].

PMID- 2236702
TI  - [Astragalocalcanean synostosis. Computer tomography diagnosis].

PMID- 2236703
TI  - [Ultrasonic and computer tomography diagnosis of schwannoma of the tibial nerve.
      Description of a case].

PMID- 2236704
TI  - [A case of arterio-venous fistula as a late complication of percutaneous puncture
      of the humeral artery in vertebral angiography: diagnosis using color Doppler].

PMID- 2236705
TI  - [Cystic ganglioneuroblastoma of the adrenal glands in childhood: ultrasonic and
      CT aspects].

PMID- 2236706
TI  - [Ruptured aneurysm of the renal artery. Computed tomographic diagnosis].

PMID- 2236707
TI  - [Bilateral renal location: is it a double tumor or a contralateral metastasis?].

PMID- 2236709
TI  - [Fundamentals and requirements of peripheral electric nerve stimulation. A
      contribution to the improvement of safety standards in regional anesthesia].
AB  - The use of a nerve stimulator allows an injection cannula to be located without
      the cooperation of the patient. Regional anesthesia thus becomes safer because
      the basic condition "no paresthesia, no anesthesia" becomes irrelevant. In
      accordance with the basic electrophysiological conditions, a stimulator should
      have the following properties: (1) adjustable constant current at resistances of
      0.5-10 kOhm; (2) monophasic square-wave initial impulse; (3) impulse duration
      selectable (0.1 ms + 1 ms, and exactly adjustable; (4) impulse amplitude (0-5 mA)
      exactly adjusted, unequivocal scale graduation or current indicator, in
      particular in the range of 0.05-1.0 mA; (5) impulse frequency 1-2 (-3) Hz; (6)
      alarm at high impedance and check on electrical circuit; (7) battery test
      (indication of battery voltage); (8) unequivocal assignment of load end; (9) high
      quality connecting cable and plug; and availability of (10) instructions for use
      with relevant parameters (tolerated variations, steady-state characteristic
      curves, etc.).

PMID- 2236708
TI  - [Role of transrectal ultrasonography in the diagnosis and follow-up of prostatic
      abscess. Description of a case].

PMID- 2236711
TI  - [No effect of injection volume on sensory and motor blockade in isobaric spinal
      anesthesia].
AB  - The authors were interested to find whether the course of sensory and motor
      blockade in isobaric spinal anesthesia was determined by the dose or the volume
      of the anesthetic agent. In a randomized double-blind study in 60 patients, each
      underwent isobaric spinal anesthesia with 17.5 mg bupivacaine. In three groups of
      20 patients, this dose was administered as 3.5 mg bupivacaine 0.5%, 7 ml
      bupivacaine 0.25% or 10 ml bupivacaine 0.175%. The development, spread and
      regression of sensory block (anesthesia, analgesia) and motor block (Bromage
      scale, rectus abdominis muscle test) were determined. The clinical data recorded
      in the three groups were comparable. The rate of development, the maximal spread
      or intensity, and the regression of sensory and motor blockade did not differ in
      the three groups. The only difference was that the complete regression was
      shorter following 10 ml bupivacaine 0.175% (P less than 0.05). It is therefore
      concluded that the dose, and not the volume, determines the course of sensory and
      motor blockade of isobaric spinal anesthesia.

PMID- 2236710
TI  - [The effect of injection speed and needle gauge on the spread of sensory blockade
      in spinal anesthesia].
AB  - Unanimity has not yet been reached on the influence of injection speed and needle
      size on the spread of sensory blockade in spinal anesthesia. While McClure et al.
      [6] proved that a change in injection speed had no effect on the spread of the
      blockade, Lanz et al. [4] showed in their investigation that increasing injection
      speed increases the spread of the blockade. The influence of needle size has
      hardly been investigated so far. Moore et al. [7] report that the needle size
      alone has no effect on the spread of the blockade. In this study the influence of
      injection speed and that of needle size on spread of sensory blockade were
      considered separately. MATERIALS AND METHODS. Spinal puncture was performed via
      the midline approach at the L3-4 interspace with the patient in a sitting
      position. Immediately after the induction of anesthesia the patients were placed
      in the supine position again. As local anesthetic 15 mg (3 ml) bupivacaine 0.5%
      with epinephrine 1:200000 was administered. The aim of the study was to find out
      how far injection speed and size of the spinal needle influenced the sensory
      spread in isobaric spinal anesthesia. The height of sensory blockade was assessed
      by means of the pin-prick method in the midline, and the onset of analgesia was
      determined as height of spread. The injection speeds for the local anesthetic
      solution were 0.25, 0.5 and 1 ml per second. The needle sizes were 22, 25, and 29
      gauge. Each group consisted of 15 patients. RESULTS. It turned out that slow
      (0.25 ml/s) and the fast (1 ml s) injection was associated with a significantly
      higher level of analgesia than the medium one (0.5 ml/s). Cephalad spread was to
      T7 in the first two groups, while the medium injection speed only achieved a
      level of T9. The results are statistically significant (P less than 0.05). The
      comparison of different needle sizes (22, 25, and 29 gauge) used for spinal
      anesthesia showed a higher spread of the sensory blockade with increased diameter
      of the spinal needle given a constant injection speed. With the 22-gauge needles
      (n = 15) sensory blockade extended on average to T7, with 25-gauge needles (n =
      15) to T9, and with 29-gauge needles (n = 15) to T10. It has to be mentioned,
      however, that with the 29-gauge needle the standard injection speed of 0.5 ml/s
      could not be achieved because of the small inner diameter. The differences
      between 22- and 25-gauge needles are statistically significant (P less than
      0.05). DISCUSSION. No direct relation could be proved between the different
      injection speeds and the spread of the blockade. Our results are hardly
      comparable with those of other investigators, since other groups have used
      different local anesthetics or performed investigations in vitro. The use of
      large spinal needles is associated with spread of the spinal block to a
      significantly higher level than is achieved with thinner needles.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2236712
TI  - [The effect of volume and dosage of isobaric bupivacaine on the sensory spread of
      spinal anesthesia].
AB  - There is some controversy about the relationship of volume, concentration and
      total dose of bupivacaine in the sensory spread of spinal anesthesia. In this
      study the effects of volume and dose were investigated. MATERIAL AND METHODS. In
      this study 120 patients undergoing lower extremity, inguinal or transurethral
      surgery were randomly divided into six groups. Bupivacaine 15 mg with the
      addition of epinephrine 1:200,000 was administered in 2 ml (0.75%), 3 ml (0.5%),
      6 ml (0.25%) and 9 ml (0.166%) solutions. In addition 3 ml isobaric bupivacaine
      in doses of 7.5 mg (0.25%), 15 mg (0.5%) and 22.5 mg (0.75%). The spinal puncture
      was performed via the midline approach at the L3-4 interspace, with the patient
      in the sitting position. The injection speed was 0.5 ml per second. Immediately
      after the injection the patients were placed in the supine position. The spread
      of sensory blockade was assessed by means of the pin-prick method in the midline.
      Motor blockade was assessed on the Bromage scale 0-3. RESULTS. There were no
      statistically significant differences in motor blockade or cardiovascular
      changes. The maximum cephalad spread of analgesia (30 min) between the 15 mg
      groups with different volumes and concentration was: group I (9 ml): T7.7, group
      II (6 ml): T7.8, group III (3 ml): T8.5 and group IV (2 ml): T10.1. The
      differences between group IV 2 ml and the groups receiving 3, 6 and 9 ml were
      statistically significant (P less than 0.05). There were no statistically
      significant differences in maximum cephalad spread between the 7.5 mg (3 ml), 15
      mg (3 ml) and the 22.5 mg (3 ml) groups. The regression after 180 min was
      significantly shorter in the 7.5 mg group than in the 15 mg and 22.5 mg groups (P
      less than 0.05). DISCUSSION. Earlier published results indicate that the dose of
      isobaric bupivacaine is more important in spinal anesthesia than the
      concentration or the volume of the solution. The comparison between 3 ml:6 ml and
      3 ml:9 ml bupivacaine showed no statistically significant differences in cephalad
      spread. A volume-dependent increase in segmental spread was between the 2 ml
      (0.75%) and 3 ml (0.5%) bupivacaine. The same statistically significant
      differences were between the 2 ml and 6 ml groups and the 2 ml and 9 ml groups.
      No statistically significant difference in cephalad spread resulted from
      increasing the dose of bupivacaine from 7.5 mg to 22.5 mg. Earlier studies on the
      effects of changes in volume, concentration and dose of bupivacaine showed
      similar "jumps of blockade" between 2 ml and 3 ml injected volume. Assembling the
      results the relation between volume and total dose does not suggest a no linear
      dependence. The anatomic configuration of the spinal cord at the conus medullaris
      may affect the distribution of the solution.

PMID- 2236713
TI  - [The effect of patient positioning on the spread of sensory blockade in
      hyperbaric and isobaric spinal anesthesia using bupivacaine].
AB  - Two prospective studies were performed to assess for how long after the
      subarachnoid injection of local anesthetics changes in position influence the
      cephalad spread of sensory blockade. Divergent accounts have been given by other
      groups. Besides the patient's position other factors may influence the cephalad
      spread of sensory blockade such as baricity of local anesthetics, speed of
      injection, dose, volume, barbotage and size of needle. Pashalidou found that
      after a supine position for 5 or 10 min, followed by Trendelenburg position for 5
      or 10 min, there were significant differences in the increase of sensory
      blockade; the following two prospective studies were carried out with this in
      mind. METHODS AND MATERIAL. Study 1. Injection of the local anesthetics in
      sitting position, puncture at L3/4 interspace using a 25-gauge needle, speed of
      injection 3 ml/10 s, without barbotage. After injection the patients were supine
      for 30 min, then changing to the Trendelenburg position (n = 20) or the lithotomy
      position (n = 20), each for 20 min. The spread of blockade was tested by means of
      pin-pricks in the midline at 5-min intervals. Local anesthetics used were
      bupivacaine 0.5% with adrenaline (1:200,000) (n = 20) and bupivacaine 0.5% in 8%
      glucose (n = 20), 3 ml each. Study 2. Intrathecal injection was done as described
      above, but the speed of injection was 3 ml/6 s. Local anesthetics used were
      bupivacaine 0.5% with adrenalin (1:200,000) and bupivacaine 0.5% with adrenalin
      (1:200,000) in 5% glucose, 3 ml each. The patients were kept supine for either 15
      or 20 min followed by 20 degrees Trendelenburg position for 10 min. RESULTS.
      Study 1. The mean spread of sensory blockade with isobaric bupivacaine was 16.95
      segments (T6). After the 20 degrees Trendelenburg position the spread of blockade
      increased by 0.85 segments. After the lithotomy position there was no increase in
      sensory blockade. With hyperbaric bupivacaine the mean spread of sensory blockade
      after 30 min in the supine position was 17.3 segments (T5/6). After the
      Trendelenburg position there was no increase in sensory blockade. After the
      lithotomy position the sensory blockade spread by 0.4 more segments. This shows
      that there is no significant increase of cephalad spread of sensory blockade with
      either isobaric or hyperbaric bupivacaine. Study 2. With isobaric bupivacaine the
      mean spread of sensory blockade (n = 15) after 15 min in the supine position was
      14.4 segments (T8/9). Following the Trendelenburg position the caphalad spread
      was increased by 0.93 segments (p less than 0.05). With hyperbaric bupivacaine
      the mean spread of sensory blockade (n = 15) was 16 segments (T7). Following the
      Trendelenburg position the spread was extended by 2.0 segments (p less than
      0.05). After 20 min in the supine position following isobaric bupivacaine the
      mean spread of the sensory blockade (n = 15) was 15.4 segments (T7/8).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2236714
TI  - [The effect of barbotage on the sensory spread in spinal anesthesia using
      isobaric and hyperbaric 0.5% bupivacaine].
AB  - The effect of spinal anesthesia with barbotage versus without barbotage on the
      spread of analgesia was investigated. For comparison, hyper- and isobaric
      bupivacaine 0.5% with adrenaline 1:200,000 was used. MATERIAL AND METHODS.
      Barbotage was accomplished as follows: after lumbar puncture 0.5 ml CSF was
      aspirated into the local anesthetic solution, followed by reinjection of 1.0 ml
      of the solution. This process was repeated six times. Sixty patients who were
      scheduled for urological or lower limb surgery under spinal anesthesia were
      selected for this study. Patients were each arbitrarily assigned to one of four
      groups (isobaric and hyperbaric, without and with barbotage). RESULTS. There was
      no statistically significant difference in the maximum level of sensory
      analgesia. The mean maximum level of sensory analgesia reached T9 (group 1), T8
      (group 2), T9 (group 3) and T8 (group 4). Time to highest dermatome was
      significantly shorter with barbotage (groups 1-4: 19.0 min, 13.0 min, 18.7 min,
      12.3 min). Times for regression of analgesia to T12 (mean maximum duration) were
      142 (+/- 54.9) min, 164 (+/- 29.7) min, 130 (+/- 40.4) min and 144 (+/- 36.2) min
      (groups 1-4). Motor block grade 3 (Bromage) was achieved in significantly shorter
      times with barbotage than without. The shortest onset time was recorded with
      isobaric bupivacaine. The onset time of a complete motor block was 12.5 (+/- 5.5)
      min in group 1, 6.1 (+/- 2.9) min in group 2, 15.8 (+/- 4.7) min in group 3, and
      11.7 (+/- 5.1) min in group 4. CONCLUSIONS. The results showed no significant
      differences between the maximum segmental sensory levels or duration of
      anesthesia observed with isobaric and with hyperbaric bupivacaine (with and
      without barbotage). Sufficient analgesia was obtained with barbotage and without
      barbotage. Uncontrolled cephalad spread of spinal anesthesia was not observed.
      Barbotage has the advantage of shortening time for spread to highest dermatome
      and the time to onset of complete motor block.

PMID- 2236715
TI  - [The function of peripheral nerve stimulators in the implementation of nerve and
      plexus blocks].
AB  - A selection of nine instruments supplied by eight different manufacturers for
      carrying out peripheral nerve stimulation were checked for their suitability,
      safety and ease of operation, and were compared and contrasted with reference to
      a spectrum of characteristics that appear desirable in theoretical and practical
      terms. Measurements at Ohm's resistance showed that in the clinically relevant
      range of impulse amplitudes (0.1-1.0 mA) the quality of adjustment of the
      instruments varied widely. The actual electrical impulse delivered by some of the
      instruments deviated so widely from the adjusted theoretical value that they must
      be regarded as unsuitable. The duration of the impulse corresponded to the
      manufacturer's specifications for only two instruments. Four instruments did not
      generate a monophasic square-wave signal despite assertions to the contrary in
      the instructions for use, and one instrument did generate such a signal although
      a "special biphasic asymmetrical" impulse is described by the manufacturer.
      Impulse-like overshooting at the beginning of the signal, oscillations into the
      positive range at the end of the signal and fall in current during the course of
      the signal were the form variants indicating technically inadequate design in the
      other instruments. Resistance to the square-wave current impulse engendered by
      the complex body resistance (impedance), a good approximation to the mathematical
      e-function to be expected, could be demonstrated for the rising signal flank,
      whereas the signal curve in the lower part of the descending flank was flatter
      than expected owing to polarization effects in the body tissue. The
      characteristic voltage and time values calculated for the signal curves are shown
      in tables.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236716
TI  - [In electric nerve stimulation can the distance from the nerves be inferred from
      the intensity of muscle contraction? Possible parameters and sources of error].
AB  - Electrical nerve stimulation is a useful tool in regional anesthesia; it assists
      in locating the nerves. This investigation deals with electrical resistances at
      adhesive electrodes attached to the skin. The influence of external electrical
      resistance on the stimulating impulse is demonstrated. A new type of nerve
      stimulator is described; which integrates a measuring device that indicates the
      electrical impulse actually flowing in the patient. With this device,
      relationships between stimulating impulse, intensity of muscle contraction, and
      distance of the puncture cannula from the nerve can be assessed. MATERIALS AND
      METHODS. The electrical curve I = f (R) was determined using 3 different nerve
      stimulators (R = 1 - 15k omega). On each of five test persons, five adhesive
      electrodes were attached to the skin 10 cm apart. The resistance was assessed
      between these electrodes and a subcutaneously inserted puncture needle. The right
      and left brachial plexuses of the 5 subjects were punctured, using the axillary
      approach. A synchronized video camera simultaneously recorded the following
      values: (1) electrical impulse; (2) corresponding muscle contraction; and (3) the
      position of the puncture cannula. A scale ranging from 0-5 was applied to define
      the strength of the muscle contractions. RESULTS. The external resistance as
      measured under clinical conditions may limit the output impulse of nerve
      stimulators. In this case, the exerting impulse is lower than that indicated by
      the appliance. This error can only be identified using an impulse-measuring
      device. Nerve stimulators not equipped with a measuring device increase the risk
      of malpuncture, potentially resulting in nerve lesions. Skin resistance at
      adhesive electrodes varied from patient to patient within a range of 1.1 to 8.2 K
      omega. Preparing the skin appropriately (wiping with sandpaper) decreased the
      resistance by only 6% during the first 30 min. Within a distance of 50 cm to the
      puncture needle, the position of the adhesive electrode did not play a
      significant role. Axillary puncture of the brachial plexus resulted in the
      following values: (1) A stimulating impulse (cross-wave) of 1 mA and 1 ms exerted
      at a distance of 4 mm to the nerve induced a contraction of strength 3. (2)
      Reducing the impulse at this site by one-half (0.55 mA) resulted in just-visible
      contractions (strength 1). (3) Advancing the cannula at a stimulating impulse of
      0.55 mA inside the neurovascular sheath again produced contractions of strength
      3. (4) Performing the puncture with a blunt needle and tracing a distinct
      resistance, the impulse of 0.6 mA elicited contractions of strength 2. The needle
      tip was still outside the vascular nerve sheath. If this resistance was overcome
      and the needle tip lay inside the neurovascular sheath, the impulse could be
      reduced by one-half (0.32 mA) to produce contractions of strength 2.

PMID- 2236717
TI  - [A peridural catheter obstructed with glass particles--should a filter always be
      used in a test dose?].

PMID- 2236719
TI  - Role of lymphatics in peritoneal dialysis.

PMID- 2236718
TI  - Acute renal failure due to falciparum malaria.
AB  - Seventy-two patients with severe falciparum malaria are described. Twenty-four
      (33.3%) were complicated by acute renal failure. Comparing patients with renal
      failure and those without, statistically significant differences occurred
      regarding presence of cerebral malaria (83% vs 46%), jaundice (92% vs 33%), and
      death (54% vs 17%). A significantly higher number of patients with renal failure
      were nonimmune visitors to malaria endemic regions. Renal failure was oliguric in
      45% of cases. Dialysis was indicated in 38%, 29% died in early renal failure, and
      33% recovered spontaneously. It is concluded that falciparum malaria is
      frequently complicated by cerebral malaria and renal failure. As nonimmune
      individuals are prone to develop serious complications, malaria prophylaxis and
      vigorous treatment of cases is mandatory.

PMID- 2236720
TI  - Lupus nephritis at the University Hospital of the West Indies, Kingston, Jamaica:
      a 10-year experience.
AB  - The case records of 75 patients who had systemic lupus erythematosus (SLE) and
      renal involvement on renal histology were reviewed. There were 70 females and 5
      males, with a ratio of 14:1. The majority of the patients were in their second
      and third decades of life. SLE nephritis was distinctly uncommon in patients
      below 10 years of age and above 50 years of age. In nearly 80% of the patients,
      SLE nephritis was diagnosed within the year prior to presentation. The most
      common presenting clinical features were arthritis in 78% and a rash in 48%. The
      two most common renal features were proteinuria in 60% and renal failure in 55%.
      Of these patients, 20%, 12%, 48%, and 17% fell into Class II (mesangial GN),
      Class III (focal GN), Class IV (diffuse GN), and Class V (membranous GN),
      respectively, when the renal histological abnormalities were categorized
      according to the World Health Organization classification. The remaining 3% of
      patients had sclerosis and as a result were unclassifiable. The two major
      clinical manifestations in the Class IV patients were an acute nephritis syndrome
      in 83% and renal failure in 61%. The nephrotic syndrome was seen in 62% of Class
      V (membranous GN) cases. There was 100% survival in Classes II (mesangial GN) and
      V (membranous GN), and 62% percent in Classes III (focal GN) and IV (diffuse GN)
      combined.

PMID- 2236721
TI  - Recent developments in the pathogenesis of hemolytic uremic syndrome.

PMID- 2236722
TI  - The spectrum of acute renal failure in a developing country.

PMID- 2236723
TI  - Variations of glomerular properties and their effect on glomerular disease.
AB  - The possibility that inherited glomerular properties predispose individuals to
      certain glomerulopathies is an exciting new hypothesis. It opens new avenues to
      the investigation and treatment of patients which may be most easily applied in
      newly diagnosed diabetics and patients with multiple relapses of minimal change
      nephropathy. These treatments are unlikely to involve dangerous cytotoxic drugs
      which have been the fruit of years of investigation concentrated on the immune
      and inflammatory consequences of glomerular diseases. The differences between the
      two strains also cast doubt on the wisdom of extrapolating results obtained in
      the Munich Wistar rat to the rest of the animal kingdom.

PMID- 2236724
TI  - Cardiac conduction defects associated with aortic and mitral valve calcification
      in dialysis patients.
AB  - The prevalence of aortic valve and mitral valve or mitral annular calcification
      by echocardiography was studied in 66 dialysis patients and correlated with
      results of 24-h ambulatory and resting ECG data and 12-month survival. The well
      known association of mitral valve or mitral annular calcification with cardiac
      conduction defects was confirmed. Those patients with mitral valve or mitral
      annular calcification demonstrated a higher prevalence of first-degree
      atrioventricular block and bundle branch block. Despite advanced age and these
      conduction defects, those patients with mitral valvular calcification did not
      show decreased survival at 12 months.

PMID- 2236725
TI  - Intraocular pressures during high-flux hemodialysis.
AB  - The intraocular pressures of 16 patients with end stage renal failure treated
      with high-flux dialysis were measured before and during a high-flux dialysis
      treatment. The patients were selected so as not to have glaucoma or history of
      glaucoma. Intraocular pressures did not change significantly in any patients
      during or following a high-flux hemodialysis treatment. These data suggest that
      high-flux hemodialysis does not result in increases in intraocular pressure nor
      does it precipitate acute glaucoma in well-dialyzed patients undergoing
      intermittent in-center hemodialysis.

PMID- 2236726
TI  - Calcium channel blocker nisoldipine in chronic renal failure.
AB  - Patients with a stable progression of chronic renal failure with a creatinine
      clearance of 15-45 mL/min were randomly assigned to two groups of
      antihypertensive therapy: 1--nisoldipine as the only antihypertensive agent and 2
      -antihypertensive drugs without calcium channel blockers and a placebo tablet
      instead of nisoldipine. The patients were already on a low-protein diet and some
      form of antihypertensive therapy but without calcium channel blockers. There were
      18 patients in the placebo group and 20 patients in the nisoldipine group. The
      follow-up period averaged 23.7 +/- 10.6 (SD) months in the placebo group and 23
      +/- 11.3 months in the nisoldipine group. The slopes of the reciprocal of serum
      creatinine were calculated for the period prior to and following our
      intervention. The number of patients whose slopes improved following intervention
      was 6/18 in the placebo group and 15/20 in the nisoldipine group (p less than
      .02). The patients whose slopes improved had a significant fall in systolic and
      diastolic BP, as well as in the MAP. Those whose slopes did not improve had a
      significant decrease in systolic BP, but no change in diastolic BP and no
      significant difference in the MAP. When all 38 patients are analyzed together,
      regardless of their grouping, the correlation between the difference percent in
      the slope, and the difference percent in the MAP, was significant. Furthermore,
      punch biopsies of the skin showed a markedly different calcium content in the two
      groups, which was significantly less in the nisoldipine-treated patients as
      compared with the patients not receiving calcium blockers.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2236727
TI  - An epidemic outbreak of Serratia marcescens septicemia in a hemodialysis unit.

PMID- 2236728
TI  - The effect of successful renal transplantation on hormonal status of female
      recipients.
AB  - The pituitary, thyroid, and ovarian hormone levels were measured by enzyme and
      fluorescence polarization immunoassays in 18 women with successful renal
      transplants (recipients): 10 menstruating, mean age 34.7 years, mean time after
      transplantation (Tx) 112.00 months, mean SCr 130.60 mumol/L; and 8 menopausal,
      mean age 52.7 years, mean time after Tx 61.00 months, and mean SCr 119.00
      mumol/L. Five women of the menstruating group conceived 7 times and gave birth to
      4 healthy infants. The findings were compared to 30 age-matched healthy subjects
      (controls) and to 13 women under chronic hemodialysis (hemodialyzed patients): 2
      menstruating, 24 and 36 years old, and 11 menopausal, mean age 59.4 years. Serum
      prolactin (PRL) showed a highly significant increase in hemodialyzed patients (p
      less than .0001) compared to controls. In recipients, PRL levels were
      significantly lower than in hemodialyzed patients, but higher than in controls (p
      less than .0001). LH and FSH were elevated in menstruating hemodialyzed patients
      (p less than .0001, p less than .02, respectively) and significantly high in
      menopausal hemodialyzed patients (p less than .02, p less than .01,
      respectively). In menstruating recipients, LH was also highly elevated (p less
      than .001), while FSH showed no significant difference from controls. In
      menopausal recipients the increase of LH was less prominent (p less than .02) but
      FSH was highly increased (p less than .001). T3, T4, and FTI were absolutely
      normal in recipients, while they were significantly lower than normal (p less
      than .0001) in hemodialyzed patients. Estradiol showed no significant difference
      in both groups of recipients, as well as in menopausal hemodialyzed
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236729
TI  - Comparison of toxicity of radiocontrast agents to renal tubule cells in vitro.
AB  - We have previously reported that radiocontrast agents induce direct renal tubule
      cell toxicity in vitro. The observed toxic effects were markedly potentiated by
      concomitant hypoxia. In addition, we have reported that the ionic radiocontrast
      agent diatrizoic acid is more toxic than the nonionic radiocontrast agent
      iopamidol in this system. Using suspensions enriched in rabbit renal proximal
      tubule segments, we compared the direct toxicities of the ionic dimeric ioxaglic
      acid to the nonionic monomeric compound iopamidol. Toxicity was assessed by
      comparing tubule potassium and calcium content, ATP levels, and respiratory rates
      after exposure to clinically achievable concentrations of radiocontrast agents.
      Ioxaglate (25 mM) produced significant declines in tubule cation content and
      respiratory rate with 30 min of hypoxia followed by 60 min of reoxygenation
      compared to molar-equivalent concentrations of iopamidol under similar
      conditions. Meglumine, a cationic compound frequently present in ionic contrast
      agent solutions, and ioxaglate tubule toxicity was additive. Iopamidol and
      ioxaglate exhibited similar tubule cell toxicity when comparison was based on
      iodine content. These experimental results suggest that the intrinsic nephrotoxic
      potential of ioxaglic acid is greater than that of iopamidol on a molar basis,
      but that the nephrotoxic potential of the two radiocontrast agents is similar
      when comparison is based upon iodine content.

PMID- 2236730
TI  - Differential susceptibility to gentamicin toxicity within the proximal convoluted
      tubule.
AB  - The proximal convoluted tubule (PCT) is the major target for injury in gentamicin
      nephrotoxicity but the necrosis is often patchy and focal. The PCT is
      structurally, functionally, and metabolically heterogeneous, and the possibility
      of differential vulnerability to gentamicin-induced necrosis based on this
      heterogeneity has not been examined. A quantitative analysis comparing the extent
      of necrosis in the initial portion of the PCT (S1) to that in the more distal PCT
      (S2) and comparing necrosis in the PCT of superficial nephrons to that in
      juxtamedullary nephrons was done in rats after eight daily intraperitoneal doses
      of 100 mg gentamicin/kg rat weight. The results indicate that the PCT of
      superficial nephrons are more susceptible to necrosis than the PCT of
      juxtamedullary nephrons and that the initial S1 segment even in the superficial
      nephrons is remarkably resistant to injury. These findings suggest that some
      aspects of the functional or metabolic heterogeneity within the PCT may be
      related to either differential rates of uptake of the drug or to differences in
      intrinsic susceptibility to its toxic effects.

PMID- 2236731
TI  - The effect of calcium channel blockers on the cyclosporine dose requirement in
      renal transplant recipients.
AB  - Thirteen patients found to be hypertensive following renal transplantation were
      treated with either a calcium channel blocker or other antihypertensive therapy
      for control of blood pressure. Immunosuppression was either with cyclosporine and
      prednisone alone or with cyclosporine, azathioprine, and prednisone. Patients had
      weekly or biweekly cyclosporine whole-blood levels measured by radioimmunoassay
      drawn approximately 12 h after their last dose. Patients treated with
      cyclosporine and prednisone alone had their cyclosporine dosage adjusted to
      maintain their cyclosporine level between 400 and 900 ng/mL between 1 and 6
      months following transplantation. Patients treated with cyclosporine,
      azathioprine, and prednisone had their cyclosporine level adjusted to be between
      100 and 400 ng/mL during this same time period. Cyclosporine levels were
      significantly higher in verapamil-treated patients and significantly lower in
      nifedipine-treated patients as compared to controls. The dose of cyclosporine
      administered was significantly lower in the verapamil-treated patients and higher
      in the nifedipine-treated patients than controls. Normalizing the whole-blood
      cyclosporine level for the dose of cyclosporine, and verapamil-treated patients
      had a significantly greater, and the nifedipine-treated patients a significantly
      lower value than control patients. These data suggest the verapamil treatment
      results in significantly higher levels of cyclosporine whereas nifedipine therapy
      may actually result in lower cyclosporine levels for a given dose of cyclosporine
      than seen in patients not exposed to these drugs.

PMID- 2236732
TI  - Folate nephropathy occurring during cytotoxic chemotherapy with high-dose folinic
      acid and 5-fluorouracil.
AB  - High-dose folinic acid with 5-fluorouracil (5-FU) is a novel combination
      chemotherapy used in the treatment of metastatic gastrointestinal cancer. One of
      the mechanisms of action of 5-FU is its conversion into fluorodeoxyuridylate
      (FdUMP), which inhibits thymidilate synthetase (TS). The rate of inhibition of TS
      is augmented by increasing concentrations of folinic acid. On the other hand, it
      is well known that treatment of animals with high doses of folinic acid results
      in acute renal failure due to tubular obstruction. In order to find out whether
      there are similar findings in the clinical setting, we investigated 8 patients
      (pts.) with metastatic gastrointestinal cancer who were treated with this
      chemotherapy. We used the following parameters: 1. excretion of four urinary
      enzymes (LDH, LAP, GGT, NAG); 2. creatinine clearance on days 1 and 5. Therapy
      consisted of folinic acid 200 mg/m2 i.v. on days 1-5 and 5-fluorouracil 400 mg/m2
      on days 1-5. Each treatment cycle was repeated on day 28. We found a constant
      decrease in the excretion of all 4 enzymes from normal to subnormal values which
      was statistically significant (p less than .05) during the two treatment cycles.
      Creatinine clearance decreased about 50% in three patients from normal initial
      values. In conclusion, during therapy with high-dose folinic acid and 5
      fluorouracil we found signs of tubular damage which are similar to those found in
      folate nephropathy.

PMID- 2236733
TI  - Hyperlactatemia and increasing metabolic acidosis in hepatorenal failure treated
      by hemofiltration.
AB  - We report a case of increasing hyperlactatemia in the course of repeated
      treatment by machine hemofiltration (MHF) using a lactate-buffered replacement
      solution. The hyperlactatemia was associated with a reduction in mean arterial
      pressure, and in the majority of treatments a metabolic acidosis developed.
      Hyperlactatemia due to exogenous lactate may not be as benign as previously
      discussed.

PMID- 2236734
TI  - [Dye penetration of 3 temporary ready-to-use cements].
AB  - Dye penetration following obturation of standardized access cavities with three
      different ready to use temporary cements was compared (Cavit G, Dentorit and
      Ciprospad). Leakage and dye penetration of the materials were simultaneously
      evaluated. Ciprospad appears to be the most adapted material.

PMID- 2236735
TI  - [Experimental study of the effect of a photopolymerizable glass ionomer cavity
      liner on pulp pressure and temperature].
AB  - The biocompatibility of a light curing glass ionomer cement was studied for its
      pulpal effect when used as a capping agent in a dentin cavity. Pulpal pressure
      and temperature were recorded in 14 dog canines after placement of the glass
      ionomer cement. No increase was observed in 12 specimens on 14 samples. These
      results indicate that no pulpal effect can be demonstrated when using Vitrabond
      as a dentin capping agent.

PMID- 2236736
TI  - [Efficiency factors in endodontic instruments. Study of linear movement].
AB  - This study of the efficiency of endodontic tools in a linear motion values
      different parameters. The cross section seems to be the most important factor.
      The triangular section instruments are more efficient than the square section
      ones, but are more easily worn. The helical angle, the outline and the diameter
      have no influence on the efficiency.

PMID- 2236737
TI  - [Treatment of a double periapical abscess].

PMID- 2236738
TI  - [Titularization. Repeat of a treatment of left first mandibular molar].

PMID- 2236739
TI  - [Titularisation].

PMID- 2236740
TI  - [Daily practice and pulp diseases].
AB  - Constructive or destructive processes of pulp tissue depend on many factors:
      anatomic topography, particular physiology, or intensity and duration of
      infectious, mechanical and chemical aggression. Also irritation of the pulpo
      dentinal complex induce histologic and physiologic changes. The positive
      diagnosis of hyperemia, acute or chronic pulpitis, pulpal necrosis and acute or
      chronic apical abscess is performed by clinical investigations which allow a
      differential diagnosis with other dental or extra-dental diseases. These multiple
      steps lead to an adapted and appropriate treatment.

PMID- 2236741
TI  - [Occlusion and complete dentures].

PMID- 2236742
TI  - Lead in the environment: coming to grips with advocacy versus scientific
      integrity in risk assessment.

PMID- 2236744
TI  - Dermal uptake of organic chemicals from a soil matrix.
AB  - Uptake of chemicals from soil on human skin is considered. Based on a review of
      literature on the structure of human skin, the processes by which chemicals pass
      through this boundary, and experiments that reveal the rate and magnitude of this
      transport process; a two-layer model is presented for estimating how chemical
      uptake through the stratum corneum depends on chemical properties, skin
      properties, soil properties and exposure conditions. The model is applied to two
      limiting scenarios--(1) continuous deposition and removal of soil on the skin
      surface and (2) a one-time deposition of soil onto the skin surface. The fraction
      of soil-bound chemical that passes through the stratum corneum is dependent on
      the skin-soil layer thickness; the dimensionless Henry's law constant, Kh and the
      octanol-water partition coefficient, Kow of the soil-bound chemical. The nature
      of this dependence is discussed.

PMID- 2236743
TI  - Effects of the Chernobyl accident on public perceptions of nuclear plant accident
      risks.
AB  - Assessments of public perceptions of the characteristics of a nuclear power plant
      accident and affective responses to its likelihood were conducted 5 months before
      and 1 month after the Chernobyl accident. Analyses of data from 69 residents of
      southwestern Washington showed significant test-retest correlations for only 10
      of 18 variables--accident likelihood, three measures of impact characteristics,
      three measures of affective reactions, and hazard knowledge by governmental
      sources. Of these variables, only two had significant changes in mean ratings;
      frequency of thought and frequency of discussion about a nearby nuclear power
      plant both increased. While there were significant changes only for two personal
      consequences (expectations of cancer and genetic effects), both of these
      decreased. The results of this study indicate that more attention should be given
      to assessing the stability of risk perceptions over time. Moreover, the data
      demonstrate that experience with a major accident can actually decrease rather
      than increase perceptions of threat.

PMID- 2236745
TI  - Associations between morbidity and alternative measures of particulate matter.
AB  - This paper explores the association between acute respiratory morbidity and
      different measures of exposure to airborne particulate matter, including
      sulfates, total suspended particulates, and fine and inhalable particulates.
      Regression analysis was used to test for the impacts of these alternative
      measures of particulate matter on respiratory morbidity using the 1979-1981
      annual Health Interview Surveys and EPA's Inhalable Particle Monitoring Network.
      The general results indicate that, of the surrogate measures for particulate
      matter, sulfates appear to have the greatest association with morbidity. To the
      extent that sulfuric acid aerosols are correlated with airborne sulfates, the
      results suggest that respiratory impairment sufficient to lead to days of reduced
      activity may be related to the existence of acidity in the air. These findings
      are consistent with the results of ecological studies reporting an association
      between mortality and exposures to fine particles and sulfates.

PMID- 2236746
TI  - Comparison of the cancer risk of methylene chloride predicted from animal
      bioassay data with the epidemiologic evidence.
AB  - Methylene chloride has been shown to be a lung and liver carcinogen in the mouse;
      yet, the current epidemiologic data show no adverse health effects associated
      with chronic exposure to this compound. Hearne et al. have compared the results
      of a large mortality study on occupational exposure to methylene chloride to the
      human risk predictions based on the rodent bioassay to point out the
      inconsistency between the animal toxicologic and human epidemiologic data. The
      maximum number of lung and liver cancers predicted due to methylene chloride
      exposure based on the rodent bioassay data was 24 compared to 14 deaths from
      these cancers actually observed in the Hearne et al. epidemiology study. We
      assess the minimum risk detectable by the human study in order to calculate the
      upperbound potency of methylene chloride and compare it to the potency derived
      from the bioassay data. Results from the epidemiology study imply an upperbound
      potency of 1.5 x 10(-2) per ppm, compared to 1.4 x 10(-2) per ppm calculated
      using the most conservative analysis of the animal data. We conclude that the
      negative epidemiology study of Hearne et al. is not sufficiently powerful to show
      that the risk is inconsistent with the human risk estimated by modeling the
      rodent bioassay data. Specifically, the doses to which the workers were exposed,
      the population studied, and the latency period were not adequate to determine
      that the risks are outside the bounds of the risk estimates predicted by low-dose
      modeling of the animal data.

PMID- 2236747
TI  - Interpretation of airborne asbestos measurements.
AB  - Transmission electron microscopy (TEM) is the preferred method of measuring
      airborne asbestos in buildings, but TEM measurements cannot be used directly in
      the existing equations relating risk to exposure because the equations are based
      on measurements made with a different technique--phase contrast microscopy (PCM).
      Comparison between measurements made by different methods is not simple because
      the methods differ in the size of particles they can detect, and the relationship
      between exposure and disease is thought to depend on, among other things,
      asbestos fiber size. Previous suggestions for converting TEM measurements to PCM
      equivalents lack generality because they fail to take into account the size
      distribution of the asbestos particles and the expectation that fiber-size
      distributions in current nonoccupational environments could differ from the
      workplaces of the past on which the risk equations are based. A mathematical
      model is presented for investigating the conversion of airborne asbestos
      measurements made by one method to an equivalent measurement made by another
      method. "Equivalent" means having the same potential to cause disease. The model
      clarifies the issues of concern and suggests approaches for obtaining meaningful
      conversion factors that will allow TEM measurements to be used in PCM-based risk
      equations.

PMID- 2236748
TI  - Uncertainties in pharmacokinetic modeling for perchloroethylene. I. Comparison of
      model structure, parameters, and predictions for low-dose metabolism rates for
      models derived by different authors.
AB  - In recent years physiologically based pharmacokinetic models have come to play an
      increasingly important role in risk assessment for carcinogens. The hope is that
      they can help open the black box between external exposure and carcinogenic
      effects to experimental observations, and improve both high-dose to low-dose and
      interspecies projections of risk. However, to date, there have been only
      relatively preliminary efforts to assess the uncertainties in current modeling
      results. In this paper we compare the physiologically based pharmacokinetic
      models (and model predictions of risk-related overall metabolism) that have been
      produced by seven different sets of authors for perchloroethylene
      (tetrachloroethylene). The most striking conclusion from the data is that most of
      the differences in risk-related model predictions are attributable to the choice
      of the data sets used for calibrating the metabolic parameters. Second, it is
      clear that the bottom-line differences among the model predictions are
      appreciable. Overall, the ratios of low-dose human to bioassay rodent metabolism
      spanned a 30-fold range for the six available human/rat comparisons, and the
      seven predicted ratios of low-dose human to bioassay mouse metabolism spanned a
      13-fold range. (The greater range for the rat/human comparison is attributable to
      a structural assumption by one author group of competing linear and saturable
      pathways, and their conclusion that the dangerous saturable pathway constitutes a
      minor fraction of metabolism in rats.) It is clear that there are a number of
      opportunities for modelers to make different choices of model structure,
      interpretive assumptions, and calibrating data in the process of constructing
      pharmacokinetic models for use in estimating "delivered" or "biologically
      effective" dose for carcinogenesis risk assessments. We believe that in
      presenting the results of such modeling studies, it is important for researchers
      to explore the results of alternative, reasonably likely approaches for
      interpreting the available data--and either show that any conclusions they make
      are relatively insensitive to particular interpretive choices, or to acknowledge
      the differences in conclusions that would result from plausible alternative views
      of the world.

PMID- 2236749
TI  - Mite control: is it worthwhile?

PMID- 2236750
TI  - Interactions between macrophages and granulocytes in allergic asthma.

PMID- 2236751
TI  - Late asthmatic responses.

PMID- 2236752
TI  - Tuberculosis screening and prevention in new immigrants 1983-88.
AB  - Although only 11 cases of active tuberculosis in new immigrants were found, 29.9%
      of those aged under 30 were tuberculin negative on entry and were given BCG
      vaccination. In addition 12.8% of children aged under 16 were strongly tuberculin
      positive and were given chemoprophylaxis. The defects of the official Port of
      Arrival system for reporting new immigrants are discussed. Entry screening of new
      immigrants allows worthwhile preventive action, BCG vaccination or
      chemoprophylaxis, in a substantial proportion of those screened.

PMID- 2236753
TI  - Skin reactivity to atypical mycobacteria in cystic fibrosis.
AB  - Atypical mycobacterial disease has been described in a small number of patients
      with cystic fibrosis. Apart from one uncontrolled study, there is little
      information regarding atypical mycobacterial skin reactivity in this group of
      patients. We evaluated delayed cutaneous hypersensitivity to purified extracts of
      Mycobacterium avium, Mycobacterium intracellular, Mycobacterium kansasii and
      Mycobacterium bovis in 23 healthy controls and 43 adult and adolescent patients
      with cystic fibrosis. Fifteen of the cystic fibrosis group were receiving regular
      corticosteroids. Additionally, direct smear examination and Lowenstein Jensen
      culture were performed on sputum from the cystic fibrosis group. The prevalence
      of positive skin reactions was similar in the group with cystic fibrosis (30%)
      and in the control group (57%). Subgroup analysis showed that those cystic
      fibrosis patients receiving corticosteroids had a markedly lower prevalence of
      positive reactions (7%) compared to controls (P less than 0.01). When this
      subgroup was excluded from analysis, the prevalence of positive skin reactions
      among patients with cystic fibrosis was 43%. In the prospective sputum
      bacteriology study, one of the 43 cases grew Mycobacterium avium-intracellulare
      and had clinical and radiological evidence of this disease. Of note, this patient
      showed positive skin tests to all four mycobacterial species tested. Our data
      show no difference in the prevalence rate of positive skin reactions to atypical
      mycobacterial antigens between a control population and an adult cystic fibrosis
      population. In addition, the predictive value of skin testing is low in cystic
      fibrosis due to the high prevalence of cross-reactivity between different
      mycobacterial species and the high prevalence of anergy among those patients with
      advanced disease receiving treatment with corticosteroids.

PMID- 2236754
TI  - Survey of student nurses' smoking habits in a London teaching hospital.
AB  - As a preliminary to a 3-year intervention project to reduce smoking levels and
      prevent smoking commencement among student nurses, a survey of smoking habits
      among all 368 student nurses at The Royal Free Hospital was conducted in the
      Autumn of 1988. Absence rates of smokers and those who had never smoked were also
      studied. The response rate was high (95%) and the survey showed a high percentage
      (43%) of smokers among the student nurses. There was a higher proportion of
      smokers among those who did not respond to the first mailing of the
      questionnaire. The absence rate among smokers was almost twice that of the
      nonsmokers (P less than 0.005) and the number of days absent was related to the
      number of cigarettes smoked (P less than 0.05). Sixty-two per cent of nurses who
      smoked before they started their training (n = 125) said they had increased their
      smoking since commencing training and 39 (11%) nurses started smoking after
      starting nurse training. 'Stress', greater opportunity to smoke and peer
      influence were given as reasons for increased smoking and smoking commencement
      during nurse training.

PMID- 2236755
TI  - Passive smoking in cystic fibrosis.
AB  - The families of 32 children with cystic fibrosis (CF) were interviewed about both
      their tobacco consumption and their childrens physical activities. Hospital
      records informed about treatment frequency, lung function and clinical score.
      Cystic fibrosis families smoked far more than the Swedish average and the passive
      smokers among our patients seemed to fare less well in all parameters. The
      children of smoking mothers required significantly longer periods of intravenous
      antibiotic treatment (P greater than 0.05). Frequent physical exercise seemed to
      compensate for the potential harmful effects of passive smoking and children with
      high physical activity living in families who smoked needed significantly less
      frequent antibiotic treatment than the inactive children (P greater than 0.02).
      Although this series is small, the results indicate that a smoke-free environment
      may be important for CF patients. General information is insufficient and
      extensive psychological support to the families is probably necessary.

PMID- 2236756
TI  - Prophylaxis of exercise-induced asthma with inhaled formoterol, a long-acting
      beta 2-adrenergic agonist.
AB  - The prophylaxis of exercise-induced asthma with inhaled formoterol (12
      micrograms) was compared with inhaled salbutamol (200 micrograms) and placebo in
      12 patients with atopic asthma. Both drugs produced equal bronchodilation 2 and 4
      h after administration. Both drugs protected equally against exercise-induced
      bronchoconstriction 2 h after administration; at 4 h, formoterol gave
      undiminished protection from that seen at 2 h while salbutamol was no more
      effective than placebo.

PMID- 2236757
TI  - Experience with fibreoptic bronchoscopy in the diagnosis of pulmonary shadows in
      renal transplant recipients over a 12-year period.
AB  - Despite improvements in immunosuppressive therapy, pulmonary infections remain an
      important cause of morbidity and mortality in renal transplant recipients. Over a
      12-year period (1 January 1977 to 31 December 1988) we prospectively assessed the
      value of fibreoptic bronchoscopy in diagnosing radiographic pulmonary shadows in
      this group of patients. Forty-eight bronchoscopies were performed on 46 patients.
      A definitive diagnosis was established in 28/48 (58%) procedures (and was
      partially definitive for one of two organisms ultimately identified in another).
      The procedure failed in 19/48 (40%), although in 15 of these, the radiographic
      shadows resolved on antibiotics (9) or spontaneously (3) or autopsy revealed
      acute pneumonia (3). In four instances a specific diagnosis was made by
      alternative means. Clinically useful information which led to changes in
      management was obtained in 17/48 (35%) procedures and bronchoscopy was thought to
      have favourably influenced survival in 16/48 (33%). Fibreoptic bronchoscopy is in
      our experience a safe (only one pneumothorax and no significant haemorrhage) and
      useful technique in evaluating pulmonary shadows in renal transplant recipients.

PMID- 2236758
TI  - Culture and comparison of human bronchial and nasal epithelial cells in vitro.
AB  - Human nasal and bronchial epithelial cells were cultured in vitro and compared
      morphologically and functionally. Morphologic assessment by both light and
      electron microscope and indirect immunoperoxidase staining techniques confirmed
      the identity of the two cell types as being epithelial. Light microscopy of
      confluent cultures revealed tightly packed cell monolayers, whilst electron
      microscopy showed that cells were linked by tight junctions. Estimation of cell
      size by planimetry found these cells to have a mean width of 10.6 +/- 1.1 microns
      for nasal cells and a mean width of 10.2 +/- 1.0 microns for bronchial cells. A
      high proportion of both the nasal and the bronchial cells exhibited features of
      the mature ciliated cell types, and constituted between 50 and 76% of the total
      cells at the earlier stages of culture although this decreased to between 16 and
      23% of the total by 4 weeks in culture. The ciliary beat frequencies of the nasal
      and bronchial cells were found to be similar at 10.8 +/- 0.7 Hz and 11.8 +/- 2.3
      Hz, respectively. The cilial beat on adjacent cells was synchronous, suggesting
      the presence of intercellular communication between the neighbouring cells. These
      studies demonstrated that there was little difference between the cultured nasal
      and bronchial epithelial cells with respect to either their morphology or ciliary
      activity.

PMID- 2236759
TI  - Antibacterial and mutagenic activity of inhaled bronchodilators on the
      respiratory pathogen Haemophilus influenzae.
AB  - The U.K. prevalence of non-beta-lactamase-mediated resistance to ampicillin among
      Haemophilus influenzae reached 4% in 1986. The majority (70%) of isolates of this
      type come from sputa of patients with chronic obstructive airways disease. This
      study investigated whether bronchodilator drugs delivered directly to the
      respiratory tract have any antibacterial activity and/or play a role in promoting
      selection of organisms with this type of resistance. Antibacterial activity was
      detected in two out of six pharmaceutical preparations for nebulization
      examination but was entirely attributable to the preservative (benzalkonium
      chloride) in them. Exposure of ampicillin-susceptible H. influenzae (minimum
      inhibitory concentration 0.25 mg l-1) to concentrations of salbutamol, fenoterol
      and beclomethasone theoretically attainable in vivo resulted, after 48 h, in
      isolation of colonies with reduced susceptibility to ampicillin (minimum
      inhibitory concentration 1-4 mg l-1) but reversion to beta-lactam susceptibility
      occurred following serial subculture on chocolate agar. Organisms with stable
      reduced susceptibility to ampicillin were obtained when exposure to one of these
      three bronchodilators in broth was followed by serial subculture on agar
      containing the same preparations at equivalent concentrations and when the period
      of exposure to salbutamol at 100 mg l-1 in broth was extended to 5 days. The
      occurrence of these phenomena in vivo might be contributing to failures in
      treatment of exacerbations with ampicillin and to an increasing prevalence of
      beta-lactamase-negative, ampicillin-resistant H. influenzae.

PMID- 2236760
TI  - Factors influencing the compliance of patients using oxygen concentrators for
      long-term home oxygen therapy.
AB  - A previous study in the Liverpool district on patients receiving long term oxygen
      treatment using a domiciliary oxygen concentrator showed that only 55% were both
      using oxygen therapy correctly and had stopped smoking. To try and identify which
      factors influence patient behaviour, all 55 patients in this district receiving
      long-term oxygen therapy for hypoxaemic chronic airflow limitation were studied.
      We found that those with more symptoms were more likely to comply with this
      therapy. The prescription of a concentrator on the advice of a hospital physician
      did not improve on the compliance rates attained in those patients assessed by
      the general practitioner alone.

PMID- 2236761
TI  - Estimation of pulmonary artery pressure by Doppler echocardiography in normal
      subjects made hypoxic.

PMID- 2236762
TI  - Wegener's granulomatosis presenting as pulmonary metastases: value of
      antineutrophil cytoplasmic antibodies in diagnosis.

PMID- 2236763
TI  - Relapsing polychondritis presenting with bronchorrhoea.

PMID- 2236764
TI  - [Tuberculosis and AIDS. The situation in Spain. The outlook].

PMID- 2236765
TI  - [Spontaneous bacterial peritonitis in the cirrhotic patient. A study by
      discriminant analysis].
AB  - Infection of peritoneal fluid in cirrhotic patients requires an early diagnosis
      and treatment. Different parameters have been used for the diagnosis of this
      complication, however, the statistical study has not used multivariable analysis
      techniques. We have therefore designed this work performing a discriminating
      analysis in order to find the best variable combination. Twenty-six cirrhotic
      patients who were consecutively admitted to our hospital have been studied. Total
      adn polymorphonuclear leukocytes, glucose, LDH, and lactic acid were determined
      in peritoneal fluid. Eighteen peritoneal fluids were classified as non infected
      and the rest as infected. The criteria obtained from the discriminating function
      which combines total leukocytes, LDH, and glucose has been chosen as optimal. The
      utility of discriminating analysis is discussed and we conclude with the need to
      verify in a later study the value of the calculated function.

PMID- 2236766
TI  - [A clinical and biological study of 33 cases of polycythemia vera].
AB  - The clinical, analytical, evolutive and therapeutic aspects of 33 cases of
      polycythemia vera which were diagnosed according to the Polycythemia Vera Study
      Group criteria, are described. Mean age was 65 years with a slight predominance
      of females (54.5%). Hemorrhagic manifestations were the most frequent (67%) with
      a great number of patients with digestive manifestations consisting of GI
      hemorrhage, abdominal pain, portal or suprahepatic veins thrombosis. Splenomegaly
      was the most frequently found sign upon examination (73%). The mean hemoglobin
      leukocyte, and platelet levels were 18 g/dl, 16,000 mm3 and 738,000 mm3
      respectively. It is note worthy the value of the erythropoietin for the
      differential diagnosis of secondary erythrocytosis as well as the value of the
      bone marrow histologic study which should be included in the diagnostic criteria
      of the disease. The evolution of the process is favorably altered by bleedings
      and chemotherapeutic cytoreduction which are often performed simultaneously.

PMID- 2236767
TI  - [Differences by sex in the presentation and follow-up in the first year of acute
      myocardial infarct].
AB  - Three-hundred and nine patients, 242 males and 67 females diagnosed of myocardial
      infarction were studied during the acute phase and followed for a year to
      evaluate any differences. The corrected incidence was greater amongst males, 11.1
      vs 3.6/10,000 inhabitants. The presenting age was significantly lower in males
      below 50 and greater in women above 70. Hypertension, hypercholesterolemia and
      sedentariness were more prevalent amongst women; smoking was more prevalent
      amongst males. Infarction presentation was typical in both sexes being
      significant a 5 hour delay in arriving to the hospital in female patients. On
      hospital admission Killip III-IV was significantly more frequent amongst women
      (17% vs 4.6%). Hospital mortality although it was higher in women this was not
      statistically significant (19.4% vs 14.4%). During follow up there was a better
      control of risk factors in the male patients. Heart failure and mortality were
      greater amongst women during the first three months (p less than 0.001).
      Mortality differences continued being statistically significant during the
      following three months. From the sixth month to the first year, mortality rates
      were similar. The study suggests that infarction prognosis is worse in females.

PMID- 2236768
TI  - [The reflex sympathetic dystrophy syndrome associated with breast cancer].
AB  - Reflex sympathetic dystrophy syndrome (RSDS) is a rare entity of unknown
      etiopathogenesis, associated to different precipitating factors such as malignant
      tumors of several localizations. A new clinical variety has been recently
      described which has been denominated palmar fasciitis and polyarthritis syndrome.
      We present here two patients with RSDS associated to breast cancer: one case
      presenting fasciitis and polyarthritis and another case also associated to
      polymyalgia rheumatica. We emphasize the importance of reducing the tumor mass in
      the treatment of this syndrome, as well as including it in the gammagraphic
      differential diagnosis of bone metastasis.

PMID- 2236769
TI  - [The recurrence of a gynecological neoplasm as a solitary thyroid nodule].
AB  - We present a case of a patient who sought medical assistance because of a single
      thyroid nodule and had a history of cervix carcinoma and hysterectomy three years
      earlier not having had any signs of progression of that disease since. The
      aspiration puncture of the thyroid nodule revealed atypical squamous cells
      suggestive of metastasis of the gynecological neoplasia. The rareness of the
      clinical presentation of the thyroid metastasis as well as of the involvement of
      this gland in the dissemination of cervix neoplasia are discussed, noting on the
      possible role of radiotherapy on the variation of the progression patterns of the
      disease. Similarly, the usefulness of cytology obtained by aspirative puncture
      with a thin needle, in the diagnosis of thyroid nodule is highlighted.

PMID- 2236770
TI  - [The human immunodeficiency virus type 2 (HIV-2)].

PMID- 2236771
TI  - [The nutritional quality of the fat intake of the Spanish population].
AB  - The present study originated because of the importance and current interest in
      fat intake and its relationship with cardiovascular diseases. The quality and
      quantity of fat intake is studied in the Spanish population as a whole, as well
      as in each of the Autonomic Communities. The quality of the ingested fat is
      analyzed considering the intake of saturated, monounsaturated, and
      polyunsaturated fatty acids using different index such as:
      polyunsaturated/saturated ratio (P/S), Keys, Anderson and Grande's index, and
      vegetable fat + fish fat/animal fat--fish fat ratio. The differences found
      according to the geographical localization of the Autonomic Community were
      studied, finding the influence of what is known as the "Mediterranean diet".

PMID- 2236772
TI  - [The characteristics of the opportunistic infections associated with AIDS:
      tuberculosis and toxoplasmosis].

PMID- 2236774
TI  - [Is discontinuous digitalis therapy efficacious?].

PMID- 2236773
TI  - [Abdominal pain and a palpable mass with previous abdominal surgery].

PMID- 2236775
TI  - [Disseminated cryptococcosis as the first manifestation of the acquired
      immunodeficiency syndrome].

PMID- 2236777
TI  - [Septic arthritis due to Haemophilus influenzae in adults].

PMID- 2236776
TI  - [Hyperthyroidism, pregnancy and the panic attack].

PMID- 2236778
TI  - [Intramuscular buprenorphine in the symptomatic treatment of renal colic].

PMID- 2236779
TI  - [Pseudomonas and not Pseudomona, nothing to do with plural].

PMID- 2236780
TI  - [Adenocarcinoma of the ovary in the ovarian remnant syndrome].

PMID- 2236781
TI  - [Prognostic factors for success in catheter ablation of the right Kent bundle:
      report of 27 patients].
AB  - In 27 patients with atrial fibrillation and/or reciprocating tachycardia,
      ablation of right-sided Kent bundles (23 in the right posterior paraseptal region
      and four of the right free wall) was performed. The anterograde refractory period
      of the accessory pathways was 253 +/- 70 msec and the shortest R-R interval
      during atrial fibrillation 211 +/- 47 msec. Cumulative energies of 589 +/- 396 J
      per patient were used, with 3 +/- 2 shocks and 195 +/- 312 J per shock. Accessory
      pathway ablation was effective in 16/27 patients (59%) during an 11 +/- 8 months
      of follow-up (in 15/16 pre-excitation disappeared; in nine of them the
      anterograde and retrograde conductions were abolished and in the other six the
      anterograde and retrograde conductions were severely altered; ablation was
      partially ineffective in 1/16 patients who remained asymptomatic on medical
      treatment and without inducible reciprocal rhythm). Ablation was ineffective in
      11/27 patients. Three hours after ablation a patient died from electromechanical
      dissociation; during ablation a 200 J shock cancelled preexcitation, not being
      possible to produce reciprocal rhythm. The emergency echocardiography only showed
      a minimum posterior pericardial effusion. Ablation was effective in 15/23
      patients (65%) right posterior paraseptal. Overall success in 1989 (10/27
      patients) was 70% (7/10 patients). The success in 1989 was 70% (6/8 patients)
      right posterior paraseptal. The shortest RP' interval (was 82 +/- 19 msec) during
      the reciprocal rhythm, where the ablation was performed, was 82 +/- 19 msec (74
      +/- 17 msec with success and 99 +/- 19 msec with failure).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2236782
TI  - [Percutaneous mitral valvulotomy using the Inoue balloon technique].
AB  - We have reviewed our initial experience with percutaneous mitral valvulotomy
      (PMV) in 29 consecutive patients with mitral stenosis using the Inoue mono
      balloon technique. In all cases, the venous transeptal anterograde approach was
      used. Age was 49.5 +/- 12.5 years (range 21-78) and only 5 (17%) patients were
      male. Clinical status was as follows: 15 patients were in NYHA class II, 13 NYHA
      class III and one in NYHA class IV. Atrial fibrillation was present in 15 (52%)
      patients and 16 (55%) were on coumarin. An echocardiographic score was employed
      to assess mitral valve anatomy, parameters including degree of thickening,
      mobility, calcification and subvalvular involvement were scored independently
      from 1 to 4. The echocardiographic score so determined was 7.72 +/- 2.1 for the
      entire group. Ten patients presented mild (+) mitral regurgitation prior to PMV.
      The mean duration of PMV was 76.2 +/- 29.6 minutes. In only one patient an
      inadequate positioning of the balloon prevented dilatation of the valve whereas
      the remaining 28 patients had their valves successfully dilated. Mitral valve
      area, by means of both Gorlin and Doppler (pressure half time) methods, increased
      in all cases: from 0.95 +/- 0.17 cm2 to 1.92 +/- 0.31 cm2 (p less than 0.001) and
      from 0.97 +/- 0.22 to 1.84 +/- 0.33 cm2 (p less than 0.001), respectively. Mitral
      regurgitation increased angiographically in more than 1 degree only in 1 patient,
      but no other cardiac or vascular complication occurred. Thus, in our experience
      PMV with the Inoue mono-balloon catheter is a safe and effective method for
      dilating mitral valve stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236784
TI  - [Natural and unnatural history of the univentricular heart].
AB  - We examined the cases of 90 patients found to have univentricular heart at
      catheterization from January 1971 to January 1988. These patients are the 3.8% of
      the 2,322 children diagnosed of congenital heart disease by catheterization and
      angiography in this 17-year period of time. The mean follow-up was 9.5 years. The
      prognosis is poor: of the 90 patients, 50 died (55.5%) 43 of them in the first
      year of life. The actuarial survival rate is only the 38.5% at 5 years. Between
      the 56 children unoperated the mortality rate was the 62.5% and only the 16% (9
      patients) survived with good functional results, class I and II of the New York
      Heart Association. The earlier palliative surgery changes the prognostic and the
      adverse natural history. The mortality rate in the operated group was the 44.1%.
      Another 44.1% (15 patients) of the operated group survived, 14 patients in class
      II and one in class III. The systemic-pulmonary artery shunts are the elective
      surgical procedure for important pulmonary stenosis, and the Fontan-type
      procedure is the elective for posterior, definitive repair.

PMID- 2236783
TI  - [Complete atrioventricular canal and tetralogy of Fallot: surgical
      considerations].
AB  - Nine patients with complete atrioventricular canal and tetralogy of Fallot
      underwent intracardiac repair of both anomalies between 1982 and 1989. The ages
      of the patients ranged from 6 months to 7 years. Six of the 9 had one or more
      previous systemic-pulmonary artery shunts. Two-dimensional echocardiography
      showed diagnostic characteristics of both malformations in all patients. The
      diagnosis was confirmed by cardiac catheterization and cineangiography. The
      ventricular septal defect was repaired by a combined right atrial and ventricular
      approach in every patient. Outflow tract reconstruction was performed with the
      use of a transannular patch (4), infundibular patch (4), and a valved conduit
      (1). There were no hospital deaths. Meningitis was responsible for the death of a
      patient 2 years after repair. We recommend early palliation, complete repair in
      those older than 4 or 5 years, surgical technique depending on the anatomical
      findings, combined atrial and ventricular approach, 2 separate patches to close
      the ventricular septal defect in required cases, adjusted correction of the right
      ventricular outflow tract, and careful postoperative care.

PMID- 2236785
TI  - [Valvular heart diseases (IX). Valvular endocarditis in non-heroin addicted
      patients].

PMID- 2236786
TI  - [A child affected by the Romano-Ward syndrome born of a mother with the Jervell
      and Lange-Nielsen syndrome].
AB  - We report a child affected with the Romano-Ward syndrome (long QT, normal
      hearing), born from a mother affected with the Jervell and Lange-Nielsen syndrome
      (long QT plus deafmutism). We discuss the possible pathogenetic reasons for this
      uncommon association.

PMID- 2236787
TI  - [Coexistence of two hemodynamically significant mechanisms for syncope associated
      with glossopharyngeal neuralgia].
AB  - Syncope is a rare presentation of glossopharyngeal neuralgia (GN). A patient with
      squamous cell cancer of the pharynx had GN and syncope due to asystolic pauses
      and extreme hypotension. The bradyarrhythmias were atropine-sensible, but both
      this treatment and pacing failed to prevent recurrence of syncopal hypotensive
      crises, blood pressure continuing to fall during GN attacks. These data suggest
      that during a neuralgic attack the stimulation excites vagi, causing asystole,
      and simultaneously abolishes sympathetic tone. Carbamazepine was effective in
      controlling the symptoms of the patient.

PMID- 2236788
TI  - [Silent uncomplicated patent ductus arteriosus in children. Diagnosis with echo
      Doppler].
AB  - Three cases are presented of patent uncomplicated ductus arteriosus in children,
      with short systolic murmur, in which the noninvasive diagnosis could not be
      possible without the echo-Doppler help. Although are cases with small shunts and
      hemodynamically well tolerated, its diagnosis and surgical treatment are
      essential in order to prevent the risk of bacterial endocarditis of those
      patients.

PMID- 2236790
TI  - [Patch angioplasty in isolated left main coronary artery stenosis].
AB  - A 50 year old male with isolated left main coronary artery disease was surgically
      treated with saphenous vein patch angioplasty. Surgery results are reviewed by
      coronariography 2 months later and we comment its use as alternative technique in
      selected cases.

PMID- 2236791
TI  - [An informatics program for the management of patients with pacemakers].
AB  - We are introducing a software package (Dbase III application) for the management
      of patients wearing cardiac pacemakers. It runs on any IBM compatible
      microcomputer with a minimum of 512 Kb RAM and a 10 Mb hard-disk. It works with 6
      separate databases: 1) identification-indications; 2) implants; 3) explant
      closure; 4) follow-up; 5) pacemakers, and 6) electrodes. The program runs
      completely by menus, tasks being started by one key stroke. The patient databases
      are structured following the European Pacemaker Patient Card, including its
      codes. Data introduction is facilitated by friendly screen formats. The pacemaker
      database contains 495 models and 304 electrodes of all brands. Automatic searches
      include: 1) hospital number (from last and/or first name); 2) complete pacing
      history; 3) listing of patients by stimulation mode, loss of follow-up or
      proximity of expected battery end of life; 4) pacemaker or electrode definition,
      and 5) pacemaker models contained in the database. The program has been applied
      by nurses for over 6 months in our service, proving its efficacy with an easier
      and better follow-up. The accuracy of the automatic searches has been confirmed
      manually.

PMID- 2236789
TI  - [Color Doppler study of 2 complicated aortic abscesses ruptured into the right
      ventricle and left atrium].
AB  - This report describes 2 patients with infective endocarditis who subsequently
      developed aortic abscesses which eventually ruptured, in one case to the right
      ventricular outflow tract and, in the other, to the left atrium causing, in both
      patients, severe hemodynamic derangement. The site of communication between the
      abscesses and the receiving chamber was accurately diagnosed by color flow
      Doppler imaging which provided more valuable preoperative information than
      conventional techniques.

PMID- 2236792
TI  - [Permanent cardiac pacing and the Grupo do Trabajo do Marcapasos].

PMID- 2236793
TI  - [Physiological mode of pacing in pediatrics].
AB  - The concept of physiologic pacing is often primarily to involve the preservation
      of atrioventricular synchrony. Nevertheless, specially in children there are
      other mechanisms different than atrial filling to improve cardiac output such as
      heart rate increase with exercise. Taking as physiologic pacing those modes of
      pacing improving hemodynamic condition of the patient we must add to the DDD, the
      DDDR and SSIR modes of pacing. In this report our experience with 70 consecutive
      children paced in physiological mode of pacing is described: 51 in SSIR mode, DDD
      in 16, and DDDR in 3 cases. In five out of the 16 cases with DDD mode it was
      found an unidirectional crosstalk and in two atrial sensing failure (failure rate
      with DDD of 47.75% at 48 months of follow-up). In 26 children with rate
      responsive pacing by means of activity sensing a treadmill exercise test
      according to Bruce protocol was performed found a significant increase in both,
      heart rate and maximal work capacity, associated to an improvement in the
      clinical status and no evidence of arrhythmias in any case. In conclusion, rate
      responsive pacing by means of activity sensing in children is an adequate,
      reliable and effective physiological mode of pacing.

PMID- 2236794
TI  - [Evaluation of DDD and VVIR pacemakers with gated radionuclide ventriculography].
AB  - Gated radionuclide ventriculography was performed in 53 patients, with 29 DDD and
      24 VVIR pacemakers. Ejection fraction and regional contractility was studied in
      three conditions: a) At rest. b) With tachycardia after exercise. And c) With
      induced tachycardia at rest. At a rate similar to the one reached with the
      exercise. Stimulation in different parts of the right ventricule did not show any
      differences in the ejection fraction. Induced ventricular stimulation in
      comparison with natural ventricular contractions did not alter or change ejection
      fraction if the reached rate was the same an not too high in both cases. Induced
      stimulation at rest with a rate of 110-120/min, decreased the ejection fraction
      in 10% (p less than 0.001). Induced stimulation by exercise (VVIR. DDD) increased
      the ejection fraction in 10% (p less than 0.003) and if there were zones of
      dyskinesia they improved or disappeared. There were no statistical differences
      between VVIR and DDD pacemakers. It seems that a limited tachycardia is
      convenient for patients with rate response pacemakers (VVIR).

PMID- 2236795
TI  - [Maturation of the electrode-endocardium interface].
AB  - It's largely known that the implanted lead in the endocardium develops an
      inflammation and posterior fibrosis of the cardiac tissue, increasing the
      stimulation threshold. It's also demonstrated that the chronic threshold values
      keep relation with the electrode surface area. There are several factors in the
      fibrosis genesis according mechanical of physical properties of the lead, such as
      tension, tip design, surface area and the patient reaction to a foreign body.
      Electrical factor is not yet sufficiently studied. We developed an experimental
      study in 12 dogs, separated in two groups (four explanted at 8 days or subacute
      group, and eight explanted at 35 days or chronic group), looking for a
      correlation between current density crossing the interface endocardial-electrode
      and the posterior fibrosis. The mechanical factor was minimized by using small
      surface area electrodes, with little tension. Three leads were implanted in each
      dog, connected respectively to 0, 2.5 and 5 volts. The simultaneous working of
      two pacemakers in the same dog, was possible by programming one of them in VVI at
      140 per minute, and the other in VOO at 75. The tirht lead was implanted as a
      reference. The threshold pacing values, in voltage and in current, the R wave and
      impedance were measured at implant and at explant of the leads. Differences
      statistically significative were observed between reference electrodes and
      electrical active ones, according their current density. The leads stimulating
      with great current density (more voltage) generated more fibrosis and therefore
      higher pacing threshold values and lower R waves and impedances. The convenience
      to stimulate at low voltages was seen.

PMID- 2236796
TI  - [Ambulatory control and follow-up of patients carrying a unicameral pacemaker].
AB  - The follow-up schedule after pacemaker implantation should be arranged to allow
      close monitoring during the immediate post-implant period, and frequent
      observations during the life of the system. Such follow-up has as major goals the
      evaluation of the electrical functions of the pacing system to detect
      malfunctions or imminent power source depletion and the evaluation of the patient
      cardiac status so that reprogramming can be accomplished.

PMID- 2236797
TI  - [Comparison between the unipolar and bipolar mode for estimation and detection of
      auricular and ventricular duration in acute and chronic cardiac pacing].
AB  - To add data on controversy between the advantages and inconveniences of using
      either unipolar or bipolar modes for permanent cardiac pacing, we have studied 15
      patients. In all of them a CPI Delta-925 (DDD) pulse generator was implanted. Non
      invasive pacing threshold values in volts were measured at 0.05, 0.08 and 0.1 ms
      for each chamber programmed either to unipolar or bipolar mode, at 1, 2, 3, 4, 5,
      6, 7, 8, 14, 21, 30, 60, 90, 120, 180 and 365 days after the implant. Sensing
      thresholds were measured at the same time. For any pulse width the mean pacing
      thresholds in atrium and ventricle increase uniformly, reaching its maximum
      values between the days 8 and 14 after the implant and decreases to a stable
      value between 90 and 120 days after the implant, without statistically
      significant differences for both: unipolar and bipolar modes. Pacing thresholds
      (V +/- SD) for 0.05 ms in the day 365th were in atrium: unipolar 2.85 +/- 0.79,
      bipolar 3.35 +/- 0.92 (p = 0.56) and ventricle: unipolar 3.92 +/- 1.01, bipolar
      4.36 +/- 1.35 (p = 0.58). Sensing thresholds in atrium and ventricle decreases
      from the 1st day after the implant with the minimum mean value the day 8th,
      increasing eventually. No statistically significant differences were found
      between sensing unipolar/bipolar mode at each chamber. Sensing thresholds (mV +/-
      SD) in the 365th day were in atrium: unipolar 4.40 +/- 2.07, bipolar 4.10 +/-
      2.10 (p = 0.82) and ventricle: unipolar 11.20 +/- 3.63, bipolar 10.10 +/- 5.13 (p
      = 0.71). CONCLUSIONS: for every single patient: 1) There are not statistically
      significant differences in the evolution of unipolar and bipolar pacing
      thresholds both in atrium and ventricle, regarding rate and time of increase,
      maximum value, rate of decrease and stable chronic values. 2) There are neither
      statistically significant differences regarding unipolar and bipolar sensing in
      atrium and ventricle respect to rate of decrease, time and value of the minimum
      and stable chronic values.

PMID- 2236798
TI  - [Sensing anomalies with the VVI pacemaker. Clinical study by Holter].
AB  - Defective sensing incidence is controversial. It has rarely been assessed by
      Holter in series of consecutive patients. Holter was used in 59 cases (84% of
      implants over 9 months) with a follow-up of between 7 and 19 months. The
      generators came from 2 manufacturers, 44 unipolar and 15 bipolar, with standard
      sensitivity level and in VVI with rates covering up the patient's own rythm.
      Results. Unipolar: all asymptomatic registration and two symptomatic in the
      follow-up. There were myopotential inhibitions in 31 (70%), but only in 6% lasted
      over 2,000 msec, there were less than 16 episodes in 94% of cases distributed
      along the day with an increase between 6 am and 3 pm, and absent from 4 to 6 am.
      In six (14%) there were inhibitions and reversion to asynchronous.+ pacing with
      the R on T phenomenon and non conducted artifacts in four; in one case the
      asynchronous stimulation occurred over sinus rhythm. Undersensing was confirmed
      in four (9%) but in three was caused by PVC. Bipolar: all were asymptomatic and
      without sensing anomalies. Conclusions. The high incidence of asymptomatic
      oversensing in unipolar generators limits Holter's value in the diagnosis of
      symptomatic cases by myopotential interference. Its routine use for detecting
      anomalies in sensing seems inadvisable. The reversion to asynchronic functioning
      is not unusual and could be a potentially provocative mechanism of ventricular
      arrhythmias.

PMID- 2236799
TI  - [Permanent atrial stimulation (AAI) in the sick sinus syndrome].
AB  - A consecutive series of 18 patients (5 males, 13 females, mean age +/- DS 65 +/-
      12 and 66 +/- 13 years, respectively, and mean +/- DS Wenckebach point of 162 +/-
      20 ppm) given arterial pacemakers for sinus node dysfunction (SND) were followed
      to study the incidence of lead failure, atrioventricular conduction disturbances
      and chronic atrial tachyarrhythmias. The mean follow up time +/- SD was 18 +/- 10
      months. There was not lead dislodgement. Chronic voltage output was reduced to
      2.5 volts in 73% of patients because of a reduced chronic pacing threshold. One
      patient presented acute transient rise of pacing threshold and temporary loss of
      atrial detection. Progression to AV block was not documented. One patient had
      asymptomatic Wenckebach AV block during the night while on digoxin plus
      amiodarone. The AV block disappeared after cessation of drug therapy. Patients
      with previous episodes of paroxysmal atrial fibrillation did not presented the
      arrhythmia during follow up, while 75% of patients with previous atrial flutter
      presented the arrhythmia. None of the patients had systemic embolism. In
      conclusion, AAI pacing is a reliable and safe mode of pacing in patients with
      SND.

PMID- 2236800
TI  - [Biosensors and rate-responsive cardiac pacing].
AB  - Patients with atrioventricular block and ventricular pacemakers at a fixed rate
      have their exercise ability limited. This situation has been solved through dual
      chamber pacing in those patients keeping an adequate sinus node function. For the
      remaining, showing chronotropic failure or atrial fibrillation, the ability to
      increase their pacing rate is only possible when signals other than atrial
      activity, and reflecting metabolic needs, are used as a guide. These signals
      detected by a sensor, act through an algorithm modifying the pacing rate and are
      the cornerstone of rate-responsive pacing. Indications for these stimulation
      modes are analyzed as so are characteristics of different sensors used for this
      aim (pH, respiratory rate, QT interval, body activity, minute respiratory volume,
      central venous pressure, preejection period + stroke volume, right ventricular
      dp/dt, evoked QRS response and venous oxygen saturation).

PMID- 2236801
TI  - [Escape rhythms after ablation of the atrioventricular junction and implantation
      of a pacemaker].
AB  - Escape rhythms characteristics after successful catheter ablation of the
      atrioventricular junction and intentional complete heart block were compared with
      those due to others etiologies as well as the advantage of the posterior
      implantation of a rate responsive pacemaker (VVIR). In 22 patients, 9 men and 13
      women, with permanent AV block after fulguration and follow-up periods from 4 to
      58 months, escape rhythms data studied during the procedure and at short and long
      term periods, showed the following characteristics: 1) Classical parameters of
      valuation are not as a whole useful to evaluate subsidiary escape rhythms after
      electrical fulguration of the atrioventricular junction system. 2) The QRS
      morphology of the escape rhythm exhibited frequently right or left bundle branch
      block and specially the former. 3) Spontaneous variability of the escape rhythm
      recovery time makes this parameter unreliable. 4) Electrophysiological parameters
      previous to the shock and energy delivery do not predict the origin and
      characteristics of the subsidiary escape rhythms. 5) Active ventricular
      arrhythmias appearing immediately postshock are unrelated with any subsequent
      complication. 6) Permanent pacing increases pacemaker dependency at least
      temporarily. In 15 of 22 patients, a rate responsive multiprogrammable pacemaker
      controlled by QT interval was implanted. Cardiac performance and life-quality was
      improved in these patients due to the addition of several factors: 1) Control of
      the tachyarrhythmias. 2) Elimination of antiarrhythmic drugs and their side
      effects on ventricular function. 3) Self-regulation of cardiac rate through
      permanent stimulation with a QT sensitive rate responsive pacemaker.

PMID- 2236802
TI  - [Hemodynamic benefits of AV interval adjustment and heart rate increase during
      exercise in dual-chamber pacing as determined by Doppler].
AB  - In order to determine the relative significance of ventricular rate increase and
      AV delay on exercise cardiac output, we have studied 10 patients (8 male and 2
      female, 16-59 years) with complete chronic heart block treated with AV sequential
      pacing. Cardiac output variations (delta CO) were estimated by pulsed Doppler
      comparisons of the aortic flow velocity in the supine position, at rest and
      during bicycle exercise. The following pacing programs were tested: DDD with AV
      intervals of 50, 100 and 150 ms (DDD50 o DDDD100, DDD150), VVI at 70 ppm (VVI70),
      and VVI at the maximal available rate in this pacing mode-113 or 130 ppm
      depending on the PM type (VVIM). Exercise measurements in DDD mode were taken
      when that rate was reached. The delta CO was calculated as a percent change of
      the product flow velocity integral x heart rate, from that obtained with VVI70
      mode at rest. At rest, the delta CO obtained with DDD pacing was 20.4 +/- 14.7%
      and the optimal AV delay was 50 ms in 1 patient, 100 ms in 3 patients and 150 ms
      in six. During exercise, the delta CO was higher in DDD and VVIM modes (82.0 +/-
      30.8% and 56.2 +/- 37.6%, respectively; p less than 0.01) than in VVI70 mode
      (20.4 +/- 10.4%; p less than 0.005), the greatest delta CO was reached at DDD
      mode in 8 out of 10 patients (p less than 0.03). The optimal AV delays were 50 ms
      in 5 patients, 100 ms in 4 patients and 150 ms in one. Thus, DDD pacing with the
      optimal AV delay seems to obtain greater haemodynamic benefits during exercise
      than does rate-responsive pacing; the optimal exercise AV delay varies from
      patient to patient and is usually less than 150 ms.

PMID- 2236803
TI  - [Experience with dual-chamber pacemakers at the Valencia General Hospital].
AB  - We report our experience with dual chamber pacemakers in 70 patients (mean age
      64.5), of whom 42 had AV block and 28 sick sinus syndrome, nine of them
      associated with AV block. Other cardiac disease coexistent with the conduction
      disturbance was present in 57% of the patients. Follow-up was conducted after
      implantation at first, 3rd, 6th month, and thereafter each 6 months. Mean follow
      up was 20 +/- 14.3 months (2-72); of the 70 patients, 88% and 73% were followed
      at least for 6 and 12 months, respectively. Six patients (five had AV block) died
      17 months on average after implantation. All patients but one had concomitant
      cardiac disease. Eleven patients (15.6%) presented complications, being all of
      them related to atrial channel: reprogramming to VVI in five (7%), mainly due to
      chronic atrial fibrillation (4 patients), whereas in the other one was secondary
      to loss of pacing and sensing functions; acute dislocation corrected with
      reoperation in 3 patients (4.3%); temporary loss of atrial sensing in 2 patients,
      and chronic in the last one, with change to DVI mode. Overall, considering deaths
      and changes to VVI mode, 15.6% of patients were not be able to maintain dual
      chamber pacing. In conclusion, our results show: 1) low rate of major
      complications; 2) good outcome of patients suffering from sick sinus syndrome; 3)
      the development of chronic atrial fibrillation was the main limitation of DDD
      pacing system.

PMID- 2236804
TI  - [Anterograde tachycardia caused by the antitachycardia mechanism in a DDD
      pacemaker].
AB  - If there is a demonstrable ventriculo-atrial conduction at the time of a DDD
      pacemaker implantation, the possibility of a pacemaker mediated tachycardia is
      always present. The latest technological advances tries to solve this problem by
      the refractory time programmability and specially by the automatic extension of
      the atrial refractory period. A new and special mode of premature ventricular
      contraction-synchronous atrial stimulus has been developed as an additional and
      more effective mechanism anti pacemaker mediated tachycardia. We present one case
      in which this anti pacemaker mediated tachycardia mode just unchains one
      tachycardia. The understanding of this tachycardia doesn't offer difficulties and
      the correction would be made by different steps.

PMID- 2236805
TI  - [Clinical experience and long-term results of antitachycardia pacemakers in
      patients with supraventricular tachycardia].
AB  - Patients with episodes of recurrent paroxysmal supraventricular tachycardia,
      refracted to different pharmacologic therapies, can be treated with automatic
      antitachycardia pacemakers. Long term results of 8 patients (6 females and 2
      males), mean age 49.8 +/- 12.7 years, are presented. There were implanted an
      antitachycardia pacemaker 262-12 Intertach, with an electrode in right atrium.
      Electrophysiologic study showed a node reentry mechanism in 6 cases due to AV
      node functional dissociation; one case of accessory concealed pathway and other
      case with a double accessory pathway was undetected in the electrophysiologic
      study and it was the unique case in which the pacemaker was explanted due to
      their inefficiency. Every tachycardia were orthodromic with narrow QRS wave and
      mean cycle was 361 +/- 23 msec (range 310-400 msec). One case had two types of
      tachycardia, one with narrow QRS wave and other wide QRS wave tachycardia and
      different length of cycle what reduced to detect a previously double pathway. A
      reoperation was necessary in one case due to an electrode displacement and,
      finally, another one needed a reprogramming auricular sensitivity. Mean time
      follow-up was more than 2 years. Seven patients have sinusal rhythm without drugs
      and they have 6 months follow-up with a better quality of life, less hospital
      incomes and medical cares.

PMID- 2236806
TI  - [Sleep apnea syndromes and the pathology of respiratory disorders during sleep].

PMID- 2236807
TI  - [The physiology and pathology of sleep].

PMID- 2236808
TI  - [The upper airway and respiratory disorders during sleep].

PMID- 2236809
TI  - [The role of respiratory muscles in the interruption of the obstructive sleep
      apnea].

PMID- 2236811
TI  - [Diagnosis of sleep apnea syndrome].

PMID- 2236810
TI  - [Polygraphic registration during sleep].

PMID- 2236812
TI  - [From snoring to sleep apnea syndrome].

PMID- 2236813
TI  - [From sleep apnea syndrome to chronic respiratory insufficiency and right cardiac
      effects].

PMID- 2236814
TI  - [The epidemiology of sleep apnea syndrome in adults].

PMID- 2236815
TI  - [Surgical treatment of sleep apnea syndrome].

PMID- 2236816
TI  - [Instrument treatment of sleep apnea syndrome].

PMID- 2236817
TI  - [The medical treatment of sleep apnea syndrome].

PMID- 2236818
TI  - [Respiratory pathology during sleep in children].

PMID- 2236819
TI  - [Hypoxemia of chronic obstructive bronchopneumopathy and sleep].

PMID- 2236820
TI  - Perspectives and limits in the eradication of infectious diseases.
AB  - Eradication of an infectious disease on a global scale means that transmission of
      the disease has been completely vanished and the disease caused by the infection
      has totally disappeared. Regional eradication represents disappearance of an
      infection from a certain area or region whereas elsewhere it continues to be
      transmitted. Smallpox which was finally eradicated in 1977 had been progressively
      eliminated from one continent after another in the preceding years. At the
      present time regional elimination of paralytic poliomyelitis has almost succeeded
      in the USA, the United Kingdom, Europe and Asia through routine use of Sabin live
      oral vaccine. Paralysis associated with the use of this vaccine has continued
      with an extremely low incidence-rate. Contact-infection and spread of virus
      excreted by recently-vaccinated persons occur to a significant extent and
      fortunately with polioviruses mostly unchanged in virulence. The second disease
      with attempted regional elimination is measles. In the USA county-wide
      elimination was successful in 1985 in all but a minority of counties. There
      followed two years with many more cases before a decline in incidence resumed
      once again. Elsewhere the general sponsoring of immunization under the expanded
      programme (EPI) of WHO is slowly taking effect.

PMID- 2236822
TI  - [A clinico-epidemiological study on the efficacy of thymopentin therapy in
      patients with chronic bronchitis and cellular immunity deficiency].
AB  - The immunological in vivo effects of thymopentin (TP5) treatment in eleven hypo
      anergic patients affected with chronic bronchitis are reported. Significant
      improvement of cellular immunity, evaluated by skin tests, and an increase of
      percentage of CD4+ cells and natural killer activity are demonstrated. The
      clinical evaluation showed an evident reduction of infectious episodes of acute
      bronchitis after TP5 treatment.

PMID- 2236821
TI  - [The new aspect of pneumonia in an area of the Middle Adriatic].
AB  - The present work reports the findings of a ten-year, research, the aim of which
      is to outline current views of pneumonia in a zone of the Middle Adriatic (USL 17
      Regione Marche). The study confirmed, in its entirety, a lesser aggressiveness
      and loss of the "seasonal feature" of today's pneumonias. The high incidence of
      Atypical Pneumonia (AP) due to viral-like microorganisms (mycoplasma, chlamydia,
      coxiella, legionella) and an even higher one of unknown etiology is reported.
      After having analysed the most likely reasons for such a change and its various
      implications, the authors conclude that this type of research should be extended
      in order to trace a map of the more common infectious agents in single
      geographical zones, as an indispensable premise for a more concrete etiological
      diagnosis and for a more rational choice of the antibiotic.

PMID- 2236823
TI  - [Abdominal lymph node tuberculosis: a diagnostic surprise].
AB  - The case of a patient submitted to sonographic abdominal examination because of
      recent onset of fever, abdominal pain and weight loss, with the finding of
      multiple enlarged lymph nodes along great vessels, is reported. Because of the
      negativity of noninvasive procedures, the patient underwent laparatomy and
      biopsy. The histologic and bacteriologic diagnosis of tuberculous lymphnodes was
      unexpected, as the patient was unreactive to the tuberculin skin test and had no
      signs of active pulmonary tuberculosis. Although uncommon, tuberculosis must be
      included in the differential diagnosis of subdiaphragmatic lymphadenopathies even
      if symptoms of mycobacterial infection or other signs of the infections are not
      presented.

PMID- 2236824
TI  - Search of HIV DNA by polymerase chain reaction in the urine sediments of
      seropositive individuals.
AB  - We have utilized the polymerase chain reaction (PCR) technique to detect proviral
      sequences of the human immunodeficiency virus (HIV) from urine sediments of HIV
      seropositive individuals. HIV amplified DNA sequences, easily detectable in
      peripheral blood cells, were not found in the urine sediments of the seropositive
      individuals. This finding is in agreement with previous observations that the
      urines of seropositive individuals are not infective.

PMID- 2236826
TI  - [Pulmonary and tonsillar distribution of ceftriaxone and cefonicid and the
      resultant bactericidal activity of the organ].
AB  - The therapeutic efficacy of Ceftriaxone and Cefonicid 1 g I.M. single-dose
      against S. Pneumoniae, H. Influenzae and K. Pneumoniae in tonsil and lung
      infections was studied using bactericidal quotient (BQ). Samples of lung tissue
      and serum were obtained from two groups of surgical patients, treated with
      Ceftriaxone or Cefonicid 1 g I.M., 2-8-16 and 24 hours before surgery. From two
      other groups of 10 surgical patients, treated as above, samples of tonsil tissue
      and serum were obtained. In lung tissue the higher levels of Ceftriaxone and
      Cefonicid appeared at the second hour (11.54 +/- 1.59 mcg/g and 11.4 +/- 2.49
      mcg/g respectively); the lower values were observed at the 24th hour (2.18 +/-
      0.47 mcg/g for Ceftriaxone and 0.64 +/- 0.21 mcg/g for Cefonicid). Higher
      Ceftriaxone and Cefonicid levels also appeared in tonsil tissue at the 2nd hour
      (11.12 +/- 2.42 mcg/g and 9.22 +/- 3.12 mcg/g respectively); the lower values
      were observed at the 24th hour (1.54 +/- 0.46 mcg/g for Ceftriaxone and 0.42 +/-
      0.23 mcg/g for Cefonicid). BQ values were estimated using the ratio between the
      mean concentrations of Ceftriaxone and Cefonicid in tissue samples and the MBC
      mean values determined for the above mentioned pathogens, isolated in hospital.
      Ceftriaxone always showed BQ values greater than 1 during 24 hours versus levels
      observed for the three reported pathogens. Cefonicid showed BQ values greater
      than 1 during 24 hours against S. Pneumoniae and BQ values less than 1 for 6-8
      hours against H. Influenzae and for 1-4 hours against K. Pneumoniae.

PMID- 2236825
TI  - Empiric antibiotic and antifungal therapy for granulocytopenic patients with
      acute leukemia.
AB  - A prospective study was undertaken to determine the effectiveness of an empiric
      antibiotic treatment employing the combination of a beta-lactam and an
      aminoglycoside followed in non responders by vancomycin and amphotericin B after
      48 and 96 hours respectively. We have evaluated 180 febrile episodes in 102
      granulocytopenic leukemic patients. Febrile episodes (44%) were microbiologically
      documented; 29% were only clinically documented and 27% were possible. In the 180
      evaluable episodes treated with a beta-lactam and an aminoglycoside the overall
      response rate was 61%. In non responders the addition of vancomycin increased the
      response rate to 83% and the subsequent addition of amphotericin B moved the
      total responders to 96%. Antibiotic related side effects were minimal. These data
      suggest the importance of an empiric strategy for treatment of bacterial
      infections arising in granulocytopenic patients. An early empiric antifungal
      therapy also appears necessary to control clinically undetected fungal invasion.

PMID- 2236827
TI  - [Disulfiram-like effect of cefonicid: first observation].
AB  - The disulfiram-like reaction is linked to the assumption of ethyl alcohol during
      therapy with the cephalosporin latamoxef, cefamandole and cefoperazone. The
      reaction is commonly ascribed to the methyl-thiotetrazole group, resembling part
      of the disulfiram molecule. We describe the case of a patient who experienced on
      two different occasions a disulfiram-like effect during therapy with cefonicid.
      This cephalosporin contains the methylsulphothiotetrazole group in place of the
      methylthiotetrazole group. Our observation is the first related to cefonicid.

PMID- 2236828
TI  - [Clinico-hematological evaluation of 57 patients undergoing antiaggregant
      treatment with indobufen].
AB  - A long-term administration of Indobufen, 400 mg daily, was evaluated in 57
      patients with cardiovascular diseases. Aggregation waves induced by ADP, collagen
      and epinephrine showed a significant and persistent inhibition of platelet
      function. Minor side effects were observed and in 6 patients the drug was
      withdrawn: 4 patients began to experience gastric troubles, 1 patient had
      positive occult test for blood, 1 patient developed an allergic rush. Clinical
      evaluation and platelet aggregation study before starting indobufen and during
      the follow up period seem to be useful in the evaluation of effectiveness,
      safety, compliance and suitable daily dose.

PMID- 2236829
TI  - [Severe hemorrhagic thrombopenia during epidemic rubella. Description of 2
      cases].
AB  - The authors describe two cases of severe hemorrhagic thrombocytopenia during
      epidemic rubella. They evaluate the pathogenetic mechanisms.

PMID- 2236830
TI  - [Professional responsibility of the hospital physician].

PMID- 2236832
TI  - Hormone-related malignant tumors.

PMID- 2236831
TI  - [Tuberculosis and mycobacteriosis in HIV-1 infection].
AB  - Tuberculous and mycobacterial infections and diseases increase now everywhere.
      Patients HIV-1 infected or with AIDS get more and more a mycobacterial
      complication. The clinical and radiological features of this event are: the
      bilateral extension in the lung, the importance of these lesions, the atypical
      appearance of radiological shadows, the frequency of other concomitant
      opportunistic pneumopathies of non-mycobacterial origin. Tuberculosis are almost
      always induced by drug-sensible mycobacteria which usually allows clinical
      healing or clinical improvement.

PMID- 2236833
TI  - Adrenocortical tumors: clinical and diagnostic findings.

PMID- 2236834
TI  - Contributions of nuclear endocrinology to the diagnosis of adrenal tumors.

PMID- 2236835
TI  - Aspects of surgical therapy of adrenal tumors.

PMID- 2236836
TI  - Molecular biology of the male endocrine system.

PMID- 2236837
TI  - Development of hormone refractory tumors: adaption versus clonal selection.

PMID- 2236838
TI  - Localization of hormones by antibodies.

PMID- 2236839
TI  - Basic and clinical relevance of hormonal influence in breast cancer.

PMID- 2236840
TI  - Hormonal therapy in endometrial carcinoma.
AB  - Although hormonal agents have been used to treat endometrial cancer for nearly 30
      years, response rates have remained essentially unchanged. Furthermore, objective
      response rates vary considerably from institution to institution, presumably
      because of differences in accepted response criteria and patient selection. The
      latter is particularly influenced by the distribution within the treated
      population of well-differentiated and poorly differentiated tumor histologic
      types. Nevertheless, the rapid attrition after hormonal therapy begins and the
      limited long-term salvage in nonselected patients with advanced primary or
      recurrent disease suggest primary nonresponsiveness or acquired tumor
      refractoriness to hormonal therapy. The determination of tumor progesterone
      receptor levels has made it easier to identify patients with sensitivity to such
      therapy. Recent investigations have shown favourable response rates (72%) after
      administration of progestational agents in patients with progesterone receptor
      rich tumors. Similarly, responses have been reported with antiestrogens and
      combination progestin-antiestrogen therapy, recent laboratory observations having
      suggested potential benefit from sequential administration. Although these
      clinical and laboratory findings are encouraging, the limited duration of
      objective responses and the poor long-term survival rates continue to temper
      enthusiasm for routine hormonal therapy. Properly stratified (according to
      pathologic, biochemical, and clinical criteria), prospective, randomized, double
      blind studies with more definitive end points, such as progression-free survival
      and overall survival, are mandatory to further evaluate the merits of various
      therapeutic regimens using gonadal hormones.

PMID- 2236841
TI  - Hormone-secreting ovarian tumors.

PMID- 2236842
TI  - Ovarian hormones and carcinoma of the uterine cervix.

PMID- 2236843
TI  - Tumours of the adrenal gland.

PMID- 2236845
TI  - Advances in breast cancer detection. The Fourth International Copenhagen
      Symposium. Copenhagen, August 1988. Proceedings.

PMID- 2236844
TI  - Clinical and diagnostic findings in patients with chromaffin tumors:
      pheochromocytomas, pheochromoblastomas.

PMID- 2236847
TI  - Earlier detection of breast cancer: an overview.

PMID- 2236848
TI  - Stereotactic, X-ray guided, fine needle aspiration biopsy of nonpalpable breast
      lesions: comparison with the coordinate grid localization technique.

PMID- 2236846
TI  - Relative doses in mammography: the future development of film/screen mammography
      systems.

PMID- 2236849
TI  - Stereotactic breast puncture: an indispensable complement to the detection of
      breast cancers within the framework of a screening program.

PMID- 2236850
TI  - Stereotaxic fine needle aspiration of nonpalpable breast lesions with the
      cytoguide unit: first experiences.

PMID- 2236851
TI  - Preoperative diagnostic and prognostic information on nonpalpable breast tumors.

PMID- 2236852
TI  - Why and by whom are patients referred for mammography?

PMID- 2236853
TI  - Imaging techniques other than mammography for the detection and diagnosis of
      breast cancer.

PMID- 2236854
TI  - Breast ultrasound in the detection of breast cancer.

PMID- 2236855
TI  - A new method for assessment of radiation risk from screening mammography.

PMID- 2236856
TI  - Should breast self-examination be included in a mammographic screening program?

PMID- 2236858
TI  - Inflammatory disease of the breast.

PMID- 2236857
TI  - Imaging the breast treated by segmental mastectomy and irradiation.

PMID- 2236859
TI  - Stellate lesions of the breast.

PMID- 2236860
TI  - Screening for breast cancer: opportunities, status and challenges.
AB  - Screening mammography and physical examination have made major contributions to
      the earlier detection of breast cancer. Mammography is the only reliable means of
      detecting nonpalpable cancers and can detect many minimal breast cancers when
      they appear to be curable. Low-cost, high-quality mass screening mammography,
      accurately interpreted, is feasible and could reduce overall mortality from
      breast cancer if it were more widely applied. Recognition of the need and desire
      to provide the service are essential initial motivating factors. The challenge to
      radiology is to obtain sufficient competent personnel and facilities.

PMID- 2236861
TI  - Follow-up studies of the health insurance plan study and the breast cancer
      detection demonstration project screening trials in the USA.

PMID- 2236862
TI  - Low-cost mass screening as a means of reducing overall mortality from breast
      cancer.
AB  - Mammography is a screening method that has been proven effective and could
      significantly reduce the overall mortality from breast cancer if it were more
      widely applied. The challenge to radiology is to provide sufficient competent
      personnel and adequate facilities such that reproducibly optimal screening
      mammography, accurately interpreted at the lowest possible cost, is made widely
      available.

PMID- 2236863
TI  - Screening for breast cancer with mammography in Bohuslan County, Sweden.
AB  - The unique organization of breast cancer screening in Bohuslan, using a specially
      designed mammography bus, has allowed women from a relatively large area to be
      screened for breast cancer. The cooperation with radiologists and surgeons at the
      central hospitals in the county is very positive and interesting. As can be
      appreciated, this is a very streamlined and efficient operation. So far, we have
      arrived at the same results as pilot investigations in other counties.

PMID- 2236865
TI  - Quality requirements in mammographic screening in Sweden.

PMID- 2236864
TI  - Evaluation and comparison of mammographic quality at facilities participating in
      a regional breast cancer awareness program.

PMID- 2236866
TI  - One versus two views per breast for screening mammography.

PMID- 2236867
TI  - Mammographic features of malignancy found during screening.
AB  - Mammographic detection of nonpalpable breast cancer permits earlier diagnosis and
      reduces mortality from the disease. The increasing emphasis on screening
      asymptomatic women with mammography is placing the responsibility for tumor
      detection more and more in the hands of the radiologist. While it has long been
      known that cancer can present mammographically with less than textbook features
      of malignancy, it has only recently become apparent that this occurs frequently
      among nonpalpable neoplasms, just those tumors that we must discover by
      screening. Radiologists must learn to search carefully, not only for
      characteristic tumor masses and clustered calcifications, but especially for the
      more subtle and indirect signs of malignancy.

PMID- 2236868
TI  - Breast cancer screening in Iceland: preliminary results.

PMID- 2236869
TI  - Role of epidemiology in health risk assessment.
AB  - Human health risk assessment has been the object of systematic study in recent
      years, with formal models of risk assessment and risk management having been
      proposed by several national and international health agencies. The particular
      model developed by the Environmental Health Directorate of Health and Welfare
      Canada was examined in some detail and used to focus on the role of epidemiology
      in the overall process of risk assessment. In addition to providing information
      fundamental to the identification of environmental carcinogens and the estimation
      of carcinogenic risks, epidemiology may also play a role in shaping risk
      perception and in improving risk communication practices. Taken collectively,
      epidemiologic data on health risks provide a basis for improved disease
      surveillance and prioritization of public health concerns. Both descriptive and
      analytic epidemiologic protocols may be used to gather information on disease
      etiology. Because of the potential for bias and confounding in observational
      studies of human populations, epidemiological data should be subjected to careful
      evaluation in accordance with established criteria before a causal relationship
      between exposure and disease is inferred. Toxicological studies using nonhuman
      test systems may be used to avoid these problems, but at the expense of obtaining
      indirect information on human health risks. Nonetheless, toxicological data
      provide an important complement to epidemiological data, providing information on
      potential health risks in advance of human exposure and offering a means of
      indirectly assessing risks in situations where human studies fail to provide
      informative results. The complementary roles of epidemiology and toxicology in
      health risk assessment were examined using four case studies. While the
      epidemiological evidence linking tobacco consumption to lung cancer is now
      unequivocal, the corresponding data on involuntary smoking, although strongly
      suggestive of increasing the relative risk of lung cancer, requires further
      confirmation before providing the same degree of evidence as now exists for
      active smoking. At present, the best estimates suggest that overall mortality
      attributable to active smoking may exceed that due to passive smoking by roughly
      100-fold. Despite this large difference in health impact, passive smoking
      continues to be the focus of much public concern, in part because of the
      involuntary nature of the risk involved. Because of the abundance of good
      epidemiological data on tobacco, toxicology has assumed a secondary role in
      defining the health risks associated with smoking. In contrast, while
      epidemiological studies with saccharin and formaldehyde have provided unequivocal
      evidence of carcinogenic effects in animals exposed to high doses, thereby
      raising concerns over potential human carcinogenicity.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 2236871
TI  - Cancer risks due to asbestos and man-made fibres.

PMID- 2236870
TI  - Identification of occupational cancer risks using a population-based cancer
      registry.
AB  - The study of Xuan Wei fuel use and lung cancer mortality and also the interim
      case-control study suggested an association between domestic smoky coal use and
      Xuan Wei lung cancer. The collaborative studies of physical characterization,
      chemical analysis, and toxicology further substantiated this linkage. The Xuan
      Wei residents who used smoky coal inhaled extremely high concentrations of mostly
      submicron-sized particles, which can be inhaled and deposited effectively deep in
      the lung. These fine particles were composed mostly of organic compounds (72%),
      including mutagenic and carcinogenic organic compounds, especially in the
      aromatic and polar fractions. These residents were exposed to polycyclic aromatic
      compounds, such as benzo[a]pyrene, at comparable or higher levels than those
      measured in coke oven plants and other occupational environments (International
      Agency for Research on Cancer 1984). In comparison with wood and smokeless coal
      combustion emissions, the organic extracts of smoky coal emission particles
      showed much higher activity of genotoxicity and carcinogenicity. These results
      all point to a strong etiological link between the complex organic mixtures from
      smoky coal emissions and Xuan Wei lung cancer. This study and studies reported by
      other investigators (de Koning et al. 1984) suggested little association between
      indoor open-fire wood smoke and lung cancer. The less efficient lung deposition
      of the larger particles from wood combustion, as well as the lower concentrations
      of biologically active organic compounds, may contribute to the low rate of lung
      cancer in the wood-burning communes. As to the smokeless coal emissions, the
      lower particulate concentration and the lower organic content of the particles
      emitted may also contribute to the low lung cancer rate in the commune using this
      fuel. In conclusion, the complex organic mixtures from combustion emissions are
      genotoxic and carcinogenic in animal and in vitro assays. The magnitude of the
      cancer risks from the complex organic mixtures in man depends on the degree of
      the exposure, the types of the compounds contained in the mixtures, and the
      concentrations of these biologically active compounds present in the combustion
      emissions.

PMID- 2236872
TI  - Herbicides and cancer: a review and discussion of methodologic issues.

PMID- 2236873
TI  - Cancer risks from exposure to radon progeny in mines and dwellings.

PMID- 2236874
TI  - Cancer risks due to exposure to electromagnetic fields.

PMID- 2236875
TI  - Human lung cancer risks due to complex organic mixtures of combustion emissions.

PMID- 2236876
TI  - Discovering occupational carcinogens in population-based case-control studies:
      review of findings from an exposure-based approach and a methodologic comparison
      of alternative data collection strategies.

PMID- 2236877
TI  - Recent approaches to retrospective exposure assessment in occupational cancer
      epidemiology.

PMID- 2236878
TI  - Effects of measurement errors on estimates of exposure-response relationships.

PMID- 2236879
TI  - Adjustment for confounding in occupational cancer epidemiology.

PMID- 2236880
TI  - Statistical issues in the analysis of data from occupational cohort studies.

PMID- 2236881
TI  - Towards an automated micronucleus assay as an internal dosimeter for carcinogen
      exposed human population groups.

PMID- 2236882
TI  - Keep the fire burning.

PMID- 2236883
TI  - Stressors and stress management--1 month after myocardial infarction.
AB  - Stressors and stress management behaviors reported by 52 myocardial infarction
      (MI) patients were identified from a content analysis of transcriptions of
      nurse/patient/spouse interactions that took place 30 days postinfarction.
      Subjects defined stress primarily in terms of distress related to appraisals of
      harm, loss, or threat. Stressors and stress management behaviors varied, although
      subjects were similar in age and occupation and were in the same phase of
      recovery. Most stressors related to recent myocardial infarction and pertained to
      thoughts and feelings more than to external events. Others, related to family
      and/or work, were ongoing before the MI. Stress management behaviors comprised a
      continuum of physical, cognitive, and verbal behaviors ranging from active to
      passive. Avoidance of situations, ignoring situations, expressing feelings, and
      thinking things through were the four major modes of stress management behaviors.
      Implications for rehabilitation nursing practice are identified.

PMID- 2236884
TI  - The self-help movement in head injury.
AB  - The purpose of the research project reported in this article was to describe head
      injury support groups and compare them to other types of self-help groups. A 21
      item questionnaire inquired about the impact, benefits, and description of the
      support group selected for study. Seventy-seven members of four randomly selected
      state chapters of the National Head Injury Foundation (NHIF) answered the survey.
      Eighty-two percent of the members felt that their membership was helpful in their
      adjustment. The perceived benefits of the groups were (a) to obtain information
      on head injury; (b) to be with others who were experiencing the same ordeal; (c)
      to increase awareness about head injury; and (d) to learn about available
      resources.

PMID- 2236885
TI  - Bowel continence for the child with a neurogenic bowel.
AB  - For more than 10 years, the Alfred I. duPont Institute's Spinal Dysfunction
      Clinic in Wilmington, DE, has helped families and their children with
      myelomeningocele and neurogenic bowels to establish workable, acceptable,
      physiologically sound bowel programs. The basic bowel management program at the
      Alfred I. duPont Institute is described here, as is a program by which a child
      with a neurogenic bowel can obtain continence. The program is based on the
      child's developmental level, physiological abilities, and any necessary
      pharmacologic intervention. The program has enabled approximately 75% of its
      child patients over age 5 with neurogenic bowel to be continent of stool.

PMID- 2236886
TI  - Heparin lock for nighttime intravenous fluid management in a dysphagic patient.
AB  - Dysphagia, with its inherent risk of aspiration, is a clinical problem frequently
      encountered in patients with brain injury from trauma or cerebrovascular
      accident. The use of nasogastric tubes and intravenous lines for nutrition and
      hydration can be cumbersome and uncomfortable for the patient, and can interfere
      with rehabilitation therapy. With the advent and increased use of video- and
      cinefluoroscopy to evaluate swallowing, the type of dysphagia can be defined more
      readily. This article describes the use of a heparin lock at night to provide
      fluids intravenously to a patient who could swallow solid or semisolid food, but
      aspirated thin liquids. This approach insured adequate hydration while keeping
      the patient free of parenteral lines and nasogastric tubes during therapy. This
      technique was continued for 3 1/2 weeks until the patient's dysphagia improved
      and a full oral diet could be resumed. The authors recommend the use of nighttime
      intravenous feeding via a heparin lock as an option for managing this subset of
      dysphagic patients in a rehabilitation setting.

PMID- 2236887
TI  - Roles of a new rehabilitation director of nursing.

PMID- 2236889
TI  - Need for pediatric content.

PMID- 2236888
TI  - The Neuman Systems Model: an analysis of a clinical situation.

PMID- 2236890
TI  - [What has spinal stabilization contributed for the paraplegic patient?].
AB  - The aim of spondylodesis is to restore the injured spinal column to its previous
      shape and stability. In the transverse SCI patient, it entails easier intensive
      care in case of multiple injury as well as easier general nursing tasks, and
      greater intensity of physiotherapy in the acute and early phases. Compared to
      conservative management of the injured spinal column, mobilization is effected
      some 21 to 39 days earlier in surgical patients, total hospitalization in
      tetraplegics is shortened by 5 days, and by 34 to 57 days in paraplegic patients.
      Functionally valuable neurological recovery in primary complete paralysis occurs
      in 19%/20% of conservative/surgical cases, in primary partial paralysis in
      67%/58%. Stabilization of the spinal column however does not at the same time
      achieve a stabilization of the transverse SCI patient's entire situation-
      physical, psychological, social. Irrespective of the scope of paralysis, the
      advantages of a spondylodesis should be considered also in case of total
      paraplegia. Conservative management retains its importance in cases where surgery
      is not indicated, or even contraindicated. Comparable results are very rarely
      achieved outside the specialized centres. Acute cases of SCI should therefore be
      referred to spinal centres as soon as possible, which for their part have to be
      able to admit patients 24 hours a day, as well as to provide adequate care until
      completion of the entire treatment.

PMID- 2236891
TI  - [Vocational rehabilitation of psychiatrically handicapped people].
AB  - The article describes the working concepts of "Lankwitzer Werkstatten", a
      facility for vocational rehabilitation of persons with (chronic) mental illness.
      The working concept of this sheltered workshop is crafts- and service-oriented.
      Some 60 rehabilitees and sheltered workshop employees work in four small "shops".
      Work structures and everyday organization are somewhat unusual in that they
      follow general labour market conditions as closely as possible. In their working
      structures, the sheltered workplaces usually do not differ from workplaces in
      small crafts enterprises of the general labour market. As far as remuneration is
      concerned, the workshop is in a position to at least envisage levels of pay that
      will ensure independence from social assistance supplements if the facility's
      technical equipment can be kept current and work planning made more efficient.
      Within the limits of the legal possibilities, and making the most of them, both
      the diagnostic-prognostic benefits of the entry procedure in the work training
      process as well as the placement opportunities for rehabilitees in the general
      labour market are being utilized, with occasionally very successful outcomes.

PMID- 2236892
TI  - [Didactic problems of education and instruction of patients with craniocerebral
      trauma].
AB  - While concepts for the solution of didactical-methodological problems are
      available for brain-injured children and young people, such concepts are almost
      nonexistent for adults with craniocerebral trauma sequels. A case example is
      presented from an educationist perspective, illustrating the disruptive impact of
      craniocerebral trauma on the person's biography. Didactical and methodological
      problems not only arise from deficient cognitive functioning but also due to the
      psychosocial impact of severe brain trauma. Inter alia dealt with is the question
      of whether an independent didactical approach is needed, or whether concepts
      derived from general didactics can be applied. For learners with craniocerebral
      trauma, "learning theory-based didactics" is an especially suitable model; a
      brief description is given, and its application to the specific situation of this
      population outlined. People with brain trauma display problems in knowledge
      acquisition and concept formation (cognitive learning), in transfer of learning
      content and performance control. Though an independent didactical concept may not
      be necessary, it is however crucial that in respect of the teaching/learning
      processes in this population, due attention is being paid to methodological
      principles applied in the special education field.

PMID- 2236893
TI  - [The state of professional psychological guidance for patients with multiple
      sclerosis].
AB  - Over a period of two years, a total of 847 patients with multiple sclerosis (283
      male and 564 female aged 18 to 79 years) were interviewed relative to the
      psychological care provided. Two patients currently participated in regular
      client-centered group therapy, 11 patients had regularly attended individual or
      group psychotherapy in previous years, and one patient had undergone family
      therapy several years ago. Another 26 patients reported occasional supportive
      counselling by their neurologist or family doctor in the framework of outpatient
      care. Ten patients used relaxation techniques such as autogenic training, and 42
      patients reported emotional benefit from contacts within an MS self-help group.
      The findings of our study show that professional psychological care of persons
      with MS is extremely sparse, substantiating the call for better psychological
      services in coping with MS.

PMID- 2236894
TI  - Interregional elderly migration and population redistribution in four
      industrialized countries. A comparative analysis.
AB  - Though differing in cultures, languages, and socioeconomic attributes, the
      industrialized nations of the world share a common characteristic: relatively low
      fertility levels and relatively high proportions of elderly people. These elderly
      persons are not spread uniformly across their national territories; they exhibit
      distinct population geographies. This article examines the elderly migration and
      population redistribution process in four industrialized countries, identifies
      their principal retirement regions, and analyzes the sources of regional elderly
      population growth in these regions. It concludes that the United Kingdom and the
      United States are approaching the final stages of their "elderly mobility
      transition," whereas Japan is only entering the first stage, with Italy occupying
      a position somewhere in between.

PMID- 2236895
TI  - The experience of micro- and macroevents. A life span analysis.
AB  - This study investigated how individuals retrospectively construe their lives in
      terms of major life events. Ninety-nine participants sorted a set of personal and
      historical events in terms of perceived importance for their lives. Analyses of
      variance with repeated measures and rank comparisons were computed. Overall
      findings revealed no cohort differences with regard to the perception of life
      events. However, within-cohort differences were found, indicating that more life
      events were recalled from the young adult years. Those experiences were also
      perceived as having been more important in the participants' lives than events
      from other age segments. With regard to historical events, war-related
      experiences were among the highest ranked. Analyses of variance revealed
      intracohort differences but not intercohort differences, indicating higher scores
      for the time between 1930 and 1948 relative to other historical periods.

PMID- 2236896
TI  - Feasibility and efficacy of verbal consents.
AB  - Refusal rates for participation in geriatric research have been surprisingly
      high. This may be due in part to inherent difficulties with a written consent
      procedure. A simple, easily administered, standardized verbal consent procedure
      (VCP) for the institutionalized elderly was developed to address this problem. Of
      114 patients eligible for enrollment in a study evaluating outcomes of group
      psychotherapy, 100 gave verbal consent. When written consent was requested, 60
      signed immediately; 35, only after substantial coaxing. Five patients refused to
      sign a consent form, although verbally agreeing to participate. It is estimated
      that the number of study participants would have been reduced by 40% had written
      consent been required. The findings raise ethical and logistical issues
      pertaining to a verbal consent procedure.

PMID- 2236898
TI  - In vivo and perfused liver caffeine kinetics in the rat.
AB  - The kinetics of caffeine (1,3,7-TMX) was investigated in male rats given four
      different doses (1, 2.5, 10 and 25 mg/kg), comparing the patterns found in vivo
      and after liver perfusion. The same animals were used in both experimental
      conditions in order to reduce the variability of the caffeine profile. For doses
      less than 10 mg/kg or mg/L, caffeine blood or perfusate concentrations/time
      profiles followed first-order kinetics and the elimination rate constant (average
      0.013 min-1) and half-life (55 min) were similar for the in vivo and ex vivo
      conditions. After larger doses (10 and 25 mg/kg or mg/L), kinetics were
      nonlinear. The area under the blood or medium concentration-time curve increased,
      but not in proportion to the dose, and modifications of pharmacokinetic
      parameters were observed, with significant differences for t 1/2 and CL after 10
      and 25 mg/kg or mg/L, due to dose-dependent elimination of caffeine at these
      doses (Km of 8.3 and 7.8 micrograms/ml in vivo and in vitro, respectively). The
      two different approaches gave close kinetic estimates in vivo and in vitro. Thus,
      under standardized conditions, the isolated perfused liver technique is a useful
      tool for studying the kinetics of drugs eliminated by hepatic metabolism.

PMID- 2236897
TI  - Effects of anticholinergic antiparkinsonian drugs on binding of muscarinic
      receptor subtypes in rat brain.
AB  - Anticholinergic antiparkinsonian drugs have been widely used for the treatment of
      extrapyramidal disorders for a long time although their pharmacological
      characterization has been unclear. We studied the rank of potency of the effects
      of anticholinergic antiparkinsonian drugs to binding of 3H-QNB and 3H-PZ and
      calculated the affinity of each drug to the M1 receptor. All the drugs were
      potent inhibitors of 3H-QNB and 3H-PZ binding. The order of potency for 3H-QNB
      being: mazaticol greater than atropine greater than piroheptine greater than
      trihexyphenidyl greater than biperiden greater than ethopropazine greater than
      pirenzepine. The order of potency for 3H-PZ being: mazaticol greater than
      atropine greater than trihexyphenidyl greater than biperiden greater than
      ethopropazine greater than pirenzepine. Ki ratio indicated that trihexiphenidyl
      and biperiden bound to the M1 receptors selectively with high affinity and
      mazaticol would bind to the M2 receptors with higher affinity than atropine.
      These data suggest that we may be able to consider the pathophysiology of some
      extrapyramidal disorders based on the therapeutic efficacy of anticholinergic
      drugs which selectively affect M1 or M2 receptors.

PMID- 2236899
TI  - Plasma calcitonin levels in patients with cystic fibrosis.
AB  - Plasma levels of calcitonin were investigated in patients with cystic fibrosis
      and compared with age- and sex-matched healthy controls. About forty per cent of
      the cystic fibrosis patients had plasma calcitonin levels that were markedly
      higher than normal. Elevated levels were found predominantly in female patients.
      In general, patients with marked pulmonary involvement had high plasma calcitonin
      levels. Immunoextraction and gel chromatography, carried out on plasma of one of
      the patients demonstrated monomer-like forms of calcitonin similar to those found
      in the healthy subjects.

PMID- 2236900
TI  - Effects of dietary supplementation with n-3 fatty acids on kidney morphology and
      the fatty acid composition of phospholipids and triglycerides from mice with
      polycystic kidney disease.
AB  - The DBA/2FG-pcy strain of mouse has been developed as an animal model for adult
      polycystic kidney disease and we have determined the effects of feeding an n-3
      fatty acid-enriched diet on kidney morphology and the fatty acid compositions of
      the constituent phospholipid and triglyceride fractions in this strain. Twelve
      male and female DBA/2FG-pcy mice were fed lab chow or semi-purified diets
      containing sunflower seed oil (SO) or a n-3 fatty acid-enriched concentrate
      (MaxEPA) for 60 days. At necropsy, blood and urine samples were taken and the
      kidneys processed for examination by light microscopy. Gas-liquid chromatography
      of the fatty acids in the kidney lipids was also performed. Male and female mice
      fed the MaxEPA-based diet tended to have lower mean kidney weights. Hematocrits,
      blood urea, and serum creatinine levels were similar among the lab chow-, SO- and
      MaxEPA-fed groups. All the groups exhibited a moderate hematuria; the incidence
      of this symptom was lowest in the MaxEPA-fed male animals. Extensive tubular
      dilatation was apparent in the cortices and medullae from the lab chow-fed
      animals; these lesions were slightly less severe in the SO-fed group and least
      severe in kidneys from the MaxEPA-fed animals. By morphometry, the renal area
      occupied by cysts was also lowest in the male Max-EPA-fed group; females fed the
      MaxEPA-based diet did not show a marked decrease in the proportion of kidney area
      occupied by cysts. Fatty acid compositions of the total phospholipid and
      triglyceride fractions from kidneys of male mice fed the MaxEPA-based diet showed
      a reciprocal replacement of the n-6 fatty acids with the n-3 fatty acids compared
      to kidneys from males fed the SO-based diet.

PMID- 2236901
TI  - Verapamil-induced creatine kinase loss from rat slow and fast muscles.
AB  - The purpose of this study was to determine the dose-response relationship between
      verapamil HCl and creatine kinase (CK) release from isolated rat slow (soleus, S)
      and fast (flexor digitorum profundus, F) skeletal muscles. Total CK activity in F
      muscle was approximately 2x greater than in S muscle. For both S and F muscles,
      CK release as a function of verapamil concentration in the incubation medium was
      linear (r = 0.94); the slope of the line for F muscle was 4.5x that of the S
      muscle. S and F muscles lost up to 38-44% of their total CK activity during the 2
      hr incubation. The CK activity lost to the medium was 100% of the MM isoform. The
      mechanism of the enzyme release is not known.

PMID- 2236902
TI  - Chronic carbamazepine treatment and folate-dependent one-carbon metabolism.

PMID- 2236903
TI  - Dependence of benzo(a)pyrene metabolism on NADPH pool in normal and glucose-6
      phosphate dehydrogenase deficient human fibroblasts.
AB  - Human skin fibroblasts (HSF), from normal donors and donors carrying the
      Mediterranean variant of glucose-6-phosphate dehydrogenase, grown in vitro in the
      presence of 0.25-5 microM benzo(a)pyrene (BaP), produced the following organic
      soluble metabolites: 9,10-diol, 7,8-diol, quinones, 3- and 9-hydroxide and a more
      polar fraction, and the following water-soluble metabolites: more polar, 3- and 9
      hydroxide and 9,10-diol. Single organic- and water-soluble metabolites increased
      with BaP concentration in both types of HSF, but the ratio normal/variant
      increased with BaP concentration. NADPH level and NADPH/NADP+ ratio underwent a
      slight decrease in normal HSF incubated with 2.5 microM BaP, while a greater fall
      occurred in the deficient HSF at 0.25 and 2.5 microM BaP. NADPH content seems to
      be rate-limiting for BaP metabolism in the deficient cells.

PMID- 2236904
TI  - Lovastatin-acetaminophen subchronic toxicity in mice.
AB  - A subchronic, toxicity study of lovastatin-acetaminophen combination in s/w mice
      is reported. Oral administration of lovastatin in corn oil 30 mg/kg three times a
      week and acetaminophen 0.75% w/v in drinking water for 13 weeks resulted in
      significant increase in SGPT (ALT) in both male and female mice. Histopathology
      of the liver revealed centrilobular hepatocyte swelling. These results provide
      evidence of hepatic injury in s/w mice when concomitantly exposed to lovastatin
      and acetaminophen.

PMID- 2236905
TI  - The effect of phenobarbital on the impairment of drug metabolism by carrageenan
      induced inflammation in male rat.
AB  - Treatment of male rats with phenobarbital markedly stimulated, the activity of
      the hepatic microsomal monooxygenase system while in rats bearing carrageenan
      induced inflammation the activity of this system was lowered. When both agents
      were administered together, the stimulatory effect of phenobarbital and the
      inhibitory effect of carrageenan-induced inflammation cancelled each other.

PMID- 2236906
TI  - An outbreak of congenital hydranencephaly and cerebellar hypoplasia among calves
      in South Kyushu, Japan: a pathological study.
AB  - An outbreak of congenital hydranencephaly and cerebellar hypoplasia occurred
      between November 1985 and May 1986 in Miyazaki, South Kyushu, Japan. Seventy
      three calves had nervous signs of varying severity such as inability to stand,
      locomotor difficulties, defective vision and difficulty in sucking. At necropsy,
      62 calves had macroscopic lesions in the central nervous system: hydranencephaly
      accompanied by cerebellar hypoplasia in 47; hydranencephaly alone in eight; and
      dilatation of the lateral ventricle in seven; none had arthrogryposis.
      Microscopically, all 62 cases involved various degrees of hypoplasia of neural
      components, such as total or partial thinning of the cerebral or cerebellar
      laminae. Heterotopia, such as abnormal islands of granule cells or Purkinje cells
      was also observed. Fourteen of these animals had other lesions such as non
      purulent encephalitis, focal gliosis, neuronal degeneration, calcification or
      pseudocalcification, and cholesterol deposits, activation of vascular endothelial
      cells and haemorrhage. From the findings, these cases were considered to
      represent mainly hypoplasia of nerve tissue due to infection with a virus
      different from Akabane virus.

PMID- 2236907
TI  - Effect of copper oxide wire particle treatment on establishment of major
      gastrointestinal nematodes in lambs.
AB  - Eighty-four 10-week-old lambs were used to investigate the effect of copper oxide
      wire particle treatment on the establishment of major gastrointestinal nematodes.
      They were maintained on pasture previously treated to minimise larval
      contamination. Five grams of uniform sized copper oxide wire particles were given
      orally five days before infection with either 20,000 Trichostrongylus
      colubriformis larvae, 20,000 Ostertagia circumcincta larvae or 3000 Haemonchus
      contortus larvae given as three doses at three-day intervals. The animals were
      slaughtered 21 or 22 days after the last infective dose. Parasite burdens in the
      lambs treated with copper oxide wire particles were reduced by 96 per cent in the
      case of H contortus and by 56 per cent in the case of O circumcincta compared to
      burdens in controls. There was no significant effect of copper particles on the
      establishment of T colubriformis.

PMID- 2236908
TI  - Passive protection of piglets by monoclonal antibodies against experimental
      infection with Actinobacillus pleuropneumoniae.
AB  - Mouse monoclonal antibodies 11C11 (an IgG) and 4A9 (an IgM), which combine with a
      superficial component of cells belonging, respectively, to serovars 1 or 3 of
      Actinobacillus pleuropneumoniae, were given intraperitoneally 24 hours before and
      intranasally one hour before two-week-old, colostrum-deprived piglets were
      exposed by the intranasal route to 10(9) viable cells of either strain Shope 4074
      (serovar 1) or 2/10 (serovar 3). Compared with control piglets given phosphate
      buffered saline or the heterologous monoclonal antibody, this procedure conferred
      substantial protection against the development of peracute or acute
      pleuropneumonia. Protection against the experimental disease was somewhat less in
      other piglets to which monoclonal antibody 4A9 was given only by the intranasal
      route one hour before the organism was administered than in those given the
      antibody intraperitoneally 24 hours beforehand, although its effect was still
      significantly greater than in piglets given phosphate buffered saline only. These
      two monoclonal antibodies consequently offer means of investigating at the
      molecular level the pathogenesis of the disease associated with A
      pleuropneumoniae and the potential value of anti-idiotypes as immunising agents.

PMID- 2236909
TI  - Anaemia and changes in erythrocyte morphology associated with copper and selenium
      deficiencies and dietary restriction in rats.
AB  - Both selenium and copper deficiencies in rats caused morphological changes in
      erythrocytes but only copper deficiency resulted in anaemia. Similar but less
      severe morphological changes occurred when rats consuming selenium- and copper
      adequate diets had their food intake restricted to that of the copper-deficient
      animals. Since selenium deficiency did not affect the severity of changes due to
      copper deficiency this suggests that alterations of erythrocyte morphology may
      not be entirely due to impaired functions of selenium and copper in cell
      antioxidant systems. Thus, erythrocyte structure was sensitive to several dietary
      changes and such alterations are probably independent of the anaemia induced by
      copper deficiency. This possibility should be considered when changes in
      erythrocyte morphology are attributed to copper or selenium deficiency in animals
      which also have a restricted food intake.

PMID- 2236910
TI  - Effect of feeding on plasma secretin concentrations in sheep.
AB  - Changes in plasma secretin concentration during the 24 hours after feeding were
      observed in five female sheep fed 1500 g of lucerne pellets and 300 g of orchard
      grass hay once daily. The pre-feeding concentration of plasma secretin was 50 +/-
      9 pg ml-1. The plasma secretin concentration began to increase immediately after
      the beginning of feeding, reached values approximately double the pre-feeding
      values six hours after feeding, and remained significantly above the pre-feeding
      value for more than 10 hours after feeding (P less than 0.01 or less than 0.05).

PMID- 2236911
TI  - Variation in plasma halflife of gentamicin between species in relation to
      bodyweight and taxonomy.
AB  - Data on the plasma halflife of gentamicin during the elimination phase were
      collected from the literature for 30 species for analysis of the effects of
      bodyweight and taxonomy. Log halflife was significantly correlated to log
      bodyweight between species of birds (r = 0.784, n = 9, P less than 0.05) and
      mammals (r = 0.873, n = 13, P less than 0.001), but not among the poikilotherms
      (n = 9). The slopes of regressions of log halflife on log bodyweight for mammal
      and bird species did not differ significantly (0.27 +/- 0.045 and 0.32 +/- 0.095,
      respectively) but the elevations did (t = 2.73, P less than 0.05). The variations
      in halflife between species in relation to bodyweight and taxonomy were broadly
      consistent with variations in glomerular filtration rate. The results illustrate
      the value of interspecies comparisons of pharmacokinetic data for estimating
      appropriate dosage regimes for vertebrates for which no specific data are
      available.

PMID- 2236912
TI  - Effect of meclofenamic acid on the response of parasite-naive lambs and adult
      sheep to Ostertagia circumcincta.
AB  - Meclofenamic acid was used to inhibit prostaglandin synthesis in lambs challenged
      with Ostertagia circumcincta. It lowered the number of parasites which
      established in treated animals but not significantly. In treated animals plasma
      pepsinogen values were elevated at the time of parasite emergence but had dropped
      below the values achieved in control lambs towards the end of the experiment when
      parasites were at the adult, lumenal dwelling stage. Meclofenamic acid
      administered to adult immune ewes during challenge with third stage O
      circumcincta larvae did not significantly affect the establishment of the
      parasites, nor did it affect the rise in pepsinogen concentration associated with
      the challenge.

PMID- 2236913
TI  - Immunohistochemical demonstration of canine distemper virus antigen as an aid in
      the diagnosis of canine distemper encephalomyelitis.
AB  - Brain tissue from 33 dogs with non-suppurative encephalitis was examined for
      evidence of canine distemper virus (CDV) encephalitis. Sections were examined for
      lesions, inclusion bodies, syncytial cells and CDV antigen using a double bridge
      unlabelled antibody enzyme technique. Histopathological lesions considered to be
      typical of granulomatous meningoencephalomyelitis were found in seven dogs. They
      all lacked inclusion bodies, syncytial cells and CDV antigen. The remaining 26
      dogs all had histopathological lesions typical of CDV encephalitis. Inclusion
      bodies were found in 24 dogs, four of which also had syncytial cells and CDV
      antigen was detected immunocytochemically in 25. One dog had no inclusion bodies
      or syncytial cells and was immunohistochemically negative. Syncytial cells have
      been found to be of limited diagnostic value for the diagnosis of CDV
      encephalitis. While inclusion bodies proved to be a good diagnostic criterion for
      the confirmation of CDV infection, the immunohistochemical demonstration of CDV
      antigen proved to be superior. CDV antigen was more prevalent than inclusion
      bodies in tissue sections and much more easily detectable.

PMID- 2236914
TI  - Ultrastructural abnormalities in seven-day-old broilers reared at high altitude.
AB  - Fine structural abnormalities in seven-day-old broilers reared at high altitude
      are described. Tissue changes were seen in the heart, kidney and lung that
      resembled those previously reported in four-week-old broilers reared at altitude
      with an ascitic syndrome. Almost half of the hearts examined had myofibril
      disorganisation and mitochondrial hyperplasia. Renal changes occurred principally
      in tubule morphology and the lungs showed capillary congestion as well as
      engorged parabronchi. Increased levels of cartilaginous and osseous nodules in
      the lungs of 28-day-old ascitic birds reared at high altitude supported
      observations from a previous study conducted at low altitude. The observations in
      this study of seven-day-old chicks, may indicate that the embryo is at greater
      risk of developing abnormalities following exposure to low oxygen tension.

PMID- 2236915
TI  - Benzylpenicillin kinetics in the ewe: influence of pregnancy and lactation.
AB  - Benzylpenicillin kinetics were investigated in a breed of sheep adapted to life
      in barren areas. Important pharmacokinetic differences, dependent on reproductive
      status (control, pregnancy, lactation), were demonstrated. In control ewes, the
      steady state volume of distribution was 0.23 +/- 0.15 litre kg-1 and the plasma
      clearance was 12.4 +/- 3.19 ml kg-1 min-1. During pregnancy, these two parameters
      were not significantly modified. During lactation, the plasma clearance and
      volume of distribution were significantly higher than during the control period
      and pregnancy (27.4 +/- 3.22 ml kg-1 min-1 and 0.696 +/- 0.20 litre kg-1,
      respectively (P less than 0.01). In contrast the mean residence time (25.0 +/-
      4.6 minutes) was similar to those of the control period (17.54 +/- 6.25 minutes)
      and pregnancy (23.18 +/- 5.94 minutes). These modifications in benzylpenicillin
      kinetics were explained in terms of fluid balance adjustments and renal function
      adaptation observed during pregnancy and lactation, and it is suggested that an
      appropriate dosage regimen for benzylpenicillin should take into account the
      physiological status of the animal.

PMID- 2236916
TI  - Species differentiation of Leptospira interrogans serovar hardjo strain
      Hardjobovis from strain Hardjoprajitno by DNA slot blot hybridisation.
AB  - Slot blot hybridisation studies with total genomic DNA probes were used to
      compare Leptospira interrogans serovar hardjo strain Hardjoprajitno, strain
      Hardjobovis and a number of other Leptospira interrogans serovars. Strains
      Hardjoprajitno and Hardjobovis were found to have little genetic relationship
      with each other when compared to some of the other serovars tested.
      Hardjoprajitno is closely related to serovar icterohaemorrhagiae and not to
      Hardjobovis whereas Hardjobovis is closely related to serovars vietnam, balcanica
      and javanica but not to serovar icterohaemorrhagiae; this places strain
      Hardjoprajitno in the species L interrogans and strain Hardjobovis in the species
      L borgpetersoni. Because of this lack of genetic relatedness between strains
      Hardjoprajitno and Hardjobovis, it is proposed to remove the prefix Hardjo from
      the strain name Hardjobovis and call it L borgpetersoni serovar hardjo strain
      Bovis.

PMID- 2236917
TI  - A larval development test for the detection of anthelmintic resistance in
      nematodes of sheep.
AB  - First stage larvae of a number of species of parasitic nematodes of sheep have
      been shown to develop to third stage larvae in the presence of a defined medium
      consisting of Earle's balanced salt solution and yeast extract. A larval
      development test, based on this culture technique, was used as a screen for
      detecting the presence of anthelmintic resistance in nematodes of sheep. It was
      found to be sensitive and simple to use and also appeared capable of detecting
      resistance to any of the main anthelmintic groups. Available anthelmintic
      sensitive and resistant strains of Haemonchus contortus and Ostertagia
      circumcincta showed differences in development when incubated in the presence of
      either thiabendazole, levamisole and ivermectin. These differences were expressed
      as the minimum inhibitory concentration required to prevent larval development
      over the incubation period.

PMID- 2236918
TI  - Treatment of experimental enzootic pneumonia of the pig by norfloxacin or its 6
      chloro analogue.
AB  - The 6-chloro analogue of norfloxacin (compound A) administered continuously in
      the feed at 400 ppm for 21 days markedly reduced the extent and activity of
      pneumonic lesions in pigs with pneumonia induced experimentally with an
      homogenate of pneumonic lung and broth cultures of Mycoplasma hyopneumoniae.
      Norfloxacin at 100 ppm or compound A at 200 ppm in the feed did not reduce the
      extent of lung lesions, although half the pigs treated with norfloxacin had
      lesions which appeared histologically to be healing. M hyopneumoniae was detected
      either by culture or immunofluorescence in the lungs of 60 per cent of the pigs
      treated with compound A at 400 ppm compared with all the pigs in the other
      groups. These results were related to the amount of drug in the lungs and body
      fluids during therapy. Only compound A at 400 ppm produced concentrations in the
      lungs and bronchial secretions exceeding the minimum inhibitory concentration
      against M hyopneumoniae. Mycoplasmacidal concentrations were not reached either
      in the lungs or bronchial secretions which might account partly for the frequent
      detection of M hyopneumoniae in the lungs after treatment. Drug resistance did
      not appear to be responsible for the persistence of M hyopneumoniae in vivo since
      the M hyopneumoniae isolates from the pigs after therapy were sensitive in vitro
      to both quinolones. As daily weight gain and feed-conversion efficiency improved
      in all groups of treated pigs compared with the controls, these effects were
      probably unrelated to the antimycoplasmal activities of the two quinolones.

PMID- 2236919
TI  - Transvenous pacemaker leads in the dog: an experimental study.
AB  - Tined transvenous pacing leads were inserted into nine healthy large-breed dogs
      as part of an experimental study evaluating an implantable defibrillator. The
      pacing leads were used to induce ventricular fibrillation on the day of
      insertion, two and four weeks after insertion and then monthly. Despite daily
      running exercise on and off a leash, the tined leads remained firmly anchored to
      the right ventricular apex for the full experimental period of up to 12 months.
      Apart from mechanical endocarditis of the tricuspid valve, and partial
      penetration of the ventricular wall in one dog, problems associated with the
      pacing leads were not encountered. The use of tined leads and careful technique
      may minimise the likelihood of transvenous lead displacement.

PMID- 2236920
TI  - Field trials of a food-based vaccine to protect village chickens against
      Newcastle disease.
AB  - The food pellet vaccine has been shown to be effective in trials conducted under
      laboratory and simulated field conditions. The village chickens vaccinated with
      the food pellet vaccine during the field trial were protected against virulent
      Newcastle disease virus. The efficacy of the food pellet vaccine in the field was
      evaluated by challenge trial in which 60 per cent protection was obtained, or by
      monitoring the incidence of Newcastle disease in vaccinated and unvaccinated
      birds. There was no report of Newcastle disease outbreaks in the vaccinated birds
      during the two-year period of the field trial. The ease in administering the food
      pellet vaccine makes it readily accepted by the farmers.

PMID- 2236921
TI  - Bile agar migration test: a novel method for testing the viability of
      Dictyocaulus viviparus larvae in lungworm vaccine.
AB  - A bile agar migration (BAM) test was used to determine the viability of
      Dictyocaulus viviparus larvae in lungworm vaccines. Percentage migration values
      for 10 batches of vaccine varied from 8.8 to 33.2 per cent compared with 99 per
      cent of unirradiated larvae tested under similar conditions. On the other hand a
      conventional viability count (CVC), based on subjective assessment of larval
      shape, gave figures of 95.1 to 98.7 per cent for the 10 vaccine batches. The BAM
      test may therefore have potential for providing a more discriminatory assessment
      of vaccine quality than CVC.

PMID- 2236922
TI  - Effect of creep feeding on the incidence, duration and severity of post-weaning
      diarrhoea in pigs.
AB  - The effect of creep feeding on the response of pigs weaned at two or three weeks
      old to infection with an enteropathogenic strain of Escherichia coli (O149;
      K91[B], K88 a, c [L]) was studied in two separate experiments. Gastric intubation
      was adopted to regulate the intake of creep feed during the sucking period.
      Animals were given the enteropathogenic strain either before weaning or at
      weaning and the course and outcome of the infection followed bacteriologically
      and clinically. The response of the animals to the infection varied considerably
      in accord with recent reports of multiple phenotypes (to K88 +ve organisms) among
      pigs but consumption of creep feed before weaning did not significantly affect
      the prevalence, duration or severity of the diarrhoea induced experimentally by
      the organism. Hence reputed immunological responses mounted against dietary
      antigens did not predispose to or protect against this infection.

PMID- 2236923
TI  - Use of the forced oscillating airflow technique to measure the resistance of the
      equine upper airway: effects of laryngoventriculectomy and laryngoplasty.
AB  - Investigations were carried out to determine whether measurements of total
      respiratory resistance (TRR) made in resting animals could detect changes due to
      laryngeal hemiplegia. Control values of TRR were obtained in eight ponies and in
      six of these the measurements were repeated after division of the left recurrent
      laryngeal nerve in the mid-cervical region; two were retained as controls. A
      further set of measurements were made before two of the operated animals were
      subjected to left laryngoventriculectomy (Hobday operation). A laryngoplasty
      ('tie-back' operation) was performed on another two animals. Measurements of TRR
      were made at three-monthly intervals on all eight ponies for the next two years.
      Endoscopic examination of the larynx was carried out at the time of the
      measurements. All ponies showed a marked, but regular, variation in TRR over the
      two-year observation period. Nerve section was shown to be associated with an
      increase in TRR in five ponies. The Hobday operation decreased TRR in one animal
      and had no marked effect in the second. The tie-back operation was associated
      with a decreased TRR in one pony and an increase in the second. Autopsies were
      carried out on all six operated ponies and measurements of TRR and lower
      respiratory resistance (LRR) were made immediately before the animals were
      killed. Evidence of regeneration of the recurrent laryngeal nerve was seen in one
      of the ponies which underwent the Hobday operation. Histological evidence of
      regeneration was found in another pony.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236924
TI  - Inclusion of low metabolisable energy wheat in broiler diets and the incidence of
      the fatty liver and kidney syndrome.
AB  - Chickens were fed a diet containing wheat of low metabolisable energy (ME)
      content (11.3 MJ kg-1 dry matter [DM]) or a diet containing a wheat of high-ME
      content (14.5 MJ kg-1 DM). The diets, although of identical ingredient
      composition differed in energy to protein ratio. Chicks fed the diet containing
      the low-ME wheat and with the low ratio had more severe biotin deficiency lesions
      but a much reduced incidence of the fatty liver and kidney syndrome.

PMID- 2236925
TI  - Isolation and identification of anaerobic bacteria from ovine foot rot in Spain.
AB  - A microbiological study was made of 125 Merino sheep showing clinical signs of
      foot rot. A total of 435 strictly anaerobic strains were isolated, belonging to
      the following genera: Bacteroides, Peptostreptococcus, Tissierella,
      Fusobacterium, Megasphaera, Eubacterium, Acidaminococcus, Clostridium,
      Peptococcus and Propionibacterium. Of the 35 species obtained, the following were
      found in more than 10 per cent of animals sampled: Bacteroides nodosus, B
      putredinis, B buccae, B ruminicola subspecies brevis, Tissierella praeacuta,
      Peptostreptococcus anaerobius and Megasphaera elsdenii. Six culture media were
      used for isolation. Agar brucella and agar brucella enriched with G-N anaerobe
      supplement proved to be the most efficient for isolating anaerobic bacteria.

PMID- 2236926
TI  - A new type of macrolide resistance in staphylococci from bovine subclinical
      mastitis.
AB  - Staphylococcal (nine Staphylococcus aureus and 14 coagulase negative) strains,
      isolated from subclinical bovine mastitis, showed three patterns of macrolide
      resistance: (i) macrolide-lincosamide constitutive resistance; (ii) macrolide
      generalised resistance; and (iii) lincosamide generalised resistance. The second
      pattern of resistance appeared to be a new resistance phenomenon. None of the
      strains showed dissociated or inducible resistance, neither was there any strain
      which could inactivate erythromycin, oleandomycin, lincomycin or clindamycin.

PMID- 2236927
TI  - Elemental composition, water, and total lipid content in peripheral nerves,
      spinal cord and brain of healthy adult dogs.
AB  - Peripheral nerves, spinal cord, and brain of healthy adult dogs were analysed
      biochemically for sodium, potassium, calcium, magnesium, copper, zinc, iron,
      aluminium, silicon, total chloride, total tissue water and total lipid content.
      Flame atomic absorption spectrophotometry was used for elemental quantitation of
      the hydrochloric acid tissue extracts. Cerebrum and spinal cord had similar
      values for all parameters measured. Total sodium values were higher in nerves
      compared to central nervous system (CNS) (brain and spinal cord), while
      respective values for potassium were lower. Tissue levels of calcium, iron and
      silicon were comparable in brain, spinal cord and nerves. However, magnesium
      concentrations were two to three times higher in CNS than in nerves; and the
      reverse was true for aluminium levels. Tissue concentrations of zinc and copper
      were marginally higher in CNS than in nerves.

PMID- 2236928
TI  - Effects of dietary borate and aluminate on riboflavin metabolism in the breeding
      hen.
AB  - Breeding hens were used to investigate the effects of aluminate and borate
      ingestion on riboflavin metabolism. Groups of six hens were fed on either a
      control diet, or the control diet plus 15 g kg-1 of either sodium metaborate or
      sodium meta-aluminate. All diets contained 6 mg kg-1 riboflavin. Daily egg
      production per hen in the borate group had mean values of 0.71, 0.21 and 0.02 for
      the three weeks of the study. The values were 0.91, 0.91, 0.86 and 0.86, 0.74,
      0.89 for the control and aluminate groups, respectively. Fertility (fertile eggs
      per 100 set) and hatchability (live chicks per 100 fertile eggs) were both nil in
      the borate-treated hens, compared with 57 and 95 and 59 and 100 for the control
      and aluminate-treated hens, respectively. Fluorimetric analysis of blood plasma,
      egg yolk and albumen showed that the riboflavin contents of all tissues were
      greatly reduced in the borate-treated hens. Borate ingestion can therefore induce
      a severe riboflavin deficiency in the hen, but aluminium, a more universal
      contaminant of food or water, did not impair riboflavin metabolism when fed as
      aluminate.

PMID- 2236929
TI  - Dose-related effect of beclomethasone dipropionate on airway responsiveness in
      asthma.
AB  - The effects of twice daily inhaled beclomethasone dipropionate (BDP) at two dose
      levels (500 and 1,000 micrograms daily) on the airway responsiveness to inhaled
      histamine was evaluated by a randomized, single-blind, cross-over study in 10
      patients with stable asthma. The 12-week study began with a 3-week run-in period
      of baseline treatment, which was continued unchanged throughout the study, and
      the two treatment periods were separated by a 3-week placebo period. Patients
      attended the laboratory every 3 weeks for spirometry and histamine inhalation
      tests to determine the provocative concentration of histamine causing a 20% fall
      in forced expiratory volume in 1 s (PC20 of FEV1). There was a similar
      significant improvement (p less than 0.05) in mean FEV1 after both treatments.
      There was no significant change in PC20 after treatment with 500 micrograms
      daily, the geometric mean being 0.587 mg/ml after the placebo period and 0.860
      mg/ml after BDP treatment. There was a significant improvement in PC20 (1.930
      mg/ml) after treatment with 1,000 micrograms BDP daily in comparison with the
      placebo and treatment periods with 500 micrograms BDP daily (p less than 0.001).
      These results suggest that higher doses than usual of inhaled BDP must be used to
      control airway responsiveness in asthmatics.

PMID- 2236930
TI  - The state of leukocyte adhesiveness/aggregation in the peripheral blood of
      patients with respiratory tract infections.
AB  - The state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood has
      been employed as a marker of inflammation. In the present study we examined
      patients with varying intensities of inflammation caused by respiratory tract
      infections to further investigate the reliability of the state of LAA for the
      detection and assessment of the severity of disease activity. The study includes
      140 controls, 46 patients with upper respiratory tract infection, 30 with
      bronchitis, 27 with suspicion of pulmonary infiltrate, and 39 with small and 18
      with large pulmonary infiltrate. Assessment was based on assuming an increasing
      severity of inflammation from the 1st to the 6th diagnostic category and by
      making use of discriminant analysis. It was found that the state of LAA proved to
      be the best variable to classify the patients into their diagnostic category (F
      to enter 27), followed by erythrocyte sedimentation rate at the 1st h (F to enter
      20.8) and total white blood cell count (F to enter 8.3). These studies were
      followed by animal experimentation. A highly significant correlation (p = 0.005)
      was found between the state of LAA in the peripheral blood and the degree of
      pulmonary leukostasis in a model of endotoxemia in rabbits. These results suggest
      that the state of LAA is not an epiphenomenon and represents the tendency of the
      white blood cells to stick to the endothelium which facilitates their migration
      into the tissues.

PMID- 2236931
TI  - Severe acute asthma. Pathophysiology, clinical assessment, and treatment.
AB  - Bronchial asthma is characterized as a disease with recurrent, reversible, and
      generalized airway obstruction and an increased airway responsiveness to
      nonspecific stimuli. Besides symptoms of airway hyperresponsiveness, episodic
      asthmatic attacks, and chronic airway obstruction, severe acute asthma, or
      'status asthmaticus', is an important and life-threatening manifestation of the
      disease. This paper gives an overview of the pathophysiology, clinical risk
      assessment, and treatment of severe acute asthma.

PMID- 2236932
TI  - Serial physiologic studies of a chronic obstructive pulmonary disease patient in
      acute respiratory failure: clues for weaning?
AB  - A patient with severe chronic obstructive pulmonary disease was studied during
      acute respiratory failure. On the day of intubation his respiratory rate was 42,
      the tidal volume 295 ml, and the maximal inspiratory pressure 8 cm H2O. These
      parameters improved with rest by mechanical ventilation to 16, 620 ml, and 30 cm
      H2O, respectively, on the day of successful weaning. Daily tidal volumes
      correlated significantly with maximal inspiratory muscle pressures (r = 0.936; p
      less than 0.001). Respiratory system compliances and resistances were measured by
      the inflation, the end-inspiratory occlusion, and the interrupter methods. In
      general, inflation compliance and occlusion compliance were comparable and
      significantly smaller than the interrupter compliance (p less than 0.002 and p
      less than 0.003, respectively), whereas inflation resistance and occlusion
      maximal resistance were also comparable but significantly smaller than the
      interrupter resistance (p less than 0.0008 and p less than 0.0006, respectively).
      The former was due to increased hysteresis of the pressure volume curves and the
      latter due to expiratory compression of airways. The compliance was low, and the
      resistance was high on the day of intubation and became much higher and lower,
      respectively, on the day of successful extubation. These physiological changes
      were associated with weaning difficulty. We conclude that respiratory failure and
      weaning are complex physiologic events under the influence of muscle strength,
      lung mechanics, gas exchange, and control of breathing. Therefore, prediction of
      weaning success based upon one or two measured parameters as has been done is
      probably inadequate in difficult patients.

PMID- 2236933
TI  - Primary pulmonary manifestation of Hodgkin's disease.
AB  - We describe 2 patients with rare primary pulmonary manifestation of Hodgkin's
      disease. Our 1st patient, who had unilateral pulmonary involvement and has been
      treated with segmental resection and cyclophosphamide, has survived greater than
      18 years without relapse. He is the first patient reported with such a long
      survival. Our 2nd patient had bilateral pulmonary involvement and B symptoms and
      has been treated with an aggressive chemotherapy regimen. She is alive after 3
      years without evidence of disease.

PMID- 2236935
TI  - Intrathoracic lipomas demonstrated by computed tomography.
AB  - Nine cases of intrathoracic lipoma are reported. Computed tomography (CT) proved
      to be helpful in the diagnosis and management of these cases. The attenuations of
      the masses ranged from -70 to -140 Hounsfield units (HU). In 4 cases, needle
      biopsies were taken, confirming lipoma with mature fat cells. One patient also
      had a coelomic cyst with an attenuation of 20 HU, which was confirmed at
      thoracotomy. Another had an atypical lipoma which infiltrated the thoracic wall
      but was benign. In conclusion, we recommended investigation with CT scan for the
      diagnosis of lipoma.

PMID- 2236934
TI  - Cardiopulmonary effects of a brief exposure to cigarette smoke in the guinea pig.
AB  - To investigate whether the acute inflammatory response produced by acute
      cigarette smoke exposure is associated with alterations in pulmonary and
      cardiovascular function, using a respirator we exposed 8 guinea pigs to 350 ml of
      cigarette smoke diluted in 2,000 ml room air for 10 min. Lung volumes, pressure
      volume curves and flow volume curves were performed. Measurements of pulmonary
      artery pressure, systemic pressure, heart rate and cardiac output were taken at
      baseline, immediately after the smoke exposure, and 1.5 h after smoke exposure.
      Aliquots of peripheral blood for total white cell count and differential count
      were obtained. After animal sacrifice, the right lung was lavaged and white cell
      count and differential count performed. We found that acute exposure to cigarette
      smoke produced a peripheral blood neutrophilia which rose progressively from a
      baseline of 36.3 +/- 8% to a maximum of 72.2 +/- 7.7% at 1.5 h after exposure.
      There was pulmonary neutrophilia with 24.6 +/- 6.3% neutrophils in the lavage
      fluid of the smoke-exposed animals compared to 8.4 +/- 4.3% in the control
      animals. Immediately after smoke exposure, there was acute airflow obstruction
      with a decrease in the peak flow and forced expiratory flow between 25-75% vital
      capacity. This was associated with airtrapping, as shown by a transient increase
      in residual volume. There was a slight decrease in systemic blood pressure in the
      smoke-exposed animals associated with a nonsignificant decrease in the heart
      rate, and the cardiac output remained stable.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236936
TI  - Relationship between nonspecific airway hyperreactivity and antigen-induced
      contraction in an allergic animal model in vitro.
AB  - Tracheal strips from actively sensitized guinea pigs exhibited an enhanced
      responsiveness (greater maximal effects; Emax) and sensitivity (smaller effective
      concentration 50%; pD2) to CaCl2 (in K(+)-depolarized tissues), KCl and histamine
      compared with that of strips from nonsensitized animals. A significant
      correlation was found between the magnitude of the contraction produced by bovine
      serum albumin (1 mg/ml) and the Emax and pD2 values of CaCl2, KCl and histamine
      in tracheal strips from sensitized guinea pigs. This indicates that specific and
      nonspecific challenges correlate in sensitized guinea pig trachea.

PMID- 2236937
TI  - Vagal cooling and positive end-expiratory pressure reduce systemic to pulmonary
      bronchial blood flow in dogs.
AB  - Positive end-expiratory pressure (PEEP) reduces systemic to pulmonary bronchial
      blood flow [Qbr(s-p)] presumably because it increases bronchial vascular
      resistance. Since PEEP increases lung volume and thus could stimulate pulmonary
      stretch receptors, we investigated the hypothesis that the PEEP-related decrease
      in bronchial blood flow was due to a reflex mediated by the vagus. In open-chest
      dogs the left lower lobe (LLL) was isolated, independently ventilated, perfused
      in situ with a closed pulmonary vascular circuit and weighed continuously. Qbr(s
      p) was measured as LLL vascular circuit overflow and changes in LLL weight. When
      LLL PEEP was increased from 5 to 15 cm H2O in a group of 11 dogs Qbr(s-p) was
      reduced by half from 60.8 +/- 10.5 to 31.6 +/- 6.1 ml/min/100 g dry lobe weight.
      In another group of 7 dogs Qbr(s-p) was 46.5 +/- 6.9 with PEEP = 5 cm H2O; it
      decreased to 28.3 +/- 6.8 with bilateral cervical vagal cooling (0-1.5 degrees C)
      and did not decrease further after increasing PEEP to 15 cm H2O. We conclude that
      the effect of resting vagal tone is to increase Qbr(s-p) and that the effect of
      PEEP on Qbr(s-p) may be mediated at least partially by vagal influences.

PMID- 2236938
TI  - Prophylactic treatment to the fellow eye of patients with phakic lattice retinal
      detachment: analysis of failures and risks of treatment.
AB  - The authors performed a retrospective analysis on 296 phakic patients who had
      bilateral lattice degeneration and a retinal detachment in one eye. The analysis
      was done to determine the complications of full prophylactic treatment to lattice
      and breaks in the fellow eye and to explain the reasons that this treatment
      sometimes did not prevent new retinal breaks or detachments. The patients were
      followed for a mean +/- SD of 7.415 +/- 5.422 years after their first detachment.
      Twenty-four new tears occurred in the fellow eyes during this time, seven (29.2%)
      of which were away from areas of visible lattice. Prophylactic treatment did not
      appear to cause new tears or increase the risk of detachment if a new tear
      occurred. It also did not compromise the surgical repair in those patients who
      had eyes in which new breaks or detachments developed. The risk of visual loss
      was similar in those patients receiving prophylactic treatment compared with
      those not receiving treatment.

PMID- 2236939
TI  - Complications of primary scleral buckling procedures in high myopia.
AB  - Repair of retinal detachments in high myopia may be associated with numerous
      intraoperative complications. Included are complications involved with the
      drainage of subretinal fluid as well as those arising from thin sclera. Highly
      myopic eyes tend to be more prone to these complications than less myopic or
      nonmyopic eyes. A retrospective study of 51 consecutive highly myopic eyes (six
      diopters (D) or greater) undergoing primary scleral buckling procedures was
      performed. Intraoperative complications occurred in a total of six eyes (12%).
      The complications were related to drainage of subretinal fluid in four eyes (8%)
      and associated with thin sclera in two eyes (4%). Despite the above-noted
      complications, there was no adverse effect on the final level of visual acuity or
      on the anatomic status of the retina. In the comparison of the incidence of
      drainage-related complications with previously published studies not preselected
      according to refractive status, there appears to be no added risk of
      complications based on the degree of myopia.

PMID- 2236940
TI  - Vitrectomy in asteroid hyalosis.
AB  - Asteroid hyalosis (AH), a condition in which calcium-lipid complexes form in the
      collagen meshwork of the vitreous, affects from 0.5% to 0.9% of the general
      population. In patients with dense AH and visual loss, obscuration of fundus
      detail on ophthalmoscopy and even on fluorescein angiography may complicate the
      diagnosis and treatment of underlying posterior segment disease. To evaluate the
      usefulness of vitrectomy in AH, we reviewed 7 cases of dense AH in 6 patients who
      underwent vitrectomy in the setting of decreased visual acuity of uncertain
      cause. Additional diagnoses made following surgery included age-related macular
      degeneration (ARMD) in 2 eyes, ARMD with associated epiretinal membrane in one
      eye, and the staging of diabetic retinopathy as proliferative in one eye.
      Although no major surgical complications occurred in this series, the potential
      for serious complications exists, and pars plana vitrectomy (PPV) should be
      considered only after less invasive diagnostic evaluations and therapeutic
      approaches have been exhausted.

PMID- 2236942
TI  - Central venous stasis retinopathy following the use of tranexamic acid.
AB  - Central venous stasis retinopathy (CVSR) was observed in two young women
      following the administration of oral tranexamic acid (TA) for the treatment of
      menorrhagia. Clinical and laboratory parameters were normal. Withdrawal of the
      drug and treatment with systemic steroids and fibrinolytic drugs resulted in
      improvement of visual acuity to 6/6. The pathogenesis of the CVSR in these cases
      is suggested, and the rationale of systemic treatment is discussed.

PMID- 2236941
TI  - Goldmann-Favre maculopathy.
AB  - A healthy 17-year-old girl presented with typical symptoms and physical features
      of Goldmann-Favre vitreoretinal degeneration. She had reduced visual acuity in
      both eyes and night blindness. Her parents were first cousins. Striking fundus
      features included typical maculopathy with a radiating stellate pattern
      surrounded by tiny vacuole-like pockets of retinoschisis throughout the posterior
      pole within the temporal vascular arcades. The fundus features were quite typical
      and permitted a firm diagnosis when combined with the other features of night
      blindness, gender, and electroretinogram (ERG) abnormalities.

PMID- 2236943
TI  - Bilateral macular holes in sporadic posterior microphthalmos.
AB  - The authors report an unusual sporadic case of bilateral posterior microphthalmos
      in an 8-year-old Chinese girl. Cycloplegic refraction showed hyperopia of 12.5
      diopters in both eyes. Anterior segment examination showed normal corneal
      diameters, open angles, and normal lens thicknesses. Ultrasonography showed short
      vitreous compartments resulting in short axial lengths of 17.2 mm. Fundoscopy
      showed full-thickness macular holes associated with radiate retinal striae. This
      is the first report of bilateral macular hole formation in sporadic posterior
      microphthalmos. The literature is reviewed.

PMID- 2236944
TI  - The histopathology of successful retinal reattachment.
AB  - Fifteen eyes with rhegmatogenous retinal detachment that were successfully
      reattached with scleral buckling were studied histopathologically after
      enucleation or autopsy. Postoperative visual acuities ranged from 20/25 to 5/200.
      Epiretinal membranes were present in 9 of 15 eyes (60%) and cystoid macular edema
      was present in 4 of 15 (26%). Although the reattached retina was of normal
      morphology by light microscopy in 9 of 15 eyes, significant atrophy of outer
      retinal layers was noted in 4 of 15 eyes (26%). In 5 of 13 patients, reduced
      postoperative vision could be histopathologically correlated with macular edema
      or lack of retinal regeneration, but there was no compelling histopathologic
      explanation for reduced vision noted in 5 other cases.

PMID- 2236945
TI  - Surgical treatment of postoperative dilated, nonreactive pupil in eyes after
      combined pars plana lensectomy and vitrectomy.
AB  - Synechiae between the iris and tissue posterior to the iris can cause a markedly
      dilated, nonreactive pupil that is cosmetically undesirable after combined pars
      plana lensectomy and vitrectomy for complicated forms of retinal detachment. The
      authors have used a combined limbal and pars plana approach to lyse the posterior
      synechiae, resulting in partial pupillary constriction. The surgical technique is
      described, and clinical results are illustrated.

PMID- 2236946
TI  - A technique for the transfer of retinal images from the mirror of a contact lens.
AB  - In 1965 Rene Dufour developed a method for the direct transfer of retinal images
      reflected in the mirrors of a contact lens to retinal drawing paper. The retinal
      images are drawn on the reverse side of semi-transparent paper that is oriented
      such that the sector of the retinal diagram is aligned with the mirror of the
      contact lens that is viewing the sector. The images can be drawn exactly as they
      are seen in the mirror. When the drawing is viewed right-side-up over a light
      box, the detail is oriented correctly. The method is valuable for the precise
      localization of retinal breaks that are discovered through the slit-lamp
      microscope but are too small to be seen by indirect ophthalmoscopy. The breaks
      can be oriented in relation to other fundus detail large enough to be seen
      through the ophthalmoscope and then found at the operating table without the aid
      of a microscope.

PMID- 2236947
TI  - Clinicopathologic correlation of recurrent epiretinal membranes after previous
      surgical removal.
AB  - Recurrent epiretinal membranes (ERMs) causing macular pucker developed after
      surgical removal in seven eyes and were subsequently removed. A specimen was
      available for electron microscopic study from four of the seven primary
      operations and all seven of the repeat operations. The diagnostic associations
      for the primary cases included retinal holes or tears (four eyes), trauma,
      inflammation (one eye each). In one eye the membrane was idiopathic. The primary
      and recurrent ERM specimens contained similar cell types and structural
      characteristics but were not identical. No one cell type predominated in either
      primary or recurrent ERM. Compared with studies of idiopathic ERMs,
      myofibroblasts were present with increased frequency in recurrent membranes.
      Fibrocytes, fibrous astrocytes, and retinal pigment epithelial cells were also
      present in most specimens. Other features of both the primary and recurrent ERM
      specimens included the presence of cells with myoblastic differentiation,
      fragments of internal limiting membrane, new collagen, and nerve fiber elements.

PMID- 2236948
TI  - Syphilitic disc edema and periphlebitis.
AB  - This photo essay shows the retinal findings in a patient with presumed syphilitic
      disc edema and periphlebitis. Resolution of these findings after treatment with
      penicillin is documented by improvement in visual acuity from 20/50 to 20/25 in
      the right eye and from 20/200 to 2/20 in the left eye. Photographic documentation
      of the resolution of retinal findings, including disc edema and periphlebitis, is
      presented.

PMID- 2236949
TI  - Penetrating ocular injuries.

PMID- 2236950
TI  - Retinol macroaneurysms treated with the yellow dye laser.

PMID- 2236951
TI  - [Newer modes of mechanical ventilation].

PMID- 2236952
TI  - [High frequency chest wall compression ventilation].

PMID- 2236953
TI  - [Respiratory muscle fatigue and artificial ventilation: reduced respiratory work
      by ventilatory support and unloaded muscle atrophy].

PMID- 2236954
TI  - [Computer-controlled optimization of ventilatory support].

PMID- 2236955
TI  - [Home ventilation therapy].

PMID- 2236956
TI  - [An application of ambulatory intracardiac electrogram recording by telemetry
      system on analysis of pacemaker function].

PMID- 2236957
TI  - [Coronary angioscopy system with PTCA balloon catheter].

PMID- 2236958
TI  - [Atrioventricular delay and diastolic mitral regurgitation in patient with DDD
      pacemaker implantation, and cardiac function].
AB  - We examined the mitral valve motion, the mitral valve flow pattern, and changing
      atrioventricular (AV) delay in 34 patients with DDD pacemaker implantation, using
      M-mode echocardiography and pulse Doppler echocardiography. In 28 patients, B-B'
      step and diastolic mitral regurgitation (DMR) were induced by extending the AV
      delay. 8 of 12 patients who showed B-B' step and DMR with the AV delay less than
      or equal to 165 mS had heart failures. In such patients, P-B-B' step (DMR)
      interval was 174 +/- 31 mS shorter than the other patients (216 +/- 26 mS, p less
      than 0.001), and Q-C interval was 131 +/- 26 mS longer than the other patients
      (63 +/- 31 mS, p less than 0.001). The minimal value of the AV delay that induces
      B-B' step and DMR can be decided under the influence of cardiac functions, and
      this echocardiographic examination is useful, giving us information about the
      cardiac function of the patients with DDD-PM. B-B' step is the mitral valve
      motion that corresponds with the DMR, so we can check the DMR through the B-B'
      step easily.

PMID- 2236960
TI  - [Distinctive response of coronary artery compared acute myocardial infarction
      with angina pectoris associated with angioplasty].
AB  - There has been much controversy over the mechanism of successful percutaneous
      transluminal coronary angioplasty (PTCA). To examine clinical and angiographic
      factors that might be related to a successful PTCA, we assessed 224 branches
      treated with emergent or elective angioplasty in evolving acute myocardial
      infarction (AMI) and angina pectoris (AP). The patients were divided into three
      groups; group 1 (G1): AP (n = 113), group 2 (G2): AMI with complete obstruction
      of infarct-related artery (IRA) (n = 79), group 3 (G3): AMI with incomplete
      obstruction of IRA (n = 32). The morphology of stenotic lesion was classified
      into smooth type and irregular type. The former shows concentric smooth border,
      the latter shows eccentric irregular border and multiple irregular border
      according to the Ambrose classification. Regarding the severity of the stenosis
      immediately after successful PTCA, there was no significant differences between
      G2 and G3, however in G1 it was significantly higher than in other groups (G1 vs
      G2 vs G3, 56% vs 81% vs 78%, p less than 0.001). Irregular type at stenotic
      lesions before PTCA were present in 72 of 113 branches in G1 vs 60 of 69 in G2
      and G3. Regarding the incidence of acute coronary obstruction during PTCA, there
      was no significant differences between G1 and G2. However, in G3 it was
      significantly higher than in other groups (G1 vs G2 vs G3, 8% vs 9% vs 38%, p
      less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236959
TI  - [Contractile properties of coronary artery bypass conduit--comparison between
      saphenous vein and internal mammary artery].
AB  - This study was designed to examine the response of coronary artery bypass conduit
      to serotonin, phenylephrine, and ergonovine as provocation agents of
      vasoconstriction. Saphenous veins (SV) and internal mammary arteries (IMA) were
      obtained during coronary artery bypass grafting (CABG), and their contractile
      properties were measured using isometric contraction recording apparatus. Both SV
      and IMA showed sigmoid contraction curves indicating dose dependence to
      ergonovine, serotonin, and phenylephrine. The concentration-response relations
      for phenylephrine showed a similar curve in both SV and IMA, however, those for
      ergonovine and serotonin showed a leftward shift in SV compared with IMA. Half
      maximum effective dose for ergonovine and serotonin were less in SV than IMA.
      From these results, it was suggested that "perioperative spasm" during CABG might
      occur not only in coronary arteries but also in the graft conduit itself. Graft
      spasm might be a possible mechanism for occlusion of the bypass graft. In
      conclusion, greater hyperreactivity of SV compared with IMA in response to
      ergonovine and serotonin was suggested, so it is concluded that, from this point
      of view, IMA is more suitable for use in CABG.

PMID- 2236961
TI  - [Silent myocardial ischemia in diabetics--by treadmill exercise testing].
AB  - We examined silent myocardial ischemia in diabetics by treadmill exercise
      testing. There were 28 diabetic men and 64 diabetic woman without angina, with a
      mean age of 59 +/- 11 years. Symptom-limited treadmill exercise testing was
      performed, and we used the electrocardiogram during exercise and immediately
      after exercise for judgement. ST segment depression was defined as positive if
      there was at least 0.1 mV of ST depression 80 ms from the J point. It was defined
      as negative if max heart rate (HR) was more than 80% of target HR and there was
      no significant ST depression. It was defined as equivocal if there was no
      significant ST depression but max HR was less than 80% of target HR. In 92
      diabetics, 21 patients (23%) showed positive ST depression, 35 (38%) showed
      negative ST depression, 36 (39%) showed equivocal ST depression. In 56 diabetics
      exclusive of treadmill equivocal patients, 38% of patients showed positive ST
      depression. Treadmill positive diabetics had a significantly higher rate of
      smokers, patients with hypertension, and a higher triglyceride level as compared
      with treadmill negative diabetics. Coronary arteriography, which was performed in
      six treadmill positive diabetics, revealed coronary stenosis of more than 75% in
      four patients.

PMID- 2236962
TI  - [Biphasic effects of a combined administration of SOD and CAT on Ca overload and
      recovery of function and metabolites].
AB  - The present study was performed to clarify whether the combination of superoxide
      dismutase (SOD) and catalase (CAT) can reduce Ca2+ overload and improve recovery
      of function and metabolites during reperfusion in isolated globally ischemic rat
      hearts. In non-treated hearts, left ventricular developed pressure (LVDP)
      recovered to only 30% of the preischemic value with elevation of left ventricular
      end-diastolic pressure (LVEDP) after 30 min of reperfusion following 30 min of
      global zero-flow ischemia. ATP and CP fell by 40% and 60%, respectively with 13
      fold increase in Ca2+ uptake. A combined administration of SOD and CAT at low
      concentrations improved recovery of function (LVDP to 60%), reduced Ca2+ uptake
      (10 fold) without any improvement in high energy phosphates. However a
      combination of SOD and CAT at higher concentrations did not improve, or even
      deteriorate functional and metabolic recovery with increased Ca2+ overload (12 to
      14 fold). These results indicated that the extracellular free radical scavengers,
      SOD and CAT, had a biphasic effect on reperfusion injury and could be partially
      beneficial at low concentrations.

PMID- 2236963
TI  - [A case of acute pericarditis secondary to mediastinitis].
AB  - A 45-year-old man who complained of swallowing disturbance and chest pain in
      inspiration phase was admitted for evaluation of "pericarditis". A chest X-ray
      film on admission disclosed a wide mediastinal shadow and pleural effusion on the
      right side. Bilateral tonsils were swollen, and covered with pus. A Computed
      tomogram of the chest showed a shadow of exudate contained with air in the
      mediastinum. Mediastinal drainage, tonsillectomy and drainage of fistula from pre
      tracheal space to upper mediastinum were immediately performed. Staphylococcus
      aureus was confirmed from the sputum and mediastinal effusion. Thus, acute
      mediastinitis was confirmed as an etiological diagnosis of "pericarditis" in this
      patient.

PMID- 2236964
TI  - [A successfully operated case of tetralogy of Fallot with marked left ventricular
      dysfunction in adult].
AB  - Adults, especially high-aged patients with tetralogy of Fallot (TOF) are said to
      have a higher operative risk than younger ones because of fragility of their
      myocardium, bleeding from rich collateral circulation to lungs, and other
      complications such as brain abscess and endocarditis. It is often difficult to
      determine the surgical risk for total correction in cases of high-aged patients
      who have such complications. We report a successfully operated high-aged case of
      TOF with marked left ventricular dysfunction. A 52-year-old male was referred to
      our hospital because of exertional dyspnea and cyanosis. He had a history of
      cerebral embolism and meningitis several months prior to admission. On admission,
      he was NYHA class 3, and cyanosis and clubbed fingers were present. Cardiac
      catheterization showed a large VSD, 50% over-riding of the aorta and an
      infundibular pulmonary stenosis. Right to left shunt was 60% and Qp/Qs was 0.38.
      The left ventricular end diastolic volume index was 109 ml/m2, slightly larger
      than normal, and the ejection fraction was only 30%. This left ventricular
      dysfunction was thought to be caused by fibrosis of the myocardium due to
      longstanding hypoxemia and hypoxemia itself. There is no previous case report
      dealing with a successful total correction for a high-aged patient with TOF
      associated with such a severe left ventricular dysfunction. Congestive heart
      failure in the post-operative period was successfully treated by catecholamine
      for two weeks. Postoperative cardiac catheterization showed a small left-to-right
      shunt, and an improvement of left ventricular ejection fraction from 30% to
      38%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2236965
TI  - [A case of hypertrophic cardiomyopathy with right ventricular outflow obstruction
      manifested during three-year follow-up study].
AB  - A case is reported of a 55-year-old female with idiopathic hypertrophic
      cardiomyopathy, which was accompanied with outflow obstruction in the right
      ventricle developed during the previous 3 years without lesion of the left
      ventricle. In 1984, she was admitted to our hospital to be examined for cardiac
      murmurs and abnormal electrocardiogram including ST depression and inverted T.
      The findings of echocardiography and cardiac catheterization revealed non
      obstructive hypertrophic cardiomyopathy. She had been treated with sympathetic
      beta-blockade and calcium antagonist for 3 years until she complained of dyspnea
      on exertion, and she was readmitted to our hospital in 1987. Echocardiographic
      findings showed protrusion of the ventricular septum toward the right ventricle
      and systolic turbulent flow along the right ventricular outflow tract (by pulsed
      Doppler technique). A pressure gradient of 20 mmHg across the protrusion was
      detected by the examination of the cardiac catheter. However, neither protrusion
      nor pressure gradient was observed in the left ventricular outflow tract as well
      as that in 1984. Idiopathic hypertrophic cardiomyopathy has been described as
      involving both ventricles, and outflow obstruction is the usual hemodynamic
      finding in the left ventricle. However, right ventricular outflow obstruction is
      the usual hemodynamic finding in the left ventricle. However, right ventricular
      outflow obstruction with the left ventricular outflow tract intact has been very
      rare. In addition, in this case, the change of hemodynamic characteristics from
      non-obstructive to obstructive hypertrophic cardiomyopathy, and the development
      of these changes only in the right ventricle were observed during the last 3
      years.

PMID- 2236966
TI  - [Inhibition of vasospastic angina by alcohol ingestion].
AB  - A 66-year-old man having a long history of angina on effort has started to show
      frequent episodes of angina at rest since 6 months ago. He noticed that chest
      pain was uncommon after taking alcohol. A variant form of angina pectoris
      (variant angina) was diagnosed by documentation of typical ST elevation during
      anginal attack and also by inducing coronary arterial spasm with intracoronary
      administration of ergonovine maleate. Ambulatory ECG monitoring revealed frequent
      ST elevation during sleep. Since the history suggested that alcohol ingestion
      could be effective for preventing variant angina, this effect was examined by
      giving 540 ml of "sake" in the evening. Variant angina was inhibited, while
      plasma ethanol was detected. The plasma ethanol reached its peak value as 152
      mg/dl at 10 o'clock pm and returned to zero after 12 hours. When ethanol
      disappeared in the plasma, variant angina recurred again. Although the precise
      mechanism for inhibition of variant angina by alcohol ingestion is not clear,
      alcohol or its metabolite such as acetaldehyde seems to be able to inhibit
      coronary arterial spasm.

PMID- 2236967
TI  - [Coronary revascularization with reduction of serum cholesterol level using LDL
      apheresis in patient with homozygous familial hypercholesterolemia].
AB  - We reported a case of a 48-year-old male with homozygous familial
      hypercholesterolemia who underwent coronary revascularization successfully.
      Coronary artery bypass grafting (CABG) utilizing internal mammary artery graft to
      LAD, and percutaneous transluminal angioplasty for residual stenosis after CABG
      was able to relieve symptomatic myocardial ischemia. LDL apheresis every two
      weeks in addition to combined drug treatment had maintained total cholesterol at
      an acceptable level (120-280 mg/dl) before and after CABG. It was confirmed by
      repetition of coronary angiography at one year after CABG that all grafts were
      widely patent, and the native coronary artery did not accelerate the
      atherosclerotic lesion. It was important in patients with homozygous familial
      hypercholesterolemia, to carry out active coronary revascularization with
      reduction of serum cholesterol level by using LDL apheresis.

PMID- 2236968
TI  - [Right pulmonary artery obstruction and pulmonary hypertension secondary to
      aortitis syndrome].
AB  - A 56-year-old woman with aortic arch syndrome and finally right pulmonary artery
      obstruction secondary to Takayasu's aortitis was presented. She had had a history
      of visual disturbance and dizziness when she looked upward since 1983. On
      admission in July, 1984, aortography showed obstruction of the right innominate
      artery and of the left subclavian artery. Pulmonary arterial pressure, pulmonary
      perfusion and ventilation images seemed to be normal at that time. After
      discharge from our hospital, she began in 1987, to be aware of dyspnea on effort.
      Because of this symptom, she was admitted again in March, 1988. The pulmonary
      perfusion images showed complete lack of perfusion in the right lung, and
      arterial blood gas showed hypoxia with 62 mmHg in PaO2, 39 mmHg in PaCO2. Cardiac
      catheterization confirmed pulmonary hypertension with pulmonary artery pressure
      of 56/18 mmHg. In conclusion, pulmonary perfusion and ventilation scintigraphy
      proved to be the best way to clarify the nature of a lesion of the pulmonary
      artery in aortitis syndrome.

PMID- 2236969
TI  - [Prognosis of intrahospital cardiorespiratory arrest. Experience at a referral
      center for internal medicine and surgery].
AB  - In order to identify prognostic features associated with in-hospital
      cardiopulmonary arrest (CPA) a prospective study was designed. A total of 130
      first episodes of CPA were seen during a 6 month period. In 34 cases (26%)
      cardiopulmonary resuscitation (CPR) was attempted and 17 showed a positive
      response (recovery of cardiac automatism for more than 15 min). Median survival
      time in those who recovered was 38 hr. Only two patients were discharged alive
      from the hospital. Practice of CPR was strongly and inversely associated with the
      degree of anticipation on the occurrence of CPA held by the physician in charge.
      Age was the only variable prognostically associated with response to CPR, being
      the younger group (less than 40 yr) those with the worst prognosis. Aside of age
      and the possible beneficial effect of infection, there were no other demographic,
      clinical, therapeutic or other circumstances of the episode associated with
      response to CPR. The need of response systems to CPA, always in standby and
      reiterative training, is stressed.

PMID- 2236970
TI  - [Splenectomy in idiopathic thrombocytopenic purpura].
AB  - Between January 1976 and December 1987, 44 patients with idiopathic
      thrombocytopenic purpura were submitted to splenectomy. This study analyzes the
      results of treatment and the usefulness of several prognostic markers. There were
      38 female patients and six males with a median age of 28.5 years (range 11 to 66
      years). Forty two out of 44 patients received preoperative steroids. Seventy five
      percent achieved a satisfactory response to this treatment but 31 relapsed (in
      eight recurrence was observed when the steroid dose was tapered). Eleven patients
      persisted symptomatic notwithstanding medical treatment. In two cases splenectomy
      was performed as an emergency procedure, and in one patient who was already in
      remission with previous steroid treatment, splenectomy was performed for other
      medical reasons. Operative mortality rate was 4 percent, and five patients
      developed postoperative complications (three had pneumonia, one pulmonary
      thromboembolism and one would infection). Eighty four percent of the patients
      were free of disease at one year followup survival at 10 year period was 80
      percent. No correlation was found between age, duration of symptoms, previous
      response to steroids or time-period of medical treatment with the results
      obtained with splenectomy.

PMID- 2236971
TI  - [Plasma cells in the cerebrospinal fluid of patients with cerebral
      cysticercosis].
AB  - We studied in twenty patients with proven cerebral cysticercosis the presence of
      plasma cells in the cerebrospinal fluid (CSF). We found plasma cells in 50 per
      cent of the patients. All of them had subarachnoid cysticercosis or basal
      arachnoiditis. The presence of plasma cells was significantly associated to
      higher protein levels, greater number of inflammatory cells, and higher levels of
      IgG in the CSF. None of the patients had received medical treatment or steroids
      prior to the test. These findings suggest a role of plasma cells in the
      pathogenesis of the cysticercotic disease. The presence of plasma cells in the
      CSF is part of the immune response against the parasite. We also found that
      plasma cells are more frequently encountered in the CSF (50 per cent) than
      eosinophils (20 per cent) in patients with cerebral cysticercosis.

PMID- 2236972
TI  - Pathophysiology of experimental nephrotic syndrome induced by puromycin
      aminonucleoside in rats. I. The role of proteinuria, hypoproteinemia, and renin
      angiotensin-aldosterone system on sodium retention.
AB  - The pathophysiology of the nephrotic syndrome (NS), characterized by protenuria,
      edema, sodium retention and hyperlipidemia, is not clear. We studied the role of
      some systemic factors on sodium retention in an experimental model of NS. NS was
      induced in rats by a single subcutaneous injection of puromycin aminonucleoside
      (PA) (15 mg/100 g); control animals received vehicle. All rats were kept in
      metabolic cages for 24 days (3 days before and 21 days after PA-injection). Urine
      was collected daily. Blood samples were obtained every day until day 10, and then
      every other day up to the end of the study. The rats showed the following
      alterations after PA injection: a) a rise in serum angiotensin converting enzyme
      activity (ACEA) and plasma aldosterone (PAldo) at day 1; b) a rise in urinary
      aldosterone (UAaldoV), azotemia and sodium retention at day 2; c) massive
      proteinuria (UProt) and decrease in plasma angiotensinogen concentration (PAC) at
      day 4; d) increases in plasma renin activity (PRA), plasma renin concentration
      (PRC) and serum creatinine as well as hypoproteinemia, hypercholesterolemia,
      hypertriglyceridemia, ascitis and edema at day 5; e) increase in urine volume at
      day 6. PAldo became normal at day 7; urine sodium (UNaV), PRA and PRC at day 8;
      UAldoV at day 9; serum urea and ACEA at day 10; urinary volume at day 11; PAC,
      serum total protein and creatinine at day 12. The edema disappeared at day 11.
      UProt, hypercholesterolemia and hypertriglyceridemia persisted, though they
      decreased substantially by the end of the study (day 21). Light microscopy
      studies revealed normal glomerular morphology, but electron microscopy showed
      fusion of podocytes before proteinuria. These data suggest that: a) sodium
      retention was not a consequence of proteinuria or hypoproteinemia; b) sodium
      retention seems non-related to renin secretion, but may be partially mediated by
      a fall in glomerular filtration rate or by an increased tubular resabsorption
      secondary to other factors; c) the increase in PAldo, UAldoV and ACEA are non
      related to renin secretion: all occurred before PRA rose; d) water retention,
      increase in PRA and PRC, hypercholesterolemia and hypertriglyceridemia are
      secondary to the hypoproteinemia.

PMID- 2236973
TI  - [Evaluation of the activity of creatine phosphokinase for the detection of
      carriers of Duchenne-type muscular dystrophy in families in the city of
      Monterrey, Mexico].
AB  - The activity of serum creatine phosphokinase (CPK) was determined in 80 female
      members of 23 families with affected members of Duchenne type muscular dystrophy
      (DMD) and compared with the values of a control group of 100 unaffected women.
      The control group values exhibited a normal distribution of frequency with a mean
      of 21 U/L and standard deviation from the mean of 7.9 U/L. Sixty nine percent
      (11/16) of obligatory carriers showed CPK values higher than the mean of the
      control group plus two standard deviations of the mean. Thirty one percent (5/16)
      had false negative values. These percentages are similar to those reported in
      other studies. Elevated CPK activity was found in 45% (18/40) of type A possible
      carriers (relatives of obligatory carriers) and the group of possible carriers
      type B (mothers and relatives of isolated cases) 42% (10/24) exhibited high CPK
      values. Bayesian analysis was also used in all possible-carriers (A and B). We
      also report an estimation of the fertility of the DMD gene carriers and of their
      attitude towards family planning. It is concluded that the determination of serum
      CPK activity, despite its shortcomings, associated with Bayesian analysis when
      necessary, could be the method of choice for quick and inexpensive evaluation of
      the carrier status, mainly in families with members affected by DMD.

PMID- 2236974
TI  - [Diagnosis of thrombosis of cavernous sinus in magnetic resonance imaging].
AB  - The diagnosis of the cavernous sinus thrombosis requires a careful clinical
      evaluation and appropriate radiological methods. In this report we describe the
      magnetic resonance imaging findings in a patient with the clinical diagnosis of
      cavernous sinus disorder and its correlation with orbital phlebography and
      histopathologic studies.

PMID- 2236975
TI  - [Oculopharyngeal muscular dystrophy: 1st report in Mexico].
AB  - We report a case of a woman of Mexican origin with oculopharyngeal muscular
      dystrophy (OMD). This is the first OMD reported in Mexico. She was healthy until
      the age of 30, when she noticed slowly progressive ptosis and dysphagia. She
      developed dermatitis and polyneuritis which we attribute to a deficiency of
      nutrients due to her dysphagia. In contrast to most previous reported cases this
      patient had also a distal myopathy. It is recommended in this type of patients a
      strict dietary control in order to avoid complications. It is also recommended to
      perform biopsies of several muscles to complete the diagnosis and prognosis.

PMID- 2236976
TI  - [Ethical aspects of modern genetics].

PMID- 2236977
TI  - [24-year-old woman with hematuria, mental changes, loss of visual acuity and
      ulcers on the fingers].

PMID- 2236978
TI  - [Surgical risk and complications after major surgery in patients with cirrhosis].
AB  - In this study we report the morbidity and the mortality observed in 55 patients
      with cirrhosis who had a major surgical procedure between October 1986 and June
      1988, as well as its relation with different variables. The overall mortality was
      34.5% and it was due to multiple organ failure or bleeding because of
      coagulopathy in 18 of 19 patients. The preoperative variables associated with
      major mortality were: emergency surgery, classification 3 or 4 of the American
      Society of Anesthesiology (ASA) and poor hepatic reserve evaluated with the Child
      Turcotte classification (the mortality for A group was 16%, B 62%, and C 100%).
      The transoperative hypotension increased the mortality 4.5 times. In the
      postoperative period an elevated APACHE (Acute Physiologic and Chronic Health
      Evaluation) II score (mortality of 100% in those with greater than 20 points),
      multiple organic failure (100% died with 2 or more organ failures) or surgical
      reintervention in the patients with Child A increased significatively the
      mortality. The 24 patients who survived without complications were discharged on
      the 19th day (+/- 9 S.D.), while those with complications stayed during 46 days
      (+/- 18 S.D.).

PMID- 2236980
TI  - The role of nutrition in the management of dermatoses.

PMID- 2236979
TI  - Nutritional influences on immunity.
AB  - There is no doubt that nutrient deficiencies and excesses can influence immune
      responses. Despite advances in the development of therapeutic agents, a competent
      immune system is crucial for prevention and resolution of disease. Leukocytes are
      some of the most metabolically active cells in animals. We know that growing
      animals require nutrients to sustain growth and reach their full potential,
      whether that is size, strength, speed, or agility. We do not expect kittens to
      grow or greyhounds to run without provision of adequate nutrients. To expect the
      immune system to function in the face of nutrient deficiency neglects our
      knowledge of the physiological needs of metabolically active tissues. Immune
      responses may be modified through dietary manipulations. However, the clinician
      must answer the question "to what end or consequence will the response be
      changed?" No "golden" nutrient ensures an appropriate immune response in all
      conditions, just as no "golden" drug heals all diseases. Our knowledge of
      nutrient-immune system interactions is increasing. Yet, for all of the current
      knowledge of nutrient effects on immunity, the words of Dr R.K. Chandra hold
      sterling advice, "Moderation is a good dictum in biology and medicine, and it
      applies equally to nutritional immunology."

PMID- 2236981
TI  - Nutritional management of diabetes mellitus.

PMID- 2236982
TI  - Nutritional management of chronic renal failure.

PMID- 2236983
TI  - Nutritional support in the surgical patient.

PMID- 2236984
TI  - Renal nutrition.

PMID- 2236985
TI  - Energy and fuel substrate metabolism in the kidney.

PMID- 2236986
TI  - Amino acid metabolism in the kidney.

PMID- 2236987
TI  - Glucose metabolism and the kidney.
AB  - Although the kidney both takes up and produces glucose, its net contribution to
      overall glucose homoeostasis is negligible since these two processes
      approximately counterbalance each other. Glucose uptake primarily occurs in the
      distal medullary segments of the nephron where the glycolytic enzymes are present
      in high concentration. The major metabolic fates of the glucose which is taken up
      by this region of the kidney are oxidation to carbon dioxide and conversion to
      lactate. In contrast, gluconeogenesis primarily occurs in the proximal tubular
      portion of the renal cortex where free fatty acids represent the major metabolic
      fuel which supplies the energy requirements of the cell. However, in certain
      conditions, including metabolic acidosis, prolonged fasting, and poorly
      controlled diabetes mellitus, renal gluconeogenesis can be enhanced markedly and
      a net output of glucose by the kidney is readily observed.

PMID- 2236988
TI  - Nutritional factors affecting renal growth and hypertrophy.

PMID- 2236989
TI  - Factors controlling intracellular protein turnover in the kidney.

PMID- 2236990
TI  - The effect of the nephrotic syndrome on the renal handling of protein and other
      nutrients.

PMID- 2236991
TI  - The effect of amino acids on ischemic and toxic injury to the kidney.

PMID- 2236992
TI  - [Controversy over brain death in Japan].

PMID- 2236993
TI  - Three-dimensional observation of the rat endocrine pancreas by a scanning
      electron microscope.
AB  - A three-dimensional observation was performed on chemically digested rat
      pancreata and vascular corrosion casts of it with a scanning electron microscope.
      The Langerhans islets were sporadically situated in the exocrine tissue and were
      surrounded by the fibrous capsule, which was so tough that it could not be
      chemically digested easily. This capsule was considered to play different roles
      in the collection of the endocrine cells in a functional unit, in the prevention
      of secreted hormones spreading into the adjacent exocrine and stromal tissue, in
      the support of the microvascular structure, and in the protection for the islet
      cells from the pancreatic enzymes, which are leaking into the stromal spaces
      physiologically. The microvascular structure of the islet, disclosed by the
      corrosion vascular casts, showed afferent vessels branching into the capillaries
      at the periphery of the islet and entering the core of it by a twisted course.
      These findings were considered to be related to the islet cell distribution, that
      is, A and D cells are at the periphery of the islet and B cells at the center of
      it. This might support the existence of a hormonal regulating mechanism among
      endocrine cells. In addition, the efferent vessels from the islet that
      communicate to the vascular network of the exocrine tissue might suggest that the
      endocrine system also regulates the exocrine function in a circulatory dynamic
      state.

PMID- 2236994
TI  - [Image analytic studies of melanin granules of human hairs with transmission
      electron micrographs].
AB  - Using electron micrographs of human hairs, we measured the minor axis and density
      of melanin granules by an image analyser. The melanin density of the outer hair
      cortex was higher than that of the inner hair cortex, and significant differences
      were evident especially in the minor axis and density of melanin granules among
      individuals. These quantitative analyses as to the minor axis and density of hair
      melanin granules are a reliable tool for the measurement of hair color.

PMID- 2236995
TI  - [Effects of sex difference on the toxicity of ethylene oxide. IV. Anemia].
AB  - Wistar male and female rats were exposed to ethylene oxide (EO) at a
      concentration of 250 ppm, 6 hours a day, 5 days a week for 17 weeks
      simultaneously, and the sex difference of anemia induced by EO was investigated.
      Hemoglobin concentrations of both the male and female exposed groups were
      decreased when compared with each control group, and the anemia in the female
      exposed group was more severe than that in the male exposed group. Absolute
      spleen weight increased only in the female exposed group. We have already
      reported that a decrease of the glutathione reductase activity in the erythrocyte
      plays an important role in the EO-induced anemia. In the present study, the
      activity in both male and female exposed groups decreased when compared with each
      control group, and there was no sex difference in the degree of the decrease.
      From these observations, we concluded that there was a sex difference in the EO
      induced anemia.

PMID- 2236996
TI  - Sarcoid reaction observed in a worker with a history of asbestos exposure.
AB  - Bilateral hilar and mediastinal lymphadenopathy was observed in a 32-year-old man
      who had been engaged in asbestos spraying for 16 years. Lymph nodes obtained from
      Daniel's biopsy revealed tissue reaction compatible with sarcoidosis. On the
      other hand, a large number of asbestos particles were detected in the lung tissue
      from transbronchial lung biopsy and in bronchoalveolar lavage fluid, but no
      epithelioid granuloma was observed in the lung tissue. Various immunoserological
      findings such as PPD skin test, serum angiotensin converting enzyme activity,
      serum beta-glucuronidase and lysozyme level, serum antinuclear antibody,
      lymphocyte subset of blood and bronchoalveolar lavage fluid were inconsistent
      with sarcoidosis. However, lymph node enlargement and immunological abnormalities
      in this patient may be related to asbestos exposure and may not have occurred
      merely by chance.

PMID- 2236998
TI  - [Topographic mapping: thoughts on the past and the future].

PMID- 2236997
TI  - [An autopsy case of acute interstitial pneumonia].
AB  - An autopsy case of a 77-year-old male with acute interstitial pneumonia (AIP) is
      reported. The patient died of respiratory failure in the extremely rapid course
      of 8 days. The histogenesis of the thickening of the alveolar wall and the
      intraluminal lesions were noticed. Incorporation of the hyaline membrane as well
      as the intraseptal edema and septal cell proliferation played an important role
      in the fibrous thickening of the alveolar wall. The intraluminal granulation
      tissue was observed in the alveolar space and the alveolar duct, often extending
      into the respiratory bronchioles. Intraluminal granulation tissues in the alveoli
      frequently had the appearance of intraluminal buds of mesenchymal cells, so
      called Masson's bodies, and there was little remodeling of pulmonary structures
      in this case. These findings suggest an acute, diffuse and severe damage of the
      peripheral respiratory tract and are consistent with bronchiolitis obliterans
      with classical interstitial pneumonia (BIP) by Liebow and AIP by Katzenstein.
      This patient had suffered from suspected "Bronchiolitis obliterans organizing
      pneumonia" (BOOP) one and half years ago. The relationship between AIP, BIP and
      BOOP is discussed.

PMID- 2236999
TI  - Alcoholism recovery in lesbian women: a theory in development.
AB  - Utilizing the modified practice-theory strategy for theory building, a
      provisional theoretical model was developed to describe alcoholism recovery in
      lesbian women. Assumptions are acknowledged, key concepts are identified, and
      propositions are formulated for the purpose of generating nursing knowledge about
      a significant health problem in this aggregate of women. The theory's
      implications for nursing research, practice, and further theory development are
      discussed.

PMID- 2237000
TI  - Effects of antepartal stress on health status during early motherhood.
AB  - A group of high-risk women who were hospitalized for a pregnancy-risk
      complication, and a group of low-risk women experiencing normal pregnancy were
      compared for differences in health status and the effects of antepartal stress on
      their health status from pregnancy through early motherhood. High-risk women
      reported a statistically significant poorer health status during pregnancy, early
      postpartal hospitalization, and at eight months following birth. High-risk women
      reported greater stress from negative life events in addition to their greater
      pregnancy risk. Among both groups of women, negative life events' stress had
      indirect effects on health status over time through either self-esteem, family
      functioning, mate relationships or perceived support. The effects of a high-risk
      pregnancy on health status were evident at eight months following birth; high
      risk women's feelings about their pregnancy and the extent of stress from
      hospitalization had direct effects on their health status, while negative life
      events had indirect effects.

PMID- 2237002
TI  - Personal control and other determinants of psychological well-being in nursing
      home elders.
AB  - The purpose of this correlational study was to identify predictors of
      psychological well-being in nursing home elders. Predictors considered were two
      dimensions of personal control, physical health, functional health, socioeconomic
      status, length of stay in the nursing home, and interaction variables. The
      nonrandom sample consisted of 302 cognitively intact nursing home elders with
      poor to excellent self-rated physical health. Instruments used included the Life
      Satisfaction Index A, Affect Balance Scale, Desired Control Measure, The Index of
      Activities of Daily Living, and The Two Factor Index of Social Position.
      Regression analysis demonstrated that dimensions of personal control and self
      rated physical health explained 33% (p less than .001) of the variance of
      psychological well-being. Findings suggested predictor variables to guide the
      promotion and maintenance of psychological well-being in the subjects of this
      sample.

PMID- 2237001
TI  - Personal knowing: evolving research and practice.
AB  - Personal knowing is essential to the development of knowledge central to the
      practice of nursing. Personal knowing as a process of research within practice is
      conceptually developed through definition, components, attributes, and examples.
      Although personal knowing, i.e., discovery of self-and-other arrived at through
      reflection, synthesis of perceptions, and connecting with what is known, has been
      identified as a fundamental way of knowing for nursing (Carper, 1978), the
      process has not previously been systematically developed or tied in with the
      theoretical, syntactical, and practice structures of nursing. In this article, an
      increased emphasis on personal knowing within the research and practice domains
      of nursing is proposed, and implications and questions are raised regarding
      implementation.

PMID- 2237003
TI  - [The sociocultural correlates of psychopathic personalities].

PMID- 2237004
TI  - [Clonidine treatment in manic episodes].
AB  - The authors have treated 20 patients hospitalized for acute manic disorders with
      450-750 micrograms of clonidine per day for a period of one month. The tolerance
      to the drug was excellent. A marked decrease in manic symptoms was noted in 65%
      of the patients after the first ten days of therapy. The response was rapid and
      was maintained for the entire duration of the study, and clonidine was efficient
      for all the symptoms of the manic syndrome. The supra-sedation effect was much
      lower than with neuroleptics, and clonidine could be considered to represent a
      practical progress in the acute therapy of manic patients. Clonidine, usually
      employed as an anti-hypertensive drug, is an alpha-2-adrenergic agonist. It is
      believed that this property decreases the neural transmission by noradrenaline by
      stimulating pre-synapsis inhibitor receptors.

PMID- 2237005
TI  - [The types of remission in schizophrenia in students. A clinical catamnestic
      study].

PMID- 2237006
TI  - [Observations on deaths in alcoholism].
AB  - The present study is an attempt to establish the death rate of alcoholic patients
      with their various psycho-organic complications. The study was done on cases of
      alcoholic patients hospitalized in our Clinic over the past three decades. Thus,
      if the mortality index in 46,591 psychic patients hospitalized between 1959 and
      1988 was of 0.36%, in alcoholics (totalling 5,580 of all patients) the mortality
      index was of 1.97%. An analysis of these figures with the aid of the X-square
      method showed a p of less than 0.001, indicating a significant difference with a
      probability of over 99.90% between these two groups of patients.

PMID- 2237008
TI  - [Transient global amnesia (a study of 30 cases)].
AB  - The authors have studied 30 patients with transient global amnesia aged between
      49 and 76 years (median age of 63 years), without focal neurologic signs that
      have been followed for periods varying between 6 months and 10 years. Three of
      the patients had recurrent attacks of transient global amnesia, and another three
      had a stroke, although at some distance from the amnesia attack. Association was
      noted with certain risk factors including high blood pressure, and angiopathic
      changes of the eye fundus (in 50% of the patients), dyslipidemia (in 30%),
      diabetes (in 10%), and essential polyglobulia (in 7%). Coagulation studies
      including thrombelastograms were carried out in 22 patients, and demonstrated
      hypercoagulability in 50% of them. Changes in the arterial wall were noted in 85%
      of the 14 patients in whom carotid sphygmograms were recorded. The presence of
      these risk factors could explain the occurrence of cerebrovascular accidents in
      patients with transient global amnesia. Electroencephalograms performed
      immediately or a short time after the amnesia attack have evidenced in 18
      patients rapid-type dysrhythmia, or diffuse theta waves, predominantly located in
      the deep layers of the left and right temporal areas. The EEG tracings were
      either flat or normal in the remaining 12 patients. Of the 30 patients presenting
      with global transient amnesia only two had migraine in antecedents, and another
      six had headache during the evolution of amnesia. The neurologic examination did
      not reveal any abnormality in 27 of the patients. Sequelar signs of neurological
      deficits were noted in the remaining three patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2237007
TI  - [Olivopontocerebellar atrophy in the context of progressive cerebellar atrophies
      (a clinico-anatomical study)].
AB  - The study of 15 cases of progressive cerebellar atrophies, and especially of the
      olivopontocerebellar atrophy, that was investigated both clinically and
      anatomically, has attempted to evidence particularities and correlations existing
      between these two types of atrophy. Olivopontocerebellar atrophy appears to be an
      abiotrophy of the cerebellum, considered to be spontaneous, sporadic, and
      sometimes with a hereditary familial background. It is a systemic disease,
      predominantly of the neocerebellum and involving the cerebellopedal system. It is
      at the opposite end of Holmes-type atrophies, and of the cerebello-olivary
      atrophies of the young (I. T. Niculescu, Th. Hornet, 1936) which mainly involve
      the paleocerebellum. The disease has a polymorphous symptomatology, it has a
      slow, progressive evolution with mostly cerebellar signs, with extrapyramidal
      phenomena and psychical disturbances due to lesions of the telencephalic
      pathways, and sometimes of the spinal, cerebellar and bulbar proprioceptive
      afferences, with spinal and bulbar involvement (Cezar Ionel, 1949, 1972).

PMID- 2237009
TI  - [Calcification of the cerebral hemispheres in an infant. A clinical case].

PMID- 2237010
TI  - [The diagnosis of cerebral lesions by stereotaxic biopsy].

PMID- 2237012
TI  - [Cutaneous tuberculosis, a forgotten disease?].

PMID- 2237011
TI  - [Risk factors in cerebral ischemic vascular diseases and their primary
      prevention].

PMID- 2237013
TI  - [Stress of medical origin and "education" of the patient].

PMID- 2237014
TI  - [Therapeutic strategies in pregnancy bacteriuria].

PMID- 2237015
TI  - [Post-concussion vertigo. Vertigo of cervical origin].

PMID- 2237016
TI  - [Importation of animal and human tropical myiasis by Cochliomyia hominivorax
      (Coquerel) in Libya (diptera: Calliphoridae)].

PMID- 2237017
TI  - [Splenectomy].

PMID- 2237018
TI  - [Electronic gas analyzer].

PMID- 2237019
TI  - [Growth disorders. Treatments].

PMID- 2237020
TI  - [Growth disorders. Surgical lengthening by external fixators].

PMID- 2237021
TI  - [Growth disorders. Ilizarov fixator].

PMID- 2237022
TI  - [Growth disorders. Initial project and realization].

PMID- 2237023
TI  - [A problem of height].

PMID- 2237024
TI  - [Delegation].

PMID- 2237025
TI  - [The nursing assistant in the patient care team].

PMID- 2237026
TI  - [Growth in length of lower limbs].

PMID- 2237027
TI  - [Our systems of retirement. The future].

PMID- 2237028
TI  - [Echoguided kidney puncture biopsy].

PMID- 2237029
TI  - [The world situation of AIDS].

PMID- 2237030
TI  - [Growth delays in children].

PMID- 2237031
TI  - Performance variables associated with the competitive gymnast.

PMID- 2237032
TI  - Thermoregulation in pregnancy. Implications for exercise.
AB  - Studies concerning exposure to heat during pregnancy have indicated that maternal
      hyperthermia can be teratogenic, causing primarily CNS abnormalities. Data, using
      the animal model, have consistently indicated that the effects of heat are most
      hazardous when exposure occurs in the first trimester of pregnancy. However, the
      human data from retrospective studies and sauna bath exposure are not conclusive.
      Since the risk potentially exists, physicians have been advising expectant
      mothers to avoid self-inflicted conditions that may result in core temperatures
      above 38.9 degrees C (102 degrees F). Research has indicated that exercise can
      result in core temperatures above the recommended level. Considering that early
      in pregnancy the mother may not appreciate her pregnancy and could exercise at
      high intensities, the possibility of exposing the fetus to hyperthermia exists.
      Of the limited studies of exercising pregnant women, there are no data suggesting
      that normal women actually exercise to a level of exertion that causes
      significant hyperthermia. However, these studies have been limited to nonathletic
      populations, in which the exercise has not been prolonged and of high intensity,
      or sufficient to induce dehydration. Other data indicate that if hyperthermia is
      a potential consideration for the exercising mother, then exercise in the water
      may be better as it provides for greater heat loss. The data concerning exposure
      to cold, although sketchy, suggest that unless the hypothermia is detrimental to
      maternal survival, there is minimal risk to the fetus.

PMID- 2237035
TI  - Athlete's nodules. Treatment by surgical excision.
AB  - Athlete's nodules are connective tissue nevi of the collagen type (collagenomas)
      which appear as thick dermal masses at sites of chronic trauma. They have been
      described as occurring on the dorsum of the feet, knees, and knuckles of surfers,
      boxers and marble players. Recurrent minor blunt trauma and pressure are
      aetiological factors in this condition. We report a 54-year-old man with dermal
      nodules on the dorsal surface of his feet. These lesions initially appeared
      during his participation as a player on a high school football team. They were
      attributed to the chronic pressure of his high-laced athletic sneakers and
      frequent minor injuries to the involved areas. We describe the successful
      treatment of our patient's lesions by surgical excision. We also discuss the
      differential diagnosis and other therapeutic options for athlete's nodules.

PMID- 2237036
TI  - [What is your diagnosis? Osteoid osteoma].

PMID- 2237033
TI  - The assessment of physical activity by leisure-time physical activity
      questionnaires.
AB  - The assessment of physical activity by questionnaire is currently the most
      popular and practical method of quantifying physical activity levels. Many
      questionnaires, past and present, have considered overall or habitual physical
      activity, which includes occupational (or nonleisure) activity. Others have
      focused specifically on leisure-time physical activity (LTPA) owing to the
      recognition of its dominating contribution to the total physical activity of
      developed populations. This review covers questionnaires that wholly or in part
      attend to LTPA levels. Typically, self-complete or interviewer-administered
      questionnaires record information on the types, frequency and duration of
      activities performed over a particular period of time. Activity-specific energy
      cost values, expressed in metabolic equivalents (METS) or kilocalories, are then
      commonly used to estimate the total energy expenditure from all activities and/or
      categories of activities. The validation of LTPA questionnaires has had to rely
      upon indirect methods, such as the assessment of cardiorespiratory fitness, body
      composition and activity diaries. The reporting of the reliability of
      questionnaires has frequently been ignored, although in cases where it has been
      reported, doubt exists as to whether the consistency of the questionnaire or the
      consistency of subjects' physical activity habits were being examined. LTPA
      questionnaires first appeared in the literature in the mid-1960s for use among
      specific, mainly middle-aged male population groups. Though they varied in their
      modes of scoring, periods of activity recall, and overall complexity,
      associations were universally observed between physical activity levels and
      chronic health conditions. However, it became apparent that different
      questionnaires did not yield the same results. In 1978, a questionnaire to assess
      only LTPA, the Minnesota LTPA Questionnaire, was published and despite its
      substantial limitations, has since established itself as the most popular option
      available. In recent years, shorter and simpler alternatives have been advocated,
      though most have yet to be adequately scrutinised. Associations have been found
      between LTPA and fitness levels, prompting the use of LTPA questionnaires in
      large-scale fitness surveys of both adults and children. Although LTPA has
      continued to be estimated in terms of energy expenditure, little attempt has been
      made to extend existing knowledge on the energy cost of physical activities.
      Existing values do not accommodate for individual intensities and inter
      population activity variations. Consequently, standardised questionnaires are not
      yet viable. There exists considerable scope for further work with LTPA
      questionnaires, especially since the association between coronary heart disease
      and physical activity is now well recognised. Efforts ought to be directed at
      wider social groups for whom leisure-time activity may have distinct
      implications.

PMID- 2237037
TI  - [Femoral neck fractures].

PMID- 2237038
TI  - [The eye as a reference organ for diseases of the nervous system. Simple
      examination methods for office practice and at the bedside].
AB  - The eye is not only for vision. In diseases of the nervous system it can fulfill
      the task of a diagnostic tool. As a highly developed sensory organ, the eye is
      affected by disorders of the visual pathways, the pupillo-motor structures or the
      ocular motor system. Several simple clinical tests are presented which can be
      performed in practice or at the bedside without any technical equipment.

PMID- 2237034
TI  - Erythrocytic system under the influence of physical exercise and training.
AB  - It is obvious that physical performance, endurance capacity and resistance to
      fatigue in humans are dependent upon many different factors. One factor, the
      oxygen carrying capacity of blood, seems to be of particular importance. This
      factor is mainly determined by haemoglobin concentration, number of circulating
      erythrocytes and the efficiency of their functions. A single bout of physical
      effort and, even more, repeated exercise may change the morphological indices of
      blood and influence the erythropoietic processes in the bone marrow. That is why
      there is so great an interest now attached to the effects of physical exercise on
      the erythrocytic system. Although in recent years many papers have been published
      on the subjects their findings pertaining to the effects of single bouts of
      exercise and systematic training on the erythrocytic system are often
      contradictory. The haematological parameters in some top-class athletes,
      particularly those performing in endurance disciplines are lowered at rest.
      Anaemia has been described in sportsmen, even among the members of Olympic teams.
      This type of anaemia has been called 'sports anaemia', 'athletes' anaemia' or
      'postexercise anaemia' in order to emphasise its character. Among many possible
      causes which may bring about the development of sports anaemia the most commonly
      recognised are: postexercise plasma expansion, intensified haemolysis during
      physical efforts, iron deficiency, losses of erythrocytes by the way of bleeding
      into the digestive and urinary systems and also some disturbances in
      erythropoiesis. However, there is evidence of the intensification of
      erythropoiesis by many factors occurring during physical exercise.

PMID- 2237039
TI  - [Recurrent inguinal hernia].
AB  - Recurrence is the most common complication after operation for inguinal hernia. A
      first recurrence is seen in 1 to 10%, depending on the type of operation.
      Recurrence rates up to 39% are observed after multiple recurrences. After a mean
      follow-up of 8.8 years we found 238 recurrences, in 52% lateral, in 41% medial
      and in 7% combined ones. The follow-up showed that the probability to acquire a
      new recurrence after operation for recurrent hernia rises with increasing numbers
      of recurrences. Age is without influence on recurrence formation. In 37% of the
      operations the primary inguinal hernia repair was performed in the same hospital.
      In this group of patients no correlation was observed between recurrence and
      illness with raised intraabdominal pressure or lipomas of the cord. In 47% we
      found lateral recurrent hernias, after medial recurrences one third of the
      patients were presented with a new recurrence, and after combined hernias about
      20% had a new recurrence. Beside various discussed factors it seems that the
      operation technique mostly influences the result of the operation.

PMID- 2237040
TI  - [Vertebral and costal stippling. A pitfall in scintigraphy].
AB  - Bone scintigraphy is largely used for diagnosis and surveillance of
      osteoarticular diseases. Interpretation of fortuitous increased isotope
      accumulation elsewhere on the skeleton may be difficult. We report a man with a
      peripheral seronegative inflammatory arthropathy, whose bone scintigraphy
      disclosed stippled ribs and vertebral increased isotope uptake, corresponding to
      rib enthesopathy and vertebral hyperostosis. Better knowledge of these unusual
      pictures should prevent further unnecessary investigations.

PMID- 2237041
TI  - [Myoma in pregnancy--a case report and a literature review].
AB  - We report the complications of uterine leiomyomas during pregnancy in a case
      report and a review of the literature. The major complication is the syndrome of
      painful myomas. Other problems are premature labor, abruptio placentae and
      postpartum hemorrhage. The method of delivery seems not to be influenced by
      uterine myomas. Leiomyomas are no contraindication for pregnancy, but intensive
      antenatal care is advised.

PMID- 2237042
TI  - [Tenosynovial giant cell tumor in the differential diagnosis of painful heel].
AB  - Based on a case report regarding a patient with a tenosynovial tumor in the
      calcaneal spur area, we present a compilation of the differential diagnoses in
      the event of heel pain. The diagnostic procedure is dealt with peripherally. As
      to the various therapeutic possibilities, we refer to the literature.

PMID- 2237043
TI  - [A case from practice (191). Acromegaly due to microadenoma of the hypophysis
      with cardiomyopathy and arterial hypertension].

PMID- 2237044
TI  - [A case from practice (192). Cryptogenic peripheral facial paralysis (Bell's
      palsy)].

PMID- 2237045
TI  - [Control of diabetes and late complications].
AB  - When insulin was introduced in medical therapy in 1922, it permitted to save
      diabetics from premature death; however, it has allowed, after a certain period
      of time, for the appearance of a cohort of chronic complications connected more
      or less specifically to the degree of hyperglycemia. After a short review of the
      pathophysiology of the microangiopathy, the authors have tried to demonstrate, on
      the basis of numerous prospective and retrospective studies in the human as well
      as in the animal, that an important relationship exists between the degree of
      glycemic control and the severity of the classical complications, retinopathy,
      neuropathy and nephropathy. However, the most recent studies have stressed the
      role of some other factors, not well established in the past, as for example the
      potential negative impact on retinopathy of rapid normalization of glycemia,
      following a long period of poor metabolic control. Likewise, high blood pressure,
      smoking, genetic background, as well as probably also excess of protein intake,
      do play an important etiopathogenic role. Thus, the simplistic equation
      hyperglycemia = complications is not completely valid. Microangiopathic risk in
      insulin-dependent diabetics seems to be low as long as their HbAlc is below 7.5%,
      and they do not have hypertension and do not abuse tobacco. Finally, the general
      approach to therapy is redefined: Try to get as close as possible to near
      normoglycemia by multiple insulin injections, without causing, however, major
      hypoglycemia; this should be done very early after the onset of the
      disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2237046
TI  - [Dyslipidemia in diabetes mellitus: significance, diagnosis and treatment].
AB  - Dyslipidemias are frequent in diabetic subjects: they increase the risk for
      atherosclerosis, in addition to the risk of diabetes mellitus per se. The
      pathogenesis of dyslipidemias differs between type I and type II diabetes:
      untreated type I diabetic subjects demonstrate frequently increased triglyceride
      concentrations due to diminished removal of triglyceride-containing particles, as
      a result of diminished activity of lipoprotein lipase. In addition, more
      triglycerides are produced due to increased lipolysis and increased free fatty
      acid supply to the liver. Type II diabetic subjects demonstrate very low density
      lipoprotein (VLDL) over-production due to obesity, insulin resistance and caloric
      overconsumption. In addition, triglyceride removal may be diminished due to
      diminished lipoprotein lipase activity when diabetes mellitus is poorly
      controlled. In addition, high density lipoprotein (HDL) is frequently lowered.
      During decompensation low density lipoprotein (LDL) concentrations may also
      increase. LDL particle composition is frequently abnormal. A severe dyslipidemia
      in diabetes mellitus is frequently a combined effect of diabetes mellitus and a
      congenital lipoprotein abnormality. The evaluation and treatment of dyslipidemias
      in diabetic subjects should be performed similarly to non-diabetics according to
      the guidelines published recently by the Working Group 'Lipids' of the Swiss
      Foundation of Cardiology. Additional accents in diabetic subjects are necessary.
      It is recommended that serum cholesterol, triglycerides and HDL are determined in
      every patient when diabetes mellitus is diagnosed. If serum cholesterol is
      greater than 6.5 mmol/l and the cholesterol/HDL-ratio is greater 6.5, dietary
      treatment should be reinforced; if its effect is insufficient, drug therapy
      should be considered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2237047
TI  - [Diabetic retinopathy].
AB  - The risk of blindness in diabetes may be significantly reduced by a suitable
      ophthalmic therapy. In order to apply this therapy in due time to the population
      at risk, all diabetics should be referred to ophthalmological follow-up
      examination at regular intervals. A rapid progression of a retinopathy may occur
      in young patients, especially during puberty and pregnancy, after change from
      oral antidiabetics to insulin and, temporarily, following strict control of blood
      glucose. Besides normoglycemia, the prevention of a high blood pressure is an
      important prerequisite of an efficient treatment of diabetic retinopathy. Retinal
      photocoagulation has been proven the most effective mode of therapy. The correct
      indication and stage-depending dosage of retinal laser coagulation in diabetes is
      a demanding task which should be reserved to well-trained specialists in this
      field. Diabetic vitreous bleeding and retinal traction detachment are
      complications of advanced proliferative diabetic retinopathy, which can be
      treated successfully in 60-70% of the cases by modern techniques of vitreoretinal
      surgery.

PMID- 2237048
TI  - [Diabetic neuropathy].
AB  - Neuropathy is a frequent late complication of diabetes. The severity and duration
      of hyperglycaemia are probably the principal causal factor. The consequences of
      the effects of neuropathy on the lower-limb and the autonomic nervous system are
      major causes of morbidity. Apart from glycaemic control, no specific treatment is
      yet available, but measures for symptomatic alleviation of certain painful and
      visceral manifestations of diabetic neuropathy exist and are outlined in these
      guidelines. The guidelines also describe simple diagnostic strategies for
      detecting potentially threatening neurological signs, notably reduction or loss
      of lower-limb sensation which expose the patient to the risk of ulceration,
      unnoticed trauma and amputation. The guidelines also summarize the preventive
      educational measures required to minimize these risks.

PMID- 2237049
TI  - [Social and economic aspects in diabetes mellitus].
AB  - The possibility of obtaining health and accident insurance as well as
      participation in a pension scheme does not pose any problems for diabetics in
      Switzerland. However, for a life insurance contract, the diabetic must often pay
      a surplus. The socio-medical evaluation for invalidity insurance for diabetics is
      based upon an eventual decrease in efficiency associated with functional
      alteration of certain organs. Diabetics treated only by dietary means can
      exercise any profession. When treated with oral antidiabetic agents or insulin,
      certain professions are discouraged, particularly when a metabolic crisis might
      be hazardous to the diabetic or a third party. Treatment of active diabetics most
      often aims at obtaining normoglycemia. This should enable patients to follow a
      physically active, even irregular life in their profession, studies and leisure
      without excessive risk.

PMID- 2237050
TI  - [Teaching and education of diabetic patients].
AB  - The instruction of the patient with diabetes mellitus, aimed at the mastery of
      technical elements in self-management, as well as his/her education to a coherent
      behavior respecting both the quality of metabolic control and the quality of
      life, are basic elements of diabetes treatment. To neglect them would be a
      professional error. The physician in charge of a diabetic patient must take into
      account the knowledge and the capabilities that have been acquired by the patient
      before, as well as his/her actual demand for information and instruction.
      Concepts and methods of learning and teaching for diabetic patients that have
      been developed and applied over the last decade may serve as reference for all
      levels of health education.

PMID- 2237051
TI  - [Immunosuppression in Type I diabetes mellitus].
AB  - The etiopathogenesis of type I or insulin-dependent diabetes mellitus is not
      known in details. It is now generally accepted, that type I diabetes is the
      result of an autoimmune disease. Type I diabetes begins after the destruction of
      80-90% of insulin-producing beta cells in the pancreas. This knowledge let to
      immune intervention trials with various immunosuppressive drugs, especially
      cyclosporine A. These studies are still in an experimental stage. Because of
      inefficiency and severe side effects of these drugs, the med.-scientific section
      of the Swiss Diabetes Association recommends not to use immunosuppressive drugs
      in newly diagnosed patients with type I diabetes.

PMID- 2237052
TI  - [Semiautomatic insulin injection equipment (pens)].
AB  - To the best of our knowledge, a good glycaemic control must be advised to avoid
      or delay the degenerative complications of diabetes, bearing in mind an increased
      risk of hypoglycaemias. Among other techniques, a treatment consisting of
      multiple injections (basal-bolus concept) is one way to achieve a good control.
      Although this form of treatment is rather restrictive (frequent blood glucose
      determinations), the use of pens makes it more acceptable. A fully informed and
      cooperative patient is a prerequisite before considering this particular type of
      insulin therapy which, however, is usually not very helpful for older diabetics.
      It is a misconception to think that every patient receiving insulin should do so
      with a pen, just as it is incorrect to recommend multiple injections for all type
      I diabetics. Whether such a therapeutic strategy is indicated should be
      established for each patient individually. In addition, the fashion for pens
      should not distract us from all the other problems associated with inadequate
      diabetic control, such as foot care and systematic blood pressure measurements.

PMID- 2237053
TI  - [Insulin injection/insulin pharmacokinetics].
AB  - Whereas the importance of changing dietary composition and physical activity for
      metabolic control in diabetic patients is well respected, pharmacokinetic
      variables of insulin are often neglected in therapeutic decisions. The ambitious
      goal of euglycemia can rearly be achieved, however, without a profound knowledge
      of factors influencing the pharmacokinetics of insulin, such as site of
      injection, injection technique, miscibility of insulins, dose of insulin,
      injection volume, local blood flow, etc. Available data indicate that it is of
      major importance to implement pharmacokinetic aspects in the daily care of the
      insulin-treated patient.

PMID- 2237054
TI  - [Insulin treatment of Type II diabetes].
AB  - Secondary failure to oral hypoglycemic agents occurs in some 5% of type II
      diabetic patients per year, such that treatment with insulin becomes warranted.
      In most of the cases only hyperglycemia is apparent, while signs of severe
      metabolic derangement such as thirst, polyuria and weight loss are lacking.
      However, the hyperglycemic state adversely affects endogenous insulin secretion
      and favors the development of microvascular complications and neuropathy. In
      addition, dyslipidemia is often present, and the patient's well-being may be
      impaired. To differentiate between real secondary drug failure and transient
      metabolic impairment due to insufficient compliance with the diet prescriptions,
      plasma C-peptide should be measured. Insulin therapy should be initiated with a
      dose of 6-8 IU of an intermediate-action preparation and subsequently adjusted
      based on blood glucose measurements. Frequently it will be necessary to employ
      twice daily a mixture of (rapid- and intermediate-action) insulin in order to
      achieve adequate control of postprandial hyperglycemia. In some cases insulin
      therapy can be discontinued since the endogenous insulin secretion may improve
      during insulin treatment. We do not recommend to use as initial therapy of
      patients with secondary failure to oral hypoglycemic agents a combination of
      sulfonylureas and insulin since the 'insulin-saving' effect is small and not cost
      effective.

PMID- 2237055
TI  - [Human insulin and hypoglycemia].
AB  - It has been reported over the last few years that transferring diabetic patients
      from animal to human insulin can lead, in some of the patients, to a diminution
      of the classical hypoglycaemic symptoms, as hunger and sweating, and to the more
      frequent occurrence of neuroglycopenic symptoms, as the first manifestation of
      hypoglycaemia. These changes seem to involve a fraction of patients estimated
      between 8 and 36%, depending on the type of selection of the patients. A decrease
      in the adrenergic counterregulatory response to hypoglycaemia has also been shown
      in some studies with human insulin. Similar changes in the sequence of
      hypoglycaemic symptoms are also described in various clinical conditions--as
      intensive insulin therapy with tight glycaemic control, long diabetes duration
      and presence of autonomic neuropathy, thus acting as confounding factors.
      According to these facts, a few recommendations are proposed: briefly, human
      insulin should only be prescribed to new patients who are able to learn from the
      very beginning the sequence of hypoglycaemic symptoms with human insulin;
      patients already treated with porcine insulin should not be transferred to human
      insulin. On the whole, studies available to date have not shown an increased
      frequency of severe hypoglycaemia with human insulin; however, this important
      matter still has to be conclusively clarified through well-designed prospective
      studies.

PMID- 2237056
TI  - [The AIDS virus does indeed originate from Africa].

PMID- 2237057
TI  - [What is your diagnosis? Atrial myxoma].

PMID- 2237058
TI  - [Cutaneous manifestations of tuberculosis].
AB  - Tuberculous lesions of the skin occur rarely nowadays. We therefore have mostly
      lost the knowledge to recognize this entity. Furthermore, the great variability
      of the clinical and particularly dermatologic manifestations of the disease can
      tax the most astute clinician. The challenge is even greater, when the patient
      has an intercurrent condition such as a malignancy or AIDS. In order to make
      understanding easier, we replace all descriptive terms, some carried over from
      the last century, by a useful pathogenetic and clinical, algorithmic
      classification. Finally the necessity of biopsy and specific cultures for proper
      diagnosis and treatment of any skin lesion consistent with skin tuberculosis is
      emphasized.

PMID- 2237059
TI  - [Pasteurellosis in human pathology].
AB  - Pasteurella are common bacteria among healthy animals. Humans usually are
      infected by dog and cat bites or scratches. Besides, local skin infection,
      Pasteurella may spread, in some cases, to lungs, joints, bones or, less
      frequently, to other organs.

PMID- 2237061
TI  - [Hand dermatoses in children].
AB  - Dermatoses of the hand in children are part of an original entity which can be
      classified in two groups: a group involving exclusively the hands and another one
      which is predominantly involving the hands. Attention has been focussed mostly on
      hand dermatoses in children (acropustulosis of infancy, papular, acrodermatitis,
      hand foot and mouth disease, subungual, exostosis). We discuss also the
      diagnostic and therapeutic aspects of scabies in children.

PMID- 2237060
TI  - [Cyclosporin in dermatology].
AB  - Cyclosporin is a potent immunosuppressive agent with a selective and reversible
      inhibitory effect on helper T lymphocytes functions mainly interleukin-2
      production. Cyclosporin has no myelotoxic, mutagenic or teratogenic effect. The
      drug is effective in preventing organ rejection, as well as in various auto
      immune and inflammatory diseases. In dermatology the drug is extremely effective
      in psoriasis. Low doses (less than 5 mg/kg per day) have to be used to decrease
      the risk of nephrotoxicity and hypertension.

PMID- 2237062
TI  - [What is your diagnosis? Seropositive chronic polyarthritis in pregnancy].

PMID- 2237063
TI  - [Diagnostic and therapeutic aspects of the initial epileptic seizure].
AB  - We present the concept of an 'epileptic syndrome' which is important for
      prognostic statements and the application of appropriate therapeutic measures. We
      then discuss the epileptic seizure and the assessment of suspected seizure,
      indications for admission to a hospital, diagnostic measures (EEG, CT scan,
      laboratory tests, lumbal puncture, MRI scan, PET scan, angiography), therapy and
      procedures for imminent status epilepticus. Finally, we try to answer the
      question whether anticonvulsant medication should be instituted after a first
      epileptic seizure.

PMID- 2237064
TI  - [Hemiplegia: diagnosis and differential diagnosis].
AB  - Hemiplegia is the most frequent form of paralysis in humans and involves face,
      arm and leg on one side of the body. Diseases localized in the cortex, the
      cerebral white matter (corona radiata) and the internal capsule usually manifest
      themselves by weakness or paralysis of the face, the arm and the leg on the
      opposite side. In the causation of hemiplegia, vascular diseases of cerebrum and
      brainstem exceed all others in frequency. Trauma ranks second, and other
      important causes are brain tumor, encephalitis or abscess and demyelinating
      diseases.

PMID- 2237065
TI  - [Sudden blindness].
AB  - Blindness means no light perception. In that case one observes a fixed dilated
      pupil. An unilateral amaurosis of sudden onset is caused either by an ocular or
      an optic nerve condition. The most common causes are: --occlusion of the central
      retinal artery --apoplexy of the papilla --traumatic lesions to the optic nerve
      Bilateral blindness occurring suddenly is for anatomic reasons due to a
      chiasmatic lesion. It is mainly associated with pituitary apoplexy. More commonly
      bilateral blindness develops sequentially and may be discovered only after the
      second event. Besides other ocular diseases bilateral occipital brain infarction
      has to be considered.

PMID- 2237066
TI  - [Physiological aspects of pain in high voltage therapy application in
      physiotherapy].
AB  - Treatment of pain in the locomotor system is one important goal of physiotherapy.
      To suit this need electrotherapy provides different approaches. Electric impulses
      in the range of microseconds and a potential of up to 500 Volts are in use for
      several years. This article deals preferentially with neurophysiologic aspects on
      the effects of high-voltage-therapy. They may serve the physician as basis for a
      more conscious selection of indications.

PMID- 2237067
TI  - [A case from practice (193). Eosinophilia in Enterobius vermicularis infestation.
      Central hemorrhagic chorioretinopathy of the left eye].

PMID- 2237069
TI  - [The value of isometric exercise in patients with coronary disease].

PMID- 2237068
TI  - [A case from practice (194). Relapsing fever].

PMID- 2237070
TI  - [Silent myocardial ischemia in the diabetic patient].

PMID- 2237072
TI  - [Leiomyosarcoma of the small intestine: apropos of 3 case reports].

PMID- 2237071
TI  - [Preventive and therapeutic management of diabetic patients, a report of
      failure?].

PMID- 2237073
TI  - [Bursitis of the iliopsoas: an unrecognized cause of leg pain].

PMID- 2237074
TI  - [Rheumatism and Crohn's disease. Apropos of 3 cases of preceding arthropathy].

PMID- 2237075
TI  - [Postpartum hemorrhage: hazard... or linkage?].

PMID- 2237076
TI  - [Endometrial adenocarcinoma and polycystic ovary syndrome].

PMID- 2237077
TI  - [A case of Asian rachitis].

PMID- 2237078
TI  - [A model of socio-professional rehabilitation of psychiatric patients].

PMID- 2237079
TI  - [Management for psychotic patients and drug addicts in a community environment
      from the psychoanalytic viewpoint].

PMID- 2237080
TI  - [The treatment of alcoholism in a general hospital. Experience of an alcoholism
      unit].

PMID- 2237082
TI  - [Urodynamic studies in the incontinent woman in a peripheral hospital: a
      challenge?].

PMID- 2237081
TI  - [Alcoholism: is there a rational explanation for and a specific treatment of the
      alcohol-dependent patient?].

PMID- 2237083
TI  - Thoracic neoplasms.

PMID- 2237084
TI  - Adjuvant treatment in resected lung cancer.
AB  - There have been many attempts to develop effective postoperative adjuvant therapy
      in patients with resected lung cancer. Metastatic disease is the commonest site
      of first recurrence. In squamous cell carcinoma local failure is another major
      problem and in adenocarcinoma brain metastases are frequent. There is evidence to
      suggest that radiotherapy can prevent local recurrence but does not appear to
      impact on survival. Response rates to chemotherapy alone and chemo-radiotherapy
      with prolongation of disease-free survival have been encouraging in locally
      advanced (resected stage II, III) disease when treated postoperatively. Results
      of clinical trials using immunotherapy or chemotherapy in early stage disease
      have been disappointing. Several prospective randomized studies by the Lung
      Cancer Study Group were undertaken to assess the merits of various adjuvant
      treatments and are presented.

PMID- 2237085
TI  - Neoadjuvant chemotherapy and surgery of cancer of the esophagus.
AB  - Neoadjuvant, or pre-operative, chemotherapy for esophageal cancer has become an
      area of increasing interest because of the failure of conventional therapy
      (surgery or radiation) to improve disease-free or overall survival. Several
      autopsy series have demonstrated that, in many symptomatic Western patients,
      esophageal cancer is a systemic disease. Neoadjuvant chemotherapy thus, in
      theory, allows a simultaneous attack on both the primary and metastatic disease.
      A number of single-arm, phase II multi-modality trials have been completed.
      Toxicities of chemotherapy, while substantial, have been tolerable. With careful
      attention to detail, operative morbidity and mortality has not been increased.
      Large-scale randomized trials, needed to evaluate the impact of this technique on
      disease-free and overall survival, have been designed and will shortly be
      activated.

PMID- 2237086
TI  - Adenocarcinoma in Barrett's esophagus.
AB  - Adenocarcinoma arising in association with the columnar-lined esophagus is now
      recognized with increasing frequency. The incidence of malignant degeneration in
      Barrett's esophagus, its etiology, and pathogenesis are all issues of ongoing
      debate. The role of gastroesophageal reflux in driving the malignant change
      remains unproven. Surgical resection is the treatment of choice; however,
      prognosis is generally poor. Surveillance of patients with non-malignant
      Barrett's esophagus permits detection of early lesions where resection results in
      excellent long-term survival.

PMID- 2237087
TI  - Diagnosis and treatment of pleural mesothelioma.
AB  - Pleural mesotheliomas are uncommon tumors. They can be broadly classified as
      localized and diffuse. The localized form is a non-epithelial neoplasm that
      occurs as commonly in women as in men and is not related to asbestos exposure. It
      is usually asymptomatic, and is occasionally associated with paraneoplastic
      syndromes. Localized mesotheliomas arise more frequently from the visceral than
      from the parietal or mediastinal pleura. The long-term outcome of these tumors is
      determined mainly by their clinical presentation, and by whether or not they can
      be completely resected. Diffuse pleural mesotheliomas are invariably malignant.
      They are clearly related to asbestos exposure, and are far more common in men
      than in women. Histologically, they are completely or partially epithelial
      tumors. Diffuse mesotheliomas present with dyspnea, chest pain, and weight loss
      and are not associated with paraneoplastic syndromes. Distinguishing malignant
      mesothelioma from metastatic adenocarcinoma can be difficult and usually requires
      a large tissue biopsy on which immunohistochemistry and electron microscopy can
      be performed. The management of diffuse malignant mesothelioma remains
      controversial. Treatment appears to prolong survival which ranges from 6 to 12
      months with supportive care alone. Surgical resection, either with extrapleural
      pneumonectomy or by pleurectomy/decortications remains the mainstay of treatment
      because of the relative ineffectiveness of radiation and chemotherapy. Surgical
      resection alone, however, is inadequate, so most current treatment regimens
      combine operation with radiation and/or chemotherapy. Even with aggressive
      multimodality treatment, the median survival currently ranges from 18 to 24
      months. A better understanding of prognostic factors, a better staging system,
      and innovative treatment strategies are desperately needed in this disease.

PMID- 2237088
TI  - Management of anterior mediastinal tumors.
AB  - The most common neoplasms of the anterior mediastinum are thymomas, lymphomas,
      and germ cell tumors. Surgical exploration was the routine approach to the
      diagnosis and management of these tumors. This is no longer true. The appropriate
      initial treatment of these neoplasms varies from surgical resection to radiation
      therapy to systemic chemotherapy. Except for the small well-encapsulated anterior
      mediastinal mass, it is imperative that a definitive tissue diagnosis be obtained
      before initiating treatment. An overview of these tumors and the specific
      approaches to their treatment are detailed.

PMID- 2237089
TI  - Prognostic indicators in patients with pulmonary metastases.
AB  - Pulmonary metastases from different primary neoplasms have different biological
      characteristics which may correlate with patient survival. Objective criteria to
      reliably select or exclude patients who would benefit from resection of these
      metastases are not available; however, various prognostic indicators have been
      studied for their correlation with post-resection survival. Prognostic indicators
      differ among various tumor histologies. Prognostic indicators identified
      preoperatively which may influence post-resection survival include age, sex,
      histology and location of the primary tumor, tumor doubling time, disease free
      interval, the number of nodules on preoperative roentgenographic studies, and the
      number of metastases resected. Following surgery, resectability, and the number
      of metastases resected may predict expected survival for patients meeting certain
      criteria. No single criterion should be used to exclude patients from surgery as
      resection will provide numerous patients with significant post-resection
      survival.

PMID- 2237090
TI  - Surgical resection of pulmonary metastases.
AB  - Since the first pulmonary resection for metastatic carcinoma to lung in 1939,
      this procedure can now be offered to any patient who fills the following
      criteria: has a controlled primary, resectable lung lesion, has no better
      treatment method available, and is a good surgical risk. With the increased
      incidence of this procedure, more and more attention is being directed to the
      predictors of survival to determine which patients will obtain the best benefit.
      Disease-free interval, tumor doubling time, and number of lesions are discussed
      with the effect each has on survival. This paper covers our experience from 1965
      to 1985 of 415 patients who underwent resection for primary carcinomas with
      metastases to lung. The overall mortality rate is 2%, morbidity rate under 10%,
      and survival rate best for testicular (51%), and head and neck primaries (47%).
      This procedure has a proven efficacy for increasing survival rates in properly
      selected patients.

PMID- 2237091
TI  - [Functional metabolic neuroimaging by positron-emission tomography in man].
AB  - Positron emission tomography allows an in vivo assessment of various
      physiological and biochemical processes, for example cerebral blood flow,
      metabolism, or interactions between ligands and receptors. Data quantification
      and interpretation rest on models describing in a simple way the behavior of the
      labelled molecules. The general principles are common, but each model has
      limitations. The different methods are first validated in and applied to normal
      populations under resting conditions. New techniques for rapid assessments of
      blood flow and metabolism make it possible to measure cerebral activation after
      sensori-motor, mental or pharmacological stimulation. This should allow the study
      of recovery or plasticity of the lesioned brain, after a stroke for example. PET
      measurements of cerebral blood flow, oxygen consumption and extraction, and
      cerebral blood volume are particularly well suited to investigate the
      physiopathology of cerebrovascular diseases. Remote metabolic disturbances give
      information on interregional cerebral connections, and on clinico-metabolic
      correlations. In epilepsy, PET is useful in localizing the epileptogenic focus in
      partial epilepsy: it is hypometabolic interictally. The meaning of the
      hypometabolism has still to be established. New information about the
      neurochemistry of the epileptogenic focus should become available from studies of
      benzodiazepine, excitatory amino acid or opiate systems, for example. PET has
      already enabled pathophysiological hypotheses to be tested in status epilepticus.
      Disturbances of metabolism and neurotransmission systems have been observed at
      various stages and in various types of neurodegenerative diseases. The
      modifications are not only an early reflection of anatomopathological lesions,
      but could give more direct information on the pathogenesis or symptomatology of
      these diseases and hence lead to new therapeutic endeavours, such as appropriate
      replacement therapy analogous by to dopatherapy in Parkinson's disease.

PMID- 2237092
TI  - [Spontaneous cerebellar hematoma in adults. 44 cases].
AB  - Spontaneous cerebellar hematomas account for 10 p. 100 of all spontaneous intra
      cranial hemorrhages. In this series of 44 cases, 3 clinico-pathological groups
      are described on the basis of clinical and pathological data (small, middle and
      massive hematomas). The mortality rate was high (50 p. 100). Nevertheless, early
      and direct draining of the hematomas provides the best chances of survival.

PMID- 2237093
TI  - [Cerebellar ataxia and unilateral asterixis caused by thalamic hematoma. Presumed
      mechanisms].
AB  - A 76 year-old hypertensive man developed an acute inability to stand due to a
      right cerebellar ataxia. Somatosensory performances were normal, but a transient
      and mild weakness of the right arm and leg with Babinski's sign was observed.
      There was a prominent asterixis of the right hand. CT scan showed a hemorrhage of
      the thalamus with surrounding edema of the adjacent internal capsule. Initial
      median nerve somatosensory evoked potentials showed a mild reduction of left
      parietal responses with absent left frontal SEPs (P22 and N30). Fourty days later
      the cerebellar ataxia was persisting while asterixis had disappeared. A second
      recording of SEPs showed a complete recovery of all cortical components. MRI
      performed at the same time showed a left postero lateral thalamic lesion. CT, MRI
      and SEPs findings suggested that asterixis could result from interruption of
      somatosensory fibres projecting to the motor cortex.

PMID- 2237094
TI  - [Standardization of a modular and hierarchic cognitive evaluation scale
      applicable to dementia. A French version of the Hierarchic Dementia Scale].
AB  - We tested a revised version of the Hierarchic Dementia Scale (HDS), proposed by
      Cole and Dastoor (1980), in order to improve its clinical usefulness and to
      enrich our knowledge about ageing. The scale was built with 20 subtests which
      covered the entire range of cognitive and motor functions. Each subtest was
      hierarchically organized so that success in a item implied success in inferior
      items. This hierarchical principle was time-saving and was validated by Cole and
      Dastoor. 149 control subjects performed this test. They were equally divided in 4
      age-groups (55-64, 65-74, 75-84, 85-97) and 2 educational levels. None of these
      subjects had previous history of somatic or neuropsychiatric disease. They were
      completely self-sufficient in daily life. A large part of the controls failed in
      the most difficult items of some subtests: Learning, Calculation, Mental Control,
      Drawing, Recall, Similarities, Constructional Praxis. For these subtests,
      significantly different mean-scores were observed between age-groups and
      educational levels. However, the influence of each factor was variable from one
      subtest to another. Moreover, subgroups seem to exist in our population according
      to specific difficulties in some of these subtests. This study calls for caution
      in the interpretation of results in demented patients. Comparisons with other
      psychometric tools remain to be performed. This scale seems to be more useful for
      the quantification and follow-up of cognitive deficits than for the early
      diagnosis of dementia. In addition, this scale, which briefly explores many
      aspects of cognitive functions, seems especially useful to approach the
      heterogeneity of DAT.

PMID- 2237095
TI  - [Intradural extramedullary neuro-enteric cysts without associated malformation. 3
      cases with magnetic resonance imaging].
AB  - We report 3 cases of extramedullary neurenteric cyst without associated dysraphic
      lesions. One of the cases had an ultrastructural study. Magnetic resonance
      imaging provided a preoperative diagnosis. The embryogenesis of neurenteric
      cysts, their main clinical aspects and their surgical treatment are reviewed.

PMID- 2237096
TI  - [Neurological disorders disclosing auricular myxoma: 3 cases].
AB  - We report 2 cases (n. 1 and 2) of cerebral infarction caused by a left atrial
      myxoma, and 1 case (n. 3). of dementia associated with a large left atrial
      myxoma. Cerebral emboli and neurological symptoms which can occur prior to
      cardiac obstructive and/or systemic signs require echocardiography. The cardiac
      post-operative condition was dramatically improved in cases revealed by an
      hemiplegia.

PMID- 2237098
TI  - [Intracerebral cavernous angioma and transient ischemic complications].
AB  - A patient with capsulo-lenticular cavernous angioma presented with transient
      hemiparetic attacks. A diagnosis of transient ischemic attacks has been accepted
      and a platelet thrombo-embolic mechanism is suggested.

PMID- 2237097
TI  - [Meningoencephalitis caused by Coxiella burnetii].
AB  - Meningoencephalitis caused by Coxiella burnetii is exceptional and its clinical
      presentation is varied. We report a case which presented as transient central
      neurological deficits and intracranial hypertension without fever. The condition
      was diagnosed by indirect immunofluorescence.

PMID- 2237099
TI  - [Protracted recurrent neuroleptic malignant syndrome].
AB  - The natural course of untreated neuroleptic malignant syndrome (NMS) does not
      usually exceed 3 weeks. Its duration is reduced by dantrolene and/or
      bromocriptine. We report a patient in whom NMS developed after an injection of
      haloperidol decanoate and fluctuated during 3 months. This was due perhaps
      because the initial treatment with oral neuroleptic was pursued, or because the
      doses of dantrolene were insufficient.

PMID- 2237100
TI  - [Oculo-palatal myoclonus and multiple sclerosis].
AB  - A 33 year-old woman with multiple sclerosis developed bilateral palatal
      myoclonus. Rotatory pendular nystagmus and gaze-evoked nystagmus were present and
      analyzed by electro-oculographic recordings. Magnetic resonance imaging
      demonstrated abnormal signals in the pons. To our knowledge, this is the first
      report of palatal myoclonus in the course of a definite case of multiple
      sclerosis.

PMID- 2237101
TI  - [Conference at the Salpetriere. January 1989. Progressive paralysis of phonation
      and deglutition in a 22-year-old man].

PMID- 2237102
TI  - [Early diagnosis of cancers of the mouth].
AB  - Oral cancers are frequent among men aged 45-60. They are detected by dentists
      stomatologists and general practitioners, at advanced stages with cervical
      metastasis node. The routine oral examination and detection of a precancerous
      lesion or an early cancer for alcohol drinkers are tobacco smokers. Main cancer
      symptoms are presented there to support diagnosis.

PMID- 2237103
TI  - [Choice of sectional planes and advantages of the scanner in implantology].
AB  - The future site of the implant, close anatomical obstacles and the insertion axis
      of single various implants, can be determined by the use of the scanner. Giving
      precise instructions is very important in determining the selection of sectional
      planes to be used the radiologist such as: axial sections, direct or
      reconstructed frontal sections, sagittal or reconstructed sagittal oblique
      sections. Precise measures can be directly realized on the scanner. When it is
      impossible to obtain the orthogonality of all the sectional planes, correction of
      the measures can be realized by using the cosinus of the angle obtained by the
      effective sectional plane and the ideal plane.

PMID- 2237105
TI  - [Histological aspects of tooth bleaching technics].
AB  - The chemical principles of tooth bleaching are detailed in order to analyze
      scanning microscopy data obtained following internal and external bleaching tooth
      bleaching appears harmless to the enamel structure providing no etching is
      applied prior to bleaching. Previous enamel undermining appears to increase the
      porosity along preexisting cracks. Internal bleaching gives way to enamel and
      dentinal demineralization, which is of particular importance at the dento enamel
      junction. The biological effects of bleaching on dental hard tissues must be
      viewed in light of the clinical indications for these procedures.

PMID- 2237104
TI  - [Paresthesia of the inferior dental nerve: clinical signs, etiological diagnosis
      and prognosis 1].
AB  - This article is about the different iatrogenic (or others) mechanical and/or
      chemical trauma that can affect the mandibular nerve and which can lead to
      paresthesia. Depending on the different causes of the paresthesia, the prognosis
      for nerve sensitivity regeneration will vary: In some cases treatment is
      necessary to make the symptoms disappear, in others expectation will be the rull
      and the prognosis is very poor.

PMID- 2237107
TI  - [Ex-vivo study of the capacity of bacteria of the genus Capnocytophaga to adhere
      to human buccal epithelial cells].
AB  - The bacteria of the genre Capnocytophaga are part of the subdominant flora of the
      oral cavity. For diverse microorganisms it has been proved that the adhesion
      constitutes the first step of the colonization of a place leading to the eventual
      pathology. The adhesion capacity to human epithelial cells (keratinised and non)
      of eight strains of genus Capnocytophaga has been studied. All strains appear to
      have a very weak capacity of adhesion. This diministe can be originated from the
      fact that the host cells have been harvested from healthy subjects.

PMID- 2237106
TI  - [Canal Finder System 89!!! Improvements and indications after 4 years of
      experimentation and use].
AB  - Actually, the CANAL FINDER SYSTEM is the only entirely automated endodontic
      device. After four years of existence, many evaluations were able to show the
      qualities of this system regarding root canal penetration, cleaning and shaping.
      The earlier concerns such as ergonomical problems were solved: automated
      extraction of the K-file, automated sodium hypochlorite irrigation. A new file
      was created, particularly well adapted to the root canal shaping of curved
      canals. This addition has improved the efficiency of the automated
      instrumentation. The CANAL FINDER SYSTEM has reached a maturity level permitting
      an excellent reliability and ease of use.

PMID- 2237108
TI  - [Influence of age of the periodontal status of adult diabetics: clinical study].
AB  - 340 adult diabetics participated to this work in Conception's Hospital of
      Marseille. The examinated teeth were the 16, 21, 24, 36, 41 and 44. The indexes
      (Pl.I., G.I.), the depths of the pockets (upon these teeth), the quantity of
      gingival fluid (upon 21 and 24 only) were registrated. Statistically, the results
      showed: the gingival inflammation, the quantity of plaque and the severity of the
      periodontal disease increase with age and that with a maximum between 55 and 65
      years.

PMID- 2237109
TI  - Bacterial tracheitis: report of eight new cases and review.
AB  - Bacterial tracheitis, previously referred to as nondiphtheritic laryngitis with
      marked exudate, was commonly discussed in pediatric textbooks before 1940. It
      seemed to disappear as a clinical entity after that time, but it has been
      recorded with increasing frequency in the pediatric literature since 1979. We
      describe eight new cases and review 110 previously described cases. The clinical
      course consists of a prodromal upper respiratory illness with stridor, fever, and
      a variable degree of respiratory distress. Unlike patients with croup, patients
      with bacterial tracheitis do not respond to aerosolized racemic epinephrine. Most
      patients require endotracheal intubation; some require tracheostomy. Reported
      complications include pneumonia, pneumothorax, formation of pseudomembranes,
      toxic shock syndrome, and cardiopulmonary arrest. Bacterial tracheitis is a
      secondary bacterial infection following a primary viral respiratory infection.
      The most common preceding viral infection is parainfluenza. Staphylococcus aureus
      and Haemophilus influenzae are the predominant causes of bacterial tracheitis.
      Secondary bacterial infection may occur as a result of tracheal mucosal injury or
      impairment of normal phagocytic function due to viral infection.

PMID- 2237110
TI  - Hypercalcitoninemia, hypocalcemia, and toxic shock syndrome.
AB  - Toxic shock syndrome is a multisystem illness frequently complicated by
      hypocalcemia. The etiology of the hypocalcemia, which may be severe, is not well
      understood. We report two cases of fatal toxic shock syndrome accompanied by
      severe hypocalcemia; each patient also had an inappropriately elevated serum
      calcitonin level, which in one case was as high as 179,000 pg/mL.
      Hypercalcitoninemia may be a cause of the low serum calcium levels as well as of
      certain clinical manifestations of toxic shock syndrome.

PMID- 2237112
TI  - Acute respiratory disease in Spain: seven years of experience.
AB  - The clinical and epidemiologic features of viral and nonviral pathogens involved
      in acute respiratory diseases are described in the context of cases of infection
      (especially atypical pneumonia and bronchiolitis) studied at the Centro Nacional
      de Microbiologia, Virologia e Immunologia Sanitarias in Madrid during a 7-year
      period (1979-1986). These etiologies were demonstrated in 1,637 (36.2%) of 4,521
      cases. Among viruses, respiratory syncytial virus most frequently infected
      children; influenza virus showed the same pattern of circulation as in other
      European countries. Of nonviral agents, Mycoplasma pneumoniae and C. burnetii
      were most often involved in lower respiratory tract infections, with a variable
      predominance in patients of different ages. A high proportion of cases of M.
      pneumoniae infection occurred in infants and children aged less than 1 year, and
      most of these cases occurred during spring and summer. The majority of Q fever
      cases, including those observed in two outbreaks, occurred in the northern
      region.

PMID- 2237111
TI  - Brucella endocarditis: the role of combined medical and surgical treatment.
AB  - Brucella endocarditis, although a rare complication of brucellosis, is the main
      cause of death related to this disease. This report describes a case of aortic
      endocarditis due to Brucella abortus in an elderly farmer with known aortic
      stenosis. Urgent valve replacement was performed because of progressive heart
      failure despite appropriate antimicrobial treatment. The infection was cured with
      trimethoprim-sulfamethoxazole and rifampin given for 3 months after surgery. A
      review of the literature reports on the 38 other cases of cured brucella
      endocarditis made clear the need for combined antimicrobial treatment and
      surgical valve replacement.

PMID- 2237113
TI  - Tuberculous psoas muscle abscess following chemoprophylaxis with isoniazid in a
      patient with human immunodeficiency virus infection.
AB  - A 34-year-old man with human immunodeficiency virus infection and disseminated
      Mycobacterium avium and Mycobacterium intracellulare infection developed a right
      psoas muscle abscess due to Mycobacterium tuberculosis. The abscess occurred 18
      months after completion of a 12-month course of chemoprophylaxis with isoniazid
      that was given because of a positive reaction with purified protein derivative of
      tuberculin. The adjacent vertebrae did not appear to be involved. The abscess was
      drained with a percutaneously inserted catheter, and he received standard
      antituberculous chemotherapy. Three weeks into therapy, a second drainage with a
      catheter was required. The isolation of two mycobacteria in this patient and the
      apparent failure of chemoprophylaxis with isoniazid are noted.

PMID- 2237114
TI  - Resolution of lung abscess due to Pseudomonas aeruginosa with oral ciprofloxacin:
      case report.
AB  - A case of lung abscess due to Pseudomonas aeruginosa is presented that did not
      resolve with the use of conventional antipseudomonal antibiotics, including
      tobramycin with ticarcillin-clavulanate and ceftazidime with gentamicin and
      ticarcillin-clavulanate. Oral ciprofloxacin was administered for 12 weeks, and
      the infection was resolved. No resistance occurred, and there was no recurrence
      of abscess within 18 months following therapy.

PMID- 2237115
TI  - Pulmonary and disseminated infection due to Mycobacterium kansasii: a decade of
      experience.
AB  - Fifty-five patients with Mycobacterium kansasii isolates (47 pulmonary and eight
      disseminated) were identified at a large Texas hospital from 1975 to 1985. The
      mean age of patients was 60 years, and there was a slight male predominance.
      Isolation of M. kansasii usually represented disease. The great majority of
      patients with pulmonary infection due to M. kansasii had underlying pulmonary
      diseases, and 70% had nonpulmonary predisposing factors. M. kansasii pulmonary
      disease clinically and radiographically resembled pulmonary tuberculosis.
      Disseminated M. kansasii infection occurred in severely immunocompromised
      patients, who frequently had pulmonary predispositions as well. Disseminated
      infection most of ten involved the lung, reticuloendothelial system, bone, joint,
      and skin and presented with signs and symptoms related to these organs. Despite
      only moderate in vitro susceptibility of M. kansasii to routine antituberculous
      drugs, most patients responded to rifampin-containing regimens. The prognosis of
      patients with M. kansasii disease was determined primarily by their underlying
      diseases.

PMID- 2237116
TI  - Spectrum of Cryptococcus neoformans infection in 68 patients infected with human
      immunodeficiency virus.
AB  - Sixty-eight patients infected with human immunodeficiency virus (HIV) and
      Cryptococcus neoformans who presented to three major medical centers in New
      Orleans, Louisiana, were studied retrospectively. In patients with meningitis the
      most common presenting symptoms were fever and headache. Those without central
      nervous system involvement generally had an isolated pulmonary infection due to
      C. neoformans and presented with cough and dyspnea. CSF parameters were abnormal
      in 41% of patients, and the India ink preparation was positive in 88% of patients
      with cultures of CSF positive for C. neoformans. The overall median survival time
      for the 47 patients who died was 5 months, with a range of 0-22 months. Of the 27
      patients who received maintenance therapy with amphotericin B, two (7%) relapsed.
      The only factors found to be associated with a poor prognosis were abnormal
      computed tomography of the head and altered mental status on presentation. C.
      neoformans infections in HIV-infected patients remain difficult to treat and have
      a poor prognosis.

PMID- 2237117
TI  - Comparison of species distribution and antimicrobial susceptibility of aerobic
      actinomycetes from clinical specimens.
AB  - To compare the species distribution and antimicrobial susceptibility of aerobic
      actinomycetes, we evaluated 366 isolates referred to the Centers for Disease
      Control from October 1985 through February 1988. We used conventional biochemical
      tests to identify the various species. Four species accounted for 191 (52%) of
      aerobic actinomycete isolates: Nocardia asteroides (98 isolates), Actinomadura
      madurae (42 isolates), Streptomyces griseus (28 isolates), and Nocardia
      brasiliensis (23 isolates). Sputum and wounds were the most common sources. No
      isolate was resistant to amikacin, no N. brasiliensis isolate was resistant to
      sulfamethoxazole or trimethoprim-sulfamethoxazole, and no A. madurae isolate was
      resistant to ceftriaxone or imipenem. In summary, our findings show that unusual
      species of aerobic actinomycetes can cause infection, colonization, or both and
      that antimicrobial resistance varies markedly by species.

PMID- 2237118
TI  - Early treatment with acyclovir for varicella pneumonia in otherwise healthy
      adults: retrospective controlled study and review.
AB  - The effect of early acyclovir therapy on the course of varicella pneumonia in
      previously healthy adults was assessed. Medical records from five university
      affiliated medical centers were retrospectively reviewed; included were all
      immunocompetent adults with a clinical diagnosis of primary varicella, a chest
      radiograph consistent with varicella pneumonia, and an arterial blood gas
      measurement indicating significant hypoxia. Of the 38 patients who met the study
      criteria, 11 had had a course of intravenous acyclovir initiated within the first
      36 hours of hospitalization; the mean time from admission to initiation of
      therapy in this early-treatment group was 9.6 hours. The group that received
      early acyclovir treatment had a lower mean temperature beginning on the fifth day
      of hospitalization (37.0 degrees C vs. 37.7 degrees C; P = .011) and a lower mean
      respiratory rate beginning on the sixth day of hospitalization (21 vs. 28
      respirations per minute; P = .004). Early acyclovir therapy also resulted in a
      significant improvement in oxygenation beginning on the sixth day of
      hospitalization in patients with follow-up arterial blood gas measurements (P =
      .035). Thus, early institution of acyclovir therapy is associated with reduction
      in fever and tachypnea and improvement in oxygenation in otherwise healthy adults
      with varicella pneumonia.

PMID- 2237119
TI  - Pneumococcal endometritis and neonatal sepsis.
AB  - A recent case of postpartum maternal endometritis and neonatal sepsis due to
      Streptococcus pneumoniae prompted this report and a review of previous citations.
      Although this rare presentation of pneumococcal infection is potentially fatal to
      both mother and child, early empiric antibiotic coverage for the most frequent
      etiologic agents of this syndrome, group B streptococci, was and is adequate for
      systemic pneumococcal infections.

PMID- 2237120
TI  - Visceral protothecosis mimicking sclerosing cholangitis in an immunocompetent
      host: successful antifungal therapy.
AB  - A healthy 39-year-old man who had clinical findings consistent with sclerosing
      cholangitis was found to have systemic protothecosis at surgery. Severe
      granulomatous inflammation and palpable nodules were found in the gallbladder, on
      the surface of the liver, and in the duodenum. Prototheca wickerhamii was
      detected in biopsied specimens and stool; the titer of indirect fluorescent
      antibody to this organism was 1:2,000. The patient recovered after a short course
      of treatment with amphotericin B and 3 months of oral therapy with ketoconazole.
      He had no other concurrent illness and had no abnormality in his immune system.
      This is the second reported human case of systemic protothecosis. An elevated IgG
      level, an elevated erythrocyte sedimentation rate, eosinophilia, and abnormal
      levels of enzymes in the liver were found in both cases. Protothecosis should be
      considered in the differential diagnosis of hepatic and biliary inflammatory
      diseases of uncertain etiology.

PMID- 2237121
TI  - Enterobacter bacteremia in pediatric patients.
AB  - Enterobacter has emerged as an important human pathogen, particularly in sick,
      hospitalized patients. Previous reports of nonepidemic enterobacter bacteremia
      have focused on adult patients. In this report, the epidemiologic factors,
      clinical characteristics, treatment, and outcome for 33 patients with
      enterobacter bacteremia in a large children's hospital during a 5-year period are
      reviewed. The ratio of males to females was 1.2:1. The patients' ages ranged from
      2 days to 24 years, and 18 patients were less than 18 months old. Twenty-two
      cases were nosocomially acquired; six were polymicrobial in nature. Significantly
      underlying conditions were present in 32 patients. The biliary tract and central
      venous catheters were the most common sources of bacteremia. Two-thirds of
      patients had preceding antibiotic therapy. The overall mortality was 24%;
      mortality attributable to enterobacter bacteremia was 18%. Statistically
      significant differences in mortality were associated with an age less than 18
      months (P = .031) or thrombocytopenia (P = .017); presence of fever was of
      borderline significance (P = .098). Enterobacter bacteremia is an important cause
      of morbidity and mortality in pediatric patients.

PMID- 2237122
TI  - Postoperative pancreatic abscess due to Plesiomonas shigelloides.
AB  - Plesiomonas shigelloides is being recognized with increasing frequency as a human
      pathogen. The organism is ubiquitous in fresh and brackish water, and clinical
      illness has been associated with foreign travel and ingestion of inadequately
      cooked seafood. We describe a 64-year-old Filipino woman who presented 2 weeks
      after elective cholecystectomy and pancreatic biopsy with left upper quadrant
      pain, abdominal distention, and fever. Computerized tomography of the abdomen
      revealed an abscess in the tail of the pancreas with fluid accumulation in the
      lesser omental sac. Percutaneous aspiration yielded purulent material, and P.
      shigelloides was recovered in pure culture. To our knowledge, this is the first
      reported case of pancreatic abscess due to P. shigelloides.

PMID- 2237123
TI  - Endocarditis due to ampicillin-resistant nontyphoid Salmonella: cure with a third
      generation cephalosporin.
AB  - A case of ampicillin-resistant salmonella bacteremia complicated by endocarditis
      in a 78-year-old man is presented. Previous rheumatic valvular heart disease and
      the lack of response to initial treatment with chloramphenicol prompted us to
      consider this diagnosis. There was a good clinical response after treatment with
      ceftriaxone alone and corresponding improvement on the echocardiogram. This case
      demonstrates the possible endovascular complications of salmonella bacteremia in
      elderly people and that endocarditis should be included among the invasive
      infections due to ampicillin-resistant Salmonella that could potentially be
      treated with the newer cephalosporins.

PMID- 2237124
TI  - Listerial myocarditis in cardiac transplantation.
AB  - Clinical signs of heart failure developed in two cardiac transplant recipients
      and were interpreted initially as graft rejection. Morphologic examination of
      explanted hearts revealed myocarditis with abscess formation and necrosis
      consistent with a bacterial process; Listeria monocytogenes was isolated from
      myocardial tissue in the first case and from blood in both. The first patient
      also developed signs of meningoencephalitis, but the second had no signs of
      infection outside the heart. Antimicrobial therapy and retransplantation were
      successful in eradicating listeriosis. The differential diagnosis of heart
      failure in cardiac transplant recipients includes infectious myocarditis due to
      L. monocytogenes.

PMID- 2237125
TI  - Pneumonia due to Legionella micdadei in bone marrow transplant recipients.
AB  - Legionella micdadei has previously been described as a cause of nosocomial
      pneumonia, particularly in kidney transplant recipients. Cell-mediated immunity
      is the principal host defense against this pathogen. A common clinical scenario
      in the immunocompromised host is that of septic pulmonary embolus, but
      asymptomatic infections have also been reported. The organism is weakly acid-fast
      in clinical specimens but loses this property when grown on solid media. We
      report two cases of L. micdadei pneumonia, differing markedly in clinical
      severity and outcome, in bone marrow transplant recipients. Additionally, we note
      the growth of the organism in liquid culture media with preservation of its acid
      fast property.

PMID- 2237126
TI  - Group C streptococcal arthritis: case report and review.
AB  - Streptococci account for approximately 15%-20% of cases of nongonococcal septic
      arthritis. The majority of these are due to group A streptococci, but group B and
      group G streptococci are being isolated more frequently. We present a case of
      group C streptococcal arthritis and summarize nine additional cases reported in
      the literature. The group C streptococci include the large colony of Voges
      Proskauer-negative bacteria (Streptococcus equi, Streptococcus equisimilis,
      Streptococcus zooepidemicus, and Streptococcus dysgalactiae) as well as as the
      minute colony of Voges-Proskauer-positive Streptococcus anginosus ("Streptococcus
      milleri") group C organisms. Any joint may become infected, but joints affected
      by preexisting rheumatologic abnormalities are more frequently involved.
      Bacteremia was documented in five of the 10 patients. One patient had an
      associated pneumonia, and another patient had an associated acute aortic valve
      endocarditis. None of the infections involved a prosthetic joint or an overlying
      cellulitis, associations reported for group G streptococcal arthritis. Surgical
      drainage of the infected joint was required in six of the 10 patients. We
      concluded that the presence of two groups of organisms sharing the same
      Lancefield group antigen necessitates the careful identification of isolates to
      determine potential clinical differences.

PMID- 2237127
TI  - Primary meningococcal conjunctivitis: report of 21 patients and review.
AB  - Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis.
      Twenty-one cases of primary meningococcal conjunctivitis (PMC) are reported
      herein and 63 cases published in the literature since 1899 are reviewed. In the
      84 cases of PMC available for analysis, the male-to-female ratio was 1.76:1; nine
      of the patients were neonates, 55 were children, and 20 were adults.
      Conjunctivitis was unilateral in 66.3% of the patients. Gram stain of
      conjunctival exudate disclosed gram-negative diplococci in all cases in which it
      was done. Culture of the conjunctival exudate yielded N. meningitidis in all
      cases, and 44% of the isolated meningococci belonged to serogroup B. Ocular
      complications, which occurred in 15.5% of the patients, most frequently were
      corneal ulcers. Systemic meningococcal disease developed in 17.8% of the
      patients; the overall mortality was 13.3% for patients with PMC complicated by
      systemic disease. Development of systemic disease was significantly more frequent
      in patients receiving only topical therapy than in those treated with systemic
      therapy (31.71% vs. 2.38%; P = .001). Gram-negative diplococci observed in
      conjunctival exudate are an indication for systemic antibiotic therapy because of
      the risk of systemic complications associated with the use of topical therapy
      alone. When properly treated, patients with PMC have a favorable prognosis.

PMID- 2237128
TI  - Emphysematous gastritis: case report and review.
AB  - Emphysematous gastritis is a condition involving gastric wall inflammation,
      radiologic or intraoperative evidence of intramural gas, and systemic toxicity. A
      recent case of emphysematous gastritis in a 57-year-old diabetic man is reported,
      and 27 cases published since 1889 are reviewed. Predisposing factors include
      ingestion of corrosive substances (37%) and alcohol abuse (22%). Diagnosis of
      emphysematous gastritis is based on the clinical presentation of an acute abdomen
      with systemic toxicity and on radiographs demonstrating gas bubbles within the
      stomach wall. For the case reported herein, computed tomography was useful both
      in establishing the diagnosis and in following the resolution of emphysematous
      gastritis. Organisms most commonly involved were Escherichia coli (six cases),
      Streptococcus species (six cases), Enterobacter species (five cases), and
      Pseudomonas aeruginosa (three cases). The mortality was 61% (17 of 28 patients),
      and morbidity with gastric contractures occurred in 21% of cases (6 of 28).
      Optimal therapy has not been defined; however, antimicrobial chemotherapy and
      surgery, when appropriate, may improve survival rates.

PMID- 2237129
TI  - Emerging role of lactobacilli in the control and maintenance of the vaginal
      bacterial microflora.
AB  - The vaginal microflora of healthy asymptomatic women consists of a wide variety
      (two to five isolates at any one time) of anaerobic and aerobic bacterial genera
      and species dominated by the facultative, microaerophilic, anaerobic genus
      Lactobacillus. That the vaginal flora forms part of a dynamically changing
      ecosystem is evident from the variable prevalence and population levels of each
      bacterial species detected with repetitive longitudinal sampling, with pregnancy,
      and with stage in the menstrual cycle. This review emphasizes the role that
      vaginal lactobacilli may play in control of the vaginal microflora and
      maintenance of the normal state. Lactobacilli possess many antagonistic
      properties and produce many metabolites that may be important in maintaining
      dominance in the vagina. Contradictory data from previous studies regarding the
      impact of factors such as contraception, catamenial products, and physiologic
      elements on the vaginal microflora are due in part to poor study design and
      differences in methodology. Well-designed and controlled investigations with
      large numbers of individuals in each group are needed, and the limitations of the
      methodology for such investigations must be considered. Studies of the normal
      flora, exploring the interaction of lactobacilli and other bacterial species,
      must be performed before the pathologic processes resulting in vaginitis or
      systemic sequelae are investigated.

PMID- 2237130
TI  - Quinolone antibiotics in the treatment of Salmonella infections.
AB  - The 4-fluoroquinolones are a new class of antimicrobial agents that possess broad
      in vitro antibacterial activity, including efficacy against enteric pathogens
      such as Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio species. These
      drugs are clinically effective against both drug-sensitive and multiresistant
      strains of Salmonella typhi and Salmonella paratyphi that cause enteric fever. In
      salmonella enterocolitis, the quinolones--unlike older antimicrobial agents that
      may have little impact on the duration of symptomatic illness and can in fact
      prolong fecal carriage of salmonellae--actually shorten the course of clinical
      disease and terminate excretion of these organisms in the stool. Similarly, for
      chronic carriers of both typhoidal and nontyphoidal Salmonella strains, the
      quinolones are effective in eradicating biliary and fecal reservoirs of
      infection. Immunosuppressed persons with salmonellosis, such as those with AIDS,
      may benefit from both short-term treatment and prolonged prophylaxis with a
      quinolone antibiotic. The optimal agent, dose, and duration of quinolone therapy
      for all salmonella syndromes remain to be determined by larger controlled trials.

PMID- 2237131
TI  - Infectious diseases as a Canadian subspecialty, with projections to the year
      2000.
AB  - Infectious diseases is a relatively new subspecialty in Canada. During the past
      decade, however, important advances have been made. These include the formation
      of the Canadian Infectious Diseases Society and the development of the first
      Royal College of Physicians and Surgeons examinations in the subspecialty of
      infectious diseases. The majority of Canadians training for practice in the field
      of infectious diseases are now enrolled in programs in Canada. Despite
      predictions in the United States of an excess of physicians who specialize in
      infectious diseases, such a situation has not occurred in Canada. More physicians
      with training in infectious diseases will be required in Canada in the next
      decade to fill positions in patient care, microbiology (for individuals with both
      clinical and laboratory training), research, epidemiology and infection control,
      programs related to human immunodeficiency virus infections, geographic and
      international medicine, the pharmaceutical industry, and education and
      administration. In Canada, the extent to which infectious diseases physicians are
      involved in these areas varies from that in the United States. This review
      suggests a continued need for physicians with appropriate training in infectious
      diseases.

PMID- 2237132
TI  - Current advances in the diagnosis and treatment of AIDS: an introduction.
AB  - Significant progress has been made in the diagnosis and treatment of AIDS.
      Laboratory tests available for assessment of human immunodeficiency virus (HIV)
      infection include the detection of antibodies to HIV type 1, the direct detection
      of the virus, the identification of surrogate markers, and the phenotypic
      analysis of peripheral blood mononuclear cells. Clinicians have made great
      strides in the treatment of tumors, opportunistic infections, and complications
      associated with AIDS as well as in the treatment of the infection itself. In
      selected patients, treatment with interferon-alpha has been successful against
      AIDS-related Kaposi's sarcoma. Attempts to treat the leukopenia and anemia of
      patients with AIDS by the administration of hematopoietic growth factors have
      resulted in increased white blood cell counts and a decrease in erythrocyte
      transfusion requirements. In addition to zidovudine, several antiretroviral
      agents are undergoing testing, including the nucleoside analogues dideoxycytidine
      and dideoxyinosine, soluble CD4, and the glycosidase inhibitor N
      butyldeoxynojirimycin.

PMID- 2237133
TI  - Laboratory methods in the diagnosis and prognostic staging of infection with
      human immunodeficiency virus type 1.
AB  - Laboratory evaluation of infection with human immunodeficiency virus type 1 (HIV
      1) may involve detection of antibodies to HIV-1, direct detection of HIV-1
      itself, and measurement of an individual's immunologic status at the time of
      presentation. The ELISA is currently the preferred initial screening test,
      although a variety of other rapid immunoassays have also been developed. Methods
      defining the antigenic specificity of the antibody response, such as the western
      blot, have become standard confirmatory tests in this setting. CD4+ cell
      enumeration and the HIV-1 antigen capture assay are useful in predicting the
      course of HIV-1 infection and in monitoring antiretroviral therapies. Newer
      techniques of HIV-1 co-cultivation permit the characterization of viral isolates
      and the stratification of patients and facilitate monitoring of the effects of
      antiretroviral agents. The polymerase chain reaction is of value in identifying
      HIV-1 infection in individuals with inconclusive serologic results. Judicious use
      of other laboratory tests, including surrogate markers such as beta 2
      microglobulin, also provides prognostic information potentially useful in
      clinical management of HIV-1-infected patients.

PMID- 2237134
TI  - Management of the hematologic complications of human immunodeficiency virus
      infection.
AB  - Replication of various strains of human immunodeficiency virus can be increased
      in vitro by certain colony-stimulating factors (CSFs), but the protective effect
      of zidovudine (AZT) on macrophages is not antagonized in the presence of those
      factors--specifically, in the presence of granulocyte-macrophage CSF (GM-CSF). In
      clinical studies, GM-CSF given alone dramatically increased counts of white
      cells, particularly neutrophils and band cells. Very small doses of GM-CSF, self
      administered subcutaneously, restored white cell production in leukopenic
      patients with AIDS. Combination treatment with AZT and GM-CSF in AZT-intolerant
      patients allowed resumption of AZT treatment and increased bone marrow
      cellularity. Treatment of anemic patients who have AIDS or AIDS-related complex
      with recombinant human erythropoietin (r-HuEPO) produced promising results. After
      12 weeks of treatment with r-HuEPO, the need for transfusions to maintain
      hematocrit values within the normal range was reduced significantly or eliminated
      in patients with low baseline levels of endogenous erythropoietin. Studies
      combining AIDS chemotherapy with CSF or erythropoietin treatment are proposed.

PMID- 2237135
TI  - Therapeutic approaches to neoplasms in AIDS.
AB  - The multifactorial etiology of Kaposi's sarcoma (KS), which is seen primarily in
      men, includes genetic predisposition and immunosuppression. Recently, the KS seen
      in association with human immunodeficiency virus (HIV) infection has been shown
      to be mediated by the production of certain growth factors. HIV per se may also
      play an etiologic role via its tat gene. Therapeutic options include irradiation
      for local or cosmetic control, interferon-alpha, combinations of antiretroviral
      agents and interferon-alpha, and chemotherapy. The use of antineoplastic agents,
      either individually or in combination, in cases of advanced disease has been
      somewhat successful, but resultant immunosuppression and neutropenia may
      predispose patients to further infection, thereby adversely affecting survival.
      AIDS-related lymphoma, a late manifestation of HIV infection, often presents with
      widespread extranodal disease; the median survival time in all series has been
      approximately 6 months. Two-thirds of patients may have central nervous system
      involvement at some time in the course of illness. Intensive chemotherapeutic
      regimens are associated with an increased likelihood of opportunistic infection
      and do not prolong survival. Combinations of antineoplastic agents given at low
      doses for short periods may be associated with long-term remissions.

PMID- 2237136
TI  - New antiretroviral agents in the clinic.
AB  - Since the first controlled clinical trial of zidovudine (ACT) was terminated in
      the fall of 1986, much has been learned concerning the use of this agent in the
      treatment of human immunodeficiency virus (HIV) infection. The recent report of
      HIV resistance associated with long-term AZT therapy has accelerated the sense of
      urgency about the development of additional agents for use--either alone or in
      combination with AZT--against this infection. Several new agents are in various
      stages of preclinical or clinical evaluation. Some, such as dideoxycytidine,
      dideoxyinosine, dideoxydidehydrothymidine, azidouridine, and foscarnet, inhibit
      viral DNA synthesis through inhibition of reverse transcriptase. Other
      potentially useful agents presumably act at different stages of infection.
      Soluble CD4, for example, is a soluble form of the receptor to which HIV must
      bind to infect cells, and castanospermine represents a new class of compounds
      that block the maturation process of the viral glycoprotein. An apparently more
      potent and less toxic analogue of the latter agent, N-butyl-deoxynojirimycin, is
      currently in phase I testing.

PMID- 2237138
TI  - Persistent neutrophilic meningitis due to Pseudallescheria boydii.

PMID- 2237139
TI  - Infections in patients with cancer in Mexico.

PMID- 2237137
TI  - Measles in Israel, the West Bank, and Gaza: continuing incidence and the case for
      a new eradication strategy.
AB  - Measles continues to occur in epidemic waves in Israel, Gaza, and the West Bank,
      causing morbidity and mortality. In Israel, immunization of infants against
      measles began in 1967, and 90% had been immunized by the mid-1980s. In Gaza and
      the West Bank, where immunization of infants against measles began in 1973 and
      1976, respectively, the immunization rate reached 75% in the late 1970s and
      increased to greater than 90% in the 1980s. Measles epidemics, which previously
      had occurred in 5- to 7-year cycles, occurred every 2-4 years in the 1980s and
      affected individuals who were older than those affected in previous years.
      Israel's commitment to eradicating measles by 1992 will require a substantially
      expanded immunization program in comparison with the traditional program that
      requires immunization of infants alone. The benefits of several alternative
      immunization strategies considerably exceed their costs. A new, two-dose
      immunization will be needed as a minimal strategy, and a campaign for
      administering booster doses to school-aged children may be required as well to
      achieve control and eradication of measles. Measles is a serious but preventable
      public health problem; appropriate strategies must be devised by national and
      international public health officials to control the disease in developing and
      developed countries.

PMID- 2237140
TI  - Disseminated infection due to Mycobacterium fortuitum in a patient with AIDS.

PMID- 2237141
TI  - Dexamethasone for the treatment of children and adults with bacterial meningitis.

PMID- 2237142
TI  - Mixed staphylococcal and cryptococcal epidural abscess in a patient with AIDS.

PMID- 2237144
TI  - [A rare cause of pleurisy from subdiaphragmatic origin: epidermoid cyst of the
      spleen].
AB  - Subdiaphragmatic diseases are a classical but uncommon cause of pleural effusion.
      We report here the case of a woman admitted for a left pleural effusion which led
      to the discovery of a splenic tumour. Pathological examination of the splenectomy
      specimen showed that the tumour was an epidermoid cyst of the spleen. Cysts of
      the spleen are exceptionally revealed by pleurisy. Epidermoid cysts account for
      10% of all non-parasitic splenic cysts. They remain silent for a long time and
      are usually disclosed by such complications as compression of surrounding organs,
      rupture or superinfection.

PMID- 2237143
TI  - [Bronchial tuberculosis. Radiologic endoscopic and clinical aspects].
AB  - Nowadays, bronchial tuberculosis is an uncommon, although probably
      underestimated, form of tuberculosis. The records of 23 patients hospitalized
      between 1978 and 1989 were reviewed retrospectively. Mean age was 57 years
      (range: 22 to 84 years). Only one female patient of african origin was a recent
      immigrant. The disease was pseudo-tumoral in 2 cases and included lymph node
      fistulae in 4 cases. M. tuberculosis was found at microscopic examination in only
      10 patients. The course of the disease was slow and sometimes erratic, even under
      a well-conducted medical treatment. In one of the female patients, a lymph node
      fistula appeared after 6 months of chemotherapy, and it is clear that medical
      treatment must be pursued well beyond the conventional time limits. Several
      mechanisms are responsible for bronchial tuberculosis: either invasion of the
      neighbouring bronchi by pulmonary tuberculosis; or lymph node fistula now more
      frequently due to reactivation of old lesions than to a recent primary infection;
      or again primary bronchial lesions mimicking bronchial carcinoma.

PMID- 2237145
TI  - [Demons-Meigs' syndrome. Report of a case with ovarian tumor of the granulosa].
AB  - We report an original and atypical case of Meigs' syndrome with bilateral pleural
      blood effusion and without ascites in a woman with a rare ovarian tumour
      involving the stratum granulosum. Excision of the tumour rapidly resulted in the
      pleural effusion drying up.

PMID- 2237146
TI  - [Cutaneous necrosis at the initiation of antivitamin K treatment disclosing
      hereditary protein C deficiency].
AB  - We report the case of a 57-year old woman whose severe protein C deficiency was
      revealed soon after oral anticoagulants were introduced into her treatment. Two
      previous episodes of deep leg vein thrombosis followed by a third episode with
      suspicion of embolus migration had led to treatment with heparin later replaced
      by oral anticoagulants. On the 4th day of anticoagulant therapy, she developed
      skin necrosis of the left calf. A protein C assay showed severe deficiency (19%
      level as compared with the 70-120% normal levels). The main causes of acquired
      protein C deficiency were excluded. The first results of a family study
      demonstrated moderate protein C deficiency in a 30-year old, asymptomatic
      daughter.

PMID- 2237147
TI  - [Hepatic toxicity of antitubercular agents: role of the HBS antigen carriers].

PMID- 2237148
TI  - [Mediastinal abscess fistulized in the esophagus].

PMID- 2237149
TI  - [Consensus conference: pneumocystosis in HIV infections. 1st consensus conference
      in anti-infection therapeutics organized by "la Societe de Pathologie Infectieuse
      de langue francaise", May 11, 1990].

PMID- 2237150
TI  - [Thoracic actinomycosis. Report of 8 cases].
AB  - We report 8 cases of thoracic actinomycosis, a disease which is now uncommon
      owing to the widespread use of antibiotics and which is caused by anaerobic
      filamentous bacteria living as saprophytes in natural cavities. Recent
      pathogenetic data, such as propagation by continuity or blood stream, as well as
      bacteriological and clinical data (mediastino-pulmonary, pleural, parietal,
      cardiac and disseminated lesions) are reviewed. Diagnostic problems are due to
      the difficulties encountered in trying to isolate the saprophytic organism, and
      pathological examination is often required for the diagnosis. Treatment is
      basically medical and consists of penicillin G or A administered for prolonged
      periods. Nitroimidazoles are ineffective against these anaerobic bacteria.

PMID- 2237151
TI  - [Bronchial cancer in patients infected with human immunodeficiency virus (HIV).
      Report of 3 cases].
AB  - We report 3 cases of bronchial carcinoma in patients with human immunodeficiency
      virus (HIV) infection. Like the other 13 cases found in the literature, these
      were characterized by their occurrence in young subjects, their often
      adenocarcinomatous nature and their abnormally severe course. These clinical
      features raise the problem of the role played by HIV in the development and,
      above all, the clinical expression of bronchial carcinoma.

PMID- 2237152
TI  - [From the anatomy to the technic of vaginal hysterectomy].
AB  - The technical difficulties in the vaginal hysterectomy (VH) are principally
      raised by the special conceptualization of the normal anatomy in the craniocaudal
      direction and the topographical modifications from the surgical manipulations.
      These modifications have been studied during an operative dissection on a dead
      body non-formulated, but with the vessels previously injected with coloured
      latex. Our observation and the numerous works of per-operative radiology are
      showing that, at every period of the VH there is an ureterical safety margin much
      more important than in the abdominal hysterectomy. The prime manipulation in its
      realization is the caudal and continuous traction of the cervix in order to
      individualize the ligaments and to make easier the dissections. The operation
      amounts to three primary stages: breaking away the uterus from its visceral
      connections in order to hold them distant with valves; releasing the uterus from
      its ligaments with ligatures spaced from the cervix to the fundus; restituating
      the peritoneal cavity and the vaginal fornix in its topography and statics. The
      vaginal hysterectomy has notable advantages in swiftness, absence of intestinal
      manipulations and scarceness of ureterical injuries. The anatomical limits in the
      low way, depend on the vaginal compliance, the mobility of the pelvic organs and
      the disproportion between the vagina and the deferent duct.

PMID- 2237153
TI  - [What place is given to autopsy in cases of perinatal death?].
AB  - The authors studied two series of deaths (437 cases in all), one from a
      prospective study on the Centre region and the other from a retrospective study
      on the Tourangelle region; they compared the clinical and paraclinical data
      recorded during pregnancy, labour and the neonatal period to the autopsy results
      and those of the different tissue examinations, and strived to define the most
      judicious indications for autopsies in case of perinatal death. From their
      conclusions, based on the clinical context of the death, 5 different types of
      situations can be distinguished: for two of them, namely the medico-legal context
      and the malformation context, the post mortem examination seems indispensable for
      different reasons. In case of "obvious clinical diagnosis", the need for an
      autopsy has not been proven. However, when the clinical diagnosis seems
      "probable" or when the aetiology has not been found clinically, the post mortem
      examination of the foetal body is recommended, although certain particular
      situations, related to the age of the mother, the parity, the interest shown by
      the couple about the result, to ethnic or religious factors, may lead to the
      request of only a limited examination, which is much less expensive.

PMID- 2237154
TI  - [Indications and results of autotransfusion. Normovolemic hemodilution in
      gynecology-obstetrics].
AB  - Considering the importance of haemorrhagic complications in gynaecology
      obstetrics and the increasing fear of accidents during blood transfusion, the
      authors propose, from the literature and the study of 13 cases, a reflection on
      the indications of deferred autotransfusion (DAT) and of normovolemic
      haemodilution (NVH). In obstetrics, even if DAT has undoubtedly certain
      advantages (besides viral contaminations, appearance of allo-antibodies...), it
      can be indicated at present only for pregnant women exposed to a predictable risk
      of haemorrhage or for women with a rare blood group. In gynaecology, the authors
      have not found any significant advantages in our study as regards NVH associated
      with DAT. However, as in obstetrics, the technique is harmless, and no thrombo
      embolic complications have been observed, even in women at high thrombotic risk.
      These methods are expensive and require qualified personnel. Their exact
      modalities and indications, as well as their medico-legal aspects, are yet to be
      defined.

PMID- 2237155
TI  - [Diagnostic value of calcifications in mammography].
AB  - The authors underline the importance of the mammographic screening of
      calcifications in the early diagnosis of breast tumours. Most of the time, their
      semeiology seems to be well codified in benign and malignant lesions, although
      the "visibility threshold" is still not very satisfactory, even by the valuable
      xeromammographic method.

PMID- 2237156
TI  - [Serous tumors of the ovary with limited malignancy. Current analysis of a review
      of the international literature apropos of a case].
AB  - Serous ovarian tumours on malignancy borderline represent 2 to 5% of the
      epithelial ovarian tumours. They differ from malignant tumours by two
      particularities, namely: precise histological characteristics, the main one being
      the absence of stroma invasion, a favourable prognosis. The diagnosis rests on
      conventional histology in spite of the value of histo-immunoclinical markers or
      tumoral markers. The treatment is surgical, based on hysterectomy with bilateral
      adnexectomy, even if a conservative attitude may be considered for the young
      woman who wishes a pregnancy. Prolonged post-operative surveillance is very
      important because of possible relapses, whose detection seems to be facilitated
      by antigen CA 125 assay.

PMID- 2237157
TI  - [Antithrombin III deficiency and pregnancy. Apropos of a case].
AB  - Congenital deficiency of antithrombin III is a disease inherited as an autosomal
      dominant which predisposes to thromboembolism. Pregnancy and the postpartum
      period constitute a major additional risk factor for thromboembolism in deficient
      women. However, pregnancy may be envisaged without risk since there has been an
      improvement in knowledge concerning the physiology of the AT III molecule, its
      exact role in coagulation, the application of accurate laboratory tests which
      measure the deficiency, and especially the programming of pregnancy under cover
      of preventive treatment consisting of the perfusion of AT III concentrate in
      association with heparin. The treatment is restricting and costly but is,
      nevertheless, the only one to recreate conditions that are similar to
      physiological conditions, and its effect is therefore more certain.

PMID- 2237159
TI  - [Fetal thoracopagus. Echographic diagnosis at 26 weeks].
AB  - The authors report on one case of thoracopagus discovered by echography carried
      out after 26 weeks of amenorrhoea. The pregnancy was terminated therapeutically
      by hysterotomy when common viscera were identified (heart and liver). Echographic
      diagnosis during the first part of pregnancy allows evacuation to be carried out
      by the vaginal approach. The authors summarize the criteria for echographic
      diagnosis and also the epidemiological and embryological data required for
      assessing the prognosis.

PMID- 2237158
TI  - [Tubo-ovarian actinomycosis].
AB  - Pelvic actinomycosis is uncommon and usually represents a complication of an
      intrauterine device (IUD). This organism is very difficult to culture, and most
      actinomyces is actually identified by histologic features in pathologic specimens
      or by cytologic features on Papanicolaou smears. A specific fluorescent antibody
      stain is also available. Tubo ovarian abscess is usually polymicrobial with a
      preponderance of anaerobic organisms and the exact role of actinomyces in abscess
      formation remains unclear.

PMID- 2237160
TI  - [Veins and hormones: a conflicting couple].
AB  - The female reproductive lifetime is marked by a number of disruptions in hormonal
      conditions (oral contraception, pregnancy, menopause), whose impact on the
      cardiovascular system is not negligible. The author reviews these different
      stages and their repercussions on the venous system.

PMID- 2237162
TI  - [Continuing education].

PMID- 2237161
TI  - [The planet in peril].

PMID- 2237163
TI  - [The nursing profession in France. F4. Professional continuing education.
      Functions of the hospitals].

PMID- 2237166
TI  - [The need for nursing research and care].

PMID- 2237164
TI  - Phenotypic analysis of human peripheral blood lymphocytes by automatic sampling
      flow cytometry after stimulation with mitogens or allogeneic cells.
AB  - Human peripheral blood lymphocyte (PBL) phenotypes have been analyzed before and
      after stimulation with phytohemagglutinin (PHA), concanavalin A (ConA) and
      pokeweed mitogen (PWM) for 3 days and in mixed lymphocyte culture (MLC) for 7
      days. PBL labeled with each of 10 fluorescent monoclonal antibodies were
      automatically sampled for flow cytometry from 96-well microtiter plates using a
      microsample delivery system. The reference phenotypic ranges were determined in
      fresh cells and control cultures. PHA was mostly mitogenic for T PBL bearing the
      CD3, CD5, CD7, CD8 and CD25 differentiation clusters, and a low density of CD1
      and CD4 had a small effect on human natural killer cells (HNK) and also did not
      stimulate B (CD19) and HLA-DR+ PBL. There was an incomplete phenotypic
      overlapping between PHA- and ConA-stimulated cultures, ConA being more mitogenic
      for CD4 and less mitogenic for CD8 PBL. The mitogenic effect of PWM was evident
      on CD3, CD5, CD7, CD4, CD25 and CD8, but not on HNK, HLA-DR and CD19 B PBL, which
      presumably had already differentiated into antibody-secreting cells. After MLC
      stimulation all T, B and HNK PBL subsets tested were increased, but the cells
      bearing CD1, CD4, CD5, CD7, CD25, HNK, CD19 and HLA-DR had the greatest
      proliferation with respect to the unmixed control PBL. The present approach to
      the phenotyping of PBL subsets could offer more complete and accurate data for
      monitoring and follow-up of patients in transplantation and immunopathology
      hospital wards.

PMID- 2237165
TI  - [The function of the hospital in overcoming the crisis in medicine].

PMID- 2237167
TI  - [Bladder rehabilitation of the spinal cord injury patient].

PMID- 2237168
TI  - [Nursing coresponsibility in a health team].

PMID- 2237169
TI  - [Sexuality in the elderly. The building of a myth?].

PMID- 2237170
TI  - [The diabetic adolescent].

PMID- 2237171
TI  - [The quality of life, the quality of care].

PMID- 2237172
TI  - [On the food habits and consumption of the elderly. A practical study].

PMID- 2237173
TI  - [The peridural catheter].

PMID- 2237174
TI  - [The fatigue of waiting].

PMID- 2237175
TI  - [Continuing education. 51. Subject: basic nursing. Topic: the nursing care
      process].

PMID- 2237176
TI  - [Radiologic methods in cases of coronary heart disease: diagnostic requirements
      from the cardiology point of view].
AB  - Radiological and especially scintigraphic methods are important tools in
      diagnosis finding, diagnosis evaluation, risk stratification and therapy control
      in patients with coronary artery disease. The major task is to document or
      exclude myocardial perfusion defects. Within this framework, thallium
      scintigraphy and radionuclide ventriculography occupy a definite place for non
      invasive evaluation. The decision for revascularisation (bypass surgery,
      angioplasty) and the evaluation of the risk frequently depends on the results of
      the scintigraphic methods. Conventional radiological techniques and computer
      tomography are helpful in differential diagnosis of acute chest pain syndromes.

PMID- 2237177
TI  - [Cardiac diagnosis in the conventional chest x-ray].
AB  - Thoracic x-ray examination supplies information that is important in diagnosing
      heart disorders. The article presents the pathophysiological fundamentals and x
      ray morphology criteria for assessing the size of the entire heart and of the
      individual cavities as well the cardiac functions, in a comprehensive survey.

PMID- 2237178
TI  - [The assessment of myocardial perfusion using contrast echocardiography].
AB  - A brief survey is given on the state of the art of qualitative and quantitative
      myocardial contrast echocardiography as well as on the contrast agents used.
      Exact qualitative assessment of coronary perfusion areas is possible. In
      addition, myocardial areas of collaterals of less than 100 microns in diameter
      can be visualized and measured that were not seen by routine coronary
      angiography. Quantitative analysis was done in 5 normal subjects and 16 patients
      with coronary artery disease before and after right ventricular stimulation (170
      bpm over 75 s). While decay half time (T1/2) remained unchanged in normal
      subjects before and after pacing (7 +/- 4 s vs 7 +/- 5 s), it increased
      significantly from 5 +/- 1 to 16 +/- 1 s in patients with coronary stenoses
      between 50% and 75%. Stenotic area reduction greater than 75% had significant
      prolongations of T 1/2 = 12 +/- 7 s already at rest with further prolongation to
      36 +/- 17 s (p less than 0.05) after pacing. Regional wall motion in these areas,
      however, was not significantly altered either in the fixed axis or floating axis
      system. Following dipyridamole hyperaemia (0.56 mg/kg i.v.), normal subjects
      showed a significant shortening of T 1/2 (6 +/- 2 vs 1.6 +/- 1; p less than 0.01;
      n = 5), while T 1/2 of patients with multiple vessel disease was prolonged from 9
      +/- 6 to 15 +/- 6 s (p less than 0.01; n = 7). This prolongation was not uniform,
      since some myocardial areas were found to be hyperaemic after dipyridamole. One
      patient showed an opening of antegrade collaterals following dipyridamole. In
      first results myocardial contrast echocardiography proved capable of recognizing
      ischaemic and hyperaemic myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2237179
TI  - Future perspectives: diagnostic possibilities with positron emission tomography.
AB  - While evaluation of regional myocardial metabolism for diagnostic purposes is
      currently confined to ischemic heart disease, the emergence and implementation of
      new tracer approaches is likely to expand the scope of clinical applications.
      Evaluation of neuronal control of the heart with tracers of adrenergic neuron
      densities and beta-adrenergic and cholinergic post-synaptic activity promises to
      be useful in patients with electrical instability and with cardio-myopathies as
      well as for verifying responses to therapeutic interventions. The possibility to
      measure regional oxidative metabolism should further prove useful for
      distinguishing between residual oxidative and anaerobic metabolism in ischemia
      and thus prove useful for more accurate characterization of the ischemic injury.
      The method should further become useful for examining cardiac efficiency and
      detecting the effect of therapeutic interventions. Lastly, techniques for
      measurements of protein synthesis are likely to become important for defining
      myocardial maturation, compensatory adjustments of the myocardium to increased
      pressure and volume loading as well as assessment of repair processes after
      injury to myocardium.

PMID- 2237180
TI  - [Computed tomography and magnetic resonance tomography in cases of coronary heart
      disease].
AB  - MR has replaced CT in cardiology as a tomographic examination method with the
      exception of the identification and differentiation of cardiac calcifications. MR
      combines good morphological visualization with function diagnostics and
      biochemical informations. Both methods are inappropriate for diagnosing diseases
      of the coronary vessels.

PMID- 2237181
TI  - [The estimation of blood circulation parameters using imaging techniques-
      comparison with measurements made using the Swan-Ganz catheter].
AB  - Circulation can be evaluated by means of measuring parameters in X-ray-thorax and
      ultrasonography. Changes in haemodynamics can be estimated by measured changes in
      width of vena azygos. Additional sonography of systemic veins of thoracic inlet
      (V. jugularis interna, V. cava inferior) improves multiple correlation to
      circulating blood volume up to r = 0.81. Supine or erect position and type of
      ventilation are influencing factors. Diaphragm motility was measured by means of
      ultrasonography: patients with assisted ventilation showed significantly
      decreased motility compared to patients with spontaneous breathing.

PMID- 2237182
TI  - [Acute lupus erythematosus disseminatus in adults: clinical aspects & course].
AB  - Acute systemic lupus erythematosus (SLE) is characterized by a variety of
      manifestations and by the almost constant presence of anti-nuclear antibodies. In
      order to distinguish it from other systemic diseases, eleven diagnostic criteria
      have been laid down, four of which at least must be present. In 50 p. 100 of the
      cases the disease is revealed by a non-destructive inflammatory polyarthritis
      which is highly suggestive when associated with a "butterfly" facial erythema.
      The main prognostic criteria are renal lesions and their histological type.
      Nervous system involvement seems to be less frequent and less severe nowadays,
      but it may leave sequelae. Pleuropericarditis and vascular thrombosis are
      commonly part of the clinical set up. Antinuclear antibodies are detected by
      immunofluorescence in more than 95 p. 100 of the patients, but they are not
      specific to SLE. Their absence in the initial phase of the disease may throw
      doubts on the diagnosis. Antibodies to DNA and Sm are more specific but
      inconstant. SLE is a chronic disease with intermittent flare-ups: 30 p. 100 of
      the patients may hope for a prolonged complete remission. At present, the
      survival rate at 10 and 20 years is higher than 80 p. 100 and 70 p. 100
      respectively at the cost of a very close supervision but also of iatrogenic
      complications in increasing numbers.

PMID- 2237183
TI  - [Chronic lupus erythematosus, subacute cutaneous lupus].
AB  - The cutaneous manifestations of lupus erythematosus (LE) are extremely varied,
      and they predominate among the clinical signs of chronic LE and subacute
      cutaneous LE. In chronic LE, typical lesions are found in regions exposed to
      sunlight and consist of erythema, hyperkeratosis and skin atrophy. The skin of
      patients with subacute cutaneous LE is also highly sensitive to light; the
      lesions consist of an annular or polycyclic or sometimes psoriasiform erythemato
      squamous eruption observed mainly in uncovered areas. These dermatological forms
      are part of the wide spectrum of "lupus". Cutaneous manifestations are often
      associated with systemic signs of varying type and severity and with
      immunological abnormalities, such as antibodies to Ro in subacute cutaneous LE,
      which act as markers of the disease.

PMID- 2237184
TI  - [Antiphospholipid syndrome].
AB  - The antiphospholipid antibody syndrome is characterized by venous and/or arterial
      thrombosis, repeated miscarriages and the presence of anticardiolipin antibodies
      and/or a circulating lupus anticoagulant. Antibodies directed against
      phospholipids constitute a family of immunoglobulins with different
      specificities. The mechanism through which lesions are induced by these
      antibodies has not yet been fully determined. Treatment includes
      immunosuppressive measures and prevention of recurrent thrombosis.

PMID- 2237185
TI  - [Lupus and protein deficiencies of the classical complement pathway].
AB  - Deficiencies in proteins of the classic complement pathway are particularly
      frequent in patients with autoimmune diseases, notably systemic lupus
      erythematosus (SLE). The C4 component is a polymorphous glucoprotein coded by two
      closely linked genes, C4A and C4B, located within the HLA complex. C4, and in
      particular the C4A isotype plays a major role in maintaining immune complexes in
      solution. Fifty percent of patients with SLE are homozygous or heterozygous to
      the silent allele C4 AQO. Hereditary CE deficiency is often complicated by lupus
      related diseases which may be associated with repeated infections. The biological
      particularity of SLE associated with complement protein deficiencies is the
      frequency of anti-SSA (Ro) antibodies.

PMID- 2237186
TI  - [Iatrogenic lupus].
AB  - Drug-related lupus accounts for about 10 p. 100 of all lupoid diseases. The main
      responsible drugs are antihypertensive, antiarrhythmic and anticonvulsant agents,
      phenothiazines and beta-blockers. Iatrogenic lupus has a better prognosis than
      idiopathic lupus, since renal and neurological lesions are rare and, when
      present, repress after the responsible drug is withdrawn. The presence of
      antinuclear antibodies is indispensable to the diagnosis. The detection of anti
      histones and denatured anti-DNA in the absence of anti-native DNA and/or anti-SM
      is the usual immunological pattern of drug-related lupus.

PMID- 2237187
TI  - [Sharp's syndrome].
AB  - The author presents the current concept of Sharp's syndrome and mixed connective
      tissue diseases, as well as the detailed composition, determined by modern
      immunological methods, of the U1-RNP antigen against which patients with this
      syndrome develop antibodies. A physiopathological concept of the syndrome is
      outlined.

PMID- 2237189
TI  - [Treatment of lupus erythematosus disseminatus].
AB  - Corticosteroids have transformed the prognosis of systemic lupus erythematosus
      (SLE), but no further advance has been achieved during the last few years.
      Treatment of SLE rests on the use, as rational as possible, of those therapeutic
      tools that are available. However, diagnosing SLE does not necessary, they must
      be given promptly in effective doses whilst preventing their side-effects,
      notably by the simultaneous management of atheroma factors. Non-steroidal anti
      inflammatory agents and synthetic antimalarial drugs may be used to replace
      corticosteroids or reduce their dosage. Severe forms of SLE which are function-
      or life-threatening require immunosuppressants, the best one being
      cyclophosphamide administered monthly as intravenous bolus injections, as this
      drug has been shown to be effective and to have low morbidity. Plasmapheresis is
      exceptionally needed. The risk of thrombogenesis due to the frequently associated
      "antiphospholipid syndrome" can be avoided by anticoagulants or antiplatelets the
      respective indications of which have not yet been clearly determined. SLE being a
      chronic disease, patient's compliance with treatment is very important and
      justifies the efforts made to train and inform these young male or female
      patients.

PMID- 2237188
TI  - [Contraception and pregnancy in systemic lupus erythematosus].
AB  - In 1990 conflicting views are still being held concerning oral contraception and
      risks associated with pregnancy in women with systemic lupus erythematosus. As
      regards oral contraceptives, all authors agree that oestrogen-progestin
      combination pills are harmful, but the best alternative hormonal contraception
      remains to be determined. Protein-based "micropills" seem to be harmless;
      cyproterone acetate appears to be without side-effects, and its usefulness in
      preventing recurrences is being evaluated. As regards pregnancy, it would be wise
      not to contemplate having a child until 6 months have elapsed since the onset of
      remission. Blood pressure, platelet count and serum creatinine and uric acid
      levels must be closely monitored. Two types of antibodies may be present in the
      mother and are known to be responsible for foetal complications. These are
      antibodies to phospholipids (antiprothrombinase, anticardiolipin, antibodies
      responsible for dissociated treponema serology), which expose to spontaneous
      abortion or intrauterine death, and the antibody to SS-A (or anti-Ro), which
      exposes to foetal cardiomyopathy and congenital atrioventricular block.

PMID- 2237190
TI  - [Protein intake and kidney failure].

PMID- 2237191
TI  - [Amyotrophic lateral sclerosis: Charcot's disease or a syndrome].

PMID- 2237193
TI  - [The mysterious Doctor Davila].

PMID- 2237192
TI  - [Therapeutical trials in arterial hypertension in 1990].

PMID- 2237194
TI  - [Menopause. Diagnosis, consequences and principles of treatment].

PMID- 2237195
TI  - [Mediterranean boutonneuse fever. Epidemiology, etiology, diagnosis, principles
      of treatment].

PMID- 2237197
TI  - [Cancer of the esophagus. Epidemiology, etiology, diagnosis, development and
      prognosis, principles of treatment].

PMID- 2237196
TI  - [Obstructive malformations of the upper urinary tract. Diagnosis, principles of
      treatment].

PMID- 2237198
TI  - [Erysipelas, lymphangitis. Etiology, diagnosis, clinical course and prognosis,
      treatment].

PMID- 2237199
TI  - [Renal regulation of the acid-base equilibrium].
AB  - The kidney controls extracellular bicarbonate concentration and the pH of the
      body by modulating neat acid excretion (ammonium plus titratable acidity minus
      bicarbonate) according to the systemic acid-base balance. Proton, bicarbonate and
      phosphate transport and ammonium synthesis in the proximal tubules change in a
      homeostatic manner. The intercalycial A (proton secreting) and B cells
      (bicarbonate secreting) of the distal tubule and cortical collecting ducts have a
      high capacity of adaptation. The wide ascending branch of the loop of Henle also
      plays an important role in the bicarbonate and ammonium transport. Recent data
      suggest a pluri-hormonal regulation of urinary acidification. Therefore, the
      precision of the renal response to metabolic acidosis depends on the coordinated
      regulation of different segments of the nephron by the parathyroid hormone,
      aldosterone and the glucocorticosteroids.

PMID- 2237200
TI  - [Determination of pH in the body: methodologic review].
AB  - The maintenance of a defined free H+ concentration within narrow limits is a
      prerequisite and feature of living organisms. In recent years the different
      disciplines of biological science have made considerable progress in the
      elucidation of the mechanisms involved in pH homeostasis. Recent advances have
      occurred also in the field of pH measurement. This review focuses mainly on the
      modern instruments for pH and blood gas analysis. The techniques of intracellular
      pH currently in general use are described together with some of the techniques
      for determination of pH in subcellular compartments.

PMID- 2237201
TI  - [Non-lactic metabolic acidosis].
AB  - The definition of metabolic acidosis (MA) is a primary decrease in plasma
      bicarbonate concentration. The visceral consequences are largely dependent on the
      degree of acidosis and the rapidity of its onset; they have been studied mainly
      in animal studies and therefore, extrapolation to the clinical situation should
      be cautious. The MA can be classified in two groups according to whether the
      anionic serum gap is increased or normal (hyperchloremic acidosis). The
      etiologies of the first group are lactic acidosis, the cetoacidoses and renal
      failure. The hyperchloremic acidoses usually result from gastro-intestinal
      bicarbonate losses; the biochemical diagnosis of rarer causes of hyperchloremic
      acidosis is facilitated by measuring the serum potassium, urinary pH and the
      urinary anionic gap. Although all causes of MA must be treated, the use of
      bicarbonate should be discussed in each individual case.

PMID- 2237202
TI  - [Lactic acidosis and hyperlactatemia].
AB  - Lactic acidosis is a relatively frequent acid-base disorder in a hospital
      setting. It is defined by the association of an arterial pH inferior to 7.35 and
      an arterial lactate level superior to 5 mmol/l. Classically, 2 types of acidosis
      are distinguished on the basis of their mechanisms of onset: the type A, with
      evident clinical signs of tissue hypoperfusion and the type B, more are, without
      apparent hypoxia. This last category is observed in various circumstances such as
      diabetes, acute liver failure, poisoning and, more rarely, inborn errors of
      carbohydrate metabolism. Treatment aims primarily at the correction of the cause.
      The efficacy of sodium bicarbonate is presently debated, considering the risk to
      worsen hyperlactatemia and to induce hyperosmolarity or rebound alkalosis. The
      administration of dichloroacetate, an activator of pyruvate dehydrogenase,
      permits to correct partially the lactic acidosis but is not harmless especially
      in case of prolonged administration. Other therapeutic modalities are evoked.
      Arterial lactate level is a reliable prognostic index of shock, because blood
      values do not depend only of the oxygen debt but also of the efficacy of hepatic
      and renal lactate uptake. Sequential measurements are recommended.

PMID- 2237203
TI  - [Renal acidosis].
AB  - Normal adults with normal protein intakes have a urinary NH4 excretion of 40 to
      50 mmol/24 hours and a variable urinary pH. In cases of metabolic acidosis a
      urinary pH less than 5.5 suggests an extra-renal origin whilst a urinary pH
      greater than 5.5 is in favour of renal acidosis, but there are many exceptions to
      this rule. On the other hand, urinary NH4 excretion is always greater than 70
      mmol/24 hours in the first case and less than 40-50 mmol/24 hours in the second;
      and the use of the urinary anionic gap (Na + K - Cl), negative in the first case
      and positive in the second, enables the two situations to be distinguished. The
      acidosis of nephron reduction is easily recognised in cases of severe renal
      failure with an increase in unmeasured plasma anions whilst tubular acidoses are
      accompanied by a hyperchloremia. Measurement of fractional HCO3 excretion after
      an oral loading dose of NaHCO3, preferably by TmCHO3 with respect to GFR,
      distinguishes proximal tubular acidosis (low TmHCO3) from distal tubular acidosis
      (normal or high TmHCO3). In the latter case, the presence of hypokalemia suggests
      a distal tubular acidosis either due to deficiency of the H(+)-ATPase pumps
      (absence of increased urinary pCO2 after oral loading dose of NaHCO3) or to the
      inability of the kidney to maintain a normal H+ gradient (normal increase of
      urinary pCO2. The presence of hyperkalemia suggests diseases associated with
      hypoaldosteronism (low or inappropriate serum aldosterone concentrations),
      abnormal transepithelial voltages or with a pseudo-hypoaldosteronism syndrome
      (high plasma aldosterone concentration). The prevalence of distal tubular
      acidosis with hyperkalemia is on the increase whilst tubular acidosis with
      hypokalemia remains rare.

PMID- 2237204
TI  - [Metabolic alkalosis].
AB  - Metabolic alkalosis (MA) only occurs after bicarbonate administration if given
      quickly and massively, or in the presence of renal failure. Most cases of MA are
      caused by a loss of hydrogen ions. This paper reviews the common causes (gastric
      aspiration, chronic diuretic therapy) and updates the list of drugs which may
      lead to this complication. Rare causes (such as hyper mineralo-corticoid
      secretion) should be suspected in patients with MA unresponsive to usual doses of
      potassium chloride. Hydrochloric acid infusions are reserved for very special
      cases.

PMID- 2237205
TI  - [Computer and acid-base disorders].
AB  - The diagnosis of acid-base disorders has been subject to computerised analysis
      for many years. Expert systems, an application of artificial intelligence, have
      been validated. They are of help to clinical decision making, enabling the
      different diagnostic possibilities of given acid-base and hydro-electrolytic
      situations to be evaluated and appropriate therapy to be instituted. Computer
      networks improve the transmission of laboratory results to the intensive care
      units and the integration of data facilitates the monitoring of biochemical
      tendencies. Computers can also be used for teaching acid-base physiology and
      pathology.

PMID- 2237206
TI  - [Clonidine in anesthesia and in intensive care: rejuvenation of a compound?].

PMID- 2237207
TI  - [Tropical spastic paraplegia (TSP) and HTLV1 associated to paraplegia (HAP)].

PMID- 2237208
TI  - [Motor disorders of the esophagus].

PMID- 2237209
TI  - [History of medical responsibility].

PMID- 2237210
TI  - [Hernias. Diagnosis, principles of surgical treatment].

PMID- 2237211
TI  - [Acute fever. Diagnostic orientation and management].

PMID- 2237212
TI  - [Venous thrombosis of the lower limbs. Etiology, physiopathology, diagnosis,
      clinical course and prognosis, treatment].

PMID- 2237213
TI  - [Spontaneous abortion. Diagnosis, course and prognosis, treatment].

PMID- 2237215
TI  - [Epidemiology of HTLV-I infection in its hyperendemic foci (Japan, tropical
      Africa, Caribbean)].
AB  - HTLV-1 infection is endemic in Japan, black Africa, the Caribbean and several
      regions of South America. In these foci, the infections is very heterogeneously
      distributed (variations from village to village, intrafamilial clustering). The
      virus is transmitted from mother to child, and breast feedings seems to play a
      major role. Sexual transmission is usually from man to woman. The frequency of
      transmission by blood transfusion must not be underestimated. It justifies the
      systematic detection of HTLV-1 infection in areas where it is economically
      feasible.

PMID- 2237214
TI  - [Polyuriapolydipsia syndrome. Diagnostic orientation and management].

PMID- 2237216
TI  - [Neurologic pathology and HTLV-I virus].
AB  - In most cases the only manifestation of nervous system pathology associated with
      HTLV-1 infection is spastic paraplegia. The virus is transmitted by breast
      feeding from mother to child, by transfusion of contaminated blood (or by
      syringes of intravenous drug addicts) or sexually from husband to wife.
      Paraplegia usually begins progressively after the age of 30 years by motor and
      sphincteral disorders, followed by a phase of stabilization. Other clinical
      entities, such as pseudo-LAS syndromes, polymyositis, lymphocytic alveolitis,
      vasculitis or meningitis, may coexist or show varying degrees of expression.
      There is no treatment capable of modifying the course of the disease, but
      corticosteroids are worth trying, notably in the initial stages of paraplegia and
      in polymyositis.

PMID- 2237217
TI  - [Malignant strongyloidiasis and the HTLV-I virus].
AB  - A significant association between Strongyloides stercoralis and HTLV-1 infections
      has been demonstrated in areas (such as southern Japan and the Caribbean) where
      HTLV-1 is endemic. Due to the immunomodulating effects of the virus and the
      parasite, patients with both infections would be at risk for overwhelming
      strongyloidiasis as well as for T-lymphocyte haemopathy. S. stercoralis is
      thought to be a cofactor for viral replication and leukaemogenic power.

PMID- 2237218
TI  - [HIV infection and "malignant" strongyloidiasis].
AB  - Disseminated Strongyloides stercoralis infection occurs in immunocompromised
      patients. Despite the epidemiological overlap of HIV infection and
      strongyloidiasis observed in certain parts of the world, only six cases of
      dissemination have been reported in AIDS patients. The clinical presentation has
      no special features, except for the frequency of other opportunistic infections.
      The prognosis is poor. This lack of association between disseminated
      strongyloidiasis and HIV infection had led to the exclusion of extra-intestinal
      forms of this paraistosis from the revised classification of AIDS.

PMID- 2237219
TI  - [Epidemiology of HIV infections in Africa].
AB  - Africa is the continent most severely affected by the pandemic of
      immunodeficiency viruses (HIV-1 and HIV-2). Nowadays (1990), at least 3 million
      individuals are infected and about 300,000 cases of acquired immunodeficiency
      syndrome (AIDS) have been recorded. HIV infections started in the seventies as
      sporadic cases in remote areas and spread throughout black Africa where they are
      now epidemic, with high seroprevalence (1p. 100-20 p. 100), even in the general
      population. Due to heterosexual transmission, the groups at highest risk are
      female prostitutes and their customers and people with genital ulcers and/or
      sexually transmitted diseases (STDs). The vertical infection rates remain
      uncertain but may be estimated at 40 to 65 p. 100 of pregnancies in HIV-infected
      mothers. Blood transfusions are the third mode of infection because of high
      demands for blood (sometimes not tested) arising from severe anaemias in children
      (malaria and sickle cell anaemia), in pregnant women and in patients needing
      surgery. STDs causing ulcers undoubtedly are cofactors in the invasion by HIV,
      while the most important cofactors in AIDS progression are recurrent STDs,
      chronic activation of the immune system and repeated pregnancies that activate
      HIV-infected lymphocytes. The minimum mortality rate of AIDS is about 1 in 5000.
      Spatial, cultural and demographic factors should also be taken into consideration
      for all AIDS control programmes which must be integrated into the primary health
      care systems of African states.

PMID- 2237220
TI  - [Clinical aspects of AIDS in Africa].
AB  - The clinical manifestations of HIV infection in Africa are similar to those
      observed in Europe and North America. However, some features related to
      ecological and diagnostic factors give the disease a certain African peculiarity.
      In more than 80 p. 100 of the cases AIDS is characterized by deep alteration of
      the subject's general condition, with chronic diarrhoea, severe asthenia,
      prolonged fever and massive loss of weight. This "slim disease" is only found at
      the terminal stage of AIDS in North America. Opportunistic infections are
      multiple, often associated, and their frequency differs from that found in Europe
      and the USA. Thus, pulmonary pneumocystosis is rare (12.5 to 21 p. 100 of the
      cases, as against 50 to 80 p. 100 in Europe). Isosporosis is frequent (4 to 48 p.
      100 of the cases instead of 0.2 p. 100 in the USA), and this also applies to
      cryptosporidiosis (7 to 21 p. 100 of the cases, compared with 3.3 p. 100 in the
      USA). Gastrointestinal candidiasis occurs in 21 to 49 p. 100 and cryptococcosis
      in 10 to 30 p. 100 of the patients. Material problems make it impossible to
      evaluate the prevalence of certain infections, notably toxoplasma and CMV
      infections. The prevalence of Kaposi's sarcoma is low (15 to 20 p. 100).
      Dermatological manifestations occur at an early stage and are both common and
      varied (papular eruption, prurigo, herpes zoster, changes in the hair and skin
      appearance); they characterize the "African aspect" of AIDS. Tuberculosis is
      particularly frequent: in Africa, 30 to 40 p. 100 of tuberculous patients are HIV
      seropositive, as opposed to 10-25 p. 10 in Western countries.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2237221
TI  - [HIV infection and malaria].
AB  - In sub-Saharian Africa, most HIV seropositive subjects carry either haematozoa
      (especially children) or antimalarial antibodies. Despite a transient decrease in
      cell-mediated immunity during malarial paroxysms, Plasmodium falciparum malaria
      does not seem to influence the course of the HIV infection. Paroxysms may be
      slightly more frequent or slightly more severe in HIV seropositive subjects, but
      they raise no diagnostic or therapeutic problem. Some cases of HIV contamination
      have been attributed to the blood transfusions required by malaria-induced
      anaemia. Prophylactic measures include early chemotherapy of malaria and
      detection of dangerous blood donors, if necessary by quick tests. Modern HIV
      tests avoid most of the false-positive reactions sometimes observed during
      malaria.

PMID- 2237222
TI  - [Tegretol in psychiatry].

PMID- 2237223
TI  - [Chromosomal abnormalities in colorectal cancers].

PMID- 2237224
TI  - [Bone marrow aplasia and artificial respiration].

PMID- 2237225
TI  - [Epidemic asthma].

PMID- 2237226
TI  - [Haemophilus influenzae type B infections: epidemiology, prospects for
      vaccination].

PMID- 2237228
TI  - [Paget's disease. Diagnosis, principles of treatment].

PMID- 2237227
TI  - [Historical research on the discovery of nystagmus and its physiopathologic
      significance].

PMID- 2237229
TI  - [Acute pancreatitis. Etiology, diagnosis, course and prognosis, principles of
      medical and surgical treatment].

PMID- 2237230
TI  - [Diplopia. Exploration of the extrinsic and intrinsic motricity].

PMID- 2237231
TI  - [Cancer of the floor of Mouth, cheeks, lips, palate and gingiva. diagnosis,
      principles of treatment].

PMID- 2237232
TI  - [Chronic lymphoid leukemia. Diagnosis, development and prognosis].

PMID- 2237233
TI  - [The effect of repeated fasting on the ratio of individual fatty acids in the
      brain and blood of rats of various ages].
AB  - In locally bred, 5-day old and full grown rats, the authors conducted experiments
      where they investigated the influence of repeated fasting (3 X 18 hours food
      deprivation on three consecutive days) on a wide spectrum of fatty acids in the
      cerebral cortex, medulla oblongata and serum. The fatty acids were assessed as
      methyl esters by gas chromatography, as described in previous work (1, 13, 14,
      17). In 5-day old rats after repeated fasting an evident decline in the ratio of
      saturated fatty acids in serum was recorded; at the same time the ratio of
      arachidonic acid increased markedly and in the cerebral cortex there was a
      significant drop of the palmitic acid participation. In adult rats 16
      statistically significant changes took place (treble as compared with the 5-day
      old rats). The large number of significant changes pertained to 18 carbon fatty
      acid (a rise in all instances in the brain; the ratio of 18:3n-6 in plasma
      declined significantly). In the serum of adult rats the ratio of arachidonic acid
      increased also. The authors discuss possible reasons of the described changes.

PMID- 2237234
TI  - [Is the argon laser suitable for angioplasty procedures?].
AB  - Laser angioplasty is a perspective method for the treatment of complications of
      atherosclerosis of peripheral and coronary arteries. The present study deals with
      the effects of an argon laser on cadaverous coronary arteries with
      atherosclerotic plaques. Radiation of the argon laser created in the plaque a
      circular defect with a singed margin. The energy of radiation being equal, the
      size of the defect depended on the position of the optic fibre -- it was greatest
      when the optic fibre was in contact with the plaque. The defect thus formed had
      uneven margins with adjacent layers of thermal damage which were larger in
      calcified plaques than in fibrous and fibrolipomatous plaques. Penetration of
      radiation into the plaque depended on its composition -- being least in calcified
      plaques. When the arteries were rinsed with saline during irradiation, the effect
      of radiation on the tissue was reduced as the tissue was cooled. The argon laser
      causes greater thermal damage of the arteries than pulsed lasers and therefore
      its clinical application will be restricted.

PMID- 2237235
TI  - [The effect of corticoids on bone tissue in myasthenia gravis].
AB  - Myasthenia gravis is an autoimmune disease where corticoids are the basis of
      therapy. They are taken for short periods in large amounts, as well as for
      prolonged periods in medium or small doses. The authors investigated in the
      described groups the effect of corticoids on bone tissue. They provided evidence
      of a significant effect on the diffraction pattern, geometrical arrangement of
      the apatite grid and ion changes in relation to the period of corticoid
      administration without significant clinical manifestations of osteoporosis, when
      respecting therapeutic principles.

PMID- 2237236
TI  - [The relation of nucleoli to precancerous conditions of the cervix].
AB  - Oestrogens act at the nuclear level. To these steroids also a cancerogenic effect
      is ascribed. By staining for nuclear structures according to Smetana and Busch
      the authors proved morphological structures of the nucleolus in vaginal epithelia
      and in cells from cervical lesions. This applies to solid nucleoli -- which are
      active, annular nucleoli which are resting and nucleoli which have completed
      their activity -- micronucleoli. Hyperoestrogenic women have in their vaginal
      epithelia of the upper third of the vagina more active nucleoli (11.4%) than
      hypooestrogenic women (2.1%). Women suffering from cervical carcinoma during the
      menopause have more active nucleoli in the vaginal epithelia (30.8%), as compared
      with healthy hyperoestrogenic women of productive age. Patients during the
      menopause with grade III dysplasias have fewer active nucleoli in cervical
      epithelia than women with cervical cancer (25.0%), however, as compared with
      hyperoestrogenic women of productive age, much more. A large number of active
      nucleoli was proved by staining by Smetana's method also in cells taken from
      cervical lesions carcinoma type and grade III dysplasia in postmenopausal
      patients. Evaluation of morphological changes of the nucleoli suggests their
      activity, the activity of the whole nucleolus and is a sensitive indicator of the
      activity of the whole cell.

PMID- 2237237
TI  - [Possibilities of comprehensive care of oncologic patients in the framework of a
      polyclinic facility].
AB  - The authors evaluated five years of experience with ambulatory cytostatic
      chemotherapy at the policlinical department of clinical oncology in the District
      Institute of National Health in Prague 4. At the same time they draw attention to
      the necessity to create an in-patient department for oncological patients in this
      area.

PMID- 2237238
TI  - [New aspects of intolerance of the aqueous iodinated x-ray contrast medium,
      adipiodone--fatal interaction of adipiodone-Ultrabil with the immunomodulators
      Corynebacterium parvum (CP) and Shigella dysenteriae endotoxin (LPS)].
AB  - The authors assume a new type of interaction of the aqueous X-ray contrast
      substance type adipiodone (Ultrabil 50% Spofa) with immunomodulators of
      Corynebacterium parvum (CP) and the endotoxin of Shigella dysenteriae (LPS). The
      fatal type of interaction developed regularly as a result of the concurrent i.v.
      administration of the X-ray contrast substance adipiodone with the endotoxin of
      Shigella dys. (LPS) to laboratory animals (mice) which had five days previously a
      single dose of Corynebacterium parvum (CP). The effect of the interaction was
      evaluated using LD50 of adipiodone (Ultrabil Spofa) which in interaction with the
      immunomodulators of CP and LPS was identical as the dose used in diagnostic
      practice. The authors considered the possible development of "oxygen stress" as a
      consequence interacting processes and complement activation.

PMID- 2237239
TI  - [Auditory function in children and adolescents with diabetes mellitus].
AB  - The authors examined by audiometry 49 diabetics aged 3-18 years. Of these 47
      patients aged 6-18 years (23 girls and 24 boys) were evaluated. A hearing
      disorder was found in four children. In one instance a conduction disorder after
      repeated otitis media was involved. In three children, i.e. 6.4%, perception
      hypacusia was found (once bilateral, twice unilateral). Based on the mentioned
      findings, the authors recommended systematic monitoring of the auditory function
      of all diabetic children.

PMID- 2237240
TI  - [History of the beginnings of Czech stomatology].
AB  - The authors present a brief account of the history of dental surgery--stomatology
      -in Bohemia and Moravia from the very beginnings to the period after the Second
      World War with indicators of the brisk development of the discipline in the new
      democratic state which occurred in particular after the foundation of the
      stomatological branch of medical faculties in 1950/51. The authors mention in
      more detail only the main personalities and representatives of the discipline who
      contributed most to the development, being aware that they collaborated with
      several tens of teachers and research workers of more than four generations who
      also deserve admiration and gratitude.

PMID- 2237241
TI  - [Use of a new type of hydrogel in bone surgery].
AB  - The authors submit information on the properties of a new macroporous hydrogel,
      which was synthetized specially for use in bone surgery. In animal experiments
      the authors evaluate microscopically the biocompatibility and process of
      biodegradation of the implant in osseous tissue.

PMID- 2237242
TI  - [Prevalence of mineralization disorders in dental tissues in children in
      fluoridated regions of Kladno].
AB  - The authors subjected to dental examinations a group of children aged 12-13 years
      from the Kladno area and surrounding rural communities. The children from Kladno
      drank from birth fluoridated water from the water mains, while the rural
      children, where well water had a minimum fluoride content, had to rely on sodium
      fluoride tablets. In all children the prevalence of non-carious changes of dental
      tissues was assessed, the cariosity (DMF), oral hygiene (OHI) and the state of
      the gingiva (PI). The objective was to assess to what extent and in which
      indicators the urban and rural children differ. The results were compared with
      the status in Prague children who were not exposed to fluoride during the first
      years of life. The results revealed that the Kladno children differ only as
      regards cariosity which is significantly higher in the rural children. This
      finding can be explained by irregular intake of sodium fluoride tablets. As
      compared with Prague children, there was a marked difference in the prevalence of
      non-carious changes of dental tissues in favour of the children from the Kladno
      area. Their cariosity was also significantly lower. The results provide evidence
      that fluoridation of drinking water is not only the most effective way how to
      prevent caries but that it prevents also inadequate mineralization of dental
      tissues.

PMID- 2237243
TI  - [Oral health in cariology and endodontics to the year 2000].
AB  - In 1978 the World Health Organization proclaimed the programme "Health for All by
      the Year 2000". In 1982 the International Stomatological Federation joined this
      programme with "Oral Health by the Year 2000". It comprises actual anti-caries
      targets for various age groups, e.g. 50% of 65-year-old subjects should have 20
      natural functional teeth. Comparative investigations indicate that the above
      programme is successfully implemented in those developed industrial countries
      where it has become a matter of course for the wide public and where in its
      implementation also non-stomatological medical disciplines participate. The
      purpose of the present paper is to remind of some comprehensive coordinated
      aspects of caries prevention and some most frequent complications of caries, i.e.
      pathological conditions of the dental pulp and apical periodontium.

PMID- 2237244
TI  - [Current views on periodontosis].
AB  - Diseases of the suspensory dental apparatus are very widespread. Its consequences
      and course frequently lead to restriction of dental function and frequently also
      to loss of teeth with adverse health, social and economic sequelae. The objective
      of the present paper is to makes doctors of non-stomatological disciplines
      familiar with contemporary views on the genesis and therapy of these diseases.

PMID- 2237245
TI  - [Differential diagnosis in painful dysfunctions of the mandibular joint].
AB  - The painful dysfunctional syndrome of the mandibular joint is characterized by an
      impaired functional equilibrium of the masticating apparatus, the main
      constituents of which are the mandibular joint, the masseters and dentition. The
      symptoms associated with the syndrome are usually non-specific and are found also
      in other diseases of the orofacial region. The author describes some pathological
      conditions which may be mistaken for painful dysfunctional syndrome, in
      particular if they take an atypical course with a less marked symptomatology.

PMID- 2237246
TI  - [Aspects of corticoid therapy in patients with pemphigus and pemphigoid in the
      oral cavity].

PMID- 2237247
TI  - [Rehabilitation of the dentition using intraosseous blade implants].
AB  - Intraosseous blade vent implants extend hitherto existing clinical methods of
      prosthetic treatment of some conditions of defective teeth by new possibilities.
      It is a method which can produce satisfactory and long-term results. One of the
      prerequisites is, however, that generally valid and local limitations for
      indication of the implantation will be respected, that the implantation will be
      implemented by reliable surgical technique along with high standard prosthetic
      treatment which in the course of recovery will carry the implant to its
      functional period. Results of our investigations revealed unequivocally that the
      use of implants with a low or predominantly low intraosseous part leads in the
      majority to unsatisfactory results of implantations.

PMID- 2237248
TI  - [Phagocyte function deficiency determined by methods using chemotaxis and
      chemiluminescence].
AB  - The chemotactically oriented and not oriented migration of polymorphonuclear
      leucocytes was examined in 21 patients with acute ulcerative gingivitis, using
      the method of assessment of chemotaxis under an agarose layer. In the same group
      of patients also the chemiluminescence of leucocytes was assessed. In 16 patients
      the chemotactically oriented and non-oriented cell migration was reduced. In four
      patients both types of activity were enhanced. The chemiluminescent leucocyte
      activity was reduced in all patients of this group.

PMID- 2237249
TI  - [Complex stomatologic care in patients with anorexia nervosa].
AB  - The authors describe a group of 25 patients with anorexia nervosa treated at the
      Psychiatric Clinic, First Medical Faculty, Charles University. They compare their
      experience with dental treatment of these patients with data in the literature.
      Extensive dental damage in these patients calls for comprehensive dental care
      which is not only time consuming but frequently also pretentious from the
      economic aspect. The authors recommend therefore dispensary care and emphasize
      the necessity of collaboration between the psychiatrist and stomatologist.

PMID- 2237250
TI  - [Training in social competence in undergraduate education in pediatric
      stomatology].
AB  - Hitherto practised training revealed that in the undergraduate training in
      paedostomatology there are disproportions between the shaping of the professional
      skill and the formation of professional social and psychological qualities of the
      student. The consequences of the one-side attention of teaching to professional
      training are manifested already during clinical practicals and during the
      implementation of systematic dental care in practice. The authors innovated the
      programme of undergraduate training in paedostomatology. This resulted in
      rationalization, not extension of the training at the expense of other subjects.
      As far as stomatological training is concerned, they adhered as regards scope and
      contents to the hitherto existing seven thematic entities of the uniform
      curriculum. A new subjects, psycho-social training was included where students
      are not taught only basic theoretical knowledge; methods of social training were
      applied and students are taught the necessary practical skills. The method was
      applied so far for five years in the training of paedostomatology at the First
      Chair of Stomatology. The acquired experience justifies the statement that the
      method was accepted by members of the department (of all categories), child
      patients and parents. The children become rapidly familiar with the technique of
      substitutional signals of communication. During subsequent visits they do not
      require treatment by the same doctor but adherence to the ritual. The change of
      the general style of training enables the teacher to make the students familiar
      in a more instructive manner with the basic principles of three-step preventive
      care, to teach the students not to treat but to "be a doctors". By simulation of
      field practice in the final part of the clinical course training was approximated
      to the actual procedure in practical work.

PMID- 2237251
TI  - Autoradiographic localization of receptor sites of 3H-spiroperidol in the CNS of
      rat.
AB  - Our study presents macroautoradiographic maps of the distribution of 3H
      spiroperidol in the CNS of rat. The radioactively labeled butyrophenone
      neurolepticum enables in vivo after brain intraventriculo-cisternal perfusion an
      exacter autoradiographic localization of dopamine receptors in various regions of
      the brain. For the first time 3H-spiroperidol has been administered by
      intraventriculo-cisternal perfusion. Also original are the finding of receptor
      labelling by means of 3H-spiroperidol on astroglia and in the spinal grey matter.

PMID- 2237252
TI  - Statistical properties of ABR amplitudes and latencies. Implications for
      computation of reference limits and relation to click phase.
AB  - A method for statistical analysis and computation of reference limits for ABR
      latency and amplitude variables is presented. Condensation and rarefaction ABRs
      from 47 healthy controls aged 4-58 years were investigated. With respect to
      gaussianity of distributions, the square root transformation was superior to the
      logarithmic transformation for amplitudes, while the logarithmic transformation
      performed better for amplitude ratios. Wave V latency and the I-V interpeak
      latency were nearly normally distributed, while other latencies and inter-peak
      latencies displayed varying displacement from a normal distribution. Rarefaction
      ABR distributions were slightly closer to normality than were condensation ABRs.
      Amplitude vs. following amplitude and latency vs. amplitude correlation
      coefficients were larger for R than for C click ABRs; thus R clicks seem to evoke
      a better synchronized neural volley. Most of the correlation between amplitude
      and latency could be explained by the influence of age and sex. Hence, age and
      sex matched reference limits for ABR amplitudes, without correction for latency,
      seem to be adequate in practical clinical work.

PMID- 2237253
TI  - Intensity operating range measures as predictors of word-recognition ability in
      cochlear implant subjects.
AB  - The purposes of the experiment were to examine the appropriateness of pre- and
      post-implant intensity measures (thresholds, most comfortable listening level,
      and loudness discomfort level) as predictors of post-implant phoneme-recognition
      ability and to study the relationship between pre- and post-implant intensity
      measures. Pre-implant intensity measures were obtained on 16 subjects who were
      eventually implanted with either a Nucleus device (n = 8) or a Symbion device (n
      = 8). Phoneme scores on a NU-6 word list were obtained on these 16 subjects at 1
      month post-implant. Post-implant intensity measures were also made on the 8
      Symbion subjects at 1 month post-implant. The results showed that none of the pre
      implant intensity measures correlated significantly with post-implant phoneme
      scores. In addition, pre-implant intensity measures did not correlate with the
      same post-implant intensity measures. However, post-implant MCLs and LDLs
      correlated significantly with phoneme scores as reflected by correlation
      coefficients that were larger than 0.8. These preliminary results suggest that
      although intensity measures may relate to phoneme-recognition ability, their use
      as predictive measures (as in pre-implant measures) for post-implant ability is
      questionable.

PMID- 2237254
TI  - Hypoacusis among the Polar Eskimos of northwest Greenland.
AB  - Audiological tests were conducted on 188 Polar Eskimos (75 males and 43 females)
      in small, remote, nonindustrialized settlements of Northwest Greenland. Most
      males of this small Eskimo tribe hunt regularly for food using rifles and
      shotguns. The means of the pure tone hearing thresholds indicated that 77% of the
      males in the population sample had a hearing loss (greater than 25 dB HL) in the
      high frequency range (above 2,000 Hz), in one or both ears. Also, 73% of the
      males had bilateral hearing losses (greater than 25 dB HL), and 73% had hearing
      thresholds greater than or equal to dB in one or both ears. A high frequency
      hearing loss was found in 46% of the males of the younger age groups (less than
      or equal to 40 years), mainly in the 3,000 to 8,000 Hz range, with the mean loss
      gradually extending to 2,000 and 1,000 Hz, and increasing in severity with age.
      The mean pure tone thresholds of 6- to 60-year-old female Polar Eskimos (who do
      not hunt with firearms) were generally within normal limits over the entire
      audiometric frequency range for the younger groups, and increased with age to the
      mild hearing loss range. Among the females, 35% had a hearing loss (less than
      25dB HL) in the high frequency range (above 2,000 Hz) in one or both ears, and
      21% had thresholds of greater than or equal to 50 dB in one or both ears.
      Conductive hearing losses in the low frequency range were not widespread among
      the males or females of this survey. The findings of this study suggest: (1) The
      high incidence of age-related hearing loss among the Polar Eskimo males is the
      result of frequent exposure to high intensity, impulse firearm noise, which is
      the major source of noise for this population, in an otherwise "noise-free"
      environment. (2) The primary noise-induced permanent threshold shift among Polar
      Eskimo hunters occurs in the age range of 10-40 years, and increases slowly
      thereafter, mainly as a result of continual noise exposure and presbyacusis. It
      is recommended that ear protectors and a comprehensive hearing
      conservation/rehabilitation program be provided for the Polar Eskimo population
      at once in order to prevent further hearing impairment and to rehabilitate those
      persons presently suffering from hearing loss.

PMID- 2237255
TI  - An electrical network model of inertially induced bone-conducted sound.
AB  - A model for the description of inertially induced bone-conducted sound has been
      developed and a discussion of the appropriate techniques for its representation
      as an electrical network is described. Predictions are made for the sound
      pressure produced in the meatus in the cases of normal ears and pathological ears
      resulting from vibration applied to the skull. Evidence from this modelling
      suggests that the technique may provide improved discriminability over
      conventional immitance measurements for some types of pathology.

PMID- 2237256
TI  - Brain stem (ABR) and middle latency (MLR) auditory evoked responses in infants.
AB  - We examined ABRs and MLRs for click and/or 500-Hz tone pip stimuli in infants (36
      44 weeks conceptional age) admitted to the NICU and measured the threshold and
      detectability of those responses. We took the threshold indicators of those
      responses as Jewett V for ABR measurement and wave PO Nal Na2 for MLR
      measurement. Thresholds of MLRs for click stimuli were almost equal to those of
      ABRs for click stimuli. On the other hand, thresholds of MLRs for 500-Hz tone pip
      stimuli were slightly worse than ABRs for click stimuli, the average differences
      being less than 10 dB. Wave Po Nal Na2 are the best threshold indicators of MLRs
      in infants, but the diagnostic significance of wave Pa was questionable in our
      measurements.

PMID- 2237257
TI  - Individual differences in auditory electric responses: comparisons of between
      subject and within-subject variability. IV. Latency-variability comparisons in
      early, middle, and late responses.
AB  - In this series of reports to date (Lauter & Loomis, 1986, 1988; Lauter & Karzon,
      1990 a & b) we have described patterns of relative variability observed in
      latency and amplitude of auditory brainstem responses (ABRs) collected in a
      repeated-measures within-subjects design testing two groups of neurologically
      normal adults. Each of the two groups of subjects was additionally tested for one
      other type of auditory evoked potential, according to the same schedule of eight
      weekly sessions: middle-latency responses (MLRs: 10 to 50 ms post-stimulus) were
      collected from Group II (four females and four males), and late responses (50 to
      300 ms post-stimulus) from Group I (four females and three males). This paper
      presents data comparing and contrasting the patterns of relative variability of
      waveform-peak latency observed in middle-latency, late responses, and the ABR
      data previously reported. Results document a trimodal distribution of response
      latency variability, with ABR peak V in one category, characterized by high
      within-subject stability and low between-subject stability, ABR peaks II, III,
      and IV, together with MLR peak No in a second category, of intermediate within
      subject stability, and a third category consisting of ABR peak I together with
      all auditory-evoked-potential (AEP) peaks subsequent to MLR peak No, in which
      consistency of peak latency calculated within subjects approaches the low level
      of consistency calculated across subjects.

PMID- 2237258
TI  - Different tympanometric procedures compared with direct pressure measurements in
      healthy ears.
AB  - Different tympanometric procedures were compared regarding their reliability and
      systematic differences in middle ear pressure estimation in healthy adults. In a
      second part of the study the accuracy of measurement was judged by correlating
      tympanometric readings, obtained by using the different procedures, with known
      pressure levels applied after cannulating the mastoid air cell system. There were
      no significant differences in reliability between the different tympanometric
      procedures tested (p greater than 0.05). However, forward-backward tracing
      tympanometry and 'zero sweep rate' tympanometry gave smaller errors in the middle
      ear pressure estimates than the conventional decreasing pressure sweeps. Forward
      backward tracing tympanometry at high sweep rate is recommended both for pressure
      measurements during physiological studies and in clinical practice.

PMID- 2237259
TI  - Reproducibility of hearing threshold measurements. Supplementary data on bone
      conduction and speech audiometry.
AB  - The reproducibility of bone-conduction pure-tone audiometry and speech
      recognition thresholds has been tested in groups of normal-hearing subjects. Each
      person was tested twice during the same day, and the test-retest difference was
      calculated. The reproducibility is presented as the standard deviation of this
      difference. Bone-conduction threshold measurements have a high degree of test
      retest precision, whereas air-bone gaps show a large range of distribution in
      these normal-hearing subjects. This makes the interpretation of such gaps
      spurious when values are below 20-30 dB. Speech recognition threshold has the
      highest degree of test-retest precision of all audiometric tests, and this is
      probably due to the steep slope of the psychometric function at 50%
      intelligibility. A more detailed graphic presentation of the 50% point of
      intersection will bring the reproducibility down to less than 2.5 dB.

PMID- 2237260
TI  - Clinical evaluation of cathodic trypsin-like immunoreactivity in pancreatic
      diseases in adults.

PMID- 2237261
TI  - HPLC separation and quantification of bilirubin and its glucuronide conjugates in
      faeces and intestinal contents of germ-free rats.
AB  - We describe an accurate reverse-phase high-performance liquid chromatography
      (HPLC) method for the separation and quantification of unconjugated bilirubin
      (UCB) and its monoglucuronide (BMG) and diglucuronide (BDG) conjugates in faeces
      and intestinal contents from germ-free (GF) rats. We demonstrated that female GF
      rats excreted predominantly BMG and that the percentage of this conjugate was at
      most 71.7% of the total bilirubin excreted with the faeces. The highest
      percentages for BDG and the UCB were 27.9% and 6.0%, respectively. The bile
      pigment composition in duodenal contents was 59.8% BDG and 40.2% BMG (median
      percentage) and was 47.7% BDG, 50.1% BMG and 2.2% UCB in ileal contents.
      Deconjugation of BDG to BMG was profound in caecal contents with 26.0% BDG, 67.4%
      BMG and 6.6% UCB. Endogenous (mammalian) beta-glucuronidase activity was present
      in intestinal contents throughout the entire length of the intestine and in
      faeces of the GF rats. The results indicated that it is very likely that
      endogenous beta-glucuronidase plays a role in the deconjugation of bilirubin
      glucuronides as well as of other glucuronides in the intestine of the GF rat.

PMID- 2237262
TI  - A review of 23Na nuclear magnetic resonance spectroscopy for the in vitro study
      of cellular sodium metabolism.
AB  - Changes in intracellular sodium have been associated with a number of different
      diseases. Consequently, various methods have been used to quantify the level of
      intracellular sodium concentrations. Traditional methods like flame photometry
      and ion-selective electrodes are destructive or invasive, thereby potentially
      altering the intracellular sodium levels. There has been an increasing interest
      in evaluating the method of 23Na nuclear magnetic resonance in recent years,
      since this method allows for non-invasive continuous monitoring of intracellular
      sodium in cell suspensions and tissues. A phenomenological approach to basic
      theory, review of methodology, applications to the in vitro study of cellular
      sodium metabolism, and difficulties of interpretation of this analytical modality
      is presented.

PMID- 2237263
TI  - Levels of neutrophil elastase and cathepsin B activities, and cystatins in human
      sputum: relationship to inflammation.
AB  - Sputum samples from 25 patients with bronchiectasis were assayed enzymatically
      for myeloperoxidase, neutrophil elastase and cathepsin B, and immunologically for
      cystatin A, cystatin B, cystatin C, cystatin S and kininogen. High
      myeloperoxidase and neutrophil elastase levels were found in those sputum samples
      that were assessed visually to be purulent. These samples were also found to
      contain high levels of cathepsin B activity and cystatin A, but low levels of
      cystatin S and of the most effective cathepsin B inhibitor, cystatin C. In
      contrast, sputum samples that were low in myeloperoxidase and neutrophil elastase
      activities had low levels of cathepsin B and cystatin A, but high cystatin C and
      S levels. It is concluded that cathepsin B activity in sputum is positively
      correlated with the degree of inflammation and neutrophil recruitment. Although
      this may be due in part to reduced amounts of cathepsin B inhibitors,
      particularly cystatin C, theoretical considerations suggest that factors other
      than the gross level of inhibitors must be involved in the control of cathepsin B
      activity.

PMID- 2237264
TI  - Bone mass measured by photon absorptiometry: comparison of forearm, heel, and
      spine.
AB  - We assessed bone mass quantification at different skeletal sites by single and
      dual photon absorptiometric (SPA and DPA) methods. Improved DPA measurement of
      spinal bone mineral density in young healthy subjects showed a short- and long
      term precision of 1.2% and 1.6%. Compared to the conventional DPA method the
      imprecision was reduced by more than 50%. The appendicular measurements were more
      precise (0.5-1.2%). We present the intercorrelations and predictive errors
      between peripheral measurements and improved spinal and total body bone
      measurements in early postmenopausal women (n = 144) recruited in 1988. To
      compare the improved system with the conventional methods, we retrieved data on
      age-matched early postmenopausal women (n = 151) recruited in 1983. In the 1988
      population all peripheral methods had similar predictive errors in estimation of
      spinal bone mineral density (SEE = 11-13%) and total body bone mineral density
      (SEE = 4-5%). Measurement of trabecular bone in the heel and distal forearm did
      not improve the validity of predicting spinal bone mass. In a cadaver study (n =
      11) the predictive error in estimation of the spinal ash weight from forearm
      measurements was of the same magnitude (15%) as that in estimation of the spinal
      BMC from the forearm (16%). We conclude that the predictive error in estimation
      of spinal bone mass from peripheral bone measurements is more likely to be caused
      by intra-skeletal variation in bone mass than by precision errors. However, this
      does not reflect the inability of peripheral bone mass measurements to predict
      fracture risk.

PMID- 2237265
TI  - Accuracy of pulse oximetry during moderate exercise: a comparative study.
AB  - This study was designed to discriminate, according to their accuracy, between
      eight pulse oximeters (PO) using a realistic evaluation performed by means of a
      moderate exercise to provide artefacts and thus represent a typical clinical
      situation. Accuracy was assessed by calculating error on saturation (EOS) as the
      difference between simultaneous measurement of non-invasive (SpO2) and invasive
      functional (SfO2) arterial blood oxygen saturation. An index of homogeneity of
      EOS (InH), calculated using a Lehmann analysis, was chosen as a representative of
      error dispersion, leading to a statistical classification; the influence on error
      introduced by the drift of EOS with SfO2 was thus eliminated. We obtained a clear
      cut separation of the eight PO (Datex Satlite (DA), Kontron 7840 (KO), Nellcor
      200 (NE), Novametrix 505 (NO), Ohmeda 3700 (OH), PPG-Hellige (PP), Physiocontrol
      1600 (PH), and Radiometer Oxi (RA] into two statistically different subgroups by
      comparing their InH standard deviation (SD). There is a highly statistically
      significant difference between the accuracy measured for the high precision
      subgroup with an InH SD ranging from +/- 1.6 to +/- 1.9% SaO2 (DA, PH, and RA),
      and that measured for the low precision subgroup whose InH SD ranges from +/- 2.8
      to +/- 5.0% SaO2 (NE, OH, NO, KO, PP). These results suggest that, in our
      clinical conditions, there is a wide range of inhomogeneity of error from one PO
      to another. The error introduced by the drift of EOS with SfO2 should be
      considered separately.

PMID- 2237266
TI  - Analysis of purine nucleotides in muscle tissue by HPLC.
AB  - Optimal conditions for simultaneous analysis of the purine nucleotides adenosine
      triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP),
      inosine monophosphate (IMP), inosine, adenosine, hypoxanthine, xanthine and uric
      acid in muscle samples by high-performance liquid chromatography (HPLC) were
      evaluated. A neutralized perchloric acid extract of freeze-dried human or rat
      skeletal muscle tissue was injected on to a reversed-phase silica column and
      eluted by a gradient composed of ammonium dihydrogen phosphate buffer and
      methanol. Good resolution for all the nucleotides was achieved within a retention
      time of about 20 min. Linearity for each of the nucleotides within the
      concentration intervals obtained in the samples was demonstrated. Purity of each
      peak was verified by use of the photodiode array technique. Reproducibility for
      biological samples with variation coefficients below 3.6% for ATP, ADP, AMP,
      inosine and hypoxanthine and 6.7% for IMP was obtained. The stability of the
      compounds after extraction was specifically addressed. Storing of frozen extracts
      at -20 degrees C for 24 h gave acceptable values, while storage for 7 days cannot
      be recommended. Storage of unfrozen extracts at 4 degrees C was acceptable for
      (up to) 7 h. This technique provides a sensitive, convenient and reliable method
      for simultaneous analysis of a large number of purine nucleotides in small
      skeletal muscle biopsies, provided that certain precautions are taken with
      respect to the instability of these metabolites.

PMID- 2237267
TI  - Prevalence of anti-insulin antibodies and its relation to severe hypoglycaemia in
      insulin-treated diabetic patients.
AB  - The prevalence of anti-insulin antibodies (AIABs) and their association with
      clinical parameters, metabolic control and severe hypoglycaemia were investigated
      in a geographically defined population of insulin-treated diabetic patients.
      Eighty per cent of the patients (479) delivered venous blood samples and answered
      a questionnaire on severe hypoglycaemic problems during a 12-month period.
      Circulating AIABs were demonstrable in 78% of the patients, being more common
      among those with type 1 diabetes and in long-duration patients. High levels of
      AIABs were also more frequent in patients in whom insulin treatment had been
      initiated prior to the era of highly purified insulins. The AIABs did not
      correlate to metabolic control, insulin dose or severe hypoglycaemia. It is
      concluded that AIABs is not a risk factor for severe hypoglycaemia in insulin
      treated diabetic patients.

PMID- 2237268
TI  - Serum ferritin, iron status and plasma ascorbic acid in 40- to 49-year-old males
      in the Faroe Islands.
AB  - Iron status (haemoglobin, S-ferritin, S-iron, S-transferrin, and transferrin
      saturation) was evaluated in an epidemiological survey comprising a
      representative sample of 118 (4%) of the 40- to 49-year-old Faroese male
      population. All had normal haemoglobin, (mean +/- SD 153 +/- 9 g/l; 9.5 +/- 0.6
      mmol/l). Median S-ferritin was 151 micrograms/l, 5-95 percentile 46-588
      micrograms/l, observed range 33-1166 micrograms/l. None had depleted iron stores
      (S-ferritin less than or equal to 20 micrograms/l), 2.5% had 'small' iron stores
      (S-ferritin 21-40 micrograms/l), 80.5% had 'normal' iron stores (S-ferritin 41
      300 micrograms/l) and 17% had 'increased' iron stores (S-ferritin greater than
      300 micrograms/l). Transferrin saturation values were greater than 16% in all
      males; high values greater than 50% were found in 9.3%, and the combination of
      high transferrin saturation and S-ferritin greater than 300 micrograms/l was
      found in 3.4% of the males. Median P-ascorbic acid was 26 mumol/l, 5-95
      percentile 7-67 mumol/l; significantly higher in subjects taking vitamin
      supplements (n = 35, median 50 mumol/l) than in those not taking supplements (n =
      81, median 23 mumol/l) (p less than 0.0001). There was no correlation between P
      ascorbic acid and iron status markers. The results indicate a high frequency of
      ample iron reserves in the Faroese male population.

PMID- 2237269
TI  - Age-associated decline of hepatic handling of cholephilic anions in humans is
      reverted by S-adenosylmethionine (SAMe).
AB  - Decreased fluidity of hepatocyte plasma membrane may contribute to the age
      associated changes of liver function. This study aimed at investigating whether
      the hepatic clearance of organic anions declines with age and whether S
      adenosylmethionine (SAMe), a substance proven to be effective in reversing the
      age-related decrease of membrane fluidity, might influence this process.
      Nicotinic acid (NA) half-life and serum bilirubin pharmacokinetics after NA load
      (5.9 mumol/kg body weight i.v.) were studied in 10 healthy young males (YM) aged
      14-28 years and in 10 healthy elderly males (EM) aged 65-81 years, before and
      after SAMe administration (800 mg/day intravenously for 10 days). At baseline, EM
      showed serum total bilirubin (STB) levels significantly higher than YM.
      Similarly, the bilirubinaemic mean curves, STB peak and STB time curve
      concentration after NA load, expressed as area under the curve (AUC), were
      significantly higher in EM than in YM (p less than 0.01). NA half-life was also
      significantly prolonged in the aged group (p less than 0.001). SAMe treatment was
      followed by a significant decrease of basal STB, STB peak and AUC of STB after NA
      load in EM (p less than 0.01 vs pre-treatment values) while NA half-life was
      significantly shortened in both groups (p less than 0.001). As NA and bilirubin
      share a common carrier protein for hepatic uptake, bilitranslocase, the changes
      observed in EM may be attributed to the reduced lateral mobility of hepatocyte
      plasma membrane proteins occurring with age. SAMe, by improving membrane
      fluidity, may increase the diffusion coefficient of bilitranslocase restoring the
      hepatic handling of organic anions.

PMID- 2237270
TI  - Reference intervals for immunoglobulins IgA, IgG and IgM in serum in adults and
      in children aged 6 months to 14 years.
AB  - Reference intervals were estimated for immunoglobulins IgA, IgG and IgM in serum
      in 313 healthy adults aged 17 to 64 years and in 399 children aged 6 months to 14
      years. In adults a nonparametric method was chosen for estimating reference
      interval limits. In children the limits were estimated age-specifically using
      regression analysis. Immunoglobulin assays used in this study were standardized
      with a Finnish secondary standard which was calibrated against the World Health
      Organisation 67/99 immunoglobulin standard. Later, another international primary
      standard (US National protein standard preparation) was used, the immunoglobulin
      levels of which are calibrated against the WHO standard. The nominal
      immunoglobulin concentrations assigned by the manufacturers of several commercial
      immunoglobulin standard preparations were found to differ from the concentrations
      measured with the international calibrator used in this study. In conclusion, the
      reference intervals estimated in this study should be transferable to any
      laboratory using immunoglobulin assays calibrated against the WHO standard. The
      usefulness of commercial immunoglobulin standard preparations not calibrated
      against these primary standards is limited.

PMID- 2237272
TI  - Horizons in gastroenterology--breaking the barriers. Proceedings of an
      international meeting held in Port Douglas, Queensland, Australia, 1 to 5
      September 1990.

PMID- 2237271
TI  - Enhanced fractional sodium reabsorption in the ischaemic kidney revisited with
      lithium as a probe.
AB  - Extraction of lithium and 51Cr-EDTA across each of the two kidneys was determined
      during renal vein catheterization in 14 hypertensive patients with unilateral or
      bilateral renovascular disease before and after i.v. injection of furosemide.
      Before the administration of furosemide an increased fractional lithium
      reabsorption was demonstrated across the affected, or more affected kidney. This
      difference was abolished by furosemide. Using lithium as a probe for sodium, our
      data suggest an increased fractional tubular sodium reabsorption in the ischaemic
      human kidney probably located to the proximal tubules as well as to the loop of
      Henle. Determination of single-kidney fractional lithium reabsorption holds
      promise as a new research tool for future evaluation of functional abnormalities
      during divided renal function studies.

PMID- 2237273
TI  - Inflammatory bowel disease revisited: surgery today and tomorrow.
AB  - Both topical and systemic medical therapy are helpful in controlling the symptoms
      in patients with ulcerative colitis. However, no drug therapy is known to
      influence the natural history of Crohn's disease. Surgical management is often
      required for the complications of acute colitis unresponsive to medical treatment
      and for socially incapacitating diarrhoea and urgency due to ulcerative colitis.
      The gold standard of such surgical treatment is a panproctocolectomy with end
      ileostomy. In young patients with a good anal sphincter, total colectomy with the
      formation of an ileal pouch-to-anus anastomosis obliterates the disease and
      usually results in satisfactory continence. There appears to be no prospect of
      using gut transplantation in the management of this disease. In the absence of
      curative medical treatment for Crohn's disease surgical intervention is often
      needed to control the complications of Crohn's disease. The initial complication
      that makes the disease symptomatic is stenosis from the healing of asymptomatic
      ulcers. If strictures can be detected early, they can be treated before secondary
      complications such as abscess or fistula occur. Some success is being achieved
      with balloon dilatation of strictures. For the first presentation of ileo-caecal
      Crohn's disease limited resection offers good long-term cure without the need for
      continued medical therapy. For recurrent and multiple strictures strictureplasty
      offers a safe alternative to extensive resection.

PMID- 2237274
TI  - Alcoholic hepatitis: pathogenesis and approaches to treatment.
AB  - Alcoholic hepatitis is a necrotizing, often inflammatory, process that is an
      important precursor to the development of cirrhosis. Acetaldehyde, which is
      derived from alcohol by the action of alcohol dehydrogenase, is apparently the
      most important factor leading to alcohol-induced liver injury. Other factors of
      importance in determining the appearance and rate of progression of liver
      diseases in patients who are chronic alcoholics include sex, nutritional status,
      and various immunologic reactions. In addition, there is an incompletely
      understood genetic predisposition to the development of alcoholic hepatitis.
      Several histologic features found in patients with alcoholic hepatitis have been
      evaluated in efforts to determine which are of prognostic value. The predominance
      of the alcohol-induced injury in zone III of the hepatic lobule; deposition of
      collagen, IgA, and fibronectin in the space of Disse; defenestration of
      endothelial cells; and transformation of lipocytes and myofibroblasts to
      fibroblasts have been investigated. Prolongation of the prothrombin time and
      marked elevation of serum bilirubin levels are indicators of a subgroup of
      patients with alcoholic hepatitis who have a poor prognosis, especially if there
      is also evidence of hepatic encephalopathy. Supportive care and abstinence from
      alcohol are the foundations of therapy. Corticosteroid therapy appears to
      decrease the number of early deaths in patients with severe alcoholic hepatitis.
      Other experimental approaches to therapy include the use of propylthiouracil,
      anabolic-androgenic steroids, and insulin and glucagon.

PMID- 2237275
TI  - Epidemiology in peptic ulcer disease. Current status and future aspects.
AB  - Peptic ulcer incidence is declining. A decreased prevalence of smokers together
      with other factors have contributed to this change. The widespread use of non
      steroidal anti-inflammatory drugs (NSAID) has increased the incidence of ulcer in
      the older population and serious complications, such as perforation and bleeding,
      have been observed especially in older women. Helicobacter pylori infection is
      virtually always present in duodenal and gastric ulcer and active chronic
      gastritis, but not prepyloric ulcer. The fact that this organism is not
      eradicated with the use of most drugs for peptic ulcer may explain the high rate
      of recurrence in ulcer disease since relapse rates are reported to be
      considerably lower when H. pylori is eradicated. In a substantial number of
      patients peptic ulcers are silent. These fall into two categories: the regular
      ulcer patient with relapses that heal spontaneously and rarely cause problems,
      and older patients without prior ulcer disease receiving NSAID treatment,
      presenting with a life-threatening complication as the first indication of ulcer
      disease. Despite all the new knowledge of peptic ulcer disease presented, the
      questions still outnumber the answers; it is therefore suggested that future
      research focus on the role of NSAIDs and H. pylori.

PMID- 2237276
TI  - AIDS and the gastroenterologist.
AB  - Over the next several decades the gastroenterologist practicing anywhere in the
      world will be confronted with patients with AIDS-related gastrointestinal
      disorders. Universal body substance isolation precautions should be practiced,
      however, in dealing with all patients, including those outside traditional 'risk'
      groups for AIDS. Principal among these precautions are using gloves for personnel
      involved in procedures and high-level disinfection or sterilization for all
      endoscopy equipment. Endoscopic procedures should be planned well in advance with
      special attention to endoscope selection and transport media availability. Organ
      associated symptoms are reviewed, especially dysphagia, odynophagia, hemorrhage,
      diarrhea, and abdominal pain. Opportunistic infections and malignancies often
      present characteristic endoscopic appearances such as that seen for
      cytomegalovirus ulceration or Kaposi's sarcoma. AIDS-related biliary disorders
      should also be recognized, principally sclerosing cholangitic or papillary
      stenosis.

PMID- 2237277
TI  - Helicobacter pylori: fact or fiction?
AB  - The recent isolation and classification of the spiral gastric bacteria
      Helicobacter pylori has led to an explosion of worldwide research. The data
      strongly suggest that H. pylori is the causative agent for type-B active chronic
      gastritis. The role of H. pylori in duodenal ulcer awaits clarification, and,
      more importantly, potential treatment regimens need clear documentation and
      further detailed research. The past decade has revealed many intriguing facts
      about H. pylori infection. If, during the 1990s, eradication of H. pylori by
      means of appropriate and safe medication can lead to the control and prevention
      of gastroduodenal disease, then major clinical and economic benefits can be
      anticipated.

PMID- 2237278
TI  - Screening strategies in gastrointestinal cancer.
AB  - The concept of screening is based on the notion that regular examination can
      reduce the mortality from gastrointestinal cancer, but there is as yet little
      evidence that this is the case in either Barrett's esophagus or ulcerative
      colitis. Screening is carried out by regular endoscopy with multiple biopsies in
      an attempt to detect dysplasia, which has traditionally been regarded as the end
      point of surveillance and the time when resection should be considered.
      Considerable departure from these guidelines has occurred. Attempts are
      increasingly being made to select patients in both of these groups who might be
      at particular high risk of developing dysplasia because of the presence of
      nuclear aneuploidy, the assumption being that these patients are at particular
      risk of developing dysplasia and carcinoma. However, data to support
      stratification at this level are unavailable. In addition, there is not good
      agreement as to whether surveillance is indicated at all in some groups of
      patients such as those with less than total colitis or short-segment Barrett's
      esophagus. The end point of surveillance has also been questioned, with
      reluctance to recommend colectomy in ulcerative colitis with the finding of low
      grade dysplasia, possibly because the sampling problem is so great that it may be
      impossible to confirm that diagnosis on repeated endoscopy and biopsy. While
      better markers than dysplasia may be required to predict patients at highest
      risk, there are currently no marker other than the development of invasive
      carcinoma on which the decision to resect can be based.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2237279
TI  - Stress ulcers.
AB  - Gastric stress ulceration occurs rapidly in patients after severe trauma.
      However, bleeding from stress ulceration is a rare but very serious complication
      after trauma and major surgery. Important risk factors for stress ulcer bleeding
      are shock, especially septic shock, and the development of other components of
      the multiple system organ failure syndrome. The pathophysiology and treatment of
      stress ulceration is reviewed in this paper. Prophylaxis is the best form of
      treatment, and the most effective prophylaxis is optimal resuscitation and
      intensive care. In addition, pharmacologic prophylaxis, including antacids,
      sucralfate, or acid secretory inhibitors, has been advocated. Once profuse
      bleeding has started, measures other than aggressive treatment of shock and
      sepsis are usually unsuccessful.

PMID- 2237280
TI  - Recent studies of the pathophysiology and diagnosis of esophageal symptoms.
AB  - The three main symptoms of esophageal disease or disorder are dysphagia, chest
      pain, and heartburn. Dysphagia in achalasia is mainly due to a non-relaxing lower
      esophageal sphincter (LES). The mechanism of dysphagia in diffuse esophageal
      spasm and related motor disorders is related to a combination of several factors
      including incomplete LES relaxation, failed or weak peristalsis (pressure less
      than 30 mmHg in the distal esophagus, and orad positive pressure gradient). Meal
      manometry and balloon distention may prove to be useful provocation tests. Chest
      pain of esophageal origin may be due to gastroesophageal reflux and esophageal
      motility disorders; it may also be a manifestation of an irritable esophagus, in
      which the esophagus is hypersensitive to various stimuli (chemical, mechanical,
      ischemic). Esophageal provocation tests may suggest the esophageal origin of the
      pain but do not give information on the nature of the esophageal disorder. Twenty
      four-hour pH and pressure measurements may, however, yield this information.
      Heartburn and acid regurgitations are the most typical symptoms of
      gastroesophageal reflux. Transient relaxations of the LES are considered to be an
      important contributory mechanism of reflux. Absent basal LES pressure is another
      mechanism, which accounts for about one-fourth of the reflux episodes in patients
      with severe reflux esophagitis. During long-lasting inappropriate relaxations,
      swallows often produce deglutitive contraction waves that die out in the upper
      esophagus, suggesting that reflux often occurs during periods of inhibition of
      both LES tone and peristaltic esophageal activity.

PMID- 2237281
TI  - Where do we stand on gastric motility?
AB  - This review deals with several aspects of gastrointestinal motility. It attempts
      to relate basic knowledge to clinically relevant issues. The review is organized
      around specific contractile patterns and tasks in the gastrointestinal region
      that are grouped into three broad categories: tonic contractility of the stomach,
      antral phasic contractility, and resistance of the gastric outlet. There is also
      a section dealing with the evaluation of gastric motor function for diagnostic
      purposes describing the technologic means for investigating motility disorders in
      patients presenting with different clinical syndromes. In this section there is
      also reference to the criteria to be used in interpretation of the results and
      practical advice on the use of each test. Finally, the review deals with the
      issue of treatment of gastric motor disorders, comprising both dietary and
      pharmacologic approaches.

PMID- 2237282
TI  - Pressure relationships within the human bile tract. Normal and abnormal
      physiology.
AB  - Bile is secreted continuously, although at various rates, from the liver into the
      biliary tree; whether bile is then diverted into the gallbladder or the duodenum
      depends on the relative resistance to flow mainly determined by the contractile
      state of the gallbladder and the choledochoduodenal junction. The resistance of
      the sphincter of Oddi is considered the principal factor in the regulation of the
      intracholedochal pressure and, therefore, of the common bile duct-gallbladder
      pressure gradient; however, filling of the gallbladder may also take place after
      total sphincterotomy. During late phase II of the interdigestive period
      intragallbladder pressure increments favour flow of a small amount of bile into
      the bile duct and, through the sphincter of Oddi, into the duodenum. During phase
      III of the interdigestive period maximal frequency of sphincter of Oddi phasic
      contractions blocks bile flow into the duodenum. After a meal tonic active
      contraction of the gallbladder causes an increase of the intraluminal pressure
      followed shortly by volume reduction of the viscus and outflow of bile
      accompanied by an intracholedochal pressure increment. Gallbladder hypotonia is a
      relevant factor in the pathogenesis of gallbladder stones. The gallbladder acts
      as a reservoir, since intracholedochal pressure is higher after than before
      cholecystectomy, and this may explain post-cholecystectomy choledochal dilatation
      and biliary pain by obstructed bile flow due to either stenosis or dyskinesia of
      the sphincter of Oddi.

PMID- 2237283
TI  - Frontiers of biliary endoscopy.
AB  - The value of endoscopic retrograde cholangiography has been expanded recently by
      attention to technical detail and new methods for tissue diagnosis. Diagnostic
      information has been complemented by the new techniques of peroral
      choledochoscopy and endoscopic ultrasonography. The indications for endoscopic
      management of bile duct stones have become clearer, especially in patients with
      the gallbladder in situ. Techniques for distintegration and removal of large
      stones have improved. In patients with benign and malignant strictures recent
      emphasis has focused on the role of endoscopic management when compared with
      percutaneous and surgical approaches. Expandable metal stents are an interesting
      new option. The latest frontier is the gallbladder, which can now be reached with
      endoscopic catheters, and even directly with choledochoscopes through the
      papilla.

PMID- 2237284
TI  - Non-surgical management of severe chronic pancreatitis.
AB  - The observation that drainage of the MPD in selected cases of severe chronic
      pancreatitis has a radical benefit on pain reduction supports the hypothesis that
      pain is mainly due to obstruction of the MPD. Further follow-up study is needed
      to assess whether endoscopic management can prevent progression of the disease
      and especially postpone the onset of diabetes and steatorrhea. The iterative
      character of the endoscopic management is at least an advantage when compared
      with surgery, which, in principle, might be considered definitive in only one
      operation. The present excellent results of non-surgical management of chronic
      pancreatitis suggest that these new procedures will find a prominent role similar
      to that already achieved for biliary tract procedures. Therapeutic endoscopy of
      the pancreas and chronic pancreatitis has focused on the 'stone and stricture'
      nature of the disease, and techniques have developed accordingly.

PMID- 2237285
TI  - Etiology of inflammatory bowel diseases: where have we been? Where are we going?
AB  - The cause or causes of Crohn's disease and of ulcerative colitis remain
      uncertain. In spite of extensive investigations, searching for immunologic or
      infectious causes, clear evidence suggesting an underlying etiology is lacking.
      Recent studies involving mycobacteria suggest that occasional patients thought to
      have Crohn's disease may indeed be infected with a mycobacterium. However, clear
      cause-and-effect relationships have not been established. Future efforts at
      trying to establish the relationship between environmental factors, including
      infectious agents, and immunologic mediators seem appropriate on the basis of
      available data. For the present, the causes or cause of these diseases remains
      obscure.

PMID- 2237286
TI  - Tumour necrosis factor alpha (TNF-alpha) and interleukin 6 in a zymosan-induced
      shock model.
AB  - TNF plays a central role in septic shock induced by endotoxin or Gram-negative
      bacteria. Zymosan can elicit a septic shock-like syndrome in rodents in the
      absence of endotoxin. TNF and IL-6 release in mice treated with zymosan was
      investigated. One hour after intraperitoneal zymosan injection, maximal TNF
      levels were measured in serum, followed by IL-6 peak levels 1 h later. Treatment
      with a monoclonal antibody against TNF lowered zymosan-induced mortality from 63
      to 11.6%, while maximal IL-6 levels were lowered by about 40%. Mechanisms
      triggering zymosan-induced cytokine release in murine macrophages were analysed
      in vitro. Cytokine release was only slightly triggered by uncoated zymosan
      particles. Thirty-nine per cent of TNF release by macrophages appeared to be
      triggered by zymosan-bound activated complement. Maximal TNF release also
      required the presence of natural antibodies against zymosan and zymosan-activated
      serum. In contrast, maximal IL-6 release was reached upon stimulation with
      zymosan-activated serum only, while the presence of zymosan particles lowered
      this response. We conclude that TNF is a crucial mediator in zymosan-induced
      shock. TNF release can be induced by different immunological pathways, without
      the need for the direct presence of endotoxins. Although IL-6 release during
      septic shock is partly dependent on TNF, in vitro trigger mechanisms for IL-6 and
      TNF differ remarkably.

PMID- 2237287
TI  - Dynamics of blood components and peritoneal fluid during treatment of murine E.
      coli sepsis with beta-1,3-D-polyglucose derivatives. I. Cells.
AB  - Beta-1,3-D-polyglucose derivatives protect mice against otherwise lethal
      bacterial infections. This protective effect has previously been considered to be
      mediated through mononuclear phagocytes. We have now investigated the cellular
      composition in blood and peritoneal fluid after administration of the beta-1,3-D
      polyglucose before and after challenge with Escherichia coli. In animals treated
      with beta-1,3-D-polyglucose derivatives, the total white cell number was
      significantly increased in both blood and peritoneal fluid before and after
      challenge with E. coli. The increased total cell number was mainly the result of
      raised levels of granulocytes. The effects of beta-1,3-D-polyglucose-derivatized
      microbeads (GDM) and soluble aminated beta-1,3-D-polyglucose (AG) were similar.
      Bacterial counts in peripheral blood in GDM- and AG-treated animals increased
      with 6 h after challenge and approached zero after 24 h. In untreated animals the
      bacterial counts increased gradually until the animals died after about 12 h.
      Bacterial counts in peritoneal fluid of GDM- and AG-treated animals declined to
      zero after 24 h. In untreated animals there was a slight increase in bacterial
      counts until the animals died after about 12 h. By using radioactive labelling,
      we localized the bacterial as well as the beta-1,3-D-polyglucose derivatives
      during the period following injection. Particle-bound beta-1,3-D-polyglucose was
      recovered mainly in the milky spots of the omentum. A conspicuous number of
      bacteria were also recovered in the milky spots. The soluble aminated beta-1,3-D
      polyglucose was recovered mainly in the liver. However, on a weight basis, the
      greatest concentration of radioactivity was in the milky spots.

PMID- 2237288
TI  - Cardiac amyloidosis: report of a patient heterozygous for the transthyretin
      isoleucine 122 variant.
AB  - Amyloid fibril material was extracted from autopsy material of a patient who died
      from progressive cardiac failure at age 64. He had enlarged heart on routine X
      ray at age 47 and the first symptoms of cardiac failure at age 62. Fractionation
      of the fibril material resolved peptide fragments immunoreactive with anti-human
      transthyretin (TTR). One of the peptides was further purified by high-performance
      liquid chromatography (HPLC) and subjected to tryptic peptide mapping along with
      TTR isolated from the patient's serum. In both instances, sequencing procedures
      revealed, in addition to the normal peptide 12 (residues 105-126), an abnormal
      peptide with an isoleucine for valine substitution at position 122. This
      substitution has been described previously in a patient with systemic senile
      amyloidosis (SSA) homozygous for this variant. The results question whether SSA
      is a clinical entity related to TTR Ile 122 with phenotypic expression in the
      homozygous condition.

PMID- 2237289
TI  - Abstracts of papers presented at the twenty-first annual general meeting of the
      Scandinavian Society for Immunology. Stockholm, Sweden, 11-14 June 1990.

PMID- 2237290
TI  - [Evaluation of the effectiveness of health care].
AB  - During the last two decades, the economic aspects of health care acquired an
      outstanding attentiveness in all developed countries. Simultaneously, the methods
      have been searched for a more intensive and perfect application of internal
      health sources, i.e. manpower, materials and money. New approaches in evaluating
      health care efficacy (conception of health provision as a branch of national
      economy) have been made. In accord with them, the efficiency of either individual
      or partial health actions such as health care programs, preventive measures,
      diagnostical and curative procedures etc.) is measured. All these questions are
      the up to date topic for Health care of Czechoslovakia which now is far to
      dispose of sources comparable with the majority of economically developed
      countries in Europe. At present, they are approximately similar in supplying 1
      person health care needs with 500-1000 dol. a year and even more in several
      countries, whereas Czechoslovakia spends about 200 dol. on health needs of 1
      inhabitant a year. This fact is closely connected with relatively low efficacy of
      our economy incapable to produce the sufficient sources for providing health care
      on one hand, and on the other it is due both to the budgetary politics as
      practiced now and the conception of national product division. The shortage in
      Health care sources is manifested mainly in retardation of material and technical
      base of health service altogether with low levelled renumeration of health
      workers consequential in psychologic, social and political problems. The
      consequences of this condition are reflected negatively in a level of health
      service provision. This is as far important as the czechoslovac population health
      status viewed from the so-called strategic health indices (averaged life
      expectancy, specific mortality, occurrence of cardiovascular diseases and
      malignancies etc.) is not favourable due to a number of factors, and its
      improvement will require considerable efforts from both the health workers and
      community as a whole. Besides the needful enlargement of sources, these
      complicated questions are resolvable in observing unity of medical,
      organizational and economical rationality on all levels of health service
      management and in all health institutions. This is also the way how to improve
      the efficiency of health care. The term of efficiency in relation to the health
      services. In economics, the efficiency is the ratio between the achieved result
      (effect) and the expenditure of a specified amount of resources. Mathematically,
      this ratio is expressed as follows: efficiency = end-result/costs Linked to the
      Health care, the efficiency may be understood also differently from its economic
      term.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2237291
TI  - Laser treatment of recurrent urethral condylomata acuminata in men.
AB  - Fifty-six consecutive men with recurrent condylomata acuminata of the urethra and
      possibly also of the external genitalia were treated with carbon dioxide or ND:
      YAG laser or both. In all patients previous conservative treatments had failed.
      Half the patients responded completely to a single treatment and 86% to a maximum
      of three treatments. No important side effects were encountered, and the cosmetic
      results have been excellent.

PMID- 2237293
TI  - Laser combined with TURP in the treatment of localized prostatic cancer.
AB  - Laser treatment associated with transurethral resection of the prostate is a new
      and promising treatment of the stages T0 diffuse, T1 and T2 prostatic cancer. Our
      standardized treatment procedure gives few complications. So far we have not
      recorded any local recurrence in the 26 patients we have treated and followed up
      from 6 to 42 months.

PMID- 2237292
TI  - Implantation of beads into the penile skin and its complications.
AB  - Embedding of beads into the penile skin was observed among 60 foreign workers in
      the employ of certain Saudi Arabian companies. The procedure had been performed
      by an unqualified person. They had undergone this procedure in order to increase
      sexual stimulation of the mate. Infection secondary to implantation procedure had
      occurred in only 2 cases, necessitating surgical treatment. The first patient was
      suffering from a penile abscess (one week) after embedding of an ivory bead. The
      second one was troubled by a painful erection (3 months) after embedding of three
      glass beads. The other 58 persons had had their implanted beads for varying
      periods of time, ranging from 3 months to 8 years, without complaint. They
      refused to have the beads removed. This abnormal procedure is considered to be a
      manifestation of a suppressed psycho-sexual neurosis.

PMID- 2237294
TI  - Screening of urinary tract abnormalities among day and nightwetting children.
AB  - In order to detect possible urinary tract abnormalities among wetters,
      assessments of previous history completed by ultrasonography of the urinary tract
      and uroflowmetry were obtained for 145 wetting children and a random sample of
      156 sex-matched non-wetting children drawn from a population of 3,375 seven-year
      olds. Ultrasonography revealed abnormalities, including both morphological ones
      and cases with incomplete bladder emptying, in 5 out of 73 nightwetters (6.8%,
      95% confidence limit, CL, 1.1-12.6), 10 out of 72 day and day and nightwetters
      (hereafter daywetters) (13.9%, CL 5.9-21.9) and 4 controls (2.6%, CL 0.1-5.0),
      the figure for the daywetters differing significantly from that for the controls
      (p less than 0.01). A fractioned voiding curve was recognized in 1 nightwetter
      (1.4%, CL -1.3-4.0), 7 daywetters (9.7%, CL 2.9-16.6) and 7 controls (4.5%, CL
      1.2-7.7) the difference between the nightwetters and daywetters being significant
      (p less than 0.05). Depending on the previous history and abnormal findings in
      ultrasonography or uroflowmetry, examinations were continued with intravenous
      pyelography, voiding cystography, cystoscopy and/or by cystometry. Finally,
      marked structural or functional disorders of the urinary tract were detected in
      11 out of 72 daywetters (15.3%, CL 7.0-23.6), 1 out of 73 pure nightwetters and 1
      out of 156 control children. It is concluded that imaging of the urinary tract is
      not necessary for pure nightwetters, while ultrasonography or uroflowmetry and
      more sophisticated radiological or urological methods should be focused on those
      children with daytime wetting and clinical symptoms of voiding disturbances.

PMID- 2237295
TI  - Local bacillus Calmette-Guerin therapy for superficial bladder cancer: clinical,
      histological and ultrastructural patterns.
AB  - The effectiveness of intravesical administration of bacillus Calmette-Guerin as a
      prophylaxis of superficial bladder cancer has been definitely demonstrated. On
      the other hand, therapeutic regimens, duration effects, efficacy of either
      maintenance cycles or repeated courses of therapy in case of failures are still
      controversial. We report the results achieved in 15 cases of carcinoma in situ of
      the bladder and in 48 cases of superficial bladder cancer (Ta-T1 stage of
      disease) with bacillus Calmette-Guerin immunotherapy. Our patients underwent an
      initial six week cycle and a following maintenance cycle with monthly
      administrations for one year. Median follow-up was 19 months (range 18-21
      months). Patients with carcinoma in situ are now free of disease; on the
      contrary, patients with Ta-T1 tumors experienced 18 recurrences (28%). There was
      a marked decrease of recurrence rate when compared to previous local
      chemotherapy. We report in detail the adverse effects encountered and both
      histologic and ultrastructural findings observed after immunotherapy. Bacillus
      Calmette-Guerin therapy can influence positively the natural history of the
      disease but possible adverse effects should always be considered before starting
      the treatment.

PMID- 2237296
TI  - Cisplatin and medium dose methotrexate in advanced transitional cell carcinoma of
      the urinary tract.
AB  - Twenty-seven patients with advanced transitional cell carcinoma of the urothelium
      were studied. The area of each tumour was measured by computed tomography. Twenty
      four of the 27 patients were evaluated after treatment with the following course
      of chemotherapy given intravenously: day 1-cisplatin 50 mg/m2; day 2-methotrexate
      250 mg/m2; and folinic acid rescue treatment 24 hours after the methotrexate
      infusion. Each cycle of treatment was given three times, with two weeks between
      cycles. There were two complete and 11 partial responses, and the primary tumour
      responded as often as the distant metastases. The toxicity of the regimen was
      acceptable, even given the advanced age of most of the patients. Most of whom
      found that their disturbances of micturition and sleeping problems were improved
      by the treatment. Cisplatin combined with methotrexate achieves a response rate
      of about 50% in advanced transitional cell carcinoma. When combinations of
      chemotherapy are being chosen for these often elderly patients the curability and
      palliation effects must be balanced against the toxicity and morbidity.

PMID- 2237297
TI  - Results of 5,035 stone analyses: a contribution to epidemiology of urinary stone
      disease.
AB  - Between 1978 and 1988 5,035 urinary calculi have been analysed by X-ray
      diffractometry. 1,615 of these stones have additionally been investigated by
      scanning electron microscopy (SEM). The overall sex-ratio was 1.86 (m/f). Ca
      stones and uric acid containing stones are more frequent in male patients (m/f =
      2.08 and 3.86, respectively) whereas infection stones and cystine stones show a
      higher rate of appearance in female patients (m/f = 0.6 and 0.88, respectively).
      The percentage of open surgery ranged about 30% in the first few years but
      decreased to 5-7% in the last few years due to the new methods of stone removal.
      The rate of occurrence of the crystalline phases does not differ remarkably from
      other statistics except for a higher incidence of apatite because of the high
      sensitivity of detection of this phase by SEM. The recurrence rate of brushite
      stones amounting to 66.7% is very high and exceeds even that of cystine stones
      (60.7%).

PMID- 2237298
TI  - The role of hyperoxaluria in the formation of calcium oxalate urinary calculi,
      and its association with other biochemical measurements.
AB  - The part played by hyperoxaluria in the formation of calcium oxalate urinary
      calculi was studied in 153 patients who had each been diagnosed as having calcium
      oxalate urinary calculi on one or more occasions. Seventy-seven of the patients
      excreted normal amounts of calcium (less than 6.2 mmol/d), and 76 had
      hypercalciuria (excretion greater than or equal to 6.2 mmol/d); each group was
      divided into a further two groups depending on whether the oxalate concentration
      was above or below 0.16 mmol/l. Pure calcium oxalate stones were more common in
      patients whose calcium excretion was normal, and mixed calcium oxalate and
      phosphate stones were more common among hypercalciuric patients. Urinary
      concentrations/day of magnesium, citrate, and phosphorus were significantly lower
      in the two groups in which the oxalate concentrations were below 0.16 mmol/l than
      in a normal control group, and magnesium and phosphorus were significantly lower
      in the two groups in which oxalate concentrations were less than 0.16 mmol/l than
      in the two in which they were above that value. The concentration of citrate was
      also lower, but not significantly so. In addition, the pH of the urine in
      patients with mixed stones was significantly higher in all groups than when the
      stones were composed of pure calcium oxalate.

PMID- 2237299
TI  - Urinary tract calculi dissolved by means of renacidin. An experimental study.
AB  - Removal urinary tract calculi by surgery may be difficult in patients with poor
      health or in patients who have been operated on earlier. By means of percutaneous
      nephrostomy it is possible to irrigate the renal pelvis with Renacidin to
      dissolve calculi. Renacidin is a buffer and mainly consists of citrate and
      gluconate. The solution makes it possible to dissolve some calculi. This study
      was carried out in order to evaluate the influence of the concentration of
      renacidin and of the speed of the irrigation. Urinary tract calculi were obtained
      from five patients. The calculi were cut into 2 mm thick slices. Each slice was
      weighed before it was placed in a chamber for irrigation. Irrigation of the
      slices by means of renacidin was performed at speeds of 30, 60 or 120 ml/h.
      Slices wre also kept in vessels containing renacidin without replacing the fluid
      during the irrigation. In two series dissolution was investigated for various
      concentrations of renacidin. Elementary analysis using absorption and
      spectrophotometric techniques was performed and a qualitative evaluation of the
      distribution of the inorganic components was carried out using the
      microradiographic technique. The speed of the dissolution of urinary calculi
      varied between 0.43 and 7.7 mg/h. Two stones were easily dissolved (5 and 7.7
      mg/h) while the three others were more resistant (0.5, 1.0 and 3.0). Diluted
      renacidin fluid (1:3) was less effective and reduced dissolution from 5.8 to 0.7
      mg/h. The speed of the irrigation was of minor importance in the experimental
      situation. The dissolving effect of renacidin varied for different
      calculi.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2237300
TI  - Hemodialysis does not always protect against recurrence of Wegener's
      granulomatosis.
AB  - Hemodialysis may protect against disease activity in Wegener's granulomatosis. We
      report here a 41-year-old woman with Wegener's granulomatosis, in whom renal
      transplantation was performed after a 10-month period of hemodialysis during
      which no signs of disease activity were detected. Recurrence of disease did,
      however, take place 2 years after renal allograft transplantation despite
      immunosuppressive therapy with cyclosporine A and prednisone. Reinstitution of
      hemodialysis and graftectomy did not improve the patient's condition but
      plasmapheresis and treatment with cyclophosphamide and prednisone eliminated all
      signs of disease within a fortnight. A proposal for better maintenance of these
      patients is made.

PMID- 2237301
TI  - Primary renal non-Hodgkin lymphoma.
AB  - Two cases of primary renal non-Hodgkin lymphoma are presented. Clinical and
      pathologic characteristics and diagnostic aspects are discussed. Radical
      nephrectomy followed by chemotherapy is the treatment of choice. New chemotherapy
      patterns have improved the prognosis. Although rare, non-Hodgkin lymphoma should
      be included in the differential diagnosis of space-occupying renal lesions.

PMID- 2237302
TI  - Amatoxin intoxication.
AB  - Ingestion of mushrooms followed after 6-12 hours by gastrointestinal symptoms and
      after 3-4 days by hepatic symptoms is diagnostic for the life-threatening
      amatoxin intoxication and should be treated as soon as possible. Four case
      histories are reported and recommendations for treatment are given.

PMID- 2237303
TI  - Huge renal angiomyolipoma presenting with bleeding in a 76-year-old woman. Case
      report.
AB  - Renal angiomyolipoma is a rare, benign and hypervascular tumour. Its symptoms may
      be acute, with severe bleeding, or protracted, few and recurrent, due to bleeding
      and pressure. A symptomatic case is presented. The patient seems to be the oldest
      on record, and with the longest-lasting symptoms and the biggest tumour.

PMID- 2237304
TI  - Vaginal metastasis as the first sign of renal cell carcinoma. A case report and
      review of the literature.

PMID- 2237305
TI  - Calciuria in Bartter's syndrome.

PMID- 2237306
TI  - Autotransplantation of lymph node fragments. Structure and function of
      regenerated tissue.
AB  - In pigs slices of autologous lymph nodes were implanted in the subcutaneous fat,
      under the muscular fascia or under the kidney capsule to study the regeneration
      of autotransplanted lymph node tissue. The regenerated nodules consisted of all
      the normal compartments found in lymph nodes and there was evidence that afferent
      lymphatics reached these nodules. Superficial inguinal lymph nodes regenerated
      more often and with a better structure than mesenteric lymph nodes. The sites
      under the kidney capsule and the fascia of muscles were found to be a less
      stimulating microenvironment for regeneration than the subcutaneous tissue.
      Regeneration of transplanted lymph node tissue was observed in pigs which had
      been operated on as young piglets or as adults. The regeneration of
      autotransplanted lymph node tissue might be a useful model for draining
      lymphedema, especially from the extremities.

PMID- 2237307
TI  - Effect of bleeding and hypervolaemic haemodilution on traumatic vasospasm in
      rabbits.
AB  - The effect of bleeding (20% of total blood volume) and of hypervolaemic
      haemodilution with dextran infusion (20% of total blood volume) on traumatic
      vasospasm was studied in the central ear arteries of 10 rabbits. The blood
      pressure dropped significantly after bleeding and the packed cell volume was
      significantly lower after dextran infusion. Neither treatment had any effect on
      the duration, intensity or severity of the vasospasm. The results suggest that
      moderate changes in blood volume do not influence traumatic vasospasm.

PMID- 2237308
TI  - The palmar digital venous anatomy.
AB  - Fresh human cadaveric hands were injected with a liquid plastic polymer and
      dissected under the operating microscope. On the palmar aspect of the digits,
      four different venous patterns could be identified, characterized by their
      tributaries and branching pattern, and by the presence, position and direction of
      valves. Arborized veins drain a limited volume of tissue by a number of very
      slender vessels that come together to form a common trunk. Venous arches are
      found both superficial and deep, palmar and lateral; they neither branch nor have
      valves, except at both ends. Deep axial veins accompany the digital arteries as
      comitant veins. They drain to both the metacarpal comitant veins and the web
      space veins. Superficial axial veins run principally in the subdermal layer of
      the finger; they drain either directly to dorsal veins or to the natatory vein on
      the ligament of the same name.

PMID- 2237309
TI  - Superficial venous anatomy of the human palm.
AB  - In a study of the venous anatomy of the palm, a high degree of consistency has
      been found in the organization of the superficial vessels, which lie between the
      palmar fascia and the dermis. Although in the superficial palm, as previously
      reported for the fingers, there are large individual variations in the detailed
      topography, the basic functional venous anatomy remains highly consistent. The
      present paper demonstrates the findings from dissections of 12 human cadaver
      hands after injection of a polymerizing plastic solution into the vascular tree.
      The basic types of superficial venous structures found in the superficial palm
      are presented, and their functional importance for the drainage of blood from the
      palm is discussed.

PMID- 2237310
TI  - Effects of electrical nerve stimulation (ENS) in ischemic tissue.
AB  - Blood flow was measured in the skin flaps of 20 patients who had undergone
      reconstructive surgery. All flaps were showing clinical signs of deficient
      circulation. Local blood flow in skin flaps was significantly increased by
      electrical nerve stimulation (ENS) (p less than 0.001), but not by placebo ENS.
      Repeated ENS treatment reduced stasis and oedema significantly (p less than
      0.001), and the capillary refill was also significantly improved (p less than
      0.001).

PMID- 2237311
TI  - Tissue expansion and skin circulation. Simultaneous monitoring by laser Doppler
      flowmetry and transcutaneous oximetry.
AB  - The skin circulation was examined in nine patients during filling of their breast
      expander prostheses. Despite the high expansion pressure, which was increased
      above the systolic blood pressure, the overlying skin showed good circulation
      both clinically and when measured with a laser Doppler flowmeter and a
      transcutaneous oximeter. We conclude that the expansion was therefore directed to
      the tissues between the expander and the skin--that is, the fibrous capsule
      surrounding the prosthesis. Nine subcutaneous tissue expanders located in
      different anatomical regions were overfilled to a pressure at which all skin
      circulation ceased. Sufficient saline was then removed to allow skin circulation
      to return. Oxygenation of the skin ceased at a relatively low pressure when
      measured by transcutaneous oximetry, whereas when the skin circulation was
      measured with a laser Doppler flowmeter it did not disappear until the expander
      pressure had been raised appreciably above that level.

PMID- 2237312
TI  - Cleft lip and palate patients prior to delayed closure of the hard palate:
      evaluation of maxillary morphology and the effect of early stimulation on pre
      school speech.
AB  - Speech and maxillary development were analysed in two groups of patients with
      unilateral cleft lip and palate; both groups had early jaw orthopaedic treatment
      and a surgical regimen that included two-stage lip surgery (mean ages of 2 and 19
      months) and soft palate repair (8 months). Closure of the hard palate was
      postponed until the children were 8 to 10 years of age. The first group comprised
      10 consecutive patients who were analysed at 5 and 7 years of age, and the second
      group seven patients who were studied at the age of 5. Both groups were thus
      investigated before the repair of the cleft in the hard palate. In addition to
      surgical and jaw orthopaedic treatment, the second group of patients received
      early stimulation of lip and tongue tip movements. Our results indicated that
      hypernasality was less a problem than was retracted palatal or velar articulation
      of dental consonants. These deviations tended to be reduced, however, after early
      stimulation. There seemed to be no clear association between the size of the
      residual cleft in the hard palate and the extent of speech development. The
      average size of the residual cleft in our patients was comparatively small, and
      decreased further during follow up. We conclude that preschool children with
      unilateral cleft lip and palate may develop good speech, in spite of the residual
      cleft, if they use an intraoral plate and are given extra lip and tongue tip
      stimulation, together with early speech therapy if necessary.

PMID- 2237313
TI  - Closure of the cleft palate in one or two stages: the surgical methods.
AB  - The details of two consecutive groups of cleft palate patients treated with one-
      or two-stage palate repair are presented. The total number of patients is 237,
      with 128 operated in one stage, and 109 operated in two stages. In the two-stage
      group, the frequency of 'unintended' palatal fistulas decreased by 80%, and the
      use of blood transfusions was greatly reduced, but total operation time and
      hospital stay were longer. The results in terms of speech quality, facial growth
      and dental occlusion, will be reported on separately.

PMID- 2237314
TI  - Reactivity of the microcirculation in port wine stain hemangiomas evaluated by
      laser Doppler fluxmetry.
AB  - Twelve patients with port wine stains (both untreated and treated with argon
      laser) had their microcirculation monitored by laser Doppler flux at rest and
      after arterial occlusion lasting one minute. The blood cell flux was measured in
      normal, untreated and treated skin areas. The resting flux was significantly
      higher in untreated port wine stains than in the normal skin. The reactive
      hyperemia response was significantly impaired in the untreated skin, although a
      60% increase in blood cell flux was achieved by the short arterial occlusion. In
      most of the recorded parameters the treated areas showed a less pathological
      reaction than the untreated ones. We conclude that peroperative vasodilation can
      be induced in port wine stains, and this may be used to improve the outcome of
      argon laser treatment.

PMID- 2237315
TI  - Gustatory rhinorrhea after radical parotidectomy.
AB  - A man of 63 developed unilateral gustatory rhinorrhea shortly after radical
      parotidectomy for infiltrating squamous cell carcinoma that had metastasised to
      the parotid lymph nodes. There is a similarity between this condition and the
      gustatory vasodilatation and sweating of Frey's syndrome, but despite
      circumstantial evidence that misdirected nerve regeneration causes these
      symptoms, their exact aetiology is still unknown.

PMID- 2237317
TI  - Isolated compression of the motor branch of the median nerve by a ganglion. Case
      report.
AB  - A 25-year-old hairdresser presented with a fluctuant lump in the palm of her
      right hand that was intermittently painful and made control of her right thumb
      difficult. She had no sensory loss. At operation a cystic swelling was found 8 mm
      in diameter distal to the carpal ligament and compressing the median nerve. The
      cyst ruptured during dissection, and it was not possible to localise the pedicle.
      Histological examination showed that it was a ganglion, and nine weeks after the
      operation the patient had regained normal use of her hand and resumed her work.

PMID- 2237318
TI  - Aneurysmal bone cyst of the hand. An unusual location in the first phalanges of
      the first finger. Case report.
AB  - A 40-year-old woman presented with a lesion on the first phalanx of her right
      thumb, which on radiography appeared to be a cystic lesion. This was treated with
      curettage and bone graft but recurred a year later. It was treated in the same
      way, and 18 months later there has been no sign of recurrence. Histological
      examination confirmed that it was an aneurysmal bone cyst.

PMID- 2237316
TI  - Closed longitudinal splitting of the carpus. Case report.
AB  - Closed longitudinal splitting of the carpus is a rare injury with disruption of
      the transversal carpal arch. One case with a stroke injury is reported; the
      injury was work-related and occurred as a broad stroking injury to the volar side
      of the right hand and wrist. The patient was treated with open reduction,
      ligament repair and percutaneous pinning of a wide diastasis. Despite the return
      of wrist motion, pinch and grip strength remained below normal at follow-up
      examination. There appears to be a weak point between the capitate and hamate and
      the third and fourth metacarpals.

PMID- 2237320
TI  - Perichondrial grafting for total replacement of the patella. Experimental study
      in rabbits.
AB  - In five adult rabbits excision of the patella of one knee joint was carried out.
      The defects were reconstructed with free grafts taken from rib perichondrium.
      After survival times of 2.5 and 5 months, neocartilage was seen in all grafts on
      histological examination. In three of the five, the central part of the
      reconstructed patella showed bone formation.

PMID- 2237321
TI  - Strategies in the education of humane physicians.
AB  - Various reforms to change the character of medical education have been
      implemented since the 1960s at American medical schools. The public demand for a
      more "humane" physician resulted in the incorporation of new sciences in the
      medical curriculum--behavioral sciences in the 1960s and 1970s and humanities in
      the 1980s. It is argued that broader structural changes in the American health
      care system underlie the need for these educational reforms, which in practice
      allow the medical profession to maintain its autonomy and control over its work.
      For comparison the curricular innovations in medical education in the Nordic
      countries are examined.

PMID- 2237319
TI  - The effect of growth factors and synovial fluid on chondrogenesis in
      perichondrium.
AB  - Reconstruction of cartilage with perichondrium depends on the chondrogenic
      property of the perichondrial fibrocytes. The present investigation concerns the
      conditions for the differentiation of fibrocytes into chondrocytes both in vivo
      and in vitro. For the in vivo studies specimens of rib and auricular
      perichondrium from adult rabbits were wrapped round silicon rods which were
      enclosed in dialysis bags. One was placed in the suprapatellar pouch of the knee
      joint and one was placed intraperitoneally in each rabbit. After two months the
      bags were extracted, the perichondrium prepared for microscopic examination, and
      the chondrogenesis evaluated. In vitro the perichondrium was divided into small
      pieces and incubated with tissue culture medium. The medium was supplemented with
      fetal calf serum, together with epidermal growth factor, platelet derived growth
      factor, synovial fluid, or with human serum albumin (control group). After three
      weeks the explants were prepared for microscopy. Chondrogenesis was judged by the
      degree of cellular enlargement, capsule formation, deposition of matrix, and
      activation of the outer fibrocytic layer. In vivo, good cartilage development was
      found in all specimens placed in the knee joint but, in those placed
      intraperitoneally, little if any chondrogenesis was seen. In vitro profound
      differentiation occurred in all cultures supplemented with epidermal growth
      factor and platelet derived growth factor. An equivalent differentiation was
      found in perichondrium that had been incubated with synovial fluid. We conclude
      that the differentiation of perichondrial fibrocytes is initiated in vitro by
      growth factors. In addition, we have shown that synovial fluid contains factors
      that promote and enhance the development of cartilage from perichondrium.

PMID- 2237322
TI  - Simply osteoporosis--or multifactorial genesis for the increasing incidence of
      fall injuries in the elderly? The need for a scientific approach to reducing
      injuries.
AB  - Both the high and rising incidence of injuries in old age and a situation where
      accidents are looked upon as "super-human" events, impossible to prevent, call
      for a scientific approach to the problem. Another strong reason for stressing the
      scientific approach is the complex aetiological origin of injuries in the
      elderly. Individual factors as well as factors overrepresented in the injured
      population must find a developed model as site for their importance compared to
      agent factors and environmental factors. If not, there will be an everlasting
      contradiction between the discussion on monofactorial "causes" of injuries like
      osteoporosis, lacking physical exercise, environmental risks, etc. Still another
      reason is that the present serious situation with an increasing incidence of
      injuries in the elderly call for urgent preventive programmes as well as
      development of operation methods, rehabilitation methods and environmental
      changes. Unfortunately, in spite of the importance and magnitude of the number of
      injuries as a public health problem, relative little scientific attention has
      been given to the area of injury control. In the paper it is concluded that there
      is a need for model development. These models should combine an epidemiological
      approach with a behavioural scientific method as well as a system-oriented model.
      Such models are available in occupational injury prevention and should as well be
      tested in prevention of injuries in the elderly.

PMID- 2237323
TI  - Varicella among immigrants from the tropics, a health problem.
AB  - The incidence of varicella in Tamil refugees in Denmark was evaluated. Of 256
      Tamils, 44% developed varicella infection in the first few months after arrival,
      representing 38% of the adults, and 68% of the children. During approximately
      four months' observation in Denmark, 75% of the refugees with no history of
      varicella developed a typical infection whereas only 2% of those with a history
      of varicella developed the disease. Tropical refugees with a negative history of
      varicella must therefore be considered nonimmune. Nine of 44 fertile women were
      pregnant. Two acquired the varicella infection during the first-trimester, none
      in relation to delivery. By organizing a health-check on arrival, prophylactic
      measures can reduce the health hazard of varicella infection in refugees from the
      tropics.

PMID- 2237324
TI  - Salmonella and Shigella carriers among refugees from the middle east and Sri
      Lanka in Denmark.
AB  - One per cent of ten thousand refugees were asymptomatic carriers of Salmonella
      and Shigella species found by a differentiated health check programme at a Danish
      Red Cross arrival centre in Denmark 1985 and 1986. Six patients with typhoid
      fever and one with S. parathyphi-A septicaemia all fell ill within the first few
      weeks after arrival. A child of a chronic S. typhi carrier developed typhoid
      fever four months after arrival. Cases of sporadic and mild diarrhoea occurred
      due to Salmonella and Shigella species. The carriers were instructed in
      prophylactic, hygienic measures and no outbreaks developed. The health check
      system in this period seemed to be sufficient in relation to preventing outbreaks
      of infections caused by non-typhoid Salmonella and Shigella species. The relative
      cost-effectiveness of a more intensive S. typhi screening on arrival is
      questionable. The organization of health check systems should be reviewed
      regularly, as each refugee situation is different and will change in different
      periods.

PMID- 2237325
TI  - Work and "lifestyle" in occupational mortality in Denmark.
AB  - Using social class standardization Fox and Adelstein found that 18% of all
      mortality was attributed to work, while 82% was attributable to lifestyle. Fox
      and Adelstein had access to 25 occupational orders. We have made similar
      calculations on Danish mortality statistics including 146 occupational groups.
      Our results are very different: more than 50% of all mortality among Danish men
      seems to be related to work. Of 51,317 work-related deaths in 10 years, one third
      were due to cancer, and half due to cardiovascular diseases (CVD). The marked
      differences in results have lead to considerations on the applicability of the
      model and the underlying assumptions. One conclusion is that social differences
      and differences in mortality between social groups are so small in Denmark that a
      few subgroups with "deviant" mortality and/or lifestyle will be determinants of
      the results. Inclusion of more occupational groups increases the percentage of
      deaths associated with work.

PMID- 2237326
TI  - The penetrating educational effect of a mass-media based fund-raising campaign
      "heart for life".
AB  - A one-Sunday fund-raising TV-show in 1987 was broadcasted by the state-owned TV
      channel in Norway which is the only channel covering the whole country. The six
      hour TV-show consisted of a considerable amount of information on risk of heart
      disease intermingled with entertainment and money-counting results. Mass media
      had covered the forthcoming TV-show extensively. The show is presently evaluated
      as a nationwide mass-media based health education campaign through a stratified
      random sample of 976 persons aged 15 years and above. More than 95% of the
      population were aware of the campaign and 75% followed the TV-show beyond the
      news reports. The sampled persons were asked for self-reported changes in health
      knowledge and behaviour. Fifty-seven per cent reported that they gained new
      knowledge and 25% reported behaviour changes in a positive direction. Women
      reported more knowledge gain than men. Low socioeconomic groups reported more
      gain in knowledge and more positive changes in health behaviour than high groups.
      A close association was found between reported new knowledge and change of health
      behaviour (p less than 0.001). The results of the study indicate that this
      campaign has reached segments of the population that previously have been
      difficult to reach and that this is possibly due to the extensive advance
      coverage of the show in the mass media and the "entertaining" character of the
      show with emotional appeals in addition to factual information.

PMID- 2237327
TI  - Illness behaviour in mental ill-health in Kuwait.
AB  - Two hundred and eight individuals were interviewed in order to study the
      behaviour they adopt in relation to the most common somatic and emotional
      symptoms of mental ill-health. Illness behaviour included ignoring, brooding,
      self-help and consultation of others. Older individuals tended more frequently to
      resort to meditation, native healers and doctors. Males consulted doctors more
      than females. Brooding was more frequent in well educated subjects. A group of
      married expatriates who left their wives in their original countries were the
      most likely to consult doctors. Education and marital status were the most
      predictive of brooding and self-help behaviour. Self-help was the most commonly
      adopted illness behaviour. The results are explained in terms of the social and
      cultural background of the individuals studied because this influences their
      methods of expressing distress and their action in relation to symptoms.

PMID- 2237328
TI  - Social conditions of children born after artificial insemination by donor.
AB  - Few objective data are available concerning the social conditions of children
      born after artificial insemination by donor (AID). We have studied 341
      consecutive AID children born of 261 women during a 13-year period. Data from
      hospital archives were compared with information from the National Register of
      Norway. The parameters studied included age-relations of parents and offspring,
      sex- and age-relations between siblings as well as the divorce rate in AID
      families. Median maternal age at birth of the first AID child was 30 years. Forty
      three percent of AID children were born in families that already had children or
      that later obtained an additional child; the majority of these siblings were
      conceived by AID. Mean age difference between the closest related AID siblings
      was three years. Six of the 261 AID families were split by divorce during the
      study period. The results only reflect such information as can currently be
      obtained with maintenance of the promise of secrecy.

PMID- 2237329
TI  - Male partners in infertile couples. Personal attitudes and contact with the
      Norwegian health service.
AB  - The present study summarizes the results of a questionnaire sent to 312 men
      involved in a fertility investigation. The answers illustrate the psychological
      problems linked to the infertile state, indicate that men are generally well
      orientated about the extent of the problem and imply an increasing negative
      attitude to donor insemination. In the majority of cases, the infertile couples
      first contacted a gynecologist rather than a general practitioner or other
      specialist. In over one third of the cases, this contact occurred within the
      first 12 months of attempting to procure a pregnancy. In most cases, the male
      partner was already involved in the fertility investigation at the start.
      Approximately one fifth had at some time consulted fringe medicine (e.g.
      homeopathy or acupuncture).

PMID- 2237330
TI  - Premature deaths among men in a Swedish municipality--civil status and primary
      health care utilization prior to death.
AB  - Causes of premature deaths among men in relation to civil status and primary
      health care utilization were studied in a Swedish municipality. Alcoholism,
      suicide and accidents (psycho-social deaths and accidents) were of special
      concern (40% of all deaths). When principal and contributing causes of death were
      considered, alcoholism was registered in 21% of all men. Including information
      from primary health care records, the Social Services and the local outpatient
      alcohol clinic, the proportion of men with alcohol abuse was 40%. Half of the men
      with psychosocial deaths and accidents were divorced at the time of death. The
      time elapse between divorce and death was especially short for those who
      committed suicide, 1.4 years, compared to 9.5 years when death was due to
      alcohol. Half of the men who visited the primary health care centre six months
      before death were single, and the problem of the final antemortem visit
      anticipated the cause of death in the majority of these men.

PMID- 2237331
TI  - A trial that failed, and the reasons why: comparing the Minnesota model with
      outpatient treatment and non-treatment for alcohol disorders.
AB  - A randomised clinical trial was conducted in order to compare treatment results
      between Minnesota model treatment for alcohol abuse and outpatient treatment. The
      trial had to be discontinued due to problems in recruitment of subjects and a
      high rate of attrition among subjects allocated to Minnesota model treatment. In
      this paper the problems encountered during the trial are discussed. Different
      methods of recruitment of subjects to a randomised trial are compared.

PMID- 2237332
TI  - HIV infection and health personnel: health care workers' opinions concerning some
      ethical dilemmas.
AB  - A survey was made of a sample of 359 Norwegian health workers to assess attitudes
      towards HIV infected colleagues, and how the respondents would behave if they
      themselves became HIV infected. Two thirds of the 268 (75%) who responded would
      not allow that a HIV positive health worker treated their family, and 47%
      supported routine HIV screening of health workers to protect patients. Most of
      the respondents were opposed to disability pensioning of HIV infected health
      personnel in general, and would not ask for this if were found HIV positive. One
      hundred ninety-six would not tell colleagues if they became HIV infected. Within
      this group, the proportion (153/196) that would not accept practising HIV
      positive health personnel was significantly larger than that among those who
      would report own seropositivity (24/64). The study revealed substantial anxiety,
      and inconsistencies between expected behaviour of others, and the respondents'
      own reactions also were found.

PMID- 2237333
TI  - Survival of AIDS patients in Norway.
AB  - The survival function of the 100 first AIDS patients in Norway is presented and
      analyzed with respect to four factors obtained at the time of diagnosis; a) year
      of diagnosis b) initial AIDS related disease c) knowledge of HIV seropositivity
      prior to onset of AIDS and d) age at time of diagnosis. The median survival was
      9.3 months. Among the known seropositive AIDS patients there were almost twice as
      many with Pneumocystis carinii pneumonia as initial AIDS related disease, as
      among the not known seropositives (relative risk 1.8). With Cox regression
      analysis we found that known seropositivity and age are factors that appear to
      influence survival, whereas year of diagnosis and initial AIDS related disease
      apparently do not. The mechanism whereby prior knowledge of HIV seropositivity
      leads to apparent increase in survival may be due to better follow-up and thereby
      an earlier date of diagnosis.

PMID- 2237335
TI  - [Nutrition in the first days of life: how many infants need supplemental food?].
AB  - A prospective study of 280 consecutive newborns (birth weight greater than 2500
      g) showed that on discharge from hospital 88.5% were fully and 8.6% partly
      breastfed. Only 8 children (2.9%) were weaned. In the group of the fully
      breastfed infants, 8.5% received no prelacteal food or fluid, 85.9% received a
      10% dextromaltose (DM) solution and in only 5.6% of the children was there
      additional feeding with an adapted milk formula for some days. This restrictive
      attitude concerning supplemental feeding involved no observable drawbacks. The
      increasing incidence of atopic diseases--especially cow's milk allergy, the
      evolution of which is essentially promoted by the administration of foreign
      proteins in the first days of life--justifies a feeding policy on these lines.
      The elimination of bovine proteins in the newborn period is of considerable
      preventive significance. On the other hand, restriction of water supply (10% DM
      solution) is not advisable in our opinion.

PMID- 2237334
TI  - Occupational cancer in Denmark. Cancer incidence in the 1970 census population.
AB  - Data sources and creation of data files. The cohort of persons who were 20-64
      years of age at the time of the 1970 census has been followed for cancer
      incidence for a ten-year period. The study was made by linkage of individual
      records from the 1970 census, the Central Population Register, death
      certificates, and cancer registrations. Data were included on individual
      characteristics recorded in the census on prevalent cancer cases at the time of
      the census and on deaths, emigrations, and incident cancer cases during the ten
      year follow-up period. The study includes a total of 2.8 million persons, of whom
      2.0 million were economically active at the time of the 1970 census. A total of
      115,000 incident cancer cases were registered during the follow-up period, and
      77,000 of these occurred in persons who were economically active in 1970. The
      classifications used in the census included 218 codes for occupation and 245
      codes for industry. The Cancer Registry data included 639 codes for diagnosis.
      Cancer incidence by social groups in Denmark. The cancer incidence was tabulated
      across 32 socioeconomic groups for 43 cancer sites among the men and 45 cancer
      sites among the women. The study showed an almost twofold difference in the
      overall cancer incidence between the socioeconomic groups of the men. Self
      employed farmers were at low risk (RR 0.68), and unskilled workers in
      shipping/fishing were at high risk (RR 1.28) when the cancer incidence among all
      economically active men was used for the comparison. The social pattern in cancer
      incidence correlated well with the pattern for cancer mortality among men. As a
      rough estimate, the cumulative incidence for all cancer among persons under 75
      years of age could be reduced by 32% if all Danish men had the cancer incidence
      of farmers. There was a fivefold or larger difference between the socioeconomic
      groups in the incidence for nine cancer sites. These nine cancer sites together
      represented 7% of the cumulative incidence for all cancer. Estimated in a similar
      way, the cumulative incidence could be reduced by 44% if all Danish men had the
      site-specific cancer incidence of the respective low-risk groups. The overall
      cancer incidence among the women varied from a relative risk of 0.71 for
      unskilled workers in agriculture to a relative risk of 1.18 for self-employed
      women in other industries I (dentists, lawyers, etc) when the cancer incidence
      among all economically active women was used for the comparison.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2237336
TI  - [Cardiac complications of American trypanosomiasis (Chagas disease). Various case
      reports and general observations].
AB  - Three young female patients with heart problems and positive serologic tests or
      characteristic histologic lesions for Chagas' disease (American trypanosomiasis)
      are reported, one of them having presented with acute anterior myocardial
      infarction with only minor coronary lesions. The most prominent features of the
      disease are discussed with emphasis on late cardiac complications. Chagas'
      cardiomyopathy is the leading cause of sudden death in Latin America, where an
      estimated 10 to 12 million people are infected in endemic areas from southern
      Mexico to southern Argentina. It has also been termed "emboligenic
      cardiomyopathy" since arterial embolism is a very frequent complication. Embolic
      obstruction of a coronary artery may therefore well be the most probable cause of
      myocardial infarction in young people with Chagas' disease, although other
      mechanisms cannot be excluded.

PMID- 2237337
TI  - [Particle retention in the intrapulmonary conducting airways in hamsters].
AB  - Inhalation and the subsequent deposition, retention and clearance of particles
      play a pivotal role in pulmonary medicine. It has been widely accepted that
      inhaled insoluble particles which are deposited in the conducting airways are
      largely cleared within 24 hours by the mucociliary escalator. Recent reports,
      however, suggest that this view should be revised. We therefore investigated by
      light and electron microscopy the number and location of particles retained in
      the intrapulmonary conducting airways of hamsters as a function of time. The
      number of retained particles was estimated unbiasedly with a novel stereological
      method, the fractionator. Seven male Syrian Golden hamsters inhaled an aerosol of
      6 microns polystyrene particles under controlled conditions. The lungs of 3
      animals were fixed by intravascular perfusion 20 minutes after the inhalation,
      whereas those of the other 4 animals were fixed 24 hours later. Retained
      particles were found in all generations of the intrapulmonary conducting airways.
      They were submerged in the extracellular matrix in close contact with the
      epithelial cells between the cilia. The particles were coated by a thin layer of
      osmiophilic material which was interpreted as surfactant. In the lungs fixed
      immediately after the inhalation, 36% of the retained particles were ingested by
      macrophages. 24 hours after inhalation we still found 14% of the initially
      retained particles. 90% of these remaining particles were phagocytized. We
      conclude that: (1) Surfactant is important for the retention of particles in the
      intrapulmonary conducting airways of hamsters. (2) There is evidence for the
      existence of a resident population of very active airway macrophages which play a
      pivotal role in clearance of the retained particles.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2237338
TI  - [Reversible ophthalmoplegia, cerebellar syndrome and vigilance disorders
      following phenytoin poisoning].
AB  - A 20-year-old man developed marked ophthalmoplegia and cerebellar symptoms after
      suicidal intoxication with phenytoin (maximal plasmatic level 73.6 mg/l).
      Symptoms of toxicity completely resolved with supportive care and with activated
      charcoal. The clinical picture of acute phenytoin intoxication is reviewed. The
      most common disorders are ataxia, nystagmus and mental status changes, but
      ophthalmoplegia is rare.

PMID- 2237339
TI  - [Epilepsy and pregnancy].
AB  - Epilepsy affects almost 1% of all pregnant women. The effect of pregnancy upon
      epilepsy is unpredictable for the individual patient. In one third to one half of
      the patients epilepsy had no effect on seizure frequency, in one fourth to one
      third of the patients seizure frequency increased, and in one third to one fourth
      it improved. Several reasons are discussed for a frequently observed tendency to
      a drop in plasma concentration of antiepileptic drugs during pregnancy where the
      daily dose was kept unchanged. For unknown reasons, perinatal lethality is up to
      twice as high as in controls. The risk of bearing children with malformations is
      approximately 1.5-3 times higher for mothers with epilepsy than in non-epileptic
      mothers. Apart from antiepileptic drugs the role of genetic factors, the type and
      severity of epilepsy and the possible influence of grand-mal seizures during
      pregnancy must be considered to be involved in congenital anomalies. Polypharmacy
      produces more frequent anomalies than monotherapy. Valproate should be avoided in
      the pregnant women due to the increased incidence of neural tube defects. At this
      time there is no reason to discourage a mother on antiepileptic drug therapy from
      breast feeding.

PMID- 2237340
TI  - [Physiopathological basis of protection of the ischemic myocardium].
AB  - Ischemia initiates a cascade of intracellular events that culminates in the death
      of the myocyte. Reperfusion of ischemic myocardium is the most efficient way of
      salvaging jeopardized cells. Additional measures referred to as "myocardial
      protection" may further reduce ischemic injury, primarily by delaying the
      progression of cellular damage during ischemia. The pathophysiological aspects of
      ischemic injury and the possibilities for protection of ischemic myocardium are
      reviewed. In addition to the "established" methods of myocardial protection, the
      concept of prevention of "reperfusion injury", presently under experimental
      investigation, is discussed.

PMID- 2237341
TI  - Recent advances in myocardial protection using antegrade/retrograde blood
      cardioplegia.
AB  - This presentation details techniques of delivery of antegrade/retrograde blood
      cardioplegia to ensure its distribution to prevent ischemic damage during aortic
      clamping, and describes methods of using warm blood cardioplegia to "resuscitate"
      the heart when used to induce cardioplegia and "avoid reperfusion damage" when
      given just before aortic unclamping. A technique of rapid transatrial cannulation
      of the coronary sinus is described to permit safe, rapid, and simple use of
      retrograde cardioplegia and avoid right heart isolation. Theoretic objectives of
      these operative techniques are discussed, together with presentation of the
      specific methods of achieving the aforementioned goals of using blood
      cardioplegia for resuscitation, prevention, and avoidance of ischemic and
      reperfusion damage. The preliminary clinical experience with antegrade/retrograde
      cardioplegia is summarized, and these results have led to adoption of these
      techniques of blood cardioplegia as the preferred method of myocardial protection
      in all adult operations and in many pediatric cardiac procedures.

PMID- 2237342
TI  - [Cardiopulmonary resuscitation in Switzerland: time to act!].
AB  - Cardiovascular related deaths still represent about 50% of all demises despite
      their decreasing incidence in the United States and in Switzerland. About two
      thirds of these deaths are due to ischemic heart disease in which half of the
      patients die outside hospital, the majority of them two hours after the first
      symptoms. Moreover, sudden death is the first symptom of coronary artery disease
      in 25% of cases. In this country few of these persons receive adequate basic life
      support (BLS) at the scene because a coordinated plan to teach BLS to the citizen
      does not yet exist in Switzerland. With the aid of specialized medical societies,
      the Swiss Red Cross and affiliated organizations, it is proposed to elaborate a
      plan to teach BLS to the general public in Switzerland on the basis of the future
      European guidelines for BLS.

PMID- 2237343
TI  - [Catheter ablation in ventricular tachycardia].

PMID- 2237344
TI  - [Surgery of tachycardia].

PMID- 2237345
TI  - [The treatment of persistent ventricular arrhythmias using implantable automatic
      defibrillators].

PMID- 2237346
TI  - [Coronary angiography, percutaneous transluminal coronary angioplasty and
      coronary surgery, valvular interventions and anti-arrhythmia agents and
      fibrinolysis for acute myocardial infarction in Switzerland].
AB  - Besides the description of the activities of the Working Group PTCA and
      Fibrinolysis of the Swiss Society of Cardiology, number and distribution of
      coronary angiograms and angioplasties (PTCA) and aortocoronary bypass operations
      performed in 13 Swiss centers during 1989 are presented and commented. It is of
      note that the number of PTCA procedures has increased further during the last
      year, whereas the number of bypass operations stayed fairly constant over the
      last three years. PTCA is done today almost as frequently as coronary artery
      bypass surgery in Switzerland. There are, however, marked differences between
      individual centers: the number of PTCA procedures in relation to coronary
      angiograms varies between 5% and over 40%. A large part of these interventions is
      performed at private hospitals. More than 85% of the PTCA procedures were single
      vessel procedures. Catheter interventions on heart valves and on the conductive
      system were done almost exclusively at University Hospitals. The 1989 survey of
      the treatment of acute myocardial infarction with fibrinolysis covers only
      hospitals with catheterization laboratories and is therefore not entirely
      representative for the total activity in Switzerland. Almost 20% (0-80%) of all
      patients admitted for acute myocardial infarction received fibrinolysis with
      important differences between individual centers.

PMID- 2237347
TI  - [The current status of cardiac rehabilitation in Switzerland].
AB  - The aim of this study was to investigate the present situation of
      institutionalized cardiac rehabilitation in Switzerland. In 1989, there were 21
      rehabilitation clinics and 21 ambulatory cardiac rehabilitation programs in
      Switzerland. All programs include physical activity and risk factor intervention.
      There is a wide variety of program selection and intensity. The medical care, the
      physical activity program, the strategy for risk factor intervention, the
      technical equipment and the emergency concept can be regarded as good in most
      rehabilitation clinics and in the ambulatory rehabilitation programs. However, a
      search for quality criteria for further activities in cardiac rehabilitation in
      Switzerland seems desirable.

PMID- 2237348
TI  - [Science and practice].

PMID- 2237349
TI  - [Are additional filters made of niobium superior to the copper filter in dental
      radiology?].
AB  - At a dental X-ray unit the effect of an additional filter made of niobium has
      been tested in the molar region of the mandible with respect to dose reduction.
      It has been compared against the effect of an additional filter made of copper.
      With regard to the same dose at the film, radiation dose at the surface of the
      patient proved to be slightly more reduced after application of the copper filter
      than after application of the niobium filter. Radiographs have been made by
      exposure of intraoral dental films (Kodak film Ultra Speed D) together with a
      hydroxyapatite step-wedge. Measurements of optical density resulted in the same
      values after application of the copper filter and the niobium filter,
      respectively. Reduced image contrast due to application of one of these
      additional filters proved to be helpful. In short, an additional copper filter
      placed in the X-ray beam shows identical or better results when compared against
      an additional filter made of niobium.

PMID- 2237350
TI  - [An in-vitro test procedure for evaluating dental restoration systems. 2.
      Toothbrush/toothpaste abrasion and chemical degradation].
AB  - The development of an in-vitro test for evaluation of dental restorative systems
      comprised primarily the construction of a chewing simulator, which was able to
      produce occlusal mechanical load and thermal cycling. This machine was described
      in a previous publication. Additionally, chemical disintegration and
      toothbrush/toothpaste abrasion have to be included in the cycle. The aim of the
      present study was to develop appropriate test methods to simulate the two letter
      parameters and to integrate these methods in the in-vitro test cycle. The results
      indicated, that the toothbrush/toothpaste abrasion did not show any significant
      effect in the occlusal contact area. Chemical cycling induced a generalized
      swelling of the composite samples and a modified wear curve. The
      toothbrush/toothpaste abrasion led to a rough composite surface in the contact
      free area.

PMID- 2237352
TI  - [Traumatology in the deciduous dentition (I). The clinical and therapeutic
      aspects].

PMID- 2237351
TI  - [Complications in overfilling of the root canals].

PMID- 2237354
TI  - [The CPS, organ of the SSO, specializing in the area of health policy. Interview
      by Kurt Venner.. Societe Suisse d'Odonto-Stomatologie].

PMID- 2237353
TI  - [Periodontal prosthodontics (I)].

PMID- 2237355
TI  - [HIV infection and AIDS--the problems of labor law].

PMID- 2237356
TI  - [Swiss dental medicine and the European dimension].

PMID- 2237357
TI  - [Feminization in dental medicine].

PMID- 2237359
TI  - [Reconstructions with bone-integrated implants. Interview by Kurt Venner].

PMID- 2237358
TI  - [The ivory tower mentality belongs to the past. Interview by Kurt Venner].

PMID- 2237361
TI  - [Learning from mistakes].

PMID- 2237360
TI  - ["It smells like a dentist". The patient office survey by Dr. Jakob
      Rothlisberger, Langnau].

PMID- 2237362
TI  - [Hyperpigmentation of the oral mucosa in HIV infection].
AB  - In ten HIV-infected patients oral hyperpigmentations (HP) were observed, which
      seemed to be unrelated to any of the known endogenous or exogenous etiological
      factors. Light microscopy revealed accumulation of Fe-negative pigment in
      keratinocytes of the stratum basale as well as extra- and intracellularly within
      the subepithelial connective tissue. The ultrastructure of HP was characterised
      by the occurrence of melanosomes and premelanosomes within keratinocytes,
      melanocytes, macrophages and occasionally in fibroblasts, while especially in
      keratinocytes of the superficial cell layers immature melanosomes were found.
      Immunohistochemical examination pointed to an increase of HLA-DR positive cells
      and an altered distribution pattern of immunocompetent cells within the
      hyperpigmented mucosa. The finding of oral HP in HIV-infected patients may occur
      due to an increased activity of melanocytes, an increased production of
      melanosomes and their increased transfer to keratinocytes.

PMID- 2237363
TI  - [The shearing strength with the silicoater procedure of conditioned bonded
      retaining elements].
AB  - The shear-bond strength of 120 sandblasted and silicoated metal elements (Wiron
      88, Ni-Cr alloy) bonded with three different composites (ABC-cement, Superbond,
      Comspan opaque) to the plane of the prepared enamel surface of extracted teeth
      was measured. The effect of the interval between silicoating and bonding and that
      of 30 days' water storage was evaluated. The silicoating technique resulted in
      significantly higher bond strength than pure sandblasting, regardless of the
      composites used. After a one-day water storage the lowest bond strength was
      obtained with ABC-Cement and the highest with Superbond and Comspan opaque,
      independent of the interval between silicoating and bonding. After 30 days water
      storage elements bonded 30 min or 4 to 5 h after the silicoating procedure showed
      a loss of bond strength of an average of 25% regardless of the composites used.
      This decrease could not be measured with silicoated metal elements which were
      preserved by application of a bonding agent and bonded 24 h later.

PMID- 2237364
TI  - [The distribution of different collagen types and laminin in the gingiva of the
      common marmoset (Callithrix jacchus)].
AB  - The distribution of the collagen types I, III, IV, V, VI and of the glycoprotein
      laminin have been examined in the healthy gingiva of the marmoset with the
      indirect immunofluorescence method. It has been shown that collagen type I formed
      thick fibrils in a wave-like pattern, while collagen type III formed thinner
      fibrils, especially under the epithelial basal membrane. Collagen type IV and
      laminin showed a strong fluorescence in the basal membrane (epithelium, vessels,
      nerves). Collagen type V has been demonstrated as a fine fibrillar pattern in the
      lamina propria and occasionally close to the basal membrane. Collagen type VI has
      been represented as a microfibrillar network in the connective tissue matrix with
      a brilliant pericellular fluorescence around vessels and nerves. The study showed
      the structural model of the connective tissue matrix of the marmoset gingiva and
      allows a later comparison between inflamed and healthy gingiva.

PMID- 2237365
TI  - [Learning from mistakes. A contribution to the grinding of abutment teeth for
      partial removable dentures].

PMID- 2237366
TI  - [Reconstruction after a hemimaxillectomy. The functional restoration of the
      maxilla after a hemimaxillectomy].

PMID- 2237368
TI  - [Until now no AIDS transmission in medical personnel].

PMID- 2237367
TI  - [In search of a typical Swiss compromise. Interview by Kurt Venner].

PMID- 2237369
TI  - On again, off again. Custom drug-delivery systems emulate the body's own
      patterns.

PMID- 2237370
TI  - New order. Artificial evolution creates proteins nature missed.

PMID- 2237371
TI  - Seeing the light. A glimmer of hope for retinal transplants.

PMID- 2237372
TI  - Adjusted agenda. AIDS activists accelerate alternative approaches.

PMID- 2237373
TI  - Cannabis comprehended. The "assassin of youth" points to a new pharmacology.

PMID- 2237374
TI  - Profile: vive la difference. Doreen Kimura plumbs male and female brains.

PMID- 2237375
TI  - [Terminology of ultrasonic vascular diagnosis].
AB  - There is at present no accepted nomenclature regarding diagnostic vascular
      ultrasound. At two scientific meetings, the Study Group for Vascular Diagnosis of
      the German Society of Ultrasound in Medicine (DEGUM) developed a terminology for
      Doppler and duplex sonography of the arteries and veins supplying the brain and
      of peripheral vessels. The most important of these sonographic terms and their
      synonyms are presented. Recommendations as to which of the presently employed
      terms should be avoided, are given.

PMID- 2237376
TI  - [Spectrum analysis of Doppler signals].
AB  - Doppler signal spectrum analysis contains useful haemodynamic information.
      Several parameters of the spectrum can be documented in numerics. Random
      interaction of the reflectors, the size of the ultrasound sample volume and the
      procedure of signal analysis influence the results and hence may cause
      misinterpretation of the data selected. Essential mechanisms influencing the
      clinician's Doppler-spectrum-analysis are discussed on the basis of a series of
      59 angiographically and sonographically examined carotid arteries as well as in
      the light of theoretical considerations and a review of the literature. Peak
      frequency linked with a battery of spectrum parameters accuracy are useful to
      differentiate various degrees of lumen narrowing. Identification or exclusion of
      minor plaques cannot be achieved with sufficient sensitivity and specificity.

PMID- 2237377
TI  - [Color-coded Doppler sonography--possibilities for application in the neck area,
      the abdomen and the extremities].
AB  - Colour coded Duplex sonography has definite advantages over duplex sonography for
      the investigation of neck and limb vessels. Diagnosis of arterial stenoses,
      occlusions and aneurysms can be readily made. The method also allows to follow
      the evolution after vascular surgery and percutaneous transluminal angioplasty.
      Deep venous thromboses can be reliably detected without the use of contrast
      media. Application for abdominal vascular diagnosis is still limited.

PMID- 2237378
TI  - [The value of obstetrical continuous-wave Doppler sonography: effect of various
      study modifications on the diagnosis of fetal growth retardation].
AB  - In a comparative study on 484 pregnant women the influence of different
      modifications of the examination by continuous wave (cw)--Doppler was tested. The
      aim was to improve the detection rate of foetal growth retardation (IUGR): 1.
      Among different definitions of normal ranges the mathematical "smoothing" of
      normal values by regression analysis improves the results. 2. Of the most
      commonly used flow indices the A/B ratio is more reliable than the resistance and
      the pulsatility index. 3. Comparing the results of one to three examinations of
      the same patient in the course of pregnancy the relation of sensitivity to
      specificity is best after two examinations. 4. On evaluating the examinations of
      the umbilical arteries and the arcuate arteries, an intolerably false positive
      rate was found in the evaluation of arcuate arteries by cw Doppler.

PMID- 2237379
TI  - [Are Doppler methods appropriate for the study of adaptive maternal central
      circulation regulation in pregnancy?].
AB  - Echocardiographic Doppler measurements of blood flow velocity are a noninvasive
      way of studying maternal central haemodynamics. Part 1 reports on conditions as
      well as on practical and theoretical problems recognized as contributing
      significantly to the use and interpretation of Doppler ultrasound techniques in
      the assessment of adaptive central circulatory regulation in pregnancy. The
      significance of different techniques is shown by assessments of the peak velocity
      and the velocity time integral.

PMID- 2237381
TI  - [Sonographic localization of ureteral calculi on extracorporeal shock wave
      lithotripsy].
AB  - Using the new Dornier lithotriptor MPL 9000* (multi-purpose lithotriptor) 381
      treatments of urinary stones were performed from July 1988 to December 1989, 107
      (28%) of them for ureteral calculi. Sonography enables stone localisation even in
      many cases where positioning by conventional x-ray fluoroscopy would not be
      possible. In 20 cases of upper ureteral stones, localization had to be performed
      partly by indirect measures, i.e. at the end of the dilated ureter. In 10
      ureteral stones of the middle third sonographic positioning and complete
      disintegration was achieved. Treatment was without anaesthesia and was performed
      in a comfortable supine position. Therapy of 77 ureteral calculi in the caudal
      part--without anaesthesia--has proved extremely successful. Since it is less
      invasive than other measures (e.g. uretero-renoscopy or loop extraction), it is
      now the method of choice for the treatment of stones in the middle and lower
      third of the ureter.

PMID- 2237380
TI  - [Sonographic diagnosis of Hill-Sachs lesions in unstable shoulder joints].
AB  - In a prospective study we evaluated the use of diagnostic ultrasound for Hill
      Sachs lesions in unstable shoulder joints of 71 patients. The arthroscopic
      control of the sonographic findings showed a high sensitivity of 100%, a
      specificity of 89%, an accuracy of 95%, a positive predictive value of 93%, and a
      negative predictive value of 100%. With these results ultrasound seems to be more
      reliable than x-ray in the diagnosis of Hill-Sachs lesions.

PMID- 2237382
TI  - [Ultrasonic diagnosis prior to vitrectomy. Critical evaluation of 51 cases].
AB  - In ophthalmology it is of increasing importance to assess intraocular pathology
      prior to vitroretinal surgery by means of B- and A-mode ultrasound. Even for the
      experienced examiner with advanced instrumentation, major problems can arise as
      to whether retinal detachment has developed or not. This task involves the
      ability for acoustical differentiation of thin tissue membranes. The authors
      compared preoperative ultrasonic results obtained in 51 cases with the surgical
      findings during vitrectomy. The presence or absence of retinal detachment was
      evaluated correctly in 33 cases (91.7%) using high resolution contact B-mode
      alone. In difficult cases maximal echo amplitudes reflected from the suspected
      membranes were evaluated using a hand-held A-mode transducer (level difference A
      mode echography) in addition to contact B-mode. Even the combined technique,
      though helpful in most cases, could not detect the presence or absence of retinal
      detachment in all cases.

PMID- 2237383
TI  - Maine school nurse works with Sister Teresa.

PMID- 2237384
TI  - Mortality and increasing drug use in Edinburgh: implications for HIV epidemic.
AB  - Mortality among a group of known drug users shows small numbers of deaths from
      AIDS so far but increasing deaths from overdose, especially in young women.
      Steadily rising numbers of drug injectors are observed. The need for a distinctly
      different educational approach in areas of very high seroprevalence is discussed
      and the requirement for close co-operation between prescribing sources
      identified.

PMID- 2237385
TI  - Cardiac arrhythmias associated with upper gastrointestinal endoscopy in elderly
      subjects.
AB  - Continuous Holter monitoring was performed before, during and after upper
      gastrointestinal endoscopy in 50 unselected, consecutive elderly patients (median
      age 80 years: range 68-89). In contrast to other studies the patients received no
      atropine or opiate premedication and were monitored for a prolonged period
      usually 24 hours after endoscopy. Comparison of a control period when the patient
      was lying at rest before endoscopy with the period of endoscopy itself revealed
      an increased frequency of arrhythmias during endoscopy. Forty-eight per cent of
      patients developed a new arrhythmia or an increased frequency of existing
      arrhythmia during endoscopy. All arrhythmias were short and self-terminating.
      Evidence of cardiac disease conferred a significantly increased risk of
      developing an arrhythmia during endoscopy.

PMID- 2237386
TI  - Contact lens related problems presenting in casualty.
AB  - The use of contact lenses in preference to spectacles has gained much popularity
      over recent years. This, however, is not without its complications and eye
      departments are now seeing an increasing number of contact lens related eye
      disease. This study seeks to show the range of complications seen, their
      treatment and outcome. It also outlines the types of contact lens in popular use,
      the reason for wear, the duration of wear and the sex, age and professional
      distribution of contact lens wearers.

PMID- 2237387
TI  - Paracetamol overdose in children.
AB  - The severity of paracetamol poisoning varies but in general, children are
      considered less susceptible to its toxic effects compared to adults. In this
      report we describe the relatively benign ingestion of paracetamol in children and
      also highlight a case of intrauterine exposure to a potentially toxic dose of
      paracetamol.

PMID- 2237388
TI  - A Scottish Hebridean antithrombin III deficient family--twelve years on.
AB  - The members of this family with ATIII deficiency have been followed for at least
      12 years (1976-1989). All those with previous venous thrombo-embolism have been
      free from recurrence when on warfarin. During the half century 1931-1981, all 11
      full term pregnancies in four affected patients were associated with venous
      thromboembolism; one patient was enigmatic having one full term pregnancy,
      without thrombotic event; between 1982 and 1989 three pregnancies have been
      actively managed with no clinical thrombosis. Management involved use of
      monitored, self administered, subcutaneous heparin before or very soon after
      conception and throughout pregnancy (warfarin having been stopped), planned
      delivery under cover of intravenous antithrombin III, reduction of heparin dosage
      at delivery and reintroduction of warfarin in the puerperium. The recognised
      hazards of heparin therapy in pregnancy did not occur. The involvement of the
      arterial system is reviewed. Clinical evidence provides tentative suggestions on
      (a) possible additional risk of cigarette smoking (b) avoidance of venography (c)
      avoidance of varicose vein surgery. A probe is now available for the defective
      antithrombin III gene in this family, but there has been no occasion yet to apply
      this in antenatal diagnosis.

PMID- 2237389
TI  - Clinical and biochemical pregnancy in two respective recipients without ovarian
      function following gamete intrafallopian transfers using oocytes from a single
      donor.
AB  - Infertility resulting from premature ovarian failure in two independent patients
      was treated using a combination of steroid replacement, oocyte donation and
      gamete intrafallopian transfer (GIFT). Following ovarian stimulation four oocytes
      were retrieved from a volunteer donor undergoing simultaneous laparoscopic
      sterilisation. Two oocytes were subsequently replaced into each recipient's
      fallopian tube together with capacitated sperm from their respective husbands. In
      one recipient (Turner's syndrome) an intrauterine sac with fetal heart present
      was observed by ultrasound six weeks post GIFT whereas in the second recipient
      (premature menopause) plasma beta-hCG reached a peak value of 954mIU/ml eighteen
      days after GIFT before decreasing rapidly in the absence of ultrasound evidence
      of pregnancy. Intramuscular administration of progesterone appeared to be
      necessary during the post-GIFT period for maintenance of pregnancy. The above
      treatment was carried out on a predominantly out-patient basis in a small
      assisted conception unit based in a teaching hospital.

PMID- 2237390
TI  - Primary retroperitoneal choriocarcinoma with pulmonary metastases in an elderly
      man.
AB  - We describe a 56-year old male smoker who presented with bilateral gynaecomastia
      and a large shadow in the upper zone of the right lung. Lobectomy revealed a
      haemorrhagic tumour at the apex of the right upper lobe. Histology revealed pure
      choriocarcinoma. Further investigations revealed normal testes and a
      retroperitoneal mass. Apart from histology, the other poor prognostic factors in
      this patient were the extragonadal site, gynaecomastia and age. Complete
      remission was achieved with an aggressive 5-day chemotherapy regime. Primary
      retroperitoneal choriocarcinoma is extremely rare and is predominantly seen in
      the age group between 20-30 years.

PMID- 2237391
TI  - Wilson's disease presenting as acute fulminant hepatic failure.
AB  - A fatal case of fulminant hepatic failure in an adolescent is described. Post
      mortem examination revealed the cause to be Wilson's Disease. This rare
      presentation is characterised by apparently atypical changes in copper
      metabolism. Wilson's Disease should be a differential diagnosis of any adolescent
      presenting in liver failure.

PMID- 2237392
TI  - A short history of medical degrees in the University of Aberdeen.
AB  - Aberdeen University was the first university in Great Britain to recognise the
      teaching of medicine by the creation of a teaching post, that of "mediciner." It
      was first occupied by James Cumyne, the burgh medical officer. The first medical
      degree granted by the university was doctus in medicina--learned in medicine. The
      degree was first awarded in 1630. The first examination paper for the M.D. was
      set in 1787 at the time of proposal to unit King's and Marischal Colleges and
      following criticism of the sale of degrees in medicine and midwifery "for ready
      money." The present degrees of M.B., ChB. were introduced in 1895.

PMID- 2237393
TI  - Rheumatology--the way ahead.

PMID- 2237394
TI  - Statewide breast cancer study. South Dakota Tumor Registrars' Association.
AB  - The South Dakota Tumor Registrars' Association reviewed breast cancer cases in
      South Dakota for the years 1983 and 1988. There were 225 cases in the 1983 group
      and 266 cases in the 1988 group. Data from this project revealed over 16% of
      patients in both groups had positive family histories for breast cancer. More
      cases in 1988 (119) were Stage I as compared to 1983 (69) suggesting earlier
      detection through increased awareness of the dangers of this disease by improved
      educational programs from 1983 to 1988, and the increased use of mammography in
      1988 (86.8% of patients) as compared to 1983 (48% of patients). Modified radical
      mastectomy was the initial therapy in the majority of cases in both groups.
      Segmental resection followed by radiation therapy was the initial local therapy
      for 13 patients in 1988 as compared to six patients in 1983. Hormone receptor
      analysis was obtained in over 70% of patients in both groups. Adjuvant drug
      therapy was given to 25% of patients in both groups. Only two patients in 1983
      and one patient in 1988 were entered on national research protocols.

PMID- 2237395
TI  - Accumulation of heavy metals in a lake ecosystem.
AB  - The concentrations of Cu, Zn, Fe, Mn, Ni, Cd, Pb and Co have been determined in
      water, bottom sediments, plankton, zoobenthos and ichthyofauna of mesotropic Lake
      Piaseczno located in eastern Poland. In water, sediments, plankton and benthos
      the most abundant heavy metals were Fe, Zn and Mn, whereas in fish Zn, Cu, and Mn
      were most abundant. The amount of heavy metals in the biotic components was
      dependent upon their concentration in water and partly upon the concentration in
      bottom sediments. A considerably less important role in the translocation of
      heavy metals is probably played by trophic interactions.

PMID- 2237396
TI  - Lead and cadmium contamination of soil and vegetables in the Upper Silesia region
      of Poland.
AB  - Studies of the lead and cadmium content of soils and vegetables from 126
      allotments in 12 towns in a polluted region of Poland are described. Metal
      concentrations in parsley, celery, carrots and red beet were determined using
      AAS. In most cases, metal concentrations in soils and vegetables exceeded
      accepted standards and concentrations found in rural regions. A total of 756
      vegetable samples were studied and only 170 met the standard for lead and 17 for
      cadmium. The lowest lead content was found in parsley roots and the highest in
      celery leaves. Cadmium content between species did not differ greatly and the
      highest concentrations were recorded for celery. The metal intake by the consumer
      was also calculated using questionnaire data concerning vegetable consumption. In
      relation to the reference area, the metal intake in the polluted area was 2-5
      times higher for lead and 2-16 times higher for cadmium. The main species
      responsible for the high metal concentrations were carrots and red beet.
      Replacing carrots and red beet with the same species grown in an unpolluted
      region would reduce the consumer's metal intake from vegetables considerably.

PMID- 2237397
TI  - Absence of cadmium in the blood of horses fed oats grown on municipal sludge
      amended soil.
AB  - Effluents from a number of industries which are typically treated in municipal
      sewage plants result in cadmium-containing sludge. Disposal of such sewage sludge
      by application to agricultural land can result in uptake of cadmium by crops. In
      this study, oats were grown on soils which had been amended with sewage sludge
      from Syracuse, New York. The cadmium concentration in the sludge-grown oats was
      1.79 ppm dry weight. Horses were fed the sludge-grown oats for 6 weeks during
      which time blood samples were taken for the determination of cadmium. No
      significant differences (p greater than 0.05) were found in the concentration of
      cadmium in the blood of the horses consuming the oats compared with that in the
      blood before feeding began (control). The well-known efficient accumulation of
      renal cadmium by horses may account for a lack of significantly increased cadmium
      in blood during the feeding period.

PMID- 2237398
TI  - Risk-based oversight of experiments in the environment.

PMID- 2237399
TI  - Filovirus infection in newly imported monkeys.

PMID- 2237400
TI  - Cold Spring Harbor turns 100.

PMID- 2237401
TI  - Gallo reports mystery break-in.

PMID- 2237402
TI  - Not enough monkey business.

PMID- 2237403
TI  - DNA looping and unlooping by AraC protein.
AB  - Expression of the L-arabinose BAD operon in Escherichia coli is regulated by AraC
      protein which acts both positively in the presence of arabinose to induce
      transcription and negatively in the absence of arabinose to repress
      transcription. The repression of the araBAD promoter is mediated by DNA looping
      between AraC protein bound at two sites near the promoter separated by 210 base
      pairs, araI and araO2. In vivo and in vitro experiments presented here show that
      an AraC dimer, with binding to half of araI and to araO2, maintains the repressed
      state of the operon. The addition of arabinose, which induces the operon, breaks
      the loop, and shifts the interactions from the distal araO2 site to the
      previously unoccupied half of the araI site. The conversion between the two
      states does not require additional binding of AraC protein and appears to be
      driven largely by properties of the protein rather than being specified by the
      slightly different DNA sequences of the binding sites. Slight reorientation of
      the subunits of AraC could specify looping or unlooping by the protein. Such a
      mechanism could account for regulation of DNA looping in other systems.

PMID- 2237404
TI  - Tetraplex formation of a guanine-containing nonameric DNA fragment.
AB  - A combination of spectroscopic and calorimetric techniques has been used to
      characterize the structures formed by a family of short, guanine-containing DNA
      single strands of the form d[GGTTXTTGG], X = A, C, G, T. In 1 molar NaCl at low
      temperatures, these molecules do not behave like single strands, but rather
      exhibit properties consistent with tetraplex formation. The standard state
      enthalpies, entropies, and free energies for formation of each tetraplex have
      been measured, as have preliminary nuclear magnetic resonance (NMR) spectra. In 1
      molar KCl, the melting behavior of the structure or structures is more complex
      than in 1 molar NaCl. This observation may be related to the recently proposed
      "sodium-potassium switch."

PMID- 2237405
TI  - Underexpression of beta cell high Km glucose transporters in noninsulin-dependent
      diabetes.
AB  - The role of defective glucose transport in the pathogenesis of noninsulin
      dependent diabetes (NIDDM) was examined in Zucker diabetic fatty rats, a model of
      NIDDM. As in human NIDDM, insulin secretion was unresponsive to 20 mM glucose.
      Uptake of 3-O-methylglucose by islet cells was less than 19% of controls. The
      beta cell glucose transporter (GLUT-2) immunoreactivity and amount of GLUT-2
      messenger RNA were profoundly reduced. Whenever fewer than 60% of beta cells were
      GLUT-2-positive, the response to glucose was absent and hyperglycemia exceeded 11
      mM plasma glucose. We conclude that in NIDDM underexpression of GLUT-2 messenger
      RNA lowers high Km glucose transport in beta cells, and thereby impairs glucose
      stimulated insulin secretion and prevents correction of hyperglycemia.

PMID- 2237406
TI  - Involvement of the silencer and UAS binding protein RAP1 in regulation of
      telomere length.
AB  - The yeast protein RAP1, initially described as a transcriptional regulator, binds
      in vitro to sequences found in a number of seemingly unrelated genomic loci.
      These include the silencers at the transcriptionally repressed mating-type genes,
      the promoters of many genes important for cell growth, and the poly[(cytosine)1-3
      adenine] [poly(C1-3A)] repeats of telomeres. Because RAP1 binds in vitro to the
      poly(C1-3A) repeats of telomeres, it has been suggested that RAP1 may be involved
      in telomere function in vivo. In order to test this hypothesis, the telomere
      tract lengths of yeast strains that contained conditionally lethal (ts) rap1
      mutations were analyzed. Several rap1ts alleles reduced telomere length in a
      temperature-dependent manner. In addition, plasmids that contain small, synthetic
      telomeres with intact or mutant RAP1 binding sites were tested for their ability
      to function as substrates for poly(C1-3A) addition in vivo. Mutations in the RAP1
      binding sites reduced the efficiency of the addition reaction.

PMID- 2237407
TI  - Protection of mice against the Lyme disease agent by immunizing with recombinant
      OspA.
AB  - Lyme borreliosis is a tick-borne illness caused by Borrelia burgdorferi. The gene
      for outer surface protein A (OspA) from B. burgdorferi strain N40 was cloned into
      an expression vector and expressed in Escherichia coli. C3H/HeJ mice actively
      immunized with live transformed E. coli or purified recombinant OspA protein
      produced antibodies to OspA and were protected from challenge with several
      strains of B. burgdorferi. Recombinant OspA is a candidate for a vaccine for Lyme
      borreliosis.

PMID- 2237409
TI  - Key primate research institute flounders.

PMID- 2237410
TI  - Final verdict on science budget: not bad at all.

PMID- 2237408
TI  - Detection of bcr-abl fusion in chronic myelogeneous leukemia by in situ
      hybridization.
AB  - Chronic myelogeneous leukemia (CML) is genetically characterized by fusion of the
      bcr and abl genes on chromosomes 22 and 9, respectively. In most cases, the
      fusion involves a reciprocal translocation t(9;22)(q34;q11), which produces the
      cytogenetically distinctive Philadelphia chromosome (Ph1). Fusion can be detected
      by Southern (DNA) analysis or by in vitro amplification of the messenger RNA from
      the fusion gene with polymerase chain reaction (PCR). These techniques are
      sensitive but cannot be applied to single cells. Two-color fluorescence in situ
      hybridization (FISH) was used with probes from portions of the bcr and abl genes
      to detect the bcr-abl fusion in individual blood and bone marrow cells from six
      patients. The fusion event was detected in all samples analyzed, of which three
      were cytogenetically Ph1-negative. One of the Ph1-negative samples was also PCR
      negative. This approach is fast and sensitive, and provides potential for
      determining the frequency of the abnormality in different cell lineages.

PMID- 2237411
TI  - Does medical mystery threaten biotech?

PMID- 2237412
TI  - A new bestiary for aging research.

PMID- 2237413
TI  - Gerontology research comes of age.

PMID- 2237414
TI  - In search of Methuselah: estimating the upper limits to human longevity.
AB  - Estimates of the upper limits to human longevity have important policy
      implications that directly affect forecasts of life expectancy, active life
      expectancy, population aging, and social and medical programs tied to the size
      and health status of the elderly population. In the past, investigators have
      based speculations about the upper limits of human longevity on observations of
      past trends in mortality. Here the estimate of the upper bound is based on
      hypothesized reductions in current mortality rates necessary to achieve a life
      expectancy at birth from 80 to 120 years and an expectation of life at age 50
      from 30 to 70 years. With the use of conditional probabilities of death from
      complete life tables for the United States, reductions in mortality required to
      achieve extreme longevity (that is, 80 to 120 years) were compared with those
      resulting from hypothetical cures for all cardiovascular diseases, ischemic heart
      disease, diabetes, and cancer. Results indicate that in order for life expectancy
      at birth to increase from present levels to what has been referred to as the
      average biological limit to life (age 85), mortality rates from all causes of
      death would need to decline at all ages by 55%, and at ages 50 and over by 60%.
      Given that hypothetical cures for major degenerative diseases would reduce
      overall mortality by 75%, it seems highly unlikely that life expectancy at birth
      will exceed the age of 85.

PMID- 2237415
TI  - A thermodynamic scale for the helix-forming tendencies of the commonly occurring
      amino acids.
AB  - Amino acids have distinct conformational preferences that influence the
      stabilities of protein secondary and tertiary structures. The relative
      thermodynamic stabilities of each of the 20 commonly occurring amino acids in the
      alpha-helical versus random coil states have been determined through the design
      of a peptide that forms a noncovalent alpha-helical dimer, which is in
      equilibrium with a randomly coiled monomeric state. The alpha helices in the
      dimer contain a single solvent-exposed site that is surrounded by small, neutral
      amino acid side chains. Each of the commonly occurring amino acids was
      substituted into this guest site, and the resulting equilibrium constants for the
      monomer-dimer equilibrium were determined to provide a list of free energy
      difference (delta delta G degree) values.

PMID- 2237416
TI  - Side chain contributions to the stability of alpha-helical structure in peptides.
AB  - Short peptides that contain significant alpha-helical structure in aqueous
      solution allow the investigation of the role of amino acid side chains in
      stabilizing or destabilizing alpha-helix structure. A host-guest system of
      soluble synthetic peptides was designed that consisted of chains with the block
      sequence TyrSerGlu4Lys4X3Glu4Lys4, denoted EXK, in which X represents any "guest"
      amino acid residue. Circular dichroism spectroscopy indicates that the extent of
      helicity of these peptides follows the order Ala greater than Leu greater than
      Met greater than Gln greater than Ile greater than Val greater than Ser greater
      than Thr greater than Asn greater than Gly. This order differs from both host
      guest copolymer values (Met greater than Ile greater than Leu greater than Ala
      greater than Gln greater than Val greater than Thr greater than Asn greater than
      Ser greater than Gly) and the tendencies of these amino acids to occur in helices
      in globular proteins (Ala greater than Met greater than Leu greater than Gln
      greater than Ile greater than Val greater than Asn, Thr greater than Ser greater
      than Gly), but matches the order found in a series of synthetic coiled-coil alpha
      helices, except for Ser. Proton nuclear magnetic resonance analysis of several
      EXK peptides indicates that these peptides are partially helical, with the
      helical residues favoring the amino terminus.

PMID- 2237418
TI  - Inefficient remediation of ground-water pollution.

PMID- 2237417
TI  - Down-regulation of LFA-1 adhesion receptors by C-myc oncogene in human B
      lymphoblastoid cells.
AB  - The function of the c-myc gene and its role in tumorigenesis are poorly
      understood. In order to elucidate the role of c-myc oncogene activation in B cell
      malignancy, the phenotypic changes caused by the expression of c-myc oncogenes in
      human B lymphoblastoid cells immortalized by Epstein-Barr virus were analyzed. C
      myc oncogenes caused the down-regulation of lymphocyte function-associated
      antigen-1 (LFA-1) adhesion molecules (alpha L/beta 2 integrin) and loss of
      homotypic B cell adhesion in vitro. Down-regulation of LFA-1 occurred by (i)
      posttranscriptional modulation of LFA-1 alpha L-chain RNA soon after acute c-myc
      induction, and (ii) transcriptional modulation in cells that chronically express
      c-myc oncogenes. Analogous reductions in LFA-1 expression were detectable in
      Burkitt lymphoma cells carrying activated c-myc oncogenes. Since LFA-1 is
      involved in B cell adhesion to cytotoxic T cells, natural killer cells, and
      vascular endothelium, these results imply functions for c-myc in normal B cell
      development and lymphomagenesis.

PMID- 2237419
TI  - Drug abuse prevention programs.

PMID- 2237420
TI  - Animal carcinogen testing challenged.

PMID- 2237421
TI  - Stanford, claiming censorship, sues NIH.

PMID- 2237422
TI  - FDA gets Kessler; NIH gets left out.

PMID- 2237423
TI  - Immigration bill saves AIDS meeting.

PMID- 2237424
TI  - Animal rights activism threatens dissection.

PMID- 2237425
TI  - A meeting of the minds on the genome project?

PMID- 2237426
TI  - Miami vice metabolite.

PMID- 2237427
TI  - New HIV infection mechanism?

PMID- 2237428
TI  - The energetic basis of specificity in the Eco RI endonuclease--DNA interaction.
AB  - High sequence selectivity in DNA-protein interactions was analyzed by measuring
      discrimination by Eco RI endonuclease between the recognition site GAATTC and
      systematically altered DNA sites. Base analogue substitutions that preserve the
      sequence-dependent conformational motif of the GAATTC site permit deletion of
      single sites of protein-base contact at a cost of +1 to +2 kcal/mol. However, the
      introduction of any one incorrect natural base pair costs +6 to +13 kcal/mol in
      transition state interaction energy, the resultant of the following
      interdependent factors: deletion of one or two hydrogen bonds between the protein
      and a purine base; unfavourable steric apposition between a group on the protein
      and an incorrectly placed functional group on a base; disruption of a pyrimidine
      contact with the protein; loss of some crucial interactions between protein and
      DNA phosphates; and an increased energetic cost of attaining the required DNA
      conformation in the transition state complex. Eco RI endonuclease thus achieves
      stringent discrimination by both "direct readout" (protein-base contracts) and
      "indirect readout" (protein-phosphate contacts and DNA conformation) of the DNA
      sequence.

PMID- 2237429
TI  - Methylation of an immediate-early inducible gene as a mechanism for B cell
      tolerance induction.
AB  - Stage-specific gene regulation is important in determining cell function during
      development. Immature B cells expressing membrane-bound immunoglobulin M (mIgM)
      are sensitive to antigen-induced tolerance, whereas mature B cells are activated
      by antigen. Previous studies have established an association between Egr-1 gene
      induction and antigen receptor (mIgM)-mediated activation of mature B cells. Here
      it is shown that the immature B cell line WEHI-231 and tolerance-sensitive bone
      marrow-derived B cells do not express Egr-1. It is further shown that lack of
      inducible expression in these cells is due to specific methylation of the Egr-1
      gene. Thus, covalent inactivation of an activation-associated gene may explain
      tolerance sensitivity at specific stages of B cell development.

PMID- 2237430
TI  - cdc2 gene expression at the G1 to S transition in human T lymphocytes.
AB  - The product of the cdc2 gene, designated p34cdc2, is a serine-threonine protein
      kinase that controls entry of eukaryotic cells into mitosis. Freshly isolated
      human T lymphocytes (G0 phase) were found to have very low amounts of p34cdc2 and
      cdc2 messenger RNA. Expression of cdc2 increased 18 to 24 hours after exposure of
      T cells to phytohemagglutinin, coincident with the G1 to S transition. Antisense
      oligodeoxynucleotides could reduce the increase in cdc2 expression and inhibited
      DNA synthesis, but had no effect on several early and mid-G1 events, including
      blastogenesis and expression of interleukin-2 receptors, transferrin receptors, c
      myb, and c-myc. Induction of cdc2 required prior induction of c-myb and c-myc.
      These results suggest that cdc2 induction is part of an orderly sequence of
      events that occurs at the G1 to S transition in T cells.

PMID- 2237431
TI  - Sequence-specific binding of human Ets-1 to the T cell receptor alpha gene
      enhancer.
AB  - Expression of the human T cell receptor (TCR) alpha gene is regulated by a T cell
      specific transcriptional enhancer that is located 4.5 kilobases (kb) 3' to the C
      alpha gene segment. The core enhancer contains two nuclear protein binding sites,
      T alpha 1 and T alpha 2, which are essential for full enhancer activity. T alpha
      1 contains a consensus cyclic adenosine monophosphate (cAMP) response element
      (CRE) and binds a set of ubiquitously expressed CRE binding proteins. In
      contrast, the transcription factors that interact with the T alpha 2 site have
      not been defined. In this report, a lambda gt11 expression protocol was used to
      isolate a complementary DNA (cDNA) that programs the expression of a T alpha 2
      binding protein. DNA sequence analysis demonstrated that this clone encodes the
      human ets-1 proto-oncogene. Lysogen extracts produced with this cDNA clone
      contained a beta-galactosidase-Ets-1 fusion protein that bound specifically to a
      synthetic T alpha 2 oligonucleotide. The Ets-1 binding site was localized to a 17
      base pair (bp) region from the 3' end of T alpha 2. Mutation of five nucleotides
      within this sequence abolished both Ets-1 binding and the activity of the TCR
      alpha enhancer in T cells. These results demonstrate that Ets-1 binds in a
      sequence-specific fashion to the human TCR alpha enhancer and suggest that this
      developmentally regulated proto-oncogene functions in regulating TCR alpha gene
      expression.

PMID- 2237432
TI  - A map of visual space induced in primary auditory cortex.
AB  - Maps of sensory surfaces are a fundamental feature of sensory cortical areas of
      the brain. The relative roles of afferents and targets in forming neocortical
      maps in higher mammals can be examined in ferrets in which retinal inputs are
      directed into the auditory pathway. In these animals, the primary auditory cortex
      contains a systematic representation of the retina (and of visual space) rather
      than a representation of the cochlea (and of sound frequency). A representation
      of a two-dimensional sensory epithelium, the retina, in cortex that normally
      represents a one-dimensional epithelium, the cochlea, suggests that the same
      cortical area can support different types of maps. Topography in the visual map
      arises both from thalamocortical projections that are characteristic of the
      auditory pathway and from patterns of retinal activity that provide the input to
      the map.

PMID- 2237433
TI  - Analysis of junctional diversity during B lymphocyte development.
AB  - Immunoglobulin rearrangement is central to generating antibody diversity because
      of heterogeneity generated during recombination by deletion or addition of
      nucleotides at coding joints by the recombinase machinery. Examination of these
      junctional modifications revealed that the addition of nongermline-encoded
      nucleotides was more prevalent in adult versus fetal B cells, thus partially
      limiting the fetal antibody repertoire. In contrast, deletion of nucleotides
      occurs equivalently in B cells at different stages of development and at
      different points in B cell ontogeny. Finally, the bias in murine immunoglobulins
      for one DH segment reading frame occurs at the DHJH intermediate.

PMID- 2237434
TI  - Inhibition of the complement cascade by the major secretory protein of vaccinia
      virus.
AB  - The complement system contributes to host defenses against invasion by infectious
      agents. A 35-kilodalton protein, encoded by vaccinia virus and secreted from
      infected cells, has sequence similarities to members of a gene family that
      includes complement control proteins. Biochemical and genetic studies showed that
      the viral protein binds to derivatives of the fourth component of complement and
      inhibits the classical complement cascade, suggesting that it serves as a defense
      molecule to help the virus evade the consequences of complement activation.

PMID- 2237435
TI  - Does diphtheria toxin have nuclease activity?

PMID- 2237436
TI  - Experts clash over cancer data.

PMID- 2237437
TI  - Orphan drug compromise Bush-whacked.

PMID- 2237438
TI  - Technical advances power neuroscience.

PMID- 2237439
TI  - DOE to map expressed genes.

PMID- 2237440
TI  - Self-incompatibility: a self-recognition system in plants.
AB  - Self-incompatibility (SI), a genetically controlled mechanism to prevent
      inbreeding in plants, offers a relatively simple model system for studying the
      interactions between plant cells or between a plant cell and the secreted product
      or products of another cell. Examples of two major types of SI, gametophytic and
      sporophytic, have been studied by cloning cDNAs corresponding to glycoproteins of
      the female tissues that segregate with particular variants encoded by the
      putative S locus. These secreted glycoproteins are envisaged to interact with the
      currently undescribed pollen component to cause arrest of pollen tube growth.

PMID- 2237441
TI  - Localized all-or-none calcium liberation by inositol trisphosphate.
AB  - Laser confocal microscopy was used to monitor calcium ion (Ca2+) liberation from
      highly localized (micrometer) regions of intact Xenopus oocytes in response to
      photo-released inositol 1,4,5-trisphosphate (InsP3). Local Ca2+ release varied in
      an all-or-none manner with increasing amount of InsP3, in contrast to signals
      recorded from larger areas, which grew progressively as the concentration of
      InsP3 was raised above a threshold. Liberation of Ca2+ was restricted to within a
      few microns of the site of InsP3 release and, in response to agonist activation,
      localized regions of the oocyte showed asynchronous oscillations in cytoplasmic
      Ca2+ release. Results obtained with this technique provided direct evidence that
      InsP3-induced Ca2+ liberation was quantized and suggest that the InsP3-sensitive
      Ca2+ pool may be a collection of independent, localized compartments that release
      Ca2+ in an all-or-none manner.

PMID- 2237442
TI  - A cytoplasmic protein inhibits the GTPase activity of H-Ras in a phospholipid
      dependent manner.
AB  - A cytoplasmic protein has been identified that inhibits the guanosine
      triphosphatase (GTPase) activity of bacterially synthesized, cellular H-Ras
      protein. This GTPase inhibiting protein is able to counteract the activity of
      GTPase activating protein (GAP), which has been postulated to function as a
      negative regulator of Ras activity. The potential biological importance of the
      GTPase inhibiting protein is further supported by its interaction with lipids.
      Phospholipids produced in cells as a consequence of mitogenic stimulation
      increase the activity of the GTPase inhibiting protein, as well as inhibit the
      activity of GAP. The interaction of such lipids with each of these two regulatory
      proteins would, therefore, tend to increase the biological activity of Ras and
      stimulate cell proliferation.

PMID- 2237443
TI  - Mesodermal control of neural cell identity: floor plate induction by the
      notochord.
AB  - The floor plate is a specialized group of midline neuroepithelial cells that
      appears to regulate cell differentiation and axonal growth in the developing
      vertebrate nervous system. A floor plate-specific chemoattractant was used as a
      marker to examine the role of the notochord in avian floor plate development.
      Expression of this chemoattractant in lateral cells of the neural plate and
      neural tube was induced by an ectopic notochord, and midline neural tube cells
      did not express the chemoattractant after removal of the notochord early in
      development. These results provide evidence that a local signal from the
      notochord induces the functional properties of the floor plate.

PMID- 2237444
TI  - Regulation of gene expression with double-stranded phosphorothioate
      oligonucleotides.
AB  - Alteration of gene transcription by inhibition of specific transcriptional
      regulatory proteins is necessary for determining how these factors participate in
      cellular differentiation. The functions of these proteins can be antagonized by
      several methods, each with specific limitations. Inhibition of sequence-specific
      DNA-binding proteins was achieved with double-stranded (ds) phosphorothioate
      oligonucleotides that contained octamer or kappa B consensus sequences. The
      phosphorothioate oligonucleotides specifically bound either octamer transcription
      factor or nuclear factor (NF)-kappa B. The modified oligonucleotides accumulated
      in cells more effectively than standard ds oligonucleotides and modulated gene
      expression in a specific manner. Octamer-dependent activation of a reporter
      plasmid or NF-kappa B-dependent activation of the human immunodeficiency virus
      (HIV) enhancer was inhibited when the appropriate phosphorothioate
      oligonucleotide was added to a transiently transfected B cell line. Addition of
      phosphorothioate oligonucleotides that contained the octamer consensus to Jurkat
      T leukemia cells inhibited interleukin-2 (IL-2) secretion to a degree similar to
      that observed with a mutated octamer site in the IL-2 enhancer. The ds
      phosphorothioate oligonucleotides probably compete for binding of specific
      transcription factors and may provide anti-viral, immunosuppressive, or other
      therapeutic effects.

PMID- 2237445
TI  - Changes in the fibrinolytic system during pregnancy.

PMID- 2237446
TI  - Evolutionary assembly of blood coagulation proteins.

PMID- 2237447
TI  - Pathologic fibrinolysis as a cause of clinical bleeding.

PMID- 2237449
TI  - Current and future radiopharmaceuticals for brain imaging with single photon
      emission computed tomography.
AB  - Development of radiopharmaceuticals for functional brain imaging has progressed
      rapidly in recent years. Measurement of regional cerebral blood flow in humans
      can be achieved by using [123I]-iodoamphetamine or [99mTc]-HMPAO. Several other
      lipid-soluble [99mTc]-technetium complexes are currently undergoing clinical
      trials. New 123I-labeled agents designed to measure central nervous system
      receptors, including D1 and D2 dopamine, serotonin, muscarinic, and
      benzodiazepine receptors, have been developed. In conjunction with single photon
      emission computed tomography, they may provide useful tools to evaluate brain
      function related to changes in receptor concentration.

PMID- 2237448
TI  - Instrumentation and computers for brain single photon emission computed
      tomography.
AB  - Cerebral single-photon emission computed tomography (SPECT) requires attention to
      the instrumentation because of the anatomical location of the head at one end of
      the body, with a generally narrower diameter than the rest of the body. For a
      number of years, there have been SPECT units designed especially for head work,
      as well as general-purpose units that have performed well in imaging the head.
      The current emphasis on cerebral perfusion, using either agents that wash in and
      out with blood flow or agents that reflect blood flow in their static
      distribution, has allowed a concentration on imaging hardware and computer
      hardware and software for this purpose.

PMID- 2237450
TI  - An overview of the contribution of regional cerebral blood flow studies in
      cerebrovascular disease: is there a role for single photon emission computed
      tomography?
AB  - Regional cerebral blood flow (rCBF) findings and their application to
      cerebrovascular disease are reviewed. Although the coupling of cerebral blood
      flow and metabolism are best studied with positron emission tomography, single
      photon emission computed tomography measurements of rCBF can contribute to
      patient management. Potential indications for the use of rCBF functional brain
      imaging include differential diagnosis, early prediction of late recovery in the
      late subacute and chronic phases of stroke (3 months or more postonset), and
      evaluation of vasospasm following subarachnoid hemorrhage.

PMID- 2237451
TI  - Single photon emission computed tomography in epilepsy.
AB  - Functional brain imaging by either single photon emission computed tomography
      (SPECT) or positron emission tomography (PET) is now a well-established technique
      in the diagnosis and evaluation of the epilepsies. Perhaps only in stroke have
      these emerging technologies proven of greater significance. Scalp, cortical, or
      depth electroencephalographic (EEG) data previously have been the gold standards
      for the localization and subcharacterization of epileptic activity in the human
      brain. Yet, they are fraught with difficult interpretations, technical
      difficulties, and limitations in sampling accuracy. Both SPECT and PET have
      localizing power approaching that of combined scalp and depth EEG. In the
      following discussion, a brief overview of the results of PET investigations in
      epilepsy is presented as background and comparative material for the concurrent
      and, more recently, dominant role of SPECT in evaluating patients with seizure
      activity. SPECT results in the interictal state in partial and generalized
      seizure activity are reviewed followed by an analysis of the role of ictal SPECT
      imaging in epilepsy. Next, relationships among interictal hypoperfusion (or
      hypometabolism) and computed tomography, magnetic resonance imaging,
      neuropathology, clinical severity, and cognitive function are discussed. The role
      of perfusion or metabolism imaging in the management of antiepileptic
      pharmacotherapy is also discussed, and the potential for receptor imaging in the
      evaluation of the epilepsies is examined. Finally, application in pediatric
      epilepsy are presented.

PMID- 2237452
TI  - Single photon tomography in Alzheimer's disease and the dementias.
AB  - Measurements of brain blood flow has evolved over the past 50 years, and during
      the latter half of that time radionuclide techniques have been used to study this
      important function. Using Xenon 133 and scintillation multiprobe systems, several
      teams of investigators measured regional cerebral blood flow (rCBF), and noted
      that under many circumstances it could be equated with local brain physiological
      activity. The dementias were investigated using the scintillation multiprobe
      method, and posterior flow deficits were described in patients who were thought
      to have Alzheimer's disease. The multiprobe technique gave way first to planar,
      and then tomographic imaging, with initial favorable results achieved by positron
      emission tomography (PET). Soon investigators learned to measure rCBF with single
      photon emission computed tomography (SPECT) using high-sensitivity systems and
      133Xe as a tracer, or high-resolution systems with 123I-iodoamphetamine (IMP),
      and later, 99mTc-HMPAO. Three-dimensional tomographic imaging shows to advantage
      the flow patterns that characterize Alzheimer's disease, with rCBF reductions in
      temporal, parietal, and sometimes frontal areas, as opposed to randomly
      distributed deficits in multiinfarct dementia, reduced frontal flow in entities
      such as Pick's disease, and others. Herein we will review our own experience with
      high-sensitivity rCBF SPECT in 119 patients with dementia, and with high
      resolution SPECT, using a new, three-camera scanner and 99mTc-HMPAO in an
      additional 39 patients. SPECT rCBF study of patients with dementia and
      Alzheimer's disease, will aid in separating patients with untreatable Alzheimer's
      from those patients who may have treatable causes of dementia, and will be useful
      in evaluating experimental drugs for the treatment of Alzheimer's disease.

PMID- 2237453
TI  - Brain imaging in acquired immunodeficiency syndrome dementia complex.
AB  - Human immunodeficiency virus (HIV) infections are accompanied by many different
      types of neurological complications. Opportunistic infections and neoplasms,
      particularly lymphoma, are often an underlying cause for these complications in
      patients with acquired immunodeficiency syndrome (AIDS). Frequently, these can be
      detected by cerebrospinal fluid (CSF) examination, double-dose contrast
      transmission computed tomography (CT), and/or magnetic resonance imaging (MRI).
      It has become apparent that the HIV itself is responsible for a significant
      percentage of neurological disease in the HIV-seropositive individual. The onset
      may be subtle and may occur before the onset of frank immunosuppression.
      Diagnosis of HIV encephalitis or AIDS dementia complex (ADC) is complicated by
      the frequent coexistence of opportunistic infections. Structural neuroimaging (CT
      or MRI) shows atrophy and in some case white matter abnormalities, but imaging
      pathological correlation suggests that these modalities are relatively
      insensitive to the presence of HIV brain infection. Functional neuroimaging, both
      18fluorodeoxyglucose positron emission tomography (PET) for evaluation of glucose
      metabolism and 123I iodoamphetamine or 99mTc-HMPAO single-photon emission
      computed tomography (SPECT) for evaluation of cerebral perfusion, can demonstrate
      abnormalities in the subcortical gray matter structures and the cerebral cortex
      in patients with ADC. These abnormalities may be observed early in the course of
      ADC even when MRI is negative and the patient is relatively asymptomatic. Also,
      PET and SPECT may be useful to follow progression of the dementia or response to
      therapy.

PMID- 2237454
TI  - Thyrotoxicosis with low thyroidal uptake of radioiodine.

PMID- 2237455
TI  - Enterogastric reflux demonstrated by radionuclide hepatobiliary scintigraphy.

PMID- 2237456
TI  - Sound and vibration in pregnancy, Part II.

PMID- 2237457
TI  - Physiological correlates of development of the human cochlea.

PMID- 2237459
TI  - Effects of early auditory experience on development of binaural pathways in the
      brain.

PMID- 2237458
TI  - Development of auditory coding in the central nervous system: implications for in
      utero hearing.

PMID- 2237460
TI  - Prenatal and perinatal risks of hearing loss.

PMID- 2237461
TI  - The fetal vibroacoustic stimulation test: an update.

PMID- 2237462
TI  - Vibration: principles, measurements, and health standards.

PMID- 2237463
TI  - Low frequency noise and vibration: role of government in occupational disease.

PMID- 2237464
TI  - Pregnant women in the workplace.

PMID- 2237465
TI  - Selected legal issues related to sound and vibration in pregnancy.

PMID- 2237466
TI  - The group B streptococci: from natural history to the specificity of antibodies.

PMID- 2237467
TI  - Antimicrobial defenses in the neonate.
AB  - Serious life-threatening neonatal infections with microbial species that are
      infrequently associated with infections in adults are related to the immature
      immune system of human newborn infants. The usually sterile intrauterine
      environment of the fetus is associated with a primed but inactive immune system
      at the time of birth. Sudden introduction into a complex microbial world
      stimulates the inflammatory system and an effective host defense rapidly
      develops. Defense mechanisms include innate phagocytic and complement systems,
      and specific adaptive immunity including antimicrobial antibodies. Fortunately,
      neonates have protective antibodies against many microbes at birth provided by
      their mothers via placental transfer of IgG. Specific antimicrobial antibody
      production by the newborn infant is delayed. Neutrophil numbers in the
      circulation are high in the normal neonate, but the bone marrow pool of cells is
      limited. Chemotactic responsiveness of circulating phagocytic cells is decreased
      in comparison with adult cells, although phagocytic and microbicidal activity of
      neonatal neutrophils and monocytes are normal. The newborn infant's lymphocyte
      system is relatively mature, and neonatal mononuclear cells have normal antigen
      presenting and secretory function. T lymphocytes are present in normal numbers
      and although response of these cells to antigens is somewhat slower than in adult
      cells, a near normal response suggests intrauterine stimulation by maternally
      derived immunoregulators. B lymphocytes are also present in newborn human
      infants. However, maturation of B lymphocytes into antibody-producing plasma
      cells occurs gradually during the first weeks of life.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2237468
TI  - Murine type-specific monoclonal antibodies in experimental group B streptococcal
      infection: interaction with complement components and phagocytes.

PMID- 2237469
TI  - Escherichia coli infection in neonates: humoral defense mechanisms.

PMID- 2237470
TI  - Neonatal listeriosis.

PMID- 2237471
TI  - Acute suppurative thyroiditis with progression to abscess.

PMID- 2237472
TI  - The role of ultrasound in the clinical practice of obstetrics.

PMID- 2237473
TI  - Update on the safety of ultrasound in obstetrics.

PMID- 2237474
TI  - Gestational age: what to measure and when.

PMID- 2237475
TI  - Fetal growth disturbances.
AB  - IUGR is a fetal disorder characterized by diminished fetal growth, especially in
      the third trimester. Growth retardation may be due to primary placental
      insufficiency or may result from a variety of maternal or fetal causes and is
      associated with elevated perinatal mortality and morbidity. Numerous conventional
      and Doppler ultrasound criteria have been proposed for diagnosing IUGR
      prenatally, but none on its own permits confident diagnosis of this condition.
      Diagnosis or exclusion of IUGR can best be achieved by the combined use of three
      parameters: estimated fetal weight, amniotic fluid volume, and maternal
      hypertension. When IUGR is suspected based on these parameters, Doppler
      ultrasound can help to determine the prognosis. Large fetuses, particularly those
      weighing more than 4,000 grams at birth, are at risk for perinatal morbidity and
      mortality due to obstetrical complications. These fetuses occur more frequently
      and are at especially high risk in diabetic mothers. The estimated fetal weight
      is the most direct parameter for diagnosing LGA and macrosomia and is moderately
      accurate with positive predictive values up to 67% in the general population and
      77% in diabetics. It can be an important factor in deciding on the route of
      delivery in diabetic mothers.

PMID- 2237476
TI  - The fetal central nervous system.
AB  - CNS anomalies are some of the most common and clinically important congenital
      malformations encountered in utero. Improved detection of CNS anomalies requires
      a systematic survey of the cranium and spine as a part of all obstetric sonograms
      performed after the first trimester. Recognition of characteristic cranial
      findings associated with spina bifida can dramatically improve detection of small
      spinal defects before the time of fetal viability, even when the sonogram is
      performed for low-risk indications. Patients suspected to be carrying a fetus
      that has a cranial or spinal anomaly should ideally be referred to a tertiary
      center for confirmation of the defect, evaluation of possible additional
      anomalies, and for patient management and counseling.

PMID- 2237477
TI  - Disorders of the fetal thorax and abdomen.
AB  - Many disorders of the fetal thorax and abdomen can be evaluated using ultrasound.
      Even when a definitive diagnosis cannot be made prenatally, sonography can
      provide valuable clinical information regarding the nature and location of the
      abnormality, associated anomalies, and the presence of secondary complications.
      An awareness of these disorders and their sonographic appearance is important to
      impact upon obstetrical management and overall prognosis.

PMID- 2237478
TI  - Fetal genitourinary tract.

PMID- 2237479
TI  - Nonimmune hydrops fetalis: a heterogeneous disorder and therapeutic challenge.

PMID- 2237480
TI  - [To stop smoking: "yes", "no", "maybe". A course for freedom to be attempted].

PMID- 2237481
TI  - [The World Tobacco-Free Day: 31 May. "A childhood and a youth without tobacco"].

PMID- 2237482
TI  - [Children and youth, victims of tobacco].

PMID- 2237483
TI  - [Women and tobacco].

PMID- 2237484
TI  - [When and how to extubate in the recovery room].

PMID- 2237485
TI  - [Reflections on theoretical models and their applicability].

PMID- 2237486
TI  - [Filariasis].

PMID- 2237487
TI  - [A simple cure for diarrhea].

PMID- 2237488
TI  - [Encounter groups].

PMID- 2237489
TI  - [How and when should one act against postoperative fever?].

PMID- 2237490
TI  - [You have to resign yourself!. Interview by Ruth Landy].

PMID- 2237491
TI  - [Resin replaces the traditional gypsums].

PMID- 2237492
TI  - [The bone marrow transplant in childhood].

PMID- 2237493
TI  - [Recommendations for the use of drugs in arterial hypertension. The Chief Medical
      Committee of Social Security].

PMID- 2237495
TI  - [The responsibility of the Church in education for health].

PMID- 2237494
TI  - [Education for health].

PMID- 2237496
TI  - [The human person].

PMID- 2237497
TI  - [Primary health care: the clinical, social and ethical aspects].

PMID- 2237499
TI  - [Education for the family and health professionals].

PMID- 2237500
TI  - [The sterilization of a female psychiatric patient. Towards an ethical
      evaluation].

PMID- 2237498
TI  - [The prevention of cancer every week of the year].

PMID- 2237501
TI  - [The concrete action of the Church in education for health. Organized
      intervention].

PMID- 2237502
TI  - [The body and old age].

PMID- 2237503
TI  - [Churches as an avenue for the control of arterial hypertension].

PMID- 2237504
TI  - International migration of health manpower in Sub-Saharan Africa.
AB  - This paper concerns itself with a few questions related to the impact of the
      emigration of health manpower on the health status of individuals and economic
      development of Sub-Saharan Africa (SSA). The paper evaluates the harmfulness of
      the migration from Sub-Saharan Africa. The analysis leads to some observations
      about the effect of the quality of the migration on Africa's health care system
      development and the appropriateness of some of Africa's policies for controlling
      the migration.

PMID- 2237505
TI  - Medicine and the social sciences in Africa.

PMID- 2237506
TI  - Debt crisis, health and health services in Africa.
AB  - In the early 1960s when most of Africa became independent, the hope for the
      resolution of the related problems of poverty, illiteracy and disease became the
      primary agenda of its sovereign states. There were indeed initial gains in
      various aspects of social infrastructure, especially education and medical
      services. Beginning from the mid 1970s, but particularly since 1980, this initial
      progress is, however, being reversed as Africa totters under an excruciating debt
      burden and accompanying austerity programmes. This essay provides a kaleidoscope
      of this ominous decay with particular reference to health and health services.
      Several proposals for the way forward are discussed.

PMID- 2237507
TI  - Economic development strategies: maternal and child health.

PMID- 2237508
TI  - Health services for the aged in Sub-Saharan Africa.
AB  - This paper addresses itself to the problems faced by the aged with regards to the
      use and availability of health services in Sub-Saharan Africa (SSA). The paper
      maintained that the development of a sound public policy on ageing in SSA
      requires two types of knowledge; an understanding of what consequences will
      follow from a particular course of action, and an evaluation of the desirability
      of those consequences. It concluded that there is a need to improve the database
      that will form a basis for any policy prescription that is geared towards
      alleviating the problems of the aged in this sub-region.

PMID- 2237509
TI  - Malaria in Sub-Saharan Africa.
AB  - Malaria as a threat to health has remained undaunted in Sub-Saharan Africa (SSA).
      It has been mathematically modelled, vertically attacked and continuously
      appraised and yet it continues unabated. Malaria is an acute and chronic disease
      caused by intracellular protozoa of the genus Plasmodium which are transmitted by
      the bite of female Anopheles mosquitoes. Approximately 2.6 billion people are at
      risk worldwide resulting in at least 100 million clinical cases and of the order
      of 1 million fatalities. The social and economic consequences of such morbidity
      and mortality have not been adequately documented.

PMID- 2237510
TI  - Impact of HIV/AIDS on African children.
AB  - In Central and East Africa, pediatric human immunodeficiency virus (HIV)
      infection and acquired immunodeficiency syndrome (AIDS) are becoming increasing
      threats to child health due to the predominance of heterosexual transmission of
      HIV, high HIV infection rates in women of reproductive age and high birth rates.
      This paper examines the potential impact of HIV/AIDS on orphanhood and under-five
      mortality in 10 Central and East African countries. The author estimates that, in
      the 10 countries studied, HIV/AIDS in children under age five will cause between
      one-quarter and half a million child deaths annually by the year 2000. Whereas
      the United Nations estimate (without AIDS) and target for the under-five
      mortality rate in this 10-country region by the year 2000 are 132 and 78,
      respectively, HIV/AIDS will cause the under-five mortality rate to rise to
      between 159 and 189. Increasing HIV/AIDS-related adult mortality is creating a
      large and growing number of children under age 15 whose mothers have died of
      HIV/AIDS. During the 1990s, HIV/AIDS will kill a total of between 1.5 and 2.9
      million women of reproductive age in this region, producing between 3.1 and 5.5
      million AIDS orphans--which means that between 6 and 11% of the population under
      age 15 will be orphaned. National and international government and nongovernment
      service providers in Central and East Africa need to recognize this potential
      impact of HIV/AIDS on children, expand AIDS-prevention efforts, and develop
      policies and programs to address children's HIV/AIDS-related needs.

PMID- 2237511
TI  - Orphans as a window on the AIDS epidemic in Sub-Saharan Africa: initial results
      and implications of a study in Uganda.
AB  - Provisional estimates from a Save the Children Fund enumeration study in four
      Ugandan districts indicate that the total number of orphans (one or both parents
      missing) ranges between 620,000 and 1,200,000. Needs assessments with guardians
      and local administrators show that although extended family networks are
      absorbing these children according to traditional rules, they may be vulnerable
      to increased mortality due to economic and health stresses on their caretakers,
      many of whom are elderly persons. The orphan burden will increase in Uganda and
      other Sub-Saharan African countries over the next few years. Allocation of
      additional national and international resources must be considered to avert
      breakdowns in community and familial support systems and consequent increases in
      under 5 mortality. The orphan burden is a window on the potential for massive
      social breakdown and dislocation in Sub-Saharan Africa resulting from high AIDS
      related mortality. Methodologies for data collection and planning that use
      indigenous political systems must be built quickly to avert disaster.

PMID- 2237512
TI  - Substance abuse, health and social welfare in Africa: an analysis of the Nigerian
      experience.
AB  - Substance abuse has become a significant problem in the African continent in
      recent years. Reports of increasing abuse of alcohol and cannabis have appeared
      in many countries. In Nigeria, beginning from the early 1980s, the abuse of
      cocaine and heroin has been added to the problem. Even though epidemiological
      findings show low rates of abuse of these illicit substances in the general
      population, hospital-based studies point to a growing incidence of cocaine and
      heroin-related mental health problems. Information from recent studies in Nigeria
      is utilized in an analysis of the drug abuse scene. It is suggested that drug
      trafficking by Nigerians, which has been unprecedented in the past 10 years, has
      contributed to the observed shift in the pattern of drug abuse from cannabis and
      alcohol to cocaine and heroin. It is suggested that there should be regional
      sharing of information on drug abuse in the continent and that governments should
      treat as urgent the formulation and implementation of broadly-based drug
      policies.

PMID- 2237513
TI  - Psychology and health in Africa.

PMID- 2237514
TI  - Aging as a feminist issue.

PMID- 2237515
TI  - My name is legion, for we are many: diagnostics and the psychiatric client.

PMID- 2237516
TI  - The impact of race on volunteer helping relationships among the elderly.
AB  - As programs solicit their help in providing transportation, shopping assistance,
      telephone reassurance, counseling, and information and referral to needy elderly
      people, older adults are going to fill increasingly important roles as volunteers
      in the social service system for this aging society. Little empirical work has
      been done on effective volunteer behavior. This article aims to increase
      understanding of this topic by exploring how race influences relationships
      between volunteers and the people they serve. This analysis reveals that race by
      itself does not affect volunteer helping behavior; black and white older adults
      perform similarly in volunteer roles on measures of time committed to service and
      satisfaction levels of clients. However, the racial composition of the dyad does
      have significant effects on the helping relationship; higher levels of contact
      and client satisfaction are reported when the volunteer and the client are of the
      same race. Professional training and support are necessary to overcome problems
      associated with racial differences between volunteers and their clients.

PMID- 2237517
TI  - Working families and eldercare: a national perspective in an aging America.
AB  - The competing demands of employment and caring for a dependent elderly family
      member can create stress for families, and some employers are becoming concerned
      about the impact of eldercare on the workplace. This first national survey of
      workers examined the extent of eldercare and its impact on workers. In this
      article, the authors profile the employees who described themselves as
      caregivers, the older people they were caring for, the care they were giving, the
      extent to which they reported conflict between their work and caregiving
      responsibilities, and the workplace supports they would have found helpful in
      managing these roles. Women were devoting more time to caregiving and were more
      likely to report work and caregiving conflict than were men. Social workers in
      occupational and community settings can play a key role in providing information
      about eldercare services, in counseling caregivers, and in advocating for
      employee benefits and community services to help workers maintain both work and
      family roles.

PMID- 2237518
TI  - Personnel to serve the aging in the field of social work: implications for
      educating professionals.
AB  - This survey of 476 members of the National Association of Social Workers (NASW)
      was conducted to better describe their characteristics, educational background,
      and perceptions of the field of aging. The findings indicated that although 26
      percent (29,650) of NASW members currently work with older people, 62 percent of
      those who do not work with older people reported that gerontology knowledge was
      required in their current jobs. Respondents perceived that the area of aging
      would be much larger and more important in the future, and they recommended
      increased gerontological preparation for all social work students.

PMID- 2237519
TI  - The consequences of elderly wives caring for disabled husbands: implications for
      practice.
AB  - This study examines the mental well-being and special problems of 188 elderly
      wives identified as the primary caregivers who care for their disabled husbands.
      The findings indicate that the women have low morale scores associated with the
      arduous tasks of caregiving. Despite low morale scores, the health status of an
      elderly wife appeared to contribute significantly to her ability to cope with the
      caregiving responsibilities of a disabled spouse. Constant care and supervision,
      emotional and physical strain, and reduced social contact and finances were the
      major problems encountered in the caregiving commitment.

PMID- 2237520
TI  - Older women and poverty.
AB  - The popular perception of the financially secure economic status of elders,
      referred to as the "greening of the aged," does not reflect the reality faced by
      many older women. Older women's economic positions depend largely on marital
      status. Women who are widowed and other women living alone are among the most
      poor. Cuts in Social Security benefits, viewed by some policymakers as a possible
      solution to the problem of the federal budget deficit, would exacerbate the
      poverty of older women who rely on Social Security as their main source of
      income. Social workers concerned with poverty among older women must ensure that
      older women's interests are not sacrificed to resolve the federal deficit.

PMID- 2237521
TI  - Family response to the farm crisis: a study in coping.
AB  - The recent farm crisis created major economic disruptions for rural communities
      and families. To understand the effects of these disruptions on rural families, a
      study was conducted with community leaders and adult members of rural families
      that had experienced these disruptions. Family members experienced many stress
      reactions, especially withdrawal and depression. Families coped primarily by
      marshalling family efforts to solve financial problems and to provide emotional
      support. Significant barriers prevented people from turning to others in the
      extended family and the community for help. Family members created barriers by
      their withdrawal and their sense of individualism and shame. Judgmental attitudes
      and lack of understanding by others as well as demeaning and inappropriate
      criteria for help also created barriers. Interventions require monitoring policy
      issues and mobilizing community resources, as well as helping individual families
      to cope.

PMID- 2237522
TI  - A social work practice model of case management: the case management grid.
AB  - Case management is a major component of the current mainstream of social work
      practice. Nevertheless, the field has failed to adequately conceptualize case
      management. The first step in defining case management practice is to separate it
      from the administrative structure that forms the context of practice. The next
      step is to delineate the two basic dimensions of case management--enabling and
      facilitating. The role of the social work case manager is to integrate formal
      systems of care with the activities of families and primary groups. Case
      management practice focuses on enabling individuals and primary groups to reach
      their full potential and on facilitating more effective interaction with the
      larger social environment. The case management grid illustrates how social work
      practitioners integrate enabling and facilitating into their practice approaches.

PMID- 2237523
TI  - The empirical base for the implementation of social skills training with
      maltreated children.
AB  - Empirical research on the psychosocial sequelae of child maltreatment has
      identified numerous and severe social skills deficits in abused and neglected
      children that negatively affect their healthy adjustment. Social skills training
      programs have been successful in helping adults and nonmaltreated children
      improve their skills in interpersonal communication, problem solving, self
      control, assertiveness, and stress management. Such training appears promising
      for intervention with maltreated children. Guidelines and rationales are
      presented for developing social skills training programs specifically focused on
      the developmental and situational needs of abused and neglected children.

PMID- 2237524
TI  - Social work's contribution to psychosocial rehabilitation.
AB  - This article describes the social work profession's contribution to the emerging
      field of psychosocial rehabilitation and presents principles that enable social
      workers to work effectively with people with chronic mental illnesses. Although
      model psychosocial rehabilitation programs have been established throughout the
      United States, psychosocial rehabilitation has not been widely articulated in the
      social work literature. This article specifically defines the psychosocial
      rehabilitation approach in the model programs, often called "clubhouses," and
      describes the contribution of social work to the model's development.

PMID- 2237525
TI  - [Aspirin].

PMID- 2237526
TI  - [The patient with aspiration drainage. Nursing care].

PMID- 2237527
TI  - [AIDS and lymphoma. Some problems for the patient care team].

PMID- 2237528
TI  - [Hematopoietic growth factors. Therapeutic trials].

PMID- 2237529
TI  - [Interleukin 2 in oncology].

PMID- 2237530
TI  - [GM-CSF. Cellular growth factor].

PMID- 2237531
TI  - [Gene therapy in onco-hematology. Perspectives and ethics].

PMID- 2237532
TI  - [Trans-retinoic acid. Treatment by differentiation of acute promyelocytic
      leukemia].

PMID- 2237533
TI  - [Central catheter sepsis. Diagnosis and current treatments].

PMID- 2237534
TI  - [Intrathecal injection of morphine. Nursing interventions].

PMID- 2237535
TI  - [Allogenic bone marrow transplant. Latest developments].

PMID- 2237536
TI  - [Hematologic reconstitution after transplant with umbilical cord blood cells].

PMID- 2237537
TI  - [Allogenic bone marrow transplants in voluntary unrelated donors].

PMID- 2237538
TI  - [3rd International Congress on Wound Care].

PMID- 2237539
TI  - [Reduction in the use of allogenic blood products].

PMID- 2237540
TI  - [Intra-arterial treatment of breast cancers].

PMID- 2237541
TI  - [Indications and techniques for intraperitoneal catheters].

PMID- 2237542
TI  - [Injectable anti-cancer drugs. Stocking, preparation and administration].

PMID- 2237543
TI  - [Implantable vascular access ports. Use and maintenance].

PMID- 2237544
TI  - [Onco-hematology service. The suffering of the nurses].

PMID- 2237545
TI  - [Nurses and death in the hospital. Duties and role].

PMID- 2237546
TI  - [AIDS. Some facts].

PMID- 2237547
TI  - A late look at the fourth: freedom botched and blotched.

PMID- 2237548
TI  - Syphilis, human immunodeficiency virus infection, and targeting prevention.
AB  - To examine the interaction between syphilis and human immunodeficiency virus-type
      1 (HIV-1) infection in Oklahoma, we conducted an unlinked HIV seroprevalence
      survey using serum specimens submitted to the Oklahoma State Department of Health
      for serologic test for syphilis. Of specimens with positive results from
      fluorescent treponemal antibody absorption test (FTA-ABS), 6.3% were HIV-1
      seropositive compared to 0.8% of those that had negative results from FTA-ABS.
      Among specimens positive for syphilis, HIV-1 seropositivity was found almost
      exclusively among those from persons 20 to 39 years of age and more often among
      those from men than those from women (9.9% vs 1.3%). Of syphilis-positive
      specimens from 20- to 39-year-old men, 17.6% were HIV-1 seropositive. In
      Oklahoma, an area with a relatively low overall prevalence of HIV-1 infection,
      targeting prevention efforts to young adults who test positive for syphilis
      should be an efficient way to reach some persons at high risk for HIV-1
      infection.

PMID- 2237549
TI  - Relationship between body weight and mortality in men aged 75 years and older.
AB  - As our population ages, recommendations about weight control in the elderly will
      assume increasing importance. But such recommendations are not supported by the
      literature, in that there is little information about the independent effect of
      obesity on survival in subjects who are more than 70 years old. We studied body
      weight, as assessed by Quetelet's index (weight in kilograms divided by the
      square of the height in meters), in 162 men aged 75 to 98 years (mean age = 81 +/
      5.3). Length of follow-up averaged 28.6 months. Early deaths (those occurring
      within the first year of the study) were attributed to preexisting morbid
      conditions. Cox regression was determined for the entire group, and then for the
      same group with early deaths excluded. Covariates were Quetelet's index, age,
      race, history of cigarette smoking, glucose intolerance, and hypertension. Two
      variables, a low Quetelet's index and glucose intolerance, were significantly
      associated with decreased survival for the entire group. When early deaths were
      excluded, however, the only variable significantly related to survival was age.
      These data suggest that the inverse relationship of body weight to mortality in
      aged men is due to preexisting morbid conditions and that when these morbid
      conditions are accounted for, body weight is not significantly related to
      survival. Hence, the relationship between body weight and mortality risk in aged
      men differs substantially from that in younger adults.

PMID- 2237550
TI  - Prevalence of previously undiagnosed hypothyroidism in residents of a midwestern
      nursing home.
AB  - Hypothyroidism in the elderly may be associated with nonspecific symptoms. To
      determine the prevalence of undiagnosed hypothyroidism in residents of a skilled
      nursing facility, we screened 434 male and 137 female residents, aged 60 years or
      older, for thyroid dysfunction. Overt hypothyroidism was found in three men and
      two women. Subclinical hypothyroidism was diagnosed in 42 men (9.7%) and 20 women
      (14.6%). Tests for thyroid antibodies were positive in all patients with overt
      hypothyroidism and in 12 (34%) of the 35 men and 12 (67%) of the 18 women with
      subclinical hypothyroidism who had thyroid antibody testing. All residents with
      newly diagnosed overt hypothyroidism and 54 (87%) of the 62 with subclinical
      hypothyroidism had been under medical observation for 1 year or longer. The
      institutionalized elderly should be screened for hypothyroidism because this
      abnormality may otherwise remain undiagnosed. The detection of subclinical
      hypothyroidism is important, as affected individuals are at risk for further
      decline in thyroid function.

PMID- 2237551
TI  - Complications of extracorporeal membrane oxygenation in neonates.
AB  - In cases of severe respiratory failure, cardiopulmonary bypass has been used as
      support until cardiac and pulmonary recovery occurs. We report the Wilford Hall
      USAF Medical Center experience with extracorporeal membrane oxygenation (ECMO)
      and its associated complications. From July 1985 to March 1989, 57 neonates were
      placed on membrane oxygenators. The overall survival was 79%. Technical
      complications encountered included catheter-related problems, mechanical
      complications of the pump apparatus, and hemorrhage. Hemorrhagic complications
      were the most frequent and devastating complications encountered. Intracranial
      hemorrhage accounted for six deaths associated with bypass. Extracorporeal
      membrane oxygenation is successful in significantly improving survival of
      neonates whose predicted mortality approaches 100% with conventional treatment.
      The rate of infant mortality using the membrane oxygenator is not affected by
      technical complications related to catheter position, mechanical problems with
      the circuit, or hemorrhage, excluding intracranial hemorrhage. The major cause of
      death of infants receiving extracorporeal membrane oxygenation is the underlying
      disease process leading to cardiopulmonary failure.

PMID- 2237552
TI  - Mitral valve prolapse: comparison of diagnosis by physical examination and
      echocardiography.
AB  - To determine how well physical examination findings suggestive of mitral valve
      prolapse (MVP) correlate with echocardiographic evidence of MVP, we
      retrospectively reviewed the charts of 104 patients referred to an Air Force
      Cardiology Clinic for echocardiography to rule out MVP. In each case, the
      referring physician's specialty and his findings on cardiac physical examination
      were recorded. All patients had M-mode echocardiography, and half of the patients
      had two-dimensional echocardiography. Sensitivities, specificities, and
      likelihood ratios for the physical examination were calculated using
      echocardiography as the comparison standard. The combination of a systolic click
      and a systolic murmur was the physical examination finding most predictive of
      echocardiographic MVP, with a positive likelihood ratio of 2.43. Other
      combinations of physical findings yielded likelihood ratios close to 1. No
      differences were found based on the specialty of the examining physician. We
      conclude that when practicing physicians find a systolic click and murmur, MVP is
      likely to be present on echocardiography, though one third of the patients will
      have normal echocardiograms. Other combinations of physical findings are of
      little help in predicting echocardiographic MVP.

PMID- 2237553
TI  - Primary prevention of coronary artery disease through a family-oriented cardiac
      risk factor clinic.
AB  - Primary prevention of coronary artery disease in children and young adults is
      important and can be instituted through a family-oriented cardiac risk factor
      clinic. Such a clinic was initiated at the Medical College of Georgia in March
      1988. Children whose total cholesterol level (TC) exceeded 200 mg/dL when
      screened by their primary care physician were referred with their siblings and
      parents for fasting lipid profile and further evaluation. Data are available for
      the initial 21 families, including 30 children and 36 adults. The mean TC level
      was 258 mg/dL for index cases, 195 mg/dL for siblings, and 233 mg/dL for parents.
      Follow-up data obtained after therapy at a mean of 6 months are available for 12
      families, including 14 children and 14 adults. The mean change in TC was from 265
      to 246 mg/dL; 82% of the patients had a decrease in TC. Only one index case was
      documented as having neither a sibling nor a parent with an elevated cholesterol
      level. Family-oriented cardiac risk factor clinics are important for the
      identification and treatment of hypercholesterolemia in asymptomatic young people
      when primary prevention is possible.

PMID- 2237554
TI  - Analysis of the two-team approach to anterior spinal fusion.
AB  - An anterior approach to the spine via a thoracoabdominal incision offers the
      surgeon many advantages. The major vascular structures are visualized,
      stabilization of a long segment of the spine is strong, and recovery is speedy.
      Nevertheless, this is a major operation and one with potential morbidity and
      mortality. At Children's Hospital of New Orleans, the Pediatric Surgery and
      Pediatric Orthopedic Surgery Services work together to reduce these risks and in
      so doing maintain an acceptable morbidity. With this two-team approach; we
      operated on the spines of 39 patients between 1978 and 1988. The most common
      indications for operation included idiopathic scoliosis, neuromuscular disease,
      and congenital abnormalities. A thoracoabdominal approach was used in 32
      patients, a thoracic approach in four patients, and an abdominal approach in
      three patients. Twenty-nine patients experienced 65 complications; 45 of these
      complications were respiratory in nature. There were no postoperative deaths.
      Factors unrelated to the incidence of postoperative complications included age,
      volume of crystalloid infused during operation, volume of blood replacement, and
      length of anesthesia.

PMID- 2237555
TI  - Pursuing mild elevations of liver enzyme values to exclude hemochromatosis.
AB  - To determine whether physicians in an academic medical center excluded
      hemochromatosis as a diagnosis in a population of patients with mildly elevated
      liver enzyme values, we reviewed 100 charts of patients with both aspartate
      aminotransferase and alkaline phosphatase levels that were less than twice the
      upper limit of normal. We analyzed each chart to determine if hemochromatosis
      would have been excluded by a subsequent workup. Those patients who did not have
      a complete workup were assigned to one of three categories: (1) no mention was
      made of abnormal liver enzyme values; (2) liver enzyme values were ascribed to
      some condition other then hemochromatosis and no definitive workup was done; and
      (3) the condition of the patient was so poor that assessment did not seem
      indicated. Ninety of 100 patients were not given a workup to exclude
      hemochromatosis. Physicians often ignore mild elevations in liver enzyme values.

PMID- 2237556
TI  - Survey of Alabama physicians' use of mammography, 1989.
AB  - In early 1989 we surveyed by questionnaire Alabama primary care physicians (N =
      1800) concerning their attitudes toward and use of mammography. There were 681
      respondents (37.8%). The majority (83%) recommend mammograms for their patients
      according to the American Cancer Society guidelines and obtain baseline studies
      in asymptomatic women between the ages of 35 and 40 years. It appears that the
      cost of mammograms is decreasing in Alabama; a screening study was available for
      $50 or less to 34% of responding physicians. Almost one half (48%) of the
      physician respondents believe that more than 50% of their patients have had at
      least one mammogram.

PMID- 2237558
TI  - New drug and biologic product approvals in 1989.

PMID- 2237557
TI  - Tamoxifen therapy for painful idiopathic gynecomastia.
AB  - We have evaluated the efficacy of the antiestrogen tamoxifen in six men with
      painful idiopathic gynecomastia. Subjects were given either tamoxifen or placebo
      for 2 to 4 months and then were given the other agent for an identical period.
      Breast size was considered to have been reduced only if it had decreased by one
      or more Marshall-Tanner stages during the treatment period. Pain reduction with
      tamoxifen therapy was statistically significant for the group, occurring in five
      of six subjects during tamoxifen treatment and in only one of six during the
      placebo period. Size reduction with tamoxifen was only marginally significant for
      the entire group, but occurred in all three subjects who were initially in
      Marshall-Tanner stage III and in none of the three subjects who were initially in
      stage V. During tamoxifen treatment, there was a significant increase in the
      serum levels of luteinizing hormone and total estradiol and a marginally
      significant increment in the total testosterone level.

PMID- 2237559
TI  - Surgical literature and "surgispeak": a critique.

PMID- 2237560
TI  - Normeperidine-induced seizures in hereditary coproporphyria.
AB  - Seizures are common in acute exacerbations of hepatic porphyria, even though the
      etiology is not identified in most cases. We have reported a case of
      normeperidine-induced seizures in a patient with hereditary coproporphyria.
      Although meperidine is commonly used for pain control during acute attacks in
      these patients, this report suggests that meperidine is not a good analgesic
      choice in porphyria. Normeperidine-induced seizures in patients with porphyria
      may be treated by withdrawal of meperidine therapy and selective use of
      anticonvulsants.

PMID- 2237561
TI  - Pneumocystis carinii pneumonia manifested as a hilar mass and cavitary lesion: an
      atypical presentation in a patient receiving aerosolized pentamidine prophylaxis.
AB  - A case of Pneumocystis carinii pneumonia (PCP) in a patient with AIDS was
      manifested radiographically as a hilar mass and cavitary lesion. The patient had
      been receiving aerosolized pentamidine as prophylaxis against PCP. Nonuniform
      deposition of aerosolized pentamidine was probably responsible for this atypical
      radiographic appearance of PCP.

PMID- 2237562
TI  - Achromobacter xylosoxidans: a drug-resistant pathogen in newborns and
      immunocompromised patients.

PMID- 2237563
TI  - Postural hypotension: pressor effect of octreotide not mediated by
      norepinephrine.
AB  - Orthostatic hypotension of the Shy-Drager syndrome is a chronic incapacitating
      condition characterized by lack of an appropriate increase in the plasma
      norepinephrine level in response to standing. Recently, the somatostatin analogue
      octreotide has been reported to induce a pressor response in patients having this
      syndrome. We have reported a case of Shy-Drager syndrome in which octreotide was
      effective, but the rise in blood pressure was not accompanied by an increase in
      the plasma norepinephrine level. Hence, the pressor effect of octreotide is not
      mediated by stimulation of the sympathetic nervous system, but probably through
      splanchnic vasoconstriction.

PMID- 2237564
TI  - Synchronous Hodgkin's disease and myelofibrosis terminating with granulocytic
      sarcoma and acute megakaryocytic leukemia.
AB  - Our patient had stage IIIAI Hodgkin's disease with synchronous myelofibrosis and
      myeloid metaplasia. A slowly progressive myeloproliferative disease developed
      over 9 1/2 years and terminated in a painful osteolytic bone disease, spinal
      extradural granulocytic sarcoma and acute megakaryocytic leukemia. It is likely
      that this was a result of the myeloproliferative disease rather than a late
      complication from combination chemotherapy. Our case demonstrates the importance
      of a curative approach to Hodgkin's disease even in the face of a coexistent
      disease with a long or unknown natural history.

PMID- 2237565
TI  - Cytophagic histiocytic panniculitis evolving into total lipodystrophy.
AB  - A 15-year-old boy had persistent fever with severe neutropenia, thrombocytopenia,
      coagulation disorder, and marked elevation of lactate dehydrogenase values. A
      diagnosis of cytophagic histiocytic panniculitis was made after repeated skin
      biopsies. Three years after onset, he gradually lost 20 kg in body weight, and
      both skin and bone marrow specimens revealed degenerative changes of fatty tissue
      without any inflammatory cells. These findings suggest that total lipodystrophy
      syndrome results from the inflammatory destructive process of adipose tissue. To
      our knowledge, our report is the first to show, in a series of histologic
      studies, that an inflammatory destructive process may be involved in some cases
      of total lipodystrophy syndrome.

PMID- 2237566
TI  - Isolated erythroid hypoplasia and renal insufficiency induced by long-term
      griseofulvin therapy.
AB  - We describe a patient with hematuria, pyuria, eosinophiluria, decreased renal
      function, and severe anemia that developed while she was receiving chronic
      therapy with griseofulvin for onychomycosis. We offer evidence that griseofulvin
      can cause an isolated erythroid hypoplasia and possibly an allergic interstitial
      nephritis. This is the first documented case of the above entities induced by the
      agent. We would recommend, based on our report, that otherwise healthy patients,
      when maintained on the drug for extended periods of time, have periodic
      determinations of renal function and hematologic status. As drug-induced
      erythroid hypoplasia typically occurs after a relatively long period of dosing,
      it may be prudent in certain individuals to monitor the CBC at approximately
      bimonthly intervals after initiation of therapy. Recommendations regarding
      monitoring of renal function are more difficult, as acute allergic interstitial
      nephritis can occur after either short- or long-term exposure to certain drugs.

PMID- 2237567
TI  - Hypercalcemia as a clinical prodrome to lymphoma.
AB  - A 73-year-old man was admitted for evaluation of unexplained hypercalcemia and
      was found to have a large-cell non-Hodgkin's lymphoma with stage IV disease.
      Treatment with cyclophosphamide, doxorubicin (Adriamycin), vincristine sulfate,
      and prednisone chemotherapy returned his calcium levels to normal. Hypercalcemia
      with lymphoma is rare, and persistent evaluation for malignancy is essential.

PMID- 2237568
TI  - Arteriovenous malformation of the tongue.
AB  - Polyvinyl alcohol particles used to embolize an arteriovenous malformation of the
      tongue were only temporarily successful. Additional embolization therapy was
      necessary and was complicated by ischemic ulcers of the tongue. We conclude that
      embolization therapy can be used, but the efficacy of this therapy in the longer
      term remains to be determined.

PMID- 2237569
TI  - Pseudohypoglycemia in adult victims of adolescent incest.
AB  - Two patients with complaints of hypoglycemia came for evaluation, and both
      complained of intermittent episodes of mental dullness, disorientation,
      confusion, and palpitations relieved by eating. Plasma glucose levels at the time
      of symptoms were always above 70 mg/dL. Initial onset of symptoms was within 1 to
      2 years after cessation of repeated incest, and on recognition of this, both
      patients associated the onset of episodes of similar feelings with the acts of
      incest. Recognition of this connection did not decrease the frequency of
      episodes. Both persistently refer to the episodes as "hypoglycemia" despite
      recognition that no glucose level below 70 mg/dL has been recorded during an
      episode. Recurrent episodes of derealization and depersonalization in both
      patients appear to be sequelae of adolescent incest experiences, but these
      patients cling to the label "hypoglycemia," perhaps in part because they are
      unwilling to accept a psychiatric diagnosis for their episodes.

PMID- 2237570
TI  - Neurologic abnormalities in a patient with human ehrlichiosis.
AB  - Human ehrlichiosis is a tick-borne rickettsial disease characterized by fever,
      headache, myalgias, anorexia, and occasionally rash. In our patient, changes in
      mental status, upper motor neuron signs, cerebrospinal fluid pleocytosis, and
      increased serum protein levels were found in association with serologically
      confirmed ehrlichiosis and were most likely due to vasculitis involving the
      central nervous system. Intraleukocytic inclusions, although observed in our
      case, have been infrequently found in other reported cases of ehrlichiosis.

PMID- 2237571
TI  - Acute obstructive jaundice in the multiple trauma patient.
AB  - The appearance of acute jaundice in the multiple trauma patient may result from
      obstruction of the common bile duct by clot. Management of this problem may be
      hindered by a delay in diagnosis, especially where alterations in pigment load
      and hepatic clearance may have produced the jaundice. A high index of suspicion
      combined with the judicious use of various noninvasive imaging modalities may be
      helpful in making the diagnosis. The progression of jaundice in a patient
      suspected of having acute obstructive hemobilia should prompt rapid operative
      intervention. At laparotomy, cholangiography or common bile duct exploration
      should be done. Persistent bleeding should be managed initially with angiographic
      localization and transcatheter embolization; its failure would necessitate
      surgical control of the source.

PMID- 2237572
TI  - Traumatic diaphragmatic hernia and intestinal obstruction due to penetrating
      trunk wounds.
AB  - We have reported two cases of intestinal obstruction due to traumatic
      diaphragmatic hernia, both resulting from apparently trivial knife wounds. When
      TDH is due to a penetrating injury, it tends to produce symptoms of intestinal
      obstruction. A high index of suspicion, a chest x-ray film, and barium studies of
      the gastrointestinal tract are usually needed to make the diagnosis, though CT
      scans, ultrasonography, laparoscopy, and radionuclide scanning may also be
      useful. Surgeons and emergency physicians should be aware of the potential for
      TDH when there is a history of a penetrating wound of the chest or abdomen.

PMID- 2237573
TI  - Adenocarcinoma of the appendiceal stump.
AB  - We have reported the case of a 58-year-old woman with nonspecific abdominal
      complaints in whom barium enema and subsequent colonoscopy showed a 3 cm
      lobulated adenocarcinoma within a villous adenoma arising from the appendiceal
      stump. Because such appendiceal malignancies have no specific clinical signs,
      symptoms, or radiologic features, preoperative diagnosis is extremely difficult,
      and colonoscopy may be required to clarify radiologically demonstrated
      irregularities.

PMID- 2237575
TI  - Left ventricular pseudoaneurysm complicating mitral valve replacement in a 4-year
      old child with acute bacterial endocarditis.
AB  - A 4-year-old child with acute bacterial endocarditis required mitral valve
      replacement. A left ventricular pseudoaneurysm developed following surgery. The
      etiology and diagnosis of this complication are discussed.

PMID- 2237574
TI  - Trabecular or Merkel's cell carcinoma.
AB  - Two cases of trabecular cell carcinoma of the skin are presented. The clinical
      presentation and behavior, and the histologic findings, of the tumor are
      described. Surgical excision of the primary lesion with regional lymph node
      dissection, if indicated, is the treatment of choice. Distant metastasis is
      treated by local irradiation.

PMID- 2237576
TI  - Peripartum myocardial infarction from presumed Kawasaki's disease.

PMID- 2237577
TI  - Adenocarcinoma of the colon occurring with intussusception in an adolescent.
AB  - Hydrostatic reduction of intussusception is definitive therapy in most infants
      with this abnormality. In the older child, adolescent, and adult, a polyp or
      tumor is often present. Operative intervention should be considered earlier in
      the clinical course both to relieve the intussusception and to define the nature
      of the lead point.

PMID- 2237578
TI  - Pleuropulmonary tularemia: successful treatment with erythromycin.
AB  - A 64-year-old man had community-acquired pneumonia that was retrospectively
      diagnosed as pleuropulmonary tularemia. He was successfully treated with
      erythromycin. We review the case and briefly discuss the literature on this
      point.

PMID- 2237579
TI  - Medicare and MAAC.

PMID- 2237580
TI  - Bad X-ray reports.

PMID- 2237582
TI  - Health status and urban poverty.

PMID- 2237581
TI  - Atenolol and retroperitoneal fibrosis.

PMID- 2237583
TI  - Molecular technology: improving strategies for controlling hydatid disease and
      cysticercosis.
AB  - Recombinant DNA and related technologies are providing valuable, novel reagents
      for application in control strategies against the major parasitic diseases,
      including hydatid disease and cysticercosis. The impact of these powerful
      techniques for improving diagnosis and identification of various life cycle
      stages of Echinococcus spp. and Taenia solium, essential pre-requisites for
      epidemiological studies and for evaluating control programs, is beyond question.
      Furthermore, the use of molecular technology for characterizing sub-specific
      variants of strains of both Echinococcus and T. solium has led to important
      revisions of our understanding of the diseases they cause. In light of the recent
      remarkable development of a recombinant vaccine against T. ovis, the first
      practical parasite vaccine to be produced, the prospects for rapid development of
      similar vaccines against the medically important taeniids appear to be very
      encouraging.

PMID- 2237584
TI  - Epidemiological study of sulfonamide and trimethoprim resistance genes in
      Enterobacteriaceae.
AB  - Sulfonamide (Su) and trimethoprim (Tp) resistance are known to caused by the
      production of drug resistant dihydropteroate synthase (DHPS) and dihydrofolate
      reductase (DHFR), respectively. Sulfonamide and trimethoprim are often used in
      combination under the name cotrimoxazole. Cotrimoxazole resistance in various
      enteric bacteria isolated at Ramathibodi Hospital was studied. The rate of
      resistance from 1984-1989 of many genera was rather constant at 40%-60% except in
      Shigella spp in which the rate increased rapidly in 1987 till 1989. Seventy-five
      percent of Su-Tp resistant (Sur-Tpr) bacteria were also found to be resistant to
      other drugs such as ampicillin, aminoglycosides, tetracycline and chloramphenicol
      in addition to cotrimoxazole. Two hundred and forty Su-Tp resistant strains were
      analysed for the presence of type I and II dihydropteroate synthase as well as
      type I and V dihydrofolate reductase genes by hybridization with the
      corresponding gene probes. Type I DHPS gene predominated in Su-Tp resistant
      bacteria at 60.8% whereas type II DHPS was found in only 25%. Some strains
      (11.7%) had both genotypes but 2.5% did not have any. In the trimethoprim
      resistance study, the DHFR type I gene was also found more frequently (30%)
      whereas type V DHFR was only 19%. The remaining of Tp resistance (51%) was
      unclassified. The coexistence of Su and Tp resistance genes of each type was
      investigated among 118 Su and Tp resistant strains. It was found that type I DHPS
      gene was found together with either type I or V DHFR gene and type II DHPS was
      found with type I DHFR gene at about the same rate (28.9%, 27.1% and 26.3%,
      respectively). However, the presence of type II DHPS together with type V DHFR
      was rather low, only 5.9% of isolates were found to have both types of genes.

PMID- 2237585
TI  - Drug resistance of Haemophilus ducreyi.
AB  - Chancroid, the disease caused by H. ducreyi is one of the common sexually
      transmitted diseases (STD) in Thailand and other tropical countries. In Thailand,
      the diagnosis of chancroid is still based on clinical appearance which may be
      confused with other STD manifested by genital ulcers. In recent years the
      increasing resistance strains of H. ducreyi to these antimicrobial agents has
      been reported so that cultivation and antimicrobial susceptibility tests of this
      organism have become more important. This study showed that MBV is the best
      medium for isolation with a success rate of 48%. All strains tested from isolates
      of this study were resistant to ampicillin, due to production of beta-lactamase.
      Approximately 99% of the strains were resistant to tetracycline 92% of strains
      were resistant to sulfamethoxazole and 32% were resistant to trimethoprim. All
      isolates were susceptible to chloramphenicol, ceftriaxone, erythromycin and the
      fluorinated quinolones ciprofloxacin, norfloxacin, ofloxacin and pefloxacin. Beta
      lactamase enzymes produced by 37 strains of H. ducreyi were determined for their
      isoelectric point (pI). All had pI of 5.4, indicative of plasmid-mediated beta
      lactamase type TEM-1.

PMID- 2237586
TI  - Haemophilus influenzae and Streptococcus pneumoniae in children with acute
      respiratory infection.
AB  - The incidence of Haemophilus influenzae and Streptococcus pneumoniae in children
      with acute respiratory infection (ARI) under 5 years was carried out by throat
      swab culture, blood culture, body fluid or tissue culture in 688 patients from a
      community, 744 patients from a teaching hospital in Bangkok, 766 normal children
      from the community and 303 children from a hospital well baby clinic. H.
      influenzae was found in the throats of 15-20% of patients and in the throats of 4
      6% of normal children (p less than 0.001 for both hospital and community
      patients). Only 12/332 strains (3.6%) of H. influenzae were type b. The rest of
      H. influenzae were non type b. The most common biotype of H. influenzae non type
      b was biotype II. S. pneumoniae was found in hospital patients in highly
      significant numbers compared to the controls (12% vs 4%). No significant
      difference was observed in strains from the community patients.

PMID- 2237587
TI  - The use of a coagglutination test to presumptively identify Salmonella typhi in
      bone marrow-oxgall medium cultures from typhoid fever patients.
AB  - A study was conducted to test a coagglutination procedure for detection of
      Salmonella typhi in bone marrow cultures from suspected typhoid patients admitted
      to Friendship Hospital, Jakarta, Indonesia. The results of the coagglutination
      tests were compared to the results from standard cultural isolation and
      identification. Bone marrow aspirates (356) were cultured in oxgall medium and
      aliquots subcultured daily for 7 days while simultaneously testing for the
      presence of Salmonella group D and Vi antigens using coagglutination (COAG). S.
      typhi was isolated from 220 (62%) of the cultures and the D- and Vi-COAG tests
      were positive for those same cultures. The COAG test was also negative for 6
      cultures containing S. paratyphi A. The COAG results were available within 10
      minutes after 18 to 24 hours incubation of the primary cultures whereas the
      isolation and confirmed identification took 2 to 3 days longer. The COAG test is
      valuable as an aid to rapidly identify S. typhi in bone marrow-oxgall cultures.

PMID- 2237588
TI  - Prevalent serogroups and antimicrobial susceptibility of Shigella strains in
      Metro Manila, 1982-1988.
AB  - From 1982 to 1988, Shigella was detected in 4% of stool specimens cultured at The
      Research Institute for Tropical Medicine (RITM), Manila. S. flexneri was the most
      prevalent serogroup with 2a, 1b and 1a as the predominant serotypes. Isolation
      was most frequent during the July to December period. Drug resistance was most
      often observed in S. flexneri with serotype 2a exhibiting resistance to the
      combination of ampicillin, chloramphenicol, tetracycline and streptomycin. More
      multiple-drug than single-drug resistant strains were observed for the last four
      years. Ampicillin is still the most frequently used drug for most forms of
      shigellosis in the Philippines. However, the demonstration of increasing
      resistance among the isolates studied in RITM underscores the need to monitor
      antibiotic susceptibility studies and document the emergence of resistant strains
      in the entire country.

PMID- 2237589
TI  - Occurrence of beta-hemolytic streptococcus group G in school children and sick
      children.
AB  - We studied the occurrence of Streptococcus group G in throat cultures obtained
      from school children of poor socioeconomic status and in sick children brought to
      our hospital. The results revealed a high occurrence of group G Streptococci (44%
      and 91.5% respectively) in cases positive for beta-hemolytic Streptococci.

PMID- 2237590
TI  - Relationship of vibriocidal antibodies to history of cholera vaccination in Thai
      adult volunteers.
AB  - Vibriocidal antibodies were determined by microtechnique in 5 groups of Thai
      adult volunteers who had never received or had received cholera vaccination
      within one year, more than one to five years ago, more than five to ten years ago
      and more than ten years ago respectively. Detailed questionnaires about
      socioeconomic status, educational levels and environmental factors were presented
      to every volunteer. There were no differences statistically in incomes,
      educational levels and environmental factors among the groups. It was found that
      the reciprocal geometric mean titers of antibodies in volunteers who had never
      received cholera vaccination was generally low. The reciprocal geometric mean
      titers of the volunteers who had received cholera vaccination within one year
      were statistically different from other groups (p = 0.05). There was no
      correlation between blood groups of volunteers and vibriocidal antibodies.

PMID- 2237591
TI  - The species of green pit viper in Bangkok.
AB  - The aims of this study were to delineate the species of Green pit viper and
      clinical patterns in Bangkok areas. This study was a blind independent
      comparison. Among 188 Green pit vipers collected only two species, i.e.
      Trimeresurus alborabris and T. macrops were found. There were no differences in
      snake sizes and in clinical patterns of snake bite. The majority of the clinical
      cases (90.1%) was classified as of mild degree of severity and severe
      envenomation was observed only in T. alborabris victims. The ratio between T.
      alborabris and T. macrops victims in Bangkok residents was 1.7:1 but the ratio
      was reversed in Thonburi residents.

PMID- 2237592
TI  - Characterization of a monoclonal antibody that neutralizes the hyaluronidase
      activity of Russell's viper venom.
AB  - Three monoclonal antibodies (WPN1, WPN2 and WPN3) raised against a partially
      purified fraction of Russell's viper venom (RVV) were characterized. All three
      monoclonal antibodies reacted with crude RVV when tested by ELISA, but only two
      (WPN1, WPN2) neutralized its hyaluronidase activity. WPN1 was the more potent and
      was effective at an antigen: antibody ratio of 1:3. Furthermore, WPN1 was shown
      to recognize only the 14,000 MW component of crude RVV. This has been identified
      in a previous study to be hyaluronidase. This antibody was also found to
      recognize some components of Calloselasma rhodostoma venom which also possesses
      potent hyaluronidase activity. The potential therapeutic role of antibodies that
      neutralize the hyaluronidase component of snake venoms should be investigated
      further.

PMID- 2237593
TI  - Competitive antibody binding inhibition ELISA for the detection of Plasmodium
      falciparum antigen.
AB  - A competitive antibody binding inhibition ELISA to detect Plasmodium falciparum
      infected cells in clinical specimens was developed. Optimum conditions developed
      included: 12.5 micrograms/ml of P. falciparum antigen for plate coating, 25
      micrograms/ml of polyclonal rabbit anti-P. falciparum IgG, 30 minute incubation
      of a mixture of infected red blood cell extract with anti-P. falciparum IgG,
      dilution of 1:500 of alkaline phosphatase-conjugated anti-rabbit IgG, and reading
      of the absorbance values 60 min after adding the p-nitrophenyl phosphate
      substrate. Reproducibility of the assay against cultured P. falciparum-infected
      red blood cells varied according to parasitemia, the higher the parasitemia, the
      better the reproducibility. The sensitivity of the assay was approximately 110
      parasites/10(6) red blood cells. The assay was applied to field conditions
      involving 103 cases with falciparum malaria, 38 cases with vivax malaria and 30
      healthy controls. With the 10% antibody binding inhibition as a cutoff, 87.4% of
      falciparum cases and 26.3% of vivax cases were positive. After treatment, the
      majority of cases became parasitologically negative with the corresponding
      negative assay. Regression analysis showed only weak but statistically
      significant correlation between the percent inhibition with parasitemia (r =
      0.38, p less than 0.001), and this was more clearly shown in patients with high
      parasitemia.

PMID- 2237594
TI  - Cardiac involvement in beta-thalassemia/hemoglobin E disease: clinical and
      hemodynamic findings.
AB  - Clinical and hemodynamic studies were conducted in 6 women and 2 men with beta
      thalassemia/hemoglobin E disease. All except one had splenectomy. The patients
      were hospitalized in the state of congestive heart failure. The systemic blood
      pressure was low or normal. The electrocardiograms revealed normal sinus rhythm
      in all, right axis deviation in some, right atrial enlargement in the majority
      and repolarization abnormalities in some. The echocardiograms were sensitive to
      detect the right heart abnormalities and pericardial effusion. Cardiac
      catheterization disclosed moderate to marked hypoxemia. All patients except one
      had pulmonary hypertension. Some had left ventricular dysfunction. From this
      study. It is concluded that right heart involvement secondary to diffuse
      pulmonary thromboembolic disease is a major complication of beta
      thalassemia/hemoglobin E disease.

PMID- 2237595
TI  - Fecal egg output in relation to worm burden and clinical features in human
      opisthorchiasis.
AB  - A study of the relation of fecal egg excretion to worm burden and clinical
      features was carried out in 45 opisthorchiasis patients who had no signs of
      biliary obstruction. The fecal egg excretion was consistent and correlated with
      the worm burden. Although there was no definite association between clinical
      signs and intensity of infection, mild hepatomegaly and thickened wall or
      dilatation of the gallbladder were found more commonly in heavily infected
      patients. Eosinophilia was observed more often than previous reports. Concomitant
      parasitic infections were found in 82% of the patients. After praziquantel
      treatment, egg counts increased greatly during the first few days then decreased
      to very low levels in 7 days.

PMID- 2237596
TI  - Isolation of indigenous larvicidal microbial control agents of mosquitos: the
      Malaysian experience.
AB  - A nationwide screening program searching for microbial control agents of
      mosquitos was initiated in Malaysia in 1986. A total of 725 samples were
      collected and 2,394 bacterial colonies were isolated and screened for larvicidal
      activity. From such screening, 20 Bacillus thuringiensis, 6 B. sphaericus, 1
      Clostridium bifermentans and 2 Pseudomonas pseudomallei larvicidal isolates were
      obtained. Of these, a new B. thuringiensis named as subspecies malaysianensis was
      found, while the C. bifermentans was also a new anaerobe individualized as
      serovar malaysia. It was concluded that this screening program was highly
      successful.

PMID- 2237597
TI  - Health status of children living in a squatter area of Manila, Philippines, with
      particular emphasis on intestinal parasitoses.
AB  - In 1988 a study was performed in a squatter area of Manila, Philippines. Three
      substudies were carried out: (1) an analysis of the reported health situation and
      the available health services for the population of Smokey Mountain, (2) a
      vaccination coverage survey and (3) a cross-sectional stool sample survey.
      Respiratory infections, diarrhea, measles and malnutrition were the most
      frequently reported causes of ill-health and death. Not only governmental but
      also various non-governmental health services have been developed over the last
      few years. Better coordination and cooperation between the various health care
      providers, furtherance of community participation, improvements in the
      performance of the community health volunteers and stronger emphasis on
      preventive health care (such as health education) are suggested. The vaccination
      coverage cluster survey performed among children aged 1-2 years revealed that 24%
      of the surveyed children were fully immunized and 19% not immunized at all. The
      drop-out rates of children vaccinated through non-governmental organizations were
      significantly lower than those of the children vaccinated through a governmental
      agency. The cross-sectional stool sample survey performed among 238 children aged
      8 months to 15 years revealed that 96% of the surveyed children were harboring
      intestinal parasites. Most common was Trichuris and Ascaris. The prevalence of
      hookworm was 10%, and those of Entamoeba histolytica and Giardia lamblia 21% and
      20%, respectively. Most children (84%) were affected by multiparasitism. The need
      to adapt the concept of Primary Health Care to the context of the urban poor and
      not only to provide health services but also to change social and economic
      conditions is emphasized.

PMID- 2237598
TI  - Sexual behavior of Filipino female prostitutes after diagnosis of HIV infection.
AB  - A study of female prostitutes in Manila who tested positive for human
      immunodeficiency virus (HIV) antibody ascertained demographic and sexual behavior
      information following diagnosis. Counselling alone did not appear to have a major
      impact on the sexual behavior of the HIV positive women since most continued to
      work as prostitutes. Switching from high risk to low risk jobs in bars is not
      effective in preventing HIV positive women from engaging in prostitution.
      Revoking work permits is only effective if enforced with adequate follow up.
      Alternative job training programs may offer a viable approach.

PMID- 2237599
TI  - Behavior of urban based child caretakers in the home treatment of diarrheal
      diseases.
AB  - Behaviors of low income urban mothers and child caretakers in the treatment of
      childhood less than 5 year diarrhea were analysed from a surveillance study
      conducted between August 1988 and July 1989. Help seeking behaviors of mothers
      and caretakers for 412 episodes of child diarrhea were as follows: investigators
      37.1%, drug stores 18.2%, wait and see or self treatment 17.0%, private clinics
      12.6%, near by hospital 10.2%, and local health center 4.9%. Major treatment
      practices included ORT alone (54%) and ORT plus antibiotics and/or antidiarrheal
      drug (22%). Overall ORT usage was 76%. Twelve percent of diarrheal episodes no
      treatment was given to the children. Antimicrobials were believed to be essential
      in addition to ORT especially when diarrhea was associated with fever, vomiting
      and bloody stools. Thirty-six percent of invasive diarrhea cases (Shigella,
      Salmonella, Campylobacter) were treated with antibiotics. Only 18.2% of
      noninvasive diarrhea received antibiotics, most of this antibiotic use being in
      rotavirus diarrhea where vomiting and some fever are prominent. Availability of
      oral rehydration salts (ORS) and good experience with ORT were the key to the
      extensive use or ORT in this study. A surprisingly small number of mothers and
      child caretakers (4.9%) sought help from the local health center when their
      children had diarrhea.

PMID- 2237600
TI  - Acquired aplastic anemia in children: a review of 100 patients.
AB  - A retrospective study of acquired aplastic anemia in 100 Thai children treated
      with testosterone and prednisolone during 1969 to 1987 is reported. The age
      ranged from 3-14.5 years (mean 10.3 years). The male to female ratio was 2.3:1.
      The duration of follow up ranged from 1-17 year (mean 5 years). Prior exposure to
      possible etiologic agents was found in 36% : antipyretics, Ya-chood,
      insecticides, benzene, chloramphenicol and paint. The presenting symptoms were
      bleeding and anemia 72%, fever with either bleeding or anemia 28%. The common
      sites of bleeding were purpura, epistaxis, gum and teeth, and the
      gastrointestinal tract. All patients received appropriate supportive treatment
      and testosterone combined with prednisolone. The results of treatment were
      evaluated in 80 cases who were followed up until death or at least one year after
      the diagnosis. Two-thirds of the patients presented with laboratory findings
      similar to severe aplastic anemia; the fatality rate was 50% (40/80). Most of
      them succumbed to infection or bleeding in the first 6 months after diagnosis.
      The recovery rate was 50% with complete, partial and initial responses in 28%,
      17% and 5% respectively. The late malignancy rate was 2%. For severe aplastic
      anemia or for patients who have poor prognostic factors, early approaches of bone
      marrow transplantation or antilymphocyte globulin administration should be
      considered.

PMID- 2237601
TI  - Giardiasis coinciding with cryptosporidiosis in an immunocompetent patient with
      protracted watery diarrhea.

PMID- 2237602
TI  - Immune function in a case of endemic malaria with sinus histiocytosis with
      massive lymphadenopathy.

PMID- 2237603
TI  - Self-esteem and depression. II. Social correlates of self-esteem.
AB  - The Self-Evaluation and Social Support Schedule (SESS), an interview-based
      instrument, is described, which aims to give a comprehensive description of a
      person's social milieu in terms of 'objective' and 'subjective' measures. On the
      basis of a population survey of 400 largely working-class women, a tentative
      causal model is developed which relates both the quality of current interpersonal
      ties and childhood experiences to current negative and positive measures of self
      esteem. A major purpose of the exercise is to develop positive and negative
      indices of the social environment that can be used to elucidate the aetiological
      role of self-esteem in the development of depression. This is the task of a third
      paper.

PMID- 2237604
TI  - Self-esteem and depression. III. Aetiological issues.
AB  - This is the last of a series of three papers dealing with the role of self-esteem
      in the onset of clinical depression. On the basis of a longitudinal population
      enquiry a comprehensive psychosocial model of depression is developed. It is
      concluded that self-esteem (primarily in terms of a negative measure) does play a
      significant role. However, this can be only properly interpreted in the light of
      the full model. This highlights: 1. the importance of the occurrence of both a
      negative environmental factor (negative interaction with children or husband for
      married or negative interaction with children or lack of a very close tie for
      single mothers) and a negative psychological factor (low self-esteem or chronic
      subclinical condition); and 2. how a relatively small group of high risk women in
      these terms (23% of total at risk based on measures collected well before any
      onset) contain three-quarters of all instances of onset of depression occurring
      over a 12 month period.

PMID- 2237605
TI  - Self-esteem and depression. IV. Effect on course and recovery.
AB  - The present paper, the fourth and last in a series examining the role of self
      esteem in depressive disorder in the general population, deals with
      recovery/improvement from a disorder at a case level. Both positive evaluation of
      self (PES) and absence of negative evaluation of self (NES) measured during a
      chronic episode are related to subsequent recovery or improvement. A causal
      effect is suggested since the measure adds over and above to that of
      environmental factors previously established to relate to recovery/improvement-
      the reduction of an ongoing difficulty or fresh-start event. Positive evaluation
      of self was also related to recovery/improvement from subsequent onsets of case
      depression. In this instance, unlike that for the chronic conditions, self-esteem
      was measured outside the episode of depression. A causal effect was also
      suggested because it made an independent contribution vis-a-vis the effect of
      fresh-start events. Given the small size of the sample the study should be seen
      as an exploratory one.

PMID- 2237606
TI  - The Mannheim Interview on Social Support. Reliability and validity data from
      three samples.
AB  - Social support questionnaires usually provide scant information about the members
      of supporting networks, while network-analytical approaches often fail to
      sufficiently detail the functional aspects of social support available to an
      individual. A structured interview, the "Mannheim Interview on Social Support"
      (MISS) is presented which combines the advantages of both approaches by mapping
      an individual's social resources in a "support matrix" of [network members] *
      [relationship characteristics + support functions]. Stability and validity data
      collected in three different samples (discharged depressed in-patients,
      university students, and parents of children afflicted with cancer) are reported.
      Test-retest correlations are compared with alternative measures of stability, and
      the relationship of various MISS scores to scores based on conceptually related
      instruments is explored. The results indicate good test-retest stability of the
      main functional and structural MISS scores rtt = 0.66 to 0.88 for a four-week
      interval, and rtt = 0.42 to 0.79 for a six-month-interval). It is shown that the
      MISS captures several dimensions of a person's social support environment not
      covered by questionnaires targeting subjective perceptions of support.

PMID- 2237607
TI  - Depression among Cuban Americans. The Hispanic Health and Nutrition Examination
      Survey.
AB  - This paper presents the findings on depressive symptomatology and major
      depressive disorder in Cuban American respondents to the Hispanic Health and
      Nutrition Examination Survey (HHANES). The HHANES represents the first population
      based assessment of the mental health status of Cuban Americans. High levels of
      depression, as measured by a CES-D score of 16 or more, were found in ten percent
      of the sample. Female gender was independently associated with CES-D caseness.
      The lifetime, six-month, and one-month prevalence rates of major depressive
      disorder, as measured by the National Institute of Mental Health Diagnostic
      Interview Schedule (DIS), were 3.15%, 2.12%, and 1.50%, respectively. An income
      level of less than ten thousand dollars was independently associated with a
      lifetime diagnosis of major depression.

PMID- 2237608
TI  - A reanalysis of the impact of non celebrity suicides. A research note.
AB  - Previous work on suicide and the media has neglected theoretical issues. Some
      work has implied that only celebrity suicides can be expected to trigger
      additional suicides in the real world. The present study focuses on non celebrity
      suicides. Correcting coding errors in a previous work, it finds that the suicides
      of non celebrities are associated with increases in the national suicide rate. An
      index of publicized celebrity suicide stories was, however, more closely
      associated to increases in suicide than the publicized non celebrity stories. The
      model explains 90 percent of the variance in monthly suicide rates.

PMID- 2237609
TI  - Time-series analyses of the American suicide rate.
AB  - A time-series study of suicide in the USA from 1940 to 1984 explored the extent
      to which social and economic variables could predict the actual suicide rate, the
      smoothed trend in the suicide rate, and deviations of the actual suicide rate
      from the smoothed trend. It was found that the social and economic variables were
      more successful in predicting the smoothed trend in the suicide rate.

PMID- 2237610
TI  - The GHQ-12 as a screening tool in a primary care setting.
AB  - The performance of the 12-item General Health Questionnaire (GHQ) was tested
      against a modified version of a structured diagnostic interview for making DSM
      III-R diagnoses, the Composite International Diagnostic Interview (CIDI), in a
      population of 787 primary care patients, 214 of whom were interviewed. The Yoruba
      versions of both instruments were found to be feasible in this setting and the
      inter-rater reliability of the CIDI was good. The GHQ-12 showed a sensitivity of
      68% and a specificity of 70% when only cases meeting the criteria for specific
      DSM III-R disorders were considered. The sensitivity was better for certain
      individual disorders and the overall performance was marginally improved when
      scoring was made according to the revised method proposed by Goodchild and Duncan
      Jones.

PMID- 2237611
TI  - [Complex automatic data processing in multi-profile hospitals].
AB  - The computerization of data processing in multi-disciplinary hospitals is the key
      factor in raising the quality of medical care provided to the population,
      intensifying the work of the personnel, improving the curative and diagnostic
      process and the use of resources. Even a small experience in complex
      computerization at the Botkin Hospital indicates that due to the use of the
      automated system the quality of data processing in being improved, a high level
      of patients' examination is being provided, a speedy training of young
      specialists is being achieved, conditions are being created for continuing
      education of physicians through the analysis of their own activity. At big
      hospitals a complex solution of administrative and curative diagnostic tasks on
      the basis of general hospital network of display connection and general hospital
      data bank is the most prospective form of computerization.

PMID- 2237612
TI  - [Problem of methodology of evaluation of the quality of public health].
AB  - The basic general methodological assessments of public health quality are
      considered. An analogy is drawn with quality assessment in industry, approaches
      to the development of multi-aspect and multi-parameter assessment of public
      health quality are substantiated. A term of "qualimetry " of public health is
      suggested.

PMID- 2237613
TI  - [Sociological study of the quality of medical services].

PMID- 2237614
TI  - [Educational status and life expectancy].
AB  - The article provides a foundation for the necessity of studying the social
      differentiation of mortality, in particular the influence of educational status
      and character of labour on length of life. It is indicated that higher indices of
      length of life are found among populations with high educational status and among
      people engaged in intellectual pursuits. The description is given of the
      methodological approaches to the construction of life expectancy tables according
      to the educational status and character of labour.

PMID- 2237615
TI  - [Improving the teaching of social hygiene and public health administration].

PMID- 2237616
TI  - [Planning of sampling studies of morbidity and hospitalization at large
      territories].
AB  - This paper provides the methodological principles of planning sample survey of
      hospital morbidity of population at the level of large economic regions and the
      republic at large. Proceeding from the example of socio-hygienic study of burn
      injuries requiring hospital treatment, and organization of hospital care for the
      burned, the methods of elaborating the principles of sample surveys, the use of
      stratified cluster selection with optimum placing of sample units are described.
      The methodological scheme permits to minimize the size of the sample and to
      obtain representative evaluations of the needed indices at large territories.
      While studying 23 sample units from 796 formed in the republic, evaluations of a
      number of indices were obtained which virtually coincided with the indices
      calculated according to the total data reported.

PMID- 2237617
TI  - [Definition of the concept of "health-related activity"].

PMID- 2237618
TI  - [Health of young people].

PMID- 2237619
TI  - [Use of the main component method in complex socio-hygienic study of life style
      and health status of workers' families].
AB  - On the basis of the survey of 350 families an analysis is made of the impact of
      some particular living conditions and mode of life on the families health by
      using the method of main components. This made it possible to range the factors -
      the main components according to the degree of their influence and to single out
      the leading ones in the formation of health. The analysis indicated that more
      than a half of contribution to the general dispersion of the internal structure
      of health phenomenon of family members is made by lifestyle factors.

PMID- 2237620
TI  - [Use of computers in preparing the data regarding morbidity with temporary
      disability].
AB  - The use of "Iskra-1256", "Iskra-1030" and other kinds of computers provide a
      scientific and valid foundation for solving the problem of health-promoting
      activities among workers of timber enterprises. The findings of the study
      indicate that each timber enterprise has its own distinctive features, working
      and living conditions, organization of industrial process which determines the
      main causes of diseases. The complex approach to the evaluation of morbidity
      should provide the basis for the planing and distribution of financial resources
      for occupational safety and workers' health protection, placing of personnel and
      medical facilities.

PMID- 2237621
TI  - [Experience of medical institutes with the training in the field of general mass
      screening].

PMID- 2237622
TI  - [Strokes to the portrait of N.A. Semashko].

PMID- 2237623
TI  - [Physician-revolutionary V.M. Bogutskii (1871-1929)].

PMID- 2237624
TI  - 1990 Volvo Award in clinical sciences. The consistency and accuracy of
      roentgenograms for measuring sagittal translation in the lumbar vertebral motion
      segment. An experimental model.
AB  - An experimental model of the L4-L5 lumbar motion segment was developed that
      allowed precise manipulation of sagittal translation, rotation of L5 relative to
      L4, tilt of L4 on L5, and control of roentgenogram quality (image clarity) by
      placing a water bath between the tube and the vertebral body. A series of
      experiments were designed to systematically assess the consistency and accuracy
      of sagittal translation measurements from roentgenograms of varying quality,
      using different measurement protocols and various rater combinations on models
      with varying degrees of concomitant motions (rotations and tilts). Study 1
      assessed the effects of roentgenogram quality, raters, and seven measurement
      methods on the consistency and accuracy of evaluating translations in the
      sagittal plane. Results indicated very high reliabilities across roentgenogram
      quality, raters, and measurement. As expected, high-quality roentgenograms were
      more accurately evaluated than lower-quality roentgenograms. However, closer
      inspection of the consequences of errors in measured translations indicated
      surprisingly high false-positive and false-negative rates, with significant
      differences observed between measurement methods. Study 2 assessed the effects of
      concomitant motions and measurement methods on the consistency and accuracy of
      evaluations. Within-rater consistency and accuracy indices were remarkably high
      and similar across measurement methods and degrees of concomitant motions.
      However, important differences in the false-positive and false-negative rates
      were again observed. Method 2, described by Morgan and King, demonstrated the
      overall best performance and the least interference due to concomitant motions.
      Study 3 assessed the effects of raters and measurement methods on the consistency
      of measuring translation in clinical roentgenograms, where concomitant motion
      factors may be present, but not explicitly considered. Results indicated
      substantially lower within- and between-rater consistency estimates relative to
      consistencies obtained from the model, although these magnitudes were similar to
      those reported by others evaluating clinical roentgenograms. The implications of
      lower consistency estimates relative to increased false-positive and false
      negative rates must be more closely examined. These studies present evidence
      suggesting that high consistency and accuracy indices do not ensure acceptable
      false-positive and false-negative rates and, thus, provide empirical evidence
      supporting the view that using roentgenograms as a basis for diagnosing
      instability often can lead to errors in classification. This is less so when
      observed translations are relatively large (+/- 5+ mm) on roentgenograms that are
      relatively clear, with little obliquity, and when concomitant motions are
      minimal.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2237625
TI  - 1990 Volvo Award in experimental studies. The dependence of intervertebral disc
      mechanical properties on physiologic conditions.
AB  - In vivo creep-recovery and disc pressure measurements were performed on the
      lumbar spine of immature and mature swine. The creep-recovery measurements were
      performed using a custom materials testing apparatus designed to apply static or
      dynamic loads to the spine of anesthetized animals. A series of three separate
      experiments were performed to assess the effects of: (I) animal death, (II)
      graded injury to the disc anulus, and (III) respiratory mechanics on the
      biomechanical response of the porcine L1-L3 vertebral unit (VU). In Experiments I
      and II, creep rate, modulus, and viscosity parameters were computed using a three
      parameter solid rheological analysis of the displacement-time response recorded
      during the application of a 300-N load. In Experiment III, the effects of
      respiratory volume and frequency changes on disc pressure were assessed in the
      unloaded, statically loaded, and immobilized porcine VU. Our results indicated
      that the adult VU tended to be stiffer, deform or creep more slowly, and had a
      significantly higher viscosity than the VU of immature pigs. The results of
      Experiment I demonstrated that the biomechanical response for the VU was
      significantly altered by the death of the animal; the VU of the living animal
      (adolescent or mature) was more compliant and deformed at a faster rate than the
      VU of the same animal after death. Disc injury produced changes in stiffness,
      viscosity, and creep rate analogous to that of aging, and on the basis of the
      graded injuries created in this study, it appears that a small defect in the
      annulus is just as deleterious as removing a large section of anular material.
      The results of Experiment III indicated that respiration plays an important role
      in the normal, in vivo mechanical and nutritional behavior of the porcine VU.
      Altogether, these results demonstrate that, in the absence of normal physiologic
      conditions, one may not be able to reliably predict the mechanical response of
      the lumbar spine, and suggest that standards for the testing, handling, and
      storage of biologic tissue should be established.

PMID- 2237626
TI  - 1990 Volvo Award in experimental studies. Anulus tears and intervertebral disc
      degeneration. An experimental study using an animal model.
AB  - An animal model was developed to test the hypothesis that discrete peripheral
      tears within the anulus lead to secondary degenerative changes in other disc
      components. In 21 adult sheep, a cut was made in the left anterolateral anulus of
      three randomly selected lumbar discs. The cut was parallel and adjacent to the
      inferior end-plate, and had a controlled depth of 5 mm. This left the inner third
      of the anulus and the nucleus pulposus intact and closely reproduced the rim Lear
      lesion described by Schmorl. Animals were randomly allocated to different groups
      in relation to the length of time interval between operation and death, varying
      from 1 to 18 months. At death, the lumbar spine was cut into individual joint
      units and each disc sectioned into six parasagittal slabs. After observation of
      the slabs under the dissecting microscope, two of the six slabs, the one
      containing the anulus lesion and a contralateral, were processed for histology.
      The results of this study suggest that, despite the great care taken at operation
      to ensure that the inner anulus was left intact, progressive failure of the inner
      anulus was seen in all sheep and occurred in the majority of discs between 4 and
      12 months after the operation. Although the outermost anulus showed the ability
      to heal, the defect induced by the cut led initially to deformation and bulging
      of the collagen bundles, and eventually to inner extension of the tear and
      complete failure. These findings suggest that discrete tears of the outer anulus
      may have a role in the formation of concentric clefts and in accelerating the
      development of radiating clefts. Peripheral tears of the anulus fibrosus
      therefore may play an important role in the degeneration of the intervertebral
      joint complex.

PMID- 2237627
TI  - The loads on the lumbar spine during work at an assembly line. The risks for
      fatigue injuries of vertebral bodies.
AB  - This study was performed in an attempt to determine the total spinal compressive
      load during assembly line work to find a possible association with the many
      complaints of back pain. A flexion analyzer was used to register trunk movements,
      and analysis of postures and lifted weights was done from video recordings. The
      load on the spine at the L3 level was calculated through a biomechanical model,
      meant for analysis of static, sagittally symmetric postures and lifting tasks.
      Maximum lift tests were performed before and after a full work day. The peak load
      on the L3-L4 level when lifting corresponded to an average 22% of the load at the
      lift test. The mean load during a work cycle was 818 N. It was concluded that the
      many complaints of back pain could not be attributed to high peak loads,
      repetitivity of the lifts, or large load doses. Monotony, stress, and low job
      satisfaction are more likely factors of greater importance.

PMID- 2237628
TI  - Comparison of structure, mechanical properties, and functions of lumbar spinal
      ligaments.
AB  - The organization of collagen in the supraspinous, interspinous, and longitudinal
      ligaments, as well as the ligamenta flava, in lumbar spines from human cadavers
      has been investigated by polarized light microscopy, scanning electron
      microscopy, and x-ray diffraction. These experiments were performed on ligaments
      in situ, with their bony attachments undisturbed, and on excised ligaments at a
      range of applied strains. Results were related to the composition (investigated
      by standard histologic techniques) and gross structures (investigated by light
      microscopy) of the ligaments. More importantly, the results were related to the
      mechanical properties of the ligaments, which include stiffness, failure
      conditions, stress relaxation, and hysteresis. Where necessary, results were
      supplemented by or compared with those obtained from pig ligaments. Mechanical
      properties were related to postural changes by ligament strains induced in
      cadaveric specimens, using results from the literature. Thus, ligament structures
      could be related to their physiologic functions.

PMID- 2237629
TI  - Computer-assisted tomography of scoliosis operated with or without Harrington's
      rod. Biomechanics aspects of the fusion.
AB  - Forty-eight cases of posterior vertebral arthrodesis for scoliosis, performed
      with or without instrumentation, were examined using computed tomography (CT)
      scanning to study the evolving fusion mass. The authors observed that the fusion
      mass area is more voluminous in the cases performed without instrumentation than
      in the ones performed with instrumentation, and that 2 years after fusion the
      bone mass shows already a considerable increase. For the cases operated with
      Harrington's technique, the increase of the fusion mass is very slow and becomes
      considerable 5 years after operation. In both series, the section of the fusion
      masses at the apex of the curve is asymmetric (with prevalence on the concave
      side), with an area of central resorption that shows the structure of a long bone
      (box section).

PMID- 2237630
TI  - Factors influencing the result of posterior spinal fusion in the treatment of
      adolescent idiopathic scoliosis.
AB  - Sixty-six consecutive patients with adolescent idiopathic scoliosis treated by
      posterior spinal fusion using Harrington distraction compression instrumentation
      were followed for a minimum of 3 years. Initial surgical correction was
      satisfactory, but during the follow-up period, mean 4.4 years (3-5 years), there
      was a loss of correction. Several factors (age, sex, the number of vertebrae in
      the fusions, and the use of cross wires) were important influences on correction.
      A method of assessing the balance of a posterior spinal fusion is described that
      is useful when assessing radiographs.

PMID- 2237631
TI  - The operative treatment of progressive early onset scoliosis. A preliminary
      report.
AB  - Thirteen patients with progressive early onset scoliosis have been managed
      operatively in an attempt to achieve correction without bracing and to allow the
      spine to grow. All had posterior segmental spinal instrumentation (SSI) without
      fusion and 9 of 13 had anterior apical growth arrest as a separate additional
      procedure. At 2-year follow-up, curve correction averaged 46%. Patients who had
      anterior apical growth arrest and SSI without fusion had less curve deterioration
      than those who had SSI alone. New methods are described for 1) measuring growth
      of the instrumented segment of the spine and 2) calculating the predicted growth
      of the instrumented segment. Eight of the 13 had more than 50% of predicted
      growth, three had 30-50% of predicted growth, and two had less than 30% of
      predicted growth. Operative treatment has been successful in the short term in
      all but the most malignant form of infantile idiopathic scoliosis.

PMID- 2237632
TI  - An analysis of the effect of the Zielke operation on S-shaped curves in
      idiopathic scoliosis. A follow-up study revealing some skeletal and soft tissue
      factors involved in curve progression.
AB  - This article analyzes the fate of S-shaped idiopathic spinal curves during follow
      up in 18 patients having the Zielke VDS operation. The spinal radiographs were
      evaluated by Cobb angle, end-vertebra angles (EVAs), vertebral rotation, and by a
      new method using the tilt of the surgically fused spinal block in the frontal
      plane. Spinal growth was measured. Using the conventional criterion for Cobb
      angle progression, 83% of the lower curves and 50% of the upper curves progress.
      The use of EVAs shows that progression occurs mainly in the middle
      (thoracolumbar) segment of the spine. Curve progression occurs in the frontal
      plane without any significant change in vertebral rotation. The progression of
      the upper curve Cobb angle is not related to the progression of the Cobb angle of
      the lower curve; but it is related to 1) tilt of the spinal block, 2) growth of
      the spine below the block and 3) overall linear spinal growth (T1-S1).
      Progression of the upper EVA of the upper curve is associated with skeletal
      immaturity. The key features leading to curve progression after the Zielke
      operation appear to be spinal asymmetry in the frontal plane, linear spinal
      growth, and concave lumbar muscle tether (myostatic contracture). The surgical
      implications of the findings are outlined.

PMID- 2237633
TI  - Effects of rib elongation on the spine. I. Distortion of the vertebral alignment
      in the rabbit.
AB  - Elongation of one rib on the right side by 1 cm was achieved in two groups of
      adult rabbits of different age, by osteotomy and application of a metallic
      expander. The procedure resulted in immediate deviation of the spine in the
      frontal and sagittal planes, with moderate scoliosis, convex to the left, and a
      significant decrease in the normal cervicothoracic lordosis and thoracolumbar
      kyphosis. Moreover, computed tomography (CT) scanning demonstrated rotation of
      vertebra about the longitudinal axis relative to the anterior midline of the
      body, and deviation of the spinous process toward the convex, left side, of the
      scoliotic deformity. Rib hump developed on the right side--that of the elongated
      rib. These changes, which occurred simultaneously in the three planes, were less
      pronounced in the group of older animals. Two weeks after the operation, the
      distorted configuration of the spine remained unchanged. The observed changes in
      the alignment of the vertebrae--changes that, except for their direction on the
      horizontal plane, resembled those associated with idiopathic scoliosis in man-
      support the earlier proposed link between the early stage of development of this
      condition and asymmetry of rib growth.

PMID- 2237634
TI  - Effects of rib elongation on the spine. II. Correction of scoliosis in the
      rabbit.
AB  - Three intercostal nerves on the right side of growing rabbits were resected
      partially. From 1 to 3 months later, moderate left-convex thoracic scoliosis with
      rotation of vertebrae had developed, and the sagittal curvatures of the spine had
      diminished. In one group of these animals, a mechanically produced increase of 1
      cm in the length of one rib on the side of the convexity resulted in an immediate
      correction of the scoliotic deformity, an improvement that was still evident 3
      weeks after the operation. In two other groups of rabbits, a further resection of
      three intercostal nerves, this time on the left convex side, 1 and 2 months after
      the first operation, resulted in regression of scoliosis or halted its
      progression. These results further support a new concept in which the
      precipitating factor in the development of scoliosis is ascribed to asymmetric
      longitudinal growth of the ribs. They also suggest that regulation of the rib
      length could be a promising approach to the effective correction of progressive
      scoliosis at an early stage in man.

PMID- 2237635
TI  - Maintenance of cell viability in stored bone.
AB  - Although stored autogenous bone is routinely used for bone grafting in spinal
      surgery, the cellular elements of this bone do not survive the period of storage
      under standard conditions. By the use of tissue culture techniques, the authors
      show that it is possible to keep bone cells alive for many weeks. The potential
      advantages of maintaining cellular viability in grafted bone is discussed.

PMID- 2237636
TI  - A variant of severe deformation of the thoracic spine with favorable neurologic
      outcome.

PMID- 2237638
TI  - Monochromosomal mouse microcell hybrids containing inserted selectable neo genes.
AB  - Normal mouse fibroblasts at early passage levels were used as a starting material
      to construct mouse-hamster microcell hybrids (MCH). The neor gene, carried on the
      pSV2neo and pZIP-NeoSV(X)1 plasmids, was introduced into the mouse fibroblasts by
      gene transfection and retroviral infection, respectively, prior to microcell
      hybridization into the E36 Chinese hamster cell line. In total about 180 MCH
      clones were isolated and their amount of mouse DNA was estimated by dot-blot
      analysis. About 50% of the transfection based hybrids (T-hybrids) showed signals
      indicating one mouse chromosome, less than 10% more than one mouse chromosome,
      and the remaining clones contained only subchromosomal amounts of mouse DNA. In
      the infection-based hybrid series (I-hybrids) more than 95% showed only
      subchromosomal mouse DNA content. Chromosomal integration analysis verified the
      presence of neor insertions in all 42 hybrid clones analyzed. C-banding analysis
      verified 14 of 15 hybrids scored as monochromosomals on dot blots. Chromosome
      fragmentation in T-type MCH was found to be (1) nonrandom, preferentially
      occurring in MCH derived from certain transfectants, (2) late in clonal
      establishment, and (3) essentially not related to prolonged cultivation in vitro.
      Once established, most T-type MCH clones including mono- and subchromosomal
      hybrids were essentially stable during prolonged cultivation. In contrast MCH
      initially containing several mouse chromosomes tend to lose the nonselectable
      ones during prolonged cultivation. In total we estimate the number of independent
      monochromosomal MCH derived in this study to more than 30.

PMID- 2237637
TI  - Giant-cell tumor involving a lumbar vertebra. Long-term follow-up after
      radiotherapy.

PMID- 2237639
TI  - Targeted gene replacement at the endogenous APRT locus in CHO cells.
AB  - We demonstrate the feasibility of targeted gene replacement at an endogenous,
      chromosomal gene locus in cultured mammalian cells, employing a two-step strategy
      similar to an approach routinely used for genetic manipulation in yeast.
      Utilizing an APRT+ recombinant generated by targeted integration of plasmid
      sequences (including a functional copy of the gpt gene) at the CHO APRT locus, we
      have been able to select gpt- "pop-out" recombinants that have arisen by
      intrachromosomal recombination between APRT direct repeats at the targeted
      integration site. Reciprocal exchanges leading to "pop-out" of integrated
      plasmid/gpt gene sequences occur at a rate of approximately 6.3 x 10(-6) per cell
      generation. Depending on the site of crossover, such "pop-out" events result in
      either replacement or restoration of the original APRT target gene sequence.

PMID- 2237640
TI  - Isolation of temperature-sensitive CHO-K1 cell mutants exhibiting chromosomal
      instability and reduced DNA synthesis at nonpermissive temperature.
AB  - Twenty-five temperature-sensitive (ts) mutants were isolated from Chinese hamster
      CHO-K1 cells after mutagenization with N-methyl-N'-nitro-N-nitrosoguanidine. Of
      13 complementation groups identified, nine exhibited chromosomal instability at a
      nonpermissive temperature. They were classified into three major classes
      according to inducibility of sister chromatid exchange (SCE) and/or chromosomal
      aberration (CA): class 1 resulted in predominant SCEs, class 2 manifested both
      SCEs and CAs, and class 3 exhibited higher induction of CAs. Flow cytometric
      analysis of the mutants exhibiting chromosomal instability indicated that many of
      the mutants were arrested in the S or S to G2 phases of the cell cycle at the
      nonpermissive temperature, accompanied by a decrease in the rate of DNA
      synthesis. These results imply that ts defects are related to some points in DNA
      replication and might be responsible for the induction of SCEs and/or CAs at the
      nonpermissive temperature.

PMID- 2237641
TI  - Replication-dependent mutagenesis by 5-bromodeoxyuridine: identification of base
      change and sequence effects on mutability.
AB  - The molecular mechanism of reversion induced by 5-bromodeoxyuridine (BrdU)
      replication-dependent mutagenesis in mammalian cells was studied. Murine cells
      with single mutant copies of the E. coli gpt gene integrated chromosomally as
      part of a shuttle vector were mutagenized with BrdU, and GPT+ revertants were
      selected. Thirteen mutant cell lines (each of which had a gpt gene that varied
      from the wild-type gene by a different GC----AT base transition in the coding
      region) were mutagenized, and only four were found to be effectively reverted.
      All revertant gpt genes that were analyzed had reverted via AT----GC base
      transition at the original site of mutation, thus demonstrating that replication
      dependent mutagenesis by BrdU causes AT----GC transitions. The nine cell lines
      that were nonrevertible by BrdU replication-dependent mutagenesis could be
      mutated by this protocol to ouabain resistance as effectively as the four
      revertible lines, indicating that the nonrevertible lines were susceptible to
      such mutagenesis. Thus, differences among the cell lines in frequencies of HATr
      revertants generated by BrdU replication-dependent mutagenesis could not be
      attributed to differences in general susceptibility of the lines to the mutagenic
      protocol. The revertible and nonrevertible lines could not be separated according
      to the position of the original GC----AT transition in the gpt coding region.
      However, there was evidence that the DNA base sequence flanking the site of
      mutation affected the susceptibility of that site to BrdU replication-dependent
      mutagenesis. For example, six of the cell lines tested had gpt genes in which the
      mutant T residue was immediately adjacent on its 3' side to an A residue, and all
      six were found to be nonrevertible by BrdU replication-dependent mutagenesis.
      Furthermore, a target AT base pair flanked by GC base pairs in opposite
      orientation and either immediately adjacent to or one base removed from the
      target site on both the 5' and 3' sides appeared to have an increased
      susceptibility to BrdU replication-dependent mutagenesis.

PMID- 2237642
TI  - Genes for C4b-binding protein alpha- and beta-chains (C4BPA and C4BPB) are
      located on chromosome 1, band 1q32, in humans and on chromosome 13 in rats.
AB  - C4b-binding protein is involved in the regulation of the complement system. It is
      a multimeric protein composed of seven identical alpha-chains and a single copy
      of a unique beta-chain. The latter was identified only recently and its structure
      determined by cDNA cloning. Both subunits in C4b-binding protein belong to the
      same superfamily of proteins composed predominantly of tandemly arranged short
      consensus repeats (SCR) approximately 60 amino acid residues in length. The gene
      for the human alpha-chain is known to be located in a gene cluster on chromosome
      1, band 1q32, which is called the regulators of complement activation (RCA) gene
      cluster. We have used cDNA probes for both alpha- and beta-chains of human C4b
      binding protein to localize their genes with an in situ hybridization technique.
      We find the genes for both chains to be located on chromosome 1, band 1q32, in
      the human. This suggests that the beta-chain gene is also a member of the RCA
      gene cluster and that the alpha- and beta-chain genes are located close to each
      other. The cDNA probes for the alpha- and beta-chains also were used to screen
      mouse-rat somatic cell hybrids using Southern blotting to localize their genes in
      the rat. Both the alpha- and beta-chain genes were shown to be located on
      chromosome 13 in the rat. These are the second and third genes to be located on
      rat chromosome 13, and the results suggest that the genes for the alpha- and beta
      chains together with the gene for coagulation factor V represent a conserved
      chromosomal region in rat and man.

PMID- 2237643
TI  - [Current radiologic diagnosis of esophageal tumors].

PMID- 2237644
TI  - [Spiral-CT: a new technique for volumetric scans. I. Basic principles and
      methodology].

PMID- 2237645
TI  - [Vascular embolization for the treatment of life-threatening hemorrhages in the
      pelvic area].

PMID- 2237646
TI  - [An atypical radiologic finding in a case of Pneumocystis carinii pneumonia].

PMID- 2237647
TI  - [Merkel cell carcinoma: differential diagnosis and appropriate therapy].

PMID- 2237648
TI  - [Problems of hemorrhage in the cerebellum].
AB  - The authors give an account on their experience with the treatment of five
      patients (three women and two men) with non-traumatic haemorrhage into the
      cerebellum. The oldest patient was 67 years, the youngest 14 years, the mean age
      was 51.2 years. In four the cause of haemorrhage was hypertension, in one patient
      an A-V malformation. The correct diagnosis was established by CT examination,
      while originally it was assumed that a supratentorial cerebrovascular attack was
      involved. One female patient recovered after conservative treatment, in the
      remainder the haematoma was removed by suboccipital craniectomy. One patient
      died, the fourteen-year-old female patient which was admitted with symptoms of
      decerebration, survives with a marked neurological deficit, three patients feel
      well. In one instance hydrocephalus developed which was treated by ventriculo
      peritoneal drainage with a valve.

PMID- 2237649
TI  - [Epidural hematomas in the posterior cranial fossa].
AB  - In the course of twenty years 92 patients with intracranial epidural haematomas
      (EH) were operated. In five these patients, i.e. 5.4%, the EH was in the
      posterior cranial fossa (EHPF). Focal symptoms of compression of the cerebellum
      and the lower cranial nerves developed only in subacute EHPF. In acute EHPF it
      was masked by manifestations of an affection of the brain stem. Direct evidence
      of EHPF was produced by AG. The best diagnostic method is computed tomography.
      Attention to EHPF can be however, drawn also clinical sings of injury of the bask
      of the skull or the finding of a fracture of the occipital bone on an X-ray
      picture of the skull. Evacuation of the EHPF provides favourable perspectives of
      a normal future life even on patients who are in a poor condition incl. signs of
      and impaired respiration.

PMID- 2237650
TI  - [Prevention of pulmonary embolism after brain surgery with the use of local
      heparinization].
AB  - The authors describe briefly anticoagulation treatment of thrombosis of the lower
      extremity by heparin which developed on the third day after operation of a
      glioblastoma of the temporal lobe. An adequate therapeutic dose of heparin
      administered by infusion into the affected lower extremity was neutralized by an
      infusion of protamine into the upper extremity. Haematological examination
      revealed normal clotting in the systemic circulation. The method of local
      heparinization improved the clinical symptoms, pulmonary embolism did not develop
      and was there was no hemorrhage complication in the surgical field.

PMID- 2237651
TI  - [Intracranial hemorrhage as a complication of anticoagulation therapy].
AB  - The authors describe two cases of intracranial haemorrhage as a complication of
      anticoagulation treatment, and compare their results with those reported in the
      literature. They analyze risk factors which in conjunction with anticoagulants
      chuan lead to haemorrhage.

PMID- 2237652
TI  - [Instruments used in various operations in the area of the gasserian ganglion].
AB  - The authors describe instruments which make it possible to perform retrogasserian
      thermolesions (RGT), glycerol radiculolysis (GRL) or trigeminal balloon
      compression (TBC) or possibly a combination of these methods from a single
      surgical approach. This makes it possible to adjust the selection of the type of
      lesion to unforeseen conditions any time during the operation. The surgical
      results are compared in 308 RGT, 50 GRL and 22 TBC. There are no substantial
      differences and therefore the selection of the type of lesion depends on
      technical circumstances during operation.

PMID- 2237653
TI  - [Diagnosis of traumatic ruptures of the bronchi].
AB  - The author presents a report on the course of the disease and diagnostic
      difficulties of a rupture of the bronchus in a patient with a severe thoracic
      injury. He draws attention to the diagnostic difficulties in these injuries and
      evaluates diagnostic and therapeutic possibilities. She assumes that with more
      frequent chest injuries the possible more frequent incidence of these injuries
      must be foreseen. The author emphasizes interdisciplinary team work in the
      diagnosis of the condition and the comprehensive character of care.

PMID- 2237654
TI  - [Bacteriological findings in bronchial secretions of the lower respiratory tract
      in resected lungs].
AB  - The authors investigated during operation the bacteriological findings in the
      bronchial secretion of the respiratory pathways of resected lungs. Of 100
      patients whom they included in the group they detected a positive finding in 42.
      Wound in 27 patients. Twenty of them had a positive bacteriological finding in
      the lower respiratory pathways. The authors discuss the problem of prophylactic
      use of antibiotics in pulmonary surgery. Based on data in the literature and
      their own observations, the authors recommend preventive administration of
      antibiotics in pulmonary surgery.

PMID- 2237655
TI  - [Functional treatment of calcaneal fractures].
AB  - The authors discuss functional treatment of fractures of the calcaneus. They
      compare the therapeutic results of the most serious type of these fractures-
      intraarticular compressive fractures with depression of Bohler's angle, treated
      in the classical manner by long-term plaster and by the modern method--functional
      treatment which involves a minimal period of immobilization--general and local-
      and makes early and intensive rehabilitation possible very soon after the injury.
      The functional method gives very good results and reduces the period of
      treatment. By reducing the period of work incapacity it is an asset for the
      national economy.

PMID- 2237656
TI  - [False aneurysm of the anterior tibial artery as a sequela of complicated foreleg
      fracture].
AB  - The authors discuss the aetiology, diagnosis and therapy of false aneurysms and
      mention their possible occurrence at different sites, whereby they emphasize the
      rare occurrence of pseudoaneurysms in conjunction with fractures of the bones of
      the extremities. The rare nature of the mentioned complication stimulated the
      authors to present a case-history of a pseudoaneurysm of the anterior tibial
      artery.

PMID- 2237657
TI  - [Pitfalls and complications of the Weidner-Ender method of osteosynthesis in the
      treatment of fractures of the proximal part of the femur].
AB  - Ender's method is associated not only with advantages but also with some pitfalls
      and risks. The advantages--adequate stability, small surgical stress, small blood
      losses during operation, minimal risk of infection. Complications during
      operation, during the postoperative period and during subsequent by evaluation of
      the general condition of the patient and the type of fracture, by perfect
      reposition, correct surgical procedure--selection of a trepanation aperture,
      correct length of wires, adequate number of wires, early mobilization and gradual
      bordening of the operated extremity during walking. The authors present a group
      of 174 operated patients, incl. 159 where Ender's method of osteosynthesis was
      applied: in a total of 18 basicervical, 148 pretrochanteric and 8 subtrochanteric
      fractures. Complications developed in 11 patients--8 times distal dislocation of
      the wires, 6 times various dislocations of the fragments, 7 patients died after
      operation.

PMID- 2237658
TI  - [Replantation of traumatically amputated parts of extremities-- indications and
      nomenclature].
AB  - The authors submit a brief report on replantation activities during the past five
      years and discuss the problem of indications and terminology of traumatic
      amputations. The paper contains instruction regarding communication by telephone
      between the attending surgeon and a specialized microsurgical department. There
      are also instruction how to handle the amputated portion of the limb and how to
      transport the patient and the amputated portion of the limb. The authors
      discusses traditional procedures in replantation surgery on the basis of his own
      experience with 292 replantations or revascularizations.

PMID- 2237659
TI  - [Professional profiles of physicians].

PMID- 2237660
TI  - [Evaluation of emergency surgical procedures and their tolerance by the patient].

PMID- 2237661
TI  - [Use of a scoring system for categorizing polytrauma and polytraumatism].

PMID- 2237662
TI  - [Emergency conditions and surgery in Czechoslovakia].
AB  - Urgent surgical operations account for cca 28% of all surgical activities in
      Czechoslovakia. Their lethality is by cca one third higher than in other
      operations. The period of treatment is, however, shorter, no doubt, because
      before operation there is not time for complicated examinations. A great
      proportion of urgent operations is formed by acute abdomen, cca 60%. So far even
      prolonged efforts did not succeed to achieve earlier hospital admission. The
      operations are, however, made at an earlier stage and thus the lethality
      declined. As to age, a great proportion of urgent conditions occur in older
      children and adolescents, old patients above 65 years and in particular above 75
      years. Men are affected more frequently. Interregional comparisons indicate a
      varied incidence but in particular a varied lethality. It is high specially in
      Prague and the South Bohemian region although the two regions have a relatively
      low relation of incidence. In the conclusion the authors emphasize that it is
      important to make an effort to improve care of urgent patients by health
      education and by convincing doctors of the importance of the time factor.

PMID- 2237663
TI  - [The professional profile of level I and II certified urologists].

PMID- 2237664
TI  - [The role of ultrasonographic examination in the diagnosis of thyroid gland
      disorders].
AB  - The authors compared the results of ultrasonographic examinations of thyroid
      processes with clinical and histological findings of operated patients. The
      results proved the importance of ultrasonographic examinations as one in the
      complex of examination methods before operation of the thyroid gland for the
      assessment of the preoperative diagnosis.

PMID- 2237665
TI  - [Supravalvular aortic stenosis].
AB  - The authors describe the case of an inborn supravalvular aortal stenosis in an
      adult patient who was successfully treated by a plastic operation of the stenotic
      portion of the ascendent aorta by means of a synthetic patch. At the same time
      also a plastic operation of an incompetent mitral valve was made.

PMID- 2237666
TI  - [Do we amputate too much or too little? A retrospective analysis of the situation
      in the East Bohemian Region].
AB  - A retrospective analysis of 1146 amputations of the lower extremities in five
      departments of the East Bohemin a region revealed that the number of amputations
      in the thigh is higher and less frequently preceded by angiographic examination
      and reconstruction operations of the arteries as compared with distinguished
      departments abroad. The mortality after amputations was 12.5%. The results call
      for more intensive training of vascular surgeons and the establishment of
      vascular surgical departments where it would be possible by early reconstruction
      operations made in time to prevent amputations or at least shift the height of
      the amputation in the most distal direction possible.

PMID- 2237667
TI  - [Diagnostic and therapeutic problems in carcinoma of the esophagus and cardia].
AB  - The authors describe their experience with the treatment of 180 patients with
      tumours of the oesophagus and cardia, during a 13-year period, at the Surgical
      Clinic, Medical Faculty, Comenius University, Bratislava. Most frequently the
      tumorous process was in the median portion of the oesophagus. A radical operation
      could be performed only in 27.2% of patients. The reason was that frequently the
      tumours were already very advanced when the patients were admitted to the
      surgical department; that means: late diagnosis. This explains also the short
      postoperative survival. The authors analyze the reasons for the above described
      facts and submit their concept of the diagnostic and therapeutic approach to the
      problem of carcinoma of the oesophagus and cardia.

PMID- 2237668
TI  - [Personal experience with liver injuries].
AB  - The authors give an account of 69 patients hospitalized in 1975-1986 in the
      Traumatological Research Institute in Brno on account of liver injuries. The mean
      age of the patients was 38.3 years. The liver injury was very frequently
      associated with serious craniocerebral injuries, with injuries of the chest and
      other intraabdominal organs and the total lethality was 62.3%. The most frequent
      cause were traffic injuries (50 cases). Blunt liver injuries accounted for 92.8%
      of the cases.

PMID- 2237669
TI  - [Postcholecystectomy syndromes].
AB  - The author analyzes postcholecystectomic complaints in 513 patients
      cholecystectomized in 1981-1985. He mentions the relationship between
      postcholecystectomic syndromes and preoperative complaints, the peroperative
      diagnosis and surgical operation. He recommends diagnostic investigations to
      elucidate the dyspepsia; the doctor must not be satisfied with the finding of
      cholecystolithiasis. The author also compares postcholecystectomic syndromes in
      patients with a biliodigestive anastomosis with papillosphincterotomy. The author
      analyzes in more detail the experience with treatment of nine patients, i.e.
      1.75% patients with the finding of residual concrements.

PMID- 2237671
TI  - [Necrotizing pancreatitis and its complications managed by surgery].
AB  - The authors have summed up their 10-years experiences (1978-1987) with the
      therapy of acute necrotizing pancreatitis and of some serious surgical
      complications. While in 252 patients operated early for biliary pancreatitis
      mortality rate did not exceed 8.7% in 65 patients operated for necrotizing
      abscessing pancreatitis and its complication it was as many as 63%. The stress
      has been laid both on early operations of biliary tract diseases and the
      prevention of developing severe forms of pancreatitis. Even in the cases of
      advanced necrotizing pancreatitis, priority has been given to radical necrectomy
      as early as in the second week of the disease duration supplemented with lavage
      and profuse drainage. The maintenance of therapeutical laparostomy is suitable.

PMID- 2237670
TI  - [Treatment of liver rupture in an experiment].
AB  - The authors investigated in experiments on rabbits healing of liver incisions
      under various circumstances: spontaneous healing, liver incisions treated by
      suture by application of the tissue glue Tissucol, the collagenous haemostatic
      felt Collastypt combined with one stitch. Healing was followed up after several
      time intervals. From normal, i.e. the group of spontaneous healing, differed the
      groups treated by Tissucol and Collastypt where marked encapsulating fibrous
      tissue reactions round the necroses on the wound margins were found with numerous
      eosinophils as a transient phenomenon. The final result (with a maximum of cca
      two months) was adequate in all groups--as a rule a thin fibrous tissue scar with
      few remnants of atrophic hepatic trabeculae. In the treatment of small injuries
      it seems best to use the collagenous haemostatic Collastypt. In the treatment of
      sutures in rare instances a large number of leucocytes was found in the area of
      the necrosis and stitches, perhaps as result of contamination of the wound or
      sewing material.

PMID- 2237673
TI  - [Methylprednisolone-pulse therapy in a patient with rheumatoid arthritis and
      diffuse interstitial pneumonia/pulmonary fibrosis].
AB  - A forty-eight year-old female with rheumatoid arthritis developed cough, sputum
      and dyspnea. Chest X-ray film demonstrated bilateral diffuse interstitial
      pneumonia and pulmonary fibrosis. Laboratory findings were as follows: ESR 29
      mm/h, CRP 3.86 mg/dl, RA test (+), RAHA (-) and WBC 7200/mm3. Marked hypoxemia
      (po(2)45 Torr) was demonstrated by blood gas analysis. Asymptomatic pulmonary
      fibrotic lesions which preceded articular symptoms were identified on her
      previous chest X-ray films. Methylprednisolone-pulse therapy (1g/day, for 3 days)
      was repeated three times with a 2-week interval. The treatment rapidly improved
      both pulmonary symptoms and chest X-ray findings. Although the fibrotic shadows
      on chest X-ray did not completely disappear, her conditions have been maintained
      well under the treatment with prednisolone (10mg/day) plus D-penicillamine
      (200mg/day).

PMID- 2237672
TI  - [Quantitation of intact form of complement protein B and its fragment Ba in human
      serum by radioimmunoassay].
AB  - A sensitive solid-phase radioimmunoassay for intact complement protein B and its
      smaller fragment Ba is described which quantitates human B and Ba to 30 ng/ml.
      The assay was proved to be useful to evaluate the activation of the alternative
      pathway of the complement system by measuring intact B and Ba in normal human
      sera activated with zymosan. In sera from patients with systemic lupus
      erythematosus (SLE), the level of intact B was decreased and that of Ba was
      increased in the active phase, and the level of Ba was increased though intact B
      which was within normal limits in the inactive phase. The present result suggests
      that the activation of the alternative pathway is occurring both in the active
      and inactive phase in SLE, and the measurement of intact B and Ba concentration
      in pathological sera would be useful to evaluate the activation of the
      alternative complement pathway.

PMID- 2237675
TI  - [A retrospection of long-time research on fibrinoid, and its further problems].

PMID- 2237674
TI  - [Protein kinases in signalling of T-cell growth].

PMID- 2237676
TI  - [Intra-articular rheumatoid nodules of the knee joint].
AB  - Intra-articular rheumatoid nodules found in 6 knee joints of 4 patients with
      rheumatoid arthritis were reported with histological findings. All patients were
      women, ranging in age from 32 to 61 years, with 6 to 41-year history of
      rheumatoid arthritis. The masses were exclusively in the anterolateral aspect of
      the joint. Snapping occurred when the joint was flexed by 20 degrees in four
      joints and by 60 degrees in two. The masses had the sizes of a thumb tip to index
      finger tip, and were elastic and soft. Histologic examination of the masses
      revealed the typical formation of rheumatoid nodule in two joints. Myxomatous
      degeneration and granulation tissue consistent with rheumatoid arthritis were
      found in two joints. Perivascular fibrosis and myxomatous degeneration were
      mainly demonstrated in two joints which had developed masses two months before
      excision.

PMID- 2237677
TI  - [Clinical studies on 9 patients with Heberden's nodes of premenopausal onset].
AB  - Nine patients with Heberden's nodes of premenopausal onset were studied for
      complications in the form of thyroid disorders as well as from the hereditary,
      roentgenological and immunological aspects. In addition, rheumatoid arthritis,
      psoriatic arthritis, traumatic arthritis, erosive osteoarthritis or adult Still's
      disease was excluded in these patients. All patients had thyroid disorder
      (Basedow's disease in 6 patients, Hashimoto's thyroiditis in 2 patients and
      granular thyroiditis in one patient). Immunological examinations were positive
      for anti-thyroglobulin antibody in 5 patients and anti-microsome antibody in 3
      patients and anti-nuclear antibody in 2 patients. Roentgenological findings
      revealed no typical signs of primary generalized osteoarthritis.

PMID- 2237678
TI  - 5-HT--crossing a new frontier.

PMID- 2237679
TI  - Towards safer anaesthesia--implementing practice standards.

PMID- 2237680
TI  - Doomsday forecasts of the AIDS epidemic.

PMID- 2237681
TI  - Our daily bread--is it threatened?

PMID- 2237682
TI  - On the maximum size of the AIDS epidemic among the heterosexual black population
      in South Africa.
AB  - Using a macro-simulation model, the maximum size of the acquired immunodeficiency
      syndrome (AIDS) epidemic among the heterosexual black population of South Africa
      is assessed. As a result of the simulations, it appears very unlikely that the
      demographic impact of AIDS is such that the size of the black population will be
      substantially reduced during the next three decades. A realistic 'worst-case'
      scenario is that population growth will come to a halt on a population level
      substantially higher than the present one. It is also unlikely that peak
      infection levels among the sexually active population will exceed 30-40%.
      However, especially in urban populations, it cannot be ruled out at present that
      infection levels of 30% will be reached within the next 10-15 years.

PMID- 2237683
TI  - Knowledge, attitudes and beliefs about AIDS in township school students in Cape
      Town.
AB  - Students (N = 377) from four Cape Town township high schools were surveyed to
      obtain information on their knowledge of and attitudes towards the acquired
      immunodeficiency syndrome (AIDS), and on their sexual behaviour. The study was
      undertaken to provide information for planning an AIDS education intervention.
      Three-quarters of students reported that they had had sexual intercourse. Most
      students had heard of AIDS, and the majority of these knew that it was
      infectious. More than half of the students were confused or lacked knowledge
      about the modes of transmission. Two-thirds of the students believed AIDS could
      be prevented, but knowledge of prevention strategies was superficial. Of the
      sexually active students only 11.4% had ever used a condom, and of all students
      39.6% stated that they would use a condom in the future. Two-thirds of the
      students were not aware that there is no cure for AIDS. Students did not
      acknowledge that AIDS could affect them directly, and attributed the problem to
      prostitutes and 'promiscuous' people in 36.4% of responses, and to 'white' people
      in 23.8% of responses. Students expressed intolerance, fear and rejection of
      people with AIDS, and only 6.4% would accept an affected person into their class.
      Almost all the students wanted AIDS education at school, and most of these
      requested that the school nurse facilitate this education. It is concluded that
      appropriate AIDS prevention education is urgently required for both high school
      and junior school students.

PMID- 2237684
TI  - Knowledge, beliefs and practices among black goldminers relating to the
      transmission of human immunodeficiency virus and other sexually transmitted
      diseases.
AB  - The Chamber of Mines of South Africa employs approximately 750,000 miners from
      all over southern Africa. Sero-surveys in 1986 showed that, depending on
      geographical area of origin, between 0.02% and 3.76% of miners were positive for
      human immunodeficiency virus (HIV) antibodies. As a consequence, an intensive
      education campaign to stop the spread of HIV infection was launched. A study was
      undertaken to establish a valid baseline level of knowledge about black miners'
      beliefs, attitudes and practices related to HIV infection, acquired
      immunodeficiency syndrome (AIDS) and sexually transmitted diseases (STDs), and to
      recommend appropriate changes to the educational efforts of the Chamber of Mines.
      A structured, pre-tested questionnaire was used to interview in their home
      language 429 systematically sampled black miners from four different mines. The
      most relevant findings were that younger age, not being married and how general
      education predispose to contracting STDs, while a feeling of being at risk for
      contracting HIV infection is positively correlated with level of education. Close
      friends were the most important source of information on STDs, but the media and
      medical staff were the most important sources of information on AIDS/HIV
      infection. Condoms were used by 31% of respondents, while the main reasons for
      non-use were trust in the sexual partner and lack of availability. Promotion of a
      stable family life for miners may significantly impact on the transmission of HIV
      infection.

PMID- 2237685
TI  - Some early observations on HIV infection in children at King Edward VIII
      Hospital, Durban.
AB  - Nine black children aged between 3 months and 30 months of age, with human
      immunodeficiency virus type I (HIV-I) infection are described to draw the
      attention of health professionals in southern Africa to special clinical
      characteristics useful for recognising this problem, which has many shared
      features with common diseases of infancy and childhood in the Third World. The
      main presenting complaints were chronic cough and persistent diarrhoea and
      vomiting. These children frequently had diarrhoea (8 of 9 patients),
      mucocutaneous candidiasis (8), pneumonia (7), hepatosplenomegaly (9), significant
      lymphadenopathy (5) and wasting (5). All were infected by common bacteria, such
      as Gram-negative organisms, Mycobacterium tuberculosis and Campylobacter jejuni,
      or by opportunistic infections such as Candida or cytomegalovirus (CMV), or by
      both bacterial and opportunistic organisms. A raised total serum globulin level,
      anaemia, lymphopenia and a cerebrospinal fluid (CSF) pleocytosis were frequent
      findings. Incomplete data on parental HIV status suggest perinatal transmission.
      Three of the children were HIV-antigen positive. The diagnosis of full-blown
      acquired immunodeficiency syndrome (AIDS), using the stringent Centers for
      Disease Control criteria, is difficult in our situation because of limited
      diagnostic resources; however, using these criteria, and the clinical case
      definition for AIDS recommended by World Health Organisation, it is thought that
      probably 4 of these children could be considered as having AIDS.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2237686
TI  - Human immunodeficiency virus infection in children--prevalence and psychosocial
      impact.
AB  - As at 20 September 1989, 15 children with the acquired immunodeficiency syndrome
      (AIDS) had been diagnosed in South Africa and indications are that this number is
      going to increase at a rapid rate in the near future as the disease establishes
      itself in the heterosexual population. A brief overview of the clinical aspects
      of human immunodeficiency virus infections in children is given before the
      psychosocial implications are considered in more detail.

PMID- 2237687
TI  - AIDS and tuberculosis.
AB  - The diagnostic and therapeutic implications of human immunodeficiency virus (HIV)
      infection and tuberculosis in South Africa, where tuberculosis remains a major
      health problem, are reviewed. Mycobacterium tuberculosis is a high-grade pathogen
      and is able to establish infection early in immunodeficiency. With HIV infection
      showing significant entry into the heterosexual population in the RSA, an
      increasing number of cases with both infections can be expected to occur. The
      radiological appearance in combined infection is variable, ranging from a formal
      cavitatory picture to the more common finding of diffuse pulmonary infiltration.
      Intrathoracic adenopathy is a more specific sign of tuberculosis in HIV
      infection, since it is not associated with persistent generalised lymphadenopathy
      and pulmonary opportunistic infections, such as Pneumocystis carinii pneumonia.
      Intercurrent pneumonic infections and other pulmonary manifestations of HIV
      disease render the interpretation of new infiltrates on chest radiography
      problematical. Tuberculin skin testing remains useful in HIV infection and should
      be performed in all HIV-infected patients. The value of tuberculosis serology
      still remains questionable. Standard antituberculosis drug regimens are
      effective, but maintenance treatment must be continued for life and should
      include isoniazid and rifampicin. BCG vaccination is recommended routinely at
      birth in infants with HIV infection and for asymptomatic HIV-infected individuals
      who have not previously been immunised.

PMID- 2237688
TI  - Electro-encephalography and performance in a poorly nourished South African
      population.
AB  - The electro-encephalographic (EEG) characteristics and psychometric performance
      of 'normal' black South African peri-urban children were assessed in the course
      of a large-scale normative study. Children identified as being poorly nourished
      according to growth standards were compared with a group of mildly growth
      retarded children and with another group with normal growth. The socio-economic
      backgrounds of the three groups were checked and found to be the same. The
      children had had access to regular clinic attendance and none had ever been
      hospitalised for any serious illness--in particular malnutrition. Across the
      entire age range the poorly nourished children invariably were found to fare
      worse on both EEG and psychometric measures than the normal group.

PMID- 2237689
TI  - Electro-encephalographic disturbances due to chronic toxin abuse in young people,
      with special reference to glue-sniffing.
AB  - A study was carried out in order to document any abnormalities in the electro
      encephalogram (EEG) that might appear in young adolescents who have deliberately
      inhaled the range of volatile substances loosely referred to as 'glue'. The EEGs
      of a group of 'street children' being assisted in a Johannesburg shelter were
      examined. The records were analysed for any clinical abnormalities and also
      subjected to spectral analysis in order to examine the overall characteristics of
      frequency, power and spatial distribution. The EEGs clearly revealed that,
      although at the time of the examination the subjects were ostensibly abstinent,
      both clinical and normative evidence of continuing brain disturbance was present.
      It was concluded that glue sniffing is likely to have long term electrocerebral
      sequelae.

PMID- 2237690
TI  - Primary thyroid lymphomas. A clinicopathological study of 8 cases.
AB  - Eight elderly women with primary non-Hodgkin's lymphoma were treated with a
      combination of surgery, chemotherapy and radiation with excellent outcome.
      Clinically, the patients presented with thyromegaly and did not have
      lymphadenopathy or hepatosplenomegaly. On histological examination, the lymphomas
      resembled diffuse follicle-centre cell tumours. All patients showed extension
      beyond the thyroid capsule and lympho-epithelial lesions; 3 displayed kappa-light
      chain restriction and 2 lambda-monoclonality. Thyroid lymphomas fall into the
      spectrum of mucosa-associated lymphomas, which have a better prognosis than their
      equivalent nodal-based counterparts.

PMID- 2237691
TI  - Prophylaxis after needlestick injuries.

PMID- 2237692
TI  - Caesarean section rates in the private and public sectors.

PMID- 2237693
TI  - Death from septicaemia as a consequence of unwanted pregnancy.

PMID- 2237695
TI  - Unsuccessful sterilisation of woman--doctor liable for child-raising costs.

PMID- 2237694
TI  - The vitamin D status of South African women living in old-age homes.

PMID- 2237697
TI  - Worksite health promotion.

PMID- 2237696
TI  - An organizational perspective on worksite health promotion.
AB  - Worksite disease prevention and health promotion have developed into a field of
      endeavor that is accepted by a majority of employers in the United States and
      welcomed by many of their employees. This chapter examines the evolution of
      worksite health promotion and describes current worksite activities and their
      benefits. The authors also discuss several issues that must be addressed for the
      future.

PMID- 2237698
TI  - Debunking the myth of individual health promotion.
AB  - The myth is that individual health promotion programs work. The reality is that
      they only work in healthy organizations. An individual health promotion program
      is one that focuses exclusively on employee behavior change independent of the
      context in which the person is expected to change. This context could include the
      environment, the corporate culture, or the health promotion program by itself. In
      this chapter the author describes how individual health promotion can be enhanced
      through organizational health promotion and environmental modification.

PMID- 2237699
TI  - Meeting the health promotion challenge through a model of shared responsibility.
AB  - AT&T's Total Life Concept (TLC) program has incorporated a multidimensional
      strategy for health promotion that attempts to avoid the pitfalls of a unifocal
      individual approach. Combining individual, organizational, and environmental
      health promotion efforts, TLC has adopted an "ecological" model, which is
      described in this chapter. The central philosophy that unifies these three
      dimensions is a "shared responsibility" for health care.

PMID- 2237700
TI  - Reducing the risk of cancer through worksite intervention.
AB  - This chapter examines existing activities reported in the literature in the areas
      of smoking, nutrition, and screening; explores the prominent theories of behavior
      change that have guided some of these activities; and presents a model for
      worksite cancer prevention programs that is currently being tested in a large
      trial. A major theme of this chapter is the need for simultaneous changes in
      individual behaviors and the worksite environment. For each factor (smoking,
      nutrition, and screening) the discussion is divided into interventions for
      individuals and those for the environment or organization.

PMID- 2237701
TI  - Preventing substance abuse as an integral part of worksite health promotion.
AB  - Problems of substance abuse damage the well-being of many workers and drain
      substantial resources from the organization. While companies have adopted drug
      testing to screen out drug users and employee assistance programs to provide
      services to troubled workers, serious substance abuse prevention strategies have
      been virtually ignored. The authors describe some of the obstacles to
      implementing substance abuse programs. Attempts to integrate these programs into
      worksite health promotion are described and a model for a health-oriented
      substance abuse program is presented.

PMID- 2237702
TI  - Promoting mental health at the workplace: the prevention side of stress
      management.
AB  - Stress in the workplace is now widely recognized as a major problem facing
      American industry. A growing number of companies are offering some form of stress
      management intervention. However, for those seeking to introduce stress
      management activities, too little in the way of guidance and direction has been
      available. This chapter aims to help organizations better understand the sources
      and dynamics of stress at the worksite and examines how they can reasonably
      assess, implement, and evaluate their stress management options.

PMID- 2237703
TI  - Development of the AT&T Health Audit for measuring organizational health.
AB  - Like any behavioral intervention, health promotion programs require a thorough
      initial assessment of an array of individual and organizational problems, needs,
      interests, and resources. Accurate risk assessment should include both contextual
      and personal characteristics as well as the interaction between the two. This
      article describes the AT&T Health Audit, a survey that addresses worksite health
      issues and collects data on the prevalence of lifestyle risk factors, as well as
      the attitudes, knowledge, and skills related to health. A copy of the Health
      Audit is provided and its applications are discussed.

PMID- 2237704
TI  - Employer-sponsored health promotion: why and how to make it a family affair.
AB  - The inclusion of family members in employer-sponsored health promotion activities
      is an area gaining attention. Several investigations into the state-of-the-art of
      employer-sponsored health promotion programs for family members have been
      undertaken. This chapter describes the findings of the Washington Business Group
      on Health project. The costs and benefits of family-related health care are
      discussed. The authors also outline a number of ways for companies to recruit
      family members.

PMID- 2237705
TI  - Ethnic/racial populations and worksite health promotion.
AB  - This chapter describes the health characteristics and health risks of ethnic
      racial populations and the implications for planning and delivering health
      promotion programs at the worksite. Special consideration is given to
      occupational stratification, which separates these groups from their white
      counterparts, thus requiring special attention. Guidelines are given for
      designing culturally appropriate worksite health promotion programs.

PMID- 2237706
TI  - Aging in the 1990s and beyond.
AB  - The future of aging persons in an aging society will depend equally upon the
      exogenous factors of the society and upon our attitudes and behaviors. The
      changes in the numbers and proportions of elderly create constraints and
      pressures upon resources and services. These incentives for decision-making are
      then mirrored in our behaviors and attitudes about aging, and about the elderly.
      The role of the aging person is undergoing re-evaluation--from "retired,"
      "grandparent," and "being seen and not heard" in family matters, to a more active
      and participative role. Retirement to (rather than from) second careers,
      political participation, community leadership, and new creativity in the choices
      of leisure roles are the new norms for aging persons. The changing demographic
      profile motivates us to anticipate new approaches to health care for an aging
      population. In the face of increasing longevity, the primary concern to be
      addressed is the development and administering of a system of services for the
      chronically ill. These health services must be coordinated to meet a range of
      needs from nutrition to hospice care, and yet to protect the individual and
      personal rights of the individual and to respond to the changing attitudes of the
      elderly as well as toward the elderly.

PMID- 2237708
TI  - Preventive care for the elderly.
AB  - While prevention has received a great deal of attention in the medical community
      in the last 15 to 20 years, little of this research or clinical activity has been
      addressed directly to the elderly population. Today, with an increasing emphasis
      on geriatric care, there is a rising awareness that clinicians' preventive
      efforts on behalf of the elderly can yield important benefits not only for
      individuals, by improving their quality of life, but also for society through
      potential cost savings. This chapter describes the effects of prevention
      strategies for the elderly.

PMID- 2237707
TI  - The aging workforce: implications for organizations.
AB  - Older workers may perform as well as or better than younger workers. Their
      accumulated knowledge, skills, and experiences, as well as their low absenteeism,
      turnover, and accident rates, makes them valuable employees. This chapter
      examines both the positive and negative effects of an aging workforce. A variety
      of issues regarding demographic trends, ageism, stereotyping of the older worker,
      appropriate health promotion strategies, elder care, and health care costs are
      addressed.

PMID- 2237709
TI  - Legal issues in the delivery of worksite health promotion.
AB  - Employee health promotion programs typically involve one or more of the
      following: (1) education programs, (2) cholesterol, blood pressure, diabetes, or
      other similar screening programs, (3) smoking cessation programs, (4)
      drug/alcohol testing and counseling programs, (5) exercise facility or activity
      programs, and (6) recreational activity programs. The authors examine potential
      legal implications of these activities. This chapter is intended for those
      attempting to define and establish these programs or to focus and operate them
      without undue conflict or legal system involvement.

PMID- 2237710
TI  - Are we there yet? Anticipating the future of worksite health promotion.
AB  - This chapter predicts future areas of concern for worksite health promotion
      programs. The shared responsibility of the employee and the organization in
      health promotion is stressed. The author also described the importance of
      recognizing the interrelationships among the personal domains of physical,
      emotional, mental, and spiritual health.

PMID- 2237711
TI  - The earnings test and the short-run work response to its elimination.
AB  - Eliminating the earnings test will have different effects on the work effort of
      persons aged 65-69, depending on whether or not they are currently working or
      currently receiving Social Security benefits. This article reviews the
      development of the earnings test and examines the theoretical implications on
      work effort of removing the test for members of this age group. It looks at the
      Current Population Survey (CPS) data to determine how many persons aged 65-69
      have characteristics that can be identified with groups that would theoretically
      increase, decrease, or not change their work effort should they no longer be
      subject to the earnings test. This analysis suggests that at least 80 percent,
      and perhaps more than 90 percent, of the 9.7 million persons aged 65-69 will not
      change their level of work effort if the earnings test is eliminated. Individuals
      who would modify their hours worked and earnings are fairly evenly split among
      those who would increase, decrease, or have an undetermined direction of change
      in their work effort.

PMID- 2237712
TI  - Understanding depression in medical patients. Part I: Diagnostic considerations.
AB  - Little attention has been devoted to integrating theoretical conceptions of
      depression when considering patients with medical illness. This is more true of
      the social work literature than the psychiatric, in which medical formulations
      and treatment of depression gain primary focus. This paper presents an approach
      for understanding the phenomenon of depression in medical patients. It
      incorporates a theoretical perspective on the mechanism of depression relevant to
      social work intervention. Topics reviewed include diagnostic criteria for
      depression in the medically ill, organic factors in depression, and psychosocial
      theory of depression applied to medical patients. A second part of this paper
      will provide case examples and recommendations for social work intervention.

PMID- 2237713
TI  - Understanding depression in medical patients. Part II: Clinical intervention.
AB  - This paper presents case examples to illustrate key aspects of social work
      intervention with medical patients. Principles of clinical technique are
      discussed in relation to diagnosing and treating depression in the medically ill.
      This paper is a follow-up companion to "Understanding Depression in Medical
      Patients Part I: Diagnostic Considerations" and emphasizes the unique
      contribution of social work in the complex treatment of the biopsychosocial needs
      of individuals and families coping with physical illness.

PMID- 2237714
TI  - Enhancing patient participation: clinical strategies in the discharge planning
      process.
AB  - Social workers are in an excellent position to develop clinical interventions to
      enhance patient control over decision making about post hospital care.
      Participation in decision making has been identified in many studies as
      influencing well-being, health status and even mortality rates for elderly
      individuals facing relocation. Some of the practice patterns that support patient
      autonomy include: (1) involving the patient when working with families; (2)
      reaching for underlying conflict; (3) creating a sense of choice within existing
      parameters; (4) preparing patients for discharge; and (5) educating families and
      hospital caretakers to assist in this process.

PMID- 2237716
TI  - Beyond relationship: the current challenge in clinical practice.
AB  - Clinical social workers in health settings have used time and relationship and
      the understanding of individual and family dynamics, biophysiology, and larger
      systems issues to assist patients and families in resolving health related
      problems. The current economic crisis is limiting time and focus and
      necessitating revisions in intervention techniques. Clinicians experience this as
      a threat to their identity as a caring profession and to their ability to support
      patient autonomy within the health care environment. Effective adaptation
      requires a different use of self, expanded diagnostic skills, greater use of
      networking and systems interventions, and more sophisticated clinical techniques.
      Often, engagement, assessment and intervention have to occur within the same
      session. To accomplish this shift in practice, there has to be strong clinical
      leadership and a conscious focus on adapting clinical models to meet the current
      economic restrictions.

PMID- 2237717
TI  - Managing stress in health social work roles today.
AB  - Stress on social workers in health settings is of increasing professional
      interest and concern. This article suggests individual and system sources of such
      stress and outlines pathways for nurture of the authentic and creative self in
      health careers. Replenishing measures include empowerment through teamwork,
      stress management techniques, consciousness raising to alter self defeating
      cognitions, and activities within and outside the setting to enrich definition
      and use of self.

PMID- 2237715
TI  - Empowering families of the chronically ill: a partnership experience in a
      hospital setting.
AB  - An intervention model has been developed which teaches family members, in
      partnership with social workers, to obtain and monitor services for their
      chronically ill elderly relatives. The research site is a Boston teaching
      hospital with a patient population that is ethnically and racially diverse.
      Initial results of the study reveal that case management is easily accepted by
      most families, and the partnership between the family member and social worker
      enhances the delivery of needed services.

PMID- 2237718
TI  - The predictive value of needle localization mammographically assisted biopsy of
      the breast.
AB  - This study was done to review critically the experience at the University of
      California at San Diego in needle localization mammographic biopsy of the breast
      with regard to use and accuracy in identifying early carcinoma of the breast.
      Ninety-seven patients underwent needle localization mammographic biopsy of the
      breast between 1985 and 1987. Indications for this procedure included the
      presence of microcalcifications or a mass shown on mammographic examination, or
      both, in conjunction with physical examination which did not define a discrete
      abnormality in the area. Mammographic, demographic, pathologic, hormone receptor
      data and staging information were recorded and processed on the MicroVax II
      computer (Digital Equipment Corporation). Twenty-four per cent of lesions with
      needle localization mammographic assisted biopsy proved to be malignant. Sixteen
      lesions were diagnosed as an infiltrating ductal carcinoma and ten of these had
      an accompanying intraductal carcinoma. Over-all, intraductal carcinoma was
      present in 16 of the 23 specimens diagnosed as malignant. At biopsy, the margins
      were clear in 17 of 23, and vascular invasion was present in only one patient
      with an infiltrating lobular carcinoma. Five were tumor in situ, 12 were stage 1
      and five were stage 2 (staging information was not available in one instance).
      Hormone receptor data were available in 17 of 23 specimens. Estrogen receptors
      were positive in 13 and progesterone receptors were positive in six. The smallest
      preinvasive malignant lesion was 4 millimeters, as seen on the mammogram, and the
      smallest free-standing invasive lesion was 8 millimeters. Preinvasive lesions
      (intraductal) presented as microcalcifications in 80 per cent. Invasive lesions
      presented as either a mass (n = 9) or as a mass and microcalcifications (n = 5)
      in 81 per cent. All five lesions presenting as both a mass and
      microcalcifications on mammogram proved to be malignant. Multifocal lesions on
      mammographic examination which proved to be malignant were multifocal
      pathologically in only 50 per cent. Needle localization mammographic biopsy is
      useful in detecting early carcinoma of the breast. Biopsy should be done on
      lesions presenting on mammogram as both a mass and microcalcifications and not
      observed. Focality of lesions on mammogram does not correlate with focality on
      biopsy and may be misleading as criteria for operative planning.

PMID- 2237719
TI  - Preventing postoperative acute bleeding of the upper part of the gastrointestinal
      tract.
AB  - Two hundred and ninety-eight critically ill patients at risk for the development
      of postoperative stress ulcers and bleeding were randomized into three groups.
      The first group comprised 85 patients who received meciadanol, a new
      bioflavonoid, 500 milligrams every six hours through a nasograstric tube; the
      second group comprised 100 patients who received sucralfate (crushed tablets),
      1,000 milligrams every six hours through a nasogastric tube, and the third group
      comprised 113 patients who received an antacid (Maalox [magnesium aluminum
      hydroxide gel]) through a nasogastric tube at an initial dose of 15 milliliters
      every hour. The gastric pH was measured hourly and titrated to a pH greater than
      or equal to 4.0 in patients in the group receiving the antacid. The gastric pH
      was measured every two hours in the other two groups. Bleeding in the upper part
      of the gastrointestinal tract was determined visually (frank blood in gastric
      contents) or by guaiac testing. Bleeding occurred in seven patients receiving
      meciadanol, nine receiving sucralfate and six receiving the antacid. The
      difference in rates of bleeding was not statistically significant. Correlation
      between the severity of illness index and the development of bleeding was poor,
      at least in the low and intermediate index range. In contrast, there was a strong
      correlation between the age of the patient and the development of bleeding. Only
      one patient younger than 50 years had bleeding develop. Apparently, meciadanol
      exerts its action by a mechanism other than pH control. It may, therefore, fill
      an important gap in the ability to prevent postoperative stress ulcers and
      bleeding.

PMID- 2237720
TI  - Stapling or suturing for anastomoses of the left side of the large intestine.
AB  - Two hundred and fifty patients undergoing elective surgical treatment involving
      anastomoses of the left side of the colon or colon and rectum have been studied
      in a randomized trial in which the EEA (U. S. Surgical Corp.) circular stapler
      has been compared with single layer sutured anastomoses. Only patients in whom
      either technique was feasible were included in the analysis. The operative
      techniques were largely standardized. Patients were studied by means of a limited
      barium enema on the ninth or tenth postoperative day. The data have been analyzed
      for leakage rate (clinical and roentgenologic), other complications and degree of
      experience of the surgeon. Eleven patients were excluded from the analysis
      because the selected technique could not be carried out; of these, eight were in
      the stapled group in which it was possible to perform a sutured anastomosis.
      There were no instances in which it was possible to staple but not possible to
      suture. The remaining three exclusions were patients in whom either a coloanal
      anastomosis or a Hartmann procedure was performed. There was no over-all
      difference in the leakage rate--roentgenologic, clinical or total--between the
      two groups. However, when analyzed by the surgeon, the clinical leakage rate for
      surgeons in training was greater for sutured anastomoses than for stapled
      anastomoses (p = 0.053). Thus, it appears that the benefits of experience are
      more pronounced for sutured anastomoses but that, in experienced hands, neither
      technique is superior.

PMID- 2237721
TI  - Deleterious effects of testicular venous occlusion in young rats.
AB  - To determine the differences between testicular arterial and venous obstruction,
      the spermatic artery or vein, or both, were occluded for varying periods of time
      in young rats. Two months later, at the conclusion of the study, the testes were
      examined. Histologic degeneration after vascular obstruction was graded by a
      modified Johnsen's tubular biopsy score (TBS). The testicular concentrations of
      enzymes (lactic dehydrogenase and sorbitol dehydrogenase), known to decrease with
      testicular injury, were measured. TBS and seminiferous tubule diameter (STD) were
      found to decrease significantly after two hours of vascular occlusion and were
      similar regardless of whether the obstruction was produced by occlusion of
      arterial inflow or venous drainage, or both. Testicular concentration of enzymes
      decreased significantly after permanent ligation of the spermatic artery and
      vein, but decreased minimally when the vascular obstruction lasted less than 120
      minutes. Testicular injury produced by venous occlusion was equally severe and
      occurred as rapidly as injury produced by arterial or combined arteriovenous
      occlusion. No significant injury was noted in the contralateral testes in any
      group.

PMID- 2237722
TI  - Intraoperative scintigraphy for active small intestinal bleeding.
AB  - Localizing active sites of bleeding within the small intestine remains a
      difficult task. Endoscopic, angiographic or scintigraphic studies may point to
      the small intestine as the site of blood loss, but at operation, without a
      palpable lesion, the exact site of bleeding remains elusive. Patients are managed
      at laparotomy with intraoperative endoscopy, angiography, multiple enterotomies,
      "blind" resections, or placement of an enterostomy. We describe two patients in
      whom intraoperative scintigraphy accurately identified active sites of bleeding
      in the small intestine when other modalities failed. Intraoperative scintigraphy
      is rapid, easy to perform and is an effective means of identifying active sites
      of bleeding within the small intestine.

PMID- 2237723
TI  - Time to recurrence varies inversely with thickness in clinical stage 1 cutaneous
      melanoma.
AB  - The thickness of a tumor has been identified as the principal prognostic factor
      in cutaneous malignant melanoma. However, time to recurrence has not conclusively
      been related to thickness. A retrospective study of 216 patients with a primary
      cutaneous malignant melanoma that recurred was conducted to clarify this
      relationship and investigate possible independent relationships between age at
      diagnosis and sex of patients to time to recurrence. The results of analysis of
      linear regression revealed an inverse linear relationship between thickness and
      time to recurrence (p less than 0.001). Patients more than 50 years of age at the
      time of diagnosis were shown to relapse sooner than those less than 50 years of
      age (p = 0.014). Sex was not a significant factor in predicting time to
      recurrence (p greater than 0.10). These results suggest that thickness of tumor
      provides an indication of time to recurrence in those patients destined to recur
      and stress the need for long term surveillance in patients with a history of
      malignant melanoma because of the possibility of late relapse even with thin
      lesions.

PMID- 2237724
TI  - Mediastinal tracheostomy using a pectoralis major myocutaneous flap after
      resection of carcinoma of the esophagus involving the proximal part of the
      trachea.
AB  - An operative procedure of mediastinal tracheostomy using a pectoralis major
      myocutaneous flap is presented. In this procedure, the terminal portion of the
      trachea penetrates through the center of a pectoralis major myocutaneous flap and
      the tracheal wall is completely wrapped with the muscular portion of the flap.
      Between 1981 and 1988, eight patients with carcinoma in the cervicothoracic
      segment of the esophagus underwent mediastinal tracheostomy after
      laryngoesophagectomy and extended resection of the proximal part of the trachea
      through sternal manubrectomy, because of invasion into the trachea. In five of
      eight patients, a pectoralis major myocutaneous flap was used to construct a
      tracheal stoma. A skin flap only, or both a skin flap and a muscle flap, was used
      in the other three. In four of eight patients, tracheal necrosis occurred, and
      rupture of the brachiocephalic artery occurred in one patient when the tracheal
      stoma had been constructed using both a skin flap and a muscle flap. However,
      neither skin breakdown nor bleeding from the major vessels occurred when using
      the myocutaneous flap. Therefore, it is concluded that the construction of the
      tracheal stoma using a pectoralis major myocutaneous flap is recommended for
      mediastinal tracheostomy after laryngoesophagectomy with extended resection of
      the proximal part of the trachea.

PMID- 2237725
TI  - Calcifications of the breast after reduction mammoplasty.
AB  - Mammograms of 152 patients after mammoplasty were studied and 37 patients were
      noted to have calcifications. The pattern of these calcifications was studied to
      determine if specific characteristics could be identified. The calcifications
      were found to occur within the skin of the breast, mainly at a periareolar
      location. The ability to identify these benign calcifications further aids in
      reliably monitoring patients by mammography after reduction mammoplasty.

PMID- 2237727
TI  - Use of inferior epigastric artery for reconstruction of a small accessory renal
      artery in renal transplantation.

PMID- 2237726
TI  - The justification for surgical treatment of metastatic melanoma of the
      gastrointestinal tract.
AB  - Fifty-six patients with symptomatic metastatic melanoma of the gastrointestinal
      tract (GIT) treated surgically at the Sydney Melanoma Unit between 1974 and 1989
      were reviewed. The majority of these patients presented with abdominal pain or
      symptoms of anemia. The small intestine was the site of metastasis in more than
      80 per cent. The mean over-all survival time was 11.7 months (range of one to 60
      months) after surgical treatment of a first metastasis to the GIT and 3.6 months
      (range of zero to 12 months) postoperatively for a second GIT metastasis. Forty
      four of the patients reported complete relief of their symptoms postoperatively.
      The results suggest that an aggressive approach to symptomatic GIT metastases
      from malignant melanoma is justified both to relieve distressing symptoms and to
      prolong life.

PMID- 2237728
TI  - A safe and quick method for endoscopic retrieval of multiple gastric foreign
      bodies using a protective sheath.

PMID- 2237729
TI  - The contributions of John B. Murphy to thoracic surgery.
AB  - John B. Murphy was a prominent surgeon who lived in Chicago from the 1880s until
      his death in 1916. During his career, he was associated with both Rush
      Presbyterian and Northwestern Medical Schools. He was responsible for
      popularizing the use of an artificial pneumothorax as an effective adjunct in the
      treatment of pulmonary tuberculosis. This modality was not, however, his original
      concept. In addition to all of the fields of general surgery, Murphy undertook
      the management of empyema and lesions of the chest wall and also performed
      thoracoplasty procedures. Although he had done several thoracotomy procedures in
      his laboratory, he rarely undertook this operation in a clinical setting. Drop
      ether anesthesia was used for all surgical procedures. Murphy did not use closed
      water seal drainage of the chest. His oration on thoracic surgery, given at the
      annual meeting of the AMA, in 1898, was an excellent monograph on the subject and
      undoubtedly contributed to the increased interest and progress in this field of
      surgery. Murphy was a wise surgeon, an able technician and a scholarly teacher.
      The high regard in which he was held by his contemporaries is best expressed by
      the remark of William Mayo, "...he was the surgical genius of our generation".

PMID- 2237730
TI  - An overview of intimal hyperplasia.
AB  - Many hypotheses have been postulated for the development of intimal hyperplasia
      in vein and prosthetic grafts. In these hypotheses, the central theme seems to be
      endothelial injury, but not always denuding injury. As we progress into the
      biologic era with more sophisticated research tools, the study of the endothelial
      cell may give us the answers to the problem of intimal hyperplasia. In addition,
      the leukocyte is still a relatively unknown entity and further modification of
      their function may hold promise.

PMID- 2237731
TI  - Peptic ulcer medication usage, United States, 1989.
AB  - An estimated 10 percent of Americans at one time or another will have a peptic
      ulcer. Thus a class of specific ulcer medications (antisecretory drugs--ASDs)
      will continue to be an important part of the pharmaceutical market. The U.S.
      market for ASDs has increased more than 50-fold since their introduction 13 years
      ago. By 1989, seven ASDs were available in the U.S. and 42.6 million
      prescriptions were dispensed. New prescriptions accounted for 43 percent of this
      total. Per capita consumption varied substantially by state: Arkansas led with
      162.9 per 1,000 and Nevada had the lowest rate (65.1 per 1,000). Zantac,
      manufactured in 1983, accounted for 44.1 percent of the 1989 market; Tagamet
      (available since 1977) followed with 28.2 percent of the market. Internists were
      the predominant source of the prescriptions and ASDs were prescribed for peptic
      ulcers 82.8 percent of the time.

PMID- 2237732
TI  - MetLife's experience with fitness and wellness programming.
AB  - MetLife converted a recreational gymnasium into a fitness and wellness facility
      designed to reduce the risk of cardiovascular disease in employees. Fitness
      assessments, customized workouts, and specialized classes were offered. One
      hundred and fifty-two employees who exercise regularly had initial and six-month
      fitness tests. This group's evaluation data showed favorable cardiovascular
      trends with decreases of 3.6 percent in resting heart rate, 6.4 percent in total
      cholesterol, 3.5 percent in systolic blood pressure, 2.8 percent in diastolic
      blood pressure and an increase of 2.7 percent in HDL cholesterol. Continuing
      analysis of the program will establish the efficacy of MetLife's Wellness and
      Fitness Program.

PMID- 2237733
TI  - AIDS: MetLife's experience.
AB  - The national health burden created by AIDS/HIV disease has had a significant
      impact on the insurance industry. In an analysis of the MetLife health and life
      insurance claims from 1986 through 1989, it was found that a total of
      $323,900,000 has been paid for AIDS/HIV disease. This figure and related
      information from those years were based on the Company's underwriting and claims
      files, with personal and group operations reported separately. Personal life
      insurance claims rose from 344 in 1986 to 874 in 1989 with the dollar amounts
      increasing from $3.2 million to $8.9 million. In 1989 there were 689 group life
      claims with a face amount of $31.5 million and 6,450 people who received group
      medical claim payments for a total of $111.2 million. In 1989 AIDS claims
      comprised 1.61 percent of MetLife claims--up from 0.4 percent in 1986.

PMID- 2237734
TI  - Forecast for the '90s: good health means better business.

PMID- 2237736
TI  - [Pressure distribution pattern in relation to foot structure during muscular
      active and passive load impacts].
AB  - A piezoelectric pressure distribution platform (1000 elements) was employed, to
      investigate the mechanical behavior of three different foot structures. Ten male
      subjects in each of the foot groups Cavus, Rectus, and Planus performed
      voluntarily controlled jumps with one leg onto the pressure distribution
      platform. Using a trap door arrangement, the subjects fell in a second set of
      experiments unexpectedly onto the sensor matrix. In order to exclude a voluntary
      foot muscle response, the time duration of falling was restricted by choosing a
      falling height of only 20 cm. Comparing the data from both impact conditions the
      influence of active foot muscle involvement could be investigated. The analysis
      of the temporal pressure pattern, the local peak pressures and the regional
      impulses permitted an insight into the mechanical characteristics of the
      different foot structures.

PMID- 2237735
TI  - Modified radical mastectomies: average charges, 1988.
AB  - Average charge of $6,160 was billed to Metropolitan Life Insurance Company for
      807 modified radical mastectomies during 1988. The average physicians' fees were
      $2,090. Length of hospital stay averaged 4.3 days across the country. The charges
      varied by as much as 92 percent between states. Among the 19 states included in
      the study, New York and California reported the highest average total charges
      ($7,870 and $7,290) and Iowa and Minnesota reported the lowest average charges
      ($4,100 and $4,620). On average, hospital expense comprised 66 percent of the
      total charges and ancillary fees accounted for almost three-fourths of the
      hospital bill.

PMID- 2237737
TI  - [Experiences with joint-preserving operations in arthrosis of the upper ankle
      joint].
AB  - During a period of ten years we performed 140 joint conserving operations on
      patients with arthrosis of the ankle joint. The use of this procedure was
      analysed in 85 patients, whom we followed up. Mainly (in 89%) positive results
      were obtained. The success of such joint conserving surgery depends on the one
      hand on the seriousness of the injury leading to arthrosis and on the other hand
      on the duration of the complaints. If attention is paid to these factors we have
      after the failure of conservative therapy a satisfying complementary treatment
      before using the arthrodesis.

PMID- 2237738
TI  - [Therapy-resistant heel pain--an indication for surgery in sports traumatology].
AB  - Posterior heel pain can be caused by inflammation or pathology of the achilles
      tendon, the tendon sheath, the retrocalcaneal and subcutaneous tendoachilles
      bursa, can be caused by osteophytes or stress fracture of the os calcis and by
      rheumatoid or metabolic diseases. The majority of patients can be treated
      successful nonoperatively; however, there is a small group of patients who are
      refractory to nonoperative managements. In the years 1984 to 422 patients with
      posterior heel pain were treated conservatively, 26 of these patients were
      refractory to that management. There were 9 cases of achilles tendinitis and/or
      tenosynovitis, 7 cases of bursitis, 3 cases of osteophyte of the os calcis. In 7
      cases there was seen a combination of these three diseases. The following
      operative procedures were performed: discision of the tendon sheath, excision of
      thickened parts by inflammation, excision of degenerative and necrotic pain
      producing areas in the achilles tendon, excision of bursa and ostectomy of
      osteophyte at the posterior-superior angle of the os calcis. The mean follow-up
      was 2.7 years (range, 1/2 to 5 years). Overall there were 79% good results. In
      our opinion cases of posterior heel pain refractory to non-operative treatment
      are an indication of sports surgery, especially in patients who like to continue
      sports without pain.

PMID- 2237739
TI  - [Acute compartment syndrome of the anterior thigh caused by muscular
      overexertion].
AB  - The object of this paper is to describe the problems of acute compartments
      syndromes, caused by muscular overexertion (in this case in the thigh) by a case
      report. Besides the description of the causes a potential pathomechanism in acute
      compartment syndrome, the authors discuss diagnostics, therapy and complications
      of these syndromes with due regard to the relevant scientific publications.

PMID- 2237740
TI  - [The value of arthroscopic labrum stapling in anterior shoulder dislocation].
AB  - Shoulder luxations are common injuries in relation to sports. Isokinetic strength
      was evaluated in 24 patients on the average 1 year after performing arthroscopic
      stabilisation of an anterior shoulder luxation. Using the Merac (Universal Gym
      Equip., Cedar Rapids, Iowa, USA), test data were gathered on both shoulders in
      flexion-extension, abduction-adduction and in the supine 90 degrees abducted test
      position in external-internal rotation. Tests were performed at 60, 180 and 500
      deg/sec. Means and standard deviations for peak torque, total work, peak torque
      to body weight ratios and agonist/antagonist ratios are presented. Our one year
      follow-up showed, that 82% of all patients were free from complaints and had
      almost the same data as on the non-operated shoulders. Arthroscopic stabilisation
      of anterior shoulder luxations in combination with intensive physiotherapy gave
      excellent results in most cases.

PMID- 2237741
TI  - [Ultrasonography of meniscus lesions].
AB  - Controversy exists about the value of ultrasonography of meniscal tears. We
      therefore examined 101 knee joints of 99 patients in a prospective study. Prior
      to the arthroscopy the menisci were scanned from an independent team by using 7.5
      and 10.0 MHz ultrasound waves. 81 meniscal tears were seen at arthroscopy; 36% of
      these tears could not be detected with the scanner (false negative results) while
      20% of intact menisci showed positive echogenic structures, which were analysed
      as meniscal tears. It seems that ultrasonography of the menisci is still of
      experimental use without any clinical importance.

PMID- 2237743
TI  - [Position on "Results of diagnostic sonography in injuries of the knee joint"].

PMID- 2237744
TI  - [20 years at the University Clinic for Radiotherapy and Radiobiology in Vienna
      (K.H. Karcher)].

PMID- 2237742
TI  - [Results of diagnostic sonography in injuries of the knee joint].
AB  - In an experimental study we examined three knee specimens with regard to the
      value of ultrasound for imaging soft tissue structures. Afterwards we documented
      artificial lesions of the menisci and ligaments. With this experience we started
      a prospective study of 101 patients suffering from acute knee injuries or chronic
      knee complaints. We compared the results of preoperative ultrasound investigation
      done by two different examiners with the final diagnosis after arthroscopy. For
      ultrasound evaluation we used a 5 MHz linear and a 7.5 MHz sector scanner. In
      both the experimental and the clinical study the menisci were well visualized.
      For medial meniscus lesions the less experienced examiner reached an accuracy and
      a predictive value of 81%. For the lateral meniscus the accuracy was 80%,
      although there was only a predictive value of 7% because of a high number of
      false positive results. The more experienced examiner got an accuracy of 83% and
      a predictive value of 91% for medial meniscus lesions. For the lateral meniscus
      the accuracy was 89%, however, the predictive value was only 22%. Both examiners
      were not able to detect ACL-ruptures surely. But ultrasound was useful to
      visualize Baker-cysts, bursitis, and jumpers-knee.

PMID- 2237745
TI  - [Brachytherapy using Ru-106 applicators in ophthalmology].
AB  - Two Ru-106 applicators of the type CCB as manufactured by the "Zentralinstitut
      fur Isotopen- und Strahlenforschung" (Berlin, GDR) were investigated. The
      homogeneity of the relative dose distribution at the surface of the applicators
      was determined. For the evaluation of the data extremely small TLD crystals (2 x
      1 x 1 mm) had to be manufactured as well as an almost tissue equivalent acrylic
      eye phantom. In order to assure reproducibility of the applicator positioning,
      the plaque suture eyelets had to be placed on locating pins. 120 points of
      measurements located within the active plaque area of 20 mm diameter were
      evaluated. The results show that the area to be used in tumor treatment is about
      20 to 25% less than expected. One plaque shows a considerable inhomogeneity with
      respect to dose distribution (up to 40%). A modified eye phantom was used for the
      determination of the central axis depth dose distribution.

PMID- 2237746
TI  - [Increasing the thermal enhancement ratio by simultaneous application of
      radiation and hyperthermia--technical possibilities in interstitial application].
AB  - Whereas the cytotoxic effect of hyperthermia is independent and without any time
      relationship with the radiation treatment, the heat induced radiosensitization
      only appears with simultaneous application of radiation and heat. Although the
      highest thermal enhancement ratio (TER) can be achieved with simultaneous
      application this protocol is not used in clinical practise because of technical
      problems. From a practical point of view the major effect of a non simultaneous
      application will have to rely on hyperthermic cytotoxicity. A two-zone needle
      which offers the possibility to conduct radiation and heat simultaneously in
      order to confine this to a three-dimensional radiation and heat is described.

PMID- 2237747
TI  - [The effect of 5-fluorouracil on the radiosensitivity of granulocytopoietic stem
      cells in the bone marrow and the blood].
AB  - The radiation tolerance of haematopoietic stem-cells, originating from blood and
      bone marrow, after exposure to 5-Fluorouracil (5-FU) was investigated. The CFU-C
      Colony Formation Test was used to determine the surviving fraction of
      cryopreserved mononuclear bone marrow and blood cells, after incubation in
      culture medium containing 1 ng/ml 5-FU for 24 hours. With the same assay system
      we determined the radiation tolerance of peripheral CFU-C from three patients
      before and after 5-FU radio-chemotherapy (1000 mg/m2/24 h per day for four days),
      while the influence of the small radiotherapeutic treatment volume was neglected.
      Neither in the in vitro experiments nor in the patients we found a significant
      variation of the dose-survival curves with or without 5-FU. So it is concluded,
      that the enhanced myelodepression of 5-FU combined with radiation may be due to
      an additive effect or by effects on the microenvironment or on the pluripotent
      stem cell system.

PMID- 2237748
TI  - [Interstitial radiotherapy of breast cancer. Preliminary report of a prospective
      study of 165 cases subjected to breast-conserving treatment].
AB  - The results of a prospective study on breast conserving therapy in early stage
      breast cancer are presented. From January 1983 to June 1987 165 patients were
      treated by a standardized therapy-protocol. The criteria for entering the trial
      were stage T1 to T2 and N0 to N1. Surgical breast conservation was achieved by
      segmental resection in 148 cases and by tumorectomy in 17 cases. 160 patients
      underwent axillary lymph node dissection. Obligatory 45 to 50 Gy were delivered
      percutaneously to the operated breast and optional 50 Gy to the regional lymph
      nodes (axillary lymph node involvement greater than 3 nodes). In addition, the
      area of the primary breast lesion itself was boosted interstitially by an Iridium
      192 implant (LDR-technique: 15 to 20 Gy, HDR-technique: 10 to 12 Gy). RESULTS:
      Progression of disease in 10% of the patients (16/165), local recurrence rate in
      the operated breast: 2% (3/165), axillary recurrence: 0.5% (1/165). 5% of the
      patients (8/165) died from metastatic disease, two patients died free of
      recurrence for reasons unrelated to cancer, two other patients died on unknown
      reasons. Because of the low number of local recurrences and the observation
      period of 32 months, no statistically contribution on high risk factors for local
      failure could be found.

PMID- 2237749
TI  - [Therapy monitoring and after care of irradiated anorectal cancer using
      transrectal sonography].
AB  - Pretherapeutic staging before radiotherapy and peri- and posttherapeutic
      endosonographic screening was carried out on 33 patients with anorectal
      carcinoma. The results showed the transrectal endosonography to be essential for
      staging and for the differential diagnosis of tumor recurrence/post irradiation
      changes during follow up. The sonomorphological criteria of tumor recurrences and
      post irradiation bowel wall changes are discussed.

PMID- 2237750
TI  - [Oxygen consumption during photodynamic therapy in vitro].
AB  - The consumption of dissolved molecular oxygen was measured during photodynamic
      therapy in vitro. Aqueous solutions of hematoporphyrin derivative (HpD)
      containing different concentrations of serum or numbers of cells were prepared.
      Decrease in oxygen in the solution and cell suspensions was monitored during
      light-irradiation (at a wavelength of 610 to 640 nm). The rate of oxygen
      consumption increased with increasing concentrations of HpD, serum levels or
      numbers of cells. Upon repeated irradiation of the same solutions (after
      restitution of the initial pO2 of 100 mm Hg), the rate of oxygen consumption
      decreased indicating a disaggregation process of HpD. The rate of oxygen content
      of the solutions decreased independently of the actual oxygen partial pressure.
      Even at a low pO2 below 10 mm Hg, oxygen consumption was unimpeded until the
      solutions were free of oxygen. No O2-consumption was noted in aqueous solutions
      of HpD (up to 40 g/ml) without serum or cells during irradiation.

PMID- 2237751
TI  - [Chemo- and radiosensitivity testing of tumor tissue cultured in vitro.
      Development of a fiber culture system for cell harvesting].
AB  - Chemo- and radiosensitivity-testing of tumour cells should be performed in vitro
      under in vivo-like conditions. One problem is to grow cells to tissue-like cell
      densities in vitro. A hollow fiber reactor was prepared for cell growth to high
      densities. In order to obtain cells during and after sensitivity testing for
      quantitating cell damage, a harvesting fiber system was developed which can be
      inserted in the nutritional hollow fiber system. These hollow fibers have a
      diameter of 300 microns and a wall thickness of 10 microns. Small holes between
      10 and 100 microns can be cut into the fibers for cell harvesting by electric
      sparks. Up to 60 holes per mm fiber length can be produced.

PMID- 2237752
TI  - [Retrobulbar irradiation of endocrine ophthalmopathy: a comparison between 10 and
      16 Gy total dose].
AB  - Severe Graves' ophthalmopathy has been treated in 44 cases by orbital
      irradiation. 36 out of 37 patients showed a good response or a suspend of the
      progressive disease. In 17 out of 33 primary irradiations a dose of 10 Gy and in
      16 cases a dose of 16 Gy was applied. Measured by ophthalmopathy-index
      significant better results have been achieved by a total dose of 16 Gy. Because
      of recurrence after primary irradiation of 10 Gy a re-irradiation became
      necessary in 35% of the cases. Primary irradiation of 16 Gy has required no
      further treatment during the same time of observation. A single series of 16 Gy
      irradiation has shown better results than two series of 10 Gy irradiation
      concerning the proptosis and alleviation of symptoms.

PMID- 2237753
TI  - Multi-modality in management of primary malignant non-Hodgkin lymphomas of the
      central nervous system.
AB  - A retrospective study of nine patients with primary malignant non-Hodgkin
      lymphomas of the central nervous system was carried out with emphasis on
      treatment results. Detailed investigations before or during the treatment
      excluded the presence of extraneural malignant lymphoma. The varying radicality
      of surgery was followed by radiotherapy, with different doses and techniques
      occasionally with adjuvant drug treatment. Two patients received chemotherapy.
      Surgical removal and subsequent radiotherapy as well as the histology were almost
      identical in patients with longer survival. It was tried to evaluate the
      prognostic influence of different factors on treatment and survival.

PMID- 2237754
TI  - [Therapy of medulloblastomas--results from 1968 to 1985].
AB  - Between 1968 and 1985 35 patients with an histological proven medulloblastoma
      received radiotherapy after surgery. Patients are divided into three groups,
      showing the improvement in diagnostic procedures as well as in therapy. These
      changes result in a higher proportion of patients living longer without disease.
      Only a close cooperation between surgeon, radiotherapist and pediatric oncologist
      will give these patients the best chances of cure, if they are treated in
      multicenter studies.

PMID- 2237755
TI  - [A new system for cervix application using the afterloading technique].
AB  - We developed a new application system for the intracavitary afterloading therapy
      of the cervix carcinoma. With this system special problems of the application as
      the possible perforation of the cervix uteri are prevented.

PMID- 2237756
TI  - [Simple endoscopic positioning of a double-barrelled afterloading applicator
      based on the Seldinger principle].
AB  - The endoluminal positioning of afterloading applicators without exact guidance
      may be time wasting and difficult in cases of unsteady or higher degree
      gastroenterological tumor stenosis. The open catheters, which were developed
      especially for this, will be pushed over a guidewire and have an obligatory
      contamination of catheter and radiation source with body secretions. For this
      case we have developed a double channeled afterloading applicator, which will
      give the advantages of the Seldinger technique with the safety of a closed
      system, combined with endoscopic guiding of the wire. With this technique we
      simplified the endoluminal radiation. Our method is safe, time saving and less
      stressful for the patients.

PMID- 2237757
TI  - Cataract extraction in uveitis patients.
AB  - Cataracts are known to develop at an accelerated rate in many forms of uveitis.
      Until recently, cataract surgery in such eyes was regarded as a hazardous
      procedure that yielded unpredictable and often discouraging results. Recent
      evidence from a number of reports suggests that newer surgical techniques and
      careful medical management allow a significant number of patients with uveitis to
      undergo cataract extraction successfully. Intraocular lens implantation using in
      the-bag posterior chamber lens technique has been successful in selected cases.
      Careful patient selection, coupled with the use of an appropriate surgical
      technique, appear to be of major importance. Herein we review the current
      literature on cataract extraction in uveitis and provide guidelines for patient
      and technique selection based on the type of inflammation present. The management
      of common surgical problems and complications is discussed, as is the role of the
      intraocular lens. Specific surgical techniques useful in the management of eyes
      with cataract and uveitis are discussed.

PMID- 2237758
TI  - Antibodies in human tears during and after infection.
AB  - The tear content of antibodies specific for various infectious agents has
      recently begun to be investigated. Important parameters of tear analysis with
      respect to antibody content are the method of tear collection and the laboratory
      techniques used to detect specific antibodies in the lacrimal fluid. Normal tears
      contain antibodies directed against both bacteria and viruses, and the antibody
      response in lacrimal fluid during immunization of animals and humans has been
      studied to some extent. This response has also been analyzed in humans during and
      after natural infection with certain viral and bacterial pathogens. It has become
      clear that local antibody synthesis takes place in the lacrimal gland, but at
      least some of these antibodies appear in tears because of lymphocyte
      sensitization in the common mucosal immune system. A certain degree of
      transudation of serum antibodies to tears is also often encountered, especially
      in severely inflamed eyes. Much of the data currently available needs to be
      confirmed, and more extensive studies need to be carried out for many pathogens.
      Potential benefits of such studies include development of new diagnostic
      techniques as well as a better understanding of when and how antibodies confer
      protection or may be potentially damaging.

PMID- 2237759
TI  - Disc swelling in an adult diabetic patient.
AB  - A patient with insulin dependent adult onset diabetes presented with bilateral
      disc edema and minimal visual dysfunction. Initial work-up excluded an
      intracranial lesion, and a lumbar puncture revealed a normal opening pressure.
      The patient developed proliferative retinopathy, for which she received
      photocoagulation therapy. She subsequently developed an exacerbation and change
      of her disc swelling, associated with raised intracranial pressure. The
      differential diagnosis of diabetic papillopathy and papilledema is discussed.

PMID- 2237760
TI  - Caspar Stromayr: sixteenth century ophthalmologist.
AB  - Caspar Stromayr, ophthalmologist and hernia surgeon, is credited with writing the
      first German ophthalmic work of known authorship. Written in about 1559 as an
      appendix to Practica Copiosa, a larger work on hernia surgery, the ophthalmic
      chapters describe Stromayr's thoughts on the etiology and treatment of cataract.
      Stromayr, a master craftsman, also expresses his hostility to the shams and
      ignorance of the charlatan eye surgeons of his day. This interesting historical
      article provides a biographical sketch of Stromayr, a description of his book,
      and a translation of two chapters, "On Cataract of the Eye: How They Take Their
      Beginning and Whence they Come" and "How You Recognize the Cataract, When It is
      Ripe to Recline or to be Taken Away."

PMID- 2237761
TI  - Congenital craniofacial anomalies of ophthalmic importance.
AB  - Congenital craniofacial abnormalities frequently require ophthalmic evaluation
      and surgical management. Called upon to perform as part of the craniofacial team
      managing the often severely deformed craniofacial patient, the ophthalmologist
      must bring a basic knowledge of craniofacial syndromes and developmental anatomy,
      as well as clinical acumen to help preserve or improve ocular and adnexal
      function. As an introduction to this area of ophthalmology, the clinical
      features, classification, appropriate facial embryology, assessment and surgical
      considerations of the various congenital craniofacial abnormalities are reviewed.
      The expanding availability of craniofacial surgeons and surgical teams along with
      improved surgical results will ultimately require an increasing involvement by
      many more ophthalmologists in the evaluation and management of these congenital
      abnormalities.

PMID- 2237762
TI  - High or low hepaticojejunostomy for bile duct strictures?
AB  - The 19 patients who underwent 22 postoperative repairs of bile duct stricture in
      our institution between 1973 and 1984 were evaluated to assess whether the
      recognition of the tenuous blood supply of the supraduodenal bile duct in 1979
      had improved the results thereafter. Thirteen of these 22 operations followed a
      previous biliary tract repair; in 10 of the operations a low anastomosis had been
      performed without taking blood supply into account. Follow-up was complete and
      ranged from 5 to 15 years. There were no operative deaths and minimal morbidity.
      There were three deaths at a later time. Five of the 11 patients treated by
      surgery to 1979 had a clinically unsatisfactory result: recurrent strictures
      developed in all five patients. All but one of the eight patients receiving a
      high hepaticojejunostomy from 1980 had a clinically satisfactory result with no
      recurrent strictures. The one exception was the patient who had a second repair
      with separate high right and left hepatic duct anastomoses and who has ongoing
      symptoms from preexisting secondary sclerosing cholangitis. The results in the
      five high repairs performed for low strictures were particularly striking: All
      five were asymptomatic. This study lends support to the hypothesis of an ischemic
      basis for biliary strictures and to the recommendation that strictures be
      repaired with a high hepaticojejunostomy.

PMID- 2237763
TI  - Biliobiliary fistula: preoperative diagnosis and management implications.
AB  - Experience with cholecystohepaticodochal and cholecystocholedochal fistulas as a
      result of an erosion of gallstones from the gallbladder into the adjacent common
      duct in five patients is presented. The incidence was 1.4% in a population of 350
      patients undergoing cholecystectomy. The condition was indicated clinically on
      the basis of a symptom triad of jaundice, fever, and pain with cholelithiasis in
      a small contracted gallbladder. In addition, proximal intra- and extrahepatic
      ductal dilatation, calculus in the common duct, and normal-caliber (or
      unprofiled) distal common duct on ultrasound scan were present in all the
      patients. Endoscopic retrograde cholangiopancreatography proved to be the most
      useful means of investigation, and it confirmed the diagnosis in four patients
      before surgery. A modified antegrade cholecystectomy was performed with the
      gallbladder opened inferiorly at the fundus, and the stones were evacuated. A
      partial cholecystectomy and choledochoplasty were accomplished with gallbladder
      flaps whenever feasible. Other useful operative procedures are side-to-side
      hepaticodochojejunostomy and hepaticodochoduodenostomy. In the presence of high
      benign bile duct stricture, an approach to the left hepatic duct is now preferred
      for biliary bypass.

PMID- 2237764
TI  - Hyperbaric oxygen therapy for necrotizing fasciitis reduces mortality and the
      need for debridements.
AB  - Twenty-nine patients with necrotizing fasciitis were treated from 1980 to 1988.
      This study evaluates how the addition of hyperbaric oxygen (HBO) therapy to
      surgical treatment has affected mortality and the number of debridements required
      to achieve wound control in these patients. Two groups of patients were viewed:
      group 1 (n = 12) received surgical debridement and antibiotics only; group 2 (n =
      17) received HBO (90 minutes at 2.5 atm, average 7.4 treatments) in addition to
      surgery and antibiotics. Both groups were similar in age, race, sex, wound
      bacteriology, and antimicrobial therapy. Body surface area affected was similar,
      however, perineal involvement was more common in group 2 (53%) than in group 1
      (12%). The admitting conditions of patients in group 1 (non-HBO) were diabetic,
      33%; white blood cell count more than 12,000, 50%; and shock, 8%. The admitting
      conditions of patients in group 2 (HBO) were diabetic, 47%; white blood cell
      count more than 12,000, 59%; and shock, 29%. Although group 2 patients receiving
      HBO were more seriously ill on admission, mortality was significantly lower (23%)
      compared to group 1 (66%) (p less than 0.02). In addition, only 1.2 debridements
      per group 2 patient were required to achieve wound control versus 3.3
      debridements per group 1 patient (p less than 0.03). The addition of HBO therapy
      to the surgical and antimicrobial treatment of necrotizing fasciitis
      significantly reduced mortality and wound morbidity (number of debridements) in
      this study, especially among nonclostridial infections. We conclude that HBO
      should be used routinely in the treatment of necrotizing fasciitis.

PMID- 2237765
TI  - The role of gastric resection in the management of multicentric argyrophil
      gastric carcinoids.
AB  - A patient with pernicious anemia, atrophic non-antral gastritis,
      hypergastrinemia, and widespread hyperplasia of enterochromaffin-like cells and
      manifest enterochromaffin-like cell carcinoma was followed up during 39 months,
      including 15 months after gastric resection. In this case normalization of
      gastrin levels did not prevent the development of multiple gastric carcinoids in
      the fundic mucosa, suggesting that factors other than gastrin are of importance
      in the pathogenesis.

PMID- 2237766
TI  - Myoelectric effects and histology after stapled occlusion of the small bowel.
AB  - Braun enteroenterostomy with stapled occlusion of the afferent limb has been
      advocated to treat bile gastritis and to avoid the motility effects of Roux-en-Y
      gastrojejunostomy. However, the motility effects of stapled occlusion are
      unknown. Myoelectric activity and histologic features were studied after stapled
      occlusion of the small bowel in a canine model. A 35 cm "recirculating loop" was
      created with a side-to-side anastomosis, beginning 25 cm from the ligament of
      Treitz. Serosal electrodes were placed at 5 cm intervals on the loop; at a second
      operation in one dog and simultaneously in three dogs, the bowel was occluded
      midway between two electrodes with 4.8 mm staples. Fasting recordings were
      obtained at weekly intervals to 6 months after surgery and were analyzed for slow
      wave frequency proximal and distal to the staple line and for propagation time of
      phase 3 of the migrating myoelectric complex across the staple line. The side-to
      side anastomosis did not alter myoelectric activity. However, after stapled
      occlusion of the small bowel, the slow wave frequency dropped from a mean of 18.2
      +/- 0.4 cpm proximally to 15.4 +/- 1.0 cpm distally (p less than 0.05). This
      correlated with loss of myogenic continuity in three of four animals. Propagation
      of phase 3 slowed across the staple line (115 +/- 27 seconds versus 47 +/- 9
      seconds) (p less than 0.02). The bowel lumen recannulated in all animals.
      Stapling across the small bowel alters myoelectric activity, and occlusion of the
      bowel lumen may not be permanent.

PMID- 2237767
TI  - Traumatic disruptions of the thoracic aorta: treatment and outcome.
AB  - Of 27 patients admitted to our level I trauma center with acute disruption of the
      thoracic aorta, two patients died of exsanguination before aortic repair. One
      patient had massive leakage from the aneurysm after aortography and died during
      surgery. All patients suffered from multiple injuries. Eighty-three percent of
      the patients had major operations in addition to the aortic repair. "Clamp and
      sew" technique was used in 18 patients (75%), two of whom had multiple tears of
      the aortic arch. Heparin-coated shunts were used in five patients (20.8%), and a
      cardiopulmonary bypass was performed in one patient who had multiple tears. Three
      postoperative deaths were related to polytrauma, cardiogenic shock, and sepsis.
      Paraplegia developed in three patients, two of whom had multiple aortic lesions
      necessitating longer ischemia time during the repair. Only one patient had
      complete neurologic deficit at the 1-year follow-up. In our series, neither
      surgical procedure proved superior. We conclude that the "clamp and sew"
      technique for repair of the disrupted thoracic aorta may allow for a more
      favorable outcome.

PMID- 2237768
TI  - Sequential gradient pneumatic compression enhances venous ulcer healing: a
      randomized trial.
AB  - The treatment of venous ulcers has remained largely unchanged for centuries. The
      application of properly applied graduated compression bandages, the use of
      graduated compression stockings, and surgery have been shown to achieve healing.
      However, some ulcers persist despite appropriate management. A randomized study
      was undertaken to compare two regimens of treatment for such patients. Both
      regimens included ulcer debridement, cleaning, nonadherent dressing, and
      graduated compression stockings. In one regimen, sequential gradient intermittent
      pneumatic compression was applied for 4 hours each day. Only one of 24 patients
      in the control group had complete healing of all ulcers compared with 10 of 21
      patients healed in the intermittent pneumatic compression group. The median rate
      of ulcer healing in the control group was 2.1% area per week compared to 19.8%
      area per week in the intermittent pneumatic compression group. The results
      indicate that sequential gradient intermittent pneumatic compression is
      beneficial in the treatment of venous ulcers.

PMID- 2237769
TI  - Esophageal reflux before and after isolated myotomy for achalasia.
AB  - Four patients with achalasia underwent 24-hour esophageal pH measurements as
      ambulatory patients before and after limited myotomy without fundoplication.
      Resting lower esophageal sphincter pressure was reduced from 24.3 +/- 1.3 mm Hg
      to 7.5 +/- 4.3 mm Hg. No significant differences (p greater than 0.05) were found
      before and after operation in the total 24-hour pH data distribution (pH 6.24 +/-
      0.84 vs 5.75 +/- 1.03), the fraction of time below pH 4.0 (4.8% +/- 5.3% vs 8.0%
      +/- 6.9%), or the mean duration of reflux episodes greater than 5 minutes (22.8
      +/- 18.8 minutes vs 23.0 +/- 10 minutes), all +/- SD. Effective relief of
      esophageal obstruction in achalasia is feasible by isolated limited myotomy
      without producing gastroesophageal reflux.

PMID- 2237770
TI  - Rejection of multivisceral allografts in rats: a sequential analysis with
      comparison to isolated orthotopic small-bowel and liver grafts.
AB  - Multivisceral isografts and allografts were transplanted to Lewis rats, and the
      histopathologic changes were studied in the liver, intestine, and other
      constituent organs. Rats receiving isografts had indefinite survival with
      maintenance of weight. With multivisceral allografts (from Brown-Norway donors),
      the intestinal component was rejected more severely than the companion liver and
      with about the same severity as when intestinal transplantation was performed
      alone. Intestinal rejection in either circumstance was a lethal event, causing
      death in 10 to 12 days. The earliest (by day 4) and most intense cellular
      rejection was in the Peyer's patches and mesenteric lymph nodes. This was
      associated with or followed by cryptitis, epithelial cell necrosis, focal abscess
      formation, mural necrosis, and eventual perforation. Liver allografts
      transplanted alone or as part of multivisceral grafts also had histopathologic
      evidence of rejection, but this was self-limiting and spontaneously reversible
      when the liver was transplanted alone. Thus the Achille's heel of multivisceral
      grafts is the intestinal component that is not protected by the presence of the
      liver in the organ complex. Better immunosuppression should permit successful
      experimental and clinical transplantation of such grafts.

PMID- 2237771
TI  - Improved preservation of the rat liver for orthotopic liver transplantation: use
      of University of Wisconsin-lactobionate solution and retrograde reflushing.
AB  - This study investigated cold preservation and reflushing before orthotopic liver
      transplantation by examining (1) new University of Wisconsin solution (UW) versus
      Euro-Collins solution (EC), (2) retrograde reflushing (RR) versus antegrade
      reflushing (AR), and (3) the addition of a platelet-activating inhibitor (PAF),
      superoxide disumatase (SOD), or SOD + catalase to UW. Syngeneic, male Lewis rats
      (200 to 400 gm) were used. Preservation for 9, 12, 18, or 24 hours in UW or EC
      with RR (through the inferior vena cava) was used. The 9- and 12-hour groups
      experienced a significant decrease in the weight of the grafts preserved in UW.
      The 3-week survival rate after 9 hours of preservation (n = 6) in UW was 66%, and
      the survival rate with EC was 0% (p less than 0.025). After 12 hours of
      preservation, recipient survival rate was 70% (n = 10) with UW versus 0% (n = 4)
      with EC (p less than 0.025). RR of the graft with cold lactated Ringer's solution
      immediately before reimplantation significantly improved 3-week survival in the
      12-hour group to the level of the control group (no preservation time, 69%).
      Preservation for 12 hours in UW followed by AR yielded a 3-week survival of 14%;
      3-week survival for the RR group was 70% (p less than 0.025). Furthermore, RR
      allowed a 3-week survival of 33% and 20% after 18 and 24 hours of UW
      preservation, respectively. In the 24-hour RR/UW group, donor pretreatment with
      SRI 63-441 (20 mg/kg, intravenously) and recipient treatment with SOD (15 mg/kg,
      intravenously) or SOD + catalase (15 mg/kg and 5000 units/kg, intravenously)
      produced a 3-week survival comparable to preservation in UW followed by RR alone.
      These studies show that UW is a profound improvement over EC for cold
      preservation of liver and that the new application of RR to rat orthotopic liver
      transplantation improves survival. However, the addition of free-radical
      scavengers or PAF does not improve organ function or recipient survival in this
      model.

PMID- 2237772
TI  - Portal vein resection with a new antithrombogenic catheter.
AB  - Curative resection of pancreatic and hepatobiliary tumors is rarely possible
      because of local invasion, especially into the portal vein. We developed a new
      antithrombogenic catheter using a heparinized hydrophilic polymer to allow portal
      vein bypass during resection of tumors invading the portal vein. Pancreatectomy
      or hepatectomy accompanied by portal vein resection was performed for pancreatic
      or hepatobiliary cancer, with an intraoperative shunt from the superior
      mesenteric vein to the femoral vein or from the superior mesenteric vein to the
      intrahepatic portal vein through the umbilical vein or the hepatic hilar portal
      vein. Use of the shunt prevented stasis in the superior mesenteric vein and
      hepatic ischemia even during prolonged occlusion of the portal vein, and portal
      vein resection was performed in 81 patients with hepatobiliary and pancreatic
      disease with greater safety and ease.

PMID- 2237773
TI  - Adoptive immunotherapy of human pancreatic cancer with lymphokine-activated
      killer cells and interleukin-2 in a nude mouse model.
AB  - A pancreatic cancer cell line was grown in orthotopic and heterotopic positions
      in young Swiss/NIH nude mice, which were tested with adoptive immunotherapy. Mice
      were injected with 1 x 10(7) human cancer cells in the subcutaneous tissue and
      duodenal lobe of the pancreas. The mice were randomly divided into four groups:
      group IA (LAK + IL-2) (N = 25) received 2 X 10(7) human lymphokine-activated
      killer (LAK) cells from normal donors by tail vein injection followed by 10,000
      units of human recombinant interleukin-2 (IL-2) given intraperitoneally every 12
      hours for 28 days; group IB (IL-2) (N = 27) was given the same dose of IL-2
      alone; group IC (RPMI-1640) (N = 18) received a placebo consisting of 1 ml of
      RPMI-1640 intraperitoneally every 12 hours; and group ID (LAK) (N = 14) received
      2 X 10(7) LAK cells but no IL-2. Toxicity was significantly higher in group IB,
      with a mortality rate of 45.5% (10/22 animals) versus a 0% mortality (0/25) in
      group IA. None of the group IA or IB animals died of pancreatic cancer during the
      experiment. The animals that did not receive IL-2 died before 28 days in 14.2% of
      group IC and in 16.7% of group ID. The area under the growth curve of
      subcutaneous tumors during the course of treatment and the pancreatic tumor
      weight at the end of treatment were compared in each group. Subcutaneous tumors
      had a reduced rate of growth in group IA animals compared to all the other
      treatments. Pancreatic tumor growth was slowed in group IA. The animals treated
      with IL-2 alone (group IB) showed some slowing of tumor growth that was
      intermediate between group IA, group IC, and group ID. A similar experiment was
      done with irradiated (375 rad) mice. Nine nude mice with tumors were treated with
      LAK + IL-2 (group IIA), eight received IL-2 alone (group IIB), and seven received
      placebo (group IIC). The antitumor effect of IL-2 alone was not present in the
      irradiated mice. A highly significant difference persisted between group IIA and
      all other groups. There was no difference in the histologic characteristics of
      tumors in control mice and in mice with inhibited tumor growth treated with IL-2
      or IL-2 and human LAK cells. These results show that adoptive immunotherapy with
      human LAK cells and human recombinant IL-2 is effective against human pancreatic
      cancer growing in nude mice. This effect is independent from antitumor activity
      from IL-2 administrations alone.

PMID- 2237774
TI  - Gastric outlet obstruction caused by traumatic pseudoaneurysm of superior
      mesenteric artery.
AB  - Traumatic pseudoaneurysms of the superior mesenteric artery (SMA) are extremely
      rare. We describe two cases of posttraumatic proximal SMA pseudoaneurysms with
      symptoms of gastric outlet obstruction. Repair was accomplished by aorta-SMA
      bypass with saphenous vein. Injuries to the proximal SMA are easily missed at
      laparotomy, especially if intestinal ischemia or hematomas are absent.
      Recognition and repair are stressed to avoid the complications associated with
      pseudoaneurysm formation.

PMID- 2237775
TI  - Severe primary hyperparathyroidism in a neonate having a parent with
      hypercalcemia: treatment by total parathyroidectomy and simultaneous heterotopic
      autotransplantation.
AB  - Neonatal primary hyperparathyroidism is a life-threatening disease because of
      marked hypercalcemia and severe respiratory distress caused by the hypoplastic
      thorax and occasional rib fractures. We report a 29-day-old girl treated by total
      parathyroidectomy and simultaneous autotransplantation of parathyroid tissue (one
      fifth of each of the two glands) in the femoral quadriceps muscle near the groin.
      At the time of operation, all four of the parathyroid glands were markedly
      enlarged, and their total weight was 900 mg. Part of the resected parathyroid
      tissue was cryopreserved for further autotransplantation should
      hypoparathyroidism develop. Two years six months after surgery, the infant was
      well and had normal levels of serum calcium and immunoreactive parathyroid
      hormone in the absence of any supplementary treatment. Asymptomatic hypercalcemia
      in the presence of abnormally low fractional excretion of calcium was found in
      the father. Based on our experience and review of the literature, we recommend
      total parathyroidectomy, autotransplantation, and cryopreservation for the
      neonate with primary hyperparathyroidism.

PMID- 2237776
TI  - Cholinergic modulation of responses to single tones produces tone-specific
      receptive field alterations in cat auditory cortex.
AB  - Acetylcholine (ACh), acting via muscarinic receptors, is known to modulate
      neuronal responsiveness in primary sensory neocortex. The administration of ACh
      to cortical neurons facilitates or suppresses responses to sensory stimuli, and
      these effects can endure well beyond the period of ACh application. In the
      present study, we sought to determine whether ACh produces a general change in
      sensory information processing, or whether it can specifically alter the
      processing of sensory stimuli with which it was "paired". To answer this
      question, we restricted acoustic stimulation in the presence of ACh to a single
      frequency, and determined single neuron frequency receptive fields in primary
      auditory cortex before and after this pairing. During its administration, ACh
      produced mostly facilitatory effects on spontaneous activity and on responses to
      the single frequency tone. Examination of frequency receptive fields after ACh
      administration revealed receptive field modifications in 56% of the cells. In
      half of these cases, the receptive field alterations were highly specific to the
      frequency of the tone previously paired with ACh. Thus ACh can produce stimulus
      specific modulation of auditory information processing. An additional and
      unexpected finding was that the type of modulation during ACh administration did
      not predict the type of receptive field modulation observed after ACh
      administration; this may be related to the physiological "context" of the same
      stimulus in two different conditions. The implications of these findings for
      learning-induced plasticity in the auditory cortex is discussed.

PMID- 2237777
TI  - Chronic treatment with clozapine or haloperidol differentially regulates dopamine
      and serotonin receptors in rat brain.
AB  - Long-term administration of the atypical neuroleptic clozapine (CLZ) poses a much
      lower risk of extrapyramidal side effects (EPS) than does the use of typical
      neuroleptics such as haloperidol (HAL). To investigate the neural mechanisms of
      the differing CNS activities of these two drugs, we used quantitative
      autoradiography to measure changes in dopamine and serotonin receptors in rats
      after injection with CLZ or HAL for 21 days at clinically relevant dose ratios.
      Levels of D1, D2, and 5-HT2 receptors were determined in frontal cortex, caudate
      putamen, and nucleus accumbens. Rats that received CLZ chronically showed CNS
      receptor changes markedly different from those in chronic HAL-treated animals.
      Whereas rats treated chronically with HAL showed enhanced striatal D2 binding
      (average increase of 42%), those treated with CLZ did not. In contrast, chronic
      CLZ, but not chronic HAL, induced enhanced striatal D1 binding (average increase
      of 43%). Finally, CLZ treatment decreased 5-HT2 receptor binding by an average of
      37%, while HAL had no significant effect. The effects of chronic HAL or CLZ
      treatment on receptors were similar in all forebrain areas examined. However,
      since D1 and 5-HT2 receptors are more abundant than D2 sites in limbic and
      neocortical areas, the preferential modulation of D1 and 5-HT2 receptors by CLZ
      suggests a greater impact of this atypical neuroleptic on activity of the limbic
      system than that achieved by the typical neuroleptic, HAL. These findings suggest
      that the clinical profile of atypical neuroleptics such as CLZ may be attributed
      to their effects on a receptor profile differing in pharmacological
      characteristics and anatomical distribution from that affected by typical
      neuroleptics.

PMID- 2237778
TI  - Modulation of gonadotropin-releasing hormone neuronal activity as evidenced by
      uptake of fluorogold from the vasculature.
AB  - Peripheral injections of the tracer fluorogold (FG) and immunocytochemistry were
      used to study the modulation of gonadotropin-releasing hormone (GnRH) cell
      secretory activity in adult mice. Intraperitoneal administration of FG would make
      it available to all GnRH terminals outside the blood-brain barrier. The degree of
      capture of the dye would be linked to exocytotic (e.g., secretory) events at the
      nerve terminal. Single injections of tracer were made into intact mice of both
      sexes, and this resulted in the retrograde labeling of two-thirds of the GnRH
      cell bodies. Administration of identical doses to 3 week castrate mice revealed a
      reduction in the percentage of GnRH cells, with detectable FG, to 40% of the
      total. Castration did not diminish the number of GnRH cells visualized. When
      castrate animals received two doses of FG, the number of GnRH cells with tracer
      was increased to slightly greater than intact levels. This suggests that the
      secretory rate of individual GnRH cells might be reduced under conditions of
      castration. In addition, when ovariectomized females treated with estrogen and
      progesterone to induce luteinizing hormone (LH) surge were injected with FG just
      prior to that surge, over 80% of the GnRH neurons were robustly labeled with FG.
      These latter data are interpreted as representing GnRH neurons at maximally
      synchronized activity. This study suggests that peripheral administration of FG
      can be used in this species to follow alterations in neurosecretory rates.

PMID- 2237779
TI  - Electrophysiological identification of a pathway from the septal area to the
      medial amygdala: sensitivity to estrogen and luteinizing hormone-releasing
      hormone.
AB  - Medial amygdala neurons responsive to electrical stimulation of the medial septal
      area were electrophysiologically identified in ovariectomized, urethane
      anesthetized female rats. Peristimulus time histograms were collected and used to
      define the orthodromic response. The action of iontophoretically applied
      luteinizing hormone-releasing hormone (LHRH) and an LHRH fragment, Ac-LHRH5-10,
      on the activity of orthodromically responsive neurons was tested. Of a total of
      187 neurons recorded, 119 were identified as orthodromically responsive. Three
      types of orthodromic responses were observed: excitatory, inhibitory, and
      complex. Priming the animals with 5 micrograms estradiol benzoate (EB) 48 hr
      prior to recording had no effect on the overall number of neurons responding to
      septal area stimulation, but EB priming did significantly reduce the percentage
      of orthodromically excited neurons. The firing rate of the majority of amygdala
      neurons responsive to septal area stimulation was not affected by
      iontophoretically applied LHRH (59 of 76) or LHRH fragment (41 of 65). In some
      cases, application of LHRH (10 of 76) or Ac-LHRH5-10 (12 of 55) produced a change
      in neuronal firing that was similar in direction to the orthodromically evoked
      response. When applied during the collection of peristimulus time histograms,
      both peptides were also able to modulate the orthodromically evoked response
      (five of 18 cells tested with LHRH and three of 14 cells tested with Ac-LHRH5
      10). The results demonstrate a large projection from the septal area to the
      amygdala, one component of which is altered by estrogen priming.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2237780
TI  - Autoradiographic localization of cocaine binding sites by [3H]CFT ([3H]WIN
      35,428) in the monkey brain.
AB  - The cocaine analog [3H]2 beta-carbomethoxy-3 beta-(4-fluorophenyl)tropane
      ([3H]CFT or [3H]WIN 35,428 binds with high affinity and selectivity to cocaine
      receptors in the monkey caudate-putamen. [3H]CFT was used to map the regional
      distribution of cocaine binding sites in slide-mounted sections of monkey brains
      using autoradiographic techniques. Hemicoronal brain sections were incubated with
      [3H]CFT (3 nM) alone or in the presence of excess (-)-cocaine (30 microM) to mask
      the binding sites. High densities of [3H]CFT binding sites were detected in the
      caudate nucleus, putamen, and nucleus accumbens. In all three regions, binding
      was markedly reduced by coincubation with unlabeled (-)-cocaine, indicating low
      levels of nonspecific binding. Little or no binding was observed in the cortex,
      thalamus, globus pallidus, or white matter tracts at the levels studied. In order
      to characterize binding sites for [3H]CFT in tissue sections, competition
      experiments were conducted using a fixed concentration of [3H]CFT (3 nM) and a
      range of concentrations of (-)-cocaine, (+)-cocaine, CFT, Lu 19-005, GBR 12909,
      bupropion, and citalopram. The IC50 values for the drugs in tissue sections
      corresponded closely with their reported IC50 values in monkey caudate-putamen
      membranes (r = 0.99, p less than 0.001), suggesting that [3H]CFT binding is
      similar in the two preparations. These findings support the view that cocaine
      receptors labeled by [3H]CFT are localized predominantly in dopamine-rich brain
      regions implicated in the behavioral effects and abuse of cocaine.

PMID- 2237781
TI  - Electrosensory systems in fish.
AB  - A close integration of behavioral, neurophysiological, and neuroanatomical
      approaches has guided research on the neural basis of electrosensation and the
      generation of behaviors associated with this modality. By postulating neuronal
      implementations of specific computations in sensory information processing,
      behavioral studies have been crucial in focusing studies at the neuronal level
      onto behaviorally relevant structural and functional aspects. Physiological and
      anatomical studies have analyzed a) neural networks underlying the distributed
      processing of sensory information, b) the role of descending recurrent pathways
      and efference copy mechanisms for the filtering of incoming information, c) the
      significance of multiple topographic representations for sensory information
      processing, and d) the modulation of sensory and motor structures through various
      transmitters and receptor subtypes. Developmental studies have explored the
      significance of steroid hormones for the tuning of electroreceptors to the
      frequency of an endogenous neuronal oscillator which drives the electric current
      pulses necessary for their stimulation. Embryological studies have revealed that
      the development of mechanoreceptors and electroreceptors in the fish's skin is
      induced by the innervation of primary afferent nerve fibers which are specific
      with regard to their central connections as well as with regard to the type of
      receptor induced in the periphery.

PMID- 2237782
TI  - Analysis of a multiple-contact synapse missing a normally obligatory postsynaptic
      neuron: an electron microscopic study in the compound eye of Musca domestica.
AB  - In the compound eye of the adult female fly Musca domestica, photoreceptors form
      populations of multiple-contact output synapses, stereotypic in their
      architecture and in the identity of the four postsynaptic elements. Two
      postsynaptic elements, always originating from monopolar interneurons L1 and L2,
      lie side by side beneath the elongated presynaptic bar. Beneath each end of the
      bar, a further postsynaptic contact is located. These contacts most often are two
      processes either of amacrine cells or of epithelial glial cells. Monopolar cell
      L3 may be postsynaptic as well, with either an amacrine or a glial process
      completing the tetrad. To learn more about the factors determining connectivity
      and synaptic architecture, a three-dimensional reconstruction of serial electron
      microscopic sections was used to analyze a population of photoreceptor synapses
      at which one of the normally obligatory postsynaptic neurons, L1, was missing. In
      this abnormal case, the synapses make the normal four postsynaptic contacts in
      only 39% of the cases, otherwise making three (39%) or two (22%) contacts.
      Specificity of connectivity is preserved faithfully except that beta processes of
      T1 cells were postsynaptic at 2% of the synapses, where they do not normally
      contribute. In contrast to normal synapses, where amacrine and glial cell
      processes are mutual exclusive, such pairings could coexist in the aberrant
      synapse (27% of all synapses). All postsynaptic cells contributed the normal
      number of processes to a synaptic site, except for three synapses each with a
      supernumerary amacrine cell process. The postsynaptic cells therefore may be
      involved in regulating the number of their contacts made to a synaptic site.

PMID- 2237783
TI  - Synaptic remodelling of perforated synapses during development and maturation in
      a visual projection area in birds.
AB  - Perforated synapses are characterized by the appearance of one or more
      discontinuities in the postsynaptic density (PSD). These synapses are thought to
      represent intermediate stages in synaptic remodelling and turnover. To determine
      the dynamic level of these processes, the development of perforated synapses at
      different ages was examined in the neuropil of the ectostriatum, a visual
      projection area in birds. The overall number of perforated synapses per unit
      volume increases during development. Single and multiple perforated synapses,
      however, show a different developmental trend. Between 20 and 100 days, when the
      number of multiple perforated synapses decreases by 46%, single perforated
      synapses increase by 83% in number per unit volume. No significant changes in
      single or multiple perforated synapses can be observed at younger ages (i.e., 5
      or 10 days). Various parameters increase between 10 and 20 days, followed by a
      reduction at 100 days: The relative frequency of perforations per synaptic
      contact, the length of the postsynaptic density including the size of the
      perforation, the length of the synaptic contact zone in perforated synapses
      excluding the size of the perforation, and the size of the perforation follow the
      same trend.

PMID- 2237784
TI  - Long-term synaptic potentiation in the amygdala.
AB  - The manner in which the circuitry of the amygdala computes its suspected mnemonic
      functions has been a mystery, partly because the cytoarchitectual complexity of
      this nuclear group has impeded the necessary cellular analysis. Here we report in
      vitro methods and results that may help elucidate cellular learning mechanisms in
      amygdala neurons. The amygdala brain slice preparation was combined with the
      single-electrode clamp (SEC) technique for intracellular analysis of membrane
      properties and synaptic responses. With respect to the active and passive
      membrane properties, we found considerable diversity among the population of
      cells that were sampled in the lateral and basolateral nuclei (n = 85). Synaptic
      inputs to these neurons were studied by stimulating the external capsule (EC),
      which was shown to produce a complex response that typically consisted of an
      excitatory followed by an inhibitory component. Based on several criteria, the
      excitatory component appeared to reflect a monosynaptic connection from the EC.
      One immediate goal was to discover whether the excitatory component displays the
      phenomenon of long-term potentiation (LTP)--a persistent increase in synaptic
      strength that can be induced by brief periods of the appropriate synaptic
      stimulation. Indeed, we found that high-frequency (100 Hz) stimulation of the EC
      induced LTP in 80% of the cells from which suitable recordings were obtained (n =
      20). This finding of LTP in the amygdala is significant in regard to current
      efforts to explore linkages between this use-dependent form of synaptic
      plasticity and rapid kinds of associative learning.

PMID- 2237786
TI  - [We did the right thing. Faeroe's hospital on a starvation diet].

PMID- 2237785
TI  - Identification of a subpopulation of neuropeptide Y-containing locus coeruleus
      neurons that project to the entorhinal cortex.
AB  - A fundamental question important to the understanding of the neurochemical
      organization of the central nervous system focuses on the relationships between
      the differential phenotypic expression of multiple neurotransmitter markers in
      individual neuronal populations and the factors that regulate their expression.
      The first approach in studying this phenomenon is the determination of specific
      relationships between neurochemically distinct neuronal subpopulations and their
      efferent targets. The pontine nucleus locus coeruleus (LC) provides a useful
      model for addressing this question since the projections of LC neurons are
      topographically organized and several neuropeptides are expressed along with
      noradrenergic markers in subsets of these neurons. In these studies, we have
      focused on defining the efferent targets of LC neurons that contain neuropeptide
      tyrosine (NPY)-like immunoreactivity. This has been accomplished by injecting the
      retrograde fluorescent tracer fluorogold into specific cortical and hippocampal
      targets in adult rats and identifying the proportion of retrogradely labeled LC
      neurons that are positive for NPY-like immunoreactivity. In agreement with other
      investigators, no preferential cortical projections of NPY-positive LC neurons
      were observed. However, when fluorogold injections included or were limited to
      the entorhinal cortex, a discrete cluster of round or ovoid neurons in the
      dorsomedial portion of the LC approximately 9.8 mm posterior to bregma were found
      to contain NPY-like immunoreactivity. This observation demonstrates that some
      topographic organization of NPY-containing LC neurons does exist. In fact, these
      data indicate that morphologic and topographic organization exists even within
      neurochemically distinct subsets of neuronal populations.

PMID- 2237787
TI  - [Barricades].

PMID- 2237788
TI  - [Breast cancer. Drawing lots with powerless research personnel].

PMID- 2237789
TI  - [Holitis and a pain in the paradigms].

PMID- 2237790
TI  - [Livsdraben. Interview by Teddy Osterlin Koch].

PMID- 2237791
TI  - [Next to a miracle].

PMID- 2237792
TI  - [A transfusion of love].

PMID- 2237793
TI  - [Fantasy as a tool].

PMID- 2237794
TI  - [The system-preserving stopper].

PMID- 2237795
TI  - [Professional nursing guidance. Teacher, teacher, teacher].

PMID- 2237796
TI  - [Professional nursing guidance. Help for isolated nurses].

PMID- 2237797
TI  - [Death criteria. Legislation on autopsy and transplantation].

PMID- 2237798
TI  - [Award-winning new building is shameless].

PMID- 2237799
TI  - [Work time--37 hours = 5 X 7 hours and 24 minutes].

PMID- 2237800
TI  - [Important questions are still unanswered].

PMID- 2237801
TI  - [Funen was fine].

PMID- 2237802
TI  - [Psychiatric nursing. The face of force].

PMID- 2237803
TI  - [Pension Fund].

PMID- 2237804
TI  - [Madonna in crisis].

PMID- 2237805
TI  - [Primary health care. An end to records].

PMID- 2237806
TI  - [Health education. Health for sale].

PMID- 2237807
TI  - [Work environment. Violence is not a private affair].

PMID- 2237808
TI  - [Education. Sweet Suzie picks up the fight with Florence].

PMID- 2237809
TI  - [Work environment. Patients get all the psychological care].

PMID- 2237810
TI  - Cellular-phase fibrinolysis and coronary reperfusion during acute myocardial
      infarction: a study in patients receiving intravenous streptokinase
      methylprednisolone therapy.
AB  - Activation of plasma plasminogen to plasmin is the objective of current
      strategies for thrombolytic therapy. Although thrombolytic activity in blood
      involves a large cellular component as well as that in plasma, the contribution
      of this cellular phase to clinical thrombolysis has not been examined. Using a
      125I-fibrin test tube assay, we determined blood, plasma and calculated cellular
      phase fibrinolytic activities in 39 patients with acute myocardial infarction
      before, immediately after, and at 2 hours after therapy with an intravenous
      streptokinase-methylprednisolone regimen. By coronary angiography and time to
      peak creatine phosphokinase levels, 32 patients had coronary reperfusion and 7
      did not. Before streptokinase therapy, cellular phase activity of patients who
      reperfused was more than 2-fold greater than that of patients who did not
      reperfuse (p less than 0.001), while plasma activities were identical, suggesting
      that intrinsic cellular phase activity may be a determinant of the success of
      subsequent thrombolytic therapy. In both groups, in addition to the expected (and
      similar) increases in plasma activity, cellular phase activity increased when
      compared with pre-treatment values (+96% to +248%; p less than 0.001), with
      accompanying increase in blood granulocyte count (+23% to +65%), indicating that
      blood cells, as well as plasma, are major contributors to streptokinase-mediated
      fibrinolysis. Cellular phase stimulation was reproduced in a patient receiving
      streptokinase without methylprednisolone, and by addition of streptokinase to
      normal blood in vitro, indicating that streptokinase alone could account for
      these effects. Increased cellular phase activity in patients who reperfused after
      streptokinase was similar to that in those who did not reperfuse, when pre
      treatment values were considered. These findings indicate that initial cellular
      phase activity in blood may determine subsequent fibrinolytic response, and that
      there is a significant cellular phase component to the fibrinolytic response to
      streptokinase, probably mediated by increased numbers of blood neutrophils, with
      a possible contribution from increased activity of individual neutrophils.

PMID- 2237811
TI  - Platelet von Willebrand factor assay: results using two methods for platelet
      lysis.
AB  - Two different methods (using Triton X-100 and glycerol) for lysing platelets to
      measure platelet vWF concentrations were compared directly. The platelet
      concentration of von Willebrand factor antigen (vWF:Ag) was similar for both
      methods, whereas ristocetin cofactor activity (Ricof) was higher with Triton than
      with glycerol. After storing platelet lysates for two months at -80 degrees C
      vWF:Ag and Ricof concentrations decreased with both methods of lysis. Larger than
      normal (supranormal) vWF multimeric forms could be visualized in platelet lysates
      obtained using both methods, with no change of the multimeric pattern during
      storage. Triton can be recommended as the agent of choice to lyse platelets for
      measurement of their vWF concentration, but the samples must be assayed within
      two weeks to avoid decay of Ricof activity.

PMID- 2237812
TI  - d-Indobufen inhibits collagen-induced intracellular calcium mobilization and
      inositol phosphates formation in human platelets.
AB  - We obtained evidence that the cyclooxygenase inhibitor d-indobufen, (+)2[p-(1-oxo
      2-isoindolinyl)phenyl] buthylic acid has a potent and specific inhibitory effect
      on collagen-induced aggregation and 40K-protein phosphorylation (Mamiya, S.,
      Hagiwara, M., Ishikawa, T., and Hidaka, H. Thromb. Res. 54, 447, 1989). In Fura-2
      loaded platelets, d-indobufen inhibited collagen-induced intracellular calcium
      mobilization in a dose dependent manner and this inhibitory effect on calcium
      mobilization paralleled that on aggregation, either in the presence or absence of
      extracellular free calcium ions. This compound inhibited inositol phosphates
      (IPs) formation in collagen-stimulated platelets. In arachidonic acid-stimulated
      platelets, d-indobufen caused a lag on calcium mobilization, as observed with
      arachidonic acid-induced aggregation. There was no significant effect on thrombin
      or A23187-induced calcium mobilization or on aggregation. These observations
      suggest that the collagen receptor couples to a distinct intracellular calcium
      mobilization system possibly via inositol phospholipid metabolism and that d
      indobufen blocks the collagen-induced aggregation by arresting mobilization of
      intracellular calcium.

PMID- 2237813
TI  - Fibrinogen-containing membrane-associated structures arising at the surfaces of
      ADP-stimulated blood platelets.
AB  - Ultrastructural studies of ADP-stimulated gel-filtered human platelets incubated
      with different concentrations of fibrinogen reveal unusual extracellular
      structures composed at least partly of the aggregated fibrinogen. Development of
      these structures depends on the exogenous fibrinogen concentration and duration
      of the incubation. Fibrinogen-containing extracellular material exists in two
      different structural forms. As was shown earlier, one of them is represented by
      dense, amorphous intercellular matrix and is localized mainly in platelet
      microaggregates (Belitser et al., Thromb. Res., in press). Another one consists
      of huge sheet-like structures bearing individual or clumped platelets bound
      either to one or to both of their surfaces. After thrombin treatment, these
      structures could not be found anymore; sometimes they seem to be substituted by
      the fibrin-like fibers spatially connected to each other and/or to the platelet
      membranes. It has been suggested that soluble fibrinogen interacting with its
      specific membrane receptors undergoes conformational changes promoting
      intermolecular interactions and resulting in the fibrinogen aggregates formation
      at the surfaces of the activated platelets. A probable physiological significance
      of the structures described is discussed. It is supposed that under certain
      conditions in vivo they may play an important role, in particular as a highly
      concentrated substrate for the thrombin action, providing in such a way a
      possibility of rapid, effective consolidation of the initial platelet thrombi
      with the fibrin fibers.

PMID- 2237814
TI  - Lack of cross-reactivity between anticardiolipin antibodies and
      glycosaminoglycans.

PMID- 2237815
TI  - Phast assessment of vWf:Ag multimeric distribution.

PMID- 2237816
TI  - The hirudin standard.

PMID- 2237817
TI  - Antithrombin III activity in Chinese women with preeclampsia.

PMID- 2237818
TI  - Effect of endothelial cells on platelet aggregation in platelet rich plasma (PRP)
      and whole blood.

PMID- 2237819
TI  - Bilirubin induces platelet aggregation.

PMID- 2237820
TI  - Localization of human tissue factor antigen by immunostaining with monospecific,
      polyclonal anti-human tissue factor antibody.
AB  - Tissue factor, the cofactor for factor VIIa-catalyzed activation of factors IX
      and X, plays an important role in the initiation of hemostasis. However, the
      distribution of tissue factor in the body has not been defined until recently. In
      the present study frozen sections of non-malignant human tissues were
      immunostained using polyclonal, monospecific rabbit anti-human tissue factor
      antibodies. Specificity of the anti-tissue factor antibody was established by
      Western blotting. Sensitivity of the immunostaining technique for tissue factor
      antigen was confirmed by correlating staining of non-perturbed and perturbed
      cultured human umbilical vein endothelial cells with their surface membrane
      tissue factor coagulant activity. Brain, lung and placenta, all known to possess
      large amounts of tissue factor procoagulant activity, stained strongly for tissue
      factor, as did peripheral nerves and autonomic ganglia. Epithelium of skin,
      mucosa, and glomeruli also stained; however, epithelium lining excretory ducts
      failed to stain. Skeletal muscle did not stain, but cardiac muscle stained
      faintly. Smooth muscle also did not stain except for the muscularis mucosa of the
      esophagus, which stained brightly. Fibroblasts varied in stainability; those
      found in the adventitia of vessels stained strongly. The endothelium, tunica
      intima and tunica media of blood vessels consistently failed to stain. The
      distribution of tissue factor antigen as demonstrated by immunostaining supports
      the hypothesis that maintenance of a physical barrier between tissue factor
      activity and blood is key to the normal regulation of hemostasis.

PMID- 2237821
TI  - Modifications of biological activities of heparin and fraxiparine induced by the
      size and the age of a thrombus. Experimental study.
AB  - Heparin and its fractions have often been tested on fresh experimental
      thrombosis. However in human clinic, drugs are administered not on fresh, but
      rather on old constituted thrombi. In order to evaluate the effects of
      antithrombotic agents in these conditions, both drugs (unfractionated heparin and
      Fraxiparine) were administered on 150 rats at different times and so, could take
      effect on thrombi with different ages. Heparin was more active as its fraction on
      fresh thrombi (2 hours old), but no more effects could be observed for all drugs
      when the thrombus was 52 hours old. Biological activities (A.P.T.T., anti-IIa and
      anti-Xa activities) decreased as the thrombi increased in weight and age.

PMID- 2237822
TI  - A new competitive binding enzyme-linked immunosorbent assay for glycocalicin in
      plasma and platelet concentrate supernatants.
AB  - A new competitive binding enzyme-linked immunosorbent assay (CB ELISA) for
      glycocalicin (GC) was developed using GC coated wells and a monoclonal antibody
      (MAb) to glycoprotein Ib (AN51). The principal stages of the CB ELISA consisted
      of coating the plate with GC extract overnight, blocking with 3% BSA, incubating
      the wells with test or standard sample dilution and AN51, and a final incubation
      with horseradish peroxidase-conjugated goat anti-mouse IgG. Serial dilutions of
      purified GC, starting in 2% BSA, yielded standard curves which were linear
      between 10 and 0.4 micrograms/ml. Parallel curves were obtained for platelet
      concentrate supernatants and for citrated plasma. We used the ELISA to measure GC
      levels in platelet concentrates during storage. The results indicated that
      soluble GC increased progressively during storage from 3.3 to 6.7 micrograms/ml,
      while GC levels in platelet-poor plasma remained at 1.9-2.2 micrograms/ml. These
      results show that the new CB ELISA is a simple and short assay for the direct
      measurement of GC in plasma solutions, and may be of use in clinical studies.

PMID- 2237823
TI  - Collagen-platelet interaction: type XI collagen-induced platelet aggregation.
AB  - Type XI collagen in its native fibrillar but not in soluble monomeric form
      mediates human platelet aggregation and release of adenosine triphosphate in a
      dose-dependent manner. Its action is inhibited by aspirin. Type XI collagen also
      increased radiolabelled phosphate incorporation into protein bands with molecular
      weights of 42 KDa and 22 KDa, respectively. In contract, these events were not
      observed in platelets incubated with type IX collagen. These results suggest that
      the fibrillar type XI collagen has the same ability as other types of collagen to
      induce human platelet aggregation.

PMID- 2237824
TI  - Ability of high-affinity heparin fractions with decreasing affinity for
      antithrombin III to activate ATIII isoforms.
AB  - Previous studies investigated the effect of heparin fractions on the rates of
      thrombin inhibition by naturally occurring antithrombin III (ATIII) isoforms
      differing in affinity for heparin. Heparin with low-affinity for ATIII increased
      the rate of thrombin inhibition by the higher affinity isoform about 10-fold more
      effectively than by the other isoform. This paper reports on the effect of a
      series of high-affinity heparin fractions with decreasing affinity for ATIII. As
      affinity decreased, the ability of the heparin fractions to increase the rate of
      the ATIII-thrombin reactions decreased, and these fractions slightly more
      effectively increased the rate of thrombin inhibition by the higher-affinity
      ATIII isoform. The effect of the heparin fractions on the ATIII-factor Xa
      reactions was also investigated. The activity of the fractions in this reaction
      also showed a dependence on ATIII-affinity. Studies on the competition of
      isoforms for immobilized heparin showed that the isoform with higher affinity for
      ATIII effectively competes with its congener for binding to heparin. The results
      indicate that heterogeneity in high-affinity heparin results in heterogeneity in
      affinity for ATIII that is significantly correlated with the ability of the
      heparin to potentiate ATIII-protease reactions. In spite of about equal
      activation of the ATIII isoforms by high-affinity heparin, the importance of the
      higher-affinity isoform is indicated by its ability to compete effectively for
      these heparin species.

PMID- 2237825
TI  - Effects of calcium channel blockers on platelet aggregation and thromboxane A2
      formation: an in vivo double blind randomized study.
AB  - In this double blind cross over study against placebo the in vivo effects of
      diltiazem, nifedipine and verapamil on platelet aggregation and Thromboxane A2
      (TxA2) formation were evaluated in eighteen healthy adults. No significant
      inhibition of platelet aggregation or TxA2 formation was found either after acute
      or short term (8 days) administration of the three calcium channel blockers at
      the usual therapeutical dosages. Our study indicate that diltiazem, nifedipine
      and verapamil are unable to significantly affect platelet aggregation and TxA2
      formation in healthy subjects.

PMID- 2237826
TI  - Thrombin generation in prothrombin-complex-preparations; its effect on a
      chromogenic substrate, fibrinogen and platelets.
AB  - The kinetics of thrombin generation in various prothrombin-complex-preparations
      (PCC) were investigated using a chromogenic substrate assay. The rate of thrombin
      formation and the total activity of thrombin generated varied considerably among
      different preparations. The thrombin generation velocity influenced the rate of
      fibrinogen to fibrin conversion, measured as plasma viscosity alteration per unit
      of time. It also influenced thrombin induced platelet aggregation with regard to
      maximum aggregation and aggregation velocity. The kinetic parameters measured
      photometrically and coagulometrically showed reduced generation velocities and
      less thrombin effects with thrombin formed in PCCs than with thrombin generated
      in plasma. The quantitative differences between thrombin effects in various PCCs
      on platelet aggregation did not correlate with the data of the amidolytic and
      fibrinogenolytic measurements. The significance of the results is discussed with
      regard to the question of whether, or to what extent, PCCs could cause or
      accelerate a disseminated intravascular coagulation.

PMID- 2237827
TI  - Platelet-reactive sites in human collagens I and III: evidence for cell
      recognition sites in collagen unrelated to RGD and like sequences.
AB  - Following fragmentation of the collagen molecule with cyanogen bromide (CB), two
      major platelet-aggregatory sites were detected with human platelets in the alpha
      1(I)-chain of human collagen I corresponding to those detected previously in
      bovine alpha 1(I)-chains. Two main sites were also detected in the human alpha
      1(III)-chain, at locations different from those in the alpha 1(I)-chain. Only one
      of these had been previously recognised. The new site was found in the peptide
      alpha 1(III)CB3, the amino acid sequence of which does not contain the cell
      recognition site RGD nor comparable sequences that might be supposed to serve
      this function such as KGD, RGE or KGE. The peptide does, however, contain the
      sequence GRPGRPGER which reflects a spacing of basic residues (at positions 2 and
      9) we have previously postulated to be essential for collagen to cause platelet
      aggregation. None of the CB-derived peptides was able to cause an aggregation of
      rabbit platelets. Human platelet secretion, as aggregation, was only induced by
      CB-derived fragments in triple-helical, polymeric form. One fragment, peptide
      alpha 1(III)CB8, was able to induce secretion although lacking aggregatory
      activity. Platelet adhesion occurred to all of the fragments, including those
      lacking aggregatory activity. Adhesion also occurred to the collagen-like
      polypeptide (PGP) n. However, inhibition studies suggested that the GPP sequence
      which occurs frequently along the length of the collagen molecule is not
      responsible for platelet adhesion to collagen.

PMID- 2237828
TI  - Production of plasminogen activator and plasminogen activator inhibitor by bovine
      lymphatic endothelial cells: modulation by TNF-alpha.
AB  - We have investigated whether lymphatic endothelial cells in culture produce
      plasminogen activators (PAs) and their inhibitors (PAIs) and if these activities
      can be modulated by the inflammatory cytokine Tumor Necrosis Factor alpha (TNF
      alpha). Examination by reverse fibrin autography of the conditioned medium from
      these cells revealed a PAI of Mr 50 kDa. Also evident by fibrin autography were
      two species of PAs, of Mr 110 kDa and Mr 60 kDa. The 110 kDa protein co-migrated
      with the PA-PAI complexes and the 60 kDa protein co-migrated with tissue
      Plasminogen Activator (tPA). Functional and immunological assays indicated the
      human TNF-alpha increased the type 1 plasminogen activator inhibitor (PAI-1) in a
      time dependent manner. Treatment of the cells with recombinant human TNF-alpha
      for 24 hours resulted in a 3 to 7 fold increase in the amount of PAI released
      into the conditioned media. Immunoblot analysis identified the PAI in the TNF
      alpha treated cell conditioned media, as PAI-1. Deposition of PAI-1 in the
      extracellular matrix then became apparent. TNF-alpha increased 4 fold the amount
      of tPA-PAI-1 complexes (Mr 110 kDa) detected in the conditioned media. Free tPA
      (Mr 60 kDa) decreased to 1/5 of control. Net fibrinolytic activity, as determined
      by a chromogenic substrate assay, decreased after TNF-alpha treatment. No
      urokinase type Plasminogen Activator (uPA) activity was detected in control or
      treated cells. This fibrinolytic activity may be important in maintaining free
      fluid movement in the interstitium and lymphatic vessels and in inflammatory
      states this potential may be decreased by the increase in PAI-1.

PMID- 2237829
TI  - Qualitative and quantitative abnormalities of von Willebrand antigen in patients
      with diabetes mellitus.
AB  - Previous reported studies of vVWf antigen (vWf:Ag) in patients with diabetes
      mellitus have not shown qualitative abnormalities despite frequent documentation
      of raised vWf:Ag. Twenty two patients with established diabetes mellitus have
      been studied and qualitative abnormalities of vWf:Ag multimers were found in 10
      patients who had poorer glycaemic control (as judged by plasma fructosamine) than
      the other 12 patients. Seven of the 22 patients were restudied after a 3 month
      period of improved glycaemic control and the vWf:Ag multimer abnormalities
      disappeared in 6 of these. Some of the structural abnormalities were accompanied
      by loss of vWf functional activity. As vWf:Ag is synthesised in the endothelial
      cell, vWf:Ag abnormalities during periods of poor glycaemic control may reflect
      endothelial cell damage with vWf:Ag release and possibly subsequent proteolysis.

PMID- 2237830
TI  - Effect of dietary canola and reference oils upon serum lipids and platelet
      aggregation.
AB  - To compare Canola a terrestrial (n-3) oil with fish oil (n-3) and common
      vegetable oil (n-6) in decreasing serum lipids and platelet aggregation, various
      oils were included in Chow-based diets and fed to rats in an eight-weeks feeding
      trial. The Chow diet contained 2% cholesterol along with either Canola, menhaden,
      safflower, or partially hydrogenated soy oil, or no oil addendum. The menhaden
      oil group was the only one to show a significant reduction in serum cholesterol
      and triglycerides and at the same time yielded the most uniform decrease in
      platelet aggregability. However, this same group was also the only one to show a
      decrease in serum tocopherol levels, suggesting that improving an atherogenic
      risk profile may require antioxidant supplementation. In these rat trials, Canola
      oil supplementation did not yield the same results measured during menhaden
      supplementation.

PMID- 2237831
TI  - Interference of levamisole with Forssman shock.
AB  - The anti-helminthic drug levamisole has been used as an adjunct in the treatment
      of some immunologic defects including cancer. Recently, it has been shown that
      this drug inhibits thromboxane synthetase as well. Since Forssman shock in guinea
      pig is used as a model for pulmonary thromboembolism involving thromboxane A2, we
      studied the interference of levamisole with bronchoconstriction,
      thrombocytopenia, endothelial cells and pulmonary damage induced by Forssman
      antiserum. Levamisole inhibited dose-dependently the pathological changes
      produced by Forssman antiserum raising the possibility that levamisole may be
      effective for the treatment of pulmonary thromboembolism in man.

PMID- 2237832
TI  - Release of extrinsic pathway inhibitor after heparin injection: increased
      response in cancer patients.

PMID- 2237833
TI  - Binding properties of hirudin determined by gel filtration and gel
      electrophoresis.

PMID- 2237834
TI  - Antiphospholipid antibodies detected as anticephalin and anticardiolipin
      antibodies in patients with acute myocardial infarction: immunological response
      to myocardial necrosis?

PMID- 2237835
TI  - Histidine-rich glycoprotein levels in children: the effect of age.

PMID- 2237836
TI  - Discrepancies between clotting and amidolytic assay in congenital clotting
      disorders.

PMID- 2237837
TI  - Effect of 1-desamino-8-D-arginine vasopressin (DDAVP) on human platelets.
AB  - Intravenous infusion of 1-desamino-8-D-arginine vasopressin (DDAVP), an analog of
      arginine vasopressin (AVP), results in a rise in plasma levels of factor VIII
      coagulant activity and the von Willebrand factor. DDAVP infusion has been shown
      to shorten the prolonged bleeding time of patients with inherited platelet
      defects but the mechanism for this has not been fully clarified. There is little
      information available on the direct effect of DDAVP on platelets. We examined the
      effect of DDAVP on platelet responses, including Ca2+ mobilization, to understand
      the mechanisms by which DDAVP shortens the bleeding time in patients with primary
      platelet defects. In normal human platelets, DDAVP alone upto 100 microM did not
      induce aggregation, secretion or a rise in the intracellular Ca2+ concentration,
      monitored using quin2. In contrast AVP induced all three responses in a dose
      dependent manner. Interestingly preincubation of platelets with DDAVP at a 100
      fold greater concentration inhibited the responses to AVP indicating that DDAVP
      does interact with the platelets. Moreover, DDAVP did not either potentiate or
      inhibit the responses to thrombin or ADP. These studies indicate that it is
      unlikely that the beneficial effect of DDAVP in patients with primary platelet
      defects is related to a direct stimulatory effect on platelets.

PMID- 2237839
TI  - Conformational differences between latent and active plasminogen activator
      inhibitor, PAI-1: a spectroscopic study.
AB  - The protein conformation of latent and active PAI-1 has been studied with
      circular dichroism, absorbance and fluorescence spectroscopy. The far ultraviolet
      circular dichroism spectrum of latent PAI-1 displays a more negative band at 220
      nm than active PAI-1, crossing the baseline at a lower wavelength. Active PAI-1
      shows an absorption maximum at lower wavelength (269 nm) than present in latent
      PAI-1 (278 nm). In consistency, slow denaturation of active PAI-1 by incubation
      for two hours at 37 degrees C induces a shift in the absorption maximum from 268
      nm to 274 nm. The fluorescence emission maximum of latent PAI-1 is at lower
      wavelength (335 nm) than that of active PAI-1 (340 nm). These spectroscopic
      differences are interpreted as reflecting a more tight conformation, with the
      tryptophan residues in a more apolar environment, in latent PAI-1 compared to
      active PAI-1.

PMID- 2237838
TI  - Selective effects of dietary fats on vascular 13-HODE synthesis and
      platelet/vessel wall interactions.
AB  - Fish oil (FO) diets are associated with decreased thrombosis, which is though to
      be related, in part, to changes in platelet and vessel wall prostanoid synthesis.
      Recently, we found that 13-hydroxyoctadecadienoic acid (13-HODE) synthesized in
      the vessel wall from linoleic acid (LA, 18:2 n-6) via the lipoxygenase pathway,
      also decreases platelet/vessel wall interactions. Thus, we determined whether
      diets containing fish oil, walnut oil (rich in linoleic acid), black currant seed
      oil (rich in both linoleic and gamma linolenic acids, 18:3 n-6), or lard
      influenced vessel wall 13-HODE synthesis and platelet/vessel wall adhesion in
      rabbits. In vivo, vessel wall thrombogenicity was decreased in animals fed the
      black currant seed oil rich diet for 4 weeks as compared to the control "LARD"
      diet. This latter effect was better obtained when gamma linoleic acid was present
      suggesting a secondary effect of this fatty acid. The decreased vessel wall
      thrombogenicity in those animals, was associated with increased vessel wall 13
      HODE synthesis. In contrast, ex vivo platelet adhesivity was significantly
      decreased in the fish oil diet fed animals, as compared to the control "LARD"
      diet and correlated with decreased platelet 12-HETE synthesis. We conclude that
      both fish oil and black currant seed oil rich diets inhibit platelet/vessel wall
      adhesion; the black current seed oil diet by increasing the availability of
      linoleic acid for 13-HODE synthesis and inhibiting vessel wall thrombogenicity;
      the fish oil diet, by inhibiting platelet 12-HETE synthesis and subsequent
      platelet adhesion.

PMID- 2237840
TI  - Fibrinolysis as a feature of disseminated intravascular coagulation (DIC) after
      Pseudonaja textilis textilis envenomation.
AB  - Blood was obtained from four patients envenomated by the Australian common brown
      snake, Pseudonaja textilis textilis. This elapid snake has one of the most toxic
      venoms in the world, containing extremely potent neurotoxic and coagulant
      components. The latter is a potent complete prothrombinase, converting
      prothrombin to alpha-thrombin, and comprises more than 30% of the total venom
      protein. The four envenomated patients developed a typical consumption
      coagulopathy. Serial serum and plasma samples from patients were studied by
      immunoaffinity adsorption, 2-alanine precipitation of fibrinogen and fibrinogen
      related products and 2-dimensional immunoelectrophoresis, and assayed for
      crosslinked fibrin degradation products as D dimer, using the monoclonal
      antibody, DD-3B6/22. These procedures showed the virtually complete disappearance
      of fibrinogen, accompanied by the appearance of large quantities of fibrinogen
      and fibrin degradation products consisting of both crosslinked and noncrosslinked
      species. With recovery, a homogeneous high molecular weight fibrinogen was
      observed. The data suggest that the prothrombin activator of this venom causes
      the generation of thrombin which subsequently converts fibrinogen to fibrin and
      stimulates partial crosslinking of both alpha and gamma-chains. The resultant
      disseminated intravascular coagulation is accompanied by very active secondary
      fibrinolysis which apparently limits the extent of any microvascular thrombosis
      but which may contribute to a bleeding tendency.

PMID- 2237841
TI  - Thrombin activity in pulmonary emboli obtained at autopsy.

PMID- 2237842
TI  - A comparison of different reagents for the activated partial thromboplastin time
      in rabbit and rat plasma.

PMID- 2237843
TI  - [The sexual debut of Norwegian youth].

PMID- 2237844
TI  - [What quality assurance are we to demand for diagnosis and treatment of
      gastrointestinal cancer in Norway during the 1990's?].

PMID- 2237845
TI  - [Study and diagnosis of pancreatic cancer].
AB  - The most common initial symptom was abdominal pain. Other frequent debut symptoms
      were loss of weight and jaundice. ERCP and PTC were found to be the best
      diagnostic procedures. CT or ultrasonography were normal in 10-20% of the
      patients. Nearly all tumors of the pancreas were found by the ERCP procedure. We
      also used angiography to evaluate operability of the pancreas tumor. Angiography
      was found to be a very uncertain diagnostic procedure, however, and we have now
      decided not to use angiography in the future evaluation of patients with cancer
      of the pancreas.

PMID- 2237846
TI  - [Cancer of the pancreatic head and the periampullary region].
AB  - Between 1976 and 1988, 16 patients underwent a Whipple resection or total
      pancreatectomy for carcinoma of the head of the pancreas, the ampulla of Vater or
      the distal common bile duct. Nine patients had carcinoma of the pancreas. Two of
      these patients are long-term survivors. The tumors in these patients were highly
      differentiated and localized close to the common bile duct. Four had ampullary
      lesions, and are all alive today. Three patients had carcinoma of the common bile
      duct. One of these patients is alive.

PMID- 2237847
TI  - [Views on simple surgical aspects of gastrointestinal cancer in Norway].
AB  - A questionnaire was used to study various aspects of the surgical treatment of
      cancer of the oesophagus, pancreas, stomach and colon/rectum in Norway. 48 of 51
      departments replied. Half of the departments perform radical operations for
      oesophageal cancer and nearly all do total gastrectomies and low anterior
      resections for rectal cancer. Palliative surgery is seldom performed for
      oesophageal cancer, but is frequently performed for gastric cancer. Obstruction
      of the colon is relieved preferably by primary resection. Low anterior resection
      is usually performed when a free resection margin of 2 cm can be achieved.
      Jaundice is relieved palliatively preferably by endoscopy. University hospitals
      perform total gastrectomy to a greater extent than other hospital and have
      greater faith in radical operations for pancreatic cancer. Otherwise there are no
      conspicuous differences of opinion between the different categories of hospitals.

PMID- 2237848
TI  - [Abdominal injuries after blunt trauma].
AB  - We present a series of 331 patients admitted to hospital in 1980-87 with
      abdominal injuries after blunt trauma. The patients included 230 males and 101
      females. The median age was 29 years. More than half of the patients were injured
      in traffic accidents. 11% were transferred to our Trauma Center from other
      hospitals, median five hours after the accident. A doctor-manned helicopter
      transported 52 patients (18%) directly to our hospital. 70% had extra-abdominal
      injuries as well. A minimum of 20% were intoxicated by alcohol and/or drugs.
      Severe injuries (AIS greater than 3) were present in 46%. 168 patients underwent
      laparotomy, in 56% within two hours of admission. In 27 of the 168 laparotomized
      patients (16%) no intraabdominal injury was encountered that needed repair.

PMID- 2237849
TI  - [Reconstructive surge of blunt renal trauma].
AB  - The most usual causes of blunt renal injuries are motor vehicle accidents, falls
      and participation in contact sports. Severe injuries are rare and a conservative
      approach in the treatment of such injuries is advocated by most authors. In this
      article we present a patient who suffered a major injury to the right kidney
      which was treated successfully by reconstructive surgery. We discuss the
      diagnosis of renal injuries, indications for surgery and surgical technique.

PMID- 2237850
TI  - [Infantile hypertrophic pyloric stenosis].
AB  - We present 40 patients operated consecutively for pyloric stenosis during an 8
      year period (1981-88). The most common symptom was projectile vomiting, which
      occurred in 92.5% of the cases. On examination only three patients had a palpable
      hypertrophic pylorus. In 39 patients, a preoperative x-ray examination with
      contrast was necessary to confirm the diagnosis. A pyleromyotomy was performed in
      all patients. We discuss the diagnostic routines and the results of our
      treatment.

PMID- 2237851
TI  - [Ischemic left ventricular failure. Main stem coronary stenosis treated with
      angioplasty].
AB  - We describe a patient with stenosis on the left main stem and severe impairment
      of the left ventricular function. Because of reversible myocardial ischaemia in a
      patient whose clinical situation prohibited surgery, angioplasty on the left main
      stem was performed, leading to considerable improvement of the ventricular
      function. Improvement was slow, however, probably due to "stunning" of the
      myocardium. We underline the importance of early angiography in patients when it
      is suspected that a larger part of the myocardium is affected by severe,
      reversible ischaemia.

PMID- 2237853
TI  - [Acetylsalicylic acid in the prevention of arterial thrombosis. Dosage problems
      in general and in the authors' experiment].
AB  - Acetylsalicylic acid is now accepted as a clinically useful drug for secondary
      prophylaxis against several thromboembolic complications, but there is still much
      controversy about the dosage. We discuss this problem, in the light of data from
      newly published clinical trials and of results from a pharmacological study
      performed by ourselves. All in all it seems reasonable to recommend 100-150 mg
      acetylsalicylic acid per day for prophylaxis after acute myocardial infarction.
      As for cerebrovascular indications, no clinical data available so far justify a
      dose reduction below 300 mg.

PMID- 2237852
TI  - [Organophosphate poisoning].
AB  - Three cases of poisoning by organophosphate dimethoate are described and the
      importance of correct diagnosis and adequate treatment emphasized. Therapy
      consists of large doses of atropine, to counteract the muscarinic and other
      effects on the central nervous system, followed by a reactivator (e.g. toxogonin)
      to reverse muscle weakness (nicotinic effects).

PMID- 2237855
TI  - [Chylothorax].
AB  - A 51 year old man developed chylothorax from a non-Hodgkin lymphoma located in
      the abdomen. The main causes of chylothorax are trauma and malignant disease. The
      condition is quite often idiopathic. The treatment is usually a combination of
      surgical treatment, conservative treatment, high voltage radiation and/or
      pleurodesis with a sclerosing agent.

PMID- 2237854
TI  - [Post-splenectomy septicemia].
AB  - The spleen is a major component of the immune system and plays an important role
      in the defence against encapsulated bacteria. It is well recognized that
      splenectomized patients run increased risk of developing serious invasive
      bacterial infections, especially post-splenectomy septicaemia caused by
      pneumococci. Two case reports are used to draw attention to infections in
      patients without a spleen. The author discusses the indications for the use of
      pneumococcal vaccine, and recommends more extensive use of the vaccine in
      splenectomized patients in Norway.

PMID- 2237856
TI  - [Simple spirometry and peak flow measurements].

PMID- 2237857
TI  - [The age of sexual debut among Norwegian adolescents].
AB  - Kaplan-Meier estimates were used to study age at first intercourse among
      Norwegian adolescents. The data stemmed from a nation-wide study of 3,000
      Norwegian adolescents aged 17-19 years. The response rate was 61.8%. Median age
      at first intercourse was 17.3 years for girls and 18.0 years for boys. The
      results indicate that median age at first intercourse has not become lower in
      Norway since 1975. Age at first intercourse was significantly associated with
      educational aspirations and frequency of visits to church by respondents and
      parents. Furthermore, age at first intercourse was significantly associated with
      smoking behaviour, alcohol consumption, peer affiliation and frequency of
      visiting a discotheque. These inter-relationships confirm that age at first
      intercourse is an important indicator of the lifestyle of an individual. Thus, in
      order to influence the sexual behaviour of adolescents it thus seem appropriate,
      as a supplement to traditional methods of sex education, to employ health
      promotion activities which focus on environmental and structural factors.

PMID- 2237859
TI  - [Ventricular arrhythmias. What can be achieved by drug therapy?].

PMID- 2237858
TI  - [Hemoglobin, sedimentation and community health legislation. Frequency of tests
      and fees at the Vaga community health center during 1983-87].
AB  - On the basis of laboratory records and doctors' list of appointments, we analyzed
      the number of hemoglobin tests and sedimentation rates performed at Vaga
      community health centre during the period 1983-87. In 1983 the doctors worked on
      a "fee for service" basis. Since 1984 they have been paid a fixed salary.
      Individual doctors showed little variation in their use of tests, but there were
      considerable differences between doctors. The average number of tests per patient
      was stable and seemed independent of how the doctors were reimbursed.

PMID- 2237860
TI  - [Anticoagulant therapy and cerebral hemorrhage].

PMID- 2237861
TI  - [Quality assurance in Norwegian health care].

PMID- 2237862
TI  - [Sjogren's syndrome--new aspects].

PMID- 2237863
TI  - [Neck distorsions after traffic accidents].

PMID- 2237864
TI  - [Facial injuries].

PMID- 2237865
TI  - [Osteosynthesis with miniplates in unstable maxillo-zygomatic fractures].
AB  - This article discusses the etiology and classification of zygomatic fractures, as
      well as indications and methods of surgery. Osteosynthesis with a miniplate is a
      new treatment modality for unstable zygomatic fractures. The operative procedure
      is relatively simple and gives good cosmetic and functional results. We describe
      the technique illustrated with pre- and postoperative x-rays of a patient.

PMID- 2237866
TI  - [Charcot-Marie-Tooth disease. Peroneal muscular atrophy].
AB  - The classification of Charcot-Marie-Tooth disease is provisional, because the
      chromosome and gene localization is still not precisely known, and gene products
      have not been identified. This article presents an analysis of the clinical,
      genetical and neurophysiological data of eight Charcot-Marie-Tooth patients. The
      study was carried out to find out if it is possible to classify the disease from
      neurophysiological and genetical data. We found Charcot-Marie-Tooth disease
      transmitted autosomal dominant in three cases, whereas no family pattern was
      apparent in the remaining five. Among the three cases of autosomal dominant
      transmission, two were of the segmental demyelinization type, and one had axonal
      neuropathy. The five patients without a distinct family pattern consisted of
      three with segmental demyelinization and two with axonal neuropathy. Thus, the
      neurophysiological subdivision did not correlate with the inheritance, which
      indicates a genetical heterogeneity for the Charcot-Marie-Tooth disease.

PMID- 2237867
TI  - [Prognosis of patients with nervous system lesions caused by organic solvents].
AB  - 19 patients with chronic organic solvent intoxication of the nervous system were
      interviewed and examined three years after the diagnosis was set. The study shows
      a significant reduction of subjective symptoms, especially among the youngest
      patients. Clinical neurological examination was almost unchanged. 18 of the
      patients were no longer occupationally exposed to organic solvents. Six patients
      were still working, and three other patients were being re-educated. Most of the
      patients were followed by general practitioners.

PMID- 2237868
TI  - [Epididymis. Anatomy, function and pathology].
AB  - Studies on the human epididymis suggest that both histologically and
      biochemically, it can be subdivided into discrete segments with different
      functions. Current research attempts to isolate segment-specific secretory
      markers which can be used in localizing dysfunction and pathology in cases of
      male infertility. In cases of azoospermia, the segmental level of an occluding
      lesion also has prognostic relevance for the results of epididymovasostomy.
      Infection with Chlamydia trachomatis is the most frequent cause of acute
      epididymitis but an epididymal involvement is also a common feature of chronic
      prostato-vesiculitis, the etiology of which is unknown. This article provides a
      short review of the structure and function of the epididymis, the pathological
      changes in the organ associated with male infertility and the potential methods
      of treatment.

PMID- 2237869
TI  - [Intraocular Candida albicans infection].
AB  - The article discusses three patients with an intraocular Candida albicans
      infection. Vitrectomy was performed on two patients in whom the infection
      occurred after abdominal surgery. Both had significant corpus vitreum
      involvement. One of these patients regained good visual acuity, while in the
      other patient preretinal proliferation caused permanently reduced vision. The
      third patient had only chorioretinal involvement. After intracranial surgery for
      acusticus neurinoma his general condition deteriorated and he developed
      septicemia. He was treated with intravenous amphotericin B and visual acuity
      returned to normal. Early diagnosis and treatment are important for
      satisfactorily preservation of vision. Therefore patients in risk groups with
      ocular complaints should be referred immediately to an ophthalmologist. Early
      diagnostic and therapeutic vitrectomy should be considered for all patients with
      suspected vitreous involvement.

PMID- 2237870
TI  - [Treatment of lymphedema in institutions. Two weeks of in-hospital intensive
      lymphatic drainage followed by maintenance treatment with a pulsator].
AB  - 54 patients were admitted to The Norwegian Radium Hospital (hotel ward) for
      treatment of secondary lymph drainage in the arm or the leg. The treatment
      consisted of 14 days intensive lymph drainage, including massage and physical
      exercises, and intermittent compression with pulsator and bandaging.
      Information/instruction was given continuously. Good elastic stockings were
      supplied before the patients left the hospital. The treatment was succeeded by a
      maintenance programme, which the patients carried out themselves at home. The
      patients were closely followed up and reported on for six months, and were
      rechecked after another four and 12 months. We present the results after 14 days
      of intense treatment, followed by a 12-month maintenance programme.

PMID- 2237871
TI  - [Mesalazine (5-ASA) in ulcerative colitis].

PMID- 2237872
TI  - [Written information from hospital to primary physician about discharged
      patients].
AB  - Discharge communications from hospitals to general practitioners in respect of
      203 patients have been analyzed in two municipalities in Western Norway. The
      average interval between discharge from hospital and the first visit to the GP
      was 25 days (1-198 days). The mean period before arrival of the final report was
      28 days (0-175 days). In 38% of the cases the GPs had received no written
      communication from the hospital upon first contact after discharge. 42% of the
      preliminary reports and 18% of the final reports were judged to be inadequate. At
      the first attendance, the GPs were uncertain about the drug regimen in 25% of the
      cases and about other forms of treatment in 32%. They felt uncertainty about
      follow-up procedures in the case of 44%. As evaluated by the GPs, in 22% of the
      cases the absence or inadequacy of the discharge letters might have had a
      negative influence on the patient's health. A survey of the literature provides a
      basis for the following recommendations: On leaving the hospital the patient
      should be given an interim discharge summary containing any information essential
      for immediate follow-up, to be delivered to the general practitioner by hand. The
      final discharge letter should focus upon topics of particular interest for the
      general practitioner: results from clinical examinations and laboratory
      investigations should be restricted to data necessary for making clinical
      decisions; treatment given in hospital, including adverse reactions, and drug
      regimen at discharge; any information on the nature and prognosis of the disease
      given to the patient and/or relatives during the stay in hospital; evaluation of
      prognosis and advice on sociomedical rehabilitation in everyday life and at work;
      a plan for future management of the patient with emphasis on well-defined sharing
      of tasks and responsibilities between the hospital, the outpatient department and
      the GP.

PMID- 2237873
TI  - [The challenge of ecology to medicine].
AB  - The science of ecology is an important tool for reflecting upon the interaction
      between organisms and the environment. However, this science cannot be applied
      directly to human systems, since human interaction is very complex and is often
      based on symbolic meanings. An interdisciplinary approach to human ecology is
      therefore necessary. At a deeper level, ecological thinking might be integrated
      into a vision of the unity of reality, which includes both subjective and
      objective experiences, and where human values are just as important as facts.
      Ecological thinking challenges medicine to take a multidimensional view of man
      and to regard man, in common with life in general, as a self-organizing system.
      Value-based ecological thinking should be just as relevant in situations as
      diverse as our relationship to the individual patient and his community, and our
      own relationship to the industrial society and our common global environment.

PMID- 2237874
TI  - [Contraindications for cervix screening].

PMID- 2237875
TI  - [Acute pulmonary failure syndrome in adults. New radiologic findings].

PMID- 2237876
TI  - [Physicians' continuing and postgraduate education 1991].

PMID- 2237877
TI  - [Animal experiments: advice concerning conscientious objections in employment].

PMID- 2237878
TI  - [Veterinary Chief Inspection of Public Health. Salmonella studies and especially
      study for S. enteritidis in Dutch poultry].

PMID- 2237879
TI  - [Splenomegaly in stomach torsion].

PMID- 2237880
TI  - Metabolic reduction in hypothermia: pathophysiological problems and natural
      examples--Part 1.
AB  - Following a description of the protective effects of hypothermia, the limitations
      resulting from "cold swelling" of the brain, caused by a progressive discrepancy
      between active and passive cellular transport processes, are discussed. The
      observation that the tolerable limits of metabolic reduction lie well below the
      normal turnover rates leads to a short survey of the evolution of energy
      metabolism. The gradual development of the latter from anaerobiosis to aerobiosis
      and from poikilothermy to homeothermy apparently provides the background for
      transient reductions to lower rates which spontaneously occur even in higher
      vertebrates. As an impressive example of such a natural strategy, the anaerobic
      survival of diving turtles is outlined which essentially depends on an efficient
      buffering. This dependence bears analogy to cardioplegia, where an increase in
      buffering capacity can greatly retard the fall of energy turnover, thus leading,
      as is shown by microcalorimetry, to an intermediate plateau of anaerobic
      metabolism.

PMID- 2237881
TI  - Metabolic reduction in hypothermia: pathophysiological problems and natural
      examples--Part 2.
AB  - As an example of spontaneous cooling in homeothermic organisms, hibernation of
      mammals is described. Based on the fact that all hibernators, at their regulated
      minimal body temperature, display a uniform turnover rate, related to body
      weight, the hypothesis is developed that cold tolerance of mammals is generally
      limited by a common specific minimal metabolic rate, which larger organisms,
      because of their lower basal metabolism, already attain in less profound
      hypothermia. The observation that there is, in natural lethargic states, a
      certain independence between metabolic rate and body temperature, subsequently
      leads to considerations on the presumable modulating influence exerted by the
      acid-base balance. Finally, referring to the time limitations of such adaptation
      strategies, the cold-induced disintegration of metabolic processes with differing
      temperature dependence is illustrated which, however, will be more pronounced in
      the intermediate temperature range than in lower cooling. Thus, despite a limited
      cold tolerance, an extremely profound hypothermia of short duration seems not
      altogether impossible even for large homeotherms, provided some adequate
      conditions of rewarming are observed.

PMID- 2237882
TI  - Performance characteristics of centrifugal pumps with heparin surface coating.
AB  - Heparin surface coating is one approach to improve the biocompatibility of
      existing blood pumps used for mechanical circulatory support. Experimental
      evaluation of centrifugal pumps with heparin surface coating was performed during
      open chest left heart bypass (3.7 L/min over 6 hours) in two series of bovine
      experiments. Eight calves (74 +/- 4 kg) were perfused either by heparin surface
      coated equipment without systemic heparinization or uncoated equipment with
      systemic heparinization (300 I. U,/kg bodyweight; ACT greater than 400 s). A
      standard battery of analyses was performed before and at regular intervals after
      onset of perfusion. At the end of perfusion all pump-heads were gently rinsed.
      There were no macroscopic clots for both groups whereas macroscopic clots were
      observed in uncoated tubings introduced for control in the group perfused without
      systemic heparinization. The hemodynamics were significantly better in the group
      perfused without systemic heparinization and maintained functional coagulation
      system. Clinical application of heparin surface coated equipment during resection
      of thoraco-abdominal aortic aneurysms is showing promising results in 12
      patients.

PMID- 2237883
TI  - Tricuspid valve replacement: factors influencing early and late mortality.
AB  - Seventy four patients underwent tricuspid valve replacement (TVR), between 1968
      and 1983. 93% were female, mean age was 44 +/- 4 years. Tricuspid valve was
      replaced with a mechanical prosthesis in 52 and a bioprosthesis in 22 patients.
      Fifty seven patients underwent primary TVR and 17 underwent a secondary TVR
      following a mean interval of 41 +/- 2 months (SEM) following a previous mitral or
      tricuspid valve operation. Preoperatively 86% patients were in NYHA class III-IV
      and congestive cardiac failure (CHF). Early mortality for primary TVR was 36.8%
      and 35.2% for secondary TVR. Early mortality has been significantly reduced since
      the introduction of cardioplegic protection for the associated valve lesions.
      Early mortality was significantly influenced by the reduced preoperative values
      of FVC and FEV1 in patients with long standing mitral valve disease and by raised
      preoperative levels of plasma bilirubin and alkaline phosphate in patients with
      CHF. Risk of thrombotic occlusion and late deaths remained high during the first
      year after TVR with a mechanical prosthesis.

PMID- 2237884
TI  - Echocardiographic evaluation of systolic left-ventricular function in infants
      with critical aortic stenosis before and after aortic valvotomy.
AB  - Infants with critical aortic stenosis may have global or regional left
      ventricular contraction abnormalities. In order to evaluate the clinical
      significance of these contraction abnormalities, we examined the systolic left
      ventricular function before and after aortic valvotomy in 16 infants operated on
      between 1980 and 1987. Left ventricular free wall and septal motion were studied
      by cross sectional echocardiography using the apical 4-chamber view. Enddiastolic
      and endsystolic left ventricular frames were digitized. The relative systolic
      reduction of the total left ventricular area (reflecting ejection fraction) as
      well as of 5 left ventricular sectors (reflecting regional wall motion) was
      calculated and compared to previously established normal values. Before
      valvotomy, 8 infants had normal and the other 8 impaired left ventricular
      systolic wall motion. These latter infants showed hypokinesia of the apex and/or
      the posterolateral left ventricular wall resulting in a decreased systolic
      reduction of the total left ventricular area. Four of these infants had evidence
      of myocardial infarction on intraoperative inspection. Early after operation, the
      systolic reduction of the total left ventricular area was normal in all infants,
      and the left ventricular apex and poster-lateral wall were either normo- or
      hyperkinetic. Follow-up studies of all infants more than 10 months and of 7
      infants more than 3 years after operation showed that the left ventricular
      systolic wall motion remained normal in all, irrespective of whether it was
      normal or abnormal preoperatively. This study suggests that left ventricular
      contraction abnormalities in infants with critical aortic stenosis may be
      reversible and thus do not constitute a contraindication against aortic
      valvotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2237885
TI  - An unusual cause of disabling angina following aortic valve replacement.
AB  - Severe ostial stenosis of the coronary arteries following aortic valve
      replacement is a potentially lethal complication. The usual presentations are
      recent onset of severe angina, ventricular arrhythmias, congestive heart failure,
      and sudden death. It is generally accepted to arise from injury to the coronary
      arteries during direct cannulation and continuous perfusion of cardioplegia under
      high pressure during operation. We report on a patient who developed critical
      left coronary ostial stenosis after aortic valve replacement. The cause for the
      stenosis was probably related to the over-sizing and orientation of the
      prosthesis. The prosthesis was replaced and patch angioplasty of the left
      coronary ostia performed. The patient was well with normal coronary anatomy three
      years after surgery.

PMID- 2237886
TI  - The mobilized omentum and muscle flaps in the treatment of infectious
      complications in cardiovascular surgery.
AB  - Infection in cardiovascular surgery invariably constitutes a very serious
      complication that cannot be controlled by antibiotics in all cases. Improved
      blood supply to the tissue affected by infection largely helps to control these
      complications. The article reports on three cases in which mobilized muscle and
      omental flaps helped essentially to heal infectious complications following heart
      transplantation, aortic valve replacement, and reconstruction of arteries of the
      lower limb.

PMID- 2237887
TI  - Carcinosarcoma of the lung, a tumour which has a poor prognosis and is extremely
      rarely diagnosed preoperatively.
AB  - Out of about 2,000 patients operated on for lung cancer in the period from 1975
      to 1990, four were found with the very rare condition carcinosarcoma. The
      diagnosis was verified by immunohistochemical investigation. The problems
      concerning this rare tumour are discussed with reference to four case
      descriptions and with consideration of the pertinent literature. On the one hand,
      they comprise the difficulty of making a correct histological diagnosis
      preoperatively, and on the other hand the poor prognosis, even in the NO stage.

PMID- 2237888
TI  - Endocrine secreting malignant mediastinal teratoma.
AB  - Malignant mediastinal teratoma containing yolk sac elements are rare tumours and
      invariably have a poor prognosis. An elevated alpha fetoprotein level is a useful
      indicator of the malignant nature and the invasiveness of the tumour. A case with
      such a tumour who also presented with precocious puberty is described. This
      patient was treated with radiotherapy and chemotherapy prior to radical surgical
      excision, and has now survived for over 64 months without evidence of metastases.

PMID- 2237890
TI  - [Position of heart surgery 1988 in Germany. Report of the Hospital Commission
      study group of governing Medical officials (AGLMB)].

PMID- 2237889
TI  - Thoracic Research scholarship 1989: St. Louis University--new developments in the
      field of lung transplantation.

PMID- 2237891
TI  - [Extension of heart surgery capacity in Germany].

PMID- 2237893
TI  - Tumors of the heart. Proceedings of the Third Symposium on Cardiac Surgery.
      Giessen.

PMID- 2237892
TI  - [Present position of heart surgery in East Germany and prospects].

PMID- 2237894
TI  - Clinical aspects of cardiac tumors.
AB  - Due to surgical advances, cardiac tumors now represent a potentially curable form
      of heart disease. Primary cardiac tumors are very rare; secondary, metastatic
      tumors are 10-40 times more frequent. The majority (75%) of primary tumors is
      benign. Cardiac tumors may produce hemodynamic disturbances, mechanical
      hemolysis, biochemical effects and constitutional symptoms. According to the
      anatomic location of the tumor, some special symptoms and physical findings can
      be grouped with regard to pericardial, myocardial, and endocardial involvement.
      Several laboratory data (elevated sedimentation rate, anemia, thrombocytopenia
      etc.) may give additional hints to suggest cardiac involvement in neoplastic
      disease. Among the diagnostic procedures, two-dimensional echocardiography has
      become the most important method for non-invasive detection of cardiac tumors.
      The importance of invasive procedures has declined by the improvement of non
      invasive imaging techniques, but pressure measurements within the cardiopulmonary
      system, left-sided, pulmonary angiography as well as coronary angiography give
      additional useful and necessary information prior to surgery. Within the spectrum
      of differential diagnosis, particularly mitral, aortic, or tricupid valve
      disease, bacterial endocarditis, or autoimmune diseases have to be ruled out.
      Thus, in the vast majority of cases the correct diagnosis can be made. This is
      crucial for further management of the patient since the majority of primary
      cardiac tumors can be successfully treated by surgery.

PMID- 2237895
TI  - Immunology of cardiac tumors.
AB  - Whereas abundant literature is available on mechanisms imposed by neoplastic
      diseases on the immune system, only few details are known about immunological
      parameters of autoreactive mechanisms directed against the heart. This report
      will focus on cardiac autoreactivity in patients with endomyocardial types of
      cardiac tumors (e.g. atrial myxomas), Hodgkin's disease, and with neoplastic
      pericardial effusion. In patients with atrial myxomas antimyolemmal antibodies
      were significantly increased when compared to non-cardiac controls.
      Antisarcolemmal antibodies were positive in 100% of trivalent immunoglobulin
      binding. Antiendothelial antibodies of the IgG type could be found in 86% of
      patients with atrial myxoma. Circulating immune complexes were present in 6 out
      of 7 patients. In 107 patients with Hodgkin's disease without pericarditis the
      presence of antimyolemmal antibodies was lower than in healthy controls. The
      incidence of antimyolemmal antibodies in 10 patients with pericarditis
      lymphogranulomatosa was 10%, whereas in postradiation pericarditis 8 of 15
      patients demonstrated antimyolemmal antibodies. Antiendothelial antibodies were
      positive in 7 out of 15 patients. The number of patient lymphocytes available for
      functional assays is yet too small to permit further conclusions on cellular
      autoreactive mechanisms in Hodgkin's disease. Antimyocardial antibodies were
      found both in the serum and in the effusions at least in lower titers in all
      patients. With regard to in-vitro analysis it can not be excluded that a balance
      between protective and cytolytic antibodies keeps a normal mean of antibody
      mediated cytolysis. Analysing the first line of defense, the natural killer cell
      activity was found significantly increased in neoplastic pericardial effusions,
      whereas peripheral blood and pericardial effusion showed no lymphocytotoxicity
      with isolated myocardial cells.

PMID- 2237896
TI  - Special considerations on primary cardiac tumors in infancy and childhood.
AB  - Primary cardiac tumors are rare at all ages and are even less common in infants
      and children. In the vast majority of cases, they are benign tumors that show
      little tendency to growth. Primary malignant tumors of the heart are
      exceptionally rare. Rhabdomyomas are the most common type of tumors in infants,
      followed in frequency by the fibromas and the teratomas. Myxomas are very rare in
      pediatric patients. Symptoms that derive from the presence of a neoplastic mass
      are usually due to obstruction or compression. In young symptomatic patients,
      usually affected by rhabdomyomas, there is little chance of survival without
      surgery. On the other hand several patients with cardiac neoplasms are totally
      asymptomatic. The indication for surgery is differenciated according to the
      severity of the clinical picture. Since 1974, 15 infants with a cardiac tumor
      have been observed in our hospital. Our recent experience with 5 cases, which are
      described in this report, confirm our opinion, that the most important fact is
      the restoration of the best possible heart function. Total resection of a tumor
      should not always be the main therapeutical aim. Surgical intervention is
      required for those patients, who develop relevant clinical symptoms. Close
      observation of the clinical course is mandatory in all patients with a doubtful
      indication for operation.

PMID- 2237897
TI  - MR and CT for detection of cardiac tumors.
AB  - Although echocardiography is mostly applied for the diagnosis of heart tumors
      there are restrictions concerning the representation of the mediastinal and
      cardial topography in spite of the usage of transoesophageal echocardiography.
      Computed tomography (CT) and magnetic resonance imaging (MR) are able to give a
      full representation of the heart and also the thorax with mediastinum, pleura,
      and lungs. Not only for the diagnosis of various kinds of heart tumors but also
      for decisions concerning the therapy, the detection of postoperative
      complications and development are CT and MR very valuable procedures. The ability
      to deliver a complete cross-section of all cardial, mediastinal, pulmonal and
      thoracic structures--in contrast to angiocardiography--and without any anatomic
      restrictions in contrast to echocardiography--is another advantage of CT and MR.
      Because of the fullness of information CT and MR supply these procedures are
      especially used for the detailed planning of operative procedures. They are also
      a big help in determining whether surgery might have to be excluded because a
      complete tumor resection is not possible anymore.

PMID- 2237898
TI  - Classification of malignant cardiac tumors with respect to oncological treatment.
AB  - Because of the small incidence of primary cardiac neoplasms there have been no
      randomized clinical trials to establish rational therapeutic strategies. Surgery
      is the first choice of therapy in all patients with small cardiac neoplasms. But
      it is not known whether adjuvant chemotherapy may be benefitial in patients in
      whom "curative" surgery has been performed. Chemotherapy must be considered as
      the first choice of therapy in primary cardiac tumors with extracardiac
      metastases. Combination of several agents is more effective than single-agent
      therapy. Radiation should be applied in less sensitive tumors only if surgery is
      not feasible and prior chemotherapy has failed. In patients in whom cardiac
      surgery was performed with a curative aim, chemotherapy but not radiation is the
      adjuvant therapy of choice. Patients with metastatic tumors to the heart should
      be treated according to the established rules for the involved tumor. Therapeutic
      strategy depends on the kind of tumor and the cardiac structure involved. Tumor
      spread to the pericardium will cause pericarditis or pericardial effusion up to
      pericardial tamponade. Instillation of tetracyclines, isotopes and
      chemotherapeutic agents in the pericardial space have been successfully applied
      to prevent recurrent effusion. Radiation did prolong life in patients with
      pericardial metastases as compared with repeated pericardiocentesis. Additional
      cardiac damage may be induced by radiation as well as by drugs. A trial with
      chemotherapy can be useful in all sensitive cardiac tumors.

PMID- 2237899
TI  - Surgical treatment of cardiac neoplasms: 32-year experience.
AB  - In the last 25 years, there have been extraordinary advances and new developments
      in diagnosis and surgical treatment for cardiac tumors. New diagnostic methods
      have almost replaced the need for cardiac catheterization and ventriculography.
      During cardiopulmonary bypass the myocardium can be protected by means of
      hypothermia and cardioplegia. Various techniques have been developed to excise
      cardiac tumors. Depending upon the site and the extent of the neoplasm,
      additional cardiac repair may be required, including bypass grafting or valve
      replacement. Primary tumors of the heart are usually intracavitary lesions and
      more than 75% are benign. Myxomas are the most common cardiac tumors. They are
      usually attached to the intraatrial septum in the left atrium close to the fossa
      ovalis. Left atrial myxomas must be distinguished from mitral valve disease,
      since the clinical presentation may suggest rheumatic feaver and acute
      myocarditis. Since 1957 we have operated upon 71 patients with myxomas with no
      deaths. Removal of a myxoma should be undertaken more aggressively and thoroughly
      than formerly was recommended. Rhabdomyomas are usually multiple tumors, and most
      often they involve the ventricular myocardium. Because these tumors do not grow
      rapidly, surgical resection can be successful. It the tumor is large, it can be
      partially resected to release the obstruction. We have operated upon 3 patients
      with this tumor. Cardiac fibromas are the second most common tumor in infants and
      children. These are usually solitary tumors which compress the surrounding
      structures as they grow. Complete excision of fibromas is difficult since the
      tumors tend to grow large. We have operated upon 11 patients with this
      tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2237900
TI  - Primary cardiac tumors: experience at the University of Minnesota.
AB  - A review of all primary cardiac tumors seen at the University of Minnesota or
      entered in the Registry of Cardiovascular Disease, affiliated with the University
      of Minnesota, between 1959 and 1989. Of a total of 124 primary cardiac tumors,
      103 (83%) were benign and 21 (17%) were malignant. Atrial myxomas (51 cases)
      accounted for 42% of all tumors and 50% of benign neoplasias. The remaining 51
      benign tumors were, in order of frequency: rhabdomyomas, 14 (13%), papillomas, 12
      (11%), fibromas, 9 (9%), hamartomas, (4%), teratomas (2%), lipomas (2%),
      mesotheliomas (2%), fibroelastomas, hemangiomas, glomangiomas, and a few others.
      The 21 malignant tumors, all sarcomas, were, in order of frequency:
      rhabdomyosarcomas, 6 (29%), angiosarcomas, 4 (19%), myxosarcomas, 3 (14%),
      fibrosarcomas, 2 (10%), and one each leiomyosarcoma, reticulum cell sarcoma, and
      liposarcoma. There were 3 cases of spindle cell sarcoma (14%) originating in the
      great vessels: 1 in the pulmonary artery and 2 in the aorta. The prognosis of the
      resected benign tumors was good, with no complications of recurrences for up to
      15 years of follow-up. Tumors that could not be excised included mostly
      rhabdomyomas, in newborns, and cavernous hemangiomas involving most of the heart,
      with poor prognosis. Malignant tumors of the heart had a very poor prognosis,
      even when operated on promptly after diagnosis. The mean survival time of these
      patients was 5 months after resection, even when followed with chemotherapy
      and/or radiation; 26% of the tumors had already metastasized at the time of
      operation. Extensive resections in malignant tumors did not render satisfactory
      results.

PMID- 2237901
TI  - Primary cardiac tumors--French studies of 533 cases.
AB  - The present study combining the Eisenman French Joint Study and the Broussais
      Hospital experience is based upon 533 primary cardiac tumors which were operated
      on in France and by French-speaking teams during a period of about 25 years. The
      diagnosis of heart tumors was facilitated by the progressive development of new
      examination techniques. Echocardiography seems to be the simplest, safest, and
      the most reliable diagnostic method and is used more frequently then
      angiocardiography. Cardiac tumors occur at every age with a prevalence for
      females. About 10% of the surgically treated primary cardiac tumors were
      malignant (53 patients) with a constantly poor prognosis. The mean survival time
      of this collective after operation was only 1.5 years. 8% of the benign cardiac
      tumors were non-myxomatous (36), including fibromas, rhabdomyomas, and
      hamartomas. The mean age of this group was lower (21 years) than in the
      collectives with myxomas or with malignant cardiac tumors. Another characteristic
      of non-myxomatous tumors is the involvement of the ventricles by the neoplasm
      (88%). Complete resection of the tumor was possible in 75%, only 3 operative
      deaths occurred. Myxomas are the most common tumors of the heart, representing
      83% of all primary cardiac tumors (444). Female patients were involved more often
      than males. The age of the patients ranged widely from 2.5 to 82 years. The
      typical localization of the myxomas was the left atrium (83%), followed by the
      right atrium (11%). In 5 cases myxomas were found multilocalized. Very often
      myxomas were mimicing valvular disease. In more than 30% peripheral embolization
      provoked the diagnosis. Only in 2% was the tumor totally asymptomatic.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2237902
TI  - Incidences and surgical aspects of cardiac myxomas in Bulgaria.
AB  - 63 patients with cardiac tumors underwent operative treatment between January
      1970 and December 1988. Three additional patients refused the operation, despite
      the large left atrial myxomas and obstruction of the mitral valve, recognized by
      echocardiography. 62 patients had benign tumors: the only malignant neoplasm was
      a fibrosarcoma, originating from the right ventricle. Myxomas were found in 57
      patients: 54 were located in the left and 2 in the right atrium. In one case the
      myxoma originated from the left ventricle. The hospital mortality of the 22
      patients who underwent excision of cardiac myxomas between 1970 and 1984 was
      18.18% (4 deaths), and 2.44% (1 death) of 41 patients operated on from 1984 to
      1988 for cardiac tumors (35 of them with myxomas). During the follow-up time of 6
      to 140 months, recurrence of myxomas occurred in only one patient, 4 years after
      surgery for multifocal myxoma in the left atrium. Surgical excision of the myxoma
      is the only acceptable therapy able to cure. Without surgical treatment, the
      medium and long-term prognosis is fatal. Therefore once the cardiac myxoma is
      identified by two-dimensional echocardiography, the tumor should be removed even
      in patients without symptoms. The removal of myxomas doesn't require excision of
      the full thickness of the interatrial septum or ventricular wall. The risk of
      postoperative arrhythmias after extensive excision increases. Conduction
      disturbances may be related to the resection of a large area of the atrial septum
      or wall. No recurrences have been registered after less radical procedures--
      removal with excision only of the underlying endocard.

PMID- 2237903
TI  - Tumors of the heart. Incidence and clinical importance of cardiac tumors in Japan
      and operative technique for large left atrial tumors.
AB  - In 1986, a total of 18 430 open-heart procedures was performed in Japan. Whereas
      surgery of congenital heart disease amounted to 46% of all operations, cardiac
      tumors caused only 0.8% (148 cases). The results of an investigation based on
      data from 9 Japanese institutes over a period of 5 years show that myxomas are
      the most frequent tumors of the heart (74 out of 89 cases). Among 89 cardiac
      tumors there were 6 malignant neoplasms. More females were affected than male
      patients. Most of the myxomas were localized in the left atrium (66 out of 74).
      The majority of the myxomas originated from the atrial septum, two myxomas
      derived from atrio-ventricular valves. Inflow and outflow obstruction, valvular
      dysfunction and arrhythmias were the most common symptoms of cardiac tumors. In
      88 patients resection of the tumor could be performed, in 4 cases combined with
      mitral valve replacement and in one case mitral valvuloplasty. In one patient,
      only a tumor biopsy was possible. Reoperation for recurrent myxoma had to be
      carried out in 4 patients after an interval of 1-6 years. In the case of a large
      left atrial tumor the circular incision of the biatrium is preferred by our
      group. This large approach facilitates the removal of the tumor, enables the
      repair of the left atrial posterior wall and atrial septum as well as the surgery
      of the mitral valve. If necessary, this surgical technique can easily be switched
      to cardiac autotransplantation. With regard to new operative procedures we are
      convinced that surgical intervention for cardiac tumors can be applied more
      widely in future.

PMID- 2237904
TI  - Incidence and clinical importance of cardiac tumors in China--review of the
      literature.
AB  - The first successful excision of a left atrial myxoma in China was performed in
      1962. Till October 1988, 656 surgical cases of cardiac tumors have been reported
      in the Chinese literature. The diagnosis of all excised tumors was confirmed by
      pathologic studies. The age of patients ranged from 46 days to 72 years. Among
      these 656 cases, 647 tumors were benign (97%) and 9 tumors were malignant (3%).
      633 myxomas (97.8%) represented the vast majority of the benign cardiac tumors.
      In 26 cases, myxomas were found multilocalized. Before 1975, echocardiography
      could not be performed universally in our country, and diagnosis often failed. At
      present, echocardiography is the most used and the most reliable examination
      method for cardiac tumors in China. The majority of the patients presented
      clinical symptoms of congestive heart failure with palpitation, dyspnoe, syncope,
      and hemoptysis. In 99% the main abnormality was an atypical and frequently
      variable heart murmur. Arterial embolization occurred in 15%. In all patients the
      myxomas was removed as a whole with its attachment to the interatrial septum or
      the atrial wall to prevent recurrence. Examination of all heart chambers should
      be performed to exclude multilocalized tumors. The operative mortality ranged
      between 5.8 to 13%. The recurrence rate of myxomas in China was reported to
      amount to 3%.

PMID- 2237905
TI  - Tumors of the heart. Experiences at the Giessen University Clinic.
AB  - Of 54 cardiac tumors operated upon in our clinic, 42 were classified as benign
      and only 12 as malignant. The major part of the benign tumors were myxoma, mainly
      located in the left atrium. While smaller tumors could be treated by local
      resections, extensive resections were necessary in 14 patients with greater
      tumors followed by reconstructions of the pulmonary and caval vein, mitral and
      tricuspid valve, and major parts of the right and left ventricular wall. In one
      patient with a huge benign myxoma, tumor exposition and total resection could
      only be achieved by an autotransplantation of the heart. While mortality after
      surgical therapy of benign tumors was only 1.4% (1/42) within a mean follow-up
      time of 48 months, the prognosis of malignant tumors is still fatal with a
      mortality of 50% (6/12) within a mean follow-up time of 24 months, despite
      additional chemotherapy or radiation.

PMID- 2237906
TI  - The effect of submandibular gland removal on testicular and epididymal
      parameters.
AB  - The effect of sialoadenectomy (submandibular gland removal) for four weeks
      duration was studied in five C3H mice and four sham-operated controls. This
      preliminary experiment using small numbers of animals indicated that sperm
      production parameters were lowered in sialoadenectomized animals although there
      were no significant differences between the sialodenectomized and sham-operated
      group. In a second experiment using larger numbers of animals, significant
      differences in testicular weights, epididymal weights, and testis weights were
      noted. These parameters were reduced only 10-14% from control levels. Epididymal
      sperm head counts were reduced 10% after sialoadenectomy but the two groups were
      not significantly different (P less than 0.05). No difference in testicular
      histology was observed. The present report contrasts to that of Tsutsumi et al.
      (1986) who indicate that submandibular removal with subsequent depletion of
      epidermal growth factor (EGF), is extremely deleterious (40-55% decreases in
      spermatid and sperm content) to the progress spermatogenesis.

PMID- 2237907
TI  - Ultrastructural study of oogenesis in the acoel turbellarian Convoluta.
AB  - An ultrastructural investigation of oogenesis has been carried out on the acoel
      turbellarian Convoluta psammophyla. Developing female germ cells are not
      contained in well delimited ovaries but are freely distributed in the parenchyma
      and are surrounded by narrow cytoplasmic projections of accessory-follicle cells.
      Oogenesis can be divided into two periods, the previtellogenic and the
      vitellogenic phase. In the first period the oocyte undergoes a number of cell
      differentiations necessary for the intense biosynthetic activity of the second
      period. The ample development of nucleolus, ribosomes, endoplasmic reticulum and
      Golgi complexes along with the appearance of large lipid droplets and clusters of
      electron dense granules characterize the previtellogenic phase. The formation of
      yolk globules is the main feature of the second period of oogenesis. It occurs by
      an autosynthetic mechanism involving endoplasmic reticulum and Golgi complexes,
      since no endocytotic activity has been detected in the developing oocyte. The
      electron dense granules apparently move towards the cortical ooplasm during the
      late vitellogenic phase and take part in egg covering formation. Hypotheses on
      the role of follicle cells and on the phylogenetic significance of a comparative
      analysis of egg inclusions with homologous structures of other Turbellaria are
      suggested.

PMID- 2237908
TI  - Immunohistochemical localisation of the thymidine analogue 5-bromo-2-deoxyuridine
      in insect tissue: preservation of cellular ultrastructure.
AB  - The incorporation of the thymidine analogue 5-bromo-2-deoxyuridine and its
      detection by a specific monoclonal antibody, is proving a valuable tool in the
      study of cell kinetics and proliferation. To date, however, its use has been
      largely restricted to the light microscope level. The fixatives and processing
      required do not preserve the cellular ultrastructure. This paper details an
      immunohistochemical procedure which retains both structural details and preserves
      sufficient antigenicity for the use of the monoclonal at the electron
      microscopical level.

PMID- 2237909
TI  - Embryonic and adult neurones of the housefly (Musca domestica) in culture.
AB  - This paper provides a detailed description of the dissociation and maintenance in
      culture of cells derived from embryonic tissue and from the central nervous
      system of adult housefly, Musca domestica. Dissociation of embryonic tissue
      produced several cell types of which muscle and neurone-like cells predominated.
      These cells were morphologically distinct once development had started in vitro
      with muscle cells often producing rhythmic contractions. Neurones had small cell
      bodies (less than 10 mum) and showed extensive outgrowth of neurites. Neuronal
      cell bodies readily sealed onto patch pipettes and with pipette solutions
      containing nicotinic agonists, single channel currents could be recorded. With
      cell-attached patches, these currents were inward at the cell resting potential
      and reversed with depolarization. Channels with two different conductances could
      be seen in the majority of patches.

PMID- 2237910
TI  - Cleaning insect oocytes by dissection and enzyme treatment.
AB  - Vitellogenic oocytes from the cockroach Blattella germanica were dissected free
      of the surrounding follicle cell layer. The continued presence of a resting
      potential indicated that the defolliculated oocytes remained viable. In other
      experiments, lysozyme was injected into last nymphal instars; scanning electron
      micrographs showed that the bacteroids normally found between the follicle cell
      epithelium and the oocyte membrane were removed by this treatment. Oocytes from
      injected animals were known to be viable because they developed into living
      progeny. To assess the mode of action of lysozyme, defolliculated oocytes were
      exposed in vitro to lysozyme and then a hypotonic rinse; scanning electron
      micrographs showed that these oocytes were largely free of bacteroids.

PMID- 2237911
TI  - Comparison of the disposition and in vitro metabolism of 4-vinylcyclohexene in
      the female mouse and rat.
AB  - 4-Vinylcyclohexene (VCH) is a chemical to which humans are exposed in the rubber
      industry. A chronic carcinogenicity bioassay conducted by the National Toxicology
      Program showed that oral administration of VCH induced tumors in the ovaries of
      mice but not in those of rats. The hypothesis tested was that the species and
      organ specificity of VCH toxicity was due to differences in the disposition of
      VCH between the female rat and mouse. Therefore, the disposition of a single oral
      dose of 400 mg/kg [14C]VCH was studied in female B6C3F1 mice and Fischer 344
      rats. Mice eliminated greater than 95% of the dose in 24 hr, whereas rats
      required 48 hr to eliminate greater than 95% of the dose. The major routes of
      excretion of [14C]VCH-derived radioactivity were in the urine (50-60%) and
      expired air (30-40%). No evidence was obtained to indicate that the ovaries of
      either species retained VCH as a parent compound or as radioactive equivalents. A
      dramatic difference was observed between the rat and mouse in the appearance of a
      monoepoxide of VCH in blood from 0.5 to 6 hr after VCH administration (800 mg/kg,
      ip). VCH-1,2-epoxide was present in the blood of mice with the highest
      concentration at 2 hr (41 nmol/ml). The blood concentration of VCH-1,2-epoxide in
      rats was less than 2.5 nmol/ml at all times examined. VCH-7,8-epoxide was not
      present in the blood of either species at the level of detection. These findings
      were supported by in vitro studies of VCH epoxidation by liver microsomes. The
      rate of epoxidation of VCH (1 mM) to VCH-1,2-epoxide was 6.5-fold greater in
      mouse liver microsomes than that in rat liver microsomes. The species difference
      in the rate of epoxide formation by the liver may be an important factor in the
      species difference in susceptibility to VCH-induced ovarian tumors.

PMID- 2237912
TI  - The role of epoxidation in 4-vinylcyclohexene-induced ovarian toxicity.
AB  - 4-Vinylcyclohexene (VCH) is present in gases discharged during synthetic rubber
      production. Chronic treatment of B6C3F1 mice and F-344 rats with VCH by gavage
      has been shown to induce ovarian tumors in mice but not in rats. Our objective
      was to understand the mechanism of the species difference in VCH-induced ovarian
      tumors. Since a critical step in the induction of ovarian tumors is destruction
      of the small oocyte, small oocyte counts obtained from serially sectioned ovaries
      were used as an index of toxicity. VCH or its epoxide metabolites [VCH-diepoxide,
      VCH-1,2-epoxide, and VCH-7,8-epoxide (in mice only)] were given to 28-day-old
      female mice and rats in corn oil, ip, at doses ranging from 0.07 to 7.4 mmol/kg
      body wt/day for 30 days. The dose which reduced the small oocyte count to 50%
      that of control was defined as the ED50. In mice, the ED50 for the reduction in
      small oocytes by VCH was 2.7 mmol/kg, whereas, no detectable oocyte loss occurred
      in rats at the highest dose of VCH (7.4 mmol/kg). The potency of the epoxides of
      VCH was greater than that of VCH in both species. The ED50 for oocyte loss by VCH
      1,2-epoxide in mice and rats was 0.5 and 1.4 mmol/kg, respectively. In mice, VCH
      7,8-epoxide had comparable potency to VCH-1,2-epoxide (ED50 = 0.7). VCH diepoxide
      was even more potent with ED50 values of 0.2 and 0.4 mmol/kg, in mice and rats,
      respectively. The dose response of the blood concentration of VCH-1,2-epoxide in
      mice after VCH showed that doses of VCH which caused minimal toxicity had the
      lowest blood level of this ovotoxic epoxide. Pretreatment of mice with the
      cytochrome P450 inhibitor chloramphenicol (200 mg/kg, ip) inhibited VCH
      epoxidation in vivo and in vitro and partially protected mice from VCH toxicity.
      Thus it appears that metabolism of VCH to epoxides and their subsequent
      destruction of oocytes are critical steps in VCH-induced ovarian tumors. Rats may
      be resistant to ovarian tumor induction by VCH because the amount of VCH
      converted to epoxides is insufficient to produce oocyte destruction.

PMID- 2237913
TI  - Increased hepatic nicotine elimination after phenobarbital induction in the
      conscious rat.
AB  - Elimination parameters of [14C]nicotine in conscious rats receiving nicotine (0.3
      mg/kg) either intravenously or orally were studied. The oral availability of
      unchanged nicotine, derived by comparison of the respective areas under the
      concentration vs time curves (AUC), was 89%, indicating low hepatic extraction
      ratios of about 10%. Pretreatment of rats with phenobarbital (PB) markedly
      increased hepatic first-pass extraction of nicotine. The oral availability of
      unchanged nicotine in plasma dropped to 1.4% of the corresponding values obtained
      from PB-treated rats receiving nicotine iv. After PB pretreatment, the clearance
      of iv nicotine was increased approximately twofold over controls, much less than
      the observed more than ninefold increase of hepatic first-pass extraction. It is
      assumed that extrahepatic metabolism contributed significantly to the rapid
      removal of nicotine from the plasma. The elimination of cotinine, originating
      from nicotine administered either po or iv, was significantly increased by PB
      pretreatment, as determined by the ratio of corresponding AUCs. The pattern of
      nicotine metabolites in urine also indicated an increase in the rate of cotinine
      metabolic turnover. The amount of norcotinine in the organic extract of urine
      paralleled PB microsomal enzyme induction. The ratio between urinary
      concentrations of the normetabolite and cotinine correlated strongly with the PB
      induced state of rat liver. This may be a suitable indicator of PB-inducible
      hepatic cytochrome P450 isoenzyme(s). Since smoking habits in man are feedback
      regulated by nicotine plasma concentrations, a similar increase of nicotine
      elimination by microsomal enzyme induction in man may be of relevance for tobacco
      consumption.

PMID- 2237914
TI  - Evidence for the participation of activated oxygen species and the resulting
      peroxidation of lipids in the killing of cultured hepatocytes by aryl halides.
AB  - Primary cultures of rat hepatocytes were used to explore the mechanisms of the
      toxicity of aryl halides. The sensitivity of the hepatocytes to chloro-, bromo-,
      and iodobenzene was enhanced by inhibition of glutathione reductase with 1,3
      bis(2-chloroethyl)-1-nitrosourea (BCNU). In each case, the increased cell killing
      depended on the metabolism of the toxicant, a result shown by the protective
      effect of SKF-525A, an inhibitor of mixed function oxidation. BCNU decreased the
      metabolism of [14C]bromobenzene and the covalent binding of its metabolites by
      20%. Chelation by deferoxamine of a cellular source of ferric iron prevented the
      cell killing in the presence or absence of BCNU. Deferoxamine had no effect on
      the metabolism or the covalent binding of [14C]bromobenzene. Similarly, the
      antioxidant N,N'-diphenyl-p-phenylenediamine (DPPD) reduced the cell killing and
      had no effect on the metabolism of [14C]bromobenzene. Thus, the toxicity of the
      three aryl halides was manipulated in ways that modify the sensitivity of
      hepatocytes to an oxidative stress, and the changes in cell killing occurred
      without parallel changes in the metabolism of [14C]bromobenzene or the covalent
      binding of its metabolites.

PMID- 2237915
TI  - Toxicokinetic study of norfloxacin-induced arthropathy in juvenile animals.
AB  - A toxicokinetic study of norfloxacin-induced arthropathy in juvenile animals was
      undertaken using nalidixic acid as a standard drug. Norfloxacin and nalidixic
      acid were subcutaneously administered to rats and rabbits, orally administered to
      dogs, and norfloxacin was orally dosed to monkeys once a day for 7 consecutive
      days. Of the dose levels tested, the minimum arthropathic doses of norfloxacin
      were 100, 25, and 50 mg/kg/day in rats, rabbits, and dogs, respectively. At these
      doses, the peak serum concentrations (Cmax) on Day 6 were 16.1, 9.73, and 5.11
      micrograms/ml, and the areas under the serum concentration/time curve (AUC0---
      infinity) were 31.9, 22.9, and 26.2 micrograms.hr/ml, in respective animals.
      Monkeys showed no arthropathy with norfloxacin at doses of less than 500
      mg/kg/day, at which the Cmax and AUC0----infinity were 15.6 micrograms/ml and 103
      micrograms.hr/ml, respectively. The minimum arthropathic doses of nalidixic acid
      were 50, 100, and 25 mg/kg/day in rats, rabbits, and dogs, respectively. The Cmax
      and AUC0----infinity of nalidixic acid were higher than those of norfloxacin in
      all animals. Joint tissues took up more norfloxacin than nalidixic acid, but when
      arthropathy was present the articular cartilage concentrations of the two drugs
      were in the same range. The penetration of norfloxacin into the articular
      cartilage was the same regardless of the joint's anatomical locations, but
      differed among species, being highest in rats and lowest in monkeys. The Cmax and
      AUC0----infinity of norfloxacin in animals at their arthropathic doses were far
      higher than those measured clinically in children, whereas those of nalidixic
      acid in animals did not differ much from its clinical parameters.

PMID- 2237916
TI  - Efflux of endogenous zinc liberated from metallothionein and alcohol
      dehydrogenase in the liver by replacement with cadmium.
AB  - Efflux of endogenous zinc (Zn) from the liver was examined to aid elucidation of
      the mechanisms of the discriminative uptake between the essential heavy metal Zn
      and the nonessential heavy metal cadmium (Cd). Cd was injected intravenously into
      rats with or without pretreatment of a small dose of Cd 6 or 24 hr earlier. The
      concentration of Zn in the whole liver decreased with time after Cd injection and
      the extent of the decrease was more apparent in the liver that contained the Zn
      bound to metallothionein (MT) by pretreatment. Time course curves of Cd and Zn in
      liver supernatants were identical to those of the corresponding whole livers,
      indicating that the changes observed in the whole livers were due to the changes
      in the supernatants. Distribution profiles of Cd and Zn by gel filtration
      chromatography indicated that Cd replaced Zn bound to both alcohol dehydrogenase
      (ADH) and MT. The decrease of Zn in the liver caused by Cd injection was
      explained by the efflux of the Zn liberated from ADH and MT, which suggests that
      efflux of Zn ions but not Cd ions occurs from the liver. The results are
      discussed from the viewpoint of discriminative uptake between Cd and Zn by the
      liver.

PMID- 2237917
TI  - Synaptic terminal degeneration and remodeling at the rat neuromuscular junction
      resulting from a single exposure to acrylamide.
AB  - Repetitive exposure to low doses of acrylamide results in extensive pathological
      changes at the neuromuscular junction (NMJ), but it remains undetermined if a
      single exposure to a larger dose will produce a similar neuropathological
      outcome. In the present study, morphometric and ultrastructural analyses of rat
      soleus NMJ were performed to determine early pathological effects of an
      intraperitoneal injection of 100 mg/kg acrylamide. Widespread nerve terminal
      degeneration, terminal sprouting, and endplate lengthening were evident as early
      as 4 days after injection. Degenerating terminal branches were swollen and
      exhibited enhanced argyrophilia. Ultrastructurally, the majority of terminals
      exhibited axolemmal abnormalities, neurofilament accumulations, and a paucity of
      synaptic vesicles; occasional swollen terminals lacked neurofilaments but
      contained increased numbers of tubulovesicular profiles. This early morphological
      pattern of nerve terminal changes suggests that acrylamide may disrupt both
      synaptic vesicle recycling and neurofilament degradation. These findings indicate
      that a single high dose of acrylamide triggers pathological lesions and
      remodeling in motor nerve terminals virtually identical to those resulting from
      multiple low doses.

PMID- 2237918
TI  - Estimating the risk of liver cancer associated with human exposures to chloroform
      using physiologically based pharmacokinetic modeling.
AB  - A physiologically based pharmacokinetic (PB-PK) model for CHCl3 has been used to
      prepare estimates of the probability that human populations exposed to low levels
      of CHCl3 will develop liver tumors similar to those seen in rodent bioassays. The
      PB-PK model for CHCl3 was based on a model reported earlier by Corley et al.
      (1990), but this model differed from that of Corley et al. in that it was also
      capable of describing a pharmacodynamic endpoint: induction of cytotoxicity in
      the liver of CHCl3-exposed animals produced by reactive metabolites of CHCl3.
      Pharmacodynamic descriptions in this model were derived from experimental
      measurements of cell replication ([3H]thymidine incorporation) as well as from
      quantitative histopathology in the liver of rats and mice. Two different
      approaches were used for hazard evaluation: (1) a "Safety Factor" approach based
      on no observed effect levels for liver tumors. and (2) calculation of lower
      confidence limits on risk-specific doses with the GLOBAL83 computer program. In
      each case, cytotoxicity produced by reactive CHCl3 metabolites was used as the
      measure of "dose" to the liver. The Safety Factor approach suggested that
      continuous exposure of human populations to concentrations of CHCl3 less than
      2840 ppb in air or 13,900 ppb in water would not be likely to significantly
      increase the risk of developing liver tumors. The second approach suggested a
      "plausible upper 95% confidence limit" of 1 x 10(-5) for lifetime excess cancer
      risk for human populations continuously exposed to 2200 or 13,100 ppb CHCl3 in
      air or water, respectively.

PMID- 2237919
TI  - Acetaminophen hepatotoxicity: correspondence of selective protein arylation in
      human and mouse liver in vitro, in culture, and in vivo.
AB  - Human and mouse liver were exposed to an APAP-activating system, in vitro.
      Subsequent immunochemical analysis of electrophoretically separated proteins with
      an affinity-purified anti-APAP antibody indicated that when a cytosolic fraction
      from human liver was incubated with APAP, an NADPH-regenerating system, and mouse
      microsomes selective APAP binding occurred predominantly to proteins of
      approximately 38, 58, and 130 kDa. To evaluate whether similar proteins are
      targeted in situ, primary cultures of human hepatocytes were treated with 10 mM
      APAP for 4 hr prior to immunochemical analysis. APAP binding was again detected
      in protein bands of approximately 38, 58, and 130 kDa. In addition, selective
      binding was also noted to other cytosolic protein bands, e.g., approximately 52
      and 62 kDa. For mouse liver, the majority of the binding, in vitro or in culture,
      was to proteins of approximately 44 and 58 kDa with lesser binding to proteins of
      approximately 33 and 130 kDa among others. By contrast, at the times monitored,
      little covalent binding was detected in the 44-kDa region in the human liver
      experiments. Most noteworthy was the finding that when the protein arylation
      patterns on liver samples from a human APAP fatality were compared to those from
      a mouse given a hepatotoxic dose of APAP, the binding patterns were similar to
      those detected after the in vitro and the culture experiments with mouse and
      human livers. Furthermore, an immunohistochemical analysis revealed that as with
      the mouse, APAP covalent binding in the human liver exhibited a distinct zonal
      pattern consistent with centrilobular binding. That APAP arylation of the 58- and
      130-kDa proteins was observed in livers from both mice and humans suggests that
      the mouse provides a valid model for studying the mechanistic importance of
      covalent binding. Elucidation of the identities and functions of the common
      targeted proteins may clarify their toxicological significance.

PMID- 2237920
TI  - In vivo effects of T-2 mycotoxin on synthesis of proteins and DNA in rat tissues.
AB  - Rats were given an ip injection of T-2 mycotoxin (T-2), the T-2 metabolite, T-2
      tetraol (tetraol), or cycloheximide. Serum, liver, heart, kidney, spleen, muscle,
      and intestine were collected at 3, 6, and 9 hr postinjection after a 2-hr pulse
      at each time with [14C]leucine and [3H]thymidine. Protein and DNA synthesis
      levels in rats were determined by dual-label counting of the acid-precipitable
      fraction of tissue homogenates. Rats given a lethal dose of T-2, tetraol, or
      cycloheximide died between 14 and 20 hr. Maximum inhibition of protein synthesis
      at the earliest time period was observed in additional rats given the same lethal
      dose of the three treatments and continued for the duration of the study (9 hr).
      With sublethal doses of T-2 or tetraol, the same early decrease in protein
      synthesis was observed but, in most of the tissues, recovery was seen with time.
      In the T-2-treated rats. DNA synthesis in the six tissues studied was also
      suppressed, although to a lesser degree. With sublethal doses, complete recovery
      of DNA synthesis took place in four of the six tissues by 9 hr after toxin
      exposure. The appearance of newly translated serum proteins did not occur in the
      animals treated with T-2 mycotoxin or cycloheximide, as evidenced by total and
      PCA-soluble serum levels of labeled leucine. An increase in tissue-pool levels of
      free leucine and thymidine in response to T-2 mycotoxin was also noted. T-2
      mycotoxin, its metabolite, T-2 tetraol, and cycloheximide cause a rapid
      inhibition of protein and DNA synthesis in all tissue types studied. These
      results are compared with the responses seen in in vitro studies.

PMID- 2237921
TI  - The B lymphocyte is the immune cell target for 2',3'-dideoxyadenosine.
AB  - 2',3'-Dideoxyadenosine (ddA) is a nucleoside analogue with anti-HIV activity and
      one of its metabolic products, 2',3'-dideoxyinosine (ddI), has shown promising
      results in clinical trials for the treatment of acquired immunodeficiency
      syndrome (AIDS). Because AIDS viruses target the immune system, it is important
      to understand the potential effects of anti-AIDS drugs, including natural
      nucleosides, on the immune system. Previous immunotoxicological studies have
      shown that 22 treatments with ddA to female B6C3F1 mice over a period of 30 days
      had no effect on cell-mediated immunity, including the mixed lymphocyte reaction
      and response to mitogenic signals, but suppressed in vitro IgM plaque-forming
      cell (PFC) response to sheep red blood cells. The present studies show that
      suppression of the IgM PFC response was dose dependent with a 96% reduction in
      IgM PFCs/10(6) spleen cells at the highest dose (350 mg/kg). The in vivo IgM PFC
      response to DNP-Ficoll and the in vitro IgM PFC response to lipopolysaccharide,
      both T-independent antigens, were also suppressed in the spleens of ddA-treated
      mice. The analysis of splenocyte subtypes shows no change in the percentage of B
      cells (surface immunoglobulin positive cells), T helper cells (L3T4 positive
      cells), and T suppressor cells or T cytotoxic cells (Lyt-2 positive cells) in the
      spleens of ddA-treated mice. In vitro separation and reconstitution studies in
      which the IgM PFC response was monitored indicated that the B lymphocyte rather
      than the T lymphocyte or antigen-presenting cell is the primary cell targeted by
      ddA. This information provides a data base for further mechanistic study and may
      reflect on the clinical use of other nucleoside analogues, e.g., ddI by providing
      the clinician with information indicating the potential decrease in humoral
      immunity.

PMID- 2237923
TI  - Mechanism of action of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)

PMID- 2237922
TI  - Propanil-induced methemoglobinemia and hemoglobin binding in the rat.
AB  - Administration of [ring-U-14C]propanil (3,4-dichloropropionanilide) to male
      Sprague-Dawley rats (30, 100, and 300 mg/kg, ip) increased the formation of
      methemoglobin at the two highest doses. Following a propanil dose of 100 mg/kg,
      methemoglobin formation attained a maximum level of 5% by 1.5 hr and declined to
      normal levels (approximately 2.5%) by 12 hr. Hemoglobin binding attained a
      maximum level of 50 pmol/mg protein by 12 hr, and remained constant for 24 hr.
      Following a propanil dose of 300 mg/kg, methemoglobin formation attained a
      maximum level of 24% by 4.5 hr, and declined to a level of 5% by 24 hr.
      Hemoglobin binding attained a maximum level of 425 pmol/mg protein by 12 hr, and
      remained constant for 24 hr. Hemoglobin binding was also detected at the lowest
      propanil dose (10 pmol/mg protein) even though methemoglobin formation was not
      observed. HPLC analysis of alkaline-treated hemoglobin from propanil-treated rats
      indicated the presence of one radiolabeled compound with the same HPLC retention
      time as 3,4-dichloraniline. These data are consistent with the concept that
      propanil is converted to N-hydroxy-3,4-dichloroaniline in the liver.
      Subsequently, this metabolite enters the erythrocyte and is oxidized by
      hemoglobin to 3,4-dichloronitrosobenzene with concomitant conversion of
      oxyhemoglobin to methemoglobin. The 3,4-dichloronitrosobenzene binds to cysteine
      residues on hemoglobin as the corresponding sulfinic acid amide adduct. These
      data suggest that human exposure to propanil may be monitored in the absence of
      observable toxicity by the analysis of propanil metabolites bound to hemoglobin.

PMID- 2237924
TI  - Developmental toxicology of industrial alcohols: a summary of 13 alcohols
      administered by inhalation to rats.
AB  - The developmental toxicology of 13 industrial alcohols (methanol, ethanol, 1
      propanol, isopropanol, 1-butanol, 2-butanol, tertiary-butanol, 1-pentanol, 1
      hexanol, 2-ethyl-1-hexanol, 1-octanol, 1-nonanol, and 1-decanol), and the
      behavioral teratogenicity of 4 of these alcohols, were assessed in a series of
      experiments. The results of individual alcohols have been published previously,
      but the present paper summarizes the results in view of structure-activity
      relationships among these alcohols. The alcohols were administered by inhalation
      for 7 hours per day (6 hours/day for 1-decanol) on gestation days 1-19 to groups
      of approximately 15 pregnant Sprague-Dawley rats. For developmental toxicology
      evaluations, dams were sacrificed on gestation day 20. Fetuses were serially
      removed, weighed, sexed, and examined for external malformations. The frequency
      of visceral malformations and variations was determined in one-half of the
      fetuses, and the frequency of skeletal deviations was determined in the other
      half. Behavioral teratology endpoints were investigated in groups of 15 pregnant
      rats exposed to one of four alcohols (ethanol, 1-propanol, 1-butanol, and
      tertiary-butanol) and also involved groups of 18 male rats which were exposed to
      the same concentrations of each alcohol for 6 weeks, and then mated to untreated
      females. In the behavioral teratology evaluations, all litters were culled to
      eight pups and fostered to unexposed mothers. Offspring were tested from days 10
      90 on a series of behavioral tests designed to evaluate neuromotor integrity,
      activity levels, learning, and memory. Additionally, brains were removed from 10
      offspring per group at 21 days of age, and were dissected into cerebrum,
      cerebellum, brainstem, and midbrain; these samples were assayed for steady-state
      levels of protein and the neurotransmitters acetylcholine, dopamine,
      norepinephrine, 5-hydroxytryptamine (serotonin), substance P, B-endorphin, and
      met-enkephalin. Congenital malformations were noted for methanol, 1-propanol,
      isopropanol, and 1-butanol, but only at concentrations in excess of 5000 ppm.
      These concentrations also produced toxicity in the maternal animals; thus, there
      was little evidence of selective developmental toxicity among the alcohols.
      Although sporadic behavioral and neurochemical deviations were detected, no
      consistent pattern of effects was seen for any of the alcohols we tested. It
      should be noted that alcohols with chain lengths longer than the butyl series
      could not be generated as vapors at sufficiently high concentrations to produce
      observable toxicity in the maternal animals. This limits the generality of these
      findings to the possible developmental effects of these alcohols when taken
      through other routes of exposure.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2237925
TI  - Growth and development in the rat during sub-chronic exposure to low levels of
      hydrogen sulfide.
AB  - The effects of low levels of hydrogen sulfide (H2S) on mammalian growth and
      development are unknown although it has long been postulated that H2S can inhibit
      critical developmental functions through the cleavage of disulfide bonds and
      chelation of essential metal ions. Gravid rat dams exposed to H2S (less than or
      equal to 75 PPM) from day 6 of gestation until day 21 postpartum (PP)
      demonstrated normal reproductive parameters until parturition. At parturition,
      however, delivery time was extended in a dose dependent manner with a maximum
      increase of 42% at 75 PPM. Maternal liver cholesterol content was elevated
      significantly on day 21 postpartum following exposure to 75 PPM H2S each day for
      6 weeks. Pups which were exposed in utero and neonatally to day 21 postpartum
      developed with a subtle decrease in time of ear detachment and hair development
      and with no other observed change in growth and development through day 21
      postpartum.

PMID- 2237926
TI  - Subchronic inhalation of triethylamine vapor in Fischer-344 rats: organ system
      toxicity.
AB  - Male and female F-344 rats were exposed at 0, 25, or 247 ppm triethylamine (TEA)
      vapor, 6 hr per day, 5 days per week for up to 28 weeks in order to characterize
      the subchronic organ system toxicity. Rats were weighed biweekly and scheduled
      sacrifices were performed following about 30, 60, and 120 days of exposure. No
      statistically significant treatment-related effects on organ weights, hematology,
      clinical chemistry, or electrocardiographic indices were observed. Body weight
      gain was not affected by TEA treatment. No physiologic or pathologic evidence of
      cardiotoxicity was seen in rats exposed to either TEA concentration for up to 28
      weeks. No gross or histopathologic lesions attributable to TEA exposure were
      noted in any of the organs examined, including the nasal passages. This latter
      finding is in marked contrast to previously reported findings from this
      laboratory in which squamous metaplasia, suppurative rhinitis, and lymphoid
      hyperplasia were found in the respiratory epithelium of F-344 rats exposed to the
      structurally related chemical, diethylamine, under the same conditions as this
      study (Lynch et al., 1986).

PMID- 2237927
TI  - Assessment of the delayed neurotoxicity of tributyl phosphate, tributoxyethyl
      phosphate, and dibutylphenyl phosphate.
AB  - There industrial organophosphorus compounds were tested for their ability to
      cause organophosphorus compound-induced delayed neurotoxicity (OPIDN) in the
      adult hen. The compounds tested were tributyl phosphate (TBP), tributoxyethyl
      phosphate (TBEP), and dibutylphenyl phosphate (DBPP). The acute oral LD50 of TBP
      and DBPP were estimated to be 1,863 and 1,500 mg/kg, respectively, and the dose
      equal to the LD50 was used as a test dose. The acute oral LD50 of TBEP was
      greater than 5,000 mg/kg and 5,000 mg/kg was used as a test dose. An oral dose of
      750 mg tri-o-cresyl phosphate (TOCP) was used as a positive control. For the
      acute delayed neurotoxicity test, hens were given two test doses of the test
      materials 21 days apart and killed 21 days after the second dose. None of the
      hens given TBP, TBEP, or DBPP exhibited nerve damage or clinical signs which
      distinguished them from untreated control animals. A single dose of TOCP resulted
      in paralysis and a histopathological profile typical of a distal neuropathy. For
      the assay of the inhibition of esterases, hens were killed 24 hours after a
      single dose equal to the greater of either the LD50 or 5000 mg/kg. TOCP
      administration resulted in over 90% inhibition of brain neurotoxic esterase
      (NTE), but none of the other three compounds inhibited NTE to an extent (greater
      than 70%) which would be expected to result in OPIDN. Administration of TOCP,
      TBEP, or DBPP resulted in approximately a 70% decrease in plasma
      butyrylcholinesterase (BuChE) activity. TBP caused a 2-3 fold increase in BuChE
      activity. TBEP administration resulted in about 45% inhibition of
      acetycholinesterase (AChE) in brain. These results indicate that TBP, TBEP, and
      DBPP are all unlikely to cause OPIDN with any single sublethal dose.

PMID- 2237928
TI  - A promising indicator of neurobehavioral toxicity using the nematode
      Caenorhabditis elegans and computer tracking.
AB  - A promising screening test for neurotoxicity has been developed using a computer
      tracking system and a species of nematode, Caenorhabditis elegans. The animals
      are viewed in dark-field illumination by a video camera interfaced directly to a
      microcomputer. Several hundred nematodes are tracked simultaneously and rates of
      locomotion and frequency of change of direction are reported in real time. This
      system can rapidly obtain reliable data on a variety of behavioral parameters
      relating to locomotion and response to sensory stimulation. Initial testing has
      examined the effects of six chemicals on locomotion. Four metals (copper,
      beryllium, mercury, and lead) and two organophosphate pesticides (malathion and
      vapona) have been studied. Copper and beryllium were chosen as chemicals that
      have not been shown to be neurotoxins and the other four chemicals were chosen as
      substances known to be neurotoxins. Our findings indicate that the rate of
      movement of exposed nematodes compared to the rate of movement of vehicle
      controls may prove to be useful as an indicator of neurotoxicity.

PMID- 2237929
TI  - The reproductive and developmental toxicity of High Flash Aromatic Naphtha.
AB  - Catalytic reforming is a refining process that converts naphthenes to aromatics
      by dehydrogenation to make higher octane gasoline blending components. A portion
      of this wide boiling range hydrocarbon stream can be separated by distillation
      and used for other purposes. One such application is a mixture of predominantly 9
      carbon aromatic molecules (C9 aromatics, primarily isomers of ethyltoluene and
      trimethylbenzene), which is removed and used as a solvent--High Flash Aromatic
      Naphtha. A program was initiated to assess the toxicological properties of High
      Flash Aromatic Naphtha since there may be human exposure through inhalation or
      external body contact. The current study was conducted to assess the potential
      for developmental toxicity in the mouse and for reproductive toxicity in the rat.
      In the developmental toxicity study in CD-1 mice, exposure of dams by inhalation
      to near lethal levels (1500 ppm) resulted in fetal mortality, reduced weight,
      delayed ossification, and an increased incidence of cleft palate. At 500 ppm, a
      level at which maternal weight gain was slightly reduced, fetal weight gain was
      also reduced, but there was no other evidence of developmental effects. The
      lowest exposure level (100 ppm) did not cause any maternal or developmental
      toxicity. There was no consistent evidence of reproductive toxicity in rats, even
      at exposure levels which resulted in significantly reduced parental weight gain.
      In addition, when parental exposure was stopped on GD (gestation day) 20, birth
      weights as well as postnatal survival were generally similar to control values,
      even in the 1500 ppm exposure group. Postnatal weight gain was also similar to
      controls early in weaning, but, if maternal exposure was reinitiated, weight gain
      was reduced in the high exposure group. However, when exposure was continued
      until delivery, pups in the high exposure group exhibited reduced litter size,
      birth weight and poor survival. Thus it was likely that the reduction in fetal
      weight, seen in the developmental toxicity study in mice, was transient and had
      no postnatal consequences if maternal exposure was terminated at any time prior
      to delivery.

PMID- 2237930
TI  - An evaluation of the developmental toxicity of 2,4-pentanedione in the Fischer
      344 rat by vapour exposure.
AB  - The developmental toxicity of 2,4-Pentanedione (2,4-PD; CAS No. 123-54-6), a
      widely used industrial chemical, was investigated by vapour exposure, because of
      its widespread use, and potential for human exposure. Timed-pregnant Fischer 344
      rats were exposed on gestational days (gd) 6 to 15 inclusive to analytically
      measured concentrations (as mean +/- SD) of 53 +/- 1.6, 202 +/- 4.7 and 398 +/-
      5.7 ppm 2,4-PD vapour. At sacrifice (gd 21) foetuses were examined for external,
      visceral and skeletal variations and malformations. There was no maternal
      mortality, and body weight was reduced only at 398 ppm. Histological examination
      of maternal brains from the 398 ppm group showed no abnormalities. No treatment
      related effects were seen on number of corpora lutea; total, nonviable or viable
      implants per litter; pre-or post-implantation losses; or foetal sex ratio.
      Reduced foetal body weight per litter was seen at 398 ppm (males and females and
      all foetuses) and 202 ppm (males and all foetuses). There was no concentration
      related, or statistically significant, increase in the incidence of individual
      malformations, malformations by category (external, visceral or skeletal), or
      total malformations. Partial foetal atelectasis was increased at 398 ppm, and the
      increased incidence of 17 skeletal variants (out of 79 observed) indicated a
      consistent pattern of foetotoxicity at 398 ppm. In summary, at 398 ppm there was
      maternal toxicity (reduced body weight) and foetotoxicity (reduced body weight
      and ossification) and at 202 ppm there was foetotoxicity (reduced body weight).
      Embryotoxicity or teratogenicity were not seen at any concentration. The no
      observable-effects concentration was 53 ppm for both maternal and developmental
      toxicity.

PMID- 2237931
TI  - A 90-day toxicity study of the effects of petroleum middle distillates on the
      skin of C3H mice.
AB  - Petroleum middle distillates (PMDs) elicit skin tumors in mouse epidermal
      carcinogenesis studies. The response is characterized by a long latency with only
      a small percentage of animals developing tumors. Although the carcinogenic
      activity of certain other petroleum hydrocarbons largely depends upon the
      presence of polycyclic aromatic hydrocarbons (PAHs), many PMDs contain relatively
      low concentrations of PAHs. PMDs are also irritating to mouse skin, and chronic
      irritation may be involved in the development of skin tumors. This study was
      conducted to investigate the patterns of cutaneous irritation elicited by topical
      application of PMDs having compositional differences. The three PMDs selected for
      study were a steam cracked gas oil (SCGO), a lightly refined paraffinic oil
      (LRPO), and a jet fuel (JF). Male C3H/HeNCr1BR mice (25/group) were treated
      topically (37.5 microliters 2x/week for 13 weeks) with 10%, 50% or 100%
      (undiluted) concentrations of each PMD. Catalytically cracked clarified oil
      (CCCO, 10%), a potent carcinogen to mouse skin, was also tested. The vehicle was
      a noncarcinogenic mineral oil with a viscosity of 90 SUS. Cutaneous changes were
      evaluated by gross observations and light microscopy. Cutaneous irritation was
      the only significant toxic response in this study. Neither the vehicle nor any of
      the 10% PMD concentrations produced significant cutaneous irritation. The 10%
      CCCO and 50% PMD treatments all elicited slight to moderate proliferative and
      inflammatory changes in mouse skin. Ulcers were also observed microscopically in
      mice treated with 10% CCCO and 50% SCGO. The 100% SCGO treatment produced
      evidence of necrosis on Days 1-7 but not later in the study despite continued
      treatment. In contrast, the irritating effects of 100% LRPO were not evident
      until 2-3 weeks of study, and at study completion were characterized by
      moderately severe inflammatory and proliferative changes. The effects of 100% JF
      were qualitatively similar to 100% LRPO but less marked. Thus, the SCGO caused a
      different pattern of cutaneous responses than either LRPO or JF. The possible
      relationships of these cutaneous changes to epidermal carcinogenesis are being
      studied further.

PMID- 2237933
TI  - The lawyer looks for an "expert" expert.

PMID- 2237934
TI  - 'In vitro immunotoxicology and immunopharmacology: studies on drugs of abuse' by
      R.M. Pillai and R.R. Watson.

PMID- 2237932
TI  - Enhanced arrhythmogenicity of Freon 113 by hypoxia in the perfused rat heart.
AB  - The interaction of Freon 113 (1,1,2-trichloro-1,2,2-trifluoroethane) and hypoxia
      on the heart conduction system was studied using electrocardiogram monitoring of
      isolated perfused rat hearts. Freon 113 (0.2 mM) alone elicited significant
      atrioventricular conduction delay (p less than 0.05) and heart rate decrease (p
      less than 0.01), which were significantly enhanced by hypoxia (75% oxygen
      decrease), for instance, resulting in 2:1 AV block. The data suggest that
      arrhythmogenicity of Freon 113 on the heart conduction system may be enhanced
      synergistically by hypoxia.

PMID- 2237935
TI  - In vitro immunotoxicology and immunopharmacology: studies on drugs of abuse.
AB  - The application of immunotoxicology to the toxicologic assessment of drugs of
      abuse is a field of increasing importance. Interest in the effects of drugs of
      abuse on the immune system has greatly increased as a result of the AIDS
      epidemic. If drugs of abuse compromise the immune system, their use may well
      become a predisposing factor in the development or enhancement of AIDS in high
      risk groups. Therefore development and validation of newer methods of assessment
      of immunotoxicology and their adaptation to routine analysis is an absolute
      necessity. An important feature in toxicology in general, and in immunotoxicology
      in particular, is the need to develop in vitro assessment systems. Recent
      research has provided newer models, data on correlations of immune function
      variables, and a better understanding of the biologic relevance of certain immune
      function parameters. This paper analyzes these features in relation to the role
      of drugs of abuse in the modulation and alteration of the immune system and
      reviews the various in vitro techniques that could be used to evaluate
      immunotoxicity.

PMID- 2237936
TI  - Covalent binding of o,p'-DDD in rabbit lung and isolated rabbit lung cells.
AB  - The irreversible binding of o,p'-DDD was examined in isolated lung cells, in lung
      microsomes and in vivo in male New Zealand White rabbits. Non-ciliated
      bronchiolar (Clara) cells had the highest capacity to bind o,p'-DDD, followed by
      alveolar type II cells. A fraction of mixed unidentified lung cells was also able
      to bind o,p'-DDD while no binding was observed in alveolar macrophages. The
      activation of o,p'-DDD was shown to be mediated by cytochrome P-450 in both lung
      microsomes and isolated lung cells. In vivo, the binding was preferentially
      localized in the lung alveolar and bronchiolar regions. The binding of o,p'-DDD
      observed in vivo may thus be caused by the capacity of several cell types to
      activate o,p'-DDD.

PMID- 2237937
TI  - Studies of the rad-equivalence of ethylene oxide in the presence and absence of
      12-O-tetradecanoylphorbol-13-acetate (TPA) in C3H/10T1/2 cells.
AB  - Cell transformation in vitro of C3H/10T1/2 cells, using gamma-radiation and
      ethylene oxide (EtO), in both the absence and presence of the cancer promoter, 12
      O-tetradecanoylphorbol-13-acetate (TPA), was studied. TPA promotes transformation
      of C3H/10T1/2 cells to the same extent. In the dose ranges studied the average
      enhancement of the transformation frequency was 2.4 and 2.5 for EtO and gamma
      radiation, respectively. The rad-equivalence of EtO in the presence of TPA was
      calculated to be 75 +/- 52 rad/mMh (95% confidence interval) which is consistent
      with the value 78 +/- 14 rad/mMh (95% confidence interval) obtained without TPA
      treatment.

PMID- 2237939
TI  - The effect of Biostim (RU-41740) on the expression of cytokine mRNAs in murine
      peritoneal macrophages in vitro.
AB  - The immunomodulatory agent Biostim (RU-41740) was investigated for its ability to
      induce the expression of cytokine mRNAs in murine peritoneal macrophages in
      vitro. Northern blot analysis showed that in quiescent macrophage populations,
      both IL-1 alpha and IL-1 beta mRNA levels were dramatically increased in response
      to 1 microgram/ml Biostim. Dot-blot analysis showed that in quiescent macrophage
      populations the expression of mRNAs for IL-1 alpha, IL-1 beta, IL-6 and TNF-alpha
      could be elevated by concentrations of Biostim as low as 1-10 pg/ml, detectable
      after 3 h exposure. In parallel experiments LPS was effective only at the higher
      concentration of 10 ng/ml. Time-course analysis showed that the expression of
      these cytokine mRNAs was transient, peaking after 1-3 h; only transcripts of IL-1
      beta were detectable after 23 h exposure. No effects were seen on the expression
      of actin, a high-turnover housekeeping gene. We propose that this type of
      analysis represents a sensitive, specific and reproducible method for assessing
      the ability of drugs and chemicals to modulate the expression of cytokines that
      play a pivotal role in the induction of the immune response.

PMID- 2237938
TI  - Regulation of polyamine biosynthesis by 2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD).
AB  - We have examined the effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on
      tissue polyamine concentrations in CD1 mice. Two days after a low dose treatment
      with TCDD, polyamine content of the liver and thymus of treated mice showed a 49
      82% decrease, but that of spleen was not affected. Based on this finding, we
      examined the role of alterations in polyamine levels in the toxicity of TCDD. We
      administered the polyamine biosynthetic inhibitor difluoromethylornithine (DFMO)
      to animals treated with a toxic dose of TCDD. DFMO dramatically increased the
      toxicity of TCDD as measured by mortality, ascites and changes in organ weights.
      In addition, administration of the polyamine putrescine was able to reduce the
      toxicity of TCDD. These results suggest that a decrease in polyamine
      concentrations in critical organs may play an important role in the toxic effects
      of TCDD.

PMID- 2237940
TI  - 1-Methyl-4-phenylpyridinium (MPP+) does not exhibit paraquat-like
      immunoreactivity.
AB  - The structural analogy of paraquat with 1-methyl-4-phenylpyridinium (MPP+) has
      been implied in the aetiology of Parkinson's disease. The cross-reactivity of
      MPP+ to a specific antibody to paraquat was assessed by radioimmunoassay and was
      found to be very low. The results suggest that this polyclonal paraquat antibody
      does not mimic the MPP+ receptor.

PMID- 2237941
TI  - Enhanced antibody production in W/Wv mice exposed to ozone.
AB  - To investigate the modulation of defense mechanisms by ozone (O3) exposure, mast
      cell-deficient WBB6F1-W/WV and normal WBB6F1(-)+/+ mice were continuously exposed
      to 0.8 ppm O3 for 7 days. Although no differences in weights of lung, thymus and
      spleen were shown between exposed and control W/WV mice, antibody response to
      sheep red blood cells (SRBC) in exposed W/WV mice was markedly enhanced compared
      to control W/WV mice. In normal +/+ mice O3 exposure induced an increase in lung
      weight but did not enhance antibody production. These studies suggest that the
      susceptibility of W/WV mice to O3 may be different from that of +/+ mice.

PMID- 2237942
TI  - Sex hormones and coronary disease: a review of the clinical studies.

PMID- 2237943
TI  - Transformation of epiandrosterone into 3-oxa-, 3-thia-, 3-selena-, and 3-aza-17
      oxaandrostanes of the 5 alpha series based on beta-scission of alkoxyl radicals.
AB  - 3 beta-Hydroxy-5 alpha-androstan-17-one was transformed into 17-oxa-5 alpha
      androstan-3 beta-ol in five steps involving conversion of the 17-ketone via the
      corresponding lactol to its hypoiodite and thence a regioselective beta-scission
      under irradiation to give ring D seco iodoformate, from which the 17-oxasteroids
      were derived. Four bisheterosteroids 3,17-dioxa-5 alpha-androstane, 3-thia-17-oxa
      5 alpha-androstane, 3-aza-17-oxa-5 alpha-androstane, and 3-selena-17-oxa-5 alpha
      androstane) were synthesized from 17-oxa-5 alpha-androstan-3 beta-ol via 5, 8, 8,
      and 9 steps, respectively, involving a second regioselective beta-scission of an
      alkoxyl radical as the key step.

PMID- 2237944
TI  - High ethanol consumption as risk factor for intracerebral hemorrhage in young and
      middle-aged people.
AB  - We examined the prevalence of high ethanol intake, hypertension, and other risk
      factors for intracerebral hemorrhage in a case-control study of 24 young and
      middle-aged patients with intracerebral hemorrhage. We recorded ethanol
      consumption, history of hypertension, liver disease, cigarette smoking, and mild
      or severe coagulation disorder in each case of intracerebral hemorrhage and in 48
      control patients matched by sex and age. In univariate matched analyses, the
      frequencies of high ethanol intake (p = 0.009), hypertension (p = 0.05), and
      coagulation disorder (p = 0.05) were higher in the cases than in the controls.
      After controlling for possible confounding factors, we found that high ethanol
      intake and hypertension were the only independent risk factors for intracerebral
      hemorrhage (p = 0.02 and p = 0.05, respectively). The hemorrhagic lesion found in
      cases with a high ethanol intake tended to be located in the cerebral lobes (p =
      0.01), contrasting with the typical basal ganglia location of hypertensive
      hematomas (p = 0.009). We conclude that chronic, high ethanol intake should be
      considered as an important risk factor for lobar hematomas in young and middle
      aged people.

PMID- 2237945
TI  - Stroke in systemic lupus erythematosus.
AB  - We investigated the clinical and pathologic characteristics of stroke in 234
      patients with systemic lupus erythematosus. Thirteen patients (5.6%) developed
      cerebrovascular disease. Cerebral infarction was noted in eight, cerebral
      hemorrhage in two, and subarachnoid hemorrhage in three. In seven (54%) of these
      13 patients, stroke occurred less than or equal to 5 years after systemic lupus
      erythematosus was diagnosed. Among the predisposing risk factors for stroke,
      hypertension was the most important. Lupus anticoagulant was detected in three
      (38%) and anticardiolipin antibody in three (43% of seven investigated) of the
      patients with infarction. Evaluation of the clinical manifestations and
      autoantibodies indicated that renal involvement and high titers of anti
      deoxyribonucleic acid antibody were more frequent in the stroke group than in the
      non-stroke group. Autopsy studies on six of the patients with stroke revealed
      small infarcts and hemorrhages in all, but in no case was true angiitis observed.
      Libman-Sacks endocarditis was found in two of the three patients with infarction.
      In conclusion, the important contributory factor to the development of stroke in
      patients with systemic lupus erythematosus is considered to be hypertension
      mediated by immunologic abnormalities. Antiphospholipid antibodies and Libman
      Sacks endocarditis are closely associated with occlusive cerebrovascular disease.

PMID- 2237946
TI  - Regression of intracardiac thrombus after embolic stroke.
AB  - Using two-dimensional echocardiography, we studied the pathophysiology of
      intracardiac thrombus regression accompanied by anticoagulant therapy in 82
      consecutive patients with acute cardiogenic cerebral embolism. We noted
      intracardiac thrombus in 15 patients; nine of the 15 were started on
      anticoagulant therapy with warfarin potassium to maintain the prothrombin time
      between 2.5 and 3.5 (international normalized ratio). Serial two-dimensional
      echocardiograms were obtained for these nine patients before and after
      anticoagulation, with the plasma levels of fibrinopeptide A, fibrinopeptide B
      beta 15-42, and D-dimer measured at the same time. In eight of the nine patients
      the intracardiac thrombi gradually decreased in size while the plasma level of
      fibrinopeptide A fell to within the normal range and the plasma levels of
      fibrinopeptide B beta 15-42 and D-dimer remained above the normal ranges. In the
      other patient the thrombus disappeared, with embolization to the right arm
      immediately after starting anticoagulant therapy. Mobile or small thrombi
      regressed earlier than nonmobile or large ones. We conclude that regression of
      intracardiac thrombi after anticoagulation may be based on the relative
      predominance of plasma fibrinolytic activity over anticoagulation-inhibited
      thrombin activity.

PMID- 2237947
TI  - Surgical experience with cerebral amyloid angiopathy.
AB  - Cerebral amyloid angiopathy can present as lobar intracerebral hemorrhage in an
      elderly person, presumably due to increased fragility of the vessels affected by
      amyloid deposition. For this reason, patients presenting with intracerebral
      hemorrhage and suspected of having cerebral amyloid angiopathy have often been
      treated nonsurgically. Since 1983 we have evaluated 11 patients with cerebral
      amyloid angiopathy (nine women and two men, mean age 73 years) who have undergone
      either intracerebral hematoma evacuation or brain biopsy. Nine of the 11 patients
      presented with intracerebral hemorrhage, which was unilobar in three patients and
      multilobar in six and involved the parietal lobes seven times, the frontal lobes
      four times, the temporal lobes four times, and the occipital lobes twice. These
      nine patients underwent hematoma removal, with no cases of abnormal
      intraoperative bleeding or recurrent hemorrhage. Six patients improved
      neurologically, and two were unchanged after hematoma evacuation; the remaining
      patient had a fatal cardiopulmonary arrest during the immediate postoperative
      period. During follow-up in seven patients (median 11 months, range 1 week to 74
      months) none experienced a recurrent intracerebral hemorrhage and four continued
      to improve. Two of the 11 patients had cerebral amyloid angiopathy diagnosed by
      brain biopsy as part of an evaluation for dementia, also without surgical
      complications. This series suggests that patients with cerebral amyloid
      angiopathy may safely undergo operative procedures, and patients presenting with
      intracerebral hemorrhage may show neurologic improvement following evacuation of
      the hematoma.

PMID- 2237949
TI  - Correlation of clinical and computed tomographic findings in stroke patients.
AB  - We evaluated the correlation between clinical features and computed tomographic
      findings in a prospective study of 1,191 consecutive patients with acute
      cerebrovascular disease seen during 1 year. In the 386 patients in whom symptoms
      and signs initially suggested a cerebrovascular disorder, computed tomography
      revealed a relevant lesion in 154 (hemorrhagic in 52 [33.8%], ischemic in 102
      [66.2%]) and a significant nonstroke abnormality in 14 (3.1%). Among the
      remaining 805 patients with symptoms and signs suggesting some central nervous
      system disorder other than stroke, computed tomography revealed a cerebrovascular
      lesion in 38 (4.7%); 35 of these lesions were ischemic. The computed tomographic
      findings was compatible with the final clinical diagnosis in 192 (84.2%) of the
      228 patients with lesions. In the entire sample of 1,191 patients, a
      cerebrovascular disorder would have been missed in 38 (3.2%) without computed
      tomography. On the other hand, computed tomography failed to visualize a
      cerebrovascular lesion in 40 patients in whom such a lesion was clinically
      obvious. Our results emphasize that both careful neurologic assessment and a
      policy of early computed tomography are of crucial importance in the diagnosis of
      stroke and for therapeutic considerations.

PMID- 2237948
TI  - Remote effect of deep-seated vascular brain lesions on cerebral blood flow.
AB  - We measured regional cerebral blood flow using the xenon-133 inhalation method,
      at approximately 1 month after onset, in 60 stroke patients who had no evidence
      of major carotid artery stenosis or occlusion. Their single lesions (43 infarcts
      and 17 hematomas) were located in the capsulothalamolenticular region, sparing
      the cortex. Hemispheric mean cerebral blood flow was reduced on the side of the
      lesion in 25 patients and on both sides in 20. Regional hypoperfusion was
      observed in 46 patients (ipsilaterally in 34, bilaterally in 10, and
      contralaterally in two). Regional hypoperfusion was observed most frequently in
      the frontal lobe, particularly in the motor and premotor cortices of the
      prerolandic area. The 46 patients with regional hypoperfusion were compared with
      the 14 patients without regional hypoperfusion, considering the size and location
      of the lesion as well as the functional and analytic motor performances. As a
      rule, the lesion was slightly smaller and more posterior and the functional (p
      less than 0.001) and analytic (p less than 0.05) motor performances were
      significantly better in the 14 patients without regional hypoperfusion. Since the
      xenon-133 inhalation method examines cortical blood flow, we can attribute blood
      flow reductions resulting from deep-seated lesions to a functional depression
      akin to diaschisis. Interpretation of the clinical consequences and pathogenesis
      of this phenomenon requires further sequential and pathologic studies.

PMID- 2237950
TI  - Ultrasonic evaluation of early carotid atherosclerosis.
AB  - We investigated the prevalence of carotid atherosclerosis, including mild early
      lesions, and its association with cervical bruits and various risk factors (age,
      male sex, hypertension, hyperlipidemia, diabetes mellitus, obesity, and cigarette
      smoking) in 232 consecutive Japanese patients. High-resolution real-time B-mode
      ultrasonography was performed to determine the extent of atherosclerosis, and it
      was quantified by using a scoring system. The prevalence of carotid
      atherosclerosis was 49%, 59%, and 41% in all 232 patients, the 100 symptomatic
      patients, and the 132 asymptomatic patients, respectively. Although carotid
      lesions were detected frequently (87%) in the 30 patients with cervical bruits,
      bruits were noted in only 30% of the 88 examined patients with carotid
      atherosclerosis. Independent risk factors for carotid atherosclerosis in these
      patients were found to be age, male sex, and hyperlipidemia; diabetes mellitus
      was a possible risk factor for carotid atherosclerosis. Our study did not show a
      close association between hypertension and carotid atherosclerosis, and this
      might be caused by the high prevalence of hypertension in our patients. Our
      findings suggest an increasing prevalence of carotid atherosclerosis in the
      Japanese, though this should be confirmed in a population-based study. Our study
      demonstrates the clinical usefulness of high-resolution B-mode ultrasonography
      for the evaluation of early carotid atherosclerosis.

PMID- 2237951
TI  - Effect of emitted power on waveform intensity in transcranial Doppler.
AB  - This study assesses the problem of transcranial Doppler recording failure and
      seeks to determine the extent to which this can be ameliorated by increased
      emitted power. We hypothesized that waveform intensity is directly related to the
      rate and quality of successful recording and may be compared quantitatively among
      groups of patients. Among a large group of patients recorded at 800 mW/cm2
      emitted power, intensity was strongest in white men, weakest in black women, and
      intermediate in black men and white women. It declined with age in women of
      either race, but not in men of either race. Analysis of the effect of emitted
      power on intensity predicted that significant numbers of waveforms recorded at
      800 mW/cm2 could not be recorded at the current clinical standards of 100 mW/cm2,
      the difference being most pronounced in elderly black women. Temporal bone window
      thickness measured in a series of adult cadaver skulls was least in white men,
      greatest in black women, and intermediate in black men and white women. The
      findings of this study support the hypothesis that temporal bone window thickness
      is an important determinant of recording difficulty and suggest that increased
      emitted power can significantly increase successful recording, particularly in
      black and elderly patients. Increased power alone, however, cannot completely
      solve the recording problem within safe limits.

PMID- 2237952
TI  - Correlates of middle cerebral artery blood velocity in the elderly.
AB  - We analyzed the association between hematologic factors and blood velocity of the
      middle cerebral artery in 42 healthy ambulatory subjects aged 63-86 years. We
      found a significant inverse association between mean velocity and both hematocrit
      (r = -0.37, p less than 0.02) and fibrinogen concentration (r = -0.42, p less
      than 0.005). These two variables are independently associated with velocity and
      together explain 29% of the variance in mean velocity. Both hematocrit and
      fibrinogen concentration should be considered in the interpretation of
      transcranial Doppler findings in this population.

PMID- 2237953
TI  - Comparison of transcranial and cervical continuous-wave Doppler in the evaluation
      of intracranial collateral circulation.
AB  - Adequate intracranial collateral circulation reduces risk of stroke in carotid
      artery surgery. To evaluate their relative accuracies in assessing intracranial
      collateral blood flow, we prospectively compared transcranial Doppler and
      continuous-wave Doppler of the cervical carotid arteries combined with
      compression of the common carotid artery in 28 consecutive patients before
      carotid endarterectomy. Ten healthy volunteers served as controls. Three patients
      (11%) were excluded from compression of arteries because of diffuse disease in
      the common carotid artery. A total of 199 compressions were performed without
      complications. Lack of a suitable transtemporal window precluded the performance
      of transcranial Doppler in three patients (12%). The anterior communicating
      artery was identified in all the normal volunteers and 80% of patients by both
      methods. The posterior communicating artery was identified by both methods in 16
      of 20 attempts in controls. Continuous-wave Doppler identified the posterior
      communicating artery in 30 of 50 attempts in patients; transcranial Doppler
      identified the posterior communicating artery in 20 of 44 attempts in patients (p
      greater than 0.5). Detection of intracranial collaterals correlated with
      intraoperative carotid artery back pressure measurements in 23 of 25 patients
      (92%). We conclude that continuous-wave Doppler of the extracranial arteries
      combined with common carotid artery compression is a safe and easy way to detect
      intracranial collaterals, with an accuracy equivalent to transcranial Doppler.

PMID- 2237954
TI  - Moderate hypothermia after cardiac arrest of 17 minutes in dogs. Effect on
      cerebral and cardiac outcome.
AB  - Moderate hypothermia (30 degrees C) induced before circulatory arrest is known to
      improve neurologic outcome. We explored, for the first time in a reproducible dog
      outcome model, moderate hypothermia induced during reperfusion after cardiac
      arrest (resuscitation). In three groups of six dogs each (N = 18), normothermic
      ventricular fibrillation cardiac arrest (no blood flow) of 17 minutes was
      reversed by cardiopulmonary bypass--normothermic in control group I (37.5 degrees
      C) and hypothermic to 3 hours in groups II (32 degrees C) and III (28 degrees C).
      Defibrillation was achieved in less than or equal to 5 minutes and partial bypass
      was continued to 4 hours, controlled ventilation to 20 hours, and intensive care
      to 96 hours. All 18 dogs survived. Electroencephalographic activity returned
      significantly earlier in groups II and III. Mean +/- SD best neurologic deficit
      between 48 and 96 hours was 44 +/- 8% in group I, 38 +/- 12% in group II, and 35
      +/- 7% in group III (differences not significant). Best overall performance
      category 2 (good outcome) between 48 and 96 hours was achieved in none of the six
      dogs in group I and in four of the 12 dogs in the combined hypothermic groups II
      and III (difference not significant). Mean +/- SD brain total histologic damage
      score was 130 +/- 22 in group I, 93 +/- 28 in group II (p = 0.05), and 80 +/- 26
      in group III (p = 0.03). Gross myocardial damage was greater in groups II and III
      than in group I--numerically higher overall and significantly higher in group III
      for the right ventricle alone (p = 0.02). Moderate hypothermia after prolonged
      cardiac arrest may or may not improve cerebral outcome slightly and can worsen
      myocardial damage.

PMID- 2237955
TI  - Protective effects of a monosialoganglioside derivative following transitory
      forebrain ischemia in rats.
AB  - We evaluated the effects of treatment with the inner ester derivative of the
      monosialoganglioside GM1 on cortical electroencephalographic activity and
      hippocampal CA1 morphology after transitory, near-complete cerebral ischemia in
      rats. Ischemia was induced by the four-vessel occlusion method, and we studied
      only the 58 rats that showed flattening of the cortical electroencephalogram for
      the entire 30 minutes of occlusion. The ganglioside (n = 30) or saline (n = 28)
      was administered intravenously immediately after release of the carotid clips and
      then intramuscularly for 21 days of observation. Cortical electroencephalographic
      activity was monitored throughout the experiment. After 21 days of recirculation
      we assessed hippocampal CA1 damage by light microscopy. The results indicate that
      treatment with the ganglioside reduces postischemic secondary damage to the
      cortical circuitry (as indicated by significantly higher cortical
      electroencephalographic activity late after reperfusion) and limits neuronal loss
      in the CA1 region. Our results lend support to the possible therapeutic use of
      ganglioside in human pathologic conditions associated with cerebrovascular
      insufficiencies.

PMID- 2237956
TI  - Effect of ischemia induced by middle cerebral artery occlusion on superoxide
      dismutase activity in rat brain.
AB  - Acute cerebral ischemia increases the generation of free radicals, causing cell
      damage, and theoretically may decrease the activity of the scavenging enzyme
      superoxide dismutase. To investigate the role of superoxide dismutase in cerebral
      ischemia, we used a model of middle cerebral artery occlusion in rats. In this
      model an infarct is produced in the pyriform and frontoparietal cortices,
      extending into the lateral basal ganglia. We measured superoxide dismutase
      activity by using the xanthine oxidase cytochrome c reduction assay in these
      areas of rat brains. Tissue samples were analyzed 20 minutes, 2, 6, or 24 hours,
      or 7 days after middle cerebral artery occlusion and 2 or 24 hours or 7 days
      after sham operation (n = 8-10 at each time). There was no significant change in
      superoxide dismutase activity relative to control values in any brain area at any
      time up to 24 hours after surgery. However, 7 days after middle cerebral artery
      occlusion a significant decline in superoxide dismutase activity, to 55%-68% (p
      less than 0.05) of that in unoperated controls, was observed in all brain areas.
      Our results do not support an important role for changes in the activity of
      endogenous superoxide dismutase during the acute phase of cerebral ischemia.
      However, the decrease in superoxide dismutase activity 7 days after ischemia
      could indicate ongoing additional damage to peri-infarct tissue.

PMID- 2237957
TI  - Progressing cerebral infarction in relation to plasma glucose in gerbils.
AB  - We studied neurologic morbidity and its evolution during hyperglycemia induced
      immediately after permanent unilateral common carotid artery ligation in
      Mongolian gerbils. A total of 60 animals were divided into five groups: one
      experiencing severe hyperglycemia for 1 hour after the onset of ischemia (brief
      hyperglycemia group, n = 13), a normoglycemic control group for the brief
      hyperglycemia group (n = 12), a group with severe hyperglycemia for 4 hours after
      the onset of ischemia (prolonged hyperglycemia group, n = 11), a normoglycemic
      control group for the prolonged hyperglycemia group (n = 13), and a hyperosmolar
      normoglycemic control group for the prolonged hyperglycemia group (n = 11).
      Neurologic morbidity and mortality were higher in the two hyperglycemic groups
      than in the three normoglycemic control groups. The neurologic deficit progressed
      according to the duration of severe hyperglycemia. In the three normoglycemic
      control groups neurologic status stabilized 120 minutes after the onset of
      ischemia, in the brief hyperglycemia group stabilization occurred at 210 minutes,
      and in the prolonged hyperglycemia group neurologic deficit progressed for
      approximately 360 minutes, coinciding with the death of all but one gerbil, in
      which the neurologic deficit remained stable until death 23 hours after ischemia.
      We suggest that hyperglycemia is another cause of progressing cerebral
      infarction.

PMID- 2237958
TI  - Giant basilar aneurysm in the course of subacute bacterial endocarditis.
AB  - We describe a man aged 42 years with mitral valve regurgitation who suffered from
      subacute bacterial endocarditis caused by Streptococcus morbillorum. The clinical
      picture began with a toxic syndrome. Five months later, the patient had an
      embolic episode and a right rostral pontine stroke, which was followed a few days
      later by an adversive focal seizure on the right. Despite antibiotic treatment,
      he suffered complete third nerve palsy. Arteriography, magnetic resonance
      imaging, and computed tomography of the brain showed a giant aneurysm in the
      rostral end of the basilar artery; the aneurysm was clipped. We discuss the
      clinical features, radiology, and characteristics of this aneurysm as a unique
      case of a giant bacterial aneurysm in the vertebrobasilar system.

PMID- 2237959
TI  - Rebleeding from intracranial dissecting aneurysm in the vertebral artery.
AB  - We describe two patients with rebleeding from intracranial vertebral artery
      dissecting aneurysms during the acute stage. One patient had excellent results
      after emergency surgery. A review of recent reports including 60 patients with
      this disorder revealed a rebleeding rate of 30%, mostly during the acute stage.
      This suggests that a ruptured dissecting aneurysm in the vertebral artery is at
      risk for rebleeding during the acute stage, similar to a saccular aneurysm in the
      same location.

PMID- 2237960
TI  - Embolic stroke after smoking "crack" cocaine.
AB  - A 39-year-old woman had an embolic upper division middle cerebral artery branch
      occlusion 3 hours after smoking the free base of cocaine ("crack"). Radionuclide
      ventriculography demonstrated cardiomyopathy, and echocardiography documented a
      left atrial thrombus. This case demonstrates that embolism is one mechanism of
      ischemic stroke after cocaine use, and that cardiomyopathy, possibly cocaine
      induced, may be the source of embolus. A cardiac source of embolus should be
      sought in patients with cocaine-associated cerebral infarction.

PMID- 2237961
TI  - Restorative neurology. Drugs and recovery following stroke.

PMID- 2237962
TI  - Ephedrine-induced intracerebral hemorrhage and central nervous system vasculitis.

PMID- 2237963
TI  - Pulmonary arteriovenous fistulas are at high neurologic risk.

PMID- 2237964
TI  - Effect of hyperoxia differs during ischemia and reperfusion.

PMID- 2237965
TI  - Predisposing factors in cardiogenic cerebral embolism.

PMID- 2237966
TI  - Cerebrovascular diseases--seventeenth Princeton Conference. Durham, North
      Carolina, March 16-18, 1990. Proceedings.

PMID- 2237967
TI  - Protein phosphorylation during ischemia.
AB  - Many investigations have shown that calcium and adenosine triphosphate are
      crucial to central nervous system functions. It is probable that alterations of
      these substances during central nervous system ischemia are involved in the
      processes that cause irreversible neural damage. Calcium regulates several
      protein kinases that are responsible for phosphorylation of proteins vital for
      many central nervous system functions. Using a rabbit spinal cord ischemia model,
      we found protein kinase C and calcium/calmodulin-dependent kinase were severely
      affected during the first hour of ischemia. Protein kinase A was not
      significantly affected. The time course of lost protein kinase C enzyme activity
      closely corresponded to irreversible loss of neurologic function, and there is
      evidence that protein kinase C inhibitor activity is generated. Also, drugs that
      inhibit protein kinase C increased neurologic damage when administered during the
      early phases of ischemia. These results suggest that protein phosphorylation,
      particularly by protein kinase C, is critical to maintenance of neurologic
      function.

PMID- 2237968
TI  - Progress report of the Stroke Prevention in Atrial Fibrillation Study.
AB  - The Stroke Prevention in Atrial Fibrillation Study recently found and reported
      (SPAF Investigators, N Engl J Med, 1990;322:863-868) a beneficial effect of both
      warfarin and aspirin compared with placebo in the primary prevention of ischemic
      stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
      Among warfarin-eligible patients, the event rates were 1.6%/yr for those
      receiving active antithrombotic therapy (warfarin or aspirin) and 8.3%/yr for
      those receiving placebo (p less than 0.00005) (risk reduction 81%, 95% confidence
      interval 56-91). Ironically, we did not find a beneficial effect of aspirin in
      warfarin-ineligible patients. On the basis of these results, the study has been
      reshaped to directly compare these two antithrombotic agents. Insight into the
      apparent aspirin unresponsiveness noted in some patients also is being sought.
      Interpretation of the preliminary results and the reshaping of the study have
      been made more complex by the continued blinding of the investigators to certain
      portions of the data. Presented is an account of the study from its inception
      through its recent redesign.

PMID- 2237969
TI  - Growth factor expression after stroke.
AB  - Fibroblast growth factors are polypeptides with potent trophic effects on central
      nervous system cells. Both acidic and basic forms of fibroblast growth factor are
      found in the mammalian brain. We have examined the expression of these factors
      after focal brain injury or stroke. After infarction of the lateral cerebral
      cortex in the mature rat brain, we found a twofold to threefold increase during
      the first 3 weeks after stroke in levels of fibroblast growth factors in tissue
      surrounding infarcts. This increase persisted for at least 2 months and appeared
      mainly to be due to increased levels of basic, but not acidic, fibroblast growth
      factor. Because of its gliotrophic, angiogenic, and neuronotrophic properties,
      basic fibroblast growth factor may play an important role in the cascade of
      cellular reactions that contributes to wound healing and functional recovery
      after stroke.

PMID- 2237970
TI  - Genetics of cerebrovascular disease.
AB  - Stroke is a complex disease, with both genetic and environmental factors having a
      role in its pathogenesis. A review of past studies shows some evidence of genetic
      influences in the development of stroke. This is supported by studies of
      cardiovascular disease, which indicate major genetic influences at several levels
      including the development of risk factors. New approaches to phenotypic
      classifications, patient ascertainment, and genetic analysis will stimulate
      research into the role of genetics in cerebrovascular disease.

PMID- 2237971
TI  - Modification of stroke susceptibility by genotype-dependent maternal influences.
AB  - The influence of the prenatal and postnatal maternal environment on stroke
      susceptibility was evaluated by reciprocally crossing the spontaneously
      hypertensive (SHR) and the Dahl salt-sensitive (SS/Jr) inbred rat strains to
      produce reciprocal F1 hybrids that were nurtured, respectively, during prenatal
      and postnatal life by SHR or SS/Jr mothers. Following placement on a high-salt
      diet containing 8% NaCl at 35 days of age, F1 rats reared by SHR mothers had
      shorter survival times and were more likely to die with cerebral hemorrhage than
      F1s reared by SS/Jrs. Across reciprocal F1 female groups, enhanced susceptibility
      to stroke was associated with greater elevations of systolic blood pressure, but
      this association was not seen across reciprocal F1 male groups. There was also an
      association between blood pressure and stroke within each F1/gender subgroup:
      Rats eventually suffering strokes developed higher blood pressure after placement
      on the high-salt diet than rats that did not suffer stroke. Lower day 35 body
      weights (before exposure to the high-salt diet) were associated with greater
      likelihood of stroke both across the reciprocal F1 groups, and within three of
      the four F1/gender subgroups. The differences in stroke susceptibility between
      the reciprocal F1 groupings may be due to systematic differences in the prenatal
      and/or postnatal environments of SHR and SS/Jr mothers and may be mediated by
      variations in the nutritive capacity of the two inbred mothers.

PMID- 2237972
TI  - Multilevel transneuronal degeneration after brain damage. Behavioral events and
      effects of anticonvulsant gamma-aminobutyric acid-related drugs.
AB  - Recent morphologic and behavioral studies of the effects of gamma-aminobutyric
      acid agents on transsynaptic degeneration after cortical and striatal damage are
      reviewed and discussed. Following unilateral lesions of the anteromedial cortex,
      mild atrophy appears in the ipsilateral striatum and substantia nigra pars
      reticulata. Long-term diazepam administration greatly enhances this degeneration,
      extends the degeneration into the thalamus, and severely disrupts recovery from
      somatosensory asymmetries. Following unilateral excitotoxic lesions of the
      striatum, progressive degeneration of neurons occurs in the substantia nigra pars
      reticulata and efferent targets in the thalamus. This degeneration can be
      prevented by chronic infusion of muscimol, a gamma-aminobutyric acid agonist.
      Unexpectedly, this treatment did not facilitate recovery from somatosensory
      asymmetries. Recovery in muscimol-treated animals was impaired relative to saline
      treated controls. Thus, gamma-aminobutyric acid agonists either may enhance or
      prevent neural atrophy secondary to brain damage, but the behavioral outcome
      appears to depend importantly on the excitatory and inhibitory characteristics of
      the affected networks.

PMID- 2237973
TI  - Influence of amphetamine treatment on somatosensory function of the normal and
      infarcted rat brain.
AB  - The consequences of acute amphetamine administration on the metabolic
      responsiveness of the cerebral cortex to physiologic activation were studied in
      normal and infarcted rats. Treated rats received a 4 mg/kg intravenous injection
      of d-amphetamine 1 hour before unilateral vibrissae stimulation and 2
      deoxyglucose study. In nontreated normal rats, metabolic activation was
      restricted to the major relay stations of the vibrissae-barrel circuit. In
      amphetamine-treated rats, stimulation-induced increased glucose utilization was
      widespread, including ipsilateral and contralateral cortical regions outside the
      barrel field circuit. For example, an 84% increase in glucose utilization above
      control was seen in cortical areas anterior to the barrel field region. Increased
      glucose utilization induced by stimulation was severely depressed in nontreated
      rats that had undergone infarction of the left cortical barrel field 2 weeks
      previously. Vibrissae stimulation failed to increase glucose utilization
      significantly in cortical areas remote from the infarct. In contrast, bilateral
      increases in glucose utilization were observed within cortical regions of treated
      infarcted rats. For example, a 50% increase in glucose utilization was detected
      in cortical areas bordering the infarct. Thus, in the normal and infarcted rat,
      amphetamine appears to promote alternate circuit activation--a pharmacologic
      property that may be advantageous for recovery after injury.

PMID- 2237974
TI  - Effects of MK-801 on recovery from sensorimotor cortex lesions.
AB  - Histologic evidence suggests that drugs acting as noncompetitive antagonists at
      the N-methyl-D-aspartate receptor can have beneficial or pathologic effects on
      central nervous system neurons. In the present experiments we examined the
      effects of MK-801 on recovery of behavioral function after unilateral lesions in
      the rat somatic sensorimotor cortex. In the first experiment, rats with
      unilateral sensorimotor cortex lesions were given either MK-801 (1 mg/kg) or
      saline 12-16 hours after surgery. Additional injections were given on
      postoperative days 2, 4, and 6. Behavioral tests measured somatosensory
      asymmetries (i.e., bilateral tactile stimulation tests) and forelimb placing.
      After creation of sensorimotor cortex lesions, rats showed an ipsilateral
      somatosensory bias and an impairment in placing the contralateral forelimb. Rats
      treated with MK-801 recovered slightly faster than saline-treated animals as
      measured by a bilateral tactile stimulation test (p less than 0.05). In contrast,
      there was no significant difference between the groups in the recovery of
      forelimb placing. In a second experiment, rats with sensorimotor cortex lesions
      were treated with a single injection of MK-801 after behavioral recovery. Twenty
      hours after the MK-801 injection, rats with sensorimotor cortex lesions showed a
      reinstatement of the placing deficits. The impairment endured for at least 7 days
      after injection. These behavioral data support the idea that MK-801 can have
      either beneficial or detrimental effects when administered after brain damage.

PMID- 2237975
TI  - Ionic channels, cholinergic mechanisms, and recovery of sensorimotor function
      after neocortical infarcts in rats.
AB  - Unilateral photochemical infarcts were produced in the hind limb sensorimotor
      neocortex of 243 rats by intravenous injection of the fluorescein derivative Rose
      Bengal and focal illumination of the intact skull surface. Facial contact stimuli
      governed the degree and recovery rate of contralateral tactile/proprioceptive
      forelimb placing reactions. Contralateral forelimb placing recovered, whereas
      hind limb placing was resistant to recovery. Infarcted rats displayed marked
      recovery of spontaneous limb usage (beam traversing). However, deficits in
      isolated tactile/proprioceptive hind limb placing reactions endured.
      Posttreatment with the class IV calcium antagonist flunarizine after neocortical
      infarction protected sensorimotor function in a dose-dependent manner. This
      protective effect may be due to the peculiar ionic channel blocking profile of
      flunarizine. Scopolamine hydrobromide reinstated contralateral placing errors in
      infarcted rats at a dosage that did not affect neurologically intact rats. The
      cognitive enhancer sabeluzole, a novel benzothiazol derivative, dose-dependently
      blocked the anticholinergic-induced deterioration of a sensorimotor deficit in
      rats.

PMID- 2237976
TI  - Brain natriuretic peptide-like immunoreactive innervation of the cerebrovascular
      system in the rat.
AB  - Brain natriuretic peptide is a recently discovered neuropeptide. We used an
      antiserum against porcine brain natriuretic peptide to identify a system of
      immunoreactive innervation of the cerebrovascular tree in the rat. The internal
      carotid artery and the proximal portions of the middle and anterior cerebral and
      posterior communicating arteries were the most intensely innervated by
      immunoreactive fibers. The density of innervation decreased distally along the
      anterior, middle, and posterior cerebral arteries and the basilar and vertebral
      arteries. Brain natriuretic peptide and the related atrial natriuretic peptide
      are known to cause dilatation of cerebral arteries. Our findings suggest that
      brain natriuretic peptide may serve as a vasodilatory neuromodulator in the
      cerebral circulation.

PMID- 2237977
TI  - Neurogenic control of the cerebral circulation during global ischemia.
AB  - The influence of the trigeminal nerve on the cerebral circulation was
      investigated in chronically denervated cats during and after reversible four
      vessel occlusion for 10 minutes combined with controlled hypotension (50 mm Hg).
      Postocclusive hyperemia 30 minutes after reperfusion was attenuated by up to 48%
      in cortical gray matter of the anterior, middle, and posterior cerebral artery
      territories on the side of trigeminal ganglionectomy. Similar results were
      observed for denervation accomplished by direct surgical ablation and by the
      topical application of capsaicin to a cortical branch of the middle cerebral
      artery. Denervation did not alter basal cerebral blood flow or the duration of
      hyperemia, nor did it impair the cerebrovascular response to hypercapnia. These
      data demonstrate the importance of neurogenic mechanisms in the development of
      postischemic hyperperfusion and suggest that strategies directed at blocking axon
      reflex-like mechanisms may be beneficial in reducing the morbidity that follows
      severe cortical hyperemia.

PMID- 2237978
TI  - Magnetic resonance imaging demonstrates that electric stimulation of cerebellar
      fastigial nucleus reduces cerebral infarction in rats.
AB  - We sought to determine whether high spatial resolution magnetic resonance imaging
      is useful for noninvasive quantitation of the ischemic infarct produced by
      occlusion of the middle cerebral artery and for detection of reduced infarct
      volume elicited by electric stimulation of the cerebellar fastigial nucleus. Male
      rats of the spontaneously hypertensive strain were anesthetized, the middle
      cerebral artery was occluded, and the fastigial nucleus was stimulated for 1
      hour. Twenty-four hours later, rats were reanesthetized and T1- and T2-weighted
      images were obtained. Rats were killed and the volume and distribution of the
      lesion was established by histopathology. Magnetic resonance imaging estimates of
      the lesion volume were 271 +/- 41.0 mm3 (middle cerebral artery, n = 5) and 148
      +/- 8.4 mm3 (middle cerebral artery + fastigial nucleus stimulation, n = 6; 45%
      reduction, p less than 0.05). Histopathological analysis revealed a lesion of
      229.8 +/- 15.4 mm3 involving somatosensory cortex, lateral caudate putamen, and
      lateral hippocampus. Fastigial nucleus stimulation resulted in a 36% reduction in
      infarct volume to 146.0 +/- 10.3 mm3. The retrieved zone was largely in the
      cortex dorsal and ventral to the lesion and mostly posterior to the lesion. The
      estimates of lesion volume by magnetic resonance imaging and histopathology did
      not differ and were highly correlated (r = 0.90; p less than 0.001). This study
      confirms our previous finding that fastigial nucleus stimulation reduces the
      volume of a focal ischemic infarct and demonstrates that magnetic resonance
      imaging not only accurately estimates the volume of the lesion but also can
      detect changes as small as 50-100 mm3.

PMID- 2237979
TI  - Spreading depression-like depolarization and selective vulnerability of neurons.
      A brief review.
AB  - If oxygen is withdrawn from rat hippocampal slices, a spreading depression-like
      response occurs earlier and is of larger amplitude in the CA1 area than in the
      dentate gyrus. After reoxygenation, recovery of synaptic transmission correlates
      inversely with the time spent in spreading depression. Recovery occurs more
      frequently in dentate gyrus than in CA1. Chlorpromazine and the gangliosides GM1
      and AGF2 promote recovery from hypoxic depression of synaptic transmission in
      CA1. Prevention of irreversible loss of function correlates closely with a
      shortening of the time spent in spreading depression. If Ca2+ is withdrawn before
      hypoxia, then synaptic function recovers upon restoration of oxygen and [Ca2+]o,
      despite prolonged spreading depression. When spreading depression lasting more
      than 6-9 minutes is induced in fully oxygenated slices by superfusion with high
      K+ solution, then transient recovery is followed by long-lasting loss of synaptic
      function. In intact brain of anesthetized rats, synaptic transmission in CA1
      recovers after spreading depression-like depolarization lasting more than 30
      minutes, but is lost irreversibly after 60 minutes. We conclude that entry of
      Ca2+ into neurons caused by spreading depression-like depolarization is important
      in the selective vulnerability of neurons; the duration of depolarization is
      critical to cell survival; and in the presence of a normal blood supply, neurons
      resist protracted spreading depression-like depolarization.

PMID- 2237980
TI  - Ionic concomitants of astroglial transformation to reactive species.
AB  - Brain injury, including ischemia, changes normal astrocytes into reactive species
      that hypertrophy and begin to proliferate. Understanding the mechanisms that
      underlie these changes could lead to new abilities to promote regeneration and
      retard neural degeneration after ischemia. Because ionic changes occur after
      nonneural cells are exposed to mitogens, we have begun to examine the ionic
      changes that may trigger reactive gliosis. We showed that two changes thought to
      be important for mitogenesis, elevation of interstitial potassium or
      intracellular pH, are correlated with reactive gliosis as indicated by increased
      immunohistochemical staining for glial fibrillary acidic protein. This relation
      was seen after activation of cerebral cortex by recurrent spreading depression
      but not by physiologic stimulation. Deoxyribonucleic acid synthesis occurs in
      fibroblasts only when intracellular potassium exceeds 90 mM, a level seen in
      astrocytes only during spreading depression. Thus, our results support the
      contention that a threshold level of potassium (and pH) must be exceeded in
      eukaryotic cells before proliferation or anabolism will proceed.

PMID- 2237981
TI  - Symptomatic carotid endarterectomy trials.
AB  - The possible benefit of carotid endarterectomy in stroke prevention is being
      evaluated in three major clinical trials. To date, the European Carotid Surgery
      Trial has randomized 2,200 patients, 30% of whom have a carotid stenosis of
      greater than 70% appropriate to their symptoms. The North American Symptomatic
      Carotid Endarterectomy Trial has randomized 1,000 patients, of whom more than
      half have this severity of appropriate stenosis. Quality control and the
      evaluation of outcome events in this trial is achieved by a three-tier review,
      including review by medical and surgical adjudicators who are blinded to the
      treatment arm of each patient. Baseline characteristics of the patients eligible
      but not randomized are similar to those of patients who have been randomized. Two
      percent of the patients randomized to the surgical arm have declined surgery and
      crossed over to the medical arm, and 3% have elected surgery after randomization
      to the medical arm. Both of these studies, as well as a Veterans Administration
      trial, are continuing to randomize patients.

PMID- 2237982
TI  - Neuronal protection correlates with prevention of calcium-calmodulin binding in
      rats.
AB  - We correlated the efficacy of several clinically relevant pharmacotherapies with
      their ability to prevent calcium influx into neurons and subsequent binding to
      calmodulin. We studied the administration of CGS 19755, nimodipine, nicardipine,
      and combinations of these drugs before or immediately after ischemia in globally
      ischemic rats. Calcium-calmodulin binding was graded by an immunohistochemical
      assay after 2 and 24 hours of reperfusion (n = 5-6 at each time period), and
      histologic damage was graded by light microscopy after 72 hours of reperfusion (n
      = 6). Calcium-calmodulin binding correlated with the severity of delayed
      histologic damage in various brain regions. In untreated ischemic control rats,
      marked calcium-calmodulin binding was seen in CA1 and CA3 after 24 hours of
      reperfusion (p less than or equal to 0.01). Administered before ischemia, CGS
      19755 prevented calcium-calmodulin binding across all brain regions after 2 and
      24 hours of reperfusion compared with controls (p less than or equal to 0.05).
      This effect was most prominent in CA3 and CA1, where the drug also reduced
      delayed neuronal damage (p less than or equal to 0.05). Lower doses or
      postischemic administration of CGS 19755, nimodipine, nicardipine, and a
      combination of postischemic CGS 19755 and nicardipine had a more limited effect
      on calcium-calmodulin binding and did not protect against delayed neuronal
      damage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2237983
TI  - N-methyl-D-aspartate and non-N-methyl-D-aspartate antagonists in global cerebral
      ischemia.
AB  - The hippocampal lesion induced by cerebral ischemia has several excitotoxic
      features. Denervation of the ischemia-vulnerable pyramidal cells has a protective
      effect. Because most synapses are glutamatergic, administration of glutamate
      antagonists after ischemia also could be protective. Growing evidence now
      indicates that non-N-methyl-D-aspartate antagonists are more effective than N
      methyl-D-aspartate antagonists in complete global ischemia. One explanation
      offered is that ischemia may sensitize pyramidal neurons so that "normal"
      postischemic synaptic activity induces lethal damage.

PMID- 2237984
TI  - Ischemia induces release of glutamate in regions spared from histopathologic
      damage in the rat.
AB  - Excessive release of glutamate is thought to play a major role in the
      susceptibility of neurons to ischemia. In the present study, we evaluated whether
      differences in the magnitude of glutamate release resulted in some regions being
      vulnerable to ischemia, but others being spared from irreversible histopathologic
      damage. Specifically, we compared the temporal profile of ischemia-induced
      changes in extracellular levels of glutamate in a region selectively vulnerable
      to 10 minutes of transient ischemia (CA1 sector of the hippocampus) to the
      changes occurring in regions that, although rendered ischemic, are usually
      unaffected by a 10-minute insult (i.e., thalamus, cortex, and dorsolateral
      striatum). In an attempt to correlate the regional changes in glutamate release
      to the magnitude of the ischemic insult, the degree of ischemia (e.g., ATP
      depletion, lactate accumulation, and local cerebral blood flow reduction) and the
      final histopathologic outcome were also evaluated in these regions. Blood flow
      reduction and energy depletion were severe and uniform in all regions. However,
      the histopathologic outcome illustrated a different pattern. Although the CA1
      sector of the hippocampus was severely damaged, all other brain regions were
      unaffected by the 10-minute insult. Extracellular glutamate levels, measured by
      microdialysis, were significantly elevated during ischemia in all four regions.
      These levels continued to increase during the early recirculation period and
      gradually returned to baseline by 30 minutes of reperfusion, with a similar
      temporal changes in all four brain structures. These results, taken with our
      previous findings, demonstrate that elevated intraischemic glutamate levels are
      insufficient to independently engender ischemic damage.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2237985
TI  - Comparison of phenytoin with noncompetitive N-methyl-D-aspartate antagonists in a
      model of focal brain ischemia in rat.
AB  - Recent in vitro and in vivo experiments have suggested that excitatory amino acid
      antagonists, particularly those active at the N-methyl-D-aspartate receptor
      subtype, are effective in ameliorating ischemic injury due to their
      antiexcitotoxic activity. However, these drugs are also potent and effective in
      vivo anticonvulsants. The present experiments compared the noncompetitive N
      methyl-D-aspartate antagonists phencyclidine and MK-801 with the anticonvulsant
      phenytoin in a model of focal brain ischemia. Fisher F-344 rats were subjected to
      tandem occlusion of the middle cerebral and ipsilateral common carotid arteries
      under halothane anesthesia. Compounds were administered intravenously 30 minutes
      and 24 hours after arterial occlusion; infarct size was assessed at 48 hours
      after occlusion. Phencyclidine had no effect on infarct volume at 1 mg/kg,
      significantly reduced (by 36%) infarct volume at 3 mg/kg, and produced a
      nonsignificant 26% decrease at 10 mg/kg. The more potent and selective
      noncompetitive antagonist MK-801 reduced (by 32%) infarct volume significantly at
      0.1 mg/kg, produced a nonsignificant 23% decrease at 0.3 mg/kg, and had no effect
      at 0.5 mg/kg. Phenytoin, which is not a glutamate antagonist, reduced the infarct
      volume by 45% at 28 mg/kg. A single dose of phenytoin (28 mg/kg) administered 30
      minutes after occlusion was neuroprotective, but delaying drug administration for
      more than 2 hours was ineffective. These data suggest that blockade of the N
      methyl-D-aspartate receptor is effective in reducing the infarct size after focal
      cerebral ischemia. The neuroprotective activity of phenytoin suggests that this
      may be related to the common anticonvulsant action.

PMID- 2237986
TI  - The pathophysiology of anoxic injury in central nervous system white matter.
AB  - White matter of the mammalian brain is susceptible to anoxic injury, but little
      is known about the pathophysiology of this process. We studied the mechanisms of
      anoxic injury in white matter using the isolated rat optic nerve, a typical
      central nervous system white-matter tract. Optic nerve function, measured as the
      area under the compound action potential, rapidly failed when exposed to anoxia.
      Postanoxic recovery was variable, depending on duration of the anoxic insult;
      after a standard 60-minute period of anoxia, the compound action potential
      recovered to 28.5% of control. Irreversible anoxic injury was critically
      dependent on extracellular Ca2+; maintaining the tissue in zero [Ca2+] solution
      throughout the anoxic period resulted in 100% compound action potential recovery.
      Increasing perfusate [Ca2+] during anoxia from zero to 4 mM resulted in
      progressively less recovery. Anoxic damage to the optic nerve appears to depend
      on the gradual accumulation (over tens of minutes) of Ca2+ in a cytoplasmic
      compartment. The inorganic Ca2+ channel blockers Mn2+ (1 mM), Co2+ (1 mM), or
      La3+ (0.1 mM) had no effect on recovery of the compound action potential after
      anoxia; only Mg2+ (10 mM) significantly improved recovery. Treatment with the
      dihydropyridine Ca2+ channel blockers nifedipine (1-10 microM) or nimodipine (1
      40 microM) also had no effect on recovery from anoxia. Thus, Ca2+ influx during
      anoxia does not occur via conventional Ca2+ channels. Preliminary evidence
      suggests that this Ca2+ influx may occur via other cation channels that are
      imperfectly selective for Ca2+ or via the Na(+)-Ca2+ exchanger.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2237987
TI  - Putative neuroexcitation in cerebral ischemia and brain injury.
AB  - Involvement of neuroexcitatory mechanisms in cerebral ischemia and brain injury
      was explored in experimental models of repetitive forebrain ischemia by temporary
      occlusion of carotid arteries in gerbils and cryogenic injury to the cerebral
      cortex in rats and gerbils. Our observations in these models revealed a pattern
      of injury that involved some anatomic structures outside the areas of direct
      ischemic or traumatic insult. Such foci of injury revealed conspicuously abnormal
      uptake of 45Ca associated with slight or moderate neuronal alteration, whereas
      severely injured areas showed no 45Ca uptake. Electron microscopic observations
      revealed a characteristic presence of calcium in swollen dendrites, closely
      resembling pictures obtained in neuroexcitatory conditions such as epileptic
      seizures. Abnormal uptake of 45Ca was associated with apparent blood-brain
      barrier changes characterized by intracytoplasmic uptake of extravasated albumin
      into the neurons. Protein synthesis assayed by in vivo [3H]leucine incorporation
      was reduced in regions showing calcium accumulation. Our observations suggest
      that neuroexcitation may play an important role in development of secondary and
      chronic changes after ischemic or traumatic brain insults.

PMID- 2237988
TI  - Intracellular free calcium increases in cultured cortical neurons deprived of
      oxygen and glucose.
AB  - Dissociated neocortical cultures from fetal mice exposed transiently to a medium
      lacking both glucose and oxygen developed neuronal degeneration without glial
      degeneration. We have found that this injury depends on extracellular calcium and
      is associated with uptake of calcium from the culture medium. We measured free
      cytoplasmic calcium in individual neurons using the fluorescent calcium indicator
      fluo-3 and provide evidence that oxygen and glucose deprivation injury increases
      the intracellular calcium signal. Both intracellular calcium elevation and
      subsequent neuronal loss could be blocked by the N-methyl-D-aspartate receptor
      antagonist dextrorphan.

PMID- 2237989
TI  - Reduced neurotoxicity in transgenic mice overexpressing human copper-zinc
      superoxide dismutase.
AB  - The role of oxygen-derived free radicals, superoxide in particular, in the
      pathogenesis of neuronal cell death induced by glutamate was studied using
      cultured cortical neurons from transgenic mice overexpressing human copper-zinc
      superoxide dismutase. Primary cortical neuron cultures were developed from 15-day
      old fetuses of both transgenic mice and their normal littermates. Both human
      copper-zinc-superoxide dismutase and host mouse copper-zinc-superoxide dismutase
      activities in cultured neurons were identified by native gel electrophoresis
      followed by nitroblue tetrazolium staining. Cultured neurons grown for 10-12 days
      in vitro were exposed briefly to 0.5 mM glutamate for 5 minutes, followed by
      biochemical and morphological examinations at 2, 4, and 24 hours. Our data have
      demonstrated that glutamate neurotoxicity is significantly reduced in transgenic
      neurons at 2 and 4 hours following exposure to glutamate, as measured by the
      efflux of lactate dehydrogenase, the 3-O-methyl glucose space, and by phase
      contrast and bright-field trypan blue staining. These data indicate that
      transgenic neurons containing twofold to threefold the normal amount of copper
      zinc-superoxide dismutase activity as the result of expression of the human
      copper-zinc-superoxide dismutase transgene are protected against glutamate
      neurotoxicity in vitro. Our results suggest that oxidative stress, at least in
      part, plays an important role in the biochemical pathways amplifying N-methyl-D
      aspartate receptor-mediated neurotoxicity.

PMID- 2237990
TI  - Nonsteroidal lazaroid U78517F in models of focal and global ischemia.
AB  - U78517F is a novel inhibitor of iron-catalyzed lipid peroxidation that combines
      the tetramethylchroman antioxidant ring portion of alpha-tocopherol with the
      amine of the previously described 21-aminosteroids (e.g., U74006F). U78517F
      inhibited 200 microM FeCl2-initiated lipid peroxidation in rat brain homogenates
      by 50% at a concentration of 0.6 microM compared with 8 microM for U74006F, 28
      microM for alpha-tocopherol, and 43 microM for the ring portion of alpha
      tocopherol (i.e., trolox). U78517F is devoid of hypothermic or antiexcitotoxic
      actions or interactions with known neurotransmitter receptors. When administered
      intraperitoneally to male gerbils at 10 minutes before and again at the end of a
      3-hour period of unilateral carotid artery occlusion, U78517F decreased 24-hour
      postischemic cortical neuronal necrosis. Neuronal density in the medial portion
      of the cortex was increased from 34.2% of normal in vehicle-treated animals to
      86.3% in the U78517F-treated animals. In the lateral cortical area, the vehicle
      group showed only 3.3% neuronal survival versus 48.2% in the drug-treated group.
      In a separate series of experiments with the same focal ischemia model, identical
      dosing with U78517F enhanced the postischemic recovery of cortical extracellular
      calcium without any effect on ischemic or postischemic cortical blood flow. The
      effect on calcium recovery was observed at intraperitoneal doses as low as 0.1
      mg/kg. The compound also was effective in partially attenuating 1-week
      postischemic hippocampal CA1 neuronal loss in a gerbil global ischemia model
      involving brief (15-minute) bilateral carotid occlusion, but sustained dosing was
      required. These results document the anti-ischemic efficacy of a novel and potent
      inhibitor of iron-catalyzed lipid peroxidation and further support a key role of
      oxygen radicals in postischemic brain damage.

PMID- 2237991
TI  - Platelet-activating factor. A putative mediator in central nervous system injury?
AB  - Platelet-activating factor (1-O-hexadecyl-2-acetyl-sn-glycero-3
      phosphorylcholine) is a potent lipid autacoid produced by many cell types.
      Platelet-activating factor is produced by cerebellar granule cells in culture and
      has been extracted from brain tissue. Multiple platelet-activating factor
      receptors have been demonstrated in brain tissue. Activation of platelet
      activating factor receptors in transformed neuronal cell lines involved increases
      in intracellular calcium. Platelet-activating factor has potent actions on
      cerebral vessels and cerebral metabolism when administered in vivo, but may not
      have direct effects on brain microvessels. Excessive platelet-activating factor
      production in pathological states of the nervous system such as neurotrauma and
      stroke has been shown in only a few models (e.g., spinal cord ischemia and
      reperfusion or focal repercussion brain injury). In multiple studies using highly
      specific and potent platelet-activating factor antagonists, reversal or
      prevention of key consequences of brain injury such as hypoperfusion following
      ischemia, reperfusion and edema, inflammatory cell accumulation, neurologic/motor
      deficits, and neuronal salvage were demonstrated. This review provides and
      analyzes evidence in support of the role that platelet-activating factor might
      have in modulation of brain function and pathophysiological processes in brain
      ischemia and trauma.

PMID- 2237992
TI  - Hypoxic-ischemic damage and the neuroprotective effects of GM1 ganglioside.
AB  - In vitro studies have shown that monosialoganglioside GM1 reduces excitatory
      amino acid-related neurotoxicity by limiting the downstream consequences of
      abusive excitatory amino acid receptor stimulation. Systemic administration of
      GM1 appears to be efficacious in reducing acute neuronal damage and in
      facilitating medium- and long-term functional recovery after brain injury. We
      propose that GM1 protective effects in the acute injury phase results from
      attenuation of excitotoxicity, whereas the functional recovery seen at longer
      term could reflect GM1 potentiation of neuronotrophic factors. The potential
      therapeutic efficacy of GM1 administration in humans is suggested by clinical
      studies demonstrating improved neurologic outcome in stroke patients.

PMID- 2237993
TI  - The reliability of menses to indicate the return of ovulation in breastfeeding
      women in Manila, The Philippines.
AB  - Demographic studies generally use menses to indicate the return of fertility
      during breastfeeding. In a prospective study of 40 breastfeeding women in Manila,
      the resumption of ovarian activity was monitored by urinary hormone assays, and
      menstrual status was determined by weekly interview. For the women who
      menstruated before six months postpartum, first menses was not a good indicator
      of ovulation because there was a high proportion of anovular menses (67 percent),
      and the lag between anovular first menses and subsequent ovulation was 15.7 (+/-
      4.4) weeks. After six months postpartum the proportion of anovular first menses
      declined to 22 percent, and the lag between anovular first menses and ovulation
      was 7.3 (+/- 4.6) weeks. If all anovular and ovulatory menstrual episodes are
      considered, the mean interval between first observed menses and first ovulation
      was 8.4 weeks during the first six months postpartum and only 0.1 week after six
      months. Thus, in breastfeeding women, menses is an inaccurate proxy measure for
      the timing of fertility return before six months postpartum, but a good indicator
      of the resumption of ovulation after six months.

PMID- 2237995
TI  - Mass media family planning promotion in three Nigerian cities.
AB  - Television promotion of family planning and clinic sites in three cities of
      Nigeria--Ilorin, Ibadan, and Enugu--played a significant role in 1985-88 in
      increasing the number of new acceptors at family planning clinics in each city.
      Family planning skits, prepared with advice and support from the local service
      providers, were included in existing popular entertainment shows. Questions asked
      in a recall survey among the exposed population in Enugu and Ibadan revealed that
      about half of those surveyed in both cities had seen the television episodes. Of
      those who had watched, 79 and 99 percent, respectively, recalled the family
      planning messages, and 69 and 88 percent, respectively, recalled specific clinic
      sites mentioned. Following the media promotion, the number of new clinic clients
      per quarter in Ilorin increased almost fivefold (in the original clinics
      evaluated); in Enugu, the number of new clients per month more than doubled; and
      in Ibadan, the number of new clients increased threefold. Use of entertainment
      through this "enter-educate approach" is a promising technique that can be
      replicated in different settings to encourage new clients to seek family planning
      services.

PMID- 2237994
TI  - An evaluation of Profamilia's female sterilization program in Colombia.
AB  - The findings of three surveys and three studies used by Profamilia to evaluate
      and improve their voluntary female sterilization program are presented. The
      surveys measured sociodemographic characteristics of users, factors behind the
      sterilization decision, and user satisfaction with the operation in the short run
      and over time. The studies explored methodologies for more accurate cost
      effectiveness analysis. Results of the projects were used by Profamilia
      management to identify areas of program strengths and weaknesses and to implement
      operational changes.

PMID- 2237996
TI  - Cultural influences on health care use: two regional groups in India.
AB  - While health care services are increasingly being seen as a major proximate
      determinant of decreased mortality in a population, it also seems to be the case
      that the mere provision of services does not lead to their better utilization.
      However, in general, it is difficult to explore differences in utilization
      because the availability of services itself varies so greatly. This report
      presents the results of a study in India of two distinct regional groups of
      similar socioeconomic status, residing in the same locality and, therefore,
      theoretically exposed to the same health services. Both groups share a strong
      faith in modern medicine (especially if it is obtained from a private
      practitioner) for the treatment of most common illnesses. However, important
      cultural differentials exist in the medical services sought for childbirth and in
      the treatment of morbidity in children of different ages and sexes. These
      cultural commonalities and differentials are described, their possible causes-
      primary among these being the status of women--explored, and some policy
      recommendations made.

PMID- 2237997
TI  - Islam and family planning acceptance in Bangladesh.
AB  - One frequently cited barrier to more widespread adoption of family planning in
      Moslem countries is religious opposition. To examine the depth and extent of such
      opposition in Bangladesh, 106 men who had been identified by their wives as
      religiously opposed to family planning were interviewed. Unexpectedly, 26 percent
      of the "opposing" husbands reported that they were current users of a
      contraceptive and an additional 50 percent, although not practicing, said they
      were in favor of family planning. Of the alleged "opposers," only 23 percent said
      they opposed family planning on religious grounds. One-fourth of this last group
      were able to cite specific islamic injunctions against family planning. It
      appears on the basis of these data, which were collected in the religiously
      conservative area of Lakshimipur, that the perception of widespread Islamic-based
      resistance to contraception in Bangladesh is not founded in fact.

PMID- 2237998
TI  - Botswana 1988: results from the demographic and health survey.

PMID- 2238000
TI  - Intracellular transfer of lipid molecules.

PMID- 2237999
TI  - Nonenzymatic proteins mediating intracellular lipid transport and metabolism.
      Current status and emerging trends.

PMID- 2238001
TI  - Glycolipid transfer protein in animal cells.

PMID- 2238002
TI  - Transport and metabolism of phosphatidylinositol in eukaryotic cells.

PMID- 2238003
TI  - Intracellular fatty-acid-binding proteins. Characteristics and function.

PMID- 2238004
TI  - Application of fluorescent phospholipid analogues to studies on phospholipid
      transfer proteins.

PMID- 2238005
TI  - Intracellular and extracellular flow of dolichol.

PMID- 2238006
TI  - Phospholipid transport in microorganisms.

PMID- 2238007
TI  - Intracellular trafficking of sterols.
AB  - Cavalier-Smith (1981) has identified 22 characters that are universally present
      in eukaryotes but absent in prokaryotes. Of these, he argues that one,
      exocytosis, might have been the driving force behind the evolution of modern
      eukaryotic cells. Bloom and Mouritsen (1988) further argue that sterols may have
      removed an evolutionary bottleneck to cytosis. Therefore, the advent of sterols
      in membranes might have been the single feature that led to eukaryote evolution.
      The evolutionary advantage conferred by cholesterol is associated primarily with
      plasma membrane function, since the majority of cellular free cholesterol resides
      in that membrane. However, sterol synthesis occurs in the ER; therefore, the cell
      must have a mechanism for transporting sterol to the plasma membrane and its
      regulation. As has been pointed out in this review, much remains to be elucidated
      in the study of intracellular sterol trafficking. To date, neither diffusion nor
      vesicle-mediated transport can be fully confirmed or ruled out. Microtubule and
      microfilament involvement appears important in some routes (e.g., mitochondria)
      but not in others. In addition, trafficking roles of cytoplasmic lipoproteinlike
      particles have not been addressed. Finally, although some "sterol carrier
      proteins" demonstrate the ability to mediate intervesicular transfer of
      cholesterol in vitro, the true physiological role of these proteins remains
      obscure. Future research in this field awaits the refinement of available
      techniques. Particularly valuable would be cytochemical methods for detection of
      sterol at the ultrastructural level. Possibly, direct microscopic visualization
      of radiolabeled components in cells represents the necessary approach.
      Purification of elements carrying newly synthesized sterols would allow the
      proteins mediating transport to be identified. Continued analysis of mutants
      defective in transport, such as in type C Niemann-Pick disease, will shed light
      on this complex problem. The importance of extracellular trafficking of
      cholesterol owing to its involvement in the progression of atherosclerosis, has
      been emphasized in recent years. Little emphasis has been placed on intracellular
      trafficking of sterol; however, it can be argued that such transport also plays a
      major role in atherosclerosis, possibly by fueling retrotransport of cholesterol
      to the liver and secretion in the bile. Therefore, we hope this review will serve
      to stimulate research interest in this area.

PMID- 2238008
TI  - Spontaneous transfer of lipids between membranes.

PMID- 2238009
TI  - Extra- and intracellular transport of retinoids.

PMID- 2238010
TI  - Phospholipid transfer proteins as probes of membrane structure and function.

PMID- 2238011
TI  - Intracellular transfer of phospholipids, galactolipids, and fatty acids in plant
      cells.

PMID- 2238012
TI  - The impact of a medical student's suicide.
AB  - The suicide of a medical classmate can have a profound effect upon the survivors.
      After the violent death of a third-year medical student at the University of
      California-San Francisco, the level of concern expressed in discussion groups
      suggested a need to study the impact in more detail. Interviews and scale data
      from 20 volunteer medical students identified a pattern of posttraumatic symptoms
      persisting over several months. The interviewees' tendency to identify with the
      victim was related to the prevalent experience of medical student depression.
      Specific suggestions are made both for immediate crisis management and for
      preventive intervention strategies within a medical school.

PMID- 2238013
TI  - Correlates of suicidal ideation among rural adolescents.
AB  - This study examined potential predictors of suicidal ideation among a
      nonclinical, rural adolescent population. A sample of 76 male and female
      adolescents enrolled in a rural public high school completed a personal
      information form, a suicide information questionnaire, short forms of the Beck
      Depression Inventory and the Family Environment Scale, and the Life Events
      Checklist. A stepwise multiple regression suggested significant predictive
      relationships between magnitude of suicidal ideation and measures of family
      social climate (i.e., Organization, Conflict, Expressiveness, and Independence
      subscales from the Family Environment Scale--Short Form). Multivariate analyses
      of variance and a discriminant-function analysis revealed no significant sex
      differences.

PMID- 2238014
TI  - Psychosocial vulnerability, life stress, and suicide ideation in a jail
      population: a cross-validation study.
AB  - The purpose of this present investigation was to cross-validate a stress
      psychosocial vulnerability model of suicidal ideation and behavior in a jail
      population. Measures of social alienation, cognitive distortions, adaptive
      resources, situational (jail environment) stress, depression, hopelessness, and
      suicide ideation were administered to 146 male inmates at a county jail facility.
      It was predicted that each of the vulnerability factors, in addition to jail
      stress, would be significantly related to suicide ideation among inmates.
      Furthermore, it was hypothesized that psychosocial vulnerability among inmates
      would interact with jail stress to best explain suicide intent. The result of a
      multiple-regression analysis, stepwise forward-inclusion algorithm, indicated
      that 51% of the variation in suicide ideation could be accounted for by the
      linear combination of low reasons for living, irrational beliefs, jail stress,
      and loneliness. In addition, when the variables were entered into a hierarchical
      multiple-regression model, interactions between select psychosocial vulnerability
      factors and jail stress were found to best explain suicide intent. Results of the
      study are discussed in terms of the proposed model, and implications for future
      research and prevention efforts in jail suicide are noted.

PMID- 2238015
TI  - Suicide in the Israeli army.
AB  - The present study was an attempt to analyze the problem of suicide in the Israel
      Defense Forces (IDF). Suicide is increasing among populations aged 18-21, which
      in Israel is the age when most young people are called up for a 3-year period of
      compulsory military service. The service may have a catalytic effect on suicide.
      but on the other hand may serve as a control mechanism reducing suicide. The
      study used data for the period 1974-1985, and examined suicide in combat and
      noncombat units by duration of service and by preservice psychiatric, medical,
      and motivational data. The suicide groups were also compared with a matched
      sample of nonsuicide groups along the relevant variables. The findings seem to be
      consistent with some established theoretical perspectives of situational stress,
      social support, and status incompatibility, and seem to bear practical
      implications for the reduction of suicide.

PMID- 2238017
TI  - Suicidal behavior and cognitive flexibility: design and verbal fluency after
      attempted suicide.
AB  - Aspects of problem solving were measured in nine male psychiatric patients,
      hospitalized after attempted suicide. Testing took place within 3 weeks (except
      for one patient) of the suicide attempt. Controls were patients with chronic
      idiopathic pain and healthy volunteers. Suicidal patients had significantly lower
      scores on general intellectual tests and in verbal and design fluency. No
      differences in problem solving (the Perceptual Maze Test and the Wisconsin Card
      Sorting Test) and flexibility (the Uses of Objects Test and the Stroop Test) were
      found. The results are interpreted as indicating a decreased ability of suicidal
      patients to generate new ideas, when no alternatives are provided.

PMID- 2238016
TI  - An application of the empirical Bayes approach to directly adjusted rates: a note
      on suicide mapping in California.
AB  - A simple, reliable, and comparable measure for suicide mapping and other health
      problems is needed. Because standardized mortality ratios (SMRs) may not indicate
      the relative meaning of their magnitudes when compared with one another, and
      statistical significance levels of tests for SMRs overlook the areas that have
      small populations, neither of these approaches provides a satisfactory index. The
      results using directly adjusted rates can be ordered directly according to their
      magnitudes. However, because of the lack of reliable estimates of local age
      specific rates, the usefulness of directly adjusted rates in mapping suicide is
      also limited. To extend the usefulness of directly adjusted rates, an empirical
      Bayes approach whereby information from other areas is borrowed to improve the
      precision of the estimates of local age-specific rates in calculating directly
      adjusted rates--especially in the areas with small population sizes--is proposed.
      When an empirical Bayes approach was applied to the 1983 suicide data for
      California counties, a more reasonable conclusion than could be obtained by using
      directly adjusted rates was reached.

PMID- 2238019
TI  - Surgical asepsis revisited.
AB  - Basic principles, rituals, and surgical conscience are essential components of
      surgical asepsis. Surgical asepsis has become too complicated. Protective asepsis
      describes principles of good hygiene, sanitation, and impeccable aseptic
      technique; the term has received renewed interest in the advent and increased
      awareness of bloodborne diseases. Rituals may actually enhance learning and
      efficiency in the operating room even though they may or may not directly affect
      nosocomial infection rates.

PMID- 2238018
TI  - Clinical issues: treating the difficult patient.

PMID- 2238020
TI  - What's happened to aseptic discipline in the OR?
AB  - Aseptic discipline is the sum of the constraining factors governing the human
      behavioristic interface between the surgical environment and the surgical
      patient. Although certain details of the discipline may change with advances in
      immunology, pharmacology, surgical techniques, instrumentation, and other
      elements in the surgical environment, the basic principles of aseptic discipline
      must prevail and be enforced. Surgical professionals enter into an unwritten
      covenant to keep an unspoken promise to discharge their unseen duties in the
      aseptic chain of events, with only their own consciences to monitor their
      responsibility to the patient. The discussion of aseptic discipline is divided
      into its application to the five D's of infection control: discipline, defense
      mechanisms, drugs, devices, and design of the environment.

PMID- 2238021
TI  - The nosocomial wound infection report. Its impact in the OR.
AB  - 1. Reporting surgical wound infection rates to the OR nurse is valued and used as
      a feed-back mechanism to monitor aseptic technique in the operating room. 2. At
      the institution surveyed, the chief influences on OR personnel's surgical aseptic
      practice were the OR nurse, followed by the infection control nurse and then the
      attending surgeon. 3. If the clean surgical wound infection rate was above 3%,
      the OR personnel would review preoperative and intraoperative risk factors at the
      institution surveyed.

PMID- 2238022
TI  - A review of antiseptics. Cleansing agents.
AB  - 1. The cells of the stratum corneum are rough, jagged, and contain myriad niches
      in which bacteria dwell. The complex structure of the stratum corneum limits
      complete access of any chemical; an antiseptic agent must have contact to kill
      bacteria. 2. Shaving hair on the skin, long considered essential prior to
      surgery, has been shown to sabotage the effectiveness of the preoperative skin
      preparation. 3. Experimental evidence over a long period has documented that no
      other agent can achieve as rapid and large a reduction in skin flora as alcohol.
      4. The preoperative hand scrub calls not only for removal of dirt, grease, and
      pathogens from the surface of the hands, but also a maximum reduction of the
      resident flora.

PMID- 2238023
TI  - Disinfection in the OR.
AB  - 1. Items that enter sterile tissue or the vascular system are considered critical
      items and must be sterile (eg, surgical instruments, cardiac catheters,
      implants). 2. Semicritical items are those objects that come in contact with
      mucous membranes or with skin that is not intact. Endoscopes, anesthesia
      breathing circuits, respiratory therapy equipment, and endotracheal tubes are
      included in this category. These items require high-level disinfection. 3.
      Noncritical items (eg, floors, blood pressure cuffs) come in contact with intact
      skin. These items require low-level disinfection. 4. Flash sterilization is
      overused in hospitals. Control measures should be used to minimize infections
      traced to sterilizer failure.

PMID- 2238024
TI  - Environmental concerns in surgery in the 1990s.
AB  - 1. The surgical environment is the sum of the physical and the functional milieu
      in which surgical operative procedures are carried out in the course of patient
      care. 2. Although we acknowledge advances in surgical technology that have made
      possible a whole array of new procedures, we must be concerned with their effects
      on the surgical environment of the 1990s. These concerns include control of the
      spread of blood borne diseases and the lagging field of infectious and hazardous
      waste disposal. 3. The needs are clear for better departmental and institutional
      master planning, better systems analysis, better inservice training of personnel,
      and more precise and functional programming and planning. All must be
      accomplished within a framework of safety, efficiency, and economy.

PMID- 2238025
TI  - Keeping a lid on OR waste.

PMID- 2238026
TI  - It's second nature to me now. OR rituals.
AB  - Insufficient data exist relating to surgical asepsis; relying solely on data
      collection to determine practices limits patient care. Until clinical data are
      available that support or disclaim established traditions, it may be wise to hold
      customs that we believe have kept the patient safe. Rituals define and maintain
      sterility and provide freedom; certain traditions become part of the OR team's
      practice so that attention can be focused on the surgical procedure. As
      professional nurses, it is our responsibility to question dogma and to change our
      rituals when studies indicate the need for change.

PMID- 2238027
TI  - Syphilis screening in the 1990s.

PMID- 2238028
TI  - The prevalence of antibody to HTLV-I/II in United States plasma donors and in
      United States and French hemophiliacs.
AB  - Antibody to HTLV-I/II was detected in 19 (0.3%) of 6286 plasma donors from five
      regions of the United States (US). This seroprevalence rate is approximately 10
      times that in whole blood donors. The regional distribution of infection was as
      follows: Southwest, 0.68 percent; Southeast, 0.45 percent; Midwest, 0.28 percent;
      Northwest, 0.1 percent; and Northeast, 0.0 percent. Rates of HTLV-I/II infection
      in blacks (0.74%) and Hispanics (0.66%) were higher (both, p less than 0.001)
      than those in whites (0.08%). All 19 infected units were donated by subjects aged
      30 or older, even though 52.9 percent of the donations came from persons less
      than 30 years old. Equal rates of HTLV-I/II infection were found in men (0.31%)
      and women (0.29%). No HTLV-I/II antibody was detected in 154 French and 25 US
      hemophiliacs who were transfused regularly with noninactivated plasma or its
      derivatives. This suggests that the transfusion of HTLV-I/II-seropositive plasma
      products does not transmit the viral infection.

PMID- 2238029
TI  - American blood donors seropositive for human T-lymphotropic virus types I/II
      exhibit normal lymphocyte subsets.
AB  - Recent reports have demonstrated that some lymphocyte subsets are abnormal in
      Japanese blood donors who are seropositive for human T-lymphotropic virus type I
      (HTLV-I). To determine if similar changes characterize American blood donors who
      are seropositive for HTLV-I/II, lymphocyte subsets were measured in 42 HTLV
      seropositive and 42 HTLV-seronegative blood donors. The seronegative individuals
      were matched by age, race, and gender to the seropositive individuals. Peripheral
      blood mononuclear cells were treated with a panel of 12 monoclonal antibody pairs
      and then analyzed by two-color flow cytometry. No significant differences were
      observed between the seropositive and seronegative groups with respect to the
      absolute number of circulating lymphocytes or the percentages of lymphocytes
      belonging to the subsets assessed. These subsets included B, T, CD4, and CD8
      cells and subpopulations of CD4 and CD8 cells defined by the coexpression of
      markers that appear (CD25, HLA-DR, CD38) or disappear (Leu 8, CD45RA) after
      activation. These findings indicate that HTLV-seropositive persons in the
      American blood donor pool do not exhibit the lymphocyte subset alterations
      reported for HTLV-I-seropositive blood donors in Japan.

PMID- 2238030
TI  - Evaluation of the manual hexadimethrine bromide (Polybrene) technique in the
      investigation of autoimmune hemolytic anemia.
AB  - The use of the direct manual hexadimethrine bromide (Polybrene) test (DPT) in the
      investigation of patients for autoimmune hemolytic anemia (AIHA) was evaluated.
      Seventy-nine blood samples from 68 patients were tested. A direct antiglobulin
      test (DAT) using monospecific reagents and the DPT were performed, and a
      concentrated ether eluate was tested. The DAT was positive in 62 (78%) of 79
      patients and negative in 17 (22%). There is a good correlation among DAT, eluate,
      and DPT in demonstrating the presence of immunoglobulin on the red cell surface.
      In contrast, the DPT does not detect C3d and is often negative in cases of AIHA
      in which C3d alone is demonstrated by the DAT. In DAT-negative cases, DPT results
      correlated with reactive eluates. However, in four cases of steroid-responsive,
      DAT-negative hemolytic anemia, the DPT supported the diagnosis of AIHA when the
      eluate did not react. The DPT is a useful additional screening test for the
      investigation of AIHA, but it is not recommended as a replacement for either
      eluate testing or the DAT.

PMID- 2238031
TI  - An unexcluded paternity case investigated with hypervariable DNA loci.
AB  - A paternity case involving a putative father, a child, and the mother was
      referred to our laboratory for testing. Parentage was not excluded with 23 kinds
      of standard blood group markers and HLA, but the putative father requested more
      affirmative evidence of paternity. Seven kinds of DNA probes that recognize
      hypervariable loci were applied. On the basis of the allelic frequencies and
      their confidence intervals previously reported among unrelated Japanese
      individuals, as well as confirmed codominant segregation of the polymorphism, the
      exclusion probability and paternity index were calculated for this case. The
      cumulative paternity index from the seven DNA probes was 1.4 x 10(6), which was
      316 times higher than that from the 23 standard blood group markers and HLA.
      Accordingly, DNA polymorphism is considered to be informative enough for
      paternity testing.

PMID- 2238032
TI  - Density gradient separation of peripheral blood stem cells: comparison of an
      automated cell processing device and manual methods.
AB  - Peripheral blood stem cells were collected from normal donors by leukapheresis on
      a cell separator. The leukapheresis product contained 1.5 x 10(10) mononuclear
      cells (MNCs) and was divided into two aliquots that underwent either automated or
      manual density gradient separation with ficoll-hypaque and subsequent washing. In
      the automated process, recovery of MNCs was 85 percent, reduction in platelet
      content was 64 percent, and the final hematocrit (Hct) was less than 1 percent.
      The manual separation resulted in 76-percent MNC recovery, a 79-percent reduction
      in platelet content, and a final Hct of less than 1 percent. The purified MNCs
      were then placed in methylcellulose culture at a concentration of 4 x 10(5) MNCs
      per mL. Quadruplicate 1-mL aliquots were cultured, and colonies were counted and
      classified on Day 14. Comparison of automated and manual ficoll-hypaque
      separations demonstrated no differences in the total, erythroid, or granulocyte
      macrophage colony numbers. The cell processor used is fast, reliable,
      uncomplicated, and provides a sterile product containing progenitor cells that
      are not adversely affected by the automated ficoll-hypaque separation.

PMID- 2238033
TI  - Efficiency of white cell filtration and a freeze-thaw procedure for removal of
      HIV-infected cells from blood.
AB  - Strategies for diminishing the risk of blood transfusion-associated transmission
      of HIV-1 were evaluated. HIV-1-infected peripheral blood mononuclear cells were
      added to blood that was subsequently filtered by using different white cell (WBC)
      filters (cellulose acetate and polyester). The average log reduction of infected
      cells with polyester filters was at least 2.5 as measured by ID50 titration and
      polymerase chain reaction. In two WBC filtration experiments with blood from
      seropositive donors diluted 1:4 with seronegative blood, log reductions of 2.4
      and greater than 2.5 were observed. No cell-free virus was retained by the filter
      used. A freeze-thaw procedure applied to HIV-1-contaminated blood resulted in a
      minimal log reduction. These results indicate that the reduction of HIV-1
      infectivity as a result of filtration is mainly due to the removal of HIV-1
      infected WBCs, and that complete removal of infected WBCs cannot be achieved by
      the current filtration or freeze-thaw procedures. However, the development of
      filters with enhanced ability to remove (possibly infected) WBCs may have the
      added benefit of improving the safety of donor blood, especially in multiply
      transfused patients.

PMID- 2238034
TI  - Life-threatening, antiglobulin test-negative, acute autoimmune hemolytic anemia
      due to a non-complement-activating IgG1 kappa cold antibody with Pra specificity.
AB  - A 21-year-old man with fulminant cold autoantibody hemolytic anemia (CAHA) was
      hospitalized with hemoglobinemia, hemoglobinuria, hemoglobin concentration of 3.3
      gm per dL, a negative direct antiglobulin test (DAT) with polyspecific and anti
      C3d reagents, a negative Donath-Landsteiner test, and a cold agglutinin titer of
      80. He failed to respond to corticosteroids, multiple plasma exchanges, and
      cyclophosphamide; he required 54 transfusions in 10 days to maintain a hemoglobin
      concentration of 6.0 to 10.0 g per dL. He improved dramatically after a
      splenectomy was performed. The wide-thermal-amplitude cold agglutinin proved to
      be an IgG1 kappa antibody with Pra specificity. The patient's serum exhibited
      normal complement activation. When the DAT was carried out at 0 to 4 degrees C,
      the result was strongly positive for IgG; the indirect antiglobulin test at 0 to
      4 degrees C was positive with the patient's serum diluted 1 in 640. Within 6
      months, he was in complete remission and receiving no therapy. As compared with
      eight patients with CAHA that was exclusively IgG-mediated, this patient is
      remarkable for his requirement for many transfusions and for DATs that were
      consistently negative for C3d.

PMID- 2238035
TI  - Syphilis and blood transfusion: a global perspective.

PMID- 2238036
TI  - HLA-matched blood products and posttransfusion graft-versus-host disease.

PMID- 2238037
TI  - The pH value in platelet concentrates prepared and stored for 5 days in bags of
      seven manufacturers.

PMID- 2238038
TI  - Transmission of HIV-1 by component type and duration of shelf storage before
      transfusion.

PMID- 2238039
TI  - A 'swell' way to regulate metabolism.

PMID- 2238040
TI  - The major blood group ABO(H) determining genes are isolated.

PMID- 2238041
TI  - Halophilic proteins and the influence of solvent on protein stabilization.
AB  - Competition between protein-solvent and protein-protein interactions is arguably
      the most important contributing factor to polypeptide folding in general. A study
      of halophilic proteins, correlating their stability and solution structures in
      different conditions, focuses on the effects of a high salt solvent. A mechanism
      is proposed to explain how these proteins have adapted to such an extreme
      environment.

PMID- 2238042
TI  - Non-cholinergic actions of acetylcholinesterases: a genuine peptidase function or
      contaminating proteases?

PMID- 2238043
TI  - Endocrinization of the early embryo: an emerging role for hormones and hormone
      like factors.
AB  - In the last decade, we witnessed the extension of endocrinologically based
      concepts and molecules to many other arenas of intercellular communication, e.g.
      immunology, hematology and cancer biology. At the start of the new decade we are
      witnessing the beginning of a similar transformation in our understanding of
      early embryogenesis, i.e. that hormones, growth factors and other hormone-like
      agents and their receptors, familiar to us in other contexts, may be the long
      sought mediators of many key events in early embryogenesis. Why these agents were
      overlooked before and how they have started to emerge is the theme of this essay.
      The title 'Endocrinization of the Early Embryo' refers to both the biological and
      intellectual developments.

PMID- 2238044
TI  - Protein kinase recognition sequence motifs.
AB  - Protein kinases play a crucial role in the regulation of many cellular processes.
      They alter the functions of their target proteins by phosphorylating specific
      serine, threonine and tyrosine residues. Identification of phosphorylation site
      sequences and studies with corresponding model peptides have provided clues to
      how these important enzymes recognize their substrate proteins. This knowledge
      has made it possible to identify potential sites of phosphorylation in newly
      sequenced proteins as well as to construct specific model substrates and
      inhibitors.

PMID- 2238046
TI  - Protein transport across the ER membrane.
AB  - Protein transport across the endoplasmic reticulum (ER) membrane may be divided
      into two phases: an initiation or targeting cycle, which has been fairly well
      characterized, and the actual transfer of the polypeptide chain through the
      membrane, the mechanism of which is still unknown. In this review, the initiation
      cycle is discussed with emphasis on the mechanism of signal sequence recognition
      by the 54 kDa polypeptide of the signal recognition particle (SRP) and on the
      efficiency of targeting of nascent chains. Recent results are reviewed suggesting
      the transfer of the polypeptide chain by means of a translocation complex, a
      constituent of which appears to be the signal sequence receptor protein (SSR).

PMID- 2238045
TI  - Self-splicing group II and nuclear pre-mRNA introns: how similar are they?
AB  - The splicing pathway of pre-mRNA introns bears similarities to that of the group
      II introns, some members of which undergo self-splicing. The snRNAs may provide
      the pre-mRNA introns with RNA structures in trans comparable to those available
      in cis in group II introns. This article examines the available evidence for the
      hypothesis that the catalysis of these two splicing pathways is fundamentally
      equivalent.

PMID- 2238047
TI  - Regulation of MHC transcription.

PMID- 2238048
TI  - Time-related morphological changes in cold-stored rat livers. A comparison of
      Euro-Collins solution with UW solution.
AB  - Rat livers were stored in cold UW solution and Euro-Collins solution for various
      periods. Morphological investigations were performed using light microscopy, as
      well as scanning and transmission electron microscopy. In the UW-stored livers,
      the appearance of blebs derived from hepatocytes and the destruction of
      sinusoidal endothelial cells (SEC) occurred more slowly than in the EC-stored
      livers. Almost no ultrastructural damage in the hepatocytes was observed even
      after 48 hr of storage in UW solution, while extremely swollen and degenerated
      hepatocytes were observed in the 48-hr EC-stored livers. After 48-hr of storage,
      livers stored in UW solution lost 7.9% of their weight though EC-stored livers
      gained 29.7% of weight. Light microscopic morphometry revealed that there was a
      significant increase of 24.3% in the mean hepatocyte area of 24-hr EC-stored
      livers, whereas the UW-stored hepatocytes did not show any significant increase
      even after 48 hr of storage. After perfusion fixation, livers stored for more
      than 8 hr in EC solution showed a mosaic pattern of uneven fixation indicating a
      microcirculatory disturbance, whereas the UW-stored livers showed a rather
      uniform fixation after 12 hr of storage. It is suggested that the
      microcirculatory disturbance occurred more slowly in the UW-stored livers than in
      the EC-stored livers, which might be due to the protection of SEC and the
      suppression of bleb formation and the swelling of hepatocytes by UW solution.

PMID- 2238049
TI  - Evidence of mitochondrial impairment during cardiac allograft rejection.
AB  - NADH laser fluorimetry and mitochondrial oxigraphy were used to study myocardial
      oxidative energy metabolism during cardiac allograft rejection. Heterotopic
      cardiac transplantation was performed on Lewis rats; allografts (with Fischer rat
      donors) were compared with isografts (with Lewis rat donors). In vivo and in
      vitro assays were performed six days after transplantation. Myocardial NADH
      fluorescence was recorded in vivo from grafted hearts, at baseline; during brief,
      complete ischemia; and during reperfusion. Oxygen consumption of mitochondria
      isolated from both native and grafted hearts was determined. Neither baseline
      levels nor maximum ischemic levels of NADH fluorescence (F0 = k[NADH]) were found
      to be significantly different between allografts (0.45 +/- 0.05 to 0.87 +/- 0.10)
      and isografts (0.45 +/- 0.04 to 1.11 +/- 0.05). During recovery, the rate of
      fluorescence decrease was significantly lower in allografts than in isografts
      (0.024 +/- 0.001 vs. 0.038 +/- 0.002 delta F0.s-1, P less than 10(-3], indicating
      a lower rate of NADH reoxidation. In the presence of malate and glutamate
      substrates, mitochondrial O2 consumption was significantly lower in allografts
      than in isografts (30 +/- 9 vs. 100 +/- 15 nanoatoms O2. min-1.mg prot-1, P less
      than 10(-2]. These results indicate that mitochondrial oxidative metabolism was
      impaired during the rejection process. Such energy production disturbances may
      contribute to the dysfunction of rejecting hearts.

PMID- 2238050
TI  - Ranolazine--a new drug with beneficial effects on renal preservation.
AB  - Ranolazine is a new drug with a novel mode of action as a metabolic modulator and
      membrane stabilizer. In this prospective randomized double-blind trial, a porcine
      model of renal autotransplantation was used to assess the effects of this drug
      during preservation and reperfusion of kidneys cold-stored for 24 hr in phosphate
      buffered sucrose (PBS140). Three groups of 10 animals were compared: a Placebo
      group (placebo given intravenously to the animal before nephrectomy, added to the
      preservation solution, and given again to the animal during reperfusion); a
      Storage group (Ranolazine before and during storage, placebo during reperfusion);
      and a Reperfusion group (placebo before and during storage, Ranolazine during
      reperfusion). Detailed analysis of posttransplant renal function was carried out
      over a 14-day follow-up period. There were 7 deaths with primary nonfunction: 2
      Placebo, 1 Storage, 4 Reperfusion. Analysis of the whole group and separate
      analysis of the survivors demonstrated significantly improved glomerular (P less
      than 0.05), tubular (P less than 0.05), and loop of Henle (P less than 0.05)
      function in the Storage group. The results of this study clearly demonstrate the
      beneficial effects of Ranolazine during the storage phase of porcine renal
      preservation, and further investigation of this drug is warranted.

PMID- 2238052
TI  - Development of stable mixed T cell chimerism and transplantation tolerance
      without immune modulation in recipients of vascularized bone marrow allografts.
AB  - A consistent majority (62.5%) of immunologically unmodified rat recipients
      transplanted with vascularized hind-limb bone marrow allografts across a
      semiallogeneic transplant barrier developed tolerance with absence of graft
      versus-host disease. A minority of recipients (37.5%) demonstrated lethal GVHD.
      Transplantation tolerance in the majority was associated with the induction of
      stable low-level mixed T cell chimerism, including donor CD5+, CD4+, and CD8+
      lymphocytes. Chimeras were specifically immune nonresponsive to host
      alloantigenic determinants. These results emphasized a potentially important
      mechanism for low-level stable mixed lymphoid chimerism (SMLC) in tolerance
      induction, independent of immune suppressive effects due to irradiation or
      immunopharmacologic intervention. These vascularized bone marrow transplantation
      (VBMT) results may establish the experimental foundation for a novel approach to
      stem cell transfer and bone marrow transplantation.

PMID- 2238051
TI  - Use of yttrium-90-labeled anti-Tac antibody in primate xenograft transplantation.
AB  - The high-affinity interleukin-2 receptor (IL-2R) is expressed by T cells
      activated in response to foreign histocompatibility antigens but not by normal
      resting cells. Thus, blockade of the interaction of IL-2 with its receptor could
      achieve selective immunosuppression. Accordingly, anti-Tac, a murine IgG2a class
      monoclonal antibody specific to the IL-2R, was used alone or in a chelated form
      with yttrium-90 (90Y), a pure beta emitter, to inhibit rejection of cardiac
      xenografts from Macaca fascicularis (cynomolgus) donors transplanted to the
      cervical or abdominal region of Macaca mulatta (rhesus) recipients (n = 20).
      Animals received no immunosuppression (n = 3, group I, controls), unmodified anti
      Tac (n = 5, 2 mg/kg q.o.d., group II), or 90Y-anti-Tac (n = 5, 16 mCi, group
      III). To distinguish the nonspecific immunosuppressive effect of radiation, 90Y
      was administered bound to UPC-10 (n = 4, 16 mCi, group IV), another murine
      monoclonal antibody that does not specifically recognize activated
      immunoresponsive cells. All immunosuppression was administered in divided doses
      during the first 2 weeks posttransplant. Group I animals rejected their grafts at
      6.7 +/- 1 days and demonstrated a rise in soluble IL-2R levels at the time of
      rejection, indicating the generation of Tac-expressing and -releasing cells.
      Graft survival in group II was not prolonged compared with controls (mean
      survival 6.2 +/- 1 days; P greater than 0.05). In contrast, graft survival in
      animals that received the designed dosage of 90Y-anti-Tac was significantly
      prolonged to an average of 38.4 +/- 5 days compared with groups I and II (P less
      than 0.005 and P les sthan 0.0005, respectively). Prolongation of graft survival
      occurred in animals that received 90Y-UPC-10 (mean survival 21.3 +/- 5 days, P
      less than 0.05 versus group I, P less than 0.01 versus group II). However, 90Y
      UPC-10 was significantly less effective in prolonging graft survival than 90Y
      anti-Tac, in which one-half the per-kilogram dosage of radioactivity was
      delivered in specific fashion via anti-Tac (P less than 0.025). Reversible
      nonlethal bone marrow suppression occurred without associated nephro- or
      hepatotoxicity, and virtually all animals developed antibodies to the murine
      monoclonal. Thus, the approach used in the present study, IL-2R-directed therapy
      with 90Y-anti-Tac, may have potential applications in organ transplantation and
      in the treatment of Tac-expressing neoplastic diseases.

PMID- 2238053
TI  - Methotrexate as an adjunct in the treatment of persistent mild cardiac allograft
      rejection.
AB  - Because methotrexate arrests inflammation in autoimmune disease, we studied its
      efficacy in persistent low-grade cardiac allograft rejection. Seventeen patients
      aged 39.5 +/- 0.9 years (mean +/- SE) had persistent rejection despite previous
      therapy with high dose corticosteroids. Maintenance immunosuppression consisted
      of prednisone, azathioprine, and cyclosporine. The rejection episode treated with
      methotrexate occurred 180 +/- 55.4 days posttransplantation. Patients had
      incurred 2.7 +/- 0.3 previous episodes of rejection with the first episode
      occurring 30.6 +/- 6.2 days post transplant. Methotrexate was administered orally
      in 3 doses to an average weekly dose of 12.8 +/- 0.8 mg. The duration of
      methotrexate therapy was 9.0 +/- 1.1 weeks. Sixteen of the seventeen persistent
      rejection episodes resolved by 22.8 +/- 3.2 days of methotrexate therapy. Using
      methotrexate, the prednisone dose was decreased from 22.4 +/- 4.8 mg/day at
      initiation of methotrexate to 9.7 +/- 1.4 mg/day at the completion of
      methotrexate therapy (P less than 0.01). Over a 306 +/- 35-day follow-up, 9 of 17
      patients (53%) have remained rejection-free. Leukopenia, necessitating reduction
      in azathioprine occurred in 10 patients. One patient developed herpes zoster
      during therapy. These data indicate that methotrexate is effective in resolving
      persistent cardiac allograft rejection with minimal morbidity. In addition, the
      use of methotrexate for treatment of rejection allows reduction in maintenance
      corticosteroid doses.

PMID- 2238054
TI  - Percutaneous needle biopsy of the renal allograft. A clinical safety evaluation
      of 1129 biopsies.
AB  - In many transplant centers there is a reluctance to perform percutaneous core
      needle biopsies in renal allografts for fear of complications that may jeopardize
      the graft. We have evaluated the safety of percutaneous renal allograft biopsy by
      retrospectively studying 1129 biopsy specimens in 513 patients between 1974 and
      1988. All biopsies were performed with a conventional 2.0 mm TruCut disposable
      needle (Travenol Labs.; Deerfield, IL) without radiographic aid for localization
      of the kidney. Kidney tissue was obtained in 1095 cases (97.0%). In 1037 biopsies
      (91.9%) enough renal tissue for histological evaluation was obtained. In 34
      biopsies (3.0%) no renal tissue and in 58 (5.1%) only renal medulla was found.
      All the complications were demonstrated by with macroscopic bleeding into the
      urinary tract system. Thirty-two patients (2.8%) developed hematuria requiring
      hospitalization and some type of active treatment (catheter-a-demeure, n = 14;
      cystoscopy, n = 11; percutaneous nephrostomy, n = 3; surgery, n = 4). On 8 biopsy
      occasions blood transfusion was required. Three graft removals (0.3%) were
      attributed to the procedure of biopsy for emergency diagnostic purposes. All
      three grafts were severely damaged by rejection and had little or no function. No
      grafts were lost among the biopsies taken for long-term follow-up. No deaths
      occurred. Biopsies yielding only renal medulla were found to carry a greater risk
      of bleeding than adequate biopsy specimens (P less than 0.001), as did biopsies
      from transplants with acute vascular rejection. Conversely, biopsies taken for
      routine check-ups of long-term renal allografts were associated with a lower risk
      than biopsies taken because of poor or deteriorating renal function (P less than
      0.05). An analysis of 340 biopsies, taken in accordance with a protocol during
      periods of stable renal function, revealed no deterioration in graft function at
      1 and 12 months after the biopsy. In this study, we have found that conventional
      percutaneous needle biopsy of the renal allograft involves a certain risk of
      complications, even including graft loss. We have also defined a number of risk
      factors for such complications. However, we think that the benefits outweigh the
      risks, and needle biopsy should therefore remain an important diagnostic tool
      among all the others in the posttransplantation management of the renal
      transplant recipient.

PMID- 2238055
TI  - Orthotopic liver transplantation for Byler disease.
AB  - Byler disease is a rare form of familial intrahepatic cholestasis that is fatal
      before puberty. This retrospective study reviewed the results of orthotopic liver
      transplantation in 14 children with Byler disease using 12 whole-liver grafts and
      2 reduced-size grafts. One post-operative death occurred after retransplantation
      for arterial thrombosis. In the other patients, infectious problems and rejection
      episodes were the most frequent complications during the postoperative period. In
      the 13 patients alive, graft function, growth, and quality of life were good
      after an average follow-up of 17 months without any sign of disease recurrence.

PMID- 2238056
TI  - 8-Methoxypsoralen and ultraviolet A therapy for cutaneous manifestations of graft
      versus-host disease.
AB  - The potentially beneficial effect of 8-methoxypsoralen and ultraviolet A (PUVA)
      irradiation for treatment of drug-resistant cutaneous manifestations of graft
      versus-host disease led us to investigate the effect of this therapy in a larger
      series of patients with GvHD. To date, 11 patients with histologically
      demonstrated cutaneous GvHD (acute GvHD grade III-IV in 4 patients, extensive
      lichenoid chronic GvHD in 6 patients, sclerodermatous chronic GvHD in 1 patient)
      have received PUVA treatment for 2-24 weeks. All patients have been on CsA for
      GvH prophylaxis; 5 with mismatched grafts had additionally received methotrexate
      or monoclonal antibody campath-1 after bone marrow transplantation. Seven
      patients were on CsA and prednisolone; 2 patients on CsA, prednisolone, and
      azathioprine; 1 patient on azathioprine and prednisolone; and 1 patient had no
      immunosuppressive treatment for the duration of PUVA treatment. The 8
      methoxypsoralen (0.6 mg/kg bw) was given as photosensitizer before each
      ultraviolet A irradiation (0.3-8.5 joules/cm2). The only observed adverse
      reaction was mild nausea. In all patients improvement of cutaneous lesions could
      be observed with complete response in 5 patients and partial response in 6
      patients. Immunosuppressive drugs could be withdrawn in 2 patients and reduced in
      8 patients after initiation of PUVA treatment. These findings suggest that PUVA
      therapy may be a useful adjunct to conventional therapy for cutaneous GvHD.

PMID- 2238057
TI  - MHC class II reactivity of human villous trophoblast in chronic inflammation of
      unestablished etiology.
AB  - Absence of class II MHC antigens from human syncytiotrophoblast is a common
      finding in normal-term placentae. Since chronic villitis of unestablished
      etiology is a placental lesion frequently found in normal and abnormal term
      placentae, and fetal stem vessels are MHC class II-positive in these lesions, we
      asked if syncytiotrophoblast in villitis is reactive for MHC class II antigens.
      We found segments of syncytiotrophoblast that were reactive for the MHC class II
      HLA-DR, DP, and DQ antigens in villitis areas of normal-term placentae and in
      placentae from women with a history of recurrent spontaneous abortions. This
      reactivity was not due to trophoblast replacement by activated macrophages,
      though the possibility of crossreactive antigens and binding of soluble MHC class
      II antigens by receptors developed in areas of villitis could not be excluded.
      MHC class II antigen expression on syncytiotrophoblast could be due to cytokine
      release from activated macrophages and helper T lymphocytes which we have
      previously described in areas of villitis of unestablished etiology.

PMID- 2238058
TI  - Morphological changes in rat pancreatic acinar cells induced by long-term
      treatment with cyclosporine and their reversal after withdrawal.
AB  - Cyclosporine (CsA), administered to rats at daily doses of 10 and 50 mg/kg body
      weight, for 21 days, influenced negatively the structures involved in the
      synthesis, storage and secretion of digestive enzymes in pancreatic acinar cells.
      A dose-related, significant reduction in basophilic cell regions, secretion
      granule content, and overall size of acinar cells was appreciable by light
      microscopy and morphometry. By electron microscopy, the acinar cells of the rats
      given 10 mg/kg/day CsA were similar to the controls, whereas with the higher dose
      most cells showed reduction in the size of nucleoli, increase in the number of
      lysosomes, and evidence of autophagy. In only a few cells was autophagy
      particularly severe and involved almost the entire cytoplasm. Nine weeks after
      withdrawal from CsA treatment, the structural recovery of acinal cells was
      complete, and features indicating enhanced protein synthesis and mitochondrial
      multiplication were observed by electron microscopy. In conclusion, prolonged
      administration of CsA to rats induces changes in the acinar cells indicating a
      depression of their activity, without substantial impairment in the viability of
      the most of them, even at high doses. This accounts for complete restoration of
      the acinar tissue upon withdrawal.

PMID- 2238059
TI  - Mechanisms of total lymphoid irradiation-induced immunosuppression. II. Failure
      of con A-stimulated splenocytes from TLI-treated mice to express IL-2 and IL-2
      receptor RNA.
AB  - Total lymphoid irradiation is a radiotherapy procedure used as an alternative
      immunosuppressive regimen in organ transplantation. Following TLI mature
      lymphocytes are depleted, and splenocytes do not proliferate to mitogens, produce
      IL-2, or express IL-2 receptors. We now show that mitogen stimulated splenocytes
      from TLI-treated mice do not secrete IL-2 protein by an IL-2 ELISA assay.
      Northern blot analysis and RNase protection assays reveal that TLI splenocytes do
      not make IL-2 RNA or IL-2 receptor RNA following mitogen stimulation. TLI
      splenocytes produce at least 1000 times less IL-2 RNA after Con A stimulation
      than normal splenocytes. TLI therapy resembles anti-CD4 therapy and CsA in that
      each results in an IL-2-"depleted" state.

PMID- 2238060
TI  - Inhibition of leukocyte chemotaxis by immunosuppressive agents. Specific
      inhibition of lymphocyte chemotaxis by cyclosporine.
AB  - Since chemotaxis is an important mechanism by which leukocytes are recruited to
      allografts during rejection, the effect of immunosuppressant agents on in vitro
      chemotactic responses of neutrophils, monocytes, and lymphocytes was studied.
      Cyclosporine caused profound inhibition of lymphocyte chemotaxis to three
      different chemotactic factors at pharmacologic levels but had no effect on
      neutrophil or monocyte chemotaxis. Methylprednisolone and azathioprine both
      inhibited chemotactic responses of neutrophils and monocytes as well as
      lymphocytes. These data suggest that immunosuppressant agents are potent
      inhibitors of leukocyte chemotaxis and that drugs differ as to which leukocyte
      cell type they inhibit. The selective action of cyclosporine might explain why
      this drug is ineffective in reversing established rejection episodes in which
      monocytes and neutrophils are also involved. Inhibition of leukocyte chemotaxis
      may be an important mode of action of immunosuppressant drugs, and drug regimes
      might be adjusted to cause selective inhibition of particular cell types.

PMID- 2238061
TI  - Induction of HLA-specific CTL to nonimmunogenic, heat-inactivated lymphocytes by
      interleukin 2.
AB  - Human lymphocytes that have been heat-inactivated (1 hr, 45 degrees C) were used
      as stimulator cells in a model system to study the requirements of allogeneic T
      cell activation in vitro. Cytotoxic T lymphocytes were not generated in either
      primary or secondary mixed lymphocyte cultures after exposure to heated
      stimulator cells. Successful reconstitution of cytolytic activity in primary
      cultures was achieved by the addition of rIL-2. Further, cytotoxic T cell lines
      could be maintained in culture for several weeks by stimulation with heated
      allogeneic cells and periodic addition of exogenous IL-2. The cytotoxic T cells
      generated in primary cultures or in the T cell lines were specific for the HLA
      class I antigens of the stimulating cells. Thus, the combination of heated cells
      and IL-2 stimulated antigen-specific cytotoxic cells, and not merely lymphokine
      activated killers. Although IL-2 production appeared to be a crucial missing
      component of MLCs with heated lymphocytes, the addition of IL-1, a factor known
      to act as a second signal for stimulating IL-2 production, did not reconstitute
      cytolytic activity. These results indicate that (1) heat treatment does not
      appreciably affect class I structure; (2) HLA class I/T cell receptor
      interactions are intact, resulting in responsiveness to IL-2 but not IL-1; and
      (3) heating creates a defect that has a minimal effect on CTL precursor
      activation but does disrupt a T helper cell/stimulator cell interaction critical
      for IL-2 production.

PMID- 2238062
TI  - A cadaveric kidney transplant functioning for a quarter of a century--a case
      report.

PMID- 2238063
TI  - Development of a malignant tumor in a liver transplant graft procured from a
      donor with a cerebral neoplasm.

PMID- 2238064
TI  - The impact of ischemic and immunologic factors on early graft function in
      pediatric renal transplantation.

PMID- 2238065
TI  - Reduced bone mineral density in men and women with allogeneic bone marrow
      transplantation.

PMID- 2238066
TI  - Adult respiratory distress syndrome following chronic rejection of a pancreatic
      allograft--a case report.

PMID- 2238067
TI  - The therapeutic role of plasma exchange in acute renal allograft rejection.

PMID- 2238068
TI  - Combined liver-kidney transplantation in primary hyperoxaluria type 1.

PMID- 2238069
TI  - Effect of ciprofloxacin on cyclosporine pharmacokinetics.

PMID- 2238070
TI  - Pharmacokinetics of cyclosporine in the weanling pig.

PMID- 2238071
TI  - Lack of effect of portal diversion on the outcome of liver allograft in rats.

PMID- 2238072
TI  - Prolongation of survival of discordant kidney xenografts by C6 deficiency.

PMID- 2238073
TI  - Immunocytochemical investigations of vessel allograft arteriosclerosis using
      smooth muscle cell- and macrophage-specific monoclonal antibodies.

PMID- 2238074
TI  - Changes in proximal tubular morphology following hypothermic storage in two
      preservation solutions. A comparative study using canine and porcine kidneys.

PMID- 2238075
TI  - University of Wisconsin solution without lactobionate and raffinose. Protection
      of metabolism in cold-stored kidneys.

PMID- 2238076
TI  - The influence of matching in living-related transplants.

PMID- 2238077
TI  - Rapid assessment of S. cerevisiae mating type by PCR.

PMID- 2238078
TI  - The trouble with 'PCR' machines.

PMID- 2238079
TI  - In situ hybridization to pre-fixed polytene chromosomes.

PMID- 2238080
TI  - The continuing search for the mammalian sex-determining gene.

PMID- 2238082
TI  - Determination of 3' end processing in retroelements.

PMID- 2238081
TI  - Ribonucleotide reductase and its regulation during the cell cycle.

PMID- 2238083
TI  - PCR amplification of plasmid inserts from bacterial colonies and their
      restriction analysis in a single tube.

PMID- 2238084
TI  - Quick DNA recovery from agarose gels by ultracentrifuge run.

PMID- 2238085
TI  - Genetic mapping of common diseases: the challenges of manic-depressive illness
      and schizophrenia.
AB  - Advances in genetic mapping of human diseases have led to the identification of
      single locus susceptibility for several common disorders. There have been a
      number of reports of linkage for the psychiatric disorders manic-depressive
      illness and schizophrenia, but none of these linkage reports is uncontested.
      Nonetheless, it appears promising to continue attempts to map these psychiatric
      disorders, since linkage can now be detected even when the inheritance is complex
      and includes genetic heterogeneity and variable penetrance.

PMID- 2238086
TI  - Making stripes in the Drosophila embryo.
AB  - The striped pattern of expression of the Drosophila primary pair rule genes is
      controlled by independent regulatory units that give rise to individual stripes.
      The different stripes seem to respond in a concentration-dependent manner to the
      different combinations of maternal and gap protein gradients found along the
      anterior-posterior axis of the early embryo. Thus, the initial periodicity
      appears to be generated by putting together a series of nonperiodic events.

PMID- 2238087
TI  - Brittle bones--fragile molecules: disorders of collagen gene structure and
      expression.
AB  - Mutations in the genes that encode the chains of type I collagen, the major
      structural protein in most tissues, usually produce brittle bones. The
      consequences of even apparently minor mutations--single base substitutions--can
      range from lethal to mild, and the phenotypic consequences reflect the nature and
      position of the mutation. The manner in which phenotypes are produced depends on
      the effect of the mutation on the structural integrity of the molecule and on
      whether or how the abnormal molecules can be incorporated into an extracellular
      matrix.

PMID- 2238088
TI  - Transcriptional enhancers can act in trans.
AB  - Enhancers have been defined operationally as cis-regulatory sequences that can
      stimulate transcription of RNA polymerase-II-transcribed genes over large
      distances and even when located downstream of the gene. Recently, it has become
      evident that enhancers can also stimulate transcription in trans if they are
      brought into close proximity to the promoter/gene. These reports provide clues to
      the mechanism of remote enhancer action. In addition, the findings, together with
      genetic studies in Drosophila, strongly suggest that enhancer action in trans
      could underlie phenomena such as 'transvection', where one chromosome affects
      gene expression in the paired homolog.

PMID- 2238089
TI  - Overcoming barriers to the oral administration of peptide drugs.

PMID- 2238090
TI  - Caffeine as a model drug of abuse.

PMID- 2238091
TI  - Subtypes of the D2 dopamine receptor.

PMID- 2238092
TI  - Pharmacology of alpha-fluoromethylhistidine, a specific inhibitor of histidine
      decarboxylase.
AB  - alpha-Fluoromethyl-[S]-histidine (FMH) is a specific and potent inhibitor of
      histidine decarboxylase, which forms histamine from histidine. It acts
      selectively and irreversibly by formation of a covalent linkage, possibly with
      the serine residue in the active site of the enzyme. A single administration of
      FMH decreases the histamine content only of non-mast cells in the brain and
      stomach of rodents, but repeated administration gradually decreases the histamine
      content of mast cells in all tissues. Thus, FMH can be used to deplete histamine
      in pharmacological studies. As no marked side-effects have been observed during
      administration of FMH, it may be useful in pathological conditions, such as some
      allergic diseases, peptic ulcers and mastocytosis, in which excess production of
      histamine is involved.

PMID- 2238093
TI  - Immunomodulatory activity of small peptides.
AB  - The activity of the immune system can be modulated by a wide variety of natural
      and synthetic peptides. Here, Vassil St Georgiev summarizes the actions of some
      of the immunostimulatory and immunosuppressant small peptides that have shown
      most promise as therapeutic agents. Some are already in use as vaccine adjuvants
      or to prevent graft rejection. There are now indications that these peptides may
      also be of benefit in conditions in which the immune system is compromised, in
      autoimmune disease and in cancer.

PMID- 2238094
TI  - Excitatory amino acid neurotoxicity and neurodegenerative disease.
AB  - The progress over the last 30 years in defining the role of excitatory amino
      acids in normal physiological function and in the abnormal neuronal activity of
      epilepsy has been reviewed in earlier articles in this series. In the last five
      years it has become clear that excitatory amino acids also play a role in a wide
      range of neurodegenerative processes. The evidence is clearest where the
      degenerative process is acute, but is more controversial for slow degenerative
      processes. In this article Brian Meldrum and John Garthwaite review in vivo and
      in vitro studies of the cytotoxicity of amino acids and summarize the
      contribution of such toxicity to acute and chronic neurodegenerative disorders.

PMID- 2238095
TI  - [Fetal chromosome studies in the first trimester of pregnancy].
AB  - The possibility of transcervical biopsy of chorion by the method of forceps and
      production of "direct" preparations of chromosomes in the first trimester of
      pregnancy has been studied. Satisfactory preparations are obtained during short
      term incubation of villi for 24 and 48 hours. Portion of complete metaphases
      constitutes 0.23.

PMID- 2238096
TI  - [The incorporation of macromolecules into the germ cells of male mice via
      electroporation and dimethyl sulfoxide].
AB  - Electroporation (incorporation of macromolecules into the living cells by means
      of electric pulses) provides inclusion of plasmid 14C-DNA into immature cells of
      spermatogenic epithelium. The highest level of foreign DNA incorporation into
      spermatocytes and spermatids has been induced by 8kV electric pulses applied 3
      times with 20 sec intervals. Meanwhile, mature sperms are found to be exclusively
      resistant to exogenous DNA irrespective of the voltage level, the number of
      pulses and Ca++ uptake (contents). Incubation of mature sperms for two hours in
      the medium with Ca++ (10 mM) and dimethylsulfoxide--(DMSO, 33%) provides highly
      reliable incorporation of plasmid 14C-DNA into sperm heads. The sperm cells with
      foreign DNA incorporated by means of Ca++ and DMSO treatment still remain alive
      and mobile. The possibilities of mature sperms loaded with foreign DNA for the
      creation of transgenic mammals are discussed.

PMID- 2238097
TI  - [The cytogenetic effect of natural mutagenesis modifiers in a human lymphocyte
      culture. The action of aminobenzamide during the gibberellic acid induction of
      chromosome aberrations].
AB  - The 3-aminobenzamide sensibilization of the cytogenetic activity of gibberellic
      acid in the culture of human lymphocytes has been investigated. Two-three-fold
      increase of the chromosome aberrations induced by gibberellic acid, irrespective
      of the time of 3-aminobenzamide addition to the cultures (the 28th, 46th, 72th
      hrs of the cultivation) is shown.

PMID- 2238098
TI  - [Chromosomal disorders in the oocytes of rats after stress exposure in the
      preovulatory period].
AB  - Female rats at the stage of proestrus have been subjected to a stress effect-
      immobilization for an hour. Oocytes were cytogenetically analyzed and embryonal
      mortality was determined. It is shown that this stress effect at the end of the
      fist meiotic division of the oocytes increased the rate of aneuploid gametes and
      the level of embryonal mortality.

PMID- 2238099
TI  - [The cloning of "residual" DNA and the determination of the primary structure for
      the fragments of the barley-specific family of tandem repetitive sequences].
AB  - High molecular weight "relic" DNA fraction can be separated from the bulk of
      barley DNA digested with different restriction enzymes by agarose gel
      electrophoresis. The majority of AluI-relic DNA clones contained barley simple
      sequence satellite DNA and other families of repetitive DNA. The clones
      representing HvRT family were sequenced. This family was found to be barley
      specific. It is composed of tandemly arranged 118-bp monomers and presents in 7 x
      10(5) copies in barley genome.

PMID- 2238100
TI  - [A mathematical model of the proliferative kinetics of cells labelled with
      brominated DNA precursors].
AB  - A mathematical model of cell division is presented. It permits analyzing cell
      proliferation obtained by using BrdU. Numerical experiments show that this model
      adequately describes experimental data. Application of this model permits
      decreasing experimental data bulk.

PMID- 2238101
TI  - [Aneuploidy in man (facts and hypotheses)].
AB  - Mechanisms of the human aneuploidy formation are discussed proceeding from the
      review of the published data obtained by Soviet and foreign authors. It is
      supposed that hereditary determination of this process plays a main role as
      compared with new genomic mutations resulting from the induction by ecological
      factors. Microstructural rearrangements and nonhomologous recombination in
      nondisjunction of chromosomes during cell division are considered parallel with
      mosaicism as one of possible reasons of genetic predisposition.

PMID- 2238102
TI  - [The cytogenetic effects of 22-MeV neutrons].
AB  - 22-MeV neutrons affecting the culture of human peripheral blood lymphocytes have
      been studied for their cytogenetic peculiarities. Linear character of the
      dependence of chromosome aberrations yield within the dose range of 0.2-4.0 Gy is
      noted. Relative biological efficiency of 22-MeV neutrons reaches the highest
      values at low doses (18.8-2.4). Pair fragments and dicentrics prevail in spectrum
      of aberrations.

PMID- 2238104
TI  - [The age-related and genotypic variability of the blood serum enzymes in swine at
      an industrial farm complex].
AB  - Enzymes in pig blood serum have been studied for the dynamics of their activity
      as dependent on the breed peculiarities and production types. High correlations
      are revealed between the enzyme activity and the pig's fattening capacity as well
      as their stress-resistance. The use of the developed exponential functions makes
      it possible to achieve high probability (r = 0.88-0.89) in predicting meat and
      fattening capacities of pigs.

PMID- 2238103
TI  - [Genetic disorders in laboratory mice exposed in the area of the Chernobyl Atomic
      Electric Power Station].
AB  - Laboratory male mice (CBA X C57Bl)F1 were exposed in three sectors with different
      contamination degree of radionuclides within 30 km-zone of the Chernobyl Atomic
      Power Plant. The total absorbed radiation doses in testes were 0.1; 3 and 25 Gy,
      respectively. Great depression of spermatogenesis was observed in exposed mice up
      to complete sterility in males from the most contaminated sector. The mutagenic
      effect of radiation was relatively low and did not increase with growth of the
      contamination degree.

PMID- 2238105
TI  - [The genomic organization and localization on the chromosomes of the HvRT family
      of DNA repetitive sequences in barley].
AB  - HvRT family of repetitive DNA sequences from barley genome appears to have
      complex hierarchical organization. Tandem repetition of 118-bp monomers
      constitutes lower level of HvRT-family organization. Amplification units of the
      higher level consist of several contiguous 118-bp monomers. RFLP between
      different species and cultivars of barley resulted from the differences in the
      higher-order repeat structure. Individual chromosomes of barley contain specific
      HvRT subfamilies. This family also possesses separate domains differing in the
      restriction enzyme sites density. HvRT family is presented in the genomes of H.
      vulgare, H. leporinum, H. murinum, H. jubatum, but is absent in the genomes of H.
      marinum, H. geniculatum and wheat.

PMID- 2238106
TI  - [The lampbrush chromosomes of the chicken. Cytological maps of the
      macrobivalents].
AB  - The lampbrush chromosomes (LBC) were prepared from growing oocytes 0.75-1.50 mm
      in diameter. A map of 6 autosomes and the ZW sex bivalents is presented. Several
      types of landmarks were noticed: lumpy loops (LL), telomeric bow-like loops
      (TBL), some large loops in interstitial regions (marker loops--ML). Supposedly,
      the centromeres of LBC in the chicken are at one of the axial bars bearing no
      loops. The landmarks PBL and DBL mark the proximal and distal boundaries of bars.
      LBC-A (probably, chromosome 1 of the chicken karyotype) is about 185 microns.
      There are 7.3 +/- 0.2 chiasmata. Chiasmata are distributed at quasi-random. In
      LBC-A one chiasma is localized in a telomere, as a rule. Coordinates of 13 of the
      14 different landmarks in LBC-A have been estimated. LBC-B (probably, chromosome
      2) is about 151 microns, there are 5.50 +/- 0.23 chiasmata. The LBC-B may be
      identified by LL-21 and LL-22. LBC-C (probably, chromosome 3) is 128 microns;
      there are 4.70 +/- 0.18 chiasmata. The chromosome can be identified by
      characteristic loops LL-31, an unlooped chromomere bar near the telomere (T-32),
      a characteristic distribution of normal loops along LBC-C: about one half of this
      LBC bears large loops, and the other one--small loops. LBC-D (chromosome 4?) is
      107 microns; there are 3.80 +/- 0.31 chiasmata. Double-loop bridges appear
      frequently near ML-41. LBC-E (chromosome 5?) is about 72 microns with 2.50 +/-
      0.28 chiasmata. There are characteristic TBL loops with abundant RNP material
      thus being like LL-loops. LBC-F (chromosome 8?) is about 36.5 microns; there are
      2 chiasmata. This LBC can be identified by giant telomeric loops GML-F1 and by
      unlooped bar in the middle of LBC.

PMID- 2238107
TI  - [The differentiation of oval cells into hepatocytes during induced hepatic
      carcinogenesis in mice. An electron microscopic study].
AB  - An electron microscopic study of murine oval cells, induced by a single injection
      of genotoxic agent dipin and by a partial hepatectomy, has shown that their
      ultrastructure and direction of differentiation depend on localization in the
      liver lobule. Oval cells around portal tracts go through three stages of
      development: low differentiated cells 4.40 +/- 0.51 mu in diameter with ovoid
      nuclei 3.43 +/- 0.44 mu, intermediate cells, and young hepatocytes. They form
      common ducts surrounded by a basal lamina, and produce bile canaliculi-like
      structures and intermediate junctions between them. Another part of the oval cell
      population is organized similar to the bile duct epithelium. It consists of cells
      9.37 +/- 1.1 mu in diameter with nuclei 7.28 +/- 1.16 mu in diameter and form a
      system of branching and anastomosing ducts widespread along the parenchyma from
      the portal to the central veins. Our data indicate that the oval cells can
      differentiate into hepatocytes, and support a hypothesis according to which the
      cells of terminal bile ductules are liver epithelial stem cells which can
      differentiate into a hepatocyte or a bile duct cell lineage in periportal
      microenvironment.

PMID- 2238108
TI  - [Morphofunctional changes in the exocrine pancreatic cells in acute experimental
      pancreatitis in rats].
AB  - Experimental pancreatitis was induced by cooling the splenetic part of rat
      pancreas with chlorethyl, and the cells of duodenal area of the pancreas were
      studied at different stages of pancreatitis using cytomorphometry, cytomorphology
      and autoradiography. Interlobular and interacinar oedemas were observed at the
      first hours after treatment. In 24 hours the intracellular oedema of exocrine
      pancreatic cells (EP) was detected. On day 14 after treatment typical acute
      edematous pancreatitis developed. The observed changes involve a pathological
      activation of EP of the duodenal area, a subsequent restoration of the structure
      of this area, and later a passage of pancreatitis into the chronic form. The
      usefulness of this model of pancreatitis for quantitative cytochemical studies of
      EP during pathogenesis and drug treatment is discussed.

PMID- 2238109
TI  - [The sensitivity to growth factors of NIH 3T3 cells transformed by the v-myc
      oncogene].
AB  - Transformation of NIH 3T3 cells, induced by v-myc oncogene, activates a
      proliferative potential of the cells cultivated in the serum-free medium, and
      reduces the ratio of 3H-Tdr incorporation into the cells grown in the presence of
      10% fetal serum in comparison to those grown in the serum-free medium. The v-myc
      transformed cells (NIH 3T3-v-myc) as well as the untransformed ones are very
      responsive to insulin. On the other hand, the epidermal growth factor, able to
      stimulate proliferation of NIH 3T3 cells, exert no effects on the NIH 3T3-v-myc
      cells. The NIH 3T3-v-myc cells cultivated in the medium, containing 2.5% human
      plasma enriched with thrombocytes, have the same proliferative characteristics as
      cells grown in the thrombocyte-free plasma. It is concluded that transformation
      of NIH 3T3 cells induced by v-myc oncogene may reduce a requirement for
      thrombocyte-released growth factors and EGF but not for insulin.

PMID- 2238110
TI  - [The cultivation of hybridoma cells in agarose granules].
AB  - The results of cultivation of agarose gel immobilized hybridoma cells producing
      monoclonal antibodies to human alpha 2-interferon are presented. The immobilized
      cultured cells retained the higher viability for 10-28 days without changing the
      growth medium, in comparison with cultured cells in control suspension. The cells
      immobilized in agarose gel demonstrated a tendency to polyploidization as was
      revealed by the technique of DNA cytofluorimetry with Hoechst 33258.

PMID- 2238112
TI  - [The effect of the spontaneous level of the chromosome aberration rate on its
      alterations after a single local irradiation].
AB  - With X-ray examinations of the stomach and duodenum, changes in chromosomal
      aberration frequencies in peripheral blood lymphocytes were shown to depend on
      the spontaneous level of these aberrations in patients exposed to a single local
      irradiation by 25 R. The cytogenetic efficiency of radiation exposure was found
      to be local in patients with the lower frequency of spontaneous chromosomal
      aberrations. A genetic genesis of the revealed dependence is supposed. The effect
      of irradiation on the correlation between radiosensitivity and radioresistance of
      the cytogenetic process is regarded as a possible mechanism of the appearance of
      the observed dependence.

PMID- 2238111
TI  - [Differences in the photodestruction parameters of flavin fluorescence in normal
      and tumor cells at a decreased pH of the incubation medium].
AB  - Further investigation of the peculiarities of flavin fluorescence
      photodestruction in malignant cells was made. In normal cells incubated in low pH
      (3.0-3.2) physiological solutions, the decrease in the oxidized flavoprotein
      fluorescence intensity under irradiation is the same as in normal pH condition,
      whereas in tumor cell in low pH solutions a significant increase in the
      photodestruction level was noticed. The cells isolated from foci of
      transformation, following treatment of 3T3 NIH fibroblasts with the carcinogen N
      methyl-N'-nitro-N-nitrosoguanidine, displayed the photodestruction parameters
      similar to those in tumor cells. A two-step analysis of cells is proposed for
      distinguishing between the normal and malignant cells.

PMID- 2238113
TI  - [A flow diffusion chamber for research on cells in culture].
AB  - A flow diffusion chamber designed for studying cells and tissues in culture is
      described. The chamber contains a plate with a great number of isolated holes,
      which enables one to perform the cultivation of cells at different distances from
      the porous membrane separating the cells from the perfused medium. An individual
      porous membrane can be placed above each hole. Evidence for the selective
      permeability of domestic membranes under the conditions of cell culture in
      chamber is presented. The chamber makes possible a simultaneous cultivation of a
      great number of various cultures with different conditions of mass exchange with
      common perfused medium, which contributes to intensification of studies.

PMID- 2238114
TI  - [An electron microscopic study of Cryptosporidium. II. The stages of
      gametogenesis and sporogony in Cryptosporidium parvum].
AB  - The ultrastructure of stages of gametogony and sporogony of C. parvum from the
      intestine of experimentally infected suckling rats was studied by transmission
      electron microscope. Unlike merogony, in which the whole cytoplasm of the mother
      meront is used up for the merozoite formation, during microgametogony the large
      residual mass of gamonts remains in contact with the feeder organelle even after
      microgamete outbudding. Unlike other coccidia, during the microgametogenesis in
      C. parvum, the nuclear substance of the daughter nuclei is not separated into
      osmiophilic (containing the condensed chromatin) and achromatinic parts. The
      gamete outbudding in C. parvum is accompanied by evagination of the pellicle of
      the mother gamont whose cytoplasm displays some slit-like canals that seem to
      sequester the daughter nuclei with some portion of the surrounding cytoplasm. The
      flagella-free microgametes of C. parvum resemble somatic cells, rather than male
      sexual cells of other coccidia. The study of thick-walled oocysts of C. parvum
      made it possible to suggest that the fragile wall of the oocyst proper may be
      easily destroyed in the course of processing of the material to look eventually
      as a ghost of electron lucent substance in the parasitophorous vacuole, whereas
      the structures revealed on the electronograms may presumably represent the outer
      and inner layers of the sporocyst. If so, the suture described elsewhere in the
      cryptosporidial oocysts, is to be considered as belonging to the sporocyst wall
      rather than to the oocyst wall, i.e. likely as in other investigated coccidia.
      However, the question on the mode of sporozoite excystment in the thin-walled
      oocysts of C. parvum still remains obscure.

PMID- 2238115
TI  - [The effect of the disruption of the cytoskeletal elements on uncoupler-induced
      changes in the centrosome].
AB  - The disruption of microtubules with nocodazole or microfilaments with
      cytochalasin B did not prevent mother centrioles from nonrandom, preferentially
      perpendicular orientation with respect to the substrate plane after FCCP
      treatment. The microtubules affect negatively the reorientation of centrioles,
      because after their disruption by nocodazole the percentage of centrioles with
      the perpendicular orientation (the angle is tipped to the substrate plane by over
      74 degrees) is seen to increase. The microfilaments have the positive effect,
      because after their disruption by cytochalasin B the share of centrioles with the
      perpendicular orientation decreases. Thus, our observations do not support the
      hypothesis that the long microtubules can provide the perpendicular orientation
      of centrioles anchoring them in the cytoplasm.

PMID- 2238116
TI  - [Immunomorphological research on the formation of the extracellular matrix in
      epithelial cell cultures].
AB  - Formation of extracellular matrix structures in cultures of rat liver epithelial
      nontransformed cell line IAR2 was studied with antisera to fibronectin, laminin
      and type IV collagen by immunofluorescence and immunoelectron microscopy of
      platinum replicas. Fibronectin formed peripheral spots of variable size some of
      which outlined free cell edges, as well as fibrils located towards the center of
      single cells or of cellular islands. Similarly distributed structures were seen
      in isolated matrices. Codistribution of fibronectin and actin was observed only
      for the peripheral line of fibronectin spots and marginal circular actin bundle.
      Basement membrane components. laminin and type IV collagen, formed mainly spots
      of variable size predominantly beneath the cell or each cell in an island.
      Occasional fibrils were seen also. Essentially the same results were obtained by
      immunofluorescence and immunogold electron microscopy. Cytochalasin D treated
      cells displayed spots of both fibronectin and laminin. The relevance of
      previously postulated receptor-mediated assembly of extracellular matrix
      structures to the epithelial cells is discussed.

PMID- 2238117
TI  - [The immunomodulation of the natural killer activity of the splenocytes in C3HA
      mice during hepatoma 22a growth].
AB  - A single injection of C3HA mice with various immunomodulators-ds-RNA, thymogene
      (TM) and cyclophosphamide (CY)--performed one day before transplantation of
      syngeneic hepatoma 22a cells led to a decrease in the tumor growth rate. The most
      prominent effect was found following the CY treatment. The NK cell activity
      estimated per spleen of mice treated with ds-RNA and TM was seen increased in
      comparison with the control mice not given the modulators. The rate of tumor
      growth was due probably to this fact. The protective effect of CY may be
      accounted for by a direct action of this agent on tumor cells.

PMID- 2238118
TI  - [Chromosomal interrelations in the interphase nucleus].
AB  - The distribution of prekinetochores in human lymphocytes has been studied by
      indirect immunofluorescence with autoantibodies against kinetochore. Lymphocyte
      flattening that allowed a 5-6 increase in their size, was suggested in addition
      to a method of lymphocyte stretching allowing a 10-fold extension.
      Prekinetochores in flat and stretched lymphocytes are seen settled down as
      separate pairs. The equal pattern of staining of these prekinetochores in each
      pair suggests that homologous chromosomes located in pairs.

PMID- 2238119
TI  - Tubercle 1978-1990.

PMID- 2238120
TI  - Factors of prognostic significance in Chinese children with tuberculous
      meningitis.
AB  - A study was undertaken to identify factors of prognostic importance for 199
      Chinese children with tuberculous meningitis treated in Hong Kong between 1961
      and 1984 inclusive. During the period under study rifampicin and then
      pyrazinamide were introduced into treatment regimens and intrathecal therapy was
      abandoned. An analysis of pretreatment characteristics and details of
      chemotherapy by multivariate logistic regression identified two independent
      variables that predicted prognosis, namely clinical stage at the time of
      diagnosis, and age. Changes in treatment policies and the introduction of new
      anti-tuberculosis drugs did not appear to influence prognosis.

PMID- 2238121
TI  - Chromosome damage in untreated tuberculosis patients.
AB  - The frequency of chromosomal aberrations and sister chromatid exchanges (SCEs)
      were estimated in the lymphocytes of 95 untreated tuberculosis patients to
      evaluate the chromosomal damage with reference to bacterial invasion. The
      frequency of chromosomal aberrations was significantly higher in tuberculosis
      patients compared to controls (p less than 0.001) while the SCE frequency did not
      show any statistically significant differences. These findings indicate that the
      basic mechanism of formation of chromosomal aberrations and SCE are different and
      they suggest that the tubercle bacillus might be capable of inducing chromosome
      damage.

PMID- 2238122
TI  - Sister chromatid exchanges in the lymphocytes of tuberculosis patients receiving
      short-term chemotherapy.
AB  - The frequency of sister chromatid exchanges was estimated in tuberculosis
      patients undergoing three different short term chemotherapy regimens (2SHRZ, 2HRZ
      and 2H2R2Z2), to evaluate the possible genetic damage caused by anti-tuberculous
      drugs. Of the three combinations studied, two combinations (2SHRZ and 2HRZ),
      which were administered daily, enhanced the frequency of sister chromatid
      exchanges significantly (p less than 0.05), while the third bi-weekly combination
      (2H2R2Z2) did not show any significant enhancement in the frequency of sister
      chromatid exchanges. These results are of importance in the treatment of
      tuberculosis, and indicate the need to select a drug combination that is equally
      efficient in the control of disease and at the same time less harmful to the
      genome of the patient.

PMID- 2238123
TI  - Evaluation of BCG at birth in the United Arab Emirates.
AB  - A total of 387 healthy full term infants who received BCG vaccination at birth
      were evaluated by the tuberculin PPD test at 6-8 weeks post vaccination. A total
      of 92% of these infants had visible BCG scars at that time. All infants were
      tested with PPD but only 264 returned for the test to be read. The tuberculin
      test was negative in 37 (14%) and of less than 5 mm induration in another 60
      (23%) of the infants. The same pattern was observed in different nationalities.
      Of 11 infants with no BCG scar after vaccination, 3 had positive PPD reactions of
      more than 5 mm induration. There was a significant correlation between the size
      of the BCG scar and induration of tuberculin test P less than 0.001. The
      complications of the vaccination were minimal. We have observed 3 sterile
      abscesses at the site of BCG vaccination which resolved spontaneously. We think
      the available vaccine is safe and potent, and that the rate of BCG scar formation
      and of tuberculin conversion is higher than in most studies.

PMID- 2238124
TI  - Characterisation of plasmids extracted from AIDS--associated Mycobacterium avium
      isolates.
AB  - The plasmid profiles of 12 Mycobacterium avium strains isolated from 12 different
      patients with acquired immunodeficiency syndrome were analysed. Plasmids were
      identified in 9 of these strains. Plasmids were isolated from all 7 serovars 4
      and 8 strains, a serovar 20a strain and an untypeable strain, but were not
      detected in either of 2 serovar 3b strains or an untypeable isolate. Southern
      blot hybridisations revealed that extracts derived from all of the plasmid
      containing strains hybridised to a DNA probe prepared from known mycobacterial
      plasmid sequences. However, restriction analyses suggest that native plasmids
      which hybridised to the DNA probe and were similar in mass were not identical.

PMID- 2238125
TI  - Tuberculosis in patients with various HLA phenotypes.
AB  - Tuberculosis patients and healthy subjects from six ethnic groups of the Soviet
      Union were HLA-A, -B, -C, and DR typed. The frequencies of the HLA-A, -B and -C
      antigens differed amongst the ethnic groups. With all groups, however, patients
      with tuberculosis showed a significantly increased frequency of HLA-DR2 and a
      reduced frequency of HLA-DR3 type. Unfavourable dynamics of tuberculosis was
      significantly associated with an increased incidence of B15 and DR2 and a reduced
      incidence of B27 and DR3. Family studies revealed that the inheritance of
      susceptibility to tuberculosis (from parent to offspring) is associated with the
      inheritance of certain HLA haplotypes. Tuberculosis patients bearing the DR2
      antigen had increased levels of IgG antibodies to PPD and the frequency of B7
      and, more particularly, DR2 was higher in anergic patients.

PMID- 2238126
TI  - In-vitro bacteriostatic and bactericidal activity of isoniazid on the
      Mycobacterium avium-Mycobacterium intracellulare complex.
AB  - Isoniazid inhibited the growth of Mycobacterium avium-Mycobacterium
      intracellulare strains at concentrations of 0.1-25 micrograms/ml and was even
      bactericidal for several strains. The bactericidal activity was observed in
      relatively susceptible strains. The susceptibility did not correlate with
      colonial morphology but correlated with species identification. Mycobacterium
      avium strains were more resistant to isoniazid than Mycobacterium intracellulare
      strains.

PMID- 2238127
TI  - Minimal bactericidal and inhibitory concentrations of ofloxacin on Mycobacterium
      fortuitum at pH 7 and 5: therapeutic implications.
AB  - Mycobacterium fortuitum infections of sternotomy wounds have been successfully
      treated with ofloxacin, a fluoroquinolone. We studied the MBCs and MICs in vitro
      of this antibiotic on the organism under neutral pH (7) and acidic pH (5) and
      found marked escalation of these values under the latter condition. This provides
      hints on the therapy of these infections under in vivo settings.

PMID- 2238128
TI  - Distribution of liposomes in tuberculous mice.
AB  - The dynamics of the distribution of liposomes for use as drug carriers for the
      treatment of tuberculosis is studied. While the free radiolabel injected into
      mice was rapidly excreted by the kidneys, the same label trapped within liposomes
      was retained for longer periods in the liver, spleen and lung. There were
      variations in the distribution and retention times of liposomes of different
      composition. When the distribution of liposomes in healthy and tuberculous mice
      was compared, a greater accumulation in the liver, spleen and lungs of healthy
      mice was observed, although the retention time in tuberculous mice was longer.
      These findings merit consideration in the design of therapies based on liposome
      entrapped drugs as the dynamics of distribution and retention differ between
      normal and infected animals.

PMID- 2238129
TI  - Differential effects of free and liposome encapsulated amikacin on the survival
      of Mycobacterium avium complex in mouse peritoneal macrophages.
AB  - Liposome-encapsulated amikacin shows significantly greater inhibitory activity
      against the survival of Mycobacterium avium complex inside mouse peritoneal
      macrophages than the free drug. Similar results were obtained whether the drug
      was added simultaneously with, 48 h prior to, or 48 h after the addition of
      mycobacteria to the macrophages. These observations support the hypothesis that
      the in vivo intravenous delivery of liposome-encapsulated amikacin results in the
      localization of the antibiotic in phagosomes containing mycobacteria inside
      resident macrophages of the liver and spleen.

PMID- 2238130
TI  - Cardiac tamponade due to tuberculous mediastinal lymphadenitis.
AB  - Pneumopericardium is rare in tuberculous mediastinal lymphadenitis. Much rarer is
      the association of pneumopericardium with cardiac tamponade. The case is reported
      of a 29-year-old patient in whom tuberculous mediastinal lymphadenitis resulted
      in a fatal tension pneumopericardium.

PMID- 2238131
TI  - Tuberculosis of the breast: a rare modern disease.
AB  - A case of mammary tuberculosis is reported. A communication between the axillary
      glands and the breast emphasises Cooper's theory that the breast becomes
      secondarily involved by lymphatic extension. Involvement of other organs by acid
      fast bacilli could not be demonstrated. A relapse occurred sixteen months after a
      6-month course of treatment with rifampicin, isoniazid, ethambutol and
      pyrazinamide.

PMID- 2238132
TI  - Hepatic tuberculosis; a rare case of bleeding gastric varices.
AB  - A laparotomy was performed on a 68-year-old female who, in spite of medical
      treatment, suffered from uncontrolled upper gastrointestinal bleeding due to
      ruptured gastric varices. Histological examination of the liver tissue taken
      during operation revealed tuberculosis. Hepatic tuberculosis, although rare,
      should be kept in mind as one of the differential diagnosis when there is
      unexplained, noncirrhotic bleeding gastric varices.

PMID- 2238133
TI  - Primary tuberculosis of the penis in an infant.
AB  - Primary tuberculosis of the penis with associated bilateral inguinal lymph node
      enlargement and a discharging sinus is described. Its rarity is emphasized and
      its likely mode of transmission is also highlighted so that it can be looked for
      in areas where infantile circumcision is practised, particularly in developing
      countries.

PMID- 2238134
TI  - [Current role of diagnostic isotopes in cardiology].

PMID- 2238135
TI  - [Treatment of Basedow's exophthalmos].

PMID- 2238136
TI  - [Bladder exstrophy. Analysis of 50 cases].

PMID- 2238138
TI  - [Primary small bowel tumors (lymphomas excluded). Report of 19 cases (1978-88)].

PMID- 2238137
TI  - [Surgical treatment of bronchiectasis].

PMID- 2238139
TI  - [Congenital pulmonary emphysema in children: report of 19 cases].

PMID- 2238140
TI  - [Systematic titers in syphilitic serology: a prospective study].

PMID- 2238141
TI  - [Hypertension in the older patient].

PMID- 2238142
TI  - [Nutrition of the pregnant woman and the infant's birth weight].

PMID- 2238143
TI  - [Pompe's disease: a report of 3 cases (clinical, biochemical, anatomo
      pathological study].

PMID- 2238144
TI  - [Splenic and mesenteric arterial hydatic emboli secondary to a primary hydatic
      cyst of the thoracic aorta].

PMID- 2238145
TI  - [Plasma cell granuloma and pulmonary fibroxanthoma: report of 2 cases].

PMID- 2238146
TI  - [The effect of mepacrine and propranolol on lipid level in the alveolar
      surfactant during anaphylactic shock].
AB  - It is shown that the development of anaphylactoid shock in rats is connected with
      a decrease of the surface activity of alveolar surfactant and liberation of
      arachidonic acid from pulmonary surfactant phospholipids. Preventive injection of
      lipomodulators--A2 phospholipase inhibitor (mepacrine) or triglycecolipase
      inhibitor (propranolol)--to animals normalizes the level of lipids in the
      surfactant and blocks liberation of arachidonate and palmitate from surfactant
      phospholipids in an anaphylactoid shock.

PMID- 2238147
TI  - [Increase in free Ca2+ level determined by quin-2 in spleen lymphocytes from
      irradiated rats].
AB  - The output of lymphocytes, obtained on a ficoll-verografin gradient and
      intracellular free Ca2+ concentration were studied in the rat spleen 1, 3 and 6
      days after X-ray irradiation in a dose of 0.5 Gy. The amount of lymphocytes
      decreased by 30% a day after irradiation and turned to the control level 3 days
      after exposure of animals. Free Ca2+ concentration remains abnormally high during
      all the examined period, increasing to 411 nM a day after irradiation and
      approaching to the control value 6 days after irradiation.

PMID- 2238148
TI  - [The effect of sodium nitrite, stable radical of 4-hydroxy-2,2,6,6
      tetramethylpiperidin-1-oxyl and their mixture on methemoglobin formation].
AB  - Sodium nitrite oxidizes the mice hemoglobin in vitro. The stable radical 4
      hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl inhibits the process of oxidation.
      This effect is achieved when the radical is introduced into the system before
      sodium nitrite. The same effect is achieved in vivo. The level of methemoglobin
      is not influenced when mice get only the radical in comparison with the control
      group. We have not found the changes in the level of carboxyhemoglobin in the
      groups of mice that got the sodium nitrite, the radical and their mixture in
      comparison with the control group.

PMID- 2238150
TI  - [Characteristics of brain gastrin/cholecystokinin-binding proteins].
AB  - Gastrin/cholecystokinin-binding proteins were purified using the column affinity
      chromatography on immobilized pig tetragastrin and cholecystokinin.
      Immunoblotting analysis of different human tissue extracts with specific antisera
      obtained against gastrin-binding proteins was performed. It was found that high
      molecular weight polypeptide zones of 120 kDa and 35 kDa were characteristic of
      the brain only. Autoantisera of patients with type A gastric disease reacted with
      some gastrin/cholecystokinin-binding proteins in human brain and mucosa including
      human brain polypeptide of 120 kDa. It is supposed that there are neurospecific
      gastrin-binding proteins (possibly gastrin/cholecystokinin receptors in the
      brain).

PMID- 2238149
TI  - [Minor peptides of animal proteins as antibiotics and possible factors of
      nonspecific immunity].
AB  - Screening of more than twenty short synthetic peptides characteristic of
      different proteins has revealed antimicrobial activity of the KRFAE peptide--from
      human preproenkephalin A against gram-negative bacteria. Modification of the
      peptide structure by means of administration of d-amino acids has permitted
      obtaining dKRFdLE analogue with the expressed and stable antimicrobial activity
      in vitro when growing bacteria on the minimum glucose-mineral medium. Changes and
      rearrangements of aminoacids in the dKRFdLE peptide in the second, third and
      fourth positions sharply decreased anti-microbial activity. The weaker
      antimicrobial activity as compared with that in dKRFdLE was peculiar to peptides
      with the other primary structure. Possible participation of peptides as
      antibiotics in the mechanisms of nonspecific immunity as well as the methods of
      their rational search are discussed.

PMID- 2238151
TI  - [Adenylate cyclase and adrenoreceptors in the myometrium].
AB  - Data are presented on the content and hormonal regulation of alpha- and beta
      adrenoreceptors in myometrium, interrelation of adrenoreceptors with adenylate
      cyclase and contractile state of myometrium. Processes in the structure of adenyl
      cyclase complex during the enzyme desensitization have been discussed.

PMID- 2238152
TI  - [Composition and physical structure of atherogenic lipoproteins in ischemic heart
      disease].
AB  - The results of comparative studies in atherogenic lipoproteins of blood plasma
      under heart ischemic disease (HID) which is accompanied by hypercholesterinemia
      or proceeds without disturbances in the lipid metabolism, evidence for
      considerable differences in the composition and physical structure of very low
      density lipoproteins (VIDL) and low-density ones (LDP) under the investigated
      states. The decrease in the surface charge density and in sizes of VLDL, as
      compared to normal, which are least expressed at HID and an increase in the
      surface charge density with certain increase of LDL radii under this pathologic
      state are revealed.

PMID- 2238153
TI  - [Properties of a complex of nonspecific esterases from the green oak roller
      moth].
AB  - A complex of nonspecific esterases of green oak roller moth is represented by of
      series of multiple forms including carboxyl-, acetyl-, aryl-esterase and esterase
      with mixed properties. Esterases characterized by different substrate specificity
      and belonging to different types change their activity in the insect ontogenesis.
      The authors have established the interaction of esterases with the secondary
      metabolism substances large amounts of which are concentrated in the oak leaves.

PMID- 2238154
TI  - [Isoenzyme spectrum and kinetic properties of pyruvate kinase from the liver of
      thiamine-deficient rats].
AB  - Thiamine-deficiency in animals induced by everyday subcutaneous administration of
      oxythiamine in a dose of 4, 40 and 100 mg/kg of weight for 10 days results in a
      decrease of the total activity of pyruvate kinase in the liver tissue and does
      not affect the mentioned index in the kidney and heart tissues. It is shown that
      as a result of the enzyme fractionation in the column with DEAE-cellulose the
      total activity of pyruvate kinase in the liver tissue of rats with thiamine
      deficiency decreases due to L-isoform while the content of M-isoform remains
      unchanged. Thiamine deficiency does not affect kinetic characteristics of the L
      isoform, extracted from the liver and this shows the absence of changes in the
      degree of phosphorylation of pyruvate kinase L-isoform under these conditions.

PMID- 2238156
TI  - [The effect of pH on the passive transport of Ca2+ by membranes of fragmented
      sarcoplasmic reticulum of skeletal muscles].
AB  - The initial rate of Ca2+ translocation in vesicular preparations of the
      sarcoplasmic reticulum membranes is shown to fall with a pH decrease to 6.0 or
      5.0 and to rise with a pH change to 7.0 to 7.8 in respect to the initial 6.5. It
      is established that the Ca2+ sorption by the membranes or their fluidity make no
      essential contribution to the recorded changes of 45Ca2+ level in the membrane
      preparations. It is shown that the passive Ca2+ transport depends to a
      considerable extent on the concentration of a proton at the outer surface of the
      sarcoplasmic reticulum membrane: an excess of H+ inhibits the Ca2+ input and
      output, while a decrease of the proton concentration promotes an increase in the
      rate of these processes in the sarcoplasmic reticulum.

PMID- 2238155
TI  - [Activity of neutral peptide hydrolases and oxidative enzymes in the myocardium
      and blood during hypoxic hypoxia].
AB  - The citric cycle dehydrogenases and neutral peptide hydrolases (NPH) activity was
      determined in the myocardium and blood serum of Wistar rats under acute and
      prolonged hypoxic hypoxia. It was shown that the NPH activity and the activity of
      the most oxidative enzymes change in the same direction during adaptation to the
      high-altitude conditions. The role of the NPH in the oxidative metabolism
      reconstruction under acute and chronic hypoxia was discussed.

PMID- 2238157
TI  - [Spectral-fluorescent characteristics of rat transcortin in normal conditions and
      during experimental circulatory insufficiency].
AB  - Spectral-fluorescent parameters of rat transcortin isolated from blood plasma of
      intact rats and rats with circulatory insufficiency were studied. The differences
      in the Schtern Folmer constants and the dissociation constants for the
      transcortin-corticosterone complex obtained during the protein titration by
      corticosterone may be due to different tryptophanyl surroundings in the molecules
      of the studied proteins. This may be a consequence of the conformational
      rearrangements of the corticosteroid-binding globulin molecules.

PMID- 2238159
TI  - [The effect of hypoxic hypoxia on the activity of glycolysis enzymes in rat
      erythrocytes].
AB  - The oxygen-binding properties of hemoglobin, concentration of 2,3
      diphosphoglycerate, activity of carbohydrate metabolism enzymes and kinetics of
      rat erythrocyte hemolysis have been studied at high altitudes. The hemoglobin
      affinity to oxygen, glycolysis enzyme activity and erythrocyte membrane
      resistance are established to increase at the initial period of adaptation. The
      activation of the pentose-phosphate pathway of the glucose, transformation and
      inhibition of the glycolytic process in these cells are observed on the 10th day.

PMID- 2238158
TI  - [Activity and properties of L-lysine amidase in Salmonella strains].
AB  - Distribution, activity level and properties of alpha-lysinamidase have been
      studied in Salmonella strains. The Km value for L-lysinamide was calculated to be
      4.2 mM and for L-alpha-aminocaprolactame--5.1 mM. This enzyme, parallel with
      lysinamide, catalyzes hydrolysis of alpha-aminocaprolactam and leucinamide.
      Asparagine, glutamine, caprolactam, triptophanamide were not lysinamidase
      substrates.

PMID- 2238160
TI  - [The effect of alpha-ketoglutarate, malate and alpha-glycerophosphate on
      bioenergetic processes in ischemic myocardium].
AB  - Anti-ischemic action of exogenous natural metabolites and their effect on
      biological combustion processes indexes in cardiac muscle has been investigated
      on white rats with the experimental myocardial infarction. It has been
      established that the marked cardioprotective effect of malate and alpha
      ketoglutarate is associated with the glycolysis and enzymes activation of
      creatine kinase system of energy transport. At the same time malate activates
      pentose-phosphate cycle and tissue respiration enzymes. alpha-glycerophosphate
      displays definite anti-ischemic properties not associated with the intervention
      into biological combustion processes.

PMID- 2238161
TI  - [Dynamics of lipid peroxidation and steroidogenesis in adrenal cortex during
      stress].
AB  - The phase character of lipid peroxidation has been found in the rabbit adrenal
      cortex in the process of adaptation to extreme loads. Under acute stress the
      activation of lipid peroxidation is directly dependent on the hormonal synthesis
      processes. Under conditions of the prolonged stress factor an enhancement of the
      lipid peroxidation intensity in the adrenal cortex coincides with a decrease in
      the steroidogenesis rate.

PMID- 2238162
TI  - [Survival of the unsatisfied?].

PMID- 2238163
TI  - [Space medicine].

PMID- 2238164
TI  - [Schizophrenia: an organic disease? Current status and debate].
AB  - Schizophrenia may be interpreted as a group of conditions with various etiologies
      and pathogeneses but with common clinical features. In chronic forms with
      negative symptoms, CT scanning reveals atrophy of the brain. Other imaging
      techniques such as MR and PET confirm these findings and neurochemical,
      physiological and anatomical investigations demonstrate, similarly, that organic
      changes in the brain occur in patients with schizophrenia. The changes are
      probably due to a developmental defect and not to tissue degeneration. The
      results of the numerous neuroscientific investigations suggest that the
      therapeutic contributions for schizophrenia should have altered priorities.
      Medical therapy and psychotherapy must be supplemented by neuropsychological and
      social rehabilitation. Prophylaxis and early diagnosis will probably be possible
      in the near future so that the poor prognosis of this disease may be altered.
      Danish psychiatry is still characterized by development in neuroscience to a
      limited extent on account of marked technological delay. Establishing of a
      neuropsychiatric speciality now opens an interesting future perspective.

PMID- 2238165
TI  - [Prostatic cancer and growth factors].
AB  - Advanced prostatic cancer (PC) involves a serious prognosis. PC cells form growth
      factors, which affect growth in autocrine or paracrine manner. PC cell lines,
      hormone dependency, and growth modalities are mentioned. Interference with these
      model systems by TGF-alpha, TGF-beta and EGF is described. The presence of less
      characterized growth factors in homogenates and conditioned media from PC cells
      is mentioned. An abundance of EGF and EGF-receptors has been found in PC compared
      to BPH samples. New strategies for treatment are outlined.

PMID- 2238166
TI  - [Social situation of the 70-year old population in the past and present. A cohort
      comparison of 70-year old men and women born in 1987 and 1914 in Glostrup].
AB  - A cohort comparison between two different populations of 70 year-olds in Glostrup
      studied in 1967 (230 men and 210 women) and in 1984 (412 men and 392 women) was
      conducted for the purpose of identifying differences in social background factors
      known to have influence on health and the quality of life of old people. The
      findings show, that from 1967 to 1984, the standard of housing had improved.
      Significantly more 70 year-olds had better housing conditions with bath, toilet,
      kitchen and central heating in 1984 (65-92%). Women in the 1914 cohort had
      significantly longer education and a larger proportion were employed outside the
      home than in the 1897 cohort. Another significant cohort difference found was a
      tendency toward earlier retirement in the order of 2-3 years. This was seen for
      both sexes and all occupational groups. Since the two populations of 70 year-olds
      in Glostrup differ with regard to both social conditions and on health variables,
      this cohort comparison offers a useful starting point for research on how living
      conditions in combination with other factors affect health and aging.

PMID- 2238167
TI  - [Health status of the 70-year-old population in the past and present. A cohort
      comparison of 70-year old men and women born in 1987 and 1914 in Glostrup].
AB  - A cohort comparison between two different populations of 70 year-olds in Glostrup
      who had health examinations in 1967 (230 men and 210 women) and in 1984 (412 men
      and 392 women) was conducted with the purpose of describing changes in health
      variables among old people during a period of falling mortality for both men and
      women. From the 1967 investigation to the 1984 investigation there was a
      significant improvement of the cardiovascular risk profile (i.e. body mass index,
      blood pressure, serum cholesterol, glucose tolerance) which is consistent with
      other such investigations. In contrast to these findings, symptoms of chronic
      conditions (angina pectoris, intermittent claudication and bronchitis) as well as
      the need for health care were the same in the two populations of 70 year-olds. In
      addition, the 1914 cohort reported a more pessimistic outlook with regard to
      their general health and greater consumption of medicine. The results of this
      investigation are consistent with expectations regarding changes in risk factors
      and mortality in older generations. The consequences of the falling mortality for
      morbidity and functional ability in a life perspective are, however, still
      uncertain, and cannot be evaluated alone from results such as these.

PMID- 2238168
TI  - [Epidemiology of burns. A follow-up from a 20-year period at Odense hospital].
AB  - The numbers of patients admitted with burns, as an expression of the incidence of
      burns, registered in the Burns Unit, Odense University Hospital were compared for
      two ten-year periods: 1968-1977 and 1978-1987. A total of 1,548 hospitalized
      patients were involved. The etiology of the accidents, distributed according to
      sex, age and degree of severity and the number of deaths were calculated. A
      significant decrease in the total number of burning accidents was demonstrated,
      mainly due to the decrease in children aged 0-5 years and 6-15 years. Where the
      youngest children were concerned, this decrease was due to a decline in the
      number of scalds but also because of reductions in the number of contact burns
      and electrical and corrosive injuries. This was corrected for the altered age
      distribution with relatively fewer children during the second decade.

PMID- 2238169
TI  - [Quality of life of hemodialysis patients before and after erythropoietin
      therapy. A double-blind, randomized, placebo controlled study].
AB  - In a double-blind, placebo-controlled trial of rHu-EPO (recombinant human
      erythropoietin) comprizing 19 haemodialysis patients (rHu-EPO: n = 9, placebo: n
      = 10) the patients' opinion about the influence of the treatment on the quality
      of life was investigated. At the commencement of the trial and after eight weeks,
      a score was registered by means of a structured interview with a range of 0-10
      concerning the complaints most frequently expressed by haemodialysis patients.
      Erythropoietin was effective in the treatment of renal anaemia. In the
      therapeutic group, the mean haematocrit value increased from 0.206 to 0.338 (p
      less than 0.0005), while no change in the haematocrit value was observed in the
      placebo group. In the therapeutic group, significant decreases were found in the
      interview scores for fatigue, vertigo (p less than 0.001), dyspnoea (p less than
      0.0025), muscular weakness (p less than 0.01) and palpitations (p less than
      0.05). No significant differences were found in the placebo group. The treatment
      had no serious side-effects. On the basis of this material, it is concluded that
      erythropoietin treatment of haemodialysis patients is effective and that a marked
      improvement in the quality of life can be observed already after treatment for
      eight weeks.

PMID- 2238170
TI  - [Complications caused by intrauterine contraceptive devices].
AB  - During the period 1981-1982, IUDs were introduced in 1,697 women in the Advisory
      Clinic for Contraception in the County of Arhus. The course in a period of six
      years after this was investigated retrospectively in view of the frequencies of
      complications. A total of 459 IUDs were either lost or had to be removed on
      account of haemorrhage/pain, infection or pregnancy. Where all types of
      complications were concerned, higher frequencies of complications were
      encountered in the younger age groups and in nulliparous women. The dependence of
      the frequency of complications on the age of the patients was most marked among
      women who had borne children previously. In the total population, 29% of the
      women had the IUD removed within a period of three years. In women under the age
      of 20 years, 45% were removed and, in women over the age of 35 years, only 18%
      were removed during the same period. The total pregnancy risk was 2.7/100 women
      after use for two years and 3.2/100 women after three years. In contrast to this,
      the risk in women under 20 years was 6.6/100 women and 10.8/100 women after use
      for two and three years, respectively. On account of a high frequency of
      infection, increased tendency to extrusion and poor effectivity, the use of IUDs
      in young nulliparous women is not recommended.

PMID- 2238171
TI  - [Intracavernous self-injection for treatment of erectile dysfunction inpatients
      with spinal cord injuries].
AB  - Twelve patients (aged 18-70 years, average 41 years) with known spinal cord
      lesions with durations of 1-25 years and with levels of the lesions from C II
      incomplete to L III complete received intracavernous injection of papaverine with
      a commencing dose of 15 mg papaverine. Following this, nine patients could obtain
      usable erection lasting from 30 to 300 minutes with doses from 15-60 mg. In one
      patient, however, 60 mg papaverine was supplemented by 5 mg phentolamine. The
      patients were then trained in the technique of self-injection. On contact 1-37
      months after the primary instruction, eight patients had performed a total of 40
      self injections with the object of coitus, which was successful in all of the
      cases. Because he had no partner, one patient had no employed self-injection but
      would like to employ the method if the appropriate situation arose. Two patients
      did not want to continue self-injection. One of these considered that the method
      was too complicated to use and the other had had an episode of prolonged erection
      requiring treatment. No other side effects requiring treatment were observed. The
      relationship to possible partners and the experience of libido, "orgasm" and
      feeling of self esteem as compared to previous experiences were registered. Six
      out of nine patients had experienced improvement in at least one of these fields
      and none had experienced deterioration. A total of seven patients planned to
      employ the method in future. The authors conclude that self-injection of
      papaverine is a promising supplement in the treatment of erective dysfunction in
      patients with spinal cord lesions.

PMID- 2238172
TI  - [Vasectomy in specialized surgical practice].
AB  - In the county of Roskilde an exception was made from the Danish legislation
      concerning sterilization that vasectomy should be performed in hospitals only on
      account of the long waiting list for this intervention. Two surgical specialists
      were selected to perform the operation in their practices. 88% (176/199) elected
      to accept the offer. All of these sterilizations were carried out within a period
      of six months. A questionnaire investigation did not reveal any difference in
      satisfaction between conduct of the intervention by the practising specialist in
      surgery or in hospital. Justification of the requirement that this form of
      sterilization can only be undertaken in hospital is discussed.

PMID- 2238173
TI  - [Spontaneous perforation of the biliary tract during the neonatal period].
AB  - Spontaneous perforation of the biliary passages is a rare condition during the
      first months of life. The course of the condition may be acute or more chronic.
      The symptoms are jaundice, clay-coloured stools, dark urine, distended abdomen,
      regurgitation and failure to thrive. The diagnosis can be established by scanning
      of the abdomen and 99mTc-HIDA-scintigraphy of the biliary passages. The
      perforation is usually found to be localized to the transition between the cystic
      duct and the common hepatic duct and is probably due to a localized development
      defect in the biliary passages. Operation is always required. The prognosis is
      good and the infants do well after operation.

PMID- 2238174
TI  - [Congenital duodenal obstruction caused by an abnormal superior mesenteric vein].
AB  - A case of congenital duodenal obstruction caused by an abnormal superior
      mesenteric vein is presented. The obstruction was successfully treated by
      duodenoduodenostomy anterior to the vein.

PMID- 2238175
TI  - [Prevention--need for periodic ophthalmologic examinations of diabetics].

PMID- 2238176
TI  - [Thyroid surgery].

PMID- 2238177
TI  - [Discharge records as information sources].

PMID- 2238178
TI  - [Can ultrasonic scanning replace phlebography in the diagnosis of deep
      thrombophlebitis of the leg?].
AB  - Until recently, phlebography with contrast agents has been the standard method
      for demonstration of deep venous thrombosis in the lower limb (DVT). In recent
      years, however, this has been replaced to an increasing extent by ultrasonic
      scanning. In contrast to radiographic examination, this method does not require
      injection of a contrast agent and it does not employ ionizing irradiation. The
      principle of ultrasonic scanning is that a normal vein may be compressed flat by
      means of slight pressure from the transducer whereas a vein filled with thrombi
      cannot be compressed. Ultrasonic examination is not (yet?) of diagnostic value in
      the leg but, more centrally, it is of the same diagnostic value as radiographic
      examination. It is suggested that ultrasonic scanning can replace phlebography in
      patients with their first DVT. If this gives a negative result, it may possibly
      be supplemented by phlebography of the veins of the leg.

PMID- 2238179
TI  - [Evaluation of the discharge summary by general practitioners. A questionnaire
      study].
AB  - In March 1986, a questionnaire investigation was sent to 250 general
      practitioners chosen at random in Denmark. In this questionnaire, general
      practitioners were asked about their assessment of the total activity involved in
      letters of discharge. Out of the practitioners questioned, 188 replied to the
      questionnaire (75.2%). 74% of the practitioners considered that changes were
      necessary in discharge letters. Most dissatisfaction was expressed about late
      receipt of discharge letters. 34% of the practitioners found that these letters
      should be received 0-3 days after discharge of the patient while 61% considered
      that 4-7 days after discharge could be accepted. A total of 92% considered that,
      on an average, they received letters of discharge later than seven days after
      discharge of the patient. As regards the contents of the letters of discharge,
      68% of the practitioners considered that these were usually satisfactory.
      Practitioners appreciated substantial letters with emphasis on conditions of
      significance for the post-hospital treatment. The most important information was
      considered to be: medicine on discharge, information given to the patient,
      reasons for possible changes in medication, information about the subsequent
      treatment in addition to medicine and information about patho-anatomical findings
      at operation or biopsy. This investigation has provided a general consumer review
      of the form of discharge letters, the language, content, use and time of sending.

PMID- 2238180
TI  - [Evaluation of the discharge summary by physicians in charge. A questionnaire
      study].
AB  - In September 1986, a questionnaire about letters of discharge was sent to 250
      physicians-in-charge i 250 clinical hospital departments in Denmark. Out of
      these, 214 replied to the questionnaire (85.6%). Only 110 (51%) of the physicians
      in-charge stated that there was a definite time (number of days) by which the
      letter of discharge should be sent after the discharge of the patient. In 99
      departments (46%), the letters of discharge were, on an average, sent later than
      the physician-in-charge found acceptable. 50% of the physician-in-charge found
      that the acceptable time of sending the letter of discharge after discharge of
      the patient was 0-3 days. 43% of the physicians-in-charge found that 4-7 days
      after discharge of the patient could be accepted. Formalized teaching in writing
      letters of discharge only took place in 24 departments (11%). Only few physicians
      in-charge stated that they often or fre quently received negative or positive
      feed-back from general practitioners about letters of discharge. The following
      concrete proposals to improve the quality of letters of discharge and to shorten
      the time until sending are discussed: simplifying the passage from dictation of
      the letter to dispatch, increased formalized teaching of house officers and
      generally higher priority for letters of discharge.

PMID- 2238181
TI  - [Evaluation of the discharge summary by resident staff physicians. A
      questionnaire study].
AB  - In September 1986, a questionnaire about letters of discharge was sent to 250
      house officers in 250 clinical departments in Denmark. Out of these 197 replied
      to the questionnaire (78%). 32% of the house officers found that an acceptable
      time for the general practitioner to receive the letter of discharge was 0-3 days
      after discharge of the patient, while 53% of the house officers found that 4-7
      days time was acceptable. 23% of the house officers stated that they had now or
      previously received formalized teaching about how to write letters of discharge.
      44% of the house officers stated that they never received criticism or advice
      about writing of letters of discharge from their physicians-in-charge. The house
      officers considered that the most important information in the letter of
      discharge was, in general: medication on discharge, recommended follow-up
      treatment apart from medicine, information about possible outpatient visits,
      pathological findings at operation or biopsy and information about the treatment
      during hospitalization. 88% of the house officers considered that the letter of
      discharge was a good form of communication. 29% of the house officers considered
      that alterations of the work in toto of the letters of discharge were necessary
      and remarked that this was particularly important as regards early dispatch of
      letters of discharge to general practitioners. A description of the function of
      letters of discharge as seen by house officers is attempted in this
      investigation.

PMID- 2238182
TI  - [Epicrisis. A report from the county of Copenhagen].
AB  - During a random week in 1987, 35% of the general practitioners from all of the
      municipalities in the County of Copenhagen participated in a questionnaire survey
      whose objective was to illuminate the quality, expedition time, and possible
      problems associated with the letter of discharge (LD), an important link between
      the primary and secondary medical services. It can be concluded that the
      expedition time for a large number of LD's from the hospitals of Copenhagen
      County is unacceptably lengthy. A surprisingly large number of patients visited
      their own general practitioner during the week following discharge with questions
      about the information which had been given them during their hospital stay,
      regardless of agreements for ambulatory monitoring at the department from which
      they had been discharged. A preliminary LD can, to a certain extent, alleviate
      the problems brought about by the lack af an LD but ought not to replace or delay
      the issuance of the actual LD, and is a more expensive solution. The quality and
      content of the LD can be evaluated generally as good, but could be improved if
      the recommended follow-up treatment and information to the patients and relatives
      is routinely carried out.

PMID- 2238183
TI  - [The patterns of anxiety and crying among normal Danish infants with and without
      colic].
AB  - On the basis of a descriptive, prospective investigation, the patterns of fussing
      and crying in normal Danish infants aged from 2-3 to 14 weeks are described. A
      total of 102 infants were included in the investigation and 85% completed the
      investigation. The parents carried out daily registration of the periods of
      fussing and crying. The great majority of the infants were very placid. The mean
      duration of fussing for the entire group was half an hour per week during the
      third week of life. This increased to 2 1/2 hours per week at the sixth week of
      life and then decreased gradually to 0 hours per week from the 12th week of life.
      The material was subdivided into quartiles. Infants in the first and second
      quartiles showed practically no fussing. Infants in the third quartile were fussy
      at the commencement of the period and became gradually more placid from the fifth
      week of life. Infants in the fourth quartile were fussy during the first 9-10
      weeks of life, after which the fussing gradually diminished. In infants in the
      third and fourth quartiles, fussing was most marked in the evenings. Two pairs of
      parents considered that their infants had colic. Ten infants were defined as
      having infantile colic. In these infants, the patterns of fussing and crying
      showed a common pattern and this was significantly different from the remainder
      of the group. The basic variables for the 25% most placid infants and the ten
      infants presumed to have colic are compared.

PMID- 2238184
TI  - [The optimal dose of bendroflumethiazide in hypertension. A randomized double
      blind dose-response study].
AB  - The object of this study was to determine the clinically relevant dose of
      bendrofluazide for the treatment of arterial hypertension. A material of 257 male
      and female subjects, age 25-70 years, with sitting diastolic blood pressures
      between 100-120 mmHg after six weeks of placebo treatment participated in this
      randomized, double-blind placebo-controlled parallel group study. The patients
      were treated with either 0, 1.25, 2.5, 5.0 or 10 mg bendrofluazide daily for 12
      weeks. Blood pressure was measured with a random zero sphygmomanometer and a
      Tricuff. Compliance was checked by tablet counts. The mean decreases in diastolic
      blood pressure were 3.5, 9.8, 10.8, 10.1 and 10.8 mmHg in the five treatment
      groups respectively. The heart rates were unchanged in all groups. Dose-effect
      relations were demonstrated for potassium, urate, glucose, cholesterol and
      apolipoprotein B. The lowest dose of bendrofluazide, 1.25 mg, affected only
      urate, whereas all of the mentioned biochemical variables were affected by the
      highest dose of 10 mg. It can be concluded that the optimal dose of
      bendrofluazide for aterial hypertension is 1.25 mg daily. Increase in the dose
      beyond this level only results in more pronounced adverse biochemical effects
      including the lipid-metabolism and subjective adverse events.

PMID- 2238185
TI  - [Spirapril and nitrendipine in arterial hypertension. A comparison of therapeutic
      effects and tolerance].
AB  - In a double-blind, randomized parallel-group investigation, a new angiotensin
      converting enzyme-inhibitor, spirapril, was compared with a calcium antagonist,
      nitrendipine, in 266 patients with mild to moderate hypertension (diastolic blood
      pressure 96-119 mmHg). The object was to reduce the diastolic blood pressure
      measured 24 hours after intake of medicine to less than or equal to 90 mmHg.
      After monotherapy for four weeks with either 20 mg nitrendipine once daily or 12
      mg spirapril once daily, the dosages were doubled in the patients in whom the
      desired blood pressure had not been obtained. After treatment for eight weeks,
      12.5 mg hydrochlorthiazide daily was employed as a supplement in patients who had
      not yet obtained satisfactory blood pressures. Both methods of treatment resulted
      a lower number of patients who responded and lesser decreases in blood pressure
      than anticipated. No differences were found in the decreases in blood pressure
      resulting from the two therapeutic methods. The effect of supplementary
      hydrochlorthiazide to spirapril treatment was as anticipated while the
      combination with nitrendipine only resulted in a marginally extra decrease in
      blood pressure. Nitrendipine resulted in significantly more side effects and more
      patients defected from the investigation on account of side effects in the
      nitrendipine group (27%) than in the spirapril group (7%). This investigation had
      documented the abilities of nitrendipine and spirapril to reduce blood pressure
      and the side effects associated with this but does not predict whether the
      preparations can be employed to prevent the complications of hypertension which
      constitute the indications for treatment. Supplementing nitrendipine therapy with
      hydrochlorthiazide is not recommended.

PMID- 2238187
TI  - [Pain and dysesthesias in the mastectomy scar].
AB  - With the object of investigating the occurrence of pain and dysaesthesiae in the
      scar following mastectomy, 120 were interviewed by a standard questionnaire in a
      prospective study. These women had commenced postoperative control or treatment
      in the Department of Oncology in the University Hospital of Aarhus consecutively
      during a one-year period. One hundred and ten of these women were interviewed
      again one year later. In 92% of the patients with scar pain and dysaesthesiae,
      these appeared within the first three months postoperatively. At the first
      interview, 42 patients (35%) had scar pain and 15 of these (13%) experienced
      constant scar pain. One year later, 25 patients (23%) still had scar pain and 13
      patients (12%) had experienced persistent scar pain throughout the entire year.
      Two of the patients (8%) with scar pain had constant pain while, at the second
      interview, 14 patients (56%) reported that the scar pain lasted for seconds.
      Twenty-seven patients (23%) had dysaesthesiae at the first interview while 29
      patients experienced these continually one year after operation. Both the
      intensity and the duration of the scar pain diminished with the elapse of time.
      This held also true where dysaesthesiae were concerned but was not so marked.

PMID- 2238186
TI  - [Measurement of systolic finger blood pressure with a pulse oximeter].
AB  - In order to investigate whether the pletysmographic curve on a pulse oximeter can
      be employed for measurement of the systolic finger blood pressure, the authors
      compared the method with a strain-gauge method and undertook 160 measurements
      with a finger cuff on 11 healthy volunteers. By varying the pressure in two cuffs
      placed on the arm, the blood pressure in the finger could be altered from normal
      to very low values. The difference between the connected values was analysed and
      it was found that the difference between strain-gauge and pulse oximeter
      measurements read on the printer on employment on a new volunteer will be -0.9 +/
      3.8 mmHg. If the blood pressure is read on a manometer, the same difference will
      be -1.5 +/- 5.2 mmHg. The authors consider that the method is interesting in view
      of future employment for assessment of the collateral circulation in the hand but
      they recommend further investigations on patients with occlusive
      arterioschlerotic disease in the upper limbs.

PMID- 2238188
TI  - [Human milk substitutes based on cow's milk].

PMID- 2238189
TI  - [Prevention of allergy. Guiding norms].

PMID- 2238190
TI  - [Continued education course on the problems of sleep apnea and snoring, Uppsala,
      21-23 March 1990].

PMID- 2238191
TI  - [Cesarean section--why such variations in frequency?].

PMID- 2238192
TI  - [Health screening in the workplace. Benefits and principles].
AB  - This article describes the prophylactic programmes for health surveillance which
      exist in the occupational environment in Denmark. Compared with other
      industrialised countries, Denmark has only few established surveillance
      programmes. Nevertheless, these investigations exist, particularly in the form of
      non-specific general clinical health investigations at local workplaces, in
      certain branch agreements and in certain types of work. In addition, the article
      provides a review of the literature concerning health and health-economic effects
      of supervision of health. It is concluded that with the existing knowledge, pre
      employment examinations and periodic health examinations as routine examinations
      without and clearly defined object must be regarded as having limited
      prophylactic value and that examinations of this nature can scarcely give the
      worker any health benefit or give the employer any economic profit. On the other
      hand, programmes of this nature may give the employees a false sense of security
      and contribute towards interpreting of justifiable levels of exposure, on an
      incorrect basis. Biological monitoring and occupational medical screening
      include, as a rule, more well directed programmes which will probably be employed
      to a greater extent in the coming years. Finally, a set of American directives
      for criteria of utilization, particularly for screening in occupational medicine
      are discussed. It is maintained here, among other things, the necessity of an
      integrated analysis of biological monitoring, screening and control of exposure
      so that health surveillance can be of benefit for all the employees at a
      workplace and not only the individual worker.

PMID- 2238193
TI  - [Leber's hereditary optic atrophy. A hereditary disease caused by mitochondrial
      DNA mutation].
AB  - Leber's hereditary optic neuropathy is a genetic disorder characterized by sudden
      bilateral loss of vision. It is transmitted exclusively through females
      (matroclinous inheritance) due to a mutation in mitochondrial DNA (mtDNA), most
      frequently a GC----AT substitution of base pair no. 11778 ('The Wallace
      mutation'). All children of homoplasmic female carriers inherit the disease gene.
      Penetrance is incomplete, but high in males. Genetic heterogeneity has been
      reported, as has heteroplasmy. The nature of the mutation and the degree of
      heteroplasmy have prognostic value, and genetic counselling as well as clinical
      evaluation should therefore include mtDNA analysis. Diagnostic mtDNA analysis is
      illustrated for three Danish patients, one of whom is without known affected
      relatives. All three were homoplasmic for the Wallace mutation. Neither
      prophylaxis nor therapy, by medication are possible as yet. Loss of vision may be
      prevented, or delayed, if at-risk individuals refrain from smoking and
      consumption of certain foodstuffs.

PMID- 2238194
TI  - [Variations in frequency of Cesarean sections in Denmark].
AB  - An investigation is presented on the basis of the medical register of births
      concerning all primiparae who were delivered of a liveborn singleton infant in
      1982 and 1986. On the basis of the section on complications in the notification
      of the births, we have made a subdivision into four "approximate indications". We
      find a variation in frequencies of Caesarean section from 9.7% (1982) to 17.1%
      (1986) between the various counties and an increase during the period
      investigated of 19%. 50% of the increase occurred in the group termed "other
      causes", 25% in the group of foetal distress and 25% in the group of dystocia.
      The group of breech presentations is, by and large, unchanged in Denmark as a
      whole but great differences are present between counties. This register
      investigation does not permit the possibility of deeper analysis of the reasons
      for the variations.

PMID- 2238195
TI  - [Prenatal diagnosis in the county of Viborg before and after decentralization of
      sample taking].
AB  - On account of an increase in the frequency of amniotic fluid samples (AFS), the
      need for further decentralisation of sampling developed. Viborg Amt (Viborg
      County) was able to offer this service to all pregnant women in the county after
      01.VIII.1985 who fulfil the indication for prenatal diagnosis (PD). Among 902
      registered AFS divided over a period of two years before and two years after the
      decentralisation there was no significant deterioration of the service measured
      by the number of spontaneous abortions and unsuccessful AFS. The indications for
      prenatal diagnosis altered in such a way that the unofficial indication of
      anxiety rose significantly while the indication of maternal age greater than or
      equal to 35 years decreased. Furthermore, a positive correlation was registered
      between a reduction of distance from the pregnant woman to the centre of sampling
      and the percentage of referrals made by the local practitioner. The paper also
      shows that more pregnant women, referred for AFS on account of advanced age,
      accepted PD than was registered in an earlier research, but this pattern declined
      in the research period.

PMID- 2238196
TI  - [Information to women applying for sterilization].
AB  - On the basis of a questionnaire investigation among the general practitioners in
      the County of Frederiksborg, the authors have compared the information given to
      women applying for sterilization with information in the available literature
      about the nature of the intervention, its sequelae and the risks involved. The
      authors found that under half of the practitioners gave informations about
      disturbances of menstruation, dyspareunia and altered sexual life. In the
      literature, it is stated that these occur in 10-60%, 3-11% and 4-48% of the
      women. Less than one third of the practitioners gave information about the risk
      of perforation of an organ or vessels, tearing of the ovarian tubes and
      postoperative pain. In the literature, it is stated that these occur in 0.1-2.5%,
      0.28-9% and 24% of the women depending on the operative method used. The authors
      recommend revision of our knowledge on these subjects and alterations in the
      written information provided.

PMID- 2238197
TI  - [Hearing of the mentally retarded living at home].
AB  - The present article was undertaken to illustrate the frequency of defective
      hearing in adult mentally retarded persons living in their homes in the
      Municipality of Copenhagen. The investigation concerns 115 persons, 57 men and 58
      women with an average age of 38 years, range 20-79 years. At the time of the
      investigation, the persons examined constituted 26% of the total population of
      adult mentally retarded persons living at home in the Municipality of Copenhagen.
      The investigation revealed that 5% experienced problems in hearing in quiet
      surroundings while 15% had hearing problems with background noise. On the basis
      of pure tone audiometry, normal hearing was found in 60% (less than or equal to
      20% dB HL) with frequency criterion including 4 kHz, while 67% (77/115) were
      found to have normal hearing without including 4 kHz in the frequency criterion.
      In other words, 40%/33% had defective hearing and were therefore outside the
      normal range. In order to assess the presence of defective hearing, the limit of
      greater than or equal to 25 dB HL in the ear with best hearing and the frequency
      criterion with or without 4 kHz, respectively, was established. On the basis of
      these criteria a reduction of hearing in the best ear of 30%/24% was found. the
      investigation revealed, in addition, that at least 17% should have been treated
      with hearing aids but only one of the persons examined had a hearing aid which
      was, however, not in use. (ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238198
TI  - [Drug utilization in Hvalso. An attempt to change the attitude of the population
      and physicians to drug use].
AB  - All of the prescriptions, a total of 1,876, issued by the five practitioners in
      Hvalso in four chosen weeks in 1987/88 were copied. The prescribed drugs, a total
      of 3,177, were calculated for the individual groups of drugs and corrected for
      the age distribution among the population as a whole and in the individual
      doctor's practice. The main results from the following groups of drugs are
      presented here: hypnotics, drugs for neurosis, antibiotics, drugs for cardiac and
      circulatory disease, drugs for asthma, contraceptive pills and female sex
      hormones. By and large, considerably more medicine was prescribed for women than
      for men. For example, twice as much medicine for insomnia was prescribed for
      women. This is enough for every fourth woman over the age for 70 years to receive
      a daily dose of hypnotics. Women appear to commence using hypnotics at the age of
      40 years and men at 60 years. Marked differences were found in the patterns of
      prescription between the individual practitioners and thei is apparently greatest
      as regards prescriptions for men while the more liberal prescription of hypnotics
      to women was observed for all of the practitioners. Two groups of drugs were,
      however, prescribed mostly for men, viz, asthma medicine for all age groups and
      cardiac and circulatory medicine for persons greater than 60 years. Where all of
      the groups of drugs were concerned, comparisons were undertaken between the
      prescription habits of the individual practitioners. The results of this
      investigation are employed in local health work among the population, in study
      circle work among the practitioners and as basic ideas for the county drug
      committee activities.

PMID- 2238199
TI  - [Temporary pacemaker treatment in Denmark].
AB  - The employment of temporary pacing (TP) in Denmark in 1986 is illustrated by
      means of a questionnaire investigation. Seventy-four out of 77 Danish hospitals
      with a medical-cardiological specialist returned usable replies. Facilities for
      temporary pacing were available in 39 (53%) of the hospitals. The method of
      pacing most extensively employed was the transvenous method which was used in 33
      hospitals while external transcutaneous pacing by Zoll's method was available in
      13 hospitals. In transvenous pacing, the subclavian vein was employed routinely
      in 24 hospitals while a cubital vein was used primarily in eight hospitals. More
      than 85% of the pacing catheters employed were of disposable type. Only one
      hospital always employed a permanent pacing lead which could be utilised if
      permanent pacing should be required. A total of 486 patients with or without
      acute myocardial infarction (AMI) were submitted to temporary pacing. Employment
      of temporary pacing in patients with AMI was 0-8.3% (average 3.7%). In general,
      it was found that hospitals with cardiac laboratory facilities showed the
      greatest temporary pacing activity. The indications for temporary pacing are
      assessed on the basis of two case reports. The greatest employment of temporary
      pacing was found in patients with AMI with third degree atrioventricular block
      and ventricular escape rhythm (anterior wall 74%, posterior wall 56%). Employment
      of temporary pacing was least in symptomfree patients with anterior wall AMI and
      bifascicular block (9%).

PMID- 2238200
TI  - [Reoperation for angina pectoris].
AB  - During the 16-year period from 1974 to 1989, coronary bypass operations were
      carried out on 938 patients. During the same period, 48 patients (5.1%) were
      submitted to reoperation on account of recurrent angina pectoris. Patients with
      early recurrence had more frequently graft-occlusion than patients with late
      recurrence in whom the main cause was progression of the arteriosclerotic cardiac
      condition. The actual rethoractomy was carried out without serious complications.
      The perioperative frequency of complications and the mortality correspond to the
      frequencies at the first operation. Follow-up control of these patients was
      undertaken after an average of 34 months (8-100) after reoperation. The results
      after reoperation as regards freedom from symptoms are not quite as good as the
      results after the primary operation but approximately 2/3 of the patients will
      benefit from reoperation.

PMID- 2238201
TI  - [Unwanted pregnancy after removal of the IUD].
AB  - Four cases of unwanted pregnancy occurring in the same cycle as removal of an IUD
      are presented. The duration of ovum transport from the Fallopian tube into the
      uterine cavity, survival of spermatozoa in the female genital tract and timing of
      ovulation, which may be delayed in women with IUDs are variables which influence
      the probability of pregnancy and should be taken into consideration when removing
      an IUD. Unless pregnancy is desired, it is recommended when possible not to
      remove an IUD after the ninth day of the menstrual cycle unless another
      contraceptive method has been initiated.

PMID- 2238202
TI  - [Allergy to insulin developed during exposure to human insulin].
AB  - A case of allergy to human insulin is presented. The allergy developed during
      treatment with semisynthetic humanised insulin and was verified by a prick-test
      and RAST analysis.

PMID- 2238203
TI  - [Why are chronic pain patients given opioids via injections?].

PMID- 2238204
TI  - [Gambling mania].

PMID- 2238205
TI  - [Physical therapy and mask treatment of chronic bronchitis and chronic
      obstructive lung disease (COPD)].
AB  - The literature concerning traditional chest physiotherapy (postural drainage,
      percussion, vibration, breathing exercises), treatments with masks (CPAP, IPPB,
      RMT, PEP, PEEP) and general physical training in the treatment of chronic
      bronchitis is reviewed. The mucociliary clearance is increased after postural
      drainage, cough, forced expiratory manoeuvres and general physical training, but
      the influence of this upon the course of the disease is unknown. Chest
      physiotherapy in the treatment of patients admitted on account of acute
      exacerbation of chronic bronchitis does not appear to help. The use of face masks
      in this population has only been subject to limited investigation, but results
      from controlled trials do not indicate any favourable effect. In contrast,
      general physical training seems to increase physical endurance and decrease
      dyspnoea. Specific rehabilitation programmes comprising psychological assistance,
      cessation of smoking and general physical training seem promising.

PMID- 2238206
TI  - [Testicular torsion in neonates. With special emphasis on bilateral cases].
AB  - The literature concerning torsion of the testis in neonates is reviewed with
      special reference to bilateral cases. The incidence, pathogenesis, diagnosis,
      differential diagnoses and treatment are discussed. The importance of immediate
      surgical intervention is emphasized in order to avoid necrosis of spermatogenic
      tissue and subsequent infertility.

PMID- 2238207
TI  - [Urinary symptoms in elderly women in nursing homes. Frequency and social
      consequences of urinary incontinence in elderly women living in nursing homes].
AB  - All 278 female residents of nursing homes in the County of Roskilde were assessed
      as regards the extent and severity of urinary incontinence and possible urinary
      infections. A total of 168 (58.5%) were incontinent. Culture of the urine was
      performed in 210 women and significant bacteriuria was demonstrated in 50%.
      Thirty-four out of the total of 287 women (12%) had indwelling catheters. In
      incontinent women without catheters, great quantities of urine were often voided
      involuntarily. Despite this, only few were subjectively inconvenienced or
      inhibited in their social activities. The investigation revealed a connection
      between urinary incontinence and reduced mobility while no connection was
      observed with current urinary infections, intake of medicaments and parity. It is
      emphasized that these results are based on findings in very old women living in
      nursing homes.

PMID- 2238209
TI  - [Medical services on an inspection ship in the north Atlantic].
AB  - The Danish Naval Inspection Ships sail in the North Atlantic waters with a doctor
      on board. The object of this investigation was to illustrate the medical services
      on board and to elucidate the significance of various factors to predict seeking
      medical advice. During a period of three months, all of the medical services and
      certain basic factors were registered. The crew was interviewed about consumption
      of alcohol and tobacco, previous life at sea and family background. A total of
      305 consultations were used by the crew of 72 men. This figure is five times the
      anticipated figure in general practice. Low rank and low age were predictors for
      frequent medical consultations. The diagnosis groups of traumata/injuries,
      dermatological conditions and disease in the nervous system or organs of sense
      were relatively overrepresented. A series of factors may possibly have influenced
      the pattern of seeking medical help so that this differs from general practice.
      It is concluded that the dangerous working environment and poor possibilities for
      good hygiene are important factors whereas the mental stress is of lesser
      significance.

PMID- 2238208
TI  - [Urinary incontinence in women aged 30-59 years. An epidemiological study].
AB  - Among the female population of Aarhus Municipality, Denmark, 3,114 women were
      drawn at random and sent a postal questionnaire about the occurrence of urinary
      incontinence (UI) in adult life. The response rate was 85%. 26% of the
      respondents had experienced one or more episodes of UI in adult life. 14% had
      perceived UI as a social or hygienic problem cf. the UI definition of The
      International Continence Society. The mean 1987 period prevalence was observed to
      be 17% (ICS defined UI, 10%). UI incidence rose with increasing age, especially
      in age groups 25-29 and 45-49 years. By the age of 59, 30% had experienced UI
      (ICS defined UI, 18%). Pure stress UI and combined stress and urge UI were the
      most frequent clinical types.

PMID- 2238210
TI  - [Wound complications after suturing of Achilles tendon ruptures].
AB  - During the period 1983-1988, 254 patients underwent simple end-to-end repair of
      closed ruptured Achilles tendons in our institution. During the same period,
      eight patients were treated with plastic repair on account of old ruptures, and
      19 patients were treated conservatively on account of relative contraindication
      to open repair. The material of simple end-to-end repair is analyzed as regards
      factors which may be supposed to contributory to the rate of infection, wound
      healing and repeated rupture. The rate of major wound complication was low (2.4%)
      as was the rate of repeated rupture (1.6%). No single factor responsible for
      complications could be pointed out. However, compared to a high rate of deep
      infection in patients treated with plastic repair in our material and also in
      other studies, simple end-to-end suture is recommended in the treatment of
      rupture of the Achilles tendon when this is possible.

PMID- 2238211
TI  - [Frequency of recurrence after acute herniotomy].
AB  - Ninety-one cases of emergency herniotomy are reviewed as regards the short- and
      long-term results. The review shows that immediate surgery does not involve any
      increased risk to the patient as regards mortality and recurrence rate. The
      frequencies of bowel resection and mortality are related to the duration of the
      history and the type of hernia.

PMID- 2238212
TI  - [Experience with Doppler echocardiography in infants with systolic murmur].
AB  - In a one-year period, 33 infants with a systolic cardiac murmur were examined by
      Doppler-echocardiography. The clinical diagnosis based on ECG, X-ray and physical
      examination by a pediatrician or cardiologist was changed or established by
      Doppler-echocardiographic examination in 63% of the cases. In almost all cases,
      this meant changing of the strategy concerning further diagnostic evaluation and
      therapy. In eight (24%) of the infants no malformation was detected by Doppler
      echocardiography, and no further cardiological examinations were carried out. In
      eight (24%) infants a complex heart malformation was detected. Three of these
      infants had no clinical signs of heart disease except for the murmur. Because an
      early and accurate diagnosis is important in the management of infants with heart
      disease, we recommend that infants suspected of having congenital heart disease
      are examined by Doppler-echocardiography in a department with experience in this
      technique.

PMID- 2238213
TI  - [Proctoscopic versus histologic diagnosis of rectal polyps].
AB  - On the basis of the endoscopic appearance, 71 rectal polyps were assessed as
      adenomata or non-neoplastic polyps, after which the endoscopic diagnosis was
      compared with the results of histological examination. The diagnosis based on
      macroscopic examination of the polyps proved correct in only 62% of the cases. It
      is concluded that the diagnosis of adenoma cannot be established solely on the
      proctoscopic appearance of a polyp and, as adenomata are premalignant, removal of
      all polyps found at proctoscopy is recommended.

PMID- 2238214
TI  - [Rupture of biceps tendon after injection of steroid].
AB  - A case of distal rupture of the biceps tendon preceded by injection of steroid on
      account of lateral epicondylitis three and five months previously is presented.
      This complication is extremely rare although the treatment is extensively
      employed. It is recommended that steroid should not be employed as the first
      choice. In addition active measures should be employed to avoid recurrence.

PMID- 2238215
TI  - [AIDS and dementia].
AB  - Two case histories are presented of patients with AIDS. In both cases, the
      initial symptom, apart from the generalized symptoms, was rapidly progressive
      dementia. The most important neurological symptoms in the AIDS dementia complex
      are reviewed and the CNS complications of AIDS are mentioned. In patients with
      atypical neurological clinical pictures, the diagnosis of AIDS should be
      considered.

PMID- 2238217
TI  - [The DANAMI study. A Danish multicenter comparative study of medical and invasive
      treatment in patients with ischemia after acute myocardial infarction].

PMID- 2238216
TI  - [2 fatal cases of pneumococcal septicemia after bone marrow transplantation].
AB  - Patients with bone-marrow transplants have an increased risk of developing
      fulminant pneumococcal infections for years after transplantation. In order to
      illustrate this, two cases of fetal pneumococcal septicaemia in patients with
      bone-marrow transplants are described. Self-medication with penicillin in case of
      fever is recommended.

PMID- 2238218
TI  - [General anesthesia without gas].

PMID- 2238219
TI  - [Cholesterol anarchy?].

PMID- 2238220
TI  - [Smoking among health personnel and smoking regulations in Danish hospitals].

PMID- 2238221
TI  - [Knowledge and attitudes to the tobacco problem among Danish physicians, nurses
      and midwives in 1989].
AB  - In an investigation including 2,233 Danish doctors, nurses and midwives between
      72 and 96% replied that they found definite proof of connections between smoking
      and the diseases: cancer of the lung, cardiac infarction and chronic bronchitis.
      The highest percentages were found among doctors and, in all three instances,
      among nonsmokers. Approximately 2/3 of the persons questioned felt inconvenienced
      by other peoples' tobacco smoke. Even among health staff, there were,
      surprisingly enough, often problems between smokers and non-smokers. The majority
      of persons questioned considered that Danish hospitals and places of work for
      health staff should be free from smoke, so that none of the staff smoked at work.
      Half of the doctors and 3/4 of the nurses and midwives replied that they received
      insufficient teaching about the deleterious effects of tobacco smoking on health.
      All of the participants were unanimous that future campaigns against the tobacco
      problem in the population should be concentrated on prevention of recruitment of
      new smokers and increase of information about the deleterious effects of tobacco
      on health. As health staff constitute a very important group in the future
      campaigns against tobacco, we have obtained the impression from the questionnaire
      investigation that a thorough debate is necessary about how to solve the problem
      of tobacco smoking in Danish hospitals and other places of employment of health
      staff.

PMID- 2238222
TI  - [Smoking habits among Danish physicians, nurses and midwives in 1989].
AB  - Health staff play a central role in distribution of knowledge about the injurious
      effects of tobacco by influencing the smoking habits of the population. The
      danish council on smoking and health has therefore chosen health staff as one of
      the first targets for its activities. One of these was conduct of a questionnaire
      investigation among a representative section of Danish doctors, nurses and
      midwives about smoking habits and attitudes to the tobacco problem. The random
      sample consisted of 2,997 persons, of whom 2,606 (87%) replied to the question
      about daily smoking habits. In all of the age groups, the frequency of smoking
      was considerably lower among health staff than in the population as a whole,
      primarily because many had stopped smoking. The frequency among men was 23% for
      doctors as compared with 50% in the normal population (age 20-69 years) and 15%
      for female doctors, 29-30% for nurses and midwives as compared with 46% in the
      normal population. The frequency of smoking among doctors has decreased
      considerably since 1980. Very few heavy smokers were found among health staff,
      particularly among doctors, and many male doctors smoked pipes (47% of the
      smokers). Even though health staff smoke less than the rest of the population,
      attention must still be focussed on this group on account of its function for
      establishing opinions in the health sector.

PMID- 2238223
TI  - [Selective screening for hypercholesterolemia. Results from a screening model in
      general practice].
AB  - At present, it appears to be probable that both dietary changes and medicinal
      treatment can reduce the risk of development of coronary disease in middle-aged
      men with moderately to severely raised blood cholesterol values. Internationally,
      the limits for cholesterol intervention are considerably lower than in Denmark.
      Extensive cholesterol screening is, however, very expensive and the identified
      persons with high cholesterol values will frequently be found in sex and age
      groups where the beneficial effect of intervention is probably limited. A model
      for selective cholesterol screening in high risk groups in general practice is
      described here. In 20 general practices, all of the men aged 45-59 years
      belonging to the practice were invited to examination of cholesterol and blood
      pressure. Plasma cholesterol was measured by means of a Reflotron (results are
      available within three minutes) and the blood pressure and tobacco consumption
      were registered. After this, the patient's own general practitioner calculated
      with each of the persons the risk for development of myocardial infarction within
      the next ten years and intervention could be commenced immediately. 41% of those
      invited came for examination. Out of these, 29% had cholesterol values greater
      than or equal to 7.0 mmol/l (Danish limiting value), 44% greater than or equal to
      6.5 mmol/l (limiting value in the remainder of Western Europe), and 5% greater
      than or equal to 9.0 mmol/l (severe hypercholesterolaemia) while only 18% had
      completely normal cholesterol less than 5.2 mmol/l. In every practice, two
      patients on an average were found with severe hypercholesterolaemia greater than
      or equal to 9.0 mmol/l. 28% of the participants had at least two of the three
      risk factors investigated. (ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238224
TI  - [Formalized dietary advice in hypercholesterolemia. Results in 110 men diagnosed
      by selective screening in general practice].
AB  - In connection with a screening investigation for high blood cholesterol in middle
      aged men in general practice in the Municipality of Copenhagen, all participants
      with cholesterol values greater than or equal to 7.5 mmol/l were given brief
      advice by their own general practitioner and were invited to come for fasting
      blood lipid tests approximately ten days later. In cases with continued
      cholesterol greater than or equal to 6.8 mmol/l, the participants together with
      wives or partners were invited to formalized dietary advice in small groups.
      Already before the formalized dietary advice, an average decrease in serum
      cholesterol of 10% was observed. This was attributed to biological variation,
      absence of fasting, the degree of error between the measuring methods and also a
      genuine decrease on the basis of the brief dietary advice by the general
      practitioner. On control after dietary advice, a further decrease in cholesterol
      of 15% was observed while low density lipoprotein cholesterol fell by 20% and
      triglycerides by 23%. These decreases must be considered to result mainly from
      the dietary advice. It is concluded that a single but professional session of
      dietary advice in small groups and with involvement of the wives or partners is
      an effective method of treatment in hypercholesterolaemia. If the decrease in
      cholesterol obtained can be maintained, the literature suggests that the risk of
      development of ischaemic heart disease during the subsequent 5-7 years is reduced
      by 20-30%.

PMID- 2238225
TI  - [Measurement of blood cholesterol, decentralized, using a Reflotron, or
      centralized in a laboratory. A comparison].
AB  - In connection with an extensive screening programme for blood cholesterol, the
      cholesterol values in 105 participants were measured on a sample of capillary
      blood employing a Reflotron and, simultaneously, samples of venous blood were
      examined by conventional enzymatic analysis in a laboratory. Whereas the day-to
      day variation and the scatter involved were quite limited in the laboratory, the
      variation scatter between the two methods of measurement was 0.65 mmol/l. This
      figure was, however, no greater than that described between different
      laboratories in USA. Nevertheless, it is an important problem with the Reflotron
      method that even slight deviations from the recommended procedure of withdrawing
      blood involve a systematic risk for erroneously low cholesterol results.

PMID- 2238226
TI  - [Screening for cardiovascular risk factors in a large workplace].
AB  - A screening investigation was carried out in a large industry in the Copenhagen
      region and 1,472 of the employees were offered examination of blood cholesterol
      and measurement of blood pressure. At this examination the employees completed a
      one-page questionnaire about other cardiovascular risk factors. 45% of those
      invited participated in the investigation, the poorest participation was among
      women and the greatest among the male officials. On account of the limited number
      of female employees, the majority of results were only calculated for men. Over
      1/3 of these had hypercholesteremia (greater than or equal to 7.0 mmol/l) and
      nearly 1/3 had, simultaneously, at least two cardiovascular risk factors in
      addition to age and male sex. Extensive occupational investigations under the
      auspices of WHO have demonstrated that energetic intervention at the place of
      work aimed at the cardiovascular risk factors can reduce the risk of development
      of coronary heart disease and death within a six-year follow-up period. It is
      therefore emphasized that similar interventions are very necessary also in
      Denmark.

PMID- 2238227
TI  - [Intensive dietary advice for patients with severe hypercholesterolemia].
AB  - Screening in general practice revealed a total of 124 patients (71 men and 53
      women) with severe hypercholesterolaemia, defined as serum cholesterol levels
      over the 95th percentile for sex and age. The average serum cholesterol was 9.3
      mmol/l with a maximal value of 15.5 mmol/l. On the basis of a dietary history for
      48 hours and a dietetic interview, a dietician undertook a dietary analysis with
      the help of a computer programme (DANKOST) before and after dietary alterations
      for one and three months. The aims were normal body weight, cholesterol intake of
      under 200 mg/day, ratio between saturated and unsaturated fat between 1.0 and 1.8
      and a roughage content of 26-30 g/day. A total of 61 patients completed the
      recommended dietary alterations. Alcohol intake was significantly higher in men
      and constituted more than 8% of the energy intake in 43 patients. Serum
      cholesterol was reduced by a total of 15.3%, triglyceride by nearly 20% while
      high density lipoprotein remained unchanged. The maximal decrease in serum
      cholesterol was 43%. In patients who adhered to the dietary changes, the average
      decrease was over 20%. Patients with hypertension and patients with serum
      cholesterol levels greater than or equal to 9 mmol/l showed greater decreases
      than the group as a whole. On the basis of the dietary interview, it did not
      prove possible to predict which patients would stick to the dietary restrictions.

PMID- 2238228
TI  - [Treatment of severe primary hypercholesterolemia with lovastatin (Mevacor). A
      new therapeutic principle].
AB  - An open clinical trial comprising 59 outpatients with severe hypercholesterolemia
      (including 35 patients with familial hypercholesterolaemia) and considerable
      predisposition to ischaemic cardiac disease revealed a dosage-related pronounced
      effect of lovastatin on serum cholesterol and subfractions of this. After dietary
      regulation for a period of four months, a decrease in serum cholesterol of 11.7%
      was observed and after further treatment for six months with lovastatin with an
      average dose of 59 mg per 24 hours, the serum cholesterol decreased with a total
      of 45% of original value. Low density lipoprotein (LDL)-cholesterol decreased 44%
      and high density lipoprotein (HDL)-cholesterol increased by over 21%. Serum
      triglyceride fell by 20%. The serum-cholesterol/HDL-cholesterol ratio was reduced
      from 8.8 to 4.9. Only slight and transient subjective side-effects were observed
      and none of the patients dropped out of the trial for this reason. One patient
      with recognized ischaemic heart disease died from myocardial infarction. A
      tendency towards increasing liver parameters and creatin kinase was observed in
      the group as a whole but was not significant.

PMID- 2238229
TI  - [Smoking regulations in Danish hospitals].
AB  - An investigation undertaken by the Danish Council on Smoking and Health in July
      1989 concerning smoking rules in Danish hospitals reveals that still fewer
      hospitals or hospital departments permit entirely free smoking. Conditions are,
      however, far from satisfactory everywhere. Smoking is permitted in no less than
      28% of hospital wards in Denmark. In 82% of hospitals or departments, smokers and
      nonsmokers are admitted to the same sickrooms. In one fifth of the Danish
      hospitals, non-smokers risk being admitted to sickrooms where smoking is
      permitted. This is not acceptable. In 2% of hospitals or hospital departments,
      there are no restrictions about smoking for the caring staff. In 27% of hospitals
      or hospital departments, there are no smoking restrictions for the administrative
      staff. Only 2% of hospitals or hospital departments have complete prohibition of
      smoking. Many hospitals or hospital departments have no restrictions concerning
      common areas. This is true for 26% of the waiting rooms, 20% of the elevators,
      30% of the passages and 46% of the lavatories. A total of 2% of hospitals or
      hospital departments have no smoking restrictions for visitors while 14% have
      complete prohibition of smoking for visitors. The goal of smokeless working
      environments for all health staff is recommended.

PMID- 2238230
TI  - [Acceptance of HIV antibody testing among pregnant women].
AB  - During the period April 17-July 14, 1989, 820 pregnant women were offered HIV
      antibody testing at the antenatal clinic, Aarhus Municipality Hospital. Seven
      hundred and seventy-nine (95%) agreed to complete a questionnaire concerning,
      among other things, previous HIV-antibody testing. 20% of the participants had
      been tested previously, half of them because they were blood donors. More than 3%
      had been tested because of self-perceived risk behaviour or a risk environment.
      In three women, the previous test had shown HIV-antibodies to be present, and
      three further women refused to report the test result. 81% of the women consented
      to be tested. Acceptance declined during the project period. Those who had not
      been tested previously consented more frequently than those who had. Students
      were less willing to consent than others. Nineteen out of 20 women (2.6%), who
      considered themselves at high risk, accepted the offer to be tested. Thirty-eight
      (5%) of the 150 women who declined to be tested, would have accepted if their
      general practitioner had suggested it. None of the women tested at present were
      found to be HIV-antibody positive. When the project was terminated, a total of
      87% of the women had been HIV-antibody tested previously or at present. We
      suggest routine HIV surveillance of pregnant women by use of voluntary HIV
      antibody testing in combination with anonymous testing (AUT technique) in case
      the women does not want to know the test result.

PMID- 2238231
TI  - [Biopsy of chorionic villi].

PMID- 2238232
TI  - [Metformin-associated lactic acidosis].

PMID- 2238233
TI  - [Short muscles in children and adolescents in an orthopedic practice].

PMID- 2238234
TI  - [Gastroesophageal reflux and esophagitis].

PMID- 2238235
TI  - [Treatment of postoperative pain].
AB  - Intensive research during recent years concerning treatment of postoperative pain
      has demonstrated that the majority of operation patients can be rendered free
      from pain but that this is far from being the case in clinical practice. This
      article reviews the physiological mechanisms of acute pain and the methods
      available for treatment of pain related to acute physiology of pain.
      Postoperative treatment of pain should be aggressive with the object of
      preventing pain and normalizing the vital functions with the object of reducing
      the perioperative morbidity and mortality. A series of recommendations are given
      for treatment of pain after surgical intervention.

PMID- 2238236
TI  - [Radiographic diagnosis of abdominal manifestations of AIDS].
AB  - Abdominal complications as intercurrent infections and malignancies in AIDS
      patients are one of the principal sources of morbidity and mortality in this
      disease. Air-contrast barium radiography of the gastrointestinal tract and
      computed tomography or sonography of the abdomen is of great clinical value in
      the evaluation of visceral and nodal lesions in AIDS. The diagnosis is impeded by
      the coexistence of several diseases in many of the patients and the
      nonspecificity of the radiographic findings.

PMID- 2238237
TI  - [Risk factors in home accidents among preschool children].
AB  - The present investigation is part of an investigation concerning preschool
      children's accidents at home. A total of 3,011 homes with preschool children were
      examined with the object of reducing the number of accidents involving preschool
      children. Selected risk factors were registered (falls, burns, poisoning)
      responsible for accidents to preschool children in their homes and this
      information was compared with information about the type of housing, district and
      the social status. The investigation revealed that 30% of the homes had
      "dangerous" windows, 30% had taps which could be swung out over free floor space
      and 42% did not have special electric safety main switches. Articles for
      cleaning, medicine and poisons were only stored in locked cupboards in 2.5 and 8%
      of the homes, respectively. These circumstances were more common in flats than in
      one-family homes. No significant differences were found between the physical risk
      factors chosen in the present investigation between the individual social status
      groups. Prevention of children's accidents in the home consists of increased
      information to families with children, to architects and manufacturers and
      increased attention to safety in the home by legislation and guidelines.

PMID- 2238238
TI  - [The cardiovascular risk profile in the Glostrup region, Monica screening II,
      1986/87].
AB  - Information about risk factors and cardiovascular disease was collected from 30,
      40, 50, and 60 year old representatives of the suburban Danish population (n =
      1,504). Reference values for systolic and diastolic blood pressure and total
      serum-cholesterol are given. A comprehensive risk profile is discussed on the
      basis of selected risk factors: arterial hypertension, total serum-cholesterol
      greater than 7.5 mmol/l, smoking of ten cigarettes or more per day, intake of
      five alcoholic drinks or more per day, lack of physical exercise, and body mass
      index greater than 25 kg/m2.

PMID- 2238239
TI  - [Acute admissions to the Psychiatric Children's Hospital, Risskov, during 1
      January 1982-31 December 1987. A retrospective descriptive study].
AB  - During the period concerned, 50 children were admitted as emergencies to the
      Psychiatric Children's Hospital. These were compared with 90 children over the
      age of nine years who were admitted in the ordinary manner during the same
      period. The children admitted as emergencies were aged ten years or more, they
      were older than the control group and the sex distribution was more uniform. The
      emergency admissions were, as a rule, instigated by the parents. Half of the
      families involved had had contact with the Children's Psychiatric Hospital
      previously. The majority of the children in the control group were referred by
      school psychologists. The three most important reasons for emergency admission
      were psychotic symptoms, threats of suicide or attempted suicide and behavioural
      disorders. Nearly half of the children admitted as emergencies were hospitalized
      for less than three months and nearly one third were hospitalized for less than
      one month. Almost all of the children admitted as emergencies and all of the
      children in the control group had had contact with the social supportive agencies
      prior to admission. The recommendations on discharge did not differ essentially
      in the two groups.

PMID- 2238240
TI  - [The Swanson silicone implant for wrists in rheumatoid arthritis].
AB  - The Swanson silastic implant was employed in 16 wrists in 13 patients who were
      followed up for a median of 59 months. At follow up examination, pain had
      decreased in ten wrists while three remained unchanged. Ten patients were
      satisfied with the total result. Only few complications occurred. Prosthetic
      fracture occurred in two wrists (14%). The authors consider that the Swanson
      silastic wrists implant can produce favourable results in patients with
      rheumatoid arthritis with moderate to severe radiological destruction.

PMID- 2238241
TI  - [Genital prolapse and urinary incontinence. A clinical assessment of patients
      with prolapse with particular emphasis on surgical methods and their long-term
      effects].
AB  - A review based on a follow up of 215 patients who had been treated operatively
      for genital prolapse and urinary incontinence after observation for 5-10 year is
      presented. The operation regime was predominantly conventional and the various
      vaginal methods involved 182 patients (80%). The Kelly-Kennedy plastic operation
      (K-K-pl) was employed for stress incontinence and slighter cases of prolapse. In
      more severe degrees of both of these conditions, K-K-pl was combined with the
      Manchester operation. The operative method of election in this department for
      marked cases of utero-vaginal descent was the Manchester operation supplemented
      by colpo-perineal plastic. The most advanced cases of prolapse were treated
      either with the Moschowitz operation or colpocleisis. This investigation revealed
      that the late results of the individual methods at primary operative treatment of
      both prolapse and incontinence showed the same high results of treatment with
      satisfactory results in 75-100%. On the other hand, the results of secondary
      operation showed great variation, depending upon the method, with satisfactory
      results from 25-85%.

PMID- 2238242
TI  - [Accidents with home-made metal-tube fireworks].
AB  - At the turn of the year 1988/89, injuries caused by home-made fireworks were
      treated in the orthopaedic-surgical casualty department. Four accidents are
      described. Construction and use of home-made fireworks are warned against.

PMID- 2238243
TI  - [Evaluation of the catalase reaction as a sign of pus in feces].

PMID- 2238244
TI  - [Hospitals and disaster planning--once more].

PMID- 2238245
TI  - Ultrasonic velocity hydration numbers of polyamines.
AB  - Ultrasonic velocity hydration numbers of diamines, triamines and tetraamines and
      hydrochlorides of these amines were determined by measuring the maximum velocity
      of ultrasound in aqueous-ethanolic solutions. The results are interpreted on the
      basis of the hydrogen-bonded framework model of the water structure.

PMID- 2238246
TI  - Non-contact acoustic method for the simultaneous measurement of thickness and
      acoustic properties of biological tissues.
AB  - The frequency dependence of the magnitude and phase shift of reflected waves from
      a thin tissue specimen has been found to yield characteristic patterns as a
      function of the specimen thickness. By analysis of those characteristic patterns,
      the specimen thickness can be determined so that the attenuation constant and the
      sound speed can be obtained by a non-contact procedure. The method is
      demonstrated in the frequency range 100 MHz to 200 MHz, using a scanning acoustic
      microscope and approximately 10 microns thick myocardial tissue samples of human
      origin, one paraffin embedded.

PMID- 2238247
TI  - Some of the factors involved in the Sarvazyan method for recording ultrasound
      field distributions with special reference to the application of ultrasound in
      physiotherapy.
AB  - The mapping of ultrasound fields using the dye paper method is described. The
      mode of action by which the dye concentration is increased has been investigated.
      Microbubbles on the paper surface and microstreaming of dye solution seem to be
      essential features of the mapping method. The streaming is thought to inhibit the
      formation of a dye depletion layer near the paper to an extent dependent on local
      sound intensity A linear relation between streaming velocity and intensity is
      derived.

PMID- 2238248
TI  - Microbial content of aerosols produced from suspensions exposed to megahertz
      frequency ultrasound.
AB  - A piezo-electric bowl transducer was used to generate aerosols by focusing
      ultrasound in the frequency range 1-7 MHz at a liquid/air interface. Atomization
      at the liquid surface and the production of a fountain contributed to aerosol
      formation. When the liquid consisted of suspensions of representatives from the
      viral, bacterial, and yeast groups of micro-organisms (covering a 0.2-11.5
      microns size range) living organisms were isolated from the aerosols at all
      frequencies. The fountains were implicated as a major source of air-borne micro
      organisms because significant numbers of isolates were obtained in the presence
      of fountains but in the absence of obvious atomization, and theoretical
      predictions make the sizes of droplets arising from atomization at the higher
      frequencies too small to have carried some of the larger organisms.

PMID- 2238250
TI  - Observation of cesarean section scar by transvaginal ultrasonography.
AB  - Transvaginal ultrasonography, with its higher frequency and proximity to the
      pelvic structures has offered us a powerful tool for observing the uterine scar
      of a previous Cesarean section. We have examined 87 previous Cesarean section
      scars by transvaginal ultrasonography. Forty cases (group A) were in the third
      trimester. Fifty-two percent of this group showed normal patterns. In the
      remaining cases, thickening of the previous incision site was the most common
      finding. Also, thinning, ballooning and wedge defect were noted. Forty-seven
      cases (group B) were examined within 3 months (group B1) or after 3 months of
      Cesarean section (group B2). Similarly half of them showed normal patterns. In
      the remaining cases, wedge defect was the most common finding. The others were
      outward or inward protrusions, hematoma formation and inward retraction. An
      evaluation of the previous section scar, preferably by high resolution
      transvaginal ultrasonography is highly recommended in considering a trial of
      labor after previous Cesarean deliveries.

PMID- 2238249
TI  - The assessment of abnormal pelvic blood flow by transvaginal color and pulsed
      Doppler.
AB  - Transvaginal color Doppler was used to analyze a group of 19 healthy, 48
      infertile and 8 postmenopausal women; 67 patients with uterine and 151 patients
      with adnexal masses, and 19 patients with a suspected ectopic pregnancy. The
      ultrasonographer had not been informed of other clinical findings and indications
      for operative treatment. A 5 MHz transvaginal color Doppler probe was used to
      visualize the pelvic anatomy and blood flow. Each arterial blood flow velocity
      was classified into either of two types. In the normal flow pattern, the
      diastolic flow component was absent or small and the value of resistance index
      (RI) was greater than 0.50. In the abnormal flow pattern, a large diastolic flow
      component was evident and the value of RI was less than 0.50. Transvaginal color
      and pulsed Doppler studies in confirmed malignant uterine masses had moderate
      accuracy (90.2%), with a sensitivity (55.6%) and specificity (100%); and in
      confirmed malignant adnexal masses high accuracy (100%), sensitivity (100%) and
      specificity (100%). Comparison of blood flow characteristics within benign and
      malignant tumor tissue revealed less impedance and higher velocity in cases of
      malignancy. Blood flow studies in both uterine arterias have not shown clinically
      important values. This method can be also used in the diagnosis of ectopic
      pregnancy.

PMID- 2238251
TI  - Doppler waveform pulsatility index and resistance, pressure and flow in the
      umbilical placental circulation: an investigation using a mathematical model.
AB  - A mathematical model of the umbilical placental circulation was used to examine
      the effect of different physiological variables on the pulsatility index (PI) of
      the umbilical artery Doppler waveform. The variables include the umbilical and
      placental resistances, the volume flow rate and the pressure. In the model the
      branching structure of the placental villous tree is considered in detail, while
      each arterial branch is itself represented simply using a resistor and a
      capacitor. Placental vascular disease is modelled as obliteration of a fraction
      of the terminal branches of the tree. The model umbilical artery PI depends on
      the ratio of the placental resistance to the umbilical artery resistance. The PI
      increases with vascular disease, but the rate of increase is not uniform.
      Initially, the placental resistance and the PI increase very slowly with vessel
      obliteration. Once the level of vessel obliteration has reached a large enough
      value--typically between 60% and 90% obliteration--the PI begins to rise sharply.
      A larger placental vascular bed can accommodate a greater level of vessel
      obliteration before this rapid PI rise begins. The umbilical artery PI also
      depends on the pulsatility of the input (aortic bifurcation) pressure waveform,
      but blood pressure variations in the physically attainable range cannot account
      for the very high PI values associated with fetal compromise. Physically
      attainable pressure waveform changes would, however, enable the fetus with
      substantial placental vascular disease to maintain umbilical volume flow rate,
      and at the same time exhibit a raised umbilical artery PI value.

PMID- 2238252
TI  - Biological effects of shock waves: effect of shock waves on the liver and
      gallbladder wall of dogs--administration rate dependence.
AB  - The effect of extracoporeal shock waves on the liver and the gallbladder wall was
      compared in two groups of dogs exposed to 1500 shock waves generated in an
      electrohydraulic lithotripter with 15 kV and 80 nF. The waves were focused on the
      gallbladder wall. In the experimental group, a shock wave burst of 10 consecutive
      waves with an interval of 10 ms between the waves was administered each second;
      in the control group, single shocks were released each second. The day following
      shock wave exposure, the dogs were anaesthetized, killed and then dissected. In
      the liver, subcapsular and intraparenchymal focal haemorrhages occurred in the
      high pressure field and venous thrombi in portal veins. There was a
      nonsignificant trend towards an increased number of venous thrombi after burst
      application. The gallbladder wall was haemorrhagic and oedematous, the mucosa was
      ulcerated in the focal area; blood clots were found in nearly all gallbladders.
      No differences were detected between the groups. The free plasma haemoglobin was
      only increased after fast shock wave administration. Increased haemolysis and the
      trend towards an increased number of thrombi favour cavitation as a mechanism of
      shock wave damage. The similar extent of tissue damage suggests that shock wave
      bursts can be applied for gallstone destruction in humans if the major liver
      vessels are kept out of the high pressure field.

PMID- 2238253
TI  - Biological effects of shock waves: cavitation by shock waves in piglet liver.
AB  - Shock waves are known to generate cavitation in vitro. In vivo, extracorporeal
      shock waves may cause haemorrhages in tissues. Two types of changes were detected
      by conventional, real-time B-scan ultrasound when shock waves were administered
      to 5 piglet livers in vivo: transient changes consisting of bright signals in
      intrahepatic branches of the portal vein and tributaries of the hepatic vein,
      presumed to originate from gas bubbles, and stationary changes consisting of
      brightening of the area along the long axis of the high pressure field, presumed
      to indicate an increased number of gas-filled bubbles in this area. Transient
      changes appeared from the start of shock wave administration; bright signals were
      seen in liver vessels for several hundred microseconds before they were flushed
      away with the blood flow. Stationary changes appeared later, increased in
      intensity over several hundred shock waves and persisted for minutes after
      cessation of shock wave administration. Both types of signals were interpreted as
      direct evidence that lithotripter shock waves generated cavitation in vivo.
      Similar signals were received in the partly degassed water of the lithotripter
      tub. At autopsy of the piglets, focal intralobular haemorrhages and thrombi of
      portal veins were detected in the shock wave path. The occurrence of cavitation
      and tissue damage in the same gross area suggests that cavitation might be
      involved in the generation of tissue damage by shock waves.

PMID- 2238254
TI  - A novel method to control P+/P- ratio of the shock wave pulses used in the
      extracorporeal piezoelectric lithotripsy (EPL).
AB  - There is growing evidence that acoustic cavitation plays an important role in
      stone fragmentation during extracorporeal shock wave lithotripsy (ESL) treatment.
      In addition, side effects of the treatment, such as the hemorrhage and
      destruction of the tissue in the vicinity of the stone are also ascribed to
      cavitation phenomenon. Since cavitation is associated with the maximum negative
      pressure in the shock pulse, it would thus appear that possibility of controlling
      this pressure would be desirable in ESL applications. This paper describes a
      novel technique developed to control the ratio of compressional peak (P+) to
      rarefactional peak pressure (P-) of the shock wave for use in lithotripsy
      treatment. The procedure is based on the finite amplitude wave generation by
      focused piezoelectric transducers and subsequent interaction of the shocked waves
      in the common focal region. The highly asymmetrical shock wave is produced in the
      focal region by providing an appropriate time delay to each of the high voltage
      electrical excitation signals which drive the transducers. The degree of relative
      reduction of negative halfcycles and the corresponding positive halfcycles
      amplification increases with the number of the acoustic sources used. The
      practical implementation of the shock wave generator was obtained by using 5 cm
      diameter, focused 1 MHz transmitter, and additional transducers of identical
      construction having frequencies corresponding to the harmonics and subharmonics
      of the 1 MHz frequency. The importance of the results for the future development
      of lithotripters, and stone treatment efficiency is pointed out.

PMID- 2238255
TI  - Temperature elevation generated by a focused Gaussian beam of ultrasound.
AB  - The steady state temperature elevation generated by a focused Gaussian beam,
      including the effect of perfusion, has been calculated along the beam axis. The
      medium is assumed to be a homogeneous absorbing one. The results indicate: (1)
      The temperature rise is an increasing function of the intensity gain of the
      focusing transducer, but never seems to exceed twice that at the interface of the
      transducer and the medium generated by its unfocused counterpart; and (2) The
      temperature rise at the interface of the transducer and the medium is not
      affected significantly by focusing.

PMID- 2238256
TI  - A triangulation method for the quantitative measurement of arterial blood
      velocity magnitude and direction in humans.
AB  - A triangulation method has been applied to a duplex ultrasound scanner to
      quantify blood flow velocities in two dimensions. A position locating system
      (PLS) connected to the scanhead locates the sample volume (SV) in 3-D space to a
      precision of 1 mm. The PLS is used to obtain flow velocity data from two
      independent lines of sight in the human femoral artery. Data are gathered from
      anatomic sites of interest along one line of sight. Later the computer directs
      the SV to interrogate the same points in space from a second line of sight. Water
      tank studies using both constant velocity and pulsatile string targets were used
      to validate the method. Velocity magnitudes could be calculated to within 5%
      error for Doppler angles below 75 degrees for various string depths and speeds;
      the error in Doppler angle calculation was usually less than 3 degrees. Results
      from the superficial femoral artery show flow velocity vectors are nearly
      parallel to the vessel walls. Peak systolic velocity magnitudes range from 63-66
      cm/s in three presumed normal individuals. Following the validation studies
      addressed in this paper, this triangulation approach is intended in future work
      to document the complex nonaxial character of blood flow that occurs normally at
      branch points and in regions of intraluminal disease.

PMID- 2238258
TI  - Source of double Doppler shift in blood flow.

PMID- 2238257
TI  - On the behavior of instantaneous frequency estimators implemented on Doppler flow
      imagers.
AB  - Analytical and experimental results have been used to examine the behavior of the
      "autocorrelator" or instantaneous frequency detector (IFD) applied to color-coded
      Doppler flow mapping. Two effects were studied. The first was the influence of
      noise, as modified by a stationary echo canceler, on the Doppler frequency
      detector. Our theoretical considerations predict that uncorrelated input noise
      signals become partially correlated after cancellation, and bias the response to
      flow signals. This effect was confirmed by experiment. The canceler introduces a
      constant negative bias into the denominator of the algorithm implemented by the
      estimator, thus changing the indicated frequency. The second phenomenon, examined
      through processing computer simulated Doppler signals added to real noise, is
      related to the possible ambiguity, called aliasing, of measurements of the mean
      frequency for wide-band Doppler spectra. We show that aliasing cannot be observed
      with these spectra unless the signal is first processed by a canceler. Thus,
      regions of apparent reversed flow direction on two-dimensional flow images of
      turbulence must usually be due to real reversal of the flow direction.

PMID- 2238259
TI  - Calculation of Vmax incorporating dynamic range and attenuation.

PMID- 2238260
TI  - Doppler angle error due to refraction.

PMID- 2238261
TI  - Doppler or doppler?

PMID- 2238262
TI  - Doppler color flow in echocardiography: analytical and in-vitro investigations of
      the quantitative relationship between orifice flow and color jet dimensions.
AB  - The goal of this investigation was to explore the relationship between orifice
      flow rate and the dimensions of the resulting color jet. Equations were derived
      which describe flow rate as a function of the color jet dimensions, instrument
      characteristics, and a coefficient which represents the unknown velocity profile
      across the jet. Experiments in which fluid was injected at a variety of flow
      rates via an assortment of orifice sizes into a compliant, axisymmetric chamber
      were performed for comparison with the analytical results. During each injection,
      orifice flow rate and color jet dimensions were recorded. The experimental
      results were closely predicted (r = 0.97) by an equation which expresses flow
      rate as a function of the ratio of the color jet area and color jet length, and
      with a coefficient which approximates that of a parabolic velocity profile.

PMID- 2238263
TI  - Doppler ultrasound color flow imaging in the study of breast cancer: preliminary
      findings.
AB  - A prospective study of the Doppler color flow features of 55 proved breast
      cancers was performed. On a three-level scale of low to marked vascularity,
      visual assessment of the color flow images classified 82% of the cancers as
      moderately or markedly vascular (minimal: 14%, moderate: 29%, marked: 53%). Four
      percent of the cancers had no detectable flow. In 29 women, a volume of tissue
      comparable to the cancer was scanned in the contralateral normal breast. Sixty
      nine percent of the normal breasts had moderate or marked vascularity (minimal:
      28%, moderate: 41%, marked: 28%), and 3% were avascular. There was poor
      distinction between normal tissues and cancer which suggests that more sensitive
      Doppler methods than were employed in this study may be needed in order to detect
      the small vessel flow reported to be rather specific for malignancy. The high,
      82%, detection rate of tumor vessels in this study suggests the potential use of
      color flow Doppler for directing more specific but lengthy Doppler procedures.

PMID- 2238264
TI  - Quantitative tissue motion analysis of digitized M-mode images: gestational
      differences of fetal lung.
AB  - Quantitative analysis of transmitted cardiac motion in fetal lung is evaluated by
      applying correlation techniques to digitized M-mode images in 21 patients,
      subdivided into two subgroups by gestational age: (I) 25-30 weeks (11 patients),
      and (II) greater than or equal to 35 weeks (10 patients). The corresponding
      numbers of M-mode images analyzed for each group are 23 and 18, respectively.
      This partition is expected to reflect functionally "immature" and "mature" lungs.
      The estimated maximum mean radial deformation per unit epicardial excursion, (r),
      is calculated from the two-time, spatially averaged correlation function obtained
      between diastolic and systolic M-mode lines. The collective results for each
      subgroup are (r) I = 0.79 +/- 0.11 (sem) and (r) II = 0.62 +/- 0.13 (sem). The
      analysis presented, albeit in a limited population, is indicative of a trend in
      accordance with qualitative observations of Birnholz and Farrell (1985). M-mode
      analysis, as indicated by Adler et al. (1989) is a potentially useful technique
      to quantify such tissue motion.

PMID- 2238265
TI  - The use of a Diasonics DRF400 duplex ultrasound scanner to measure volume flow in
      arterio-venous fistulae in patients undergoing haemodialysis: an analysis of
      measurement uncertainties.
AB  - A pilot study to measure volume flow in arterio-venous fistulae in patients
      undergoing haemodialysis was undertaken to determine the accuracy and precision
      of values obtained using a modern duplex ultrasound scanner. A Diasonics DRF400
      duplex ultrasound scanner was used with a small parts 10 MHz mechanical sector
      probe incorporating a 4.5 MHz Doppler transducer. Volume flow was measured in the
      brachial artery of 13 patients with surgically created arterio-venous fistulae in
      the distal circulation. Volume flow was also measured using a flow phantom in
      which the true volume flow was known. An analysis of the measurements made by the
      duplex scanner was performed to determine the sources of random and systematic
      uncertainty. Repeatability was improved with the probe clamped in position over
      the brachial artery giving a coefficient of variation in repeated measurements of
      volume flow in a patient of +/- 12%. Measured flows ranged from 884-3088 mL min
      1. Comparison with measurements on the flow phantom showed these values from
      patients to be overestimated by 200-600 mL min-1. The values from the phantom
      should therefore be used to calibrate patient measurements. Analysis of
      uncertainties showed that precision was limited by random uncertainties in the
      measurement of vessel diameter and Doppler angle.

PMID- 2238266
TI  - Effects of lithotripter fields on development of chick embryos.
AB  - Chick embryos at 72 h incubation were subjected to three double shock waves from
      a Wolf Model 2137.50 Electrohydraulic Lithotripter. The pressure amplitude at the
      embryo was adjusted by variation of the distance from the source to the embryo.
      After a total of 120 h of incubation, they were assessed for developmental
      abnormalities. Early deaths, delayed deaths and malformations were all
      significantly increased at pressures of 10 MPa with suggestions of possible
      effects at lower pressure levels.

PMID- 2238267
TI  - Biological effects of shock waves: cell disruption, viability, and proliferation
      of L1210 cells exposed to shock waves in vitro.
AB  - L1210 cells were exposed in suspension to shock waves generated with a Dornier
      XL1 lithotripter. After 1000 discharges at 25 kV, the number of nondisrupted
      cells was 15% and the number of trypan blue excluding cells was 7% as compared to
      100% in sham treated controls; the shock-wave effect was more prominent at higher
      voltages and less prominent at higher discharge numbers when compared at similar
      electrical input energies. Overall proliferation of cells which were trypan blue
      negative after exposure exceeded 70% of the proliferation of sham treated
      controls, except after 1000 shocks at 25 kV, where proliferation was reduced to
      42%. The latter reduction in proliferation was found to be due to a reduced
      growth for 24 h after exposure, with a return to normal proliferation during the
      following days. Limiting dilution analysis revealed that the reduced growth was
      mainly due to a transitory increase of the doubling time and not to a reduction
      of the number of proliferating cells. Cell disruption by shock waves was
      completely inhibited by exposing the cells at an elevated pressure of 101
      atmospheres, pointing to the possible involvement of cavitation in the shock wave
      effect.

PMID- 2238268
TI  - Influence of the shock wave application mode on the growth of A-Mel 3 and SSK2
      tumors in vivo.
AB  - We examined the influence of different shock wave application modes with a
      Dornier XL1 electrohydraulic lithotripter on the growth of A-Mel 3 and SSK2
      tumors implanted under the dorsal skin of hamsters or mice. In a basic protocol,
      500 shock waves a day on 4 consecutive days were administered at a discharge rate
      of 100 waves per minute and focused to the tumor center. This did not affect A
      Mel 3 growth. A similar result was obtained with the basic protocol modified to
      1000 shock waves a day and a wave application rate of 100 shock waves per second.
      Growth of A-Mel 3 and SSK2 tumors was significantly delayed, when the basic
      protocol was used, but the 500 shock waves a day were distributed over four
      points at the tumor edges and the tumor center. With the same shock wave
      protocol, lowering the water level over the tumor from 10 cm to 1 cm induced
      temporary regressions of SSK2 tumors. This was not due to the higher energy
      applied to the tumor, since twice the number of shock waves (1000 a day instead
      of 500 a day) was applied at a high water level and did not induce regressions.
      Four consecutive treatments with intervals between treatments shortened to 3 h
      and an additional treatment 12 h later at a low water level completely controlled
      tumor growth in 8 out of 12 SSK2 tumors for more than 150 days. The result showed
      that addition of a reflected wave from the water surface was most important for
      the shock wave effect, and suggested that shock wave devices generating similar
      wave forms should be applied for tumor therapy.

PMID- 2238269
TI  - A simulation of transit time effects in Doppler ultrasound signals.
AB  - A signal model is proposed which can be used to study frequency extraction
      techniques for Doppler ultrasound. The signal is based on the physics of the
      Doppler process and depends on a sliding window used to average a set of
      independent Gaussian random numbers. This window is related to the shape of the
      sample volume for the Doppler pulse and depends on the Doppler angle. Simulation
      results compare favorably with results from flow experiments in terms of the
      variance of the estimated Doppler shift, the shape of the power spectra and the
      behavior of the signals with respect to Burg autoregressive power spectra. A
      potential use of the signal in the study of spectral analysis techniques is
      presented.

PMID- 2238270
TI  - Bioeffects of diagnostic ultrasound on auditory function in the neonatal lamb.

PMID- 2238271
TI  - Shock wave lithotripsy produces large cavitation bubbles.

PMID- 2238272
TI  - [The self-treatment of the hemophiliac at home: "AIDS has come to jeopardize the
      experiences of these remaining years"].

PMID- 2238273
TI  - [Osteoporosis: long-term prevention and future treatment. Interview by Robert
      Henry].

PMID- 2238274
TI  - [Periodic medical examination, update 1989: 4. Electronic surveillance of the
      fetus during labor and prevention of herpes in newborn infants. The Canadian
      Study Group on Periodic Medical Examination].

PMID- 2238276
TI  - [Cholesterol. The more the story advances, the more complicated it becomes.
      Interview by Robert Henry].

PMID- 2238275
TI  - [Acute non-calculus cholecystitis. The Sherbrooke University Hospital Center
      experience 1969-88].
AB  - This paper presents a survey of the experience gathered in the field of acute
      cholecystitis at the Sherbrooke University Hospital from 1969 to 1988. Diagnosis
      of acute cholecystitis in the absence of stone (according to histopathological
      criteria) was made in 26 cases. The relative number of such cases increased over
      the last 10 years of the study. Risk factors together with clinical and
      paraclinical data have been analyzed. Sonography is the diagnostic test of
      choice. Gall-bladder scanning is a useful adjuvant in cases of doubtful or
      negative sonography. Gangrene and/or perforation of the gall-bladder was reported
      in 57.7% of patients. Cholecystectomy was selectively performed in 23 of 24 cases
      when diagnosis was established in vivo. Cholecystectomy and percutaneous drainage
      are discussed.

PMID- 2238277
TI  - [Clinical case. Apropos of a case of precipitated polyuria in a hospital
      setting].

PMID- 2238278
TI  - [1990 classification criteria of fibromyalgia from the American College of
      Rheumatology. Report of the Multicenter Criteria Committee].

PMID- 2238279
TI  - [A 29-year-old patient consults for an abnormal ECG].

PMID- 2238280
TI  - [Otitis: multiple problems of diagnosis and therapy. Antibiotics do not
      themselves alone control therapeutic efficacy. Interview by Robert Henry].

PMID- 2238281
TI  - [Hypertension and the sympathetic nervous system: research to pursue. Interview
      by Robert Henry].

PMID- 2238282
TI  - Transurethral prolapse of a simple ureterocele in a boy: case report.
AB  - Although simple ureteroceles are commonly encountered on urography, transurethal
      prolapse of the ureterocele in a male is an exceedingly rare complication. A
      fourth such case, with graphic, potentially confusing ultrasound and urographic
      findings, is presented and discussed.

PMID- 2238283
TI  - Ultrasound findings in diffuse granulomatous cystitis in chronic granulomatous
      disease of childhood.
AB  - Chronic granulomatous disease (CGD) is a genetically inherited disease of
      childhood, which is characterized by repeated bacterial and/or fungal infections.
      The genitourinary tract is rarely involved. We report a case of CGD with
      involvement of the urinary bladder. Pertinent clinical and sonographic findings
      of this disease are described.

PMID- 2238284
TI  - Hysterographic demonstration of multiple endometrial polyps: case report.
AB  - Endometrial polyps vary in size, shape, location, histology, and number. An
      unusual example of multiple endometrial polyps is reported.

PMID- 2238285
TI  - Bilateral fallopian tubal polyps: radiologic and pathologic correlation.
AB  - A case of bilateral fallopian tube filling defects found on hysterosalpingography
      performed on a patient for infertility work-up is presented. Repeat
      hysterosalpingography performed 4 years later showed no change. Microsurgical
      resection revealed the defects to be fallopian tubal polyps of endometrial
      origin.

PMID- 2238286
TI  - MR evaluation of renal space-occupying lesions: diagnostic criteria.
AB  - In order to assess the ability of magnetic resonance (MR) imaging to distinguish
      simple renal cysts from renal tumors, images from 53 patients with 74 lesions
      were reviewed. MR image characteristics, including signal strength and
      homogeneity for each lesion, were evaluated and compared with the final
      diagnoses. There were 53 cysts and 21 tumors. For 56 lesions (76%), MR allowed
      accurate diagnosis; on T1-weighted images, homogeneous low-intensity lesions were
      always cysts and inhomogeneous medium- or high-intensity lesions were always
      tumors. The remaining 18 lesions (24%) could not be distinguished, and T2
      weighted images failed to improve differential diagnostic ability. In our
      experience, MR imaging allows differentiation of renal cysts and tumors less
      frequently than does computed tomography (CT) or ultrasound (US). MR criteria for
      simple renal cysts and tumors are offered, with the understanding that
      modification may be necessary as experience with these lesions increases.

PMID- 2238287
TI  - Unusual manifestations of renal artery aneurysms.
AB  - Two unusual cases of renal artery aneurysm are presented. The first, a 10.4-cm
      aneurysm, the largest yet reported, manifested as an abdominal mass in an
      otherwise asymptomatic patient. The second was associated with renovascular
      hypertension in a 6-month-old infant, the youngest patient yet reported.

PMID- 2238288
TI  - Embolization of iatrogenic renal hemorrhage following percutaneous nephrostomy.
AB  - Renal bleeding of iatrogenic origin was diagnosed in three patients with massive
      hematuria. Although percutaneous nephrostomy was the initial injury in all cases,
      the angiographic presentation was very variable. All cases were successfully
      managed with arterial embolization, using different techniques. Symptoms
      regressed totally in all patients avoiding surgical intervention.

PMID- 2238289
TI  - Coexistent xanthogranulomatous pyelonephritis and massive replacement lipomatosis
      of the kidney: CT diagnosis.
AB  - Replacement lipomatosis (RPL) is seen in patients in whom renal parenchyma is
      destroyed due to chronic calculous disease and inflammation. The triggering
      mechanism for xanthogranulomatous pyelonephritis (XGP) is also the same. We
      report a case in which RPL and XGP coexist in the same kidney. To our knowledge,
      this coexistence has not been previously reported.

PMID- 2238290
TI  - Splenic abscess arising by direct extension from a perinephric abscess.
AB  - A case of a perinephric abscess invading the spleen in a 25-year-old woman with
      bladder exstrophy is reported. Treatment utilized both percutaneous drainage and
      open surgery. Perinephric abscesses have not been previously reported to extend
      into the spleen.

PMID- 2238291
TI  - Sonographic pseudokidney after nephrectomy.
AB  - When interpreting renal sonograms, one should be aware of the possibility of
      mistaking fat and scarring in the renal fossa for a normal kidney in a patient
      with a history of prior nephrectomy. When in doubt, the ultrasound findings
      should be confirmed with a CT scan.

PMID- 2238292
TI  - Eccentric nephroscopy for the incarcerated nephrostomy.
AB  - Following a percutaneous stone extraction and demonstration of antegrade flow,
      conventional methods of traction and coaxial dilatation failed to allow removal
      of a Stamey-Malecot nephrostomy. An eccentric track was created for nephroscopy.
      Grasping forceps were used to cut the fibrous tissue from the "wings" of the
      nephrostomy tube to allow its easy withdrawal. The combined approach by the
      radiologist and urologist safely overcame the fibrous entrapment.

PMID- 2238293
TI  - Excessive accumulation of normal retroperitoneal fat mimicking a neoplasm:
      urographic/CT correlations.
AB  - Computed tomography (CT) was performed on four patients in whom excretory
      urograms revealed marked displacement of the kidneys and/or ureters. CT in each
      case was remarkable for the presence of excessive accumulation of normal
      retroperitoneal fat and failed to document the existence of a retroperitoneal
      neoplasm, lymphadenopathy, or other pathological mass.

PMID- 2238294
TI  - Application of urologic techniques to nonurinary calculi.

PMID- 2238295
TI  - Radiation therapy of early (stages I and II-A) seminoma of testis after initial
      orchiectomy.
AB  - With initial orchiectomy and radiation therapy, the prognosis of the patients
      with early (Stages I and II-A) testicular seminoma is nearing almost 100 percent.
      Thirty-two patients with Stage I and 13 patients with Stage II-A seminoma of the
      testis were treated with initial orchiectomy. This was followed by estimation
      biochemical markers and radiologic investigations. All the patients with Stage I
      disease received radiotherapy to the ipsilateral pelvic and para-aortic nodes.
      The patients with Stage II-A disease also received radiation therapy to the
      supradiaphragmatic regions. The disease-free survival in both groups of patients
      was found to be 100 percent.

PMID- 2238296
TI  - Management of superficial G2 (pTa and pT1) bladder cancer.
AB  - A total of 143 patients with superficial G2 (pTa, pT1) bladder cancer (48 G2pTa;
      95 G2pT1) presenting between 1970 through 1987 were reviewed. Of 48 patients with
      G2pTa followed for up to eighteen years, G3 recurrence developed only in 1
      (2.0%), and invasive cancer (greater than pT2) developed only in 2 (4.2%). They
      both received radiotherapy and have responded completely. There have been no
      cancer-related deaths. In contrast, in the 95 patients in whom the basement
      membrane had been breached (pT1), higher grade tumor (G3) developed in 11
      (11.5%), and 15 (16%) had recurrences with invasion of muscle (greater than pT2).
      Among these there were 7 (7.3%) cancer-related deaths.

PMID- 2238297
TI  - Whole bladder photodynamic therapy: critical review of present-day technology and
      rationale for development of intravesical laser catheter and monitoring system.
AB  - Present-day whole bladder photodynamic therapy (WBPDT) is cumbersome and time
      consuming because cystoscopic and ultrasonic manipulations are necessary to
      position the light emitter within the bladder. More important, WBPDT is
      inherently unsafe and often ineffective since neither uniform photoirradiation
      nor accurate light dosimetry can be achieved with the techniques employed to
      photoirradiate the bladder wall. The intravesical laser catheter (IVLC)
      eliminates the need for cystoscopy and ultrasonography because passage of the
      treatment fiber into the catheter's central lumen automatically positions its
      light-diffusing tip within the center of the bladder. Use of the IVLC delivery
      system also assures accurate photoirradiation of the bladder wall since inflation
      of the catheter's balloon transforms the asymmetric bladder into a sphere of
      known diameter. The light sensor incorporated in the balloon wall provides a
      method to monitor light fluence and measure total light dose. When provided the
      parameters of bladder volume, laser energy output, and desired light dose, the
      computerized control system calculates treatment time and automatically adjusts
      the period of photoirradiation to compensate for variations in laser light
      production, energy losses during transmission, and for variations in light
      intensity resulting from the integrating sphere effect of the bladder wall. This
      delivery system also increases the safety of WBPDT since the monitor
      automatically discontinues treatment if any unsafe situation, with respect to
      light fluence, develops during photoirradiation.

PMID- 2238298
TI  - Stress incontinence: a new endoscopic approach.
AB  - We describe our experience in using a new endoscopic technique for suspending the
      bladder neck and urethra in 16 patients with stress incontinence. The procedure
      was started by dissecting the retropubic space, first with a sound and then with
      a Foley catheter before passing an absorbable suture from the abdominal fascia to
      the bladder neck using an elbowed needle introduced into the bladder through the
      neck and exteriorized through the urethra. The dissection of the retropubic space
      helped to form postoperative adherences which fixed the bladder neck and the
      urethra firmly to the pubic symphysis. The technique is simple, it does not
      require vaginal surgery, and the incidence of complications is minimal.

PMID- 2238299
TI  - Management of Peyronie disease by implantation of inflatable penile prosthesis.
AB  - Sixty-seven patients with advanced Peyronie disease were treated by implantation
      of an inflatable penile prosthesis (IPP). Twenty-eight of the 67 patients had
      documented total erectile failure. The remaining 39 patients had significant
      penile curvature causing "mechanical impotence" due to inability to achieve
      adequate vaginal penetration and chose implantation of an inflatable penile
      prosthesis (in some cases, combined with a straightening procedure) rather than
      one of the standard penile straightening procedures. Currently, 63 of the 67
      patients have functioning prosthetic devices; in 3 other patients the device was
      removed because of infection, and 1 patient was dissatisfied and had the device
      removed. For impotent patients with severe Peyronie disease for whom other
      medical or surgical treatment is neither desirable nor suitable, we recommend
      implantation of an inflatable penile prosthesis combined with a possible
      straightening procedure.

PMID- 2238300
TI  - Use of distal Thiersch-Duplay urethroplasty for proximal hypospadias repairs in
      conjunction with short island pedicle flap.
AB  - Experience with 8 boys having proximal hypospadias with severe chordee and a
      foreshortened dorsal hooded foreskin is presented. Use of a distal Thiersch
      Duplay tube was incorporated in addition to an island pedicle flap to achieve the
      correct meatal location on the glans. One boy with perineal hypospadias required
      both proximal and distal Thiersch tube with an island flap interposition. Follow
      up of nine months to 3.5 years demonstrated excellent cosmetic and functional
      results with no recurrent chordee or urethral stenosis. The only fistula noted
      developed at the proximal Thiersch tube-island flap anastomosis in the boy with
      perineal hypospadias. Advantages of the aforementioned procedure include
      decreasing the risk of chordee on the basis of a foreshortened island pedicle
      flap, use of vascularized flaps, and completing the procedure in one stage with a
      satisfactory result.

PMID- 2238301
TI  - Radiologic staging of chest in testicular seminoma.
AB  - We investigated the usefulness of chest x-ray (CXR), conventional planar
      tomography (TOM), and computerized axial tomography (CAT) in evaluating patients
      with Stages I and II testicular seminoma. All patients had a CXR, and 22 patients
      had either TOM or CAT as part of initial staging. No occult pulmonary or
      mediastinal nodal disease was found during initial staging, and none of the
      patients manifested recurrence of tumor in these sites as a first event. Review
      of the literature corroborates our finding of a very small thoracic failure rate
      in early stage seminoma. Routine use of CAT or TOM is not indicated in staging
      these patients.

PMID- 2238302
TI  - Urodynamic tests for female geriatric urinary incontinence.
AB  - Most urodynamic tests currently in use in the evaluation of female urinary
      incontinence have not been applied to a community-based sample to determine their
      specificity. In this study of a random sample of noninstitutionalized elderly,
      258 self-reported continent and 198 self-reported incontinent women sixty years
      and older, who participated in a household survey, underwent a clinic evaluation
      (history, physical examination, and urinalysis); of these 67 continent and 100
      incontinent female respondents underwent urodynamic testing. The uroflowmetry,
      cystometry, and supine static urethral pressure profilometry (UPP) findings did
      not differ significantly between continent and incontinent subjects (whether
      based on a self-report or a clinician's diagnosis of urinary continence status).
      Standing static and dynamic UPP and lateral cystography showed significant
      differences between self-reported continent and incontinent respondents. The
      provocative stress test significantly distinguishes continence from incontinence,
      and stress incontinence from other types. The sensitivity of the provocative
      stress test was 39.5 percent, whereas its specificity is 98.5 percent. Urodynamic
      testing including uroflow study, static UPP, and lateral cystography should not
      be used as a screening test but rather selectively as a confirmatory test, and to
      determine the therapeutic approach, and to assess the outcome of therapy.

PMID- 2238303
TI  - Influence of high-energy shock waves and cisplatin on antitumor effect in murine
      bladder cancer.
AB  - The potential application of high-energy shock waves (HESW) for control of
      experimental bladder cancer was investigated. Subcutaneous 3-d murine bladder
      cancer (MBT-2) in C3H mice were exposed to HESW alone (250 to 1,500 shocks) or in
      combination with cisplatin (5 to 10 mg/kg, i.p.). Although HESW alone showed no
      influence on tumor growth, HESW/cisplatin combination therapy suppressed tumor
      growth more than cisplatin alone. Subsequent studies revealed that an air-fluid
      interface relative to tumor location played a pivotal role for the
      chemosensitizing effect of HESW. HESW treatment was able to enhance the cisplatin
      cytotoxicity only when the tumors were placed adjacent to the air-fluid
      interface.

PMID- 2238304
TI  - Oncocytic renal tubular adenoma (so-called oncocytoma) in seventeen-year-old
      girl.
AB  - Renal tubular neoplasms (adenomas or adenocarcinomas) are rare in children or
      young adults. Herein, we report an oncocytic renal tubular adenoma (so-called
      oncocytoma) that was found in a seventeen-year-old girl. Preoperative evaluation
      included aspiration of this tumor, and we suggest that preoperative aspiration is
      an important procedure in the diagnosis and management of suspected renal tumors
      in children and young adults.

PMID- 2238305
TI  - Raz double-prong ligature carrier for transvaginal bladder and bladder neck
      needle suspension.

PMID- 2238306
TI  - Partial resection of symphysis pubis.

PMID- 2238307
TI  - Simplification of double-dye test to diagnose various types of vaginal fistulas.

PMID- 2238308
TI  - Intravesical condyloma acuminatum with progression to verrucous carcinoma.
AB  - Condyloma acuminatum is a common form of venereal disease. Most patients with
      condylomata acuminata suffer from only the local cosmetic and irritative effects
      of the lesions. Few patients have progression to aggressive, regionally
      distributed lesions that can be life-threatening. We describe a forty-three-year
      old white woman who had a seventeen-year history of scleroderma with extravesical
      and intravesical condylomata acuminata. During two years of conservative
      management with transurethral excision, electrocoagulation, and intravesical
      chemotherapy, the disease progressed to involve the entire bladder and resulted
      in obstructive renal insufficiency that required anterior exenteration and
      urinary diversion. The natural history of the disease is described, and the
      relevant literature is reviewed.

PMID- 2238310
TI  - Advances in the management of prostatic diseases. Proceedings of a symposium held
      in conjunction with the annual meeting of the American Urological Association.
      New Orleans, Louisiana, May 15, 1990.

PMID- 2238309
TI  - In treating impotence, urology and sex therapy are complementary.
AB  - Urologists and mental health professionals are neither competitors nor
      adversaries. The principles of sex therapy represent a thoughtful and sensitive
      way to approach patients with almost any clinical problem so that they are more
      comfortable with the recommended tests or treatments. Sex therapy may be very
      helpful as an adjunct in treating "organic" as well as primarily emotional
      erectile dysfunction. We believe that with information we can help build a bridge
      between urologists and mental health professionals.

PMID- 2238311
TI  - Diagnosis and treatment of prostatic infections.
AB  - The diagnosis and management of prostatitis and pelviperineal pain is a challenge
      to the clinician. Careful examination of the prostatic fluid and bacteriologic
      cultures to differentiate bacterial from nonbacterial prostatitis are essential.
      Antimicrobial therapy is effective in the majority of men with acute or chronic
      bacterial prostatitis. Nonbacterial prostatitis is the most common type of
      prostatitis. The etiology is unknown and treatment with repeated antimicrobial
      therapy is ineffective. Alpha-blocking agents may relieve symptomatology.
      Pelviperineal pain may be of prostatic origin but other nonprostatic causes
      should be sought.

PMID- 2238312
TI  - Applications of prostate ultrasonography.
AB  - Transrectal ultrasonography is a relatively new imaging modality that may be
      useful in the evaluation and management of patients with prostate cancer.
      Although cancer may have a characteristic appearance, it cannot always be
      reliably differentiated from benign conditions. While this technique has clinical
      applications in staging, monitoring tumor response to therapy, and assisting in
      biopsy, it is unclear as to whether useful information is obtained in the
      evaluation of patients with palpable disease. The role of transrectal
      ultrasonography in patients with nonpalpable disease or as a screening tool has
      yet to be determined. Other diagnostic tests in conjunction with ultrasound may
      in the future prove to be useful. Carefully performed prospective investigations
      with state-of-the-art equipment are still needed to further define the role of
      this diagnostic modality.

PMID- 2238313
TI  - [Interlamellar refraction keratoplasty with central keratectomy of superficial
      corneal laminae in the correction of aphakia].
AB  - Interlamellar refraction keratoplasty with central keratectomy of superficial
      laminae of the cornea was used to correct aphakia in 15 patients and the results
      followed up for 2.5-7 years. This method permits a simultaneous refraction and
      optic transplantation of the cornea. Corneal refraction was enhanced by 7.2-14.8
      diopters (the mean value 11.03 diopters). The technique is an extraocular one and
      therefore may be widely used for aphakia correction, particularly in cases with
      superficial opacities of the cornea.

PMID- 2238314
TI  - [Surgical correction of astigmatism using kerato-resection methods].
AB  - The authors analyze the results of surgical correction of hypermetropic and mixed
      astigmatism, carried out by two methods: clinoid resection of the cornea and
      clinoid resection of the cornea with tangent autoclinoplasty (i. e. implantation
      of the resected site to the tangent incision in strongly refracting meridian).
      Surgical technique has been mastered in experiments with isolated eyes and the
      mechanism of changes in corneal refraction, resultant from its resection,
      studied. Experiments with rabbit eyes have shown that after corneal resection
      cicatrization is over by the third month after surgery. 17 operations with
      classical clinoid resection and 17 ones with that and tangent clinoid
      autoclinoplasty were carried out in patients with corneal astigmatism of 2.0 to
      6.25 diopters, the follow-up periods being from 6 months to 4 years. The mean
      reduction of astigmatism after the use of the aforesaid methods has made up 2.47
      and 4.8 diopters respectively (according to the data of subjective examination of
      refraction).

PMID- 2238315
TI  - [A new method of scleroplasty in progressive myopia].
AB  - The author analyzes the results of sclera fortification carried out in 154
      patients (220 eyes) with progressive myopia by the method he developed,
      consisting in transplantation of dry solid multilobar perforated transplant of
      silica-dried sclera that retained its natural configuration in the course of
      preservation. The method is simple, safe for the patients, since compression of
      vorticose veins and optic nerve is ruled out, easily tolerated, and yields a high
      stabilizing effect (97 percent) as evidenced by a follow-up of 1.5 do 3 years.

PMID- 2238316
TI  - [Prospects of the use of decompression surgery of the optic nerve in atrophy of
      vascular etiology].
AB  - The technique of decompression surgery on the optic nerve in vascular atrophy has
      been developed. Optic disk staining grew more intensive, visual field widened,
      and vision acuity improved after such surgery. Results of fluorescent angiography
      of the fundus oculi and ultrasonic dopplerography evidence an essential
      improvement of the blood stream in the central retinal artery after the
      operation. The positive effect of surgery persisted over the entire follow-up
      period (8 months). The authors consider that enlargement of the inner diameter of
      the posterior scleral ring permits a more loose disposition of the vessels and
      fibers of the optic nerve in this ring, this being conducive to better
      circulation in the optic disk and retina.

PMID- 2238317
TI  - [Clinical experience with the use of improved-design monolithic intraocular
      lens].
AB  - A monolithic intraocular lens (IOL) design is described, made of with a total
      diameter of 8.5-9.0 mm. This design is intended for intracapsular fixation after
      extracapsular cataract extraction. Sixty operations with implantation of the
      improved monolithic IOL design were carried out in patients with age-associated
      cataracts. No complications were recorded. After surgery vision acuity aided by
      spectacle correction has been 0.5-1.0 diopters in 93.3 percent of patients.

PMID- 2238318
TI  - [Resistance to blindness and frequency-contrast characteristics of the eye with
      artificial lens].
AB  - Contrast sensitivity of vision was examined by the frequency-contrast
      characteristics method (FCC) and vision resistance to glare studies with
      Niktoskop equipment in 48 patients with artiphakia. FCC was estimated from the
      curve shape as well as from the mean threshold contrast in all space frequencies.
      Blindness resistance was assessed from the period of mesopic vision acuity
      recovery (MVAR) up to 0.3 diopters after the glare flash. The group included 28
      patients with iris clips lenses and 20 with posterior-chamber lenses. Patients
      with vision acuity of 0.8-1.0 diopters were referred to the first and those with
      vision acuity of 0.5-0.7 diopters to the second category. The mean threshold
      contrast, whose normal value is 8.0 +/- 0.7 percent, was drastically elevated 3
      months after surgery in all the patients and only in a year normalized in the
      first-category patients with iris clips lenses or posterior-chamber lenses after
      posterior chamber dissection. Blindness resistance of patients with intraocular
      lenses was on the whole worse than in normal eyes: MVAR was by 26.2 +/- 0.7
      percent higher than the normal value and normalized to reach 29.0 +/- 0.6 sec
      only in a year in the first-category patients with posterior-chamber lenses whose
      posterior capsule was not dissected. Therefore, FCC and MVAR values depend on the
      end vision acuity and type of intraocular lens and are on an average better after
      implantation of posterior-chamber lenses and not of iris clips lenses.

PMID- 2238319
TI  - [Ophthalmologic care of patients injured in accidents].
AB  - The authors analyze the results of treatment of patients whose organ of vision
      was injured in accident. They point out a complex of measures promoting a
      relatively favorable optic and cosmetic outcome of injuries and discuss the
      shortcomings of ophthalmologic service. Various aspects of the problem are
      considered to develop practical recommendations on effective care of the injured
      patients.

PMID- 2238320
TI  - [Results of exophthalmometry. Incidence of ciliary-choroid detachment].
AB  - Examinations of 87 patients with different positions of the eyeball in the orbit
      have revealed that if the eyeball sinks even slightly deeper in the orbit than
      normally, collapse of the cornea is observed during cataract extraction and
      ciliary-choroid detachment develops during the postoperative period. If the
      eyeball protrudes forward no corneal collapse or ciliary-choroid detachment
      occur.

PMID- 2238321
TI  - [Results of fluorescence angiography of the iris in surgical treatment of
      recurrent anterior uveitis].
AB  - Seventeen patients (17 eyes) with anterior recurrent uveitis, aged 18 to 58, were
      examined by fluorescent iris angiography before and after surgery, extracapsular
      cataract extraction with vitrectomy. The findings evidence disordered
      microcirculation in the iris in anterior recurrent uveitis. The severity of the
      micro-circulatory shifts depended on the disease standing and the period elapsed
      since the last uveitis recurrence. Surgical treatment of the condition promoted
      recovery of the iris angioarchitectonics and the time parameters of the vascular
      system microcirculation.

PMID- 2238322
TI  - [Use of thrombin in the prevention and arrest of intraocular hemorrhage during
      vitrectomy in traumatic hemophthalmos].
AB  - Thrombin obtained from donor blood plasma was used to achieve hemostasis during
      vitrectomy for traumatic hemophthalmos. Analysis of the results of surgery in 21
      patients and in 28 controls has shown a manifest hemostatic activity of the
      agent. If introduced intravitreally, it induced no local reaction of tissues.
      Thrombin is recommended for clinical application.

PMID- 2238323
TI  - [Histological changes in the tissues of the posterior segment of the eye in
      intravitreal YAG-laser coagulation].

PMID- 2238324
TI  - [Effects of phosphaden on hemodynamics of the eye in patients with post
      thrombotic retinopathy].
AB  - A course of treatment with phosphaden, a rheologic agent, has been administered
      to 33 patients with postthrombotic retinopathy. The treatment resulted in
      improvement of the fundus oculi status and of vision acuity in the majority of
      patients. Rheo-ophthalmography data indicate an improvement of blood supply to
      the eyes after such treatment. The authors claim that ocular hemodynamics
      improvement is related to correction of impaired blood rheology. The findings
      evidence the efficacy of phosphaden in the management of postthrombotic
      retinopathy.

PMID- 2238326
TI  - [Electrophysiological diagnosis in partial optic nerve atrophy syndrome].
AB  - Vision conduction routes were examined in 75 patients with the syndrome of optic
      nerve partial atrophy by recording the visual evoked potentials, threshold of
      electric sensitivity emergence, critical frequency of phosphene disappearance,
      electroretino- and electroneurograms. The findings of these examinations
      correlated best of all with the clinical picture when visual evoked potentials
      (latency increase, decrease of the amplitude with atrophy augmentation,
      interhemispheric asymmetry in chiasmal and retro-chiasmal involvement) or the
      critical frequency of phosphene disappearance (reliably reduced if a disease was
      developing) were recorded. Introduction of electrodes with therapeutic and
      diagnostic purpose permitted assessment of optic nerve function from the
      electroneurogram amplitude and time parameters.

PMID- 2238325
TI  - [Novocaine blockade of the carotid sinus zone in multimodal treatment of optic
      vascular neuropathies].
AB  - Carotid sinus zone blocking with 2 percent procaine solution was used in multiple
      modality treatment of 91 patients with optic vascular neuropathies. Visual
      function improvement was achieved in 85.1 percent of patients. The effect was the
      best in the patients with sector vascular papillitis (91.7 percent) and the
      lowest in sclerotic atrophy of the optic nerve (79.3 percent).

PMID- 2238327
TI  - [Mechanisms of organic drug electrophoresis].
AB  - Riboflavin, riboflavin mononucleotide, and fluorescein penetration from the
      ocular bath without electric current (control), from the anode, from the cathode,
      and without current after preliminary galvanization was studied in rabbit eyes.
      Penetration of organic drugs into intraocular fluid in electrophoresis was found
      to be increased not only from the adequate pole of the active electrode, but from
      the contrary pole as well. Galvanic current sharply abated the barrier function
      of the cornea. Therapeutic electrophoresis of the eyeball permits the use of many
      component solutions with drug ions of different charge.

PMID- 2238328
TI  - [Fluorescein movement in a transparent lens].
AB  - Fluorescein movements in the lens laminae of isolated porcine eyes were examined
      by biomicroscopy. The stain disseminated in two directions: from the lens nucleus
      to capsules and fluorescein release into the intraocular fluid and from the outer
      laminae of the equatorial zone to the nucleus. Lecozyme, a proteolytic agent,
      accelerated fluorescein movement in both directions. The method suggested by the
      authors permits an objective assessment of fluorescein movement in the lens,
      which appears to reflect the processes of extracellular fluid ultrafiltration in
      the lens. The data evidence the possibility of effecting the extracellular
      intralenticular fluid microcirculation by proteolytic enzymes. The suggested
      technique may be useful in studies of cataract pathogenesis and of anticataract
      action of various drugs.

PMID- 2238329
TI  - [Determination of the medium molecular level in the evaluation of the
      effectiveness of quantum hemotherapy in uveitis].
AB  - Estimation of blood serum medium-molecular level is recommended for assessment of
      the therapy efficacy in uveitis patients. Therapy of these patients by UV
      irradiation of the blood with Soviet Izolda MD-73M apparatus is described, that
      proved highly effective: 93 percent of patients were cured and only 5 percent
      developed recurrences. Clinical status of the patients correlated with the blood
      serum medium-molecular level.

PMID- 2238330
TI  - [Laser irradiation: study of general and local mechanisms of its action in
      irradiation of the eyeball. An experimental study. 3].
AB  - Rabbit ocular tissues, brain, and blood were examined before and after
      irradiation of the eyeball with He-Ne laser. Scanning electron microscopy,
      radioimmunoassay, and biochemical methods were employed in the study. The
      findings evidence that irradiation of the eyeball results in reduced lipid
      peroxidation activity and elevated antiradical defense enzymes activity not only
      in ocular tissues but in the corresponding brain hemisphere and blood, which fact
      appears to be due to direct effect of laser radiation on the blood and brain via
      the optic nerve that may be a light conductor for a certain wavelength. Local
      increase of the eyeball corneal permeability in laser irradiation may be
      explained by activation of membrane phospholipases, combined with electrolyte
      shifts; morphologically and functionally it manifests by changed endotheliocyte
      stereotopography.

PMID- 2238331
TI  - [Comparative tonometric and perimetric examinations in open-angle glaucoma].

PMID- 2238332
TI  - [Changes in parameters of the eyeball during the 1st year of life].
AB  - The authors have examined the eyes in a group of healthy full-term infants during
      the first year of life. Anatomic and optic parameters of the eyes of newborns
      aged 2 hrs to 7 days and 1-year-old infants were under study. The data are
      important for ophthalmic surgery of infants of this age group.

PMID- 2238333
TI  - [Ophthalmological aspects of Reiter's disease].
AB  - Clinical picture and course of eye involvement were studied in 254 patients with
      Reiter's disease. Altogether 130 patients suffered from conjunctivitis of varying
      severity, 23 from keratitis, 21 from episcleritis, 20 from uveitis, 2 from
      detachment of the retina, and 5 from secondary glaucoma. Chlamydia were detected
      in one third of conjunctivitis patients in scrapings off the conjunctiva. The
      eyes may be accidentally infected by agents from the urogenital organs if the
      patient does not observe the hygienic rules. Uveitis developed as a rule after a
      prolonged course of Reiter's disease. They were resistant to antichlamydial
      therapy because of autoimmune factors that underlay the condition pathogenesis.
      Deposits of immune complexes on antigens of ocular vascular coating were detected
      with the use of monospecific antiglobulin sera in 7 of 10 patients with active
      uveitis symptoms. The risk of Reiter's disease development in HLA B27 carriers is
      27.17 times higher than the mean incidence of this disease in the population. HLA
      A9 and B40 antigen combinations occurred 7 times more often in uveitis patients
      than in reference subjects, A1 and B27 combinations were 4-5 times more incident.

PMID- 2238334
TI  - [Amyloidosis of fundus oculi tissues in senile maculopathy (a clinico
      morphological study)].
AB  - The authors analyze the findings of clinical and morphologic studies of the
      pathologic changes in fundus oculi tissues of 3 patients who died with senile
      macular dystrophy, examined in life time by ophthalmoscopic technique with
      transformed light. The sclera, vascular coating, retina, macula retinae, optic
      nerve region were thoroughly studied with the use of review histological,
      histochemical methods, selective test for amyloid, thiazine red fluorescent
      histochemical method, and thioflavin T fluorescence. In 2 of the 3 cases amyloid
      degeneration in the presence of amyloid deposits in choroid vessels, arterial
      plexus vessels round the optic nerve presence of amyloid deposits in choroid
      vessels, arterial plexus vessels round the optic nerve orifice, in Bruch's
      membrane and in the sclera. Retinal vessels, optic nerve and its coatings were
      intact. Further investigations are to follow.

PMID- 2238336
TI  - [A case of progressive facial hemiatrophy].

PMID- 2238337
TI  - [Case of anaerobic infection in penetrating injury of the eye].
AB  - A patient with penetrating wound of the eye is described, whose wound has been
      contaminated with anaerobic infection. Clinical picture of anaerobic
      panophthalmitis has been rather typical, with the infection penetrating into soft
      tissues of the orbit. Evisceration of the eyeball was performed. Multiple
      modality treatment was carried out. The infectious process has not progressed
      beyond the orbit. The diagnosis has been confirmed bacteriologically.

PMID- 2238335
TI  - [Syndrome of the superior oblique muscle rigidity: clinico-anatomical aspects and
      results of treatment of 8 patients].
AB  - Tenectomy of the superior oblique muscle resulted in complete disappearance of
      Brown's syndrome in 7 out of 8 children operated on. In view of this, it can be a
      method of choice in treatment of the syndrome. There was the first clinical case
      of an additional abnormal attachment of the superior oblique muscle tendon to the
      sclera. In another patient an abnormal marked vascularization of the tendon
      identified histologically had the appearance of a muscular structure at the site
      of the tendon seen at the operation.

PMID- 2238338
TI  - [Syphilitic lesions of the organ of vision (review)].

PMID- 2238340
TI  - [Characteristics of vestibulo-ocular interaction in patients with unilateral
      lesion of the peripheral part of the vestibular system. Mechanisms of inhibition
      of the vestibulo-ocular reflex (report 2)].
AB  - This paper gives a description of the mechanisms of inhibition of the vestibulo
      ocular reflex by the gaze mechanisms in patients with unilateral lesion of
      peripheral compartments of the vestibular system at the stage of decompensation
      and subcompensation.

PMID- 2238339
TI  - [Results of combined use of taufon and timolol in the treatment of patients with
      open-angle glaucoma].
AB  - The effect of taufon and timolol maleate combination on intraocular pressure and
      ocular hemodynamics was studied in 44 patients (63 eyes) with primary open-angle
      glaucoma. Combined administration of these agents elevated almost twofold the
      fluid discharge efficacy coefficient and normalized Becker's coefficient in 68.6
      percent of patients. The patients were followed up for 8 weeks. Taufon addition
      to timolol modified the action of this latter drug, normalizing the ocular
      hemodynamics.

PMID- 2238341
TI  - [Comparative analysis of the variants of experimental intra-aural
      pharmacophysical intervention].
AB  - The permeability of the blood-brain barrier of rabbits was measured in response
      to different methods of endaural pharmacophysical intervention and intravenous
      injection of radioactive DL (2,3-3H2) leucine. The concentration of labelled
      leucine was measured in the inner ear fluids. The experiments were performed
      using 28 rabbits. The maximum amount of the drug entered the labyrinth as a
      result of endaural superphonoelectrophoresis. In this case the positive effect
      was reached after a smaller number of therapeutic sessions. This method is
      recommended for clinical treatment of cochleovestibular lesions.

PMID- 2238342
TI  - [New symptom in early diagnosis of bilateral acoustic neuroma].
AB  - Eleven patients were admitted to the hospital with the diagnosis of unilateral
      tumor of the vestibulocochlear nerve at the stage of clinical manifestations or
      at a well advanced stage. Their otoneurological examinations revealed a
      microtumor at the side opposite to the major tumor node. Of great diagnostic
      importance were vestibulometric data which showed lack of vestibular excitation
      on both sides: in some cases it was not recorded during caloric tests while in
      other cases it was not recorded during caloric or rotation tests. In view of the
      lack of the vestibular response on the "healthy" side, it was supposed that there
      was a microtumor there. In all cases this diagnosis was confirmed either by
      computer tomography or by CT and surgery. This symptom can be very helpful for an
      early detection of a microtumor or the vestibulocochlear nerve on the side
      opposite to the major tumor node. It is emphasized that special attention should
      be given to arm displacement, during caloric tests.

PMID- 2238343
TI  - [Neurosensory hearing loss in children with acute and chronic otitis media
      diagnosed by the measurement of short-latency auditory evoked potentials].
AB  - The sensory component of acute otitis media, especially in children, has been
      poorly studied. In order to identify the importance of ERA for the diagnosis of
      the neurosensory component of hypoacusis associated with acute otitis media, we
      examined 56 children. In all the patients ERA were recorded, and in children over
      3 years old tonal audiometry was performed. Comparison of ERA and audiographic
      data showed that in some cases ERA was helpful to reveal the sensory component of
      impaired hearing which was not seen audiographically. This allowed detection of
      preclinical stages of perceptive disorders. It is concluded that in young
      children (younger than 3 years) ERA can help to measure the level of conductive
      hearing impairment as well as to detect inflammatory changes in the inner ear
      structures.

PMID- 2238344
TI  - [Otogenic and rhinogenic brain abscesses in children].
AB  - Otogenic and rhinogenic abscesses of the brain in children (25 cases) constitute
      4.4% of neurosurgical pathologies and 26.9% of all brain abscesses in children.
      Rhinogenic abscesses (10 cases) were located in the frontal lobes and otogenic
      abscesses (15 cases) were found supra- or subtentorially. It is difficult to
      diagnose brain abscesses in children. In this respect computer tomography is very
      valuable. All the above patients underwent surgical intervention, which included
      such methods as aspiration, drainage and block removal. The lethality rate was
      36%, although during the last 5 years (9 cases) no lethal cases were recorded.

PMID- 2238345
TI  - [An automated thermographic complex: new possibilities of the diagnosis of ORL
      disease].
AB  - The Kiev Research Institute of Otorhinolaryngology has built an automatic
      diagnostic system that includes a Raduga thermograph and a CM-1403 computer. The
      diagnostic algorithms are based on the thermosemiotics of ENT inflammatory
      diseases developed by the authors. The advantages of the system are: production
      of a hard copy of thermograms, registration and long storage of information,
      mathematical treatment of thermal images, data base and rapid search for the
      thermogram needed, screening diagnosis based on the "healthy-sick" principle.

PMID- 2238346
TI  - [Effect of the functional state of the eustachian tube on the sanative process
      after ear surgery].
AB  - After radical operation 40 patients, who showed exacerbation of chronic purulent
      otitis media, were treated for problems of the Eustachian tube. All the patients
      showed granular salpingitis. The patients were subdivided into two groups with
      respect to the therapeutic method used: 1) in 18 patients, a punctured bougie
      catheter was inserted into the Eustachian tube. The catheter was used to wash the
      tube with antiseptics (dioxydin, balyse-2, microcide) and to blow oxygen for 20
      min; 2) in 22 patients, the permeability of the Eustachian tube was restored by
      bougieurage; then an antibiotic ointment was administered and, after purulent
      discharge stopped, solcoseryl ointment was placed. It was concluded that the
      incidence of exacerbations of chronic purulent otitis media after radical
      operation decreased, when the Eustachian tube underwent specific therapy.

PMID- 2238347
TI  - [Ultrasonic ethmoidotomy combined with intracavitary magnetotherapy in chronic
      polypous ethmoiditis].
AB  - The efficacy of ultrasonic ethmoidectomy combined with magnetic therapy was
      investigated in 90 patients. Ultrasonic ethmoidectomy was applied with the help
      of a LORA system consisting of a generator and an acoustic unit connected to a
      waveguide with a spoon-shaped end (44 Hz frequency and 35-40 microns amplitude).
      Under visual control the ultrasonic spoon was inserted into the meatus nasi
      medius, and the injured medial, superior and some anterior cells of the ethmoidal
      bone were opened. Bone trabecules of the cells were removed together with the
      polypous mucous membrane and polyps, by moving the concave surface forwards and
      keeping the long axis of the bent portion of the spoon in the vertical position.
      Follow-up of the treated patients during 6 months to 4 years revealed the absence
      of polyps in 79.7%. Repeated application of this treatment in the case of severe
      recurrent forms of polypous ethmoiditis improved the therapeutic efficacy.

PMID- 2238348
TI  - [Study of the changes in microcirculatory bed in children with vasomotor rhinitis
      based on biomicroscopy of conjunctival blood vessels].
AB  - Thirty-eight patients with vasomotor rhinitis, aged 6 to 15 years, were examined
      by means of biomicroscopy of eyeball conjunctiva vessels. As a result, the
      following microcirculatory disorders were detected: vessel enlargement, diameter
      nonuniformity, pathological convolution and red blood cell aggregation. Patients
      with allergic lesions showed most significant structural changes. The prevalence
      of functional changes over structural ones in the eyeball conjunctiva of children
      with neurogenic vasomotor rhinitis can be used as a differential diagnostic
      indicator.

PMID- 2238349
TI  - [Hyperbaric oxygenation in the postoperative treatment of children with
      cicatricial laryngostenosis].
AB  - Hyperbaric oxygenation (HBO) was used in the combined treatment of 20 children,
      aged 2 to 14 years, after reconstructive surgery of the larynx. All the patients
      had been exposed to tracheostomy. As a result, optimal regimens of compression
      and decompression of operated children were developed which were 0.025 ata/min
      and 0.04 ata/min, respectively. HBO was most effective when whole-body and
      regional hypoxia was applied simultaneously. The optimal pressure in an altitude
      chamber was 0.9 to 1.0 ata for as long as 40 to 50 min. HBO made it possible to
      shorten the degenerative-inflammatory process. Positive changes in pH of the
      wound were regarded as an indication of reductive aerobic metabolism there.

PMID- 2238350
TI  - [Various aspects of endonasal corrective surgery].
AB  - This paper discusses the results of 649 rhinoseptoplastic and 139
      rhinoconchoplastic operations performed according to modified methods of Killian
      and Cottle. The surgical intervention led to the following complications: 1)
      deformation of the nasal septum in the vestibule area (11 patients); 2)
      perforation of the nasal septum of atrophic origin (15 patients); 3) saddle-like
      deformation of external nose (7 patients); 4) vibration of the nasal septum which
      occurred in most patients after total resection of the cartilage and vomer. The
      author elaborated methods of plastic operations of: the vestibule of the nose in
      order to prevent its postoperative deformation, the vomerine zone in order to
      preserve intraosseous vessels in the foramen incisivum area, the ridge of the
      nose in order to avoid the saddle-like nose, and implantation of the zigzag
      cartilage graft in order to prevent vibration of the nasal septum. Analysis of
      the rhinoconchoplastic operations allowed the author to propose medial
      positioning of the nasal concha in the case of hypotrophic rhinitis and
      implantation of autocartilage into the nasal concha in order to enlarge it in the
      case of hypotrophy.

PMID- 2238351
TI  - [Combined treatment of stage III laryngeal cancer with different schedules of
      radiotherapy and surgery. Evaluation of preventive methods of the treatment of
      regional areas (cooperative randomized study)].
AB  - In 1980-1987, a cooperative randomized study of 363 patients with stage III
      laryngeal cancer (T1-3N0-1M0) was carried out. In 249 patients tumor was located
      in the vestibular space and in 114 in the vocal cord area; 78.5% of the patients
      had no regional metastases (N0) and 21.5% had metastases (N1). Combined therapy
      was applied to 251 patients, 135 of which were first exposed to radiotherapy and
      then to surgery and 116 were first exposed to surgery and then radiotherapy. In
      71 patients, regional zones underwent preventive treatment (in 24 patients
      elective radiotherapy and in 47 preventive removal of the cervical fat were
      used). In 112 patients, the therapeutic protocol was modified due to different
      reasons (69 patients underwent only surgery and 43 radical radiotherapy). The
      therapeutic results were assessed in terms of three parameters: incidence of
      relapses and regional metastases, relapse-free time, and survival. This approach
      revealed no significant differences in the efficacy of the different protocols of
      the combined treatment. The 5-year survival rate of the patients with vestibular
      and cord space tumor was 77.9% and 80.7% respectively, when treated according to
      the radiotherapy + surgery protocol, and 82.8% and 89.2%, respectively, when
      treated according to the surgery + radiotherapy protocol. Comparison of
      preventive approaches showed that the 5-year survival rate increased by 92% as a
      result of removal of the subcutaneous fat from the neck area.

PMID- 2238352
TI  - [Clinico-morphological substantiation of the selection of optimal variants of
      therapeutic tactics in non-epithelial tumors of the nasal cavity and paranasal
      sinuses].
AB  - Out of 227 cases of nonepithelial tumors of the nasal cavity and paranasal
      sinuses, 147 patients with benign neoplasms had a good prognosis while 80
      patients with malignant neoplasms had a poor prognosis. The efficacy of their
      therapy can be enhanced on the basis of a differential approach, measurement of
      tissue radiosensitivity and adequate surgical intervention.

PMID- 2238353
TI  - [Clinico-morphological characteristics of esthesioneuroblastoma with extensive
      dissemination of the neoplastic process].
AB  - Eight disseminated esthesioblastomas were investigated. The specific features of
      these cases were: prolonged development of the disease prior to correct diagnosis
      (up to 2 years), tumor dissemination outside the nose and paranasal sinuses, and
      mixed morphological changes indicating various tumor types.

PMID- 2238354
TI  - [Methodological principles of otorhinolaryngological ambulatory examinations and
      medical rehabilitation of workers exposed to intensive occupational noise and air
      pollutants].
AB  - This paper presents principles of otorhinolaryngological mass-scale examination
      of industrial workers exposed to noise and dust. They require not only early
      detection of pathologies of the hearing organ and upper airways but also
      assessment of the health status of each person and identification of groups at
      risk. Dynamic observation over healthy and sick subjects as well as proper
      application of prophylactic and therapeutic measures helps maintain good health
      and high performance of industrial workers.

PMID- 2238355
TI  - [Otomycoses in the Kuznetsk region and organization of medical services for this
      group of population].
AB  - In the Kuzbass region the author examined 238 patients, aged 15 to 80 years, with
      persistent otitis or inflammatory pathologies of the ears that could not be cured
      by routine therapy. As a result, in 90 patients (37.8%) otomycosis was diagnosed.
      Mycosis of the external acoustic meatus was identified in 43 patients (55 mycotic
      ears or 52.4%), fungal otitis media was found in 21 patients (22 ears or 20.9%),
      and mycosis of the postoperative cavity was detected in 26 patients (28 mycotic
      cavities or 26.7%). The following fungi occurred most frequently: Aspergillus
      niger (75.2%), Candida albicans (6.7%), and Penicillium flavum March (3.8%). In
      the presence of fungi the bacterial growth was less significant, thus indicating
      the predominant role of fungi during otomycosis. Nitrofungin and clotrimazol in
      combination with 1% decamine ointment were effectively used in the treatment. A
      good antipruritic drug was 7% chloracetophose ointment. Out of 90 patients
      complete regression was recorded in 84 cases, with 6 patients having relapses.

PMID- 2238356
TI  - [Hereditary deafness associated with eye pathology].

PMID- 2238357
TI  - [Parapharyngeal abscess in a child].

PMID- 2238358
TI  - [Foreign body of the maxillary sinus].

PMID- 2238359
TI  - [Osteoma of the maxillary sinus].

PMID- 2238360
TI  - [Suppurative sphenoiditis complicated by thrombophlebitis of the cavernous sinus
      and meningitis in a pregnant woman].

PMID- 2238361
TI  - [Modification of the lighting system of Mezrin's bronchoesophagoscope].

PMID- 2238362
TI  - [A device for applying sutures].

PMID- 2238363
TI  - [Report on the activities of the All-Union Scientific Society of
      Otolaryngologists 1988].

PMID- 2238364
TI  - [History of the M.F. Vladimirskii Otorhinolaryngological Clinic of the Moscow
      Scientific Institute of Clinical Research (the pre-war period)].

PMID- 2238365
TI  - [Short-latency auditory evoked potentials in patients with acoustic neuroma and
      relatively normal hearing].
AB  - Out of 37 patients with verified neurinoma of the vestibulocochlear nerve 11 had
      essentially normal hearing and showed significant disorders of BERA (of the
      scissors type). This proved high sensitivity of computer audiometry (CA) applied
      to examine patients suspected for retrocochlear lesions. It is recommended to use
      CA when examining patients complaining of unilateral hearing impairment in order
      to rule out neurinoma of the 8th cranial nerve, especially at its early stage.

PMID- 2238366
TI  - Introduction to endoscopy.
AB  - Endoscopy is an area of rapidly growing interest within veterinary medicine. This
      is understandable, because it is a relatively noninvasive procedure in which a
      tremendous amount of diagnostic data may be obtained. The purpose of this article
      is to introduce the novice to the equipment and potential uses of endoscopy.

PMID- 2238367
TI  - Veterinary endoscopy.

PMID- 2238368
TI  - Upper gastrointestinal endoscopy.
AB  - Upper GI endoscopy is a frequently performed endoscopic procedure that is
      particularly suited for the diagnosis of upper GI diseases with a luminal or
      mucosal location. Contraindications are few and complications are rare.
      Procedures that can be performed during upper GI endoscopy include mucosal
      biopsy, brush cytology, aspiration of duodenal fluid for culture and cytology,
      foreign body retrieval, bougienage of strictures, and endoscopic placement of
      gastrostomy tubes. Unresolved issues that face veterinary endoscopists include
      the interrelationship between contrast radiology and endoscopy, the advisability
      of routine combination of upper and lower GI endoscopy, the reasons for
      discordance among clinical signs, endoscopic appearance, and biopsy findings, and
      the role of post-treatment biopsies.

PMID- 2238369
TI  - Endoscopy of the lower gastrointestinal tract.
AB  - Colonoscopy is an extremely valuable diagnostic technique. It allows the
      veterinarian to visualize the lower gastrointestinal tract and obtain tissue for
      a definitive diagnosis with a noninvasive approach. This article reviews the
      indications, contraindications, instrumentation, and technique of endoscopy of
      the lower gastrointestinal tract.

PMID- 2238370
TI  - Rhinoscopy.
AB  - This article presents a diagnostic protocol for nasal disease evaluation that
      provides consistent success in diagnosis of chronic cases. The protocol includes
      history, physical examination, blood clinical pathology assessment, radiographs,
      culture and sensitivity tests, rhinoscopy, histopathology, fungal serology, and
      allergy screening. The sequence of diagnostic procedures and their techniques are
      discussed, and rhinoscopic appearance of the normal nasal cavity is presented,
      along with findings of commonly seen nasal diseases, including neoplasia, mycotic
      rhinitis and sinusitis, foreign body obstruction, dental disease, allergic
      rhinitis, bacterial rhinitis, and idiopathic rhinitis. Rhinoscopy is a highly
      effective diagnostic technique with minimal morbidity and mortality that has
      virtually eliminated the need for exploratory rhinotomy.

PMID- 2238371
TI  - Laryngoscopy.
AB  - The larynx normally functions in vocalization, deglutition, and respiration.
      There is no substitute for direct laryngoscopy in animals suspected of having
      laryngeal disease. Clinical signs that should alert the veterinarian include
      cough, choking while eating or drinking, exertional cyanosis and syncope, noisy
      breathing, inspiratory dyspnea, stridor, and significant change in sound
      production. Controlled anesthesia is mandatory for animals with suspected
      laryngeal disease because many of these patients have compromised respiratory
      function. Laryngoscopy is used to note abnormalities in the shape, color, and
      motility of the larynx with special attention to correlating the movement of the
      arytenoid cartilages and vocal folds with the respiratory cycle.

PMID- 2238372
TI  - Tracheobronchoscopy.
AB  - Fiberoptic tracheobronchoscopy is a safe and rewarding technique for the
      diagnosis and management of a wide spectrum of respiratory tract diseases. A
      nomenclature system has recently been developed that allows the systematic
      identification of canine endobronchial anatomy during bronchoscopy. This system
      results in an improved ability to communicate bronchoscopic findings and provides
      a basis for performing a thorough bronchoscopic examination. Complications of
      tracheobronchoscopy are uncommon, but patients must be carefully monitored during
      the procedure because complications may be severe and life-threatening when they
      occur. Special techniques enhance the diagnostic spectrum of bronchoscopy and
      include brush cytology, forceps biopsy, bacterial culture, transbronchial lung
      biopsy, transbronchial needle aspiration, and bronchoalveolar lavage.

PMID- 2238373
TI  - Cystoscopy.
AB  - Cystoscopy is a diagnostic and therapeutic procedure commonly employed in human
      medicine but that has received limited application in small animal practice.
      Readily applicable, cost-effective instruments are available for use in the dog
      and cat. The urethral opening, urethra, bladder, and ureteral openings can be
      effectively assessed, and samples can be collected for histopathology, cultures,
      and stone analysis. Cystoscopy is indicated for assessment of chronic cystitis,
      hematuria, tenesmus, increased frequency of urination, urinary incontinence,
      alteration of urinary stream, trauma, and cystic and urethral calculi. Most cases
      can be evaluated transurethrally; the rest can be assessed by prepubic
      percutaneous cystoscopy.

PMID- 2238374
TI  - Thoracoscopy.
AB  - This article presents endoscopic evaluation of the pleural cavity, or
      thoracoscopy, an effective diagnostic technique that can be employed to provide
      additional diagnostic information in cases of intrathoracic disease. The
      techniques of thoracoscopy are described, and normal and abnormal findings are
      discussed. Thoracoscopy allows visual examination of the pleural space and
      surrounding structures without surgical exploration. The stress, expense,
      morbidity, and mortality of thoracoscopy are far less than those of thoracotomy.
      Disease for which thoracoscopy has been employed diagnostically include primary
      and metastatic neoplasia, hilar lymphadenopathy, pericardial effusion,
      spontaneous pneumothorax, and diaphragmatic hernia. Therapeutically, thoracoscopy
      has been used for drainage of pericardial effusion.

PMID- 2238375
TI  - Avian endoscopy.
AB  - Endoscopic techniques in birds provide invaluable information on the medical care
      and husbandry of avian species. The instruments required to perform these
      examinations have been adapted from human arthroscopic instruments. With the
      advances in avian anesthetic techniques, endoscopic techniques can be readily and
      successfully applied to the avian patient in a general practice setting.

PMID- 2238376
TI  - The future of veterinary endoscopy.
AB  - The developing areas of video endoscopy, endoscopic ultrasonography, and small
      bowel endoscopy are discussed in this article, and new endoscopic approaches to
      strictures and bleeding lesions of the gastrointestinal tract are presented. The
      potential applications of these techniques in veterinary medicine are left to the
      imagination of the reader.

PMID- 2238377
TI  - [The adenohypophyseal response and effect of GnRh (Dirigestran inj. Spofa)
      administration in cows in the postpartum period].
AB  - Radioimmunological investigation (RIA) of the level of pituitary FSH in the
      peripheral blood of cows after parturition demonstrated that this level increased
      successively. The FSH value of 32.93 +/- 3.71 ng per 1 ml, recorded the fourth to
      sixth day post partum, increased to as much as 57.78 +/- 40.98 ng per 1 ml 40
      days after parturition. The LH level changed only slightly over the same period
      (from 1.12 +/- 0.21 ng per ml to 1.72 +/- 1.15 ng per ml). The concentration of
      progesterone in the blood of the cows was about 0.40 ng per ml during the first
      15 days after parturition, but from the 25th day post partum it trebled, on an
      average (1.53 +/- 1.19 - 1.59 +/- 1.25 ng per ml). The response of the
      adenohypophysis of the cows to the administration of 200 micrograms of synthetic
      gonadoreline (spec. Dirigestran inj. Spofa) increased with increasing length of
      time from parturition. FSH concentration increased less markedly during the first
      28 days p.p. and this increase was not uniform in time (the average increase was
      1.5 to three times); in the later period the highest increase 300-500% was
      recorded, as a rule, 120 minutes after GnRH administration. The situation was
      similar in the increase in LH concentration in peripheral blood, but after the
      26th day post partum the average increase in LH accounted for 500 to 600%. The
      concentration of progesterone in peripheral blood increased by more than 300%, on
      an average, from the 25th day after parturition. This testifies to the first post
      partum ovulation and to the formation of a new yellow body in the majority of
      cows under study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238378
TI  - [Morphological changes and sperm decapitation as a cause of fertility disorders
      in breeding stock].
AB  - Decapitation of spermatozoa was recorded in a young boar as a consequence of
      epididymitis and in a young dog (mastiff) and a young bull (Brown Swiss breed) as
      a congenital cause of the subfertility and sterility of the affected animal.
      Decapitation of spermatozoa as a consequence of an inflammation led to the
      sterility of the breeding male and affected 52 to 68% of the spermatozoa. The
      motility of the spermatozoa was reduced considerably (10 to 20%) and the flagella
      were not observed to move without the heads. In cases of congenital decapitation
      of spermatozoa, sperm motility in the dog and bull was reduced, but the flagella
      were observed to move without the heads. Decapitation affected 15 to 42% of the
      spermatozoa and most frequently it was accompanied by a narrowing of head base
      and by the presence of a protoplasmic drop, located proximally. Further
      developmental changes, affecting the flagella of the sperms, were observed in the
      dog. The mentioned morphological changes led to infertility in the dog and to a
      substantial reduction of fertility in the bull. After natural mating of the bull
      with a superovulated cow, the ten eggs obtained included four blastocysts, two
      were degenerated, and four were unfertilized.

PMID- 2238379
TI  - [Quantitative micromorphological study of the ovaries in sheep after estrus
      synchronization and superovulation in the autumn mating season].
AB  - The quantitative micromorphological changes of tertiary follicles and corpora
      lutea (CL) were studied in ewes in the autumn mating season after oestrus
      synchronization, induced by administration of PGF2 alpha (Oestrophan Spofa) at a
      rate of 125 micrograms, and after superovulation, induced by administration of
      PMSG (Antex Leo, Denmark) at a rate of 1000 I. U., or PMSG at rates of 750 and
      1000 I. U. together with 50,000 I. U. vitamin A (Axerophthol Spofa). The highest
      number of ovulations was obtained in ewes treated with 1000 I. U. together with
      vitamin A (3.4 +/- 3.0) and after administration of 1000 I. U. PMSG alone (2.6 +/
      2.74). The highest number of tertiary follicles was recorded in ewes after
      administration of PGF2 alpha. The proportion of tertiary atretic follicles was
      the highest in ewes after administration of PMSG (64.6%). The occurrence of the
      luteinizing form of atresia was recorded only in ewes treated with PMSG (4% of
      the total number of atretic follicles). Using the caryometric analysis of the
      luteal cells of corpora lutea, the ewes of the experimental groups had two-peak
      variation curves; this corresponds to the theory of the presence of two luteal
      types in the tissue of the corpus luteum in ewes. As determined morphometrically,
      the smallest proportion of connective tissue out of the total volume of ewes'
      ovaries was found after administration of 1000 I. U. PMSG together with vitamin
      A. Administration of vitamin A together with PMSG had a favourable influence on
      the over-all follicular response, on the average number of ovulations, and on the
      proportion of non-atretic follicles.

PMID- 2238380
TI  - [Use of filter paper for blood specimen collection in poultry for use in the
      detection of antibodies to Newcastle disease virus].
AB  - Trials were conducted to verify the possibility of poultry blood sampling with
      filter papers for subsequent examination of the eluates for the presence (and
      level) of haemagglutination-inhibition antibodies against the Newcastle disease
      virus (NDV). Qualitative examination was performed in 294 paired samples of sera
      and eluates, representing 10 selective sets, coming from three vaccinated poultry
      flocks. The numbers of positive sera (dilution ratios 1:20 and higher) and
      positive eluates of filter papers (dilution ratios of 1: 2 and higher) were
      compared and it was found that there were 238 positive paired samples (81%) and
      30 were negative (10.2%), hence, there were like reactions in 268 paired samples
      (91.2% of the total number of samples examined). It was only in 25 paired samples
      that positivity was recorded just in the sera: 22 times with a titre of 1:20 and
      three times with a titre of 1:40. In one case, positivity was recorded just in
      the eluate. The final titres were compared in 181 paired samples of sera and
      eluates, all diluted at a ratio of 1:2, and it was found that the concentration
      of the haemagglutination-inhibition antibodies in the eluates corresponded to
      serum dilution ratio of 1:20. Under this assumption, the antibodies were found to
      have the same titre in 164 paired samples (55.8%) during the quantitative
      evaluation. A lower titre was recorded in 82 eluate samples (27.9%) and a higher
      antibody titre in 48 eluate samples (16.3%) (in comparison with the antibody
      titres in the respective sera). The over-all average geometrical titre (GMT) of
      antibodies was 1:65 in the eluates and 1:75 in the sera.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2238381
TI  - [The interdependence of age on the utilization of proteins and intake of fats of
      various quality].
AB  - From an age of 30 days to 150 days, male rats were given ad libitum feed with a
      physiological content of nutrients (adequate to their age) and with different
      sources of fat: sunflower oil, pork lard, butter. The net protein ratio (NPR),
      body fat content, and the specific activity of phosphoenolpyruvate carboxykinase
      PEPCK were determined every 15 days. For all the three fat sources, NPR had the
      same high values in the intensive growth period (age 45 and 60 days: increased
      protein demand for building the organism); lower and the same again are the NPR
      values at an age of 75 to 105 days. From an age of 120 days to 150 days (the end
      of maturation), the long-continued intake of lard and butter had an adverse
      effect on the availability of protein for the animals, though their food had a
      physiological structure and an optimum proportion of the saccharide components.
      The result correlates with the growth of PEPCK activity, as indicated by
      exploitation of protein as substrate for gluconeogenesis, not for
      proteosynthesis. Pork lard and butter with a 3.5 - to 5-fold prevalence of
      saturated fatty acids, compared with sunflower oil, implies that short-chain
      fatty acids were provided as effectors of gluconeogenesis and that, under the
      conditions of physiological intake of nutrients, substrates were also provided
      for mitochondrial synthesis of fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238383
TI  - [Pathologico-morphologic changes in the digestive system in rabid foxes].
AB  - Pathologico-morphological changes in the digestive tract were investigated in
      fifty naturally infected common foxes (Vulpes vulpes crucigera). Nineteen animals
      were found to suffer from mild cachexia, 31 animals suffered from complete
      cachexia. Erosions were observed in the mucosa of oral cavities of 21 foxes.
      Traumatic injuries appeared in the teeth of 11 animals. One case of swollen and
      hyperaemic tongue was described; in three cases there occurred sialo-adenitis. A
      mild degree of inflammation was recorded in the gullet in three animals. Fifteen
      animals had empty stomachs, thirty-five animals had atypical food or foreign
      bodies in the stomach contents; simple hyperaemia was recorded 18 times, acute
      catarrhal gastritis 19 times and haemorrhagic gastritis was observed in two
      cases. Acute catarrhal enteritis was found in six cases, haemorrhagic enteritis
      in one case.

PMID- 2238382
TI  - [Evaluation of the the effectiveness of a newly developed tissue-inactivated
      vaccine against rabies using the NIH test].
AB  - NIH test was used to verify 12 operation batches of the newly developed
      inactivated tissue vaccine against rabies. The number of international units per
      1 cm3 of vaccine was determined by the volumetric method. The number of
      international units (I.U.) per 1 cm3 of the newly developed vaccines ranged from
      1.08 I.U. to 2.59 I.U. per cm3. The average value of all the 12 batches tested is
      1.52 I.U. per cm3. The average value of international units in the vaccination
      dose for dogs is 4.57. All the tested operation batches of the newly developed
      vaccines met the activity standard recommended by the World Health Organization
      for veterinary vaccines of this type.

PMID- 2238384
TI  - Erythrocyte pathology and mechanisms of Heinz body-mediated hemolysis in cats.
AB  - Despite the frequency of both oxidant drug-induced and spontaneous Heinz body
      formation in cats, the cellular and biochemical mechanisms by which Heinz bodies
      result in red blood cell (RBC) destruction and hemolytic anemia in this species
      remain unknown. Feline spleens are non-sinusoidal and inefficient at removing
      Heinz body-containing RBC from the circulation; therefore, alternative mechanisms
      must be involved in accelerated RBC destruction. Propylene glycol (PG) ingestion
      causes dose-dependent Heinz body formation and decreased RBC survival in cats. We
      investigated several aspects of Heinz body-containing RBC from three cats
      ingesting diets that provided 8.0 g PG/kg body weight for up to 3 weeks, in order
      to characterize cellular lesions that are associated with the presence of Heinz
      bodies and that might contribute to chronic, accelerated RBC destruction, as well
      as to gain insight into the mechanism by which PG induces Heinz body formation.
      Erythrocytes with PG-induced Heinz bodies had decreased levels of reduced
      glutathione and adenosine triphosphate and reduced deformability. There was no
      change in hemoglobin isoelectric focusing or membrane lipid peroxidation.
      Electrophoretic patterns of Heinz body-containing RBC membranes were
      significantly altered, and membrane surface charge distribution was disturbed.
      Progressively protruding Heinz bodies suggested that extrusion of Heinz bodies
      may be a means of cell healing and/or destruction in the absence of splenic
      pitting. When compared to results obtained using RBC from cats treated with the
      oxidant drug phenylhydrazine, significant differences were noted in packed cell
      volume, turbidity index, membrane heme, and morphologic appearance of Heinz
      bodies. Our results indicate that multiple cellular abnormalities develop in RBC
      with PG-induced Heinz bodies that do not cause acute hemolysis but that may
      shorten RBC survival. Propylene glycol-induced Heinz bodies provide an ideal
      model for studying the chronic effects of Heinz bodies on RBC structure and
      function and may be useful in understanding the mechanisms of formation and the
      consequences of endogenous Heinz bodies in cats.

PMID- 2238385
TI  - Pathologic changes of the small intestinal mucosa of pigs after feeding Phaseolus
      vulgaris beans.
AB  - The jejunal mucosa of pigs fed diets containing Phaseolus vulgaris beans was
      characterized grossly as mucosal atrophy and microscopically as atrophy and
      blunting of the villus in association with elongation of crypts with cells with
      increased mitotic activity. These morphologic findings were most severe in the
      proximal and middle parts of the jejunum. Compared to controls, goblet cells were
      significantly decreased in the villus but markedly increased in the crypt region.
      The activity of aminopeptidase and sucrase-isomaltase in the test animals was
      also significantly lower than in the controls. The findings in this study
      suggested that feeding Phaseolus vulgaris beans reduced the digestive and
      absorptive capacity of the mucosa, resulting in weight loss and diarrhea of
      affected pigs.

PMID- 2238386
TI  - Neosporosis in cats.
AB  - Six cats (Nos. 1-6) were inoculated intramuscularly with (1 x 10(6)) and orally
      (5 x 10(5)) tachyzoites of Neospora caninum. Three (Nos. 1-3) of the six cats
      were given 40 mg/kg methylprednisolone acetate 7 days before and on the day of
      inoculation with N. caninum tachyzoites, and three cats (Nos. 4-6) were not given
      methylprednisolone acetate. Two of the cats (cat Nos. 1 and 2) given
      methylprednisolone acetate died suddenly. Cat No. 1 died 8 days post-inoculation,
      and cat No. 2 died 16 days post-inoculation. Cat No. 3 was euthanatized 21 days
      post-inoculation. Cat No. 1 had lesions of gram-positive bacterial septicemia.
      Necrotizing encephalitis, myelitis, disseminated skeletal muscle necrosis,
      hepatic necrosis, interstitial pneumonia, and renal tubular necrosis were the
      main lesions in cat Nos. 2 and 3. The cats that were not given methylprednisolone
      acetate remained clinically normal except for slight weight loss in cat No. 6.
      All three of these cats were euthanatized 55 days post-inoculation. Mild myositis
      and encephalitis were noted on microscopic examination of tissues from these
      three cats. Neuromuscular lesions were not seen in six control cats (Nos. 7-12)
      not inoculated with N. caninum and euthanatized 21 or 22 days after
      administration of the first two doses of methylprednisolone acetate (40 mg/kg),
      given at a weekly interval.

PMID- 2238387
TI  - Histologic and ultrastructural studies of dermal sarcoma of walleye (Pisces:
      Stizostedion vitreum).
AB  - Sixty-seven adult walleye fish were examined by light and transmission electron
      microscopy. The fish were affected by a mesenchymal tumor previously termed
      Walleye Dermal Sarcoma that commonly affects up to 27% of the population
      seasonally. Biopsies from 24 fish were collected, and complete postmortem
      examinations were performed on 43 fish. Grossly, the tumors had the appearance of
      randomly distributed, often clustered, spherical nodules, 2-5 mm in diameter with
      a smooth and often ulcerated surface. The tumors arose from the superficial
      surface of scales and consisted of fibroblast-like cells separated by a moderate
      amount of collagen (43/67) or osteoid material (24/67). Lymphocytic infiltration
      (28/67) associated with vacuolar degeneration of tumor cells (28/67) and
      centrally located coagulation necrosis (30/67) were observed. Although tumor
      cells were often highly anaplastic, no local invasions or metastases were
      present. In contrast with previous descriptions of this tumor, no viral particles
      could be observed electron microscopically. The variably anaplastic appearance of
      the tumor, its biological behavior, and its restriction to dermis are features in
      common with canine cutaneous histiocytoma and equine sarcoid. The multicentric
      origin, the restriction to the dermis, and the absence of invasion or metastases
      of Walleye Dermal Sarcoma differ from retrovirus-induced avian and murine
      sarcomas that arise locally, that invade, and that often metastasize.

PMID- 2238388
TI  - Bovine fetal encephalitis and myocarditis associated with protozoal infections.
AB  - Bovine fetuses submitted to the California Veterinary Diagnostic Laboratory
      System were evaluated during a 2-year period (1987 to 1989) for the presence of
      multifocal necrotizing nonsuppurative encephalitis, nonsuppurative myocarditis,
      or tissue protozoa. Eighty-two of 445 (18%) fetuses submitted met these
      histologic criteria. Fetuses were from 54 dairy and two beef herds located
      throughout the state. In 17 fetuses (21%) protozoa were found in fetal tissues.
      Protozoa were found in brain parenchyma of ten fetuses (12%), in endothelial
      cells in four fetuses (5%), in cardiac myofibers in one fetus (1%), and were
      associated with endothelial cells in two fetuses (2%). In most fetuses there were
      no significant gross pathologic findings other than autolysis. While aborted
      fetuses were from 3 to 9 months gestation, the majority were between 5 and 7
      months gestation. They were submitted year round, but more were seen in the fall
      and winter months. Additional salient histologic features included portal
      nonsuppurative hepatitis, focal hepatic inflammation and necrosis, and focal
      nonsuppurative myositis. Nonsuppurative inflammation was also found in decreasing
      frequency, in the adrenal medulla, kidney, mesentery or abdominal fat, placenta,
      and lung. In two fetuses (Nos. 1 and 2), the location and morphology of the
      protozoa were compatible with Sarcocystis spp. The identity of protozoa in the
      remaining 15 fetuses is unknown. The histopathologic changes in these 82 fetuses
      and the presence of protozoa in 21% of the fetuses suggest these abortions are
      due to fetal protozoal infections.

PMID- 2238389
TI  - Genetic regulation of Mycobacterium paratuberculosis infection in recombinant
      inbred mice.

PMID- 2238390
TI  - A congenital interstitial cell hamartoma of the equine ovary.

PMID- 2238391
TI  - Diffuse cutaneous mastocytosis in a cat.

PMID- 2238392
TI  - Comparison of meningio-angiomatosis in a man and a dog.

PMID- 2238393
TI  - Islet cell hyperplasia in an aged spider monkey (Ateles paniscus).

PMID- 2238394
TI  - Immunohistochemistry and ultrastructure of intestinal ganglioneuroma in a dog.

PMID- 2238395
TI  - Vets in society--an expanding role.

PMID- 2238396
TI  - Wooldridge memorial lecture. The role of vets in society.

PMID- 2238397
TI  - The DairyCHAMP program: a computerised recording system for dairy herds.
AB  - The DairyCHAMP program is an animal health and management software program that
      helps daily animal management, herd performance monitoring and problem analysis.
      Data entry to the program uses a data dictionary and includes an error-checking
      system that ensures the consistency and appropriateness of data entered.
      DairyCHAMP performs health management functions, provides a convenient user
      interface, ensures uniform data across farms by using a standard data dictionary,
      can be fully integrated with decision-making software programs like DairyORACLE,
      and is flexible enough to be useful for many types of dairy facilities. Data are
      entered via a menu-based system. Animal events are organised around reproduction
      and lactation cycles and health records. Farm records include inventories for
      drug, feed and semen. Farm parameters can be established which customize the
      program for an individual farm. The database system is an integration of three
      schemas: the individual user's view, the community view and the storage system.
      The individual user's view must be easy to use, while the storage system must be
      compact enough to fit within the disc storage space on a microcomputer. This
      conflict requires a translation from one schema to another. The DairyCHAMP
      program accomplishes this through a coding system which assigns a code number to
      each event. The program can add synonyms to this event dictionary by assigning
      the same code number to the synonym the user chooses. The DairyCHAMP program
      provides access to the large amounts of data required to aid in daily animal
      management, allow performance monitoring and analyse problems. Its highly
      integrated system is efficient and easy to use and maintain.

PMID- 2238398
TI  - 'Jackson's ratio' and the Aldabra giant tortoise (Geochelone gigantea).

PMID- 2238399
TI  - Phocid distemper virus--a threat to terrestrial mammals?

PMID- 2238400
TI  - Employing staff: perils and pitfalls.

PMID- 2238401
TI  - Dystocia in Friesian heifers.

PMID- 2238402
TI  - Wool slip in Wiltshire horns.

PMID- 2238403
TI  - Use of leeches.

PMID- 2238404
TI  - Juvenile bovine angiomatosis: a syndrome of young cattle.
AB  - This report describes the clinical and pathological features associated with
      angiomatous lesions in two calves. In the first case, a single mass located in
      the atrioventricular ring of the heart was responsible for congestive cardiac
      failure. The mass was composed of numerous vascular cavities filled with blood
      and lined by a single layer of well differentiated endothelial cells. The second
      case had multiple blood-filled cutaneous masses which were confirmed as benign
      vascular tumours by histological examination of a biopsy specimen. The calf was
      later euthanased after profuse and uncontrollable haemorrhage from one of the
      lesions. At necropsy, additional tumours were found in the liver, spleen,
      kidneys, spinal canal and attached to the pleura, omentum and mesentery. It is
      proposed that these two cases are representatives of solitary and multiple forms
      of a syndrome which should be called juvenile bovine angiomatosis.

PMID- 2238405
TI  - Causes of mortality in impala (Aepyceros melampus) on 20 game farms in Zimbabwe.
AB  - The most common cause of death in impala (Aepyceros melampus) herds on 20 game
      farms in Zimbabwe was stress or physical injury during capture. Acute
      fascioliasis due to Fasciola gigantica was identified as the main disease problem
      associated with smaller game farms and where impala had been recently introduced.
      Losses associated with ticks and tick-borne diseases were rare. Impala in
      Zimbabwe are maintained in a healthy condition on game farms where they are given
      supplementary feed during the dry winter.

PMID- 2238406
TI  - Reduction in UK warble infestation levels: serological survey, 1990.

PMID- 2238407
TI  - Pulmonary epidermoid cysts in a cat.

PMID- 2238408
TI  - Gastric dilatation in a bulldog.

PMID- 2238409
TI  - Pet health insurance.

PMID- 2238410
TI  - Suspected poisoning of cats.

PMID- 2238411
TI  - Disease in young pheasants.

PMID- 2238412
TI  - Strength of bones in chickens.

PMID- 2238413
TI  - Efficacy of ivermectin against benzimidazole-resistant nematodes of sheep.
AB  - Two trials involving a total of 36 Dorset horn lambs were conducted to assess the
      anthelmintic efficacy of ivermectin against experimental infections of
      benzimidazole-resistant strains of Haemonchus contortus and Ostertagia
      circumcincta. Two resistant strains of each of the two species were used and in
      each trial the lambs were allocated to three groups. One group was given 200
      micrograms ivermectin/kg bodyweight orally, the second group was given 5 mg
      oxfendazole/kg bodyweight orally and the third group remained untreated as
      controls. Fourteen days after treatment the lambs were necropsied. Ivermectin was
      found to be more than 99 per cent to 100 per cent effective against all four
      benzimidazole-resistant strains, whereas oxfendazole was 78.6 per cent and 83.8
      per cent effective against the H contortus strains, and 25.6 per cent and 39.8
      per cent effective against the O circumcincta strains.

PMID- 2238414
TI  - Holoacardius amorphus totalis in two Friesian cows carrying natural and induced
      twins.
AB  - Two cases of holoacardius amorphus totalis are described and the classification,
      epidemiology, aetiology and pathophysiology of the condition are reviewed. One
      case is the first reported example of holoacardius amorphus totalis in a dairy
      cow carrying twins induced by embryo transfer.

PMID- 2238415
TI  - Isolation of peste des petits ruminants from goats in Saudi Arabia.

PMID- 2238416
TI  - Quality assurance in private veterinary laboratories.

PMID- 2238418
TI  - Lead contaminated cattle feed.

PMID- 2238417
TI  - Enterohaemolysin and shiga-like toxin genes in E coli.

PMID- 2238419
TI  - Side effects of indomethacin in ponies.

PMID- 2238420
TI  - International disease surveillance. Quarterly report April to July 1990.

PMID- 2238421
TI  - Concurrent maedi-visna virus infection and pulmonary adenomatosis in a commercial
      breeding flock in East Anglia.
AB  - The seroprevalence of maedi-visna virus infection in thin potential cull ewes
      aged over two years in a flock in East Anglia increased from 3.7 per cent in
      August 1985 to 39.0 per cent in September 1987 and 93.3 per cent in May 1989.
      This increase coincided with the first appearance of sheep pulmonary adenomatosis
      in the flock. Four emaciated ewes which were dyspnoeic were necropsied between
      1987 and 1989. Maedi and pulmonary adenomatosis were confirmed histologically in
      one of these ewes and pulmonary adenomatosis was confirmed in the other three.

PMID- 2238422
TI  - 1;16 tandem translocation with trisomy 16 in a Brown Swiss bull.

PMID- 2238423
TI  - An outbreak of botulism type B in horses.

PMID- 2238424
TI  - Dystocia in Friesian heifers.

PMID- 2238425
TI  - Strength of bones in chickens.

PMID- 2238426
TI  - Equine tapeworms more prevalent.

PMID- 2238427
TI  - Diagnosis of bovine cryptosporidiosis by an enzyme-linked immunosorbent assay.
AB  - This paper describes an enzyme-linked immunosorbent assay (ELISA) for the
      diagnosis of cryptosporidiosis. A monoclonal antibody with a high affinity
      against an oocyst antigen was used to set up the test. The efficiency of this
      assay was compared with that of the flotation test; 275 calf faecal samples were
      examined by the two methods. There was 96% agreement between the two tests. For
      the 11 conflicting samples, the two tests were repeated and a modified Ziehl
      Neelsen staining was performed on faecal smears. All these 11 samples contained
      few oocysts, but only five and six of them were shown to be positive by the ELISA
      and flotation tests, respectively. The degree of sensitivity of the ELISA and
      flotation tests is comparable; samples heavily or moderately contaminated with
      oocytes are detected by both methods. This ELISA is reliable and never gives rise
      to false positive results. Nevertheless, as with the flotation test, the
      occasional case containing very few oocysts will not always be detected by this
      test. If necessary, very accurate diagnosis can be made by a staining technique
      or by a direct immunofluorescent assay. In veterinary medicine, the ELISA seems
      to be a method of choice; it appears to be a fast and reliable technique which
      could be used as a routine test for the detection of Cryptosporidium oocysts.
      Nevertheless the degree of sensitivity must always be borne in mind. There is no
      need for a microscopic examination, which is an additional advantage.

PMID- 2238428
TI  - Effects of multiple dose infections with Ascaris suum on blood gastrointestinal
      hormone levels in pigs.
AB  - Ten consecutive daily doses of infective Ascaris suum eggs were administered to
      pigs in two experiments and the levels of gastrointestinal hormones in their
      blood were measured. The piglets in each experiment were divided into low-dose
      (LDI) and high-dose (HDI) infections and control groups. Infected pigs had lower
      feed consumption, lower weight gains, and lower feed efficiency than control
      pigs. Serum gastrin levels in infected pigs were significantly lower than the
      controls from Days 7 to 17 post first inoculation (PFI), and so were their serum
      glucagon levels from Days 12 to 24 PFI. Serum insulin levels in infected animals
      were sometimes lower than those in controls. These differences were usually more
      intense in the LDI pigs than in HDI pigs. The plasma cholecystokinin (CCK) levels
      in the LDI group were significantly higher than those in controls from Day 10 PFI
      to the end of the experiment, while the CCK levels in the HDI group did not
      differ significantly from the controls. Increased plasma CCK levels could be a
      satiety factor in A. suum infection since the time of occurrence of high levels
      of CCK matched the period of reduced feed consumption.

PMID- 2238429
TI  - The seasonal epidemiology of gastrointestinal nematodes in N'Dama cattle in The
      Gambia.
AB  - From June 1987 to June 1988, a total of 180 N'Dama cattle were necropsied to
      identify and enumerate parasites present, including 39 sick calves and 25 dead
      calves from local village herds, and 116 adult cattle from a local abattoir. Of
      175 animals infected with one or more helminths (97%), Haemonchus contortus was
      found in 67% of all necropsied animals, Cooperia punctata in 75%, Cooperia
      pectinata in 55%, Oesophagostomum radiatum in 71% and Bunostomum phlebotomum in
      21%. There was a wide range of worm burdens (0-22 925) and a pronounced seasonal
      pattern occurred. Eighty-two percent of the total adult Haemonchus burden
      occurred during the rainy season (June-October). By the end of the rainy season,
      almost 100% of the Haemonchus burden was present as inhibited larvae. By
      contrast, a different survival strategy appeared to occur in Cooperia spp.;
      Oesophagostomum spp. and Bunostomum spp., which were found as adults throughout
      the year. Results indicated that, apart from malnutrition during the dry season,
      gastrointestinal nematode infections, especially haemonchosis, represent a major
      constraint on the health and productivity of N'Dama cattle under West African
      savanna conditions.

PMID- 2238430
TI  - Absence of hypobiosis in abomasal nematodes of sheep and goats in Egypt.
AB  - A total of 96 abomasa from sheep and goats at the Zagazig abattoir, Sharkia
      Province, Egypt, were examined, during the four climatic seasons from April 1986
      to March 1987, for the presence of adult and larval nematodes. Adults of
      Trichostrongylus axei were most numerous followed by adult Haemonchus contortus.
      Adult Ostertagia sp. and Parabronema skrjabini were less prevalent. There was no
      significant difference between sheep and goats in infection rates, but worm
      burdens of the nematodes other than Ostertagia sp. were significantly higher (P
      less than 0.05) in sheep than in goats. The animals were uniformly infected with
      these parasites throughout the year as there were no significant differences in
      the incidence or intensity of infections between the four seasons. The numbers of
      larvae recovered from the wall of the abomasa were small in relation to the total
      adult worm population throughout the year with a slight increase during the
      summer. Hypobiosis, therefore, seems not to be important in the life cycle of
      abomasal nematodes of sheep and goats in Sharkia Province, Egypt.

PMID- 2238432
TI  - Eimeria infections of sheep in northwest Germany.
AB  - To investigate the incidence of ovine Eimeria spp. and seasonal dynamics in
      oocyst output, fecal samples of sheep from three different management systems
      were collected monthly over a 1-year period and examined for oocysts. A total of
      10 species of Eimeria were observed. The most frequent species were E. bakuensis,
      E. ovinoidalis, E. weybridgensis/crandallis, E. parva and E. ahsata whereas E.
      faurei, E. granulosa, E. intricata and E. pallida were found less often. Lambs
      passed larger numbers of oocysts in their feces than either ewes or yearlings.

PMID- 2238431
TI  - Is there a relationship between haemoglobin genotype and the innate resistance to
      experimental Haemonchus contortus infection in Merino lambs?
AB  - Responses to a single or repeated infection with 7000 infective larvae of
      Haemonchus contortus were studied in an experiment using a total of 106 3-month
      old lambs with AA, AB or BB haemoglobin (Hb) genotypes. Results were assessed by
      faecal egg counts, adult worm counts, haematocrit values, haemoglobin
      concentrations, total serum protein and serum antibody IgG1 and IgA ELISA titres.
      None of these parameters showed a strong relationship to the Hb type. The
      prevalence of low responder (greater than 500 worms) and of high responder (less
      than 50 worms) animals in groups AA, AB and BB Hb types was 3.8 and 34.6, 20.6
      and 35.2, 28.1 and 43.7%, respectively, suggesting that the responsiveness to
      nematode infection is under the control of gene(s) not closely linked with those
      determining the Hb genotype. Worm counts of a primary infection are more subject
      to variation than those of a secondary infection. There is a strong relationship
      between adult worm counts and faecal egg counts taken close to the time of
      slaughter. In living animals low and high responder discrimination can be based
      on individual faecal egg counts around 50 days after a secondary infection.
      Haematocrit values proved to be of little value in the low and high responder
      selection. In this regard neither Hb concentration nor total serum protein values
      are of practical significance. In 3-month-old lambs primary infection induced
      partial immunity which could prevent the establishment of a part of the secondary
      infection, irrespective of the presence or absence of the primary worm
      population. The development of immunity was not associated with an increase of
      serum IgG1 and IgA antibody levels. Specific antibody production was not
      influenced by Hb types. Mean antibody levels of low responder lambs showed no
      difference from those of high responders. Thus, serum IgG1 and IgA levels are of
      no predictive value in identifying lambs which are genetically resistant to
      Haemonchus infection.

PMID- 2238433
TI  - Effects of the combination of DL-alpha-difluoromethylornithine and diminazene
      aceturate in Trypanosoma congolense infection of dogs.
AB  - The therapeutic activity of a combination of difluoromethylornithine (DFMO) with
      diminazene aceturate was investigated in mongrel dogs experimentally infected
      with Trypanosoma congolense. The criteria used in the assessment of the
      trypanocidal effect of the therapy include the examination of the blood for
      parasites, as well as clinical and haematological changes at intervals following
      treatment. Diminazene aceturate and DFMO alone and in combination produced
      intermittent aparasitaemia in the dogs. Although relapse infection occurred with
      all three treatment regimes, the drug combination gave the best result. The
      packed red cell volume, haemoglobin concentrations and red blood cell values
      decreased significantly following parasite inoculation but increased after
      treatment. The total leucocyte counts decreased in all the infected dogs but
      improved with treatment, and the differential leucocyte counts indicated
      neutropenia in all the infected animals prior to treatment.

PMID- 2238434
TI  - Cantharidin decreases in vitro digestion of alfalfa and smooth bromegrass.
AB  - Blister beetles (Coleoptera:Meloidae) containing the toxin cantharidin can be
      incorporated with alfalfa (Medicago sativa L) during forage conservation.
      Cantharidin inadvertently ingested with animal feed may cause illness or death.
      Little information is available on the effects of cantharidin on ruminant
      microbial digestion. The objective of our study was to determine cantharidin
      effects on digestibility of alfalfa and smooth bromegrass (Bromus inermis Leyss)
      by measuring in vitro digestible dry matter (IVDDM) and cell wall digestion
      (CWD). Alfalfa dry matter digestibility, measured after IVDDM at 48 and 96 h
      fermentation periods, decreased as cantharidin concentration increased.
      Increasing cantharidin concentration also significantly reduced IVDDM of smooth
      bromegrass at 24 and 96 h digestion time. The CWD of alfalfa and smooth
      bromegrass decreased as cantharidin concentration increased. These results
      indicate that ingestion of cantharidin by ruminants may decrease microbial
      digestion of fibrous feeds and therefore may decrease the efficiency of feed
      utilization by ruminants.

PMID- 2238435
TI  - The effect of testosterone or estradiol on the development of TOCP-induced
      delayed neurotoxicity in immature broiler-breed cockerels.
AB  - Immature cockerels were susceptible to OPIDN when dosed with TOCP. Using 30
      broiler-breed cockerels, 6 w old, 10 birds each received 28 daily im injections
      of either 50 mg estradiol, 100 mg testosterone or 0.1 ml of vehicle. At 7 w of
      age, 5 birds in each of the 3 groups received a single oral dose of 500 mg
      TOCP/kg body weight, while the remaining 5 birds/groups were given corn oil. The
      birds were observed daily for 14 d beginning on day 8 post-TOCP exposure for the
      development of clinical signs characteristic of OPIDN. At 21 d post-TOCP, all
      birds were killed and the adrenal gland and testes were prepared for
      histopathology of the birds that received TOCP, 1 of 5 that were given
      testosterone and 2 of 5 that received estradiol had signs typical of OPIDN. All
      of the 5 birds that received TOCP alone showed OPIDN signs. The testes of the
      TOCP-exposed birds that showed clinical signs had reductions in the size of the
      seminiferous tubules and no evidence of spermatogenic activity. This study
      demonstrated that sex hormones can modulate the clinical effects of TOCP in
      immature cockerels through unknown mechanisms that are similar to those reported
      for corticosterone in adult chickens.

PMID- 2238436
TI  - Oral forms of the oxime HI-6: a study of pharmacokinetics and tolerance after
      administration to healthy volunteers.
AB  - New pharmaceutical formulations of the oxime HI-6 as sustained-release and
      conventional tablets were studied in healthy volunteers. Twenty-six subjects,
      divided into 3 groups, received 3784 mg or 7568 mg doses of HI-6 conventional
      tablets or 4027 mg of the oxime in the form of sustained-release tablets. Peak
      plasma concentrations of HI-6 were reached within 0.6 h (10.2 mumol/l) and 1.6 h
      (21.4 mumol/l) following the ingestion of conventional tablets. Elimination half
      lives were similar (1.7 h and 1.3 h) and the respective urinary recoveries
      amounted to 3.2% and 2.9%. After the administration of sustained-release tablets
      of HI-6, maximal concentration (8.8 mumol/l) was attained in 2.2 h, elimination
      half-life was 1.9 h and 4.2% of the dose was excreted unchanged in urine.
      Undesirable side effects were not reported by the subjects or revealed by
      clinical or laboratory tests. The results indicate low bioavailability of the
      oral formulations of HI-6 in man.

PMID- 2238437
TI  - Study of delayed neurotoxicity caused by fatty acid anilides in hens.
AB  - We have observed that the oral administration of a single dose of a mixture of
      oleyl and linoleylanilides (80 mg/kg) in adult hens determines the apparition of
      delayed muscular neuropathy, which we have compared to that induced by
      metamidophos as a model of organophosphate-induced delayed neuropathy (OPIDN). We
      have compared the modifications produced by each of the 2 treatments on the
      enzymatic activity of neuropathy target esterase (NTE) measured in nervous tissue
      homogenates of brain, medulla and sciatic nerve. In addition we determined total
      esterases (TE), acetylcholine esterase (AchE) and serum creatine phosphate kinase
      (CPK). The organophosphate compound (OP) induced an initial reduction in the
      activity of NTE, TE and AchE which was reestablished 48 h later, except for brain
      TE which increased slowly during the latency period. This behaviour was
      accompanied by a permanent increase in the activity of serum CPK. Anilides
      induced a strong activation of AchE, NTE and TE (except brain TE) in the first 24
      36 h. Normal levels were relatively quickly reestablished in brain (by 48 h) and
      slowly in medulla and sciatic nerve. But the AchE activity remained high
      throughout the whole period of latency. This activity level coincided with the
      AchE level observed at the onset of signs in animals dosed with OPs. CPK was also
      increased in sciatic nerve at 15 d but was depressed in serum throughout the
      whole latency period. Substances with chemical characteristics very different
      from OPs can induce a delayed neuropathy with modification of the activity of
      NTE.

PMID- 2238438
TI  - Evaluation of potential antidotes for sodium fluoroacetate in mice.
AB  - Pathogenesis in fluoroacetate poisoning is multifactorial. Biochemically it is
      characterized by lethal synthesis of fluorocitrate, causing hypocalcemia, and
      energy deficiency through blockade of the TCA cycle. Calcium gluconate (CaG) was
      chosen to antagonize hypocalcemia, while sodium alpha kelogluterate (NaKG) and
      sodium succinate (NaSuc) were selected as potential antidotes to revive the TCA
      cycle. Effectiveness of each of these antidotes individually and in certain
      combinations was tested in mice exposed to lethal doses (15 mg/kg ip) of sodium
      fluoroacetate (NaFAC). Antidotal treatments were administered at 15 min, 4 h, 10
      h, 24 h, and 36 h after NaFAC. All 3 of the antidotes alone, as well as a
      combination of CaG with NaKG, were ineffective in reducing mortality in mice
      after NaFAC. On the other hand, a combination of CaG (130 mg/kg) with NaSuc (240
      mg/kg) was effective if the 2 solutions were either injected at separate sites or
      mixed in the same syringe just prior to injection. Similar solutions, if mixed
      for 24 h or longer before administrations, were ineffective. Increasing the dose
      of NaSuc to 360 or 480 mg/kg with CaG (130 mg/kg) was unrewarding. These results
      indicate that CaG in combination with 240 mg NaSuc/kg offer a promising therapy
      modality in NaFAC intoxication. Additional studies involving biochemical
      parameters and other species are needed to confirm the efficacy and mechanism(s)
      of action of this combination.

PMID- 2238439
TI  - Dermal toxicity to rats of isoproturon technical and formulation.
AB  - Information on the toxicity of urea-based herbicides is meagre and no data are
      available on the subacute dermal toxicity of isoproturon and its formulation.
      Repeated applications of isoproturon technical (IPT) and its wettable powder
      formulation (IPF) to the skin of male and female rats for 21 days caused mild to
      moderate toxic effects. IPT was more toxic to male rats as evidenced by animal
      mortality and enzymatic and hematological changes. The toxicity of IPF was less
      to both sexes. No dose response relationship could be established since the
      enzymatic and hematological changes produced by 3 different dose levels were
      equal.

PMID- 2238440
TI  - In vitro modifications of rat NTE and other esterases by chemicals which induce
      delayed neurotoxicity in vivo.
AB  - A rat in vitro model has been developed which permits direct study of the
      biochemical mechanisms involved in delayed neurotoxicity induced by any chemical
      compound, not only organophosphates. Using rat brain homogenate, a parallel study
      on the activity of neurotoxic esterase (NTE) and total esterases (TE) compared
      the action of metamidophos, which is known to induce delayed neurotoxicity, and
      the synthetic fatty acid anilides, oleylanilide and linoleylanilide. Inhibition
      in the activity of NTE and TE, unrelated to the concentration and the incubation
      time assayed, was caused by metamidophos, while the anilides showed a 2-phase
      concentration-time dependent behaviour. This confirmed the results we previously
      obtained in vivo. In both cases the appearance of delayed neuropathy was related
      to modification of NTE activity. We concluded that phosphorylation of the enzyme
      may not be the only biochemical requirement for the development of delayed
      neurotoxicity syndromes in which modification of NTE is produced.

PMID- 2238441
TI  - Mojave rattlesnake (Crotalus scutulatus scutulatus) venom: in vitro effect on
      platelets, fibrinolysis, and fibrinogen clotting.
AB  - Rattlesnake envenomation commonly produce defects in the hemostatic mechanism.
      However, Mojave rattlesnake (Crotalus scutulatus scutulatus) envenomation has
      been reported not to cause a systemic bleeding diathesis. In this study, whole
      venom from the Mojave rattlesnake was tested in vitro for fibrinogen clotting
      activity, ability to induce platelet aggregation, and for fibrinolytic activity.
      The Mojave venom caused no fibrinogen clotting and it displayed very weak ability
      to cause platelet aggregation and fibrinolytic activity. These in vitro studies
      support the clinical observation that Mojave envenomation does not cause a
      coagulopathy.

PMID- 2238442
TI  - Signal grass (Brachiaria decumbens) toxicity in sheep: changes in rumen microbial
      populations and volatile fatty acid concentrations.
AB  - Brachiaria decumbens toxicity resulted in an altered reticulorumen environment in
      the sheep. This adversely affected the growth and activity of microorganisms in
      the rumen as reflected by greatly decreased concentrations of the volatile fatty
      acids (acetic, propionic and butyric) in B decumbens-intoxicated sheep.

PMID- 2238443
TI  - Xylene/amitraz: a pharmacologic review and profile.
AB  - There are no reports of xylene/amitraz ingestion in children. Studies have
      characterized the adverse reactions caused by dermal applications in dogs, but
      the mechanisms involved were undetermined Accidental ingestion of the product by
      a child prompted a retrospective search of the medical records of the Georgia
      Animal Poison Information Center to profile the signalment, clinical signs, route
      of exposure and target sites of the suspected toxicosis in dogs. Clinical signs
      of depression, ataxia, stupor, and coma were most attributable to the xylene and
      propylene oxide components. Hyperglycemia, hypotension, and bradycardia were
      probably attributable to the alpha-2 adrenoceptor agonist action of amitraz. Most
      reports were initiated by owners, using the prescription product at home.

PMID- 2238444
TI  - A review of carboxymyoglobin formation: a major mechanism of carbon monoxide
      toxicity.
AB  - Clinical data suggest, and experimental studies indicate direct cardiotoxic
      effects of carbon monoxide, apart from carboxyhemoglobin formation. Carbon
      monoxide interactions with cytochrome oxidase and myoglobin are suspect. Of
      these, myoglobin is the favored tissue target for carbon monoxide binding. On
      what evidence? Examination of the literature reveals the following: A 16% greater
      "volume of distribution" (Vd) for carbon monoxide, versus other blood volume
      indicators, concentrating in skeletal and cardiac muscle; A high myoglobin
      content in these tissues corresponding to this "excess" Vd for carbon monoxide;
      Evidence from animals of significant carboxymyoglobin concentrations; Hemeprotein
      independent changes produced by carbon monoxide which promote carbon monoxide
      myoglobin interactions; A high ratio of deoxymyoglobin (carbon monoxide binding
      form) to oxymyoglobin intracellularly; Direct intercellular measurements of
      oxymyoglobin saturations and "cycling" in vivo illustrating favorable conditions
      for carbon monoxide binding; Data indicating decrements in cardiac performance
      with loss of functional myoglobin; Evidence that myoglobin is important to the
      proper functioning of cardio-adaptive mechanisms in stress. The total picture of
      carbon monoxide poisoning must take into account pathogenic effects due to
      carboxymyoglobin formation.

PMID- 2238445
TI  - The lead content of plants and animals as indicators of environmental
      contamination.
AB  - Lead content of tissues from some edible plants, pigeons and a vulture, and from
      human and cattle blood were determined to gain insight into the extent of
      environmental lead contamination in Zaria and Kaduna environs of Kaduna state of
      Nigeria. The results suggest that environmental lead contamination in these areas
      was insignificant when compared to values from developed countries like US.
      However, there is need for more work of this nature on a regional basis to
      ascertain the true picture of total environmental lead pollution in Nigeria.

PMID- 2238446
TI  - A review on biochemical roles, toxicity and interactions of zinc, copper and
      iron: IV. Interactions.
AB  - While the major impetus of most of our present knowledge of these metals
      emphasizes their deficiencies or toxicities, little has been done on their
      metabolic interactions. Such interactions acknowledge the importance of
      nutritional deficiencies or toxicities in the biospheres. The effect of dietary
      zinc supplementation on the bioavailability of copper and iron is a matter of
      conjecture. Likewise, further research is needed before a unifying hypothesis can
      be established on the effect of imbalances or interactions among copper and iron.
      Such mineral imbalance studies will be of value in determining their dietary
      requirements and in appraising circumstances in which risk to human and animal
      health may arise.

PMID- 2238447
TI  - Research note: an inexpensive temporary incubator conversion for submerged organ
      culture.

PMID- 2238448
TI  - Button batteries: letting the skeleton out of our closet.

PMID- 2238449
TI  - Fatal poisoning by Rumex crispus (curled dock): pathological findings and
      application of scanning electron microscopy.
AB  - A case of fatal poisoning due to ingestion of the plant Rumex crispus (curled
      dock) is described. The patient, a 53-year-old male, presented with
      gastrointestinal symptoms, severe hypocalcemia, metabolic acidosis and acute
      hepatic insufficiency. Despite therapeutic measures, the patient died 72 h after
      ingestion of the plant material. Noteworthy among the pathological findings were
      centrolobular hepatic necrosis and birefringent crystals in the liver and kidneys
      that were identified by histochemical techniques and scanning electron
      microscopy. These observations are compared with other reports in the medical
      literature, with an emphasis on the risk involved in the use of these plants for
      culinary or medicinal purposes.

PMID- 2238450
TI  - Publication of presented abstracts at annual scientific meetings: a measure of
      quality?
AB  - One measure of the quality of research presented at the annual scientific meeting
      is publication of the data presented in a peer review journal. This allows for a
      more rigorous review of design, methodology and conclusions. To determine the
      rate of subsequent publication, MEDLARS searches were performed on the 269
      presented abstracts at the 1984 and 1986 meetings of the American Association of
      Poison Control Centers, The American Academy of Clinical Toxicology, The American
      Board of Medical Toxicology and the Canadian Association of Poison Control
      Centers. Of the 296 presented abstracts, 134 (49.8%) were published. There was no
      difference in the eventual publication rate between the 1984 and 1986 meeting.
      There were 38 non-reviewed symposia publications and 96 peer-reviewed articles.
      Publications of 35.7% of presented abstracts in peer review journals compares
      poorly with the percentage of peer-reviewed publication from other scientific
      meetings. If publication in a peer-review journal is important, steps should be
      taken to improve the percentage of presented abstracts that are accepted by peer
      review journals.

PMID- 2238451
TI  - Species differences: the applicability of data from one animal model to another.

PMID- 2238452
TI  - Incidence and management of poisonings in livestock.
AB  - Insecticides, nitrates, gossypol, copper, and plants are a few of the common
      toxicoses observed in livestock in a particular specie due to various factors.
      Some species may have anatomical or physiological uniquenesses making them more
      susceptible to certain agents. Another specie may be exposed to some agents more
      frequently than others, increasing the likelihood of toxicosis in that specie.
      Once recognized, therapy is often unrewarding due to the advanced stage of the
      condition when first recognized, the stress involved in administering the
      treatment, and the unfeasibility of multiple treatments on many animals. Because
      of the poor response to treatment and the large number of animals potentially at
      risk, prevention assumes a greater importance in food animals than in companion
      animals. Prevention consists of making the diagnosis, findings and removing the
      source of the toxicant, and educating the owner on how future problems can be
      avoided.

PMID- 2238453
TI  - Incidence and management of poisoning in companion animals.

PMID- 2238454
TI  - Human effects of veterinary biological products.

PMID- 2238455
TI  - Nitrate intoxication.

PMID- 2238456
TI  - Isolation and restriction endonuclease analysis of a tetracycline resistance
      plasmid from Staphylococcus hyicus.
AB  - A plasmid of 4.550 kb, conferring resistance to tetracycline, was demonstrated in
      Staphylococcus hyicus cultures from piglets with exudative epidermidis. The
      plasmid-encoded properties were determined both by curing and interspecific
      protoplast transformation experiments. The tetracycline resistance (TET) plasmid,
      designated pST1, was characterized by restriction endonuclease analysis and a
      preliminary restriction map was constructed. The pST1 plasmid was demonstrated in
      19 (57.6%) of 33 S. hyicus cultures by Southern blot hybridization. It was also
      detectable by electron microscopy.

PMID- 2238457
TI  - Slide precipitation: a simple method to type Actinobacillus (Haemophilus)
      pleuropneumoniae.
AB  - Soluble thermostable antigens prepared from Actinobacillus pleuropneumoniae, as
      commonly applied in the ring precipitation test, were used in rapid slide tests.
      This method was easier to perform than the ring precipitation test and showed the
      same specificity. This specificity was higher than that obtained in slide
      agglutination tests using whole bacterial cells.

PMID- 2238458
TI  - Detection of Eperythrozoon suis DNA from swine blood by whole organism DNA
      hybridizations.
AB  - A procedure is described for isolating Eperythrozoon suis DNA of sufficient
      quantity and purity to serve as a probe in whole-organism DNA hybridizations for
      detecting parasitized swine. The E. suis organisms were isolated from the blood
      of infected swine; the DNA was recovered and digested with restriction
      endonucleases and resolved on agarose gels. In DNA hybridizations using recovered
      E. suis DNA, blood samples from parasitized swine could be differentiated from
      uninfected, control samples. A high salt lysate recovery technique was used in
      sampling swine whole blood for E. suis DNA and found to offer many advantages in
      the collection and recovery process.

PMID- 2238459
TI  - The growth response of Mycoplasma hyopneumoniae and Mycoplasma flocculare based
      upon ATP-dependent luminometry.
AB  - Cultures of Mycoplasma hyopneumoniae and M. flocculare in Friis' broth grew
      faster and to higher titers in air than in 8% CO2; cultures in air grew better
      when shaken than when stationary. Under the optimal conditions, both species have
      generation times of about 10 h and achieve maximum titers of at least 10(9)
      organisms per ml. Maximum growth was reached near pH 7.0, before the phenol red
      indicator had noticeably changed colour. Changes in growth were readily detected
      by an ATP assay based upon the luciferin-luciferase reaction. Concentrations of
      ATP fell rapidly after peak growth. Although the addition of 27 mM glucose to the
      medium did not change the pattern of growth and gas chromatography gave no
      evidence of the production of volatile or non-volatile end-products, washed
      harvested cells of both species metabolized [14C]-glucose. The addition of 29 mM
      arginine to the medium inhibited growth.

PMID- 2238460
TI  - The humoral immune response of lambs experimentally infected with Mycoplasma
      ovipneumoniae.
AB  - Using sera from lambs experimentally infected with Mycoplasma ovipneumoniae and
      Pasteurella haemolytica, the development of a good humoral immune response to M.
      ovipneumoniae was detected by ELISA. The antibody titres peaked 41 days post
      infection and good antibody titres were maintained over the 16-week experimental
      period. Immunoblotting revealed that antibodies to specific antigens appeared in
      the sera in a sequential manner, some being seen shortly after infection and
      others developing only after a substantial time lag. Antibodies were raised
      against almost all the major antigens detected in one laboratory strain (956/2)
      and against all antigens previously shown to be conserved in 22 Scottish field
      isolates of M. ovipneumoniae.

PMID- 2238461
TI  - The development and evaluation of an enzyme-linked immunosorbent assay for the
      detection of Mycobacterium bovis.
AB  - A double antibody sandwich layer enzyme-linked immunosorbent assay (ELISA) was
      used to detect Mycobacterium bovis. The ELISA detected M. bovis is pure culture
      at concentrations of 1 x 10(5) colony-forming units (CFU) ml-1 and greater,
      compared to a minimum detection level of 1 x 10(6) CFU ml-1 for isolation
      techniques. Neither technique detected M. bovis at 1 x 10(4) CFU ml-1. The ELISA
      did not cross-react with common mycobacterial contaminants such as Mycobacterium
      avium intracellulare-scrofulaceum complex serotypes 18 and 42, M. terrae, M.
      fortuitum, M. flavescens and with Escherichia coli or Rhodococcus equi. Further
      work is needed to evaluate this assay in detecting M. bovis in tissues and the
      environment.

PMID- 2238463
TI  - Control and expression of 3' open reading frames in clover yellow mosaic virus.
AB  - The genomic RNA of clover yellow mosaic virus (CYMV) contains at least seven open
      reading frames (ORFs) which are organized in a more elaborate array than in other
      sequenced members of the potexvirus group. We have investigated the strategy by
      which ORFs located in the 3' region of CYMV's genomic RNA are differentially
      expressed by correlating the location of the 5' termini of the two abundant viral
      subgenomic RNAs with their coding potential. We have mapped the 5' termini of the
      subgenomic RNAs precisely to the nucleotide level and have shown that both are
      capped. The larger 2.1-kb subgenomic RNA encodes as its 5' ORF a 25-kDa
      polypeptide, whose function is unknown. The smaller 1.0-kb subgenomic RNA can
      encode only the 23-kDa coat protein. All four ORFs in the 3' 1095 residues of
      CYMV are efficiently expressed in vitro, but of these only coat protein, which
      can be expressed from a subgenomic RNA, is detectable in CYMV infected tissue.
      For this reason, we believe that expression of ORFs in the 3' one-third of CYMV
      RNA are controlled at the transcriptional level.

PMID- 2238462
TI  - Replication of an adenovirus type 34 mutant DNA containing tandem reiterations of
      the inverted terminal repeat.
AB  - A mutant of human adenovirus type 34 (Ad34) has been isolated which contains DNA
      molecules with tandem reiterations of from two to eight copies of a 131-bp
      sequence within the right-sided inverted terminal repetition. Terminal
      heterogeneity was not eliminated by repeated plaque purifications indicating that
      the population of DNA molecules with various numbers of reiterations could
      rapidly evolve from the DNA of a single virus particle. These enlarged DNA
      molecules were capable of replication both in vivo and in vitro. The nucleotide
      sequence of the mutant Ad34 inverted terminal repetitions contained most of the
      essential features of the Ad origin of DNA replication. These features include
      the ATAATATACC sequence which is present between the highly conserved bases 9-18
      in all human adenoviruses, as well as the consensus sequences for the binding of
      nuclear factor I and nuclear factor III. However, the reiterated sequences lacked
      a dG appropriately placed on the template strand to serve as a potential site for
      internal initiation. It appears that the rapid amplification of two to eight
      copies of the reiterated terminal sequences does not arise from internal
      initiation during replication but probably from homologous recombination.

PMID- 2238464
TI  - Structure-specific binding of wound tumor virus transcripts by a host factor:
      involvement of both terminal nucleotide domains.
AB  - A gel retardation assay was used to demonstrate binding of wound tumor virus
      transcripts by a protein component of leafhopper vector cell extracts.
      Comparative binding studies employing terminally modified and internally deleted
      transcripts established that the segment-specific inverted repeats present in the
      terminal domains of the viral transcripts were necessary but not sufficient for
      optimal binding. An additional involvement of internal sequences in either the
      formation or the stabilization of the binding complex was indicated. Results of
      competitive binding experiments confirmed the sequence- and structure-specificity
      of the protein-RNA interaction and revealed apparent differences in the ability
      of individual viral transcripts to form a stable binding complex. Possible
      implications of structure-specific interactions between wound tumor virus
      transcripts and a host component and the role of the terminal inverted repeats
      are discussed.

PMID- 2238465
TI  - Tissue-specific expression of the TMV coat protein in transgenic tobacco plants
      affects the level of coat protein-mediated virus protection.
AB  - Transgenic tobacco plants were produced that express a chimeric gene encoding the
      coat protein (CP) of tobacco mosaic virus (TMV) under the control of the promoter
      from a ribulose bisphosphate carboxylase small subunit (rbcS) gene. Plant lines
      expressing comparable levels of CP from the rbcS and cauliflower mosaic virus 35S
      promoters were compared for resistance to TMV. In whole plant assays the 35S:CP
      constructs gave higher resistance than the rbcS:CP constructs. On the other hand,
      leaf mesophyll protoplasts isolated from both plant lines were equally resistant
      to infection by TMV. This indicated that the difference in resistance between the
      lines in the whole plant assay reflects differences at the level of short- and/or
      long-distance spread of TMV. Therefore, we propose that the difference in tissue
      specific expression between the 35S and rbcS promoters accounts for greater
      resistance in the plant lines that express the 35S:CP chimeric genes.

PMID- 2238466
TI  - A single amino acid change in E3 of ts1 mutant inhibits the intracellular
      transport of SFV envelope protein complex.
AB  - At 39 degrees the envelope protein complex (E1-p62) of Semliki Forest virus
      mutant ts1 is arrested in the rough endoplasmic reticulum (RER). When the
      infected cultures are shifted to 28 degrees, the complex is transported to the
      cell surface. During the transport p62 is cleaved into E2 under conditions in
      which no virus budding takes place. We have sequenced the cDNA, which encodes the
      envelope proteins of ts1. Comparison with the respective wild-type nucleotide
      sequence shows only one nucleotide change, G----A, causing a replacement of
      cysteine-58 (TGC) with tyrosine (TAC) in the E3 protein of ts1. A cDNA fragment
      from the ts1 genome encoding the mutation in E3 was used to replace the
      respective fragment of prototype SFV in an eukaryotic expression vector.
      Intracellular arrest of envelope proteins at 39 degrees was seen in transfected
      BHK21 cells. A shift of the transfected cells to 28 degrees resulted in the
      appearance of the envelope proteins at the cell surface. We conclude that the
      single point mutation is solely responsible for the temperature-sensitive
      transport defect of ts1 envelope glycoproteins.

PMID- 2238467
TI  - Mutational analysis of barley stripe mosaic virus RNA beta.
AB  - Barley stripe mosaic virus (BSMV), the type member of the hordeivirus group, has
      a plus-stranded genome comprising RNA species designated alpha, beta, and gamma.
      Although RNA beta is essential for infection of whole plants, it is dispensable
      for infection of barley protoplasts. We have used a full-length cDNA clone of RNA
      beta from which infectious in vitro transcripts can be derived to construct a
      number of mutations in its four genes. Mutations introduced into the beta b, beta
      c, or beta d genes eliminated infectivity of the RNA. The coat protein and the
      RNA sequences encoding the coat protein were completely dispensable for infection
      of barley plants by BSMV, and no detrimental effect on systemic movement of the
      virus was observed. However, besides eliminating coat protein expression in vivo,
      mutations within the coat protein gene and the first intercistronic region
      affected a number of other phenotypes: (1) expression of a downstream gene (beta
      b), (2) stability of the genomic RNA during virus multiplication in planta, (3)
      the requirement for a trans-acting BSMV protein (gamma b), (4) symptomatology and
      disease development in infected barley plants, and (5) host range.

PMID- 2238468
TI  - Expression of plasmid-encoded structural proteins permits engineering of
      bacteriophage T4 assembly.
AB  - A complementation system for studying bacteriophage T4 tail assembly has been
      developed and used to test the effects of nonviable mutations on the function of
      a specific T4 tail protein, gp48. The complementation system assays the assembly
      function of gp48 without requiring that viable phage be produced, circumventing
      the operational problems of maintaining nonviable mutants of this lytic
      bacteriophage. The protein to be tested was preexpressed from cloned genes in a
      host cell prior to infection with the challenge phage. Assembly activity was
      assayed by monitoring the conversion of one tail assembly intermediate, the
      baseplate lacking gp48, into baseplates containing gp48 or into tube baseplates
      (or sheathed tails) assembled from such baseplates. Specific incorporation of
      gp48 into these structures was confirmed using gp48-specific antiserum, and the
      same serum was used in direct immunoelectron microscopy experiments to localize
      gp48 to the baseplate-proximal end of the T4 tail tube, at the site where the
      tube and sheath bind to the baseplate. The protein gp48 has been previously shown
      to be a baseplate protein, as well as a tail-tube-associated protein, and was
      tested for a possible role as a tail-length tape-measure protein. Tests with a
      deleted variant of gp48 were inconclusive because the protein was inactive. A
      variant of gp48, 20% longer than wild-type protein due to an internal
      duplication, was found to be partly functional in our assembly complementation
      system. This abnormally elongated protein allows several assembly steps to
      proceed, including the assembly of normal length T4 tails, implying that it does
      not specify tail length. The insertion-duplication variant of gp48 appears to
      have a defect in its interaction with the tail sheath protein, leading to
      abnormal sheath contraction.

PMID- 2238469
TI  - Molecular characterization of a new hemagglutinin, subtype H14, of influenza A
      virus.
AB  - Two influenza A viruses whose hemagglutinin (HA) did not react with any of the
      reference antisera for the 13 recognized HA subtypes were isolated from mallard
      ducks in the USSR. Antigenic analysis by hemagglutination inhibition and double
      immunodiffusion tests showed that the HAs of these viruses are similar to each
      other but distinct from the HAs of other influenza A viruses. Nucleotide sequence
      analysis showed that these HA genes differ from each other by only 21
      nucleotides. However, they differ from all other HA subtypes at the amino acid
      level by at least 31% in HAI. Thus, we propose that the HAs of these viruses
      [A/Mallard/Gurjev/263/82 (H14N5) and A/Mallard/Gurjev/244/82 (H14N6) belong to a
      previously unrecognized subtype, and are designated H14. Unlike any other HAs of
      influenza viruses, the H14 HAs contained lysine at the cleavage site between HA1
      and HA2 instead of arginine. Experimental infection of domestic poultry and
      ferrets with A/Mallard/Gurjev/263/82 (H14N5) showed that the virus is avirulent
      for these animals. Based on comparative sequence analysis of different HA genes,
      it is suggested that differences of 30% or more at the amino acid level in HA1
      constitute separate subtypes. Phylogenetic analysis of representatives of each HA
      subtype showed that H14 is one of the most recently diverged lineages while H8
      and H12 branched off early during the evolution of the HA subtypes. These latter
      two subtypes (H8 and H12) have been isolated very infrequently in recent years,
      suggesting that these old subtypes may be disappearing from the influenza
      reservoirs in nature.

PMID- 2238470
TI  - Replication of sonchus yellow net virus in infected protoplasts.
AB  - Tobacco (Nicotiana edwardsonii and N. benthamiana) protoplasts infected with the
      plant rhabdovirus sonchus yellow net virus (SYNV) were found to be suitable for
      studies of replication. SYNV messenger RNAs could be detected within 2 hr
      postinoculation (PI), accumulated to a maximum within 24 hr, and subsequently
      declined to undetectable levels by 60 hr. Plus- and minus-sense genomic RNAs
      appeared later and were most abundant by 36 hr PI, but the levels decreased by 60
      hr. The four major SYNV structural proteins could be detected by Western blot
      serological analyses by 24 hr PI and were present in highest concentrations
      between 43 and 60 hr PI. Among various glycosylation inhibitors, only tunicamycin
      treatment of protoplasts altered viral protein patterns and resulted in synthesis
      of a glycoprotein with an apparent molecular weight (Mr) 10% smaller than that
      found in untreated protoplasts. Two specific cleavage products of the
      nucleocapsid protein estimated to be 21,000 and 37,000 Mr appeared in N.
      benthamiana-infected protoplasts by 60 hr PI, but in the presence of tunicamycin,
      the cleavage products were evident by 38 hr. This result suggests that specific
      cleavage of the N protein is correlated with stress of infected cells due to
      viral accumulation and/or tunicamycin treatment.

PMID- 2238471
TI  - Defective interfering particles: effects in modulating virus growth and
      persistence.
AB  - Defective interfering virus particles (DIP) frequently play an important part in
      viral persistence in vitro, and may in some instances modify a virus infection in
      vivo, causing attenuation or persistence of the infection. To explain certain
      aspects of the growth of these mutants in vitro, other factors have been invoked
      such as interferon, mutations in the wild-type virus or the infected cells, or
      other substances released by infected cells that attenuate the infection. We
      present here a simple model of the growth of DIP in vitro which shows that (a)
      the observed population dynamics of DIP can readily be explained without invoking
      such extrinsic factors; (b) the initial multiplicity of infection of DIP is the
      principal determinant of the outcome of infection in both single- and repeated
      passage cultures; and (c) in a long-term culture in vitro, the criterion used to
      decide the time of virus passage directly determines how long the standard virus,
      DIP, and cells survive. This model may be used with minor modifications to
      predict the behavior in vitro of other mutant viruses with a dominantly
      interfering phenotype.

PMID- 2238472
TI  - The human immunodeficiency virus type 1 envelope glycoprotein precursor acquires
      aberrant intermolecular disulfide bonds that may prevent normal proteolytic
      processing.
AB  - The envelope glycoprotein of human immunodeficiency virus consists of two
      subunits, designated gp120 and gp41, derived from the cleavage of a precursor
      polypeptide gp160. When expressed from a recombinant vaccinia virus and analyzed
      by velocity gradient sedimentation and polyacrylamide gel electrophoresis, a
      significant proportion of gp160 molecules formed oligomers that were stabilized
      by intermolecular disulfide bonds. Oligomeric forms of both gp120 and gp41 were
      also observed, but these oligomers were noncovalently associated. Both the
      intermolecularly linked oligomers of gp160 and the unlinked oligomeric envelope
      protein subunits were found to accumulate with time. These results indicate that
      there are two populations of gp160 precursors, one that is folded and processed
      correctly into gp120 and gp41 and another that is intermolecularly disulfide
      bonded and remains uncleaved. We propose that the formation of intermolecular
      disulfide bonds is not an intermediate step in the maturation of the envelope
      glycoprotein, but rather a result of misfolding of the gp160 precursor which
      prevents it from being properly processed.

PMID- 2238473
TI  - Reovirus RNA is infectious.
AB  - Conditions under which reovirus RNA is infectious have been worked out. In brief,
      single-stranded (plus-stranded, ss) and/or double-stranded (ds) RNA of reovirus
      serotype 3 (ST3 virus) is lipofected into L929 mouse fibroblasts together with a
      rabbit reticulocyte lysate in which ss or melted dsRNA has been translated. After
      8 hr the cells are then infected with a helper virus, ST2 reovirus. Virus yields
      are harvested 24 or 48 hr later. Under these conditions virus that forms plaques
      by 5 days is produced, all of which is ST3 virus; ST2 virus forms plaques only
      after 12 days. No reassortants are present among the progeny. The virus yields
      are about 0.2 PFU/cell; immunofluorescence assays show that this progeny is
      derived from about 4% of the cells. Double-stranded RNA is 20 times as infectious
      as ssRNA; ds and ssRNA together yield 10 times as much infectious virus as dsRNA
      alone, the reason being that dsRNA greatly increases the infectiousness of ssRNA.
      All species of both ss and dsRNA are required for the operation of this additive
      effect. The primed rabbit reticulocyte lysate is not essential, but increases
      virus yields by 100-fold. Its activity is proportional to the time for which
      translation has proceeded; however, this activity is not due solely to newly
      synthesized proteins because destruction of the RNA following translation
      abolishes activity which cannot be restored by simple addition of more RNA.
      Translation of all species of RNA is essential. Whereas no reassortants are
      formed when ss and dsRNA of different genotypes are lipofected together, mixtures
      of dsRNAs of different genotypes do yield reassortants. The same is true for such
      mixtures of ssRNA. These findings will permit the introduction of new or altered
      genome segments into the reovirus genome. They open the way to the identification
      of encapsidation and assortment signals on reovirus genome segments, the
      characterization of functional domains on reovirus proteins, and the development
      of reovirus as an expression vector.

PMID- 2238474
TI  - Molecular characterization of the Borna disease agent.
AB  - Borna disease (BD) is a neurologic syndrome characterized by profound
      disturbances in behavior and the accumulation of specific antigens in limbic
      system neurons. The potency of brain homogenates from animals with BD to cause
      disease in normal animals is reduced by exposure to detergents. We have recently
      described isolation and characterization of clones derived from the BD agent.
      Here we present evidence that suggests that the BD agent is a negative-sense,
      single-strand RNA virus. The 8.5-kb genome of this virus appears to be associated
      with nuclei and encodes two major RNA transcripts of 2.1 and 0.8 kb.

PMID- 2238475
TI  - Identification and sequence analysis of the maize stripe virus major noncapsid
      protein gene.
AB  - The maize stripe virus (MStV) major noncapsid protein (NCP) gene was
      characterized, and the location of the NCP gene was identified among the 5-RNA,
      18-kb genome. A 12-amino-acid sequence of the NCP was compared with nucleotide
      sequence data for MStV RNAs 3 and 4 and was found to align perfectly within a 528
      nucleotide open reading frame (ORF) of RNA 4. The amino acid composition of
      purified NCP was almost identical to that deduced from the putative coding
      region. The deduced NCP molecular weight was 19,815, very similar to that
      determined by SDS-PAGE analysis of the purified NCP. In vitro transcription and
      translation analysis of the cDNA representing this region showed unequivocally
      that this region encoded the NCP. Primer extension analysis using a synthetic
      oligonucleotide complementary to a sequence near the 5' end of the coding region
      revealed that the NCP ORF is located 61 nucleotides from the 5' end of RNA 4.

PMID- 2238477
TI  - Expression of gag precursor protein and secretion of virus-like gag particles of
      HIV-2 from recombinant baculovirus-infected insect cells.
AB  - A recombinant baculovirus carrying the gag gene but lacking the protease coding
      sequences of human immunodeficiency virus type 2 (HIV-2) has been constructed.
      When this recombinant baculovirus is used to infect insect cells, a high level of
      gag precursor protein, gag pr41, is expressed. Electron microscopy showed that
      the majority of gag pr41 was budding through the plasma membrane and being
      released into the culture medium in spherical virus-like particles with a
      diameter of approximately 100 nm. Metabolic labeling demonstrates that gag pr41
      is myristylated. Our results demonstrated that HIV-2 gag pr41 can be assembled
      into virus-like particles in the absence of other HIV proteins. Rabbits immunized
      with purified gag pr41 particles produced high-titer antibody and Western blot
      analysis showed that anti-gag pr41 rabbit sera recognize p17, p24, and p55 gag
      proteins of HIV-1. These results show that gag pr41 particles are highly
      immunogenic and that gag proteins of HIV-1 and HIV-2 have similar antigenic
      epitopes.

PMID- 2238476
TI  - Hepatitis B virus propagated in a rat hepatoma cell line is infectious in a
      primate model.
AB  - The human hepatitis B virus (HBV) produced by a rat hepatoma cell line through
      transfection with HBV DNA is infectious in the human primate model--chimpanzee.
      Since hepadnaviruses are known to have an extremely narrow host range, our
      results support the idea that the host species barrier of HBV infection resides
      on the penetration/adsorption step rather than any postpenetration intracellular
      event during the virus life cycle.

PMID- 2238478
TI  - Alternative splicing of hepatitis B virus RNAs in HepG2 cells transfected with
      the viral DNA.
AB  - We identified a novel spliced RNA of 2.6 kb from a human hepatoma cell line HepG2
      transfected with the hepatitis B virus (HBV) genome. The splicing acceptor site
      of the novel 2.6-kb RNA (position 489) was shown to be common to that of the
      previously described 2.1-kb spliced RNA which codes for an altered core antigen
      lacking the carboxy-terminal amino acid, cysteine. However, the donor site of the
      2.6-kb RNA is different from any of the spliced RNA reported and located at 538
      nucleotides (nt) downstream of the donor site of the 2.1-kb RNA. Introduction of
      single-base change mutations in the consensus sequence of the donor site of the
      2.1-kb RNA maintained the splicing by using the cryptic donor site. The amount of
      the 2.6-kb spliced RNA was unchanged by these mutations. These results suggest
      independent regulations for the synthesis of the 2.1- and 2.6-kb spliced RNAs.

PMID- 2238479
TI  - Two bases are deleted from the termini of HIV-1 linear DNA during integrative
      recombination.
AB  - Proviral integration is a required step in the retrovirus life cycle. The
      mechanism of integration involves specific modification of the ends of linear
      viral DNA and subsequent recombination with host sequences. Integration results
      in the limited loss of sequence information at the termini of the viral genome.
      The composition of the intact linear DNA termini were inferred by sequencing the
      2-long terminal repeat (2-LTR) circle junction that is formed when the linear
      molecule undergoes intramolecular, blunt-end ligation. The junction sequence
      contained the nucleotides GTAC that were not present at the ends of the
      integrated provirus. Comparison with the sequence of the LAV-1 strain of HIV-1
      demonstrated that the GT dinucleotide derived from the right-hand terminus (U5)
      of the linear viral DNA and the AC dinucleotide came from the left-hand terminus
      (U3). Therefore, the corrected size of the LAV-1 LTR is 637 bp. This conclusion
      was confirmed independently by assessing the structure of linear viral DNA in
      acutely infected T cells. A portion of the population of linear HIV-1 DNA
      molecules were specifically deleted at their 3' ends; the extent of this deletion
      was 2 bases. This result is consistent with the activity of viral integrase
      protein on linear viral DNA and it accounts for the structure of integrated HIV-1
      proviruses.

PMID- 2238480
TI  - Inhibition of uncoating of tobacco mosaic virus particles in protoplasts from
      transgenic tobacco plants that express the viral coat protein gene.
AB  - The uncoating of tobacco mosaic virus (TMV) particles in protoplasts isolated
      from leaves of transgenic tobacco plants that express the TMV coat protein gene
      was investigated. Extracts of these protoplasts collected up to 1 hr after
      inoculation with TMV contained fewer of the complexes ("striposomes") thought to
      be involved in cotranslational disassembly of virus particles than did extracts
      of protoplasts that do not express the viral coat protein gene. These results are
      consistent with the hypothesis that TMV coat protein-mediated resistance is at
      least in part the result of inhibition of the uncoating of the virus particles in
      the inoculum.

PMID- 2238481
TI  - The putative RNA replicase of potato virus M: obvious sequence similarity with
      potex- and tymoviruses.
AB  - On the basis of comparison of the protein sequences of the putative virus
      specific replicases, carlaviruses can be placed in the "Sindbis-like" supergroup
      of plus-stranded RNA viruses. Among these, the amino acid sequences of the
      replication proteins of potex- and tymoviruses showed the highest similarity to
      potato virus M. The possible functions of conserved domains are suggested to be
      methyltransferase, nucleotide-binding domain, and RNA polymerase.

PMID- 2238482
TI  - Complementation of coat protein-defective TMV mutants in transgenic tobacco
      plants expressing TMV coat protein.
AB  - Transgenic tobacco plants (Nicotiana tabacum cv. Xanthi) which express tobacco
      mosaic virus (TMV) U1 strain coat protein (CP) can complement both the assembly
      and the long-distance spread of CP-defective (DT1) or coat proteinless (DT1G)
      mutants of TMV. Both mutants arose spontaneously from PM2 and exist only as
      unencapsidated RNA in the inoculated leaves of control tobacco plants, where they
      are unable to form virus particles or to spread systemically. TMV CP expressed in
      transgenic tobacco plants [CP+ line 3404; P. Powell Abel, R. S. Nelson, B. De, N.
      Hoffman, S. G. Rogers, R. T. Fraley, and R. N. Beachy, 1986, Science 232, 738
      743] was able to package some of either mutant viral RNA into TMV-like particles
      in vivo and resulted in the long-range spread of infection. In vivo encapsidated
      DT1 RNA was recovered and reinoculated onto control or new CP+ transgenic tobacco
      plants. Localized infection of control plants confirmed that no RNA recombination
      or reversion of the mutant RNA to wild-type had occurred during passage in the
      first CP+ plant. In contrast, encapsidated DT1 RNA was unable to produce even
      local infection in CP+ transgenic plants confirming that CP-mediated protection
      operates during the early stages of virus infection, including particle
      uncoating. By positive complementation, these results also confirm that TMV CP is
      required for the long-distance spread of infection.

PMID- 2238483
TI  - Crystallization of cauliflower mosaic virus.
AB  - Cauliflower mosaic virus has been crystallized in hanging and sitting drops. The
      hexagonal and octahedrally shaped crystals are up to 0.5 mm in mean diameter. The
      octahedrally shaped crystals diffract to about 27 A resolution. The results are
      discussed in relation to the lability and aggregation of the virions.

PMID- 2238485
TI  - [Medical care for burn patients on board naval fighting ships].

PMID- 2238484
TI  - Plan and operation of the NHANES I Epidemiologic Followup Study, 1986.
AB  - This report describes the plan and operation for the 1986 data collection wave of
      the Epidemiologic Followup to the First National Health and Nutrition Examination
      Survey (NHANES I). Tracing and data collection were conducted on 3,980 persons 55
      74 years of age at NHANES I who were not known to be deceased in the 1982-84 data
      collection wave of the NHANES I Epidemiologic Followup Study.

PMID- 2238486
TI  - [Delivering medical care to the victims in mass peacetime catastrophes].

PMID- 2238487
TI  - [The principles of formulating a pathogenetic therapy in the early period of the
      crush syndrome].

PMID- 2238488
TI  - [The clinico-immunological changes in general cooling of the body].

PMID- 2238489
TI  - [The clinical picture and treatment of acute radiation sickness in the recovery
      period (a review of the literature)].

PMID- 2238490
TI  - [Mobile clinico-diagnostic laboratories abroad].

PMID- 2238491
TI  - [The current problems of medical support for naval military personnel].

PMID- 2238492
TI  - [Ways to improve the primary medical card].

PMID- 2238493
TI  - [A "triage post" kit (an innovation suggestion)].

PMID- 2238494
TI  - [The current problems in the advanced training of officers of the medical reserve
      corps].

PMID- 2238495
TI  - [The research work and training of the students in a department of management
      medical staff].

PMID- 2238496
TI  - [Criteria for the comprehensive evaluation of the activities of military medical
      hospital commissions].

PMID- 2238497
TI  - [The current problems of specialized proctological care in military medical
      institutions].

PMID- 2238498
TI  - [High-frequency artificial ventilation of the lungs in the prevention of
      postoperative pneumonias].

PMID- 2238500
TI  - [The use of agents to stimulate and correct the immune system in the prevention
      of infectious diseases among the troops].

PMID- 2238499
TI  - [The current trends in the diagnosis and treatment of ankylosing spondylitis].

PMID- 2238501
TI  - [Experience in organizing epidemic-control measures in children's summer health
      promoting institutions].

PMID- 2238502
TI  - [An evaluation of the efficacy of health and hygiene measures performed in the
      barracks].

PMID- 2238503
TI  - [The pharmacological correction with asparkam of the functional status of pilots
      in army aviation in a hot climate].

PMID- 2238504
TI  - [The risk factors and prognosis of syncopal states in pilots].

PMID- 2238505
TI  - [The biorhythms and work capacity of sailors under hypokinetic conditions].

PMID- 2238506
TI  - [The Academic Medical Council of the Central Military Medical Administration (on
      the 50th anniversary of its formation)].

PMID- 2238507
TI  - [The principles of N. I. Pirogov's "system of dispersion" and their development
      during World War II].

PMID- 2238509
TI  - [The effect of a 3-day fast on psychophysical functions in young people].
AB  - Presented are results of the effect of a complete three-day fasting with
      permitted optional water intake on some anthropometric, biochemical-metabolic and
      functional parameters significant in the assessment of psychophysical fitness of
      healthy, well-developed and normally-nourished young men aged 19.5 years in
      average. It was found that a three-day complete fasting with average daily energy
      expenditure of 14.89 MJ resulted in significant body mass reduction, significant
      glycemia and respiratory quotient decrease, significant blood urea, keto-bodies
      and triglyceride levels increase and in significantly reduced endurance at
      strenuous physical work performance.

PMID- 2238508
TI  - [Lyme disease in Yugoslavia].
AB  - Presented are results of the last five-year period study of the lyme disease in
      Yugoslavia. On the basis of published papers and professional communications over
      2500 cases of lyme disease.were detected in our country within this period.
      Presented are common epidemiologic and clinical features of the disease and
      particularly cases diagnosed in Belgrade. Since 1987 a group of various
      specialists has been working on the research project in collaboration with many
      centres in the country. Indirect immunofluorescence test as the diagnostic
      laboratory technique has been introduced in the Military Medical Academy in
      Belgrade in 1987. First species of Borrelia burgdorferi from ticks Ixodes ricinus
      have been isolated and cultivated in May and June 1990. Current problems
      concerning research work, medical and epidemiological aspects of the lyme disease
      are presented.

PMID- 2238510
TI  - [Working environment conditions and occupational disorders in artillery unit
      personnel].
AB  - Occupational environment risk factors and health status of 172 soldiers and 89
      officers were examined aiming to discover early signs of occupational diseases
      and disorders in artillery personnel. Among all physical and chemical risk
      factors noise caused by artillery and infantry firing (140 to over 170 dB) were
      the most frequent and among occupational diseases/disorders only perceptive
      hearing disorders being very frequent in artillery officers (65.22%) were found
      out. Preventive measures against occupational environment risk factors were
      suggested.

PMID- 2238511
TI  - [Preparation of a DNA probe for thermolabile toxin and its use in the
      identification of enterotoxic Escherichia coli].
AB  - Enterotoxic Escherichia coli (ETEC) having a gene for thermolabile toxin were
      identified by the hybridization technique. HindIII-SmaI fragment with 423 basic
      pairs (dp) including subunit portions A and B of the gene for thermolabile toxin
      (elt) was used as the DNA probe.

PMID- 2238512
TI  - [Use of the ELISA immunoenzyme test and indirect immunofluorescence in the
      diagnosis of a toxoplasmosis epidemic].
AB  - Etiologic agent of lymphadenitis outbreak in one our military environment was
      detected by two serologic tests: ELISA (enzyme-linked immunosorbent assay) and
      indirect immunofluorescence test (IIF) both specific for IgM and IgG antibody
      detection in toxoplasmosis diagnosis. IgM-ELISA analysis of the first serum
      sample taken from a group of 79 soldiers with lymphadenitis was positive in 65
      examinees (82.28%) and IgG-IIF technique in 52 (65.82%). In a group of 33
      soldiers from the same unit with no signs of the disease IgM-ELISA test was
      positive in 12 (36.36%) and IgM-IIF in 9 (27.27%). In a group of 40 officers from
      the unit with the disease outbreak specific IgM antibodies were found by both
      tests only in the head cook. IgM antibodies were not found in a control group of
      102 healthy soldiers from other units of the same garrison. Results of this
      investigation thermal injury showed variations in immune response to infection in
      dependence on trauma effect duration (in dependence on the phase). In the early
      posttraumatic phase organism is capable to react effectively to the inoculated
      infective agent and in the late posttraumatic phase this reaction is much less
      effective. Authors conclude that these results may influence upon the thermal
      injury management strategy in dependence on the trauma effect duration.

PMID- 2238513
TI  - [Methods for the detection of salmonellae in food].
AB  - Presented are results of modern immunological and culture medium techniques for
      the salmonella isolation from chicken trunks compared with those obtained by
      standard technique (ST). By using fluorescent antibody technique (FAT), enriched
      serum techniques (ES) and immune stain-reaction (ISR) a larger number of positive
      samples was detected (31%-41%) in comparison with standard culture medium
      techniques (ST) (25%). Statistically significant differences were obtained by
      FAT. By both Rappaport-Vassiliadis (RV) and modified semi-solid Rappaport
      Vassiliadis (MSRV) culture medium techniques about thrice higher percentage of
      salmonella positive findings were obtained than in comparison with the standard
      techniques. Compared to RV, the MSRV culture media technique reduces the
      salmonella isolation period for 48.

PMID- 2238514
TI  - [Acute gastroenteritis of viral etiology].
AB  - Retrospective analysis of own experiences and investigations concerning the role
      of the viral etiology in acute gastroenteritis were presented. Stools of children
      and soldiers with acute gastroenteritis were examined by electron microscopy. The
      most frequent causative agents were rotaviruses and much less frequently found
      were other viral particles of: coronaviruses, adenoviruses, Norwalk-like viruses,
      astroviruses, caliciviruses and "small round viruses".

PMID- 2238515
TI  - [Surveillance methods in hospital infections].
AB  - In the prevalence study of postoperative pyogenic-inflammatory disease in 1,000
      operated patients three parallel controls have been undertaken: comprehensive
      prospective control, current state and standard control. Current prevalence
      control has been proved the most suitable, practical and for hospital personnel
      the most acceptable control method.

PMID- 2238516
TI  - [Seasonal distribution of intestinal fungal infection by the genus Candida].
AB  - To follow-up seasonal distribution of intestinal fungal infection by Candida
      genus (CGF) in patients and healthy subjects 3786 stool samples have been
      examined. There were 1302(34.4%) stools of patients and 2484 of healthy subjects
      of which 421 (16.9%) samples were infected by CGF. In both groups of examinees
      infection by CGF had a seasonal character. Significantly lower incidence was
      found within the period January-March (the three-month average percentage of
      infection was 25.2%, that is, 13.9%) than within the period October-December (the
      three-month average percentage of infection distribution was 42.7%, that is
      20.4%).

PMID- 2238517
TI  - [Health and medical problems in supplying water to the armed forces during times
      of peace].

PMID- 2238518
TI  - ["Health for All by the Year 2000" with special emphasis on the prevention of
      chronic non-infectious diseases].

PMID- 2238519
TI  - [Health problems of enclosed environments at work and in the home].

PMID- 2238520
TI  - [Various indices of lipid metabolism in patients with gastroduodenal pathology].
AB  - Lipid metabolism was studied in patients with impairments of gastroduodenal tract
      before and after treatment. The data obtained suggest that the treatment of these
      patients should involve both antioxidants and angioprotective drugs in order to
      prevent vascular deteriorations.

PMID- 2238522
TI  - [The effect of tuftsin on various aspects of metabolism in the sensorimotor
      system of the animal brain].
AB  - Rates of synthesis and degradation of monoamines, acetyl choline and protein were
      distinctly altered in cortex-subcortex structures of the brain locomotory system
      after a single administration of tetrapeptide tuftsin Thr-Lys-Pro-Arg during the
      period 15-30 min of its pronounced effect on the animal motor activity.
      Correlation between the functional and morphological alterations in cellular and
      subcellular brain structures, caused by the peptide administration, is discussed.

PMID- 2238521
TI  - [Molecular mechanism of hemosorption].
AB  - Several humoral and intracellular components of blood were investigated in
      patients with esophageal carcinoma treated with preventive hemosorption +
      chemotherapy, and also in patients with purulent complications after surgery
      before hemosorption, during hemosorption and 3 hrs, 1, 3 and 7 days after
      hemosorption. It was demonstrated that during hemosorption and in the first days
      following it no significant changes occurred either in blood count or in protein
      content, protein composition, levels of alpha 1-AT, IgG, IgA and IgM in blood
      plasma. Preventive hemosorption did not cause hypo- or dysproteinemias in these
      patients. Hemosorption led to normalization of certain biochemical indices of
      blood: increase in BAEE activity and decrease in the level of middle molecular
      toxins, which indicated the reduction of endotoxicosis in patients. During
      hemosorption there was a marked (100-200 times) increase in blood plasma of
      lactoferrin, which is a component of specific granules in neutrophils. It is
      assumed that the leading modifying mechanism of action of hemosorption is an
      output of physiologically active components the main of which is lactoferrin.

PMID- 2238523
TI  - [The effect of 24,25-dihydroxyvitamin D3 (dioxyvit) on Ca metabolism and immune
      status during chronic kidney failure].
AB  - Active metabolite of vitamin D3, 24R,25 (OH)2D3 (dioxyvit) was used at a daily
      dose of 100 micrograms in treatment of children affected with tubulointerstitial
      disease of kidney and with chronic glomerulonephritis under conditions of kidney
      insufficiency. The drug exhibited distinct normalizing effect on patterns of
      calcium metabolism: increase of total and ionized Ca2+ and of 25-OHD, decrease in
      concentration of parath hormone and osteocalcine in blood serum as well as on
      immunological parameters: restoration of decreased content of T- and 0
      lymphocytes. Concentration of receptors of hormonal form of 1,25(OH)2D3 was found
      to be minimal in lymphocytes under conditions of chronic kidney insufficiency,
      while their expression, after the dioxyvit action, was detected only in patients
      with glomerulonephritis. Specific calcitropic effect of dioxyvit with
      simultaneous correction of vitamin D deficiency were apparently responsible for
      high efficacy of the drug in treatment of calcium metabolism and immunity
      impairments in children with renal deteriorations at the step of chronic kidney
      insufficiency.

PMID- 2238524
TI  - [Ethanol and protein biosynthesis in the animal liver (review of the
      literature)].
AB  - Protein biosynthesis was markedly altered in liver cells after acute and chronic
      administration of ethanol in vivo and in vitro. The effects were dose- and time
      dependent. Synthesis of cytoplasmic and nuclear proteins was inhibited in
      hepatocytes. In chronic intoxication activity of fibroblasts and collagen
      synthesis were stimulated. The data obtained suggest that inhibition of amino
      acids activation, impairment of translation and transcription were involved in
      mechanisms of the ethanol toxic effects on liver tissue. At the same time,
      negative effects of ethanol and its metabolites appear to be related to post
      translation modification of polypeptides.

PMID- 2238525
TI  - [ADP-induced aggregation of human platelets in diabetes mellitus].
AB  - Dilution of thrombocyte-rich blood plasma (down to 2.5 x 10(8) thrombocytes/ml)
      enabled to avoid an irreversible phase of the ADP-induced thrombocyte
      aggregation; the reversible phase of aggregation was followed by deaggregation.
      The reversible aggregation of thrombocytes was studied in healthy persons and
      patients with diabetes mellitus within wide ranges of ADP concentrations
      (including 10 microM) using the diluted blood plasma. Thrombocytes of the
      patients with diabetes mellitus of the I and II types were found to be 1.6- and
      2.33-fold more sensitive to the ADP aggregating effect as compared with
      thrombocytes of healthy persons. The elevated rate of thrombocytes aggregation in
      diabetes mellitus appears to be related to early decrease in activity of
      thrombocyte guanylate cyclase and to its ability to be activated.

PMID- 2238526
TI  - [Formation of interpolymer complexes with human seminal plasma proteins].
AB  - Formation of interpolymeric complexes was studied involving human lactoferrin,
      prostate beta-globulin, specific acid phosphatase and polymers of various nature:
      polysaccharides--heparin, dextran sulfate; polylysine-16; proteins--human
      albumin, equine hemoglobin, gelatin, protamine. Immunoelectrophoresis proved to
      be a sensitive procedure to register the interpolymeric complexes formed.
      Electrophoretic mobility of lactoferrin and prostatic beta-globulin was most
      distinctly altered. Mechanisms of the complexes formation, including ionic and
      hydrophobic interactions, are discussed.

PMID- 2238527
TI  - [Plasma and platelet lipids in patients with newly diagnosed angina and chronic
      heart disease].
AB  - In patients with ischemic heart disease impairments in blood plasma lipid
      spectrum were more distinct in the chronic form of the disease. At the same time,
      the phospholipid composition was altered in thrombocytes as compared with that of
      persons free of ischemic heart disease and of stenosing coronary atherosclerosis.

PMID- 2238528
TI  - [Incidence among men of atherogenic potential of the serum detected in a culture
      of mouse peritoneal macrophages].
AB  - Blood serum of 63 persons out of 191 men examined, randomly selected among non
      organized population, caused in primary culture of mice peritoneal macrophages
      the 1.3-4-fold increased accumulation of intercellular cholesterol. Blood serum
      of other 128 men studied did not exhibit any atherogenic properties in the
      culture. The atherogenic potential of blood serum did not correlate with content
      of blood serum lipids, apolipoproteins B and A-I, while it correlated with the
      ratio apo B/apo A-I in blood serum and with one of ischemic heart disease risk
      factors--increased arterial pressure. Blood serum atherogenic potential, detected
      in experimental model, appears to be involved in development of human
      atherosclerosis.

PMID- 2238530
TI  - [Mitochondrial oxidation in the liver during visceral-ischemic shock].
AB  - Distinct decrease in respiratory and phosphorylating functions of liver
      mitochondria was found under conditions of visceral-ischemic shock induced in
      rabbits after 2 hrs occlusion of superior mesenteric artery and the subsequent
      step-by-step revascularization. Endogenous intoxication was mainly responsible
      for inhibition of electron transport through respiratory chain. Impairment of
      mitochondrial oxidation is one of important factors related to development of the
      shock "irreversible" phase.

PMID- 2238529
TI  - [The effect of ascorbate, NADPH and chloditan on lipid peroxidation in the
      adrenal glands of dogs and guinea pigs in vitro].
AB  - Lipid peroxidation was studied in dog and guinea pig adrenal cortex homogenates
      in vitro in presence of ascorbate, NADPH and I-(o-chlorophenyl)-I-(p
      chlorophenyl)-2,2-dichloroethane (o,p'-DDD, chloditane) the substance exhibiting
      the specific impairing effect on human and dog adrenal gland cortex. The higher
      rate of spontaneous lipid peroxidation was detected in adrenal gland homogenates
      of guinea pig. NADPH inhibited accumulation of hydroperoxides in dog adrenal
      gland homogenates, while ascorbate-Fe2(+)-activated lipid peroxidation.
      Chloditane at concentrations 15.6 and 156 microM decreased the rate of
      spontaneous lipid peroxidation in dog adrenal gland homogenates and increased--in
      guinea pig preparations. Chloditane decreased distinctly the rate of lipid
      peroxidation in guinea pig adrenal gland homogenates, which was stimulated by
      ascorbate.

PMID- 2238531
TI  - [The effect of progesterone on metabolism of cholesterol esters in macrophages
      cultured with acetylated low density lipoproteins].
AB  - Effect of progesterone on esterification of free cholesterol, on content of free
      cholesterol and its esters was studied in rat macrophages, cultivated in presence
      of acetyl-derivatives of low density lipoproteins (Ac-LDL), as well as on
      mobilization of cholesterol from macrophages. Progesterone at a dose of 0.5-10
      micrograms per I ml of cultivating medium caused dose-dependent inhibition of I
      14C-oleate incorporation into cholesterol esters of macrophages cultivated with
      Ac-LDL (50 micrograms of protein/ml). In the medium free of LDL progesterone
      caused an increase of cholesterol in macrophages by 45%, while addition of 100
      micrograms/ml LDL led to a decrease of free cholesterol by 20% of the initial
      level. If macrophages pre-enriched with 4-C14-cholesterol were cultivated in LDL
      containing medium, progesterone increased the 4-14C-cholesterol liberation into
      medium and decreased the cholesterol content in macrophages. Under conditions of
      macrophages incubation in the LDL-free medium, progesterone increased the free
      cholesterol content in these cells but did not affect the 4-14C-cholesterol
      liberation into medium. The data obtained suggest that the progesterone-induced
      inhibition of free cholesterol esterification may increase its mobilization from
      macrophages only if the LDL acceptor function is unaltered.

PMID- 2238532
TI  - [Lysosomal hydrolases of various rat organs in the process of cell nutrition].
AB  - Activity of lysosomal proteinases cathepsins A, B, C, D, H and L was studied in
      liver, kidney, spleen, thymus, heart, skeletal muscle and brain tissues of rats,
      maintained on full value diet, on a diet free of proteins and on the diet
      enriched with methionine. Distinctly dissimilar reactions of thiol-dependent
      proteinases was detected in liver, heart tissues and skeletal muscles as compared
      with the reaction of cathepsins A and D; activity of cathepsins B, H and L was
      decreased 1.5-2-fold in the animal groups maintained on diets both free of
      proteins and enriched with methionine. The data obtained suggest that
      concentration of endogenous inhibitors of lysosomal thiol-dependent proteinases
      rather than content of SH-groups in tissues was responsible for alterations of
      their activity under conditions of protein starvation.

PMID- 2238534
TI  - [Heparin-histamine complex, its physico-chemical and biological properties].
AB  - Complexes between heparin and histamine at various ratio exhibited various
      physiological activity. The complex containing heparin-histamine at the ratio of
      6:1, 10:1 or 15:1 showed anticoagulation, antipolymerization and nonenzymatic
      fibrinolytic effects. The complex dissociated in circulation within 90 min after
      its administration. This complex effected also the rheologic properties of blood.

PMID- 2238533
TI  - [The effect of ascorbic acid on the collagen synthesis in skin fibroblasts of
      children with funnel chest].
AB  - Relative synthesis of collagen was studied in skin fibroblasts of children with
      funnel chest and of corresponding age children (control) in presence of ascorbic
      acid. In presence of ascorbic acid the rate of collagen synthesis was 2-2.4-fold
      lower that in corresponding controls both in proliferating and stationary
      cultures. At the same time, relative synthesis of collagen was quite similar both
      in the patient and control fibroblasts in presence of ascorbic acid. Estimation
      of the 14C-Hypro/14C-Pro ratio in collagens isolated from cultural media showed
      that there was no difference in the hydroxylation rate of collagens in control
      and patient fibroblasts. These data suggest that funnel chest is one of the forms
      of systemic connective tissue diseases, which impaired mainly the cartilages.

PMID- 2238535
TI  - [Vitamin B6 level in the cerebrospinal fluid and plasma of children with acute
      leukemia].
AB  - Content of pyridoxal in cerebrospinal fluid exceeded its level in blood plasma of
      healthy children. Transport of pyridoxal through hematoencephalic barrier was
      decreased in children with acute leukosis, especially, with neuroleukosis, while
      content of pyridoxal-5-phosphate was similar to normal values. Possible
      mechanisms are considered which are involved in stabilization of pyroxal-5
      phosphate content in cerebrospinal fluid of patients with acute leukosis, when
      transport of pyridoxal was impaired in central nervous system.

PMID- 2238536
TI  - [Various characteristics of protein-synthesizing apparatus of the myocardium
      during total ischemia].
AB  - A decrease in the rate of protein synthesis as well as an increase in the
      synthesis time of "medium-size" polypeptide chain were detected in total rabbit
      myocardium ischemia, which were evaluated using rabbit myocardium cell-free
      protein-synthesizing systems. The decrease in the synthesis rate of total
      myocardial proteins was shown to depend on the state of ribosomes function.
      Redistribution in the pools of membrane-bound and free ribosomes as well as a
      decrease of polyribosomes amount in total pool of myocardial ribosomes were
      observed under conditions of total myocardial ischemia.

PMID- 2238537
TI  - [The study of the additive antioxidative activity of total natural lipid
      antioxidants].
AB  - Kinetics of methyl oleate and ethylbenzene oxidation was studied in presence of
      tocopherol homologues alpha, beta, gamma, delta, tocopherol derivatives C6 and
      C11, ubichinol QH2-9, which were isolated from natural lipids. Effects of various
      natural antioxidants in mixtures were interindependent.

PMID- 2238538
TI  - [Inhibition of the angiotensin-converting enzyme from bovine kidney by
      organophosphorus analogs of amino acids].
AB  - Reactions of amino acid phosphoorganic derivatives with angiotensin-converting
      enzyme (dipeptidyl carboxypeptidase) were studied. Substitution of the amino acid
      carboxyl group by HS- or P(O) (OH)2-groups did not cause the enzyme considerable
      inhibition. The enzymatic activity was inhibited by 20-50% in presence of 1 X 10(
      3) M Asp, Met and Cys phosphoorganic derivatives. These amino acid derivatives
      may be used as potential antihypertensive drugs because of their metabolic
      stability and inhibitory action on the enzyme.

PMID- 2238539
TI  - [Immunochemical characteristics of vibrio neuraminidases isolated from aerated
      culture filtrates].
AB  - Immunochemical analysis of neuraminidases, isolated from choleraic and non
      choleraic vibrios, was carried out. Antineuraminidase antiserum was used in
      procedures of immunoelectrophoresis, diffusion precipitation in agar gel and disc
      immunoelectrophoresis in polyacrylamide gel. Antigen composition of
      neuraminidases was shown to be similar both in choleraic and non-choleraic
      vibrios.

PMID- 2238540
TI  - [The use of biochemical blood indices for the laboratory diagnosis of internal
      diseases using the automated complex device-computer].
AB  - Application of biochemical parameters of blood, reflecting disturbances in lipid,
      protein, carbohydrate, pigment and water-saline metabolism for diagnostics for
      internal organs diseases is discussed. Methods of clinical biochemistry in
      combination with subsequent automatic processing of the data obtained on the
      basis of probability theory and mathematical statistics methods can be used for
      preliminary computer diagnosis and further examination of a patient, as well as
      for construction of specific complexes of symptoms for some diseases. Due to
      their mobility, the preliminary computer diagnostics data can be successfully
      applied to different pathologies and groups of population.

PMID- 2238541
TI  - [Express-method of determination of DNA-binding proteins in the mammalian blood].
AB  - Quick test for estimation of DNA-bound proteins (PBD) in mammalian blood serum
      involved filtration of blood serum through Wathman filters containing DNA. DNA
      was fixed in the Wathman filters by means of UV irradiation. Some physicochemical
      and chromatographic properties of PBD from mice blood serum were studied. The
      data obtained suggest that blood serum PBD constituted one of gamma-globulin
      fractions. Applicability of the PBD test for studies of tumoral diseases was
      shown using mice with Ehrlich ascites carcinoma.

PMID- 2238542
TI  - [A new method of purification of L-lysine-alpha-oxidase from the fungus
      Trichoderma].
AB  - A new procedure is developed for purification of the antitumoral enzyme L-lysyl
      alpha-oxidase from Trichoderma sp. The procedure included two steps: hydrophobic
      chromatography on butyl sylochrome C-80 and chromatography using biospecific
      sorbent AH-Sepharose. The simplified procedure enabled to increase distinctly the
      specific enzymatic activity from 30 to 50 IU/mg in the preparation obtained with
      a good yield.

PMID- 2238543
TI  - [A modified method of determination of the total serum antioxidant activity].

PMID- 2238544
TI  - [The role of beta-glucuronidase in the tumor process and cancer prevention].

PMID- 2238545
TI  - [Enzymatic imprinting and its possible significance in carcinogenesis].

PMID- 2238546
TI  - [The effect of surgical trauma on the metabolism of essential fatty acids in
      patients with cancer of the esophagus and stomach].
AB  - The dynamics of levels of essential fatty (linolic and arachidonic) acids in
      blood plasma and erythrocytes as well as that of free fatty acids fraction versus
      duration of surgery was assessed by gas chromatography in 49 patients with cancer
      of the esophagus and gastric cardia. Surgical procedures lasting longer than 5
      hours are followed by overmobilization of essential fatty acids from body lipids
      their endogenous store being depleted. As a result, a double increase in the
      level of free arachidonic acid, an immediate prostaglandin precursor, develops to
      satisfy the body's augmented requirements in essential fatty acids due to
      application of aggressive surgical procedures.

PMID- 2238547
TI  - [Malignant histiocytosis in children].
AB  - The analysis of peculiarities of clinical course and morphology of malignant
      (acute) histiocytosis in 50 pediatric patients made a case for identification of
      the disease as separate pathology of histiocytic sarcoma type. Clinical course
      features include: lymphadenopathy, involvement of bones and--less frequently-
      lungs, skin and subcutaneous fat, marked fever and weight loss. Cytologic and
      histologic examination show polymorphic tumor cells of varying degree of
      differentiation, with blasts predominating. Well-developed Golgi complex,
      presence of lysosomes, phagosomes and erythrophagocytosis are among the
      characteristic ultrastructural features of the disease.

PMID- 2238548
TI  - [The prognostic significance of the anatomical forms of esophageal cancer].
AB  - Among the great variety of anatomic patterns of esophageal cancer growth, three
      basic patterns--exophytic, mixed and endophytic--should be distinguished.
      Anatomic pattern of growth is one of the basic prognostic criteria for tumor
      stage assessment. This finding is supported by five-year survival evidence for
      cases of radical surgery: 58.8 +/- 10% with exophytic form, 16.6 +/- 10%-
      ulcerative infiltrative and 3.3 +/- 6% with diffuse infiltrative pattern of tumor
      growth.

PMID- 2238549
TI  - [An analysis of the oncologist personnel in some economic and geographical
      regions of the USSR].
AB  - The study of age and sex structure, length of service and proficiency of clinical
      oncologists showed oncologic dispensaries to be largely staffed with well-trained
      physicians. However, the following problems still existing in the rural oncologic
      service were identified: no oncologic offices in a third of rural areas, many
      vacancies of district oncologists are still unoccupied, oncologic care is often
      given by specialists other than oncologists and finally, postgraduate training
      standards do not meet the requirements of present-day oncology.

PMID- 2238550
TI  - [The clinical x-ray diagnosis of pulmonary hamartomas].
AB  - A clinico-roentgenologic study of 67 patients with hamartoma of the lung was
      carried out. Hamartoma could not be even suggested unless X-ray examination was
      performed but even this procedure sometimes failed to identify the disease. It
      was far from being each case that typical roentgenologic features of hamartoma
      were observed. Transthoracic needle biopsy may be helpful in identifying the
      nature of a roentgenologically detected tumor. Roentgenologically, hamartoma
      should be first of all distinguished from peripheral lung cancer. When clinico
      roentgenologic and needle biopsy data are inconclusive with respect to lung
      cancer diagnostic thoracotomy should be performed.

PMID- 2238551
TI  - [A program to instruct women in breast self-examination].
AB  - The study was concerned with analysis of the second stage of evaluation of a
      breast self-examination training program aimed at early detection of cancer. A
      total of 60,079 of women were recruited into the WHO/USSR Project in Moscow in
      1985-1988: study group--30,465 and controls--29,614. At 6 months, 52.5% of women
      performed breast self-examination on a regular basis whereas at 12 months the
      percentage decreased to 42.0. Breast cancer was diagnosed in 6 out of 11,548
      females of the study group (stage I--1 case, stage II--3 and stage III--2 cases)
      and in 10 out of 23,083 controls (stage I--2, stage II--5, stage III--2 and stage
      IV--1 patient). In the study group, medical advice was sought 4.5 times more
      frequently than in controls.

PMID- 2238552
TI  - [Ultrasonically guided aspiration biopsy in the diagnosis of liver tumors].
AB  - The paper is concerned with the analysis of the results of sonographically guided
      biopsy of hepatic tumors which had been carried out in 30 outpatients suffering
      primary cancer of the liver (3 cases), metastases (16), lymphosarcoma (2), cysts
      (2), adenoma (2), hemangioma (4) and hydatidiform mole (1 patient). The
      sensitivity of the method in tumor diagnosis was 89%, specificity--80%.
      Ultrasonographic features of the liver pathologies were studied versus
      morphologic type. Indications and technical requirements for ambulatory
      ultrasonographically guided biopsy of the liver are discussed.

PMID- 2238553
TI  - [Drainage-free ureterocutaneostomy].
AB  - Drainage-free cutaneous fistula of the ureter is suggested to assure permanent
      extravesical outlet of the urine in patients with incurable tumor-induced
      obstruction of the pelvic segment of the ureter. Fistulous orifice is formed with
      the aid of a triangular flap sitting on a pedicle; the flap is placed into a
      longitudinal incision in the stump of the drained ureter. Fifteen ureteral
      fistulas were formed in nine patients. Fourteen of them functioned reliably for
      several years without causing renal complications.

PMID- 2238554
TI  - [The readaptation problems of cancer patients].
AB  - The paper discusses certain problems involved in communication between physician,
      cancer patient and society. The authors suggest that information given to a
      cancer patient on his or her diagnosis should be determined by the patient's
      willingness to know and prognosis. Also, suggestions on improvement of treatment
      of cancer patients of clinical group 4 are made.

PMID- 2238555
TI  - [The correlation of the lymphographic and pathohistological changes in the
      postmastectomy syndrome].

PMID- 2238557
TI  - [A case of a chondrosarcomatous lesion of the cardiovascular system].

PMID- 2238556
TI  - [The prevention of radiation injuries to the rectum and bladder in cervical
      cancer patients].

PMID- 2238558
TI  - [Synchronous early cancer of the esophagus and larynx in a patient with complete
      situs viscerum inversus].

PMID- 2238559
TI  - [Treatment results in ovarian sarcomas].

PMID- 2238560
TI  - Semi-quantitative determination of H type 1 and type 2 antigens on buccal
      epithelial cells and in saliva of secretors and non-secretors.
AB  - The amount of H antigens on buccal epithelial cells (BEC) of secretors and non
      secretors was measured by flow cytometry. H type 1 and H type 2 on BEC were
      detected with fluorescein-labelled Ulex europaeus lectin, and H type 2 was
      measured with mouse monoclonal antibody. Between 3.5 and 6 times more H antigen
      was detected on cells from secretors compared with cells from non-secretors. The
      level of H type 2 was the same on BEC of secretors and non-secretors. Adsorption
      of H type 1 antigen from secretor saliva onto non-secretors BEC was demonstrated.
      A simple and sensitive ELISA method was developed for the determination of H in
      saliva with biotin-labelled Ulex lectin. This system provides a simple means for
      measuring the amount of H present in saliva and for the determination of secretor
      status.

PMID- 2238561
TI  - Acid treatment of platelets as a simple procedure for distinguishing platelet
      specific antibodies from anti-HLA antibodies: comparison with chloroquine
      treatment.
AB  - The identification of antibodies to platelet-specific antigens is important for
      correctly diagnosing neonatal alloimmune thrombocytopenia, posttransfusion
      purpura and refractoriness due to platelet-specific antibodies. However, the
      serologic identification of these platelet-specific antibodies is complicated by
      the presence of anti-HLA antibodies. We examined and compared the diagnostic
      usefulness of acid-treated and chloroquine-treated platelets for the
      discrimination of platelet-specific antibodies from anti-HLA antibodies. The
      viability of acid-treated platelets is 83.4%, which is better than that of
      chloroquine-treated platelets (52.6%). The antigenicity of HLA class I antigens
      of acid-treated platelets was significantly reduced compared with that of PBS- or
      chloroquine-treated platelets. On the other hand, platelet surface glycoprotein
      Ib and glycoprotein IIb/IIIa, and platelet-specific antigens were stable
      following acid or chloroquine treatment. Chloroquine-treated platelets were not
      suitable targets for analysis by immunofluorescence flow cytometry because of
      nonspecific fluorescence derived from platelet damage. We conclude that acid
      treated platelets are more suitable targets than chloroquine-treated platelets
      for screening for platelet-specific antibodies and also for analyses of the
      specificity of platelet-specific antibodies.

PMID- 2238562
TI  - Transmission of HTLV-II via blood transfusion.
AB  - Transmission of HTLV-I by transfusion is well documented in Japan, where HTLV-I
      is endemic. In non endemic regions such as the United States, HTLV-I/II infection
      has been transmitted by transfusion as well, but no effort to distinguish HTLV-I
      from HTLV-II infection was made in these studies. There is a growing body of
      evidence that a substantial proportion of HTLV-I/II seropositivity in the US is
      due to infection with HTLV-II. We report 2 cases of apparent transfusion
      transmitted HTLV-II infection and discuss the importance of distinguishing
      between the two viruses in blood donors and recipients.

PMID- 2238563
TI  - Post-transfusion thrombocytopenia: its duration in splenic and asplenic
      individuals.
AB  - Previous work in our department showed that after blood transfusion, the platelet
      count often falls to levels which are clinically significant. The probable site
      of platelet sequestration was identified as the spleen, and post-transfusion
      thrombocytopenia was prevented by blood filters which remove microaggregate
      debris from the donor blood. Since the duration of the thrombocytopenia has not
      been investigated, the purpose of the present study was to establish the rate of
      onset and duration of post-transfusion thrombocytopenia following packed red
      blood cell transfusions. In addition, the effect of spleen size, patients'
      diagnosis and post-transfusion history were examined. These observations provide
      interesting new data on the mechanisms involved in this phenomenon.

PMID- 2238564
TI  - 'Complete' warm hemolysins producing an autoimmune hemolytic anemia.

PMID- 2238565
TI  - Immunoblotting of Dr(a-) cells with antibodies to Cromer-related antigens.

PMID- 2238566
TI  - The impact of preoperative autologous blood donation on orthopaedic surgical
      practice.
AB  - We have conducted a retrospective 3-year analysis of our autologous blood
      donation program to assess its impact on orthopaedic surgery. We conclude: (1)
      utilization has increased from less than 5% of eligible patients in the first
      audit interval to nearly 50% in the last audit interval; (2) in the last audit
      interval, autologous blood donation resulted in a reduction of homologous blood
      transfusion from 41% in nonautologous blood patients to 14% in autologous blood
      donors; (3) increasingly conservative transfusion practice is seen for all
      patients undergoing elective orthopaedic surgery; (4) regional blood centers are
      responding to increasing requests for autologous blood with programs that are
      effective in attracting autologous blood donors; (5) on the basis of utilization
      and efficacy, preoperative autologous blood donation as an alternative to
      homologous blood transfusion now represents a standard of practice for elective
      orthopaedic surgery.

PMID- 2238567
TI  - Moderate and severe reactions during autologous blood donations are no more
      frequent than during homologous blood donations.
AB  - Because autologous donation is permitted for donors who do not meet homologous
      blood donation standards, referring physicians and blood center personnel may be
      concerned about autologous donor reactions. Small studies have determined that
      mild reactions do not occur more frequently, but the incidence of rarer, more
      serious, moderate and severe reactions is unknown. We therefore studied the
      frequency of reactions during 10,200 autologous and 219,307 concurrent homologous
      donations at four blood centers. No significant difference was seen for severe
      reactions: autologous 0.039% (4/10,200), homologous 0.037% (82/219,307) (p =
      0.79); moderate reactions: autologous 0.19% (19/10,200), homologous 0.22%
      (473/219,307) (p = 0.60) or mild reactions: autologous 2.26% (231/10,200),
      homologous 2.26% (4946/219,307) (p = 0.98). We conclude moderate and severe
      donation reactions do not occur more frequently among autologous donors who are
      preselected by referring physicians and screened by blood center personnel.

PMID- 2238568
TI  - Erythrocyte endogenous proteinase activity during blood bank storage.
AB  - We studied proteolytic alterations of membrane proteins in ghosts derived from
      human red blood cells, preserved up to 35 days in the liquid state either as
      whole blood or with additive solution. The study was carried out by performing
      sodium dodecyl sulfate polyacrylamide gel electrophoresis of stromal proteins
      from erythrocytes, either previously treated with proteinase inhibitors or
      previously incubated in conditions promoting proteolysis. To differentiate the
      effect of erythrocyte from granulocyte proteinases, the investigation was also
      carried out in leukocyte-free red cell preparations. The results show: (1) the
      effects of endogenous proteinases on membrane proteins derived from red cells
      stored under blood bank conditions; (2) a decrease of proteolytic effects in
      ghosts derived from red cells which have been submitted to a longer storage; (3)
      a relevant influence of the red cell resuspending medium before lysis on the time
      dependent onset and exhaustion of proteolysis in ghosts. The presence of
      increased proteolysis in ghosts could be regarded as a marker of molecular
      lesions induced in red cells by storage under blood bank conditions.

PMID- 2238569
TI  - Comparison of IgM and IgG anti-A and anti-B levels in Asian, Caucasian and Negro
      donors in the North West Thames Region.
AB  - This study was undertaken to test the widely held belief that higher levels of
      immune anti-A and anti-B are characteristic of Negro and Asian populations with a
      corresponding increased risk factor for AB0 haemolytic disease of the newborn.
      Overall, 300 serum samples from male and female Asian. Caucasian and Negro blood
      donors in the North West Thames Region of groups A, B and 0 were collected. The
      sera were titrated in microplates against pooled group A1 and pooled group B red
      blood cells. Although the results show that the highest levels for IgG anti-A and
      anti-B were found in group 0 female Negro donors, statistically these levels are
      not significantly higher than those of the other group 0 donors tested. We
      suggest that the potent anti-A and anti-B reported by others in Negro and Asian
      populations may arise from environmental rather than genetic factors.

PMID- 2238570
TI  - Serological characterization of murine monoclonal antibodies directed against
      acquired B red cells.
AB  - Balb/c mice were immunized with acquired B red cells. Twelve clones specific for
      acquired B red cells were obtained from two fusions. A detailed investigation of
      three clones is reported here. These antibodies appear to be directed to the B
      like epitope since they are inhibited by galactosamine and fail to react after
      acetylation of red cells. E 231 is an example of a series of antibodies closely
      specific for acquired B red cells which can be useful in elucidating some AB0
      typing problems. E 167 and F 47 showed a cross-reactivity with A1 red cells and a
      synthetic A trisaccharide. No affinity for B antigen could be demonstrated for
      any of the antibodies.

PMID- 2238571
TI  - Erythrocyte antibody screening in solid-phase: a comparison of two solid-phase
      microplate assays with the indirect antiglobulin test in polyethylene glycol for
      the detection of irregular erythrocyte antibodies.
AB  - The screening of a serum for irregular erythrocyte antibodies in the indirect
      antiglobulin test is a well-established technique. We compared the test results
      of two different solid-phase microplate indirect antiglobulin tests with a liquid
      phase indirect antiglobulin test in tubes. Antibody screening with both solid
      phase microplate techniques proved to be more sensitive than the liquid-phase
      indirect antiglobulin test. In addition, a difference in sensitivity between the
      two solid-phase techniques was observed: prior immobilization of test
      erythrocytes on the microplate followed by incubation with a serum and detection
      of sensitization with antihuman IgG-coated detector cells gave better test
      results than secondary immobilization on the microplate of test erythrocytes
      sensitized with antibodies and an antihuman globulin serum.

PMID- 2238572
TI  - Long-term intravenous immunoglobulin treatment in patients with AIDS-related
      complex.

PMID- 2238573
TI  - Major histocompatibility complex class I to III allotypes in patients with AIDS
      related complex/Walter-Reed 5, disseminated Kaposi's sarcoma and in normal
      controls. The ARC-IVIG Study Group.
AB  - In HIV-infected patients major histocompatibility complex (MHC) class I and II (=
      HLA-A, B, C, DR) association has been controversial. Of the MHC class III coded
      complement components C2, BF, C4A/C4B especially C4 allotypes appear of major
      immunogenetic relevance for their potential differences in virus neutralizing
      potency and immune complex formation. In the present study 29 patients with AIDS
      related complex and Walter-Reed 5 ARC/WR5), 35 patients with disseminated
      Kaposi's sarcoma (KS), and 160 HIV-negative control individuals were compared for
      MHC class I to III allotypes. Diagnosis of ARC and KS (WR criteria) was done by
      clinical and laboratory parameters, MHC testing, by standard procedures. An
      increase in frequency (p less than or equal to 0.05) was observed between ARC/WR5
      patients and controls for HLA-B35/CW4, DRW14, a decrease for B16, CW6/DR7.
      However, values were not significant if corrected for the number of tested
      antigens. No significant differences were seen between KS and ARC patients or
      controls for class III allotypes, nor for previously reported associations, e.g.
      for B8, DR2, DR3, and especially DR5, including the DR5 splits DRW11, 12. The
      results indicate the lack of a strong MHC association with the investigated
      antigens in West German Caucasoids, and support the hypothesis of ethnic
      dependence of HIV-related diseases. The HLA-B35/CW4 increase, also associated
      with the duplicated C4 A*3 A*2 and the silent C4B*Q0, was more pronounced in ARC
      patients with progression to AIDS-OI. The increased frequency of C4B*Q0 alleles
      in these patients was thought to be secondary to a hypothetical increase in
      'converted' and dysregulated C4 genes not seen to be associated in this study.

PMID- 2238574
TI  - Cellular immunologic parameters in HIV-positive patients with AIDS-related
      complex and intravenous immunoglobulin therapy.
AB  - In a randomized double-blind longitudinal study with 30 HIV-1-positive patients
      with AIDS-related complex or stage Walter-Reed 5 disease, the effectiveness of
      intravenous immunoglobulin (IVIG) was tested for correcting eventual immune
      dysregulation. Although the IVIG-treated patients showed an improvement of their
      clinical score, no significant changes were observed in lymphocyte phenotypes,
      activation markers, immunoglobulins and subclasses, lymphocyte turnover or in
      indicators of acute inflammation. Since severe bacterial infections or autoimmune
      processes usually leading to IVIG therapy were not prevalent in the patients of
      the study, such therapy should probably be reserved for later stages of the
      disease. HIV-1 antigen expression in blood lymphocytes remained uninfluenced by
      IVIG treatment.

PMID- 2238575
TI  - Complement levels and circulating immune complexes in a controlled, longitudinal,
      multicentre study on effects of intravenous immunoglobulin in adults with AIDS
      related complex/Walter-Reed 5. The ARC-IVIG Study Group.
AB  - The complement system, as the effector mechanism of the antigen-antibody
      reaction, and the levels of circulating immune complexes in a 1-year, double
      blind, randomized, placebo-controlled study served as laboratory parameters to
      assess the effect of long-term high-dose intravenous immunoglobulin (IVIG)
      therapy in 30 adult patients (2 x 15) with AIDS-related complex/Walter-Reed 5
      (ARC/WR5). We obtained no evidence of an adverse effect in such patients of high
      dose IVIG administered over a 6-month period: none of the parameters studied
      showed a significant difference between the two groups of patients. In both
      groups, using data before the first infusion or using data of the whole study, a
      correlation between circulating immune complexes and classical complement pathway
      activation was found. The most striking increase was seen in the two groups of
      patients for functional serum factor D. The accumulation of serum factor D was
      not paralleled by an increase in serum creatinine. In patients with disease
      progressing from ARC to AIDS within the study period, an accumulation of serum
      factor D was not more or less pronounced than in those who remained in the ARC
      stage. Accumulation of factor D was not related to the clinical score as assessed
      in this study.

PMID- 2238576
TI  - Comments on the statistical evaluation of the ARC-IVIG Study.

PMID- 2238577
TI  - [The new management mechanism in public health].

PMID- 2238579
TI  - [The temporary loss of work capacity in workers in the hot shops of the
      metallurgical industry due to diseases of the circulatory organs].
AB  - It was established that morbidity with temporary loss of working capacity due to
      diseases of the circulatory organs showed a tendency towards increase among
      workers of modern hot shops of the blast furnace, steel-smelting furnace,
      converter and the steel rolling industry. Most frequent in these category of
      workers was incidence of ischemic heart disease, hypertensive disease and
      hemorrhoid. The incidence varied among different professions enumerated above and
      depended also on the age, working conditions. The nosological entities varied as
      well.

PMID- 2238578
TI  - [The cardiopulmonary age of workers in hot jobs in glass manufacture].
AB  - Data are reported on the effect of heating microclimate on the enhancement of
      functional aging of the cardiovascular system in workers of the glass industry.
      It is shown that enhancement of the aging tempo was noted during the first 5
      years of work in condition of hot microclimate and following 15 years of work in
      these conditions. The enhancement of biological aging of the individual is also
      influenced by the age of the worker beginning to work in conditions of hot
      climate.

PMID- 2238580
TI  - [The effect of leukocyte interferon on the kinin system indices of the blood in
      patients with acute intestinal infections].
AB  - The authors studied the efficiency of using rectally interferon in acute
      intestinal infections, the influence of the agent on the kinin system in these
      patients. 42 children with bacterial intestinal infections were examined. They
      were given rectally 1000 IU of interferon. This results in a rapid disappearance
      of the intoxication symptoms, signs of lesions of the gastrointestinal tract,
      normalization of the kinin system indices.

PMID- 2238581
TI  - [The effect of differentiated treatment on the the indices of the hepatic cholate
      forming function in patients with chronic enterocolitis].

PMID- 2238582
TI  - [The epidemiology of escherichiosis in 2 agrarian regions].
AB  - A study of the epidemiology of escherichiosis in two agricultural regions of the
      Ukraine revealed differences in the etiological structure in the limits of
      regions, points within a twelve-year period. It is concluded that continuous
      monitoring of serological pictures of pathogenic Escherichia is necessary.

PMID- 2238583
TI  - [The use of hemosorption in leptospirosis patients with pronounced
      thrombocytopenia].
AB  - The authors describe a rare case from the clinical practice. Treatment including
      hemosorption was employed in a 38-year-old with a severe form of
      icterohemorrhagic leptospirosis accompanied by acute reno-hepatic failure and
      pronounced thrombocytopenia--15 x 10(9)l. The relative significance of
      thrombocytopenia as one of the main contraindication to hemosorption is
      suggested.

PMID- 2238585
TI  - [Experience in managing a system for the rational utilization of the residual
      work capacity of agricultural workers].

PMID- 2238584
TI  - [The one-stage system in organizing medical first aid for patients with acute
      myocardial infarct].

PMID- 2238586
TI  - [The hemodynamics of the lesser circulation in liver diseases].
AB  - The authors analyze data obtained in complex clinico-instrumental examination of
      the state of hemodynamic of the right compartments of the heart in 45 patients
      with chronic portal hypertension 20 patients with liver cirrhosis using two
      dimensional echocardiography. The right ventricle and right atrium were located
      from the apical position of the gauge in the 4-chamber projection of the heart.
      Compared were values of areas of heart chambers and rate characteristics of
      movements of their walls and cusps of the pulmonary artery. Simultaneously
      ultrasonometry [correction of ultrasensometry] of the venous vessels of the
      abdominal cavity, liver and spleen was carried out. Signs of portal and pulmonary
      hypertension, loads on the right heart compartments were found in these two
      diseases that were more pronounced in patients with liver cirrhosis.

PMID- 2238587
TI  - [The effect of calcium antagonists on the hemodynamic function in patients with
      heart failure].
AB  - The therapeutic effect of calcium antagonists corinfar and phinoptin was studied
      in 48 patients with ischemic heart disease with chronic circulatory insufficient
      (CCI). The hemodynamic effects of these calcium antagonists were characterized by
      an increase of indices of cardiac contraction and essential reduction of the
      general peripheral resistance with simultaneous reduction of the left ventricle
      volumes during diastole and systole. It is concluded that corinfar and phinoptin
      are indicated in patients with CCI.

PMID- 2238588
TI  - [The effect of korinfar on the systemic hemodynamics and myocardial contractile
      function in hypertension patients].

PMID- 2238589
TI  - [The transport function of the serum albumin in patients with ischemic heart
      disease and in persons with risk factors for its occurrence].
AB  - Persons of the ischemic heart diseases risk group and patients with ischemic
      heart disease showed a reduction of the transport function of serum albumin that
      correlated with the sex and age of examined persons, presence of that of another
      risk factor of ischemic heart disease as well as with its clinical form of
      manifestation. Established were correlations between the level of
      hypercholesterolemia and state of the transport function of serum albumin and a
      positive effect of sex hormones on the transport function of serum albumin. The
      obtained data suggest a major role of protein metabolism in the pathogenesis of
      ischemic heart disease.

PMID- 2238590
TI  - [The immunological indices of patients who have had a myocardial infarct].
AB  - The authors carried out immunological examination of 68 patients with ischemic
      heart disease with a history of one or several myocardial infarctions. The
      patients showed changes of the immune status, mainly of the humoral type due to
      allergic reactions caused by immune complexes and also anaphylactic reactions
      provoked by IgE-antibodies. The above changes occurred against the background of
      T-cellular immunodeficiency and increased content of B-lymphocytes. Increase of
      the level of indices of unspecific defence is a manifestation of compensatory
      reactions directed to elimination of the increased content of circulating immune
      complexes from the body of the patients.

PMID- 2238591
TI  - [Drug interaction with cardiac glycosides (a review of the literature)].

PMID- 2238592
TI  - [Dilated cardiomyopathy with a benign course].
AB  - Perspective observation of 224 patients with dilated cardiomyopathy showed that
      in 21 cases (9.4%) the course of the disease was benign characterized by
      insignificant limitation of their physical condition and its stabilization.
      Dilatation of the left cardiac ventricle and reduction of its contractile
      function did not reach significant levels that is caused by a relatively larger
      as compared with other patients capacity to the development of compensatory
      hypertrophy.

PMID- 2238593
TI  - [The use of pulse-width modulation sinusoidal currents in the combined treatment
      of peptic ulcer].
AB  - The efficacy of pulse-duration modulation currents was evaluated in 143 patients
      with duodenal ulcer at the phase of reducing exacerbation. It was established
      that pulse-duration modulation currents in T5-T3 parameters produced a positive
      effect both on the clinical course of the disease and on the functional
      morphological state of the gastrointestinal system. Absence of side-effects,
      simplicity and availability allow this method for implementation in the clinical
      practice of different medical institutions.

PMID- 2238594
TI  - [Structural changes in the gastric mucosa of patients with rheumatic diseases (a
      review of the literature)].

PMID- 2238595
TI  - [The morphological characteristics of the cardiac lymphatic bed in chronic
      coronary failure].
AB  - A study is presented of the morphological changes of the lymphatic circulation in
      chronic ischemic heart disease (IHD). Examinations were carried out on clinical
      material: intraoperative cardiac biopsies and on hearts of patients who died of
      this disease at the age of 36-59 years. Transmission electron microscopy was
      used. A clinical comparison was realized of changes of intramyocardial and
      subepicardial regions of the heart lymph circulation and morphological
      equivalents of disorders of outflow of lymph from the heart in chronic IHD were
      evaluated. The obtained data indicate the lymph stasis possessing cardiotoxic and
      sclerogenous properties is an essential pathogenetic factor of myocardial
      fibrotization in chronic coronary insufficiency.

PMID- 2238596
TI  - [Transplantation of the heart and of the heart-lung block (a review of the
      literature)].

PMID- 2238598
TI  - [The immunological reactivity indices of patients with chronic nonspecific lung
      diseases].
AB  - At height of the disease patients with chronic bronchitis showed a reduction of
      immunological indices of reactivity of the body. A direct dependence was
      established between the severity of the course of the disease and degree of
      reactivity reduction. Absence of complete normalization of indices of
      immunological reactivity at discharge from the clinic indicates incomplete
      control of the inflammatory process and short-term character of the remission.
      The reaction of lymphocyte blast transformation may be used for detection of both
      latent and clinically manifest staphylococcal infection. Increased sensitivity to
      staphylococcal allergen results in a reduction of the phagocytic activity of
      neutrophils in patients with chronic bronchitis.

PMID- 2238597
TI  - [A histophotometric study of the liver dehydrogenases in acute arterial occlusion
      of the lower extremities].

PMID- 2238599
TI  - [The efficacy of kalipsol in the intensive therapy of status asthmaticus].

PMID- 2238600
TI  - [Pulmonary ventilation and central hemodynamics in pulmonary tuberculosis
      patients].
AB  - Computerized devices were used for evaluation of the state of pulmonary
      ventilation and central hemodynamics in 32 patients with pulmonary tuberculosis
      depending on the spread of the specific process. Patients with limited changes in
      the lungs, showed disorders of bronchial patency and compensatory increase of
      organic ejection of the right ventricle. In the presence of spread changes in the
      lungs the above mentioned changes were supplemented by restrictive ventilation
      disorders with a reduction of the contractile myocardial capacity. These
      functional changes should be considered in the treatment of patients with
      pulmonary tuberculosis.

PMID- 2238601
TI  - [Central hemodynamics in young and middle-aged patients with the initial
      manifestations of cerebral circulatory failure].
AB  - The authors studied the indices of general hemodynamics in 53 patients with
      initial manifestations of cerebro-circulatory insufficiency of young and middle
      age. Young patients suffering of cerebral atherosclerosis and vegetative-vascular
      dystonia showed a hyperkinetic type of hemodynamics while the middle-aged with
      atherosclerosis showed the hypokinetic type evidencing abnormal function of
      autoregulatory mechanisms.

PMID- 2238602
TI  - [The efficacy of the laser therapy of peptic ulcer patients].
AB  - Data are reported of treatment efficacy of 67 patients with gastric and duodenal
      ulcer. In 52 complex treatment included lasers. It is concluded that employment
      laser radiation produced a significant analgetic effect and stimulated
      epithelialization of the ulcer defect.

PMID- 2238603
TI  - [The neuroendocrine and neurotrophic changes in combined brain concussion and
      locomotor trauma (a review of the literature)].

PMID- 2238605
TI  - [Nervous system involvement in herpes zoster (a review of the literature)].

PMID- 2238604
TI  - [Psychoautonomic dysfunction of adaptation origin].
AB  - Data are reported of a psycho-vegetative examination in 123 sailors in the
      dynamics of long-term cruises. A correlation was established in the development
      of psychological and vegetative disadaptation. The initial stages are
      characterized by hypersthenic processes in the psychic activity and
      hypersympathicotonus in the vegetative functions. Three months later the
      adaptogenesis is prevailed by asthenic processes and by parasympathetic trends of
      vegetative activity.

PMID- 2238606
TI  - [The reactivity of the autonomic nervous system in patients with the hypothalamic
      syndrome].

PMID- 2238607
TI  - [The central hemodynamic function of obese patients].
AB  - The authors substantiate the employment of radiocardiography for the examination
      of the cardiohemodynamics in patients with obesity of the III and IV grades. On
      the basis of a study of the main hemodynamic indices in patients with extreme
      obesity a trial is made to evaluate the pathogenesis of cardiac insufficiency in
      these patients.

PMID- 2238608
TI  - [The effect of low doses of ionizing radiation on human health].
AB  - Data are reported on the possible mechanism of biological effects of small doses
      of ionizing radiation on the human body. The lesioning effect of this radiation
      resulted in some of the persons in the development of disorders of the function
      of information and vegetative-regulatory systems determined as a disintegration
      syndrome. This syndrome is manifested in unspecific neuro-vegetative disorders of
      the function of most important physiological and homeostatic system of the body
      leading to weakening of the processes of compensation and adaptation. This
      condition is characterized by an unspecific radiation syndrome as distinct from
      acute or chronic radiation disease which is a specific radiation syndrome.

PMID- 2238610
TI  - [A case of urticaria during carsil treatment].

PMID- 2238609
TI  - [The therapeutic procedure in autoimmune thrombocytopenia in relation to the
      immunoglobulin specificity of the antithrombocytic autoantibodies].
AB  - The author studied dependence of choice of therapeutic tactics on the
      immunoglobulin specificity of antithrombocytic autoantibodies in patients with
      idiopathic autoimmune thrombocytopenic purpura. It was found that in case of
      detection of antithrombocytic autoantibodies with a IgG specificity the patients
      are more sensitive to the treatment with glucocorticoids. In case of detection of
      IgM antithrombocytic autoantibodies, splenectomy at early stages of the disease
      is more effective.

PMID- 2238611
TI  - [Enterosorption in the treatment of patients with chronic urticaria].
AB  - A synthetic carbon sorbent (SKNP-2) was included in the treatment of 197 patients
      with relapsing urticaria. Courses lasted 7, 14, 20 days. The clinical effect was
      favourable and its efficacy increased with prolongation of the therapy course
      time using the enterosorbent. Immunological parameters did not change in the
      course of treatment.

PMID- 2238612
TI  - [The correction of functional disorders of the cardiovascular system in patients
      with acute kidney failure treated by hemodialysis].
AB  - A study is presented of the central hemodynamics in 38 patients with severe forms
      of acute renal failure of different genesis. Disorders were revealed related both
      to renal failure and use of active methods of extracorporal detoxication, namely,
      hemodialysis and hemosorption. Measures on the correction of disorders of the
      central hemodynamics are described.

PMID- 2238613
TI  - [The treatment of sexual disorders in men with autonomic dystonia].
AB  - Results are reported of a study of 55 males with disorders of sexual potency with
      an objectively registered manifestation of vegetative dystonia. It was shown that
      sexual disorders in these patients have a psychogenic character. All of them
      showed neurosis and neurosis-like symptoms. With the purpose of finding effective
      treatment psychotherapy, phallic stimulation and physiotherapy were tried. Most
      effective was individual psychotherapy with elements of hypnotic suggestion and
      phallic vascular stimulation by local negative pressure.

PMID- 2238614
TI  - [The immunomorphological characteristics of prolonged exposure to the herbicide
      linuron].
AB  - The authors investigated the effect of long-term use of the herbicide linuron on
      the histo- and ultrastructure of the thymus and factors of immunological defense.
      It was found that the use of linuron in animals resulted in development of
      secondary immunodeficiency states manifested in pathology of the thymic
      structure, first of all lesions of the epithelial cells-feeders and disorders of
      immunological indices.

PMID- 2238615
TI  - [Circulating immune complexes in workers in glass fiber-reinforced plastics
      manufacture].
AB  - The authors examined 182 workers engaged in manufacturing of glass-reinforced
      plastics and revealed an increase of the level of circulating immune complexes
      and their content middle-molecular immune complexes. This makes it possible to
      suggest the pathogenetic role of circulating immune complexes in the development
      of allergic lesions in workers contacting with epoxide compounds.

PMID- 2238616
TI  - [Amiodarone--the current view of its therapeutic use].

PMID- 2238617
TI  - [The current treatment of left-sided heart failure in acute myocardial infarct].

PMID- 2238618
TI  - [The testicular biopsy--pro and contra].

PMID- 2238619
TI  - [The carcinoembryonic antigen in chronic pancreatitis].
AB  - The fasting carcinoembryonal antigen (CEA) concentrations in the serum and
      duodenal juice and after venous stimulation of the exocrine pancreas with the
      hormones CCK and secretin (Boots) were studied. Radioimmunologic test with a kit
      of the firm "Labimex"--PPR was used. 28 patients with clinically proved chronic
      pancreatitis and a control group of 27 healthy persons were examined. The fasting
      CEA serum concentrations in the patients with chronic pancreatitis were
      statistically significantly higher than those of the healthy persons--mean--16.5
      ng/ml vs mean--8.2 ng/ml (p less than 0.001). In 14% of the healthy persons and
      57% of of the patients with chronic pancreatitis the basic CEA concentrations
      were significantly increased. After stimulation with CCK and secretin the serum
      CEA concentration did not change substantially. The duodenal juice CEA
      concentrations after CCK and secretin stimulation were about 11 times higher than
      those in the serum--mean--113 ng/ml and mean--104 ng/ml for the control group vs
      mean--118 ng/ml and mean--110 ng/ml for the patients with chronic pancreatitis.
      No statistically significant difference between the patients with chronic
      pancreatitis and the control group of healthy persons was established. The
      results reveal the low specificity of the CEA as a "tumor marker".

PMID- 2238620
TI  - [The development of remission in patients with bronchial asthma].
AB  - The efficacy of the therapeutic programs and rehabilitation measures for
      achievement of a permanent remission of bronchial asthma was studied in 436
      patients, 18 to 71 years of age (mean age 45.3 years), 283 women and 153 men. In
      42.89% of the patients the asthma was severe, in 47.07% it was moderate and in
      10.09%--mild. 30.05% of the patients were with atopic asthma, 52.06%--with
      infectious dependence, 8.03%--with glucocorticoid deficiency and 2.98%--with
      hormonal imbalance. In all patients remission was achieved with a different
      reliability. Full remission was achieved in 24.08%, partial remission 1 degree-
      in 58.03% and partial remission II degree--in 17.89% of the patients. The
      duration of the remission varied from 2 up to 46 months. A remission longer than
      6 months was achieved in 72.10% of the patients treated with intal or zaditen, in
      61.36% of the patients treated with corticosteroids and only in 27.70% of the
      patients treated with symptomatic and general hygienic means. The duration and
      the quality of the remission depend on the correct selection of the therapy in
      the acute stage, the severity and the form of bronchial asthma. Better results
      are achieved in the mild form of bronchial asthma. The most frequent causes for
      destabilization of the remission were bronchopulmonary infections, incorrect
      reduction or discontinuing of the medication, formal supportive therapy,
      psychologic demobilization and irrational supportive therapy.

PMID- 2238621
TI  - [The diagnostic potentials of spatial velocity ECG in assessing the changes in
      ventricular depolarization].
AB  - The study includes 702 patients (with left ventricular load, myocardial
      infarction and bundle branch block) and 130 healthy persons. To all these a
      spatial velocity EKG was made (SVEKG) as well as corrected orthogonal electro-
      and vectorcardiogram according to Frank, spatial ECG and standard EKG in 12
      leads. The indices of the spatial velocity ECG were compared with those of the
      other methods on the basis of the criteria sensitivity and specificity. In the
      patients with right ventricular load the indices of the spatial
      electrocardiography showed the highest sensitivity; in the patients with left
      ventricular load and bundle branch block the indices of the corrected orthogonal
      electrocardiography showed the highest sensitivity. In the patients with
      myocardial infarction the potentials of several methods were equal. The
      insufficient number of investigations concerning the spatial velocity ECG cannot
      give a clear view of its potentials and its place in the clinical practice but
      some of its advantages make it very convenient for preparing a system of
      automatic analysis of the heart electrophysiological signal.

PMID- 2238622
TI  - [Doppler transmitral blood flow--a new method for assessing myocardial ischemia].
AB  - A new method for interpretation of Doppler transmitral flow is presented. The
      peak of the early diastole is divided into two time intervals and the velocity of
      the rising and falling of this peak is determined. The method was applied in 31
      patients with ischemic heart disease proved by coronarography and 30 healthy
      persons before and after bicycle ergometry [correction of veloergometric] load.
      Statistically significant changes of the parameters studied were found. These
      changes were compared with parallel changes in the electrocardiogram (12 standard
      leads). This led to the conclusion that Doppler transmitral flow is a more
      sensitive method for the diagnosis of myocardial ischemia than the
      electrocardiogram.

PMID- 2238623
TI  - [Lyme disease and the forms of its manifestation in Bulgaria].
AB  - Two cases of serologically proved cardiac form of Lyme's disease are presented
      (for the first time in Bulgaria). An A-V block III degree was found in the first
      patient and an A-V block I degree in the second patient. The diagnosis is
      supported by epidemiologic data--endemic region, other patients with Lyme's
      disease, insects bite, season, etc.

PMID- 2238624
TI  - [Arterial pressure studies of the workers and employees of a textile plant].
AB  - The results of a study of the arterial pressure of the workers and employees in a
      textile plant in Vratsa are presented and discussed. The frequency of
      hypertension is 16.32%, symptomatic hypertension--3.22%, borderline hypertension-
      27.07%, hypotension--5.36%. Statistically significantly hypertension is more
      frequent in persons with a hereditary predisposition for arterial hypertension,
      are over 40 years of age and with overweight. The borderline hypertension becomes
      frequent after 50 years of age. Hypertension was not found statistically
      significantly more often in persons who work or had worked in conditions of
      professional noise above 85-105 decibels, are with higher education, psychic
      trauma, using more salt and smokers. Hereditary predisposition and overweight
      were equally frequent in the patients with renal hypertension and hypertension
      disease. The results support the conception that hypertension is a polygenic
      hereditary disease in the basis of which lies renal mechanism.

PMID- 2238626
TI  - [The early and late treatment results with azathioprine in Behcet's syndrome].
AB  - Four patients (one man and 3 women) with generalized form of Behcet's syndrome
      with 3-7 years duration were followed up. Prior admission to the clinic the
      patients had been treated symptomatically, two of them with cyclophosphamide and
      one patient with corticosteroids without effect. In the clinic they were treated
      with Azathioprin 2 mg/kg body mass. At the end of the second month remission of
      the disease was registered in all four patients which lasts without discontinuing
      the treatment in one of the patients 7 years, in the second patient--4 years, in
      the third patient--3 years and in the fourth patient--2 years. The supporting
      treatment is 1 mg/kg body mass of Azathioprin which begins at the end of the
      first year after achieving a stable clinical remission. No side effects were
      observed.

PMID- 2238625
TI  - [Calcium-phosphorus metabolism and calcitrophic hormones in patients with active
      acromegaly with and without osteoporosis].
AB  - Calcium-phosphor metabolism was studied in patients with active acromegaly with
      or without osteoporosis, mean age 45.2 +/- 11.4 years and mean duration of the
      basic disease 5.52 +/- 3.6 years. No significant deviations and no direct
      relation with the high serum growth hormone and prolactin levels were found. The
      normal basic secretion of the calcitrophic hormones--parathyroid hormone and
      calcitonin and their normal response to the hypercalcemia after intravenous
      calcium load of the patients with and without osteoporosis reject their direct
      participation in the pathogenesis of osteopenia. The changed skeletal sensitivity
      to calcitrophic hormones closely connected with the patients' age and the
      duration of the basic disease in combination with many other factors probably
      plays a major role in the pathogenesis of osteopenia.

PMID- 2238627
TI  - [Gordon's syndrome--a combination of hyperkalemia and arterial hypertension with
      preserved kidney function].
AB  - A case of Gordon's syndrome in a 38 years old man is presented--hyperpotassemia
      and arterial hypertension with preserved renal function, normal supra-adrenal
      function, no data for hemolysis, normal coagulation state, mild compensated
      metabolic acidosis. Renal tubular defect, for excretion of potassium and
      chlorides, sodium reabsorption, tubular resistance to mineralocorticoids are
      discussed. The combination of hyperpotassemia and arterial hypertension might be
      due to phenotype manifestations of a single gene.

PMID- 2238628
TI  - [Autosomal recessive polycystic kidney].
AB  - A case of a 22 years old woman with autosomal-recessive form of kidney
      polycystosis is presented. The diagnosis was made in early childhood. A
      combination of renal anomaly and hepatic fibrosis with manifestations of portal
      hypertension was present. No deviations from the other internal organs were
      found. At the age of 12 she entered into the stage of chronic renal failure. The
      last five years she is on dialysis treatment. She had survived several acute
      bleedings from esophageal varices. The authors are of the opinion that the case
      is of interest since patients with autosomal-recessive renal polycystosis very
      rarely reach majority.

PMID- 2238629
TI  - The clinical use of oral sulfonylureas in the management of non-insulin dependent
      diabetes mellitus (NIDDM).
AB  - Eighty percent of Americans afflicted with diabetes mellitus have Type II or non
      insulin dependent diabetes mellitus (NIDDM). Impaired or defective insulin
      secretion and insulin resistance are universal pathophysiologic findings.
      Management involves attention to diet, exercise, and commonly the use of insulin
      and/or oral sulfonylureas. Currently there are six marketed first and second
      generation agents available for use in the United States. Although the newer
      agents are more potent, they all share a similar mechanism of action. These
      agents can only be effective if the patient has retained beta cell secretory
      function. Pharmacokinetic and pharmacodynamic differences may make the newer
      agents, glyburide and glipizide, preferred in the management of Type II diabetes
      mellitus. The combined use of insulin and oral sulfonylureas may be useful for
      the patient exhibiting persistent fasting hyperglycemia despite maximal oral drug
      therapy. The precise role for combination therapy and optimal patient
      characteristics awaits further study.

PMID- 2238630
TI  - Magnesium deficiency.
AB  - Over the past 40 years, human magnesium deficiency has become recognized as a
      world-wide clinical problem. In 1926, Leroy (1), demonstrated the absolute need
      of magnesium for growth and life in mice, and the need for magnesium in plants
      was demonstrated in 1860. Although clinical deficiency was first reported in
      1934, it was not until the 1950s that interest in clinical magnesium deficiency
      developed rapidly. Before the 1950s, textbooks of medicine, pediatrics and
      biochemistry did not mention magnesium disturbances. In this paper I shall
      emphasize the recognition and treatment of magnesium deficiency by giving details
      of the setting, i.e. illnesses, the multifaceted manifestations, the laboratory
      findings and safe protocols for treatment.

PMID- 2238631
TI  - Tort reform recommendations for West Virginia.
AB  - Tort reform is central to resolution of the malpractice issue in West Virginia.
      This article examines tort law and malpractice as viewed from federal and state
      levels and compares general liability costs in states. The article also looks at
      national trends in malpractice awards; at state initiatives in tort reform; and
      finally extracts what works and what doesn't. It presents strategies for
      legislative approaches to tort reform.

PMID- 2238632
TI  - Pectoralis major myocutaneous flap in reconstruction of head and neck defects.
AB  - Immediate reconstruction of head and neck defects due to various causes is
      required to restore structure, function, and appearance. The pectoralis major
      myocutaneous flap (PMMF) is the ideal reconstructive tissue for its
      accessibility, versatility, reliability, and cosmeticity. This paper reports a 10
      year experience on the use of the PMMF for restoration of extensive head and neck
      defects.

PMID- 2238633
TI  - Lymphadenopathy in children: a concise review.
AB  - Lymphadenopathy is commonly found in sick children and the cause of the enlarged
      nodes is usually evident. However, lymphadenopathy of a prolonged duration or
      with larger than anticipated nodes often presents a diagnostic dilemma. Knowledge
      of the normal pattern of lymph node size in children and the mechanisms of
      lymphadenopathy are prerequisites to approaching the diagnosis. Historical and
      physical clues help to guide the diagnostic evaluation and may indicate the need
      for certain laboratory tests, a trial of antibiotics, immediate biopsy, or simply
      close observation. If a biopsy is performed, comprehensive evaluation of the
      lymph node is critical to the diagnosis and subsequent treatment. Although most
      children with peripheral adenopathy have reactive hyperplasia of unknown
      etiology, it is important to monitor children with persistent lymphadenopathy
      until a diagnosis is made or the adenopathy resolves.

PMID- 2238635
TI  - A new role.

PMID- 2238634
TI  - Just the facts, mam.

PMID- 2238636
TI  - This is still the United States of America.

PMID- 2238637
TI  - The confusion in obesity research standards.

PMID- 2238638
TI  - Patterns of symptomatology of adult women incest survivors.

PMID- 2238639
TI  - Scoliosis treatment effects on selected variables among adolescents.

PMID- 2238640
TI  - Value orientations of homeless men.

PMID- 2238641
TI  - Theoretical modeling to predict subjective well-being.

PMID- 2238642
TI  - Clinical colleagues as a source of data for faculty evaluation.

PMID- 2238643
TI  - Importance of expert judgment in content-related validity evidence.
AB  - The unified conceptualization of validity with regard to content-related evidence
      has been expressed succinctly by the authors of the Standards for Educational and
      Psychological Testing (AERA et al., 1985): Content-related evidence of validity
      is a central concern during [instrument] development, whether such development
      occurs in a research setting, in a publishing house, or in the context of
      professional practice. Expert professional judgment should play an integral part
      in developing the definition of what is to be measured, such as describing the
      universe of content, generating or selecting the content sample, and specifying
      the item format and scoring system. Thus, inferences about content are linked to
      [instrument] construction as well as to establishing evidence of validity after
      [an instrument] has been developed and chosen for use. (p. 11) This article has
      demonstrated the process of collecting content-related validity evidence in terms
      of the specific requirements of the Standards. Five standards were identified and
      interpreted according to the initial stages of instrument construction: domain
      specification, item development, and item, subscale, and scale content
      validation. The role of expert judgment during these stages and the variety of
      evidence that can be gathered were described. For most instruments, the review
      process would necessitate two meetings of 1 to 2 hours each to review the domain
      specifications and another two meetings to determine the match between the items
      and the specifications. The importance of these 8 hours or whatever additional
      time is needed to obtain the validity evidence was emphasized. Finally, an
      application of the Standards was provided to illustrate step-by-step how the
      judgmental review process can be planned and executed.

PMID- 2238644
TI  - A psychometric evaluation of a visual analogue scale of craving for cigarettes.

PMID- 2238645
TI  - Father's family violence and son's delinquency: conflict tactics, bonding, and
      serious juvenile crime in the Mexican-American family.

PMID- 2238646
TI  - Ethical similarities internationally.

PMID- 2238648
TI  - Collaboration for the development of a nursing diagnosis system.

PMID- 2238647
TI  - Longitudinal research--the challenge of maintaining continued involvement of
      participants.

PMID- 2238649
TI  - [Modification of physical fitness of patients with coronary heart disease with
      nifedipine during a stay at altitude].
AB  - With this study including 9 patients with angiographically proven coronary heart
      disease it could be shown that a monotherapy with nifedipine in the galenic
      preparation as Adalat SL (Bayer AG, Leverkusen, FRG) is efficient in reducing
      myocardiac ischemia and concomitantly raising working capacity during bicycle
      ergometry as well after first time application of this drug as after continuous
      therapy with 1 tablet twice daily during 4 weeks. This findings are true both at
      normal environmental conditions (1000 ft above sea level) and at conditions of
      altitude induced hypoxia (9000 ft above sea level), simulated in a hypobaric
      chamber. There was no development of drug tolerance during continuous therapy
      with 1 tablet of Adalat SL twice a day. Out of these findings the conclusion can
      be drawn that in patients with coronary heart disease receiving protective
      therapy with Adalat SL there is no remarkably higher risk of episodes of angina
      pectoris or even myocardiac infarction at altitudes up to 9000 ft above sea level
      than is to be expected during daily life.

PMID- 2238650
TI  - [Mediastinal lymphadenectomy. Anatomical basis and its surgical relevance in
      central bronchus carcinoma].
AB  - 102 patients with potentially curable bronchial carcinoma were subjected to
      pneumonectomy and mediastinal lymph node dissection regardless of gross
      appearance of the mediastinum at the time of surgery. 83 of these patients were
      analysed retrospectively. In 34 patients (41%) enlarged mediastinal lymph nodes
      were found; in 19 of these (56%) malignant invasion was verified histologically,
      whereas in 15 of these 34 patients (44%) the enlarged lymph nodes revealed only
      inflammatory changes. On the other hand, in 49 patients (59%) the mediastinum was
      grossly inconspicuous, yet in 2 of these patients (4.1%) microscopic invasion by
      carcinoma was found. This confirms that the assessment of the mediastinum by
      gross appearance is unreliable. As a consequence, mediastinal lymph node
      dissection should be performed routinely in all patients in order to detect
      occult metastases since only patients who had a complete resection have a change
      of cure. This approach is justified as in our experience mediastinal lymph node
      dissection does not impose an additional operative risk and long-term survival or
      even cure may be achieved in individual patients. Estimated 5-year survival in
      our patients with histologically proven mediastinal lymph node metastases was
      22%; 3 of 21 patients with N 2 carcinoma are alive 8, 10 and 13 years p.o.,
      without evidence of recurrence. The operative strategy and technical aspects
      based on anatomical knowledge of pathways of lymphatic spread of carcinoma of the
      lung are presented.

PMID- 2238651
TI  - [Significance of food allergens for the development of hyperreactive airway
      diseases].
AB  - Food allergies may lead to local and systemic allergic reactions. Participation
      of respiration tract is rare and is only noticed in combination with additional
      systemic allergic reactions. Food allergies seem not to have influence on the
      origin of bronchial hyperreactivity or Asthma. Furthermore the question of
      genetic influence on the origin of children's allergies and possible preventive
      measures are discussed.

PMID- 2238652
TI  - [Relationship between pseudocroup and air pollutant burden of the inhaled air and
      weather].
AB  - An epidemiological study is presented to demonstrate, in addition to the viral
      aetiology, the influence of airpollution and various weather conditions to the
      incidence of croup. By means of a special statistic tool (baseline data curves)
      we could demonstrate that rapid changes in airpollutants (especially NO and NO2)
      are followed by increased occurrence of croup. In addition, the quotient NO2/NO
      seems to correlate directly to the O3 concentration. The noticeable influence of
      airpollution as well as changing climatic conditions demonstrate the multiform
      aetiology of croup.

PMID- 2238653
TI  - [Relationship between pseudocroup and air pollutant burden of the inhaled air and
      weather--comment on the article by Dr. J.P. Guggenbichler].

PMID- 2238654
TI  - CEA and CA 15-3 in primary and recurrent breast cancer.
AB  - To evaluate CA 15-3, a new breast cancer associated antigen, and to compare it
      with carcinoembryonic antigen (CEA), all patients presenting with breast cancer
      had preoperative and serial (3-monthly) postoperative levels measured. Of 124
      patients with primary breast cancer, 23% had an elevated CA 15-3 (greater than 25
      units/ml) while 11% had an elevated CEA (greater than 5 ng/ml) (p = not
      significant). Neither marker was an indicator of spread to regional lymph nodes
      in primary breast cancer. In 45 recurrences of breast cancer, CA 15-3 was
      elevated at the time of first recurrence in 58% while CEA was elevated in 47% (p
      = not significant). Of 17 patients with locoregional recurrence alone, none had a
      CA 15-3 above 40 units/ml while 11 of 12 with synchronous locoregional and
      distant recurrence had a CA 15-3 level greater than 40 units/ml (chi 2: 21.36, p
      less than 0.0001). This study shows that CA 15-3, like CEA, is of little clinical
      value in primary breast cancer. CA 15-3, however, is an accurate indicator
      (overall accuracy, 97%) of synchronous distant metastases in patients with
      locoregional recurrence from breast cancer. This information has important
      implications for further investigation and management of such patients.

PMID- 2238655
TI  - Changing trends in surgery for acute cholecystitis.
AB  - Surgery for acute cholecystitis has become the most frequent abdominal surgery in
      most hospitals, yet aspects of its management remain controversial. The aim of
      this study was to focus on the recent trends by demonstrating the principal
      differences between 2 series of patients operated on during 10-year intervals.
      Two hundred fifty-six consecutive operations for acute cholecystitis were
      performed from 1970 to 1977 (group O) and were compared to 260 cases operated
      from 1980 to 1987 (group N). Thirty-six variables were recorded in each case. All
      data obtained were computer recorded and analyzed. Several trends were observed
      in group N: 1. The population was significantly older with a higher proportion of
      males and diabetics. 2. There was a marked increase in common bile duct stones,
      acalculous cholecystitis, and gangrenous changes in the gallbladder. 3. There was
      a significant increase in patients operated on within 48 hours of admission. 4.
      There was a significant increase in the number of patients without previous
      history of biliary symptoms. 5. There was a significant decrease in the rate of
      wound infections and no statistically significant differences in mortality (N:
      3.0%, O: 2.7%). 6. A decrease of the average postoperative hospital stay of 3.2
      days was observed. In spite of the older and sicker population in group N, no
      significant increase in mortality occurred and the postoperative hospital stay
      was reduced.

PMID- 2238657
TI  - Dilatation of intrahepatic biliary strictures in patients with hepatolithiasis.
AB  - To investigate the role of balloon dilatation in the management of complicated
      hepatolithiasis with intrahepatic biliary stricture, 57 consecutive patients who
      received 208 sessions of dilatation in addition to the usual treatment were
      analyzed. The strictures were located in the right intrahepatic ducts (84.2%),
      left intrahepatic ducts (12.3%), or both (3.5%). Dilatation began 3-4 weeks after
      surgery. The routes of dilatation included the matured T-tube tract (3 cases),
      percutaneous transhepatic biliary drainage tracts (42 cases), and both (12
      cases). The immediate overall success rate of complete stone clearance increased
      significantly from 0% predilatation to 94.7% postdilatation. The main
      complications of dilatation therapy consisted of septicemia (10.5%), hemobilia
      (10.5%), and mild diarrhea (80%). Eight patients (14%) with long-segment
      strictures received 11 postdilatation biliary stentings. Complications were 1
      patient with occlusion and 2 patients with "spontaneous" hemobilia. Severe
      multiple strictures and coexistent secondary biliary cirrhosis were the
      contributing factors to complications. During the follow-up of 3.4 +/- 1.2 years,
      recurrence of strictures was found in 4 patients. Two of them belonged to the
      stenting group. The cumulative probability of restricture was low: 4% at 2 years,
      6% at 2.5 years, and 8% at 3 years. We conclude that in complicated cases of
      hepatolithiasis with intrahepatic biliary stricture, dilatation and stenting are
      good adjuvant therapies.

PMID- 2238658
TI  - Previous abdominal colectomy affects functional results after ileal pouch-anal
      anastomosis.
AB  - We assessed the effect of previous abdominal colectomy on functional results
      after ileal "J" pouch-anal anastomosis (IPAA) in patients with ulcerative
      colitis. Twenty-five patients with colectomy prior to IPAA were compared with 22
      patients who underwent noncolonic abdominal operations prior to IPAA. No
      differences were observed in pre- or postoperative resting anal sphincter
      pressure, squeeze pressure, or rectal inhibitory reflex. Previous colectomy was
      associated with a greater incidence of postoperative small bowel obstruction.
      Mean +/- SEM daily stool frequency at 1 and 12 months postoperatively,
      respectively, was 8.9 +/- 0.8 and 5.7 +/- 0.3 for patients who had undergone
      previous colectomy, and 8.2 +/- 0.7 and 6.0 +/- 0.5 for the no-previous colectomy
      group (p = not significant). At the same postoperative intervals, nocturnal stool
      frequency was 1.9 +/- 0.3 and 1.1 +/- 0.2 for the colectomy group and 1.5 +/- 0.3
      and 0.6 +/- 0.1 for the no colectomy group (p = 0.05 at 1 year). More patients in
      the previous colectomy group had greater than or equal to 1 nocturnal stool after
      1 year (71% versus 33%, p = 0.03). Although pouch capacity at 1 year was not
      different in the 2 groups, pouch capacity was directly related to stool frequency
      in the no colectomy group (r2 = 0.48, p = 0.01), but not in the previous
      colectomy group (r2 = 0.08, p = not significant). We conclude that previous
      abdominal colectomy may be associated with a higher overall incidence of small
      bowel obstruction. Moreover, previous colectomy is a determinant of postoperative
      nocturnal stool frequency after IPAA, most likely due to altered ileal pouch
      function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238659
TI  - Neonatal necrotizing enterocolitis: experience with 100 consecutive surgical
      patients.
AB  - One hundred newborns with neonatal necrotizing enterocolitis (NEC) were treated
      surgically according to a uniform protocol between July, 1980 and June, 1988. The
      infants (53 females, 47 males) weighed between 600 and 3,800 g, averaging 1,500
      g. Twenty-eight weighed less than or equal to 1,000 g, 38 weighed from 1,001 g to
      1,500 g, and 34 weighed more than 1,500 g. Median age at the time of surgery was
      14 days. Surgery was performed for pneumoperitoneum in 40, a "positive"
      paracentesis in 51, and for other reasons in 9 infants. A paracentesis was
      performed if intestinal gangrene was suspected clinically. Resection of
      gangrenous bowel with exteriorization was the usual procedure; in only 5 patients
      was primary closure performed. The hospital survival for the infants was 54% for
      the group weighing less than or equal to 1,000 g, 74% for the group weighing from
      1,001 g to 1,500 g, and 79% for the group weighing more than 1,500 g. Overall
      hospital survival was 70%; it was 81% for those having a definitive procedure
      (excluding 14 infants with NEC "totalis"). There were 3 late deaths from causes
      unrelated to NEC. Significant long-term complications included failure-to-thrive
      in 23% and stricture formation in 30% of the survivors. Long-term follow-up
      showed gastrointestinal status to be normal in 74%; only 8% have persistent major
      gastrointestinal dysfunction. Mental and motor development was considered grossly
      normal in only 53% of the patients.

PMID- 2238656
TI  - Adenocarcinoma of the stomach: a review of 35 years and 1,710 cases.
AB  - The records of 1,710 patients with adenocarcinoma of the stomach treated at
      Charity Hospital over a 35-year period were reviewed to note any trends which
      might help in understanding the decreasing incidence and poor prognosis of the
      disease. The yearly number of gastric cancer patients has dropped from
      234/100,000 in the 1950's to 195/100,000 in the 1960's to 108/100,000 patients in
      the last decade. The percentage of affected white males is decreasing at a rate
      equal to the increasing frequency of black female patients, while the ratios for
      black males and white females remain constant. The median age rose from 61.5
      years to 66 years over the study period. The operability rate decreased from
      82.4% to 72.8% and the resectability rate was 49%. Subtotal gastrectomy was the
      most common procedure, but radical subtotal gastrectomy gave the best 5-year
      survival. There are fewer lesions of the antrum today, but the highest number of
      5-year survivors had antral lesions. Long-term survival of patients with lesions
      of the cardia improved from zero in the first 25 years to 14% in the last decade.
      For the last 2 decades, patients with stage III and IV lesions comprised one-half
      of the 5-year survivors. Our overall 5-year survival was 7.9%, but in the last
      decade it was 8.9%. Our 5-year survival for all patients who underwent a
      resection was 17.9%, but increased to 24.8% for the last decade. These
      improvements, in combination with a decrease in incidence, have dropped the
      overall mortality from gastric cancer.

PMID- 2238660
TI  - Cervical node metastases in early squamous cell carcinoma of the floor of the
      mouth: predictive value of multiple histopathologic parameters.
AB  - A semiquantitative assessment of multiple histological parameters was applied
      retrospectively to 66 patients with stage I and II squamous cell carcinoma of the
      floor of the mouth to determine if prognostic information relative to cervical
      node metastases could be obtained. Three parameters relating to the tumor cell
      population and 5 describing the tumor-host interface were evaluated on a point
      scale from 1 to 3 with the highest score going to the most threatening
      characteristic. Twenty of the 66 patients had either occult metastases identified
      by elective lymphadenectomy (n = 11) or developed metastases to the neck (n = 9).
      There was no correlation between traditional histological grading as recorded at
      the time of presentation and the frequency of cervical metastases (p greater than
      0.05). Histological reevaluation defined 3 groups of patients with low (less than
      14), moderate (14-16), and high scores (greater than 16) with an incidence of
      cervical metastases of 5/39 (12.8%), 6/17 (35.3%), and 9/10 (90%), respectively
      (p less than 0.001). The results suggest that microscopic grading could be a
      useful adjunct to the present TNM staging system in selecting patients likely to
      benefit from elective treatment of the neck.

PMID- 2238661
TI  - Multifactorial analysis of survival in primary extremity liposarcoma.
AB  - The treatment of extremity soft tissue sarcoma is now directed at limb
      preservation with the addition of various adjuvant therapies to improve treatment
      results. To achieve this goal, a knowledge of prognostic factors for extremity
      soft tissue sarcoma becomes increasingly critical. The object of this study was
      to analyze prognostic factors for survival in patients with extremity
      liposarcoma. Eighty-three patients with primary localized extremity liposarcoma,
      admitted from 1968 to 1978, were retrospectively reviewed. Surgical resection was
      the primary mode of treatment. Eleven prognostic factors were analyzed. Tumor
      factors included: histologic subtype, tumor grade, size, depth, invasion of vital
      structures, and site; operative factors included: type of operation, and surgical
      margins; and patient factors included: symptoms, age at diagnosis, and sex.
      Kaplan-Meier survival curves, and univariate and stratified log-rank tests of
      association were performed. Independent factors for predicting survival were
      identified using the Cox model stepwise regression technique. In univariate
      analysis of the entire group of patients, 5 factors were significant for tumor
      mortality: tumor grade (p = 0.00005), histologic subtype (p = 0.00025), tumor
      size greater than or equal to 5 cm (p = 0.005), type of surgery/margin (p =
      0.0001), and invasion of vital structures (p = 0.008). When associations among
      all factors were analyzed, it was found that many factors were interdependent.
      The independent prognosticators were, therefore, determined according to the Cox
      model technique. For the multivariate analysis, well-differentiated and
      lipoblastic liposarcomas were excluded because of lack of survival variation
      within each group. The former group had no tumor-related deaths and the latter
      group showed 80% tumor mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238662
TI  - Coloanal anastomosis after resection of low rectal cancer in the elderly.
AB  - Twenty-two patients had coloanal anastomoses performed after resection of low
      rectal tumors (16 adenocarcinomas and 6 large degenerated villous adenomas). The
      patients had an average age of 72 years (range: 62-85). A hand-sewn anastomosis
      was performed between a "J"-shaped colonic reservoir and the anal sphincter,
      except in 3 patients who underwent a straight end-to-end coloanal suture without
      pouch. A defunctionalized stoma was made in 18 cases. Mortality within 30 days of
      operation was 9%. Specific complications occurred in 2 patients (9%). Mean follow
      up in this series was 20.2 +/- 11.7 months (+/- standard deviation). Fifteen
      patients were alive and free of disease up to 54 months after surgery. One
      patient was found to have local recurrence at 19 months. The actuarial 3-year
      survival rate was 73% in the whole group (operative mortality included).
      Functional results were good in 16 of 19 patients, with an average 1.8-2.9
      stools/24 hours and the continence rate was good. Three patients had
      complications requiring a permanent colostomy. From these preliminary results,
      coloanal anastomosis appears to be satisfying in regard to oncologic results and
      affords good anal function, even in the elderly patient (over 62 years of age).

PMID- 2238663
TI  - The "Kergin pneumonectomy".
AB  - Out of a series of 211 stage III (A and B) lung cancers radically resected with
      routine lymphadenectomy from 1971 to 1987, a total of 11 were squamous cell
      carcinomas invading the right main bronchus and lateral portion of the trachea.
      These patients were managed using a particular technique that we have always
      arbitrarily called, "Kergin pneumonectomy," after the Toronto surgeon who
      described it in 1952. These patients, today, are staged III B. There was no
      operative mortality and only 2 minor complications. Two patients survived 3 years
      and 1 is alive and free of disease 7 years from surgery. This technique should be
      considered before embarking on more perilous surgery such as "sleeve
      pneumonectomy," a procedure which still carries high mortality and morbidity
      rates and requires special equipment and intensive postoperative care.

PMID- 2238664
TI  - A new simple test for evaluation of intestinal bacteria.
AB  - We investigated a newly synthesized conjugate of ursodeoxycholic acid with para
      aminobenzoic acid (PABA) to determine its suitability to evaluate enteric
      bacteria. This compound, PABA-UDCA, is deconjugated by cholylglycine hydrolase to
      release free PABA whereas it is completely resistant to deconjugation by
      pancreatic and intestinal mucosal enzymes. In bacteriological experiments, almost
      all of the microorganisms which split glycocholic acid deconjugated this
      compound. In animal experiments, urinary excretions of PABA were measured for 6
      hours following oral administration of 10 mg PABA-UDCA. Ten control rats excreted
      338.5 +/- 43.8 micrograms (mean +/- SD) of PABA; 10 rats with intestinal
      bacterial overgrowth due to enteric stagnant loops excreted more (673.6 +/- 222.1
      micrograms; p less than 0.01), whereas 10 rats in each of 8 groups with
      intestinal antisepsis by oral administration of various antibiotics excreted
      significantly less (p less than 0.001) (ampicillin + doxycycline + fradiomycin:
      18.3 +/- 16.7, polymixin B + tinidazole: 14.0 +/- 8.0, polymixin B: 224.9 +/-
      74.3, tinidazole: 42.7 +/- 27.3, kanamycin: 50.3 +/- 18.2, clindamycin: 57.4 +/-
      23.3, vancomycin: 70.4 +/- 27.0, and paromomycin: 160.4 +/- 51.9 micrograms).
      These observations indicate that this compound is likely to offer a simple and
      rapid method for evaluation of intestinal microorganisms without the use of
      radioisotopes or expensive, special apparatus.

PMID- 2238665
TI  - Suppression of the human mucosal-related colonic microflora with prophylactic
      parenteral and/or oral antibiotics.
AB  - The purpose of this investigation was to assess the effects of preoperative
      administration of parenteral antibiotics with or without concomitant preoperative
      administration of oral antibiotics on the colonic mucosal-related microflora.
      Thirty-one patients were studied in a prospective fashion. Group A patients (n =
      8) had colonoscopic mucosal biopsies performed after mechanical bowel
      preparation. Group B patients (n = 5) received neomycin and erythromycin (NE), 1
      g each following mechanical bowel preparation, at 1, 2, and 11 p.m. the evening
      prior to either elective colon resection (n = 2) or prior to colonoscopic biopsy
      (n = 3). Emergent trauma patients who had left colon or sigmoid perforations due
      to gunshot wounds requiring segmental resection comprised group C (n = 7). These
      patients received cefoxitin or cefotetan 2 g intravenously preoperatively.
      Individuals in group D (n = 11) all had elective left hemicolectomies or sigmoid
      resections due to nonobstructing malignancies. These patients underwent the same
      regimen as group B patients in addition to receiving intravenous cefoxitin
      perioperatively. Quantitative and qualitative bacterial cultures as well as
      scanning electron microscopy (SEM) were used to study the mucosa-associated
      flora. Tissue for culture and SEM were obtained from the pathologic specimen
      immediately after removal. The interval between the dosage of parenteral
      antibiotics to tissue removal was 3 hours in both groups. Anaerobic and aerobic
      counts were suppressed the greatest in patients receiving both oral and
      parenteral antibiotics (p = 0.0001). Mean anaerobic counts decreased from 3.4 X
      10(7) in group A to 1.8 X 10(2) (mean cfu/g) in group D patients. Mean aerobic
      counts in group A decreased from 3.7 X 10(6) to 64 (mean cfu/g) in group
      D.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238666
TI  - Pylorus-preserving duodenopancreatectomy: long-term complications and comparison
      with the Whipple procedure.
AB  - We have performed 33 pylorus-preserving duodenopancreatectomies. Twenty patients
      presented with severe chronic pancreatitis and 13 with periampullary
      adenocarcinoma. We have no postoperative mortality and a 24% rate of morbidity.
      Complications include anastomotic leaks (2), surgical bleeding (1), anastomotic
      ulceration (1), and others (4). We have complete follow-up for all cases. In the
      tumor group, 8 (62%) patients are alive with a mean survival time of 20 months
      (range: 2-46). In the pancreatitis series, all patients are alive after a mean of
      34 months (range: 4-66). We have observed 5 cases (15%) of anastomotic
      ulcerations responsible for stenosis (2) and acute perforation with peritonitis
      (2) occurring after a mean interval of 18 months. Four cases have been confirmed
      histologically after resection. The short- and long-term beneficial effects of
      the pylorus-preserving operation on patient well-being and nutritional status
      were confirmed and compared with the results achieved after a Whipple procedure
      performed in a series of 18 consecutive patients.

PMID- 2238668
TI  - West Germany: still an underdeveloped country in the diagnosis and early
      treatment of primary hyperparathyroidism?
AB  - Early diagnosis of asymptomatic patients with primary hyperparathyroidism
      (primary HPT) has been achieved in Scandinavia, the United States of America, and
      the United Kingdom during the last 20 years. Comparable results have been
      reported from some medical centers from West Germany; however, clinical
      manifestations were pronounced and patient symptoms were high in our population
      with primary HPT (N = 128) operated on at the University of Dusseldorf from
      April, 1986 to July, 1989. Only 19 patients (14.8%) were asymptomatic while the
      others suffered from nephrolithiasis (39%), osteopathy (32%), gastrointestinal
      disturbances (28.9%), and depression (11.7%). In 46 (35.9%) of our patients, the
      duration of these clinical symptoms exceeded 10 years, in 27 patients (21%) 15
      years, and in 12 patients (9.3%) even 25 years. We, therefore, conclude that
      primary HPT is still a grossly underdiagnosed illness in parts of West Germany,
      presently, with patients suffering from severe clinical symptoms for more than 1
      2 decades before definitive treatment.

PMID- 2238667
TI  - Evaluation of effectiveness of mass screening for colorectal cancer.
AB  - As the first step in the epidemiological evaluation of the effectiveness of mass
      screening for colorectal cancer, we compared clinicopathological features and
      survival rates of patients with cancer detected by mass screening (screened
      group) with those for patients treated in our outpatient clinic in the same
      period (outpatient group). The screened group consisted of 53 patients with
      colorectal cancer detected by 2-day or 3-day screening for fecal occult blood by
      guaiac slides. Their background factors were comparable to those of 120 patients
      of the outpatient group in regard to age, sex ratio, location of cancer, and
      histological type of cancer. In the screened group, 90% of patients had no
      complaints, and positive occult blood tests led to the detection of cancers. More
      than 60% of the patients had Dukes' A and B1 early cancers while only about 30%
      had advanced cancers. In the outpatient group, nearly 90% of patients were
      symptomatic, most commonly from rectal bleeding. Early-stage cancers made up only
      20%, and large, advanced-stage cancers accounted for 80%. The 5-year survival
      rate of the screened group was 91.5%, being significantly higher than the 60%
      survival rate for the outpatient group. It is anticipated that mass screening for
      colorectal cancer by guaiac fecal occult blood testing will significantly reduce
      the mortality due to this neoplasm.

PMID- 2238669
TI  - Acquired and congenital clotting syndromes.
AB  - Although Virchow postulated 100 years ago that hypercoagulability states exist,
      it has only been in recent years that methods of documenting hypercoagulability
      have been developed. These clotting tendencies can be acquired or congenital. The
      common causes of acquired clotting tendencies include conditions which result in
      tissue and cellular damage, shock, transfusion reactions, and tissue necrosis.
      Certain drugs and drug reactions, and certain disease states which include blood
      dyscrasias and cancer are also associated with clotting problems. In certain
      diseases such as homocystinuria, hyperlipidemia, and lupus erythematosus,
      abnormal clotting tendencies may also develop. Important advances in the
      recognition of hypercoagulability have come with the documentation that
      congenital clotting abnormalities exist. Moreover, these abnormalities are
      proving to be more common than are congenital bleeding syndromes. Patients who
      appear to have spontaneous clotting manifestations and are under 40 years of age
      should be screened for one of these abnormalities. These congenital clotting
      tendencies can be classified as defects in thrombosis inhibitors,
      dysfibrinogenemias, or defects in fibrinolysis. The first thrombotic inhibitor
      defect recognized was antithrombin III deficiency which was reported in 1965.
      Subsequently, Protein C, Protein S, and Heparin cofactor II deficiencies have
      been recognized as contributing to thrombotic tendencies. Dysfibrinogenemias are
      relatively rare and most are associated with bleeding problems; however, 11% of
      the abnormal fibrinogens are associated with a clotting tendency. The reason
      appears to be that these fibrins are resistant to fibrinolysis. The most common
      defects which are associated with thrombotic tendencies appear, at the present
      time, to be due to defects in fibrinolysis. These include hypoplasminogenemia,
      decreases in plasminogen activator, increases in plasminogen activator inhibitor,
      and Factor XII deficiency.

PMID- 2238671
TI  - Use of plasminogen activators in venous thrombosis.
AB  - A major advance in the treatment of thrombosis has been the development of
      thrombolytic agents. Streptokinase and urokinase have been the standard agents
      available for many years, but in recent years the most exciting change in the
      field has been the development of a new generation of plasminogen activators, the
      principal one being tissue plasminogen activator. The first generation of
      plasminogen activators--streptokinase and urokinase--do not have fibrin
      specificity and predictably induce plasma proteolysis when administered
      systemically in doses which introduce thrombolysis. The second generation of
      plasminogen activators are much more fibrin-specific and offer a promise of fewer
      complications. In a number of major randomized studies, these thrombolytic agents
      have proved effective clinically. The major complication of thrombolytic therapy,
      however, is hemorrhage. The risk of hemorrhage increases with the length of
      infusion and occurs most often from sites of vascular invasion such as needle
      punctures or cutdown sites from surgical wounds. This can be treated by applying
      pressure over the wound and discontinuing the thrombolytic agent whose half-life
      is measured in hours. It is believed that as more experience is acquired with the
      second-generation plasminogen activators, better control of these drugs will
      result in fewer complications and more effective and wider application of
      therapy.

PMID- 2238670
TI  - Diagnosis of deep vein thrombosis.
AB  - A wide range of clinical symptoms and signs are observed with venous thrombosis.
      Nonetheless, clinical diagnosis has been found to be unreliable and accurate
      diagnostic methods must be used before potent therapy such as anticoagulation is
      instituted, since the complications of treatment themselves can be life
      threatening. Phlebography is still the basic reference for evaluation of deep
      venous disease. While it is felt to be the most accurate, there are still
      limitations relative to difficulty in separating acute from chronic disease, and
      in obtaining adequate contrast in certain veins such as calf muscles and in the
      larger intraabdominal veins. Moreover, it is an uncomfortable invasive test, not
      without complications of its own. The 125I-fibrinogen uptake test is an excellent
      test for screening for forming thrombi. The sensitivity of this test is high,
      particularly in the detection of small calf vein thrombi. The primary drawbacks
      of this technique are that it is falsely positive in cases where there has been
      bleeding, inflammation, gross edema, arthritis, or leg ulceration. It is not
      accurate above mid-thigh because of the high blood flow at the level of the groin
      and pelvis. Radioactive labeled plasmin which will adhere to the surface of
      recently formed thrombi can also be used for diagnosis. The limitations are a
      very short half-life of the radioactive label so that repeated investigation of a
      patient cannot be performed unless new injections are given. The diagnostic
      accuracy is comparable to that of radioactive labeled fibrinogen and has the same
      advantages and disadvantages. Plethysmographic techniques have been used with
      various modifications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238673
TI  - Development of the postthrombotic syndrome: its management at different stages.
AB  - The postthrombotic syndrome consists of clinical features which follow thrombosis
      of deep venous return of the limb. Patterns of postthrombotic changes remain
      difficult to predict and once established, difficult to contain and reverse.
      Following a thrombotic event of the lower limb, 3 clinical stages can be observed
      which may be followed by intervening quiescent intervals. Stage I, or the early
      phase, is characterized by the residual obstructive process following acute
      venous occlusion. This can be manifested by either a bursting type of pain
      (venous claudication) or edema of the leg. A thrombotic process can involve the
      calf veins, thigh veins, pelvic veins, or any combination of the three. Specific
      clinical syndromes develop depending on the venous pump system involved. The
      venous pump system consists of the plantar calf pump and the thigh pump. These
      serve to propel blood upward. Involvement of any one or more of the 3 in the
      thrombotic processes can result in a relative obstruction with a specific pattern
      of clinical symptoms. Optimally, the venous thrombotic process should be treated
      during this early phase to prevent the subsequent events which may render the
      process irreversible. The second stage of the postthrombotic syndrome consists of
      the development of fat sclerosis. At this stage, the process becomes
      progressively irreversible as the extravasation of fibrin into the interstitial
      space results in progressive fibrosis and sclerosis. This results in damage to
      the skin and subcutaneous tissues which render the process irreversible. Specific
      treatment, while still introducible at this stage, can halt the progress of the
      syndrome, but rarely results in complete reversal.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2238674
TI  - Military surgeons as internationalists.

PMID- 2238675
TI  - History, culture and health care.

PMID- 2238676
TI  - HMOs are not the answer.

PMID- 2238677
TI  - Making certain that children are immunized.

PMID- 2238672
TI  - Surgical treatment of acute deep venous thrombosis.
AB  - In patients with venous thrombotic disease and in whom anticoagulation or
      thrombolytic therapy is inappropriate, ineffective, or even contraindicated,
      insertion of vena caval filters or venous thrombectomy must be considered. The
      primary indication for the placement of vena caval filters is in patients who
      have developed a pulmonary embolus and in whom anticoagulation is either
      contraindicated or in whom anticoagulation must be discontinued because of the
      development of bleeding complications. At the present time, either the Greenfield
      filter placed through a jugular, femoral, or axillary venotomy or the bird's nest
      filter are appropriate and appear to be the most effective and least fraught with
      complications. The use of venous thrombectomy has waxed and waned over the last
      several decades. At the present time, the procedure is advocated mainly for lower
      limb venous thrombosis which is extensive enough to threaten limb viability. On
      occasion, it may be appropriate to extend the indications for venous thrombectomy
      to include femoral thrombosis of less than 10 days duration or iliac thrombosis
      of less than 3 weeks duration with floating thrombi at the level. Technical
      modifications which improve the patency of the obliterated veins which are
      predisposed to rethrombosis include the creation of a temporary arteriovenous
      fistula and meticulous care in removing the entire clot. The patient should be
      treated with anticoagulants postoperatively to prevent a recurrence of the
      problem. The main theoretical advantage of venous thrombectomy is a reduced
      incidence of postthrombotic syndrome. Objective data to support this contention
      do not exist.

PMID- 2238678
TI  - Tears.

PMID- 2238679
TI  - Hunting-related injuries.
AB  - One hundred four patients treated for injuries incurred while hunting were
      prospectively studied during two consecutive fall seasons. A questionnaire was
      completed at initial evaluation and hospital records were subsequently reviewed.
      One hundred (98%) patients were male. Patient ages ranged from 10 to 78 years
      (median = 32 years). Mechanism of injury included knife or arrow penetrations
      (25), firearm wounds (12), falls (17), overexertion (5), and misadventures with
      hazards (40). Soft tissue, maxillofacial and orthopedic injuries predominated.
      Four patients experienced cardiac events. Hypothermia was noted in three, and
      animal-related injuries occurred in five. Eighteen (17%) patients were
      hospitalized. Serious injury was evident in 34 (33%). There were no deaths.
      Outpatient follow-up was necessary in 90%. Mishaps most frequently occurred
      because of overexcitement, unfamiliarity with equipment, or carelessness. Alcohol
      and drug use were only rarely identified. Almost one half of patients were
      injured during the 9-day gun deer hunting season. A wide variety of injuries
      occur during hunting activities. While many are minor, serious morbidity with
      potential long-term disability may result. Costs in time and money may be
      substantial. Simple measures could prevent many hunting-related mishaps.

PMID- 2238680
TI  - Magnesium metabolism.
AB  - Magnesium is the second most abundant intracellular cation in the human body and
      is necessary as a cofactor in more than 300 enzymatic reactions. The generation
      and use of adenosine triphosphate is dependent on the presence of magnesium. The
      assessment of the magnesium status of a patient is problematic because there are
      no easily performed tests that reliably predict the intracellular concentration.
      There are recognized molecular and cellular actions of magnesium that explain
      clinically recognizable problems when a magnesium deficiency or excess is
      present. Guidelines for therapy of magnesium deficiency are given. Future
      directions in research are given.

PMID- 2238681
TI  - I-123 Iofetamine SPECT scan in children with neurological disorders.
AB  - I-123 Iofetamine (IMP) single photon emission computed tomography (SPECT) imaging
      of the brain in 42 patients (ages 14 days to 23 years) was compared with other
      localizing studies in children with neurological diseases. All had an EEG and at
      least one imaging study of the brain (computed tomography (CT) or magnetic
      resonance imaging (MRI), or both). Seventy-eight percent of the patients had an
      EEG within 24-72 hours of the IMP-SPECT scan. Thirty-five (83%) had a history of
      seizures, and the remainder had other neurological conditions without a history
      of seizures. In most cases, a normal EEG reading with normal CT or MRI result
      predicted a normal SPECT study. When the EEG was abnormal the majority of the IMP
      SPECT scans were abnormal and localized the abnormality to the same region. A
      comparison with CT and MRI showed that structural abnormalities involving the
      cortex were usually well demonstrated with IMP-SPECT imaging. Structural lesions
      confined to the white matter were generally not detectable with IMP-SPECT. In a
      few cases, SPECT scans revealed abnormalities in deep brain areas not identified
      by EEG. IMP-SPECT imaging is a valuable technique for the detection and
      localization of abnormal cerebral metabolic activity in children with seizure
      disorders. A correlation with CT or MRI is essential for proper interpretation of
      abnormalities detected with IMP SPECT imaging.

PMID- 2238682
TI  - Cruzan: a clinician's response.

PMID- 2238683
TI  - Power of attorney for health care.

PMID- 2238684
TI  - Self-reported barriers to mammography: implications for physicians.

PMID- 2238685
TI  - Why have our patients lost faith in us?

PMID- 2238687
TI  - Coronary reconstruction in a patient with patent double Vineberg implants and
      subclavian stenosis.

PMID- 2238686
TI  - Patterns of red blood cell use in southeastern Wisconsin.
AB  - We conducted a retrospective study of red blood cell use in southeastern
      Wisconsin to characterize transfusion practices and provide data for designing
      educational programs. Charts of 533 patients who received 3,006 units of blood at
      ten hospitals were reviewed. Demographic, diagnostic, surgical, and laboratory
      data and indications for transfusion were obtained. Mean blood use per patient
      (U/pt) was 5.6, 7.2, and 4.1 units for all patients, surgical and non-surgical,
      respectively. Fifty percent of the patients underwent surgery, used 64% of the
      blood, and required more postoperatively (4.2 U/pt) than intraoperatively (2.8
      U/pt). Open-heart surgeries required 32% of all blood. Eighty-two percent of
      postoperative transfusions occurred when the hematocrit was less than or equal to
      30%. Only 2.8% of eligible elective surgery patients made pre-deposit autologous
      donations and contributed 1% of the total blood used.

PMID- 2238688
TI  - New federal hospital patient transfer requirements.

PMID- 2238689
TI  - Can we influence adolescent health behavior?

PMID- 2238691
TI  - Wisconsin's Clean Indoor Air Act: an overview.

PMID- 2238690
TI  - The Wisconsin mammography quality assurance program.

PMID- 2238692
TI  - Environmental epidemiology.

PMID- 2238693
TI  - Indoor air pollution in developing countries.
AB  - Of the four principal categories of indoor pollution (combustion products,
      chemicals, radon and biologicals), research in developing countries has focused
      on combustion-generated pollutants, and principally those from solid-fuel-fired
      cooking and heating stoves. Such stoves are used in more than half the world's
      households and have been shown in many locations to produce high indoor
      concentrations of particulates, carbon monoxide and other combustion-related
      pollutants. Although the proportion of all such household stoves that are used in
      poorly ventilated situations is uncertain, the total population exposed to
      excessive concentrations is potentially high, probably several hundred million. A
      number of studies were carried out in the 1980s to discover the health effects of
      such stove exposures. The majority of such studies were done in South Asia in
      homes burning biomass fuels or in China with coal-burning homes, although a
      sprinkling of studies examining biomass-burning have been done in Oceania, Latin
      America and Africa. Of the health effects that might be expected from such
      exposures, little, if any, work seems to have been done on low birthweight and
      eye problems, although there are anecdotal accounts making the connection.
      Decreased lung function has been noted in Nepali women reporting more time spent
      near the stove as it has for Chinese women using coal stoves as compared to those
      using gas stoves. Respiratory distress symptoms have been associated with use of
      smoky fuels in West India, Ladakh and in several Chinese studies among different
      age groups, some with large population samples. Acute respiratory infection in
      children, one of the chief causes of infant and childhood mortality, has been
      associated with Nepali household-smoke exposures. Studies of chronic disease
      endpoints are difficult because of the need to construct exposure histories over
      long periods. Nevertheless, chronic obstructive lung disease has been associated
      with the daily time spent near the stove for Nepali women and found to be
      elevated among coal-stove users compared to gas-stove users in Shanghai. In
      contrast to early reports, there seems to be little or no risk of nasopharyngeal
      cancer from cookstove smoke. Several studies in China, however, have found smoke
      to be a strong risk factor for lung cancer among non-smoking women. In addition,
      severe fluorosis has been observed in several parts of China where coal fluoride
      levels are high.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238694
TI  - Acute pesticide poisoning: a major global health problem.
AB  - The global problem of acute pesticide poisoning has been confirmed as extensive
      by a variety of independent estimates. Further, it is also recognized to be a
      problem confined to the developing countries. Most estimates concerning the
      extent of acute pesticide poisoning have been based on data from hospital
      admissions which would include only the more serious cases. The latest estimate
      by a WHO task group indicates that there may be 1 million serious unintentional
      poisonings each year and in addition 2 million people hospitalized for suicide
      attempts with pesticides. This necessarily reflects only a fraction of the real
      problem. On the basis of a survey of self-reported minor poisoning carried out in
      the Asian region, it is estimated that there could be as many as 25 million
      agricultural workers in the developing world suffering an episode of poisoning
      each year. This article emphasizes the need to control the problem on a
      collaborative basis by all concerned, including national governments,
      agrochemical industries, international agencies, scientists and victims.

PMID- 2238695
TI  - Assessing the health impact of urbanization.
AB  - Several components of urbanization influence health status, but it is difficult
      to attribute changes in health status to any particular component. The overall
      impact may be estimated by relating the degree of urbanization of populations to
      some proxy measure, like the under-5 mortality rates. In this respect the net
      effect of urbanization is shown to be beneficial. A variety of survey and
      computational methods have been used to clarify the relationship. Some illustrate
      the effects of urbanization upon particular clinical conditions, such as
      promoting the eradication of leprosy, others of particular components, such as
      overcrowding and pollution, on infant mortality. To help set goals, excess or
      avoidable mortality may be computed for a country or region by relating its
      experience to current mortality levels in a developed country; and changes in the
      levels of avoidable mortality from sentinel conditions such as infectious
      diseases may be related to changes in particular aspects of urbanization, e.g.
      improvements in levels of sanitation. Migration to the urban environment imparts
      the tendency to acquire the health characteristics of the host population. Rapid
      urbanization causes problems of psychosocial adjustment for older children.
      Urbanization may impact upon the incidence and prevalence of disability. Where
      sex-age disability-survey data exist, they may be combined with age-specific
      mortality data to construct an index of disability-free life expectancy, a more
      subtle measure for assessing the progressive impact of urbanization. Up to now,
      however, there have been no international studies of how levels of disability
      change according to the progress of urbanization, and there are no international
      census or survey recommendations for harmonizing the classification of disabled
      people.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238696
TI  - Urban air pollution in Latin America and the Caribbean: health perspectives.
AB  - In the last few years, air pollution has become a major issue in some countries
      of Latin America and the Caribbean because of urban development and growing
      industrialization. In addition to industrial processes often concentrated in the
      cities, vehicle emission and stationary-source fuel combustion are the primary
      sources of air pollution. Although air-quality standards have been established in
      some Latin American countries, these are frequently exceeded. Adverse health
      effects of air pollution have been mainly associated with the following
      pollutants: sulfur dioxide and particulate matter, photochemical oxidants,
      nitrogen dioxide and carbon monoxide, and lead. Short-term as well as long-term
      effects can be expected at levels exceeding WHO guidelines. The Latin American
      urban areas most affected by anthropogenic pollutant emissions are: the area of
      Sao Paulo (Brazil), the city of Santiago (Chile) and the metropolitan area of
      Mexico City. However, situations similar to those prevailing in these cities
      could well occur in other cities of Latin America and the Caribbean. The
      population exposed to air-pollutant levels exceeding WHO guidelines can be
      estimated to 81 million or 26.5% of the total urban population of Latin America
      and 19% of its total population. These estimates correspond to 30 million
      children (0-14), 47 million adults (15-59) and 4 million elderly people (60+). To
      date a very limited number of epidemiological studies have been carried out to
      determine the potential health effects of air pollutants in Latin America. To
      obtain a rough estimate, a scenario was hypothesized in which subjects living in
      cities would be exposed to a given level of air pollutant, using data from the
      international literature to extrapolate the expected number of events in
      different strata of the hypothetical population. The estimated health effects are
      considerable and warrant priority control intervention. This is true although
      epidemiological studies are needed to evaluate the health impact of specific
      pollutant compounds as well as their interactions in Latin American populations
      exposed to high levels of pollution.

PMID- 2238697
TI  - Lead in petrol: the mistake of the XXth century.
AB  - The health aspects of the use of lead in petrol were evaluated in the 1920s in
      the United States of America and, in spite of warnings from certain lead-toxicity
      experts, lead addition to petrol became standard international practice.
      Available data now show that lead in petrol at the scale of use in the 1970s
      produced significant environmental lead contamination and increased average blood
      lead levels in the general population. National sample surveys of blood-lead
      levels in the United States carried out annually from 1976 show a decreasing
      trend closely correlated with the use of lead in petrol. Recent longitudinal
      epidemiological studies have concluded that the exposure levels associated with
      lead in petrol can cause a reduced average mental ability in children. These
      studies accounted for the potential confounding from socioeconomic and other
      factors. The practical conclusion from the studies reviewed is that there should
      be as little human lead exposure as possible, because there may be no threshold
      for the effects occurring and many thousand children have already been affected
      in the United States and other countries. The environmental health calamity
      caused by lead in petrol could have been avoided if the initial warnings had been
      heeded and better preliminary research of the health issues had been carried out.
      Nevertheless, incontrovertible proof of causality should not be required before
      regulations are made to protect public health.

PMID- 2238698
TI  - Health risks associated with pollution of coastal bathing waters.
AB  - A number of bacterial, viral and other diseases can be contracted by man through
      exposure to sewage-polluted bathing-water or beach sand. The increasing use of
      the sea for recreation has led to major concern regarding health hazards to both
      local and tourist populations. Epidemiological studies attempting to correlate
      microbiological water quality with health effects have produced different
      results, leading to a wide variation in recreational water quality criteria and
      standards applied, and to considerable controversy regarding their
      implementation. The Mediterranean provides a good example of a problem region
      where health risks are accentuated as a result of high utilization of bathing
      areas coupled with long exposure periods. Coastal pollution by sewage is still a
      major concern and control measures vary considerably. A number of
      microbiological/epidemiological studies have been carried out since 1953 in an
      attempt to define the levels of risk following exposure to different
      concentrations of bacteria in bathing waters. Most of these have been prospective
      studies whose design involved subject recruitment on the beach itself,
      classification of swimmers on the basis of immersion of the head in the water,
      and follow-up interviews after 7-10 days, together with a system for validation
      of gastrointestinal symptomatology. Practically all studies showed higher
      morbidity among bathers as compared to non-bathers, but correlation between
      specific symptoms and bacterial indicator concentrations varied considerably. On
      the basis of the 1972-1978 Cabelli Environmental Protection Agency (EPA) study in
      the United States of America, later developed by EPA into a recommended health
      effects criterion for marine recreational waters, one would expect 25-40
      gastrointestinal cases per 1,000 persons exposed to seawater containing 100
      enterococci per 100 ml. Extrapolation of these figures to annual bathing
      populations indicates the potential magnitude of the problem. Much more work is
      needed however before a satisfactory dose-response relationship is obtained,
      principally because of confounding factors inherent in all studies carried out so
      far, which still require a solution.

PMID- 2238699
TI  - The role of environmental and occupational hazards in the adult health
      transition.
AB  - In the course of economic development from the pre-industrial to the post
      industrial stages, human communities go through major social and economic
      transitions. The demographic transition, a long established concept, refers to
      the change from a stage of high birth rates and mortality rates to one of low
      birth rates and mortality rates. The mortality rates have always decreased before
      the birth rates, giving rise to a period of rapid population growth in each
      society. The recently-coined term "health transition" provides a more detailed
      view of the different aspects of the mortality decline and of the changes in
      morbidity and causes of morbidity which also accompany economic development. The
      health transition is associated with major changes in exposure to environmental
      and occupational health hazards. The traditional hazards of the pre-industrial
      stage include unsafe drinking-water, poor sanitation, infected food, tropical
      disease vectors, indoor air pollution from biomass smoke, and accidents in
      agriculture and fishing. Gradually these are replaced by or overlap with the
      modern hazards, such as urban air pollution, tobacco smoking, pesticides,
      occupational hazards in new industries and traffic accidents. The health impact
      of these hazards depends very much on the preventive measures taken. For some
      hazards there is an increasing health risk, in parallel with the increasing
      occurrence of the hazard, which is followed by a decreasing health risk as
      preventive actions become effective. This intervention transition does not occur
      automatically with economic development, but requires specific policies and
      plans, as well as community involvement. The adult age group (15-59 years) is
      likely to be at particular risk for environmental and occupational hazards which
      emerge during the health transition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238700
TI  - Isolation of urinary p-hydroxylated metabolites of mephentermine and phentermine
      in male Wistar rats.
AB  - 1. p-Hydroxymephentermine (p-hydroxy-MP) and p-hydroxyphentermine (p-hydroxy-Ph)
      were isolated as hydrochlorides from urine of male Wistar rats repeatedly dosed
      with mephentermine (MP). In addition, p-hydroxy-Ph was isolated as the
      hydrochloride from urine of the rats dosed with phentermine (Ph). 2. These
      results substantiate previous indications that p-hydroxylation of MP and Ph was a
      primary metabolic reaction in the rat.

PMID- 2238701
TI  - Development of a 19F-n.m.r. method for studies on the in vivo and in vitro
      metabolism of 2-fluoroaniline.
AB  - 1. A 19F-n.m.r. method has been developed for study of the metabolism of 2
      fluoroaniline both after in vivo exposure of rats and in in vitro model systems.
      2. From the 19F-n.m.r. spectrum of the 24 h urine it was calculated that over 90%
      of the dose was excreted within 24 h. The metabolic pattern showed that 85% of
      the metabolites were para-hydroxylated, 72% sulphated, 13% glucuronidated and 29%
      N-acetylated, 4-amino-3-fluorophenyl sulphate being the main urinary metabolite
      (53%). 3. In vitro studies of phase I metabolism of 2-fluoroaniline with rat
      liver microsomes was representative for the in vivo metabolism as hydroxylation
      in both systems was observed only at the para-position. 4. Phase I+II metabolism
      was studied in vitro in either isolated rat hepatocytes in suspension or in a 1 h
      recirculating liver perfusion system. In both these in vitro systems para
      hydroxylation, N-acetylation, sulphation and glucuronidation of 2-fluoroaniline
      were observed. The ratio between glucuronidation and sulphation was dependent on
      sulphate availability. 5. Of the in vitro systems tested, hepatocytes in Krebs
      Ringer (sulphate limited) medium was the best model for in vivo metabolism. 6.
      The detection limit for fluoro-containing metabolites in this 19F-n.m.r. method
      was 1 MicroM for an overnight run using a Bruker CXP 300 spectrometer. From this
      it can be concluded that 19F-n.m.r. urine analysis is a useful tool in
      biomonitoring studies. For 2-fluoroaniline the method appears to be more
      sensitive than currently available h.p.l.c./t.l.c. methods. In addition,
      concentration of urine samples can result in either lower detection limits, or in
      shorter times needed for n.m.r. data acquisition. 7. N-acetylation is known to
      show genetic polymorphism. Therefore, the 19F-n.m.r. method, detecting all 2
      fluoroaniline metabolites, has the additional advantage of eliminating the risk
      of obtaining false negatives for fast acetylators.

PMID- 2238702
TI  - Metabolism of illudin S, a toxic principle of Lampteromyces japonicus, by rat
      liver. I. Isolation and identification of cyclopropane ring-cleavage metabolites.
AB  - 1. Illudin S, a toxic principle of the basidiomycete Lampteromyces japonicus, was
      incubated with rat liver 9000 g supernatant and its metabolites studied. 2. Two
      metabolites, M1 and M2, were isolated and identified as cyclopropane ring
      cleavage compounds by n.m.r., i.r. and mass spectral analyses. Moreover, M2
      contained a chlorine atom. 3. On the basis of detailed analyses of the 2D n.m.r.
      spectra and differential nuclear Overhauser effect experiments, the previous
      assignments of the cyclopropane carbons of illudin S were revised.

PMID- 2238703
TI  - Species differences in metabolism of codeine: urinary excretion of codeine
      glucuronide, morphine-3-glucuronide and morphine-6-glucuronide in mice, rats,
      guinea pigs and rabbits.
AB  - 1. Metabolites of codeine were determined by use of h.p.l.c. in urine of male
      mice, rats, guinea pigs and rabbits injected with 10 mg codeine/kg
      subcutaneously. 2. In 24 h urines of these species, unchanged codeine, codeine
      glucuronide, free morphine, and morphine-3-glucuronide were as follows: mice,
      6.8, 1.6, 0.8 and 7.6% dose; rats, 1.6, 0.2, 4.3 and 23.9% dose; guinea pigs,
      1.6, 39.8, 0.2 and 1.6% dose; rabbits, 2.2, 24.5, 1.3 and 17.9% dose. Urinary
      excretion of morphine-6-glucuronide was 0.7% dose in guinea pigs, 1.9% in
      rabbits, and not detectable in mice and rats. Norcodeine was found only in the
      urine of mice. 3. These results indicate that codeine is metabolized in all four
      species by glucuronidation and by oxidative N- and O-demethylation, but the
      quantitative excretions of metabolites were quite different in different species.

PMID- 2238704
TI  - Flumecinol, a novel inducer of testosterone 16 alpha-hydroxylation in male rats.
AB  - 1. Flumecinol, a new inducer of the cytochrome P-450 monooxygenases, was studied
      in rats as a possible effector of liver microsomal testosterone oxidases. The
      drug enhanced the total content of liver cytochrome P-450 in immature and adult
      rats. 2. When total testosterone oxidation activity was compared in liver
      microsomes of treated and untreated rats, no differences in activities were
      observed in 60-day-old-rats, but a slight decrease was found in 35-day-old
      treated rats. 3. Several regio- and stereo-specific hydroxylases were modified by
      flumecinol administration; in 35-day-old rats only 16 alpha-hydroxylation was
      induced, whereas in 60-day-old rats a slight increase in 2 alpha-hydroxylation
      was also observed.

PMID- 2238705
TI  - Studies on the cytochrome P-450 of avocado (Persea [corrected] americana)
      mesocarp microsomal fraction.
AB  - 1. Because of the low concentration of cytochrome P-450 in avocado fruit,
      microsomal fractions were prepared using polyethylene glycol aggregation and low
      speed centrifugation, thus avoiding the need for high-speed centrifugation of
      large volumes of post-mitochondrial supernatant. Recoveries of cytochrome P-450
      by this means (0.29 nmol/g tissue) were similar to those after the usual high
      speed centrifugation preparation (0.26 nmol/g). The cytochrome P-450 content of
      tulip bulb (0.30 nmol/g) was similar to that of avocado, but both plant tissues
      had much lower P-450 contents than did rat liver (13.0 nmol/g). 2. Spectral
      studies indicate that cytochrome P-450 of avocado mesocarp microsomal fraction
      binds fewer substrates than does the rat liver enzyme system. Type I binding
      spectra are given by fatty acids (C7-C14), aryl hydrocarbons (C7-C12), p-chloro-N
      methylaniline and N,N-dimethylaniline. Type II binding is seen with inhibitors of
      mammalian cytochrome P-450 such as metyrapone, and with the imidazole antifungal
      agents such as clotrimazole. 3. These binding spectra provide a rapid method for
      identifying possible substrates and inhibitors of avocado cytochrome P-450, and
      also provide information concerning the nature of the active site of avocado
      cytochrome P-450. 4. Avocado cytochrome P-450 catalysed the N-demethylation of
      N,N-dimethylaniline (17.1 nmol/min per nmol P-450) and p-chloro-N-methylaniline
      (13.1 nmol/min per nmol P-450), and the hydroxylation of lauric (dodecanoic) acid
      (1.1 nmol/min per nmol P-450).

PMID- 2238706
TI  - Quaternary N-glucuronides of 10-hydroxylated amitriptyline metabolites in human
      urine.
AB  - 1. Conjugated metabolites were isolated from the urine of patients receiving
      amitriptyline treatment using a combination of solid-phase extraction, h.p.l.c.
      and t.l.c. 2. By n.m.r. and mass spectrometry, N-glucuronides of E- and Z-10
      hydroxyamitriptyline and of trans-10,11-dihydroxyamitriptyline were identified in
      addition to the previously described O-glucuronides of E- and Z-10
      hydroxyamitriptyline and -nortriptyline and amitriptyline-N-glucuronide. 3. The
      quaternary ammonium glucuronides proved to be resistant to acid hydrolysis, but
      could be cleaved enzymatically. 4. In urine samples from three patients, 35-60%
      of conjugated 10-hydroxyamitriptyline was found in the form of N-glucuronides. 5.
      A volunteer given an i.v. infusion of amitriptyline-N-glucuronide excreted E- and
      Z-10-hydroxyamitriptyline-N-glucuronide; following ingestion of E-10
      hydroxyamitriptyline its N-glucuronide could be measured in urine.

PMID- 2238707
TI  - Analogues of N-hydroxy-4-acetylaminobiphenyl as substrates and inactivators of
      hamster hepatic acetyltransferases.
AB  - 1. A series of analogues of N-hydroxy-4-acetylaminobiphenyl (1, N-OH-AAB) has
      been synthesized and evaluated in vitro as substrates and inactivators of hamster
      hepatic N,N-acetyltransferase (N,N-AT) activity. The analogues of 1 are N
      arylhydroxamic acids in which an atom or small functional group has been
      incorporated between the phenyl rings of 1. 2. The structural and molecular
      properties of the atoms between the two phenyl rings had little influence on the
      ability of the compounds to serve as acetyl donors in the N-arylhydroxamic acid
      dependent transacetylation of 4-aminoazobenzene (AAB) catalysed by N,N-AT. An
      exception was the SO2 analogue (6) which was inactive. 3. All of the compounds
      except 6 were mechanism-based inactivators (suicide inhibitors) of hamster
      hepatic N,N-AT. The inhibition of N,N-AT by the hydroxamic acids was
      irreversible. The properties of the atom or functional group between the phenyl
      rings had a substantial influence on the relative effectiveness of the compounds
      as inactivators of N,N-AT. trans-N-Hydroxy-4-acetylaminostilbene (N-OH-AAS, 7)
      was the most potent and effective mechanism-based inactivator among the compounds
      studied. The ketone analogue (2) was the least effective among the compounds that
      exhibited inactivating activity. 4. The presence of the nucleophile cysteine in
      the incubation mixtures reduced the extent of inactivation of N,N-AT by 1 and by
      the ether (4) analogue but had little effect on the inactivation caused by 7. The
      inactivation of N,N-AT by N-OH-AAS (7) does not appear to involve electrophiles
      that are released from the active site and subsequently become covalently bound
      to the enzyme.

PMID- 2238708
TI  - Oxidative injury mediated by the hepatic cytochrome P-450 system in conjunction
      with cellular iron. Effects on the pathway of haem biosynthesis.
AB  - 1. Some polyhalogenated aromatic chemicals such as 2,3,7,8-tetrachloro-p-dioxin,
      brominated and chlorinated biphenyls, and hexachlorobenzene cause in humans,
      animals and hepatocyte systems a partial block in haem biosynthesis leading to
      accumulation and excretion of uroporphyrin, the oxidation product of the unstable
      biosynthetic intermediate uroporphyrinogen. 2. The involvement of reactive toxic
      metabolites of the halogenated chemicals has previously been suggested. The
      evidence presented in this paper supports a different mechanism involving chronic
      induction of the microsomal cytochrome P-450 system, mobilization of
      hepatocellular iron and associated oxidative stress. Besides oxidation of
      uroporphyrinogen to uroporphyrin, an inhibitor of uroporphyrinogen decarboxylase
      may also be formed. 3. Studies with iron-loaded mice and chicken embryo
      hepatocytes show that under appropriate conditions iron alone, or chemicals such
      as beta-naphthoflavone which induce the same cytochromes P-450 isozymes as do the
      chlorinated aromatics, will cause a similar uroporphyria. These findings provide
      an experimental model for the human disease porphyria cutanea tarda, sometimes
      occurring in patients with liver damage. 4. Experiments with rats and iron-loaded
      mice indicate that there may also be an association between the induction of
      uroporphyria and the development of liver tumours after administration of
      polyhalogenated aromatic chemicals.

PMID- 2238709
TI  - Effects of glutathione depletion, chelation and diuresis on iron
      nitrilotriacetate-induced lipid peroxidation in rats and mice.
AB  - 1. Rats and mice dosed with iron nitrilotriacetate (FeNTA) i.p. (2-12 mg Fe/kg)
      showed evidence of lipid peroxidation as indicated by increased exhalation of
      ethane and increased malondialdehyde formation in liver and kidney. 2. Buthionine
      sulphoximine (BSO) administered i.p. to rats and mice decreased the total
      glutathione (GSH) content of liver and kidney. When the rodents were pretreated
      i.p. with BSO prior to injection of FeNTA the increases in ethane exhalation, and
      in liver and kidney malondialdehyde production, were greater than with FeNTA
      alone, and the total GSH of liver and kidney were decreased. 3. Diuresis produced
      by i.p. administration of furosemide to mice substantially decreased the ethane
      exhalation resulting from FeNTA administration, had a lowering effect on kidney
      MDA, but had no significant effect on liver MDA production. 4. Similarly,
      desferrioxamine beta-mesylate administered i.p. to mice markedly decreased the
      ethane exhalation and kidney MDA production resulting from FeNTA administration.

PMID- 2238710
TI  - A review of recent studies on the metabolism of exogenous and endogenous
      malondialdehyde.
AB  - 1. The generation of malondialdehyde (MDA), a mutagenic product of the oxidative
      decomposition of highly unsaturated fatty acids in vivo, is increased by exposure
      to certain environmental oxidants and xenobiotics. 2. This increase is reflected
      in enhanced excretion of several MDA derivatives in the urine. The main urinary
      metabolites of MDA have been identified as N-epsilon-(2-propenal)lysine and its N
      alpha-acetyl ester. 3. Two minor metabolites have been identified as enaminals
      formed by reactions with the phospholipid bases serine and ethanolamine. A
      further MDA metabolite has been identified as a cyclized adduct with guanine. 4.
      These urinary compounds reflect the turnover of proteins, phospholipids and
      nucleic acids that have been modified by reactions with MDA in vivo. Monitoring
      of the urinary adduct with guanine may provide a practicable method of assessing
      the effect of xenobiotics and other factors on in vivo lipid peroxidation. 5. The
      proportion of total MDA in the diet, blood, urine and solid tissues that exists
      in the free state appears to be negligible. 6. Chronic oral administration of the
      enol Na salt of MDA to animals produced no significant pathology except for dose
      dependent lesions of hepatic nuclei. Nuclear abnormalities in cultured rat skin
      fibroblasts were seen at intracellular concentrations as low as 10(-7) M.

PMID- 2238711
TI  - Reactive oxygen and glomerular dysfunction.
AB  - 1. The function of the kidney glomerulus, and the formation of reactive oxygen
      species in the glomerulus, is reviewed. 2. Experimental models of glomerular
      injury, resulting from immunological and non-immune reactions, are known to give
      rise to morphological and functional changes of the glomerulus, resulting in
      proteinuria. 3. From the use of oxygen radical scavengers and inhibitors,
      glomerular injuries have been shown to be associated with the production of
      hydrogen peroxide, hydroxyl radical, and superoxide anion radical.

PMID- 2238712
TI  - Molecular mechanisms for bromotrichloromethane cytotoxicity in isolated rat
      hepatocytes.
AB  - 1. Bromotrichloromethane added to isolated rat hepatocytes resulted in increased
      cell death as determined by trypan blue uptake. Toxicity increased in a
      concentration-dependent fashion between 2.0-5.0 M bromotrichloromethane. 2. Lipid
      peroxidation (malondialdehyde) increased in a time-dependent fashion but in
      contrast to toxicity reached a maximum level at 2.0 mM bromotrichloromethane. 3.
      Hypoxia increased the toxicity of bromotrichloromethane three-fold but only
      decreased the amount of lipid peroxidation to a small degree. 4. In spite of this
      poor correlation between toxicity and lipid peroxidation, the antioxidant
      butylated hydroxyanisole and the iron chelator desferal protected the cells from
      toxicity under both aerobic and hypoxic conditions and prevented lipid
      peroxidation. 5. During treatment with bromotrichloromethane, cellular
      glutathione levels slowly decreased and oxidized glutathione appeared in the
      media. The addition of cystine to the incubation media prevented the formation of
      extracellular oxidized glutathione, indicating that cellular glutathione had
      leaked from the cell during treatment and was oxidized in the incubation media.
      Although this suggested that glutathione does not play a protective role against
      bromotrichloromethane toxicity, diethyl maleate-pretreatment of the cells to
      decrease glutathione levels markedly increased bromotrichloromethane toxicity. 6.
      The addition of ascorbic acid to the incubation media increased
      bromotrichloromethane toxicity. This was attributed to the reductive activation
      of bromotrichloromethane in an iron and oxygen-dependent reaction. 7. It was
      concluded that peroxidation of essential phospholipids contributes to
      bromotrichloromethane-induced hepatocyte cytotoxicity.

PMID- 2238713
TI  - Toxicity of nitrobenzene compounds towards isolated hepatocytes: dependence on
      reduction potential.
AB  - 1. The cytotoxicity of p-substituted nitrobenzenes towards isolated hepatocytes
      under aerobic or hypoxic conditions has been determined. The nitrobenzene
      concentration required to cause 50% cytoxicity in 2 h was a function of the one
      electron reduction potential of the nitrobenzene, with the more cytotoxic
      compounds having the strongest electron-withdrawing substituents. 2. The
      effectiveness of the nitrobenzenes at causing cytotoxicity under aerobic but not
      hypoxic conditions was markedly increased if hepatocyte catalase was inhibited
      with azide. 3. Nitrobenzenes at cytotoxic concentrations induced cyanide
      resistant respiration in isolated hepatocytes. Their effectiveness correlated
      with their cytotoxicity. 4. The rate of oxygen activation of these nitrobenzenes
      by ascorbate was also a function of the one-electron reduction potential. The
      nitro compounds with the strongest electron-withdrawing substituents were the
      most rapidly reduced. 5. Most nitrobenzenes were more cytotoxic under aerobic
      than hypoxic conditions. Ascorbate enhanced hypoxic, but not aerobic,
      cytotoxicity. 6. It was concluded that the cytotoxicity of different
      nitrobenzenes is related to their ease of reduction to nitro radical anions and
      nitrosobenzenes. Aerobic cytotoxicity is probably initiated by redox cycling and
      oxygen activation by the nitro radical anions whereas hypoxic cytotoxicity is
      probably initiated by the alkylation of macromolecules by nitrosobenzene
      metabolites.

PMID- 2238714
TI  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD)-induced decrease in the fluidity of
      rat liver membranes.
AB  - 1. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCCD)-induced lipid peroxidation has
      previously been demonstrated by assessing the hepatic content of thiobarbituric
      acid reactive substances (TBARS) as well as the NADPH-dependent microsomal
      formation of TBARS as well as the NADPH-dependent microsomal formation of TBARS
      using malondialdehyde as the standard. 2. Changes in membrane fluidity as a
      result of lipid peroxidation may occur. Therefore the dose- and time-dependent
      effects of TCDD on lipid peroxidation in mitochondrial, microsomal, and plasma
      membranes, and changes in membrane fluidity in these subcellular fractions, were
      examined. Animals were treated with either 50 or 100 micrograms TCDD/kg orally,
      and killed 3, 6, or 9 days post-treatment. 3. Time-dependent increases occurred
      in TBARS content and formation following TCDD administration for all three
      membranes. Similar results were observed after 50 and 100 micrograms TCDD/kg. 4.
      Following TCDD administration, fluorescence polarization measurements as
      determined by the fluorescence polarization (r) and anisotropy parameter (a.p.)
      values demonstrated significant decreases in membrane fluidity in all membrane
      fractions, indicative of membrane structural alterations. 5. Excellent inverse
      correlations between lipid peroxidation and membrane fluidity were observed.
      Thus, decreased membrane fluidity and increased membrane damage may contribute to
      the toxic manifestations of TCDD as a consequence of an oxidative stress.

PMID- 2238715
TI  - Orthopaedic manifestations of sickle-cell disease.
AB  - Sickle-cell disease is a well-recognized clinical entity. The pathophysiology of
      this hemoglobinopathy has been described in detail by numerous investigators
      since the first case report appeared in 1910. Orthopaedic manifestations of
      sickle-cell disease account for much of the morbidity associated with this
      disorder, including pain, osteonecrosis, arthritis, and sepsis. Effective
      management of these bone and joint sequelae reflect accurate diagnosis,
      understanding of this disorder's pathophysiology, and knowledge of available
      medical and surgical treatment alternatives. In this review, the authors
      summarize the major orthopaedic manifestations of sickle-cell disease with
      special emphasis placed upon osteonecrosis and osteomyelitis, since these
      conditions are the most disabling and serious complications in patients with
      sickle-cell disease.

PMID- 2238717
TI  - [Therapy of peptic ulcer].

PMID- 2238716
TI  - Tourette's disorder and associated complex behaviors: a case report.
AB  - A case of a man with Tourette's disorder associated with obsessive-compulsive
      disorder, multiple sexual paraphilias, and aggressive behavior is described.
      Treatment with haloperidol led to improvement in the characteristic tics of
      Tourette's disorder as well as to improvement in these three complex-associated
      behaviors. After haloperidol was discontinued, an exacerbation of tics and the
      associated behaviors occurred.

PMID- 2238719
TI  - [Survey: What should be done in epigastric pain?].

PMID- 2238718
TI  - [Occupational medicine aspects in gastroenterologic diseases].

PMID- 2238720
TI  - [Dietary treatment of hyper- and dyslipoproteinemias].

PMID- 2238721
TI  - [Age-dependent development of eosinophilia in nasal secretions in children with
      chronic non-specific respiratory diseases].

PMID- 2238722
TI  - [The value of retrograde pneumoileography in evaluating enterocolic anastomoses].

PMID- 2238724
TI  - [Therapeutic possibilities in high degree penis deviation in adulthood].

PMID- 2238723
TI  - [Ulcerating esophagitis caused by doxycycline].

PMID- 2238725
TI  - [Repeated self-mutilation caused by ingestion of a coumarin derivative].

PMID- 2238726
TI  - ["When the hour strikes"--thoughts on dying in the aged].

PMID- 2238727
TI  - [Student experiences in the "clinical rotation in social service"].

PMID- 2238728
TI  - [German-Polish edicts of the 18th century as a source in the history of
      medicine].

PMID- 2238729
TI  - [Cardiodynamic determinants of heart perception].
AB  - Subjective perception of one's heartbeat is augmented by psychological factors
      (stress, fear) as well as by physiological influences (e.g., physical work). It
      is still unclear on which cardiac or circulatory parameters the "signal" for
      cardiac perception is based. In this study, the relation between cardiac
      performance and the ability to perceive one's heartbeat was investigated. Sixteen
      healthy subjects (8 female, 8 male, aged from 21 to 31 years) participated.
      Cardiac activity was varied by a combination of passive tilt and physical work on
      a bicycle ergometer. Subjects had to perform physical work (0, 25, 50, 75, 100 W)
      on the bicycle at seven different angles (90 degrees, 75 degrees, 60 degrees, 45
      degrees, 30 degrees, 15 degrees, 0 degrees). A cardiac perception test was
      carried out after each load. The following cardiodynamic parameters were
      measured: stroke volume, contractility, and heart rate. The mean correlation
      coefficient between cardioceptive performance and cardiodynamic parameters was
      .62 for stroke volume, .45 for contractility, and .12 for heart rate. Obviously,
      a remarkable relation exists between the mass and--to a lesser degree--the
      velocity of ejected blood and cardiac perception. From this we infer,
      tentatively, that the subjectively perceivable heartbeat stimulus is generated by
      mechanical events that occur close to the left ventricle.

PMID- 2238730
TI  - [An experiment on the theory of visual motion perception].
AB  - Two classes of theories of motion perception were studied: correlation and
      gradient models (in the sense of D. Marr). Random-dot kinematograms with a
      shifted square were presented to subjects, and the 80% threshold for detection of
      correct direction of movement was determined. Correlation models predict scale
      invariance, that is, a constant shift measured in units of texture elements of
      the translated pattern in spite of a geometric magnification. This was refuted
      for all subjects. The increase of the recognizable translation with the area of
      the translated form was verified except for the patterns with the largest texture
      elements (8 minutes of arc). This prediction, however, is not very specific for
      competing theories. Gradient models are not yet fully specified, and they contain
      some free parameters. They cannot be tested strictly, but there exist reasonable
      numerical parameter values by which our data can be satisfactorily explained.

PMID- 2238731
TI  - [The course of mimetic reactions during presentation of pictures with positive,
      neutral and negative value].
AB  - The EMG reactions of m. corrugator supercilii, m. frontalis lateralis, m.
      zygomaticus major and m. depressor anguli oris in 21 male subjects were recorded
      during a 5-second presentation of pictures with positive, negative, and neutral
      valence. Compared with the m. zygomaticus activity during the presentation of
      pictures with neutral and negative valence, the activity in the m. zygomaticus
      area was prolonged during the presentation of pictures with positive valence. The
      response curve of m. zygomaticus activity during presentation of pictures with
      positive valence showed a slight negative quadratic trend with maximum activity
      at 3 seconds after stimulus presentation. Compared with the activity during the
      presentation of pictures with positive and neutral valence, the activity in the
      m. corrugator area was prolonged during the presentation of pictures with
      negative valence. The response curve of m. corrugator activity during
      presentation of pictures with negative valence showed a tendency toward a
      negative quadratic trend with maximum activity at 3 seconds after stimulus
      presentation. During the presentation of all pictures the activity in the m.
      frontalis area yielded a strong negative linear trend with maximum activity in
      the first second after stimulus presentation. This might be attributed to the
      phenomenon of "habituation." Interestingly, after the presentation of pictures
      with negative valence, the response curve of m. frontalis activity showed a
      diminished linear trend compared with the linear trends after presentation of
      pictures with positive and neutral valence. This might be attributed to the
      phenomenon of "defensive reaction."

PMID- 2238732
TI  - [Sex differences in memory performance for odors, tone sequences and colors].
AB  - Sense of olfaction would seem to be of little importance for human behavior.
      However, a closer look at this from the psychological point of view reveals many
      interesting aspects, such as sex differences in olfactory perception, that are of
      interest to differential psychology. The present study deals with sex differences
      in the memory for odors; we assume that women will do better here than men while
      other memory tasks involving acoustical and optical stimuli will show no such
      differences. Sixty women and 40 men were examined. On the first day, they had to
      retain 10 odors, 10 random-generated tone-sequences, and 10 colors. On the second
      day, 20 such stimuli for each memory task were presented, and the subjects had to
      remember and to tell which were known and which of them were unknown stimuli to
      them. A significant advantage in the olfaction memory task was found for women,
      while acoustical and optical memory scores showed no such differences. This
      expected finding is discussed in two ways. First, the female advantage might
      result from phylogenetic sources. Second, it might arise because women in general
      more often than men seem to deal with olfactory cues, so that they might simply
      have more experience and therefore the greater chance to score higher in an odor
      memory task.

PMID- 2238733
TI  - [The number of active sweat glands (PSI, palmar sweat index) in stress caused by
      blood donation].
AB  - The number of active sweat glands (PSI), heart rate, systolic (SBP) and diastolic
      blood pressure (DBP) were assessed every 2 minutes in 109 male blood donors.
      Three measurements were taken at the beginning (adaptation phase), three later
      but before blood donation (baseline), one during the venous puncture (phase 3),
      three thereafter but still during donation (phase 4), and four after removal of
      the cannula (phase 5). Analysis of variance yielded significant differences
      between phases; PSI and SBP behaved similarly, decreasing from adaptation to
      baseline, rising during puncture, and decreasing again thereafter. Mean within
      subject correlations between variables were significantly above 0. Between
      subjects correlations were significantly negative for PSI and DBP. This is best
      explained by the influence of age on both variables. Correlations of PSI values
      as determined by three raters had a mean of 0.90. The study shows that the PSI is
      a very sensitive indicator of stress that is easily accessible also in field
      studies.

PMID- 2238734
TI  - [Trends in medical microbiology--gene probes in medical microbiology].
AB  - At first the principle of nucleic acid hybridisation, some important technics
      used heretofore, and methods to label nucleic acids are described. The advantages
      and disadvantages regarding to the application to microbiological diagnostics are
      discussed. The advantage, before all, is the high specificity of the test which
      allows to detect the presence and the properties of genes which are not
      expressed. The methods known up to now can only be applied if the probe is
      labelled radioactively, since under these conditions the sensitivity is high
      enough to identify bacteria contained in clinical isolates without prior
      cultivation. The comparable complex methods are restricted, presently, to special
      mostly epidemiological problems. To improve these technics regarding increased
      sensitivity, to the use of non-radioactively labelled probes, to higher speed,
      and to the automation of the test internationally much work is carried out with
      great intensity. The solution of these problems will create conditions for a wide
      application of DNA probes in the general microbiological laboratory.

PMID- 2238735
TI  - [Special events and averages in handling of poisons in the years 1980 to 1988
      (statistical overview)].
AB  - Authors statistically analysed the "special events" in handling poisons
      registered by the Ministry of Public Health of GDR in the years 1980 to 1988.
      Emphasis was the evaluation of causes. Perceptible tendencies of development in
      this matter were presented.

PMID- 2238736
TI  - [NO2 exposure and hydroxyproline excretion].
AB  - The determination of hydroxyproline (HOP) and of the HOP-creatinine ratio in
      urine, respectively, is according to the literature probably a parameter of NO2
      caused collagen damage of the respiratory organs and therefore a parameter which
      could be used for biological monitoring of indoor exposures. Own studies on
      children from gas or electrical house keeping presented no significant
      differences. Various interpretations are discussed, further investigations seem
      to be indicated.

PMID- 2238738
TI  - On the content of arsenic, lead, copper, zinc, tin and iron in bottled fruit,
      strained fruit pulp and bottled jam produced in Poland.
AB  - One hundred and fifty-three samples of bottled fruit, strained fruit pulps and
      jams contained in glass jars were analysed for heavy metals. All arsenic
      concentrations were less than the limit of detection of 0.04 mg/kg as were all
      tin concentrations for which the limit of detection was 8 mg/kg. The
      concentrations of the lead were all below 0.2 mg/kg for bottled fruit and 0.3
      mg/kg for stained pulps and jams. In bottled fruit 98% of samples contained less
      than 3 mg/kg of copper, 98% less than 5 mg/kg of zinc and 97% less than 10 mg/kg
      of iron. In strained pulps all samples contained less than 2 mg/kg of copper and
      less than 5 mg/kg of zinc, 41% of samples contained less than 20 mg/kg of iron.
      In jams all samples contained less than 2 mg/kg of copper and less than 5 mg/kg
      of zinc, 96% samples contained less than 20 mg/kg of iron.

PMID- 2238737
TI  - [Study of heavy metal immission with dust sedimentation in various regions of the
      GDR. Results of a nationwide study of 144 measuring points (1983-1988)].
AB  - Dust sediment samples had been taken continuously from 1983 to 1988 in the
      environment of trace element emitting industrial plants, in industrial centers,
      in urban regions without specific deposits, and in background regions of the GDR.
      After wet digestion the concentrations of 17 elements (Ca, Fe, Al, Mg, Na, P, Zn,
      Mn, Ti, Ba, Pb, Sr, Cu, Cr, Cd, V, Be) have been determined by atomic emission
      spectrometry (ICP) and calculated as element fallout (mg/m2 x 30 d). More than
      60,000 data underlie statistical analysis. Measuring points with geometrical
      averaged immissions of significant elements (Zn, Cu, Pb, Cd, Be, Cr, V) above the
      84-percentile of all measuring points are listed separately. Very heavy sources
      of all analysed elements are steel plants more than nonferrous metal plants. The
      northern territories of the GDR are comparatively slightly impacted.

PMID- 2238739
TI  - [Properties and biological effect of dust of various artificial mineral fibers].
AB  - Developments and use of man-made mineral fibres are important for the progress in
      some technical fields. In the last years the number of man-made mineral fibres
      increased extraordinarily. For the medical evaluation it is necessary to
      determine the physico-chemical characteristics of the man-made mineral fibre dust
      and its biological effects in animal experiments. The results of the
      investigations are described.

PMID- 2238740
TI  - [Epidemiological aspects of spinal diseases in the GDR in 1979 to 1988].
AB  - The socio-economic impact of disorders of the spine and the back has obtained an
      increasing importance in all industrial countries. Considering indicators of
      public health and national economy, namely temporary sickness incapacity for
      work, invalidity (insured persons in the GDR), utilization of hospital services
      (total population of the GDR), of rheumatological dispensaries as well as of the
      general practitioner, frequencies have been studied and trends pursued by means
      of serial analyses in a 10-year period. Diseases of the spine and the back within
      diagnostic class XIII/ICD, 9th revision, 1975 (diseases of the musculoskeletal
      system and connective tissue) have caused--nearly 2/3 of all cases of sickness
      incapacity for work--1/3 of the incidence of disability pensions--about 1/3 of
      the utilization of hospital services--about 1/5 of the utilization of
      rheumatological dispensaries--more than 50% of all cases consulting the general
      practitioner. As to the indicators sickness incapacity for work, incidence of
      disability pensions and discharges from the hospital, the serial analyses of the
      period from 1979 to 1988 have shown that the diseases of the spine and the back
      have the highest increase within the group of class XIII.

PMID- 2238741
TI  - [Progression of noise-induced hearing loss in exposed agricultural workers--ADP
      projects "LADA" and "LEQ"].
AB  - For years now, the survey of noise deafness as an officially recognized
      occupational disease has shown agriculture, forestry and the foodstuff industry
      to be a problem field. This is particularly true of operators of self-propelled
      machines and tractors. As far as the causes are concerned, it is more or less
      only presumptions that have been voiced hitherto, since the real noise-exposure
      data (particularly long-term recordings) has been lacking. For the long-term
      storage of exposure and audiometry data two reusable computerized projects have
      been worked out. Employing them, researchers can obtain noise-deafness
      progression data on an individual basis, based on the individual's noise-exposure
      data. The preliminary assessment of the data of nearly 1000 workers shows that
      both the noise exposure and the extent of the hearing loss vary greatly between
      individuals. This adds the necessity of an individual-based recording of the
      noise-exposure data.

PMID- 2238742
TI  - [Studies on the combined effects of shift work and noise on permanent hearing
      loss].
AB  - Combined exposure to shiftwork and noise was investigated with respect to its
      aural damaging effect. The investigations were carried out on 347 male and female
      noise-exposed textile workers working in single-shift and three-shift systems.
      The average hearing loss for the PTS at 3 kHz, 4 kHz, the total hearing loss at
      0.5, 1, 2, 4, 6, 8 kHz and percentage of hearing loss according to Fowler/Sabine
      served as indicators. To fulfil this task an epidemiological cross-sectional
      study was performed. The results of the present study show lower average hearing
      loss values in the case of three-shift workers as compared with single-shift
      workers.

PMID- 2238743
TI  - [Occupational hygiene examinations of carpenters' activities in a Berliner
      building plant].
AB  - The state of health of carpenters is examined in relation to the field associated
      with their occupations. In this connection the results of occupational medicine
      concerning examinations for suitability and of observation, the recognized
      occupational diseases and notifiable industrial accidents are analysed and
      compared with those of production workers in the building and construction
      industry. The reasons for higher rates of findings and occupational diseases by
      carpenters are discussed and conclusions for occupational medical care are drawn.

PMID- 2238744
TI  - [Combined effects of pharmacological activation of the CNS and the complexity of
      mental tasks on the function of the cardiovascular and the vegetative nervous
      system and the work performance of operators].
AB  - Effect of central nervous activation and of mental workload depends on the regime
      of operator work. To evaluate the level of activation by means of a set of
      psychophysiological indices and performance data is recommended a regime of fixed
      working speed.

PMID- 2238745
TI  - [Continuous measurement of muscular stimulation conduction velocity using surface
      electrodes--methodical prerequisites and results].
AB  - During long-lasting static muscular work fatigue is accompanied by a shift of the
      mean power frequency (MPF) of EMG power density spectra to lower frequencies. It
      is mostly accepted that changes in MPF with the onset of fatigue are mainly
      related to a decrease in muscle fibre conduction velocity (CV) caused by changes
      of the electrical properties of the fibre membrane. A method was developed for
      the continuous measurement of CV from surface electromyograms (EMG). The CV is
      estimated from the time delay between EMG signals recorded by a multielectrode
      configuration placed over the muscle between tendon and endplate region. Further
      processing and artifact rejection was realized in a hardware solution. Results
      obtained by this methods from investigations of muscle fatigue and temperature
      related changes in MPF and CV are presented.

PMID- 2238746
TI  - [The effect of moderate oxygen deficiency on volume regulation in man].
AB  - In acute hypoxia or at pharmacological stimulation of the peripheral arterial
      chemoreceptors by almitrine, a transient natriuresis and diuresis occurs.
      Depending on the starting level, e.g. on the state of water diuresis or the
      osmotic diuresis, the renal excretion responded differently in our examinations.
      In water diuresis the water excretion increased isolatedly. In the opposite to
      the osmotic diuresis, the natriuresis did not increase. This response might be
      based on the proximal inhibition of the sodium and water reabsorption at
      following augmented distal sodium reabsorption and suppressed distal water
      reabsorption. In this way the organism is able to respond with increased water
      excretion at sodium excretion kept constant or with diuresis and natriuresis when
      arterial chemoreceptors are stimulated.

PMID- 2238747
TI  - [Asymptomatic myocardial ischemia].
AB  - Silent (asymptomatic) myocardial ischemia (SMI) is defined as a transient
      alteration in myocardial perfusion in the absence of chest pain or the usual
      anginal equivalents. Patients may be classified as having one of the three types
      of SMI: type A--totally asymptomatic patients with no history of angina or
      myocardial infarction; type B--asymptomatic patients with previous myocardial
      infarction; type C--patients with angina and asymptomatic ischemic episodes. SMI
      has been found in 2.5% of all healthy males aged 40-59 and in 20% of all
      postinfarction patients. In type C-patients, 80% has been found to have
      asymptomatic ischemic episodes in addition to typical angina pectoris. The
      frequency of SMI may be up to three or four times that of anginal attacks. SMI
      patients have generally reduced sensitivity to pain an differences in severity an
      duration of ischemic episodes. Diagnosis is based on screening by means of
      exercise testing in patients working in specific professions (like pilots,
      busdrivers etc.), in postinfarction patients and in patients after unstable
      angina pectoris and after coronary bypass surgery or coronary angioplasty.
      Prognosis is the same as in asymptomatic ischemia. SMI is an indicator of
      instability in certain groups of patients (post infarction, after unstable angina
      pectoris). SMI persisting after medical therapy of unstable angina is associated
      with adverse short-term-prognosis, therefore coronary surgery or angioplasty is
      indicated.

PMID- 2238749
TI  - [Role of the occupational health service in the control of hypertension].
AB  - By a representative random sample in an order of magnitude of 5,150 employees the
      determination of the degree of knowledge of the hypertensives in the factory
      health service of metal mines showed nearly 100%. In the dispensary of the
      factory medical officer 64.2% were registered. 36.6% of the hypertensives were
      stabilised to blood pressure values below 160/95 mm Hg. Forms of therapy,
      cardiovascular risk factors associated with high blood pressure and effects of
      the working environment were investigated by means of factor and discriminance
      analysis with regard to the influence on the quality of the stabilisation of high
      blood pressure. The compliance resulted as essential limiting factor in the
      treatment of hypertension. 71% of the hypertensives reported a regular intake of
      medicaments, in which case 51% admitted to interrupt it without consulting the
      physician in charge when the constitution is disturbed. 4 features were
      determined as essential factors which have influence on the compliance: the
      opinion concerning the duration of the treatment of hypertension, the attitude to
      the intake of medicaments, the frequency of the intake of the tablets and the
      observation of the terms of blood pressure control. The investigation of the
      physician's compliance resulted, apart from an overestimation of the patient's
      compliance, in distinct deviations from the recommendations for diagnosis and
      therapy given. The compliance of nurses showed deficiencies in the standardized
      measurement of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238748
TI  - [Does the calcium antagonist verapamil modify calcium metabolism?].
AB  - In 11 healthy volunteers the effects of oral verapamil administration (4 X 80
      mg/d) on plasma or serum concentrations of ionized, pH-corrected ionized and
      total calcium, on intact and midregional parathyroid hormone and on 24 h urinary
      excretion of calcium were investigated at rest. In addition the concentrations of
      ionized, pH-corrected ionized and total serum calcium were analyzed under bicycle
      exercise. Verapamil resulted in an increase of total serum calcium (p less than
      0.02) and a fall in midregional parathyroid hormone concentrations (p less than
      0.02) at rest. There was also found a statistically significant elevation of both
      ionized (p less than 0.05) and pH-corrected ionized (p less than 0.05) plasma
      calcium, and a slight increase in the total calcium under exercise (p less than
      0.1). Before verapamil a significant negative correlation between total calcium
      and midregional parathyroid hormone was evident (r = -0.618; p less than 0.05),
      which however could not be clearly discerned after verapamil.

PMID- 2238750
TI  - [Heart wall rupture as a grave complication of acute myocardial infarct].
AB  - The rupture of the heart wall is a severe complication of the acute myocardial
      infarction. We found it in 3.5% of the deceased patients with an acute myocardial
      infarction. The average age of these patients was 71 years. 75% of the patients
      died during the first five days after the event of the myocardial infarction.
      Apart from elderly patients with myocardial infarction such ones with a
      transmural myocardial infarction in the region of the left ventricle, an
      enlargement of the heart and signs of an insufficiency of the left heart, with a
      hypertension and diabetes mellitus seemed to be endangered. These patients need
      the most exact control and observation and in case of suspicion (symptomatology
      of angina pectoris which is continuing to exist) of a developing rupture of the
      heart wall and aimed diagnostics (echocardiography) and therapy must be begun
      immediately.

PMID- 2238751
TI  - [The frequency of demonstration of Campylobacter pylori].
AB  - In 376 patients who underwent gastroscopy the presence of Campylobacter pylori by
      microscopy, bacterial culture and urea test was studied. Additionally, the
      histological examination of the antral mucosa was performed. The organisms were
      detected in 47.9% of the biopsy specimens (37.2% in normal endoscopic findings
      and 70% in duodenal ulcers). Dependence on sex was not found and also no
      significant difference of Campylobacter pylori detection in patients younger than
      45 years compared with those who are older. However there was a strong
      correlation between the presence of Campylobacter pylori and the histological
      results (p less than 0.05). In comparison with international literature we found
      a distinctly lower percentage of positive Campylobacter pylori rate in patients
      with peptic ulcer; the association between the presence of Campylobacter pylori
      and the degree of gastritis was confirmed.

PMID- 2238753
TI  - [Antagonizing the effect of midazolam by flumazenil in gastroscopy: results of a
      randomized double blind study].
AB  - The action and side effects of the benzodiazepine antagonist Flumazenil were
      evaluated and compared with placebo in a double blind parallel group randomized
      trial involving 40 patients having upper gastrointestinal endoscopy under
      Midazolam premedication. Flumazenil reversed the hypnotic effect of midazolam
      within a few minutes. The patients were alert, cooperative, oriented and had
      recall of events after endoscopy. The effects were better than placebo concerning
      alertness for up to 30 minutes after administration whereas drowsiness remained
      almost stable after placebo. Time to reach full alertness was shorter after
      Flumazenil compared with placebo (42 vs 62 minutes). There were no significant
      side effects. Flumazenil allows effective reversal of midazolam premedication
      after upper gastrointestinal endoscopy.

PMID- 2238754
TI  - Elimination of Helicobacter pylori under treatment with omeprazole.
AB  - Biopsies from the stomachs (antrum and corpus) of 201 patients with peptic ulcers
      or reflux oesophagitis were retrospectively investigated for the effect of
      treatment with omeprazole on the elimination of Helicobacter pylori (HP) and on
      gastritis. Of 64 patients without gastritis two (3.1%) developed gastritis during
      treatment. Among 134 patients with HP gastritis undergoing treatment, 48 (35.8%)
      experienced no HP elimination, in 41 (30.6%) there was HP elimination from the
      antrum, but HP persistence in the corpus, while in 45 (33.6%) HP was eliminated
      from both antrum and corpus. HP elimination led to a reduction in the degree and
      activity of gastritis under omeprazole treatment. Only eight patients were
      examined after completion of treatment, and in three in whom HP had been
      eliminated, recolonization was found to have occurred. The disappearance of HP in
      Type A gastritis coupled with the fact that HP is highly sensitive to
      contamination with other bacteria--as observed in the laboratory--suggests that
      this now partially established elimination of HP under the strongly acid
      inhibiting omeprazole therapy can be traced back to a bacterial overgrowth of the
      gastric mucosa.

PMID- 2238752
TI  - [Various memorable dates from the history of smallpox vaccination].
AB  - Several dates of memory from the history of the vaccination against smallpox are
      to be registered for the year 1990. The birthday of the vaccination propagandist
      Johann Adam Reimann comes round the 300th time, the initial date of relevant
      university instructions comes round the 200th time. Issuing from this the history
      of vaccination against small pox is touched on at the instance of several marking
      points.

PMID- 2238755
TI  - [Effect of pancreatin on diabetes mellitus in chronic pancreatitis].
AB  - The effect of pancreatin on insulinopenic diabetes was studied in 10 patients
      with chronic pancreatitis and exocrine function impairment. All patients were
      treated for 4 days in a randomized crossover trial with either pancreatin (6 x 2
      capsules, 6 x 300 mg/d) or placebo. Blood glucose levels were determined 7 times
      every day and night. On day 5, the patients were studied by a glucose sensor with
      adjustment of blood glucose to 120 mg/dl until 8.00 in the morning. A test meal
      was applied with 2 capsules pancreatin or placebo. Blood glucose and plasma
      levels of C-peptide, glucagon and pancreatic polypeptide (PP) were determined in
      regular intervals for 4 hours. Blood glucose levels were not significantly
      altered by pancreatin. As shown by M-value according to Schlichtkrull (21.6 +/-
      2.9 versus 32.4 +/- 7.4), there was a tendency towards smaller oscillations of
      blood glucose with pancreatin treatment. C-peptide levels (basal 0.081 +/- 0.008
      ng/ml; postprandial 0.119 +/- 0.013 ng/ml) were not significantly altered by the
      administration of pancreatin. Basal and postprandial glucagon and PP plasma
      levels were not influenced by pancreatin. From these results, we conclude that
      pancreatic enzyme supplementation does not significantly alter the requirement of
      insulin in patients with diabetes mellitus secondary to chronic pancreatitis.
      Possible disturbances of the enteroinsular axis are discussed in this paper.

PMID- 2238757
TI  - [Duplex sonography measurement of portal vein blood flow with healthy livers and
      in patients with chronic hepatitis after a fully absorbable test meal].
AB  - In 36 patients with chronic viral hepatitis and 20 patients with an intact liver
      we determined the blood flow and blood flow velocities of the portal vein by
      means of duplexsonography. This was done before and after the intake of a test
      meal (Biosorbin MCT). According to preexisting data the cases of chronic
      hepatitis were subdivided into groups consisting of 14 cases having chronic
      persistent hepatitis, 9 cases having chronic aggressive hepatitis without
      tendency of cirrhotic transformation and 13 cases of chronic aggressive hepatitis
      with beginning cirrhotic changes. Patients with known cirrhosis of the liver or
      signs of portal hypertension were excluded from the study. It was not possible to
      assign a patient with chronic hepatitis to a definite group merely on the
      knowledge of his portal blood flow. Only after the intake of the test meal
      varying increases in blood flow velocity and volume were demonstrated. These
      increases were found to be smallest in the group of "chronic aggressive hepatitis
      with developing cirrhosis". In some individual cases this enabled us to conclude
      from changes of the portal blood flow whether or not a portal hypertension is
      developing.

PMID- 2238756
TI  - Comparison of GLP-1 (7-36amide) and GIP on release of somatostatin-like
      immunoreactivity and insulin from the isolated rat pancreas.
AB  - The effect of equimolar doses of GIP and GLP-1 (7-36amide) on insulin and
      somatostatin secretion in the isolated perfused rat pancreas was compared. At a
      perfusate glucose concentration of 70 mg/dl GLP-1 (7-36amide) 10(-9) and 10(-8) M
      and GIP 10(-9) M elicited a significant stimulation of insulin while GIP 10(-8) M
      and lower doses of both peptides (10(-11) and 10(-10) M) were ineffective. At
      elevated perfusate glucose levels of 150 mg/dl both peptides stimulated insulin
      release at 10(-11), 10(-10), 10(-9) and 10(-8) M but not at 10(-12) M. The
      insulin response at the higher glucose level was significantly greater compared
      to the effect of the same doses at normoglycemic conditions. Somatostatin release
      was stimulated significantly by GLP-1 (7-36amide) at 10(-10) and 10(-9) M at
      perfusate glucose level 70 mg/dl. At a glucose concentration of 150 mg/dl this
      effect was abolished. GIP did not alter somatostatin release at a perfusate
      glucose concentration of 70 mg/dl while at 150 mg/dl only the highest dose of GIP
      (10(-8) M) stimulated somatostatin release significantly. In conclusion, the
      present data demonstrate that in vitro in the rat pancreas both peptides are
      equally effective secretagogues of insulin release at normal and moderately
      elevated perfusate glucose levels. In contrast, somatostatin secretion is
      stimulated by GLP-1 (7-36amide) at normoglycemic conditions while only a rather
      high and presumably pharmacological dose of GIP is a stimulus of somatostatin
      secretion at moderate hyperglycemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238758
TI  - [Therapy and prevention of hemorrhage from esophageal varices].
AB  - Management of variceal hemorrhage includes emergency treatment of bleeding
      esophageal varices and prophylactic treatment for the prevention of first
      bleeding or rebleeding. Endoscopic injection sclerotherapy appears to be the most
      effective therapeutic option to control acute variceal hemorrhage. When
      sclerotherapy fails or cannot be performed a Sengstaken-Blakemore tube can be
      used. Supportive treatment is provided by vasodilator or vasoconstrictor therapy.
      At present, operative treatment modalities such as portosystemic shunts or
      esophageal transection are secondary to sclerotherapy or balloon tamponade. The
      probability of recurrent variceal hemorrhage after a first bleeding is 70%. This
      necessitates preventive measures such as endoscopic sclerotherapy, beta-blockade,
      or surgical procedures. Meta-analysis of randomised controlled trials indicates
      that sclerotherapy appears to reduce the number of episodes of recurrent variceal
      hemorrhage better than other prophylactic treatments and to improve survival.
      Chronic sclerotherapy may be the procedure of first choice in patients with good
      liver function when elective shunt surgery is provided for those who have
      recurrent bleeding despite sclerotherapy. The role of beta-blockade in the
      prevention of recurrent bleeding remains to be clearly defined. Prevention of
      first esophageal bleeding by invasive treatment modalities could reasonably only
      be performed in patients with high bleeding risk, which, however, cannot be
      defined accurately at present. The use of beta-blockers in the prevention of
      first variceal hemorrhage should be restricted to clinical trials.

PMID- 2238759
TI  - [Prevention of stress ulcer hemorrhage: a risk-benefit analysis].
AB  - The potential benefits and risks of prophylactic treatment for stress ulcer
      haemorrhage remain controversial. Analysis of previous studies indicates that 1.
      the incidence of haemorrhage and the mortality from haemorrhage have declined
      over the last two decades even in the absence of prophylactic treatment; 2. all
      drugs used for prophylaxis reduce the incidence of haemorrhage, and all drugs are
      comparably effective. 3. There is, however, no evidence that prophylactic drug
      therapy reduces the mortality or that the drugs used for prophylaxis differ in
      their effect on mortality. 4. A higher rate of pneumonia is seen only with
      antacid treatment.

PMID- 2238760
TI  - [Video-endoscopy and sonography--future developments].
AB  - Video Endoscopy and Video Sonography are new developments in the field of
      endoscopy. They will start a structural change of the common endoscopy unit. This
      article shall give an overview about new development ways and their consequences
      for the next years in the field of Video Endoscopy.

PMID- 2238761
TI  - [Gastritis: immunohistochemical detection of specific and nonspecific immune
      response to Helicobacter pylori].
AB  - Granulocyte infiltration was studied in 88 biopsies of antrum mucosa from
      patients with B-gastritis. Evidence of IgA-, IgG- and IgM-antibodies as well as
      of lysozyme in the mucosa was demonstrated by immunohistochemical methods.
      Helicobacter pylori (Hp) is coated by antibodies and a significant correlation
      between extent of opsonisation and number of plasma cells in the connective
      tissue of the lamina propria could be stated. Thus, the infiltration of plasma
      cells is a specific immune response against Hp. In the depths of gastric pits the
      antibody-coating of bacteria is faint. Instead, lysozyme and lactoferrin are
      produced there. By means of a Cross-sectional study a model is developed which
      characterizes B-gastritis as a dynamic process. Lagging behind, the inflammation
      follows the motile bacteria resulting in a patchy distribution of inflamed areas
      in the mucosa. At the peak of these local inflammation-waves the production of
      antibodies and lysozyme is intensified. Coating the bacteria with IgG and IgM
      results in complement activation liberating chemotaxin C5a. Consequently, there
      is a massive granulocyte infiltration leading to local reduction or eradication
      of Hp.

PMID- 2238762
TI  - The plain abdominal radiograph in the assessment of constipation.
AB  - To investigate the value of the plain abdominal radiograph in the assessment of
      constipation we prospectively studied 30 patients (20 females, 10 males, mean age
      48.6 years, range 21-76 years). These patients underwent the following tests:
      plain abdominal radiograph in supine position, measurement of stool weight (mean
      of 5 days) and whole gut transit time (20 radioopaque pellets, fluoroscopy of
      stools). All patients completed a questionnaire regarding their defaecation
      characteristics (a.o. average defaecation frequency and faecal consistency). The
      abdominal films were coded and independently scored for the degree of faecal
      stasis in ascending, transverse, descending colon and rectosigmoid by four
      gastroenterologists. To each of these parts of the colon a score of 1 (no faeces)
      to 4 (loaded with faeces) was assigned. The film scores given by the four
      observers were significantly correlated (p less than 0.001). Significant
      correlations were found between the radiograph scores and frequency of
      defaecation, faecal consistency and stool weight. The strength of these
      correlations were of the same order of magnitude as those between the other
      subjective and objective defaecation variables. The scores for the left colon
      (descending colon and rectosigmoid) showed a better correlation with the other
      defaecation parameters than the scores for the right colon. It is concluded that
      in the assessment of constipation a simple plain abdominal radiograph is as
      reliable as measurement of faecal weight or marker transit and can thus be
      advocated as the first procedure. When an abdominal radiograph is used for this
      purpose the stasis in the descending and sigmoid colon provides most information.

PMID- 2238763
TI  - [Spontaneous bacterial peritonitis: studies of the incidence and clinical and
      laboratory chemical parameters].
AB  - In a prospective study on 151 patients with cirrhosis of the liver we found 9
      episodes of spontaneous bacterial peritonitis (SBP) in 8 patients (5.3% of the
      whole population or 18% of the ascitic patients). There was a clear difference in
      WBC-count, polymorphonuclear cell count, LDH and lactate in the ascitic fluid
      between SBP and controls. Clinical symptoms were discrete. 6 of 8 patients had an
      advanced form of cirrhosis belonging to Child-grade C. Half of patients died. The
      clinical situation of the 4 survivors improved after antibiotic treatment.
      Ascitic analysis of WBC and PMC-count in combination with LDH and lactate may
      reveal SBP as the reason of fever or clinical impairment in cirrhotics.

PMID- 2238764
TI  - [Effect of enalapril on heart rate, arterial blood pressure and exocrine
      pancreatic secretion in the alert dog].
AB  - A changed exocrine pancreatic secretion could be a pathogenetic factor of an
      acute pancreatitis after administration of angiotensin-converting enzyme (ace)
      inhibitors. In six conscious dogs with gastric and duodenal Thomas fistulas we
      studied the effect of an intravenous (iv.) bolus injection of 10 mg enalaprilat,
      an intraduodenal (id.) bolus injection of 20 and 40 mg enalapril (e.), and 0.15 M
      NaCl (20 ml iv., resp., id.) on pancreatic bicarbonate- and protein output in
      response to secretin (20.5 pmol/kg bw/h and caerulein (29.6 pmol/kg bw/h).
      Arterial blood pressure and heart rate we also measured. The iv. and id.
      injection of enalapril(at) significantly increased heart rate by 28% after 10 mg
      of e. iv. [peak 101 +/- 11 beats/min, N = 6, X +/- SEM] and by 13 resp. 37% after
      20 resp. 40 mg e. id. [peak 89 +/- 4, resp., 108 +/- 7 beats/min] as compared to
      control [peak 79 +/- 5 beats/min]. Systolic blood pressure was significantly
      decreased by 6% after 10 mg e. iv. [lowest value 121 +/- 2 mm Hg] and by 8% and
      9% after 20 and 40 mg e. id., respectively, [lowest value 119 +/- 2, resp., 118
      +/- 1 mm Hg] as compared to control [lowest value 129 +/- 1 mm Hg]. The applied
      enalapril(at) doses had no significant effect on hormonal stimulated pancreatic
      bicarbonate- and protein output. The results confirmed the well known effects of
      enalapril(at) on heart rate and on arterial blood pressure. Beyond that the
      results exposed that therapeutical doses of enalapril(at) had no significant
      effect on exocrine pancreatic secretion. Conclusion of this study is that a
      pathogenetic role of pancreatic exocrine secretion in the ace-inhibitors and the
      acute pancreatitis induced by ace-inhibitors is unlikely.

PMID- 2238765
TI  - Carbachol priming increases glucose- and glucagon-like peptide-1 (7-36)amide-,
      but not arginine-induced insulin secretion from the isolated perfused rat
      pancreas.
AB  - The priming effect of carbachol on glucose-, arginine- and glucose plus GLP-1 (7
      36)amide induced insulin secretion was investigated. The isolated rat pancreas
      was perfused in vitro during a basal period of 10 min with Krebs-Ringer
      bicarbonate buffer containing 2.8 mmol/l glucose. This medium was then
      supplemented with carbachol (10,1.0.1 mumol/l, respectively). After an additional
      10 min period at 2.8 mmol/l glucose insulin secretion was stimulated for 44 min
      with 10 mmol/l glucose, or glucose plus GLP-1 (7-36)amide (0.5 nmol/l), or
      arginine (10 mmol/l). Pretreatment with carbachol resulted in a concentration
      dependent sensitization of B-cells to a consecutive glucose load (10 mmol/l).
      Both phases of the biphasic insulin secretory response were significantly
      enhanced. Priming experiments followed by a subsequent combined glucose / GLP-1
      (7-36)amide or arginine stimulation were performed with 10 mumol/l carbachol.
      Prior exposure of the pancrease to carbachol enhanced the glucose / GLP-1 (7
      36)amide induced insulin release, but left the arginine stimulated secretion
      unaltered. Our data suggest that in the regulation of postprandial insulin
      release cholinergic sensitizing effects might be involved which are mediated by
      muscarinic receptors.

PMID- 2238767
TI  - [Risk factors in the etiology of Crohn disease].
AB  - So far the aetiology of Crohn's disease remains unclear. Besides a genetic
      predisposition a causal role of environmental factors has been taken into
      consideration within the last time period. A number of case-control studies have
      consistently reported about an increased consumption of dietary sugar in patients
      with Crohn's disease as compared with controls. Furthermore cigarette smoking and
      the use of oral contraceptive drugs have been shown to increase disease risk.
      While the role of the former can be regarded as established the role of the
      latter still remains controversial.

PMID- 2238766
TI  - [Significance of the iron and copper content of the liver for the differential
      diagnosis of chronic liver diseases].
AB  - Liver iron and copper concentrations were estimated in 395 patients undergoing
      hepatological examination. Relations to clinical, morphological and laboratory
      data were evaluated. Liver iron concentrations were not significantly different
      in chronic hepatitis of viral, toxic or immunological origin. Liver iron levels
      exceeding 100 mg/100 g dry liver tissue (normal range up to 300 mg/100 g) were
      only found in idiopathic hemochromatosis (n = 8), in a patient with prophyria
      cutanea tarda and in a multiple transfused patient who suffered from aplastic
      anemia. Liver copper content was significantly increased in primary biliary
      cirrhosis compared to chronic hepatitis of other origin. Apart from untreated
      Wilson's disease (n = 3) copper levels higher than 25 mg/100 g dry liver tissue
      (normal range up to 6 mg/100 g) were measured in chronic active hepatitis B (n =
      2), primary biliary cirrhosis (n = 9) and in chronic hepatitis of uncertain
      origin (n = 3). Therefore excess accumulation of copper in the liver was typical
      of Wilson's disease but less diagnostic than severely elevated liver iron stores
      of idiopathic hemochromatosis.

PMID- 2238768
TI  - [Electronic data processing documentation of findings in gastrointestinal
      endoscopy].

PMID- 2238769
TI  - [Adjuvant chemotherapy improves chances of survival in curative surgery of colon
      cancer, Dukes' stage C].

PMID- 2238770
TI  - [Transesophageal echocardiography in the assessment of the severity of aortic
      valve stenosis].
AB  - The aortic valve orifice area was measured in 95 patients with valvular aortic
      stenosis by means of transthoracic and transesophageal echocardiography. These
      results were compared to invasively determined measurements. The aortic-valve
      orifice area could be measured by transesophageal echocardiography in 87 patients
      (92%), and in 13 patients (14%) by the transthoracic approach. A comparison of
      the valve-orifice area determined by transthoracic and transesophageal
      echocardiography revealed a correlation coefficient of r = 0.91. There was also a
      good agreement when the aortic-valve orifice area determined by transesophageal
      echocardiography was compared to the invasive findings (r = 0.82; p less than
      0.001). The morphology of the aortic valve could be better delineated with the
      transesophageal approach.

PMID- 2238771
TI  - [The effect of electromagnetically produced shock waves on calcified, stenosed
      aortic valves].
AB  - To determine if electromagnetically generated shock-wave lithotripsy has
      potential application for treatment of stenotic, calcified aortic valves, 38
      cusps of surgically excised human aortic valves were studied. Valves were
      weighed, photographed, and calcium deposition was determined by x-ray. Stiffness
      was determined by palpation and by measuring the pressure gradient generated in a
      perfusion system. Valves were exposed to shock waves at 16 or 18 kV with 200 or
      400 impulses each. Twenty valves reacted to exposure to shock waves with a
      reduction in pressure gradient of 1.9 +/- 2 cm H2O. Calcified valve area was
      reduced by 3.5 +/- 1.3 mm2. Valves without changes in pressure gradient showed a
      reduction of 7.1 +/- 2 mm2 of calcified valve area. There was no significant
      difference in weight loss. Using a small focus (4 mm) there was a significant
      reduction in pressure gradient and calcified valve area, but not in weight; with
      a large focus (8 mm) reduction in calcified valve area, gradient, and weight was
      significant (p less than 0.05). Changes in valve stiffness were independent of
      weight loss and reduction in calcified valve area. In conclusion, shock-wave
      lithotripsy is capable of reducing stiffness of calcified aortic valves,
      presumably by fragmentation of tissue calcium deposits.

PMID- 2238773
TI  - [Eccentric coronary stenoses--definition and incidence in coronary angiograms].
AB  - The frequency of "eccentric" stenoses was determined in 676 coronary angiograms,
      which proved to be useful to classify stenoses according to their position
      (central, eccentric), as well as to the form of residual lumen (round, not
      round). The results for 616 stenoses which could be evaluated for both position
      and form were: 30% (183/616) centrally located with round residual lumen; 10%
      (60/616) centrally located with no round residual lumen; 41% (255/616)
      eccentrically located with round residual lumen; 19% (115/616) eccentrically
      located with no round residual lumen. These results are in agreement with
      previous autopsy findings. The location and form of coronary stenoses may have
      different meanings: the prevalent round form of residual lumina (71% of all
      evaluated stenoses) may characterize a normal growing of stenoses, while no round
      forms might indicate complications such as ruptures with hemorrhage within
      plaques. The prevalent eccentric location of residual lumina (63% of all
      evaluated stenoses) may reflect a tendency to dynamic coronary tone within the
      respective coronary stenosis. This assumption is supported by similar frequencies
      of dilatative or constrictive responses in patients with coronary artery disease.
      Individual prognoses, however, with respect to coronary tone or coronary
      reactions cannot be predicted from morphology.

PMID- 2238772
TI  - [Perioperative preventive antibiotic treatment with fosfomycin in heart surgery:
      serum kinetics in extracorporeal circulation and determination of concentration
      in heart valve tissue].
AB  - A prospective clinical study was carried out to assess the adequacy of
      perioperative antibiotic prophylaxis using fosfomycin in patients undergoing open
      heart surgery for valve diseases for the prevention of early postoperative
      endocarditis, as well as for serious mediastinal infections that are caused
      mostly by multiresistant staphylococci and Gram-negative bacteria. Perioperative
      pharmacokinetics and tissue penetration were determined within the harvested
      heart valves and subcutaneous tissue. Reliable bactericidal serum levels were
      established at the first measurement 10 min after the end of intravenous infusion
      (203.7 +/- 44.7 micrograms/ml) and were maintained during surgery for at least
      120 min (124.6 +/- 58.4 micrograms/ml), even in cases of prolonged extracorporeal
      circulation. Cardiopulmonary bypass did not alter the serum elimination of
      fosfomycin in comparison with patients not undergoing extracorporeal circulation.
      Peak tissue concentrations were achieved in both aortic and mitral valves after
      30 min, ranging between 27.1 and 76.9 micrograms/g for aortic valves and 39.6
      69.4 micrograms/g for mitral valves, depending on the degree of valvular
      degeneration. MIC values of 16 micrograms/g were maintained in both valves for at
      least up to 60 min. There was no evidence of renal impairment, adverse reactions
      or infections during the postoperative course or thereafter for a period of 3
      months. It is concluded that perioperative intravenous antibiotic prophylaxis
      using fosfomycin (5 g t.i.d. in adults), beginning with induction of anesthesia
      and continued for 48 h postoperatively, provides rapid, reliable bactericidal
      serum levels and valvular tissue concentrations that will inhibit most Gram
      positive and Gram-negative organisms that cause bacterial endocarditis and other
      serious infections following cardiac surgery.

PMID- 2238774
TI  - [Dipyridamole-thallium 201 tomography following acute myocardial infarct:
      significance for stratifying cardiac risk factors].
AB  - For the purpose of risk stratification 80 consecutive patients (mean age 58 +/-
      7) with a chest pain syndrome after documented myocardial infarction underwent
      tomographic vasodilation-redistribution thallium-201 perfusion imaging, using
      0.56 mg/kg intravenous dipyridamole. Tomograms were analyzed for size and
      location of reversible and fixed perfusion defects and correlated to angiographic
      characteristics, left ventricular ejection fraction and wall motion, collateral
      status, and 1-year prognosis as measured by cardiac events within 14 +/- 3
      months. No serious side effects were noted with the diagnostic use of intravenous
      dipyridamole. According to the perfusion pattern three subgroups of post
      infarction patients were identified: 1) by ischemia at a distance with
      redistribution in non-infarct related territories (n = 48), 2) by peri
      infarctional ischemia with redistribution in the territory of the "infarct
      artery" (n = 9), and 3) by exclusively fixed defects without redistribution (n =
      23). Ischemia at a distance was associated with a larger reversible defect than
      peri-infarctional ischemia (p less than 0.05) and the pattern without
      redistribution (p less than 0.005); the fixed defect size, however, was similar
      in all three subgroups. In addition, the severity of coronary artery disease
      (Gensini score and number of diseased vessels) and the degree of
      collateralization was higher in presence of a redistribution pattern (p less than
      0.05), although no significant differences in global and regional function were
      noted as a function of thallium-201 redistribution.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2238775
TI  - [Decreasing length of stay in the hospital by coronary angiography with 5-French
      catheters].
AB  - The use of 5-French (F) coronary angiography catheters as opposed to 7-F may
      reduce arterial injury at the puncture site. Therefore, a decrease in time to
      recuperation after coronary angiography with the Judkins technique seems
      possible. In 199 patients undergoing coronary angiography with 5-F catheters,
      management, imaging, and complications were investigated. In 18 patients the
      diagnosis of a valvular defect was confirmed; in 128 patients coronary artery
      disease (lesions greater than 70%) was found. Three patients had idiopathic
      dilative cardiomyopathy. Coronary lesions of less than 70% with normal left
      ventricular function were found in 50 patients ("normals"). After coronary
      angiography with 5-F catheters bedrest was recommended for 4 h, as compared to 24
      h after a 7-F catheter procedure. Successful coronary artery imaging with 5-F
      catheters was achieved in 168 patients (84%). In 31 patients (27 coronary artery
      disease, 1 aortic stenosis, 3 normals) selective imaging was not achieved, and
      the 5-F catheter had to be replaced by a 7-F catheter. Aortic (systolic 147 +/-
      24 vs 132 +/- 20 mm Hg, p = 0.002; diastolic 74 +/- 13 vs 70 +/- 11, p = 0.05)
      and left ventricular pressures (systolic 149 +/- 26 vs 131 +/- 20 mm Hg, p =
      0.001; enddiastolic 18 +/- 8 vs 14 +/- 8 mm Hg, p = 0.035) were higher in this
      group, whereas no relations to age, sex, and diagnosis emerged.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2238776
TI  - [Effect of acute short-term ischemia during PTCA on the function of the right
      ventricle].
AB  - To determine whether a transient ischemia of the right ventricle leads to right
      ventricular impairment and whether RV function can also be influenced by septal
      ischemia caused by an occlusion of the left anterior descending coronary artery
      (LAD), RV function before and at the end of 60 s of ischemia during PTCA was
      assessed in 15 patients with single-vessel disease of either the right coronary
      artery (RCA, n = 10) or the LAD (n = 5). The RV-enddiastolic pressure and the
      pulmonary capillary wedge pressure (PCW) were recorded continuously. The RV
      ejection fraction was determined from ventriculograms performed before and during
      coronary occlusion. An increase of RVEDP from 3.7 +/- 1.2 to 8.3 +/- 1.8 mm Hg (p
      less than or equal to 0.001) and a decrease of the RV-ejection fraction from 52
      +/- 3 to 33 +/- 8% (p less than or equal to 0.001) occurred during RCA occlusion
      with a predominant ischemia of the RV free wall only, and not during LAD
      occlusion with left ventricular and septal ischemia. The extent of the RV
      dysfunction was independent of an additional increase of RV afterload (PCW
      increase). Comparable to ischemic effects on left ventricular function, an acute
      right ventricular myocardial ischemia results in a severe RV contractile failure.

PMID- 2238778
TI  - [Complication in rotation angioplasty: removal of an intracoronary metal ring
      (roentgen marker) using a balloon catheter].
AB  - Successful recanalization of an occluded left anterior descending coronary
      artery, performed by rotational angioplasty was complicated by loosening of a
      metallic ring (x-ray marker) from the rotational angioplasty system, with
      embolization into the circumflex artery. The metallic ring was extracted
      successfully by using a balloon catheter.

PMID- 2238777
TI  - [Favorable long-term prognosis following late recanalization of main branch
      occlusion of the left coronary artery].
AB  - A 52-year-old man presented with an acute anterior myocardial infarction due to
      total occlusion of the left main coronary artery. Three weeks later a successful
      recanalization was performed. At an early recoronarography the vessel was patent.
      Initially existing severe congestive heart failure (NYHA class IV) improved to
      NYHA class II over 6 months. Three years later the patient is almost without
      complaints and, at echocardiography, left-ventricular enlargement was clearly
      declining.

PMID- 2238779
TI  - [Dependency in the aged].

PMID- 2238780
TI  - [Psychosocial guidance of nursing home personnel by group therapy. Basic
      considerations and initial experience].
AB  - Support groups for those professional caregivers who work in homes for the aged
      are seldom. Focussing on occupational stressors in this profession and the
      burnout research as a conceptual framework, a support group is introduced. To
      sustain the social competence and the coping skills of the caregivers are the
      basic aims of this group. Based on role taking and psychodrama as intervention
      techniques, outcomes from this group are discussed. Recommendations for future
      groups as a support system for caregivers in homes for the aged are derived.

PMID- 2238781
TI  - [Residents and personnel as sources and targets of violence in homes for the
      aged].
AB  - Aspects of prosocial and of violent behaviour among residents, among staff, and
      between residents and staff of homes for the aged in German-speaking Switzerland
      and possible determinants were ascertained by mailed questionnaires (N = 205;
      rate of return: 20%). Prosocial behaviour is dominating but violence in many
      forms occurs too. Violence correlates with low age of the employees, with a low
      motivation for continued education, with a low satisfaction with the work
      situation in many forms, with low life satisfaction, with life problems, with
      high numbers of inhabitants of the political community, with the size of the
      home, and with unfavorable conditions of the staff. Correlations between the
      behaviour of home residents and staff leads to the proposition that violence in
      one group furthers violence in another group and hinders prosocial behaviour. The
      report is closed by considerations concerning methodological restrictions and
      practical consequences.

PMID- 2238782
TI  - [Memory training in old age: theoretical background and development of an
      intervention program for nursing home residents].
AB  - A survey of the literature reveals that studies providing hard evidence of the
      effects of training on improvement of cognitive skills in old age focus on highly
      specialized training measures. To date there are hardly any suitable procedures
      for memory training that have a broad effect on the consciousness of impaired
      individuals which would nurture a different attitude towards the entire complex
      of learning and memory. For this reason a memory training program was developed,
      aimed at conserving, reactivating, and fostering the cognitive skills of non
      demented residents of old people's homes. The training program, carried out over
      a 3-month period, consists of a total of 24, 45-min training units. The first
      half of the memory training program prompts participants to use as many channels
      of perception as possible, and thereby, also to employ compensation
      possibilities. In addition, there are exercises for improving observation and
      concentration and for understanding the functions of memory on the basis of a
      simplified model of information processing. The second half of the memory
      training program focuses on exercises to improve short-term and medium-range
      retention. The exercises are oriented in content to the daily situations relevant
      to the residents in which memory performance is expected. The memory training
      program was used for the first time in a geriatric facility in Mannheim, FRG.
      Continued use of the program, coupled with an evaluation, is planned as part of a
      research project in several homes for the elderly in that greater metropolitan
      area.

PMID- 2238783
TI  - [Detection of dementia and depression using the Brief Assessment Interview (BAI):
      results of a reliability and validity study with residents of a nursing home in
      Mannheim].
AB  - Described here is the German version of the Brief Assessment Interview (BAI), an
      instrument developed originally in the course of the US-UK cross-national studies
      and designed to compile data on dementia and depression among the elderly. A
      study in Mannheim, FRG, of residents in an old people's home tested the
      reliability and validity of the BAI. Raters corresponded to a high degree on both
      the dementia and depression scales; intraclass coefficients (ICC) amounted to
      0.95 and 0.97, respectively. Compared to the interrater reliability, test-retest
      reliability was somewhat lower (dementia scale: 0.83, depression scale; 0.74),
      but always significant at the 1% level. The internal consistency of the dementia
      scale lay between 0.62 and 0.77, and that of the depression scale between 0.78
      and 0.92. In evaluating the validity of BAI, results of the dementia and
      depression scales were compared to the corresponding diagnoses. These independent
      diagnoses had been made with the aid of the Feighner criteria by the director of
      the facility, who had special training in psychiatry. The diagnoses yielded a
      significant relationship (p less than 0.01) between the dementia (r = 0.49) and
      depression scales (r = 0.60). The BAI also attained sufficiently high values for
      sensitivity, specificity, and total efficiency. It is, therefore, well suited for
      use in elderly target groups that are otherwise difficult to assess, and it also
      affords a high degree of international comparability.

PMID- 2238785
TI  - [Use of self-rating instruments with elderly hospital patients].
AB  - The usefulness of self-rating instruments for measuring the emotionality of
      elderly and/or physical ill individuals is discussed. Therefore, 99 inpatients of
      internal wards (mean age: 65) were examined with the German form of the State
      Trait Anxiety Inventory (Laux et al., 1981). All the problems which arose when
      the test sheet was filled out were recorded and subsumed into one of the
      following categories: comprehension problems, problems with the answer
      categories, answer tendency, problems with layout. As expected, we were able to
      show that practical problems increase as patients become older. None of the
      patients over 80 years was able to complete the scale without considerable help
      in a standardized manner. We recommend to use structured interviews for assessing
      the emotional state of elderly patients.

PMID- 2238784
TI  - [Alzheimer's disease: experience, perception and reactions of patients].
AB  - Clinical research into Alzheimer's disease has predominantly focused on
      standardized assessment of cognitive impairment and behavioral changes. The
      description of feelings and attempts of adaptation of patients with Alzheimer's
      disease is a neglected area. Here we present five statements, each given by a
      patient with Alzheimer's disease, and investigate perception and attempts of
      adaptation contained in these statements. Important consequences for the care of
      patients with Alzheimer's disease are discussed.

PMID- 2238786
TI  - Caring for elderly parents in Sweden: the biographies of two groups of elderly
      and their parents.
AB  - In this study two sample groups of very old people report on needs for care among
      their parents. We report on who gave the care and if parents were
      institutionalized. Information on social class, preferences for care for oneself,
      etc., was also collected. Comparisons with contemporary data indicate that
      patterns of care remain historically quite stable, and that experiences of
      providing care influences one's own preferences many years later. The welfare
      state seems to have increased the freedom of choice for, especially, the poorer
      elderly.

PMID- 2238787
TI  - Direct sectioning of unembedded cartilage: a simple method for microscopical and
      histochemical studies on chondrocytes and extracellular matrix.
AB  - On account of the rigidity and compact structure of the hyaline cartilage,
      unfixed or formaldehyde fixed samples of this tissue can be directly sectioned by
      using a conventional ultramicrotome and a glass knife. This simple method allows
      to obtain microscopical sections from unembedded cartilage blocks, which show a
      well preserved histological structure and are very suitable to carry out
      morphological and histochemical studies on chondrocytes and cartilaginous matrix.

PMID- 2238788
TI  - Enzyme histochemical and histological changes in the adult rat kidney after
      prenatal gentamicin exposure.
AB  - Treatment of rats between day 15 and 20 of gestation with gentamicin caused
      histological as well as enzyme histochemical lesions in the kidney of the one
      year old offspring (F1 generation). Other organs were not significantly affected.
      Primarily in the female kidney dilated convoluted proximal tubulus with reduced
      or absent staining for brush border and lysosomal proteases, phosphatases and
      glycosidases and mitochondrial dehydrogenases were observed. In comparison,
      glomeruli were less frequently damaged and contained fewer capillary loops or
      irregularly arranged tissue elements with lowered or no activities for plasma
      membrane-associated proteases as well as specific and non-specific phosphatases.
      In addition, the activities of proteases and phosphatases in cortical and
      medullary endothelial cells of capillaries were reduced or even abolished in the
      kidney of the female and male F1 generation after treatment of their mothers with
      gentamicin.

PMID- 2238789
TI  - Ultrastructural and immunocytochemical study on bursal follicle medulla cells in
      Gallus domesticus.
AB  - The use of the monoclonal anti-cytokeratin 6 and 18 antibody Dako CK 1 revealed a
      marked positivity of reticulo-epithelial cells (REp). Aspecific esterase testing,
      light microscopy, and electron microscopy were used in order to obtain a
      comparison between the morphology of the lymphoid follicle medulla and the
      picture obtained by using the monoclonal antibody CK 1. Results showed that the
      bursal follicle medulla can be divided into 2 areas: an esterase-positive,
      cytokeratin-negative centre-medulla, and a more peripheral cytokeratin-positive,
      esterase-negative area. These 2 regions appear to be separated by a boundary
      composed of flattened REp cells. Desmosomes were also observed not only among
      their processes, but also between the latter and the side of the cortico-medullar
      boundary epithelium which is external with respect to the basal membrane.

PMID- 2238790
TI  - Endothelial cilia in rat mesenteric arteries and intramyocardial capillaries.
AB  - We report for the first time the presence of endothelial cilia in rat blood
      vessels. They are seen in the mesenteric arteries of hypertensive rats and the
      intramyocardial capillaries of aged rats. The cilia are solitary and have the
      shape of the "9 + 0" axonemal structure. The processes of the basal foot and the
      transitional fiber are accompanied by basal bodies. The function of the solitary
      cilia is obscure.

PMID- 2238791
TI  - Morphology of Schmidt-Lanterman incisures of human shoulder plexus nerves in
      ontogenesis.
AB  - The Schmidt-Lanterman incisures are formed in the phase of "loose" myelin at 15
      17 weeks of prenatal development with the formation of nodes of Ranvier. The
      formation of mature Schmidt-Lanterman incisure is completed in the second foetis
      period. Schmidt-Lanterman incisures distribution in nerve fibres of young men
      depends on fibre diameter. In the nerves of elderly people the distribution of
      the incisures in the internode doesn't depend on a fibre diameter. In the nerves
      of the elderly men the number of incisures is twice as much as that in the young
      people. The incisural ultrastructure in human nerve is similar to its structure
      in other mammals.

PMID- 2238792
TI  - Morphology of Schmidt-Lanterman incisures of human shoulder plexus nerves.
AB  - Morphological studies of peripheral human nerves have shown that the number o of
      Schmidt-Lanterman incisures in an internode is proportional to the fibre
      diameter. Quantitative and ultrastructural examinations of incisures in the
      shoulder plexus nerves of the juvenile have proved some common features in the
      distribution and structure of incisures, characteristic for the nerves of both
      mammals and people. However, in all probability, in the peripheral nerves of man
      under certain condition there is a mechanism, leading to a sharp increase of the
      number of incisures in the internodal segment.

PMID- 2238793
TI  - Fine structure of camel erythrocytes in relation to its functions.
AB  - The fine structure of the red cells in Arabian camels was investigated and
      certain characteristic features were noted. The plasmalemma of camel erythrocytes
      are tri-laminar, the inner and outer membranes are of high electron density
      between which is a zone of lesser electron density. No intracellular organelles
      were observed with the occasional exception of a small number of mitochondria. In
      the camel erythrocyte, a marginal band consisting of 30-45 microtubules was
      observed in many cells. Some of the possible functions of the marginal band in
      camel erythrocytes are discussed.

PMID- 2238794
TI  - [Immunohistologic studies of the distribution of proliferative compartments in
      the appendages of adult human skin].
AB  - Both, calmodulin (CaM) as well as the antigen Ki67 show a close relationship to
      cell proliferation. By means of specific antibodies against them, it has become
      possible to study the spatial distribution of proliferative compartments in
      tissues. We performed an indirect immunofluorescence study on unfixed frozen
      sections of human adult skin to gain more informations about the spatial
      distribution of immunoreactive CaM and Ki67 in skin appendages, i.e. anagen hair
      follicle, sebaceous and eccrine sweat gland. Two major patterns of
      immunoreactivity were seen: Type (1) or epidermis-like, which was present in the
      interfollicular epidermis and the pilosebaceous unit. Type (2) or sweat gland
      type, which was seen in eccrine sweat glands. Both types disclosed significant
      differences in the relative number of proliferative cells in S-phase, which might
      be a consequence of a quiet different tissue architecture. Furthermore,
      myoepithelial cells of secretory coils were likely to represent mainly SQ-cells.
      Their immunoreactivity in human skin was quiet different from other parts of
      eccrine sweat glands suggesting another ontogenetic pathway.

PMID- 2238795
TI  - Effect of progesterone (norethindrone) only oral contraceptive on mouse uterus--a
      SEM study.
AB  - Impact of progesterone (norethindrone) only oral contraceptive (MICRONOR) on
      mouse uterus was investigated by SEM. The three dimensional SEM photographs
      revealed that, flat wave like mucous folds of the uterus (control) become more
      thick and highly convoluted after 50 days of MICRONOR feeding. The uteri became
      highly secretory as indicated by increased thickness of nonciliated secretory
      cell population with their increased microvilli. Low doses of norethindrone in
      combination with circulating estrogen, instead of causing regression, maintained
      a steady and highly secretory state which may interfere implantation/gamete
      transport.

PMID- 2238796
TI  - Luteinization in the atresia of maturing ovarian follicles in mouse.
AB  - Maturing ovarian follicles undergoing atresia were ultrastructurally analyzed.
      Using the method of Okros (1968) the process of luteinization was traced, taking
      place in the basal layer of cells of granulous membrane and in the cells of inner
      layer of theca interna during the atresia. In the atresia process, numerous
      electron dense granules arranged in packets and surrounded by tubular
      mitochondria are observed in the basal cell layer of granulous membrane. A
      considerable accumulation of the grains of reaction product and the presence of
      tubular mitochondria are also found in the cells of theca interna. Such a
      behaviour of those cells can be associated with an enhanced production of steroid
      hormones (mainly estrogens) in atretic follicles.

PMID- 2238797
TI  - Ultrastructural studies on the morula in cattle.
AB  - Embryos at morula stage were ultrastructurally examined. Blastomeres of normal
      embryos are characterized by the presence of ribosomes, short single and branched
      cisterns of endoplasmic reticulum, small spherical mitochondria and vacuolar
      granular structures. An enhanced autophagy and the presence of numerous and large
      lipid droplets are signs of the beginning degeneration.

PMID- 2238798
TI  - [Functional disorders of the immune system].
AB  - In common with other organ systems in the body the immune system demonstrates
      functional disturbances which may lead to numerous immunological disorders with
      grave consequences for the health of the patient. Whenever the complex network of
      regulation and counter-regulation mechanisms within the defence system is
      impaired, by hereditary or acquired defects, immunological defect syndromes
      occur. One of the disorders that has been the object of intensive discussion in
      this context over the past few years is the acquired immune deficiency syndrome
      AIDS, a dangerous viral infection that mostly affects the T4 cells, whose helper
      and inductor function is absolutely essential for successful immunological
      defence. Furthermore, functional impairment of the antibody-producing plasma
      cells leads to the heterogeneous group of gammopathies which are characterized by
      an uncontrolled and excessive proliferation of structurally uniform antibody
      molecules in the blood. Overreactions of the immune system which wrongly attack
      endogenous tissue are accredited with causing the so-called auto-immune diseases.
      The clinical pictures within this group are exceptionally varied, and depend both
      on the self-antigen that the attack is aimed at as well as the erroneously
      triggered effector function that is affected. Whenever the immune system reacts
      disproportionately strongly against otherwise harmless foreign antigens, allergic
      clinical picture emerge.

PMID- 2238799
TI  - [Malignant lymphedema].
AB  - Malignant lymphatic oedema is due to the obstruction of lymph tracts and lymph
      nodes by tumour cells. In addition to the necessary cancer therapy and the
      administration of analgesics physical oedema therapy is the single most effective
      form of relief which is most gratefully accepted by the patients. The only
      contraindication to manual lymphatic drainage is transient in the case of
      isolated local and regional metastatic spread which would still respond to
      treatment. Thereafter, and in all other conditions involving metastatic spread,
      there are no contraindications to physical oedema therapy.

PMID- 2238800
TI  - [Edema caused by isolated hyperthermic perfusion of the extremities].
AB  - Isolated extremity perfusion today is an undisputed alternative to amputation and
      a causal form of therapy for locally and regionally metastasising melanomas. In
      order to avoid the most serious complications such treatment should only be
      carried out at special centres. Milder side-effects such as early and late
      postoperative oedema respond well to drug regimes and manual lymphatic drainage.

PMID- 2238801
TI  - [A comparison of intermittent compression with single and multi-chamber systems
      in treatment of secondary arm lymphedema following mastectomy].
AB  - In a comparative study 38 patients with secondary unilateral lymphatic oedema
      after mastectomy were investigated with regard to the efficacy of intermittent
      compression treatment using uni- or multichamber systems (Jobst and Lymph-a-mat
      respectively). Although both machines significantly reduce oedema, there is no
      difference between their reduction capacities.

PMID- 2238802
TI  - [Iatrogenic damage in sclerotherapy of varicose veins].

PMID- 2238803
TI  - [Varicose veins and chronic venous insufficiency--minor disorder or disease? A
      critical review of the literature].
AB  - The controversial question of the incidence and significance of varicoses and
      chronic venous insufficiency is analysed by a critical review of epidemiological
      studies. It is seen that many of the results which initially appear to diverge
      are attributable to different, in part unsatisfactory epidemiological methods;
      e.g. patient groups of different ages and sex, different interview and
      examination techniques in addition to, above all, different weighting of
      varicosis. Thus, studies in general practice showed that the prevalence for
      varicoses in women was four times that in men; CVI was, in fact, 15 times more
      frequent than in epidemiological studies. The different weighting of varicoses
      and chronic venous insufficiency may well be one of the major reasons for the
      absent "unite de doctrine".

PMID- 2238804
TI  - [Venous disease and pregnancy].

PMID- 2238805
TI  - [The practical aspects of research on heterophasic cavitary digestion].

PMID- 2238806
TI  - [Motion sickness: the resonance hypothesis].

PMID- 2238807
TI  - [The collateral coronary circulation and the problem of its pharmacological
      stimulation].

PMID- 2238808
TI  - [The molecular organization of the contractile apparatus and the mechanics of
      muscle contraction].

PMID- 2238809
TI  - [The effect of cerebellar structures on the epileptic activity in the brain].

PMID- 2238810
TI  - [Stressor immunodeficiencies in man].

PMID- 2238811
TI  - [The role of acetaldehyde in the mechanisms of the action of ethanol].

PMID- 2238812
TI  - [Chronic venous insufficiency today (a status determination)].
AB  - Primary as well as secondary cvi (due to deficiency of the deep venous reflux) is
      a disease that necessitates a thorough therapy planning and a life-long medical
      care. Neither operation nor sclerotherapy alone can cure these patients. Active
      measures must always be combined with conservative procedures such as
      individually manufactured pressure gradient stockings, occasional intermittent
      medical treatment of complications and careful guiding of the patients over many
      years. The first measure is of course a careful establishment of the diagnosis by
      clinical examination and modern technical methods such as Doppler ultrasound,
      plethysmography and, in selected cases, phlebography. The therapy concept must
      consider the advantages and disadvantages of the various methods. A combined
      treatment in team work with the vascular surgeon may be the starting point, but
      must always be followed by an intensive life-long guidance of the patients with
      additional treatments according to necessity.

PMID- 2238813
TI  - [Duplex ultrasound measurement of morphologic parameters before and following
      repeated puncture of the femoral artery for intermittent infusion therapy].
AB  - In order to estimate morphologic changes of the femoral artery after an
      intermittent intraarterial infusion therapy duplex scanning was performed before
      therapy, immediately after a series of 26 (10 to 52) infusions, and 30 weeks
      after hospital discharge. Minimum and maximum values of internal and external
      vessel diameter and thickness of wall were estimated in the common femoral
      artery, superficial femoral artery, and deep femoral artery. The external
      diameter values and the thickness of wall increased significantly after therapy.
      After 30 weeks these values decreased but did not reach the initial values.

PMID- 2238814
TI  - [Doppler ultrasound determination of pressure decrease in model peripheral
      arterial stenoses].
AB  - In a pulsatile in vitro flow model with mounted concentric peripheral arterial
      stenoses, we compared the mean trans-stenotic pressure difference between pre-
      and poststenotic segment with the Doppler-estimated mean pressure gradient
      calculated according to the simplified Bernoulli equation applied over an entire
      stroke cycle. A close linear correlation was found between Doppler-estimated and
      invasively measured pressure drop values: Y = 1.13X + 0.47 (r = 0.98, SEE = 1.4
      mmHg, n = 16). The Doppler-derived overestimation of the invasively measured mean
      pressure-drop by an average of 16% (absolute values 2.2 +/- 1.7 mmHg) suggests
      that in this in vitro model a small part of the kinetic energy of the stenotic
      jet is recovered distal to the poststenotic turbulences. The difference between
      both methods is so little that the Doppler-estimated mean pressure drop is
      acceptable in concentric peripheral model arterial stenoses.

PMID- 2238815
TI  - [Diagnostic value and criteria for evaluating indirect lymphography in
      lymphedema].
AB  - To evaluate the deciding diagnostic criteria of indirect lymphography in
      lymphoedema of the leg, 91 investigations were reviewed. 72 examinations were
      from lymphoedematous legs as judged by clinical appearance and isotopic
      lymphography and 19 from healthy legs. After subepidermal infusion of adequate
      water soluble contrast media (e.g. Jotrolan) in healthy legs, 17 from 19 cases
      showed normal ellipsoid dye-deposits with normally structured lymph-collectors.
      In two cases pathological lymph-collectors were shown (specificity 89%). In the
      72 legs with lymphoedema the most prominent pathological features were altered
      lymph-collectors and/or dermal backflow. Only two cases revealed a normal pattern
      (Sensitivity 97%). Indirect lymphography therefore may be recommended as a
      sensitive but less specific diagnostic tool for proving lymphoedema in a
      suspected clinical situation.

PMID- 2238816
TI  - Venous haemodynamics of the upper extremity after subclavian vein thrombosis.
AB  - Late post-thrombotic complaints after subclavian vein thrombosis are reported
      with highly varying frequencies (8-80% severe disability). The therapeutic
      approach depends partly on this frequency. With the aim to evaluate late sequelae
      a questionnaire was answered by 26 patients with arm-shoulder symptoms leading to
      arm phlebography, but where the examination did not reveal any thrombi. 65% had
      remaining symptoms 2-9 years after the examination. 3 had to change profession.
      36 patients with phlebographically shown subclavian vein thrombosis answered the
      same questionnaire. Only 9 (25%) had remaining symptoms and in 4 it was
      classified as mild, in 4 as moderate and only in 1 patient as severe leading to
      change of profession. Venous haemodynamics in the upper extremity were also
      studied in 3 groups of patients; I) healthy volunteers (n = 16 arms), II)
      patients with arm-shoulder disabilities with negative arm phlebography (n = 7
      disabled arms, n = 7 non-disabled arms), III) patients with phlebographically
      verified subclavian vein thrombi (n = 10 arms with DVT, n = 8 arms without DVT).
      Strain gauge plethysmography was used measuring venous capacity and maximal
      venous outflow. Venous pressure measurements were made both with the arms in a
      resting position and in a military position with and without work-load. Repeat
      phlebography of arms with symptoms were made. Maximal venous outflow was
      significantly lower in arms with previous subclavian vein thrombi (p less than
      0.05) and venous pressure measurements with the arm in military position was
      significantly higher in those arms. However, no correlation between these
      measurements and the degree of arm disability was noted.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2238817
TI  - Follow-up of the long-term effect of intraarterial vasodilator administration in
      patients with PAOD by means of changes in resting arterial and venous lactate and
      pyruvate levels, and in ABB parameters.
AB  - The aim of the study was to assess, on the basis of changes in the resting
      arterial and venous values and arteriovenous difference of pH, pCO2, pO2,
      lactate, pyruvate and the lactate/pyruvate ratio in blood collected from the
      common femoral artery and vein before and after therapy, and at 4 weeks after
      therapy, the long-term effect of intraarterial vasodilator administration in 42
      lower extremities with the chronic ischaemic syndrome in stages IIb, III and IV
      according to Fontaine. Ten intraarterial vasodilator infusions containing 300 mg
      trimecaine and 60 mg papaverine in 200 ml of saline led to an increase in oxygen
      extraction from circulating blood, as demonstrated by a statistically significant
      rise in arteriovenous pO2 difference persisting as long as 4 weeks after
      termination of therapy. The finding of increased CO2 release and the permanent
      drop in venous lactate levels suggest stimulation of aerobic metabolism of the
      chronically ischaemic tissue of the lower extremity induced by intraarterial
      vasodilator administration.

PMID- 2238818
TI  - Reactive oxygen metabolites in peripheral arterial occlusive disease.
AB  - Plasma oxidant activity (marker of reactive oxygen metabolites) and the
      unfractionated leucocyte filterability rate (determined through 5 micron pore
      diameter Nuclepore filters, using a positive pressure system) were monitored in
      15 stage II peripheral vascular disease (PVD) patients before and after ischaemia
      was induced by treadmill exercise (12 degrees slope/2 km/hour). Plasma oxidant
      activity increased (+ 115%) significantly (p less than 0.001) at the maximum
      walking time, correlating (r = 0.79) with a significant (p less than 0.001)
      impairment (+23%) in the unfractionated leucocyte filterability rate. At the
      transcutaneous oxygen pressure (tcPO2) half recovery time the plasma oxidant
      activity approached basal values but the unfractionated leucocyte filterability
      rate remained significantly (p less than 0.001) impaired (+16%). It returned to
      basal values at the full tcPO2 recovery time. These results show reactive oxygen
      metabolites are released during ischaemia of the lower limbs and are correlated
      with a significant impairment in the flow properties of leucocytes.

PMID- 2238819
TI  - [Vasa vasorum of subcutaneous veins and lymph vessels].
AB  - After intraarterial ink-injection the vasa vasorum of veins and lymphatic vessels
      in adults, dead born children and fetuses were demonstrated micropreparatorily.
      In their walls the larger veins of the saphena system possess a capillary network
      corresponding to the connective tissue and muscle structures/patterns in the
      vessel wall. No vasa vasorum could be found in the subcutaneous veins less than 1
      mm in diameter. The lymphatic vessels of the inner prefascial bundle show a one
      dimensional capillary network in the outer layers of the wall. Like the vasa
      vasorum of the saphena system it develops in the second half of fetal life.

PMID- 2238820
TI  - Diabetic microangiopathy treated with elastic compression--a microcirculatory
      evaluation using laser-Doppler flowmetry, transcutaneous PO2/PCO2 and capillary
      permeability measurements.
AB  - One hundred and forty patients with diabetic microangiopathy were studied by
      laser-Doppler flowmetry--measuring skin blood flow at rest (RF) and the
      venoarteriolar response (VAR)--by transcutaneous PO2 and PCO2 measurements and by
      evaluation of capillary permeability (rate of ankle swelling = RAS). Seventy were
      treated for 12 months with below-knee, elastic stockings. Seventy patients were
      left without compression acting as a control group. After 5 and 12 months there
      were no significant changes in the control group. However there was a significant
      improvement of microcirculatory parameters in patients treated with elastic
      compression. RF (increased at the beginning of the study) decreased. The VAR
      (impaired at the beginning of the study) improved significantly. PO2 (increased
      after treatment) and PCO2 (decreased) were also positively changed by elastic
      stockings. The abnormally increased capillary permeability was also improved.
      Elastic compression seems to be useful in diabetic microangiopathy improving
      microcirculatory parameters and decreasing capillary permeability and edema.
      However further studies, treating with elastic compression more patients for
      longer periods, are needed to confirm the positive effects of elastic stockings
      in improving diabetic microangiopathy and in slowing down its rate of
      progression.

PMID- 2238821
TI  - Gluteal necrosis after acute ischemia of the internal iliac arteries.
AB  - Ligation of the internal iliac artery mostly remains without consequences because
      of the well established collateral network. In patients with compromised
      collateral circulation however, acute interruption of both hypogastric arteries
      during aorto-iliac surgery or transluminal embolisation can lead to necrosis of
      the gluteal muscles and other adjacent organs (rectum, bladder, lumbosacral
      plexus). Experience with 3 similar cases after aorto-iliac surgery demonstrates
      two main intraoperative mechanisms: 1. Embolisation, 2. Ligature of both internal
      iliac arteries in patients with compromised arteriosclerotic collaterals. Despite
      of adequate therapy, mortality is over 70%. The most important feature during
      aorto-iliac operations is to preserve at least one internal iliac artery by
      either reimplantation of the main stem or by an additional bypass to this artery.

PMID- 2238822
TI  - White fingers after excessive motorcycle driving: a case report.
AB  - An 18-year-old male presented with Raynaud's phenomenon which was found to be
      caused by occlusion of the proper palmar digital arteries on the right hand and
      obstruction of the superficial palmar arterial arch on the left hand. These
      lesions in the arteries of both hands resemble those found in patients with
      vibration-induced white fingers such as in mine or foundry workers. The only
      likely cause for the pathological vascular findings in our patient was an
      exposure to vibration due to excessive off-street motorcycle driving. Therapy
      with intraarterial prostaglandins resolved the ischemic syndrome but it promptly
      recurred when the patient resumed motor cycle driving. Therefore, we suggest that
      excessive cross country motor cycle driving may cause vibration-induced white
      fingers.

PMID- 2238824
TI  - The searching sun: the Lyeime Movement--crisis, tragic events and folie a deux in
      the Papua New Guinea highlands.
AB  - An historical crisis movement from the highlands of Papua New Guinea re-examined
      from a psychiatric point of view raises the possibility that the two leaders
      suffered from mental disorder. The principal prophet apparently had paranoid
      schizophrenia. As a middle-aged man he established the cult which spread rapidly
      in the Enga area in the 1940s at the time of first contact with outsiders. A
      surviving brother, who had also been an important figure in the movement,
      suffered a similar illness--an example of shared psychotic disorder or folie a
      deux.

PMID- 2238825
TI  - Post-traumatic stress disorder (PTSD): a review of the literature and report on
      nine cases seen in Papua New Guinea.
AB  - In 1980 the American Psychiatric Association published the third edition of the
      Diagnostic and Statistics Manual (DSM-III). The DSM-III introduced post-traumatic
      stress disorder (PTSD) as a new diagnostic category in psychiatry. This provided
      firstly a framework for studying the consequences of extremely stressful life
      events, and secondly it has stimulated a substantial number of research
      publications in this area. The purpose of this paper is to review the literature
      on PTSD and to report nine cases seen in Papua New Guinea over a period of nine
      months.

PMID- 2238823
TI  - An assessment of acetylator polymorphism and its relevance in Papua New Guinea.
AB  - A number of clinically useful drugs such as isoniazid, sulphonamides,
      procainamide and dapsone are rapidly inactivated and eliminated metabolically by
      an acetyltransferase enzyme. The rate of elimination of these drugs is dependent
      upon the level of enzymatic activity, which is known to be genetically determined
      and exhibits ethnic and geographical variation. The study of acetylation
      polymorphism therefore is important especially in view of its effect on drug
      efficacy and toxicity. Limited information is available on the acetylation status
      of Papua New Guineans. Studies conducted so far have revealed an unusually high
      frequency of the rapid acetylator phenotype (greater than 90%) in certain
      populations. This study confirms the previous observations and reviews the world
      wide distribution pattern of acetylation polymorphism.

PMID- 2238826
TI  - The first hundred referrals to a new consultation-liaison psychiatric service at
      the Port Moresby General Hospital, Papua New Guinea.
AB  - Research workers in Africa have shown that psychiatric morbidity is widespread,
      with prevalence rates ranging between 20 and 50% of the primary health care
      clinic attendance. In September 1987 a new consultation-liaison psychiatric
      service was started at the Port Moresby General Hospital. The results of a
      descriptive study of the first hundred referrals to the service are presented and
      discussed. The sources of referral were internal medicine (83%), general surgery
      (11%) and obstetrics and gynaecology (6%). There were no referrals from the
      division of paediatrics in this study. It was concluded that the results have
      demonstrated acceptance of the consultation-liaison psychiatric service by non
      psychiatric specialist colleagues.

PMID- 2238827
TI  - The effect of betel nut on human performance.
AB  - The effects of low doses of betel nut on early-stage visual information
      processing were examined, using a cross-over experimental design. Three
      assessment measures were used, critical flicker fusion (an index of the
      efficiency of the visual processing system), heart rate, and analogue scales of
      subjective alertness. Only heart rate was shown to be significantly elevated,
      immediately following betel nut administration. From these results, it was
      concluded that there is no evidence to suggest that betel nut usage facilitates
      visual information processing at low-dose levels in habituated subjects, but
      there is some evidence that peripheral stimulation occurs.

PMID- 2238828
TI  - Introducing the concept of amae.

PMID- 2238829
TI  - Fatal post-splenectomy sepsis in a Papua New Guinean highlander.
AB  - A fatal case of overwhelming post-splenectomy sepsis (OPSS) occurring 5 years
      after splenectomy for trauma in a Papua New Guinean highlander is presented. The
      diagnosis of pneumococcal infection was made from a peripheral blood smear. The
      finding of OPSS in Papua New Guinea is cited as additional evidence in favour of
      a policy of conservative management, where possible, of ruptured spleen.

PMID- 2238830
TI  - A case of pseudoanaphylactic reaction to intramuscular procaine penicillin G
      (Hoigne's syndrome).
AB  - A personal record of a pseudoanaphylactic reaction to procaine penicillin G is
      presented, together with a brief discussion of the topic. Since procaine
      penicillin is widely used in Papua New Guinea the reaction may be more common
      than is generally realized. The reaction is not a true anaphylaxis and is
      probably caused by the procaine component after inadvertent intravenous injection
      of the drug.

PMID- 2238831
TI  - Neonatal septicaemia.

PMID- 2238832
TI  - The impact of acquired immunodeficiency syndrome (AIDS) on tuberculosis control
      in Papua New Guinea.

PMID- 2238833
TI  - Cancer on the increase in Papua New Guinea: the failure of preventive measures.

PMID- 2238835
TI  - The monitoring of foodhandlers in Papua New Guinea.
AB  - In early 1987 guidelines were re-enforced for pre-employment medicals and 6
      monthly health checks on foodhandlers in the Ok Tedi mining project in Papua New
      Guinea. The health monitoring program was stepped up as a result of two typhoid
      cases imported from the highlands and catering subcontractors failing to comply
      with the necessary pre-placement medicals for foodhandlers. Highlanders made up
      28% (49/174) of the Ok Tedi catering department's workforce in 1987. The initial
      screen of 155 foodhandlers and 85 non-foodhandlers in February 1987 showed 6-7%
      of each group asymptomatically harbouring Salmonella spp. or Shigella spp. A
      second survey of 160 foodhandlers in August, including private fast-food
      establishments, detected only one Shigella boydii infection at a local fast-food
      takeaway shop. Salmonella typhi was not detected in foodhandlers but was isolated
      from two non-foodhandlers recently returned from the highlands; in one case this
      resulted in a contact becoming infected at Tabubil. Infected persons were treated
      accordingly and foodhandlers were relieved of catering duties until follow-up
      cultures proved negative. Helminth infections were detected in 38% (309/811) of
      the stool samples examined. The low prevalence of Ascaris lumbricoides (2.5%) and
      Trichuris trichiura (1.1%) acquired locally, and a significant difference
      compared with outside groups supports the view that these species have recently
      been introduced to the North Fly (Ok Tedi) region. The majority of all Ascaris
      and Trichuris infections detected (61% and 73%, respectively) were found in
      highlanders, infection rates ranging from 3 to 15% depending on province of
      origin. Infections were treated accordingly to prevent possible transmission via
      food.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238834
TI  - Diethylcarbamazine in the control of bancroftian filariasis in the highly endemic
      Ok Tedi area of Papua New Guinea: phase 1.
AB  - The effects of a well-spaced diethylcarbamazine (DEC) mass drug application in
      areas highly endemic for Wuchereria bancrofti in Papua New Guinea are not known.
      In 1986 a semi-annual single-dose 6 mg/kg body weight administration of DEC was
      initiated in the Ok Tedi area of Western Province, Papua New Guinea. The rate of
      bancroftian filariasis in the area was 39%. Within two years the rate of
      detectable microfilaraemia was reduced from 31% to 11% in the treated group. The
      mean blood density of the parasite was reduced from 79 to 19 microfilariae per 20
      microliters. A survey of untreated villages in the immediate area (not surveyed
      before 1988) showed a filariasis rate of 39%. A 14-fold difference in the total
      microfilaraemia count was noted between the two groups when 1988 data were
      compared. A reduction in the annual rate of filariasis may be monitored through a
      well-established passive case detection program for malaria. The DEC treatment
      program was well accepted despite side-effects encountered in 20% of the treated
      population early on in the program. The success of the 2-year Phase 1 program has
      expanded into an annual single-dose administration of DEC over a larger area.

PMID- 2238836
TI  - Identification of irradiated foods by the thermoluminescence of mineral
      contamination.
AB  - This investigation assessed the radiation-induced thermoluminescence (TL) of food
      minerals for identifying irradiated foods. Mineral contamination, rather than the
      inherent mineral content, of foods was studied. Positive identification of foods
      given 1-10-kGy doses depends on the contents and composition of the mineral
      contamination and the time span between irradiation and TL analysis. All 20
      irradiated spice and herb samples could be identified without comparing them with
      unirradiated material. Three out of 60 lots of spices and herbs examined so far
      were so pure that the mineral contents were too low to allow TL analysis. If the
      soil where potatoes are grown contains feldspars, sprout inhibition treatment
      with 100-200-Gy doses can also be detected for up to one year, using the 90-250
      degrees C low-temperature part of the TL spectrum for evaluation.

PMID- 2238837
TI  - The effects of gamma-irradiation on some pure aroma compounds of spices.
AB  - Chemical changes due to gamma-irradiation were investigated in 11 pure aroma
      compounds typically found in spices. Samples were irradiated with doses of 0, 10,
      and 50 kGy. The irradiation source was 60Co. Irradiated samples and unirradiated
      controls were analyzed by gas chromatography alone and coupled with mass
      spectrometry. Significant changes due to the irradiation occurred only in (+/-)
      linalool and alpha-terpineol, which are typical components of, for example,
      coriander and bay leaf. Their total amounts decreased by about 4-13% and some
      minor peaks increased as a result of irradiation. However, different results may
      be obtained when the spices themselves are irradiated.

PMID- 2238838
TI  - [Chronic use of analgesics].
AB  - Quantitative aspects of longterm analgesic intake are presented, based on a case
      control-study on the relation between regular analgesic intake and endstage renal
      failure in the area of West Berlin (1984-86). Lifetime analgesic consumption of
      more than 1000 persons were investigated. A total of 285 longterm analgesic users
      (185 cases = 35.8%; 100 controls = 19.3%) were detected. An odd ratio of 2.44
      (95% CI: 1.77-3.39) was computed. Regular analgesic intake was defined as an
      intake of at least 15 analgesic doses per month continuously over a period of at
      least 12 months. 90% of the regular users preferred mixed analgesics compounds,
      in most cases with the psychotropic additive caffeine.

PMID- 2238839
TI  - [General practitioners and internists prescribe psychopharmaceutic drugs].
AB  - An epidemiological study using data from a local German health insurance fund on
      the psychotropic drug prescription of physicians and the drug utilisation of
      their patients is presented. Taking a sample of 280 out-patients, descriptive
      methods are presented (defined daily dose (DDD), prescribed daily dose (PDD),
      active-agent-oriented classification of drugs, therapy-oriented classification of
      diagnoses). The following questions are answered by this study: Which patients
      with which indication received which dosage of which psychotropic drug for how
      long from which physicians? The patient-based structure of the data, taking into
      account the prescriptions of all physicians allows the course of therapies and
      the study of overall psychotropic medication. Prevalences estimates concerning
      the patients are also possible. Our results are compared with those of similar
      pharmaco-epidemiological studies; the difference in prevalence estimates, as well
      as advantages and possible disadvantages arising from the use of such secondary
      data base, are discussed.

PMID- 2238840
TI  - Patients compliance in an early detection program for upper aero-digestive tract
      tumours in north-eastern Italy.
AB  - An early detection program for tumours of the upper respiratory and digestive
      tract has been conducted from December, 1988 to May, 1989 in the Friuli Venezia
      Giulia region, Northeastern Italy. This region shows very high mortality rates
      for cancers in these sites. Six hundred seventy-one high risk patients (i e
      habitual smokers and/or drinkers) were referred to Ear, Nose and Throat (ENT)
      specialists from 16 General Practitioners (GPs) for a free examination as part of
      the screening program. Four hundred thirty-six patients underwent the visit (65%)
      with fifty-five precancerous lesions and eight epithelial tumours detected among
      them. This program appears to have accomplished its aims of establishing a closer
      relationship between GPs and ENT specialists, discovering early cancerous and
      precancerous lesions, and targeting high risk patients with an educational
      message against smoking and heavy drinking.

PMID- 2238842
TI  - [Butter versus margarine?].

PMID- 2238841
TI  - [Reasons for athletic activity versus inactivity of urban population of Basel
      Stadt 1988].
AB  - A representative sample of 778 inhabitants of Canton Basel-Stadt aged 16 to 75
      years were asked about their exercise habits and reasons for participating in or
      abstaining from sports (Response rate: 81%). 56% of the responders took part in a
      sport more than once a month; the percentage was higher among younger adults and
      markedly lower among obese subjects. For 27% of the "active" respondents, the
      most important single motivation for sports was "fun, pleasure und well-being",
      in 20% of the cases "fitness", in 16% "health" and in 12% "compensation for work
      and relaxation". For 32% of the "inactive" group, the main reason for abstaining
      from sports was "lack of time", for 22% "no interest" and in 16% of the cases
      "sickness or disability"; "no clubs or sports-facilities" was hardly ever
      mentioned as a reason for being physically inactive (1%). Some significant
      differences were found when sociodemographic subgroups were analysed. For
      example, "health" was more often given as a reason for sports by the elderly, and
      "compensation for work and relaxation" was more often mentioned as the level of
      education rose. "Lack of time" was a more frequent reason for being physically
      inactive among young adults, whereas "sickness" was more important among the
      elderly. A better knowledge of the relative importance of the motivation for
      leisure time physical activity is likely to be significant for effective sports
      promotion.

PMID- 2238843
TI  - [Precipitating factors for shunt insufficiency in post-hemorrhagic hydrocephalus
      in the premature infant].
AB  - Between January 1984 and March 1989 twenty-seven low birth weight infants (mean
      birth weight 1351 gm, mean gestational age 30 weeks) required shunts after
      development of a posthaemorrhagic hydrocephalus. Revision of the shunt occurred
      in 78% of the patients with a range of 1 to 11 revisions. Obstruction of the
      ventricular catheter was the main cause of mechanical complications that occurred
      in 75%. Preterm infants weighing less than 1000 gm revealed an enormous infection
      rate of 71%. Initial shunt placement in the first 8 weeks of life was more likely
      to need shunt revision (94%) than that placed at older age (44%). There was no
      difference between the type of shunt and percentage of shunt revision, but the
      Heyer-Schulte system in comparison with the Codman Uni shunt was more likely to
      have mechanical complications. Infants with Grade IV haemorrhage required the
      same percentage of revisions as those with Grade III haemorrhage. There was no
      association between preoperative therapy and the need for shunt revision. A great
      amount of erythrocytes and very low glucose levels in the preoperative CSF were
      more likely to predict shunt revision than predicted by the CSF protein.

PMID- 2238844
TI  - [Esophageal atresia and quality of life].
AB  - To evaluate the quality of life of patients with oesophageal atresia we studied
      122 questionnaires about children operated on in several centres of the Federal
      Republic of Germany. On the basis of this information, the literature, and our
      own cases, we found that early childhood is complicated by operations,
      dilatations, difficulties in swallowing and frequent pulmonary infections. These
      problems improved in most cases during the first years of life. Later on the
      quality of life can be regarded as good.

PMID- 2238845
TI  - The fate of swallowed button batteries in children.
AB  - The method of treatment and fate of 41 button batteries ingested by 34 children
      were analysed; 31 batteries were in the stomach and 10 beyond the pylorus. In 31
      batteries situated in the stomach, removal by magnet tube technique was attempted
      in 30 batteries, 25 being successfully taken out, while 5 failed passing through
      the pylorus at the duodenum. One was removed endoscopically, since a magnet tube
      was not available. The remaining 10 batteries in 10 children were found at
      different levels from the duodenum to the rectum. In addition, 5 batteries were
      pushed down from the stomach during magnet tube removal. These 15 batteries,
      located in the intestine were excreted during 35 hours. In contrast to other
      asymptomatic foreign bodies that are allowed to pass through the GI tract
      spontaneously, we feel that button batteries should be removed by magnet tube
      technique to avoid complications such as GI tract perforation with associated
      bleeding, possible mercury poisoning and burns. Magnet tube removal is a simple
      and safety method requiring neither anaesthesia nor admission.

PMID- 2238846
TI  - [Surgical therapy of malrotations in childhood].
AB  - From a total of 174 children treated with malrotations from 1971 to 1988, 148
      could be evaluated for long-term results of surgical treatment. The various
      modalities of treatment were: no correction, dissection of Ladd's bands only,
      caecoascendopexy, Ladd's procedure and the so-called total correction. Comparing
      the late results in children with and without correction it was found that those
      without correction, i.e. without pexy, had to be reoperated in 17% of the cases,
      whereas the totally corrected children required reoperation in 8% of the cases
      only. Corrected cases needed to be admitted but not operated later because of
      pain, constipation, vomiting or poor weight gain in 23%, the uncorrected ones in
      6%. Likewise, corrected malrotations resulted in complaints in 27% in contrast to
      the noncorrected ones in 9%. The conclusion is that total correction results in
      fewer reoperations but in more symptoms not requiring surgery.

PMID- 2238847
TI  - Intussusception complicated by bowel perforation during hydrostatic reduction.
AB  - Most perforations of the bowel during attempt at hydrostatic reduction of
      intussusception occur in an area of localised infarction in the normal transverse
      or left colon. An animal model of intussusception was used to find indications
      for the cause of this phenomenon. We submitted the intussuscipiens of 10
      strangulated intussusceptions in 6 dogs to a histological examination. In 6 of 10
      intussusceptions we found ischaemic changes in the mucosa of the intussuscipiens.
      In 3 cases these lesions were multiple. All lesions were found in locations where
      there was a close contact between the intussusceptum and the intussuscipiens. We
      did not find signs of impaired circulation of the whole intussuscipiens. We
      conclude that our findings give an indication that perforation of the
      intussuscipiens during attempt at hydrostatic reduction occurs through areas of
      localised ischaemic infarction on the basis of direct pressure by the
      intussusceptum.

PMID- 2238848
TI  - Air reduction for intussusception in infancy and childhood: ultrasonographic
      diagnosis and management without X-ray exposure.
AB  - For the treatment of uncomplicated intussusception in infants and children, we
      attempted air reduction without x-ray study to avoid the genetic and carcinogenic
      effects of radiation. Intussusception could generally be diagnosed by
      ultrasonography in addition to the history and typical clinical signs without
      using a barium enema. The success of reduction could also be safely evaluated
      from the disappearance of both the characteristic sonographic target sign and the
      abdominal palpable mass, and improvement in the general condition 2 or 3 hours
      after completing this procedure. This simple, cheap and clean reduction method
      was applied to 127 patients under strict indications and sedation with diazepam.
      The successful reduction rate was high (90.6%) and equal to that by hydrostatic
      reduction. Accordingly, this procedure appears to be safely applicable to the
      management of uncomplicated intussusception in infancy and childhood.

PMID- 2238849
TI  - Surgery in unilateral multicystic kidney.
AB  - During a 15-year period 29 patients were treated for unilateral multicystic
      kidney. The diagnosis was obtained from antenatal ultrasonography in 17 cases,
      investigation of an abdominal mass at routine palpation in 10, UTI investigation
      in 1 and uraemia investigation in 1. Eleven patients had associated
      malformations. Further investigations included ultrasonography, intravenous
      pyelography, micturition uretrocystography and in a few cases computed tomography
      and Dimercapto-succinic acid (DMSA) scan. Percutaneous pyelography was performed
      in 9 cases. Twenty-six children were operated on and 3 were not operated, of
      which 1 with severe cardiac malformations, died. The age at operation was under 6
      months in 14 cases and between 6 and 12 months in 8. Four children developed
      hypertension preoperatively but the hypertension disappeared within 1 week
      postoperatively in all cases. The indication for surgery in unilateral
      multicystic kidney seems to be clear if the patient is symptomatic. In the
      asymptomatic patient, the complications of a remaining multicystic kidney like
      hypertension, malignancy, infection and pain suggest a surgical approach at
      around 6 months of age.

PMID- 2238850
TI  - Current management of childhood neuropathic bladder: review of 156 cases.
AB  - Management of neuropathic bladder aims to maintain renal function and to secure
      appliance-free continence; because of recent advances, both objectives are
      theoretically attainable. Our present scheme of management, based upon
      preliminary video-urodynamic assessment, is outlined. In the years 1984-1988 we
      treated 156 children suffering from neuropathic bladder. In 5 per cent of cases
      the upper renal tracts have deteriorated on treatment; in patients presenting
      with upper tract dilatation, improvement has been obtained in 68 per cent. A
      quarter of the patients were considered too generally disabled to achieve
      appliance-free continence; these have been managed by penile appliance,
      indwelling urethral catheter or, occasionally, urinary diversion. For three
      quarters of the patients, most ambulant, appliance-free continence was the goal;
      68 per cent have been managed nonsurgically and 32 per cent surgically. Reliable
      day-time continence has been achieved in 78 per cent of the former and 86 per
      cent of the latter, 80 per cent overall.

PMID- 2238851
TI  - Tissue expansion facilitates operation of large myelomeningoceles.
AB  - Two children had delayed operations for large myelomeningoceles. As a preparatory
      operation one silicon tissue expander was inserted on each side of the lesion and
      successively inflated by weekly injections of saline. After an expansion time of
      5 to 6 weeks the definitive procedure was performed. The newly formed fibrous
      capsule greatly facilitated the reconstruction of the spinal canal. The surplus
      of skin and subcutaneous tissue allowed the large defects to be easily close in
      the midline. Both children managed quite well postoperatively.

PMID- 2238852
TI  - Postoperative recurrence of splenic epithelial cyst; treatment with subtotal
      splenectomy.
AB  - Three children were operated upon for congenital epithelial cysts of the spleen
      in the five-year period 1983-1987. Their mean age was 9.8 +/- 2.3 years. Two of
      them were boys. They comprise 1.6% of the surgical pathology of the spleen in our
      hospital, which is a Reference Centre for congenital haemolytic diseases. Two of
      the children had been suffering from intermittent colic pain in the left
      hypochondrium with a tender palpable mass for a short while to the present day.
      The third patient was asymptomatic; a splenic cyst with calcification of its wall
      was accidentally revealed by a plain x-ray of the abdomen. Contrast
      gastrointestinal studies and intravenous pyelography helped us with the
      diagnosis; they indicated a splenic mass that caused visceral displacement
      adjacent to the spleen. Ultrasonography proved the cystic nature of the
      enlargement of the spleen in all the cases. Marsupialization was performed in one
      patient and removal of the cysts in the other two. All three patients were
      followed up and re-checked 1-5 years postoperatively (May-June 1988). In one boy
      who underwent removal of the cyst four years ago, recurrence of the splenic cyst
      was revealed by ultrasonography, CT scan and radionuclide scan. Subtotal
      splenectomy was performed. The remaining upper pole is supplied with blood by the
      short gastric arteries. The recurrence was attributed to coexistence of invisible
      tiny cysts that had remained in the splenic tissue after the dissection of the
      major cyst during the previous operation. Subtotal splenectomy is an acceptable
      alternative procedure for splenic cysts.

PMID- 2238853
TI  - [Mediastinal sequestration with ectopic pancreatic tissue].
AB  - We report on a five-year-old patient with a chronic pneumonia of the upper left
      lobe of the lung, in whom a broncho-enteric sequestration with ectopic pancreas
      was found in the mediastinum. Reviewing the literature, different theories on the
      embryogenesis of this extremely rare anomaly are discussed.

PMID- 2238854
TI  - Primary Burkitt's lymphoma of the appendix.
AB  - Appendicitis is a very rare presenting symptom of abdominal Burkitt's lymphoma.
      Only four cases have previously been identified in the literature, all of them
      males. This is the first reported case of a female as well as the youngest and is
      representative of the therapeutic considerations in this unusual manifestation of
      the disease.

PMID- 2238855
TI  - Accessory scrotum: report of a case.
AB  - Perineal ectopic (accessory) scrotum is an uncommon anomaly. We could trace only
      5 such cases reported in the literature (8, 10, 11). A case of accessory scrotum
      and glandular hypospadias has been presented and discussed.

PMID- 2238857
TI  - Oesophageal rupture due to air-blast injury in children: case report and review
      of the literature.
AB  - Perforation of the oesophagus is a surgical emergency that is usually lethal if
      untreated and commonly fatal if treatment is delayed. The most common type of
      trauma causing oesophageal perforation is a penetrating injury. Oesophageal
      ruptures due to external blunt or air-blast injuries are very rare. We report for
      the first time a case of oesophageal rupture related to air-blast injury to the
      chest and upper abdomen in a child.

PMID- 2238856
TI  - Accessory scrotum with lipoma in an infant.
AB  - We report on a 2-year-old male infant with accessory scrotum with lipoma
      presenting a perineal mass. Preoperatively no abnormality in the urinary tract
      and the anorectum was demonstrated. The tumour was resected and perineoplasty was
      performed. The resected specimen histologically revealed lipoma with tissue
      suggestive of scrotum. The patient recovered well and was discharged with no
      clinical complaints. This rare congenital anomaly is described in this paper. The
      slight continuity between the left scrotum and an accessory scrotal tissue in
      this case may suggest that this rare anomaly was derived from some abnormality in
      the migration of precursor tissue of scrotum.

PMID- 2238858
TI  - [Inflammatory changes in the urogenital tract and therapeutic possibilities in
      the course of adjuvant disease in the male rat].
AB  - The adjuvant disease of the rat is an experimental disease, not only important as
      an arthritis model, but also as an "urethritis model" in clinical and
      therapeutical respects. The polyarthritic syndrome in rats following injection of
      Freund's adjuvant also shows regularly involvement of the genitourinary system.
      Urethritis, cavernitis, and balanitis are common inflammatory manifestations of
      the penis, which can mostly be observed. In the peritesticular and periepididymal
      fat, granulomata and nonspecific inflammatory reactions do occur. Prostata,
      bladder, kidneys, testes, and epididymis are seldom involved in the inflammatory
      process. This therapeutical study demonstrated clearly that acetylsalicylic acid
      (dosage: 80 mg/kg BW/day) cannot be of benefit for these changes. However, it was
      possible to significantly influence the inflammatory changes by using
      prednisolone (dosage: 1.5 mg/kg BW/day).

PMID- 2238859
TI  - [Pharmacokinetic study of percutaneous absorption of salicylic acid from baths
      with salicylate methyl ester and salicylic acid].
AB  - Percutaneous uptake of methyl salicylate was investigated by use of Leukona
      Rheumabad (Dr. Atzinger) in 10 volunteers. Percutaneous uptake of salicylic acid
      was investigated by use of Contrheuma-Bad (Spitzner) in 15 volunteers. By use of
      bathing concentration of 0.03 g/l of methyl salicylate, plasma levels of 220-820
      ng/ml were found 1 h after beginning, and 46-193 ng/ml after 6 h. 2.3-8.7 mg of
      salicyluric acid was eliminated on the first day, and 0.47 to 1.48 mg on the
      second day. By use of bathing concentration of 0.33 g/l of salicylic acid
      constant plasma levels of 10 +/- 1.27 ng/ml were found in a period of 24 h. The
      renal elimination of 0.92 +/- 0.14 at first day, 0.72 +/- 0.11 at second day, and
      0.50 +/- 0.08 mg salicyluric acid at third day was found. Salicylic acid was
      eliminated 0.086 +/- 0.009 resp. 0.079 +/- 0.007 resp. 0.043 +/- 0.011 mg by
      those days. The half-time of elimination in urine after methyl salicylate bathing
      is (as with injected salicylic acid) between 2.4 to 4 h. Conversely half-time of
      elimination in urine by salicylic acid bathing is between 30 to 50 h, and is
      greater with salicylic acid bathing than with other application forms. This is in
      agreement with earlier examinations and results which point out the deposition of
      salicylic acid in skin. Any definitive deposition of salicylic acid in skin by
      methyl salicylate bathing was not found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238860
TI  - Joint manifestations of Lyme borreliosis in Czechoslovakian patients.
AB  - Involvement of the musculoskeletal system in 50 Lyme borreliosis patients seen in
      Czechoslovakia is described. Thirty-three patients reported tick bites or that
      they had removed a tick, four patients had been bitten by some other insect. Skin
      reaction following tick bite were found in 29 patients. Neurologic involvements
      have been described in 40 subjects. In one patient complete heart block developed
      after ECM, so that a permanent pacemaker was necessary for two weeks. Mainly
      three types of involvement of the musculoskeletal system were observed, mostly as
      intermittent episodes of arthralgia or migratory musculoskeletal pain. In 37
      patients brief attacks of monoarthritis or asymmetrical oligoarthritis were seen,
      chiefly of intermittent subacute course. Chronic arthritis was diagnosed in seven
      cases, sacroiliitis in four patients. The authors discuss differential diagnosis,
      especially in patients with chronic joint involvement.

PMID- 2238861
TI  - [The HLA system and rheumatoid arthritis].
AB  - Recent developments in molecular biology allow a more detailed description of and
      insight into the interaction between T-cell receptor, antigen/peptide, and MHC
      gene products. These advances also provide a better approach to understanding the
      molecular genetics of susceptibility to certain diseases. This review tries to
      interpret MHC structure/function relationships, using rheumatoid arthritis as a
      paradigm. The following aspects are of special importance: Most likely MHC class
      II gene products are directly involved in the pathogenic process and are not only
      to be considered as "markers". Susceptibility to rheumatoid arthritis is not
      associated with a single serologically defined HLA-specificity (e.g., HLA-DR4).
      However, there is substantial evidence that shared functional epitopes on
      different MHC molecules (e.g., HLA-DR1 and HLA-DR4 subtypes) confer risk for
      rheumatoid arthritis.

PMID- 2238862
TI  - [Destructive spondylopathy in chondrocalcinosis ("pseudospondylodiscitis")].
AB  - A case of degenerative spondylopathy in chondrocalcinosis (pseudospondylo
      discitis) is presented. The incidence of vertebral involvement in
      chondrocalcinosis reported in the literature is reviewed. In approximately 4-10%
      of all cases of chondrocalcinosis the vertebral column is involved as well.
      Especially in elderly patients, a differential diagnosis based on clinical,
      radiological and laboratory findings must include infectious spondylodiscitis. In
      the presence of additional degenerative spondylolisthesis, as well as
      radiculopathy and/or symptoms of spinal stenosis, surgery is often performed.
      However, there are cases reported in which improvement occurs after spontaneous
      vertebral fusion without surgical intervention. If any vertebral change is
      detected that is suggestive of chondrocalcinosis, even in asymptomatic patients,
      it is recommended to obtain radiographs of other joints, for example, the knee
      and wrist, which are frequently also involved in chondrocalcinosis.

PMID- 2238863
TI  - [Diabetic osteoarthropathy of the foot].
AB  - Neuropathic joint disease (described by J.M. Charcot in 1868) is now most
      commonly seen in patients with diabetic mellitus. We present a patient suffering
      from a characteristic diabetic neuro-arthropathy of the foot. We report the
      clinical features, roentgenographic signs, new diagnostic possibilities, and
      treatment.

PMID- 2238864
TI  - [Causality of neurotic and psychosomatic diseases].

PMID- 2238865
TI  - [Disputation of the manuscript by W.Brautigam: causality of neurotic and
      psychological dieases].

PMID- 2238866
TI  - [Predisposition and environment. Remarks on W. Brautigam's "Causality in neurotic
      and psychosomatic diseases"].

PMID- 2238867
TI  - [Thoughts on the article by W. Brautigam: Causality in neurotic and psychosomatic
      diseases].

PMID- 2238868
TI  - [The tension area practice/theory in medicine. Commentary on the article from
      Walter Brautigam].

PMID- 2238869
TI  - [Opinion on the article by Prof. Dr. W. Brautigam. Causality in neurotic and
      psychosomatic diseases].

PMID- 2238870
TI  - [Comments on " Causality in neurotic and psychosomatic diseases" from Walter
      Brautigam].

PMID- 2238871
TI  - [Structural analysis of social behavior in training and research. A contribution
      to the "functional histology" of the psychotherapy process].
AB  - To be able to identify qualitative differences in the results of
      psychotherapeutic activity and to establish a relationship between those results
      and the particularities of the treatment process involved, the problems of the
      patient, the relevant events during therapy, and therapeutic results must be
      interrelatable both terminologically and theoretically (P-T-O congruence; Strupp
      et al., 1989). If, therefore, the relevant qualities of the relationships
      involved in interpersonal transactions during the therapeutic process are to be
      represented adequately and independently of schools, an appropriate instrument is
      required for both clinical and research use. This instrument is introduced here
      in the form of the Structural Analysis of Social Behavior (SASB) after Lorna
      Smith Benjamin by means of the key question: Who acts how toward whom and how
      does the latter react to this?

PMID- 2238872
TI  - [Social integration of Crohn disease and ulcerative colitis patients. Study of
      the relations of somatic, psychological and social factors].
AB  - 63 patients with Crohn's disease and 58 patients with ulcerative colitis were
      tested with the "Fragebogen zur sozialen Integration" (FSI, questionnaire of
      social adjustment), the "Freiburger Personlichkeitsinventar" (FPI) and a
      semistandardized interview and were compared with surgical controls. Activity,
      course and symptoms of the disease were registered. We found significant
      restrictions in working and lesiure activities, partnership and sexual life in
      patients with inflammatory bowel disease. Social adjustment of patients with
      Crohn's disease was more dependent on disease activity than in patients with
      ulcerative colitis. Social impairment in patients with Crohn's disease correlated
      with higher stool frequency and abdominal pain, in patients with ulcerative
      colitis with reduced general state of health, tiredness and limpness. In the
      "Freiburger Personlichkeitsinventar" (FPI) the patients with chronic inflammatory
      bowel disease described themselves significantly more nervous, inhibited,
      reserved and less aggressive, sociable and composed. The FPI scores in patients
      with Crohn's disease depended more on disease activity and on somatic symptoms
      than in patients with ulcerative colitis.

PMID- 2238873
TI  - [Psychosomatic medicine for research and therapy in the field of human
      relations].

PMID- 2238874
TI  - [Obstructive urine transport disorders of the upper urinary tract--pelvi-ureteral
      obstruction].
AB  - In the present paper a review is given on etiology, pathology, morphology and
      pathophysiology of ureteropelvic junction obstruction. According to own
      experience and a literature review the current diagnostic and therapeutic
      procedure are evaluated with respect to their clinical relevance.

PMID- 2238875
TI  - [Electron microscopic study of calcium oxalate microcrystals].
AB  - Morphology and size distribution of calcium oxalate microcrystals in the urine of
      healthy people and calcium oxalate stone formers are examined by scanning
      electron microscopy. The data are compared with coulter-counter investigation and
      the following clinically important result is discussed. This initial crystal
      population be composed of single crystals and in sick people larger crystals have
      been found.

PMID- 2238876
TI  - [Studies on the crystallization tendency of calcium oxalate in urine--a study of
      experimental and computer-assisted determination of the risk of urinary calculi
      formation].
AB  - In this study a method o the semiquantitative determination of the
      crystallization tendency for calcium oxalate in urine is described. It is based
      on the addition of a well-defined amount of ammonium oxalate (31.3 nmol) to a
      urine sample (30 ml). The so caused clouding of the urine is measured by a
      photometer 20 min later. The method guarantees an acceptable reproducibility and
      is simple to be performed in each clinical laboratory. The results of
      mathematical correlation and discriminant analysis show that the calcium
      concentration influences the crystallization of calcium oxalate as most of all
      urinary constituents. Furthermore, evidence of a high specificity of the method
      is given by a reclassification rate of about 80% in the discriminant analytical
      computation.

PMID- 2238877
TI  - [Severe oligozoospermia as a sequela to partial obstruction of the seminiferous
      tubules].
AB  - Arguments for the presence of a partial obstruction as cause of severe
      oligozoospermia may result from following findings. 1. The frequency of normal
      FSH values in oligozoospermia (44.9%) do not differ significantly from cases with
      azoospermia (50%). 2. Including a quantitative analysis of testicular morphology
      5 out of 63 patients (7.9%) suffering from severe oligozoospermia show a normal
      spermatogenesis. 3. The frequency of this constellation in our material including
      severe oligozoospermia, normal testicular volume, normal FSH value, and normal
      spermatogenesis agree with few findings in the literature. The number of
      etiological factors of partial obstruction require also invasive diagnostical
      procedures like vas deferens radiography and surgical exploration.

PMID- 2238878
TI  - [Effects of chemotherapy and radiotherapy of malignant testicular tumors on
      residual testicular tissue].
AB  - By morphologic and morphometric investigations of the residual testis after
      treatment of testicular cancer the deleterious effect of chemo- and radiotherapy
      are estimated. Approximately 4-5 years after treatment the reversibility of
      spermatogenesis is better in patients chemotherapy than in patients after
      radiotherapy.

PMID- 2238879
TI  - [Studies on the occurrence of texture types in calcium oxalate urinary stones].
AB  - A review of texture types of calcium oxalate calculi and a pattern of 4 basic
      texture types was presented. A method of texture classification as a part of the
      routine polarization microscopy urinary calculus analysis was developed. Thereby
      a representative material could presented on the distribution of texture types. A
      connection between pathological urinary parameters and the texture type was
      demonstrated.

PMID- 2238880
TI  - [Urolithiasis in 2,8-dihydroxyadeninuria: presentation of 3 additional cases].
AB  - To the now 17 case reports in caucasian patients of an urolithiasis in a rare
      purine metabolism disorder 2,8-dihydroxyadeninuria due to missing activity of
      adenine phosphoribosyltransferase 3 further cases are presented. Firstly, a
      monozygotic twin pair is afflicted (13-year-old boys). All calculi be composed of
      pure 2,8-DHA, except a mixed calculus in a 38-year-old man containing of 80% 2,8
      DHA and 20% calcium oxalate. The actual literature is reviewed.

PMID- 2238881
TI  - [Simultaneous determination of the GRF and the ERPF (effective renal plasma flow)
      using a single blood sample in the slope clearance with 99mTc-DTPA and I 131
      hippurate].
AB  - In patients with various indications to renal split function diagnostics the
      plasma slope clearance of the Tc99m-DTPA and J131-Hippurate to the estimation of
      GFR and ERPF were performed with two or three blood samples in the
      monocompartment model (1 KM). In comparison these functional parameters were
      calculated on the basis of the only least blood sample (single-point procedure-
      EPV). The results of linear regression GFR (1 KM) = 12.7 + 0.978 * GFR (EPV), r =
      0.986, N = 102 or ERPF (1 KM) = 22 + 1.13 * ERPF (EPV), r = 0.889, N = 68 may
      recommend the use as patient-safe procedure especially in poor venous access. Two
      short BASIC programs for estimation of GFR and ERPF are presented and the error
      ranges discussed.

PMID- 2238882
TI  - [Obstructive urine transport disorders of the upper urinary tract--pregnancy and
      iatrogenic lesions].
AB  - The most important disturbances of pregnancy excluding the birth canal are
      complications due to diseases and alterations of the kidney and the urinary
      tract. The urinary transport disorders are of significant importance; frequency
      and clinical relevance and follow-up are presented. In the second part an
      overview to urinary tract disorders due to iatrogenic injuries is given.

PMID- 2238883
TI  - [Diagnosis and therapy of single kidney cysts].
AB  - By means of observation of 191 own patients suffering from a symptomatic single
      renal cyst and a literature review, epidemiology, clinical presentation,
      diagnostic procedures and therapy are presented. The significance of
      ultrasonography and computerized tomography are emphasized. For single, symptom
      free cysts besides regular ultrasonographic examinations no further therapy is
      necessary. In case of a required therapeutic procedure, an open resection of the
      cyst should be preferred to percutaneous a required therapeutic procedure, an
      further therapy is necessary. In case of a required therapeutic procedure, an
      open resection of the cyst should be preferred percutaneous approach.

PMID- 2238884
TI  - [Factors influencing the result of kidney transplantation with special reference
      to the HLA system in conventional immunosuppression].
AB  - Among 331 recipients of cadaveric renal allografts, transplanted from 1976 to
      1986 at the Rostock Transplant Center the graft survival rates have been
      analyzed. All patients have been treated by conventional immunosuppressive
      therapy using azathioprine and prednisolone. A relation between graft survival
      and immunological factors was found: the better the HLA match, the better the
      transplant results. The necessity of a restrictive transfusion regime was
      stressed. The higher the number of pretransplant transfusions, the higher is the
      panel reactivity with following lower graft survival. Cold ischemic time was
      without influence on graft survival. The introduction of cyclosporin may improve
      the graft survival rate as known of 10-20%.

PMID- 2238885
TI  - [Precision of data from models of sodium kinetics in hemodialysis].
AB  - The 1-pool-model of sodium kinetics during hemodialysis is based upon the
      assumption of an immediate compensation of osmotic shifts. This assumption is not
      supported by measurements of plasma sodium, total protein concentration and
      colloid osmotic pressure kinetics. When a high dialysate sodium concentration is
      applied, an inflow of sodium into the plasma space occurs, which results in an
      osmotic suction and thus a plasma dilution. These conditions can be represented
      by a 2-pool-model taking into consideration capillary filtration. The results
      indicate that following the first treatment period the sodium kinetics are
      sufficiently explained by a 1-pool-model with the total body water as
      distribution volume. Both the plasma sodium concentration and the eliminated
      sodium at the end of a hemodialysis treatment can be described to an acceptable
      level by the 1-pool-model. The input of the measured in-vivo sodium dialysance
      value (or alternatively the urea clearance) is necessary.

PMID- 2238886
TI  - [Measuring the thickness of the peritoneum as a dialysis membrane using various
      osmolar concentrations of dialysis fluid].
AB  - Thickness measurements solutions on the rat peritoneum using peritoneum using
      peritoneal dialysis solutions of various osmolalities show a marked reduction of
      the distances between capillaries and peritoneal surface with increasing
      osmolality. This may caused by a dehydration of the peritoneum and support the so
      called canaliculus theory. If the dehydration of the peritoneum may outlast
      temporal the dialysis cycle with higher osmolar solution, it could be an
      explanation for the efficacy of following low-molecular solutions.

PMID- 2238887
TI  - Detection of circulating immune complexes in MRL mice with different forms of
      glomerulonephritis.
AB  - Serum levels of circulating immune complexes (CIC) in MRL mice were determined
      using the 125I-C1q binding test and a conglutinin enzyme assay. The serum 125I
      C1q and conglutinin binding capacity were correlated to the development of
      different forms of glomerulonephritis (GN) detected by light microscopy. The
      study was carried out with a total of 132 MRL/MpJ-lpr/lpr and MRL/MpJ(-)+/+ mice
      of different age groups. From the age of 3 months on an enormous elevation of C1q
      and conglutinin-binding CIC occurred in MRL/MpJ-lpr/lpr mice, while in MRL/MpJ(
      )+/+ mice the mean values of CIC remained low in all age groups studied. The
      results corresponded to histopathological glomerular findings. In lpr/lpr-mice,
      from the age of 3 months on, extremely severe proliferative forms of GN occurred.
      In most cases of +/+(-)mice examined comparatively mild glomerular lesions were
      found. In serum samples of Han:NMRI and C3H/He mice an increase of conglutinin
      binding material was found in certain age groups, while the levels of 125I-C1q
      binding activity remained low in mice of all age groups studied.

PMID- 2238888
TI  - [The sodium excretion behavior of anesthetized and conscious spontaneously
      hypertensive (SHR) and normotensive (WKY) rats].
AB  - Urethane-anesthetized and conscious, immobilized SHR subjected to osmotic
      diuresis, responded to intravenous saline loading with a larger natriuresis than
      WKY-rats due to an increased urine sodium concentration without differences in
      urine flow. Blood pressure and heart rate reactions after saline loading were
      qualitatively different in anesthetized and conscious rats. The magnitude of
      these changes was larger in WKY than in SHR in both experimental groups.

PMID- 2238889
TI  - Effect of high sodium and high water intake on 24 h-potassium balance in dogs.
AB  - The influence of different amounts of oral sodium intake combined with high oral
      water intake on potassium excretion and plasma potassium concentration (PK) was
      evaluated. Female beagle dogs (11-16 kg) were divided into 2 groups: 1. Normal
      Sodium and high Water Intake (NSWI): 2.5 mmol Na, 3.55 mmol K, 91 ml H2O, and 277
      kJ per kg body mass and 24 h (31 24 h-balance studies with 11 dogs). 2. High
      Sodium and high Water Intake (HSWI): Same diet as NSWI but 14.5 mmol Na x kg body
      mass-1 x 24 h-1 (55 24 h-balance studies with 21 dogs). The 24 h-balance studies
      were performed after different periods of time after onset of the respective diet
      (dogs in metabolic cages). Plasma sodium concentration (PNa) on NSWI was 148.4 +/
      2.6 mmol x 1(-1), whereas it was lower on HSWI (145.9 +/- 2.4 mmol x 1(-1). The
      lower plasma aldosterone concentration (PAC) on HSWI (24 +/- 8 pg x ml-1)
      compared to NSWI (67 +/- 38 pg x ml-1) may account for the lower PNa on HSWI. 24
      h-sodium excretion was 93.6 +/- 6.5% of intake (%i) on HSWI and 91.5 +/- 20.7% i
      on NSWI. 24 h-water excretion was not different between both groups (81 +/- 7%
      i). PK was 3.93 +/- 0.25 mmol x 1(-1) on NSWI regardless of the time the dogs
      were on NSWI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2238891
TI  - [Marburger prophylaxis model and its spread in the districts--report after 8
      years].

PMID- 2238890
TI  - Effects of age and body mass of recipients on survival of transferred embryos in
      mice.
AB  - To examine the effects of age and body mass of recipients on embryo survival
      during gestation, ICR embryos were transferred to nulli- or primi-parous females
      of 4 strains of mice. Out of 530 recipients, 383 (72.3%) produced a litter.
      Transfer of 3,465 embryos to 383 recipients resulted in production of 1,637 pups
      born alive, an overall rate of embryo survival of 47.2 +/- 1.1%. Regression
      analyses revealed that embryo survival decreased in older recipients and
      increased in heavier recipients. The results were consistent in each
      parity/strain group and all groups combined.

PMID- 2238892
TI  - [Toothpastes are more than polishing agents].

PMID- 2238893
TI  - [War: the grim teacher of face surgery].

PMID- 2238894
TI  - [Dental documentation with the office computer].

PMID- 2238895
TI  - [Development of expert abilities in dental practice].

PMID- 2238896
TI  - [Practice justified rubber dam technic].

PMID- 2238897
TI  - [Much treatment in spite of dentists' own serious physical problems].

PMID- 2238898
TI  - [Clinical matters of rhythm disturbances].

PMID- 2238899
TI  - [Clinical, radiological and surgical therapeutic aspects. Mesiodens].

PMID- 2238900
TI  - [Dentist of the future without helper?].

PMID- 2238901
TI  - [Computer supported radiographic interpretation in everyday practice].

PMID- 2238902
TI  - [RadioVisioGraphy: an innovation in dental radiography technic].

PMID- 2238903
TI  - [Problems of epithetic concerns of facial defects].

PMID- 2238905
TI  - [Non-precious alloy double crowns. Dental technic position].

PMID- 2238904
TI  - [Real quality is only found after many years].

PMID- 2238907
TI  - [EDP in dental office: present state of the art].

PMID- 2238906
TI  - [Transcortical anchorage of subperiosteal splints: biomechanics and case report].

PMID- 2238908
TI  - [Selection criteria of dental EDP-systems].

PMID- 2238910
TI  - [Are confectioner's caries still an occupational disease?].

PMID- 2238909
TI  - [EDP in dental practice. Future outlook].

PMID- 2238911
TI  - [Dental importance of Morbus Bourneville-Pringle (tuberous sclerosis)].

PMID- 2238912
TI  - [Pathophysiology of marginal periodontitis].

PMID- 2238913
TI  - [T-scan--possibilities and limits of new occlusal diagnostic procedure].

PMID- 2238914
TI  - [Intramuscular tongue lipoma].

PMID- 2238915
TI  - [Dental group prophylaxis in kindergarten].

PMID- 2238916
TI  - [Office hygiene: protection for patient and dental team].

PMID- 2238917
TI  - [Esthetic posterior restoration--a field with limitless possibilities?].

PMID- 2238918
TI  - [Materials in tooth retention: adhesive technics belong to the future!].

PMID- 2238919
TI  - [Dental care in East Germany--an additional need].

PMID- 2238920
TI  - [Investigation of preventive fissure sealing in caries prone dentition].

PMID- 2238921
TI  - [History of calcium hydroxide in dentistry].

PMID- 2238922
TI  - [Amalgam?].

PMID- 2238923
TI  - [Caries prevention with fluoride--no risk for health].

PMID- 2238924
TI  - [Intraligamentary anesthesia in dental practice: clinical study].

PMID- 2238925
TI  - [Composite materials in posterior region: indications].

PMID- 2238927
TI  - [Nutrition and nutritional guidance--treatment needs for dentists].

PMID- 2238926
TI  - [State of dental implantation in Hungary].

PMID- 2238928
TI  - [Prevention with fissure sealants].

PMID- 2238929
TI  - [Activity of prevention aide in lower school].

PMID- 2238930
TI  - [Oral hygiene--dental competence is questioned!].

PMID- 2238931
TI  - [Complementary diagnostic and therapeutic methods].

PMID- 2238932
TI  - [Radiographic diagnosis and clinical procedures with gutta percha points for root
      canal therapy].

PMID- 2238933
TI  - [Possibilities for hypnosis in dental practice].

PMID- 2238934
TI  - [Development of dental income].

PMID- 2238935
TI  - [Safety measures in dental practice--what should be watched?].

PMID- 2238936
TI  - [Quality and security of single use gloves].

PMID- 2238937
TI  - [New possibilities of gingivitis and plaque prevention].

PMID- 2238938
TI  - [Diffusion of chlorhexidine-C14 in dental enamel].

PMID- 2238939
TI  - [Tooth abnormalities under different considerations of the distal end of dental
      arch].

PMID- 2238940
TI  - [Occlusal surface structure in erosion using scanning electron microscopy].

PMID- 2238941
TI  - [Posterior registration of articulated total prosthesis].

PMID- 2238942
TI  - [Dental prophylaxis from peoples' point of view].

PMID- 2238944
TI  - [Numerical steered finishing of prosthesis--start of a new era in dentistry?].

PMID- 2238943
TI  - [Periodontology and function teaching].

PMID- 2238945
TI  - [Changes in orthodontic findings in dyskinesia and dysgnathia after myofunctional
      therapy].

PMID- 2238946
TI  - [Significance of ISO-Norm 6474 for aluminum oxide implants].

PMID- 2238947
TI  - [Antimicrobial containing impression and model materials for infection prevention
      in the laboratory].

PMID- 2238948
TI  - [Dental care in Norway].

PMID- 2238949
TI  - [Aspects of use of new radiograph direct enlargement in dentistry].

PMID- 2238950
TI  - [Occlusal surface modelling: individual buildup of finished pieces].

PMID- 2238951
TI  - [Morita Panex-AC panoramic radiograph with autofocus system and automatic
      lighting].

PMID- 2238952
TI  - [Pathologico-anatomic findings in spontaneous abortion and induced abortion
      during the 2nd pregnancy trimester].
AB  - Reported in this paper are results obtained from morphological investigations of
      200 fetal abortions which had occurred in the fourth to sixth months of
      pregnancy. They were spontaneous abortions and abortions induced primarily for
      fetal indications (31 cases). Causes are subdivided in this report by placental,
      fetal, and maternal factors. Fetal causes accounted for 18.5% of all cases (most
      of them fetal malformations, induced abortions included). Maternal causes
      accounted for 7.5%, among them edema-proteinuria-hypertension (EPH) gestosis and
      premature rupture of the amnion. No unambiguous clinical or morphological
      findings were established as causes in 36 cases, i.e. 18%. The majority of all
      causes, 55.5% was related to placental factors, among them impaired maturation of
      the placenta in 14.5%, disorders in maternal circulation in 17%, and inflammatory
      alterations in 23.5%. Early disorders in placentation accounted for a
      conspicuously high number of after-birth findings (complex early impairment of
      placental maturation in 28.6%), and so did maternal circulatory disorders,
      including retroplacental hemorrhage (55.2%), as well as decidual and membranous
      inflammations (43.4%).

PMID- 2238953
TI  - [Non-Hodgkin's lymphoma of the thyroid gland. Morphologic and immunohistochemical
      findings in 2 cases].
AB  - Described in this paper are two cases of non-Hodgkin lymphoma (NHL) of the
      thyroid gland in women with Hashimoto's thyroiditis. NHL may be misinterpreted
      for its histological similarity to anaplastic thyroid carcinoma. The
      immunoperoxidase technique can be used with good success to confirm the
      lymphocytic origin of tumor cells.

PMID- 2238954
TI  - [Endophlebitis hepatica obliterans. Unusual cause of liver insufficiency in early
      childhood in a dizygotic twin].
AB  - Findings recorded from obliterative hepatic endophlebitis are described in this
      paper and are compared with international literature. They had been obtained from
      a male twin who had died with clinical symptoms of hepatic failure. Differential
      diagnosis of liver insufficiency in early childhood is discussed in some detail.
      Also recorded was obliterative angiitis of intramural blood vessels in the ileum.
      Systemic vasculitis is postulated, possibly developed on the basis of an
      immunological reaction. Intra-uterine infection had probably been the most likely
      cause.

PMID- 2238955
TI  - [Tumor progression and metastasis].
AB  - The heterogeneity of cells capable of metastasation has proved to be the greatest
      obstacle to successful treatment or to prevention of metastatic diseases. This
      variety appears to be attributable to processes of selection. Cytobiological
      investigations which are helpful in casting some light at selective mechanisms of
      metastasation may, perhaps, make substantive contributions to cancer therapy.

PMID- 2238956
TI  - [Effect of regional centralized treatment on chances of survival in rectal cancer
      in East Germany].
AB  - Based on cases of rectum-carcinoma reported to the National Cancer Registry a
      population based method is demonstrated to measure the influence of a regional
      centralized treatment on the relative survival rates for cancer patients. This
      new approach use a centralization-index, characterizing the centralization of
      treatment activities in single countries. It is shown, that the end results in
      regions with a high index are much better than that in other regions.

PMID- 2238957
TI  - [The value of positron emission tomography in the diagnosis of recurrent rectal
      cancer].
AB  - In 21 patients with clinically suspected recurrent rectal cancer showing a mass
      in the pelvic CT scan, Positron Emission Tomography (PET) was performed to
      measure metabolic rate of the mass. In 13 of the 21 patients an increased F-18
      Fluorodeoxyglucose (FDG) uptake in the suspect tissue could be found. All of
      these patients were proven to suffer recurrent cancer by biopsy. 8 of the 21
      patients showed normal uptake and 7 of them revealed scar tissue by histology.
      Therefore PET could distinguish clearly between cancer and scar tissue.

PMID- 2238958
TI  - [Surgical and oncologic principles of the removal of the rectum].
AB  - Excision of the rectum should take in account that the main lymphatic spread
      follows the cranial route and that dissection of the rectal wall should be
      performed across its adjacent anatomical lamellae. It is not clear whether an
      extensive pelvic dissection and high ligature of the inferior mesenteric artery
      are beneficial. Spontaneous or iatrogenic perforation of the tumour considerable
      increases the incidence of local recurrence. The frequency of postoperative
      urinary and sexual dysfunction ranges from 3.5-57% and 14-38% respectively. The
      reported surgical mortality averages 5-6%.

PMID- 2238959
TI  - [Relevant "end points" for evaluation of the colon pouch after deep rectum
      resection].
AB  - After low colo-rectal anastomosis there is in 25% a degree of urgency and
      increased bowel movements. In order to improve the reservoir continence the
      construction of a J-shaped colonic pouch seems reasonable. We have operated 5
      patients with the new technique and worked up our preliminary results in
      connection with a literature overview. Increased bowel movements and urgency are
      reduced postoperatively but some patients report pouch evacuation problems, using
      enemas or suppositories to empty their reservoirs. To estimate the value of this
      new technique innovative endpoints as overall well-being and quality of life
      might be more important than conventional endpoints measuring only functional
      results.

PMID- 2238960
TI  - [Comment on the contribution: Pathogenesis of cancer in the operated stomach (St.
      Dittrich and G.-M. Fleischer)].

PMID- 2238962
TI  - [When is there an indication for primary femoral amputation in patients with
      vascular disease?].
AB  - Every patient suffering from arterial occlusive disease has to be considered a
      candidate for a bilateral amputation. Below-knee amputation is preferable if at
      all possible. Poor wound healing and reamputation at a higher level are factors
      to be expected in 20-30% of these patients. Therefore primary above-knee
      amputation is indicated only if a more distal amputation level is not possible,
      or if lower amputation offers no advantage to the patient. The question must be
      answered in each individual case.

PMID- 2238961
TI  - [Current status of amputation surgery].
AB  - Limb salvage by revascularisation of occluded arterial pathways is main goal of
      vascular surgical activities. However, if dying or gangrenous tissue has to be
      removed, the question of: where to amputate--and the potential rehabilitation has
      to be answered. Septic amputation being an emergency operation has to be compared
      with elective one with definitive shaping of the stump. In major amputations knee
      disarticulation is preferred nowadays as being mostly "atraumatic" and well able
      for rehabilitation. In minor amputations bunions of the great and the little toes
      should be preserved especially in case the whole phalangeal and metatarsal
      forefoot amputation seems to have better results than removal of the first of
      fifth toe together with their metatarsia. A distal borderline amputation can only
      be performed in diabetics and after revascularisation of the feeding arterial
      tree.

PMID- 2238963
TI  - [Heart surgery interventions in risk patients. New possibilities for improving
      therapeutic results].
AB  - Perioperative therapy in conjunction with cardiac surgery had so far been guided
      by functional, paraclinical, and clinical parameters which only conditionally
      enabled objective appraisal of the present condition of the myocardium.
      Perioperative recording of the arterio-coronary-venous concentration difference
      of lactate (acDL) has now enabled the use of an objectivated parameter for
      accurate description of the metabolic-energetic situation of the myocardium. This
      will be helpful in metabolic-energetic condition monitoring (MESM) to optimise
      perioperative cardiotonic therapy. Stabilisation of the metabolic-energetic
      situation of the myocardium, objectivated by MESM, has proved to be superior to
      premature cardiac support, using catecholamines. It has been associated with
      improved restitution with high significance (p less than 0.005).

PMID- 2238964
TI  - [Abdominal complications following heart surgery using the heart-lung machine].
AB  - Reported in this paper are 17 abdominal complications among 2,161 patients,
      following cardiac surgery, using cardiopulmonary bypass. This incidence is
      comparatively low, accounting for only 0.78 percent, whereas figures between 0.3
      and 1.6 percent have been reported in the international literature. Lethality
      worldwide has been quoted to be between 25 and 50 percent and amounted to 23.5
      percent for the above patients. This seems to underscore the great importance of
      early decision-making on appropriate therapy. Haemorrhage from the upper gastro
      intestinal tract due to stress-related ulcers had been the predominant finding in
      this study. Acute pancreatitis developed in two patient, one of them ending in
      death. Acute cholecystitis and ischaemic colonic gangrene were additional
      complications. No significant extension of perfusion periods was established,
      which was in deviation from findings made by other authors.

PMID- 2238965
TI  - [Subcutaneous myxomas in atrial myxoma. A contribution to Swiss syndrome. A case
      report].

PMID- 2238966
TI  - [A suture technique of transverse staged fixation plication following
      disobliteration of the carotid artery].
AB  - A combination of carotid artery plication and fixing of the distal intima level
      is proposed in order to improve the surgical management during carotid
      endarterectomy. The own experience since 1987 (70 cases) shows this procedure to
      be recommendable especially for all cases with severe penetrating
      atherosclerosis.

PMID- 2238967
TI  - [Initial experiences in diagnosis of graft rejection following clinical heart
      transplantation. Detection of graft-directed activated T-cells].
AB  - The binding of antigen-loaded carrier to mononuclear cells of heart transplant
      recipients has been investigated by means of an antigen-specific rosette
      technique. The increase of rosette forming cells and the inhibition of this
      reaction with monoclonal antibodies against activated T-cells is a sign of a
      beginning rejection. 3-6 days later infiltrating immunological competent cells
      are seen in biopsy.

PMID- 2238968
TI  - [Algorithm for diagnosis and prevention of postoperative deep vein thrombosis].
AB  - An algorithm is described in this paper for diagnosis and prevention of
      postoperative deep venous thrombosis. It is presented in the form of a network
      graph and is based on an evaluation of the relative risk of pulmonary embolism of
      17.785 patients. Age above 60 years, malignant disease, and more than four days
      of postoperative immobilisation were found to be the greatest risk factors for
      lethal embolism of the pulmonary artery. Examination of the venous flow bed by
      non-invasive methods has proved to be indicated for any patient who has not
      resumed spontaneous movement on the fourth postoperative day. Diagnostic coverage
      has so far been achieved for 75 per cent of all patients still immobilised four
      days after surgery. Peroral or rectal administration of aspirin (1.5 g:24 h-1) is
      recommended for its good therapeutic effectiveness to reduce complications and
      for economic reasons.

PMID- 2238969
TI  - [Our surgical heritage. On the development of abdominal surgery in the mirror of
      the controversy between Franz Kuhn and Hans Kehr].

PMID- 2238970
TI  - [Life style and quality of life of children and adolescents following malignant
      tumor disease].
AB  - Psychosocial support after the diagnosis of childhood cancer is absolutely
      necessary to help not only the patients but also the parents, family members, and
      friends to deal effectively with the emotion and social problems arising from the
      disease. Psychological support for the whole family, rooming-in facilities on the
      ward, parent-self-help-groups, social and financial helps reduce problems which
      flow from such a diagnosis and may develop a positive coping strategy.
      Experiences over a long period of psychosocial aftercare in the University
      Hospital of Heidelberg are analyzed and some scientific data of this model are
      reported.

PMID- 2238971
TI  - [Reconstructive surgery in tracheobronchial tumors].
AB  - Malignant tumours are the most frequent indications for reconstructive
      tracheobronchial surgery. From 1970 to 15.6. 1989 there were 95 reconstructive
      operations on the tracheobronchial tree from this indication. Primary tumours of
      the trachea and the bifurcation are very rare, especially benign tumours. All
      tumours of the trachea and the bifurcation have need of a reconstruction, while
      this is an elective operation on the bronchial tree. The purpose of these
      operations is the preservation of lung tissue despite of radical resection. The
      main problem ist the insufficiency of the anastomosis (n = 6) associated with an
      acute pulmonary hemorrhage (n = 4) and death. The perioperative mortality was
      9.5%.

PMID- 2238972
TI  - [Perioperative ultrasound examination of the breast in breast cancer].
AB  - 127 cases of breast carcinoma were examined in a prospective study. By means of
      preoperative ultrasonography the staging following the pTNM-system validates the
      tumor size in 85.5% and the lymph node involvement in 77.2%. Multicentric
      multifocal carcinomas were diagnosed by ultrasonography in 20 of 29 cases, merely
      9 of 29 by mammography. Ultrasonography of specimen is recommended in cases of
      negative clinical findings and positive ultrasound examination to verify tumour
      excision. In addition to clinical exploration and mammography the ultrasonography
      of the breast obtains a diagnostic significance for planning a conservative
      management of breast cancer.

PMID- 2238973
TI  - [Benign pulmonary coin lesions following multiple cancer surgeries].

PMID- 2238974
TI  - [Tibial shaft fracture. Forms of therapy and their complications].
AB  - The rate of complications in treatment of lower leg fractures has continued to be
      high, which calls for critical appraisal of possible therapeutic approaches. The
      effectiveness of both conservative and surgical treatment has been shown by a
      prospective study which covers a period from 1984 to 1988. An analysis of 166
      cases proved helpful in providing guidelines for therapy of closed and open lower
      leg fractures. Conditions and prerequisites are expounded for the use of various
      surgical techniques, and hints are given on how to reduce complications.

PMID- 2238975
TI  - [Early complications and fatalities following surgical treatment of fractures of
      the upper ankle joint].
AB  - In a retrospective study of 1,140 patients (1970-1988) with ankle joint
      fractures, treated according to the AO principles, we analyzed the surgical
      treatment. After surgical treatment of 501 patients the rate of early
      complications was 5% and the mortality 1%. In our opinion all fractures should be
      treated by the AO principles to ensure a good follow-up result.

PMID- 2238977
TI  - [Severe impalement injury with primary surgical, gynecologic and urologic
      management].

PMID- 2238976
TI  - [External fixator in the district hospital].
AB  - Follow-up checks were performed on 59 cases of external fixation between 1 and 9
      years after operation. Complications are not severe, and all patients of this
      group finally had achieved a good or very good functional end result. External
      fixator is found a favourite method for use in an ordinary hospital as the
      author's. The criteria of indication particularly found a new evaluation. The
      need of giving the external fixator in accurately defined instability is
      emphasized.

PMID- 2238978
TI  - [Bone healing--an immunoreactive process?].
AB  - Cell mediated immune reactions, demonstrated by leukocyte migration assay and
      histological analysis of spleen and lymph nodes, could be observed after fresh
      autografting of cortical segments in rats. The detected immune answer showed a
      bone-specific reaction pattern. In consideration of the temporal correlation of
      the observed immune reactions and the histological signs of graft incorporation,
      a connection of bone healing and immune system may be possible.

PMID- 2238979
TI  - [Functional therapy in treatment of fractures and joint injuries].
AB  - Full and timely restoration of the function of an injured segment of the
      locomotor system is the treatment goal for all fractures and joint injuries.
      Functional aspects therefore have to be considered, when operative or
      conservative forms of treatment are chosen for a particular injury. We define a
      treatment as purely functional if the involved limb is either not immobilized at
      all or whenever the immobilization is incomplete and for a limited time only. At
      least partial function of the involved segment is therefore restored during the
      treatment. Purely functional treatment ist most applicable for stable fractures.
      Stable can be defined as the property of biological tissues to withstand
      physiological loads. Many joint injuries such as AC separation, ankle ligament
      rupture, Achilles tendon rupture, and isolated rupture of the medial collateral
      ligaments of the knee can also be treated functionally.

PMID- 2238980
TI  - [Which estrogens and gestagens should be prescribed after 45 years of age and for
      how long?].

PMID- 2238981
TI  - [Effects of adjuvant chemotherapy of breast cancer on gonadal function].
AB  - Premenopausal breast cancer patients frequently develop amenorrhea during
      adjuvant chemotherapy. Despite psychic distress and severe weight loss are
      possible causes for secondary amenorrhea in cancer patients, it is in this case
      due to the gonadotoxicity of the cytostatic drugs. Alkylating agents, such as
      cyclophosphamide, damage ovaries directly, resulting in ovarian fibrosis, atretic
      follicles and decline in estrogen production. Elevated plasma levels of LH and
      FSH show adequate reaction of the hypothalamohypophyseal unit. There is no change
      in the androgen production of stromal cells as well as in the plasma levels of
      prolactin and adrenal androgen precursors. Ovarian damage goes along with hot
      flushes, loss of libido and dyspareunia. The onset of amenorrhea is age- and dose
      related. Commonly the changes are irreversible. Estrogen replacement therapy
      promptly removes menopausal symptoms but is contra-indicated regarding the
      possible hormone-dependence of the tumor. In this case low dose medroxy
      progesterone acetate is indicated.

PMID- 2238982
TI  - [A modified Sarafoff suture for closure of the uterine wound in Cesarean
      section].
AB  - Using a retrospective investigation the authors demonstrate the advantage of the
      modified Sarafoff-suture (a one layer suture of the myometrium) in comparison
      with the two-layer suture. The results shows a lower rate of febrile courses,
      less postoperative complications and a shorter hospital stay. The first clinical
      experiences showed less scar complications in the courses of vaginal delivery in
      patients with a previous caesarean section. Therefore, the authors advise the
      modified Sarafoff-suture for wound closure in caesarean section.

PMID- 2238983
TI  - [Development of partner relations and of the child after successful therapeutic
      donor insemination].
AB  - The psychological development of couples and children was examined after
      successful therapeutic insemination by donor (TID). 222 couples were investigated
      by sending questionnaires to the families. 122 (55%) couples fulfilled our
      requests. The answers suggested that there was no deviation from the behaviour of
      the control groups concerning attitudes towards pregnancy and delivery, actual
      interrelation between wife and husband, degree of neurosis of the parents and
      children. The conclusion could be drawn that there was no need for more
      restriction on the TID provided that a good psychological diagnostic regarding
      the special TID-problems was performed before the insemination treatment.

PMID- 2238984
TI  - [Male subfertility and oral bacterial diseases].
AB  - More than 70% of the husbands consulting the Dept. of Gynecology and Obstetrics
      of the RWTH Aachen for sterility since June 1987 needed treatment for
      bacteriospermia with germ concentrations greater than 10(4) cfu/ml ejaculate. In
      23% of the treated men however, no convincing reduction of germ concentration
      were achieved. 36 patients with therapy-resistant bacteriospermia were sent to
      the Dept. of Dentistry of the RWTH Aachen. A lot of intra-oral foci were found,
      which got eliminated. Intra-operational bacterial specimens were taken and
      evaluated by a special diagnostic technique in the Dept. of Microbiology. It was
      shown that the bacterial spectrum of the intraoral specimens and the spermiograms
      were identical. Six months after completion of the dental therapy a new
      andrological examination was performed. Two thirds of the spermiograms now were
      already sterile. There was an improvement of the spermparameters as well as
      motility, morphology and density. It can be concluded from these results that
      there is a direct causal relationship between a symptomatic dental primary
      disease and bacteriospermia which probably leads to subfertility.

PMID- 2238985
TI  - [Complete closure or open healing of the skin of the vaginal stump in vaginal
      hysterectomy].
AB  - This retrospective study covers a period of 10 years (1977-1986) during which a
      vaginal hysterectomy with or without colporrhaphy was carried out in 431 women.
      In 317 patients the skin at the end of the vaginal stump was closed primarily,
      whereas it was left open in 114 patients. Comparing both groups less morbidity-,
      secretion-, infection- and bleeding-rates can be found in the group with primary
      closure of the vaginal stump. The healing of the operative wound is much better
      when closed primarily. Fear of entrapped secretions or formation of abscess or
      hematoma is not justified.

PMID- 2238987
TI  - [Treatment of primary dysmenorrhea with Jenapharm piroxicam].
AB  - 36 patients with 432 menstrual cycles and primary dysmenorrhea were treated with
      Piroxicam-Jenapharm. Piroxicam-Jenapharm was given in a dose of 40 mg once daily
      for the first 2 days followed by 20 mg once daily. Piroxicam, a nonsteroidal-anti
      inflammatory drug (NSAID) is an effective drug in reducing menstrual pain
      intensity in 80%. Piroxicam was well tolerated with no patient reporting side
      effects. The treatment of primary dysmenorrhea with total 100 mg Piroxicam
      Jenapharm over 3 days is recommended.

PMID- 2238986
TI  - [Computer-assisted analysis of the tocogram. Initial experience using a new
      evaluation procedure].
AB  - This paper describes first observations with a new computer aided analysis of
      tocogram. It seems that length of uterine contraction is an important parameter
      for quality of labour. In 9 from 12 cases promotion to constant length of labour
      with relatively low absolute duration of contractions was connected with a
      distinct increase of the velocity of cervical dilatation. The uniformity can be
      an important factor for the conversion into active phase of labour.

PMID- 2238988
TI  - [Differential diagnosis of pelvic tumors. Abscess forming ileovesical fistula in
      Crohn's disease. A case report].
AB  - A report is given about a case of preoperatively unrecognized ileovesical-fistula
      caused by Crohn's-disease. Despite of uncharacteristic symptoms a more extensive
      medical history might have brought to also more extensive diagnostic methods and
      to suspicion of the intestinal disease.

PMID- 2238989
TI  - [New pregnancy following previous HELLP syndrome. A case report].
AB  - The HELLP-Syndrome (H = hemolysis, EL = elevated liver enzymes, LP = low
      platelets) is a well known and severe form of gestosis. In this case report we
      analyse the positive outcome of a pregnancy after HELLP-Syndrome has happened.
      The obstetric management requires regular control of the complete blood count,
      SMAC and coagulation.

PMID- 2238990
TI  - [Aspiration of a gestational sac controlled by vaginal ultrasound in multiple
      pregnancy for the purpose of selective abortion].
AB  - A case of an infertile married couple by whom the cause of infertility was
      oligoasthenospermia of man is described. The couple was treated by intrauterine
      insemination by capacitated spermatozoa in a cycle stimulated by clomiphene. The
      ultrasonography revealed a pregnancy of triplets. The patient refused a multiple
      pregnancy and asked for its interruption. As an alternative we proposed the
      selective abortion by means of an ultrasound-guided aspiration of two gestational
      sacs. Description of this method and the result are the theme of our paper.

PMID- 2238991
TI  - [Is in hypertension in labor, for example in EPH gestosis, active control of the
      placental period defensible?].

PMID- 2238992
TI  - [Screening for toxoplasmosis and rubella in prenatal care?].

PMID- 2238994
TI  - [Bacteriuria screening in gynecologic practice: what is the value of mid-stream
      urine?].
AB  - In 55 healthy women corresponding urine proofs were taken by suprapubic punction
      and by mid stream technique from the same content of the urinary bladder. For
      detection or exclusion of bacteriuria both collection-methods are of equal value.
      In 96% of the cases the microbiological results were corresponding. The leucocyte
      count is of no value to detect indirectly a bacteriuria as well in punction- and
      in mid stream urine. A pathologic count is just as little pathognomonic for
      infection as a normal count excludes a bacteriuria. Therefore the counting of
      leucocytes should be given up to the favour of a better microbiological
      observation in gynecological outpatient departments.

PMID- 2238993
TI  - [Lesion of the ureteral wall caused by gynecologic surgeries from the urologic
      viewpoint].
AB  - It is reported on 31 ureteral strictures in 29 female patients after abdominal or
      vaginal, simple or complex hysterectomy. In 21 cases the ureteral obstruction was
      combined with an external urinary fistula. In 11 cases it was noted a spontaneous
      receding of the ureteral obstruction respectively a sanitation of the urinary
      fistula without stenosis. The general renal protection in form of a nephrostomy
      as an important component of therapy is recommended. Directions for the medical
      care of intraoperatively diagnosed ureteral lesions are given.

PMID- 2238995
TI  - [Diagnosis of urinary tract infections in puerperium].
AB  - In 225 puerperant urine proofs were taken both by suprapubic puncture and by mid
      stream technique. The corresponding proofs were examined culturally and
      microscopically. 42% of the mid stream proofs containing more than 10(5) germs/ml
      were evaluated to be false-positive. The corresponding urine taken by suprapubic
      puncture was uninfected. A pathologic leucocyte-count is just a little
      representative for urinary tract infection as a normal leucocyte count excludes
      an infection. Therefore, the counting of leucocytes is worthless and should be
      given up to the favour of bacteriologic examinations. Every ward for puerperant
      should presuppose the technique to take urine proofs by suprapubic puncture.

PMID- 2238996
TI  - [Urogynecologic follow-up examinations after radiotherapy of gynecologic
      malignancies].
AB  - 47 women treated by radiotherapy for gynecologic malignancies have been examined
      urogynecologically. There are only some changes of subjective cystometric
      parameters (volume of the first desire to void, bladder capacity), but
      statistical significant changes of the parameters "compliance" and "bladder
      pressure at capacity". The parameters of urethrocystometry and uroflowmetry are
      not influenced by irradiation. The urethroscopy demonstrates a white mucosa of
      the bladder wall caused by irradiation fibrosis, agreeing to data reported by
      literature. Only 10 of the 47 patients examined had to be treated by drugs.

PMID- 2238997
TI  - [Delayed hypersensitivity to Candida albicans].
AB  - Conditions and factors influencing the formation of delayed hypersensitivity (DH)
      to yeast-like fungi of the species C. albicans under experimental conditions have
      been studied. The intensity of this reaction has been found to depend on the dose
      and method used for infecting mice, the time of the test and the qualitative
      state of fungal cells. As the result of this study, the infectious model of DH to
      C. albicans has been proposed. This model may be used for the study of the
      influence of different exogenous and endogenous factors of cell-mediated immune
      response to candidiasis.

PMID- 2238998
TI  - [An evaluation of the extent to which young people are informed about the
      acquired immunodeficiency syndrome].
AB  - The data on the evaluation of the volume of information on the transmission
      routes of HIV infection, risk groups and prophylactic measures, acquired by young
      people aged 14-18 years, their attitude to different sources of information on
      AIDS, as well as the evaluation of the influence of lectures on the formation of
      their opinion of these problems, are presented. As found by questioning, 84.4
      98.7% of adolescents who answered the questionnaires correctly indicated the
      routes of the transmission of HIV infection, prophylactic measures were known to
      73.1-90.3%, risk groups were correctly defined by 80.6-98.0%, more than 70% of
      adolescents covered by questioning believed that mass media provided insufficient
      information on AIDS. In a group of adolescents given a lecture an increase in the
      number of correct answers and a decrease in the number of wrong answers on the
      transmission routes of HIV infection and on risk groups were registered.

PMID- 2238999
TI  - [The anti-infection resistance system and the pathogenesis of bacterial
      endocarditis in patients with congenital heart defects].
AB  - The clinico-immuno-microbiological study of 24 patients with congenital heart
      diseases was made. Clinically, the patients were subdivided into two groups: 8
      patients with diagnosed bacterial endocarditis (BE) prior to the operation and 16
      patients without BE. The analysis of the results of investigation carried out
      prior to the operation showed that age, the form of the disease and its duration
      did not affect the level of anti-infectious resistance factors (AIRF): in both
      groups a decrease in the level of AIRF characteristics (cell-mediated and
      humoral) was noted and no characteristic differences were determined. The results
      of the study of microflora from the nasal and laryngeal mucosa showed no
      difference in both groups of the patients. At the same time the detailed analysis
      of the results made it possible to suggest that BE caused by Streptococcus
      epidermidis and Streptococcus aureus inhabiting the mucous membrane of the
      anterior sections of the nasal cavity, alpha-hemolytic streptococci and S.
      epidermidis inhibiting the laryngeal mucosa. The results of the analysis made 3-6
      months after the operation were also indicative of the absence of essential
      differences between AIRF characteristics observed in patients with confirmed and
      clinically unconfirmed BE. The clinical manifestation of this fact was an
      increase in the percentage of diagnosed BE cases up to 70% as compared with that
      before the operation (33%). This clinico-immuno-microbiological study made it
      possible to come to the conclusion that any form of congenital heart disease
      develops in combination with BE and/or is its prodrome.

PMID- 2239000
TI  - [The antimicrobial action of the xanthine oxidase-xanthine system on the
      causative agent of cholera].
AB  - As revealed in experiments on V. cholerae, the enzymatic link xanthine oxidase
      xanthine produces a vibriostatic effect at the concentration of xanthine oxidase
      equal to 0.0125 g/l and a vibriocidal effect at the concentration of xanthine
      oxidase equal to 0.025 g/l in a medium with pH 7.5-7.6. In the presence of
      protein the antivibrionic activity of the xanthine oxidase link is decreased. The
      introduction of bivalent iron into the enzymatic link xanthine oxidase-xanthine
      enhances its vibriocidal action on V. cholerae.

PMID- 2239001
TI  - [The immune status of children in foci of measles infection studied by an
      immunoenzyme method].
AB  - Children immunized with live measles vaccine in the foci of measles infection
      varying in intensity (1-9 cases per focus) have been subjected by two methods:
      the hemagglutination inhibition (HAI) test and the enzyme immunoassay (EIA). As
      shown in this study, in most cases (98% of all blood serum samples) the
      correlation between the results of the HAI test and EIA is not high (r = 0.5),
      which is linked with the detection of a wider spectrum of antibodies in EIA. The
      percentage of seronegative children detected by these two methods was practically
      the same (4.05 and 4.4, respectively). The analysis of the results obtained in
      this study indicates that EIA is a more informative and sensitive method, which
      confirms the effectiveness of its use for the determination of the level of
      collective immunity.

PMID- 2239003
TI  - [The results of an immunoepidemiological examination of foci of epidemic
      parotitis].
AB  - The immunoepidemiological survey of 54 foci of epidemic parotitis showed that the
      epidemiological effectiveness index at preschool institutions, equal to 2.7, was
      essentially higher than at schools (2.1). The significant difference (t = 3.35)
      in the epidemiological effectiveness indices was due to the presence of a large
      number of persons having had inapparent and faintly pronounced forms of epidemic
      parotitis among school children, as well as due to more close contacts of
      children with the foci of infection at preschool institutions. The study showed
      that among children immunized with some lots of parotitis vaccine elevated
      morbidity in epidemic parotitis was registered. In the foci of infection
      children, immunized in the presence of low initial titers of specific
      hemagglutinins in their sera, responded by a booster effect with different
      duration of stimulation of antibody formation. The hemagglutinin titer of 1:20
      was shown to protect children from epidemic parotitis.

PMID- 2239002
TI  - [The meadow-field type of tularemia foci in eastern Siberia].
AB  - The article characterizes a meadow-type focus tularemia, discovered in
      Zalarinski'i District of Irkutsk Province in 1988. This focus and another similar
      focus discovered in 1985 at the Krasnoyarsk Territory belong to the meadow type,
      which makes it possible to regard their presence in Eastern Siberia as an
      established fact. The main reservoirs and sources of infection in these foci are
      two species of voles (Microtus gregalis and M. subarvalis).

PMID- 2239004
TI  - [The clinico-epidemiological characteristics of the course and diagnosis of tick
      borne rickettsiosis in northern Asia].
AB  - The study of tick-borne rickettsiosis in Northern Asia has made it possible to
      determine the clinico-epidemiological features of the modern course of this
      disease, which should be taken into consideration for the timely diagnosis of
      this infection. The laboratory verification of the diagnosis should be carried
      out, as recommended by the authors, in the agar precipitation and leukocytosis
      tests in their modification.

PMID- 2239005
TI  - [The enterotoxigenic capacity of hemolysin-producing strains of Proteus isolated
      in acute intestinal infections in children].
AB  - The capacity of P. mirabilis and P. vulgaris strains isolated in acute enteric
      infections in children for producing enterohemolysin, a new type of hemolysin,
      has been shown. The relationship between the capacity of Proteus cultures for
      producing enterohemolysin and their capacity for inducing toxic secretory
      reaction on a ligated loop on the small intestine of rabbits in the absence of
      known thermostable and thermolabile antitoxin in bacteria.

PMID- 2239006
TI  - [Infectious disease mortality in the USSR].
AB  - In recent decades infectious and parasitic diseases (class 1 according to the
      International Classification of Diseases-9) constitute 2-3% of causes in the
      total morbidity structures in the USSR. The main causes of death among diseases
      of class 1 are tuberculosis (37%), acute enteric infections (30%), septicemia
      (11%), viral hepatitides (11%), meningococcal infection (4%), measles (2%). The
      main groups are children aged up to 2 years (48% of fatal cases of diseases
      belonging to class 1). The territorial irregularity of mortality indices has been
      revealed.

PMID- 2239007
TI  - [The results of multiyear observations on the duration of the maintenance of
      immunity in those vaccinated and revaccinated against and recovered from
      measles].
AB  - The results of 5-year observations on the duration of immunity to measles virus
      in persons vaccinated and revaccinated against measles, as well as in persons
      having had this infection, are presented. The intensity of immunity was
      determined in the same persons with the use of the passive hemagglutination test.
      The study revealed differences in the formation, intensity and duration of
      postvaccinal immunity. A significant decrease in the concentration of antibodies
      over the period of 5 years was established in 50.0-52.3% of vaccines.
      Revaccination with live measles vaccine is an effective measure for enhancing
      immunity to measles virus in persons with initial antibody titers less than 1:10
      1:20, but revaccination made in a single injection is not sufficient for the
      stable maintenance of measles morbidity at the sporadic level. Postinfectious
      immunity is characterized by stability and has no tendency towards decrease.
      Persons having had measles have no need in additional measures irrespective of
      the time elapsed after the disease.

PMID- 2239008
TI  - [The rapid diagnosis of measles by using immunoenzyme analysis based on
      peroxidase-labelled viral antigens].
AB  - The sensitivity and specificity of the enzyme immunoassay (the capture variant),
      based on the use of the complex of anti-IgM-IgM to purified measles virus, the
      peroxidase-labeled lysate and nucleocapsid antigens of measles virus, were
      evaluated. The advantages of the nucleocapsid conjugate were established. The
      study of 200 serum samples from measles patients revealed that antimeasles IgM
      antibodies could be detected in 100% of cases, and the assay of 15 serum samples
      from healthy donors and 5 serum samples from patients with autoimmune diseases
      did not yield a single false positive result.

PMID- 2239009
TI  - [The indices of antipneumococcal immunity in children with chronic pneumonia].
AB  - In 76 children with chronic pneumonia the levels of serum antibodies to
      pneumococcal capsular polysaccharide antigens (serotypes 1, 3, 6B, 8, 9N, 15F,
      23F), O-polysaccharide and pneumococcal protein somatic antigens were determined
      by ELISA techniques. The study showed that in sick children the content of
      antipneumococcal antibodies in the blood increased with age. No correlation
      between the content of total immunoglobulins and that of antipneumococcal
      antibodies in the blood of the patients was established, but a sharp decrease in
      the concentration of antibodies was registered in a child with hypoglobulinemia.
      No increase in the level of antibodies to pneumococcal antigens was observed in
      cases of the exacerbation of Pneumococcus-induced inflammatory process in the
      lungs.

PMID- 2239010
TI  - [The protection of vertebrate animals from experimental tick-borne encephalitis
      with active and passive immunization against tick antigens].
AB  - The active and passive immunization of laboratory animals against Ixodes antigens
      has been experimentally shown to lead to the development of their resistance to
      homologous Arthropoda species and a change in the intensity of the circulation of
      tick-borne encephalitis virus between carriers and their hosts. The immunization
      of vertebrates with Ixodes antigens may supposedly lead to a decrease in the
      number of bloodsucking arthropods-carriers of the causative agents of infectious
      diseases-and protect animals from infections whose causative agents are
      transmitted by Ixodes ticks.

PMID- 2239011
TI  - [Chemonucleolysis: the last step in the conservative treatment of lumbar
      herniated disk].

PMID- 2239013
TI  - [Respiratory physiotherapy in lung diseases].

PMID- 2239012
TI  - [Peripheral facial paralysis. Experience of a multidisciplinary approach].
AB  - The authors report the evolution of 54 patients suffering from complete paralysis
      of the seventh cranial nerve. They point out the interest of a good diagnose and
      a multidisciplinary treatment including: drugs, infiltration, kinesitherapy and
      electrotherapy. A good repair (77%) is obtained if the treatment is early and
      regular. This therapy will be used according the results of clinical and
      electrophysiological examinations.

PMID- 2239014
TI  - [Congenital malformations at the level of the upper extremities: Poland
      syndrome].
AB  - The authors describe the different congenital anomalies of the upper extremity.
      Starting from a case, thereafter they give a precise description of the Poland
      syndrome.

PMID- 2239015
TI  - [Respiratory problems and rehabilitation in medullary lesions].

PMID- 2239016
TI  - [Peri-articular ossifications].
AB  - Restriction of motion of the joints due to peri-articular ossifications
      constitute a major problem in the rehabilitation of patients with transverse
      spinal cord lesion. The therapeutic possibilities as well as the preventive
      measurements are described and illustrated with a few case reports.

PMID- 2239017
TI  - A retrospective study of the conservative treatment of tennis-elbow.
AB  - The files of 64 patients (70 tennis elbows) treated in our department because of
      tennis elbow complaints, were reviewed. The results showed injection with a
      corticosteroid preparation to be effective in alleviating the pain in the short
      term (91% improvement within 1 week), but the incidence of recurrence of symptoms
      to be high (51%) after an average period of 3 months). Physical therapy appeared
      to be less effective (47% improvement after an average of 6 weeks or 20
      sessions), but recurrence of symptoms was far less frequent (5%).

PMID- 2239018
TI  - [EMG study of the external anal sphincter: current diagnostic aids].

PMID- 2239019
TI  - Effect of small bowel resection on fecal bile acid excretion and on experimental
      colon tumour in rats.
AB  - Ileal and jejunal resections were carried out to investigate their effect on the
      faecal bile acid excretion and on the development of 1,2-dimethylhydrazine (DMH)
      induced colonic cancer in rats. Both resection types raise the total daily faecal
      bile acid level compared to the control sham-operated group, whereas ileal
      resection has a more pronounced effect. The incidence of tumours was found higher
      in groups with enhanced faecal bile acid level. Our findings show a connection
      between the daily faecal bile acid excretion and the incidence of DMH-induced
      colonic cancer.

PMID- 2239021
TI  - Factors affecting the cold transfer during cryotherapy.
AB  - Cryotherapy of the cervix was made in 40 patients for chronic cervicitis, and the
      thickness of the ice zone around the probe was measured in function of treatment
      time, under standard cooling conditions. The pace of growth of the ice zone
      allowed the author to draw conclusions as to the conductivity of the studied
      tissue. It was established that in the study-group, the patient's age and their
      histories of abortions did not influence the cold transfer significantly. The
      difference between the average values of ice zone thickness measured in the
      groups of nulliparae and multiparae was, however, significant. Findings have
      shown that the spread of cold in the cervical tissue in nulliparous women is
      better than in multiparae and so a greater efficacy of cryotherapy can be
      expected in nulliparae.

PMID- 2239020
TI  - The modern approach of hangman's fracture.
AB  - Upper cervical spine injuries associated with the characteristic alterations of
      the axis are termed by the international literature as hangman's fracture (HF).
      The specific changes of the clinical picture include fracture of the bilateral
      pedicles of the axis, dislocation of the arch, luxation and discopathy between
      the second and third (C2-C3) vertebrae, eventually other accessory fractures of
      vertebrae C2-C3 (Fig. 1). There are two kinds of it, i.e. (i) one of a
      hyperextensive-distractive mechanism with the very severe neurological lesion
      leading to the classical injury due to hanging and (ii) one of a hyperextensive
      compressive mechanism without neurological lesion of current traffic injuries or
      with slight neurological symptoms. The latter more often occurring type of injury
      encompasses a relatively wide range, which can be classified into three types:
      The stable injuries can be managed by conservative treatment, the unstable ones
      by Halo treatment or ventral surgical therapy meeting the up-to-date
      requirements. Prognosis is good. The authors have been the first in Hungary to
      present a critical and detailed survey of the world literature and their 11-year
      experience, in the form of a clinical study.

PMID- 2239022
TI  - Invasive intrauterine procedures in twin pregnancies discordant for fetal
      malformation.
AB  - Invasive intrauterine procedures in two twin pregnancies for exencephaly and
      multiple malformations are reported. In the first case, to ensure the development
      of the normal fetus, selective feticide of the affected fetus was undertaken by
      transabdominal intracardial injection of 20% NaCl solution. A healthy newborn
      infant with normal weight and a fetus papyraceus were delivered at term. In the
      second case, because of monoamnial placentation, the procedure was regarded too
      dangerous, therefore, only therapeutic amniocentesis was carried out to decrease
      the volume of amniotic fluid. The fetuses were delivered in the preterm period.
      The advantages of the procedure of selective feticide developed by the authors
      are also discussed.

PMID- 2239023
TI  - Fentanyl-midazolam-flumazenil anaesthesia during induced abortion.
AB  - A new anaesthetic method (fentanyl-midazolam-flumazenil) was compared with
      recently administered (pethidine-diazepam-ketamine) anaesthesia in two groups of
      25 women, each undergoing termination of pregnancy. No significant difference was
      found between the two groups in the quality of anaesthesia. Recovery was assessed
      by means of the Aldrete score and a visual analogue scale. The recovery time was
      significantly shorter in patients who received midazolam-flumazenil. In the
      ketamine group, 36% of the patients complained of unpleasant dreams. The recovery
      in the midazolam group was comfortable.

PMID- 2239024
TI  - Measuring blood loss during transurethral resections.
AB  - Blood loss was measured in 70 patients during the transurethral resection for
      bladder neck adenoma and prostatic tumour on the basis of the haemoglobin content
      of the irrigation fluid, and the factors influencing blood loss were assessed. In
      20 patients an irrigation fluid of body temperature was used. Their
      investigations have not proved the irrigation fluid of a higher temperature to be
      of a bleeding-inducing effect. It was stated that the absolute amount of bleeding
      was directly proportional to the weight of the resected tissue and the time of
      resection. These data revealed that a blood loss/1g of resected material/1 min of
      resection time does not increase with a larger resection weight or during a
      longer operation.

PMID- 2239025
TI  - Vitamin B12 absorption in some selected pathological states of the
      gastrointestinal tract.
AB  - The absorption of vitamin B12 in selected pathological states of the
      gastrointestinal tract was studied. Schilling test was performed with 37 kBq (1
      microCi) of 57Co-labelled vitamin B12 as an analysis of urinary radioactivity. No
      increase in cobalamin absorption was present after exogenous IF had been
      administrated to patients after resection of the upper part the stomach and total
      gastrectomy. This suggests that there is another factor likely to affect vitamin
      B12 absorption.

PMID- 2239026
TI  - Data on the pathophysiology and clinical aspects of the mechanical obstruction of
      the small intestine.
AB  - A brief overview is given of the relevant physiology of the small intestine, and
      the pathomechanism of the clinical picture, based on a material of 423 patients
      with mechanical obstruction of the small intestine. The various forms of the
      mechanical obstruction of the small intestine are reviewed, with special regard
      to strangulation and adhesive obstruction. The possible forms of treatment are
      dealt with, with an emphasis on the importance of an early surgical intervention
      and of a careful after-treatment with a view to reducing the still high morbidity
      rate.

PMID- 2239027
TI  - Long-term feeding of casein or soy protein with or without cholesterol in
      Mongolian gerbils. I. Morphologic effects.
AB  - This study was designed to determine whether male Mongolian gerbils (Meriones
      unguiculatus) develop atherosclerosis (AS) during long-term feeding of diets
      similar to those consumed by humans. Gerbils were fed diets containing 16% casein
      (C) or soy (S) protein +/- 0.1% cholesterol (CH) for 15 months. The energy
      contribution from protein, fat and carbohydrate was similar to the energy
      distribution reported for the average North American (NA) diet and the level of
      added dietary CH resembled the average NA intake. At mo 0, 3, 6, 9, 12 and 15,
      animals were killed and tissue sections were prepared for histologic examination.
      Microscopic observations of cardiovascular tissues did not reveal any evidence of
      AS in any of the diet groups. Liver fatty infiltration (FI) was evident in the
      C+CH and C groups at mo 3 and 9, respectively, and continued to occur at all
      subsequent sampling times. Livers from gerbils fed S+CH also began to exhibit FI
      at mo 9, while livers from S-fed gerbils did not show any significant morphologic
      changes. Biochemical liver total lipid results supported the histological liver
      findings. Other tissues examined did not reveal any morphological changes related
      to diet. The gerbil may be a useful animal model to study mechanisms which
      inhibit AS development.

PMID- 2239028
TI  - Long-term feeding of casein or soy protein with or without cholesterol in
      Mongolian gerbils. II. Plasma lipid and liver cholesterol responses.
AB  - Male Mongolian gerbils (Meriones unguiculatus) were fed casein or soy protein in
      the presence and absence of dietary cholesterol for 15 months. Diets resembled
      the average North American diet in energy contributions from protein, fat and
      carbohydrate, cholesterol content and fatty acid profile. At month 0, 3, 6, 9, 12
      and 15, plasma samples were analyzed for total cholesterol (TC), HDL cholesterol
      (HDLC) and triglyceride (TG) concentrations. Plasma LDL cholesterol (LDLC) was
      estimated indirectly. Liver TC was also determined at these time points.
      Comparisons of protein source and cholesterol level were averaged over the 15
      month period. Casein-fed gerbils had significantly higher plasma TC and TG levels
      and lower HDLC levels (as a percent of TC) compared to soy-fed animals,
      independent of the presence or absence of dietary cholesterol. LDLC was
      significantly elevated in casein-fed gerbils only when cholesterol was present in
      the diet. Elevations in plasma TC levels were reflected by elevations in liver
      TC. Despite plasma lipid elevations that are consistent with the development of
      atherosclerosis (AS) and coronary heart disease (CHD) in humans, hyperlipidemic
      gerbils do not develop AS. Further characterization of gerbil lipid metabolism
      responses to dietary alterations aimed at the prevention of CHD in humans is
      necessary to elucidate the mechanism for the gerbil's resistance to AS.

PMID- 2239029
TI  - Serum calcium and blood pressure in Greek girls.
AB  - In a random sample of 492 girls 12-15-years-old total serum calcium appeared to
      be correlated with blood pressure. Adolescents with total serum calcium equal to
      a greater than the cohort mean (2.5 mmol/l) had higher systolic blood pressures
      than those with a value below the cohort mean. This was present at all ages.

PMID- 2239030
TI  - Changes in dietary habits, cardiovascular risk factors and mortality in Japan.

PMID- 2239031
TI  - Legionellosis and "torsades de pointes".
AB  - Myocarditis, pericarditis and endocarditis are rare manifestations of Legionella
      pneumophila infection. We describe a case of myocarditis complicated with a
      potentially fatal arrhythmia: "torsades de pointes".

PMID- 2239032
TI  - [Renal autotransplantation].
AB  - The progress of renal transplantation in the last 2 decades has made possible the
      development of autotransplantation and extracorporeal surgery of the kidney. By
      those techniques, it is possible to operate upon patients in which conservative
      conventional surgery is impossible. In this article the technique is described,
      and two typical cases are reported. The mean indications are renal vascular
      hypertension, malignant tumors of the kidney, traumatic lesions of the kidney and
      ureteral lesions. All these indications are described in detail.

PMID- 2239033
TI  - [The treatment of perforated gastro-duodenal ulcer].
AB  - Seventy-four patients, admitted in emergency for acute perforation of a duodenal
      or gastric ulcer were reviewed retrospectively: 40 patients with one or several
      risk factor such as shock, old perforation, severe chronic illness or advanced
      age and 34 other patients without any risk factor. In this selected population,
      the surgical treatment, initially performed in 44 cases, consisted of suturing
      the perforation and draining the peritoneal cavity in all cases but four in which
      it was associated with a vagotomy (2 cases) or a distal gastrectomy (2 cases).
      Thirty younger patients admitted without shock, within 6 hours following the
      onset of the perforation were initially treated by digestive aspiration alone:
      this medical treatment was successful in 15 patients but required a subsequent
      laparotomy in the other cases. The overall postoperative mortality is 18% but is
      zero in the group of patients in whom a medical therapy was initially performed.
      Long-term follow-up shows that 70% of the patients with a perforated duodenal
      ulcer and without any anti-inflammatory drug past history at the time of the
      perforation are free from any symptom. A strategy for the management of
      perforated duodenal and gastric ulcers, applicable to a non-selected population,
      is proposed in reference to the surgical literature.

PMID- 2239034
TI  - [Gastric metastases of ovarian adenocarcinoma. Apropos of a case].
AB  - A case report and review of literature. Four types of neoplastic dissemination
      exist in presence of ovarian adenocarcinomas. Commonly, these tumors metastasize
      along intraperitoneal ways or lymphatic channels. Less frequently, the tumors are
      invading surrounding organs by direct extension. Rarely, there is a hematogenous
      dissemination. The observation of a gastric metastasis is reported; we consider
      it as a hematogenous one. Reviewing the literature, we find few similar cases.
      Gastric metastases originate more frequently from malignant melanomas,
      adenocarcinomas of the breast and bronchogenic tumors.

PMID- 2239035
TI  - [Giant chondrosarcoma: a case report].
AB  - Chondrosarcoma is a slow-growing malignant tumor, with a mainly local
      infiltration, usually arising from skeletal cartilaginous cells. However, a few
      such neoplasms also arise from extraskeletal mesenchymal cells. Metastasis are
      usually seen with undifferentiated tumors (grade III), mainly within the lungs.
      The best treatment associates total surgical resection with chemotherapy.
      Radiotherapy is of poor use. Isolated pulmonary metastasis can be profitably
      withdrawn. Prognosis is about of 75% of survival after 10 years, in case of well
      differentiated tumors (grade I). The prognosis is far worse for undifferentiated
      tumors (grade III), turning around 10% of survival after 10 years.

PMID- 2239036
TI  - [Orthopedic treatment of the child with multiple injuries and its current
      progress].
AB  - We regularly use the Elastic Stable Intramedullary Nailing (ESIN) for children
      over seven years old with shaft limb fractures. This technique is especially
      adapted to pediatric traumatology, and is to be preferred to rigid osteosynthesis
      or osteotaxis in closed fractures. We use ESIN as a rule for femoral shaft
      fractures. Unstable fractures of shaft forearm, tibia and humerus are treated
      following this technique, as for multiple fractures of the lower limbs. Because
      of immediate and complete fracture stability. ESIN is especially useful in
      multiple trauma patients, where nursing facilities and easy transport are
      helpful. Moreover, re-education can be performed immediately, with a very early
      walk recovery.

PMID- 2239037
TI  - [Simultaneous coronary and carotid surgery: apropos of 73 cases].
AB  - A series of 73 simultaneous carotid and coronary revascularizations (Group I) is
      presented (January 1980-December 1988). Age, sex, risk factors, severity of
      angina, coronarography, neurological symptoms, angiographic carotid lesions and
      operative outcome of these 73 patients are compared with the aspects of 3544
      coronary bypass patients (Group II) and 1001 carotid endarterectomized patients
      (Group III) during the same period. The angina in Group I is more severe, with
      22% belonging to NYHA class IV and 26% having a stenosis of the left main
      coronary artery, vs 14% and 13% in Group II. Seventy percent of the carotid
      lesions in Group I are asymptomatic vs 33% in Group III. Group I patients had
      more problems in the perioperative period, with 16.4% needing prolonged high
      doses analeptics and 5.4% intraaortic counterpulsation balloon. Operative
      mortality is higher (7%) in Group I compared with Group II (2.3%) and Group III
      (1.7%). These results permit to define a population of polyvascular patients with
      concomitant coronary and carotid disease, characterized by a more diffuse
      atherosclerosis and a higher operative risk. Operative morbidity and mortality
      after combined myocardial and cerebral revascularization remains nevertheless
      inferior to the cumulated surgical risk of the sequential procedures (74 patients
      with coexistant coronary and carotid lesions operated in two sessions before
      1986).

PMID- 2239038
TI  - Combined one stage cardiac and pulmonary surgery by median sternotomy.
AB  - From 1985 to 1989, 6 patients underwent a pulmonary surgical procedure
      simultaneously with a cardiac operation. All patients were male with a mean age
      of 60 +/- 8 years. The cardiac procedures included: 1 aortic and 1 mitral valve
      replacement, 3 coronary artery bypass grafts and 1 closure of an atrial septal
      defect. Four patients had primary pulmonary nodules: 2 bronchogenic carcinomas
      and 2 benign hamartomas. They presented with cardiac symptoms, and lung nodules
      were incidentally found on preoperative Chest X-Rays. The 2 last patients had
      pulmonary metastases of colonic neoplasms previously resected, respectively 3 and
      6 years before. After completion of the cardiac procedures, during the rewarming
      of the patient, the pulmonary resection was performed on a deflated lung, via the
      median sternotomy. Pulmonary procedures included: right upper segmentectomy (n =
      1), left pneumonectomy (n = 1), left interior lobectomy (n = 1), right middle
      lobectomy (n = 1), left upper wedge resection (n = 1), and right upper lobe wedge
      resection (n = 1). All patients were extubated on day one. One patient died from
      rythm disturbances on day 13. All other patients are alive with a mean survival
      of 30 months. The authors conclude that combined surgery is feasible in selected
      cases. Sternal approach is not a limitation to pulmonary resection.

PMID- 2239040
TI  - [Surgical treatment of the sequelae of ischemic postdysplasia femur head necrosis
      in children. II. Surgical technique].
AB  - The author presents its concept concerning the possibilities of the surgical
      treatment of the sequelae of the postdysplastic necrosis of the femoral head
      originating from the treatment of congenital dislocation or subluxation of the
      hip joint. The classification is based on the division according to Bucholz and
      Ogden into 4 types. Indicated for the surgical treatment are hips with the injury
      of the type II and III. In Grade II type the joint congruence is not affected and
      the method of operation is the redirection pelvic osteotomy. In children up to
      the age of 10 the author applies Salter osteotomy and in elder children and
      adolescents he performs a triple osteotomy of pelvis. Grade III type is the most
      severe impairment because of the concurrent defect of the joint congruence, limb
      discrepancy and extensive anatomic changes of the proximal end of femur. Up to
      the age of 10 he recommends Salter innominate osteotomy with the simultaneous
      valgus osteotomy, in elder children he recommends successively a triple pelvic
      osteotomy and a double intertrochanteric valgus osteotomy. This facilitates a
      considerable improvement of most hip joints affected in this way and at the same
      time the compensation of the limb length.

PMID- 2239039
TI  - [Fournier's gangrene].
AB  - Two patients with a necrotizing soft tissue infection of the scrotum and perineum
      are described. The etiology was found to be a gram negative synergistic gangrene.
      Patients were managed with extensive necrotectomy with a planned second look
      operation and supportive antibiotics (aminoglycosides, amoxicillin,
      metronidazole). Despite this aggressive approach one of the patients died of
      ongoing necrosis. The therapeutic management for necrotizing soft tissue
      infection comprises early surgical intervention with supportive antibiotic
      treatment. Nevertheless the disease is associated with a high mortality rate.

PMID- 2239041
TI  - [The esthetic effect of surgical treatment of idiopathic scoliosis].
AB  - Idiopathic scoliosis has a negative impact on the heart and lungs in the deformed
      chest, its creates a cosmetic defect, i.e. asymmetry of the paravertebral
      prominence, shortening of the trunk, asymmetry of the shoulders and protruding
      scapulae. Later it may cause pain and nervous disorders. In a group of 46
      patients aged 15.5 years with thoracic right-sided idiopathic scoliosis the
      effect of operation by Harrington's instrumentation and spondylodesis on
      improvement of the curvature and the cosmetic effect were investigated.
      Preoperative curvature of 69 degrees according to Cobb improved to 35 degrees (by
      50%) and the prominence from 38 mm before operation to 23 mm after operation (by
      32%). The operation had also a positive effect from the cosmetic aspect which is
      of great psychological importance for the patients, in particular girls.

PMID- 2239042
TI  - [Spondylothoracic dysplasia].
AB  - The authors describe 4 cases of spondylothoracal dysplasia. In two of them the
      severity of scoliotic deformity necessitated surgical treatment, the other two
      cases are under observation, as numerous malformations are at present
      compensating each other. All of them fall into the type II with a good life
      prognosis. The analysis of patients and survey of findings from the available
      literature facilitates a better familiarization with this syndrome.

PMID- 2239043
TI  - [Tuberculosis of the upper cervical spine].
AB  - The authors present a case report on a 25-year-old female patient with the
      tuberculous spondylitis of 2nd cervical vertebra. For the treatment they choose a
      two-stage surgical procedure. Within the first stage they removed transorally the
      focus and filled in the defect in the body of the vertebra with autospongy bone
      grafts. In the second stage they stabilized the spine from the dorsal approach.
      Postoperative treatment in the plaster of Paris collar lasted three months. Thus
      the disease was quickly eliminated.

PMID- 2239044
TI  - [The tasks and objectives of geriatric orthopedics].
AB  - The ageing of population all over the world including Czechoslovakia where the
      share of people above 60 years of age is 14-15 per cent of the whole population
      (by the year 2010 this share should reach 20 per cent and a very frequent
      incidence of diseases and traumatism of osteoarticular apparatus in elderly
      people necessitates specialized care of geriatric patients. Geriatric
      orthopaedics is a combination of the principles of internal medicine and
      orthopaedics applied on old people. Geriatric orthopaedics deals with 3 major
      problem areas of diseases in old age: 1. osteoporosis, 2. osteo-arthrosis, 3.
      traumatism. The author concentrates on the problems of diagnostics, prevention
      and treatment of osteoporosis as well as on its social and economic aspects. He
      also deals with the incidence, conservative and surgical treatment of osteo
      arthrosis in old age and with the possibilities of its prevention. Presented are
      the principles of an up-to-date treatment of geriatric traumatism and the
      rehabilitation based on the author's experience and recent data from the
      literature.

PMID- 2239045
TI  - [Traumatic indications for total hip joint prosthesis].
AB  - In the years 1978-1986 the authors implanted 207 total prostheses in patients
      with the fracture of the femoral neck or after the fractures in the area of the
      hip joint. 50 patients were operated on for an acute fracture of the neck. The
      surgical technique in these indications does not differ on principle from the
      surgical technique of coxarthrosis. They point out a higher number of some
      peroperative complications. They checked 141 patients with and average follow-up
      of 47 months. In 4.2 per cent of late complications they reported
      roentgenological symptoms of loosening. Reoperation because of the loosening of
      the acetabular component was inevitable in 2.9 per cent of patients. All these
      cases fall into the group of patients in which the total hip arthroplasty was
      performed after the fractures of the acetabulum. In no patient it was necessary
      to reoperate the femoral component. Within the check up the patients underwent
      roentgenological examination and the result was assessed by the method according
      to Harris. In total, excellent result was reported in 43.2 per cent of patients,
      good result in 29.8 per cent, fair result in 14.2 per cent and poor result in
      12.8 per cent of patients. With regard to a low number of complications and very
      good results of the evaluation according to Harris the authors consider total hip
      arthroplasty in the treatment of post-traumatic conditions for fully indicated.
      Total hip arthroplasty is indicated also in acute fractures of the femoral neck
      in which it brings in a short time interval good functional results with minimum
      complications. A group at risk is represented by patients operated on after the
      fractures of acetabulum.

PMID- 2239047
TI  - [Definition of "polytrauma" and "polytraumatism"].
AB  - Polytrauma (multitrauma) is a short verbal equivalent used for severely injured
      patients usually with associated injury (i.e. two or more severe injuries in at
      least two areas of the body), less often with a multiple injury (i.e. two or more
      severe injuries in one body area). An important condition for the use of the term
      polytrauma is the incidence of the traumatic shock and/or hemorrhagic hypotensis
      and a serious endangering of one or more vital functions of the organism. At
      least one out of two or more injuries or the sum total of all injuries endangers
      the life of the injured person with polytrauma. For its variable and non
      homogeneous content the term polytrauma cannot be used as a final diagnosis
      without an objective quantification of the extent of the severity of the injury.
      The author therefore recommends to use this term to express a severe injury
      endangering the life as a general term which must be necessarily specified by the
      actual morphological and functional diagnoses. The term "polytraumatism" used in
      practice is not exactly a synonym of polytrauma, however, it has a direct
      generalizing relation to it. Polytraumatism embraces the broad health care and
      general societal problem area relating to severe associated and multiple injuries
      (i.e. to polytrauma). The author presents the actual classification of
      polytraumas according to their severity into four, three or two groups. This
      classification is based on the principles of general quantification of the
      severity of the injury (from the viewpoint of individual injuries and at the same
      time from the viewpoint of all concurrent injuries) divided into five or six
      grades.

PMID- 2239046
TI  - [Tissue loss injury of the proximal phalanx of the thumb and repair using a rib
      graft].
AB  - In their case report the authors deal with the loss tissue injury of the proximal
      phalanx of the thumb caused by a circular saw. The first treatment on the day of
      the injury was carried out at the local clinic, the edges of the wound were
      trimmed and the residual small bone fragments were removed. Then suture was made
      of the dorsal aponeurosis and a K-wire was drilled in percutaneously through the
      distal phalanx into the base of the proximal phalanx in order to maintain the
      distance between the fragments. Wide-spectrum antibiotics were applied together
      with antitetanus-toxic injections and anti-gangrenous serum. After 9 weeks when
      the wound was healed per primam the patient was sent for further treatment to the
      central clinic. There they introduced extension through the nail of the thumb and
      left it there for 15 days. 11 weeks after the injury the patients was operated
      on. A bone graft was made from part of 6th rib and fixed to the residue of the
      base by a T-shaped plate. The distal phalanx was then transfixed to the bone
      graft by 2 crossed-K-wires. The wound healed per primam, K-wires were removed
      after 6 weeks. The grasping function of the hand was preserved, the residual
      motion was possible in the metacarpophalangeal joint of the thumb,
      interphalangeal arthrodesis was stable. The patient resumed his original job as a
      painter.

PMID- 2239048
TI  - [The information system at the Orthopedic Clinic of the Institute for Physicians
      and Pharmacists].
AB  - Technological progress in the eighties achieved in the development and
      implementation of computer technology facilitates new approaches to information
      processing. Informatics becomes one of the key branches of economy of advanced
      countries. Under the conditions of the present growth of the volume of
      information also health care must change the classical form of information
      processing if it is to fulfil its function properly. The consideration is
      presented on the possibilities of the introduction of computer technology in our
      clinics and the problems resulting from it. The experience is described with
      developing a data base information system of the Orthopaedic clinic of the
      Institute for In-Service Training of Physicians and Pharmaceutists using ADT 4700
      minicomputer.

PMID- 2239049
TI  - [An instrument for injection of bone cements].
AB  - The author describes the use of a specially developed instrument, which in
      combination with Chirana 30 ml syringe for one use facilitates the injection
      application of bone cement in the implantation of the femoral component of total
      hip arthroplasty or cervicocapital endoprosthesis of the hip. Emphasis is put on
      the availability of this instrument for all clinics and on the importance of the
      application of bone cement under pressure from the view point of longterm results
      of the above mentioned joint arthroplasty. No evident disadvantages in comparison
      with imported instruments have been found out.

PMID- 2239050
TI  - The treatment of infected wounds. Review.

PMID- 2239051
TI  - Rapid estimation of serum myoglobin concentration during rhabdomyolysis with a
      latex-agglutination test (Rapi-Tex).
AB  - A latex-agglutination test (Rapi-Tex) was used for semiquantitative estimation of
      myoglobin concentration in 89 serum samples obtained from ten patients undergoing
      lower-limb arterial embolectomy. Each serum sample was tested with Rapi-Tex both
      undiluted and after 1:50 dilution with saline. The myoglobin concentration was
      additionally measured with enzyme-immunoassay. In the undiluted samples there
      were five 'false negative' Rapi-Tex results--two in the myoglobin concentration
      interval 0-300 micrograms and three in the samples with myoglobin exceeding
      25,000 micrograms/l--and four 'false positive' results. None of the diluted
      samples gave rise to false classification. Using 1:50 diluted serum, the negative
      predictive value of the Rapi-Tex test for identification of a myoglobin
      concentration greater than 5,000 micrograms/l was 0.99 (95% confidence limits
      0.94-1.00), and the positive predictive value was 1.00 (0.61-1.00). Rapi-tex is
      concluded to be a useful emergency test for severe hypermyoglobinemia.

PMID- 2239052
TI  - An improved prognostic index of axillary node involvement in breast cancer
      incorporating DNA ploidy and tumour size.
AB  - A multivariate prognostic index based on clinical data and the results of flow
      cytometry for the grading of breast cancer was evaluated in 117 patients whose
      disease had been detected and treated by mastectomy with axillary clearance
      between 1974 and 1976. Survival analysis with Cox's regression model pointed to
      three important prognostic factors: lymph node involvement (p less than 0.001),
      DNA ploidy (p less than 0.01) and tumour size (p less than 0.01). These factors
      were incorporated into a prognostic index, in which the lymph node involvement,
      DNA ploidy, and tumour size contributed to the index in that order. Logistic
      discriminant analysis with five year follow-up as the fixed end point (70 alive,
      47 dead) gave the same result; lymph node involvement, tumour size, and DNA
      ploidy were the best prognostic indicators of survival. The result showed that
      our multivariate prognostic index was more powerful than lymph node involvement
      alone. The use of this prognostic index is recommended for selecting patients for
      different treatments.

PMID- 2239053
TI  - Host defence and bacterial growth in fosfomycin-treated peritonitis. Experimental
      observations in pigs.
AB  - An approximately steady state of bacterial density intraperitoneally has been
      observed in bacterial peritonitis. This state, which follows an initial (0-4 h)
      phase of rapid elimination of bacteria, was now studied in a model of porcine
      peritonitis. Twelve pigs were intra-abdominally infected with 10(10) CFU each of
      Escherichia coli and Bacteroides fragilis. Six of the pigs received no antibiotic
      and six were given two doses of fosfomycin (anti-aerobic), 1 g i.v., with the aim
      of disturbing possible equilibrium between rapid proliferation and destruction of
      the sensitive E. coli. Levels of fosfomycin up to 90 times the minimum inhibitory
      concentration (1 mg/l) were detected in the peritoneal exudate, but the
      antibiotic had no discernible effect on E. coli density or elimination pattern
      compared with B. fragilis in the same pig or with observations in controls. The
      results favoured the concept of slow-replicating E. coli and hence declining
      activity of the defence mechanisms a few hours after the induction of
      peritonitis.

PMID- 2239054
TI  - A porcine model for acute distal aortic occlusion.
AB  - Periarterial and intramural nerves and lymphatics as well as the vascular
      endothelium may influence pathophysiologic responses to acute arterial occlusion.
      For study of such pathophysiologic patterns, experimental models resembling the
      clinical situation are therefore preferable. In this porcine study acute distal
      aortic occlusion was mimicked by use of a balloon catheter introduced via a
      vascular graft anastomosed to the lateral aortic wall. Peripheral circulatory
      disturbance was assessed by measurements of femoral vein blood flow, skin blood
      flow in the hind foot and oxygen tension in the calf muscle, which verified the
      degree of ischemia. During the 4-hour ischemic period, repeated arterial and
      venous blood gas analyses showed increasing acidosis in effluent venous blood
      from the hind limbs, which after reperfusion slowly normalized. As highly
      reproducible conditions are achievable with the present experimental model, it
      can be used for studies of pathophysiologic responses to acute distal aortic
      occlusion.

PMID- 2239055
TI  - Indomethacin and pancreatic blood flow. An experimental study in pigs.
AB  - Indomethacin has been reported to decrease pancreatic blood flow. The drug has
      been used as an analgesic in acute pancreatitis. As decreased blood flow to the
      pancreas may detrimentally affect the outcome of acute pancreatitis, we
      investigated the effects of indomethacin on blood flow in the normal porcine
      pancreas. Regional blood flows, with special reference to the pancreatic flow,
      were studied with radioactively labelled microspheres in ketamine-anesthetized
      pigs before and after intravenous administration of indomethacin 2 mg/kg during
      10 min. A transient decrease of cardiac output was seen during the infusion.
      Basal pancreatic blood flow was significantly increased 10 and 30 min after
      administration of indomethacin. No significant changes were found in small
      intestinal or renal blood flow. We conclude that indomethacin does not reduce
      blood flow in normal porcine pancreas.

PMID- 2239056
TI  - Local energy metabolism in healing colon anastomosis. An enzyme-histochemical
      study in rats.
AB  - Local energy metabolism in healing colonic anastomosis was studied in rats. A one
      layer, inverting colo-colostomy was performed and frozen sections from the
      anastomotic area were enzyme-histochemically stained for key enzymes in energy
      metabolism. Anaerobic metabolism prevailed in the anastomotic area during the
      first postoperative week. The repair tissue between the inverted colonic leaves
      showed the first sign of aerobic glycolysis 1 week postoperatively. Increasing
      lactate dehydrogenase activity, however, was seen from day 3 onwards
      (simultaneously with revascularization), and indicators for amino acid
      metabolism, lysosomal activity and metabolism via the pentose phosphate shunt
      were present even earlier--from day 1 onwards. Anastomotic surgery was followed
      by severe reduction of metabolism in all layers of the colonic wall 0-5 mm from
      the anastomotic line. Normal metabolism was not restored until postoperative day
      21. These findings should be considered in surgical techniques and post-operative
      management.

PMID- 2239057
TI  - Thoracic empyema--a delayed complication of excluded benign thoracic oesophagus.
      Case report.
AB  - Delayed 'blow-out' of retained thoracic oesophagus, 2 years after its exclusion
      for iatrogenic oesophageal perforation, gave rise to thoracic empyema.
      Oesophageal exclusion performed for benign, non-caustic conditions tends
      particularly to cause complications. Excision of the oesophageal remnant should
      therefore be considered in restoration of alimentary-tract continuity.

PMID- 2239058
TI  - Resectable leiomyosarcoma of inferior vena cava presenting as carcinoma of the
      pancreas. Case report.
AB  - A 61-year-old woman was thought to have a cancer of the head of pancreas on
      ultrasonography, computed tomography, and endoscopic retrograde
      cholangiopancreatography (ERCP). At laparotomy, however, the pancreas was normal,
      and the tumour originated in the inferior vena cava. Histological examination
      showed a moderately differentiated leiomyosarcoma. The outcome was uneventful
      after caval resection and reconstruction with a polytetrafluoroethylene (Goretex)
      patch.

PMID- 2239059
TI  - Toxicokinetics in clinical toxicology.
AB  - Toxicokinetics is an essential step in clinical toxicology. The methodology is
      based on the same parameters which are used in pharmacokinetics. However, the
      interpretation and the aims are different. For each toxicon, the interpretation
      of kinetic data needs to take account of the spontaneous toxicokinetics, the
      factors of variation, the relationship kinetic data and symptoms, the severity
      and prognosis criteria. The evaluation of treatment has to take account of the
      global kinetic action of the toxicon during the intoxication and the effects on
      the symptomatology. The mechanism of toxicity, is an essential item in the
      interpretation of toxicokinetic data. By the exact knowledge of toxicokinetics,
      it is possible to determine for each toxicon, the relevant parameters which will
      be of use in clinical practice.

PMID- 2239060
TI  - Accidental nasal eucalyptol and menthol instillation.

PMID- 2239061
TI  - Accidental ingestion of a sterilising tablet (dichloroisocyanurate) by a 28 day
      old infant.

PMID- 2239062
TI  - Acute intoxication by ingestion of inorganic mercury salts.

PMID- 2239063
TI  - Biological valuation of extra-corporeal techniques in acute poisoning.
AB  - The efficiency of dialysis methods a/o hemoperfusion in acute poisoning cannot be
      clinically estimated, because: a) Concomitant intestinal absorption, hepatic
      metabolism and urinary excretion must be taken into account. b) With supportive
      treatment alone, spontaneous recovery usually occurs in 98% of the intoxications
      in Intensive Care Units. The efficiency of these methods can only be estimated
      biologically. Measuring the blood level at the beginning and the end of the
      treatment as well as measuring the clearances of the drug is misleading. A better
      method is to measure the amount of extracted drug, either indirectly by
      calculation (from hourly differences of arteriovenous measures of drug
      concentration multiplied by the blood flow) or directly by elution of the
      cartridge or measures in dialysis fluid. Plasma kinetics under dialysis a/o
      hemoperfusion should be compared with spontaneous toxicokinetic of the substance
      and not with pharmacokinetic data. The experience of toxicologists has shown
      dialysis a/o hemoperfusion to be ineffective for drugs with weak extra-cellular
      distribution (such as Digoxine, Tricyclic drugs, heavy Metals, Colchicine). In
      the case of intoxication with Paraquat or Paracetamol, there is a negative
      correlation between the amount of removed intoxicant and the survival: death is
      likely to occur when the procedure has been very productive. In the case of
      intoxication by hypnotic drugs, one hemodialysis a/o hemoperfusion allows the
      removal of an average of 4-12% of the ingested barbiturates, 7-17% of the
      ingested Meprobamate. Whether these results can be judged satisfactory, life
      saving of insignificant is largely a matter of personal standards.

PMID- 2239065
TI  - The role of the laboratory of toxicology in the diagnosis and therapy of the
      poisoned patient.

PMID- 2239064
TI  - Current status of antidotal therapies in acute human intoxications.
AB  - The purpose of this work is a review of usefulness, indications and handling of
      some antidotes which are at our disposal for therapeutic use since several years,
      especially naloxone, flumazenil, Fab fragments of digoxin specific antibodies,
      hydroxocobalamine, 4-methyl-pyrazole, N-acetylcystein or the new metal chelators.
      Older clinically relevant substances are also reviewed.

PMID- 2239066
TI  - Specificities of child poisoning.

PMID- 2239067
TI  - Carbon monoxide poisoning--recent advances.

PMID- 2239069
TI  - Poisoning by some insecticides, herbicides and fungicides.
AB  - To avoid accidental poisoning, pesticides must be handled according to prescribed
      rules. Furthermore, the exact composition of the pesticide formulation should be
      known. Cases of acute poisoning usually occur by ingestion and less frequently by
      the other routes. Symptoms may appear immediately but sometimes they can appear
      later and/or be more prolonged giving rise to delayed death and/or delayed
      morbidity. Acute poisoning by raticides and by organophosphate insecticides
      should deserve all our attention. Poisoning by herbicides containing chlorate
      salts, oxidative phosphorylation uncouplers or bipyridilium derivatives may be
      particularly dangerous. The ingestion of Paraquat, in particular, which is a
      veritable lesional poison, could be beyond all therapeutic resources.

PMID- 2239068
TI  - Caustic intoxication.
AB  - After a retrospective study of 17 cases of caustic intoxication in the intensive
      care unit, the epidemiologic, pathophysiologic, clinic and therapeutic aspects
      are reviewed. The following procedure is suggested: early endoscopies, abstention
      of any gastric lavage, corticosteroids and empiric antibiotic therapy and the
      most early possible introduction of a parenteral nutrition.

PMID- 2239070
TI  - Anticholinergic intoxications. A case report.

PMID- 2239071
TI  - Self-poisoning treated in an intensive care unit.

PMID- 2239072
TI  - False negative results in routine analytical toxicology screening in the case of
      an acute scopolamine poisoning.

PMID- 2239074
TI  - Weather influence on the prevalence of carbon monoxide intoxications.

PMID- 2239073
TI  - Strychnine poisoning, hypoxic damage, severe acidosis: a case report.

PMID- 2239075
TI  - Acute poisoning in a children's hospital: an 8 year experience.

PMID- 2239076
TI  - Growth hormone secretion patterns in relation to LH and testosterone secretion
      throughout normal male puberty.
AB  - Pulsatile growth hormone secretion patterns were studied in relation to LH and
      testosterone release in 30 healthy prepubertal boys and 2 adult men. Plasma GH
      was measured every 10 min, plasma LH and testosterone every hour. Night-time GH
      secretion parameters were 2-3 times higher than daytime values. During daytime,
      mean GH level and the fraction of GH in pulses increased from Tanner stage G2 to
      G4 (p = 0.01); during night-time these parameters increased as well (p less than
      or equal to 0.1) and decreased from stage G5 to adulthood (p = 0.05). GH pulse
      number did not increase; the number of high-amplitude (greater than 8
      micrograms/l pulses, however, increased from stage G2 to G4 (p = 0.05) during the
      day. Height velocity correlated with their number of high pulses during day and
      night (tau = 0.39, p less than 0.003). From stage G2 to G4 significant
      correlations were observed between nocturnal testosterone levels and GH secretion
      parameters (tau = 0.53-0.57), in contrast to nocturnal LH levels. It is concluded
      that during puberty 1. GH secretion increases as a result of an increased pulse
      amplitude; 2. there is no consistent correlation between GH and LH levels; 3.
      increasing nocturnal testosterone levels are correlated with the increasing GH
      secretion; therefore GnRH does not seem to influence GH secretion directly, but
      an indirect effect via testosterone is more conceivable, and 4. height velocity
      is correlated with the number of high GH pulses.

PMID- 2239077
TI  - Pulsatile growth hormone release in Turner's syndrome and short normal children.
AB  - To determine whether the quantitative and qualitative aspects of GH secretion in
      girls with Turner's syndrome are similar to those of short-normal children we
      studied the 24-h GH secretion of 10 patients with Turner's syndrome and 9 short
      normal children with comparable auxological features. GH profiles, obtained by 30
      min sampling, were analysed by the Pulsar programme. The pulsatile GH release
      over the 24 h in Turner's syndrome was similar to that in normal children.
      However, when the GH release over the 12 day and night hours were separately
      analysed, only normal children showed a night-time increase in the sum of peak
      amplitudes. Moreover, patients with Turner's syndrome had significantly decreased
      number and frequency of peaks in the night-time compared with short children. In
      short-normal children but not in Turner's syndrome, height velocity was related
      to the 24-h integrated concentration of GH, area under the curve over zero-line
      and over baseline, sum of peak areas, and amplitudes. Night-time GH area over
      zero-line and over baseline, mean peak amplitude, height area, sum of peak area
      and amplitudes were positively correlated with height velocity in short children,
      whereas in Turner's syndrome height velocity was related to daytime parameters
      only. In conclusion, girls with Turner's syndrome have a discrete pattern of
      pulsatile GH release. However, the relation of GH secretion to growth in these
      patients, is uncertain.

PMID- 2239078
TI  - Pharmacokinetics of the antiprogesterone RU 486: no correlation to clinical
      performance of RU 486.
AB  - The pharmacokinetics and metabolism of RU 486 were characterized in 17 women who
      received a single dose of 600 mg of RU 486 for termination of an early unwanted
      pregnancy. Based on the clinical outcome and serum chorionic gonadotropin values,
      the subjects were divided into two groups: those who aborted completely (i.e.
      responders: N = 13) and those who did not respond to RU 486 treatment (i.e. non
      responders: N = 4). The serum levels of RU 486, the monodemethylated,
      didemethylated and hydroxylated metabolites of RU 486 were measured by HPLC
      preceded by column chromatography. There were no significant differences in the
      serum levels of RU 486 or its metabolites between the two groups. The serum
      concentrations of alpha 1-acid glycoprotein, the binding protein for RU 486, were
      quantitated by immunoturbidimetry. The alpha 1-acid glycoprotein concentrations
      were similar in responders and non-responders. The metabolism of RU 486 was also
      studied by fractionating extracts of serum pools of responders and non-responders
      on thin-layer chromatography, and subsequent RIA analysis of the eluates of the
      sliced thin-layer chromatography. Spots with similar distribution and percentages
      of cross-reactivity were found in both groups on the chromatography; the results
      were also similar to those from a serum pool to which synthetic RU 486 and its
      three metabolites had been added. Hence it is concluded that failure to abort in
      response to RU 486 therapy is not associated with altered pharmacokinetics or
      metabolism of RU 486.

PMID- 2239079
TI  - Antithyroid drug treatment of Graves' disease in pregnancy: long-term effects on
      somatic growth, intellectual development and thyroid function of the offspring.
AB  - With regard to their thyroid function, somatic and intellectual development, we
      compared 17 children of 13 hyperthyroid mothers (group I) receiving antithyroid
      drug treatment during their pregnancies with 25 children of 15 mothers who were
      euthyroid without any antithyroid treatment during their pregnancy (group II).
      Mean duration of maternal treatment was 3.5 months in group I, using carbimazole
      or thiamazole (N = 12) and propylthiouracil (N = 1). Age at examination in group
      I was 7.2 +/- 6.2 years, in group II 8.7 +/- 7.1 years (mean +/- SD). Both groups
      showed no significant differences in the results of the clinical examination and
      in the degree of their mental and psychomotoric development at the time of study.
      We found the mean birth weight of the infants in group I significantly lower than
      in group II (3165 +/- 339 vs 3666 +/- 670 g, p less than 0.03). The individual
      birth weights, however, were normal for gestational age. The body weight
      difference between groups disappeared during the further somatic development of
      the children. The serum concentration of free thyroxine in group I was
      significantly higher than in group II (17.2 +/- 2.4 vs 14.9 +/- 1.9 pmol/l, p
      less than 0.003), but fell in both groups within the normal range. The evaluation
      of the psychomotoric and intellectual capacity of the children at different
      developmental stages showed no abnormalities detectable by our tests. Thus, in
      the children of the two groups we found no adverse effects of a maternal
      antithyroid drug treatment during pregnancy or of inactive maternal Graves'
      disease alone, neither on thyroid gland size and function nor on the physical or
      intellectual development, after the neonatal period.

PMID- 2239081
TI  - Epidermal growth factor and platelet-derived growth factor in blood in diabetes
      mellitus.
AB  - Epidermal and platelet-derived growth factors are potent mitogens for many types
      of cells, including smooth muscle cells. Epidermal growth factor in blood of
      humans is present both in platelets (as reflected in its serum level) and in
      plasma, the source(s) of which remains unknown. We assayed its level in 82
      diabetic patients and 53 age-matched controls. In diabetes, epidermal growth
      factor level was increased in serum (191 +/- 43 vs 155 +/- 64 pmol/l, p = 0.0002)
      and plasma (53 +/- 9 vs 38 +/- 14 pmol/l, p less than 0.0001), without any
      difference between the patients with and without complications. Platelet-derived
      growth factor level was assayed only in serum of 19 patients with uncomplicated
      diabetes and found elevated (222 +/- 47) as compared with 13 controls (160 +/- 26
      pmol/l), (p = 0.0002). Type of diabetes, its duration, mode of therapy, control,
      presence of retinopathy or albuminuria (in case of epidermal growth factor), as
      well as C-peptide age and sex did not correlate with epidermal or platelet
      derived growth factor levels. Serum but not plasma epidermal and platelet-derived
      growth factor were negatively correlated with serum creatinine (correspondingly,
      r = -0.373, p = 0.0008 and r = -0.564, p = 0.0285). It is concluded that diabetes
      itself and not its complications cause increased levels of epidermal growth
      factor in plasma and serum and of platelet-derived growth factor in serum.

PMID- 2239082
TI  - The corticotropin-releasing factor test in the differential diagnosis of
      Cushing's syndrome: a comparison with the lysine-vasopressin test.
AB  - The diagnostic accuracy of the CRH test was compared with that of the LVP test in
      28 consecutive patients with ACTH-dependent Cushing's syndrome. A false negative
      response to CRH was found in 3 of 21 patients with pituitary-dependent Cushing's
      disease and to LVP in 4. The 7 patients with ectopic ACTH secretion were
      unresponsive to CRH, whereas 2 did respond to LVP. CRH and high-dose
      dexamethasone tests combination led to concordant results in 79% of patients. In
      all cases the etiological diagnosis suggested was correct. LVP and high-dose
      dexamethasone tests combination led to concordant results in only 71% of patients
      and the etiological diagnosis suggested was erroneous in one. Individual
      tolerance to the CRH test was also clearly better than that to the LVP test. It
      is concluded that the CRH test, alone or in combination with the high-dose
      dexamethasone test must be preferentially used to the LVP test in the
      differential diagnosis of ACTH-dependent Cushing's disease.

PMID- 2239083
TI  - Influence of growth hormone on the immunosuppressive effect of prednisolone in
      mice.
AB  - Growth hormone can be used to counteract some catabolic effects of long-term
      administration of glucocorticoids, such as impairment of growth in children and
      osteoporosis. However, owing to its immunostimulatory properties the hormone may
      counteract the effect of glucocorticoids on the immune system. To investigate
      this question we administered different doses of hGH (4, 8, 40 IU/kg) to
      C57/Bl/6J mice treated for two days with prednisolone, and evaluated thymus and
      spleen parameters and natural killer activity. Growth hormone at the dose of 4
      and 8 IU/kg reversed prednisolone-induced reduction of spleen and thymus weight
      and cellularity, whereas the highest dose showed to be immunosuppressive in
      itself. Two days after treatment withdrawal, a recovery of spleen parameters was
      evident, whereas the thymus was still suppressed by preceding prednisolone or hGH
      (40 IU/kg) treatments. The pattern of natural killer activity displayed by the
      splenocytes resembled that present under treatment. In a second experiment
      prednisolone, administered for 10 days, drastically reduced the number of viable
      spleen and thymus cells as well as the relative spleen and thymus weights, an
      effect reversed by concomitant administration of hGH (0.8, 4, 8 IU/kg). Natural
      killer activity, which was significantly depressed by prednisolone, was restored
      by the intermediate GH dose only. The 8 IU/kg GH dose was immunosuppressive in
      itself.

PMID- 2239080
TI  - Monoclonal antibodies reveal circulating growth hormone of high molecular weight
      not detectable by conventional assays.
AB  - A radioimmunoassay based on a monoclonal antibody. Mc-ab 1, which was raised
      against growth hormone but cross-reacted with human placental lactogen yielded
      higher GH immunoreactivity levels in serum than one based on a polyclonal
      antiserum. This discrepancy was noted in subjects with normal GH secretion as
      well as in patients with GH insufficiency. To characterize this GH
      immunoreactivity detected by Mc-ab 1, affinity purification and molecular sieve
      chromatography of serum were performed. High molecular weight proteins with GH
      immunoreactivity were found with both techniques. These proteins were associated
      with carbohydrates. Affinity cross-linking showed specific binding of
      radiolabelled GH to high molecular weight proteins in the serum. After
      fractionation of serum, the GH immunoreactivity became detectable by the
      polyclonal antiserum assay as well as by an immunoradiometric assay. GH
      immunoreactive material with an approximate mass of 80 kD was subjected to
      isoelectric focusing. When GH immunoreactive fractions at pH 5 were re
      chromatographed, GH immunoreactivity was recovered in the elution volume
      corresponding to monomeric GH. Our results show that sera from normal subjects as
      well as from patients with deficient GH secretion contain notable amounts of high
      molecular weight GH which is undetectable by antibodies generally used for GH
      measurements, but which can be revealed after fractionation of serum.

PMID- 2239084
TI  - The source of cholesterol for progesterone synthesis in cultured preovulatory
      human granulosa cells.
AB  - There are three possible sources of cholesterol for immediate use in progesterone
      production by preovulatory human granulosa cells: follicular fluid high-density
      lipoprotein, de novo synthesis of cholesterol, and performed intracellular
      cholesteryl ester stores. In the present study these three alternatives were
      investigated. First, an in vitro model was established that mimics the
      preovulatory environment, including short-term cultures and use of autologous
      follicular fluid in the culture medium, instead of serum. Using this model it was
      found that the presence of high-density lipoprotein from follicular fluid in the
      culture medium did not affect the synthesis of progesterone by the granulosa
      cells. Next, addition of inhibitors of de novo sterol synthesis, like low-density
      lipoprotein, 25-OH cholesterol and compactin to the culture medium, did not
      reduce [14C]acetate incorporation into sterols and steroids by the cells. The
      sterol synthesis was accordingly interpreted to be at a low and therefore
      uninhibitable level. Finally, the content of free and esterified cholesterol in
      freshly isolated granulosa cells was found to be 50 +/- 7 and 52 +/- 13 pmol/mg
      cell protein, respectively. We suggest that neither follicular high-density
      lipoprotein nor endogenous synthesis is the immediate cholesterol source for the
      progesterone production in preovulatory human granulosa cells. However, granulosa
      cells have a large store of cholesteryl esters that may provide free cholesterol
      for the preovulatory progesterone production.

PMID- 2239085
TI  - Intravenous administration of recombinant IGF-I lowers serum GHRH and TSH.
AB  - Recombinant IGF-I was administered as an iv bolus of 75 micrograms/kg to 10
      patients with Laron type dwarfism (3 children aged 9, 11 and 12 years and 7
      adults aged 30.6 +/- 3.5 years) and to 8 healthy subjects (mean age 19.9 +/- 12.1
      years) and determinations of IGF-I, GHRH, hGH, TSH, and glucose were made before
      and at 2, 5, 15, 30, 60, 90, and 120 min. The following effects were observed: a.
      an immediate, marked and sustained drop in blood glucose (p less than 0.001),
      more prolonged in the patients; b. in both groups, a dramatic rise in plasma hGH
      (p less than 0.01) which peaked at 60-90 min; in the patients this occurred after
      an initial immediate fall in plasma hGH (p less than 0.01); c. a progressive
      decrease of plasma GHRH and TSH (p less than 0.05, 0.02) in both patients and
      healthy controls. An hypothesis is put forward that acute and time-limited
      release of somatostatin by IGF-I is the main cause of the hormonal changes
      registered. As the IGF-I bolus also suppressed circulating insulin levels, the
      hypoglycemia is considered to be a direct effect of IGF-I.

PMID- 2239086
TI  - Evidence for a long-term storage of calcitriol in a patient with 1-alpha
      hydroxylase deficiency and rickets.

PMID- 2239087
TI  - Thyroid size and function in healthy pregnant women with thyroid autoantibodies.
      Relation to development of postpartum thyroiditis.
AB  - In a study of postpartum thyroiditis, thyroid function and ultrasonically
      determined thyroid size were evaluated in 36 thyroid autoantibody positive
      healthy women during pregnancy and the first postpartum year. Twelve women (33%)
      developed postpartum thyroiditis with permanent thyroid dysfunction in three.
      However, only one woman had symptoms and needed treatment. The most common type
      of thyroid dysfunction was a transient hyperthyroid phase as seen in 7 women. A
      significant increase by 20-30% in mean thyroid volume during pregnancy was
      demonstrated independent of development of postpartum thyroiditis. We conclude
      that initial thyroid volume or changes during pregnancy and post partum are not
      useful indicators of the development of postpartum thyroiditis. The fact that the
      condition is oligosymptomatic suggests that screening procedures are necessary if
      one wants to diagnose the earliest phases of postpartum thyroiditis.

PMID- 2239088
TI  - Parathyroid localization by 201Tl-99mTc subtraction scintigraphy: results in
      secondary hyperparathyroidism.
AB  - Subtraction scintigraphy with 201Tl and 99mTc for parathyroid localization was
      performed preoperatively in 13 patients with chronic renal failure and secondary
      hyperparathyroidism. Twenty of the 37 examined pathological glands were predicted
      correctly (sensitivity 54%). In 3 patients with recurrent hyperparathyroidism
      after surgery all pathological glands found at second operation had been detected
      correctly by subtraction scintigraphy. We conclude that this localization method
      has a limited value when used prior to first neck exploration in secondary
      hyperparathyroidism. In persistent hyperparathyroidism after surgery it may play
      a useful role in localizing missed and ectopic glands.

PMID- 2239089
TI  - Thyroid peroxidase/microsomal antibodies are not identical with thyroid cytotoxic
      antibodies in autoimmune thyroiditis.
AB  - Cytotoxic activity in sera of patients with Hashimoto's thyroiditis was measured
      with an antibody-dependent cell-mediated cytotoxicity assay. Cytotoxicity was
      determined in a 51chromium release assay using human thyroid cell targets
      incubated with heat-inactivated serum or IgG from patients with Hashimoto's
      thyroiditis. Effector cells were obtained from peripheral mononuclear cells of
      normal subjects. Cytotoxicity was significantly increased in patients with
      Hashimoto's thyroiditis (median specific lysis 20.2%, range 2.1-58.8) compared
      with normals (median specific lysis 8.1%, range 0-19.5; p less than 0.00001). The
      amount of percent specific lysis did not correlate with the titres of microsomal
      antibodies determined by different methods: passive hemagglutination technique (r
      = 0.2), enzyme immunoassay with microsomal antigen (r = 0.16), and
      radioimmunoassay for thyroid peroxidase antibody (r = 0.02). The cytotoxic
      activity was located in the IgG fraction, both in microsomal antibody positive
      and negative sera. After pre-incubation of microsomal antibody/thyroid peroxidase
      antibody positive or negative sera with purified thyroid peroxidase followed by
      analysis in the antibody-dependent cell-mediated cytotoxicity assay, cytotoxicity
      decreased in only 2 cases but was unchanged in the remaining sera. Western blot
      experiments with solubilized thyroid membranes and immunoblotting with cytotoxic
      positive/microsomal antibody negative sera showed no binding to thyroid
      peroxidase. Our data suggest that cytotoxicity in sera from patients with
      Hashimoto's thyroiditis is not mediated by antibodies against thyroid peroxidase,
      but by antibodies not yet identified.

PMID- 2239090
TI  - Diurnal variation in melatonin effect on adenosine triphosphate and serotonin
      release by human platelets.
AB  - The effect of the pineal hormone melatonin on adenosine diphosphate-induced human
      platelet aggregation and adenosine triphosphate release was assessed in platelet
      rich plasma obtained from normal volunteers at 08.30 and 20.30 h. In 10(-7)-10(
      5) mol/l concentrations melatonin inhibited ADP-induced platelet aggregation only
      in the evening (p less than 0.05). ADP-induced ATP release, an index of platelet
      secretory processes, showed a generally greater, dose-dependent inhibition after
      adding melatonin (10(-9)-10(-5)mol/l) at 20.30 h as compared with 08.30 h. The
      inhibitory activity of melatonin (10(-9)-10(-5) mol/l) on [3H]serotonin release
      elicited by thrombin in washed human platelets obtained from normal volunteers
      was dose-dependent; the effect was generally greater at 20.30 h. The activity of
      the potent platelet anti-aggregating agent prostacyclin did not exhibit diurnal
      differences with respect to impairing ADP-induced platelet-rich plasma
      aggregation. These results indicate the existence of a diurnal variation of
      sensitivity to melatonin in human platelets.

PMID- 2239091
TI  - Action and formation of inositol bisphosphate and inositol trisphosphate in rat
      anterior pituitary cells.
AB  - Inositol 4,5-bisphosphate and inositol 1,4,5-trisphosphate, administered
      exogenously at a concentration of 3 x 10(-5) mol/l increased LH release in
      superfused rat pituitary cells by 950 +/- 267% and 281 +/- 83%, respectively.
      This stimulatory effect was reversible and dose-dependent. Other inositol
      phosphates (inositol 1-monophosphate, inositol 1,4,5,6-tetrakisphosphate,
      inositol 1,3,4,5,6-pentakisphosphate and inositol 1,2,3,4,5,6-hexakisphosphate),
      tested in vitro, did not significantly influence LH release. In saponin
      permeabilized cells, the rate of basal and stimulated LH release was twice that
      in non-permeabilized cells. Penetration of inositol bisphosphate and inositol
      trisphosphate into saponin-treated pituitary cells did not increase the secretory
      potency of these agents compared with their effect on non-permeabilized cells.
      The new findings document that inositol trisphosphate formation occurs within 5
      45 s after GnRH (10(-7) mol/l) administration and seems to be involved in
      mediating the rapid, first phase of LH release, whereas inositol bisphosphate
      formation occurs after 3-15 min and is probably related to later phases of LH
      secretion. Our results suggest that inositol bisphosphate and inositol
      trisphosphate are important regulators of the release of luteinizing hormone and
      can exert their effects not only intracellularly, but also extracellularly.

PMID- 2239092
TI  - Relationship between molecular structures of sugars and their ability to
      stimulate the release of glucagon-like peptide-1 from canine ileal loops.
AB  - The structure-activity relationship of sugars inducing secretion of glucagon-like
      peptide-1 from the gut was examined using intestinal loops prepared from the
      terminal portion of the ileum of dogs. The plasma glucagon-like peptide-1
      concentration in a mesenteric vein draining only the looped region of the
      intestine was increased after infusion of 139 mmol/l solutions of D-glucose, D
      galactose, D-glucuronic acid, 3-0-methyl-D-glucose, maltose, sucrose or maltitol
      into the intestinal lumen, but not after infusion of solutions of D-fructose, D
      fucose, D-mannose, D-xylose or lactose. The increases in plasma glucagon-like
      peptide-1 concentration correlated with the corresponding increases in glucagon
      like immunoreactivity induced by these sugars. The plasma glucose level of the
      regional mesenteric vein increased significantly from the basal level after
      instillation of D-glucose, but not after instillation of other sugars. It is
      suggested that cells of the gut have a glucose sensor for release of products of
      the glucagon gene and that this sensor has specific steric requirements. The
      sugars that induced glucagon-like peptide-1 release share the molecular features
      of electron density near C(6), an equatorial hydroxyl at C(2), and an axial
      hydroxyl at C(1), which could account for their recognition by the glucose sensor
      to initiate the releases of glucagon-like peptide-1 and glucagon-like
      immunoreactivity.

PMID- 2239093
TI  - Parathyroid hormone and calcitonin may modulate hepatic IGF-I production in
      calves.
AB  - Four young milk-fed calves were fitted with catheters chronically implanted in
      the mesenteric, portal and hepatic veins and in the hepatic artery, and with
      electromagnetic blood flow probes in the portal vein and hepatic artery, allowing
      continuous measurement of IGF-I hepatic production. According to a latin square
      design, these calves received iv mesenteric infusion of calcium (Ca2+; 5 mg/kg)
      or synthetic salmon calcitonin (sCT; 1 microgram/kg), or synthetic bovine
      parathyroid hormone (1-34) (bPTH; 1 microgram/kg), or solvent alone (1.2 ml/kg).
      Ca2+, sCT or bPTH had no significant effect on portal vein or hepatic artery
      blood flow. Hypercalcemia observed following Ca2+ infusion did not significantly
      modify hepatic IGF-I production. sCT decreased plasma Ca2+, inorganic phosphorus
      and GH concentrations and hepatic IGF-I production. bPTH induced a slight
      hypercalcemia and hypophosphatemia. It had no significant effect on plasma GH
      concentration, but increased significantly hepatic IGF-I production. Thus, the
      anabolic effects of PTH on bone may be partly mediated through an increase in
      hepatic IGF-I production.

PMID- 2239095
TI  - [Echographic specificity in the early diagnosis of human hydatidosis].
AB  - Ultrasonography (US) were used for screening of hydatid disease in 1321
      asymptomatic individuals fron Rio Negro Province, Argentina. A total of 76
      positive subjects were identified with possible hydatid disease. Surgery was
      performed in 30 patients, conforming in 28 of them sonographic diagnosis
      (93.34%).

PMID- 2239094
TI  - Interleukin 1 beta and tumour necrosis factor alpha stimulate the release of
      gonadotropin-releasing hormone and interleukin 6 by primary cultured rat
      hypothalamic cells.
AB  - The abilities of recombinant human interleukin 1 beta and tumour necrosis factor
      alpha to induce release of GnRH and interleukin 6 from primary culture of rat
      hypothalamic cells were examined. The effect of estradiol on the release of
      interleukin 6 by these cells was also tested. Both interleukin 1 beta and tumour
      necrosis factor alpha caused significant stimulation of GnRH secretion from the
      hypothalamic cells within 5 min. The hypothalamic cells secreted interleukin 6
      spontaneously, and their secretion over 24 h was stimulated dose-dependently by
      interleukin 1 beta, tumour necrosis factor alpha and estradiol. These results
      suggest that interleukin 1 beta and tumour necrosis factor alpha stimulate the
      secretions of GnRH and interleukin 6 in the hypothalamus, and that these
      cytokines may be involved in the mechanism of GnRH secretion in the hypothalamus.

PMID- 2239096
TI  - [Evaluation of esophageal endoprosthesis].
AB  - In 60 patients with either non operable esophageal pathology on neighbouring
      organs pathology with esophageal involvement, esophageal endoprosthesis therapy
      was assessed. The various implantation techniques are described. Main causes for
      implantation were epidermoid esophageal carcinoma in 48 instances and gastric
      adenocarcinoma with esophageal involvement in 9 cases. The causes most frequently
      associated with early morbimortality were perforation in 4. All cases were
      medically treated with a 16.9% mortality rate (10 cases), due to broncoaspiration
      as main cause. Endoscopic reimplantation of the prosthesis was the treatment of
      choice in perforated cases.

PMID- 2239097
TI  - [Percutaneous hepatic biopsy puncture in patients with hemostasis disorders. A
      new technique].
AB  - In order to avoid the inconveniences of the trans-jugular liver biopsy, a
      modified percutaneous liver biopsy with embolization has been performed in 27
      patients with chronic hepatic diseases with or without hemostatic disorders. By
      means of a sheath and a Menghini or Tru Cut needle type, an embolization of the
      needle tract was carried out utilising coagulations factors (I, IIa and XIII).
      All procedures were laparoscopically visualised and the "Hepatic bleeding time"
      measured. With or without embolization, the "Hepatic bleeding time" found was 0-6
      seconds and 2-6 minutes, respectively. This modified technic is a safe and
      effective method for high risk bleeding patients and no hemorrhagic complications
      postprocedure observed.

PMID- 2239098
TI  - [Atypical chest pain: study by the hydrochloric acid provocation test].
AB  - Evaluation by means of gastroenterological and cardiological methods. The purpose
      of this paper was to study the origin of chest pain (CP) in patients with normal
      and pathological coronary arteries as characterized by coronary arteriogram (CA).
      Sixteen normal control individuals (X 27 years -7 females and 9 males) were
      studied by means of esophageal manometry (EM) with a 3 way catheter perfused by a
      low compliance capillary system. Twenty-one patients with chest pain were studied
      and divided according to coronary arteriogram in normal (NC) and pathological
      arteries (PC). They were simultaneously studied by means of EM, heart
      rate/pressure product (RPP), and 12 lead ECG monitoring. After a basal period
      they were given a Bernstein's provocative chest pain test, and after each of its
      stages we determined in a simultaneous fashion CP, EM, ECG and RPP. In 61.9% of
      the patients abnormal basal EM was found. It was characterized by increase in
      HPZ, duration, propagation velocity and pressure of the peristaltic waves: as
      well as an increase in the percentage of aperistaltic waves. In 14.2% of the
      patients the Hydrochloric provocative test was positive. The only statistically
      significant datum was the heart rate/RPP relationship. We conclude that in future
      studies it would be of interest to combine 24 hour monitoring EM and pH as well
      as a more sensitive provocation test such as edrophonium chloride.

PMID- 2239099
TI  - [Peutz-Jeghers syndrome: a case report].

PMID- 2239100
TI  - [Non-invasive staging in liver cirrhosis].

PMID- 2239101
TI  - Quantitative genetic analysis of longitudinal trends in height: preliminary
      results from the Louisville Twin Study.
AB  - A preliminary series of quantitative genetic models was applied to a subset of
      longitudinal height data, spanning birth to maturity, gathered from twin families
      in the Louisville Twin Study. Descriptive Cholesky factor parameterization was
      found to give more satisfactory results than did a system of constraints based on
      a model of developmental transmission of a time-constant and time-specific
      factors. The results from application of two autosomal sex-limitation models are
      contrasted with those from a model specifying both autosomal and sex-chromosomal
      patterns of inheritance. The latter model was more conducive to parameter
      reduction. Although these models do not constitute conclusive tests of autosomal
      sex-limitation versus sex-linkage, the more parsimonious model is consistent with
      previous research suggesting a stature locus on the long arm of the Y chromosome.
      Heritability of height is estimated at about 90% or greater from 6 years of age
      on. Substantial and fairly constant longitudinal genetic correlations are found
      from 3 years of age on. Shared environmental effects unrelated to parental height
      were seen for birth length, corrected for gestational age, to height at 3 years
      of age, but these are not satisfactorily differentiated from possible twin
      effects in the present sample. The genetic consequences of assortative mating are
      emphasized since failure to take assortment into account can lead to
      overestimation of shared environmental effects and under-estimation of genetic
      effects. The results indicate that about 20% of within-gender variability for
      mature height can be attributed to the genetic consequences of assortment, even
      though the phenotypic marital correlation of 0.22 is quite modest. The importance
      of testing the assumption of multivariate normality underlying the application of
      the method of maximum-likelihood is also highlighted.

PMID- 2239102
TI  - Simultaneous genetic analysis of longitudinal means and covariance structure
      using the simplex model: application to repeatedly measured weight in a sample of
      164 female twins.
AB  - The simultaneous analysis of means and covariance structures is applied to
      longitudinal twin data. Body weight was measured on six occasions in a sample of
      young female MZ and DZ twins. When average body weight at the first measurement
      occasion, as well as the increments in weight at later occasions, are specified
      in the genetic part of the model that also adequately explains the covariance
      structure, a good fit is obtained. In this application the increase in body
      weight at each occasion is weighted by the square root of the genetic variance
      innovation terms that represent the new genetic variance entering into the
      process.

PMID- 2239104
TI  - Genetic influences on respiratory sinus arrhythmia across different task
      conditions.
AB  - Respiratory sinus arrhythmia (RSA) has been shown to be a sensitive index of
      vagal cardiac control. We studied the genetic and nongenetic influences on
      individual differences in RSA in a sample of 160 adolescent twins. RSA was
      measured during rest and across two different tasks. Results show that
      heritability is task dependent. The amount of genetic variance is the same,
      however, during rest and task conditions. Because nonshared environmental
      variance decreases during tasks, heritability is larger for RSA measured under
      more stressful conditions than for RSA as measured during rest. Multivariate
      models assessed the continuity of the genetic and environmental influences and
      show genetic influences to be the same across different conditions, while
      environmental influences are different. More specifically, a one-factor model is
      found for genetic influences and a second-order autoregressive model for the
      environmental factors.

PMID- 2239103
TI  - Incorporation of twins in the regressive logistic model for pedigree disease
      data.
AB  - Segregation and twin disease concordance analyses have assumed a theoretical
      underlying liability following a multivariate normal distribution. For reasons of
      computation, of incorporation of measured explanatory variables, and of testing
      of fit and assumptions, newer analytical methods are being developed. The
      regressive logistic model (RLM) relies on expressing the pedigree likelihood as a
      product of conditional probabilities, one for each individual. In addition to
      logistic regression modelling of measured epidemiological variables on disease
      prevalence, there is modelling of vertical transmission, of transmission of
      unmeasured genotypes and of sibship environment. This paper discusses methods for
      the analysis of binary traits in twins and in pedigrees. Some extensions to the
      RLM for pedigrees which include twins are proposed. These enable exploration of
      twin concordance in the context of the twins' common parenthood, the sibship
      similarities within the family, and the twins' similarity in age, sex, genes and
      environment.

PMID- 2239105
TI  - Genetic and environmental influences on special mental abilities in a sample of
      twins reared apart.
AB  - The Minnesota Study of Twins Reared Apart has conducted comprehensive medical and
      psychological assessments of monozygotic (N = 49) and dizygotic (N = 25) twin
      pairs, separated early in life (average age of separation = 0.3 and 1.1 years,
      respectively) and reared apart during the formative years (average age of reunion
      = 30.3 and 37.2 years, respectively). The twins are administered two special
      mental ability batteries. The Hawaii Battery (H-B), supplemented by several
      Educational Testing Service tests, is administered toward the beginning of the
      assessment week. The Comprehensive Ability Battery (CAB) is administered toward
      the end of the assessment week. All data are age- and sex-corrected. The average
      MZA and DZA intraclass correlations for the 15 H-B subtests were 0.45 and 0.34,
      respectively, and the average MZA and DZA intraclass correlations for the 13
      subtests of the CAB were 0.48 and 0.35, respectively. Biometric model-fitting of
      these data indicate an average heritability of about 0.50. Data for groups of
      subtests in the Verbal, Spatial, Perceptual Speed and Accuracy and Memory domains
      were compared to a meta-analysis of the special mental ability findings in the
      ordinary twin literature. The Spatial domain appears to yield the highest and the
      Memory domain the lowest heritabilities.

PMID- 2239106
TI  - Genetic influences on neonatal temperament.
AB  - The genetic contribution to temperament was assessed during the neonatal period
      in 172 newborn infants from 47 pairs of monozygotic (MZ) and 39 pairs of same-sex
      dizygotic (DZ) twins. Zygosity was not related to the neonatal temperament
      variables. Examination of the scores for twin concordance indicated significant
      within-pair concordance in temperament ratings, but MZ twins were not more like
      each other than DZ twins. The results suggested that neonatal temperament was
      influenced by environmental factors. Further analyses indicated that neonatal
      temperament was influenced by perinatal variables such as birth weight, 1- and 5
      minute Apgar scores, and number of days spent in the hospital. It was concluded
      that there was no clear pattern of genetic influence on neonatal temperament, and
      that nonshared environmental factors were an important source of variance for
      temperament during this period.

PMID- 2239107
TI  - Living habits and personality development of adolescent twins: a longitudinal
      follow-up study in a birth cohort from pregnancy to adolescence.
AB  - The living habits of 289 twins in a one-year birth cohort beginning during
      pregnancy and followed up to adolescence were compared with those of 11,623
      singletons and two sets of controls matched either by maternal factors and place
      of residence only or by these and perinatal morbidity, all from the same cohort.
      The twins went in for sports more often than the singletons or any kind of
      controls. A nonsignificant trend was found indicating that twins smoked less
      often than their matched controls. The twins also used alcohol less often than
      their controls. The intrapair similarities of twins were higher than the
      similarities of twins and either type of controls in all four variables tested:
      sports, smoking, use of alcohol, as well as having been drunk.

PMID- 2239108
TI  - Qualitative and quantitative aspects on mathematics achievement in MZ and DZ
      twins.
AB  - Mathematics achievement test results have been collected for 22 MZ and 24 DZ same
      sex twin pairs in the Swedish compulsory school. The twins were approximately 11
      13 years of age and attended grades 4, 5, or 6. The twin pairs were part of a
      larger collaborative study between Israel and Sweden (the KAM-project). Teachers
      were asked how they planned and evaluated their work in the subjects Swedish and
      Mathematics. In addition to this, results for the twins on Maths tests given by
      the teachers in their regular work were collected. These tests were thus used by
      the teachers as an instrument to evaluate the educational process. Intrapair
      similarity for MZ and DZ twins has been compared for qualitative and quantitative
      aspects of the Maths tests. Different tests were used by the teachers but the
      same criteria have been used in the comparison. MZ twins are somewhat more
      similar than DZ twins for both the qualitative and quantitative aspects. Only one
      quantitative aspects, however, percentage of correct answers, shows a significant
      difference between the twin categories. A comparison was also made of intrapair
      similarity in classes, where the teachers differed according to planning and
      evaluation of their education. Irrespective of that, the MZ twins seemed to be
      more similar than the DZ twins in number of correct answers on the Maths tests.
      Educational implications are discussed.

PMID- 2239109
TI  - "Twins in school". An Australia-wide program.
AB  - The multiple birth family is more likely to have a dispute with the education
      system than with any other service. So many potential areas of conflict exist
      over the abilities and behaviour of multiples and over such issues as separation
      or keeping back one twin. One reason for disputes is the lack of good data to
      adequately reflect the different perspectives of parents and teachers and the
      differing needs of families: the same solution does not apply to all. To provide
      the first large-scale data base and building upon an initial survey of 85% of all
      primary school teachers in South Australia, the LaTrobe Twin Study and AMBA
      worked with Education Departments to set-up in each state Education Research
      Teams (ERTs) of parents of multiples who were also teachers. The ERTs were
      crucial in three phases. 1) Developing and circulating questionnaires and
      publicising the nationwide survey. 784 families and 1264 teachers of their
      children completed these questionnaires, many reporting that simply having to
      address the issues raised in the questionnaire was a valuable learning
      experience. 2) Exploring the data base. Issues arising included the very
      different bases on which parents and teachers judged separation desirable, with
      teachers emphasising the unsubstantiated claim that separation is essential to
      individual development. Separation became more common over the first three years
      of schooling but 20-25% of twins separated one year were back together the next.
      3) Running regional meetings of parents, teachers and administrators to discuss
      the results and to pool experiences and plan policies at the local level. A need
      clearly exists to improve the level of consultation between families and school
      personnel and to ensure the widespread availability of information which
      identifies key issues in making decisions for that multiple birth family.

PMID- 2239110
TI  - Permissiveness-restrictiveness for twins and controls in two educational
      settings: The Swedish compulsory school and the Israeli kibbutz.
AB  - In a previous longitudinal twin project a model was developed for studying
      heredity-environment interaction. One important environmental dimension in this
      model is permissiveness-restrictiveness. The purpose of the present study has
      therefore been to investigate perceived and imposed restrictiveness at the
      societal and classroom level and possible interactional effects on pupil
      behavior. Results are reported from grade 4 to grade 6 in Israeli kibbutzim and
      Swedish compulsory school. One major finding is that no systematic differences
      have been found between twins and controls in the two countries. In both Swedish
      schools and Israeli kibbutzim permissiveness-restrictiveness will vary depending
      upon perspective (perceived or imposed) and upon content (type of subject or rule
      breaking activity). Preliminary within-pair comparisons for the Swedish twins are
      reported for different types of test results. In agreement with the model,
      logical abstract thinking as well as reading and mathematics achievement seem to
      be less influenced by hereditary factors in a restrictive educational setting
      than in a permissive one.

PMID- 2239111
TI  - What information should the multiple birth family receive before, during and
      after the birth?
AB  - Advances in the management of the multiple pregnancy and delivery must be
      accompanied by corresponding improvements in service access outside key centres
      and especially in the information families receive about what may happen during
      or after the pregnancy. A major review of birthing services in Victoria has
      focussed attention on four areas where the quality of information is often
      inadequate. 1) Prepregnancy and the standard of counselling about the incidence
      of multiples as a result of fertility drugs and in vitro fertilization procedures
      and about problems which may accompany a multiple birth. 2) Antenatal: At what
      stage of the pregnancy should parents be told of the multiple pregnancy and how
      should monitoring of the mother and procedures such as bedrest take into account
      what are often conflicting demands within the family? 3) Perinatal: Families are
      frequently illprepared for a cesarean delivery and for the procedures for
      premature multiples. The problem is often compounded by separation of the mother
      from one or both twins. While bereavement services are improving, much still
      needs to be learned about handling congenital abnormalities in one or more
      multiples. 4) Postnatal: Irrespective of the level of prenatal advice, families
      greatly underestimate the workload with multiples. The resulting stress
      contributes to the incidence of postnatal depression, child abuse and divorce now
      being reported from multiple birth families. Some suggestions are made from
      social psychology and genetic counselling about how families can best handle risk
      information to achieve the goal of neither under- nor overestimating the risks at
      these different stages of the multiple pregnancy.

PMID- 2239112
TI  - What is it like to be a parent of twins?
AB  - A questionnaire was given to parents of twins concerning their perceptions of
      dependency and similarity in their twin children. Also, the parents were asked if
      they tried to influence their children to become more dissimilar. 70 same-sex
      twin pairs (35 MZ and 35 DZ) were included in the study and a questionnaire was
      sent both to the mother and the father of the twins. The twins were approximately
      12 years old and attended grade 4, 5 or 6 in the Swedish compulsory school.
      Results indicated that parents consider MZ twins to be dependent upon each other
      and to spend more time together. This was especially evident for girls. If the
      twins had a free choice they would also tend to choose similarly. This trend was
      also more pronounced for the MZ girls. Irrespective of zygosity, most parents
      reported that they did not try to influence their children. In the case of MZ
      twins this will probably make them become more similar over time. Differences
      between maternal and paternal answers tended to be nonsignificant.

PMID- 2239113
TI  - Ventilation-perfusion relationships and atelectasis formation in the supine and
      lateral positions during conventional mechanical and differential ventilation.
AB  - Patients without respiratory symptoms were studied awake and during general
      anesthesia with mechanical ventilation prior to elective surgery. Ventilation
      perfusion (VA/Q) relationships, gas exchange and atelectasis formation were
      studied during five different conditions: 1) supine, awake; 2) supine during
      anesthesia with conventional mechanical ventilation (CV); 3) in the left lateral
      position during CV; 4) as 3) but with 10 cm of positive end-expiratory pressure
      (PEEP) and 5) as 3) but using differential ventilation with selective PEEP (DV +
      SPEEP) to the dependent lung. Atelectatic areas and increases of shunt blood flow
      and blood flow to regions with low VA/Q ratios appeared after induction of
      anesthesia and CV. With the patients in the lateral position, further VA/Q
      mismatch with a fall in PaO2 and increased dead space ventilation was observed.
      Atelectatic lung areas were still present, although the total atelectatic area
      was slightly decreased. Some of the effects caused by the lateral position could
      be counteracted by adding PEEP. Perfusion of regions with low VA/Q ratios and
      venous admixture were then diminished, while PaO2 was slightly increased; shunt
      blood flow and dead space ventilation were essentially unchanged. During CV +
      PEEP, there was a decrease in cardiac output, compared to CV in the lateral
      position. DV + SPEEP was more effective than CV + PEEP in decreasing shunt flow
      and increasing PaO2 in the lateral position; in addition to this, cardiac output
      was not affected.

PMID- 2239114
TI  - A new method for studying the ventilatory response in patients.
AB  - A method for clinical studies of the ventilatory response to carbon dioxide and
      to hypoxaemia in patients is described. The main parameters with this method are
      respiratory frequency, tidal volume, minute volume, timing, and drive. The
      ventilation of volunteers was not affected while breathing air through the
      designed apparatus. The response to carbon dioxide and to hypoxaemia in
      volunteers was reproducible and similar to what has previously been described.
      Our method proved suitable to test the ventilatory responses in patients with
      varying degrees of impaired ventilation-perfusion ratios and thus also in
      patients with a low PaO2. Our method has a higher accuracy than earlier methods.

PMID- 2239116
TI  - The effect of removal of cerebrospinal fluid on cephalad spread of spinal
      analgesia with 0.5% plain bupivacaine.
AB  - Increased intraabdominal pressure is well known to cause higher cephalad spread
      of spinal analgesia. The reason for this is believed to be a decrease in the
      cerebrospinal fluid (CSF) volume. If this mechanism is correct, then the cephalad
      spread of local anesthetic solutions should also be facilitated when the CSF
      volume is intentionally reduced without increasing the intraabdominal pressure.
      Sixty-six patients without evidence of increased intraabdominal pressure and
      undergoing urological procedures were randomly allocated to three groups. All
      received 10 mg 0.5% bupivacaine for spinal anesthesia. In Group I, the anesthetic
      was injected after free drops of CSF. In Groups II and III, three and five ml
      were removed, respectively, before injecting bupivacaine. Mean cephalad spread of
      analgesia 20 min after injection in the three groups was T10.2 +/- 2.0, T9.4 +/-
      1.8 and T7.0 +/- 2.1, respectively. When CSF was reduced by 5 ml, the level of
      spread not only showed a statistically significant difference from that of the
      control group, but also from that of Group II (P less than 0.05). Our results
      show that higher cephalad spread of spinal anesthetic is possible by reducing the
      CSF volume without evidence of increased intraabdominal pressure.

PMID- 2239115
TI  - Intermittent high frequency ventilation. Clinical evaluation of a new mode of
      ventilation.
AB  - In this first clinical study of a new mode of ventilation, called intermittent
      high frequency ventilation (IHFV), a comparison was made in ten patients after
      myocardial revascularization, between normal ventilation, high frequency
      ventilation (HFV) and IHFV at 15, 60, 100 and 160 breaths per min (b.p.m.).
      During IHFV the ventilation was interrupted for 3 s 7 times per min. The measured
      mean trapped gas volumes were 219 ml at 60 b.p.m. and 716 ml at 160 b.p.m. At 160
      b.p.m. during IHFV, the mean, mean airway pressures, pulmonary artery (PAP) and
      capillary wedge pressures and the Paco2 were decreased, while the cardiac output
      increased. When the Paco2 was maintained constant, IHFV also allowed a reduction
      in the mean peak and mean airway pressures. This new mode of ventilation can
      prevent sustained increases in the lung volume and provide a reduction in
      intrapulmonary pressures. It also permits the measurement of the trapped gas
      volume and end-tidal CO2 gas concentrations several times a minute for the
      clinical management of patients during high frequency ventilation.

PMID- 2239117
TI  - Position of minitracheostomy tube verified fiberoptically--a report of 2 cases.
AB  - Two reports concerning difficulties at insertion of a minitracheostomy cannula
      are presented. In one patient, a minitracheostomy tube perforated the posterior
      wall of the trachea, resulting in pneumomediastinum. In another patient,
      conventional signs, i.e. airflow and passing of a suction catheter through the
      cannula, were misleading in assessing the position of the tube. Fiberoptic
      tracheoscopy immediately after the performance of minitracheostomy revealed the
      position of the cannula in both cases.

PMID- 2239118
TI  - Disturbances in renal cortical perfusion with reference to the microsphere
      technique.
AB  - The microsphere technique for studying renal blood flow is based on injection of
      a small volume containing radioactively labelled microspheres into the left
      atrium, left ventricle or possibly the root of the aorta. In the present
      methodological study, superficial renal cortical blood flow and tissue
      oxygenation were measured in anaesthetized pigs by laser Doppler flowmetry and by
      oxygen surface electrode technique. Rapid and profound transient decreases in
      superficial renal cortical blood flow and tissue oxygenation were found after
      injection of small volumes of plasma and saline into the left atrium. This
      response was present also when solutions without microspheres were injected. The
      reaction was not abolished by careful adjustment of the injectate temperature.
      When the rapid onset of flow reduction is related to the estimated time of
      delivery of the bolus with microspheres, the validity of regional blood flow
      measurements using the microsphere technique within the superficial renal cortex
      must be seriously questioned.

PMID- 2239119
TI  - Continuous blockade of the lumbar plexus after knee surgery: a comparison of the
      plasma concentrations and analgesic effect of bupivacaine 0.250% and 0.125%.
AB  - In 20 patients a continuous block of the lumbar plexus was administered after
      knee-joint surgery, and the analgesic effect of two different concentrations of
      bupivacaine was compared. The same volume of bupivacaine was given to both groups
      of patients: a bolus dose of 0.4 ml/kg, 0.5% or 0.25%, followed by infusion of
      0.14 ml/kg/h, 0.25% or 0.125%, respectively, via a catheter placed in the
      neurovascular fascial sheath of the femoral nerve according to the "3-in-1 block"
      technique. The median morphine consumption during the first 16 h postoperatively
      was 6.0 mg when bupivacaine 0.5/0.25% was used and 9.5 mg when 0.25/0.125% was
      used. This difference is not significant. The visual analogue pain scores were
      also similar in the two groups (P greater than 0.05). All plasma concentrations
      were below 4 micrograms/ml, the highest concentration measured being 3.6
      micrograms/ml. It is concluded that when used for a continuous block of the
      lumbar plexus after knee-joint surgery, bupivacaine in a concentration of 0.125%
      offers the same pain relief as a concentration of 0.25%, and the risk of toxic
      reactions is reduced.

PMID- 2239121
TI  - Amrinone in perioperative low cardiac output syndrome.
AB  - Amrinone has been shown to have a beneficial effect on left ventricular function
      in low output syndrome (LOS), but its use after open-heart surgery has not been
      extensively revised. We studied 10 patients with LOS post-cardiopulmonary bypass
      (CPB), who failed to respond to conventional treatment (vasoactive drugs plus
      intraaortic balloon pump) and were treated with amrinone, 0.75 mg.kg-1 followed
      by a continuous infusion of 5 to 10 micrograms.kg-1-min-1. One patient failed to
      respond to the treatment and subsequently died, but in the other nine patients
      blood pressure and cardiac index increased, left filling pressure decreased and
      they were successfully weaned from the CBP and survived. These results suggest
      that amrinone, either alone or combined with other inotropic drugs and mechanical
      support, is a valuable drug in the management of LOS after CPB.

PMID- 2239120
TI  - Comparison of methohexital and pentobarbital for premedication in children.
AB  - Thirty children scheduled for elective orchiopexy or herniotomy were
      consecutively assigned at random to premedication with methohexital 80 mg/ml, 20
      mg/kg rectally, 15 min before transportation to the operating room, or
      pentobarbital 28 mg/ml, 7 mg/kg rectally, 45 min before transportation. The
      quality of premedication was recorded at induction with halothane 1-2% and 60%
      N2O in O2 by mask. All patients received a caudal injection of bupivacaine 1.9
      mg/ml, 1.25 ml/kg before surgery. Following completion of anaesthesia, the
      postoperative wake-up time and the duration of stay in the post-operative
      recovery room were recorded. The degree and quality of recovery were assessed
      using the Aldrete score every 30 min until discharge from the recovery room. The
      group of children receiving methohexital showed a highly significantly shorter
      awakening time, and a highly significantly shorter stay in the recovery room
      compared to the pentobarbital group. The children in both groups had a quiet,
      easy recovery without significant signs of confusion or agitation, and no
      difference in quality of recovery could be shown. Emergence delirium or agitation
      in connection with pentobarbital premedication and a possible relation to
      postoperative pain is discussed.

PMID- 2239122
TI  - The effects of incisional bupivacaine on postoperative narcotic requirements,
      oxygen saturation and length of stay in the post-anesthesia care unit.
AB  - We compared postoperative pain and narcotic requirements, oxygen saturation
      (SaO2) and length of stay in the post-anesthesia care unit (PACU) in patients who
      received 30 ml of either 0.25% bupivacaine (B) or saline placebo (S) infiltrated
      into the operative incision. Twenty ASA I-III patients undergoing abdominal
      surgery were studied in a double-blinded randomized prospective trial. Study and
      control groups were not different in patient age, procedure, intra-operative
      narcotics administered or preoperative SaO2. In the PACU, patients receiving B
      had significantly lower analog pain scores (6.0 vs 8.3, P = 0.02). They had lower
      respiratory rates (15.6 b/min vs 19.1, P = to 0.02), required significantly less
      narcotic (4.5 mg morphine sulphate vs 11.0, P = to 0.03) and were discharged from
      the PACU almost an hour sooner than patients receiving S (P = 0.02). Patients
      receiving B had significantly higher minimum SaO2 than those receiving S (93.3%
      vs 89.9, P = 0.04). Discharge pain scores, SaO2 and respiratory rates were not
      significantly different between B and S groups. Finally, mean requirements for
      narcotics for the first 24 h were reduced by approximately 30% (from 406.9 mg
      meperidine to 255.5 mg, P = 0.006). This study demonstrates that infiltration of
      a long-acting local anesthetic lowers initial pain scores and requirements for
      narcotics in the PACU. The effect can be seen for at least the first 24 h. A
      lower requirement for postoperative narcotics is accompanished by faster wake-up,
      more alert patients, and, most importantly, higher SaO2 and shorter PACU stay.
      This may have a significant effect on pulmonary morbidity following abdominal
      operations.

PMID- 2239123
TI  - Effects of epidural anesthesia on sympathetic nerve discharge to the skin.
AB  - Direct intraneural recordings of skin sympathetic activity (SSA) were performed
      to determine the magnitude of blockade of sympathetic fibers to the lower
      extremities during epidural anesthesia. Lumbar epidural catheters were inserted
      in nine volunteers. Multiunit postganglionic sympathetic activity was recorded in
      a skin fascicle of the peroneal nerve before and after injection of 4 ml of
      mepivacaine 2% epidurally, followed by an additional 12-16 ml after 5 min.
      Arousal stimuli such as sudden loud noises and noxious electrical skin
      stimulation were used to elicit transient sympathetic activation. Epidural
      anesthesia with upper level of sensory blockade at T4-T8 (n = 7) completely
      blocked spontaneous SSA and no detectable skin sympathetic activity could be
      provoked by arousal stimuli later than 14 min after the test dose. Sympathetic
      blockade was accompanied by marked increases in foot skin blood flow and loss of
      skin resistance responses to arousal. Epidural anesthesia with sensory blockade
      up to T10-11 (n = 2) only produced a partial sympathetic blockade. The result
      shows that epidural anesthesia with sensory blockade at T8 or above is equally as
      effective as injections of local anesthetics directly at postganglionic nerve
      fibers or ganglionic blockade in producing a complete sympathetic blockade of
      intraneurally recorded SSA. This neural blockade was paralleled by skin
      vasodilatation and a loss of sudomotor responses in the foot.

PMID- 2239124
TI  - The influence of 10 mg and 20 mg of bambuterol on the duration of succinylcholine
      induced neuromuscular blockade.
AB  - Bambuterol is an inactive prodrug which is enzymatically cleaved by plasma
      cholinesterase to yield the active compound, terbutaline. This catalytic process
      is accompanied by a selective inhibition of plasma-cholinesterase, the enzyme
      also necessary for the break-down of succinylcholine. We therefore studied the
      possible effect of bambuterol on succinylcholine-induced neuromuscular blockade
      in a double-blind fashion in patients undergoing surgery under general
      anaesthesia. Of the 39 patients studied, 13 patients had 10 mg of bambuterol, 12
      had 20 mg and 14 were given placebo 10-16 h prior to anaesthesia. Succinylcholine
      1 mg.kg-1 bw was administered after induction of anaesthesia. Following
      supramaximal train-of-four stimulation of the ulnar nerve, the tension developed
      in the adductor pollicis muscle was measured. Onset time and the durations of
      action (times to 10%, 25%, 75% and 90% recovery of the first twitch of the train
      of four response) were recorded. The mean recovery times were prolonged 30-50% in
      patients who had received 10 or 20 mg of bambuterol as compared with placebo. It
      is concluded that a prolonged duration of action of succinylcholine can be
      expected in patients being treated with bambuterol.

PMID- 2239125
TI  - Anaesthesia for resection of tumours in the trachea and central bronchi using the
      Nd-YAG-laser technique.
AB  - The use of lasers in upper airway surgery is now common practice. The
      introduction of the Nd-YAG laser technique makes it possible to perform
      endoscopic resection of tumours located in the trachea and central bronchi.
      Usually these patients require general anaesthesia. Our experience in 13 patients
      using total intravenous anaesthesia and jet ventilation with air is reported.
      Oxygen saturation was maintained at a higher level than when the patients were
      breathing 100% oxygen before anaesthesia. Occasional reductions in saturation
      were due to airway obstruction and were easily corrected by a short interruption
      of the procedure. All patients tolerated the anaesthesia and surgery well. No
      complications related to the anaesthetic method or the use of the Nd-YAG-laser
      occurred. A review of the possible hazards in these procedures is given together
      with advice on safety precautions needed.

PMID- 2239126
TI  - Long-term continuous axillary plexus blockade using 0.25% bupivacaine. A study of
      three cases.
AB  - Three patients, presenting with various traumatic, vasospastic and chronic
      neuromuscular disorders of the upper body, received continuous axillary block
      ranging from 4 to 16 days. Intermittent injections of 0.25% bupivacaine were used
      to provide analgesia, sympathetic blockade and muscle relaxation. No systemic or
      neurological side-effects were recorded. Nerve function recovered promptly after
      stopping the injections. It is concluded that continuous brachial plexus blockade
      is a clinically safe and effective technique for the relief of acute traumatic
      pain and vasospastic disorders of the upper limb. The technique, its merits and
      possible complications are discussed.

PMID- 2239127
TI  - Pronounced bradycardia after application of POR-8 (Ornipressin) under total
      intravenous anesthesia with propofol.

PMID- 2239129
TI  - Epidemiology of young strokes in rural Kashmir, India.
AB  - Kuthar valley in the Anantnag district of south Kashmir (North-west India) was
      surveyed to ascertain the prevalence of completed strokes. In a population of
      63,645, the survey was from July to November 1986; 91 cases of completed stroke
      were detected giving a crude prevalence of 143/100,000. Only 10 (10.9%) cases
      (7W: 3M) were in the age group 15-39 years, a prevalence rate of 41/100,000.

PMID- 2239128
TI  - [A case of the anomalous intercostal, subcostal and lumbar arteries in man].
AB  - This report describes an anomalous case of the multiple ipsilateral common trunk
      formation in the parietal arteries encountered during observed in the dissection
      of a 71 year-old Japanese female cadaver in the anatomical laboratory of Kanazawa
      Medical University. This subject had thirteen parietal arteries. Among the
      thirteen parietal arteries two arose from both the subclavian arteries (superior
      intercostal artery), and eleven arose from the descending aorta (aortic parietal
      arteries). Five arteries (R-1-R-5) were located on the right side, and eight (L-1
      L-8) on the left. Of the eleven aortic parietal arteries, nine formed the
      ipsilateral common trunk, and the other two were independent branches (left 11th
      intercostal and 2nd lumbar arteries). The branching states of these parietal
      arteries were as follows: on the right side, R-1 was the common trunk for the 1st
      and 2nd intercostal arteries (the right superior intercostal artery), R-2 (was
      the common trunk) for the 3rd, 4th, 5th, 6th and 7th intercostal arteries, R-3
      for the 8th and 9th intercostal arteries, R-4 for the 10th and 11th intercostal
      arteries and R-5 for the subcostal, 1st, 2nd, 3rd and 4th lumbar arteries. On the
      left side, L-1 was the common trunk for the 1st and 2nd intercostal arteries (the
      left superior intercostal artery), L-2 for the 3rd, 4th and 5th intercostal
      arteries, L-3 for the 6th and 7th intercostal arteries, L-4 for the 8th, 9th and
      10th intercostal arteries, L-6 for the subcostal and 1st lumbar arteries, and L-8
      for the 3rd and 4th lumbar arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239130
TI  - Soluble class 1 antigens (sHLA) in CSF and serum of patients with HIV infection.
AB  - sHLA are secreted by B and T lymphocytes upon activation. These antigens are
      present in serum and cerebrospinal fluid (CSF). The establishment of a sHLA
      index, IH = (CSF sHLA/serum sHLA)/(CSF albumin/serum albumin) helped us to define
      that values above 9.7 reflect an intrathecal synthesis of these proteins. IH was
      significantly increased in a group of patients with intrathecal production of IgG
      against HIV-1 (HIV) and directly correlated with the synthesis of such
      antibodies. Therefore, IH seems to be an index of lymphocyte activation in CNS.

PMID- 2239131
TI  - Intermittent prophylaxis in febrile convulsions: diazepam or valproic acid?
AB  - In an open, prospective, randomized, and hospital-based study, comprising 219
      consecutive children, 169 were given intermittent prophylaxis for one year,
      receiving either diazepam or valproic acid after their first febrile convulsion.
      Children admitted on odd dates (n = 89) were given rectal diazepam in solution
      every 12 h, whenever the temperature was 38.5 degrees C or more. Children
      admitted on even dates (n = 80) were given valproic acid as suppositories at
      times of fever. Twenty-three children in the diazepam group had a recurrence
      within 1 year versus 14 in the valproic acid group. On an intention-to-treat
      basis the 12-month recurrence rates in the 2 groups were similar, 27% vs 20%. The
      latter is well below figures for untreated controls from Denmark (32%),
      suggesting that intermittent valproic acid at times of fever may be effective,
      but further studies are needed. The number of complex recurrences, however, were
      significantly higher in the valproic acid group than in the diazepam group.
      Parental non-compliance was a major problem, and in the 2 study groups only 5 and
      12 children, respectively, with recurrences were treated adequately. Sixty-nine
      children receiving diazepam had side-effects vs 37 receiving valproic acid. None
      were serious.

PMID- 2239132
TI  - Presence of plasma proteins in spinal nerve roots. An immunohistochemical study
      in the rat.
AB  - The presence of plasma proteins in the spinal nerve roots of normal rats was
      investigated using an avidin-biotin peroxidase technique on formaldehyde-fixed,
      paraffin-embedded material. Sections from the roots, exposed to a rabbit-anti rat
      albumin antiserum showed widespread, intense immunoreactivity which filled the
      spaces between the nerve fibers. The reaction product usually ended at the
      junction between the roots and the spinal cord. The sheath enclosing the roots
      showed the same strong immunoreaction. There was also a marked reaction in the
      dorsal root ganglia and peripheral nerve. Spinal cord sections, however, showed
      no extracellular reactivity, but many motor neurons of the ventral horn were
      distinctly positive, presumably the result of a normally occurring retrograde
      axonal transport from the periphery. Parallel sections from the roots exposed to
      rabbit anti rat IgG antiserum, rabbit anti rat IgM antiserum, rabbit anti human
      fibrinogen antiserum and rabbit anti human fibronectin antiserum revealed no
      positive immunoreaction. Thus, rat spinal nerve roots normally contain material
      with albumin antigenic properties. This would indicate that albumin is present in
      the extracellular fluid of the roots in the same way as in the endoneurium of
      peripheral nerves. The fluid microenvironment of the roots, therefore, appears to
      be different from that in the CNS which lacks extracellular albumin due to the
      impermeability of the blood-brain barrier.

PMID- 2239133
TI  - High-dose praziquantel for neurocysticercosis: serum and CSF concentrations.
AB  - Serum and CSF concentrations of praziquantel were analyzed in 8 patients with
      active neurocysticercosis aged 35 +/- 16 (mean +/- sd) years, in order to
      determine factors that may improve the therapeutic ratio. Praziquantel was given
      orally at 6-h intervals for 10 days at a daily dose of 100 mg/kg. Serum
      concentrations were determined at 1, 2 and 4 h, and CSF concentrations at 2 h
      after the morning dose. Peak serum concentrations occurred between 1 and 2 h
      after administration. There was a trend towards a drop in serum concentration
      from Days 1 through 5 to 10 of therapy. A fourfold increase in oral dose led to
      an eightfold rise in serum and CSF concentration, indicating saturation of
      hepatic metabolism. There were linear correlations (p less than 0.01) between
      serum and CSF concentrations of praziquantel, indicating free flow across the
      blood-brain barrier, above an apparent threshold, which may be related to
      occupation of plasma protein-binding sites. The results indicate that monitoring
      of serum concentrations may be clinically useful.

PMID- 2239134
TI  - A randomized, within-patient, cross-over, placebo-controlled trial on the
      efficacy and tolerability of the tricyclic antidepressants chlorimipramine and
      nortriptyline in central pain.
AB  - Antidepressant drugs are increasingly used in the management of chronic pain.
      They are mainly prescribed for cancer-related pain and central pain, e.g. phantom
      or stump pain, post-herpetic neuropathy. However, no controlled clinical trials
      have validated their in either pathology. Thus, physicians still do not know
      whether antidepressants are really effective and which might be best. It is still
      debated whether the effect of antidepressants in the management of chronic pain
      is limited to the amelioration of frequently concomitant depression or extends to
      pain itself. To verify both the analgesic effect of tricyclic antidepressants,
      and the possible relationship between their antidepressant effect and the relief
      of central pain, we carried out a randomized, within-patient (cross-over) placebo
      controlled study in patients suffering from central pain. The results clearly
      indicate the better analgesic effect of tricyclic antidepressants over placebo (p
      less than 0.0001). Within the antidepressants tested, chlorimipramine, a blocker
      of serotonin reuptake, is significantly more effective (p less than 0.0001) than
      notriptyline, a blocker of noradrenaline reuptake. Finally, the antinociceptive
      effect is independent of the effects of the two drugs on the symptoms of
      depression.

PMID- 2239135
TI  - Computerized coordination ability testing.
AB  - Quantitative measurements of coordination ability were carried out on 76 women
      with a median age of 37, range 15 to 60. Spacing control, timing control and
      performance speed were recorded using newly developed computerized equipment,
      Catsys, presented in this paper. Twenty-three subjects were re-examined 2-3
      months after the first measurements. A fair or even high degree of
      reproducibility of tests was found. Normal values for the entire group and
      correlation values for the re-examined group are presented. The results from this
      small study implies that the Catsys may be useful, e.g., in future clinical
      neurological practice of diagnostics and follow up on patients, in occupational
      medicine for detection of neurotoxic effects of various neurotoxic substances, in
      evaluation of drug effects and side effects and for testing people in occupations
      where normal coordination skills are absolutely necessary.

PMID- 2239136
TI  - Identification of IgG subclasses' oligoclonal bands in multiple sclerosis CSF.
AB  - IgG subclasses' oligoclonal bands in unconcentrated CSF from MS patients were
      detected by isoelectric focusing in agarose gel with subsequent immunoblotting
      using mouse monoclonal antibodies to human IgG subclasses and double-antibody
      avidin-biotin-alkaline phosphatase system. All MS CSF showed presence of
      oligoclonal bands specific to the IgG1 subclass; in addition, several of these
      samples also had oligoclonal bands specific to IgG3, IgG2, or IgG4, in order of
      decreasing frequency. Since the CSF of a greater number of MS patients showed
      oligoclonal bands specific to the IgG1 and IgG3 subclasses, the findings are
      consistent with those reported in patients with chronic viral infections and
      autoimmune diseases.

PMID- 2239138
TI  - Spinal arteriovenous malformations: neurological aspects and results of
      embolization.
AB  - Twenty consecutive patients with spinal arteriovenous malformations (AVMs) were
      found to have either a progressive, remitting or remitting-progressive course of
      disease. A characteristic progressive neurological decline was observed in 11
      patients with dural fistulas and a similar decline was seen in 5 of the 9
      patients with intradural AVMs. In addition to paraparesis and mixed sensory
      disorder, which ascended to a level of about T10, areas with spared sensation
      were occasionally found below this level. All cases with this progressive
      longitudinal myelopathy showed radiological evidence of a dilated medullary
      venous plexus. All patients were treated by embolization with only a low
      frequency of complications. Follow-up data verified a significant improvement of
      motor and sensory function, mainly during the first year after embolization.
      Cases with progressive neurological decline (dural and intradural AVMs) stopped
      deteriorating or improved and cases with a history of acute incidents (intradural
      AVMs) probably run less risk of acute deterioration.

PMID- 2239137
TI  - Red blood cell and adipose tissue fatty acids in mild inactive multiple
      sclerosis.
AB  - The fatty acid profiles of phosphatidyl ethanolamine (PE) and phosphatidyl
      choline (PC) of the red blood cells of 30 patients with mild inactive multiple
      sclerosis (MS) and 30 healthy controls were studied by gas chromatography. The
      groups were well matched for factors likely to influence tissue lipid levels,
      including diet. The MS patients showed a significant reduction in PE
      eicosapentaenoic acid (p = 0.009) especially in women, and an increase in both PE
      dihomo-gamma-linolenic acid (p = 0.004) and PC stearic acid (p = 0.04). No
      reduction in linoleic acid was observed in either the PC or PE fractions of the
      MS subjects. A similar study of the fatty acid profile in adipose tissue in 26 MS
      and 35 healthy controls found no detectable eicosapentaenoic acid in either
      group. However, whereas docosahexaenoic acid was not detectable in any MS
      patient, 40% of the controls had measurable levels varying from to 0.1 to 0.3% of
      total estimated fatty acid (p = 0.0003). No reduction in linoleic acid in MS
      subjects was observed. Supplementation with oral fish body oil demonstrated that
      n-3 fatty acids were incorporated into red blood cells over 5 weeks and this
      occurred equally in MS and controls. The effects of oral supplementation on
      adipose tissue were studied after 1 and 2 years. Whereas many fatty acids such as
      linoleic acid were raised at 1 year, but did not rise subsequently,
      eicosapentaenoic acid and docosahexaenoic acid continued to rise through the 2
      year period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239139
TI  - Follow-up of antibiotically treated and untreated neuroborreliosis.
AB  - Follow-up of 57 patients who suffered from antibiotically untreated acute,
      monophasic neuroborreliosis 5 to 27 years ago shows no significant difference in
      comparison with the follow-up of 66 patients who suffered from antibiotically
      treated acute, monophasic neuroborreliosis during the last 5 years. In both
      groups, the involution of clinical symptoms and the normalization of pathological
      CSF findings were nearly identical. We found no significant difference of
      sequelae between the groups. Following acute neuroborreliosis, neither the
      antibiotically untreated nor the antibiotically treated patients developed
      chronic neuroborreliosis. Only in rare cases of primary chronic neuroborreliosis
      with CNS involvement did we observe convincing effects of antibiotics, which were
      given mostly in combination with glucocorticosteroids.

PMID- 2239140
TI  - Effect of methylprednisolone on motor function and spinal cord blood flow after
      spinal cord compression in rats.
AB  - The effect of methylprednisolone (MP) on neurologic recovery and spinal cord
      blood flow (SCBF) was investigated up to 4 days after a spinal cord compression
      injury in rats. The injury was produced at midthoracic level by applying a load
      of 35 g on a 2.2 x 5.0 mm compression plate for 5 min, which resulted in
      transient paraparesis. MP was given as a bolus dose of 30 mg/kg i.v. 60 min after
      injury (n = 20) and controls were given saline (n = 10). The motor performance
      was assessed daily as the capacity angle on the inclined plane and SCBF was
      measured by 14C-iodoantipyrine autoradiography on Days 1 or 4. On Day 1 the
      capacity angle was reduced from about 63 degrees preoperatively to 33 +/- 2
      degrees (mean +/- SEM) in the control group and to 50 +/- 1 degrees in the group
      treated with MP (p less than 0.05). Thereafter there was a slight improvement in
      both groups, but the difference persisted throughout the observation period. On
      Day 4 both gray and white matter SCBF was better preserved in MP-treated animals
      than in the control group (59 +/- 4 versus 49 +/- 3 ml/min/100 g tissue for gray
      matter and 13.6 +/- 0.6 versus 10.7 +/- 0.8 ml/min/100 g tissue for white
      matter). Posttraumatic treatment with MP, thus, improved both the neurologic
      recovery during the first 4 days and SCBF as measured on Day 4. It is speculated
      that the effect of MP is at least partly exerted on the vascular bed.

PMID- 2239141
TI  - Long-term effect of ACTH treatment of relapse in multiple sclerosis.
AB  - A controlled, randomized study of the long-term effects of ACTH-treatment (100
      units intramuscular, tapered over 12 weeks) of acute relapse in 29 MS patients
      was performed. Follow-up lasted one year. In some Kurtzke Functional System, the
      Ambulation Index and the Kurtzke Incapacity Scale a transient greater improvement
      in the ACTH-treated patients was observed. These superior results in the ACTH
      group were no longer present at 6 months. Significantly more side-effects were
      reported in the ACTH-group. After treatment with ACTH a higher, though not
      statistically significant, relapse rate in the following months was noticed.

PMID- 2239142
TI  - Seizures of unknown origin after the age of 50: vascular risk factors.
AB  - To investigate the possible etiologic factors of late onset seizures of unknown
      origin, 50 consecutive patients whose seizures started after age 50 and who had a
      normal CT, were screened. The seizures in this group were generalized in 70% and
      infrequent. The hypothesis that late-onset seizures of unknown origin were
      frequently due to microinfarcts, was evaluated by comparing the frequency of
      arterial hypertension, coronary heart disease, peripheral vascular disease,
      carotid bruits, diabetes mellitus and smoking in these patients with appropriate
      control groups. The results showed that the frequencies of these cardiovascular
      risk factors were similar to those of sex and age-matched controls and much lower
      than in a comparable series of patients whose seizures followed a stroke, or
      patients with stroke but not seizures. These data suggest that subclinical
      cerebrovascular disease is probably not a frequent etiology of late-onset
      epilepsy of unknown origin. The cause of these seizures remains to be elucidated.

PMID- 2239143
TI  - Conventional vs controlled-release carbamazepine: a multicentre, double-blind,
      cross-over study.
AB  - The tolerability and pharmacokinetics of a new controlled-release (CR)
      formulation of carbamazepine (CBZ), were assessed in a multicentre, double-blind,
      cross-over trial, carried out in 48 epileptic patients (21 men, 27 women; mean
      age 34.2 years) on conventional CBZ monotherapy, but without complete seizure
      control (n = 22) or with intermittent side effects (n = 4), or with both (n =
      22). Eligible patients were randomized to conventional CBZ or CR CBZ, each given
      in sequence at individualized daily doses, subdivided into the lowest number of
      administrations. Each period of the cross-over consisted of a first phase of
      optimal dose finding (lasting up to two months) and a second one of maintenance
      (lasting one month) used for evaluation. At the end of each period, a 10-h plasma
      CBZ and CBZ-epoxide concentration profile, as well as the tolerability and the
      efficacy of the drugs, were evaluated. The mean CBZ daily dose increased by 16%
      during the administration of the CR formulation. Fluctuations of total CBZ and
      10, 11-epoxide plasma level daily profiles at steady-state were significantly (p
      less than 0.001) lower during CR CBZ treatment, leading to a significant (p less
      than 0.001) decrease in intermittent side effects (6 patients on CR CBZ vs 26 on
      conventional CBZ). Finally, 38 patients on CR CBZ (vs 15 patients on conventional
      CBZ) were treated with a b.i.d. regimen.

PMID- 2239144
TI  - A computer-aided technique for testing cognitive functions. Validated on a sample
      of Danes 30 to 60 years of age.
AB  - With the growing importance of occupational behavioural neurotoxicology the
      demand for a standardized and reliable cognitive test battery has become urgent.
      The present study deals with the compilation of a test battery, the purpose of
      which is to be sensitive to mild brain dysfunction and suitable for modern
      microcomputer administration and scoring. The battery comprises tests of learning
      and memory functions specific for each brain hemisphere (Face Recognition Test
      and Number Learning Test), visuomotor function separately for continuous and
      discrete tasks (Figure Drawing Test and Pen-to-Point Test), visuospatial function
      (Parallelogram Test), visual and auditive perception, attention and vigilance
      (Bourdon-Wiersma Test and Continuous Reaction-Time Test), and concentration
      (Continuous Graphics Test). The complete test battery was administered and scored
      on a slightly modified Tektronix 4052 computer with a Tektronix 4956 digitizer as
      a peripheral device. The validity of the battery was analysed on the basis of a
      sample of the normal Danish population (N = 1262) stratified for the ages 30, 40,
      50, and 60 years, the two sexes, and residence in one of 11 municipalities in the
      western part of Copenhagen County. Using a 16-dimensional multivariate model
      comprising biological, social, psychological, and environmental factors, and also
      examiner behaviour, statistical analyses confirmed hypotheses of influence by the
      factors Age, Sex, Schooling, and Social Group, i.e. these factors partially
      explained the variance in the case of almost all the test parameters. Moreover,
      psychic stress, as determined in a questionnaire, had explanatory power with
      tests demanding attention and concentration. Hypotheses of effects on test
      performance by Smoking Status and psychophysiological diurnal or annual rhythms,
      i.e. Time of Day, and Time of Year, were confirmed for a few parameters, but the
      effects differed to some extent from those described in the literature. Alcohol
      Consumption, Drug Consumption Affecting the CNS, Cardiovascular Diseases or
      Disorders, Metabolic Diseases or Disorders, CNS Injuries or Disorders, and
      Occupational Activity Status, all revealed by questionnaire, were not found to
      show the assumed significant effects on test performance. However, a hypothesis
      of an effect originating in differences between different examiners' behaviour
      was confirmed for a number of test parameters, although all the test measurements
      and scorings were done automatically by computer. On the basis of a re
      examination of 19 patients previously diagnosed as suffering from diffuse organic
      psychosyndrome, the sensitivity of the test battery was estimated to be 0.79. The
      specificity was estimated to be 0.79 on the basis of the results of the original
      sample.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2239145
TI  - Morphometric studies on the human sural nerve.

PMID- 2239147
TI  - The behavior of the extracellular matrix and the basal lamina during the repair
      of cryogenic injury in the adult rat cerebral cortex.
AB  - A well-defined coagulative lesion was produced in the fronto-parietal cortex of
      adult rats by application of a cold probe, and the chronological sequence of
      events during the healing process, particularly the relationship between
      astroglial processes and the newly forming basal lamina (BL) and the behavior of
      the extracellular matrix (ECM) was examined immunocytochemically and
      ultrastructurally. By electron microscopy, new BL synthesis was first noted 7
      days following injury, and a continuous and well-defined BL was present from 14
      days onward. These findings correlated well with the pattern of immunoreactivity
      for laminin and for type IV collagen. Both laminin and type IV collagen appeared
      both to be produced primarily by mesenchymal cells within and around the wound as
      well as those of the blood vessels, and to become an integral part of the new BL.
      Although there was no immunocytochemical evidence to indicate secretion of
      laminin, type IV collagen or fibronectin by astrocytes, a well-defined BL
      appeared to form only in tight apposition with astroglial processes over the pial
      surface. This suggests that the BL is formed by subpial astrocytes in close
      interaction with ECM components at the pial surface. Fibronectin appears to
      contribute significantly to the formation of the BL by providing a suitable
      substratum for the coordinated cellular interaction necessary for successful
      regeneration of the BL.

PMID- 2239146
TI  - Tumors of the meninges: proposed modifications of the World Health Organization
      classification.
AB  - The present WHO classification of meningiomas has served us well. In keeping with
      the adage, "if it ain't broke, don't fix it," alterations should be made with due
      caution. These proposed modifications of the WHO classification are prompted by
      advances in our understanding of the pathobiology of meningeal neoplasms, as well
      as a need for an orderly scheme based upon factors of clinical importance. The
      author is well aware, that given the vastly differing technologies available to
      those utilizing the "blue book," its application must have a basis in routine
      histology rather than in "high-tech" procedures. No classification is ideal, but
      the modifications suggested represent a compromise between the pathologist's need
      for a complete morphologic exposition and the clinician's desire for a concise
      classification of therapeutic and prognostic significance.

PMID- 2239148
TI  - Alzheimer neuropathology in non-Down's syndrome mentally retarded adults.
AB  - We examined the brains of 385 mentally retarded adults aged 23-90 years without
      Down's syndrome (DS), metabolic disorder, or hydrocephalus to extend our
      knowledge about the occurrence of Alzheimer-type neuropathology in this
      population. Relevant measures of neuropathology also were related to selected
      information available from clinical records. The presence of one or more
      neurofibrillary tangles (NFT) and/or neuritic plaques (NP) was observed in 63.4%
      of all cases and varied with age. The prevalence of positive cases was higher
      when mental retardation was due to head trauma, congenital malformation, or
      familial factors and when a history of seizures was reported. Comprehensive
      morphometric analyses of neocortical, hippocampal and parahippocampal areas
      indicated that recommended age-specific quantitative criteria for the diagnosis
      of Alzheimer disease [Khachaturian ZS (1985) Arch Neurol 42:1097-1105] were met
      in 9.5% of cases less than 50 years of age, 54.2% between 50 and 65, 70% between
      66 and 75, and 87% of the cases greater than 75 years of age. However, a limited
      immunohistochemical study revealed that in most cases the NP did not have a
      neuritic component containing paired helical filaments and in this respect most
      of the plaques observed in this population may differ from those most strongly
      associated with Alzheimer disease. In addition, substantial numbers of NFT were
      seen in frontal cortex, contrasting with results reported in the literature for
      nonretarded populations. The number of NP per mm2 consistently increased with age
      for all areas examined, while the relationship between NFT density and age varied
      across areas, and was clearly not monotonic.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239149
TI  - Ultrastructure of the neuropil threads in the Alzheimer brain: their dendritic
      origin and accumulation in the senile plaques.
AB  - Thread-like structures immunoreactive with paired helical filaments and tau
      antisera were demonstrated as mesh-works in the neocortices of five brains with
      Alzheimer-type dementia, but not in those of five normal aged control brains. The
      ultrastructure of the threads was examined using paired routine electron
      microscopic ultrathin sections and adjacent 0.4-micron-thick semithin sections,
      immunostained for beta protein. Outside the beta protein-positive senile plaques,
      neuropil threads appeared sporadically as small slender neurites, containing
      either regularly constricted or straight filaments. These neurites often showed
      dendritic profiles. Similar threads were also seen within the senile plaques. The
      threads were accumulated in amyloid fibril-rich primitive plaques, but not in
      amyloid fibril-poor diffuse plaques. The presence of these threads was closely
      associated with neurofibrillary tangle formation. Our findings suggest that wide
      spread change of the neuropil neurites, neuropil threads or curly fibers, both
      outside and inside of the senile plaques are dendritic in origin and play an
      important role in the clinical manifestation of dementia.

PMID- 2239152
TI  - Effect of denervation on regenerating muscle plasma membrane integrity: freeze
      fracture and dystrophin immunostaining analyses.
AB  - We investigated time sequentially, the densities of intramembranous assembly
      "orthogonal arrays" of regenerating rat extensor digitorum longus muscle after
      bupivacaine-induced muscle injury. There was no evidence of orthogonal arrays at
      the early stage, but the densities of orthogonal arrays increased with the
      maturation of the innervated regenerating myofibers. In contrast, the orthogonal
      arrays were scarcely observed at any time point examined in denervated
      regenerating muscles. Therefore, the neural factor may have an important effect
      on the appearance of orthogonal arrays. Moreover, we studied the
      immunostainability of Duchenne muscular dystrophy gene product "dystrophin" in
      the regenerating muscle at the same time points. Positive immunostaining was
      observed in both innervated and denervated regenerating myofibers even from the
      early stage of regeneration. On the basis of these data, the relationship between
      orthogonal array and dystrophin are discussed.

PMID- 2239150
TI  - Amyloid in the brains of aged squirrel monkeys.
AB  - In this immunocytochemical study, the brains of nine squirrel monkeys (Saimiri
      sciureus), ranging from 8 to 27 years of age, were examined for the presence and
      distribution of beta/A4 amyloid, a 4-kilodalton peptide. In aged squirrel
      monkeys, amyloid is associated primarily with intracerebral and meningeal
      capillaries and arterioles and occurs to a lesser degree as small and/or diffuse
      deposits in the neural parenchyma and in the dense cores of senile plaques.
      Cerebrovascular amyloid is found primarily in neocortex, amygdala, and septum
      verum and is rare or nonexistent in other subcortical gray structures, white
      matter, cerebellum, and spinal cord; this pattern of localization is comparable
      to that in humans with cerebral amyloid angiopathy. There is a significant
      correlation between cerebrovascular and parenchymal deposits of amyloid. However,
      cerebrovascular amyloid is always the most abundant form in squirrel monkeys,
      even in cases of severe cerebral amyloidosis. In contrast to squirrel monkeys,
      aged rhesus monkeys (Macaca mulatta) develop mostly parenchymal deposits of
      amyloid and have relatively less vascular amyloid. This species difference in the
      histological distribution of amyloid suggests that separate mechanisms may
      influence the accumulation of amyloid in cerebral blood vessels and in the neural
      parenchyma. These data also indicate that the squirrel monkey can serve as a
      model for investigations of cerebrovascular amyloidosis.

PMID- 2239151
TI  - Morphology and distribution of HIV-1 gp41-positive microglia in subacute AIDS
      encephalitis. Pattern of involvement resembling a multisystem degeneration.
AB  - Among 100 brains from patients with acquired immunodeficiency syndrome (AIDS), 33
      brains (21 adults and 12 children) with histological evidence of subacute AIDS
      encephalitis were immunostained with one of the most sensitive antibodies to HIV
      1 antigen, anti-gp41. Twenty-six (20/21 adults, 6/12 children) of the 33 brains
      showed pg41 positivity. Brains from children had fewer gp41-positive cells than
      brains from adults. The distribution of gp41-positive cells was characteristic.
      They were frequently detected and most numerous in the globus pallidus (medial
      greater than lateral). Although gp41-positive cells were prevalent, fewer were
      detected in the corpus striatum and thalamus. Of infratentorial areas involved,
      the ventral midbrain, especially the substantia nigra, and the dentate nucleus
      contained many positive cells. Lower levels of infections, often patchy, were
      noted in the cerebral and cerebellar white matter and pontine base. Gp41-positive
      cells were rarely seen in the cerebral cortex, medulla, spinal cord,
      leptomeninges, choroid plexus, ependyma, subependymal areas and endothelia.
      Besides immunoreactive macrophages and multinucleated cells, gp41-positive
      microglia with various morphological alterations were abundant in the deep
      cerebral gray matter, ventral midbrain and dentate nucleus. Most of these
      microglia were undetectable with conventional histological methods. We discuss
      the significance of the distribution of HIV-1-infected cells, especially
      microglia, with respect to cellular tropism and involvement of deep gray matter
      nuclei in a pattern reminiscent of a multisystem atrophy.

PMID- 2239153
TI  - Anti-macrophage CR3 antibody blocks myelin phagocytosis by macrophages in vitro.
AB  - Myelin phagocytosis in Wallerian degeneration of peripheral nerves depends on
      invasion of nerves by non-resident macrophages. The present study was done to
      clarify the role of the macrophage complement receptor type 3 (CR3) in myelin
      removal. Myelin phagocytic capacity of invading macrophages was abolished by
      treatment of cultured nerves and macrophages with anti-CR3 antibody or by serum
      complement depletion with cobra venom factor. This indicates that myelin
      phagocytosis is mediated by the macrophage CR3.

PMID- 2239155
TI  - Skeletal muscle changes associated with equine myotonic dystrophy.
AB  - A progressive neuromuscular disorder in young horses, clinically apparent as
      early as 1 month of age, is characterized by generalized myotonia, muscle
      stiffness, muscle weakness and atrophy. Myotonia is identified by percussion
      dimpling and myotonic EMG discharges. Changes in one case included testicular
      hypoplasia, cataract formation, and glucose intolerance, indicating a systemic
      involvement. Pathologic changes in skeletal muscles from three affected foals
      were examined. Sarcoplasmic masses, ringed fibers, internal positioning of
      sarcolemmal nuclei, and nuclear rowing were among the primary histologic changes
      noted. Variation in fiber diameter size, especially atrophy, and type I
      predominance were also prominent changes. A neurogenic involvement was indicated
      by type grouping changes in several muscles.

PMID- 2239154
TI  - Expression of monoamine oxidase B activity in astrocytes of senile plaques.
AB  - Monoamine oxidase (MAO) histochemistry has been performed in brains from patients
      with dementia of Alzheimer type (DAT) and aged controls. Conspicuous MAO-positive
      cell clusters were frequently observed in the amygdala, hippocampus, and insular
      cortex in the brains of DAT. Double staining with glial fibrillary acidic protein
      immunohistochemistry revealed that the cluster-forming MAO-positive cells were
      astrocytes. Using Bielschowsky's method, Congo red and thioflavin S
      counterstaining, this astrocytic mass was shown to be associated with senile
      plaques. By the enzyme inhibition experiment, MAO activity in senile plaques was
      revealed to be of type B. The present results clearly indicate that MAO-B
      activity is expressed in fibrillary astrocytes in or around senile plaques,
      suggesting that these astrocytes metabolize exogenous amines in senile plaques.

PMID- 2239156
TI  - The early effects of methylmercury on the developing rat brain.
AB  - The effects of organic mercury compounds on the development of the brain are well
      known since the exposure of people at a large scale to methylmercury in the
      Minamata Bay area and in Iraq. The neuropathological examination of the brains of
      children prenatally exposed revealed dysplasia of the cerebral and cerebellar
      cortex, neuronal ectopia and several other developmental disturbances. In this
      experimental study we examined developmental mechanisms involved in methylmercury
      induced cerebral anomalies. By examining the fetuses soon after treatment we
      concentrated in the initial effects of the treatment. The pregnant rats were
      given 10 mg/kg methylmercury chloride i.p. on day 18. Already at 2 h after
      administration mitochondrial degeneration occurred in the endothelium of the
      cerebral capillaries. Subsequently hemorrhages developed interfering with the
      cellular arrangement in the ventricular zone, with neuronal migration in the
      intermediate zone and with the development of the cortical cytoarchitecture.
      Macrophages and cavities appeared in the hemorrhagic areas. It is suggested that
      the abnormalities seen in the experiments can be considered as the initial
      methylmercury-induced effects which, in combination with various other toxic
      effects, ultimately result in the anomalies that have been observed in the brains
      of children prenatally exposed to methylmercury.

PMID- 2239157
TI  - Lauge-Hansen classification of malleolar fractures. An assessment of the
      reproducibility in 118 cases.
AB  - The radiographs of malleolar fractures in 118 consecutive patients were assessed
      by 4 observers using the Lauge-Hansen classification. The interobserver variation
      was large; only 51 of the 118 radiographs were classified identically by all 4
      observers. With the purpose of assessing intraobserver variation, the same
      observers classified the same radiographs 6 weeks later. The first and the second
      classification were identical in 75-97 of 118 radiographs (64-82 percent). These
      results show that the Lauge-Hansen system is difficult to apply in a reproducible
      way.

PMID- 2239158
TI  - Ankle instability caused by prolonged peroneal reaction time.
AB  - The reaction of 15 functionally unstable ankles to sudden inversion was described
      by monitoring muscle activity, joint motion, and alternation of the body center
      of pressure. The results were compared with those of 15 stable controls. Stable
      and unstable subjects showed a similar reaction pattern to sudden inversion:
      first, a peripheral reflex action, namely, a contraction of the peronei
      counteracting the ankle inverting momentum, and, then, a centrally elicited
      pattern, namely, a flexion of the hip, knee, and ankle relieving the vertical
      pressure on the ankle and producing ankle eversion. Unstable subjects did not
      show a defect in their central processing of afferent input. In contrast, a
      prolonged reaction time (median 84 msec compared with 69 msec in stable subjects)
      suggested a partial deafferentation of the reflex stabilization of the ankle and
      substantiated the theory of a proprioceptive deficit being responsible for ankle
      instability.

PMID- 2239159
TI  - Anterior stabilization of pathologic dens fractures.
AB  - By an anterior approach, six pathologic dens fractures were stabilized with
      screws and methyl methacrylate cement. All the patients had immediate pain relief
      and could be mobilized without external support. Using the anterior approach, the
      tumor can be removed and the instability neutralized at the site of the lesion.

PMID- 2239160
TI  - Chronic trapezius myalgia. Morphology and blood flow studied in 17 patients.
AB  - Bilateral open biopsies from the painful upper part of the trapezius muscle were
      studied in 17 patients with localized chronic myalgia related to static load
      during repetitive assembly work. Isolated pathologic ragged red fibers were
      related to the presence of myalgia. The phenomenon indicating disturbed
      mitochondrial function was confined to the Type 1 fibers. Using a laser-Doppler
      flowmeter, the muscle blood flow was recorded in the exposed muscle before a
      biopsy was taken. Pain was assessed and graded as the difference between the two
      sides, as was the presence of ragged red fibers. The myalgia correlated with
      reduced local blood flow: the greater the pain difference, the greater the
      reduction in blood flow. There was a correlation between the presence of
      mitochondrial changes and reduced muscle blood flow.

PMID- 2239161
TI  - Microsurgery versus standard removal of the herniated lumbar disc. A 3-year
      comparison in 150 cases.
AB  - The outcome of 150 patients with herniated lumbar disc treated by either
      microsurgical or standard discectomy were retrospectively reviewed after an
      average of 3 years. Both techniques provided satisfactory results, with 85
      percent good or excellent outcome. Microsurgery gave less intraoperative
      bleeding, shorter hospitalization, and more rapid return to work. The main
      drawback was a higher recurrence rate of disc prolapse.

PMID- 2239162
TI  - Function and social status 10 years after hip fracture. Prospective follow-up of
      103 patients.
AB  - Function and social outcome for 103 consecutive patients, mean age 75 years,
      admitted from their own homes after a hip fracture were studied during a 10-year
      period. Within 4 months after the fracture, 81 patients had returned home, and
      the percentage of survivors living at home from then on was then fairly constant.
      At 10 years after fracture, 31 patients were living at home, 6 were in
      institutions, and 66 were dead. ADL, walking ability, and household activities
      remained at the level already achieved within 4 months after fracture during the
      10-year period. The need for social services help did not increase; about one
      third of the survivors had communal home help throughout the 10-year period.
      Patients who before fracture were healthy and living with someone and within 2
      weeks after the fracture could walk with a four-legged aid or better had a good
      prognosis for living in their own home. The hip fracture did not effect their
      subsequent fate.

PMID- 2239163
TI  - Internal fixation of 410 cervical hip fractures. A randomized comparison of a
      single nail versus two hook-pins.
AB  - Totally, 410 patients with a cervical hip fracture were randomized between two
      methods of osteosynthesis: a single nail (Rydell) and two hook-pins (LIH).
      Seventy-five percent of the patients were women. Sixty-nine percent were alive
      after 2 years. The patients were followed up with clinical and radiographic
      examinations for 2 years postoperatively. No difference between the two groups
      were found regarding quality of reduction, early displacement within 3 months,
      extraction after healing, nonunion, late segmental collapse, or reoperation with
      a total hip arthroplasty. Nor did we find any differences between the two groups
      when selecting those alive after 2 years or when dividing the fractures in
      displaced and nondisplaced fractures.

PMID- 2239164
TI  - Fixation of femoral neck fractures. A four-flanged nail versus threaded pins in
      200 cases.
AB  - Two methods of internal fixation for cervical hip fractures were compared in a
      "randomized to surgeons" type of study. One hundred patients were treated with
      the Rydell four-flanged nail and 100 with the Gouffon pins. Redisplacement,
      nonunion, or segmental collapse occurred in 27 patients operated on with the
      Rydell nail and in 29 patients operated on with the Gouffon pins. According to
      the actuarial method of follow-up, the failure rates after 2 years were 31 and 33
      percent in the two groups.

PMID- 2239165
TI  - Hip physiolysis. Bilaterality in 62 cases followed for 20 years.
AB  - The frequency of bilateral physiolysis colli femoris was evaluated in 62
      patients. At first admission, 5 patients had a bilateral slipping. Further, 9
      patients had slipping diagnosed in the contralateral hip during adolescence 1-3
      years after the primary operation. At the follow-up examination 22 years after
      the primary operation, radiographs showed bilateral sequelae of slipping in 30 of
      62 patients. Of the nine slips diagnosed later during adolescence, one showed
      mild and two severe arthrosis. Among the 16 slips diagnosed at follow-up, mild
      arthrosis was found in four hips. We recommend bilateral pinning at first
      admission in all patients with a slipped capital femoral epiphysis.

PMID- 2239166
TI  - Age-related changes in femoral trabecular bone in arthrosis.
AB  - Age-related changes in the cancellous bone in selected regions of the proximal
      femur and iliac crest were assessed. An arthrosis group and a control cadaver
      group, partitioned into subjects younger and older than aged 50 years, were
      compared. The control group comprised 69 heads of femur and iliac crest samples.
      The arthrosis group comprised 28 consecutive heads of femur affected by primary
      arthrosis and an iliac crest biopsy taken during hip arthroplasty. Cancellous
      bone was sampled from four selected regions in the proximal femur.
      Histomorphometric estimates of percentage bone volume were determined using image
      analysis. In the young controls the bone volume was higher than that in the old
      controls for all the regions. In the arthrosis group the bone volume was higher
      than that of the old controls except for the subchondral principal tensile and
      medial to the greater trochanter regions. The old controls had regression of bone
      volume on age for the subchondral and medial principal compressive regions and
      the iliac crest. The arthrosis group had a minimal dependence of bone volume on
      age. Our study showed that primary arthrosis modulates the age dependence of bone
      volume in the proximal femur.

PMID- 2239167
TI  - Indomethacin influences Moloney's sarcoma and associated periosteal osteogenesis
      in the mouse.
AB  - The effect of indomethacin on periosteal osteogenesis mediated by the Moloney
      sarcoma virus was studied using a mouse model. In the indomethacin-treated
      animals, the development of sarcoma was inhibited, as evaluated by the tumor
      incidence, tumor size, and maximal tumor duration. Periosteal osteogenesis
      mediated by this sarcoma was lower than in saline-treated control mice.

PMID- 2239168
TI  - Epidemiology of meniscal lesions in the knee. 1,215 open operations in Copenhagen
      1982-84.
AB  - In a suburban area of Copenhagen with approximately 620,000 inhabitants, all the
      openly operated on meniscal lesions of the knee joint between 1982 and 1984
      inclusive were reviewed. The mean annual incidence of meniscal lesions per 10,000
      inhabitants was 9.0 in males and 4.2 in females. The highest incidences were seen
      in the 3rd, 4th, and 5th decades of life. A higher frequency of trauma related to
      onset of symptoms was found among males (77 percent) than among females (64
      percent). The bucket-handle lesion was the most frequent type of meniscal lesion
      in males (35 percent), whereas peripheral detachment was the most frequent in
      females (41 percent). A variable frequency of trauma inducing the lesions in
      males and females did not explain differences in type of meniscal lesion.
      Nineteen percent of our 1,215 patients had a partial meniscectomy, whereas 0.7
      percent had meniscal repair.

PMID- 2239169
TI  - Scintigraphy in the assessment of anterior knee pain.
AB  - Sixty knees presenting with chronic anterior pain were investigated. A diffusely
      increased uptake indicated sympathetically mediated pain provided other diagnoses
      such as synovitis or widespread arthrosis were excluded. Focal uptake was not
      specific to any one condition, but could occur in chondromalacia patellae or
      recent dislocations. However, the commonest appearance found in chondromalacia
      patellae was a normal scan. A characteristic scintigraphic appearance in
      symptomatic postpatellectomy knees, which has not been previously reported, was
      increased uptake in the femoral groove. In all the cases where no clinical or
      arthroscopic diagnosis was made, the bone scan was normal. The use of
      radioisotope scintigraphy is recommended in the problem knee presenting with
      anterior pain.

PMID- 2239171
TI  - Proximal row carpectomy in perilunate dislocations and lunatomalacia.
AB  - Proximal row carpectomy was performed in 13 wrists with old unreduced perilunate
      dislocations and in 4 wrists with Kienbock's disease. One failure was converted
      to wrist arthrodesis, and 2 patients were lost to follow-up. The remaining 14
      patients were reexamined after 11 (3-19) years. Average ranges of wrist motion
      were 37 degrees of dorsiflexion, 30 degrees of palmar flexion, 5 degrees of
      radial deviation, and 24 degrees of ulnar deviation. Grip strength averaged two
      thirds of the uninvolved hand. Pain relief was achieved in 12 patients, who all
      returned to their previous occupations. The results according to Cooney's
      criteria were 1 good, 8 fair, and 5 poor.

PMID- 2239170
TI  - Effect of glycosaminoglycan polysulfate on chondromalacia patellae. A placebo
      controlled 1-year study.
AB  - The effect of glycosaminoglycan polysulfate (GAGPS) on damaged patellar cartilage
      and clinical symptoms of chondromalacia was studied on 31 patients in a placebo
      controlled double-blind trial. The clinical diagnosis was confirmed by
      arthroscopy. The treatment consisted of 12 intramuscular injections of either
      GAGPS or placebo, and the patients were followed for 1 year. In 26 patients,
      rearthroscopy was performed at the 1-year follow-up. Comparison of the two
      arthroscopies showed improvement in 8/13 patients in the GAGPS group compared
      with 3/13 in the placebo group. The clinical parameters correlated well with the
      results of the arthroscopies. The results support the use of GAGPS for
      chondromalacia patellae.

PMID- 2239172
TI  - Cast or external fixation for fracture of the distal radius. A prospective study
      of 126 cases.
AB  - In a prospective 4-year study, 126 consecutive patients with a fracture of the
      distal radius were followed. Functional, anatomic, and radiographic final results
      of fixation with above-the-elbow cast immobilization were compared with the
      results obtained with external fixation. The results following external fixation
      of comminuted intraarticular fractures were better than those of similar
      fractures treated in a cast. Aged osteoporotic patients tolerated better residual
      deformities, and the clinical results had a relatively low correlation with the
      final anatomic alignment. We suggest that extraarticular fractures of the distal
      radius should be treated with cast immobilization. Comminuted intraarticular
      fractures of the distal radius should be treated with external fixation, which
      maintains accurate anatomic position until solid fracture healing is achieved.

PMID- 2239173
TI  - Epidemiology of distal radius fractures in Iceland in 1985.
AB  - Between March 1985 and March 1986, 249 fractures of the distal radius in patients
      over 15 years of age were treated in the Reykjavik area, which had a total at
      risk population of 100,154. The incidence pattern was similar to what has been
      reported in recent Nordic studies except that the fracture risk of women was
      lower than in Oslo in 1979 and Malmo in 1980-81, and for men higher than in
      Fredriksborg in 1981. Fifty-seven percent of the patients had employment at the
      time of accident. The majority of accidents happened outdoors, especially on
      sidewalks and in streets, and were more common during the winter months.

PMID- 2239174
TI  - Short-term cefotaxime prophylaxis reduces the failure rate in lower limb
      amputations.
AB  - The effect of prophylaxis with a broad-spectrum antibiotic agent in lower limb
      amputations was studied in a prospective, randomized investigation of 38
      patients. Nineteen received cefotaxime (Claforan) and 19 served as controls.
      Three patients died in the immediate post-operative period. In the treatment
      group, 15/18 healed compared with 10/17 controls (P less than 0.001). We
      concluded that short-term cefotaxime prophylaxis increases the chances to achieve
      good stump healing.

PMID- 2239176
TI  - Late pulmonary metastases from chondroblastoma of the distal femur. A case
      report.
AB  - A patient treated with curettage and bone grafting for a chondroblastoma of the
      distal femur sustained a pathologic fracture after a local recurrence. He then
      underwent a local, radical resection and an arthrodesis of the knee. Ten years
      after the first operation, pulmonary metastases were found, for which he
      underwent a metastasectomy (thoracotomy). At the latest follow-up, 1 year later
      there were no signs of tumor.

PMID- 2239175
TI  - Coccygodynia treated by resection of the coccyx.
AB  - Sixty-five patients suffering from coccygodynia resistant to conservative
      treatment had total or partial coccygectomy, all without serious complications.
      Eight reoperations were performed. After an average of 15 years, 46 of the 55
      patients seen at follow-up were satisfied. A normal radiograph of the coccyx does
      not exclude a good result from coccygectomy. We recommend total coccygectomy
      using a longitudinal incision in carefully selected and well-informed patients.

PMID- 2239177
TI  - Distal tibial osteochondroma deforming the fibula.
AB  - Three children had osteochondromata in the lateral part of the distal metaphysis
      of the tibia causing impingement with erosion and deformity of the fibula. The
      osteochondromata were removed through an anterior approach without osteotomy of
      the fibula. At reexamination 1.5-11 years postoperatively, the patients had
      normal ankle function. Remodeling of the fibula had gradually occurred in all the
      cases, most in the youngest patient. There was no injury to the distal tibial
      physis.

PMID- 2239178
TI  - Fracture dislocation of the ankle with the fibula trapped behind the tibia. A
      case report.
AB  - The authors present a case of fracture dislocation of the ankle with the fibula
      entrapped behind the tibia--Bosworth's fracture. It is often unrecognized as such
      because it is so rare and because radiographs are not correctly interpreted. A
      stable reduction can be obtained by closed treatment when promptly recognized.

PMID- 2239179
TI  - First Scandinavian-Japanese Shoulder Meeting. Helsinki, Finland, June 26-29,
      1989. Abstracts.

PMID- 2239180
TI  - Danish Orthopedic Society. Copenhagen, October 27-28, 1989. Abstracts.

PMID- 2239182
TI  - The Netherlands Orthopedic Society. Utrecht, January 18-19, 1990. Abstracts.

PMID- 2239181
TI  - Norwegian Orthopedic Society. Oslo, October 27-28, 1989. Abstracts.

PMID- 2239183
TI  - Finnish Orthopedic Association. Kuusamo, April 23-27, 1990. Abstracts.

PMID- 2239185
TI  - Finnish Orthopedic Association. Mariehamn, May 11-12, 1990. Abstracts.

PMID- 2239184
TI  - Danish Orthopedic Society. Helsingor, May 4-5, 1990. Abstracts.

PMID- 2239186
TI  - The Netherlands Orthopedic Society. Soest, May 12, 1990. Abstracts.

PMID- 2239187
TI  - The Swedish Orthopedic Society. Kalmar, September 5-7, 1990. Abstracts.

PMID- 2239188
TI  - [Magnetic resonance imaging in knee injuries].
AB  - Of all the diagnostic imaging techniques for the injured knee, Magnetic Resonance
      Imaging (MRI) has been shown the most worthwhile. Indications for standard X
      rays, arthrography and ultrasonography are briefly reviewed. Advantages of MRI,
      the technical aspects and the sequences used are explained. After a short
      description of the signals of all the common anatomic components of the knee, we
      describe MR findings in meniscal pathology, tenoligamentous lesions and cartilage
      and bone injuries.

PMID- 2239189
TI  - Internal fixation of tibial plateau fractures using the AO instrumentation.
AB  - Between January 1970 and December 1985, 76 patients (76 fractures) underwent
      internal fixation for tibial-plateau fractures as recommended by the AO-group
      (14). Fifty patients were available for follow-up. The long term results of this
      retrospective study are reported. Subjective results were satisfying. Forty-four
      percent of the patients were painfree and only 8% had severe postoperative pain,
      which was clearly related to osteoarthritis. Eight-eight percent of patients had
      no instability at follow-up. Clinical and radiographic results were evaluated for
      mobility, laxity and osteoarthritis. Thirty-five patients had a loss of flexion
      averaging 16.6 degrees. In 12 patients the average decrease in extension amounted
      to 7.5 degrees. Valgus increase averaged 9.7 degrees in 17 patients, and the
      average varus increase was 7.5 degrees in 4 patients. Seventy-four percent of
      patients showed no laxity at follow-up. The finding of osteoarthritis on X-ray
      was well correlated with the postoperative incongruence of the articular surface.
      It was also found to develop earlier in patients who underwent (partial)
      meniscectomy. Some general considerations about tibial condyles fractures are
      presented, and the technique used by the authors is discussed at length. The
      indications for internal fixation are also evaluated. The importance of adequate
      reduction, stable internal fixation and vigorous postoperative rehabilitation is
      stressed.

PMID- 2239190
TI  - About radioactivity in some PMMA bone cements.
AB  - Various bone cements containing zirconium oxide (ZrO2) as X-ray contrast medium
      were tested for radioactivity by means of a gamma spectrometer. All measured bone
      cements (PALACOS, IMPLAST, SULFIX-6) showed a certain degree of radioactivity.
      The radiation source in the bone cement is the added zirconium oxide, which is
      polluted by radioactive elements. As these X-ray contrast media remain in the
      body for decades as components of the bone cement, the radioactive zirconium
      oxides should be substituted by high purity radiation-free zirconium oxide or
      barium sulfate.

PMID- 2239192
TI  - Shoulder instability in Ehlers-Danlos syndrome. An indication for surgical
      treatment?
AB  - In a 19-year-old female patient with Ehlers-Danlos Syndrome and bilateral
      multidirectional voluntary dislocations, multiple surgical attempts to achieve
      stability were ineffective. Joint laxity and hyperelastic tissue are underlying
      factors contributing to failure of stabilization. More importantly, voluntary
      dislocations often achieve secondary gain and need preoperative psychological
      evaluation.

PMID- 2239191
TI  - [The risk of thromboembolism in prosthetic surgery of the hip, and its prevention
      by administration of individualized heparin dosages].
AB  - After hip replacement, thromboemboli remain a very frequent and severe
      complication. Different techniques of prevention have been described but there is
      no pharmacological method of definitively proving the effectiveness of such
      techniques. The use of low-dose heparin has been recommended, but owing to the
      variable results obtained in this type of surgery, certain authors prefer using
      an individualized dose. The authors report their experience with this regimen in
      30 patients with certain individual thromboembolic risk factors who underwent hip
      arthroplasty. Despite these cases of deep vein thrombosis, no symptomatic
      pulmonary emboli were diagnosed. There were two patients with hematomas at the
      iliac crest which resolved without sequelae after drainage. The different rules
      to be followed for prevention of these complications are analyzed; the authors
      underscore the need for individual adaptation of the heparin dose.

PMID- 2239193
TI  - [Reflections on a small series of cementless total hip prostheses].
AB  - We report on our series of 48 patients with uncemented hip prostheses, with an
      average follow-up of 3 years. The clinical results, according to the Merle
      d'Aubigne's classification, are comparable to those obtained with cemented
      prostheses except for transitory pain, very often localized to the lateral aspect
      of the thigh, which seems to be correlated with the bone adaptation to the
      implant. Radiological findings are valuable in the assessment of long-term
      results with uncemented prostheses. During the operation, it is of utmost
      importance that the surgeon obtain a very tight fit of the prosthesis into the
      bone, which must be confirmed on postoperative X-ray. Under such conditions, the
      radiological appearance remains the same, showing a condensation line outlining
      the cup and absence of radiolucent lines along the stem. On the other hand,
      cortical thickening, bony condensation around the tip of the stem and sclerotic
      lines are the radiological evidence of bone adaptation to the prosthesis. They
      are not indicative of a less good result. Finally, radiolucent lines wider than 1
      millimeter, extending along the stem, or a progressive sinking of the femoral
      component are the radiological signs of implant instability. In these rare cases,
      the prognosis may be compromised.

PMID- 2239194
TI  - [Tibial fractures following Maquet's tuberosity advancement. Apropos of 2
      clinical case reports].
AB  - Although accustomed to using the Maquet tibial tuberosity advancement, the
      authors had two similar and rare complications in which a fracture of the tibial
      shaft occurred at the end of the vertical osteotomy. Both incidents arose from a
      mechanical incision effect. This can be prevented by making a larger circular
      hole in the distal portion of the osteotomy.

PMID- 2239195
TI  - Treatment of nonunion using pulsed electromagnetic fields: a retrospective follow
      up study.
AB  - Pulsed electromagnetic fields (PEMF) are a useful means of treating cases of
      fracture nonunion. In 67.7% of nonunions with a disability time of at least 24
      months, complete consolidation was obtained. This success rate is increased to
      76.6% if we exclude nonunion, that presented contraindications for treatment with
      PEMF. The disability time had no effect on the success rate. Lesions of the
      humerus and atrophic nonunion had an unfavorable prognosis.

PMID- 2239196
TI  - [Treatment of painful spondylolysis using Morscher's hook].
AB  - An original technique of direct isthmic reconstruction described by E. Morscher
      was used in 25 patients with painful spondylolysis after failure of conservative
      treatment. After a follow-up of 25 months, the functional and radiological
      results were evaluated and compared with other techniques. Nineteen patients had
      an excellent or good functional result, in 2 patients the result was fair, and 4
      patients had no beneficial effect on pain. The best results were seen in patients
      younger than 20 years, with an olisthy of less than 10 mm, without associated
      joint, disc or ligament pathology. In these cases, good results were achieved in
      90%, and there was radiological consolidation in 100%.

PMID- 2239197
TI  - Surgical treatment of tibial pseudarthrosis using the Ilizarov apparatus. A
      critical analysis.
AB  - Since November 1985 the authors have added the Ilizarov procedure to their
      armamentarium for the treatment of tibial pseudarthrosis. The results of a first
      clinical study of 10 patients are reported. The mean duration of follow-up is 17
      months. The consolidation rate is higher with a transverse than with an oblique
      pseudarthrosis. The Ilizarov procedure combined with a corticotomy offers new
      perspectives in the management of massive bone defects. In the presence of severe
      malalignment, a gradual reduction can be carried out. The main complications are
      pin tract infections and algodystrophy.

PMID- 2239198
TI  - The natural history of chondromalacia patellae. A 12-year follow-up.
AB  - A series of 45 patients with chondromalacia patellae demonstrated clinically and
      by arthrotomy, but without demonstrable biomechanical misalignment, was
      investigated retrospectively. Thirty-one of the patients had only been treated
      conservatively while partial chondrectomy was performed in 14. All of the
      patients underwent an intensive rehabilitation program. After 12 years the
      patients were interviewed. Eighty-one percent of the patients who were treated
      conservatively and 57 percent of the patients in whom partial chondrectomy was
      performed had mild or no pain and no other knee complaints. The results were
      better for patients aged 20 years or younger. Two patients received disability
      pensions on account of poor knee function and 6 had changed to less strenuous
      occupations. Restraint is advised as regards operative treatment of
      chondromalacia patellae.

PMID- 2239199
TI  - [Subcapital fracture of the femoral neck. A rare complication of a
      pertrochanteric fracture healed in coxa vara position].
AB  - Subcapital stress fracture occurring after a previously healed intertrochanteric
      fracture is a rare event. One further case is reported. A new etiology and
      different ways of preventing such a complication are proposed.

PMID- 2239200
TI  - [Cauda equina syndrome due to early postoperative migration of an adipose tissue
      flap following laminectomy].
AB  - The authors reported an early case of cauda equina syndrome after hemilaminectomy
      and discectomy for lumbar disc herniation. CT-scan revealed the migration of the
      free fat graft used for preventing peridural scar formation. Removal of the graft
      resulted in total patient's recovery.

PMID- 2239201
TI  - Subcapital fracture of the femoral neck following internal fixation with a
      dynamic hip screw.
AB  - A case of subcapital femoral neck fracture following osteosynthesis of a
      trochanteric fracture is described. The implant used was the dynamic hip screw.
      This kind of fracture is very rare, and has to our knowledge never been described
      with the use of the dynamic hip screw.

PMID- 2239202
TI  - 'Carrusel': an expert system for vestibular diagnosis.
AB  - Neuro-otology is the only field of otolaryngology in which diagnoses are mainly
      deductive. Although many technological advances have indeed occurred, the patient
      history still remains the most important part of the evaluation of a patient
      complaining of vertigo and/or dizziness. The use of artificial intelligence
      methods as an aid for the solution of clinical problems is not new. "Carrusel" is
      a Prolog build-up expert system dealing with the diagnosis of vestibular
      disorders that achieves a success rate of 97% when compared to the human experts
      involved in its design.

PMID- 2239203
TI  - Body sway stabilization in human posture.
AB  - Electromyographic (emg) responses and joint movements of the leg were analysed in
      subjects standing with eyes closed on a sinusoidally moving treadmill (0.16 Hz or
      0.33 Hz, amplitude 33 cm). Activity in antagonistic leg muscles was reciprocally
      modulated, with a predominant gastrocnemius activation during deceleration of
      forward movement and tibialis anterior activation during deceleration of backward
      movement of the treadmill. In these phases, it was necessary to compensate for
      sway induced by body inertia. The match between treadmill movement and emg
      activity was better for the gastrocnemius than for the tibialis anterior muscle.
      The characteristic pattern of leg muscle emg activity is suggested to be
      modulated predominantly by vestibulo-spinal reflexes partly because treadmill
      movements did not evoke muscle strength, and partly because patients with loss of
      vestibular function showed basic alterations in the emg pattern and could only
      compensate for the slow sinus while standing unsupported.

PMID- 2239204
TI  - Head-shaking nystagmus during vestibular compensation in humans and rhesus
      monkeys.
AB  - Nystagmus evoked after rapid horizontal head-shaking is believed to be a
      sensitive indication of the existence and location of a unilateral vestibular
      lesion. Its origin is the directional asymmetry in vestibular responses of the
      healthy labyrinth (Ewald's second law). For nystagmus to appear after the head
      has stopped moving, however, the directionally asymmetric responses must have
      been stored during the head-shaking to be discharged afterwards. Our results
      confirm the notion that head-shaking nystagmus is most likely generated by a
      directional preponderance in vestibular responses but only in combination with a
      functioning central velocity-storage mechanism. If velocity-storage is lost
      completely, as may occur during the acute phase of a unilateral peripheral
      vestibular lesion, even a large vestibular preponderance does not lead to head
      shaking nystagmus. Thus, to interpret the results of the head-shaking test the
      condition of the velocity-storage mechanism must be taken into account.

PMID- 2239205
TI  - Significance of pressor input from the human feet in anterior-posterior postural
      control. The effect of hypothermia on vibration-induced body-sway.
AB  - The importance to postural control of the mechanoreceptors of the soles was
      investigated in thirteen healthy subjects. Body-sway velocity was evaluated
      before and after exposing the subject's feet to hypothermia, and when calf
      muscles were exposed to vibration at frequencies between 20 and 100 Hz. Subjects
      were tested both with eyes open and closed. Body-sway velocity was found to
      increase significantly during hypothermia of the feet. The difference in body
      sway between hypothermal and normothermal conditions was less prominent when the
      subject's eyes were open though the difference was significant in both cases. The
      present results indicate the importance of the mechanoreceptors of the soles to
      postural control and elucidate their interaction with compensatory visual input
      in maintaining postural control. These findings also suggest, that factors
      affecting pressor input should be taken into consideration when assessing
      patients with complaints of dysequilibrium.

PMID- 2239206
TI  - Galvanically induced asymmetric optokinetic after-nystagmus.
AB  - The effect of an asymmetric vestibular input on the symmetry of horizontal
      optokinetic after-nystagmus (OKAN) was studied in twenty healthy subjects.
      Optokinetic nystagmus (OKN) was elicited by a whole-field optokinetic drug,
      rotating at 90 degrees/s, and eye-movements were recorded by a DC electro
      oculographic technique (EOG). The ratio of OKAN following right and left-beating
      OKN respectively was computed. An asymmetric vestibular input was generated by a
      continuous bi-polar, bi-aural galvanic stimulus (1 mA) to the vestibular nerves
      during the optokinetic stimulation and the recording of the OKAN. During galvanic
      stimulation the relation between left and right-beating OKAN was asymmetric,
      compared with the OKAN found after optokinetic stimulation only. The galvanic
      stimulus caused a preponderance for OKAN with the fast phase beating toward the
      cathode. Thus, the small vestibular asymmetry induced by the galvanic stimulus,
      which was not strong enough to produce nystagmus by itself, caused an asymmetric
      OKAN. These findings suggest that examination of OKAN may be of value to detect
      small vestibular asymmetries in peripheral vestibular disorders in man.

PMID- 2239208
TI  - The influence of middle ear pressure on the vestibular nerve activity in cats.
AB  - The influence of middle ear pressure on the vestibular nerve activities was
      investigated in anesthetized cats. The vestibular nerve activities were recorded
      intraaxonally and positive or negative pressure was applied to the middle ear
      cavity through a tympanic membrane perforation. The firing of vestibular nerve
      fibers, especially the regular type nerve that responded to horizontal
      semicircular canal stimulation, increased with positive pressure and decreased
      with negative pressure. Most vestibular nerves that responded to anterior or
      posterior semicircular canal stimulation were not influenced by changes in the
      middle ear pressure. These results indicate that middle ear pressure load is
      transmitted to the vestibular end organs and then to vestibular nerve.

PMID- 2239207
TI  - Effects of anti-cholinergic and cholinergic drugs on habituation to motion in
      rats.
AB  - The effects of the anti-cholinergic drug scopolamine, an anti-motion sickness
      drug, and of the cholinergics physostigmine and neostigmine on habituation to
      motion sickness in rats were examined using pica, measured as eating of kaolin,
      as a behavioural index of motion sickness in rats. Rats were rotated around two
      axes for 1 h once a day for 10 or 11 days. Rotation-induced kaolin intake of
      control rats gradually decreased from day 9 of daily rotation. Test rats were not
      treated for the first 3 days, given drugs on days 4-7 of rotation and then again
      given no drugs for the next 3 or 4 days. Rotation-induced kaolin intake of test
      rats was compared to that of controls. Results showed that TTS (Transdermal
      Therapeutic System)-scopolamine administration facilitated habituation to
      rotation, whereas physostigmine, a centrally acting cholinesterase inhibitor,
      suppressed it, and neostigmine, a peripherally active cholinesterase inhibitor,
      had no effect on habituation at all. These findings suggest that the central
      cholinergic neuron system plays an important role in the neural mechanism of
      habituation to motion in rats.

PMID- 2239209
TI  - Effect of perilymphatic air perfusion on cochlear potentials.
AB  - Perilymphatic fistula is now widely recognized to cause acute profound hearing
      loss. It is still controversial, however, which mechanism it is that causes the
      reversible hearing loss. Recently, it has been suggested by two groups of
      researchers that the intrusion of air bubbles into the perilymphatic space (a
      condition called pneumolabyrinth or aerolabyrinth) through the ruptured
      labyrinthine window(s) may be one of the causes. In order to examine the
      mechanism underlying the hearing loss associated with pneumolabyrinth, the
      perilymphatic space of the guinea pig cochlea was perfused with air and cochlear
      potentials were recorded. Although perfusion of the scala tympani with air at a
      rate as high as 200 microliter/min caused an immediate and drastic decrease of
      the cochlear microphonics (CM) and the compound action potential (AP), it had
      little effect on the endocochlear dc potential (EP) during perfusion for 20 min.
      A decline in EP was seen in half the ears, but only when the duration of
      perfusion exceeded 30 min. These results show that the EP has an amazing
      resistance to air trapped in the scala tympani of the cochlea and that the
      initial decrease of hearing acuity after the elimination of perilymph from the
      scala tympani (or introduction of air into the scala tympani) is probably due to
      interference in CM and AP generation mechanisms rather than to strial
      dysfunction.

PMID- 2239210
TI  - Quantum type bone remodeling in the otic capsule of the pig.
AB  - Normal quantum type bone remodeling was studied in temporal bones of young
      domestic pigs by means of combined microradiography, osteofluorochrome labelling
      and osteoid staining. Evolving secondary osteons were morphologically normal
      although much less in the otic capsule than in the surrounding compacta of the
      temporal bones or in long bones. Moreover, remodeling was totally absent in bone
      tissue immediately adjacent to perilymphatic spaces suggesting the presence of a
      local mechanism controlling resorption and perhaps formation in the bony otic
      capsule.

PMID- 2239211
TI  - Distribution of glycoconjugates during cochlea development. A histochemical
      study.
AB  - Specific occurrence and distribution of glycoconjugates in the developing mouse
      cochlea was investigated using Alcian blue/PAS staining. The AB/PAS positive
      staining occurred intracellularly, extracellularly, pericellularly, and as
      glycocalyx. Pericellular staining occurred between certain epithelial cells in
      early stages of development, and extracellular deposit occurred mostly in
      mesenchymal tissue surrounding the cochlear duct and later in developing spiral
      ligament. During early stages of development, mesenchymal tissue and pericellular
      space of different epithelial cells of the cochlear duct were intensely stained,
      suggesting that these glycoconjugates may play an important role in the
      differentiation of the cochlear structures. Different supporting cells (e.g.
      Deiters' cells, pillar cells) were intensely stained at different development
      stages coinciding with the time when the subcomponents of the tectorial membrane
      (TM) were being formed. This finding suggests that glycoconjugates in the TM are
      produced by these cells.

PMID- 2239212
TI  - Ultrastructure of ampullar dark cells in the absence of circulating
      adrenocorticosteroid hormones.
AB  - The morphology of rat ampullar dark cells was studied in the absence of
      circulating adrenal hormones at two time intervals of 8-14 and 22-28 days. Five
      morphological parameters of dark cells were quantitatively determined: cell area
      per baseline length, basolateral membrane surface density, basolateral membrane
      length per baseline length, volume density of intercellular space and volume
      density of vacuoles. Significant statistical reduction of basolateral membrane
      length per baseline length was observed after an absence of circulating adrenal
      hormones for 8-14 days and 22-28 days compared to sham operated animals that
      served as control. The basolateral membrane surface density decreased
      significantly in the animals sacrificed 22-28 days following adrenalectomy
      compared to sham operated animals. Cell area per baseline length decreased and
      volume density of vacuoles increased at both time intervals following
      adrenalectomy; however, these differences were statistically insignificant. The
      volume density of intercellular space between dark cells was practically constant
      among the groups. Results of this study are similar to those reported for ion
      regulating nephron cells, and support the hypothesis that cells involved in
      microhomeostasis of vestibular endolymph may at least be partly regulated by
      adrenal hormones.

PMID- 2239213
TI  - Mitochondrial volume density of Schwann cells associated with rat vestibular
      ganglion cells.
AB  - The purpose of this study was to quantitate the mitochondrial volume density
      (MVD) within Schwann cells associated with vestibular ganglion cells in the
      female Wistar rat. Results show that this type of Schwann cell (SC) has a
      significantly higher MVD (19.4% +/- 1.9) than that reported for myelinating SC of
      peripheral nerve (1-5%). This large difference in SC MVD may be related to the
      energy requirements needed to maintain the local ion homeostasis around the
      ganglion cells given the environmental differences created by the different
      barrier systems of these regions of the nervous system.

PMID- 2239214
TI  - Involvement of cochlear nerve in acoustic tumours.
AB  - With conventional light and transmission electronmicroscopy we studied 10 cases
      of acoustic nerve tumour, 3 of which proved to be instances of von Recklinghausen
      neurofibroma and 7 of schwannoma. Schwannomas were not found to infiltrate the
      cochlear nerve. Hearing loss, if present in cases of schwannoma, could be related
      to non-specific lesions of the uninfiltrated cochlear nerve in the vicinity of
      the vestibular nerve tumour. Only neurofibromas were found to infiltrate the
      cochlear nerve. Distinction between tumour infiltration and non-specific lesion
      could be made by electron microscopy.

PMID- 2239215
TI  - Three-dimensional graphic reconstruction of the tympanic bulla of the rat with
      special reference to the middle ear muscles.
AB  - On the basis of functional questions, graphic three-dimensional reconstructions
      of the tympanic bulla of the rat were made to gain insight into the spatial
      organisation of the contents of the bulla and especially of the tympanic membrane
      -ossicular chain--middle ear muscle complex. For this purpose drawings of
      microscopical sections of complete bullae were fed into the computer to make
      three-dimensional graphic reconstructions with hidden line removal. From these
      reconstructions plastic representations were made by the medical artist. The
      topographical anatomy of the tympanic bulla is discussed in detail and compared
      to the anatomy of the middle ear in man. It is postulated that, despite
      differences in spatial organisation of the middle ear of the rat compared to that
      of man, the middle ear muscles influence the ossicular chain in a comparable way.
      On the basis of the topographical anatomy it is feasible that the muscles in the
      rat act synergistically in increasing the stiffness of the ossicular chain.

PMID- 2239216
TI  - Anatomic variations of the chorda tympani canal.
AB  - The anatomic variations of the facial recess are of interest in certain
      otosurgical procedures. The medial border of the recess is the mastoid portion of
      the facial nerve canal, and the lateral border is the bony canal of the chorda
      tympani. These two structures were investigated in 64 polyester casts of temporal
      bone specimens. The point of exit of the chorda tympani canal from the facial
      canal was assessed together with the angle, formed between these two nerve
      channels. As a further way of describing the spaciousness at the facial recess,
      the distance between the sulcus of the stapedius muscle and the chorda tympani
      canal was evaluated.

PMID- 2239217
TI  - Changes of middle ear mucosa in secretory otitis media treated with ventilation
      tubes.
AB  - The present study was designed to obtain the precise ultrastructural status of
      the middle ear mucosa of patients to whom ventilation tubes were applied for the
      treatment of secretory otitis media (SOM). This study comprised 14 children with
      SOM aged 5-11. Normal epithelium obtained from otosclerotic patients as controls
      was composed of three main cell types; basal, ciliated, and secretory. Electron
      microscopic observations revealed that ciliated cells were almost completely
      absent in the epithelium of patients with SOM. Secretory cells, on the other
      hand, were noted to be increased in number with cytoplasmic features indicating
      active secretory phase; abundant secretory granules in these cells featured both
      serous and mucoid characteristics. Following the application of ventilation
      tubes, the micrographs exhibited a vast number of ciliated cells. Furthermore,
      the secretory cells were less conspicuous and the secretory granules were mostly
      serous in type. The ultrastructural findings of this investigation strongly
      suggest that the application of ventilation tubes in cases of SOM stimulates
      ciliated cell regeneration, inhibits secretion of mucoid material, and activates
      serous secretion; all of which eventually shorten the recovery period.

PMID- 2239218
TI  - Amoxicillin/clavulanate treatment in secretory otitis media. Bacteriological
      findings in the nasopharynx.
AB  - A double blind, placebo controlled study was undertaken to evaluate the
      antibiotic impact of amoxicillin/clavulanate acid on the nasopharyngeal flora in
      children treated for 4 weeks for secretory otitis media (SOM). In 131 children
      who received antibiotic, a significant fall in H. influenzae and S. pneumoniae
      was observed in comparison to 133 children who received placebo. Beta-haemolytic
      streptococci and S. aureus were less frequent and did not decrease significantly.
      One month after discontinuation of treatment the nasopharyngeal bacterial flora
      was restored to pretreatment level. Seasonal variation was found only for S.
      pneumoniae. No persistent beta-lactamase producing H. influenzae was noticed. In
      the light of previously published results this study confirms that the
      nasopharyngeal flora plays an aetiological role in the development of SOM in
      children, and that the used antibiotic did not disturb the nasopharyngeal flora
      in the long run.

PMID- 2239219
TI  - Effects of middle ear ventilation on cholesteatoma development in experimental
      animals.
AB  - This study was designed to evaluate the effect of middle ear ventilation on
      cholesteatoma formation following propylene glycol application in experimental
      animals. Fifteen chinchillas had stainless steel ventilation tubes chronically
      implanted in their bullae and 60% propylene glycol was subsequently instilled
      into the middle ear cavities. The animals were kept alive for 4 weeks, during
      which time the middle ear pressure was monitored tympanometrically and the tubes
      were frequently inspected to verify patency. Of the 30 ears in the study, 20
      (66.6%) developed middle ear cholesteatoma--a rate of occurrence comparable to
      that found in earlier studies in which middle ear ventilation was not provided.
      These results indicate that negative middle ear pressure is not a necessary
      factor for cholesteatoma development following application of chemical irritants
      in experimental animals.

PMID- 2239220
TI  - Nasal physiology in swimmers and swimmers' sinusitis.
AB  - To investigate the pathogenesis of swimmers' sinusitis we questioned and examined
      a group of 20 swimmers and 20 controls. Clinical examination was followed by
      rhinomanometry, sonography of the maxillary sinuses, a saccharine test to assess
      mucociliary transport in the nose, and a viable cytological sampling of the nasal
      mucosa. The history showed a preponderance of symptoms of sinusitis and chronic
      rhinitis in the swimmers' group, as well as a reddening of the nasal mucosa and a
      swelling of the adenoids. Sonography showed mucosal thickening in the antrum in
      more cases among the swimmers. Rhinomanometry, saccharine test, and viable
      cytological sampling revealed no differences of significance between the groups.
      It is discussed that pathogenesis is more probable through cooling of the skin of
      the face and the whole body than by entrance of water into the upper respiratory
      tract.

PMID- 2239221
TI  - Age-dependent changes in bacterial adherence to epithelial cells of nasopharynx
      in vivo.
AB  - Epithelial cells were scraped from the posterior wall of the nasopharynx (NPH) of
      20 consecutive patients (age range 1 to 52 years, 9 males, 11 females) undergoing
      ENT surgery under general anaesthesia. The cellular mixture was immediately
      homogenized, filtrated through a 5 microns pore filters and centrifuged (10 min,
      1,500 rpm). Non-ciliated, squamous epithelial cells caught by the filter were
      harvested and stained with acridine orange. Epithelial cells with bacteria
      attached were evaluated when specimens were examined under a fluorescence
      microscope. A distinct difference was noted between young individuals and adult
      patients regarding bacterial adherence to nasopharyngeal epithelial cells,
      adherence in young patients being especially remarkable. Bacteria appeared not to
      attach to ciliated epithelial cells. The high incidence of otitis media
      infections among young individuals may be due to the remarkable bacterial
      adherence to nasopharyngeal non-ciliated epithelial cells in this age group.

PMID- 2239222
TI  - Mucosal blood volume and oxygen saturation in the human vocal fold.
AB  - With a newly developed spectrophotometric analyzer we were able to measure
      hemoglobin (Hb) concentration and its oxygen saturation in the human vocal and
      ventricular folds. Studies were made on 30 subjects including 18 normal controls.
      In laryngomicrosurgery under general anesthesia, measurements were made with a
      fiber probe touching the laryngeal mucosa. Results were as follows: In normal
      mucosa of the vocal fold, the mean value of IHb was 40 and the ISO2 was 55, while
      in that of the ventricular fold, the mean values were 74 and 56, respectively.
      Thus, in spite of the influence of general anesthesia, the mucosal blood volume
      was lower in the vocal fold than in the ventricular fold. The mean value of IHb
      was 30 in the vocal fold polyps, 122 in the vocal fold nodule, 43 in the polypoid
      degenerations, 17 in the vocal fold cyst, 62 in the granuloma, 6 in the sulcus
      vocalis and 19 in the hyperkeratoses. This method is considered useful for
      objective and quantitative analysis of pathological conditions in the vocal fold.

PMID- 2239223
TI  - Expression of epidermal growth factor receptor in laryngeal dysplasia and
      carcinoma.
AB  - The immunoreactivity of epidermal growth factor receptor (EGFR) was studied in
      laryngeal biopsy specimens from 24 patients. The study comprised 5 cases of
      normal laryngeal mucosa, 5 cases of dysplasia, 7 cases of well differentiated
      squamous cell carcinoma, and 7 cases of poorly to moderately differentiated
      squamous cell carcinoma. EGFR was in general not expressed in normal and
      dysplastic epithelia, whilst all carcinomas showed a rather strong positive
      immunoreactivity. There was no significant difference in staining patterns
      between the well and poorly to moderately differentiated carcinomas. The results
      suggest that EGFR constitutes a component of neoplastic, but probably not
      preneoplastic, laryngeal disease. The study failed to reveal any difference in
      staining pattern between different types of laryngeal squamous cell carcinoma.

PMID- 2239224
TI  - Scanning electron microscopy in a case of infantile inborn deafness.
AB  - The temporal bones of a one-year-old, congenitally deaf boy were removed 3 1/2
      days post mortem, fixed in formaldehyde and prepared for scanning electron
      microscopy (SEM). In the apical coil the organ of Corti had the normal
      configuration. In the second coil there was a continuous decrease of both the
      number of sensory cells and their conservation. Altered sensory cells with giant
      or bullous distended hairs were found. Throughout the basal coil the hairs of the
      sensory cells were absent, while the other cells of the organ of Corti appeared
      normal.

PMID- 2239225
TI  - Histopathological changes in the temporal bone in Bell's palsy.
AB  - The changes in the facial nerve at autopsy are described in a case in which there
      had been an acute onset of lower motor neurone facial paralysis, with a clinical
      diagnosis of Bell's palsy, 11 days before death. There was congestion and
      infiltration of the nerve in the internal auditory meatus and proximal fallopian
      canal by lymphocytes. Features indicating compression of the nerve in the
      proximal part of the fallopian canal were seen in the presence of congestion and
      osteoclastic resorption of the bone surrounding the proximal fallopian canal.
      Demyelination was present in the tympanic part of the nerve. A bulge below Bill's
      bar was found on the normal as well as the pathological side and cannot be
      accepted as evidence of pathological change. It is suggested on the basis of the
      pathological findings that the symptoms of Bell's palsy may arise from
      compression of the facial nerve in the proximal part of the fallopian canal.

PMID- 2239226
TI  - Immunohistochemistry of otosclerosis.
AB  - Immunoglobulins G (IgG) and A (IgA) were found in plasma cells, osteocytes,
      chondrocytes and in connective tissue of active otosclerotic (= otospongiotic)
      lesions. The application of antibodies against paramyxovirus and rubella virus
      antigens reproducibly determined the expression of these antigens at different
      sites in the otosclerotic stapes, but also in the epithelial cells of the
      overlying middle ear mucosa. By using specific T-lymphocyte and B-lymphocyte
      markers, about 80% of the lymphocytes present in the otosclerotic footplate were
      revealed to be T-lymphocytes. There was neither deposition of immunoglobulins nor
      any expression of viral antigens in non-otosclerotic footplates which were
      investigated as controls.

PMID- 2239227
TI  - Methods for cellular and subcellular visualization of intermediate filament
      proteins in the human inner ear.
AB  - The preservation of antigenicity for monoclonal antibodies (mAbs) directed
      against the five classes of intermediate filament proteins and their subgroups
      was analysed in inner ear specimens from both early embryonic (6-8 gestation-week
      old) human labyrinths and inner ears from newborn CBA/CBA mice. After initial
      fixation in 2% paraformaldehyde, the specimens were embedded in either polyvinyl
      alcohol (PVA) or the low viscosity acrylic resin LR White. Both embedding media
      allowed sectioning at room temperature with a specimen thickness of 0.5-1
      microns, which gives a resolution at the subcellular level in the light
      microscope. Immunoreactivity occurred in the PVA-embedded material, but not in
      specimens embedded in LR White. However, considerably fewer mAbs showed
      immunostaining in the PVA-embedded material than in both cryofixed-cryosectioned
      or paraformaldehyde-fixed-cryosectioned human inner ears. Immunoelectron
      microscopy using colloidal gold (particles 10 nm in diameter) was successful in
      the PVA-embedded (but not the LR White-embedded) material.

PMID- 2239228
TI  - Investigation of intracellular organelles in the human organ of Corti using
      backscattered electrons (BSE).
AB  - Using ligand-mediated osmification (OTOTO technique), human cochleae were
      prepared for scanning electron microscopy. The surface of the organ of Corti and
      the bodies of the sensory cells were observed with secondary and backscattered
      electrons. Detecting the backscattered electrons emitted from the depth of the
      cells, intracellular organelles such as subsurface cisternae, mitochondria and
      nuclei became visible in their reciprocal arrangement.

PMID- 2239229
TI  - Clinical experience with early post-mortem human inner ear perfusion.
AB  - Early fixation of human temporal bones is a difficult but very important task.
      The author reports on his experience in hospital wards.

PMID- 2239230
TI  - Preservation of the human cochlea with two different fixatives.
AB  - The cochlear morphology of eight inner ears from 4 patients was studied by
      electron microscopy. The perilymphatic perfusion was performed in 2 of them 2 and
      2 1/2 h and in 2 others, 10 and 11 h post mortem. In each patient, Karnovsky's
      fixative was used in one ear and Britta's fixative in the other. No structural
      differences between the two ears were ascertained in the patients with a short
      post-mortem fixation time. The cochleas with 2 h post-mortem fixation time were
      better preserved than those with the 10 and 11 h delay. The cochleas with the
      longer delay from death to perilymphatic perfusion were still fairly well
      preserved. However, in these cochleas the stronger fixative (Britta's fixative)
      gave a better preservation.

PMID- 2239231
TI  - Progress in temporal bone histopathology. III. An improved technique for
      immunohistochemical investigation of the adult human inner ear.
AB  - A new tissue processing technique is described for immunohistochemistry of the
      adult human inner ear, avoiding the immuno-compromising step of prolonged
      decalcification. The procedure allows reliable investigation of frozen sections
      of the chemically fixed, non-decalcified, adult human cochlea and vestibular
      sense organs. Preservation of immunoreactivity, combined with satisfying tissue
      morphology, is illustrated by the immunohistochemical localization of the
      intermediate filament constituents cytokeratins and neurofilament proteins
      throughout the membranous labyrinth.

PMID- 2239232
TI  - Human auditory and vestibular pathology--studies of early development, ageing and
      disease. Proceedings of the Fifth Workshop on Histopathology of the Human Audio
      Vestibular Organ. Milan, 25-27 June 1989.

PMID- 2239233
TI  - Developmental aspects of the human endolymphatic sac.

PMID- 2239234
TI  - Early bone formation in the human fetal otic capsule. A methodological approach.
AB  - The present study was concentrated on the use of energy-dispersive X-ray analysis
      and backscattered electron imaging as practical tools for advanced autopsy of
      human fetuses when diagnostic evaluation of ear pathology is required. These
      methods were used to revisit the primary calcification front of the fetal otic
      capsule between 18 and 36 weeks' gestational age. Energy-dispersive X-ray
      analysis indicates an equal Ca/P ratio in all the three layers of the otic
      capsule. These results are discussed in view of calcium homeostasis and inner ear
      function.

PMID- 2239235
TI  - Quantitative evaluation of the human cochlear nerve.
AB  - In 18 human temporal bones of patients with normal hearing or sensory neural
      deafness, the cochlear neurons were evaluated at the level of the peripheral
      axons in the osseous spiral lamina, the ganglion cells in the spiral ganglion and
      the central axons in the cochlear nerve in the inner acoustic meatus. The total
      number and the segmental distribution were both determined.

PMID- 2239236
TI  - Transmission electron microscopy of previously embedded celloidin sections.
AB  - A technique to re-embed celloidin sections of human temporal bones for
      transmission electron microscopy (TEM) is presented. The procedure consists of
      basically four different steps, starting with loosening of the celloidin sections
      from the glass slides, removing the celloidin using clove oil, to staining and
      embedding in epoxy resin. The technique allows TEM analysis of the intact
      labyrinth in various regions in the same specimen, as well as on the same
      section. This may prove useful, as prior dissection of the fragile tissue
      components of the membranous labyrinth is not longer necessary. The technique
      makes possible the retrospective study of temporal bone collections. It may also
      be of value for the study of the ultrastructural histopathology of the human
      inner ear in optimally preserved tissue.

PMID- 2239237
TI  - Quantitative analysis of cochlear sensory cells and neuronal elements in man.
AB  - The myelinated radial fibres in the osseous spiral lamina and the myelinated
      fibres in the cochlear nerve in the internal auditory canal as well as the
      sensory cells were counted in cochleae from 15 dissected temporal bones from 8
      patients. Light microscopy was carried out on semithin sections of epoxy resin
      embedded tissue. Audiometry had been performed within 6 months prior to death.
      Three patients had normal hearing for their age group, 2 had slight presbyacusis
      and the remaining 3 had sustained noise injury. All specimens clearly had fewer
      fibres in the spiral lamina than in the internal auditory canal. The cochleae
      from patients with normal hearing for their age group had a difference in the
      nerve fibre counts of up to 34%. A case of sensorineural presbyacusis showed 31%,
      and a case of neural presbyacusis, 47% difference. The greatest difference was
      found in a case of acoustic trauma, the range in this group being between 25% and
      55%. The lower the number of fibres in the spiral lamina, the greater was the
      difference in all but two specimens. A slow retrograde degeneration, i.e.
      beginning in the peripheral process of the cochlear nerve, could be an
      explanation for these findings.

PMID- 2239238
TI  - Ultrastructural aspects of the human peripheral vestibular system.
AB  - The sensory epithelia from the membranous labyrinths of 4 patients were examined
      by transmission electron microscopy. The distribution ratio of type 1 to type 2
      cells was recorded, compared for each sensory area and correlated with age. An
      ultrastructural assessment confirmed generalized patterns consistent with
      autolytic and preparation artefact, viz. calyceal dilatation, cytoplasmic
      protrusions and some sensory hair loss. More specific features, i.e. lipofuscin
      accumulation, membrane-bound inclusions and neural degeneration were consistent
      with pre-mortem pathological change. In 2 patients, total nerve fibre counts of
      15,766 and 19,741 were obtained. Total fibre counts correlated with the sensory
      cell density of the innervated areas. Differential counts of the superior and
      inferior vestibular nerves suggested that there was a reduced number of fibres in
      the superior division of both patients, in comparison with established normative
      data. Morphometric analysis of the constituent fibre diameters revealed a skewed
      distribution with a modal value of 6 microns for both patients.

PMID- 2239240
TI  - Acoustic trauma in mineworkers revealed by temporal bone necropsy.
AB  - Six selected human cochleae showing definite signs of mechanical damage caused by
      exposure to high intensity noise (acute acoustic trauma) are reviewed. Patterns
      of degeneration of cochlear hair cells were compared with the functional
      audiometric examinations. Tonotopic relations, mechanism of damage to the organ
      of Corti as well as pathological changes of the tectorial membrane are discussed.

PMID- 2239239
TI  - Observations on the pattern of sensorineural degeneration in the human cochlea.
AB  - Cochlear sensory and neural degeneration was examined in nine pairs of human
      temporal bones fixed by perilymphatic perfusion, using phase-contrast and
      electron microscopy. Four pairs, three from females, had only slight
      sensorineural degeneration, limited to the very basal end of the cochlea. A
      predominantly neural degeneration was identified in a 54-year-old male. The
      process was bilateral, asymmetrical, uneven, and involved the entire length of
      the cochlea with several circumscribed areas of severe nerve degeneration. One
      case had mild, diffuse sensorineural degeneration in the lower half of the basal
      turn characteristic of presbyacusis. The other three pairs, all from males,
      revealed sensorineural degeneration patterns associated with noise injury and
      were remarkably similar to or almost identical with cochleas described
      previously. There was a good correlation between the presence of supporting cells
      and the survival of nerve fibres in the osseous spiral lamina in the
      corresponding area. In one cochlea, however, the degeneration of only inner hair
      cells in a small area was associated with complete nerve degeneration in the
      corresponding sector of the spiral lamina. Giant cilia were frequently seen in
      the apical turn.

PMID- 2239241
TI  - Aeration of the tympanomastoid cavity and the Eustachian tube.
AB  - Physiological changes in body position affect the degree of opening and closing
      of human auditory tubes. Notable changes were observed in lateral body position
      concerning the opening rate of the auditory tubes, which corresponds to the
      changes in pressure within the lower portion of the middle ear cavity. This
      physiological mechanism seems to be related with the anatomical direction of the
      auditory tube and the natural mechanism for the protection of the middle ear
      cavity. When a change takes place which moves the compliance of the eardrum to
      the positive side (e.g. head position change or static lateral body position),
      observation suggests the possibility of venostatis and production of gas.
      Measurement of the oxygen tension in the middle ear cavity under atmospheric
      pressure revealed the existence of constant gas production which maintains the
      pressure in the middle ear cavity at the same level as atmospheric pressure. This
      result denies the influx of gas from the atmospheric environment into the middle
      ear cavity. These results stem from the intrinsic physiologic mechanism of the
      middle ear cavity, namely maintenance of effective auditory sound conduction (a
      function to keep eardrum compliance as close to zero as possible), by keeping the
      pressure within the middle ear cavity below the atmospheric pressure, either at
      the same level as or slightly higher than that of the environment pressure. Gas
      emission from the middle ear cavity in the atmospheric environment and a low
      oxygen tension are a natural physiologic mechanism to protect the middle ear
      cavity from infection and other hazards.

PMID- 2239242
TI  - New findings in observations by tubo-tympano-aerodynamic method.
AB  - We studied Eustachian tube function of healthy adults by two air flow methods,
      namely tubo-tympano-aerodynamic graphy by Valsalva maneuvre, and Tyonbee maneuvre
      during swallowing. We observed for the first time the presence of reciprocal
      features in normal Eustachian tubes. We also compared the tubal function of the
      same group using an air flow method and sound transmission method. The results of
      these observations showed that 77.4% of the subjects were positive for TTAG in
      Valsalva pattern, and 85.4% for sonometry. It can be inferred that data on the
      tubal opening in response to Valsalva and Toynbee maneuvres is obtained more
      easily by sonometry than by TTAG. TTAG, which permits examination of minute
      changes in air flow dynamics even in healthy Eustachian tubes, provides more
      important information on tubal function than does sonotubometry.

PMID- 2239243
TI  - Middle ear ventilation mechanism.
AB  - The ventilation mechanism of the middle ear is very important as regards the
      pathogenesis of middle ear disease, but its mode of function is still obscure.
      Therefore, we tried to measure the ventilation and clearance of the middle ear
      using radio-isotope imaging techniques and 133Xe in order to gain a clearer
      picture of the ventilation mechanism. In normal Eustachian tube cases,
      approximately 10% of the initially insufflated gas immediately entered into the
      middle ear cavity and mastoid air cells. The gas introduced into the middle ear
      diminished at a rate of 8% of volume per hour in the normal resting state. Two
      hours after the first procedure, air was insufflated, and gas volume in the
      middle ear cavity immediately diminished by 30%. In stenotic tube cases, it
      proved difficult to insufflate the gas into the middle ear, however, its
      diminishing rate with the passage of time was slightly faster than in normal tube
      cases. From this data, it was evident that air could easily and quickly enter
      into even the periphery of the mastoid air cells by insufflation via the
      Eustachian tube, despite the fact that the middle ear and mastoid air cells form
      a closed cavity. In the resting state, moreover, the air in the middle ear was
      thought to be absorbed mainly into the middle ear mucosa at a regular rate. It
      was confirmed that the insufflation procedure as a therapy for tubal stenosis and
      OME is very useful for the ventilation of the middle ear.

PMID- 2239244
TI  - PO2 levels in middle ear effusions and middle ear mucosa.
AB  - We measured PO2 values in mucoid and serous middle ear effusions (M-MEE, S-MEE)
      and in the middle ear mucosa of patients with otitis media with effusion (OME)
      and compared these values with those obtained from patients with middle ear
      barotrauma (MEBT). The mean and S.D. values of PO2 in M-MEE, S-MEE and MEBT
      effusions were 28.9 +/- 11.3, 31.5 +/- 9.5 and 37.0 +/- 15.4 mmHg, respectively;
      the mean and S.D. values in mucosa were 27.1 +/- 11.9, 27.0 +/- 13.2 and 32.5 +/-
      1.0 mmHg, respectively. In health, PO2 values in middle ear mucosa are regulated
      by its blood supply, oxygen solubility in blood and the blood-to-cavity partial
      pressure gradient of the gas. When the Eustachian tube (ET) function is severely
      impaired, PO2 values in the middle ear air cavity depend on the mucosal
      condition, though some studies have shown a lack of relationship between ET
      function and PO2 values. Our results show that PO2 values in MEBT are
      consistently higher than in OME, suggesting that the attributable factor could be
      a better ET function in MEBT.

PMID- 2239245
TI  - Eustachian tube and middle ear diseases.

PMID- 2239246
TI  - Evaluation of clearance function of the Eustachian tube by sequential contrast
      CT.
AB  - Comparisons of Eustachian tube (ET) functions studied by sequential contrast
      computerized tomography (CT) and by tubotympanic aerodynamics (TTAG) were made.
      ET clearance function was assessed by the shape of the cartilaginous portion
      before, during and at the end of swallowing; ventilatory function was studied by
      TTAG. ET clarity, real-time dynamics and resolution were all better when observed
      with sequential CT. Contrast medium was instilled into the middle ear via a
      drumhead perforation and 1 scan/sec taken during swallowing. We classified ET
      function based on the presence or absence of a) movement of the cartilaginous
      portion, and b) contrast medium in the ET as i) movement present, contrast medium
      seen in ET: ii) movement absent, contrast medium present in ET; and iii) movement
      present, no contrast medium in the ET. Ventilatory and clearance functions did
      not parallel one another, attributable to some mechanical, differences between
      the two functions.

PMID- 2239247
TI  - Eustachian tube function in OME patients with cleft palate. Special reference to
      the prognosis of otitis media with effusion.
AB  - Eustachian tube function was investigated in two groups of cleft palate patients
      who had otitis media with effusion. One group consisted of 16 ears that healed
      after one ventilatory tube insertion, the other consisted of 33 ears that needed
      repeated tube insertion and did not heal in 2 years. The latter group was
      characterized by low opening pressure and inability to sustain lower middle ear
      positive pressure. This decrease force in the Eustachian tube was considered to
      be related to the prognosis of otitis media with effusion in patients with cleft
      palate.

PMID- 2239248
TI  - Eustachian tube function and mastoid pneumatization.
AB  - We investigated the relationship between the Eustachian tube's ventilatory
      function and the pneumatization of mastoid air cells. In 65 adults (66 ears) with
      chronic otitis media (COM), ventilatory Eustachian tubal function was evaluated
      by the inflation-deflation test, while the area of mastoid air cells was measured
      by the rectangular method on X-ray film. Group I represents good function in both
      the inflation and deflation tests. Group II represents good function in the
      inflation test but poor function in the deflation test. Group III represents a
      poorly functioning Eustachian tube in both tests. The opening pressure in Group
      III was statistically higher than in Group I and Group II. The area of mastoid
      air cells in Group I was statistically larger than in Group III. There was no
      correlation between opening pressure and area of mastoid air cells in COM.
      Postoperative failure of the tympanic membrane was frequently found in Group III.
      We discuss the tubal function and pneumatization of mastoid air cells.

PMID- 2239249
TI  - Prognosis of otitis media with effusion in children, and size of the mastoid air
      cell system.
AB  - We studied 334 ears in 176 patients who were chosen from children diagnosed as
      having otitis media with effusion (OME) at our clinic. These 176 patients were re
      examined about 5 years and 10 months after the first visit and categorized into
      three groups according to otological findings at the time of review: group A
      (normal), group B (sequelae), group C (OME). For this study, 168 ears of 86
      persons were examined by roentgenography both at the time of the first visit and
      at review, and the size of mastoid pneumatization and differences in size between
      the three groups were compared. The results of the investigation can be
      summarized as follows. The size of mastoid pneumatization in group A was large at
      the time of the first visit and the increase in size was also greater than in the
      other two groups. These results led us to conclude that the degree of mastoid
      pneumatization is an important prognostic sign of the clinical course of OME and
      provides important information about treatment.

PMID- 2239250
TI  - Suppressed mastoid pneumatization in cholesteatoma.
AB  - Mastoid pneumatization size was studied by X-ray in 289 patients with otitis
      media (134 with cholesteatoma and 155 with chronic suppurative otitis media (COM)
      and 73 patients with traumatic tympanic membrane perforation (controls). The
      results demonstrated that mastoid pneumatization in the diseased ear of
      cholesteatoma patients was greatly suppressed. In these patients, the
      contralateral ear also showed significant suppression compared with controls;
      mastoid pneumatization size in the healthy ear contralateral to cholesteatoma was
      similar to that in patients cured of otitis media with effusion (OME). Hence, we
      conclude that cholesteatoma is a sequela of OME in childhood.

PMID- 2239251
TI  - Effects of myringotomy and orally administered drugs on viscosity and elasticity
      of middle ear effusions from children with otitis media with effusion.
AB  - Clinical and rheological studies were performed on 42 children with otitis media
      with effusion. Twenty-one patients received S-carboxymethylcysteine (group A),
      and the other 21 patients were administered Kampo medicine (group B), a Japanese
      traditional herbal medicine, for 4 weeks following myringotomy. At the end of the
      4-week treatment period, 47.2% of the ears in group A and 40.5% in group B were
      regarded as being free from middle ear effusion (MEE). For rheologically thick
      MEEs, where the viscosity (eta') and elasticity (G') are much greater than the
      optimal values for mucociliary transport, post-treatment values of eta' for group
      A decreased significantly, but those of G' did not, in comparison with pre
      treatment values. No such changes in either eta' or G' were observed in group B.
      Results suggests that the combined therapy for myringotomy and oral SCMC is
      effective for improving the rheological properties of thick MEE in children.

PMID- 2239252
TI  - Is change in middle ear air volume following ventilation tube insertion a
      reliable prognostic indicator?
AB  - Ninety ears (52 patients, aged 3-11 years) affected by secretory otitis media
      (SOM) were treated by insertion of a ventilation tube (VT). Following VT
      insertion, the middle ear air volume of these ears was estimated by using an
      impedance audiometer, at 1, 3, and 6 months postoperatively, and every 6 months
      thereafter. The middle ear air volume, expressed as the compliance value,
      increased rapidly for the first 3 months, followed by a gradual increase
      thereafter. A great difference was observed among the compliance values of ears,
      ranging from over 10 cc to below 1.5 cc at 6 months, postoperatively. Twelve
      percent of the ears had compliance values of less than 1.5 cc, and in this group,
      CT showed opacified and poorly developed mastoid cells. Although the association
      of upper respiratory disorders such as chronic sinusitis, nasal allergies and
      cleft palate were found to be more frequent in cases of ears with smaller
      compliance values, this was not statistically significant. Small compliance
      values (middle ear air volume) were correlated with the early onset of acute or
      secretory otitis media, repeated otorrhea after VT insertion and high recurrence
      rates after the extrusion of the VT.

PMID- 2239253
TI  - Eustachian tube function in tympanoplasty.
AB  - Prognostic value of preoperative Eustachian tube function was examined in 77 ears
      subjected to type 1 tympanoplasty. Eustachian tube function was evaluated by
      positive and negative pressure equalization tests, and clearance test. Based on
      the results of these three tests, the ears were classified into four grades. The
      outcome of the ear surgery was judged by postoperative hearing, presence of
      otorrhea, atelectasis and perforation of the eardrum. Results of the positive
      pressure equalization and clearance tests of the tube were correlated with the
      outcome of ear surgery, although the negative pressure equalization test had no
      correlation with it. The percentage of unsuccessful outcomes increased with the
      grade of tubal dysfunction, indicating that tubal function is closely associated
      with the outcome of ear surgery. Thus, it was revealed that the preoperative
      tubal function test including positive pressure test and clearance test are
      useful for predicting the prognosis of ear surgery.

PMID- 2239254
TI  - The vascular anatomy of the vestibular labyrinth in man.
AB  - 1. A survey of the literature on the vascular anatomy of the vestibular labyrinth
      in Man is presented, and the methods of investigation used to visualize the
      vessels are evaluated. A generally correct picture of the subject is provided by
      the various studies published since Siebenmann's monograph. There are, however,
      some conflicting points as well as some lack of data with regard to the course
      and relationships of the large vessels and the capillary areas of the cristae and
      maculae. 2. This study presents a systematic description of the vascular anatomy
      of the vestibular labyrinth in Man, from the main arterial and venous stems to
      the capillary areas, with particular attention to the relationships between the
      vessels and the osseous walls, neural, and membranous structures. The vessels
      were visualized by a composite method including the selective injection of the
      internal auditory artery with coloured silicone or India ink; the counterstaining
      of the labyrinth with osmic acid; the cutting of the petrous bone in 1-mm thick,
      serial sections that were cleared with methylsalicylate. The sections were
      studied by stereomicroscopy, using mainly reflected light. Photos and drawings
      were made to illustrate the findings. New names were introduced for vessels
      hitherto unnamed, and some traditional names were modified in order to give a
      more precise and descriptive terminology. 3. The description followed the two
      main arteries, the capillary areas and the three main veins. The vestibular
      labyrinth is supplied by the superior vestibular artery and by the inferior
      vestibular artery which is a branch of the vestibulo-cochlear artery. The
      superior vestibular artery runs along the anterior aspect of the vestibule from
      the utricular nerve up to the cristae of the superior and lateral canals. It
      supplies the macula of the utricle, the cristae and ampullar crures of the
      superior and lateral canals. The inferior vestibular artery runs mainly along the
      medial wall of the vestibule. It supplies the last tract of the scala media and
      the vestibular caecum with a peculiar pattern which appears to be an adaptation
      of the common cochlear arrangement to the different spatial condition. It also
      supplies the macula of the saccule, the crista and ampullar crus of the posterior
      canal as well as the simple crures of the three canals. The vascular arrangement
      of the maculae and cristae has a similar three-layered architecture.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 2239255
TI  - [The effect of a histamine nasal provocation tests on the results of the tubal
      compliance manometry test (TCM) in normal study subjects].
AB  - The Tubal-compliance-manometric test (TCM) assesses the passive and active tubal
      opening as well as the equilibration ability. The pressures necessary to open the
      eustachian tube (ET) are measured while performing the Valsalva maneuver and
      during swallowing (if needed with added pressure). The equilibration ability is
      also checked. Subjects with normal tympanometry were twice tested, at an interval
      of 1 to 2 weeks; 52 ETs (in 28 persons) entered the study. According to a
      variance analysis (ANOVA), there was no significant difference (alpha = 5%)
      between the two measurements (the results were time-independent). The mean
      opening pressures were 610 daPa (SD = 108) during the Valsalva maneuver and 97
      daPa (SD = 40) during the swallow test. Nearly 14% of the tubes were considered
      floppy (unable to maintain a positive pressure). In order to study the influence
      of mucosal swelling on tubal function, 9 subjects (18 tubes) underwent a TCM
      before and after a nasal histamine provocation. The opening pressures in both
      tests were significantly altered (higher) after the provocation (ANOVA; 0.001
      less than p less than 0.01). One tube became obstructed and two became floppy.
      The equilibration ability was not altered. The TCM proved to be of value as an
      easy, fast and quantitative test for assessing active and passive tubal function.

PMID- 2239256
TI  - [Benign cervical tumors of neuroectodermal origin: apropos of 3 clinical cases].
AB  - Neuroectoblastic benign cervical tumors. Report of three clinical cases. Cervical
      neurogenic tumors are uncommon. They arise from the cranial nerves, the cervical
      sympathetic chain and the paraganglion cells of the parasympathetic system (non
      chromaffin cells). Three cases are reported (schwannoma-ganglioneuroma
      chemodectoma). The pertinent literature is reviewed for the classification, the
      diagnosis and the treatment.

PMID- 2239258
TI  - The puzzling success of allograft tympanoplasty. Possible immunological
      explanations.

PMID- 2239257
TI  - [Otological manifestations of leukemia. Apropos of a clinical case].
AB  - The authors describe a clinical case of acute lymphoblastic leukemia, showing
      major leukemic infiltration of the cochlea and the acoustic nerve. The patient
      however didn't present any otological symptom. A brief literature review is added
      (clinical aspects, histopathological aspects ...). The authors stress on
      performing routine audiometric examinations in leukemia, especially in the acute
      forms of the disease.

PMID- 2239259
TI  - Empyema of a concha bullosa in a child with cystic fibrosis (case report).
AB  - An empyema of a concha bullosa or a middle turbinate pyocoele caused unilateral
      complete chronic nasal obstruction in an 8 year old girl affected by cystic
      fibrosis and was successfully operated. The possible pathogenetic mechanisms
      involved are reviewed and discussed.

PMID- 2239260
TI  - [An unusual cause of laryngeal stridor: the Shy-Drager syndrome].
AB  - A case of laryngeal stridor in an adult patient is presented and the diagnose of
      syndrome of Shy-Drager is proposed. This syndrome is the result of a degeneration
      of the central nervous system. Some autonomic functions are involved in this
      process. The leading symptoms are an orthostatic hypotension, parkinson-like
      symptoms and laryngeal stridor. The last symptom results from a neurogenic
      paralysis of both posterior crico-arytenoideus muscles. A depletion of
      neurotransmitters in the central nervous system would be the cause of the
      syndrome. The treatment is symptomatic. Concerning the laryngeal stridor,
      tracheotomy, eventually followed by a crico-arytenoidopexy, is the only treatment
      which can be proposed.

PMID- 2239261
TI  - Vascularized temporoparietal fascial flap for closure of a nasal septal
      perforation. Report of a case.
AB  - The temporoparietal fascia is a thin, pliable and well-vascularized sheet of
      tissue available in large amounts. It is easily transferred to distant recipient
      sites by microvascular anastomosis or can be used as island pedicle flap. The
      fineness and flexibility of this flap, combined with the absence of sequelae at
      the donor site led us to use the fascia in a case for closure of a nasal septal
      perforation.

PMID- 2239263
TI  - Analysis of 185 submandibular gland excisions.
AB  - A review of 185 submandibular gland excisions over a ten year period is
      presented. The symptoms, physical findings, diagnosis on pathological examination
      and prognosis have been noted in each case to determine the incidence of
      neoplastic versus non-neoplastic disease. In our series non neoplastic disease of
      the submandibular gland was found in 141 patients (76%) with a large predominance
      of inflammatory lesion, while only 26 patients (14%) had a neoplastic lesion (6
      benign lesions and 20 malignant tumors). There were also 18 (10%) patients
      surgically treated with gland excision for a glandular metastatic involvement
      from adjacent nodes. The significance of these findings is discussed.

PMID- 2239262
TI  - Possibilities in hypopharyngeal reconstruction--comparative study.
AB  - A comparative study between three types of hypopharyngeal reconstruction after
      laryngopharyngectomy is presented by evaluation of the following parameters:
      complications, duration of hospitalization and postoperative swallowing time.
      Each group contains the five most recently cases treated at the E.N.T. department
      of the K.U. Leuven. In recent years, the following types of hypopharyngeal
      reconstruction were used: the pectoralis major flap, the free radial forearm flap
      and the revascularized jejunum interposition. For reconstruction of
      circumferential hypopharyngeal defects after total laryngopharyngectomy, the
      jejunal graft presents hopeful results.

PMID- 2239264
TI  - Autonomic reflexes in preterm infants.
AB  - Some autonomic nervous reflexes often tested in adult medicine have been studied
      in 21 preterm infants (25-37 gestational weeks). The aim was to develop such
      tests for preterm infants and see if there were any differences in babies with
      recurrent apnea and bradycardia and babies who had been exposed to
      sympathicolytic drugs before birth. To test sympathetic nervous activity the
      peripheral vascular resistance was measured before and during 45 degrees of head
      up tilting. To test parasympathetic nervous activity the degree of bradycardia
      was measured in response to cold face test (application of an ice-cube on the
      fore-head) and laryngeal stimulation with saline. Finally the heart rate changes
      after a sudden noise (85 dB) were studied as an indicator of both sympathetic and
      vagal activity. The peripheral resistance was found to be relatively low in these
      preterm infants, particularly in some infants tested at the postnatal age of
      about two months. Heart rate and mean blood pressure did not change during
      tilting, while the peripheral resistance increased significantly mainly due to
      lowered limb blood flow. The median decrease of the heart rate during the cold
      face test was 20.0% and during laryngeal receptor stimulation 23.7%. The sudden
      noise usually caused a biphasic heart rate response. An autonomic nervous reflex
      score was calculated and found to be negative (parasympathetic) in infants with
      recurrent prolonged apnea and bradycardia and positive in infants with clinical
      signs of increased sympathetic nervous activity.

PMID- 2239266
TI  - Urinary and serum urea as indicators of protein metabolism in very low
      birthweight infants fed varying human milk protein intakes.
AB  - Urea concentrations in serum and urine were measured in 28 growing, very low
      birth weight, appropriate-for-gestational age infants fed varying human milk
      protein intakes (range 1.7 to 3.9 g/kg/day). We found a high correlation between
      serum urea values at the end of the study and mean protein intake (rs = 0.85, p
      less than 0.001) and between urinary urea concentrations in eight-hour urine
      collections and protein intake (rs = 0.81, p less than 0.001). All serum and
      urine urea values were below 1.6 and 18 mmol/l, respectively, at protein intakes
      less than 3 g/kg/day. Higher protein intakes caused higher serum and urinary urea
      concentrations. We also found a strong correlation between the individual serum
      and urinary urea values at the end of the study (rs = 0.90, p less than 0.001).
      The presented data are consistent with the growth data previously reported and
      indicate that inadequate or excessive protein intakes can be detected by
      measurement of urea concentrations in serum and/or urine. If urine urea samples
      alone can be used for estimating optimal protein intake, painful blood sampling
      procedures could be obviated.

PMID- 2239265
TI  - Concentration of twelve plasma proteins at birth in very low birthweight and in
      term infants.
AB  - Plasma samples obtained at birth from 70 very low birth weight (VLBW) infants
      (gestational age 24 to 34 weeks) and from 20 term infants were analysed for
      concentrations of 12 different proteins. The plasma concentrations of albumin,
      transthyretin (TTR), retinol-binding protein (RBP), vitamin D-binding protein,
      apolipoprotein A I, fibronectin, orosomucoid and alpha 1-antichymotrypsin were
      significantly lower in the VLBW infants than in the term infants, whereas the
      values of alpha-fetoprotein (AFP) were significantly higher in the VLBW infants.
      No differences were found between the two groups for apolipoprotein A II,
      apolipoprotein B and transferrin. Birth asphyxia and sex had no influence on the
      measured plasma protein concentrations. The plasma concentrations of
      apolipoprotein A I and A II were significantly lower in small-for-gestational age
      (SGA), VLBW infants compared with appropriate-for-gestational age (AGA), VLBW
      infants. Possible acute inflammation (defined as raised concentrations of
      orosomucoid or alpha 1-antichymotrypsin) was associated with significantly higher
      values of vitamin D-binding protein in both VLBW and term infants, suggesting
      that this protein may act as an acute phase protein in newborn infants.

PMID- 2239267
TI  - Suboptimal mineral composition of cow's milk formulas: a risk factor for the
      development of late metabolic acidosis.
AB  - Late metabolic acidosis was observed in a term baby boy with renal tubular
      acidosis type 4 who received two cow's milk formulas in succession. Suboptimal
      mineral composition of the formulas turned out to be an important risk factor for
      the development of late metabolic acidosis.

PMID- 2239268
TI  - Immediate effects on lung function of instilled human surfactant in mechanically
      ventilated newborn infants with IRDS.
AB  - We have studied the effects on lung volume, respiratory mechanics and ventilation
      during the first hours after instillation of 60 mg/kg of human surfactant into
      the trachea of 4 very preterm, newborn infants with severe IRDS under mechanical
      ventilation. Measurements were made with a "face-out" body plethysmograph and a
      modified nitrogen wash-out method. In addition to a transient decrease in total
      and alveolar ventilation immediately after the instillation we found an immediate
      rise in lung volume, but respiratory compliance decreased. These changes lasted
      less than two hours. Oxygen requirements fell in 3 out of 4 infants. The changes
      in lung volume and compliance are explained in terms of changes in the shape of
      the static recoil pressure characteristics of the diseased lungs after treatment.
      Mechanisms behind the short duration are sought in mode of instillation, dosage,
      age at treatment, and severity of disease.

PMID- 2239269
TI  - Myocardial dysfunction and cerebral blood flow velocity following birth asphyxia.
AB  - Birth asphyxia often leads to left ventricular myocardial dysfunction. To assess
      the effect of myocardial dysfunction on cerebral perfusion, we evaluated cardiac
      output and cerebral blood flow velocity in the anterior cerebral and internal
      carotid arteries in 20 asphyxiated term newborn infants during the first 4 days
      of life using 2-dimensional/pulsed Doppler ultrasound. In 8 infants with
      myocardial dysfunction cardiac output was reduced on days 1 and 2 and within
      normal limits thereafter. In these infants changes in mean cerebral blood flow
      velocity and pulsatility index were passively related to changes in mean arterial
      pressure and cardiac output. In 12 infants without myocardial dysfunction a
      stable cerebral blood flow velocity pattern was found, which was unaffected by
      changes in mean arterial pressure. We conclude that infants presenting with a
      reduced cardiac output after deliveries associated with severe asphyxia may be at
      risk for additional ischemic or hemorrhagic cerebral damage because of lack of
      autoregulation.

PMID- 2239270
TI  - Red cell phosphate metabolism in preterm infants with idiopathic respiratory
      distress syndrome.
AB  - Phosphate metabolism was studied in twenty-one preterm infants with idiopathic
      respiratory distress syndrome during and after oxygen (O2) therapy using a hood.
      Plasma, red cell inorganic phosphate (Pi) and the red cell concentrations of
      organic phosphate metabolites ATP and 2,3-diphosphoglycerate were significantly
      lower in the sick infants when compared to controls of similar age and
      birthweight, and remained low even 24 h after cessation of therapy. Plasma
      cortisol levels were elevated at the onset of the disease and decreased to almost
      control levels by the end of O2 therapy while the values of plasma calcitonin did
      not show any difference from controls. Plasma creatinine phosphokinase and blood
      lactic acid levels followed the pattern of the control group with a small
      increase at the beginning of the study and decreasing thereafter. Several factors
      may be implicated in the cause of hypophosphatemia in these infants such as
      inadequate feeding, acidosis and hypercortisolaemia due to stress leading to
      phosphaturia.

PMID- 2239271
TI  - The value of neonatal serum thyroglobulin determinations in the follow-up of
      patients with congenital hypothyroidism.
AB  - Serum thyroglobulin was determined in 68 newborn infants with positive screening
      tests for congenital hypothyroidism. In 38 infants the diagnosis was confirmed
      (patients), but the remaining 30 were euthyroid at follow-up (controls). The mean
      thyroglobulin concentration at the age of 2 weeks did not differ significantly
      between the patients and the controls (179 vs. 125 micrograms/l). Thyroid
      scintigraphy was performed in 15 patients. All seven with thyroid aplasia, based
      on 99mTc pertechnetate scintigraphy, had measurable thyroglobulin (greater than 2
      micrograms/l) and thyroid hormones in their serum. This indicates that total
      absence of thyroid tissue is very rare in Swedish patients with congenital
      hypothyroidism. Scintigraphy based on 99mTc does not permit detection of small
      amounts of thyroid tissue. The neonatal concentrations of thyroglobulin did not
      correlate with the results of Griffiths test at 3 years and are therefore not
      useful for prognosis of psychomotor development. We conclude that neonatal
      measurement of thyroglobulin is of limited value in the follow-up of patients
      with congenital hypothyroidism.

PMID- 2239272
TI  - Prediction of final height in Turner's syndrome. A comparative study.
AB  - Various methods are used for prediction of final height in girls with Turner's
      syndrome (TS), but their accuracy has not been systematically investigated or
      compared. We have compared predictions of final height made with the most
      commonly used methods in 20 Turner girls at ages 9.5-18 years. Growth standards
      based on growth and final height of 78 Danish Turner women were used for
      calculation of standard deviation scores (SDS). In order to provide the necessary
      basis for "index of potential height" (IPH) method, bone age development was
      determined from 74 X-rays of 38 untreated Turner girls aged 5.2-19 years. This
      method was further modified and improved for use in TS. Prediction methods based
      only on height and chronological age (CA) showed little difference from methods
      including bone age. The IPH method in our modification was more accurate than
      those of Bayley-Pinneau and Tanner. At younger ages the IPH method showed better
      results when using Tanner-Whitehouse 2 (TW2) bone age than when using Greulich
      Pyle bone age. Accuracy of predictions were considerably improved by combining
      methods with and without allowance for bone age. Combinations including the IPH
      method based on TW2 bone age appeared to be the most accurate. Predictions of
      final height in Turner's syndrome should therefore be made by combining the IPH
      method and one of the methods based on height and CA.

PMID- 2239273
TI  - Effect of oxandrolone on growth and final height in Turner's syndrome.
AB  - Thirty-two girls with Turner's syndrome aged 11.5-16.7 years were treated with
      oxandrolone (0.125 mg/kg/day). The treatment period was scheduled to 2 years.
      Height velocity (HV) was expressed in Standard Deviation Scores (SDS), calculated
      by growth standards for untreated Danish Turner-girls. For girls with initial
      bone age below 13 years HV increased significantly from a mean pretreatment value
      of -0.2 SDS (3.1 cm/year) to +3.5 SDS (5.6 cm/year) in the 1st year of treatment
      and +2.1 SDS (4.1 cm/year) in the 2nd year. Mean bone age velocity during
      treatment was 0.9 year/year. Twenty-two girls have reached final height.
      Predictions of their final height were made by three different methods and
      compared to observed final height. A significant (p less than 0.001) improvement
      in the order of 3-4 cm was found for girls with initial bone age below 13 years,
      while girls with higher initial bone age had no height gain (p greater than 0.3).
      Side effects were seen in 16% of the girls.

PMID- 2239274
TI  - Neurosecretory dysfunction of growth hormone secretion in thalassemia major.
AB  - The growth retardation of children with thalassemia major is multifactorial.
      Along the endocrine axis of growth hormone (GH), serum somatomedin has been shown
      to be deficient and GH response to GH-releasing hormone impaired, while GH
      response to provocative stimuli is normal. We studied the spontaneous secretion
      of GH in seven patients with thalassemia major and growth retardation. Three of
      the patients were hypothyroid, and the other four were euthyroid. Spontaneous
      secretion of GH in all seven patients was subnormal: the number of pulses, the
      mean pulse amplitude, and the integrated concentration of GH were all lower than
      in 14 age- and sex-matched (10 pubertal and 4 prepubertal) control subjects. GH
      response to provocative stimuli was normal in the euthyroid patients. This
      pattern of response corresponds with the definition of neurosecretory dysfunction
      of GH secretion. It is concluded that the growth retardation of patients with
      thalassemia major is partly due to neurosecretory dysfunction of GH secretion.

PMID- 2239275
TI  - Growth and growth hormone therapy in hypochondroplasia.
AB  - The growth of 84 patients with hypochondroplasia (56 male, 28 female) was
      studied. A wide spectrum of severity was found from quite severe short limbed
      dwarfism to short apparently normal prepubertal children who manifested
      disproportion only at puberty when growth failed. The onset of puberty was at the
      normal time but the pubertal growth spurt appeared not to materialize and it is
      this lack which resulted in severely compromised adult heights of 145-165 cm in
      boys and 133-151 cm in girls. Twenty (12 M, 8 F) hypochondroplastic children aged
      between 4.3 and 12.8 years were recruited to a study of the effects of
      biosynthetic growth hormone. All had normal growth hormone responses (greater
      than 15 mU/l) to a pharmacological test of growth hormone secretion. Biosynthetic
      growth hormone in doses between 12-32 mu/m2/week produced a significant
      acceleration in height velocity standard deviation score (SDS) for chronological
      age (CA) from a pretreatment mean of -1.66 (SD 1.36) to +1.62 (SD 1.52) (p less
      than 0.001). Significant increases were also observed in the height SDS for bone
      age (BA), sitting height (SH) SDS and subischial leg length (SILL) SDS. A longer
      period will be required to assess the effect of treatment on adult height
      prognosis.

PMID- 2239276
TI  - Anticardiolipin response in Kawasaki disease.
AB  - Antibodies against cardiolipin are formed in many different infectious diseases,
      and high levels are associated with susceptibility to thrombosis, especially in
      patients with systemic lupus erythematosus. In view of the postulated infectious
      etiology of Kawasaki disease an its association with thrombosis, we have studied
      the occurrence of anticardiolipin antibodies in this disease. Serial serum
      specimens from 36 patients were tested, using a solid-phase enzyme immunoassay. A
      change of at least 0.3 optical density units between two consecutive specimens
      for at least one immunoglobulin class was observed in 47% of cases. Peak levels
      occurred one to two weeks after the onset of symptoms. Four patients developed
      coronary artery aneurysms, and they all showed a clear anticardiolipin response.
      Anticardiolipin antibodies might be one factor contributing to coagulation
      abnormalities in patients with Kawasaki disease.

PMID- 2239277
TI  - Increased interleukin-1 (IL-1) production from LPS-stimulated peripheral blood
      monocytes in children with febrile convulsions.
AB  - Peripheral blood mononuclear cells (MNC) from 27 children with a febrile
      convulsion were tested for production of interleukin-1 (IL-1) in culture. MNC
      stimulated with lipopolysaccharide (LPS) showed a significantly increased
      production of IL-1 when compared to MNC from children without convulsions but
      with bacterial infections (p less than 0.001), viral infections (p less than
      0.005) or no infection (p less than 0.005). Children who had experienced a
      febrile convulsion were retested several months later; this time the IL-1
      production from LPS-stimulated MNC was not different from controls. These results
      demonstrate that MNC at the time of febrile convulsions have increased
      sensitivity to LPS and possibly to other IL-1 inducers; the resulting enhanced IL
      1 response from sensitized MNC may have a role in the pathogenesis of febrile
      convulsions.

PMID- 2239278
TI  - Growth after treatment of solid tumours in childhood.
AB  - We examined 90 survivors of childhood solid tumours diagnosed in our hospital
      between 1960 and 1976. Their ages at the time of this study ranged from 12.2 to
      41.5 years. Adult standing height was usually normal. However, final standing
      height was less than expected in the females, and sitting height was below the
      normal mean in the males. The males who had received both chemotherapy and
      radiation therapy to the spine had a greater decrement in sitting height, but we
      did not find any association between radiation therapy to the spine without
      chemotherapy and subsequent total growth of the spine as measured by sitting
      height. We conclude that these children generally do not experience any major
      growth disturbances.

PMID- 2239279
TI  - Fibrosing alveolitis in childhood. A long-term follow-up.
AB  - A retrospective analysis of 14 pediatric cases with fibrosing alveolitis, proved
      by lung biopsy, was carried out. The children were initially 6-16 years old
      (mean: 9.8 years) and were observed for 2 to 7 years. Symptoms had been present
      prior to diagnosis for 1 to 156 weeks (median: 11 weeks). The most prominent
      clinical findings were dyspnoea (100%), dry cough (91%), tachypnoea (85%), and
      weight loss (70%). Open (n = 9) or transbronchial (n = 5) lung biopsy specimens
      had predominantly cellular appearances in 8 children (group A) and showed
      predominantly fibrotic changes in 6 cases (group B). Lung function tests revealed
      a marked ventilatory impairment in all children. Mean vital capacity was 44% (SD
      16%), and total lung capacity 58% (SD 14%) of the predicted normal values.
      Specific lung compliance was significantly lower in children with fibrotic
      changes (mean: 0.016 vs. 0.030 ml/cmH2O/ml in patients of group A, p less than
      0.05). Results from 200 lung function measurements were evaluated during the
      follow-up. Corticosteroid treatment improved vital capacity in all children after
      6 and 12 months of treatment to 64% and 62% of the predicted normal,
      respectively. Deterioration of pulmonary function was observed in 7 children when
      prednisone was tapered to below 10 mg per day. Only 4 children had a normal vital
      capacity at their last visit to the clinic. We conclude that children with
      fibrosing alveolitis experience severe alterations in lung function, and that the
      overall outlook is quite unfavorable.

PMID- 2239280
TI  - The course of biological parameters and 6-mercaptopurine pharmacokinetics during
      maintenance treatment of children with acute lymphoblastic leukaemia.
AB  - Twenty patients on maintenance therapy (MT) for acute lymphoblastic leukaemia
      (ALL) with oral 6-mercaptopurine (6-MP) and methotrexate (MTX) were studied.
      White cell and red cell indices and platelets counts were monitored every second
      week as were drug levels. Mean values for 6-MP and MTX doses, and blood component
      parameters were calculated for each 6-month period for the whole patient group. 6
      MP plasma concentrations and liver-function tests were determined once every six
      months and mean values calculated. 6-MP and MTX mean doses did not change
      significantly during MT. The mean area under the concentration versus time curve
      (AUC) 0-4 hours varied slightly from the start to the end of the MT (257 and 296
      ng/ml.h, respectively). The mean plasma peak concentration increased from 98
      ng/ml to 195 ng/ml (p less than 0.01) during the same period. There were
      significant decreases between the initial white blood cell counts (WBC) and red
      blood cell counts (RBC) as compared to levels at the end of therapy (p less than
      0.01 and 0.02, respectively). A linear correlation was found between 6-MP peak
      concentrations and both WBC (r = 0.96) and RBC (r = 0.87). At the end of MT liver
      function tests became normal in all except 6 patients. In conclusion, MT have
      moderate effects on bone marrow and liver and monitoring 6-MP plasma
      concentration might be of value for determination of the optimal WBC levels
      during MT.

PMID- 2239281
TI  - Use of medical care and antibiotics among preschool children in different day
      care settings.
AB  - The use of medical care among 880 1-5 year olds in different day care settings
      was studied using register information on physician visits, purchases of
      antibiotics and municipal day care in 1984. The unit of analysis was months in
      the different day care settings and not children. The rates of physician visits
      were 1.4 to 1.8 times higher for acute upper respiratory tract infections and all
      acute infections and 2 to 3 times higher for secretory otitis media during day
      care centre months and family day care months as compared to home care months.
      The rate of visits for bronchial asthma was 5 times higher during day care centre
      months than during home care months. No differences were found between day care
      centre months and family day care months with respect to the rates of physician
      visits for acute upper respiratory tract infections, acute otitis media and all
      acute infections. Among children in family day care, the daily number of hours in
      day care, and size, average age and age homogeneity of the groups were not
      significantly associated with rates of visits for all acute infections or
      purchases of antibiotics.

PMID- 2239283
TI  - Central venous catheter insertion in neonates.

PMID- 2239282
TI  - Acute alcohol intoxications in children treated in hospital.
AB  - Cases of alcohol intoxication in children are common; they are encountered every
      day in Finland. Studies other than case studies of alcohol intoxication in
      children are few. Metabolic acidosis was a frequent finding in juvenile alcohol
      intoxication. Capillary or arterial blood pH was below normal (less than 7.36) in
      61.4% of patients and bicarbonate (less than 22) in 55.3% of patients. pCO2 was
      varied; the higher the blood alcohol concentration the higher the pCO2. Metabolic
      acidosis and blood pH correlated with the blood alcohol concentration and
      consciousness. The lower the blood pH the higher the serum glucose. Hypoglycemia
      is the most common reported symptom in children under 5 years of age. In the
      present study three patients were slightly hypoglycemic. Hypokalemia was the most
      important change (in 12.2%) in serum electrolytes. Alcohol intoxication causes
      metabolic acidosis and respiratory depression in children. Metabolic acidosis
      reduces consciousness.

PMID- 2239284
TI  - Vascular air embolism--possible survival.

PMID- 2239285
TI  - Comment on C3d generation in septicaemic newborns.

PMID- 2239286
TI  - The shape of a child: is it normal or abnormal?

PMID- 2239288
TI  - Sex-related differences of bone mineral content in low birthweight infants fed
      cow's milk formula.

PMID- 2239287
TI  - Protein requirement may correlate to postconceptional age and not birthweight in
      very low birthweight infants.

PMID- 2239289
TI  - Ocular findings of Williams' syndrome.

PMID- 2239290
TI  - Use of a long acting somatostatin analogue in controlling ileostomy diarrhoea in
      infants.

PMID- 2239291
TI  - Reduced plasma carbamazepine level during chemotherapy in a child with malignant
      lymphoma.

PMID- 2239292
TI  - Necrotizing bowel disease with candida peritonitis following severe neonatal
      hypothermia.
AB  - Peritonitis due to Candida albicans is rare in the newborn infant. Three low
      birthweight, extremely ill premature infants who were severely hypothermic at the
      time of admission developed perforation of the gastrointestinal tract. C.
      albicans was cultured from the peritoneal fluid in each case. In view of the
      rareness of C. albicans peritonitis in newborns, this cluster of infants suggests
      a relationship between severe neonatal hypothermia, and bowel perforation with
      peritonitis due to this fungus.

PMID- 2239294
TI  - Child abuse.

PMID- 2239293
TI  - Children with epilepsy as adults: outcome after 30 years of follow-up.
AB  - The study dealt with a representative sample of the epileptic population in
      southwestern Finland, followed up prospectively for 23-39 years. At the end of
      the follow-up period, 55.5% of the original sample, i.e. 63.2% of the subjects
      who participated in the last follow-up evaluation, or 76.4% of those who were
      alive at that time, had not had epileptic attacks for at least the previous three
      years. A total of 60% lived independently; 21% of subjects, on the other hand,
      were not gainfully employed and lived in institutions. The intermediate group was
      the smallest (less than 18%); these were receiving a disability pension but had
      not been institutionalized. A certain polarization thus seemed to take place
      here: the epileptic patient either lead a normal life or was in institutional
      care. The intermediate group showed a steady decline in size in the course of the
      follow-up.

PMID- 2239295
TI  - The morbid anatomy of the human genome: the role of gene mapping in clinical
      medicine.

PMID- 2239296
TI  - Antioxidant enzymes and lipoperoxide in blood in patients with Kawasaki disease.
      Comparison with the changes in acute infections.
AB  - Increased production of active oxygen species from activated neutrophils is
      postulated to contribute to endothelial damage in Kawasaki disease, leading to
      the formation of coronary aneurysms. To determine whether an altered oxidant
      antioxidant balance exists in acute phase of Kawasaki disease, antioxidant
      enzymes in peripheral blood cells and plasma lipid peroxide were measured in
      patients. The two isoenzymes of intracellular superoxide dismutase were assayed
      by specific radioimmunoassays. Lipid peroxide in plasma and manganese superoxide
      dismutase in both polymorphs and lymphocytes were increased in the acute phase of
      Kawasaki disease. The erythrocyte glutathione peroxidase and catalase were also
      increased. On the other hand, copper zinc superoxide dismutase in polymorphs,
      lymphocytes and erythrocytes was unaltered. Acute infections did not appear to
      modify the levels of either antioxidant enzymes or lipid peroxide in blood. These
      results suggest that increased oxidative stress in Kawasaki disease evokes a
      reactive increase in antioxidant enzymes, and that this response in the defense
      system is related to the reversible nature of the tissue damage in most patients
      with Kawasaki disease.

PMID- 2239297
TI  - Serum levels of glycated albumin in non-diabetic and insulin-dependent diabetic
      children.
AB  - The serum levels of glycated albumin (GA) in 83 non-diabetic children and 26
      children with insulin-dependent diabetes mellitus (IDDM) were measured by high
      performance liquid chromatography (HPLC). In non-diabetic children over one year,
      the GA levels were found to be uninfluenced by age, while the fructosamine (FRA)
      levels increased with age. The mean level of GA in IDDM children was 39.1 +/-
      9.1%, which was significantly higher than in non-diabetic children with values of
      16.1 +/- 1.1% (p less than 0.01). The GA levels of non-diabetic and IDDM children
      did not overlap, whereas their FRA levels did overlap. The GA levels correlated
      with HbAlc levels (r = 0.74, p less than 0.01) and FRA levels (r = 0.66, p less
      than 0.01) in IDDM children. The GA levels were more closely correlated than the
      FRA levels with the blood glucose two and three weeks previously. Thus, the GA
      level is a useful indicator of short-term control in diabetes mellitus.

PMID- 2239298
TI  - Urinary dicarboxylic acids in X-linked adrenoleukodystrophy.
AB  - The urinary excretion of dicarboxylic acids in X-linked adrenoleukodystrophy (X
      ALD) was studied. The dicarboxylic acid profile in X-ALD did not show any
      specific pattern, unlike Zellweger syndrome and neonatal adrenoleukodystrophy.
      Medium-chain dicarboxylic acids with an even number of carbon atoms (adipic,
      suberic, sebacic) and an odd number of carbon atoms (pimelic, azelaic) were
      excreted within the normal ranges. Dicarboxylic acids with more than 10 carbon
      atoms were not found. These findings may be due to the normal beta-oxidation
      system of dicarboxylic acids in X-ALD.

PMID- 2239299
TI  - Flowcytometric analysis of DNA pattern of cells derived from xeroderma
      pigmentosum A--hypersensitivity to vincristine, etoposide and methotrexate.
AB  - Xeroderma pigmentosum complementation group A (XPA) is one of the DNA repair
      deficient syndromes. The cell biological features of XPA were examined by
      flowcytometry using Epstein Barr (EB) virus-transformed lymphoblastoid cells.
      Cellular sensitivity to vincristine (VCR), etoposide (VP-16) and methotrexate
      (MTX) were assayed by DNA pattern changes by flowcytometry. Recently, ataxia
      telangiectasia (AT), one of the same kind of disorder, has been reported to have
      an increased sensitivity to VCR and VP-16. However, AT showed some resistance to
      MTX according to other reports. Our results showed that XPA had an increased
      sensitivity to VCR and also to VP-16. Moreover, different from AT, XPA showed
      some sensitivity to MTX. Thus there is some cell biological similarity between
      XPA and AT, as well as some difference of the abnormality in the DNA repair
      pathway.

PMID- 2239300
TI  - Prevalence of Paragonimus westermani in some Ulchin school children.
AB  - In order to estimate the prevalence of Paragonimus westermani among the school
      children in Ulchin county, Kyungpook Province, five primary schools were selected
      for sampling. The children were first examined using an intradermal test with
      Paragonimus antigen, Lot No. 890417, and then examined for Paragonimus eggs from
      sputa and stools collected from the intradermal-positive cases. In a total of 382
      children examined, 53 cases or 13.9 percent revealed positive reactions for
      Paragonimus westermani. The sex specific rate of infection was a little higher in
      boys than in girls. The age specific rate of Paragonimus westermani infections
      varied from age to age. Paragonimus westermani was most prevalent in the 8-year
      old group in both sexes and showed about the same proportion among boys and girls
      of each age group. A comparison of the reliability for the detection of
      Paragonimus eggs from intradermal positive cases in this study showed that the
      sputum test was more sensitive than the stool test. Summarizing the results, this
      study indicates that the prevalence for Paragonimus westermani is still high and
      the endemic foci of the fluke exists in Ulchin county, Kyungpook Province, Korea.

PMID- 2239301
TI  - Relation between blood pressure, left ventricular mass and pulsed Doppler
      parameters in healthy school children.
AB  - We analyzed the relations between blood pressure in sitting and supine positions,
      left ventricular mass (LVM) and Doppler aortic, pulmonary and mitral flow
      velocity measurements in 163 healthy school children. Systolic blood pressure in
      a supine position correlated significantly with aortic acceleration (ATc) and
      ejection time (ETc), corrected by the square of R-R interval, pulmonary AT and
      peak flow velocities. Moreover, the systolic blood pressure in a sitting position
      correlated with pulmonary AT and LVM. LVM correlated with pulmonary ATc, the
      ratio of AT to ET and average acceleration, and aortic ETc and peak flow
      velocity. These data suggest the following: (1) the posture influences the
      relation between blood pressure and flow velocity, (2) pulmonary hemodynamics are
      influenced by systemic blood pressure in healthy children and (3) the development
      of LVM may be dependent not only on blood pressure but also on cardiac work in
      childhood.

PMID- 2239302
TI  - Changes of left ventricular isovolumic relaxation time with growth in children.
AB  - We investigated the changes of left ventricular isovolumic relaxation time
      (LVIRT) with growth and the factors influencing them during childhood, in a 10
      year follow-up study. We measured the body height (BH), body weight (BW), lean
      body weight (LBW), heart rate (HR), blood pressure (BP), left ventricular muscle
      volume index (LVMVI), and LVIRT corrected by the preceding R-R interval (IRT/R
      R), of 187 healthy children at 3-year intervals (6, 9, 12, 15 years old). IRT/R-R
      were prolonged with growth in boys and girls. At the ages of 12 and 15, the IRT/R
      R of girls were longer than those of boys. Significant correlation coefficients
      for IRT/R-R on systolic and diastolic, BW, and LVMVI were 0.28, 0.31, 0.20, 0.28,
      respectively. These data suggest that (1) IRT/R-R is mainly determined by the
      diastolic BP, (2) left ventricular diastolic function of children develops with
      growth of body size, especially BW, and (3) left ventricular early diastolic
      function in adolescents is related to sexual maturation.

PMID- 2239303
TI  - Treatment of pediatric malignant tumors with VP-16. West Japan Pediatric Oncology
      Group.
AB  - The West Japan Pediatric Oncology Group studied the treatment of pediatric
      malignant tumors with VP-16 from December 1984 to March 1988. Study subjects were
      divided into two groups. One group received only VP-16, while the other received
      VP-16 combined with other anti-tumor agents. VP-16 evaluation was possible in a
      total of 116 cases. The efficacy rate was calculated by considering both complete
      and partial remission as effective. The efficacy rate for VP-16 alone was 87.5%
      for primary cases of ANLL and 100% for primary cases of histiocytosis. The
      efficacy rates for combination therapy were as follows: 92.6% for primary cases
      of ANLL, 66.7% for primary cases of histiocytosis, 45.5% for relapsed cases of
      ANLL and 66.7% for relapsed cases of ALL. Bone marrow suppression was seen in the
      form of leukopenia and thrombocytopenia for 2 to 3 weeks after VP-16
      administration. Alopecia, mucositis and gastrointestinal symptoms were also
      observed, but they presented no significant problem. From our results, we believe
      that chemotherapy including VP-16 is effective for remission induction therapy in
      primary cases of ANLL and for salvage therapy in relapsed leukemia. Additionally,
      VP-16 is considered to be effective for the treatment of histiocytosis.

PMID- 2239304
TI  - Ectopic nesidioblastosis.
AB  - We observed one case of ectopic nesidioblastosis. A solitary nesidioblastoma was
      observed in the anterior wall of the duodenum. Ectopic nesidioblastosis has not
      been previously reported, but our experience suggests the necessity of
      examination for ectopic pancreas in cases of SIDS or its near-miss.

PMID- 2239305
TI  - Pernicious anemia in a patient with hypogammaglobulinemia.
AB  - A 19-year-old male with pernicious anemia and hypogammaglobulinemia (common
      variable immunodeficiency: CVID) is reported in comparison with classical
      pernicious anemia. This case was characterized by an earlier onset of anemia, the
      absence of autoantibodies to intrinsic factor or gastric parietal cells and
      involvement of the pyloric antrum as well as the gastric corpus. It is suggested
      that dysregulation of cellular immunity produces the autoimmune lesion in the
      gastric mucosa, including the pyloric antrum, in a patient with CVID, and that
      some of such cases develop pernicious anemia.

PMID- 2239306
TI  - Intrauterine Chlamydia trachomatis infection in a premature infant.
AB  - Intrauterine Chlamydia trachomatis infection was strongly suspected in a
      premature infant born in the 32nd week of gestation. The membranes were
      artificially ruptured at the time of delivery. This infant showed a high titer of
      specific IgM antibody to Chlamydia trachomatis at one hour after birth. He showed
      mild respiratory distress and was treated with oral erythromycin for three weeks.
      He was discharged home at the age of 46 days.

PMID- 2239307
TI  - Detection of C. trachomatis by in situ DNA hybridization: report of two cases
      with neonatal pneumonia.

PMID- 2239308
TI  - Therapeutic benefit of growth hormone in achrondroplastic dwarfism.

PMID- 2239309
TI  - Echocardiography may be misleading in assessing coronary sequelae of MCLS: a CT
      scan helps.

PMID- 2239310
TI  - Uptake of immunization of children with asthma.

PMID- 2239311
TI  - Acute phenobarbital intoxication in an infant.

PMID- 2239312
TI  - Influence of timing of administration of liposome-encapsulated superoxide
      dismutase on its prevention of acetaminophen-induced liver cell necrosis in rats.
AB  - The possible participation of acute oxidative stress in the in vivo mechanism by
      which acetaminophen (APAP) induces hepatocellular injury was examined. Male
      Sprague-Dawley rats were administered 3-methylcholanthrene, fasted for 18 h, then
      given APAP and sacrificed after a further 6 h of fasting. Extensive centrilobular
      liver cell necrosis along with markedly elevated serum activity of
      aminotransferases was observed. Liposome-encapsulated human recombinant Cu-Zn
      superoxide dismutase (LSOD) administered 1 or 0.5 h prior to APAP or
      simultaneously with the toxin completely prevented APAP-induced hepatocellular
      injury. In contrast, LSOD administered 5 or 2.5 h before or 1, 2.5 or 5 h after
      the toxin treatment did not prevent APAP toxicity. Incomplete protection against
      APAP-induced injury was obtained when LSOD was administered 0.5 h after the
      toxin. These results support the proposal of an oxidative mechanism for APAP
      hepatotoxicity.

PMID- 2239313
TI  - Expression of vimentin and epithelial membrane antigen in human malignant
      lymphomas.
AB  - Immunoreactivity with monoclonal antibodies against the intermediate filament
      protein, vimentin, and epithelial membrane antigen (EMA) was examined in 330
      cases of lymphoma (317 non-Hodgkin's and 13 Hodgkin's lymphomas), 12 reactive
      lymph nodes and mononuclear cells of the peripheral blood using either indirect
      immunoperoxidase staining or the avidin-biotin immunoperoxidase complex
      technique. The cell origin of each tumor was established using a panel of
      monoclonal antibodies against lymphocyte differentiation antigens. There were 41
      T-cell, 247 B-cell and 29 undetermined lymphomas, and 13 cases of Hodgkin's
      disease in the series. Vimentin was expressed in 24 T-cell lymphomas (58.5%) and
      60 B-cell lymphomas (24.2%). This difference in frequency was statistically
      significant. Vimentin expression in follicular lymphomas was less frequent than
      in diffuse B-cell lymphomas. In diffuse lymphomas, small and medium cell types
      were more reactive with anti-vimentin than large cell types. Reed-Sternberg cells
      (R-S cells) in Hodgkin's disease were positive for vimentin in 11 cases (84.6%).
      The frequency of EMA reactivity in lymphomas was low, particularly in T-cell
      lymphomas. No positive cases were found among follicular lymphomas. In diffuse
      non-Hodgkin's lymphomas, EMA was expressed only in mixed and large cell types,
      but never in smaller ones. In conclusion, monoclonal antibodies against vimentin
      and EMA appear to be of limited usefulness for the diagnosis of non-Hodgkin's
      lymphomas, but anti-vimentin antibody may be used as an adjunct to the diagnosis
      of R-S cells in Hodgkin's disease.

PMID- 2239315
TI  - Juvenile granulosa cell tumor in a three-year-old infant. An immunohistochemical
      and ultrastructural study.
AB  - A three-year-old female infant with a juvenile granulosa cell tumor of the ovary
      and precocious pseudopuberty is presented. Laboratory tests revealed elevated
      levels of serum and urinary estrogen. Histological examinations showed an
      immature follicular pattern surrounded by theca-like stromal tissue. The
      immunohistochemical localization of estradiol, estriol, progesterone and
      testosterone was studied by indirect immunoperoxidase staining of cryostat
      sections. All of these steroid hormones were localized mainly in stromal cells
      and in some follicular cells. Electron microscopic examination revealed three
      types of tumor cell, i.e. polygonal cells, spindle cells and transitional cells.
      Well developed smooth endoplasmic reticulum, mitochondria with tubulovesicular
      cristae, and lipid droplets in the cytoplasm, which are typical features of
      steroid synthesis, were conspicuous mainly in the last type of cell. Such
      transitional cells almost corresponded to steroid-positive cells. These cells
      were considered to have a close relationship to theca gland cells of developed
      ovarian follicles and to have mainly participated in steroid synthesis in the
      present tumor. In addition, some spindle cells showed features of myofibroblasts,
      such as intracytoplasmic filaments, dense body-like structures, and pinocytotic
      vesicles. These features suggest that the cells might all be derived from the
      same progenitor of ovarian mesenchyme.

PMID- 2239314
TI  - Lung carcinoma metastatic to microfollicular adenoma of the thyroid. A case
      report.
AB  - A 75-year-old woman with lung adenocarcinoma in whom autopsy revealed metastasis
      to microfollicular adenoma of the thyroid is described. A thyroid tumor specimen
      from this patient was initially interpreted as representing primary encapsulated
      follicular carcinoma of the thyroid associated with a component of poorly
      differentiated carcinoma of follicular cell origin. The widespread involvement of
      the lungs and other sites was also interpreted as metastases from the poorly
      differentiated carcinoma component within the encapsulated follicular carcinoma
      of the thyroid. Subsequent meticulous histologic examination revealed that the
      thyroid tumor was a microfollicular adenoma, and that the component of poorly
      differentiated carcinoma within it was the same as the lung carcinoma.
      Immunohistochemical investigation revealed that the poorly differentiated
      carcinoma cells within the thyroid tumor were stained positively with polyclonal
      and monoclonal antibodies against carcinoembryonic antigen (CEA) and negative for
      thyroglobulin and calcitonin. The carcinoma cells from the lungs and other sites
      also showed positive staining for CEA. These findings support the view that the
      component of poorly differentiated carcinoma was a metastatic lesion from the
      primary lung carcinoma to the microfollicular adenoma of the thyroid. The present
      study emphasizes that attention should be directed to thyroid metastasis, even if
      it is within a thyroid primary neoplasm.

PMID- 2239316
TI  - [Synthesis of catechol aminoketone and its analogues].
AB  - In this paper, the synthesis of a series of aminoketone derivatives are reported.
      Compounds I1-9 and II1-10 were synthesized from substituted chloroacetophenone
      with various amines. Compounds I10-12 and II11-12 were synthesized from
      substituted acetophenones with corresponding amines through Mannich reaction. The
      1HNMR and MS were discussed. Pharmacological study showed that the vascular
      contraction of dog mesenteric and basilar arteries induced by serotonine and
      calcium in vitro could not be antagonized by this kind of compounds and the known
      compound 3,4-dihydroxy acetophenone (I0). Except I10, the vasodilator effects of
      all compounds as shown by measurement of arterial blood flow after injection into
      femoral artery in dogs are weaker than I0. After intravenous injection in
      anesthetized dogs, I10 showed the same effect as I0 to increase coronary blood
      flow and myocardial contraction. Furthermore, the ventricular arrhythmia induced
      by aconitine and chloroform could also be protected by compound I10, but compound
      I0 was not effective.

PMID- 2239317
TI  - [Mass spectrometric studies on dibenzocyclooctadiene lignan compounds from
      Schisandraceae plants].
AB  - Mass spectrometric studies on fragmentation patterns of 23 dibenzocyclooctadiene
      lignan compounds isolated from Schisandraceae plants, such as schisandra A (1),
      were carried out by using low and high-resolution mass spectrometric techniques
      and metastable ion analyses. The main mass spectral characteristics were
      summarized to provide a sound basis for further researches on Schisandraceae
      plants and for structural elucidation of similar new compounds.

PMID- 2239318
TI  - [Structure of swertiamacroside from Swertia macrosperma C.B. Clark].
AB  - From the air-dried whole plant of SwerBia macrosperma C. B. Clark four compounds
      I-IV were isolated. One of them is a new caffeic acid disaccharide ester. Its
      structure was elucidated as 1-O-trans-caffeoyl-6-O-alpha-L-rhamnopyranosyl-beta-D
      glucopyranos ide, i. e. trans caffeic acid-1-O-rutinose ester on the basis of
      chemical and spectroscopic analysis, and named swertiamacroside (I). The other
      three known compounds were identified as mangiferin (II), bellidifodin (III) and
      bellidifodin-8-O-beta-D-glucopyranoside (IV).

PMID- 2239319
TI  - [Structure of pingbeimine C].
AB  - A new C-nor-D-homosteroid alkaloid, C27H43O6N, mp 171.5-173 degrees C, named
      pingbeimine C, was isolated from the bulb of Fritillaria ussuriensis Maxim. On
      the basis of IR, MS, 1HNMR and 13CNMR spectroscopic data, particularly X-ray
      crystallographic analysis, structure IV has been assigned to this alkaloid.

PMID- 2239320
TI  - [Reverse-phase HPLC determination of coumarins in the traditional Chinese drug
      bai-zhi (Angelica dahurica forma bai-zhi)].
AB  - A reversed phase HPLC procedure has been developed for the separation and
      determination of oxypeucedanin (I), imperatorin (II) and isoimperatorin (III) in
      Bai-zhi simultaneously. I, II and III were extracted from Bai-zhi by using ether.
      The solution was evaporated to dryness and the residue was redissolved in 25 ml
      of ethyl acetate and 10 microliters of the solution were analysed on Waters mu
      Bondapak C13 column (300 x 3.9 mm ID) using methanol-water (70:30) as the mobile
      phase and detecting at 254 nm. The results were calculated by external standard
      method on the basis of peak area. The average recoveries of the standards added
      to the sample were 101.36, 100.54 and 97.91% for I, II and III respectively, and
      coefficients of variation were less than or equal to 3.33%. Analytical results by
      HPLC method are in agreement with those by TLC method. This method is rapid,
      reproducible and accurate and has been applied to analyse the contents of three
      components in 42 samples of angelica. The results of fourteen samples were given.

PMID- 2239321
TI  - [Application of ridge regression spectrophotometry to the determination of
      multicomponents in aspirin compound tablet].
AB  - In this paper, a ridge regression method of spectrophotometry in multiwavelength
      is proposed. The basic principle and computing of this method applied to
      multicomponent analysis were discussed. This method was applied to simultaneous
      determination of multicomponents in aspirin compound tablet and satisfactory
      results were obtained. The experiment clearly indicates that ridge regression may
      provide a new approach to experimental measurement of multicomponent analysis
      computations.

PMID- 2239322
TI  - [Study on prolonged action cefotoxime].
AB  - A prolonged action cephalosporin was prepared by the reaction of cefotaxime
      sodium (CTX) with N,N-dibenzylethylene diamine acetate. It is reasonable to
      consider the resultant as benzathine cefotaxime (BCTX) by means of elemental
      analysis, DSC, UV spectra, IR spectra, NMR spectra and mass spectra. In contrast
      to CTX, BCTX appeared to be almost insoluble in water and its intrinsic
      dissolution rate was 0.183 micrograms/ml.min. The stability revealed that the
      degradation of BCTX suspension in water followed zero-order kinetics and the rate
      of degradation at room temperature was found to be 1.67 X 10(-7) mg/ml.s. An in
      vivo test by using 12 rabbits given BCTX suspension and CTX solution
      intramuscularly was conducted. The results showed that the former was longer in
      maintaining serum drug level than the latter.

PMID- 2239323
TI  - [The pharmacokinetics of dihydroqinghasu given orally to rabbits and dogs].
AB  - Qinghaosu (QHS), also known as artemisinine and arteannuin, is isolated from the
      Chinese herb Artemisia annua L. It is highly active against both chloroquine
      sensitive and chloroquine-resistant strains of P. berghei and has been approved
      by the Ministry of Health for the treatment of malaria. When QHS is treated with
      sodium borohydride, dihydroqinghaosu (DH QHS) is resulted with the antimalarial
      activity enhanced several fold. This paper reports the pharmacokinetics of DHQHS
      studied with the radioimmunoassay method. When the drug was given orally in
      tablet form to rabbits at doses of 10, 20 and 30 mg/kg, peak serum levels of
      0.03, 0.05 and 0.13 micrograms/ml, respectively, were obtained in 1 to 2 h. The
      corresponding T1/2 of the drug were found to be 1.19, 1.00 and 1.10 h and the
      MRTs were 1.73, 1.36 and 1.53 h. No significant difference between dosages used
      was observed. When dogs were given DHQHS tablets at the dose of 20 mg/kg, a peak
      serum concentration of 0.13 micrograms/ml wes reached in about 2 h with a T1/2 of
      2.10 h and an MRT of 3.04 h. However, when dogs were given QHS tablets at the
      dose of 70 mg/kg, no drug was detected in the serum. It would appear that the
      bioavailability of DHQHS tablets is much higher than that of QHS when given
      orally to the dog.

PMID- 2239325
TI  - [Study on the determination of zinc in plasma after oral administration of
      licorzin by atomic absorption spectrophotometry and the pharmacokinetics of zinc
      in healthy volunteers].
AB  - A rapid, accurate and sensitive atomic absorption spectrophotometry was
      established for the determination of zinc in plasma after oral administration of
      licorzin to healthy volunteers. The plasma sample diluted with de-ionized water
      (1:1) was determined directly. A 5% glycerol solution was used as the solvent of
      zinc standard solution. The recovery of the proposed method was 97.3 +/- 4.3%.
      The precisions (CV%) of within-day and day-to-day were less than 5%. The
      pharmacokinetics of zinc in healthy volunteers after oral administration of 2.5 g
      licorzin was studied. The results showed that an one-compartment model (Ka = K)
      was found in 10 healthy volunteers. The pharmacokinetic parameters were as
      follows: Ka = K = 0.380h-1, Tmax = 2.7h, V = 33.03 L, T1/2 = 1.9h.

PMID- 2239324
TI  - [A new diterpenoid quinone sapriparaquinone].
AB  - A new diterpenoid quinone, named sapriparaquinone (1) was isolated from the root
      of Salvia prionitis Hance. 1 was identified as 3-hydroxy-6-methyl-2-(1-methyl)-5
      (4-methylpenten-3-yl)-1, 4-naphthoquinone by spectral analysis and chemical
      transformation of saprorthquinone (2). 1 and 2 are 4,5-seco-5, 10-frideoabietane
      derivatives and must be biogenetically derived from an abietane structure. Like
      2, 1 also showed cytotoxicity against P388 leukemia cells.

PMID- 2239326
TI  - [Use of fluorescence polarization immunoassay and microbiological assay in the
      study of gentamicin pharmacokinetics in man and a comparison of the results].
AB  - Ninety serum samples of gentamicin were determined by fluorescence polarization
      immunoassay (FPIA) and microbiological assay (MA) and the results were compared.
      Liner regression analysis showed that the two methods were highly correlated with
      a correlation coefficient of 0.98. The mean concentration of gentamicin as
      determined by MA method was significantly higher than that by FPIA method. Serum
      concentration-time data derived from 5 patients were fitted to a one-compartment
      model. No significant differences in the pharmacokinetic parameters and estimated
      dosages were observed. The FPIA method was shown to be as correct and reliable as
      the MA method in estimating gentamicin pharmacokinetic parameters.

PMID- 2239327
TI  - [Studies on anti-implantation and hormone activity of yuehchukene, an alkaloid
      isolated from the root of Murraya paniculata].
AB  - Oral or subcutaneous administration of yuehchukene to female mice at the dosage
      of 2 or 4 mg/kg.d on day 1-3 of gestation resulted in 100% anti-implantation
      effect. However, yuehchukene at 4 mg/kg.d was found to have no anti-implantation
      effect in hamsters. Allen-Doisy test showed that yuehchukene had obvious
      estrogenic activity. Treatment of immature mice with yuehchukene at the dosage of
      2 or 4 mg/kg.d for 3 days caused an increase of uterine weight. Combined use of
      yuehchukene with estradiol was shown to have synergistic effect on promoting
      uterine growth. Experiments showed that the estrogenic activity of yuehchukene
      was weaker than that of estriol. The affinity of this compound for estrogen
      receptor was also found to be weaker than that of estriol.

PMID- 2239328
TI  - [Effect of scopolia drugs on the gastric mucosal lesion in rats].
AB  - In the present paper, effects of scopolia drugs (scopolamine, anisodine,
      anisodamine) on experimental gastric mucosal lesion models in rats were
      investigated. Scopolia drugs were found to be effective anti-ulcer agents in
      three experimental gastric ulcer models (i.e. cold-restraint stress induced
      ulcer, indomethacin induced ulcer and acetic acid induced chronic ulcer) in rats
      in a dose dependent manner. Biochemical analysis of gastric juice and blood
      showed that scopolia drugs could inhibit gastric acid secretion and pepsin
      activity, increase gastric barrier mucus and concentration of serum gastrin,
      suggesting that these actions may contribute to its anti-ulcer effect.

PMID- 2239329
TI  - [Studies on biotransformation of jing song ling, a new anesthetic].
AB  - Jing song ling (2,4-xylidinothiazoline, XT) is a new anesthetic agent for
      veterinary uses in China. From urine of rats given the drug three metabolites
      (MA1, MA2 and MB3) were isolated with structure shown in page 98 in addition to
      the parent compound (MB1). Preliminary observations showed that the toxicity and
      pharmacological activity of MB3, MA2 and MA1 decreased significantly compared
      with the parent drug XT. Species difference of biotransformation of XT between
      rat and mouse was also observed.

PMID- 2239331
TI  - [Synthesis of 2-methyl-5-substituted phenoxy-primaquine and antimalarials
      activity].
AB  - In searching for efficient, safe and radically curative agent and causal
      prophylactics for malaria, seven 2-methyl-5-substituted phenoxy-6-methoxy-8-(1
      methyl-4-aminobutylamino)-quinolines (II1-7) were synthesized and their
      antimalarial activities were compared with the corresponding 4-methyl substituted
      derivatives of primaquine. The starting material, 2-nitro-4-methoxy-5-bromo
      acetanilide (III), was prepared from p-methoxy aniline through acetylation,
      bromination and nitration. III was then condensed with substituted phenols in the
      presence of potassium carbonate. The condensed products were subsequently
      hydrolyzed with dilute alcoholic hydrochloric acid to yield 2-nitro-4-methoxy-5
      substituted phenoxy-aniline (V) which underwent Skraup's reaction with 2-butenal
      to provide the key intermediates 2-methyl-5-substituted phenoxy-6-methoxy-8
      nitroquinolines (VI). These 8-nitroquinoline derivatives were reduced to 8
      aminoquinoline derivatives (VII). The latter were condensed with 4-bromo-1
      phthalimido-pentane and then hydrolyzed with hydrazine hydrate, the final
      products were obtained as oxalate or succinate. The structure of the target
      compounds and unknown intermediates were confirmed by elementary and spectral
      analysis. Primary biological evaluation showed that all compounds II1-7 were much
      less active than the 4-methyl substituted derivatives and slightly less active
      than primaquine in both causal prophylactic test against Plasmodium yoelii and
      suppressive antimalarial test against P. berhei.

PMID- 2239330
TI  - [Effects of the polysaccharides isolated from mycelium and fermentation fluid of
      Schizophyllum commune on immune function in mice].
AB  - SPG1 and SPG2 are polysaccharides extracted respectively from fermented cultural
      mycelium and fermentation fluid of Schizophyllum commune. This paper reports the
      effect of SPG1 and SPG2 on concanavalin A (Con A) induced proliferation of
      lymphocyte from C57BL/6J mice in vitro. SPG1 (10, 25, 50 and 100 micrograms/ml)
      and SPG2 (10, 50 and 100 micrograms/ml) was found to significantly increase
      lymphocyte proliferation. In addition, SPG1 (10, 25, 50 and 75 micrograms/ml)
      antagonized the suppressive effect of hydrocortisone on proliferation of mouse
      spleen cells, while SPG2 did not. In vivo, at the dose of 2.5 and 5.0 mg/kg ip
      for 9 days, SPG1 and SPG2 remarkably enhanced the delayed-type hypersensitivity
      to 2, 4-dinitrochlorobenzene (DNCB) in mice. SPG1 (1.25, 2.5 and 5.0 mg/kg, ip
      for 1 day) and SPG2 (2.5 and 5.0 mg/kg, ip for 1 day) promoted the plaque forming
      cell (PFC) response to sheep red blood cells (SRBC) in mice. The effects of SPG1
      and SPG2 on immune function were studied in aged immunodeficient mice. SPG1 (10
      and 25 micrograms/ml) and SPG2 (25 micrograms/ml) was found to enhance the Con A
      induced lymphocyte proliferation in 14 months aged mice. At the dose of 2.5
      mg/kg, SPG1 and SPG2 produced respectively 162.1 and 136.0% increase in PFC
      response in 14 months aged mice.

PMID- 2239332
TI  - [Structure correction and synthesis of subspinosin].
AB  - "Subspinosin" isolated from the root of Damnacanthus subspinosus Hand-Mazz
      (Rubiaceae) and deduced as 3-ethoxymethyl-2-hydroxy-1-methoxyan-thraquinone 1 by
      Li et al in 1981, should be corrected as 2-ethoxymethyl-3-hydroxy-1
      methoxyanthraquinone 5 by comparison with the synthetic compound. Since 5 is
      already known as damnacanthol-omega-ethyl ether, the name "Subspinosin" for 1
      (not yet a natural isolate) should be abandoned in order to acknowledge this
      priority, and, what is more, to avoid confusion. The anthraquinones 1 and 5 were
      synthesized by condensation of phthalic anhydride with 3-methylcatechol or 2
      methylresorcinol in fused AlCl3/NaCl (5:1), followed sequentially by selective
      acetylation, methylation, bromination and condensation with sodium ethoxide.

PMID- 2239333
TI  - [Studies on the alkaloids of Gynura segetum (Lour.) Merr].
AB  - Six alkaloids were isolated from Gynura segetum (Lour.) Merr. Four of them were
      identified. Alkaloids I and II were identified as known senecionine and
      seneciphylline, respectively. Alkaloids III and IV were found to be new compounds
      named seneciphyllinine and (E)-seneciphylline respectively. Their structures were
      confirmed on the basis of spectral data (UV, IR, MS, 1HNMR, 13CNMR, C-H COSY).

PMID- 2239334
TI  - [A rapid FIA-spectrophotometric method with online extraction for the content
      uniformity test of atropine sulfate tablets].
AB  - A rapid spectrophotometric method based on FIA for the content uniformity test of
      atropine sulfate tablets has been developed. By means of the self-designed FIA
      system with an on-line extraction device, many difficulties resulting from
      extraction, such as slow analytical rate, environmental pollution, poor
      reproducibility, etc, were overcome, and the routine procedure of the official
      content uniformity test was tremendously simplified. Results obtained with the
      proposed method agree well with those obtained with the official test.
      Furthermore, the proposed method attained a sampling rate of 60 samples per hour,
      a recovery of 100.0%, a relative standard deviation of 0.7%, and a detection
      limit of 0.24 micrograms/ml. Uniform design proves effective to optimize complex
      FIA conditions, and FIA promises a new approach to test the content uniformity of
      pharmaceutical tablets.

PMID- 2239335
TI  - [Application of convolution curve method for simultaneous determination of four
      components in somidon].
AB  - The computer-aided convolution curve method has been applied to the determination
      of phenacetin, aminopyrine, caffeine and phenobarbitone in the tablet of somidon
      without prior separation. The convolution curve method is a compound difference
      method developed on the basis of Glenn's orthogonal function using computer
      information treatment technique. The corresponding average recovery and the
      coefficients of variation were as follows: 99.96, 0.36% for phenacetin; 99.76,
      0.43% for aminopyrine; 99.98, 0.48% for caffeine and 99.26, 0.89% for
      phenobarbitone.

PMID- 2239336
TI  - [Screening for in vitro metabolites of meisoindigo using RP-HPLC-DAD with
      gradient elution].
AB  - A method of screening for in vitro metabolites of meisoindigo using RP-HPLC-DAD
      (photodiode array detector) with gradient elution was reported. Meisoindigo, a
      new structural antitumor agent, was metabolized by rat liver microsomes in vitro.
      The extract of the metabolic sample was dissolved in MeOH-acetone (9:1). An
      aliquot of the solution was injected onto a 5 microns YWG-C18 (ODS) column (15 cm
      X 4.0 mm I D) and separated with H2O (0.05% H3PO4)-MeOH in linear gradient
      elution. The flow rate was 0.5 ml/min and the oven temperature was 40 degrees C.
      Two simultaneous monitoring wavelengths (270 and 380 nm) were used in order to
      avoid detective losses of unknown metabolites. The spectral recording range of
      chromatographic peaks was set from 220 to 440 nm. After comparison of the
      chromatograms and the spectra of chromatographic peaks, ten metabolites were
      screened out which gave similar spectrum. Of them, the main chromatographic peaks
      (No. 7, 8) were confirmed as two monohydroxy metabolites by EI-MS. Their relative
      contents were calculated by area normalization method. The experimental results
      show that this method is characteristic of highly effective separation and
      specific detection. The whole analytical course can be completed in less than two
      hours. The effects of different elution models, detective parameters and
      components of mobile phase on the analytical results were discussed.

PMID- 2239337
TI  - [Bioavailability studies on the preparations of biphenyl dimethyl
      dicarboxylate(DDB)].
AB  - Since the bioavailability of the suspension and the tablet of DDB given orally is
      only 20-30%, we have prepared four kinds of DDB solid dispersion preparations
      (DDB pilule I with polyethylene glycol 6000 as the vehicle, DDB pilule II with
      polyethylene glycol 6000 and absorption accelerator as the vehicle, capsule of
      DDB-urea fusing mixture and DDB-polyvinyl pyrrolidone coprecipitate), and the
      bioavailability of these preparations were studied in rabbits, rats and human
      volunteers by HPLC method. All four preparations showed better absorption than
      the DDB tablet, and the area under serum DDB concentration-time curve of pilule
      II was 19 fold that of the tablet in rabbits, meaning that the absorption of
      pilule II is the best of the four preparations. After administration of the four
      solid dispersion preparations, the fecal excretion of DDB were all lower than the
      tablet in both animals and human volunteers. The protective action of pilule II
      against CCl4 hepatotoxicity was about six times stronger than that of the
      suspensions. Therefore, there are good reasons to use DDB pilule II instead of
      the tablets of suspension in the clinic.

PMID- 2239338
TI  - [Effect of artesunate transdermal preparation on Plasmodium cynomolgi].
AB  - Artensunate transdermal preparation at 5, 10, or 15 mg/kg, bid, for 3 days
      applied locally on the shaved skin of the back of monkeys showed reliable
      therapeutic effects on Plasmodium cynomolgi, but recrudescence of the parasites
      was not controlled. If some azone was added in the artesunate transdermal
      preparation at the dosage of 5 mg/kg, bid, for 3 days, the parasitemia of
      Plasmodium cynomolgi could be cleared and recrudescence prevented, thus, the
      antimalarial effects was enhanced.

PMID- 2239339
TI  - [Deformation phenomena occurring during compression. III. Changes of maximal
      compression strength in quasi-static condition].
AB  - Four materials of different properties in respect of compressibility, lactose,
      sodium chloride, microcrystalline cellulose (Avicel PH 101) and so-called simple
      granulate were investigated. In function of time and that of actual pressing
      force decrease of axial force on upper punch were measured in quasi-state.
      Evaluating relations it was established that both pressing time and pressing
      force had influence on deformation structural changes occurring inside compressed
      form. Furthermore, summing up of results showed that useful conclusions could be
      drawn from diagrams--which represented decrease of force--to compressibility
      properties of materials too.

PMID- 2239340
TI  - [Electroanalysis of nifedipine].
AB  - Nifedipine is an electrochemically active compound. Reducibility of 2-nitrophenyl
      group on dropping mercury electrode renders polarographic determination of
      nifedipine possible. Reductive half-wave potential of nitro group depends on
      saturation of neighbouring pyridine ring i.e. 1,4-dihydropyridine is reduced on
      more negative potential than aromatic pyridine derivatives. The different half
      wave potentials can be explained with the different stereo structures. On this
      basis differential pulse polarographic (DPP) method was developed for
      determination of nifedipine and its photolytic decomposition products (its
      aromatic nitro and aromatic nitroso derivatives). The DPP method has been
      suitable for determination of pharmaceutical preparations (tablets and capsules)
      as well as for pharmacokinetic determination of plasma levels. The fact that 1,4
      dihydropyridine functional group is oxidizable has made possible selective
      voltammetric determination of nifedipine (on graphic and platinum electrodes) and
      its EC detection in liquid chromatography. Mechanism of oxidation was studied
      with comparison to analogous chloro derivatives.

PMID- 2239341
TI  - [Biopharmaceutical study of aminophenazone-containing suppositories. 1.
      Experimental materials and methods, determination of physical qualities of the
      suppositories].
AB  - Suppositories containing aminophenazone in quantities of 0.30 g/2 g were prepared
      by pouring technology. Two kinds of lipophilic suppository masses Witepsol W 35
      and Estarinum 299 have been used as vehicles. Both of suppository bases are
      official in Ph. Hg. VII. As ingredients ten sorts of liquid tensides in
      concentrations of 5% have been applied. Experimental methods have been described:
      compression stability, disintegration time, special penetration time and drug
      release of suppositories by membrane diffusion method. Results of determinations
      have been discussed in the second part of the publication. On the basis of
      experimental results it has been established that the physical parameters of
      Massa Estarinum 299 had proved to be more advantageous. In 5% concentrations
      tensides softened consistency of suppositories favorably and shortened
      disintegration time beneficially in the case of both vehicles. The authors think
      that special penetration time is more suitable for measuring "disintegration" of
      suppositories of high powder content at 37 degrees C than the classical
      disintegration time.

PMID- 2239342
TI  - [Biopharmaceutical study of aminophenazone-containing suppositories. 2. Results
      of in vitro drug release and in vivo drug absorption].
AB  - Ten kinds of surface active ingredients of Th. Goldschmidt AG. (Essen-FRG) in
      concentrations of 5% were mixed with Witepsol W 35 and Massa Estarinum 299
      suppository masses of Huls-Troisdorf AG. Werk (Witten-FRG) which are official in
      Hungary. According to the authors the above tensides, which have been used
      advantageously first of all in ointments, creams and cosmetic preparations, can
      also be applied in rectal preparations. In the publication of two parts it has
      been established that these ingredients influence physical parameters of
      suppositories beneficially. They always increase significantly in vitro diffusion
      values and in some cases with order of magnitude. Massa Estarinum 299 containing
      5% of Emulgator BTO proved to be the best in case of chosen suppositories
      containing aminophenazone. Correlation between in vitro and in vivo
      investigations has shown the importance of correct selection of base and
      ingredient materials in biopharmaceutical work.

PMID- 2239343
TI  - [Determination of paracetamol in urine by liquid chromatography].
AB  - Since the biotransformation of paracetamol (Acetaminophen) is practically
      confined to conjugation, the quantitative determination of paracetamol excretion
      may provide important information on phase II of the drug metabolism. We
      elaborated a simple and rapid liquid chromatographic method for the assessment of
      paracetamol and its conjugated metabolites in the urine to be available for
      routine use in the clinicopharmacological laboratory. The persons involved in the
      trial were administrated 500 mg of paracetamol to be taken on an empty stomach in
      the morning. Subsequently, their urine was collected for 8 hours. The so-called
      free paracetamol of unchanged form excreted into the urine was measured from this
      0 to 8 hours' urine fraction, then, after treating it with beta
      glucuronidase/arysulphatase enzyme, the total amount of paracetamol released from
      the conjugate, as well as that of the existing free paracetamol, the so-called
      total paracetamol were determined. The urine extracts containing paracetamol
      obtained by ethylacetate, at pH 10, and dried under nitrogen stream were analysed
      by HPLC on an ODS column in an eluent of methanol and water mixture (3:7, v/v) in
      the presence of 3-acetaminophenol internal standard. The flow rate was 1 ml/min,
      the detection wavelength was 254 nm.

PMID- 2239344
TI  - [Bromatometric determination of oxprenolol].
AB  - A bromatometric method was elaborated for the quantitative determination of
      oxprenolol. 15 to 150 mg of oxprenolol dissolved in 10 cm3 of water is brominated
      by adding 20.00-40.00 cm3 of 0.02 or 0.1 N potassium bromate solution followed by
      0.5-3 g of potassium bromide and 1-10 cm3 of 10% w/w hydrochloric acid. After a
      reaction time of 15 min. 2-10 cm3 of 10% w/w potassium iodide solution is added
      followed by 20-40 cm3 of chloroform. The liberated iodine is titrated with
      standard 0.1 N or 0.01 N sodium thiosulphate solution. A blank titration is also
      performed and the oxprenolol content is calculated from the difference of the two
      titrations. Under these conditions one oxprenolol molecule reacts with six
      bromine atoms. The relative standard deviation is 1.31%.

PMID- 2239345
TI  - Exercise-induced muscle fatigue: the significance of potassium.

PMID- 2239346
TI  - Renal hypertension following aortic constriction is abolished by angiotensin II
      converting enzyme inhibitor, but not by low-salt diet.
AB  - This study evaluates the role of different sodium intakes and the role of
      angiotensin II in the development and the maintenance of renovascular
      hypertension in rats with constriction of the aorta proximal to the renal
      arteries. The rats were studied 3 weeks after surgery when the hypertension was
      well established. Glomerular filtration rate was decreased and filtration
      fraction was increased in rats with proximal aortic constriction. Low and high
      salt intakes had no effect on glomerular filtration and filtration fraction.
      Treatment with angiotensin II converting enzyme inhibitor increased the
      glomerular filtration rate and reduced the filtration fraction in rats with
      proximal aortic constriction to the same levels as in control rats. Serum levels
      of angiotensin II were about the same in rats with proximal aortic constriction
      as in control rats. Conclusion. The renovascular hypertension in proximal aortic
      constriction is influenced by locally formed angiotension II but not by
      alterations in salt intake.

PMID- 2239347
TI  - Plasma catecholamines, corticosterone, glucose and fatty acids concentrations and
      mean arterial pressure and body temperature in haemorrhagic hypovolaemia,
      hypothermia and a combination of these in the rabbit.
AB  - Venous plasma noradrenaline, adrenaline, dopamine, corticosterone, glucose and
      free fatty acid concentrations were measured in anaesthetized rabbits during
      hypovolaemia, hypothermia and a combination of these. The anaesthetic used was
      Hypnorm, which contains fentanyl and fluanisone. In the hypovolaemia group blood
      was shed via the venous cannula until the mean arterial pressure was 50 mmHg. The
      rabbits in the hypothermia group were cooled in iced water to a central
      temperature of 32 degrees C, and the rabbits in the combined hypovolaemia
      hypothermia group were bled until hypovolaemic and then cooled in iced water to a
      central temperature of 32 degrees C. Rewarming was done in dry air at 43 degrees
      C. Bleeding and hypothermia activated the sympathicoadrenal system, causing a
      rise in the noradrenaline and adrenaline concentrations, as well as a rise in
      corticosterone. There were no significant differences in plasma noradrenaline and
      adrenaline values between the groups, whereas hypovolaemia alone also increased
      the dopamine concentration. In the hypothermia group the amount of corticosterone
      after cooling and rewarming was higher than in the combined group. Hypothermia
      and hypovolaemia increased the level of free fatty acids and blood glucose, which
      in the hypovolaemia group remained higher after volume replacement than in the
      other groups. Hypothermia in both groups increased the mean arterial pressure. In
      conclusion, the results suggest that hypothermia may prevent some harmful effects
      of hypovolaemia, e.g. by correcting mean arterial pressure, thus preventing the
      mortality seen in the hypovolaemia group.

PMID- 2239348
TI  - Influence of the interval between removal and freezing of muscle samples on
      muscle fibre size with special reference to sample size and fibre type.
AB  - To study the influences of the interval between removal and freezing of a muscle
      sample on fibre size, rat hindlimb muscles (soleus and extensor digitorum longus,
      EDL) were cut into three or five pieces and frozen at different intervals, cross
      sectioned, stained and analysed morphometrically. As in a previous study (Larsson
      & Skogsberg 1988), a pronounced interval-dependent change in soleus muscle fibre
      size was observed, the fibres in soleus muscle samples frozen immediately (within
      15 s) being significantly (P less than 0.01-0.001) larger than those samples
      frozen 4 or 10 min after removal. However, the interval-dependent change was only
      noted in small muscle samples, i.e. those where the maximum muscle fibre length
      was 6.5 mm, while samples in which the fibres were approximately twice this
      length showed no change. In the slow-twitch soleus, type I fibres predominate,
      and type II fibres were often too few in one or more cross-sections in each
      animal to allow reliable measurements of fibre size. The fast-twitch EDL was
      therefore studied, and the results indicated an interval-dependent change in
      fibre size which was differentiated according to enzyme-histochemical type, i.e.
      there was a significant change in type I and IIA fibres but not in type IIB. It
      is concluded that the interval between removal and freezing of small muscle
      samples, as in percutaneous muscle biopsies in man, is of vital importance for
      fibre size, and that this interval should be at least 2-4 min.

PMID- 2239349
TI  - ATP content in single fibres from human skeletal muscle after electrical
      stimulation and during recovery.
AB  - The ATP content was measured in type I and type II fibres from human vastus
      lateralis muscle at rest, after electrical stimulation and during recovery. At
      rest the mean values were 25.2 +/- 4.02 and 25.9 +/- 3.62 mmol kg-1 dry muscle
      (mean +/- SD) for type I and type II fibres respectively. Normal distribution
      curves were found for both types I and II fibres. After intermittent electrical
      stimulation for 83 s (1.6 s stimulation, 1.6 s pause) with occluded blood flow,
      the force generation decreased to 22% of the initial value and the muscle tissue
      showed a mean decrease in ATP to 14.8 and in phosphocreatine to 5.44 mmol kg-1
      dry muscle; lactate increased to 128.9 mmol kg-1 dry muscle. The ATP content in
      isolated fibres was equally decreased in both fibre types to 16 mmol kg-1 dry
      muscle. In 11% of the fibres the ATP content was lower than 10 mmol kg-1 dry
      muscle. After 15 min rest with intact blood circulation ATP was completely
      resynthesized in type I fibres and to 91% in type II fibres.

PMID- 2239350
TI  - Influence of reduced glycogen level on glycogenolysis during short-term
      stimulation in man.
AB  - The relationship between muscle glycogen concentration and the rate of glycogen
      breakdown during short, intense contraction has been investigated in man. Prior
      to the experiment, muscle glycogen content was manipulated by a combination of
      exercise and diet, and varied from 155 +/- 19 to 350 +/- 25 mmol kg-1 dry muscle
      (36-81 mmol kg-1 wet wt). The quadriceps femoris muscle was stimulated
      electrically at a frequency of 20 Hz for 1 min. The blood flow to the leg was
      occluded during the experiment and muscle biopsies were taken before and after
      10, 30 and 60 s stimulation. Force development and glycogenolytic rate were
      maintained constant during electrical stimulation and similar in all conditions,
      irrespective of the initial glycogen concentration. The phosphorylase a fraction
      was increased after 10 s stimulation, but returned to the initial values at the
      end of the stimulation. Muscle ATP was unaltered during the first 30 s
      stimulation, but decreased thereafter. The decrease in ATP was accompanied by a
      stoichiometric increase in inosine monophosphate. Phosphocreatine decreased
      during stimulation and was almost depleted at the end of stimulation. Muscle
      lactate and glucose 6-phosphate (Glu 6-P) increased during stimulation. None of
      these changes was significantly affected by the reduced glycogen contents. It is
      concluded that the rate of muscle glycogen breakdown is not affected by the
      initial glycogen level in the range of 155 +/- 19 to 350 +/- 25 mmol kg-1 dry
      muscle.

PMID- 2239351
TI  - Glycogen and lactate metabolism during low-intensity exercise in man.
AB  - The influence of high lactate concentration on glycogen metabolism in active type
      I and inactive type II fibres was investigated. High muscle lactate concentration
      (26.7 +/- 1.4 mmol kg-1 wet wt) was achieved by three bouts (2 min duration) of
      bicycle exercise at 112% Vo2 max. Exercise was continued at 40% Vo2 max for 1 h.
      Serial venous blood samples and biopsies from the vastus lateralis muscle were
      taken. Over the first 20 min of this low-intensity exercise muscle lactate
      concentration decreased by 22.9 +/- 0.7 mmol kg-1 wet wt, while glycogen remained
      unchanged in type I fibres and increased by 20 mmol kg-1 wet wt in type II
      fibres. During the next 40 min of low-intensity exercise lactate decreased by 1.6
      +/- 1.2 mmol kg-1 wet wt, while glycogen concentration decreased by 21 +/- 7 mmol
      kg-1 wet wt in type I fibres but remained stable in type II fibres. In a second
      series of experiments, in which lactate was allowed to disappear before the light
      exercise was started, no changes in glycogen concentration were seen in type II
      fibres during the 1 h of 40% Vo2 max exercise, while a continuous reduction in
      glycogen of 28 +/- 8 mmol kg-1 wet wt was found in type I fibres. The results
      indicate that in the presence of high lactate levels muscle glycogen was
      resynthesized in inactive type II muscle fibres, while lactate was oxidized in
      preference to glycogen in type I fibres.

PMID- 2239352
TI  - Viscoelastic properties of the slowly adapting stretch receptor muscle of the
      crayfish.
AB  - The viscoelastic properties of the muscle associated with the slowly adapting
      stretch receptor organ of the crayfish (Astacus astacus) were studied by
      recording the tension response to various length changes. When steady-state
      length changes were applied to the muscle, the tension developed in a non-linear
      way, increasing slowly for small extensions and rapidly when extension increased.
      Muscle tension responses to ramp-and-hold extensions were characterized by a
      transient peak followed by a gradual decline in tension. At the onset of the ramp
      the tension increased rapidly, similar to the response seen in resting skeletal
      muscle. The relation between peak dynamic tension and extension was non-linear.
      In a log-log plot the relation was linear with a mean slope of 1.4. At small
      extensions (less than 5%) the slope seemed to be lower. The experimental results
      have been analysed in relation to a viscoelastic model consisting of a Voigt
      element in series with a non-linear spring. The model could describe both the
      static length-tension relation and the dynamic response, but different parameters
      for the springs had to be used for the two cases. When the measured tension
      response was transformed by an exponential function of the squared tension, in
      accord with recent findings on stretch-activated channels, a good agreement was
      obtained with the time course of the receptor currents. Adaptation is thus likely
      to be caused by both the mechanical properties of the receptor muscle and the
      characteristics of stretch-activated channels of the neuron.

PMID- 2239353
TI  - Phencyclidine activates rat A10 dopamine neurons but reduces burst activity and
      causes regularization of firing.

PMID- 2239354
TI  - A psychiatric study of suicide among urban Swedish women.
AB  - A total of 104 suicides among women were investigated by means of a modified
      psychological autopsy, including interviews with survivors and a review of
      somatic and psychiatric records. Diagnosis according to Research Diagnostic
      Criteria (RDC) showed that 35% were suffering from a major depressive disorder
      during their final month and another 24% were also depressed; 12% were substance
      abusers and 14% had adjustment disorders. Two thirds had attempted suicide and
      another 23% had communicated suicidality in other ways. Slightly more than half
      of the women had been psychiatric inpatients and another 19% had at some time
      been outpatients. Fifty-seven percent had been psychiatric inpatients or
      outpatients during the final year of life. An increasing number of life events
      occurred during the final 6 months. In most cases the depressed women had been
      treated ineffectively with antidepressant drugs.

PMID- 2239355
TI  - Patient interactions in four psychiatric wards.
AB  - This article describes the interactions between patients and between patients and
      staff in 4 psychiatric wards. Two of the wards are acute admission units and 2
      are for long-stay chronic patients. The hospital is diagnostically streamed so
      that not only does the average length of stay vary between wards but so, for one
      ward, does the predominant diagnostic group. Patient interactions were analysed
      in terms of 5 major interactional categories: individual verbal, individual
      nonverbal, group verbal, group nonverbal and physical. The results show that,
      although there was little change in the overall level of verbal interaction as a
      function of chronicity, there were large shifts in patient-patient and staff
      patient interaction rates. Variations between the 4 wards on the 4 other
      interactional categories are explained in terms of the known diagnostic
      characteristics of the patients.

PMID- 2239356
TI  - The new revolving-door patients: results from a national cohort of first
      admissions.
AB  - A cohort of all first admissions to New Zealand psychiatric hospitals and
      psychiatric wards of general hospitals in 1980 and 1981 was followed up for 5
      years. The cohort consisted of 3875 males and 3965 females aged from 15 to 64
      years. Of these subjects, 59.4% had only one admission; 14.6% met our criteria
      for a revolving-door patient, as they had 4 or more admissions within the 5-year
      follow-up period. Based on first-admission information, patients who were younger
      and had a psychotic diagnosis had an increased likelihood of becoming a revolving
      door patient. Stepwise logistic regression showed that younger age and psychotic
      diagnosis independently and in interaction were associated with a high
      probability of becoming a revolving-door patient. Although patients with a first
      admission diagnosis of schizophrenia constitute a large group of the new
      revolving-door patients for both males and females, for women those with
      affective disorders and for men those with substance abuse comprise the largest
      proportion of the new revolving-door patients. This is because affective
      disorders in women and substance abuse in men are the most common diagnoses on
      first admission, rather than because the disorders themselves are associated with
      a high probability of the patients having multiple admissions.

PMID- 2239357
TI  - The prevalence of schizophrenia in three counties in Ireland.
AB  - This article reports a study of the prevalence of schizophrenia in 3 counties in
      Ireland based on case-register data and using a standardized diagnostic
      instrument--the Present State Examination. The estimate of prevalence varies
      depending on the criteria of schizophrenia employed. A middle-range estimate of
      3.9 per 1000 population does not differ substantially from previous estimates of
      prevalence obtained elsewhere. Over 60% of all schizophrenic prevalence patients
      and over half of schizophrenic inpatients did not score as cases, suggesting that
      the continued hospitalization of symptomatically recovered cases has given rise
      to the mistaken impression that the prevalence of schizophrenia is unduly high in
      Ireland. The work reported here indicates substantial differences between the
      results of case ascertainment by hospital admission data compared with those
      arrived at by standardized interview diagnostic techniques.

PMID- 2239358
TI  - Reactive psychosis among elderly people.
AB  - Two cases of reactive psychosis occurring over the age of 65 are briefly
      reported. The role of organic impairment and evaluation of previous psychiatric
      illness in the diagnosis of reactive psychosis in elderly people is discussed. In
      addition, a brief review of the relevant Scandinavian literature is provided.

PMID- 2239359
TI  - Alcohol consumption in parents and offspring: a study of the family correlation
      structure in a general population.
AB  - Alcohol consumption was recorded for 2390 spouses and 498 children of age 18 or
      above living with their parents. The spouse correlation was 0.67, whereas parent
      offspring and sibling correlations were all close to 0.35. This family
      correlation structure implies an upper limit for heritability of 0.44. The design
      does not permit a separation of effect of cultural (environmental) and genetic
      transmission in families, but comparisons with previous heritability analyses
      suggest that heritability is in fact close to the upper limit, implying little or
      no cultural transmission. There were virtually no correlations between alcohol
      consumption and symptoms of anxiety and depression. Nor did consumption correlate
      substantially with symptoms in first-degree relatives. These results do not
      support hypotheses of common genetic nor even of common environmental
      determinants for alcohol consumption and mental disorders.

PMID- 2239360
TI  - Do children with autism have March birthdays?
AB  - One hundred people with autistic disorder (DSM-III-R) without a known cause who
      comprised a total population of children with autism were compared with "autistic
      like" children, Asperger syndrome and age-matched comparison children from the
      general population and were examined with regard to month of birth. There was an
      excess of March birth in the group of children with autism. The possible reasons
      for this finding are discussed.

PMID- 2239361
TI  - From community mental health services to specialized psychiatry: the effects of a
      change in policy on patient accessibility and care utilization.
AB  - In 1975, a community mental health (CMH) centre with most of its resources
      channelled to outpatient services was set up in a defined catchment area of
      75,000 inhabitants near Stockholm. In 1981, the CMH centre was allocated 3
      inpatient wards of its own. An outpatient unit to treat long-term psychotic
      patients was also built up from existing resources. Emergency cases were directed
      to the primary health care services or to the emergency department of a hospital.
      During the same period, the number of doctors in the area's primary health care
      services increased fourfold. The social, demographic and diagnostic composition
      of the patient population and its utilization of in- and outpatient care in
      connection with these organizational changes are described. The population of the
      cathment area increased by 12.5% and the patient population decreased by 40%. The
      decrease was particularly great among first-time visitors (-54%), patients from
      lower social groups (-53%) and those with crisis diagnosis (-71%). The number of
      patients with psychoses increased (+26%). Outpatient visits and hospital
      utilization increased by one third. The number of compulsory admissions increased
      by 20% (still being far below the mean number in Stockholm). The decrease in the
      patient population is attributed to the reduction in accessibility to the CMH
      centre at a time when primary care services in the area were undergoing a
      sizeable expansion. The increased care utilization is the result of an internal
      redistribution of resources in favour of resource-demanding, long-term psychotic
      patients.

PMID- 2239362
TI  - Development of case vignettes to assess the mental health training of primary
      care medical officers.
AB  - This article reports the development of case vignettes as a method of assessing
      the short-term in-service training of primary care medical officers in mental
      health care. A pool of 18 case vignettes representing common psychiatric problems
      and a standard response sheet were written first. This was mailed to 45
      psychiatrists for their comments. Based on the comments received from 21
      psychiatrists, 2 sets of questionnaires with 7 vignettes in each set were
      developed. When administered to a group of 32 medical officers, this method of
      assessment was found to be sensitive in detecting gain in knowledge and skills
      following training. Further, performance on case vignettes was found to correlate
      positively with clinical skills when actual cases were given for assessment.

PMID- 2239363
TI  - Factor study of the Hamilton Rating Scale for Depression and the Bech Melancholia
      Scale.
AB  - In this study, a sample (n = 234) of elderly people between the ages of 60 and 95
      was evaluated. Items from the Hamilton Rating Scale for Depression and the Bech
      Rafaelsen Melancholia Scale were factorialized using the oblique rotation method
      oblimin. Three clinically significant factors were obtained, accounting for 41%
      of variance. The first was interpreted as a dimension of inhibition and
      melancholic depression; the second, insomnia; and the third, somatic and psychic
      anxiety. It is concluded that the set of items on both scales increases the
      capacity for evaluating melancholic aspects of depression. In the interpretation
      of factor analysis, the possible artifact represented by the repetition of
      similar items must be kept in mind. Despite the loss of simplicity oblique
      rotation implies, it is considered preferable to orthogonal rotation since it
      allows for a greater congruity with clinical situations.

PMID- 2239364
TI  - The experience of dysmenorrhea and its relationship to personality variables.
AB  - The aims of this study were: to relate women's subjective experience of primary
      dysmenorrhea to psychogenic needs assessed longitudinally at the age of 15 and at
      the age of 25 in a nonclinical sample; to compare the psychogenic needs of women
      with severe primary dysmenorrhea with those of other women who never have
      experienced dysmenorrhea; and to examine whether women with severe dysmenorrhea
      were less conventionally feminine than women who never have experienced
      dysmenorrhea. At 25 years, 42% of the women experienced dysmenorrhea and 15%
      experienced pain that limited their daily activity. Differences in psychogenic
      needs according to the Cesarec Marke Personality Schedule and in psychological
      masculinity and femininity according to the Attitude Interest Schedule were found
      in women with severe primary dysmenorrhea compared with women who never
      experienced dysmenorrhea. The results indicate that women with severe
      dysmenorrhea have less self-esteem at 15 years, but compensate for this at 25
      years by being more achievement-oriented and aggressive than women who never
      experienced dysmenorrhea. Further, women with severe dysmenorrhea are more
      conventionally feminine than women who never have experienced dysmenorrhea.

PMID- 2239365
TI  - Osteoclasts isolated from membranous bone in children exhibit nuclear estrogen
      and progesterone receptors.
AB  - Osteoclasts were isolated from membranous bone from four children without
      metabolic bone disease who were undergoing craniotomy for either tumor or trauma.
      Both freshly isolated osteoclasts and those cultured for 4-7 days exhibited the
      following characteristics: production of tartrate-resistant acid phosphatase (9.5
      14.8 units), contraction in response to application of 100 mg/ml of human
      calcitonin, and formation of resorption lacunae on devitalized bone wafers.
      Nuclear estrogen and progesterone receptors were demonstrated by
      immunohistochemical techniques and quantitated in two of the patients by
      radioimmunoassay (estrogen receptor RIA, 23.6 and 23.8 cpm/micrograms protein;
      progesterone receptor RIA, 36.7 and 74.2 cpm/micrograms protein). The
      demonstration of sex steroid hormone receptors in the nucleus of osteoclasts
      derived from children with normal membranous bone has established a potential
      mechanism whereby direct modulation of bone resorption by the sex steroid
      estrogen and progesterone may occur.

PMID- 2239366
TI  - Chemotactic response of osteoblastlike cells to transforming growth factor beta.
AB  - Transforming growth factor beta (TGF-beta) has multiple effects on bone cell
      metabolism in vitro but its exact role in bone remodeling still needs to be
      defined. Here we demonstrate that TGF-beta is chemotactic for osteoblastlike
      cells from fetal rat calvariae and osteoblastlike ROS 17/2.8 osteosarcoma cells.
      Maximal chemotaxis occurred at 5-15 pg/ml of TGF-beta and was observed with TGF
      beta 1 and TGF-beta 2 at equivalent concentrations. Conditioned medium from
      osteoblastlike cells containing latent TGF-beta failed to stimulate chemotactic
      migration. However, chemotactic activity was observed in conditioned medium that
      had been transiently acidified. Since acidification is known to activate TGF
      beta, these results suggest that only active TGF-beta is capable of inducing a
      chemotactic response. Preincubation of osteoblastlike cells with TGF-beta in
      concentrations from 10 pg/ml to 1 ng/ml for 48 h abolished a subsequent
      chemotactic response of these cells to TGF-beta, indicating that TGF-beta-induced
      chemotaxis is a transient phenomenon. Since TGF-beta may be released from the
      bone matrix and/or activated during bone resorption, the chemotactic activity of
      TGF-beta for osteoblastlike cells may be important for the recruitment of
      osteoblastlike cells to sites of bone remodeling.

PMID- 2239367
TI  - Different pattern of alkaline phosphatase, osteopontin, and osteocalcin
      expression in developing rat bone visualized by in situ hybridization.
AB  - Alkaline phosphatase (AP), osteopontin (OP), and osteocalcin (OC) are expressed
      during osteoblastic differentiation. However, previous studies suggested
      differences in the timing and possibly the site of their expression. In this
      study we used in situ hybridization to follow the distribution of these
      osteoblastic markers during bone development. Frozen sections of neonatal rat
      long bones and calvariae were hybridized with 35S-labeled RNA probes
      complementary to the AP, OP, and OC mRNAs. Controls included sections hybridized
      with the sense (mRNA) probes or pretreated with RNase. Positive cells were
      identified in all areas of bone formation of the long bones and calvariae. Based
      on quantitative silver grain distribution and density, high levels of OP
      expression were present only in osteoblasts in close proximity to bone (one to
      two cell layers). OC expression, apparently at lower levels than OP, was also
      localized to osteoblasts in contact with bone. In contrast AP, which was
      expressed at lower levels than OP, was present in a large number of cells,
      including preosteoblasts that were many layers removed from the bone-forming
      surface. These findings are consistent with the asynchronous expression of
      phenotypically related genes and suggest that AP is an earlier differentiation
      marker than OP and OC during the formation of endochondral and membranous bone.

PMID- 2239369
TI  - T lymphocyte surface antigen markers in osteoporosis.
AB  - Two distinct syndromes of osteoporosis have been postulated: type I, which is
      characterized by accelerated bone loss occurring in women during the early
      postmenopausal period; and type II, an age-related process of bone loss affecting
      both men and women in and after the seventh decade. Recently there has been
      indirect evidence linking local products of the immune system with bone
      remodeling. We therefore studied peripheral blood profiles of specific lymphocyte
      phenotypes in women with type I osteoporosis and in older women and men with type
      II osteoporosis. The ratio of CD4-bearing (T helper) cells to CD8-bearing (T
      cytotoxic-suppressor) cells (CD4/CD8 ratio) was elevated in women with
      symptomatic type I disease. In addition there was a significant negative
      correlation (r = -0.62, P less than 0.001) between the CD4/CD8 ratio and the
      spinal bone mineral density measured by dual-photon absorptiometry. In contrast,
      older men with a history of fracture (hip or spine) had CD4/CD8 ratios similar to
      control men. The number of T cells bearing IL-2R or VLA-1 was not different
      between osteoporotic subjects and controls in either men or women. This study
      supports the concept that local products of the immune system may be directly or
      indirectly involved in the pathogenesis of type I osteoporosis.

PMID- 2239368
TI  - Bone mineral loss and recovery after 17 weeks of bed rest.
AB  - The purpose of this work was to determine the rate and extent of bone loss and
      recovery from long-term disuse and in particular from disuse after exposure to
      weightlessness. For this purpose, bed rest is used to simulate the reduced stress
      and strain on the skeleton. This study reports on the bone loss and recovery
      after 17 weeks of continuous bed rest and 6 months of reambulation in six normal
      male volunteers. Bone regions measured were the lumbar spine, hip, tibia,
      forearm, calcaneus, total body, and segmental regions from the total-body scan.
      The total body, lumbar spine, femoral neck, trochanter, tibia, and calcaneus
      demonstrated significant loss, p less than 0.05. Expressed as the percentage
      change from baseline, these were 1.4, 3.9, 3.6, 4.6, 2.2, and 10.4, respectively.
      Although several areas showed positive slopes during reambulation, only the
      calcaneus was significant (p less than 0.05), with nearly 100% recovery.
      Segmental analysis of the total-body scans showed significant loss (p less than
      0.05) in the lumbar spine, total spine, pelvis, trunk, and legs. During
      reambulation, the majority of the regions demonstrated positive slopes, although
      only the pelvis and trunk were significant (p less than 0.05). Potential
      redistribution of bone mineral was observed: during bed rest the bone mineral
      increased in the skull of all subjects. The change in total BMD and calcium from
      calcium balance were significantly (p less than 0.05) correlated, R = 0.88.

PMID- 2239370
TI  - Fluoride bioavailability from slow-release sodium fluoride given with calcium
      citrate.
AB  - Clinical pharmacology of slow-release sodium fluoride given with calcium citrate
      was examined in acute and long-term studies. Following a single oral
      administration of 50 mg slow-release sodium fluoride, a peak serum fluoride
      concentration (Cmax) of 184 ng/ml was reached in 2 h; thereafter, serum fluoride
      concentration declined with a T1/2 of 5.9 h. The concurrent administration of
      calcium citrate (400 mg calcium) gave an equivalent Tmax (time required to attain
      Cmax) and T1/2, but a lower Cmax of 135 ng/ml. The coadministration of a meal
      with fluoride also reduced Cmax but increased Tmax. The area under the serum
      concentration curve of slow-release sodium fluoride was reduced 17-27% by a meal
      or calcium citrate. Thus, calcium citrate reduced fluoride absorption and peak
      fluoride concentration in serum of slow-release sodium fluoride but did not
      affect the time required to reach peak concentration or the rate of subsequent
      decline. The effect of a meal was similar, except for a longer period required to
      reach peak serum concentration. During long-term administration of 25 mg slow
      release sodium fluoride coadministered with 400 mg calcium as calcium citrate on
      a twice daily schedule, the trough level of serum fluoride could be kept between
      95 and 190 ng/ml, believed to be the therapeutic window.

PMID- 2239371
TI  - Osteoporosis as the sole presentation of bone marrow mastocytosis.
AB  - Three (young) adults with severe generalized osteopenia and vertebral compression
      fractures were studied. Extensive clinical and laboratory investigations were not
      contributory. Undecalcified bone biopsies demonstrated multiple mast cell
      granulomas in the marrow in two patients and numerous mast cells diffusely
      distributed throughout the bone marrow in the third patient. Mast cells may serve
      as a pathogenic agent in osteoporosis. Therefore, we conclude that isolated
      skeletal mastocytosis without clinical evidence of mast cell mediator release
      should be sought in the evaluation of a patient with unexplained severe bone
      loss.

PMID- 2239373
TI  - L'art et la maniere. A French title for a European lecture.

PMID- 2239372
TI  - Effect of sodium warfarin on vitamin K-dependent proteins and skeletal
      development in the rat fetus.
AB  - Sodium warfarin was administered daily to Sprague-Dawley rats from gestational
      day 8 to day 22 to examine the effects of this compound on the developing fetal
      skeleton and on the vitamin K-dependent bone and cartilage proteins. At a dose of
      175 micrograms/kg of sodium warfarin there was a 43% mortality rate among the
      dams. Maternal prothrombin times and serum osteocalcin levels were slightly
      elevated but not significantly. In the surviving litters, fetal bone osteocalcin
      and gamma-carboxyglutamic acid were significantly reduced (50 and 57%,
      respectively, on gestational day 22) when compared to age- and/or weight-matched
      control pups. The high correlation of osteocalcin content in long bone (R = 0.64)
      and calvariae (R = 0.77) to fetal body weight observed in control fetuses was not
      seen in the warfarin-exposed pups. Examination of alizarin-stained warfarin
      exposed fetal skeletons for ossification centers showed no difference from
      controls. However, analysis of the tibial growth showed several changes compared
      to control that included (1) widened hypertrophic zones, (2) increased
      calcification of the hypertrophic zones, and (3) disorganization of the
      hypertrophic cells. These results suggest that the growth plate abnormalities
      seen with prenatal warfarin exposure relate to the inhibition of the vitamin K
      dependent proteins of the skeletal system.

PMID- 2239374
TI  - Surgical management of brain stem vascular malformations.
AB  - Vascular malformations of the brain stem are a histologically heterogenous
      collection of lesions which most often present with sudden and progressive
      neurologic deficit related to haemorrhage. Since 1987 the authors have treated
      eleven cases of brain stem vascular malformation. Seven of the patients were
      treated with complete surgical extirpation of the haematoma and malformation
      because of progressive neurologic deficit. Four additional patients made a full
      neurologic recovery and are being carefully observed for signs suggestive of the
      need for surgical treatment. Complete surgical excision of brain stem vascular
      malformations is mandatory for patients with progressive neurologic deficit
      related to recurrent haemorrhage.

PMID- 2239376
TI  - Cerebral blood flow in moyamoya disease. Part 1: Correlation with age and
      regional distribution.
AB  - A study has been made of the cerebral blood flow (CBF) in moyamoya disease from
      the perspective of hemispheric cerebral blood flow and regional CBF (rCBF). The
      material includes 21 children between the ages of 5 and 15 years with moyamoya
      disease, and 19 adult moyamoya cases--all of which had virtually no neurological
      symptoms at the time of the study. CBF was measured using the 133Xe intravenous
      injection method. Comparison was made with the measurements from 16 normal
      children and 14 normal adults. Study was also made of the relationship between
      the angiographic stage of the disease and the CBF. With the exception of the more
      elderly patients, CBF was found to be significantly lower in the moyamoya cases
      than in normal subjects of the same age group. In all age groups, the
      distribution of rCBF showed a dominant posterior distribution, dissimilar to the
      dominant anterior distribution found in the normals. Among the juvenile moyamoya
      cases, there was a tendency toward decreasing hemispheric blood flow together
      with advancing disease--as determined angiographically. Moreover, with advancing
      stages of the disease, there was a continuing transition from the normal pattern
      of frontal dominance to one of occipital dominance. This dominance of posterior
      rCBF is thought to be a characteristic feature of moyamoya disease.

PMID- 2239375
TI  - Contrecoup fractures of the anterior cranial fossae as a consequence of blunt
      force caused by a fall.
AB  - Contrecoup fractures of the base of the skull are regarded as rare in the
      clinical literature. In our material (n = 171 falls on the same level and on or
      from stairs), the overall frequency of contrecoup fractures of the anterior
      cranial fossa in fatal cranio-cerebral trauma due to falls was 12%, as compared
      to 24% with occipital point of impact of the head. The relationships between the
      impact site on the head, form of fracture at the point of impact with involvement
      of the skull cap and/or the base of the skull, coup and contrecoup injuries of
      the brain, localization of contrecoup fractures in the anterior cranial fossa and
      the occurrence of monocle and spectacle haematomas display a major variability.
      Fractures occur in the form of simple fractures and as impression fractures
      (fracture fragments or fracture boundaries displaced to the inside). Clinical
      diagnosis is difficult because of the concealed position of the anterior skull
      base. Contrecoup fractures become of forensic medical significance when symptoms
      of a frontobasal injury occur for the first time after trauma which has occurred
      some time in the past and when the question arises as to the causal connection
      with the original trauma. In investigation of living persons, it may be difficult
      to decide whether haemorrhages in the region of the orbit and its vicinity result
      from a direct blunt force or derive from fractures of the base of the skull,
      especially contrecoup fractures.

PMID- 2239377
TI  - Histological differences between rootlets sectioned during selective posterior
      rhizotomy by two surgical techniques.
AB  - During selective posterior rhizotomy, for the treatment of spasticity in
      infantile cerebral palsy, the rootlets to be divided are chosen by the type of
      electromyographic response elicited by intraoperative electrical stimulation. Two
      different surgical techniques were used for exposing the lumbar roots. The first
      approach was to expose the conus medullaris through a T 12-L 1 laminectomy, while
      the other approach to the dorsal roots was distally in the cauda equina through a
      L 2-L 3 to S1 laminectomy. Although the clinical results obtained with either of
      them are not very different, there is anatomical evidence that suggests that the
      histological structure of the divided rootlets may be different in the two
      techniques. We designed our study to determine of a significant difference in the
      number of large myelinated fibers was found between rootlets divided close to the
      conus medullaris and those divided distally in the cauda equina. Two groups of
      five children with spasticity secondary to cerebral palsy where randomly designed
      to be operated upon by one of the techniques. The divided rootlets were processed
      with standard histological techniques and the large myelinated fibers were
      counted on enlarged (40 x) photomicrograph of the rootlet. A significantly (p
      less than 0.001) larger number of large myelinated axons was found in the
      rootlets dissected and divided close to the conus medullaris.

PMID- 2239378
TI  - Study of nerve regeneration in centrocentral anastomosis.
AB  - Nerve regeneration was studied in a model of centrocentral anastomosis (CCA)
      performed on the sciatic nerve of the rat. Experimental CCA was made by suturing
      the proximal end of the peroneal branch on the proximal end of the sural branch,
      placing between them a peroneal nerve graft (Group I, 20 rats) or a silicone
      chamber (Group II, 12 rats). Nerve grafts had a length of 5 mm and silicone
      chambers 7 mm. In six silicone chambers an 1 mm nerve graft was placed in the
      centre of the tube. In group I animals anterograde degeneration was studied by
      cutting the graft 60 days after surgery. In group II, nerve regeneration was
      studied 2, 4 and 8 weeks after surgery. Results indicate that in CCA: 1)
      regenerated axons coming from one nerve end grow into the graft but do not cross
      the contralateral suture line; 2) regeneration is poorer in silicone chambers
      than in nerve grafts; and 3) in silicone chambers regeneration is related to
      time. The reduction in the regenerative capability in CCA seems to be related to
      the alteration of nerve sprouts aiming for the peripheral targets.

PMID- 2239379
TI  - Lhermitte-Duclos disease (dysplastic gangliocytoma of the cerebellum). Report of
      a case and review of the literature.
AB  - The authors report the third published case of a Lhermitte-Duclos disease
      diagnosed preoperatively with the help of MRI, stressing its possible extension
      beyond the limits of the posterior fossa. The pertinent literature is reviewed
      concerning the clinical and radiological picture of this disease, as well as the
      different pathogenic hypothesis.

PMID- 2239380
TI  - Practical application of intraoperative ultrasound imaging.
AB  - Intraoperative real-time ultrasound imaging (US) was used in over 500 patients to
      investigate which of the previously considered applications are of practical use
      in everyday neurosurgery. During all intraoperative applications for a wide
      variety of pathological conditions, small deep-seated as well as subcortically
      located lesions were detected with accuracy; in many instances they could be
      approached through smaller surgical exposures. US guidance was accurate in 209
      cases for the stereotactic introduction of needles or endoscopes into various
      lesions: thus burrhole evacuation was performed on 148 intracerebral haematomas;
      in 16 patients endoscopic biopsy and resection of ventricular tumours was
      performed as well as biopsies of 39 hemispheric brain tumours and aspiration of a
      brain abscess in 6 instances. Seventy six gliomas were investigated by US
      imaging; the frequently unclear boundary between tumour and surrounding oedema
      was not better visualized than with CT or MRI. Moreover, US imaging for the
      detection of residual tumour towards the end of operation was unreliable.
      Postoperative imaging through burrholes or other cranial defects was mostly of
      unacceptably low quality for therapeutic decision making.

PMID- 2239381
TI  - Metastatic adenocarcinoma in cerebral astrocytoma: clinicopathological and
      immunohistochemical study with review of the literature.
AB  - Metastatic spreading of carcinoma into a pre-existing cerebral glioma is
      extremely rare and only a few well-documented cases have been reported in the
      literature. Here we report a 53-year-old man who at the age 49 was first operated
      on for a frontal astrocytoma (WHO-grade II). This tumour was completely resected
      and no post-operative radio- or chemotherapy was applied. About five years later
      the patient presented again with a large partially cystic space-occupying lesion
      at the same site, which pre-operatively appeared as a recurrence of the
      astrocytoma. Histologically, however, this tumour proved to be a metastatic
      adenocarcinoma into a recurrent astrocytoma. Further clinical examinations
      revealed a bronchial carcinoma as the primary lesion responsible for this unusual
      metastatis. The clinical and neuropathological findings of this interesting case
      including immunohistochemistry are presented and discussed.

PMID- 2239382
TI  - Philosophical and ethical problems regarding life and death.

PMID- 2239383
TI  - Concepts of consciousness.

PMID- 2239384
TI  - The Abhidhamma view of consciousness.

PMID- 2239385
TI  - The Buddhist world-view and the scientific world-view: a comparative analysis.

PMID- 2239386
TI  - Regulations on brain death in the Netherlands.

PMID- 2239387
TI  - Evolution of criteria for determination of brain death in Japan.

PMID- 2239388
TI  - New law in Hungary, concerning brain death and organ transplantation.

PMID- 2239389
TI  - Brain death.

PMID- 2239390
TI  - [A 10-month experience with extracorporeal shockwave therapy of urolithiasis].
AB  - From November 1987 treatment of urinary lithiasis regardless location was
      initiated in our Service of extracorporal renal lithofragmentation using
      shockwaves. Up until August 1988 (10 months), 411 patients have been treated
      representing a total of 590 lithiasis and 699 sessions on which the present
      communication is based; treatment included calculus of various chemical
      composition, as well as different sizes and locations. Also the relationship
      between sex, age, number of waves, use of analgesia, hospital stay, etc, has been
      considered. Results obtained after a 2.5 months follow-up are: 60.34% fragments
      free and 39.41% in expulsion stage. Monotherapy was chosen in 98% cases and
      multiple drug therapy in the remaining 2%. There has been no case of
      complementary open surgical therapy. Thus, we consider extracorporal renal
      lithofragmentation as the ideal treatment for urinary lithiasis, as long as the
      indication is correct. And we believe it to be the ideal treatment since it is a
      simple procedure, highly effective and with few complications.

PMID- 2239391
TI  - [Kidney transplantation].
AB  - In a consecutive series of 639 Renal Transplants (RT) performed between January
      1st 1978 and December 31st 1988, 75 Renal Transplanctectomies (RTX) were carried
      out. Of those, fifty-seven (76%) were due to immunological causes, 10 (13.3%) to
      vascular complications, 7 (9.3%) to urological problems and 1 (1.3%) to deep
      infection. The time elapsed between RTX and RT was as follows: 25 were performed
      earlier than 6 weeks, 17 between 6 weeks to 6 months, and 33 after 6 months. The
      higher number of complications did not happened, as it is frequently described,
      in the first group; on the contrary, it fell in the group that had been
      transplanted longer. There were 13 immunologically caused renal rhexis, 5 of
      which were RTX, another 5 were operated on and diagnosed at perioperation, and
      immediately received the appropriate treatment so they were able to keep their
      kidney, and finally, 3 patients were diagnosed a rejection with renal rhexis,
      ecographically confirmed. These patients were given only medical treatment, which
      was enough to allow jugulation of the picture. RTX techniques used were:
      extracapsular in 28 cases and intracapsular in 47. Surgical approach, except for
      2 cases of simultaneous kidney and pancreas transplantation, was extraperitoneal.

PMID- 2239392
TI  - [Evaluation of the penile artery by ECO-Duplex in the diagnosis of erectile
      dysfunction].
AB  - An Eco-Duplex study of the penile arterial system in 19 patients which consulted
      their physician for impotence is presented and a two-group classification is
      made: Group 1, arterial cause (7 patients) and, Group 2, non-arterial cause (12
      patients). Diameter and blood flow of the cavernous artery pre-and post
      intracavernous injection of papaverine was evaluated. A significant difference
      was found in the increase of arterial diameter in both groups as well as in the
      quantification of arterial flow pre- and post-application of papaverine, these
      being larger than 32 cm/sec in all non-arterial impotent patients (group 2).

PMID- 2239393
TI  - [Limitations of CAT scan in the diagnosis of myelolipoma of the adrenal gland].
AB  - The suprarenal myelolipoma is a myeloid tissue and fat tissue tumor. It can
      undergo degenerative processes of haemorrhage, necrosis and calcification. The
      diagnostic key is based on the finding of fat tissue in the inside of a
      suprarenal mass. A CAT would be the method allowing a more accurate diagnosis.
      Its limitations came from the presence of myelolipomas with abundant myeloid
      tissue, or which have suffered major degenerative processes in which it is
      difficult to identify the fat tissue, and in large retroperitoneal masses in
      which it is impossible to recognize their suprarenal origin.

PMID- 2239394
TI  - [Hypercalciuria and hyperuricosuria causing hematuria in the absence of
      nephrolithiasis].
AB  - A prospective study was made of 38 adult patients (15 male and 23 female, age
      30.5 +/- 10.8 years) with isolated hematuria of unknown etiology in which
      presence of hypercalciuria and/or hyperuricosuria without lithiasis was observed.
      Eighteen patients also referred episodes of macroscopic hematuria. Twenty-six
      patients had hypercalciuria (5.1 +/- 1.4 mg/kg/day), 29 hyperuricosuria (1053 +/-
      198 mg/day) and 17 presented both alterations. A four months treatment was
      instituted with thiazides in patients with hypercalciuria and allopurinol in
      those with hyperuricosuria. From the first months and throughout the whole
      therapy, urinary excretion of calcium an uric acid became normalized in all
      cases. In 22 patients (57.8%) (Group I: Respondents) hematuria disappeared
      coinciding with normalization of calcium and uric acid values in urine and was
      maintained during the follow-up months. In the remaining 16 patients (Group II:
      Non-Respondents) the hematuria condition persisted in spite of such
      normalization, in most cases other causes for hematuria becoming clear later. No
      differences with regard to age, relationship male/female nor basal calciuria and
      uricosuria values were seen between both Groups. Group I had a greater incidence
      of macroscopic hematuria episodes (64% vs 12% in Group II, p less than 0.01) and
      of family nephrolithiasis (64 vs 25% in Group II, p less than 0.05). We conclude
      that hypercalciuria and hyperuticosuria are potentially reversible causes of
      hematuria in adults. Therefore, urinary determination of calcium and uric acid
      should be included in urinary evaluation of patients with hematuria even though
      they do not present renal lithiasis.

PMID- 2239396
TI  - [Use of an urologic resector in rectal pathology: experience at our office].

PMID- 2239395
TI  - [In situ tumor excision of a renal neoplasm].
AB  - The present work reviews the conservative surgical options to treat renal tumor
      formation in patients who still have both kidneys, and tries to clarify the
      diagnostic aspects, indications and therapeutical alternatives. The controversial
      items are analyzed versus treatments advocating a radical surgical approach,
      establishing a parallelism with current trends of surgical non-intervention in
      renal traumatism of moderate to severe condition (grade II). A case is presented
      where these two pathological circumstances are concurrent: Renal traumatism with
      complete parenchymatous rexhis and contralateral solid renal mass, both treated
      conservatively. Pre-surgical diagnosis was left renal traumatism grade II and
      righ renal neoformation and was based in findings with CAT and arteriographia.
      Histology of the piece from tumorectomy was renal angiomyolipoma. After a post
      surgical evolution of twelve months, therapeutical results were assessed as
      excellent, with no evidence of either immediate not late complications.
      Considering data recently communicated by most authors, the concept of simple
      tumorectomy or renal tumoral enucleation is suggested as valid. However,
      arguments both clinical and surgical, in order to confirm its indication, require
      very rigorous criteria and a careful selection of patients.

PMID- 2239397
TI  - [Paratesticular liposarcoma of the spermatic cord].
AB  - Funiculus liposarcoma is a very uncommon tumor. Most cases have a low degree of
      malignancy. Inguinal orchiectomy with a wide local excision is the appropriate
      treatment. Liposarcoma presurgical diagnosis is very infrequent and
      ultrasonography is the method that can provide some help to locate it. Currently,
      chemotherapy indication is unclear. Due to recurrence, specially of local foci,
      being a possibility a periodical follow-up is necessary in these patients.
      Nowadays, local recurrences are treated with repeated ample local excisions and
      radiotherapy. This work reviews the literature and presents a new case of round
      cells liposarcoma of the funiculus.

PMID- 2239398
TI  - [Renal carcinoma and acquired cystic disease of the kidney in a patient after
      transplantation and under hemodialysis].
AB  - Renal Acquired Cystic Disease (RACD) is a frequent entity in patients with a long
      standing renal failure under hemodialysis treatment. Incidence of a tumor
      pathology is higher in those patients than in the general population. A new case
      is presented and some possible etiopathologenical factors of RACD and neoplasias
      on such pathology are established.

PMID- 2239399
TI  - [The value of high dose steroid therapy in obstructive uropathy caused by a
      tumor].
AB  - The case of an 82-years old female patient with acute renal failure secondary to
      tumoral obstructive uropathy by neoplasic invasion of the trigone is described.
      The condition was treated with urinary deviation through percutaneous nephrostomy
      of the left kidney which achieved an improvement in the renal function. Later,
      the percutaneous nephrostomy was unintentionally moved not being possible to
      place a new one in none of the kidneys. The patient remained anuric for 24 hours,
      and therapy was then instaured with high doses of intravenous steroids (6 Metyl
      Prednisolone 1.5 g I.V. in 24 hours), diuresis was recovered and renal function
      became normalized within a few days. The mechanism of action and therapeutic
      usefulness of high dosage steroids in tumoral obstructive pathology is discussed.

PMID- 2239400
TI  - [Cysts of the seminal vesicles. Diagnosis and treatment].
AB  - Congenital cysts in the seminal vesicle represent a rare by illustrative example
      of embryological malformation. They are often associated with ipsilateral urinary
      tract anomalies. We have analyzed the diagnostic and therapeutic schemes followed
      in the study of this uncommon pathology.

PMID- 2239401
TI  - [Renal carcinoma associated with benign tumoral pathology of the adrenal glands].
AB  - Three cases of renal carcinoma where homolateral suprarenal mass was detected
      during nephrectomy which was all together extirpated with the nephrectomy piece
      are presented. In all three cases pathological anatomy revealed a being
      suprarenal pathology (adenoma, myelolipoma, and cortical hyperplasia
      respectively). The infrequency of these pathologies association is commented upon
      and diagnostic methods to be used in its detection are discussed.

PMID- 2239402
TI  - [Late adrenal gland metastasis of contralateral renal adenocarcinoma].
AB  - A case of adrenal gland metastasis caused by contralateral adenocarcinoma of
      kidney nephrectomized 11 years previously in a 68 years old patient is presented.
      The rarity of the case due to its limited frequency and the long disease-free
      interval is emphasized, and the possible routes of metastatic affectation of the
      adrenal gland by renal tumors discussed.

PMID- 2239403
TI  - [Renal hydatid cyst: a nuclear magnetic resonance study].
AB  - A case of renal hydatid cyst (R.H.C.) in which study both traditional diagnostic
      methods (such as serology, radiology, ecoraphia, C.A.T., etc.) and the newer
      ones, including Nuclear Magnetic Resonance (N.M.R.) were used, is presented. The
      diagnostic characteristics of this type of cystic pathology were reviewed through
      N.M.R. study, as well as current criteria to outline a correct differential
      diagnosis with simple Renal Cysts (R.C.). Finally, a theoretical place for each
      of these methods within the diagnostic algorithm of renal masses is suggested.

PMID- 2239404
TI  - [Incidental carcinoma of the kidney with renal vein thrombosis].
AB  - Incidental carcinoma of kidney is an increasingly common pathology as a result of
      a wider use of high resolution diagnostic methods. The special characteristics of
      these tumors, usually small and in a low grade or stage, make conservative
      surgery to be considered as a valid therapeutical option. An incidental carcinoma
      of kidney with tumoral thrombosis of the renal vein undetected in the pre
      surgical study, circumstance which allows to emphasize the malignant potential of
      these tumors is presented here. Based on this, we believe that a meticulous
      evaluation of the renal vein condition should be made, in patients considered as
      possible candidates for conservative surgery. In this sense, selective renal
      phebography and magnetic resonance could be considered explorative means that
      play an important role in the introduction of renal preservation surgery, if
      future studies show that its use allows an early detection of the tumoral
      condition of renal vein.

PMID- 2239405
TI  - [Testicular malacoplakia].
AB  - This paper present the case of a patient with orchioepidimiditis quickly evolving
      to scrotal fistulization. The study of the orchiectomy piece showed testicle
      malacoplakia.

PMID- 2239406
TI  - [Thyroid metastasis of renal carcinoma].
AB  - Clinical detection of thyroideal metastasis of renal carcinoma is very rare;
      diagnosis of this type of metastasis is usually done at post-mortem examination.
      A case of thyroideal metastasis six years after nephrectomy due to renal
      carcinoma is presented. The slow evolution and good prognosis following surgical
      exercises justify an active therapy. Thirty-two months after the operation our
      patient is still free from the disease.

PMID- 2239407
TI  - [Growing teratoma syndrome in metastatic germinal non-seminomatous testicular
      tumors].
AB  - Presence of retroperitoneal or mediastinal mature teratomas secondary to
      metastatic testicle germinal tumours which have not responded to multiple
      chemotherapy constitute the so called Growing Teratoma. They can either represent
      the metastasis of a mature teratoma site in the original testicle tumour or the
      evolution from a non-differentiated lesion during therapy. The first two cases of
      Growing Teratoma Syndrome published in the national literature are presented
      here. Both cases had a retroperitoneal growth of the mature teratoma following
      successful achievement of normalization of serum tumoral markers through
      chemotherapy with CDDP, Bleomycin, and VP-16 in one case (Hospital Clinico) and
      with BOMP/EPI (Belomycin, Metrothexate, Vincristine, Cisplatin/Vo-16, Cisplatin,
      Iphosphamide) in the second one (Hospital del Mar) of a non-seminomatose testicle
      tumour. After a follow-up of 14 and 9 months respectively the good prognosis of
      these mature teratomas was verified in both cases, so as in the rest of the
      literature. We coincide with regard to performing a retroperitoneal
      lymphadenectomy with exeresis of tumoral masses as the most adequate attitude,
      both to prevent growth of the mature teratoma and to allow us to discard the
      presence of residual immature lesions.

PMID- 2239409
TI  - [Bonding and enamel prisms: is the "bevel" still significant?].
AB  - Following a recall of the various preparations of the cavo-surface for posterior
      composites (straight, rounded, concave bevel, or without bevel), a study at the
      M.E.B. analysed the interface between the tooth and the filling in each case
      investigated. With the straight bevel with a slight angulation (40 degrees), the
      limit of the cavity-filling joint is clear. A disintegration of the material
      exists with the straight bevel having a 70 degrees angulation. The hiatus is even
      more marked with rounded or concave bevels. The absence of a bevel provides a
      clear occlusal joint without irregularity at the cavo-surface limit. In the light
      of this investigation and the results observed in the clinic in the medium and
      long term, it appears that the preparation of the cavo-surface margins of
      occlusal cavities of the pre-molars and molars for posterior composites may make
      do with a bevel which is not very extensive and not widely opened (40 degrees),
      or even the total absence of a bevel.

PMID- 2239408
TI  - [Left supraclavicular adenopathy as a symptom of prostatic adenocarcinoma].

PMID- 2239410
TI  - [Influence of chemical composition and polymerization technic on the quality of
      removable denture resins].
AB  - With the new means of investigation, such as scan electron microscopy and gaseous
      phase chromatography combined with mass spectrometry, the authors have analyzed
      some of the variables involved in the preparation of resin bases for removable
      prostheses. Various polymerization methods were tested: --the pressed technique:
      standard and Acron MC systems; --the injection technique: SR-Ivocap and Unipress
      systems. They were thus able to demonstrate the effect of the chemical
      composition on the homogeneity of the microscopic surface structure of the
      resins. They also pointed out that some of the muffle systems induce visible
      strains on the macroscopic surface structure. Besides, they observed that the
      polymerization cycle does not modify the microscopic surface structure of the
      resin. In conclusion, they advocate the use of resins with a chemical composition
      fitted in systems inducing minimum tensions.

PMID- 2239411
TI  - [Drug interactions in dentistry].
AB  - The authors describe the various interactions which may exist between the medical
      treatments followed by patients and various groups of substances used in odonto
      stomatology: non-steroid anti-inflammatory drugs, antibiotics, antifungicides,
      vasoconstrictors and local anaesthetics. They clarify the clinical risk relating
      to each of these medicament interactions.

PMID- 2239412
TI  - [Immediate placement of an implant after extraction: indications and surgical
      requirements].
AB  - Following the extraction of a tooth, a 3 to 6 months period of healing is
      generally necessary before a screwed or impacted titanium implant can be placed.
      After what, another 3 to 6 months period is necessary before it is possible to
      expose the implant and put it to function. Nonetheless, in some clinical
      situations, and under certain surgical conditions, it has become apparent that
      the immediate positioning of an implant after extraction is currently possible
      and even recommended, thus ensuring an aesthetic and psychological advantage for
      the patient.

PMID- 2239413
TI  - [Medical treatment of epulis by local injection penicillin therapy].
AB  - Treatment in November 1987, of an epulis-type gingival tumor, with in situ
      penicillin G injections, resulted in complete eradication of this benign tumor
      with no recurrence more than one year later. This case-report may be added to
      others of the same type reported by Dr. Joseph ABRAVANEL: since 1978, date of the
      first presentation at the "Hospital Necker Scientific Meeting", all cases treated
      (approximately ten) resulted in complete cure without any recurrence; the cases
      reported in 1978 were all followed and there was no recurrence. Since this
      technique demonstrated a superior efficacy over Surgery, we decided to report
      this last case with a follow-up period exceeding one year. However, we are aware,
      in spite of the long follow-up and the constant results, of the limited number of
      cases in the study. We hope that, with the help of all our colleagues, we will be
      able to improve our results. The mechanism of action of penicillin G opens a
      number of prospects in the pathology of the oral mucosa, especially iatrogenic
      pathologies: Cyclosporine, Dihydan, etc.

PMID- 2239414
TI  - [Correction of upper impacted canines in vestibular position with segmental
      osteotomy advancing the incisal block. Apropos of 5 cases].
AB  - The author reports on 5 cases of segmental osteotomy advancing the upper incisal
      block, in the treatment of vestibular retention of an upper canine associated
      with an upper retro-alveolitis and/or brachypremaxillitis. This surgery is
      proposed as an alternative to the extraction of the 4 pre-molars, which is
      usually done in these cases of apparent disharmony.

PMID- 2239415
TI  - [Mandible and its image, thought on cephalometry].
AB  - Starting with the mandible, chosen as a pretext, the author of this book thinks
      about the necessity of its shape as it is observed by anatomists and
      orthodontists; he draws conclusions which lead him to have reservations as to the
      kind of thinking which impel most of the methods of cephalometric analysis and
      argues for a new "look" in imaging.

PMID- 2239416
TI  - [Mandibular osseous lacuna, salivary inclusion].
AB  - Salivary inclusion is seen, on panoramic films of the maxilla and the mandible,
      in the form of a mandibular osseous lacuna. Such an indicative diagnostic image,
      the prognosis for which is often sobering, requires CT scan exploration. The
      latter permits the diagnosis of Stafne's lacuna, the nature of which is benign.
      Quick and sure.

PMID- 2239417
TI  - [Evaluation of time needed to treat periodontal conditions classified according
      to the C.P.I.T.N. index].
AB  - A questionnaire was sent to 623 members of the "French Society of Periodontology"
      with a view to assessing the time necessary to provide instructions concerning
      hygiene, carry out root planing, surgery on 3.5 to 5.5 mm pockets, surgery on
      pockets of 6 mm or more, and to ensure maintenance. 282 responses were received
      from the practitioners and were computer analysed. The time required for
      instructions concerning hygiene was estimated to be approximately 15 mn. This
      information was usually repeated 4 times. It was determined that scaling and root
      planing require an average of 29.19 mn per sextant. The surgical interventions
      for 3.5 to 5.5 mm and 6 mm or more pockets are estimated to last an average of
      77.03 and 107.36 mn respectively. Finally, the assessment of the time necessary
      for maintenance of the whole mouth was 30 to 60 mn, with an average of 45.11 mn.
      A quarterly check-up was recommended by 48.9% of the practitioners. The treatment
      of complex cases requires much more time, and maintenance is indispensable in
      order to avoid relapse. A plaque control programme undertaken sufficiently early
      might avoid long treatment stages.

PMID- 2239418
TI  - [Importance of diabetic equilibrium in periodontal condition. Clinical study].
AB  - Three hundred forty diabetic adults were examined. Initially 39 well equilibrated
      diabetic patients (W.E.D.), with Hb A 1C less than or equal to 6% and 301 poorly
      equilibrated diabetic patients (P.E.D.) with Hb A 1C greater than 6% were
      involved. During a second phase, 60 moderately well equilibrated diabetic
      patients (M.W.E.D.) were counted with Hb A 1C less than or equal to 7% and 280
      poorly equilibrated diabetic patients (P.E.D.) with Hb A 1C greater than 7%. The
      teeth examined were 16, 21, 24, 36, 41 and 44. The indices used were Pl. I. and
      G.I.; the depths of the pockets were measured. The gingival fluid was sampled
      from 21 and 24. There was no influence of equilibrium on the Pl. I., G.I., depth
      of the pockets and the gingival fluid, or any correlation between Hb A1C and the
      four criteria chosen. The equilibrium of a diabetic patient, whether it be
      perfect or mediocre, does not seem to influence the periodontal condition.

PMID- 2239419
TI  - Seventh annual meeting. Singapore, November 4-11, 1990. Abstracts.

PMID- 2239421
TI  - Circulating regulatory factors and neuroendocrine function. Proceedings of a
      symposium. June 26-July 1, 1989, Smolenice Castle, Czechoslovakia.

PMID- 2239420
TI  - The tuberoinfundibular dopaminergic neurons of the brain: hormonal regulation.
AB  - The role of prolactin and of estradiol and progesterone in the control of the
      biosynthetic and secretory activity of TIDA neurons has been investigated in the
      following animal models: young female rats, aged female rats, and young male
      rats. The indices of TIDA neuronal function employed were a) mass of TH in
      neurites in the ME, b) total in situ activity of TH in the ME, c) in situ molar
      activity of TH in the ME, and d) secretion of dopamine into hypophysial portal
      blood. It was found that prolactin in high concentration in the circulation and
      in the CSF had little, if any, effect on the mass of TH in the ME. However, a
      high concentration of prolactin in either the circulation or in the CSF
      stimulated significantly the in situ TH activity in the ME whether expressed in
      terms of total activity per ME or activity per mole of TH. The stimulation of TH
      activity with prolactin was prevented by immunoneutralization of circulating
      prolactin. A high concentration of prolactin in the CSF was as effective in
      stimulating TH activity in the ME of rats with intact pituitary glands as in
      hypophysectomized rats. In addition to prolactin, treatment of animals with
      intact pituitaries with a combination of estradiol and progesterone markedly
      stimulated the total in situ activity of TH of the ME as well as the in situ
      molar activity of TH of the ME, but neither estradiol nor progesterone alone had
      an effect on TH activity. Hypophysectomy abolished the stimulatory action of
      estradiol and progesterone on TH activity of the ME. In addition to the in situ
      activity of TH in the ME, estradiol-progesterone treatment stimulated the
      secretion of dopamine into hypophysial portal blood. Neither estradiol nor
      progesterone alone affected dopamine secretion by TIDA neurons. We conclude that
      exposure to high concentrations of prolactin or to both estradiol and
      progesterone stimulate the biosynthetic and secretory activity of TIDA neurons.
      These hormones are effective in old rats and well as young rats and in males as
      well as females.

PMID- 2239422
TI  - Regulation of the sympathetic nervous system by circulating vasopressin.

PMID- 2239423
TI  - Antibodies to neuropeptides: biological effects and mechanisms of action.

PMID- 2239424
TI  - Circulating corticotropin-releasing factor in pregnancy.

PMID- 2239425
TI  - Central action of adrenal steroids during stress and adaptation.
AB  - Corticosteroids interact with receptors in the central nervous system. These
      receptors display heterogeneity and can be distinguished as corticosterone- and
      aldosterone-binding mineralocorticoid receptors and dexamethasone-binding
      glucocorticoid receptors. Ligand specificity of mineralocorticoid receptors for
      either corticosterone or aldosterone seems to be determined by co-localized
      transcortin and the enzyme, 11 beta-hydroxysteroid dehydrogenase. Aldosterone
      selective mineralocorticoid receptors appear to be present in the
      circumventricular organs and the AV3V region of the hypothalamus and mediate
      behavior that is driven by salt appetite. Highest concentrations of
      mineralocorticoid receptors are found in neurons of the hippocampus. These limbic
      mineralocorticoid receptor sites mediate tonic influences of corticosterone on
      brain processes. Glucocorticoid receptors bind corticosterone with a tenfold
      lower affinity than do mineralocorticoid receptors, and are widely distributed in
      neuronal and glial cells of the brain. Glucocorticoid receptors are involved in
      the termination of the stress response (negative feedback). Studies involving
      measurement of glucocorticoid receptor mRNA and binding sites have revealed that
      glucocorticoid receptors are subject to autoregulation. After ADX, glucocorticoid
      receptor concentration increases, but is reduced after chronic stress, chronic
      administration of glucocorticoids, and at senescence. A diminished glucocorticoid
      receptor concentration may compromise the negative feedback action exerted by
      glucocorticoids after stress. After ADX, mineralocorticoid receptor binding is
      acutely up-regulated and reaches its maximum between 7 and 24 hours post-ADX.
      Mineralocorticoid receptor mRNA level shows a transient increase following ADX.
      Long-term ADX has no effect on the mineralocorticoid receptor concentration, but,
      interestingly, chronic dexamethasone treatment results in an up-regulation of
      mineralocorticoid receptors. Mineralocorticoid receptor level is decreased at
      senescence, but this age-related decrement can be reversed by chronic treatment
      with the ACTH4-9 analog, ORG 2766. Functionally, mineralocorticoid receptors and
      glucocorticoid receptors are involved in different aspects of the organization of
      the stress response, and in conjunction they control the stress responsiveness of
      the animal.

PMID- 2239426
TI  - The physiology of the blood-brain barrier.
AB  - The BBB is a dynamic interface between blood and the central nervous system
      enabling the brain to keep an optimal internal environment. The endothelial cells
      of the brain capillaries are unique epithelial-like cells that are fused together
      by tight junctions and have a low pinocytotic activity. The entry of a specific
      substance will, therefore, mainly depend on its lipid solubility, and whether or
      not it has access to any of the carriers in the endothelial cells. Enzymatic
      degradation in the endothelium can prevent entry into the brain of substances
      that do enter the endothelial cells. Astrocytes may have an important role by
      inducing and upholding some barrier functions. An intact BBB is evidently
      important for optimal brain function. Manipulation of the BBB to allow entry of
      therapeutic agents may be justified under certain circumstances but should be
      done with caution until we know more about the long-term consequences of such
      manipulation.

PMID- 2239427
TI  - Effects of thyroid hormones on the hypothalamic dopaminergic neurons.

PMID- 2239428
TI  - Inhibin and related proteins: localization, regulation, and effects.
AB  - Inhibin has originally been defined as a gonadal hormone that exerts a specific
      negative feedback action on the secretion of FSH from the gonadotropic cells of
      the pituitary gland. The existence of inhibin was postulated by Mottram and
      Cramer (15) as early as 1923. However, only after reliable and sensitive bioassay
      systems had been developed for detection and estimation of inhibin and an ample
      source of inhibin was found in the form of ovarian follicular fluid, was progress
      made on the isolation and characterization of the hormone. It is apparent now
      that inhibin, which itself consists of a dimer of two different subunits, alpha
      and beta, is a member of a much larger family of (glyco)protein hormones and
      growth factors that includes Mullerian inhibiting substance, transforming growth
      factor-beta, activin/erythroid differentiation factor, bone morphogenetic
      proteins, and an insect and a Xenopus protein. All play important roles in cell
      differentiation. Gonadal inhibin is produced in the Sertoli cells in the testis
      and in the granulosa cells in the ovary. The production of inhibin is stimulated
      by FSH, but controversy exists about other factors that might play a role in the
      regulation of the production of inhibin. It appears likely that inhibin plays an
      important role in the feedback regulation of peripheral concentrations of FSH
      during the period in which Sertoli cells and granulosa cells--the target cells
      for FSH--divide, i.e., during puberty in male animals and during the development
      of ovarian follicles in female animals. In this way, inhibin may be an important
      regulator of the number of developing Sertoli cells and of the length of the
      seminiferous tubuli in the testis and of the number of developing follicles in
      the ovary. Apart from its function in the pituitary-gonadal axis, inhibin and
      activin may be produced and act in a number of other organs such as the placenta,
      hypothalamus, adrenal, and bone marrow. Investigation of the role of the members
      of the inhibin family in these systems has only begun, but will certainly be a
      field of major interest in the near future.

PMID- 2239429
TI  - Neuroendocrinology of interleukin-1.

PMID- 2239430
TI  - Role of monokines in control of anterior pituitary hormone release.
AB  - It has long been known that endogenous pyrogen, released as a result of injection
      of typhoid vaccine or in response to infection, produces fever and increases ACTH
      secretion. Recent studies have indicated that endogenous pyrogen is, at least in
      part, IL-1. This monokine has now been shown to activate the release of ACTH by a
      hypothalamic mechanism with release of CRF and possibly vasopressin, which
      stimulates the corticotrophs. There may also be a pituitary action to stimulate
      the release of ACTH directly. In our experiments we showed that IL-1 at low but
      not higher doses appears to act intrahypothalamically to stimulate GH and PRL
      release and to inhibit TSH release. In the meantime, another monokine, cachectin,
      was isolated and its structure determined. We have found that this monokine can
      act following its third ventricular injection to stimulate ACTH, PRL, and GH
      release and to inhibit TSH release, at least in part, by release of
      prostaglandins since indomethacin, an inhibitor of prostaglandin synthesis,
      produced a blockade of the responses except for those of ACTH. This peptide also
      has highly potent effects to alter pituitary hormone release by direct action on
      the pituitary to stimulate ACTH, GH, and TSH and to a slight extent PRL release.
      These actions appear to involve prostaglandins since indomethacin blocks all of
      the effects except for the effect on ACTH secretion. This monokine also produces
      a dose-related lowering of anterior pituitary cyclic AMP levels. When the
      monokine was incubated along with somatostatin, the lowering of cyclic AMP was
      reversed, and a potent PRL-releasing effect of the monokine was visible. We have
      begun studies with a third monokine, gamma interferon, which indicate that it
      stimulates ACTH release but suppresses plasma GH and TSH levels by a hypothalamic
      action. It is apparent that these various monokines have powerful effects to
      alter hypothalamic-pituitary function and that they probably mediate most of the
      effects of infections on the release of anterior pituitary hormones.

PMID- 2239431
TI  - Interleukins, signal transduction, and the immune system-mediated stress
      response.
AB  - Overwhelming evidence indicates that the administration of cytokines such as IL-1
      alpha and beta, IL-6, and TNF-1 alpha stimulates one or more components of the
      HPA axis. The hypothesis driving this research is that host infection and tissue
      injury trigger the synthesis and release of several cytokines that act locally at
      sites of trauma and distally upon entering the circulation. Available evidence
      suggests that the primary source of HPA axis-acting or circulating cytokines is
      activated monocytes or macrophages; therefore, a direct relationship should exist
      between the appearance of monokines in plasma and the subsequent appearance of
      pituitary-adrenocortical hormones in plasma as well. Clarification of the
      physiological role of monokines as mediators of the host stress response will
      come from in vivo studies in which the type, sequence of appearance, duration of
      elevation, and quantification of each monokine is monitored along with ACTH and
      glucocorticoids, following an appropriate immune challenge. In several recent
      reports, investigators have administered bacterial-derived endotoxin or LPS to
      stimulate the physiological events associated with infection or injury and
      chronicled plasma levels of IL-1, IL-6, and TNF-alpha (37,56,57). In human
      subjects, endotoxin challenge enhanced plasma TNF-alpha levels by 1 hour, which
      returned to basal levels by 4 hours (37), whereas, IL-6 plasma activity increased
      at 2 hours post-challenge and returned to baseline by 6 hours (56). Thus, both of
      these monokines are implicated as possible acute activators of the HPA axis. In
      perhaps the most revealing study to date, LPS challenge of mice indicated both a
      differential appearance and disappearance rate in serum for TNF-alpha and IL-1
      and a differential regulation of these monokines by glucocorticoid feedback (57).
      Serum TNF was detected 45 minutes post-LPS, peaked by 1 hour, and returned to
      control levels by 3 hours. Serum corticosterone concentrations rose rapidly over
      a time course similar to that of TNF. Even after serum TNF concentration had
      returned to basal conditions, corticosterone levels remained maximally elevated,
      and serum corticosterone was still significantly above basal levels 24-hour post
      LPS. The rapid return of circulating TNF to pre-LPS challenge levels appeared to
      be regulated by negative glucocorticoid feedback, because TNF remained maximally
      elevated for at least 6 hours in adrenalectomized or hypophysectomized mice. LPS
      induced levels of IL-1 were delayed as compared to serum TNF, peaked at 4 hours,
      and remained elevated even at 24 hours.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2239432
TI  - Immunoneurology: a serum protein afferent limb to the CNS.

PMID- 2239433
TI  - Neuroendocrine mechanisms in the thermogenic responses to diet, infection, and
      trauma.

PMID- 2239434
TI  - The blood-brain barrier in diabetes mellitus.

PMID- 2239435
TI  - Circulating blood glucose and hypothalamic-pituitary secretion.

PMID- 2239438
TI  - Exchange of peptides between the circulation and the nervous system: role of the
      blood-brain barrier.

PMID- 2239437
TI  - Blood-brain barrier and neuroendocrine regulations.

PMID- 2239436
TI  - Nutritional and hemodynamic factors influencing adenopituitary function in man.

PMID- 2239439
TI  - Vasopressin, the blood-brain barrier, and brain performance.

PMID- 2239440
TI  - Macrophage phospholipase A2 activity and eicosanoid production: studies with
      phospholipase A2 inhibitors in P388D1 cells.

PMID- 2239441
TI  - Phospholipase A2--role and function in inflammation. Based on the proceedings of
      the Symposium on Phospholipase A2: Pathophysiological Role of Soluble and
      Membrane-Bound Enzymes. January 15, 1989, New York, New York and the Federation
      of American Societies for Experimental Biology Symposium on the Release and
      Function of Phospholipase A2. March 22, 1989, New Orleans, Louisiana.

PMID- 2239442
TI  - Mobilization and function of extracellular phospholipase A2 in inflammation.

PMID- 2239443
TI  - Cellular and extracellular phospholipase A2 activity in zymosan pleurisy in rat.
AB  - The pleural exudate from rats treated intrapleurally with zymosan contains
      phospholipase A2 (PLA2) activity which is Ca2(+)-independent and optimally active
      at a neutral pH. This PLA2 activity was found in approximately equal amounts in
      both the cellular and extracellular fractions of the exudate. The Ca2(+)
      independency of the PLA2's in the pleural exudate distinguishes them from plasma
      PLA2's and this suggests that the source of the exudate PLA2's is not plasma. The
      appearance of PLA2 activity in zymosan-induced pleural exudate correlates
      temporally with increases in exudate volume and pleural cell number. In all
      cases, the maximum response was seen 24 hr after zymosan challenge. All
      parameters of pleurisy and PLA2 activity are similarly sensitive to the steroid
      dexamethasone which has been hypothesized to act, in part, through the synthesis
      of PLA2 inhibitory peptides. In its entirety, this information suggests that
      there is a relationship between pleural PLA2 activity and the appearance of
      pleural inflammation (exudate volume and cells) and that PLA2 may play an
      important role in the initiation and propagation of this inflammatory process in
      rats. Furthermore, the zymosan-induced pleurisy model may serve as a useful model
      for the identification of PLA2 inhibitors with antiinflammatory activity.

PMID- 2239444
TI  - Pharmacological control of phospholipase A2 activity in vitro and in vivo.

PMID- 2239445
TI  - Localization and evolution of two human phospholipase A2 genes and two related
      genetic elements.
AB  - Mammals are now known to contain at least two distinct classes of phospholipases
      A2, the progenitors of which can be seen in the venoms of snakes. Mammalian "Type
      I" PLA2, synthesized primarily by the pancreas, is also present in smaller
      amounts in other tissues including lung, spleen, and kidney. Recently, a
      mammalian "Type II" PLA2 has been sequenced, and shown to occur in platelets,
      synovial cells and fluid, cells of inflammatory peritoneal exudate, liver,
      intestine, kidney, and placenta. This form, referred to here as Type IIA PLA2,
      could play a key role in arachidonate release in both normal and pathologic
      inflammation. The genes encoding both forms have also been recently cloned. Here,
      the sites of synthesis and respective roles of the two known enzymes are
      discussed, along with an analysis of the evolutionary conservation of Type IIA
      PLA2 gene sequence. In addition, two related genetic elements containing
      sequences homologous to a portion of Type II PLA2 are described, which map to the
      same chromosome as the Type IIA PLA2 gene (chromosome 1). Either or both of these
      could also encode a portion of additional mammalian PLA2s.

PMID- 2239446
TI  - Structure and properties of a secretable phospholipase A2 from human platelets.

PMID- 2239447
TI  - Phospholipase A2 activation is the pivotal step in the effector pathway of
      inflammation.
AB  - Our understanding of the mechanisms of initiation and propagation of local and
      systemic inflammatory processes is clearly imperfect if one uses the available
      therapeutic modalities as a yardstick. While glucocorticoids are potent anti
      inflammatory drugs, the pharmacologic target of this class of agents has not been
      identified with certainty, and the use of steroids is fraught with the risk of
      considerable and potentially dangerous side effects. On the other hand, non
      steroidal anti-inflammatory drugs (NSAIDS), while more specific, are relatively
      weak anti-inflammatory compounds and frequently require the addition of more
      potent agents. Cytotoxic drugs or anti-metabolites effectively suppress acute and
      chronic inflammatory reactions, but also predispose to infection and initiate the
      development of neoplasms following long-term exposure. The inadequacy and
      relative non-specificity of these approaches underscore the deficiencies in our
      understanding of the principles that govern these responses. A better
      understanding of these processes will be applicable to broad categories of human
      disease including autoimmunity, the collagen vascular diseases, aberrations in
      host defense and the response to trauma and infection.

PMID- 2239449
TI  - Activation, structure, and organization of genes involved in microbial defense in
      plants.

PMID- 2239448
TI  - Response of plant antioxidant defense genes to environmental stress.

PMID- 2239450
TI  - Molecular and cellular biology of the heat-shock response.

PMID- 2239451
TI  - Effects of heat and chemical stress on development.
AB  - Similarities in the means by which developmental defects are induced in
      vertebrates and Drosophila suggest that some kinds of defects may be induced by
      similar mechanisms. The similarities include the fact that heat and a group of
      chemicals that induce synthesis of heat-shock proteins induce defects in mammals,
      chickens, and flies. Different kinds of defects are even produced in one type of
      animal, depending on the precise timing of the environmental insult. The
      effectiveness of the environmental treatment in inducing defects depends on the
      genetic background of the animal as well as on past exposure to chemicals and
      heat. Developmental defects induced by heat in mice, rats, and flies can all be
      prevented by thermotolerance-inducing treatments. The basis for these effects has
      been studied at the molecular level in Drosophila, and the evidence indicates
      that these teratogens and the thermotolerance-inducing treatments affect the
      level or timing of expression of specific genes during critical periods in the
      developmental program.

PMID- 2239453
TI  - Cholinergic muscarinic binding of blood lymphocytes in patients with Parkinson's
      disease.

PMID- 2239452
TI  - Neurotrophic factors and Parkinson's disease.

PMID- 2239454
TI  - Brain glucose metabolism in Parkinson's disease.

PMID- 2239455
TI  - Superoxide dismutase-like activity in the Parkinson's disease brain.

PMID- 2239456
TI  - The "serotonin hypothesis" for depression in Parkinson's disease.

PMID- 2239458
TI  - Kinematic properties of upper-limb trajectories in Parkinson's disease and
      idiopathic torsion dystonia.

PMID- 2239457
TI  - Conditioning transcranial cortical stimulation (TCCS) by exteroceptive
      stimulation in parkinsonian patients.

PMID- 2239459
TI  - Precision grip in parkinsonian patients.

PMID- 2239461
TI  - Behavioral and biochemical effects of 4-phenylpyridine, 2-phenylpyridine, and 1
      methyl-4-phenyl-1,2,3,6-tetrahydropyridine in rodents.

PMID- 2239460
TI  - Age, environments, and the number of substantia nigra neurons.
AB  - We examined forty-eight midbrain sections from normal brains containing SN at the
      level of the exiting fibers of the IIIrd cranial nerve. The cases were classified
      into two groups based on at least 80% life exposure to either rural or urban
      provincial environments, respectively. Linear regression analysis revealed a
      lower SN neuron count in the rural group by age 20, although this difference was
      not statistically significant. There was a 34% decline in urban and a 17% decline
      in rural residents' neuron counts between ages 20 and 80. These results are
      consistent with our previous studies, which indicate a higher risk of PD in the
      Saskatchewan rural population. We believe that studies of environmental factors
      in early life will provide the most rewarding clues to the etiology of PD.

PMID- 2239462
TI  - Interference of 3-O-methyldopa with L-dopa treatment for MPTP-induced
      parkinsonism in mice.

PMID- 2239463
TI  - Research diagnostic criteria for Parkinson's disease.

PMID- 2239464
TI  - Muscular weakness in Parkinson's disease.

PMID- 2239465
TI  - Psychogenic tremors.

PMID- 2239467
TI  - Progressive supranuclear palsy: motor, neurobehavioral, and neuro-ophthalmic
      findings.

PMID- 2239466
TI  - Cerebrospinal fluid dopamine, norepinephrine, and epinephrine concentrations in
      Parkinson's disease correlated with clinical symptoms.

PMID- 2239468
TI  - Parkinson's disease and hydrocephalus.

PMID- 2239469
TI  - Do parkinsonians exhibit visuospatial deficits?

PMID- 2239470
TI  - Shifting ability in Parkinson's disease: does shifting ability really
      deteriorate?

PMID- 2239471
TI  - Parkinson's disease and the frontal hypothesis: task alternation in verbal
      fluency.

PMID- 2239472
TI  - Aspects of language in parkinsonism.

PMID- 2239473
TI  - Premorbid personality and idiopathic Parkinson's disease.

PMID- 2239474
TI  - The premorbid personality of patients with Parkinson's disease: a comparative
      study with healthy controls and patients with essential tremor.

PMID- 2239475
TI  - Risk factors for dementia in Parkinson's disease.

PMID- 2239476
TI  - Psychosocial problems of Parkinson patients: approaches to assessment and
      treatment.

PMID- 2239477
TI  - Parkinson's disease, motoneuron disease and Alzheimer's disease: origins and
      interrelationship.
AB  - The cause of neurodegenerative disease is considered. For Alzheimer's disease,
      Parkinson's disease, and motoneuron disease, accumulating evidence over the last
      3 years indicates that (a) the usual etiological mechanisms involve a subclinical
      lesion which kills some neurons and reduces the life expectation of their
      surviving neighbors, and (b) there may be more than one cause for each of the
      idiopathic syndromes now termed AD, PD, and MND.

PMID- 2239478
TI  - Motor response complications with chronic levodopa therapy.

PMID- 2239480
TI  - Longitudinal study of effects of early levodopa treatment on disability and
      mortality in Parkinson's disease.

PMID- 2239479
TI  - Utilization of antiparkinsonian drugs in Sweden, 1974-1987.

PMID- 2239482
TI  - Parkinson's disease mortality: preliminary report.

PMID- 2239481
TI  - Psychiatric complications and shift of death age in Parkinson's disease.

PMID- 2239483
TI  - Bromocriptine and levodopa in early combination in Parkinson's disease: first
      results of the Collaborative European Multicentric Trial.

PMID- 2239485
TI  - Autonomic nervous system disturbances in Parkinson's disease.

PMID- 2239484
TI  - Vitamin E therapy in Parkinson's disease.

PMID- 2239486
TI  - Levodopa treatment of Parkinson's syndrome: past and future.

PMID- 2239487
TI  - Madopar HBS (hydrodynamically balanced system) in the treatment of Parkinson's
      disease.

PMID- 2239488
TI  - Inhibitors of dopamine inactivating systems as antiparkinson drugs.

PMID- 2239489
TI  - Catechol-O-methyltransferase and its role in catecholamine metabolism.

PMID- 2239490
TI  - Ro 40-7592, a novel, very potent, and orally active inhibitor of catechol-O
      methyltransferase: a pharmacological study in rats.

PMID- 2239491
TI  - Clinical and pathological features of corticobasal degeneration.

PMID- 2239492
TI  - Controlled-release dopamine polymers as a novel approach to the treatment of
      Parkinson's disease.

PMID- 2239493
TI  - Madopar HBS in nocturnal symptoms of Parkinson's disease.
AB  - Madopar Hydrodynamically Balanced System (HBS), a new sustained-release levodopa
      preparation, was used to control severe nightly disabilities in 15 outpatients
      suffering from Parkinson's disease in an advanced state and with long-term
      levodopa therapy. This medication was given ante noctem in addition to an
      otherwise unchanged daily regimen of levodopa administration. In 13 patients a
      considerable diminution in nocturnal akinesia and in the frequency of waking up
      was reached with a mean dosage of 308 mg of Madopar HBS. Early morning akinesia
      was only slightly alleviated in four patients. The nocturnal off-period pain
      disappeared in one patient. Adverse effects consisted of nocturnal dyskinesia in
      two patients and early morning dystonia in another two patients. The regular use
      of sleeping pills was clearly reduced after Madopar HBS therapy.

PMID- 2239494
TI  - Clinical experience with cabergoline, a new ergoline derivative, in the treatment
      of Parkinson's disease.

PMID- 2239495
TI  - The clinical benefit of NADH as stimulator of endogenous L-dopa biosynthesis in
      parkinsonian patients.

PMID- 2239496
TI  - Adrenal neural transplants in Parkinson's disease.

PMID- 2239498
TI  - Adrenal medullary tissue transplantation in Parkinson's disease: a review.

PMID- 2239497
TI  - Adrenal medullary transplants as a treatment for Parkinson's disease.

PMID- 2239499
TI  - Methods in teaching consultation-liaison psychiatry.

PMID- 2239500
TI  - Consultation-liaison models for teaching psychiatry to primary care physicians.

PMID- 2239501
TI  - Models for the assessment of clinical performance in consultation-liaison
      services.

PMID- 2239502
TI  - Models for research in consultation psychiatry.

PMID- 2239504
TI  - Training issues at the interface between consultation-liaison psychiatry and
      behavioral medicine.

PMID- 2239503
TI  - A family-systems model for consultation psychiatry.

PMID- 2239505
TI  - Consultation-liaison education in a community hospital setting.

PMID- 2239506
TI  - The three-function model of the medical interview. An educational device.

PMID- 2239507
TI  - Training physicians in the clinical evaluation of the suicidal patient.

PMID- 2239508
TI  - [Birth weight of newborn infants in relation to body height and body weight of
      parents with special reference to duration of pregnancy].
AB  - Using the data of the 1985 GDR somatogram standards (birthweight percentiles
      calculated from 51,570 liveborn singletons) the impact of parental weight and
      length on the birthweight were calculated. Peristatic factors in combination with
      the genetic 'anlage' act first of all via maternal weight. Body height and/or
      length of mother and father are more representative for the genetic constitution.
      Their impact on neonatal weight seems to be less significant, however
      statistically calculable. The paternal 'anlage' is relatively modified by the
      intrauterine environment (maternal constitution).

PMID- 2239509
TI  - [Psychophysical prerequisites and mental performance of school children].
AB  - By extensive investigations and statistical calculations it is possible to
      establish the psychophysical prerequisites for performance, which consist of
      "mental processing speed" and "vegetative reactivity". These can be developed by
      training and thus contribute to improved mental performance.

PMID- 2239510
TI  - [Early psychological diagnosis in children with brain damage].
AB  - Considerations of the essential aspects of establishing diagnosis are explained
      fro a psychologist's point of view who has the possibility of observing the
      course of all children with cerebral injury registered early in the district
      polyclinic. Their qualitative performance parameters are evaluated, especially
      attention and the mother-child relation. Subsequently, we discuss the courses of
      development for 130 children who attended a rehabilitation nursery, and refer to
      constellations of symptoms which rendered it more difficult to establish early
      diagnoses.

PMID- 2239511
TI  - [Longitudinal study of early intervention, clinical course and school performance
      of mildly retarded kindergarten children].
AB  - Two groups of 6-8 children aged 3-4 years with a mental retardation of 6 to 9
      months were educated in special Kindergarten groups for one year. The effects
      were checked three times during the year and in the children's third or fourth
      year at school. A control group matched for age and mental development continued
      in the Kindergarten as usual and was checked in the same way. As we had supposed,
      the children in the small groups demonstrated better results in their mental and
      behavioural development after one year of special education. There was also some
      evidence that it had a positive effect up to the age of 10 years. The positive
      effect on their behaviour was more pronounced (according to psychological
      examinations, school marks and questionnaires for teachers and mothers) than on
      their intellectual performance. Thus, special education in small groups can
      promote a more harmonious development of the personality of slightly retarded
      children.

PMID- 2239512
TI  - [Psychophysical status of high school graduates. Results of sociologic studies].
AB  - This article intends to describe the present state and development of the
      psychophysical state of health of GDR graduates. Special attention is given to
      various quantities influencing the state of health, above all job-related
      determinants. The empirical basis is an interval study, carried out by the
      Zentralinstitut fur Jugendforschung Leipzig; this study registered and attended
      hundred of people from the beginning of their studies in 1970 during the
      following 15 years in seven intervals. Preferably social factors and determinants
      were studied empirically and partly problematical interrelations between health
      and working conditions and contents as well as critical development trends of
      health were pointed out. In this way important starting points for taking
      measures to influence exogene health determinants were fixed: especially
      questions of working contents, of correct appointment of graduates corresponding
      to their profession and qualification, of a permanent training of psycho-physical
      capabilities.

PMID- 2239513
TI  - [Effects of health education intervention on the physical activity of
      adolescents].
AB  - A report is given about the results of physical activities in spare time and the
      physical capacities of 967 pupils of the 7th to 10th form. These pupils were
      asked and examined in 1987 in the country of Hohenmolsen. Particularly, the
      results are compared with the basic investigation on pupils of the same age in
      1983. Nearly half of the pupils finished an interventional programme. The other
      part served as a control group. The comparison of both cross-section
      investigations even as the statements of a longitudinal-section study and a cross
      section study from 1985 documented a good up to a very good increase of physical
      activities in spare time and physical capacities with regard to the complex test
      and long-distance race, especially at girls. The control group also shows an
      increase of the examined parameters. Finally, aspects for the improvement of the
      results in both groups are discussed.

PMID- 2239515
TI  - Facial disfigurement: problems and management of social interaction and
      implications for mental health.
AB  - The concern of this article is with the impact of facial disfigurement on social
      interaction during brief encounters, the ramifications of which have the
      potential for psychological and social destruction. Largely ignored by those
      interested in the social and psychological problems and rehabilitation of the
      functionally impaired, such as the blind, the deaf, the amputee, the intent here
      is to point up the major problems associated with facial disfigurement and to
      explore some of the ways of dealing with them. The data on which this article is
      based were collected over many years and are no longer new, but this attempt to
      synthesize them for a particular purpose is.

PMID- 2239514
TI  - Dermal and subdermal tissue filling with fetal connective tissue and cartilage,
      collagen, and silicone: experimental study in the pig compared with clinical
      results. A new technique of dermis mini-autograft injections.
AB  - The early reaction to the injection of silicone, collagen, and lyophilized
      heterologous fetal connective and cartilage tissues into the limiting zone deep
      dermis-superficial subcutaneous tissue was histologically examined in the pig and
      compared with clinical results. The inflammatory reaction to lyophilized
      heterologous fetal tissue is considerably more intense than that to collagen and
      silicone and lasts for several weeks. Therefore, it is not recommended for soft
      tissue filling in the face. Admitting an inferior antigenicity of fetal tissues,
      the authors suggest that enzymatically denaturalized collagen should be
      manufactured from heterologous fetal connective tissue, to be then further
      tested. The reaction of tissue to silicone and collagen is minimal. Silicone is
      preferred for dermal injections since in clinical experience it remains in the
      site of injection much longer. For subdermal injections, however, collagen is
      preferred. Based on experience with over 600 patients since 1958, the first
      author continues using liquid silicone. The lack of complications is probably a
      result of the fact that only small amounts (milliliters) of silicone were used in
      wrinkles or small depressions in the dermal layer and that from the beginning
      injection into the subcutaneous tissue was avoided. Since 1988 a new technique
      for the treatment of wrinkles and skin depressions with injections of dermal
      miniautografts has been used with satisfactory results.

PMID- 2239516
TI  - Circumferential liposuction of calves and ankles.
AB  - Calf and ankle liposuction was performed on 110 patients for a total of 166
      cases. Only 84% of these patients were satisfied with the results compared with
      98% of those who underwent liposuction in other parts of the body. The author
      presents statistics and explains the criteria used to select patients for
      treatment. Selection is partly based on the preoperative thickness of
      subcutaneous fat. He also outlines the minimum amount of fat that should be
      reserved to avoid postoperative skin irregularity. The difficulties encountered
      during liposuction that are caused by the anatomical characteristics of the
      calves and ankles are discussed, and suggestions for solving such problems are
      presented. The author also describes special instruments he designed.

PMID- 2239517
TI  - Suction-assisted lipectomy of the upper arm: a four-cannula technique.
AB  - A new technique for suction-assisted lipectomy of the upper arm is described. It
      uses four separate cannulas of varying lengths, all with an internal diameter of
      only 3.0 mm. Only a single incision is required. The benefits include the
      elimination of the complication of excessive fat suctioned from the middle of the
      arm, reduced scarring, and reduced surgical time. The patient recovers quickly
      with less bruising and more comfort. Results are pleasing with virtually no
      complications.

PMID- 2239518
TI  - Aesthetic improvement of the forehead utilizing methylmethacrylate onlay
      implants.
AB  - Forehead augmentation occasionally is necessary for obtaining a desirable upper
      facial contour. The final contour must be sexually appropriate and must project
      beyond the cornea of the eyes an amount that makes the contour aesthetically
      pleasing. Methylmethacrylate onlay implants, preformed or sculpted at the time of
      surgery, lend themselves to obtaining a desirable contour which can be modified
      easily at surgery, which is completed in a one-stage procedure, has few
      complications, and yields an aesthetically pleasing result. The methods for
      fabricating and implanting the onlay prosthesis in a single step and the results
      of such procedures, which have been performed over a 12-year period without
      complications, are presented.

PMID- 2239519
TI  - Dye laser treatment of port-wine stains.
AB  - The author treated 456 cases of port-wine stains using a tunable dye laser (577
      nm wavelength, 1-microsecond pulse, 2-3-mm diameter spot), and followed up 22
      cases for a year or more after the initial treatment. The treatment was regarded
      as effective in 80.5% of the abnormal lesions. The results were influenced by
      location: good results were achieved in the neck region and face, but results in
      the extremities were poor. The dye laser can achieve selective injury to abnormal
      vessels of port-wine stains while inflicting less damage to the overlying dermis
      than the argon laser. Therefore, dye laser treatment for port-wine stains is more
      effective than argon laser treatment.

PMID- 2239520
TI  - An improved draping method for otoplastic surgery.
AB  - An alternative method of draping of the ears is presented in which a mesh gauze
      dressing is used as an adjunctive method for restraining hair from the surgical
      field. Its use is rapid and permits exposure and visibility of the ears
      bilaterally.

PMID- 2239521
TI  - Patients seeking symmetrical recontouring for "perceived" deformities in the
      width of the face and skull.

PMID- 2239522
TI  - Early history of lipoplasty in the United States.

PMID- 2239523
TI  - A critical look at blood samples in CB and COAD.
AB  - Few studies have utilized measurements of blood variables to estimate the
      clinical activity of chronic bronchitis in relation to clinical trials. In one
      study, we have followed such patients with repeated measurements of serum levels
      of lactoferrin, myeloperoxidase and lysozyme as markers of neutrophil and
      monocyte/macrophage activity. We showed that these patients have raised lysozyme
      levels, as signs of ongoing activation of the macrophage population, irrespective
      of the presence of infectious exacerbations. Lactoferrin and myeloperoxidase
      levels, on the other hand, showed large variations with peaks mostly coinciding
      with the infectious exacerbations. In another study, we made repeated
      measurements during a 6-months' period of a number of neutrophil activities.
      These data showed increased activities with respect to migration and oxidative
      metabolism during the period of increased numbers of infectious exacerbations.
      All but one variable became normal during periods of few infectious. Thus, the
      lucigenin-enhanced chemiluminescence was subnormal during this period suggesting
      an abnormality of neutrophil oxidative metabolism in patients with chronic
      bronchitis. We conclude that the monitoring of markers of inflammatory cell
      activity in serum may be useful as indicators of the clinical activity of chronic
      bronchitis and that the measurement of functional activities of the neutrophil is
      dependent on seasonal variations in the exposure to infectious agents in the
      community.

PMID- 2239524
TI  - Airway pathology of functional significance in chronic bronchitis and chronic
      obstructive airway disease.
AB  - The three major hypothesis for reduction in the calibre of the peripheral airways
      in chronic obstructive lung disease are 1) a loss of elastic recoil in the
      alveolar supporting structure, 2) destruction of the alveolar attachments to the
      outer wall of the small airways, and 3) a chronic inflammatory process in the
      wall and lumen of the peripheral airways. This presentation is based on the
      analysis of an ongoing study where lung function has been measured a few days
      prior to lung resection. The data collected to date support the third hypothesis
      and are of interest in developing strategies to treat patients with COAD because
      they suggest that therapy should be directed at preventing the inflammatory
      process in the peripheral airways rather than the prevention of lung destruction
      by emphysema.

PMID- 2239525
TI  - A critical view on lavage sampling techniques.
AB  - The constituents of the liquid aspirated in bronchoalveolar lavage are determined
      by the distribution of the fluid within the bronchial tree, the diffusion through
      membranes and the dilution by body fluids. Small volume lavages, sample cells,
      and soluble constituents from the surfaces of the proximal bronchial tree, and
      usually contain fewer cells than large volume bronchoalveolar lavages.

PMID- 2239526
TI  - Assessment of soluble parameters in sputum.
AB  - The concentrations of soluble protein in lung secretions are dependent upon the
      degree of inflammation, local production and cell activation. Infections and
      corticosteroid therapy will alter the protein content of lung secretions as a
      result of their effect on lung inflammation.

PMID- 2239527
TI  - Sputum cell counts in airway disease: a useful sampling technique.
AB  - Quantitative sputum cell counts from patients with asthma and chronic bronchitis
      were performed and found to be reproducible. Sputum from carefully characterized
      subjects with asthma contained large numbers of eosinophils and formalin
      sensitive metachromatic (mast) cells. In contrast, the macrophage was the
      dominant cell type in the sputum from smokers with chronic bronchitis. In a third
      group of patients with corticosteroid responsive-chronic cough and normal
      methacholine airway responsiveness the sputum contained eosinophils and
      metachromatic cells, similar to the asthmatic subjects. Sputum cell counts are a
      useful, noninvasive method for the identification of this pattern of inflammatory
      response in patients with airway diseases.

PMID- 2239528
TI  - Bronchial biopsies in drug intervention studies in CB and COAD.
AB  - So far, little information is available on the usefulness of the biopsy method in
      drug intervention studies in COAD and CB. Quantitation studies at electron
      microscopical level are time consuming. Comparative studies between and within
      the patient groups are needed to attain basic and clinically relevant
      information. Pathology studies may lead to a better understanding of basic
      pathophysiological mechanisms behind the diseases. The sequences of cellular
      events could be revealed so that morphology may be useful in intervention
      studies.

PMID- 2239529
TI  - Inflammatory indices for chronic bronchitis and chronic obstructive airway
      disease. Cell populations in bronchial and bronchoalveolar lavage.
AB  - The development of chronic bronchitis (CB) and chronic obstructive airway disease
      (COAD) seems to be related to inflammatory changes of airway structure. However,
      the cause and the exact location and type of these changes resulting in altered
      airway function are not known. Mucosal inflammation is characterized by the
      recruitment of granulocytes, macrophages and lymphocytes as well as by the
      shedding of epithelial cells. The present chapter discusses the usefulness of
      bronchial lavage (BL; 50 ml of lavage volume) directly followed by
      bronchoalveolar lavage (BAL; 200 ml), for the characterization and quantification
      of inflammation in proximal and peripheral airways, respectively. On the basis of
      results from the literature and a pilot study on CB patients with or without
      coexisting COAD, the following conclusions may be drawn: There is a profound
      difference in lavage cell composition and numbers between non-smokers and
      smokers. However, within the group of smokers there are few additional changes in
      cell numbers and composition when concomitant airway disease is present. The
      obstruction of the COAD patients is correlated to a reduced recovery of BL and
      BAL fluid. Furthermore, these patients seem to have a reduced number of most cell
      types in their BL. This diminitution is not just related to the reduced fluid
      recovery. The BL cells have a lower viability and BL macrophages have a reduced
      phagocytic capacity when compared with matching BAL cells. The viability of cells
      was lowest in BL from the COAD group. These findings may suggest that COAD
      entails a reduced transport of macrophages to the small airways and/or an
      enhanced turnover of these cells in the bronchi. Functional studies of lavage
      cells may supply additional, and perhaps more specific, information on the
      mechanisms involved in the inflammatory process.

PMID- 2239530
TI  - The generation of reactive oxygen-derived species by phagocytes.
AB  - The generation of reactive oxygen-derived species is one main constituent of the
      microbicidal activity of professional phagocytes. This process is known as the
      respiratory or the oxidative burst. It is initiated by a cyanide- and azide
      insensitive increase in O2-consumption and the concomitant generation of
      superoxide radicals catalyzed by a membrane-localized NADPH oxidase which is
      triggered by an appropriate stimulation of the cells. The generated O2 is
      converted to hydrogen peroxide, hydroxyl radicals and other reactive products of
      oxygen which, if released extracellularly (for example in connection with
      frustrated phagocytosis), are potentially harmful to the tissue. The oxidative
      burst is not necessarily dependent on phagocytosis, nor is it necessarily
      associated with degranulation. Therefore, the process constitutes an important
      independent variable of phagocyte activity, and researches aiming to characterize
      various forms of airway inflammation may derive valuable information from an
      examination of the oxidative burst.

PMID- 2239531
TI  - Assessment of long-term changes in airway function.
AB  - There is some evidence supporting long-term 'tracking' of decline in FEV1 at
      least in middle-aged male smokers, so that a moderately reduced FEV1 predicts
      subsequent disability and death. Distribution of individual rates of decline in
      FEV1 stabilizes after follow-up for 4 to 5 years, but large and unexplained
      differences in decline in FEV1 are found between individuals with similar smoking
      history. There are theoretical advantages to following post-bronchodilator FEV1
      but few studies of its usefulness are available. Changes in other tests derived
      from the single breath N2 test or the maximum expiratory flow-volume curve have
      been less informative than originally postulated and their long-term prognostic
      value remains unknown.

PMID- 2239532
TI  - Inflammatory indices in chronic bronchitis. Monocyte-macrophage microbicidal
      activity.
AB  - Alveolar macrophages are important to the host defence of the lower airways. In
      smokers and patients with chronic bronchitis, important defects of blood monocyte
      functions have been identified, which may explain the increased incidence of
      pulmonary infections in these patients. Upon chronic stimulation, e.g. from
      tobacco smoke, disease may progress and macrophage activity is probably involved
      in the tissue damage of chronic bronchitis. As regards microbicidal activity of
      macrophages in patients with chronic bronchitis, no studies are available.
      Following pharmacological intervention, it is probably more reliable to measure
      specific components of macrophage metabolic and secretory activities, which are
      associated with microbicidal events, than to assess over-all microbicidal
      activity.

PMID- 2239533
TI  - Indices of inflammatory activity in CB and COAD. Phagocyte secretion and
      chemotaxis.
AB  - The monitoring of inflammatory activity in the lungs of patients with chronic
      obstructive airways disease may be accomplished by the measurement of specific
      markers of inflammatory cell activity such as the eosinophil cationic protein and
      the neutrophil-derived myeloperoxidase. However, no specific marker, which
      reflects the activity of the alveolar macrophage, is available. Eosinophil and
      neutrophil chemotactic activity may be detected in broncho-alveolar fluid as a
      sign of macrophage activity. We report preliminary data, which indicate that both
      chemotactic activities are elevated in patients with chronic bronchitis. The
      predominant activities elute at a molecular weight of about 10 kDa but also at a
      position after the total volume of the column. We conclude that secretory
      products from inflammatory cells may be measured in broncho-alveolar fluid from
      patients with chronic bronchitis. Whether such measurements will prove useful in
      relation to therapeutic trials in these patients is not known but is most likely.

PMID- 2239534
TI  - Inflammatory indices for chronic bronchitis and COAD. Proteases and
      antiproteases.
AB  - The study of lung secretion proteinases and their inhibitors, both functionally
      and quantitatively, provide information concerning the degree of inflammation in
      the lung. Interpretation of individual parameters may be difficult in isolation.
      However, a general pattern of response provides supportive evidence of a
      reduction in lung inflammation, including 1) reduction in plasma inhibitor
      concentrations, 2) increase in local inhibitor concentrations, 3) increase in
      enzyme inhibition, and 4) reduction in enzyme activity. Thus such changes provide
      an objective basis for the assessment of drug therapy.

PMID- 2239535
TI  - Exudative indices in airways inflammation.
AB  - Airways inflammation has come to be equated with the presence of inflammatory
      cells and their products in airway lumen and tissue. However, the inflammatory
      condition must also, or rather, be determined by indices which show to what
      degree the tissue itself is affected by the process. Plasma exudation from
      abundant subepithelial microvessels is a specific defence/inflammatory tissue
      response to mucosal provocations; promptly after extravasation, the plasma
      exudate reversibly and non-injuriously creates intercellular pathways across the
      mucosa; the exudate enters the airway lumen without compromising the epithelial
      lining as a barrier to luminal solutes; there is a good correlation between
      surface and tissue plasma exudates. I propose that plasma tracers on the mucosal
      surface can identify the ongoing airway inflammation, its intensity and time
      course in great detail.

PMID- 2239536
TI  - The measuring of "respiratory-membrane permeability" and local production of
      immunoglobulins and antibodies by means of an analysis of sputum.
AB  - When measuring the exudation of serum proteins and the local production of
      immunoglobulins and antibodies within the lung by means of an analysis of sputum,
      the permeability properties of the respiratory membrane should be taken into
      account. In this paper, we describe the "loss of size selectivity" that usually
      accompanies an increased permeability on the part of the respiratory membrane.
      This phenomenon enables us to measure respiratory membrane permeability
      independently of the sputum water content. Consequences with regard to
      discrimination between leakage from the circulation and/or local production of
      immunoglobulins and antibodies are discussed. Sequential studies which take these
      factors into account may provide insights into the extent of local inflammatory
      reactions in individual patients.

PMID- 2239537
TI  - A critical look at mucus markers.
AB  - Methods of collecting tracheobronchial secretions in conditions such as chronic
      bronchitis are reviewed. The virtual absence of such secretions in healthy lungs
      means that there is no normal baseline for comparison. In addition, the
      inaccuracy of most of the methods does not allow good quantitation of secretory
      output. A large number of physical and chemical analyses of secretions in many
      airways diseases does not point to any variables which are specific for the
      diagnosis of chronic bronchitis. This may be in part due to the contamination of
      glandular secretion by epithelial secretion, transudation and cellular debris.
      However, studies on mucus may be of value in following the course of disease and
      its response in therapy.

PMID- 2239538
TI  - Points of importance in long term intervention studies in CB/COAD.

PMID- 2239539
TI  - Which markers of inflammation should be used in therapeutic intervention studies
      of CB/COAD?

PMID- 2239540
TI  - The role of measurements of airway responsiveness.
AB  - In smokers with chronic airflow limitation (CAL), airway hyperresponsiveness
      (AHR) to stimuli like methacholine, which act directly on airway smooth muscle,
      are not specific for the pathogenesis which is responsible for AHR to
      methacholine in subjects with normal spirometry, nor predictive for a beneficial
      effect of glucocorticosteroid (GCS) treatment. In contrast, AHR to stimuli like
      hyperventilation, which act indirectly through mediator release, may be specific
      for the pathogenesis of asthma and predictive for a beneficial effect of GCS. The
      validation of this possibility requires the demonstration that patients with CAL
      and AHR to hyper-ventilation demonstrate improvement after treatment with GCS
      (and have an increase in eosinophils and metachromatic cells in the sputum or
      bronchoalveolar lavage (BAL), like that seen in asthmatics uncomplicated by CAL).

PMID- 2239541
TI  - Effects of corticosteroids in "chronic bronchitis" and "chronic obstructive
      airway disease".
AB  - In order to improve our knowledge concerning the supposedly beneficial effects of
      corticosteroids in patients with "chronic bronchitis" and "chronic obstructive
      airway disease" (COAD), it is necessary to define our patients carefully, so that
      every investigator can interpret the data adequately. Up to now, no definite
      conclusion can be drawn as to the profitable effect of corticosteroids in COAD. A
      combination of data from many studies on oral and inhaled corticosteroids
      strongly suggests that long-term studies in large groups of patients are
      essential if we wish to determine a potential treatment effect. In this way, a
      sub-group of patients who improve on corticosteroids may be found too. In
      addition to objective measurements, e.g. degree of airflow obstruction and airway
      hyperresponsiveness (AH), subjective data and information on the patient's
      quality of life and exacerbations should be included for evaluation.

PMID- 2239542
TI  - Epidemiology of obstruction, exacerbations and hyperreactivity. Effects of
      glucocorticosteroids and other anti-inflammatory treatment.
AB  - Validated and standardized questions are available for self-reporting of
      exacerbations of symptoms due to bronchopulmonary infections but not for non
      infective exacerbations. The presence of non-specific bronchial
      hyperresponsiveness may help to identify smokers with a high risk of rapid
      decline in lung function, but change in bronchial responsiveness with treatment
      probably cannot be used to predict subsequent long-term progression in FEV1. In
      non-asthmatic individuals three months' treatment with glucocorticosteroids has
      not improved FEV1 nor reduced bronchial responsiveness; the effects of
      glucocorticosteroids on bronchial secretions and infections and long-term decline
      in FEV1 are largely unknown.

PMID- 2239543
TI  - Airways hyperreactivity, bronchial inflammation and obstructive lung disease.
AB  - Understanding the mechanisms responsible for the development of chronic airflow
      obstruction is very important since this disease is the fifth leading cause of
      death in the United States and it produces a significant economic and social
      burden for society. Since reversal of established airflow obstruction is not
      possible, it would appear that the best prognosis and therapeutic results can be
      obtained by early diagnosis and prevention of irreversible disease. Understanding
      the underlying pathophysiologic mechanisms is necessary to detect susceptible
      individuals and develop effective interventions.

PMID- 2239544
TI  - Clinical trials in asthma and chronic airflow obstruction.
AB  - Clinical trials are becoming increasingly important in objectively evaluating
      therapeutic interventions in pulmonary medicine. Although the overall methodology
      for clinical trials is similar for most diseases, there are specific questions
      and problems unique to pulmonary medicine. This review is limited to a discussion
      of the general design and commonly encountered "problems and pitfalls" for
      clinical trials in respiratory medicine. Three examples of designs for
      intervention in asthma and chronic obstructive airways disease are presented.

PMID- 2239545
TI  - Inflammatory indices in chronic bronchitis.

PMID- 2239546
TI  - [Recent advances in the virological diagnosis of ocular disease].

PMID- 2239547
TI  - [Optic nerve finding in experimental retinitis induced by herpes simplex virus].
AB  - We reported histological changes and viral localization of HSV-1 in the optic
      nerve by the ABC-method and electron microscopy, after intravitreal inoculation.
      There was neither histological change nor antigen deposition on the specimen of 3
      days after inoculation. Some series of antigen-positive sites were successively
      found along the nerve fiber from the lamina cribrosa to the optic chiasma in the
      optic nerve on 4 days after inoculation. Round cell infiltration were also found
      around these sites, and these changes increased on the 8th day. Antigen-positive
      cells were mainly considered to be oligodendroglia and astrocytes. These results
      suggested that HSV-1 infected the optic nerve fiber via the retina. On the way to
      be the brain by axonal transport, they would infiltrate to the glial cells, where
      they could replicate and spread to neighbouring glial cells.

PMID- 2239548
TI  - [Chronic organophosphorus intoxication and aging in rats].
AB  - Possible acceleration of aging due to the administration of organophosphorus
      pesticide (OP) was studied. Fenthion (6 mg/kg/day) was subcutaneously
      administered dorsally to rats over a period of 12 weeks. The amounts of
      fluorescent lipid peroxidation products (FLPP) and superoxide dismutase (SOD)
      activity were measured in various tissues. Microscopic examination was added only
      in the lens. The amount of FLPP in the retina-choroid, lens, kidney and heart of
      the rats was found to be increased (lens; p less than 0.01, kidney; p less than
      0.05). The activity of SOD in the retina-choroid, optic nerve, liver and heart
      increased temporarily, but eventually returned to control levels. The lens
      preparations at the end of the 12-week administration period showed irregular bow
      configuration and epithelial nuclear dislocation in the bow area. FLPP are
      fluorescent products produced by peroxide lipids and their amounts increase with
      aging. Increase in the amounts of these products and microscopic findings for the
      lens were indications of the progress of aging. There is thus the possibility
      that the inducement of SOD production may decrease with aging. It was concluded
      that the organophosphorus pesticide may accelerate the aging of rats.

PMID- 2239549
TI  - [Rapid etiologic diagnosis of epidemic keratoconjunctivitis].
AB  - We evaluated enzyme-linked immunosorbent assay (Adenoclone) in 253 cases of
      epidemic keratoconjunctivitis (EKC), pharyngeal conjunctival fever (PCF) and
      acute conjunctivitis. The clinical diagnosis due to adenoviral ocular infection
      was 86/114 (75%) in EKC, 26/50 (52%) in PCF and 25/89 (28%) in acute
      conjunctivitis, Adenoclone was positive only within 7 days after the disease
      onset. The specificity (87%) and sensitivity (74%) of Adenoclone were confirmed
      by isolate cell culture. Cases with corneal complication due to adenoviral
      infection show higher a value than the OD value in Adenoclone and the bulbar
      conjunctiva is a suitable site to detect adenoviral antigen. In this survey,
      isolated adnovirus type 4 was recognized in 53%, Ad8 in 14%, Ad3 in 13%, Ad37 in
      5%, Ad19 in 2% and non typed Ad in 12%. Clinical findings due to Ad4 showed EKC
      in 50%, PCF in 30% and acute conjunctivitis in 20% respectively.

PMID- 2239550
TI  - [Clinical features of uveitis in childhood during the past 20 years].
AB  - One hundred and fifty five cases (237 eyes) of children with uveitis were
      clinically observed in the past 20 years. There was no fluctuation in the number
      of patients during the period. Concerning the age as the first visit, the
      smallest group was under 4 years of age and the numbers of patients increased at
      ages 14 and 15. Chief complaints usually corresponded to the age of the cases.
      Cases with anterior uveitis accounted for 25% of all cases, intermediate uveitis
      12%, posterior uveitis 45% and panuveitis consisted of 17% of all cases,
      respectively. In the course of treatment, improvement of visual acuity was not
      statistically significant; the visual prognosis of cases affected under age 7
      years was relatively poor. At the time of final observation, the visual acuity of
      cases, who had first visited during the past 10 years, were better than those who
      presented during the previous decade. Uveitis had healed or improved in 68% of
      cases treated in our clinic. As complications, band-shaped keratopathy was seen
      in 8% of the patients, cataract in 22% and glaucoma in 5%, respectively. Thirty
      two per cent of the cases received systemic steroid therapy and the average
      duration was 3.8 months. Fifty two operations were performed in 30 cases (19%),
      37 eyes (16%); 16 were cataract operations and 24 were operations for glaucoma.

PMID- 2239551
TI  - [Retinochoroidal changes in toxemia of pregnancy with the relation to
      hypertensive retinopathy and choroidopathy].
AB  - Thirty patients who suffered from ocular involvement caused by toxemia of
      pregnancy were examined ophthalmologically during the nine-year period between
      1980 and 1988 at Osaka Medical Center and Research Institute for Maternal and
      Child Health. The ophthalmoscopic findings were divided into the following five
      categories: cotton wool patches (CWP), retinal hemorrhages (RH), hard exudates
      (HE), yellowish opaque foci (YOF) and serous retinal detachments (SRD). Although
      the first three types of findings were recognized as hypertensive retinopathy
      (Keith-Wagener III or IV), the last two were recognized as choroidal vascular
      damage. Based on the frequency of fundus findings, patients were divided into
      three types: R-type mainly suffered from retinal vascular occlusion (CWP), C-type
      mainly suffered from choroidal vascular occlusion (YOF, SRD), and R + C-type
      consisted of mixed vascular occlusion. The maximum systolic blood pressure of C
      type patients was significantly lower than that of R-type. The maximum diastolic
      blood pressure of C-type patients was also significantly lower than those of R
      type and R + C-type. There were five C-type cases with systolic blood pressure of
      less than 160 mmHg in which the choroidal ischemia was concluded not to be
      hypertensive choroidopathy but a specific alteration characterized by toxemia of
      pregnancy (hypercoagulopathy).

PMID- 2239552
TI  - [Treatment and prognosis of retinoblastoma from 1975 to 1987].
AB  - Among 21 cases of retinoblastoma (28 eyes) treated during the past 14 years in
      our clinic, 14 cases were unilateral, and 7 were bilateral. The average ages at
      the first visit were 27 months in unilateral cases and 7.2 months in bilateral
      cases. In all unilateral cases, in all of which the tumors were large (over group
      III according to Reese's classification), we removed the affected eye, and all
      patients survived without any evidence of metastasis or recurrence during a 5
      year follow-up period. In bilateral cases, we removed the advanced eyes in which
      the tumors were large (over group III according to Reese's classification) in all
      cases, and the contralateral eyes underwent conservative treatment by
      radiotherapy, photocoagulation or chemotherapy. When tumors in contralateral eyes
      were small (Group I or II in Reese's classification), tumors of the retina
      subsided and all patients survived without recurrence or metastasis. However,
      when the tumors were large (group V), tumors of retina did not subside and
      survival was very poor. Our results show that the prognosis for survival in
      bilateral cases depends mainly upon the size of the tumor in the remaining eye.

PMID- 2239553
TI  - [Interferon-alpha for the treatment of retinal vasculitis associated with human T
      lymphotropic virus type I myelopathy (HAM)].
AB  - Interferon-alpha was effective for the treatment of retinal vasculitis and
      vitreous opacity in a patient with human T-lymphotropic virus type I associated
      myelopathy (HAM). The patient was a 40-year-old male with retinal vasculitis,
      vitreous opacity and Koeppe's iris nodules. Systemic administration of
      corticosteroid hormone was not fully effective for the treatment of ocular
      involvements except for iris nodules. After Interferon-alpha treatment, given 3
      million IU/day as the intramuscular injection for 4 weeks, the retinal vasculitis
      subsided and vitreous opacity disappeared.

PMID- 2239554
TI  - [Clinical study of risk factors concerning arteriosclerosis of the patients
      undergoing hemodialysis].
AB  - To study the risk factors of arteriosclerosis of the patients undergoing
      hemodialysis, aortic pulse wave velocity (PWV) was measured in 42 patients (26
      male and 16 female) undergoing hemodialysis. The relationships were examined
      between PWV value and various risk factors, such as age, blood pressure, serum
      lipid level and aortic calcification index (ACI). PWV value was elevated with age
      and it was higher in the patients group than the age-matched control subjects.
      There was a statistically significant correlation between PWV value and blood
      pressure. The effect of elastase on PWV value was found in the patients with high
      PWV value (over 9.0 m/sec). However, no correlations were found between PWV value
      and serum lipid level such as total cholesterol, triglyceride, HDL-cholesterol
      and beta-lipoprotein. On the other hand, PWV value was changeable according to
      ACI and this relationship was statistically significant (p less than 0.01). These
      results suggested that aortic calcification could be one risk factor for
      arteriosclerosis of the patients with chronic renal failure undergoing
      hemodialysis.

PMID- 2239555
TI  - A clinical study of total cystectomy for transitional cell carcinoma of the
      urinary bladder.
AB  - Fifty six patients with transitional cell carcinoma of the urinary bladder were
      treated by total cystectomy from January, 1979 through December, 1988. A
      retrospective study was conducted on 52 patients on whom prognosis could be
      followed up. There were 40 men and 12 women (male to female ratio: 3.3: 1),
      between 32 and 79 years old (mean age, 64.1 years old). The overall 1-, 3- and 5
      year survival rates were 65.8%, 54.1% and 43.0%, respectively. The 5-year
      survival rates for patients with low grade (G, I, II) and high grade (G. III)
      were 41.9% and 42.7%, respectively: with no significant difference in the
      survival curves between the two groups. The 5-year survival rates according to
      histopathological stage were 78.9% for patients in low stage, 24.7% in high
      stage, and the difference in the survival curves between the two groups was
      statistically significant (P less than 0.001). The mortality in the 21 cases of
      the 33 high stage cases in which cisplatin was used was 42.9%, with 3- and 5-year
      survival rates were 53.1% and 36.8%, respectively. In the remaining 12 cases in
      which cisplatin was not used for post-operative chemotherapy, the mortality in
      the 12 cases was 83.3%, with 3- and 5-year survival rates of 25.1% and 12.3%,
      respectively. Thus, the patients who received post-operative chemotherapy showed
      a better survival rate than those who did not with a significant difference (P
      less than 0.05). The results of the present study suggest the usefulness of post
      operative adjuvant chemotherapy in the high stage case.

PMID- 2239556
TI  - [Ultrasonographic assessment of intravesical urine volume].
AB  - The assessment of intravesical urine volume is very important in the management
      of the patients with lower urinary tract obstruction or incontinence. As the non
      invasive method for measuring residual urine volume, accuracy and usefulness of
      ultrasonographic measurement was evaluated in a total of 116 occasions in
      comparison with the conventional catheter technique. The values of the maximum
      transverse (W), cranio-caudal (H) and antero-posterior distance (D) of the
      inflated bladder were obtained by trans-abdominal scanning. These parameters were
      used for the ellipsoid formula (pi/6 x W x H x D). The ultrasonographic
      measurement of urine volume showed a high coefficiency against the conventional
      catheterized volume (r = 0.9543). Although a mean standard error was 56.3% of the
      actual volume, the amount of residual urine at the target of 50 ml and 100 ml
      could be accurately assessed by ultrasound with an accuracy of 90.5%. The method
      was also valid in follow-up study to monitor the changes of residual urine
      volume. The ultrasonographic assessment of intravesical urine volume is, thus, a
      non-invasive, useful tool in the management of the patients with voiding
      disturbance.

PMID- 2239557
TI  - [The effect of ganglioside on diabetic neurogenic bladder].
AB  - The effect of ganglioside was studied in 6 diabetic patients with neurogenic
      bladder. Ganglioside is glycosphingolipids which seems to be involved in the
      processes of nerve growth, regeneration and tissue reinnervation. The treatment
      consisted in the daily intramuscular administration of 20 mg ganglioside.
      Clinical symptoms, vibration sensation and urodynamic studies were recorded at
      the beginning and 4 weeks later. The clinical responses assessed by subjective
      complaints and vibration sensation were effective, but no statistically
      significant difference in urodynamic studies was obtained. Side effects were not
      observed. In conclusion, ganglioside treatment seems to have a positive effect on
      diabetic neurogenic bladder.

PMID- 2239558
TI  - [A case of retroperitoneal tumor presenting with gross hematuria].
AB  - A case of retroperitoneal tumor presenting with gross hematuria is reported. A 62
      year-old female consulted our clinic with the chief complaint of gross hematuria.
      On physical examination, a goose-egg sized tumor was palpable in the left flank
      region. Drip infusion pyelography and computerized tomographic scan showed left
      retroperitoneal tumor which deviated the left kidney upwards. Percutaneous needle
      biopsy of the tumor revealed no malignancy. Total resection of the tumor was
      performed subsequently. A yellowish solid tumor was macroscopically encapsulated
      by fibrous tissue, weighed 230 g and 6 x 7 x 10 cm. Histopathological diagnosis
      was malignant schwannoma. After operation, the hematuria stopped without any
      treatment and deviation of the left kidney was improved. Soft tissue tumor should
      be treated by adjuvant chemotherapy with irradiation because of its high
      frequency of recurrence and metastasis. Combined chemotherapy with VCR, ADR, CPM
      and DTIC (CYVADIC) was performed and she is in good health at 1 year after
      operation.

PMID- 2239559
TI  - Solitary pancreatic metastasis from renal cell carcinoma.
AB  - A case of asynchronous bilateral renal cell carcinoma with pancreatic metastasis
      is described. Left nephrectomy and tumorectomy in the right kidney were
      performed. Solitary metastasis to the pancreas without symptoms was treated by
      distal pancreatectomy with tumor and splenectomy. Although bilateral renal cell
      carcinomas were histologically renal cell carcinoma (clear cell subtype, grade
      2), the resected pancreatic tumor was renal cell carcinoma with sarcomatoid
      change. Therefore, the metastatic tumor had a more malignant potential than the
      primary tumor. The pancreatic metastasis was seen at 6 years 10 months and 2
      years 6 months after left nephrectomy and enucleation of the right renal tumors,
      respectively. The patient is alive without disease and is being treated by alpha
      interferon for 12 months after distal pancreatectomy. A careful long-term follow
      up of the patient with renal cell carcinoma seems to be necessary.

PMID- 2239560
TI  - [Danazol therapy of endometriosis of the bladder and ureter: a case report].
AB  - Endometriosis of the urinary tract is uncommon. A thirty-year-old woman was
      referred to our hospital, complaining of macrohematuria. Intravenous pyelography
      (IVP) showed bilateral hydro nephrosis. Cystoscopic examination revealed a mass
      around the bilateral ureteral orifice. Danazol therapy was commenced. After 6
      months of therapy, IVP showed the improvement of hydronephrosis of left kidney
      and cystoscopy revealed the resolution of most of the mass in the bladder. For
      definite diagnosis and treatment, danazol therapy is considered to be effective
      for endometriosis, but if secondary fibrosis has occurred, surgical treatment may
      be necessary.

PMID- 2239561
TI  - [A case of everting ectopic ureterocele in child--controversy in the surgical
      treatment].
AB  - A 4-year-old girl with the history of repeated urinary tract infections was
      referred from the pediatric department to our department on January, 1987. Under
      the diagnosis of right ectopic ureterocele of everting type with complete
      duplication of renal unit, the one-stage operation, that is, right hemi
      nephroureterectomy with complete excision of the ureterocele and ureteral stump
      was carried out on January 27, 1987. Reimplantation of the orthotopic mate ureter
      was done because of injury to lower part of the mate ureter during operation,
      although reflux of the mate ureter did not exist. After the operation, the
      voiding symptom became better except for large residual urine volume (300 ml). In
      order to protect renal function, intermittent catheterization was carried out.
      Two years and 8 months after that operation, residual urine volume was reduced to
      20 ml. Judging from the literature and our experience, if the patient is not in a
      severe condition, we recommend one-stage operation, that is, total correction (a
      single operation designed to correct abnormalities of the upper and lower urinary
      tract) for ectopic ureterocele in children.

PMID- 2239562
TI  - [Primary paraganglioma of the urinary bladder: a report of two cases].
AB  - We report two cases of primary paraganglioma of the urinary bladder. Case 1. A 61
      year-old man was hospitalized with the chief complaints of gross hematuria,
      dysuria and headache. The patient had a history of hypertension. Cystoscopy
      disclosed a nonpapillary, sessile tumor in the retrotrigonum of the bladder. An
      attack of paroxysmal hypertension was induced by bimanual palpation of the tumor,
      and paraganglioma was suspected. Partial cystectomy with staging pelvic
      lymphadenectomy was performed. Case 2. A 65-year-old man was hospitalized with
      the chief complaints of gross hematuria and urinary retention. The patient had no
      history of hypertension. Cystoscopy disclosed a nonpapillary tumor in the right
      lateral wall of the bladder. Transurethral resection was performed with no
      cardiovascular complication. Prostatic needle biopsy showed the histological
      evidence of prostatic adenocarcinoma. Radical retropubic prostatectomy with
      limited lymphadenectomy was performed. There was no histological evidence of
      lymph node involvement of paraganglioma or adenocarcinoma. The histological and
      biochemical examinations revealed a chromaffin positive, functioning and non
      malignant tumor in Case 1, and a chromaffin negative, non-functioning and non
      malignant tumor in Case 2. In total, 29 cases of primary paraganglioma of the
      urinary bladder have been so far reported in Japan. The tumor recurrence,
      multiple or metastases were recorded in 8 of 29 cases (27.6%), mainly in regional
      lymph node metastases. We recommend lymphadenectomy at the initial operation,
      irrespective of pathological finding of the primary paraganglioma of the urinary
      bladder.

PMID- 2239563
TI  - [Primary malignant lymphoma of the urinary bladder: report of a case].
AB  - A case of primary malignant lymphoma of the bladder is presented. A 42-year-old
      woman was admitted to our clinic with the chief complaint of asymptomatic
      hematuria. Examination of cystoscopy, IVP, ultrasonography and CT scan suggested
      a non-epithelial tumor of the bladder, which was reported as malignant lymphoma,
      non-Hodgkin, by findings of transurethral biopsy. Subsequent systemic CT scan, Ga
      scintigraphy and bone marrow puncture revealed no abnormalities. Therefore, this
      case was thought to be primary malignant lymphoma of the bladder. Partial
      cystectomy with pelvic lymph node resection was carried out. The tumor, 2 x 1 cm
      in diameter, invaded into the middle portion of muscularis. Histological
      diagnosis of the tumor was follicular lymphoma, medium-sized cell type according
      to LSG classification, and immunohistological findings also showed B-cell
      lymphoma. Resected lymph nodes had no signs of neoplasms. Postoperative adjuvant
      chemotherapy consisting of vincristine, cyclophosphamide and prednisolone was
      performed. She has been doing well without any clinical evidence of recurrence
      for 16 months after the operation.

PMID- 2239564
TI  - [A bulky mass non-Hodgkin's lymphoma with dysuria in the rectovesical space].
AB  - A case of non-Hodgkin's lymphoma is reported. A 71-year-old man presented with
      complaint of dysuria and urinary frequency. Rectal examination and CT scan
      revealed a bulky mass in the rectovesical space. Transperineal needle biopsy of
      the tumor revealed non-Hodgkin's lymphoma, large cell type, diffuse. The patient
      received combination chemotherapy of adriamycin, cyclophosphamide, vincristine,
      prednisolone and pepleomycin. After two days the tumor was marvelously reduced in
      size, and partial response (PR) by CT was achieved after two months. PR was
      sustained for two months with cyclophosphamide, vincristine and prednisolone.
      However, the tumor progressed gradually, and he died five months after the first
      treatment and two additional courses of chemotherapy. Autopsy showed a 1,700 g
      bulky mass in the rectovesical space. The mass was covered with peritoneum and
      had a fistula from rectum to central necrosis of the tumor. Nine cases of the non
      Hodgkin's lymphoma with complaint of dysuria have been reported in Japan before
      our case, which seemed to arise from the submucosal tissue of anterior rectal
      wall, prostate or lymphatic tissue of rectovesical space.

PMID- 2239565
TI  - Leiomyoma of the bladder causing bilateral hydronephrosis: a case report.
AB  - We report a case of bladder leiomyoma with marked bilateral hydronephrosis caused
      by chronic urinary retention. Surgical finding was that the mass was smooth, fist
      sized and had a thin stalk connected to the bladder wall. The tumor was
      completely removed. Histopathological diagnosis was leiomyoma of the bladder and
      the post-operative course was uneventful.

PMID- 2239566
TI  - [A case of urachal abscess].
AB  - A 26-year-old male with urachal abscess was demonstrated. Ultrasonography, CT and
      MRI revealed that there was a mass at the supravesical region, which was
      connected to the umbilicus. However, a differential diagnosis as to whether the
      mass was a tumor or an abscess was difficult from these examinations. Thus we
      performed an open biopsy. A pathological examination revealed no malignant change
      in the biopsy specimen. On the other hand, the pathological diagnosis of a
      follicular tumor located at the roof of the urinary bladder was TCC G2, but we
      considered that, this change was a reactive hyperplasia with dysplasia resulting
      from chronic inflammation of urachal abscess. Thus, the complete excision of
      urachal abscess and partial cystectomy were performed. The serial sections of the
      bladder wall revealed no malignant changes. We reviewed similar cases reported in
      our country and discussed various factors causing urachal abscess, especially
      related to the infectious root.

PMID- 2239567
TI  - [Two cases of benign polyps of the posterior urethra (ectopic prostatic tissue)].
AB  - We report two cases of benign polyps of the posterior urethra. Their first
      symptoms were gross hematuria and urinary frequency. Both specimens obtained by
      transurethral resection were histologically identified as prostatic tissue.
      Discussion on benign polyps of the posterior urethra as ectopic prostatic tissue
      was done with review of literature.

PMID- 2239568
TI  - [Utility of pre-operative imaging diagnosis in spermatic cord liposarcoma].
AB  - A case of spermatic cord liposarcoma was revealed by imaging diagnosis. The
      patient was a 59-year-old male, who consulted our clinic with the complaint of
      painless right scrotal swelling on June 30, 1989. One year earlier, he noticed
      this swelling, which was slow growing little by little. Palpation revealed a
      movable mass in right scrotum, 7 x 3 x 3 cm in size and separated from the right
      testis. Scintigraphy could not show RI accumulation and ultrasonography showed a
      capsulated homogeneous mass. Computed tomography (CT) and magnetic resonance
      imaging (MRI) showed capsulated fat-like almost homogeneous mass, which enclosed
      the right spermatic cord. This mass was suspected of spermatic cord lipoma or
      liposarcoma and was removed with radical orchiectomy. The weight of the mass was
      246 g. This mass had a bunch of grape appearance and consisted of several masses
      of various sizes surrounding the spermatic cord, and could be separated from the
      right epididymis and testis. Histological examination revealed well
      differentiated liposarcoma and lipoma. Spermatic cord liposarcoma is very rare
      and this preoperative diagnosis is very difficult. Imaging diagnosis, such as CT,
      MRI may help our preoperative diagnosis.

PMID- 2239569
TI  - [Clinical evaluation of ofloxacin in the treatment of chronic complicated urinary
      tract infection].
AB  - Ofloxacin was administered orally at a daily dosage of 300 mg and 600 mg in three
      divided doses for 14 days to 24 and 60 patients with chronic complicated urinary
      infections, respectively, in order to evaluate the therapeutic efficacy. The
      clinical efficacy was evaluated according to the criterion proposed by the UTI
      Committee in Japan and its efficacy was evaluated in 84 cases. In the group of 24
      patients receiving a daily dosage of 300 mg, the clinical effectiveness after a 5
      day treatment was excellent in 13 cases and moderate in 7 cases. The overall
      clinical efficacy was 83.8%. In the group of 60 patients receiving a daily dosage
      of 600 mg, the rate of overall clinical efficacy after a 5-day treatment was
      83.3%, being excellent in 23 cases and moderate in 27 cases. The eradication rate
      was 85.3% and 92.5% by 300 mg and 600 mg dosages of ofloxacin, respectively. As
      adverse reactions, anorexia and nausea occurred in 2 cases. Laboratory anomalies
      consisted of 1 case of slight and transient elevation of transaminase, and 1 case
      of elevated serum creatinine.

PMID- 2239571
TI  - [Comparison of the effects of various immunosuppressive drugs on subrenal capsule
      assay (SRC assay)].
AB  - We evaluated the effect of various immunosuppressive drugs in the SRC assay. We
      chose the most appropriate day to obtain the results of the SRC assay using the
      MBT-2 tumor. MBT-2 tumor-bearing mice of homogenic and heterogenic strains were
      separately given one of the three: cyclophosphamide, azathioprine or mizoribine.
      These drugs were evaluated on the 6th and the 11th day for the immunosuppressive
      effects expected from a host versus graft reaction. Concerning the homogenic mice
      that were injected with drugs, on the 11th day, the growth of the tumor was
      favorably suppressed in comparison with the growth of the control group (A-1) due
      to the anti-tumor effect of immunosuppressive drugs. We concluded that the 6th
      day was the most, appropriate day to obtain the results of this assay. Concerning
      the heterogenic mice, similar results were observed. In the mizoribine-group, we
      subcutaneously injected 200 mg/kg on alternate days. Yet the implanted tumor grew
      almost at the same rate as that of the A-1 group. In this group, a histological
      study showed reduction of the tumor cells and few inflammatory cells. We
      concluded that this drug was more useful than the others in the SRC assay and the
      suitable day for judgement was the 6th day.

PMID- 2239570
TI  - [Clinical evaluation of the combination of carumonam and fosfomycin in the
      treatment of complicated urinary tract infection].
AB  - Carumonam (CRMN), the first monobactam antibiotic in Japan, has excellent
      activity against gram-negative bacteria and is useful in the treatment of urinary
      tract infections. However, it may be insufficient in the treatment of complicated
      urinary tract infections because of the increase in isolation of gram-positive
      bacteria, and it may be necessary to co-administer antibiotics active against
      gram-positive organisms to achieve a broader spectrum of coverage in connection
      with severe infections. The combination of CRMN and fosfomycin (FOM) was
      evaluated for its effectiveness and safety at the Department of Urology, Yamagata
      University Hospital and 7 affiliated hospitals. Clinical efficacy was assessed on
      64 patients with complicated urinary tract infection according to the Criteria
      for Clinical Evaluation of Antimicrobial Agents in UTI (3rd. ed.) recommended by
      the Japan UTI Committee. Clinical efficacy was evaluated as excellent in 16,
      moderate in 32, poor in 16, with an overall clinical effectiveness rate of 75.0%,
      which is superior compared with CRMN alone. Of the total of 92 bacterial strains
      isolated, 66 (71.7%) were eradicated. Subjective adverse reaction was seen in 1
      patient (1.4%), as nausea and anorexia. Slight increases in serum GOT and GPT
      ware recorded in 5 patients (7.1%). These findings disappeared after the
      termination of administration without treatment. The combination of CRMN and FOM
      might therefore be useful in the treatment of complicated urinary tract
      infections.

PMID- 2239572
TI  - [Subrenal capsule assay for chemosensitivity test of urological malignancy].
AB  - We evaluated the subrenal capsule assay with a chemosensitivity test using 47
      fresh surgical explants, including 16 renal cell carcinomas and 10 uroepithelial
      cancers. Forty-one explants were evaluable and 166 drug tests were performed.
      Forty-seven tests (28.3%) were found to be sensitive. Ten of 16 renal cell
      carcinomas involved a sensitive drug, 3 involved more than 2 sensitive drugs. VP
      16, ADM, BLM and 5-FU were the most sensitive compared with the others.
      Concerning the uroepithelial cancers, 8 of 10 involved a sensitive drug, 5
      involved more than 2 sensitive drugs. CDDP and VP-16 were more effective than the
      other drugs. This result showed a good correlation with the clinical therapeutic
      efficacy using CDDP. In the future, we hope to evaluate the clinical correlation
      between clinical efficacy and this assay.

PMID- 2239573
TI  - [Treatment using CDDP and radiation therapy in treating bladder tumor].
AB  - Combination therapy consisting of cis-diamine-dichloroplatinum (CDDP) and
      radiotherapy was used to treat bladder cancer. The subjects were 20 patients with
      bladder cancer we experienced since September, 1986. They were between 33 and 83
      years old and consisted of 13 males and 7 females. Among the histotypes and
      grades, there were 3 cases of G2, 7 of G2-G3 and 10 of G3 metastatic epithelial
      carcinoma. The classification of primary tumors was T2 in six cases, T3a in 12
      cases and T4 in two cases. In 12 cases where the bladder was preserved, this
      therapy was performed after TUR biopsy or TUR, and the effects were evaluated
      after observation periods of 5-17 months. Side effects caused by CDDP were
      anorexia in 15 cases, nausea and vomiting in 10 cases, leukopenia in 10 cases and
      thrombocytopenia in four cases. Those caused by the radiotherapy were diarrhea in
      seven cases and skin disorders in six cases. All of these side effects were mild
      and the patients recovered spontaneously.

PMID- 2239574
TI  - [Neurogenic bladder after operation of rectal cancer].
AB  - Of the patients who had had a urodynamic examination during the five year period
      from 1982 to 1987 in our clinic, 48 patients underwent operations for rectal
      cancer prior to the study. In 35 of them, the operation mode was known. If the
      pelvic nerve is damaged by operative modes for rectal cancer, urinary
      disturbances of severe kinds may occur. In spite of such disturbances, 71.4% of
      those who had had excision of the low anterior part and 51.9% of those with
      Miles' operation could be weaned from the clean intermittent self-catheterization
      and take up spontaneous urination. Even in patients who developed severe dysuria,
      if catheterized at an early stage, many of them could urinate by abdominal
      pressure with in several months after operation, without the aid of a catheter.
      This transition took place mostly within one year after operation. When a patient
      develops dysuria after radical surgery for rectum cancer, treatment mainly with
      self-catheterization is an effective method at present.

PMID- 2239575
TI  - [Study on etoposide therapy of relapsing prostatic cancer patients].
AB  - Eight patients with hormone resistant prostate cancer were treated with 30 mg/m2
      etoposide every two or three weeks. A response rate of 37.5% in clinical status
      was noted. Slight toxicity was seen temporarily. We think this etoposide therapy
      is a useful regimen for advanced or relapsing carcinoma of the prostate.

PMID- 2239576
TI  - [Effect of tegafur administration combined with hormonal therapy in patients with
      newly diagnosed stage D prostatic cancer].
AB  - To study the effect of tegafur administration combined with hormonal therapy on
      the survival rate of newly diagnosed patients with stage D prostatic cancer, 66
      patients, 70.9 years old in mean age, were treated from 1979 to 1986. The cancer
      was proven by the histological or cytological examination of the specimen which
      was obtained by the needle biopsy and/or aspiration biopsy of the prostate. The
      histopathological diagnosis of 59 patients was as follows: well differentiated
      type of adenocarcinoma was observed in 13 patients, moderately differentiated
      type in 19 cases, poorly differentiated type in 24 cases and mixed type in 3
      cases. Daily 600 mg tegafur was administered orally as long as possible from the
      beginning of the treatment combined with hormonal therapy. Actual and relative 5
      year survival rates calculated with Kaplan-Meier's method were 31.2% and 39.2%,
      respectively. When deaths other than prostatic cancer death were counted as lost
      cases, the actual survival rate was 47.5%. The present study also demonstrated
      that there were some factors affecting the patients' prognosis. They were the age
      of onset of the disease (patients under 64 years old were worse than those over
      65 years old; p less than 0.05), performance status (patients with PS from 0 to 2
      at the first admission were better than those with PS 3 to 4; p less than 0.025),
      differentiation of the tumor (well differentiated type was better than
      moderately; p less than 0.025 or poorly differentiated type; p less than 0.005).

PMID- 2239577
TI  - [Clinical studies on chronic prostatitis and prostatitis-like syndrome (4). The
      kampo treatment for intractable prostatitis].
AB  - Kampo treatment was attempted in cases of chronic nonbacterial prostatitis and
      prostatitis-like syndrome which was intractable or recurred when treated with
      western medicine. The clinical effects of Kampo treatment were excellent in 21.3%
      with an efficacy rate of 67.2% for the cases with chronic non-bacterial
      prostatitis, and excellent in 19.5% with an efficacy rate of 52.4% in the cases
      with prostatitis-like syndrome. When the clinical effects were compared with
      those of western therapy performed in the cases which had recurrence, Kampo
      treatment showed more excellent effects (p less than 0.1) for both types of
      disease, and the treatment with Chinese medicine was suggested useful. In a
      comparison of the effects between the cases given only Kampo treatment and those
      given both Kampo treatment and western treatment using anti-inflammatory agents,
      no difference was seen in the cases with the prostatitis-like syndrome, but in
      the cases with chronic non-bacterial prostatitis, the effects were better in the
      concomitant treatment group than in the group given only Kampo treatment (p less
      than 0.1). The response to the Kampo treatment differed depending on the type of
      disease. Among the antibacterial agents used concomitantly in the cases of
      chronic non-bacterial prostatitis, new-quinolones showed better results than ST
      compounds or tetracyclines, but no statistically significant differences were
      seen among the drugs. Of the Kampo drugs used, Keisibukuryogan and Simotuto
      showed high clinical usefulness in both types of disease and there was no
      statistically significant difference among the other drugs. The incidence rate of
      side effects (Goji) due to Kampo treatment was 6.3% and was higher in patients
      administered Keisibukuryogan.

PMID- 2239578
TI  - [Malignant pheochromocytoma presenting as an acute abdomen: a case report].
AB  - A case of right adrenal malignant pheochromocytoma was reported. The patient was
      a 16-year-old boy who complained of severe right side abdominal pain due to
      spontaneous hemorrhage into the retroperitoneal space. Right adrenalectomy was
      performed on Feb. 22, 1988 but the preoperative high serous catecholamine level
      did not drop to the normal level. Postoperatively bone and liver metastasis were
      detected by a 131I-MIBG scan. He was treated with a combination chemotherapeutic
      regimen consisting of cyclophosphamide, vincristine and dacarbazine in 2 repeated
      cycles but there was no effect. He died 5 months after the operation.

PMID- 2239579
TI  - [A case of primary aldosteronism due to unilateral multiple adrenal adenomas].
AB  - A 64-year-old female with hypertension, hypokalemia visited our hospital.
      Endocrinological examinations showed a low level of plasma renin activity and
      high level of plasma aldosterone. Circadian rhythmicity of plasma aldosterone
      level was recognized. No change in the plasma level of aldosterone was observed
      after loading of standing and administration of furosemide. Adrenal scintigraphy,
      adrenal venous aldosterone assay and CT scan revealed two tumors in the left
      adrenal. The diagnosis of primary aldosteronism by left adrenal tumors was made
      from the above findings. A left adrenalectomy was performed and pathological
      findings showed two adenomas, which had no capsule either and were surrounded by
      normal adrenocortical tissue. Blood pressure normalized after surgery and the
      plasma levels of aldosterone and plasma renin activity were normalized.

PMID- 2239580
TI  - [A case of renal cell carcinoma and bladder carcinoma associated with von Hippel
      Lindau disease].
AB  - A case of renal cell carcinoma and bladder carcinoma associated with von Hippel
      Lindau disease is reported. A 31-year-old female was referred to the Department
      of Urology for further examination of right renal mass which was incidentally
      found on abdominal computed tomography (CT). The patient was operated on spinal
      hemangioma in May 19 and July 8, 1975, on cerebellar hemangioblastoma in July,
      1976 and June 10, 1981 and on cerebellar cyst in June 20, 1988. Angiography
      revealed three hypervascular renal tumors in the right kidney. Cystoscopy
      revealed a papillary bladder tumor (TCC Grade 1). Transurethral resection of
      bladder carcinoma was performed on July 28, 1988. Right radical nephrectomy and
      lymphadenectomy were performed on August 2, 1988. Histopathologically, the tumor
      was renal cell carcinoma of clear cell type (Grade 1). Postoperative course was
      uneventful and the residual kidney is being followed up in the outpatient clinic.

PMID- 2239581
TI  - Metastatic tumor of the spermatic cord from renal cell carcinoma.
AB  - A 56-year-old male visited our hospital with macroscopic hematuria. Physical and
      X-ray examinations showed he had right renal cell carcinoma with tumor thrombosis
      in the inferior vena cava and the right spermatic vein. Radical nephrectomy and
      tumor thrombectomy were performed and he was discharged with no evidence of
      disease 1 month after the operation. At 5 months after the discharge, he noticed
      a palpable mass in the scrotum. Right orchiectomy was performed. The tumor was
      located in the right spermatic cord and histological examination revealed it to
      be a renal cell carcinoma (clear cell subtype) which was a metastatic lesion from
      a right renal tumor. In this case, the renal cell carcinoma was considered to
      have retrogradely metastasized through the spermatic vein. In conclusion, a
      complete physical examination, including the spermatic cord is recommended during
      the follow-up period of renal cell carcinoma.

PMID- 2239583
TI  - Giant renal angiomyolipoma with an uncommon growth pattern: a case report.
AB  - A case of a giant renal angiomyolipoma with uncommon growth pattern in a 66-year
      old female is reported. The tumor originated from the upper pole of the left
      kidney and simultaneously grew posteriorly in a sheet-like fashion while a
      spheroid mass projected upwards. With magnetic resonance imaging (MRI), the
      relationship between the tumor and adjacent organs was clear. Tumorectomy
      employing cavitron ultrasonic surgical aspirator (CUSA) was performed, and proved
      to be a safe and simple procedure. There has been no recurrence of the growth 2
      years post-operatively.

PMID- 2239582
TI  - [A case of double cancer: renal cell carcinoma and transitional cell carcinoma of
      urinary bladder].
AB  - This is a case report on a patient with double cancer of kidney and urinary
      bladder. The patient was a 65-year-old female, and she was admitted with the
      chief complaint of gross hematuria and right flank pain. After careful
      examinations, she was diagnosed with right nonfunctioning kidney caused by
      invasive bladder cancer. Computerized tomography incidentally revealed a mass in
      the upper pole of the left kidney. Selective left renal arteriography showed
      stretched arteries and irregularity and tortuosity of the smaller vessels. She
      was diagnosed with double cancer of bladder and left kidney. Owing to the damage
      of the right renal function, left partial nephrectomy, total cystectomy, right
      nephroureterectomy and left ureterocutaneostomy were performed. According to DMSA
      scintigraphy measured 15 days later, the uptake value of the left kidney was
      13.25%, compared to the preoperative value of 25.62%. To date, this case is 36th
      reported case in Japan.

PMID- 2239584
TI  - A case of adenocarcinoma of the renal pelvis.
AB  - A 28-year-old female had adenocarcinoma arising from the renal pelvis with
      ascites containing adenocarcinoma cells. The primary site was treated with
      radical nephrectomy, resection of the remnant ureter with a bladder cuff.
      Combination chemotherapy with cisplatin, doxorubicin, and cyclophosphamide (CAP)
      was performed as an adjuvant therapy. Approximately 3 years after the
      nephrectomy, she is currently alive with no clinical evidence of recurrence. CAP
      seems to have been effective in the treatment of the disease.

PMID- 2239585
TI  - [Transitional cell carcinoma of the renal pelvis in a woman discovered at
      childbirth].
AB  - We report a case of transitional cell carcinoma of a renal pelvis in a woman
      discovered after childbirth. A 38-year-old woman, who delivered an immature male
      infant in cesarean section 29 days prior to hospitalization, was admitted
      complaining of asymptomatic gross hematuria. Excretory urography and retrograde
      pyelography showed a filling defect of the right renal pelvis, Spontaneous urine
      cytology indicated class 5. Renal computed tomographic scan demonstrated a mass
      lesion in the right kidney. Right total nephroureterectomy and partial cystectomy
      was performed for diagnosis and treatment. Pathological diagnosis was papillary
      transitional cell carcinoma (grade 2). This is the first case of transitional
      cell carcinoma of the renal pelvis occurring in a childbearing woman in Japan.

PMID- 2239586
TI  - [Clinical evaluation of sultamicillin in the treatment of urinary tract
      infections].
AB  - Sultamicillin, a new semisynthetic oral beta-lactam antibiotic, was evaluated for
      its antibacteria susceptibility and clinical efficacy against urinary tract
      infection (UTI), and the following results were obtained. The sensitivity of
      sultamicillin (SBTPC) on 518 strains of clinical isolates from the urine were
      tested and compared to ampicillin (ABPC). S. aureus, S. epidermidis, Enterococcus
      sp., Streptococcus sp., E. coli, K. pneumoniae, K. oxytoca, P. mirabilis, M.
      morganii and Acinetobacter sp. showed high sensitivity to SBTPC. The
      antibacterial activity of SBTPC was superior to that of ABPC in most strains and
      especially more superior in beta-lactamase producing strains. The clinical
      effectiveness rate on a total of 15 patients with acute uncomplicated cystitis
      was 93.3% and the eradication rate of causative organisms was 93.3%. On 15
      patients with chronic complicated UTI, the clinical effectiveness rate was 73.3%
      and eradication rate was 76.5%. Side effects (diarrhea) were observed in 3 cases,
      but this symptom was not severe and soon disappeared. Abnormal laboratory data
      due to the drug were not observed.

PMID- 2239587
TI  - [Clinical effect of oxybutynin hydrochloride (1 mg/tablet)].
AB  - The clinical efficacy of oxybutynin hydrochloride was studied on 21 patients with
      neurogenic bladder or unstable bladder complaining of urinary frequency, urgency
      and urgent incontinence. Oxybutynin hydrochloride (1 mg/tablet) was administered
      orally for 26.7 days, on average, 3 mg per day in 3 and 6 mg per day in 18
      patients and the usefulness of this drug was assessed subjectively and
      objectively. Of 21 patients treated, 9 had neurogenic bladder and 10 had unstable
      bladder. Urinary frequency was normalized in 6 out of 16 (37.5%), urgency ceased
      in 6 out of 17 (35.7%) and urgent incontinence disappeared in 9 out of 14 (50%)
      patients. The mean volume at the first desire to void and the maximum cystometric
      capacity increased significantly on the cystometrogram after the administration
      of oxybutynin hydrochloride (p less than 0.01). Furthermore, the maximum vesical
      pressure decreased significantly (p less than 0.05). The maximum urinary flow
      rate increased slightly (p less than 0.1) and the residual urine volume
      significantly increased (p less than 0.05) after medication, although no changes
      were observed in tidal voiding volume or mean urinary flow rate. Of 20 patients,
      9 showed improvement globally (45%), although no subjective or objective
      improvement was observed in 4 (20%) patients. Marked side effects were observed
      in 5 cases (two of acute urinary retention, each of increased urgency, residual
      urine and liver dysfunction), and side effects were seen in 10 of the 21 (47.6%)
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239588
TI  - [Comparative study of the patients with renal cell carcinoma before and after
      1980].
AB  - Patients with renal cell carcinoma treated at Jikei University and affiliated
      institutions were studied with regard to temporal differences. Our study
      population was divided into two groups: an earlier group comprising 169 patients
      treated between January 1957 and December 1979, and a later group comprising 165
      cases treated between January 1980 and December 1984. The mean age in the earlier
      group was 56.2 years, while that in the later group was 60.4 years. Therefore,
      the patients in the earlier group were generally younger than those in the later
      group. Patients in the earlier group were more likely to present with urinary
      symptoms at the time of diagnosis. On the other hand, patients in the later group
      were more likely to present with extra-urinary symptoms or to be asymptomatic.
      The time period between the onset of symptoms and initial consultation with
      physician was longer (within one month) in the earlier group. Most patients in
      the later group underwent nephrectomy using the transperitoneal or
      thoracoabdominal approach. Few patients in the later group were treated with
      radiotherapy. As adjuvant chemotherapy, MFC (MMC, 5-FU and Ara-C) or MACV
      (methotrexate, actinomycin D, cyclophosphamide and vincristine) regimen were most
      commonly employed in the earlier group. FAV (5-FU, adriamycin and vinblastine)
      regimen or interferon therapy which was classified as biological response
      modifiers (BRM) were more commonly employed in the later group. More cases were
      diagnosed as stage II in the earlier group, and more cases were diagnosed as
      stage IV in the later group. No significant differences were observed between the
      earlier and later groups, with regard to 5- and 10-year survival rates.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2239589
TI  - [Clinical study of extracorporeal shock wave lithotripsy for 1000 patients with
      renal and ureteral stones].
AB  - Using a Dornier HM3 lithotripter, we treated 1,000 patients with renal and
      ureteral stones from April, 1986 to July, 1989. They consisted of 612 solitary
      stones (pelvic stones, 152; calyceal stones, 167; ureteral stones, 293), 265
      multiple stones and 123 staghorn calculi (complete, 48; partial, 75). The overall
      rate of the auxiliary procedure was 59.3% (pre-operative, 47.9%; post-operative,
      11.4%). Pre-operative procedure included 430 catheterizations, 26 percutaneous
      nephrostomies (PNSs) and 23 pyelograms . Post-operative procedure included 69
      transurethral lithotripsy , 21 PNSs, 26 percutaneous nephrolithotripsy (PNLs), 6
      meatotomy , 5 chemolysis and 1 open surgery. 484 (68.3%) in 709 good follow-up
      cases were stone-free at the time of 3 months since the first extracorporeal
      shock-wave lithotripsy (ESWL). Complications were pain (34.8%), fever (4.3%),
      pain & fever (8.5%), subcapsular hematoma (0.1%) and ureteral obstruction (0.1%).
      Thus, ESWL is considered to be a useful means for renal and ureteral stones and
      in the case of large stone the combination therapy with PNL is more effective
      than ESWL-monotherapy.

PMID- 2239590
TI  - [Clinical studies on hyperuricemia and gout after transplantation].
AB  - We performed renal transplantation on 67 patients (living 37, cadaver 30) between
      November 1975 and December 1987. Twenty-seven of the 67 patients had
      hyperuricemia (serum uric acid: male greater than or equal to 8.0 mg/dl, female
      greater than or equal to 7.0 mg/dl) and 2 of them had episodes of gout. However,
      there was no correlation between serum creatinine and uric acid in 27
      hyperuricemic patients. Twelve of 27 hyperuricemic patients were treated with
      either allopurinol or benzbromarone. These therapies were effective for 9 of them
      and serum uric acid level controlled well. One of 2 gouty patients developed gout
      4 years after cadaveric renal transplantation. She was treated with anodyne and
      benzbromarone for gout. These treatments were effective and she has been in good
      condition. We consider it necessary to treat hyperuricemia after renal
      transplantation and to control serum uric acid well.

PMID- 2239591
TI  - [Stereological estimation of mean nuclear volume in bladder cancer--measurement
      by point sampled intercepts].
AB  - To obtain objective information about bladder cancer, we measured the mean
      nuclear volume of bladder cancer cells by using the "Point Sampled Intercepts"
      method, which was published by Gundersen et al. Thirty one cases of bladder
      cancer were selected and divided into 2 groups: group A; no recurrence over 3
      years after initial TUR (12 cases), group B; cystectomy or cancer death (19
      cases). Estimated mean nuclear volume was significantly smaller in group A than
      in group B. It is suggested that estimation of the mean nuclear volume by this
      stereological method may provide objective information for predicting the
      prognosis of patients with bladder cancers. Further studies in additional
      patients are required to substantiate the predictive potential of this method.

PMID- 2239592
TI  - [A comparative study of the effects of propiverine, terodiline, oxybutynin on the
      lower urinary tract function in the decerebrate dog].
AB  - The effects of propiverine, terodiline, oxybutynin on the lower urinary tract
      function was studied by cystometry in 44 decerebrate dogs. Micturition was
      induced by bladder filling before and after the intravenous administration of
      each drug. The statistical analysis was carried out on the urodynamic parameters.
      Propiverine at a dose of 5, 10 mg/kg significantly increased the bladder volume.
      And, there was a substantial increase in the functional bladder volume at a dose
      of 10 mg/kg. Terodiline at a dose of 5 mg/kg also significantly increased the
      bladder volume and residual volume. Oxybutynin at a dose of 0.5 or 1 mg/kg
      produced a substantial increase in the bladder volume and residual volume, and
      produced a significant decrease in contraction pressure. Furthermore, there was a
      significant decrease in the functional bladder volume at a dose of 1 mg/kg. This
      study compared the three drugs under the same test conditions. Only propiverine
      increased the functional bladder volume, thus suggesting promise for the relief
      of pollakisuria in the clinical applications.

PMID- 2239593
TI  - [Correlation between histologic grading and prognosis of prostatic cancer-
      comparing the grading system of the Japanese general rules of prostatic cancer
      with Gleason's grading].
AB  - To evaluate the correlation between the histological grade and the prognosis, we
      reviewed 100 cases of prostatic cancer according to the Japanese General Rules of
      Prostatic Cancer (JGRPC) and Gleason grading system. The study led to the
      following results: (1) There was a close relation between the JGRPC grade and
      Gleason score (GS). (2) The JGRPC grade and Gleason score were equally concerned
      with the clinical stage. (3) There were significant differences in survival rate
      between well and moderately, well and poorly differentiated groups by the JGRPC
      grading system, and between GS 2-4 and GS 5-7, GS 2-4 and GS 8-10 groups by
      Gleason score. (4) In proportion to the JGRPC grade, the cancer death rate
      increased linearly in each stage. (5) When the patients were grouped according to
      their JGRPC grades of main lesion and accompanied lesion, the cancer death rate
      increased in the cases with lower differentiated elements. We conclude that the
      JGRPC grading system is easily comprehensible, and equal with the Gleason grading
      system to predict the prognosis of prostatic cancer.

PMID- 2239594
TI  - [Bladder metastasis from renal cell carcinoma three years after nephrectomy].
AB  - A 47-year-old man presented with gross hematuria. He underwent right nephrectomy
      for renal cell carcinoma (clear cell subtype, pT1N0M0) three years ago.
      Cystoscopy revealed a solitary, non-papillary tumor in the middle of the inter
      ureteric ridge. Transurethral resection of the tumor was done. Histological
      diagnosis was renal cell carcinoma (clear cell subtype). This was considered to
      be a metastatic tumor from the renal cell carcinoma treated three years earlier.
      This case may represent a so-called latent distant metastasis.

PMID- 2239596
TI  - [A case of multiple renal leiomyoma located at renal sinus and hilus].
AB  - A case of multiple renal leiomyoma of the right kidney in a 60-year-old woman,
      complaining of lower abdominal pain of two months duration, is presented.
      Ultrasonography, intravenous pyelography and CT scan showed the masses at the
      right renal sinus and hilus. Selective right renal angiography demonstrated very
      hypovascular tumors. Right radical nephrectomy was performed. There were two
      lobulated tumors with no connections, which were elastic hard in consistency and
      smooth in surface; one was 4 x 2 x 2 cm in size and located at the renal sinus
      between the upper and middle calyces, the other was 6.5 x 5 x 4 cm in size and
      located at the renal hilus, apart from the renal parenchyma, pelvis, artery and
      vein. Histological examination revealed these tumors to be benign leiomyoma. Both
      were covered with the Gerota's fascia, but not the renal capsule. The renal
      parenchyma was completely covered with the renal capsule histologically, although
      these tumors were closely attached to the parenchyma on gross examination. The
      tumor at renal sinus was considered to arise from the outer layer of the renal
      pelvis or from the blood vessel in the connective tissues at renal sinus. The
      tumor at renal hilus was considered to arise from the blood vessel in the
      connective tissues at renal hilus. This appears to be the first reported case as
      multiple renal leiomyoma in both Japanese and English literatures.

PMID- 2239595
TI  - Complete resolution of multiple pulmonary metastases of renal cell carcinoma
      following intravenous drip infusion of r-interleukin 2: a case report.
AB  - A 68-year-old man with multiple pulmonary metastases from a right renal cell
      carcinoma was treated with alpha interferon, but there was no improvement. For
      this reason, alpha interferon was ceased, and daily monotherapy with recombinant
      interleukin-2 (1,000,000 units/day) was commenced. After 4 months, plain chest x
      ray and chest CT revealed complete clearance of the pulmonary metastases. There
      were no side effects except general fatigue and slight fever. Immunological
      studies revealed elevation of the leukocyte count (lymphocytes, eosinophils) and
      enhancement natural killer activity. At 10 months after discontinuation of the
      drug, recurrence has not been observed. Our case indicates the potential value of
      interleukin-2 following treatment with alpha interferon.

PMID- 2239597
TI  - [A case of renal pelvic tumor due to phenacetin abuse].
AB  - An 80-year-old female had been taking phenacetin-containing analgesics due to
      severe pain in her legs and headache caused by SMON since 1957. The total
      accumulated dose of phenacetin that she had taken was about 2.3 kg. She visited
      the department of urology in our hospital complaining of gross hematuria in May,
      1987. DIP showed that bilateral kidney were atrophic and her left pyelogram was
      non-visualized. A solid mass was located in her renal pelvis on the CT scan.
      Under the diagnosis of a left renal pelvic tumor, nephrectomy was performed on
      her left kidney in January, 1988. Histological diagnosis was interpreted as a
      transitional cell carcinoma, at a grade 1 greater than 2 and interstitial
      nephritis was detected. She died 8 months after the operation because of lung and
      bone metastasis. In autopsy, interstitial nephritis of the right kidney was also
      recognized. Our case is the fourth report of renal pelvic tumor due to phenacetin
      abuse in Japan.

PMID- 2239598
TI  - [Transitional cell carcinoma of the ureter with an inverted growth pattern which
      was accompanied with bladder tumor: a case report].
AB  - The patient was a 75-year-old man who complained of macrohematuria which had set
      in from April 12, 1988. Under the clinical diagnosis of bladder tumor, total
      cystectomy with ureterosigmoidostomy was performed on June 25. During his
      surgery, we discovered a polypoid lesion of the right ureter close to the common
      iliac artery. The tumor was peanut-sized and had a stalk suggesting benign
      nature, so we resected it. Postoperative pathological examination revealed the
      tumor was transitional cell carcinoma (grade 2) with an inverted growth pattern.
      Though we could find no signs of tumor recurrence, the presence of tumor's
      residuum could not be ruled out. We performed nephroureterectomy of the right
      side on December 19. Follow-up on July 1, 1989 this patient revealed no tumor
      recurrence.

PMID- 2239599
TI  - [A case of emphysematous cystitis].
AB  - Emphysematous cystitis is a rare but interesting disease. A case is reported of
      cystitis emphysema with acute pyelonephritis and uncontrolled diabetes. The
      patient was a 54-year-old woman complaining of gross hematuria and fever. A
      submucosa emphysema in bladder was found by cystoscopy . Radiography showed the
      gas around the bladder. The patient was administered antibiotics, then symptoms
      was improved. We reviewed 12 cases of emphysematous cystitis reported in Japan
      and summarized the pathophysiologic features of this entity.

PMID- 2239601
TI  - [A case of cystic lymphangioma grown in subcutaneous tissue of the pubis].
AB  - A 37-year-old man visited our hospital with the chief complaint of a painless
      mass in subcutaneous tissue of the pubis. We extirpated the localized cyst 2.5 x
      4 cm in size. Histological diagnosis was cystic lymphangioma without malignant
      findings. We reviewed the literature on lymphangioma, a rare disease seldom seen
      in urological fields.

PMID- 2239600
TI  - [Granulomatous prostatitis after intravesical BCG immunotherapy of superficial
      bladder cancer: a case report].
AB  - We report a case of granulomatous prostatitis after intravesical BCG
      immunotherapy for superficial bladder cancer. A 58-year-old man presented with
      gross hematuria. Cystoscopic examination revealed multiple tumors at the
      posterior wall of the bladder. The patient underwent transurethral resection of
      the tumor. Intravesical BCG immunotherapy was postoperatively followed and it
      eradicated the disease. Digital examination revealed that the prostate became
      stony-hard and larger 10 weeks after the initial BCG immunotherapy. A needle
      aspiration cytology and biopsy of the prostate revealed the granulomatous
      prostatitis due to BCG immunotherapy.

PMID- 2239602
TI  - Leiomyoma of the scrotum: a case report and sonographic findings.
AB  - A rare case of leiomyoma of the scrotum is presented, and its ultrasonographic
      features are described. The ultrasound was of great help in the successful
      management by simple excision of the tumor.

PMID- 2239603
TI  - [Clinical study of iohexol in excretory urography].
AB  - Excretory urography was performed using iohexol (Omnipaque 300 and Omnipaque 350)
      on 388 patients requiring urography in the Department of Urology, Nagoya
      University School of Medicine and 10 affiliated hospitals. Adverse reactions were
      observed in 3 cases (0.8%), but they were all mild. Good image efficacy was
      obtained in more than 95% of the patients injected 20 ml, 40 ml, and 100 ml of
      Omnipaque 300 and 40 ml of Omnipaque 350. There was no difference in the results
      of image efficacy between 40 ml (Omnipaque 300) and 100 ml (Omnipaque 300)
      groups. Therefore, the use of 40 ml of Omnipaque 300 for excretory urography was
      considered to be a very useful screening method for the urinary tract.

PMID- 2239604
TI  - [Clinical application of Therasonic lithotripsy treatment system for upper
      urinary tract calculi].
AB  - Extracorporeal shock wave lithotripsy (ESWL) using a Therasonic lithotripter was
      performed on 30 patients with urinary tract calculi between July, 1989 and
      February, 1990. The results obtained in 31 cases (one patient had bilateral renal
      stones) were presented. There were 22 inpatients and 8 outpatients in this
      series. The stone location was: renal pelvis in 15 cases, renal calyces in 10
      cases, parenchyma or diverticulum of renal calyces in 3 cases, ureteropelvic
      junction in 1 case, and upper ureter in 2 cases. Sixteen cases (52%) became stone
      free and residual stones (less than or equal to 4 mm) remained in 9 cases
      (overall effective rate 81%) at one month after the treatment. There were no
      serious complications including bacteremia and renal hematoma. We concluded that
      Therasonic lithotripter is useful in the management of upper urinary tract
      calculi.

PMID- 2239605
TI  - [Treatment of urinary stones with Therasonic, the third generation piezoelectric
      shock wave lithotripter].
AB  - The THERASONIC lithotripsy treatment system, a newly developed piezoelectric
      lithotripter, uses both an X-ray and ultrasound system and enables stone
      localization effective. Treatment of urinary stones with THERASONIC was begun in
      June, 1989 and 57 treatments have already been performed on 38 patients.
      Successful treatment, defined as either stone free or with a residual stone less
      than 4 mm in diameter on flat X-ray film, was accomplished in 95% of the renal
      stones and over 50% of the ureteral stones. The overall success rate was 74%.
      Blood pressure and laboratory values did not show any significant change during
      or after the treatment. No major complication has been observed except for one
      perirenal hematoma which was resolved with conservative therapy.

PMID- 2239606
TI  - [Clinical statistics of the bladder tumor--clinical and pathological aspects of
      325 cases].
AB  - We analyzed 325 primary bladder tumor patients who were treated in our hospital
      during the past 15 years. There were 242 males and 83 females who were between 20
      and 84 years old with an average age of 63 years old. The most frequent complaint
      was macroscopic hematuria in 76.9% of the patients (250/325). Cystoscopically, a
      single tumor was seen in 71%, the tumor was medium sized (1 to 3 cm) in 32%, and
      56% were papillary tumors with a stalk. Histologically, 300 (92.3%) cases were
      transitional cell carcinoma. There were 42, 206 and 52 patients with grades 1, 2
      and 3 transitional cell carcinoma and stage Tis, Ta, T1, T2, T3a, T3b, T2-4M1 and
      Tx were 2,46, 151, 30, 15, 16, 37 and 3 cases each. Transurethral resection was
      performed in 231 (71.1%), partial cystectomy in 6 (1.8%) and total cystectomy in
      44 (12.5%) cases each.

PMID- 2239607
TI  - [Clinical statistics of the bladder tumor--survival rates of 325 cases].
AB  - To study the relationship between clinical features and prognosis of the bladder
      tumor, 325 patients who were treated in our hospital were analyzed. The overall 5
      year and 10-year actual survival rates were 65% and 51%. There was no statistical
      significance in the actual survival rate between the single and multiple tumor
      group. Although, there was a significant difference in tumor size, tumor growing
      type and the mode of treatment. The ten-year survival rates for grades 1, 2 and 3
      cases were 76%, 57% and 18%, respectively. There was a significant difference
      between grades 1 and 3 (p less than 0.001) and grades 2 and 3 (p less than
      0.001). The ten-year survival rates for stages Ta, T1, T2, T3a, T3b and T2-4 M1
      were 79%, 68%, 43%, 0%, 19% and 5%, respectively. There was a significant
      difference between the Ta, 1 and T2-4 group (p less than 0.001).

PMID- 2239608
TI  - [Clinical statistics of the bladder tumor--transurethral resection cases].
AB  - Two hundred and thirty one patients who underwent transurethral resection of a
      bladder tumor (TUR-Bt) at our hospital during the past 15 years were analyzed.
      There were 176 males and 55 females, and the average age at the initial TUR-Bt
      was 62 years old. Histopathologically, 225 cases were of transitional cell
      carcinoma, 4 cases of papilloma and 2 cases of squamous cell carcinoma. Grading
      and staging of 225 transitional cell carcinoma cases revealed grades 1, 2 and 3
      in 32, 132 and 21 cases, and stages Ta, T1, T2, T3 and T2-4M1 in 48, 135, 20, 17
      and 11 cases, respectively. The frequency of TUR-Bt varied from 1 to 10 times.
      Among the 231 cases TUR-Bt was done once, twice and three times in 149 (64.5%)
      and 41 (17.8%), and 22 (9.6%) cases, respectively and the total number of TUR-Bt
      was 400 times. The duration of the TUR-Bt operation was from 5 min. to 160 min.
      (mean: 32.4 min.) and the resected weight of tumor between 0.5 g and 85 g (mean:
      5.4 g). As a complication of TUR-Bt, TUR-fulguration was necessary to control
      postoperative bleeding in 7 cases (1.7%), and blood transfusion was required in
      13 cases (3.3%) during TUR-Bt. Postoperatively blood transfusion was required in
      8 cases (2%), intraperitoneal perforation in 2 cases (0.5%), extraperitoneal
      perforation in 6 cases (1.5%) and hyponatremia in 1 case (0.3%).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2239609
TI  - [Prognosis of the patients with prostate cancer clinically confined within the
      pelvis].
AB  - Between 1975 and 1989, 90 patients with prostate cancer in clinical stage A2 to C
      underwent pelvic lymphadenectomy. Median follow-up period was 38 months. Almost
      all of the patients with pN0-1 (49) and 4 of pN2 were treated by curative
      treatment, such as radical prostatectomy (7) or radiation therapy (45). The
      remaining pN2 (26), pN3 (4) and pM1 LYM (6) received endocrine therapy. Pelvic
      lymph node metastasis were noticed in 50 cases (56%). Rates of positive node and
      degree of nodal extension were related to clinical stage and histological grade.
      Disease-free survival of the patients with pN0-1 was better than that of the
      patients with more than pN2. There was no difference in disease-free survival
      between the patients with pN0 and pN1. We concluded that the patients with pN0
      and pN1 were the candidates for curative therapy and recommend that the patients
      with more than pN2 be treated with endocrine therapy.

PMID- 2239610
TI  - [Effects of trospium chloride on the lower urinary tract function].
AB  - The effects of trospium chloride on the lower urinary tract function were studied
      by combined recording of cystometry and sphincter electromyogram in 13
      decerebrated dogs. Micturition was induced by bladder filling before and after
      drug administration. A statistical analysis was carried out on the urodynamic
      parameters. Trospium chloride at the dose of 0.1 mg/kg showed a small but
      significant decrease in the threshold pressure during the collecting phase. In
      the urodynamic parameters of the emptying phase which is considered to be
      influenced by cholinergic activity, there was a significant decrease in maximum
      bladder pressure at 0.03, 0.1, and 0.3 mg/kg and a significant increase in
      residual urine at 0.3 mg/kg. Trospium chloride is probably acting as a
      antimuscarinic agent in this study. Trospium chloride appears to be useful for
      the relief of symptoms associated with hyperactive bladder contraction.

PMID- 2239611
TI  - [Clinical study of asymptomatic microhematuria].
AB  - A statistical survey was performed on 200 patients with asymptomatic
      microhematuria who visited our hospital between January 1986 and October 1989.
      Urinalysis, urinary cytology, urinary culture, IVP, echography and cystoscopy
      were carried out for the evaluation of the origin and nature of the
      microhematuria. In 92 patients (46%), urological abnormalities were observed.
      Among them, urological lesions requiring medical and surgical treatments were
      found in 28 patients (14%) including two malignant cases of bladder tumor. No
      urologic lesion could be identified in 108 patients (54%). The degree of
      hematuria was unrelated to the seriousness of its cause. Thirteen of 28 patients
      (46%) with diseases that required treatment had under 5 red blood cells per high
      power field on the microscopic urinalysis. Therefore, complete urologic
      investigation of all patients with any degree of asymptomatic microhematuria is
      recommended.

PMID- 2239612
TI  - Transitional cell carcinoma with adeno-squamous carcinoma component of renal
      pelvis in horseshoe kidney: a case report.
AB  - A case of renal pelvic transitional cell carcinoma accompanied by an adeno
      squamous carcinoma component in a horseshoe kidney is reported. This case is the
      first case reported in Japan to the best of our knowledge.

PMID- 2239613
TI  - [Percutaneous drainage of renal and perinephric abscesses].
AB  - Two patients with renal or perinephric abscess were successfully managed by
      percutaneous drainage under ultrasonic guidance. We recommend percutaneous
      drainage as the first choice of treatment for a renal or perinephric abscess
      instead of traditional open surgery, especially in a high risk patient.

PMID- 2239614
TI  - [Unilateral hydronephrosis with hypertension due to ureteral endometriosis].
AB  - A 35-year-old female patient was hospitalized for a headache. She was referred to
      our department for the evaluation of right hydronephrosis noted on the excretory
      urogram which was performed as part of a hypertensive diagnostic study. Endocrine
      examination revealed renal hypertension. Excretory urogram and antegrade
      pyelography showed obstruction of the lower part of the right ureter. On surgical
      exploration, the lower part of the right ureter was surrounded by brown tissue.
      Complete hysterectomy and ureterovesiconeostomy were performed. Histologically,
      the brown tissue around the ureter was diagnosed as endometriosis. One year after
      the operation, excretory urogram showed normal urinary tract and the blood
      pressure was 130/80 mmHg. Endometriosis is a common gynecological disease but
      ureteral endometriosis is relatively rare. Review of the Japanese literature
      disclosed 16 previous cases of ureteral endometriosis and we report the 17th case
      with a review of the literature.

PMID- 2239615
TI  - [A case of giant prostatic cystadenoma].
AB  - An 80-year-old man was admitted to our hospital with the chief complaint of
      urinary retention. On physical examination, a large tumor was recognized in
      pelvic cavity. Serum levels of prostatic acid phosphatase and gamma-seminoprotein
      were elevated. Anterior pelvic exenteration was performed because the tumor was
      huge and malignancy could not be ruled out preoperatively. The tumor weight was
      660 g (11 x 8 x 7 cm) and had a multicystic structure macroscopically.
      Immunohistochemical study by the prostatic specific antigen stain showed positive
      staining in the epithelial cells of the tumor, which suggest that the tumor was
      of prostatic origin.

PMID- 2239616
TI  - [Two cases of congenital urethral stenosis complicated with vesicoureteral
      reflux].
AB  - Secondary vesicoureteral reflux (VUR) is not uncommon, but is rarely accompanied
      by congenital urethral stenosis in children. We report 2 cases. Case 1 was in a 3
      year-old boy who had congenital anterior urethral stenosis accompanied by VUR.
      Urethroplasty by Johanson's operation was performed and 6 years later VUR
      disappeared. Case 2 was in a 7-year-old girl, who had congenital peripheral
      urethral stenosis accompanied by VUR. The urethra was dilated by a balloon
      dilator and about 1 year later VUR disappeared.

PMID- 2239617
TI  - [Cavernous hemangioma of the penis: report of a case immunohistochemically
      studied].
AB  - An 18-month-old boy was admitted in April, 1988 because of a penile mass which
      had been first noted at the age of one month. From nine months after birth,
      transient bleeding from the mass accompanied by pain had been occasionally noted.
      At the age of 14 months, the mass seemed to grow markedly. On physical
      examination, there was an irregularly shaped mass on the right side of the
      prepuce. It was palpated subcutaneously, soft in consistency and was 10 mm in
      diameter. It had a light-purple color. Upon surgery, the mass was found not to
      have originated from the cavernous body of the penis, so that it could be excised
      without difficulty. Histopathological diagnosis was cavernous hemangioma.
      Electron microscopic examination revealed findings suggestive of newly formed
      blood vessels such as abnormal cuboidal shape of endothelial cells and a high
      nucleocytoplasmic ratio. Immunohistochemical examination of factor VIII-related
      antigen was in homogeneously positive in vascular endothelial cells. To our
      knowledge, this is the twenty-eighth case reported in Japan.

PMID- 2239619
TI  - [Castleman disease in the pelvic retroperitoneum].
AB  - About 50% of the cases with Castleman disease firstly described by Castleman in
      1956 occur in the thoracic cavity. The pelvic cavity is a rare location affected
      by the disease; there are only 7 reports. Herein, a case of Castleman disease of
      the pelvic cavity is reported. A 41-year-old man complaining of microscopic
      hematuria consulted us. Drip intravenous pyelography and computerized tomography
      showed a solitary mass at the pelvic retroperitoneum. Abnormal laboratory
      findings were as follows; glucose tolerance test (GTT), erythrocyte sedimentation
      rate, alpha 2-globulin level, CRP titer and hematuria. With the diagnosis of a
      pelvic retroperitoneal tumor, pelvic exploration was performed. The resected
      tumor was encapsulated, elastic hard and 4x3x2 cm in size. The cut surface was
      homogeneously granular and yellowish white in color. Histological diagnosis was
      the plasma cell type of Castleman disease. Within three weeks after the
      operation, laboratory abnormalities diminished except for GTT and microscopic
      hematuria. The patient is free from the disease with no signs of recurrence for 2
      years postoperatively.

PMID- 2239618
TI  - [A case of paratesticular rhabdomyosarcoma].
AB  - A case of paratesticular rhabdomyosarcoma in an 18-year-old male is reported. The
      patient was admitted for swelling of the right scrotum and right inguinal pain.
      Malignant tumor of the right testis was suspected and a high inguinal orchiectomy
      was performed. The pathological diagnosis was paratesticular rhabdomyosarcoma.
      Following retroperitoneal lymph node extirpation, chemotherapy, so-called CYVADIC
      therapy, consisting of cyclophosphamide, vincristine, adriamycin and dacarbazine
      was employed in 3 regions. The patient is in good health without recurrence 16
      months after the surgery.

PMID- 2239620
TI  - [A case of Fournier's gangrene: was it triggered by prostatic massage?].
AB  - We have experienced a case of Fournier's gangrene which progressed rapidly after
      prostatic massage. The patient was a 70-year-old man who had poorly controlled
      diabetes mellitus, hemorrhoid, urethral stricture and benign prostatic
      hyperplasia. He visited an urologist complaining of pollakisuria and miction
      pain. Under the diagnosis of prostatitis, prostatic massage was performed. From
      that night, he developed a high grade fever. Simultaneously, redness, swelling
      and pain of the scrotum progressed rapidly, and 11 days later, he was admitted to
      our hospital. An X-ray examination revealed subcutaneous gas formation in the
      scrotum. Immediately, incision and drainage with extensive debridement of
      necrotic tissue were performed combined with chemotherapy using broad spectrum
      antibiotics and insulin therapy. About 3 months later, the gangrene and the wound
      were healed with granulation and scarring. Cultures of the pus and the necrotic
      tissue from the scrotum were positive for Bacteroides fragilis and several
      aerobes including Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella
      pneumoniae, Enterococcus and Staphylococcus epidermidis. The case proved to be
      non-clostridial gas gangrene.

PMID- 2239621
TI  - [Plasma methotrexate concentrations in urothelial cancer chemotherapy].
AB  - The plasma methotrexate (MTX) concentration was measured during 50 courses of
      chemotherapy on 26 urothelial cancer patients. A dose of 300 mg/body MTX was
      infused within 2 hours and plasma concentrations were measured at the scheduled
      times. Plasma level at the end of infusion was (2.3 +/- 0.8) x 10(-5) M/L, (2.9
      +/- 1.9) x 10(-5) M/L at the 6th-hour, and (1.9 +/- 1.8) x 10(-7) M/L at the 24th
      hour after the infusion. The plasma MTX concentration values were inversely
      correlated with creatinin clearance. In 6 cases of Kock pouch bladder, clean
      intermittent self catheterization of urine caused no meaningful increase of MTX.

PMID- 2239623
TI  - Extradural spinal cord compression from metastatic tumor.
AB  - Extradural spinal cord compression (ESCC) as a consequence of metastasis from
      various primary cancers represents the most common type of malignant lesion
      affecting the spinal cord. It has been estimated that 5% of all patients with
      systemic cancer who are autopsied have pathologic evidence of tumor invading the
      extradural space. The incidence of ESCC is expected to increase due to improved
      survival of the cancer patient. The current approach to the diagnosis of ESCC
      depends upon the recognition of early symptoms and signs of spinal cord
      compression. Despite the increasing clinical awareness of these complications,
      irreversible loss of ambulation continues to occur in over half of these
      patients. Early diagnosis is critical since onset of spinal cord injury may be
      sudden, often progressing to irreversible paralysis in a period of hours.
      Consequently, physicians dealing with cancer patients must maintain a high index
      of suspicion. This paper analyzes prognostic factors based on our prospective
      study and emphasize the use of diagnostic tests in early recognition of ESCC
      before onset of neurologic deficits.

PMID- 2239622
TI  - [Percutaneous removal of renal and upper ureteral stones: clinical results and
      complications of 103 cases].
AB  - We report the results and complications of 103 consecutive patients who underwent
      percutaneous removal of renal and ureteral stones. The overall clinical success
      rate was 80.6%. For the recent 33 cases in which UL-arm fluoroscopy was used,
      however, the success rate was as high as 87.9%, which was considered to be due to
      easier establishment of percutaneous direct access. The most common complications
      were bleeding (18.5%), extravasation (15.5%) and fever (9.7%). Four cases with
      significant bleeding required arteriography, but there were no sign of
      arteriovenous fistula nor pseudoaneurysms in any cases. To study renal
      parenchymal damage in the percutaneous procedures, plasma renin activities (PRA)
      were compared in 54 cases after six months. However, significant elevation of PRA
      did not occur in any case.

PMID- 2239624
TI  - The Alabama automated defibrillation pilot program.
AB  - The Alabama Chapter of the American College of Emergency Physicians is now
      sponsoring a pilot program using EMT-Basic equipped with semi-automatic ("smart")
      defibrillators for the treatment of cardiac arrest patients in the field. This
      article outlines the rationale for the program along with present status of
      results.

PMID- 2239625
TI  - Physician and provider obligations under the Medicare antidumping provisions.
AB  - The Medicare antidumping provision enacted in 1986 and revised in 1989 has
      serious implications, not only for hospitals, but also for physicians who provide
      care for emergency patients. In this article, the author discusses the
      obligations of health care providers under that provision, some recent
      developments under the emerging case law, and the implications of these
      developments for physicians.

PMID- 2239626
TI  - Nutrition counseling: guidelines for the practicing physician.
AB  - Americans thrive on news about food, nutrition, diets and fitness. Testimony to
      this phenomenon is the predominance of popular literature related to these topics
      in the print and broadcast media. All too often the emphasis is on overnight or
      simple solutions to complex problems. The public is an easy mark for the "health
      peddler" who lacks credentials but possesses effective motivational skills and
      speaks with conviction about unfounded promises and exaggerated outcomes.
      Nutrition misinformation wastes billions of dollars every year but the greatest
      harm occurs when needed medical intervention is delayed or ignored. Patients
      expect physicians to be able to answer nutrition related questions and to know
      where to refer them for further nutritional guidance when needed. (1) In order to
      assure appropriate referrals, physicians need to know where to find a qualified
      dietitian/nutritionist and how to verify appropriate credentials. When a patient
      is referred to a dietitian for nutrition assessment and counseling, the
      expectations should be clear to all concerned and should include a plan for
      follow-up communication. This article describes the basis for and benefits of a
      partnership between the physician and dietitian in providing quality health care
      and patient education.

PMID- 2239627
TI  - Mucormycosis: a community hospital perspective.
AB  - Mucormycosis (synonymous with phycomycosis and zygomycosis) is a devastating
      fungal infection which usually involves patients with diabetes mellitus, often
      complicated by ketoacidosis, and malignant neoplasms, commonly leukemia and
      lymphoma. Clinical manifestations include rhinocerebral, pulmonary, disseminated,
      isolated cerebral, gastrointestinal and cutaneous disease. Common to all forms of
      mucormycosis is vascular invasion with production of necrotic tissue. The
      diagnosis is achieved by demonstrating broad, non-septate hyphae with right-angle
      branching in a tissue biopsy specimen. Successful treatment consists of early
      diagnosis, intensive systemic antifungal therapy with amphotericin B, aggressive
      surgical debridement and control of the underlying disease. In our experience
      with mucormycosis at Huntsville Hospital, the patients were immuno- compromised
      and the infection was restricted to the lung. Despite use of amphotericin B in
      all patients, the only one who survived underwent surgical section of infected
      tissue.

PMID- 2239628
TI  - A closer look.

PMID- 2239630
TI  - Why this time?

PMID- 2239629
TI  - The art of medicine.

PMID- 2239631
TI  - In-office physician laboratories.

PMID- 2239632
TI  - Clonidine dosage.

PMID- 2239633
TI  - Use of very-low-calorie diets in obesity.

PMID- 2239634
TI  - Nasolaryngoscopy for family physicians.
AB  - Nasolaryngoscopy is easy to learn and safe and convenient to perform. It is
      readily accepted by patients and is a rich source of clinical information. The
      flexible nasolaryngoscope allows the physician to directly observe the anatomy of
      the nasal passages, pharynx and larynx. The procedure is helpful for identifying
      the etiology of chronic nasal complaints and hoarseness. Other possible
      indications for nasolaryngoscopy include suspected nasal foreign body, recurrent
      nasal or pharyngeal bleeding, and epiglottitis. With the use of this instrument,
      treatment of otolaryngologic conditions may be more specific, thereby reducing
      unnecessary referral or delay in treatment.

PMID- 2239635
TI  - Measles update.
AB  - The incidence of measles in the United States dramatically increased in the
      1980s, from a low of 1,497 cases in 1983 to over 17,000 cases in 1989. Family
      physicians can help reverse this trend by following the revised immunization
      schedule, which includes a measles-mumps-rubella (MMR) booster for preschool-age
      children. New guidelines also recommend that either the two-dose MMR schedule or
      serologic evidence of immunity be required for all persons entering college or
      employed in the medical field. Immunization policies for physician's offices
      should ensure that all office staff have acquired measles immunity and that a
      triage policy separating patients with rash from those with other illnesses is
      utilized. Mild upper respiratory illness, a history of seizures, nonanaphylactic
      egg allergy and asymptomatic human immunodeficiency virus infection are not
      contraindications to measles vaccine. All cases of measles should be reported to
      the local health department.

PMID- 2239636
TI  - Coarctation of the aorta.
AB  - Coarctation of the aorta is a common cardiovascular disorder with an unknown
      etiology. In the preductal type, blood flows from a patent ductus into the distal
      aorta. When the coarctation is juxtaductal or postductal, blood flows to the
      lower extremities by way of the subclavian arteries and collaterals. Plain films
      may show the reverse sign in postductal coarctation. Arteriography is the gold
      standard for making the diagnosis. However, magnetic resonance imaging will
      probably become an increasingly important diagnostic tool. The treatment of
      choice is surgery, with complete resection of the stenosed segment.

PMID- 2239637
TI  - Estrogen prophylaxis. The U.S. Preventive Services Task Force.
AB  - RECOMMENDATION: Although routine postmenopausal estrogen replacement is not
      recommended, estrogen therapy should be considered for asymptomatic women who are
      at increased risk for osteoporosis, who lack known contraindications and who have
      received adequate counseling about potential benefits and risks.

PMID- 2239638
TI  - Nutritional rickets.
AB  - Nutritional rickets was diagnosed in 18 infants aged eight to 24 months. Clinical
      features included progressive leg bowing, poor linear growth, a diet deficient in
      vitamin D, seizures, and abnormal serum calcium, phosphate and alkaline
      phosphatase levels. Wrist radiographs and serum alkaline phosphatase levels were
      the most useful confirmatory tests. Breast milk may not contain enough vitamin D
      to protect infants, particularly dark-skinned children and those living in
      cloudy, northern U.S. cities, from rickets after six months of age. As breast
      feeding becomes more widely practiced, care is required to ensure that infants at
      high risk for rickets receive appropriate vitamin D supplementation.

PMID- 2239639
TI  - Venous ulcers: pathophysiology and medical therapy.
AB  - Venous ulcers may occur as a result of lower extremity calf pump failure, with
      ensuing edema, trapping of white blood cells and deposition of pericapillary
      fibrin. Acute, smaller lesions are easily treated with adequate compression and
      occlusive dressings. Larger, more chronic wounds often benefit from some form of
      external compression. Occlusive dressings and local wound care are most effective
      when used simultaneously with compression. Sequential compression pumps merit
      study and may prove to be of therapeutic and prophylactic value. In refractory
      cases, long-term use of compression devices may be required to prevent ulcer
      recurrence.

PMID- 2239640
TI  - Constipation: pathophysiology and treatment.
AB  - Although many physicians consider constipation a trivial problem, it is one of
      the most frequent and chronic digestive disorders in the United States, affecting
      4.53 million people and causing considerable morbidity. More than $200 million
      are spent for over-the-counter laxatives and untold millions of dollars are spent
      for prescription drugs and other medical services to manage this disorder.
      Successful management requires an appreciation of the magnitude of the problem,
      an understanding of colorectal function and a clear assessment of the causes.
      Careful examination of the patient's anorectal anatomy and improvement in the
      patient's dietary habits are the first steps in management. Therapeutic options
      include behavioral modification strategies, diet and lifestyle changes,
      pharmacologic therapy and, rarely, surgical intervention.

PMID- 2239641
TI  - Tartrazine sensitivity.
AB  - Tartrazine (FD & C Yellow No. 5) is an approved azo dye present in many drugs and
      food products. During the 1970s, many cases of tartrazine sensitivity were
      reported. This led to new regulations that required the listing of azo dyes on
      package inserts of drugs and on packages of food products. Tartrazine sensitivity
      is most frequently manifested by urticaria and asthma. Although azo dyes have
      been implicated in accentuating hyperkinetic syndromes, tartrazine is not
      considered an offender. Vasculitis, purpura and contact dermatitis infrequently
      occur as manifestations of tartrazine sensitivity. Cross-sensitivity in aspirin
      sensitive and NSAID-sensitive patients may also occur. The mechanism of
      sensitivity is obscure and has been called pseudoallergic. Management consists
      mainly of avoidance of drugs and food products that contain tartrazine.

PMID- 2239642
TI  - Family physicians can clarify issues for HIV-positive patients.

PMID- 2239643
TI  - Recommended core educational guidelines on alcoholism and substance abuse for
      family practice residents. American Academy of Family Physicians.

PMID- 2239644
TI  - NIH statement covers early breast cancer treatment.

PMID- 2239645
TI  - Methadone use for controlling HIV.

PMID- 2239647
TI  - Access to health care.

PMID- 2239646
TI  - Family physicians and a smoke-free society.

PMID- 2239648
TI  - Silent myocardial ischemia: dilemma or blessing?
AB  - Developing an optimal strategy for the evaluation and management of patients with
      silent myocardial ischemia is extremely difficult. Although otherwise healthy,
      asymptomatic individuals may be at risk of dying suddenly during exercise,
      neither exercise testing nor Holter monitoring reliably identifies those at
      greatest risk. In patients with underlying coronary artery disease, silent
      ischemia increases the risk of an adverse outcome.

PMID- 2239649
TI  - New perspectives in the management of Alzheimer's disease.
AB  - Alzheimer's disease is the most common cause of progressive dementia in older
      adults. Diagnosis is based on a careful history, a thorough physical examination
      and appropriate laboratory studies. Although the pathology of Alzheimer's disease
      is well described, the etiology remains unknown. The only well-established risk
      factors are advanced age and family history. Management problems frequently
      include depression, delirium, wandering, urinary incontinence and iatrogenic
      disease.

PMID- 2239650
TI  - Approaching the protein-sparing modified fast.
AB  - The protein-sparing modified fast is a safe and effective method for losing a
      large amount of weight relatively quickly. This diet should be used in
      combination with an exercise program, behavior modification and patient
      education. Caloric intake is in the range of 400 to 800 per day. Candidates for
      the diet should be generally healthy; they should have at least 40 lb to lose or
      be at more than 120 percent of their ideal body weight.

PMID- 2239651
TI  - Recognition and treatment of major depression.
AB  - Major depression is a syndrome that can be triggered by numerous physical and
      psychosocial factors. Concurrent somatic complaints can complicate the diagnosis.
      Patient evaluation requires a comprehensive history, physical and mental status
      examinations, and a number of laboratory studies. Effective treatment of
      depression enhances the quality of life, reduces the probability of secondary
      alcoholism or suicide, frequently improves coexisting medical problems and
      reduces the high rate of health care use by these patients.

PMID- 2239653
TI  - Initial evaluation of HIV-infected patients.

PMID- 2239652
TI  - Hypnosis in family medicine.
AB  - Hypnosis can be a useful adjunct to other treatment modalities. For example,
      hypnosis may induce a level of relaxation that allows patients to cooperate more
      easily with conventional treatment. The often dramatic historical background of
      hypnosis has led to misconceptions about hypnotic technique and its clinical
      applications in modern medicine. Hypnosis is useful in the treatment of acute and
      chronic pain, somatoform and habit disorders, anxiety and depression. Persons who
      are attempting to stop smoking, patients with bulimia and those with psychogenic
      impotence may respond to hypnosis.

PMID- 2239654
TI  - Persistent uptake of indium-111-antimyosin monoclonal antibody in patients with
      myocardial infarction.
AB  - Indium-111(111In)-antimyosin scintigraphy was investigated in 27 patients with
      myocardial infarction. 111In-antimyosin Fab was administered intravenously, and
      planar and single photon emission computed tomographic images were obtained 48
      hours later. Uptake of 111In-antimyosin was present in 9 of 10 patients (90%)
      studied within 6 days of infarction. During the second week positive scans were
      seen in 16 of 16 patients (100%) including 13 (81%) who had normal creatine
      kinase levels. The mechanism of persistent positive antimyosin images in the
      subacute stage of myocardial infarction remains to be clarified. 111In-antimyosin
      scintigraphy may be useful as a noninvasive method for the detection of
      myocardial injury late and early after a suspected acute myocardial infarction.

PMID- 2239655
TI  - Coronary perfusion catheter: its effectiveness in an experimental model of acute
      coronary occlusion.
AB  - The effectiveness of a coronary perfusion catheter was studied in an animal model
      of acute coronary occlusion. Systemic hemodynamic variables, regional myocardial
      blood flow (RMBF) in the subepicardium and subendocardium, and regional systolic
      function (systolic segmental shortening) of the area perfused by the circumflex
      coronary artery (CX) were measured in eight anesthetized dogs. After baseline
      measurements, the CX coronary artery was occluded with a silk snare and
      measurements were repeated after 5 minutes of ischemia (occlusion No. 1). The
      snare was released and 1 hour later the snare occlusion was repeated after
      placement of a perfusion catheter in the CX coronary artery. After 5 minutes,
      measurements were repeated (occlusion No. 2). To determine the long-term
      effectiveness of the catheter, hemodynamic variables and regional function
      measurements were then obtained every 15 minutes for a total of 60 minutes.
      During occlusion No. 1, RMBF decreased from 1.30 +/- 0.20 to 0.41 +/- 0.13 ml.min
      1.gm-1 (p less than 0.01), and subendocardial RMBF decreased from 1.44 +/- .24 to
      0.34 +/- 0.15 ml.min-1.gm-1 (p less than 0.01). After insertion of the perfusion
      catheter (occlusion No. 2), subepicardial RMBF was maintained at 0.97 +/- 0.16
      and subendocardial RMBF was maintained at 0.78 +/- 0.13 ml.min-1.gm-1; during
      occlusion No. 2 subepicardial RMBF was greater (p less than 0.05) than occlusion
      No. 1 and was not different from baseline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239657
TI  - Left ventricular asynchrony: an indicator of regional myocardial dysfunction.
AB  - There is a marked heterogeneity of myocardial wall thickening within the left
      ventricle and among different individuals. It is therefore difficult to detect
      regional myocardial dysfunction from absolute values of systolic wall thickening.
      We tested whether the extent of left ventricular asynchrony during ischemia and
      reperfusion can be used to quantify the severity of regional myocardial
      dysfunction when nonischemic baseline function is not known. In six anesthetized,
      open-chest dogs regional myocardial wall thickness was measured by means of
      sonomicrometry under control conditions, at three degrees of ischemic dysfunction
      (mild, moderate, and severe), and after release of a 15-minute occlusion of the
      left circumflex coronary artery, when degrees of moderate and mild reperfusion
      dysfunction similar to the preceding ischemic dysfunction were present. Two
      indexes of left ventricular asynchrony were calculated: (1) postejection
      thickening (PET) and (2) the phase difference of the first Fourier harmonic of
      posterior versus anterior myocardial wall motion (PD). Systolic myocardial wall
      thickening was decreased from 15.3 +/- 3.1 (standard deviation) % (control value)
      to 9.7 +/- 1.4% (mild ischemia), 4.2 +/- 1.6% (moderate ischemia), and -3.7 +/-
      3.1% (severe ischemia). Conversely PET increased from 0.02 +/- 0.04 mm (control
      value) to 0.15 +/- 0.22 mm (mild ischemia), 0.19 +/- 0.15 mm (moderate ischemia),
      and 0.50 +/- 0.26 mm (severe ischemia). PD increased from 9 +/- 28 degrees
      (control value) to 22 +/- 19 degrees (mild ischemia), 54 +/- 18 degrees (moderate
      ischemia), and 107 +/- 21 degrees (severe ischemia). After release of the 15
      minute left circumflex coronary artery occlusion, PET and PD recovered to 0.34 +/
      0.19 mm and 36 +/- 24 degrees (moderate dysfunction) and 0.25 +/- 0.31 mm and 29
      +/- 8 degrees (mild dysfunction), respectively. There were inverse linear
      relationships between systolic wall thickening and PET (r = -0.86, p less than
      0.001) and between systolic wall thickening and PD (r = -0.87, p less than
      0.001). Inotropic stimulation by postextrasystolic potentiation increased
      regional systolic myocardial posterior and anterior wall thickening but did not
      alter the extent of left ventricular asynchrony. Thus, when normal baseline
      function is not known, the severity of regional myocardial dysfunction at a given
      inotropic state can be determined by analysis of left ventricular asynchrony.
      There was no significant correlation between the extent of PET and PD during
      ischemia and at early reperfusion and the recovery of contractile function at
      late reperfusion. Thus PET does not provide a prospective marker for the
      functional outcome of reperfusion.

PMID- 2239656
TI  - Dose-dependent reduction of myocardial infarct size with the perfluorochemical
      Fluosol-DA.
AB  - The perfluorochemical Fluosol-DA has been shown to reduce infarct size. However,
      the dose-response relationship of the agent is unknown. Because
      perfluorochemicals (PFC) can potentially saturate the reticuloendothelial system
      and decrease carbon clearance as well as cause a transient elevation in liver
      enzymes, the present study was conducted to determine the lowest effective dose.
      New Zealand White rabbits (n = 73) were randomly selected prior to infarction to
      receive 10, 15, 20, 25, or 30 ml/kg PFC or an equivalent volume of 5% dextran
      (control) intravenously. Animals underwent 30 minutes of coronary artery
      occlusion with PFC or dextran infused over a 30-minute period starting at 20
      minutes into the occlusion. Animals were put to death at 24 hours and infarct
      size was determined histologically and quantitated by computerized planimetry.
      Neutrophil infiltration into the ischemic myocardium was evaluated
      semiquantitatively. No hemodynamic differences were noted within groups. Infarct
      size was similar to that of controls in animals treated with 10 or 15 ml/kg PFC.
      Significant infarct size reduction, however, was noted in animals treated with
      20, 25, and 30 ml/kg PFC versus controls; (p = 0.05, 0.04, and 0.02,
      respectively). Maximal infarct size reduction was seen with 30 ml/kg PFC (35%).
      Neutrophil infiltration was significantly decreased in all groups treated with
      PFC. These results show that intravenous Fluosol-DA significantly reduces infarct
      size at a minimal dose of 20 ml/kg.

PMID- 2239658
TI  - Detection and quantitation of ischemic left ventricular dysfunction using a new
      video intensity technique for regional wall motion evaluation.
AB  - Eighty patients with ischemic heart disease and 17 normal subjects were evaluated
      for left ventricular regional wall motion by means of a new method. The wall
      motion analysis is based on video intensity. This technique uses a temporally
      sliding analysis to evaluate the cardiac cycle in 100 msec intervals. Presence of
      coronary artery disease was defined as more than 50% measured diameter stenosis.
      Wall motion abnormalities in regions perfused by stenotic vessels were most
      common in early diastole (76%). Sensitivity of this method at rest in patients
      with coronary artery disease was 79.7% (p less than 0.0001) and overall accuracy
      was 84.2% (p less than 0.0001). Abnormalities in both systole and diastole were
      more common in regions perfused by severe lesions (greater than 75%) than in
      those perfused by moderately stenotic (less than 75%) vessels (p less than 0.05).
      A comparison of the new method with phase and amplitude analysis was performed in
      15 patients and with two-frame analysis in 40 patients. This new method yielded a
      higher sensitivity than either of the other two methods.

PMID- 2239659
TI  - Silent myocardial ischemia and infarction in diabetics with peripheral vascular
      disease: assessment by dipyridamole thallium-201 scintigraphy.
AB  - We investigated the incidence of silent myocardial ischemia and infarction as
      assessed by dipyridamole thallium scintigraphy in 30 diabetic patients with
      peripheral vascular disease and without clinical suspicion of coronary artery
      disease. Seventeen patients (57%) had thallium abnormalities, with reversible
      thallium defects compatible with ischemia in 14 patients (47%) and evidence of
      prior, clinically silent myocardial infarction in 11 patients (37%). Thallium
      abnormalities were most frequent in patients with concomitant hypertension and
      cigarette smoking (p = 0.001). These results suggest that unsuspected coronary
      artery disease is common in this particular group of patients with diabetes
      mellitus.

PMID- 2239660
TI  - Coronary angioplasty in symptomatic patients after bypass surgery.
AB  - With the availability of percutaneous transluminal coronary angioplasty (PTCA),
      the management of patients who present with recurrent angina following coronary
      artery bypass surgery (CABG) has changed. From January 1987 to December 1988, 149
      symptomatic post CABG patients underwent coronary angiography at our institution.
      Ninety were treated with medical antianginal therapy, 14 had repeat surgery, and
      45 underwent PTCA. Complications of repeat CABG included one death, two
      perioperative myocardial infarctions, and four patients with postoperative
      supraventricular arrhythmia. PTCA was performed on 42 lesions in 37 native
      vessels (88% success rate), and on 24 lesions in 23 vein grafts (91.7% success
      rate). Complications included acute reocclusion (one patient), peripheral artery
      occlusion (one patient), hematoma formation (one patient), and periprocedure
      myocardial infarction (one patient). No deaths occurred. At a mean follow-up of
      5.9 +/- 3.8 months, 10 patients had recurrent symptoms, six of whom were found to
      have restenosis. Repeat PTCA was successfully accomplished in four patients; the
      other two were treated medically. It is concluded that PTCA is a feasible
      alternative to repeat CABG in selected patients and can be achieved with a high
      success rate and minimal complications.

PMID- 2239661
TI  - Early assessment of coronary reserve after bypass surgery by dipyridamole
      transesophageal echocardiographic stress test.
AB  - The evaluation of coronary reserve within a few hours of aortocoronary bypass
      surgery could be of extreme utility for the follow-up or therapeutical management
      of these patients. In 11 men patients who underwent aortocoronary bypass surgery,
      a dipyridamole echocardiography stress test was carried out before (1 to 3 days),
      early after (68 to 130 minutes), and 1 week after surgery. The first and third
      tests were performed using a standard transthoracic approach, while the second
      was performed by a transesophageal approach. Dipyridamole was administered
      intravenously at a dose of 0.56 mg/kg body weight (low dose) and eventually
      adding 0.28 mg/kg body weight (high dose), always in the absence of antiischemic
      therapy. An arbitrary wall motion score (0 = eukinesia; 1 = hypokinesia; 2 =
      akinesia; 3 = dyskinesia) was assigned to the seven different myocardial regions
      in which the left ventricle was divided in order to have a semiquantitative
      score. Under basal conditions wall motion score per patient in the three series
      of tests did not change significantly (1.6, 1.4, and 1.5, respectively), while
      the mean score during dipyridamole administration showed significant differences
      (3.6, 1.9, and 1.9, respectively), indicative of the results obtained by surgical
      repair. The test, positive in all patients before surgery, showed wall motion
      abnormalities and ischemic ECG changes in two patients immediately after surgery
      by the transesophageal approach. One patient who had a normal basal contraction
      pattern and an abnormal response after the test developed in the following days a
      perioperative myocardial infarction, while a second patient in the follow-up
      period developed low-level effort angina.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239662
TI  - Clinical significance of simple heart rate-adjusted ST segment depression in
      supine leg exercise in the diagnosis of coronary artery disease.
AB  - To evaluate the clinical significance of simple heart rate-adjusted ST segment
      depression (delta ST/delta HR) in the diagnosis of coronary artery disease, 42
      patients with stable exertional angina underwent supine leg exercise testing and
      cardiac catheterization. During exercise, heart rate, a multilead
      electrocardiogram, and pulmonary artery wedge pressure were recorded. The
      sensitivity and accuracy of the delta ST/delta HR criteria (greater than or equal
      to 3.0 microV/beat/min) were significantly greater than the conventional analysis
      of ST segment depression criteria (greater than or equal to 0.2 mV) for detecting
      three-vessel coronary artery disease at a matched specificity of 72% (100% versus
      46%, 81% versus 64%, p less than 0.01). A significant linear correlation was
      found between maximum pulmonary artery wedge pressure increments during exercise
      (delta PAWP) or Gensini score and the delta ST/delta HR (delta PAWP: r = 0.51, p
      less than 0.001; Gensini score: r = 0.47, p less than 0.001). There were no
      statistically significant differences in the delta PAWP or Gensini score between
      patients with three-vessel disease who had delta ST/delta HR greater than or
      equal to 3.0 microV/beat/min and those with one- or two-vessel disease who had
      delta ST/delta HR greater than or equal to 3.0 microV/beat/min (delta PAWP: 18.1
      +/- 2.0 versus 21.9 +/- 3.3, p = NS; Gensini score: 68.5 +/- 6.6 versus 66.3 +/-
      11.3, p = NS). These findings demonstrate that delta ST/delta HR is more useful
      than a conventional analysis of ST segment depression for identifying not only
      anatomically severe coronary artery disease but also functionally severe coronary
      artery disease.

PMID- 2239663
TI  - Electrophysiologic effects of exogenous phosphocreatine in cardiac tissue:
      potential antiarrhythmic actions.
AB  - The cellular electrophysiologic effects of exogenous phosphocreatine (PCr) were
      analyzed to ascertain its purported antiarrhythmic properties during myocardial
      ischemia and reperfusion. Transmembrane potentials were recorded from isolated
      guinea pig papillary muscles and Purkinje fibers studied in vitro. Under control,
      normoxic conditions, 10 mmol/L PCr significantly increased the action potential
      duration (measured at 90% of repolarization) in ventricular muscle by 14.6 +/-
      3.3 msec and the effective refractory period by 11.5 +/- 3.8 msec (both p less
      than 0.01). Under ischemic-like conditions (hypoxia, lactic acidosis, elevated
      [K+]o, zero substrate) PCr had no effect. Phosphocreatinine, a related compound
      that is not a direct substrate in the creatine kinase reaction, acted similarly
      to PCr suggesting that alterations induced by PCr did not involve a change in the
      energy state of cells. However, PCr reduced free [Ca2+]o by nearly 20%, and its
      electrical effects under normoxic conditions could be largely reversed by a
      concomitant 20% increase in [Ca2+]o. In Purkinje fibers superfused with low [K+]o
      Tyrode's solution to elicit conditions of Ca2+ overload, delayed
      afterdepolarizations and triggered responses were reversibly inhibited by PCr.
      These data suggest that the antiarrhythmic effects of PCr in situ may involve
      prolongation of the effective refractory period in nonischemic tissue or
      attenuation of membrane changes elicited by Ca2+ overload in ischemic cells. The
      mechanism by which PCr produces these effects may be related in part to changes
      in extracellular Ca2+ composition.

PMID- 2239664
TI  - ACE inhibition improves vagal reactivity in patients with heart failure.
AB  - The deranged autonomic control of heart rate was studied in 34 patients with
      heart failure (New York Heart Association [NYHA] functional class II to III) by
      examining the carotid sinus baroreflex. The carotid sinus baroreceptors were
      stimulated by graded suction. The slope of the regression line between increases
      in cycle length and the degree of neck suction was taken as an index of
      baroreflex sensitivity. The reflex response is mediated by a selective increase
      of vagal efferent activity. Baroreflex sensitivity therefore represents a measure
      of vagal reactivity. Using multiple regression analysis, baroreflex sensitivity
      (BS) correlated positively to stroke volume index (SVI) and inversely to plasma
      renin activity (PRA) and to age: BS = 0.47 SVI - 0.38 PRA - 0.23 age + constant
      (r = 0.74; p less than 0.0005). In addition to digitalis and diuretics,
      angiotensin-converting enzyme (ACE) inhibitors (captopril or enalapril) were
      given to 16 patients for a mean of 17 +/- 3 days. The patients with hemodynamic
      improvement (group A) exhibited improved baroreflex sensitivity (1.4 +/- 0.4 to
      3.6 +/- 1.2 msec/mm Hg; p less than 0.01). Baroreflex sensitivity remained
      unchanged (3.1 +/- 0.8 to 2.4 +/- 1.0 msec/mm Hg; n.s.) in the patients without
      hemodynamic improvement (group B). The increase in reflex sensitivity did not
      correlate with hemodynamic alterations. Baroreflex sensitivity during ACE
      inhibition (BSD) was only related to the baseline baroreflex sensitivity (BSB):
      BSD = 2.8 BSB - 0.46 (r = 0.84; p less than 0.005). In patients with heart
      failure, reflex bradycardia decreases with age and with PRA and increases with
      stroke volume. Chronic therapy with ACE inhibitors enhances vagal reactivity in
      patients with hemodynamic improvement.

PMID- 2239665
TI  - Are ioxaglate and iopamidol equally safe and well tolerated in cardiac
      angiography? A randomized, double-blind clinical study.
AB  - A randomized, double-blind, parallel-group study was performed in 50 patients
      undergoing left ventriculography and coronary arteriography to evaluate ECG
      changes and the effects on left ventricular function of a low-osmolar ionic
      contrast agent, ioxaglate, as compared with a low-osmolar nonionic contrast
      medium, iopamidol. Twenty-five patients received ioxaglate (group 1) and 25
      patients received iopamidol (group 2). All patients underwent 48 hours of
      continuous ECG recording beginning 24 hours before the cardiac catheterization.
      Left ventricular systolic and end-diastolic pressure, peak positive dp/dt, and
      dp/dt/P ratio were measured immediately before and after left ventriculography
      and 3 minutes later. Left ventricular systolic pressure did not change after
      injection of either contrast medium. Left ventricular end-diastolic pressure
      increased by 30% in group 1 (p less than 0.01) and by 22% in group 2 (p less than
      0.01) immediately after left ventriculography. A further increase by 45% in group
      1 (p less than 0.01) and by 24% in group 2 (p less than 0.01) was observed 3
      minutes later. No differences were observed between values obtained in the two
      groups. Peak positive dp/dt did not change immediately after injection of either
      contrast medium but decreased by 5% (not significant) in group 1 and by 7% (p
      less than 0.02) in group 2 three minutes after left ventriculography. There were
      no significant differences between the two groups. Analysis of continuous 48-hour
      ECGs showed that both ioxaglate and iopamidol induced a slight increase (by 8%
      and 7%, respectively; p less than 0.05) in heart rate during injection with early
      and complete recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239666
TI  - Color Doppler diagnosis of mechanical prosthetic mitral regurgitation: usefulness
      of the flow convergence region proximal to the regurgitant orifice.
AB  - In prosthetic or paravalvular prosthetic mitral regurgitation, transthoracic
      color Doppler flow mapping can sometimes fail to detect the regurgitant jet
      within the left atrium because of the shadowing by the prosthetic valve. To
      overcome this limitation, we assessed the utility of color Doppler visualization
      of the flow convergence region (FCR) proximal to the regurgitant orifice in 20
      consecutive patients with mechanical prosthetic mitral regurgitation documented
      by surgery and cardiac catheterization (13 of 20 patients). In addition, we
      studied 33 patients with normally functioning mitral prostheses. Doppler studies
      were performed in the apical, subcostal, and parasternal long-axis views. An FCR
      was detected in 95% (19 of 20) of patients with prosthetic mitral regurgitation.
      A jet area in the left atrium was detected in 60% (12 of 20) of patients. In 18
      of 19 patients with Doppler-detected FCR, the site of the leak was correctly
      identified by observing the location of the FCR. A trivial jet area was detected
      in eight patients with a normally functioning mitral prosthesis; in none was an
      FCR identified. Thus color Doppler visualization of the FCR proximal to the
      regurgitant orifice is superior to the jet area in the diagnosis of mechanical
      prosthetic mitral regurgitation. Moreover, FCR permits localization of the site
      of the leak with good accuracy.

PMID- 2239668
TI  - The effects of lying position on ventricular volume in congenital absence of the
      pericardium.
AB  - In patients with congenital absence of the left pericardium, the heart is
      supported by the existing right pericardium in the right lateral position, while
      it is not in the left lateral position. To investigate the change in ventricular
      size resulting from postural change, seven patients with this malformation were
      examined. Ventricular volumes were calculated by computed tomography, integrating
      areas of computed tomographic cross sections measured at 1 cm intervals from the
      cardiac apex to the aortic arch. In the right lateral position, right ventricular
      (RV) and left ventricular (LV) volumes were no different from those of five
      control subjects. With a change in the lying position to the left, the increase
      in the ventricular volume was significantly greater than that in the control
      subjects (35 +/- 11 versus 3 +/- 3 ml in the right ventricle and 15 +/- 13 versus
      3 +/- 8 ml in the left ventricle). The increases in RV and LV end-diastolic
      pressure, however, were almost the same as those in the 11 control subjects. It
      is concluded that the cardiac ventricle, especially the right ventricle, dilates
      significantly with a small increase in preload in patients with congenital
      absence of the pericardium. It may be a clue for clarifying the ventricular
      distensibility being freed from physiologic restraint of the pericardium for a
      long period.

PMID- 2239667
TI  - Transesophageal echocardiography in the awake elderly patient: its role in the
      clinical decision-making process.
AB  - To assess the impact on the management and safety of transesophageal
      echocardiography (TEE) in the elderly population, the results and limitations of
      this technique were retrospectively analyzed in 88 patients. TEE was indicated
      whenever the transthoracic approach was not diagnostic or was inconsistent with
      the clinical setting. The most frequent clinical indications were to investigate
      the source of emboli, assess valvular regurgitation, and identify valvular
      vegetations. In 72 patients (82%) TEE significantly influenced management
      decisions. In selected patients TEE avoided the use of more invasive diagnostic
      procedures. Adverse effects included occasional premature atrial or ventricular
      beats (11 patients), sinus bradycardia (six patients), and protracted nausea (one
      patient). We conclude that in elderly patients with cardiovascular diseases, TEE
      plays a significant role in the decision-making process without adding a
      significant risk.

PMID- 2239669
TI  - Noninvasive assessment of cardiac output in children using impedance
      cardiography.
AB  - This study evaluated the effect of intracardiac shunting on the accuracy of
      thoracic bioimpedance-derived cardiac output determinations. Twenty-six patients,
      ranging in age from 3 months to 17 years, underwent cardiac catheterization
      during which simultaneous Fick and impedance measurements of cardiac output were
      obtained. The subjects were divided into three groups: 10 children with no
      intracardiac shunts, nine children with predominant left-to-right intracardiac
      shunts, and seven children with predominant right-to-left intracardiac shunts.
      Positive correlations between impedance and Fick-derived cardiac output
      determinations were obtained in the non-shunt group (r = 0.84), with lower
      correlations in the left-to-right shunt group (r = 0.70). In the right-to-left
      shunt group, the impedance derived cardiac output correlated with Fick pulmonary
      flow (r = 0.82), but the variability was unacceptably large. Although further
      study is needed, impedance cardiography appears to have validity as a methodology
      in pediatric critical care and cardiovascular health research.

PMID- 2239670
TI  - The evolving pattern of digoxin intoxication: observations at a large urban
      hospital from 1980 to 1988.
AB  - Digoxin intoxication has been reported to be a common adverse drug reaction with
      an in-hospital incidence of 6% to 23% and an associated mortality rate as high as
      41%. A retrospective review was conducted to assess the accuracy of diagnosis,
      the morbidity and mortality of digoxin intoxication, and its incidence in
      hospitalized patients with heart failure. We reviewed the medical records of 219
      patients discharged with the diagnosis of digoxin intoxication between 1980 and
      1988. Patients were classified as follows: (1) Definite intoxication--patients
      with symptoms and/or arrhythmias suggestive of digoxin intoxication that resolved
      after discontinuation of digoxin; (2) possible intoxication--patients with
      symptoms and/or arrhythmias suggestive of digoxin intoxication in the absence of
      documented resolution after discontinuation of digoxin, or the presence of other
      clinical illnesses that could possibly account for those findings; (3) no
      intoxication--patients whose symptoms or ECG abnormalities were clearly explained
      by other associated clinical illnesses and persisted after withdrawal of digoxin.
      We identified only 43 patients (20%) with definite intoxication. The majority of
      patients discharged with the diagnosis of digoxin intoxication (133 or 60%) were
      classified as possibly digoxin intoxicated, and 43 patients (20%) had no clinical
      evidence to support this diagnosis. To estimate the incidence of digoxin
      intoxication, we also reviewed the medical records of 994 patients admitted in
      1987 with heart failure. Of these, 563 were receiving digoxin and in 27 the
      diagnosis of digoxin intoxication was made by their clinicians. Our review showed
      that only four were definitely intoxicated (0.8%), and the diagnosis could not be
      excluded in another 16 (4%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239672
TI  - A simplified method to measure coronary blood flow velocity in patients:
      validation and application of a Judkins-style Doppler-tipped angiographic
      catheter.
AB  - To facilitate more rapid and safe measurement of coronary flow velocity reserve
      in patients, we developed a Judkins-style angiographic catheter tipped with a 20
      MHz Doppler crystal. In 19 patients without coronary artery disease, resting and
      hyperemic (10 mg intracoronary papaverine) mean and phasic coronary flow velocity
      signals were measured with the Judkins-style and 2.5F intracoronary Doppler
      catheters at identical coronary loci. Mean coronary flow velocity at rest was
      similar (14 +/- 8, 10 +/- 7 cm/sec, p = ns), but was higher during hyperemia for
      the Judkins-Doppler (41 +/- 8 versus 32 +/- 14 cm/sec, p less than 0.05).
      Coronary flow velocity reserve, calculated as the ratio of mean velocity at rest
      to mean velocity following papaverine, was 3.3 +/- 1.4 and 3.7 +/- 1.2 units (p =
      ns) for the Judkins and intracoronary Doppler techniques, respectively (r =
      0.801, p less than 0.001). The Judkins-style Doppler catheter technique permits
      flow velocity and coronary flow velocity reserve measurements that correlate
      strongly with those of the intracoronary catheter technique, facilitating safe,
      quick, and accurate assessment of coronary physiology.

PMID- 2239671
TI  - Is obesity-related hypertension less of a cardiovascular risk? The Framingham
      Study.
AB  - The hypothesis that obesity-related hypertension is relatively innocuous was
      explored by an examination of cardiovascular events over 34 years of follow-up
      when related to biennially measured weights and blood pressures using time
      dependent covariate proportional hazards analysis. The 5209 participants were
      also classified by age, cigarette smoking, and antihypertensive treatment at each
      of four baseline examinations with 8-year follow-up periods. Over the period of
      follow-up, there were 978 cardiovascular events in men and 836 in women. Risk of
      cardiovascular morbidity and mortality in general and of CHD in particular was as
      strongly related to hypertension at all levels of body mass index. This was also
      found to apply when adjustment was made for possible confounding by cigarette
      smoking. Age and smoking-adjusted absolute risks of cardiovascular events were
      found to be higher in hypertensive individuals with high than with low BMIs.
      Furthermore, the relative risk of cardiovascular disease did not vary
      significantly with BMI. Thus hypertension is at least as dangerous in obese as in
      lean persons at all ages in either sex, providing no support for the hypothesis
      that hypertension in the obese is more benign. This is important, since obesity
      predisposes to hypertension and most who have hypertension are obese. This report
      examines the hypothesis for CVD outcomes considered by previous reports and also
      the subcategories of CVD disease such as myocardial infarction and stroke, and
      includes data on both men and women and on young and old.

PMID- 2239673
TI  - Clinical factors associated with delay time in suspected acute myocardial
      infarction.

PMID- 2239674
TI  - Iatrogenic left coronary artery fistula-to-left ventricle following PTCA: a
      previously unreported complication with nonsurgical management.

PMID- 2239675
TI  - Dehiscence of the proximal anastomosis of aortocoronary bypass graft.

PMID- 2239676
TI  - Idiopathic multiple left ventricular aneurysms.

PMID- 2239677
TI  - Aortic pseudoaneurysm occurring after cardiac transplantation.

PMID- 2239678
TI  - Right atrial myxoma causing total destruction of the tricuspid valve leaflets.

PMID- 2239679
TI  - Two-dimensional echocardiography and magnetic resonance imaging in diagnosis of
      idiopathic dilation of the right atrium.

PMID- 2239680
TI  - Acquired left ventricular-right atrial and right ventricular communication due to
      infective endocarditis after aortic valve replacement.

PMID- 2239682
TI  - Echocardiographic diagnosis of pulmonary embolus.

PMID- 2239681
TI  - Balloon dilatation of double-chamber right ventricle.

PMID- 2239683
TI  - Acutely blocked Blalock-Taussig shunt following cardiac catheterization:
      successful recanalization with intravenous streptokinase.

PMID- 2239684
TI  - Clinically undetected cardiac lymphoma causing fatal congestive heart failure.

PMID- 2239685
TI  - Common-type atrial flutter exhibiting double potential with phenomenon of
      entrainment assessed.

PMID- 2239687
TI  - The future of pharmacy: pharmaceutical care.

PMID- 2239686
TI  - Congenital coronary artery fistula: diagnosis by two-dimensional Doppler
      echocardiography.

PMID- 2239688
TI  - Georgia consumers' awareness and perceptions of generic drugs after the scandals.

PMID- 2239689
TI  - Give patients their Rx rights!

PMID- 2239690
TI  - Tapping employee insights with the Nominal Group Technique.
AB  - In our scenario, we brought together the manager, pharmacist, full-time and part
      time sales people, the delivery person, and the stock person, to give a
      perspective from every possible area of operation. We have found that input from
      all employees often generates ideas that they would not have thought of on their
      own. We suggest that NGT, used on a quarterly basis, for instance, would be an
      excellent means of developing team spirit, employee participation, and meaningful
      and effective solutions to problems. NGT is much better than trying to "go it
      alone," especially in today's competitive environment. NGT helps us realize that
      the potential contribution of employees is great, but generally untapped. The
      process requires planning but little time; yet it can produce astounding results,
      both in encouraging team spirit and in protecting profitability. The process
      fosters effective use of a participative style of management. It forces us, in
      effect, to use our most valuable resource: the people we manage.

PMID- 2239691
TI  - Phenylpropanolamine hydrochloride.
AB  - Phenylpropanolamine has been classified by the FDA advisory review panel as
      generally safe and effective for short-term weight control. The maximum daily
      dose for this indication is 75 mg. When used in recommended doses by patients
      without significant risk factors, serious side effects appear to occur
      infrequently. The pharmacist has an important role in preventing misuse and abuse
      of phenylpropanolamine through counseling the patient about its appropriate,
      short-term (not exceeding 12 weeks) use in a comprehensive weight-reduction
      program. Patients should be alerted to signs and symptoms of serious adverse
      reactions and advised to discontinue use if any reactions appear.

PMID- 2239693
TI  - Pharmaceutical care and the elderly.

PMID- 2239692
TI  - Overview of infectious diseases, Part 1.
AB  - Microbiologic characteristics include virulence, inoculum size, and the interplay
      between normal flora and pathogenic organisms. These characteristics, as well as
      relevant host factors, are an important part of the infectious disease process.
      Parts 2 and 3 of this series will review the use of drug therapy and the general
      manifestations of infectious diseases.

PMID- 2239694
TI  - Experimental contrast-associated nephropathy and its clinical implications.
AB  - Acute renal failure after contrast media injection has been recognized for at
      least 35 years but the exact mechanism responsible for the renal injury remains
      an enigma. The clinical characteristics of contrast-induced nephropathy (CAN) are
      well-known although more recently the nonoliguric presentation has occurred at an
      increased frequency--in 70 to 90% of cases. For nonoliguric presentation of CAN,
      one can expect an asymptomatic increase in serum creatinine, the mean peak
      occurring at 4.2 days. If oliguric, the fractional excretion of sodium will be
      less than 1% and resistant to either fluid challenge or loop diuretics.
      Preexisting renal insufficiency, with or without diabetes mellitus, increases the
      risk of CAN 6- to 10-fold but recovery is expected, with less than 10% of all
      patients requiring dialytic support. Despite the growing body of published
      reports, the lack of a suitable animal model to evaluate various proposed
      mechanisms of renal injury has compromised our ability to devise a technique for
      preventing CAN. A popular scheme has been proposed to describe the possible
      sequence by which ischemia or nephrotoxins, or both, induce acute renal failure.
      In particular, a vascular mechanism (i.e., ischemia), is an appealing explanation
      for CAN since acute changes in renal hemodynamics after contrast media injection
      have been confirmed by several animal experiments. Unlike other vascular beds in
      which contrast media induce acute vasoconstriction followed by vasodilatation,
      the initial effect on the renal circulation is acute vasodilatation, followed by
      progressive vasoconstriction, increasing renal vascular resistance and a
      concomitant decrease in both renal blood flow and glomerular filtration
      rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239695
TI  - Contrast media: the relation of chemical structure, animal toxicity and adverse
      clinical effects.
AB  - Chemotoxicity and osmotoxicity of contrast media (CM) are determined by chemical
      structure. The lower the chemotoxicity and osmotoxicity of the CM, the less
      animal toxicity and higher clinical tolerance in humans will be achieved.
      Nonionic monomers such as iohexol and iopamidol in iodine-equivalent
      concentrations have approximately half the osmolality and therefore half the
      osmotoxicity of ionic monomers such as diatrizoate, iodamide, iothalamate and
      metrizoate. Absence of carboxyl groups in nonionic CM, as opposed to the presence
      of carboxyl groups in ionic CM, results in a lower chemotoxicity in nonionic CM.
      Similarly, a larger number of hydroxyl groups in nonionic CM than in ionic CM
      result in a lower chemotoxicity. The lower chemotoxicity of nonionic CM is
      reflected as a higher subarachnoid and intravenous tolerance both in animals and
      in the clinical setting.

PMID- 2239696
TI  - A hematologist's view of contrast media, clotting in angiography syringes and
      thrombosis during coronary angiography.
AB  - While ionic contrast media (CM) are stronger anticoagulants and antiplatelet
      agents, both nonionic and ionic CM retard clotting, fibrinopeptide A generation
      and platelet aggregation (at least by Born-O'Brien aggregometry). Thus, nonionic
      CM do not cause clots and thrombi. Rather, the driving force for clot or thrombus
      formation, when it occurs, is blood contact with and activation by the foreign
      surface of a syringe or catheter itself. A marked enhancement of clotting by
      glass syringes in comparison to plastic ones supports this view. Blood in any
      syringe or catheter, therefore, will clot more slowly in the presence of nonionic
      or ionic CM, the inhibitory effects of the latter being more profound. With
      respect to models of thrombosis at sites of vascular injury or stenosis, the
      antithrombotic effects of CM may either be transient owing to the dynamic nature
      of blood flow (local endothelial cell denudation model), or as in the case of
      ionic CM, actually to enhance local platelet aggregation (stenosis model). In
      these situations, preservation of the antithrombotic functions of endothelium
      with nonionic CM may be quite critical.

PMID- 2239697
TI  - Selection of a contrast agent in the cardiac catheterization laboratory.
AB  - The evolution of contrast material for intravascular use has been directed toward
      the development of better-tolerated agents. Currently, a variety of such "dyes"
      are available for coronary angiography and left ventriculography. Considerable
      animal and human investigation suggests that significant differences exist
      between the families of contrast agents that relate to patient tolerance. The
      newer low osmolality agents (especially the nonionic agents) produce less
      perturbation of the homeostatic state, which is clinically manifested by a
      lessened incidence of side effects, including those of a hemodynamic and
      electrophysiologic nature. While controversy continues over the cost/benefit
      ratio of the low osmolality contrast agents compared to traditional high
      osmolality agents, the former are rapidly becoming the community standard for
      diagnostic and especially therapeutic cardiologic procedures. Accepting the
      advantages of the low osmolality contrast agents, differences between the ionic
      dimers and the nonionic agents have been examined. Both experimental and clinical
      data suggest superiority of the nonionic agents. Although controversy still
      surrounds the issue of thromboembolism with the nonionic agents, accumulating
      evidence fails to support a clinically significant relation. The choice of
      contrast material is the responsibility of the invasive cardiologist. While the
      benefits of low osmolality agents are most obvious in high-risk patients,
      experience with large-scale intravenous studies suggests that the choice of
      contrast agent is a better discriminator of adverse reaction than is
      preprocedural risk stratification.

PMID- 2239698
TI  - Contrast media safety: what do we know and how do we know it?
AB  - Use of an intravenous injection of a water-soluble iodine compound (sodium
      iodide) for visualizing the urinary tract was first described by Osborne in 1923.
      However, sodium iodide was accompanied by a high incidence of side effects and
      the image quality was not good. As newer, improved contrast agents were
      introduced, a number of investigators reported on the incidence of death and side
      effects incurred by their use. In 1975, the first large-scale, multicenter,
      prospective study on the incidence of fatal and nonfatal reactions was reported
      by Shehadi. In this series, the overall incidence of adverse reactions was 5.65%,
      of which 3.77% were mild, 1.77% were moderate, 0.02% were severe, and 0.0007%
      were fatal. Shehadi also noted that a history of allergy doubled the risk of
      adverse reaction and a history of a previous adverse reaction to contrast
      material trebled the risk; also, the risk of a reaction to an intraarterial
      injection was half that of the risk associated with an intravenous injection.
      With the introduction of low osmolar nonionic agents, other large-scale studies
      were performed because these agents appeared to cause significantly fewer adverse
      reactions. However, they were from 10 to 15 times more expensive than their
      predecessors. In 1987, Lasser reported on the increased safety of ionic agents
      when patients were pretreated with steroids. Palmer in Australia and Katayama in
      Japan collected 120,000 and 335,000 patients, respectively, and compared the
      incidence of adverse reactions of the ionic versus the nonionic agents. Wolf
      recently reported a study that included a direct comparison of ionic agents with
      pretreatment with steroids versus nonionic agents.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2239699
TI  - The cardiac catheterization laboratory--1990.
AB  - Over the past several decades, there has been an evolution and proliferation of
      catheterization laboratories. During the latter half of the 1980s, these changes
      have resulted from the development of a number of catheter-based therapeutic
      techniques. In general, it would seem reasonable to predict that the 1990s will
      continue to show expansion of laboratory services in both traditional hospital
      and nontraditional settings. In the latter, the free-standing laboratories will
      probably grow substantially. The types of patients studied in this new era will
      continue to be largely those with suspected or known coronary artery disease. The
      most dramatic changes in laboratory configuration will be in the image system.
      High-definition systems will become the standard. Images will be recorded direct
      to solid-state memory using fluoroscopic techniques. Resolution will be increased
      at reduced noise and enhanced contrast. Higher resolution video monitors and
      video recorders will be the cornerstones of the laboratory. The image information
      for an entire day's work will be stored first on a digital tape system, probably
      a rapidly accessed reel system, and by the late 1990s in solid-state memory.
      Individual case data will then be copied to smaller cassettes for patient
      reports. An entirely digital system will provide rapid electronic acquisition,
      processing, storage and transmission of information. In addition, physicians will
      be able to call up previous studies that have been copied to this format for
      storage. Storage space will be reduced considerably. Access of information will
      be relatively rapid compared with cine equipment.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2239700
TI  - Clinical cardiovascular magnetic resonance imaging.
AB  - Magnetic resonance imaging (MRI) is a powerful tool providing high-resolution
      images of the heart and great vessels without the use of ionizing radiation or
      contrast agents. MRI systems currently in use at many hospitals can be used
      effectively in the routine, clinical evaluation of many forms of cardiovascular
      disease, including great vessel disease, ischemic cardiac disease and congenital
      cardiac disease. Moreover, quantitative and cine MRI techniques are now
      available, which provide highly accurate measures of chamber size, wall motion
      and wall thickening. Recent developments in the areas of myocardial tagging, high
      speed imaging and MR assessments of flow and perfusion suggest potential for an
      increasing role of MRI in the clinical evaluation of the cardiovascular system.

PMID- 2239701
TI  - Clinical nuclear magnetic resonance spectroscopy: insight into metabolism.
AB  - Nuclear magnetic resonance (NMR) spectroscopy can nondestructively evaluate
      changes in metabolites with different disease states, as well as with therapeutic
      interventions. Animal studies have provided the basis for understanding changes
      in high-energy phosphates with myocardial ischemia. Studies of graded ischemia
      due to partial coronary stenosis have shown the sensitivity of the ratio of
      phosphocreatinine to inorganic phosphate to small reductions in myocardial blood
      flow and its relation to myocardial function. The application of NMR spectroscopy
      to humans requires precise localization techniques to avoid acquiring
      contaminating information from structures around the heart, such as the chest
      wall and diaphragm. With these localization techniques, metabolic evidence of
      ischemia has been demonstrated in patients with myocardial infarction and
      patients with known coronary disease, although the sensitivity of this technique
      for the diagnosis of inducible ischemia is unknown. At rest, patients with
      dilated and hypertrophic cardiomyopathies often have an elevated phosphodiester
      resonance, possibly signifying abnormal breakdown of membrane phospholipids.
      Increasing oxygen demand in these patients does not usually alter high-energy
      phosphates, suggesting that oxidative energy metabolism is preserved under these
      conditions. NMR spectroscopy is a powerful tool to increase understanding of
      metabolic changes in a variety of pathologic conditions.

PMID- 2239703
TI  - Role of magnetic resonance contrast agents in cardiac imaging.
AB  - Improvements in magnetic resonance imaging (MRI) technology allow adequate
      spatial and temporal resolution to capture cardiac anatomy and contractile
      function in exceptional detail and with little risk. However, tissue
      characterization of the pathophysiologic state of the myocardium may require
      special indicators or MR contrast agents. These must be tailored for detection by
      the MRI process, but available agents are effective at low dose and provide a
      wide range of indicator properties (e.g., myocardial extracellular space, blood
      pool, capillary permeability and membrane transport). Each agent has a dynamic
      washin and washout time-intensity curve that may reflect myocardial perfusion or
      consequences of ischemia. The combined use of MRI and MR contrast agents may
      provide a single diagnostic examination that fully and quantitatively assesses
      all indexes of cardiac performance. Such information would be both global and
      regional, and would be well tolerated by patients. The cost, value and cost
      effectiveness of such studies remain speculative.

PMID- 2239702
TI  - Positron emission tomography and interventional cardiology.
AB  - Current noninvasive diagnostic techniques have limited accuracy for detection of
      coronary artery disease (CAD) in symptomatic and (particularly) asymptomatic
      patients with silent disease. Furthermore, no standard noninvasive method
      provides reliable diagnostic information on the location of the coronary arteries
      involved, the severity of stenosis, the presence of collaterals and myocardial
      viability. Based on greater than 1,000 cardiac studies at the University of
      Texas, cardiac positron emission tomography (PET) with either generator-produced
      rubidium-82, cyclotron-produced N-13 ammonia, or F-18 deoxyglucose is suitable
      for 4 routine diagnostic purposes: (1) noninvasive diagnosis of CAD in either
      symptomatic or asymptomatic subjects with a sensitivity of 95 to 98% and
      specificity of 95 to 100%. This accuracy is now sufficient to schedule diagnostic
      catheterization and multivessel angioplasty with surgical backup on the basis of
      the PET scan. At the University of Texas we carry out PET in asymptomatic and
      symptomatic patients to direct those with mild disease to cholesterol-lowering
      reversal therapy and those with severe disease to percutaneous transluminal
      coronary angioplasty (PTCA); (2) assessment of physiologic severity of coronary
      artery stenosis as compared to automated quantitative coronary arteriographic
      analysis. Changes in stenosis severity are followed before and after
      interventions including PTCA, bypass surgery, vasodilator drugs and cholesterol
      control regimens for reversal of coronary atherosclerosis; (3) imaging myocardial
      infarction, ischemia, viability, zone at risk and sizing of these
      pathophysiologic processes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239704
TI  - Cardiovascular effects of iodinated contrast agents.
AB  - The ideal intravascular contrast agent would be biologically inert and have no
      pharmacologic actions. Pharmacologic actions of currently used radiographic
      contrast agents are determined principally by 3 physicochemical properties of the
      iodine-bearing molecule and its formulation: osmolality, sodium concentration and
      calcium-binding properties. Within this framework, the calcium-binding 1.5 ratio
      agents have the most marked effects, and the 3.0 ratio nonionic agents the least,
      with the noncalcium-binding formulations of 1.5 ratio agents and ioxaglate (the
      only 3.0 ratio ionic agent) in between. Differences in hemodynamic effects are
      predominantly related to osmolality with the 3.0 agents causing less hemodynamic
      disturbance. The magnitude of difference is small enough that the 3.0 ratio
      agents have no important clinical advantage when used in patients with good or
      moderately impaired left ventricular function. However, the difference may be
      important in patients with severely impaired circulatory performance. The
      principal electrophysiologic differences are between the calcium-binding 1.5
      ratio agents (which are associated with a clear-cut greater frequency of
      ventricular fibrillation during coronary injection than the noncalcium-binding
      1.5 ratio agents) and the 3.0 ratio agents. There is no justification for the use
      of calcium-binding 1.5 ratio agents, since noncalcium-binding formulations of the
      same molecule are available at the same price. The circulatory reserve of most
      patients makes the differences between 3.0 ratio agents and noncalcium-binding
      1.5 ratio agents clinically unimportant. In view of the substantial price
      disparity between 1.5 ratio and 3.0 ratio agents, noncalcium-binding 1.5 ratio
      agents are appropriate for patients with good circulatory performance and 3.0
      ratio agents are best reserved for patients with impaired circulatory
      performance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239705
TI  - A symposium: triggering and circadian variation of onset of acute cardiovascular
      disease. Introduction.

PMID- 2239706
TI  - Epidemiologic studies demonstrating increased morning incidence of sudden cardiac
      death.
AB  - To determine if sudden cardiac death shows a circadian variation, the mortality
      records of the Massachusetts population and the Framingham Heart Study were
      analyzed. The Massachusetts mortality data analysis revealed an increased morning
      incidence for out-of-hospital cardiac deaths similar to that previously described
      for nonfatal myocardial infarction. The records of the Framingham Heart Study
      allowed more comprehensive analysis of the time of sudden cardiac death. In this
      study, a prominent circadian variation was also identified in which frequency of
      sudden cardiac death increased sharply between 6 A.M. and 9 P.M.; distribution
      was fairly even throughout the rest of the day. This circadian pattern may be
      explained in part by physiologic changes that increase the likelihood of
      ventricular fibrillation or increase the risk of thrombosis in the morning hours.
      The possible role of the morning increase in physical and mental activity as a
      trigger of sudden cardiac death requires further investigation.

PMID- 2239707
TI  - Timing and triggers of transient myocardial ischemia.
AB  - Use of exercise tolerance testing and new techniques of ambulatory
      electrocardiographic monitoring to more objectively measure myocardial ischemia
      have enabled clinicians to better recognize the magnitude, timing and variable
      characteristics of transient ischemic events. These commonly occurring events in
      patients with coronary artery disease have a diurnal pattern strikingly similar
      to that reported for catastrophic cardiovascular events such as myocardial
      infarction, sudden cardiac death and stroke. Whether those factors that
      contribute to reversible ischemic events are similar to those causing infarction
      and sudden death has not been resolved. However, the parallel increase in morning
      activity for these related phenomena suggests that a better understanding of the
      triggers of reversible myocardial ischemia may help improve understanding of the
      causes of myocardial infarction and sudden cardiac death.

PMID- 2239708
TI  - Application of time series analysis to circadian rhythms: effect of beta
      adrenergic blockade upon heart rate and transient myocardial ischemia.
AB  - Circadian variations of transient myocardial ischemia and heart rate have been
      identified, but the rhythms and their response to beta blockade have not been
      fully characterized. Time-series analysis, a mathematical technique to describe
      oscillatory activity occurring within a continuous data set was used, to address
      these issues. Nine men with coronary artery disease underwent 72 hours of
      ambulatory electrocardiographic monitoring during therapy with placebo or
      metoprolol. During administration of placebo, ischemic time and heart rate showed
      a primary peak with a periodicity of approximately 24 hours with a tight coupling
      between the 2 variables and a secondary peak with a periodicity of 5 to 8 hours.
      During metoprolol therapy, heart rate and ischemic variation were reduced and the
      24-hour periodicity for heart rate only remained. The 24-hour periodicity for
      ischemia was eliminated, but the data with 5- to 8-hour periodicity became the
      major component of the signal.

PMID- 2239709
TI  - Transient myocardial ischemia and its relation to determinants of myocardial
      oxygen demand.
AB  - Because of conflicting data and a clear need to establish the relative role of
      increase in myocardial oxygen demand versus reduction in coronary blood flow in
      the causation of transient ischemia, the role of heart rate and blood pressure
      changes immediately preceding and during the transient ischemic events observed
      during daily life were evaluated in 25 patients with coronary artery disease.
      Elevations in heart rate before onset of ischemia were observed in 61% of the
      episodes. Similarly, 73% of the ischemic events were preceded by an increase in
      arterial pressure. These data provide evidence for a significant role of
      increased myocardial oxygen demand in the genesis of transient myocardial
      ischemia.

PMID- 2239710
TI  - Mental stress as an acute trigger of ischemic left ventricular dysfunction and
      blood pressure elevation in coronary artery disease.
AB  - Acute mental stress may be a frequent trigger of transient myocardial ischemia,
      myocardial infarction and sudden cardiac death. In an experimental setting, the
      effect of mental stress on hemodynamics and left ventricular wall motion
      abnormalities (as detected by radionuclide ventriculography) was measured in 29
      patients with exercise-induced myocardial ischemia. Seventy-five percent of the
      patients demonstrated mental stress-induced wall motion abnormalities. Patients
      frequently exhibited greater increases in peak systolic arterial pressure during
      mental stress than during exercise. Personally relevant mental stress is the most
      potent type of mental stress, both in terms of frequency and magnitude of
      ischemia. Most mental stress-induced ischemic episodes are clinically and
      electrocardiographically silent and occur at heart rates significantly lower than
      those seen during exercise. Both systolic and diastolic blood pressure increased
      during mental stress-induced ischemia, suggesting that increased myocardial
      oxygen demand plays a role in the pathophysiology of mental stress-induced
      transient ischemia. The significant magnitude and acute onset of this mental
      stress-induced blood pressure elevation may in some manner contribute to
      atherosclerotic plaque rupture. These findings may provide a pathophysiologic
      link to the epidemiologic association between mental stress and acute ischemic
      coronary events. A new ambulatory radionuclide detector that can concurrently
      monitor left ventricular ejection fraction and electrocardiographic ST-segment
      change may enhance the detection and evaluation of transient myocardial ischemia
      in ambulatory coronary patients.

PMID- 2239711
TI  - Triggers of transient myocardial ischemia: circadian variation and relation to
      plaque rupture and coronary thrombosis in stable coronary artery disease.
AB  - The phenomenon of transient myocardial ischemia is common in patients with stable
      coronary disease and appears to be due both to increases in myocardial demand and
      to episodic coronary vasoconstriction. The circadian variation of transient
      ischemic episodes closely parallels the circadian variation of acute coronary
      syndromes associated with plaque rupture, such as myocardial infarction and
      sudden death. These concordant temporal patterns of transient ischemia,
      myocardial infarction and sudden cardiac death probably represent independent
      manifestations stemming from the consequences of increased sympathetic activity.

PMID- 2239712
TI  - Cause of thrombosis in human atherosclerotic arteries.
AB  - Although it has been known for a long time that thrombosis nearly always develops
      in atherosclerotic arteries--and almost never in normal vessels--the mechanism
      through which atherosclerosis promotes thrombosis was unknown until this problem
      was explored through histologic examination of complete serial section sets of
      thrombosed atherosclerotic arteries. These studies, repeatedly confirmed,
      revealed that the thrombi are triggered by microscopic cracks in the collagen cap
      of advanced plaques. Blood most often seeps from the arterial lumen through the
      cracks into the underlying lipid gruel before the breaks or cracks are plugged by
      the thrombi (which function as hemostatic seals of the breaks). These results are
      parallel to results of experimental studies in which the synergism of
      endotheliotoxic and pressor agents produced thrombi over cap breaks and sub-break
      hemorrhages only in arteries with advanced collagen-rich plaques, not in arteries
      with early atherosclerosis or in normal vessels. This finding indicates that
      advanced atherosclerosis makes the arterial wall much more fragile and that, once
      broken, this wall exposes the blood to powerful thrombogenic materials that do
      not exist in normal arterial tissue. At present, human and experimental evidence
      suggest that the thrombogenic fissures of advanced plaque caps can be promoted by
      several factors, such as a surge in intraarterial pressure or insults that damage
      the caps structurally and increase their vulnerability to any type of stress such
      as certain metabolic, exogenous chemical and immune insults, spontaneous
      molecular changes of collagen with time and hemorrhages of capillaries that
      invade advanced plaques from the adventitia or the arterial lumen.

PMID- 2239713
TI  - Rupture of coronary vasa vasorum as a trigger of acute myocardial infarction.
AB  - Some controversy has always existed regarding the presence and extent of the vasa
      vasorum--the nutrient vessels in the wall of the human aorta--in the coronary
      arteries. Now, cinemicrographic studies using silicone polymer injections in
      cleared human hearts have identified the vasa vasorum of coronary arteries,
      revealing evidence of neovascularization in the region of atherosclerotic
      plaques. These studies suggest an important role for the vasa vasorum in the
      pathogenesis of coronary atherosclerosis and its sequelae, especially intramural
      hemorrhage and vascular spasm. The wall of the human coronary artery in regions
      of atherosclerotic injury may be particularly rich in capillary vessels of the
      vasa vasorum. From this, the evidence suggests that with the morning increase in
      blood pressure, fragile neovascular structures of the vasa vasorum may be more
      prone to rupture and may be responsible, in part, for the circadian variation in
      myocardial infarction.

PMID- 2239714
TI  - Angiographic assessment of the culprit coronary artery lesion before acute
      myocardial infarction.
AB  - Serial angiographic studies of patients with myocardial infarction and unstable
      angina suggest that the culprit plaque underlying a thrombus need not have
      produced severe luminal obstruction before onset of the event. An atherosclerotic
      coronary artery lesion can, therefore, have 2 important characteristics. First,
      it may be obstructive. Second, it may be "vulnerable" in that it has the
      potential to become thrombogenic if exposed to the appropriate triggering
      stimulus. A lesion need not be obstructive to become thrombogenic, nor do all
      obstructive lesions have thrombogenic potential. The cause of an infarction may
      thus be rupture of a nonobstructive plaque leading to occlusive thrombus
      formation. Because it may be difficult to predict the site of a subsequent
      occlusion from a coronary angiogram, coronary bypass surgery or angioplasty
      directed only at discernible stenotic lesions may not be effective for preventing
      subsequent myocardial infarctions. Appropriate therapy may need to be directed at
      the entire coronary tree. Such therapy might include cholesterol lowering, beta
      blockade and aspirin.

PMID- 2239715
TI  - Propranolol and the morning increase in sudden cardiac death: (the beta-blocker
      heart attack trial experience).
AB  - To provide insight into the protective effect of propranolol on mortality after
      myocardial infarction observed in the beta-Blocker Heart Attack Trial, the time
      of occurrence of sudden cardiac death was examined in this population. Between 5
      A.M. and 11 A.M., 25 of the 56 total deaths (38%) occurred in the placebo
      patients compared with 11 of 45 (24%) in the propranolol patients. Excluding this
      period, there were nearly equal numbers of sudden cardiac deaths in the
      propranolol and placebo groups. This retrospective analysis suggests that beta
      blockade is protective during the morning hours when a surge of sympathetic
      activity may increase the risk of sudden cardiac death.

PMID- 2239716
TI  - Exercise test predictors of ambulatory silent ischemia during daily life in
      stable angina pectoris.
AB  - The predictive value of several exercise test parameters in identifying stable
      angina patients at risk of silent myocardial ischemia during daily life were
      examined. A total of 97 patients with coronary artery disease, stable angina and
      ambulatory electrocardiographic data were evaluated. Of the 86 patients with a
      positive exercise test, 39 (group 1) had greater than or equal to 1 episodes of
      ST-segment depression and 47 (group 2) did not develop ST changes during
      ambulatory electrocardiographic monitoring. Comparison of the exercise test
      parameters between the 2 groups revealed early onset of ischemia during exercise
      tests as the single most significant (p less than 0.0005) predictor of ambulatory
      silent ischemia. The other exercise test parameters showing significant
      differences between the 2 groups were the peak exercise heart rate (117 +/- 23 vs
      126 +/- 20 beats/min, p less than 0.05) and peak systolic blood pressure (160 +/-
      27 vs 176 +/- 27 mm Hg, p less than 0.01), both of which were significantly lower
      in the group 1 patients. These data were used to derive simple mathematical
      formulas for calculating the risk of ambulatory silent ischemia. These results
      demonstrate that stable angina patients at risk of silent ischemia during daily
      life can be accurately identified by evaluation of selected exercise test
      parameters.

PMID- 2239717
TI  - Effects of theophylline, atenolol and their combination on myocardial ischemia in
      stable angina pectoris.
AB  - The effects of theophylline (400 mg twice a day), atenolol (50 mg twice a day)
      and their combination on myocardial ischemia were studied in 9 patients with
      stable angina pectoris in a randomized, single-blind, triple crossover trial.
      Placebo was administered to the patients during the run-in and the run-off
      periods. A treadmill exercise test and 24-hour ambulatory electrocardiographic
      monitoring were obtained at the end of each treatment period. Compared with
      placebo, theophylline significantly improved the time to onset of myocardial
      ischemia (1 mm of ST-segment depression) from 7.8 +/- 3.7 to 9.5 +/- 3.7 minutes
      (p less than 0.03) and the exercise duration from 9 +/- 3.4 to 10.1 +/- 3.5
      minutes (p less than 0.04). During atenolol and during combination treatment, the
      time to the onset of ischemia and the exercise duration were similar (10.8 +/-
      4.2 and 11.2 +/- 3.2 minutes, 11.2 +/- 3.6 and 11.5 +/- 3.2 minutes,
      respectively) and longer than during theophylline administration (p less than
      0.05). Ambulatory electrocardiographic monitoring showed that, during
      theophylline administration, the heart rate was higher than during placebo
      throughout the 24 hours (p less than 0.05). During atenolol and during
      combination treatment the heart rate was similar and in both cases lower than
      during placebo (p less than 0.05). Compared with placebo, theophylline decreased
      the total ischemic time from 97 +/- 110 to 70 +/- 103 minutes (p less than
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239718
TI  - Transient left ventricular cavitary dilation during dipyridamole-thallium imaging
      as an indicator of severe coronary artery disease.
AB  - Transient left ventricular (LV) cavitary dilation during dipyridamole-thallium
      imaging was reported in 45 of 510 (9%) consecutive patients referred for
      dipyridamole-thallium imaging. Clinical and hemodynamic effects observed during
      dipyridamole infusion were not predictive of transient cavitary dilation on the
      thallium images. Coronary angiography was performed in 32 of the 45 patients: 75%
      had either left main, 3-vessel or "high-risk" 2-vessel coronary artery disease.
      Although 25 of 45 patients (56%) with transient cavitary dilation were either
      asymptomatic or had only grade 1/4 effort angina, 16 of 25 patients (64%) not
      referred for coronary revascularization sustained a cardiac event during a mean
      follow-up of 12 months. Most events were cardiac deaths (75%) and 87% of events
      occurred within 4 months of the test. Noncardiac surgery was performed in 187 of
      the 510 patients. The postoperative cardiac event rate was 2% in the 101 patients
      with normal scans or fixed defects, 19% in 75 patients with reversible perfusion
      defects and 58% in 12 patients with reversible cavitary dilation (p less than
      0.0001). Thus, transient LV dilation during dipyridamole-thallium imaging is a
      marker of severe underlying coronary artery disease, denotes a poor prognosis and
      predicts a high risk of postoperative cardiac complications in patients who
      undergo noncardiac surgery.

PMID- 2239720
TI  - Videodensitometry versus digital calipers for quantitative coronary angiography.
AB  - Single-plane left coronary angiograms in 18 patients were prospectively analyzed
      using videodensitometry (XR-70 system) and handheld digital calipers to compare
      arterial dimensions, stenosis dimensions, intraobserver variability and
      interobserver variability for the methods. A total of 648 arterial segments were
      measured, yielding a highly significant correlation between videodensitometry and
      caliper-determined cross-sectional area (r = 0.96, p = 0.0001). Similarly, a
      highly significant linear relation was observed between videodensitometry and
      caliper-determined diameter (r = 0.95, p = 0.0001). When data subsets for small,
      medium and large arterial segments were examined, higher variability in the
      correlation between videodensitometry and caliper-determined area was observed in
      the large segments (greater than 10 mm2). In addition, caliper-estimated areas
      tended to be slightly smaller than videodensitometry-estimated areas in these
      segments. For diameter estimations, correlations between caliper and
      videodensitometry data were similar for the entire range of arterial segment
      sizes. Intra- and interobserver variability was low for both caliper and
      videodensitometry determination of diameter or area. Thus, over a wide range of
      arterial dimensions, results obtained with caliper estimates of luminal area and
      diameter are comparable to those obtained with videodensitometry using the XR-70
      system.

PMID- 2239719
TI  - Effects of two types of fish oil supplements on serum lipids and plasma
      phospholipid fatty acids in coronary artery disease.
AB  - Fish oil has consistently been shown to lower triglyceride levels, but its
      effects on low-density lipoprotein (LDL) cholesterol remain controversial. The
      current study compares the long-term effects of 2 different fish oil preparations
      (ethyl ester and triglyceride) versus olive oil in patients with coronary artery
      disease. Eighty-nine subjects were randomly assigned to receive capsules
      containing 6 g/day (triglyceride group) or 7 g/day (ethyl ester group) of n-3
      fatty acids, or capsules containing 12 g/day of olive oil for 6 months. Mean
      triglyceride levels decreased by 28% in the ester and 32% in the triglyceride
      fish oil groups (p less than 0.05 for both). LDL cholesterol levels increased by
      3% (difference not significant) in the ester and 12% (p less than 0.05) in the
      triglyceride fish oil groups; in hypertriglyceridemic subjects the increase was
      23% (p less than 0.01) and 14% (difference not significant), respectively. Plasma
      phospholipid fatty acid analysis showed a fivefold increase in eicosapentaenoic
      acid levels in both fish oil groups (p less than 0.001), and a long-term decrease
      in arachidonic acid levels (p less than 0.001). Achieved eicosapentaenoic acid
      level correlated with the degree of increase in LDL cholesterol (r = 0.38, p less
      than 0.05). These data suggest that fish oil administration is associated with an
      increase in LDL cholesterol levels in a diverse group of patients with coronary
      artery disease; this change appears to be correlated with n-3 fatty acid
      absorption. The impact of this increase in LDL is unknown, but should be
      considered as potentially adverse.

PMID- 2239721
TI  - Frequency of myocardial indium-111 antimyosin uptake after uncomplicated coronary
      artery bypass grafting.
AB  - The reported incidence of myocardial damage after coronary artery bypass grafting
      (CABG) is highly related to the methods used. Since indium-111 monoclonal
      antimyosin antibody scintigraphy has been shown to be highly specific and
      sensitive for myocardial necrosis, even in small lesions, uptake of this
      radiotracer was evaluated after CABG. In 23 consecutive patients without previous
      myocardial infarction who underwent CABG for stable angina, 80 MBq indium-111
      antimyosin was injected on the third postoperative day. Planar images were
      obtained 48 hours later and analyzed for myocardial uptake of indium-111
      antimyosin. Scintigraphic results were related to creatine kinase MB levels,
      duration of both aortic cross-clamping and cardiopulmonary bypass, and
      electrocardiographic changes. In all patients surgical procedure and
      postoperative course was uncomplicated. Indium-111 antimyosin uptake was present
      in 19 of 23 patients (82%). It was diffused in 7 patients and localized in 12. No
      pathologic Q waves occurred postoperatively. Fourteen patients exhibited ST
      segment changes. No good relation was found among indium-111 antimyosin uptake
      and creatine kinase MB levels, duration of cross-clamping or bypass, and ST-T
      changes. It is concluded that some degree of myocardial damage, though silent, is
      common after CABG.

PMID- 2239722
TI  - Time course and prognostic significance of serial signal-averaged
      electrocardiograms after a first acute myocardial infarction.
AB  - The prognostic significance of serial signal-averaged electrocardiograms recorded
      during the first 3 days (period 1), in the second week (period 2) after a first
      acute myocardial infarction (AMI) and 6 months later (period 3) was prospectively
      assessed in 190 patients. No patients were treated with thrombolytic therapy.
      Patients with conduction disturbances were excluded. Mean age of the 190 patients
      was 57 years (range 34 to 74) and mean left ventricular ejection fraction was 40
      + 6% (range 12 to 70). Eighty-four patients had an anterior wall AMI and the
      remaining 106 patients an inferior wall AMI. After a mean follow-up of 24 months,
      16 patients developed sustained symptomatic monomorphic ventricular tachycardia,
      7 patients were resuscitated from an episode of ventricular fibrillation, and 10
      patients died suddenly. Multivariate regression analysis using continuous
      variables showed that the strongest predictor of sustained ventricular
      tachycardia and ventricular fibrillation was the left ventricular ejection
      fraction (p less than 0.0001) followed by the duration of QRS complex on the
      signal-averaged electrocardiogram recorded during the first 3 days of AMI (p less
      than 0.0005). Sudden death was only predicted by left ventricular ejection
      fraction (p less than 0.02).

PMID- 2239723
TI  - Prognostic value of predischarge low-level exercise thallium testing after
      thrombolytic treatment of acute myocardial infarction.
AB  - Low-level exercise thallium testing is useful in identifying the high-risk
      patient after acute myocardial infarction (AMI). To determine whether this use
      also applies to patients after thrombolytic treatment of AMI, 64 patients who
      underwent early thrombolytic therapy for AMI and 107 patients without acute
      intervention were evaluated. The ability of both the electrocardiogram and
      thallium tests to predict future events was compared in both groups. After a mean
      follow-up of 374 days, there were 25 and 32% of cardiac events in the 2 groups,
      respectively, with versus without acute intervention. These included death,
      another AMI, coronary artery bypass grafting or angioplasty with 75% of the
      events occurring in the 3 months after the first infarction. The only significant
      predictors of outcome were left ventricular cavity dilatation in the intervention
      group and ST-segment depression and increased lung uptake in the nonintervention
      group. The sensitivity of exercise thallium was 55% in the intervention group and
      81% in the nonintervention group (p less than 0.05). Therefore, in patients
      having thrombolytic therapy for AMI, nearly half the events after discharge are
      not predicted by predischarge low-level exercise thallium testing. The relatively
      weak correlation of outcome with unmasking ischemia in the laboratory before
      discharge may be due to an unstable coronary lesion or rapid progression of
      disease after the test. Tests considered useful for prognostication after AMI may
      not necessarily have a similar value if there has been an acute intervention,
      such as thrombolytic therapy.

PMID- 2239724
TI  - Prognosis of acute myocardial infarction complicated by primary ventricular
      fibrillation. Principal Investigators of the SPRINT Study.
AB  - In 5,839 consecutive patients with acute myocardial infarction (AMI),
      hospitalized between July 1981 and July 1983 in 14 coronary care units in Israel,
      the incidence of primary ventricular fibrillation (VF) was 2.1%. Patients with
      primary VF resembled counterparts without VF in terms of age, gender, frequency
      of previous AMI and past cigarette smoking habits. The hospital course of
      patients with primary VF revealed increased incidence of primary atrial
      fibrillation and atrioventricular block. Increased serum levels of glutamic
      oxaloacetic transaminase and lactic dehydrogenase were noted among the patients
      with primary VF. In-hospital mortality rate was 18.8% in 122 patients with
      primary VF compared with 8.5% in 3,707 patients forming the reference group (p
      less than 0.01). Adjustment by age using logistic function yielded an estimate of
      2.86 for relative mortality odds associated with primary VF, and further
      adjustment by gender, history of AMI, systemic hypertension, and by enzymatically
      estimated infarct size slightly reduced the estimated odds, at 2.52 (95%
      confidence interval, 1.42 to 4.46). Prognosis after discharge from the hospital
      was independent of primary VF. In conclusion, primary VF exerts an independent,
      significant effect on in-hospital mortality.

PMID- 2239725
TI  - Usefulness of labetalol in chronic atrial fibrillation.
AB  - Beta-adrenergic blocking agents are useful in controlling excessive ventricular
      rate in chronic atrial fibrillation (AF) but often reduce exercise capacity. To
      investigate the advantage of labetalol--a unique beta blocker with alpha-blocking
      property--in chronic AF, 10 patients without underlying structural heart disease
      were studied with treadmill test, 12-minute walk and 24-hour ambulatory
      electrocardiographic monitoring. Patients were randomized and crossed over to
      receive 4 phases of treatment (placebo, digoxin, digoxin with half-dose
      labetalol, and full-dose labetalol). Exercise durations were 14.1 +/- 1.5, 14.2
      +/- 1.5, 16.1 +/- 1.1 and 15.6 +/- 1.1 minutes, respectively, indicating that
      labetalol did not reduce exercise tolerance. Although digoxin had no advantage
      over placebo in controlling maximal heart rate (177 +/- 2 vs 175 +/- 3
      beats/min), labetalol, both as monotherapy or as an adjunct to digoxin, was
      advantageous (156 +/- 4 vs 177 +/- 2 beats/min, p less than 0.01, and 154 +/- 4
      vs 177 +/- 2 beats/min, p less than 0.01, respectively). The rate-pressure
      product was consistently lowered by labetalol at rest and during exercise. At
      peak exercise, the addition of labetalol to digoxin reduced the maximal rate
      pressure product achieved from 30,900 +/- 1300 to 24,100 +/- 2,000 mm Hg/min (p
      less than 0.01) and the maximal rate-pressure product was lowest with full-dose
      labetalol (22,300 +/- 1,600 mm Hg/min). During submaximal exercise on treadmill
      or during the 12-minute walk, the combination of labetalol and digoxin produced
      the best heart rate control, whereas labetalol monotherapy was comparable to
      digoxin therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239726
TI  - Usefulness of combined propranolol and verapamil for evaluation of surgical
      ablation of accessory atrioventricular connections in patients without structural
      heart disease.
AB  - Successful surgical ablation of atrioventricular (AV) accessory connections may
      be confirmed during postoperative electrophysiologic testing by the absence of
      accessory connection conduction in both the anterograde and retrograde
      directions. Whereas the former may be readily apparent by examination of the
      surface electrocardiogram during sinus rhythm or atrial pacing, assessment of the
      latter may be complicated by the frequent presence of enhanced retrograde AV
      nodal conduction in the postoperative period. Consequently, availability of
      interventions that selectively affect AV nodal conduction and refractoriness
      without concomitant effects on accessory connections may be helpful for assessing
      the success of the surgical procedure. In this study the effects of combined
      propranolol and verapamil administration on electrophysiologic properties of the
      AV node and the accessory AV connection were assessed both pre- and
      postoperatively in 17 patients (12 men and 5 women, mean age 33 years) undergoing
      surgical ablation of accessory connections. Preoperatively, electrophysiologic
      characteristics of all but 1 of the accessory AV connections were unaffected by
      propranolol and verapamil administration. Postoperatively, on the other hand,
      propranolol and verapamil significantly prolonged both the retrograde AV node
      effective refractory period (baseline: 272 +/- 34 ms vs after drugs: 384 +/- 70
      ms [p less than 0.0001]) and the shortest cycle length maintaining 1:1
      ventriculoatrial conduction (baseline: 357 +/- 99 ms vs after drugs: 485 +/- 64
      ms [p less than 0.0001]). Late postoperative electrophysiologic evaluation (7 +/-
      3 weeks) revealed no evidence of residual accessory AV connection conduction, and
      all patients remain asymptomatic at 21 +/- 10 months follow-up.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2239727
TI  - Effectiveness of the once-daily calcium antagonist, lacidipine, in controlling 24
      hour ambulatory blood pressure.
AB  - The efficacy of the new once-daily dihydropyridine calcium antagonist,
      lacidipine, in reducing ambulatory intraarterial blood pressure (BP) was examined
      in 12 untreated hypertensive patients. The intraarterial recording was commenced
      24 hours before the first 4-mg dose and was continued for a further 24 hours
      thereafter. After dose titration and chronic therapy, a second 24-hour ambulatory
      BP recording was made. There was a steady onset of drug action, maximal at 2
      hours, but with reflex tachycardia after the first dose. Chronic administration
      reduced BP throughout the 24-hour period, without tachycardia. Mean daytime
      reduction in BP was 20 mm Hg systolic (p less than 0.005) and 12 mm Hg diastolic
      (p less than 0.02). Mean nighttime reduction was 8-mm Hg systolic (p less than
      0.05) and 6-mm Hg diastolic (difference not significant). There was no postural
      decrease in BP on 60 degrees head-up tilting and hypotensive action was
      maintained during isometric exercise (reduction at peak of 32/18 mm Hg, p less
      than 0.05) and throughout dynamic exercise (reduction at peak of 23/14 mm Hg, p
      less than 0.05). Lacidipine is an effective once-daily antihypertensive agent,
      with good control of stress response.

PMID- 2239728
TI  - Atenolol therapy for exercise-induced hypertension after aortic coarctation
      repair.
AB  - After successful repair of coarctation of the aorta in childhood, exercise
      induced upper body systolic hypertension is well documented. Beta blockade has
      been shown to reduce the arm/leg gradient in untreated coarctation of the aorta;
      treatment before coarctation repair has decreased paradoxical hypertension after
      repair. Ten patients with successful surgical repair of coarctation, defined as a
      resting arm/leg gradient of less than or equal to 18 mm Hg, were evaluated by
      treadmill exercise before and after beta blockade with atenolol. Mean age was 5.5
      years at repair and 18 at study. At baseline evaluation, systolic blood pressures
      at termination of exercise ranged from 201 to 270 mm Hg (mean 229 mm Hg). Arm/leg
      gradients at exercise termination ranged from 30 to 143 mm Hg (mean 84). Follow
      up treadmill exercise studies were performed after beta blockade. Upper extremity
      systolic pressures at exercise termination were normalized in 9 of 10 patients.
      Maximal systolic blood pressure recorded at exercise termination ranged from 163
      to 223 mm Hg (mean 196 mm Hg, p less than or equal to 0.005). Arm/leg gradient at
      termination of exercise also decreased significantly to a mean of 51 mm Hg (p
      less than 0.05). No patient had symptoms on atenolol and exercise endurance times
      were unchanged. The study results in this small series suggest that
      cardioselective beta blockade can be used to treat exercise-induced upper body
      hypertension effectively after surgical repair of coarctation. Because a high
      incidence of premature cardiovascular disease has been well documented after
      satisfactory surgical repair, the findings are of importance for this group of
      postoperative patients.

PMID- 2239729
TI  - Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and
      nondrinkers.
AB  - Lower cardiovascular mortality rates in lighter drinkers (versus abstainers or
      heavier drinkers) in population studies have been substantially due to lower
      coronary artery disease (CAD) mortality. Controversy about this U-shaped curve
      focuses on whether alcohol protects against CAD or, because of other traits,
      whether abstainers are at increased risk. Inclusion of ex-drinkers among
      abstainers in some studies has led to speculation that this might be the trait
      increasing the risk of abstainers. This new prospective study among 123,840
      persons with 1,002 cardiovascular (600 CAD) deaths showed that ex-drinkers had
      higher cardiovascular and CAD mortality risks than lifelong abstainers in
      unadjusted analyses, but not in analyses adjusted for age, gender, race, body
      mass index, marital status and education. Use of alcohol was associated with
      higher risk of mortality from hypertension, hemorrhagic stroke and
      cardiomyopathy, but with lower risk from CAD, occlusive stroke and nonspecific
      cardiovascular syndromes. Subsets free of baseline cardiovascular or CAD risk had
      U-shaped alcohol-CAD curves similar to subsets with baseline risk. Among ex
      drinkers, maximal past intake and reasons for quitting (medical versus non
      medical) were unrelated to cardiovascular or CAD mortality. These data show that:
      (1) alcohol has disparate relations to cardiovascular conditions; (2) higher
      cardiovascular mortality rates among ex-drinkers are due to confounding traits
      related to past alcohol use; and (3) the U-shaped alcohol-CAD relation is not due
      to selective abstinence by persons at higher risk. The findings indirectly
      support a protective effect of lighter drinking against CAD.

PMID- 2239730
TI  - Subnormal parasympathetic activity after cardiac transplantation.
AB  - Heart period variability (standard deviation of 120 consecutive RR or PP
      intervals) was used to assess baseline parasympathetic activity in 18 patients
      with congestive heart failure before and after orthotopic cardiac
      transplantation, and was compared to that of 16 age-matched control subjects.
      Mean heart period variability (+/- standard error of the mean) was significantly
      greater (p less than 0.05) in control subjects (58 +/- 5 ms) than in the patients
      at any time before or after transplantation. Heart period variability of
      innervated recipient atria did not change significantly early (1 to 4 weeks)
      after transplantation (16 +/- 2 to 24 +/- 5 ms; p = 0.11), but increased
      significantly between weeks 15 and 37 after transplantation (30 +/- 5 ms, p less
      than 0.002 versus before transplantation). A stepwise regression model (R2 =
      0.35; p = 0.01) showed that heart period variability was directly related to time
      after transplantation and inversely related to systolic arterial pressure after
      transplantation and degree of rejection. Heart period variability of the
      denervated donor atria did not change from early to late periods after
      transplantation, suggesting that vagal reinnervation of the donor heart had not
      occurred. These data indicate that baseline parasympathetic activity does not
      increase significantly during the first month after transplantation but increases
      significantly between months 3 and 6.

PMID- 2239732
TI  - Is the term "tricuspid atresia" appropriate?

PMID- 2239731
TI  - Natural history of cardiac rhabdomyoma in infancy and childhood.
AB  - Although spontaneous regression of cardiac rhabdomyoma has been reported,
      prognosis is still considered to be poor and surgery continues to be indicated.
      The experience with rhabdomyoma diagnosed in live infants over a 20-year period
      was reviewed. Diagnosis by angiography or echocardiography was accepted only if
      multiple tumors were present or if tuberous sclerosis was also diagnosed. Nine
      patients (3 diagnosed prenatally and the remaining 6 at age less than 8 months)
      were identified as having a total of 24 tumors. Measurements in 2 planes
      demonstrated at least some evidence of regression in 24 patients (100%), with 20
      of 24 having complete resolution. One patient required delayed surgery for
      excision of a subaortic ridge that appeared at the site of a resolved tumor. Our
      findings suggest that pediatric cardiac rhabdomyoma is most often a benign
      condition in which spontaneous regression is the rule. Surgery is recommended
      only for patients with refractory dysrhythmias or severe hemodynamic compromise.

PMID- 2239733
TI  - Supported coronary angioplasty and standby supported coronary angioplasty for
      high-risk coronary artery disease.

PMID- 2239734
TI  - Prognosis of congestive heart failure in elderly patients with normal versus
      abnormal left ventricular systolic function associated with coronary artery
      disease.

PMID- 2239736
TI  - Safety and efficacy of in-office cardioversion for treatment of supraventricular
      arrhythmias.

PMID- 2239735
TI  - Natural history of posterobasal left ventricular aneurysm.

PMID- 2239738
TI  - Combined obstructive hypertrophic cardiomyopathy and stenotic congenitally
      bicuspid aortic valve.

PMID- 2239737
TI  - Effect of mitral regurgitation on the left ventricular outflow pressure gradient
      in obstructive hypertrophic cardiomyopathy.

PMID- 2239739
TI  - Experience with the Gianturco-Roehm Bird's Nest vena cava filter.

PMID- 2239740
TI  - Frequencies of reactions to iohexol versus ioxaglate.

PMID- 2239741
TI  - Safety and usefulness of transesophageal echocardiography in persons aged greater
      than or equal to 70 years.

PMID- 2239742
TI  - Nucleolar structure and synthetic activity during meiotic prophase and
      spermiogenesis in the rat.
AB  - The ultrastructure of nucleoli was examined in developing rat spermatocytes and
      spermatids, with the help of serial sections. In addition, the radioautographic
      reaction of nucleoli as examined in rats sacrificed 1 hr after intratesticular
      injection of 3H(5')-uridine and taken as an index of the rate of synthesis of
      ribosomal RNA (rRNA). Primary spermatocytes from preleptotene to zygotene have
      small nucleoli typically composed of fibrillar centers, a fibrillar component,
      and a granular component, within which are narrow interstitial spaces. During
      early and mid-pachytene, nucleoli enlarge to about nine times their initial size,
      with the fibrillar and granular components forming an extensive network of cords-
      a nucleolonema--within which are wide interstitial spaces. Meanwhile, there
      appear structures identical to the granular component but distinct from nucleoli;
      they are referred to as extranucleolar granular elements. Finally, from late
      pachytene to the first maturation division, nucleoli undergo condensation, as
      shown by contraction of fibrillar centers into small clumps, while fibrillar and
      granular components condense and segregate from each other, with a gradual
      decrease in interstitial spaces. In secondary spermatocytes, nucleoli are compact
      and rather small, while in young spermatids they are also compact and even
      smaller. Nucleoli disappear in elongating spermatids. In 3H-uridine
      radioautographs, nucleolar label is weak in young primary spermatocytes,
      increases progressively during early pachytene, is strong by the end of mid
      pachytene, but gradually decreases during late pachytene up to the first
      maturation division. In secondary spermatocytes and spermatids, there is no
      significant nucleolar label. In conclusion, rRNA synthesis by nucleoli is low in
      young spermatocytes. During pachytene, while nucleoli enlarge and form a lacy
      nucleolonema, rRNA synthesis increases gradually to a high level by the end of
      mid pachytene. However, during the condensation and segregation of nucleolar
      components occurring from late pachytene onward, the synthesis gradually
      decreases and disappears. The small, compact spermatids arising from the second
      maturation division do not synthesize rRNA.

PMID- 2239743
TI  - A morphologic study of bronchus-associated lymphoid tissue in turkeys.
AB  - Bronchus-associated lymphoid tissue (BALT) in normal turkeys of ages 1 day and 1,
      2, 3, 4, 8, and 18 weeks was examined by light microscopy and by scanning and
      transmission electron microscopy. Turkey BALT resembled other mucosa-associated
      lymphoid tissues; it was made up of a population of lymphocytes covered by a
      specialized epithelium different from typical pseudostratified ciliated columnar
      bronchial epithelium. There were distinct age-related differences in BALT
      structure. Bronchus-associated lymphoid nodules were larger and more numerous in
      older turkeys. In 1-day- to 2-week-old turkeys, the primary cell type of BALT
      epithelium was nonciliated cuboidal; in 2-week old turkeys it was squamous; and
      in turkeys older than 4-weeks of age, the epithelium was primarily ciliated
      columnar. In 1- to 4-week old turkeys, large numbers of intraepithelial
      lymphocytes disrupted the normal organization of the epithelium. In older
      turkeys, epithelial and lymphoid cells were in discrete compartments separated by
      connective tissue. Lymphocytes in 1-day-old turkeys were found in loose
      aggregates around venules and within the epithelium. In 1-week old turkeys,
      lymphocytes were organized into compartments of morphologically similar cells. By
      3-weeks of age, lymphocytes were present in distinct germinal centers. Epithelial
      cells of BALT did not have large numbers of apical vesicles and thus were not
      structurally specialized for antigen uptake by endocytosis. However, the
      epithelial barrier appeared to be disrupted over lymphoid nodules, suggesting
      that antigen would be readily available to lymphocytes and phagocytes in BALT.
      Age-related differences in turkey BALT structure may have functional consequences
      with respect to the respiratory immune response.

PMID- 2239744
TI  - Histologic changes in tissue components of the hyperplastic thyroid gland during
      its involution in the rat.
AB  - Male Fischer rats were fed a low-iodine diet containing thiouracil for 21 days to
      produce hyperplastic thyroid glands, and then fed a high-iodine diet for various
      time intervals, from 5 hr to 180 days, in order to study the morphological
      changes that occur during involution. Thyroids were fixed by perfusion fixation
      and embedded in Epon. Sections were examined by light microscopy. Initially at 0
      days of involution (at the time of the change to the high-iodine diet),
      follicular lumens were very narrow and capillary lumens were very wide. The
      capsule was thick and infiltrated with mononuclear leukocytes. No obvious changes
      occurred for 1 day after the change in diet, but shortly thereafter capillary
      lumens began to narrow. By 4 days, most capillary lumens were close to normal
      size; capillaries formed a more or less normal bed except that many were embedded
      in a relatively thick or wide interfollicular matrix. This matrix was largely
      gone by 21 days. Between 1 and 21 days, follicular lumens dilated progressively
      as colloid accumulated. The density of staining of the accumulated colloid varied
      from follicle to follicle, and this variation was also observed in older
      controls. Inflammatory cells gradually disappeared from the capsule and most were
      gone by 15 days. Starting at approximately 15 days and continuing to 180 days,
      one or more disintegrating cells were found in some lumen profiles. Colloid
      goiters were not observed in these rats even after several months of involution.
      Some lumens were rather large, however, and small fractions of the follicles,
      both small and large, were bounded by flat cells and resembled "cold" follicles
      morphologically.

PMID- 2239745
TI  - Ultrastructural changes in thyroid epithelium during involution of the
      hyperplastic thyroid gland.
AB  - The ultrastructure of the thyroid epithelial cell was examined at various time
      intervals after induction of involution of the hyperplastic thyroid gland.
      Thyroids were made hyperplastic by the feeding of thiouracil in a Remington low
      iodine diet to male Fischer rats for 3 weeks. Involution was induced by replacing
      the thiouracil-containing diet with Purina Laboratory Chow, a high-iodine diet.
      During involution, organelles that play a role in the synthesis and secretion of
      thyroglobulin, such as the rough endoplasmic reticulum, Golgi apparatus, and
      apical vesicles, were well preserved and prominent features of the epithelial
      cell. The apical plasma membrane of many cells was highly irregular for
      approximately 2 weeks with signs suggesting rapid discharge of apical-vesical
      contents into the lumen of the follicle. Pseudopods and colloid droplets were
      present but were not very prominent features of the cell. No signs of extensive
      autophagy or obvious increased incidence of lysosomes were present, although
      there was an elevation in the incidence of small dense bodies starting about day
      8, and prominent by 15 days. Some of these may be phagosomes formed from luminal
      debris. The observations indicate that involution of the hyperplastic thyroid in
      which there is maintenance of the protein synthetic apparatus and little sign of
      autophagy or death of the epithelial cells is remarkably different from phenomena
      occurring during involution of prostate or mammary glands.

PMID- 2239746
TI  - Comparison of a special class of epithelial cells in hyperplastic thyroids
      undergoing involution and in thyroids in hypophysectomized rats.
AB  - In male Fischer rats, a class of follicles with flat epithelium is present as a
      minor component of thyroid glands in which most of the follicles have cuboidal
      epithelium. These follicles occur in thyroids that have been made hyperplastic by
      feeding the rats thiouracil for 21 days and then allowing involution for 21 days
      or more. They also occur in older control rats. The follicles resemble in
      morphology, at the light-microscope level, the so-called "cold" follicles that
      occur in aged mice. We have examined the ultrastructure of the flat cells in
      these follicles and compared it with that of the flat cells occurring in the
      thyroid follicles of hypophysectomized rats. The cells in involution have
      abundant rough endoplasmic reticulum (RER) and few lysosomes and, in these
      respects, differ markedly from cells in hypophysectomized rats. The follicles
      with flat cells are surrounded by a normal incidence of blood capillaries, so
      that the cells do not appear to be deprived of access to an adequate supply of
      materials necessary to satisfy their metabolic requirements. Their abundant RER
      suggests that they have thyroid-stimulating hormone (TSH) receptors, so that the
      flat cell may be the result of some process occurring at a step distal to
      receptor coupling with TSH. Their occurrence in young rats after the induction of
      hyperplasia may be a consequence of cell multiplication producing a clone of
      neighboring abnormal cells that have an abnormally small cell height.

PMID- 2239747
TI  - Scleral calcification and photoreceptor cell death during aging and exposure to
      chronic stress.
AB  - Male and female Fischer 344 rats of three different ages (12, 18, and 25 months)
      have been examined for the presence of photoreceptor (PR) cell loss and for
      occurrence of scleral cartilage and bone formation. In addition, male and female
      rats, aged 11 months at the beginning of the experiments, were exposed to chronic
      stress for either 0.5, 2, 4, or 6 months. Photoreceptor cell death gradually
      increases during the aging process and is exacerbated by exposure to chronic
      stress. It is more severe in the peripheral than the central retina and exposure
      to stress increases this pattern of cell loss. The superior retina is more
      severely affected than the inferior hemisphere in aging and during stress. The
      incidence of scleral cartilage or bone formation increases with age in male and
      female rats, but with stress exposure an increase is seen in males only. Bone
      formations occur more frequently in male than in female animals and are almost
      always (97%) located in the superior hemisphere of the eye. Although there
      appears to be a direct relationship between photoreceptor cell death and the
      occurrence of scleral ossifications in group data, in individual eyes the bone
      formations are not always associated with severity of PR cell loss. The
      relationship of PR cell death and incidence of scleral ossification to gender and
      to exposure to stress supports a hypothesis for an endocrine basis of ocular
      aging.

PMID- 2239748
TI  - Morphometric analysis of vertebrae and intervertebral discs as a basis of disc
      replacement.
AB  - In this study measurements were obtained from 359 vertebrae and 215
      intervertebral discs in an attempt to classify discs by their size. At the
      cervical and thoracic levels, this attempt was unproductive because of extensive
      variations. In the lumbar spine, discs were allocated to six size-matched groups
      and to two height-matched groups. The breadth of marginal rims were also measured
      with a view to provide surgeons operating on the spine with precise data on disc
      morphology to facilitate disc replacement.

PMID- 2239749
TI  - The effects of colchicine on the ultrastructure of odontogenic cells in the
      common skate, Raja erinacae.
AB  - Ultrastructural alterations induced by colchicine were investigated to determine
      the secretory activities of odontogenic cells during formation of tooth enameloid
      matrix in skates. Treated skate inner dental epithelial (IDE) cells did not
      display dilated cisternae of the granular endoplasmic reticulum (GER) nor
      accumulate Golgi-associated secretory granules at any dose level or time interval
      examined. This response was markedly different from that observed in teleost IDE
      cells synthesizing the enameloid collagen matrix. Treated skate IDE cells did
      show increased accumulations of glycogen-containing vesicles and intercellular
      glycogen associated with amorphous material, compared to controls. Additionally,
      the aberrant occurrence of large intracellular glycogen pools and amorphous
      material suggested that carbohydrate processing was a major function of skate IDE
      cells. Treated odontoblasts associated with enameloid matrix formation sometimes
      showed dilated GER cisternae, but procollagen secretory granules were not
      observed. Instead, electron dense material was present within the Golgi
      cisternae, tubular granules, and large granules. Some electron-dense material
      appeared to be shunted to a resorptive pathway via multivesicular bodies in
      treated odontoblasts. The continuity of tubular granules with the enameloid
      matrix suggested that they contained precursors of the enameloid matrix, and
      possibly the periodic, 17.5-nm cross-striated, "giant" fibers. Treated
      odontoblasts associated with predentin collagen matrix deposition showed dilated
      GER cisternae and accumulations of procollagen secretory granules, features
      consistent with the function of active collagen synthesis and secretion. The
      findings indicate that (1) skate IDE cells do not synthesize enameloid collagen
      as found in bony fish tooth development; (2) skate IDE cells do process glycogen
      for secretion into the enameloid matrix; (3) collagen, although present, is not a
      major constituent of skate enameloid matrix; (4) enameloid "giant" fibers are
      unique to elasmobranchs; and (5) odontoblasts synthesize and secrete proteins
      other than collagen into the enameloid matrix.

PMID- 2239750
TI  - Energy content of diets of variable amino acid composition.
AB  - Variation in the distribution of dietary nitrogen among the different amino acids
      is one factor that can modify the calorie equivalent per weight of amino acid or
      protein. This is important to consider when experimental diets with different
      amino acid compositions are compared and when indirect calorimetry is used to
      determine substrate oxidation rates. We developed a computer program to compute
      the energy content, oxygen equivalent, and respiratory quotient for arbitrary
      mixtures of amino acids and representative carbohydrates and fats. The calorie
      content of individual free amino acids was calculated by correction of the heat
      of combustion for the incomplete oxidation of amino acids characteristic of
      humans. Although these computations were presented before, we not report the
      limit of applicability of published values and the availability of the computer
      program to do these calculations.

PMID- 2239751
TI  - Prediction of 24-h energy expenditure and its components from physical
      characteristics and body composition in normal-weight humans.
AB  - The applicability of body composition as estimated by the bioimpedance method to
      predict energy expenditure (EE) was studied. Ten healthy subjects underwent
      measurement of body composition and 24-h energy expenditure (24-h EE) twice in a
      respiration chamber on a fixed program. The 24-h EE and its components, sleeping
      EE (SEE), basal EE (BEE), and daytime EE, for an individual were very
      reproducible (coefficient of variation 2.3%, 1.4%, 5.0%, & 3.1%, respectively).
      The variability of 24-h EE among subjects was 11.4% but only 4.1% when adjusted
      for differences in lean body mass (LBM). LBM was the best determinant of 24-h EE,
      BEE, and SEE and accounted for 91-93% of the interindividual variance of EE. The
      prediction equations were 24EE (kcal/d) = 390 + 33.3 LBM (r2 = 0.93, P =
      0.000001), SEE (kcal/h) = 9.8 + 1.1 LBM (r2 = 0.92, P = 0.000001), and BEE
      (kcal/h) = -3.1 + 1.35 LBM (r2 = 0.91, P = 0.000002). In conclusion, 24EE, BEE,
      and SEE can be predicted with a high degree of precision from LBM as estimated by
      bioimpedance in normal-weight subjects.

PMID- 2239752
TI  - Growth, thermogenesis, and hyperphagia.
AB  - Resting metabolic rate is demonstrated to be a function of fat-free mass and a
      growth variable related to food-energy-input imbalance rate. By use of obligatory
      energy expenditure terms, the two-reservoir energy model applied to hyperphagia
      shows that growth of the fat-free mass is rapid whereas that of the fat store is
      slow and that the growth of both is bounded. Most of the excess energy at the
      onset of hyperphagia initially goes into the fat store, but this decreases with
      time until the greater fraction is diverted to the fat-free mass. The two
      reservoir model predicts that weight gain per unit of excess energy is not
      constant but decreases monotonically until ultimately reaching an asymptotic
      value. Departure of theory and experiment in the long term suggests that
      facultative considerations become increasingly important.

PMID- 2239753
TI  - Rate and amount of weight gain during adolescent pregnancy: associations with
      maternal weight-for-height and birth weight.
AB  - This study presents information on the course and rates of weight gain and the
      associations among weight gain, prepregnancy weight-for-height, and infant birth
      weight, based on a total sample of 1419 uncomplicated term deliveries to
      adolescents. The distribution of cumulative weight gain indicates that for
      adolescents not only is the median gain at term (14.2-15.5 kg) significantly in
      excess of that reported for adults, but also weight-gain velocity is greater from
      the beginning of pregnancy. Although the contributions of prepregnancy weight-for
      height and weight gain to birth weight may be independent, they are not
      necessarily additive. Birth weight does not appear improved for the infants of
      overweight adolescents except when weight gain is low (less than 11.1-12.3 kg at
      term), and, for Puerto Rican and black adolescents, birth weight is not further
      improved at any maternal prepregnancy body mass index (weight-for-height) with
      excessive weight gains (greater than 17.9-19.3 kg at term).

PMID- 2239754
TI  - Maintenance and relapse after weight loss in women: behavioral aspects.
AB  - Obese women who regained weight after successful weight reduction (relapsers, n =
      44); formerly obese, average-weight women who maintained weight loss
      (maintainers, n = 30); and women who had always remained at the same average,
      nonobese weight (control subjects, n = 34) were interviewed. Most maintainers
      (90%) and control subjects (82%) exercised regularly, were conscious of their
      behaviors, used available social support (70% and 80%, respectively), confronted
      problems directly (95% and 60%, respectively), and used personally developed
      strategies to help themselves. Few relapsers exercised (34%), most ate
      unconsciously in response to emotions (70%), few used available social support
      (38%), and few confronted problems directly (10%). These findings suggest the
      advisability of development and prospective evaluation of individualized
      treatment programs designed to enhance exercise, coping skills, and social
      support.

PMID- 2239755
TI  - Diet and female sex hormone concentrations: an intervention study for the type of
      fat consumed.
AB  - A possible mechanism by which dietary fat may influence the development of breast
      cancer is by influencing the concentration of female sex hormones. This study
      investigated the effect of alteration in the type of fat consumed on
      concentrations of female sex hormones in serum. Female volunteers were randomly
      assigned to continue on their usual meat-eating diet, change to a vegetarian
      diet, or change to a diet that was predominantly vegetarian but where fish was
      consumed at least three times per week. Change to the vegetarian or fish diet had
      little effect on diet total hormone concentrations; however, the amount of
      estradiol was significantly decreased in the vegetarian group. When nutrient
      consumption was correlated with hormone concentrations, prolactin was directly
      associate with fat consumption, sex-hormone-binding globulin was inversely
      associated with fat consumption (particularly cholesterol consumption), and the
      proportion of nonprotein-bound estradiol was directly associated with complex
      carbohydrate consumption.

PMID- 2239756
TI  - Impaired thermoregulation and thyroid function in iron-deficiency anemia.
AB  - Ten women with iron-deficiency anemia, 8 with depleted iron stores (nonanemic),
      and 12 control women, all of similar body fatness, were exposed to a 28 degrees C
      water bath to test the hypothesis that iron-deficiency anemia impairs
      thermoregulatory performance. The anemic women had lower rectal temperatures than
      did control women (36.0 +/- 0.2 vs 36.2 +/- 0.1 degree C, respectively, P =
      0.001) and a lower rate of oxygen consumption (5.28 +/- 0.26 vs 5.99 +/- 0.29
      mL.min-1.kg body wt-1, respectively, P = 0.04) at 100 min of cold exposure.
      Plasma thyroxine and triiodothyronine concentrations were significantly (P less
      than 0.002) lower in anemic than in control women at baseline and during cold
      exposure. Responses of iron-depleted subjects were similar to those of control
      subjects. Iron supplementation corrected the anemia, significantly (P = 0.03)
      improved rectal temperature at 100 min, and partially normalized plasma thyroid
      hormone concentrations. Plasma catecholamines were unaffected by iron status.
      This experiment demonstrates a functional consequence of iron-deficiency anemia
      in the balance of heat production and loss and suggests that thyroid-hormone
      metabolism may be responsible.

PMID- 2239757
TI  - Role of carnitine in utilization of dietary medium-chain triglycerides by term
      infants.
AB  - The role of carnitine in oxidation of dietary medium-chain fatty acids (as medium
      chain triglycerides) was studied in term human infants. Infants were fed,
      alternately, formulas with fat content that was predominantly long-chain
      triglycerides, or 40% medium-chain triglycerides. Urinary acylcarnitine excretion
      was significantly higher and the ratio of free to total carnitine was
      significantly lower when infants were fed the formula with medium-chain
      triglycerides. Two groups of 10 infants were fed a commercial soy-protein-based
      formula modified to contain 40% of fat calories as medium-chain triglycerides and
      with or without added L-carnitine. By 56 d, infants fed the formula without added
      L-carnitine excreted significantly more medium-chain dicarboxylic acids than did
      the same infants at 28 d and significantly more than infants consuming the
      carnitine-supplemented formula at either 28 or 56 d. Results are consistent with
      a role for carnitine in metabolism of dietary medium-chain triglycerides in
      infants.

PMID- 2239759
TI  - Medium-chain fatty acids: evidence for incorporation into chylomicron
      triglycerides in humans.
AB  - The purpose of this study was to evaluate the fatty acid composition of
      chylomicron triglycerides isolated from subjects fed liquid-formula diets
      containing 40% of total energy as medium- (C8:0 and C10:0) or long-chain (C16
      C18) triglycerides (MCT, LCT) for 6 d. Medium-chain fatty acids (MCFA) comprised
      8% of total chylomicron triglyceride fatty acids after the first MCT meal. After
      6 d of continued MCT feeding, chylomicron triglyceride MCFA content increased to
      13%. When subjects were fed the LCT (soybean oil) diet, C16:0, C18:1, and C18:2
      comprised nearly 90% of the chylomicron triglyceride fatty acids. The mass of
      triglyceride transported in chylomicrons isolated from subjects fed the MCT diet
      was approximately 20% of that found when subjects consumed the LCT diet. We
      conclude that although total triglyceride production during MCT ingestion is low,
      the chylomicron triglycerides that are synthesized contain significant amounts of
      MCFA.

PMID- 2239758
TI  - A mixed Australian fish diet and fish-oil supplementation: impact on the plasma
      lipid profile of healthy men.
AB  - Twelve healthy men were fed in turn three diets for 6 wk each in a 3 x 3
      randomized block design: a control diet (essentially fish free), a fish diet (200
      g lean Australian fish flesh/d), and the same fish-based meal but supplemented
      with 5 g fish oil/d. Dietary eicosapentaenoic acid [EPA, 20: 5n-3 (omega-3)] was
      strongly associated with erythrocyte membrane EPA (r = 0.908 at 6 wk),
      strengthening its value as a measure of compliance in fish and fish-oil feeding
      trials. On the fish diet, subjects had increased incorporation of n-3
      polyunsaturated fatty acids (PUFAs) at the expense of n-6 PUFAs in their
      erythrocyte membranes. When the fish-based diet was supplemented with fish oil (5
      g/d), there was a significant lowering of plasma triacylglycerol (-0.16 +/- 0.24
      mmol/L; mean +/- SD). No change in plasma total cholesterol was detected although
      the fish + oil diet produced a reduction in very-low-density-lipoprotein
      cholesterol (-0.24 +/- 0.26 mmol/L).

PMID- 2239760
TI  - Flavin composition of human milk.
AB  - The identity and quantity of greater than 95% of the flavins present in human
      milk were assessed by acid-phenol extractions followed by high-performance liquid
      chromatography. Flavin adenine dinucleotide (FAD) and riboflavin were the
      predominant flavins, followed by 10-(2'-hydroxyethyl)-flavin. In addition, traces
      of 7 alpha- and 8 alpha-hydroxyriboflavins (7-hydroxymethylriboflavin and 8
      hydroxymethylriboflavin, respectively) were detected. The flavin content of human
      milk samples in this study was higher than contents reported in earlier studies
      where no correction for the internal fluorescence quenching of FAD was made. This
      finding may have implications for dietary recommendations concerning both
      lactating women and infants. In practical terms, the types and amounts of flavins
      in human milk are very similar to those recently reported for cow milk.

PMID- 2239762
TI  - Obesity and iron status in menstruating women.
AB  - The relationship between iron stores and obesity in menstruating women was
      studied in 20 obese and 20 nonobese women matched for age and contraception.
      Although no difference was observed in serum iron or total-iron-binding capacity,
      the obese group showed significantly higher hemoglobin (137 +/- 9 vs 10 g/L, mean
      +/- SD; P less than 0.01), hematocrit (0.41 +/- 0.02 vs 0.39 +/- 0.03, P less
      than 0.05), and serum ferritin concentrations (48.0 +/- 44.3 vs 25.8 +/- 19.5
      micrograms/L, P less than 0.05). There was no difference between obese and
      nonobese women in either the menstrual-cycle interval or the duration of the
      menstrual flow. Iron intake was significantly higher in the obese group (15.9 +/-
      2.9 vs 14.1 +/- 2.9 mg/d, P less than 0.05). These results suggest that obese
      menstruating women are at low risk of depleting iron stores, possibly because of
      high iron intake. Iron-fortification programs might thus be undesirable in such
      subjects.

PMID- 2239763
TI  - Effects of resection on absorption and secretion of divalent cations by small
      intestine of rat.
AB  - Resection increases villus height and crypt depth of remaining intestine. We
      examined functional consequences of resection by measuring absorption of
      strontium and secretion of calcium and magnesium by proximal and distal segments
      remaining after resecting 70% of mid small intestine. Compared with the
      transected control group, resection decreased strontium absorption per unit
      weight of mucosa (specific absorption) in the proximal segment. The decreased
      specific absorption was compensated by increased mucosal growth in the resected
      group so that absorption per unit length of segment (per cm) was the same in both
      groups. Resection increased secretion of calcium and magnesium by 66% per unit
      weight of mucosa and by 145%/cm in the distal segment. Comparing proximal with
      distal segments in the resected group, secretion was greater in distal for
      calcium and in proximal for magnesium. Intestinal resection causes responses in
      absorption and secretion of divalent cations important in mineral homeostasis.

PMID- 2239761
TI  - Selenium intake, age, gender, and smoking in relation to indices of selenium
      status of adults residing in a seleniferous area.
AB  - Duplicate meals, serum, whole blood, and toenails were collected every 3 mo for 1
      y from a group of 44 free-living adults residing in high-selenium areas of South
      Dakota and Wyoming to assess the relation of selenium intake to indices of
      selenium status. The average selenium values for the group were as follows:
      dietary intake, 174 +/- 91 micrograms/d (mean +/- SD), 2.33 +/- 1.08
      micrograms/kg body wt; serum, 2.10 +/- 0.38 mumol/L; whole blood, 3.22 +/- 0.79
      mumol/L; and toenails, 15.2 +/- 3.0 nmol/g. Selenium intake (micrograms/kg body
      wt) was strongly correlated (all values, P less than 0.01) with selenium
      concentration of serum (r = 0.63), whole blood (r = 0.62), and toenails (r =
      0.59). Men and women had similar mean values of serum, whole blood, and toenail
      selenium despite higher selenium intakes in men. Smokers had lower tissue
      selenium concentrations than did nonsmokers due, at least in part, to lower
      selenium intake. Age was not associated with tissue selenium content. Of the
      variables examined selenium intake was clearly the strongest predictor of tissue
      selenium concentration.

PMID- 2239764
TI  - Mother-daughter pairs: spinal and femoral bone densities and dietary intakes.
AB  - Bone mineral density (BMD) of the lumbar spine (L1-L4) and femur (femoral neck,
      Ward's triangle, and trochanter) was measured in 37 healthy, white mother
      daughter pairs by dual-photon absorptiometry. Mothers and daughters were aged 52
      +/- 7 and 25 +/- 4 y (mean +/- SD), respectively. Three-day dietary intakes were
      evaluated. Significant correlations between mother-daughter pairs for BMD of all
      lumbar and femoral areas [except for L2 (r = 0.26, P = 0.054)] indicated familial
      resemblances in bone mineralization. Total calcium intake was significantly
      correlated with three BMD values for the daughters (L2, femoral neck, and
      trochanter) but not for the mothers. When mothers were classified as pre- (n =
      20) or postmenopausal (n = 17), correlation coefficients for BMD were higher for
      premenopausal mothers and their daughters and lower for postmenopausal mothers
      and their daughters, except for the trochanter. The results suggest that the
      nature of inheritance of bone mass of women may have at least two components, one
      influencing the level of peak bone mass and one related to bone loss at
      menopause.

PMID- 2239765
TI  - Factors that influence peak bone mass formation: a study of calcium balance and
      the inheritance of bone mass in adolescent females.
AB  - We suggested that calcium may be an important determinant of peak bone mass. For
      further elucidation, calcium balances in adolescent females with different
      calcium intakes (270-1637 mg/d), and a 2-y intervention study of calcium
      supplementation were performed. Hereditary influences on bone status were also
      evaluated by comparing subjects' and parents' bone mass. The main determinant of
      calcium balance was calcium intake; net calcium absorption increased with intake
      and urinary calcium did not change. Adolescent females retained 200-500 mg Ca/d,
      suggesting that inadequate calcium intake may translate into inadequate calcium
      retention and a reduction in peak bone mass. There was a more pronounced increase
      in bone mass over time in the calcium-supplemented group (1640 mg Ca/d) than in
      the control group (750 mg Ca/d), but the differences between bone mass
      measurements were not statistically significant, possibly because of a type II
      error. By the age of 16 y daughters had accumulated 90-97% of the bone mass of
      their premenopausal mothers.

PMID- 2239766
TI  - Dietary fat and risk of breast cancer.
AB  - The relationship between dietary fat and subsequent risk of breast cancer was
      studied in 3988 initially cancer-free Finnish women aged 20-69 y. During a follow
      up period of 20 y, 54 breast-cancer cases were diagnosed. Risk of breast cancer
      was significantly inversely related to energy intake and nonsignificantly
      inversely related to absolute fat intake. A positive association between energy
      adjusted total fat intake and occurrence of breast cancer was also observed. The
      relative risk in the highest tertile as compared with the lowest tertile was 1.7
      (95% confidence limits 0.6-4.8). The corresponding relative risks were 1.4 (0.5
      3.7) for saturated fatty acids, 2.7 (1.0-7.4) for monounsaturated fatty acids,
      1.2 (0.6-2.8) for polyunsaturated fatty acids, and 2.2 (1.0-5.0) for cholesterol
      intake. Adjustment for different potential confounding factors did not alter the
      results. The present data suggest that breast cancer is associated inversely with
      energy intake and weakly positively with energy-adjusted fat intake.

PMID- 2239767
TI  - Breast cancer and dietary and plasma concentrations of carotenoids and vitamin A.
AB  - A case-control study of breast cancer was conducted in Buffalo. Participants
      completed a food frequency questionnaire and donated a fasting blood sample
      before definitive workup for breast masses. Dietary and plasma concentrations of
      carotenoids and retinol for 83 women found to have breast cancer were compared
      with those of 113 women found to be free of breast cancer (control subjects).
      There were no case-control differences in dietary estimates of vitamin A intake
      or in plasma alpha-carotene and lycopene. However, subjects with breast cancer
      had lower concentrations of plasma beta-carotene than did control subjects (P =
      0.02). There was no overall association between plasma retinol and breast cancer
      but a positive relationship was observed between retinol and breast cancer in the
      subgroup with low beta-carotene values. These results suggest that low plasma
      beta-carotene is associated with increased risk of breast cancer. Other studies
      will need to determine whether low carotene concentrations are a subtle effect of
      the disease or might be causally related to breast cancer.

PMID- 2239768
TI  - Dietary predictors of symptom-associated gallstones in middle-aged women.
AB  - In 1980, 88,837 women aged 34-59 y completed a semiquantitative food frequency
      questionnaire and were followed for 4 y. Four hundred thirty-three women reported
      a cholecystectomy for recent cholecystitis, and 179 reported unremoved, newly
      symptomatic gallstones diagnosed by ultrasound or x ray. Among the 59,306 women
      with Quetelet's index of relative weight less than 25 kg/m2, inverse associations
      were observed between intakes of vegetable fat and vegetable protein and the risk
      of reportedly symptomatic gallastones, after adjusting for age, Quetelet's index
      in 1980, weight change between 1976 and 1980, energy intake, and alcohol intake.
      The relative risk in the highest quintile of vegetable fat intake, as compared
      with the lowest quintile, was 0.6 [95% confidence interval (CI), 0.4-0.9], and
      the corresponding relative risk for vegetable protein intake was 0.7 (95% CI, 0.6
      0.9). No significant associations were found with energy-adjusted intakes of
      cholesterol, animal fat, animal protein, carbohydrate, or sucrose.

PMID- 2239769
TI  - Urinary organic acid excretion during feeding of medium-chain or long-chain
      triglyceride diets in patients with non-insulin-dependent diabetes mellitus.
AB  - Medium-chain triglycerides (MCTs) are absorbed and metabolized differently from
      long-chain triglycerides (LCTs). Recent data indicate that MCTs may be useful as
      a dietary substitute in a variety of clinical disorders. The current studies were
      undertaken to characterize urinary organic acid excretion in patients with non
      insulin-dependent diabetes mellitus during 4 d of an LCT or MCT diet. Urinary
      excretion of the dicarboxylic acids adipic, suberic, and 3-hydroxysebacic and the
      (omega-1) hydroxylation products 5-hydroxyhexanoic acid and 7-hydroxyoctanoic
      acid, was increased during MCT feeding as compared with LCT feeding. Urinary
      suberic and 7-hydroxyoctanoic acid excretions were increased 55- and 30-fold,
      respectively, during the MCT-substituted diet. Urinary organic acid profiles
      provide information on the fate of lipids during MCT feeding and may also be
      useful in assessing complicance during clinical trials employing MCT-substituted
      diets.

PMID- 2239770
TI  - Nutrition factors in relation to cellular and regulatory immune variables in a
      free-living elderly population.
AB  - Aging is associated with a greater susceptibility to nutrition deficiencies and
      to progressive senescence of the immune system. To test whether nutrition status
      contributes to the immunologic changes observed in elderly individuals, we
      examined the relationship between nutrition status and in vitro indices of immune
      responses in 82 healthy, free-living elderly individuals. Nutrition status was
      assessed by anthropometric measurements, 7 d food records, and blood
      concentrations of selected nutrients. Using regression analyses, we found that
      none of the nutrition factors was associated with cytotoxic activity of natural
      killer (NK) cells against the leukemic cell line K562. However, our results
      suggest that the dietary intakes of vitamins E and D negatively influenced the
      activity of interleukin 2 (IL-2) measured by a bioassay in which the CTLL cell
      line was used. An association may exist between particular aspects of nutrition
      status and regulation of immune response by IL-2. The need for further studies is
      emphasized.

PMID- 2239771
TI  - Dietary habits of smokers, people who never smoked, and exsmokers.
AB  - A large database on hospital patients with illnesses not related to tobacco or
      alcohol was used to investigate the dietary habits of males and females who never
      smoked, who were exsmokers, and who currently smoked. Smoking was positively
      related to meat consumption and negatively related to cereal consumption in
      males. Both male and female smokers consumed fewer vegetables and fruits but more
      alcohol and coffee than did people who never smoked. Exsmokers' diets were
      similar to those of people who never smoked. These results emphasize the
      importance of ruling out potential confounders or effect modifiers when studying
      the role of meat, milk, fruits, vegetables, cereal, coffee, or alcohol intake in
      the etiology of tobacco-related diseases.

PMID- 2239772
TI  - Maternal weight gain in low-income black and Hispanic women: evaluation by use of
      weight-for-height near term.
AB  - This study determined the prevalence of low maternal weight gain among a target
      group of low-income black and Hispanic women and compared weight-for-height near
      term with total weight gain during pregnancy as an index of birth-weight
      classification. One-third (30.8%) of 325 women had weights near term less than
      120% of their standard pregravid weight-for-height; there was little variation by
      ethnic group. After adjusting for gestational age as a covariate of birth weight
      (P = 0.0001), maternal weight-for-height near term (P = 0.0010), ethnicity (P "
      0.0068), and parity (P = 0.0083) significantly influenced birth weight. Women
      with near-term weights greater than or equal to 120% of their standard pregravid
      weight-for-height delivered infants with higher birth weights (P = 0.001).
      Comparison of weight-for-height near term with total weight gain as an index of
      birth-weight classification (less than or greater than or equal to 3000 g)
      revealed that the two methods differ in terms of sensitivity and specificity with
      variation in pregravid weight.

PMID- 2239773
TI  - Food fights: deciding about diet and disease.

PMID- 2239774
TI  - Basic and clinical aspects of regional fat distribution.

PMID- 2239775
TI  - Effects of common illnesses on infants' energy intakes from breast milk and other
      foods during longitudinal community-based studies in Huascar (Lima), Peru.
AB  - To assess the effects of common infections on dietary intake, 131 Peruvian
      infants were observed longitudinally. Home surveillance for illness symptoms was
      completed thrice weekly, and food and breast-milk consumption was measured during
      1615 full-day observations. Mean (+/- SD) energy intakes on symptom-free days
      were 557 +/- 128 kcal/d (92.4 +/- 26.5 kcal.kg-1.d-1) for infants aged less than
      181 d and 638 +/- 193 kcal/d (77.7 +/- 25.7 kcal.kg-1.d-1) for infants aged
      greater than 180 d. Statistical models controlling for infant age, season of the
      year, and individual showed significant 5-6% decreases in total energy intake
      during diarrhea or fever. There were no changes with illness in the frequency of
      breast-feeding, total suckling time, or amount of breast-milk energy consumed. By
      contrast, energy intake from non-breast-milk sources decreased by 20-30% during
      diarrhea and fever, and the small decrements in total energy consumption during
      illness were explained entirely by reduced consumption of non-breast-milk foods.

PMID- 2239776
TI  - Cholesterol-lowering effect of skim milk from immunized cows in
      hypercholesterolemic patients.
AB  - The effect of skim milk from cows immunized against a variety of human intestinal
      bacteria on serum cholesterol concentrations was examined in 11 patients with
      primary hypercholesterolemia in a 24-wk, randomized, double-blind, placebo
      controlled, crossover study. After a 4-wk baseline period, patients were treated
      for 8 wk either with skim milk from immunized cows (active) or with control skim
      milk (placebo) followed by an 8-wk period with the treatment order reversed.
      Eight weeks of active treatment with skim milk from immunized cows reduced serum
      total cholesterol concentrations by 0.52 +/- 0.59 mmol/L (mean +/- SD; P less
      than 0.025), or 8%, LDL cholesterol by 0.16 +/- 0.59 mmol/L (NS), or 4%, and the
      atherogenic index (total cholesterol/HDL cholesterol) by 0.42 +/- 1.85 (P less
      than 0.05), or 8%, compared with the placebo treatment. Reversal of the favorable
      development occurred upon cessation of active treatment. We conclude that daily
      supplementation of a normal diet with skim milk from immunized cows can result in
      a significant reduction of elevated blood cholesterol concentrations.

PMID- 2239777
TI  - Erythrocyte fatty acids, plasma lipids, and cardiovascular disease in rural
      China.
AB  - Cardiovascular disease (CVD) mortality (coronary heart disease, hypertensive
      heart disease, and stroke), plasma lipids, and red blood cell fatty acid
      composition were examined in an ecologic study in 65 rural counties in the
      People's Republic of China. Means of plasma total cholesterol, triglyceride, low
      density-lipoprotein (LDL) cholesterol, and high-density-lipoprotein (HDL)
      cholesterol concentrations were substantially lower and the ratio of HDL
      cholesterol to total cholesterol was higher in this Chinese population than in
      Western populations. Mortality rates for CVD in China were well below Western
      values. Within China neither plasma total cholesterol nor LDL cholesterol was
      associated with CVD. A strong inverse correlation between red blood cell oleate
      concentrations and CVD was observed. However, red blood cell oleate
      concentrations were not associated with plasma cholesterol but were strongly
      negatively associated with arachidonate concentrations, suggesting potential
      diminution of CVD by oleate through reduced platelet aggregability. The results
      indicate that geographical differences in CVD mortality within China are caused
      primarily by factors other than dietary or plasma cholesterol.

PMID- 2239778
TI  - Protein-energy requirements of prepubertal school-age boys determined by using
      the nitrogen-balance response to a mixed-protein diet.
AB  - Short-term nitrogen-balance response to a vegetable-protein mixed diet and to a
      milk-egg protein diet was tested in eight healthy male children 8-10 y old. They
      received 96, 128, 160, and 192 mg N.kg body wt-1.d-1 for 10 d while on the mixed
      diet and 160 mg N.kg-1.d-1 on the milk-egg diet. The mean regression equation was
      nitrogen balance = 0.52 (nitrogen intake) -68.3, all in mg N.kg-1.d-1. Apparent
      nitrogen digestibility was 82% and 86% for the mixed and milk-egg diets,
      respectively, when the subjects received 160 mg N.kg-1.d-1. Mean nitrogen intake
      for satisfactory nitrogen retention on the mixed diet was 150 mg N.kg-1.d-1; the
      suggested protein recommended allowance to cover 97.5% of the population was
      derived by using a CV of 12.5% is 1.2 g protein.kg-1.d-1. We conclude that
      present recommendations are adequate for short-term nitrogen retention; long-term
      studies are needed to evaluate the chronic safety of this protein allowance.

PMID- 2239779
TI  - Continuous glucose for treatment of patients with type 1 glycogen-storage
      disease: comparison of the effects of dextrose and uncooked cornstarch on
      biochemical variables.
AB  - Responses to uncooked cornstarch (UCS), dextrose (Dex), and a 3:1 mixture
      (UCS:Dex) were determined in seven children with type 1 glycogen-storage disease
      (GSD-1). UCS maintained blood glucose (BG) and serum insulin concentrations
      between 3.5 +/- 0.3 and 4.0 +/- 0.4 mmol/L (mean +/- SEM) and 50 +/- 7 and 79 +/-
      22 pmol/L, respectively, in six of the seven patients for 4 h. Only four of seven
      patients completed the 4-h test after UCS:Dex (BG 2.9 +/- 0.3 mmol/L): After Dex,
      tests had to be stopped in all patients by 150 min after initiation (BG 2.7 +/-
      0.4 mmol/L). Two methods of providing dietary glucose overnight, continuous
      intragastric glucose infusion (COG) and intermittent UCS at 2100 and 0200, were
      compared by monitoring metabolites and glucoregulatory hormones. The use of UCS
      in amounts equal to the calculated glucose production rate is an effective method
      of providing a continuous dietary source of glucose overnight to patients with
      GSD-1.

PMID- 2239780
TI  - Physical growth and development of children with type 1 glycogen-storage disease:
      comparison of the effects of long-term use of dextrose and uncooked cornstarch.
AB  - Thirteen patients with type 1 glycogen-storage disease (GSD-1) were studied to
      compare the effects on biochemical control and growth of 2 y of therapy with
      intermittent feedings of uncooked cornstarch (UCS) at the fasting glucose
      production rate and therapy with continuous overnight glucose (COG) and dextrose
      feedings during the day. Mean biochemical abnormalities for the groups were
      minimized but not normalized by either COG or UCS. Growth progressed normally
      when COG was started by 1.2 y of age and normal growth rate was maintained by
      UCS. Weight increased from 101 +/- 3% ideal body weight at onset of COG to 127 +/
      5% during COG and the first year of UCS therapy but did not increase further in
      the second year. When growth failure occurred before onset of COG [-3.7 SD score
      for chronological age (SDSCA)], only partial correction (-1.9 SDSCA) to genetic
      potential for height occurred. Intermittent feeding of UCS provides an effective
      alternative to COG for the treatment of GSD-1.

PMID- 2239781
TI  - Dietary carbohydrate and intensity of interval swim training.
AB  - We tested the effects of 9 d of a high-carbohydrate diet (80% of calories as CHO,
      80% CHO diet) vs. a moderate-CHO diet (43% of calories as CHO, 43% CHO diet) on
      the abilities of collegiate swimmers to maintain a high intensity of interval
      swim training. Interval swim times and other physiological indices were recorded
      the last 5 d of each diet. Swim-interval distances ranged from 50-m interval sets
      to continuous 3000-m swims. There were no diet effects on mean swim velocities
      for any interval distance, and mean (+/- SEM) velocities for all swims were
      identical for both diets. There were no diet effects on the physiological
      indices; however, postswim blood lactate concentrations were higher after the 80%
      CHO diet. When mean +/- SEM daily caloric intake is 19.56 +/- 2.16 MJ (4675 +/-
      516 kcal) for swimmers undertaking swim training to develop aerobic capacity, an
      80% CHO diet provides no advantage over a 43% CHO diet for maintaining interval
      swim-training intensity.

PMID- 2239782
TI  - The modified relative-dose-response assay as an indicator of vitamin A status in
      a population of well-nourished American children.
AB  - The relative-dose-response (RDR) assay first proposed by Underwood has proved to
      be a useful indicator of marginal vitamin A status. We suggested that 3,4
      didehydroretinol might be used in a simpler assay that requires only one blood
      sample for analysis. In the present study 24 healthy children aged 3.7-7.1 y were
      given 100 micrograms 3,4-didehydroretinyl acetate/kg body wt in corn oil,
      followed by ice cream (90 mL). A blood sample was taken 2, 4, 5, 6, 8, 10, or 24
      h after the dose. The mean ratio of dehydroretinol to retinaol (DR-R ratio)
      plateaued at approximately 0.02 in the plasma between 4 and 10 h. Only three
      children showed ratios greater than 0.03. Upon reinvestigation, the DR-R ratio
      remained greater than 0.03 in one child at 5 h. After vitamin A treatment the
      ratio decreased to 0.019. Thus, a tentative DR-R cutoff ratio for a satisfactory
      vitamin A status in healthy American children is 0.03.

PMID- 2239783
TI  - Vitamin A status in preschool-age Indonesian children as assessed by the modified
      relative-dose-response assay.
AB  - The modified relative-dose-response (MRDR) assay has been validated in rats as a
      function of vitamin A status and tested in a group of American children. In this
      study the MRDR assay was applied to West Javan children who are at risk of being
      vitamin A deficient. Of 86 children enrolled, 75 were tested. In a time-course
      study involving 22 children aged 3.7-5.3 y, blood samples were taken at different
      times after doses of 0.35 mumol 3,4-didehydroretinyl acetate/kg body wt.
      Generally, the ratio of dehydroretinol to retinol (DR-R ratio) peaked between 4
      and 8 h. Thereafter, in a survey of 53 children aged 0.6-4.8 y, single blood
      samples were drawn 5 h after the dehydroretinyl acetate dose. The DR-R ratio
      ranged from 0.0028 to 0.169. With a DR-R ratio of 0.03 as the cutoff value, 62%
      of the children were judged to be of marginal vitamin A status.

PMID- 2239784
TI  - Vitamin B-12: low milk concentrations are related to low serum concentrations in
      vegetarian women and to methylmalonic aciduria in their infants.
AB  - In a group of 13 strict vegetarian and 6 omnivorous lactating women,
      relationships were studied among maternal milk and serum vitamin B-12, and milk
      vitamin B-12 and infant urinary methylmalonic acid (MMA) excretion. Milk vitamin
      B-12 concentrations were lower in women consuming a strict vegetarian diet
      compared with an omnivorous diet. Milk vitamin B-12 was inversely related to
      length of time on a vegetarian diet and positively correlated with maternal serum
      vitamin B-12 concentrations. Infant urinary MMA excretion was inversely related
      to milk vitamin B-12 concentrations less than 362 pmol/L. The 1989 recommended
      dietary allowance for vitamin B-12 of 221 pmol/d for infants is close to the
      intake below which infant urinary MMA excretion is increased. We conclude that
      the current RDA for infants provides little margin of safety.

PMID- 2239785
TI  - Influence of folate status and polyphenol intake on thiamin status of Irish
      women.
AB  - The relationship of folate status and polyphenol intake to thiamin status was
      studied in 80 randomly selected elderly and young Irish women, with key variables
      affecting thiamin nutrition controlled for. Folate, thiamin, and polyphenol
      intakes were measured during a 4-wk baseline (elderly and young) and 6-wk double
      blind (elderly) supplementation period. Only elderly subjects were randomly
      assigned to placebo, folic acid (400 micrograms), thiamin (10 mg), or folic-acid
      plus-thiamin groups. Thiamin status (TPP effect) was not affected by folate
      status (plasma and erythrocyte folate) during the baseline period or with folic
      acid supplementation alone. Polyphenol intake was not correlated with thiamin
      status. Only thiamin intake and thiamin supplementation significantly affected
      thiamin status. Because the majority of subjects (102 of 160) were initially
      thiamin deficient, enrichment of Irish grain products with thiamin is
      recommended.

PMID- 2239786
TI  - Chronic ethanol feeding and acute ethanol exposure in vitro: effect on intestinal
      transport of biotin.
AB  - This study examined the effects of chronic ethanol feeding and acute ethanol
      exposure in vitro on biotin transport in rat intestine. Transport studies were
      performed with intestinal everted sacs. Ethanol was fed to rats for 6-7 wk.
      Compared with pair-fed controls, ethanol feeding significantly decreased plasma
      biotin concentrations and transport at physiological concentrations (0.01, 0.1,
      and 0.3 mumol/L) but not at pharmacological concentration (100 mumol/L). When
      added to the incubation medium of everted jejunal sacs from dry-food-fed rats,
      ethanol (2% vol:vol) significantly inhibited the transport of biotin at a
      physiological concentration (0.1 mumol/L) but not at a pharmacological
      concentration (100 mumol/L). The inhibitory effect of ethanol on the transport of
      0.1 mumol biotin/L increased with increasing concentration of ethanol in the
      incubation medium [0.5% to 5% (vol:vol)]. Acetaldehyde, the major ethanol
      metabolite, also significantly inhibited biotin transport at 0.2% (vol:vol).
      These data demonstrate that chronic ethanol feeding and acute ethanol exposure in
      vitro inhibit the intestinal transport of biotin by the carrier-mediated process.
      Chronic ethanol feeding is also associated with a significant decrease in plasma
      biotin concentrations. The ethanol-induced inhibition in intestinal transport of
      biotin may be a contributing factor in reducing plasma biotin concentrations.

PMID- 2239787
TI  - Iodine and selenium deficiency associated with cretinism in northern Zaire.
AB  - Selenium status was determined in an endemic-goiter area and in a control area of
      Zaire. Compared with the reference values of a noniodine-deficient area, serum
      selenium in subjects living in the core of the northern Zaire endemic-goiter belt
      (Karawa villages) was seven times lower in 52 school-children and similarly low
      in 23 cretins; erythrocyte glutathione peroxidase (RBC-GPX) was five times lower
      in schoolchildren and still two times lower in cretins (P = 0.004). In a less
      severely iodine-deficient city of the same endemia (Businga), selenium status was
      moderately altered. RBC-GPX activity was linearly associated with serum selenium
      concentration up to a value of 1140 nmol/L and leveled off at approximately 15
      U/g Hb at greater selenium concentration. At Karawa villages, selenium
      supplementation normalized both the serum selenium and the RBC-GPX. This combined
      iodine and selenium deficiency could be associated with the elevated frequency of
      endemic myxedematous cretinism in Central Africa.

PMID- 2239788
TI  - Catabolic effects of high-dose corticosteroids persist despite therapeutic
      benefit in rheumatoid arthritis.
AB  - Although corticosteroids (CS) cause nitrogen wasting in healthy humans, it is not
      known whether the salutary antiinflammatory and appetite-stimulating effects of
      CS in inflammatory diseases mitigate this effect. We measured nitrogen balance
      before, during, and after 3 d of high-dose methylprednisolone therapy in nine
      patients with flare-ups of rheumatoid arthritis. There was evidence of
      preexisting somatic protein and fat depletion in seven of nine subjects. Patients
      were allowed to eat freely on a metabolic ward. Nitrogen balances were -0.89 +/-
      1.38 g/d (means +/- SEM) before CS therapy, -5.77 +/- 1.30 g/d during therapy (P
      less than 0.001), and -3.54 +/- 1.38 g/d after therapy (P less than 0.01) despite
      increased energy and nitrogen intake and clinical resolution of inflammation
      during and after the pulse therapy. We conclude that patients with rheumatoid
      arthritis are often cachectic and high-dose CS cause nitrogen wasting in these
      patients despite an antiinflammatory and appetite-stimulatory benefit.

PMID- 2239789
TI  - Effects of fish-oil ingestion on cardiovascular risk factors in hyperlipidemic
      subjects in Israel: a randomized, double-blind crossover study.
AB  - Effects of a daily fish-oil supplement on serum lipids, apolipoproteins, and some
      platelet functions and hemorheologic variables were examined in 27 hyperlipidemic
      subjects in a randomized, controlled, double-blind, crossover fashion with an
      identically encapsulated vegetable oil serving as the control treatment. Despite
      the habitual high linoleic acid intake of the study population, significant
      incorporation of n-3 (omega-3) fatty acids into the serum, platelet, and
      erythrocyte lipids was observed after the fish-oil supplement. Ingestion of fish
      oil resulted in a 40% decrease in the triglyceride concentration, a 12% increase
      in HDL cholesterol, and a significant decrease in plasma viscosity, whereas the
      vegetable-oil placebo had no significant effect. We conclude that a moderate
      intake of fish oil (15 g/d) is a feasible treatment for hypertriglyceridemia even
      in patients with a background of high linoleic acid intake and that it may have a
      beneficial effect on several cardiovascular risk factors.

PMID- 2239790
TI  - Self-reported weight and height.
AB  - The error in self-reported weight and height compared with measured weight and
      height was evaluated in a nationally representative sample of 11,284 adults aged
      20-74 y from the second National Health and Nutrition Examination Survey of 1976
      1980. Although weight and height were reported, on the average, with small
      errors, self-reported weight and height are unreliable in important population
      subgroups. Errors in self-reporting weight were directly related to a person's
      overweight status--bias and unreliability in self-report increased directly with
      the magnitude of overweight. Errors in self-reported weight were greater in
      overweight females than in overweight males. Race, age, and end-digit preference
      were ancillary predictors of reporting error in weight. Errors in self-reporting
      height were related to a person's age--bias and unreliability in self-reporting
      increased directly with age after age 45 y. Overweight status was also a
      predictor of reporting error in height.

PMID- 2239791
TI  - Two-point vs multipoint sample collection for the analysis of energy expenditure
      by use of the doubly labeled water method.
AB  - Energy expenditure over a 2-wk period was determined by the doubly labeled water
      (2H2(18)O) method in nine adults. When daily samples were analyzed, energy
      expenditure was 2859 +/- 453 kcal/d (means +/- SD); when only the first and last
      time points were considered, the mean calculated energy expenditure was not
      significantly different (2947 +/- 430 kcal/d). An analysis of theoretical cases
      in which isotope flux is not constant indicates that the multipoint method can
      cause errors in the calculation of average isotope fluxes, but these are
      generally small. Simulations of the effect of analytical error indicate that
      increasing the number of replicates on two points reduces the impact of technical
      errors more effectively than does performing single analyses on multiple samples.
      It appears that generally there is no advantage to collecting frequent samples
      when the 2H2(18)O method is used to estimate energy expenditure in adult humans.

PMID- 2239792
TI  - Height-normalized indices of the body's fat-free mass and fat mass: potentially
      useful indicators of nutritional status.
AB  - Expressing fat-free mass (FFM) and body fat mass (BFM) as percentages of body
      weight or by weight is unsatisfactory. For example, tall patients with protein
      energy malnutrition (PEM) can exhibit values for FFM and BFM similar to those of
      shorter well-nourished individuals. To obviate such difficulties, we propose use
      of height-normalized indices, namely, a FFM index [FFM (kg)/height (m)2, or FFMI]
      and a BFM index [BFM (kg)/height (m)2, or BFMI]. We calculated these indices in a
      reference population of 124 healthy young men and in 32 nonobese young men (from
      the Minnesota Study) before, during, and after experimental semistarvation. When
      values for FFMI and BFMI falling below the reference cohort's 5th percentile
      cutoff point were used as a criterion for PEM, these indices, together with basal
      oxygen-consumption rate, diagnosed PEM in 27 of the 32 Minnesota Study subjects
      after 12 wk of semi-starvation. These findings indicate that FFMI and BFMI may be
      useful in nutritional assessment.

PMID- 2239793
TI  - Evidence for a secular change in obesity, height, and weight among Navajo Indian
      schoolchildren.
AB  - A survey measuring heights and weights of 1969 schoolchildren residing on the
      Navajo Indian Reservation was conducted in 1989. The findings were compared with
      National Center for Health Statistics (NCHS) reference data and with surveys of
      Navajo children from 1955, 1968, and 1981. Approximately twice as many children
      exceeded the 95th percentile of weight-for-age (11.2% of girls, 12.5% of boys)
      than would be expected for the NCHS reference population. The mean weight-for
      height z scores exceeded those for the NCHS reference population for all ages in
      both sexes. Compared with data from 1955, mean heights increased 6.1% among boys
      and 4.4% among girls whereas mean weights increased 28.8% among boys and 18.7%
      among girls across all age groups. The data suggest that there has been a secular
      change in height, weight, and obesity in Navajo Indian children over the past 35
      y.

PMID- 2239794
TI  - Aggressive oral refeeding in hospitalized patients.
AB  - Malnutrition is an important clinical condition leading to increased morbidity
      and mortality. This report describes an aggressive oral refeeding program of high
      caloric foods, which was instituted in severely anorectic patients because of
      their refusal to eat meals or supplements. After ascertaining a patient's
      favorite sweet, hospital personnel and family collaborated in providing the food.
      Frequently, sweets were the patient's only intake for weeks. We saw a gradual
      return of appetite, inclusion of other foods in the diet, and overall clinical
      improvement in comorbid conditions. These cases suggest that aggressive oral
      refeeding with high-caloric foods is an underutilized therapy for multiply
      impaired elderly patients.

PMID- 2239795
TI  - Caloric compensation for lunches varying in fat and carbohydrate content by
      humans in a residential laboratory.
AB  - Two groups of three subjects participated in a residential study that assessed
      the effects of varying the macronutrient and caloric content of a required lunch
      meal on subsequent food choice and intake. Lunches contained 431 or 844 kcal,
      with the caloric differential created by manipulating the calories derived from
      either fat or carbohydrate (CHO). Each lunch condition (high-fat, high-CHO, low
      fat, and low-CHO) was examined for 3 consecutive days. Subjects controlled their
      own patterns of food intake and could consume any item or number of items at any
      time during the day or night. There were no significant differences in total
      daily caloric intake across conditions, indicating that subjects compensated for
      the caloric content of the lunch regardless of the macronutrient content. Total
      daily caloric intake under the high-fat and high-CHO conditions was 2824 +/- 151
      (mean +/- SEM) and 2988 +/- 187 kcal, respectively, whereas intake under the low
      fat and low-CHO conditions was 2700 +/- 131 and 2890 +/- 247 kcal, respectively.

PMID- 2239797
TI  - Energy supplementation in the last trimester of pregnancy in East Java,
      Indonesia: effect on maternal anthropometry.
AB  - The effect of prenatal energy supplementation on maternal anthropometry was
      assessed in a controlled, randomized trial in Madura, East Java. At 26-28 wk of
      gestation women were either given 465 kcal/d (HE group) or 52 kcal/d (LE group).
      Two hundred seventy-six women were enrolled in the HE group and 266 women, in the
      LE group. Supplement intake was variable. Testing of effect by treatment and
      compliance was thus done by subcategories (HE 1-3 and LE 1-3, corresponding to
      less than 45, 45-89, and greater than or equal to 90 packets of supplement
      consumed). Analysis of variance did not show significant differences among the
      six subcategories in third-trimester weight gain, sum of skinfold thicknesses, 4
      wk postpartum weight, or body mass index. In this population energy
      supplementation for the short duration of the last 90-110 d of pregnancy was not
      sufficient to improve maternal nutrition as judged by anthropometry.

PMID- 2239796
TI  - Weight loss and change in resting metabolic rate.
AB  - The relation between change in resting metabolic rate (RMR) and change in fat
      free mass (FFM) after weight loss is not well understood and is often
      inappropriately expressed in kilocalories per unit of FFM. We measured RMR and
      FFM in 35 obese patients enrolled in a conservative weight-loss program. RMR per
      kilogram FFM was not different after weight loss. However, the regression of
      delta RMR on delta FFM revealed that the decline in RMR tended to be greater than
      could be accounted for by loss of FFM. At initial test and retest, body fat (Fat)
      was not a predictor of RMR after FFM had been taken into account but delta Fat
      significantly contributed to the prediction of delta RMR when added to the
      equation after delta FFM. Thus, people losing larger amounts of weight had
      declines in RMR greater than could be accounted for by loss of FFM. Self-reported
      age of onset of obesity was not related to delta RMR.

PMID- 2239798
TI  - Consumption of food and nutrients by infants in Huascar (Lima), Peru.
AB  - Consumption of breast milk, liquids, and foods by 131 poor Peruvian infants was
      measured on 1661 child-days of observation during their first year of life.
      Breast-milk intake was estimated by 12-h test-weighing; macronutrients were
      analyzed in samples of milk. Other foods and liquids were weighed at preparation
      and consumption; nutrient contents were estimated from food composition tables.
      Mean energy intakes increased with age but declined from 95% to 78% of
      recommended amounts during the year. Mean protein intakes were generally above
      recommended amounts but more than one-third of infants received less than 80% of
      the suggested safe intakes in the second (6-mo) semester. Breast milk was the
      major source of energy and protein during the first semester. Breast milk and cow
      milk together contributed more than half the energy and protein during the second
      6 mo, when cereals were also an important source of energy and protein. Mean
      intakes of calcium, thiamin, and ascorbic acid were less than recommended at some
      ages but mean intakes of other selected micronutrients exceeded recommendations.

PMID- 2239799
TI  - Diminished survival of young blacks with adenocarcinoma of the prostate.
AB  - The survival rates of 117 black and white patients treated by primary radiation
      for carcinoma of the prostate at the State University of New York Health Science
      Center at Brooklyn and Kings County Hospital Center were analyzed according to
      age and race. In addition, stage, grade, and delay time in seeking medical
      attention were analyzed. Survival was similar in both young (less than 60 years)
      and old (greater than or equal to 60 years) patients, with 45% and 41% 5-year
      survival rates, respectively. Survival was better in white patients, 48% 5-year
      survival, than in blacks, 35% 5-year survival. Black patients presented with
      higher stage disease than whites (p less than 0.01). This trend was even greater
      in young black males, who had higher grade (64% versus 11%; p less than 0.04) and
      higher stage tumors (p less than 0.05). In addition, young blacks delayed seeking
      medical attention greater than 3 months 72% of the time, as compared to 0% in
      white young males (p less than 0.005). A survival difference was also seen in
      young blacks as compared with young whites: 3.9-year median survival versus 6.0
      year median survival, respectively.

PMID- 2239800
TI  - Phase II study of vinblastine in previously treated squamous carcinoma of the
      cervix. A Gynecologic Oncology Group study.
AB  - Thirty-six patients with advanced squamous carcinoma of the uterine cervix
      recurrent after radiotherapy or surgery or first-line chemotherapy were eligible
      for a phase II study employing vinblastine in a dose of 9 mg/m2 intravenously
      every 3 weeks until disease progression or toxicity supervened. Two patients were
      never treated, leaving 34 patients evaluable for toxicity. One patient was
      inevaluable for response, leaving 33 evaluable for this parameter. Thirty-two
      patients had prior radiotherapy and 30 had prior chemotherapy. All patients had
      Gynecologic Oncology Group (GOG) performance status of 0, 1, or 2. Median age was
      46 years. Twenty patients had disease in the pelvis and 13 had extrapelvic
      metastases. Fourteen patients had grade 3 lesions. A median of three courses
      (range: 1-12 courses) was administered. Ten patients (29.4%) experienced GOG
      grade 3 or 4 leukocytopenia and 10 had grade 3 or 4 granulocytopenia. Other
      toxicity included grade 4 gastrointestinal toxicity and anemia in one patient
      each and two patients with grade 3 neurotoxicity. Twenty patients (60.6%) had
      stable disease with therapy and 13 had increasing disease. No responses were
      observed. Vinblastine in this dose and schedule is inactive in previously treated
      patients with squamous carcinoma of the cervix.

PMID- 2239801
TI  - Phase II study of recombinant alpha-interferon in malignant melanoma.
AB  - Ninety-seven evaluable patients with measurable, advanced, malignant melanoma
      were treated with recombinant alpha interferon in a cooperative phase II efficacy
      trial, whose primary objective was to estimate the response rate. Interferon
      (rIFN alpha-2a, Roferon-A) was injected subcutaneously daily for 70 days. Dose
      was escalated in four steps from three million units to 36 million units over ten
      days. Eight patients responded objectively and six patients (6%) had a complete
      response. The median duration of complete response was 11 months. Patients
      achieving complete response had only cutaneous, nodal, or pulmonary disease; some
      had extensive prior therapy; some could tolerate no more than three million units
      per day. Few patients could tolerate the target dose of 36 million units daily
      for 70 days. Limiting toxicity was primarily fatigue. Interferon in tolerable
      doses is effective in a small subset of patients with melanoma. Comparison of
      published trials of dacarbazine and recombinant alpha interferon indicates the
      two drugs have similar activity.

PMID- 2239802
TI  - Oral carmofur in advanced gastrointestinal cancer.
AB  - One hundred and twenty-four patients with a diagnosis of metastatic
      gastrointestinal cancer and no prior therapy were included in this clinical study
      of carmofur monotherapy, 300-500 mg/m2 daily for 6 weeks. For the 115 evaluable
      patients, the response rates were 19.4% in gastric cancer, 27.2% in cancer of
      mobile colon, and 12.5% in rectal cancer. No objective responses were seen in 38
      patients with pancreatic cancer, although the disease of 13 of these patients has
      remained stable over a considerably long period of follow-up. The toxicity
      profile was interesting; the main adverse effects were urinary bladder symptoms
      and flush. Hematologic toxicity was minimal. The treatment proved to be safe and
      could be used for outpatients.

PMID- 2239803
TI  - 5-Fluorouracil infusion and low-dose weekly cisplatin: an analysis of increased
      toxicity.
AB  - It has been suggested that the addition of weekly low-dose cisplatin (DDP) may
      potentiate the efficacy of continuous infusion 5-fluorouracil (5-FU) without
      adding significant toxicity. To investigate the extent of added toxicity, an
      analysis of toxicity was completed in 18 patients with advanced cancers treated
      with continuous ambulatory 5-FU infusion 300 mg/m2/day and weekly low-dose
      cisplatin (DDP) 20 mg/m2. Ten of the 18 patients (56%) developed multiple (four
      or more) toxicities during treatment. In addition, toxicity categorized as severe
      occurred in 10 patients (56%). Seventeen of the 18 patients (94%) required
      treatment interruption or dose attenuation due to toxicity and most patients
      experienced a decline in Eastern Cooperative Oncology Group performance status
      due to treatment-related toxicity. Compared with historical toxicity patterns
      when 5-FU infusion is administered alone, the addition of DDP has resulted in
      significant increases in nausea and vomiting, anorexia, diarrhea, stomatitis, and
      myelosuppression. The addition of low-dose weekly DDP adds significant toxicity
      and morbidity to the continuous 5-FU infusion regimen.

PMID- 2239804
TI  - Angiosarcoma of the forearm definitively treated by hyperfractionated
      irradiation.
AB  - A case report of an angiosarcoma treated definitively with hyperfractionated
      irradiation is presented. Radial and ulnar aspects of the proximal forearm,
      wrist, and digits were diffusely involved on angiography. Hyperfractionated
      irradiation totaling 7,440 cGy was delivered to the entire circumference of the
      hand, forearm, and distal 5 cm of the arm; a confluent dry erythema without moist
      desquamation was observed at completion of therapy. No significant local or
      systemic toxicity was noted with the administration of an Adriamycin-containing
      adjuvant chemotherapy regimen following irradiation. Local regional control at 2
      years is documented both clinically and by angiographic examination and the
      patient otherwise is free of disease. Function remains excellent with no
      lymphedema or joint fibrosis observed and grip strength of treated and untreated
      hands is comparable at 35 pounds. For patients refusing amputation or who are
      otherwise inoperable, hyperfractionated irradiation provides a therapeutic
      option.

PMID- 2239805
TI  - Nodular histiocytic lymphoma, emphasizing results of stage I disease treated by
      radiotherapy. A report of the Japan Lymphoma Radiation Therapy Study Group
      (JLRTG).
AB  - The records of 49 patients with nodular histiocytic lymphomas (NH) who were
      treated from 1972 to 1985 in hospitals belonging to the JLRTG were
      retrospectively reviewed. The actuarial survival rate and relapse-free survival
      rate of all patients after 5 years were 55.0 and 51.3%, respectively. Twenty-one
      patients with stage I disease had a significantly better survival rate than did
      12 patients with stage II disease (P less than 0.01). Without combination
      chemotherapy, all 15 patients with stage I NH treated by radiation therapy were
      in complete remission, and 14 of them remained alive and well. Among these 15
      patients, no difference in relapse was observed between patients who received
      involved field irradiation (1 of 6) and those who received extended field
      irradiation (2 of 9). Patients with stage II or more NH should be treated with
      intensive chemotherapy and radiotherapy, as are patients with diffuse histiocytic
      lymphoma (DH). However, involved field radiotherapy with careful follow-up
      observation may be the treatment of choice for patients with stage I NH, provided
      their tumors are not bulky.

PMID- 2239806
TI  - Mitoxantrone and constant infusion etoposide for relapsed and refractory acute
      myelocytic leukemia.
AB  - In an effort to search for new, synergistic and non-cross-resistant antileukemic
      regimens, the Cancer and Leukemia Group B (CALGB) investigated the activity and
      toxicity of mitoxantrone in combination with etoposide for the reinduction of
      patients with relapsed or refractory acute myelocytic leukemia (AML).
      Mitoxantrone, 12 mg/m2 daily for 3 days, was combined with three dose levels of
      etoposide, 100, 150 and 200 mg/m2 daily by constant infusion for 5 days. There
      were 19 male and 13 female patients, with a median age of 46 (range, 21-74). Of
      these, nine were primarily refractory to daunorubicin and ara-C; 17 had one prior
      complete remission (CR), five had two prior CR, and one had three prior CR.
      Thirteen patients were entered at the first dose level, 11 were entered at the
      second, and eight at the third. All but one patient, whose death occurred within
      the first 2 days of treatment, are evaluable for toxicity. There were five CR
      (four at the first and one at the second dose level) and six partial remissions
      (PR) (three at the first dose level and three at the second). Unmaintained
      responses lasted 6-33 weeks. Median survival for all patients was 12.6 weeks.
      Anti-leukemic effects with severe marrow hypoplasia were observed in all
      patients; severe nausea and vomiting were seen in four. Severe mucositis, often
      indistinguishable from superimposed candidiasis, occurred in 40% of all patients;
      it was associated with dose-limiting esophagitis (three of seven evaluable
      patients) at the highest etoposide dose. Hepatic and renal dysfunction was severe
      in three patients; no treatment-related severe pulmonary or cardiac toxicity was
      observed. Posttreatment infectious complications were severe in 11 patients. In
      three cases, they were fatal--an incidence not dissimilar from that of other
      reinduction regimens in heavily pretreated patients. The regimen appears to be
      active; the combination of mitoxantrone, 12 mg/m2 daily for 3 days, with
      etoposide, 150 mg/m2/day for 5 days, by constant intravenous infusion is now
      being explored by the CALGB in a randomized phase II study against mitoxantrone
      plus diazoquinone and diazoquinone plus etoposide.

PMID- 2239807
TI  - Hypercalcemia and malignant melanoma.
AB  - Hypercalcemia is a rare complication associated with malignant melanoma. Three
      recent cases of patients with malignant melanoma and hypercalcemia are described.

PMID- 2239809
TI  - Leptomeningeal carcinomatosis.

PMID- 2239808
TI  - Spontaneous pneumomediastinum in esophageal carcinoma.
AB  - Although fistulae and hypercalcemia are rare at the time of diagnosis of
      esophageal carcinoma, they are not uncommon terminal events. Most fistulae
      communicate with the respiratory tract. Uncommon sites of fistulae due to
      esophageal carcinoma include extension to the aorta, pleura, pericardium, and
      mediastinum. We report a patient with a spontaneous pneumomediastinum discovered
      during radiologic staging of esophageal carcinoma. The symptoms were dysphagia,
      weight loss, and pneumonia. The patient had hypercalcemia refractory to
      conventional measures, another adverse prognostic factor. Cisplatin 100 mg/m2 was
      tolerated without acute toxicity and lowered the serum calcium to normal.
      However, the patient died due to respiratory failure 2 days after cisplatin
      therapy. To our knowledge, this is the first report of a spontaneous
      pneumomediastinum at presentation of an esophageal carcinoma. The course of our
      patient and a review of the literature suggest that fistulae and/or hypercalcemia
      are medical emergencies and are often fatal in esophageal carcinoma.

PMID- 2239810
TI  - Yeuhchukene--an indole derivative interacting with guinea pig reproduction.
AB  - Natural yuehchukene in doses of 10 mg/kg/day induced a 40% reduction of
      pregnancies in the guinea pig as compared with controls (p less than 0.05).
      Yuehchukene also caused a reduction in litter size which, however, was not
      significant indicating limited toxicity of the drug. An inhibition of ovum
      fertilization and/or implantation is suggested as the mechanism of action.

PMID- 2239811
TI  - Protective effect of danshen during myocardial ischemia and reperfusion: an
      isolated rat heart study.
AB  - The effect of Danshen (Radix salviae miltiorrhizae) on mechanical activity and
      coronary flow rate of isolated rat hearts was examined to assess the ability of
      Danshen to protect the myocardium against the effects of ischemia and
      reperfusion. After 20 min of control perfusion, in the presence or absence of
      Danshen, the hearts were made totally ischemic for 30 min and then reperfused for
      30 min. Danshen had a negative inotropic effect and caused an increase of
      coronary flow rate. During post-ischemic reperfusion recovery of left ventricular
      developed pressure in the Danshen-treated hearts was significantly better and
      contracture was significantly less than in the untreated hearts. The results
      indicate that Danshen protects the heart against some of the deleterious effects
      of ischemia and reperfusion.

PMID- 2239812
TI  - Long-term reno-cardiovascular effects of orally administered aconiti tuber in
      humans.
AB  - The reno-cardiovascular effects of Aconiti Tuber were studied. In a controlled,
      double-blind, and randomized clinical trial, it was found that in 9 months,
      Aconiti Tuber, after preparation (120 degrees C, 40 min), (1) had no apparent
      adverse effects, (2) showed positive inotropic, positive chronotropic, and
      vasodilator effects, (3) increased renal blood flow, and glomerular filtration
      rate, Na+/Cl-/K+ excretions. The renal function test results could be interpreted
      as secondary to hemodynamic changes. We conclude that specially prepared Aconiti
      Tuber may be a promising cardiotonic agent.

PMID- 2239813
TI  - Medicinal plants used for the treatment of hepatitis in Taiwan.
AB  - In an extensive ethnobotanical survey of the folk medicines of Taiwan, 69 kinds
      of crude drugs and 107 species of medicinal plants were found to be used for
      hepatitis treatments. The present paper is to update a list of medicinal plants
      used in the treatment of hepatitis and evaluate their liver protection by
      ethnopharmacological and pathological studies. Results show that some of these
      drugs have prominent therapeutic effects. Further investigation regarding the
      anti-hepatotoxic principles will be made.

PMID- 2239814
TI  - Effects of sairei-to on the relapse of steroid-dependent nephrotic syndrome.
AB  - Sairei-To (Chai-Ling-Tang) was administered to four patients with steroid
      dependent relapsing nephrotic syndrome. It was associated with prednisolone and
      immunosuppressive agents. Histological diagnosis was minimal change in three
      patients and mild focal glomerulonephritis in one patient. After the start of
      Sairei-To administration the relapse was markedly suppressed in three patients
      but not at all in the other. Although we could consider Sairei-To effective for
      steroid-dependent nephrotic syndrome in the present study, a larger study is
      necessary to confirm its efficacy.

PMID- 2239815
TI  - Effects of a medicinal herbal liqueur, "yomeishu", on post-operative
      gynecological patients.
AB  - We administered 20 ml of Yomeishu (YMS) twice a day before meals for 12 weeks to
      50 post-operative patients in gynecology and then inquired into their subjective
      20 symptoms (sense of fatigue, insomnia, headache and heavy headedness, appetite,
      stomach-ache, abdominal inflation, vertigo, lumbago, etc.) The YMS group showed a
      significant improvement on 14 items compared with the control group. On the
      whole, a great improvement was observed in the YMS group with serious subjective
      symptoms as well, and there were significant differences for general condition,
      sense of fatigue, and coldness in extremities.

PMID- 2239816
TI  - Radioprotective effect of Ganoderma lucidum (Leyss. ex. Fr.) Karst after X-ray
      irradiation in mice.
AB  - Six to seven week old male mice of ICR strain were exposed to 500 or 650 cGy of X
      ray during experiments to determine if Ganoderma lucidum could be a factor in
      modification of radiation damage. Continuous intraperitoneal injection of the
      extract from Ganoderma lucidum before or after irradiation of 500 and 650 cGy of
      X-ray was found to improve the 30-day survival fractions of ICR mice, but wasn't
      significant by statistical analysis. The administration also enhanced the
      recoveries of the body weights and increased the recovery of hemograms of
      irradiated mice from radiation damage by injecting before or after radiation
      exposure, especially for the treatment of 500 cGy irradiation. The 10-day CFUs
      was significantly higher for Ganoderma lucidum treated groups than for untreated
      groups. However, the differences of radioprotective effect between the X-ray
      irradiated groups with Ganoderma lucidum pretreated and post-treated were not
      significant (p greater than 0.05).

PMID- 2239817
TI  - Effect of khatamines and their enantiomers on plasma triiodothyronine and
      thyroxine levels in normal Wistar rats.
AB  - The effect of cathinone and N-formylnorephedrine, two psychoactive amines of khat
      (Catha edulis Forsk.) and their enantiomers have been studied on plasma levels of
      triiodothyronine (T3) and thyroxine (T4) in male Wistar rats. The rats were
      injected with 5, 10 and 30 mg/kg, body weight of four khatamines and the blood
      samples were collected 2 h after their administration. In the separate set of
      experiments the effect of these khatamines at 1, 2 and 4 h after their
      administration was also examined. All the khatamines failed to produce a
      significant dose dependent increase in T3 and T4 levels in the dose of 5 mg/kg.
      However, all of these compounds produced a significant dose dependent increase in
      T3 and T4 levels at higher doses but only T4 levels were increased following the
      dose of 10 mg/kg. Our studies on the effect of khatamines in T3 and T4 levels at
      various times showed a significant increase in T4 levels in all the four groups
      treated with various khatamines and the peak effect was observed at 2 h in case
      of (-)- and (+)-cathinone and 4 h in case of (-) and (+)N-formylnorephedrine.
      This study suggests that the symptoms observed in khat chewers including
      hyperthermia, anorexia, and metabolic changes may to some extent be attributed to
      the thyroid stimulating effect of khatamines. However, further studies are needed
      to establish the mechanism of release of thyroid hormones by these compounds and
      their involvement in the pharmacological effects.

PMID- 2239818
TI  - Effects of single and multiple moxibustions on activity of platelet function,
      blood coagulation and fibrinolysis in mice.
AB  - The effects of single and multiple moxibustions on platelet function, blood
      coagulation and fibrinolytic activity in ddY mice were studied. The increase in
      platelet aggregation and ATP-release after a single moxibustion was dependent on
      moxa weight and the kind of platelet stimulus. Blood coagulative activity tended
      to increase in the early phase after a single moxibustion. However, multiple
      moxibustions maintained the homeostasis on blood coagulation and fibrinolytic
      activity. This investigation suggests that the effects of moxibustion on platelet
      functions and coagulative and fibrinolytic activities cause an enhancement of the
      phagocytic activity in the host defense mechanism.

PMID- 2239819
TI  - Follicular neoplasms of the thyroid in men older than 50 years of age. A DNA flow
      cytometric study.
AB  - The clinical behavior of follicular neoplasms of the thyroid in elderly men can
      be difficult to predict on histologic grounds alone. To assess the usefulness of
      DNA flow cytometry in predicting the metastatic potential of these tumors, the
      authors studied 44 primary and metastatic follicular neoplasms of the thyroid by
      DNA flow cytometry of paraffin-embedded tissue. The neoplasms were obtained from
      44 men ranging in age from 50 to 79 years (mean, 60). There were 29 follicular
      adenomas, 11 primary follicular carcinomas (neoplasms with capsular and/or
      vascular invasion), and 4 metastatic follicular carcinomas. Follow-up information
      was available on 40 of the 44 patients. The mean follow-up was 114 months. Twenty
      five of the 29 follicular adenomas had a diploid DNA content, 2 (7%) were
      tetraploid, and the DNA histograms on 2 were not interpretable. All patients with
      follicular adenomas had no evidence of disease (NED) at last follow-up. Eight of
      the 11 primary follicular carcinomas were diploid. Six of these patients had NED,
      one died with carcinoma at 82 months, and no follow-up was available on one.
      Three (27%) of the primary follicular carcinomas were aneuploid or tetraploid.
      Two of these patients had NED, and the third died with carcinoma 84 months after
      diagnosis. Two of the four metastatic follicular carcinomas were diploid and two
      (50%) were aneuploid or tetraploid. One of the two patients with diploid
      metastatic follicular carcinomas died with carcinoma, as did one of the two
      patients with aneuploid metastatic follicular carcinomas. These results suggest
      the following: (1) follicular carcinomas are more likely to be aneuploid or
      tetraploid than are follicular adenomas; (2) follicular neoplasms without
      capsular or vascular invasion may include a small number of aneuploid or
      tetraploid tumors; and (3) DNA ploidy does not add to the prognostic value of
      histologic studies alone.

PMID- 2239821
TI  - Improved flow cytometric determination of proliferative activity (S-phase
      fraction) from paraffin-embedded tissue.
AB  - Recent studies suggest that proliferative activity (S-phase fraction [SPF]) may
      have greater prognostic significance than total nuclear DNA content; however,
      relatively few studies have examined SPF from paraffin-embedded tissue because of
      significant contamination of histograms with debris. In this study, cell cycle
      analysis was performed on 124 matched tissue specimens. Fresh tissue was divided
      into two equal portions; one portion was frozen, whereas the other portion was
      processed and embedded in paraffin. S-phase could be determined for both frozen
      and paraffin-embedded tissue in 81 cases. Correlation between SPF from frozen and
      paraffin-embedded tissue was demonstrated (r = 0.80) when debris was subtracted
      from histograms with the use of two new subtraction algorithms referred to as
      multicut and singlecut. Unlike other debris-subtraction algorithms, the quantity
      and distribution of debris calculated by these algorithms are dependent on the
      magnitude and position of histogram peaks. A lesser degree of correlation was
      demonstrated with the use of a standard exponential debris subtraction algorithm
      (r = 0.67). Correlation of SPF for aneuploid cases was greater when SPF was
      calculated as a percentage of the aneuploid cell population rather than as a
      percentage of the entire cell population. This was attributed to the observation
      that the proportion of aneuploid cells from paraffin-embedded tissue was less
      than that from frozen tissue. The results of this study indicate that SPF can be
      calculated from paraffin-embedded tissue with values comparable to those obtained
      from frozen tissue. The ability to calculate SPF reliably from paraffin-embedded
      tissue should allow additional evaluation of this parameter as a prognostic
      indicator.

PMID- 2239820
TI  - Inflammatory myofibroblastic tumor (plasma cell granuloma). Clinicopathologic
      study of 20 cases with immunohistochemical and ultrastructural observations.
AB  - Twenty cases of inflammatory myofibroblastic tumor (IMT) were studied; 19
      involved the lung and 1 the esophagus only. The patients' ages ranged from 3 to
      72 years. There were 9 males and 11 females. Involvement of a bronchus was seen
      in one case and of mediastinal structures in four. Chest pain and dyspnea were
      common symptoms; eight patients were asymptomatic. Seven patients underwent
      lobectomy, 12 local excision, and 1 biopsy alone. The lesions were
      nonencapsulated and ranged from 1.2 to 15 cm. Various proportions of plasma
      cells, histiocytes, and spindle cells were observed; the latter corresponded
      ultrastructurally to fibroblasts and myofibroblasts, were immunoreactive for
      vimentin and actin and focally for desmin, and were negative for epithelial
      markers. Plasma cells were polyclonal for light chains. One patient had two
      recurrences, and in one case a large pleural IMT was found eight years after the
      excision of a similar lesion in the lung. All patients with follow-up (ten) were
      well as long as ten years after the diagnosis (average, 3.7 years).

PMID- 2239822
TI  - Immunophenotypic aberrancy in adult acute lymphoblastic leukemia.
AB  - Some recent reports indicate a high frequency of immunophenotypic aberrancy in
      acute lymphoblastic leukemia (ALL). To investigate this issue with regard to
      adult ALL, the authors reviewed the immunophenotyping data from 39 cases analyzed
      in their clinical laboratory. Flow cytometric analysis of peripheral blood and/or
      bone marrow was performed with the use of a panel of 21 B-cell, T-cell, and
      myeloid monoclonal antibodies (MoAbs). The surface antigen profiles of the
      leukemic cells were compared with those of normal bone marrow and thymic
      counterparts, as defined by current models. Twenty-six cases were B-precursor
      ALL, 8 were T-ALL, and 3 were B-ALL (Burkitt's leukemia). Only two cases
      coexpressed lymphoid and myeloid antigens. In contrast, intralineage aberrancy
      was quite common. Immunophenotypes from 13 of 26 B-precursor ALL cases deviated
      from normal B-lineage marrow cells as defined by a recent classification. The T
      ALL cases were also immunophenotypically heterogeneous. This high incidence of
      aberrant antigen expression in adult ALL suggests that leukemogenesis also
      involves aberrant differentiation rather than purely a process of maturational
      arrest.

PMID- 2239823
TI  - Comparison of DNA and karyotype aneuploidy in malignant lymphomas.
AB  - Tumors from 48 patients with non-Hodgkin's lymphoma were examined for flow
      cytometric DNA ploidy and chromosome constitution to determine the degree of
      concordance of these two methods. Histologically, there were 24 low-grade, 19
      intermediate, and 5 high-grade lymphomas. Flow cytometry revealed an aneuploid
      cell population in 19% of the cases. The mean DNA index of the aneuploid tumors
      was 1.58 +/- 0.71. The frequency of DNA aneuploidy was only slightly higher (23%)
      in intermediate than in low-grade lymphomas (17%). None of the five high-grade
      lymphomas showed DNA aneuploidy. The chromosome study was successful in 81% of
      cases (39 of 48), and clonal chromosome abnormalities were observed in 92% of
      these (36 of 39). In most of the chromosomally abnormal clones the chromosome
      number was in the diploid range. Most tumors with pseudodiploid (46 chromosomes),
      hypodiploid (45-44 chromosomes), or hyperdiploid (47-49 chromosomes) clones were
      DNA diploid by flow cytometry. On the other hand, all specimens with a chromosome
      number exceeding 50 were DNA aneuploid by flow cytometry. Therefore, flow
      cytometric DNA analysis appears to be a rather coarse method that will detect
      aneuploidy only when there is a major increase in chromosome material.

PMID- 2239824
TI  - Antinuclear matrix antibody. Hidden antinuclear antibody in patients with
      connective tissue diseases.
AB  - A total of 435 serum samples from patients with different rheumatic diseases were
      screened for the presence of autoantibody to nuclear matrix components by
      indirect immunofluorescence on 0.1 mol/L HCl extracted HEp-2 cell and WiL2 cell
      substrates. A total of 28 specimens were positive in this assay. Eighteen of them
      were from patients with systemic lupus erythematosus (18 of 250), 2 from patients
      with rheumatoid arthritis (2 of 115), and 8 from patients with mixed connective
      tissue disease (8 of 10). Antigenic material for this antibody is resistant to
      DNase, partially sensitive to RNase, and sensitive to trypsin. This indicates
      that the antigen is composed of protein and possibly RNA. In immunoblot analysis,
      sera positive for this antibody in indirect immunofluorescence assay recognized
      different peptides. This suggests that protein peptides are the major antigenic
      material.

PMID- 2239825
TI  - Measuring platelet aggregation with microplate reader. A new technical approach
      to platelet aggregation studies.
AB  - Platelet aggregation measurements were done with the use of a commercially
      available microtiter plate reader with specific modification of the mode of
      agitation of the samples. Satisfactory aggregation curves were obtained with use
      of an external horizontal agitator, with an amplitude of 1.3 mm and minimum
      frequency of 1,360 cycles/minute. With the use of the 96 available wells in the
      microtiter plates, all test and control platelet samples, with replicates, were
      observed simultaneously and the output data obtained within 10-15 minutes. The
      technique was validated by demonstrating the similarity of dose-response curves,
      obtained with a standard aggregometer and with the microtiter technique, of
      platelets stimulated by adenosine diphosphate, thrombin, and arachidonic acid.

PMID- 2239826
TI  - The effects of radioisotopes used in nuclear medicine on diagnostic
      radioimmunoassay testing. Is there any significant interference?
AB  - The administration of radioisotopes for diagnostic nuclear medicine scans and
      therapeutic procedures is quite prevalent today. A period of interference with
      the counting of a radioimmunoassay [RIA] test may occur with the serum of a
      patient receiving an in vivo radionuclide that decays by gamma emission. Because
      the logistics of precounting all specimens may be cumbersome and prohibitive, it
      is important to determine the degree of this interference. In this study, the
      authors evaluate the potential interference of the most commonly used
      radioisotopes with RIA studies. For two months (March and August 1988) 10,650
      patient serum specimens were counted for significant background gamma radiation
      before RIA testing. Forty-three patients, on whom 105 RIA tests were performed,
      were identified as having preassay gamma radiation in their serum. With the use
      of selective energy windows for each different interfering radionuclide,
      proportional determinations were made as to the amount of interfering gamma
      radiation spilling into the iodine 125 test marker window. It was shown that
      initial whole serum pretest gamma counts as high as 111,000 counts/minute did not
      significantly affect the results of the RIA. Because of the meticulous washing
      and decanting procedures required in modern RIA and the monoclonal nature of most
      antibodies used currently, it appears the degree of nonspecific binding of this
      potentially interfering radiation is minuscule. The energy level of cobalt 57,
      however, and many of the other commonly used radioisotopes, overlaps so closely
      that it is difficult to window for this interference. It is possible, therefore,
      that this distinction cannot be made and folate and vitamin B12 test systems
      using cobalt 57 markers may have to be routinely prescreened. The authors
      conclude that the requirement for prescreening of all RIA test samples for
      interfering gamma radiation is unnecessary (1987 CAP Commission on Laboratory
      Accreditation Inspection Checklist, Section VII, Question 07.0290).

PMID- 2239827
TI  - Microstaging of squamous cell carcinomas.
AB  - The clinical classification of squamous cell carcinoma, which was established
      primarily by the International Union Against Cancer (UICC), does not permit
      optimal estimation of expected metastasis. The authors' results indicate that
      metastasis can be more accurately estimated on the basis of invasion depth,
      histopathologic grading, and especially tumor thickness. One essential advantage
      of these criteria is that they can be established by a histopathologist. It is
      interesting to note that in the authors' collective no carcinoma less than 2 mm
      thick metastasized, that is, a relatively high percentage of carcinomas (48%) can
      be graded as no-risk carcinomas. The risk of metastasis for undifferentiated
      carcinomas greater than 6 mm thick that have infiltrated the musculature, the
      perichondrium, or the periosteum, however, is quite high. Tumors between 2 and 6
      mm thick with moderate differentiation and a depth of invasion that does not
      extend beyond the subcutis can be classified as low-risk carcinomas.

PMID- 2239828
TI  - Histiocytosis X. S-100 protein, peanut agglutinin, and transmission electron
      microscopy study.
AB  - Twenty-seven cases of histiocytosis X (HX) for which paraffin blocks were
      available were studied with the use of S-100 protein immunohistochemistry, peanut
      agglutinin affinity histochemistry, and transmission electron microscopy. The
      results show that these techniques did enable identification of Langerhans'-type
      histiocytes in 88.5%, 75%, and 47.4% of cases, respectively. All techniques were
      proved to be of some diagnostic value for HX, but none was able to confirm the
      diagnosis in all instances and none could foretell the prognosis of the patients.
      This study shows that besides the Langerhans' cells, the indeterminate cells of
      the skin and the interdigitating dendritic reticulum cells of the lymph node may
      also be involved in this process. Moreover, some multinucleate giant cells and
      foamy cells may be derived from Langerhans' and related cells.

PMID- 2239830
TI  - On the microstaging of skin cancer.

PMID- 2239829
TI  - Primary malignant melanoma of the lower respiratory tract. Report of a case and
      literature review.
AB  - The authors report a case of primary bronchial malignant melanoma, occurring in a
      34-year-old woman presenting with persistent cough. At bronchoscopic examination,
      a polypoid mass was found to occlude the left mainstem bronchus. Biopsies showed
      a malignant epithelioid tumor resembling an atypical carcinoid. Histochemistry,
      electron microscopic study, and immunohistochemistry confirmed the diagnosis of
      melanoma. Physical examination and additional clinical history to exclude other
      possible primary sites were negative. The patient underwent thoracotomy with left
      pneumonectomy. Nineteen months after resection she was found to have a
      histologically similar tumor involving her left adrenal gland. Review of the
      literature shows that melanoma of the lower respiratory tract has been reported
      only in adults and has a tendency to present as a central polypoid growth that
      may be responsive to surgical resection.

PMID- 2239831
TI  - Estimating the clinical usefulness of diagnostic tests.

PMID- 2239832
TI  - Detection and monitoring of Bence Jones proteinuria.

PMID- 2239833
TI  - Extraovarian transitional cell carcinoma of female genital tract.

PMID- 2239834
TI  - The Albert H. Ketcham Memorial Award.

PMID- 2239835
TI  - The James E. Brophy AAO Distinguished Service Awards.

PMID- 2239836
TI  - Auxiliary springs in continuous arch treatment: Part 1. An analytical study
      employing the finite-element method.
AB  - This report describes the results of a finite-element analysis with ANSYS
      (Version 4.3) from Swanson Analysis Systems and 1 mm-long, 2-D elastic beam
      elements to modify and refine the designs of maxillary and mandibular springs for
      space-closure management. This system permitted static analysis by means of
      modern software systems instead of expensive and cumbersome mechanical bench
      studies. Our examination of anterior and posterior reactions led to what we
      believe are optimal designs with clinically manageable moment/force ratios and
      new canine brackets that accommodate these springs within the framework of
      conventional and straight-wire appliance systems. Three degrees of freedom were
      used at each node for translations in the x and y directions and a rotation about
      the z axis, producing 182 elements with 183 nodes for the mandibular model and
      146 elements with 147 nodes for the maxillary model. Elgiloy retraction spring
      models (0.1650 inch x 0.02150 inch) in the edgewise mode were developed so that
      the effects of three different preactivation bends could be refined by computer
      analysis. Sixty-four analyses were performed for each spring, with each of three
      angle bends (theta 1, theta 2, and theta 3) varied from 0 degrees to 45 degrees
      in 15 degrees increments. The employment of this computer method promises to
      simplify the design and development of complex interacting orthodontic systems.
      Clinical cases are presented in Part 2 of this series, which illustrates the
      application of auxiliary springs.

PMID- 2239838
TI  - The effect of hydrogen ion concentration on the force-degradation rate of
      orthodontic polyurethane chain elastics.
AB  - The effect of pH on the force-degradation rates of seven commercial orthodontic
      polyurethane chain elastics was evaluated in an in vitro study. The pH values of
      4.95 and 7.26 were selected for testing because they represent values close to
      the reported extremes of plaque and saliva pH. Seven test elastic products were
      extended to (1) equal distances and (2) equal initial force levels, and the force
      degradation rates were recorded over 4 weeks. All the test products yielded a
      significantly greater force-decay rate in the basic (pH 7.26) solution than in
      the acidic (pH 4.95) solution over 4 weeks. A hypothesis is presented that the
      decay rate of orthodontic polyurethane chain elastics is inversely proportional
      to the oral pH, with a corollary that basic pH levels are most hostile to
      polyurethane chain elastics.

PMID- 2239837
TI  - Frictional resistance of ceramic and stainless steel orthodontic brackets.
AB  - Frictional resistance of orthodontic appliances is recognized by most clinicians
      to be detrimental to tooth movement. The purpose of this study was to compare
      planar, static frictional forces among stainless steel and ceramic brackets. Both
      nitinol and stainless steel rectangular arch wires were passed freely through the
      slots of a pair of brackets from each type. Tests were carried out in air and in
      artificial saliva. A 300-gm load was suspended from the arch wire to simulate the
      normal force, and an incremental horizontal force was applied until movement of
      the arch wire was initiated. Under all conditions, the stainless steel brackets
      had lower coefficients of friction than the ceramic brackets. The stainless steel
      wire generated less friction than nitinol, and friction increased in the presence
      of artificial saliva in comparison with air alone. These results show that, under
      experimental conditions, ceramic brackets, nitinol arch wires, and saliva all
      increase static frictional resistance.

PMID- 2239839
TI  - Sterilization of orthodontic instruments and bands in cassettes.
AB  - The purpose of this study was to determine whether orthodontic instruments and
      bands contaminated with blood or saliva and bacterial spores can be heat
      sterilized while contained in OMS-ASAPsys instrument and band cassettes. Hinged
      and nonhinged instruments and bands were contaminated and dried, placed in the
      cassettes, ultrasonically cleaned, rinsed, and dried. The cassettes were wrapped
      and then processed through standard steam, chemical vapor, or dry-heat
      sterilizing cycles. Each instrument and band was then cultured for the presence
      of live spores. The results showed that the residual spores on the instruments
      and bands after ultrasonic cleaning and rinsing had indeed been killed in all
      cases. The three types of sterilization were equally effective. The results
      indicate that contaminated orthodontic instruments and bands can be sterilized
      within OMS-ASAPsys cassettes.

PMID- 2239840
TI  - Effects of etchant concentration and duration on the retention of orthodontic
      brackets: an in vivo study.
AB  - Etching of enamel before the bonding of orthodontic attachments is usually done
      with a solution of 37% H3PO4 for 60 seconds. The purpose of this study was to
      evaluate the effects of etchant concentration and duration on the clinical
      retention of bonded orthodontic attachments. Two randomly selected groups of
      orthodontic patients participated in the study. In both groups, teeth in
      contralateral quadrants, excluding the molar teeth, were bonded. In the first
      group, 158 teeth were etched with a solution of 37% H3PO4 for 60 seconds, and 155
      teeth were etched with 37% H3PO4 for 15 seconds. In the second group, 196 teeth
      were etched with 37% H3PO4 and 196 teeth with 15% H3PO4, both for 60 seconds.
      Conventional edgewise mechanotherapy was used in both groups of patients. After
      24 months of treatment, in the first group, 8 brackets were dislodged when etched
      with 37% H3PO4 for 60 seconds and 9 when etched with 37% H3PO4 for 15 seconds. In
      the second group, 6 brackets were dislodged when etched with 37% H3PO4 for 60
      seconds and 13 were dislodged when etched with 15% H3PO4 for 60 seconds. Reducing
      the etching time of 37% H3PO4 from 60 seconds to 15 seconds or reducing the acid
      concentration from 37% to 15% H3PO4 applied for 60 seconds had no significantly
      different effect on the retention of bonded orthodontic attachments. The results
      suggest that the reduction of etchant concentration and the duration of etching
      in orthodontic bonding should be considered.

PMID- 2239842
TI  - A comparison of results of second molar and first premolar extraction treatment.
AB  - The purpose of this study was to examine treatment results of maxillary and
      mandibular second molar extraction cases and compare them with treatment results
      of maxillary and mandibular first-premolar extraction cases. Records of 22
      maxillary and mandibular second-molar extraction cases and 22 maxillary and
      mandibular first-premolar extraction cases were evaluated. For each case,
      pretreatment and posttreatment lateral cephalograms were traced and several
      cephalometric parameters were compared. From the pretreatment and posttreatment
      panoramic radiographs, angulations of the maxillary and mandibular third molars
      were evaluated. Average treatment time, in months, was recorded for both groups.
      The data obtained from each group were analyzed for statistical difference. The
      results showed that the two groups had fewer differences than indicated by
      advocates of second-molar extractions. Analysis of the cephalometric data
      demonstrated only a few statistical differences between the groups. The maxillary
      and mandibular incisors in the premolar group were retracted a significantly
      greater amount than in the second-molar group. The maxillary and mandibular first
      molars were protracted a greater amount in the premolar group than in the second
      molar group. The lower lips in the premolar group were retracted a greater amount
      than in the second-molar group. The resulting facial profile after extraction of
      second-molars appears to be no different from that obtained after extraction of
      first premolars. The pantographic evaluation of the changes in third-molar
      angulation were not statistically different. In both groups, the maxillary third
      molars showed an improvement in third-molar angulation, while the mandibular
      third-molars showed an undesirable increase in angulation. The average treatment
      time for both groups was not statistically different.

PMID- 2239841
TI  - Influence of vertical growth pattern on faciolingual inclinations and treatment
      mechanics.
AB  - Control of faciolingual tooth inclinations is obtained by using rectangular wire
      with third-order bends and standard edgewise brackets or by using a straight wire
      in a preadjusted appliance system. Ideal faciolingual inclinations have been
      determined previously by measuring facial surface contours relative to coronal
      long axes. This study evaluates faciolingual inclinations based on occlusal table
      inclinations relative to occlusal planes. The samples compared include untreated
      ideal occlusions and malocclusions in three different vertical skeletal growth
      patterns. Faciolingual inclinations of first molars and central incisors were
      measured relative to the occlusal plane and to selected cephalometric angular
      measurements. Statistical comparisons between groups revealed significant
      differences in the inclinations of the upper incisor relative to the occlusal
      plane (U1-OP) and the inclination of the occlusal plane relative to sella nasion
      (OP-SN). No statistically significant intergroup differences were found in the
      inclination of the lower incisor relative to the occlusal plane (L1-OP) or in the
      faciolingual inclinations of the maxillary and mandibular first molars. On the
      basis of the large intergroup differences in the mean angle between the occlusal
      plane and sella nasion (OP-SN), the use of straight-wire appliance therapy is
      discussed in terms of the potential for creating differential moments. Because
      differential moments may facilitate or hinder treatment goals, the practitioner
      must know the biomechanical sequelae resulting from occlusal plane-sella nasion
      variations, which differ from normative values when preadjusted brackets are
      used.

PMID- 2239843
TI  - The stability of the arch-expansion effects of Frankel appliance therapy.
AB  - To assess the long-term stability of the arch expansion effects of the functional
      regulator, mandibular dental casts were evaluated for treatment and postretention
      changes in intercanine width, width between first premolars, width between second
      premolars, intermolar width, incisor irregularity, and arch length. This study
      was comprised of 11 cases that were treated with the Frankel appliance (mean = 27
      mo.) and were and average of 4 years and 4 months out of active treatment.
      Results showed overall stability to be good, with some variability present in
      individual responses. Intercanine width, width of first premolars, width of
      second premolars, and intermolar width all demonstrated maintenance of treatment
      increases. Correction of incisor irregularity displayed better stability than has
      been reported in other stability studies. Arch length decreased with treatment
      and continued to decrease during the postretention period, although to a lesser
      extent than has been previously reported. The results of this study support the
      statements of Frankel concerning the stability of this type of arch expansion.

PMID- 2239844
TI  - Increase in vertical dimension by interpositional bone grafts and subsequent
      craniofacial growth in adolescent monkeys.
AB  - The purpose of this study was to investigate the relationship between
      craniofacial growth and total maxillary osteotomy in adolescent Macaca
      fascicularis monkeys. The monkeys' facial height was increased with the help of
      interpositional bone grafts. Four monkeys underwent surgical procedures, and five
      served as controls. The changes in growth after surgery were then assessed with
      the help of conventional cephalometry and osseous implants. Lateral cephalometric
      radiographs of all monkeys were taken before and immediately after implant
      placement, immediately after surgery, and every 4 weeks thereafter for 1 year.
      Analysis of the cephalometric head films revealed that the increases in facial
      height assisted by interpositional grafts were not stable. Postsurgical
      observations showed a relapse in total facial height.

PMID- 2239845
TI  - Humoral immune response to active root resorption with a murine model.
AB  - A depression in autoantibody titers to tooth root antigens has been shown to
      coincide with active root resorption in the dog. Since a murine model would
      facilitate immunologic studies of root resorption because of the availability of
      syngeneic and immunodeficient strains, the objectives of this study were to
      develop a quantitative mouse model for root resorption and to determine if a
      similar drop in tooth root autoantibodies coincides with active root resorption
      in this species. Uniform areas of necrosis were created in the periodontal
      ligaments of lower incisors of 36 male Swiss albino mice by inserting a cryoprobe
      through a skin incision (-80 degrees C; 5 minutes). Contralateral incisors served
      as controls. At 0, 3, 5, 7, 10, 14, and 21 days; six mice were killed, and blood
      and incisors were collected. Relative surface areas of root resorption were
      quantified with micrographs taken at a standardized position, tilt, and
      magnification with a scanning electron microscope. Serum autoantibody titers were
      determined with an enzyme-linked immune sorbent assay with antigen prepared from
      a 5 mol/L guanidine-HCl-EDTA (pH 5.0) extract of incisor roots that were
      harvested from syngeneic mice. ANOVA and the paired Student t test were used to
      compare data at the various time points. No root resorption was evident on
      control teeth. Localized lesions on treated teeth were found to be of significant
      size between 7 and 14 days (p less than 0.05), but most of these erupted into the
      mouth by 21 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239846
TI  - Loss of root length and crestal bone height before and during treatment in
      adolescent and adult orthodontic patients.
AB  - It is broadly documented that orthodontic tooth movement enhances the risk of
      apical root resorption and loss of alveolar crestal bone height, but virtually
      all studies have focused on the conventional adolescent patient. In this study,
      samples from adolescent and adult patients were matched for sex, malocclusion,
      and treatment regimen. In-treatment changes in root length were the same for both
      groups, whereas loss of crestal bone height was somewhat greater in adults. Major
      differences, however, were found at the start of treatment: Adults (mean = 28
      years) had significantly shorter roots and greater alveolar recession than the
      young teenagers (mean = 12 years). Consequently, treatment per se does not place
      adults at greater risk; it is the involvement extant at the start of
      mechanotherapy that merits careful evaluation.

PMID- 2239847
TI  - An American Board of Orthodontics case report. A nonsurgical and nonextraction
      approach in the treatment of a skeletal and dental Class III malocclusion in a
      growing patient.
AB  - This case report is presented following the specifications of the American Board
      of Orthodontics. The patient had a true maxillary retrognathism, a mandibular
      prognathism, and a lower anterior height deficiency. She was treated with a fixed
      orthopedic appliance, fixed orthodontic appliances, and intermaxillary elastics.
      [This case was presented to the American Board of Orthodontics in partial
      fulfillment of the requirement for the certification process conducted by the
      Board.

PMID- 2239848
TI  - Legal aspects of orthodontic practice: risk management concepts. Developing
      protocols for adult patients.

PMID- 2239849
TI  - Education concerning whiplash shaken infant syndrome: an unmet need.

PMID- 2239850
TI  - Neonatology blues.

PMID- 2239851
TI  - Blue sclerae and iron deficiency.

PMID- 2239852
TI  - Education concerning Whiplash Shaken Infant Syndrome: an unmet need.

PMID- 2239853
TI  - Human immunodeficiency virus infection and pregnancy outcome in intravenous drug
      users.

PMID- 2239854
TI  - Follow-up of calcium and phosphorus homeostasis in preterm infants who are not
      extremely ill.

PMID- 2239855
TI  - Transient changes in neuroimaging appearances of the brain following
      cardiopulmonary bypass.

PMID- 2239856
TI  - Racial, social, and environmental risks for childhood asthma.
AB  - Unlike a number of childhood problems, it is not clear that there are racial or
      socioeconomic disparities in the prevalence of childhood asthma. We analyzed data
      from the Child Health Supplement to the 1981 National health Interview Survey, a
      population-based survey with information concerning 15,416 children, to address
      the following questions: are there racial or socioeconomic differences in rates
      of childhood asthma; if yes, what is the contribution of social and environmental
      characteristics to the observed differences? In this sample, black children were
      more likely to have asthma than were white children (4.4% vs. 2.5%). Racial
      disparities in prevalence emerged early and at all childhood ages were due to
      higher black rates of onset between the ages of 1 and 3 years. Poverty status,
      maternal cigarette smoking, large family size, smaller size of home, low birth
      weight, and maternal age younger than 20 years at the child's birth were all
      associated with increased rates of childhood asthma. When available social and
      environmental characteristics were controlled for using multivariate analyses,
      the increased risk for asthma among black and poor children was reduced to
      statistical insignificance. We conclude that black and poor children in the
      United States do have higher rates of asthma, that social and environmental
      factors exert substantial influences on rates of asthma, and that much of the
      racial and economic disparity in prevalence can be accounted for by a variety of
      social and environmental characteristics.

PMID- 2239857
TI  - Bacteremia in an ambulatory setting. Improved outcome in children treated with
      antibiotics.
AB  - We undertook a study of 414 bacteremic patients (167 with Haemophilus influenzae
      and 247 with Streptococcus pneumoniae bacteremia) to evaluate their clinical
      presentation, laboratory and clinical results, and subsequent outcomes. Patients
      with H influenzae bacteremia were more likely to have soft-tissue foci, poorer
      clinical appearance at presentation, and be at higher risk for subsequent serious
      focal infections, persistent bacteremia, and subsequent hospital admissions than
      patients with S pneumoniae. Patients with H influenzae bacteremia had a 21.1-fold
      increase in risk of meningitis (95% confidence interval [CI] of 3.8 to 78.0)
      compared with those with S pneumoniae. The odds ratio for initial lumbar puncture
      was 5.25 (95% CI [1.1-23.6]). Ambulatory patients treated with antibiotics at
      presentation were less likely to develop new serious soft-tissue infections,
      persistent bacteremia, or to require subsequent hospital admissions than
      untreated patients. The effect of treatment was greater for patients with S
      pneumoniae than those with H influenzae. Careful follow-up and reevaluation of
      patients with presumptive bacteremia is essential because treated and untreated
      patients can still develop serious soft-tissue infections.

PMID- 2239859
TI  - Diagnostic guidelines for Kawasaki disease. American Heart Association Committee
      on Rheumatic Fever, Endocarditis, and Kawasaki Disease.

PMID- 2239858
TI  - Total and differential leukocyte counts in clinically well children. Information
      or misinformation?
AB  - To determine whether the total and differential leukocyte count is of value as a
      case-finding test, we applied the evaluation criteria developed by the US
      Preventive Services Task Force. The criteria comprise review of the current
      burden of suffering of the disease to be prevented, the attributes of the
      intervention to be used, and the quality of the evidence available. A literature
      search revealed no evidence in the form of data from patients, so a chart review
      of all complete blood cell counts ordered during a 1-year period by one group of
      pediatricians was undertaken. At least one value outside of published normal
      ranges was found on 74.7% of the tests performed on clinically well children. No
      unsuspected illness was discovered as a result of an abnormal total and
      differential leukocyte count.

PMID- 2239860
TI  - Childhood deaths from toy balloons.
AB  - We describe four children who died of suffocation by rubber balloons in Canada
      between 1983 and 1988. In the United States, at least 121 children have died in a
      similar manner in the 15 years between 1973 and 1988 according to a report by the
      US Consumer Product Safety Commission. Although the highest mortality occurred
      among infants, 30 (25%) of the 121 deaths occurred in children 6 years of age or
      older. Balloons account for 43% of the approximately 15 childhood deaths related
      to children's products that are documented each year by the Consumer Product
      Safety Commission. Toy rubber balloons are thus the leading cause of pediatric
      choking deaths from children's products. Preventive efforts should be directed
      toward a ban on this type of balloon and the development of safer alternatives.
      Meanwhile, public information campaigns should alert parents, physicians, and
      policymakers to the dangers of toy rubber balloons.

PMID- 2239861
TI  - Disproportionate septal hypertrophy associated with erythroblastosis fetalis.
AB  - We retrospectively reviewed clinical and echocardiographic data on 10 newborns
      with erythroblastosis fetalis who were admitted to our nurseries between 1984 and
      1988 and who required a double-volume exchange transfusion and neonatal intensive
      care. Echocardiograms were performed in the first 48 hours of life. In 5
      patients, disproportionate septal hypertrophy was demonstrated; 1 additional
      patient had biventricular hypertrophy with a thickened septum but not
      disproportionate septal hypertrophy. The mean septal: left ventricular free-wall
      ratio for the group (n = 10) was 1.37. No correlation was apparent between the
      occurrence of disproportionate septal hypertrophy and newborn glucose, bilirubin,
      or hematocrit values. When analyzed separately, the 4 patients who did not
      receive intrauterine blood transfusions had a ratio of 1.73 +/- 0.21 (mean +/-
      SEM); this was significantly greater than the ratio in the 6 patients who were
      transfused in utero (1.13 +/- 0.24). In patients who underwent transfusions,
      there was no correlation between the number of transfusions and the septal:left
      ventricular ratio. This study reports a significant but previously unrecognized
      cardiac hypertrophy with disproportionate septal hypertrophy in patients with
      erythroblastosis fetalis. Our data suggest a sparing effect of intrauterine fetal
      transfusions. The mechanism by which these transfusions may affect the
      hypertrophic development of the myocardium remains to be determined.

PMID- 2239862
TI  - Lead poisoning and thalassemia trait or iron deficiency. The value of the red
      blood cell distribution width.
AB  - The cause of microcytosis and anemia in lead poisoning was investigated using red
      blood cell distribution width as a screening parameter in 21 consecutive patients
      with lead poisoning and seven nonrandomly selected patients with iron deficiency
      and lead poisoning. Of the 21 consecutive patients, 11 had microcytosis as
      defined by a mean corpuscular volume of less than 72 fL, nine had thalassemia
      trait (alpha or beta), one had both alpha thalassemia trait and iron deficiency,
      and one had iron deficiency. The red blood cell distribution width was less than
      17.0 in those with thalassemia trait and greater than 17.0 in the iron-deficient
      subjects. Results of our study suggest that microcytosis in children with lead
      poisoning is due to coexistent iron deficiency or thalassemia trait. The red
      blood cell distribution width may be of value in the rapid assessment of the
      cause of microcytosis in children with lead poisoning.

PMID- 2239863
TI  - Pediatrician's knowledge and practices regarding parental use of alcohol.
AB  - Problems with alcohol are common in the United States but are too frequently
      ignored by physicians, particularly those working with children. We explored
      pediatricians' knowledge and practices regarding parental use of alcohol and
      compared these attributes with those of family practitioners. Child health care
      providers attending three continuing medical education courses in general
      pediatrics were surveyed using a closed-item questionnaire. One hundred ninety
      (69%) of the participants responded, including 90 pediatricians and 39 family
      practitioners. Forty-six percent of responding pediatricians, compared with 90%
      of family practitioners, stated that they ask about problems with alcohol in
      taking a routine family history. Thirty-eight percent of pediatricians who knew
      the frequency of alcoholism, compared with 47% of those who did not, indicated
      that they include it in taking a routine family history. Forty-six percent of
      pediatricians who have experienced a problem with alcohol in their own family,
      compared with 20% of pediatricians without such personal experience, routinely
      address the issue of alcohol use with parents and children. Similar analyses
      among the family practitioners revealed no significant differences. We conclude
      that fewer than half of pediatricians ask about problems with alcohol in taking a
      family history. The likelihood of asking about such problems was not influenced
      by the health care provider's knowledge of alcoholism, but it was influenced by
      the provider's personal family history of problems with alcohol. Because of the
      important morbidity associated with alcohol use in families, and because
      intervention can improve functioning and adaptation of the child, training and
      Continuing Medical Education courses should address this issue.

PMID- 2239864
TI  - Home care for ventilator-dependent children. Psychosocial impact on the family.
AB  - The impact of providing home care for ventilator-dependent children was studied
      in a cross-sectional survey of 18 northern California families. Through the use
      of a confidential structured interview and the impact on Family Scale, we
      obtained information on family demographics; the childrens' medical conditions;
      financial, social, and personal impact on the family; and parental coping-mastery
      of the care of a ventilator-dependent child at home. Analysis of scores from the
      impact on Family Scale showed no differences in the perceived family impact
      between primary caretakers and their spouses. Primary caretakers in the sample,
      however, showed significantly reduced Coping subscale scores with a longer
      duration of home ventilatory care. This finding, if confirmed in future studies,
      has policy implications for physicians and other health professionals working
      with ventilator-dependent children and their families, especially those who care
      for children over long periods.

PMID- 2239865
TI  - Neurodevelopmental performance of very-low-birth-weight infants with mild
      periventricular, intraventricular hemorrhage. Outcome at 5 to 6 years of age.
AB  - The neurodevelopmental outcome of 38 very-low-birth-weight neonates (birth
      weight, less than 1501 g) was followed up prospectively from birth to 5 to 6
      years of age to assess the neurodevelopmental sequelae of mild periventricular,
      intraventricular hemorrhage (grades I and II). All neonates were screened for
      periventricular, intraventricular hemorrhage at 5 to 10 days of age. Eleven
      incurred a mild periventricular, intraventricular hemorrhage (group 1) and 27 had
      no periventricular, intraventricular hemorrhage (group 2). Each of the infants
      was neurodevelopmentally normal at 1 to 2 years of age. The 38 children were
      matched by race, age, sex, and socioeconomic status with control children (group
      3) who had been born at term. On outcome measurements at 5 to 6 years of age,
      groups 1 and 2 scored significantly lower than group 3 on the combined test
      measurements and on three of the four individual measurements. Group 1 scored
      significantly lower than group 2 on the combined test measurements only. These
      data indicate that very-low-birth-weight infants are at risk for learning
      problems. Although children with mild periventricular, intraventricular
      hemorrhage did not demonstrate a significant deficit on individual test scores,
      the significant difference on the combined battery suggests that mild
      periventricular, intraventricular hemorrhage has an adverse effect on global
      performance.

PMID- 2239866
TI  - Percutaneous central venous catheterization. Three years' experience in a
      neonatal intensive care unit.
AB  - Prolonged venous access is desirable in very-low-birth-weight infants and infants
      for whom feedings are contraindicated. We prospectively evaluated 481 small
      diameter venous catheters placed percutaneously in 317 patients over 3 years. Of
      478 catheters, 241 (50%) were placed in infants weighing 1 kg or less. Mean
      catheter stay was 13 days (range, less than 1 to 77 days). Almost half (49%) of
      the central and thoracic catheters (91% of placements) were removed
      nonelectively: 43% due to problems such as leaking or clotting and 6% to
      suspicion of sepsis or venous occlusion. Of the 23 episodes of possible sepsis in
      the 478 catheter stays, six (1.3%) were confirmed catheter-related sepsis; 12
      (2.5%) were confirmed alternate locus sepsis. Three factors specific to
      percutaneous central venous catheter-related sepsis were prolonged catheter stay
      (3 to 5 weeks), Staphylococcus epidermidis, and weight less than or equal to 1
      kg. Four factors specific to alternate locus sepsis were presence of an alternate
      infection site, earlier infection (1 to 2 weeks), extremely low birth weight, and
      prolonged clinical instability. Percutaneous central venous catheterizations
      reduced the need for the stress of repeated venipuncture, resulting in lower
      complication rates than those reported with surgically placed central venous
      catheters, and leading to identification of risk factors specific to catheter
      sepsis and alternate locus sepsis.

PMID- 2239867
TI  - Physical features of Prader-Willi syndrome in neonates.
AB  - A retrospective study of 16 patients was undertaken to identify physical features
      that may typify neonates with Prader-Willi syndrome. Several features known to be
      typical of Prader-Willi syndrome in early infancy were confirmed, including
      hypotonia and genital hypoplasia. A number of features that have not previously
      been emphasized as characterizing Prader-Willi syndrome were also identified,
      most notably abnormal cry and, in males, signs of genital hypoplasia but with an
      apparently normal phallus. Other features included disproportionately large head
      circumference, disproportionately large anterior fontanelle, mild micrognathia,
      mild anomalies of the gingivae or alveolar ridges, and changes in the appearance
      of the skin. Appreciation of these features may assist the pediatrician in
      recognizing the child with Prader-Willi syndrome during the neonatal period,
      before the appearance of better-known findings of later onset, such as obesity
      and acromicria.

PMID- 2239868
TI  - Cardiovascular responses to exercise in childhood.

PMID- 2239869
TI  - Risk factors for adolescent cigarette smoking. The Muscatine study.
AB  - Smoking among adolescents is a developmental phenomenon with several factors
      exerting an influence on cigarette use at different times. We examined the
      longitudinal influences of several behavioral and social variables on the smoking
      status of 443 students followed from early to late adolescence. Of the factors
      examined, association with friends who smoke and previous smoking status were
      consistently associated with an adolescent's future smoking status. Other
      factors, such as attachment to father or to mother, parental supervision,
      extracurricular activity, perceived negative and positive effects of smoking, and
      academic involvement, were all related to late adolescent smoking status. These
      observations suggest that strategies that influence smoking behavior need to be
      directed not only to the individual child but also to influences within the
      child's home and school environment.

PMID- 2239870
TI  - Radiological case of the month. Neonatal small left colon syndrome.

PMID- 2239871
TI  - Computerized tomography in acute gastrointestinal disorders.
AB  - In recent years, computerized tomography (CT) has become one of the most
      important imaging modalities in evaluation of patients with acute
      gastrointestinal disorders. Its role, diagnostic accuracy, indications, and
      limitations in some of the most commonly encountered acute abdominal conditions
      are succinctly presented and reviewed. CT should not be used indiscriminantly,
      but is best considered a valuable primary or complimentary diagnostic tool in
      critically ill patients. Its selective use in a variety of emergency abdominal
      diseases will significantly improve accuracy of clinical diagnoses, leading to a
      prompt and adequate medical or surgical management.

PMID- 2239872
TI  - Clinical aspects of Wilson's disease.

PMID- 2239873
TI  - Effect of omeprazole and high doses of ranitidine on gastric acidity and
      gastroesophageal reflux in patients with moderate-severe esophagitis.
AB  - Thirty to fifty percent of patients with reflux esophagitis fail to heal after
      treatment with conventional doses of H2-receptor antagonists, whereas omeprazole
      administration induces more than 90% healing. To investigate the effect of
      omeprazole and higher-than-presently-recommended doses of H2-blockers, we
      evaluated gastric acidity and gastroesophageal reflux in 17 patients with severe
      moderate esophagitis before and after treatment with 300 mg ranitidine twice
      daily or 20 mg omeprazole once daily. Three pH-metric studies were performed, in
      a cross-over design, before and after 8 days of treatment with omeprazole or
      ranitidine. Both drugs significantly reduced intragastric acidity (p less than
      0.001) during both night and day hours. Median hourly 24-h intragastric pH was
      1.8 in the basal study, 2.9 after ranitidine, and 3.4 after omeprazole.
      Intragastric acidity fell from 84.0 mmol/L in the basal study to 14.2 mmol/L (79%
      inhibition) with ranitidine and 9.3 mmol/L (84% inhibition) with omeprazole.
      Patients with esophagitis were significantly more exposed to acid than healthy
      subjects, in both the supine and upright position (p less than 0.01). The time
      with esophageal pH less than 4 dropped from 23.9% in the basal study to 8.5% with
      ranitidine and to 7.2% with omeprazole (p less than 0.001). Both drugs
      significantly reduced esophageal exposure to acid in both the supine and upright
      positions (p less than 0.001), whereas neither had any effect on esophageal acid
      clearance.

PMID- 2239875
TI  - Dysphagia following fundoplication: "slipped" fundoplication versus achalasia
      complicated by fundoplication.
AB  - Failure to obtain preoperative esophageal manometry in patients being considered
      for antireflux surgery can result in immediate persistent postoperative dysphagia
      due to a missed diagnosis of achalasia. We describe the clinical assessment and
      management of a case of delayed postoperative dysphagia due to a "slipped"
      fundoplication, which is contrasted with three patients with immediate
      postoperative dysphagia due to a missed diagnosis of achalasia. Surgical revision
      was required to correct the "slipped" fundoplication, and pneumatic dilatation
      was successfully used in two of three cases of achalasia complicated by
      fundoplication. Careful preoperative esophageal evaluation with manometry is
      essential to rule out the presence of a primary esophageal motor disorder.

PMID- 2239874
TI  - Esophageal 24-h pH monitoring: is prior manometry necessary for correct
      positioning of the electrode?
AB  - In 24-h esophageal pH monitoring, the electrode is usually positioned 5 cm above
      the manometrically localized esophagogastric junction. In order to replace
      esophageal manometry for this purpose, we tested whether the esophagogastric
      junction can be identified correctly by fluoroscopy or the determination of the
      pH-step between stomach and esophagus, compared with esophageal manometry. The
      distance from the nares to the esophagogastric junction was determined three
      times with each of the three methods in 46 patients and 14 volunteers.
      Fluoroscopy assumed the esophagogastric junction 1.23 +/- 0.23 cm (mean +/- SE)
      lower than the peak pressure point determined at manometry, pH-step only 0.45 +/-
      0.16 cm. With pH-step, only one subject had a difference of more than 3 cm to the
      manometrically defined esophagogastric junction, whether gastroesophageal reflux
      disease (as proven by pH monitoring) was present or not. We conclude that the
      esophagogastric junction can usually be identified with sufficient accuracy by
      the measurement of the pH-step between stomach and esophagus. Fluoroscopy is far
      less accurate than pH-step, and should not be used.

PMID- 2239876
TI  - Endoscopic management of chronic organoaxial volvulus of the stomach.
AB  - Endoscopic correction of the chronic organoaxial volvulus of the stomach was
      attempted in seven cases of primary and three cases of secondary volvulus.
      Endoscopic correction was successful in six cases of primary volvulus and one
      case of volvulus secondary to duodenal carcinoma. This paper describes the
      details of the technique of endoscopic correction of gastric volvulus, and
      documentation of correction of the volvulus by barium meal study with a follow-up
      of 5-26 months.

PMID- 2239877
TI  - Recurrence of duodenal ulcer and elevated serum pepsinogen I levels in smokers
      and nonsmokers.
AB  - We determined serum pepsinogen I (PG I) levels by radioimmunoassay in 472
      patients with duodenal ulcer and 141 normal subjects to investigate whether serum
      PG I levels were related to cigarette smoking, and in 225 patients to determine
      whether the recurrence of duodenal ulcer was related to serum PG I levels or
      cigarette smoking. Serum PG I levels were not influenced by cigarette smoking in
      either patients with duodenal ulcer or normal subjects. The recurrence rate of
      duodenal ulcer not under maintenance therapy was significantly higher in hyperPG
      I patients than in normoPG I patients, regardless of their smoking habits. Only
      in hyperPG I patients was the recurrence rate in smokers higher than in
      nonsmokers. Patients under maintenance therapy showed similar results.
      Multilogistic regression indicated that hyperPG I had a greater effect than
      cigarette smoking on ulcer recurrence. These findings indicate that serum PG I
      levels are not influenced by smoking, and the important characteristic in
      patients with recurrent duodenal ulcers is the increased serum PG I levels.

PMID- 2239879
TI  - Granular cell tumor of the esophagus: endoscopic ultrasonographic demonstration
      and endoscopic removal.
AB  - A 35-yr-old Japanese man with a granular cell tumor of the esophagus that was
      removed by endoscopic polypectomy is presented. Radiography and endoscopy showed
      a 20 x 12 mm sessile protrusion in the distal esophagus. Endoscopic
      ultrasonography demonstrated the hypoechoic mass in the submucosa without
      continuity to the muscularis propria. The lesion was successfully treated by
      endoscopic polypectomy without complications. The cross-sections of the resected
      specimen were quite in agreement with the ultrasonographic findings. Endoscopic
      ultrasonography is valuable to assess the exact location and extent of the tumor,
      and to determine the indication for endoscopic polypectomy.

PMID- 2239878
TI  - Adenocarcinoma arising in Barrett's esophagus after total gastrectomy.
AB  - A 64-yr-old Japanese male who underwent a partial gastrectomy for a duodenal
      ulcer at the age of 21, a total resection of the remnant stomach for a stomal
      ulcer at age 25, and in whom Barrett's esophagus was diagnosed at age 47, was
      found to have a tumor at the distal esophagus and was operated on by thoracic
      esophagectomy. The tumor was a well to moderately differentiated adenocarcinoma
      invading down to the muscularis propria. The entire esophageal mucosa in the
      resected specimen was lined by columnar epithelium. This tumor was thought to
      derive from the Barrett's esophageal epithelium.

PMID- 2239880
TI  - Extramedullary hematopoiesis involving the esophagus in myelofibrosis.
AB  - In this report, we describe a case of myelofibrosis with myeloid metaplasia; a 53
      yr-old man was splenectomized for a massively enlarged spleen in which multiple
      foci of myeloid metaplasia were histologically demonstrated. The patient was
      referred to us for endoscopic examination, following the repeated occurrence of
      melena. Upper gastrointestinal endoscopy revealed two active ulcerative lesions
      in the bulb, and only a moderate erythema in the lower third of the esophagus,
      which showed no varices. There was no endoscopic evidence of active or recent
      bleeding. Subsequent histologic examination of biopsies taken from the esophageal
      lesion surprisingly revealed the presence of hematopoietic tissue.

PMID- 2239881
TI  - Diffuse hemangiomatosis of the spleen: splenic hemangiomatosis presenting with
      giant splenomegaly, anemia, and thrombocytopenia.
AB  - In an elderly patient with oligosymptomatic giant splenomegaly, clinical and
      laboratory data were nondiagnostic, while nonhomogeneous splenic enlargement was
      the only finding detected by imaging procedures. Splenectomy was performed and
      diffuse hemangiomatosis of predominantly capillary-type found. The failure of
      imaging techniques to even hint at the nature of the underlying disorder is
      comprehensible in view of the organ being essentially replaced in toto by the
      abnormal vascular channels. Diffuse splenic hemangiomatosis, a rare condition,
      may cause hypersplenism, and its diagnosis may be elusive because of misleading
      patterns on imaging.

PMID- 2239882
TI  - "Spontaneous sump syndrome": Successful treatment by duodenoscopic
      sphincterotomy.
AB  - "Sump syndrome" is a rare complication of side-to-side choledochoenterostomy
      operations which develops in the distal, nonfunctioning limb of the common bile
      duct where lithogenic bile, gastrointestinal contents, and debris accumulate. We
      report here a patient who developed spontaneous sump syndrome as a result of the
      formation of choledochoduodenal fistula, and who presented with multiple pyogenic
      liver abscesses. The patient's symptoms and liver abscesses resolved completely
      after treatment by endoscopic sphincterotomy and antibiotics. This case
      demonstrates that sump syndrome may occur spontaneously, that it can be a cause
      for pyogenic liver abscess formation, and that it may be treated effectively by
      endoscopic sphincterotomy.

PMID- 2239883
TI  - Hepatic portal venous gas: an unusual presentation of Crohn's disease.
AB  - Hepatic portal venous gas is associated with numerous conditions and
      traditionally has been regarded as an ominous prognostic sign. There are several
      reports of hepatic portal venous gas occurring in patients with inflammatory
      bowel disease after or during the performance of colonic diagnostic studies. We
      report an unusual case of Crohn's disease whose initial presentation included
      hepatic portal venous gas. The literature of hepatic portal venous gas associated
      with inflammatory bowel disease is reviewed.

PMID- 2239884
TI  - Primary abscess of the omentum.
AB  - A 65-yr-old man presented with upper abdominal pain and fever due to a primary
      abscess of the omentum. The finding of microscopic-size foreign particles within
      the abscess raised the possibility of antecedent clinically silent perforation of
      the bowel or appendix. Surgical resection and antibiotic therapy were curative.

PMID- 2239885
TI  - A chance to cut is a chance to cure?
AB  - Fifty-seven patients underwent local excision of an invasive distal rectal cancer
      as an initial operative procedure with curative intent. Five-year survival was
      82.5%, and the rectal cancer specific mortality rate was only 10.5%. The level of
      wall invasion, vascular permeation, tumor ulceration, mobility, and
      differentiation were the criteria studied for prognosis. Poor prognostic factors
      included mucinous cell differentiation and full thickness invasion, and in these
      cases, abdominoperineal resection was recommended. None of the 27 patients
      without these adverse prognostic factors died from rectal cancer. The other
      factors did not appear to influence the outcome, and local excision of distal
      rectal cancer would be the treatment of choice in such selected patients.

PMID- 2239886
TI  - Oral dissolution therapy for cholelithiasis: mix and match.
AB  - The authors conducted a prospective, randomized trial of chenodeoxycholic and
      ursodeoxycholic acid versus ursodeoxycholic acid alone in patients with
      cholelithiasis to determine their efficacy for dissolution of gallstones. One
      hundred and twenty patients with radiolucent gallstones, less than or equal to 15
      mm and who had a functioning gallbladder were enrolled. The patients were divided
      into two groups based on the diameter of their largest stones. Seventy patients
      had stones larger than 5 mm but less than 15 mm, whereas 50 patients had stones
      that measured 5 mm or less. The patients were randomly assigned to treatment with
      chenodeoxycholic acid plus ursodeoxycholic acid (5 mm/kg of each) or
      ursodeoxycholic acid (10 mm/kg) alone. Oral cholecystography, plain abdominal x
      rays, and ultrasonography of the gallbladder were done at 6, 12, and 24 months.
      Dissolution was deemed to be complete if not stones were visualized on two
      examinations. partial dissolution was defined as a 50% reduction in stone size
      and/or number. Stones that were not detected by cholecystography but still
      detected during ultrasonography were considered to be partially dissolved. Plasma
      triglycerides, serum cholesterol, HDL, and serologic liver function tests were
      determined at 1, 3, 6, 12, 18, and 24 months. In a select group of patients, bile
      rich duodenal aspirates were aspirated and analyzed for biliary lipid contents.
      In the group with small stones, defined as less than or equal to 5 mm, complete
      stone dissolution occurred significantly more often utilizing combination therapy
      at 6 months (52% vs 24%), and this trend persisted, although no longer
      significant, at 12 and 24 months. Combination therapy also achieved an improved
      rate of dissolution for large stones within 6 months; however, this did not
      persist at 12 and 24 months. Although not statistically significant, stone
      calcification occurred less often with combined therapy. All treatment regimens
      were well tolerated, with only minor changes in bowel habits and mild elevations
      in serum transaminase levels. Serum lipid levels did not change with either
      therapy. The authors concluded that the combination of chenodeoxycholic acid and
      ursodeoxycholic acid was the preferred therapy for gallstone dissolution, because
      it dissolves stones more rapidly, with a lower incidence of stone calcifications,
      and thus might reduce the long-term cost of treatment.

PMID- 2239887
TI  - "Cloggology" revisited: endoscopic or surgical decompression of malignant biliary
      obstruction.
AB  - In this study, 50 consecutive patients over age 60 with obstructive jaundice
      secondary to malignant stricture of the distal common bile duct were identified
      by endoscopic cholangiography. The patients were then randomized to palliative
      therapy with either endoscopic endoprosthesis or bypass surgery. Prospective
      indices of survival time, complication rates, hospitalization requirements, and
      quality of life were followed. All 25 patients randomized to endoprosthesis were
      treated by this procedure, whereas only 19 of 25 patients randomized to bypass
      surgery underwent operative biliary-digestive anastomosis. No difference in the
      above indices were found between the two groups. The authors concluded that
      palliation of obstructive jaundice due to a malignant bile duct stricture with
      endoscopically placed biliary stent is as effective as operative bypass.

PMID- 2239888
TI  - Very prolonged diarrhea associated with Aeromonas hydrophila.

PMID- 2239889
TI  - Gastric bezoar complicating gastric stapling.

PMID- 2239890
TI  - Pathogenesis of chronic alcoholic pancreatitis.

PMID- 2239891
TI  - High doses of 5-aminosalicylic acid enemas in chronic radiation proctitis:
      comparison with betamethasone enemas.

PMID- 2239892
TI  - The microcirculatory status of portal hypertensive gastric mucosa in "normal" and
      postsclerotherapy patients.

PMID- 2239893
TI  - Pancreatic and biliary obstruction due to eosinophilic gastroenteritis.

PMID- 2239894
TI  - Re: "Time trends in incidence rates of first hip fracture in the Uppsala Health
      Care Region, Sweden, 1965-1983".

PMID- 2239895
TI  - Re: "Prognosis after breast cancer diagnosis in women exposed to estrogen and
      estrogen-progestogen replacement therapy".

PMID- 2239896
TI  - Re: "Case-control studies using other diseases as controls: problems of excluding
      exposure-related diseases".

PMID- 2239897
TI  - Hyperinsulinemia and elevated blood pressure: cause, confounder, or coincidence?

PMID- 2239898
TI  - Racial/ethnic differences in HIV-1 seroprevalence and risky behaviors among
      intravenous drug users in a multisite study.
AB  - Differences in human immunodeficiency virus type 1 (HIV-1) seroprevalence and
      patterns of drug-use and sexual behaviors were examined among Hispanic, black,
      and white intravenous drug users recruited at multiple sites in Worcester,
      Massachusetts. A total of 1,092 (786 males, 306 females) intravenous drug users
      were interviewed, and HIV-1 antibody test results were available for 874 (80.0%).
      After adjustment for demographic differences, black males were significantly less
      likely to report risky drug-use behaviors (ever sharing needles and recently
      visiting shooting galleries) compared with white males. In contrast, Hispanic
      males were significantly more likely to report recent risky drug-use behaviors
      (sharing needles in New York City, daily needle-sharing, and visiting shooting
      galleries). Both groups were less likely to report risky sexual behaviors
      compared with whites. The odds ratios for HIV-1 seropositivity remained
      significantly greater than 1 for Hispanics compared with whites (odds ratio =
      4.5) and maintained marginal significance for blacks compared with whites (odds
      ratio = 2.1) when adjusted for risky behaviors and demographic variables. The
      different patterns of drug-use and sexual behaviors by race/ethnicity indicate
      the need for interventions targeted to specific populations.

PMID- 2239899
TI  - Association of drug injection patterns with antibody to human immunodeficiency
      virus type 1 among intravenous drug users in Baltimore, Maryland.
AB  - During 1988 and 1989, intravenous drug users recruited through extensive
      community outreach efforts in Baltimore, Maryland, were interviewed about drug
      injection and sex practices in the prior 11 years, with screening for antibody to
      human immunodeficiency virus type 1 (HIV-1). Neither interviewers nor subjects
      were aware of HIV-1 serostatus until 2 weeks after the interview. Among 2,616
      intravenous drug users who last injected drug within the same calendar year as
      screening, HIV-1 seroprevalence was 30.1% for those with any use of shooting
      galleries, 23.3% for those who shared needles but did not use shooting galleries,
      and 16.3% for drug users who denied both needle-sharing and gallery use between
      1977 and 1987. Among 608 drug users who reported persistent use of shooting
      galleries since 1977 or subsequent initiation into drug use, there was a tendency
      for HIV-1 seroprevalence to increase with more recent onset of an injection
      career. Combined with a milder but similar tendency among 739 drug users who
      reported persistent sharing of needles, and a seroprevalence of 15.1% among
      participants who had just started injecting drugs in the 18 months prior to
      baseline, these data provide indirect evidence that a high risk for HIV-1
      infection might occur early during a drug injection career.

PMID- 2239900
TI  - Serum vitamin A and subsequent risk of cancer: cancer incidence follow-up of the
      Finnish Mobile Clinic Health Examination Survey.
AB  - From 1968 to 1977, the association between the level of vitamin A in serum and
      the subsequent incidence of cancer was examined in a longitudinal study of 36,265
      persons initially aged 15-99 years in 25 population groups in Finland. During a
      mean follow-up of 8 years, 766 cancers were diagnosed. Serum retinol, retinol
      binding protein, and beta-carotene levels were measured from frozen serum samples
      (stored at -20 degrees C) drawn from these persons before the start of follow-up
      and from 1,419 controls matched for sex, age, and place of residence who did not
      develop cancer during follow-up. The mean level of serum retinol among the cancer
      cases was 645 micrograms/liter for men and 587 micrograms/liter for women. The
      corresponding levels in the controls were 3.3% and 2.8% higher. There was an
      inverse gradient between serum retinol level and the occurrence of cancer among
      men. This association was, however, mainly concentrated in the first 2 years of
      follow-up. The mean level of serum beta-carotene was 72.3 micrograms/liter among
      male cases and 119.5 micrograms/liter among female cases. The corresponding
      levels of the controls were 14.0% and 5.5% higher. The differences were
      particularly clear with regard to lung cancer. These findings suggest that the
      association between retinol and cancer may be due to preclinical cancer and that
      there may be an association between beta-carotene and cancer.

PMID- 2239901
TI  - A case-control study of milk-drinking and ovarian cancer risk.
AB  - It has been hypothesized that milk consumption increases the risk of ovarian
      cancer because of a possible association of lactose with human ovarian failure.
      Milk is also a source of animal fats in the diet, and animal fat intake is
      associated with ovarian cancer risk. To explore further the possible confounding
      of the milk-ovarian cancer association by the animal fat content of milk, the
      authors performed a case-control study of 303 ovarian cancer cases and 606 age
      matched nonmalignant-disease controls seen between 1982 and 1988 at Roswell Park
      Memorial Institute in Buffalo, New York. Total frequency of usual milk intake was
      not associated with increased risk. Usually drinking more than one glass of whole
      milk daily relative to never drinking whole milk was associated with a relative
      risk of 3.1 (95% confidence interval (CI) 1.8-5.5). Consumption of reduced-fat
      milk was associated with reduced relative risk. Among persons who reported
      drinking milk regularly, persons reporting drinking only whole milk were at
      increased risk (relative risk = 2.6, 95% CI 1.7-4.0) relative to persons who
      drank only skim milk or 2% milk. These findings suggest that milk-drinking is not
      a source of ovarian cancer risk independently of its fat content. Additional
      study of lactose and ovarian cancer risk involving careful control for
      confounding is needed.

PMID- 2239902
TI  - Hip fractures in women with breast cancer.
AB  - The authors investigated whether the incidence of first hip fracture, an
      indicator of osteoporosis, is lower in breast cancer patients, who are assumed to
      have higher levels of endogenous estrogens, than in other women. A population
      based Swedish cohort comprising 9,673 women with invasive breast cancer diagnosed
      from 1958 through 1983 was followed up with respect to the occurrence of a first
      hip fracture during the period 1965-1983. Overall, the number of observed acute
      fractures (n = 387) was slightly higher than expected (n = 348.6) (standardized
      incidence ratio (SIR) = 1.1, 95% confidence interval (CI) 1.0-1.2). Risk for
      trochanteric fractures was slightly higher than expected (SIR = 1.2, 95% CI 1.0
      1.4), but risk for cervical fractures was not (SIR = 1.0, 95% CI 0.9-1.1). Risk
      for trochanteric fracture decreased with increasing age at breast cancer
      diagnosis, reaching standardized incidence ratios close to unity after the age of
      70 years. Duration of follow-up appeared to be unrelated to the risk of either
      type of fracture. The authors conclude that the incidence of first hip fracture
      is not lower in breast cancer patients than in other women.

PMID- 2239903
TI  - The relation of endogenous sex steroid hormone concentrations to serum lipid and
      lipoprotein levels in postmenopausal women.
AB  - The relation of concentrations of endogenous estrogens and androgens to lipid and
      lipoprotein levels was examined in 176 white, postmenopausal women (mean age, 58
      years) with an average of 9 years since the onset of menopause. All of the women
      were participants in a clinical trial of the effect of walking on postmenopausal
      bone loss. In that trial, women were randomized into either a walking group or a
      control group and were followed for 3 years. There were no differences in the
      serum hormones or lipids by randomized group, and hence, results from this study
      are presented for both groups combined. None of the women were on estrogen
      replacement therapy. Data were available from year 1 (1982-1983) of the trial for
      the estrogens, lipids, and lipoproteins. Information on androgens was available
      for 143 of these women. Hormone levels were determined by highly specific methods
      involving extraction, column chromatography, and radioimmunoassay. About 50% of
      the women had estradiol levels at or below the sensitivity level (2.5 pg/ml) of
      the assay; therefore, estradiol levels were viewed as dichotomous (measurable/not
      measurable), and the estradiol results should be interpreted with caution. There
      was little relation of the androgens to the lipid values. Univariate analyses
      suggested a direct relation between total cholesterol, low density lipoprotein
      cholesterol, and triglyceride levels with estradiol. An inverse relation was
      suggested between serum estrone and estradiol and total high density lipoprotein
      (HDL) cholesterol and HDL2 cholesterol, although none of these associations were
      statistically significant. Multiple regression analyses revealed that the primary
      determinant of the HDL cholesterol and triglyceride levels was the degree of
      obesity as estimated by the body mass index (weight (kg)/height (m)2). Addition
      of estrone or estradiol to the models did not contribute to the prediction of
      lipid levels. These results do not support the hypothesis of there being a
      relation between endogenous sex hormone levels and lipid levels in postmenopausal
      women. The results suggest that sex hormones cannot explain the sex difference in
      lipid levels and may not contribute to the rise in coronary heart disease that
      occurs in women around menopause.

PMID- 2239904
TI  - Endogenous sex hormone levels in older adult men with diabetes mellitus.
AB  - In a Southern California population-based cohort of 985 men aged 40-79 years in
      1972-1974, 110 men with diabetes had significantly lower mean levels of
      endogenous plasma testosterone and sex hormone-binding globulin than did 875
      nondiabetic men. Mean androstenedione, estrone, and estradiol levels did not
      differ significantly by diabetic status. The testosterone and sex hormone-binding
      globulin differences were reduced but not eliminated after adjustment for age and
      body mass index (weight (kg)/height (m)2). Twenty-one percent of diabetic men
      compared with 13% of nondiabetic men had testosterone levels below a
      categorically defined normal level of 3,500 pg/ml. Testosterone was inversely
      related to degree of glycemia in the whole cohort. Throughout the whole range of
      plasma glucose, there was a stepwise decrease in mean testosterone levels per
      categorical increase in fasting plasma glucose, apparent in both diabetics and
      nondiabetics. The clinical and physiologic implications of the reduced
      testosterone levels in diabetic men merit further investigation.

PMID- 2239905
TI  - A prospective population-based study of alcohol use and non-insulin-dependent
      diabetes mellitus.
AB  - The effect of alcohol use on risk of non-insulin-dependent diabetes mellitus was
      assessed in a defined population. A 24-hour recall of alcohol intake and past
      week alcohol intake were obtained by separate interviewers between 1973 and 1975,
      and responses were coded by the Nutrition Coordinating Center, University of
      Minnesota. Of the 524 adults aged 30-79 years without diabetes at baseline, 31
      men and 44 women were identified as diabetic by means of a glucose tolerance test
      (World Health Organization criteria) between 1984 and 1987. Men, but not women,
      who developed diabetes reported significantly more alcohol intake in the past
      week and in the past 24 hours. The highest rate of diabetes among alcohol users
      was in heavy drinkers--statistically significant only in men. Alcohol use
      remained a significant predictor of diabetes in men after adjustment for baseline
      age, body mass index (weight (kg)/height (m)2), cigarette smoking, family history
      of diabetes, and systolic blood pressure with a logistic regression model. The
      relative risk associated with past-week alcohol intake was 1.5 per 137.8 g; for
      past-24-hour alcohol intake, it was 1.5 per 24.5 g. Adjustment for baseline
      fasting plasma glucose and triglycerides did not change the results. Alcohol
      intake appears to be associated with risk of non-insulin-dependent diabetes
      mellitus in men.

PMID- 2239906
TI  - The epidemiology of appendicitis and appendectomy in the United States.
AB  - To describe the epidemiology of appendicitis and appendectomy in the United
      States, the authors analyzed National Hospital Discharge Survey data for the
      years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in
      the United States during this period, accounting for an estimated 1 million
      hospital days per year. The highest incidence of primary positive appendectomy
      (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population
      per year); males had higher rates of appendicitis than females for all age groups
      (overall rate ratio, 1.4:1). Racial, geographic, and seasonal differences were
      also noted. Appendicitis rates were 1.5 times higher for whites than for
      nonwhites, highest (15.4 per 10,000 population per year) in the west north
      central region, and 11.3% higher in the summer than in the winter months. The
      highest rate of incidental appendectomy was found in women aged 35-44 years (43.8
      per 10,000 population per year), 12.1 times higher than the rate for men of the
      same age. Between 1970 and 1984, the incidence of appendicitis decreased by
      14.6%; reasons for this decline are unknown. A life table model suggests that the
      lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the
      lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall,
      an estimated 36 incidental procedures are performed to prevent one case of
      appendicitis; for the elderly, the preventive value of an incidental procedure is
      considerably lower.

PMID- 2239907
TI  - Maternal cigarette smoking during pregnancy in relation to oral clefts.
AB  - Studies on maternal smoking in relation to oral cleft defects have yielded
      inconsistent findings, with results ranging from no association to sixfold
      increases in risk. The authors examined this relation in a case-control study
      conducted in Boston, Massachusetts, Philadelphia, Pennsylvania, Toronto, Ontario,
      Canada, and the state of Iowa during the years 1983-1987, in which mothers of
      malformed infants were interviewed within 6 months after delivery about prenatal
      events and exposures. Maternal cigarette smoking during pregnancy for 400 infants
      with cleft lip with or without cleft palate and for 215 infants with cleft palate
      alone was compared with that for 2,710 infants with other malformations
      (controls). Relative risks (and 95% confidence intervals) were estimated for
      smokers of 1-14, 15-24, and greater than or equal to 25 cigarettes per day
      relative to never smokers; the respective estimates for cleft lip with or without
      cleft palate were 1.2 (95% confidence interval (CI) 0.9-1.6), 1.4 (95% CI 1.0
      2.1), and 0.7 (95% CI 0.3-1.6), and for cleft palate alone, estimates were 1.0
      (95% CI 0.7-1.5), 0.9 (95% CI 0.5-1.5), and 0.8 (95% CI 0.3-2.2). Relative risks
      were also close to unity for case subgroups divided according to the presence or
      absence of an associated malformation. Multivariate control of several potential
      confounders did not alter these estimates. Based on this large series of cases,
      maternal smoking during pregnancy does not appear to increase the risk of oral
      clefts.

PMID- 2239908
TI  - Maternal employment and reproductive risk factors.
AB  - Studies of reproductive hazards in the workplace must address potential biases
      related to selection for employment. The National Natality Survey, a probability
      sample of live births to married women in 1980, was used to examine the relation
      between female employment during pregnancy and factors that might affect
      reproductive outcome by analyzing the 5,927 women with complete occupational
      data. Demographic and behavioral attributes as well as reproductive history were
      compared for the 3,712 women employed and the 2,215 women not employed during
      pregnancy. Employed mothers were of more optimal reproductive age, were more
      highly educated, had higher incomes, began prenatal care earlier, had greater
      weight gain during pregnancy, and were slightly less likely to be heavy smokers.
      Employed women had markedly fewer previous births and less favorable reproductive
      histories (more stillbirths, miscarriages, and induced abortions) than unemployed
      women, controlling for gravidity. Full- and part-time workers were similar with
      regard to demographic and behavioral characteristics, but part-time workers had
      higher parity. Differences were noted by employment sector: professional women
      had especially favorable demographic and behavioral traits, and women employed as
      operatives and service workers were less advantaged. These results indicate that
      substantial differences in pregnancy-related risk factors exist in relation to
      employment, with working women generally having more favorable demographic and
      behavioral characteristics and less favorable reproductive histories. This
      pattern could produce selection bias in studies of work and reproductive health,
      and it encourages the restriction of comparison groups to other employed women,
      with a need to consider heterogeneity among working women as well.

PMID- 2239909
TI  - The prevalence of Chlamydia trachomatis infection among mothers of children with
      trachoma.
AB  - The authors studied the epidemiology of Chlamydia trachomatis infection in a
      trachoma-endemic area of central Kenya. Children with abnormal ocular discharge
      were evaluated for clinical evidence of trachoma and were cultured for C.
      trachomatis. Isolated strains of C. trachomatis were immunotyped with monoclonal
      antibodies. Overall, 221 children from 207 families were evaluated. Clinically,
      91 children (41%) had trachomatous follicular inflammation, and 130 (59%) had
      papillary hypertrophy without visible follicle and were labeled as having
      mucopurulent conjunctivitis. C. trachomatis was isolated from 31 of 91 children
      with trachoma (34%) and 17 of 130 children with conjunctivitis (13%) (p less than
      0.001). Twenty-two C. trachomatis strains were immunotyped: 17 were from children
      with trachoma (nine type A, one A/L2, five B, one Ba, and one E) and five were
      from children with conjunctivitis (two A, one Ba, one D, and one F). A total of
      168 mothers were evaluated for cervical C. trachomatis infection, and seven (4%)
      were culture-positive. Two strains were immunotyped as serovar E. The authors
      conclude that C. trachomatis ocular infections are due to heterogeneous serovars
      in this area, that most cases of trachoma are due to C. trachomatis infection
      with the classic trachoma serovars (A, B, or Ba), and that cervical C.
      trachomatis infection is uncommon among mothers of children with trachoma.

PMID- 2239910
TI  - A nested case-control study of the correlates of early menarche.
AB  - Age at menarche, an early determinant of breast cancer risk, shows both a
      downward secular trend and marked differences by socioeconomic status, both
      presumably the reflection of dietary variations. A cohort study is being
      conducted in the Quebec City, Canada, area to assess the relation between diet,
      physical activities, and menarche. In the fall of 1986, 3,022 fifth-grade girls
      (mean age, 10.7 years) agreed to participate in the study. All of the girls'
      parents provided information on health, familial, and socioeconomic variables. A
      3-day dietary record and a 7-day physical activity recall were provided by 95.8%
      of the girls. All dietary information was verified with each girl by a dietician.
      Body weight and height and two skinfold thickness measurements were also recorded
      for 98% of the subjects. At the beginning of the study, 107 girls had already
      experienced menarche. In the fall of 1987, letters were sent to the mothers of
      the remaining 2,915 girls; 2,854 (97.9%) responded. In the preceding year, 352
      girls had reached menarche. Of these, 333 (94.6%) had provided baseline dietary
      data. A case-control analysis was conducted in which these 333 girls were
      compared with 333 age-matched premenarcheal girls. There was a weak association
      between energy intake, energy expenditure, and early menarche. Weight, height,
      skinfold thickness, mother's age at menarche, and participation in a dance,
      ballet, gymnastics, or figure skating club were also associated with the early
      onset of menstruation.

PMID- 2239911
TI  - Depressed mood and development of cancer.
AB  - This study was undertaken to determine whether premorbid depressed mood is
      associated with the development of cancer. Scores on the Center for Epidemiologic
      Studies Depression Scale were available for 2,264 participants in a mental health
      study conducted in 1971-1974 in Washington County, Maryland, who were still free
      of cancer 2-4 years later. Over a 12-year follow-up period (1975-1987), 169
      cancers were diagnosed among these persons. While there was only a slight
      association of depressed mood with subsequent cancer among the total study
      population, the association was much stronger among cigarette smokers. Compared
      with the risk seen in never smokers without depressed mood, depressed mood at the
      highest level of smoking was associated with relative risks of 4.5 for total
      cancer, 2.9 for cancer at sites not associated with smoking, and 18.5 for cancer
      at sites associated with smoking.

PMID- 2239912
TI  - The association between change in cognitive function and longevity in Dutch
      elderly.
AB  - The association between rate of change in cognitive function and longevity was
      investigated with data from the Dutch Longitudinal Study Among the Elderly. A
      group of 211 Dutch persons aged 65-84 years at baseline (1955-1957) was
      reexamined twice during an 8-year follow-up period, after which mortality was
      ascertained through 1983. Cognitive function was assessed based on an adaptation
      of the Wechsler Memory Scale. Rate of change in cognitive function during the 8
      years of follow-up was determined by regression on time for each individual.
      Cognitive function declined significantly over the 8-year period (mean yearly
      change, -0.28 units; 95% confidence interval -0.34 to -0.22). The rate of decline
      in cognitive function was strongly associated with subsequent survival time in
      the ages 70 years and over, with those with a large decline having a short
      survival time. No association could be demonstrated in the age group 65-69 years.
      Adjustment for potential confounders did not affect the magnitude of the
      association. These findings suggest that the rate of decline of cognitive
      function is an independent predictor of longevity in older persons.

PMID- 2239913
TI  - Mortality by employment status in the National Longitudinal Mortality Study.
AB  - A mortality follow-up of 452, 192 persons aged 25 years or more who were
      characterized with respect to employment status was conducted using the National
      Death Index for the years 1979 through 1983. The cohort, part of the National
      Longitudinal Mortality Study, was drawn from Current Population Survey samples
      representative of the US population using selected months during the years 1979
      1983. Employed persons aged 25-64 years were found to have standardized mortality
      ratios from 61% to 74% of the average, depending upon their sex and race.
      Unemployed men had standardized mortality ratios slightly above 100, but these
      values were 1.6 and 2.2 times higher than those for employed white men and black
      men, respectively. Those classified as unable to work had very high mortality
      ratios, from two to seven times the average. In the older age groups, 65 years or
      more, very low mortality ratios were found for those who were still employed.
      These relations were maintained after adjustment for family income and
      educational level. These results 1) describe the magnitude of mortality risk for
      clearly defined employment categories, 2) identify segments of the population
      with especially high mortality requiring greater public health recognition, and
      3) suggest further research into the health consequences of the various
      employment/nonemployment conditions.

PMID- 2239915
TI  - Variability in nutrient and food intakes among older middle-aged men.
      Implications for design of epidemiologic and validation studies using food
      recording.
AB  - The authors conducted a dietary methodology study in 1984 in Finnish men aged 55
      69 years in order to validate two dietary assessment instruments being used in
      the US-Finland Alpha-Tocopherol, Beta-Carotene Lung Cancer Prevention Trial.
      Twelve 2-day food records collected from 162 men over a 6-month period, including
      every day of the week, served as the reference measure. This report focuses on
      three important questions for investigating diet and disease relations: 1) How
      many days are necessary to classify "usual" intake? 2) Is there loss as a result
      of using consecutive days? 3) Which days are necessary for assessment and
      classification of "usual" diet? A repeated-measures regression model was used to
      estimate the variance components and the effects of consecutive days, weekday
      (weekday vs. weekend), and season. Correlations between the averages of different
      numbers of days of food records and "true" usual intake were examined along with
      the resulting attenuations in relative risk. Results suggest that 7-14 days are
      required to adequately classify most individuals into categories of intake for
      most nutrients and some foods. There appears to be some loss of information from
      using consecutive days rather than days further apart. Weekday/weekend
      differences in mean intakes are slight, and the rank ordering of individuals
      appears to be preserved. A moderate seasonal effect is shown for classification
      of fruits, but only a slight one is seen for micronutrients and berries.
      Implications for the design of epidemiologic and validation studies are
      discussed.

PMID- 2239914
TI  - Accuracy of death certificate diagnosis of intracranial hemorrhage and
      nonhemorrhagic stroke. The Minnesota Heart Survey.
AB  - The validity of death certificate diagnosis of stroke and its type as the
      underlying cause of death was investigated in a sample of in-hospital deaths of
      possible stroke cases from the Minnesota Heart Survey. The 228 in-hospital deaths
      in 1970 and the 180 deaths in 1980 had a stroke diagnosis either on hospital
      discharge records or as the underlying cause of death on the death certificate.
      Relative to a standardized physician diagnosis, positive predictive values for
      the death certificate diagnosis in 1970 were 96% for all types of stroke, 59% for
      intracranial hemorrhage, and 87% for nonhemorrhagic stroke. The respective values
      in 1980 were 100%, 82%, and 97%. An increase in positive predictive values,
      particularly for intracranial hemorrhage between 1970 and 1980, was attributed to
      the increased use of computerized tomography. Sensitivity for the death
      certificate diagnosis in 1970 was 63% for all types of stroke, 66% for
      intracranial hemorrhage, and 45% for nonhemorrhagic stroke. The respective
      sensitivities in 1980 were 70%, 76%, and 58%. The lower sensitivity for
      nonhemorrhagic stroke as compared with hemorrhagic stroke was due in part to 1)
      frequent reporting of nonhemorrhagic stroke as a contributing cause of death
      rather than the underlying cause of death and 2) time from stroke onset to death.
      Specificity among these possible strokes was high in both years. The low
      sensitivity of death certificate diagnosis of stroke may reduce estimated
      relative risks in epidemiologic studies. Nevertheless, since the advent of
      widespread use of computerized tomography, a death certificate diagnosis of
      intracranial hemorrhage versus nonhemorrhagic stroke appears to be sufficiently
      accurate for use in epidemiologic studies of stroke etiology.

PMID- 2239916
TI  - The size and number of bone marrow megakaryocytes in malignant lymphoma and their
      relationship to abnormalities in platelet count.
AB  - Platelet counts were measured routinely in 718 volunteer blood donors and 124
      patients with malignant lymphoma. When considered by gender, the mean platelet
      counts of the patients with malignant lymphoma were significantly increased when
      compared to controls (P less than 0.01). In addition, 9% of males and 4% of
      females with lymphoma exhibited a thrombocytosis, in which their platelet counts
      exceeded the upper limit of the normal platelet count for control subjects
      (defined as 2 SDs in excess of the mean value). Megakaryocyte whole size,
      cytoplasmic and nuclear sizes, and megakaryocyte numbers were also quantified in
      bone marrow obtained from the iliac crest of 5 hematologically normal subjects
      and 26 patients with malignant lymphoma. Mean megakaryocyte sizes were
      significantly greater in subjects with lymphoma, when compared to control values
      (P less than 0.05). No significant differences in megakaryocyte numbers in bone
      marrow were observed between the two groups. For subjects with malignant
      lymphoma, platelet count was found to be significantly positively correlated with
      megakaryocyte size. The results of this study suggest that the elevated platelet
      count associated with malignant lymphoma is mediated by an increase in the size
      of the megakaryocytes in the bone marrow.

PMID- 2239917
TI  - Major prognostic factors of Japanese patients with lymphoma-type adult T-cell
      leukemia.
AB  - Fifty-three Japanese patients with the lymphoma-type adult T-cell leukemia (ATL)
      were analyzed to study the prognostic value of various clinical findings recorded
      at the time of diagnosis. All patients were positive for human T-cell leukemia
      virus type I (HTLV-I) antibody and demonstrated monoclonal integration of HTLV-I
      proviral DNA in their malignant cells. The important individual variables
      detected in a previous univariate analysis were placed in a multiple regression
      model to identify the major prognostic factors for survival. This analysis showed
      that serum lactate dehydrogenase (LDH), calcium, and total protein levels had a
      strong predictive relationship with the length of survival (in descending order
      of importance). Among the 53 patients, 46 were dead at the time of analysis. The
      cause of death in relation to the duration of survival is also reviewed in this
      article.

PMID- 2239918
TI  - Acute myelomonocytic leukemia: an immunoelectron microscopic study.
AB  - Acute myelomonocytic leukemia (M4; French-American-British classification) is
      light microscopically defined as the leukemia constituting leukemic cells in both
      granulocytic and monocytic lineages. Therefore, the characteristics of M4 have
      not been fully elucidated. The author previously indicated that normal
      neutrophilic granulocytes could be ultrastructurally differentiated from normal
      monocytes by the double staining of lactoferrin and lysozyme. In this
      investigation, the ultrastructural localization of both proteins were observed in
      order to make the outline of M4 clear. The leukemic cells in acute myeloid
      leukemia (M2) were also examined in comparison with those in M4. The leukemic
      cells in M4 showed the double stainability of lactoferrin and lysozyme, and the
      positive reactions were localized in the cytoplasmic matrix and in the granules.
      The staining pattern was similar to that in M2. The coexistence of lactoferrin
      and lysozyme in the leukemic cells in M4, which has ultrastructurally the
      monocytic characteristics, implied that the leukemic cells also possess the
      characteristics of the cells in the granulocytic lineage. This suggests that the
      presence of the various leukemic cells in the granulocytic lineage. This suggests
      that the presence of the various leukemic cells signifies the diversely abnormal
      maturations in vivo of the monocytes/granulocytes precursor cell and that M4
      consists of not two kinds of distinguishable cells of granulocytic and monocytic
      lineages but various consecutive cells based on a malignant transformation of the
      precursor cell.

PMID- 2239919
TI  - Dry tap bone marrow aspiration: clinical significance.
AB  - Failure to obtain bone marrow on attempted marrow aspiration, "dry tap," has
      commonly been ascribed to faulty technique. All reports of simultaneous marrow
      aspirations and biopsies performed at the University of Virginia between January
      1, 1983, and July 1, 1989, were reviewed to determine the frequency of dry taps,
      the diagnoses and pathologic findings in these cases, and the associated
      laboratory findings. Among 2,235 simultaneous bone marrow aspirations and
      biopsies, 87 were dry taps (3.9%). Of these 87 dry taps, only six (6.9%) showed
      normal marrow biopsies, whereas the majority showed significant marrow pathology,
      usually associated with fibrosis, or hypercellularity, or both. These conditions
      most likely account for the inability to aspirate marrow. The most frequent
      diagnoses were metastatic carcinoma (17.2%), chronic myelogenous leukemia
      (14.9%), idiopathic myelofibrosis (13.8%), and hairy cell leukemia (10.3%). The
      presence of peripheral blood nucleated red blood cells, thrombocytopenia, and
      elevation of the serum lactate dehydrogenase were frequent findings in patients
      who experienced dry taps. Methods to obtain sufficient marrow for rapid diagnosis
      in these cases are discussed.

PMID- 2239920
TI  - Developmental and inducible patterns of human theta 1-globin gene expression in
      embryonic/fetal and adult erythroid cells.
AB  - Human theta (theta 1)-globin gene represents a member of the alpha-like globin
      gene family residing on chromosome 16. theta 1-Specific transcripts have been
      detected so far only in erythroid tissues and in erythroleukemia K562 cells. To
      investigate systematically its inducible expression and developmental
      specificity, we analyzed at the RNA level five additional human erythroleukemia
      cell lines with diverse developmental globin programs, two somatic cell hybrids
      between K562 and mouse erythroleukemia (MEL) cells, a human fetal liver x MEL
      somatic cell hybrid, and reticulocytes and bone marrow cells from normal adults.
      theta 1-Globin gene was expressed in all cell types. Inducible expression (two-
      to sixfold) was documented both in HEL and K562 erythroleukemia cells after 5
      azacytidine treatment. Like K562 cells, HEL cells also displayed hemin-inducible
      theta 1-globin gene expression. Following transfer of human chromosome 16 from
      embryonic/fetal K562 to the adult MEL cells, theta 1-globin gene remained active
      but lost its potential for inducibility, suggesting probably a trans regulation
      mechanism. Higher levels of theta 1 mRNA were found in fetal liver cells compared
      with trace amounts in reticulocytes and normal adult bone marrow cells. These
      data clearly show that in contrast to the embryonic and adult patterns of
      expression of zeta and alpha-globin genes, respectively, theta 1-globin gene
      displays a different profile, being active predominantly during the early stages
      of ontogeny, switching to lower levels of expression in adulthood.

PMID- 2239921
TI  - Massive mediastinal extramedullary hematopoiesis in hereditary spherocytosis: a
      case report.
AB  - A case of extramedullary hematopoiesis (EMH) with a massive mediastinal mass in a
      72-year-old woman with hereditary spherocytosis is reported. Several cases of EMH
      have been described in nonsplenectomized adults with hereditary spherocytosis,
      and it is thought to be a consequence of long-term stimulation of erythropoiesis.
      The exact mechanism remains controversial. EMH should be considered in the
      differential diagnosis of an asymptomatic paravertebral mass.

PMID- 2239922
TI  - Extranodal T-cell lymphoma mimicking malignant histiocytosis.
AB  - We report a case of extranodal T-cell lymphoma with fever, hepatosplenomegaly,
      pancytopenia, and diffuse sinusoidal infiltration of the spleen, liver, and bone
      marrow by the tumor cells, mimicking malignant histiocytosis. This is the second
      case of T-gamma (T-cell suppressor) lymphoma resembling the case reported by
      Kadin et al. [N Engl J Med 304:648, 1981]. The lack of lymph node involvement in
      this case supports the theory that this type of lymphoma arises in the spleen.
      This paper draws attention to the extranodal T-cell lymphoma groups that mimic
      malignant histiocytosis and the need of immunophenotyping for a correct
      diagnosis. The causes for the absence of T-cell receptor gene rearrangement in T
      cell tumors are discussed.

PMID- 2239923
TI  - Evaluation of an automated bleeding time device in the newborn.
AB  - Sick infants frequently developed impaired hemostasis as a secondary event.
      Abnormal platelet-vessel wall interaction contributes to the hemorrhagic side
      effects. Currently, the bleeding time is the best measure of in vivo platelet
      participation in small vessel hemostasis. Bleeding times in the newborn have been
      previously determined with an automated device designed for the adult or with
      nonautomated devices. The automated bleeding time device for the adult is not
      suitable for the infant (length 5 mm, depth 1 mm). We evaluated the performance
      of an automated bleeding time device designed specifically for the newborn making
      a cut 2.5 mm in length and 0.5 mm in depth. The results with the automated device
      showed a strong correlation with the modified template bleeding time device
      previously used for the newborn. The normal range was shorter and the sensitivity
      to abnormal vessel wall interaction was greater with the automated device. As
      well, the ease of determining the bleeding time with the automated device was
      considerably improved over the template device.

PMID- 2239924
TI  - Induction of alkaline phosphatase activity in chronic myeloid leukemia cells: in
      vitro studies and speculative hypotheses.
AB  - Three patients with Ph chromosome + chronic myeloid leukemia (CML) in chronic
      phase suffered from intercurrent pleuritis of undefined origin. At that time,
      leucocyte alkaline phosphatase activity (LAPA) score was low for circulating
      neutrophils, but high for those from pleural effusion. LAP negative circulating
      CML granulocytes were incubated with the pleural liquid: after 40-70 hr, almost
      all were intensely LAP positive. This finding suggests that the low LAPA score in
      resting CML neutrophils is attributable to the absence of appropriate stimuli
      rather than to an incapacity to synthesize the enzyme.

PMID- 2239925
TI  - Recurrent disseminated intravascular coagulation and fulminant intra hepatic
      thrombosis in a patient with the anti-phospholipid syndrome.
AB  - We describe a patient with the lupus anti-coagulant who had recurrent episodes,
      over a 2 year period, of a severe and disseminated intravascular coagulopathy.
      This patient also had positive serological assays for syphilis and anti
      cardiolipin antibodies. Associated with the coagulopathy were co-expressed
      episodes of liver disease, ultimately terminating in fulminant liver failure. At
      autopsy the features were characteristic of the Budd-Chiari syndrome. This is the
      first report to document how consumptive coagulopathy may present as a dominant
      feature of the anti-phospholipid syndrome. It also clearly describes an immune
      mediated thrombotic mechanism as a cause of hepatic veno-occlusive disorders.
      Furthermore, this case highlights the varied clinical spectrum of the anti
      phospholipid syndrome and suggests that a high index of suspicion is required to
      ensure its diagnosis.

PMID- 2239926
TI  - Necrobiotic xanthogranuloma with IgA multiple myeloma: a case report and
      literature review.
AB  - The association between necrobiotic xanthogranuloma of the dermis and
      paraproteinemia and/or B-cell malignancy is best described in the ophthalmologic
      literature. We report a case which occurred in the eyelid and orbit of a 64 year
      old man that led to the diagnosis of an IgA multiple myeloma. To our knowledge,
      this is the first report of an IgA type paraproteinemia and IgA type multiple
      myeloma associated with necrobiotic xanthogranuloma.

PMID- 2239927
TI  - A fatal case of low titer anti-PR cold agglutinin disease.
AB  - Cold agglutinin disease typically produces a low-grade hemolytic anemia. We
      describe herein the unusual occurrence of an anti-PR cold agglutinin with high
      thermal amplitude which caused significant and ultimately fatal hemolytic anemia
      at very low titers.

PMID- 2239928
TI  - High-dose methylprednisolone in children with acute nonlymphoblastic leukemia.

PMID- 2239929
TI  - Autosomal dominant polycystic kidney disease--more than a renal disease.
AB  - Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic
      disease, affecting a half million Americans. The clinical phenotype can result
      from at least two different gene defects. One gene that can cause ADPKD has been
      located on the short arm of chromosome 16. This discovery has made possible new
      methods for diagnosing the disorder in gene carriers prior to the development of
      renal cysts. Although renal cysts are clearly an important manifestation of the
      gene defect, other systemic manifestations are both common and clinically
      important. Cardiac valvular lesions, intracranial aneurysms, hepatic cysts, and
      diverticula are included in the array of systemic manifestations. Moreover, renal
      cysts are only one of a myriad of renal manifestations. Although ADPKD was long
      considered an adult cystic disease, it is also a common cause of childhood cystic
      disease and must be considered in the differential diagnosis in that setting.

PMID- 2239930
TI  - Cyclosporine nephrotoxicity and the role of cyclosporine in living-related donor
      transplantation.

PMID- 2239931
TI  - HLA-identical renal transplants: impact of cyclosporine on intermediate-term
      survival and renal function.
AB  - Seventy-two and 34 consecutive HLA-identical sibling renal transplant recipients
      were treated with azathioprine/prednisone (AZA; follow-up, 5.0 years) and
      cyclosporine/prednisone (CSA; mean follow-up, 2.9 years), respectively. Both
      groups were similar in age, sex, race, and number of transplants, but there were
      more diabetics in the CSA group (34% v 8%). Actual patient survival at 1 year and
      actuarial patient survival at 5 years were 100% and 96%, respectively in the CSA
      group compared with an actual patient survival of 91% and 82% at 1 and 5 years,
      respectively, in the AZA group. Actual graft survival at 1 year improved from 85%
      in the AZA group to 97% in the CSA-treated recipients (P less than 0.05). Mean
      serum creatinine at 5 years remained stable in the AZA group at a mean of 123
      mumol/L (1.4 mg/dL) compared with a progressive increase in this parameter to a
      mean of 212 mumol/L (2.4 mg/dL) after the same time interval in the CSA patients.
      Furthermore, the slopes of the serum creatinine against time were significantly
      different between the two groups (P less than 0.01). Mean daily CSA dose averaged
      4 mg/kg 12 months following transplantation, with a decrease to 2.4 mg/kg by the
      fifth year. Causes of death in the AZA group were cardiovascular (eight), sepsis
      (three), cancer (one); and in the CSA group, Kaposi's sarcoma (one). Causes of
      graft failure in the AZA group were immunological (six), sepsis (three),
      technical (two), recurrence of disease (one), and patient death with a
      functioning graft (five). Technical (one), noncompliance (two), recurrence of
      disease (one), and patient death with a functioning kidney (one) caused graft
      failure in the CSA group. No difference in posttransplantation serum cholesterol
      or incidence of new onset diabetes was observed between the two groups, but
      hypertension was significantly more frequent (51% v 21%, P less than 0.01) when
      CSA was used. In conclusion, intermediate-term results of CSA-treated HLA
      identical transplant recipients showed improved patient and graft survival with
      less complications apart from hypertension. However, the slow, but relentless,
      increase in serum creatinine in the CSA-treated patients compared with those
      treated with AZA is of concern.

PMID- 2239932
TI  - Extracorporeal removal of anti-HLA antibodies in transplant candidates.
AB  - We report on the results of a clinical trial in which 14 transplant candidates
      were treated with an extracorporeal immunoadsorption system using Protein A that
      selectively removes immunoglobulin from plasma; we also assessed the dynamics of
      anti-HLA antibody as a model of IgG removal and re-equilibration, as well as the
      clinical safety of the procedure. At the end of a treatment course, plasma IgG
      levels were reduced by 90% +/- 8% of control values (P less than 0.01). In
      contrast, albumin levels were reduced by only 15% (P less than 0.05). Specific
      cytotoxic anti-HLA antibody titers were reduced by approximately 18-fold. Panel
      reactivity was measured as the proportion of a 40-member cell donor panel killed
      by patients' serum in the presence of complement; in nine of the 14 patients,
      there was a significant reduction in this parameter (range, 23% to 87%). During
      the 4-week follow-up period, anti-HLA antibody titers returned to baseline
      levels. There were no remarkable changes observed in blood chemistries, nor were
      there any unanticipated adverse reactions seen in the patients treated. We
      conclude that selective extracorporeal immunoadsorption is a safe and effective
      way of removing IgG-type antibodies, with potential application to reduction of
      HLA antibodies in transplant candidates.

PMID- 2239933
TI  - Adult minimal change glomerulopathy with acute renal failure.
AB  - Oliguric acute renal failure occurs in some adult patients with minimal change
      glomerulopathy. To look for clinical and pathologic factors that increase the
      risk for developing acute renal failure, 21 adults with minimal change
      glomerulopathy and a serum creatinine greater than 177 mumol/L (mean, 486
      mumol/L; range, 194 to 1,344 mumol/L) (greater than 2.0 mg/dL [mean, 5.5 mg/dL;
      range, 2.2 to 15.2 mg/dL]) were compared with 50 adults with minimal change
      glomerulopathy and a serum creatinine less than 133 mumol/L (mean, 88 mumol/L;
      range, 53 to 124 mumol/L) (less than 1.5 mg/dL [mean, 1.0 mg/dL; range, 0.6 to
      1.4 mg/dL]). Minimal change glomerulopathy patients with acute renal failure were
      older (59.5 v 40.3 years, P less than 0.001), and had higher systolic blood
      pressure (158 v 138 mm Hg, P = 0.001), more proteinuria (13.5 v 7.9 g/24 h, P =
      0.01), and more arteriosclerosis in the renal biopsy specimen (1.7 + v 0.7 + on a
      scale of 0 to 4+, P = 0.005). Tubular epithelial simplification identical to that
      observed with ischemic acute renal failure (acute tubular necrosis) was observed
      in 71% of the patients with serum creatinine greater than 177 mumol/L (greater
      than 2.0 mg/dL) and 0% of those with less than 133 mumol/L (less than 1.5 mg/dL).
      All 18 patients with renal failure for whom follow-up data were available had
      recovery of function (mean creatinine, 539 +/- 301 mumol/L [6.1 +/- 3.4 mg/dL] at
      the time of biopsy and 106 +/- 27 mumol/L [1.2 +/- 0.3 mg/dL] at last follow-up),
      but sometimes only after weeks of dialysis support.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2239934
TI  - Body fluid spaces and blood pressure in hemodialysis patients during amelioration
      of anemia with erythropoietin.
AB  - Blood pressure (BP) may increase in hemodialysis patients during treatment of
      anemia with recombinant human erythropoietin (r-HuEPO). Since fluid volume is a
      determinant of BP in dialysis patients, changes in body fluid spaces during r
      HuEPO therapy could affect BP. Thus, 51Cr-labeled red blood cell (RBC) volume,
      inulin extracellular fluid (ECF) volume, and urea total body water (TBW), as well
      as cardiac output, plasma renin activity (PRA), and plasma aldosterone
      concentration were determined postdialysis before and after r-HuEPO therapy in
      patients in whom changes in BP could be managed by ultrafiltration alone. Eleven
      patients entered the study: one had a renal transplant and two required addition
      of antihypertensive drug therapy and were excluded; eight, of whom two required
      antihypertensive drug therapy following the study, were included in the analyses.
      Results revealed an increase in predialysis hemoglobin from 67 to 113 g/L (6.7 to
      11.3 g/dL) (P = 0.001) during 18 +/- 6 weeks of therapy. Predialysis diastolic BP
      increased from 80 to 85 mm Hg (P = 0.07), while postdialysis diastolic BP was
      unchanged at 73 mm Hg. 51Cr-RBC volume increased, from 0.7 to 1.3 L (P = 0.004).
      ECF tended to decrease, from 13.7 to 10.8 L (P = 0.064), while TBW decreased to a
      similar extent, but not significantly, 34.3 to 31.2 L (P = 0.16). Postdialysis
      ECF volume was positively correlated with mean arterial BP at baseline (r = 0.89,
      P = 0.007) and after therapy (r = 0.74, P = 0.035). However, the regression lines
      for this relationship were different (P = 0.022) before and after
      therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2239936
TI  - Ten-year prospective study on the development of renal cell carcinoma in dialysis
      patients.
AB  - A prospective study was undertaken to investigate the development of renal cell
      carcinoma in dialysis patients. Three renal cell carcinomas were detected among
      96 hemodialysis patients in 1979, and screening by computed tomographic (CT) scan
      was continued yearly until 1989. During this 10-year period, one renal cell
      carcinoma was found in the second year and another in the ninth year. Autopsy
      performed on seven of 19 patients who died showed one case of small clear cell
      carcinoma accompanying acquired cystic disease. In 33 males, kidneys were found
      to have enlarged 2.7 +/- 1.7 times over the 10-year follow-up due to acquired
      cysts, while no change in kidney volume was noted in 24 females. Native kidneys
      in nine of 12 patients who maintained functioning grafts were reduced in size.
      The patient with the largest kidney enlargement (11.5 times) died from
      retroperitoneal bleeding in 1989. These prospective study results suggest that
      both the incidence and prevalence of renal cell carcinoma in dialysis patients is
      high. Furthermore, major complications of acquired renal cystic disease seem to
      occur predominantly in males.

PMID- 2239935
TI  - Bioavailability of iron in hemodialysis patients treated with erythropoietin:
      evidence for the inhibitory role of aluminum.
AB  - The dose of recombinant human erythropoietin (r-HuEPO) required to correct the
      anemia of end-stage renal disease (ESRD) varies among patients. The response to r
      HuEPO is impaired if absolute or relative iron deficiency exists. Aluminum may
      cause a microcytic anemia in patients with ESRD, but the mechanism remains
      incompletely defined. Twenty-two patients in the Canadian Multicentre EPO trial
      were studied for 6 months. In this randomized double-blind placebo-controlled
      trial, free erythrocyte protoporphyrin (FEP) was used as an indicator of iron
      deficient deficient erythropoiesis. The relationship of FEP to the estimates of
      iron availability (serum iron, transferrin saturation, ferritin) and iron
      utilization (corrected reticulocyte count, hemoglobin) was evaluated by multiple
      linear regression analysis. The effect of aluminum on FEP was evaluated by
      adjusting the statistical model for this variable. All patients were iron replete
      as assessed by serum ferritin. FEP was not related to serum aluminum before
      administration of r-HuEPO, but it was significantly correlated with aluminum in
      the treated group. In hemodialysis patients treated with r-HuEPO, the proportion
      of the variability explained by the parameters of iron utilization and iron
      availability was 0.27. The effect of aluminum increased this to 0.59. In
      hemodialysis patients not receiving r-HuEPO, the proportion of variability in FEP
      explained by the model increased from 0.16 to 0.28 by adjusting for aluminum. The
      data support the hypothesis that aluminum interferes with the bioavailability of
      stored iron for erythropoiesis and thus may result in a microcytic anemia in
      patients with ESRD or may blunt their response to r-HuEPO therapy.

PMID- 2239938
TI  - Brachial-jugular polytetrafluoroethylene fistulas for hemodialysis.
AB  - A retrospective analysis was made of 16 patients who had received a brachial
      jugular polytetrafluoroethylene (PTFE) graft for hemodialysis. In four patients,
      the procedure was used to treat malfunctioning brachio-axillary fistulas due to
      long venous stenosis in the axillary vein. In 12 other patients, the operation
      was chosen in cases of exhaustion of the veins in the upper extremity because of
      previous multiple failed fistulas. Two patients died with a functioning fistula 7
      and 10 months after placement of the graft of causes unrelated to the vascular
      access. The other 14 patients retained functioning fistulas between 8 and 26
      months after construction of the shunt. Three patients needed graft thrombectomy
      to treat occlusive episodes. No venous stenosis was found in a postoperative
      fistulography made in those patients. One patient needed substitution of a graft
      segment due to stenosis of the prosthesis crossing over the clavicle. We believe
      that the brachial-jugular graft is a procedure that can be considered as vascular
      access for hemodialysis in cases where the use of veins in the upper extremity
      and the axilla is not possible.

PMID- 2239937
TI  - Etiology of hypercalcemia in hemodialysis patients on calcium carbonate therapy.
AB  - Fourteen of 39 dialysis patients (36%) became hypercalcemic after switching to
      calcium carbonate as their principal phosphate binder. In order to identify risk
      factors associated with the development of hypercalcemia, indirect parameters of
      intestinal calcium reabsorption and bone turnover rate in these 14 patients were
      compared with results in 14 eucalcemic patients matched for age, sex, length of
      time on dialysis, and etiology of renal disease. In addition to experiencing
      hypercalcemic episodes with peak calcium values of 2.7 to 3.8 mmol/L (10.7 to
      15.0 mg/dL), patients in the hypercalcemic group exhibited a significant increase
      in the mean calcium concentration obtained during 6 months before the switch,
      compared with the mean value obtained during the 7 months of observation after
      the switch (2.4 +/- 0.03 to 2.5 +/- 0.03 mmol/L [9.7 +/- 0.2 to 10.2 +/- 0.1
      mg/dL], P = 0.006). In contrast, eucalcemic patients exhibited no change in mean
      calcium values over the same time period (2.3 +/- 0.05 to 2.3 +/- 0.05 mmol/L
      [9.2 +/- 0.2 to 9.2 +/- 0.2 mg/dL]). CaCO3 dosage, calculated dietary calcium
      intake, and circulating levels of vitamin D metabolites were similar in both
      groups. Physical activity index and predialysis serum bicarbonate levels also
      were similar in both groups. However, there was a significant difference in
      parameters reflecting bone turnover rates between groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2239939
TI  - Adult and pediatric peritonitis rates in a home dialysis program: comparison of
      continuous ambulatory and continuous cycling peritoneal dialysis.
AB  - We reviewed our 115-month experience with continuous ambulatory peritoneal
      dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) in adult and
      pediatric patients to determine whether there is a difference in the incidence of
      peritonitis between patients performing CAPD or CCPD. Peritonitis rates were
      similar in patients performing CAPD or CCPD in both the adult and pediatric age
      groups. The overall CAPD peritonitis rate was significantly lower in adult
      patients when compared with pediatric patients. There was no difference in
      peritonitis rates for CCPD between adult and pediatric patients. When the data
      are divided into 3-year subgroups, the incidence of peritonitis is significantly
      lower in adult patients undergoing either CAPD or CCPD when compared with
      pediatric patients during the years 1986 to 1988. There is significant
      improvement over time in the incidence of peritonitis in both adult and pediatric
      patients performing CCPD; similarly, there is a trend toward improvement in
      patients performing CAPD. Staphylococcus species organisms remain the most common
      bacterial cause of peritonitis, except in pediatric patients under the age of 2
      years or with nephrostomies, where gram-negative rod infections were more common.
      Peritonitis resulted in discontinuation of peritoneal dialysis in a greater
      number of adult patients. These results suggest that the number of catheter
      manipulations is not important in determining the incidence of peritonitis.
      Pediatric patients are more likely than adult patients to develop peritonitis
      with either CAPD or CCPD. Adult patients are more likely than pediatric patients
      to discontinue peritoneal dialysis secondary to peritonitis.

PMID- 2239940
TI  - The renal concentrating defect associated with potassium depletion is independent
      of prostaglandin E2.
AB  - Prostaglandin E2 (PGE2) impairs the hydrosmotic effect of vasopressin in toad
      bladder and mammalian kidney. Because some studies in animals have suggested that
      potassium depletion enhances renal PGE2 production, the present study examined
      whether the renal concentrating defect of potassium depletion in humans is
      mediated by PGE2. Five normal volunteers were studied before and after moderate
      potassium depletion achieved by 10 days of dietary potassium restriction and
      administration of a polystyrene sulfonate potassium exchange resin (Kayexalate).
      Maximal urinary osmolality (Umax) decreased from 1,094 +/- 58 (mean +/- SEM) to
      820 +/- 26 mmol/kg (mOsm/kg) (P less than 0.01) following potassium depletion,
      but urinary PGE2 excretion did not change (496 +/- 145 and 435 +/- 186 ng/d,
      respectively). Indomethacin suppressed PGE2 excretion significantly, but failed
      to increase Umax in either the normal or the potassium-depleted state (1,094 +/-
      34 and 825 +/- 56 mmol/kg, respectively). It is concluded that the renal
      concentrating defect produced by moderate potassium restriction in humans is not
      mediated by PGE2.

PMID- 2239941
TI  - Ultrasonography in the differentiation of complicated and uncomplicated acute
      pyelonephritis.
AB  - Differentiation of uncomplicated pyelonephritis versus complicated pyelonephritis
      has always been problematic. No clear physical signs or symptoms are diagnostic.
      To study differences between the two, we retrospectively reviewed charts of
      patients admitted to Charity Hospital, New Orleans, with febrile urinary tract
      infections. Criteria for inclusion were pyuria, positive urinary culture, and
      signs or symptoms of pyelonephritis. All patients underwent renal ultrasonography
      (US) before other diagnostic tests. US identified a potential emergency
      (hydronephrosis or abscess) in 11 of 98 patients (11.2%). The only significant
      contributing factor was the presence of diabetes mellitus, which was present in
      five of 11 emergent conditions and eight of 73 of the remainder (P = 0.003). US
      is inexpensive, easily obtainable in the emergency room, and sensitive enough to
      screen patients with pyelonephritis for complications. However, we believe it is
      mandatory in diabetics, because of the high incidence of abnormalities in this
      population.

PMID- 2239942
TI  - Tubulointerstitial changes in systemic vasculitic disorders: a quantitative study
      of 18 biopsy cases.
AB  - Tubulointerstitial alterations were studied in 18 biopsy cases of systemic
      vasculitis. To evaluate the changes more objectively, two indexes, the number of
      interstitial inflammatory cells and tubulitis percentage, were used. The group
      means of both of these indexes were statistically higher than those of the
      autopsy control group, while 14 of the cases (77.8%) showed a significant
      difference (P less than 0.01) between individual means and the control group
      means. On the other hand, tubulointerstitial changes in systemic vasculitis
      seemed to be less prominent than drug-induced tubulointerstitial nephritis (TIN)
      according to these indexes. However, comparing these indexes with those of drug
      induced TIN, six cases (33.3%) of systemic angiitis could be regarded as having
      developed pathologic changes similar to TIN. Statistical difference was not shown
      in the indexes between those patients with histologic evidence of necrotizing
      angiitis and those without it. Clinically, urinary N-acetyl-beta-D
      glucosaminidase (NAG) was abnormally high in all three examined cases, reflecting
      the damage of renal tubular epithelial cells. Not only the vascular and
      glomerular lesions, but also tubulointerstitial changes, should be evaluated in
      the renal biopsy specimen of systemic vasculitis.

PMID- 2239943
TI  - The role of aluminum in the functional iron deficiency of patients treated with
      erythropoietin: case report of clinical characteristics and response to
      treatment.
AB  - The quantitative variation among patients in their response to erythropoietin can
      be explained, in part, by factors that can independently cause anemia in patients
      with end-stage renal disease. Aluminum can blunt the effect of erythropoietin, in
      part by interfering with iron bioavailability. This inhibitory effect cannot be
      completely overcome by aggressive ferrotherapy, but can be reversed with aluminum
      chelation therapy. A patient is described who developed hematological evidence of
      aluminum excess after being treated with erythropoietin. The biochemical evidence
      of functional iron deficiency and the response to aluminum chelation therapy
      support the hypothesis that the inhibitory effect of aluminum on erythropoiesis
      is mediated by the interference of aluminum with the bioavailability of iron.

PMID- 2239944
TI  - Temporary loss of limb function secondary to soft tissue calcification in a
      patient with rhabdomyolysis-induced acute renal failure.
AB  - A case of unusually severe soft tissue calcification with temporary loss of limb
      function in a patient with rhabdomyolysis-induced acute renal failure (ARF) is
      described. A large dose of intravenous (IV) calcium was administered early in the
      hospital course to treat hypocalcemia, and hemodialysis, when initiated, was with
      a 1.75-mmol/L calcium dialysate. This case illustrates the danger of
      administering calcium supplementation and raises questions about the use of
      normal to high dialysate calcium concentration in the early stages of
      rhabdomyolysis-induced oliguric ARF. Calcium supplementation should be reserved
      for patients with clear clinical signs of hypocalcemia and dialysate calcium
      should be adjusted to prevent excessive positive calcium balance.

PMID- 2239945
TI  - Does magnesium play a role in the hypokalemia of Bartter's syndrome?
AB  - A patient with Bartter's syndrome manifested hypomagnesemia in addition to
      hypokalemia. Under conditions of maximal free water production, he had a
      fractional distal solute reabsorption of 0.65, a value consistent with a renal
      defect in sodium chloride reabsorption in the thick ascending limb of the loop of
      Henle. This is also the site of 65% to 70% of urinary magnesium reabsorption.
      With magnesium supplementation and amiloride, the urinary potassium decreased and
      the serum potassium increased. Atrial natriuretic peptide concentrations in the
      plasma were low. Evaluation of family members showed five of nine offspring had
      hypokalemia with no disorder in the parents, an apparent autosomal recessive mode
      of inheritance. This is a US government work. There are no restrictions on its
      use.

PMID- 2239946
TI  - De novo crescentic glomerulonephritis in a renal transplant.

PMID- 2239947
TI  - The past and future of nephrology and urology.

PMID- 2239948
TI  - A personalized history of chronic hemodialysis.

PMID- 2239949
TI  - The roaring 50s: acute renal failure and dialysis of drugs, poisons, and
      nephrotoxins.

PMID- 2239950
TI  - The development of renal physiology since 1950.

PMID- 2239951
TI  - The application of micropuncture techniques to analysis of renal function: a
      personal view.

PMID- 2239952
TI  - The evolution of the science of pathologic physiology.

PMID- 2239954
TI  - Development of pediatric nephrology.

PMID- 2239953
TI  - The development of clinical renal transplantation.

PMID- 2239955
TI  - The development of urology as a scientific and clinical discipline.

PMID- 2239956
TI  - The development of renal pathology.

PMID- 2239958
TI  - The history and current status of continuous ambulatory peritoneal dialysis.

PMID- 2239957
TI  - The development of immunopathologic investigation of kidney disease.

PMID- 2239959
TI  - The development of percutaneous renal biopsy in man.

PMID- 2239960
TI  - The future of nephrology.
AB  - The Cellular and Molecular Age of Nephrology has dawned and the future is
      remarkably exciting. The successful attack on the major causes of renal disease,
      including genetic diseases, glomerulonephritis, diabetes, vasculitis, acute renal
      failure, and hypertension, will necessitate improved knowledge about
      pathogenesis. This new knowledge will allow early detection and target-specific
      therapies, the array of which is only limited by our imagination. The challenge
      to be an active player in this exciting future as a physician-scientist in the
      field of nephrology is indeed a rare opportunity.

PMID- 2239961
TI  - The future of urology.

PMID- 2239962
TI  - AJKD in retrospect: the first ten years.

PMID- 2239963
TI  - Epilogue: the National Kidney Foundation--its contributions to nephrology.

PMID- 2239964
TI  - The United States Renal Data System's 1990 Annual Data Report: an introduction.

PMID- 2239965
TI  - Recombination between two 14-bp homologous sequences as the mechanism for gene
      deletion in factor IX Seattle 1.
AB  - Factor IXSeattle 1 is a 10-kb intragenic deletion identified in a family that has
      hemophilia B. By sequencing across the site of the deletion, we discovered at the
      deletion junction a 13-bp sequence (5' . . . TAGAA-GTTCACTT . . . 3') that was
      homologous to two 14-bp sequences 10 kb apart in introns D and F of the normal
      factor IX gene. The presence of these homologous sequences in two different
      regions of the normal gene allows us to propose that genetic recombination has
      occurred between the sequences, resulting in the gene deletion. The precise
      recombination site was able to be localized to one of 5 bp (5' . . . AGTTC . . .
      3') in the middle of the homologous sequences. The exact length of the deletion
      is 10,000 bp.

PMID- 2239966
TI  - Rapid detection of the hemoglobin C mutation by allele-specific polymerase chain
      reaction.

PMID- 2239967
TI  - The slash sheet: a simple procedure for risk analysis in cystic fibrosis.

PMID- 2239968
TI  - Family cell lines available for research.

PMID- 2239969
TI  - Genetic linkage and heterogeneity in type I Charcot-Marie-Tooth disease
      (hereditary motor and sensory neuropathy type I).
AB  - The segregation patterns of DNA markers from the pericentromeric regions of
      chromosomes 1 and 17 were studied in seven pedigrees segregating an autosomal
      dominant gene for Charcot-Marie-Tooth neuropathy type I (CMT I; hereditary motor
      and sensory neuropathy I). A multilocus analysis with four markers (pMCR-3,
      pMUC10, FY, and pMLAJ1) spanning the pericentromeric region of chromosome 1
      excluded the CMT I gene from this region in six pedigrees but gave some evidence
      for linkage to the region of Duffy in one pedigree. Linkage of the CMT I gene to
      markers in the pericentromeric region of chromosome 17 (markers pA10-41, pEW301,
      p3.6, and pTH17.19) was established; however, in these seven pedigrees
      homogeneity analysis with chromosome 17 markers detected significant genetic
      heterogeneity. This analysis suggested that three of the seven pedigrees are not
      linked to this same region. Overall, two of the seven CMT I pedigrees were not
      linked to markers tested from chromosomes 1 or 17. These results confirm genetic
      heterogeneity in CMT I and implicate the existence of a third autosomal locus, in
      addition to a locus on chromosome 17, and a probable locus on chromosome 1. This
      evidence of etiological heterogeneity, supported by statistical tests, will have
      to be taken into consideration when fine-structure genetic maps of the regions
      around CMT I are constructed.

PMID- 2239970
TI  - Localization of the microsatellite probe DXS426 between DXS7 and DXS255 on Xp and
      linkage to X-linked retinitis pigmentosa.
AB  - The microsatellite marker DXS426 maps to the interval Xp21.1-Xp11.21, the
      chromosomal region which contains two loci for X-linked retinitis pigmentosa
      (XLRP; RP2 and RP3). We have refined the localization of DXS426 both physically,
      by mapping it to a deletion which spans the interval Xp21.3-Xp11.23, and
      genetically, by studying multiply informative crossovers which indicate that
      DXS426 lies between DXS7 and DXS255 (i.e., Xp11.4-Xp11.22). As this is the region
      which contains the RP2 gene, RP2 families could be identified on the basis of
      linkage of XLRP to DXS426. Multiply informative crossovers in two RP2 families
      indicate that the most likely location of the RP2 gene is between DXS426 and
      DXS7. DXS426 is therefore an important highly informative marker for the purposes
      of carrier detection and early diagnosis of RP2 and for the localization of the
      disease gene.

PMID- 2239972
TI  - Multipoint analysis of human quantitative genetic variation.
AB  - A unique method of partitioning human quantitative genetic variation into effects
      due to specific chromosomal regions is presented. This method is based on
      estimating the proportion of genetic material, R, shared identical by descent
      (IBD) by sibling pairs in a specified chromosomal region, on the basis of their
      marker genotypes at a set of marker loci spanning the region. The mean and
      variance of the distribution of R conditional on IBD status and recombination
      pattern between two marker loci are derived as a function of the distance between
      the two loci. The distribution of the estimates of R is exemplified using data on
      22 loci on chromosome 7. A method of using the estimated R values and observed
      values of a quantitative trait in a set of sibships to estimate the proportion of
      total genetic variance explained by loci in the region of interest is presented.
      Monte Carlo simulation techniques are used to show that this method is more
      powerful than existing methods of quantitative linkage analysis based on sib
      pairs. It is also shown through simulation studies that the proposed method is
      sensitive to genetic variation arising from both a single locus of large effect
      as well as from several loosely linked loci of moderate phenotypic effect.

PMID- 2239971
TI  - Autosomal dominant retinitis pigmentosa: absence of the rhodopsin proline---
      histidine substitution (codon 23) in pedigrees from Europe.
AB  - In exon 1 at codon 23 of the rhodopsin gene, a mutation resulting in a proline-to
      histidine substitution has previously been observed in approximately 12% of
      American autosomal dominant retinitis pigmentosa (ADRP) patients. The region
      around the site of this mutation in the rhodopsin gene has been amplified and
      analyzed in affected individuals from 91 European ADRP pedigrees. The codon 23
      mutation has been found to be absent in all cases, including a large Irish
      pedigree in which the disease gene has previously been shown to be closely linked
      to the rhodopsin locus. This indicates the presence of either allelic or
      nonallelic heterogeneity in ADRP.

PMID- 2239973
TI  - Replication patterns of the fragile X in heterozygous carriers: analysis by a
      BrdUrd antibody method.
AB  - The replication status of the fragile X chromosomes was studied in short-term
      cultures of lymphocytes from six female heterozygous carriers. The fragile X was
      induced by adding 0.1 microM fluorodeoxyuridine during the last 24 h of
      culturing. The replication status of the X chromosomes was studied using a
      bromodeoxyuridine (BrdUrd) antibody method. BrdUrd was added (1) at a final
      concentration of 0.2 micrograms/ml during the early S phase of chromosome
      replication (16-10 h before harvest), (2) at 0.2 microgram/ml during the late S
      phase (the last 6 h of culturing), (3) at 20 micrograms/ml during the early S
      phase, and (4) at 20 micrograms/ml during the late S phase. BrdUrd that was
      incorporated into replicating chromosomes was detected by using a nuclease and
      BrdUrd monoclonal antibody. The frequency of the fragile X was reduced by BrdUrd
      treatment. The degree of reduction was more severe in the 20 micrograms/ml than
      in the 0.2 microgram/ml series and was more severe with late S than with early S
      treatment. Of the early- and late-replicating fragile X chromosomes, those which
      were actively replicating during a BrdUrd treatment were more reduced than the
      others. Thus, the average rate of early and late S treatment with 0.2 microgram
      BrdUrd/ml was assumed to be the closest reflection of the situation in vivo.
      There was no correlation between the average rate of the early replicating,
      active fragile X and the intelligence of the heterozygous carriers studied.

PMID- 2239974
TI  - Intravenous immunoglobulin treatment for the chronic fatigue syndrome.

PMID- 2239975
TI  - A controlled trial of intravenous immunoglobulin G in chronic fatigue syndrome.
AB  - PURPOSE: Currently, there is no established therapy for chronic fatigue syndrome
      (CFS), a recently defined illness that has been associated with a variety of
      immunologic abnormalities. Based on the hypothesis that a chronic viral infection
      or an immunoregulatory defect is involved in the pathogenesis of CFS, the
      therapeutic benefit of intravenous immunoglobulin G (IV IgG) was evaluated in a
      group of patients with CFS. Additionally, serum immunoglobulin concentrations and
      peripheral blood lymphocyte subset numbers were measured at the outset of the
      study, and the effect of IV IgG therapy on IgG subclass levels was determined.
      PATIENTS AND METHODS: Thirty patients with CFS were enrolled in a double-blind,
      placebo-controlled trial of IV IgG. The treatment regimen consisted of IV IgG (1
      g/kg) or intravenous placebo (1% albumin solution) administered every 30 days for
      6 months. Participants completed a self-assessment form prior to each of the six
      treatments, which was used to measure severity of symptoms, functional status,
      and health perceptions. Patients were also asked to report adverse experiences
      defined as worsening of symptoms occurring within 48 hours of each treatment.
      RESULTS: Twenty-eight patients completed the trial. At baseline, all 28 patients
      complained of moderate to severe fatigue, and measures of social functioning and
      health perceptions showed marked impairment. Low levels of IgG1 were found in 12
      (42.9%), and 18 (64.3%) had low levels of IgG3. At the end of the study, no
      significant therapeutic benefit could be detected in terms of symptom
      amelioration or improvement in functional status, despite restoration of IgG1
      levels to a normal range. Major adverse experiences were observed in 20% of both
      the IV IgG and placebo groups. CONCLUSION: The results of this study indicate
      that IV IgG is unlikely to be of clinical benefit in CFS. In addition to the
      ongoing need for placebo-controlled trials of candidate therapies for CFS, an
      expanded research effort is needed to define the etiology and pathogenesis of
      this disorder.

PMID- 2239976
TI  - A bleeding risk index for estimating the probability of major bleeding in
      hospitalized patients starting anticoagulant therapy.
AB  - PURPOSE: To construct and test prospectively a bleeding risk index for estimating
      the probability of major bleeding in hospitalized patients starting long-term
      anticoagulant therapy. PATIENTS AND METHODS: In an inception cohort of 617
      patients starting long-term anticoagulant therapy in one hospital, data were
      gathered retrospectively and bleeding was classified using reliable explicit
      criteria. We constructed a bleeding risk index by identifying and weighting
      independent predictors of major bleeding using a multivariate proportional
      hazards model. The bleeding risk index was tested in 394 other patients
      prospectively identified in a second hospital. The index was compared to
      physicians' predictions. RESULTS: Major bleeding developed before discharge in 61
      of all 1,011 patients (6%). The bleeding risk index included four independent
      risk factors for major in-hospital bleeding: the number of specific comorbid
      conditions; heparin use in patients aged 60 years or older; maximal prothrombin
      or partial thromboplastin time 2.0 or more times control; liver dysfunction
      worsening during therapy. In the testing group, the index predicted major
      bleeding, which occurred in 3% of 235 low-risk patients, 16% of 96 middle-risk
      patients, and 19% of 63 high-risk patients (p less than 0.001). The bleeding risk
      index performed as well as physicians' predictions, and integration of the
      bleeding risk index with physicians' predictions led to a classification system
      that was more sensitive (p = 0.03) than physicians' predictions alone. In 86% of
      patients with a high risk of major bleeding, we identified specific ways of
      improving therapy, e.g., avoiding overanticoagulation and nonsteroidal anti
      inflammatory agents. CONCLUSION: The bleeding risk index provides valid estimates
      of the probability of major bleeding in hospitalized patients starting long-term
      anticoagulant therapy and complements physicians' predictions. The possibility
      that bleeding can be prevented in high-risk patients warrants prospective
      evaluation.

PMID- 2239977
TI  - The importance of cytogenetic studies in adult acute lymphocytic leukemia.
AB  - PURPOSE: The prognostic importance of pretreatment bone marrow cytogenetic
      studies in adults with acute lymphocytic leukemia treated at a single
      institution, with an identical treatment program, is described. PATIENTS AND
      METHODS: A total of 105 patients with a documented morphologic diagnosis of acute
      lymphocytic leukemia were reviewed for the purpose of this analysis. All patients
      had an extensive workup at presentation, and cytogenetic analysis was performed
      in 103 patients, using the Giemsa banding technique with trypsin pretreatment on
      24-hour cultured cells. RESULTS: The specific cytogenetic classification in the
      103 patients who had the karyotypic analysis was as follows: diploid 27%;
      Philadelphia chromosome-positive 13%; hyperdiploid 12%; B-cell karyotype 6%; 6q-
      and 14q+ abnormalities 4%; pseudodiploid 8%; hypodiploid 2%; and insufficient
      metaphases 28%. B-cell, 6q- or 14q+, and Philadelphia chromosome-positive
      karyotypes tended to correlate with other known negative prognostic factors.
      Patients with diploid, hyperdiploid, pseudodiploid, and hypodiploid karyotypes or
      with insufficient metaphases could be combined into one group with a favorable
      prognosis. In this group, the remission rate with induction chemotherapy was 89%,
      the median complete remission duration was 26 months, and the median survival was
      25 months, with a 3-year survival rate of 45%. Patients with Philadelphia
      chromosome-positive, B-cell, and 6q- or 14q+ abnormalities collectively had an
      unfavorable prognosis. Their response rate to induction chemotherapy was 65%, the
      median response duration was 7 months, and the median survival was 8 months, with
      a 3-year survival rate of less than 10%. CONCLUSION: We conclude that the
      pretreatment bone marrow karyotype is an important part of the evaluation of
      adults with acute lymphocytic leukemia and provides significant prognostic
      information.

PMID- 2239978
TI  - Sudden death in young competitive athletes: clinicopathologic correlations in 22
      cases.
AB  - PURPOSE: To investigate the pathologic substrates of sudden death in young
      competitive athletes. PATIENTS AND METHODS: Twenty-two cases of sudden death in
      young competitive athletes occurring in the Veneto region (northern Italy) in the
      period January 1979 to December 1989 were studied by postmortem examination. The
      athletes included 19 males and three females, ranging in age from 11 to 35 years
      (mean, 23 years). RESULTS: In 18 cases, sudden death occurred during (16 cases)
      or immediately after (two cases) a competitive sport activity. In 10 subjects,
      sudden death was apparently the first sign of disease. Postmortem examination
      disclosed that this fatality was due to arrhythmic cardiac arrest in 17 cases;
      among these, right ventricular cardiomyopathy, also known as "right ventricular
      dysplasia," was the most frequently encountered cardiovascular disease (six
      cases), followed by atherosclerotic coronary artery disease (four cases),
      conduction system pathology (three cases), anomalous origin of right coronary
      artery from the wrong aortic sinus (two cases), and mitral valve prolapse (two
      cases). In two athletes, the abrupt lethal complication was "mechanical" and
      consisted of pulmonary embolism and rupture of the aorta; in three athletes,
      death was due to a cerebral cause. All athletes with right ventricular
      cardiomyopathy died during effort, and most had a history of palpitations and/or
      syncope. Whenever available, electrocardiographic (ECG) tracings showed inverted
      T waves in precordial leads and/or left bundle branch block ventricular
      arrhythmias. CONCLUSIONS: Clinicopathologic correlations indicate that in the
      Veneto region of Italy, right ventricular cardiomyopathy is not so rare among the
      cardiovascular diseases associated with the risk of arrhythmic cardiac arrest,
      and seems to account for the majority of cases of sudden death in young athletes;
      this disorder can be suspected during life on the basis of prodromal symptoms and
      ECG signs.

PMID- 2239979
TI  - Interrelationships between age, thyroid volume, thyroid nodularity, and thyroid
      function in patients with sporadic nontoxic goiter.
AB  - PURPOSE: To test the hypothesis that during the natural history of sporadic
      nontoxic goiter (SNG), a diffuse goiter precedes a multinodular goiter with
      gradual development of autonomous thyroid function. PATIENTS AND METHODS: A cross
      sectional survey of 102 consecutive patients with SNG (seven male, 95 female) was
      performed. Thyroid volume was measured by ultrasonography, and plasma thyroid
      stimulating hormone (TSH) by a sensitive assay (TSH immunoradiometric assay).
      RESULTS: Patients with a multinodular goiter were older and had a larger thyroid
      volume than patients with a diffuse or uninodular goiter. Plasma free thyroxine
      (T4) and total triiodothyronine (T3) were higher and plasma TSH was lower in
      patients than in normal subjects. Free T4 was higher in the subgroup of patients
      with a multinodular goiter and a decreased TSH response to thyrotropin-releasing
      hormone. Plasma TSH (y, in mU/L) was negatively related to thyroid volume (x, in
      mL): y = 8.2x-0.667 (r = 0.578, p less than 0.001). Thyroid volume (y, in mL) was
      positively related to age (x, in years): y = -21.8 + 2.0x (r = 0.455, p less than
      0.001); and to duration of goiter (x, in years): y = 40.6 + 2.1x (r = 0.505, p
      less than 0.001). The annual increase in thyroid volume was calculated at 4.5%.
      CONCLUSION: The data suggest a continuous growth of SNG and provide support for
      the concept of increasing thyroid nodularity and autonomy of thyroid function-
      related to increasing thyroid volume--during the natural history of this
      disorder.

PMID- 2239980
TI  - Beta 2-microglobulin predicts survival in primary systemic amyloidosis.
AB  - PURPOSE: The study assessed whether beta 2-microglobulin levels predict survival
      or response in patients with primary systemic amyloidosis without associated
      multiple myeloma. PATIENTS AND METHODS: The study group consisted of 131
      untreated patients with biopsy-proven primary systemic amyloidosis diagnosed and
      evaluated at the Mayo Clinic. No patient had multiple myeloma. The minimum follow
      up of surviving patients is 8 years. No patient was lost to follow-up. RESULTS:
      The median survival of patients with an increased beta 2-microglobulin level was
      10.8 months, compared with patients with a normal beta 2-microglobulin level
      (less than or equal to 2.7 micrograms/mL, 0.23 mumol/L) of 32.9 months (p less
      than 0.001). In a multivariate proportional-hazards model, the best model
      included congestive heart failure (p less than 0.0001) and increased beta 2
      microglobulin levels (p less than 0.05). After adjustment for the presence of
      congestive heart failure, beta 2-microglobulin level remained significant. When
      the analysis was restricted to those patients with normal renal function, the
      median survival of those with an elevated beta 2-microglobulin level was 9.1
      months versus 39.4 months for those with a normal level (p less than 0.001). The
      serum level of beta 2-microglobulin was increased in patients with nephrotic
      range proteinuria with or without renal insufficiency (p = 0.05). CONCLUSION: The
      serum beta 2-microglobulin level should be measured routinely in all patients
      with primary systemic amyloidosis because it provides a useful objective factor
      to identify subsets of patients with this disease who have unfavorable outcomes.

PMID- 2239981
TI  - Contrast nephropathy in azotemic diabetic patients undergoing coronary
      angiography.
AB  - PURPOSE: To evaluate the incidence of, risk factors for, and outcome of contrast
      nephropathy in azotemic diabetic patients undergoing coronary angiography.
      PATIENTS AND METHODS: Fifty-nine insulin-dependent diabetics with a mean serum
      creatinine level of 522 mumol/L (5.9 mg/dL) underwent coronary angiography as
      part of a pretransplant evaluation. Twenty-four azotemic diabetics undergoing
      inpatient evaluation not including angiography for transplantation formed the
      control group. Serum creatinine measurements obtained at baseline and after
      radiocontrast exposure were compared in patients and control subjects. Risk
      factors for contrast nephropathy were evaluated in patients with a 25% or greater
      increase in serum creatinine. RESULTS: Serum creatinine was significantly
      elevated 24 hours after radiocontrast exposure in patients (557 +/- 141 mumol/L
      versus 522 +/- 141 mumol/L, mean +/- SD; p less than 0.001) but not in controls.
      Seven patients required dialysis within 6 days of coronary angiography and two
      additional patients required dialysis within 14 days. Contrast nephropathy,
      defined as a serum creatinine increase of greater than 25% when measured 48 hours
      after radiocontrast exposure, occurred in 50% of patients and no controls.
      Univariate analysis of risk factors for contrast nephropathy revealed a
      significant association with dye quantity (p = 0.002), mean arterial pressure
      less than 100 mm Hg (p = 0.02), and ejection fraction less than 50% (p = 0.04).
      Stepwise logistic regression verified the independence of dye quantity and low
      mean arterial pressure but not low ejection fraction as risk factors for contrast
      nephropathy. Follow-up serum creatinine values were not significantly different
      in patients and control subjects. CONCLUSIONS: Azotemic patients with diabetes
      are at high risk of developing contrast nephropathy even when less than 100 mL of
      radiocontrast agent is used. The acute renal failure is reversible but
      precipitates the need for short-term dialysis in some patients. Radiocontrast
      quantity is an important risk factor not previously noted. The incidence of
      contrast nephropathy can be minimized by using less than 30 mL of radiocontrast
      agent.

PMID- 2239982
TI  - Interleukin-1: biology, pathophysiology, and clinical prospects.
AB  - Interleukin-1 (IL-1) is a cytokine with multiple biologic activities. Since its
      first description in 1972, significant work has been done, leading to an
      understanding of the biology of IL-1, which plays a central role in many
      important functions of the immune system. The biologic activities of IL-1 make it
      an attractive factor for use in clinical oncology, both as an antitumor agent and
      for the hematologic recovery of cancer patients receiving other forms of therapy.
      In this review the biologic effects of IL-1 are summarized. The possible
      involvement of IL-1 in the pathogenesis of some diseases is reviewed. Future
      prospects for the use of IL-1 in the treatment of malignancies are discussed.

PMID- 2239983
TI  - Liability issues and assessment of decision-making capability in nursing home
      patients.

PMID- 2239984
TI  - Myocardial infarction, cardiomyopathy, and interstitial lung disease in a 38-year
      old man.

PMID- 2239985
TI  - Preleukemic state preceding adult acute lymphoblastic leukemia.

PMID- 2239986
TI  - A new familial immunodeficiency disorder characterized by severe neutropenia, a
      defective marrow release mechanism, and hypogammaglobulinemia.

PMID- 2239987
TI  - Visceral leishmaniasis with malabsorption syndrome in a patient with acquired
      immunodeficiency syndrome.

PMID- 2239988
TI  - HTLV-I-associated adult T-cell leukemia/lymphoma presenting with nodular synovial
      masses.

PMID- 2239990
TI  - Increased urinary phosphoethanolamine in a man with asymptomatic osteopenia.

PMID- 2239989
TI  - Hepatitis-related hepatic erythropoietin production.

PMID- 2239992
TI  - Carcinoid tumor metastatic to the heart.

PMID- 2239993
TI  - Addison's disease and sarcoidosis: unusual frequency of co-existing
      hypothyroidism (Schmidt's syndrome)

PMID- 2239991
TI  - Medullary carcinoma of the thyroid in a patient treated for Hodgkin's disease.

PMID- 2239994
TI  - Liver biopsy in patients with serum antibodies to HIV.

PMID- 2239995
TI  - Antibiotic-related adverse effects in patients with leukemia.

PMID- 2239996
TI  - Cardiomyopathy related to thyroid dysfunction.

PMID- 2239997
TI  - Symptomatic hyponatremia.

PMID- 2239998
TI  - Is ovarian hemorrhage the full explanation of unexplained bleeding in a patient
      with mechanical valve prostheses?

PMID- 2239999
TI  - Diarrhea precipitated by oral liquid medication.

PMID- 2240000
TI  - Incidence of post-phlebitic syndrome after streptokinase therapy for deep vein
      thrombosis.

PMID- 2240001
TI  - Extrahepatic cholestasis as a distinct factor predisposing to gentamicin
      nephrotoxicity.

PMID- 2240003
TI  - Measurement of plasma active renin by solid phase radioimmunoassay using
      monoclonal antibodies.
AB  - A direct radioimmunoassay (RIA) for plasma active renin concentration (ARC) was
      evaluated by using plasma samples obtained from hospitalized normal volunteers
      and hypertensive patients. The direct renin RIA was performed by using a pair of
      anti-renin monoclonal antibodies and a sandwich method. It is suggested that an
      agitator should be used during the incubation, because the magnetic solid phase
      was precipitated and could not be suspended well in plasmas. Further, the thawed
      reagents should not be used for the assay. A highly significant correlation (r =
      0.96, p less than 0.01) was found between ARC and enzymatic activity of renin
      (PRA) in plasma samples obtained from hypertensive patients. The mean values of
      ARC were 22.8 +/- 3.6 pg/ml in normal subjects, 22.5 +/- 5.3 in patients with EH
      having medium levels of PRA, 113.7 +/- 11.7 in patients with renovascular
      hypertension, and undetectable in patients with primary aldosteronism. The
      results indicated good and reliable performance of the direct renin RIA, which is
      clinically useful to investigate the renin-angiotensin system.

PMID- 2240002
TI  - Effects of calcium channel blockade on calcium homeostasis in mild to moderate
      essential hypertension.
AB  - Calcium channel blockers may alter parathyroid hormone secretion in vitro, which
      would alter calcium homeostasis. To determine the chronic effect of calcium
      channel blockade in vivo, we conducted a randomized, double blind, 16 week study
      comparing the effects of two pharmacologic antihypertensive agents, the calcium
      channel blocker diltiazem and the angiotensin-converting enzyme inhibitor
      captopril on parameters of calcium homeostasis. Both diltiazem and captopril
      lowered blood pressure to a similar degree. Neither drug produced any significant
      change in blood levels of total and ionized calcium, magnesium, or phosphorus,
      which affect the regulation of parathyroid hormone and vitamin D. In addition, at
      eight or 16 weeks following initiation, neither drug altered the serum levels of
      parathyroid hormone (PTH) or 1,25-(OH)2-vitamin D3 (1,25-D). Chronic calcium
      channel blockade with diltiazem does not alter serum parameters of calcium
      homeostasis and, thus, should not affect bone mineralization.

PMID- 2240004
TI  - Indomethacin increases plasma growth hormone levels in man.
AB  - In seven normal volunteers, the basal and arginine-stimulated levels of plasma
      growth hormone, glucose, glucagon, and free fatty acids and serum insulin was
      determined during placebo and during indomethacin 25 mg four times daily. Basal
      plasma growth hormone was higher during indomethacin (5.4 +/- 1 vs 1.7 +/- 2
      ng/ml, p less than 0.005), as was the mean integrated response to intravenous
      arginine (40 +/- 14 vs 6 +/- 4 ng.min/ml, p less than 0.05). Despite lack of
      effect on plasma glucagon, indomethacin decreased the insulin response to
      arginine. The fall in free fatty acids during arginine infusion was decreased by
      indomethacin, which may in part be due to increased plasma growth hormone levels.
      In view of the many patients treated with indomethacin, the effect on growth
      hormone may be of clinical importance.

PMID- 2240005
TI  - Clinical and manometric aspects of diffuse esophageal spasm in a cohort of
      subjects evaluated for dysphagia and/or chest pain.
AB  - Manometric criteria for diffuse esophageal spasm have recently been restated. In
      this study, a cohort of 358 subjects was evaluated in a gastrointestinal motility
      laboratory for dysphagia and/or chest pain. Applying the recently proposed
      criteria of Richter and Castell, 18 subjects (5%) were diagnosed as having DES.
      Dysphagia was the major complaint (89%), while 44% of patients complained of
      chest pain and 33% of both symptoms. All patients shared more than 30%
      simultaneous contractions after wet swallows interspersed with normal peristaltic
      sequences. Associated manometric findings were repetitive (greater than 3 peaks)
      contractions (67%), high-amplitude contractions (33%), spontaneous activity
      (22%), prolonged duration (11%), and lower esophageal sphincter abnormalities
      (5%). Radiology disclosed significant abnormalities in only 27% of DES patients.

PMID- 2240006
TI  - An assault on old friends: thiazide diuretics under siege.
AB  - The adverse biochemical effects of thiazide use are of uncertain clinical
      significance. Thiazides raise LDL cholesterol only slightly in long-term studies
      and do not decrease HDL cholesterol. The evidence linking thiazide-induced
      hypokalemia with arrhythmias and sudden death is tenuous at best. Thiazide
      diuretics cause glucose intolerance, but no strong evidence has been advanced to
      suggest that this is dangerous. Because these effects are probably related to
      hypokalemia, a randomized trial comparing the effects of thiazides with thiazides
      plus a potassium-sparing diuretic on LDL cholesterol, ectopy on 48 hour
      ambulatory cardiac monitoring, fasting glucose and insulin, and post-glucose
      tolerance glucose and insulin would be of interest. The most compelling reason
      for continuing to use thiazides is that they have been shown in long-term
      randomized studies to reduce cardiovascular risk. Beta-blockers are the only
      other class of anti-hypertensive agent for which this claim can be made. The
      importance of long-term clinical trials in assessing the efficacy and toxicity of
      therapeutic agents is illustrated by the study that found clofibrate reduced
      cholesterol levels and coronary disease but increased total mortality. This
      finding remained undetected until a large randomized long-term trial was
      completed. Thiazide diuretics have not reduced the rate of coronary disease to
      the degree expected from epidemiologic studies, but the short length of the
      randomized trials may be responsible. It is not clear that other anti
      hypertensive agents will be superior. Thiazides are less expensive than other
      anti-hypertensive agents being touted as metabolically safer; the cost issue is
      not a trivial matter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240007
TI  - Hematopoietic growth factors: overview and clinical applications, Part I.
AB  - The growth and differentiation of blood cells is regulated by a group of at least
      12 glycoproteins, collectively known as hematopoietic growth factors. Advances in
      protein biochemistry and molecular genetics have provided the tools for the bulk
      production of these hormones for clinical application. Clinical trials of
      macrophage colony-stimulating factor, granulocyte macrophage colony-stimulating
      factor, granulocyte colony-stimulating factor, and interleukin-3 have all
      demonstrated significant effects on the peripheral blood counts of the
      recipients. The clinical usefulness of these agents in ameliorating post
      chemotherapy myelosuppression, in the treatment of other cytopenias, and in
      enhancing engraftment after bone marrow transplantation has already been
      demonstrated. Potential applications to the therapy and diagnosis of other
      clinical disorders is under study. The history of the elucidation of these growth
      factors, our current understanding of their properties, interactions, and
      clinical effects, and the potential prospects for their future use in the
      manipulation of human blood cell production are the subject of this review.

PMID- 2240008
TI  - Symposium introduction: technology assessment and guideline development: concerns
      and opportunities for academic general internists.

PMID- 2240009
TI  - Practice standards: implications for the internist.
AB  - Pressure for national standards of medical practice is increasing from cost
      control initiatives, medical malpractice liability, and the desire to simplify
      complex practice problems. Good standards need to be academically sound, focused
      enough to be clinically useful, yet flexible enough to allow for the realities of
      practice. Standards have already been created by several professional societies,
      including anesthesiology and cardiology in internal medicine. Although physician
      education is primary, controlling the use of expensive new technologies is an
      unwritten but important secondary goal. While standards have reduced malpractice
      liability in some professional groups, some clinicians are concerned that
      standards will be too academic and unrealistic. Currently, third-party payers are
      watching the development of practice standards but are hesitant to use them as
      criteria for determination of reimbursement. The federal government has a major
      interest in practice standards as a means of both monitoring quality of care and
      controlling costs. A number of agencies are studying the development of standards
      and their implications for use. Recent articles questioning the usefulness of
      common diagnostic tests and even the routine physical examination have raised
      concern among internists that restriction of practice and reimbursement will
      follow. Some evolving standards, such as screening for breast cancer, seem to
      ignore the realities of clinical practice and may generate more cost than they
      save. Internists need to provide input as standards are developed to guarantee
      appropriateness and feasibility.

PMID- 2240011
TI  - Decision making at the bedside: lessons for clinical policy development.

PMID- 2240010
TI  - Entering the quality assurance decade.

PMID- 2240012
TI  - Federal involvement in technology assessment: a primer.

PMID- 2240013
TI  - Primary hyperaldosteronism.

PMID- 2240014
TI  - Reliability of cell counts and protein determinations in serial bronchoalveolar
      lavage procedures performed on healthy volunteers.
AB  - We measured the variability in volume, total cells, cell types, and proteins in
      the bronchoalveolar lavage fluid recovered from 10 volunteers (five smokers, five
      non-smokers) lavaged repeatedly over a three-year period. Thirty lavages were
      performed using a rigorously standardized approach. Differential counts on the
      cytospin preparations were performed by three independent readers and
      interobserver variability in the interpretation of these counts measured.
      Variability in interpreting the cellular counts was less in smokers than non
      smokers and decreased as the number of cells of any particular type increased.
      Only one reader interpreting the mean percentage of cells recovered of one cell
      type (neutrophils) in only one smoking group, the nonsmokers, was significantly
      different from the other two. There was also considerable variability in
      bronchoalveolar lavage fluid total protein, albumin, IgG, and IgA. Expressing
      albumin and IgG as a percentage of total protein recovered and expressing IgA and
      albumin as a ratio in nonsmokers lessened the variability of these parameters.
      Mean and standard deviations of the cellular and protein concentrations showed
      that large differences in these parameters would be necessary in order to
      attribute these changes to changes in the underlying pulmonary status. Excessive
      variability in nearly all parameters in this group without recognized lung
      disease challenges the usefulness of this test in the clinical assessment of
      patients serially followed because of underlying lung disease.

PMID- 2240015
TI  - Epidemiology of Lyme disease in Virginia.
AB  - Prior to January 1986, only one case of Lyme disease was reported from Virginia.
      In 1986-87, however, the Virginia Department of Health observed an increase in
      reports of suspected Lyme disease by physicians, despite the fact that Ixodes
      dammini is not highly prevalent in the Virginia tick population. Twenty-eight
      cases of Lyme disease were identified in Virginia, of which eight cases occurred
      in 1986 and 20 in 1987. Lyme disease appears to be increasing in frequency in
      Virginia and moving southward along the Eastern Atlantic Seaboard.

PMID- 2240016
TI  - A simplified technique for the production of heart failure in the dog by rapid
      ventricular pacing.
AB  - Prolonged rapid ventricular pacing (VP) in dogs produces low output heart failure
      (HF) characterized by cardiomegaly, ascites, and elevated plasma renin and
      norepinephrine levels. Commercially available pacemaker generators have a
      protective circuit that prevents pacing at rapid rates. Previously, investigators
      have had to use either external temporary pacemakers or customized generators to
      pace at rates greater than 130 beats per minute (bpm). The authors have developed
      a simple method to perform rapid VP by gluing magnets on Medtronic VVI
      generators, which allows programming in a temporary mode to sustain rates up to
      400 bpm. Our results using 10 generators in 55 dogs demonstrates that HF is
      produced in all dogs when VP is maintained at 250 bpm for an average of 28 days.
      Technical difficulties during our early experience with this technique included
      magnets becoming unglued, loss of capture, and wound complications requiring
      generator removal. Thus, our method reuses commercially available generators to
      rapidly pace the ventricles and induce HF.

PMID- 2240017
TI  - Serum aldolase isozyme levels in patients with cerebrovascular diseases.
AB  - A subunit specific radioimmunoassay was developed for the quantification of human
      aldolase A, B, and C. The method used was a double antibody radioimmunoassay
      using radioiodinated purified aldolase A, B, or C subunits as the ligand,
      specific chicken antibodies to aldolase isozymes and rabbit antibodies to chicken
      IgG. The Iodogen method was used for iodination of the purified isozyme subunits
      in this study. Human brain tissue contained similar concentrations of aldolase A
      and aldolase C, and a smaller amount of aldolase B, which was the main isozyme of
      liver tissue. Levels of serum aldolase A were greater than 203 ng/ml, the upper
      limit of normal, in six of 24 patients with cerebral infarction and in 11 of 31
      patients with cerebral hemorrhage. Nine of 24 patients with cerebral infarction
      and 16 of 31 patients with cerebral hemorrhage had serum aldolase C levels
      greater than 4.1 ng/ml, the upper limit in normal sera. These data suggest that
      serum aldolase C may be a more specific and sensitive marker of cerebrovascular
      diseases than aldolase A. We also demonstrated that serial measurement of serum
      aldolase C in patients with cerebrovascular diseases might be useful in
      estimating prognosis, since serially increasing serum aldolase C levels during
      the course of these diseases were correlated with a high mortality rate.

PMID- 2240018
TI  - Use of intrapleural streptokinase in the treatment of thoracic empyema.
AB  - The incidence of pleural effusions in bacterial pneumonia may exceed 40%, a
      factor that may be related to increased morbidity and mortality. Options in the
      treatment of complicated pleural effusions or empyema, when unresponsive to
      closed tube drainage, include repositioning of the indwelling tube thoracostomy
      or insertion of additional chest tubes, instillation of intrapleural
      streptokinase, and surgical intervention. The authors describe the course of
      three patients wherein the use of intrapleural streptokinase was efficacious in
      effecting prompt drainage of previously inadequately evacuated empyema, thus
      eliminating the necessity for further invasive intervention.

PMID- 2240019
TI  - Molecular biology in cardiology: recent developments and opportunities for
      clinical applications.
AB  - The revolution in molecular biology that has taken place in the last decade has
      provided powerful research methods that are changing our understanding of
      cardiovascular physiology and disease. This editorial commentary will highlight
      several areas of current research activity within the broad and expanding field
      of molecular cardiology, with a special emphasis on prospects for clinical
      applications in cardiovascular medicine.

PMID- 2240020
TI  - Production of transgenic mice and application to immunology and autoimmunity.
AB  - During the last decade, transgenic animal technology has assumed an increasingly
      important role as a critical tool in animal biology, biomedical research, and
      pharmaceutical development. This technology allows virtually any fragment of DNA
      large enough to contain an entire gene to become integrated into the germline of
      the recipient animal. The newly inserted DNA will be inherited like endogenous
      genes, and will be expressed as RNA and protein at tissue locations and abundance
      depending on regulatory elements attached to the coding DNA. It is possible to
      clone a particular gene, change a regulatory coding sequence, and reinsert the
      gene to determine the effect of the change on expression and function of the
      gene.

PMID- 2240021
TI  - Pulmonary disease in AIDS patients.
AB  - Pulmonary disease remains a major complication of the human immunodeficiency
      virus (HIV). Over the past decade several changes in the pattern of disease have
      occurred. Pneumocystis carinii pneumonia (PCP) remains the most common
      opportunistic pathogen in AIDS patients, though its incidence on bronchoscopy has
      declined and empiric therapy often occurs without a specific diagnosis. Changes
      in the management of patients with PCP have included different dosages and routes
      of administration for chemotherapy, improved overall survival, and a recent
      increase in the number of patients surviving episodes of respiratory failure. In
      addition, infection with mycobacteria tuberculosis (M.Tb.) has emerged as a major
      public health problem. The pattern of M.Tb. is distinct from non
      immunocompromised patients though response to therapy usually occurs.

PMID- 2240022
TI  - Urinary tract anomalies associated with congenital diaphragmatic defects.
AB  - Anomalies of the urinary tract occur in some 13-27% of infants with congenital
      posterolateral diaphragmatic defect (CDD) and are often severe (renal agenesis,
      dysplasia, hypoplasia, or hydronephrosis). To test the hypothesis that urinary
      and diaphragmatic anomalies share elements of pathogenesis, we reviewed 60
      autopsy cases of CDD studied at our institution. Sixteen patients (27%)
      manifested anomalies of the urinary tract: 12 had markedly altered kidneys, 8 of
      which were unilateral and ipsilateral to the diaphragmatic defect. Among 27
      patients free of gross urinary tract anomalies, kidney weights formed a skewed
      distribution, with most values above published norms for body weight; by analysis
      of covariance, kidney weight (as a function of body weight) was significantly
      greater in CDD than in a control population of infants free of chronic illnesses
      and congenital anomalies who died suddenly and unexpectedly. Differences in
      glomerular number and diameter could not be identified between the latter groups.
      In 71% of patients with isolated left CDD, the left kidney was heavier than the
      right, a reversal of the usual condition in infancy. These findings demonstrate
      that both marked and subtle changes of the urinary tract in CDD are generally
      ipsilateral to the diaphragmatic defect and suggest that the pathogenetic
      mechanisms responsible for urinary and diaphragmatic anomalies may overlap
      topographically. Aberrant morphogenesis within a developmental field or fields is
      one explanation for this.

PMID- 2240023
TI  - Mesomelic dysplasia with absence of fibulae and hexadactyly: Nievergelt syndrome
      or new syndrome?
AB  - Mesomelic dysplasia is a form of short-limb dwarfism characterized by
      disproportionate shortness of the middle segment of all limbs. Included in this
      category of skeletal disorders is the Nievergelt syndrome, which typically
      manifests a rhomboidal shape of the tibiae and fibulae, an unusual foot
      deformity, radioulnar synostosis, and dysplasia of the elbow and knee joints. We
      describe a patient with mesomelic dysplasia with findings suggestive of the
      Nievergelt syndrome and with absence of fibulae and hexadactyly.

PMID- 2240024
TI  - Rokitansky sequence in association with the facio-auriculo-vertebral sequence:
      part of a mesodermal malformation spectrum?
AB  - We report on a 4-year-old first-born monozygotic twin girl with a hypoplastic
      left face, mandible and zygoma, left microtia without an external auditory canal,
      a U-shaped cleft palate, right ectopic-fused kidneys, a blindly ending vaginal
      pouch, and absent uterus. We review 3 other cases with the manifestations of the
      Rokitansky and the facio-auriculo-vertebral sequence. The anomalies in these
      disorders can be thought of as deriving from an early defect or disruption in
      fetal mesoderm or its progenitor tissue at the time of primitive streak
      formation. They are frequently associated with other mesodermally derived defects
      or sequences and may together represent an extended polytopic field defect. While
      such speculation on how these spatially separated anomalies develop is probably
      simplistic, the concept of a mesodermal "malformation" spectrum is helpful in
      reminding the clinician to look for other mesodermal defects when one
      mesodermally derived defect or sequence is detected.

PMID- 2240025
TI  - Transient hypoglycemia with hyperinsulinemia in a newborn infant with Rubinstein
      Taybi syndrome.
AB  - A newborn boy with Rubinstein-Taybi syndrome who had profound neonatal
      hypoglycemia is presented. The infant was a discordant fraternal twin with
      intrauterine growth retardation. The hypoglycemia was due to transient
      hyperinsulinemia, a condition often seen in small-for-gestational-age infants.
      Neonatal hypoglycemia may be common in infants with Rubinstein-Taybi syndrome,
      especially if they also have intrauterine growth retardation.

PMID- 2240026
TI  - The syndrome of Hirschsprung disease, microcephaly, unusual face, and mental
      retardation.
AB  - Here we report on a boy with Hirschsprung megacolon associated with microcephaly,
      narrow palpebral fissures, broad nasal bridge, congenital heart defect,
      cryptorchidism, wide-base gait, short stature, developmental delay and abnormal
      computed tomography (CT) brain scan. The findings are compared with those of
      previously described patients with the same syndrome.

PMID- 2240027
TI  - The Cohen syndrome: does mottled retina separate a Finnish and a Jewish type?
AB  - A new familial cases of the Cohen syndrome in two brothers of one-half second
      cousin parents is reported. Typical clinical manifestations of the syndrome;
      i.e., mental deficiency, hypotonia, characteristic facial appearance, long,
      narrow hands and feet with elongated fingers, and mottled retinae were present in
      both patients. Both patients also had leukopenia. Clinical manifestations of the
      Cohen syndrome in patients are highly variable, and mottled retina has been
      observed in 22 of 87 patients (25%). However, an association of mottled retina in
      patients with the Cohen syndrome is likely to be related to the families and
      ethnic groups. Among 19 familial cases, mottled retina was observed in all
      affected sibs from five families, but in 13 families none of the affected sibs
      had the mottled retina. All Finnish patients had the mottled retina, but this was
      noted in only one of 39 Jewish patients. Based on these data, we hypothesize that
      two alleles at the gene locus for the Cohen syndrome exhibit different clinical
      manifestations: one is a Finnish type with mottled retina, and the other is a
      Jewish type without retinal anomalies.

PMID- 2240028
TI  - Lambotte syndrome: microcephaly, holoprosencephaly, intrauterine growth
      retardation, facial anomalies, and early lethality--a new sublethal multiple
      congenital anomaly/mental retardation syndrome in four sibs.
AB  - We report on an Arabic sibship originating from Morocco in which four children
      manifest an undiagnosed sublethal multiple congenital anomaly/mental retardation
      (MCA/MR) syndrome of intrauterine growth retardation (IUGR), microcephaly, large
      soft pinnae, telecanthus or true hypertelorism with squint, flat face, unusual
      hooked nose, very narrow mouth, retrognathia, and extremely severe neurologic
      impairment. One child was stillborn. Three others died in a cachectic state
      during their second year. One child had a severe cerebral malformation compatible
      with semilobar holoprosencephaly. Other inconstant manifestations are anterior
      chamber cleavage defect, preaxial polydactyly of feet, interventricular septal
      defect, and atresia of the external auditory meatus. Autosomal recessive
      inheritance is likely.

PMID- 2240030
TI  - Limb reduction defects and renal dysplasia: confirmation of a new, apparently
      lethal, autosomal recessive MCA syndrome.
AB  - We report on 2 sibs, a male and a female, who died shortly after birth from
      respiratory failure. They combined growth retardation with a Potter-like face,
      complete phocomelia of the upper limbs, rib anomalies (mainly severe hypoplasia
      of the 6 upper ribs), renal dysplasia, and external genital abnormalities. We
      hypothesize that these cases represent evidence for the existence of the "new
      syndrome" described by Ulbright et al. (Am J Med Genet 17:667-668, 1984). This
      syndrome appears lethal because of the severe renal dysplasia that causes
      oligohydramnios and pulmonary hypoplasia. Its mode of inheritance seems to be
      autosomal recessive.

PMID- 2240029
TI  - Dandy-Walker variant malformation, spastic paraplegia, and mental retardation in
      two sibs.
AB  - Two sibs, a boy and a girl, had both hypoplasia of the cerebellar hemispheres and
      partial agenesis of the cerebellar vermis with normal communication between the
      fourth ventricle and arachnoid spaces, i.e., the manifestations of the Dandy
      Walker variant malformation associated with agenesis of the corpus callosum. Both
      sibs were mentally retarded and had spastic paraplegia. The occurrence of a
      distinct and similar pattern of congenital anomalies in sibs born to healthy
      parents points toward a "new" syndrome caused by the homozygous state of an
      autosomal recessive gene. Prenatal ultrasonographic diagnosis is possible at
      least for the more severe form of the brain anomalies.

PMID- 2240031
TI  - Characterization of deletions in the dystrophin gene giving mild phenotypes.
AB  - We have characterized deletions of the dystrophin gene in patients suffering from
      relatively mild muscular dystrophy. Our data show that most of the Becker
      muscular dystrophy (BMD) patients have intragenic deletions which leave the
      protein reading frame in phase. Remarkably, large deletions of the region
      corresponding to the central triple helical repeats in the protein can result in
      an exceptionally mild phenotype. Three brothers suffering from BMD, glycerol
      kinase deficiency, and adrenal hypoplasia possess a deletion at the 3' end of the
      gene. They also display developmental delay. Thus the 3' processing of the gene
      must be necessary for the correct function of the dystrophin molecule.

PMID- 2240032
TI  - Severe combined immunodeficiency syndrome associated with autosomal recessive
      familial multiple gastrointestinal atresias: study of a family.
AB  - Hereditary multiple atresias involving the gastrointestinal tract from pylorus to
      rectum are the most unusual form of intestinal atresia; the type of inheritance
      was suggested to be autosomal recessive. The inheritance of the severe combined
      immunodeficiency syndrome can be autosomal recessive or X-linked. We report on 3
      sibs with multiple-level intestinal atresias. One sib had severe combined
      immunodeficiency syndrome and clinical histories of the other 2 sibs strongly
      suggested a congenital immunodeficiency syndrome. The parents of those children
      were healthy and nonconsanguineous. To our knowledge, this is the first report of
      the association of multiple gastrointestinal atresias and immunodeficiency which
      appears to have an autosomal recessive pattern of transmission. Our family report
      suggests that, in the presence of multiple gastrointestinal atresias, attention
      should be given to possible associated immunological disorders.

PMID- 2240033
TI  - Carrier testing and prenatal diagnosis for hemophilia: experiences and attitudes
      of 549 potential and obligate carriers.
AB  - Experiences with and attitudes toward carrier testing and prenatal diagnosis were
      evaluated among 549 potential and obligate carriers of hemophilia. Almost
      everybody considered carrier testing to be useful. Forty-nine percent had been
      tested for carriership, 10% had only received limited information, and 41% had
      not been tested and had never received information about the heredity of
      hemophilia. More married women, women with severe hemophilia in their family, and
      women closely related to a patient with hemophilia had been tested for
      carriership than others. Lack of information about the probability of carriership
      for female relatives and a similar ignorance of the possibility of carrier
      testing were important reasons for not having been tested. Eleven percent of the
      women with one or more children had undergone prenatal diagnosis in the past.
      Thirty-one percent of the study population would favour prenatal diagnosis with
      the implication of a potential abortion in early pregnancy and half of them would
      choose this option even in late pregnancy. Most of the women who objected to
      prenatal diagnosis did so because they did not consider hemophilia to be a
      sufficiently serious disorder to justify an abortion.

PMID- 2240034
TI  - Familial sex chromosomal mosaicism.
AB  - Familial mosaicism has rarely been reported either for autosomes or sex
      chromosomes. Its recognition poses problems in prognosis, especially in prenatal
      diagnosis. Three generations of females showed sex chromosomal mosaicism with 3-4
      cell lines, the diploid predominant. Phenotypic effect, if any, appeared limited
      to reduced fertility. The proposita, ascertained prenatally, has grown and
      developed normally. A dominant gene mechanism most likely accounts for the
      observations, either autosomal or X-linked. If the mechanism in this family is
      monogenic, then the gene may not be strictly private considering the frequency of
      mosaic amniotic fluid cell cultures.

PMID- 2240035
TI  - Euchromatic 9q + heteromorphism in a family.

PMID- 2240036
TI  - Anophthalmia in Delleman syndrome.

PMID- 2240038
TI  - A sibship with Roberts/SC phocomelia syndrome.
AB  - We report on a family in which 3 sibs have Roberts/SC phocomelia syndrome. One
      child has survived to age 9 years. The clinical manifestations and the natural
      history of this syndrome are reviewed.

PMID- 2240037
TI  - An animal model of the Marfan syndrome.
AB  - A congenital syndrome of long, thin limbs, severe joint and tendon laxity,
      microspherophakia, ectopia lentis, heart murmurs and aortic dilatation was
      identified in 7 calves. All affected calves were sired by a single phenotypically
      normal bull suspected of germline mosaicism for a new mutation resulting in this
      disease. One of the calves subsequently died with ruptured aorta at age 16
      months. Histopathologic and electron microscopic studies of the aortic media of
      affected calves demonstrated disorganized elastin and narrowed elastic lamina
      separated by widened spaces. This bovine disease provides a unique animal model
      of the human Marfan syndrome. A herd of cattle with this disease is being
      developed for further studies.

PMID- 2240039
TI  - Craniosynostosis and lid anomalies: report of a girl with Michels syndrome.
AB  - We report on a 2-year-old girl with Michels syndrome, a condition characterized
      by mental deficiency, craniosynostosis, blepharophimosis, ptosis, and epicanthus
      inversus. The phenotypic findings are compared with those of previously reported
      cases.

PMID- 2240040
TI  - Segregation analysis of the X-chromosome in a family with Rett syndrome in two
      generations.
AB  - We report on the first family in which Rett syndrome (RTS) appeared in two
      consecutive generations. The index case is a 12-year-old girl (classical RTS);
      her maternal aunt, age 44 years, has mild RTS. Clinically, the family illustrates
      the wide phenotypic variability between cases, particularly in severity of
      neurological manifestations. We have analyzed the short arm of the X-chromosome
      of the family with gene technology. This did not uncover any genetic marker for
      diagnosis, but it did suggest how the syndrome might have segregated in the
      family. A cytogenetic analysis gave no information about chromosome
      abnormalities.

PMID- 2240041
TI  - Familial tetralogy of Fallot and glaucoma.
AB  - All 3 daughters of a mother with glaucoma had a conotruncal abnormality of the
      heart and glaucoma. The presence of heart and eye anomaly may be coincidental;
      however, both may be related to abnormal development of neural crest. The
      pedigree suggests autosomal dominant inheritance in this family.

PMID- 2240042
TI  - EEC syndrome: report on 20 new patients, clinical and genetic considerations.
AB  - We report on 20 Brazilian patients (11 sporadic and 9 familial cases) with the
      ectrodactyly, ectodermal dysplasia, clefting syndrome (EEC syndrome). Genetic
      aspects, clinical manifestations, and differential diagnosis of the syndromes
      involving ectodermal dysplasia/limb anomalies and cleft lip/palate are discussed.

PMID- 2240043
TI  - Microphthalmos in the presumed homozygous offspring of a first cousin marriage
      and linkage analysis of a locus in a family with autosomal dominant cerulean
      congenital cataracts.
AB  - A family with autosomal dominant congenital cataracts was studied to determine
      clinical variability. A total of 159 relatives was ascertained; 17 affected and
      19 normal individuals were evaluated and their blood sampled for inclusion in the
      linkage analysis. The disease was compatible with normal to mildly decreased
      visual acuity until adult life in all affected except the product of a
      consanguineous marriage of affected first cousins who was born with bilateral
      microphthalmos and dense congenital cataracts, attributed to homozygosity of the
      cataract gene. There were no extraocular abnormalities; the patient was of normal
      intelligence. Twenty-three markers were typed, 18 of which were informative.
      Linkage could be excluded for all 18 markers at short distances.

PMID- 2240044
TI  - Unilateral VATER association.
AB  - We describe a case of unilateral "VATER association." In addition to the VATER
      manifestations, the patient had hemihypoplasia, unilateral congenital paralysis
      of a leg, and delayed ossification of the femoral head and carpal bones. All of
      the manifestations involved the left side of the body. The only drug exposure
      identified was a Chinese herbal medicine taken by the mother during early
      pregnancy.

PMID- 2240045
TI  - De novo (15;21) unbalanced translocation of paternal origin in a girl with Prader
      Willi syndrome.
AB  - We describe a 3-month-old girl with Prader-Willi syndrome and a de novo
      unbalanced karyotype 45,XX,t(15;21)(q13;q22.3). This rearrangement, resulting in
      monosomy for the pericentromeric region of chromosome 15 and a virtual monosomy
      for the 21q distal band, had a paternal origin as demonstrated by Q and NOR
      staining.

PMID- 2240046
TI  - Syndrome of mental retardation, facial anomalies, hypopituitarism, and distal
      arthrogryposis in sibs.
AB  - A brother and a sister presented with a malformation syndrome consisting of
      facial anomalies, distal arthrogryposis with camptodactyly of fingers and "hammer
      toes," severe mental retardation, and hypopituitarism. The girl is now 6 1/2
      years old and exhibits severe mental retardation. She has abnormal secretion of
      growth hormone and responded to growth hormone therapy. Her brother was born with
      the same facial manifestations, distal contractures, and hypopituitarism. He died
      unexpectedly at age 3 months of no apparent cause. The occurrence of the syndrome
      in 2 sibs of different sex suggests autosomal recessive inheritance.

PMID- 2240048
TI  - Ring chromosome 4 in a child with duodenal atresia.
AB  - We report on a 19-month-old girl with ring chromosome 4 and a multiple congenital
      anomaly syndrome. The clinical and cytogenetic findings are compared with those
      of previous cases in whom the breakpoints in ring chromosome 4 are known.

PMID- 2240047
TI  - Determining the origins and the structural aberrations of small marker
      chromosomes in two cases of 45,X/46,X, + mar by use of chromosome-specific DNA
      probes.
AB  - A 17-year-old girl (S.M.) and a 13-year-old girl (C.L.) both with Ullrich-Turner
      syndrome (UTS) were found to have 45,X/46,X, + mar mosaicism. The marker
      chromosomes in both patients were very small in size. In S.M. the marker
      chromosome was present in 80% of phytohemagglutinin-stimulated lymphocytes, 28%
      of skin fibroblasts, and 11-20% of gonadal fibroblasts. In C.L., the small marker
      chromosome was found in 50% of stimulated lymphocytes. S.M. is of normal height,
      but C.L. is short. Molecular hybridization with a number of Y-specific DNA probes
      demonstrated their presence in S.M. but absence in C.L. In situ hybridization
      with Y-specific and X-centromere-specific DNA probes confirmed the Y origin of
      the marker chromosome in S.M. and the X origin of the minute chromosome in C.L.
      Biotinylated centromere and telomere probes were also used for in situ
      hybridization to show the presence of centromeric and telomeric sequences in the
      Y-marker chromosome, suggesting that the deletion of this marker chromosome is
      interstitial.

PMID- 2240049
TI  - Walker-Warburg syndrome with microtia and absent auditory canals.
AB  - Walker-Warburg syndrome is a lethal, autosomal recessive disorder characterized
      by anomalies of the central nervous system and eye. Typical findings include
      hydrocephalus, agyria, retinal dysplasia, cerebellar dysgenesis, anterior chamber
      dysgenesis, and encephalocele. Recently, the phenotypic spectrum has been
      expanded to include congenital muscular dystrophy. Two sibs with Walker-Warburg
      syndrome are reported. One sib had congenital glaucoma and hydrocephalus. The
      other sib had hydrocephalus, microtia, absent auditory canals, and pale retinas,
      barely within the phenotypic spectrum of the disorder. Elevation of muscle
      enzymes was consistent with the diagnosis of Walker-Warburg syndrome.

PMID- 2240050
TI  - Adjacent-2 disjunction of a maternal t(9;22) leading to duplication 9pter----q22
      and deficiency of 22pter----q11.2.
AB  - The proposita presented at birth with multiple congenital anomalies including
      craniofacial anomalies, bilateral cleft lip and palate, abnormalities of the
      urogenital system, talipes equinovarus, and the DiGeorge sequence. Cytogenetic
      investigation showed a 46,XX,-22,+der(9)t(9;22)(q22;q11.2) karyotype. The mother,
      maternal uncle, and maternal grandmother of the infant are carriers of a
      reciprocal balanced translocation involving chromosomes 9 and 22 at regions q22
      and q11.2, respectively. The unbalanced karyotype seen in the proposita arose due
      to an adjacent-2 disjunction of the quadrivalent in the mother. Prenatal
      diagnosis of the second pregnancy of this woman showed a similar karyotype.
      Review of the literature shows that adjacent-2 disjunction may occur
      preferentially when certain chromosomes are involved in translocations.

PMID- 2240051
TI  - Prevalence study of Prader-Willi syndrome in North Dakota.
AB  - A prevalence study of Prader-Willi syndrome (PWS) has been conducted in North
      Dakota. All pediatricians, neurologists, child psychiatrists, psychologists, and
      clinical geneticists were surveyed. The state's comprehensive evaluation center,
      the state hospital, the state institution for the mentally retarded, and group
      homes for the developmentally disabled, including one for persons with PWS, were
      also contacted. Seventeen patients were identified, 8 males, 8 females, and one
      patient whose sex was not specified. This suggests a prevalence rate of 1 per
      16,062 in North Dakota.

PMID- 2240052
TI  - Familial IgM mesangial nephropathy: a morphologic and immunogenetic study of
      three pedigrees.
AB  - Eight patients belonging to 3 unrelated families had biopsy-proven IgM mesangial
      nephropathy. In the first family, the mother and the 2 daughters were affected;
      in the second, the mother and the son; in the third, 2 sisters and the brother.
      Two additional sisters of the third family showed a clinical picture consistent
      with chronic glomerulonephritis. The clinical picture was that of hematuria
      and/or proteinuria. No patients had nephrotic syndrome. Genealogic investigation
      enabled us to discover 2 additional affected members in the kindred of the first
      family (1 with IgA nephropathy, 1 with clinical glomerulonephritis) and 3 other
      affected members in the pedigree of the third family (1 with IgA nephropathy, 1
      with sclerosing glomerulonephritis, 1 with clinical glomerulonephritis).
      Immunogenetic studies showed the recurrence of an extended haplotype bearing DR
      beta 11-DQ beta 3B-DQ alpha 2-C4A3-C4B1-BfS in 9 of 10 affected members. Our data
      suggest that genetic factors may be involved in the mechanism of the disease and
      support the hypothesis that IgM nephropathy is a distinct disease entity.

PMID- 2240053
TI  - Lysine vasopressin in the treatment of refractory hemodialysis-induced
      hypotension.
AB  - The etiology of hemodialysis-induced hypotension is multifactorial. We assessed
      the efficacy of intranasal lysine vasopressin (LV) in 6 patients with refractory
      hemodialysis-induced hypotension. Autonomic testing was abnormal in all.
      Intranasal LV and placebo were assessed in a double-blind crossover fashion. With
      LV, the mean number of hypotensive episodes was less (0.9 +/- 0.8 vs. 1.5 +/- 1;
      t = 3.95, p less than 0.05), as was the total volume of intravenous fluid
      administered because of hypotension (155 +/- 57 vs. 280 +/- 123 cm3; t = 2.98, p
      less than 0.05). Systolic, diastolic, and mean arterial blood pressures were
      significantly greater at 90 min of the dialysis session. Measured baseline
      epinephrine, norepinephrine, and antidiuretic hormone levels were elevated above
      normal levels and fell with hypotension despite the use of LV. The results from
      this study demonstrate the utility of LV in the treatment of refractory
      hemodialysis-induced hypotension.

PMID- 2240055
TI  - End-stage renal disease in systemic amyloidosis: clinical course and outcome on
      dialysis.
AB  - We studied a group of 48 patients with systemic amyloidosis and end-stage renal
      disease (ESRD) treated with chronic dialysis to analyze the clinical course and
      the factors which can influence survival. This group was compared to a control
      group of 63 nondiabetic patients without amyloidosis with ESRD treated with
      hemodialysis. The median survival of the experimental group was 52 months; 1-, 2-
      and 6-year actuarial survival was 72, 62, and 44%, while in the control group it
      was 95, 91, and 81%, respectively (p less than 0.001). Survival was significantly
      shorter for patients with amyloidosis who rapidly (less than 3 months) progressed
      to ESRD or who had an acute deterioration in renal function immediately prior to
      the need for dialysis. The median survival in these cases was 4 and 1.5 months,
      respectively. Age, the presence or the degree of renal failure at the moment of
      diagnosis, and the type of amyloidosis did not affect the survival of these
      patients. Despite a shorter period of time spent on dialysis, these patients had
      a similar number of hospital admissions, cardiovascular and infectious events as
      the control patients, but more gastrointestinal disorders (bleeding and chronic
      diarrhea) and blood access problems. In conclusion, amyloidotic patients
      maintained on chronic dialysis have high morbidity and mortality rates.
      Nevertheless, acceptable survival is predictable in stable patients who progress
      slowly to ESRD.

PMID- 2240054
TI  - Normal T lymphocyte function in patients with end-stage renal disease
      hemodialyzed with 'high-flux' polysulfone membranes.
AB  - T lymphocyte function was analyzed in patients hemodialyzed with 'high-flux'
      polysulfone membranes, which have been reported to improve the patients' overall
      clinical condition and well-being. For comparison purposes, patients treated by
      the use of 'low-flux' cuprophane membranes were also studied. Peripheral blood
      white cell counts, numbers of lymphocytes as well as the numbers of T cells and
      their CD4 and CD8 subsets were within normal range in both patient groups. The
      absolute number of B cells was slightly decreased in cuprophane-membrane- but not
      polysulfone-membrane-treated patients. The proliferative response of T
      lymphocytes after stimulation with optimal concentration of phytohemagglutinin
      (PHA) was normal in patients treated with 'high-flux' membrane dialysis but
      significantly reduced in those treated with cuprophane membranes. The generation
      of interleukin-2 (IL-2) receptor on T lymphocytes after PHA stimulation was
      normal in the polysulfone-membrane-treated group and slightly impaired in the
      cuprophane-membrane-dialyzed patients. Production of both IL-2 and interleukin-1,
      as well as the natural killer cell activity, in patients treated by 'high-flux'
      membrane dialysis were also comparable to controls. The levels of serum beta 2
      microglobulin were significantly elevated in patients-maintained on 'high-flux'
      dialysis membranes but did not reach the levels seen in patients dialyzed by
      cuprophane membranes. The beta 2-microglobulin at levels seen in patients on
      cuprophane dialysis had no effects on activation and proliferation of control
      lymphocytes in vitro. These results suggest that impaired functional responses of
      T lymphocytes seen in end-stage disease patients on prolonged hemodialysis with
      cuprophane membranes are not seen in similar patients hemodialyzed with
      polysulfone membranes.

PMID- 2240056
TI  - Development of hypertension in IgA nephropathy as a marker of a poor prognosis.
AB  - We have studied 209 patients with IgA nephropathy. 26 were hypertensive at the
      time of renal biopsy, and 59 patients developed hypertension during follow-up.
      Survival statistics show that only 45% of the patients will remain normotensive
      10 years after renal biopsy. The presence of hypertension at renal biopsy
      correlated well with the usual parameters of a poor prognosis. The same markers
      predicted a later development of hypertension in patients who were normotensive
      at the time of renal biopsy. When hypertension is established, the prognosis is
      poor. Three years after diagnosis of hypertension, the renal survival was found
      to be 70% in the 59 patients we have followed. It is also possible that the
      markers of a poor prognosis actually predict the progression rate rather than the
      prognosis, because in time, some patients with initially mild manifestations of
      the disease will progress to end-stage renal failure.

PMID- 2240057
TI  - The spectrum of ciclosporin nephrotoxicity.

PMID- 2240058
TI  - Caffeine potentiates the nephrotoxicity of mefenamic acid on the rat renal
      papilla.
AB  - The effect of caffeine given in combination with mefenamic acid on the renal
      papilla was studied. Sprague-Dawley rats were divided into four groups and gavage
      fed either control suspension, mefenamic acid, mefenamic acid and caffeine or
      caffeine alone for 4 months. Semiquantitative urinalysis was performed at 3
      months and showed increased haematuria in the mefenamic acid and caffeine group.
      There were no significant differences in serum creatinine at sacrifice. Renal
      histology revealed more advanced papillary necrosis in rats gavage fed mefenamic
      acid and caffeine compared with all other groups (p less than 0.0001). Rats fed
      mefenamic acid alone showed more damage than control and caffeine-fed groups (p
      less than 0.0001, p less than 0.0002, respectively). This suggests that caffeine
      potentiates the nephrotoxicity of the non-steroidal anti-inflammatory drug,
      mefenamic acid, on the rat renal papilla. The mechanism of this potentiation by
      caffeine is yet to be defined.

PMID- 2240059
TI  - A role for adenosine calcium and ischemia in radiocontrast-induced intrarenal
      vasoconstriction.
AB  - These studies were designed to test the hypothesis that adenosine and calcium are
      important in mediating radiocontrast-media-associated reduction in renal blood
      flow (RBF) in the dog. Intravenous verapamil (V) and diltiazem (DTZ) infusion
      significantly attenuated the magnitude of the vasoconstrictor response observed
      after each intrarenal contrast media (CM) injection. (First injection: -47 +/- 8%
      control vs. -14 +/- 3% V, p less than 0.03; -38 +/- 4% control vs. -19 +/- 3%
      DTZ, p less than 0.02. Second injection: -33 +/- 6% control vs. -12 +/- 1% V, p
      less than 0.03; -32 +/- 5% control vs. -17 +/- 2% DTZ, p less than 0.03. Third
      injection: -32 +/- 6% control vs. -11 +/- 5% V, p less than 0.03; -38 +/- 5%
      control vs. -10 +/- 5% DTZ, p less than 0.02). Furthermore, V and DTZ almost
      completely abolished the increase in renal vascular resistance (RVR) induced by
      each CM administration. Theophylline also significantly attenuated the magnitude
      of the vasoconstrictor response observed after CM injection (first injection: -31
      +/- 3% control vs. -12 +/- 3% theophylline, p less than 0.05; second injection: 
      26 +/- 3% control vs. -12 +/- 3% theophylline, p less than 0.03). Similarly,
      theophylline blunted the increase in RVR induced by CM injection. In addition,
      theophylline inhibited exogenous adenosine-induced decrease in RBF (-61 +/- 10%
      and -26 +/- 1% decrease in RBF without and with theophylline, respectively). In
      contrast, dipyridamole significantly enhanced the vasoconstriction induced by CM
      (first injection: 25 +/- 3% control vs. 49 +/- 4% dipyridamole; second injection:
      31 +/- 3% control vs. 48 +/- 4% dipyridamole p less than 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2240061
TI  - Unusual case of crescentic glomerulonephritis associated with malignant lymphoma.
      A case report and review of the literature.
AB  - Renal lesions in non-Hodgkin's lymphoma are rare. Furthermore, to the best of our
      knowledge, only 5 cases of crescentic glomerulonephritis associated with non
      Hodgkin's lymphoma have been previously described. We report a case of crescentic
      glomerulonephritis and renal failure which preceded the diagnosis of non
      Hodgkin's lymphoma. Following steroid therapy there was a resolution of these
      histological findings a year later.

PMID- 2240060
TI  - Membranous nephropathy associated with giant lymph node hyperplasia. A case
      report with histological and ultrastructural studies.
AB  - A young woman presented with nephrotic syndrome due to membranous nephropathy and
      a localized form of giant lymph node hyperplasia (Castleman's disease) occurring
      as a large intra-abdominal mass. Five months after surgical removal of the mass,
      only mild proteinuria persisted. Twenty months later a second kidney biopsy
      showed a near-normal morphology. Six years later the patient was free of symptoms
      and had normal urinalysis. Reviewing the pertinent literature, it seems to be the
      first case of a biopsy-proven cure of membranous nephropathy in a patient with
      membranous nephropathy and Castleman's disease.

PMID- 2240062
TI  - Nonamyloidotic fibrillar glomerulopathy and recurrent gestational anasarca.
AB  - Congo-red-negative microfibrils have been described in various glomerular
      diseases, some of which have no known etiology. We report the unusual case of a
      young woman who, over a period of 17 years, developed recurrent gestational
      anasarca but was asymptomatic between pregnancies except for proteinuria. Her
      blood pressure and renal function have remained normal over the years. A renal
      biopsy done 5 years after her third pregnancy showed diffuse mesangial expansion
      and irregular thickening of the glomerular basement membrane, both caused by the
      deposition of nonamyloidotic microfibrils. We discuss the differential diagnosis
      of this case and review the pertinent literature.

PMID- 2240063
TI  - Control of renovascular hypertension by renal embolization.
AB  - Two cases with medically well-controlled renovascular hypertension due to
      unilateral contracted kidney were treated by percutaneous renal embolization. One
      of the patients had two aneurysms of the renal artery in addition to the
      stenosis. Both patients remained normotensive without medication after follow-ups
      of 6 and 24 months, respectively.

PMID- 2240064
TI  - Primary oxalosis mimicking hyperparathyroidism diagnosed after long-term
      hemodialysis.
AB  - Primary oxalosis is a rare inborn error of oxalate metabolism. Most cases are
      discovered in children, but occasionally symptoms begin later in life. Since
      early deaths in the past were from renal failure, prolonged survival obtained
      with chronic dialysis allows oxalosis to develop. This paper presents a 38-year
      old man with an atypical history of type-I primary hyperoxaluria, not diagnosed
      until after 5 years of dialysis. Bone biopsy was performed because the
      biochemical and radiologic features did not seem consistent with a putative
      diagnosis of secondary hyperparathyroidism. This case emphasizes the clinical
      heterogeneity of this disorder, and the need for its considerations in the
      spectrum of dialysis-related bone diseases. It also stresses that bone oxalosis
      may mimic hyperparathyroidism, especially radiologically. Differential diagnosis
      is therefore mandatory.

PMID- 2240065
TI  - Adenoviral acute hemorrhagic cystitis following renal transplantation.

PMID- 2240066
TI  - Replanted pride in nursing.

PMID- 2240067
TI  - Are you a worrier?

PMID- 2240068
TI  - A nursing nightmare--or was it?

PMID- 2240069
TI  - Men in nursing.

PMID- 2240070
TI  - Early-stage breast cancer: the options.

PMID- 2240071
TI  - Early-stage breast cancer: how nurses help.

PMID- 2240072
TI  - Early-stage breast cancer: adjuvant drug therapy.

PMID- 2240073
TI  - AIDS: light at the end of a decade.

PMID- 2240074
TI  - Emergency! It's cyanide!

PMID- 2240075
TI  - What's right about grievances?

PMID- 2240076
TI  - How do you manage extraventricular drainage?

PMID- 2240077
TI  - Southwest job focus: spirit of the Southwest: action in the 90's.

PMID- 2240078
TI  - Doin' the oyster check.

PMID- 2240079
TI  - Arizona job focus. More than a pretty place.

PMID- 2240080
TI  - IRS challenges the "independent contracting" option for nurses.

PMID- 2240081
TI  - Human oocyte and preembryo donation: an evolving method for the treatment of
      infertility.
AB  - The utilization of oocyte and preembryo donation in the treatment of infertility
      has recently expanded. Since 1983, modifications in the retrieval of donated
      female gametes have enhanced both the safety and the efficacy of the procedure.
      Pregnancy rates in women receiving donated preembryos are remarkably high, with
      success occurring in 25% to 50% of transfer cycles. The technology used for
      preembryo donation continues to evolve, and the current and future role ovum
      donation in the treatment of infertility.

PMID- 2240082
TI  - Does obstetric ethics have any role in the obstetrician's response to the
      abortion controversy?
AB  - We defend the view that the obstetrician's response to the abortion controversy
      cannot be based on accounts of the independent moral status of the fetus, because
      all such accounts are irresolvably disputable. That response, however, can be
      based on an account of the dependent moral status of the fetus. For such an
      account the central question is, "When is the fetus a patient?" Viable fetuses
      are patients. Nonviable third-trimester fetuses are not patients. Previable
      fetuses are patients solely as a function of the woman's autonomous decision to
      confer such status. The abortion of a viable fetus is, with few exceptions, never
      ethically justified, because it is a patient. The abortion of nonviable third
      trimester fetuses (i.e., premature termination of pregnancy) is justified when
      the pregnant women consents to it. Abortion of the previable fetus is justifiable
      when the pregnant women consents to it. We distinguish between professional and
      private conscience. We identify the limits of the former and the legitimate role
      of the latter, especially in the area of religious beliefs. Finally, we address
      the implications of our view for residency training programs. The most important
      of these implications is that requiring all residents to perform abortions is
      ethically unjustifiable.

PMID- 2240083
TI  - Interleukin-1 beta, human leukocyte antigen HLA-DR alpha, and transforming growth
      factor-beta expression in endometrium, placenta, and placental membranes.
AB  - Maternal immune recognition of the fetal semiallograft appears to be necessary
      and beneficial for fetal survival and growth. Interleukin-1 beta and human
      leukocyte antigen HLA-DR are important for foreign antigen recognition by the
      immune system, whereas transforming growth factor-beta inhibits many of the
      immunostimulatory properties of interleukin-1 beta. In this study we found that
      first-trimester decidua and term placental membranes expressed significantly
      higher levels of interleukin-1 beta, interleukin-1 beta messenger ribonucleic
      acid, and human leukocyte antigen HLA-DR alpha messenger ribonucleic acid
      expression. All tissues found at the maternal-fetal interface, including first
      trimester decidua, placenta, and placental membranes, contained transforming
      growth factor-beta and expressed transforming growth factor-beta 1 messenger
      ribonucleic acid. On the basis of these findings, we suggest that the increase in
      decidual interleukin-1 beta and human leukocyte antigen HLA-DR alpha during
      pregnancy may be involved in maternal recognition of the fetal semiallograft and
      that transforming growth factor-beta production may regulate the local maternal
      immune response and prevent rejection of the fetus.

PMID- 2240085
TI  - Immunocytochemical distribution and localization of 15-hydroxyprostaglandin
      dehydrogenase in human fetal membranes, decidua, and placenta.
AB  - Biochemical studies have shown the presence of type I oxidized nicotinamide
      adenine dinucleotide-dependent 15-hydroxyprostaglandin dehydrogenase in human
      fetal membranes, decidua, and placenta. However, the localization of
      prostaglandin dehydrogenase within these tissues is not known. Because the
      distribution of prostaglandin dehydrogenase may affect the concentration of
      prostaglandins that reach the myometrium, we used immunocytochemistry to localize
      immunoreactive prostaglandin dehydrogenase in fetal membranes and placenta. We
      also examined whether this distribution changed with labor. Tissues were
      collected at term elective cesarean section or after term spontaneous labor and
      delivery, were fixed, embeded, and sectioned at 5 microns. Immunoreactive
      prostaglandin dehydrogenase was determined with a polyclonal primary antibody to
      human placental prostaglandin dehydrogenase and visualized with the avidin-biotin
      procedure. Epithelial and epithelium-derived cells were identified by positive
      staining with a polyclonal antikeratin primary antibody. Cytokeratin staining was
      observed in amniotic epithelium, trophoblast layer of chorion, invading
      trophoblast in decidua, and all subsets of trophoblast in the placenta.
      Immunoreactive prostaglandin dehydrogenase was localized to the trophoblast layer
      of chorion, invading trophoblast in decidua, and in syncytiotrophoblast and
      intermediate trophoblast but not cytotrophoblast in the placenta. In chorion,
      approximately 50% to 60% of the nonvacuolated trophoblast cells stained
      positively for prostaglandin dehydrogenase. There was no change in the
      localization of immunoreactive prostaglandin dehydrogenase in any tissue in
      association with labor.

PMID- 2240084
TI  - Prevalence and determinants of estrogen replacement therapy in elderly women.
AB  - To better understand which women use estrogen replacement therapy, we examined
      the prevalence and determinants of estrogen replacement therapy in 9704 nonblack
      women, age greater than or equal to 65 years, who participated in the multicenter
      prospective Study of Osteoporotic Fractures. Overall, 13.7% of women reported
      current use of oral estrogen; 10.9% took estrogen alone and 2.8% took estrogen
      opposed by progestin. Four percent currently used parenteral estrogen compounds.
      Current use declined sharply with age from 17% at age 65 to 4% at age greater
      than or equal to 85. The primary determinant of estrogen replacement therapy was
      the type of menopause; the odds of using estrogen replacement therapy in current
      users compared with never users were approximately five times higher in women
      with a surgical menopause. Estrogen use was more common among women who had
      higher levels of education and were less obese. Furthermore, estrogen replacement
      therapy users were more likely to drink alcohol and to participate in sports and
      recreation. A diagnosis of osteoporosis was the major determinant of continued
      estrogen use, but only 24% of women with a diagnosis of osteoporosis used
      estrogen replacement therapy. We conclude that only a small proportion of elderly
      women in the United States use estrogen replacement therapy. Selection factors
      for use of estrogen are evident and may introduce bias in studies of estrogen and
      disease. In consideration of the distribution of these selection factors,
      estrogen users will tend to be at lower risk of coronary disease and possibly
      breast cancer but at greater risk for hip fractures.

PMID- 2240086
TI  - The effect of physical activity during pregnancy on preterm delivery and birth
      weight.
AB  - The relationship between physical activity during pregnancy, preterm birth, and
      gestational age-adjusted birth weight was investigated prospectively in a cohort
      of 7101 women. This study is one of few to evaluate both employment- and non
      employment-related physical activity. Prolonged periods of standing were
      associated with a modestly increased risk of preterm delivery (adjusted odds
      ratio for greater than or equal to 8 hours/day of standing = 1.31). Heavy work or
      exercise was not associated with preterm delivery (adjusted odds ratio for
      greater than or equal to 4 hours per day of heavy work = 1.04). The proportion of
      infants born preterm did not differ among women working in predominantly
      standing, active, and sedentary occupations. Physical activity was not associated
      with gestational age-adjusted birth weight after controlling for confounding
      variables. These data suggest that unmeasured socioeconomic differences among
      women reporting different levels of activity may account for previously described
      associations between physical activity and pregnancy outcome. Most pregnant women
      who report increased levels of physical activity are not at increased risk of
      preterm delivery or reduced intrauterine growth. However, these data do not
      address the role of activity restriction in the management of selected women at
      high risk for adverse pregnancy outcome.

PMID- 2240087
TI  - Prenatal diagnosis of laryngeal atresia.
AB  - In a patient in whom preeclampsia developed at 23 weeks' gestation,
      ultrasonographic examination of the fetus showed enlarged edematous lungs, a
      compressed fetal heart, severe ascites, fetal hydrops, and placental edema.
      Autopsy of the hydropic stillborn infant showed laryngeal atresia. The
      ultrasonographic appearance of this rare malformation is presented.

PMID- 2240088
TI  - Correlations between antepartum maternal metabolism and newborn behavior.
AB  - We suggested that antepartum maternal metabolism may affect later cognitive and
      behavioral function of progeny by impacting on developing brain cells in utero.
      This study reports on the observed relationships between serial characterizations
      of maternal fuels during pregnancy and Brazelton neonatal behavioral assessment
      scale ratings of offspring from 73 well-controlled pregestational diabetic
      patients, 112 gestational diabetic patients, and 24 nondiabetic patients. After
      controlling for the effects of premature birth on the Brazelton neonatal
      behavioral assessment scale, significant correlations were found between second-
      and third-trimester glycemic regulation (hemoglobin A1c and fasting plasma
      glucose levels) and three of four newborn behavioral dimensions of the Brazelton
      neonatal behavioral assessment scale. In each case, as maternal glucose
      increased, the newborns' Brazelton neonatal behavioral assessment scale responses
      were poor. Results were not substantially different when gestational and
      pregestational diabetic patients were analyzed separately, nor can they be
      attributed to various perinatal events (neonatal asphyxia, hypoglycemia) or
      differences in socioeconomic status or ethnicity. The presence of fuel-related
      neurobehavioral deficits in neonates of diabetic mothers suggests that such
      infants start their interactions with care givers from a modified base.

PMID- 2240089
TI  - Antenatal microbiologic and maternal risk factors associated with prematurity.
AB  - In a prospective study of 202 women (gestational age 24 +/- 4 weeks), we
      evaluated possible influences of lower genital tract infection or bacterial
      conditions on obstetric outcomes, including preterm labor, preterm premature
      rupture of membranes, and preterm birth. The presence of bacterial vaginosis
      (18.7%) was associated with an increased risk of preterm labor (relative risk,
      2.6; 95% confidence interval, 1.08 to 6.46). For women with bacterial vaginosis
      who also had Mobiluncus species morphotypes identified on Gram stain, the
      relative risk of preterm labor was 3.8 (95% confidence interval, 1.32 to 11.5).
      Presence of vaginal Mycoplasma hominis (10.8% of patients) was associated with
      both preterm labor (relative risk, 1.8; 95% confidence interval, 0.77 to 4.4) and
      preterm birth (relative risk, 5.1; 95% confidence interval, 1.45 to 17.9).
      Recovery of Staphylococcus aureus (3.0%) was associated with preterm labor
      (relative risk, 3.1; 95% confidence interval 1.12 to 8.7). Identification of two
      or more bacterial-linked abnormalities was also associated with preterm labor
      (relative risk, 3.3; 95% confidence interval, 1.44 to 7.58). An increased level
      of vaginal wash protease (greater than or equal to 10 trypsin units) (16%) was
      associated with preterm labor and was noted in 50% of women with preterm
      premature rupture of membranes. A history of prior preterm birth was the single
      best historical predictor of both preterm labor (relative risk, 3.6; 95%
      confidence interval, 1.92 to 6.83) and preterm birth (relative risk, 6.7; 95%
      confidence interval, 2.2 to 20.4). History of three or more abortions, antenatal
      urinary tract infection, and occurrence of medical complications during pregnancy
      also correlated with increased risk of preterm labor. These findings affirm and
      refine associations of various maternal reproductive tract infections with
      preterm labor, premature rupture of membranes, and birth, allowing for controlled
      treatment trials aimed at prevention of preterm birth.

PMID- 2240090
TI  - The relationship between plasma estradiol and the increase in bone density in
      postmenopausal women after treatment with subcutaneous hormone implants.
AB  - Twenty-three postmenopausal women with a median of 2 years past menopause (range,
      1 to 12 years) and a median age of 52 years (range, 39 to 62 years) were
      recruited to participate in a longitudinal study designed to investigate the
      factors that influence the increase in bone density with subcutaneous estradiol
      and testosterone implants. All women received 75 mg of estradiol with 100 mg
      testosterone subcutaneously. Bone density was measured at the spine and hip by
      dual-photon absorptiometry before therapy and after 1 year of subcutaneous
      hormonal therapy. The mean pretreatment bone density at the lumber vertebrae and
      neck of the femur was 0.84 grams of hydroxyapatite per square centimeter (SD,
      0.11) and 0.73 grams of hydroxyapatite per square centimeter (SD, 0.10),
      respectively. The bone density at both sites increased with values of 0.91 grams
      of hydroxyapatite per square centimeter (SD, 0.11) and 0.75 grams of
      hydroxyapatite per square centimeter (SD, 0.11), respectively. These values
      represent an increase of 8.3% (p less than 0.0001) at the spine and 2.8% (p less
      than 0.01) at the neck of the femur. The plasma estradiol level increased from a
      median of 80.5 pmol/L to 453 pmol/L (p less than 0.001). The percentage increase
      of vertebral bone density was not related to age, number of years past the
      menopause, pretreatment bone density, or serum testosterone levels, but a
      significant correlation was found between the percentage increase in bone density
      at the spine and the serum estradiol level (p less than 0.02, r = 0.45).

PMID- 2240091
TI  - Fetal eye movement assessed with real-time ultrasonography: are there rapid and
      slow eye movements?
AB  - The goal of this study was to determine whether rapid eye movement and slow eye
      movement exist during the eye-movement period in the human fetus in utero. We
      studied 21 fetuses with real-time ultrasonography, 10 from 33 to 36 weeks and 11
      from 37 to 41 weeks' gestation. We used the duration of eye-movement unit as a
      parameter and calculated the cumulative duration from the shortest to a given
      duration of eye movement per individual case. A scattergram of cumulative
      duration versus given duration obtained from all cases in each age group was
      analyzed with piecewise linear regression to search for a critical point(s).
      Critical given duration points were noted and reached statistical significance at
      0.62 second and at 0.76 second during 33 to 36 and 37 to 40 weeks of gestation,
      respectively. These findings reveal two different types of eye movement: one with
      a duration of less than 0.6 to 0.8 second and the other with a duration of
      greater than 0.6 to 0.8 second. These findings are compatible with previous
      criteria on rapid and slow eye movements, respectively, at 33 weeks of gestation
      onward. The mean value of cumulative duration at the critical point increased
      from 29.0% between 33 and 36 weeks to 47.1% between 37 and 41 weeks of gestation,
      indicating an increase in the proportionate amount of time maintaining rapid eye
      movement as gestation advances.

PMID- 2240092
TI  - Continuous or interrupted fascial closure: a prospective evaluation of No. 1
      Maxon suture in 402 gynecologic procedures.
AB  - During a 14-month period of using a long-term absorbable suture (No. 1 Maxon),
      402 patients were entered into a prospective, randomized trial of fascial
      closure. Patients were randomized between a continuous closure (201 patients) and
      an interrupted en bloc (201 patients) technique. Each patient was subjected to a
      preoperative and intraoperative protocol for wound management. There were no
      acute wound failures. Wound infection rates and risk of hernia were not
      apparently affected by closure technique.

PMID- 2240093
TI  - Endometrioma of the liver.
AB  - Hepatic endometriosis is extremely rare. We describe a patient sent to us with
      epigastric pain as the only symptom and who was found to have associated
      endometrioma of the liver and left ovary. We suggest a gynecologic evaluation
      before surgery for hepatic cyst of unknown cause.

PMID- 2240094
TI  - Antinuclear antibodies in sera of patients with recurrent pregnancy wastage.
AB  - Four groups of women were studied to determine whether low-level antinuclear
      antibody titers are associated with a higher risk for pregnancy loss. Group A
      consisted of 30 patients with a history of unexplained fetal losses. Group B
      consisted of 30 women with "explained" fetal losses (e.g., uterine septum or
      luteal phase defect). Ages and number of losses were comparable between the women
      in groups A and B. Group C consisted of 61 healthy pregnant women. Group D
      involved 61 healthy nonpregnant women of reproductive age. In groups A and B, 40%
      and 53.3% of the respective patients had antinuclear antibody titers greater than
      or equal to 1:40. In groups C and D the frequencies of positive antinuclear
      antibody titers were 8.2% and 5.6%, respectively. This study demonstrates a high
      prevalence of low-titer antinuclear antibody-positive serum in patients with
      explained and unexplained pregnancy losses.

PMID- 2240096
TI  - Hemoperitoneum as a result of coital injury without associated vaginal injury.
AB  - Hemoperitoneum as a result of coital injury without associated vaginal injury is
      an extremely rare entity, and evidence by only five cases that have been reported
      in the medical literature to date. We report five additional cases encountered in
      two medical centers. Two of these were ruptured corpus luteum cysts, one was a
      laceration of the round ligament, another was a laceration of an ovary, and the
      fifth was rupture of a serous cystadenoma. This diagnosis should be considered in
      patients with hemoperitoneum after coitus.

PMID- 2240095
TI  - Corpus luteum function in early pregnancies is primarily determined by the rate
      of change of human chorionic gonadotropin levels.
AB  - Regulation of human corpus luteum activity was studied with radioimmunoassays and
      bioassays of sera drawn serially from women suspected of having ectopic
      pregnancies. Progesterone values exhibited considerable overlap in pregnancies
      that were subsequently classified as normal intrauterine (n = 21), ectopic (n =
      35), or spontaneous abortion (n = 14). The rate of change of human chorionic
      gonadotropin concentration was significantly correlated with progesterone levels
      in ectopic (r = 0.64) and all pregnancies (r = 0.70). There was no correlation (r
      = -0.18) between the rate of change of human chorionic gonadotropin and the
      bioactivity produced per volume of serum. Ectopic pregnancies and normal
      intrauterine pregnancies did not differ in their ratio of in vivo bioactivity to
      immunoactivity. From these data we conclude that corpus luteum activity is
      primarily regulated by the rate of change of human chorionic gonadotropin
      concentration, without the involvement of other serum factors. We also conclude
      that reduced corpus luteum function in ectopic pregnancies is not a result of
      biochemical modification of the human chorionic gonadotropin molecule. Finally,
      we discourage the use of single progesterone values in screening for ectopic
      pregnancies because of the considerable overlap in progesterone values among
      these and normal intrauterine pregnancies.

PMID- 2240097
TI  - Postmortem chorionic villus sampling is a better method for cytogenetic
      evaluation of early fetal loss than culture of abortus material.
AB  - In utero chorionic villus sampling at the time of diagnosis of intrauterine fetal
      death is compared with more traditional use of cultured fetal skin, products of
      conception, or amniocentesis. A total of 102 specimens from early fetal losses
      were evaluated for success in karyotyping and chromosomal results. We found
      postmortem chorionic villus sampling is technically possible, offers the highest
      likelihood of getting a cytogenetic result, and is a rapid, reliable, and safe
      technique. The extraembryonic component of intrauterine fetal deaths appears to
      remain viable and continues to grow long after the embryo has died. Samples
      obtained at the time of diagnosis of fetal death offer the greatest changes of
      successfully obtaining a karyotype. The incidence of chromosome abnormalities
      associated with fetal loss, particularly trisomies, is higher than previous data
      suggested.

PMID- 2240098
TI  - Detection of congenital toxoplasmosis by chorionic villus sampling and early
      amniocentesis.
AB  - We describe a strategy used in this case to detect congenital toxoplasmosis early
      in pregnancy. Combination of chorionic villus sampling and early amniocentesis
      with an in vitro cell culture technique makes prenatal diagnosis of congenital
      toxoplasmosis possible from the end of the first trimester of pregnancy.

PMID- 2240099
TI  - The "stuck twin" phenomenon: ultrasonographic findings, pregnancy outcome, and
      management with serial amniocenteses.
AB  - Thirteen consecutive twin pregnancies affected by the "stuck twin" phenomenon
      were reviewed to determine the potential benefit of serial amniocenteses. The
      fetal survival rate for the eight pregnancies that underwent serial amniocenteses
      was 69% (11 of 16 fetuses). This is significantly improved compared with a fetal
      survival rate of 20% among the five preceding pregnancies managed without serial
      amniocenteses at the same institution (p = 0.01). It is also markedly improved
      compared with a combined fetal survival rate of 16% among 48 previously reported
      pregnancies with the stuck twin phenomenon managed without serial amniocenteses
      (p less than 0.0001). Survival correlated with the absence of concomitant
      pregnancy complications (i.e., maternal hypertension or intractable labor) and
      with the absence of severe fetal structural abnormalities. Procedural
      complications occurred in three of eight pregnancies (37.5%) managed with serial
      amniocenteses and was attributed as a cause of fetal death in one case. Two of 11
      survivors (18%) had complications after serial amniocenteses including brain
      infarction and renal tubular necrosis. Serial amniocenteses may significantly
      improve the survival rate of twin gestations affected by the stuck twin
      phenomenon but may be associated with complications among survivors.

PMID- 2240100
TI  - Twin-twin transfusion syndrome.
AB  - Twin-twin transfusion syndrome associated with acute polyhydramnios in one sac
      and severe oligohydramnios in the other, which characteristically is diagnosed
      between 18 and 28 weeks, is associated with a high mortality rate for the
      involved twins. Patients who are managed without intervention have essentially
      100% perinatal mortality. Nineteen patients with this diagnosis were treated at
      Good Samaritan Medical Center over a 5-year period. Because of the known
      perinatal mortality and because of early experiences with the twin-twin
      transfusion syndrome, we began to actively intervene in such patients with
      various modes of therapy. As experience was gained, it was found that repeated
      therapeutic amniocenteses, if performed before severe maternal abdominal
      distention or labor, appears to be beneficial.

PMID- 2240101
TI  - Pregnancy in a patient with treated Wilson's disease: a case report.
AB  - Pregnancy should have a successful outcome in a patient with treated Wilson's
      disease if complications are excluded before conception. Chelating treatment must
      be maintained, although there is some concern about its teratogenicity. We
      describe the course of pregnancy in a patient followed up in our department.

PMID- 2240102
TI  - Nature of gonadotropin-releasing hormone self-priming of luteinizing hormone
      secretion during the normal menstrual cycle.
AB  - To investigate further the nature of the gonadotropin-releasing hormone self
      priming effect on luteinizing hormone release, we administered two submaximal
      doses of gonadotropin-releasing hormone 2 hours apart to women at three stages of
      the menstrual cycle and analyzed the resultant luteinizing hormone secretory
      episodes with deconvolution analysis. When the characteristics of the secretory
      episodes associated with the second gonadotropin-releasing hormone challenge were
      compared with those associated with the first, both an enhanced maximal secretory
      rate and mass of luteinizing hormone secreted was demonstrable at each phase of
      the cycle. No differences in the luteinizing hormone secretory event half
      duration were detected when the responses to the first and second gonadotropin
      releasing hormone doses were compared. These data confirm the gonadal hormone
      milieu-associated self-priming effect of gonadotropin-releasing hormone on
      luteinizing hormone release and indicate that it is the rate with which
      luteinizing hormone molecules are discharged from the pituitary gland, rather
      than the duration of the secretory episode itself, that provides for the self
      priming effect.

PMID- 2240103
TI  - The perinatal impact of cocaine, amphetamine, and opiate use detected by
      universal intrapartum screening.
AB  - Universal urine testing for cocaine, amphetamines, and opiates was performed on
      1643 women admitted to an obstetric service for a 1-year period with 20.5% having
      positive results. There were 299 patients with positive toxicology results
      matched for race and discharge date with patients having negative toxicology and
      drug history. Significant differences in age, prior obstetric history, prenatal
      care, alcohol history, and smoking were noted between groups. There was a
      significant decrease in birth weight, head circumference, length, and gestational
      age for the drug-positive group, which was most marked in cocaine and multiple
      drug users. These differences persisted after we controlled for smoking, prenatal
      care, and prior preterm births. Differences in birth weight and head
      circumference remained after we controlled for gestational age. Rates of
      congenital anomalies and abruptio placental were similar between groups.
      Perinatal substance abuse is independently associated with growth retardation and
      prematurity. Multiple risk factors are frequently present, necessitating a
      comprehensive approach to prenatal care.

PMID- 2240104
TI  - Inhibition of aromatase activity by 8-bromo-cyclic adenosine monophosphate in
      cultured first-trimester human trophoblast.
AB  - We have previously shown that 8-bromo-adenosine-3':5'-cyclic monophosphate
      inhibits production of estradiol from androgen precursors in trophoblast isolated
      from term placentas. In these experiments we sought to evaluate the effect of 8
      bromo-adenosine-3':5'-cyclic monophosphate on aromatase activity in first
      trimester trophoblast culture. Trophoblast cells were enzyme dispersed from first
      trimester placentas and purified on a Percoll gradient. On the third and fourth
      day after dispersion cultures were treated with androstenedione or testosterone
      with and without 2 mmol/L 8-bromo-adenosine-3':5'-cyclic monophosphate. The
      quantity of estradiol, estrone, progesterone, human placental lactogen, and human
      chorionic gonadotropin was determined by radioimmunoassay. We concluded that in
      first-trimester trophoblast, as previously reported in term trophoblast, 8-bromo
      adenosine-3':5'-cyclic monophosphate inhibited the production of estradiol from
      the supplied androgen precursors. Human chorionic gonadotropin and human
      placental lactogen production was stimulated by 8-bromo-adenosine-3':5'-cyclic
      monophosphate. Progesterone production was either stimulated or was unchanged by
      the presence of 8-bromo-adenosine-3':5'-cyclic monophosphate.

PMID- 2240105
TI  - A reappraisal of the need for autologous blood donation in the obstetric patient.
AB  - There has been recent interest in autologous blood donation in obstetric
      patients, but little attention has been paid to whether such programs are needed
      or whether the patients that will require transfusion can be accurately
      predicted. At the University of California San Diego Medical Center from July 1
      to Dec. 31, 1988, there were 2265 deliveries; 13 women (0.57%) received blood
      transfusions. Traditionally accepted risk factors were identified in 251
      patients, with only four (1.6%) requiring transfusion. Among the 150 patients
      delivered by repeat cesarean section, only one (0.7%) required blood. one of 27
      (3.7%) multiple gestations, two of eight (25%) patients with placenta previa, and
      none of the 66 grandmultiparous women had transfusions. These data suggest that
      autologous blood donation may not be beneficial or cost effective when the low
      frequency of blood transfusions in this high-risk obstetric population and the
      difficulty in accurately predicting those likely to require transfusions are
      considered.

PMID- 2240106
TI  - Direct ultrasonographic measurement of fetal lung length in normal pregnancies
      and pregnancies complicated by prolonged rupture of membranes.
AB  - Fetal lung length was measured directly with ultrasonography in 20 patients with
      prolonged rupture of membranes, commencing before 25 weeks' gestation.
      Measurements were made weekly and compared with data collected from 310 normal
      pregnancies. Measurement of fetal lung length by ultrasonography was a good
      predictor of pulmonary hypoplasia, predicting greater than 90% of cases. There
      was a good correlation between lung size assessed by the last ultrasonographic
      examination and lung weight postmortem (r = 0.783, p less than 0.05). Lung length
      measurements were superior to fetal chest circumference measurements in the
      identification of pulmonary hypoplasia. There was a significant negative
      association between the amount of amniotic fluid and pulmonary hypoplasia (p less
      than 0.05). There were fetuses with pulmonary hypoplasia that had respiratory
      movements seen at the majority of ultrasonographic examinations.

PMID- 2240107
TI  - Color flow Doppler--a useful instrument in the diagnosis of vasa previa.
AB  - Vasa previa is associated with an increased perinatal mortality rate and rarely
      is diagnosed in the antepartum period. We present a case in which vasa previa was
      correctly diagnosed by use of color flow Doppler imaging. This modality is a
      valuable adjunct in the evaluation of patients suspected to have vasa previa.

PMID- 2240108
TI  - Reliability of ultrasonographic formulary in the prediction of fetal weight and
      survival of very-low-birth-weight infants.
AB  - Antenatal management of very-low-birth-weight infants often requires difficult
      obstetric decisions. This study was designed to evaluate the predictive value for
      neonatal outcome of antenatally acquired estimation of gestational age and
      ultrasonographically estimated fetal weight or a combination of both in very-low
      birth-weight infants. Sixty-seven fetuses with estimated gestational ages between
      22 0/7 and 28 6/7 weeks were studied ultrasonographically to estimate fetal
      weight. A comparison of accuracy of estimated fetal weight with actual birth
      weight showed good correlation (r = 0.93). Neonatal outcome of these infants was
      analyzed by estimated gestational age and estimated fetal weight. Estimated
      gestational age and estimated fetal weight greater than 25 weeks and greater than
      750 gm were associated with 50% survival, respectively. However, when both of
      these conditions were met survival reached 85%. This information may be useful to
      guide antepartum management decisions in this very-low-birth-weight group.

PMID- 2240109
TI  - Hyperadrenergic orthostatic intolerance as a result of postpartum blood loss.
AB  - This article describes a young women in whom orthostatic intolerance developed as
      a result of protracted postpartum vaginal bleeding. The cardiovascular
      abnormalities were unresponsive to usual treatment measures, and she required
      combination therapy directed at increasing plasma volume and decreasing
      sympathetic nervous system activity. After resolution of her symptoms, the
      patient required no long-term therapy. Chronic blood loss has not been reported
      as a cause of this syndrome.

PMID- 2240111
TI  - Intrauterine Listeria infection: prenatal diagnosis by biophysical assessment and
      amniocentesis.

PMID- 2240110
TI  - Cervicovaginal microflora and pregnancy outcome: results of a double-blind,
      placebo-controlled trial of erythromycin treatment.
AB  - Available information suggests that some instances of preterm birth or premature
      rupture of membranes are associated with clinically unrecognized infection and
      inflammation of the lower uterine segment, decidua, and fetal membranes. Various
      cervicovaginal microorganisms have been recovered from these sites. Many of these
      microorganisms produce factors that may lead to weakening of the fetal membranes,
      release of prostaglandins, or both. This study evaluated the presence of various
      lower genital tract microflora and bacterial conditions in 229 women enrolled in
      a double-blind, placebo-controlled trial of short-course erythromycin treatment
      at 26 to 30 weeks' gestation to prevent preterm birth. Demographic, obstetric,
      and microbiologic parameters were prospectively evaluated. Premature rupture of
      membranes occurred less frequently (p less than 0.01) among women who received
      erythromycin (6%) versus placebo (16%). Preterm premature rupture of membranes
      also occurred less frequently, although not significantly (p = 0.3) in patients
      who received erythromycin (2%) versus placebo (5%). Erythromycin treatment
      significantly decreased the occurrence of premature rupture of membranes among
      women who were initially positive for Chlamydia trachomatis infection. Logistic
      regression analysis demonstrated that C. trachomatis (p = 0.05; odds ratio, 9),
      vaginal wash phospholipase C (p = 0.08; odds ratio, 6) and prior preterm birth (p
      = 0.007; odds ratio 17) were associated with increased risk of preterm birth.
      Bacterial vaginosis, Mycoplasma hominis, Ureaplasma urealyticum were not
      significantly associated with increased risk of preterm birth or preterm rupture
      of membranes. These findings support a role for selected lower genital tract
      microflora in preterm birth and premature rupture. Large controlled treatment
      trials of specific infections or conditions associated with preterm birth and
      premature rupture of membranes are required to confirm the value of antimicrobial
      treatments in prevention of microbial-associated preterm birth.

PMID- 2240112
TI  - Pregnancy outcomes among mothers infected with human immunodeficiency virus and
      uninfected control subjects.
AB  - Between June 26, 1985, and Feb. 24, 1989, 101 seropositive pregnant women and 129
      seronegative pregnant women from the same prenatal clinics in Brooklyn and the
      Bronx were recruited into a prospective study of human immunodeficiency virus
      infection in pregnant women and their offspring. This report details the course
      of pregnancy and short-term neonatal outcomes of 91 seropositive women and 126
      seronegative women who gave birth during the study period. Seropositive mothers
      were significantly more likely to have sexually transmitted diseases (17.6% vs
      7.1%, p = 0.017) and medical complications (43.0% vs 25%, p = 0.006) during
      pregnancy. No other obstetric complications (e. g., chorioamnionitis,
      endometritis, toxemia, or placental problems) were associated with serologic
      status. After controlling for confounding variables (drug use, tobacco use, age
      of mother, and clinic), we found that the mother's serologic status was not
      significantly associated with birth weight, gestational age, head circumference,
      or Apgar scores among live infants. For example, after adjustment on confounders
      we found that children born to seropositive mothers weighed about 7 gm more than
      children of seronegative mothers (95% confidence interval, -180 to 194 gm). We
      conclude that in this population human immunodeficiency virus infection has
      little demonstrable impact on the status at birth of live neonates.

PMID- 2240113
TI  - Direct analysis of uncultured cytotrophoblastic cells from second- and third
      trimester placentas: an accurate and rapid method for detection of fetal
      chromosome abnormalities.
AB  - Transabdominal chorionic villus sampling can be readily used for detection of
      fetal chromosome abnormalities in the second and third trimesters of pregnancy.
      Although culture of chorionic villi offers little advantage over cultured
      amniotic fluid cells with respect to time required to obtain results, cytogenetic
      analysis of chorionic villi by direct analysis of uncultured cytotrophoblastic
      cells offers clear advantages because of the very short time required to obtain
      results. To determine whether direct analysis of uncultured cytotrophoblastic
      cells from second- and third-trimester placentas can routinely provide rapid and
      accurate assessment of fetal status, we evaluated chorionic villus specimens
      obtained from 57 placentas; 49 placentas were sampled in the second trimester
      whereas eight were sampled in the third trimester. Direct preparations yielded
      karyotypes in 56 (98.2%) preparations; all results of direct analyses were
      available within 72 hours and, when requested, within 12 hours. All results were
      confirmed by chromosome analysis of cultured mesenchymal core cells or cultured
      fetal tissue. We conclude that direct analysis of cytotrophoblastic cells from
      second- and third-trimester placentas is a very rapid and accurate method for
      determining fetal chromosome status that is comparable with, if not superior to,
      percutaneous umbilical blood sampling.

PMID- 2240114
TI  - Perinatal mortality in Victoria, Australia: role of group B Streptococcus.
AB  - Group B beta-hemolytic streptococcus is the most common infective cause of
      neonatal morbidity and mortality. It is therefore surprising that no agreement
      exists for an approach to its prevention. There is also increasing evidence that
      occult infection may play an etiologic role in premature rupture of the membranes
      and preterm labor. In this report we review the role of group B beta-hemolytic
      streptococcal sepsis as a cause of perinatal wastage in the state of Victoria,
      Australia during the period 1982 to 1987. Group B beta-hemolytic streptococcus
      accounted for 1.7% of overall perinatal deaths, and for 30.3% (77 of 254)
      perinatal deaths directly attributable to infection. By comparison, over the same
      6-year period, erythroblastosis accounted for 0.5% of perinatal wastage and there
      were only two deaths as a result of congenital syphilis. The true incidence of
      lethal group B beta-hemolytic streptococcal infection is probably greater because
      of the absence of histologic and bacteriologic studies in many perinatal deaths.
      We believe that intrapartum chemoprophylaxis with penicillin of all group B beta
      hemolytic streptococcus-positive carrier mothers would significantly reduce
      neonatal morbidity and mortality from this cause.

PMID- 2240115
TI  - A comparison of sperm antibody assays.
AB  - Cytotoxicity and Immunobead-binding immunoglobulin G assays agreed in 81% of sera
      from infertile men (n = 173), 74% of sera from their wives, 75% of seminal
      plasma, and 82% of cervical mucous samples (p less than 0.001; chi 2 analysis of
      positive and negative results) when tested against sperm from the same donors.
      Cytotoxic and immunofluorescent IgG antibody results agreed in 79% of sera from
      men and women, 76% of seminal plasma, and 76% of cervical mucus (p less than
      0.001; chi 2 analysis of positive and negative results). Titers or percent
      binding of sperm by cytotoxicity, hemagglutination, and IgG Immunobead-binding or
      immunofluorescence assays in serum and secretions of husbands and wives
      correlated (p less than 0.001). A significantly increased number of positive
      results was observed in cytotoxic and Immunobead-binding IgG assays when the
      husbands' and donors' sperm were used rather than donors' sperm alone. On the
      basis of this study we conclude: (1) that cytotoxicity, Immunobead-binding IgG,
      and immunofluorescent IgG sperm antibody assays correlate when sperm from the
      same source are used, (2) that women's isoimmunity to husbands' sperm is
      associated with their husbands' autoimmunity to sperm irrespective of the assay,
      and (3) that it is desirable to use sperm from the husbands and nonautoimmune
      fertile men in these assays.

PMID- 2240116
TI  - Extensive vulvar and vaginal varicella necessitating abdominal delivery.
AB  - Maternal varicella occurs in fewer than five per 10,000 pregnancies in the United
      States. A case is reported in which markedly painful, extensive vulvar and
      vaginal ulcers prevented cervical examination, and cesarean section was performed
      with the patient under general anesthesia.

PMID- 2240117
TI  - The role of fetal membranes in regulating production, transport, and metabolism
      of prostaglandin E2 during labor.
AB  - The level of prostaglandin E2, a potent stimulator of myometrial contractions,
      increases in amniotic fluid during labor. We tested whether amniotic
      prostaglandin E2 crosses the reflected fetal membranes to the myometrium during
      labor. Disks of amnion, chorion-decidua, and amnion chorion-decidua from 10 term
      pregnancies before labor and nine vaginal deliveries after normal spontaneous
      labor were incubated in two-sided perfusion chambers in the absence or presence
      of 1 mumol/L indomethacin, or in the presence of a bolus of prostaglandin E2 and
      radiolabeled prostaglandin E2 added to the fetal chamber. Net amniotic
      prostaglandin E2 increased significantly (p = 0.003) after labor. However, there
      was no significant difference in prostaglandin E2 concentrations on the maternal
      side of amnion chorion-decidua between labor conditions. High-pressure liquid
      chromatography identified the transport of intact tritiated prostaglandin E2
      across amnion but not across chorion-decidua or amnion chorion-decidua in which
      prostaglandin E2 was completely metabolized. Because of 15-hydroxyprostaglandin
      dehydrogenase activity in chorion, we suggest that amniotic prostaglandin E2
      transport to the myometrium is impaired. Thus the increase in prostaglandin E2
      production that occurs in amnion tissue after labor commences does not result in
      an increase in prostaglandin E2 concentration on the myometrial side of the fetal
      membranes in the in vitro preparation.

PMID- 2240118
TI  - Surgical staples in cesarean section: a randomized controlled trial.
AB  - This randomized controlled trial compares the use of the Auto Suture Poly CS 57
      disposable surgical stapler (n = 98) with standard hysterectomy (n = 102) in low
      transverse cesarean sections. Subjective assessment of blood loss by the surgeon
      resulted in lower mean (+/- SEM) total blood loss estimates in the stapled group
      (492 +/- 24 ml) than in the nonstapled group (579 +/- 38 ml) (p = 0.05). However,
      surgeon's estimation of blood loss as a result of the hysterotomy and blood loss
      estimated by the hemoglobin deficit measured on the second postoperative day did
      not significantly differ between the two groups. The use of the stapling device
      tended to lengthen the total operating time, which averaged 42.5 minutes in the
      group with the staples and 39.2 minutes in the group with the standard
      hysterotomy (p = 0.05). The risk of febrile morbidity, the frequency of
      endometritis, and the length of hospitalization were similar in the two groups.
      Our results do not support the routine use of the Auto Suture Poly CS 57
      disposable surgical stapler in low transverse cesarean sections.

PMID- 2240119
TI  - The associated anomalies that determine prognosis in congenital omphaloceles.
AB  - Cogenital abdominal wall defects such as omphaloceles can be recognized by fetal
      ultrasonography. To determine whether associated anatomic features may be useful
      in determining fetal prognosis, a retrospective study was performed over a 5-year
      period. There were 28 cases of omphalocele; 16 were larger than 5 cm and
      classified as giant, and the remainder were considered small. Eleven of the 12
      infants with small omphaloceles survived with minimal neonatal complications. Ten
      of the 16 infants with giant omphaloceles died because of associated congenital
      anomalies. These were congenital heart disease, central nervous system
      malformations, and diaphragmatic hernias. This review suggests that the prognosis
      is good when a prenatal diagnosis of giant omphalocele is made and careful fetal
      ultrasonography, including echocardiography, does not identify heart, central
      nervous system, or diaphragmatic malformations, even when there is liver
      herniation into the omphalocele.

PMID- 2240120
TI  - Ultrasonographic assessment of placental abnormalities.
AB  - Current ultrasonographic techniques offer a novel approach for the identification
      of a wide variety of placental abnormalities usually described postnatally by the
      pathologist. Placental vascular lesions, placental tumors, and abnormal
      placentation are potentially associated with perinatal complications and their
      diagnosis in utero may influence the pregnancy management. An ultrasonographic
      classification of placental lesions that is based on their location, size,
      echogenicity, and number is proposed. Repeated ultrasonographic examination,
      together with biologic investigations, is important for the prenatal differential
      diagnosis of most these lesions and for full understanding of their
      pathophysiologic characteristics and significance.

PMID- 2240121
TI  - Preferential mitogenic activity for myoblast-like cells can be extracted from
      uterine leiomyoma tissues.
AB  - The presence of mitogen(s) in leiomyoma extracts stimulating cells with the
      fibroblast, myoblast, and osteoblast phenotype was documented. Mitogenic activity
      in leiomyoma extracts was acid stable and sensitive to tryptic digestion. Reverse
      phase high-performance liquid chromatography successfully separated mitogen(s)
      with preferential activity for myoblast cells from mitogens with a broad type of
      cell specificity and from inhibitors. This leiomyoma-derived preferential
      activity for myoblasts was absent in identically treated myometrial and
      endometrial extracts. This suggests that leiomyoma-derived substances with
      preferential growth factor activity for myoblast-like cells may play a role in
      the pathophysiologic characteristics of uterine leiomyomas.

PMID- 2240122
TI  - Platelet activating factor enhances in vitro fertilization of rabbit oocytes.
AB  - Capacitation of spermatozoa is essential for fertilization. Rabbit spermatozoa
      are particularly difficult to capacitate in vitro and require treatment with high
      ionic-strength Brackett's defined medium. Spermatozoa treated with platelet
      activating factor had significantly higher fertilization rates when compared with
      nontreated (fresh, twice washed) spermatozoa (63% vs 34%). Fertilization rates of
      spermatozoa treated with platelet activating factor, although higher than those
      of high-ionic-strength capacitated spermatozoa, were not significantly different
      (63% vs 57%). Spermatozoa treated with lyso-platelet activating factor, the
      biologically inactive form of platelet activating factor, were noted to have
      fertilization rates similar to those of the untreated (noncapacitated) group.
      These data show that synthetic platelet activating factor treatment of
      uncapacitated spermatozoa induces fertilization of rabbit oocytes in vitro in a
      manner similar to that for spermatozoa capacitated by high-ionic-strength media
      and significantly higher than that for untreated spermatozoa or after treatment
      with the biologically inactive form of platelet activating factor (lyso-platelet
      activating factor).

PMID- 2240123
TI  - Adhesion formation after ovarian wound repair in New Zealand white rabbits: a
      comparison of ovarian microsurgical closure with ovarian nonclosure.
AB  - Thirty female New Zealand white rabbits underwent standard laparotomy. Each ovary
      was bivalved and hemostasis was achieved with bipolar electrocautery. One ovary
      was then randomized to the closure group, whereas the other ovary was placed in
      the nonclosure group. In the closure group, the ovarian capsule was closed with a
      continuous suture of 8-0 Vicryl absorbable surgical suture material with
      microsurgical technique. In the nonclosure group, the ovaries were left open.
      Three weeks later the animals were killed and the ovarian adhesions were graded
      with a standardized scale by an observer (A. A. T.) blinded to the closure status
      of the animals. Five control animals underwent sham operations with minimal
      adhesion formation. Statistical analysis of the study animals by the paired
      Student t test showed a significantly higher adhesion score on the ovaries that
      were microsurgically closed compared with the ovaries not closed (p = 0.02).

PMID- 2240124
TI  - Uterine artery estrogen receptors in the nonpregnant and pregnant guinea pig.
AB  - Uterine artery, heart, and aorta or carotid specimens of nonpregnant,
      midpregnant, and term pregnant guinea pigs were examined for estrogen receptors
      by immunocytochemical methods. Estrogen receptors were found in the nuclei of
      cells in the endothelial, muscle, and adventitia layers of the uterine artery
      wall. The concentration of estrogen receptors was slightly higher in nonpregnant
      and term pregnant animals than in midpregnancy. No estrogen receptors were found
      in the heart, aorta, or carotid specimens of all animals. These results confirm
      the uterine artery as a target organ of estrogen action that would eventually
      lead to arterial functional adaptation in different biologic periods.

PMID- 2240125
TI  - Discrepancies in hemoglobin levels.

PMID- 2240126
TI  - Cytogenetic uncertainties surrounding the fragile X in Martin-Bell syndrome.

PMID- 2240127
TI  - Magnesium sulfate is not an ideal anticonvulsant.

PMID- 2240128
TI  - Parameters of hypothalamic aging.

PMID- 2240129
TI  - One case of 45,X abortus with high CA 125 level.

PMID- 2240130
TI  - Neuromodulatory regulation of gonadotropin-releasing hormone pulsatile discharge
      in women.
AB  - The pulsatile release of gonadotropin-releasing hormone and the consequent
      secretion of gonadotropins are regulated by a complex interplay of steroids,
      neuropeptides, catecholamines, and environmental factors. Estrogen and
      progesterone influence the amplitude and frequency of luteinizing hormone
      pulsatile secretion. These effects lead to both a diurnal variation in pulse
      frequency, with a lower frequency at night, and variation during the menstrual
      cycle, with a lower frequency and increased amplitude during the luteal phase.
      Opioid peptides inhibit the pulsatile discharge of gonadotropin-releasing hormone
      and luteinizing hormone. The opioid antagonist, naloxone, causes an increase in
      luteinizing hormone secretion, particularly during the luteal phase. The
      administration of opioid receptor agonists, such as beta-endorphin, results in a
      decline in serum luteinizing hormone during the early follicular phase.
      Corticotropin-releasing factor, which is increased during stress, inhibits
      pulsatile luteinizing hormone secretion, and this effect can be blocked by the
      simultaneous administration of naloxone. These observations suggest that
      corticotropin-releasing factor exerts its effects on luteinizing hormone through
      an opioidergic intermediary. Endogenous catecholamines such as dopamine inhibit
      pulsatile luteinizing hormone release; however, the mechanism involved is not
      clear.

PMID- 2240131
TI  - Practical aspects of pulsatile gonadotropin-releasing hormone administration.
AB  - Pulsatile administration of gonadotropin-releasing hormone represents a major
      advance in the treatment of anovulation in women who fail to ovulate with
      clomiphene citrate and is an alternative for many women who currently receive
      human menopausal gonadotropin. Four issues must be addressed before administering
      pulsatile gonadotropin-releasing hormone: (1) safety, (2) efficacy, (3)
      convenience, and (4) cost. Each of these issues will be affected by the three
      major decisions a physician makes with gonadotropin-releasing hormone therapy:
      (1) patient selection, (2) route of administration, and (3) dose of gonadotropin
      releasing hormone. The ideal candidate for gonadotropin-releasing hormone therapy
      is a patient with an absence of endogenous pulsatile gonadotropin-releasing
      hormone, as seen in hypothalamic amenorrhea. Although women with polycystic
      ovarian disease can be treated with pulsatile gonadotropin-releasing hormone, a
      decreased ovulation rate should be expected. The route of administration,
      intravenous or subcutaneous, and the degree of monitoring can be tailored by the
      physician to fit each patient's needs. Pulsatile gonadotropin-releasing hormone
      therapy is a safe, effective, convenient, and economical alternative to human
      menopausal gonadotropin for ovulation induction in women resistant to clomiphene.

PMID- 2240133
TI  - Publications of Lorenz E. Zimmerman.

PMID- 2240132
TI  - Letters of tribute and articles dedicated to Lorenz E. Zimmerman on the occasion
      of his 70th birthday.

PMID- 2240134
TI  - Pseudoexfoliative fibrillopathy in the skin of patients with ocular
      pseudoexfoliation.
AB  - In addition to its occurrence within the eye, pseudoexfoliative fibrillopathy has
      been reported in the conjunctiva and around a posterior ciliary artery. To
      determine whether it has a more diffuse extraocular distribution, we studied skin
      biopsy specimens ultrastructurally from one to three areas in 13 patients with
      classic pseudoexfoliation. A fibrillopathy closely resembling that in the eye was
      found in 11 of the 13 patients. Only one of the 13 control subjects, a 78-year
      old man with advanced low-tension glaucoma, had a similar fibrillopathy. In the
      patients with pseudoexfoliation who were more than 70 years of age, the
      accompanying dermal elastosis made evaluation difficult, because the
      pseudoexfoliative nodules in the skin occur primarily along elastic fibers, and
      their morphologic characteristics appeared to be influenced by the elastotic
      process. These results suggest that pseudoexfoliation is a systemic process
      related closely to elastosis, and that further search for pseudoexfoliative
      fibers should be made in the elastic system of the deep tissues and internal
      organs.

PMID- 2240135
TI  - Ocular adnexal Kaposi's sarcoma in acquired immunodeficiency syndrome.
AB  - We examined histopathologically 18 ocular adnexal Kaposi's sarcoma lesions
      related to acquired immunodeficiency syndrome. These lesions were classified into
      three types. Type I consisted of thin, dilated vascular channels lined by flat
      endothelial cells with lumen-containing erythrocytes. Type II featured plump,
      fusiform, endothelial cells, often with a hyperchromatic nucleus and foci of
      immature spindle cells and occasional slit vessels. Type III was characterized by
      large aggregates of densely packed spindle cells with hyperchromatic nuclei,
      occasional mitotic figures, and abundant slit spaces often containing
      erythrocytes in between. Clinically, type I and type II tumors were patchy and
      flat (less than 3 mm in height) and of less than four months' duration. Type III
      tumors were nodular and elevated (greater than 3 mm in height). We describe the
      clinical and histopathologic types of Kaposi's sarcoma that may help in
      diagnosis.

PMID- 2240136
TI  - Ocular pathologic features of arteriohepatic dysplasia (Alagille's syndrome).
AB  - Arteriohepatic dysplasia (Alagille's syndrome), an autosomal dominant condition
      involving jaundice caused by a developmental scarcity of intrahepatic bile ducts,
      has characteristic cardiovascular, skeletal, facial, and ocular features that
      distinguish it from extrahepatic biliary atresia and an array of other neonatal
      intrahepatic cholestatic disorders. Two children who died of this syndrome had
      prominent Schwalbe's rings with attached iris strands characteristic of
      Axenfeld's syndrome. Additional histologic findings of iris atrophy and stromal
      nodules, however, made the designation Axenfeld-Reiger's syndrome more
      appropriate. Pigmentary retinopathy, degeneration of Bruch's membrane, and
      prominent lipofuscin deposition in the ciliary muscle noted in one of the
      patients were not regarded as primary changes of Alagille's syndrome, but were
      believed to be secondary to acquired deficiency of the fat-soluble vitamins A and
      E. Early recognition of the ocular changes in arteriohepatic dysplasia is helpful
      in establishing the proper diagnosis to avoid unnecessary abdominal surgery and
      institute vitamin therapy.

PMID- 2240137
TI  - Cholesterol localization in ultrathin frozen sections in Schnyder's corneal
      crystalline dystrophy.
AB  - We examined a 57-year-old woman who had bilateral corneal crystalline deposits
      associated with xanthelasma. The patient's son had bilateral stromal haze. Plasma
      cholesterol and apolipoprotein A-I and B levels were normal. Histopathologic
      examination disclosed lipid deposits, particularly in the superficial stroma and
      Bowman's layer. These deposits stained with oil red O and filipin, a fluorescent
      probe that specifically detects unesterified cholesterol. Cryoultramicrotomy
      disclosed more specific ultrastructural localization of unesterified cholesterol
      with an array of crystals resembling multiple plates in extracellular corneal
      tissue.

PMID- 2240138
TI  - Traumatic enucleation for posterior uveal melanoma.
AB  - Two features of eyes enucleated for posterior uveal melanoma that may serve as
      indicators for traumatic enucleation and relate to dissemination of tumor cells
      at the time of enucleation are myelin artifact of the optic nerve head and acute
      hemorrhage within the tumor. Myelin artifact occurs when crushed optic nerve
      tissue is squeezed into the eye at the time of enucleation. Intralesional
      hemorrhage may occur during surgery and may be correlated with fluctuations in
      intraocular pressure. We reviewed 519 cases of posterior uveal melanoma treated
      by enucleation between 1950 and 1970. Without knowledge of the follow-up data, we
      examined histologic sections for myelin artifact, intralesional hemorrhage,
      subretinal hemorrhage, Callender cell type, size of tumor, necrosis, and scleral
      or orbital invasion. Neither myelin artifact nor intralesional hemorrhage were
      independent prognostic risk factors. These findings do not support or refute the
      hypothesis that excessive trauma during enucleation results in a worse prognosis.

PMID- 2240140
TI  - Orbital intramuscular schwannoma.
AB  - In an 8-year-old girl with asymptomatic proptosis, computed tomographic scans
      showed a large medial orbital mass that contoured the globe anteriorly, bowed the
      optic nerve laterally, and extended posteriorly to the orbital apex. T1-weighted
      coronal magnetic resonance images showed the mass to be a diffusely enlarged
      medial rectus muscle. Histopathologic examination of a medial rectus muscle
      biopsy specimen disclosed a multinodular, intramuscular schwannoma, separating
      and infiltrating normal skeletal muscle fibers. The intramuscular location and
      multinodular configuration of this tumor, together with its occurrence in a
      child, distinguish it from previous orbital schwannomas.

PMID- 2240141
TI  - Notes from the dugout.

PMID- 2240139
TI  - A randomized study of methanol-extraction residue of bacille Calmette-Guerin as
      postsurgical adjuvant therapy of uveal melanoma.
AB  - A randomized controlled clinical trial of methanol-extracted residue of bacille
      Calmette-Guerin adjuvant treatment of posterior uveal melanoma was undertaken. Of
      113 patients, 34 patients received adjuvant immunotherapy and 79 patients
      received no treatment. No difference in survival was observed between the
      adjuvant-treated group and the control group of patients. This study found that
      the size of the tumor was a highly significant risk factor for death caused by
      metastasis of uveal melanomas. The standard deviation of the nucleolar area of
      the neoplastic cells was a significant risk factor, even though patients with
      tumors composed of Callender's spindle-type cells were not included in the study.

PMID- 2240142
TI  - Visual improvement after long-term success of pancreatic transplantation.

PMID- 2240143
TI  - Duane's retraction syndrome in the fetal alcohol syndrome.

PMID- 2240145
TI  - Long-term follow-up of facioscapulohumeral muscular dystrophy and Coats' disease.

PMID- 2240144
TI  - Delayed drug-induced periorbital angioedema.

PMID- 2240146
TI  - A total orbital floor fracture with prolapse of the globe into the maxillary
      sinus manifesting as postenucleation socket syndrome.

PMID- 2240148
TI  - Conjunctivitis caused by Thelazia californiensis.

PMID- 2240147
TI  - Aplastic anemia with platelet autoantibodies in a patient after taking
      methazolamide.

PMID- 2240150
TI  - Corneoscleral rupture ten years after radial keratotomy.

PMID- 2240151
TI  - Translimbal iris hook for pupillary dilation during vitreous surgery.

PMID- 2240149
TI  - An unusual case of neurosarcoidosis confirmed by a muscle biopsy specimen.

PMID- 2240152
TI  - A sutureless self-retaining infusion cannula for pars plana vitrectomy.

PMID- 2240153
TI  - Liability for intraocular lens calculations.

PMID- 2240154
TI  - Primate trabeculectomies with 5-fluorouracil collagen implants.

PMID- 2240155
TI  - Recurrent conjunctival papilloma causing nasolacrimal duct obstruction.

PMID- 2240156
TI  - Increase of beta 1-6-branched oligosaccharides in human esophageal carcinomas
      invasive against surrounding tissue in vivo and in vitro.
AB  - The -GlcNAc beta 1-6Man- (beta 1-6) branched N-glycosidic oligosaccharides
      expressed on tumor cells have been found to contribute to malignant and
      metastatic potential in experimental tumor models. Phaseolus vulgaris
      leukoagglutinin (L-PHA) requires the beta 1-6-linked lactosamine antenna for high
      affinity binding and was used histochemically to characterize the distribution of
      these sugar structures in human esophageal squamous cell carcinomas from 42
      patients. Leukoagglutinin-reactive carcinoma cells in the invasive tumors were
      distributed predominantly on the outer surface of the tumor adjacent to the
      surrounding tissue. Furthermore, when TE 1 cells, a human esophageal squamous
      cell carcinoma line, were cultured in a collagen gel matrix to obtain colonies in
      a three-dimensional form, these colonies exhibited high affinity for L-PHA
      binding only in the outer cell layer facing the collagen matrix, unrelated to the
      cell growth cycle. These findings suggest that the increase in beta 1-6-branched
      oligosaccharides in esophageal carcinomas is an important trait of the tumor in
      the invasion into the surrounding tissue.

PMID- 2240157
TI  - Mechanisms of edema formation in experimental autoimmune encephalomyelitis. The
      contribution of inflammatory cells.
AB  - Most of the central nervous system (CNS) endothelium regulates the passage of
      solutes and functions as a blood-brain barrier (BBB). During experimental
      autoimmune encephalomyelitis (EAE), an inflammatory demyelinating disease of the
      CNS, loss of BBB function occurs. The authors have previously shown an increase
      in endothelial transcytotic activity associated with decreased mitochondrial
      content as evidence of BBB dysfunction in EAE. These changes occurred in the
      capillary bed and correlated with CNS edema and clinical signs. In the present
      report, a fixation procedure before infusion of the intravascular tracer
      horseradish peroxidase (HRP) in rats at the height of clinical EAE has been used.
      In these animals, tracer leakage was only noted in inflamed venules with
      diameters of 12 to 19 mu. The authors detected several mechanisms of passive
      leakage: 1) increased junctional permeability; 2) increased interendothelial
      space; 3) leakage alongside migrating inflammatory cells. Some small capillaries
      showed necrotic changes with minimal tracer leakage. This report demonstrates
      that BBB disruption also occurs via nonendocytic mechanisms that may be induced
      by inflammatory cells.

PMID- 2240158
TI  - Histologic similarity of murine colonic graft-versus-host disease (GVHD) to human
      colonic GVHD and inflammatory bowel disease.
AB  - In a study designed to determine which T-cell subsets are involved in the
      development of murine graft-versus-host disease (GVHD), a prospective histologic
      analysis of gastrointestinal involvement was performed. In C57BL/6JXDBA/2F1
      (B6D2F1) recipients of DBA/2 donor spleen and bone marrow cells, the colonic
      histologic findings were found to be similar in many respects to the histologic
      findings reported in human colonic GVHD and were much more severe and diffuse
      than were the abnormalities of the small intestine. Host irradiation before
      transplantation was found to play an additive or synergistic role in the
      development of GVHD. Furthermore the histologic features noted in DBA/2----B6D2F1
      murine colonic GVHD suggest that bone marrow and spleen cell transplantation in
      this strain combination may be a useful model for studying the immunologic
      mechanisms involved in human inflammatory bowel disease. Thus severe colonic
      disease noted during the course of DBA/2----B6D2F1 murine GVHD was found to have
      significant histopathologic similarities to both human GVHD enteropathy and other
      inflammatory diseases of the human colon.

PMID- 2240159
TI  - Pathogenesis of antigen-induced arthritis in mice deficient in neutrophil
      elastase and cathepsin G.
AB  - The contribution of neutrophil-derived elastase and cathepsin G to joint
      pathology has been examined in immune arthritis in the mouse. Neutrophils from
      beige mice are genetically deficient in lysosomal elastase and cathepsin G, but
      have normal levels of the acid hydrolases, beta-glucuronidase, and N-acetyl-beta
      glucosaminidase. The development of antigen-induced arthritis in normal mice has
      been compared with that in beige mice. The pattern of synovitis (both leukocyte
      accumulation and plasma leakage) were indistinguishable in normal and beige mice.
      Cartilage proteoglycan depletion was quantified by measuring the decrease in
      safranin O staining intensity, and this, too, was unaltered in mice lacking
      elastase and cathepsin G. These results suggest that neutrophil elastase and
      cathepsin G do not contribute to these aspects of joint pathology in antigen
      induced arthritis in the mouse.

PMID- 2240161
TI  - Development of multiple necrotizing enteritis induced by a tumor necrosis factor
      like cytokine from lipopolysaccharide-stimulated peritoneal macrophages in rats.
AB  - We report the development of an animal model of multiple necrotizing enteritis
      (MNE) in rats. When rats were injected directly with a culture supernatant of
      lipopolysaccharide (LPS)-stimulated rat peritoneal macrophages into the abdominal
      aorta, the overt pathologic lesions of MNE developed within 30 minutes after
      injection. The rats showed an elevated level of blood fibrinogen degradation
      product content even 30 minutes after injection. Furthermore the rats that were
      pretreated intravenously with heparin sulfate did not develop MNE, indicating the
      acute disturbances of blood microcirculation in the intestine. Multiple
      necrotizing enteritis was developed also by the injection with recombinant tumor
      necrosis factor (rTNF) but rarely was observed with even a high dose of
      recombinant interleukin-1 (rIL-1) or platelet-activating factor (PAF). The
      supernatant was cytotoxic in vitro to TNF-susceptible LM and many other cells but
      was less cytotoxic to the TNF-resistant LR line. Partial purification of the
      supernatant suggested that the supernatant contained a cytokine that has
      biochemical features of TNF. Furthermore polyclonal anti-TNF antibody could
      inhibit not only the cytotoxicity in vitro but also MNE development in vivo by
      this factor. These data strongly indicate that MNE possibly could be caused by a
      TNF-like cytokine produced by macrophages that are stimulated by the endotoxin.

PMID- 2240160
TI  - Metaplastic change in mesenchymal stem cells induced by activated ras oncogene.
AB  - 3T3 T murine mesenchymal stem cells have the potential to differentiate into a
      variety of different cell types even though they show a predilection to undergo
      adipocyte differentiation in vitro. The possibility that the activated c-Ha-ras
      (EJras) oncogene might influence the pathway of differentiation of these stem
      cells is investigated in the current study. Activated ras oncogene was
      transfected and stably expressed in 3T3 T cells; assays then were performed to
      determine its effect on differentiation. The results show that all EJras
      transfected cell lines lose their ability to differentiate to adipocytes and
      instead differentiate into cells that express many characteristics of
      macrophages. Such cells contain numerous cytoplasmic granules, extensive
      nonspecific esterase activity, and anchorage-independent growth. The modulation
      of differentiation pathway from an adipocyte lineage to a macrophagelike cell
      lineage does not result from the transforming effect of EJras, because a
      nontransformed cell clone that expresses p21EJras protein also exhibits this
      modified differentiation pathway. These data suggest that the EJras oncogene
      specifically modulates the differentiation pathway of 3T3 T mesenchymal stem
      cells. This experimental system should therefore provide an excellent model to
      evaluate the mechanistic role of EJras in the process of metaplasia.

PMID- 2240162
TI  - Ultrastructural localization of proteinase 3, the target antigen of anti
      cytoplasmic antibodies circulating in Wegener's granulomatosis.
AB  - To investigate the distribution of proteinase 3, the target antigen of anti
      cytoplasmic antibodies (ACPA or C-ANCA), within the organelles of resting normal
      human polymorphonuclear leukocytes and monocytes, the authors used
      immunocytochemical techniques on thin frozen sections. To obtain valuable tools
      for immunolabeling, two murine monoclonal antibodies (MAbs) directed against the
      ACPA antigen were produced. In neutrophils, the authors observed immunogold label
      for the ACPA antigen, predominantly in myeloperoxidase-positive azurophil
      granules, and in smaller amounts on the plasma membrane. In monocytes, the ACPA
      antigen could be detected in small granules, which occasionally also contained
      myeloperoxidase, and rare labeling was found on the monocyte membrane. The
      finding that the ACPA antigen is expressed on the plasma membrane of neutrophils
      and monocytes, thereby becoming accessible to circulating autoantibodies,
      supports the supposition that ACPA are not only markers of disease activity, but
      also are involved in the pathogenesis of Wegener's granulomatosis.

PMID- 2240163
TI  - A,B blood group antigens in tissues of AB heterozygotes. Emphasis on normal and
      neoplastic urothelium.
AB  - The tissue distribution of the A and B blood group antigens was studied in 41
      individuals with the heterozygous AB red blood cell (RBC) phenotype. A total of
      134 biopsies from a variety of normal tissues (94 from urothelium and 40 from
      other tissues) were examined. In addition, changes in the expression of these
      antigens associated with neoplastic transformation were evaluated in 70 biopsies
      from transitional cell carcinomas of 19 AB heterozygous patients. There was
      heterogeneity in the distribution of tissue A and B antigens, depending on the
      cell type, as well as among cells of the same type. Ninety-one percent of AB
      heterozygotes expressed both A and B antigens in normal epithelial cells, with a
      mosaic distribution clearly apparent in 50% of these individuals. In 21% of these
      subjects, the A antigen was undetectable in the vascular endothelial cells in all
      biopsies from several organs. In most (79%) transitional cell neoplasms, only one
      of the two antigens was consistently expressed. The results of this study may
      have implications for the clonal or specific gene deletion theories of neoplasia.
      They also demonstrate the existence of a subgroup of AB individuals in whom the A
      antigen is absent specifically from the vascular endothelium.

PMID- 2240164
TI  - Endotoxin-induced cytokine gene expression in vivo. II. Regulation of tumor
      necrosis factor and interleukin-1 alpha/beta expression and suppression.
AB  - Tumor necrosis factor alpha (TNF alpha) mRNA is present in a preformed
      intracellular pool in the spleen, liver, and small bowel of naive rats. Endotoxin
      (Salmonella typhus lipopolysaccharide) injected intravenously induces little or
      no increase in whole-organ TNF mRNA levels at 15', 30', 1 degree, 2 degrees, or 4
      degrees, whereas serum TNF levels are markedly elevated at 1 and 2 hours.
      Dexamethasone pretreatment of rats suppresses LPS-induced serum TNF
      concentrations, but does not suppress TNF mRNA levels in the spleen or bowel.
      Tachyphylaxis experiments demonstrate that a second injection of endotoxin 2
      hours after an initial injection fails to induce a second peak of serum TNF,
      although TNF mRNA levels in the spleen and bowel remain at the levels found in
      naive rats. Corynebacterium parvum upregulates endotoxin-induced serum TNF
      release and intravenous injection of IL-1 induces the release of serum TNF but
      neither alters whole-organ TNF mRNA levels. Interleukin-1 alpha (IL-1 alpha) mRNA
      was not constitutively detected in whole-organ RNA preparations of the spleen,
      liver, and small bowel of naive rats. Endotoxin induces IL-1 alpha mRNA most
      easily appreciated in the spleen beginning at 1 hour, peaking at 2 to 4 hours,
      and disappearing by 6 hours. Interleukin-1 beta (IL-1 beta) mRNA was not
      constitutively detected in the organs examined or was present in small amounts.
      Endotoxin induces IL-1 beta mRNA beginning at 0.5 hours, peaking at 1 hour, and
      disappearing by 6 hours. Dexamethasone pretreatment prevents the LPS-induced
      appearance of IL-1 alpha mRNA and suppresses but does not completely inhibit the
      appearance of IL-1 beta mRNA. C. parvum upregulates endotoxin-induced IL-1 mRNA
      expression. Intravenous injection of TNF or IL-1 both induce IL-1 mRNA
      expression. In conclusion, TNF mRNA is constitutively expressed and TNF mRNA
      levels as analyzed in whole-organ RNA preparations do not change in concert with
      serum TNF protein levels during conditions of endotoxemia, dexamethasone
      treatment, tachyphylaxis, priming with C. parvum, or after injection of IL-1. In
      contrast, IL-1 mRNA expression during endotoxemia, dexamethasone treatment,
      priming with C. parvum, or after injection of TNF or IL-1 shows clear increases
      and decreases in whole-organ RNA preparations.

PMID- 2240166
TI  - Protein A-gold immunoelectron microscopic study of amyloid fibrils, granular
      deposits, and fibrillar luminal aggregates in renal amyloidosis.
AB  - Glomeruli of archival renal biopsies, stored frozen at -70 degrees C, from three
      patients with amyloid were examined by protein A-gold immunoelectron microscopy.
      In one with both fibrillar and granular deposits from a 'skin popper' drug
      abuser, the granular deposits were labeled with anti-IgG, while the fibrillar
      deposits were labeled with anti-amyloid-A (AA) protein and amyloid P component
      (AP), suggesting coexisting immune complex disease and AA due to different, but
      possibly related, pathogenesis. In studies using double-label immunostaining of
      primary amyloidosis-lambda light chain type (AL) and AA associated with Crohn's
      disease, AP occurred as widely separated single units along the amyloid fibrils
      and represented 1.5% and 6.5% of the total gold label in AL and AA, respectively,
      while the major fibril protein was labeled in single rows, similar to beads on a
      string. Fibrillar aggregates in the capillary lumens were labeled similarly by
      antisera to the major protein and AP and appeared to be contiguous with the
      fibrillar deposits at the glomerular basement membrane (GBM)-luminal interface,
      suggesting intravascular fibrillogenesis.

PMID- 2240165
TI  - Flow cytometric analysis of the mechanism of methylmercury cytotoxicity.
AB  - Flow cytometric analysis of murine erythroleukemic cells (MELC) exposed in vitro
      to 2.5 to 7.5 mumol/l (micromolar) methylmercury (MeHg) reveals a dose-dependent
      decrease in the rate of DNA synthesis (rate of passage through the S phase of the
      cell cycle), manifested as the accumulation of most of the cells in the S phase,
      and a modest accumulation of cells in the G2/M phase of the cycle. Light
      microscopy reveals a progressive increase in chromosomal damage (condensation,
      pulverization). At or above 10 mumol/l MeHg, progression through all the phases
      of the cell cycle is blocked and mitotic cells are arrested irreversibly in
      anaphase, with most exhibiting arrangement of chromosomes in a wreathlike ring
      formation. Also the cells exhibit both nuclear propidium iodide (PI) fluorescence
      (indicative of loss of viability) and concurrent cytoplasmic carboxyfluorescein
      (CF) fluorescence (viable cells exhibit CF fluorescence and exclude PI). In
      addition, there is a dose-dependent increase in cellular refractive index (90
      degrees light scatter), an apparent decrease in cell volume (axial light loss),
      and progressive resistance to detergent (NP-40)-mediated cytolysis. Resistance to
      detergent-mediated cytolysis is indicative of fixation (protein denaturation,
      cross-linking, and so on) of the plasma membrane/cytoplasm complex. Our findings
      indicate that DNA synthesis is the primary target of MeHg cytotoxicity and that
      apparent targets and degree of cytotoxicity are a complex function of dose.

PMID- 2240167
TI  - Cyclocreatine inhibits the production of neutrophil chemotactic factors from
      isolated hearts.
AB  - This study was designed to determine the effect of cyclocreatine on the release
      of neutrophil chemotactic factors (NCF) from isolated rabbit hearts. We tested
      the hypothesis that if ischemia is important for the formation of NCF from the
      myocardium, then blocking (or delaying) ischemic changes with cyclocreatine
      should inhibit the release of NCF. Two models were used, including (1) perfusion
      of rabbit hearts (Langendorff apparatus) with oxygenated (95% oxygen) Krebs
      Henseleit buffer (K-H buffer) containing 5% cyclocreatine for 120 minutes, and
      (2) incubating hearts with phosphate-buffered saline (PBS) containing 5%
      cyclocreatine for 120 minutes. For both models, rabbits were injected
      intravenously with 10 ml of 5% cyclocreatine solution 30 minutes before the
      animals were killed and the hearts removed. Control rabbits were injected with 5%
      creatine solution or saline for 30 minutes before perfusing hearts with K-H
      buffer or incubating with PBS. Chemotactic activity was assayed in the perfusates
      and supernatants using modified Boyden chambers and rabbit peritoneal neutrophils
      as indicator cells. The chemoattractant f-Met-Leu-Phe (f-MLP) was the positive
      control for a 100% response rate. Isolated hearts perfused with cyclocreatine
      showed significantly lower chemotactic activity (ie, 1.24 +/- 1% f-MLP; P less
      than 0.0001) compared to hearts perfused with K-H buffer (129 +/- 18%) or
      creatine (227 +/- 42%) (mean +/- standard error). Similar results were obtained
      using incubated hearts. Next the effect of cyclocreatine on neutrophils in the
      Boyden chamber was determined and it was found that it did not alter neutrophil
      migration, which excludes a direct inhibitory effect on the cells. Furthermore
      supernatant from cyclocreatine-treated hearts did not inhibit neutrophil
      chemotaxis to C5a, indicating absence of a chemotaxis inhibitor in this
      preparation. Results of these studies suggest that the observed low activity
      recovered in perfusate and supernatant of cyclocreatine-treated hearts is a
      result of reduction in the synthesis and/or release of the factors from
      myocardial tissues. Similar to previously established data, cyclocreatine
      treatment significantly preserved myocardial nucleotide levels (ie, adenosine
      triphosphate and creatine phosphate), which supports our hypothesis that the
      formation of NCF is ischemia dependent and that maintaining elevated levels of
      myocardial energy nucleotides reduced chemotactic factor release.

PMID- 2240168
TI  - Immunocytochemical localization of progesterone receptors in endocrine cells of
      the human pancreas.
AB  - Progesterone receptors (PgR) have been immunocytochemically localized in the
      nuclei of several (40% to 75%) endocrine cells of the human pancreas and in a
      more variable number of neoplastic cells of 7 of 18 endocrine pancreatic tumors.
      Conversely the exocrine epithelial cells of the pancreas did not exhibit any PgR
      immunoreactivity in normal as well as in different pathologic conditions,
      including pancreatic adenocarcinomas. Estrogen receptors were not detected in any
      of the pancreatic samples investigated. Double immunocytochemical experiments
      have documented that PgR immunoreactivity in normal Langerhans islets is a
      consistent feature of most (75%) glucagon-producing A cells, of approximately 5%
      to 20% of insulin-producing B cells, and of a variable percentage of pancreatic
      polypeptide (PP)-producing cells, ranging from 5% to 70%. These figures were not
      affected by the sex, age, or underlying disease of the patients. The reported
      findings corroborate previous clinical and experimental evidence indicating that
      sex steroid hormones may have some regulatory effects on the functional activity
      of the endocrine pancreas.

PMID- 2240169
TI  - Paroxysmal positional vertigo: what the patient needs to know.

PMID- 2240170
TI  - Homograft tympanoplasty: the Iowa experience.
AB  - Homograft tympanic membranes have been used in tympanoplasty for nearly 30 years.
      Reported anatomical success rates vary from 50 to 100 percent. One hundred and
      one homograft tympanoplasty procedures were performed at the University of Iowa
      over the 10-year period of July 1978 through June 1988. The anatomical success
      rate was 76 percent. Hearing results were satisfactory in 86 percent of cases.
      The homograft tympanic membrane, with or without ossicles, has proven to be a
      highly satisfactory modality for the reconstruction of the severely ravaged
      middle ear.

PMID- 2240171
TI  - Immunohistochemical localization of vimentin and S-100 antigen in small acoustic
      tumors and adjacent cochlear nerves.
AB  - To clarify the involvement of cochlear nerves in small acoustic tumors, we used
      immunoperoxidase techniques to determine the presence and distribution of
      vimentin and S-100 antigens in two acoustic tumor specimens and a transected
      vestibular nerve. Schwann cells and acoustic tumor cells failed to react
      positively with monoclonal antibody to vimentin. Reaction was observed in
      mesenchymal-appearing cells within both the normal nerve and the acoustic tumors,
      predominantly in association with blood vessels. Normal schwann cells and
      acoustic tumor cells reacted with polyclonal antibody to S-100 antigen with a
      similar, uniform distribution. Mesenchymal-appearing cells did not react with
      antibody to S-100. Immunostaining of a vestibular nerve from a Meniere's disease
      patient, used as a control, did not differ significantly from nerves adjacent to
      acoustic tumors. Because tumor cells and normal schwann cells stained similarly
      with antibody to S-100, it was not possible to establish with certainty if tumor
      cells invaded adjacent nerves.

PMID- 2240172
TI  - Effects of electrode placement on the auditory brainstem response using ear canal
      electrodes.
AB  - The effects of electrode placement on the latency and amplitude of the auditory
      brainstem response (ABR) were investigated in normal-hearing subjects. Ear canal
      (EC) electrodes were used in conjunction with surface electrodes to obtain ABRs.
      Three electrode combinations were evaluated: (1) vertex-EC-EC; (2) vertex-EC
      neck; and (3) forehead-EC-neck. Absolute and interwave latencies and absolute and
      relative amplitudes were computed for Waves I, III, and V at 75 dB SL. Standard
      errors of measurement (SEmeas) revealed excellent test-retest reliability for
      latency (SEmeas = 0.06 ms) but only fair reliability for amplitude (SEmeas = 55
      nv). No reliability differences were observed among the three electrode
      combinations. No significant latency or interwave latency differences were found
      among the three montages. No amplitude differences were found for Waves I and III
      among the montages. However, the Wave V amplitude was larger for the vertex-EC-EC
      and vertex-EC-neck montages than for the forehead-EC-neck montage. Because the
      vertex-EC-EC montage does not require additional electrodes on the contralateral
      neck, this montage is recommended.

PMID- 2240173
TI  - The fallopian canal and facial nerve in sclerosteosis of the temporal bone: a
      histopathologic study.
AB  - Sclerosteosis is an uncommon subtype of osteopetrosis that is frequently
      associated with recurrent facial nerve palsy. Because of the need for detailed
      measurements of the fallopian canal and facial nerve in this disease, a study was
      carried out using a new method of surface area measurement. The results show
      narrowing of the fallopian canal and facial nerve in the labyrinthine, distal
      tympanic and mastoid segments. Maximum surface area loss occurred in the
      labyrinthine segment for both the canal and nerve. In addition, bony occlusion of
      the stylomastoid artery was found. From these findings we conclude that ischemia
      and bony compression are the underlying causes of recurrent facial palsy in this
      disease. We also conclude that because the labyrinthine segment is the most
      severely affected, surgical decompression must include this portion of the
      fallopian canal.

PMID- 2240174
TI  - Early onset sensorineural hearing loss: association studies with major
      histocompatibility class III (complement) markers.
AB  - In 39 families with at least one child suffering from moderate or severe
      bilateral sensorineural hearing loss (SNHL), major histocompatibility complex
      (MHC) class III complement phenotypes were retrospectively determined by standard
      methods; MHC class I segregation data was also available. The families were
      treated in the Hospital for Communication Disorders and selected for the HLA-B16
      and B18 specificities, respectively. Haplotype and allele frequencies were
      derived from segregation analysis in the families. From 31 unrelated children
      with random and familiar forms of SNHL significant deviations in the distribution
      were seen for the following MHC class III alleles using as a control population
      60 German healthy individuals: duplicated C4A alleles (C4"DA") p = 0.009, silent
      C4A alleles (C4A*Q0) p = 0.006, duplicated heavy C4 beta-chain alleles (C4
      beta"DHH") p = 0.0003, and silent C4 beta-chain alleles (C4 beta*Q0) p = 0.0075.
      In serum samples from patients with an assumed genetic disposition according to
      clinical criteria indications for an association were found for C4"DA" (p =
      0.03), C4A*Q0 (p = 0.003), C4B*3 (p = 0.046), C4 beta"DHH" (p = 0.004), and C4
      beta*Q0 (p = 0.02). The underrepresentation of C4A*Q0 may be an indicator for
      aberrant or duplicated C4 alleles on the same haplotype or exhibit a protection
      mechanism for acquiring the inheritable forms of early onset SNHL.

PMID- 2240175
TI  - Gamma knife: hydrocephalus as a complication of stereotactic radiosurgical
      treatment of an acoustic neuroma.
AB  - Stereotactic radiosurgery is at present being marketed as a reliable alternative
      to conventional tumor removal in patients with acoustic neuromas. Hearing
      preservation is possible and treatment modality is presented as being very low. A
      case history is presented, in which a patient with an 18 mm tumor and normal
      hearing developed severe hydrocephalus and dizziness 9 months after irradiation,
      in addition to losing her hearing. Whether the Gamma knife is to be considered a
      reliable alternative to surgical removal of acoustic neuromas is discussed.

PMID- 2240176
TI  - Use of the Million Clinical Multiaxial Inventory in evaluating patients with
      severe tinnitus.
AB  - The Million Clinical Multiaxial Inventory (MCMI) was evaluated as a diagnostic
      tool for personality disorder among 41 patients with severe tinnitus. Nearly 70
      percent of the subjects demonstrated a personality disorder. Nearly half of the
      patients fell into one of two categories; dependent/submissive or the
      narcissistic category. Other important features include a high incidence (24%) of
      severe anxiety. One-third of the patients had a complaint tendency but 50 percent
      had a denial problem. We have found the MCMI to be easy to administer and
      evaluate and it provides the clinician with useful information. We believe that
      more routine use of this or similar instruments would improve the treatment
      outcome of tinnitus sufferers by bringing into focus the important psychological
      factors found in each patient.

PMID- 2240177
TI  - Dysequilibrium and audiovestibular function in panic disorder: symptom profiles
      and test findings.
AB  - Patients with panic disorder commonly report symptoms of dizziness and imbalance.
      We studied the relationship between objective measures of audiovestibular
      function, phenomenologic, and self-report measures of dysequilibrium and related
      somatic symptoms in a sample of panic disorder patients with and without
      agoraphobia, unselected for the complaint of dysequilibrium. Of seventeen
      patients evaluated by electronystagmography, 71 percent exhibited abnormal
      vestibular test findings. These latter patients had higher total anxiety ratings
      than patients without vestibular abnormalities. We conclude that patients with
      panic disorder warrant evaluation of audiovestibular function.

PMID- 2240178
TI  - Autoimmune sensorineural hearing loss: a preliminary experimental study.
AB  - The aim of this study was to compare cochlear alterations produced by induction
      of anti-type II collagen antibodies with alterations produced by passive transfer
      of anticochlear antibodies. Guinea pigs (GP) were used. The anticochlear
      antibodies were obtained by injecting GP membranous cochlea plus Freund's
      adjuvant into rabbits. After partial purification of the immunoglobulins, the
      antibodies (20 mg) were injected intramuscularly into 10 normal GP. A second
      group of 10 normal GP received intramuscular injections of purified chicken type
      II collagen (1 mg) plus Freund's adjuvant. A control group of 10 normal GP was
      studied under the same conditions without any stimulus. The cochlea function was
      analysed with brainstem evoked audiometry (BERA). The structural study was
      carried out by immunofluorescent and hematoxylin preparations. The results showed
      structural alterations in both experimental groups (loss of nucleus in the spiral
      ganglion); however, significant changes in the BERA were not found. Only increase
      of the latency of wave I could be seen. These preliminary results support the
      hypothesis that antibodies to collagen type II may play an important role in
      human autoimmune sensorineural hearing loss, but the possible existence of other
      cochlear antigens is discussed.

PMID- 2240179
TI  - Hyperbaric oxygen management of chronic staphylococcal osteomyelitis of the
      temporal bone.
AB  - Hyperbaric oxygen (HBO) has proven efficacious in the adjunct management of
      selected otolaryngologic problems: radiation therapy-induced osteoradionecrosis
      of the temporal bone, malignant external otitis, mandibular osteoradionecrosis
      and refractory osteomyelitis, soft tissue head and neck necrotizing fasciitis,
      compromised skin flaps and grafts, acute air or gas embolism, and otologic
      barotrauma. Herein is described the management of an insidious Staphylococcus
      aureus osteomyelitis of the temporal bone by pre- and postoperative HBO in
      conjunction with surgical debridement. The possible application of angiogenic
      agents and tetracycline bone-labeling in combination with hyperbaric oxygen
      therapy in the management of refractory neurotologic disease will be discussed.

PMID- 2240180
TI  - Malleus head fixation: association with pseudohypoparathyroidism.
AB  - Pseudohypoparathyroidism (PHP) is a heterogenous syndrome resulting from bone and
      renal resistance to parathyroid hormone (PTH). Hypocalcemia and hyperphosphatemia
      occur despite elevated PTH levels. Head and neck manifestations of PHP include
      tetany, laryngeal spasm, and ectopic calcification in the eye, dentition,
      subcutaneous tissue and brain. The first case of malleus head fixation caused by
      ectopic calcification in a PHP patient is reported. Normalization of serum
      calcium and phosphate levels does not appear to retard or correct this
      abnormality. Ossiculoplasty or amplification is currently the recommended
      treatment in PHP patients with malleus head fixation.

PMID- 2240181
TI  - Slowly progressive facial paralysis due to vascular malformation of the brain
      stem.
AB  - Slowly progressive facial paralysis is suggestive of a diagnosis other than
      Bell's palsy. A case of slowly progressive facial paralysis caused by a cavernous
      angioma of the brain stem is presented. The classification of vascular
      malformations of the central nervous system is described with emphasis on the MRI
      appearance of these lesions.

PMID- 2240182
TI  - 5-year-old with sudden facial paralysis.

PMID- 2240183
TI  - 45-year-old nondiabetic male with recurrent facial paralysis.

PMID- 2240184
TI  - Reanimation options for lower face in a patient post acoustic surgery.

PMID- 2240185
TI  - The deafness of Beethoven: an audiologic and medical overview.
AB  - The hearing loss of Ludwig von Beethoven has fascinated physicians, audiologists,
      and musicologists for almost 200 years. In this review of the literature, the
      features, treatment, and differential diagnosis of the composer's malady are
      discussed. An original series of hypothetical audiograms and actual
      photomicrographs depicting cochlear otosclerosis and Paget's disease are also
      provided. The author concludes with the majority of otologists that cochlear
      otosclerosis is the most likely diagnosis for the hearing loss. In addition, a
      summary of Beethoven's complicated medical history and results of the autopsy
      that confirmed chronic liver disease are included.

PMID- 2240186
TI  - Hearing loss--risk factor for cisplatin ototoxicity? Observations.
AB  - Ototoxicity associated with cisplatin chemotherapy is well established, but
      opinion is split regarding the relative risk associated with preexisting hearing
      loss. The emerging consensus is that pretreatment loss does not increase the risk
      of cisplatin ototoxicity. Results from a preliminary study of a small sample from
      our patient population supports this consensus.

PMID- 2240187
TI  - Thoughts on the management of chronic facial, head, and neck pain.
AB  - As previously stated in this paper, the therapeutic goal in the management of
      patients with chronic pain conditions in the face, head and neck is management
      and rehabilitation, striving for a 50 percent decrease in pain, a 50 percent
      increase in function and mobility, and a 50 percent decrease in medication with
      the elimination of agents with an addicting potential. These results will best be
      obtained through proper diagnosis and utilization of the aforementioned
      techniques in an interdisciplinary fashion as has been described.

PMID- 2240189
TI  - Private practice and paper writing: four suggestions to make both possible.

PMID- 2240188
TI  - A complex case of cochlear implant electrode placement.

PMID- 2240191
TI  - Sulfhydryls on frog skeletal muscle membrane participate in contraction.
AB  - To examine the molecular mechanism underlying contractile activation, we studied
      effects of a sulfhydryl reagent, N-(7-dimethylamino-4-methylcoumarinyl)maleimide
      (DACM), on twitch, Ag(+)-induced contraction, and K+ and caffeine contractures in
      single toe muscle fibers of frog. DACM suppressed twitch and Ag(+)-induced
      contraction, dose dependently, but not caffeine contracture. K+ contracture also
      was decreased appreciably by exposure to 40 microM DACM for 10 min. DACM elicited
      no shift of the mechanical threshold or inhibition of resting potential but
      slightly inhibited action potential. Increase of the fluorescence intensity
      produced by binding of 10 microM DACM to sulfhydryl groups was depressed by brief
      pretreatment with 100 microM Ag+. When exposed to 1 mM dithiothreitol (DTT)
      within 5 s of the rising phase of 5 microM Ag(+)-induced contraction, the fiber
      rapidly decreased the tension to the resting level. In this case, reapplication
      of 5 microM Ag+ after washing out DTT elicited a new contraction similar to the
      first Ag(+)-induced contraction. The second contraction amplitude depended on the
      time between the onset of the first Ag(+)-induced contraction and DTT
      application. If DTT was applied after more than 16 s, tension no longer developed
      on the second exposure to Ag+ or K+. The experiments provide evidence that
      crucial sulfhydryl groups participate in muscle activation. The possible role of
      the sulfhydryl group on the transverse tubular membrane in tension development is
      discussed.

PMID- 2240190
TI  - Platelet-activating factor and related acetylated lipids as potent biologically
      active cellular mediators.
AB  - Platelet-activating factor (PAF or 1-alkyl-2-acetyl-sn-glycero-3-phosphocholine)
      is the most potent lipid mediator yet discovered. It is known to stimulate a wide
      span of biological responses ranging from aggregation and degranulation of
      platelets and neutrophils to a variety of cellular effects involving the
      stimulation of chemotaxis; chemokinesis; superoxide formation; protein
      phosphorylation; activation of protein kinase C, arachidonic acid, and
      phosphoinositide metabolites; glycogenolysis; and tumor necrosis factor
      production. Obviously, with such a diversity of biological activities, it is not
      surprising that PAF has been considered to be a key component in numerous
      diseases related to hypersensitivity and inflammatory responses. Evidence has
      also been presented for the role of PAF in physiological processes, particularly
      those involving reproduction and fetal development. Furthermore, because of its
      potent hypotensive action, PAF has been implicated as a contributing factor in
      blood pressure regulation. PAF is produced by two independent enzymatic pathways.
      The remodeling route involves the structural modification of a membrane lipid (1
      alkyl-2-acyl-sn-glycero-3-phosphocholine) by replacement of the acyl moiety with
      an acetate group. An alternate route is the de novo synthesis of PAF from an O
      alkyl analogue of a lysophosphatidic acid that requires a reaction sequence of
      acetylation, dephosphorylation, and phosphocholine addition steps.
      Hypersensitivity and other pathophysiological reactions are thought to be caused
      by activation of the remodeling pathway, whereas the de novo route is believed to
      be the source of endogenous levels of PAF required for physiological functions.
      Inactivation of PAF occurs when the acetate group is hydrolyzed by an
      acetylhydrolase that is present in both extra- and intracellular compartments,
      although the catalytic activity of the two forms of acetylhydrolase are
      identical, some of their properties differ. The control of PAF metabolism is very
      complex, but acetylhydrolase, Ca2+, phosphorylation/dephosphorylation of enzymes,
      and fatty acids (especially polyunsaturates) appear to be important regulatory
      factors. Specific PAF receptors have clearly been demonstrated on several
      different types of cells, and although the mechanism of PAF actions is poorly
      understood, it appears that the PAF/receptor-induced responses are closely
      associated with the signal transduction process; both G proteins and adenyl
      cyclase appear to be involved. Because significant quantities of PAF are often
      retained within certain cells, the possibility of PAF serving as an intracellular
      mediator has also been proposed.

PMID- 2240192
TI  - Erythrocyte cation permeability induced by mechanical stress: a model for sickle
      cell cation loss.
AB  - Human red blood cells were subjected to mechanical shearing in a Couette
      viscometer at 37 degrees C, using polyvinylpyrrolidone to increase the medium
      viscosity. At stresses greater than 300 dyn/cm2, movement of both Na and K down
      their concentration gradients was observed. The net rate of both monovalent
      cation fluxes appeared to be linear with applied stress in the range of 300-910
      dyn/cm2. The applied shear forces caused no fragmentation of the cells. Observed
      hemolysis was slight. The observed cation fluxes are not a result of hemolysis
      because the amount of K released by the hemolyzed cells is quantitatively
      inadequate to account for the net K efflux, and there is a net uptake of Na by
      the stressed erythrocytes, which cannot be a consequence of hemolysis. The rates
      of net Na uptake and K efflux were nearly equal (ratio = 0.93 +/- 0.40, n = 6).
      The stress-induced permeabilities were reversible when shearing was halted. This
      work demonstrates the existence of cation permeability inducible in the red cell
      membrane by mechanical deformation, which may be a model for the sickling-induced
      monovalent cation exchange observed in deoxygenated sickle cells.

PMID- 2240193
TI  - Pb2(+)-induced secretion from bovine chromaffin cells: fura-2 as a probe for
      Pb2+.
AB  - The effect of Pb2+ on catecholamine release was studied in isolated intact and
      permeabilized bovine chromaffin cells. Fura-2 was used to monitor intracellular
      Pb2+. A characterization of Pb2(+)-fura-2 interactions in solutions simulating
      intracellular ionic composition showed that Pb2+ forms a 1:1 Pb2(+)-fura-2
      complex (apparent dissociation constant = 4.2 x 10(-12) M, pH 7.05) whose
      fluorescence resembles that of the Ca2(+)-fura-2 complex. Spectra recorded from
      fura-2-loaded cells indicate entry of Pb2+ into the cells. Intracellular Pb2+
      concentrations were proportional to extracellular Pb2+ concentrations and were
      found to be 10(-11)-10(-12) M in cells exposed to micromolar Pb2+ concentrations.
      Pb2+ elicited the release of tritiated norepinephrine from fura-2-loaded cells,
      indicating the extraordinary effectiveness of Pb2+ as a releasing agent.
      Permeabilization of cells with digitonin showed that Pb2+ is able, in the absence
      of Ca2+, to produce exocytotic release at concentrations of 3.2 x 10(-10) M or
      higher (3 orders of magnitude lower than Ca2+). These results support the notion
      that Pb2+ can act as a potent Ca2+ surrogate in triggering secretion.

PMID- 2240194
TI  - Alteration in the myosin phosphorylation pattern of smooth muscle by phorbol
      ester.
AB  - Pretreatment with a high concentration of phorbol 12-myristate 13-acetate (PMA,
      100 nM) increased the degree of tension and extent of myosin light chain (MLC20)
      phosphorylation in the K(+)-stimulated rabbit aortic artery. Pretreatment with
      100 nM PMA did not alter the relationship between MLC20 phosphorylation and the
      tension seen with K+ stimulation in the initial phase and steady state of
      contraction. However, a low concentration of PMA (10 nM) potentiated only the
      MLC20 phosphorylation during the steady state of contraction with no effect on
      the tension. In contrast, the prostaglandin (PG) F2 alpha-induced tension
      development and the MLC20 phosphorylation were not affected by PMA pretreatment
      at both low and high concentrations. The inhibitory action of nifedipine on the
      K(+)-induced contraction was not affected by pretreatment with 100 nM PMA; the
      concentration producing half-maximal inhibition of nifedipine for the K(+)
      induced contraction (33 nM) was the same as that of the K+ plus 100 nM PMA
      induced contraction (32 nM). Our results suggest that PMA may increase the level
      of myosin light chain kinase-dependent MLC20 phosphorylation and the tension in
      the K(+)-stimulated artery, an effect which differs from that seen with increases
      in K+ concentrations. The regulatory mechanism for the contraction involving PGF2
      alpha stimulation may differ from that seen in the case of K+ stimulation.

PMID- 2240195
TI  - Foreign anion substitution for chloride in human red blood cells: effect on ionic
      and osmotic equilibria.
AB  - In human red blood cells, when chloride was replaced isosmotically with a
      permeant chaotropic anion of the lyotropic series (NO3, I, or SCN), an immediate
      and significant loss of cell water was observed. In contrast, replacement of
      chloride by a substituted monovalent sulfonate, such as methanesulfonate or
      sulfamate, had no significant effect on cell water. Cell water loss in the
      presence of lyotropic anions was not the result of hemolysis or cation loss but
      was associated with a significant fall in the distribution ratios of protons
      (out/in) and chloride (in/out), suggesting an increase in nondiffusible
      intracellular negative charges. This hypothesis was examined using the
      equilibrium dialysis technique of Freedman and Hoffman (J. Gen. Physiol. 74: 157
      185, 1979) in which fixed charges are titrated in cells permeabilized by
      nystatin. The equilibrium concentration ratios (in/out) of potassium, sodium, and
      chloride were determined at various external pH (pHo) values. The point at which
      anion and cation ratios are equal is the effective isoelectric point for the
      intracellular charges. In normal chloride-containing medium at 24 degrees C, this
      point was found at a pHo of 6.93. When chloride was replaced by a chaotropic
      anion, the isoelectric point at 24 degrees C shifted to a lower pHo: NO3 (6.38),
      I (5.98), and SCN (5.70). The substituted monovalent sulfonates had little effect
      on isoelectric point: methyl sulfate (6.81), sulfamate (7.00), and
      methanesulfonate (7.07). Calculation of the intracellular charges from titration
      data, as well as equilibrium distribution studies with [14C]SCN, suggests that
      lyotropic anion binding to intracellular sites (mainly hemoglobin) is responsible
      for the observed changes in cell water, cell pH, and chloride distribution.

PMID- 2240196
TI  - Role of polyamines in mitogenic and secretory responses of pancreatic beta-cells
      to growth factors.
AB  - We have investigated the effects of glucose and the polypeptide growth factor
      growth hormone (GH), platelet-derived growth factor (PDGF), insulin-like growth
      factor I (IGF-I), epidermal growth factor (EGF), and transforming growth factor
      alpha (TGF alpha) on the polyamine content, in relation to proliferation and
      insulin secretion and content, of pancreatic beta-cells. Fetal rat pancreatic
      islets containing a high proportion of beta-cells were cultured for 3 days with
      growth factors. beta-cell replication was significantly increased by glucose, GH,
      and PDGF plus IGF-I in parallel with increased islet polyamine contents. In
      contrast, neither EGF nor TGF alpha influenced the islet DNA synthesis rate,
      polyamine content, insulin content, or insulin accumulation in culture medium.
      When the increased polyamine content evoked by growth-promoting agents was
      prevented by inhibitors of polyamine synthesis, elevated DNA synthesis rates
      persisted or were even augmented. However, subcellular fractionation analysis of
      islet homogenates revealed that the nuclear polyamine content was not affected by
      the inhibitors. On the other hand, islet insulin content and glucose-regulated
      insulin release were decreased by polyamine synthesis inhibitors. Glucose
      oxidation rates remained unchanged, suggesting that inhibitors were not toxic to
      islet cells. We conclude that prevention of increases in total cellular content
      of polyamines in response to glucose, GH, or PDGF plus IGF-I does not prevent
      mitogenicity of these growth factors. However, when their synthesis is inhibited
      normal levels of polyamines seem to be maintained in the cell nucleus, an event
      that may be sufficient to permit a mitotic signal to be translated into a
      proliferative response.

PMID- 2240197
TI  - Tricarboxylic acid cycle intermediates in human muscle during prolonged exercise.
AB  - Seven subjects cycled to fatigue [75 +/- 5 (SE) min] at a work load corresponding
      to approximately 75% of their maximal oxygen uptake. Biopsies were taken from the
      quadriceps femoris muscle at rest and during exercise. Muscle glycogen decreased
      from a preexercise level of 445 +/- 33 mmol glucosyl units/kg dry wt to 50 +/- 14
      at fatigue. The sum of the measured tricarboxylic acid cycle intermediates (TCAI
      = malate + citrate + fumarate + oxaloacetate) was 0.49 +/- 0.05 mmol/kg dry wt at
      rest, increased to 4.41 +/- 0.23 after 5 min of exercise, and then decreased
      continuously to 3.33 +/- 0.29 and to 2.83 +/- 0.27 mmol/kg dry wt after 40 min of
      exercise and at fatigue (P less than 0.05 vs. 5 min), respectively. The point of
      fatigue was characterized by an enhanced deamination of AMP (judged by increase
      in IMP) and reduced contents (vs. 5 min of exercise) of lactate, pyruvate, and
      alanine. In contrast, acetylcarnitine (reflects the availability of acetylunits)
      increased threefold at the onset of exercise and was maintained approximately at
      this level until fatigue. It is concluded that prolonged exercise to fatigue at
      moderate work loads results in glycogen depletion, energy deficiency (increased
      AMP deamination), reduced levels of three-carbon compounds and TCAI (compared
      with the initial phase of exercise) but in maintained levels of acetylunits. The
      present data indicate that carbohydrate depletion may impair aerobic energy
      production by reducing the level of TCAI.

PMID- 2240198
TI  - Regulation of Cl- permeability in normal and cystic fibrosis sweat duct cells.
AB  - Reabsorptive cells of the human sweat gland normally exhibit a high basal Cl-
      permeability but are markedly impermeable to Cl- in cystic fibrosis (CF). We
      examined the possibility that the reduced basal Cl- permeability of CF sweat duct
      cells in primary culture is due to a defective regulation of plasma membrane Cl-
      permeability by prostaglandin E2 (PGE2), which is endogenously produced by
      cultured sweat duct cells. The macroscopic Cl- permeabilities of normal and CF
      sweat duct cells were assessed using a halide-specific fluorescent dye, 6-methoxy
      N-(3-sulfopropyl)quinolinium, in combination with fluorescence digital-imaging
      microscopy. The Cl- and Br- permeabilities of normal sweat duct cells were
      markedly reduced by inhibiting endogenous PGE2 production with indomethacin. This
      inhibition of Cl- permeability by indomethacin was largely reversed by the
      addition of PGE2 (10 nM to 1 microM), but not forskolin. Conversely, PGE2 failed
      to stimulate the low Cl- permeabilities of sweat duct cells cultured from CF
      subjects. Our results support the following conclusions: 1) a defective
      regulation of Cl- permeability in CF is a feature of reabsorptive as well as
      secretory epithelial cells, and 2) the nature of this regulatory defect extends
      beyond altered Cl- permeability regulation by adenosine 3',5'-cyclic
      monophosphate-dependent protein kinase.

PMID- 2240199
TI  - Glucose homeostasis and hypothalamic-pituitary-adrenocortical axis during
      development in rats.
AB  - Glucoprivation represents a model stress in which activation of different stress
      responses at different ages can be monitored both in vivo and in vitro.
      Physiological data indicate rat brain contains a liver/pancreas-type glucose
      sensor, yet no biochemical or immunocytochemical evidence exists for such a
      sensor. Young rats appear to lack normal hypothalamic glucose-sensing ability and
      do not show typical secretory patterns of corticotropin-releasing factor,
      adrenocorticotropic hormone, or corticosterone after experimentally induced
      glucoprivation. However, they hypersecrete catecholamines and glucagon (compared
      with adults) and thrive on fuel sources other than glucose that are abundant
      after birth. High steroid levels during the first 24 h after birth may be
      critical for inducing gluconeogenic enzymes and promoting differentiation of
      tissues like pancreas. Neonatal rats also have unique control systems to combat
      the damaging effects of other stresses like hypoxia; these systems may disappear
      in adults. Thus the definition of stress may change during development, and the
      compensatory mechanisms employed to combat stress change from neonatal to adult
      life and are intricately related to the metabolic needs of the animal.

PMID- 2240200
TI  - Fluxes and membrane transport of amino acids in rat liver under different protein
      diets.
AB  - The aim of the present work was to evaluate in vivo the role of the transport
      step in hepatic amino acid metabolism. To vary hepatic utilization of amino
      acids, rats were adapted to diets containing various concentrations of casein (5,
      15, and 60%). In rats fed 5 or 15% casein diets, Gln and Glu were released by the
      liver, and there was a significant uptake of Ala. Hepatic fluxes of amino acids
      increased considerably after adaptation to high-casein diet (up to 1.55 mumol.min
      1.g liver-1 for Ala), because of the rise in afferent concentrations as well as
      enhanced uptake percentage (peaking at 60-75% for most glucogenic amino acids).
      Adaptation to a high-protein diet led to induction of not only system A but also
      of most of the other transport systems (Gly, anionic, T, y+, and to a lesser
      extent system N); only systems ASC and L were unchanged. The study of amino acid
      repartition between liver and plasma with different diets indicates that
      transport could modulate utilization of Ala, Ser, Thr, Gly, Gln, and Asp. For Arg
      and Asn, present in very low concentrations in liver under any condition, the
      transport step should be the major locus of control of their metabolism. For
      amino acids chiefly transported by nonconcentrative systems, such as aromatic
      amino acids, cellular metabolism could also be limited by the transport process.
      In conclusion, during adaptation to a high-protein diet, there is apparently a
      coordinated adaptation of amino acid transport and of their intracellular
      metabolism. For some amino acids, induction of catabolic enzymes seems greater
      than that of transport, so that the transport step may play an important role in
      control of metabolic fluxes. For example, concentration of amino acids such as
      Thr may be markedly depressed in rats adapted to a high-protein diet.

PMID- 2240201
TI  - Dexamethasone increases glucose cycling, but not glucose production, in healthy
      subjects.
AB  - We established that measurement of glucose fluxes through glucose-6-phosphatase
      (G-6-Pase; hepatic total glucose output, HTGO), glucose cycling (GC), and glucose
      production (HGP), reveals early diabetogenic changes in liver metabolism. To
      elucidate the mechanism of the diabetogenic effect of glucocorticoids, we treated
      eight healthy subjects with oral dexamethasone (DEX; 15 mg over 48 h) and
      measured HTGO with [2-3H]glucose and HGP with [6-3H]glucose postabsorptively and
      during a 2-h glucose infusion (11.1 mumol.kg-1.min-1). [2-3H]- minus [6
      3H]glucose equals GC. DEX significantly increased plasma glucose, insulin, C
      peptide, and HTGO, while HGP was unchanged. In controls and DEX, glucose infusion
      suppressed HTGO (82 vs. 78%) and HGP (87 vs. 91%). DEX increased GC
      postabsorptively (three-fold) P less than 0.005 and during glucose infusion (P
      less than 0.05) but decreased metabolic clearance and glucose uptake (Rd), which
      eventually normalized, however. Because DEX increased HTGO (G-6-Pase) and not HGP
      (glycogenolysis + gluconeogenesis), we assume that DEX increases HTGO and GC in
      humans by activating G-6-Pase directly, rather than by expanding the glucose 6
      phosphate pool. Hyperglycemia caused by peripheral effects of DEX can also
      contribute to an increase in GC by activating glucokinase. Therefore, measurement
      of glucose fluxes through G-6-Pase and GC revealed significant early effects of
      DEX on hepatic glucose metabolism, which are not yet reflected in HGP.

PMID- 2240202
TI  - Effect of two methods of hand heating on body temperature, forearm blood flow,
      and deep venous oxygen saturation.
AB  - Two methods of hand heating [warmed blanket 40 degrees C (WB) and warm-air box 55
      degrees C (WA)] were compared with the effect of no heating (control) in six
      healthy females. After 30 min baseline, the left hand was either heated for 1 h
      or not heated. Measurements were made of skin temperature (ST), core temperature
      (CT), right forearm (FBF) and skin blood flow (SBF), and right forearm deep
      venous blood oxygen content with and without occlusion of the hand circulation.
      CT rose above baseline in WB (by +0.2 degrees C, P less than 0.01) but not with
      control or WA. Abdominal ST rose only with WB (by +0.66 degrees C above baseline,
      P less than 0.01). FBF increased above baseline values with both WA (by +10 ml.l
      forearm-1.min-1) and WB (by +12 ml.l forearm-1.min-1), but neither was
      significantly greater than the control. SBF increased above baseline only with WB
      (by +202 mV, P less than 0.01), and this was significantly greater than control
      SBF. With an occluded hand circulation, deep venous oxygen content rose above
      baseline values with WB only (+6.0%, P less than 0.01) but was not greater than
      control with either method of hand heating. We conclude that using a warm-air box
      has less effect than a heated blanket on the measured variables.

PMID- 2240204
TI  - Role of corticosterone in adaptive changes in energy expenditure during refeeding
      after low calorie intake.
AB  - We examined the importance of corticosterone in elevated efficiency of energy
      utilization during refeeding after low food consumption. Energy balance studies
      during refeeding (over periods of 14 or 16 days) were conducted in rats
      previously food restricted for 16 days at 50% of normal food intake. Comparisons
      made with nonrestricted weight-matched controls after validation studies
      indicated that 2-wk-younger weight-matched controls had similar maintenance
      energy requirements and similar efficiency of energy utilization above
      maintenance (i.e., net efficiency) to nonrestricted age-matched controls. Results
      indicate that relative to controls refeeding after low food consumption was
      associated with enhanced energy conservation underlain by a 16-18% reduction (P
      less than 0.001) in total energy expenditure over a 14-day period. This metabolic
      adaptation for energy conservation resulted in a threefold increase (P less than
      0.001) in body fat accretion but no difference in body protein deposition.
      Bilateral adrenalectomy (ADX) 2 days before refeeding reduced differences in
      energy expenditure between refed group and controls from 18 to 8% (P less than
      0.01) and attenuated body fat gain from a three- to twofold increase (P less than
      0.001) above control group. Effects of ADX were prevented by daily corticosterone
      replacement. Data suggest that after a period of low calorie intake an adaptive
      neurohormonal switching mechanism facilitates replenishment of fat stores during
      refeeding. This metabolic reorientation (characterized by an adaptive fall in
      energy expenditure) has both an adrenal as well as a nonadrenal component,
      because it is partially reversed by prior bilateral ADX, an effect attributed to
      removal of corticosterone-induced inhibition of thermogenesis.

PMID- 2240203
TI  - Low ratio of fat to carbohydrate oxidation as predictor of weight gain: study of
      24-h RQ.
AB  - Reduced oxidation of fat leading to a positive fat balance could be a factor in
      the development of obesity. Twenty-four-hour respiratory quotient (RQ) was
      measured in 152 nondiabetic Pima Indians fed a weight-maintenance diet [87 males
      and 65 females; 27 +/- 6 yr (mean +/- SD); 93.9 +/- 22.9 kg; 32 +/- 9% fat].
      Twenty-four-hour RQ varied from 0.799 to 0.903. Prior change in body weight, 24-h
      energy balance, sex, and percent body fat explained 18% of the variance in 24-h
      RQ (P less than 0.001). In a subgroup of 66 siblings from 28 families, family
      membership explained 28% of the remaining variance in 24-h RQ (P less than 0.05).
      In 111 subjects for whom follow-up data (25 +/- 11 mo) were available, 24-h RQ
      was correlated with subsequent changes in body weight and fat mass (r = 0.27, P
      less than 0.01 and r = 0.19, P less than 0.05, respectively). Subjects with
      higher 24-h RQ (90th percentile) independent of 24-h energy expenditure were at
      2.5 times higher risk of gaining greater than or equal to 5 kg body weight than
      those with lower 24-h RQ (10th percentile). We conclude that in Pima Indians fed
      a standard diet 1) family membership is the principal determinant of the ratio of
      fat to carbohydrate oxidation, and 2) a low ratio of fat to carbohydrate
      oxidation is associated with subsequent weight gain independent of low energy
      expenditure and may contribute to the familial aggregation of obesity.

PMID- 2240205
TI  - Regulation of serum 1,25-dihydroxyvitamin D3 in lactating rats.
AB  - To characterize further the mechanism(s) underlying the increased serum 1,25
      dihydroxyvitamin D3 [1,25(OH)2D3] concentration associated with lactation in the
      rat, we examined hormone biosynthesis [i.e., renal 25-hydroxyvitamin D-1 alpha
      hydroxylase (1 alpha-hydroxylase) activity] and hormone disappearance in groups
      of lactating Holtzman rats and age- and sex-matched nonlactating controls. 1
      alpha-Hydroxylase activity was significantly greater in kidneys from lactating
      rats (4.0 +/- 0.42 fmol.mg-1.min-1) on a basal diet than in those from nonmated
      females (1.4 +/- 0.08 fmol.mg-1.min-1), an increment sufficient to account for
      the observed fourfold elevation of 1,25(OH)2D3 in the dams. The increase occurs
      despite the lower serum 1,25(OH)2D3 levels in lactating than in nonlactating rats
      at 12 and 24 h after a bolus injection of 1,25(OH)2D3 (2 ng/g body wt). Elevation
      of serum 1,25(OH)2D3 is not a requisite consequence of lactation, however,
      because dams receiving supplemental calcium from food (1.6%) and water (0.3%)
      exhibited no increase of either serum 1,25(OH)2D3 or 1 alpha-hydroxylase activity
      compared with controls. In contrast, lactating rats that received a diet with
      only 0.1% calcium had 5-fold higher serum 1,25(OH)2D3 levels and 20-fold higher 1
      alpha-hydroxylase activity than nonlactating rats on the same diet. We conclude
      that other factors in conjunction with lactation, but not the lactating state per
      se, promote the changes in 1,25(OH)2D3 metabolism observed.

PMID- 2240206
TI  - Contribution of liver and skeletal muscle to alanine and lactate metabolism in
      humans.
AB  - To quantitate alanine and lactate gluconeogenesis in postabsorptive humans and to
      test the hypothesis that muscle is the principal source of these precursors, we
      infused normal volunteers with [3-14C]lactate, [3-13C]alanine, and [6-3H]glucose
      and calculated alanine and lactate incorporation into plasma glucose corrected
      for tricarboxylic acid cycle carbon exchange, the systemic appearance of these
      substrates, and their forearm fractional extraction, uptake, and release. Forearm
      alanine and lactate fractional extraction averaged 37 +/- 3 and 27 +/- 2%,
      respectively; muscle alanine release (2.94 +/- 0.27 mumol.kg body wt-1.min-1)
      accounted for approximately 70% of its systemic appearance (4.18 +/- 0.31
      mumol.kg body wt-1.min-1); muscle lactate release (5.51 +/- 0.42 mumol.kg body wt
      1.min-1) accounted for approximately 40% of its systemic appearance (12.66 +/-
      0.77 mumol.kg body wt-1.min-1); muscle alanine and lactate uptake (1.60 +/- 0.7
      and 3.29 +/- 0.36 mumol.kg body wt-1.min-1, respectively) accounted for
      approximately 30% of their overall disappearance from plasma, whereas alanine and
      lactate incorporation into plasma glucose (1.83 +/- 0.20 and 4.24 +/- 0.44
      mumol.kg body wt-1.min-1, respectively) accounted for approximately 50% of their
      disappearance from plasma. We therefore conclude that muscle is the major source
      of plasma alanine and lactate in postabsorptive humans and that factors
      regulating their release from muscle may thus exert an important influence on
      hepatic gluconeogenesis.

PMID- 2240207
TI  - Reversal of enhanced muscle glucose transport after exercise: roles of insulin
      and glucose.
AB  - Exercise stimulates insulin-independent glucose transport in skeletal muscle and
      also increases the sensitivity of the glucose transport process in muscle to
      insulin. A previous study [D. A. Young, H. Wallberg-Henriksson, M. D. Sleeper,
      and J. O. Holloszy. Am. J. Physiol. 253 (Endocrinol. Metab. 16): E331-E335, 1987]
      showed that the exercise-induced increase in glucose transport activity
      disappears rapidly when rat epitrochlearis muscles are incubated for 3 h in vitro
      in the absence of insulin and that 7.5 microU/ml insulin in the incubation medium
      apparently slowed the loss of enhanced sugar transport. We examined whether
      addition of insulin several hours after exercise increases glucose transport to
      the same extent as continuous insulin exposure. Addition of 7.5 microU/ml insulin
      2.5 h after exercise (when glucose transport has returned to basal levels)
      increased sugar transport to the same level as that which resulted from
      continuous insulin exposure. This finding provides evidence for an increase in
      insulin sensitivity rather than a slowing of reversal of the exercise-induced
      increase in insulin-independent glucose transport activity. Glucose transport was
      enhanced only at submaximal, not at maximal, insulin concentrations. Exposure to
      a high concentration of glucose and a low insulin concentration reduced the
      exercise-induced increase in insulin-sensitive glucose transport. Incubation with
      a high concentration of 2-deoxy-D-glucose (2-DG) did not alter the increase in
      insulin sensitivity, even though a large amount of 2-DG entered the muscle and
      was phosphorylated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240208
TI  - Food deprivation alters liver glycogen metabolism and endocrine responses to
      hemorrhage.
AB  - Liver glycogen content, blood glucose, insulin, glucagon, and epinephrine were
      determined during 1 h hemorrhagic hypotension at 60 mmHg and 23 h thereafter in
      fed and two groups of 24-h food-deprived rats receiving either no infusion or 30%
      glucose intravenously during hemorrhage. Liver glycogen content was reduced by
      greater than 90% after 24-h food deprivation. Fed and food-deprived rats given
      glucose developed similar and substantial elevations of blood glucose during
      hemorrhage, whereas changes in blood glucose were modest in food-deprived rats
      given no infusion. In fed rats, liver glycogen was reduced by 60% during the 1-h
      bleed, but within 2 h after hemorrhage repletion of liver glycogen content
      commenced. By 6 h, approximately 75% of the glycogen lost during hemorrhage had
      been restored, and 23 h after hemorrhage liver glycogen content was six times
      greater compared with nonbled controls. Although glycogen levels increased after
      hemorrhage in food-deprived animals, the increase was negligible compared with
      that found in fed rats. Infusion of glucose during hemorrhage or adrenergic
      blockade after hemorrhage did not alter glycogen repletion in food-deprived rats.
      Posthemorrhage fed animals had high levels of insulin, glucagon, and epinephrine
      during hemorrhage, whereas insulin levels remained low in food-deprived rats
      despite exogenously induced hyperglycemia. It is concluded that rapid and
      substantial glycogen repletion can occur even immediately poststress. The
      conditions seem to be related to the nutritional state at the time of the insult.

PMID- 2240209
TI  - Insulin- and thyroid hormone-independent adaptation of myofibrillar proteolysis
      to glucocorticoids.
AB  - Myofibrillar protein breakdown in skeletal muscle progresses through two distinct
      phases in response to chronic glucocorticoid administration in the rat, i.e., an
      early phase lasting 4-5 days, during which proteolysis increases followed by a
      later phase during which proteolysis decreases. The possible involvement of
      insulin and the iodothyronines in this phenomenon has now been examined.
      Diabetic, thyroidectomized, and normal rats were treated with corticosteroid for
      10-11 days, and at timed intervals muscle proteolysis was evaluated by measuring
      the release of 3-methyl-L-histidine (3-MH) and tyrosine from the perfused
      hindquarter as well as the excretion of 3-MH in the urine. Corticosterone (CTC)
      administration to normal rats increased plasma insulin, whereas plasma 3,5,3'
      triiodothyronine responded with an early rise followed by a fall after 4-5 days.
      However, the biphasic response of myofibrillar proteolysis to chronic
      glucocorticoid treatment was not abolished in CTC-treated diabetic or
      thyroidectomized rats. CTC treatment increased release of tyrosine by perfused
      muscle of diabetic rats but, unlike 3-MH release, did not diminish later. Thus
      the adaptation of myofibrillar proteolysis to chronic glucocorticoid treatment
      appears to be independent of insulin and thyroid hormones. However, insulin may
      play a role in curtailing glucocorticoid-induced breakdown of nonmyofibrillar
      proteins.

PMID- 2240210
TI  - Different responses of trabecular and cortical bone to 1,25(OH)2D3 infusion.
AB  - Previous studies regarding the effects of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]
      on bone have suggested that 1,25(OH)2D3 increases bone mass and calcium. Many of
      these studies have focused on trabecular or total bone without examining cortical
      bone per se. To determine whether the response of trabecular bone to 1,25(OH)2D3
      differed from the response of cortical bone, we infused 1,25(OH)2D3 into rats and
      examined bone mass, 45Ca accumulation, and the density distribution of bone
      particles (as a measure of bone maturation) in both the proximal tibia and shaft.
      In the proximal tibia 1,25(OH)2D3 decreased 45Ca accumulation, yet increased bone
      mass and shifted the particle distribution to more mineralized fractions. In the
      shaft there was a redistribution of bone to less mineralized fractions that was
      not accompanied by a change in total bone mass or a decrease in 45Ca
      accumulation. Thus 1,25(OH)2D3 may retard bone maturation and mineralization
      throughout the tibia, but this effect in the proximal tibia appears to be
      overshadowed by a reduction in bone resorption resulting in an accumulation of
      well-mineralized bone in that region. Bone resorption, however, was not measured
      directly. The net result is an increase in bone mass and density of trabecular
      bone not seen in cortical bone.

PMID- 2240211
TI  - Dose-dependent effect of insulin on plasma free fatty acid turnover and oxidation
      in humans.
AB  - Methodology for measuring plasma free fatty acid (FFA) turnover/oxidation with [1
      14C]palmitate was tested in normal subjects. In study 1, two different approaches
      (720-min tracer infusion without prime vs. 150-min infusion with NaH14CO3 prime)
      to achieve steady-state conditions of 14CO2 yielded equivalent rates of plasma
      FFA turnover/oxidation. In study 2, during staircase NaH14CO3 infusion,
      calculated rates of 14CO2 appearance agreed closely with NaH14CO3 infusion rates.
      In study 3, 300-min euglycemic insulin clamp documented that full biological
      effect of insulin on plasma FFA turnover/oxidation was established within 60-120
      min. In study 4, plasma insulin concentration was raised to 14 +/- 2, 23 +/- 2,
      38 +/- 2, 72 +/- 5, and 215 +/- 10 microU/ml. A dose-dependent insulin
      suppression of plasma FFA turnover/oxidation was observed. Plasma FFA
      concentration correlated positively with plasma FFA turnover/oxidation in basal
      and insulinized states. Total lipid oxidation (indirect calorimetry) was
      significantly higher than plasma FFA oxidation in the basal state, suggesting
      that intracellular lipid stores contributed to whole body lipid oxidation.
      Hepatic glucose production and total glucose disposal showed the expected dose
      dependent suppression and stimulation, respectively, by insulin. In conclusion,
      insulin regulation of plasma FFA turnover/oxidation is maximally manifest at low
      physiological plasma insulin concentrations, and in the basal state a significant
      contribution to whole body lipid oxidation originates from lipid pool(s) that are
      different from plasma FFA.

PMID- 2240212
TI  - Interpretation of isotopomer patterns in tracing glycogen synthesis and glucose
      recycling using [13C6]glucose.
AB  - Tracing glycogen synthesis with [U-13C]glucose involves determination of
      isotopomer patterns in precursors and products. The contribution of the direct
      pathway to glycogen synthesis has been estimated from the ratio (R) of the number
      of glycogen glucose molecules having six 13C atoms to the total number of glucose
      molecules having one to six 13C atoms. Using theoretical examples, we show that
      the equation to calculate R underestimates the contribution of the direct
      pathway. We derive a correct stoichiometric expression for R. Also, we show how
      to correct these estimates for 1) recondensation of two M+3 three-carbon
      intermediates into M+6 glucose 6-phosphate, and 2) the increasing enrichment of
      arterial glucose in various isotopomers arising from the indirect pathway.
      Finally, using the developed formulas we recalculate data from the literature.
      Similar considerations apply to investigations of glucose recycling using [U
      13C6]glucose.

PMID- 2240213
TI  - Effect of T. spiralis infection on intestinal motor activity in the fasted state.
AB  - We sought to determine the effects of Trichinella spiralis infection on small
      intestinal motor activity in the fasted state in dogs and relate it to clinical
      symptoms during the intestinal phase of trichinosis. Motor activity was recorded
      by strain gauge force transducers. Infection with T. spiralis resulted in a
      significant increase in the incidence and proximal origination of giant migrating
      contractions (GMCs) during the first 5 days postinfection. This was also the time
      when the dogs had diarrhea. The dogs were often restless and showed signs of
      discomfort during proximally originating GMCs. The incidence of retrograde giant
      contractions (RGCs) increased significantly on the 2nd and 3rd day postinfection.
      RGCs were followed by vomiting 71% of the time during infection. The migrating
      motor complex cycle length increased significantly, and this was due to
      intestinal "amyogenesia" and "dysmyogenesia". During these phenomena, electrical
      control activity was almost completely obliterated in the proximal half of the
      small intestine (amyogenesia) and became irregular and unstable in the distal
      half (dysmyogenesia). Intestinal amyogenesia and dysmyogenesia lasted up to 4 h
      and were terminated by a GMC. We conclude that diarrhea induced by T. spiralis
      infection is closely associated with an increase in the incidence and proximal
      origin of GMCs. These GMCs may also be the motor correlates of abdominal cramping
      and pain during the intestinal phase of trichinosis.

PMID- 2240214
TI  - Relationship between maternal milk PGE2 and gastric acid secretion in newborn
      rats.
AB  - We previously demonstrated that in rats gastric acid secretion declines after
      birth and drops steeply on day 12 of life. In the present study, we investigated
      the part played in this decline by prostaglandin E2 (PGE2) from maternal milk.
      PGE2 content was first measured in the milk of untreated dams 0, 1, 5, 10, 12,
      15, and 18 days after parturition. PGE2 levels were high during the first 5 days
      (123.5-200.5 pg/ml), declined significantly between days 10 and 15 (56.6-85.4
      pg/ml; P less than 0.05), and dropped to 18.4 pg/ml on day 18. We also found that
      depleting milk of PGE2 prevented drop of acid secretion in 12-day-old suckling
      rats. Injecting lactating dams with indomethacin significantly reduced milk PGE2
      content by 65% vs. milk of untreated dams. Surprisingly, administration of sesame
      oil, the indomethacin vehicle to the dams, increased milk PGE2 content by 182%.
      In the pups of the indomethacin-treated dams, acid secretion did not drop. On the
      contrary, in vivo basal and histamine-induced acid output rose markedly by 40 and
      50%, respectively, and in vitro the net movements of 36Cl and 22Na measured in
      the isolated stomach indicated that active Cl- secretion had resumed. Mucosal
      PGE2 did not appear to be significantly involved in early development of acid
      secretion because administration of indomethacin to pups from untreated dams did
      not significantly modify the secretion measured on day 12. Data indicate that
      maternal milk depletion of PGE2 prevents the drop of gastric acid secretion
      previously observed in 12-day-old pups and suggest that in infant rats maternal
      PGE2 plays a physiological part in regulating acid secretion.

PMID- 2240216
TI  - Comparison of calcium and magnesium absorption: in vivo and in vitro studies.
AB  - Transport characteristics of Ca and Mg were compared at three different levels of
      the absorptive process in male (120-170 g) Wistar rats. Balance studies in intact
      rats revealed that fractional Ca absorption decreased with increased Ca intake so
      that net Ca absorption remained constant. Fractional Mg absorption decreased
      modestly with increased Mg intake so that net Mg absorption increased
      proportionately with increased dietary Mg. Everted duodenal sacs demonstrated the
      presence of active Ca absorption with serosal-to-mucosal (S/M) ratio of 2.65 +/-
      0.20 (n = 6), which was greater than unity (P less than 0.001). In contrast, the
      S/M for Mg did not exceed unity. Mucosal duodenal Ca uptake exhibited a large
      saturable (Michaelis constant of 4.80 +/- 0.34 mM, maximal velocity of 4.71 +/-
      0.13 nmol.min-1.mg-1) and a small nonsaturable component (0.12 +/- 0.01 nmol.min
      1.mg-1) in 5-wk-old rats (120 g). In 72-wk-old rats (600 g) the diffusional
      component of Ca uptake became predominant, and the slope increased significantly
      to 0.32 +/- 0.01 (P less than 0.05). Duodenal Mg uptake was completely
      concentration dependent and exhibited no age-related changes.

PMID- 2240217
TI  - Fasting and postprandial hepatic bile flow in unanesthetized opossums.
AB  - In conscious opossums, we evaluated the relationship between hepatic bile flow
      and the intestinal motor function during fasting as well as after feeding. In six
      opossums, bipolar electrodes were implanted from the gastric antrum to the
      terminal ileum. After cholecystectomy, the common duct was ligated, and a
      catheter was tied into the proximal common duct for collecting hepatic bile.
      During subsequent studies, hepatic bile flow was measured, and bile was returned
      to the duodenum through an externalized duodenal catheter. Cyclic increases in
      bile flow during fasting did not show a close correlate with the duodenal
      migratory motor complex (MMC) cycle. Rather, bile flow showed peak values [0.11
      +/- 0.02 (SE) ml/min] when phase III MMC activity reached the midileum. Hepatic
      bile flow correlated closely with the amount of bile acid secreted by the liver.
      When the bile acid pool was depleted by diverting bile from the intestine,
      hepatic secretion of bile fell to uniformly low values of approximately 0.04
      ml/min that did not show cyclic variation. Hepatic bile flow after feeding
      increased to a maximal value of 0.12 +/- 0.01 ml/min at 90 min. We conclude that
      increases in hepatic bile flow during fasting and after meals are determined
      mainly by variations in intestinal motor activity that alter small bowel transit
      and thereby affect the enterohepatic circulation of bile acids.

PMID- 2240215
TI  - Fat feeding increases size, but not number, of chylomicrons produced by small
      intestine.
AB  - To test the regulatory effect of dietary triglyceride (TG) on rat lymphatic
      apolipoprotein B (apo B) transport, lymph-fistula rats were infused
      intraduodenally for 8 h at 3 ml/h with a lipid emulsion containing 40 mumol TG
      labeled with glycerol [9,10-3H(N)]triolein, 7.8 mumol egg phosphatidylcholine,
      and 57 mumol sodium taurocholate in phosphate-buffered saline with or without 1
      mg/h Pluronic L81 (L81). L81 is known to prevent lipid transport in the intestine
      by inhibiting the formation of chylomicrons (CM). This action of L81 is quickly
      reversible by merely replacing L81 infusion by saline infusion. In the control
      rats (without L81 added to the infusate), the amount of apo B secreted in either
      whole lymph, CM, or the very-low-density lipoprotein (VLDL) fractions did not
      change significantly during lipid infusion compared with fasting. Compared with
      the fasting, the apo B output in lymph during L81 plus lipid or saline infusion
      in the experimental rats did not change significantly. The lymphatic apo B output
      data were also supported by the incorporation studies using [3H]leucine. In
      summary, these data demonstrate that the absorption of a physiological load of
      lipid into lymph does not affect the apo B synthesis in the mucosa or the
      secretion of apo B in lymph. Furthermore, the action of L81 is probably not by
      inhibiting intestinal apo B production because apo B secretion was not affected
      by the presence of L81. This study also demonstrates that the number of CM
      particles made by the small intestine remains relatively constant during fasting
      or active lipid uptake and transport. During active lipid absorption, instead of
      increasing the number of CM, the enterocytes expand the size of the CM particles.
      Lastly, the number and TG content of VLDL particles synthesized and secreted by
      the small intestine also seems to remain relatively constant during fasting and
      active lipid absorption.

PMID- 2240218
TI  - Leukotriene D4 excitation of rabbit distal colon arises in the region of the
      muscularis mucosae.
AB  - We previously have demonstrated in vivo that intra-arterial administration of
      leukotriene D4 (LTD4) causes increased myoelectric and mechanical activity in the
      rabbit distal colon. The aim of this study was to use both in vivo and in vitro
      techniques to try to elucidate the mechanism underlying this effect. In vivo the
      excitatory response of the rabbit distal colon to LTD4 was abolished by
      pretreatment with atropine (0.1 mg/kg iv) or hexamethonium (5 mg/kg iv) or the
      LTD4 receptor antagonist SK&F 102922 (0.8 micrograms/kg ia). In vitro neither the
      longitudinal nor the circular muscle layer responded to LTD4 (10(-10) to 10(-7)
      M) with a contractile response. Over the same concentration range, LTD4 caused
      contractions of the muscularis mucosae that were attenuated by either SK&F 102922
      (10(-9) to 10(-7) M) or indomethacin (10(-6) M) but were unaffected by atropine
      (10(-6) M), pyrilamine (10(-6) M), or tetrodotoxin (10(-6) M). Full thickness
      segments of longitudinal muscle, circular muscle, and muscularis mucosae did not
      contract to LTD4. These data imply that LTD4-induced excitation of the rabbit
      distal colon in vivo arises as a result of the excitation of LTD4 receptors in
      the region of the muscularis mucosae and that this leads ultimately to the
      release of acetylcholine onto the muscularis propria. It is proposed that one
      possible mechanism leading to the latter effect is an increased excitability of
      intrinsic nerves resulting from a prostaglandin-induced depression of
      norepinephrine release from nerves impinging on the submucosal plexus.

PMID- 2240219
TI  - Glycyl-L-sarcosine transport by ATP-depleted isolated enterocytes from chicks.
AB  - Normally energized and ATP-depleted isolated chicken enterocytes have been used
      to investigate the energetics of intestinal glycyl-L-sarcosine (Gly-Sar)
      transport, and the results were compared with those obtained for 3-O-methyl-D
      glucose (3-OMG) active transport, which is known to be energized by the
      electrochemical Na+ gradient. The results show that even though Gly-Sar had no
      effect on Na+ efflux from labeled (22Na) enterocytes, 20 mM L-leucine and 20 mM 3
      OMG increased the rate constant of Na+ efflux by 34 and 76%, respectively. In ATP
      depleted cells 3-OMG was accumulated in response to experimentally imposed inward
      Na+ gradients; however, Gly-Sar was not accumulated. In the absence of Na+, an
      inward proton gradient slightly increased Gly-Sar uptake, although no transient
      accumulation was observed. An increase in membrane potential by replacement of Cl
      by NO3- or by imposition of an outward K+ gradient in the presence of
      valinomycin stimulated both 3-OMG and Gly-Sar uptake, even in the absence of
      either H+ or Na+ gradient. When in addition to a K+ diffusion potential, a Na+
      gradient was present, 3-OMG transient accumulation was further increased
      (approximately 2-fold over equilibrium value), and Gly-Sar uptake showed the same
      pattern as that observed when only membrane potential was present. However, in
      the presence of an outward K+ diffusion potential and an inward H+ gradient Gly
      Sar was stimulated approximately threefold, clearly showing a significant
      overshoot, whereas 3-OMG was not transiently accumulated.

PMID- 2240220
TI  - Evaluation of selective liver denervation methods.
AB  - This study compares four methods of hepatic denervation and defines the rate and
      physiological significance of reinnervation. Five groups of rats were prepared:
      10 underwent orthotopic liver transplantation. In nine rats a 90% aqueous phenol
      solution was applied circumferentially to the portal vein. Thirteen rats
      underwent microsurgical denervation; 28 received different doses of 6
      hydroxydopamine (6-HODA) administered as a single intraportal injection [50 (n =
      10), 75 (n = 6), and 100 mg/kg (n = 6)]. Twelve rats were studied as controls.
      Rats were killed 1, 4, and 8 wk after surgery to determine liver tissue content
      of norepinephrine (NE). Changes in mean arterial pressure (MAP) in response to
      hepatic nerve stimulation, which was supramaximum in intensity and frequency,
      were measured before rats were killed. NE content in controls ranged from 121 to
      204 ng/g and MAP increased by 30-38 mmHg after electrical stimulation. At 1, 4,
      and 8 wk after treatment the liver NE content was less than 1, 2.3, and 20.2 ng/g
      in the transplant group; less than 1, 2.7, 4.1 ng/g in the phenol group; and
      17.2, less than 1, and 3 ng/g in the surgically denervated group. In the 6-HODA
      group, values were 18.9, 47, and 61.5 ng/g (50 mg/kg); 5.7, 20.2, and 15 ng/g (75
      mg/kg); and 7.7, 2.5, and 17.5 ng/g (100 mg/kg). When the level of NE was
      undetectable, MAP increase after stimulation was 0-18% that of controls. When NE
      content was 15-23% of normal, MAP increased 49-62% regardless of the denervation
      technique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240221
TI  - Water and ion handling in the rat cecum.
AB  - The minute-by-minute net water movement (Jw) in the rat cecum was correlated with
      the transepithelial potential difference (PD), short-circuit current (Isc), and
      the unidirectional Na+, Cl-, and Rb+ fluxes, with the following results. 1) Jw
      was a linear function of the applied hydrostatic or osmotic transepithelial
      gradients (hydrostatic permeability coefficiency = 0.164 +/- 0.018 cm/s, n = 13;
      osmotic permeability coefficient = 0.0014 +/- 0.0002 cm/s, n = 6). 2) A fraction
      of this absorptive Jw (0.17 +/- 0.03 microliter.min-1.cm-2, n = 13) was
      independent of the presence of any osmotic, hydrostatic, or chemical gradient. 3)
      This fraction was Na+ dependent, associated with an amiloride-insensitive PD and
      net Na+ (2.37 +/- 0.68 mu eq.h-1.cm-2, n = 6) and Cl- influxes (3.45 +/- 1.46 mu
      eq.h-1.cm-2, n = 6), measured under short-circuit conditions. No net Rb+ movement
      was detected. 4) The absorptive Jw increased when HCO3- was replaced by
      tris(hydroxymethyl)aminomethane (Tris+) buffer or Cl- by SO4(2-). A good
      agreement between the observed and the expected Jw (assuming isosmotic
      reabsorption) was observed in the absence of HCO3-. 5) The presence of an osmotic
      but not a hydrostatic transepithelial gradient generated a transepithelial PD.
      These results show that water movement across the rat cecum in vitro is the
      result of a combination of hydrostatic-, osmotic-, and transport-associated
      transfers. Concerning this last driving force, the observed results indicate that
      the transport-related Jw results from the addition of an absorptive Jw, coupled
      to a nonelectrogenic NaCl entry, plus a secretory Jw probably coupled to HCO3-
      secretion.

PMID- 2240222
TI  - Sulfate and oxalate exchange for bicarbonate across the basolateral membrane of
      rabbit ileum.
AB  - The purpose of these studies was to further define the transport of SO4(2-) and
      oxalate across the basolateral membrane (BLM) of rabbit ileum. We previously
      found evidence for Cl-(-)SO4(2-) exchange but no evidence for carrier-mediated
      oxalate transport. A HCO3- gradient (but not a pH gradient) was found to
      stimulate SO4(2-) and oxalate uptake in BLM vesicles; uptake was inhibited by
      DIDS. Oxalate cis-inhibited HCO3- gradient SO4(2-) uptake and trans-stimulated
      SO4(2-) uptake, suggesting SO4(2-) and oxalate used the same carrier (SO4(2-)-
      and oxalate-HCO3-exchange). Cl- had no effect on HCO3- gradient-stimulated SO4(2
      ) uptake, indicating that Cl(-)-SO4(2-) exchange was a different carrier. Other
      substrates found to be transported on the HCO3- exchanger were oxaloacetate and
      S2O3(2-)-.SO4(2-), S2O3(2-). and oxalate were found to also use the SO4(2-)-Cl-
      exchanger, whereas oxalate was only transported on the HCO3- exchanger. SO4(2-)
      HCO3- exchange was found on villus, but not crypt cell, BLM. These results
      indicate that there is a SO4(2-)-HCO3- exchanger on the BLM of villus cells that
      also transports oxalate, and along with our previous studies, the results provide
      evidence for the transepithelial transport of oxalate.

PMID- 2240223
TI  - Phagocytosis by Kupffer cells predominates in pericentral regions of the liver
      lobule.
AB  - These studies were designed to determine whether particle phagocytosis could be
      monitored from the surface of the perfused liver. To achieve this goal, decreases
      in reflected light were measured during phagocytosis of colloidal carbon
      particles. Livers were illuminated with 623-nm light via a relatively large fiber
      optic light guide (tip diam 2 mm), and reflected light was monitored
      continuously. A decrease in reflected light was observed when carbon was infused
      that was proportional to the influent carbon concentration. Initial changes in
      reflected light were linearly related to rates of carbon uptake by Kupffer cells.
      Subsequently, rates of carbon uptake were determined from changes in reflected
      light in periportal and pericentral regions of the liver lobule with miniature
      fiber-optic light guides. In perfusions in the anterograde direction, rates of
      carbon uptake were approximately 80% higher in pericentral than periportal
      regions of the liver lobule. This pattern was reversed when livers were perfused
      in the retrograde direction. Thus particle phagocytosis predominates in
      downstream regions of the liver lobule. Because decreasing the pH of the influent
      perfusate increased carbon uptake, the pH gradient over the liver lobule may be
      involved in the regulation of particle uptake at the sublobular level.

PMID- 2240224
TI  - Luminal glucose concentrations in the gut under normal conditions.
AB  - Luminal glucose (Glc) concentrations in the small intestine (SI) are widely
      assumed to be 50-500 mM. These values have posed problems for interpreting SI
      luminal osmolality and absorptive capacity, Glc transporter Michaelis-Menten
      constants (Km), and the physiological role of active Glc transport and its
      regulation. Hence we measured luminal contents, osmolality, and Glc, Na+, and K+
      concentrations in normally feeding rats, rabbits, and dogs. Measured Glc
      concentrations were compatible with the portion of measured osmolality not
      accounted for by Na+ and K+ salts, amino acids, and peptides. Mean SI luminal
      osmolalities were less than or equal to 100 mosmol/kg hypertonic. For animals on
      the most nearly physiological diets, SI Glc concentrations averaged 0.4-24 mM and
      ranged with time and SI region from 0.2 to a maximum of 48 mM. The older
      published very high values are artifacts of direct infusion of concentrated Glc
      solutions into the gut, nonspecific Glc assays, and failure to test for
      quantitative recovery or to centrifuge samples in the cold. By storing food after
      meals and releasing it between meals, rat stomach greatly damps diurnal
      fluctuations in quantity and osmolality of food reaching the SI and hence also
      damps fluctuations in absorption rates. These new values for luminal Glc have
      five important physiological implications: the problem of accounting for
      apparently very hypertonic SI contents in the face of high osmotic water
      permeability disappears; the effective Km of the SI Glc transporter is now
      comparable to prevailing Glc concentrations; the SI no longer appears to have
      enormous excess absorptive capacity for Glc; regulation of Glc transport by
      dietary intake now makes functional sense; and the claim that high luminal Glc
      concentrations permit solvent drag to become the major mode of Glc absorption
      under normal conditions is undermined.

PMID- 2240225
TI  - Modulation of PAF-induced leukocyte adherence and increased microvascular
      permeability.
AB  - The objective of this study was to assess whether superoxide and leukocyte
      adhesion glycoproteins (CD18) mediate the leukocyte adherence to mesenteric
      microvessels and increased intestinal microvascular permeability induced by
      platelet-activating factor (PAF). PAF was infused into the arterial supply of an
      isolated autoperfused segment of cat intestine. Thirty minutes into the infusion,
      the number of adherent leukocytes within mesenteric venules was measured. This
      was followed by intravenous administration of either human recombinant superoxide
      dismutase (hSOD), hydrogen peroxide-inactivated hSOD, or a monoclonal antibody
      against the leukocyte adhesion molecule CD18 (MoAb IB4), and 30 min later,
      adherence measurements were repeated. hSOD and MoAb IB4 produced a 30 and 66%
      decrease, respectively, in leukocyte adherence, whereas inactivated hSOD had no
      effect. Adherence of PAF-activated cat neutrophils to plastic was reduced only by
      MoAb IB4, suggesting that PAF-induced leukocyte adherence is mediated by both
      CD18 and superoxide and that endothelium is necessary for the superoxide-mediated
      adhesion. In a correlate study, hSOD and MoAb IB4 were shown to attenuate the PAF
      induced increase in microvascular permeability by 40 and 70%, respectively. These
      data indicate that the increased microvascular permeability induced by PAF can be
      attenuated when leukocyte adherence to microvascular endothelium is reduced using
      molecules that either bind to CD18 adhesive glycoproteins or scavenge superoxide.

PMID- 2240226
TI  - Transport of biotin in basolateral membrane vesicles of rat liver.
AB  - We examined biotin transport across the basolateral membrane (BLM) of rat liver
      using BLM vesicles (BLMV) technique. The purity and suitability for transport
      studies of liver BLMV were demonstrated by morphological (electron microscopy),
      enzymatic, and functional criteria. Orientation of liver BLMV was determined by
      freeze-fracture electron microscopy and by [3H]ouabain binding methodology and
      was found to be 65.3-69.7% in the right-side-out orientation. Uptake of biotin by
      liver BLMV was found by osmolarity and temperature studies to be mostly the
      result of transport of the substrate into an active intravesicular space with
      little binding to membrane surfaces. Transport of biotin was found to be Na+
      gradient dependent with a distinct "over-shoot" phenomenon. Initial rate of
      transport of biotin as a function of concentration was found to include a
      saturable component in the presence of a Na+ gradient (out greater than in) but
      was linear and lower in the presence of a K+ gradient (no Na+). Kinetic
      parameters of the saturable Na+ gradient-dependent transport process were 0.39
      microM and 1,807 fmol.mg protein-1.20 s-1 for the apparent Km and Vmax,
      respectively. In the presence, but not the absence, of a Na+ gradient (out
      greater than in), the addition of structural analogues to the incubation medium
      caused significant inhibition in the transport of 0.079 microM [3H]biotin.
      Induction, with the use of valinomycin and an inwardly directed K+ gradient, of a
      relatively positive intravesicular space caused significant inhibition in the
      initial rate of biotin transport.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240227
TI  - Characterization of cholecystokinin receptors on the sphincter of Oddi.
AB  - To characterize directly the ability of cholecystokinin (CCK) to interact with
      receptors on the sphincter of Oddi (SO), we measured binding of 125I-labeled
      Bolton-Hunter-labeled COOH-terminal octapeptide of cholecystokinin (125I-BH-CCK
      8) to tissue sections from the guinea pig SO. Autoradiography localized binding
      of 125I-BH-CCK-8 over the SO smooth muscle layer. Binding was saturable,
      specific, dependent on time, pH, and temperature, and was reversible. Binding of
      125I-BH-CCK-8 was inhibited by various CCK receptor agonists with the following
      potencies: CCK-8 much greater than des(SO3)CCK-8 much greater than gastrin-17-I
      and by various CCK receptor antagonists with the following potencies: L-364,718
      greater than proglumide analogue 10 much greater than carbobenzoxy-Tyr(SO3H)-Met
      Gly-Trp-Met-Asp-NH2 greater than N2,O2' dibutyryl guanosine 3',5'-cyclic
      monophosphate. The potencies of agonists in stimulating and of antagonists in
      inhibiting CCK-8-stimulated SO contractions correlated closely with their
      abilities to inhibit binding of 125I-BH-CCK-8. Analysis of binding of 125I-BH-CCK
      8 to SO tissue sections revealed two classes of CCK binding sites: a high
      affinity site [dissociation constant (Kd) 0.2 nM] and a low-affinity site (Kd 70
      nM). Atropine or tetrodotoxin (TTX) caused a similar rightward shift of the CCK-8
      dose-response curve for stimulation of SO contraction. Comparison of receptor
      occupation to CCK-8-induced contraction suggested that CCK-8 occupation of the
      high-affinity binding site correlated with contraction in the absence of atropine
      and the low-affinity CCK binding with contraction in the presence of atropine or
      TTX.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240228
TI  - Chicken gastrin: a member of the gastrin/CCK family with novel structure-activity
      relationships.
AB  - The biological activity of natural chicken gastrins isolated from the "antrum"
      like region of the chicken gut have been studied on gastric secretion in
      chickens, turkeys, and rats, pancreatic secretion in turkeys and rats, and
      gallbladder contraction in chickens and guinea pigs. Natural chicken gastrin was
      shown to be approximately 85% sulfated on the tyrosine that occurs at position 7
      from the COOH-terminus. In both avian and mammalian systems, chicken gastrins
      were found to be potent stimulants of acid secretion but were virtually inactive
      as stimulants of pancreatic secretion and gallbladder contraction. Peptides with
      the COOH-terminal tetrapeptide amide of CCK and a sulfated tyrosine at position 7
      from the COOH-terminus are usually potent stimulants of pancreas and gallbladder.
      However, although chicken gastrin has a CCK-like structure, it has a gastrin-like
      spectrum of biological actions. A proline immediately adjacent to the sulfated
      tyrosine may produce a steric effect that lowers the activity of chicken gastrin
      on pancreas and gallbladder. Evidently, then, the factors that determine
      specificity of action of CCK and gastrin are different in birds and mammals.

PMID- 2240229
TI  - Single-nephron responses to systemic administration of amino acids in dogs.
AB  - It has been suggested that the tubuloglomerular feedback (TGF) system is
      responsible for renal vasodilation during systemic infusion of amino acid
      solutions. We evaluated the effect of intravenous administration of amino acids
      (serine, alanine, proline, and glycine; total dose of 0.075 mmol of amino
      acids.kg body wt-1.min-1) on whole kidney and single-nephron hemodynamics in
      pentobarbital sodium-anesthetized dogs. At spontaneous renal arterial pressure
      (RAP; 125.4 +/- 4.7 mmHg), measurements of single-nephron function obtained
      during tubular blockade, stop-flow pressure (SFP; 48.2 +/- 2.0 vs. 58.9 +/- 2.3
      mmHg, P less than 0.01), and proximally determined single-nephron glomerular
      filtration rate (SNGFR-TPC; 73.9 +/- 7.0 vs. 93.4 +/- 7.6 nl/min, P less than
      0.01) increased in parallel to the increases of outer cortical blood flow (OCBF;
      15.4 +/- 1.1 vs. 19.1 +/- 1.5 units, P less than 0.05), renal blood flow (RBF;
      4.60 +/- 0.18 vs. 5.73 +/- 0.22 ml.min-1.g kidney wt-1, P less than 0.01), and
      glomerular filtration rate (GFR; 0.885 +/- 0.034 vs. 1.116 +/- 0.034 ml.min-1.g
      kidney wt-1, P less than 0.01). Free-flow tubular fluid-to-plasma inulin ratios,
      determined from late proximal recollections during saline (control) and amino
      acid infusions failed to provide evidence for altered proximal reabsorption rate
      (1.63 +/- 0.12 vs. 1.58 +/- 0.17 during amino acids, NS). At reduced RAP (92.6 +/
      1.9 mmHg), where it is presumed that TGF-mediated vasodilation is already near
      maximal, the vasodilatory response to amino acid infusion was intact and single
      nephron parameters measured during tubular blockade increased to the same extent
      as OCBF, RBF, and GFR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240230
TI  - Effects of growth hormone and IGF-I on renal function in rats with normal and
      reduced renal mass.
AB  - To characterize actions of growth hormone (GH) and insulin-like growth factor (
      (IGF-I) on renal function in rats with normal and reduced renal mass, we
      administered recombinant bovine growth hormone (bGH) or human IGF-I (hIGF-I) to
      normal rats or to rats that had undergone unilateral nephrectomy and two-thirds
      infarction of the contralateral kidney, and measured inulin and p-aminohippurate
      clearances over 10-17 days. Administration of either bGH (100-200 micrograms/day)
      or hIGF-I (200 micrograms/day) to rats with normal renal mass increased inulin
      and p-aminohippurate clearances compared with those measured in animals that
      received vehicle. Filtration fractions were not affected by either bGH or hIGF-I.
      Inulin clearance was decreased to approximately 17% of normal 1 day after
      reduction of renal mass in rats. Over the next 3 days insulin clearance increased
      significantly in rats with reduced renal mass that were administered vehicle. No
      further enhancement occurred during the next 7 days. Neither bGH nor hIGF-I
      affected inulin clearance in rats with reduced renal mass. We conclude that both
      GH and IGF-I enhance glomerular filtration rate when administered to rats with
      normal renal mass, but not when administered in the same quantities to rats in
      which renal functional mass is reduced. Glomerular filtration rate increases
      within 4 days of renal mass reduction independent of exogenous GH or IGF-I.

PMID- 2240231
TI  - Polarity of kallikrein release and activation in perfused rat kidneys.
AB  - The polarity of release and activation of renal kallikrein and its regulation by
      adrenal hormones was studied in isolated perfused rat kidneys. Bilateral
      adrenalectomy (AX) produced a decrease in kallikrein and prokallikrein excretion
      into urine and perfusate of isolated kidneys, as well as in active kallikrein
      excretion in vivo. One-week treatment with deoxycorticosterone acetate (DOCA 2.5
      mg/day) or dexamethasone (DEX 0.25 mg/day) increased the urinary output of active
      and total kallikrein above AX levels but below control. In contrast, neither
      corticoid increased enzyme secretion to perfusate. Regardless of AX or
      corticosteroid treatment, the prokallikrein fraction was 90% of total enzyme in
      perfusate and only 40% in urine. These results confirm that adrenal steroids are
      necessary for renal kallikrein synthesis and excretion; however, neither DOCA nor
      DEX appears to be a unique regulator for release or activation of this enzyme. In
      addition, whereas the processes of secretion and activation toward the urine are
      regulated in parallel, kallikrein release to the venous effluent seems to be
      regulated separately.

PMID- 2240232
TI  - Ion concentrations in the rat CCD: differences between cell types and effect of
      alkalosis.
AB  - We have previously shown that the isolated perfused cortical collecting duct
      (CCD) from chloride-depleted alkalotic (CDA) rats continues to secrete HCO3 for
      up to 3 h. To determine whether the sustained alteration in transport was
      associated with changes in intracellular ion concentrations, we performed energy
      dispersive X-ray microanalysis in microdissected tubule bundles obtained from CDA
      rats and rats with normal acid-base status (CON). Before analysis, the bundles
      from both groups were incubated for 1 h in vitro in a modified Ringer solution
      (pH 7.4, 105 mM Cl). Principal (PC) and intercalated cells (IC) of the CCD from
      CON animals differed in the nuclear concentration of Na (17.0 vs. 24.7 mmol/l
      cell water), K (192.5 vs. 177.0 mmol/l cell water), and Cl (17.8 vs. 47.8 mmol/l
      cell water). Cells of the cortical thick ascending limb of Henle (CTAL) had the
      lowest Na and Cl values (11.5 and 14.8 mmol/l cell water, respectively). CDA
      resulted in no systematic Cl changes. In the IC the nuclear Na concentration was
      significantly increased (32.0 vs. 24.7 mmol/l cell water) and in all cells a
      small reduction in K concentration was detectable. These findings suggest that 1)
      the different transport functions of IC, PC, and CTAL are associated with
      differences in the intracellular ion composition, and 2) the sustained HCO3
      secretion seen in CCD from CDA rats cannot be explained as the result of
      intracellular Cl depletion.

PMID- 2240233
TI  - Maturation of HCO3- transport in rabbit collecting duct.
AB  - Newborn rabbits maintain a state of hypochloremic metabolic alkalosis with plasma
      HCO3- concentrations generally exceeding 27 mM. The large amounts of potential
      net base in mother's milk probably contribute to the generation of this
      alkalosis. We surmised that immature handling of H+ or HCO3- by the neonatal
      collecting duct helps maintain this alkalosis. Net HCO3- transport was measured
      in perfused collecting ducts taken from maturing rabbits, in solutions simulating
      adult rabbit plasma ultrafiltrate and then in presence of Cl(-)-free bathing
      solution. Cortical collecting ducts (CCD) from newborn and 4-wk-old rabbits
      failed to secrete HCO3- under baseline conditions and could not be stimulated to
      secrete HCO3- in Cl(-)-free bath. Neonatal segments perfused at very slow flow
      rates showed significant HCO3- absorption; inhibition of HCO3- secretion by
      removal of luminal Cl- revealed a substantial HCO3- absorptive flux. Segments
      from 6-wk-old and mature animals secreted net HCO3- and generally showed more
      than a fivefold increase in HCO3- secretion after Cl- removal from the bath.
      Outer medullary collecting ducts (OMCD) from newborn rabbits absorbed HCO3- at
      rates approaching that of mature segments. We conclude that relatively high rates
      of HCO3- absorption in OMCD and lack of HCO3- secretion in CCD may contribute to
      the metabolic alkalosis of the neonatal rabbit.

PMID- 2240234
TI  - Factors affecting the ratio of different organic osmolytes in renal medullary
      cells.
AB  - Renal medullary cells contain high concentrations of sorbitol, inositol,
      glycerophosphorylcholine (GPC), and betaine, which balance the variably high
      osmolality of extracellular NaCl. We found that PAP-HT25 (rabbit renal medullary)
      cells in tissue culture increase their content of all four when medium osmolality
      is increased by adding NaCl and urea. However, this requires that betaine be
      added to medium in addition to customary constituents. Some factors affecting the
      mix of organic osmolytes in these cells during hypertonicity are as follows. 1)
      Urea in medium increases cell GPC and tends to decrease others, particularly
      betaine. 2) With small increases in medium NaCl, intracellular inositol is
      highest, whereas sorbitol predominates with large NaCl increases. 3) When
      osmolality is suddenly decreased, these four organic osmolytes exit rapidly from
      cells, but in differing relative amounts (betaine much greater than sorbitol
      greater than inositol much greater than GPC). 4) Altering cell betaine levels (by
      varying betaine in medium) causes reciprocal changes in cell sorbitol (by
      affecting aldose reductase activity) and vice versa, whereas inositol and GPC are
      less affected. 5) Raising medium glucose concentration (from which sorbitol is
      synthesized) increases cell sorbitol and decreases cell inositol and betaine. 6)
      Decreasing the amount of GPC in cells (by removing choline from medium) causes
      small changes in betaine and sorbitol, but not in inositol. Changing the amount
      of inositol does not affect the others. Similar interrelations may operate in
      vivo to vary the mix of organic osmolytes in renal medulla.

PMID- 2240236
TI  - Role of endothelium in reactive dilation of skeletal muscle arterioles.
AB  - In cremaster muscle of pentobarbital-anesthetized rats, the role of endothelium
      in the reactive dilation of an arteriole (mean control diameter: 18.2 +/- 0.5
      microns) during and after short (approximately 20 s) or long (approximately 80 s)
      occlusion of a parent arteriole was investigated. Distal to the occluder,
      arteriolar diameter increased during the occlusion (mean peak increase: 6.9 +/-
      0.4 and 6.7 +/- 1.1 microns, respectively) and increased even further after the
      release of the occlusion as blood flow was reestablished (additional mean
      increase: 6.5 +/- 0.7 and 5.8 +/- 0.8 microns, respectively). The duration of
      arteriolar dilation after the release of the occlusion was dependent on the
      duration of occlusion (252.2 +/- 37 vs. 411.3 +/- 57 s; P less than 0.05). After
      impairment of the arteriolar endothelium by light/dye treatment, a dilation was
      still present during both the shorter and longer occlusions (mean increase: 4.73
      +/- 1.4 and 4.73 +/- 1.3 microns, respectively); however, in both cases the
      additional dilation after release of the occlusion was greatly diminished. The
      duration of reactive arteriolar responses following impairment of the endothelium
      was significantly reduced only on release of the shorter occlusions. The results
      suggest that reactive dilation (hyperemia) of arterioles is the result of
      multiple, endothelium-dependent and endothelium-independent vasoactive factors.

PMID- 2240235
TI  - Bladder contributes to eicosanoids excreted in urine.
AB  - The excretion of eicosanoids was examined in urine collected from the bladder or
      the ureter in normal rats. We found that the excretion of thromboxane B2 (the
      stable metabolite of thromboxane A2), prostaglandin E2, and 6-ketoprostaglandin
      F1 alpha was significantly greater in urine collected from the bladder than in
      urine collected from the ureter. This suggests that the bladder contributes
      significantly to the amount of eicosanoids present in the urine.

PMID- 2240237
TI  - Effects of hypoproteinemia on blood volume and arterial pressure of volume-loaded
      dogs.
AB  - Studies were performed in 14 conscious, anephric dogs to clarify the role of
      blood volume in the genesis of hypertension. The dogs were splenectomized and had
      plasma protein concentration (PPC) reduced to 2.7 g/dl by daily plasmapheresis
      for 9 days. This hypoproteinemia resulted in a 20% decrease in both blood volume
      and mean arterial pressure. On the 10th day the dogs were nephrectomized. On the
      11th day after a 3-h control period with plasmapheresis, lactated Ringer
      equivalent to 10 or 20% of body weight was intravenously infused. By 25 h
      postinfusion blood volume had not increased, and the dogs were still hypotensive.
      At 25 h plasma protein mass was returned to normal by intravenous infusion of
      autologous plasma, the average blood volume of the three low PPC groups increased
      approximately 50%, and the arterial pressure increased greater than 60%. The
      decrease in PPC shifted the regression of blood volume on sodium space down the
      blood volume axis. In conclusion, the dependence of arterial pressure on blood
      volume was demonstrated by the decrease in both blood volume and arterial
      pressure after PPC reduction, the constancy of blood volume and pressure during
      Ringer infusion, and the increase in both volume and pressure after plasma
      infusion.

PMID- 2240238
TI  - Effects of sympathectomy on blood pressure and its variability in conscious rats.
AB  - To further assess the role of the sympathetic nervous system (SNS) in the control
      of blood pressure (BP), continuous recordings of BP were performed in conscious
      freely moving rats that had received daily injections of guanethidine or saline
      from 7 to 90 days of age. Guanethidine extensively destroyed the peripheral
      sympathetic fibers as indicated by marked decreases in the norepinephrine content
      of the heart and kidneys and the absence of pressor response to tyramine
      injection. Such a chronic sympathectomy did not alter the BP and heart rate (HR)
      levels but markedly enhanced the BP variability while the HR variability and the
      sensitivity of the cardiac baroreceptor reflex were not altered. Angiotensin
      converting enzyme inhibition with perindopril induced a rapid fall in BP and
      normalized the BP variability in sympathectomized animals. It is concluded that
      in rats, the SNS is not necessary for the full development of the BP level but is
      essential to buffer the spontaneous variability of BP. After sympathectomy, BP is
      maintained at nearly normal levels mainly through activation of the renin
      angiotensin system.

PMID- 2240239
TI  - Reflex responses of renal nerve activity during isometric muscle contraction in
      cats.
AB  - Renal sympathetic nerve activity (RSNA), arterial blood pressure (AP), and heart
      rate (HR) were measured during isometric muscle contraction of a hindlimb in
      chloralose-anesthetized cats. In 14 cats RSNA, AP, and HR increased during a 1
      min contraction by 45%, 39 mmHg, and 11 beats/min, respectively; however, in
      three cats there was a brief initial decrease in RSNA followed by an increase. In
      11 cats isometric contraction was maintained for 5 min by alternate stimulation
      of the L7 and S1 ventral roots. In the first 1 min of sustained contraction,
      there was a positive correlation (gamma = 0.58, P less than 0.005) between RSNA
      and tension development. Thereafter RSNA remained elevated despite a tension
      decrease, and there was no significant correlation between these changes. The
      RSNA response to contraction of both hindlimbs was greater than that to
      contraction of either hindlimb alone. Passive stretch of the hindlimb muscle
      significantly increased RSNA. Thus the initial increase in RSNA during sustained
      contraction is likely due to activation of muscle mechanoreceptors, whereas the
      later increase is probably caused by activation of the muscle metaboreceptors.

PMID- 2240240
TI  - Endothelium-dependent L-Arg- and L-NMMA-sensitive mechanisms regulate tone of
      brain microvessels.
AB  - Pial arterioles on the surface of the mouse brain were observed via television
      microscopy and measured with an image-splitting technique. The vessels were
      dilated by L-arginine (L-Arg) in concentrations as low as 10(-5) M and were
      constricted in dose-dependent manner by NG-monomethyl-L-arginine (L-NMMA). Both
      the dilation and the constriction were abolished by endothelial damage. This
      damage was produced over a short segment of endothelium by a well-established
      technique that involves exposing the endothelium to a helium-neon laser in the
      presence of intravascular Evans blue dye. In arterioles that were responsive to
      10(-5) M L-Arg, five other L-amino acids, also at 10(-5) M, failed to have any
      effect. The data provide direct evidence for the endothelium-dependent nature of
      the responses to L-Arg and L-NMMA in vivo in a defined segment of the cerebral
      vasculature. L-NMMA inhibited dilation by either L-Arg or acetylcholine. The data
      are consistent with data from in vitro studies and from studies demonstrating
      that L-NMMA acutely raises blood pressure. From all these earlier studies it has
      been hypothesized that there is a continuously acting, endothelium-dependent, L
      Arg-dependent, and L-NMMA-inhibitable mechanism tending to relax blood vessels.
      The mediator of this mechanism is thought to be the endothelium-dependent
      relaxing factor for acetylcholine. Our data suggest that this mechanism is acting
      in the resistance vessels of the brain in vivo.

PMID- 2240241
TI  - Finite strains in anterior and posterior wall of canine left ventricle.
AB  - Piezoelectric crystals were implanted in the anterior and posterior midwall of
      the left ventricle in six anesthetized dogs to compare regional two-dimensional
      finite deformations. Increasing left ventricular end-diastolic pressure (LVEDP)
      from 3 to 18 mmHg caused a similar expansion in the end-diastolic configuration
      (similar end-diastolic principal strains), but maximal lengthening was more
      circumferential in the anterior wall (-18 +/- 13 degrees) and more longitudinal
      in the posterior wall (-54 +/- 19 degrees). End-diastolic in-plane shears were
      negative in both regions, consistent with a left-handed diastolic torsion. As
      LVEDP increased, maximal shortening strains increased similarly (similar end
      systolic principal strains), but there was a preferential increase in end
      systolic circumferential strain in the anterior wall and preferential increase in
      longitudinal strain in the posterior wall. End-systolic in-plane shears were
      small and positive in both regions. The circumferential strain accurately
      reflected maximal end-diastolic and end-systolic principal strains in the
      anterior wall at mid and high LVEDP but underestimated the maximal end-diastolic
      principal strain by 50% and the maximal end-systolic principal strain by 30% in
      the posterior wall at all LVEDPs. We conclude that the magnitude of end-diastolic
      and end-systolic strains is similar for anterior and posterior walls over a wide
      range of LVEDP. However, there are regional differences in the directions of
      maximal deformation that should be considered when evaluating regional
      ventricular function.

PMID- 2240242
TI  - Comparison between force-velocity and end-systolic pressure-volume
      characterization of intrinsic LV function.
AB  - We reanalyzed experiments in in situ hearts of 16 open-chest anesthetized dogs,
      in which two different loading interventions were performed, i.e., an occlusion
      of the descending aorta (InP) and a rapid volume infusion (InV). Previous studies
      had demonstrated that the end-systolic elastance (Ees) of the InP was
      substantially larger than the Ees of the InV suggesting either a load dependency
      of Ees as such, or an increase in contractility during InP. The data were
      reanalyzed in the light of the muscular pump concept by plotting peak normalized
      velocity of circumferential shortening versus a global representative force
      approximating the left ventricle by a sphere. In all but one experiment the
      points of the two interventions are located on a single relationship over a very
      broad range of forces (from 397 to 2,461 g between the control states of
      experiments and from 602 to 3,278 g difference between control and highest load
      within experiments). The virtual independence of the force-velocity relation
      (FVR) and the dependence of the end-systolic pressure-volume relation (ESPVR) on
      the type of loading intervention can be ascribed to the fact that the former is
      assessed early during ejection and is therefore less influenced by shortening
      deactivation and internal resistance than the ESPVR. We conclude that the FVR
      offers a more consistent characterization of intrinsic LV function than the
      ESPVR.

PMID- 2240243
TI  - Antibiotics versus cardiovascular support in a canine model of human septic
      shock.
AB  - This study compares the efficacy of antibiotics (cefoxitin and gentamicin),
      cardiovascular support (fluids and dopamine titrated by intravascular monitoring
      to hemodynamic end points), and a combination of these two therapies in dogs with
      septic shock induced by an intraperitoneal clot containing Escherichia coli.
      Survival rates were 0, 13, 13, and 43% in groups receiving no therapy (controls),
      antibiotics alone, cardiovascular support alone, or combined therapy (P less than
      0.01), respectively. The improved survival observed in the group receiving
      combined therapy considerably exceeded that in the groups receiving either
      therapy alone (i.e., a synergistic increase P less than 0.05). Compared with
      antibiotics alone, cardiovascular support alone prolonged survival time (P less
      than 0.006). All groups developed similar and significant (P less than 0.01)
      increases in endotoxin levels; however, in the combined therapy group,
      nonsurvivors (compared with survivors) had higher levels of endotoxemia (P less
      than 0.05). Although survivors and nonsurvivors in the combined therapy group
      required similar (P = 0.10) quantities of fluid therapy, nonsurvivors gained more
      weight (P less than 0.05), suggesting abnormal vascular permeability with
      extravascular retention of fluids in the nonsurvivors. This study demonstrates
      that antibiotics alone and cardiovascular support alone are relatively
      ineffective in the treatment of septic shock. When combined, however, these two
      therapies provide moderately successful treatment for this highly lethal
      disorder.

PMID- 2240244
TI  - Permeability of time-dependent K+ channel in guinea pig ventricular myocytes to
      Cs+, Na+, NH4+, and Rb+.
AB  - Currents through time-dependent K+ channels (also referred to as IK or the
      delayed rectifier) were studied with the whole cell patch-clamp technique in
      isolated guinea pig ventricular myocytes. IK measurements were restricted to the
      examination of deactivation tail currents. Substitution of various monovalent
      cations for external K+ produced shifts of the reversal potential of IK. These
      shifts were used to calculate permeability ratios relative to K+. The
      permeability sequence for the IK channels was K+ = Rb+ greater than NH4+ = Cs+
      greater than Na+. Time-dependent outward currents were also examined when the
      myocytes were dialyzed with Cs+ instead of K+. A sizeable time-dependent outward
      current, quite similar to that seen with K+ dialysis, was demonstrated. This
      current was primarily carried by intracellular Cs+, as the reversal potential of
      the current shifted 46 mV per 10-fold change of external Cs+ concentration. The
      significance of Cs+ permeation through IK channels is discussed with respect to
      the common use of Cs+ in isolating other currents.

PMID- 2240245
TI  - Effect of atrioventricular relationship on ventricular refractoriness in humans.
AB  - Right ventricular refractory periods obtained using atrial and ventricular pacing
      with an atrioventricular (AV) interval of 160 ms were compared with those
      obtained with an AV interval of 0 ms in a group of 53 patients. The mean right
      ventricular effective refractory periods were longer at an AV interval of 160 ms
      than at an AV interval of 0 ms at pacing cycle lengths of 600 (mean 2.5 +/- 1.8
      ms difference) and 400 ms (mean 3.8 +/- 2.4 ms difference; P less than 0.01). In
      a subset of 10 patients, left ventricular volumes measured by two-dimensional
      echocardiography demonstrated that pacing with an AV interval of 160 ms was
      associated with a higher end-diastolic volume and stroke volume than pacing with
      an AV interval of 0 ms (P less than 0.001). Autonomic blockade did not alter the
      relationship between AV interval and ventricular refractoriness. We conclude that
      1) right ventricular refractory periods are shorter at an AV interval of 0 ms
      than at an AV interval of 160 ms; 2) these differences are not caused by changes
      in autonomic tone but are associated with differences in ventricular volumes; and
      3) if precise determinations of ventricular refractoriness are desired, then the
      timing of atrial systole should be controlled by atrial pacing.

PMID- 2240246
TI  - Interstitial adenosine in guinea pig hearts: an index obtained by epicardial
      disks.
AB  - Epicardial porous disks were used to estimate left ventricular interstitial fluid
      adenosine in the isolated guinea pig heart perfused at constant flow. To validate
      this technique, adenosine was infused with 0.5 microM dipyridamole and 5 microM
      erythro-4-(2-hydroxy-3-nonyl)adenine hydrochloride (EHNA) to inhibit adenosine
      uptake and deamination, respectively. Under these conditions, with 6 or 12 microM
      adenosine in the arterial infusate, the venous and steady-state left ventricular
      disk adenosine values equaled those of the perfusion fluid, reflecting the
      expected equilibration between vascular and left ventricular interstitial fluid
      (disk) compartments. The concentration of endogenous adenosine in the
      interstitial fluid as estimated by the epicardial disks under control conditions
      was 0.28 +/- 0.03 microM with a concomitant coronary sinus concentration of 0.004
      +/- 0.001 microM. We conclude that a marked adenosine gradient exists between the
      interstitial fluid and the vascular space and that disk adenosine measurements
      provide a useful index of left ventricular interstitial fluid adenosine.

PMID- 2240247
TI  - Recombinant human interleukin 1 alpha dilates pial arterioles and increases
      cerebrospinal fluid prostanoids in piglets.
AB  - Effects of recombinant human interleukin 1 alpha (IL-1 alpha) on vasomotor tone
      of pial arterioles and cerebrospinal fluid (CSF) prostanoid levels were examined
      in anesthetized piglets by employing the closed cranial window method. IL-1 alpha
      in a dose of 10.8 micrograms infused under the window increased pial arteriolar
      diameter [initial size, 160 +/- 9 (SE) micrograms] significantly at 15 min
      postinfusion through 30 min (30-min study), exhibiting a maximum dilation of 13
      +/- 1% (n = 8) over the control levels. Significant increases in levels of
      prostaglandin E2 (PGE2, 75%), 6-keto-PGF1 alpha (84%), and PGF2 alpha (35%) but
      not for thromboxane B2 (TxB2, 2%) were observed when CSF was sampled from under
      the window 30 min after 10.8 micrograms IL-1 alpha. A lower dose of IL-1 alpha
      (1.0 micrograms, n = 4) significantly increased the diameter of pial arterioles
      with a tendency for longer onset (25-30 min) and smaller magnitude (9-10%) than
      the higher dose. In IL-1 alpha time-response studies, CSF sampled 10 min after
      10.8 micrograms IL-1 alpha infusion (10-min study, n = 6) under the window
      exhibited the same levels of PGE2, 6-keto-PGF1 alpha, PGF2 alpha, and TxB2 as
      those of the controls. There was no vasodilation in the 10-min study. However,
      when sampled 20 min after 10.8 micrograms IL-1 alpha (20-min study, n = 6), CSF
      levels of all prostanoids except for TxB2 significantly increased over the
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240248
TI  - Three-dimensional mapping of acute ischemic regions using MRI: wall thickening
      versus motion analysis.
AB  - Three-dimensional (3D) endocardial wall motion and thickening were compared as
      quantitative methods for distinguishing ischemic from non-ischemic myocardium and
      for their potential to map regional left ventricular (LV) function. Data were
      obtained by gated magnetic resonance (MR) images in seven open-chest dogs with
      acute ischemia. The LVs were reconstructed in 3D at end diastole (ED) and end
      systole (ES) with a helical coordinate system that wraps the endocardium and
      epicardium. Thickness and percent wall thickening were calculated by a 3D volume
      element method. Wall motion was calculated by the 3D displacement of the
      endocardium perpendicular to the wall using both fixed and floating centroids.
      Monastral blue nonstaining identified the ischemic regions from five anatomical
      slices of the LV, which corresponded to the in vivo image planes. Thickening and
      motion were compared at the centers of the ischemic and the remote normal zones,
      in addition to comparing the functional maps of the entire LV to the postmortem
      anatomical maps. All methods distinguished between the center of the ischemic
      zone and the remote normal zone; however, thickening discriminated most strongly
      between zones. Comparison of the 3D in vivo maps with the 3D postmortem maps
      showed that the sensitivity, specificity, and overall accuracy of the thickening
      algorithm exceeded those obtained by the wall motion algorithms with fixed or
      floating centroids. Thus wall thickening utilizing the 3D volume element approach
      is superior to 3D wall motion algorithms in distinguishing ischemic from
      nonischemic zones and in mapping regional function in the entire LV.

PMID- 2240249
TI  - Influence of dietary n-3 fatty acids on myocardial ischemia and reperfusion.
AB  - We have investigated the effect of elevated n-3 (omega-3) fatty acid content in
      the diet on arrhythmias, ischemic damage, and inflammatory cell infiltration into
      the reperfused left ventricular free wall (LVFW). Weanling rats were fed purified
      diets in which the lipid was replaced with either corn oil (CO) or menhaden oil
      (MO). After 4 wk, MO feeding resulted in significant elevations in both the ratio
      of n-3 to n-6 fatty acids and the unsaturation index in myocardial phospholipids.
      Rats were subjected to 15 min of ischemia followed by reperfusion. After 6 h of
      reperfusion of the left coronary artery there was significantly less creatine
      kinase (CK) lost from the LVFW of rats fed MO. Leukocyte infiltration into the
      LVFW, as measured by myeloperoxidase (MPO) activity, was also significantly
      reduced with MO feeding at 6 h. Arrhythmias were studied in a separate group of
      17 rats; both the incidence and severity of ventricular tachycardia and
      ventricular fibrillation were significantly reduced during the ischemic and
      reperfusion periods with MO feeding. After 24 h of reperfusion there was also
      significantly less CK lost from the LVFW of MO-fed rats; however, there was no
      significant difference in tissue MPO activity in ventricular homogenates.
      Survival after 24 h of reperfusion was 76% (16/21) for MO- and 41% (9/22) for CO
      fed rats. The data suggest a protective effect for dietary MO in myocardial
      ischemia-reperfusion, which may involve both an early reduction in leukocyte
      infiltration and a reduction in the incidence of fatal arrhythmias.

PMID- 2240250
TI  - Myocyte structure, function, and calcium kinetics in the cardiomyopathic hamster
      heart.
AB  - The hereditary cardiomyopathic strain of the Syrian hamster has been studied
      extensively as a model of cardiomyopathy and heart failure. However, the primary
      defect underlying the cascade of events leading to heart failure has not been
      identified. In the present study, isolated cardiac cells were obtained for study
      from 8-mo-old cardiomyopathic (Bio 14.6) and age-matched normal hamsters (F1B).
      We examined the relationships among structure, contractile function, and calcium
      kinetics in these isolated cardiomyocytes. The cardiomyopathic myocytes were
      wider and longer than controls, and myopathic cells were less calcium tolerant.
      The sarcoplasmic reticulum and T-tubule systems from myopathic hearts were more
      abundant as determined by electron microscopy. The amplitude and velocity of
      contraction was decreased in cardiomyopathic cells, whereas diastolic relaxation
      velocity was not different between the two groups. The size of the rapidly
      exchangeable calcium pool determined by 45Ca2+ uptake was significantly increased
      in cardiomyopathic myocytes. Time-averaged cytosolic Ca2+ in these cells (472 +/-
      60 nM) was significantly higher than control (260 +/- 15 nM) as measured by the
      fura-2 fluorescence ratio. When extracellular Ca2+ ([Ca2+]o) was increased to
      greater than 1.2 mM, the resulting increase in intracellular calcium
      concentration was less than that in normal control cells. The corresponding
      [Ca2+]o-induced increase in amplitude of cell motion was significantly attenuated
      in the cardiomyopathic cells compared with normal control myocytes. We conclude
      that distinct abnormalities of contractile function and calcium homeostasis can
      be identified in single cells isolated from cardiomyopathic hamster hearts.

PMID- 2240251
TI  - Nature of defibrillation: determinism versus probabilism.
AB  - The gradual transitions that are found between unsuccessful and successful shock
      strengths in percent success or dose-response curves suggest that defibrillation
      is a probabilistic phenomenon. This concept appears to be reinforced by the fact
      that a frequency distribution is observed in defibrillation threshold data and
      that a dose-response relationship is also obtained by integration of the
      frequency distribution. The purpose of this study was to investigate whether a
      deterministic threshold model (based on experimental results) could produce 1)
      gradual transitions in dose-response curves, and 2) a threshold frequency
      distribution for individual subjects. In the experimental phase of the study, a
      linear deterministic relationship was found between transthoracic threshold
      current and defibrillation episode number (other variables held constant) in
      pentobarbital-anesthetized dogs. The correlation coefficient for each dog was
      between 0.77 and 0.98 (P less than 0.01), and both positive and negative slopes
      were found. Based on these results, threshold current was modeled for computer
      simulation as a linear function of episode number. The model was thus purely
      deterministic with no random variability. For each simulated experiment, several
      parameters were varied: order of shocks (increment, decrement, random order),
      slope of threshold function, and percent error of the initial threshold. Several
      hundred computer simulations were performed to determine the effect of varying
      these parameters. In all cases, threshold-frequency distributions and sigmoidal
      dose-response curves with gradual transitions were produced. The results of this
      investigation demonstrate that the apparent probabilistic behavior of
      defibrillation can be produced by a deterministic relationship.

PMID- 2240252
TI  - Age-related cerebrovascular response to global ischemia in pigs.
AB  - We tested the hypothesis that 1- to 2-wk-old pigs (piglet) have improved recovery
      of cerebral blood flow (CBF), cerebral oxygen consumption (CMRO2), and
      somatosensory-evoked potentials (SEP) compared with 6- to 8-mo-old pigs (pig)
      after transient global cerebral ischemia. All animals were anesthetized with
      pentobarbital sodium. After tracheostomy ventilation was adjusted to maintain
      normoxia (arterial oxygen pressure, 100-150 mmHg) and normocarbia (arterial
      carbon dioxide pressure, 35-40 mmHg). Arterial blood gases, blood pressure, and
      hemoglobin concentration remained within physiological limits throughout the
      experiment. Cerebral ischemia was produced by sequentially tightening ligatures
      around the inferior vena cava and ascending aorta. During ischemia the
      electroencephalogram and SEP became isoelectric within 40 and 120 s,
      respectively. At 10 min of reperfusion hyperemia occurred in most brain regions
      (e.g., whole brain: piglet, 270 +/- 45%; pig, 316 +/- 48%). In pigs delayed
      hypoperfusion occurred in all regions except white matter. In contrast, piglets
      only had delayed hyperperfusion to the brain stem and caudate nucleus. Throughout
      reperfusion CMRO2 was decreased in pigs (3.3 +/- 0.4 to 1.9 +/- 0.2 ml.min-1.100
      g-1) but was not different from control (2.7 +/- 0.3 ml.min-1.100 g-1) in
      piglets. By the end of reperfusion SEP amplitude was closer to control in piglets
      than pigs (55 +/- 9 vs. 32 +/- 4% of control). We conclude that 1- to 2-wk-old
      piglets have quicker return of CBF, CMRO2, and SEP to control values after global
      ischemia, which mechanistically may explain previous reports of improved
      neurological recovery in young animals after transient ischemia.

PMID- 2240253
TI  - Myocardial electrophysiological effects of vasoactive intestinal peptide in dogs.
AB  - Vasoactive intestinal peptide (VIP) is a potent inotrope and coronary
      vasodilator. To test whether VIP also exerts regional myocardial
      electrophysiological (EP) effects, dose-response and time-course effects of
      intracoronary injections (10(-10)-10(-4) M) were obtained in 4 intact hearts and
      12 in situ normoperfused right ventricular flap preparations in chloralose
      anesthetized dogs. Under constant rate, activation (A), recovery (R), and A-R
      interval (ARI) maps were constructed from multiplexed unipolar surface
      electrograms recorded simultaneously from 32 sites. Effects were compared with
      those of isoproterenol (Iso) and forskolin (For). The main finding with all
      agonists was the uniform shortening of ARIs in a dose-response fashion with a
      maximum of 30 +/- 4 ms or 20% from control. Although the maximal EP changes were
      similar for all agonists, they occurred at different molecular concentrations
      (10(-6) Iso, 10(-5) VIP, and 10(-4) For). Also, whereas the duration of EP effect
      did not exceed 5 min for Iso and For, it was markedly sustained for VIP,
      outlasting its contractile but paralleling its vasodilatory effect. The
      physiological endoepicardial differences in ARI and the recovery sequence were
      preserved for all agonists. Thus VIP, in addition to coronary vasodilation and
      myocardial inotropy, exerts a strong balanced global myocardial EP effect,
      similar to, but more sustained than, the adrenergic effect. The difference in
      duration of inotropic and EP effects may point to different mediating mechanisms.

PMID- 2240254
TI  - Metabolic and functional consequences of barium-induced contracture in rabbit
      myocardium.
AB  - Barium contracture tonically activates myocardium while preserving cellular
      integrity. We studied the metabolic and mechanical consequences of sustained Ba2+
      contracture. We measured the time course of phosphocreatine (PCr), ATP, Pi, total
      phosphate, and intracellular pH via 31P nuclear magnetic resonance (NMR) in
      isolated, isovolumic rabbit hearts. For mechanical studies, we measured force
      transients and dynamic stiffness in excised rabbit right ventricular papillary
      muscles at different elapsed times in Ba2+ contracture. In the perfused hearts,
      PCr fell steadily to 20% of control after 60 min. ATP remained constant for
      approximately 25 min then fell to 25% by 60 min. Pi rose to 200% within 15 min
      and then remained unchanged, whereas total phosphate dropped steadily to 50% of
      control by 60 min. Myocardial O2 consumption remained near control for 30 min and
      then declined to 50% by 60 min. Consistent with ATP and O2 consumption
      measurements, mechanical responses were unchanged for approximately the first
      half hour. Because of the elevated Pi, however, myofilament kinetics may have
      been accelerated compared with the control metabolic state. After the initial
      period of stable contracture, the gradual alteration of mechanical behavior
      exhibited a progressive trend toward more rigor-like characteristics. In summary,
      myocardium in Ba2+ contracture is metabolically and mechanically stable for
      approximately 30 min but begins to degrade thereafter. When compared with other
      tonic states of activation, Ba2+ contracture appears to be less demanding
      energetically.

PMID- 2240256
TI  - Analysis of thermopile records from contracting isolated cardiac muscle.
AB  - Recovery heat production after contraction in rabbit papillary muscle at 20
      degrees C occurs at an exponentially declining rate. The time constant describing
      this decline is 25 s; it is not different when 10 twitches or when a steady-state
      twitch train is studied, and it is unaltered by changing stimulus frequency from
      0.125 to 0.2 Hz. The same value has previously been found after single twitches.
      If it is assumed that phosphocreatine (PCr) resynthesis is the cause of recovery
      heat production and that it occurs also during contractions at a rate
      proportional to the amount of PCr depletion, it is possible to divide the total
      heat production for any period of stimulation into that caused by this recovery
      process (R) and that caused by initial (I) processes (presumed to be PCr
      splitting). The value of R/I obtained by using this method is 1.10 +/- 0.04
      (means +/- SE, n = 27 muscles), close to the theoretical value of 1.13. The
      correspondence between the measured and the predicted ratio supports the
      assumptions underlying the measurement. Thus in heart muscle the heat produced
      during and after contraction can be explained by PCr splitting and reformation.
      The older Bugnard method of analysis applied to the same data gives an R/I value
      of 1.5; the reasons for the discrepancy are described.

PMID- 2240255
TI  - Evidence for protein kinase C involvement in arteriolar myogenic reactivity.
AB  - Little information exists as to the cellular events that couple the myogenic
      contractile response of an arteriole to an acute rise in intravascular pressure.
      The aim of this study was to examine whether protein kinase C (PKC), which has
      been implicated in the contractile response to agonists, contributes to myogenic
      vasoconstriction of cremaster muscle arterioles. Studies were performed on
      anesthetized rats, enclosed in an airtight Plexiglas box, with the cremaster
      exteriorized into a bath containing Kreb's solution. Pressure in the box was
      increased to elevate intravascular pressure by 20 mmHg. To examine PKC
      involvement, studies were performed in the absence or presence of inhibitors of
      PKC: H 7 (10(-9)-10(-5) M) or staurosporine (10(-10)-10(-7) M). Inhibitors were
      added to the tissue bath and produced no observable systemic effects or
      alterations in arteriolar diameter. Third-order arteriole (16 +/- 1 microns diam)
      responses to these agents and alterations in intravascular pressure were
      monitored by in vivo microscopy and vessel diameter was measured with a video
      caliper. H 7 produced a concentration-dependent inhibition of myogenic
      vasoconstriction, inhibiting the extent of constriction by 75% at 10(-5) M.
      Similarly, staurosporine caused a concentration-dependent inhibition of pressure
      induced constriction. At 10(-7) M staurosporine the myogenic response was
      inhibited by 82%. Further support for a role for PKC in the myogenic response was
      provided by the observation that indolactam (10(-6) M), a stimulator of PKC
      activity, induced myogenic reactivity in first-order arterioles, which under
      basal conditions show passive distension to increased intravascular
      pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240257
TI  - Coronary resistance increase by nondefatted albumin in saline-perfused rabbit
      hearts.
AB  - In isolated hearts perfused with salt solutions, albumin is often added in low
      concentrations for preservation of endothelial function. Albumin in low
      concentrations is also sometimes used as an intravascular indicator in such
      preparations. We perfused isolated rabbit hearts according to Langendorff with a
      constant flow of Tyrode solution. Despite maximal vasodilation with 10 microM
      adenosine, coronary vascular resistance increased by 14% after 0.3 g/100 ml
      nondefatted bovine serum albumin (Sigma A-9647) was added to the perfusate
      compared with the control resistance with no albumin present. The 50% response
      time for the vasoconstrictive response to the step change in albumin
      concentration was 20 +/- 13 s (mean +/- SD). When 0.3 g/100 ml of defatted
      albumin (Sigma A-6003) was added, the resistance increase was only 1.4% and is
      explained by increased viscosity. Vasoconstrictive effects of certain nondefatted
      albumin preparations must be taken into account by investigators who perfuse
      organs with albumin-containing solutions.

PMID- 2240259
TI  - Circulatory effects of endothelin in newborn piglets.
AB  - Endothelin, a recently described endothelial cell-derived peptide, produces
      pulmonary and coronary vasoconstriction in mature animals. We investigated the
      acute hemodynamic effects of porcine endothelin in 14 anesthetized open-chest new
      born piglets during normoxia (Pao2 = 102 +/- 5 mmHg) and hypoxia (fractional
      inspired O2 concentration = 0.12 X 15 min, Pao2 = 31 +/- 1 mmHg). Six of these
      animals were pretreated with indomethacin, a cyclooxygenase inhibitor. Low-dose
      (100 pmol/kg) intravenous bolus injection of endothelin decreased pulmonary
      vascular resistance index (PVRI) (42 +/- 6 to 16 +/- 4 mmHg.l-1.min.kg, P less
      than 0.01) and increased coronary blood flow (CBF) (17 +/- 2%, P less than 0.01);
      cardiac index (CI) and coronary vascular resistance were unaffected. The
      pulmonary and coronary responses to endothelin were preserved during hypoxia:
      PVRI fell (160 +/- 22 to 83 +/- 13 mmHg.l-1.min.kg, P less than 0.05) and CBF
      rose (35 +/- 11%, P less than 0.05). Low-dose endothelin moderately increased
      mean arterial pressure (61 +/- 3 to 75 +/- 6 mmHg, P less than 0.05) and systemic
      vascular resistance index (SVRI) (375 +/- 23 to 491 +/- 41 mmHg.l-1.min.kg, P
      less than 0.01). High-dose (1,000 pmol/kg) endothelin mildly decreased PVRI (51
      +/- 7 to 35 +/- 12, NS), moderately increased SVRI (375 +/- 45 to 594 +/- 95
      mmHg.l-1.min.kg, P less than 0.05), and markedly diminished CBF (-54 +/- 6%, P
      less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240258
TI  - Quinidine blocks adenosine 5'-triphosphate-sensitive potassium channels in heart.
AB  - The ATP-sensitive potassium channel current (IK-ATP) was studied in excised
      inside-out patches from rat ventricular cells at 20-23 degrees C. The bath
      solution contained 140 mM KF, and the pipette solution contained 140 mM KCl and
      1.2 mM MgCl2. ATP (0.5 mM) in the bath inhibited IK-ATP. In the absence of ATP,
      10 microM quinidine decreased open probability 67 +/- 1% (n = 6) at -50 mV and 28
      +/- 12% at -130 mV (n = 5) without affecting single channel conductance (48-52
      pS). The block increased with 25 and 50 microM quinidine and could be reversed on
      washing quinidine for several minutes. Interburst (closed) intervals were
      increased by quinidine, whereas open and closed time distributions within bursts
      were not changed. We conclude that quinidine blocks IK-ATP in a "slow" and
      voltage-dependent manner in clinically relevant concentrations. Because of the
      postulated role for IK-ATP in cardiac ischemia, quinidine block of this channel
      may play a role in ischemic arrhythmias.

PMID- 2240260
TI  - Effects of reduced uterine blood flow on fetal cardiovascular, renal, and lung
      function.
AB  - Uterine blood flow (UBF) was reduced for 1 h by partially occluding the maternal
      aorta below the renal arteries in seven pregnant ewes (gestation age 126-134
      days). Fetuses became hypoxic, acidemic, and hypercapnic. They developed
      hypertension (P less than 0.005) and a bradycardia (P less than 0.05). During
      restricted UBF, fetal hematocrit (Hct) rose (P less than 0.005) and blood volume
      fell in five of seven fetuses. After release of constriction, fetal Hct fell, and
      blood volume rose by 7.5 +/- 3.26% (P less than 0.05) relative to control. During
      reduced UBF, lung liquid and urine flow rates fell (P less than 0.025 and P less
      than 0.05, respectively). After the occluder was released, Na excretion (which
      did not fall significantly during reduced UBF) increased (P less than 0.05), and
      fractional reabsorption of Na fell (P less than 0.05). Changes in fetal blood
      volume (FBV) were directly related to changes in maternal lower body flow (r =
      0.47, P = 0.01, n = 33), and changes in fetal Hct were inversely related to
      maternal flow (r = -0.635, P = 0.001). Fetal urinary Na excretion per kilogram
      body weight was directly related to FBV per kilogram (r = 0.44, P = 0.005, n =
      40), whereas fractional reabsorption of Na was inversely related to FBV per
      kilogram body wt (r = 0.48, P less than 0.002, n = 39). It is concluded that
      reductions in UBF cause fetal hypoxemia and acidemia, which lead to changes in
      fetal cardiovascular function and in FBV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240261
TI  - Salt sensitivity in hypertensive rats with angiotensin II administration.
AB  - We examined the salt sensitivity of blood pressure in angiotensin II (ANG II)
      induced hypertension. Wistar rats, salt loaded (0.66, 2, or 8% salt-containing
      diet) for 4 or 12 days, were infused intravenously with 15 or 60 ng/min of ANG
      II. Systolic blood pressure (SBP) was not increased by long-term (12 days) salt
      loading, and SBP was unchanged with ANG II and normal-salt (0.66%) diet. However,
      when combined with salt loading, ANG II produced hypertension in a dose-dependent
      fashion; compared with control (120 +/- 2 mmHg), SBP was increased with 15 ng/min
      of ANG II and 8% salt diet (145 +/- 5 mmHg, P less than 0.05) and with 60 ng/min
      of ANG II and either 2 or 8% salt diet (149 +/- 8 and 174 +/- 8 mmHg, P less than
      0.05, respectively). Na space (exchangeable Na) was increased in a roughly
      similar pattern and correlated significantly (r = 0.531, P less than 0.05) with
      SBP. However, with 15 ng/min of ANG II, Na space was not different among rats on
      either level of salt loading, although the 8% salt diet elevated SBP. Data
      obtained with short-term (4 days) treatment indicate that an elevated Na space
      preceded development of hypertension. With 15 ng/min of ANG II and 8% salt diet
      for 4 days, Na space was markedly (P less than 0.05) increased, but SBP was
      unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240262
TI  - Role of central mineralocorticoid binding sites in development of hypertension.
AB  - The possibility that central mineralocorticoid binding sites are involved in the
      development of mineralocorticoid hypertension was examined using chronic blockade
      of these sites with a specific mineralocorticoid receptor antagonist RU 28318
      administered by intracerebroventricular (icv) infusion. The antagonist
      significantly attenuated the development of deoxycorticosterone acetate (DOCA)
      salt hypertension, but the development of one-kidney, one-clip renal hypertension
      was not affected. This antihypertensive action was attributable to a central
      action, since intraperitoneal infusion of the same dose of mineralocorticoid
      antagonist did not alter the peak development of DOCA-salt hypertension. The icv
      infusion of RU 28318 did not change either the increase of fluid intake induced
      by DOCA-salt treatment or the pressor reactivity to centrally or peripherally
      injected arginine vasopressin and angiotensin II and peripherally administered
      phenylephrine. The antihypertensive action of icv infusion of the
      mineralocorticoid antagonist was associated with a reduction of neurogenic
      vasomotor tone and a restoration of impaired arterial baroreflexes. We conclude
      that functional integrity of central mineralocorticoid binding sites is required
      for the full development of DOCA-salt hypertension.

PMID- 2240263
TI  - Light-dark cycle modulates drinking to homeostatic challenges.
AB  - Both homeostatic and rhythmic variables are empirically and theoretically
      important controls of behavior. Yet, drinking behavior has been studied largely
      from one point of view or the other. The present study examined both homeostatic
      and rhythmic variables and found evidence for an important interaction of these
      two types of control of drinking behavior. The drinking rhythm of rats on a light
      dark cycle was established. Water intake after cellular- or extracellular-related
      challenges was then measured both at a time of a peak and at a time of a trough
      of the drinking rhythm. The results indicate that rats drink more water after
      challenges in their early active phase than in their early inactive phase. The
      results demonstrate that rhythmic variables modulate the homeostatic controls of
      drinking behavior. The importance of the interaction of homeostatic and rhythmic
      variables in models of integrative control of behavior is discussed.

PMID- 2240264
TI  - Stimulatory effects of cold exposure and cold acclimation on glucose uptake in
      rat peripheral tissues.
AB  - The effects of cold exposure on the net rates of 2-[3H]deoxy-D-glucose uptake
      (Ki) in rat peripheral tissues were investigated comparatively in warm- and cold
      acclimated animals to determine whether cold acclimation induces regulatory
      alterations in glucose metabolism. Acute exposure of warm-acclimated (25 degrees
      C) rats to cold (48 h at 5 degrees C) markedly increased the Ki values in red and
      white skeletal muscles (2-5 times), in the heart (8 times), in several white
      adipose tissue (WAT) depots (4-20 times), and in brown adipose tissue (BAT) (110
      times). After cold acclimation (3 wk at 5 degrees C), the Ki values further
      increased in the heart (15 times) and WAT (up to 29 times) but decreased in BAT
      (36 times). Remarkably, glucose uptake was still increased in muscles of cold
      exposed/cold-acclimated animals (that do not shiver), demonstrating that enhanced
      glucose uptake may occur in muscles in the absence of shivering thermogenesis (or
      contractile activity). When cold-acclimated rats were returned to the warm for 18
      h, the Ki values of all tissues, except WAT, returned to control levels. Cold
      exposure synergistically potentiated the stimulation of tissue glucose uptake
      induced by a maximal effective dose of insulin (0.5 U/kg iv) in warm- as well as
      in cold-acclimated animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240265
TI  - Role of renal sympathetic nerves in response of the ovine fetus to volume
      expansion.
AB  - To investigate the role of renal sympathetic nerves in the fetal response to
      hypervolemia, studies were carried out in conscious, chronically instrumented
      fetal sheep aged 137-142 days of gestation. Bilateral renal denervation (n = 9)
      or sham surgery (n = 8) was carried out under halothane anesthesia 3-6 days
      before experiments. Bilateral renal denervation did not alter basal fetal renal
      hemodynamics, glomerular filtration rate (GFR), or Na+ excretion. Volume
      expansion with 6% Dextran 70 (18 ml/kg) was associated with a fall in fetal
      hematocrit, a sustained increase in mean arterial blood pressure, and a sustained
      diuresis and natriuresis. There was no significant change in GFR during fetal
      hypervolemia from control levels of 4.51 +/- 0.74 ml/min (intact) and 4.43 +/-
      0.43 ml/min (denervated). Atrial natriuretic factor increased from 144 +/- 34 to
      464 +/- 134 pg/ml, and plasma renin activity decreased from 5.15 +/- 1.7 to 3.04
      +/- 1.0 ng.ml-1.h-1 in intact animals, within 30 min of completion of the dextran
      infusion. Similar changes occurred in denervated fetuses. Plasma aldosterone
      levels remained constant in intact and denervated fetuses during hypervolemia at
      control levels of 40.8 +/- 5.4 and 59.3 +/- 8.4 pg/ml, respectively. These
      findings suggest that renal sympathetic nerves do not influence basal renal
      hemodynamics or function and do not appear to play an important role in the
      natriuretic response to volume expansion during fetal life. This can be explained
      by a low tonic renal nerve activity before birth.

PMID- 2240266
TI  - Vasopressin and oxytocin in rat brain in response to prostaglandin fever.
AB  - Urethan-anesthetized rats were used to identify effective stimuli for the release
      of the peptides arginine vasopressin (AVP) and oxytocin into the ventral septal
      area (VSA) of the brain. Febrile responses to intracerebroventricular injection
      of prostaglandin E1 (PGE1) were observed in rats whose body temperatures were
      maintained at 35, 37, or 39 degrees C. Microinjection of the AVP antagonist
      d(CH2)5Tyr(Me)AVP into the VSA enhanced fever only when PGE1 administration was
      associated with a significant rise in body temperature. Passive elevation
      ("artificial fever") or reduction of body temperature in the absence of a PGE1
      stimulus was not affected by the antagonist. Push-pull perfusion of the VSA and
      the dorsal hippocampus, followed by radioimmunoassay of perfusates for AVP and
      oxytocin, revealed enhanced release into the VSA of AVP only when PGE1
      administration was followed by a rise in body temperature. Oxytocin was released
      whenever body temperature was raised. Peptide concentrations in simultaneous
      perfusates of dorsal hippocampus did not change in response to PGE1
      administration or to passive elevation of body temperature. We conclude that AVP
      is released into the VSA, but not the dorsal hippocampus, of the rat during a
      fever induced by PGE1. Oxytocin is released into the VSA, but not the
      hippocampus, when temperature is elevated.

PMID- 2240267
TI  - Simulation of mechanoenergetics of asynchronously contracting ventricle.
AB  - We simulated mechanoenergetics of ventricular asynchronous contraction using a
      model comprising two compartmentalized asynchronous time-varying elastic
      elements, E1 and E2. Their elastances [e1(t) and e2(t)] waxed and waned
      cyclically with a variable time lag (tau). The pressure-volume area (PVA1 or
      PVA2) circumscribed by the maximum (emax) and minimum e1(t) or e2(t) lines and
      the contracting pressure-volume trajectory of E1 or E2 quantifies the mechanical
      energy generated by a contraction of E1 or E2. Similarly, the PVA circumscribed
      by the resultant Emax (ventricular contractility index) line, the end-diastolic
      pressure-volume (P-V) line, and the systolic P-V trajectory quantifies the
      mechanical energy of the entire ventricle. PVA of the ventricle is equal to the
      sum of PVA1 and PVA2. We found that Emax decreased with increases in tau despite
      constant emax, and hence ventricular PVA decreased with increases in tau. This
      simulation helps us to better understand the mechanism of decreased oxygen
      consumption with increasing ventricular asynchrony reported in the literature.

PMID- 2240268
TI  - Different in vivo metabolic activities of suprachiasmatic nuclei of Turkish and
      golden hamsters.
AB  - The 14C-labeled 2-deoxy-D-glucose technique was used to measure in vivo glucose
      utilization of the suprachiasmatic nuclei (SCN) of Turkish and golden hamsters
      during the middle hours of the light phase of the 12:12 h light-dark cycle. The
      nuclei were clearly visible on autoradiographs made from the brains of Turkish
      hamsters, and their rate of glucose utilization (69 +/- 6 mumol.100 g-1.min-1)
      was similar to that previously measured in other rodents, whereas the nuclei were
      hardly visible on autoradiographs from golden hamsters, and their rate (33 +/- 2
      mumol.100 g-1.min-1) was less than half this value. Thus the high energy
      metabolism characteristic of the SCN of most species is not required for the
      circadian pacemaker in the nuclei to generate its oscillation.

PMID- 2240269
TI  - Relationships between plasma ketones and fasting duration in neonatal elephant
      seals.
AB  - Long-duration fasting in mammals can ultimately lead to stage three terminal
      starvation, which is characterized by depleted fat stores, a metabolic shift away
      from fat metabolism toward lean tissue catabolism, and a sharp decline in
      circulating levels of plasma fatty acids and ketone bodies. However, this
      biochemical shift has never been observed outside of the laboratory in a
      naturally fasting, nonhibernating mammal. In the current study, plasma levels of
      the ketone body D-beta-hydroxybutyrate (beta-HBA) were assayed in 10 Northern
      elephant seal pups during suckling and the postweaning fast and in 12 fasting
      adult seals. Plasma beta-HBA concentration in the pups was minimal during
      suckling (0.09 +/- 0.06 mM; n = 10) and began to increase immediately after
      weaning. The concentration rose until about 55 days into the fast (1.34 +/- 0.36
      mM; n = 10) and then declined sharply. Within 10 days of this deflection point,
      the seal pups left for sea. By contrast, adult elephant seals showed consistently
      low levels of beta-HBA after several months of fasting (0.06 +/- 0.07 mM; n =
      12). The data suggest that the duration of fasting in elephant seal pups may be
      determined, in part, by biochemical shifts that occur near the end of the fast
      and that the regulation of ketone concentration is different in fasting neonatal
      and adult elephant seals.

PMID- 2240270
TI  - Repeated measurement of gastric emptying in rats.

PMID- 2240271
TI  - Long-term arterial pressure control: an analysis from animal experiments and
      computer and graphic models.
AB  - Long-term arterial pressure control is very different from acute control, because
      many of the acute control systems are overridden by a single long-term mechanism
      that has little to do with short-term control. This is the renal fluid volume
      mechanism for pressure control. It is based on a simple functional property of
      the kidney: as the arterial pressure rises, the kidney output of water and
      electrolytes increases dramatically. When the output rises above the net intake
      of water and electrolytes, negative body fluid balance occurs, causing both the
      body fluid volume and the pressure to decrease. This decrease continues until the
      kidney fluid output exactly balances the net fluid intake. Conversely, if the
      pressure falls below the exact level for balance, intake becomes greater than
      output; then fluid builds up in the body and the pressure rises until intake and
      output again exactly balance each other. This fluid mechanism for pressure
      control has been known from the beginning of blood pressure research. However,
      its overpowering importance was not appreciated until a mathematical computer
      analysis in 1966 demonstrated the renal-fluid feedback mechanism to have infinite
      feedback gain for long-term pressure control. This is the principal topic of the
      present review.

PMID- 2240272
TI  - Neurogenesis of respiratory rhythm and pattern: emerging concepts.
AB  - We present three hypotheses related to the nervous system control of breathing in
      mammals: 1) that neural mechanisms controlling breathing change with state and
      that the relationship between mechanisms in different states can be described in
      terms of either modulation or a basic transformation of properties, or both; 2)
      that the mechanisms generating respiratory rhythm and pattern are separate; and
      3) that conditional pacemaker cell activity is the basis for respiratory rhythm
      in highly reduced states.

PMID- 2240273
TI  - Chemoreceptor modulation of endogenous respiratory rhythms in vertebrates.
AB  - The relative contributions of O2- and CO2-sensitive chemoreceptor information to
      centrally generated respiratory patterns have changed dramatically during
      vertebrate evolution. Chemoafferent input from branchial O2 chemoreceptors
      modulates centrally generated respiratory patterns but is not critical for
      respiratory rhythmogenesis in fishes. In air-breathing fishes, branchial O2
      chemoreceptors monitoring internal and external stimuli control the relative
      contributions of the gills and air-breathing organ to net ventilation, and
      chemoafferent input is necessary for initiating air breathing. In the transition
      from water to air breathing by amphibious vertebrates, rhythmic patterns of
      branchial ventilation are completely replaced by arrhythmic and intermittent
      patterns of air breathing, and there is progressive dependence on CO2 as a source
      of respiratory drive. Periodic initiation of air breathing in resting animals
      appears to depend on attaining a threshold level of afferent activity from O2-
      and CO2/pH-sensitive chemoreceptors, since hyperoxia and/or hypocapnia can
      abolish air breathing in all air-breathing vertebrates. Conversely, chemoreceptor
      stimulation in amphibians and reptiles converts intermittent to more continuous
      air breathing patterns, suggesting that adequate biasing input from
      chemoreceptors activates a central rhythm generator. Chemoafferent input in
      homeotherms serves as one of several sources of drive for rhythmic breathing and
      supplies feedback for blood gas homeostasis in the face of metabolic or
      environmental change.

PMID- 2240274
TI  - Mechanoreceptor modulation of endogenous respiratory rhythms in vertebrates.
AB  - While pulmonary mechanoreceptors appear to play little or no role in determining
      the eupneic breathing pattern in some species of vertebrates, they do in others
      as well as in all species under conditions of elevated respiratory drive. Tonic
      and phasic inputs from this receptor group have independent roles in determining
      breathing pattern. Thus withholding lung inflation produces very different
      results from receptor denervation. There are at least five phases to the
      respiratory cycle that appear to be under separate control. Tonic receptor input
      is involved primarily in regulating the length of the respiratory pause, which
      can occur at the end of inspiration or expiration, depending on the species.
      Phasic receptor input has different effects during different phases of the cycle
      as well as different effects at different times during a single phase. This
      activity contributes to phase switching during the ventilation cycle and thus to
      the regulation of breathing frequency and tidal volume. The significance of the
      modulatory effects of phasic input on the duration of different phases of the
      ventilation cycle is not totally clear, but the evidence suggests that phasic
      input acts to stabilize the respiratory pattern and may be instrumental in
      optimizing the breathing pattern in terms of ergometric costs. This appears to be
      the case in all vertebrate classes, despite dramatic differences in the
      mechanical events associated with ventilation arising from different respiratory
      pumps. These receptors also appear to have significant roles other than those
      associated with modulation of respiratory rhythm, particularly in lower
      vertebrates. Many of these roles, such as maintaining the integrity of the gill
      curtain in fish or buoyancy control and regulation of blood flow distribution in
      reptiles, may be as important as their role in modulating the endogenous rhythm.

PMID- 2240275
TI  - Receptor interactions in modulating ventilatory activity.
AB  - The ventilatory control system utilizes a variety of sensory receptor groups,
      including chemoreceptors and mechanoreceptors, to provide feedback concerning the
      status of controlled variables. Most ventilatory responses to altered receptor
      inputs generally involve a complex interaction between several receptor groups,
      central integrative mechanisms, and other modulatory inputs (e.g., "state,"
      hormonal, or neurotransmitter status). Because the control system is complex,
      nonlinear, and dynamic, the ultimate ventilatory response elicited by a given
      stimulus is not easy to predict based on the reflex effects of individual
      receptor groups studied in isolation. A full understanding of the role that
      sensory receptors play in ventilatory control requires information concerning
      interactions among receptor groups and with other elements of the control system.
      The complexity of the problem and the lack of a uniform definition of the term
      "interaction" has hindered research in this area. An interaction is defined as a
      nonadditive relationship between independent inputs to the system. Within this
      definition, five domains of interaction are described. 1) Algebraic interactions
      occur in ventilation and/or its components because of their multiplicative and
      nonlinear relationship. 2) Closed-loop interactions occur because of the
      prevalence of feedback loops within the respiratory control system. 3) Neural
      interactions reflect central nervous system integration of simultaneous receptor
      inputs and are demonstrated when feedback loops are opened. Three subdomains of
      neural interactions are defined: modulatory, dynamic, and range-specific neural
      interactions. 4) Mechanical interactions result from nonlinear transformations of
      motoneuron output into mechanical actions. 5) Adaptive interactions occur when
      paired receptor or modulatory inputs alter future responses. To understand the
      role of any sensory receptor group in ventilatory control, it is necessary to
      define its interactions with other control system elements in each of these
      domains. Understanding the mechanisms of these interactions requires detailed
      information about the physical system subserving ventilatory control (mechanics
      and gas exchange) and the relevant properties of the neural network coordinating
      their actions.

PMID- 2240276
TI  - Circadian rhythm in recognition threshold of salt taste in healthy subjects.
AB  - The circadian rhythm in recognition threshold of salt taste was examined in six
      healthy young subjects. Plasma aldosterone (PA) and cortisol concentrations,
      plasma renin activity (PRA), salivary sodium concentration, and salt recognition
      thresholds were measured every 3 h for a 24-h period. The salt recognition
      threshold and salivary sodium concentration exhibited similar circadian rhythms,
      with the lowest values recorded in the afternoon. Positive correlations were
      observed between the recognition threshold and salivary sodium (P less than
      0.001) and between cortisol and PA (P less than 0.001). There was no correlation
      between PRA and PA. A negative correlation was observed between PA and salivary
      sodium concentration (P less than 0.01). These data indicate that the recognition
      threshold for salt taste has a circadian rhythm in young healthy subjects. This
      rhythm appears to be related to daily variations in the plasma aldosterone
      concentration and its subsequent effects on salivary sodium concentration.

PMID- 2240277
TI  - Net basolateral potassium flux and short-circuit current in ouabain-treated frog
      skin.
AB  - A new technique has been developed to correlate K loss from cells (JK) across the
      basolateral membrane into a K-free ouabain Ringer solution and short-circuit
      current (Isc) for a model Na-transporting epithelium, the frog skin. Distinct
      differences were observed when the tissue was bathed in sulfate or chloride
      Ringer. In sulfate Ringer, K-free ouabain treatment caused both JK and Isc to
      decline in a nearly parallel fashion with time. JK-Isc was approximately 1
      microA/cm2. In sulfate Ringer, isoproterenol caused parallel increases, whereas
      amiloride (apical side) caused parallel decreases in JK and Isc. In chloride
      Ringer, K-free ouabain treatment caused Isc to decline at a slightly faster rate
      than JK.JK-Isc was approximately 8 microA/cm2. Bumetanide decreased JK with very
      little effect on Isc. Barium caused small parallel changes in both Isc and JK.
      Amiloride decreased Isc with very little effect on JK. These experiments show
      that after ouabain treatment changes in JK from the cells across the basolateral
      membrane can largely account for changes in Isc. However, JK also occurs via
      neutral mechanisms and perhaps from cells not related to the transport pathway,
      demonstrating that there is not always a tight coupling of K loss at the
      basolateral membrane with Na entry across the apical membrane.

PMID- 2240278
TI  - Neurons controlling cardiovascular responses to emotion are located in lateral
      hypothalamus-perifornical region.
AB  - We did four experiments to determine whether the lateral hypothalamus
      perifornical (LH/PF) region is the source of neuronal cell bodies responsible for
      producing the cardiovascular (CV) responses associated with emotion or the
      defense reaction. Of particular concern was whether the paraventricular nucleus
      (PVN) plays a role in the generation of these CV responses. Mapping the
      hypothalamus with electrical stimulation showed that the CV pattern of responses
      was never produced by stimulating the PVN and was invariably produced by
      stimulating the LH/PF region. Complete electrolytic destruction of the PVN and
      subsequent axonal degeneration did not change the CV pattern of responses
      elicited by LH/PF stimulation, whereas any encroachment of the lesion on the
      LH/PF region decreased the magnitude of the CV responses. Injection of the
      neuroexcitotoxin ibotenic acid (Ibo) into the PVN did not affect responses to
      LH/PF stimulation, whereas Ibo injection into the LH/PF region eliminated or
      severely attenuated the CV responses. Retrograde labeling of cells from the
      thoracic cord and the ventrolateral reticular formation revealed a scattered
      group of cells in the LH/PF region that may be the cells controlling the CV
      responses. These results point directly to the LH/PF region as the source of the
      cell bodies responsible for the autonomic responses associated with emotion or
      defense reactions.

PMID- 2240279
TI  - Baroreflex sensitivity in the canine model of obesity-induced hypertension.
AB  - Studies have demonstrated abnormalities in baroreflex function in various models
      of hypertension. The purpose of this study was to examine baroreflex sensitivity
      in the canine model of obesity-induced hypertension. Baroreflex sensitivity was
      determined by the relative changes in heart rate (HR) in response to changes in
      mean arterial pressure (MAP) induced by sodium nitroprusside (Nitro) and
      phenylephrine (Pe). Studies were performed in conscious lean dogs (n = 10) and
      obese dogs fed a high-fat diet for 6 wk (n = 8). Body weight averaged 18.1 +/-
      0.3 kg in the lean dogs and 26.5 +/- 0.5 kg in the obese dogs. Associated with
      the 46% increase in body weight in the obese dog group were significant increases
      in MAP (120.7 +/- 3.0 vs. 102.8 +/- 1.5 mmHg) and HR (132.7 +/- 8.5 vs. 96.4 +/-
      3.3 beats/min). Administration of Nitro (0.5, 1.0, 5.0 micrograms.kg-1.min-1)
      resulted in comparable reductions in MAP in the lean and obese dogs. The reflex
      increases in HR were significantly greater in the obese animals only with a dose
      of 5.0 micrograms.kg-1.min-1 of Nitro (55.5 +/- 7.7 vs. 32.0 +/- 7.5 beats/min).
      Administration of Pe (0.5, 1.0, 5.0 micrograms.kg-1.min-1) resulted in
      significantly greater increases in MAP in the obese dogs (17.8 +/- 4.6 vs. 4.9 +/
      2.6, 37.1 +/- 4.4 vs. 19.6 +/- 2.7, and 72.7 +/- 7.5 vs. 51.5 +/- 7.1
      mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240280
TI  - Quantitative genetics of maximal oxygen consumption in a garter snake.
AB  - Broad-sense heritabilities and genetic correlations of maximal oxygen consumption
      (VO2max), blood hemoglobin levels, and ventricle mass were estimated in a natural
      population of snakes. Traits were measured for six or fewer presumed full-sibling
      offspring from each of 45 wild-caught gravid garter snakes (Thamnophis sirtalis).
      VO2max was highly reproducible between replicate trial days (r = 0.88). In an
      attempt to reduce maternal effects, correlations of each character with body
      mass, snout-vent length, age at testing, litter size, dam mass, and dam snout
      vent length were removed by computing residuals from multiple-regression
      equations. These residuals were used in subsequent genetic analyses. Approximate
      coefficients of variation of residuals were 16% for VO2max, 19% for hemoglobin
      level, and 13% for ventricle mass. Broad-sense heritabilities were highly
      significant for all characters [P less than 0.0001; VO2max heritability (h2) =
      0.88; hemoglobin level h2 = 0.63; ventricle mass h2 = 0.41], suggesting that they
      could respond genetically to selection. Phenotypic correlations (rP) among
      residual characters were significant only between VO2max and ventricle mass (rP =
      +0.27). VO2max and ventricle mass exhibited a significant (broad-sense) genetic
      correlation of +0.64; this might facilitate the correlated evolution of these two
      traits in response to natural or artificial selection. Ventricle mass and
      hemoglobin level showed a significant environmental correlation of +0.43.
      Treadmill endurance crawling time (Evolution 42: 335-350, 1988) showed a weak but
      significantly positive rP with VO2max (rP = +0.17).

PMID- 2240281
TI  - Induction of plasma inhibitors of interleukin 1 and TNF-alpha activity by
      endotoxin administration to normal humans.
AB  - Several naturally occurring inhibitors of interleukin 1 (IL-1) and tumor necrosis
      factor-alpha (TNF-alpha) have been demonstrated both in serum and urine of
      febrile patients. These factors are considered to be part of a regulatory system
      counteracting potential deleterious effects of the cytokines. We have assayed
      plasma samples of volunteers who received a bolus intravenous injection of either
      4 ng/kg body wt of Escherichia coli endotoxin (n = 6) or 0.9% saline (n = 4) for
      the presence of IL-1 and TNF-alpha inhibitory activity. Plasma obtained 3 h after
      endotoxin injection inhibited IL-1-induced PGE2 release from fibroblasts by 57%
      (P less than 0.001 vs. baseline and saline controls, respectively). Maximal IL-1
      inhibitory capacity coincided with fever and tended to disappear with declining
      body temperature. Normal plasma was found to inhibit TNF-alpha-induced PGE2
      release by 20-35%. This inhibitory effect increased to 50-60% in plasma obtained
      during endotoxinemia. Maximal TNF-alpha inhibitory capacity became detectable
      when circulating TNF-alpha levels peaked at 120 min after the injection of
      endotoxin. Our data demonstrate that both IL-1 and TNF-alpha inhibitory activity
      can be induced experimentally by intravenous endotoxin administration to humans
      and that their appearance coincides with fever and circulating TNF-alpha levels.

PMID- 2240282
TI  - Diminished epinephrine response to hypoglycemia despite enlarged adrenal medulla
      in trained rats.
AB  - Studies in humans have indicated that trained athletes compared with sedentary
      subjects have an increased capacity to secrete epinephrine. To investigate
      whether this is due to an adaptation induced by physical training or a selection
      phenomenon, rats were swim trained (T) 10 wk for 6 h/day or served as controls
      being either sedentary freely eating (C), food restricted (FR), sham swim trained
      (ST), or cold stressed (CS). Adrenal glands were weighted and cross sectioned for
      light microscopic determination of size of the adrenal medulla. Endurance-trained
      compared with control rats had heavier adrenal glands (P less than 0.05), higher
      catecholamine content in the glands (P less than 0.05), and higher adrenal
      medulla volumes (P less than 0.05) [males: 2.74 +/- 0.16 (T) vs. 2.05 +/- 0.16
      (C), 1.90 +/- 0.10 (ST), and 2.21 +/- 0.08 mm3 (CS)] [females: 2.55 +/- 0.11 (T)
      vs. 1.92 +/- 0.06 mm3 (C)]. Cold stress or sham swim training did not increase
      adrenal weight or volume of adrenal medulla (P greater than 0.05). To stimulate
      adrenal medulla secretion, rats had an insulin-induced hypoglycemia. Insulin dose
      needed to suppress plasma glucose below 4.0 mM was four times greater in
      sedentary compared with trained rats. During hypoglycemia the epinephrine
      response was much smaller in trained than in untrained rats (P less than 0.05).
      In conclusion, in rats strenuous endurance training causes an enlargement of the
      adrenal medulla. However, possibly reflecting an adaptation within the central
      nervous system to reduced blood glucose levels induced by repeated exercise
      bouts, the epinephrine response to insulin-induced hypoglycemia is markedly
      diminished after training.

PMID- 2240284
TI  - Modern fictional protagonists: motherless children, fatherless waifs.

PMID- 2240283
TI  - Dreams and transference.

PMID- 2240285
TI  - The evolution of schizoid orality.

PMID- 2240286
TI  - A linguistic model of psychosis--Lacan applied.

PMID- 2240287
TI  - Dementia, related disorders, and old age: psychodynamic dimensions in diagnosis
      and treatment.

PMID- 2240289
TI  - Countertransference and participant observation.

PMID- 2240288
TI  - Symbiotic recognition: a striving for acknowledgment of self.

PMID- 2240290
TI  - A brief comment on Freud's attendance at opera performances: 1880-1890.

PMID- 2240292
TI  - Risk communication and public confidence in health departments.

PMID- 2240291
TI  - Challenges for public health nutrition in the 1990s.

PMID- 2240293
TI  - A crisis of community anxiety and mistrust: the Medfly eradication project in
      Santa Clara County, California, 1981-82.
AB  - Public anxiety of near panic proportions was created by the announcement of a
      plan to commence aerial application of malathion bait over a large urban area in
      California for the eradication of the Mediterranean fruit fly within four days. A
      risk assessment had reported the project entailed no significant risk to health
      but environmentalist groups and the media ignored the report. We describe the
      successful measures taken by State health workers to counteract the anxiety which
      itself constituted a serious public health problem. The most important measure
      was the rapid convening of a Health Advisory Committee composed of recognized
      experts and local professionals and leaders to provide an authoritative,
      respected and sympathetic voice to deal with the community's concerns. These
      experiences may be of value to other communities facing unwarranted anxiety over
      perceived environmental hazards.

PMID- 2240294
TI  - Modeling the impact of breast-feeding by HIV-infected women on child survival.
AB  - This study models the survival outcomes of children born to HIV-infected (human
      immunodeficiency virus) women who are breast-fed, bottle-fed, and wet-nursed. It
      is estimated that, given the relative risk of alternatives to maternal milk in
      developing countries, the probability of HIV transmission via breast milk would
      need to be at least .12 in a community with an under five child mortality rate
      from non-HIV causes of 100/1000 live births and at least .27 in a community with
      a rate of 200/1000 before alternative feeding practices should be recommended
      even to the known HIV-infected mother who has an available feeding alternative
      with a relative risk of 2:1. While such a low relative risk may be achievable
      with wet nursing, most studies report a relative risk of at least 3:1 for bottle
      feeding. A sensitivity analysis is conducted around the relative risk of child
      mortality from non-HIV causes associated with different feeding practices. While
      the critical transmission rate does not vary significantly with a rate of false
      positives as high as 20 percent on the HIV screening test, the critical
      transmission rate is very sensitive to the availability of HIV screening. In
      communities where the HIV prevalence rate among mothers reaches 40 percent,
      breast-feeding should still be recommended in the absence of HIV screening unless
      HIV transmission via breast milk surpasses 30 percent.

PMID- 2240295
TI  - Clustering of atherogenic behaviors in coffee drinkers.
AB  - We studied the clustering of coffee consumption and selected atherogenic
      behaviors in older adults living in a southern California community. Men were
      somewhat more likely to drink caffeinated coffee while women were more likely to
      drink decaffeinated coffee. In men, but not women, caffeinated coffee drinking
      decreased with age and decaffeinated coffee drinking increased. Caffeinated
      coffee drinkers drank more alcohol, consumed more dietary saturated fats and
      cholesterol, were more likely to be current smokers and less likely to be current
      exercisers than were non-coffee drinkers. Smoking and exercise also showed a dose
      response relationship to the amount of caffeinated coffee consumed. Risk factor
      levels among drinkers of decaffeinated coffee were more like those of caffeinated
      coffee than non-drinkers. These data illustrate the clustering of atherogenic
      behaviors with coffee drinking and highlight their potential importance in
      interpreting the growing body of literature about coffee and health.

PMID- 2240296
TI  - Validation of mothers' reports of dietary intake by four to seven year-old
      children.
AB  - The validity of mothers' recall of four to seven year-old children's diet was
      assessed among 46 first generation Latino immigrant families from the Dominican
      Republic by comparing intake recalled by the mother to unobtrusive home
      observations of children. Correlations were moderate to high for calories and for
      most nutrients. There were no differences in mean intake of total calories or in
      intake of most macronutrients and micronutrients assessed. At least two-thirds of
      the children in the lowest (or highest) quintile based on home observations were
      correctly classified into the lowest or second lowest (or highest) quintiles
      based on mother's reports for calories and most nutrients. For all food items
      that were both observed and reported, 51 percent of reported portion sizes were
      equivalent to observed portion sizes, 15.5 percent were smaller, and 33.5 percent
      were larger. There was fair to good agreement on the number of food items eaten,
      with the exception of vegetables. Mothers' recall appears to be useful for
      classifying children by intake of calories, macronutrients and micronutrients,
      but provides a somewhat less accurate measure of actual foods eaten, portion
      sizes, and nutrient levels consumed.

PMID- 2240297
TI  - Development and validation of a food use checklist for evaluation of community
      nutrition interventions.
AB  - We developed a new dietary assessment instrument, the Food Behavior Checklist
      (FBC), which measures food use related to adopting lower-fat and higher-fiber
      diets. The FBC is a simplification of the 24-hour diet recall that consists of 19
      simple yes/no questions about foods consumed during the previous day. To develop
      the FBC, an expert committee generated a list of foods based on our intervention
      program, and we used focus groups and random-digit dialing pretests to refine the
      format and clarify items. To validate the FBC, we compared responses of 96 women
      on the FBC to information collected during a professionally administered 24-hour
      diet recall. For most items, agreement between the FBC and 24-hour recall, based
      on the kappa statistic, was good to excellent. Agreement was poor for items
      requiring detailed knowledge about food composition (e.g. high-fiber cereal).
      There was a trend to over-report general food categories (e.g. luncheon meats)
      but not specific food items (e.g. ice cream). In an embedded randomized study, we
      found that a set of introductory items designed to serve as a memory retrieval
      cue did not improve agreement between the FBC and 24-hour recall. These data
      provide preliminary evidence supporting the use of short checklist questionnaires
      on the previous day's food use as a means to assess diet at the group or
      community level. This relatively inexpensive and rapid measure can be used to
      inform the design of public health nutrition programs and as an evaluation tool
      in intervention research.

PMID- 2240299
TI  - Depressive mood, the single-parent home, and adolescent cigarette smoking.
AB  - The association between depressive mood and cigarette smoking among adolescents
      was examined within a multivariate model. Subjects were 205 eleventh graders (123
      boys and 82 girls) enrolled in a Northeast metropolitan public high school for
      science-oriented students. Logistic regression analysis showed an independent
      relation of depressive mood, friends' smoking behavior, and living in a single
      parent home with cigarette smoking. Depression scores correlated with the number
      of cigarettes smoked. These associations suggest that depressive mood and stress
      may contribute to the onset of smoking.

PMID- 2240298
TI  - Food and nutrient intake differences between smokers and non-smokers in the US.
AB  - Data from the Second National Health and Nutrition Examination Survey were
      analyzed to determine food and nutrient intake differences between current
      smokers (also categorized as light, moderate, and heavy smokers) and non-smokers.
      Smokers in several age-race-sex categories have lower intakes of vitamin C,
      folate, fiber, and vitamin A than non-smokers, and intake tended to decrease as
      cigarette consumption increased, particularly for vitamin C, fiber, and folate.
      Smokers were less likely to have consumed vegetables, fruits (particularly fruits
      and vegetables high in vitamins C and A), high fiber grains, low fat milk, and
      vitamin and mineral supplements than non-smokers. A negative linear trend was
      found between smoking intensity and intake of several categories of fruits and
      vegetables. These data suggest that the high cancer risk associated with smoking
      is compounded by somewhat lower intake of nutrients and foods which are thought
      to be cancer protective.

PMID- 2240300
TI  - Effects of individually motivating smoking cessation in male blue collar workers.
AB  - Adverse demonstrable health effects linked to the individual's smoking were shown
      to 2,689 American workers to motivate cessation during routine examinations to
      detect asbestosis. This intervention was evaluated six to 25 months later by a
      mailed questionnaire and by telephone to non-responders. Results were compared to
      yearly quit rates of 2.5 percent to 5 percent for 736 workers who were ex-smokers
      at the initial examination. Of the 504 men who responded by mail, 29.8 percent
      had quit smoking, 35.9 percent had cut down from a mean of 28 to 13 cigarettes
      per day, and 34.3 percent were smoking as before. Subsequent follow-up at one
      year showed that 25.6 percent remained quit, and that 23 percent of those who cut
      down had quit, for an overall quit rate of 34 percent. Of 101 non-responders
      contacted by telephone, 17 percent had quit and 53 percent had reduced smoking.
      In both samples, those who quit were more likely to have had lower alveolar
      carbon monoxide (COa) levels, to be older, and to have had asbestosis. Responders
      by mail were the same age as non-responders but had smoked longer, had higher
      prevalences of asbestosis, emphysema, chronic bronchitis and higher COa.
      Demonstration of the adverse personal effects of smoking appear to have
      contributed to the quit rates or reduced smoking rates in 65 percent of the
      responding workers.

PMID- 2240301
TI  - Epidemiologic differences between chlamydia and gonorrhea.
AB  - To assess the prevalence, demographics, and transmission patterns of genital
      chlamydia infection, we screened 3,078 patients, and compared identified cases (N
      = 511) to gonorrhea cases (N = 291) diagnosed in the same setting. Chlamydia
      cases were younger and more likely to be White than their gonorrhea counterparts.
      Chlamydia cases were distributed diffusely; geographic overlap between the two
      diseases was only about 40 percent. Gonococcal coinfection was noted in less than
      10 percent of patients with chlamydia. Nearly half of men with chlamydia and four
      fifths of women were asymptomatic and most cases were identified through
      screening or contact tracing. Populations at high risk for chlamydia are
      seemingly different from those for gonorrhea. Differences may be due to control
      interventions (active for gonorrhea, passive for chlamydia). Chlamydia case
      reporting and control initiatives are recommended.

PMID- 2240302
TI  - A small area simulation approach to determining excess variation in dental
      procedure rates.
AB  - All small area analyses need to compare the observed variability in rates to that
      expected by chance alone, but the expected variability is usually not known. This
      paper uses patient-level data for five dental procedures to simulate the
      distributions of the summary statistics that are usually generated in such
      studies. These statistics are found to vary greatly even under the "null
      hypothesis" that all dentists are using procedures at the same rates. The
      simulated dentist rates are compared to observed rates obtained in a different
      study. These findings illustrate problems that can occur in small area analysis
      studies, and emphasize the importance of using statistical techniques that are
      appropriate for the data that are to be analyzed. Investigators should make every
      effort to obtain patient-level data, or at least to understand the underlying
      distribution of the number of procedures per patient, to avoid mistaking
      significant deviations from an incorrect model as evidence for significant
      variation among small areas.

PMID- 2240303
TI  - Medical and psychosocial factors predictive of psychotropic drug use in elderly
      patients.
AB  - The purpose of this study was to investigate medical and psychosocial factors
      that may be used to identify patients at risk of psychotropic drug use.
      Population-based surveys were completed by 278 elderly health maintenance
      organization (HMO) patients in August 1984. Physical and mental health status and
      social support were measured in the survey. Automated prescription records from
      the year prior to and the year after the survey were linked to data from the
      survey. Patients received 737 prescriptions for psychotropic drugs during the two
      year period under study. Doxepin (20.2 percent), flurazepam (15.2 percent), and
      diazepam (14.8 percent) were dispensed most frequently. Nearly 30 percent of the
      patients received a prescription for at least one psychotropic drug during the
      two-year period, and 14 percent received at least one prescription during both
      years. Three significant predictors of subsequent psychotropic drug use were:
      prior use (odds ratio = 17.2, 95% CI = 6.25, 47.33), the number of physical
      impairments (OR = 1.73, 95% CI = 1.05, 2.84), and the respondent's rating on the
      Alameda Health Scale (OR = 1.65, 95% CI = 0.99, 2.75). Patients' self-reported
      mental health status and sociodemographic characteristics were not significant
      predictors of subsequent use.

PMID- 2240304
TI  - The association between Type A behavior and change in coronary risk factors among
      young adults.
AB  - The association of Type A/B behavior pattern and changes in blood pressure, total
      serum cholesterol, serum triglyceride, body mass, and smoking was estimated in a
      cohort of 375 young Black and White men and women from a rural county in Central
      Kentucky between 1978-79 and 1985-88. Type A participants experienced significant
      increases in systolic (2.90 +/- 1.29 mmHg) and diastolic (3.80 +/- 1.17 mmHg)
      blood pressure and in cigarette smoking (3.26 +/- 0.89 cigarettes per day) over
      the eight-year follow-up period, but Type B participants experienced no change.
      Type A and B individuals showed similar changes in total serum cholesterol, serum
      triglyceride, or body mass. Differences between behavioral types in blood
      pressure were present for women but not men, and for Blacks but not for Whites.
      These findings suggest a possible significance of the Type A pattern for the
      development of cardiovascular risk of young adults.

PMID- 2240305
TI  - Behavioral covariates of waist-to-hip ratio in Rancho Bernardo.
AB  - We examined lifestyle and dietary habits in 685 men and 943 women (mean age 67
      years) who completed an interview, examination, and food frequency questionnaire
      in 1984-87. Waist-to-hip ratio increased with age and body mass index in both men
      and women. In multiple regression, waist-to-hip ratio was independently
      associated with smoking, alcohol consumption, and exercise in men, and with
      smoking and alcohol consumption in women. The data suggest that waist-to-hip
      ratio is affected, at least in part, by behavioral, and potentially modifiable,
      factors.

PMID- 2240306
TI  - The Framingham Disability Study: relationship of various coronary heart disease
      manifestations to disability in older persons living in the community.
AB  - The relation between coronary heart disease and disability was examined in 2,576
      community-dwelling women and men ages 55-88 years. These Framingham Study
      participants were originally recruited in 1948-51 for an examination of
      cardiovascular disease. Twenty-seven years later, remaining members of the cohort
      were interviewed to ascertain physical abilities, and a score on a disability
      scale was assigned. Multivariate logistic analyses examined disability in
      relation to uncomplicated angina pectoris (AP), complicated AP, and coronary
      heart disease other than AP, controlling for possible confounders. In younger and
      older women and men, uncomplicated and complicated AP were associated with
      disability. Coronary heart disease other than AP was associated with disability
      only in the younger men. Congestive heart failure predicted disability only in
      the women. These results suggest that onset of AP should be recognized as a
      critical point in the development of disability and that AP is a better predictor
      of disability than is myocardial infarction or coronary insufficiency.

PMID- 2240307
TI  - The effects of psychosocial work organization on patterns of cigarette smoking
      among male chemical plant employees.
AB  - We tested the hypothesis that job strain (the combination of high psychological
      job demands and low work control) is positively associated with smoking
      prevalence and intensity in a study group of 389 males employed in a chemical
      plant, using a self-administered questionnaire. In a logistic regression analysis
      which controlled for a number of sociodemographic factors, job strain was not
      found to be associated with smoking cessation. However, among smokers, those in
      higher-strain jobs smoked more heavily than those in lower-strain positions (OR
      1.70, 95% CI = 1.10, 2.61) and were more likely to have increased the amount they
      smoke (OR 3.72, 95% CI = 1.92, 7.17).

PMID- 2240309
TI  - Use of fat-modified food products to change dietary fat intake of young people.
AB  - Food purchasing and preparation practices were modified in two boarding high
      schools to increase the polyunsaturated-to-saturated fat ratio (P/S) of the diet
      of students by changing food products rather than attempting to change eating
      behaviors. During years when fat-modified products were served, the P/S of males
      increased by 75 percent, versus a decrease of 6 percent during control years. For
      females, P/S increased by 53 percent during intervention years, versus an
      increase of 6 percent during control years.

PMID- 2240308
TI  - Garlic-in-oil associated botulism: episode leads to product modification.
AB  - In February 1989, three cases of botulism occurred in persons who consumed garlic
      bread made from a garlic-in-oil product. Testing of leftover garlic-in-oil showed
      it to have a pH of 5.7 and to contain high concentrations of Clostridium
      botulinum organisms and toxin. This was the second episode of botulism associated
      with a low acid garlic-in-oil product which needs constant refrigeration. In
      response, the Food and Drug Administration has taken steps to prevent a
      recurrence by requiring that microbial inhibitors or acidifying agents be added
      to such products.

PMID- 2240310
TI  - Weekly food servings and participation in social programs among low income
      families.
AB  - Low income families were interviewed to determine factors related to the number
      of family food servings per week. A multiple regression model indicated that
      participation in WIC (supplemental food program for women, infants and children),
      household size, and number of different income sources were associated with more
      family food servings per week. Number of food servings per week decreased the
      last week of the month most often in families with younger members.

PMID- 2240311
TI  - The buddy volunteer commitment in AIDS care.
AB  - Buddy volunteers provide crucial assistance to people with HIV-related illnesses.
      Based on volunteers' self-administered questionnaires, our study describes the
      nature of buddy work. Volunteers indicated their satisfaction with both personal
      performance and buddy program administration. Several factors were associated
      with volunteer satisfaction. This report is a first attempt to describe this
      special relationship created in response to the human immunodeficiency virus
      (HIV) epidemic.

PMID- 2240312
TI  - Epidemiology of reported cases of AIDS in lesbians, United States 1980-89.
AB  - National surveillance data for reported cases of acquired immunodeficiency
      syndrome (AIDS) were used to assess demographic characteristics and behavioral
      risk factors in lesbians. From June 1, 1980 through September 30, 1989, 79 women
      with AIDS reported sex relations only with a female partner; most of these women
      (95 percent) were intravenous drug users. Prevention of human immunodeficiency
      virus (HIV) infection in the lesbian community will require efforts to prevent
      and reduce intravenous drug use.

PMID- 2240313
TI  - Prior cesarean delivery in women with secondary tubal infertility.
AB  - The history of cesarean delivery was evaluated in a population-based case-control
      study of secondary infertility in King County, Washington. Sixty-one married
      women diagnosed with secondary infertility due to tubal problems who had a
      previous viable pregnancy were compared to 343 married women who had a previous
      viable pregnancy and then had a live birth that was conceived at the same time
      the infertile women began trying to conceive. The risk of tubal infertility was
      not substantially elevated in women who had a previous cesarean delivery in the
      most recent viable pregnancy compared to women with vaginal delivery (odds ratio
      = 1.2; 95% confidence interval = 0.4, 3.7).

PMID- 2240314
TI  - A comparison of homeless, community-wide, and selected distressed samples on the
      CES-Depression Scale.
AB  - Center for Epidemiological Studies (CES) Depression Scale results for surveys of
      homeless, community-wide and selected distressed samples are compared. Nearly
      four times the percentage of homeless fit the criterion for clinical caseness (a
      score of 16+) compared to the general population (74 to 19 percent). None of the
      distressed samples exhibited a higher rate except psychiatric patients diagnosed
      as acutely depressive. High rates of depression have implications for social
      policies directed toward homelessness.

PMID- 2240315
TI  - How valid are mammography self-reports?
AB  - We compared mammography reports in medical records to self-reports obtained
      during a 1989 telephone interview survey for a sample of 100 women members of a
      health maintenance organization (HMO) who indicated they had mammograms within
      the past year and 100 who said they had not had mammograms within the past year.
      Of the women reporting they had not had mammograms within the past year, none had
      mammogram reports in the HMO data center. Of the 100 women reporting they had
      mammograms within the past year, 94 had confirmatory radiology records.

PMID- 2240317
TI  - Developing AIDS education for women in county WIC clinics.

PMID- 2240316
TI  - Incidence of bicycle-related injuries in a defined population.
AB  - Population-based incidence rates for head injuries and total injuries resulting
      from bicycle crashes were calculated in a Seattle, Washington health maintenance
      organization population. Overall rates were 163 per 100,000 for all injuries and
      42/100,000 for head injuries. Individuals between 5 and 14 years of age are at
      highest risk for bicycle-related injuries. The data are presented for their
      potential utility in program planning.

PMID- 2240318
TI  - The 'Free Dental Day'--a voluntary public health initiative.

PMID- 2240319
TI  - Pharmacy education about HIV and condoms.

PMID- 2240320
TI  - Decline in NHSC physicians threatens patient care.

PMID- 2240321
TI  - Depression, worry, and the incidence of cancer.

PMID- 2240322
TI  - Maternal stress and depressive symptoms.

PMID- 2240324
TI  - At last--a view of Hispanic health and nutritional status.

PMID- 2240323
TI  - The art and science of interpreting survey data.

PMID- 2240325
TI  - Hypertension prevalence and the status of awareness, treatment, and control in
      the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-84.
AB  - The prevalence rates of hypertension among adult (ages 18-74) Mexican Americans,
      Cuban Americans, and Puerto Ricans were estimated using data from the 1982-84
      Hispanic Health and Nutrition Examination Survey (HHANES). Hypertension is
      defined as diastolic greater than or equal to 90 mm Hg, or systolic greater than
      or equal to 140 mm Hg, or currently taking antihypertensive medication. Among
      Mexican Americans in the Southwestern United States, 16.8 percent of the males
      and 14.1 percent of the females were found to be hypertensive. Among Cuban
      Americans in Dade County, Florida 22.8 percent of the males and 15.5 percent of
      the females were hypertensive. Among Puerto Ricans in the New York City area 15.6
      percent of the males and 11.5 percent of the females were hypertensive. The age
      adjusted rates are significantly lower than comparable rates for Whites and
      Blacks as measured in the second National Health and Nutrition Examination Survey
      (NHANES II), 1976-80. Control of hypertension in the HHANES populations fall
      short of the 1990 Objectives for the Nation established by the US Public Health
      Service 60 percent (34 percent controlled Mexican American hypertensives, 27.8
      percent controlled Cuban American hypertensives, and 29 percent controlled Puerto
      Rican hypertensives.

PMID- 2240326
TI  - A note on the measurement of hypertension in HHANES.
AB  - Using data from the HHANES, we found the rates of elevated blood pressure
      readings on clinical examination to be extremely low for a sample of Mexican
      American and Puerto Rican women. The prevalence rates were one-fourth to one
      fifth the rates found for a comparable sample of White women from NHANESII. These
      findings are discrepant with the little that is known about hypertension
      prevalence among Hispanics and with estimates of hypertension prevalence for
      Mexican Americans and Puerto Ricans drawn from NHANESII. While our HHANES samples
      women had much lower rates of clinical high blood pressure than Whites, they
      reported hypertension histories in excess of Whites. Rates of medicine usage
      among Hispanics were insufficiently large for effective treatment to explain the
      disparity. The prevalence estimates increased, but the relative discrepancies
      remained when we altered our sample specifications and clinical high blood
      pressure measure. A possible explanation for these discrepancies is that few
      physicians performed the majority of blood pressure readings in our HHANES
      sample. This may have been statistically inefficient. The discrepancies noted
      suggest that HHANES may not be a reliable source of information on hypertension
      among Hispanic women.

PMID- 2240328
TI  - Executive women and health: perceptions and practices.
AB  - The purpose of this study was to obtain a socioeconomic/health profile of a
      select group of executive women, to understand more about their personal and
      professional lives, and to examine how these factors relate to their overall
      health. The data were obtained from a self-administered 73-item questionnaire
      that was mailed during spring 1987 to the 1,000 members of a professional
      executive women's organization with 15 chapters across the United States.
      Findings suggest that the women in executive positions do not necessarily
      compromise their health. In comparison with a group of age/gender/education
      matched working women, the overall wellness and risk assessment scores were
      remarkably similar. The study group, however, reported greater life satisfaction,
      stronger social support, and excellent health status; the overwhelming majority
      was satisfied with their personal and professional lives and believed that they
      were in control of both. This perception, coupled with the relatively high
      wellness scores, suggests that on average this group of executives may be in
      better health than had been predicted as women rose to executive positions within
      organizations.

PMID- 2240327
TI  - Fruit and vegetables in the American diet: data from the NHANES II survey.
AB  - Twenty-four hour dietary recall data from the Second National Health and
      Nutrition Examination Survey (1976-80) were used to estimate the numbers of
      servings of fruit and vegetables consumed by Black and White adults, to examine
      the types of servings (e.g., potatoes, garden vegetables, fruit, and juice), and
      to estimate the mean intake of calories, fat, dietary fiber, and vitamins A and C
      by number of servings. An estimated 45 percent of the population had no servings
      of fruit or juice and 22 percent had no servings of a vegetable on the recall
      day. Only 27 percent consumed the three or more servings of vegetables and 29
      percent had the two or more servings of fruit recommended by the US Departments
      of Agriculture and of Health and Human Services; 9 percent had both. Consumption
      was lower among Blacks than Whites. The choice of vegetables lacked variety.
      Diets including at least three servings of vegetables and two servings of fruit
      contained about 17 grams of dietary fiber. Although caloric and fat intake
      increased with increasing servings of fruit and vegetables, the percent of
      calories from fat remained relatively constant. Although these data are 10 years
      old, more recent surveys have shown similar results. The discrepancy between
      dietary guidelines and the actual diet suggests a need for extensive public
      education.

PMID- 2240329
TI  - Day care characteristics associated with Haemophilus influenzae disease.
      Haemophilus influenzae Study Group.
AB  - To identify characteristics of day care facilities associated with H. influenzae
      disease, we compared 92 licensed facilities in which a case of H. influenzae
      disease had occurred with randomly selected facilities at which no cases
      occurred. Matched univariate analysis showed that personnel at facilities where
      H. influenzae disease occurred were more likely than those at control facilities
      to use towels or handkerchiefs to wipe children's noses, admit children who were
      not toilet trained or had diarrhea ("liberal fecal policy"), had a narrower age
      range, were more likely than control facilities to be for-profit and less likely
      to use volunteers. In a multivariate model that adjusted for age range, profit
      status and liberal fecal policy, towel or handkerchief use (OR 5.5, 95% CI: 1.1,
      30) was the only variable independently associated with case facilities. This is
      the first association of a specific day care practice with H. influenzae disease.

PMID- 2240330
TI  - Injury and disability in matched men's and women's intercollegiate sports.
AB  - Eight matched men's and women's intercollegiate varsity teams were studied
      prospectively for one academic year to determine the incidence of athletic injury
      and resulting disability. Sports in which both men and women participated in a
      comparable manner were chosen: basketball, fencing, gymnastics, swimming, tennis,
      indoor track, outdoor track, and volleyball. Men (232) and women (150) were
      injured at comparable rates, 42 percent versus 39 percent. When adjusted for
      exposure time, seven of the eight sports continued to show similar injury rates.
      Women gymnasts, however, experienced .82 injuries per 100 person-hours of
      exposure as compared to .21 injuries for the men (p = .0001). Disability was
      greater in women gymnasts, 7.44 days per 100 person-hours versus 1.15 days for
      men (p = .0004). Percent of season lost to injury was also greater for women
      gymnasts. Types and sites of injury were similar for men and women, with sprains
      and strains accounting for over half of all injuries. We found no evidence for
      gender differences in matched sports except for gymnastics, in which technically
      diverse events may have accounted for the differences observed.

PMID- 2240331
TI  - Coding external causes of injury (E-codes) in Maryland hospital discharges 1979
      88: a statewide study to explore the uncoded population.
AB  - We examined the trends in hospital discharge E-coding in Maryland over a 10-year
      period. The overall proportion of E-coded discharges has increased from 40
      percent in 1979 to 55 percent in 1988. E-coding was lower in the severely
      injured, the elderly, and patients with long hospital stays. Our findings
      demonstrate that E-code reporting varies because of the limited number of data
      fields available for coding of discharge diagnoses. Universal, systematic
      reporting of E-codes in hospital discharge data is essential if these data are to
      provide critically needed information about nonfatal injuries. Hospital discharge
      data formats should contain separate fields for E-codes and the use of these
      codes, we believe, should be mandated.

PMID- 2240332
TI  - A case-control study of the effectiveness of bicycle safety helmets in preventing
      facial injury.
AB  - In a case-control study we sought to assess the potential effectiveness of
      helmets in preventing facial injuries. Our study included 212 bicyclists with
      facial injuries and 319 controls with injuries to other body areas, who were
      treated in emergency rooms of five Seattle area hospitals over a one-year period.
      Using regression analyses to control for age, sex, education and income, accident
      severity, and cycling experience we found no definite effect of helmets on the
      risk of serious facial injury (odds ratio 0.81; 95 percent confidence interval =
      0.45, 1.5), but protection against serious injuries to the upper face (odds ratio
      0.27; 95% CI = 0.1, 0.8). No protection was found against serious injuries to the
      lower face. The independent effect of helmet use on facial injury was difficult
      to isolate due to the association of head and facial injuries. Our results
      suggest that bicycle helmets as presently designed may have some protective
      effect against serious upper facial injuries.

PMID- 2240333
TI  - Association of hepatitis B surface antigen and core antibody with acquisition and
      manifestations of human immunodeficiency virus type 1 (HIV-1) infection.
AB  - We examined the associations between seropositivity for hepatitis B virus (HBV)
      with the presence or development of antibodies to human immunodeficiency virus
      (HIV-1) and with HIV-1 induced T-helper lymphocyte deficiency or acquired
      immunodeficiency syndrome (AIDS). Serologic data on HBV and HIV-1, cytometric
      enumeration of CD4+ lymphocytes, clinical events (AIDS by Centers for Disease
      Control criteria) and hepatitis B vaccination histories were available on 4,498
      homosexual participants in the Multicenter AIDS Cohort Study, Men were classified
      as to previous infection with HBV and prevalent or incident infection with HIV-1.
      Although there was an association between seropositivity for HBV infection and
      HIV-1 infection at enrollment (odds ratios anti-HBc 2.6; HBsAg 4.2), the relation
      between HBV seropositivity and subsequent seroconversion to HIV-1 was weaker
      (odds ratios 1.3 and 1.6). HIV-1 seroconversion was also associated with a
      history of certain other sexually transmitted diseases, but predisposing sexual
      practices did not account for the association between HBV and HIV-1 infection.
      Seropositivity for HBV infection at entry was not related to initially low or
      more rapid subsequent decline in T-helper lymphocyte counts and was not
      associated with an increased incidence of AIDS during 2.5 years of follow-up.
      History of vaccination against HBV did not appear to decrease susceptibility to
      HIV-1 infection or to subsequent progression of immunodeficiency. We conclude
      that prior HBV infection is unlikely to be specifically associated with
      acquisition of HIV-1 infection and is unrelated to more rapid progression of HIV
      1-induced immunodeficiency.

PMID- 2240334
TI  - Death in prison: changing mortality patterns among male prisoners in Maryland,
      1979-87.
AB  - The leading causes of death (rate per 100,000 prisoner-years) in Maryland state
      prisons for the period 1979-87 were circulatory system disease (59), suicide
      (40), and homicide and legal intervention (30). Acquired immunodeficiency
      syndrome (AIDS) became the leading cause of death in 1987. Homicides declined
      after 1980; drug overdose deaths peaked in 1981 and later disappeared. Male
      inmates have 39 percent lower all-cause death rates than the general population
      of Maryland after adjustment for age and race.

PMID- 2240335
TI  - Long-term impact of smoking cessation on the incidence of coronary heart disease.
AB  - Using a simulation model of the US male population, we estimated the long-term
      impact that future smoking cessation programs would have on the distribution and
      occurrence of coronary heart disease in males ages 35-84. For interventions that
      reduce the number of smokers by 25 percent in 1990, the number of men free of
      coronary heart disease is projected to increase by 416,787 (0.7 percent) in 2015,
      and the age-standardized absolute incidence to decline by 2.3 percent. Incidence
      rates and absolute incidences are projected to fall in men under age 65, but
      absolute incidence would rise in men over age 65, in large part because of the
      increased number of men who were at risk for coronary heart disease because of a
      reduction in non-coronary smoking-related mortality. These trends were more
      marked for greater smoking reductions and were generally unaffected in a variety
      of analyses using alternative assumptions, which considered smoking as a risk
      factor in the elderly, a lag-time before benefits from smoking cessation were
      realized and secular declines in smoking prevalence. Subject to the assumptions
      of our model, we conclude that smoking reductions will markedly reduce coronary
      heart disease, especially in younger age groups, and that this benefit will be
      slightly offset by a small increase in absolute incidence in elderly men.

PMID- 2240336
TI  - Overcoming potential pitfalls in the use of Medicare data for epidemiologic
      research.
AB  - We used Medicare data bases and US Census data to address two questions critical
      to the use of Medicare files for epidemiologic research. First, we examined the
      degree to which the population enrolled in the Medicare program is similar to the
      elderly resident population of the United States, as estimated by the US Census.
      We found small differences in the total population estimates but substantial
      differences by age and race. Second, we found that among Medicare enrollees,
      physician claims identify a small proportion of hip fracture cases which are not
      documented in the hospital discharge files. This proportion varies by age,
      region, and state within the United States. Calculation of rates based on
      Medicare hospital discharge data, and probably other hospital discharge data sets
      as well, must take these limitations into account. Use of all available Medicare
      data files can overcome these limitations.

PMID- 2240337
TI  - Prospective payment and the utilization of physical therapy service in the
      hospitalized elderly.
AB  - We studied the effect, in a university teaching hospital, of the prospective
      payment system (PPS) on utilization of physical therapy (PT), a non-reimbursable
      service; subjects were hospitalized patients aged 75 or older with non-PT-related
      diagnoses (myocardial infarction, pneumonia, congestive heart failure, and
      colectomy) and PT-related diagnoses (cerebrovascular accident and hip fracture).
      The proportion of patients referred for PT increased from 68 percent pre-PPS to
      85 percent post-PPS for those with PT-related diagnoses and from 13 percent pre
      PPS to 19 percent post-PPS for those with non-PT-related diagnoses. The mean
      number of sessions of PT decreased slightly for both groups: from 8.5 to 7.6
      sessions for those with PT-related diagnoses and from 5.2 to 4.5 for those with
      non-PT-related diagnoses. In patients with PT-related diagnoses whose ambulatory
      status worsened during hospitalization, referrals for PT increased from 76
      percent pre-PPS to 98 percent post-PPS. Referrals of comparable patients with non
      PT-related diagnoses did not increase. Changes in provider education and efforts
      to reduce length of stay may account for these findings.

PMID- 2240338
TI  - Prevalence of chronic bronchitis among US Hispanics from the Hispanic Health and
      Nutrition Examination Survey, 1982-84.
AB  - In the Hispanic Health and Nutrition Examination Survey (HHANES), Puerto Ricans
      had a higher age-adjusted prevalence of self-reported chronic bronchitis (2.9
      percent, 95% CI = 2.2, 3.6) than Mexican Americans (1.7 percent, 95% CI = 1.3,
      2.1) or Cubans (1.7 percent, 95% CI = 0.9, 2.5). The prevalence of chronic
      bronchitis was at least 2 times higher in smokers as compared to nonsmokers among
      Puerto Ricans and Cubans, but not for Mexican Americans.

PMID- 2240339
TI  - Prevalence and restrictiveness of smoking policies in King County, Washington,
      manufacturing worksites.
AB  - This study examined prevalence of smoking policies and of significant smoking
      restrictions in a 1988 random sample of 1,528 manufacturing companies in the
      Seattle, Washington area, and related these characteristics to worksite size and
      industry type. Sixty-nine percent of companies had formal smoking policies and 85
      percent regulated smoking to some degree. Workforce size was directly related to
      prevalence of significant smoking restrictions, but when type of industry was
      controlled, the linear trend in the size/prevalence relationship was sustained in
      only three of the 18 industry groupings.

PMID- 2240340
TI  - Depressive symptoms and cigarette smoking among Latinos in San Francisco.
AB  - We administered the Center for Epidemiological Studies Depression (CES-D) Scale
      to 547 San Francisco Latinos as part of a random digit dialing telephone survey
      to evaluate smoking behavior. Both men and women current smokers had the highest
      mean CES-D levels (9.7 and 14.3, respectively). Logistic regression analysis
      adjusting for gender, acculturation, education, age, and employment showed that
      current smokers had an odds ratio of 1.7 (95% CI = 1.3, 2.2) for significant
      depressive symptoms compared to former smokers (OR = 1.1;95% CI = .8, 1.6) and
      never smokers (OR = 1).

PMID- 2240341
TI  - Dental office practices for tobacco users: independent practice and HMO clinics.
AB  - Surveys of independent dental practitioners and health maintenance organization
      (HMO) dentists and their adult male patients in Oregon found that cessation
      information and advice was being given to tobacco-using patients, especially
      smokeless tobacco users, and that the tobacco users surveyed expressed interest
      in obtaining help to quit. Oral health providers expressed an interest in further
      training in how to help their tobacco-using patients to quit.

PMID- 2240342
TI  - Evidence for gonococcal transmission within a correctional system.
AB  - In a study to examine sexually transmissible disease occurring within a large
      correctional system where sexual activity is prohibited, 27 male inmates acquired
      culture-proven gonorrhea from in-jail sexual activity during a three-month
      period. These results provide evidence to encourage inmate education about the
      acquired immunodeficiency syndrome (AIDS) and to support condom distribution
      programs in correctional facilities.

PMID- 2240343
TI  - HIV seroconversion in two homosexual men after receptive oral intercourse with
      ejaculation: implications for counseling concerning safe sexual practices.
AB  - Seroconversion for HIV antibody occurred in two homosexual men who reported no
      anal intercourse for greater than or equal to 5 years and multiple episodes of
      receptive oral intercourse with ejaculation. Neither man reported intravenous
      drug use or receipt of blood products. The last antibody-negative specimen was
      also negative by the polymerase chain reaction and p24 antigen assays. All
      sexually active persons should be clearly counselled that receptive oral
      intercourse with ejaculation carries a potential risk of HIV transmission.

PMID- 2240344
TI  - The AIDS-related experiences and practices of primary care physicians in Los
      Angeles: 1984-89.
AB  - Telephone interviews of random samples of Los Angeles primary care physicians in
      1984, 1986, and 1989 obtained information about their AIDS-related practice
      experiences, and sexual history taking. Data from mid-1989 reveal almost 74
      percent have worked up at least one patient for AIDS or HIV infection in the past
      six months and 39.5 percent are caring for at least one patient with AIDS or AIDS
      related complex. Self-reported use of appropriate sexual history questions has
      improved substantially over this five-year period.

PMID- 2240345
TI  - Behavioral change in longitudinal studies: adoption of condom use by
      homosexual/bisexual men.
AB  - We compared reporting serial cross-sectional prevalence of sexual behavior over
      time, to reporting individual patterns of behavioral change in a cohort of
      homosexual men at a six-month interval. Aggregate prevalence rates underestimated
      the magnitude of change to safer practices, and failed to provide information on
      relapse to less safe practices. We conclude that it is important to report data
      based on individual fluctuations in behavior for the evaluation of change over
      time.

PMID- 2240346
TI  - Seat belt use in cars with air bags.
AB  - Seat belt use was observed in 1,628 cars with air bags and manual belts and
      34,223 cars with manual seat belts only. Sixty-six percent of drivers in cars
      with air bags wore seat belts compared to 63 percent of drivers in cars with
      manual belts only. The study found no evidence for the speculation that drivers
      with air bags will reduce their seat belt use because they believe an air bag
      alone provides sufficient protection.

PMID- 2240347
TI  - Age, sex, and road-use patterns of motor vehicular trauma in Rhode Island: A
      population-based hospital emergency department study.
AB  - Population-based hospital emergency department data on motor vehicle traffic
      trauma in Rhode Island, 1984-85, are analyzed by age, sex, and road-use status.
      Annualized rates of overall and severe trauma were 1,195 cases (95% confidence
      interval [CI] = 1,164, 1,225) and 102 cases (95% CI = 94, 111) per 100,000
      population, respectively. Overall and severe rates peaked at ages 15-24 years.
      Male rate excesses were most pronounced for motor-cycle and pedal cycle trauma.

PMID- 2240349
TI  - Infant care permits: a practical method for raising the quality of infant care
      within a community.

PMID- 2240348
TI  - Evaluation of the efficacy and cost effectiveness of health education methods to
      increase medication adherence among adults with asthma.
AB  - We randomized 135 adult asthma patients to a control group, and 132 patients to
      an experimental group which received a special health education intervention.
      Four adherence measures were documented at baseline and 12-month follow-up:
      correct inhaler use, inhaler adherence, medication adherence, and total adherence
      rating. Costs to routinely deliver the intervention were $32.03/patient.
      Experimental group patients exhibited a significantly higher level of improvement
      in adherence (44 percent) than control group patients (2 percent).

PMID- 2240350
TI  - Computerization of annual immunization surveys.

PMID- 2240351
TI  - Incorporation of pyrazinamide into community-wide treatment of tuberculosis.

PMID- 2240352
TI  - Dietary vitamin C intake and cigarette smoking.

PMID- 2240353
TI  - Hispanic health and nutrition examination survey, 1982-84: findings on health
      status and health care needs.

PMID- 2240354
TI  - Placental site nodules and plaques. A clinicopathologic analysis of 20 cases.
AB  - The clinical and pathological features of 20 cases of a nodular or plaquelike
      trophoblastic lesion at the placental site, which we have designated "placental
      site nodule or plaque" (PSN-P), are described. The lesions occurred in patients
      27 to 45 years of age, and were discovered in an endometrial curettage specimen
      performed because of menorrhagia or irregular uterine bleeding, or were
      incidental findings in curettage or hysterectomy specimens. They were grossly
      visible in five cases. Microscopic examination disclosed single or multiple,
      mostly well-circumscribed, oval, or plaquelike, variably cellular nodules that
      were characteristically extensively hyalinized. The lesional cells typically had
      abundant cytoplasm that was amphophilic, eosinophilic, or occasionally
      vacuolated, and irregular, often degenerative-appearing nuclei; mitotic figures
      were absent or rare. Immunohistochemical staining for human placental lactogen
      was focally positive in all but one specimen stained; most of the lesional cells
      stained for cytokeratin. An uneventful follow-up of 1 to 7 years was obtained in
      14 cases, including five in which the only treatment was dilatation and
      curettage. The major lesion to be differentiated from the PSN-P is the placental
      site trophoblastic tumor. Features favoring the former diagnosis include its
      usually small size, circumscription, extensive hyalinization, degenerative
      appearance, and mitotic inactivity. These features, as well as the absence of
      squamous cells, help distinguish PSN-P from the rare hyalinizing squamous cell
      carcinoma of the cervix. The available evidence indicates that PSN-P is benign.

PMID- 2240355
TI  - Further phenotypic evidence that nodular, lymphocyte-predominant Hodgkin's
      disease is a large B-cell lymphoma in evolution.
AB  - Five cases of nodular, lymphocyte predominant Hodgkin's disease (nLP HD), in
      which an association with (n = 3) and transformation to (n = 2) large cell
      lymphoma (LCL) were found, were studied with monoclonal antibodies against B-, T
      , and Reed-Sternberg (R-S) cell-associated antigens and epithelial membrane
      antigen (EMA) on paraffin sections. Both lymphocytic (L) and histiocytic (H)
      cells of nLP HD and lymphoma cells of LCL expressed multiple B-cell-associated
      antigens (detected by LN-1/CDw75, L26, MB2, DBB.42, DBA.44, DND.53, DNA.7
      antibodies) but did not react with antibodies against T-cell-associated (MT1,
      UCHL1/CD45RO) (one exception for CD45RO in LCL) and R-S cell-associated (Leu
      M1/CD15, Ber-H2/CD30) antigens. EMA was expressed by L and H cells in all cases
      and conserved in LCL cells, emphasizing the frequent expression of EMA by the
      diagnostic cells of nLP HD. An antibody (BNH9) against blood group-related
      antigens (H and Y oligosaccharide antigens) that does not normally react with
      lymphoid cells was found to be reactive with few L and H cells in two of five and
      most LCL cells in four of five cases. The finding might be indicative of abnormal
      activation of lymphoid cells. The data reinforce current implications that nLP HD
      is a B-cell malignancy in evolution and that it is not truly representative of
      Hodgkin's disease in terms of biological and clinical behavior.

PMID- 2240356
TI  - Uterine lithiasis.
AB  - We report a case of uterine lithiasis in a 73-year-old Latin American woman. The
      patient underwent vaginal hysterectomy and colporrhaphy for complaints related to
      secondary uterine prolapse and cystocele. The 70-g, 8 x 5 x 3.5 cm uterus had a
      normal shape. Ten white, starlike, 0.5 x 0.5 x 0.2 cm, calcified structures were
      found within the endometrial cavity. Chemical analysis of one of these by x-ray
      diffraction showed it to be composed of calcite, one of the crystalline forms of
      calcium carbonate. To our knowledge, this is the first report of human uterine
      lithiasis in the literature.

PMID- 2240357
TI  - Identification of a mislabeled fixed specimen by DNA analysis.
AB  - Formalin-fixed, paraffin embedded surgical specimens can be identified by
      genotypic analysis. DNA was extracted from single sections of fixed tissue and
      amplified by the polymerase chain reaction for the human leukocyte antigen (HLA)
      DQ alpha and low density lipoprotein receptor genes. These two loci are
      polymorphic and fixed specimens can be distinguished based on differences between
      these alleles. The examination can be performed in 2 days and the HLA DQ alpha
      test utilized a nonisotopic color detection method. In this case report, a
      mislabeled specimen was identified as a section from a mastectomy because they
      had identical genotypes. Molecular genetic analysis of the DNA present in fixed
      specimens can yield information not otherwise evident from the histology.

PMID- 2240359
TI  - Variations in malaria transmission rates are not related to anopheline
      survivorship per feeding cycle.
AB  - Anopheline survivorship, vectorial capacity, and mosquito infection probability
      estimates from mosquito infection rates were determined 4 times in 1 year in a
      Papua New Guinea village. Estimates of survivorship over the length of the
      extrinsic incubation period differed significantly during the year. However,
      survivorship per feeding cycle, individual mosquito vectorial capacity, and
      mosquito infection probability did not vary significantly. Estimates of these
      parameters were then compared to estimates of survivorship, individual vectorial
      capacity, and mosquito infection probability in mosquito populations in other
      villages in the study area. Since survivorship per feeding cycle did not vary
      significantly among the mosquito populations in these villages, changes in
      malaria transmission potential can be better gauged from estimates of
      survivorship over the length of the extrinsic incubation period. However, as
      measurements of relative inoculation rates are easier to perform and have been
      related to parasite prevalences in children in this area, estimates of
      inoculation rates are a preferred option for estimating malaria transmission in
      the Madang area of Papua New Guinea.

PMID- 2240358
TI  - A distinctive cardiovascular lesion resembling histiocytoid (epithelioid)
      hemangioma. Evidence suggesting mesothelial participation.
AB  - This paper presents 14 examples of a distinctive cardiovascular lesion. The
      patients' ages ranged from 5 to 76 years (mean, 51 years). There were seven male
      patients and seven female patients. All of the lesions were small and represented
      incidental surgical findings. Ten were attached to the endocardium, three were
      free-floating in the pericardial cavity, and one was inside a dissecting aneurysm
      of the ascending aorta. Microscopically, the lesions were enclosed in a fibrinous
      network and composed of a solid proliferation of round to polygonal cells with
      centrally located nuclei. Immunohistochemically, the cells were negative for
      FVIII-related antigen and lysozyme, but they stained positively for keratin,
      especially when clustered in small micropapillary or tubule-like formations. The
      nature and pathogenesis of these lesions are uncertain. Their location and some
      of their microscopic features originally suggested a relationship with the entity
      described as histiocytoid (epithelioid) hemangioma. However, their intense
      immunoreactivity for keratin, occasional presentation in the pericardial sac, and
      marked morphologic similarities with nodular mesothelial hyperplasia as sometimes
      seen in hernia sacs point toward the alternative possibility of a reactive
      mesothelial nature. A possible pathogenetic mechanism for the endocardial cases
      is ingrowth of pericardial mesothelial cells along a perforation tract that may
      have developed at the time of a cardiac catheterization. There were no
      recurrences or metastases in any of the cases.

PMID- 2240360
TI  - Evaluation of survival potential and malaria susceptibility among different size
      classes of laboratory-reared Anopheles dirus.
AB  - Four size classes of Anopheles dirus were reared from different larval densities.
      Higher densities produced smaller adults with lower survivorship. Larger females
      took larger bloodmeals by artificial feeding with cultured Plasmodium falciparum
      and developed significantly more oocysts.

PMID- 2240361
TI  - Geographical distribution of Plasmodium falciparum erythrocyte rosetting and
      frequency of rosetting antibodies in human sera.
AB  - Uninfected erythrocytes bind spontaneously to those infected with certain strains
      of Plasmodium falciparum. This is known as spontaneous erythrocyte rosetting. We
      have studied the occurrence and frequency of rosetting in 75 fresh patient
      isolates and have identified rosetting strains from Africa, South America, and
      Asia. Rosetting was present in 49% of the isolates tested; the frequency of
      rosetting red blood cells (RBC) in individual isolates was 0-75% when scored
      during the first cycle of in vitro growth. Rosetting antibodies were found in 15
      out of 73 (21%) Liberian sera as measured by disruption of rosettes in vitro.
      However, antibodies able to inhibit CD36 dependent cytoadherence of P. falciparum
      infected RBC were not detected in these sera. Erythrocyte rosetting is a
      geographically widespread phenomenon. Rosetting antibodies seem to be induced by
      natural infection and the molecular mechanism of rosette formation seems distinct
      from that of endothelial cytoadherence.

PMID- 2240362
TI  - Studies in owl monkeys leading to the development of a synthetic vaccine against
      the asexual blood stages of Plasmodium falciparum.
AB  - During the development of a synthetic vaccine for human use against the asexual
      blood stages of Plasmodium falciparum, monkey trials were performed to assess
      safety, immunogenicity, and protectivity. We determined the minimal infective
      dose of the P. falciparum FVO strain, the kinetics of the immune response induced
      by vaccination with the synthetic peptide mixture (S7 + S12 + S17) or the
      synthetic hybrid polymeric protein SPf66, and the induction of protective
      immunity against the experimental challenge with 2 P. falciparum strains. A clear
      boosting effect was observed, determined by the increased antibody titers against
      synthetic peptides S7, S12, S17, and SPf66, and by improvement in the protective
      immune response against the challenge. These studies suggest that either the
      peptide mixture or the synthetic hybrid polymeric protein are excellent choices
      for the development of a vaccine against P. falciparum.

PMID- 2240364
TI  - Genetic analysis of Leishmania mexicana populations from Texas, Latin America,
      and the Caribbean.
AB  - A genetic analysis using enzyme data of 72 Leishmania mexicana isolated from
      hosts in Texas, Latin America, and the Caribbean is presented. All isolates from
      each country were combined and considered as local populations. Allomorph (allele
      determined by electrophoresis) frequencies for 20 enzyme (loci) were calculated
      and 7 populations (Texas, Mexico, Belize, Guatemala, Ecuador [EC], Venezuela, and
      the Dominican Republic [DR]) were compared pairwise in the statistic of genetic
      identity (I) (level of genetic similarity). All populations were found to be
      genetically similar with a mean I value for all comparisons of 0.890 +/- 0.067.
      When DR was included as one of the pair compared, I = 0.811 +/- 0.034. Among
      comparisons that include EC (excluding EC vs. DR), I = 0.875 +/- 0.026. The mean
      I for the other comparisons was less than 0.9. The data indicate that the DR
      population is divergent enough from the others that it can be considered at the
      subspecies/incipient species level of evolutionary divergence; the EC population
      is, to a lesser extent, distinct from the others, and the other 5 represent
      geographic populations of 1 widely distributed species. A diagrammatic
      representation of the allomorphs among the 72 isolates is included. There were
      some allomorph/geographical (or local) population relationships noted.

PMID- 2240363
TI  - Immunization of owl monkeys with a combination of Plasmodium falciparum asexual
      blood-stage synthetic peptide antigens.
AB  - A mixture of 3 synthetic peptides (35.1, 55.1, and 83.1) corresponding to
      portions of the 35 kDa, 55 kDa, and 83 kDa proteins from the asexual blood stages
      of Plasmodium falciparum and a polymer of a syntheic peptide incorporating the 3
      individual peptides (SPf66) were tested as candidate malaria vaccine antigens in
      Aotus nancymai. Monkeys were immunized with combinations of the 3 peptides from 2
      separate sources (Centers for Disease Control [CDC], Atlanta, GA or Colombia) or
      with the synthetic polymer. Animals immunized with a combination of the 3
      peptides from CDC had higher antibody titers to the 35.1 and 55.1 peptides than
      to the 83.1 peptide. Monkeys immunized with a combination of the 3 peptides
      produced in Colombia developed higher levels of antibody to the 55.1 than to the
      83.1 and 35.1 peptides. Animals immunized with the polymer produced detectable
      antibodies to the 55.1 peptide alone. Following challenge with P. falciparum, no
      differences were observed between the 3 vaccine groups and 2 control groups with
      respect to the number of animals with parasitemias greater than or equal to 10%.
      The inconsistency of serologic response to all 3 peptides in these animals
      contrasted with previous trials performed in Colombia where the monkeys developed
      high antibody titers against the 3 peptides and were protected against the
      experimental infection.

PMID- 2240365
TI  - Ultrasonographical investigations of onchocerciasis in Liberia.
AB  - The efficiency of ultrasonography (US) for the diagnosis and clinical
      characterization of onchocerciasis was evaluated. US was performed on 120
      probands in Liberia. Ninety-two patients had generalized onchocerciasis, 21
      patients suffered from the chronic hyperreactive form of onchocerciasis (sowda),
      and 7 probands served as controls. Patients were examined by US with linear (7.5
      MHz and 5 MHz) and sector (3.5 MHz) scanners. US results were evaluated by
      examination of extirpated nodules. The US structure of nodules revealed a typical
      pattern consisting of a homogeneous echogenicity with small echodense particles
      and a lateral acoustic shadow, and differentiation from lymph nodes, lipoma, or
      fibroma was achieved. Within the onchocercomata, calcifications or fluid were
      identified. Regarding the estimation of the worm burden, it is important to note
      that in 24 patients, additional nodules not previously palpated were found by US.
      Also, the number of worm centers in palpable conglomerate nodules were determined
      more exactly by US than by palpation. In 4 of 16 sowda patients, impalpable
      nodules were found by US. In 13 patients with positive microfilaria counts, no
      nodules could be detected. The highly characteristic ultrasonographical pattern
      of onchocercomata may serve as a basis for further US investigations in
      onchocerciasis.

PMID- 2240366
TI  - South American blastomycosis: ophthalmic and oculomotor nerve lesions.
AB  - A case of South American blastomycosis began with an oropharyngeal lesion which
      was followed by a granulomatous uveitis. The patient was treated with
      Amphotericin B and showed a clinical regression. Four months later, he developed
      a right 3rd cranial nerve palsy, aggravating the clinical aspect with a severe
      generalized involvement of the central nervous system and death. Necropsy showed
      blastomycotic meningoencephalitis.

PMID- 2240367
TI  - Recombinant capsular antigen (fraction 1) from Yersinia pestis induces a
      protective antibody response in BALB/c mice.
AB  - Yersinia pestis produces a glycoprotein capsule, the biosynthesis of which
      appears to be temperature dependent. The fraction I (F1) component of this
      capsule is specific to Y. pestis and the detection of F1 antibodies is the basis
      for several serological tests. We report the cloning of the F1 gene and its
      expression in Escherichia coli using the phagemid vector lambda ZAPII and a F1
      specific monoclonal antibody. The recombinant F1 antigen had a molecular weight
      of 17 kDa, which proved to be identical to that of the F1 antigen produced by Y.
      pestis. The recombinant cells produced F1 antigen at 37 degrees C but only
      minimal amounts at 27 degrees C, suggesting that the genetic features affected by
      temperature in Y. pestis may be operating in the E. coli clone. It is not known
      if their similar molecular weights reflect the glycosylated nature of both
      proteins. F1 antigen purified from the E. coli recombinant induced a protective
      immune response in BALB/c mice challenged with up to 10(5) virulent Y. pestis.
      The resistance of immunized mice to plague infection correlated with high titers
      of F1 antibody. The cloned gene expresses an immunogenically competent F1 antigen
      suitable for use in plague serodiagnostics and vaccine development.

PMID- 2240368
TI  - Infection of colonized cat fleas, Ctenocephalides felis (Bouche), with a
      rickettsia-like microorganism.
AB  - We report the ultrastructure of a rickettsia-like microorganism in a colonized
      population of the cat flea Ctenocephalides felis (Bouche). The microorganism
      occurs principally in the cytoplasm of midgut cells, but similar microorganisms
      were detected in the tracheal matrix, muscle, hypodermis, ovaries, and the
      epithelial sheath of the testes. The microorganism has a well-defined cell
      membrane consistent with rickettsia and measures 0.25-0.45 microns in diameter
      with lengths up to 1.5 microns. It was observed repeatedly in fleas of 1
      laboratory colony, including newly emerged non-bloodfed specimens, but not in
      specimens from several other sources.

PMID- 2240369
TI  - Human T cell lymphotropic virus infection in Guaymi Indians from Panama.
AB  - Preliminary studies found that 9% of Guaymi Indians from Bocas del Toro province
      have antibody to human T cell lymphotropic virus (HTLV-I/II). The present study
      enrolled 317 (21% of the population) Guaymi Indians from Changuinola, the capital
      of Bocas del Toro province and 333 (70% of the population) from Canquintu, an
      isolated rural village. Demographic information and family relationships were
      ascertained and subjects were screened for neurologic diseases. Serum specimens
      were screened by an enzyme-linked immunosorbent assay for HTLV-I/II antibody and
      positives were confirmed according to U.S. Public Health Service criteria. Twenty
      five (8%) Guaymi residing in Changuinola and 7 (2.1%) from Canquintu were
      confirmed seropositive. In Changuinola, antibody was virtually limited to
      residents greater than or equal to 15 years of age (24 [16%] of 153) and rates
      were slightly higher in males than in females; in Canquintu, antibody rates did
      not increase significantly with age and appeared higher in females than in males.
      In Changuinola, there was no evidence for household clustering of infection. In
      contrast, HTLV antibody among Canquintu residents clustered significantly by
      household. HTLV-associated neurologic disease was not detected in either
      population. The atypical seroepidemiology observed in both locations might be
      explained if the virus endemic to the Guaymi differed from HTLV-I previously
      described in the Caribbean basin and Japan.

PMID- 2240370
TI  - Persistence of mosquito-borne viruses in Kern County, California, 1983-1988.
AB  - The persistence of arboviruses was studied from 1983 to 1988 in mixed
      agriculture, marsh, riparian, and foothill habitats in Kern County, CA. Western
      equine encephalomyelitis (WEE) virus was isolated frequently during 1983 from
      Culex tarsalis and Aedes melanimon and was detected by the seroconversion of
      sentinel chickens. WEE virus then disappeared, even though vector competence
      studies during 1984-1986 showed that Cx. tarsalis was able to transmit WEE virus.
      St. Louis encephalitis (SLE) virus was detected sporadically in 3 of the 6 years
      of the study by isolation from Cx. tarsalis and/or by sentinel chicken
      seroconversion. When mosquito pools were screened for virus in suckling mice,
      Turlock (TUR) and Hart Park (HP) viruses were isolated from Cx. tarsalis during
      each summer. Vertical transmission of HP was indicated by the isolation of virus
      from a pool of male Cx. tarsalis. California encephalitis (CE) virus was isolated
      repeatedly from host-seeking Ae. melanimon females, males, and adults reared from
      field-collected immatures, verifying vertical transmission in nature. Horizontal
      transmission of CE virus among both jackrabbits (Lepus californicus) and desert
      cottontails (Sylvilagus auduboni) appeared to amplify Ae. melanimon infection
      rates during the summer of 1985, but elevated herd immunity depressed infection
      rates during 1986. Thus, CE, HP, and TUR viruses persisted in Kern County, while
      WEE virus appeared to become extinct and required reintroduction. The sporadic
      occurrence of SLE virus activity remains unexplained, but its persistence may
      require both vertical transmission and reintroduction.

PMID- 2240371
TI  - Plasmodium falciparum-infected Anopheles stephensi inconsistently transmit
      malaria to humans.
AB  - Malaria was transmitted to only 5 of 10 volunteers bitten by 1-2 Anopheles
      stephensi carrying sporozoites of the 3D7 clone of the NF54 strain of Plasmodium
      falciparum in their salivary glands. Parasites were detectable by culture in
      blood taken 7-10 days following exposure and by thick blood film 14-16.5 days
      after exposure. Infectivity did not correlate with the numbers of sporozoites in
      the salivary glands.

PMID- 2240372
TI  - Parasite antigenemia in untreated and treated lymphatic filarial infections.
AB  - To evaluate the merit of antigen detection assays as a tool to monitor the
      efficacy of chemotherapy for lymphatic filariasis, we serially measured antigen
      levels in sera from jirds infected with Brugia malayi and from humans with
      bancroftian filariasis. Antigenemia was detected in all animals with
      parasitologically proven infection and was present in jirds with prepatent or
      occult filariasis. Antigen levels correlated with worm burdens, and progressively
      declined in drug-cured animals. Treatment with diethylcarbamazine (DEC) triggered
      a transient increase in serum levels of filarial antigens bearing the epitope
      recognized by the monoclonal antibody HC 11. All patients with bancroftian
      filariasis became amicrofilaremic within one week after DEC treatment.
      Antigenemia levels slowly declined over a period of several months in all but one
      treated individual. Forty-two months after treatment, progressively rising
      antigen levels are present in 10 patients. Six of these remain amicrofilaremic;
      in the other 4, elevated antigenemia levels preceded or were detected at the same
      time as recurrent parasitemia. Periodic monitoring of antigenemia levels after
      treatment of patients with lymphatic filariasis can be used to identify
      individuals who are likely to develop recurrent microfilaremia before the
      parasites become detectable in blood samples, thereby allowing timely
      retreatment.

PMID- 2240373
TI  - Selective breeding of dogs for segregation of limb edema from microfilaremia as
      clinical manifestations of Brugia infections.
AB  - Three generations of beagles were monitored for microfilaremia (mf) and clinical
      disease during repeated infection with Brugia pahangi and were selectively bred
      for offspring manifesting limb edema and low or amicrofilaremia. A high
      microfilaremic female mated to a high microfilaremic male produced 7 pups, 6 of
      which maintained mf greater than 1,000/ml for greater than 2 years after 5
      monthly infections of 10 infective larvae each. An uninfected female mated to
      another high mf male produced 5 pups, 4 of which did not exceed 1,000 mf/ml 7
      months after initiation of the repeating infection regimen; 1 of these remained
      amicrofilaremic after 2 additional challenges. Neither the parents nor the
      offspring from these matings manifested chronic limb edema. Two matings were
      conducted with offspring from the microfilaremic female by breeding siblings with
      the lowest mf and breeding siblings with the highest mf. The high mf siblings
      produced 4/5 offspring manifesting chronic limb edema (greater than or equal to 7
      months duration) and either no mf (in 2 dogs) or less than 100 mf/ml after the
      repeating infection regimen. The lower mf siblings produced 5 offspring, all with
      greater than 1,000 mf/ml 6 months after the initiation of the repeating infection
      regimen; none manifested edema. Comparisons of IgG antibody levels, specific for
      extracts of adult worms, showed no consistent differences between these 2 litters
      of dogs that could be associated with limb edema or mf when monitored for 16
      months; however, the onset of lymph node enlargement was much earlier in the
      group of dogs manifesting limb edema than in the other litter.

PMID- 2240374
TI  - Physical activity, opportunity for reinfection, and sibling history of heart
      disease as risk factors for Chagas' cardiopathy.
AB  - A case-control study was conducted to examine whether physical activity, sibling
      history of heart disease (HHD), and length of residence in an area endemic for
      Chagas' disease were associated with the risk of developing Chagas' cardiopathy.
      Two hundred forty-seven cases of Chagas' heart disease and 345 seropositive
      subjects with normal ECG (controls) were selected in a population survey in
      Goiania, Brazil. Prevalence ratios for exposure variables were estimated for
      cases in relation to controls and for subgroups of seropositives with selected
      ECG abnormalities in relation to controls. Increasing age and male sex were
      consistently and significantly related to an increased risk of ECG abnormalities.
      HHD was significantly associated with ECG alterations in 3 of the 5 comparison
      subgroups (any ECG alteration, right bundle branch block, and left anterior
      hemiblock). No association was found between length of residence in an area
      endemic, physical activity, and ECG abnormalities. A sample of 529 seronegative
      subjects were also examined and the interaction between exposure variables and
      seropositivity was tested to assess whether the associations found were specific
      for seropositives. Males were at greater risk of any ECG alteration and left
      anterior hemiblock in relation to females if they were seropositive. An
      increasing risk of ventricular premature beats with age was clearer for
      seropositive than for seronegative subjects. Subjects with HHD were at an
      increased risk of ECG abnormalities and this was greater in those with a positive
      serological test (P less than 0.05). The findings suggest a possible geographical
      clustering or a familial aggregation of cases of Chagas' heart disease.

PMID- 2240375
TI  - Recurrence rate after discontinuation of long-term mebendazole therapy in
      alveolar echinococcosis (preliminary results).
AB  - The recurrence rate was investigated in 19 patients with non-resectable alveolar
      echinococcosis after discontinuation of a long-term therapy with mebendazole
      (average treatment 4.3 years). A control group consisted of 14 patients who
      underwent radical surgery and finished a course of prophylactic postoperative
      mebendazole treatment of 2 years. In the controls, no recurrence was observed
      after a post-therapy period averaging 3.5 years. In contrast, recurrence occurred
      in 7/19 patients (37%) with non-resectable alveolar echinococcosis an average of
      1.6 years after discontinuation of the long-term mebendazole therapy. The absence
      of clinically detectable recurrence in the remaining 12 patients seems to be due
      either to spontaneous inactivation of alveolar echinococcosis preceding
      chemotherapy or too short post-therapy surveillance. The patients with recurrence
      responded favorably to reintroduction of chemotherapy. The data indicate that
      mebendazole therapy is parasitostatic rather than parasiticidal.

PMID- 2240377
TI  - The future of general surgery training.

PMID- 2240376
TI  - Increased abundance, size, and longevity of food-deprived mosquito populations
      exposed to a fungal larvicide.
AB  - To determine whether the quantity of food available to mosquitoes in their
      aquatic environment limits the effectiveness of microbial pathogens as biological
      control agents, experimentally well-nourished and malnourished larval Aedes
      aegypti (Linn.) were exposed to graded inocula of the entomopathogenic fungus,
      Metarhizium anisopliae. First instar larvae were provided access either to 3 or
      to 5 mg of food, and lots from each food regimen were inoculated with 20, 40, 60,
      or 80 micrograms of fungal spores/ml water. Application of the fungus to well
      nourished larvae reduced the proportion developing to the adult stage, and
      increased the size of those adults that developed; their survival was not
      affected. In the case of malnourished larvae, such applications appeared not to
      effect the proportion of larvae that matured, and, paradoxically, increased the
      size and longevity of these resulting adults. By destroying a portion of the
      larvae, the pathogen apparently reduced competition among malnourished larvae,
      thereby enhancing their survival, as well as the size of the resulting adults.
      Thus, biocontrol agents may fail when used as larvicides against such nutrient
      deprived mosquitoes as frequently occur in nature.

PMID- 2240378
TI  - Educational research in perspective.

PMID- 2240379
TI  - Amputation prevention in an independently reviewed at-risk diabetic population
      using a comprehensive wound care protocol.
AB  - An independent review panel composed of an orthopedic surgeon, a vascular
      surgeon, and an endocrinologist was convened to conduct a case history review.
      The 71 patients reviewed had 124 wounds on 81 limbs and participated in the
      comprehensive wound management program of the University of Minnesota. Based on
      their expertise, the review panel classified the wounds by severity and
      identified the limb's risk for amputation. The resulting scores were then
      compared with the patient's actual outcome. The review panel predicted 65 (80%)
      of the limbs would be salvaged and 16 (20%) would be amputated. The actual
      outcome was that 75 (93%) of the limbs were salvaged and 6 (7%) were amputated (p
      less than 0.005). The university's wound management program was highly
      successful, compared with the predictions of the reviewers.

PMID- 2240381
TI  - Immediate versus delayed shoulder exercises after axillary lymph node dissection.
AB  - A total of 144 evaluable patients with breast cancer were enrolled in a
      multicenter, randomized, prospective study to establish the role of delayed
      shoulder exercises on wound drainage and shoulder function after axillary lymph
      node dissection. Patients in group 1 (n = 78) started active shoulder exercises 1
      day postoperatively. Patients in group 2 (n = 66) started on the eight
      postoperative day, following 1 week of immobilization of the arm. Patients in
      group 2 had 14% less wound drainage volume than those in group 1 (600 +/- 436 mL
      versus 701 +/- 398 mL); this difference, however, was not significant. Also, no
      differences could be established between the two groups when duration and volume
      of wound drainage, number and volume of seroma aspirations, wound complication
      rates, and shoulder function were compared 6 months after surgery.

PMID- 2240380
TI  - Algorithm for assessing renal dysfunction risk in critically ill trauma patients
      receiving aminoglycosides.
AB  - A recent retrospective study proposed that the following screening criteria be
      used in identifying critically ill trauma patients receiving aminoglycosides who
      are at significant risk to develop renal dysfunction: (1) post-admission shock,
      (2) minimum serum concentration more than 2 mg/L, and (3) diagnosis of
      septicemia. The major purpose of the present study was to validate these criteria
      and design a corresponding algorithm for clinical use. All patients admitted to a
      trauma intensive care unit and receiving an aminoglycosides was also studied. All
      patients studied over a 7-month period. A control group not receiving
      aminoglycosides was also studied. All patients were evaluated for the presence of
      renal dysfunction (i.e., serum creatinine increase greater than or equal to 0.5
      mg/dL). Univariate and multivariate statistical analyses were used to compare
      potential associated risk factors. The overall renal dysfunction incidence was
      10% in the treatment patients (n = 93) versus 5% in the control patients (n =
      199) (p = 0.13). Sensitivity and specificity of the screening criteria were 67%
      and 92%, respectively. The predictive values of a positive and negative test
      relative to correctly labeling patients at high risk or low risk to develop renal
      dysfunction were 46% and 96%, respectively. Major risk factors associated with
      renal dysfunction in the treatment group were post-admission shock, minimum serum
      concentration more than 2 mg/L, and liver dysfunction. Use of three major risk
      factors has excellent predictive value in identifying severely traumatized
      patients at low risk for developing renal dysfunction while receiving
      aminoglycosides. The modest predictive value of a positive test results in
      conservative management of patients by avoidance of aminoglycosides, i.e., use of
      alternative antimicrobial agents.

PMID- 2240383
TI  - Pouch outlet obstruction following vertical ring gastroplasty for morbid obesity.
AB  - We have experienced a 14% (38 of 264 patients) incidence of pouch outlet
      obstruction following vertical ring gastroplasty. Initial management consisted of
      dilatation in 34 of 38 patients (94%). Ten of 34 patients (29%) were spared
      reoperation by 1 to 3 dilatations. Non-passage of an endoscope through the stoma
      immediately following dilatation predicted the need for surgery; 4 of 11 patients
      (36%) with passage underwent reoperation compared with 17 of 20 patients (85%)
      without passage (p less than 0.02). Surgical findings included "tipped bands" in
      9 of 28 patients (32%); fibrous reaction to the band in 10 of 28 patients (36%);
      adhesions with angulation of the pouch in 2 of 28 patients (7%); and no
      identifiable cause of obstruction in 7 of 28 patients (25%). Surgical therapy
      consisted of removal of the band (2 patients), removal of the band and
      replacement with a similar length or larger band (20 patients), "tacking" the
      band in the horizontal position (4 patients), or conversion to a Roux-Y bypass (2
      patients). The first three options were associated with an unacceptably high rate
      of weight regain and/or continued symptoms, whereas the last-named procedure met
      with good success.

PMID- 2240382
TI  - Fish oil supplementation in patients with stable claudication.
AB  - Increased blood viscosity occurs in patients with claudication. This increase in
      viscosity, which is mainly due to elevated fibrinogen levels and a decreased red
      cell deformability, adversely influences blood flow. In addition to a positive
      effect on blood pressure, blood lipids, and platelet responsiveness, fish oil may
      improve blood flow due to a favorable influence on hemorrheology. In a
      prospective, randomized, double-blind study, we evaluated the effect of six
      capsules of fish oil (1.8 g eicosapentaenoic acid and 1.2 g docosahexaenoic acid)
      versus six capsules of corn oil (3 g linoleic acid), administered for 4 months,
      on walking distances, pressure indices during rest and after exercise, blood
      pressure, red cell deformability, fibrinogen, and lipid levels in 32 patients
      with stable claudication. No significant changes in walking distances and
      pressure indices during rest and after exercise occurred, despite a significant
      increase in red cell deformability in the fish oil group. Fibrinogen levels did
      not change in either group. In the fish oil group, a favorable change in blood
      lipids was noted; high-density cholesterol increased and triglycerides decreased.
      Mean arterial blood pressure declined to a similar extent in both groups. Thus,
      short-term supplementation with fish oil does not lead to clinically significant
      improvement of symptoms in patients with stable claudication. This suggests that
      red cell deformability is of minor importance in the arterial blood flow in the
      legs of these patients.

PMID- 2240384
TI  - An outpatient anticoagulation protocol managed by a vascular nurse-clinician.
AB  - Lifetime anticoagulation has become a therapeutic option for surgical patients
      with hypercoagulable states or prosthetic arterial bypass grafts. However,
      physicians may not achieve optimal anticoagulation or may attempt to limit the
      length of the therapy period because of the perceived morbidity from hemorrhagic
      complications of Coumadin therapy. A protocol for anticoagulant therapy monitored
      and regulated by a vascular nurse-clinician was reviewed. Coumadin was prescribed
      for 1,891 patient-months to 93 patients to maintain their prothrombin time 1.5 to
      2 times control (range: 18 to 24 seconds). The mean (+/- SD) prothrombin time for
      the study population was 19.8 +/- 1.8 seconds. During follow-up, 472 (14%) of
      3,479 prothrombin times measured were below the therapeutic range (n = 232) or
      prolonged (n = 240), prompting an adjustment in the Coumadin dose in 82 (88%)
      patients. Four patients developed recurrent vascular graft thrombosis while
      receiving anticoagulation. There were 6 major and 11 minor hemorrhagic
      complications. Patients with a chronic risk for arterial or venous thrombosis can
      have out-patient anticoagulant therapy administered at optimal intensity and
      regulated safely with a low incidence of hemorrhagic and thrombotic events.

PMID- 2240385
TI  - Comparison of blood flow assessment between laser Doppler velocimetry and the
      hydrogen gas clearance method in ischemic intestine in dogs.
AB  - Blood flow of the colon and the ileum was measured before and after intestinal
      devascularization by laser Doppler velocimetry and the hydrogen gas clearance
      technique in 10 dogs in order to evaluate the clinical usefulness of laser
      Doppler velocimetry. The submucosal blood flow of the colon and the ileum
      measured by the hydrogen gas clearance method was significantly decreased, as was
      the subserosal blood flow of both sites measured by laser Doppler velocimetry.
      There was a linear relationship between the flow values using the two methods
      both in the colon (r = 0.7192, p less than 0.001) and in the ileum (r = 0.7646, p
      less than 0.001). These data suggested laser Doppler velocimetry may be a useful
      method to assess the degree of intestinal ischemia because of its noninvasiveness
      and good correlation with submucosal blood flow by the hydrogen gas clearance
      technique.

PMID- 2240386
TI  - Hypothermia and acidosis worsen coagulopathy in the patient requiring massive
      transfusion.
AB  - Massive transfusion may cause abnormalities of electrolytes, clotting factors,
      pH, and temperature and may occur in a scenario of refractory coagulopathy and
      irreversible shock. Identification of correctable variables to improve survival
      is complicated by the interplay of this pathophysiology. Temperature may be an
      under-appreciated problem in the genesis of coagulopathy. In vitro studies have
      demonstrated that platelet function and vascular response are critically
      temperature-dependent. We reviewed the records of 45 trauma patients without head
      injury or co-morbid medical illness who required massive transfusions. The mean
      Injury Severity Score was 55 +/- 6, a mean of 22.5 +/- 5 units of blood was
      transfused, and mortality was 33%. Nonsurvivors were more likely to have had
      penetrating injury (88% versus 55%), received more transfusions (26.5 +/- 9
      versus 18.6 +/- 1, p less than 0.05), had lower pH (pH 7.04 +/- 0.06 versus 7.18
      +/- 0.02, p less than 0.05), had lower core temperature (31 +/- 1 degree C versus
      34 +/- 1 degree C, p less than 0.01), and had a higher incidence of clinical
      coagulopathy (73% versus 23%). Severe hypothermia (temperature less than 34
      degrees C) occurred in 80% of the nonsurvivors and in 36% of survivors. Patients
      who were hypothermic and acidotic developed clinically significant bleeding
      despite adequate blood, plasma, and platelet replacement. Avoidance or correction
      of hypothermia may be critical in preventing or correcting coagulopathy in the
      patient receiving massive transfusion.

PMID- 2240387
TI  - Relationship of oxygen dose to angiogenesis induction in irradiated tissue.
AB  - This study was accomplished in an irradiated rabbit model to assess the
      angiogenic properties of normobaric oxygen and hyperbaric oxygen as compared with
      air-breathing controls. Results indicated that normobaric oxygen had no
      angiogenic properties above normal revascularization of irradiated tissue than
      did air-breathing controls (p = 0.89). Hyperbaric oxygen demonstrated an eight-
      to ninefold increased vascular density over both normobaric oxygen and air
      breathing controls (p = 0.001). Irradiated tissue develops a hypovascular
      hypocellular-hypoxic tissue that does not revascularize spontaneously. Results
      failed to demonstrate an angiogenic effect of normobaric oxygen. It is suggested
      that oxygen in this sense is a drug requiring hyperbaric pressures to generate
      therapeutic effects on chronically hypovascular irradiated tissue.

PMID- 2240388
TI  - Variations in sensitivity after sectioning the intercostobrachial nerve.
AB  - The authors present a prospective study of the variations in sensitivity that
      appear in the armpit and arm after the intercostobrachial nerve has been
      sectioned in a modified radical mastectomy. Of a total of 208 patients studied
      between 1978 and 1987, the intercostobrachial nerve was sectioned in 139
      patients, whereas in 30 it remained intact; in 39 patients only peripheral
      branches of the nerve were sectioned. The patients were examined at regular
      postoperative intervals in order to evaluate their sensitivity both to touch and
      to pain in the axilla and arm. Four hundred thirty-three examinations were
      carried out and the 3 operative groups were assessed accordingly. After the nerve
      was sectioned, there was increasing anesthesia in the armpit and hypoesthesia on
      the posterointernal face of the arm, while for the patients in whom the
      intercostobrachial nerve remained intact, these alterations were less intense and
      long-lasting. Significant statistical differences between the two groups also
      exist. In the absence of axillary lymphatic ganglia infiltrated by the tumor, the
      conservation of the intercostobrachial nerve is recommended.

PMID- 2240389
TI  - Surgical management of the redundant transposed colon.
AB  - Redundancy of the transposed thoracic colon is not uncommon. Rarely, however,
      when accompanied by severe symptoms, it may necessitate surgical correction. We
      describe herein a surgical technique that allows the stretching and straightening
      of the redundant transposed organ.

PMID- 2240390
TI  - Rectal prolapse in infants and children.
AB  - Rectal prolapse that is intractable to the usual medical therapy was successfully
      managed without significant complications in 10 patients by simple subcutaneous
      encirclement of the anus with a heavy nonabsorbable suture, which was in place
      until the suture was removed or broke after 4 to 6 months. Four patients required
      two sutures and one needed a third insertion. Since this procedure is simple, has
      no serious complications, and controls rectal prolapse, it is recommended as the
      preferred initial surgical treatment of this condition.

PMID- 2240391
TI  - Prevention of pancreatic fistula by modified pancreaticojejunal anastomosis.
AB  - A major cause of morbidity after pancreatoduodenectomy is leakage from the
      pancreaticojejunal anastomosis. To prevent this complication, we have employed
      mucosal stripping from the proximal jejunum prior to end-to-end anastomosis in 19
      patients with good results.

PMID- 2240392
TI  - Role of surgery in antibiotic-induced pseudomembranous enterocolitis.
AB  - With the increased use of prophylactic and broad-spectrum antibiotics,
      pseudomembranous colitis has emerged as a significant clinical problem.
      Management with specific anti-Clostridium difficile therapy (vancomycin or
      metronidazole) has reduced mortality to less than 2%. Nevertheless, the disease
      may progress to a fulminant toxic colitis or colonic perforation. Additionally,
      another subset of patients will present with a dramatic clinical picture,
      suggesting acute peritonitis, eventuating in unnecessary laparotomy. This report
      reviews both the medical and surgical literature during the past 15 years of
      patients treated for pseudomembranous colitis. Analysis of this clinical data has
      provided us with the opportunity to both define the role of surgery in this
      disorder and illustrate the necessity for a combined medical and surgical
      cooperative approach in the early management of this iatrogenic disease.

PMID- 2240393
TI  - Acute pancreatitis after experimental pancreatic transplantation.

PMID- 2240394
TI  - Various materials used for hernia repair.

PMID- 2240395
TI  - [Anesthesia of wild animals using hypodermic devices].
AB  - Narcosis of wild animals, using projectile arms has modified and simplified
      considerably the restraint it was inevitably made under stress conditions for the
      animals before. The sedative drugs used have an analgesic effect which give us
      the opportunity to be able to practise some surgeries directly in the outside or
      inside enclosure of the animals. In the meantime, animal approach should be done
      carefully and the behavior of the zoologist before and after the shooting is the
      main key of success.

PMID- 2240397
TI  - [Communication networks in great natural disasters].
AB  - A great natural disaster destroys every energy supplies and the communication
      network necessary for the organisation of health care (telephone, telex) is
      entirely or partially not functioning. It becomes impossible to be informed about
      the hospitals and others sanitary availabilities in the disaster area. Our
      personal experience, during the El Asnam's and Mexico's earthquakes demonstrates
      the necessity to maintain a functioning network for sanitary use. The unique
      possibility is the availability of portable, battery operated radio-transmitters.
      It is necessary to have these equipment in all hospitals and health centers in
      the area of a previsible disaster. A good scheduled training is necessary for the
      medical and paramedical personal of these areas.

PMID- 2240396
TI  - [Particularities of the anesthesia of domestic carnivora].

PMID- 2240398
TI  - [Value of the 2000 radiocom system for a SAMU in a rural area].
AB  - The department "Meuse" is a region with a low density of population (190,000
      inhabitants). The creation of a "SAMU" is quite recent (February 1988). The
      financial means allowed were limited so they didn't enable us to develop a radio
      netword peculiar to the "SAMU". The arguments which made us adopt the use of the
      2000 Radiocom as a basic means of communication for "SAMU 55" are: immediate
      creation; reduced installation cost; preservation of the medical secret and
      possibility of extension.

PMID- 2240399
TI  - [Value of the radionetwork of the transportation company in Besancon for alarm
      forwarding].
AB  - The C.B. users offered for a few years a way for putting-out the distress on the
      highway. There were 2,000 in Besancon and surroundings in 1982. Today they are
      becoming no existent. Since then a new system of alarm run is born with 150
      buses, 178 kilometers of net-travel and a sweep frequency of 10 min from 6h30
      a.m., to 8h p.m, and of 30 min until 12h p.m. The 250 "C.T.B." drivers assume a
      regular surveillance of the urban and suburban highways. A standard message in
      used between the C.T.B. (Besancon Company of Buses.) regulation and Samu 25,
      regulation which allows to fix circumstances, place of road accident and
      inventory of casualties: 27 emergency calls are received in 1987, 50 in 1988. It
      might be possible to use other private or public radiotelephonic network.

PMID- 2240400
TI  - [10 fatal endocarditis: autopsy observations, causes of death].
AB  - Among 841 autopsies realized between january 1982 and september 1988, by the
      Pathological the department of Amiens University Hospital the ten patients dead
      of infectious endocarditis have been autopsied. Macroscopic and microscopic
      observations have two cases of acute endocarditis and eight of subacute
      endocarditis. For the two patients dead of acute endocarditis, autopsy affirms
      the cardiovascular etiology of death. For the eight cases of subacute
      endocarditis, necropsic findings differs from the germs. In the three cases where
      the germ is a Staphylococcus aureus, the diagnosis of endocarditis was made
      before death and the cardiovascular etiology of death was affirmed by autopsy.
      For the other germs (3 Streptococcus sp, 1 Salmonella typhimurium, and 1 germ
      unknown), the diagnosis of endocarditis was made by autopsy, but necropsy
      disclosed the cause of death in only two cases.

PMID- 2240401
TI  - [Accidental hypothermia in adults: taking charge by the SAMU of Paris].
AB  - Thirty one cases of accidental hypothermia have been taken in care by the SAMU de
      Paris during the year of 1987. The accidental hypothermias happening in the
      cities are, most of the time, moderated and not very serious. The search for a
      cause is a prime necessity. The prognosis is based on that search to guide and
      advise the patients.

PMID- 2240402
TI  - [Current practice of drug trials in healthy volunteers].
AB  - It is impossible to extrapolate for men the animal's data. Pre-therapeutical
      studies are a necessity to state precisely in man ADME for a new drug and to
      confirm pharmacological properties seen in animals. Very often, the only healthy
      volunteers are useful for Phase 1 studies: The selection of volunteers keeps
      physical and metabolic status, and psychological motivation. True but restricted
      information is necessary for "free and informed consent". Rights and duties must
      be clearly defined in written convention. Financial advantages are in agreement
      of trouble but not of hazard in the study. The safety is the main point in human
      studies. That means a safe methodology and a protocol approved by independent
      ethical committee. The monitoring of these studies must be precisely conducted
      with many clinical and laboratory examinations. Healthy volunteers studies are
      required by French Ministry of Health, rejected by medical law, condemned by
      civil law but covered by legal insurances. In French mind is illicit that is not
      specifically permitted by law. We need special legislation as we refuse medical
      and ethical responsibility.

PMID- 2240403
TI  - [Repetitive inhalation anesthesia in rats].
AB  - Inhalational anesthesia in the rat seems a good process, by a rapid induction and
      awakening if a steady state ventilation-perfusion ratio and no pollution are
      obtained. Animals are cooped up in an "induction-box" which is joined to a
      scavenger system. Anesthesia maintenance is assumed with a Bain circuit and
      allows short and frequent anesthesia. Isoflurane does not markedly decrease
      circulatory and respiratory factors at low concentration (2%). So any
      anaesthetist can do himself such a practical system.

PMID- 2240404
TI  - [Flumazenil and volatile anesthetics. Study of possible interferences in rats].
AB  - Many works suggest contradictory experimental or clinical results of flumazenil
      effects during inhalation anaesthesia. In ten rats anaesthesia was induced with
      5% isoflurane or halothane during one minute and maintained during 5 minutes with
      1% the same halogene anaesthetic in 50% N2O and O2. Then 0.2 mg of flumazenil or
      a same volume of placebo were administered intraperitoneally and during the last
      5 minutes, the rats were exposed in 1% volatile anesthetic gas flow. Sleep times
      were measured in terms of reestablishment of the righting reflex. Each rat was
      anesthetized four time: halothane and isoflurane, with flumazenil or placebo. In
      those conditions, there were no significant changes in sleep times either the
      anaesthesia were associated, with flumazenil or with placebo.

PMID- 2240405
TI  - [Prevention of venous thrombosis in neurosurgery].
AB  - Prophylaxis of thromboembolism in the neurosurgical patient remains a difficult
      problem as anticoagulant treatment increases the inherent risk of hemorrhage into
      the operative site. This review report the incidence of lower extremity deep vein
      thrombosis given in the literature, and the results of an european investigation
      realised during september 1988.

PMID- 2240406
TI  - [Epidemiology and etiopathogenesis of deep venous thrombosis of the lower limbs].
AB  - Deep venous thrombosis and pulmonary embolism are frequent complications of
      surgery. A careful evaluation of both the thromboembolic and the haemorrhagic
      risks depends on the type of intervention and associated individual risk factors.
      Such an evaluation should allow allocating the patient to an appropriate
      prevention which consists of mechanical and/or pharmacological means.

PMID- 2240407
TI  - [Hip arthroplasty and thromboembolic complications].
AB  - Orthopedic department of Centre hospitalo-universitaire de Brest use one upon
      another two procedures: from 1974 to 1984, for 1287 cases the prevention of
      thromboembolic complications is done with the help of subcutaneous heparin at
      standard dose during 12 days; the clinical diagnosis in confirmed by an isotopic
      phlebography and isotopic lung scan. In 1986 and 1987, for 391 cases this
      prevention is done with the help of subcutaneous heparin in adapted doses during
      21 days; the clinical diagnosis is confirmed by X ray phlebography and isotopic
      lung scan. The frequency of thromboembolic complications has been 4.6% in the
      first period and 1.2% in the second period. This results confirm the role of
      heparin in preventing post operative thromboembolic complications after total hip
      replacement. The results after knee arthroplasty are not so good.

PMID- 2240408
TI  - [Spinal anesthesia and prevention of thrombosis by heparin].
AB  - Non traumatic spinal hematomas are a rare pathology, anticoagulant treatments are
      one of their most frequent etiology. Therefore, the association of spinal
      anesthesia and a preventive treatment which has antithrombotic aim by the use of
      subcutaneous heparin (non fragmented or low molecular weight) is being discussed
      by many authors. It is lawful to associate spinal anesthesia with a soft dose of
      non fragmented subcutaneous heparin (Kakkar method) if the protocols are strictly
      respected. It is certainly possible to use low molecular weight subcutaneous
      heparin as well. However a slight decline in their use urges anyone to be very
      cautious.

PMID- 2240409
TI  - Pathology of peripheral vestibular disorders in the elderly.
AB  - A clinical classification of vertigo commonly seen in the elderly and caused by
      peripheral vestibular disorders is illustrated by case reports and temporal bone
      histopathology. The classification includes inducible transient vertigo and
      noninducible protracted vertigo. The peripheral vestibular pathology includes
      abnormalities of sensory, neural, and mechanical structures and is often
      asymmetric. The pathogenesis of these disorders is often speculative, but
      includes degenerative, infectious, neoplastic, and vascular insults to the
      vestibular labyrinth.

PMID- 2240410
TI  - Schwann cells associated with vestibular ganglion cells in the aging rat.
AB  - The purpose of this study was to quantify any age-related change in the
      components of Schwann cells associated with vestibular ganglion cells:
      adperikaryonal Schwann cell cytoplasm, myelin bubbles, compact myelin, Schwann
      cell lipofuscin, or mitochondria in addition to extracellular intraganglionic
      space. Studies were carried out in young (Y, 3 to 5 months of age, N = 6), old
      (0, 24 to 26 months of age, N = 3), and very old (VO, 28 to 31 months of age, N =
      6) female Wistar rats using point counting stereologic techniques. Recent reports
      have demonstrated age-related increases in the peripheral nerve counterparts to
      the following entities: adaxonal Schwann cell cytoplasm, myelin bubble,
      endoneurial space, and a decrease in Schwann cell mitochondria. Our results
      indicate no age-related change in the volume fraction of extracellular
      intraganglionic space (Y, 0.179 +/- 0.04; O, 0.174 +/- 0.049; VO, 0.205 +/-
      0.043), adperikaryonal Schwann cell cytoplasm (Y, 0.026 +/- 0.008; O, 0.019 +/-
      0.003; VO; 0.028 +/- 0.007), myelin bubble (Y, 0.004 +/- 0.003; O, 0.011 +/-
      0.009; VO, 0.006 +/- 0.002), Schwann cell lipofuscin (Y, 0.002 +/- 0.001; O,
      0.004 +/- 0.003; VO, 0.002 +/- 0.001), or mitochondria (Y, 0.194 +/- 0.019; O,
      0.208 +/- 0.024; VO, 0.205 +/- 0.04). The only age-related change was an increase
      in compact myelin (Y, 0.006 +/- 0.001; O, 0.008 +/- 0.006; VO, 0.011 +/- 0.004).
      These findings differ from those of the peripheral nerve.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2240411
TI  - Distortion product otoacoustic emissions in normal and hearing-impaired ears.
AB  - Otoacoustic emissions of distortion products (DPOAE's) were recorded in normal
      and hearing-impaired human ears using relatively straightforward methods. Two
      pure-tone stimuli at fixed frequency levels of 73 dB HL for f1 and of 67 dB HL
      for f2 were used. The frequencies of the two primaries were chosen so that their
      geometric mean represented standard audiometric frequencies. Measurements of the
      emission amplitudes at 2f1-f2 and the adjacent noise floor were achieved by
      spectral averaging. A total of 101 subjects (199 ears) were tested. Seventy-seven
      ears in 46 subjects had normal hearing (hearing levels less than or equal to 20
      dB at standard audiometric frequencies; average hearing levels, less than or
      equal to 10 dB). Thirty-six ears in 25 subjects had near-normal hearing (no
      hearing complaints, hearing levels less than or equal to 40 dB; average hearing
      levels, less than or equal to 20 dB). No significant differences in mean DPOAE
      values were apparent between these two groups of ears. All but two of these 113
      ears (98%) showed emissions at three or more of the six frequencies tested
      between 1 and 6 kHz. Emissions were detected in more than 75% at each frequency
      between 1 and 6 kHz and in more than 85% between 1 and 4 kHz. A further 86 ears
      in 44 subjects exhibited varying degrees of sensorineural hearing loss caused by
      different pathologies. In general, emission amplitudes approximated the shapes of
      the audiograms, and a highly significant correlation between hearing thresholds
      and emission amplitudes was demonstrated in the frequency range of 1 to 4
      kHz.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240412
TI  - Osteoradionecrosis of the mandible: pathogenesis.
AB  - Although the precise pathogenic mechanisms are not fully understood,
      osteoradionecrosis of the mandible is caused by radiation-induced cellular
      injury, ultimately resulting in a chronic, nonhealing wound. This etiology does
      not explain the strong predisposition of the mandible to radionecrosis relative
      to the maxilla, and overlooks the contribution of ischemic necrosis due to
      radiation-induced disturbances in circulation. In this study, irradiated
      mandibles with and without osteoradionecrosis and nonirradiated mandibles were
      examined histologically. Our findings show that osteoradionecrosis of the
      mandible is an ischemic necrosis due to radiation-induced obliteration of the
      inferior alveolar artery, while revascularization by branches of the facial
      artery is disturbed by radiation-induced vascular disease and periosteal damage.
      The most vulnerable part of the mandible is the buccal cortex of the premolar,
      molar, and retromolar regions.

PMID- 2240413
TI  - Effect of electrical stimulation on middle latency response in the guinea pig.
AB  - A temporary threshold shift (TTS) has been demonstrated in the electrically
      evoked middle latency response (EMLR) following exposure to moderate levels of
      continuous electrical stimulation via a cochlear implant. The threshold at which
      the EMLR was elicited in chronically implanted guinea pigs was elevated by
      approximately 100% following 30 minutes of moderate intensity (200 microA or
      more) sinusoidal electrical stimulation of the cochlea. Results obtained under
      anesthesia varied unacceptably. In awake animals, EMLR thresholds were stable
      over time and consistent TTSs were observed. The threshold returned to
      prestimulation levels within 4 hours following termination of the stimulation.
      The possibility of histopathologic changes and the relevance of these findings in
      setting safe output levels for cochlear implant processors are discussed.

PMID- 2240414
TI  - Pharyngoesophageal intubation injuries: three case reports.
AB  - The hypopharynx and cervical esophagus are particularly vulnerable to intubation
      trauma. Contributing factors include hasty intubation by inexperienced personnel;
      the use of curved, beveled endotracheal tubes containing stylets; malpositioning
      of the head, and the application of cricoid pressure. Iatrogenic
      pharyngoesophageal perforations may go unsuspected until characteristic signs and
      symptoms are recognized. These include cervical pain, fever, dysphagia,
      leukocytosis, subcutaneous emphysema, and pneumomediastinum. We present three
      cases that illustrate important points in recognizing, evaluating, and treating
      pharyngoesophageal perforations. The third case presents a chronic cervical
      esophageal perforation with secondary pseudodiverticulum, requiring resection of
      the pseudodiverticulum and a primary sternocleidomastoid muscle flap repair of
      the cervical esophageal defect. To our knowledge, this technique has not
      previously been reported.

PMID- 2240415
TI  - Tumors of diverse histology are sensitive to rhodamine 123 laser phototherapy in
      vitro.
AB  - Rhodamine 123 has been shown to be an efficient photosensitizer for the argon
      laser treatment of a human squamous carcinoma and a melanoma cell line in vitro.
      Rhodamine 123 laser phototherapy also eradicates these human squamous cell
      carcinomas when grown as subcutaneous tumor transplants in athymic mice. This
      study extends these observations by testing a panel of 19 human tumor cell lines
      of various histologic origins for in vitro sensitivity to rhodamine 123 and the
      argon laser. Rhodamine 123 with an absorption maxima of 502 nm in water was found
      to undergo a redshift to 516 nm after uptake by the mitochondria of human tumor
      cells. Rhodamine 123-sensitized brain tumor cells were inhibited by over 80%
      after 15 seconds and by 98% after 60 seconds of laser exposure (514.5 nm, 4 W,
      Tmax = 39 degrees C), as measured by reduced [3H]thymidine incorporation into
      cellular DNA. Laser or rhodamine 123 alone did not significantly inhibit (greater
      than 20%) tumor cell [3H]thymidine uptake. Sensitization with 20 micrograms
      rhodamine 123 for 1 hour before 45 seconds of laser illumination decreased cell
      [3H]thymidine uptake by 40% to 99% in four melanoma lines, five carcinomas, five
      leukemias, and four of five other human tumor lines. Two melanomas, two
      leukemias, and a lymphoma cell line also exhibited a 70% to 80% reduction in
      [3H]thymidine uptake after sensitization in vitro with 1 microgram/mL rhodamine
      123 and laser illumination. Rhodamine 123-sensitized tumor cells were inhibited
      even more strongly by fractional dose laser irradiation at nonthermal
      temperatures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240417
TI  - Clinical radiology quiz. Case no. 7.

PMID- 2240416
TI  - Parathyroid carcinoma: clinical presentation and treatment.
AB  - Parathyroid tumors account for only a small percentage of all head and neck
      neoplasms. The overwhelming majority of these are parathyroid adenomas that
      result in primary hyperparathyroidism. From 0.5% to 4% of hyperparathyroid
      patients, however, will be found to have a parathyroid carcinoma. In this paper,
      the authors relate their recent experience with such a patient and with two other
      such cases. Parathyroid carcinoma patients usually present with striking
      hyperparathyroidism and hypercalcemia, with the resultant related symptoms being
      more severe than those associated with parathyroid adenomas. Parathyroid
      carcinomas also tend to be large and may be detectable by current imaging
      techniques. The surgical appearance of these lesions is also distinct; the tumors
      are frequently multilobulated, gray-tan in color, quite firm, and often invasive.
      These physical findings are important since frozen section diagnosis may be
      difficult. The final histologic diagnosis depends on the presence of mitotic
      figures and capsular and vascular invasions. Preoperative medical problems,
      surgical approach, and prognostic factors are also discussed.

PMID- 2240418
TI  - The intensive psychoanalytic psychotherapy of a severe narcissistic personality
      disorder in adolescence.

PMID- 2240419
TI  - The family in treatment during the long-term inpatient care of the adolescent.

PMID- 2240420
TI  - The American educational system and the psychological development of the
      adolescent.

PMID- 2240421
TI  - Running away from treatment: observations and admission predictors for
      hospitalized adolescents.

PMID- 2240422
TI  - Reflections on the hospital treatment of adolescents at Chestnut Lodge.

PMID- 2240423
TI  - Developmental issues in young adulthood: psychoanalytic perspectives.

PMID- 2240424
TI  - The cohesive self, the nuclear self, and development in late adolescence.

PMID- 2240425
TI  - In defense of parents.

PMID- 2240426
TI  - Object relations in borderline adolescents and adults: developmental differences.

PMID- 2240427
TI  - Developmental anxieties in adolescence.

PMID- 2240428
TI  - Consistency and change in personality characteristics and affect from middle to
      late adolescence.

PMID- 2240429
TI  - Violence and unrestrained behavior in adolescents.

PMID- 2240430
TI  - Panic disorder in children and adolescents: a review with examples.

PMID- 2240431
TI  - Who mothers young mothers? Treatment of adolescent mothers and their children
      with impaired attachments.

PMID- 2240432
TI  - Adolescents in residential treatment: a six-year comparison.

PMID- 2240433
TI  - Non-self-controlled adolescents: applications of cognitive-behavioral therapy.

PMID- 2240434
TI  - Revenge or tragedy: do nerds suffer from a mild pervasive developmental disorder?

PMID- 2240436
TI  - The evolution of two-tiered health care.

PMID- 2240437
TI  - The termination of treatment in adolescents.

PMID- 2240438
TI  - The long-term setting.

PMID- 2240435
TI  - The first few minutes: the engagement of the difficult adolescent.

PMID- 2240439
TI  - [Informative value of Doppler ultrasonography in predicting the development of
      gestoses and fetal growth retardation syndrome].
AB  - Doppler studies in 102 women with uncomplicated pregnancies have indicated that
      uteroplacental and fetoplacental circulations as low-resistant vascular systems
      develop at 13-16 week's gestation. Doppler examination early in the second
      trimester allows one to identify hemodynamic disorders in the materno-placental
      fetal unit and predict their onset as well as toxemia of pregnancy and
      intrauterine growth retardation.

PMID- 2240440
TI  - [Use of hyperbaric oxygenation in the prevention of functional uterine disorders
      in pregnant women with gestoses].
AB  - Rheography revealed abnormalities of uterine hemodynamics in 71 women with
      toxemia of pregnancy. Three-five hyperbaric oxygenation treatments as part of the
      management were found to be associated with a significant improvement of its
      efficacy and normalization of hemodynamic status. Longer regimens of hyperbaric
      oxygenation resulted in a persistent increase in peripheral vascular resistance.

PMID- 2240441
TI  - [Organization of intensive therapy of eclampsia and eclamptic coma].
AB  - This is an overview of counselling, medical and methodological assistance given
      to obstetric facilities of the Moscow region during 10 years. It is concluded
      that regional obstetric-gynecologic centers should be established, which
      incorporate an intensive care unit and a mobile resuscitation team.

PMID- 2240442
TI  - [Use of helium-neon laser irradiation in prenatal prevention of uterine inertia].
AB  - This paper reports results of clinical and experimental studies which sought to
      validate endonasal laser treatment for prevention of dysfunctional labor in late
      toxemia. Electrophysiologic and histochemical studies showed stimulating effects
      of the helium-neon laser treatment on function of large cell hypothalamic nuclei
      and uterine contractility. Clinical efficiency of this treatment was seen as a
      lower incidence of dysfunctional labor and cesarean section.

PMID- 2240443
TI  - [Weight gain during pregnancy in relation to somatic types of women].
AB  - The paper presents findings on weekly weight gain in pregnant women as related to
      constitutional make-ups. Normal and apparently normal pregnant women who were
      followed up at an antenatal clinic from 7-8 to 40-41 week's gestation have been
      assigned at the beginning of pregnancy to three weight groups: normal body
      weight, excessive body weight due to increased fat deposition and deficient body
      weight. Anthropometric measurements at 7-8, 25-26 and 36-37 weeks showed that
      weight gain and fat accretion were highest in pregnancies with an initial
      deficient body weight and lowest in pregnant women with adiposity. Correlation
      analysis suggested that there was a relationship between the maternal body
      weight, gestational weight gain and neonatal birthweights. Since women with
      initial deficient body weights have a wider range of weight gain, as compared
      with other somatic types, dietary restriction counselling should be cautious and
      adequate.

PMID- 2240444
TI  - [Prognostic value of the data of ultrasonographic diagnosis of uterine hemorrhage
      during pregnancy in patients with threatened abortion].
AB  - Ultrasonographic follow-up of 240 pregnant women with congenital and acquired
      uterine malformations in 135 (56.3%) of them has detected bleedings at various
      gestational dates. Ultrasonographic correlates of bleedings were ascertained.
      Bleedings proved to be a significant determinant of outcome. Profuse transient
      bleedings were associated with a 2-3-fold higher risk of spontaneous abortion and
      premature delivery while longer and scarce bleedings correlated with a higher
      incidence of ++non-progressing pregnancy. A low placenta insertion was found in
      50-65% of the patients. This evidence indicates a need for early identification
      of pregnancies with low placenta insertion in order to prevent bleedings.
      Ultrasonography is essential for appropriate hemostatic and corrective therapy.

PMID- 2240445
TI  - [Use of UV-irradiated autologous blood in obstetrics and gynecology].

PMID- 2240446
TI  - [Differential prevention of recurrence of thrombosis during pregnancy].
AB  - Pregnancy in patients with a history of thrombotic complications puts them at a
      great risk of thrombosis and obstetric complications (hypoxia, intrauterine
      hypotrophy, bleedings). Functional strain of the hemostasis system occurs at the
      onset of pregnancy in women with a history of thrombotic complications without
      clinical symptoms of thrombosis. The incidence of disseminated intravascular
      coagulation with activation of both pro-coagulation and platelet-mediated
      hemostasis is 33% and that with activation of only platelet-mediated hemostasis
      is 64%. Differential use of antithrombotic drugs prevents thrombosis recurrence
      in 98% of patients.

PMID- 2240447
TI  - [Effect of maternal genotype characteristics on fetal adaptation to intra- and
      extrauterine conditions].
AB  - Effects of the maternal genotype on the fetal and neonatal compensatory-adaptive
      patterns have been examined in 1396 newborns. Correlations were found between the
      ante- and intrapartum progress, physical development of the newborns, early
      neonatal course and the maternal phenotype. Maternal-fetal compatibility was
      found to influence the neonatal status and later morbidity and mortality. The
      maternal phenotype should be considered in the evaluation of risks during the
      development of medical and preventive activities.

PMID- 2240448
TI  - [Recording of fetal respiratory movements based on studying the shifting of the
      amniotic fluid in the trachea by the Doppler effect].
AB  - Examination of 80 women in their third trimester with chronic fetal abnormalities
      has shown that movement of the amniotic fluid in the fetal trachea can be
      detected during fetal respirations. The pattern of amniotic fluid velocity is
      significantly affected by chronic fetal stress. Evaluation of
      pneumodopplerographic findings enables identification of 90% of satisfactory and
      80% of poor fetal conditions.

PMID- 2240449
TI  - [Ectopic pregnancy after the treatment of infertility by the method of
      extracorporeal fertilization].
AB  - During October 1987 to June 1989, 609 infertile couples have been treated using
      in vitro fertilization and embryo transfer (IVF-ET). Of 78 conceptions (15.7% of
      transferred embryos), 6 (7.7%) pregnancies were ectopic (5 tubal and 1 ovarian).
      After diagnosis of ectopic pregnancy all the patients were operated; the ovary
      was resected in 1 patients and tubectomies were done in 5 patients
      (laparoscopically in 1). All the diagnoses were confirmed histologically. Since
      prevention of ectopic pregnancy in IVF-ET is not reliable, the patients enrolled
      for IVF-ET should be considered to be at risk and closely followed up.

PMID- 2240450
TI  - [Transvaginal ultrasonography in the treatment of infertility by the method of
      extracorporeal fertilization].
AB  - Menstrual cycles of 274 women have been analyzed in order to decide on
      possibility of follow-up of follicular growth and development using echography
      and retrieval of preovulatory oocytes using sonographically guided transvaginal
      access during in vitro fertilization and embryo transfer (IVF-ET). Transvaginal
      echography proved to be a very efficient tool in monitoring follicle growth
      during an IVF-ET program and outpatient oocyte retrieval with a minimal injury.

PMID- 2240451
TI  - [The course of hypoplastic anemia in women with uterine hemorrhage].
AB  - The clinical course of hypoplastic anemia (HA) has been assessed in 21 patients
      with uterine bleedings. The disease was associated with severe onset and
      progress, profound pancytopenia and myelodepression or even critical states.
      Superimposed infectious inflammatory and other diseases aggravated HA by
      promoting hemorrhagic events, especially uterine bleedings. An initial treatment
      using packed erythrocyte transfusions and glucocorticoid hormones reversed anemia
      and hemorrhages in 11 of 21 patients with HA. Splenectomy was performed in 8 and
      ovariectomy in 1 of 11 patients whose blood and bone marrow tests improved after
      the treatment. The other 12 patients were maintained on transfusion and drug
      regimens. The efficacy of splenectomy and other interventions for HA in women
      with uterine bleedings depends on an response to received treatments.

PMID- 2240453
TI  - [Changes in serum sialic acid levels in patients with ovarian tumors in the
      process of treatment].

PMID- 2240452
TI  - [Pathogenesis of damaging effects of hyperoxia during early ontogenesis].

PMID- 2240454
TI  - [Interpretation of morphological changes in the tissues and organs of the
      reproductive system after radical surgical treatment of uterine leiomyoma].
AB  - Ovarian and endometrial changes in most patients with uterine myoma had a
      histophysiologic nature. Clinical symptoms of "rapid growth" of myoma were
      largely determined by degenerative changes in the tumor and the surrounding
      myometrium. Uterine bleedings in patients with myoma may be related to
      hyperplastic lesions of the ovaries and endometrium, vascular myometrial and
      hemodynamic endometrial disorders.

PMID- 2240456
TI  - [Fetal craniopharyngioma (ultrasonographic and pathological studies)].

PMID- 2240455
TI  - [The role of metabolic changes in the pathogenesis of bronchial asthma in
      pregnancy].

PMID- 2240457
TI  - Somatosensory evoked potentials and adaptation to extrauterine life: a
      longitudinal study.
AB  - In order to compare longitudinal data with existing cross sectional extrauterine
      life data on somatosensory evoked potentials (SEPs), two groups of appropriate
      for gestational age optimal premature infants were studied. Group A consisted of
      8 infants born between 34 and 36 weeks gestational age (GA). In this group, SEPs
      were recorded within 24 hours after delivery and then every 48-72 hours until
      discharge. Group B consisted of 7 infants born between 29 and 33 weeks GA. In
      these infants, SEPs were recorded at weekly intervals from the second week
      onwards. In group A, a marked decreased in the N1 latency was seen during the
      first week of life. Six infants had initial values above the normal range. During
      the second week of life this decrease paralleled the cross sectional data. In
      group B all the infants had a N1 latency within the normal range and the
      longitudinal data paralleled the cross sectional data. These findings must be
      taken into consideration when SEPs are used to assess the neurological integrity
      of the newborn during the first week of life.

PMID- 2240458
TI  - Studies on pediatric patients with absent auditory brainstem response (ABR) later
      components.
AB  - Eleven pediatric patients with only wave I or waves I and II of their ABR were
      clinically analyzed. The clinical diagnoses of these patients were as follows: 1)
      anoxic encephalopathy in two cases; 2) neonatal asphyxia in one; 3) infantile
      Gaucher's disease in one; 4) mitochondrial encephalomyopathy in one; 5) suspected
      Pelizaeus-Merzbacher disease in three; 6) degenerative disease of unknown
      etiology in two (presumptive diagnosis were progressive supranuclear palsy and
      dentate-rubro-pallido-Luysian atrophy); and 7) infantile spasms with congenital
      malformation of the brain and bones in one. The incidence of the patients with
      this type of ABR abnormality was 0.67% among 1,650 of our pediatric patients
      whose ABRs were examined because of audiological or neurological problems. All
      eleven patients showed severe mental retardation. Nine of the eleven had
      convulsions and likewise, eight of eleven showed deterioration in mental and/or
      motor activities. Furthermore seven of eleven had disturbed consciousness and
      four of these seven were in deep coma. Other brainstem and bulbar signs and
      symptoms were frequently found in these patients. In our series, patients without
      the later components of ABR manifested marked neurological abnormalities inside
      and outside the brainstem.

PMID- 2240459
TI  - Glucose, free fatty acid and ketone body metabolism in Duchenne muscular
      dystrophy.
AB  - We examined how the substances, especially glucose, free fatty acids (FFA) and
      ketone bodies, and hormones associated with energy metabolism change with the
      disease progress in Duchenne muscular dystrophy (DMD). Serum creatine kinase (CK)
      activity was used as an index of the stage of DMD, because this activity is
      exponentially decreases with the progress of the disease. The glucose
      concentration in DMD patients with CK activity of less than 1,000 U/l (low CK)
      was significantly lower than that in controls, although there was no significant
      difference between that in DMD patients with CK activity of more than 1,00 U/l
      (high CK) and that in controls. The FFA concentration in both high CK and low CK
      patients was significantly higher than that in controls. The FFA concentration in
      low CK patients tended to be higher than that in high CK patients. The ketone
      body concentration in low CK patients was significantly higher than that in
      controls and that in high CK patients. The [glucagon]:[insulin] ratio in low CK
      patients was significantly higher than that in controls and that in high CK
      patients. It was also observed in a correlational study that the glucose
      concentration decreased with the age and the decrease in CK activity, i.e., with
      the progress of DMD. The FFA and ketone body concentrations increased with the
      decrease in the glucose concentration. The decrease in the glucose concentration
      may be due to a caloric shortage and/or degenerated muscle, which cannot supply
      enough gluconeogenic substrates, such as alanine. The kinetics of insulin and
      glucagon in DMD may help to maintain the glucose metabolism. Increased
      concentrations of FFA and ketone bodies may be helpful in the advanced stage of
      DMD, as energy sources and as substrates, sparing muscle protein.

PMID- 2240460
TI  - Mucolipidosis III and Bardet-Biedl syndrome in the same family: diagnostic
      pitfalls.
AB  - Two brothers, offspring of an Arab inbred family suffered from both mucolipidosis
      III (ML-III) and Bardet-Biedl syndrome (BBS). Other members of this family were
      affected either with ML-III, or with BBS. It seems that this unique combination
      is probably coincidental.

PMID- 2240461
TI  - Biochemical and morphological studies of dorsal root ganglion and its cultured
      cells from twitcher mouse (murine globoid cell leukodystrophy).
AB  - The biochemical pathogenesis of globoid cell leukodystrophy (GLD) (Krabbe
      disease) was investigated in vitro using the cultured neural cells obtained from
      dorsal root ganglion (DRG) of twitcher mouse (murine Krabbe disease). Electron
      microscopic examination of twitcher DRG of 30 days old showed the demyelination
      and abnormal inclusion bodies, whereas mitochondrial structure appeared to be
      intact. Cultured neural cells from control mice were well proliferated to form
      the network processes, while those from twitcher were decreased in cell numbers
      and showed the vacuolation of cell body, degeneration of processes, and finally
      died after three weeks. There was no apparent difference of lipid composition
      between control and twitcher DRG, and the galactocerebroside levels from control
      were similar to those of twitcher. However, marked accumulation of psychosine was
      found in the 30-day-old-twitcher DRG. The level of psychosine from twitcher DRG
      was elevated approximately 70 to 80-fold compared with those of control. These
      data suggest that neural cells from twitcher mice degenerative with age also in
      vitro and accumulation of psychosine in twitcher DRG may play an important role
      for the demyelination in GLD.

PMID- 2240463
TI  - Ocular manifestations in Fukuyama type congenital muscular dystrophy.
AB  - We describe a child with Fukuyama type congenital muscular dystrophy (FCMD) who
      had several ocular manifestations since birth. These included high myopia,
      strabismus, nystagmus and optic atrophy of both eyes. Later he developed retinal
      detachment of both eyes. Our survey of 33 cases with FCMD revealed that high
      myopia and optic atrophy are common in FCMD. Retinal detachment was reported in
      two cases in addition to the present one and was considered to be of
      developmental origin. The association of congenital muscular dystrophy with brain
      changes and ocular anomalies were found in FCMD, muscle, eye and brain disease
      (MEB) and Walker-Warburg syndrome (WWS). Ocular manifestations in FCMD were, in
      general, less severe than those in WWS or MEB. Our study suggests that FCMD, MEB
      and WWS are developmental abnormalities with a continual spectrum of disease
      severity.

PMID- 2240462
TI  - The effect of L-carnitine supplementation in 4 pentenoic acid treated rats.
AB  - The effects of prolonged administration (7 days) of 4 pentenoic acid (4PA, 20
      mg/kg/day) or 4PA (20 mg/kg/day) with L-carnitine (200 mg/kg/day) on carnitine
      metabolism and morphological changes of liver mitochondria were assessed in rats.
      4PA-treated rats showed hyperammonemia, decreased levels of blood glucose, free
      fatty acids and beta-OH-butyrate, and of free carnitine in serum, muscle and
      liver, increased excretion of acylcarnitine in urine, and enlarged mitochondria
      with microvesicular steatosis, when compared to saline-injected control rats,
      respectively. 4PA plus L-carnitine rats showed decreased levels of blood ammonia
      and increased levels of beta-OH-butyrate, compared to the 4PA group. On the other
      hand, the levels of free carnitine in serum and liver in rats treated with both
      4PA and L-carnitine were increased, when compared to controls. The ratio of
      acylcarnitine to free carnitine excreted in urine in 4PA-treated rats was higher
      than that in either the control or 4PA plus L-carnitine group. The liver
      mitochondria in the 4PA plus L-carnitine group were the same as in the controls.
      The results suggested that the abnormal biochemical and morphological findings
      due to only 4PA may be relieved with L-carnitine supplementation.

PMID- 2240464
TI  - Complete external ophthalmoplegia in a patient with congenital myopathy without
      specific features (minimal change myopathy).
AB  - An 11-month-old female infant with mild asphyxia at birth had severe generalized
      muscle hypotonia and weakness, predominantly in the neck flexors, a high-arched
      palate and a funnel chest from early infancy. Her facial muscles were also
      markedly involved. In addition, she showed striking non-progressive, complete
      external ophthalmoplegia and mild ptosis. A muscle biopsy specimen showed non
      specific myopathic changes, including mild variation in fiber size, mild type 1
      fiber predominance, type 2B fiber deficiency and slightly increased acid
      phosphatase activity. Complete ophthalmoplegia may thus be seen not only in
      myotubular myopathy but also in various forms of congenital non-progressive
      myopathy.

PMID- 2240465
TI  - A serial muscle biopsy study in a case of congenital fiber-type disproportion
      associated with progressive respiratory failure.
AB  - The muscle fiber diameter and distribution were studied in serial muscle biopsy
      specimens taken at the ages of 21 months and 8 years in a girl with congenital
      fiber type disproportion. The patient was floppy from birth and showed delayed
      motor development. Progressive respiratory failure developed from the age of 8,
      which required artificial respiration during the night. The mean diameters of
      type 1 fibers at the ages of 21 m and 8 y were 10 mu and 21 mu, and those of type
      2 fibers 32 mu and 61 mu, respectively. Whereas most type 1 fibers were
      hypotrophic in both biopsy specimens, a small number of type 1 fibers
      (approximately 15%) were normal-sized or hypertrophic, measuring 50 to 90 mu, in
      the second biopsy specimen, which were thought to have arisen on the maturation
      of normal-sized or hypertrophic type 1 fibers measuring 15 to 35 mu in the first
      biopsy specimen. Excessive hypotrophy of type 1 fibers was considered to be
      responsible for the progressive respiratory failure due to weakness of the
      diaphragm. The pattern of type 1 fiber evolution from the first to the second
      biopsy specimen suggested that dysmaturation of spinal motoneurons innervating
      type 1 muscle fibers would be involved in the pathophysiology of the fiber type
      disproportion in this case.

PMID- 2240466
TI  - Brain and liver pathology in a patient with carnitine deficiency.
AB  - The ultrastructural brain and liver pathology in an infant, who died of acute
      encephalopathy due to systemic carnitine deficiency (CD), an important condition
      mimicking Reye's syndrome (RS), was reported. The major finding in the brain was
      swelling of astrocyte cytoplasm. Expanded mitochondria in nerve cells and myelin
      sheath splitting in the white matter, which have been reported to be specific to
      RS, were not observed. Also in contrast to findings in RS, hepatocytes were
      filled with macrovesicular fat droplets without expanded mitochondria. These
      findings suggest significant differences in the pathophysiology of acute
      encephalopathy in CD and RS, although the clinical and laboratory findings during
      an episode of acute encephalopathy in the former are usually very similar to
      those in the latter.

PMID- 2240467
TI  - A possible Japanese male case of Pelizaeus-Merzbacher disease.
AB  - A boy with an abnormal auditory brain stem response showing only a wave I-II
      pattern, congenital nystagmus, psycho-motor retardation, pyramidal tract signs
      and muscular hypotonia was reported. The auditory brain stem response, short
      latency somatosensory-evoked potential, somatosensory-evoked potential and visual
      evoked potential indicated an intramedullary disorder of conduction. Magnetic
      resonance imaging revealed marked high signal intensity of the cerebral white
      matter in T2-weighted images, suggesting hypomyelination. A muscle biopsy
      specimen showed neurogenic changes with mild myogenic changes.

PMID- 2240468
TI  - Plasma PIVKA-II levels in epileptic patients.

PMID- 2240469
TI  - Radiological colpocephaly.

PMID- 2240470
TI  - Ex vivo chemopurging of autologous bone marrow with 4-hydroperoxycyclophosphamide
      to eliminate occult leukemic cells. Laboratory and clinical observations.
AB  - The application of autologous bone marrow transplantation (ABMT) in treating
      acute leukemias in children has been limited by the presence of residual occult
      viable leukemic cells in the marrow cell suspension. One approach to this problem
      is the ex vivo treatment ("purging") of the autograft to eradicate these tumor
      cells yet spare the normal lymphohematopoietic stem cells. Initial studies of
      acute myeloid leukemia (AML) in a rodent model demonstrated that incubation with
      4-hydroperoxycyclophosphamide (4HC), a congener of cyclophosphamide and an active
      alkylating agent in aqueous solution, could effectively eliminate viable AML
      cells from marrow cell suspensions without apparent toxicity to normal stem
      cells. We have conducted clinical trials of ABMT with 4HC-treated marrow in
      children with acute leukemia in remission; marrow was collected, treated ex vivo
      with 4HC (100 micrograms/ml), and cryopreserved in liquid nitrogen until
      reinfusion. Children received pre-ABMT conditioning with either high-dose
      cyclophosphamide and total body irradiation (CY-TBI) for acute lymphocytic
      leukemia (ALL) or high-dose busulfan and cyclophosphamide (BU-CY) for AML. Of
      nine children who underwent ABMT with 4HC-treated marrow for ALL in second
      complete remission (CR2), all relapsed (eight in the marrow, one in the central
      nervous system) at a median of 5 months (range, 2-17) after ABMT and all have
      died with relapsed ALL or as a consequence of its treatment. Twenty-nine children
      with AML (five in CR1, 24 in CR2) received autografts with chemopurged marrow at
      a median remission duration of 3 months (range, 2-15). Three patients died from
      sepsis during aplasia; 10 children (one in CR1 and nine in CR2) relapsed with AML
      at a median of 7 months (range, 2-23) after ABMT, for an actuarial relapse rate
      of 47%. Sixteen patients with AML (four in CR1, 12 in CR2) are in unmaintained
      remission at a median of 16 months (range, 6-102) after ABMT, for an actuarial
      disease-free survival of 49%. Although ABMT with 4HC-treated marrow appears to
      have a limited role in the treatment of children with ALL who lack a suitable
      related donor, the results in AML are encouraging and compare favorably with both
      syngeneic and allogeneic BMT in similar groups of patients.

PMID- 2240471
TI  - Immunomagnetic purging of bone marrow: a model for negative cell selection.
AB  - Many in vitro techniques have been developed for removing cancer cells from the
      marrow of patients who are to undergo autologous bone marrow transplantation
      (ABMT). These purging techniques can be classified as immunological or
      pharmacological. The immunomagnetic technique has been widely used in
      neuroblastoma patients. It depends on an interaction between target neuroblastoma
      cells in the marrow and a complex of specific monoclonal antibodies and
      magnetized microspheres, the target cells being selectively removed by passage
      through a magnetic field. Laboratory studies with neuroblastoma and acute
      lymphoblastic leukemia cells have shown the high efficiency of this technique in
      selectively removing cancer cells while retaining adequate numbers of normal
      hematopoietic cells for subsequent reinfusion into the patient. Clinical studies
      in several hundred neuroblastoma patients, as well as small numbers of acute
      lymphoblastic leukemia, breast cancer, and myeloma patients, suggest that this is
      a clinically safe and effective technique. However, no clinical trial has been
      conducted comparing ABMT with and without in vitro marrow purging. Until such
      time, we will regard immunomagnetic purging as "standard of care" for
      neuroblastoma patients receiving ABMT.

PMID- 2240472
TI  - Vitamin C deficiency in patients with sickle cell anemia.
AB  - Because peroxidative damage to red cell membranes may contribute to the
      pathophysiology of sickle cell disease, deficiency of fat- and water-soluble
      antioxidants could be a determinant in the pathogenesis of this disease. We have
      previously reported a deficiency of vitamin E in sickle cell disease. The present
      study was undertaken to see if a deficiency in vitamin C might also be detected.
      Leukocyte vitamin C, which reflects total body vitamin C reserve, was measured by
      a modified 2,4-dinitrophenylhydrazine method. Sickle cell patients (N = 18) had
      lower leukocyte vitamin C levels (18.3 +/- 9.4 micrograms/10(8) cells) than
      normal controls (N = 12; 30.3 +/- 7.5 micrograms/10(8) cells; p less than 0.01).
      Furthermore, 50% of the patients had vitamin C levels below 15 micrograms/10(8)
      cells, a value consistent with vitamin C deficiency. A statistically significant
      correlation (r = -0.62 with 0.01 less than p less than or equal to 0.025) was
      found between leukocyte vitamin C levels and serum ferritin concentration.
      Because dietary vitamin C intake appeared to be adequate, increased vitamin C
      utilization may account for this deficiency. However, the mechanisms for this
      deficiency as well as its pathophysiologic consequences remain to be established.

PMID- 2240473
TI  - Planning an exchange transfusion in patients with sickle cell syndromes.
AB  - Partial exchange transfusions are performed in sickle cell patients for a variety
      of reasons. An algorithm to plan a nonautomated exchange in patients with sickle
      cell syndromes was developed and validated by a study of 40 such procedures.
      Formulas that can be used to explore alternatives, by assessing at any point
      during the exchange the current concentration of sickleable cells and the
      hematocrit, were devised: a computer program in BASIC is available for maximum
      versatility. The two most important determinants of the exchange are the
      patient's initial hematocrit and the desired final concentration of sickleable
      cells; the rate and type of exchange (continuous or discontinuous) are not
      important. The final hematocrit depends on the type of blood product used. An
      exchange can be performed with packed red blood cells (PRBC), whole blood (or its
      equivalent, PRBC reconstituted with albumin), or it can be started with PRBC and
      continued with whole blood. Whole blood decreases the concentration of
      sickeleable cells rapidly and increases the hematocrit slowly; it does not
      markedly increase the viscosity. PRBCs decrease the concentration of sickleable
      cells more slowly and increase the hematocrit faster; thus, they may increase the
      blood viscosity to dangerous levels.

PMID- 2240474
TI  - Immunologic classification of acute lymphoblastic leukemia.
AB  - The study of cell surface antigens in acute lymphoblastic leukemia (ALL) has
      provided the basic information for classification of ALL into B cell or T cell
      lineage. Each immunologic type may present at an immature or more mature stage of
      maturation. This classification has prognostic significance since mature B cell
      and T cell ALL phenotypes have a worse prognosis, compared to common acute
      lymphoblastic leukemia-associated antigen (CALLA) positive leukemias that belong
      to an immature B cell lineage and have the best prognosis. By performing these
      immunologic studies together with those of molecular biology, it is now possible
      to establish the precise level of cell differentiation, the point at which the
      malignant transformation occurred. Further studies may allow correlation of these
      different maturation stages, thus providing insight into the biologic behavior of
      lymphoblastic leukemia.

PMID- 2240475
TI  - A phase II study of diaziquone in children with recurrent or progressive solid
      tumors. Report from the Childrens Cancer Study Group.
AB  - Seventy-two children with recurrent, progressive, or metastatic lymphomas and
      other solid tumors, exclusive of primary central nervous system (CNS) tumors,
      were treated with aziridinylbenzoquinone (AZQ, diaziquone) at 9 mg/m2/day by 30
      min intravenous infusion for 5 days every 3 weeks. Fifty-four patients were
      evaluable for response. Three partial responses occurred, two in patients with
      recurrent Hodgkin's disease and one in a patient with intraocular retinoblastoma.
      Sufficient numbers of patients with osteosarcoma, neuroblastoma, and Wilms' tumor
      were evaluable to demonstrate inactivity of this dosing regimen in these tumor
      types. Numbers of evaluable patients for other tumor types were insufficient to
      conclusively demonstrate inactivity. Myelosuppression, which was profound and
      prolonged, was observed. As administered in this study, AZQ has marginal activity
      and severe myelotoxicity in children with solid tumors.

PMID- 2240476
TI  - Splenectomy in compound heterozygous hemoglobinopathies in Saudi Arabia.
AB  - Hemoglobinopathies are a major public health problem in Saudi Arabia. We studied
      the effect of splenectomy in 16 Saudi Arabian children with compound
      hemoglobinopathies. Seven patients no longer require regular blood transfusions,
      and transfusion requirements were decreased by 30 to 60% in the other eight
      patients. Three patients whose heights and weights were below the 5th percentile
      before splenectomy reached the 25th percentile 1 year after the surgery. In spite
      of preoperative pneumococcal vaccination and the penicillin prophylaxis after the
      surgery, one patient died of Haemophilus influenzae Group B bacteremia, and three
      others had six episodes of pneumonia.

PMID- 2240478
TI  - The bleeding time may be longer in children than in adults.
AB  - The bleeding time, the most frequently performed test reflecting in vivo platelet
      function, is the duration of blood flow from a standardized incision on the volar
      surface of the forearm. Normal values have been determined in adult subjects, but
      with the exception of neonates, data on the range of bleeding time values in
      pediatric patients are unavailable. Standard hematology textbooks imply that
      bleeding time values in children are similar to those of adults. We have reviewed
      our 9 years of experience with 137 children (mean age 6.5 years) who were
      referred for diagnostic evaluation of a bleeding disorder but whose history and
      physical examination were felt by us to be inconsistent with an abnormality of
      hemostasis. Bleeding time values in these individuals (mean 6.0 min, 95th
      percentile 9.0 min) were compared with those of 85 normal adult volunteers (mean
      4.4 min, 95th percentile 6.5 min). The Simplate-I disposable device and vertical
      (perpendicular to elbow crease) incision direction were used in both groups. This
      difference between the pediatric and adult bleeding time values is statistically
      significant (p less than 0.0001). Neither age nor sex had a significant effect on
      the pediatric bleeding time measurements. We conclude that the bleeding time,
      when performed as described, is longer in children than in adults and that
      pediatric standards for bleeding time should be used in order to avoid a spurious
      diagnosis of a primary hemostatic disorder in some normal children.

PMID- 2240477
TI  - Anesthesia for diagnostic and therapeutic procedures in pediatric outpatients.
AB  - Appropriate sedation of pediatric oncology patients during painful diagnostic and
      therapeutic procedures is a recognized problem. At the Memorial Sloan-Kettering
      Cancer Center the pediatric oncologists and anesthesiologists have developed a
      cooperative program that has provided safe and effective sedation of outpatients.
      The experience with 100 consecutive outpatients is reported. Patients ranged from
      3 months to 17 years of age. Procedures included lumbar puncture and/or
      intrathecal chemotherapy, multiple bone marrow aspirations, bone marrow biopsies,
      and removal of indwelling central vein catheters. Monitoring of patients during
      the procedures as well as various pharmacologic techniques to provide adequate
      working conditions are described.

PMID- 2240480
TI  - Successful treatment of acute leukemia with t(4;11) in an infant with congenital
      hypothyroidism.
AB  - We describe a case of acute leukemia with t(4;11) (q21;q23) in a 3-month-old girl
      suffering from congenital hypothyroidism. The blast cells were cytochemically and
      immunologically classifiable as acute lymphoblastic leukemia of an early B-cell
      lineage (HLA-DR +, B4 +, CALLA-). but we treated this patient with a protocol
      designed mainly for acute nonlymphocytic leukemia, employing Adriamycin,
      vincristine, and cytosine arabinoside. Although the prognosis of this type of
      leukemia is known to be extremely poor, our patient is currently alive and in
      continuous complete remission lasting 35 months to date. This case may
      demonstrate a potential alternative therapeutic strategy for acute leukemia with
      t(4;11) as well as clinical evidence for the mixed-lineage characteristics of
      this condition. However, the pathogenetic role of congenital hypothyroidism in
      the development of acute leukemia is still uncertain.

PMID- 2240479
TI  - Successful treatment of disseminated Fusarium infection in an immunocompromised
      child.
AB  - We report the first know case of disseminated fungal infection due to Fusarium
      proliferatum in a bone marrow transplant recipient to our knowledge. Fusarium was
      cultured from the blood, a paranasal sinus, and necrotic skin lesions. The
      isolate was sensitive to amphotericin B and on further sensitivity testing,
      synergy was demonstrated using rifampin in combination with amphotericin B. The
      patient had this infection while she was receiving alternate-day amphotericin,
      rifampin, and 5-flucytosine (5-FC) therapy. The infection was documented within
      48 h of discontinuing daily granulocyte transfusions, which she had received for
      3 weeks. The 5-FC was discontinued when sensitivities showed the organism
      resistant. After 6 weeks of treatment she showed complete remission of the
      infection, although neutrophil counts remained below 0.25 X 10(9)/L. From this
      case and from a review of the literature, it appears that synergic antifungal
      agents combined with leukocyte transfusions may be beneficial in the successful
      treatment of fusariosis in the compromised host.

PMID- 2240481
TI  - Polyfungal systemic infections in pediatric oncology patients.
AB  - Three cases of two fungal agents causing simultaneous systemic infection in
      immunocompromised pediatric patients are presented and the literature is
      reviewed. All three patients had several underlying factors that predispose to
      systemic fungal infections. A species of candida was identified initially as an
      etiologic agent in all of the three patients causing subcutaneous abscesses,
      urinary tract infections, fungemia, catheter exit site infection, or pneumonia.
      However, a few days later blood cultures grew aspergillus species in two of the
      three patients; in the third patient aspergillus was identified on microscopic
      examination of the spleen. All three patients had an associated bacteremia with
      either Staphylococcus aureus or S. epidermidis requiring vancomycin therapy.
      Presence of aspergillus infection required treatment with amphotericin.
      Difficulties in making a definitive diagnosis of systemic fungal disease may
      explain paucity of reports in the literature with simultaneous polyfungal
      systemic infection.

PMID- 2240482
TI  - Treatment of neonatal aortic thrombosis with urokinase.
AB  - We describe the successful treatment of a neonate with severe aortic thrombosis
      using systemic urokinase. Current knowledge regarding the treatment of this
      condition, including fibrinolytic therapy, is reviewed.

PMID- 2240483
TI  - Cystic fibrosis in a black child with hemoglobin S-D disease.
AB  - A 9-year-old black patient with the simultaneous occurrence of cystic fibrosis
      and hemoglobin S-D disease is reported. She was placed on chronic transfusion
      therapy from 1 year of age because of her rapidly worsening pulmonary condition.
      Her pulmonary function is now stable. The role of this therapy in the overall
      management of this unusual syndrome is discussed.

PMID- 2240484
TI  - Immune status in two brothers with Omenn's syndrome: no discernible chimerism on
      FACS analysis using a monoclonal antibody specific for a maternally restricted
      HLA antigen.
AB  - Sequential immunologic examinations, including lymph node biopsies, in two
      brothers with clinical characteristics of Omenn's syndrome are presented in this
      study. Although the number of circulating T cells with mature phenotype (OKT3+,
      TCR1+) was within normal range, the lymphocyte proliferative response to mitogens
      was poor. Examinations of the lymph nodes revealed marked lymphoid depletion
      associated with eosinophilic infiltration and reticular cell proliferation. Over
      the clinical course of 5 months, circulating T cells also mostly disappeared.
      Thymic hypoplasia was noted at autopsy. Although intrauterine graft-versus host
      disease (GVHD) has been hypothesized as being the pathogenetic mechanism in this
      syndrome, maternal lymphocytes circulating in these patients were not identified
      either by karyotype and HLA typing or by highly sensitive FACS analysis and
      immunohistochemical studies using a monoclonal antibody, HLA-A9, specific for a
      maternally restricted HLA antigen, Aw24. In conclusion, the familial occurrence
      and the absence of maternal chimerism might be the essential features of Omenn's
      syndrome which should be differentiated from fetal GVHD.

PMID- 2240485
TI  - Therapy for childhood non-Hodgkin's lymphomas, nonlymphoblastic type. Review of
      recent studies and current recommendations.
AB  - Childhood non-Hodgkin's lymphomas can be divided into two broad groups based on
      histologic findings: lymphoblastic and nonlymphoblastic. Lymphoblastic lymphomas
      often appear with a mediastinal mass and have a propensity for relapse in the
      bone marrow and CNS. Nonlymphoblastic lymphomas occur primarily in the abdomen
      and head-neck region. Relapses tend to occur within the first year and may be
      either local or systemic. Marrow and/or CNS involvement at diagnosis, bulk
      disease (reflected as elevated serum lactic dehydrogenase levels), and
      mediastinal occurrences are adverse prognostic features for nonlymphoblastic
      lymphomas. Chemotherapy is the treatment of choice for both types of childhood
      non-Hodgkin's lymphomas. In general, radiation therapy is not necessary for
      optimal treatment of these tumors. Localized non-Hodgkin's lymphomas of either
      histologic type are highly curable with short-course chemotherapy. Disseminated
      non-Hodgkin's lymphomas, particularly those with marrow and/or CNS involvement,
      remain a major treatment challenge.

PMID- 2240486
TI  - Problems in diagnosing and treating childhood hematopoietic malignancies in
      Cameroon, West Africa.

PMID- 2240488
TI  - Pain management case reports.

PMID- 2240487
TI  - Advances in anterior cruciate ligament surgery.
AB  - The anterior cruciate ligament is the most frequently torn ligament in the knee.
      Diagnosis of cruciate ligament tears is often a difficult task. Tests typically
      used in diagnosis are the anterior drawer test, Lachman's test, pivot shift test,
      and the flexion rotation drawer. Arthroscopy has increasingly become the standard
      for the diagnosis of anterior cruciate ligament tears. Management of these tears
      has been controversial. The diagnostic techniques are discussed and a surgical
      technique is described for anterior cruciate ligament reconstruction as an
      outpatient procedure. The middle one-third of the patellar tendon is used as a
      graft, harvested subcutaneously, and fixed with interference fit screws. The
      postoperative function of anterior cruciate ligament deficient knees has been
      quite satisfactory. Morbidity is decreased relative to open surgical inpatient
      procedures. Finally, overall cost to the patient has been significantly reduced.

PMID- 2240489
TI  - An interview: Louis W. Sullivan, M.D.

PMID- 2240490
TI  - History of medicine in Alaska. M. Walter Johnson, M.D.

PMID- 2240491
TI  - Glimpses of Alaskan medical history. The notebook of a ship's doctor (1816-17).

PMID- 2240492
TI  - Trends and patterns of postneonatal mortality in Alaska 1977 through 1984.
AB  - Several determinants of Alaska postneonatal mortality rate were examined to
      determine whether very low birth weight (less than 1500 g) and low birth weight
      (1500-2499 g) surviving neonates contributed to the lack of improvement in
      postneonatal mortality rate. For an eight year period (1977 through 1984), all
      infant deaths (n = 1020) of the 82,301 resident births were reviewed through
      vital statistics data. The infant's place of birth, ethnic group, birth weight
      and age at death were available. Ethnic and rural-specific postneonatal mortality
      rate (PNMR) significantly improved, but there was no change in birth weight
      distribution or birth weight-specific postneonatal mortality rate. However,
      surviving very low birth weight infant proportion of postneonatal mortality has
      increased from 5% to 8.2% and low birth weight proportion has remained unchanged
      (15.6%). These proportions were not offset by the decline in normal birth weight
      (greater than 2500 g) postneonatal mortality rate. This trend suggests that
      infants born weighing less than 2500 g have slowed the decline of the
      postneonatal mortality rate.

PMID- 2240493
TI  - Anaesthetists and trauma.

PMID- 2240494
TI  - Admissions to the intensive care unit after complications of anaesthetic
      techniques over 10 years. 2. The second 5 years.
AB  - Compared with the first 5 years there was a 19% increase in general anaesthetics,
      a 171% increase in local and (or) sedation techniques and a 9% increase in
      obstetric epidurals with no increase in anaesthetic staffing. In this second 5
      year period, 46 patients were admitted to the Intensive Care Unit as a result of
      a complication of an anaesthetic technique. These patients represented 1 in 2371
      anaesthetic techniques carried out in the District compared with the previous 5
      years where the incidence was 1 in 1543. Seven patients died (15.2%). The
      complication was considered to be wholly or partially avoidable in 14 instances
      (30.4%). Four of these subjects died.

PMID- 2240495
TI  - Behaviour of small children before induction. The effect of parental presence and
      EMLA and premedication with triclofos or a placebo.
AB  - The effect of the prescription of triclofos 70 mg/kg orally 90 minutes before
      operation on the behaviour of 263 children aged 1 to 5 years was studied in a
      blind, randomised, placebo-controlled trial. EMLA was applied to the dorsum of
      one hand when the premedication was administered, and all the children were
      accompanied by a parent during induction of anaesthesia. The frequency of
      satisfactory behaviour was significantly higher in the triclofos group (p less
      than 0.02), but the time spent in the recovery ward was increased.

PMID- 2240496
TI  - Blood contamination of anaesthetic and related staff.
AB  - The incidence of skin contamination of anaesthetic and related staff by patient's
      blood and saliva was studied during 270 anaesthetics in Cardiff hospitals over
      seven continuous days in October 1989. A survey was also made of current
      Hepatitis B immunisation status and glove-wearing habits of 75 anaesthetists.
      Blood from 35 (14%) patients caused skin contamination of 65 staff during 46
      incidents. Twenty-eight (61%) of the contamination incidents occurred during
      vessel cannulation. Five (8%) of the 65 staff contaminated by blood already had
      cuts on their hands. There were nine incidents (4%) of skin contamination by
      saliva. Fifty-three (71%) anaesthetists were immunised against Hepatitis B. Only
      seven (9%) anaesthetists wear gloves for oral or nasal intubation, six (8%) for
      insertion of peripheral venous cannulae, 47 (63%) for insertion of arterial lines
      and 67 (89%) for insertion of central lines. All anaesthetic and associated staff
      should wear gloves on a routine basis.

PMID- 2240498
TI  - Treatment of atelectasis of upper lung lobes. Selective bronchial suctioning with
      J-shaped catheter tip and guide mark.
AB  - We developed a technique for blind bronchial suction using a curved-tip catheter
      with a guide mark, for the treatment of atelectasis of the lower and middle lobes
      of the lung. Suction of the upper lobe bronchi could not be performed because of
      the combination of the peculiar anatomy of the upper lobe bronchi with catheter
      design. We treated successfully two cases of atelectasis of the right upper lobes
      using a Rusch Metras bronchography catheter with a guide mark which is not
      readily available. Therefore we devised a J-shape tipped catheter with a guide
      mark. We have successfully treated 13 episodes of atelectasis of the right upper
      lobe in 10 patients and one episode in the left upper lobe in one patient with
      this new catheter.

PMID- 2240497
TI  - Clinical presentation of suspected malignant hyperthermia during anaesthesia in
      402 probands.
AB  - As anaesthetists have become more aware of malignant hyperthermia the mortality
      rate has fallen, but concommitantly the number of dubious and aborted cases has
      increased. All probands who developed a suspected malignant hyperthermia reaction
      during anaesthesia and subsequently underwent muscle biopsy were classified
      according to the clinical presentation. A probability for malignant hyperthermia
      can be calculated, using the classification, for each type of clinical
      presentation; this varied from 0.96 to 0.07. Certain clinical features were found
      to be of more value as predictors than others; these included a high creative
      kinase and myoglobinuria. The accuracy of prediction depends on a clear
      contemporaneous description of the clinical events.

PMID- 2240499
TI  - Spinal catheter anaesthesia for caesarean section in a patient with spina bifida.
AB  - A patient with grossly deformed vertebral anatomy, scheduled for elective
      Caesarean section, expressed her wish to stay fully awake during the procedure.
      Epidural anaesthesia was considered to be impracticable, while dural puncture
      appeared possible only at thoracic level. Spinal anaesthesia using a subarachnoid
      catheter placed at T7-8 was employed successfully.

PMID- 2240500
TI  - Severe hypotension due to intramyometrial injection of prostaglandin E2.
AB  - Treatment of postpartum haemorrhage because of uterine atony with intramyometrial
      prostaglandin E2 1 mg, in an anaesthetised patient resulted in life-threatening
      hypotension. Anaesthetists should be aware of the potential cardiovascular side
      effects of prostaglandins.

PMID- 2240501
TI  - Laryngeal oedema from a neck haematoma. A complication of internal jugular vein
      cannulation.
AB  - Laryngeal oedema occurred after formation of a neck haematoma after attempted
      internal jugular vein cannulation. This resulted in complete respiratory
      obstruction and respiratory arrest and it was impossible to ventilate her lungs
      manually or intubate her trachea. Oxygenation of the patient was only possible
      using transtracheal ventilation.

PMID- 2240502
TI  - Mechanical ventilation during low-flow anaesthesia. Experience with an
      alternative to the bag-in-bottle.
AB  - Clinical experience with low-flow anaesthesia during controlled ventilation of
      the lungs is described. The anaesthesia circle is separated by a corrugated hose
      that serves as a large deadspace. This open connexion has no bellows or overflow
      valve and therefore the risk of mechanical dysfunction is small. No mixing of
      circle and ventilator gas occurs during normal operation. Major decreases in the
      oxygen concentration in the system are unlikely even if the fresh gas flow is
      interrupted or significant leaks from the circle occur because 100% oxygen is
      delivered by the ventilator. A hose volume larger than 1650 ml prevented gas
      mixing at tidal volumes of 380-1170 ml. There was no system-related mishap in
      over 600 patients, who comprised about 40% of the neurosurgical patients
      anaesthetised during that period. The cost of isoflurane was reduced to about 33%
      of that incurred during previous periods.

PMID- 2240503
TI  - The Woolley and Roe case. A reassessment.
AB  - In 1953, two patients, Cecil Roe and Albert Woolley, sued their anaesthetist for
      alleged negligence because they had developed painful spastic paraparesis after
      spinal anaesthesia. The court found that phenol, which was used to sterilise the
      outside of the ampoules of local anaesthetic, had percolated the glass through
      invisible cracks, contaminating the solution, but that the anaesthetist could not
      have been aware of this risk. The case was important, despite the fact that
      judgement was in favour of the anaesthetist, because of the fears that it
      generated over the incidence of paralysis after spinal anaesthesia. The
      'invisible crack' theory has been the subject of much scepticism. New information
      has been obtained, and the case re-examined objectively. The most probable source
      of contamination, which led to paralysis in the two patients, and in a third who
      received spinal anaesthesia on the same day, has been identified. A similar
      explanation may lie behind a number of other episodes of paralysis associated
      with spinal anaesthesia.

PMID- 2240504
TI  - Total intravenous anaesthesia with propofol and buprenorphine.
AB  - A combination of propofol infusion and two bolus doses of buprenorphine, 2.5 or
      5.0 micrograms/kg were evaluated in a total intravenous anaesthesia technique in
      36 patients of ASA grade 1 or 2 undergoing cholecystectomy. Additional boluses of
      propofol were given intravenously if needed. Systolic blood pressure after
      tracheal intubation increased significantly only in those who received the
      smaller dose of buprenorphine. Patients in both groups remained haemodynamically
      stable throughout surgery with minimal side effects. Recovery was fast even with
      prolonged infusions and without major side effects. No patient reported awareness
      on postoperative questioning.

PMID- 2240505
TI  - Oral premedication in children. A comparison of trimeprazine with a trimeprazine,
      droperidol and methadone mixture.
AB  - One hundred children who presented for minor general surgical procedures were
      randomly assigned to receive one of two oral premedications. Those in group A (n
      = 50) were given 3 mg/kg of trimeprazine and those in group B (n = 50) a mixture
      of trimeprazine 1.0 mg/kg, droperidol 0.15 mg/kg and methadone 0.08 mg/kg.
      Patients in group B were more likely to be asleep on arrival in the anaesthetic
      room (p less than 0.02) and were less likely to be distressed at induction of
      anaesthesia (p less than 0.02). Thiopentone requirements were less in group B (p
      less than 0.001). The incidence of side effects was similar in the two groups. It
      is concluded that the mixture produces more satisfactory sedation than
      trimeprazine.

PMID- 2240506
TI  - Anaesthesia for cardioversion. A comparison between propofol, thiopentone and
      midazolam.
AB  - This study compares the induction and recovery characteristics, haemodynamic
      changes and side effects of propofol, thiopentone and midazolam when used as the
      anaesthetic agents for cardioversion. Recovery after midazolam was significantly
      longer (p less than 0.05) than with either thiopentone or propofol. There was no
      difference in the recovery times between thiopentone and propofol. There was a
      significant decrease in mean arterial pressure 2 minutes after induction with
      propofol and midazolam. Three patients each in the thiopentone and propofol
      groups needed assisted ventilation because of apneoea, and four patients each in
      the propofol and midazolam groups had low Spo2 values (less than 95%). Flumazenil
      was used to reverse the effects of midazolam in eight patients and five of these
      were still drowsy 4 hours after the procedure. This study indicates that
      thiopentone is the most satisfactory agent for anaesthesia for cardioversion.

PMID- 2240507
TI  - Minitracheotomy: complications and follow-up with fibreoptic tracheoscopy.
AB  - Complications and changes in tracheal mucosa after minitracheotomy were evaluated
      in 28 patients. Tracheal mucosa was inspected fibreoptically after the insertion
      of a minitracheotomy cannula, and then at 3-day intervals until the cannula was
      removed. Thereafter, assessments were made every third day until the mucosa was
      considered normal. Three significant complications occurred: mediastinal
      puncture, paratracheal entrance of the cannula and subcutaneous emphysema.
      Difficulties at insertion of the minitracheotomy cannula were encountered in 15
      of 28 patients (54%). Air flow detected through the cannula in one patient, and
      lack of air flow in another patient, were misleading signs of the position of the
      cannula. Passing a suction catheter in three patients and a normal end-tidal
      carbon dioxide tracing in one patient, were also found to be misleading. The
      correct position and possible complications could be verified only by fibreoptic
      tracheoscopy. Changes in the tracheal mucosa were independent of the duration of
      minitracheotomy therapy.

PMID- 2240508
TI  - Failure of nitrous oxide supply to theatre pipeline system.

PMID- 2240509
TI  - Aspiration of hot tea.

PMID- 2240510
TI  - Pulse oximetry and methylene blue.

PMID- 2240511
TI  - Dosage or concentration.

PMID- 2240512
TI  - Day-case ophthalmic surgery: general or local anaesthesia?

PMID- 2240513
TI  - Postoperative hypoxia.

PMID- 2240514
TI  - Anaesthetic morbidity from trauma to the uvula.

PMID- 2240515
TI  - The requirement of intensive care support for the pregnant population.

PMID- 2240516
TI  - APACHE II expected outcome calculations are subject to inter-observer variation.

PMID- 2240517
TI  - Unpleasant sequelae of benzodiazepine sedation.

PMID- 2240518
TI  - Opioid supplementation during propofol anaesthesia.

PMID- 2240520
TI  - Will we ever learn?

PMID- 2240519
TI  - Partial obstruction of the laryngeal mask airway.

PMID- 2240521
TI  - A modified Intavent laryngeal mask for ENT and dental anaesthesia.

PMID- 2240522
TI  - A supraglottic oropharyngeal airway.

PMID- 2240523
TI  - The laryngeal mask airway and facial burns.

PMID- 2240524
TI  - The use of a laryngeal mask airway for CT radiotherapy planning and daily
      radiotherapy.

PMID- 2240525
TI  - Fibreoptic intubation and double-lumen tubes.

PMID- 2240526
TI  - Laryngeal mask airway for emergency tracheostomy in a neonate.

PMID- 2240527
TI  - Pulmonary artery catheter occlusion.

PMID- 2240529
TI  - Anaesthesia for cataract surgery--time for change?

PMID- 2240528
TI  - Obstruction in a pressure line.

PMID- 2240530
TI  - Effects of famotidine and cimetidine on plasma levels of epidurally administered
      lignocaine.
AB  - The effects of two H2-receptor antagonists, famotidine and cimetidine, on the
      plasma levels of epidurally administered lignocaine were studied. Group A (n =
      20) received famotidine 20 mg orally the night before surgery and 20 mg
      intramuscularly 60 minutes before induction of anaesthesia. Group B (n = 15)
      received cimetidine 200 mg orally the night before the surgery and 400 mg orally
      60 minutes before the anaesthetic induction. Group C (n = 20) received neither
      famotidine nor cimetidine and served as controls. Twelve millilitres of 2.0%
      lignocaine with adrenaline 1:200,000 was injected into the epidural space in all
      patients, after the establishment of general anaesthesia with nitrous oxide,
      oxygen, and enflurane (0.3-0.5%). The patients who received cimetidine showed
      significantly higher plasma concentrations of lignocaine compared with either
      group A or group C at all investigation times (p less than 0.01). The mean peak
      plasma concentrations were 2.4 (SEM 0.1), 3.2 (SEM 0.2) and 2.3 (SEM 0.1)
      micrograms/ml in group A, B, and C, respectively. This study suggests that
      famotidine is preferable to cimetidine for control of gastric acidity before the
      use of lignocaine as the epidural anaesthetic.

PMID- 2240531
TI  - Epidurography in premature infants.
AB  - A caudal epidural catheter was inserted in 20 premature, high risk infants for
      abdominal or thoracic surgery under combined caudal epidural and general
      anaesthesia. Epidurography was used to confirm the position of the catheter which
      was found to be misplaced in three patients. The catheter penetrated the dura in
      one case, in another the tip was located in an epidural vessel and in the third
      the catheter was seen to be curled up within the epidural space. It was concluded
      that epidurographic control is essential with this method of anaesthesia in very
      small infants, in whom it was found to provide considerable advantages despite
      serious risks.

PMID- 2240532
TI  - Anaesthetic problems in ex situ resection of the liver.
AB  - Ex-situ resection of the liver is a new surgical technique for treatment of liver
      tumours not amenable to conventional surgery. This paper describes the
      cardiovascular and metabolic changes that occurred in nine consecutive such
      patients. No severe haemodynamic or pulmonary complications occurred. Specific
      problems were encountered during the prolonged anhepatic period, which lasted an
      average of 5.96 (SD 1.46) hours. Significant metabolic and coagulation disorders
      occurred 2 to 3 hours after hepatectomy because of complete loss of hepatic
      function. The predominant findings during the anhepatic period were hypoglycaemia
      and severe metabolic acidosis, mainly from increased levels of lactic acid.
      Exogenous administration of dextrose 5% at an average rate of 188 ml/hour was
      necessary to maintain normoglycaemia, while correction of metabolic acidosis
      required 403 (SD 159.79) mmol of sodium bicarbonate, supplemented by
      hyperventilation. Tris-hydroxymethylaminomethane was used when sodium overload
      was thought to be a problem. There was a marked decrease of Factor V and
      fibrinogen, a moderate thrombocytopenia and fibrinolysis. The severity of these
      alterations was dependent on the duration of the anhepatic period and the primary
      function of the re-implanted liver.

PMID- 2240533
TI  - Combined air and oxygen entrainment. Effect on the percentage output of fixed
      performance masks.
AB  - Secondary oxygen was added to air entrained by the primary jet of a fixed
      performance mask. Twenty such masks, in each of six groups rated at 24%, 28%,
      31%, 35%, 40% and 50%, gave higher O2 percentages equivalent to those calculated
      from an equation that related the O2 concentration to the secondary flow. Actual
      values of both were closely correlated, with regression slopes and intercepts
      similar to those derived from this equation. This technique is simple and
      predictable in altering the composition of an air-oxygen mixture delivered to the
      patient.

PMID- 2240534
TI  - Loss of consciousness after emergence from anaesthesia. A case of suspected
      micturition syncope.
AB  - A case of postanaesthesia micturition syncope with respiratory arrest is
      described. If syncope occurs, the temporary myocardial ischaemia and cerebral
      hypoperfusion may increase anaesthetic risk in the marginally compensated
      patient. The loss of airway protection during the syncopal period is also a cause
      of concern. We recommend the use of an indwelling bladder catheter during any
      prolonged surgical procedure.

PMID- 2240535
TI  - The Engstrom Elsa anaesthetic machine. An electronic system for anaesthesia.
AB  - Six Engstrom Elsa anaesthetic machines have been in regular use for 18-24 months.
      The machine incorporates a number of new concepts for anaesthetic delivery and
      monitoring. At flows below 1000 ml/minute, each machine delivered 20% more than
      the indicated value; at higher flows, the indicated value was within 10% of the
      flow delivered. Minute volume, tidal volumes and oxygen concentrations were
      within the manufacturer's specifications. However, vaporizer and vapour monitor
      performance was outside the (SD) 5% accuracy claimed by the manufacturers. It was
      noted that the bistable valve requires user familiarity for the change from
      controlled to spontaneous ventilation to be accomplished with ease. It was also
      possible to misconnect the breathing system and so isolate the excess pressure
      escape valve and high-pressure alarm. Nevertheless, once familiarisation was
      achieved, the machines have proved easy to operate and are particularly
      satisfactory when used with low fresh gas flows.

PMID- 2240536
TI  - Resistance to fluid flow through two spinal needles.
AB  - A new needle, 120 mm long and 26 gauge in diameter, has been introduced for
      subarachnoid anaesthesia. The resistance to flow through the needle was measured
      using a pressure monitor infusion pump and compared with the resistance to flow
      through a 90-mm 26-gauge needle; there was a threefold increase in resistance in
      the 120-mm needle compared to the 90-mm needle, which could not be explained by
      the difference in length alone and must reflect a decrease in the internal
      diameter of the long needle. This results in difficulty in identifying the
      subarachnoid space by backflow of cerebrospinal fluid.

PMID- 2240537
TI  - Another Selectatec switch malfunction.
AB  - Malfunction of a Selectatec-3 switch mechanism is reported which caused isolation
      of the selected vaporizer. This resulted in a delivery of unsupplemented fresh
      gas to the patient.

PMID- 2240538
TI  - The Trilite inhaler. An historical review and performance assessment.
AB  - The Trilite inhaler was developed for use in World War II. Its efficient
      performance is confirmed and a brief biography of its inventor is also given.

PMID- 2240539
TI  - Intravenous diclofenac sodium. Does its administration before operation suppress
      postoperative pain?
AB  - Intravenous diclofenac sodium was evaluated in a double-blind randomised trial
      relative to intramuscular diclofenac, intravenous fentanyl, and intramuscular
      placebo in 160 patients undergoing extraction of impacted lower third molar
      teeth. The test drug was administered before operation in an attempt to alleviate
      postoperative pain. A 10-cm visual analogue scale was used to assess pain at 30
      minutes and one day after surgery, if the patients stayed overnight. Patients who
      received intravenous diclofenac had significantly less pain than the other groups
      30 minutes after operation. They also had significantly less pain one day after
      surgery than the placebo or opioid groups, but not less than the intramuscular
      diclofenac group. Capillary bleeding time, in comparison with placebo, was
      significantly prolonged after the use of intramuscular diclofenac, and a similar
      but nonsignificant trend was observed in the intravenous diclofenac group. No
      problems were encountered with excessive bleeding in any group.

PMID- 2240540
TI  - An evaluation of a 30-gauge needle for spinal anaesthesia for caesarean section.
AB  - A 30-gauge spinal needle was evaluated for Caesarean section, using a combined
      epidural/spinal technique, in 50 mothers. Spinal anaesthesia failed in six
      mothers and was inadequate in another six. General anaesthesia was required on
      one occasion. A 25% overall failure rate suggests that a 30-gauge needle is not a
      practical proposition for routine clinical practice.

PMID- 2240541
TI  - Intrathecal anaesthesia for day-care surgery. A retrospective study of 160 cases
      using 25- and 26-gauge spinal needles.
AB  - The records of 160 day-care surgical patients who received intrathecal
      anaesthesia were reviewed. No major complications were recorded. The incidence of
      postspinal headache after puncture with a 25-gauge spinal needle was nearly four
      times more frequent compared to a 26-gauge needle. The occurrence of postspinal
      headache in patients over the age of 45 years was significantly less frequent (p
      less than 0.05) than in younger patients. Intrathecal anaesthesia was acceptable
      to 91% of outpatients in this group.

PMID- 2240543
TI  - Successful difficult intubation. Tracheal tube placement over a gum-elastic
      bougie.
AB  - A randomised study was carried out to assess the effect of tracheal tube rotation
      on the passage of a tube over a gum-elastic bougie into the trachea in 100
      patients. The effect of the presence or absence of a laryngoscope on successful
      tube placement was also assessed. A grade 3 difficult intubation was simulated in
      patients with a laryngoscope. There was a significant difference in the rates for
      successful first-time intubation in those patients with tube orientation of -90
      degrees (with the bevel facing posteriorly) as compared with a tube orientation
      of 0 degrees (the normal orientation with the bevel facing left). The
      unsuccessful first-time intubations with a 0 degree orientation were frequently
      converted to successful intubations with the -90 degrees position at a second
      attempt. The presence of a laryngoscope in the mouth while rail-roading a tube
      over the bougie also made a significant difference to the rate of successful
      first-time intubations. The most successful method was to leave the laryngoscope
      in the mouth and rotate the tube to -90 degrees.

PMID- 2240542
TI  - Relief of injection pain in adults. EMLA cream for 5 minutes before venepuncture.
AB  - The effectiveness of skin anaesthesia after 5 minutes' topical application of a
      lignocaine-prilocaine cream was evaluated. One hundred and twenty patients
      estimated the pain of antecubital venepuncture both on a linear scale and
      verbally after use of the cream for either 5 or 60 minutes, a placebo cream or no
      treatment. Reported pain was significantly less after only 5 minutes of the
      lignocaine-prilocaine cream (p = 0.002). The cream can be used to relieve the
      pain of all routine injections.

PMID- 2240544
TI  - Acid aspiration prophylaxis in 288 obstetric anaesthetic departments in the
      United Kingdom.
AB  - The choice of drugs for acid aspiration prophylaxis in 288 obstetric anaesthetic
      departments in the United Kingdom was determined by questionnaire. The results
      are compared with a similar survey of anaesthetic departments 5 years ago. The
      prescription of sodium citrate and the H2 receptor antagonist ranitidine has
      superseded that of Mist. magnesium trisilicate.

PMID- 2240545
TI  - Anaesthesia and the law.

PMID- 2240547
TI  - Does xenon deserve a prominent place in anaesthetic practice?

PMID- 2240546
TI  - Children's premedication and hypoxaemia.

PMID- 2240548
TI  - Crystalloid preloading in spinal anaesthesia.

PMID- 2240549
TI  - Monitoring during sedation.

PMID- 2240550
TI  - Management of supraventricular tachycardia in septic patients.

PMID- 2240551
TI  - Trauma to epidural veins: the role of posture.

PMID- 2240552
TI  - Convulsions after cocaine and propofol.

PMID- 2240553
TI  - Electro-acupuncture and postoperative emesis.

PMID- 2240554
TI  - Problems associated with the introduction of different equipment.

PMID- 2240555
TI  - The use of transtracheal cannulation after difficult intubation.

PMID- 2240556
TI  - Laryngeal mask and anaesthetic waste gas concentrations.

PMID- 2240557
TI  - Laryngeal mask airway for inadequate reversal.

PMID- 2240558
TI  - Supplementary oxygen and the laryngeal mask airway.

PMID- 2240559
TI  - Persistent erection and general anaesthesia.

PMID- 2240560
TI  - The oesophageal detector device and the laryngeal mask.

PMID- 2240561
TI  - An inappropriate use of tape.

PMID- 2240562
TI  - Another failure of Selectatec block.

PMID- 2240563
TI  - [The effect of postural changes on cerebral hemodynamics during general
      anesthesia].
AB  - Anesthesia may compromise the regulation of systemic and cerebral hemodynamics
      following changes in body position. Sudden decreases in cerebral perfusion
      pressure due to changes from a horizontal to a head-elevated position may cause
      decreases in cerebral blood flow (CBF), particularly in patients with preexisting
      cerebrovascular disease. Transcranial Doppler sonography (TCD) permits on-line
      measurement of blood flow velocity (BFV) in human basal cerebral arteries, and
      there is evidence that monitoring of BFV may indicate relative changes in CBF.
      The present study compares the effects of changes from a horizontal to a head
      elevated position on blood flow velocity in the middle cerebral artery (MCA) in
      30 patients (ASA I) with different levels of steady state anesthesia (group A: n
      = 20, isoflurane = 1.0 vol% end-tidal; group B: n = 10, isoflurane = 0.4 vol% end
      tidal; O2/N2O; FiO2: 0.3; 6 1/min). The MCA was insonated by transtemporal
      approach using a 2 MHz Doppler ultrasound system (TC2-64 B, EME) with a range
      gating mechanism, adjustable sample volume depth, and flow direction
      discrimination. Systolic (Vsyst, cm/s) and mean flow velocity (Vmean, cm/s),
      pulsatility index (PI), mean arterial blood pressure (MAP, mmHg), heart rate (HR,
      b/min) and end-tidal CO2 (pet-CO2, mmHg) were recorded with the subjects lying
      flat (baseline values) and for 5 min following adjustment to a 35-40 degrees head
      elevated position. There was a significant reduction of 25% for Vsyst from 79 +/-
      17 cm/s (baseline) to 59 +/- 13 cm/s and a 33% decrease for Vmean from 52 +/- 9
      cm/s (baseline) to 35 +/- 9 cm/s in group A immediately after
      repositioning.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240564
TI  - [A fatal hypertensive reaction during anesthesia in a patient with acute
      subarachnoid hemorrhage].
AB  - We describe the case of a 55-year-old female patient who presented for clipping
      of cerebral artery aneurysm that had ruptured 8 h before. Anesthesia induction
      was uneventful. After adequate positioning of the patient, two injections of a
      saline solution containing ornipressin (POR 8) were given into the scalp. Before
      surgical incision the patient developed a hypertensive reaction with arterial
      blood pressure of 230/140 mm Hg and heart rate 140/min. Pharmacologic
      intervention decreased the blood pressure and heart rate to normal values within
      4 min. Upon surgical opening of the skull, the dura was found to be extremely
      noncompliant, and the pupils became wide and nonresponsive to light. Acute
      rebleeding was diagnosed, and the patient was sent back to the intensive care
      unit without clipping of the aneurysm and was declared brain-dead 12 h later. A
      Cushing response following acute rebleeding and other factors that might have
      caused the hypertensive crisis are discussed in detail. Anesthetic agents and
      adjuncts are assessed in terms of their influence on intracranial pressure and
      their protective action on the brain. Special consideration is given to
      subcutaneous ornipressin injection, which is known to be associated with
      cardiovascular side effects. Deep neuroleptanesthesia is recommended as the
      anesthetic technique of choice for clipping of cerebral artery aneurysms.
      Antihypertensive agents without cerebrovascular side effects should be used to
      treat hypertensive reactions.

PMID- 2240565
TI  - [Lymphocyte subpopulations in patients at risk of sepsis in a surgical intensive
      care unit].
AB  - Infection remains a major cause of morbidity and mortality in intensive care
      medicine. The increased susceptibility of the severely injured patient to sepsis
      and consecutive multiorgan failure has been attributed to abnormalities in cell
      mediated immunity. The purpose of our study was to determine changes in the
      pattern of lymphocyte subpopulations in severely injured patients and to relate
      these changes to any development of sepsis and to outcome (indirect
      immunofluorescence with monoclonal antibodies). During 14 months we investigated
      28 patients (ages 15-65 years) suffering from severe multisystem trauma (22
      cases) or diffuse peritonitis (6 cases), 6 of whom (21.4%) developed sepsis and
      multiorgan failure; 4 of these 6 septic patients died. According to the clinical
      data, patients developed sepsis between the 3rd and 6th days after trauma. We
      therefore defined days 1-3 as the preseptic phase, days 3-6 as the phase of
      sepsis development, and days 4-10 as the phase of septic disease. In the
      preseptic phase there was no statistically significant difference in the pattern
      of the eight lymphocyte subpopulations measured between patients who later
      developed sepsis and those who did not. During the phase of sepsis development,
      however, the patients who did develop sepsis showed significantly reduced numbers
      of CD2-, CD8-, and CD20-positive cells (P = 0.0003; P = 0.009; P = 0.012). The
      number of helper cells (CD4) was also decreased, but the difference between the
      two groups failed to reach statistical significance (P = 0.08).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2240566
TI  - [A cost comparison of Pall filters versus chemical or thermal disinfection of
      ventilator tubes].
AB  - Filter manufacturers claim that the use of disposable filters for anesthesia and
      ventilation therapy would be more economical than changing the tubes and/or
      ventilation circuits every 24 h or 48 h. We therefore compared the costs of
      chemical disinfection or thermal disinfection of 4 different ventilation tube
      systems with those of disposable Pall filters. The cost of disinfecting tubes
      used for ventilation or anesthesia varies 1.81 DM to 12.60 DM and is therefore
      lower than that of the use of disposable filters changed daily. Tubes used for
      anesthesia should be changed after each patient and tubes for ventilation therapy
      can be changed every other day, but disposable filters must be changed daily or
      after each case when used for anesthesia.

PMID- 2240567
TI  - [The handling of propofol (Disoprivan)].

PMID- 2240568
TI  - Carbohydrate characterization of recombinant glycoproteins of pharmaceutical
      interest.
AB  - Carbohydrate characterization of recombinant glycoproteins entails determination
      of the primary structures and points of attachment of the oligosaccharide
      moieties. This article reviews several methods for oligosaccharide- and
      glycosylation-site characterization. A major recent advance in carbohydrate
      analysis has been the use of high-pH anion exchange (HPAE) chromatography for
      separation of glycoprotein-derived oligosaccharides. These separations are
      sensitive to molecular size, carbohydrate composition, linkage positions, and
      anomeric configurations. As a result, HPAE chromatography is a powerful technique
      for glycoprotein characterization and can serve as the basis of an
      "oligosaccharide map." Characterization of potential N-glycosylation sites
      involves determining whether each potential site is glycosylated, the extent of
      oligosaccharide processing at each site, and ideally, a detailed description of
      the distribution of oligosaccharides at each site. Several approaches to
      characterizing glycosylation sites are described, including peptide mapping and
      mass spectrometry. Treatment of a glycoprotein with endo-beta-N
      acetylglucosaminidase H (endo H) followed by peptide:N-glycosidase F (PNGase F)
      can be used to distinguish sites that are not glycosylated from those carrying
      high-mannose structures and from those containing attached complex
      oligosaccharides. After individual glycosylation sites have been labeled by this
      series of reaction, the resulting peptides are characterized by automated Edman
      degradation. This technique is particularly valuable for characterizing peptides
      that contain more than one potential N-glycosylation site. An example is also
      given in which HPAE chromatography is used in conjunction with reversed-phase
      high-performance liquid chromatography tryptic mapping to obtain detailed
      information on the distribution of oligosaccharides at individual glycosylation
      sites.

PMID- 2240569
TI  - Optimization of high-sensitivity fluorescence detection.
AB  - We present general expressions for the number of photons emitted by a fluorescent
      chromophore as a function of the intensity and the duration of illumination. The
      aim is to find optimal conditions for detecting fluorescent molecules in the
      presence of both ground-state depletion and photodestruction. The key molecular
      parameters are the absorption coefficient epsilon, the excited singlet-state
      lifetime tau f, the excited triplet-state decay rate kT, the intersystem crossing
      rate kI, and the intrinsic photodestruction time tau d. When only singlet
      saturation and photochemistry are important, the signal-to-noise ratio depends on
      two fundamental variables: k, the ratio of the absorption rate ka to the observed
      fluorescence decay rate kf, and tau, the ratio of the duration of illumination
      taut to the intrinsic photodestruction time tau d. Equations are also developed
      for the more complicated cases when triplet formation and photochemistry are
      important. This theory was tested by measuring the fluorescence from a solution
      of beta-phycoerythrin flowed through a focused argon ion laser beam. The
      dependence of the fluorescence on the incident light intensity and the
      illumination time agrees well with the theoretical prediction for singlet
      saturation and photochemistry. The signal-to-noise ratio is optimal when the
      light intensity and the flow rate are adjusted so that both K and tau are close
      to unity (5 X 10(22) photons cm-2 s-1 and a transit time tau t of 700 mus). This
      analysis should be useful for optimizing fluorescence detection in DNA
      sequencing, chromatography, fluorescence microscopy, and single-molecular
      fluorescence detection.

PMID- 2240570
TI  - Systematic delineation of scan modes in multidimensional mass spectrometry.
AB  - A logical analysis of mass spectrometric scan modes is performed that reveals the
      full set of experiments available in multidimensional mass spectrometry. The
      analysis utilizes a symbolism that helps provide an organizational scheme for the
      representation and classification of the wide variety of experiments that exist.
      In general, for an n-stage experiment, there is a closed set of experimental
      modes producing spectral types that vary in mass dimensionality from 0 to n.
      There is a total of 2n experiments that have 1 or 0 mass dimensions, along with
      an increasing number of experiments of higher mass dimensionality. There also
      exists a set of 2n fundamental scan modes, viz., experiments in which only mass
      to-charge ratios of individual ions, but not their interrelationships, are
      specified. Scans in which functional relationships between ion masses are defined
      (e.g., neutral loss scans) introduce complexity into the total number of scan
      types available in an MSn experiment, giving a total of 1, 2, 5, 15, 52, and 203
      experiments of 0 through 5th order, respectively. It is shown that combinations
      of data from lower order experiments can be used to construct higher order
      spectra. Extraction of data of lower mass dimensionality from data of higher
      dimensionality is also demonstrated. A different method of reducing
      dimensionality, projection of dispersed data back into a smaller number of mass
      dimensions, is also introduced and characterized. The analysis reveals several
      new types of scan modes including an MS/MS/MS scan having unit mass
      dimensionality, referred to as the selective neutral-loss scan, and several new
      MS/MS/MS scans that are two-dimensional in mass. Examples of these new
      experiments are provided, and their potential value is discussed.

PMID- 2240571
TI  - Long-term performance of a gas chromatography/tandem mass spectrometry assay for
      tebufelone in plasma.
AB  - An automated gas chromatography/tandem mass spectrometry (GC/MS/MS) based method
      for the rapid determination of tebufelone (TE) in animal and human plasma has
      been routinely applied in our laboratory to more than 3000 samples over a 2-year
      period. The selectivity of MS/MS conducted on a triple quadrupole instrument,
      combined with the use of a stable-isotope-labeled internal standard, results in
      excellent analytical figures of merit, as well as minimal sample preparation,
      rapid analysis, and high assay reliability. The work described here goes beyond
      initial method development and validation studies by evaluating the long-term
      performance of quantitative GC/MS/MS. Electron ionization produces M.+ ions for
      TE and the [13C, 18O]TE internal standard, which are selected in Q1 and undergo
      collisionally activated dissociation in Q2. Quantitation is based on monitoring
      daughter ions at m/z 248 and 251, respectively, in Q3. A linear range of 1-3000
      ng of TE/sample (20 pg to 60 ng injected) provides access to an effective
      concentration range of 0.5-30,000 ppb TE in plasma (0.1-2-g samples). The assay
      shows no bias and less than 10% relative standard deviation over this range. In
      the automated mode, less than 7 min elapse from injection to report printout and
      more than 70 plasma samples are routinely prepared and analyzed in a day. Such
      performance is consistently maintained throughout long-term application.

PMID- 2240572
TI  - High-accuracy molecular mass determination of proteins using matrix-assisted
      laser desorption mass spectrometry.
AB  - A method for obtaining protein molecular masses with an accuracy of approximately
      +/- 0.01% by matrix-assisted laser desorption using an internal calibrant is
      described. The technique allows accurate mass determinations of protein sample
      sizes as small as 1 pmol. High concentrations of organic and inorganic
      contaminants (e.g. 1 M urea) do not strongly affect either the signal intensity
      or the mass assignment. The ability to assign an accurate molecular mass to a
      protein is contingent on the observation of clearly resolved protonated molecule
      ions in the mass spectrum.

PMID- 2240573
TI  - Capillary electrophoresis in 2 and 5 microns diameter capillaries: application to
      cytoplasmic analysis.
AB  - Capillary electrophoresis with electrochemical detection in 2- and 5-micron
      capillaries has been developed to study ultrasmall biological environments.
      Sample volumes as low as 270 fL have been injected into the electrophoresis
      capillary with subattomole detection limits for easily oxidized species. We have
      applied this method to the analysis of single cell cytoplasm. Sampling of the
      cytoplasm is accomplished by inserting one end of the electrophoresis capillary
      directly into a single nerve cell. The high-voltage end of the electrophoresis
      capillary has been etched with hydrofluoric acid to form a microinjector. This
      injection scheme represents an improvement over those previously used for similar
      applications. The excellent selectivity of this method is demonstrated for
      catecholamine and indolamine neurotransmitters and their metabolites found in the
      invertebrate system, the pond snail Planorbis corneus.

PMID- 2240574
TI  - Multiple mode semiconductor diode laser as a spectral line source for graphite
      furnace atomic absorption spectroscopy.

PMID- 2240575
TI  - Chemical control of reaction time in an enzyme assay and feasibility of enzyme
      spot tests.
AB  - There are many circumstances in which the understanding of a patient's status
      would be improved by knowing one or more enzyme activities. Such data are
      routinely produced in clinical laboratories, but simple, noninstrumental tests
      for enzymes are a rarity, so their extralaboratory determination is also rare.
      The essential problem is that effective clinical determinations of enzyme
      activities are typically carried out by measuring reaction rates, so the reaction
      time needs to be controlled. The reaction time of a sample can be controlled by
      using a passive, ion exchange-based titration. In this work, OH-, H+, and
      quinidine have been used to stop the enzymes LDH (EC 1.1.1.27) (with H+ and OH-)
      and cholinesterase (EC 3.1.1.8) (with quinidine). The ion exchange material
      containing the enzyme-stopping ion is separated from the sample by a filter. The
      sample contains ions that can exchange with the enzyme-stopping ion in the ion
      exchange material, and it may contain species that buffer the enzyme-stopping
      ion. The reaction time is governed by the exchanging ion's concentration in the
      sample, the quantity of buffer in the sample, the thickness of the filter between
      the ion exchange material and the sample, and the temperature. A test for LDH
      requiring 50 microL of serum and no instrumentation can be made so that results
      from sera with elevated levels appear different than those with normal levels.

PMID- 2240576
TI  - Selective determination of histamine by flow injection analysis.
AB  - A flow injection analysis (FIA) method for the determination of histamine is
      described. Control of reaction timing allows exploitation of a transient,
      chemical-kinetic increase in selectivity that occurs when o-phthalaldehyde reacts
      with histamine. The molar fluorescence ratio (selectivity) of histamine/histidine
      reaches a maximum value of 800 in 32 s, precluding the need for separation of
      histamine from histidine, spermidine, and other potential interferences in
      biological samples. On-line dilution prevents matrix effects and affords a linear
      response up to approximately 4.45 mM histamine, or 500 mg of histamine free
      base/100 g. Under these conditions the detection limit (3 times peak-to-peak
      baseline noise) is 5.5 pg (corresponding to 0.60 mg of histamine free base/100 g
      of sample) and throughput is 60 injections per hour. The high sensitivity and
      high selectivity of the method allow the rapid determination of histamine in fish
      with minimal sample conditioning and will find application in the determination
      of endogenous histamine as well, such as in blood plasma and brain tissue.

PMID- 2240577
TI  - Noninvasive method for monitoring ethanol in fermentation processes using fiber
      optic near-infrared spectroscopy.
AB  - Short-wavelength near-infrared (SW-near-IR) spectroscopy (700-1100 nm) is used
      for the determination of ethanol during the time course of a fermentation.
      Measurements are performed noninvasively by means of a photodiode array
      spectrometer equipped with a fiber-optic probe placed on the outside of the glass
      wall fermentation vessel. Pure ethanol/water and ethanol/yeast/water mixtures are
      studied to establish the spectral features that characterize ethanol and to show
      that determination of ethanol is independent of the yeast concentration. Analysis
      of the second-derivative data is accomplished with multilinear regression (MLR).
      The standard error of prediction (SEP) of ethanol in ethanol/water solutions is
      approximately 0.2% over a range of 0-15%; the SEP of ethanol in
      ethanol/yeast/water solutions is 0.27% (w/w). Results from the mixture
      experiments are then applied to actual yeast fermentations of glucose to ethanol.
      By use of a gas chromatographic method for validation, a good correlation is
      found between the intensity of backscattered light at 905 nm and the actual
      ethanol. Additional experiments show that a calibration model created for one
      fermentation can be used to predict ethanol production during the time course of
      others with a prediction error of 0.4%.

PMID- 2240578
TI  - Continuum-source atomic absorption spectroscopy with an echelle spectrometer
      adapted to a charge injection device.
AB  - An instrumental system for continuum-source atomic absorption spectroscopy has
      been developed for simultaneous multielement determinations. The system consists
      of an electrothermal atomizer and a charge injection device adapted to an echelle
      spectrometer to achieve multiplex detection. A continuous 40-nm spectral range in
      the two-dimensional echelle spectrum was acquired simultaneously through the
      capability of the charge injection device to integrate signals in its MOS
      capacitors. Novel methods were developed to compute absorbances by "scanning"
      through all orders in the entire echelle spectrum or selecting absorption lines
      randomly. In the range 300-430 nm, characteristic concentrations (1% absorption)
      were 1.6, 2.6, 2.9, and 3.8 ng mL-1 respectively for Cu, Mn, and two Cr lines;
      these values are similar to those (1.3, 2.2, 1.2, and 3.6 ng mL-1) obtained for
      single-element detection with an image-dissector system.

PMID- 2240579
TI  - Resolution of multicomponent fluorescence emission using frequency-dependent
      phase angle and modulation spectra.
AB  - We describe a new fluorescence method that allows the resolution of both the
      decay times and emission spectra of mixtures of fluorophores. This method is
      completely general and does not require any assumptions or knowledge of the decay
      times or emission spectra of the individual fluorophores. We use the phase angle
      spectra and modulation spectra of the mixture, measured over a range of suitable
      light modulation frequencies and emission wavelengths. These data are analyzed by
      nonlinear least-squares analysis to recover the emission spectra and the
      associated decay times. The principle of the method and the nature of the data
      are illustrated by using two-component mixtures with increasing spectral overlap.
      We then demonstrate the recovery of minor components, of structure emission
      spectra, and of a three-component mixture with completed overlapping emission
      spectra. And finally, we describe the resolution of a two-component mixture with
      decay times of 0.8 and 1.4 ns using modulation frequencies up to 774 MHz.

PMID- 2240580
TI  - Enzyme-linked immunosorbent assay compared with gas chromatography/mass
      spectrometry for the determination of triazine herbicides in water.
AB  - An enzyme-linked immunosorbent assay (ELISA) was compared to a gas
      chromatography/mass spectrometry (GC/MS) procedure for the analysis of triazine
      herbicides and their metabolites in surface water and groundwater. Apparent
      recoveries from natural water and spiked water by both methods were comparable at
      0.2-2 micrograms/L. Solid-phase extraction (SPE) was examined also, and
      recoveries were determined for a suite of triazine herbicides. A significant
      correlation was obtained between the ELISA and GC/MS method for natural water
      samples that were extracted by SPE. Because ELISA was developed with an atrazine
      like compound as the hapten with conjugation at the 2-position, it was selective
      for triazines that contained both ethyl and isopropyl side chains. Concentrations
      for 50% inhibition (IC50) were as follows: atrazine, 0.4 microgram/L; ametryne,
      0.45 microgram/L; prometryn and propazine, 0.5 microgram/L; prometon, 0.7
      microgram/L; simazine and terbutryn, 2.5 micrograms/L; hydroxyatrazine, 28
      micrograms/L; deethylatrazine and deisopropylatrazine, 30 micrograms/L;
      cyanazine, 40 micrograms/L; didealkylatrazine had no response. The combination of
      screening analysis by ELISA, which requires no sample preparation and works on
      160 microL of sample, and confirmation by GC/MS was designed for rapid,
      inexpensive analysis of triazine herbicides in water.

PMID- 2240581
TI  - A supratrochlear foramen in the humerus of cattle.
AB  - A supratrochlear foramen of the humerus was demonstrated in three Turkish cattle.
      The average size of the foramen was 1.2 x 0.7 cm. This appears to be a new
      anatomic finding in the bovine.

PMID- 2240582
TI  - Immunohistochemical study of peptide-containing nerves in the gastrointestinal
      tract of the Japanese field vole, Microtus montebelli.
AB  - The distribution and relative frequency of nerves containing immunoreactivity for
      substance P (SP), vasoactive intestinal polypeptide (VIP), gastrin-releasing
      polypeptide (GRP), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY)
      and menthionine-enkephalin (MENK) were studied by immunohistochemistry in the
      gastrointestinal tract of the herbivorous Japanese field vole, Microtus
      montebelli.

PMID- 2240583
TI  - Differences in fibre population in dog muscles of different functional purpose.
AB  - Samples were taken from particular sites of the tibialis cranialis (extensor),
      flexor digitalis medialis (flexor) and pectineus (adductor) muscles of 27 dogs of
      different breeds--German shepherd, Spanish greyhound, Spanish mastiff and Iberian
      hound. Samples, which were taken from right and left limbs, were subjected to
      histochemical analysis using ATPase (pH 9.4, 4.6 and 4.2) and NADH-tr. Fibre
      population was assessed using an IBAS-2 Kontron image analyser.

PMID- 2240584
TI  - [The structure of the syrinx in the duck (Anas platyrhinchos)].
AB  - The morphological and structural aspects of the Membrana tympaniformis medialis
      of the syrinx were studied with L.M. and E.M. in 32 female and male Peking ducks
      from 6 to 12 months old. The membrane is covered by pseudostratified prismatic
      epithelium which shows different regional features. While at level of the
      proximal and distal third of the tympanic membrane the morphological and
      structural aspects of the cells resemble that of the adjacent structures
      (pessulus and primary bronchi), the middle part of the epithelium layer becomes
      gradually flattered; the epithelium is made up of oblique or horizontal cells
      which touch each other by means of many lateral interdigitations. At level of the
      upper parts of the cells there are several types of cell junctions. This
      particular disposition seem to be well adapted to the contractions of the
      syringeal muscles.

PMID- 2240585
TI  - [The capillarization of the M. pectoralis of the turkey (Meleagris gallopavo)
      from hatching to the 280th day of life].
AB  - The capillarization of the M. pectoralis was examined in the turkey as it changed
      with age. Examined was the density of the muscles fibers (per mm2), the density
      of the capillaries (per mm2) and the quotient muscle fibers/capillaries. In
      accordance with the sequence of the original data four functions of organismic
      growth (slightly altered) were utilized for the approximation of the data for
      descending amounts: Putter/Bertalanffy (1920, 1934); Richards (1959); Janoschek
      enlarged after Sager (1980) and Richards enlarged after Sager (1980). The
      approximations were made via nonlinear regressions, whereby the sum of the error
      amounts and the sums of the error squares served as criteria of quality. The
      results including the deduced initial and end amounts are combined in tables
      which also contain the parameter of the way the computations were conducted.

PMID- 2240586
TI  - Neuroendocrine (NE) cells in rat neonatal lungs. A histochemical and
      immunocytochemical study.
AB  - A study has been carried out to determine the presence of NE cells in the newborn
      rat lung. The localization of these cell was achieved by an argyrophil method.
      Both single NE and NEB, were found. Immunoperoxidase techniques were performed to
      determine NSE, serotonin and calcitonin production in these NE formations.

PMID- 2240587
TI  - Morphological, histochemical and ultrastructural features of the globule
      leukocyte of the bovine respiratory tract.
AB  - The histochemical and ultrastructural features of the globular leukocyte of the
      bovine respiratory tract is described and found to be similar to those localized
      in the abomasum and bile ducts of cattle. Histochemical analysis of these cells
      demonstrated low amounts of carboxylated mucin mixed with neutral mucin and large
      amounts of basic protein. Two types of globules were seen in the leucocytes; one
      with a homegeneous electron dense material and another with vesiculated,
      crastalloid containing bodies.

PMID- 2240588
TI  - [The synovial organization of the M. fibularis longus in cats, dogs, swine,
      cattle, sheep and goats].
AB  - The synovial structures of the M. fibularis longus were studied by dissection on
      23 cat, 28 dog, 20 pig, 17 ox, 15 sheep and 17 goat limbs. Five injections with
      Technovit into the tarsometatarsal joint were made for each species. The dog had
      two tendon sheaths while all other species had only one lateral one. The
      mesotendon approached the tendon from the medial aspect and was fenestrated in
      the dog (here only in the proximal segment), pig, sheep, and goat, but in the cat
      and ox the fenestration was inconstant. In the area of the lateral malleolus the
      lateral tendon sheath narrowed (in the dog only in the proximal segment). The
      synovial structures on the plantar aspect in the cat, dog, pig, and sheep were
      formed by a recess of the tarsometatarsal joint; while in the ox and goat they
      formed a tendon sheath that took its origin from the same joint. The plantar
      recess surrounded the tendon three quarters of the way in the dog, and in cat,
      pig, and sheep only half way. Nomenclaturial consequences for the NAV are
      discussed.

PMID- 2240589
TI  - Fine structure of the feline tapetum lucidum.
AB  - The morphology of the tapetum lucidum of the domestic cat (Felis catus) was
      studied by electron microscopy. The tapetum is a tapetum cellulosum, localized in
      the choroid of the dorsal fundus. The cells comprising this structure are
      described.

PMID- 2240590
TI  - Hyperplastic and hypertrophic growth of lateral muscle in Dicentrarchus labrax
      (L.). An ultrastructural and morphometric study.
AB  - In this EM study of lateral muscle in Dicentrarchus labrax, we observed that
      during the larval period, growth of the presumptive red and white muscle layers
      occurs both by hypertrophy (as fibres already present at hatching complete their
      maturation) and by production of new fibres in germinal zones specific to the two
      muscle layers. In the first half of larval life the presumptive white muscle
      increases in thickness by the addition, superficially, of new fibres derived from
      a germinal zone of presumptive myoblasts lying beneath the red muscle layer. In
      the second half of larval life new fibres produced in this same zone form the
      intermediate (or pink) muscle layer. Dorsoventrally the myotome grows throughout
      larval life, largely by addition of new fibres from germinal zones at the hypo-
      and epi-axial extremities. Towards the end of larval life all these germinal
      zones are becoming exhausted, but another source of fibres arises as satellite
      cells, associated with large-diameter presumptive white muscle fibres, are
      activated to produce new fibres. The addition of small, new fibres gives the
      white muscle its mosaic appearance. Morphometric analysis of fibre diameters in
      the white muscle confirms that whereas these hyperplastic processes are important
      during the larval and juvenile periods, when growth is very rapid, they have
      ceased by the time the adult stage is attained. By contrast, fibre hypertrophy
      continues through into adult life. The presumptive red muscle consists initially
      of a monolayer of fibres present only near the lateral line, and during larval
      life it grows hypo- and epi-axially by addition of fibres derived from myoblasts
      already present in these areas at hatching. Lying superficially to the
      presumptive red muscle monolayer there is a near-continuous layer of external
      cells with a "flattened" profile. During the second half of larval life,
      differentiation of these external cells into myoblasts provides the source of new
      fibres which are added to the red muscle layer. This process, which occurs
      initially in the region around the lateral line and later spreads outwards, is
      responsible for the increase in thickness of the red muscle.

PMID- 2240591
TI  - Mode of neuronal migration of the pontine stream in fetal mice.
AB  - The migration of immature neurons in the pontomedullary subpial region was
      examined in fetal mice by light and electron microscopy. Immature pontine cells
      were observed forming a cell strand from the ventral aspect of the fourth
      ventricle to the pontine flexure during the period between the 14th and 17th day
      of gestation. These cells were elongated and oriented parallel to the direction
      of migration, and displayed features of immature neurons: they contained a high
      concentration of ribosomal rosettes and a few cisternae of rough endoplasmic
      reticula, as well as Golgi apparatus, mitochondria, microtubules and centrioles.
      Many of the neurons extended leading processes, and these contained
      longitudinally-arrayed microtubules. Filopodia extending from the processes were
      found beneath the pia mater. Relocating cells displayed contact relationships
      between themselves; in the caudal part of the stream, translocating neurons were
      apposed to each other and fibers of various diameters, and in the rostral area of
      the stream, many fibers were noted, and corresponded to leading processes of
      relocating neurons, to which other cell bodies had close contact. From the
      arrangement of the immature neurons and their processes, it can be inferred that
      developing fibers act as guidance substrates for the translocation of embryonic
      pontine neurons.

PMID- 2240592
TI  - Synaptic junctions between sympathetic axon terminals and pinealocytes in the
      monkey Macaca fascicularis.
AB  - The distribution of axon terminals in the pineal gland of monkeys was studied by
      electron microscopy. Numerous terminals bearing small pleomorphic agranular and
      dense-cored vesicles were localized in the perivascular space and among the
      pinealocytes in the parenchyma in normal monkeys. Following bilateral superior
      cervical ganglionectomy, they underwent degenerative changes, including the
      accumulation of glycogen masses, appearance of dense residual bodies and the
      displacement of synaptic vesicles. Some of these degenerating terminals showed
      synaptic contacts with the cell bodies of pinealocytes. At the synaptic junction
      the postsynaptic membrane was thickened asymmetrically. Examples of synaptic
      contacts were most frequently observed in 5 and 7 days postoperative animals. In
      the longer surviving (30 days) monkey, most of the axon terminals showed round
      agranular vesicles, and they were mainly presynaptic to the intrapineal ganglion
      cells with some of the pinealocytes. They remained structurally unchanged
      following the resection of both the superior cervical ganglia. A few axon
      terminals containing small dense-cored vesicles appeared to have survived the
      initial insult, but some of their vesicles appeared swollen 30 days after the
      operation. It is concluded from this study that some of the pinealocytes are
      under the influence by the postganglionic neurons in the superior cervical
      ganglia through direct synaptic contacts. The intrapineal ganglion cells are
      postsynaptic to fibres originating exclusively from the central nervous system.
      Some of these fibres, however, may be presynaptic directly to pinealocytes.

PMID- 2240593
TI  - Pronephric regression during larval life in the sea lamprey, Petromyzon marinus
      L. A histochemical and ultrastructural study.
AB  - The regression of the pronephric kidney of the lamprey, Petromyzon marinus, is
      described using histochemical and ultrastructural techniques. Regression begins
      in the third year of larval life, and by the time the animal enters metamorphosis
      the tubules have all disappeared. The nephrostomes and the renal corpuscle,
      however, persist for the remainder of the life cycle and undergo little change in
      the larva. Iron is present within the tubular epithelium prior to the beginning
      of degeneration, but as degeneration proceeds iron is observed within the tubule
      lumina. Acid phosphatase is noted within the tubule epithelia prior to
      degeneration, but as degeneration proceeds acid phosphatase is also observed
      within the intertubular area. Features of tubular regression include a prominent
      and highly folded basal lamina, numerous cytoplasmic inclusions, and dense bodies
      in the epithelia and lumina. The intertubular region is invaded by lymphocytes,
      granulocytes, plasma cells, and macrophages. The process of pronephric regression
      possesses many features of the process of apoptosis, which has been noted in the
      regression of larval organs in other vertebrates.

PMID- 2240595
TI  - On the fine structure of arc-capillaries: true a.v. anastomoses or sphincter
      capillaries?
AB  - The arc-capillaries represent vessels of the terminal bed: they are not true
      arterio-venous anastomoses. They exhibit a typical capillary structure of their
      wall. The existence of smooth muscle cells and modified smooth muscle cells, such
      as epithelioid cells, cannot be demonstrated. Likewise, a specific activation by
      nerves does not exist. The arc-capillaries differ from the net-capillaries
      neither in the structure of their wall nor in diameter. At the origin of the arc
      capillaries from the final arteriole there are no smooth muscle cells, only
      pericytes (adventitial cells). The arc-capillaries branch off where the final
      arteriole no longer possesses smooth muscle cells. The electron microscopic
      studies showed that arc-capillaries do not represent sphincter capillaries.

PMID- 2240594
TI  - Vasoactive intestinal polypeptide (VIP) containing cells in the developing rat
      occipital hemisphere.
AB  - Numerous cells were observed to show intense vasoactive intestinal polypeptide
      (VIP) immunoreactivity from birth to postnatal day 8 in the subventricular zone
      of the rat occipital hemisphere. This cell population was markedly reduced by
      postnatal day 8, but isolated clusters of VIP cells persisted into adulthood. In
      addition, long, L-shaped VIP fibers were seen in the hemispheric wall up to
      postnatal day 16, but not in the adult. Parallel to the reduction in number of
      the subventricular VIP cells an increasing number of VIP cells appeared in the
      neo- and allocortex, developing by postnatal day 12 all the features of the
      mature cortical bipolar fusiform neurons. As possible alternatives, the migration
      of subventricular VIP cells into the cortex, the transient character of the
      subventricular VIP population or the expression of VIP by radial glia are
      discussed.

PMID- 2240596
TI  - Body composition and the evolution of the Macropodidae (Potorous, Dendrolagus,
      and Macropus).
AB  - The segmental distribution of body weight and the proportions of skin, muscle,
      and bone are compared for three genera of the Macropodidae (Potorous,
      Dendrolagus, and Macropus) and one genus of the Petauridae (Pseudocheirus).
      Potorous and Macropus possess high proportions of muscle mass to total body
      weight, high concentrations of musculature in the lumbar extensors, thigh, and
      tail, and disproportionate ratios of forelimb: hindlimb bone and forelimb:
      hindlimb muscle which correspond to disproportions of intermembral length. These
      species converge with high-speed terrestrial runners in some traits and remain
      distinctive in others. Macropus, larger, more muscular, and faster than Potorous,
      appears to store and return energy to the hopping cycle more efficiently.
      Dendrolagus has less than three-fourths the musculature of the other macropod
      genera, low proportions of the back extensor muscles compared to the other
      macropods, and relatively more equal ratios of forelimb:hindlimb bone and
      forelimb:hindlimb muscle. This species converges with slow-moving arboreal
      climbers such as Pseudocheirus. These data on body mass and tissue proportions
      translate directly into center of gravity, strength-to-weight ratio, and muscular
      (kinetic) chains, key elements of macropod evolution. The geometric similarity of
      muscle between smaller potoroids and larger macropodids, and assumption critical
      to allometric comparison, is not confirmed.

PMID- 2240597
TI  - Identification of motoneurons in the spinal cord of the zebrafish (Brachydanio
      rerio), with special reference to motoneurons that innervate intermediate muscle
      fibers.
AB  - We investigated the location and size distribution of motoneurons that innervate
      red, intermediate and white muscle fibers in the axial musculature of the
      zebrafish (Brachydanio rerio). Motoneurons were identified by retrograde labeling
      from the respective myotomal compartments with horseradish peroxidase applied
      either in small polyacrylamide gel fragments or as pure crystals. We found a
      spatial relationship between the three myotomal muscle fiber types and the
      corresponding motoneurons. The white motoneurons are grouped in the dorsal part
      of the motorcolumn, near the central canal. Motoneurons of the red and
      intermediate muscle are clustered in the ventral part of the motorcolumn. The
      average position of the red motoneurons is ventral to that of the intermediate
      motoneurons. Some sizes are distributed over wide overlapping ranges, spanning
      from 41 to 352 microns 2 for red and intermediate and from 56 to 894 microns 2
      for white motoneurons. These data are discussed in relation to the recruitment
      order of myotomal muscle fibers of different types as revealed by
      electromyographic recordings in fish, and the so called "size principle" for
      motoneuron recruitment.

PMID- 2240598
TI  - Tenotomy-induced motor endplate alterations in rat soleus muscle.
AB  - The effects of tenotomy on the ultrastructure of rat soleus muscle motor
      endplates were examined both qualitatively and quantitatively. Rat soleus muscle
      was studied 2 weeks following tenotomy and compared with normal littermates. The
      motor endplates from the tenotomized muscles were found to exhibit both
      degenerative and regenerative changes. Degeneration consisted of postjunctional
      fold breakdown, exposed junctional folds, myelin-like bodies within the sub
      junctional sarcoplasm, and dense bodies within the Schwann cell cytoplasm. The
      regenerative changes consisted of several small nerve terminals occurring within
      the same primary synaptic cleft and several axons wrapped by the same Schwann
      cell. The results demonstrate that tenotomy induces denervation-like changes at
      endplates that lead to terminal sprouting within the neuromuscular junctional
      area and remodelling.

PMID- 2240599
TI  - Comparison of mesenteric with antimesenteric crypt and villus populations in the
      mouse jejunal epithelium.
AB  - Variation in the size and composition of crypts and villi along the length of the
      intestinal tract is well known. Here we investigate possible variation around the
      circumference of the intestine. This is a concern because most studies have
      ignored potential circumferential variation and its implications for experimental
      design in cell kinetic studies. We compared the crypt and villus populations of
      the mesenteric half with those of the antimesenteric half of proximal mouse
      jejunum. The branching crypt index and crypt and villus dimensions were measured.
      We found no evidence of differences in the branching crypt index, in the mean
      crypt and villus size, nor in the distribution of crypt and villus sizes between
      these two populations.

PMID- 2240600
TI  - A novel mechanism of capillary growth in the rat pulmonary microcirculation.
AB  - Postnatally, the rat lung parenchyma undergoes impressive growth. Within four
      months of birth, lung volume and alveolar and capillary surface areas increase
      over 20-fold and capillary volume 35-fold. Investigation of methacrylate casts of
      the pulmonary microvasculature revealed that, with age, lung capillaries were not
      only growing in surface and volume but also increasing their network density. We
      proposed that the capillary bed grows by formation of slender intravascular
      tissue pillars and termed this type of growth intussusceptive microvascular
      growth (Caduff et al., Anat. Rec., 216:154-164, 1986). The aim of this
      investigation was to detect the presence and to analyze the ultrastructure of
      slender tissue posts (diameter 1-2.5 microns) extending across the capillary
      lumina in serial electron microscopic sections of rat lung parenchyma (age 44
      days). Computer-assisted three-dimensional reconstruction of the capillary lumen
      confirmed that tissue posts were matching the holes previously observed in casts.
      Post ultrastructure varied with size from a simple area of interendothelial
      contact to tissue pillars with a core of interstitial tissue. Based on the
      changing morphology of the pillars, a hypothesis for their development can be
      proposed: phase I, creation of a zone of contact between opposite capillary walls
      (formation of an interendothelial bridge); phase II, reorganization of the
      intercellular junctions of the endothelium, with central perforation of the
      capillary layer; phase III, formation of an interstitial post core, with
      successive invasion by cytoplasmic extensions of myofibroblasts, pericytes, and
      finally interstitial fibers; and phase IV, growth of the slender pillar to a
      normal full size capillary mesh. These findings support the new concept of
      intussusceptive growth of the lung capillary system.

PMID- 2240601
TI  - Immunofluorescent studies for alpha-actinin in cultured cardiomyopathic hamster
      heart cells.
AB  - Primary cultures of cardiac myocytes from normal and genetically cardiomyopathic
      (CM) newborn hamsters (strain UM X7.1) were analyzed by indirect
      immunofluorescent microscopy after 3, 5, 7, and 9 days in culture. The cultures
      were fixed in cold acetone and immunostained by an indirect method using FITC
      labelled anti-alpha-actinin to label the myofibrillar Z bands. Most normal and CM
      myocytes appeared round in shape after 3 days in culture. Normal cardiac myocytes
      began to exhibit cytoplasmic projections after 5 days in culture and their
      myofibrils usually showed parallel arrangements with respect to each other. The
      cardiac cells from CM hearts showed an obvious myofibril disarray. Moreover,
      projections formed later than normal. As the size of the cells increased, more
      and more projections formed in normal hamster myocytes during development. By
      contrast, most of the cardiomyopathic myocytes showed few projections even as
      late as 9 days in culture. Hence, the number of projections per cell was much
      less in cardiomyopathic myocytes than in normal, especially after 7 and 9 days in
      culture. These results suggest that cardiomyopathic cells have abnormal shapes in
      culture and, in particular, fail to form projections as in normal cells. Whether
      this unusual behavior is related to an abnormality of the membranes or
      cytoskeletal system in cardiomyopathic heart cells or to some other factor
      requires further study.

PMID- 2240603
TI  - Pericyte of a teleost fish: ultrastructure, position, and role in neoplasia as
      revealed by a fish model.
AB  - The morphology and position of the pericyte, a periendothelial cell, is described
      for a teleost fish, Cyprinodon variegatus. This cell was found attached to the
      abluminal surfaces of capillaries, venules, and arterioles of the submucosa of
      the midgut of the fish. The cell was encompassed by a thin basal lamina,
      possessed numerous plasmalemmal vesicles, a "sole region" which contained thinner
      actin-like filaments and possibly thicker myosin-like filaments, and ranged in
      form from ovoid to stellate, with long cytoplasmic extensions that partially
      covered the endothelium of the associated microvessel. The pericyte of C.
      variegatus has been shown to give rise to hemangiopericytomas (experimentally
      induced with diethylnitrosamine) and possibly to pericytomas. The range of
      phenotypic expression of these pericyte-derived neoplasms is broad, and dependent
      upon the degree of differentiation of their constituent cells which range from
      clear cell pericytes to myofilamentous laden cells that resemble smooth muscle
      cells. In this regard and in regard to its normal ultrastructural morphology, and
      anatomical position, in relationship to microvasculature in this fish, the cell
      is very similar to other vertebrate pericytes. Limited evidence suggests that
      small fish species may be excellent study models for further elucidation of
      pericyte form, function, and role in disease.

PMID- 2240602
TI  - Influence of epithelial-mesenchymal interaction on the viability of facial
      mesenchyme. II: Synthesis of basement-membrane components during tissue
      recombination.
AB  - The presence of basement-membrane components during tissue separation procedures
      was determined employing monoclonal antibodies to laminin and type IV collagen.
      In addition, the reconstitution of basement-membrane components and the formation
      of the basement-membrane were examined in isolated epithelium and mesenchyme and
      in tissue recombination. Epithelium and mesenchyme of maxillary processes of
      chick embryos were separated by a variety of protocols, including those employed
      in a prior study (Saber et al: Anat. Rec. 225:56-66, 1989). Results indicated
      that the protocol previously employed did not remove basement-membrane components
      after enzymatic tissue separation. A revised protocol in which the basement
      membrane components (i.e., laminin and type IV collagen) were removed from
      isolated tissues prior to recombination revealed that a developmental compartment
      and a gradient of cell viability, comparable in size and dimensions to that
      observed in the study of Saber et al. (ibid.) was present in the mesenchyme of
      recombined explants. Type IV collagen and laminin, therefore, do not appear to be
      required initially during tissue recombination in order for subsequent growth
      sustaining effects to be expressed. Additional studies revealed, however, that
      synthesis of basement-membrane components occurred not only in isolated tissues
      but was altered markedly by tissue recombination. Culture of isolated tissues
      demonstrated induction of laminin synthesis in separated epithelium by 24 hours
      and induction of collagen synthesis in isolated mesenchyme by 24 hours.
      Recombination of epithelium and mesenchyme, however, resulted in rapid induction
      of laminin synthesis within 1 hour. Recombination of epithelium and mesenchyme
      after 24 hours resulted in the presence of laminin not only in epithelium but in
      mesenchyme as well. Both tissues were required for basement-membrane formation
      which appeared to be fully reconstituted by 24 hours in culture. These
      observations indicate that recombination in culture alters the pattern of
      synthetic activity of these basement-membrane components. These can be
      characterized as "early" (temporal) and "late" spatial) responses by the
      recombined tissues.

PMID- 2240604
TI  - Developmental appearance and ultrastructural immunolocalization of a major 66 kDa
      phosphoprotein in embryonic and post-natal chicken bone.
AB  - Biochemical analyses and immunocytochemistry were used to examine the
      developmental appearance of a major approximately 66 kDa bone phosphoprotein (66
      kDa BPP) in the mid-diaphyseal region of embryonic and post-natal chicken tibiae
      in vivo. Total protein and O-phosphoserine (Ser-P) and O-phosphothreonine (Thr-P)
      content of 8-, 12-, and 18-day embryonic, and 4-wk post-natal chicken tibiae were
      determined by amino acid analysis. Similar bone samples were carried through a
      wide variety of tissue-processing regimes including different protocols for
      fixation, decalcification, dehydration, and embedding prior to electron
      microscopy. For immunocytochemistry, tissue sections were incubated with a
      polyclonal antibody raised in rabbits against 66 kDa BPP, and the antigen was
      revealed by the high-resolution protein A-gold technique. Amino acid analysis,
      Western blotting, and immunocytochemistry all showed the presence and increasing
      concentration of bone phosphoprotein with advancing developmental age. Immunogold
      labeling was observed over osteoblasts and mineral deposits throughout the bone
      with the most intense reaction occurring at the mineralization front in embryonic
      tibiae. Electron probe X-ray microanalysis confirmed the association of 66 kDa
      BPP with mineral. The levels of phosphoprotein in the tissue were directly
      correlated with increasing degrees of mineralization. These observations are
      consistent with previous proposals suggesting that phosphoproteins may play a
      significant role in the calcification of bone matrix.

PMID- 2240605
TI  - Expression and ultrastructural immunolocalization of a major 66 kDa
      phosphoprotein synthesized by chicken osteoblasts during mineralization in vitro.
AB  - Embryonic chicken osteoblasts cultured over a 30 day period were used as a model
      system for studying the expression of bone phosphoproteins during cellular
      differentiation and the possible role of these proteins in extracellular matrix
      mineralization. Accumulation of total phosphoprotein in the cultures, as
      determined by O-phosphoserine (Ser-P) and O-phosphothreonine (Thr-P) amino acid
      analysis, revealed a greater than 10-fold increase over the 30 day period. Total
      phosphoprotein synthesis, as assessed by (32P)-, (3H)-Ser-P, and (14C)-Thr-P
      protein labeling, showed the highest levels concurrent with initial mineral
      deposition within the matrix. The major phosphoprotein present in chicken bones
      and synthesized by the cultured osteoblasts had a molecular weight of
      approximately 66 kDa. This 66 kDa bone phosphoprotein (66 kDa BPP) was purified
      to homogeneity and was used for antibody production. Application of this antibody
      in Western blot analysis revealed that 66 kDa BPP was present only in protein
      extracts of mineralizing cultured osteoblasts and was absent in cultures of non
      mineralizing chondrocytes, myoblasts, and tendon fibroblasts. The 66 kDa BPP in
      vitro accumulated continuously in the extracellular matrix in a manner that
      paralleled both phosphoprotein synthesis and total phospho-amino acid production.
      A comparison of the results obtained in vitro to those from developing embryonic
      tibiae in vivo demonstrated a similar qualitative and temporal expression of
      phosphoprotein and a continual accumulation of 66 kDa BPP in the matrix with
      advancing mineralization and developmental age. Ultrastructural
      immunocytochemistry using the 66 kDa BPP antibody and the protein A-gold
      technique revealed specific immunolabeling over electron-dense regions of
      mineralization in the cultures that appeared identical to the distribution of
      labeling observed in vivo (McKee et al.: Connect. Tissue Res., 21:21-29, 1989;
      Anat. Rec., 228:77-92, 1990). These results demonstrate that this major 66 kDa
      BPP was expressed concurrently with other differentiated osteoblast functions and
      suggests that it may play a role in the initiation or regulation of
      mineralization.

PMID- 2240606
TI  - Histochemical, ultrastructural, and electron microprobe analytical studies on the
      localization of calcium in rat incisor ameloblasts at early stage amelogenesis.
AB  - The enamel organs of rat incisors were separated from the enamel surface and
      processed for rapid freezing and freeze-substitution. A histochemical stain for
      calcium (GBHA) of thick Epon sections revealed intense calcium reactions in the
      secretory ameloblasts, exclusively in the tubulovesicular structures extending
      throughout their distal cytoplasm. Electron microscopy revealed a thin layer of
      amorphous material with clusters of electron-dense granules along the distal
      surface of secretory ameloblasts. In young secretory ameloblasts without typical
      Tomes' processes, a considerable number of mitochondria were located in the
      distal cytoplasm and contained numerous electron-dense granules. Similar dense
      granules as well as fine ribbon-like electron-dense figures, all containing
      significant amounts of calcium, were observed in some of the tubulovesicular
      structures at the distal end of these cells. A putative exocytotic figure of such
      dense granules was also observed. The electron-dense granules were rare in more
      differentiated ameloblasts with elongated Tomes' processes, which occasionally
      displayed ribbon-like figures in some of the tubulovesicular structures in the
      process region. No significant calcium peak was detected in the extracellular
      amorphous material, secretory granules, or along the lateral plasma membranes.
      These observations may imply high calcium concentrations in mitochondria and
      tubulovesicular structures in the distal cytoplasm of secretory ameloblasts
      relative to that of the cytosol and support the possible contribution of these
      organelles in secretory ameloblasts to cellular calcium regulation at least in
      the early stage of amelogenesis.

PMID- 2240607
TI  - Evidence that apatite crystals of rat incisor enamel have hexagonal cross
      sections.
AB  - Images of nearly cross sectioned enamel crystals obtained with the transmission
      electron microscope were examined in detail and correlated with various possible
      cross-sectional shapes of the crystals. The following images were seen: 1)
      elongated hexagons with sharp outlines, maximal density, and minimal size (type A
      profile); 2) elongated hexagons with one pair of long sides of high contrast, two
      pairs of short sides of low contrast, high density in the center of the image,
      and low density towards the low contrast sides (type B profile); 3) slanted
      hexagons with one pair of high contrast sides, two pairs of low contrast sides
      (one pair of long, one pair of short sides), and the density decreasing from the
      center towards the low contrast sides (type C profile); this profile was seen
      more frequently than the type B profile; and 4) octagons with low contrast edges
      all around, the density decreasing from the center towards the edges (type D
      profile). Types B, C, and D profiles were larger than type A profiles. Similar
      crystal images have been described in the literature. When tilting a specimen in
      increments of 6 degrees, the transformation of type A to type C and type C to
      type D profiles was observed. Many crystal images did not change their shape
      greatly when tilting the section through 6 degrees. No rectangular or rhomboidal
      profiles were seen. It is argued that types A, B, C, and D profiles cannot be
      generated by apatite crystals with a parallelepiped cross section. They are
      easily explained, however, on the basis of crystals with hexagonal cross section.

PMID- 2240608
TI  - A scanning electron microscopy morphometric study of the rabbit peritoneal
      surface.
AB  - Rabbit peritoneum was studied by SEM to obtain information and statistically
      meaningful morphometric data of different sites of visceral and parietal
      peritoneum and to verify the existence of "stomata." Samples were fixed by
      intraperitoneal infusion of glutaraldehyde, and were photographed by SEM under
      standard conditions. Morphometric data were obtained by Kontron MOP Videoplan.
      Variable cell surface patterns were present even within limited areas; however,
      "stomata" were not observed. The heterogeneity of data obtained can be related to
      the dynamism of mesothelial cell activity and to the different motilities of the
      underlying organs.

PMID- 2240609
TI  - Spatial distribution of "tissue-specific" antigens in the developing human heart
      and skeletal muscle. I. An immunohistochemical analysis of creatine kinase
      isoenzyme expression patterns.
AB  - Using monoclonal antibodies against the M and B subunit isoforms of creatine
      kinase (CK) we have investigated their distribution in developing human skeletal
      and cardiac muscle immunohistochemically. It is demonstrated that in skeletal
      muscle, a switch from CK-B to CK-M takes place around the week 8 of development,
      whereas in the developing heart, CK-M is the predominant isoform from the
      earliest stage examined onward (i.e., 4 1/2 weeks of development). In all hearts
      examined, local differences in concentration of the CK isoforms are observed. The
      CK-M expression in the developing outflow tract (OFT) and conduction system is
      described in detail. Between the weeks 5 and 7 of development, the distal portion
      of the OFT is characterized by low CK-M expression, whereas around the week 8-10
      of development the myocardium around the developing semilunar valves in the OFT
      expresses a very high level of CK-M. At all stages examined, a relatively low CK
      M level is observed in those regions in which the "slow" components of the
      conduction system do develop (e.g., the sinoatrial junction and atrioventricular
      junction), whereas a relatively high concentration of CK-M is observed in those
      areas that are destined to become the "fast" components, i.e., the subendocardial
      myocardium of the ventricles. The high expression of CK-M in the developing "fast
      components" of the conduction system contrasts with the relatively low expression
      of CK-M in the force-producing myocardium of the interventricular septum and free
      ventricular wall.

PMID- 2240610
TI  - Glycoconjugate unique to migrating primordial germ cells differs with genera.
AB  - Previous cytochemical studies showing that rat primordial germ cells (PGCs)
      possess a unique surface glycoconjugate containing terminal alpha-N
      acetylgalactosamine were extended in this study to determine whether a similar
      distinctive glycoconjugate coats the surface of PGCs in the mouse. The results
      showed that mouse PGCs fail to react with peroxidase-conjugated lectins specific
      for localizing glycoconjugate with terminal N-acetylgalactosamine. All available
      lectin conjugates with affinity for other terminal sugars or internal sugar
      linkages also failed to stain mouse PGCs except for the conjugates that bind to
      alpha-fucose. One fucose-specific lectin conjugate stained only PGCs in the early
      mouse embryo but stained additional sites in more mature embryos and lost
      reactivity with PGCs after gestational day 14. Another fucose-specific conjugate
      stained PGCs until day 15, but with less selectivity, and a third such conjugate
      bound to several sites, but not to PGCs. The results suggest that the
      developmental mechanisms mediating cellular interaction, migration, and
      differentiation may be similar in different genera, but the specific structure of
      the cell surface glycoconjugate involved in these mechanisms differs.

PMID- 2240611
TI  - Impaired development of the thymic primordium after neural crest ablation.
AB  - Impaired thymic development as a result of ablation of neural crest has been
      observed in embryos late in development. The present study was initiated to
      determine what changes are effected early in thymic development by neural crest
      ablation. The epithelial primordia of the thymus were studied in chick embryos on
      the sixth day of incubation. Embryos with neural crest ablations were compared
      with sham-operated and untreated controls. Neural crest ablation inhibited
      formation of epithelial thymic primordia. Primordia in experimental embryos were
      fewer in number and were smaller than in shams and untreated controls. When
      primordia from shams and controls were transplanted to the chorioallantoic
      membrane of chick hosts, they were able to develop into organs with the typical
      features of embryonic thymus. Similar transplantation from neural crest-ablated
      animals, on the other hand, led to small, predominantly epithelial structures
      with meager lymphoid development. These findings are consistent with the
      hypothesis that mesenchyme derived from cranial neural crest is critical in
      initiating and sustaining the development from pharyngeal pouches of epithelial
      structures competent to attract and support the proliferation and differentiation
      of lymphoid stem cells.

PMID- 2240612
TI  - Myotome and early neurogenesis in chick embryos.
AB  - The present study was undertaken in order to verify the identification of
      profiles of presumptive growth cones in vivo. The developing spinal nerves of
      chick embryos were studied by light and electron microscopy. We traced the onset
      of efferent and afferent innervation of the myotome in 2- to 4-day-old chick
      embryos in order to be sure that we were examining the growing tips of axons. In
      the process of studying these growing axons, we were able to observe some unique
      relationships of neural tube, myotome, and differentiating spinal nerves. The
      neural tube tightly abuts the myotome in Hamburger and Hamilton's (HH) stage 14
      chick embryos and cytoplasmic projections from the myotome directly abut the
      neural tube. The first ventral roots could be identified in HH stage 15 embryos
      and dorsal roots in HH stage 16 embryos, both under 2 1/2 days of age. The
      advancing spinal nerve courses toward the anterior or cranial half of the
      myotome, and growth cones directly contact the medial wall of the myotome. The
      spinal nerves continue to abut tightly the myotome during the succeeding day of
      embryonic life, and growth cones enter the substance of the myotome by 3 days, or
      HH stage 19 embryos. These dorsolaterally directed axons will form the dorsal
      ramus of the spinal nerves and the ventral ramus continues to be contiguous with
      the myotome. Invasion of the myotome by axons (putative innervation), and thus
      innervation of myotomal cells in the 3-day chick embryos, was a totally
      unexpected finding. The myotome and its potential derivatives thus have extensive
      neural contact by 3 days of embryonic life in the chick. These findings document
      a parallel differentiation of afferent and efferent elements of the nervous
      system and confirm previous accounts identifying growth cones in an intact
      organism. These findings suggest that afferent as well as efferent nerves may
      have critical roles in the differentiation of the mesodermal as well as
      ectodermal derivatives.

PMID- 2240613
TI  - Effects of advancing age on the central response of rat facial neurons to
      axotomy: light microscope morphometry.
AB  - Following axotomy, the regrowth of peripheral axons takes longer in older
      individuals than in young ones. The present study compares central responses of
      facial motor neurons to a crush injury of the facial nerve in 3-month-old and 15
      month-old male rats sampled through 28 days post-crush (dpc). Neuronal somata,
      nuclei, and nucleoli were measured in 30 microns brain stem sections within
      subdivisions of the facial nucleus that contain the cell bodies responsible for
      the movement of the vibrissae. The temporal patterns of change in the size of the
      three structures were interpreted with reference to the re-establishment of
      functional connections, i.e., the return of voluntary vibrissae activity, which
      is delayed by 4 days in the older animals relative to the younger ones. There was
      no age-related difference in the pattern of somal swelling and recovery, nor was
      there an age-related difference in the response of nuclei and nucleoli to axotomy
      through 4 dpc. Both nuclei and nucleoli increased in size in animals of both age
      groups, but after 4 dpc in the older animals nuclear enlargement was prolonged
      and the nucleolar increases were less robust compared to the younger animals. The
      greatest age difference appeared with the re-establishment of functional
      connections. In the 3-month-old animals, the resumption of whisker activity
      coincided with vigorous transient increases in the sizes of nuclei and nucleoli;
      in the 15-month-old animals, there was little nuclear response to functional
      recovery and a comparatively small increase in nuclear sizes.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2240615
TI  - An HRP study of location of the rabbit palatopharyngeal motoneurons and
      peripheral course of their axons.
AB  - The location of the rabbit palatopharyngeal motoneurons and the peripheral course
      of their axons were investigated with intramuscular injection of HRP either in
      the normal animal or in conjunction with intracranial severing of the vagal
      rootlets. Labeled palatopharyngeal motoneurons were ipsilaterally located within
      a subdivision of the nucleus ambiguus which is formed by a compact arrangement of
      the smallest neurons of the nucleus and situated in the rostral of the nucleus.
      We named that subdivision the compact cell group (CoG). The labeled motoneurons
      occupied the caudal half of the CoG at a level from about 500 to 1,900 microns
      rostral to the obex. Labeling was completely abolished by severing the vagal
      rootlets, indicating that the axons of the palatopharyngeal motoneurons traversed
      the vagal rootlets.

PMID- 2240614
TI  - Stage-dependent spontaneous frog dorsal root ganglion neuritogenesis on
      polylysine in vitro.
AB  - Dorsal root ganglia of larval frog extended elaborate neuritic arrays in vitro
      under minimal culture conditions in the absence of medium-supplemented
      stimulatory factors. The highly adhesive attachment substratum polylysine
      provided the necessary condition for exuberant outgrowth, the extent of which was
      dependent on the developmental stage of the animal from which the neural tissue
      was derived, as was the capability for long-term survival. It appears that an
      appropriate substratum can substitute for added growth factors in eliciting
      robust and long-lived sensory neurites in vitro.

PMID- 2240616
TI  - Araldite F as injection material for quantitative morphology of cerebral
      vascularization.
AB  - This study deals with the applicability of Araldite F as injection medium for
      quantitative morphology of the cerebral vascularization. The physical properties
      of the plastic that are essential for obtaining optimal results have been
      determined and tested by injection into the cerebral vessels of ten dog brains
      and five human brains. The dynamic viscosity (at 20 degrees C) of the plastic is
      1.5 times that of blood. The polymerization time (+/- 45 min) is long enough to
      fill the whole vascular tree in a large organ such as the human brain. The
      plastic shows minimal volume shrinkage (3.90% +/- 0.05%), and the final cast is
      suitable for scanning electron microscopy (SEM) investigation after corrosion and
      histological morphometrical examination after embedding in 2-hydroxyethyl
      methacrylate (GMA). Special attention has been paid to the conditions under which
      injection of Araldite F into the cerebral arteries must take place to obtain the
      most accurate quantitative data on cerebral vascularization and vascular area
      distribution. Simultaneous injection of the major cerebral arteries of fresh
      autopsy material, after having removed blood clots by perfusing Kabikinase, is
      recommended.

PMID- 2240617
TI  - Cortisol and transcortin in human seminal plasma and amniotic fluid as estimated
      by modern specific assays.
AB  - Cortisol concentrations in human seminal plasma, as estimated by the very
      specific Amersham 'Amerlite' luminescence immunoassay, were 176 +/- 43 (85-260)
      nmol/l, that is, 63.7 +/- 15.5 (31-94) ng/ml (mean +/- SD, n = 21). This is about
      60% of random levels in blood serum and is the first description of cortisol in
      seminal fluid. In human amniotic fluid at 16-22 weeks of gestation, cortisol
      concentrations were lower, at 72.6 +/- 14.6 (63-124) nmol/l, that is, 29.3 +/-
      5.3 (23-45) ng/ml (n = 21). Concentrations were about 15% of random maternal
      serum levels in the second trimester of pregnancy. The cortisol concentrations in
      both fluids were considerably higher than those reported for saliva, which has a
      mean of about 10 nmol/l. Transcortin (corticosteroid binding globulin, CBG), has
      been found in human seminal plasma and amniotic fluid for the first time.
      Concentrations were low, with values up to 12 micrograms/ml, with no significant
      difference between the two fluids, when using the IRE-Megenix monoclonal
      iodinated radioimmunoassay. Transcortin concentrations were about 10% of levels
      in non-pregnant blood serum, compared with about 0.1% for saliva. The higher
      concentrations of transcortin could perhaps account for the greater diffusion of
      cortisol into seminal plasma and amniotic fluid. The presence of beta-endorphin,
      ACTH and cortisol in amniotic fluid, seminal fluid, ovarian follicular fluid,
      endometrial fluid and gastric fluid may possibly, indicate the existence of a
      small paracrine ACTH-cortisol axis in the relevant secretory tissues.

PMID- 2240618
TI  - Alpha-glucosidase activity and sperm motility.
AB  - We correlated the activity of alpha-glucosidase in seminal plasma with the
      motility and differential motility of sperm. Significant positive correlations
      were found between the alpha-glucosidase activity and both motility and the
      percentage sperm with good forward progression. This supports the use of alpha
      glucosidase in semen as a marker of epididymal function and specifically of the
      development of motility.

PMID- 2240619
TI  - Electrophoretic patterns of spermatozoal nucleoproteins (NP) in fertile men and
      infertility patients and comparison with NP of somatic cells.
AB  - During spermatogenesis in mammals the evolutionary early histones are replaced
      step by step by more species specific nucleoproteins (protamines). The protamines
      protect the genetic information of the male against mutagenic or other damaging
      influences and possibly play a role in male fertility. A method was presented to
      study the nucleoproteins (NP) of single human ejaculates. This procedure was
      checked concerning its usability and validity by bull spermatozoa. The NP of
      cryopreserved human spermatozoa of fertile men and of infertility patients were
      investigated and compared with the electrophoretic patterns of NP of somatic
      hepatocytes of rat and mouse. A total of 48 semen samples were studied. Ten of
      these samples were obtained from semen donors of proven fertility and 38 samples
      were collected from male partners of infertile couples. Photodensitometrically it
      could be distinguished between percentages of non-protamines (PNP) and
      percentages of protamines (PP). The PP varied intra-individually with a mean
      standard deviation of 34%, analogously to the alterations of classical semen
      parameters. The PP of fertile men did not significantly differ from the
      infertility patients with normal spermiogram parameters but showed a
      significantly higher value compared with the semen samples with pathological
      spermiograms. On average the PP of all infertile patients were significantly
      lower than the PP of fertile semen donors.

PMID- 2240620
TI  - Separation of sub-populations of sperm with higher fertility potential from
      normal and pathological semen by peanut agglutinin.
AB  - Incubation of human sperm from semen with counts below 20 x 10(6)/ml with peanut
      agglutinin (PNA) resulted in agglutination of about 70% of sperm. An inverse
      correlation was found between non-agglutinating (PNA) sperm and sperm density (r
      = 0.48, p less than 0.01) and a direct correlation with acrosome-damaged sperm (r
      = 0.83, p less than 0.001). Binding of 125I-PNA to sperm revealed high, and
      possibly also low affinity binding sites on sperm from both normozoospermic and
      oligozoospermic origins. Quantitative transmission electron microscopy analysis
      revealed that agglutinated, PNA+, sperm had lower frequency of acrosomeless
      spermatozoa than PNA(-)-sperm (44% versus 77%) and higher fertility score (+0.18
      +/- 0.1 and -1.5 +/- 0.87 respectively, p less than 0.01). Removal of PNA- sperm
      from oligozoospermic semen may increase the fertility score of the remaining
      sperm.

PMID- 2240621
TI  - Catecholamine distribution in adult rat testis.
AB  - Catecholamine distribution in the adult rat testis was examined using a sensitive
      radioenzymatic method. Norepinephrine was present in the capsule and the
      interstitial fluid, in higher concentrations than dopamine, while in the
      interstitial cell preparations only norepinephrine was found. Epinephrine was
      undetectable in all testicular compartments investigated. No catecholamines were
      found in the seminiferous tubules. Testicular denervation caused a significant
      decrease in capsular catecholamines, confirming the neural origin of these
      amines.

PMID- 2240622
TI  - Postcoital test: which form of spermatozoal motility is associated with a good
      fertility outcome?
AB  - The objectives of this study were to examine the predictive value of the PCT in
      relation to treatment-independent conception rates, to determine which cutoff
      point best predicted fertility outcome, and which form of spermatozoal motility
      on PCT is most significantly related to fertility outcome. A prospective study
      was undertaken of couples referred for the investigation of "unexplained"
      infertility. One hundred and twenty six couples were recruited between July 1984
      and April 1986. On further investigation female infertility factors were
      identified in 32 (25%) of couples, who were therefore excluded from the study.
      All conceptions were treatment independent. The relationship between the result
      of the postcoital test and the chance of conception was studied using a
      modification of Cox's regression model of life table analysis. The mean length of
      involuntary infertility prior to referral was 75 months (range = 18-192, SD =
      39.2). The mean length of follow-up was 18 months (range = 1-34, SD = 8.4). A 98%
      follow-up rate was achieved. Eighteen women conceived, giving a 32-month
      treatment-independent conception rate of 22%. A cutoff point of one spermatozoon
      exhibiting sluggish motility per HPF was the most effective method of classifying
      the results of the postcoital test (X2(1) = 4.28, P = 0.037, RR = 4.7. This would
      suggest that the most efficient form of spermatozoal motion in cervical mucus is
      slow or sluggish motility.

PMID- 2240623
TI  - Semen parameters and conception rates after surgical treatment and sclerotherapy
      of varicocele.
AB  - Varicocele is an important cause of male subfertility which may lead to varying
      degrees of pathological semen quality. Removal of varicocele can be an effective
      andrological treatment if associated with subfertility. Therefore, in a
      retrospective study, two possible methods of treatment, high ligation and
      transcatheter sclerotherapy, were compared with regard to semen parameters and
      conception rates. Three months after treatment, only high ligation showed a
      significant improvement of sperm concentration, morphology and motility. Sperm
      concentration and motility, however, similarly increased in both groups after six
      to nine months. Sclerotherapy showed a better conception rate of 25% than the
      surgical group with 14%. Sclerotherapy should be the treatment of first choice if
      associated with subfertility.

PMID- 2240624
TI  - Zinc levels in seminal plasma of fertile and infertile men.
AB  - Zinc levels were measured in seminal plasma from 78 men classified on the basis
      of spermogram analyses into five groups: normo-, oligo-, astheno-, oligoastheno-
      and azoospermia. Higher zinc levels were found in seminal plasma from the group
      of asthenozoospermia men in comparison to normo-, oligoastheno- (p less than
      0.001), oligo- and azoospermia men (p less than 0.01), while no significant
      differences appeared when other group pairs were compared. Seminal plasma zinc
      levels were positively correlated with sperm density (r = 0.6358, p less than
      0.01) in asthenozoospermia men, whereas a significant negative correlation was
      seen in all groups between percentage forms showing normal progressive motility
      and zinc concentration in seminal plasma. Although zinc is required in seminal
      plasma for normal spermatozoon functionality, excessively high levels of this ion
      may be related with defective motility in asthenozoospermia samples.

PMID- 2240625
TI  - Cytogenetical and histopathologic study of two cases of polled goats.
AB  - Two young intersexed polled goats, with ambiguous outside male genital apparatus
      and marked hypospadias, were studied at cytogenetical and anatomo
      histopathological level. One subject presented a female karyotype (60,XX) whilst
      the other had a 60,XX/60,XY chimerism, with 5% of 60,XY lymphocytes. The anatomo
      histopathologic study of the chimeric subject revealed very small testicles,
      epididymis ecstasy and atrophic part in the testicular parenchyma.

PMID- 2240626
TI  - Spermicidal activity of menfegol-coated condom.
AB  - The spermicidal activity of menfegol-coated condoms was investigated. Menfegol (P
      menthanyl-phenyl-polyxyethylene [8,8] ether) showed strong spermicidal activity
      at 0.5 mg/ml and higher concentrations. Semen was ejaculated directly into
      menfegol-coated condoms (20 mg/condom) or uncoated condoms. Immediately after
      ejaculation, sperm motility and viability were examined. In the menfegol-coated
      condoms, sperm motility was completely suppressed and no viable sperm were
      observed. In the uncoated condoms, most of the sperm were alive, although their
      motility was almost suppressed. These results indicate that the menfegol-coated
      condom represents a new birth control method in which the contraceptive efficacy
      of the condom is enhanced by the spermicidal activity of menfegol.

PMID- 2240627
TI  - Clinical pharmacology of nitrous oxide: an argument for its continued use.
AB  - We tested the hypothesis that the administration of nitrous oxide (N2O) causes
      major (e.g., myocardial infarction, neuronal injury, hypoxemia, infection, death)
      or minor (e.g., nausea, vomiting, headache, earache) untoward effects in patients
      requiring anesthesia for 1.5-4 h. Given the higher morbidity and mortality
      associated with aging, we also tested whether aging increased any untoward effect
      of N2O. Finally, we investigated whether the substitution of N2O for a fraction
      of the anesthesia supplied by isoflurane altered the latter's pharmacologic
      effects. We studied 270 patients scheduled for elective total hip arthroplasty (n
      = 100), carotid endarterectomy (n = 70), or transsphenoidal hypophysectomy (n =
      100) who were randomly assigned within each surgical group to receive isoflurane
      with or without 60% N2O. Regardless of patient age, we found no difference in
      major or minor untoward outcomes between anesthetic groups, nor a trend to
      suggest that a larger data cohort would reveal a significant adverse effect of
      N2O. The addition of N2O administration decreased the isoflurane requirement for
      clinical anesthesia but did not alter most of the clinical variables measured in
      practice, including blood pressure, heart rate, rate of recovery from anesthesia,
      development of postoperative pain, patient satisfaction with anesthesia, or
      duration of anesthesia or of hospitalization. Patients given N2O were no more
      likely to dream during anesthesia, remember events during anesthesia, or be
      frightened by those events. Our results support the continued use of N2O to
      anesthetize patients for elective surgery.

PMID- 2240628
TI  - Effect on outcome of prolonged exposure of patients to nitrous oxide.
AB  - Prolonged (several days or repeated) exposure to nitrous oxide (N2O) can cause
      injury or death. To assess whether relatively prolonged anesthesia with N2O in
      normal patients might similarly cause untoward effects, we investigated whether
      the addition of N2O to isoflurane anesthesia caused injury to patients having
      surgical resection of acoustic neuroma lasting approximately 10 h. Twenty-six
      patients undergoing surgical resection of acoustic neuroma were randomly assigned
      to a regimen that included or excluded N2O (50%-60%) during isoflurane anesthesia
      plus intravenous adjuvants. On average, slightly less isoflurane (0.24%) was used
      during anesthesia with N2O. We measured standard clinical variables (blood
      pressure, heart rate), oxygen saturation, neurologic status, pain, and the
      incidence and type of morbid outcomes. Exposure to N2O did not increase the
      incidence of morbid outcomes (including hepatic injury, infection, or hypoxemia),
      prolong hospitalization, or increase common postoperative complaints such as
      nausea, vomiting, coughing, or headache. Patients anesthetized with either
      regimen were equally satisfied with their anesthetic.

PMID- 2240629
TI  - No finding of increased myocardial ischemia during or after carotid
      endarterectomy under anesthesia with nitrous oxide.
AB  - Nitrous oxide (N2O) has been implicated as a cause of myocardial ischemia. We
      investigated whether substitution of N2O for a portion of the anesthesia supplied
      by isoflurane increased myocardial ischemia in patients at risk for such
      ischemia. Seventy patients having carotid endarterectomies (63 patients) or other
      carotid surgery (seven patients) were prospectively, randomly assigned to an
      anesthetic regimen that included or excluded N2O. All other aspects of anesthetic
      management were similar, except for greater concentrations of oxygen and
      isoflurane in patients not given N2O. Perioperative monitoring for myocardial
      ischemia and infarction included 12- or 5-lead electrocardiography,
      transesophageal echocardiography, and creatine kinase isoenzyme levels. By
      transesophageal echocardiographic or electrocardiographic criteria, 44% of
      patients given oxygen but only 21% of those given N2O had myocardial ischemia
      intraoperatively (P = 0.065). Similarly, myocardial infarction, identified by
      changes in creatine kinase isoenzymes, occurred in only one patient given N2O but
      in three given oxygen (not significantly different). Thus we found no trend
      indicating a greater incidence of myocardial ischemia or infarction associated
      with the use of N2O.

PMID- 2240630
TI  - Postoperative hypoxemia after nonabdominal surgery: a frequent event not caused
      by nitrous oxide.
AB  - We tested whether anesthesia that includes nitrous oxide (N2O) results in the
      development of intraoperative and postoperative pulmonary complications,
      including hypoxemia. We also tested whether aging contributes to the development
      of such complications, particularly when anesthesia includes N2O. We randomly
      allocated patients having total hip replacements, carotid endarterectomies, or
      transsphenoidal hypophysectomies (total n = 270) to an anesthetic regimen with
      and without N2O (stratified within surgical group). A heat-and-moisture exchanger
      was included in the anesthetic circuit of all patients. Patients were monitored
      perioperatively and for 1 wk after surgery using intermittent and continuous
      pulse oximetry to determine oxyhemoglobin saturation. Intraoperatively, mean
      oxygen (O2) saturations were lower in patients given N2O, particularly older
      patients. Hypoxemia (O2 saturation less than 86%) developed in five patients
      receiving N2O and in one receiving O2. This difference was not significant.
      Administration of N2O did not decrease postoperative O2 saturation, nor did it
      alter the incidence of postoperative hypoxemia, cough, or sputum production.

PMID- 2240631
TI  - Nitrous oxide and epinephrine-induced arrhythmias.
AB  - We asked whether the sympathomimetic effect of nitrous oxide (N2O) predisposed
      patients receiving N2O to arrhythmias in response to epinephrine administration.
      We also asked whether aging contributed to the development of arrhythmias, with
      or without N2O. One hundred patients having transsphenoidal hypophysectomy were
      randomly assigned to receive anesthesia including (n = 49) or excluding (n = 51)
      N2O. All patients were given an injection of epinephrine 1:200,000, with 0.5%
      lidocaine to produce hemostasis. Using intermittent 12-lead and continuous lead
      II electrocardiography, we determined the incidence of premature ventricular
      contraction, isorhythmic atrioventricular (AV) dissociation, and changes in T
      wave morphology. Patients given N2O had a significantly higher incidence of
      isorhythmic AV dissociation (61.2% vs 41.2%). A trend toward a higher incidence
      of multiple premature ventricular contractions (16.3% vs 7.8%) was not
      statistically significant. Both anesthetic groups had a high incidence of
      postoperative changes in T-wave morphology (46.9% in the N2O group vs 50.9% in
      the group not given N2O). Aging alone did not affect the incidence of ventricular
      ectopic beats, isorhythmic AV dissociation, or changes in electrocardiographic
      morphology, but correlated with the development of ventricular ectopy during N2O
      anesthesia. We conclude that the use of N2O correlated with a higher incidence of
      isorhythmic AV dissociation in response to injection of epinephrine with
      lidocaine.

PMID- 2240632
TI  - Nitrous oxide does not impair hepatic function in young or old surgical patients.
AB  - We investigated whether anesthesia including nitrous oxide (N2O) caused hepatic
      injury, and whether any adverse effect of N2O was affected by patient age. One
      hundred patients having total hip replacements were randomly assigned to a
      regimen that included or excluded N2O (50%-60%) during regional anesthesia
      supplemented with isoflurane and intravenous adjuvants. Using postoperative
      plasma levels of alanine aminotransferase, bilirubin, and alkaline phosphatase 1
      and 3 days after surgery as indicators of hepatic impairment, we found no
      evidence that N2O causes hepatic injury in either young or old patients.

PMID- 2240633
TI  - Effect of nitrous oxide on folate and vitamin B12 metabolism in patients.
AB  - Exposure to nitrous oxide (N2O) markedly enhances excretion of formic acid and
      formiminoglutamic acid (FIGLU) in the urine of rats, suggesting a disruption in
      the normal pathways of folic acid metabolism secondary to an N2O-induced
      inactivation of methionine synthase. We tested whether surgical patients (23
      having total hip replacements and 26 having resection of acoustic neuromas)
      exposed to isoflurane alone or combined with N2O responded similarly. We found no
      increase in urinary formic acid and FIGLU in patients exposed to N2O for hip
      replacement, but a small, transient increase in the FIGLU-to-creatinine ratio in
      those undergoing resection of acoustic neuromas (mean duration of anesthesia =
      9.3 h). This increase peaked at the end of anesthetic exposure and returned
      toward control levels by the first day after anesthesia and surgery. Low
      preoperative levels of red blood cell folate and low-normal levels of serum
      vitamin B12 did not predict an increase in formic acid or FIGLU in response to
      N2O. Although an occasional patient may prove highly susceptible to and develop
      signs of severe vitamin B12 and folic acid deficiency after exposure to N2O, our
      findings suggest that this is a rare event.

PMID- 2240634
TI  - Hematologic effects of nitrous oxide in surgical patients.
AB  - Nitrous oxide can cause hematologic abnormalities, including death, if it is
      administered for several days. However, the adverse hematologic effects of its
      use for surgical anesthesia are unclear. Accordingly, we have studied the
      hematologic responses of patients undergoing procedures involving hematologic
      stress or prolonged anesthesia with and without nitrous oxide. We measured red
      cell count, hemoglobin concentration, mean red cell volume, reticulocyte count,
      platelet count, mean platelet volume, blood leukocyte level, and leukocyte
      differential in patients undergoing total hip arthroplasty or removal of an
      acoustic neuroma. Nitrous oxide did not affect the production of red blood cells
      or platelets. Nitrous oxide treatment was associated with an increase in
      postoperative leukocyte levels that was modestly but significantly smaller than
      that found in patients not given nitrous oxide. There was no evidence that this
      small decrease in maximal leukocytosis adversely affected clinical outcome.

PMID- 2240635
TI  - Thoracic epidural anesthesia improves global and regional left ventricular
      function during stress-induced myocardial ischemia in patients with coronary
      artery disease.
AB  - The aim of the present investigation was to study the effects of high thoracic
      epidural anesthesia (TEA), including the cardiac sympathetic segments, on
      ischemic ST-segment changes and left ventricular global and regional wall motion
      abnormalities. Ten patients with a two- or three-vessel coronary artery disease,
      all treated with the beta-adrenergic blocker metoprolol because of severe stable
      angina pectoris, performed two identical exercise stress tests, the first without
      TEA (control exercise) and the second with TEA (TEA exercise). Before each stress
      test, intravenous metoprolol was given to achieve maximal or near maximal beta
      adrenoceptor blockade. Systolic and diastolic arterial pressures (radial artery
      cannula), heart rate, and rate-pressure product, as well as global and regional
      ejection fractions, using equilibrium radionuclide angiography in the left
      anterior oblique projection, were measured at rest and during maximal exercise.
      ST-segment analysis (V3 or V5) was performed, and the regional wall motion score
      was calculated at control exercise and TEA exercise. Intravenous metoprolol or
      intravenous metoprolol plus TEA at rest did not cause any significant changes of
      any of the variables. During TEA exercise, systolic arterial pressure, diastolic
      arterial pressure, and rate-pressure product, but not heart rate, were
      significantly lower compared to control exercise. The global and anterolateral
      ejection fractions were significantly higher (52.8% versus 46.5% and 53.2% versus
      46.0%, respectively, P less than 0.05), and the regional wall motion score was
      significantly lower (8.8 versus 11.8, P less than 0.01) during TEA exercise than
      during control exercise. ST-segment depression was significantly lower during TEA
      exercise (-1.03 versus -1.84 mV, P less than 0.01).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2240636
TI  - Controlled hypotension with adenosine or sodium nitroprusside during cerebral
      aneurysm surgery: effects on renal hemodynamics, excretory function, and renin
      release.
AB  - Adenosine, a potent vasodilator both in animals and in humans, has been used to
      produce controlled hypotension in patients, especially during cerebral aneurysm
      surgery. However, in animals adenosine by intrarenal infusion decreases renal
      blood flow (RBF), glomerular filtration rate (GFR), urine flow, and causes an
      inhibition of renin secretion. In this study we evaluated the effect of adenosine
      on RBF in patients (n = 15) scheduled for cerebral aneurysm surgery who had been
      anesthetized with a modified neurolept-anesthesia during controlled
      hyperventilation. Perioperative hypotension was achieved with infusion of
      adenosine (252.8 +/- 55.8 micrograms.kg-1.min-1) (n = 8) or sodium nitroprusside
      (2.5 +/- 0.8 micrograms.kg-1.min-1) (n = 7). Mean arterial pressure was lowered
      by 25%-30%, to approximately 60-70 mm Hg, in both groups. Glomerular filtration
      rate and RBF were measured using standard renal clearance methods for 51Cr
      ethylenediaminetetraacetic acid and paraaminohippuric acid. Urine and blood
      samples were collected during normotension before and after a bolus dose of
      hypertonic mannitol, during hypotension, and during normotension after clipping
      of the aneurysm. Adenosine induced a marked decrease in GFR (-91%) and RBF (
      92%), and a pronounced increase in renal vascular resistance. Sodium
      nitroprusside caused a significantly (P less than 0.01) less pronounced decrease
      in GFR (-24%) and RBF (-36%), but did not affect renal vascular resistance. After
      discontinuation of the hypotensive agents, GFR returned to baseline levels in
      both groups. Renal blood flow, however, increased above baseline after
      discontinuation of adenosine (+93%) but not after sodium nitroprusside. Sodium
      nitroprusside increased renin secretion, which was not seen with adenosine. Four
      patients in the adenosine group developed reversible atrioventricular conduction
      disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240637
TI  - Pulmonary hypertension after heparin-protamine: roles of left-sided infusion,
      histamine, and platelet-activating factor.
AB  - Severe pulmonary hypertension after protamine neutralization of heparin is an
      infrequent but life-threatening event following cardiopulmonary bypass. The
      effect of left ventricular infusion of protamine on pulmonary hypertension as
      well as a possible role of platelet-activating factor (PAF) or histamine in the
      heparin-protamine reaction was investigated in 30 pigs in four different groups
      during general anesthesia. Group 1 animals received 250 IU/kg heparin, followed
      by 100 mg protamine intravenously after 15 min. In group 2 protamine was infused
      into the left ventricle. Group 3 animals received the histamine H1- and H2
      antagonists clemastine and ranitidine 5 min before protamine infusion. In group 4
      the PAF receptor blocker WEB 2086 was given 5 min before protamine. Platelet
      activating factor was measured by a bioassay in serum samples of group 1 and
      group 4 animals. In all four groups protamine caused severe pulmonary
      hypertension, thromboxane A2 release, and a transient decrease in leukocyte
      counts. No PAF release was detected after protamine infusion. Neither left
      ventricular infusion of protamine nor histamine or PAF antagonists prevented or
      attenuated the reactions after protamine infusion. The authors conclude that left
      ventricular infusion of protamine provides no protection from pulmonary
      hypertension, and that histamine and PAF are not involved in the acute pulmonary
      vasoconstriction after protamine neutralization of heparin.

PMID- 2240638
TI  - Comparison of midazolam and propofol in combination with alfentanil for total
      intravenous anesthesia.
AB  - Hemodynamic function during induction of anesthesia, the alfentanil and naloxone
      requirements, and the speed of recovery from total intravenous anesthesia with
      alfentanil/midazolam (group M, n = 10) or alfentanil/propofol (group P, n = 10)
      were compared in patients undergoing lower limb surgery. Twenty patients were
      randomly assigned to receive either 2 mg/kg propofol in 5 min followed by 9 mg.kg
      1.h-1 for 30 min and 4.5 mg.kg-1.h-1 until skin closure, or 0.42 mg/kg midazolam
      in 5 min followed by 0.125 mg.kg-1.h-1 until skin closure. Simultaneously, a
      variable-rate infusion of alfentanil was given. Patients were ventilated with 30%
      oxygen in air. In both groups blood pressure and heart rate decreased
      significantly (P less than 0.02) and to a similar extent during induction. The
      total dose of alfentanil was similar in both groups. No patient in group P and
      nine patients in group M needed naloxone (average dose 130 +/- 70 micrograms, P
      less than 0.001). Recovery, as judged by psychomotor tests (90% score was reached
      at 1 h in the P group and at about 4 h in the M group, P less than 0.001),
      sedative scores, and orientation in time and place, was shorter in group P than
      in group M. The conclusion is reached that propofol is superior to midazolam in
      total intravenous anesthesia with alfentanil.

PMID- 2240639
TI  - Elimination kinetics of sevoflurane and halothane from blood, brain, and adipose
      tissue in the rat.
AB  - Using the rat as an animal model, the elimination kinetics of sevoflurane and
      halothane from brain, blood, and adipose tissue were compared. Elimination of
      sevoflurane and halothane from blood and brain was biexponential. The rapid,
      alpha-elimination rates of sevoflurane from blood and brain were faster than the
      corresponding rates for halothane. However, the slower beta-elimination rates
      from brain and blood, as well as the elimination rates from adipose tissue, were
      similar for both volatile anesthetics. Thus, the potential for residual
      postoperative impairment from subanesthetic tissue concentrations of halothane
      and sevoflurane may be similar even though sevoflurane is initially eliminated
      more rapidly from blood and brain.

PMID- 2240640
TI  - Resistance to atracurium-induced neuromuscular blockade in patients with
      intractable seizure disorders treated with anticonvulsants.
AB  - Previous studies have demonstrated that, with the exception of atracurium,
      resistance to the neuromuscular blocking effects of various muscle relaxants
      develops in patients receiving anticonvulsant therapy. We studied the effects of
      0.5 mg/kg IV atracurium in 53 neurosurgical patients: 21 nonepileptic patients
      receiving no anticonvulsant therapy (MED = 0); 14 epileptic patients treated with
      carbamazepine for years (MED = 1); and 18 epileptic patients treated with
      carbamazepine plus either phenytoin or valproic acid for years (MED = 2). The
      evoked compound electromyogram of the adductor pollicis brevis was recorded, and
      results were analyzed using analysis of covariance, with weight and age as
      covariables. The onset time was not significantly different among the three
      groups. Times for recovery of baseline and train-of-four responses to stimuli
      were significantly shorter in the MED = 1 and MED = 2 groups than in control
      patients (MED = 0). The recovery index (time between 25% and 75% recovery of
      baseline electromyogram values) was progressively shorter in the three groups
      (MED = 0: 8.02 min; MED = 1: 5.93 min; MED = 2: 1.96 min; P less than 0.001).
      This study demonstrates that atracurium, when used on epileptic patients
      requiring long-term (that is, years of) anticonvulsant therapy, has a shorter
      duration of action than when used in nonepileptic patients.

PMID- 2240641
TI  - Lidocaine local anesthesia for arthroscopic knee surgery.
AB  - Forty-five patients were evaluated during knee arthroscopy performed using local
      anesthesia produced by lidocaine with epinephrine to determine the dose-response
      relationship for operative analgesia. Serum lidocaine concentrations were also
      measured. Patients were randomized prospectively to receive 20 mL of 0.5%, 1.0%,
      or 1.5% lidocaine with epinephrine intraarticularly. Intraoperative discomfort
      was measured by verbal response on an 11-point linear pain scale. Pain scores
      were significantly higher in patients receiving 0.5% lidocaine during the first
      45 min of surgery (P = 0.03). After 45 min, pain scores continued to be higher in
      the 0.5% lidocaine group than in the 1.0% or 1.5% groups, but the differences
      were not statistically significant. Ninety-four percent of patients in the 1.5%
      lidocaine group were willing to repeat this anesthetic technique for surgery
      compared with 83% of those in the 1.0% lidocaine group and 75% of those in the
      0.5% lidocaine group (P greater than 0.05). The duration of postoperative
      analgesia was similar in all groups. Serum lidocaine concentrations before and
      15, 30, 60, and 120 min after instillation of lidocaine were highest in the 1.5%
      lidocaine group with a peak concentration of 278 ng/mL. No patient had symptoms
      of lidocaine toxicity. We recommend that lidocaine concentrations of 1.0% or 1.5%
      be used when 20 mL is instilled intraarticularly for knee arthroscopy based on
      patient comfort and absence of lidocaine toxicity.

PMID- 2240642
TI  - Fetal heart rate variability after epidural fentanyl during labor.
AB  - The effects of epidural fentanyl on fetal heart rate (FHR) were examined in 39
      parturients, 19 given 75 micrograms epidural fentanyl and 20 given normal saline
      in 5-mL volumes administered randomly after establishment of adequate epidural
      lidocaine analgesia. Fetal heart rate was measured 15 min before and 15 min after
      lidocaine epidural analgesia, and for 60 min at 5-min intervals after
      administration of epidural fentanyl/placebo. A perinatologist blinded to the
      injected epidural solution analyzed FHR tracings. Epidural injections of fentanyl
      and saline, when given during established epidural lidocaine analgesia, were
      associated with equal reductions in FHR variability and the frequency of FHR
      accelerations (P less than 0.003). Neonatal outcome was also similar in both
      groups. The clinical significance, if any, of these moderate reductions in FHR
      during epidural lidocaine analgesia is unclear.

PMID- 2240643
TI  - Tracheal insufflation of oxygen at low flow: capabilities and limitations.
AB  - Tracheal insufflation of oxygen (TRIO) may provide temporary oxygenation for
      patients or sustain life in apneic mass casualties when conventional ventilatory
      techniques are not available or feasible. Logistically, minimum flows of TRIO
      (Vmin) are desirable for field use and to reduce barotrauma should airway
      obstruction occur. We carried out a feasibility study to determine the efficacy
      of Vmin of TRIO delivered within 1 cm of the carina, in nine anesthetized and
      paralyzed dogs. Minimum flows of TRIO for these dogs of average weight (12 kg)
      was 91 mL/min. In six of the dogs Vmin TRIO was continued and provided
      oxygenation for an average of 1.5 h compatible with subsequent resuscitation with
      conventional ventilation. However, PaCO2 levels increased to mean values of 256
      mm Hg in the 90 min. To determine what the effect of increased gas mixing was on
      gas exchange, we repeated Vmin TRIO for 10 min in six of the dogs with and
      without high frequency oscillations superimposed on the TRIO flow. The
      oscillations (60 mL at 16.3 Hz) increased carbon dioxide excretion but
      significantly impaired oxygenation. In completely apneic animals, TRIO at low
      flow delivered by cricothyroidotomy may be useful as an emergency procedure when
      upper airway obstruction limits the use of other airway management techniques.
      However, enhancement of gas mixing during low-flow TRIO impairs oxygenation, so
      that higher flows would be required when respiratory efforts occur.

PMID- 2240644
TI  - Emergency tracheal intubation in the postanesthesia care unit: physician error or
      patient disease?
AB  - Inadequate airway maintenance has been a major factor in perioperative morbidity.
      To determine the incidence and etiology of emergency tracheal intubations in the
      postanesthesia care unit (PACU), we retrospectively reviewed 13,593 consecutive
      admissions to our PACU from October 1986 through October 1988. Twenty-six
      patients (26/13,593 = 0.19%) required the insertion of an endotracheal tube while
      in the PACU. Seventy-seven percent (20/26) of the intubations occurred within 1 h
      of extubation and/or admission to the PACU. Intubation was more common at the
      extremes of age; 54% of those intubated were more than 60 yr old (P = 0.003); 19%
      were less than 3 yr old (P less than 0.05). Twenty-three percent of the intubated
      patients had undergone otolaryngologic procedures (P = 0.008). Interestingly, 73%
      of the intubations occurred during the months of January through June (P =
      0.016). Median PACU admission scores were lower for the intubated group (P less
      than 0.001). There was no association between intubation and gender (P = 0.74),
      anesthetic technique (P = 0.41), or anesthetic agent (P = 0.49). Of the 26
      intubations, 18 (69%) were considered to be directly related to anesthetic
      management. Despite the extremely low incidence of emergency tracheal intubation
      in a heterogeneous group of patients admitted to our PACU, preventable anesthesia
      related etiologic factors including excessive sedative or anesthetic effect,
      inappropriate fluid management, persistent muscle relaxant effect, and upper
      airway obstruction contributed to the majority of these intubations.

PMID- 2240645
TI  - Clinical and radiologic evidence of the epidural plica mediana dorsalis.

PMID- 2240646
TI  - Epileptogenic foci and local cerebral metabolism.

PMID- 2240648
TI  - Parametric statistics for evaluation of the visual analog scale.

PMID- 2240647
TI  - An alternative explanation for esophageal perforation during neonatal
      resuscitation: hazards of nonregulated wall suction.

PMID- 2240649
TI  - Vasodilator-induced femoral-to-radial pressure gradient after cardiopulmonary
      bypass.

PMID- 2240650
TI  - A hazardous defect in a humidifier.

PMID- 2240652
TI  - A simple chin-support device during face mask anesthesia.

PMID- 2240651
TI  - Intralipid solution mistakenly infused into epidural space.

PMID- 2240653
TI  - The evolving legal context for drug testing programs.

PMID- 2240654
TI  - Measurement of blood cyanide with a microdiffusion method and an ion-specific
      electrode.
AB  - The use of a cyanide ion-specific electrode in combination with the Conway
      microdiffusion method was modified for the measurement of cyanide concentration
      in human red blood cells and plasma. With our modified method, the optimal pH of
      cyanide isolation from red blood cells and plasma was investigated. Cyanide
      recovery from red blood cells increased with decreasing pH. The maximal recovery
      of 96.9 +/- 2.6% was obtained at a pH of less than 1. Cyanide recovery from
      plasma, however, peaked at a pH between 7 and 8, and further changes in pH
      reduced the recovery rate. The maximal recovery rate from plasma was 74.1 +/-
      1.5%. In previous studies, cyanide isolations from both plasma and red blood
      cells were carried out at a pH of less than 1. This study shows that cyanide
      isolation from plasma should be performed at a pH between 7 and 8.

PMID- 2240655
TI  - Excessive airway pressure due to ventilator control valve malfunction during
      anesthesia for open heart surgery.

PMID- 2240656
TI  - Transvenous pacing for the anesthetic management of surgery for glossopharyngeal
      neuralgia.

PMID- 2240657
TI  - Anesthesia for a patient with Kufs' disease.

PMID- 2240658
TI  - Intramyocardial air causes right ventricular dysfunction after repair of a
      congenital heart defect.

PMID- 2240659
TI  - Severe tracheal compression caused by false aneurysm arising from the ascending
      aorta: successful airway management using induced hypotension and bronchoscopy.

PMID- 2240660
TI  - Hyperkalemic death during use of a high-capacity fluid warmer for massive
      transfusion.

PMID- 2240661
TI  - Making oral midazolam palatable for children.

PMID- 2240662
TI  - Proper technique for insertion of the laryngeal mask.

PMID- 2240663
TI  - Anesthesia machine for use during magnetic resonance imaging.

PMID- 2240664
TI  - Wearing of gloves by anesthesia personnel.

PMID- 2240665
TI  - Intravenous general anesthesia is not intravenous sedation.

PMID- 2240666
TI  - Collecting blood for autologous transfusion.

PMID- 2240667
TI  - Bloodless turbinectomy following blind nasal intubation: faulty technique?

PMID- 2240668
TI  - Dynamic testing of catheter manometer systems.

PMID- 2240669
TI  - Transesophageal echocardiography and intraoperative monitoring of left
      ventricular function.

PMID- 2240670
TI  - Relationship of regional wall motion abnormalities to hemodynamic indices of
      myocardial oxygen supply and demand in patients undergoing CABG surgery.
AB  - To investigate the hemodynamic correlates of perioperative regional wall motion
      abnormalities (RWMA), we measured wall motion continuously via transesophageal
      echocardiography (TEE), and related RWMA to continuously measured hemodynamic
      indices of myocardial oxygen supply and demand (heart rate [HR] and systemic and
      pulmonary arterial blood pressures). Fifty patients undergoing coronary artery
      bypass graft (CABG) surgery were studied throughout the prebypass postbypass, and
      intensive care unit (ICU) periods. Only 28% of TEE episodes (RWMA suggestive of
      ischemia) were preceded by acute changes in any hemodynamic parameter.
      Specifically, 7% of TEE episodes were preceded by increases in HR (20% deviation
      from control), 14% by increases in systolic blood pressure (SBP), 13% by
      decreases in diastolic blood pressure (DBP), and 9% by increases in pulmonary
      artery diastolic pressure (PAD). Twelve per cent of TEE episodes were associated
      with increases in rate-pressure product (RPP) to greater than 12,000, and 27%
      were associated with decreases in mean arterial pressure (MAP)/HR to less than 1
      at the onset of TEE episodes. Comparison among periods revealed that postbypass
      TEE episodes were more frequently associated with either increases in demand or
      decreases in supply than were prebypass episodes (53% vs. 25%, P less than 0.05).
      ECG ischemic episodes also were infrequently (30%) associated with acute changes
      in HR, SBP, DBP, or PAD. We conclude that perioperative TEE episodes are
      infrequently triggered by changes in hemodynamics, suggesting that a primary
      decrease in myocardial oxygen supply may be an important mechanism for most
      perioperative RWMA. In addition, neither pulmonary artery catheter pressure
      measurements nor specialized indices (RPP and MAP/HR) appear to be useful in
      predicting TEE episodes.

PMID- 2240671
TI  - Electroencephalographic changes during brief cardiac arrest in humans.
AB  - Slowing and attenuation of the dominant frequency of the electroencephalogram
      (EEG) are changes commonly used to detect cerebral ischemia. To assess the
      validity of this method, the EEGs recorded during 93 episodes of circulatory
      arrest in ten normothermic, lightly anesthetized patients undergoing implantation
      of automatic internal cardioverting defibrillators (AICDs) were visually
      inspected for change. The number of events recorded for each patient varied from
      5 to 18 and was a function of the duration and success of AICD testing in each
      patient. In 82 of 93 (88%) episodes, EEG changes were identified, and occurred an
      average of 10.2 s after the last normal heart beat. Of these 82, 67 (82%)
      illustrated slowing and attenuation. However, 15 (18%) of the hemodynamic events
      showed changes not previously described as indicative of cerebral ischemia: 6
      (7%) showed a loss of delta-wave activity and 9 (11%) showed an increase in the
      amplitude of theta activity. Time to onset of these unusual changes (10.6 and 9.2
      s, respectively) was not significantly different from that for EEG slowing and
      attenuation (10.2 s). Five of the ten subjects showed more than one pattern of
      EEG change. There was no significant difference in the time to onset of EEG
      change among individual patients, and neither were there differences in patterns
      of change associated with particular anesthetic agents. These results indicate
      that in normothermic, lightly anesthetized individuals, cerebral ischemia may
      cause changes in EEG pattern other than slowing and attenuation of dominant
      frequencies. These alternative patterns should be recognized as indicative of
      cerebral ischemia when intraoperative EEG monitoring is performed.

PMID- 2240672
TI  - Oral midazolam preanesthetic medication in pediatric outpatients.
AB  - A need exists for a safe and effective oral preanesthetic medication for use in
      children undergoing elective surgical procedures. We evaluated the effectiveness
      of three different doses of oral midazolam when administered in combination with
      atropine prior to ambulatory surgery. In this randomized, double-blind, placebo
      controlled study, 124 children, ages 1-10 yr, received midazolam, 0.25, 0.50, or
      0.75 mg.kg-1 po, and atropine, 0.03 mg.kg-1 po, mixed with apple juice, or a
      placebo (containing the midazolam vehicle, atropine, and apple juice). A blinded
      observer noted the child's level of sedation, the quality of separation from
      parents, and the degree of cooperation with an inhalation induction of
      anesthesia. Picture-recall was used to assess the amnesic effect of midazolam in
      children over 5 yr of age. Midazolam 0.75 mg.kg-1 produced significant sedation
      at 30 min. After procedures lasting an average of 106-113 min, recovery was not
      prolonged by the oral midazolam-atropine combination. We concluded that oral
      midazolam 0.5-0.75 mg.kg-1 is an effective preanesthetic medication for pediatric
      outpatients.

PMID- 2240673
TI  - Effects of thoracic epidural anesthesia on coronary arteries and arterioles in
      patients with coronary artery disease.
AB  - The effect of cardiac sympathetic blockade by high thoracic epidural anesthesia
      (TEA) (T1-T6, bupivacaine) on the luminal diameter of normal and diseased
      portions of epicardial coronary arteries was determined by quantitative coronary
      angiography in patients (n = 27) with severe coronary artery disease (CAD). In a
      separate group of patients (n = 9) with severe CAD, the effects of TEA on
      coronary arterioles (resistance vessels) were studied, by measuring total and
      regional myocardial blood flow and metabolism with the retrograde coronary sinus
      thermodilution technique. At the stenotic segments, TEA induced an increase in
      luminal diameter from 1.34 +/- 0.11 to 1.56 +/- 0.13 mm (P less than 0.002), but
      did not change the diameter of the nonstenotic segments (3.07 +/- 0.13 to 2.99 +/
      0.13 mm). In the second group of patients, TEA induced no changes in coronary
      perfusion pressure, total or regional myocardial blood flow, coronary venous
      oxygen content, coronary blood flow distribution, regional myocardial oxygen
      consumption, or lactate extraction or uptake. Two patients had chest pain in the
      control situation and had regional myocardial lactate production that was
      attenuated by TEA. We conclude that TEA may increase the diameter of stenotic
      epicardial coronary artery segments in patients with CAD without causing a
      dilation of coronary arterioles. These effects may be beneficial when high TEA is
      used to treat severe ischemic chest pain in patients at rest.

PMID- 2240674
TI  - Epidural clonidine analgesia after cesarean section.
AB  - Epidurally administered clonidine has been reported to produce postoperative
      analgesia. To assess the efficacy, safety, and appropriate dose of epidural
      clonidine for post-cesarean section analgesia, we designed a double-blind,
      placebo-controlled study. Sixty women were randomly assigned to receive epidural
      administration of saline bolus followed by 24-h saline infusion, 400-micrograms
      clonidine bolus followed by 10 micrograms/h clonidine infusion, or 800-micrograms
      clonidine bolus followed by 20 micrograms/h clonidine infusion. Supplemental
      analgesia was provided with patient-controlled iv morphine. Compared to saline,
      both clonidine regimens produced analgesia, as measured by verbal pain scores and
      supplemental iv morphine use during the first 6 h after bolus injection. Time to
      first morphine use was similar for both clonidine groups and significantly
      greater than saline. However, compared to saline, only the 20 micrograms/h
      clonidine infusion resulted in decreased morphine usage over the entire 24-h
      period. Compared to saline, both clonidine doses decreased blood pressure. This
      decrease was greater in the 400-micrograms than in the 800-micrograms clonidine
      group, but no patient required treatment for hypotension. Clonidine decreased
      heart rate (one patient required atropine for asymptomatic bradycardia) and
      produced transient sedation. The 800-micrograms clonidine dose prolonged
      resolution of local anesthetic-induced motor blockade compared to saline. The
      results suggest that epidurally administered clonidine provides analgesia, as
      measured by decreased need for supplemental morphine, after cesarean section, but
      continuous infusion is required for analgesia of more than 6 h duration.

PMID- 2240675
TI  - Clinical evaluation of clonidine added to lidocaine solution for epidural
      anesthesia.
AB  - The effects of clonidine added to lidocaine solution used for epidural anesthesia
      were assessed in 92 women scheduled for surgery and premedicated with diazepam 10
      mg po. Patients received 18 ml 2% lidocaine with clonidine 5 micrograms.ml-1
      (group C-5, n = 26), with clonidine 10 micrograms.ml-1 (group C-10, n = 20), with
      epinephrine 5 micrograms.ml-1 (group E, n = 26), or plain (group P, n = 20). No
      significant difference in the number of segments of analgesia was found at any
      observation period among the four groups of patients. The decreases in mean blood
      pressure (BP) observed 20 min after epidural injection in those given clonidine
      (5 +/- 8% for C-5, 10 +/- 11% for C-10, mean +/- SD) were similar to those given
      plain lidocaine (7 +/- 12%) but significantly less than those given epinephrine
      (18 +/- 12%, P less than 0.01 vs. C-5 or P). The response of BP to ephedrine
      given for restoring BP during anesthesia was not attenuated in patients who
      received epidural clonidine. Heart rate (HR) decreased significantly in patients
      given clonidine 10 micrograms.ml-1 (7 +/- 8%, P less than 0.01), but not in those
      given clonidine 5 micrograms.ml-1, whereas HR increased significantly in those
      given lidocaine plain or with epinephrine (10 +/- 8% and 28 +/- 14%,
      respectively, P less than 0.01). The incidence of sinus bradycardia was similar
      among the four groups of patients. Significant differences were also observed in
      sedation score between clonidine groups and groups P or E; sedation appeared
      approximately 10-20 min after epidural injection in both clonidine
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240676
TI  - Exogenous opioids in human breast milk and acute neonatal neurobehavior: a
      preliminary study.
AB  - Opioid analgesia requirements, distribution into breast milk, and influence on
      neonatal neurobehavior were evaluated in ten parturient-neonate pairs nursing
      after elective cesarean section during epidural anesthesia. Five patients
      received first a loading dose of intravenous meperidine after umbilical cord
      clamping, then patient-controlled analgesia (PCA) with intravenous meperidine,
      and finally meperidine tablets as needed. Five patients received morphine in the
      same manner. Treatment groups showed no differences with respect to neonatal
      Apgar scores or visual analog scale (VAS) pain or satisfaction scores at 24 and
      48 h postpartum. Breast milk specimens, obtained at 12, 24, 36, 48, 72, and 96 h
      postpartum and analyzed for opioids and metabolites, showed persistently elevated
      normeperidine concentrations in the meperidine group. A blinded psychologist
      evaluated each infant once on the 3rd day of life with the Brazelton Neonatal
      Behavioral Assessment Scale (NBAS). A priori, the "alertness" and three "human
      orientation" outcomes of the NBAS were chosen for analysis as best measures of
      opioid-induced effects. On all four outcomes, neonates in the morphine group
      scored significantly higher (P less than 0.05) than neonates in the meperidine
      group. We conclude that post-cesarean delivery PCA with morphine provides
      equivalent maternal analgesia and overall satisfaction as that provided by PCA
      with meperidine, but with significantly less neurobehavioral depression among
      breast-fed neonates on the 3rd day of life.

PMID- 2240677
TI  - Functional residual capacity in anesthetized children: normal values and values
      in children with cardiac anomalies.
AB  - To assess the increase in functional residual capacity (FRC) with growth, FRC was
      measured after induction of anesthesia in two groups of children. One group
      consisted of 74 children, 0.1-11.2 yr of age, without signs of cardiorespiratory
      disease (referred to here as "normal" children), and the other of 21 children,
      0.2-6.9 yr of age, with cardiac malformations. Anesthesia was maintained with
      halothane in the normal children and with fentanyl, droperidol, and nitrous oxide
      in the children with cardiac anomalies. All patients were paralyzed, their
      tracheas intubated, and their lungs mechanically ventilated. FRC was measured
      with an automated tracer gas washout technique. In 70 patients the measurements
      were performed in duplicate with a mean coefficient of variation of 2.0%. FRC
      correlated significantly with height, weight, and age in both groups. Multiple
      regression analysis for both groups considered together indicated no significant
      improvement when factors for the sex of the child or for the presence of cardiac
      anomalies were incorporated into the model. In normal children the simple linear
      and nonlinear regression equations for FRC (in milliliters) versus height (in
      centimeters) were: FRC = -529 + 9.48 x height, r = 0.96; and FRC = 0.00175 x
      height2.66, r = 0.97, respectively. The corresponding equations for FRC (in
      milliliters) versus weight (in kilograms) were: FRC = -92 + 29.9 x weight, r =
      0.93; and FRC = 9.51 x weight1.31, r = 0.95.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240678
TI  - High thoracic segmental epidural anesthesia diminishes sympathetic outflow to the
      legs, despite restriction of sensory blockade to the upper thorax.
AB  - To evaluate whether, after high thoracic segmental epidural anesthesia,
      sympathetic blockade spreads caudally beyond sensory blockade, we assessed
      regional skin temperatures by infrared telethermometry in 53 nonpremedicated
      patients at constant ambient temperature. Either bupivacaine (4.2 ml, 0.75%, n =
      10) or an equal volume of saline (placebo, n = 10) was injected at the C7-T2
      epidural space in a randomized double-blinded fashion. Results were contrasted to
      those observed after midthoracic (T6-T9, n = 13) and lumbar (L2-T12, n = 10)
      epidural injection of an identical dose of bupivacaine or saline (n = 10).
      Despite restriction of sensory block to the upper thorax with high thoracic
      epidural anesthesia, skin temperatures increased significantly (P less than 0.05
      vs. saline) on the foot (great toe: +1.2 degrees C +/- 2.9 SD; little toe: +0.9
      degrees C +/- 2.6) and hand (thumb: +2.0 degrees C +/- 4.0, digit 5: +2.9 degrees
      C +/- 4.2) but decreased after saline. Midthoracic injection also increased
      significantly skin temperature on the foot (great toe: +4.0 degrees C +/- 4.9;
      little toe: +3.6 degrees C +/- 4.8) but not on the hand. In contrast, with lumbar
      epidural anesthesia, skin temperature increased significantly on the foot (great
      toe: +8.5 degrees C +/- 2.5; little toe: +8.6 degrees C +/- 2.8) but decreased
      significantly on the hand (thumb: -3.1 degrees C +/- 2.1; digit 5: -2.8 degrees C
      +/- 2.5).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240679
TI  - Hypoxemia in the postanesthesia care unit: an observer study.
AB  - To determine the incidence and duration of hypoxemia in the postanesthesia care
      unit (PACU), 200 patients were investigated in a single-blind observer study. The
      number of unrecognized hypoxemic episodes, as well as risk factors and possible
      association between hypoxemia and postoperative morbidity, were studied.
      Oxygenation was monitored continuously with a pulse oximeter. One or more
      hypoxemic episodes (SpO2 less than or equal to 90%) were noted in 55% of the
      patients. SpO2 values less than or equal to 80% were noted in 13% of the
      patients. Supplementary oxygen was given during 55% of the 447 hypoxemic episodes
      registered. The hypoxemic episodes were unrecognized by the staff in 95% of the
      cases. With stepwise multiple logistic regression analyses, risk factors
      associated with a higher incidence of hypoxemia were: duration of anesthesia (P
      less than 0.0001), age (P less than 0.002) and a history of smoking (P less than
      0.01). Patients who had undergone regional anesthesia had a lower risk of
      hypoxemia (P less than 0.0002). The occurrence of hypoxemia in the PACU could not
      be correlated to postoperative morbidity. We conclude that hypoxemic episodes in
      our PACU are common and that the routine use of supplemental oxygen combined with
      normal clinical surveillance did not prevent hypoxemic episodes.

PMID- 2240680
TI  - Infection during chronic epidural catheterization: diagnosis and treatment.
AB  - A potentially serious complication of long-term epidural catheterization in
      cancer patients is infection. The early signs of infection were studied in 350
      patients in whom long-term epidural catheters were inserted. Three areas of the
      catheter track were found to be involved; exit site and superficial catheter
      track infection, and epidural space infection. The authors identified the early
      signs of infection in each area and the progress of the infection from the deep
      track to include the epidural space in four of these patients. All 19 patients
      who developed deep track or epidural infections were successfully treated with
      antibiotics and catheter removal. None of the patients required surgery for
      spinal cord decompression. Catheters were replaced in 15 of the 19 treated
      patients who requested them after treatment with no recurrent infections. It was
      concluded that use of long-term epidural catheterization is associated with a
      definable epidural infection rate. The use of epidural opioid analgesia is an
      effective and safe means of obtaining pain relief for terminally ill patients
      when patients are monitored for possible infection and receive prompt treatment
      when the diagnosis is established.

PMID- 2240681
TI  - Effects of ketamine on the cardiac papillary muscle of normal hamsters and those
      with cardiomyopathy.
AB  - The effect of ketamine (10(-5) and 10(-4) M) on the intrinsic contractility of
      left ventricular papillary muscle from normal hamsters and those with
      cardiomyopathy (BIO 82.62, 6-month old) was investigated. At these
      concentrations, ketamine induced a positive inotropic effect on normal papillary
      muscle, as shown by an increase in maximum unloaded shortening velocity (+19 +/-
      4 and +34 +/- 5%, P less than 0.05), active isometric force (+32 +/- 8 and +57 +/
      11%, P less than 0.05), and peak power output (+40 +/- 8 and +80 +/- 16%, P less
      than 0.05), and induced a slight decrease in sarcoplasmic reticulum function.
      Ketamine had no effect on the curvature of the total force-velocity curve,
      suggesting that it does not modify myothermal economy. Contractility of papillary
      muscle from hamsters with cardiomyopathy was less than that of controls, as shown
      by the decrease in isometric active force (-41%, P less than 0.02), peak power
      output (-33%, P less than 0.05), and sarcoplasmic reticulum function. The
      positive inotropic effect of ketamine on papillary muscle from hamsters with
      cardiomyopathy was less marked than in controls and almost suppressed in some
      cases: only the maximum unloaded shortening velocity was significantly increased
      with 10(-5) M ketamine (+7 +/- 6%, P less than 0.05), whereas no significant
      changes were observed in active isometric force (+14 +/- 8 and +13 +/- 11%;
      nonsignificant [NS]) and peak power output (+9 +/- 5 and +13 +/- 8%; NS) with
      ketamine (10(-5) and 10(-4) M, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240682
TI  - Nitrous oxide effects on isolated myocardium: a reexamination in vitro.
AB  - This study examined in vitro myocardial depression by 50% N2O. Maximal isometric
      contractions of guinea pig right ventricular papillary muscles were studied in
      Tyrode's superfusate at 37 degrees C within a gas-tight chamber. Superfusate (pH
      at 7.45) and chamber were equilibrated with 95% O2/5% CO2. After control
      measurements in 95% O2, muscles were studied with 50% N2 and 50% N2O (45% O2/5%
      CO2) in random order with an intervening and final recovery in oxygen. Muscles
      were field stimulated after rest and at 0.1-3 Hz. At 37 degrees C, muscle
      performance deteriorated over time with exposure to reduced oxygen; therefore,
      identical experiments were performed at 30 degrees C in which no systematic
      deterioration occurred. Peak tension and maximum rate of tension development
      (dT/dtmax) were compared for each stimulation rate. At both temperatures, N2O
      caused a 10-15% depression of contractility as compared to that observed with
      nitrogen. In a second protocol, muscles were studied at 37 degrees C in 26 mM K+
      Tyrode's solution with 0.10 microM isoproterenol to study enhanced contractions
      mediated by slow (Ca2(+)-channel-dependent) action potentials. Rested-state
      double stimulations were used (stimulus interval, 250-600 ms) resulting in a
      first rested-state contraction followed by a second contraction (C2) with rapid
      initial tension development. The muscles were exposed to nitrogen and N2O as in
      the force-frequency experiments and did not deteriorate over time. In this
      setting, N2O also caused a 10-15% depression of C2 contractility as compared with
      nitrogen. Another set of muscles was studied in 95% O2 to which 0.5% halothane or
      1% isoflurane was added before exposure to nitrogen and N2O. The combined
      depressant action of N2O with either halothane or isoflurane did not differ from
      that predicted by the simple addition of independent effects; there was no
      evidence of synergism. Furthermore, N2O (50%) alone depressed dT/dtmax in a
      manner similar to that of 0.5% halothane and different from that of 1.0%
      isoflurane. Experiments conducted in iso-osmolar 40 mM Na+ Tyrode's solution, in
      which activator Ca2+ arose from the sarcoplasmic reticulum Ca2+, also showed
      greater depression by N2O than nitrogen. N2O (50%) is a myocardial depressant
      independent of concurrent hypoxic effects with a pattern and magnitude of
      contractile depression similar to that of 0.5% halothane.

PMID- 2240683
TI  - Epidural bupivacaine suppresses local glucose utilization in the spinal cord and
      brain of rats.
AB  - Using the 2-[14C]deoxyglucose method, the effects of analgesic doses of epidural
      bupivacaine (300 micrograms) on local spinal cord glucose utilization (SP-LGU) of
      the cervical, thoracic, and lumbar regions and local cerebral glucose utilization
      (BR-LGU) in 38 brain structures were examined in conscious rats. In addition, the
      effects of intramuscular bupivacaine (300 micrograms) and the spinal cord
      transection (T2) were examined to determine whether the induced metabolic
      changes, if any, are related to the drug's systemic effect and/or
      deafferentation. Lumbar epidural bupivacaine sufficient to produce analgesia
      decreased SP-LGU in the thoracic (18-28%) and lumbar (21-29%) spinal cord but not
      in the cervical cord. Epidural bupivacaine decreased BR-LGU (15-26%) in 35 of 38
      structures examined. With intramuscular bupivacaine, SP-LGU remained unchanged in
      almost all regions, while BR-LGU was significantly decreased (11-23%) in 23
      structures. Plasma concentrations of bupivacaine in the epidural and
      intramuscular groups were comparable. With spinal cord transection alone, SP-LGU
      significantly decreased with varying degrees depending on the structure examined,
      but BR-LGU did not decrease in 36 of 38 structures examined. These results
      indicate that analgesic doses of epidural bupivacaine decrease SP-LGU, probably
      reflecting decreased neuronal activity of the spinal cord, and that reduced BR
      LGU by epidural bupivacaine is most likely due to the drug's systemic effect
      rather than deafferentation.

PMID- 2240684
TI  - Differential effect of oncotic pressure on cerebral and extracerebral water
      content during cardiopulmonary bypass in rabbits.
AB  - To study the effect of oncotic pressure on brain water content during
      cardiopulmonary bypass (CPB), 14 anesthetized New Zealand White rabbits underwent
      60 min of nonpulsatile CPB at normothermia. Animals were grouped according to the
      composition of the circuit priming fluid. Group 1 animals (n = 7) received a
      priming fluid (6.5% hydroxyethyl starch in 0.72 N NaCl; 323 +/- 13 mOsm/kg [mean
      +/- SD]) that maintained normal colloid oncotic pressure (COP) during CPB (19.0
      +/- 1.5 mmHg). Group 2 animals (n = 7) received a priming fluid (0.9 N NaCl; 324
      +/- 23 mOsm/kg) that led to a hypooncotic state (COP = 6.2 +/- 1.2 mmHg). Blood
      chemistries and hemodynamics were recorded every 15 min during CPB. Animals were
      given additional priming fluid and sodium bicarbonate during CPB to maintain a
      circuit flow of 85 ml.kg-1.min-1 and arterial pH greater than 7.35. There were no
      significant differences between groups 1 and 2 with respect to temperature,
      central venous pressure, mean arterial pressure, PaO2, PaCO2, plasma sodium
      concentration, or osmolality at any time during CPB, although osmolality
      increased in both groups. After 60 min of bypass, animals were killed and organ
      water contents were determined by wet/dry weight ratios. A separate group of nine
      similarly prepared and anesthetized animals that did not undergo cannulation or
      CPB also underwent measurement of plasma chemistries and tissue water contents
      and served as nonbypass controls (group 3). Brain and kidney water contents were
      unaffected by oncotic pressure, whereas duodenum and skeletal muscle had
      significantly greater water content (P = 0.003 and P = 0.008, respectively) after
      hypooncotic CPB.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240685
TI  - Halothane cooling contractures of skinned mammalian muscle fibers.
AB  - The effects of halothane or cooling on Ca2(+)-activated tensions and on the
      uptake and release of Ca2+ by the sarcoplasmic reticulum were investigated in
      chemically skinned fibers of the extensor digitorum longus muscle of adult
      rabbits. At 22 degrees C, halothane (greater than 0.46 mM) induced Ca2+ release
      from the SR of Ca2(+)-loaded skinned fibers that resulted in transient tensions.
      Higher concentrations of halothane (greater than 4.65 mM) reduced the steady
      state accumulation of Ca2+ in the SR at 22 degrees C. Cooling (to less than 10
      degrees C) elicited transient contractures (cooling-induced contractures [CC]) in
      Ca2(+)-loaded skinned fibers, despite the fact that the tensions elicited by
      adding Ca2+ to the bath were depressed at these low temperatures. The skinned
      fibers did not develop CCs at 12-16 degrees C. Halothane cooling contractures
      could be elicited at these temperatures by exposing the fibers to halothane
      concentrations that failed to elicit Ca2+ release at 22 degrees C. The halothane
      cooling contractures were blocked by procaine but not by lidocaine. It was
      concluded that these contractures resulted from a synergistic interaction between
      halothane and cooling that stimulates Ca2+ release from, and reduces Ca2+ uptake
      by, the sarcoplasmic reticulum.

PMID- 2240686
TI  - Local and global function of the right ventricle in a canine model of pulmonary
      microembolism and oleic acid edema: influence of ventilation with PEEP.
AB  - Right ventricular (RV) dysfunction may occur due to increased RV afterload and,
      hence, might also contribute to the decrease in cardiac output following
      institution of PEEP in patients with adult respiratory distress syndrome (ARDS).
      To test this hypothesis, the authors examined the influence of PEEP on local and
      global RV function in 12 anesthetized dogs with experimental ARDS (eARDS) induced
      by pulmonary microembolization with glass beads and oleic acid. Local RV function
      was analyzed in the RV inflow tract (RVIT) and RV outflow tract (RVOT) by
      assessing both diastolic segment length, systolic segment shortening, and segment
      work (sonomicrometry). Global RV contractility was quantified by measuring
      maximum rate of pressure rise (dRVP/dtmax) and maximum velocity of contractile
      element shortening (Vmax). In eARDS, despite a fivefold increase in pulmonary
      vascular resistance, there was no change in cardiac index (CI), global RV
      contractility, RVIT and RVOT work, and RVIT shortening, whereas RVOT shortening
      decreased from 12.4 to 7.4% (P less than 0.01). Diastolic segment length
      increased in RVIT (P less than 0.05) but not in RVOT. PEEP of 10 cmH2O did not
      alter global RV contractility, RVIT and RVOT shortening, and RVIT work but
      reduced RVOT work (-35%; P less than 0.01) and CI (-11%; P less than 0.001).
      Cardiac index further decreased during PEEP of 20 cmH2O (-38%; P less than
      0.001), while global RV contractility remained intact despite decreased RVIT and
      RVOT shortening (-32% and -69%; P less than 0.05) and work (-26% and -59%; P less
      than 0.01) in the presence of reduced fiber preload in both regions. From these
      findings, it was concluded that 1) the decreased CI during mechanical ventilation
      with PEEP at constant right ventricular end-diastolic pressure (RVEDP) is not
      caused by depressed global RV contractility in dogs with eARDS and a normal
      myocardium prior to insult. Decreased diastolic segment length and segment
      shortening during PEEP suggest that 2) PEEP reduces stroke volume by the Starling
      mechanism rather than by ischemia of the RV free wall. Finally, regionally
      incongruent changes of fiber preload indicate that 3) local differences in RV
      wall compliance are likely to occur subsequent to eARDS and PEEP.

PMID- 2240687
TI  - Differential protective effects of halothane and isoflurane against hypoxic and
      reoxygenation injury in the isolated guinea pig heart.
AB  - The authors investigated the effects of halothane (HAL) and isoflurane (ISO) on
      cardiac depression produced by global hypoxia and the recovery of function
      following reoxygenation is isolated guinea pig hearts perfused with Krebs'
      solution at constant pressure. Isovolumetric left ventricular systolic (LVSP) and
      end-diastolic pressures (LVEDP) were measured by placing a saline filled, latex
      balloon into the left ventricle. Bipolar electrodes were placed in the right
      atrium and right ventricle for measurements of heart rate (HR), atrioventricular
      conduction time (AVCT), and determination of the incidence and severity of
      dysrhythmias occurring during hypoxia and reoxygenation. Hearts were divided into
      three groups: control (n = 20), halothane (n = 12), and isoflurane (n = 13). All
      hearts were exposed in sequence to oxygenated perfusate (PO2, 530 mmHg),
      moderately hypoxic perfusate (PO2, 91 mmHg) for 30 min, and then to oxygenated
      perfusate for 40 min. Halothane (1%, 0.4 mM) or isoflurane (1.5%, 0.5 mM) were
      administered 10 min before hypoxia, during hypoxia, and during the first 10 min
      of reoxygenation. Exposure to halothane and isoflurane before hypoxia produced a
      14 and 11% decrease in heart rate, a 32 and 23% increase in AVCT, and a 47 and
      28% decrease in LVSP (all P less than or equal to 0.001) for halothane and
      isoflurane, respectively, and no significant change in LVEDP. During hypoxia, HR
      decreased and AVCT increased similarly in both groups. Left ventricular systolic
      pressure (LVSP) decreased sharply with a narrowing of the prehypoxic differences
      among the groups. In the control and isoflurane groups, LVEDP increased during
      hypoxia but remained unchanged in the halothane group.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2240688
TI  - Halothane and isoflurane alter phospholipid transmethylation in rat brain
      synaptosomes.
AB  - The mechanism of action of inhalational anesthetics is unknown, but neuronal
      membrane alteration is a favored hypothesis. Since phospholipid methylation and
      translocation play a key role in the transmission of biologic signals across cell
      membranes, we examined the effect of two commonly used halogenated anesthetics,
      halothane and isoflurane, on phospholipid methylation in rat brain synaptosomes.
      Using S-adenosyl-L-[3H-methyl]methionine as a donor, we found a two-fold increase
      in 3H-methyl incorporation into phospholipids in synaptosomes taken from rats
      exposed to concentrations that just abolish pain response, but not in rats
      exposed to higher or lower concentrations. Methylation was not increased in rats
      newly recovered from anesthesia. Halothane added to synaptosomes taken from rats
      not previously exposed to anesthetics stimulated 3H-methyl incorporation over a
      wide range of concentrations. Enhancement of phospholipid methylation by
      halothane and isoflurane may effect an alteration of neural signal transduction
      that results in the anesthetic state.

PMID- 2240689
TI  - Adenosine decreases the minimum alveolar concentration of halothane in dogs.
AB  - Adenosine has sedative properties, and adenosine-receptor agonists have been
      found to reduce anesthetic requirements in rodents. This study determined whether
      adenosine, in hypotensive doses, reduces anesthetic requirements in halothane
      anesthetized dogs. In seven animals, minimum alveolar concentration (MAC) for
      halothane was determined by a tail-clamp technique at three time points: after 2
      h of halothane anesthesia, during adenosine-induced hypotension (mean arterial
      pressure: 55 mmHg), and 1 h after adenosine was discontinued. In other dogs, the
      effects of aminophylline, dipyridamole, or the specific adenosine-receptor
      antagonist 8-phenyl-theophylline (8-PT) on the halothane-adenosine interaction
      were studied. Adenosine significantly reduced halothane MAC, by 49%, from 0.76 +/
      0.05 to 0.39 +/- 0.05 vol% (mean +/- SEM). This effect was blocked by the
      concurrent administration of aminophylline (n = 5, P less than 0.05) or 8-PT (n =
      4 of 4). When dipyridamole, which increases the plasma concentrations of
      endogenous adenosine, was administered alone, halothane MAC was reduced from 0.79
      +/- 0.03 to 0.67 +/- 0.05 vol% (n = 5, P = 0.09). We conclude that exogenous
      adenosine substantially reduces halothane MAC in dogs and that this effect is
      blocked by the concurrent administration of the adenosine-receptor antagonists
      aminophylline or 8-PT. Relatively small alterations of endogenous adenosine
      concentrations, however, do not substantially reduce halothane MAC.

PMID- 2240690
TI  - Ergonomic and human factors affecting anesthetic vigilance and monitoring
      performance in the operating room environment.

PMID- 2240691
TI  - [Evaluation of the quality of preoperative electrocardiogram interpretation by
      anesthesiologists].
AB  - This prospective study aimed to assess the quality of interpretation by Teaching
      Hospital anaesthesiologists of preoperative electrocardiograms (ECG). It was
      carried out over a period of 7 months, and included 500 patients scheduled for
      elective surgery. The ECG was first interpreted by the anaesthesiologist during
      the preoperative visit, and later during the postoperative period, by a
      cardiologist. The two interpretations were compared using the following criteria:
      minor anomalies, which would not influence the anaesthetic technique already
      selected; major anomalies, which, on the other hand, are known to increase
      anaesthetic morbidity and mortality rates, thereby influencing the choice of
      anaesthetic technique; and interpretative errors concerning only the major
      anomalies, i.e. anomalies not seen by the anaesthesiologist (false negatives),
      anomalies found which did not exist (false positives), and erroneous or
      incomplete interpretation. Interpretation of the ECG by the anaesthesiologist was
      written on the anaesthetic record for only 156 patients (31.2%). Among the 500
      ECG's, 141 were found to be abnormal by the cardiologist (28.2%). Seventy-three
      of them had 1 or more major abnormalities. Of the 156 ECG's interpreted by an
      anaesthesiologist, 64 (41%) were abnormal. The overall error rate was 21.1%, the
      major error rate being 7.1%. The overall false negative rate was 12.8%, with 7
      major ischaemic abnormalities (4.5%) having not been found, including 4 (2.6%)
      diagnostic errors. About 3.8% of ECG's were wrongly interpreted as abnormal by
      the anaesthesiologist; all errors were of minor importance, but nevertheless
      responsible for delayed surgery, loss of time, and extra expenditure in
      laboratory tests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240692
TI  - [Risk of thrombosis in prolonged catheterization of the radial artery: comparison
      of 2 types of catheters].
AB  - The thrombosis rate after long-term cannulation of the radial artery was assessed
      prospectively in 48 intensive care patients randomly assigned to groupe A
      (polyethylene Leader-Cath 115-09 catheter; n = 50, aged 55 +/- 20 years, 74% male
      patients) or groupe B (Teflon Viggo Floswitch 4441 catheter; n = 48, aged 58.6 +/
      16 years, 73% male patients). Bedside angiography was carried out with 10 to 15
      ml Hexabrix before removal of the catheter. The two groups were similar with
      regard to anthropometric parameters, used drugs, pathological events during the
      stay in ICU, arterial cannulation technique and its duration. There was no case
      of clinically significant ischaemia. The rate of X-ray total arterial thrombosis
      was 20% in group A, and 2% in group B (p less than 0.01). There was no difference
      in the rate of partial thrombosis (54% vs. 41.7% respectively, NS) and of lack of
      thrombosis (26% vs. 56.3% respectively, NS). The overall rate of thrombosis was
      greater in group A than in group B, but not significantly (74% vs. 43.7%
      respectively). The duration of arterial cannulation did not influence the rate of
      thrombosis. However it was higher in males of Group A than in those of Group B (p
      less than 0.01), when heparin was not given (p less than 0.05); when vaso-active
      drugs were used (p less than 0.05); and when the time required for cannula
      insertion was greater than 5 min (p less than 0.01). It is concluded that Teflon
      catheters are more biocompatible than polyethylene catheters.

PMID- 2240693
TI  - [Opening of a foramen ovale during liver transplantation. The value of
      transesophageal echocardiography].
AB  - A case is reported of a foramen ovale becoming patent during orthotopic liver
      transplantation (OLT). The patient had a hepatoma secondary to post-hepatitis
      cirrhosis. Monitoring included transesophageal echocardiography (TEE). A veno
      venous shunt between the right femoral, portal and left axillary veins was used
      so as to maintain the venous return during portal and caval clamping. The
      patient's haemodynamic state remained quite stable throughout this period, and no
      vasoactive drug was required. Five min after graft reperfusion, pulmonary
      arterial pressure increased suddenly (mean PAP: 27 mmHg). TEE revealed
      paradoxical movements of the atrial septum. Colour coded Doppler ultrasound
      showed blood flowing from the right to the left atrium through a patent foramen
      ovale. Fifteen min later, mean PAP decreased (18 mmHg) and TEE no longer showed
      any flow between the two atria. Several studies have reported transient pulmonary
      hypertension after unclamping when the donor liver is reperfused. This could
      induce right ventricular failure, with transient inversion of the atrial pressure
      gradient, which, in turn, could result in a right-to-left shunt through a patent
      foramen ovale. TEE can monitor regional and overall left ventricular function as
      well as the atrial septum. This technique might therefore to be useful for
      cardiac monitoring during OLT.

PMID- 2240694
TI  - [Mechanisms and prediction of hemorrhagic complications during surgery of thoraco
      abdominal aortic aneurysms].
AB  - This study, including 33 consecutive patients was designed to assess the
      haemostatic alterations occurring during repair of thoracoabdominal aneurysms.
      The surgical procedure consisted in Dacron graft replacement of the diseased
      aorta, using neither cardiopulmonary bypass, nor any shunting technique, nor any
      heparin. Blood samples were drawn before anaesthesia, before and 30 min after
      unclamping, and on the first postoperative day. The measured parameters were:
      haematocrit, platelet count, bleeding, activated cephalin, thrombin and
      prothrombin times, and concentrations of fibrinogen, factors V, VII, X and II,
      anti-thrombin III, proteins C and S, fibrin degradation products, D-dimers, alpha
      2-antiplasmin, plasminogen, tissue plasminogen activator, plasminogen activator
      inhibitor, and serum protein. Eight patients developed severe multiple
      haemorrhages; 3 of them died during the procedure because of uncontrollable
      bleeding. Although the measured parameters were similar in the "bleeding" and
      control (n = 25) groups before surgery, there was, before unclamping in the first
      group, an important increase in activated cephalin and thrombin times, with a
      fall in concentrations of factor II and V, protein C, fibrinogen, and alpha 2
      antiplasmin, and in platelet numbers. After unclamping, these changes worsened
      further, with an increase in prothrombin time and in fibrinogen levels (0,8 g.l
      1), without any increase in fibrin degradation products. Abnormal bleeding
      started about 30 min after this in all the patients of the "bleeding" group.
      These changes, involving the fibrinolytic system as well as a fall in
      concentration of all the coagulation factors, can probably be partly explained by
      the clamping and unclamping of mesenteric vessels.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 2240695
TI  - [Clonidine: from the treatment of hypertension to its use in anesthesia. II:
      Perioperative use].

PMID- 2240696
TI  - [Technical constraints in rapid vascular fluid replacement].
AB  - Rapid fluid infusion remains the cornerstone for therapy of hypovolaemic shock.
      The principal limitations of flow rate are governed by the four variables of
      Poiseuille's law: tube internal diameter and length, viscosity of the fluid
      passing through the tube, and the pressure gradient between the two ends of the
      tube. Conventional transfusion systems, with wide bore tubing (up to 5.0 mm
      internal diameter), large bore cannulas (8.5 French introducer catheters), high
      pressure (up to 300 mmHg) and diluted blood, can result in a maximum flow rate of
      about 1,000 ml.min-1 (for crystalloid solutions). Specific apparatus for rapid
      infusion can increase this to 1,500 ml.min-1 (Rapid Infusion System,
      Haemonetics). Dry-heat warming devices and microfiltration, to remove
      microaggregates and prevent non haemolytic febrile transfusion reactions, seem
      necessary when carrying out rapid transfusions. However, the use of
      microaggregate filters could be avoided by the routine production of leukocyte
      poor red blood cell concentrates.

PMID- 2240697
TI  - [Peroperative pneumothorax in thoracotomy: the value of pulse oximetry].
AB  - Two cases of pneumothorax occurring during thoracotomy under one-lung ventilation
      are reported. One case occurred before pneumonectomy was carried out. The
      decrease in Spo2 shown by pulse oximetry, together with the increase in airway
      pressures, rapidly led to the diagnosis of pneumothorax. In the other case, the
      accident occurred after pneumonectomy, with a suddenly impossible ventilation,
      and a drastic decrease in Spo2 leading to hypoxic circulatory arrest. Hypoxaemia
      occurring during one-lung ventilation may be due to different causes. Shunting in
      the upper part of the lung is the main cause, but other diagnoses must be
      discussed, such as airway obstruction by blood or sputum, displacement of the
      selective endotracheal tube, bronchospasm, and pneumothorax. Monitoring of Spo2
      by pulse oximetry would therefore seem to be mandatory during thoracic surgery,
      in order to allow an early diagnosis of hypoxaemia and speed up the treatment of
      its cause.

PMID- 2240698
TI  - [Fatal maternal streptococcus A infection after cesarean section].
AB  - A case is reported of an infection with Streptococcus pyogenes, occurring 24
      hours after an elective Caesarean section in a 30 year old woman. She worsened
      during the first 48 h, with shock (Pasys less than 70 mmHg, pH 7.28) as well as
      abdominal tenderness and guarding. Laparotomy revealed peritonitis, and subtotal
      hysterectomy was carried out. Gram positive cocci were found in the peritoneal
      exudate, with bacterial cultures yielding Streptococcus pyogenes.
      Histopathological examination of the specimen revealed necrosing endomyometritis
      with septic thrombophlebitis. During the immediate post-operative period, there
      were several prolonged episodes of circulatory arrest treated with dobutamine,
      adrenaline, and noradrenaline. Multiple organ failure occurred during the next
      five days, despite antibiotic therapy (vancomycin, tienamycin, amikacin) and
      intensive care. It included jaundice, thrombocytopaenia (10 G.l(-1] adult
      respiratory distress syndrome (ARDS). A further laparotomy was carried out
      because of abdominal and thigh cellulitis, with completion of the hysterectomy
      and bilateral salpingo-oophorectomy. Streptococcus pyogenes was still present in
      the peritoneal cavity. There followed an improvement, with a return to normal of
      the platelet count, haemodynamic stability such that vasoactive drugs were no
      longer needed, and a decrease in the degree of jaundice. However, the ARDS
      worsened, and the patient died 15 days after the Caesarean section. There have
      been recent reports of similar cases, suggesting an increase in the virulence of
      group A streptococci linked to a re-emergence of exotoxin A.

PMID- 2240699
TI  - [Venous catheterization and congenital abnormalities of the superior vena cava].
AB  - Persistent left superior vena cava is encountered in about 0.3 to 0.4% of human
      beings. It derives from remnants of the left cardinal vein system. This results
      in either a duplication of the superior vena cava or in a single left vena cava.
      The diagnosis is easy in case of associated cardiovascular anomalies. Two cases
      of single left vena cava and one case of duplication of the superior vena cava
      are described. All were identified owing to repeatedly aberrant courses of
      central venous catheters. Diagnosis was easily provided by angiography. Clinical
      course was uneventful. Despite its usual good tolerance, the persistence of a
      left vena cava, as an isolated anomaly, must not be neglected as it carries many
      practical implications which are reviewed.

PMID- 2240700
TI  - [Hyperkinetic shock and cerebral malaria].
AB  - Two cases of cerebral malaria with hyperkinetic shock are reported. The first
      case concerned a 39-year-old european male who was not taking any prophylactic
      anti-malarial drugs. After having had headache and fever for a week, he was
      admitted to the intensive care unit (ICU) in coma and with jaundice. His initial
      systolic blood pressure was 60 mmg, with a central venous pressure (CVP) of -3
      cmH2O. Five-hundred ml of modified fluid gelatin increased the CVP without
      raising the blood pressure. Haemodynamic investigations revealed a cardiac index
      (CI) = 5.2 l.min-1.m-2, peripheral arterial resistances (Rsa) = 290 dyn.s.cm-5,
      oxygen consumption (VO2) = 120 ml.min-1.m-2. Despite treatment with dopamine and
      dobutamine, the patient died 3 h after his admission, with a CI of 1.9 l.min-1.m
      2. The second patient was a 14-year-old senegalese girl, admitted in
      circumstances similar to the first case. Initial haemodynamic investigations gave
      the following figures: CI 6.5 l.min-1.m-2, Rsa = 476 dyn.s.cm-5, VO2 = 174 ml.min
      1.m-2. Recovery was obtained with fluid replacement therapy and dopamine. In the
      absence of another associated infectious disease, the plasmodial origin of the
      septic shock would seem to be the most likely in both cases. Pathophysiological
      mechanisms of these algid forms of malaria remain enigmatic. Various factors are
      discussed: cytoadherence of erythrocytes infected with Plasmodium falciparum,
      immunological disturbances, or a specific endotoxin.

PMID- 2240702
TI  - [Separate lung respiration and interatrial defect].

PMID- 2240701
TI  - [Respiratory tract obstruction caused by ballooning of an intubation tube cuff
      during nitrous oxide inhalation].
AB  - A typical case of upper airway obstruction due to deformation of a low pressure
      tracheal tube cuff is reported. It would seem that this herniation may have been
      due to nitrous oxide diffusing with in the air-filled cuff, thereby causing it to
      overdistend. This increase in pressure occurred after 3 hours of inhalation of a
      mixture of oxygen and nitrous oxide. The deformed cuff may either block the lumen
      at the end of the tube, or push the tube against the tracheal wall. The result
      is, in either case, a mechanical obstruction of the airway, with hypoxia, and
      then anoxia. In the reported case, it was the decrease of SpO2 which alerted the
      anaesthetist. Pulse oximetry was helpful for an early diagnosis. To avoid such
      accidents, it is suggested either to inflate the cuff with the gas mixture with
      which the patient is ventilated, or to deflate it every 30 min.

PMID- 2240704
TI  - [Moderate von Willebrand's disease type I: use of desmopressin].

PMID- 2240703
TI  - [Cardiocirculatory arrest during anesthesia with propofol and fentanyl].

PMID- 2240705
TI  - [Preoperative use of desmopressin in a woman treated by ticlopidine].

PMID- 2240706
TI  - [Anesthesia and factor VII deficiency].

PMID- 2240707
TI  - [History taking and thrombosis].

PMID- 2240709
TI  - [Plea for humanitarian anesthesia].

PMID- 2240708
TI  - [Occupational peroperative accident caused by atropine].

PMID- 2240710
TI  - Optimization of pulse train duration for the electrical stimulation of a skeletal
      muscle ventricle in the dog.
AB  - The optimal means of electrically stimulating a skeletal muscle to contract
      around a fluid-filled pouch (i.e., a skeletal muscle ventricle [SMV]) has not
      been determined. A SMV was made from the latissimus dorsi muscle in five dogs and
      the rectus abdominis muscle in five dogs, and each SMV was electrically
      stimulated via the motor nerve(s) to contract around a fluid-filled pouch, which
      was connected to a mock circulatory system. The pulse train duration (PTD) was
      varied from 100 ms to 800 ms in 100 ms increments to determine the effect of this
      variable upon SMV output. The pulse width of the electrical stimulus was kept
      constant at 100 microseconds and the pulse frequency was maintained at 50 s-1.
      For SMV contraction rates of 20, 30, and 40 min-1, the optimal PTD was 400 ms for
      both muscles. The peak output was 710 ml min-1 for the rectus SMV and 556 ml min
      1 for the latissimus SMV. For an SMV contraction rate of 10 min-1, the optimal
      PTD was 800 ms for the rectus SMV and 600 ms for the latissimus SMV. Use of less
      than an optimal PTD caused reductions in SMV output of 25-50%. Although SMVs made
      from rectus abdominis and latissimus dorsi had similar values for the optimal
      PTD, the maximum SMV output was usually greater with the rectus abdominis in this
      acute study with untrained muscles. We conclude that PTD is an important variable
      to control, which can markedly affect results when studying the potential use of
      skeletal muscle power for cardiac assistance.

PMID- 2240711
TI  - Human skeletal muscle: phasic type of electrical stimulation increases its
      contractile speed.
AB  - Skeletal muscles, exposed to a prolonged period of specific functional demands,
      respond adaptively. Electrical stimulation, when employed as a technique for
      subjecting selected muscles to altered use, enables precise entrainment of the
      pattern of functional activity. In this investigation, the vastus lateralis
      muscle in a group of volunteers was stimulated. The stimulation program typical
      of a phasic type of activity (high frequency, high current amplitude, short pulse
      duration) intermittently subjected the stimulated muscles to brief periods of
      intense activity, followed by relatively long pauses. The activation-relaxation
      time ratio chosen was 1 to 13. It was determined to prevent the muscles from
      fatiguing. The effects of the chronic stimulation program were established by
      measurements of the time course of contraction and relaxation and fatigue of the
      vastus lateralis muscle. Chronic phasic electrical stimulation increased the
      speed of muscle contraction by 15% while the fatigue characteristics remained
      unchanged.

PMID- 2240713
TI  - Nonlinear phenomenon of interfacial polarization immittance of a Pt electrode.
AB  - Description of a computerized, automated method to measure the interfacial
      polarization immittance of a Pt electrode in nonlinear range is presented. The
      classical three-electrode setup is used for measurements in conjunction with a
      special purpose software implemented on a Unix computer using C language. A
      collection of data at very low frequencies (below 2 Hz) and at high input
      intensities with various dc biases imposed on the input are presented to show the
      behavior of the interface in nonlinear range. The instrument also provides on
      line harmonic analysis of the output signal, by calculating the first four
      Fourier series coefficients, in response to a pure sinusoidal input.

PMID- 2240712
TI  - Isolated aorta setup for hemodynamic studies.
AB  - A setup consisting of a high-performance hydraulic pump connected to the
      ascending part of an isolated aorta, including all major distal branches, each
      loaded with calibrated artificial resistors, was developed. The system was used
      to study total aortic compliance of the baboon as a function of mean aortic
      pressure (n = 5). The aorta loaded with the resistors was mounted in a custom
      designed sink table, such that it was submersed in physiological saline
      maintained at 37 degrees C. Mean distending pressure in the entire aorta could be
      varied. The three-element Windkessel model was used to estimate total aortic
      compliance from pressure and flow waves generated by the pump. Total aortic
      compliance as a function of mean pressure was fitted with a logarithmic function:
      Ln(Compliance) = A + B * P. The value of A (+/- SE) was: 1.565 +/- 0.319 and B: 
      0.020 +/- 0.003 (P less than 0.001). The results were compared with previously
      published results (also using the same three-element Windkessel fit) obtained in
      three of the same animals in vivo. The in vivo data were A: 1.095 +/- 0.235 and
      B: B: -0.019 +/- 0.003. In vitro data had a significantly higher value of A than
      in vivo (P = 0.017), implying a significantly higher aortic compliance in vitro
      than in vivo. Occlusion of the proximal descending aorta was performed at a low
      distending pressure (55 mm Hg) to determine the proximal compliance. It was found
      (n = 4) that 46 +/- 11% (SD) of the total arterial compliance is to be attributed
      to the ascending and proximal descending aorta.

PMID- 2240714
TI  - A new geometric procedure for in vivo pulsed Doppler evaluation of velocity
      distribution inside the diametrical section of large arteries in humans.
AB  - A new geometric procedure determination of velocity profiles inside large human
      arteries, such as the brachial and femoral, has been developed. The procedure
      requires the use of two crystal element Doppler probes and a highly precise
      micromanipulator with three degrees of freedom. Precise positioning is needed to
      obtain the required high degree of parallelism between the vessel axis and the
      plane containing the two crystal elements. Once the appropriate degree of
      parallelism is achieved, a controlled translation of the probe, perpendicular to
      the ultrasonic beam plane, allows velocity waveforms to be recorded at sequential
      radial positions across the measured artery. Velocity profiles obtained with this
      geometric procedure depended on the type of artery investigated. The profiles
      measured with the geometric procedure were more symmetrical than those found
      using the electronic range-gated time system of reception. While the geometric
      and electronic methods were almost identical in determining the diameter values
      of the three arteries measured, the geometric procedure enabled greater accuracy
      for detailed analysis of velocity profiles in the peripheral large arteries in
      humans. Although the present methodology is not applicable in clinical practice
      due to prolonged data acquisition time (approximately 45 s) it is expected that
      future equipment improvements will reduce this time significantly.

PMID- 2240716
TI  - Hemodynamic determinants of subdiaphragmatic venous return during closed-chest
      CPR in a canine cardiac arrest model.
AB  - OBJECTIVE: To assess the hemodynamic determinates of peripheral subdiaphragmatic
      venous-to-right-heart return during closed-chest CPR. MODEL: Seven anesthetized
      dogs subjected to electrically induced ventricular fibrillation for five minutes.
      INTERVENTIONS: Conventional closed-chest CPR and closed-chest CPR with continuous
      abdominal binding at a chest compression rate of 60 per minute, a compression-to
      relaxation ratio of 50:50, and a ventilation-to-compression ratio of 1:5.
      METHODS: Solid-state catheters were positioned in the ascending aorta, right
      atrium (RA), and inferior vena cava (IVC). Cannulating electromagnetic flow
      probes were inserted into the IVC and a carotid artery. Analog-to-digital
      conversion was performed electronically. Five minutes after ventricular
      fibrillation was induced, interventions were performed in an alternating
      sequence. Systolic, diastolic, and mean pressures and flows were measured and
      compared. STATISTICAL METHODS: Two-tailed, unpaired t test applied to equal
      sample size, linear regression analysis, and multiple regression analysis.
      RESULTS: Abdominal binding during CPR significantly increased (P less than .05)
      all measured systolic and diastolic CPR intravascular pressures compared with CPR
      without abdominal binding but did not affect IVC-to-right-heart venous return.
      During conventional CPR without abdominal binding, venous return was dependent on
      the diastolic IVC pressure (r = .86, P = .014), mean IVC pressure (r = .80, P =
      .03), and carotid blood flow (r = .99, P = .001) but not on the IVC-to-RA
      pressure gradient. With abdominal binding, venous return was not correlated with
      any study hemodynamic variable, including the peripheral venous-to-RA pressure
      gradient. CONCLUSION: Venous return from the subdiaphragmatic venous bed during
      CPR is dependent on venous pressure, not on the peripheral venous-to-right-heart
      pressure gradient. Abdominal binding during CPR does not affect venous return.
      Venous return during CPR diastole is highly dependent on central venous
      capacitance (left heart outflow during CPR systole).

PMID- 2240717
TI  - Manual translaryngeal jet ventilation and the risk of aspiration in a canine
      model.
AB  - STUDY OBJECTIVES: Manual translaryngeal jet ventilation (TLJV) is a safe and
      effective method of maintaining normal ventilation in apneic subjects. Little
      data exist on the amount of airway protection afforded with this technique of
      airway management. We sought to evaluate the risk of aspiration during manual
      TLJV. SETTING: Data were collected in a laboratory animal model. DESIGN: A
      prospective, nonrandomized, controlled trial was performed. PARTICIPANTS:
      Seventeen adult apneic mongrel dogs were enrolled. INTERVENTIONS: Intratracheal
      Gastrograffin was instilled and radiographic changes assessed during ventilation
      using a 0 to 3 scale (none to severe). Thirty-six trials were performed, with
      equal numbers at both 30 degrees and 45 degrees head elevation. The three groups
      studied were animals without airway protection (control), animals with a cuffed
      endotracheal tube (tube), and animals with a percutaneous TLJV cannula and a 50
      psi oxygen source ventilated at a rate of 20 breaths per minute (jet).
      MEASUREMENTS AND MAIN RESULTS: Significantly less radiographic evidence of
      aspiration was noted in the jet and tube groups at 30 degrees and 45 degrees
      compared with control animals (P = .002 each). At 45 degrees head elevation a
      trend toward increased aspiration scores in the jet group compared with the tube
      group (P = .065) was observed. CONCLUSION: In our model, manual TLJV at 20
      breaths per minute and an I:E ratio of 1:2 provided protection from aspiration
      comparable to that observed with a cuffed endotracheal tube at 30 degrees head
      elevation. At 45 degrees elevation, this protection was diminished.

PMID- 2240715
TI  - Noninvasive assessment of mechanical properties of peripheral arteries.
AB  - An ultrasound examination was used to noninvasively determine the changes in
      mechanical properties associated with age for the common carotid, brachial,
      popliteal, femoral, and tibial arteries. Forty-two normal male subjects, ranging
      in age from 8 to 60 years of age, were examined. The subjects were placed in one
      of three age groups: less than 29 years of age, 29 to 38, and greater than 38.
      Mechanical properties including percentage variation in diameter, pressure
      strain, and circumferential elastic modulus were determined from changes in wall
      thickness and pulse pressure. Percentage variation in diameter (PVD) was seen to
      decrease with age for all arteries except the brachial, which remained relatively
      constant. Pressure-strain (Ep) and circumferential elastic moduli (Eo) were seen
      to increase with age in all arteries except the brachial, which remained
      relatively constant. Values of Ep and Eo were normalized into a stiffness index
      by dividing by the value found for the brachial artery. Stiffness indexes for the
      common carotid and femoral arteries were observed to increase more rapidly with
      age than the indexes obtained for the popliteal and tibial arteries. It is
      proposed that the stiffness index and changes in this parameter that occur with
      age may be useful in noninvasively assessing the progression of atherosclerosis.

PMID- 2240718
TI  - Stability of epinephrine in alkalinized solutions.
AB  - STUDY OBJECTIVE: Increasing the pH of an epinephrine solution favors its
      oxidation and may result in a decrease in its biological activity. It is
      therefore generally assumed that epinephrine and sodium bicarbonate should not be
      infused in the same IV line during CPR. The aim of this study was to determine
      the validity of this widely accepted proposition. DESIGN AND SETTING: Two
      different commercial solutions of epinephrine differing only in the concentration
      of sodium metabisulfite (0.46% and 0.02%) were studied. Two dosages of each
      solution type (1 mg/1 mL and 10 mg/10 mL) were diluted in 250 mL of 8.4% sodium
      bicarbonate. MEASUREMENTS AND MAIN RESULTS: The concentration of epinephrine was
      measured at different times for two weeks. It was found that the concentration of
      epinephrine decreased slowly to zero after two weeks, and was approximately at
      70% and 100% of control values at 30 minutes after alkalinization. CONCLUSION: It
      was concluded that epinephrine in an alkaline solution is effectively oxidized
      but has a slow reaction that may not be clinically relevant over short periods of
      time.

PMID- 2240719
TI  - Encouraging early defibrillation: the American Heart Association and automated
      external defibrillators.

PMID- 2240720
TI  - Survival rates from out-of-hospital cardiac arrest: recommendations for uniform
      definitions and data to report.
AB  - Survival rates for out-of-hospital cardiac arrest vary widely among locations. We
      surveyed the definitions used in published studies of out-of-hospital cardiac
      arrest. Data from 74 studies involving 36 communities showed survival rates
      ranging from 2% to 44%. There were five different case definitions and 11
      different definitions of survivors. The absence of uniform definitions prevents
      meaningful intersystem comparisons, prohibits explorations of hypotheses about
      effective interventions, and interferes with the efforts of quality assurance.
      The most satisfactory numerator for a survival rate appears to be survival to
      hospital discharge; the most appropriate denominator appears to be witnessed
      adult cardiac arrest of presumed heart disease etiology, with ventricular
      fibrillation as the initial identified rhythm. Proposed definitions for the data
      emergency medical services systems should report as they examine their cardiac
      arrest survival rates are presented.

PMID- 2240721
TI  - Activity-sensing permanent internal pacemaker dysfunction during helicopter
      aeromedical transport.
AB  - STUDY OBJECTIVES: This study was designed to establish the frequency, magnitude,
      and possible etiologies of the dysfunction of activity-sensing internal
      pacemakers during helicopter aeromedical transport. DESIGN: Two models of
      Medtronic Activitrax pacemakers were attached externally to healthy adult
      volunteers. Each volunteer then was loaded into the helicopter and subjected to a
      flight sequence. Pacemaker firing rates throughout this sequence were recorded.
      SETTING: On separate days, Aerospatiale Dauphin and Twinstar helicopters
      completed a total of 23 flights. TYPE OF PARTICIPANTS: Four healthy adult
      volunteers, two men and two women, participated. INTERVENTIONS: These included
      intra- and inter-flight threshold re-programming and external magnet application.
      RESULTS: The average preflight pacemaker rate of 65 beats per minute increased to
      an average in-flight rate of 105 beats per minute, which resolved to preflight
      rates on shutdown. This pattern was consistently extinguished with external
      magnet application. CONCLUSION: The effect of rotor motion and flight vibration
      on the rate-response of the Activitrax pacemaker is both predictable and easily
      preventable. Possible guidelines for the safe transport of these patients, using
      pacemaker reprogramming or external magnet application, are examined.

PMID- 2240722
TI  - Prehospital cardiac arrest: the impact of witnessed collapse and bystander CPR in
      a metropolitan EMS system with short response times.
AB  - OBJECTIVE: Numerous studies have shown initiation of bystander CPR to
      significantly improve survival from prehospital cardiac arrest. However, in
      emergency medical services (EMS) systems with very short response times,
      bystander CPR has not been shown to impact outcome. The purpose of this study was
      to determine the effect of bystander CPR on survival from out-of-hospital cardiac
      arrest in such a system. DESIGN: Prehospital, hospital, and death certificate
      data from a medium-sized metropolitan area were retrospectively analyzed for
      adult, nontraumatic cardiac arrest during a 16-month period. RESULTS: A total of
      298 patients met study criteria. One hundred ninety-five arrests (65.4%) were
      witnessed, and 103 (34.6%) were unwitnessed. Twenty-five witnessed victims
      (12.8%) were discharged alive, whereas no unwitnessed victims survived (P less
      than .001). Patients suffering a witnessed episode of ventricular
      fibrillation/tachycardia (VF/VT) were more likely to survive (21.9%) than were
      other patients (2.0%, P less than .0001). Among witnessed patients, initiation of
      bystander CPR was associated with a significant improvement in survival (20.0%)
      compared with the no-bystander CPR group (9.2%, P less than .05). Bystander CPR
      was also associated with improved outcome when witnessed patients with successful
      prehospital resuscitation were evaluated as a group; 18 had bystander CPR, of
      whom 13 (72.2%) survived compared with only 12 of 38 patients with no bystander
      CPR (31.6%, P less than .01). CONCLUSION: Our data revealed improved survival
      rates when bystander CPR was initiated on victims of witnessed cardiac arrest in
      an EMS system with short response times.

PMID- 2240723
TI  - Prehospital data entry compliance by paramedics after institution of a
      comprehensive EMS data collection tool.
AB  - OBJECTIVE: To determine the completeness of data entry by paramedics after an
      extensive modification of the prehospital first-care form in an urban emergency
      medical services (EMS) system. DESIGN: Comprehensive medical information was
      added to the EMS data collection tool used by a metropolitan fire department. We
      evaluated the frequency of failure to enter data pertaining to medical assessment
      and/or treatment of victims of cardiac arrest after implementation of the system.
      RESULTS: Failure to enter data in the first month was compared with two
      subsequent two-month blocks. A high rate of noncompliance existed in the first
      month (all medical data were missing in 24.6%). However, the subsequent two
      months revealed a marked decline in noncompliance (4.4%, P less than .001). This
      decline was maintained after a three-month interim (5.0%, P less than .001).
      CONCLUSION: Data entry noncompliance can be a significant problem after
      implementation of a new prehospital data collection system. However, compliance
      can be markedly improved over a relatively short period. Because EMS system
      evaluation is based on data collected in the field. EMS researchers and
      administrators must be aware of the data entry compliance rate in their system
      when attempting to make conclusions from such information.

PMID- 2240724
TI  - Prehospital prophylactic lidocaine does not favorably affect outcome in patients
      with chest pain.
AB  - STUDY OBJECTIVES: The purpose of our study was to determine the morbidity and
      mortality in initially stable patients presenting to paramedics with chest pain;
      to examine possible beneficial effects of its use, including reduction of sudden
      death syndrome in the prehospital and emergency department setting; and to
      determine if prophylactic lidocaine is associated with adverse effects in this
      patient population. DESIGN AND SETTING: This was a randomized, prospective study
      using prophylactic lidocaine in patients complaining of chest pain who presented
      to our paramedic system between January 1984 and January 1988. TYPE OF
      PARTICIPANTS: All patients aged 18 years or older with chest pain of suspected
      cardiac origin who presented to paramedics during the study period were included.
      Excluded were patients presenting with warning arrhythmias, second- or third
      degree heart block, bradycardias of less than 50, hypotension of less than 90 mm
      Hg systolic, or known allergy to lidocaine. INTERVENTIONS: Patients were
      randomized into two groups, the lidocaine-treated group and the control group. An
      initial bolus of 1 mg/kg IV lidocaine was administered to the lidocaine-treated
      group. A simultaneous 2 mg/min IV drip was established. Ten minutes after the
      first dose of lidocaine, a second bolus of 0.5 mg/kg was administered.
      MEASUREMENTS AND MAIN RESULTS: During the study period, 1,427 patients were
      entered; 704 received lidocaine, and 723 did not. Discharge diagnoses included
      acute myocardial infarction (31%), unstable angina (33%), other cardiac problems
      (7%), and noncardiac problems (29%); overall mortality rate was 7.4%. There was
      an equal distribution of deaths between the lidocaine-treated group (57) and the
      control group (48). Six patients had a cardiac arrest in the prehospital setting,
      and 15 had a cardiac arrest in the ED. Malignant ventricular arrhythmias as the
      precipitating arrest rhythm in patients with acute myocardial infarctions were
      similar for the lidocaine-treated and control groups. The incidence of adverse
      effects, including hypotension, bradycardias, second- or third-degree heart
      blocks, tinnitus, and altered mental status, was similar in both groups.
      CONCLUSION: There are no benefits from the administration of prehospital
      prophylactic lidocaine in stable patients with chest pain; therefore, routine use
      in this setting appears unwarranted.

PMID- 2240725
TI  - The diagnostic impact of prehospital 12-lead electrocardiography.
AB  - STUDY HYPOTHESIS: It is feasible to apply prehospital 12-lead electrocardiography
      to most stable prehospital chest pain patients. Prehospital diagnostic accuracy
      is improved compared with single-lead telemetry. POPULATION: One-hundred sixty
      six stable adult patients who sought paramedic evaluation for a chief complaint
      of nontraumatic chest pain. METHODS: One-hundred fifty-one prehospital 12-lead
      ECGs of diagnostic quality were obtained by paramedics on 166 adult patients
      presenting with nontraumatic chest pain. Paramedics and base station physicians
      were blinded to the information on acquired prehospital 12-lead ECGs and treated
      patients according to current standard of care-clinical diagnosis and single-lead
      telemetry. Final hospital diagnoses were classified into three groups: acute
      myocardial infarction (24); suspected angina or ischemia (61); and nonischemic
      chest pain (66). Paramedics and base station physicians' clinical diagnoses and
      prehospital and emergency department ECGs were similarly classified and compared.
      Prehospital and ED 12-lead ECGs were read retrospectively by two cardiologists.
      RESULTS: Paramedics achieved a high success rate (98.7%) in obtaining diagnostic
      quality prehospital 12-lead ECGs in 94.6% of eligible prehospital patients. For
      patients with acute myocardial infarction, prehospital ECG alone had
      significantly higher specificity than did the paramedic clinical diagnosis (99.2%
      vs 70.9%; P less than .001), and significantly higher positive predictive value
      (92.9% vs 32.7%; P less than .001). For patients with angina, combining the
      paramedic clinical diagnosis and the prehospital ECG significantly improved
      sensitivity (90.2% vs 62.3%; P less than .001) and increased negative predictive
      value (88.9% vs 71.3%; P less than .02) compared with paramedic clinical
      diagnosis alone. There was a high concordance between prehospital and ED ECG
      diagnosis (99.3% for acute myocardial infarction and 92.8% for angina).
      Furthermore, ten patients whose prehospital ECGs demonstrated ischemia and who
      had final hospital diagnoses of angina or acute myocardial infarction were
      mistriaged by paramedics and/or received no base station physician-directed
      therapy. CONCLUSION: It is feasible to apply prehospital 12-lead
      electrocardiography to most stable prehospital chest pain patients. Prehospital
      12-lead ECGs have the potential to significantly increase the diagnostic accuracy
      in chest pain patients, approach congruity with ED 12-lead ECG diagnoses, and may
      allow for consideration of altering and improving prehospital and hospital-based
      management in this patient population.

PMID- 2240726
TI  - Epinephrine in cardiac arrest: a critical review.

PMID- 2240727
TI  - Delayed splenic rupture.

PMID- 2240728
TI  - A basic resource guide for emergency medicine research.

PMID- 2240729
TI  - The delta (delta) gap: an approach to mixed acid-base disorders.
AB  - The anion gap (AG) is a helpful, yet underused, clinical tool. Not only does the
      presence of a high AG suggest a certain differential, but knowledge of the
      relationship between the rise in AG (delta AG) and the fall in bicarbonate (delta
      HCO3) is important in understanding mixed acid-based disorders. Simple arithmetic
      converts this relationship into a numerical value, the delta gap (delta gap). The
      delta gap = delta AG - delta HCO3. If the delta gap is significantly positive
      (greater than +6), a metabolic alkalosis is usually present because the rise in
      AG is more than the fall in HCO3. Conversely, if the delta gap is significantly
      negative (less than -6), then a hyperchloremic acidosis is usually present
      because the rise in AG is less than the fall in HCO3. Familarity with the
      relationship between the changes in AG and HCO3 can be useful in unmasking occult
      metabolic disorders.

PMID- 2240730
TI  - Plasma lidocaine levels and PaO2 with endobronchial administration: dilution with
      normal saline or distilled water?
AB  - STUDY OBJECTIVE: To determine whether water or 0.9% saline should be used as
      diluent for endobronchial drug administration. PARTICIPANTS: Twelve adult
      patients. INTERVENTIONS: Patients were endobronchially administered 2 mg/kg
      lidocaine as marker substance in either 10 mL 0.9% saline or 10 mL distilled
      water during general anesthesia. MEASUREMENTS AND MAIN RESULTS: The differences
      in mean lidocaine plasma levels at five minutes (water vs saline, 2.35 vs 1.59
      micrograms/mL) and ten minutes (water vs saline: 2.67 vs 1.88 micrograms/mL) were
      significant (P less than .05). With the initial mean PaO2 being almost (157 mm
      Hg; F1O2, 0.3) in the two groups, there was a mean drop of about 60 mm Hg in the
      saline-diluent group, but only about 40 mm Hg in the water-diluent group one
      minute after administration (P less than .05). CONCLUSION: The use of water
      resulted in better absorption of lidocaine and less impairment of the PaO2.

PMID- 2240731
TI  - Rapid visual colorimetry of peritoneal lavage fluid.
AB  - STUDY HYPOTHESIS: That visual colorimetry can be used to rapidly and precisely
      estimate the erythrocyte count of 1:5 dilutions of simulated peritoneal lavage
      fluid. POPULATION: Fifty-four normal adult human subjects. METHODS: The automated
      or chamber RBC count is often used on fluid obtained by peritoneal lavage in
      patients with abdominal trauma to help determine the need for surgery.
      Unfortunately, this method sometimes results in excessive delay. We designed and
      built a simple colorimeter that facilitated rapid direct visual comparison of
      unknown samples with known color standards. A radiograph view box was used as a
      light source. Standards were prepared in 16-mm glass tubes to simulate peritoneal
      lavage fluid with RBC counts ranging from 0 to 140,000 in 10,000 cell/microL
      increments; 1:5 dilutions with water were used throughout to reduce opacity.
      Thimerosal was added to unknowns and standards to stabilize color; all samples
      were kept refrigerated at 4 C when not in use. In a double-blind in-vitro study,
      each subject matched 20 randomly distributed unknowns ranging from 12,000 to
      131,000 erythrocytes/microL to the nearest standard. RESULTS: The mean absolute
      error for all 1,080 determinations was 3,560 RBC/microL (95% CI = 4,290-4,830; SD
      = 4,560; t = 39.6; df = 1,079; P less than .001). This method correctly predicted
      the RBC count to within 9,000 cells/microL 95% of the time. CONCLUSION: Visual
      comparison of 1:5 dilutions of simulated peritoneal lavage fluid with known color
      standards can be used to rapidly and precisely estimate the erythrocyte count.

PMID- 2240732
TI  - Effect of education on the use of universal precautions in a university hospital
      emergency department.
AB  - STUDY OBJECTIVES: To determine if an educational program would improve both
      knowledge and practice of universal precautions by nursing personnel. DESIGN:
      Participants were given a 14-question test and observed for their, practice of
      universal precautions during routine IV catheter placement or phlebotomy and
      trauma care before and six months after an education in-service. SETTING:
      University hospital emergency department. TYPE OF PARTICIPANTS: Nursing
      personnel. INTERVENTIONS: One-hour lecture addressing the occupational risk of
      human immunodeficiency virus (HIV) infection and the recommended use of universal
      precautions. MEASUREMENTS AND MAIN RESULTS: The mean overall correct response
      rates to the questionnaire before and after the in-service were 70% and 73%,
      respectively (P = NS). The pattern of incorrect responses suggested that the
      perceived risks of HIV transmission are underestimated, particularly among
      healthy-appearing patients. For care of critical trauma patients, there were
      significant increases between the frequency rates before and after the in-service
      of glove and protective eyewear use (66.7% vs 87.7%, P less than .025; 0.0% vs
      17.3%, P less than .05, respectively). The frequency rates of glove use for IV
      placement or phlebotomy in noncritical patients and of gown use for trauma
      patient care also increased (52.6% vs 65.2% and 25% vs 39.5%, respectively);
      however, these changes were not statistically significant. CONCLUSION: An
      intensive educational program was associated with a modest increase in the
      compliance of ED nursing personnel with universal precautions and had no long
      term effect on their general knowledge of HIV risk. The practice of universal
      precautions is still far from universal in this ED.

PMID- 2240733
TI  - Scapular dislocation (locked scapula).
AB  - We report the case of a 19-year-old woman who presented to the emergency
      department with pain and inability to move her right shoulder after falling
      backwards and striking it on a cart. Radiographs of the shoulder revealed a
      dislocated scapula. Closed reduction in the ED was successful. This rare case of
      scapular dislocation serves to emphasize that a heightened awareness for this
      injury is necessary if it is to be recognized and treated appropriately. Its
      treatment and prognosis are reviewed.

PMID- 2240734
TI  - Toxic streptococcal syndrome.
AB  - The streptococcal toxic shocklike syndrome is a recently recognized, multisystem
      disorder that shares many of the features of staphylococcal toxic shock syndrome,
      but is caused by toxins elaborated by group A beta-hemolytic Streptococcus. We
      describe a patient who fulfilled the major criteria for the clinical diagnosis of
      toxic shock syndrome (fever, hypotension, multisystem dysfunction, and diffuse
      macular erythroderma followed by desquamation) and who demonstrated serologic
      evidence suggesting streptococcal infection. In patients presenting with clinical
      findings consistent with a toxic shocklike syndrome, the emergency physician
      should consider streptococcal infection as a potential etiology.

PMID- 2240735
TI  - Successful CPR in a severely hypothermic patient using continuous thoracostomy
      lavage.
AB  - Severe hypothermia with cardiopulmonary arrest often requires prolonged
      resuscitation while rewarming procedures are implemented. A 63-year-old male in
      cardiopulmonary arrest with a core body temperature of 23.7 C was resuscitated
      successfully after core rewarming by means of a two-chest-tube continuous
      thoracostomy lavage procedure. This lavage procedure resulted in effective and
      rapid rewarming after other conventional rewarming methods had failed.

PMID- 2240736
TI  - Is emergency medicine research viable?

PMID- 2240737
TI  - Annals & academic respectability.

PMID- 2240738
TI  - Prophylactic lidocaine.

PMID- 2240739
TI  - From pain to reperfusion: what role for the prehospital 12-lead ECG?

PMID- 2240740
TI  - Serologic findings in Lyme disease.

PMID- 2240741
TI  - Sensitivity, specificity & positive & negative predictive values.

PMID- 2240742
TI  - Echocardiography to rule out metastatic disease.

PMID- 2240743
TI  - Complications from hyperbaric oxygen therapy?

PMID- 2240744
TI  - Additional causes of priapism.

PMID- 2240745
TI  - Early detection of acute myocardial infarction in patients presenting with chest
      pain and nondiagnostic ECGs: serial CK-MB sampling in the emergency department.
AB  - STUDY OBJECTIVES: Patients presenting to the emergency department with chest
      discomfort are a difficult problem for emergency physicians. Nearly 50% of
      patients with acute myocardial infarction (AMI) will initially have nondiagnostic
      ECGs on ED presentation. The purpose of this study was to determine if patients
      with AMI having nondiagnostic ECGs could be identified using new immunochemical
      assays for serial CK-MB sampling in the ED. DESIGN: Chest pain patients, more
      than 30 years old, with pain not caused by trauma or explained by radiographic
      findings, were eligible for the study. Serial serum samples were drawn on ED
      presentation (zero hours) and three hours after presentation, then analyzed for
      CK-MB using four immunochemical methods and electrophoresis. Standard World
      Health Organization criteria were used to establish the diagnosis of AMI,
      including new Q-wave formation or elevation of standard in-hospital serum cardiac
      enzyme markers. SETTING: A tertiary cardiac care community hospital. MEASUREMENTS
      AND MAIN RESULTS: The serum from 183 patients hospitalized for possible ischemic
      chest pain was collected and analyzed. Thirty-one of 183 patients (17%) were
      found to have AMI by standard in-hospital criteria. Sixteen of the 31 patients
      (52%) with AMI had nondiagnostic ECGs on presentation. Immunochemical
      determination of serial CK-MB levels provided a sensitive and specific method for
      detecting AMI in patients within three hours after ED presentation compared with
      standard electrophoresis. The four immunochemical methods demonstrated a range in
      sensitivity from 50% to 62.1% on ED presentation versus 92% to 96.7% three hours
      later. The immunochemical tests demonstrated specificities ranging from 83.0% to
      96.4% at three hours, with three of the four tests having specificities of 92% or
      greater. Electrophoresis had a sensitivity of 34.5% on ED presentation,
      increasing to 76.9% at three hours, with a specificity of 98.6%. CONCLUSIONS:
      Immunochemical CK-MB methods allowed rapid, sensitive detection of AMI in the ED.
      Early detection of AMI offers many potential advantages to the emergency
      physician. Early detection of AMI, while the patient is in the ED, could direct
      disposition of this potentially unstable patient to an intensive care setting.
      Such information may prevent the ED discharge of patients with AMI having
      nondiagnostic ECGs. The diagnosis of AMI within a six-hour period after symptom
      onset may allow thrombolytic therapy to be given to patients with AMI not having
      diagnostic ECGs. This study served as a pilot trial for a multicenter study of
      the Emergency Medicine Cardiac Research Group, which is currently ongoing.

PMID- 2240746
TI  - Transtelephonic defibrillation.
AB  - STUDY OBJECTIVES: This study was undertaken to assess the safety and reliability
      of a device for transtelephonic defibrillation. DESIGN: The transtelephonic
      system consists of a patient unit and a base station. The patient unit contains a
      monitor-defibrillator, electrode pads, microphone, microprocessor, and DC
      defibrillator. The base station comprises a control panel, computer, and ECG
      display. SETTING: Fifteen patients who were treated in our emergency department
      for cardiac arrest were placed on patient units that activated our base station
      in a remote location within the ED. TYPE OF PARTICIPANTS: Thirteen patients were
      treated for ventricular fibrillation, and two patients were treated for
      ventricular tachycardia. INTERVENTIONS: Thirty-one shocks were delivered
      transtelephonically. MEASUREMENTS AND MAIN RESULTS: In all cases, voice and ECG
      transmission were established without difficulty. CONCLUSIONS: We conclude that
      this system represents a safe and reliable method for the treatment of
      ventricular fibrillation, and we advocate additional use to study the prehospital
      applications of transtelephonic defibrillation.

PMID- 2240747
TI  - The validity and reliability of the navicular fat stripe as a screening test for
      detection of navicular fractures.
AB  - STUDY OBJECTIVE: The purpose of this study was to determine if the navicular fat
      stripe (NFS) is a valid and reliable screening tool in assessing potential
      navicular fractures. DESIGN: Retrospective analysis. SETTING: Minor trauma
      section of the Los Angeles County-University of Southern California Medical
      Center emergency department. TYPE OF PARTICIPANTS: Study population included
      patients seen for wrist injury between January 1987 and December 1988. The
      individuals who interpreted the radiographs included eight observers with varying
      degrees of radiographic experience. INTERVENTIONS: None MEASUREMENTS AND MAIN
      RESULTS: The positive predictive value averaged 12% or 15% depending on how we
      counted a straight NFS, and the negative predictive value averaged 93% or 95%,
      again depending on how we counted a straight NFS. A straight NFS was ten times as
      likely to occur among normal wrists than among those with navicular fractures.
      Interobserver reliability was found to be high with a Hoyt reliability
      coefficient of .79. CONCLUSIONS: An abnormal NFS is a poor predictor of a
      navicular fracture while both a straight and a normal NFS are good predictors of
      no navicular fracture. A normal NFS may allow less stringent treatment by the
      emergency physician. Extremes of radiographic experience were found to have no
      significant effect on NFS interpretation.

PMID- 2240748
TI  - Tetanus immunization status and immunologic response to a booster in an emergency
      department geriatric population.
AB  - STUDY OBJECTIVES: Although effective procedures for the prevention of tetanus
      have long been available, serosurveys done since 1977 demonstrate that 49% to 66%
      of the elderly population lacks a protective antitoxin level (more than 0.01
      IU/mL). This study was undertaken to assess the tetanus immunization status of
      patients presenting to an emergency department and to evaluate their immunologic
      response to a tetanus booster. SETTING: The study was conducted in a tertiary
      care ED. TYPE OF PARTICIPANTS: The patients enrolled were 65 or more years old
      and had breaks in their skin barriers. DESIGN: At each patient's initial
      presentation, pertinent demographic data and tetanus immunization history were
      recorded. The patient was then followed for 21 days. INTERVENTIONS: Each
      patient's antitoxin titer was determined on a serum sample by ELISA, and, if
      required by the Advisory Committee on Immunization Practices criteria, a booster
      was administered at the first visit. MEASUREMENTS AND MAIN RESULTS: Serum
      antitoxin assays were repeated on days 7, 14, and 21 after the initial visit
      until seroconversion (titer more than 0.01 IU/mL). Forty-four patients (55%) had
      protective levels at initial presentation, and in 36 (45%) the levels were not
      protective. Age and sex were not predictive of protection. Past military service
      and a definite history of three or more previous immunizations were good
      predictors of protection. Of 34 patients who were followed serially for
      inadequate initial titers, only 19 (56%) seroconverted by day 14. Patients who
      did not seroconvert were more likely to be older (P less than .05). CONCLUSIONS:
      This study demonstrated that a significant number of elderly patients lacked an
      initial protective level of tetanus antitoxin. Of these, 44% failed to
      seroconvert within 14 days and carried a potential risk of developing tetanus.

PMID- 2240749
TI  - Acute abdominal pain in the elderly.
AB  - STUDY OBJECTIVES: To determine the incidences of both specific diagnosis and
      surgical diseases in patients more than 65 years old who present to the emergency
      department with nontraumatic abdominal pain of less than one week's duration, and
      to determine the ED staff's ability to diagnose and triage elderly patients with
      acute abdominal pain. DESIGN: A 12-month retrospective review of all elderly
      patients who presented to the ED with acute, nontraumatic abdominal pain.
      SETTING: A regional trauma center serving a predominately rural population in the
      Midwest. The ED has 55,000 patient visits yearly. MEASUREMENTS AND MAIN RESULTS:
      Of the 127 patients enrolled, 30 (24%) had no specific diagnosis made in the ED.
      Biliary tract disease (12%) and small bowel obstruction (12%) were the two most
      common specific diagnoses. Overall, 53 patients (42%) required surgery, usually
      during the initial hospitalization. In four cases, the postoperative diagnosis
      differed significantly from the ED diagnosis. Of the 74 patients (58%) who did
      not undergo surgery, 51 had follow-up information available. In 14 patients, the
      follow-up diagnosis differed from the original diagnosis, but most of these
      changes did not appreciably alter the treatment and outcome. CONCLUSIONS: The
      incidence of surgical disease is high in elderly patients with acute abdominal
      pain, and ED staff are able to diagnose and triage these patients accurately.

PMID- 2240750
TI  - Buffered versus plain lidocaine as a local anesthetic for simple laceration
      repair.
AB  - STUDY OBJECTIVE: Buffered lidocaine was compared with plain lidocaine as a local
      anesthetic for simple lacerations. DESIGN: Randomized, double-blind, prospective
      clinical trial. SETTING: Urban emergency department. TYPE OF PARTICIPANTS: Ninety
      one adult patients with simple linear lacerations were enrolled. Patients with
      allergy to lidocaine and patients with an abnormal mental status were excluded.
      INTERVENTIONS: Each wound edge was anesthetized with either plain or buffered
      lidocaine using a randomized, double-blind protocol. The pain of infiltration was
      measured with a previously validated visual analog pain scale. MEASUREMENTS AND
      MAIN RESULTS: Analysis of pooled data and paired data (using patients as their
      own controls) revealed that infiltrating buffered lidocaine was significantly
      less painful than plain lidocaine (P = .03 and P = .02, respectively). There was
      no significant difference in the anesthetic effectiveness of the two agents
      during suturing. CONCLUSION: Buffered lidocaine is preferable to plain lidocaine
      as a local anesthetic agent for the repair of simple lacerations.

PMID- 2240751
TI  - Submersion in The Netherlands: prognostic indicators and results of
      resuscitation.
AB  - STUDY OBJECTIVES: To analyze prognostic indicators and the outcome of
      resuscitation in submersion victims (drowning and near drowning). DESIGN:
      Retrospective study. SETTING: Intensive and Respiratory Care Unit. Between
      January 1, 1979, and December 31, 1985, 87 submersion victims were admitted. The
      files of 83 victims were available for statistical analysis. There were 66 male
      victims and 17 female victims; the average age was 31.4 +/- 25.8 years. There
      were ten salt water and 73 fresh water submersions. MEASUREMENTS AND MAIN
      RESULTS: Predictors for better survival potentials were a young age, submersion
      of less than ten minutes, no signs of aspiration, and a central body temperature
      of less than 35 C at admission. We did not detect factors that accelerated a
      decrease in core body temperature at admission and assume that lethal hypoxia had
      preceded protective hypothermia in our submersion victims. The Orlowski score had
      a predictive value but at the same time we found nonindependent indicators in
      this score. Neurologic outcome in our patients, who were not treated according to
      a brain protection protocol, was not worse than the outcome published by authors
      who have used such a protocol. Thirty-three percent of the victims with a
      cardioventilatory arrest (15) and all victims with a ventilatory arrest (11)
      survived resuscitation and were discharged. Five nonarrest victims died due to
      late complications. CONCLUSION: This study shows that no indicator at the rescue
      site and in the hospital is absolutely reliable with respect to death or
      survival.

PMID- 2240753
TI  - The trauma triage rule: a new, resource-based approach to the prehospital
      identification of major trauma victims.
AB  - STUDY OBJECTIVE: To develop a new trauma decision rule. DESIGN: Retrospective
      clinical review. SETTING: Level I trauma center. TYPE OF PARTICIPANTS: 1,004
      injured adults. MEASUREMENTS AND MAIN RESULTS: A new trauma decision rule was
      derived from 1,004 injured adult patients using a new operational definition of
      major trauma. The rule, termed the Trauma Triage Rule, defines a major trauma
      victim as any injured adult patient whose systolic blood pressure is less than 85
      mm Hg; whose motor component of the Glasgow Coma Score is less than 5; or who has
      sustained penetrating trauma of the head, neck, or trunk. Using the operational
      definition of major trauma, the rule had a sensitivity of 92% and a specificity
      of 92% when tested on the 1,004-patient cohort. CONCLUSION: The Trauma Triage
      Rule may significantly reduce overtriage while only minimally increasing
      undertriage. This approach must be validated prospectively before it can be used
      in the prehospital setting.

PMID- 2240752
TI  - The lack of full correlation between the Injury Severity Score and the resource
      needs of injured patients.
AB  - STUDY OBJECTIVE: To determine whether the Injury Severity Score (ISS) correlates
      with the resource requirements of severely injured patients by studying the
      association of the ISS with three major interventions (fluid resuscitation,
      invasive central nervous system monitoring, and acute operative repair) trauma
      centers routinely provide severely injured patients. DESIGN: Retrospective
      clinical review. SETTING: Level I trauma center. TYPE OF PARTICIPANTS: Eight
      hundred fourteen adult injured patients. MEASUREMENTS AND MAIN RESULTS: When an
      ISS of more than 9 was used as the definition of major trauma, the ISS
      undercorrelated 11% of the time with the need for any one procedure. When an ISS
      of more than 14 was used as the definition, it undercorrelated 20% of the time.
      CONCLUSION: The ISS may not be completely correlated with the resource
      requirements of injured patients and should not be used as the sole means by
      which to define major injury.

PMID- 2240754
TI  - Prehospital administration of inhaled metaproterenol.
AB  - STUDY OBJECTIVES: We conducted a study of the prehospital use of inhaled
      metaproterenol. DESIGN, SETTING, TYPE OF PARTICIPANTS, AND INTERVENTIONS:
      Advanced life support (ALS) providers were trained with a standardized curriculum
      to identify patients likely to benefit from prehospital inhaled metaproterenol
      administration. Unit doses of metaproterenol were used in a small-volume
      nebulizer. We prospectively included 122 patients in an initial study (71 men;
      age, 63 +/- 19 years) to evaluate the safety and effectiveness of metaproterenol
      in the field, and 150 patients (including the original 122) in an additional
      study to evaluate patient selection criteria. MEASUREMENTS AND MAIN RESULTS: The
      treatments resulted in an increase in peak flows, a decrease in respiratory
      rates, and no change in heart rates. In 62% of patients, the increase in peak
      flow exceeded 15%. Wheezing improved in 59% of the patients, worsened in 4%, and
      did not change in the remainder. Air entry by auscultation improved subjectively
      in 59% of patients. Mild tremor occurred in 8% of patients, moderate tremor
      occurred in 1%, and no tremor occurred in the remainder. Significant dysrhythmias
      did not occur. CONCLUSIONS: ALS providers correctly identified patients for this
      therapy. No technical problems were encountered in the field with this treatment
      approach. We conclude that ALS providers can be taught to identify patients
      likely to benefit from inhaled metaproterenol, that inhaled metaproterenol can be
      administered in the field, and that metaproterenol is both safe and effective
      when used in the prehospital setting.

PMID- 2240755
TI  - Geriatric injury: an analysis of prehospital demographics, mechanisms, and
      patterns.
AB  - STUDY OBJECTIVE: To evaluate emergency medical services (EMS) system use, injury
      mechanisms, and prehospital assessments among elderly victims of trauma. DESIGN:
      We analyzed all prehospital data for injuries among patients 70 years old or
      older for whom 911 EMS dispatch was requested in a medium-sized metropolitan area
      during a 12-month period. RESULTS: A total of 1,154 cases occurred (women,
      65.1%), which represented 30.3% of all 911 dispatches involving elderly patients.
      Injury mechanisms were fall (60.7%), motor vehicle accident (MVA; 21.5%), fight
      (2.4%), accidental poisoning (2.3%), and choking (2.1%). Persons in their 90s had
      a lower frequency of MVAs (3.4%) than did younger patients (23.0%) (P less than
      .005). The most frequent injuries determined by prehospital assessment were head
      or face (25.1%), upper extremity (17.2%), hip (14.5%), lower extremity (13.8%),
      back (9.8%), and chest or abdomen (5.0%). The frequency of serious neurologic
      injuries was less for falls or MVAs than for other mechanisms (P less than .005).
      Suspected hip (P less than .001) and pelvic (P less than .005) injuries occurred
      more frequently during falls than during other mechanisms of injury, whereas back
      injuries occurred most frequently in MVAs (P less than .001). Seventy-one fall
      victims (10.1%) had suspected medical causes of their fall. Twelve patients
      (1.0%) were in cardiac arrest. CONCLUSION: We report injury patterns and
      mechanisms among elderly victims of trauma presenting to an EMS system. A
      knowledge of these patterns will be useful to emergency physicians and EMS
      administrators.

PMID- 2240756
TI  - Neurologic complications of cocaine abuse.
AB  - The neurologic complications of cocaine toxicity are responsible for a major
      portion of the morbidity and mortality associated with cocaine. Most of the
      complications appear to be related to the hyperadrenergic state induced by
      cocaine and may be treated symptomatically. Diazepam is the most effective drug
      for cocaine-induced seizures.

PMID- 2240757
TI  - Atypical presentation of pulmonary embolism.
AB  - Today we have discussed an interesting patient with an atypical presentation of
      pulmonary embolism. We have outlined a suggested algorithm to aid in the
      diagnosis and management of this disease. References 8 through 24 in the
      reference section are suggested readings that offer further insight into the
      diagnosis and management of this entity.

PMID- 2240758
TI  - Refusal of care and discharging 'difficult' patients from the emergency
      department.
AB  - Patients generally have the right to refuse medical care, a right based on
      certain legal precedents. Its application in the emergency department leads to
      difficult decisions for the emergency physician. A model that allows the
      emergency physician to determine the capacity of a patient to refuse care is
      presented. Certain types of patients regularly present problems in their
      treatment. These include psychiatric patients, narcotics abusers, alcoholics,
      "street people," and some patients with migraine headaches. They represent some
      of our most difficult decisions because the treatment required for the patient is
      often clear and the patient refuses care or demands inappropriate care.

PMID- 2240759
TI  - Occipital condyle fracture presenting as retropharyngeal hematoma.
AB  - Reported is the case of a 30-year-old male motorcycle accident victim who was
      found on plain cervical-spine radiography to have prevertebral soft-tissue
      swelling. Although subsequent computed tomography demonstrated no cervical-spine
      fracture, it did reveal a fracture of one occipital condyle. The mechanism,
      diagnosis, and treatment of occipital condyle fractures are reviewed, as is the
      ligamentous and fascial anatomy of the cervicocranium. Dissection of fracture
      hematoma inferiorly along vertically oriented tissue planes is hypothesized as
      the pathogenesis of our patient's retropharyngeal hematoma. In addition to being
      a sign of potential cervical-spine injury, post-traumatic prevertebral soft
      tissue swelling may also indicate occipital condyle fracture. To avoid
      overlooking such fractures, computed tomography undertaken to investigate upper
      cervical-spine prevertebral soft-tissue swelling should always include slices up
      to the level of the basal skull so as to visualize the condyles.

PMID- 2240760
TI  - Chylous drainage from a stab wound to the neck.
AB  - A 24-year-old man was assaulted and sustained a stab wound to the left lower
      neck. When he arrived at the emergency department, he was hemodynamically stable.
      Although the wound had penetrated the platysma, on initial evaluation the patient
      did not appear to have sustained significant injury. Closer examination of the
      wound revealed chylous drainage, indicating injury to the cervical portion of the
      thoracic duct. The patient was taken to the operating room for exploration of the
      wound, during which an injury to the left internal jugular vein was identified
      and repaired. The thoracic duct, which had been severed, was ligated. The
      remainder of the patient's hospital course was unremarkable. The consistent
      association between penetrating injury to the cervical portion of the thoracic
      duct and injury to neighboring vascular structures is discussed.

PMID- 2240761
TI  - Erythromycin failure with subsequent Pasteurella multocida meningitis and septic
      arthritis in a cat-bite victim.
AB  - We report the case of a 75-year-old woman who developed Pasteurella multocida
      meningitis and septic arthritis while being treated for a cat-bite wound
      infection with erythromycin. Review of the literature revealed that erythromycin
      has poor in vitro activity against this bacterium and has been associated with
      serious clinical failures. We recommend that erythromycin not be prescribed for
      empiric therapy of established animal-bite infections. Suggestions for optimal
      empiric therapy of animal-bite infections and the differential diagnosis of
      severe cat-bite-associated sepsis are discussed.

PMID- 2240762
TI  - Introduction to biostatistics: Part 6, Correlation and regression.
AB  - Correlation and regression analysis are applied to data to define and quantify
      the relationship between two variables. Correlation analysis is used to estimate
      the strength of a relationship between two variables. The correlation coefficient
      r is a dimensionless number ranging from -1 to +1. A value of -1 signifies a
      perfect negative, or indirect (inverse) relationship. A value of +1 signifies a
      perfect positive, or direct relationship. The r can be calculated as the Pearson
      product r, using normally distributed interval or ratio data, or as the Spearman
      rank r, using non-normally distributed data that are not interval or ratio in
      nature. Linear regression analysis results in the formation of an equation of a
      line (Y = mX + b), which mathematically describes the line of best fit for a data
      relationship between X and Y variables. This equation can then be used to predict
      additional dependent variable values (Y), based on the value or the independent
      variable X, the slope m, and the Y-intercept b. Interpretation of the correlation
      coefficient r involves use of r2, which implies the degree of variability of Y
      due to X. Tests of significance for linear regression are similar conceptually to
      significance testing using analysis of variance. Multiple correlation and
      regression, more complex analytical methods that define relationships between
      three or more variables, are not covered in this article. Closing comments for
      this final installment of this introduction to biostatistics series are
      presented.

PMID- 2240763
TI  - The need for ALS in urban and suburban EMS systems.

PMID- 2240764
TI  - What is 'major trauma?'.

PMID- 2240765
TI  - 'Trigger diagnoses'.

PMID- 2240766
TI  - 'Ideal' standards for pediatric EDs.

PMID- 2240767
TI  - Sludge/sluice.

PMID- 2240769
TI  - Use of the dot enzyme-linked immunosorbent assay with isolated Anaplasma
      marginale initial bodies for serodiagnosis of anaplasmosis in cattle.
AB  - Isolated Anaplasma marginale initial bodies were successfully used in a dot ELISA
      for rapid detection of antibodies to Anaplasma organisms. The enzyme immunoassay
      used only 25 ng of antigen dotted onto nitrocellulose disks. Antigen-antibody
      complexes were detected by use of alkaline phosphatase-conjugated protein A, and
      reactions were read visually after addition of a precipitable, chromogenic
      substrate. The test allowed the processing of multiple sera, either for screening
      or for titer determination, in less than 3 hours and was found to be as sensitive
      as the indirect fluorescent antibody test. The overall performance of the dot
      ELISA, using isolated A marginale initial bodies, for 580 bovine serum samples
      was as follows: sensitivity, 93%; specificity, 96%; and predictive value, 95%.
      Cross-reactivity was not observed with sera positive to Babesia bovis and B
      bigemina, Trypanosoma vivax, or common bacteria or viruses infecting cattle. The
      antigen dotted onto nitrocellulose disks was stable when stored at -20, 4, or 25
      C. Compared with the indirect fluorescent antibody test, the dot ELISA allowed
      easier, faster, and more objective interpretation of results. Its simplicity and
      low cost combined with high sensitivity and specificity indicate that this assay
      could effectively replace serologic assays currently used for diagnosis of
      anaplasmosis in cattle.

PMID- 2240768
TI  - Visual-evoked potentials and electroretinograms in ruminants with thiamine
      responsive polioencephalomalacia or suspected listeriosis.
AB  - Electrodiagnostic visual testing (electroretinogram [ERG] and visual-evoked
      potential [VEP]) was performed on 5 ruminants (3 lambs, 1 kid, and 1 steer) with
      thiamine-responsive polioencephalomalacia (PEM) and on 2 sheep with listeriosis.
      The lambs and kid had typical clinical signs of PEM, especially blindness. In
      these animals, the ERG was normal but the VEP was abnormal. Follow-up recordings
      in the kid and 1 lamb indicated an improvement in VEP recordings accompanying a
      gradual return of vision after thiamine treatment. Possible subtle changes in VEP
      peak latencies could not be assessed because of lack of normative VEP data for
      sheep and goats. All animals had complete return of vision (owner-assessed). The
      steer did not have signs of blindness, and the ERG and VEP were normal. Changes
      in VEP accompanying permanent PEM blindness are not known. One sheep with
      suspected listeriosis had lack of menace response and palpebral and corneal
      reflexes, but had intact vision. The ERG and VEP were normal. The second sheep
      with suspected listeriosis had intact menace response and vision, but became
      acutely blind and died; the ERG was normal, but VEP amplitudes were depressed.

PMID- 2240770
TI  - Ultrasonographic examination of the liver in cows.
AB  - The size of the liver, as well as the situation and diameter of vessels in cattle
      were determined by use of ultrasonography. Ultrasonographic examinations of the
      liver were performed on 10 cows 10 times within 2 weeks, using a 3.5-MHz linear
      transducer on the right side in the 12th, 11th, and 10th intercostal spaces.
      Dorsal and ventral margin of the liver as well as localization and diameter of
      the caudal vena cava and the portal vein were determined in each intercostal
      space. Furthermore, the angle of the liver in the ventral area between the
      visceral surface and the diaphragmatic surface, the dorsal margin, and the
      circumference of the gall bladder were determined. The ultrasonographic values of
      liver size and localization in healthy cows can be used as reference values for
      the diagnosis of changes in liver size attributable to illness.

PMID- 2240771
TI  - Use of inflammatory cell activities in bovine milk to diagnose mastitis.
AB  - The activity of leukocytes, determined by chemiluminescence (CL) emission, was
      compared with the somatic cell count (SCC) in 4,883 quarter-milk samples from 132
      dairy cows. The presence of bacteria was determined by bacteriologic culture of
      samples in which SCC and CL were high. Chemiluminescence was measured with an
      automated illuminometer system at 37 C after separating the leukocytes from milk
      by allowing them to adhere to cotton-wool swabs. Chemiluminescence emission was
      induced by opsonized zymosan and enhanced by luminol. After luminol and zymosan
      were added to the measuring vials containing the swabs, CL emission increased
      rapidly, reaching its maximum usually at about 15 minutes of reaction time, and
      decreasing slowly thereafter. In general, good correlation was found between CL
      and SCC (r = 0.876; P less than or equal to 0.001; n = 4,883). Even milk samples
      with low SCC gave reliably measurable CL signals. Minor pathogens in the milk
      caused about a sevenfold increase in both SCC and CL, whereas major pathogens
      caused 14- and 25-fold increases in SCC and CL, respectively. The diagnostic
      situation that requires both sensitivity and specificity to be at least 90% was
      attained only by the CL assay for major pathogens. These results suggest that the
      measurement of milk leukocyte activity by CL assay applies well to the diagnosis
      of mastitis, and has the potential to become a large-scale laboratory test, as
      well as a simple cowside test.

PMID- 2240772
TI  - Quantitative microanalysis of equine synovial fluid glycosaminoglycan
      concentration.
AB  - An alcian blue precipitation method for quantifying the hyaluronic acid (HA) and
      sulphated glycosaminoglycan concentration (SGAG) in solutions containing both
      compounds was assessed. The assay was found to be rapid and reliable in solutions
      containing 0 to 200 mg of HA/dl and 50 to 1,000 micrograms of SGAG/dl, and was
      not affected by the presence of protein, hemoglobin, or methemoglobin in
      concentrations normally found in synovial fluid. The HA and SGAG concentrations
      in intercarpal synovial fluid from 13 clinically normal and 11 arthritic horses
      were evaluated. A relationship was not found between the concentration of HA and
      SGAG and any other synovial fluid variable. The SGAG concentration was found to
      be markedly high in several of the synovial fluid samples from arthritic horses,
      but did not correlate with the degree of articular cartilage erosion.

PMID- 2240773
TI  - Comparison of two antigens for use in an enzyme-linked immunosorbent assay to
      detect African swine fever antibody.
AB  - Two African swine fever virus (ASFV) antigens were tested for use in an ELISA to
      detect antibody to ASFV. Antigens used were the cytoplasmic soluble fraction (CS
      P) of infected cells grown in the presence of porcine serum and the semipurified
      viral structural protein VP73 (SVP73). Both antigens were tested by ELISA against
      72 sera obtained during several ASF field episodes and from ASFV-inapparent
      carriers. Of the 72 sera, only 2.8% has positive results by ELISA against CS-P
      antigen; 60% of positive-reacting sera (to both antigens) had higher ELISA values
      when the CS-P antigen was used. Samples (with positive results) that reacted only
      to CS-P antigen had results confirmed by immunoblot analysis. Such sera reacted
      against ASFV-infection proteins IP25, IP25.5, and IP30, but not against IP73. In
      time-course experiments to detect appearance of ASFV-antibodies in infected
      miniature pigs, antibodies were detected by immunoblot analysis on
      postinoculation day (PID) 8. At that time, only the polypeptides IP25, IP25.5
      IP30, and IP31 were recognized; IP73 and IP12 were first detected 3 and 4 days
      later, respectively. In the same experiments, ASFV antibodies were detected by
      ELISA, using CS-P or SVP73 antigens, on PID 7 and 9, respectively. These results
      could explain the percentage of sera not having positive results by ELISA using
      SVP73 antigen, if the sera were obtained from ASFV-infected pigs during the first
      days of infection before induction of antibody response against the IP73 protein.
      This feature makes the use of CS-P antigen advantageous in early serologic
      detection of ASFV-infected pigs.

PMID- 2240774
TI  - Procollagen type-III aminoterminal peptide in serum and synovial fluid of dogs
      with hip dysplasia and coxarthrosis.
AB  - Hip dysplasia is an affection of the coxofemoral joint that progresses until
      stabilization is caused by fibrosis and osteoarthritic changes. This
      stabilization process can be examined by clinical and radiographic methods. The
      capability of evaluating the procollagen concentrations in liquids, such as serum
      and synovial fluid, has further offered the basis for an objective biochemical
      evaluation of the stabilization process. Our study was performed to evaluate
      whether determination of procollagen concentrations was suitable for the use in
      practice. The procollagen type-III aminoterminal peptide (P-III-NP) concentration
      was measured in serum and in synovial fluid from coxofemoral joints in 20 dogs.
      Dogs were grouped on the basis of evidence of dysplasia and osteoarthritic
      changes of the hip: (1) a control group of 6 dogs without clinical or
      radiographic signs of hip dysplasia, and (2) dysplastic group of 14 dogs, which
      was further grouped with respect to the coxofemoral joint laxity, as determined
      by the Ortolani test. Synovial fluid concentration of P-III-NP was significantly
      (P less than 0.05) higher in fluid from dysplastic joints than in fluid from
      normal joints. Serum concentrations of P-III-NP were significantly (P less than
      0.05) higher in dogs in which results of the Ortolani test were positive.

PMID- 2240775
TI  - Evaluation of three applanation tonometers in dogs.
AB  - The Mackay-Marg, Tono-Pen, and Challenger applanation tonometers were evaluated
      in vivo in 12 clinically normal eyes of 6 dogs. Tonometric measures of
      intraocular pressure (IOP) were compared with closed manometric IOP measurements
      from the anterior chamber of anesthetized dogs. The tonometers were evaluated at
      IOP that ranged from 5 to 100 mm of Hg. The Mackay-Marg tonometer was the most
      reliable instrument when evaluated at IOP from 5 to 100 mm of Hg (r2 = 0.996) and
      from 10 to 30 mm of Hg (r2 = 0.962). The Tono-Pen tonometer was also reliable (r2
      = 0.967) over the range of IOP, but consistently overestimated IOP at lower
      pressures and underestimated IOP at higher pressures. The Mackay-Marg and Tono
      Pen measurements were essentially linear. When evaluated from 10 to 30 mm of Hg,
      r2 was 0.828 for the Tono-Pen tonometer. The Challenger tonometer, although
      reliable over the full range of IOP (r2 = 0.965), proved to be less accurate, as
      indicated by lack of a good linear equation.

PMID- 2240776
TI  - Physiologic and body composition changes in feeder pigs under simulated marketing
      conditions.
AB  - Two experiments were conducted to determine changes in body composition and
      various physiologic variables in feeder pigs under simulated marketing
      conditions. In the first experiment, pigs were assigned to 1 of 4 treatment
      groups for 48 hours: (1) no water and feed; (2) water ad libitum, no feed; (3) no
      water, feed ad libitum; or (4) water and feed ad libitum. During a 48-hour
      recovery period, all pigs were allowed feed and water ad libitum. Plasma
      triiodothyronine decreased (P less than 0.01) within the first 24 hours in groups
      1 and -2 pigs, but increased (P less than 0.01) within the first 6 hours of the
      recovery period. The circadian rhythm of plasma cortisol was disrupted in groups
      1 and -3 pigs and during recovery in group-1 pigs. Packed cell volume increased
      (P less than 0.05) in groups-1 and -3 pigs and returned to initial values within
      the first 24 hours of the recovery period. In the second experiment, body
      composition was estimated by the 40K technique for fat-free body mass, percentage
      of nitrogen, and percentage of fat. Body composition was determined before and
      after pigs were allotted to 1 of 2 groups for 48 hours: group-1 pigs were given
      feed and water ad libitum and group-2 pigs were not given feed and water. Group-1
      pigs gained 2.2 kg of body weight (P less than 0.01), 0.6% fat (P less than
      0.01), 0.7 kg of fat-free body mass, and 0.02% nitrogen (P greater than
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240777
TI  - Lack of formyl-methionyl-leucyl-phenylalanine receptors on porcine neutrophils.
AB  - The response of blood neutrophils to the chemotactic peptide formyl-methyl-leucyl
      phenylalanine varies among species. Our results indicate that this peptide does
      not activate the respiratory burst of porcine neutrophils. Specifically,
      concentrations less than or equal to 10(-6) M did not cause production of either
      superoxide or hydrogen peroxide. Studies designed to delineate the biochemical
      deficit responsible for these results indicated that these cells do not express
      specific chemotactic peptide receptors on the external surface of the plasma
      membrane. Although these data do not rule out the possibility that internal
      stores of chemotactic peptide receptor exist, attempts to induce expression of
      the receptor by priming the cells with either lipopolysaccharide or calcium
      ionophore were unsuccessful.

PMID- 2240779
TI  - Retrograde flow of spermatozoa into the urinary bladder of dogs during
      ejaculation or after sedation with xylazine.
AB  - Retrograde flow of spermatozoa into the urinary bladder of dogs during
      ejaculation or after administration of xylazine was examined. In experiment 1,
      the mean (+/- SD) spermatozoal concentration in urine collected by cystocentesis
      before ejaculation was 0.322 +/- 0.645 X 10(6)/ml. After ejaculation, motile
      spermatozoa were present in the urine collected by cystocentesis from 12 of 15
      dogs, and the concentration of spermatozoa in the urine (5.139 +/- 7.014 X
      10(6)/ml) was higher (P less than 0.025) than the concentration in the urine
      collected before ejaculation. The percentage of the total number of spermatozoa
      that were displaced during ejaculation and flowed into the urinary bladder
      (retrograde flow) ranged from 0 to 99.75% (24.67 +/- 33.98%). In experiments 2
      and 3, administration of xylazine to sexually rested dogs induced retrograde flow
      of spermatozoa into the urinary bladder. In experiment 2, all dogs had
      spermatozoa in urine collected after xylazine administration, with motile
      spermatozoa present in the urine from 9 of 10 dogs. In experiment 3, urine
      collected from dogs before administration of xylazine was azoospermic or
      contained few, nonmotile spermatozoa (0.063 +/- 0.135 X 10(6)/ml), whereas urine
      collected after administration of xylazine had more (P less than 0.025) and
      motile spermatozoa (3.717 +/- 4.273 X 10(6)/ml). In experiment 4, administration
      of xylazine to dogs after ejaculation did not increase the concentration of
      spermatozoa in the urine. Results indicate that spermatozoa flow into the urinary
      bladder of dogs during ejaculation or after administration of xylazine to
      sexually rested dogs.

PMID- 2240778
TI  - Postadulticide pulmonary hypertension of canine heartworm disease: successful
      treatment with oxygen and failure of antihistamines.
AB  - Postadulticide pulmonary hypertension mechanisms and treatment with
      antihistamines and supplemental oxygen were studied in eight dogs with heartworm
      disease. To ensure severe postadulticide thromboembolism, additional heartworms
      (either 20 or 40 into 4 dogs each) were transplanted into naturally infected dogs
      before thiacetarsamide treatment. During pentobarbital anesthesia, 2 pulmonary
      hemodynamic studies were conducted on each dog with a sequence of baseline,
      hypoxia with FlO2 = 10%, hyperoxia with FlO2 = 100%, a second baseline, treatment
      with either diphenhydramine (D) or cimetidine (C), and another hypoxia. All dogs
      were pulmonary hypertensive, with each dog having a mean pulmonary arterial
      pressure (PPA) greater than 20 mm of Hg. Mean PPA increased from baseline
      conditions (25.0 +/- 4.5 SD for D and 24.3 +/- 4.4 for C) to hypoxia (28.5 +/-
      4.7 for D and 28.4 +/- 3.7 for C), and decreased during hyperoxia (16.9 +/- 3.0
      for D and 17.4 +/- 3.0 for C), respectively. Neither antihistamine reduced PPA at
      normoxia. The degree of pulmonary hypertension when breathing room air increased
      even more during hypoxia, and this increase was not attenuated by either
      antihistamine. Histamine did not appear to mediate pulmonary hypertension during
      postadulticide thromboembolism, nor to modify the hypoxia-mediated pulmonary
      hypertension at this disease stage. Because baseline PO2 was low (66.6 +/- 11.7
      mm of Hg for D and 69.4 +/- 14.2 for C) and because PPA decreased during
      administration of oxygen, the pulmonary hypertension was mostly hypoxia-induced.
      In addition to the arterial lesions, much of the pulmonary hypertensive mechanism
      was an active and reversible vasoconstriction in response to hypoxia caused by
      the secondary lung disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240780
TI  - Changes in oscillatory potentials in the canine electroretinogram during dark
      adaptation.
AB  - Oscillatory potentials (OP) and electroretinograms (ERG) were recorded from
      clinically normal dogs after 5, 10, 15, 20, 30, 40, 50, and 60 minutes of dark
      adaptation. At the end of the adaptation period, OP were characterized by 5
      distinct positive peaks, O1 through O5, with mean latencies of 14.46, 20.24,
      27.38, 35.31, and 44.85 ms, respectively, and with mean amplitudes ranging from
      7.20 to 34.84 microV. After 60 minutes of dark adaptation, the ERG had a mean a
      wave latency of 12.03 ms and a mean b-wave amplitude of 109.29 microV. Peaks O3
      and O4, which partially mask the summit of the b-wave, had mean latencies of
      28.66 and 36.83 ms, respectively. The mean amplitude of the b-wave measured to
      the peak of O3 was 240.06 microV and 230.73 microV when measured to peak O4.
      Changes in the OP during dark adaptation consisted of significant (P less than
      0.05) increases in the latencies of O1, O2, and O3, and significant increases in
      the amplitudes of O1, O3, O4, and O5. Concurrent ERG changes consisted of
      significant increases in the amplitudes of the a-wave and b-wave measured from O3
      and O4, and significant increases in the latencies of peaks O3 and O4 on the b
      wave.

PMID- 2240781
TI  - Correlation of sensory electroneurographic recordings and myelinated fiber
      diameters of the superficial peroneal nerve of dogs.
AB  - The compound nerve action potential (CNAP) of the superficial peroneal nerve of
      dogs was investigated to determine: (1) the influence of the stimulation
      technique on the configuration of the CNAP, with particular attention to late
      components; (2) the fiber diameter (FD) distribution; and (3) the relationship
      between FD distribution and CNAP configuration, by reconstruction of CNAP made on
      the basis of FD distributions. The CNAP were evoked in 9 dogs under halothane
      anesthesia by 2 stimulation methods: percutaneous needle electrode stimulation
      and direct stimulation of the exposed superficial peroneal nerve. Recordings were
      made with percutaneous needle electrodes. Full nerve cross sections of 7
      superficial peroneal nerves were prepared for FD morphometric analysis.
      Reconstruction of CNAP were made on the basis of the FD distributions. Late
      components of the CNAP could be evoked with either stimulation method, but only
      with a stimulus intensity of 3 to 5 times maximal for the main (early) component
      of the CNAP. The FD histograms of 7 analyzed nerves had bimodal distribution. In
      5 nerves, peaks were at 4.2 to 4.5 microns and 9.0 to 10.0 microns, with 60% of
      the fibers in the small-diameter group. In 2 nerves with lower maximal conduction
      velocities, peaks were shifted toward smaller values. The CNAP reconstructions
      made by use of FD data closely resembled actual recordings when a fifth-order
      polynomial function was applied to the relationship between nerve conduction
      velocity and FD. Reconstructions made by use of 1 or 2 linear functions did not
      accurately resemble actual recordings.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240783
TI  - Flow cytofluorometric studies on the alteration of leukocyte populations in blood
      and milk during endotoxin-induced mastitis in cows.
AB  - Alterations in the various leukocyte populations in milk, blood, and mammary
      lymph were studied by use of the flow cytometric method during acute mastitis
      episodes induced by endotoxin infusion (50 micrograms of lipopolysaccharide of
      Salmonella typhimurium SH 4809) via the teat canal. Lymph samples were collected
      via a semipermanent catheter from an afferent duct to the supramammary lymph
      node. Milk somatic cell count increased at 4 hours after infusion of endotoxin.
      Neutrophils were the predominant cell population for up to 59 hours after
      infusion. Numbers of lymphocytes and monocytes-macrophages in milk also increased
      after the endotoxin infusion. The total cell count in milk started to decrease
      during the third postinfusion day and returned to preinfusion values during the
      fourth day. Lymphocyte numbers remained high for about 1 week after the infusion,
      and lymphocytes were the predominant cell population between postinfusion days 4
      and 8. Total blood leukocyte count decreased during the first 6 hours after
      infusion, followed by an increase until postinfusion hour 31. The proportion of
      neutrophils in blood increased during the first day, whereas that of lymphocytes
      decreased. Lymph flow rate and leukocyte numbers in lymph increased after
      endotoxin infusion. The proportion of neutrophils in the lymph increased during
      the first 6 hours, whereas that of lymphocytes decreased. After postinfusion hour
      6, the inverse course of events was seen.

PMID- 2240782
TI  - Systemic and secretory antibody responses to sequential bovine respiratory
      syncytial virus infections in vaccinated and nonvaccinated calves.
AB  - To investigate the influence of humoral immunity on the severity of disease
      caused by infection with bovine respiratory syncytial virus (BRSV), an
      experimentally induced infection study was performed on vaccinated and
      nonvaccinated calves. Fifteen weanling calves were allotted to 3 groups: 1 group
      of 6 calves was exposed to 2 live virus aerosols, 35 days apart; another group of
      6 calves was vaccinated prior to the same aerosol exposures; and the remaining 3
      calves served as controls. Clinical signs of infection were converted to a
      numerical score for evaluating disease severity. For 14 days after each virus
      exposure, BRSV-specific IgG and IgM concentrations in serum and BRSV-specific IgA
      concentration in nasopharyngeal exudate and lung lavage fluid were measured by
      ELISA. Serum BRSV-specific IgG and IgM and secretory BRSV-specific IgA
      concentrations did not correlate with disease sign expression. There was a strong
      correlation between viral isolation and disease scores. Vaccination prior to
      virus exposure appeared to have little or no effect on severity of the disease,
      but it did appear to affect disease persistence. Findings indicate that the
      immunoglobulins evaluated may be primarily protective in nature and do not
      contribute to disease severity.

PMID- 2240784
TI  - Production and partial characterization of monoclonal antibodies to the neotype
      strain of Mycobacterium bovis.
AB  - Six monoclonal antibodies (MAB) to virulent Mycobacterium bovis ATCC 19210 were
      produced, using a suspension of heat-inactivated whole cells. Immunoglobulin
      isotype for MAB VMB6, VMB73, and VMB93 was IgG1, and for VMB31, VMB99, and
      VMB119, it was IgG2a. Monoclonal antibodies were examined for cross-reactivity to
      M tuberculosis, M kansasii, M fortuitum, M paratuberculosis, M avium serovars 1,
      2, 4, 8, and 10, M chelonei, M phlei, M scrofulaceum, M smegmatis, Nocardia
      asteroides, and Rhodococcus equi. Monoclonal antibodies could be grouped on the
      basis of binding activity by ELISA and immunoblot analysis, in which MAB VMB6,
      VMB31, and VMB119 had binding activity to M bovis; MAB VMB93 and VMB99 detected M
      bovis and M tuberculosis antigens, and MAB VMB73 reacted with other mycobacterial
      species, as well as with N asteroides and R equi. Apparent molecular mass of
      antigens was 30 to 25 kilodaltons (kD) for VMB6, VMB31, and VMB119 and 63 kD for
      VMB93 and VMB99, and ranged from greater than 200 to 31 kD for VMB73, as
      estimated by immunoblot analysis. Monoclonal antibody binding activity to 18
      field isolates of M bovis was evaluated, using ELISA. Each of 18 field isolates
      was detected, using MAB VMB6, VMB31, or VMB119; 10 isolates were detected, using
      MAB VMB93/VMB99, and 14 were detected by use of MAB VMB73. Use of MAB in ELISA
      failed to detect antigens from M bovis strain AN-5.

PMID- 2240785
TI  - Immune response to pulmonary injection of Pasteurella haemolytica-impregnated
      agar beads followed by transthoracic challenge exposure in goats.
AB  - A method of inducing Pasteurella haemolytica serotype 1 (Ph1) lung infection in
      goats, using low numbers of bacteria and without impairing host immunity, was
      developed. Two trials were conducted. Results of trial 1, using 10 principals
      (Ph1 agar beads) and 6 controls (agar beads alone), indicated that Ph1 organisms
      imbedded in agar beads could survive host lung defenses for 32 days. Results of
      trial 2 indicated that lung immunity in the inoculated goats (principals) was
      high and they were more protected than controls against a transthoracic challenge
      of Ph1 (1.18 x 10(7) colony-forming units) injected into a lung of each goat on
      posttreatment day 35. When comparing challenge-exposed principals with controls,
      the controls developed rectal temperatures above normal for a longer time,
      duration of anorexia was longer, and signs of depression were seen. The controls
      developed large areas of consolidated lung tissue, more Ph1 isolates were
      recovered from nasal turbinates and lung tissue, and higher Ph1 concentrations
      were found in the lungs. The serum Ph1 indirect hemagglutination antibody titers
      in the principals of both trials increased, compared with titers in controls.
      Principal goats in trial 2 had higher Ph1 indirect hemagglutination antibody
      titers after injection of Ph1-impregnated agar beads and less severe lung lesions
      after challenge exposure than did controls. The small pneumonic consolidated
      lesions in the principals, compared with extensive lesions in controls after Ph1
      challenge exposure, indicated a high degree of immunity after exposure to Ph1
      organisms imbedded in agar beads.

PMID- 2240786
TI  - Strategic use of anthelmintics to prevent parasitic gastroenteritis in cow-calf
      herds in California.
AB  - On the basis of the hypothesis that the peak numbers of infective nematode third
      stage larvae (L3) on herbage in winter months results from fall contamination of
      pastures, 2 methods to reduce fall contamination were tested. In trial 1,
      morantal sustained-release boluses were administered to 15 fall-calving cows on
      Sept 7, 1982. Fifteen untreated cows (controls) were placed on separate pastures.
      Numbers of L3 on herbage during the winter and spring were assessed by use of
      worm-free tracer calves. In trial 2, 19 cattle due to calve in the fall were
      administered 200 micrograms of invermectin/kg of body weight, SC, on Sept 2,
      1983. Also, 17 cattle similarly were given a placebo injection and served as
      control animals. Treated cattle were placed on the pasture used by control cattle
      in trial 1 and control cattle on the pasture used by treated cattle in trial 1.
      Worm-free tracer calves were again used to assess numbers of L3 on herbage. In
      trial 1, tracer calves grazing the control animal pasture from January 14 to 28
      acquired 37 times as many nematodes as did those grazing the treated animal
      pasture. In trial 2, the greatest difference observed was a 10-fold increase of
      nematodes in calves grazing control animal pastures, compared with worm numbers
      in tracer calves grazing the treated animal pasture.

PMID- 2240787
TI  - Effectiveness of arprinocid in the reduction of cryptosporidial activity in
      immunosuppressed rats.
AB  - Immunosuppressed rats inoculated with Cryptosporidium oocysts isolated from
      calves' feces were treated with arprinocid, 50 mg/kg of body weight/d. As
      determined from differences in the mean number of cryptosporidial developmental
      stages per villus in treated vs control rats, arprinocid had a substantial effect
      on cryptosporidial activity, which was parasitistatic instead of parasiticidal.
      Drug-ranging experiments indicated that arprinocid was effective at 50 and 25
      mg/kg/d, but not at 12.5 mg/kg/d. These results suggest that further testing of
      arprinocid in different animal models, or in phase-I clinical trials, is
      warranted.

PMID- 2240788
TI  - Absorption kinetics of regular insulin in dogs with alloxan-induced diabetes
      mellitus.
AB  - The absorption kinetics of porcine regular insulin following IV, IM, and SC
      administration were evaluated in 10 dogs with alloxan-induced diabetes mellitus.
      Plasma immunoreactive insulin (IRI) concentrations were evaluated immediately
      prior to and at 10, 20, 30, 45, 60, 90, 120, 180, and 240 minutes following IV
      administration; and immediately prior to and every 30 minutes for 2 hours and
      then every hour for 6 hours following IM and SC administration of 0.55 U of
      porcine regular insulin/kg of body weight. Model-independent pharmacokinetic
      analysis was performed on each data set. Plasma IRI concentration declined
      rapidly after IV administration of regular insulin and then returned to baseline
      IRI concentration by 3.2 +/- 0.8 hours. The absorption kinetics following IV
      administration of regular insulin were similar to those found in earlier studies
      in healthy dogs and human beings. The IM and SC routes of regular insulin
      administration resulted in a pharmacologic concentration of IRI at 30 minutes.
      The peak mean (+/- SD) plasma IRI concentration was significantly (P less than
      0.05) greater following SC administration than it was following IM administration
      of regular insulin (263 +/- 185 and 151 +/- 71 I microU/ml, respectively). The
      time of the peak plasma IRI concentration (68 +/- 31 minutes and 60 +/- 30
      minutes) and the time to return to baseline plasma IRI concentration (5.8 +/- 1.2
      hours and 5.8 +/- 1.3 hours) were not significantly different following SC and IM
      administration of regular insulin, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240789
TI  - Effect of gentamicin administration on the neuromuscular blockade induced by
      atracurium in cats.
AB  - Atracurium besylate, a nondepolarizing neuromuscular blocking agent, was
      administered as an infusion to 8 anesthetized cats in which neuromuscular
      blockade was assessed, using the train-of-four response. Once 50% depression of
      the first-twitch (T1) response was achieved, the infusion was held constant for
      60 minutes before being discontinued and the recovery time was determined. The
      time for recovery was recorded as the time for the train-of-four (T4 ratio) to
      increase from 50% to 75%. After recovery, atracurium infusion was reinstituted
      and the cats were again maintained for 60 minutes at 50% depression. A single
      bolus of gentamicin sulfate (2.0 mg/kg of body weight) was administered IV, and
      the infusion was continued for another 60 minutes before it was discontinued and
      the time for recovery was recorded. Within 1 minute of gentamicin administration,
      the mean +/- SD T1 response decreased from 49 +/- 5% to 33 +/- 8% of baseline and
      the T4 ratio decreased from 28 +/- 19% to 14 +/- 11%. Peak effect occurred at 5
      minutes, with a T1 response of 29 +/- 6% of baseline and a T4 ratio of 13 +/-
      12%. By 60 minutes after gentamicin administration, the T1 response had increased
      to 38 +/- 7% of baseline and the T4 ratio had increased to 21 +/- 13%. The time
      for recovery significantly (P less than 0.03) increased from 9.9 +/- 3.4 minutes
      during the control study to 18.1 +/- 10.7 minutes during the gentamicin study. In
      this study, gentamicin potentiated the neuromuscular blockade induced by
      atracurium and increased the recovery time. Residual blockade, observed after
      gentamicin administration was reversed with edrophonium.

PMID- 2240790
TI  - Effect of transport loading or noise on blood biochemical variables in calves.
AB  - The influence of 2 transport stressors (loading and noise) on several serum and
      plasma biochemical variables was studied in 4 calves. When calves were loaded and
      kept for 30 minutes on a motionless transport simulator or were exposed to the
      noise of the working simulator, increases in plasma epinephrine and serum
      cortisol and nonesterified fatty acids concentrations were similar to changes
      observed in calves subjected to simulated transport for 30 minutes. Results
      indicate that loading and noise have an important role in transport stress.

PMID- 2240791
TI  - Effects of tetracycline hydrochloride on pleurae in dogs with induced pleural
      effusion.
AB  - Pleural effusion was induced in 12 dogs by ligation of the cranial vena cava.
      Pleurodesis was attempted by injecting a solution of tetracycline hydrochloride
      into the pleural space of 8 dogs (4 dogs, 25 mg/kg of body weight; 4 dogs, 50
      mg/kg) via bilateral thoracostomy tubes. In both groups, tetracycline was diluted
      in 40 ml of normal saline solution and 10 ml of 1% lidocaine before injection.
      Half of the solution (25 ml) was instilled in each hemithorax. Four control dogs
      were treated in the same manner with a solution of normal saline and lidocaine.
      Daily pleural fluid production was measured after the attempted pleurodesis.
      Thirty days after administration of the solution, each dog was euthanatized and
      necropsied. Surface area of pleural adhesions was measured. Tissues from regions
      of pleural adhesions and areas of parietal and visceral pleura not involved in
      adhesions were analyzed histologically. Formation of pleural fluid stopped in all
      but 1 control dog within 48 hours after injection of solution. This dog effused
      throughout the study. The resolution of effusion was not significantly (P less
      than 0.05) different between the tetracycline-treated dogs and the control group.
      Although diffuse pleural adhesions were not induced in any of the dogs,
      significantly (P less than 0.0027) more surface area of lung was adhered in dogs
      treated with the higher dose of tetracycline.

PMID- 2240792
TI  - Effects of treatment of growing swine with aflatoxin and T-2 toxin.
AB  - Effects of dietary aflatoxin (AF) and T-2 toxin, singly and in combination, were
      evaluated in growing crossbred (Yorkshire x Landrace x Hampshire) pigs. The
      experimental design consisted of 4 treatment groups of 6 barrows each fed diets
      containing 0 mg of AF and T-2/kg of feed (controls; group 1), 2.5 mg of AF/kg of
      feed (group 2), 10 mg of T-2/kg of feed (group 3), or 2.5 mg of AF plus 10 mg of
      T-2/kg of feed (AF + T-2; group 4) ad libitum for 28 days (7 to 11 weeks of age).
      Production performance, and serum biochemical, and hematologic evaluations were
      made weekly. Body weight and body weight gain were depressed by all toxin
      treatments, but the effect of AF and T-2 toxin in combination was less than
      additive. Liver and kidney weights, as a percentage of body weight, were
      increased by AF treatment, and heart weight, as a percentage of body weight, was
      increased by T-2 treatment. Treatment with T-2 toxin induced necrotizing contact
      dermatitis on the snout, buccal commissures, and prepuce. Consumption of AF
      resulted in increased serum activities of alkaline phosphatase, aspartate
      transaminase, cholinesterase, and gamma-glutamyltransferase, and decreased serum
      concentrations of urea nitrogen, cholesterol, albumin, total protein, calcium,
      potassium, magnesium, and phosphorus. Consumption of T-2 toxin resulted in
      increased serum triglyceride concentration and decreased serum iron
      concentration. Treatment with AF induced lower serum unsaturated iron-binding
      capacity and high RBC count, PCV, hemoglobin concentration, WBC count, and
      prothrombin time.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240793
TI  - Effect of endotoxin administration on equine digital hemodynamics and starling
      forces.
AB  - Using a pump-perfused extracorporeal isolated digital preparation, the effects of
      a 30-minute infusion of either saline solution (control) or endotoxin on equine
      digital hemodynamics and microvascular function were determined. Digital blood
      flow and arterial, venous, and capillary pressures were recorded at 15-minute
      intervals for 150 minutes. From these data, total vascular resistance and pre-
      and postcapillary resistances were calculated. Isogravimetric capillary
      filtration coefficient, vascular compliance, and the osmotic reflection
      coefficient were determined after the last hemodynamic measurements were taken.
      Changes in hemodynamic values of control equine digits were not observed. During
      the 120 minutes after infusion of endotoxin, digital blood flow decreased 43%,
      and total vascular resistance increased 89%. Precapillary resistance increased
      122%, but postcapillary resistance did not change significantly. Changes in
      vascular compliance or the capillary filtration coefficient were not observed in
      response to either treatment. The osmotic reflection coefficient, an index of
      permeability, did not differ significantly between digits of the endotoxin
      treated and control groups. These data indicate that the increase in vascular
      resistance during endotoxemia may have been attributable to arterial/arteriolar
      constriction and that neither the permeability nor the surface area of the
      exchange vasculature within the digit was significantly affected by endotoxin.
      Although marked alterations in vascular function are seen after administration of
      endotoxin, these changes do not parallel those documented in association with
      experimentally induced laminitis.

PMID- 2240794
TI  - Plasma hormone concentrations after administration of dexamethasone during the
      middle of the luteal phase in cows.
AB  - The effect of glucocorticoids on gonadal steroid and gonadotropic hormone
      concentrations and subsequent follicular activity in cows undergoing normal
      estrous cycles was evaluated by administration of dexamethasone (DXM) during the
      middle of the luteal phase. Seven cows were given physiologic saline solution
      twice daily from day 13 to day 17 of the estrous cycle (control experiment).
      During the next estrous cycle, cows were administered DXM (2 mg, IM) twice daily
      on days 13 through 17. Plasma specimens obtained twice daily throughout the
      control and DXM-treatment cycles were assayed for progesterone and estradiol
      concentrations. The appearance of estrus after DXM treatment was delayed until
      days 23 to 25 in 3 cows and was not seen by day 35 in the other 4 cows, compared
      with mean (+/- SD) cycle length of 22.4 +/- 3.2 in cows during the control
      experiment. Progesterone concentration remained significantly (P less than 0.01)
      high on days 19 to 23, whereas estradiol values failed to increase (P less than
      0.05) on days 19 and 20 after treatment with DXM. Blood samples were obtained at
      15-minute intervals for 12 hours to compare (by analysis of covariance) the
      effect of DXM treatment on plasma hormone concentrations on day 15 of each cycle
      with those of day 10. Compared with values during the control experiment, a
      significant (P less than 0.05) decrease was observed in the size of the pulses of
      luteinizing hormone (LH) and estradiol, although the number of pulses of each
      hormone per 12 hours was not affected when cows were given DXM. Baseline
      concentrations of LH and estradiol were not altered by type of
      treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240795
TI  - Experimental model of hypochloremic metabolic alkalosis caused by diversion of
      abomasal outflow in sheep.
AB  - Hypochloremic metabolic alkalosis accompanied by hypokalemia and hyponatremia was
      induced experimentally in 7 adult sheep by diversion (loss) of gastric contents
      through an Ivan and Johnston cannula placed in the cranial part of the duodenum
      just distal to the pylorus. Cannula placement was easily accomplished, and
      cannulae were tolerated well by the sheep. Volume of effluent produced during the
      60- to 120-hour period of diversion ranged from 7.7 to 14.9 L and tended to be
      greatest during the first 24 hours. All sheep became dehydrated, with mean PCV
      and plasma total protein concentration increases of 94.2 and 61.7%, respectively.
      Plasma chloride concentration decreased in linear fashion from a prediversion
      mean of 113 mEq/L (range, 111 to 117 mEq/L) to an end-point mean of 54 mEq/L
      (range, 45 to 65 mEq/L). Plasma sodium and potassium concentrations also
      decreased, though potassium concentration increased terminally. There were rapid
      increases in arterial blood pH and bicarbonate and base excess concentrations
      during the first 48 hours after diversion. However, during the final stages of
      diversion, sheep developed superimposed metabolic acidosis with increased plasma
      lactate concentration and high anion gap.

PMID- 2240797
TI  - Evoked potentials induced by transcranial stimulation in dogs.
AB  - Evoked potentials were induced by transcranial stimulation and recovered from the
      spinal cord, and the radial and sciatic nerves in six dogs. Stimulation was
      accomplished with an anode placed on the skin over the area of the motor cortex.
      Evoked potentials were recovered from the thoracic and lumbar spinal cord by
      electrodes placed transcutaneously in the ligamentum flavum. Evoked potentials
      were recovered from the radial and sciatic nerves by surgical exposure and
      electrodes placed in the perineurium. Signals from 100 repetitive stimuli were
      averaged and analyzed. Waveforms were analyzed for amplitude and latency.
      Conduction velocities were estimated from wave latencies and distance traveled.
      The technique allowed recovery of evoked potentials that had similar
      characteristics among all dogs. Conduction velocities of potentials recovered
      from the radial and sciatic nerves suggested stimulation of motor pathways;
      however, the exact origin and pathway of these waves is unknown.

PMID- 2240796
TI  - Renal net acid and electrolyte excretion in an experimental model of
      hypochloremic metabolic alkalosis in sheep.
AB  - Renal electrolyte and net acid excretion were characterized during generation and
      maintenance of hypochloremic metabolic alkalosis in a ruminant model. Two phases
      of renal response with regard to sodium and net acid excretion were documented.
      An initial decrease in net acid excretion was attributable to increase in
      bicarbonate excretion with associated increase in sodium excretion. As the
      metabolic disturbance became more advanced, a second phase of renal excretion was
      observed in which sodium and bicarbonate excretion were markedly decreased,
      leading to increase in net acid excretion and development of aciduria. Throughout
      the metabolic disturbance, chloride excretion was markedly decreased; potassium
      excretion also decreased. These changes were accompanied by increase in plasma
      renin and aldosterone concentrations. There was apparent failure to concentrate
      the urine optimally during the course of the metabolic disturbance, despite
      increasing plasma concentration of antidiuretic hormone.

PMID- 2240798
TI  - Maturational development of drug-metabolizing enzymes in sheep.
AB  - A qualitative and quantitative assessment was made of the development of hepatic
      drug-metabolizing enzymes (DME) in sheep as part of a study of the ability of the
      food-producing species to metabolize drugs. The following DME and components were
      measured in this study: cytochromes P-450 and b5 and NADPH and NADPH-dependent
      reductases associated with each of these cytochromes; cytochrome P-450-mediated
      reactions, including aniline and coumarin hydroxylases, aminopyrine N
      demethylase, and 7-ethoxycoumarin 0-deethylase; a uridine diphosphoglucuronic
      acid glucuronyl transferase with 4-methylumbelliferone as substrate; and
      glutathione-S-transferase with dinitrochlorobenzene and dichloronitrobenzene as
      substrates. Amounts or activities of most of these components and enzymes
      increased up to and beyond the time of weaning. Amount of cytochrome b5 and
      uridine diphosphoglucuronic acid transferase activity were not affected by age,
      whereas NADPH cytochrome c (P-450) reductase activity actually decreased after
      weaning. In some instances (eg, coumarin hydroxylase, cytochrome P-450, and
      dinitrochlorobenzene-glutathione-S-transferase), differences from preweaning DME
      values were observed only after sheep were greater than or equal to 6 months old.
      All other DME activities were definitely increased, compared with the values in
      lambs before weaning (0 to 12 weeks old). Approximately a third of the sheep
      studied had some type of clinical disease that might have affected the DME
      activities. Diseases were classified as sore mouth, pneumonia, foot rot,
      parasitism, and systemic bacterial infections. Except in a few instances, these
      diseases had minimal effect on DME activities measured in vitro.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2240799
TI  - Effects of a specific thromboxane synthetase inhibitor on thromboxane generation
      and excretion in healthy dogs.
AB  - A specific thromboxane synthetase inhibitor, 3-methyl-2 (3-pyridyl)-1
      indoleoctanoic acid (CGS 12970) was administered orally to 6 healthy adult
      Beagles at a dosage of 30 mg/kg of body weight. Blood generation of thromboxane
      B2 and urinary excretion of thromboxane B2 were measured before and after
      administration of CGS 12970. Although 97 +/- 0.4% inhibition of thromboxane B2
      generation was observed within 2 hours after a single dose of CGS 12970 was
      administered orally, an effect on urinary excretion of thromboxane B2 was not
      observed. Additionally, oral administration of 30 mg/kg every 12 hours resulted
      in 80 +/- 14% inhibition of thromboxane B2 generation but had no effect on
      urinary thromboxane B2 excretion.

PMID- 2240800
TI  - Pharmacokinetics of single doses of digoxin administered intravenously to ducks,
      roosters, and turkeys.
AB  - A single dose of digoxin was injected, IV, into 5 mature male turkeys (0.066
      mg/kg of body weight), 8 male ducks (0.066 mg/kg), and 6 roosters (0.33 mg/kg).
      Twenty-three serial venous blood samples were collected before (baseline) and
      after the administration of digoxin to turkeys, ducks, and roosters. Plasma
      concentrations of digoxin were determined in duplicate by a radioimmunoassay that
      was validated for avian species. The plasma concentrations were best fitted by a
      3 (turkeys, ducks)- and 2 (roosters)-compartment open model, with first-order
      elimination from the central compartment. Significant (P less than 0.05) kinetic
      differences were determined among species. Mean half-life (t1/2) for ducks,
      roosters, and turkeys were 8.30 +/- 2.70 (mean +/- SD), 6.67 +/- 3.50, and 23.7
      +/- 4.8 hours, respectively. The volume of distribution at steady state (Vss) was
      14.7 +/- 2.9, 3.13 +/- 0.49, and 2.27 +/- 0.36 L/kg, and total body clearance
      (CL) of drug was 1.54 +/- 0.43, 0.461 +/- 0.187, and 0.136 +/- 0.022 L/h/kg for
      ducks, roosters, and turkeys, respectively. The mean residence time was 10.3 +/-
      3.9, 8.37 +/- 4.97, and 16.8 +/- 2.2 hours, respectively. Volume of distribution
      at steady state and CL in ducks were several fold higher than that in turkeys.
      The terminal half-life of digoxin determined for ducks and roosters in this study
      was considerably shorter than those previously reported for several mammalian
      species.

PMID- 2240801
TI  - Pharmacokinetics of pipemidic acid in chickens after single intravenous and oral
      dosings.
AB  - The pharmacokinetics of pipemidic acid after 2 single doses were studied in
      broiler chickens. Chickens were given single IV and oral doses of 10 and 30 mg of
      pipemidic acid/kg of body weight. Blood samples were collected over 8 hours after
      each dose administration. High-pressure liquid chromatography with UV detection
      was used to determine concentrations in plasma of pipemidic acid. The plasma
      concentration-time curves after IV administration followed 2-compartment
      characteristics, rapid initial distribution phase, and a terminal elimination
      phase. The pharmacokinetic variables differed significantly between single doses
      of 10 and 30 mg of pipemidic acid/kg. Mean disposition variables were a half-life
      at alpha phase of 0.06 hours or 0.33 hours, a half-life at beta phase of 1.18
      hours or 1.72 hours, a volume of distribution in the central compartment of 0.12
      L/kg or 0.31 L/kg, a volume of distribution during the elimination beta phase of
      1.64 L/kg or 1.05 L/kg, and a total plasma clearance of 0.97 L/h.kg or 0.41
      L/h.kg, for the 10 or 30 mg/kg dose, respectively. After oral administration, the
      pipemidic acid plasma profile could be adequately described by a 1-compartment
      model. After the single oral doses of 10 and 30 mg of pipemidic acid/kg,
      pipemidic acid was absorbed rapidly (time to maximal concentration of 0.31 hours
      or 0.71 hours) and eliminated with a mean half-life of 0.86 hours or 0.61 hours,
      respectively. The bioavailability was 39% at 10 mg of pipemidic acid/kg and 61%
      at 30 mg of pipemidic acid/kg.

PMID- 2240802
TI  - Recombinant DNA probe detecting Eperythrozoon suis in swine blood.
AB  - A genomic library to Eperythrozoon suis DNA was constructed in lambda gt11, and
      from this library, E suis clone KSU-2 was identified as a potential diagnostic
      probe. In hybridization experiments that used 100-microliters samples of blood
      collected in chaotropic salt solutions, the KSU-2 probe hybridized strongly with
      purified E suis organisms and blood samples from splenectomized swine that were
      parasitized with E suis. However, the probe under stringent conditions did not
      give radiographic indications of hybridizing with equine blood DNA, bovine blood
      DNA infected with Anaplasma marginale, canine blood DNA infected with Ehrlichia
      canis, feline blood DNA infected with Haemobartonella felis, or uninfected swine
      blood DNA.

PMID- 2240803
TI  - Endomyocardial biopsy in cats.
AB  - A technique for transvenous endomyocardial biopsy of the right ventricle was
      developed and evaluated for safety and efficacy in anesthetized healthy cats
      positioned in left lateral recumbency. At least 6 endomyocardial biopsy specimens
      were obtained from the right ventricle or interventricular septum of 11 cats. In
      4 cats, the right jugular vein was torn during attempts to pass the introducing
      catheter into the right ventricle; however, in only 1 cat did this preclude
      catheter passage. This cat's heart was biopsied via the left jugular vein. Except
      for damage to the jugular vein, complications were infrequent, and the biopsy
      procedure was well tolerated by all cats.

PMID- 2240804
TI  - Modified transvenous endomyocardial biopsy technique in dogs.
AB  - A technique for transvenous endomyocardial biopsy of the right ventricle was
      developed and evaluated for safety and efficacy in healthy dogs and dogs with
      dilated cardiomyopathy positioned in lateral recumbency. This technique allowed
      acquisition of multiple biopsy specimens from the right ventricle of each of 22
      hemodynamically normal dogs and 40 of 42 dogs with congestive heart failure. In 2
      dogs with dilated cardiomyopathy, transvenous access to the right ventricle could
      not be achieved, but left ventricular biopsy was performed without complication.
      Complications were infrequent, and dogs recovered to at least their baseline
      status within 48 hours. Evaluation of the efficacy and complication rate of the
      procedure with each of the 2 biopsy instruments currently available identified no
      differences between them.

PMID- 2240805
TI  - Evaluation of drug-induced prostatic involution in dogs by transabdominal B-mode
      ultrasonography.
AB  - The relative antiandrogen-induced prostate involution activity of the newly
      synthesized hydroxyflutamide pro-drug was compared with that of flutamide in 25
      Beagles. Secondary antiandrogen activity of both drugs on the testes and mammary
      tissue was investigated. Daily oral administration of both compounds at 2 dosages
      (ie, 2.5 and 5.0 mg/kg of body weight) during a 7-week period was monitored by
      transabdominal ultrasonography of the prostate twice a week. Cross-sectional area
      estimates of the prostate gland calculated from oblique dorsoventral, and
      transverse sonographic measurements were diminished significantly in some of the
      treated dogs as early as day 14 of drug administration. All treated dogs had
      significant differences in reduction by day 47. Involution was related directly
      to dose (P less than 0.05), but no difference was observed between test
      compounds. Differences in secondary antiandrogen activity were not remarkable.
      Flutamide was not found to have any activity advantage in vivo over
      hydroxyflutamide. It was concluded that ultrasonography can be a highly effective
      means of monitoring prostate size, and of monitoring drug-induced involution over
      time.

PMID- 2240806
TI  - Correlation of brain stem auditory-evoked responses with cranium size and body
      weight of dogs.
AB  - Brain stem auditory-evoked responses were recorded in 9 male and 11 female
      clinically normal mature dogs, weighing between 2 and 36 kg. Mean wave latency
      for the entire group of dogs, using 60-dB hearing level click stimuli at 11/s for
      waves I to VII was: 1.41, 2.21, 2.85, 3.31, 3.71, 5.12, and 6.46 ms,
      respectively. The mean interpeak latency for waves I and V (IPLIV) was 2.32 ms.
      Neither gender nor ear effect was detectable. Positive correlation was observed
      between cranium length, cranium width, nasion-external auditory meatus interval,
      and body weight for wave-V latency and IPLIV. Such correlation was not documented
      for wave I. The regression equations for their effects on IPLIV were: cranium
      length, y = 0.05x + 1.85; cranium width, y = 0.07x + 1.32; nasion-external
      auditory meatus interval, y = 0.05x + 1.79; and body weight, y = 0.01x + 2.15. On
      the basis of any of the 3 variables of cranium size or body weight, the study
      population could be classified into groups of large and small dogs, with the
      large group having significantly (P less than 0.05) longer latency for wave V and
      IPLIV. It is recommended that the effect of size variation in dogs on brain stem
      auditory-evoked responses should be compensated for by use of the regression
      equation based on cranium length.

PMID- 2240807
TI  - Morphologic and ultrastructural evaluation of effect of ischemia and dimethyl
      sulfoxide on equine jejunum.
AB  - Morphologic changes in equine jejunal segments subjected to 1 hour of ischemia
      and 1 hour of reperfusion, and protective effects of systemic administration of
      dimethyl sulfoxide (DMSO; 1 g/kg of body weight) were investigated in 18 ponies,
      using light microscopy and scanning and transmission electron microscopy. Ponies
      were allotted to 4 groups: group 1--control (n = 3); group 2--DMSO (n = 3); group
      3--ischemia (n = 6); and group 4--ischemia and DMSO (n = 6). In each pony, 2
      jejunal sections were evaluated. The first section was obtained prior to
      induction of ischemia, and the second was obtained 2 hours later after
      reperfusion. Mucosal lesions were graded from 0 (normal) to 5 (most severe).
      Combined ischemia and reperfusion of 2 hours' duration induced moderately severe
      mucosal injury to the equine jejunum (group 3; grade 1.5 to 2.5), characterized
      principally by disruption of enterocyte attachment from the basement membrane and
      lamina propria. Fluid accumulation disrupted enterocyte cell-to-cell adhesion
      toward cell bases, while apical tight junctions and desmosomal junctions toward
      the luminal surface remained intact. Intracytoplasmic organellar changes within
      enterocytes were not a prominent feature of the injury. The aforementioned
      processes were marked at the villus tip and progressed down the villus sides.
      These findings support the importance of mechanisms leading to early
      subepithelial fluid accumulation rather than that of direct severe enterocyte
      injury. Further, fluid accumulation does not appear to arise from intercellular
      migration from the luminal surface. In this model, a pathomechanical effect
      caused by vigorous villus retraction appears to exacerbate epithelial lifting
      toward the villus tip.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240808
TI  - Clinical and pathologic studies of experimentally induced Pasteurella haemolytica
      pneumonia in calves.
AB  - Pasteurella haemolytica pneumonia of the right caudal lung lobe was
      experimentally induced in 2-week-old Holstein calves (n = 11) by endobronchial
      inoculation of 7.9 x 10(10) colony-forming units of 6-hour log-phase bacteria.
      Calves were studied for 72 hours after inoculation. The challenge procedure
      consistently induced a lesion in the right caudal lung lobe, which was consistent
      radiographically with results of pathologic examination and a similar volume of
      bronchography contrast medium. Clinically, the calves developed a significant
      increase in rectal temperature within 24 hours after inoculation. Seventy-two
      hours after inoculation, the total WBC counts, absolute band neutrophil counts,
      monocyte counts, and blood fibrinogen concentrations were significantly higher
      than normal and albumin concentration was significantly decreased. Necropsy
      revealed a circular to oblong lesion that was congested, edematous, and firm and
      occupied 20 to 40% of the right caudal lung lobe. Histologic examination revealed
      a severe acute inflammatory reaction characterized by cellular exudate and
      proteinaceous fluid in the alveoli, interlobular septa, and pleura.

PMID- 2240809
TI  - Pneumonic pasteurellosis induced experimentally in gnotobiotic and conventional
      calves inoculated with Pasteurella haemolytica.
AB  - Experimental pneumonia caused by Pasteurella haemolytica was induced in 2-week
      old gnotobiotic (n = 4) and conventional (n = 6) calves by endobronchial
      inoculation into the right caudal lung lobe of 7.9 x 10(10) +/- 0.6 x 10(10)
      (mean +/- SD) colony-forming units of P haemolytica in the 6-hour log phase of
      growth. The calves were studied for 24 hours or less. Regression lines for the
      relationship between clinical index and time for the gnotobiotic group and
      conventional group of calves were compared, and the clinical index was found to
      be significantly (P less than or equal to 0.005) more rapid in the gnotobiotic
      group. There was also a significant difference in the preinoculation, absolute
      segmented neutrophil count (P less than or equal to 0.05), and in the total serum
      protein, albumin, and globulin values (P less than or equal to 0.05). Comparison
      of the preinoculation and post inoculation blood cell and blood chemical values
      revealed a significant increase (P less than or equal to 0.05) in the numbers of
      band neutrophils and fibrinogen in conventional calves, and a significant
      decrease (P less than or equal to 0.05) in the total WBC count in gnotobiotic
      calves. Necropsy of both groups of calves revealed a circular to oblong lesion
      that was congested, edematous, and firm, and which occupied 20% to 100% of the
      right caudal lung lobe and involved the remaining lung lobes to a more minor
      degree. When mean lesion scores of the 2 groups of calves were compared, no
      significant difference (P less than or equal to 0.05) was found.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2240810
TI  - Effect of in-house transport on murine plasma corticosterone concentration and
      blood lymphocyte populations.
AB  - The effect of in-house transport on plasma corticosterone concentration and blood
      lymphocyte populations of laboratory mice was investigated. Mice were transported
      within a research facility at 0900 hours in a pattern designed to simulate that
      commonly used by investigators prior to experimental manipulation. Plasma
      corticosterone concentration and WBC count were determined at 0.25, 2, 4, 8, 12,
      and 24 hours after transport. A significant (P less than 0.05) increase in plasma
      corticosterone concentration was seen in mice immediately after transport. The
      normal circadian rhythm of plasma corticosterone concentration was altered for
      the subsequent 24-hour period. Corresponding significant (P less than 0.05)
      decreases in total WBC numbers, lymphocyte count, and thymus gland weight were
      observed. The decrease in total blood lymphocyte numbers at 4 hours was reflected
      in B- and T-lymphocyte populations. The subsequent acute increase in plasma
      corticosterone concentration was associated with alterations in the cellular
      components of the immune system. Results of the study indicated that routine in
      house transport of laboratory mice should be considered a stressful stimulus.

PMID- 2240811
TI  - Cultivation of tissue from the matrix of the stratum medium of the equine and
      bovine hoof walls.
AB  - Explants from the matrix of the stratum medium of the wall of the equine and
      bovine hoof each were cultured on a microporous membrane, using a standard
      culture medium. After incubation at 37 C, the outgrowth was a mixture of
      keratinocytes and fibroblasts, with predominance of the latter. After incubation
      at 34 C, the keratinocytes dominated, covering the lateral surfaces of the
      explant as well as the basal surface. Lateral outgrowth of keratinocytes was
      observed at the borderline of the original epidermis and at the borderline of the
      explant's contact with the membrane. Epithelial outgrowth from the former
      consisted of rounded aggregates protruding into the medium, whereas outgrowth
      from the latter formed a pluristratified carpet occupying a considerable part of
      the membrane. In the outer layers, keratinocytes covering the cut surfaces of the
      dermis of the explant had a differentiation pattern of the kind that
      characterizes the keratinocytes of the hoof; differentiation was not observed in
      the lateral outgrowth.

PMID- 2240812
TI  - Detection of capsular polysaccharide in milk of cows with natural intramammary
      infection caused by Staphylococcus aureus.
AB  - Detection of capsular polysaccharide (CP) in milk of cows with natural
      intramammary infection caused by Staphylococcus aureus was attempted. Five
      quarters of 5 cows harboring S aureus strains that produce type-8 CP were
      selected. Using an ELISA with a monoclonal antibody, type-8 CP was not detected
      in extracts prepared from fresh milk collected aseptically. By contrast, CP was
      easily detectable after incubation of infected milk at 38 C for 20 hours.
      Quantitation of CP in extracts from incubated milk samples by use of ELISA
      indicated a great variation of CP expression by strains. Although an incubation
      step was necessary to detect CP, results of the study indicate that CP may be
      expressed in vivo during intramammary infection caused by S aureus.

PMID- 2240813
TI  - In vitro susceptibility of some porcine respiratory tract pathogens to aditoprim,
      trimethoprim, sulfadimethoxine, sulfamethoxazole, and combinations of these
      agents.
AB  - The in vitro antimicrobial activities of aditoprim (AP), a new dihydrofolate
      reductase (DHFR) inhibitor, trimethoprim (TMP), sulfadimethoxine (SDM),
      sulfamethoxazole (SMX), and combinations of these drugs against some porcine
      respiratory tract pathogens were determined by use of an agar dilution method.
      The minimal inhibitory concentrations (MIC) of these agents were determined twice
      against Bordetella bronchiseptica (n = 10), Pasteurella multocida (n = 10), and
      Actinobacillus pleuropneumoniae (n = 20) strains isolated from pigs suffering
      from atrophic rhinitis or pleuropneumonia. All B bronchiseptica strains were
      resistant to AP and TMP. The MIC50 values of AP and TMP for P multocida were 0.25
      and 0.06 microgram/ml, respectively, and for A pleuropneumoniae, 1 and 0.25
      microgram/ml, respectively. The MIC50 values of SDM and SMX for B bronchiseptica
      were 4 and 1 micrograms/ml, respectively; for P multocida, 16 and 8
      micrograms/ml, respectively; and for A pleuropneumoniae, 16 and 8 micrograms/ml,
      respectively. The investigated combinations of the DHFR inhibitors and the
      selected sulfonamides had synergism for the A pleuropneumoniae strains; the MIC90
      values of the combinations were less than or equal to 0.06 microgram/ml.
      Potentiation was not observed for the B bronchiseptica and the P multocida
      isolates. The MIC of the combinations against B bronchiseptica and P multocida
      corresponded respectively to the concentrations of the sulfonamides and the DHFR
      inhibitors in the combinations. For A pleuropneumoniae, 2 types of strains were
      used (25% of serotype 2 and 75% of serotype 9). Type-2 strains had lower
      susceptibility than type-9 strains to AP and TMP as well as to SDM and SMX (at
      least a fourfold difference in MIC between the 2 types of strains).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2240814
TI  - Hematologic values and plasma and tissue folate concentrations in dogs given
      phenytoin on a long-term basis.
AB  - During earlier investigations of the hepatic effects in dogs of long-term
      administration of phenytoin alone or in combination with primidone, erythrocytic
      macrocytosis, neutropenia, neutrophilic hypersegmentation, and thrombocytopenia
      were observed. Such abnormalities were observed most often in dogs given
      phenytoin and resembled those known to be attributable to folate deficiency in
      human beings with epilepsy treated with phenytoin. To pursue the theory that
      these hematologic aberrations were caused by drug-induced folate deficiency, 12
      dogs were given a diet specifically formulated to contain a minimally adequate
      concentration of folate. After 2 weeks, phenytoin was administered daily (400 mg,
      PO, q 8 h) to 8 of the 12 dogs for 54 weeks. A CBC, bone marrow aspiration
      biopsy, and measurement of plasma and RBC folate concentrations were done every 3
      weeks. Bone marrow aspirates were examined by transmission electron microscopy
      after 24 and 36 weeks, and at the end of the treatment period. Hepatic folate
      concentration was also determined in all dogs before and after treatment.
      Excretion of formiminoglutamic acid, as a marker of folate deficiency, was
      measured in all dogs at the end of the study. All dogs remained healthy
      throughout the treatment phase. Consistent abnormalities were not observed in the
      blood or bone marrow of treated dogs. Plasma and RBC folate concentrations
      decreased in control and treated dogs as a result of dietary restriction (P less
      than or equal to 0.02), and remained stable until the end of the study. The RBC
      folate content decreased further in treated dogs (P less than or equal to 0.02),
      although the hepatic folate content was similar in control and treated dogs.
      Treated dogs did not excrete formiminoglutamic acid more rapidly than did control
      dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240815
TI  - Effect of T-2 toxin on resistance to systemic Salmonella typhimurium infection of
      newly hatched chickens.
AB  - Newly hatched chickens were treated with the trichothecene mycotoxin, T-2 toxin,
      during the first day of life. Control chickens were treated with other agents
      known to cause immunosuppression--cyclosporine, cyclophosphamide, and aflatoxin.
      Chickens were infected on day 6 (5 days after treatment with T-2 toxin) by
      intraperitoneal inoculation with Salmonella typhimurium. Blood samples were
      collected from treated chickens (noninfected) and used to assess the
      responsiveness of blood lymphocytes to T-cell or B-cell mitogens,
      phytohemagglutinin, or lipopolysaccharide, respectively. The T-2 toxin had a
      profound negative effect on the ability of the chickens to resist salmonellosis,
      as measured by survival. However, the toxin effect in reducing phytohemagglutinin
      and lipopolysaccharide-stimulated mitogenesis, though significant (P greater
      than 0.05), was not severe. Our data indicate a direct effect of T-2 toxin on
      native resistance to systemic salmonellosis, which was not accompanied by marked
      alteration in T- or B-cell responses to mitogenic stimulation.

PMID- 2240817
TI  - Horseradish peroxidase study of the location of extrinsic efferent and afferent
      neurons innervating the colon of dogs.
AB  - The abdominal portion of the colon of 13 clinically normal dogs was divided into
      5 regions (ascending, transverse, left colic flexure, proximal descending, and
      distal descending), and each region was injected with 30 mg of horseradish
      peroxidase (HRP). The injected colonic region, brain stem, L7-Cd1 portion of the
      spinal cord, sympathetic trunk ganglia, celiacomesenteric ganglia, caudal
      mesenteric ganglion, pelvic plexi, distal vagal (nodose) ganglia, and L1-Cd1
      spinal ganglia were obtained at post-injection hour 48, sectioned, and processed
      by use of the tetramethylbenzidine method. The entire length of the colon was
      found to be under extrinsic influence of the parasympathetic nucleus of cranial
      nerve X (PX), with the largest average number of labeled cells resulting from
      injection of the ascending colon. It was also indicated that the entire colon is
      under extrinsic influence of the sacral portion of the spinal cord because the
      pelvic ganglia (second-order neurons) of the pelvic plexi contained labeled cells
      for all colonic regions. The largest average number of labeled cells in pelvic
      ganglia was seen after injection of the distal portion of the descending colon.
      Only after injection of the distal portion of the descending colon were labeled
      cells found in the S1-S3 portion of the spinal cord. Labeled cells in the PX,
      spinal cord, and pelvic ganglia were found bilaterally. Although the entire
      abdominal portion of the colon appears to be influenced by cranial and sacral
      parasympathetic preganglionic (via pelvic ganglia) neurons, the relative
      importance of the 2 areas seems to be reversed between the ascending colon and
      distal portion of the descending colon.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240816
TI  - Anthelmintic activity of the macrocyclic lactone F28249-alpha in sheep.
AB  - The macrolytic lactone F28249-alpha was titrated in experimentally infected sheep
      and found to be highly effective against most of the common gastrointestinal
      nematodes as a single oral dose, given at a rate of 0.025, 0.05, or 0.1 mg/kg.
      Specifically, maximal activity was evident at even the lowest dosage against
      adult Haemonchus contortus, Ostertagia circumcinta, Trichostrongylus axei, and T
      colubriformis and L4 O circumcinta. Activity against Oesophagostomum columbianum
      was also high at all dosages, with a calculated ED95 of 0.029 mg/kg. Cooperia
      curticei was eliminated at 0.1 mg/kg, but control was erratic at the lower
      dosages. The greatest weakness of this compound was its activity against C
      oncophora. The activity against this parasite was weak (less than or equal to
      85%) at all dosages, and the dosage-response curve was flat, suggesting dosages
      substantially higher than those given would be necessary for high-order control
      of this species.

PMID- 2240818
TI  - Plasma glucocorticoid concentrations in calves as an indicator of stress during
      parturition.
AB  - Plasma glucocorticoid concentrations and blood gas values were determined for 6
      days in 47 newborn calves that had been subjected to various obstetrical
      procedures at term. Concentrations of glucocorticoids were uniformly high at
      birth (70 to 103 ng/ml). Increasing degrees of acidosis were accompanied by
      increasing glucocorticoid concentrations in plasma. Plasma glucocorticoid
      concentrations decreased sharply during the first 6 hours after delivery and
      reached a plateau at 48 hours after birth (14 to 21 ng/ml). The latter was taken
      as an indication that adaptation had been achieved. Calves subjected to severe
      pulling had higher glucocorticoid concentrations at birth (110.4 ng/ml) than
      calves requiring no assistance (88.3 ng/ml), calves requiring only slight
      assistance (83.8 ng/ml), or calves that had been delivered by cesarean section
      (82.9 ng/ml).

PMID- 2240819
TI  - Characterization of distal bronchial microflora during acute exacerbation of
      chronic bronchitis. Use of the protected specimen brush technique in 54
      mechanically ventilated patients.
AB  - To obtain accurate information on distal bronchial microflora during acute
      exacerbation in patients with chronic bronchitis, we prospectively studied 54
      such patients who had been receiving mechanical ventilation because of
      hypercapnic respiratory failure. Fiberoptic bronchoscopy using a protected
      specimen brush (PSB) was performed on each patient within the first 24 h after
      admission. Cultures of protected brush specimens demonstrated no growth in 27
      patients (50%). With the exception of fever (38.2 +/- 0.8 versus 37.7 +/- 0.6
      degrees C; p less than 0.05), the initial severity of the episode of exacerbation
      was similar in patients with and without infection. A total of 44 organisms were
      isolated in the 27 patients with positive cultures; the predominant pathogens
      were Hemophilus spp. and Streptococcus spp. (involved in 74% of cases), but other
      organisms were isolated in 12 of 27 patients. Mortality rates, duration of
      mechanical ventilation, and duration of hospitalization were not significantly
      different between patients with bronchial microflora treated with appropriate
      antimicrobial therapy (n = 27) and patients without bronchial microflora either
      receiving empirical antibiotic therapy (n = 18) or not (n = 9). These data
      suggest that distal bronchial infection due to the usual pathogens, as far as
      shown by protected specimen brush cultures, may not be the sole or even the
      predominant cause of acute exacerbation of chronic bronchitis in patients
      requiring mechanical ventilation.

PMID- 2240820
TI  - Distinguishable types of dyspnea in patients with shortness of breath.
AB  - Dyspnea frequently accompanies a variety of cardiopulmonary abnormalities.
      Although dyspnea is often considered a single sensation, alternatively it may
      encompass multiple sensations that are not well explained by a single physiologic
      mechanism. To investigate whether breathlessness experienced by patients
      represents more than one sensation, we studied 53 patients with one of the
      following seven conditions: pulmonary vascular disease, neuromuscular and chest
      wall disease, congestive heart failure, pregnancy, interstitial lung disease,
      asthma, and chronic obstructive pulmonary disease. Patients were asked to choose
      descriptions of their sensation(s) of breathlessness from a dyspnea questionnaire
      listing 19 descriptors. Cluster analysis was used to identify natural groupings
      among the chosen descriptors. We found that patients could distinguish different
      sensations of breathlessness. In addition, we found an association between
      certain groups of descriptors and specific conditions producing dyspnea. These
      findings concur with those in an earlier study in normal volunteers in whom
      dyspnea was induced by various stimuli. We conclude that different types of
      dyspnea exist in patients with a variety of cardiopulmonary abnormalities.
      Furthermore, different mechanisms may mediate these various sensations.

PMID- 2240821
TI  - A family study of the variability of pulmonary function in alpha 1-antitrypsin
      deficiency. Quantitative phenotypes.
AB  - A group of 52 alpha 1-antitrypsin-deficient individuals of phenotype Pi Z and 117
      of their relatives underwent a protocol including pulmonary function testing,
      completion of a questionnaire, and blood donation. Our population permitted a
      minimum frequency estimate (7 x 10(-4)) for Pi null alleles. Five quantitative
      phenotypes were measured, including FEV1, FEF25-75, total serum alpha 1AT,
      oxidized serum alpha 1AT, and total serum IgE. We found that (1) total alpha 1AT
      levels were higher in Pi Z subjects with lung function impairment (FEV1 less than
      or equal to 65% of predicted) than in Pi Z subjects who were not impaired; (2) Pi
      Z subjects with lung function impairment had elevated serum levels of oxidized
      alpha 1AT; and (3) IgE levels were relatively elevated in first-degree Pi MZ
      relatives of impaired Pi Z subjects. Moreover, FEV1 tended to be relatively
      reduced in heterozygous parents of impaired Pi Z subjects, suggesting that a
      subset of Pi MZ individuals are at risk for development of lung disease because
      of familial factors. These results represent an initial step toward the
      development of intermediate phenotypes that will be predictive of a severe course
      in alpha 1AT deficiency; they suggest that, in addition to cigarette smoking,
      atopic predisposition and undetermined familial factors may be important
      codeterminants of lung disease progression.

PMID- 2240822
TI  - The single-breath nitrogen test, mortality, and cancer.
AB  - The relationship between indices of the single-breath nitrogen test and
      mortality, overall cancer incidence, and respiratory cancer incidence was
      examined in a cohort of 876 men, 46 to 69 yr of age, examined in 1974 and
      followed until June 1985. Closing volume, closing capacity, and slope of phase
      III were not related to mortality or cancer. In contrast, FEV1 was related to
      mortality, with an estimated relative mortality risk of 1.37 (95% confidence
      interval, 1.11 to 1.70) per liter under the expected FEV1, given height, age, and
      smoking, but FEV1 was not related to cancer. Inability to perform acceptable
      single-breath nitrogen test tracings was related to mortality with a relative
      mortality risk of 2.03 (1.45 to 2.85), but not to cancer. We conclude that
      indices of the single-breath nitrogen test have no predictive value concerning
      overall mortality and cancer incidence.

PMID- 2240823
TI  - Pulmonary function after heart-lung transplantation using larger donor organs.
AB  - Restrictive pulmonary function after heart-lung transplantation (HLT) has been
      attributed to the use of smaller donor lungs and/or an inability to generate
      normal negative pleural pressures. Pleural pressure generation depends on both
      the size of the recipient thoracic cage and its neuromuscular integrity. To
      determine whether lung volumes after heart-lung transplantation are more
      dependent on donor lung size or on recipient chest wall characteristics, seven
      HLT recipients were evaluated before and after transplantation. Postoperative
      values initially (average, 2 months), 6, and 12 months after transplantation were
      compared with predicted lung volumes for the recipient and donor organs. TLC
      dropped from a mean of 5.2 +/- 0.5 L preoperatively to 3.7 +/- 0.3 L (p less than
      0.05) 2 months after HLT, but it improved with time and ultimately was not
      different from preoperative values. The predicted TLC of the HLT donor organs
      were significantly larger than those of the recipient's predicted TLC, with a
      mean of 6.9 +/- 0.4 versus 5.3 +/- 0.3 L (p less than 0.05). DLCO, arterial PO2,
      and PCO2 did not change after surgery. Within limits, larger donor lungs appear
      to adapt to the constraints of the recipient chest and may be used with clinical
      success, without apparent adverse effects.

PMID- 2240824
TI  - Cholinergic control of human airways in vitro following extrinsic denervation of
      the human respiratory tract by heart-lung transplantation.
AB  - In heart-lung transplantation (HLT), the airways have been assumed to be
      denervated since cholinergic, adrenergic, and sensory nerves are severed.
      Challenge studies of such patients suggest that there is an increase in airway
      responsiveness to inhaled cholinergic agonists, which may be explained by
      denervation hypersensitivity of muscarinic receptors on airway smooth muscle. We
      have studied the cholinergic control of airways from lungs removed from five
      patients (8 to 31 yr of age) undergoing retransplantation because of rejection
      related bronchiolitis, with time since transplantation ranging from 12 to 32
      months. These airways were compared with airways obtained from eight heart donors
      (24 to 42 yr of age) and from five patients undergoing surgical lobectomy for
      bronchial carcinoma (54 to 72 yr of age). Bronchial rings (distal lobar and
      subsegmental) were mounted in organ baths and isometric contractile responses
      measured. Contractile responses to acetylcholine (ACh, 10 nM to 10 mM) and to
      electrical field stimulation (EFS) (40 V, 0.5 ms, 1 to 64 Hz for 15 s) were
      determined. Transplant and control airways showed the same response to ACh, with
      mean EC50 values of 61.0 +/- 0.32 microM for HLT patients, 57.6 +/- 0.24 microM
      for donor patients, and 48.7 +/- 1.2 microM for lobectomy patients, suggesting no
      denervation hypersensitivity of muscarinic receptors. EFS, which activates
      postganglionic cholinergic nerves, caused similar frequency responses in both
      transplant and control airways, suggesting that postganglionic nerves are intact.
      [3H]quinuclidinyl benzilate binding to membranes prepared from lung was performed
      to determine muscarinic binding characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240825
TI  - Pulmonary denervation in humans. Effects on dyspnea and ventilatory pattern
      during exercise.
AB  - The role of the pulmonary autonomic nerves in the mediation of respiratory
      sensation is unclear. Pulmonary neurogenic mechanisms may contribute to dyspnea
      either directly or indirectly via an influence on the pattern of ventilation.
      Using human heart-lung transplantation as a model of pulmonary denervation, we
      studied the ventilatory response, respiratory drive (P0.1), and sensation of
      breathlessness (modified Borg scale) during maximal incremental bicycle exercise.
      The subjects were four female heart-lung transplant recipients 3 to 9 months post
      transplant and 10 age-matched control subjects. The ventilatory response to
      increasing CO2 output (VCO2) was higher (p less than 0.001) in transplant
      recipients than in control subjects, such that ventilation at peak exercise was
      similar in the two groups despite a lower peak VCO2 in transplant recipients. The
      ratio of tidal volume to inspiratory capacity increased with increasing
      ventilation in a similar fashion in both groups. Although the respiratory rate
      increased more quickly in transplant recipients, it was similar at peak
      ventilation in the two groups. Ventilatory timing and duty cycle at half-peak and
      peak ventilation were similar in transplant recipients and control subjects.
      Dyspnea ratings were not different between the two groups at similar levels of
      ventilation. Dyspnea as a function of P0.1 was also similar in transplant and
      control groups. These results indicate that pulmonary neurogenic mechanisms play
      a role in determining the level, but not the pattern, of ventilation during
      exercise. Furthermore, these pathways do not appear to contribute significantly
      to the perception of breathlessness in normal humans.

PMID- 2240826
TI  - Mechanical action of the interosseous intercostal muscles as a function of lung
      volume.
AB  - On the basis of local stimulation of individual muscles, it has been suggested
      that both the external (EI) and internal interosseous intercostal muscles have an
      inspiratory action at low lung volumes and an expiratory action at high lung
      volumes. In this study, we assessed the action of the interosseous intercostal
      muscles at different lung volumes in 19 anesthetized dogs by synchronously
      activating the intercostal muscles via ventral root stimulation (VRS). An
      electrode was positioned on the upper thoracic spinal cord according to
      previously described techniques. The cervical phrenic rootlets were sectioned
      bilaterally, the accessory muscles were sectioned from the rib cage, and the
      origins of the abdominal muscles were sectioned from the middle region of the rib
      cage. Changes in airway pressure (delta P) were monitored during the application
      of supramaximal stimuli after hyperventilation-induced apnea and during airway
      occlusion. Animals were passively inflated or deflated with a volume syringe.
      Precontractile airway pressure was used as an index of lung volume. External and
      parasternal intercostal muscle (PA) lengths were monitored by sonomicrometry in
      the third intercostal space. Thoracoabdominal motion was monitored by Respitrace
      bands. During VRS, both PA and EI shortened at all lung volumes. Mean delta P
      progressively decreased with increasing lung volume. At precontractile airway
      pressures of -10, 0, and +30 cm H2O, delta P were -25 +/- 1, -16 +/- 1, and -5 +/
      1 cm H2O, respectively. After section of the internal intercostal nerves lateral
      to the costochondral junctions from the first through the seventh intercostal
      spaces to eliminate PA action, EI shortened, whereas PA usually
      lengthened.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240827
TI  - Effect of corticosteroids on respiratory muscle histopathology.
AB  - Pathologic alterations induced by corticosteroid administration were evaluated in
      the respiratory muscles and compared to those in the peripheral skeletal muscles
      of the rabbit. Alterations in gross and microscopic pathology as well as
      histochemistry were determined in the diaphragm, intercostal,
      sternocleidomastoid, extensor digitorum longus, and soleus muscles following 3 wk
      of intramuscular cortisone injections. Corticosteroid administration induced
      significant pathologic changes in all the muscles except the soleus. Although
      gross pathologic changes were greatest in the extensor digitorum longus,
      microscopic changes were greatest in the diaphragm. Reductions in total muscle
      fiber volume were similar in the diaphragm, sternocleidomastoid, and extensor
      digitorum longus muscles. The composition of muscle fiber types and the number of
      fibers in a muscle were not altered in any of the muscles studied following
      corticosteroids. There was significant atrophy of individual muscle fibers in all
      the muscles except the soleus. In the diaphragm, corticosteroids induced atrophy
      of all fiber types, including type I fibers. Atrophy of type I fibers was not
      present in the peripheral skeletal muscles or the other respiratory muscles. On
      the other hand, corticosteroids induced selective atrophy of type IIb muscle
      fibers in the intercostal and sternocleidomastoid muscles similar to that in the
      peripheral skeletal muscles. These findings suggest that the effect of
      corticosteroids on the diaphragm is unique, and one cannot extrapolate form the
      effect of corticosteroids on peripheral skeletal muscles to that in the
      diaphragm. In addition, these pathologic changes may have functional relevance,
      since atrophy of type I fibers may result in a reduction in muscle endurance.

PMID- 2240828
TI  - The role of mucous glycoproteins in the rheologic properties of cystic fibrosis
      sputum.
AB  - Cystic fibrosis (CF) is characterized by excessive amounts of thick and tenacious
      mucous secretions that obstruct organ ducts and passages. In the respiratory
      tract this is associated with chronic infection resulting in the hypersecretion
      of purulent sputum, which the patient finds difficult to clear. We have studied
      the rheologic properties of purulent sputum from six patients with CF and five
      patients with chronic bronchitis to assess whether CF is associated with
      increased sputum viscoelasticity. In addition, we have isolated the major
      rheologic determinants, mucous glycoproteins, from CF and chronic bronchitis
      sputa and, using a magnetic microrheometer, investigated the possibility that the
      altered properties of mucus in CF are associated with abnormalities in these
      glycoproteins. Creep compliance analysis indicated that the CF sputa possessed
      raised levels of both elasticity (p less than 0.01) and viscosity (p less than
      0.01). These increases in both rheologic parameters were found to be associated
      with increases in the DNA content (p less than 0.01) and dry weight (p less than
      0.05). Mucous glycoproteins were isolated from CF and chronic bronchitis sputum
      samples by gel filtration on Sepharose CL4B, followed by concentration to form 8%
      wt/wt gels. In the absence of other sputum components, no abnormality in the
      rheologic properties of CF mucin gels could be detected. However, when DNA was
      added, the CF gels responded with increases in both elasticity and viscosity of
      as much as 30% (p less than 0.05), an effect not observed in the chronic
      bronchitis gels. These results suggest that a subtle abnormality may exist in CF
      mucous glycoproteins and that this could have a role in the altered physical
      properties of mucous secretions in CF.

PMID- 2240830
TI  - Determination of serum concentrations of type III procollagen peptide in
      mechanically ventilated patients. Pronounced augmented concentrations in the
      adult respiratory distress syndrome.
AB  - Type III procollagen peptide (PCP) is a byproduct of type III collagen synthesis
      and a potential marker of collagen secretion. In chronic diffuse interstitial
      lung diseases, elevated PCP concentrations have been found in serum as well as in
      bronchoalveolar lavage fluid. It has been proposed that PCP is a marker of early,
      active stages of fibrosis. As severe fibrosis is a frequent complication in adult
      respiratory distress syndrome (ARDS), we investigated PCP in patients with ARDS
      and compared the results with those from patients requiring mechanical
      ventilation because of heart failure and after neurosurgical and surgical
      interventions, and those from spontaneously breathing patients, including healthy
      volunteers and patients with pneumonia, liver cirrhosis, and renal failure. PCP
      concentrations in patients with ARDS were extremely elevated compared with those
      in control subjects (p less than 0.001) and correlated positively with FiO2 (r =
      0.71, p less than 0.01). These results support the pathophysiologic concept of
      early fibrogenesis in ARDS. As preventing pulmonary fibrosis in ARDS is essential
      in improving survival rate, we believe PCP can be a valuable diagnostic tool in
      ARDS.

PMID- 2240829
TI  - Failure of high-dose vitamin E to correct ceruloplasmin ferroxidase deficiency in
      cigarette smokers.
AB  - Cigarette smokers have a biochemical defect in the ferroxidase activity of their
      serum ceruloplasmin. Ceruloplasmin is one of the main serum antioxidants, and
      this defect in ferroxidase activity most likely accounts for the previously
      observed decrease in smoker serum antioxidant activity. This defect may be
      related to oxidation of ceruloplasmin in the lung. We hypothesized that vitamin E
      might be able to reverse the decrease in smoker ferroxidase activity and thus
      restore serum antioxidant activity. To test this hypothesis, we administered high
      dose vitamin E to a group of young asymptomatic cigarette smokers (n = 8).
      Although serum levels of vitamin E significantly increased (8.7 +/- 0.8 to 20.6
      +/- 3.1 micrograms/ml, p = 0.01), the ferroxidase activity of smoker serum (0.139
      +/- 0.02 (0.139 +/- 0.02 to 0.144 +/- 0.03 U/ml, p = 0.824), and the antioxidant
      activity of serum (45.8 +/- 7.2 to 51.6 +/- 8.4%, p = 0.587) remained unchanged.
      Thus, at the current dose and duration of supplementation, vitamin E was unable
      to reverse the defect in smoker serum ferroxidase activity and thus unable to
      augment the antioxidant capacity of the serum.

PMID- 2240831
TI  - Effect of pentoxifylline on hemodynamics, alveolar fluid reabsorption, and
      pulmonary edema in a model of acute lung injury.
AB  - We investigated the effect of pentoxifylline (PTX) on the development of
      pulmonary edema in a model of adult respiratory distress syndrome in rabbits.
      Lung injury was induced by repeated saline lavages in adult rabbits weighing 2.5
      to 3.5 kg. Rabbits pretreated with PTX (20 mg/kg bolus followed by 20 mg/kg/h
      infusion) developed significantly lower amounts of lung edema 4 h after saline
      lavage (extravascular lung water to dry weight ratio [W/D], 6.9 +/- 0.6 SD versus
      8.9 +/- 0.5 in control animals). PTX produced a 25% increase in cardiac output,
      but there were no differences between treated and untreated groups in calculated
      pulmonary vascular resistance or microvascular pressure. To determine whether PTX
      could have lowered pulmonary venous resistance and thus lowered effective
      microvascular pressure for fluid filtration, we directly measured pulmonary
      artery and left atrial pressures, and measured by micropuncture the pressure in
      20 to 40 microns subpleural venules in four open-chested rabbits 3 to 4 h after
      lavage. Venous resistance was low (venous pressure drop 0.9 +/- 0.1 mm Hg) and
      was unchanged by PTX infusion. To determine if PTX decreased lung water by
      accelerating active alveolar fluid reabsorption, a single 60-ml aliquot of saline
      was instilled into the lungs of normal rabbits treated with saline or PTX. Both
      groups had a similar decrease in lung water content 1 and 4 h later. Our data
      indicate that PTX reduces edema formation in rabbits after saline lavage, not by
      lowering microvascular pressures for fluid filtration or by acceleration alveolar
      fluid reabsorption, but possibly by its anti-inflammatory effect on neutrophil
      function.

PMID- 2240832
TI  - IgG1-mediated acute pulmonary hypersensitivity response in the guinea pig.
      Involvement of specific lipid mediators.
AB  - We determined the pulmonary obstructive response to aerosolized antigen
      challenge, and its sensitivity to antagonists of specific lipid mediators, in
      IgG, passively sensitized (IgG1-PS) guinea pigs. Antiovalbumin (OA)-IgG1 was
      isolated by affinity chromatography from serum derived from actively immunized
      Hartley guinea pigs. Propranolol and pyrilamine pretreated, IgG1-PS guinea pigs
      were challenged with aerosolized antigen and pulmonary obstruction was quantified
      by measurements of excised lung gas volume (ELGV). ELGV increased between 150 and
      1,035% in a dose-proportional fashion with increasing antigen exposure (0.001 to
      0.1% nebulizer concentration). The leukotriene antagonists ICI-204,219 and SKF
      104,353 exhibited dose-proportional inhibitions in antigen-induced elevations in
      ELGV, inhibiting up to 65 and 87% at the maximal concentrations examined.
      Similarly, the platelet-activating factor (PAF) antagonists WEB-2086 and L
      659,989 inhibited antigen-induced elevations in ELGV, inhibiting up to 94 and 59%
      at the maximal concentrations examined. In contrast, the cyclooxygenase (CO)
      inhibitor piroxicam significantly enhanced (p less than 0.05) the OA-induced
      elevations in ELGV. Aerosolized PAF challenge produced dose-proportional
      elevations in ELGV that were significantly inhibited by the LTD, antagonist ICI
      204,219 (38 and 43% inhibition) and the CO inhibitor piroxicam (62 and 48%
      inhibition) in sensitized and nonsensitized animals, respectively. We hypothesize
      that IgG1-dependent airway obstruction is mediated in part by LTD, produced in
      response to PAF generation.

PMID- 2240833
TI  - The penetration of aminoglycosides into the alveolar lining fluid of rats. The
      effect of airway inflammation.
AB  - The concentration-time profile of gentamicin and tobramycin in the alveolar
      lining fluid (ALF) of rats was determined after intravenous bolus injection using
      bronchoalveolar lavage (BAL). BAL can be used for evaluating the penetration of
      both aminoglycosides into the ALF if highly sensitive detection methods are used,
      and an endogenous marker (urea) can be applied to avoid the unpredictable
      dilutional effect of the lavage procedure. The concentration of gentamicin and
      tobramycin in ALF reached a peak after 5 and 10 min, respectively, and remained
      high when plasma concentrations were declining, suggesting an accumulation
      reservoir in the lung acini. The ratio of the AUC of the concentration-time
      profile in ALF and plasma was 0.67 and 0.45 for gentamicin and tobramycin,
      respectively. The penetration of both aminoglycosides into the ALF was
      significantly higher after induction of airway inflammation by inhalation of
      endotoxin. The ratio of the AUC in ALF and plasma in the endotoxin-exposed
      animals was 0.76 and 0.55 for gentamicin and tobramycin, respectively. The ratio
      of the AUC of the concentration-time profile of gentamicin in ALF to that of
      tobramycin was 1.27 without inflammation and 1.44 after endotoxin exposure. Thus,
      both with and without inflammation, gentamicin penetrates better into the ALF
      than does tobramycin.

PMID- 2240834
TI  - Enzymatic modulation of vasoactive intestinal peptide and nonadrenergic
      noncholinergic inhibitory responses in guinea pig tracheae.
AB  - The airways of the guinea pig are innervated by four types of autonomic nerves:
      cholinergic excitatory, adrenergic inhibitory, nonadrenergic noncholinergic
      (NANC) excitatory, and NANC inhibitory. Tachykinins (neurokinins A and B and
      substance P) are believed to mediate NANC excitatory responses, and vasoactive
      intestinal peptide (VIP) has been proposed as the chemical mediator of the NANC
      inhibitory system. Enzymatic degradation represents an important means by which
      the biologic actions of neurotransmitters are terminated. In the present study,
      relaxation responses of guinea pig tracheae to NANC nerve stimulation and to
      exogenous VIP administration were compared in the absence and presence of various
      peptidase inhibitors. NANC inhibitory responses elicited by electrical field
      stimulation were unaffected by aprotinin or soybean trypsin inhibitor but were
      depressed by thiorphan or leupeptin. Concentration-response curves to exogenous
      VIP were shifted to the left by soybean trypsin inhibitor but were not affected
      by aprotinin, leupeptin, or thiorphan. After tachykinin depletion with capsaicin,
      thiorphan also induced a leftward shift in the VIP concentration-response curve.
      Under the same conditions, thiorphan failed to influence NANC inhibitory
      responses. These results indicate that the NANC inhibitory neurotransmitter is
      not metabolized by enzymes susceptible to inhibition by aprotinin, leupeptin,
      soybean trypsin inhibitor, or thiorphan and, accordingly, distinguish NANC
      nervous responses from those induced by VIP. The results also suggest that the
      NANC excitatory system can interact functionally with the NANC inhibitory system,
      as evidenced by the blunting of NANC relaxation responses following inhibition of
      tachykinin metabolism and elimination of this effect by capsaicin.

PMID- 2240835
TI  - Effects of inflammatory mediators on the responsiveness of isolated human airways
      to methacholine.
AB  - Several studies have suggested that in asthmatics the quantities of inflammatory
      mediators such as histamine, thromboxane A2 (TxA2), prostaglandin D2 (PGD2),
      prostaglandin F2 alpha (PGF2 alpha), and leukotriene C4 (LTC4) that are present
      in the airway lumen are related to the degree of bronchial responsiveness to
      inhaled methacholine (MCh). Therefore, we studied the effect of these mediators
      on the cholinergic responsiveness of isolated human airway segments. Lung tissue
      collected at thoracotomy from 30 patients was studied. Dose-response curves to
      MCh were obtained from bronchial segments before, during, and after incubation
      with either a subthreshold or a threshold concentration of histamine (10(-10) or
      10(-8) M), the stable TxA2 analogue U46619 (10(-11) or 10(-9) M), PGD2 (5 x 10(
      9) or 5 x 10(-7) M), PGF2 alpha (10(-9) or 10(-7) M), or LTC4 (10(-11) or 10(-9)
      M). With the exception of LTC4, the presence of any of these mediators at either
      concentration increased the sensitivity to MCh by a factor of 1.1 to 2 (p less
      than 0.05, ANOVA). This increase did not depend on the dose of the mediator (p
      greater than 0.05, ANOVA). These data indicate that mediator-induced muscle
      hypersensitivity can explain a small part of the leftward shift of the dose
      response curve to inhaled MCh as observed in asthma.

PMID- 2240836
TI  - Bronchial responsiveness to histamine in infants and older children.
AB  - Normal infants have been shown to respond to a relatively low concentration of
      inhaled histamine. However, those studies used partial maximal expiratory flow
      volume (PMEFV) curves to assess lung function. In order to directly compare
      responsiveness between infants and older children, we compared bronchial
      responsiveness to histamine between a group of 45 normal infants, median age 4 wk
      (range 2 to 6 wk) and a group of 30 nonasthmatic older children, median age 10 yr
      (range 5 to 15 yr) using PMEFV curves in both groups to assess lung function. In
      the infant group, PMEFV curves were generated using the forced expiratory flow
      volume technique. For the older children, PMEFV curves were generated by
      voluntary effort. The provocative concentration of histamine that produced a 40%
      fall (PC40) in maximum flow at functional residual capacity (VmaxFRC) was
      calculated from the PMEFV curves. The geometric mean PC40 of the infants (1.02
      g/L) was lower than the geometric mean of the older children (3.4 g/L) (p less
      than 0.001). However, these results were then corrected for dilution of the
      aerosol due to air entrainment (AE). Corrected values of PC40 were not
      significantly different between infants and older children. These results
      demonstrate the importance of accounting for AE in the evaluation of histamine
      responsiveness and suggest that bronchial responsiveness may be similar in normal
      infants and older children.

PMID- 2240837
TI  - Circadian basis of the late asthmatic response.
AB  - The late asthmatic response (LAR) to an allergen challenge has a marked impact on
      lung function in the patient with asthma. Virtually all studies on the LAR have
      been done during the daytime. This study evaluated the LAR as a function of the
      time of day an inhaled allergen challenge was performed. An allergen challenge
      given in the morning produced a LAR in 4 of 10 subjects, while the same challenge
      in the evening caused a LAR in 9 of 10 (p less than 0.05). The time to onset of
      the LAR following the morning and evening challenges was 9.4 +/- 2.0 h versus 3.1
      +/- 0.3 h, respectively (p less than 0.05). The maximal decrease in FEV1 for the
      LAR was 32.8 +/- 5.6% for the morning challenge versus 43.0 +/- 3.1% in the
      evening (p less than 0.05). Additionally, the bronchial responsiveness to
      methacholine was significantly greater at 24 h following evening allergen
      challenge than after the morning (p less than 0.05) challenge. Thus, it is
      important to take into account the time of day a patient is exposed to an
      allergen in regard to the development of the LAR.

PMID- 2240838
TI  - Ozone concentration and pulmonary response relationships for 6.6-hour exposures
      with five hours of moderate exercise to 0.08, 0.10, and 0.12 ppm.
AB  - The magnitudes of pulmonary responses we previously observed (1) following 6.6-h
      exposures to 0.12 ppm ozone (O3) suggested that responses would also occur with
      similar exposures at lower O3 concentrations. The objective of this study was to
      determine the extent of pulmonary function decrements, respiratory discomfort,
      and increased airway reactivity to methacholine induced by exposure to O3 below
      0.12 ppm. Separate 6.6-h chamber exposures to 0.00, 0.08, 0.10, and 0.12 ppm O3
      included six 50-min periods of moderate exercise (VE approximately equal to 39
      L/min, HR approximately equal to 115 bpm, and VO2 approximately equal to 1.5
      L/min). Each exercise period was followed by 10 min of rest. A 35-min lunch break
      was included midway through the exposure. Although not intended as an exact
      simulation, the overall duration, intensity, and metabolic requirements of the
      exercise performed were representative of a day of moderate to heavy work or
      play. Preexposure FEV1 averaged 4.39 L, and essentially no change (+0.03 L)
      occurred with exposure to 0.00 ppm O3. Significant decreases (p less than 0.01)
      of -0.31, -0.30, and -0.54 L were observed with exposures to 0.08, 0.10, and 0.12
      ppm, respectively. The provocative dose of methacholine required to increase
      airway resistance by 100% (PD100) was 58 cumulative inhalation units (CIU)
      following exposure to 0.00 ppm and was significantly reduced (p less than 0.01)
      to 37 CIU at 0.08, 31 CIU at 0.10, and 26 CIU at 0.12 ppm O3; reductions in PD100
      are considered indicative of increases in nonspecific airway
      responsiveness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240839
TI  - Biodistribution, tissue reaction, and lung retention of pentamidine aerosolized
      as three different salts.
AB  - Aerosolized pentamidine isoethionate is retained in the lung and appears to
      prevent Pneumocystis carinii pneumonia (PCP) in many AIDS patients. We evaluated
      alternative formulations of pentamidine that might reduce the airway irritation
      associated with aerosolized pentamidine isoethionate. Specifically, we assessed
      the biodistribution, histologic response, and lung retention of the isoethionate,
      gluconate, and lactate salts of pentamidine after aerosol administration to mice.
      For each of the three aerosolized salts tested, greater than 50% of the
      pentamidine initially recovered from the lungs after one dose was still retained
      there 14 days later. Thus, significant levels of pentamidine, aerosolized as
      three different salts, are retained in the lung for at least 2 wk after a single
      dose. The three salts of pentamidine each produced high lung to extrapulmonary
      drug ratios, the converse of that produced by intravenous injection of
      pentamidine isoethionate. At very high aerosol doses, the ability of the lung to
      retain pentamidine appeared saturable. Even aerosolized daily for 2 wk at very
      high doses, none of the three pentamidine salts produced histologic evidence of
      organ toxicity. A Phase 1 trial of aerosolized pentamidine gluconate in AIDS-PCP
      patients is now in progress to determine if this approach can reduce airway
      irritation.

PMID- 2240840
TI  - Respiratory health effects of the indoor environment in a population of Dutch
      children.
AB  - The effect of indoor exposure to nitrogen dioxide on respiratory health was
      studied over a period of 2 yr in a population of nonsmoking Dutch children 6 to
      12 yr of age. Lung function was measured at the schools, and information on
      respiratory symptoms was collected from a self-administered questionnaire
      completed by the parents of the children. Nitrogen dioxide was measured in the
      homes of all children with Palmes' diffusion tubes. In addition, information on
      smoking and dampness in the home was collected by questionnaire. There was no
      relationship between exposure to nitrogen dioxide in the home and respiratory
      symptoms. Respiratory symptoms were found to be associated with exposure to
      tobacco smoke and home dampness. There was a weak, negative association between
      maximal midexpiratory flow (MMEF) and exposure to nitrogen dioxide. FEV1, peak
      expiratory flow, and MMEF were all negatively associated with exposure to tobacco
      smoke. Home dampness was not associated with pulmonary function. Lung function
      growth, measured over a period of 2 yr, was not consistently associated with any
      of the indoor exposure variables. The development of respiratory symptoms over
      time was not associated with indoor exposure to nitrogen dioxide. There was a
      significant association between exposure to environmental tobacco smoke in the
      home and the development of wheeze. There was also a significant association
      between home dampness and the development of cough.

PMID- 2240841
TI  - Pulmonary fibrosis in aluminum oxide workers. Investigation of nine workers, with
      pathologic examination and microanalysis in three of them.
AB  - Epidemiologic surveys have indicated an excess of nonmalignant respiratory
      disease in workers exposed to aluminum oxide (Al2O3) during abrasives production.
      However, clinical, roentgenographic, histologic, and microanalytic description of
      these workers are lacking. This is a report of nine Al2O3-exposed workers with
      abnormal chest roentgenograms (profusion greater than or equal to 1/0, ILO/UC)
      from a plant engaged in the production of Al2O3 abrasives from alundum ore. Mean
      duration of exposure was 25 yr, and time since first exposure was 28 yr. in a
      subgroup of three, the severity of symptoms, reduction in the forced vital
      capacity (67% predicted) and diffusing capacity (51% predicted), and progressive
      roentgenographic changes (profusion greater than or equal to 2/2) prompted open
      lung biopsy. Lung tissue was analyzed by scanning electron microscopy and
      electron microprobe analysis. In each of the three biopsies, interstitial
      fibrosis with honeycombing was seen on routine section. In one biopsy, silica and
      asbestos fiber counts were at the low end of the range seen with silicosis and
      asbestosis; however, the absence of asbestos bodies and silicotic nodules
      suggested that the fibrosis was due to another cause. Metals occurred in amounts
      several orders of magnitude above background, and the majority was aluminum as
      Al2O3 and aluminum alloys. The findings in these nine workers suggests a common
      exposure as the possible cause. The nonspecific pathologic findings, absence of
      asbestos bodies and silicotic nodules, and the striking number of aluminum
      containing particles suggest that Al2O3 is that common exposure. The possibility
      of "mixed dust" fibrosis should also be considered.

PMID- 2240842
TI  - Molecular analysis of the heterogeneity among the P-family of alpha-1-antitrypsin
      alleles.
AB  - The rare P-family of alpha 1-antitrypsin (alpha 1AT) variants is defined by the
      position of migration of the alpha 1AT protein on isoelectric focusing of serum
      (IEF) between the common M and S variants. To begin to examine the molecular
      heterogeneity among the P-type alleles, two unrelated subjects and their families
      identified by IEF to be carrying a P allele were analyzed. The first, Plowell, is
      a deficiency allele associated with reduced serum alpha 1AT levels, and the
      second, Psaint albans, is associated with normal serum levels. DNA sequence
      analysis of Plowell, the more anodal of the two variants on IEF analysis, showed
      that if differed from the normal M1(Val213) allele by a single base and amino
      acid substitution Asp256 GAT----Val GTT. In contrast, Psaint albans, a slightly
      more cathodally positioned variant on IEF analysis, differed from the coding
      exons of the normal M1(Val213) allele by two mutations, Asp341 GAC----Asn AAC,
      and a silent substitution in the same codon as the Plowell variant, Asp256 GAT---
      Asp GAC. Evaluation of Plowell mRNA transcripts by Northern and cytoblot analyses
      demonstrated they were of normal size and amount, and Plowell mRNA transcripts
      could be translated normally in vitro. Retroviral insertion of the Plowell cDNA
      into the genome of 3T3 fibroblasts demonstrated that it directed the synthesis of
      alpha 1AT, but at levels 24% that of the Psaint albans cDNA or the normal M1
      (Val213) cDNA, with a pattern of biosynthesis consistent with the concept that
      the Plowell alpha 1AT deficiency state results from intracellular degradation of
      the newly synthesized Plowell protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240843
TI  - Phospholipase A2-induced pulmonary and hemodynamic responses in the guinea pig.
      Effects of enzyme inhibitors and mediators antagonists.
AB  - The effect of phospholipase A2 (Naja naja) PLA2) on mean arterial blood pressure
      and intratracheal pressure was examined in anesthetized guinea pigs. Intracheally
      administered PLA2 (1 to 10 U) produced acute, dose-dependent increases in mean
      arterial blood pressure and intracheal pressure. However, Intravenously
      administered PLA2 (doses as large as 1,000 U) did not alter monitored variables.
      Acute PLA2-induced morphologic alterations were characterized by airway
      constriction, airway/alveolar cell damage, and pulmonary sequestration of both
      leukocytes and platelets. PLA2-induced increases in both mean arterial blood
      pressure and intratracheal pressure were attenuated to varying degrees by
      pretreating intravenously with indomethacin (10 mg/kg), a cyclooxygenase
      inhibitor, and WEB 2086 (0.1 mg/kg), a platelet-activating factor antagonist.
      Both ICI 198,615 (1 mg/kg), a leukotriene D4, receptor antagonist given
      intravenously, and dexamethasone (50 mg/kg), a steroidal anti-inflammatory agent
      given intraperitoneally as a 2-day pretreatment, reduced PLA2-induced increases
      in intratracheal pressure. Pyrilamine (2 mg/kg), a histamine1-receptor antagonist
      given intravenously, did not modify PLA2-induced pathophysiologic responses.
      Guinea pigs exposed to aerosolized PLA2 (100 U/ml) exhibited evidence of
      increased bronchoalveolar lavage macrophage, leukocyte, and lymphocyte
      accumulation at 24 h post-PLA2. These studies suggest that in vivo PLA2-induced
      pathophysiologic changes in the guinea pig involve alterations in resident airway
      cell populations as well as sequestration and infiltration of inflammatory cells.
      Both eicosanoids and platelet-activating factor appear to contribute to these
      PLA2-induced pathophysiologic effects.

PMID- 2240844
TI  - Computerized tomography in the evaluation of allergic bronchopulmonary
      aspergillosis.
AB  - Allergic bronchopulmonary aspergillosis (ABPA) is a destructive disease of the
      lung characteristically associated with central bronchiectasis. This study was
      designed to determine if high-resolution computerized tomography (CT) could be
      used to define bronchiectasis in patients with suspected disease. Sixteen
      patients with asthma were studied. All demonstrated immediate cutaneous
      reactivity to common aeroallergens including Aspergillus fumigatus. Eight
      patients had clinical and immunologic evidence of ABPA. Six to 12 high-resolution
      CT sections (1.5 mm) were obtained at 1- to 2-cm intervals from the aortic knob
      to the dome of the diaphragm. All radiographs were evaluated separately by two
      readers in a blinded fashion and graded as to the presence and type of bronchial
      dilatation and bronchial wall thickening. Bronchial dilatation was seen in 41% of
      lung lobes in the ABPA group compared to 15% in the non-ABPA asthmatic control
      group. Upper lobe involvement and bronchial wall thickening was common to both
      groups. The presence of bronchiectasis in the control group may indicate that
      asthma is a more destructive lung disease than is currently appreciated. High
      resolution CT of the chest has been shown in previous studies to have a
      sensitivity and specificity approaching that of bronchography, and the current
      findings support its use in the detection of bronchiectasis in patients with
      asthma suspected of having ABPA.

PMID- 2240845
TI  - Computed tomography of chronic diffuse infiltrative lung disease. Part 1.

PMID- 2240846
TI  - Pulmonary histiocytosis X with mediastinal lymph node involvement.
AB  - In this report, we describe a patient with the classic histology of pulmonary
      histiocytosis X, who had bilateral reticulonodular densities and mediastinal
      lymph node involvement. The diagnosis was confirmed by the use of electron
      microscopy and immunohistochemical markers (PS100, HLA-DR, and CD1), which
      allowed us to recognize the lymph node infiltration of X histiocytes. An
      association of mediastinal lymph node enlargement with pulmonary histiocytosis X
      has been reported but it has never been histologically documented.

PMID- 2240847
TI  - Dissecting aneurysm of the pulmonary artery with pulmonary hypertension.
AB  - Pulmonary artery dissection was observed in a 64-yr-old female patient with
      severe pulmonary hypertension, which was probably primary (pulmonary vascular
      resistance, 817 dyn.s.cm-5; normal range less than or equal to 200 dyn.s.cm-5).
      The patient was admitted to the hospital because of severe dyspnea on exertion.
      Echocardiography demonstrated a dissecting aneurysm of the pulmonary artery.
      Right heart catheterization revealed severe pulmonary hypertension (mean
      pulmonary artery pressure, 64 mm Hg; normal range, 10 to 22 mm Hg); dissection of
      the pulmonary artery was confirmed by pulmonary arteriography. One-year follow-up
      was uneventful. In the literature, 28 patients with dissecting aneurysm of the
      pulmonary artery are reviewed. The dissection has only been diagnosed in life in
      one patient (by echocardiography).

PMID- 2240849
TI  - Colobronchial fistula: a rare complication of Crohn's colitis.
AB  - A 29-yr-old white woman presented with chronic pneumonia in the left lower lobe
      and with left pleural effusion. She was known to have inflammatory bowel disease,
      but she was asymptomatic under maintenance treatment with 5-ASA. She received
      numerous antibiotic regimens according to susceptibility testing of
      microorganisms cultured from sputum and bronchial lavage and on an empiric basis
      was also given antituberculosis treatment, but there was no clinical improvement
      or change in the chest radiographic findings. Sputum was repeatedly examined and
      yielded, among other organisms, Clostridium inocuum, Enterobacter, Klebsiella
      pneumoniae, Proteus mirabilis, and Staphylococcus aureus. On one microscopic
      examination of sputum, the presence of feculent material was suspected. A
      subsequent gastrografin enema revealed a cologastric and colobronchial fistula
      between the splenic flexture of the colon and the greater curve of the stomach
      and the bronchial system. Segmental resection of the colon and resection of the
      lower lobe of the left lung were performed. Histologic findings of the resected
      colon were consistent with Crohn's disease. After a long period of postoperative
      recovery, the patient returned to good general health and well-being. To our
      knowledge, a colobronchial fistula caused by Crohn's colitis has not been
      previously reported.

PMID- 2240848
TI  - Flexible bronchoscopic removal of radioccult polyurethane foam, with pneumonitis
      in a hyperventilated lobe.
AB  - An intellectually delayed adult ingested and aspirated a large quantity of
      polyurethane foam, developing acute respiratory failure in association with
      partial airway obstruction. The foam was identified by flexible bronchoscopy and
      successfully removed from the bronchus intermedius and left mainstem bronchus
      with a retrieval basket. This facilitated normalization of blood gases and
      eventual recovery. However, the unobstructed right upper lobe became infiltrated
      radiographically, presumably resulting from regional hyperinflation and/or occult
      focal aspiration.

PMID- 2240850
TI  - The rise of tuberculosis in America before 1820.
AB  - Bills of mortality, newspaper and gazette articles, journals, and other records
      with specific references to "consumption," "phthisis," and other terms for
      tuberculosis were reviewed to determine the occurrence and importance of
      tuberculosis in the American colonies before 1820. Review of these sources
      indicates a marked increase in the proportional mortality from tuberculosis in
      the United States in the 18th century. "Consumption" may have been the leading
      cause of death in adult American colonists.

PMID- 2240851
TI  - Cytokines of the lung.

PMID- 2240852
TI  - The 1990 Report of the Surgeon General: The Health Benefits of Smoking Cessation.

PMID- 2240853
TI  - Six-month isoniazid-rifampin treatment for pulmonary tuberculosis in children.
AB  - One hundred and seventeen children with pulmonary tuberculosis underwent
      treatment with a 6-month daily regimen of rifampin (15 mg/kg/day) and isoniazid
      (10 mg/kg/day). The criteria for the diagnosis of pulmonary tuberculosis were (1)
      clinical symptoms and signs in 93 children (79%), (2) history of direct contact
      with an adult with tuberculosis in 106 children (91%), (3) tuberculin reaction of
      5 mm or more, without previous bacillus Calmette-Guerin (BCG), in 45 children
      (38%), (4) suggestive radiologic alterations in all patients, and (5) positive
      bacteriology or histology in four patients (3%). The treatment was completed by
      97 children (83%). The mean weight gain during therapy was 2,145 g. There was an
      excellent clinicoradiologic response to the treatment, and improvement in chest
      roentgenograms was observed in all patients at the end of therapy. No relapses
      occurred among the patients followed for an average of 21.4 months. This study
      indicates that the treatment of primary pulmonary tuberculosis in children with a
      combination of rifampin and isoniazid daily for 6 months is efficacious and does
      not result in any relapse.

PMID- 2240854
TI  - Human intestinal tissue antibiotic concentrations. Clindamycin, gentamicin, and
      mezlocillin.
AB  - An antibiotic, to be effective for prophylaxis in abdominal trauma, should
      quickly achieve high concentrations in the intestinal wall and at enough
      inhibitory levels to kill most aerobic and anaerobic bacteria that are potential
      contaminants at the site of surgical incision. Therefore, we studied the
      intestinal tissue levels of clindamycin, gentamicin, and mezlocillin to see
      whether the tissue levels achieved by these antibiotics in the intestinal tissue
      were adequate. A single dose of mezlocillin, 4 grams; clindamycin, 600 mg and
      gentamicin, 80 mg; quickly reached the desired concentrations, i.e., 52.3, 9.69
      and 6.1 micrograms/gram of intestinal tissue respectively. These levels were high
      enough to inhibit the growth of most isolates of E. coli and B. fragilis, common
      pathogens involved in intra-abdominal abscess.

PMID- 2240855
TI  - Ponderal index as a predictor of postoperative complications.
AB  - Four hundred sixty-eight patients undergoing elective surgery were prospectively
      followed for the development of postoperative complications. There was a trend
      toward increasing complication rate with a lower ponderal index. However, lower
      ponderal indices were associated with increasing rates of diabetes mellitus and
      hypertension. Of these patients, forty cases with postoperative complications
      were matched to 40 control cases for sex, age, concomitant illness and operation
      performed. The cases of postoperative complications had a statistically
      significantly lower ponderal index than the controls (11.98 versus 12.43). The
      increased risk of postoperative complications in those patients with a ponderal
      index of less than 11 was 3.36, and less than 13 was 3.44. Surgeons who treated
      patients with lower ponderal indices need to have a high index of suspicion for
      the development of postoperative complications in these patients.

PMID- 2240856
TI  - Gastroesophageal reflux and sclerotherapy strictures.
AB  - The development of esophageal stricture is common following endoscopic variceal
      sclerotherapy (EVS). Gastroesophageal reflux may be at least partly responsible.
      Twelve randomly selected male patients underwent chronic EVS for the management
      of bleeding esophageal varices. Six patients developed strictures during or after
      EVS, six did not. There were no significant differences between stricture and
      nonstricture patients during 24 hour esophageal pH monitoring. Three of the six
      stricture patients and four of the six nonstricture patients had an abnormal
      amount of reflux. Gastroesophageal reflux occurs frequently in patients
      undergoing EVS, and it is not likely to play a major role in EVS stricture
      formation.

PMID- 2240857
TI  - The inactivation of antithrombin III by serum elastase in patients with surgical
      infections.
AB  - The relationship between serum elastase and antithrombin III was determined in
      septic surgical patients as a possible mechanism for intravascular thrombosis and
      hypercoagulability during sepsis. Eighteen patients with surgical infections and
      elevated white blood cell counts had their blood assayed daily for white blood
      cell count, serum elastase, and antithrombin III, until the patient's white blood
      cell count returned to normal. Antithrombin III was significantly lower (0.87%)
      when elastase was above the normal range (greater than 14.2 micrograms/ml).
      Elastase was significantly higher (30.6 micrograms/ml), when antithrombin III was
      less than normal. These data indicate that elevated serum elastase is associated
      with a significant reduction in circulating antithrombin III. Stimuli that
      increase serum elastase, i.e. surgery, trauma, or sepsis may promote
      intravascular thrombosis by the inhibition of antithrombin III at the blood
      endothelial cell interface.

PMID- 2240858
TI  - Nonsurgical management of breast infections in nonlactating women. A word of
      caution.
AB  - Management options for infectious mastitis have traditionally been limited to
      surgical drainage. With the advent of percutaneous fine needle aspiration (FNA),
      nonoperative treatment may be an alternative, though criteria for use have not
      been defined. During a 30-month period, 22 women presented with breast infection.
      Treatment was instituted based upon the clinical stage of infection. Patients
      with cellulitis (n = 8) were managed with diagnostic FNA/antibiotics. Those with
      focal abscess (n = 10) underwent FNA of the cavity/antibiotics. Patients with
      multiloculated abscess (n C = 3) underwent urgent surgical drainage. Of the 19
      patients initially treated nonoperatively, resolution occurred in nine (47%);
      stage of infection did not effect outcome. Surgical drainage was required in the
      remainder; two cancers were found. FNA cytology in these (and all) patients was
      negative for malignancy. All underwent mammography during treatment. In 17 (77%)
      cancer was considered of low probability. The only patient with a mammogram
      highly suspicious for cancer had fat necrosis on biopsy. Bacterial cultures were
      positive in 79 per cent, virtually all with Gram (+) cocci. Four patients
      harbored Gram (-) organisms as well, two in concert with breast cancer.
      CONCLUSIONS: 1) select breast infections can be successfully managed
      nonoperatively, 2) the accuracy of FNA and mammography in the diagnosis of breast
      cancer may be impaired by coincident infection, 3) the finding of a Gram (-)
      breast infection warrants abandonment of nonoperative management in favor of
      tissue confirmation of the disease process.

PMID- 2240859
TI  - Starch peritonitis. A case report and clinicopathologic review.
AB  - A case of starch peritonitis is presented with a review of the history of this
      continuing problem. The syndrome's presentation, diagnosis, histopathology and
      treatment are discussed. The rarity of starch peritonitis today may be due to
      more attention to glove washing by surgeons, fewer impurities in the glove powder
      or lack of recognition of the syndrome. In order to prevent a resurgence of the
      starch peritonitis syndrome we must continue to emphasize the importance of
      washing gloves, maintain the quality control and purity of the powder used, and
      be cognizant of the signs and symptoms so that such cases may be managed
      nonoperatively.

PMID- 2240860
TI  - Cecal diverticulitis presented as a cecal tumor.
AB  - Seven patients diagnosed as having acute appendicitis were operated on and a
      cecal wall mass due to cecal diverticulitis was found. In two patients the mass
      could not be separated from the cecal wall and right colectomy was performed. In
      five patients, in whom the mass could be separated from the cecum, conservative
      operations (three diverticulectomies and two wedge resections) were performed,
      thus avoiding needless, more extensive surgery.

PMID- 2240861
TI  - Intra-abdominal abscesses in Crohn's disease.
AB  - We reviewed 22 patients who had intra-abdominal abscesses secondary to Crohn's
      disease. A total of 29 abscesses were discovered. These included superficial and
      deep intraperitoneal as well as pelvic and retroperitoneal abscesses. Diagnosis
      was aided by ultrasound and computer tomographic scanning. Barium studies
      continue to play an important role in delineating the extent of bowel involvement
      and fistulization. Treatment varied depending on the location and size of the
      abscess. The need for ultimate bowel resection was determined in the majority of
      cases by the presence of fistulization between the abscess cavity and the bowel.
      The terminal ileum or neoterminal ileum were almost always involved.

PMID- 2240862
TI  - An objective appraisal of the role of computed tomographic (CT) guided drainage
      of intra-abdominal abscesses.
AB  - Computed tomographic (CT) guided drainage is an important tool in the treatment
      of intra-abdominal abscess. Its most important role is in the treatment of small,
      unilocular, well-placed abscesses. Success rates in our experience diminish
      considerably in abscesses involving necrotic tumors or those infected with yeast.
      As is frequently characteristic of new technologic procedures, the initial
      evaluation of the success rate of the procedure is overly optimistic. The
      procedure carries a considerable complication rate (13%) and mortality rate
      (15%). Most importantly, success is usually evident early; within the first 24 to
      48 hours. After this length of time, careful evaluation to consider further
      treatment should be contemplated.

PMID- 2240863
TI  - Association of acute colonic pseudo-obstruction (Ogilvie's syndrome) with herpes
      zoster.
AB  - Ogilvie's syndrome, or acute pseudo-obstruction of the colon is characterized by
      massive distension of the colon in the absence of organic distal obstruction. The
      syndrome is associated with various unrelated and, most often, extra-abdominal
      causes. An association between Ogilvie's syndrome and herpes zoster has been
      reported only once, by Ceccese et al. in 1985. We present a second such case.
      This patient did not show evidence of any active illness other than the
      involvement of the T10 dermatome by herpes zoster. The patient's symptoms of
      colonic obstruction subsided with resolution of the zosteriform rash.

PMID- 2240865
TI  - Jejunal-rectal fistula as a complication of postoperative radiotherapy.
AB  - We present the case of a patient with an unusual, complex enteric fistula with
      multiple tracts and associated abscesses. The fistula was a late complication of
      radiotherapy, administered three years earlier, after resection for carcinoma of
      the sigmoid colon. Most of the small bowel was involved in the radiation-induced
      disease. A wide resection was performed successfully. This report reviews current
      literature on intra-abdominal postradiotherapy injuries, particularly intestinal
      fistulae.

PMID- 2240864
TI  - Porta hepatis disruption from blunt trauma.
AB  - Extrahepatic porta hepatis injuries from blunt abdominal trauma are exceedingly
      rare; all recently reported cases involve disruption of the common bile duct at
      its intrapancreatic portion. We herein report a patient with lacerations of the
      proper hepatic artery and bile duct occurring from deceleration/torsion of the
      porta hepatis after high speed vehicular collision.

PMID- 2240866
TI  - Obstructing paraduodenal hematoma.

PMID- 2240867
TI  - Femoral arteriovenous fistula as a complication of percutaneous transluminal
      coronary angioplasty. A report of five cases.
AB  - Arteriovenous fistula (AVF) associated with invasive and diagnostic angiographic
      procedures is rare. The incidence is increased with procedures such as
      percutaneous transluminal coronary angioplasty (PTCA) but is still quite low. We
      report five cases of AVF within a 17-month period, representing 0.15 per cent of
      all cardiac catheterizations and 0.87 per cent of PTCAs. All five patients
      presented with groin bruits. There were two associated pseudoaneurysms and one
      patient with deep vein thrombosis. All patients underwent uneventful division of
      the fistula. A thorough understanding of the anatomy of the femoral triangle is
      necessary in order to avoid this complication. That all fistulas were in the
      superficial or profunda femoris arteries emphasizes the importance of avoiding a
      low groin puncture. Early angiography and surgical intervention are recommended
      for optimal results.

PMID- 2240869
TI  - Lower extremity revascularization via the lateral plantar artery.
AB  - Lower extremity bypass grafts to the tibial and crural arteries are commonly
      employed to treat patients with atherosclerotic limb-threatening ischemia.
      Although occasional series have mentioned bypasses to a plantar artery, few of
      these specifically examine the results of arterial reconstructions using these
      vessels. Six patients underwent femoral to lateral plantar artery (LPA) bypass
      within a 19-month period for gangrene of the forefoot. There was one early graft
      failure and in the five completely autogenous reconstructions, graft patency and
      limb salvage had been achieved during a follow-up ranging from three to 22
      months. The LPA is an acceptable site for anastomosis of lower extremity bypass
      grafts and the early results presented herein support its more liberal use when
      proximal sites are unavailable.

PMID- 2240868
TI  - The role of endoscopic retrograde pancreatography (ERP) in blunt abdominal
      trauma.
AB  - The diagnosis of pancreatic injury is often difficult because it lies
      retroperitoneally in a protected area. Delayed diagnosis and treatment of blunt
      pancreatic trauma can result in significant morbidity and mortality. Endoscopic
      Retrograde Pancreatography (ERP) is infrequently used in the diagnosis of
      pancreatic injury. We reviewed our experience with the use of ERP in patients
      with blunt pancreatic injury. Two stable patients with traumatic pancreatitis
      underwent ERP shortly after injury. CT scans revealed a transverse fracture of
      the distal pancrease in one and fluid accumulation in the other around the
      pancreas extending to the right kidney and left hepatic lobe. The absence of
      ductal disruption on ERP allowed nonoperative management of the pancreatitis.
      Resolution was documented by the absence of symptoms on regular oral intake,
      normal serum amylase levels, and normal follow-up CT scans. A third patient with
      persistent fistulae three months postinjury underwent preoperative ERP revealing
      ductal obstruction. This facilitated the planning of a distal pancreatectomy and
      subsequently the fistulae healed. A fourth patient underwent an exploratory
      laparotomy on the basis of clinical and CT scan findings that could have been
      circumvented with preoperative ERP. ERP in selected patients allows nonoperative
      treatment in the absence of ductal injury or earlier operative treatment of
      ductal injury. It also aids the treatment of late complications by delineating
      ductal anatomy.

PMID- 2240870
TI  - Normal angiograms and carotid pathology.
AB  - Nonstenotic ulcerated atherosclerotic plaques of the carotid arteries may be
      associated with symptoms of transient ischemic attacks, amaurosis fugax, and
      stroke. Preoperative evaluation of patients with these symptoms has traditionally
      included ultrasound and arch aortography angiograms of the area of the carotid
      bifurcation. Recent evidence has shown that ultrasound is more accurate in
      detection and morphologic delineation of these nonstenotic lesions. We analyzed
      the hospital records of 21 patients with ultrasonographic evidence of disease in
      whom arteriograms were negative. The patient group comprised 15 men and six
      women, with an average of 66 years. All patients had symptoms of hemispheric
      transient ischemic attacks and were evaluated with B-mode ultrasound and
      arteriography. Ultrasound was positive and arteriogram "negative" in all of the
      patients (i.e., described by the radiologist as without hemodynamic significant
      disease or ulceration, or as normal). The ultrasound diagnosis was confirmed at
      operation with findings of 20 to 50 per cent stenosis and ulcerative plaques. At
      retrospective review of the arteriograms, three ulcerations were found in the 21
      patients. We conclude that B-mode ultrasound better defines nonstenotic
      ulcerative lesions and decisions to perform carotid endarterectomy may be based
      on either positive test. An ulcerative plaque by B-mode ultrasound and
      appropriate symptoms, therefore, may not require angiography before operation.

PMID- 2240871
TI  - Endoscopic extraction of an entrapped nasogastric tube.
AB  - Inadvertent entrapment of a nasogastric tube within a stapled gastrointestinal
      anastomosis is a preventable and infrequent surgical complication. We report our
      experience with this complication and describe a successful endoscopic approach
      to management.

PMID- 2240872
TI  - Management of premature removal of the percutaneous gastrostomy.
AB  - Percutaneous endoscopic gastrostomy (PEG) has become the preferred method of
      enteral access for nutritional support. With increased use of this modality,
      complications are encountered more frequently. Premature withdrawal, inadvertent
      removal of the gastrostomy tube within the first seven days after insertion,
      before adherence of the gastric serosa to the parietal peritoneum, has been an
      indication for laparotomy. This report describes the treatment of premature
      withdrawal by immediate endoscopic replacement. Over an 18-month period, 271
      patients underwent insertion of a PEG. Five patients (1.8%) who inadvertently
      removed their gastrostomy tube within seven days of insertion were treated with
      immediate replacement using the retrograde string technique, avoiding laparotomy.
      All five PEGs were successfully replaced through the same gastrostomy site.
      Despite the presence of pneumoperitoneum, no patient developed peritonitis or
      other septic complications. Premature gastrostomy tube withdrawal is safely
      managed by endoscopic replacement and observation. Laparotomy is unnecessary and
      potentially meddlesome.

PMID- 2240873
TI  - Transmission of human immunodeficiency virus type 1 (HIV-1) by exposure to blood:
      defining the risk.

PMID- 2240874
TI  - Management of small abdominal aortic aneurysms.

PMID- 2240875
TI  - Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of
      antibody-positive blood donations.
AB  - OBJECTIVE: To assess the incidence of human immunodeficiency virus type 1(HIV-1)
      transmission by antibody (anti-HIV-1)-positive blood components, and to determine
      the immunologic and clinical course in HIV-1-infected recipients. DESIGN AND
      SUBJECTS: We retrospectively tested approximately 200,000 donor blood component
      specimens stored in late 1984 and 1985 for anti-HIV-1, and we contacted
      recipients of positive specimens to determine their serologic status. They were
      compared with both recipients of HIV-1-negative transfusions and healthy
      (untransfused) controls. Subjects were seen at 3- to 6-month intervals for up to
      4 years for clinical and immunologic evaluations. MEASUREMENTS AND MAIN RESULTS:
      Of 133 recipients, 9 had other possible exposures. Excluding these cases, 111 of
      124 (89.5%) were anti-HIV-1-positive (95% CI, 84.1% to 94.5%). The recipient's
      sex, age, underlying condition, and type of component did not influence infection
      rates. The cumulative risk for developing the acquired immunodeficiency syndrome
      (AIDS) within 38 months after transfusion was 13% (CI, 7.5% to 21.6%). At 36 +/-
      3 months after the index transfusion, seropositive recipients had lower counts of
      CD2+CDw26+, CD4+, CD4+CD29+, and CD4+CD45RA+subsets and more CD8+I2+ lymphocytes
      than did recipients of anti-HIV-1-negative transfusions. The CD4+ and
      CD2+CDw26+subsets changed the most rapidly. The absolute CD8+ count remained
      normal. CONCLUSIONS: Transfusion of anti-HIV-1-positive blood infected 90% of
      recipients. The rate of progression to AIDS within the first 38 months after
      infection was similar to that reported for homosexual men and hemophiliacs.
      Although most lymphocyte subset counts changed over time, CD8+ counts were
      constant.

PMID- 2240876
TI  - Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1)
      associated with clinical exposures. A prospective evaluation.
AB  - OBJECTIVES: To summarize the results of a 6-year, ongoing, prospective study of
      the risk for human immunodeficiency virus type 1 (HIV-1) transmission among
      health care workers, and to estimate the magnitude of the risk for HIV-1
      infection associated with different types of occupational exposures. DESIGN:
      Prospective cohort study; the median follow-up for employees sustaining
      parenteral exposures was 30.2 months (range, 6 to 69 months). SUBJECTS: Health
      care workers at the Clinical Center, National Institutes of Health, including
      those reporting parenteral and nonparenteral occupational exposures to HIV-1.
      MEASUREMENTS AND MAIN RESULTS: One thousand three hundred and forty-four clinical
      health care workers reported 179 percutaneous and 346 mucous membrane exposures
      to fluids from HIV-1-infected patients during a 6-year period. Responding to a
      supplementary questionnaire, 559 of these workers reported 2712 cutaneous
      exposures to blood from HIV-1-infected patients and more than 10,000 cutaneous
      exposures to blood from all patients during a 12-month period. Occupational
      transmission of HIV-1 occurred in a single worker after a parenteral exposure to
      blood from an HIV-1-infected patient. No infections occurred after either mucous
      membrane or cutaneous exposures to blood from HIV-1-infected patients. Use of
      newer diagnostic technologies (for example, antigen detection, gene
      amplification) has not resulted in the identification of occupationally
      transmitted seronegative infections. CONCLUSIONS: Combining our results with
      those of other prospective studies, the risk for HIV-1 transmission associated
      with a percutaneous exposure to blood from an HIV-1-infected patient is
      approximately 0.3% per exposure (95% CI, 0.13% to 0.70%); the risks associated
      with occupational mucous membrane and cutaneous exposures are likely to be
      substantially smaller. These data support the use of barrier precautions and
      suggest a need for strategies that change health care providers' attitudes and
      behaviors.

PMID- 2240877
TI  - Carotid endarterectomy for elderly patients: predicting complications.
AB  - OBJECTIVE: To determine whether the complication or death rate from carotid
      endarterectomy can be predicted from hospital and physician structural variables,
      such as the hospital's teaching status or the number of endarterectomies done by
      the surgeon per year. DESIGN: Survey of medical records. After controlling for
      the severity of the patient's condition on the basis of data in the medical
      record at the time of the endarterectomy, regression analyses were used to
      predict the postoperative stroke, heart attack, and 30-day death rate as a
      function of patient, physician, and hospital characteristics. SETTING: Three
      geographic areas (states or large parts of states; average population, 3 million)
      in the United States. PATIENTS: Random sample of 1302 patients 65 years of age or
      older having carotid endarterectomy in 1981. INTERVENTION: Carotid
      endarterectomy. MEASUREMENTS AND MAIN RESULTS: Of 1302 patients, 11.3% had a
      postoperative stroke or heart attack or died within 30 days of the operation.
      Patient age, race, income, and gender; physician volume, board certification
      status, and age; and hospital size, for-profit status, ownership, and teaching
      status were not significantly related to the postoperative complication or death
      rate. If the surgeon was a graduate of a foreign, but not a Western European or
      Canadian, medical school, however, the average complication or death rate rose
      from 10.4% to 19.6% (P less than 0.05). CONCLUSIONS: The effectiveness of carotid
      endarterectomy depends heavily on its complication rate. Because complications
      after surgery cannot, in general, be predicted from structural variables,
      referring physicians cannot rely solely on the surgeon's experience and
      qualifications when recommending a carotid endarterectomy. The surgeon's and the
      hospital's actual postoperative complication and death rate should be considered.

PMID- 2240878
TI  - Risk for colon adenomas in patients with rectosigmoid hyperplastic polyps.
AB  - OBJECTIVE: To determine whether hyperplastic polyps found in the rectosigmoid
      area of the colon are associated with proximal adenomas, and to judge whether
      patients with distal hyperplastic polyps found during sigmoidoscopy might benefit
      from full colonoscopy. DESIGN: Data on patients having colonoscopy collected
      prospectively according to a set protocol. The size and location of all polyps
      were noted, and all polyps were biopsied. SETTING: Two university hospitals.
      PATIENTS: One thousand eight hundred and thirty-six consecutive patients referred
      for colonoscopy between 31 December 1987 and 31 August 1989. RESULTS: Of the 970
      patients who met eligibility requirements, 274 (28.3%) had adenomas and 108
      (11.1%) had hyperplastic polyps. The proportion of patients with distal
      hyperplastic polyps and proximal adenomas (31.9%) was similar to the proportion
      of those without distal hyperplastic polyps (23.0%) (crude odds ratio, 1.57; 95%
      CI, 0.77 to 3.06). After adjusting for age and sex, the results were unchanged
      (adjusted odds ratio, 1.53; CI, 0.82 to 2.88). Patients with distal adenomas, on
      the other hand, were three times more likely to have proximal adenomas than those
      without distal adenomas (adjusted odds ratio, 3.42; CI, 1.99 to 5.88).
      CONCLUSIONS: Distal hyperplastic polyps are not strong predictors of risk for
      proximal adenomas. Based on the magnitude of the risk difference, we do not
      believe that finding a hyperplastic polyp during sigmoidoscopy justifies doing a
      full colonoscopy to search for proximal adenomas. Because rectosigmoid adenomas
      are associated with proximal adenomas, however, small polyps seen during
      sigmoidoscopy should be biopsied to determine their type. Colonoscopy should be
      reserved for patients who are proved to have adenomas.

PMID- 2240879
TI  - The internist in the management of head and neck cancer.
AB  - The general internist has an important role in the management of head and neck
      squamous cell cancers. This heterogeneous group of cancers must be accurately
      diagnosed and staged before planning treatment. Curability is directly related to
      stage at presentation and, because most patients with such cancers present to
      internists first, these physicians must be familiar with presenting symptoms and
      must be suspicious enough to refer patients with symptoms for appropriate
      evaluation. The work-up of patients with suspected unknown primary cancer
      presenting as adenopathy is detailed, and the physician is cautioned not to
      immediately proceed to open biopsy. As many as 10% of such primary cancers remain
      undetected, although, with proper therapy, the 5-year survival rate for squamous
      cell cancer of the head and neck is 60%. Those patients cured of head and neck
      cancer still face significant psychosocial and medical problems, including
      hypothyroidism, xerostomia, and a 20% rate of second primary cancer. Head and
      neck cancer is highly preventable; 75% of cases are related to tobacco and
      alcohol use. Smokeless tobacco has gained popularity among young Americans and is
      associated with an increased incidence of head and neck cancer at several sites.
      Education is crucial, and internists must seek strategies to stop patients from
      using tobacco products. Other etiologic factors include industrial carcinogens,
      Epstein-Barr virus, and diet. Retrospective serologic and dietary recall studies
      of vitamin A suggest an etiologic role of diet; vitamin A analogs have been
      tested in preneoplastic lesions. To reduce mortality from head and neck cancers,
      the general internist must play a central role in prevention and early detection.

PMID- 2240880
TI  - Colorectal cancer: evidence for distinct genetic categories based on proximal or
      distal tumor location.
AB  - PURPOSE: To examine studies of normal colon and colorectal cancer for evidence
      that the location of the primary tumor proximal or distal to the splenic flexure
      of the colon may determine distinct genetic categories of this disease. DATA
      IDENTIFICATION: Studies were identified through a manual search of journals,
      through MEDLINE, and through review of bibliographies in identified articles.
      STUDY SELECTION: Approximately 300 articles were examined. About 150 articles
      were excluded because tumor location was not reported or was reported in a way
      that did not permit correlation with results or conclusions. DATA EXTRACTION:
      Articles were selected either because the presentation of data permitted
      correlation of results with anatomic regions of the colon or because they were
      relevant to inherited colorectal cancer. RESULTS OF THE ANALYSIS: Differences
      were noted in biologic properties of proximal and distal segments of normal fetal
      and adult colonic epithelium and in the epidemiologic, pathologic, cytogenetic,
      and molecular features of proximal and distal colorectal cancer. Some differences
      correlated with the features of inherited colorectal cancer (proximal,
      nonpolyposis or distal, and polyposis forms). CONCLUSIONS: Developmental and
      biologic differences in proximal and distal colon may reflect differing
      susceptibilities to neoplastic transformation. Differences in proximal and distal
      colorectal cancer suggest that each may arise through different pathogenetic
      mechanisms. Proximal tumors appear to represent a genetically more stable form of
      the disease and may arise through the same mechanisms that underlie inherited
      nonpolyposis colon cancer. Distal tumors show evidence of greater genetic
      instability and may develop through the same mechanisms that underlie polyposis
      associated colorectal cancer syndromes.

PMID- 2240881
TI  - Guidelines for the physician expert witness. American College of Physicians.
AB  - Editorial Note: The Clinical Practice Subcommittee of the College's Health and
      Public Policy Committee undertook development of "Guidelines for the Physician
      Expert Witness" in order to encourage broad physician participation in providing
      this much-needed assistance to the legal system. The College believes that more
      physicians should serve as experts as a component of their professional
      activities in order to meet the need for medical testimony rather than a few
      physicians with little current involvement in patient care spending
      disproportionate amounts of time testifying. The guidelines, adapted from the
      "Statement on Qualifications and Guidelines for the Physician Expert Witness" by
      the Council of Medical Specialty Societies (20 March 1989), recommend
      qualifications for experts and give general guidance.

PMID- 2240882
TI  - Economic incentives for ethical and courteous behavior in medicine. A proposal.
AB  - Several current and proposed structural features of medical reimbursement are
      intended to alter the behavior of health care providers. I propose adding a
      structure to make physician behavior more ethical. The structure's design would
      be complex, but its core would be reminiscent of how a patron tips waiters. My
      proposal would apply the truism that society's reward systems should foster
      rather than undermine social goals. This idea draws on features of medicine's
      social background and on a theory of behavior. It challenges the taboo against
      the physician's financial interests being clearly present in the doctor-patient
      relationship and it challenges the overly pure characterization of medical
      ethical dilemmas that currently dominates. Detailed sketches of necessary
      mechanisms, such as anonymous forms for patients to complete, are offered, and
      connections to the insights of George Bernard Shaw are made.

PMID- 2240883
TI  - Rewarding medicine: good doctors and good behavior.
AB  - Many patients think that there are shortcomings in the ethical dimensions of
      patient care, and research supports their view. In this issue of Annals, Erde
      suggests that physicians' incomes should depend on patients' assessments of their
      ethical behavior in much the same way that waiters' incomes depend on patrons'
      tips. Although Erde's solution is satiric, the problem is a serious one. The
      experiences and perspectives of patients regarding their own illness are
      undervalued by physicians. A truly patient-centered care demands that physicians
      elicit, understand, and respond to patients' perspectives. Tying physicians' pay
      to measurements of patient satisfaction is unlikely to dramatically improve the
      ethical quality of patient care as long as attention to the patient's perspective
      is seen as peripheral to "good medical care." Rather than relying on a single,
      easy "fix," we must re-examine all of professional development and practice. We
      need to choose persons for medical careers who will find patient-centered care
      rewarding; we need to provide such persons with training and socialization that
      underscores the value of personalized medicine; and we need to build institutions
      and systems that facilitate and reinforce patient-centered practice. The best
      ways to achieve these objectives are as yet unclear, but if we, as physicians,
      are offended by Erde's "modest proposal," then we must respond by proposing and
      implementing our own ideas about how patient care can become more humane.

PMID- 2240884
TI  - Severe acetaminophen toxicity in a patient receiving isoniazid.

PMID- 2240885
TI  - Annual pelvic examination.

PMID- 2240886
TI  - Diarrhea and AIDS.

PMID- 2240887
TI  - Functional asplenia after bone marrow transplantation.

PMID- 2240888
TI  - Gluten-free diet for AIDS-associated enteropathy.

PMID- 2240889
TI  - Diagnosis of Cushing disease.

PMID- 2240890
TI  - Nutritional deficiency and AIDS.

PMID- 2240891
TI  - Precautions against hepatitis B.

PMID- 2240892
TI  - Financial incentives.

PMID- 2240893
TI  - Parenting during residency.

PMID- 2240894
TI  - Authorship.

PMID- 2240895
TI  - Decision analysis in the evaluation of revascularization.

PMID- 2240896
TI  - Advocacy for methadone treatment.

PMID- 2240897
TI  - Emergence of recreational drug abuse as a major risk factor for stroke in young
      adults.
AB  - OBJECTIVE: To investigate the clinical and epidemiologic relations between
      recreational drug abuse and stroke in young persons. DESIGN: A case-control study
      based on medical records. SETTING: San Francisco General Hospital, a 400-bed
      municipal hospital. PATIENTS: Consecutive sample of 214 patients aged 15 to 44
      years, admitted between 1979 and 1988 with a diagnosis of ischemic or hemorrhagic
      stroke. An equal number of control patients admitted with diagnoses of status
      asthmaticus, acute appendicitis, or acute cholecystitis were matched to stroke
      patients by age, sex, and year of hospitalization. MEASUREMENTS AND MAIN RESULTS:
      Seventy-three patients with stroke (34%) were drug abusers compared with 18 (8%)
      of the controls. In 47 patients with stroke, temporal proximity of drug
      administration (n = 34) or infectious endocarditis (n = 13) suggested a direct
      association between drug abuse and stroke. After controlling for other
      identifiable stroke risk factors, the estimated relative risk for stroke among
      drug abusers compared with that among non-drug abusers was 6.5 (95% CI, 3.1 to
      13.6), and this increased to 49.4 (CI, 6.4 to 379.0) for those patients whose
      symptoms began within 6 hours of drug administration. Among patients less than 35
      years of age, drug abuse was the most commonly identified potential predisposing
      condition (47%), and it was the only condition with a significantly elevated
      relative risk for stroke (11.7; CI, 3.2 to 42.5). Further, a substantial rise in
      the proportion of drug-related strokes was observed in the last 3 years of the
      study (31% in 1986 to 1988, compared with 15% in 1979 to 1985, P = 0.008).
      Cocaine, especially recently, was the drug used most frequently in drug-related
      strokes. CONCLUSION: In an urban population such as ours, recreational drug abuse
      appears to be a prominent and growing risk factor for strokes in young adults.

PMID- 2240898
TI  - Sexual and physical abuse in women with functional or organic gastrointestinal
      disorders.
AB  - STUDY OBJECTIVES: To determine the prevalence of a history of sexual and physical
      abuse in women seen in a referral-based gastroenterology practice, to determine
      whether patients with functional gastrointestinal disorders report greater
      frequencies of abuse than do patients with organic gastrointestinal diseases, and
      to determine whether a history of abuse is associated with more symptom reporting
      and health care utilization. DESIGN: A consecutive sample of women seen in a
      university-based gastroenterology practice over a 2-month period was asked to
      complete a brief questionnaire. MEASUREMENTS: The self-administered questionnaire
      requested information about demographics, symptoms, health care utilization, and
      history of abuse. Physicians indicated the primary diagnosis for each patient and
      whether she had ever discussed having been sexually or physically abused.
      RESULTS: Of 206 patients, 89 (44%) reported a history of sexual or physical abuse
      in childhood or later in life; all but 1 of the physically abused patients had
      been sexually abused. Almost one third of the abused patients had never discussed
      their experiences with anyone; only 17% had informed their doctors. Patients with
      functional disorders were more likely than those with organic disease diagnoses
      to report a history of forced intercourse (odds ratio, 2.08; 95% CI, 1.03 to
      4.21) and frequent physical abuse (odds ratio, 11.39; CI, 2.22 to 58.48), chronic
      or recurrent abdominal pain (odds ratio, 2.06; CI, 1.03 to 4.12), and more
      lifetime surgeries (2.7 compared with 2.0 surgeries; P less than 0.03). Abused
      patients were more likely than nonabused patients to report pelvic pain (odds
      ratio, 4.05; CI, 1.41 to 11.69), multiple somatic symptoms (7.1 compared with 5.8
      symptoms; P less than 0.001), and more lifetime surgeries (2.8 compared with 2.0
      surgeries; P less than 0.01). CONCLUSIONS: We found that a history of sexual and
      physical abuse is a frequent, yet hidden, experience in women seen in referral
      based gastroenterology practice and is particularly common in those with
      functional gastrointestinal disorders. A history of abuse, regardless of
      diagnosis, is associated with greater risk for symptom reporting and lifetime
      surgeries.

PMID- 2240899
TI  - Serum and tissue magnesium concentrations in patients with heart failure and
      serious ventricular arrhythmias.
AB  - OBJECTIVE: To compare magnesium concentrations in serum and tissue from patients
      with heart failure. Two groups of patients were compared, those with or without
      serious ventricular arrhythmias. DESIGN: Consecutive enrollment. Blinded
      laboratory analyses. SETTING: Referral inpatient service of the cardiology
      division of a university hospital. PATIENTS: Twenty-three patients with
      idiopathic dilated cardiomyopathy and mild to moderately severe congestive heart
      failure (New York Heart Association functional class II to IV) were divided into
      two groups: 9 patients with sustained ventricular tachycardias and 14 patients
      without serious ventricular arrhythmias (control). INTERVENTIONS: Medications for
      heart failure were withdrawn 12 hours or more before study. Antiarrhythmic
      therapy was continued throughout the study. MEASUREMENTS AND MAIN RESULTS: The
      patients had skeletal muscle biopsies, myocardial biopsies, and blood sampling
      for the analysis of magnesium concentrations. No statistically significant
      differences in the mean magnesium concentrations in serum, circulating
      mononuclear cells, skeletal muscle, and myocardium were found when the 9 patients
      with ventricular arrhythmias were compared with the 14 control patients without
      serious ventricular arrhythmias. CONCLUSIONS: In a general, ambulatory sample of
      patients with heart failure, magnesium depletion in serum and tissue does not
      appear to occur more commonly in patients with serious ventricular arrhythmias
      than in patients without serious ventricular arrhythmias.

PMID- 2240900
TI  - Gallium nitrate for advanced Paget disease of bone: effectiveness and dose
      response analysis.
AB  - OBJECTIVE: To evaluate whether a brief course of treatment with gallium nitrate
      can reduce biochemical parameters of accelerated bone turnover in patients with
      advanced Paget disease. DESIGN: Unblinded trial, decreasing dose schedules of
      gallium nitrate. SETTING: University hospital with primary orthopedic and
      metabolic bone disease specialty. PATIENTS: Ten patients with advanced Paget
      disease who had previously received conventional therapy consisting of
      calcitonin, etidronate, or mithramycin. INTERVENTIONS: Five patients were entered
      into each of three dose schedules: 2.5 mg/kg body weight per day by continuous
      intravenous infusion for 7 days; 0.5 mg/kg per day for 14 days by subcutaneous
      injection; and 0.25 mg/kg per day for 14 days by subcutaneous injection. Several
      patients were treated with different dose schedules. Patients were followed until
      relapse. RESULTS: Fifteen courses of treatment were administered to ten patients.
      Reductions in serum alkaline phosphatase and urinary hydroxyproline excretion
      were observed after treatment with each dose schedule. After treatment with high,
      intermediate, and low doses, the median maximum decreases in serum alkaline
      phosphatase activity were 49%, 39%, and 18%, respectively. The median maximum
      decreases in urinary hydroxyproline excretion were 50%, 52%, and 16%,
      respectively. The maximum decrease in urinary hydroxyproline excretion occurred
      within a median of 2 weeks from the start of treatment, whereas the maximum
      decrease in serum alkaline phosphatase activity occurred substantially later at a
      median of 6 weeks. All treatment schedules were well tolerated. Response duration
      was highly variable (range, 6 to 42 weeks). CONCLUSIONS: Short-term treatment
      with gallium nitrate can reduce biochemical parameters of disease activity in
      patients with advanced Paget disease of bone. Larger trials using low-dose
      intermittent treatment schedules are required to evaluate the safety and
      effectiveness of this therapy.

PMID- 2240901
TI  - Effect of human immunodeficiency virus (HIV) infection on the course of syphilis
      and on the response to treatment.
AB  - PURPOSE: To evaluate evidence that concurrent infection with human
      immunodeficiency virus (HIV) alters both the natural history of syphilis (by
      increasing the frequency of early neurosyphilis) and the response to penicillin.
      DATA IDENTIFICATION: Review of major works on syphilis in the English language
      and files maintained since 1971, supplemented by a systematic search using Index
      Medicus and MEDLARS. DATA EXTRACTION: The works mentioned above were critically
      reviewed for information on early neurosyphilis and, where relevant, HIV
      infection. RESULTS OF DATA ANALYSIS: The central nervous system is regularly
      involved in early syphilis. Standard recommended doses of benzathine penicillin
      provide cerebrospinal fluid levels that are probably at the borderline of
      efficacy, and cure relies on treatment and an adequate host immune response.
      Early neurosyphilis, appearing within 2 years of onset of infection with
      Treponema pallidum, was uncommon in the prepenicillin era and usually occurred
      after inadequate therapy. This complication was exceedingly rare in the first
      three decades of penicillin use. In contrast, in the past decade, 40 patients
      with HIV infection have been reported to have asymptomatic neurosyphilis, or
      syphilitic meningitis, cranial nerve abnormalities (predominantly in cranial
      nerves II and VIII), or cerebrovascular accidents, singly or together. In 40% of
      cases, HIV infection was first diagnosed when neurologic symptoms appeared. Of
      the 38 patients for whom information was available, 18 had the acquired
      immunodeficiency syndrome (AIDS), 7 had AIDS-related complex, and 13 had antibody
      to HIV. Sixteen had previously been treated for syphilis, of whom 5 (31%) had
      received benzathine penicillin within the previous 6 months. Preliminary data
      also suggest that skin lesions and VDRL (Venereal Disease Research Laboratory)
      antibody in HIV-infected patients with secondary syphilis respond more slowly to
      conventional penicillin therapy. CONCLUSION: Intensive therapy and follow-up
      observation is indicated for early syphilis in HIV-infected subjects. Novel
      approaches to treatment deserve systematic evaluation.

PMID- 2240904
TI  - Living the patient's story.

PMID- 2240902
TI  - Cooperation between health professionals from the United States and the Union of
      Soviet Socialist Republics. Conclusions from a trip to the Soviet Union.
AB  - The United States has long made its academic medical resources available to
      foreign medical graduates. Conspicuously absent from the number of foreign
      nationals, however, have been physicians, scientists, and educators from the
      Soviet Union. Under the new conditions of perestroika, Soviet medical
      professionals are seeking ways in which to open up broad collaboration with their
      American counterparts. Agreements are being sought between national
      organizations, between academic medical institutions, and for the exchange of
      individual scholars. Cooperation in the area of medical education is one of the
      distinctive bridges on the path to mutual understanding that will represent a
      strong link in the public diplomacy of the two superpowers. We recently had the
      opportunity to discuss in Moscow some of the issues with the U.S.S.R. Minister of
      Health and with the Pro-rector for International Programs of the Central
      Institute for Advanced Medical Studies, as well as with faculty members, young
      medical scientists, and medical students of the Moscow Medical Institutes. We
      describe briefly many of the similarities and some of the dissonances between our
      two health systems and set forth ideas for an exchange program in medical
      education.

PMID- 2240903
TI  - Improving outcomes of analgesic treatment: is education enough?
AB  - Frequent undertreatment of analgesic-responsive acute pain and chronic cancer
      pain persists, despite intensive efforts to provide clinicians with information
      about analgesics. A set of background factors must be addressed in interventions
      to improve pain treatment: Traditional patterns of clinician and patient
      interaction on the ward, quality assurance, and drug regulatory practices do not
      support prompt recognition and treatment of pain. Possible interventions to
      modify these patterns of daily practice include monitoring and displaying patient
      pain ratings routinely, making available educational tools to assist optimal drug
      ordering, encouraging patients to communicate about unrelieved pain, reviewing
      quality assurance of pain treatment regimens, increasing behavioral research into
      analgesic prescribing, and selectively modifying narcotics regulatory practices.

PMID- 2240905
TI  - A steroid-responsive nephrotic syndrome in a patient with human immunodeficiency
      virus (HIV) infection.

PMID- 2240906
TI  - Corticosteroid-associated blue toe syndrome: role of antiphospholipid antibodies.

PMID- 2240907
TI  - Intravenous immunoglobulins in gram-negative bacteremia.

PMID- 2240908
TI  - Molecular genetics of chronic myelogenous leukemia.

PMID- 2240909
TI  - Fluconazole-induced thrombocytopenia.

PMID- 2240912
TI  - Physicians and the pharmaceutical industry.

PMID- 2240910
TI  - Screening for colorectal cancer.

PMID- 2240911
TI  - Cigarette smoking, not carbon monoxide, is the problem.

PMID- 2240913
TI  - Predicting type II diabetes in persons at risk.

PMID- 2240914
TI  - Expanding the use of thrombolytic therapy for acute myocardial infarction.

PMID- 2240916
TI  - High blood cholesterol in elderly men and the excess risk for coronary heart
      disease.
AB  - OBJECTIVE: To determine whether high blood cholesterol is an important risk
      factor for mortality from coronary heart disease in elderly men. DESIGN: Cohort
      study with a mean follow-up of 10.1 years. SETTING: A health maintenance
      organization. PATIENTS: The cohort included 2746 white men 60 to 79 years of age
      who had no self-reported history of coronary heart disease. MEASUREMENT AND MAIN
      RESULTS: A total of 260 deaths occurred during 27,842 person-years of follow-up.
      The relative risk for mortality from coronary heart disease in men 60 to 79 years
      of age in the highest serum cholesterol quartile was 1.5 (95% CI, 1.2 to 2.0)
      compared with those in the three lower quartiles combined. The relative risk did
      not change greatly with age, ranging from 1.4 in men 60 to 64 years of age to 1.7
      in men 75 to 79 years of age. However, because mortality from coronary heart
      disease increased with age, the excess risk for such mortality attributable to
      elevated serum cholesterol levels increased fivefold over these 20 years, from
      2.2 deaths per 1000 person-years to 11.3 deaths per 1000 person-years.
      CONCLUSIONS: Our results support those of other observational studies in elderly
      men. If treatment of high blood cholesterol is as effective in reducing
      cholesterol-related risk for coronary heart disease after 65 years of age as it
      is in middle-aged men, it might actually produce greater reductions in mortality
      due to coronary heart disease. A clinical trial is needed to confirm this
      extrapolation.

PMID- 2240915
TI  - Slow glucose removal rate and hyperinsulinemia precede the development of type II
      diabetes in the offspring of diabetic parents.
AB  - OBJECTIVE: To determine whether insulin resistance or insulin deficiency is
      primary in the pathogenesis of type II diabetes. DESIGN: Cohort analytic study of
      persons with normal glucose tolerance but with a high risk for developing type II
      diabetes (average follow-up time, 13 years). SETTING: Outpatients had an
      intravenous glucose tolerance test and were contacted periodically to ascertain
      diagnoses of diabetes. PARTICIPANTS: One hundred and fifty-five normal offspring,
      ranging in age from 16 to 60 years, of two parents with type II diabetes and 186
      normal control subjects in the same age range who had no family history of
      diabetes. MEASUREMENTS AND MAIN RESULTS: Two phenotypic characteristics
      distinguished the offspring of diabetic parents from control subjects. They had
      slower glucose removal rates (Kg) (P less than 0.01) and higher insulin levels
      (fasting and during the second phase of insulin response to intravenous glucose;
      P less than 0.0001) than did control subjects, even after adjustment for
      differences in obesity. Sixteen percent of the offspring developed type II
      diabetes. Mean Kg at baseline was 1.7%/min among offspring who subsequently
      developed diabetes, 2.2%/min among offspring who remained nondiabetic, and
      2.3%/min among control subjects. Corresponding means for first-phase insulin were
      498, 354, and 373 pM, respectively, whereas second-phase insulin means were 329,
      117, and 87 pM, respectively. In multivariate analysis, low Kg and high serum
      insulin levels independently increased the risk for developing diabetes among the
      offspring of diabetic parents. CONCLUSIONS: One to two decades before type II
      diabetes is diagnosed, reduced glucose clearance is already present. This reduced
      clearance is accompanied by compensatory hyperinsulinemia, not hypoinsulinemia,
      suggesting that the primary defect is in peripheral tissue response to insulin
      and glucose, not in the pancreatic beta cell.

PMID- 2240917
TI  - Cardiovascular effects of the somatostatin analog octreotide in acromegaly.
AB  - OBJECTIVE: To determine the cardiovascular effects of the somatostatin analog
      octreotide in patients with acromegaly. DESIGN: Prospective nonrandomized study.
      SETTING: Referral-based endocrinology clinic. PATIENTS: Seven patients with
      active acromegaly, three of whom had refractory congestive heart failure. The
      other four patients were free of symptoms associated with heart failure.
      INTERVENTIONS: All patients were treated with octreotide, 100 to 500 micrograms
      subcutaneously three times daily. The three patients with heart failure continued
      to receive cardiovascular therapy (angiotensin converting enzyme inhibitors,
      digitalis, diuretics). MEASUREMENTS AND MAIN RESULTS: During octreotide therapy,
      patients showed a rapid decrease in growth hormone and insulin-like growth factor
      1 (IGF-1): Mean levels (+/- SD) fell from 28.1 +/- 32.7 micrograms/L to 5.2 +/-
      8.3 micrograms/L and 740 +/- 126 micrograms/L to 372 +/- 64 micrograms/L,
      respectively (P less than 0.025). Plasma volume returned to normal and heart rate
      decreased significantly. In the four patients without heart failure, right-heart
      catheterization done before and after 3 months of octreotide therapy showed an
      18.3% +/- 11% reduction in stroke volume and a return to normal of the cardiac
      index. The three patients with congestive heart failure, evaluated before and
      after 40 days and up to 2 years of therapy, showed a dramatic clinical
      improvement that was associated with an increase in stroke volume (by 24% to
      51%). In these patients, the cardiac index remained in the normal range, filling
      pressures were markedly decreased, and pulmonary wedge pressure returned to
      normal. This improvement was sustained for up to 3 years in the two patients with
      heart failure who were receiving long-term treatment. CONCLUSION: The rapid and
      sustained cardiac improvement seen in our patients shows that octreotide therapy
      for patients with acromegaly may be highly beneficial, even in those patients
      with advanced cardiac failure.

PMID- 2240918
TI  - Clarifying confusion: the confusion assessment method. A new method for detection
      of delirium.
AB  - OBJECTIVE: To develop and validate a new standardized confusion assessment method
      (CAM) that enables nonpsychiatric clinicians to detect delirium quickly in high
      risk settings. DESIGN: Prospective validation study. SETTING: Conducted in
      general medicine wards and in an outpatient geriatric assessment center at Yale
      University (site 1) and in general medicine wards at the University of Chicago
      (site 2). PATIENTS: The study included 56 subjects, ranging in age from 65 to 98
      years. At site 1, 10 patients with and 20 without delirium participated; at site
      2, 16 patients with and 10 without delirium participated. MEASUREMENTS AND MAIN
      RESULTS: An expert panel developed the CAM through a consensus building process.
      The CAM instrument, which can be completed in less than 5 minutes, consists of
      nine operationalized criteria from the Diagnostic and Statistical Manual of
      Mental Disorders (DSM-III-R). An a priori hypothesis was established for the
      diagnostic value of four criteria: acute onset and fluctuating course,
      inattention, disorganized thinking, and altered level of consciousness. The CAM
      algorithm for diagnosis of delirium required the presence of both the first and
      the second criteria and of either the third or the fourth criterion. At both
      sites, the diagnoses made by the CAM were concurrently validated against the
      diagnoses made by psychiatrists. At sites 1 and 2 values for sensitivity were
      100% and 94%, respectively; values for specificity were 95% and 90%; values for
      positive predictive accuracy were 91% and 94%; and values for negative predictive
      accuracy were 100% and 90%. The CAM algorithm had the highest predictive accuracy
      for all possible combinations of the nine features of delirium. The CAM was shown
      to have convergent agreement with four other mental status tests, including the
      Mini-Mental State Examination. The interobserver reliability of the CAM was high
      (kappa = 0.81 - 1.0). CONCLUSIONS: The CAM is sensitive, specific, reliable, and
      easy to use for identification of delirium.

PMID- 2240919
TI  - Selection of patients with acute myocardial infarction for thrombolytic therapy.
AB  - PURPOSE: To critically review the current recommendations regarding the
      eligibility of patients with myocardial infarction for thrombolytic therapy. DATA
      IDENTIFICATION: Relevant studies published from January 1980 to January 1990 were
      identified through a computerized search of the English-language literature using
      MEDLINE and by a manual search of the bibliographies of all identified articles.
      STUDY SELECTION: All randomized, controlled trials of intravenous thrombolysis in
      acute myocardial infarction and unstable angina were reviewed. Smaller,
      observational studies and previous review articles were included when relevant to
      the discussion. DATA EXTRACTION: Key data were extracted from each article,
      including the proportions of patients eligible for thrombolysis, the reasons for
      exclusion from thrombolytic therapy, and the clinical outcomes of patients
      treated and of those excluded from treatment. The validity of certain exclusion
      criteria was examined using subgroup analysis from the large, randomized
      mortality trials of intravenous thrombolysis and observations from smaller,
      nonrandomized studies. RESULTS OF DATA SYNTHESIS: To date, relatively few
      patients with myocardial infarction have been considered eligible for
      fibrinolytic therapy. In this group, both early and late mortality have been
      significantly reduced. Patients excluded from thrombolysis, however, continue to
      have a high early mortality. The data suggest that the potential benefits of this
      treatment might be extended to selected high-risk subgroups. In particular, the
      risk-benefit ratio may favor the inclusion of otherwise healthy elderly patients;
      certain patients presenting more than 6 hours after the onset of symptoms; and
      patients with a history of controlled systolic hypertension or brief,
      nontraumatic cardiopulmonary resuscitation. The data do not support the use of
      fibrinolytic therapy as primary treatment in patients with unstable angina or
      suspected myocardial infarction in the absence of confirmatory
      electrocardiographic changes. CONCLUSIONS: The full potential of thrombolytic
      therapy to alter the natural history of acute myocardial infarction can only be
      realized through the continued evaluation of selection criteria and the
      identification and treatment of the greatest possible number of eligible
      patients.

PMID- 2240920
TI  - Preoperative screening: value of previous tests.
AB  - OBJECTIVE: To determine the frequency of tests done in the year before elective
      surgery that might substitute for preoperative screening tests and to determine
      the frequency of test results that change from a normal value to a value likely
      to alter perioperative management. DESIGN: Retrospective cohort analysis of
      computerized laboratory data (complete blood count, sodium, potassium, and
      creatinine levels, prothrombin time, and partial thromboplastin time). SETTING:
      Urban tertiary care Veterans Affairs Hospital. PATIENTS: Consecutive sample of
      1109 patients who had elective surgery in 1988. MEASUREMENTS AND MAIN RESULTS: At
      admission, 7549 preoperative tests were done, 47% of which duplicated tests
      performed in the previous year. Of 3096 previous results that were normal as
      defined by hospital reference range and done closest to the time of but before
      admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat
      values were outside a range considered acceptable for surgery. Most of the
      abnormalities were predictable from the patient's history, and most were not
      noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%;
      CI, 13% to 20%) repeat values at admission were outside a range considered
      acceptable for surgery (P less than 0.001, frequency of clinically important
      abnormalities of patients with normal previous results with those with abnormal
      previous results). CONCLUSIONS: Physicians evaluating patients preoperatively
      could safely substitute the previous test results analyzed in this study for
      preoperative screening tests if the previous tests are normal and no obvious
      indication for retesting is present.

PMID- 2240921
TI  - Physician shortage in occupational and environmental medicine.
AB  - OBJECTIVE: To determine future training needs for physicians in occupational and
      environmental medicine based on goals established by the Institute of Medicine
      (IOM) for clinical practice in the field. DESIGN: A critical review of previously
      published estimates of the need and supply of physicians with clinical training
      in occupational and environmental medicine with the application of currently
      available data to produce revised estimates. MEASUREMENTS AND MAIN RESULTS: Need
      estimates reviewed from the National Institute for Occupational Safety and
      Health, the Graduate Medical Education National Advisory Committee (GMENAC), and
      the Bureau of Health Professions. Supply figures reviewed from GMENAC, the
      American Medical Association, the American College of Occupational Medicine, and
      the American Board of Preventive Medicine. Revised need figures are based on the
      estimated number of occupational and environmental physicians needed to provide
      adequate nationwide coverage as full-time academic faculty, community-based
      specialists, and public health physicians in state and local agencies. Revised
      supply estimates are based on review of available data. Need is estimated at 4600
      to 6700 physicians (board-certified or eligible or with special competence in
      occupational and environmental medicine). Supply is estimated at 1200 to 1500.
      CONCLUSIONS: This review identified a deficit of 3100 to 5500 physicians in this
      newly evolving specialty. In order to address this shortfall in the next decade,
      graduate specialty training would need to be increased to about 3 to 5 times the
      current maximum capacity.

PMID- 2240922
TI  - Effects of different calcium antagonists on proteinuria associated with diabetes
      mellitus.

PMID- 2240923
TI  - Fluid loading in septic shock.

PMID- 2240924
TI  - Treatment of cryptococcal meningitis in AIDS.

PMID- 2240925
TI  - Chronic airflow limitation and obesity.

PMID- 2240926
TI  - Syncope and functional infranodal block.

PMID- 2240927
TI  - "Jump starting" the immune system.

PMID- 2240928
TI  - Physician supply and the health care crisis.

PMID- 2240929
TI  - Unwanted journals and the environment.

PMID- 2240930
TI  - [Peptic ulcer and Helicobacter pylori].

PMID- 2240932
TI  - [Intestinal hormones and peptic ulcer].

PMID- 2240931
TI  - [Billroth I using mechanical staplers in peptic ulcer (experience in 112 operated
      cases)].

PMID- 2240933
TI  - [Tumors of the carotid glomus (chemodectomas)].
AB  - Two cases of carotid body tumor (chemodectomas) have been reported and at this
      regard the international literature reviewed. Concerning the diagnosis selective
      angiograms represent the investigation of choice in clinical assessment and
      planning operative approach. Doppler-ultrasound results particularly useful in
      the follow up of patients after surgery. With advances in vascular technique,
      complete excision of the tumor has become possible and is now associated with
      minimal morbidity and mortality. Survival rate of resected patients is equivalent
      to that for sex age matched control subjects.

PMID- 2240934
TI  - [Surgery of pulmonary and hepatic metastases].
AB  - In recent years surgery for hepatic and pulmonary metastases has been undertaken
      with a curative intent in a growing percentage of cases. In the present study the
      Authors evaluate their own experience in such a field, and summarize the state of
      the art, as it appears from a review of the international literature. At present,
      the subject is not settled, as several aspects are matter of debate (prognostic
      significance of free interval, tumor doubling time, number and location of
      metastatic lesions, histologic type, and stage, of the primary tumor, approach to
      synchronous metastases, accuracy of preoperative diagnosis), with different
      therapeutic implications according to the hepatic or pulmonary site. Pulmonary
      metastases should be managed by resection through a median sternotomy, in order
      to allow thorough exploration of both lungs. Hepatic lesions (from colorectal
      primaries) should be resected with a free margin not less than 1-2 cm. The need
      for uniformity of selection criteria and for the establishment of protocols
      including adjuvant therapy is strongly felt.

PMID- 2240935
TI  - [State of the art in the treatment of peptic ulcer].

PMID- 2240936
TI  - [Treatment of pancreatic pseudocysts: personal experience].
AB  - The authors reported their experience of 13 patients with pancreatic pseudocyst
      observed within the period 1982-1987. Three patients underwent external drainage,
      9 internal drainage and 1 exeretic operation. On the base of the results the
      authors conclude that the internal drainage should be considered the choice
      operation of pancreatic pseudocysts because of the lower mortality and morbidity.

PMID- 2240937
TI  - [Antibiotic prophylaxis in the control of infections in surgery: comparison of
      treatment in different types of surgery].
AB  - Despite the development of the most recent and powerful antimicrobic agents,
      surgical infections are to this day a constant threat to surgeons, rendering
      negative otherwise successful surgical results. It seems therefore essential that
      during surgical operations--which according to Altemeier's classification are
      defined as "contaminated" and "potentially contaminated"--patients undergo a
      perioperative antibiotic prophylaxis in order to assure elevated tissue levels of
      antibiotic as necessary. A perspective trial of two standard protocols of short
      term prophylaxis versus cefoperazone has been here outlined, given that in a
      recent study cefoperazone showed a positive effect in destroying the intestinal
      flora of patients even though this was carried out in experimental and not in
      clinical conditions. 177 patients were selected for this study with a breakdown
      of 26 and 42, that is twenty-six underwent potentially contaminated procedures
      and 42 contaminated procedures. Selecting at random, fifty percent of the first
      group was treated with cefoxitin, and the other half with cefoperazone; as far as
      the second group is concerned half the sample of patients was treated with
      cefoperazone and then compared with the other half who had been given an
      association of piperacillin and metronidazole. Primary septic complications
      amounted to 7.3% (13 cases); 7.6% in the first group (2 cases) and 21% in the
      second (9 cases). The different of sepsis between the two groups was not
      statistically significant although cefoperazone showed a higher septic result in
      contaminated surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240939
TI  - [Neuroendocrine surgery in Parkinson's disease: comparative analytical evaluation
      of approaches to microsurgical adrenalectomy. Experimental studies].
AB  - In this experimental contribution to the study of neurobiological interactions
      between adrenal medullary graft and CNS, is presented a model to estimate the
      approaches to rat adrenalectomy using statistical inference techniques. Eighteen
      rats were divided into three samples. The members of every sample were left
      adrenalectomized using lombotomic, anterior transperitoneal and posterior
      approaches respectively. A score was attributed to every experimentally
      meaningful parameter, according a previously well established plan. Scores were
      tested by analysis of variance and by previously planned orthogonal comparisons.
      Mean, standard deviation of every sample score and confidence interval for mean
      difference were computed. Statistical analysis results show that, objectively,
      there is a meaningful difference between anterior approach and posterior or
      lateral approach, anterior approach being more difficult then posterior or
      lateral approach, while there is not meaningful difference between posterior and
      lateral approach. Subjectively, on the contrary, there are not meaningful
      differences between three approaches to left adrenalectomy statistically.

PMID- 2240938
TI  - [Clinical considerations of jejunal carcinoma].
AB  - The carcinoma of the jejunum represents 3-6.5% of gastric intestinal tumors and
      33-50% of small intestine carcinomas. The observation of a case of jejunum
      carcinoma has offered the authors the idea for a critical revision on the
      subject. After an examination on the diagnostic, anatomopathological, clinical
      and therapeutic problems, the authors underline the importance of the precocious
      diagnosis of neoplasia; in fact the jejunum carcinoma is characterized by a
      hidden and aspecific symptomatology and by dangerous evolution; besides the site
      is difficult for an organic study with the common methods of investigation.
      Therefore, in all patients in whom the suspicion of a jejunum pathology exists,
      it is indispensable to carry out a precise diagnostic iter which is based on
      radiological endoscopic and tomographic investigation: in fact the small
      intestine and the jejunum in particular are intestinal tracts that are explored
      with difficult and therefore at times only an accurate effecting of the
      radiological study can permit a precocious diagnosis the only valid supposition
      for the carrying out of a truly radical surgical therapy and for the acquiring of
      a batter prognosis.

PMID- 2240940
TI  - [Colostomy control using an original occluding device. A clinico-experimental
      study].
AB  - After having examined different methods as to continence colostomy, the authors
      introduce their own control system for the stoma. The study was carried out on 6
      colostomized patients. Preliminary, the intraluminal pressure in closed colostomy
      was recorded. Pressure waves, largely varying from patient to patient, were
      obtained as to frequency of waves and pressure values. The same variations were
      observed during meals waking and sleeping. Sometimes the patients suffered from
      serious disorder, but in most cases they did not feel pain. A catheter, provided
      with an inflatable balloon for closing the stoma, formed the system tested. It
      was also provided with a second intraluminal low-pressure inflated balloon,
      connected with an external compensating chamber. As a result of the system the
      pressure dropped down to about 1/6 compared with the reference values observed
      under the same conditions. In addition, the continence was complete and the
      patient did not suffer from any disorder in non-stop recordings up to 24 hours.
      We believe that the system may be useful for colostomized patients if carefully
      carried out.

PMID- 2240941
TI  - [Role of fiber optics endoscopy in the diagnosis and follow up of peptic ulcer].

PMID- 2240942
TI  - [Is it possible to prevent cognitive disorders in the elderly?].

PMID- 2240943
TI  - [Inflammation proteins in Horton's disease. Prospective study of 25 patients].
AB  - In a study of 25 giant cell arteritis patients, whose diagnoses were made by
      temporal artery biopsy, the authors compared the evolution of the erythrocyte
      sedimentation rate (ESR) with those of the acute phase proteins (APP): fibrinogen
      (F), C reactive protein (CRP), orosomucoid (O), haptoglobin (H) and alpha 2
      globulins (alpha 2-G), before, during and after corticotherapy; 165 laboratory
      analyses were made. Prior to treatment, ESR was increased in 96% of the patients,
      O and H in 100%, F and CRP in 96% and alpha 2-G in 92%. CRP showed the greatest
      mean increase (21x). Statistically significant positive correlations were found
      between ESR and alpha 2-G, F, CRP and O. No significant relationship was observed
      between APP and the occurrence of ophthalmological complications or the length of
      treatment. The CRP level returned to normal within the first week of steroid
      therapy for 76% of the patients, before ESR, F and O. During the withdrawal phase
      of corticotherapy, an ESR greater than 30 mm almost always corresponded to an
      inflammatory syndrome and an ESR of less than 15 mm to its absence (kappa
      coefficient = 0.64, p less than 0.001); however, an ESR between 15 and 30 mm did
      not enable us to draw a conclusion as to the absence or presence of such a
      syndrome. After terminating steroid therapy, the relationship between ESR and an
      inflammatory syndrome was weaker (kappa coefficient = 0.57, p less than
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2240945
TI  - [Hyperparathyroidism with severe hypercalcemia. Treatment and results].
AB  - From 1960 to 1988, we successfully treated 1,200 primary hyperparathyroid
      patients. The serum calcium level was higher than 3.75 mmol/l (150 mg/l) in 75
      patients. Sixty-five patients had acute primary hyperparathyroidism and 10 had
      asymptomatic severe hypercalcemia. Before admission to our department, most of
      the patients were given medication to lower their serum calcium levels. Analysis
      of our diagnostic and therapeutic experience leads us to insist upon the
      importance of prompt medical treatment and rapid surgical intervention. Only
      surgery can adequately treat severe hyperparathyroidism.

PMID- 2240944
TI  - [Restenosis after transluminal coronary angioplasty. Clinical and therapeutic
      aspects].
AB  - To assess the incidence and clinical presentation of restenosis after successful
      coronary angioplasty, and the short- and mid-term results of its treatment, 160
      patients, who underwent a first coronary angioplasty between May 1987 and
      December 1988, were closely monitored. Restenosis is defined as a loss of 50% or
      more of the initial gain in area and/or 30% or more in diameter, or chronic
      coronary occlusion. These criteria were met in 43 patients (27%) within 5.1
      months (1-6 months), on the average, after angioplasty. Restenosis was expressed
      as unstable angina in 51% of the patients, stable angina in 30%, and abnormal
      thallium myocardial scintigraphy under exercise in 14%. Myocardial infarction was
      never the revealing symptom. In 63% of the cases, the pain caused by restenosis
      repeated the initial angina. A second angioplasty was performed in 75% of the
      patients with a success rate of 93%, in the absence of an occlusion, and a 37%
      rate of further restenosis.

PMID- 2240947
TI  - [Diabetic maculopathy].

PMID- 2240946
TI  - [Pulmonary artery hypertension in systemic lupus erythematosus].

PMID- 2240948
TI  - [New prospects of immunotherapy in rheumatoid polyarthritis].

PMID- 2240949
TI  - [Impotence: therapeutic possibilities].

PMID- 2240950
TI  - [First Consensus Conference on anti-infectious Treatment. Pneumocystosis in HIV
      infection. Brief report (11-13 May 1990)].

PMID- 2240951
TI  - [Pulmonary artery hypertension and systemic lupus erythematosus. A case with
      hemodynamic study].

PMID- 2240952
TI  - [Association of paroxysmal nocturnal hemoglobinuria and polymyositis].

PMID- 2240953
TI  - [Familial amyloidosis of AL type and factor X deficiency. The valve of long-term
      colchicine administration].

PMID- 2240954
TI  - [Still's disease in adults with a pulmonary site].

PMID- 2240955
TI  - [Eosinophilic meningitis. Observations on a case contracted in New Caledonia].

PMID- 2240956
TI  - [Planning in mental health--is it possible?].
AB  - The author opens the subject by questioning "why" and "how" to plan for mental
      health. Planification is a public health process. This process made modern
      countries able to develop health care policies in accordance to scientific
      progress. This allowed to stop the transmission of communicable diseases. Mental
      health disorders are one of the 4 public health priorities along with cardio
      vascular diseases, cancers an consequences of accidents. New care methods have to
      be found in order to be adapted to recent needs. In many countries, mental health
      care have been and still are on the way to be modified. These major modifications
      will be illustrated by the French "sectorisation" which will be replaced in the
      context of complete reconversion of the French mental health care system. Two
      research streams will be proposed: research focused on the health care system
      which will enlight the different systems, their characteristics, activities and
      adequation; epidemiological studies in order to measure population needs in term
      of mental health, to clarify how mental health disorders appear and what sort of
      care are used by the persons. To illustrate these themas, the author will present
      his own experience. For more than 25 years he was operating on complex private
      mental health care system using the resources of an epidemiological unit in order
      to plan the development of this care system.

PMID- 2240957
TI  - [Continuity and breaks in psychiatry. Introduction].

PMID- 2240958
TI  - [Continuity and discontinuity: definitions].

PMID- 2240959
TI  - [Lithium as founding the concept of endogenous mental disease].
AB  - The abnormal life--potentially the death--of the cell can be restored by a
      metalloid--lithium--which is nearly as common as sodium in the mineral world.
      This established fact grounds indirectly, contrary to apparent and scientific
      logic, the concept of endogenous brain disease which was until then an abstract
      concept because of a lack of objective evidence. Seven case reports are
      described.

PMID- 2240960
TI  - [Paradoxes in adolescence: break and continuity].
AB  - The psychopathological studies on adolescence underline the paradoxical
      behaviours during this period of life. After the analysis of its concept we show
      in which way the paradox helps to maintain the continuity of psychological life
      during the crisis. Thus impossible choices which are part of the contradiction in
      adolescents be avoided. It will be necessary to provoke the emergence of the
      paradox from the contradictions linked with hospitalization through on
      hospitalization to make the most of the letter in the therapeutic process.

PMID- 2240961
TI  - [The bird's name is the father's name].

PMID- 2240962
TI  - [From order to chaos in psychiatry].

PMID- 2240963
TI  - [Limitations of irrationality in our psychiatric practice].

PMID- 2240964
TI  - [I leave for good: I shall not come back before tonight].

PMID- 2240965
TI  - [From Pinel to Bateson: change in continuity].

PMID- 2240967
TI  - [The unknown of knowledge in psychiatry].

PMID- 2240966
TI  - [Continuity in break: the unbalanced patient's life].

PMID- 2240968
TI  - [Psychoses in children and security units].

PMID- 2240969
TI  - [Mythomania: conceptual changes or symptomatologic illusion?].

PMID- 2240970
TI  - [Hospital, patient care team, continuity or discontinuity of care].

PMID- 2240971
TI  - ["Where have our loves gone..."].

PMID- 2240972
TI  - [Continuity and breaks of an indestructible bond in psychiatry].

PMID- 2240973
TI  - [Short of and beyond words: breaks and continuity in language].

PMID- 2240974
TI  - [Psychic injury].

PMID- 2240975
TI  - [Concepts of the relationship between dementia and depression in Weingartner's
      works: a critical study].
AB  - The School of Weingartner has construct a theoretical framework for defining
      cognition, in which changes in cognitive performance may be related to
      alterations in "intrinsic" cognitive processes (episodic memory, semantic memory,
      processes requiring effort or performed more automatically) or non cognitive
      "extrinsic" processes (sensitivity to reinforcement, arousal/activation,
      sensorimotor capabilities, mood). The empiric fertility of this pattern enriches
      our knowledges about depression and dementia. It is able to describe suitably
      some relevant facts under the view of a systemization and to support the idea
      that the component processes of memory are psychobiologically distinct. One
      cannot nevertheless ignore the issue of the value of the cognitive categories
      produced. It is possible to judge the episodic memory by the semantic memory? The
      basis on which the latter is measured is more restrictive than the basis upon
      which it was originally defined; the quantitative experiments don't take into
      account the modalities of the realization of the meaning. The notion of effort is
      still an area of investigation more than an enrichment of answers. It must be
      closely related to the notion of anticipation and take care of the spatiotemporal
      presentations from which the thought organizes the stimuli and adapts itself to
      the content of cognition in the circumstances of the experiment. A place must be
      done especially in dementia in the limits of the paradigmatic power of that
      pattern and in the criterions of exclusion separating the demented/-non depressed
      from the demented/depressed subjects.

PMID- 2240977
TI  - [From "morbus democraticus" to passionate idealism. Different reactions of French
      alienists after the Commune of Paris].
AB  - Literary and medical works published immediately after the fall of the Commune of
      Paris purport an analysis which deserves a critical reading: the study of the
      influence that alcoholism and the federate movement had on each other, easily
      naive and not without excess, stamped with obviously reactionary emotions,
      appears as historically and scientifically questionable as the proposals towards
      an interpretation of the event in terms of mental pathology. The search of cases
      of insanity among the rebels, the idea that their acts could only express some
      kind of phrenopathic disorder opens the debate on the very existence of some
      morbid types such as Falret's and Pottier's "reasoning, inexhaustible and
      proselyte lunatics", the "many characters with fanciful projects, including
      reformists of the human race, and various utopists" that Morel includes in his
      classification of hereditary insanity, Serieux's and Capgras "idealists concerned
      with justice" found amongst delusions related to altruistic claims, Dide's and
      Guiraud's "idealistic passions, social reformers, anarchists" appear to us as
      very outdated classifications, on the border of the psychiatric field.

PMID- 2240976
TI  - [Knowledge about previous psychiatric care: is it a guaranty for therapeutic
      investment or a curse in psychiatric emergencies].
AB  - A sample of 755 psychiatric emergencies taken in charge in the emergency service
      of the St-Luc Hospital, Brussels, was divided into two groups: patients without
      psychiatric background (498) and patients having received previous psychiatric
      care (238). A background of psychiatric follow-up strongly influence the taking
      on and therapeutic decisions to be made by psychiatrists: its absence protects
      the patient and is seen as the guaranty of a good investment from the therapist
      while the existence of previous psychiatric treatment rather leads to hospital in
      lieu of crisis intervention, even when the crisis mechanisms are not
      significantly different in both samples.

PMID- 2240979
TI  - [Towards a holistic model of mental disorder. Its analogical links with the
      contemporary scientific theories].

PMID- 2240978
TI  - [Mental representations and neuronal networks].

PMID- 2240980
TI  - [Evaluation of the risk factors of suicide in patients treated for mental
      disorders. Review of the literature from 1978 to 1988].
AB  - Research on suicide risk factors among psychiatric patients has developed
      considerably over the last 10 years. The methodological problems are numerous.
      Tentatives of global prediction have been unsuccessful in describing one complete
      and specific picture of the mentally ill suicide, whereas lawsuits against
      psychiatrists are frequent after patients' suicides. Through the analysis of 37
      publications from 1978 to 1988 the authors review the main suicide risk factors
      identified among treated psychiatric patients.

PMID- 2240981
TI  - [Standardized symptomatologic inventory adapted to psychiatric emergency].
AB  - Clinical psychiatry, particularly in the case of hospital emergency, begins with
      the patient's benevolent observation. It goes on with the verbal communication,
      subordinated itself to linguistic problems. There are now daily cross-cultural
      practising and education in France. This is the presentation of a standardized
      inventory and of its instructions for use, created in connection with a
      multicentric currently analysed survey. The inventory can be used without major
      difficulty by non clinicians and general practitioners.

PMID- 2240982
TI  - [The myth of the psychiatric ward and its realities].

PMID- 2240983
TI  - [Endogenous depression and the Newcastle scale II. Study with 147 patients (2)].

PMID- 2240985
TI  - The use of biofeedback in the treatment of disorders of childhood.
AB  - Biofeedback has demonstrated its effectiveness in the treatment of childhood
      disorders over the cynicism of many clinicians. Its appropriateness to the
      pediatric population is not a function of the age of the subject, but of whether
      the disorder is amenable to treatment. To reiterate, not all disturbances are the
      same. Incontinence in the child with spina bifida may be different from
      incontinence in the aged. Hyperactivity in children, while often defined
      globally, has many concomitants, some of which help to determine the efficacy of
      biofeedback treatment. The instructions given are specific and easily understood
      and can be comprehended even by some of the youngest children. Biofeedback
      deserves to be considered as the treatment of choice, in a wide range of
      disorders occurring in childhood.

PMID- 2240984
TI  - Obesity. A biobehavioral point of view.

PMID- 2240986
TI  - A personal perspective on the development of social psychology.

PMID- 2240987
TI  - Biofeedback for disorders of initiating and maintaining sleep.
AB  - Sleep disturbances are a frequent reason for pediatric consultation. When the
      disturbance persists in the form of delays in entering or maintaining sleep
      (DIMS), a vicious cycle develops. As part of the cycle, vigilance or arousal
      occurs, further inhibiting sleep occurrence. Persistent DIMS requires treatment
      to interrupt this self-perpetuating sequence. Interruption requires reduction in
      psychophysiological arousal and deconditioning of the events surrounding sleep.
      Electromyographic (EMG) and thermal biofeedback in conjunction with relaxation
      training were used with three children who maintained high levels of arousal
      resulting from stresses common to their developmental stages. Within seven
      sessions, all three patients showed attenuation of arousal and symptom abatement
      marked by uninterrupted sleep.

PMID- 2240988
TI  - Is carbon monoxide a workplace teratogen? A review and evaluation of the
      literature.
AB  - Sixty case reports of carbon monoxide exposures involving pregnant women are
      reviewed. The circumstances under which carbon monoxide exposures adversely
      affected pregnancy and the types of effects seen are summarized. Severe acute
      exposures to carbon monoxide caused foetal death or toxic effects, including
      anatomical malformations and functional alterations. Foetal outcome was related
      to two major indices of carbon monoxide exposure: maternal blood
      carboxyhaemoglobin levels and maternal toxicity.

PMID- 2240989
TI  - Towards causal inference in occupational cancer epidemiology--I. An example of
      the interpretive value of using local rates as the reference statistic.
AB  - A brief overview is made of the criteria currently applied for establishing
      causation in occupational cancer epidemiology, and further criteria or
      'desiderata' are proposed. These supplement the present somewhat simplistic ones
      for 'sufficient evidence of carcinogenicity' advocated by the International
      Agency for Research against Cancer in their monograph series. A frequent cause of
      confounding, not always appreciated, is the limited choice of a reference
      population for the statistical analyses. The study population is often an
      industrial one with marked regional and urban biases, especially for some of the
      cancers under scrutiny: these biases can influence markedly the resultant
      Standardized Mortality Ratio (SMR) calculated, and thus lead to misleading
      conclusions. The British Rubber Manufacturers' Mortality Study, 1946-1980,
      provided an opportunity to extract the data set of one of the 13 factories
      involved. Both local and national death rates were applied as a reference, and
      the use of the former substantially reduced the high SMRs previously recorded for
      lung and stomach cancers. This emphasized the need for further analyses when
      making other internal comparisons in order to accommodate more of the
      'desiderata' listed. Ultimately causation can be inferred only after weighing up
      all the evidence, and must be based on a 'balance of probabilities'.

PMID- 2240990
TI  - The likelihood of detecting a significant hearing threshold shift among noise
      exposed workers subjected to annual audiometric testing.
AB  - The ability of annual audiometric surveillance to detect significant
      deteriorations in hearing sensitivity is examined considering the time pattern of
      the growth of noise-induced hearing loss. The yearly rate of change in hearing
      level due to the effects of noise exposure and age is computed from a
      mathematical model put forward in the International Standard ISO 1999 (1989). The
      first-order derivative of hearing level associated with noise and age was
      compared with different criteria of significant threshold shift (STS). The
      results show that the potential annual variation in hearing level at 4 kHz, the
      audiometric frequency most affected by noise, is always less than the minimum
      margin of error of audiometry under exposure to 90 dBA-8 h. At 100 dBA it nearly
      equals the margin of error only for the very first year of exposure and for the
      most sensitive individuals. The rate of change in hearing threshold at 4 kHz is
      less than or equal to 1 dB per year for a major portion of a population exposed
      to an average noise level of 90 dBA-8 h (+/- 5 dB SD). For other audiometric
      frequencies, or for combinations of frequencies, this rate is even lower. It is
      also demonstrated that, using annual hearing tests, the likelihood of measuring
      an STS in a noise-exposed population is very small. It would be nearly equal to
      the likelihood of some workers being exposed to 100 dBA-8 h or more for a first
      year. Such results throw doubt on the validity of audiometric surveillance as a
      procedure for early detection of noise-induced hearing loss. They also imply that
      the detection by audiometric tests of true cases of significant threshold shift
      due to noise is excessively expensive.

PMID- 2240991
TI  - Exposure to organic solvents--I. A survey on the use of solvents.
AB  - Organic solvent neurotoxicity is a serious occupational health problem in
      Denmark. To obtain a precise description of the use of solvents, a questionnaire
      investigation of a random sample of 1000 companies was made. Information about
      2000 liquid products, in particular various kinds of degreasers, paints and
      lacquers, was collected. Approximately two-thirds of all products contained more
      than 1% of organic solvents, and of these two-thirds contained more than 20%. A
      total of 93 different solvents were used, ethanol, industrial gasoline, toluene,
      isopropyl alcohol and acetone being the commonest. Chlorinated hydrocarbons are
      not often used now, owing to the replacement of organic solvent-based products by
      water-based products.

PMID- 2240992
TI  - Exposure to organic solvents--II. An exposure epidemiology study.
AB  - The recognition of the 'solvent syndrome' as an occupational disease in Denmark
      has created a need for mapping the exposure to organic solvents. Exposure levels
      to organic solvents were measured at 372 representative processes in Danish
      manufacturing and service industries. Half of the results calculated as
      sigma(Ci/TLVi) were below 0.25, a quarter between 0.25 and 1, and a quarter above
      1. The printing and chemical industries were found to have higher exposure levels
      than other industries. The commonest processes had the highest exposure levels. A
      comparison of exposure to organic solvents and incidence of cases recorded as
      suffering from 'solvent syndrome' in different industries, shows that a causal
      relationship cannot be disproved by the present findings.

PMID- 2240993
TI  - Increased isotransferrin ratio and reduced erythrocyte and platelet volumes in
      blood from thermoplastic industry workers.
AB  - Ten women (aged 31-61 years) and five men (aged 20-59 years) occupationally
      exposed to welding fumes of polyacetate containing diethylphthalate in a
      thermoplastic industry were studied. They had been employed 1-33 years (median:
      11 years). Seven women (aged 35-55) and eight men (aged 26-73) acted as unexposed
      controls. The exposed persons showed increased isotransferrin ratio in blood
      serum and reduced volumes of erythrocytes and platelets in blood.

PMID- 2240994
TI  - [Trimetazidine versus betahistine in vestibular vertigo. A double blind study].
AB  - The efficacy of trimetazidine (60 mg/day) in vertigo was compared with that of
      betahistine (24 mg/day) in a three-month double-blind study. Included in the
      study were only patients with peripheral vertigo associated or not with tinnitus
      or hearing loss, and excluded were those presenting with symptoms related to
      retrocochlear or central disease. Out of the 40 patients enrolled, 20 suffered
      from Meniere's disease; 4 patients either dropped out of the study or were non
      compliant to therapy and could not be taken into account in the final analysis,
      which bore on 36 patients (18 treated by trimetazidine and 18 with betahistine).
      There were no dropouts in the Meniere's disease subgroup (10 receiving
      trimetazidine and 10 receiving betahistine). Results revealed a better response
      to therapy with trimetazidine in patients suffering from vertigo, and this was
      particularly true of the Meniere's disease subgroup (p less than 0.025).
      Moreover, in the latter subgroup, all patients treated with trimetazidine fully
      recovered from vertigo spells, while these disappeared completely only in 4 of
      the patients administered betahistine (p less than 0.005). There was no
      noticeable difference between the two treatment groups as regards the evolution
      of the accompanying symptoms and the audiometric or vestibular test results.
      Clinical acceptability was equally excellent in both treatment groups. Overall,
      this study allowed to confirm the therapeutical efficacy of trimetazidine in the
      management of vertigo, as well as establishing the clinical advantage of
      trimetazidine over betahistine in patients suffering from Meniere's disease.

PMID- 2240995
TI  - [Trimetazidine versus betahistine in Meniere's disease. A double blind method].
AB  - The efficacy and acceptability of trimetazidine (60 mg daily) in the treatment of
      Meniere's disease were compared with those of betahistine (36 mg daily) during a
      double-blind study spanning two months. Enrolled in the study were 45 patients
      (33 treated with trimetazidine, 23 with betahistine) presenting cochlear symptoms
      (vertigo, tinnitus, hearing loss) compatible with a diagnosis of Meniere's
      disease. Five patients dropped out of the study (3 in the trimetazidine group did
      not comply with the therapy and 2 in the betahistine group complained of poor
      response to the treatment) and were not taken into account in the final analysis,
      which therefore bore on 40 patients (19 receiving trimetazidine and 21 receiving
      betahistine). Trimetazidine was found to be significantly more effective than
      betahistine as far as the overall evolution of the ENT disease was concerned,
      yielding 79% and 57% improvement rates in each group, respectively (p = 0.027).
      Complete disappearance of the dizziness attacks was noted in 10 patients out of
      19 in the trimetazidine group, versus 5/21 patients in the betahistine group (p =
      0.06). There was no statistically significant difference between both treatments,
      as assessed from other clinical or audiometric criteria. Clinical acceptability
      was equally excellent in both treatment groups.

PMID- 2240997
TI  - [Cochlear physiology and physiopathology. Recent data].
AB  - Our concept of cochlear physiology has changed so drastically over the last
      decade that most classical textbooks have become obsolete. This bibliographical
      inadequacy regarding the functioning of the normal cochlea is particularly
      disturbing when it comes to addressing patho-physiology problems (hearing loss or
      tinnitus). What drastic changes have there been, that can justify such need for
      information updating? These relate primarily to the role of one the two types of
      sensory cells of the cochlea; i.e., the outer hair cells (or OHC). These cells
      are endowed with contractile properties and react to tonal impulse by modifying
      the vibration of the cochlear partition. This "active mechanism" response
      provokes a localized amplification of the vibration imparting to these classical
      sensory transducers, or inner hair cells (IHC), their optimal frequency
      sensitivity and discrimination properties. This new concept alone would suffice
      to justify our present topic. We chose, however, to insert a general presentation
      of cochlear physiology, the intent of which is to briefly review the classical
      data and to analyze in some depth the issues that have drastically changed our
      knowledge.

PMID- 2240996
TI  - [A cellular anti-ischemic agent, trimetazidine prevents the deleterious effects
      of oxygen free-radicals on the internal ear].
AB  - Improvement of cochleovestibular symptoms induced by trimetazidine (TMZ) has been
      evidenced by clinical studies. However, a poor knowledge of the physiopathology
      and the scarcity of experimental models contributed to making determination of
      the mode of action of the drugs difficult. We studied the effect, in vitro, of
      TMZ on the production of oxygen-derived free radicals using, as a biological
      model, the isolated semicircular canal of the frog. This model allows to exert
      separate control over the ionic composition of the endo- and perilymphatic
      fluids. The spontaneous activity of the afferent nerve fibers, as well as the
      endolymphatic potential, were recorded at rest. Three additional parameters were
      analyzed, while the semicircular canal was subjected to mechanical stimulation,
      i.e., ampulla potential, nerve potential and the evoked frequency of action
      potentials. Free radical generation induced by the administration of phenazine
      methosulfate (PMS, 10(-5) M, 15 min) into the perilymphatic compartment, leads to
      a deterioration of the production of endolymph and the release of this afferent
      neuromediator. Inversely, PMS has no influence whatsoever on the mechanisms of
      mechanical-electrical transduction. The addition of TMZ (10(-6) or 10(-5) M) in
      the perilymphatic compartment counteracts the harmful effects of free radicals on
      the various bioelectric activities. These results suggest that the beneficial
      action of TMZ observed during treatment of cochleovestibular disorders is due, at
      least in part, to the anti-oxidizing properties of the molecule of interest.

PMID- 2240998
TI  - [Acoustic oto-emissions. Clinical uses].
AB  - Otoemissions are acoustic signals emitted by the cochlea in response to a short
      acoustic stimulation (click) that may be recorded with a miniaturized microphone
      placed within the external auditory canal. They reflect the active mechanisms of
      the cochlea as they relate to the contractile properties of the outer hair cells,
      which determine the cochlear properties of sensitivity to and selectivity of
      frequencies. We have been studying for 5 years the clinical applications of
      otoemissions in over 500 patients. Otoemissions in 100% of normal ears may be
      recorded, and the detection threshold is generally 10 dB lower than the psycho
      physiological threshold. In pathology, otoemissions present a practical interest
      in the following applications: objective investigation of perception hearing
      loss, early screening of cochlear disease consecutive to administration of
      ototoxic drugs, or sound-induced trauma; exploration of Meniere's disease; study
      of modifications induced by osmotic substances; diagnosis of retrocochlear
      disease; quick objective assessment of cochlear function in the newborn and the
      child.

PMID- 2240999
TI  - [Trimetazidine and degenerative deafness. Effect on hearing and integration].
AB  - This study was conducted in order to assess the activity of trimetazidine dosed
      at 60 mg/day in patients presenting degenerative loss of hearing. Ten centers
      participated in this multicenter double-blind placebo-controlled trial which
      spanned 6 months. Included were 251 patients (118 women, 133 men) presenting with
      pure perception bilateral symmetrical deafness concerning predominantly the acute
      frequency range. 228 patients terminated the study, including 115 in the
      trimetazidine group and 113 in the placebo group. The evolution over a 6-month
      treatment period was significantly better with trimetazidine as regards the
      following parameters: audibility as assessed by pure-tone audiometry, namely at
      the acute frequency range (p = 0.002), intelligibility as assessed by speech
      audiometry (p = 0.008), subjective evaluation of hearing loss and its impact on
      the patient's social life. Results confirm the value of trimetazidine hearing
      loss management, based on clinical, subjective criteria as well as audiometric
      ones. Parameters reflecting best trimetazidine's efficacy were intelligibility
      and the psychological/behavioral impact of the impairment, allowing for better
      social integration of the subject.

PMID- 2241001
TI  - [A multicenter double blind versus placebos study of trimetazidine in tinnitus. A
      clinical approach to tinnitus].
AB  - This multicenter controlled double-blind study versus placebo was carried out in
      order to determine in which types of tinnitus trimetazidine dosed at 60 mg/day
      was likely to be of any therapeutical benefit. This trial was conducted over a
      period spanning 2 months and involved 13 hospital centers. Enrolled were 315
      patients presenting with subjective tinnitus. The analysis bore on 290 patients
      (136 receiving trimetazidine and 154 receiving placebo). Aside from the
      epidemiological pertinence of this study, results revealed a significantly higher
      rate of improvement with trimetazidine, as assessed on the basis of subjective
      clinical criteria, intensity (p = 0.004), periodicity (p = 0.003), and the extent
      of discomfort (p less than 0.001), as well as audiometric ones. The evolution of
      the intensity of tinnitus, as measured either by Fowler's comparative scale
      method or by masking the sick ear, varied significantly (p = 0.007 and p = 0.026,
      respectively) depending upon whether patients received trimetazidine or placebo.
      The type of tinnitus which responded best to trimetazidine was recent-onset
      tinnitus (less than or equal to 2 years) and ischemic disease related tinnitus.

PMID- 2241000
TI  - [Trimetazidine (Vastarel 20 mg) and electro-acoustic stimulation in the treatment
      of tinnitus. Apropos of 64 cases].
AB  - This open pilot study was carried out with the intent of assessing the pertinence
      of combining Vastarel 20 mg with electroacoustic stimulation, as opposed to using
      solely the electroacoustic stimulation method in the management of subjective
      tinnitus. Enrolled in the study were 64 patients presenting with subjective
      tinnitus, 50% of which were related to vascular disorders. Following the entry
      visit (clinical examination, pure-tone audiometry, Metz' test, auditory evoked
      potentials, CT scans of the internal auditory canal), the patients underwent six
      45-minute sessions of electroacoustic stimulation at one-week intervals. Half the
      patients followed this sole treatment, while the other half was immediately
      started on Vastarel 20 mg (3 tablets daily) concurrently with the first
      electroacoustic stimulation session and maintained on this regimen for 3 months.
      The electroacoustic stimulation (EAS) device used (Tinitop) was operated by
      emitting a synchronic sound signal mediated by a cask and an electric signal
      mediated by adhesive electrodes placed in the pretragal area. Results Results
      were analyzed through history-taking on the 45th and 90th days following the
      onset of the treatment, subjective improvement of tinnitus being rated from 0% to
      100% based on 25% scoring levels (0 = no effect; 100% = complete disappearance of
      tinnitus spells). At day 45, the proportion of good and very good results (50%
      improvement or more) was similar (56%), regardless of whether Vastarel 20 mg was
      or not associated with EAS therapy. On the other hand, the combination of
      Vastarel 20 mg with masking of tinnitus proved particularly useful in preventing
      recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241002
TI  - [A multicenter double blind versus placebo study of trimetazidine in tinnitus.
      Measurements of tinnitus].

PMID- 2241003
TI  - [The physiopathology of vertigo].
AB  - Vertigo is the predominant symptom in labyrinthine dysfunction, and is
      characterized by an unpleasant modification of the sense of static or dynamic
      orientation. In order to arrive at a correct clinical interpretation of this
      symptom and to administer the appropriate treatment, both its etiology and the
      underlying physiopathological mechanisms need be specified. In the present paper,
      we shall review a few qualitative concepts, which seem interesting to us and
      namely concern, on the one hand, the physiopathological mechanisms of vertigo
      and, on the other hand, the basic principles of the function of peripheral
      receptors bearing some etiological significance.

PMID- 2241004
TI  - [A multicenter double blind versus placebo study of trimetazidine in tinnitus.
      Methods].

PMID- 2241005
TI  - [A multicenter double blind versus placebo study of trimetazidine in tinnitus.
      Epidemiologic analysis of the results].

PMID- 2241006
TI  - [A multicenter double blind versus placebo study of trimetazidine in tinnitus.
      Results obtained after 2 months of treatment].

PMID- 2241007
TI  - [The efficacy of trimetazidine in cochleovestibular disorders of ischemic origin.
      A crossover control versus placebo trial].
AB  - In order to assess the efficacy of trimetazidine in the treatment of ischemia
      related cochleovestibular disorders, we carried out a double-blind placebo
      controlled study with crossover. Each treatment period spanned 2 months, during
      which the patients were given either trimetazidine (20 mg tid) or placebo,
      following a two-week washout period. Enrolled in the study were 45 patients (aged
      32 to 69 years) presenting cochleovestibular symptoms (tinnitus, vertigo, hearing
      loss). Tinnitus occurred in 99.7% of cases, deafness in 88.8%, and vertigo in
      68.8% of cases. Pure-tone and speech audiometric data were not modified.
      Improvement was felt primarily with respect to subjective symptoms. The intensity
      of vertigo events and the duration of the spells improved much more substantially
      by trimetazidine and placebo, although the limited number of patients studied did
      not allow to reach the threshold of significance. The activity of trimetazidine
      was particularly apparent in relation to tinnitus. The intensity of the latter
      symptom as well as the degree of discomfort occasioned by it diminished more
      significantly with trimetazidine than placebo following a 2-month treatment
      period (p less than 0.05 and p less than 0.02, respectively). These results
      underscore the therapeutical efficacy of trimetazidine in the treatment of
      cochleovestibular syndromes, as assessed by a rigorously controlled double-blind
      trial with crossover versus placebo using a reliable methodology.

PMID- 2241008
TI  - Delayed endolymphatic hydrops and its relationship to Meniere's disease.
AB  - Delayed endolymphatic hydrops (EH) can be characterized as having ipsilateral and
      contralateral types. They are similar in that both have early and late phases of
      otologic symptoms and that the early phase is a profound hearing loss in one ear.
      The late phases differ, however, in that the ipsilateral type develops the
      symptoms of EH (episodic vertigo) in the deaf ear and the contralateral type
      develops the symptoms of EH (fluctuating hearing loss and/or episodic vertigo) in
      the hearing ear. In more than half the cases of both types of delayed EH, the
      profound hearing losses in the early phase are simply discovered to be present in
      early childhood without a known time of onset. The temporal bones of two patients
      with contralateral delayed EH show pathologic changes in the deaf ears that are
      similar to those known to occur in mumps and measles labyrinthitis, whereas the
      pathologic changes in the hearing ears are similar to those known to occur in
      Meniere's disease. These observations support the proposition that Meniere's
      disease may occur as a delayed sequela of inner ear damage sustained during an
      attack of subclinical viral labyrinthitis occurring in childhood.

PMID- 2241009
TI  - Arachnoid granulation cerebrospinal fluid otorrhea.
AB  - A case report and review of the temporal bone (TB) collection in the Department
      of Otolaryngology at SUNY Health Science Center in Syracuse demonstrated the
      occurrence of arachnoid granulations (AGs) in the posterior fossa surface of the
      TB and their role in cerebrospinal fluid (CSF) otorrhea. A large AG responsible
      for CSF otorrhea in a 64-year-old man was excised with soft tissue repair of the
      dural defect. Sixteen of 188 TBs (8.5%) in the collection contained 24 AGs
      ranging in size from 0.07 to 80.65 mm3. Nine AGs (37%) were small (less than 1
      mm3) and did not demonstrate enlargement. Twelve (50%) were of intermediate size
      (2.50 to 9.32 mm3), and three (13%) were large (49.82 to 80.65 mm3). The
      intermediate and large AGs were associated with bone erosion and a high incidence
      of communication with a pneumatized mastoid complex (serous otitis media or
      meningitis). These findings suggest that AGs of sufficient size to produce bone
      erosion are the primary responsible lesions in adult-onset spontaneous CSF
      otorrhea.

PMID- 2241010
TI  - Nerve fiber analysis and the aging process of the vestibulocochlear nerve.
AB  - Nerve fiber analyses were performed on the human vestibulocochlear nerve stained
      with Luxol fast blue-periodic acid-Schiff-hematoxylin with use of a combination
      of an image-analyzer and a computer. The axons were counted and their transverse
      (cross-sectional) areas were measured in 12 individuals. The average numbers of
      axons in each vestibular and cochlear nerve were 17,727 and 25,098, and the
      average transverse areas of their axons were 4.02 and 1.79 microns 2,
      respectively. Amyloid bodies and intervening Schwann cells in the
      vestibulocochlear nerve were also counted. The average number of amyloid bodies
      was 246 per transverse section of the nerve and their average size was 114
      microns 2. The average number of intervening Schwann cells was 1,513. Our results
      indicated that the transverse axonal areas of the cochlear nerve became reduced
      with age, while the transverse areas of the amyloid bodies in the
      vestibulocochlear nerve increased with age. The number of vestibular nerve fibers
      did not seem to change with age.

PMID- 2241011
TI  - Dimensions of the scala tympani in the human and cat with reference to cochlear
      implants.
AB  - The width, height, and cross-sectional area of the scala tympani in both the
      human and cat were measured to provide dimensional information relevant to the
      design of scala tympani electrode arrays. Both the height and width of the human
      scala tympani decreased rapidly within the first 1.5 mm from the round window.
      Thereafter, they exhibit a gradual reduction in their dimension with increasing
      distance from the round window. The cross-sectional area of the human scala
      tympani reflects the changes observed in both the height and width. In contrast,
      the cat scala tympani exhibits a rapid decrease in its dimensions over the first
      6 to 8 mm from the round window. However, beyond this point the cat scala tympani
      also exhibits a more gradual decrease in its dimensions. Finally, the width of
      the scala tympani, in both human and cat, is consistently greater than the
      height.

PMID- 2241012
TI  - Morphometry of ampullar dark cells.
AB  - The morphologic characteristics of rat ampullar dark cells were analyzed
      quantitatively. Four parameters were measured: cell area per micron baseline
      length, membrane surface density, volume density of intercellular space, and
      volume density of vacuoles. No statistically significant difference was observed
      for any parameter, either between dark cell regions of the superior, lateral, and
      posterior ampullae or between different regions of dark cells within a given
      ampulla. The membrane surface density of the ampullar dark cells was similar to
      that reported for principal cells of the cortical collecting duct in the kidney.
      The volume density of the intercellular spaces of the dark cells was very
      constant, unlike that reported for epithelia involved in isotonic fluid
      transport. Vacuoles were found to comprise only a small portion of protoplasm in
      the dark cells. This new morphometry provides a basis on which to examine the
      response of ampullar dark cells to differing experimental conditions.

PMID- 2241013
TI  - Head stability and gaze during vertical whole-body oscillations.
AB  - To understand head and eye stabilities during upright locomotion, we investigated
      head and eye movements during vertical whole-body oscillations of various
      amplitudes (1 to 10 cm) and frequencies (1 to 3 Hz) in both normal subjects (n =
      10) and patients with bilateral labyrinthine loss (n = 5). Vertical oscillations
      produced pitching motions of the head, of which the amplitude was markedly
      altered by a change in the oscillation frequency or the displacement. Vertical
      eye movements, being correlated with pitching head movements, were scarcely
      modified by gaze at 2 and 3 Hz. Acquired bilateral lesions presented deteriorated
      head stability and physically induced eye movements under stronger stimulations.
      However, significant increase of head movement upon stepping and suppression of
      pitching motion upon running, both characteristically found in bilateral lesions,
      were not reproduced by passive oscillations. Thus, these features during active
      locomotion may result from imbalance produced by alternate bipedal motions and
      from adaptation to minimize oscillopsia, respectively.

PMID- 2241015
TI  - New set of pediatric laryngoscopes.
AB  - With new advances in pediatric otolaryngology, the awareness of difficulties with
      existing laryngoscope instruments has become more apparent. The following paper
      introduces four new pediatric laryngoscopes for use in premature infants, the
      neonate and infant, the toddler-size child, and the preadolescent-size child. The
      reasons for the need of new laryngoscopes are explained, and the modifications to
      existing scopes that are currently employed are discussed. The need for
      continuous insufflation of oxygen during difficult as well as routine intubation
      is underscored with reference to the current anesthesia literature. Ventilating
      techniques in laryngoscopy for the non-respirator-dependent child are discussed.

PMID- 2241014
TI  - Management of tracheobronchial foreign bodies in children: an update.
AB  - Tracheobronchial foreign bodies continue to be a source of morbidity and
      mortality in the pediatric population. Technical advances in anesthesia and
      equipment have made the removal of these troublesome objects more feasible.
      Diligence must still be exercised and a coordinated team effort must be employed
      in order to achieve a satisfactory and safe outcome for the patient. The
      appropriate use of diagnostic studies and management techniques are discussed.

PMID- 2241016
TI  - Tracheotomy in the first year of life.
AB  - Much has been written concerning complications of pediatric tracheotomies, but
      few studies have reviewed the complication rates of tracheotomies performed in
      the first 12 months of life. We reviewed the records of 60 patients who underwent
      tracheotomy in the first year of life between 1976 and 1988. This study includes
      30 full-term infants and 30 premature infants, 16 of whom were very low birth
      weight preterm infants (less than or equal to 32 weeks' gestation and less than
      1,500 g birth weight). Overall complication rates were 3% intraoperative, 13%
      early postoperative, and 38% late postoperative. The early postoperative
      complication rate in preterm infants was nearly double that of full-term infants.
      The late postoperative complication rate of patients undergoing tracheotomy for
      airway obstruction was more than double that of patients requiring tracheotomy
      for pulmonary indications. Duration of tracheotomy, however, was felt to be the
      most important factor in the development of a late postoperative complication.

PMID- 2241018
TI  - Facial nerve monitoring in otologic surgery: clinical indications and
      intraoperative technique.
AB  - While identification of the intratemporal portion of the facial nerve is
      mandatory in most otologic surgical procedures, inadvertent instrumentation,
      traction, or thermal injury may still result from inaccurate delineation,
      purposeful avoidance, or false protection of this critical structure. Improved
      functional preservation of the facial nerve has been achieved in acoustic neuroma
      surgery through the monitoring of evoked facial electromyographic activity. This
      technique may also be used during otologic procedures in which facial nerve
      manipulation is anticipated in the management of recurrent cholesteatoma,
      temporal bone trauma, congenital deformity, or purposeful access for cochlear
      implantation. Potential indications for using facial nerve monitoring in
      contemporary otologic surgery are detailed through illustrative case
      presentations, and necessary instrumentation and techniques are briefly reviewed.
      Intraoperative monitoring can assist the surgeon in isolating the facial nerve
      when chronic inflammation, traumatic injury, or anomalous development has
      resulted in distortion or absence of microanatomic landmarks.

PMID- 2241017
TI  - Systems architecture for quantification of dynamic myoelectric and kinematic
      activity of the human vocal tract.
AB  - This paper describes a systems architecture useful for scientific investigations
      that require the acquisition and analysis of multiple, time-synchronous signals
      in large volume. The architecture has recently been developed by this group to
      enhance our capability to research and quantify central nervous system function
      in the production of normal and pathologic speech. The architecture utilizes
      modern advances in desktop microcomputers and has been designed so that vocal
      motor control laboratories (or similar settings) with modest funding can more
      fully participate in comprehensive investigations of speech production. Research
      experiments organized with this architecture may involve many more subjects and
      measures than previously possible without significant increases in time and
      personnel resources. This paper will demonstrate the technique and practicality
      of this architecture as it is being used to successfully guide research to map
      hierarchic central nervous system regions of involvement in two speech disorders:
      spasmodic dysphonia and stuttering. The architecture has broad usefulness to many
      areas of otolaryngology and health science.

PMID- 2241019
TI  - Endoscopy of the cochlea during cochlear implantation.
AB  - We have previously demonstrated that multichannel cochlear implants may be
      effective in partially obstructed cochleas. In practice, however, it may be
      difficult to determine whether electrode insertion is feasible prior to
      attempting it. Initial trials with a flexible fiberoptic otologic endoscope on 10
      cadaver temporal bones were previously reported. On the basis of these trials,
      endoscopy of the inferior segment of the cochlea during cochlear implantation
      seemed feasible. In the present study, the same endoscope was used on eight
      subjects undergoing cochlear implantation, six of whom had partially obstructed
      cochleas. Endoscopy was found to be helpful in visualizing obstructed segments,
      determining patency after the obstruction was removed, and identifying normal
      structures of the cochlea. Documentation with videotape and 35-mm photography
      constitutes the majority of this paper.

PMID- 2241020
TI  - Titration streptomycin therapy for bilateral Meniere's disease. Follow-up report.
AB  - Initial reports of the use of parenteral streptomycin for bilateral Meniere's
      disease (MD) have demonstrated success in reducing the vestibular symptoms and,
      in some patients, stabilizing hearing. The long-term follow-up (mean, 5.1 years)
      of 19 patients treated with intramuscular streptomycin for bilateral MD is
      presented. The amount of streptomycin administered (5 to 50 g) was determined by
      clinical symptoms and by serial testing of the reduction in the slow-phase
      velocity on electronystagmography. Episodic vertigo was totally relieved in 12
      patients and improved in severity and frequency in an additional 4 patients.
      Permanent posttreatment dysequilibrium occurred in 47% of the patients treated.
      The changes in hearing (speech reception threshold) were independent of the
      therapeutic effect of streptomycin on the vestibular system. The overall results
      suggest that the intramuscular titration of streptomycin should continue to be
      considered as one of the therapeutic options in patients with disabling vertigo
      due to bilateral MD.

PMID- 2241021
TI  - Retropharyngeal abscess caused by a traumatic perforation of the hypopharynx by a
      fishbone.

PMID- 2241022
TI  - Histopathologic grading of salivary gland neoplasms: II. Acinic cell carcinomas.
AB  - Acinic cell carcinomas display varied cytoarchitectural patterns of growth that
      should allow for formulation of histopathologic grading. Grading of these
      carcinomas may serve to identify subsets whose biologic behavior is more
      aggressive than the usually accepted low-grade behavior of acinic cell carcinomas
      as a group. To that end, a three-level histopathologic grading scheme is
      presented.

PMID- 2241023
TI  - [Transepidermal elimination].

PMID- 2241024
TI  - [Perforating folliculitis].
AB  - We report the case of a 20-year old male patient without significant familial or
      personal history who presented with a disseminated papular eruption on the
      abdomen, flanks and buttocks. The eruption was continual and proceeded by
      outbreaks, but it was not influenced by seasons. Physical examination of the
      skin, mucosae and skin appendages was otherwise normal. Histological examination
      showed all the criteria of perforating folliculitis as described by Mehregan and
      Coskey. On the basis of our case we would put perforating folliculitis back among
      the perforating dermatoses. The concept of this curious phenomenon is briefly
      reviewed; perforating folliculitis is part of the third group of the so-called
      primary forms. The clinical features are suggestive of the disease, with its
      small pigmented papules centred around a keratotic plug, forming a permanent
      disseminated eruption. Histology shows a granuloma facing a lateral perforation
      of the hair follicle, a pseudo-epitheliomatous epithelial hyperplasia and the
      presence of hair and keratin debris in the perforation. Various keratolytic
      treatments have been applied without success; retinoids have not been tried. The
      main diagnostic and nosological problem is Kyrle's disease. In view of clinical
      and histological data, many authors regard Kyrle's disease as a major form of
      perforating folliculitis. Pruritus, ascribed to an underlying illness in Kyrle's
      disease, is thought to increase the importance of the lesions. The specificity of
      perforating folliculitis is discussed, but it seems that side by side with
      secondary forms occurring in recognized diseases, there may be primary forms of
      perforating folliculitis. Dyskeratosis might be a cause of the perforation.

PMID- 2241025
TI  - [Anogenital warts in children].
AB  - Fourteen cases of anogenital warts in children are reported. Girls were more
      frequently affected than boys (9/5). Three children had been infected during
      birth; two had autoinfection from non-anogenital warts; two girls had apparently
      been sexually abused. In the remaining 7 cases the origin of the warts was
      unknown. The authors discuss the epidemiological, therapeutic and social
      implications of this little known but important paediatric pathology, pointing to
      the possibility of sexual transmission in cases of "apparently" unknown origin.

PMID- 2241026
TI  - [Dental caries in 2 families with tuberous sclerosis].
AB  - Four cases of tuberous sclerosis in two families are presented. We studied the
      oral manifestations of the disease and we suggest that dental pits should be
      taken as clinical markers for diagnosis in oligosymptomatic cases. We found that
      feature in all patients affected by tuberous sclerosis.

PMID- 2241027
TI  - [Acquired post-inflammatory cutis laxa].

PMID- 2241028
TI  - [What is your diagnosis? Pseudosarcomatous fibroma of the skin or atypical
      fibroxanthoma].

PMID- 2241029
TI  - [Livedo reticularis. Review of the literature].

PMID- 2241031
TI  - [Treatment of Kaposi's disease].

PMID- 2241030
TI  - [Contact hypersensitivity. Cellular aspects].

PMID- 2241032
TI  - Free temporoparietal flap in burn reconstruction.
AB  - A series of 12 patients with deep burns resulting in exposed bones, joints, and
      tendons, in whom temporoparietal free flaps were used for reconstruction, are
      presented. Flap loss was 8.3%; good and satisfactory results were achieved in
      91.7% of healed defects. Patients with large total body surface area burns are
      severely compromised, and the use of free flaps requiring prolonged periods of
      anesthesia and surgery should be a judicious decision. Prior to the availability
      of free flaps, most of these patients are left with chronic wounds and
      compromised functional results. Although our experience is limited, we think that
      in well-selected cases a one-stage reconstruction with free tissue transfer is
      expeditious, safe, and economical.

PMID- 2241033
TI  - The medial genicular artery flap.
AB  - The anatomical basis and clinical applications of the medial genicular artery
      flap, which is supplied mainly by the cutaneous perforator of the superior medial
      genicular artery, are herein described. Based on 10 cadaver dissections, the
      nutrient artery was found to be consistent and was seen to penetrate the deep
      fascia within a small triangular area bordered by the medial femoral condyle, the
      vastus medialis, and the adductor magnus tendon. The distal end of the flap must
      cover the skin over the medial femoral condyle, and the axis of the flap is along
      the lower half of the sartorius. The proximal end of the flap can be extended
      safely beyond the midpoint of the thigh. The medial genicular artery flap is thin
      and can nicely recontour defects around the knee, with an inconspicuous donor
      site on the medial aspect of the thigh.

PMID- 2241034
TI  - Chest wall deformities and their correction in bodybuilders.
AB  - Torn pectoralis major muscles are either treated acutely by orthopedic surgeons
      or, if neglected, result in deformities of the pectoralis muscle. These
      deformities are visible, with pectoralis muscle asymmetry, especially on muscle
      contraction. Bodybuilders prone to this injury accentuate the asymmetry by
      contracting the pectoralis muscles together. Late repair is not usually possible,
      and cosmetic improvement relies on removing the bulging, unattached muscles or
      camouflaging the underlying exposed ribs with a customized implant. Similar
      customized implants are used to repair pectus excavatum. Techniques must take
      into consideration the desire for accentuation of the pectoralis muscle with
      minimal visible scarring. The surgeon and the anesthesiologist should be aware of
      the possibility of anabolic steroid ingestion in the male body-builder.

PMID- 2241035
TI  - Refracture reposition of mandibular malunion.
AB  - The second most frequently injured facial bone is the mandible. For this reason,
      the incidence of mandibular fractures remains high and will continue to represent
      a considerable percentage of acute major facial injuries encountered by
      reconstructive surgeons. Fortunately, to this date, complications have been
      relatively rare. We present our series evaluating the late sequelae from 135
      patients treated by the Division of Plastic Surgery at the University of
      California, Davis Medical Center, Sacramento, California, for mandible fractures
      during the period July 1, 1987, to June 30, 1988. From this retrospective record
      review, we found only six patients who required correction of established
      traumatic deformities. We report the surgical procedure used in these six
      patients and an additional two patients referred to our center for surgery. From
      these eight patients, we delineate the anatomical and functional deformities of
      mandibular malunion as well as the etiological factors. We will present our
      surgical method using articulating dental models and occlusal splints, and the
      application of rigid internal fixation with miniplates and screws for
      stabilization. All patients in the study presented with either malocclusion or
      facial asymmetry. We were able to return to each of the patients satisfactory
      mandibular function and facial symmetry.

PMID- 2241036
TI  - Two flag flaps based on the supratrochlear vessels for nasal reconstruction.
AB  - A short forehead or a low hairline sometimes precludes the use of a median
      forehead flap for reconstruction of defects of the lower nose when both lining
      and cover are needed. Two flag flaps based on the supratrochlear vessels were
      used in a patient with a full-thickness alar defect and a narrow, short forehead.

PMID- 2241037
TI  - Lymphoscintigraphy for melanoma: is it always predictive for lymphatic basin
      mapping?
AB  - Therapeutic decision making in treating patients with melanoma is difficult, with
      very few investigative tools and a lack of treatment options. Surgical
      extirpation remains the best method for cure and supports discussion in favor of
      prophylactic regional node dissection for subgroups of patients with stage I
      disease. In melanoma of the trunk or head and neck, lymphoscintigraphy has
      reliably provided guidance for resecting the regional lymphatics draining the
      involved site. This article describes a patient with a melanoma of the posterior
      neck, with metachronous metastases to the right and left posterior cervical
      triangles. Lymphoscintigraphy performed in the context of clinically negative
      nodal regions did not show drainage to either cervical nodal chain. Several
      explanations are presented, although a false-negative lymphoscintigraphic finding
      is the only plausible explanation. To our knowledge, this dilemma has not been
      previously reported, and raises the question of the infallibility of
      lymphoscintigraphy in predicting lymphatic basin mapping.

PMID- 2241038
TI  - Successful preexpansion of a free scapular flap.
AB  - The use of pretransfer tissue expansion of a free scapular flap is described.
      This technique allows coverage of large defects with good quality skin and
      tensionless closure of the donor site.

PMID- 2241039
TI  - Complications with the use of an axillary roll.
AB  - An axillary roll is frequently used to prevent brachial plexus compression when
      operating on a patient in the lateral decubitus position. Two complications
      resulting from the use of an axillary roll are described. Such complications can
      be avoided by placing a small roll under the upper chest rather than the axillary
      region.

PMID- 2241040
TI  - Missed breast cancer in an augmented woman using implant displacement
      mammography.
AB  - Good mammography in the augmented patient is often difficult to achieve. A case
      is described that illustrates that posterior breast tissue is generally better
      seen with standard compression mammography and that physical examination by the
      radiologist must accompany mammography. Implant displacement mammography, while
      helpful, does not eliminate the need for standard compression mammography in
      selected patients.

PMID- 2241041
TI  - Umbilical keloid: an early start.
AB  - A case of umbilical keloid formation following cord separation in an infant is
      described. Treatment involved excision of the mass and reconstruction of the
      umbilicus with histological confirmation of the excised lesion. To our knowledge,
      this is the first report of an umbilical keloid occurring at such an early age.

PMID- 2241042
TI  - Klippel-Feil anomaly, cleft palate, and bifid tongue.
AB  - The Klippel-Feil anomaly is a condition characterized by congenital vertebral
      fusion, which may be associated with a short neck and a low posterior hairline.
      In the patient presented here, there was congenital cervical fusion, cleft
      palate, and bifid tongue. The occurrence of cervical fusion and cleft palate has
      been reported previously, but this is the first report, to the author's
      knowledge, of these malformations being accompanied by a bifid tongue. The
      embryological association between Klippel-Feil anomaly and cleft palate has been
      alluded to on few occasions. Investigators have suggested that the short, fused
      neck limits movement of the head and thus of the tongue from between the palatal
      shelves. This report postulates that the mechanism is more complex and that it is
      based on a change in structural relations between certain key areas involved in
      the background of palatal shelf elevation.

PMID- 2241043
TI  - Emergency free flaps to the type IIIC tibial fracture.
AB  - Type IIIC tibial fractures are complex injuries involving extensive bone and soft
      tissue devascularization that result in a high percentage of complications and
      ultimate amputation. An emergency free flap transfer not only may salvage the
      limb but also may improve the aesthetic and functional results of reconstruction
      by placing the injured structures in a well-vascularized bed. Two cases of type
      IIIC tibial fracture were treated in this manner, and we present our experience
      with a 30-month follow-up of one patient and a 6-month follow-up of another
      patient.

PMID- 2241044
TI  - Ready-Stitch: a new device for the closure of skin wounds.
AB  - Ready-Stitch (Med United Ltd., London, UK) is a new wound closure device that may
      have considerable advantages over conventional sutures in closing skin wounds. A
      preliminary study was carried out to ascertain the most appropriate surgical self
      adhesive tape to use in the construction of Ready-Stitch. Twenty-four skin wounds
      were then closed with either Ready-Stitch or conventional sutures. Ready-Stitch
      was much preferred by patients and staff alike, produced good cosmetic results,
      and may reduce the incidence of wound infection and the likelihood of needle
      stick injury in hospital staff.

PMID- 2241045
TI  - Use of a portable floor crane as an aid to resection of the massive panniculus.
AB  - Resection of the massive abdominal panniculus is technically difficult due to the
      weight of the tissue and the difficulty in controlling the tissue during surgery.
      The authors describe the use of a portable floor crane that facilitates resection
      by reducing the number of assistants required, increasing exposure, and providing
      for adequate control of the specimen, which assures proper preoperative markings
      and sterile preparation. Blood loss is reduced, as is operating time. The
      portable floor crane is usually available in hospital maintenance departments and
      can be easily modified for intraoperative use.

PMID- 2241046
TI  - Treatment of mandibular fracture: a hypothesis.

PMID- 2241047
TI  - Re: Toxicity of cleaning agents for removal of grease from wounds.

PMID- 2241048
TI  - Re: Psychological considerations in lipoplasty: the problematic or special care
      patient.

PMID- 2241049
TI  - Typhoid ileal perforations: a retrospective study.
AB  - This report examines the characteristics of 124 patients with typhoid ileal
      perforation treated over a 17-year period ending in 1986. Three adverse
      prognostic determinants were identified: prolonged fever/perforation interval,
      prolonged perforation/operation interval and multiple perforations. Simple
      closure was performed in 74 patients with a mortality of 31.1%, and trimming of
      the ulcer with closure in 38 patients with a 7.9% mortality.

PMID- 2241050
TI  - Intra-articular and subcutaneous prilocaine with adrenaline for pain relief in
      day case arthroscopy of the knee joint.
AB  - A randomised, double-blind study was conducted to assess the influence of intra
      articular and subcutaneous prilocaine with adrenaline on postoperative pain in
      day case arthroscopy of the knee. The time to first dose of oral analgesia
      postoperatively was significantly prolonged in those patients receiving
      prilocaine but no significant difference in analgesic effect was demonstrated at
      4, 8, and 12 h after operation between the two groups.

PMID- 2241051
TI  - Dislocated arytenoid: an intubation-induced injury.
AB  - Three reports describing the morbidity resulting from intubation-induced
      arytenoid cartilage dislocation are presented. Significant factors contributing
      to such an injury are: retrognathia, dental malocclusion, a large tongue base and
      intubation inexperience. We advise that in all patients who undergo a difficult
      intubation the possibility of arytenoid dislocation should be considered. A
      ventilating bronchoscope should be readily available upon extubation, to deal
      with any acute airway problem that may arise. Treatment modalities are discussed
      and the advantages of a combined anaesthetic and ENT approach highlighted.

PMID- 2241052
TI  - The association between thyroid neoplasia and intestinal polyps.
AB  - Recent reports have suggested an association between familial adenomatous
      polyposis and papillary carcinoma of the thyroid. This report describes four
      patients, each with intestinal polyps and thyroid or thyroglossal cyst carcinoma.
      One patient had a medullary rather than papillary carcinoma of the thyroid and in
      another the intestinal polyps were due to Peutz-Jeghers syndrome. This may
      indicate a wider association between thyroid carcinoma and intestinal polyps than
      has previously been recognised.

PMID- 2241053
TI  - Suturing of digital lacerations: digital block or local infiltration?
AB  - A prospective trial was carried out to assess the relative efficiency of digital
      block and local infiltration as methods of anaesthesia when suturing lacerations
      of the digits. A standard technique and questionnaire were applied to a
      consecutive group of 62 patients attending the Accident Department of the Bristol
      Royal Infirmary. Digital block was found to be a more effective technique than
      local infiltration for anaesthetising digital lacerations.

PMID- 2241054
TI  - Anaesthetic rooms: current practice in one British health region.
AB  - In Britain it is traditional that each operating theatre has an adjacent
      anaesthetic room (1). The implications for equipping current theatre suites and
      the design of new theatres are wide-ranging. There are no data available on the
      attitudes of anaesthetists in this country towards the necessity for anaesthetic
      rooms and the extent of the anaesthetic equipment found in them. This survey in
      the North West region suggests that all consultant anaesthetists regard the
      availability of an anaesthetic room as a necessity, and most consider that the
      current level of vital-signs monitoring equipment in the anaesthetic room is
      inadequate.

PMID- 2241055
TI  - Factors influencing peritoneal catheter survival in continuous ambulatory
      peritoneal dialysis.
AB  - The success of continuous ambulatory peritoneal dialysis (CAPD) is to a great
      extent determined by the survival of the peritoneal catheter. The aim of this
      study was to identify technical factors which influence CAPD catheter survival. A
      total of 453 CAPD catheters inserted into 310 patients over an 8-year period were
      analysed. Access to the peritoneum was gained either by an open surgical
      technique (n = 290) or by a closed technique using a trocar and introducer (n =
      163). Data relating to a number of potentially significant risk/benefit factors
      were analysed using multiple regression analysis (proportional hazards method of
      Cox). Three factors were found to be independently associated with improved
      catheter survival. They were: using an open surgical insertion technique,
      performing a partial omentectomy at the time of catheter insertion and the
      procedure being performed by a consultant.

PMID- 2241056
TI  - A new surgical drainage procedure for Baker's cysts.

PMID- 2241057
TI  - Videofluoroscopy in motor neurone disease prior to cricopharyngeal myotomy.
AB  - Cricopharyngeal myotomy is a recognised treatment for the dysphagia in motor
      neurone disease, although the results are sometimes disappointing. In this study,
      27 patients with motor neurone disease causing significant dysphagia have been
      investigated by the technique of videofluoroscopy, in order to determine the
      nature of their swallowing disability; those patients found suitable have been
      offered cricopharyngeal myotomy. Of the 27 patients, only seven were found to
      have cricopharyngeal dysfunction as the predominant disability and, of these, six
      underwent myotomy, resulting in relief of dysphagia in five, three of whom
      returned to a near normal diet. Previous studies showed poor overall benefit from
      cricopharyngeal myotomy. Videofluoroscopy allows accurate patient selection, and
      a much improved outcome in the selected group.

PMID- 2241058
TI  - General surgical injuries in survivors of the M1 Kegworth air crash. Nottingham,
      Leicester, Derby, Belfast Study Group.
AB  - The general surgical consequences of the M1 Kegworth air crash are described.
      Considering the severe nature of the injuries sustained by the survivors,
      surprisingly few required general surgical intervention. Intra-abdominal injuries
      were rare despite the abdomen's apparent vulnerability to injury; only five
      laparotomies were performed. However, 30 (34%) of survivors demonstrated
      significant bruising from lap belts and 13 patients had haematuria. The majority
      of operations carried out were orthopaedic related.

PMID- 2241059
TI  - Delorme's operation for rectal prolapse.
AB  - Between 1981 and 1988 inclusive, 22 patients with full-thickness rectal prolapse
      presenting to two surgeons in this hospital were treated using the Delorme
      operation. There was no mortality and morbidity was minimal. Twenty-one patients
      (95.5%) were cured of prolapse and 19 patients (86.4%) had normal anal sphincter
      function after the operation.

PMID- 2241060
TI  - Antiseptic toxicity to breast carcinoma in tissue culture: an adjuvant to
      conservation therapy?
AB  - Of 50 patients who had scrape cytology of the excision cavity after conservative
      surgery for breast carcinoma, 10 (20%) had malignant cells remaining in the
      cavity recognised by cytology. Of these patients, 18 had histological evidence of
      tumour at the resection margin, giving an accuracy of the cytology of 84%, a
      sensitivity of 56%, and a specificity of 100%. When assayed for cytotoxicity
      against a breast tumour cell line (MCF7) or human fibroblasts, chlorhexidine
      gluconate was the most effective of eight antiseptics or antitumour agents (100%
      cytotoxicity at a 1/10,000 dilution) in killing breast tumour cells and had 70%
      toxicity to human fibroblasts at the same dilution. Hydrogen peroxide appeared to
      be the most useful agent overall with 94% cytotoxicity to breast tumour cells
      with only a 12% cytotoxicity to human fibroblasts at a dilution of 1/1,000,000.
      We suggest that free malignant cells left in the cavity after conservative
      surgery for breast cancer may be a cause of local recurrence. They can be
      recognised by scrape cytology at operation and the topical use of antiseptics as
      cytotoxic agents may be beneficial and warrants further investigation.

PMID- 2241061
TI  - Primary restorative colectomy in malignant left-sided large bowel obstruction.
AB  - A series of 18 consecutive patients who underwent primary resection and immediate
      anastomosis as the treatment for malignant left-sided large bowel obstruction are
      presented. Intraoperative mechanical preparation of the colon was omitted. There
      was no clinical evidence of anastomotic dehiscence or wound infection. The mean
      duration of hospital stay was 11 days. It is suggested that colonic continuity
      can be restored immediately and safely without mechanical bowel preparation,
      providing attention is directed to constructing an anastomosis that has a good
      blood supply and is free from tension.

PMID- 2241063
TI  - Outpatient carpal tunnel decompression without tourniquet: a simple local
      anaesthetic technique.
AB  - Carpal tunnel release was performed under local anaesthesia in 108 wrists of 98
      patients. The local anaesthetic (bupivacaine 0.5% and adrenaline) was injected
      into the subcutaneous tissue down to the flexor retinaculum in the line of the
      incision. The median nerve was not anaesthetised. No tourniquet was required and
      analgesia was complete in all but four patients, who complained of some minor
      discomfort on cutting the flexor retinaculum. Protracted postoperative analgesia
      was obtained.

PMID- 2241064
TI  - Comment on presentation of statistics.

PMID- 2241062
TI  - Testicular obstruction: clinicopathological studies.
AB  - Genital tract reconstruction has been attempted in subfertile men with
      obstructive azoospermia (370 patients) or unilateral testicular obstruction (80
      patients), and in vasectomised men undergoing reversal for the first (130
      patients) or subsequent (32 patients) time. Histopathological changes in the
      obstructed testes and epididymes, and immunological responses to the sequestered
      spermatozoa have been studied to gain insight into possible causes of failure of
      surgical treatment. The results of surgery have been assessed by follow-up sperm
      counts and occurrence of pregnancies in the female partners. The best results
      were obtained with vasectomy reversal (patency 90%, pregnancy 45%), even after
      failed previous attempts (patency 87%, pregnancy 37%). Epididymovasostomy gave
      good results with postinfective caudal blocks (patency 52%, pregnancy 38%), while
      postinfective vasal blocks were better corrected by total anatomical
      reconstruction (patency 73%, pregnancy 27%) than by transvasovasostomy (patency
      9%, no pregnancies). Poor results were obtained with capital blocks (patency 12%,
      pregnancy 3%), in which substantial lipid accumulation was demonstrated in the
      ductuli efferentes; three-quarters of these patients had sinusitis, bronchitis or
      bronchiectasis (Young's syndrome). There is circumstantial evidence to suggest
      that this syndrome may be a late complication of mercury intoxication in
      childhood. After successful reconstruction, fertility was relatively reduced in
      those men who had antibodies to spermatozoa, particularly amongst the
      postinfective cases. Similarly, impaired fertility was found in men with
      unilateral testicular obstruction and antibodies to spermatozoa. Mononuclear cell
      infiltration of seminiferous tubules and rete testis was noted occasionally,
      supporting a diagnosis of autoimmune orchitis; although rare, this was an
      important observation as the sperm output became normal with adjuvant
      prednisolone therapy.

PMID- 2241065
TI  - Junior medical staff and the assessment of trauma.

PMID- 2241066
TI  - Complications of choledochal cysts in adulthood.

PMID- 2241067
TI  - Theatre delay for emergency general surgical patients: a cause for concern?

PMID- 2241068
TI  - The presentation of malrotation of the intestine in adults.

PMID- 2241069
TI  - [Transfusion and AIDS? Who should be transfused?].

PMID- 2241070
TI  - [Limb trauma during parachuting].

PMID- 2241071
TI  - [Surgical prevention of radiation injuries of the small intestine].

PMID- 2241073
TI  - [A technique of cholecystectomy by minilaparotomy without cutting muscles].
AB  - A surgical incision for cholecystectomy is described. It is characterized by its
      small size, to reduce peritoneal exposure and the resulting postoperative ileus,
      and the absence of muscular section, to minimize pain and parietal injury. The
      skin incision is transverse, symmetrical to the midline, 6 cm in length and
      located 8-10 cm from the xyphoid process. Then a transverse division of linea
      alba extending 1.5-2 cm on both sides of the two walls of the rectus sheath,
      without muscular section, is made. Cholecystectomy is commenced at the fundus and
      continued downwards.

PMID- 2241072
TI  - [Improvement in the healing of colonic anastomoses by vitamin B5 and C
      supplements. Experimental study in the rabbit].
AB  - To study the effects of vitamins B5 and C on the healing process of colonic
      anastomoses, 3 groups of 20 rabbits were given daily either placebo (group A), or
      vitamin B5 (100 mg/kg: group B) or vitamin C (100 mg/kg: group C). After 8 days
      of supplementation, via a midline incision and under general anaesthesia, 2
      colonic segments were removed, and the continuity was restored. On the 3rd post
      operative day, the rabbits were killed and the anastomoses were removed.
      Mechanical properties of both normal colon and anastomoses were determined by
      using bursting pressure tests, number of burst anastomoses, fibroblast count,
      hydroxyproline concentration and determination by microanalysis of trace element
      content: Mg, P, S, Ca, Fe, Cu, Zn and Mn. Vitamin B5 (p = 0.03) and vitamin C (p
      less than 0.01) both decreased the number of burst anastomoses. Furthermore the
      required bursting pressure values were higher with vitamin C (p = 0.01) than in
      controls. Both vitamins restored normal Zn levels at the anastomotic site,
      whereas these levels decreased on the 3rd post-operative day during the normal
      healing process of colonic anastomosis. Moreover, vitamins B5 and C increased Fe,
      Cu and Mn levels, which are intimately all involved in collagen synthesis.
      Vitamins B5 and C enhance the colonic wound healing process in the rabbit, acting
      together in synergy in vivo as well as in vitro, as previously demonstrated.

PMID- 2241074
TI  - [Thrombosis of the superior mesenteric artery and perforation of the appendix in
      a young girl].
AB  - Intestinal infarction is due to arterial occlusion or to a thrombosis of the
      superior mesenteric vein in the case of intra-abdominal sepsis. We report a case
      unique as far as we know of thrombosis of the superior mesenteric artery due to
      an appendicular abscess in a young girl without any vascular-risk.

PMID- 2241075
TI  - [Results of endoscopic ultrasonography in the preoperative assessment of rectal
      cancer].
AB  - Endoscopic transrectal ultrasonography is performed with an ultrasonic transducer
      (7.5 MHz or 12 MHz) in the tip of a side viewing endoscope. Its accuracy to
      assess the depth of rectal cancer invasion was prospectively studied in 27
      patients. The ultrasonic examination was correct in 23 cases; in 4 cases, the
      stricturing tumour could not be passed by the probe. The depth of invasion was
      correctly appreciated in 24 of the 27 cases (accuracy of 89%). The 6 superficial
      lesions were all correctly detected with endoscopic transrectal ultrasonography.
      Therefore, endoscopic transrectal ultrasonography appears to be a very promising
      method in the pretherapeutic staging of rectal cancer.

PMID- 2241076
TI  - [Contusions of the liver in adults. Initial non-operative management with
      computerized tomography follow-up is a reasonable therapeutic option. Report of
      16 cases].
AB  - Nonoperative management of blunt liver injury in adults still remains
      controversial. From February 1985 through September 1989, 27 patients were
      treated for blunt hepatic trauma: 11 required immediate operation and 16 (59%)
      were initially managed nonoperatively after evaluation of intraabdominal injury
      by computerized tomography. All of these 16 patients were hemodynamically stable
      and had no significant peritoneal signs. CT criteria for nonoperative management
      included subcapsular and intrahepatic hematoma, capsular tear or unilobar
      fracture, absence of large hemoperitoneum, absence of large devitalized liver and
      absence of other intraabdominal organ injuries. Clinical follow-up, repeated
      radiologic examinations and surgery confirmed the accuracy of CT. Only 2 patients
      required delayed operation (12.5%). Serial abdominal CT studies are an integral
      part of the conservative treatment of blunt hepatic injuries and showed complete
      resolution of hepatic injuries in the fourteen nonoperated patients in less than
      six months. No death and no delayed septic or biliary complications were noted.
      Mean hospital stay was seventeen days for all of the patients (multiple injuries
      or not) and only ten days for isolated blunt liver injury. These good results
      depend on identification of candidates for nonoperative management on strict
      clinical and CT criteria. Nonoperative management of adult blunt liver injury
      based on these findings is a useful alternative in a selected group of
      hemodynamically stable patients and decreases the rate of non-therapeutic
      coeliotomy.

PMID- 2241077
TI  - [Pathology of the inferior vena cava and liver transplantation].
AB  - Pathology of the inferior vena cava is not frequently encountered in the context
      of liver transplantation. Such a pathology was observed in 7.9% of our
      recipients, in the pre- intra- and post-operative period. Pre-existing anomalies
      of the IVC consisted the absence of the retrohepatic vena cava in 7 children with
      biliary atresia; technical adjustments were quite simple. During the operative
      period, dissection of the supra-hepatic vena cava was made very difficult in 2
      patients with hepatic alveolar echinococcosis complicated by secondary biliary
      cirrhosis it was necessary to make a trans-diaphragmatic approach to the inferior
      vena cava. Post-operative inferior vena cava thrombosis occurred in four
      recipients, in three cases, it was caused by the inadequate size of the graft and
      major anastomotic discrepancy between the inferior vena cava of donor and
      recipient and in one case IVC thrombosis occurred in a context of allergy to
      heparin. Six of the 13 recipients with pathology of inferior vena cava died
      directly of indirectly because of these problems. Analysis of the causes of this
      pathology and their possible correction will perhaps allow better results in
      these patients who undergo liver transplantation.

PMID- 2241078
TI  - [Treatment of peritoneal carcinomatosis by intraperitoneal chemo-hyperthermia
      with mitomycin C. Initial experience].
AB  - Intra-peritoneal chemo-hyperthermia with mitomycin C was used to treat 9 patients
      with very advanced gastrointestinal cancers with peritoneal seedings. Resection
      of the primary tumor was possible in 3 cases. After temporary of closure of the
      abdominal wall, 90 to 120 minutes of intra-peritoneal chemo-hyperthermia was
      performed under general anaesthesia with 32 degrees C of systemic hypothermia,
      via 3 intra-peritoneal drains forming a closed circuit, using 10 mg/l of
      mitomycin C in 61 of peritoneal dialysate warmed at the inflow temperature of 46
      to 49 degrees C. We observed no mortality or morbidity. There were only minor and
      temporary laboratory side effects and for 6 patients, no malignant cells could be
      found in the ascitic fluid after intra-peritoneal chemo-hyperthermia. In six
      patients, we conserved an improvement in the Karnofsky index 3 to 7 months after
      intra-peritoneal chemo-hyperthermia. These results show that intraperitoneal
      chemo-hyperthermia with mitomycin C is a safe and reliable treatment for
      peritoneal seedings in severely advanced gastrointestinal cancers and encourage
      us to proceed with this new therapeutic modality.

PMID- 2241079
TI  - [Gastroesophageal reflux and respiratory manifestations: diagnostic approach,
      therapeutic indications and results].
AB  - The authors report a study of 140 patients presenting with a non-allergic
      respiratory tract disease (121 cases of asthma--19 cases of spasmodic cough).
      Gastro-oesophageal reflux was detected by 24-hour pHmetry in 86 of these
      patients. In 34 of them (i.e. 40% of cases), the gastro-oesophageal reflux
      appeared to be responsible for the initial respiratory tract symptoms. These 34
      patients were submitted to a therapeutic trial of high dose anti-H2 therapy for
      at least two months. Only those patients in whom a marked improvement or even
      complete resolution of the respiratory tracts symptoms was observed underwent
      anti-reflux surgery. Out of the 13 patients undergoing surgery, there were two
      failures and 11 good results after a follow-up of more than 18 months.

PMID- 2241080
TI  - [Segmentation of the liver and anatomical variants of the portal system].
AB  - The authors, who studied 605 human livers according to various techniques,
      present their own anatomo-surgical conception of human liver segmentation, based
      on the distribution of the whole intrahepatic Glisson's system, and by dividing
      the liver into two hemi-livers, right and left (the term "lobe" being reserved,
      according to Ton-That-Tung, for the classical anatomical lobes): the right hemi
      liver is subdivided into two segments: anterior and posterior; the left hemi
      liver is subdivided into three segments: medial (IV), lateral-anterior (III) and
      lateral-posterior (II); the dorsal segment (I) or the classical Spigel's lobe
      tends to overlap both half livers (more on the left than on the right). The
      authors then describe, indicating the percentages, the typical patterns and
      anatomical variants of intersegmental fissures and the portal system. During the
      discussion, the authors say that, according to their experience, the right hemi
      liver segments can be divided into some smaller units: the posterior segment into
      two subsegments (VI and VII) and the anterior ones into three subsegments (V,
      VIIIi and VIIIe); and they justify the segmental division of the left hemi-liver.
      The authors conclude that statistical and analytical study can define a typical
      anatomical pattern but that, owing to many anatomical variants, it is easier to
      perform the transparenchymal approach to the vasculo-biliary structures,
      enveloped in the same Glisson's capsule, rather than to make long and dangerous
      dissections at the porta hepatis.

PMID- 2241081
TI  - [Conservative treatment of the spleen. Report of 50 cases].
AB  - From 1983 to 1989, 50 patients have been treated by spleen conservation.
      Traumatism was iatrogenic in 9 cases, caused by public highway accidents in 31
      cases, domestic accident in 9 cases and penetrating trauma in one case. Spleen
      conservation includes: 26 partial splenectomies, 11 cauterisations, 10 sutures, 5
      auto-transplantations, and 3 abstensions after laparotomy and little spleen
      trauma. Three deaths were observed secondary to cerebral trauma, and two
      complications have been seen: one during the operative solved by total
      splenectomy, and one rebleeding after splenorraphy, reoperated and splenectomy
      was performed with good evolution. The follow-up of partial splenectomy showed
      that splenic remnant keeps an epuration activity.

PMID- 2241083
TI  - Evidence against linkage of the gene for Usher's syndrome type 1 with group
      specific component (GC) on chromosome 4.
AB  - A linkage of the gene for Usher's syndrome with group specific component (GC) on
      the long arm of chromosome 4 has been suggested by Pelias et al., in 1988. A
      panel of 38 individuals from 7 kindreds with Usher's syndrome type 1 has been
      established to test this hypothesis. A negative lodscore was found and close
      linkage was excluded.

PMID- 2241082
TI  - [Gonadotropic adenoma. Clinical and hormonal characteristics].
AB  - The main clinical and hormonal features of gonadotropin secreting adenomas (GSA)
      are reviewed through the literature and our personal data. There is still no
      agreement about their definition and frequency. The most classical clinical
      presentation is that of men aged 50 years or more, bearing a large pituitary
      adenoma, the only biological expression of which is a moderately elevated serum
      FSH level. Female cases are less recognised and are underestimated because the
      serum LH and/or FSH elevated levels are not informative in menopausal women. The
      assay of the alpha subunit may help in these cases. In premenopausal women, few
      of them having been described so far, the GSA may be revealed by an amenorrhea
      galactorrhea syndrome with a mild hyperprolactinaemia which may result from
      different mechanisms. The absence of gonadal hyperactivity, and, conversely, the
      frequent hypogonadism associated with GSA lead the clinician to raise some
      questions: are all GSA able to secret gonadotropins? How is the bioactivity of
      the LH and/or FSH secreted by GSA? How reliable are the radioimmunoassays
      routinely used for measurement of LH and FSH in patient's serum? Furthermore,
      therapeutical management of GSA is still impaired by the lack of documented
      medical treatments which could control their growth and prevent their recurrence.

PMID- 2241084
TI  - Holoprosencephaly in a fetus with a 46,XX,der(7), t(7;8)(q36.1;p12) mat
      karyotype.
AB  - In this report we present a female fetus with hemilobar holoprosencephaly and
      46,XX,der(7)t(7;8)(q36.1;p12) mat karyotype. The holoprosencephaly-sequence is
      apparently related with the distal 7(q36.1----qter) deficiency.

PMID- 2241085
TI  - A paternal balanced translocation [t(7;22)(q32;q13.3)] leading to reciprocal
      unbalanced karyotypes in two consecutive pregnancies.
AB  - A family is reported in which a man with a balanced reciprocal translocation
      [46,XY,t(7;22)(q32;q13.3)] fathered a daughter who was trisomic for the region
      7q32----7qter and monosomic for 22q13.3----22qter, and a male fetus who was
      monosomic for 7q32----qter and trisomic for 22q13.3----22qter. The meiotic
      segregation of this translocation, as well as the phenotypes of the unbalanced
      offspring, are discussed.

PMID- 2241086
TI  - Homozygosity of a 6/18 translocation in a hydatidiform mole.
AB  - In a complete mole the chromosome investigation revealed a reciprocal
      translocation 6/18 in a homozygous status. The chromosome polymorphisms of the
      conceptus could be derived from those of the father. The delineation of the
      karyotype of the conceptus is discussed. A previous pregnancy of the mother had
      also led to an abortion of a hydatidiform mole.

PMID- 2241087
TI  - Duplication 16q12----qter arising from 3:1 segregation in a 46,XX,t(13;16)
      (q12;q12) mother.
AB  - A congenitally abnormal female baby was found to have the karyotype 46, XX, +der
      (16) t (13; 16) (q12;q12) mat. GTG, QFQ, CBG, THA and Ag-NOR banding techniques
      allowed the identification of the abnormal chromosomes in the proposita and in
      the translocation carriers through three generations. Duplication 16q resulted
      from 3:1 segregation in the carrier mother. The hypothesis of a specific meiotic
      segregation for this translocation is discussed. The phenotypic effects of
      proximal 16q duplications are analysed together with other four reported cases,
      which have similar duplicated segment and no other relevant chromosomal
      abnormality.

PMID- 2241088
TI  - Retinal cone dystrophy and chromosome 6(q26) deletions.

PMID- 2241089
TI  - Revision of the chromosome anomalies of the T-cell malignant cell line peer.
AB  - A high resolution chromosome banding method was applied to define the karyotype
      of the PEER cell line. It was found significantly different from that previously
      described, and can be characterized as follows: 46,XX,-4, del(5) (q21q23),
      del(6)(q14q22), del(9)(p12p21), i(9p), +der(4) rea(4) involving a large
      duplication of 4q. The cell cycle duration varies in relation to the time after
      splitting, slow from 0 to 48 h and faster from 48 to 96 h. The average time found
      was 25 h with durations of 6 and 15 h for G2 and S-phases, respectively. This
      variable cell cycle led us to change the conditions of BrdU incorporation to
      obtain a convenient R-banding. According to our own experience, this can be
      transposed to many other malignant cells to obtain a high resolution chromosome
      banding.

PMID- 2241090
TI  - 12q13 fragility in a family with recurrent spontaneous abortions: expression of
      the fragile site under different culture conditions.
AB  - A fragile site at the 12q13 band was found in metaphases from lymphocyte cultures
      of three members of a family. A comparison of the frequency and expression of the
      fragile site was carried out on cells cultured in RPM-I 1640 with and without
      BrdU and in 199 media. The fragile site was not typically folate-sensitive, being
      expressed in standard medium as well as in cultures after exposure to BrdU.

PMID- 2241091
TI  - Interstitial deletion of the band 4p15.3 defined by sequential replication
      banding.
AB  - A 15-year-old boy with intellectual disability was found to have a de novo
      interstitial deletion in the short arm of chromosome 4. Using GTL banding and
      sequential replication banding the deleted band was found to be the more terminal
      of the two G dark sub-bands of 4p15, that is 4p15.3. The karyotype was defined as
      46,XY,del(4)(p15.2p16.100). To our knowledge this specific deletion has not been
      previously described.

PMID- 2241092
TI  - Joubert syndrome. Review of the fifty-three cases so far published.
AB  - Joubert's syndrome (JS) is an autosomal recessive disorder, which is
      characterised by a variable combination of central nervous, respiratory and eye
      anomalies. We review the clinical characteristics of the 53 so far reported
      children with Joubert's syndrome, stressing the importance of recognising the
      syndrome in the neonatal period, in order that specific and effective therapeutic
      measures be started as soon as possible.

PMID- 2241093
TI  - Increased adenosine deaminase activity in a patient with cartilage-hair
      hypoplasia.
AB  - A boy aged 9 years presenting short stature and recurrent respiratory-tract
      infections was studied. The clinical and roentgenological pictures allowed the
      diagnosis of cartilage-hair hypoplasia (metaphyseal chondrodysplasia, McKusick
      type). Biochemical studies disclosed a four-fold increase in adenosine deaminase
      activity, but without evidence of anemia. Immunological evaluation showed
      abnormal cellular but normal humoral immunity.

PMID- 2241094
TI  - Evaluation of the ras and myc oncoproteins in benign gastric lesions.
AB  - Ras and c-myc oncoprotein expression was analyzed using specific monoclonal
      antibodies Y13-259 (for ras p21) and mycl-9E10 (for c-myc p62) in 144
      histological sections derived from benign gastric lesions. Increased expression
      of ras p21 was observed in inflammatory metaplastic, dysplastic, hyperplastic and
      cystic histological changes, and on the basis of ras p21 staining three distinct
      histological groups emerged: (i) cystic changes, hyperplastic polyps; (ii)
      inflammatory gastritis; (iii) metaplastic, dysplastic and adenomatous polyps.
      Elevated levels of ras p21 expression were found at significantly higher levels
      than those of c-myc expression in dysplastic lesions. However the expression of
      the c-myc oncoprotein was less frequent than ras p21 in all other histological
      types. With the exception of parietal cells, normal stomach mucosa was found to
      express low levels of both ras p21 and c-myc oncoproteins.

PMID- 2241095
TI  - Invasive glioma cells in tissue culture.
AB  - Malignant human glioma is characterized by an uncontrolled cell proliferation and
      infiltrative growth into the brain. The mechanisms by which invasion occurs are
      poorly understood. Due to recent development in tissue culture methods, it is
      possible to study invasion in organotypic coculture systems consisting of glioma
      spheroids and reaggregated fetal brain cells. Spheroids from well-characterized
      continuous human glioma cell lines have been tested for invasiveness in this
      model, which also allows studies of the invasive capacity of glioma cells derived
      from biopsy material within a week after surgery. Invasion may furthermore be
      studied in chemically defined media. The methods of studying in vitro glioma
      invasiveness are reviewed, together with recent results which may throw light
      upon important mechanisms related to glioma invasion, at the peri- and
      extracellular level. Mechanisms of glioma cell invasion are discussed with
      emphasis on the interactive process between cells, growth factors, proteolytic
      enzymes and the extracellular matrix.

PMID- 2241096
TI  - Cell death via apoptosis and its relationship to growth, development and
      differentiation of both tumour and normal cells.
AB  - Cell death can occur by two possible mechanisms, necrosis or apoptosis. Necrosis
      is the classically recognised form of cell death and is characterised by high
      amplitude swelling of the mitochondria, nuclear flocculation and uncontrolled
      cell lysis. Tissue necrosis is normally seen following severe trauma to cells.
      The alternative form of cell death is via a programmed sequence of events and is
      termed apoptosis. Apoptosis occurs under a variety of physiological conditions
      and cells dying by this process undergo cytoplasmic and nuclear condensation,
      coupled with cleavage of the cell's DNA into nucleosome size fragments. DNA
      cleavage is due to the activation of a specific endogenous endonuclease. The cell
      finally fragments into apoptotic bodies which are engulfed by neighbouring cells
      and degraded. Apoptosis is an energy requiring process requiring intact energy
      generating systems, unlike that of necrosis. In relation to malignant disease,
      apoptosis is the mechanism by which cytotoxic T cells kill tumour target cells;
      it may also be the mechanism which accounts for the high loss of cells in growing
      tumour masses. Extensive apoptosis is seen in regressing tumours and also in
      those treated with chemotherapeutic agents. This form of death may require the
      activation of specific death genes, although in view of work carried out in this
      and other laboratories, demonstrating that inhibitors of both protein and RNA
      synthesis will readily induce apoptosis, this may not be universal. Finally,
      apoptosis has far reaching implications for the treatment of malignant disease,
      since only by understanding how cells die will be able to develop more effective
      means of killing them.

PMID- 2241097
TI  - A potential role for antisense oligonucleotide analogues in the development of
      oncogene targeted cancer chemotherapy.
AB  - The identification of activated oncogenes as the basic biochemical difference
      between tumour cells and normal cells has opened up the possibility for
      development of truly tumour specific chemotherapy. It may be hypothesized that
      malignant cells would revert to a more normal phenotype and might even be
      triggered into terminal differentiation if expression of the appropriate
      oncogenes were inhibited. Although, at present, it is not possible to anticipate
      what form future therapy based upon this approach would take, it is clear that
      the immediate priority must be to establish the general validity of the
      hypothesis with a variety of tumour cell types in vitro. For this purpose
      antisense oligonucleotide analogues appear to offer considerable promise as
      sequence specific inhibitors of oncogene expression. However, no analogue
      structure yet devised fulfils all the requirements of an ideal antisense effector
      in terms of biological stability, cell uptake, non-toxicity, hybridization
      efficiency and mechanism of action on target nucleic acids. Inhibition of
      oncogene expression in certain cell types has been reported using antisense
      oligonucleotides but the technique is not universally applicable and more
      detailed biochemical investigations of the interactions of oligonucleotides with
      intact cells are required before improved structures may be developed.

PMID- 2241098
TI  - Colorectal carcinogenesis: sequential steps in the in vitro immortalization and
      transformation of human colonic epithelial cells (review).
AB  - The development of colorectal cancer is an excellent example of the complex
      multistage nature of carcinogenesis and most colorectal cancers are thought to
      develop from adenomas. In this paper we have reviewed in vitro models developed
      in our laboratory for the study of human colorectal carcinogenesis. For these
      studies epithelial cell lines have been isolated from hereditary and sporadic
      colorectal adenomas representing different stages in tumour progression.
      Karyotypic analysis has shown specific abnormalities of chromosomes 1, 7, 14, 17,
      18 and 22 to occur in these premalignant adenoma cell lines. The majority of cell
      cultures derived from small adenomas (less than 1 cm in diameter) senesced
      whereas the larger adenomas (greater than 2 cm in diameter) were more likely to
      give rise to immortal cell lines indicating that the acquisition of in vitro
      immortality occurs at a relatively late stage of colorectal carcinogenesis.
      Abnormalities of chromosome I have been implicated in tumour progression and in
      the in vitro immortalization of colorectal adenomas. Furthermore, several stages
      have been described in the transformation of an adenoma cell line PC/AA to a
      tumorigenic phenotype. Sodium butyrate and the potent carcinogen N-methyl-N-nitro
      nitrosoguanidine (MNNG) were used in this transformation. Sodium butyrate is
      proposed to act as a possible promoter of colorectal carcinogenesis, and MNNG to
      cause the further genetic changes required for the conversion of the premalignant
      cells to a carcinoma. Markers to study the progression of an adenoma cell line to
      a tumorigenic phenotype in vitro include in vitro immortalization, aneuploidy,
      clonogenicity, resistance to the inhibitory effects of sodium butyrate, anchorage
      independent growth, ras gene activation, production of active proteinases and
      tumorigenicity in athymic nude mice. A role for a constitutively produced tumour
      promoter in colorectal carcinogenesis is discussed together with the possibility
      that different events are involved in the development of sporadic versus
      hereditary tumours due to the importance of the microenvironment in hereditary
      cancer. Our in vitro progression provides the first experimental evidence for the
      adenoma to carcinoma sequence and the cytogenetic evidence suggests that it is
      relevant to in vivo carcinogenesis.

PMID- 2241099
TI  - Response of human immunodeficiency virus long terminal repeat to growth factors
      and hormones.
AB  - We have employed a recombinant plasmid, pBHIV1, carrying the long terminal repeat
      (LTR) of the human immunodeficiency virus-1 (HIV-1) linked to the reporter
      chloramphenicol acetyl transferase (cat) gene and to the aminoglycoside
      phosphotransferase (aph) gene as a selectable marker. We have introduced pBHIV1
      in rat 208F and human MRCSV40TGR fibroblasts and obtained stable geneticin
      resistant RFBHIV1-1 and SVTGHIV-1 transfectant cells respectively. Both RFBHIV1-1
      and SVTGHIV1-1 cells express CAT activity from the HIV LTR promoter. The response
      to insulin, epidermal growth factor, hydrocortisone and dexamethasone was studied
      on the LTR regulated CAT activity in both cell lines. It was found that, at
      optimal concentrations, insulin, epidermal growth factor and hydrocortisone
      regulate positively the expression of CAT from the HIV LTR in rat RFBHIV1-1 but
      not in human SVTGHIV1-1 cells. On the other hand dexamethasone at 10(-5) M
      stimulated CAT activity in both types of cells.

PMID- 2241100
TI  - Genetic regulation of metastatic progression.
AB  - Metastasis is a complex process which results in the growth of tumor cells at
      sites distant from the primary neoplasm. It is likely that many of the large
      number of biological changes associated with metastatic ability are controlled
      through alterations in the expression of a relatively small number of key genes
      usually referred to as cellular oncogenes and tumor suppressor genes. These genes
      are normally required for the regulation of growth-related processes in the cell,
      and alterations through mutations and/or expression are important in establishing
      metastatic properties of malignant cells. In this article, we review evidence
      indicating that oncogenes play an important role in metastatic spread, and we
      have placed emphasis on studies with the ras oncogenes. Metastatic progression is
      dependent upon an accumulation of multiple genetic changes in malignant cells.
      Therefore, we have also briefly addressed the related questions of altered growth
      factor regulation, and the cooperative interactions observed between dominantly
      acting oncogenes and between these genes, and tumor suppressor genes.

PMID- 2241101
TI  - Enzyme kinetics of thymidine kinase isoenzymes of Ehrlich ascites tumour.
AB  - Three isoenzymes of thymidine kinase (TK) identified on Ehrlich ascites tumour
      corresponding to pl values of 5.3, and 6.9 and 8.3 were studied with respect to
      their kinetic properties. The isoenzymes were separated by thin-layer isoelectric
      focusing and measured in the presence of thymidine (TdR) as substrate,
      adenosinetriphosphate (ATP) as phosphor donor and deoxythymidinetriphosphate
      (dTTP) as inhibitor. Exponentially growing cells and growth inhibited cells were
      used with high proportions of the isoenzymes at pl values of 6.9 and 8.3, and 5.3
      respectively. The concentrations of the former were further enhanced by the use
      of S-phase cells isolated by elutriator centrifugation. The isoenzymes were
      identified as TK1-onc, earlier found in human leukemia cells. In order to confirm
      the existence of TK1, particular at pl value 5.3, the ability of the isoenzymes
      to use different phosphor donors (ATP and uridinetriphosphate (UTP)) and
      substrates (TdR and deoxycytidine (dCdR) was also studied. These results showed
      that the isoenzymes at pl 6.9 and 8.3 correspond to TK1, while the isoenzyme at
      pl 5.3 is heterogeneous. Further, high resolution isoelectric focusing confirmed
      the existence of two isoenzymes at pl values of 5.1 and 5.3, representing
      mitochondrial (TK2) and cytoplasmic (TK1) isoenzymes.

PMID- 2241102
TI  - Influences of various substrata on morphology, motility and invasiveness of rat
      tumour cells. II. Studies on the highly metastatic variant BSp 73 ASML.
AB  - In a previous paper we studied the influences of the basal lamina and its
      components on the invasive but nonmetastatic variant BSp 73 AS of a rat
      pancreatic adenocarcinoma. In continuation of this publication we used the in
      vivo strongly metastasizing but hardly invasive variant BSp 73 ASML. On plastic
      or glass supports the low passaged ASML-cells grew separately, spread very
      scarcely and remained passive. Compared to these standard culture conditions, the
      behaviour of the tumour cells could be modified by biomaterials like collagen
      type I/III and type IV, fibronectin, laminin, matrigel, lens capsule and basal
      lamina. On these substrata (compared to plastic supports) the ASML-cells showed
      increased spreading, filopodial outgrowth and secretion of membrane vesicles.
      Only signs of motility as well as penetration of the biomatrices could be
      observed. Interestingly, highly passaged ASML-cells displayed an increased
      tendency to spread even on plastic. Under dynamic conditions these cells even
      failed to adhere. Obviously the biomatrices in vitro as well as long-term
      passaging are able to lead the ASML-cells partly to reactivate the behaviour that
      is characteristic of malignant tumour cells. Additionally, there is some evidence
      that the ASML-cells in vitro can strongly respond to chemotactic stimuli by
      exhibiting both flattening and translocative motility.

PMID- 2241103
TI  - Epidermal growth factor receptors in human tumors of the central nervous system.
AB  - Epidermal growth factor receptors (EGF-R) have been measured in human tumors of
      the Central Nervous System (CNS) by 125I EGF ligand binding. High affinity
      receptors (Ka congruent to 1 x 10(9) M-1) were detected in nearly all individual
      specimens of meningiomas and tumors of glial origin (astrocytomas,
      glioblastomas). The phosphotyrosine kinase activity associated with the EGF-R was
      evaluated by measuring the incorporation of gamma 32P-ATP, after
      immunoprecipitation of the receptor with the monoclonal antibody EGFRI. A good
      relationship was observed between the EGF-binding capacity and the
      autophosphorylation of the receptor, indicating that in most cases functional
      molecules of EGF-R were expressed on the tumor membranes. In the group of
      meningiomas, no relationship could be established between the EGF-R level and the
      histopathology of the tumors. Astrocytomas exemplify a progression of malignancy,
      from benign (low grade astrocytomas) towards an increased malignant phenotype
      (glioblastomas). In this group, our observations indicate a positive relationship
      between the EGF-R level and phosphokinase activity and the degree of malignancy.

PMID- 2241104
TI  - Antitumor activity of a novel synthetic polyamine analogue, N,N'-bis-[3
      (ethylamino)-propyl]-1-7-heptane diamine: potentiation by polyamine oxidase
      inhibitors.
AB  - The requirement of the natural polyamines, putrescine, spermidine and spermine,
      for cell growth suggests that appropriate structural analogues of these compounds
      could serve as potential antiproliferative agents acting via polyamine
      antagonism. In this investigation, the antiproliferative activity of N, N'-Bis[3
      (ethylamino)-propyl]-1-7-heptane diamine (BEPH), a synthetic polyamine analogue,
      was investigated employing HeLa cells in culture and L1210 leukemia in mice. BEPH
      inhibited the growth of HeLa cells with an IC50 of 0.25 microM during a four day
      culture period. This concentration of the compound was cytotoxic to the cells as
      evidenced by an 80% reduction in cloning efficiency. Only marginal changes in
      intracellular polyamine concentrations were observed during incubation with 0.25
      microM BEPH. In both HeLa cells and L1210 cells in culture, incorporation of
      radioactive precursors into DNA, RNA and protein were reduced by BEPH. Inhibition
      of protein synthesis was discernible prior to inhibition of RNA and DNA in these
      cells. In mice inoculated i.p. with 10(5) L1210 cells on day 0, i.p.
      administration of 10.0 mg/kg of BEPH qd(X5) beginning on day 1 prolonged the
      survival time by 84% compared to controls. The same dose of the compound, in
      combination with 10.0 mg/kg of N,N'-bis-2-3-butadienylputrescine, an inhibitor of
      the polyamine catabolizing enzyme polyamine oxidase (PAO), produced a 100% cure
      rate. Similar results were obtained when BEPH was combined with N-methyl-N'-2-3
      butadienylputrescine, another PAO inhibitor. Furthermore, animals cured of the
      leukemia by the combination chemotherapy were resistant to a subsequent challenge
      with L1210 cells, indicating the development of tumor "immunity". The striking
      antitumor activity along with the development of tumor immunity indicate that
      synthetic polyamine analogues have potential for development as antineoplastic
      agents.

PMID- 2241105
TI  - Comparative in vitro binding characteristics and biodistribution in tumor-bearing
      athymic mice of anti-ovarian carcinoma monoclonal antibodies.
AB  - The interactions of four monoclonal antibodies (OV-TL 3, OV-TL 16, OV-TL 30 and
      OC 125) with ovarian carcinoma cells (NIH: OVCAR-3) were compared in vitro as
      well as in a nude mouse model. The affinity constants of the antibodies ranged
      from 1.0 X 10(9) M-1 (OC 125) to 3 X 10(9) M-1 (OV-TL 30). The cell binding
      kinetics of the antibodies were studied in vitro: OV-TL 30 associated fastest
      (50% binding after 25 min), OV-TL 3 and OV-TL 16 associated more slowly (50%
      binding after 75 min), while the association of OC 125 was slowest (50% binding
      after 120 min). Dissociation rates of the antibodies also differed: OC 125
      displayed the lowest dissociation rate (t1/2 = 360 min). The OV-TL antibodies
      showed a faster, biphasic dissociation characteristic. The biodistribution of the
      radioiodinated antibodies in NIH:OV-cAR-3 xenograft-bearing athymic mice,
      following intravenous injection, was compared. Highest tumor accumulation 48 h
      p.i. was found with OV-TL 3 (13.3 +/- 2.1% ID/g) and OV-TL 16 (11.0 +/- 2.0%
      ID/g), while the uptakes of OV-TL 30 and OC 125 were markedly lower (4.9 +/- 0.9%
      and 6.0 +/- 0.9% ID/g, respectively). The fact that in this experimental model
      the in vivo tumor accumulation of OV-TL 3 and OV-TL 16 was approximately twice as
      high as the tumor accumulation of OC 125 could not be fully ascribed to
      parameters of the antibodies determined in vitro (immunoreactive fraction,
      affinity constant, antigen density, association and dissociation rate). It is
      suggested that the antibodies OV-TL 3 and OV-TL 16 are suitable tools for
      clinical radioimmunodetection of ovarian carcinomas.

PMID- 2241106
TI  - Factors in prostate cancer metastasis.
AB  - Death related to prostate cancer is invariably due to the tumor metastasis (to
      lungs, skeleton and lymph nodes). Tumor cell metastatic behaviour is still poorly
      understood. The R3327 prostate tumor model in the male Copenhagen rat offers an
      opportunity to investigate the different aspects of metastatic processes in vivo
      and to evaluate effects of current and new treatment approaches. Lymphatic spread
      of cancer cells can be measured by determining volume of local load in successive
      draining lymph node stations. Surgical removal of primary tumor and inguinal
      lymph node shows that lymphatic metastasis in the R3327-MATLyLu tumor variant is
      a continuous progressive phenomenon, which starts already in early stages of
      tumor growth after subcutaneous transplantation. Spread to the lungs can be
      quantified by enumeration of macroscopically visible pleural lung colonies.
      Metastatic spread to the lungs can be mimicked by intravenous injection of
      monodispersed tumor cell suspension. Within 10 days pleural tumor colonies become
      visible. Effects of different agents and treatments like chemotherapeutic drugs,
      heparin, surgery and high energy shock wave (HESW) treatment have been described
      using these methods. Recently, metastasis to the vertebral column was induced by
      temporal occlusion of venous blood flow through the caval veins while injecting
      tumor cells in the lateral tail vein. The resulting osteoblastic metastatic
      lesions in the lumbar vertebrae and the concomitant spinal cord compression led
      in time to the loss of motoric and sensory function of the hind legs. These
      observations permit investigation of the mechanisms of bone metastasis based on
      biological functions, i.e. sensory and motoric function of the hind legs.
      Finally, it can be said that the various variants of the R3327 rat prostate tumor
      offer an appropriate model to study various aspects of prostate cancer and
      metastasis.

PMID- 2241107
TI  - Is vitamin D deficiency a risk factor for prostate cancer? (Hypothesis).
AB  - Prostate cancer is a major cause of cancer death among males, yet little is known
      about its etiology. We hypothesize that Vitamin (Hormone) D deficiency may
      underlie the major risks for prostate cancer, including age, Black race, and
      northern latitudes. These factors all are associated with decreased synthesis of
      Vitamin D. Mortality rates from prostate cancer in the U.S. are inversely
      correlated with ultraviolet radiation, the principal source of Vitamin D. This
      hypothesis is consistent with known antitumor properties of Vitamin D, and may
      suggest new avenues for research in prostate cancer.

PMID- 2241108
TI  - Phenotypic stability of B16-BL6 melanoma exposed to low levels of tyrosine and
      phenylalanine.
AB  - We previously demonstrated that tyrosine (Tyr) and phenylalanine (Phe)
      restriction suppresses metastatic heterogeneity of B16-BL6 (BL6) melanoma and
      selects for tumor variants with decreased metastatic potential. In this study, we
      investigate stability of this Tyr- and Phe-modulated tumor phenotype by
      sequentially transplanting BL6 in vivo into mice fed Low Tyr and Phe Diet.
      Metastatic potential of BL6 is suppressed after one subcutaneous passage.
      Suppression is unlikely to result from inhibition of tumor growth, since growth
      in vitro is significantly increased. The metastatic potential of the Tyr- and Phe
      modulated tumor is unstable after in vivo passage, and lung colonizing ability is
      regenerated after ten in vivo passages. Conversely, the antimetastatic effect of
      Tyr and Phe restriction is stable after prolonged in vitro passage. The
      metastatic potential of tumors from mice fed Normal Diet is unstable after long
      term in vitro culture. Sensitivity to adriamycin of BL6 from mice fed Low Tyr and
      Phe Diet is increased and is not altered by change in metastatic potential.

PMID- 2241109
TI  - Differentiation-related alterations in the plasma membranes of chemically
      transformed murine fibroblasts.
AB  - One of the pathways of action of the differentiation-inducing agent DMF, in
      chemically transformed AKR-MCA fibroblastic cells, is through the concurrent
      restoration of the synthesis of the cell-surface adhesion molecule fibronectin
      and receptors for fibronectin. In order to identify plasma membrane components
      that are intimately associated with the induction of differentiation by DMF in
      the AKR-MCA cells, we have purified, characterized and compared the plasma
      membranes prepared from DMF treated and untreated AKR-MCA cells and from DMF
      treated and untreated AKR-2B cells (untransformed control cells). While DMF was
      found to have a non-discernible effect on the plasma membranes of the
      untransformed AKR-2B control cells, it restored the expression of several major
      AKR-2B associated plasma membrane proteins to the transformed AKR-MCA cells.
      These included major plasma membrane proteins of molecular weight 46 and 38
      kilodaltons which were identified by one-dimensional SDS-PAGE, and two other
      major silver staining proteins identified by two-dimensional gel electrophoresis.
      Plasma membrane carbohydrate moieties were also analyzed by 125I-lectin probes
      following SDS-PAGE fractionation and electrophoretic transfer of plasma membranes
      to nitrocellulose. Differences in the radiolabeled Con A and RCA 1 binding
      profiles were observed between the untransformed and transformed cells. DMF
      induced an overall restoration of the untransformed AKR-2B associated lectin
      binding profiles to the differentiated AKR-MCA cells. This study identified
      several plasma membrane proteins and lectin binding carbohydrate moieties, the
      qualitative or quantitative alterations of which were intimately associated with
      chemical transformation and differentiation induction of the transformed cells.

PMID- 2241110
TI  - Differentiation can convey resistance to transformation by activated ras
      oncogene.
AB  - Nonterminal cellular differentiation has recently been shown to induce
      transformed cells to revert to a benign state and to become resistant to
      retransformation by chemical and physical carcinogens without limiting their
      proliferative potential. Nonterminal differentiation also induces native 3T3 T
      mesenchymal stem cells to become resistant to transformation induced by numerous
      chemical and physical carcinogens. This characteristic has been designated
      anticancer activity. In the current study, experiments show that cells expressing
      differentiation-associated anticancer activity are also resistant to
      transformation by the activated ras (EJras) oncogene. Resistance to EJras
      transformation is shown not to result from a reduced efficiency of DNA
      transfection nor from reduced integration of EJras into the genome. Moreover, the
      results show that the EJras oncogene product can be expressed in cells
      demonstrating anticancer activity. Nonterminal cellular differentiation,
      therefore, induces resistance to transformation caused by activated ras oncogene
      as well as to numerous physical and chemical carcinogens.

PMID- 2241111
TI  - Growth factor modulation of metastatic lung colonization.
AB  - Altered production and response to growth factors is often involved in neoplasia
      but little is known about their effect on the dissemination of tumors. Therefore,
      we have examined the effect of growth factors on metastatic lung colonization.
      Autocrine induction of the metastatic phenotype was demonstrated in NIH-3T3 cells
      transformed by a signal peptide-bFGF gene but not bFGF in the absence of the
      signal peptide. In addition, exogenous growth factor regulation of metastasis was
      demonstrated. Treatment of ras transformed C3H-10T 1/2 cells and ras or src
      transformed NIH-3T3 cells with bFGF prior to intravenous injection resulted in
      potent inhibition of metastatic potential. Stimulation of v-fms transformed cells
      by the natural fms-ligand, CSF-1, resulted in potent stimulation of metastatic
      behavior in freshly plated or refed cells, whereas following autocrine
      conditioning of the medium, the metastatic properties of these cells were
      sensitive to inhibitory effects of CSF-1. These observations indicate that
      specific growth factors can regulate the metastatic phenotype and, depending on
      the oncogenes responsible for cell transformation and autocrine conditioning,
      these effects can be either stimulatory or inhibitory.

PMID- 2241113
TI  - Stroke in pediatric acquired immunodeficiency syndrome.
AB  - In a 4 1/2-year period, 4 of 68 children in a longitudinal study of neurological
      complications of human immunodeficiency virus (HIV) infection had clinical and/or
      neuroradiological evidence of stroke, yielding a clinical incidence of stroke in
      this population of 1.3% per year. During this period, 32 subjects died, and
      permission for autopsy was granted in 18 of the patients, including 3 of 4 who
      had clinical evidence of stroke. The prevalence of cerebrovascular pathological
      features in our consecutive autopsy series was higher than the clinical
      incidence. At autopsy cerebrovascular disease was documented in 6 (24%) of 25
      children with HIV infection, including all 3 children who had clinical evidence
      of stroke. Four patients had intracerebral hemorrhages, 6 patients had
      nonhemorrhagic infarcts, and 3 had both. Hemorrhage was catastrophic in 1 child
      and clinically silent in 3 children, all of whom had immune thrombocytopenia. One
      child had an arteriopathy that affected meningocerebral arteries. In another
      child, the arteries of the circle of Willis were aneurysmally dilated. Two
      children had coexisting cardiomyopathy and subacute necrotizing
      encephalomyelopathy with vascular proliferation. These results suggest that
      stroke should be considered when children with HIV infection develop focal
      neurological signs.

PMID- 2241112
TI  - CA-125 monitoring in the management of ovarian cancer.
AB  - In 100 ovarian cancer patients serum CA-125 was monitored during treatment and
      follow-up to verify the prognostic value of its pre-surgery marker level and the
      usefulness of the test for disease monitoring. A low pre-operative CA-125 was not
      associated with improved survival or progression-free survival. A significant
      survival advantage was evident for patients in whom the marker had decreased
      during treatment, compared to patients in whom the antigen remained unchanged or
      increased. In 40 patients CA-125 was measured before second look laparotomy: the
      marker was negative in 100% of patients in, pathological complete response and in
      53.5% of patients with residual disease at second look. A marker increase was
      evident in 32 of 41 patients with either progressive or recurrent disease, and in
      17 patients the CA-125 increase was documented from 1 to 9 months before clinical
      evidence of progression. The pre-operative level of CA-125 did not appear to be
      of prognostic value. However, the monitoring of CA-125 during treatment and
      follow-up can provide a reliable method of assessing response and prognosis. CA
      125 monitoring is particularly useful for early detection of recurrence.

PMID- 2241114
TI  - Myasthenic thymus and thymoma are selectively enriched in acetylcholine receptor
      reactive T cells.
AB  - We compared T-cell proliferative responses to acetylcholine receptor (AChR) and
      to purified protein derivative (PPD) (of tuberculin) of hyperplastic thymus,
      thymoma, and blood cells from patients with myasthenia gravis (MG). Hyperplastic
      MG thymus cells gave significantly higher and more consistent responses to AChR
      than parallel cultures of autologous blood cells, whereas responses to PPD showed
      an opposite trend. Thus there was a preferential localization of AChR-reactive T
      cells in the hyperplastic MG thymus. Furthermore, there was a strong correlation
      between blood and thymus cell responses to PPD (but not to AChR), arguing that
      the hyperplastic MG thymus contains a sample of sensitized peripheral T cells. By
      contrast, both AChR- and PPD-responsive T cells were almost undetectable in
      thymus from nonmyasthenic patients, which is evidently much less receptive to
      circulating T cells. Cells from MG thymomas showed the highest stimulations by
      AChR but did not consistently react to PPD. However, the uninvolved thymus
      adjacent to these thymomas behaved almost identically to the hyperplastic samples
      described above. Our interpretation is that AChR-specific T cells are initially
      sensitized in the MG thymoma but are selectively trapped in the hyperplastic
      thymus after being primed elsewhere.

PMID- 2241115
TI  - Auras and subclinical seizures: characteristics and prognostic significance.
AB  - The characteristics and prognostic significance of subclinical seizures and
      independent auras were studied in 40 patients with partial epilepsy who had long
      term electroencephalographic (EEG) monitoring with intracranial electrodes.
      Focal, restricted subclinical seizures were noted in 23 patients, and 11 patients
      experienced auras that were accompanied by ictal EEG discharges. Auras and
      subclinical seizures usually were identical in EEG appearance, but were
      distributed differently among patients. The subclinical seizures and auras
      usually had the same origin as complex partial seizures, but did not always
      reliably indicate complex partial seizure origin. Subclinical seizures and auras
      were of favorable prognostic significance for patients undergoing temporal
      lobectomy. A majority (greater than 80%) of individuals with subclinical seizures
      and auras were free of complex partial seizures after surgery, whereas a minority
      (29%) of patients without subclinical seizures and auras became free of complex
      partial seizures.

PMID- 2241116
TI  - Increased MEPP frequency as an early sign of experimental immune-mediated
      motoneuron disease.
AB  - Intracellular recordings of miniature end-plate potentials were performed in
      extensor digitorum longus muscles from guinea pigs with experimental immune
      mediated motoneuron destruction. In the early stages of the disease, the
      miniature end-plate potential frequency was elevated compared to that in control
      and normal animals. The amplitude and time course of the miniature end-plate
      potentials as well as the resting potential of the muscle fibers were not
      altered, which implies integrity of the postjunctional membrane. The increase in
      frequency of miniature end-plate potential reflects an increase of basal
      acetylcholine release and documents dysfunction of the presynaptic terminal of
      the neuromuscular junction. The increased frequency was associated with high
      levels of antimotoneuronal IgG in the blood and the presence of IgG at motor end
      plates. These data suggest that the presynaptic terminal of the neuromuscular
      junction may be involved in the immune attack in animal models of motoneuron
      degeneration.

PMID- 2241117
TI  - Anoxic injury of mammalian central white matter: decreased susceptibility in
      myelin-deficient optic nerve.
AB  - The rat optic nerve, a typical central nervous system white matter tract, rapidly
      loses excitability when it is exposed to anoxia and is irreversibly damaged by
      prolonged anoxia. Neonatal optic nerve is extremely resistant to anoxia-induced
      dysfunction and injury; the adult pattern of response to anoxia appears between
      10 and 20 days postnatal, that is, during the period of oligodendroglial
      proliferation and myelination. To test the hypothesis that myelination, or
      associated events, confer anoxic susceptibility on developing white matter, we
      analyzed the effects of anoxia on the myelin-deficient (md) strain of rat.
      Acutely isolated optic nerves from 19- to 21-day-old md rats and control optic
      nerves from unaffected male littermates were maintained in vitro at 37 degrees C,
      and exposed to a standard 60-minute period of anoxia. The supramaximal compound
      action potential was recorded and amplitude of the compound action potential,
      expressed as % of amplitude before anoxic exposure, was determined. The compound
      action potential was nearly abolished within 3 to 6 minutes after onset of anoxia
      in control optic nerves, while optic nerves from md rats displayed a slower
      decrease in compound action potential amplitude during anoxia, with a distinct
      action potential present even after 60 minutes of anoxia. Optic nerves from md
      rats showed significantly greater recovery of compound action potential (71 +/-
      25%) than did control optic nerves (33 +/- 21%; p less than 0.02) after 60
      minutes of anoxia. These findings support the hypothesis that myelination, or
      changes associated with it, may be important in the development of anoxic
      susceptibility in central white matter.

PMID- 2241118
TI  - Major histocompatibility complex antigen expression in the affected tissues in
      amyotrophic lateral sclerosis.
AB  - Monoclonal antibody immunocytochemistry was used to examine spinal cord and
      muscle in amyotrophic lateral sclerosis for changes that would indicate ongoing
      or potential immune activity. Increased expression of class I and II major
      histocompatibility complex (MHC) antigens was seen in the affected areas of
      spinal cord. New MHC expression was concentrated in phagocytes, particularly in
      degenerating white matter in which they were dispersed in the tissue and also
      packed around blood vessels. MHC antigen was not revealed in motor neurons or
      skeletal muscle fibers. An anti-pan-T-cell monoclonal revealed small numbers of T
      cells in degenerating white matter. Similar changes have been seen in other
      neurodegenerative disorders. They suggest a potential for (secondary) cell
      mediated activity in the affected areas rather than an ongoing MHC-restricted T
      cell response. Vessel-associated phagocytes may be a source of antigen to
      peripheral lymphoid tissue, stimulating production of the autoantibodies that
      have been described.

PMID- 2241119
TI  - Cerebral circulation and oxygen metabolism associated with subclinical
      periventricular hyperintensity as shown by magnetic resonance imaging.
AB  - A combined magnetic resonance imaging and positron emission tomography study was
      performed on 21 patients with cerebrovascular risk factors but without
      neurological abnormalities. Our purpose was to investigate the hypothesis that
      periventricular hyperintensity (PVH) reflects ischemia. Periventricular
      hyperintensity was evaluated with a method we devised, and cerebral circulation
      and oxygen metabolism were evaluated with the oxygen-15 steady-state technique.
      We concluded that the brain with severe periventricular hyperintensity had
      abnormal circulation, although oxygen metabolism was not measurably affected. The
      role of a compensation mechanism under conditions of decreased oxygen supply was
      considered.

PMID- 2241120
TI  - Drop attacks with Meniere's syndrome.
AB  - We report the clinical features of 12 patients with drop attacks associated with
      Meniere's syndrome. Each described a sensation of being pushed, thrown, or
      knocked to the ground or a sudden illusion of movement of the environment that
      led to a fall. These episodes were not accompanied by symptoms of their typical
      attacks of Meniere's syndrome. The drop attacks occurred early and late in the
      course of the disease; they were the initial manifestation in 1 patient. In the
      majority the episodes spontaneously remitted, although Meniere's syndrome
      continued to progress. These attacks probably result from a sudden mechanical
      deformation of the otolithic membrane of the utricle or saccule due to pressure
      gradients within the inner ear. They are important to recognize because their
      prognosis is relatively benign compared to other causes of drop attacks.

PMID- 2241121
TI  - Electroencephalography laboratory diagnosis of prolonged QT interval.
AB  - Patients with prolongation of the QT interval are at risk for significant
      neurological morbidity and mortality secondary to ventricular tachyarrhythmias.
      These patients frequently undergo electroencephalographic (EEG) examination to
      evaluate episodes of loss of consciousness, which may be associated with
      convulsions. Electrocardiogram recording as a part of the EEG is a simple and
      common practice, but analysis for possible QT prolongation is not routinely
      performed by electroencephalographers. This is, in part, due to the fact that
      while calculation of the corrected QT interval is straight forward, a calculator
      is generally required. A nomogram that is presented simplifies determination of
      the corrected QT interval, facilitating diagnosis of prolongation of the QT
      interval in the EEG laboratory.

PMID- 2241122
TI  - Spinal cord compression with paraplegia in xanthomatosis due to
      normocholesterolemic sitosterolemia.
AB  - A 48-year-old woman with a 30-year history of tendinous xanthomatosis developed
      paraplegia. The magnetic resonance image revealed extramedullary tumors. The
      analysis of her sera and tumors revealed increased amount of plant sterols,
      especially sitosterol, and the diagnosis of sitosterolemia was made. This is the
      first reported case of a patient with sitosterolemia who had the neurological
      complication of spinal cord compression due to extramedullary sitosterolemic
      xanthomas.

PMID- 2241123
TI  - Recurrent seizures in children with Shigella-associated convulsions.
AB  - Fifty-five children with Shigella-associated convulsions were followed
      prospectively to investigate their risk of subsequent febrile or nonfebrile
      seizures. The duration of the follow-up period was between 6.9 and 14.1 years
      (9.7 +/- 3.1 years). No case of nonfebrile seizures and only 2 cases (3%) of
      subsequent febrile seizures were observed during this period. We conclude that
      although febrile and Shigella-associated convulsions share many clinical
      features, the natural history of these two conditions seems to be distinctly
      different. Shigella-related convulsions are not associated with an increased
      incidence of subsequent febrile or nonfebrile convulsions.

PMID- 2241124
TI  - Ergotamine headache mistaken for temporal arteritis.

PMID- 2241125
TI  - Report of unusual HIV transmission demands attention, not legislation.

PMID- 2241126
TI  - Hemophiliac patients in surgery. Implications for perioperative nurses.
AB  - The introduction of plasma clotting factor concentrates has changed the treatment
      of patients with clotting factor deficiencies dramatically. They have enabled
      hemophiliacs to be independent and have some control over the management of their
      disease as informed participants. This has played a role in shortening the number
      of hospitalizations that hemophiliacs may have to endure and to decrease the
      length of stay when they are admitted. Additionally, staff who care for these
      patients do not need to be afraid of the disease if they are aware of the disease
      process and the therapy available for its amelioration.

PMID- 2241127
TI  - Fractures. Types, treatment, perioperative implications.

PMID- 2241128
TI  - Perioperative nurse internship. Designing, implementing a collaborative program.

PMID- 2241129
TI  - Outpatient hernia repair. The Shouldice technique.

PMID- 2241131
TI  - Outpatient care needed for AIDS patients.

PMID- 2241130
TI  - Fibrous bile duct obstructions. Diagnosis, treatment, prognosis.
AB  - International experiences with operative repair of fibrous strictures indicate
      that satisfactory results are obtained with 80% to 85% of patients at least three
      years after the stent is removed. Although opinion regarding the length of time
      stents should be left in place is not unanimous, stents usually can be removed
      six months after operation. The mortality rate associated with this operative
      procedure should be between 1% and 2%. Benign fibrous obstruction of the bile
      duct occasionally occurs, especially after cholecystectomy. Operative repair,
      usually with the use of anastomosis of the hepatic duct to the jejunum, gives the
      best long-term results. Percutaneous transhepatic dilation with the long-term use
      of a stent to prevent restricture at times is indicated and can be curative.

PMID- 2241132
TI  - Recommended practices. Surgical hand scrubs. AORN Recommended Practices
      Coordinating Committee.

PMID- 2241133
TI  - Ambulatory surgery nurses have unique opportunities to provide patient care.

PMID- 2241134
TI  - Enhancing trauma skills.

PMID- 2241135
TI  - Software terms and technology; bits and bytes; disk compatibility; 'boot' disks.

PMID- 2241136
TI  - Informed, assisted, delegated consent for elderly patients.

PMID- 2241137
TI  - Applications of the 'captain of the ship' doctrine.

PMID- 2241138
TI  - Body image and weight preoccupation: a comparison between exercising and non
      exercising women.
AB  - Relationships were examined among certain personality characteristics and
      variables which assess weight, diet, and appearance concerns for two groups of
      women--those who were avid exercisers (n = 86) and those who exercised only
      occasionally or not at all (n = 72). Multiple regression analyses indicated that
      emotional reactivity (measured by the N scale of the Eysenck Personality
      Inventory) was strongly related to weight preoccupation (measured by three
      subscales of the Eating Disorder Inventory) in both groups. Body Mass Index
      (BMI), but not a measure of subjective body shape, also predicted weight
      preoccupation for the non-exercisers while the opposite relationship was found
      for exercisers. In this group, subjective body shape and not BMI influenced
      weight preoccupation. It was also found that greater body dissatisfaction was
      related to poorer emotional well-being in the exercise group, and these women
      reported, to a significantly greater degree than non-exercisers, that their
      physical appearance was important to their self-esteem. It is possible that an
      excessive preoccupation with diet and body shape leads some women to take up a
      vigorous exercise program. However, the absence of differences in weight
      preoccupation between the groups argues against this. A possibility that has
      seldom been considered in the literature is that dedication to regular exercise
      fosters a heightened degree of body narcissism and a distorted impression of
      one's body size. A focus of attention in an exercise program on the relationship
      between body size and maximal performance may, in susceptible individuals,
      increase the likelihood of developing an obsessive attitude toward weight
      control.

PMID- 2241139
TI  - Opioid effects on intake of sweet solutions depend both on prior drug experience
      and on prior ingestive experience.
AB  - Two experiments investigated the effect of opioids on ingestion of sweet
      solutions in non-deprived rats. Experiment 1 replicated previous work from our
      laboratory showing virtually complete inhibition of sucrose and saccharin intake
      during 10 days of daily naloxone treatment. During recovery, prior naloxone
      experience significantly stimulated sucrose intake but had no effect on saccharin
      intake. In the absence of naloxone treatment, ingestive experience alone reduced
      naloxone's typical intake-suppressant effect. These findings suggest that drug
      experience and ingestive experience may interact to determine the intake
      suppressant effect of naloxone. Experiment 2 examined the effects of opioid
      agonists on sucrose ingestion during 10 days of initial drug treatment and 5 days
      of recovery. A low dose of the kappa agonist U-50,488H significantly stimulated
      sucrose ingestion during the drug treatment period and this effect persisted for
      several days after treatment ended. Initial (non-significant) intake suppressant
      effects of the mu agonist morphine or a high dose of U-50,488H tended to decrease
      with repeated testing and did not reappear during recovery. These data suggest
      that in addition to immediate, direct effects on motivation, opioids may affect
      long-term changes in responsiveness to sweet tastes.

PMID- 2241140
TI  - Mechanisms of action of the intragastric balloon in obesity: effects on hunger
      and satiety.
AB  - We evaluated the effect of a 500-ml intragastric balloon (Ballobes) on some
      aspects of eating-related behaviour and weight loss on nine massively obese
      patients. An 800-kcal mixed meal test was performed some days before, 2-3 days
      and 2 months after the implant of the balloon. A hypocaloric program was started
      after the second meal test. At hourly intervals, before and after the meal,
      patients were asked to rate the desire to eat, hunger, satiety and prospective
      consumption of food. After 2 months, weight loss was 12.0 +/- 5.1 kg. A
      significant decrease in the balloon diameters was observed, but none completely
      deflated. During the meal test performed 2-3 days after the implant, subjects
      rated themselves as significantly less hungry, fuller and desiring to eat less
      food. These patterns, however, returned to the baseline levels at the meal test
      performed after 2 months. No relationship was found between weight loss and
      reduction in the balloon diameters, nor between the latter and the changes in
      temporal profiles of eating ratings. The effect of a 500-ml balloon on meal
      related hunger and satiety therefore seems to disappear with time.

PMID- 2241141
TI  - The effects of d-amphetamine on food intake of humans living in a residential
      laboratory.
AB  - Two groups, each consisting of three normal weight, male research volunteers,
      lived continuously in a residential laboratory for 15 days. All contact with the
      experimenters was through a networked computer system and subjects' behaviors,
      including food intake, were continuously recorded. During the first part of the
      day, subjects remained in their private rooms doing work activities. During the
      remainder of the day, they had the option to socialize with each other. A wide
      variety of food items were continuously available. Subjects controlled their own
      patterns of food intake, and could consume any item, or number of items, at any
      time during the day. Beverages containing d-amphetamine (10 mg per 70 kg) or
      placebo were consumed daily at 0930 and 1630 hrs. Amphetamine significantly
      reduced total daily caloric intake to about 70% of placebo levels. The reduction
      in intake was a consequence of a decrease in number of eating occasions per day;
      no changes in mean intake per occasion were observed. Amphetamine produced
      similar decreases in the daily number of snack and meal items, and in protein,
      fat, and carbohydrate intake. These results demonstrate that amphetamine has
      significant effects on human food intake, and the study of human feeding behavior
      under similar naturalistic conditions should provide important information about
      the behavioral actions of drugs affecting food intake.

PMID- 2241142
TI  - Effects of variety on food intake of underweight, normal-weight and overweight
      women.
AB  - The food intake of 27 underweight, normal-weight and overweight women was
      monitored during laboratory luncheon meals of solid food units (SFUs), bite-sized
      spirals of bread with different sandwich fillings. Simultaneous, but not
      sequential, presentation of three SFU flavors increased intake compared to
      presentation of a single flavor in normal-weight and overweight women. Neither
      variety manipulation enhanced intake in the underweight women, who are more than
      the other subjects in all conditions. The fact that the foods were so similar
      probably reduced the effectiveness of the variety manipulations. Overweight and
      normal-weight subjects had different patterns of intake, but only when eating a
      single flavor of SFU. Only overweight subjects ate less when three flavors of
      SFUs were hidden from view in the apparatus used to monitor intake. This
      procedure prevented subjects from selecting particular flavors of SFUs.
      Differences in cognitive restraint probably do not explain the differences in the
      eating behavior of normal-weight and overweight subjects in the present study.
      Lack of dietary restraint or a high level of hunger may account for the different
      eating behavior of the underweight subjects compared to the other subjects.

PMID- 2241143
TI  - Preferences and intake measures of salt and sugar, and their relation to
      personality traits.
AB  - The inter-relationship of personality with dietary intake of salt and sugar, and
      with hedonic responses to saltiness and sweetness, was examined among 62 female
      and 38 male university students. Thirty-five personality traits were assessed
      using five standard questionnaires: (1) Sixteen Personality Factor (16PF), (2)
      Jenkins Activity Survey (JAS), (3) Eysenck Personality Questionnaire (EPQ), (4)
      Multidimensional Health Locus of Control (MHLC), and (5) Sensation Seeking Scale
      (SSS). Dietary intakes of salty and of sweet foods were estimated from dietary
      frequency questionnaires. Hedonic responses to sodium chloride in beef broth and
      to sucrose in lemonade were measured by category scaling of like/dislike and by
      ad libitum addition to maximum preference. While subjects with a high salt intake
      liked saltier broths (p less than 0.05), a similar relationship was not found for
      sugar intake and sweetness preferences. Hedonic scaling of both saltiness and
      sweetness was highly related to the ad libitum results. Only a few significant
      personality effects were observed. The more outgoing individuals liked sweeter
      lemonade than the more reserved subjects, and subjects who felt they had self
      control over their health liked lower levels of salt in broth, while those who
      felt that chance or others controlled their health liked higher levels. Using
      personality traits as independent variables in step-wise multiple regression
      analysis accounted for 13% of the variance in the concentrations of salt and
      sugar, respectively, which received maximum hedonic responses.

PMID- 2241144
TI  - The effect of high pH upon diphtheria toxin conformation and model membrane
      association: role of partial unfolding.
AB  - Penetration of membranes by diphtheria toxin in vivo is at least partially
      triggered by a low pH-induced conformational change occurring within the lumen of
      an acidic organelle. In order to gain insight into the nature of this change the
      behavior of the toxin at high pH was characterized and compared to that
      previously determined at low pH. We find that near pH 10.5 a major conformational
      change occurs. This change is accompanied by a marked decrease in fluorescence
      intensity, a red shift in fluorescence emission maximum, and increased
      susceptibility of protein fluorescence to acrylamide quenching. Differential
      scanning calorimetry shows that the high pH conformational change involves a
      cooperative endothermic unfolding transition. These changes at high pH are very
      similar to those induced by low pH, supporting the conclusion that the changes at
      low pH also involve a denaturation-like process. In addition, at high pH the
      toxin gains the ability to bind to model membranes, again similar to its behavior
      at low pH. On the basis of these studies we conclude that exposure of hydrophobic
      sequences due to partial unfolding is one dominating component in inducing
      hydrophobic behavior at both high and low pH, but that at low pH Asp/Glu
      protonation also contributes to hydrophobicity.

PMID- 2241146
TI  - Variations in the activity of glutathione reductase and the cellular glutathione
      content in relation to sensitivity to methylviologen in Escherichia coli.
AB  - To study the function of glutathione reductase and glutathione in Escherichia
      coli the coding sequence of the bacterial glutathione reductase gene (gor gene)
      was cloned into the vector pBR322, and the gor gene was expressed under the
      control of the promoter of the tetracycline-resistance gene (tet gene) in
      different Escherichia coli strains. Cells of the gor-mutant strain SG5 containing
      the vector pBR322 (SG5:pBR322) had no detectable glutathione reductase activity
      and a significantly lower total glutathione (GSH + GSSG) content relative to
      control cells of the strain JM101 (JM101: pBR322). The gor mutant cells were less
      sensitive to inhibition by methylviologen (as defined by changes in growth) than
      cells of the strain JM101. Elevated levels of both glutathione reductase activity
      and the total glutathione content (GSH + GSSG) were found when the gor gene was
      expressed in cells of the gor-mutant strain SG5 (SG5:pJIK1). Thus the activity of
      glutathione reductase is essential in order to maintain a high glutathione
      content. Furthermore, cells of the strain SG5: pJIK1 showed an increased
      sensitivity to methylviologen compared to cells of the gor mutant containing the
      vector pBR322 alone without the cloned gor gene insert (SG5:pBR322). In all
      experiments, the glutathione pool (GSH + GSSG) of bacterial cells was 90%
      reduced. In methylviologen-sensitive sodB mutant cells lacking iron superoxide
      dismutase activity (QC773:pBR322) overexpression of the cloned gor gene resulted
      in an elevated level of glutathione reductase activity which partially protected
      sodB mutant cells (QC773:pJIK1) against methylviologen toxicity. In sodB mutant
      cells expressing the gor gene (QC773:pJIK1) protection by glutathione reductase
      was, however, less effective than protection provided by expression of the iron
      superoxide dismutase gene (sodB gene) in these mutant cells (QC773:pJIK2). In
      sodA mutant cells lacking manganese superoxide dismutase activity but expressing
      the cloned gor gene (QC772:pJIK1) increased cellular glutathione reductase
      activity did not provide protection against methylviologen.

PMID- 2241145
TI  - Pattern of accumulation of elastin and the level of mRNA for elastin in aortic
      tissue of growing chickens.
AB  - Synthesis and accumulation of elastin in many elastic tissues begins in the last
      third of fetal development, reaches a maximum shortly after birth, and then
      declines rapidly. For the aorta of the chick and the pig and the ligamentum
      nuchae and lung of the sheep, it has been shown that increased levels of elastin
      production with fetal development are correlated with increased levels of elastin
      mRNA in the tissue, measured both by cell-free translation and by hybridization
      to cDNA probes. In this study we examine the relationship between insoluble
      elastin accumulation and message levels for tropoelastin in aortic tissue of
      chickens during posthatching development and growth. Whether evaluated by cell
      free translation or by dot blot hybridization, steady state levels of
      tropoelastin message increase to a maximum at 2 weeks after hatching, and then
      fall rapidly with further development and growth. This pattern correlates well
      with production of insoluble elastin by the aorta, determined either by direct
      measurements of synthesis or by rate of accumulation of insoluble elastin. The
      data indicate that the major site of regulation of elastin production is
      pretranslational throughout the entire period of development and growth of the
      chicken aorta.

PMID- 2241147
TI  - Kinetics of purple membrane dark-adaptation in the presence of Triton X-100.
AB  - The kinetics of purple membrane dark adaptation were studied at pH 5 and 7, in
      the presence and absence of the nonionic detergent Triton X-100. The effect of
      both sublytic and lytic surfactant concentrations has been considered. Our
      results show that: (a) dark adaptation is faster at pH 5 than at pH 7, (b) dark
      adaptation is slower, and of smaller amplitude, in the presence than in the
      absence of Triton X-100. The data may be interpreted in terms of a simple first
      order kinetic model, according to which light-dark adaptation would depend
      basically on the equilibrium between the 13-cis- and the all-trans-isomers. The
      experiments also suggest that at pH 5, but not at pH 7, solubilizing surfactant
      concentrations produce a considerable increase in the velocity of the dark
      adaptation reaction, perhaps through changes in the microenvironment of a
      protonable group.

PMID- 2241148
TI  - The action of the glutathione transferase substrate, 1-chloro-2,4-dinitrobenzene
      on synaptosomal glutathione content and the release of hydrogen peroxide.
AB  - We studied the action of the glutathione transferase substrate, 1-chloro-2,4
      dinitrobenzene (CDNB) on the synaptosomal production of H2O2. We found that CDNB
      (30-40 microM) readily depletes the cytosolic glutathione but is almost without
      effect on the mitochondrial fraction. The depletion of the cytosolic glutathione
      induced by CDNB affords the detection in the extracellular space of H2O2 produced
      intrasynaptosomally upon increasing the cytosolic Ca2+ concentration that is
      otherwise destroyed by glutathione peroxidase. Higher concentrations of CDNB
      induce a H2O2 production which is not related to the glutathione content. This
      H2O2 is of mitochondrial origin and requires that NAD be reduced. The primary
      product of the mitochondrial CD-NB-dependent oxygen reduction is at least in part
      the superoxide anion.

PMID- 2241149
TI  - Different types of formaldehyde-oxidizing dehydrogenases in Nocardia species 239:
      purification and characterization of an NAD-dependent aldehyde dehydrogenase.
AB  - Three different dehydrogenases able to oxidize formaldehyde were found in the
      Gram-positive methylotroph, Nocardia sp. 239: an NAD-dependent aldehyde
      dehydrogenase (NA-ADH), and NAD- and factor-dependent formaldehyde dehydrogenase
      (FD-FDH), and a dye-linked aldehyde dehydrogenase (DL-ADH). The ratio of the
      activities observed for the two NAD-linked enzymes varied with growth conditions:
      batch-wise grown cells had nearly the same activities for both enzymes; in fed
      batch-wise grown cells (methanol limitation) only FD-FDH was detected. The latter
      is clearly involved in formaldehyde oxidation, since the enzyme and the factor
      were found only in methanol-grown cells and the enzyme is specific for
      formaldehyde. In contrast, the two aldehyde dehydrogenases may have significance
      for aldehyde dissimilation in general, since both activities could also be
      demonstrated in ethanol-grown cells (but not in glucose-grown cells) and higher
      aldehydes are even better substrates than formaldehyde. NA-ADH was purified to
      homogeneity. The enzyme seems to be a homotetramer since it showed a relative
      molecular mass of 200,000 and the denaturated form of 55,000. Other
      characteristics are as follows: the enzyme showed substrate inhibition for the
      aldehydes tested; optimal activity was found at pH 9.2; the reverse reaction was
      not observed; the enzyme was specific for NAD; GSH, K+, or NH4+ addition did not
      stimulate formaldehyde oxidation; the order of NAD and substrate addition to the
      enzyme was not important; several compounds able to block SH groups were
      inhibitory. Comparison with NAD-linked aldehyde dehydrogenases from Gram-negative
      bacteria showed that the Nocardia enzyme is distinct from the enzyme of
      Pseudomonas putida (EC 1.2.1.46) and of Hyphomicrobium X.

PMID- 2241150
TI  - Increased vitamin E content in the lung after ozone exposure: a possible
      mobilization in response to oxidative stress.
AB  - Vitamin E (vE) is a biological free radical scavenger capable of providing
      antioxidant protection depending upon its tissue content. In previous studies, we
      observed that vE increased significantly in rat lungs after oxidant exposure, and
      we postulated that vE may be mobilized to the lung from other body sites under
      oxidative stress. To test this hypothesis, we fed Long-Evans rats either a vE
      supplemented or a vE-deficient diet, injected them intraperitoneally with 14C
      labeled vE, and then exposed half of each group to 0.5 ppm ozone (O3) for 5 days.
      After exposure, we determined vE content and label retention in lungs, liver,
      kidney, heart, brain, plasma, and white adipose tissue. Tissue vE content of all
      tissues generally reflected the dietary level, but labeled vE retention in all
      tissues was inversely related to tissue content, possibly reflecting a saturation
      of existing vE receptor sites in supplemented rats. Following O3 exposure, lung
      vE content increased significantly in supplemented rats and decreased in
      deficient rats, but the decrease was not statistically significant, and vE
      content remained unchanged in all other tissues of both dietary groups. Retention
      of 14C-labeled vE increased in all tissues of O3-exposed rats of both dietary
      groups, except in vE-deficient adipose tissue and vE-supplemented brain, where it
      decreased, and plasma, where it did not change. The marked increases in lung vE
      content and labeled vE retention of O3-exposed vE-supplemented rats support our
      hypothesis that vE may be mobilized to the lung in response to oxidative stress,
      providing that the vitamin is sufficiently available in other body sites.

PMID- 2241151
TI  - Three-step purification method and characterization of the bovine brain 90-kDa
      heat shock protein.
AB  - A protein that cross-reacted with antibody against the 90-kDa heat shock protein
      (HSP90) of a mouse lymphoma cell line was purified from bovine brain by three
      steps. Fifty milligrams of the 90-kDa protein was recovered from 350 g of the
      brain cortex. The sedimentation coefficient and Stokes radius of the purified
      protein were 6.0 s and 6.7 nm, respectively. The molecular weight was calculated
      to be 170,000. The molecule was composed of two identical 90-kDa subunits. A
      partial amino acid sequence (23 residues) of this protein was homologous (96%) to
      human HSP90 (the sequence of 174-196). These facts led to the identification of
      the 90-kDa brain protein with HSP90. In bovine tissues, the brain contained this
      protein at a remarkably high concentration. The brain HSP90 was separable from
      glucocorticoid receptor by heparin-agarose and DNA-cellulose columns. It is
      concluded that HSP90 is present in brain cytosol and mostly as free molecules.
      Immunohistochemical studies showed that the protein was localized in nerve
      excitable cells. It was not found in nuclei but in cytosol.

PMID- 2241152
TI  - Thermodynamic nonideality as a probe of reversible protein unfolding effected by
      variations in pH and temperature: studies of ribonuclease.
AB  - Thermodynamic nonideality arising from the space-filling effect of added sucrose
      is employed to confirm that the reversible unfolding of ribonuclease A effected
      by acid may be described as an equilibrium between native and unfolded states of
      the enzyme. However, the extent of the volume change is far too small for the
      larger isomer to be the fully expanded state, a result signifying that the acid
      mediated unfolding of ribonuclease does not conform with the two-state
      equilibrium model of protein denaturation. Although the thermal denaturation of
      ribonuclease A is characterized by a larger increase in volume, quantitative
      reappraisal of published results on the effects of glycerol on this transition at
      pH 2.8 (Gekko, K., and Timasheff, S. N., 1981 Biochemistry 20, 4677-4686) leads
      to an estimated volume increase that is much smaller than that inferred from
      hydrodynamic studies--a disparity attributed to the dual actions of glycerol as a
      space-filling solute and as a ligand that binds preferentially to the thermally
      unfolded form of the enzyme. Even in this unfavorable circumstance the fact that
      glycerol exerts a net excluded volume effect at least confirms that the thermal
      unfolding of ribonuclease A is an equilibrium transition between two discrete
      states. The strengths and limitations of using thermodynamic nonideality as a
      probe of the two-state equilibrium model of protein denaturation are discussed in
      the light of these findings.

PMID- 2241153
TI  - Presence of individual enzymes of cholesterol biosynthesis in rat liver
      peroxisomes.
AB  - Cholesterol biosynthesis by isolated rat liver peroxisomes was examined. Labeling
      of cholesterol from [3H]-mevalonate in the presence of peroxisomes required the
      addition of cytosol, since peroxisomes, like microsomes, apparently possess only
      those enzymes of cholesterol biosynthesis subsequent to the steps involving
      farnesyl-PP. Under the conditions employed the amounts of 4,4-dimethyl and
      desmethyl sterols generated by peroxisomes were equal to or exceeded those
      produced by the microsomes. In addition, marker enzyme analysis demonstrated
      minimal microsomal contamination in the peroxisomal fraction. The metabolite
      patterns observed by HPLC after incubation of these two fractions with
      [3H]mevalonate were different. Dihydrolanosterol oxidase, steroid-14-reductase,
      steroid-8-isomerase, and steroid-3-ketoreductase activities were present in
      peroxisomes. Separation of peroxisomes into membranes and contents revealed that
      all the synthesizing activities are associated with the membrane fraction. 7
      alpha-Hydroxylase, which catalyzes the first step in the biosynthesis of bile
      acids, was also present in peroxisomes, but it remains to be clarified to what
      extent peroxisomal cholesterol is a substrate for bile acid synthesis.

PMID- 2241155
TI  - Studies on the interaction of a thiol-dependent hydrogen peroxide scavenging
      enzyme and phenylalanine hydroxylase.
AB  - Rat liver phenylalanine hydroxylase is irreversibly inactivated by a H2O2
      dependent process. Since H2O2 can be produced by autooxidation of the
      tetrahydropterin cofactor required for the hydroxylation reaction, in vitro
      assays are usually carried out in the presence of added catalase. On the basis of
      a dithiothreitol-dependent protecting assay of phenylalanine hydroxylase, carried
      out in the absence of catalase, we have isolated an enzyme fraction from neonatal
      rat livers which has similar properties to the known enzyme, glutathione
      peroxidase. The developmental time course for phenylalanine hydroxylase in rats
      has been reported to follow two different patterns. Using the dithiothreitol
      assay, McGee et al. (1972, Biochem. J. 127, 669-674) have found that newborn rats
      have low phenylalanine hydroxylase activity which increases to adult levels over
      several months. On the other hand, using catalase-supplemented assays, others
      have found that newborn rats have nearly adult levels of phenylalanine
      hydroxylase activity. The protective effect of glutathione peroxidase on
      phenylalanine hydroxylase suggests that the developmental time course found by
      McGee et al. may represent the slow developmental time course previously found
      for glutathione peroxidase. In addition, feeding rats a selenium-deficient diet,
      which reduces the hepatic activity of the selenium-containing glutathione
      peroxidase, results in a concomitant irreversible loss of phenylalanine
      hydroxylase activity, suggesting that glutathione peroxidase may play a vital
      role in protecting phenylalanine hydroxylase in vivo from peroxide inactivation.

PMID- 2241154
TI  - Heme oxygenase-2 mRNA: developmental expression in the rat liver and response to
      cobalt chloride.
AB  - We have previously identified two isozymes of heme oxygenase, HO-1 and HO-2, in
      the rat liver exhibiting vastly different molecular biochemical properties,
      including their responses to various chemical inducers. In the present study of
      the livers of fetal and newborn rats (-1 day to 21 days) we observed marked
      differences in the developmental pattern of expression of the transcripts for the
      two forms of heme oxygenase. In addition, the transcripts for HO-1 and HO-2 vary
      in their number and response to treatment with cobalt chloride. Specifically,
      using a full length cDNA probe for HO-2, we observed the 1.3-kb mRNA previously
      shown to encode HO-2 in the testis, as well as a second less abundant transcript
      of 1.9 kb. An HO-1 cDNA probe detected only the anticipated single transcript of
      1.8 kb. The abundance of each HO-2 homologous transcript was unaffected by cobalt
      chloride treatment (4 or 24 h) in newborn (7 days old) and adult rats. The 1.8-kb
      HO-1 mRNA, however, was markedly increased in abundance in both age groups by
      this treatment. The 1.3-kb HO-2 mRNA level nearly doubled after parturition, but
      remained essentially unchanged during the first 2 weeks of life, and only
      modestly increased by age 21 days. At all stages of development, the relative
      abundance of the 1.3- and 1.9-kb transcripts remained unchanged. In the case of
      1.8-kb HO-1 mRNA, the level of mRNA was relatively constant during the first week
      of life, but was substantially reduced by age 14 days, and was further decreased
      by age 21 days and in the adult animals. In adult rats, the abundance of the 1.3
      kb HO-2 mRNA did not markedly increase over that detected in the course of the
      early postparturition developmental period. The data suggest that the abundance
      of the two HO-2 homologous transcripts is not readily subject to regulation by
      chemicals at any stage of development. The expression of HO-1, on the other hand,
      is subject to such regulation throughout life, and its high transcript abundance
      in newborn rats may well reflect availability of an endogenous inducer.

PMID- 2241156
TI  - Hydroperoxidase I catalyzes peroxidative activation of 3,3'-dichlorobenzidine to
      a mutagen in Salmonella typhimurium.
AB  - Dichlorobenzidine can be peroxidatively activated in Salmonella typhimurium Ames
      tester strains. Mutagenicity is observed when an S. typhimurium strain which is
      sensitive to frame-shift mutagens is incubated with dichlorobenzidine and
      hydrogen peroxide. In this paper, we show that the bacterial enzyme,
      hydroperoxidase I, is responsible for much of this activation. We constructed
      isogenic tester strains which lack hydroperoxidase I or II, due to Tn10
      insertions in the structural genes encoding these proteins. Hydrogen peroxide
      dependent mutagenicity of dichlorobenzidine was measured in each strain. A tester
      strain lacking hydroperoxidase I activity was much less sensitive than was the
      parent strain. When hydroperoxidase I activity was restored in this strain, via a
      plasmid-borne copy of the gene encoding the Escherichia coli protein, sensitivity
      to peroxide-dependent dichlorobenzidine mutagenicity was enhanced.

PMID- 2241157
TI  - Characterization of the 46,000-dalton subunit of eIF-4F.
AB  - Three protein synthesis initiation factors, eukaryotic initiation factor (eIF)
      4A, -4B, and -4F are required for the ATP-dependent binding of mRNA to the
      ribosome. To extend the characterization of the eIF-4A-like subunit of eIF-4F, a
      cDNA clone encoding eIF-4A has been isolated from a rabbit liver cDNA library and
      sequenced. The clone is almost full length for the coding region and complete for
      the 3' noncoding region. The sequence of the rabbit cDNA has been compared to the
      sequence of the two similar, but not identical, genes and cDNAs encoding mouse
      eIF-4A (termed eIF-4AI and eIF-4AII). The rabbit cDNA sequence is very similar to
      the mouse eIF-4AI genomic and liver cDNA sequence with 100% identity at the amino
      acid level and 90% identity at the nucleotide level within the protein coding
      region; however, there is very little similarity in the 3' noncoding region.
      Amino acid sequencing of purified rabbit reticulocyte eIF-4A protein indicates
      that it is eIF-4AI (encoded by the eIF-4AI gene and cDNA) and none of the amino
      acid residues sequenced are in disagreement with those predicted from the mouse
      liver or rabbit liver cDNA sequences. Subsequently, we have analyzed the p46
      subunit of eIF-4F, a three subunit protein whose molecular weights have been
      estimated by sodium dodecyl sulfate gel electrophoresis to be 220,000, 46,000 and
      24,000. The p46 subunit has physical properties similar to eIF-4A. This subunit
      was isolated from rabbit reticulocyte eIF-4F and sequenced chemically. Our
      results indicate that this peptide is a mixture of eIF-4AI and eIF-4AII in an
      approximate ratio of 4 to 1, respectively. No eIF-4AII was observed in our rabbit
      reticulocyte eIF-4A preparation. Therefore we have concluded that either the eIF
      4AI and the eIF-4AII proteins were resolved from each other in the purification
      of rabbit reticulocyte eIF-4A or that eIF-4AII preferentially associates with the
      p220 and p24 subunits of eIF-4F. Evidence favoring the latter possibility is
      discussed.

PMID- 2241158
TI  - Role of heme in phenobarbital induction of cytochromes P450 and 5-aminolevulinate
      synthase in cultured rat hepatocytes maintained on an extracellular matrix.
AB  - When hepatocytes are cultured on matrigel, a reconstituted basement membrane
      matrix, mRNAs for cytochrome P450 class IIB1/2 and class III genes can be induced
      by treatment with phenobarbital. We took advantage of this new system to
      critically evaluate the role of heme as a regulator of these cytochromes P450 and
      of 5-aminolevulinate synthase (ALA-S), the rate-limiting enzyme in heme
      biosynthesis. Phenobarbital treatment of rat cultures increased the total amount
      of cytochrome P450, activities catalyzed by IIB1/2 (benzyloxy- and
      pentoxyresorufin O-dealkylases) and ALA-S activity, and ALA-S mRNA. Treatments
      with phenobarbital combined with succinyl acetone, an inhibitor of heme
      biosynthesis at the step of 5-aminolevulinate dehydrase, blocked the induction of
      the proteins for cytochrome P450IIB1/2 and cytochrome P450IIIAI, as indicated by
      spectral, immunological, and enzymatic assays. However, at the same time,
      succinyl acetone cotreatment failed to inhibit the induction of the mRNAs for
      cytochrome P450IIB1/2 and cytochrome P450IIIA. Lack of effect on the cytochrome
      P450 mRNAs was selective inasmuch as treatment with phenobarbital combined with
      succinyl acetone synergistically increased both ALA-S activity and ALA-S mRNA,
      presumably by blocking formation of heme, the feedback repressor of ALA-S.
      Indeed, the increase in ALA-S mRNA caused by the combined treatment was abolished
      by adding heme itself to the cultures. In contrast to earlier concepts, we
      conclude that in the intact hepatocyte, phenobarbital-induced cytochrome P450
      induction is independent of changes in heme synthesis.

PMID- 2241159
TI  - Chemical modification of chalcone isomerase by diethyl pyrocarbonate: histidine
      residues are not essential for catalysis.
AB  - Chalcone isomerase form soybean is inactivated by treatment with diethyl
      pyrocarbonate (DEP). The competitive inhibitor 4',4-dihydroxychalcone provides
      kinetic protection against inactivation by DEP with a binding constant at the
      site of protection in agreement with its binding constant at the active site.
      Very high concentrations of the competitive inhibitors 4',4-dihydroxychalcone or
      morin hydrate offer a 10- to 40-fold maximal protection, suggesting a second
      slower mechanism for inactivation which cannot be prevented by blockage of the
      active site. Blockage of the only cysteine residue in chalcone isomerase with p
      mercuribenzoate does not affect the rate constant for DEP-dependent inactivation
      and indicates that the modification of the cysteine residue is not responsible
      for the activity loss observed in the presence of DEP. Treatment of inactivated
      enzyme with hydroxylamine does not restore catalytic activity, indicating that
      the modification of histidine or tyrosine residues is not responsible for the
      activity loss. All five histidines of chalcone isomerase are modified by DEP at
      pH 5.7 and ionic strength 1.0 M. The rate constant for the modification of the
      histidine residues of chalcone isomerase is close to that for the reaction of N
      acetyl histidine with DEP, indicating that the histidine residues are quite
      accessible to the modifying reagent. The rate of histidine modification is the
      same in native enzyme, in urea-denatured enzyme, and in the presence of a
      competitive inhibitor. In the presence of the competitive inhibitor morin
      hydrate, all of the histidine residues of chalcone isomerase can be modified
      without significant loss in catalytic activity. These results demonstrate that
      the histidine residues of chalcone isomerase are not essential for catalysis and
      therefore cannot function as nucleophilic catalysts as previously proposed.

PMID- 2241160
TI  - Aspartate aminotransferase from Eleusine coracana, a C4 plant: purification,
      characterization, and preparation of antibody.
AB  - Aspartate aminotransferase (AspAT) isozymes from Eleusine coracana (an NAD-malic
      enzyme type C4 plant) were examined. Three groups of isoenzymes were identified
      (AspAT-1, AspAT-2, and AspAT-3). AspAT-1 (localized in the mesophyll cells) and
      AspAT-3 (localized in the bundle sheath cells), both of which are considered to
      function in the C4 acid pathway, were purified and their kinetic and physical
      properties studied. Both isoenzymes had a molecular mass of 80 kDa and were shown
      to consist of two identical 40-kDa monomers. Except for the higher affinity for
      aspartate and the lower activity for the forward direction (Asp----OAA) at lower
      pH exhibited by AspAT-3 compared with AspAT-1, the isozymes had similar kinetic
      properties. However they had quite different isoelectric points. Polyclonal
      antibodies raised against AspAT-3 preferentially cross-reacted with AspAT-3 but
      did show some cross-reactivity with AspAT-1.

PMID- 2241161
TI  - Substitution of Gly-96 to Ala in the 5-enolpyruvylshikimate-3-phosphate synthase
      of Klebsiella pneumoniae results in a greatly reduced affinity for the herbicide
      glyphosate.
AB  - The aroA gene of Klebsiella pneumoniae encoding the shikimate pathway enzyme 5
      enolpyruvylshikimate 3-phosphate (EPSP) synthase, which is the target of the
      herbicide glyphosate, was cloned and sequenced from both the wild-type and the
      glyphosate-resistant mutant K. pneumoniae K1, which possesses a glyphosate
      insensitive EPSP synthase. Both genes were expressed in Escherichia coli and were
      capable of complementing an auxotrophic aroA mutation. The transformed cells
      showed increased tolerance to glyphosate due to the overproduction of either the
      mutant or the wild type EPSP synthase. Nucleotide sequence analysis of the K.
      pneumoniae aroA gene indicated a protein-coding region of 427 amino acids with a
      derived Mr for the EPSP synthase of 45,976. Comparison of the two aroA alleles
      showed a single base change resulting in a substitution of Gly-96 to Ala in the
      deduced amino acid sequence. By comparison with other known EPSP synthase
      sequences the mutation was shown to be located in a highly conserved region,
      indicating that this region is essential for the binding of the herbicide
      glyphosate.

PMID- 2241162
TI  - Fluorescence studies with malate dehydrogenase from Bradyrhizobium japonicum 3I1B
      143 bacteroids: a two-tryptophan containing protein.
AB  - A number of fluorescence studies, both of trp residues and bound NADH, have been
      reported for porcine malate dehydrogenase (MDH). The large number of trp residues
      (six) complicates the interpretation of some studies. To circumvent this we have
      performed studies with a two-tryptophan (per subunit) MDH from Bradyrhizobium
      japonicum 3I1B-143 bacteroids. We have performed phase/modulation fluorescence
      lifetime measurements, as a function of temperature and added quencher KI, in
      order to resolved the 1.2-ns (blue) and 6.5-ns (red) contributions from the two
      classes of trp residues. Anisotropy decay studies have also been performed. The
      binding of NADH dynamically quenches the fluorescence of both trp residues, but,
      unlike mammalian cytoplasmic and mitochondrial MDH, there is not a large
      enhancement in fluorescence of bound NADH upon forming a ternary complex with
      either tartronic acid or D-malate.

PMID- 2241163
TI  - Isoforms of chicken triosephosphate isomerase are due to specific oxidation of
      cysteine126.
AB  - The electrophoretic isoforms of mammalian triosephosphate isomerase (TPI; EC
      5.3.1.1) are due to deamidation at two Asn-Gly sites (Asn15 and Asn71).
      Deamidation of these two asparagines in the subunit-subunit interface of the
      isologous dimer appears to destabilize the dimer and initiate degradation of the
      protein. Chicken TPI contains a lysine substitution for Asn71, thus precluding
      this deamidation site. Nevertheless, the chicken enzyme exhibits three
      electrophoretic isoforms. This multiplicity is not the result of deamidation of
      the remaining Asn15 site, but due to a specific site which is highly susceptible
      to oxidation. The three isoforms of chicken TPI can be reduced to a single form
      in the presence of high concentrations of reducing agents (e.g., greater than 15
      mM dithiothreitol or greater than 50 mM 2-mercaptoethanol) and are also generated
      when oxidizing agents, such as oxidized glutathione, are present. The oxidized
      isoforms exhibit lowered catalytic activity and are more susceptible to
      denaturation and proteolytic degradation than the native enzyme. Structural
      analysis of the isoforms by chemical cleavage at the cysteine peptide bonds with
      2-nitro-5-thiocyanobenzoic acid and subsequently at the methionines with CNBr
      followed by peptide sequencing reveals that Cys126 is the site of the
      modification. Since the oxidized isoforms of chicken TPI accumulate in vivo
      during aging analogous to the deamidated isoforms from mammals, it appears that
      TPI is the first example of a protein which has evolved two specific types of
      weak links which may initiate turnover of the protein.

PMID- 2241164
TI  - Isolation and characterization of human glucose-6-phosphate isomerase isoforms
      containing two different size subunits.
AB  - Previously undetected isoforms of human glucose-6-phosphate isomerase (GPI) have
      been isolated utilizing substrate-induced elution of the enzyme from spherical
      cross-linked phosphocellulose as an affinity ligand and subjected to a series of
      physical and chemical studies. The two major isoforms (1, 48%, pI 9.13; 2, 36%,
      pI 9.00) are homodimers of subunits of 63.2 kDa (Type-A) and are charge isomers,
      probably representing deamidation of specific Asn-Gly sequences as in other
      species. Isoform 3 (13%, pI 8.84) is a heterodimer composed of the Type-A subunit
      and a previously unreported larger subunit of 69.8 kDa (Type-B). Isoform 4 (3%,
      pI 8.62) is a BB-homodimer. Structural differences in the two types of subunits
      are also apparent from CNBr fragmentation patterns. Carbohydrate analyses show
      that, even though potential N- and O-linked glycosylation sites exist, the
      isoforms are not due to glycosylation. Recently recognized sequence similarities
      between GPI and the neurotropic lymphokine, neuroleukin (NLK) suggest that GPI
      and NLK are either derived from the same gene or represent modifications of the
      same protein. The possibility of NLK-GPI dimers exists, but the new isoforms
      identified in this study do not appear to represent hybrids of GPI subunits with
      mature NLK.

PMID- 2241165
TI  - Expression of mammalian renal transporters in Xenopus laevis oocytes.
AB  - We have injected mRNA from rabbit renal cortex into Xenopus oocytes and
      demonstrated the expression of renal carriers for Na(+)-independent transport of
      L-phenylalanine and L-lysine and Na(+)-dependent transport of L-alanine and
      succinate. Maximal expression of renal amino acid transporters occurred 6-8 days
      following mRNA injection. The proteins responsible for transport of these four
      substrates were translated from mRNAs which are between 1.5 and 3.0 kb. This
      information serves as a starting point for expression cloning of these transport
      proteins.

PMID- 2241166
TI  - Diversity in responses from endogenous and expressed mammalian receptors which
      cause chloride ion efflux from ovarian follicles of Xenopus laevis.
AB  - Inositol phosphates are produced in ovarian follicles of Xenopus laevis on
      activation of endogenous acetylcholine receptors, which also stimulates Ca2+
      release and efflux of Cl- ions detected electrophysiologically. Inositol
      phosphates were not detectable on activation of endogenous angiotensin II
      receptors which did, however, stimulate both a dose-dependent Ca2+ efflux and a
      depolarizing current very similar in maximum size and other characteristics to
      those caused by acetylcholine action. In contrast, activation of exogenous
      receptors for angiotensin II expressed by microinjected mRNA extracted from
      bovine adrenal did form measurable inositol phosphates. Also, the endogenous
      electrophysiological responses to angiotensin II and acetylcholine desensitize
      homologously but fail to cross-desensitize (Lacy, McIntosh, and McIntosh, 1989,
      Biochem. Biophys. Res. Commun, 159, 658-663). It appears that endogenous ovarian
      angiotensin II receptors in Xenopus activate a different transduction mechanism
      from endogenous acetylcholine receptors and expressed mammalian adrenal
      angiotensin II receptors and/or may be sited in the electrically connected
      follicular cells rather than in the oocyte itself.

PMID- 2241167
TI  - Human immunodeficiency viral protease is catalytically active as a fusion
      protein: characterization of the fusion and native enzymes produced in
      Escherichia coli.
AB  - Processing of the gag and pol gene precursor proteins of retroviruses is
      essential for the production of mature infectious virions. The processing is
      directed by a viral protease that itself is part of these precursors and is
      presumed to cleave itself autocatalytically. To facilitate study of this process,
      the protease was produced as a fusion protein in Escherichia coli. In this
      construct, the 10,793-Da protease was preceeded by two copies of a modified IgG
      binding domain derived from protein A. The IgG binding domain was linked to the
      protease by an Asp-Pro peptide bond which could not be cleaved by the viral
      protease. A dimer of the 25,400-Da fusion protein was catalytically active,
      specifically cleaving a substrate peptide at the correct Tyr-Pro bond. Thus, the
      fusion protein could serve as a model of the viral gag-pol polyprotein. The
      finding that the fusion protein was catalytically active supports the suggestion
      that a gag-pol dimer can initiate a proteolytic cascade after budding of the
      immature virus. The fusion protein also provided a source of authentic protease.
      The protease was released from the fusion construct by incubation with formic
      acid, cleaving the Asp-Pro linkage which had been inserted between the IgG
      binding domain and the protease.

PMID- 2241168
TI  - New tandem-repeating peptide structures in polysialoglycoproteins from the
      unfertilized eggs of kokanee salmon.
AB  - New polysialoglycoproteins, designated PSGP(On), were isolated from the
      fertilized and unfertilized eggs of the kokanee salmon, Oncorhynchus nerka
      adonis. The polysialylglycan chains consisting of alpha-2,8-linked O-acetylated
      poly(N-glycolylneuraminyl) chains have recently been characterized. We have now
      determined the complete amino acid sequence of the tandem-repeating units of
      PSGP(On) from the unfertilized eggs of kokanee salmon and found that the
      following two distinct forms are present in PSGP(On) in almost identical amounts:
      [formula: see text] and [formula: see text] where * denotes the O-glycosylation
      site and mean value of m, n = about 20. Upon fertilization these high-molecular
      weight forms of PSGP(On) were proteolytically cleaved to the corresponding
      repeating units, low-molecular-weight PSGP(On), by the action of a specific
      protease (PSGPase) at the position two residues set C-terminally to the Pro
      residue and N-terminally to the Asp residue, i.e. -Pro-Ser-Xaa-Asp-: [formula:
      see text] and [formula: see text].

PMID- 2241169
TI  - Effect of ligand-induced conformational changes on the reactivity of specific
      sulfhydryl residues in rat brain hexokinase.
AB  - Rat brain hexokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) contains 21
      cysteine residues. On the basis of the amino acid sequence of the enzyme, these
      are predicted to be distributed among 14 peptides produced by tryptic digestion.
      Ten of these peptides, containing cysteine residues derivatized by reaction with
      the specific sulfhydryl reagent 2-bromoacetamido-4-nitrophenol have been
      identified in HPLC peptide maps; the four missing peptides are predicted to be
      relatively large and hydrophobic in character, properties that may have prevented
      their detection under the present conditions. The sequences encompassed by the 10
      identified peptides include 12 of the 21 cysteine residues in the enzyme. The
      relative reactivity of these sulfhydryl groups with 2-bromoacetamido-4
      nitrophenol has been assessed, and is in general accord with what might be
      predicted on the basis of their accessibility in the previously proposed
      structure for this enzyme. The effect of various ligands on reactivity of
      identified sulfhydryl groups has been determined; unique patterns of altered
      reactivity, resulting from ligand-induced conformational changes, have been
      observed. Biphasic effects were observed with increasing concentrations of either
      glucose 6-phosphate (Glc-6-P) or Pi. In both cases, decreased reactivity of
      sulfhydryls in the N-terminal half of the molecule was observed at low
      concentrations of the ligand, while further increase in ligand concentration
      resulted in decreased reactivity of sulfhydryl groups in the C-terminal half. In
      contrast, sulfhydryls in both N- and C-terminal halves were protected
      concomitantly by increasing concentrations of Glc. These results are consistent
      with previous studies that indicated (a) the existence of two sites for binding
      of Glc-6-P or Pi, a high affinity site in the N-terminal half and a site with
      lower affinity in the C-terminal half of the brain hexokinase molecule, and (b)
      binding of Glc to a single site located in the C-terminal half but evoking
      conformational effects throughout the molecule; the glucose analog, N
      acetylglucosamine, previously shown to have more limited effects on conformation,
      affected reactivity of sulfhydryl groups only in the C-terminal half of the
      molecule. As reflected by effects on reactivity of sulfhydryl groups,
      conformational changes induced by binding of nucleotides depends markedly on the
      specific nature of the purine or pyrimidine base as well as the length and
      chelation status of the polyphosphate side chain. These results focus attention
      on specific regions of the molecule (the immediate environment of the sulfhydryl
      groups) that are affected by the binding of these ligands.

PMID- 2241170
TI  - Regulation of intestinal calbindin-D28K gene expression: a solution hybridization
      study.
AB  - A solution hybridization assay employing specific synthetic oligodeoxynucleotide
      probes was developed to study the regulation of intestinal calbindin-D28K mRNA.
      The technique is rapid and quantitative and eliminates the need for sample
      transfer, blotting, autoradiography, and densitometry. Following validation of
      the assay, chick intestinal calbindin-D and calbindin-D mRNA levels were compared
      under conditions known to stimulate intestinal calcium (Ca) transport. Both the
      protein and its mRNA were undetectable in 25-day-old vitamin D-deficient chicks.
      Following acute administration of vitamin D3, calbindin-D mRNA levels increased
      somewhat more rapidly than calbindin-D protein, but overall, the correlation was
      excellent. Chicks fed a nutritionally adequate diet for 14 days and then changed
      to a low Ca (0.1%) diet responded with increased calbindin-D and calbindin-D mRNA
      levels. Again the correlation was excellent over the ensuing 14-day experimental
      period. The combined effects of vitamin D repletion and dietary Ca status were
      also investigated with respect to calbindin D and its mRNA. Fourteen-day-old
      vitamin D-deficient chicks were changed to diets containing vitamin D and either
      adequate (1.2%) or low (0.3%) in Ca. The intestinal responses were measured at
      intervals up to 14 days. In the normal Ca situation, there were initial increases
      in both calbindin mRNA levels, which peaked at between 4 and 7 days, and
      calbindin protein levels, which peaked at 7 days. Both values subsequently
      declined during the remaining 7 days of the experimental period. In the low Ca
      situation, there were similar increases in calbindin mRNA and protein levels
      through 4 and 7 days respectively, but these levels remained high for the
      remainder of the 14-day experimental period. The present results demonstrate that
      intestinal tissue levels of calbindin D and its mRNA respond similarly to vitamin
      D repletion and dietary Ca restriction as well as the combination of these
      stimuli. There is no evidence to support significant post-transcriptional
      regulation of calbindin-D by Ca.

PMID- 2241171
TI  - Site-specific oxidation of angiotensin I by copper(II) and L-ascorbate:
      conversion of histidine residues to 2-imidazolones.
AB  - The reaction of a histidine-containing peptide (angiotensin I) with copper
      (II)/ascorbate under physiological conditions has been studied chemically. In the
      presence of a catalytic amount of copper(II) ion, ascorbate mediated the
      oxidative damage to the peptide via selective loss of the histidine residue.
      Furthermore, the reaction of copper(II)/ascorbate with the peptide gave two
      products (AGT-1 and AGT-2) selectively. From amino acid analysis of the modified
      peptides, it was found that either of the two histidine residues within the
      native peptide was modified. Amino-terminal sequence analysis indicated that AGT
      1 and AGT-2 were modified at the His9 and the His6, respectively. In addition,
      the data of FAB-MS and 1H NMR suggested that the unknown residues (modified
      histidine) within AGT-1 and AGT-2 should have the 2-imidazolone structure. In
      order to confirm the 2-imidazolone residue in both modified peptides, they were
      hydrolyzed and analyzed by reverse-phase HPLC. The result demonstrated that the
      acid hydrolysis of modified peptides gave a product which was identical to
      authentic 2-imidazolone residue. Consequently, it was confirmed that the reaction
      of Cu(II)/ascorbate occurs specifically at the C-2 position of the imidazole ring
      of the histidine residue within a peptide.

PMID- 2241172
TI  - Glycosphingolipid-binding specificity of the mannose-binding protein from human
      sera.
AB  - Mannose-binding protein was purified from human serum to apparent homogeneity by
      affinity chromatography on mannose-Sepharose, followed by affinity chromatography
      on underivatized Sepharose. Approximately 0.4 mg protein was obtained from 1
      liter serum. The glycosphingolipid-binding specificity of the purified protein
      was examined by chromatogram overlay and solid phase assays. It binds with high
      affinity to Lc-3Cer (GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1ceramide) and n
      Lc5Cer (GlcNAc beta 1-3Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc beta 1
      1ceramide). It does not bind to many other glycosphingolipids without terminal N
      acetylglucosamine residues that were tested. Thus, these data suggest that N
      acetylglucosamine-terminated glycosphingolipids may serve as cell-surface
      attachment sites for mannose-binding protein in vivo. In addition, the binding
      specificity of the protein can be used as a sensitive probe for determining the
      levels of Lc3Cer and nLc5Cer in tissues, as it exhibits half-maximal binding to
      about 10 pmol of these lipids in solid phase assays, and detects less than 20
      pmol of Lc3Cer in chromatogram overlay assays. This technique was utilized to
      demonstrate that one sample of chronic myeloid leukemia cells contains both
      Lc3Cer and nLc5Cer.

PMID- 2241174
TI  - Tributyltin stimulates apoptosis in rat thymocytes.
AB  - Treatment of rat thymocytes with micromolar concentrations of tributyltin caused
      a rapid increase in the cytosolic free Ca2+ concentration that was inhibited by
      Ni2+, which blocks Ca2+ influx through membrane channels. The elevation of
      cytosolic Ca2+ was associated with extensive DNA fragmentation, which was
      prevented by pretreatment of the cells with either of the intracellular Ca2+
      chelators quin-2 or 1,2-bis(2-amino-phenoxy)ethane-N',N',N',N',-tetraacetic acid.
      Loss of thymocyte viability, which followed DNA fragmentation, was also prevented
      by the two Ca2+ chelators or by removing extracellular Ca2+ with ethylene glycol
      bis(beta-aminoethyl ether)N,N'-tetraacetic acid. The pattern of DNA fragmentation
      was characteristic of that produced by agents which activate a Ca2(+)- and Mg2(+)
      dependent endogenous endonuclease during apoptosis or programmed cell death.
      Additional studies showed that other organotin compounds, including trimethyltin,
      triphenyltin, and dibutyltin had minimal effects on cytosolic Ca2+, DNA
      fragmentation, and cell viability. These results are consistent with a greater
      susceptibility of thymocytes to tributyltin and provide a basis for understanding
      its selective immunotoxicity in vivo.

PMID- 2241173
TI  - Fibronectin and proteoglycan synthesis in long term cultures of cartilage
      explants in Ham's F12 supplemented with insulin and calcium: effects of the
      addition of TGF-beta.
AB  - Canine cartilage explants were maintained in a basal medium supplemented with a
      commercially available supplement (ITSCR+) which includes insulin for up to 12
      days in culture. During this time it was found that proteoglycan synthesis, as
      measured by 35SO4 incorporation into high molecular weight proteoglycans, was
      maintained at levels comparable to those at Day O. This is in substantial
      agreement with the results of McQuillan et al. (1) for bovine cartilage explants.
      Since the basal medium which we used, Ham's F12, is low in calcium, we found that
      supplementation with additional calcium also was needed for maintenance of
      proteoglycan synthesis. This defined medium was not adequate to prevent a
      decrease in fibronectin, total protein, and collagen synthesis relative to Day O
      levels. The addition of transforming growth factor-beta (TGF-beta) at 2 and 10
      ng/ml to the defined medium not only prevented the decline in fibronectin
      synthesis but progressively increased the rate of fibronectin synthesis until the
      Day O levels were exceeded by an average of fourfold. This TGF-beta-induced
      increase in fibronectin synthesis was contrasted with the increase in fibronectin
      synthesis previously reported for degenerated cartilage of osteoarthritic joints
      (2,3), and possible implications for understanding the disease were discussed.

PMID- 2241175
TI  - Novel forms of ferredoxin and ferredoxin-NADP reductase from spinach roots.
AB  - Ferredoxin and the enzyme catalyzing its reduction by NADPH, ferredoxin-NADP
      reductase (ferredoxin-NADP+ oxidoreductase or FNR), were found to be present in
      roots of spinach (Spinacia oleracea). Localization experiments with endosperm of
      germinating castor beans (Ricinus communis), a classical nonphotosynthetic tissue
      for cell fractionation studies, confirmed that ferredoxin and FNR are localized
      in the plastid fraction. Both proteins were purified from spinach roots and found
      to resemble their leaf counterparts in activity, spectral properties, and complex
      formation, but to differ in amino acid composition and amino terminal sequence.
      The results indicate that the primary structures of the FNR and ferredoxin of
      spinach roots differ from that of the corresponding leaf proteins. Together with
      earlier findings, the present results provide evidence that nonphotosynthetic
      plastids, including those of roots, are capable of reducing ferredoxin with
      heterotrophically generated NADPH.

PMID- 2241177
TI  - The kinetic mechanisms of the bifunctional enzyme aspartokinase-homoserine
      dehydrogenase I from Escherichia coli.
AB  - The kinetic mechanisms of the reactions catalyzed by the two catalytic domains of
      aspartokinase-homoserine dehydrogenase I from Escherichia coli have been
      determined. Initial velocity, product inhibition, and dead-end inhibition studies
      of homoserine dehydrogenase are consistent with an ordered addition of NADPH and
      aspartate beta-semialdehyde followed by an ordered release of homoserine and
      NADP+. Aspartokinase I catalyzes the phosphorylation of a number of L-aspartic
      acid analogues and, moreover, can utilize MgdATP as a phosphoryl donor. Because
      of this broad substrate specificity, alternative substrate diagnostics was used
      to probe the kinetic mechanism of this enzyme. The kinetic patterns showed two
      sets of intersecting lines that are indicative of a random mechanism.
      Incorporation of these results with the data obtained from initial velocity,
      product inhibition, and dead-end inhibition studies at pH 8.0 are consistent with
      a random addition of L-aspartic acid and MgATP and an ordered release of MgADP
      and beta-aspartyl phosphate.

PMID- 2241176
TI  - Hemin-promoted peroxidation of red cell cytoskeletal proteins.
AB  - Hemin-induced crosslinking of the erythrocyte membrane proteins was analyzed at
      three levels: (i) whole membranes, (ii) integrated or dissociated cytoskeletons,
      and (iii) isolated forms of the three main cytoskeletal proteins, spectrin,
      actin, and protein 4.1. Addition of H2O2 and hemoglobin to resealed membranes
      from without did not affect any of the membrane proteins. Hemin that can
      transport across the membrane induced, in the presence of H2O2, crosslinking of
      protein 4.1 and spectrin. Both free hemin and hemoglobin added with H2O2 induced
      crosslinking of integer cytoskeletons and mixtures of isolated cytoskeletal
      proteins, but hemin was always more active. Of the three major cytoskeletal
      proteins, spectrin and protein 4.1 were most active while the participation of
      actin was only minor. The yield of crosslinked products was increased in all
      reaction mixtures with pH, with an apparent pK above 9.0. Replacement of H2O2 by
      phenylhydrazine and tert-butyl hydroperoxide resulted in crosslinking of the same
      proteins, but with lower activity than H2O2. Bityrosines, which were identified
      by their specific fluorescence emission characteristics, were formed in reaction
      mixtures containing hemin and hydrogen peroxide and either spectrin or protein
      4.1, but not actin. On the basis of fact that bityrosines were revealed only in
      reaction mixtures that produced protein adducts, formation of intermolecular
      bityrosines was analyzed to be involved in crosslinking of the cytoskeletal
      proteins. Since the levels of membrane-intercalated hemin are correlated with
      aggregation of membrane proteins, it is suggested that the peroxidative
      properties of hemin are responsible for its toxicity.

PMID- 2241178
TI  - [Epidemiology of lung cancer--recent topics].
AB  - Lung cancer has been increasing markedly in recent years in Japan. It is
      estimated that the number of lung cancer deaths will exceed that of stomach
      cancer deaths by around 1995. The reason of the marked increase of lung cancer
      deaths is not clear, but the following factors may have contributed to the
      increase of lung cancer in Japan: 1) the increase in accuracy of diagnosis of
      lung cancer (a decrease in number of overlooked lung cancer cases), 2) an
      increase in number of aged population (this factor has been considered in the age
      adjusted mortality rate), 3) an increase in consumption of cigarettes and an
      increase of other risk factors of lung cancer. A number of studies have been
      conducted on the relationship between husband's smoking habit and lung cancer in
      non-smoking wives. The results of these studies implicate the effect of passive
      smoking on lung cancer, but more studies are needed to confirm the casual
      relationship. A recent study by Kawajiri et al on the DNA polymorphism of the
      cytochrome P450IA1 gene in lung cancer cases implicates a variation of the
      individual susceptibility to lung cancer.

PMID- 2241179
TI  - [Progress of imaging diagnosis for the cancer therapy--breast cancer].
AB  - As two main modalities for the breast cancer, ultrasonography (US) and
      mammography (MMG) were discussed about the efficacy and limitation of qualitative
      diagnosis. The accuracy rate of US and MMG for the breast cancer were 90.0% and
      92.7% at the Aichi Cancer Center Hospital during these 2 years (1986-1988). The
      number of patients with the breast cancer is increasing recently in Japan. This
      cancer, however, is one of the curable cancer at the early stage. Therefore, it
      is very important thing to detect a small malignant mass less than 1cm in a
      diameter by using these modalities. In addition, the establishment of the mass
      screening system for breast cancer is desired. In order to make a precise
      diagnosis, it is necessary to add some devices on the ordinary modalities. For
      examples, mechanical improvement of the Moribuden tube with 0.1mm focus,
      operation of ductgraphy and cystography by double contrast method in MMG and
      application of 10MHz transducer in US. Furthermore, needle biopsy under US or X
      ray is expected positively to make a fast diagnosis. On the other hand, DMR
      (Digital Mammo-Radiography) system has a bright prospect for the mass screening
      of the breast cancer in the respect of efficacy, cost and radiation hazard. DMR
      system has many advantages as follows, 1. The system is capable of bringing out
      clearly very minor differences of contrast. 2. Tumor shadows can be easily
      displayed. 3. The lateral projection only is sufficient (allowing examination of
      the chest wall also). 4. The X-ray dose is small: 0.03-0.05mSv. 5. The equipment
      is inexpensive to use. 6. Patient positioning is simple, and examinations take
      little time. 7. Long operator training programs are unnecessary. 8. The system
      uses digital signals, and so automatic diagnosis is possible. 9. Theoretically,
      at least, tumors as small as 0.2 mm in diameter can be detected.

PMID- 2241180
TI  - [Imaging diagnosis of genitourinary tract tumors].
AB  - Recent advance of imaging technique have brought great advantages for management
      of genitourinary tract tumors. We described few examples of changes in this field
      from our experience. Many asymptomatic masses are discovered in the kidney and
      adrenal gland associated with wide clinical application of CT and US. In the
      kidney, the greater part of incidental masses are renal cell carcinomas (RCC) and
      the rate of such cases has been increasing. When small RCC is diagnosed without
      any clinical symptoms, better survival would be expected. Many adrenal incidental
      mass are also discovered by routine use of CT for abdominal workup. Since greater
      part of these masses are benign nonfunctioning adenomas, correct diagnosis should
      be made in order to avoid inappropriate surgery. Rapid development of MR also
      resulted in some changes in the diagnosis of urinary tract tumors. However, MR
      cannot be used as a screening method. For staging of RCC, intravascular or
      adjacent organ invasion was well determined with MR compared with CT.
      Differentiation of adrenal carcinomas from nonfunctioning adenomas is suggested
      by the difference of signal intensity on T2 weighted images. Fast spin echo scan
      with GD-DTPA enhancement is new MRI technique separating bladder mucosal layer
      from muscle layer as hyper-intensity area. Using this method, diagnostic accuracy
      of deep muscle invasion for bladder tumor would be improved.

PMID- 2241181
TI  - [Gynecologic tumor].
AB  - The image diagnosis of a gynecologic tumor is progressing with the propagation of
      magnetic-resonance imaging (MRI), fast X-ray computed tomography (CT), and
      transvaginal probe. We introduce you the role which an image diagnosis should
      play in the decision of the therapeutic plan and the evaluation of the
      therapeutic effect of a uterine cervical cancer, a uterine endometrial cancer,
      and an ovarian cancer. In a uterine cervical cancer, MRI is useful to grasp the
      stage and the tumor size, and contributes toward determining a therapeutic plan.
      In addition, we may guess the response to the therapy, and judge the existence of
      a residual tumor during or immediately after an irradiation or an intraarterial
      injection. In a uterine endometrial cancer, MRI will contribute toward
      demonstrating a cervical invasion and toward assessing a myometrial invasion,
      therefore may help us to modify a therapeutic plan. To stage an ovarian cancer,
      it is necessary to visualize a small disseminated lesion. However, as all imaging
      modalities has a limitation to reveal the small disseminated nodules, they will
      not replace probe laparotomy. The probability of X-ray CT to take the place of
      second-look operation by an improvement has been suggested. MRI is poor at the
      visualization of a dissemination, however it is sometimes helpful for the
      evaluation of the therapeutic effect of a localizing tumor with demonstrating the
      changes of the signal intensity. We suppose that also an image diagnosis leaves
      room for expectation to contribute toward deciding the therapeutic plan of an
      ovarian cancer.

PMID- 2241182
TI  - [Cooperative research of UFT E phase II study. Cooperative Study Group of UFT E
      in Tohoku Area].
AB  - Phase II clinical research of UFT E granules (enteric coated) was carried out in
      18 institutes (21 clinical dept.) by Study Group of UFT E in Tohoku Area, to
      investigate its effect and safety on cancer of the digestive organs. Of all the
      registered 26 cases, 21 cases were available for evaluation (perfect cases: 17
      and imperfect cases: 4). Patients were administered UFT E 600 mg/body/day in
      principle. The response rate of the overall 26 cases was 14.3% and that of
      perfect 17 cases was 17.6%. PR was seen in 2 cases with far advanced gastric
      cancer and in 1 case with sigmoid colon cancer metastasized to lung, NC in 8
      cases and PD in 6 cases. Side effects more than Grade II were seen in 4 cases
      (19%), of which 1 case caused diarrhea with leucopenia, 1 case caused diarrhea
      with anorexia, fever, pigmentation, stomatitis and general tiredness, 1 case
      caused anorexia and the other 1 case caused paresthesia on both legs with
      diarrhea and anorexia. Side effects in upper digestive tract were slight, making
      it possible to continue administration. But 1 case, which caused simultaneously
      Grade II anorexia, Grade II diarrhea and Grade III paresthesia on both legs,
      refused administration and dropped out. He recovered from those symptoms 5 days
      after discontinuance of administration. UFT E is able to administer for a long
      term because of its slight side effects on the upper digestive tract.

PMID- 2241183
TI  - [Combination chemotherapy with etoposide, ADM, and CDDP (EAP) for advanced
      gastric cancer].
AB  - EAP therapy has been performed on 50 cases of advanced gastric cancer from
      January 1988 to September 1989. Adriamycin 20 mg/m2, Cisplatin 40 mg/m2 and
      Etoposide 100 mg/m2 were administered on day 1 and 7, 2 and 8, and 4, 5 and 6,
      respectively, with not less than 2 courses every 3 to 4 weeks. Complete success,
      PR, NC and PD were obtained in 48, 21, 20 and 7 cases, respectively, the rate of
      effectiveness being 43.8% with a confidence interval 95% of 30-58%. The rate of
      effectiveness by lesions for evaluation was high (30.4, 100, and 50% for primary
      lesion, Virchow's lymphnodal metastasis and liver metastasis, respectively). MST
      was 5.1 months for EAP therapy, which was highly effective but led to no
      prolonged survival period. Thus, it is thought that good control of leukopenia, a
      dose limiting factor remains to be examined.

PMID- 2241184
TI  - [A multicenter clinical study of oral topical administration of G-512 on
      chemotherapy-associated intraoral mucosal lesions of patients with hematological
      malignancies. G-512 Therapeutic Study Group for Intraoral Mucosal Lesions].
AB  - We evaluated the usefulness of PGE2 on chemotherapy-associated oral mucosal
      lesions of the patients with hematological malignancies and compared the efficacy
      of the troche with that of the tablet. One hundred and fifty three patients were
      given 0.5 mg of these PGE2 topically three times daily. One hundred and fourty
      five cases were evaluable (Tablet; 85, Troche; 60). 1) Symptoms and signs were
      improved in 102/144 (70.8%) and 102/145 (70.3%), respectively. The overall
      response rate was 70.3%. 2) The improvement rates were 77.5% (55/71), 85.7% (6/7)
      and 62.7% (32/51) in leukocyte count-increased, -unchanged and -decreased
      patients, respectively. 3) No background factor of the patients except
      performance status affected the improvement rate. 4) Higher improvement rate was
      noted in the PGE2 early starting group (within 5 days after the appearance of
      oral lesions) than the late group (6 days and thereafter) (76.5% v.s. 55.8%: U
      test p less than 0.1, chi2-test p less than 0.05). 5) There was no difference in
      the efficacy rate between the tablet and the troche. 6) Mild side effects were
      seen in 10 cases. These results suggest that topical administration of PGE2 is
      safe and useful for improving chemotherapy-associated oral mucosal lesions of
      patients with hematological malignancies.

PMID- 2241185
TI  - [Phase I study of YNK01 (1-beta-D-arabinofuranosylcytosine-5'-stearylphosphate)].
AB  - Phase I study of YNK01 (1-beta-D-arabinofuranosylcytosine-5'-stearylphosphate), a
      derivative of cytosine arabinoside (Ara-C), was conducted by cooperative study
      groups between January 1986 and June 1987. The dosage for the single and 5-day
      oral administration ranged 50 to 1,200 and 100 to 900 mg/body/day, respectively.
      The main adverse effects were myelo-suppression and gastrointestinal toxicities
      such as nausea, vomiting, anorexia and diarrhea. In the single administration,
      the maximum tolerated dose (MTD) could not be determined, however, in the 5-day
      schedule MTD was considered to be 700 to 900 mg/body/day, and the dose limiting
      factor to be thrombocytopenia. After the single administration (800 mg/body/day)
      of YNK01, the plasma concentration of Ara-C, an active metabolite of YNK01, was
      3.43 ng/ml (Cmax) at 24 hrs. and 0.82 ng/ml at 72 hrs. During the 5-day
      administration for 300 mg/body/day and 500 mg/body/day, the Ara-C concentration
      changed from 2.3 to 4.1 ng/ml, and from 1.5 to 11.9 ng/ml respectively, and
      sustained almost the same concentration as to during the administration period
      until the 2nd day after the completion of the administration.

PMID- 2241187
TI  - [Effects of urinastatin against nephrotoxicity of cisplatinum].
AB  - Nephrotoxicity is the major side effect of cisplatinum (CDDP) and it is often the
      dose limiting factor. We have studied the effect of urinastatin (US) to decrease
      the nephrotoxicity of CDDP administration. 28 patients with gynecological cancer
      treated by chemotherapy including CDDP (13 mg/m2 daily for 5 days) were assigned
      to two groups, the group with US (n = 14) and the group without US (n = 14). The
      former was added each 150,000 units of US before and after administration of
      CDDP. The BUN, serum creatinine (Cre), creatinine clearance (Ccr) and the
      excretion of beta 2-microglobulin (beta 2-MG) index and N-acetyl-beta
      glucosaminidase(NAG)index were measured. The BUN, Cre and Ccr were within normal
      range during four cycles. However NAG index rose remarkably when CDDP was treated
      by CDDP. And the increase in NAG index, which reflect the magnitude of renal
      tubal damage, was less in the group with US than in the group without US. It was
      suggested that US had effects to reduce nephrotoxicity of CDDP in chemotherapy,
      and that we could treat patients by high dose CDDP.

PMID- 2241186
TI  - [Pharmacokinetics of cis-diammine (glycolato) platinum (254-S), a new platinum
      antitumor agent, following an intravenous and intraperitoneal infusion bioactive
      platinum concentration profile].
AB  - The pharmacokinetics of cis-diammine (glycolato) platinum (254-S) was
      investigated in cancer patients following intravenous and intraperitoneal
      infusion. The serum concentrations of total and unbound 254-S were determined by
      bioassay and chemical assay as platinum. Platinum detected by bioassay was
      thought to be active and unchanged 254-S. Almost all of platinum in plasma were
      found to be active and unbound to protein because of no differences in the
      concentrations determined by bioassay and chemical assay and in plasma and plasma
      filtrate. In abdominal ascites, platinum concentrations determined by bioassay
      corresponded with those determined by chemical assay, suggesting that 254-S was
      stable in abdominal ascites. The Cmax and AUC of active 254-S in plasma
      determined by bioassay following an intraperitoneal infusion were about 60% and
      60-80% of those following an intravenous infusion, respectively. These results
      showed that 254-S was well absorbed into systemic circulation from abdominal
      ascites as an active form. It is concluded that antitumor effect may be obtained
      following an intraperitoneal infusion of 254-S as well as for the reduction of
      abdominal ascites.

PMID- 2241188
TI  - [Activity of cytochrome P450 in the stomach, with special reference to
      postoperative survival rate of patients with gastric cancer treated by tegafur].
AB  - In routine histological preparation of gastric wall and liver specimens,
      immunohistochemical study of P450 was performed in the total of 116 absolutely
      noncurative resection of gastric cancer which followed by postoperative
      administration of tegafur. P450 in the liver, which considered to play a main
      role of tegafur activation, was strongly stained and correlated well with that of
      the stomach. Divided the cases into 3 groups from the degree of
      immunohistochemical staining of P450, postoperative survival was significantly
      correlated with the intensity of staining in the stomach. And the more the stage
      of gastric cancer advanced, the less the tissue P450 was stained. From the
      results obtained, reasonable consecutive administration of tegafur would be
      possible by immunohistochemical checking the P450 in the gastric wall.

PMID- 2241189
TI  - [Chemosensitivity assays for malignant gliomas].
AB  - Chemosensitivity assays including colony forming assay (CFA), MTT dye reduction
      assay (MTT assay) and thymidine incorporation assay (TIA) for cultured rat and
      human glioma cells were conducted to determine the correlation among them and the
      in vivo antitumor efficacy of anticancer drugs using rats implanted glioma cells.
      Cytotoxicity of various agents such as ACNU, ACR, CDDP, VCR or BLM, was estimated
      from the concentrations which caused 50% inhibition of the cell growth at the
      peak plasma concentration. The survival time of tumor bearing rats was assessed
      after ip treatment with these agents at their estimated clinical doses. This
      parameter was greater in the drugs that were shown to be highly sensitive in CFA
      and was consistent with the data for CFA. In the chemosensitivity assays, CFA
      closely correlated to MTT assay for all agents except VCR, but poorly so to TIA.
      The results in this study indicate that MTT assay seemed to be useful for
      determining the chemosensitivity of anticancer drugs and that chemosensitivity
      assay should be conducted depending on the nature of anticancer drug.

PMID- 2241190
TI  - [A case of local recurrent breast cancer with complete response to combination of
      systemic chemotherapy and topical use of adriamycin ointment].
AB  - A Case of local recurrent breast cancer in a 45-year-old female with complete
      response to Combination of chemotherapy and topical administration of Adriamycin
      is reported. The patient had left mastectomy for breast cancer in 1978, and then
      right mastectomy for breast cancer in 1987. Two years later, she was readmitted
      to our hospital with right neck lymph node metastasis and local recurrence at
      right chest wall. Neck lymph node metastasis was treated with irradiation with
      good response. On the other hand, Adriamycin ointment was applied to recurrent
      cancer on the right chest. The cancer was gradually diminished in size. Seventy
      eight days after treatment, the local chest wall with cancer was resected.
      Histologically, the entire resected tissue showed no viable cancer cells and
      Adriamycin concentration in the tissue was extraordinary high (ten to forty fold
      over on systemic chemotherapy). Adriamycin ointment may be an alternative
      treatment of choice for local recurrent breast cancer.

PMID- 2241191
TI  - [A case of recurrent ovarian cancer markedly responding to daily oral
      administration of low dose etoposide].
AB  - A 67-year-old woman with recurrent ovarian cancer, who had carcinomatous
      peritonitis and large abdominal cystic lesions, was treated by daily oral
      etoposide at a dose of 50 mg/day for 21 consecutive days at 2-week intervals in
      the outpatient department. After 15 days of administration, the serum level of
      CA125 decreased from 2,220U/ml to 445U/ml, and that of LDH from 2,725 WU to 906
      WU. After the third course of treatment, the abdominal cystic lesions were
      remarkably reduced, and the performance status improved grade 1 from 3 prior to
      the administration. No severe side effects except for alopecia and mild
      myelosuppression were noted during the 3-month treatment.

PMID- 2241192
TI  - [A case of early gastric carcinoma which disappeared with treatment of low dose 5
      FU].
AB  - A 60-year-old male with early gastric carcinoma of Ha type, had received
      colectomy for his carcinoma in transverse colon. He was treated after operation
      with 5-Fluorouracil (5-FU) orally at 200 mg per day. One and a half month after
      operation at a total dose 8.4 g 5-FU, the patient was examined on his stomach by
      endoscope and barium enema. The polypoid tumor in the stomach was not recognized
      there. No lesion has been noticed in his stomach endoscopically in the following
      1 year.

PMID- 2241193
TI  - [Protective effect of urinastatin on cisplatin-induced cytotoxicity in the renal
      tubules].

PMID- 2241194
TI  - [Tumor marker: practical usage of tumor marker for recurrent breast cancer--our
      experience].
AB  - The point of practical usage of monitoring tumor marker, CEA and CA15-3, for
      breast cancer patients was indicated and discussed. We presented several cases
      with recurrent breast cancer patients and verified the practical usefulness of
      monitoring tumor marker, CEA and CA15-3. Fundamental changing pattern of these
      markers in serum on semi-logarithmic graph was exhibited to show linear pattern
      and the two curves of CEA and CA15-3 kept basically parallel except several
      conditions, when both markers were positive. From the graphical changes of
      markers we could made early and correct judgement of the effect of the treatment.
      However, there existed several cases who showed strange and paradoxical changing
      pattern of these markers apart from clinical courses. That is the situation that
      heterogenetic changes of the tumor or tumor lysis syndrome are taken place. It
      was emphasized that the value of serum tumor markers should be taken notice of
      the changes of markers in these situations.

PMID- 2241195
TI  - Modified nasolabial transposition flap provides vestibular lining and cover of
      alar defect with intact rim.

PMID- 2241196
TI  - The nasolabial flap as a single-stage procedure.
AB  - The nasolabial flap is a useful reconstructive technique for the repair of
      defects on the nose. An improved technique used in 32 patients is presented,
      which allows use of this procedure as a single-stage rather than the more
      commonly seen two-stage procedure. The alterations include the following: (1) the
      excision of a Burow's triangle superior edge of the defect toward the inner
      canthus; (2) the use of a periosteal or suspension suture to minimize tenting
      across the concave junction of the nose and cheek; (3) wide undermining of the
      skin surrounding the defect to create a stabilizing platelike scar; (4)
      significant thinning of the donor flap; and (5) adjust the size of the flap to
      recreate the original preincisional skin tension on the flap after suturing. None
      of the 32 patients presented required a second-stage procedure to correct
      trapdoor defects or to recreate natural folds or creases.

PMID- 2241197
TI  - Cutaneous T-cell lymphoma (parapsoriasis en plaque). An association with
      pityriasis lichenoides et varioliformis acuta in young children.
AB  - Pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides
      chronica (PLC) are related benign disorders without recognized association with
      cutaneous T-cell lymphoma (CTCL). We report the cases of two children with
      documented PLEVA evolving into CTCL over several years. One child had the
      clinical lesions of PLC but the dermatopathologic findings of PLEVA at age 2
      years. At age 12 years, he had skin changes of poikiloderma atrophicans vasculare
      and dermatopathologic findings consistent with parapsoriasis en plaque. The
      second child presented at age 7 years with scaling dermatitis and
      dermatopathologic findings of PLEVA. At age 12 years, the histologic diagnosis
      was parapsoriasis. Monoclonal antibody studies performed on biopsy specimens from
      both patients revealed 70% to 100% cells staining with CD5, 80% to 90% staining
      with CD4, 30% to 50% staining with CD8, and an increase in CD1-staining cells in
      the papillary dermis, indicating a predominantly helper T-cell infiltrate. We
      believe that PLC and PLEVA may be part of the spectrum of CTCL. Furthermore, CTCL
      may be more common in young children than once thought.

PMID- 2241198
TI  - Characterization of the dermal infiltrate in human immunodeficiency virus
      infected patients with psoriasis.
AB  - We investigated the dermal inflammatory cell infiltrates of psoriatic lesions
      from nine human immunodeficiency virus-infected patients and nine age-, sex-, and
      site-matched control specimens. The study was retrospective and observer blinded.
      T lymphocytes were quantitated using UCHL-1, a pan-T-cell monoclonal antibody,
      and plasma cell number was estimated in hematoxylin-eosin-stained sections.
      Differences in both variables reached statistical significance. There were fewer
      T cells and the number of plasma cells was significantly higher in specimens from
      the human immunodeficiency virus-positive individuals in comparison with control
      specimens. As plasma cells are readily identified on hematoxylin-eosin-stained
      sections, their presence in skin biopsy specimens from psoriatic leisons should
      arouse suspicion of human immunodeficiency virus infection. The depletion of
      helper/inducer T lymphocytes by the human immunodeficiency virus may promote the
      presence of plasma cells in cutaneous inflammatory infiltrates.

PMID- 2241199
TI  - Cicatricial pemphigoid. Identification of two distinct sets of epidermal antigens
      by IgA and IgG class circulating autoantibodies.
AB  - A patient with severe cicatricial pemphigoid demonstrated both in vivo bound and
      circulating anti-basement membrane zone antibodies of the IgA and IgG classes.
      Complement component 3 (C3) was also deposited in the basement membrane zone of
      lesional skin as well as in normal-appearing buccal mucosa of the patient.
      However, C1q was absent, while granular deposits of two factors of the
      alternative complement activating pathway, properdin and properdin factor B, were
      present only in the basement membrane zone of lesional skin, but not in normal
      buccal mucosa. Deposition of alternative complement pathway reactants in the
      lesion suggests that complement activation by IgA was associated with lesion
      development. Western blot analysis of the patient's serum on electrophoresed
      cultured keratinocyte antigens identified two distinct sets of epidermal
      antigens. While IgG bound antigens of 230, 205, 140, and 90 kd, the patient's IgA
      antibodies bound a distinct set of antigens, 180 and 130 kd. The potential
      pathogenic role of IgA in cicatricial pemphigoid is discussed.

PMID- 2241200
TI  - Dermatitis herpetiformis bodies. Ultrastructural study on the skin of patients
      using direct preembedding immunogold labeling.
AB  - Skin samples from three adult patients with dermatitis herpetiformis (DH) and
      granular IgA deposits in the papillary tips were studied using ultrastructural
      immunogold technique. IgA positive, so-called DH bodies were identified as
      amorphous clumps--most probably immunocomplex aggregates--scattered throughout
      the upper papillary dermis. Dermatitis herpetiformis bodies were seen underneath
      the basement membrane, sometimes along microfibrillar bundles, as well as
      adjacent to the papillary collagen fibers and within the surface (microfibrillar)
      region of elastic tissue. Some DH bodies, however, were not related to any
      fibrillar components. The collagen and elastic fibers, microfibrillar bundles,
      anchoring fibrils, and elastic microfibrils themselves were unlabeled. Dermatitis
      herpetiformis bodies were not found in normal human skin. The results of our
      ultrastructural study indicate that DH bodies either are bound to a nonfibrillar
      component of dermal connective tissue or represent deposits of immune complexes
      trapped in DH skin.

PMID- 2241201
TI  - The familial occurrence of bullous mastocytosis (diffuse cutaneous mastocytosis).
AB  - We studied four patients (a mother, her two daughters, and her son) with bullous
      mastocytosis, or diffuse cutaneous mastocytosis, whose genetic inheritance
      suggested an autosomal dominant pattern. The clinical characteristics included
      extensive bullae, numerous urticaria, pruritus, flushing, and pseudolichenified
      skin over all body surfaces without systemic organ involvement. The
      histopathologic findings disclosed a pronounced accumulation of mast cells in the
      dermis. Electron microscopic studies of lesional skin obtained in infancy showed
      round or spindle-shaped mast cells with numerous fingerlike villous protrusions.
      The cytoplasmic granules varied in size and shape, and the appearance of
      degranulation was markedly noted. In the adult, most mast cells had markedly
      decreased numbers of granules and cytoplasmic villi. Some cells displayed
      degenerative or necrotic appearances. These findings correlated well with the
      clinical course of these cases, which improved spontaneously over time.

PMID- 2241202
TI  - Ichthyosis, mental retardation, and asymptomatic spasticity. A new neurocutaneous
      syndrome with normal fatty alcohol:NAD+ oxidoreductase activity.
AB  - A number of inherited disorders of cornification have been related to abnormal
      lipid metabolism. In the recessively inherited Sjogren-Larsson syndrome, defined
      by the triad of ichthyosis, mental retardation, and spasticity, fatty
      alcohol:NAD+ oxidoreductase deficiency has recently been reported. These patients
      accumulate fatty alcohol in the plasma and cultured fibroblasts. A 19-year-old
      woman with ichthyosis, mental retardation, and mild spasticity is described in
      whom fatty alcohol metabolism was normal, as determined by plasma octadecanol
      level and fibroblast fatty alcohol:NAD+ oxidoreductase activity. Ultrastructural
      studies on skin from the patient revealed morphologically abnormal epidermal
      lamellar bodies, not unlike those seen in neutral lipid storage disease with
      ichthyosis. We postulate that this patient has a novel neurocutaneous syndrome
      that may be secondary to abnormal lipid metabolism.

PMID- 2241203
TI  - Dermatology in the German Democratic Republic.

PMID- 2241204
TI  - Current status of dermatologic surgery: new special requirements for dermatology
      residency training.

PMID- 2241205
TI  - A pruritic vesicular eruption. Henoch-Schonlein purpura.

PMID- 2241206
TI  - Purpuric vesicular eruption in a 7-year-old girl. Vesicular pityriasis rosea.

PMID- 2241207
TI  - Urticarial skin eruption in a child. Leukemia cutis.

PMID- 2241208
TI  - Psoriasis induced at the injection site of recombinant interferons.

PMID- 2241209
TI  - Pruritic urticarial papules and plaques of pregnancy are not related to maternal
      or fetal weight gain.

PMID- 2241210
TI  - Cutaneous mucinosis in a patient with eosinophilia-myalgia syndrome associated
      with L-tryptophan ingestion.

PMID- 2241211
TI  - Dermal mucinosis in the eosinophilia-myalgia syndrome.

PMID- 2241212
TI  - Thrombocytopenia-absent radii syndrome and lack of response to the pulsed dye
      laser.

PMID- 2241214
TI  - Pemphigoid nodularis.

PMID- 2241213
TI  - Follow-up study of a cutaneous adult T-cell leukemia/lymphoma patient by southern
      blot analysis.

PMID- 2241215
TI  - Psoriasis after allogeneic bone marrow transplantation.

PMID- 2241216
TI  - A family outbreak of acute guttate psoriasis.

PMID- 2241217
TI  - Acral pseudolymphomatous angiokeratoma of children.

PMID- 2241218
TI  - Genomic imprinting.

PMID- 2241219
TI  - Neonatal infections with coagulase negative staphylococci.

PMID- 2241220
TI  - Prediction of acute renal failure after birth asphyxia.
AB  - Twenty-one babies of 34-41 weeks' gestational age with birth asphyxia (5 minute
      Apgar score less than or equal to 5 or umbilical artery pH less than or equal to
      7.2) were studied during the first two days of life to find out whether the
      urinary excretion of tubular markers of renal function is of value in the early
      diagnosis of acute renal failure. Urinary retinol binding protein, myoglobin, and
      N-acetyl-beta-D-glucosaminidase (NAG), expressed as a ratio with urinary
      creatinine, were measured and excretion profiles repeated at 3-6 days in 15
      infants and at 7-14 days in 11 infants. Plasma creatinine concentration,
      creatinine clearance, plasma myoglobin concentration, and fractional sodium
      excretion were measured where possible in asphyxiated infants. Control data were
      obtained from 50 healthy infants: 28 gave urine samples alone, 17 urine and
      blood, and five blood alone. Normal urinary values were derived from 17, 25, and
      three infants, respectively, for the three time periods. The number of control
      samples was limited for ethical reasons. Four asphyxiated infants had acute renal
      failure (group 1), four had tubular dysfunction without glomerular disturbance
      (group 2) and 13 had normal renal function (group 3). Group 1 were clearly
      identified by greatly increased urinary retinol binding protein (greater than
      27,000 micrograms/mmol creatinine) and myoglobin (greater than 1500
      micrograms/mmol creatinine) excretion measured in the first two days of life. In
      control infants the range of excretion of retinol binding protein within the same
      time period was 3 to 967 micrograms/mmol creatinine and urinary myoglobin was
      undetectable. Excretion of NAG failed to discriminate between groups 1 and 2.
      Acute renal failure occurred only in infants who had heavy myoglobinaemia.
      Tubular dysfunction in group 2 was transient and not accompanied by plasma
      electrolyte disturbances. We conclude that measurement of urinary excretion of
      retinol binding protein or myoglobin after birth is helpful in the early
      diagnosis of acute renal failure.

PMID- 2241221
TI  - Area of lateral ventricles measured on cranial ultrasonography in preterm
      infants: reference range.
AB  - Serial ultrasound imaging of the brain was carried out in 87 preterm infants of
      27 to 36 weeks' gestational age while they were in the special care nursery and
      during their first postnatal year. None had evidence of intracranial disease
      during the neonatal period and 94% had good neurodevelopmental outcome at 2 years
      of age. Lateral ventricle area measurements were plotted against independent
      variables including postnatal age and head circumference at the time of the
      examination. The measurements increased as age and head circumference increased.
      During the first six weeks of life the mean (SD) postnatal head circumference
      growth velocity (rate of growth) was 0.53 (0.13) cm/week and the mean postnatal
      ventricular area growth velocity was 0.39 (0.19) mm2/week. A reference range for
      lateral ventricle area values was developed from these serial measurements in
      infants with documented good short term developmental outcome.

PMID- 2241222
TI  - Spontaneous resolution of bone mineral depletion in preterm infants.
AB  - Fifteen preterm infants and 17 born at full term whose gestational ages ranged
      from 25 to 34 weeks and 38 to 42 weeks, respectively, were examined initially at
      postconceptional ages ranging from 38 to 44 weeks and subsequently at 46 to 71
      weeks. Each examination included measurement of bone mineral content of the mid
      forearm by single photon absorptiometry. For the preterm group, the mean (SD)
      value of bone mineral content at the first examination was 109.0 (27.6) mg/cm and
      was significantly lower than the corresponding value of 194.4 (19.6) mg/cm for
      the whole full term group. The mean subsequent rate of mineral accretion in the
      preterm group was 8.70 (4.60) mg/cm/week, the mean individual duration of
      observation being 9.7 weeks. Rate of mineral accretion for the full term group
      was independent of the duration of observation and averaged 1.60 (2.20)
      mg/cm/week. The difference between mean values of rate of mineral accretion in
      the preterm and full term groups was highly significant. Our results show that
      there is a phase of rapid mineral accretion starting at 40 weeks' postconception
      in preterm infants that substantially reduces the perinatal mineralisation
      deficit.

PMID- 2241223
TI  - Preoperative stabilisation in congenital diaphragmatic hernia.
AB  - Between January 1983 and November 1986, 26 newborn infants with congenital
      diaphragmatic hernia were treated by early operation at a mean of 7 hours of age.
      A further 23 infants admitted between December 1986 and December 1989 were
      stabilised for a mean period of 40 hours before operation. There was no
      significant difference in survival between the two groups. Delayed operation is
      not detrimental to infants with congenital diaphragmatic hernia.

PMID- 2241224
TI  - Peak inspiratory pressure requirements in infants born weighing less than 750 g.
AB  - The possibility that peak inspiratory pressure requirements or the
      arterial:alveolar oxygen ratio can predict the clinical outcome in infants
      weighing less than 750 g at birth was explored in a consecutive series. Nine of
      10 infants (90%) with a peak inspiratory pressure requirement of more than 18 cm
      H2O at 48 hours or more than 16 cm H2O at 72 hours from age subsequently died
      later of respiratory causes (defined as death after 72 hours of pulmonary
      interstitial emphysema, bronchopulmonary dysplasia, or cor pulmonale). Twenty of
      21 remaining infants (95%) survived until discharge. Using these data a 95th
      centile for peak inspiratory pressure requirement during the first 72 hours of
      life was constructed. The potential value of this centile in predicting later
      death of respiratory causes was examined in a separate series. Twelve of 15
      infants (80%) whose peak inspiratory pressure requirements remained below the
      95th centile, or were not ventilated (n = 6), survived. In contrast, 11 of 12
      (92%) infants whose requirements crossed the 95th centile died later of
      respiratory causes. The infants who died had more radiological changes and higher
      mean arterial carbon dioxide pressure than survivors suggesting that the severity
      of the initial lung disease rather than the way that ventilation was managed
      determined prognosis. Peak inspiratory pressure requirement was more useful than
      arterial:alveolar oxygen ratio in clearly distinguishing between survivors and
      infants who died later of respiratory causes.

PMID- 2241225
TI  - Amniotic fluid insulin concentration as a predictor of obesity.
AB  - Longitudinal correlations were obtained between amniotic fluid insulin
      concentration at 32 to 38 weeks' gestation and anthropometric characteristics at
      the age of 6 years in 56 children of diabetic mothers. The prospective studies
      indicated that at the age of 6 years, as at birth, the greatest increase in
      weight in relation to height (relative obesity) was seen in children who
      experienced the greatest exposures to insulin in the uterus (as judged by
      amniotic fluid insulin concentration). Significant correlations between amniotic
      fluid insulin and relative obesity at the age of 6 years were found after
      adjustment for maternal obesity and macrosomia at birth. The highest amniotic
      fluid insulin values are clustered in the subgroup of 14 children who were
      obviously obese by the age of 6 years. These findings are consistent with the
      hypothesis that there is an association between anthropometric development and
      intrauterine metabolism, and suggest that premature and excessive exposure to
      insulin during gestation may predispose to obesity in childhood. The amniotic
      fluid insulin concentration may predict this eventuality.

PMID- 2241226
TI  - Ramadan and birth weight at full term in Asian Moslem pregnant women in
      Birmingham.
AB  - The birth weights of 13,351 babies born at full term from 1964-84 to Asian Moslem
      mothers in Birmingham were analysed to see if the effect of the Ramadan fast on
      maternal biochemical profiles was of any clinical relevance. These were compared
      with two age matched control groups comprising white and non-Moslem Asian babies.
      Ramadan had no effect on mean birth weight at whatever stage of pregnancy it
      occurred. There was an increase in the prevalence of low birth weights (4.5% to
      8%) among babies who were born at full term when Ramadan had occurred during the
      second trimester, but this was not significant. We conclude that the Ramadan fast
      has no effect on the birth weights of babies born at full term.

PMID- 2241227
TI  - Outcome after acute osteomyelitis in preterm infants.
AB  - Eight cases of skeletal infection in preterm infants were studied. All the
      infants were systemically unwell, with polymorpholeucocytosis. Diagnosis was by
      blood culture, and any radiographic changes were apparent at the time of
      presentation. Infection was often multifocal, with sites around the knee being
      most commonly affected. Staphylococcus aureus was the pathogen isolated in six of
      the eight cases; in these treatment with fusidic acid was effective and well
      tolerated, even at doses that were less than the recommended therapeutic minimum.
      Even with prompt diagnosis and aggressive treatment orthopaedic sequelae are
      common.

PMID- 2241228
TI  - Skin conductance and arousal in the newborn.
AB  - We measured skin conductance continuously from the sole of a foot in babies of
      different conceptional ages before, during, and for 10 minutes after a 'heel
      prick' carried out for routine blood sampling. We studied 82 healthy babies whose
      gestational and postnatal ages ranged from 25-42 weeks, and 1-73 days. The median
      skin conductance level (preheel prick) in babies of 40-43 weeks' conceptional age
      was 0.6 microS (microsiemens) and differed significantly between awake babies
      (1.2 microS) and those who were asleep (0.5 microS). In contrast babies less than
      40 weeks had a significantly lower median skin conductive level (0.3 microS)
      which was identical in awake and asleep babies. In response to the heel prick all
      babies became aroused and skin conductance rose sharply and immediately in 21 out
      of 22 (95%) babies 40-43 weeks' conceptional age, and in seven out of 23 (30%)
      babies 36-39 weeks. The median rise at one minute in babies of 40-43 weeks was
      significantly higher than those 36-39 weeks (2.7 microS compared with 0.5
      microS). No babies less than 36 weeks had a change in their skin conductance
      after the heel prick. These results are consistent with the notion that
      'emotional sweating' is a function of maturity and does not develop until 36
      weeks' conceptional age.

PMID- 2241229
TI  - Gut blood flow velocities in the newborn: effects of patent ductus arteriosus and
      parenteral indomethacin.
AB  - The effects on gut blood flow velocities of parenteral indomethacin (0.2 mg/kg)
      given either quickly as a bolus or slowly as an infusion were compared in
      consecutive studies of two groups of infants with symptomatic patent ductus
      arteriosus. In the presence of patent ductus arteriosus the range of velocities
      in the superior mesenteric artery before indomethacin was given was characterised
      by pronounced abnormalities including absent--or in some cases even retrograde-
      diastolic flow. In eight subjects the first rapidly given bolus dose of
      indomethacin (duration 20 seconds or less) caused a pronounced and sustained fall
      in the velocity of the superior mesenteric artery blood flow (mean peak systolic
      velocity (cm/second): before 74; after 38; median time to maximum fall 7.4
      minutes; median time to recovery 50 minutes). A further 10 subjects received
      their first dose of indomethacin by slow infusion (duration 30-35 min) and the
      percentage fall in peak systolic velocity was both substantially less (22%
      compared with 47%) and later (median time to maximum fall 37.3 minutes) than
      after rapid infusion. Qualitatively similar but smaller changes were seen in the
      coeliac axis. Return of antegrade end diastolic flow in the superior mesenteric
      artery within one hour of the first dose of indomethacin was a good predictor of
      subsequent closure of the ductus. These data suggest that there is a profound
      disturbance in mid gut perfusion in infants with patent ductus, which is
      exacerbated by indomethacin given rapidly by intravenous bolus. They may also
      provide a rational explanation for the well recognised association between
      necrotising enterocolitis and both patent ductus arteriosus and indomethacin
      administration. The unwanted effects of the indomethacin are abrogated by slow
      infusion, without loss of efficacy in closure of the ductus.

PMID- 2241230
TI  - Hiccups and breathing in human fetuses.
AB  - Serial recording in 45 low risk fetuses throughout the second and third
      trimesters showed that hiccups were the predominant diaphragmatic movement before
      26 weeks' gestational age and that there was a significant negative correlation
      with gestational age. There was a pronounced reduction between 24 and 26 weeks,
      which was the result of a decrease in the number of episodes of hiccups rather
      than a change in the duration of episodes. In contrast, fetal breathing was
      positively correlated with gestational age, the greatest increase in breathing
      occurring between 26 and 32 weeks' gestation. This was the result of both an
      increase in the number and duration of episodes. From the time that rest-activity
      cycles of behaviour could be determined in recordings, both breathing and hiccups
      were dependent on behavioural state or cycle, occurring predominantly during
      active episodes. This association between quiet and active behaviour and
      breathing did not alter with increasing gestational age, and the variables in
      fetal behavioural state became increasingly closely linked. The importance of
      prolonged and repeated recording, and also the need to take account of other
      variables in fetal behaviour, before any sinister conclusions can be drawn about
      the absence of fetal breathing is emphasised.

PMID- 2241232
TI  - Bronchopulmonary dysplasia: early diagnosis, prophylaxis, and treatment.

PMID- 2241231
TI  - Bronchopulmonary dysplasia: then and now.

PMID- 2241234
TI  - Withdrawal of life support in babies: deceptive signals.

PMID- 2241233
TI  - Bronchopulmonary dysplasia: a new look at management.

PMID- 2241235
TI  - Dr William Harvey (1578-1657): physician, obstetrician, and fetal physiologist.

PMID- 2241236
TI  - Chlorinated hydrocarbons in fat tissue: analyses of residues in healthy children,
      tumor patients, and malformed children.
AB  - The content of chlorinated hydrocarbons (CHC) was determined by means of
      capillary column gas chromatography in samples of fat tissue from 183 healthy
      children, 46 children with malignant tumors and 33 children with benign tumors or
      congenital malformations. The highest concentrations were found for total
      polychlorobiphenyls (PCB) (mean = 1.614 ppm), followed by the DDT group (mean =
      0.556 ppm, HCB (mean = 0.097 ppm), the HCH isomers (mean = 0.083 ppm), dieldrin
      (mean = 0.020 ppm) and total heptachlor (mean = 0.010 ppm). Neonates displayed
      high concentrations in the adipose tissue before the first uptake of food. In the
      first six months of life, the concentrations of total PCB, the individual PCB
      components as well as DDT and HCB decreased significantly. In the second year of
      life, they rose again to the initial values and then remained relatively constant
      during the rest of childhood. The regional differences with regard to total CHC
      residues were slight, so that the CHC exposure cannot be reduced by a change of
      domicile within West Germany (FRG). Children with congenital malformations or
      benign or malignant tumors do not display raised concentrations of CHC.

PMID- 2241237
TI  - Biological monitoring of human exposure to acephate.
AB  - Acephate is a water-soluble organophosphate insecticide whose action on insects
      has been related to its conversion to methamidophos, a very potent
      anticholinesterase agent which has caused delayed neuropathy in man. Inhalation
      and skin exposure to acephate was evaluated in four workers engaged in 8-day
      campaigns with the formulation of the 97%-pure technical product. Before, during,
      and after exposure, the workers were monitored for the urine content of acephate
      and methamidophos, and for erythrocyte (AChE) and plasma (PChE) cholinesterase
      levels. Median air concentrations (8-hr TWA) ranged from 0.278 to 2.170 mg/m3;
      median total-body skin deposition ranged from 26.1 to 41.9 mg/day. Based on these
      values, daily workers' absorption of acephate was estimated to be in the order of
      10-20 mg. Urinary excretion of unchanged acephate followed a pattern consistent
      with exposure, showing peak values of excretion during the workshift or in the
      eight hr after the end of the workshift. The urine levels of unchanged acephate
      were found to vary from 1 to 10 mg/L. Methamidophos was not detected in any urine
      sample (detection limit: 30 micrograms/L). High correlation (r = 0.78) was found
      between skin exposure level and urine acephate elimination. No changes in AChE or
      PChE were observed for the workers whose urinary concentrations of acephate were
      1 or 2 mg/L. One subject who had urinary acephate excretion between 3 and 8 mg/L,
      showed slightly decreased values of PChE during exposure and of AChE after
      exposure.

PMID- 2241238
TI  - The effect of copper on the embryonic development and hatching of Sepia
      officinalis L.
AB  - The influence of copper on embryonic development and hatching of Sepia offinalis
      was investigated. Copper exerts a profound effect on both hatching stage and time
      to-hatching. At high copper concentrations (50-200 ppb Cu2+), the embryos hatch
      earlier than the controls but have a lower survival potential. No external
      morphological malformations were found. Whereas copper does not accumulate in the
      embryo or in the vitellus, it is absorbed by the envelope and/or the chorion.

PMID- 2241239
TI  - Children in out-of-home placement: a psychiatric nursing challenge.

PMID- 2241240
TI  - The use of touch with the hospitalized psychiatric patient.
AB  - A descriptive study was designed to identify and describe the ways in which
      registered nurses use nonprocedural touch in the inpatient psychiatric setting.
      Natural setting observation and nurse interviews were used to examine the
      decision-making process and intentions of nurses who used touch. Twenty-five
      incidents of nonprocedural touch initiated by 13 registered nurses with 17
      psychiatric patients were recorded over 27.5 hours of observations. Touch was
      primarily used by nurses in a discriminating manner and for specific reasons, and
      was correlated with numerous factors such as the patient's age and gender, and
      the nurse's feelings, beliefs, intuition, and personal style.

PMID- 2241241
TI  - Forced relocation of hospitalized psychiatric patients.
AB  - By virtue of their disability and hospital program requirements, severely and
      chronically mentally ill patients are subject to involuntary transfer from the
      community to hospitals, within hospitals, between hospitals, and from hospitals
      to the community. These forced relocations, no matter how humanely they were
      initially conceived to be, have become highly routine. The consequence is loss of
      the sense of the patient as a human being with individual needs. This research
      elicited the patients' own descriptions and the meanings they attached to the
      experience of forced relocation. The findings point to the need for greater
      success of programs designed to keep patients in their home communities to the
      greatest extent possible. The findings also suggest the need for hospital staff
      to eliminate or reduce intrahospital transfers and to develop and maintain humane
      transfer procedures when forced relocation becomes necessary.

PMID- 2241242
TI  - A family systems model for divorce and the loss of self.
AB  - The dissolution of a marriage through divorce represents a major loss in the
      lives of all family members. Losses can include those of a physical, social, and
      emotional nature. The self as it was defined within the marital context and the
      loss of that self as a result of divorce is a significant source of potential
      dysfunction in adult family members during and after the divorce. From a family
      systems' perspective, the lower the level fo differentiation of self in family
      members, the greater is the likelihood that the self was defined in a fusional
      way during the marriage. As such, when the fused common self is lost through
      divorce, one or both spouses is likely to experience a significant sense of loss
      as well as potential dysfunction. The purpose of this article is to propose a
      model that helps divorced people deal with the loss of self and assists them to
      define a more differentiated sense of self.

PMID- 2241243
TI  - Assessment and management of depression: an imperative for community-based
      practice.
AB  - The purpose of this mental health training program was to increase primary care
      nurses' knowledge and skills about depression. The program emphasized criteria
      for assessing depression, presented psychopharmacological and psychotherapeutic
      content, discussed care coordination among multiple agencies and providers, and
      addressed referral resources. Highlighted were cultural and developmental issues
      for Native Americans, Mexican-Americans, the elderly, and adolescents. The
      training program successfully increased primary care nurses' knowledge about
      depression and their abilities to use this knowledge in clinical practice.

PMID- 2241244
TI  - A psychogeriatric nursing assessment protocol for use in multidisciplinary
      practice.
AB  - The assessment of geriatric patients with psychiatric or neurobehavioral problems
      demands a multidisciplinary approach linking nursing, psychiatry, neurology,
      geriatrics, and internal medicine. While the medical disciplines have relatively
      well-established approaches to assessing psychogeriatric patients, nursing lacks
      a comprehensive assessment strategy that supports both nursing and
      multidisciplinary practice. This article describes the Psychogeriatric Nursing
      Assessment Protocol (Abraham, 1989) developed for use in a multidisciplinary
      geriatric neuropsychiatric outpatient clinic. The relationship of the protocol to
      psychiatric, neurological, geriatric, and medical assessments is discussed in an
      attempt to clarify the linkages of knowledge and care required for successful
      service delivery to geriatric patients with psychiatric or neurobehavioral
      problems, as well as to their families and formal and informal caregivers.

PMID- 2241245
TI  - Psychiatric-mental health head nurse management concerns.
AB  - Psychiatric-mental health head nurses supervise and direct patient care, and
      therefore, possess a critical, front-line perspective of nursing practice
      problems. This article explores this perspective by interviewing four head nurses
      about patient care, staffing, and organizational management concerns.
      Interestingly, some of the findings of the study, such as head nurse concerns
      regarding retaining, recruiting, and motivating staff, and increasing patient
      acuity, already have been supported in the general nursing literature. Other
      concerns, including the need to clarify the role of the nurse and to define areas
      of responsibility with other mental health professionals, seem unique to mental
      health nursing.

PMID- 2241246
TI  - Consultee satisfaction with a psychiatric consultation-liaison nursing service.
AB  - A consumer satisfaction survey was conducted with nurses who made consecutive
      consultation requests to a general hospital psychiatric consultation-liaison
      nursing service. In each of 69 responses, global satisfaction ratings indicated
      that the consultee either was satisfied or very satisfied with the assistance
      provided. Particular strengths were noted in relation to the ease with which the
      consultants could be notified, the speed of response, and the clarity with which
      their formulations were expressed. The respondents were least satisfied with the
      extent of written documentation and the amount of follow-up. In a multiple
      regression analysis, only the total number of visits emerged as a significant
      predictor of satisfaction scores. However, comparisons of replies of most
      satisfied and least satisfied also indicated that high satisfaction ratings were
      more likely to be given to consultations requesting assistance with patients'
      families rather than to consultations requesting help in the management of
      patients with major psychiatric disorders.

PMID- 2241247
TI  - Loneliness in veterans with AIDS and its relationship to the development of
      infections.
AB  - The purposes of this study were to examine loneliness in men with AIDS over a 6
      month period and relate the extent of loneliness to the development of
      infections. Psychoneuroimmunology theory suggests that emotional distress alters
      immune response. It was believed that loneliness would increase vulnerability to
      infection. A convenience sample of 31 veterans participated in the study.
      Although there were no significant changes in loneliness over the 6-month period
      for the total sample, gay men had a significant increase (P greater than .03) in
      loneliness related to romantic sexual attachment. Despite an average of 3.4
      infections over the 6-month period, there was no relationship between development
      of infection and loneliness. Factor analysis was performed for the demographic
      and study variables. The three factors identified from the study variables were
      loneliness, social support, and vitality.

PMID- 2241249
TI  - A passion for people, quality, and service.

PMID- 2241248
TI  - Clozapine: a new antipsychotic drug.
AB  - Clozapine is a new antipsychotic drug that displays antipsychotic efficacy of the
      classic neuroleptics without the associated extrapyramidal side effects. This
      article briefly reviews the action and use of clozapine in order to help nurse
      clinicians become familiar with the drug usage. Clozapine is presently in use
      only in clinical trials, but is expected to be marketed by Sandoz Pharmaceutical
      Corporation (Hanover, NJ) in 1990.

PMID- 2241250
TI  - Nursing, quality, and health policy: a partnership for change.
AB  - In this article, Kathryn M. Mershon, MSN, RN, CNAA, senior vice president for
      nursing at Humana Inc. and a member of the Prospective Payment Assessment
      Commission (ProPAC), examines several ideas or initiatives that need to be
      explored to help advance nursing to where it should be in the future. These
      include among others getting rid of "sacred cows" that impede change,
      understanding nursing's influence on health policy reform, examining quality in
      the current health care environment, and implementing steps for future change.

PMID- 2241251
TI  - Certification in nephrology nursing: an interview with NNCB president Janel
      Parker. Interview by Patricia S Jordan.
AB  - Certification in nephrology nursing became a reality in 1987 with the formation
      of the Nephrology Nursing Certification Board (NNCB), and the development and
      administration of the nephrology nursing certification examination. Three years
      later, NNCB President Janel Parker discusses the evolution of the NNCB
      examination, the significance and impact of the examination, and the future of
      certification in nephrology nursing.

PMID- 2241253
TI  - A dialysis patient classification system for establishing nurse/patient ratios.
AB  - In Connecticut, dialysis-related patient classification systems have taken on
      greater significance as state regulations deemphasize traditional nurse/patient
      ratios. The patient classification system devised for the Rockville General
      Hospital End Stage Renal Disease Unit is based on a process-oriented system and
      addresses both the physiologic and psychologic needs of the patient. Use of the
      system has provided nurses with a more efficient and effective means of matching
      patient care needs with daily staffing assignments. This article addresses the
      development of a patient classification system tool and the validity and
      reliability studies conducted to test the tool.

PMID- 2241252
TI  - Life satisfaction and coping of diabetic hemodialysis patients.
AB  - End-stage diabetic patients who are dependent on hemodialysis live with multiple
      deficits and discomforts. Their quality of life would seem dismal to others. The
      perceptions of the patients themselves, however, might be quite different. In
      this descriptive study, 12 such patients were interviewed using Cantril's Self
      Anchoring Striving Scale. The mean satisfaction rating for the anticipated future
      was almost as high as the past, despite experiencing a long-standing downward
      health spiral. Content analysis of the interviews suggested coping patterns of
      people who are living with a chronic disease.

PMID- 2241255
TI  - Care of the family of the child with end stage renal disease.
AB  - A major challenge for the pediatric nephrology nurse is to build a relationship
      with the family of the child with end stage renal disease (ESRD) that is neither
      intrusive nor fosters overdependence. Strategies addressed in this article
      include assessment, the team approach, teaching, emotional support, counseling,
      and coping with the health care system.

PMID- 2241254
TI  - Cultural considerations in teaching the Saudi Arabian renal transplant recipient.
AB  - Teaching renal transplant recipients in Saudi Arabia requires incorporation of
      basic nursing principles with cultural and religious beliefs to develop
      individualized plans of care. Multinational nursing staffs collaborate on
      teaching methods and materials to promote compliance with diet, medications, and
      activities to return the transplant patient to health and a normal lifestyle.

PMID- 2241256
TI  - Spice of life: a strategy to enhance dietary compliance.
AB  - A creative teaching strategy was implemented to stimulate patients' motivation to
      incorporate learned dietary concepts into their daily life-style. Thirty-five
      hemodialysis patients were given a pamphlet that described herbs and spices to
      enhance the flavor of specific foods and 25 sample seasoning packets for their
      experimentation. Most stated that the pamphlet was helpful (82.9%) and use of the
      spices made the diet palatable 75% or more of the time (93.4%).

PMID- 2241258
TI  - "Women working with women" session lacked 'sensitivity'.

PMID- 2241257
TI  - Case management of the anemic patient. Epoetin alfa: focus on nutrition
      management.
AB  - As the use of Epoetin alfa to treat the anemia of chronic renal failure expands,
      attention is beginning to focus on the dietary changes that may occur subsequent
      to therapy. The anemia-related pattern of poor appetite, lethargy, and decreased
      mental and physical status can often be reversed as anemia is corrected. Changes
      in nutritional status increase the importance of monitoring serum chemistries and
      providing timely interventions. Potentially serious side effects associated with
      changes in serum chemistries can be minimized or prevented by a teamwork approach
      involving the physician, nurse, and renal dietitian.

PMID- 2241259
TI  - A tribute to nephrology nurses.

PMID- 2241260
TI  - The ANCA test: its clinical relevance.

PMID- 2241261
TI  - Oral contraceptives and rheumatoid arthritis: new data from the Royal College of
      General Practitioners' oral contraception study.
AB  - From data available at April 1987 it was found that the standardised risk ratio
      for rheumatoid arthritis between current users of oral contraceptives and never
      users was 0.82 (95% confidence interval 0.59 to 1.15); the ratio between former
      users and never users was 0.94 (95% confidence interval 0.72 to 1.22). Important
      secular trends have occurred within our study population. The incidence of
      rheumatoid arthritis among former and never users has declined over the past two
      decades. Current users have not experienced this temporal trend, and the ratio
      between current and never users has, therefore, approached unity. These secular
      changes may explain why some studies have found that oral contraceptives have a
      protective effect, while others have been unable to show such an effect.

PMID- 2241262
TI  - Measurement of the chemotactic complement fragment C5a in rheumatoid synovial
      fluids by radioimmunoassay: role of C5a in the acute inflammatory phase.
AB  - Evidence suggests that complement is activated in rheumatoid joints. A sensitive
      radioimmunoassay for the activation fragment of C5, C5a, which is a potent
      chemoattractant for neutrophils, was therefore developed. A mean C5a
      concentration in 22 rheumatoid joint fluids of about 2.5 x 10(-9) mol/l was
      found. This concentration of C5a is sufficient to induce two of the
      characteristic features of the acute inflammatory phases of rheumatoid arthritis:
      neutrophil accumulation and microvascular plasma protein leakage. In animal
      models it has been shown that C5a is a potent inducer of inflammatory oedema by a
      neutrophil dependent mechanism. A striking feature of the acute inflammatory
      phases of rheumatoid arthritis is the appearance of high numbers of neutrophils
      in the synovial fluid. It is suggested that C5a might have a role in mediating
      neutrophil accumulation and, as a consequence, may be important in acute joint
      swelling and pain.

PMID- 2241263
TI  - Smoking, lung function, and rheumatoid factors.
AB  - Positive rheumatoid factor (RF) reactions commonly precede the onset of
      clinically manifest rheumatoid arthritis (RA). Thus if items associated with RF
      reactions were traced at the community level this might provide clues to the
      cause of RA. The relations between smoking and lung functions and the occurrence
      of RA and RFs in a population sample representative of the adult Finnish
      population were studied. Rheumatoid factor testing was performed for 7124
      subjects (89% of the sample) by the sensitised sheep cell agglutination test.
      Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
      were measured with spirometry. 'False positive' RF reactions occurred twice as
      often in current smokers and ex-smokers than in those who had never smoked. The
      prevalence of high titres was fourfold greater among current smokers than among
      those who had never smoked. These associations were statistically significant and
      independent of age, FVC, and FEV1 in both sexes. The women with airflow
      limitation (FEV1/FVC less than 70%) had a significantly increased occurrence of
      RFs which was independent of their smoking history, but no such relationship was
      found in men. The results suggest an impact of smoking on RF production; a follow
      up study may show whether the raised RF titers in smokers will be reflected as an
      increased incidence of RA.

PMID- 2241264
TI  - Specificity of rheumatoid factors in relation to the disease state in rheumatoid
      arthritis.
AB  - Rheumatoid factors found in patients with rheumatoid arthritis react with human
      IgG and with IgG from some other species. The levels of rheumatoid factor give
      some indication of prognosis, albeit a rather poor one in this highly variable
      disease. The high degree of variability may, in part, be due to differences in
      the fine specificity of the rheumatoid factor in each individual patient, leading
      to differences in the types of immune complex formed. To study this hypothesis
      the fine specificity of rheumatoid factors of the IgM, IgA, and IgG classes for
      IgG from human, baboon, orangutan, macaque, owl monkey, gorilla, marmoset, cow,
      pig, sheep, goat, horse, mouse, and chicken was examined. Differential reactivity
      for these species was found and associations between the presence of rheumatoid
      factor and the development of moderate or severe erosions.

PMID- 2241265
TI  - Clinical assessment of osteoarthritis of the knee.
AB  - The repeatability of physical signs used to assess osteoarthritis of the knee has
      not been systematically examined. The within and between observer variation of 10
      commonly used physical signs to determine osteoarthritis of the knee has been
      assessed here. The results obtained show variation in the repeatability of these
      signs. For those examining the tibiofemoral joints the repeatability was greater
      than for those examining the patellofemoral joint. It would therefore seem vital
      to take note of the repeatability of physical signs in determining the number of
      subjects to be studied in epidemiological studies and therapeutic studies in
      osteoarthritis.

PMID- 2241266
TI  - Do clinical findings associate with radiographic osteoarthritis of the knee?
AB  - From a population survey of 2865 subjects, test characteristics of a number of
      clinical findings relating to knee osteoarthritis were calculated against the
      standard of radiographic diagnosis. The clinical findings included from the
      history were age, gender, current pain in the knee, swollen knee, pain in both
      hands, morning stiffness, osteoarthritis in any joint, pain or stiffness, or
      both, in knees or hips when rising from seated position, and pain in knees or
      hips while climbing stairs; and from the physical examination: Quetelet's index,
      Heberden's nodes, bony enlargement, palpable effusion, soft tissue swelling,
      limitation of knee function, pain with knee flexion, bony tenderness and,
      finally, the latex fixation test. Of 18 clinical variables, all but Heberden's
      nodes, palpable knee effusion, pain in both hands, and latex fixation test showed
      a significant association after adjustment for age. Neither one single variable
      nor a combination could predict radiographic osteoarthritis of the knee with
      reasonable accuracy and thus be applicable in clinical practice. The x ray film,
      therefore, keeps its place in the diagnosis of knee osteoarthritis in general
      practice as well as in epidemiological research.

PMID- 2241267
TI  - A prospective study on antiribosomal P proteins in two cases of familial lupus
      and recurrent psychosis.
AB  - In two siblings with systemic lupus erythematosus (SLE), who experienced two
      episodes of psychosis each, a longitudinal study of autoantibodies, including
      antibodies to ribosomal P proteins, is described. In two of three evaluable
      periods of 15 weeks antedating psychosis a rise followed by a spontaneous drop in
      anti-P levels was recorded. In the third period antibodies to ribosomal protein P
      were absent. It is concluded that results with single samples are not
      informative, and that frequent measurement of antibodies to ribosomal protein P
      in patients with SLE may have limited predictive value for psychosis.

PMID- 2241268
TI  - Stress fractures of the legs and swelling of the ankles in a patient with lupus:
      a diagnostic dilemma.
AB  - A patient with systemic lupus erythematosus (lupus) is described, in whom stress
      fractures of both legs developed, accompanied by swelling of both ankles. The
      swelling of the right ankle associated with fracture mimicked lupus synovitis,
      but resolved with healing of the fracture. On the left side the swelling
      represented true lupus synovitis coexistent with the tibial stress fracture. This
      presentation posed a diagnostic dilemma. It is necessary to maintain vigilance in
      the diagnosis of these fractures in lupus.

PMID- 2241269
TI  - Demonstration of a geode by magnetic resonance imaging: a new light on the cause
      of juxta-articular bone cysts in rheumatoid arthritis.
AB  - The magnetic resonance imaging (MRI) features of a rheumatoid arthritic geode are
      presented. Development of such a cyst from before x ray diagnosis to its
      coalescence with the wrist joint is described. The evidence suggests that these
      juxta-articular cysts are not merely an intrusion of the synovial cavity into the
      bone marrow but start as isolated structures beneath the subchondral bone.

PMID- 2241270
TI  - Treatment with cimetidine of atypical fasciitis panniculitis syndrome.
AB  - Three patients presented with septal fasciitis and panniculitis, associated with
      clinical and laboratory features which precluded straight-forward classification
      into eosinophilic fasciitis, localised scleroderma, or lupus erythematosus
      profundus. Treatment with cimetidine caused the remission of cutaneous
      manifestations and the extracutaneous abnormalities, such as nailfold capillary
      disturbances and the presence of antithyroid antibodies, improved. It is
      concluded that features of eosinophilic fasciitis or localised scleroderma and
      certain additional atypical elements should be categorised as atypical fasciitis
      panniculitis syndrome.

PMID- 2241271
TI  - Evans' syndrome associated with dermatomyositis.
AB  - Autoimmune haematological complications in dermatomyositis are very uncommon.
      This case report describes autoimmune haemolytic anaemia and thrombocytopenia in
      a patient with dermatomyositis and pulmonary fibrosis.

PMID- 2241272
TI  - Comparative study of test kits for measurement of rheumatoid factors by the latex
      fixation test.
AB  - The performance of 14 test kits for the measurement of rheumatoid factors by the
      latex fixation test was investigated; all results were expressed in IU/ml.
      Reproducibility and properties of control sera were also studied. It was found
      that half of the kits did not satisfactorily detect rheumatoid factor levels
      lower than 25 IU/ml. Most kits performed reasonably well in practice. Positive
      control sera only rarely met strict requirements. The relative costs did not
      always have a clear correlation with the quality of the results. The variation
      caused by differences between kits became acceptable when the results were
      expressed in IU/ml.

PMID- 2241273
TI  - Management of rheumatoid neck.

PMID- 2241275
TI  - Negative antineutrophil cytoplasmic antibodies in Behcet's disease.

PMID- 2241276
TI  - Pregnancy loss, menopause, and the onset of rheumatoid arthritis.

PMID- 2241274
TI  - Psychological disorders in rheumatoid arthritis: a growing consensus?
AB  - Previous reviews of psychological factors in arthritis have emphasised the
      methodological weaknesses of many studies, especially those attempting to measure
      personality after years of disabling disease. To make sense of the published
      reports three factors need to be considered separately: previous personality,
      social stresses, and current mental state. Each can now be measured reliably and
      independently of symptoms which might be directly attributable to the arthritis.
      There is a growing consensus that the normal range of personality is represented
      among patients with early arthritis, that the prevalence of depression is similar
      to that of patients with other medical conditions, and that social stress is more
      closely related to depression than activity and the disabling effect of
      arthritis. Longitudinal studies are now required to examine which social stresses
      can be attributed to the disabling effect of arthritis. Depression and social
      stress often manifest themselves to the rheumatologist as excessive complaints of
      pain and frequent clinic attendances so appropriate psychosocial treatments may
      reduce this behaviour.

PMID- 2241277
TI  - Sternoclavicular erosions in polymyalgia rheumatica.

PMID- 2241278
TI  - Immunological indices of patients with rheumatoid arthritis after
      methylprednisolone pulse therapy.

PMID- 2241279
TI  - Response criteria for slow acting antirheumatic drugs.

PMID- 2241280
TI  - Trauma and seronegative spondyloarthropathy: rapid joint destruction triggered by
      physical injury in HLA-B7.

PMID- 2241281
TI  - Rheumatoid arthritis, malignancy, and paraproteins.

PMID- 2241282
TI  - Concentration and reactivity of the sulphydryl group population on the membrane
      of intact erythrocytes in patients with rheumatoid arthritis.
AB  - The sulphydryl population on erythrocyte membrane is shown to vary as a function
      of the nutritional status of the cell. When an assay based on reaction with
      Ellman's reagent and controlled conditions were used the mean values (SEM) for
      the sulphydryl population on the membranes of normal erythrocytes incubated
      overnight in the presence and absence of glucose were found to be 3.29 (0.27) and
      2.56 (0.25) million sulphydryl functions per cell respectively. Under identical
      conditions rheumatoid erythrocytes incubated in the presence and absence of
      glucose were found to have a significantly lower sulphydryl population--1.54
      (0.08) and 1.15 (0.08) million respectively. The predominant concentrations of
      sulphydryl groups on the membrane are found at sites on the transmembrane
      proteins and, in particular, on the hexose transport protein. By influencing the
      nutritional status of the cells significant differences in activity between the
      normal and diseased state have been identified and these may have a role in the
      aetiology of rheumatoid arthritis by altering the response of cells to oxidative
      stress.

PMID- 2241283
TI  - Articular cartilage defects of the knee: correlation between magnetic resonance
      imaging and gross pathology.
AB  - Magnetic resonance imaging (MRI) of the knee articular cartilage is possible
      owing to the contrast provided by different signal intensities of adjacent
      menisci and subchondral bone. The objective of this study was to determine the
      accuracy of MRI in quantitatively detecting thinning and focal defects of
      articular cartilage in vivo. High resolution MRI was performed followed by
      dissection of the knee within one hour of amputations above the knee of eight
      patients (62-89 years) with peripheral vascular disease. Articular cartilage was
      examined for erosions, surface irregularities, and appearance. Mean thicknesses
      of femoral and tibial articular cartilage sagittal sections from MRI were
      statistically indistinguishable from matched gross thicknesses. In those joints
      in which cartilage erosions, thinning, or irregularities were detected by MRI the
      same defects were apparent by gross examination. Cartilage that appeared normal
      by MRI had a normal gross appearance by gross examination. Thus high resolution
      MRI can accurately predict gross articular cartilage appearance and thickness,
      allowing an objective, quantitative, noninvasive assessment of eroded cartilage.

PMID- 2241284
TI  - Mast cells in the labial salivary glands of patients with Sjogren's syndrome: a
      histochemical, immunohistochemical, and electron microscopical study.
AB  - Mast cells in labial salivary glands obtained from patients with xerostomia with
      or without focal sialadenitis/Sjogren's syndrome were studied. There was no
      significant correlation between the intensity of local lymphocyte infiltration
      and the morphometrically analysed number of mast cells staining positive with
      toluidine blue. Histamine staining with heterologous 11C antiserum showed
      significantly fewer positive cells than staining with toluidine blue (mean (SD)
      62 (10) v 138 (30)). This suggests heterogeneity of the mast cell population.
      Furthermore, there was a correlation between the focus score and the number of
      mast cells containing histamine. This suggests that the proliferation of mast
      cells containing histamine may be locally regulated by the immune inflammation,
      possibly through mediators from macrophages and fibroblasts. In contrast, the
      number of mast cells staining positive with toluidine blue could not be used as a
      marker of the degree of local inflammation. Although transmission electron
      microscopic analysis did not disclose signs of 'en masse' mast cell
      degranulation, mast cells may have a role in the local disease process.

PMID- 2241285
TI  - Juvenile psoriatic arthritis and HLA antigens.
AB  - The clinical, laboratory, and radiological features, including histocompatibility
      typing, of 28 patients with juvenile psoriatic arthritis are reported. The most
      common presentation was that of psoriasis preceding or occurring simultaneously
      with arthritis. The most common course of juvenile psoriatic arthritis was to
      start as an oligoarthritis and progress, usually to polyarthritis. No patients
      with juvenile psoriatic arthritis had uveitis. Overall, most patients had a good
      outcome (93% in functional class I and II), though 8/28 (29%) did require disease
      modifying drugs over a mean period of 8.8 years of follow up. The clinical
      features of these patients were very similar to those of a group of 158 adult
      patients with psoriatic arthritis with the same disease duration followed up in
      the clinic. Although there was an increased prevalence of B17 in both juvenile
      and adult psoriatic arthritis, juvenile psoriatic arthritis showed increased
      prevalence of A2, whereas adult psoriatic arthritis showed increased prevalence
      of B27, Bw39, and Cw6. This HLA association differed from that reported in other
      forms of juvenile arthritis.

PMID- 2241286
TI  - Significance of low molecular weight C1q in systemic lupus erythematosus.
AB  - The significance of high serum concentrations of low molecular weight C1q (LMW
      C1q) in patients with systemic lupus erythematosus (SLE) was studied.
      Concentrations of LMW-C1q were increased in SLE, but not in rheumatoid arthritis
      or acute poststreptococcal glomerulonephritis. Concentrations of LMW-C1q in SLE
      serum samples correlated with titres of anti-dsDNA and were inversely related to
      concentrations of normal C1q and C3. Serial studies in six patients, who had
      rising anti-dsDNA titres and who developed a major exacerbation requiring
      admission to hospital, showed that LMW-C1q increased in parallel with anti-dsDNA,
      reaching peak values of more than 2000% of normal just before or at the time of
      clinical relapse and decreasing during convalescence. Most marked increases in
      LMW-C1q were noted in the three patients in whom C1q concentrations remained
      normal, whereas increases were less in the three patients who had strongly
      depressed concentrations of normal C1q. A study of C1q biosynthesis by
      macrophages cultured from patients with SLE and high serum concentrations of LMW
      C1q did not show impaired secretion of normal C1q in favour of LMW-C1q, but
      indicated that serum concentrations of LMW-C1q may reflect the synthetic rate of
      C1q in vivo. The results show that increased serum concentrations of LMW-C1q may
      be helpful in diagnosing SLE and suggest that serial determination of LMW-C1q in
      serum may have predictive value in monitoring patients with SLE.

PMID- 2241287
TI  - Effect of fibronectin on the Crithidia luciliae test for anti-double-stranded DNA
      antibodies.
AB  - The various tests for anti-double-stranded DNA antibodies do not always agree.
      Plasma fibronectin specifically binds DNA, is a component of immune complexes,
      and shows variations in concentration with disease activity in systemic lupus
      erythematosus. It may therefore interfere with the detection of DNA
      autoantibodies. This possibility was examined in a series of studies using the
      Crithidia luciliae test. Studies were based on serum samples received during one
      year (250 samples). Serum samples from 50 patients which were positive or weakly
      positive in the C luciliae test were used. In blocking experiments fibronectin
      was added either to the wells or to the serum. In a second series of experiments
      fibronectin was depleted by affinity chromatography from six serum samples with
      weak anti-DNA staining. Preincubation of wells with fibronectin or addition of
      fibronectin to serum invariably blocked the interaction of anti-DNA antibodies
      with the C luciliae kinetoplast. When fibronectin was removed from serum the
      intensity of staining was increased. These results indicate that fibronectin
      influences the detection of anti-double-stranded DNA antibodies using C luciliae
      and may explain the disparity between the results of different tests for DNA
      antibodies. Furthermore, the unmasking of positive reactivity when fibronectin is
      removed from serum has implications for the diagnosis and treatment of systemic
      lupus erythematosus.

PMID- 2241288
TI  - Immunogenetic study of the response to streptococcal carbohydrate antigen of the
      cell wall in rheumatic fever.
AB  - An immunogenetic study of the response to streptococcal carbohydrate antigen of
      the cell wall was carried out on members of 15 multiplex families each having
      more than one sib affected with rheumatic heart disease. They comprised 30
      parents and 61 sibs (32 with rheumatic disease and 29 without). Fifty healthy
      unrelated subjects served as controls. A history was taken and clinical
      examination carried out. Rheumatic activity was determined and HLA typing was
      carried out for nine A antigens, 15 B antigens, and six DR antigens. The immune
      response of lymphocytes to streptococcal polysaccharide antigen of the cell wall
      of group A beta haemolytic streptococci in vitro was studied by tritiated
      thymidine uptake. The results were statistically and genetically analysed. It was
      found that (a) all subjects with rheumatic disease were highly responsive to the
      streptococcal polysaccharide antigen of the cell wall, the sib pairs being mostly
      HLA identical; (b) all low responders had no rheumatic disease and their
      phenotypes were mostly different from those of the rheumatic member of their sib
      pair; (c) correlation of immune responsiveness (high or low) between HLA
      identical sibs was significant, but insignificant between haplotype identical and
      non-identical sibs; (d) the gene responsible for high responsiveness to the
      streptococcal polysaccharide antigen of the cell wall is recessive and closely
      linked to HLA. In conclusion, it was found that exposure to pharyngeal infection
      with group A beta haemolytic streptococci may lead to acute rheumatic fever in
      those with an inherited recessive gene responsible for high responsiveness to the
      streptococcal polysaccharide antigen of the cell wall.

PMID- 2241289
TI  - Clinical and laboratory studies in patients with leprosy and enthesitis.
AB  - In a combined clinical, radiological, and laboratory study of 77 patients
      throughout the leprosy spectrum, 10 patients had an enthesitis which has not been
      described previously as far as is known and which was not associated with the
      characteristics of erythema nodosum leprosum reactions. C reactive protein and
      alpha 1 acid glycoprotein values were significantly lowered only in those
      patients with leprosy and enthesitis. No radiological abnormalities were found.

PMID- 2241290
TI  - Arthritis in a human T lymphotropic virus type I (HTLV-I) carrier.
AB  - The case is described of a 57 year old woman with polyarthritis fulfilling the
      1987 revised criteria of the American Rheumatism Association for rheumatoid
      arthritis, accompanied by clinical carrier state infection of HTLV-I. Anti-HTLV-I
      IgM antibodies were detected by western blot analysis in her synovial fluid and
      serum. Atypical lymphocytes with nuclear convolutions were found in synovial
      fluid and synovial tissue obtained from the affected knee joint, suggesting in
      situ activation of HTLV-I infected lymphocytes in the affected synovial
      compartment. The HTLV-I antigens were detected (1.2%) in short term cultured
      synovial fluid lymphocytes, by indirect immunofluorescence. These findings
      supported the possibility that HTLV-I has a role in triggering or modifying
      inflammation in the synovial compartment.

PMID- 2241291
TI  - Lymphoedema of the limbs as an extra-articular feature of rheumatoid arthritis.
AB  - Seven patients with lymphoedema of the hands and arms, an unusual extra-articular
      feature of rheumatoid arthritis, are described. In all cases the lymphoedema
      persisted throughout follow up--in one case for more than five years--and was
      resistant to treatment with slow acting drugs, steroids, or cytotoxic agents.
      There was no correlation with severity of disease. It is concluded that the
      lymphoedema in these patients may be associated with reduced numbers of lymphatic
      vessels; increased capillary permeability or abnormal fibrinolysis may also be
      contributory factors. Conservative management of such patients is recommended.

PMID- 2241292
TI  - Antiproteinuric effect of captopril in a patient with lupus nephritis and
      intractable nephrotic syndrome.
AB  - A 22 year old woman presented with lupus nephritis, hypertension, and intractable
      nephrotic syndrome. Albumin and furosemide given intravenously was ineffective.
      Captopril administered in a daily dose of 62.5 mg was associated with a reduction
      in proteinuria from 28 g/24 hours to 11.5 g/24 hours over 10 weeks, resulting in
      a weight reduction of 16 kg. This was achieved with relative preservation of
      renal function. Captopril should be considered in the treatment of intractable
      proteinuria in patients with lupus nephritis, or when cytotoxic drugs are
      refused, because of its efficacy and relative safety. Captopril should, however,
      be used as an adjunct and not as a substitute for standard treatment.

PMID- 2241293
TI  - Simultaneous presentation of upper lobe fibrobullous disease and spinal
      pseudarthrosis in a patient with ankylosing spondylitis.
AB  - A 51 year old man with a 20 year history of ankylosing spondylitis and pronounced
      thoracic gibbus presented with two simultaneous complications of longstanding
      ankylosing spondylitis, upper lobe fibrobullous disease, and spinal
      pseudarthrosis. No neurological sequelae developed and treatment was
      conservative. Both these lesions mimic tuberculosis, and so it is important to
      determine them accurately to avoid unnecessary antituberculosis treatment. Both
      of these complications are reported to occur in longstanding ankylosing
      spondylitis and their simultaneous presentation may be more common than is
      realised. This case is believed to be the first such report of their association.

PMID- 2241294
TI  - Avascular necrosis of the femoral head presenting as trochanteric bursitis.
AB  - Five patients are described with avascular necrosis of the femoral head who
      presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip
      joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It
      is suggested that clinical trochanteric bursitis, especially when refractory to
      local corticosteroid treatment, may be the initial sign of hip disease. In the
      patient with risk factor(s) for avascular necrosis that diagnosis should be
      considered and evaluated with appropriate studies, such as magnetic resonance
      imaging, to prevent weight bearing at an early stage and permit possible surgical
      decompression in the hope of postponing or obviating the need for total hip
      replacement.

PMID- 2241295
TI  - First two decades of British rheumatology: a personal perspective.

PMID- 2241296
TI  - Systemic sclerosis: is there a treatment yet?

PMID- 2241297
TI  - Surgery of the rheumatoid shoulder.

PMID- 2241298
TI  - Surgery of the rheumatoid knee.

PMID- 2241299
TI  - Rheumatoid arthritis and ankle surgery.

PMID- 2241300
TI  - Surgery of the rheumatoid cervical spine.

PMID- 2241301
TI  - The rheumatoid foot: a sideways look.

PMID- 2241302
TI  - Surgical treatment of the rheumatoid hip.

PMID- 2241303
TI  - Surgery for the rheumatoid wrist and hand.

PMID- 2241304
TI  - Surgery of the rheumatoid elbow.
AB  - I suggest that for too long the problem of the rheumatoid elbow, particularly the
      need for surgical intervention, has been underestimated. Where the latter has
      been advocated the philosophy has been adopted that synovectomy and debridement
      with excision of the head of the radius is probably all that is required, or that
      in the late case excision arthroplasty may yield an adequate result. I suggest
      that these approaches are no longer tenable. Synovectomy and debridement with or
      without excision of the head of the radius does indeed retain an extremely
      valuable place in the management of stage 1, 2, and early stage 3 disease. In the
      later stages of the disease, however, serious consideration must now be given to
      total joint replacement, the results of which can be remarkably successful and
      durable, and the complications from which can now be contained within acceptable
      limits provided that the operating team is fully experienced. It must also be
      stressed how necessary it is in the medical or combined clinic to pursue careful
      clinical and radiological monitoring of the rheumatoid elbow so that signs of
      dangerous deterioration can be recognised early, and surgery applied at a time
      when optimal conditions for the particular surgical weapons to be used still
      exist.

PMID- 2241305
TI  - [Current possibilities in the control of Loa Loa filariasis].
AB  - Loa loa is currently considered as a major pathogen in man. The clinical
      repercussions of this filariasis have been clearly established and treatment is
      considered essential. Ivermectin, administered alone or with diethylcarbamazine
      presents interesting therapeutic possibilities. The review of vector control
      methods show that trapping is the only effective measure of protection. In order
      to reduce the endemicity of loaiasis, mass treatment with ivermectin could be
      envisaged immediately. However, the development of this filariasis is directly
      related to the development of the Central African forest region.

PMID- 2241306
TI  - [Epidemiological status of onchocerciasis in the Congo].
AB  - Analysis of 25 surveys carried out in the Congo between 1978 and 1987 (covering
      nine of the ten administrative regions), during which 6,215 subjects were
      examined, showed that onchocerciasis is endemic in the southern part of the
      country. Two main foci meeting at the southern exit of Brazzaville (Pool region)
      were identified. One focus in the Djoue basin. The other is the zone along the
      Congo river stretching from below Brazzaville south west to the Zaire border. Two
      secondary foci were noted, one in the region of the Bouenza and the other west of
      the Mayombe mountains. Surveys carried out in the north of the country and in the
      west did not reveal any onchocerciasis. However, certain areas of primary forest
      in these regions were found to be endemic for Mansonella streptocerca. Simulium
      damnosum s.l. in the sole vector of onchocerciasis. In both the Pool foci, and in
      the Mayombe focus, prevalences assessed from microfilarial and cyst counts were
      high but the mean microfilarial densities were relatively low. In certain
      villages over 90% of the population aged over 14 years may present with
      microfilariae and nearly 70% may present cysts.

PMID- 2241307
TI  - [Study of the transmission of onchocerciasis in the surroundings of a refugee
      camp located in the savanna zone of Cameroon].
AB  - Chadian refugees, most of whom are free from onchocerciasis, settled recently in
      a camp in a savanna area of the northern Cameroon where the prevalence is about
      80% and the blindness rate is 4% of the adult population. In view of the risks of
      onchocerciasis facing the immigrants, the authors carried out an entomological
      survey in this region aimed at determining the modes of transmission and
      assessing the possibilities for the control of this disease. After a three-month
      survey in the study area, it appears clearly that 1) transmission takes place
      only during the rainy season, 2) the main vectors are the two savanna species,
      Simulium damnosum s.s. and Simulium sirbanum, 3) the larval breeding sites are
      not located on the principal river, the Faro, but on its small seasonal
      tributaries, 4) the local populations still free from onchocerciasis and the
      Chadian refugees who farm close to these tributaries run the risk of getting
      serious ocular lesions in the long run which could lead to blindness. The
      conclusions of this survey prompted the authors to envisage an onchocerciasis
      control campaign in this area against the larval stages of the vectors.

PMID- 2241308
TI  - [Helminths of domestic pork in Ituri, Upper Zaire].
AB  - In Ituri (Upper-Zaire) pig farming is extensively and traditionally managed,
      animals wandering about in the villages and neighbouring fields. Helminths of the
      gastrointestinal tract most commonly encountered are Oesophagostomum sp.
      Hyostrongylus rubidus, Globocephalus urosubulatus and Ascarops strongylina.
      Parasitic burdens are low and gross lesions not frequently seen except nodules of
      oesophagostomiasis. Infections with Metastrongylus salmi and Metastrongylus
      pudendoctus have a very high prevalence (between 64 and 86%) causing gross
      lesions of pneumonia on the diaphragmatic lobes. The present socio-economic
      pattern of pig production in Ituri doesn't allow hardly to plan a rational
      control of helminth disease by use of drugs. Hydatidosis (Echinococcus
      granulosus) seeming to be absent in this area of Zaire, the only serious
      helminthic zoonosis we have to take into account is cysticercosis due to
      Cysticercus cellulosae. Its very high endemicity (between 10 and 30%) will have
      to lead the veterinary service to improve the search and destruction of infected
      carcasses.

PMID- 2241309
TI  - [Sexually transmitted diseases in the female population of Pikine, Senegal].
AB  - The prevalence of some sexually transmitted disease is determined in 250
      gynaecology patients and in 200 pregnant women seen in primary health centers in
      Pikine, Senegal. The main reason for consultation at gynaecology is infertility.
      Gonorrhoea and Chlamydia trachomatis infection are present respectively in 1.5%
      and 7% of pregnant women and in 4.4% and 7.6% of gynaecology patients. Human
      papillomavirus infection, determined by DNA extraction and hybridization
      technique, is seen in 4% of obstetric and in 1.2% of gynecology patients.
      Cytological anomalies is found in 5.5% of pregnant women and in 4.8% of
      gynecology patients.

PMID- 2241310
TI  - From monitoring to predicting outcome.

PMID- 2241311
TI  - The acutely affected abdomen in paraplegic spinal cord injury patients.
AB  - The records of 145 paraplegic or quadriplegic patients were reviewed to identify
      those factors useful in the correct diagnosis of the acute abdomen in this
      population. Twenty-one patients had 22 episodes of acute or subacute abdominal
      problems. Presenting complaints, physical findings, and laboratory results were
      useful in various ways. However appropriate radiographic studies led to the
      correct diagnosis in 77% of patients. Although paraplegic and quadriplegic
      patients are predisposed to a distinct constellation of medical problems,
      including urinary tract infection and calculi, they also may present with other
      abdominal conditions that cause significant morbidity and mortality if not
      promptly recognized.

PMID- 2241312
TI  - Intraoperative blood pressure. What patterns identify patients at risk for
      postoperative complications?
AB  - While monitoring blood pressure is a routine part of intraoperative management,
      several methods have been proposed to characterize intraoperative hemodynamic
      patterns as predictors of postoperative complications. In this prospective study
      of a high-risk population of hypertensive and diabetic patients undergoing
      elective noncardiac surgery, one objective was to compare different approaches to
      the assessment of intraoperative hemodynamic patterns to identify those patterns
      most likely to be associated with postoperative complications. Twenty-one per
      cent of the 254 patients sustained cardiac or renal complications after
      operation. Patients with more than 1 hour of greater than or equal to 20-mmHg
      decreases in mean arterial pressure (MAP) or patients with less than 1 hour of
      greater than or equal to 20-mmHg decreases and more than 15 minutes of greater
      than or equal to 20-mmHg increases were at highest risk for postoperative
      complications. Together these two patterns had a 46% sensitivity rate and a 70%
      specificity rate in predicting postoperative complications. Using 20% change in
      intraoperative MAP produced results nearly identical to 20-mmHg changes. When the
      duration of 20-mmHg changes was accounted for, changes of a greater magnitude
      (e.g., 40 mmHg) were not significant independent predictors of complications. The
      use of the mean difference from preoperative MAP was misleading because patients
      who experienced both high and low MAPs tended to have nearly normal mean MAPs,
      but high complication rates. The absolute magnitude of intraoperative MAPs,
      regardless of the preoperative levels, also was evaluated. The overall mean
      intraoperative MAP was not a significant predictor of complications. Specific
      intraoperative MAPs (e.g., less than 70 mmHg and more than 120 mmHg) also were
      evaluated. While neither was a significant predictor, there was a trend for
      increased complications among patients whose MAPs decreased to less than 70 mmHg.
      Intraoperative blood pressure should be analyzed in relation to the patient's
      preoperative blood pressure. Prolonged changes of more than 20 mmHg or 20% in
      relation to preoperative levels were significantly related to complications.

PMID- 2241315
TI  - Parietal cell vagotomy and dilatation for peptic duodenal stricture.
AB  - Gastric outlet obstruction due to peptic duodenal stricture (pyloric stenosis)
      was treated with parietal cell vagotomy and dilatation of the stricture in 32
      patients. Follow-up is in the range of 5 years in 37.4% of the patients, while 6
      to 10 years follow-up is available in 62.4% of the patients. At their last follow
      up, 74.9% of the patients were in either Visick 1 or 2 clinical status.
      Recurrence rates have been 3.1% at 1 year, 9.3% at 5 years, and 21.8% after 6 to
      10 years follow-up. There has been only one instance (3.1%) of restenosis. Two
      patients required reoperation because of recurrence and one of them died.

PMID- 2241314
TI  - Positive results of combined therapy of surgery and intraperitoneal hyperthermic
      perfusion for far-advanced gastric cancer.
AB  - To evaluate the clinical efficacy of intraperitoneal hyperthermic perfusion
      (IPHP) for far-advanced gastric cancer, particularly with peritoneal seeding, we
      investigated the survival times of 59 patients who underwent distal subtotal
      gastrectomy, total gastrectomy, or total gastrectomy combined with concomitant
      resection of some of the remaining intra-abdominal organs. In all the 30 patients
      given IPHP, no cancer cells were present posthyperthermically in the lavage from
      the Douglas pouch. The 30 patients given IPHP lived longer than the 29 patients
      not given IPHP (p = 0.001), with a 1-year survival rate of 80.4% in the former
      group compared to 34.2% in the latter. With respect to a comparison of survival
      time of patients with peritoneal seeding, 7 patients not given IPHP had a 6-month
      survival rate of 57.1% and did not survive more than 9 months, whereas 20
      patients given IPHP had 1- and 2-year survival rates of 78.7% and 45.0%,
      respectively; here the difference was significant (p = 0.001). The IPHP and
      control groups without peritoneal metastasis included 10 and 22 patients,
      respectively, and the 1-year survival rates are 85.4% and 45.3%, respectively.
      The survival rates of the former exceeded those of the latter, with p = 0.015 by
      the generalized Wilcoxon test. Thus this combined therapy offers the promise of
      extended survival for patients with far-advanced gastric cancer.

PMID- 2241313
TI  - Results of a multicenter trial comparing imipenem/cilastatin to
      tobramycin/clindamycin for intra-abdominal infections.
AB  - We designed a multicenter study to compare tobramycin/clindamycin to
      imipenem/cilastatin for intra-abdominal infections. We included the Acute
      Physiology and Chronic Health Evaluation (APACHE II) index of severity and
      excluded patients without established infection. Two hundred ninety patients were
      enrolled, of whom 162 were evaluable. Using logistic regression to analyze both
      outcome at the abdominal site of infection and outcome as mortality, we found a
      significant correlation for both with APACHE II score (p less than 0.0001 for
      both). Next we analyzed the residual effect of treatment assignment and found a
      significant improvement in outcome for imipenem/cilastatin-treated patients (p =
      0.043). The differences in outcome were explained by a higher failure rate for
      patients with gram-negative organisms for tobramycin/clindamycin-treated patients
      (p = 0.018). This was reflected in a significantly higher incidence of fasciitis
      requiring reoperation and prosthetic fascial replacement. Maximum peak tobramycin
      levels were analyzed for 63 tobramycin/clindamycin patients harboring gram
      negative organisms. For failures the maximum peak was 6.4 +/- 1.9 micrograms/mL,
      and time to maximum peak was 4.6 +/- 5.2 days. For successes the maximum peak was
      6.1 +/- 1.7 micrograms/mL, occurring at 3.8 +/- 2.6 days. This study supports
      inclusion of severity scoring in statistical analyses of outcome results and
      supports the notion that imipenem/cilastatin therapy improves outcome at the
      intra-abdominal site of infection as compared to a conventionally prescribed
      amino-glycoside-based regimen.

PMID- 2241316
TI  - Intrarectal ultrasonography in rectal cancer staging and in the evaluation of
      pelvic disease. Clinical uses of intrarectal ultrasound.
AB  - Accurate preoperative staging of a rectal cancer patient may impact heavily on
      subsequent management. This study attempts to evaluate the accuracy of
      intrarectal ultrasonography (IRUS) in staging rectal cancers compared to clinical
      and pathologic examination. In addition the accuracy of IRUS was assessed in a
      group of patients with uncertain pelvic-perirectal disease after a negative
      physical examination. In a prospective manner, 52 cancer patients were staged
      with digital exam and IRUS. Accuracy rates were 48% and 83%, respectively,
      compared to pathologic evaluation in assessing wall penetration, and IRUS
      identified positive lymph nodes in 12 of 17 cases. In patients with pelvic
      disease, IRUS corresponded with pathologic diagnosis in 15 of 17 cases and
      revealed new information in 6 patients. Intrarectal ultrasonography appears to be
      the most accurate imaging technique for staging rectal cancers and demonstrates
      promise in the evaluation of perirectal-pelvic disease.

PMID- 2241317
TI  - Localization and peptide content of endocrine pancreatic tumors.
AB  - Endocrine pancreatic tumors contain and frequently secret neurohormonal peptides.
      This phenomenon can be used as a diagnostic and classifying tool. This study
      analyzes 31 patients operated on because of an endocrine pancreatic tumor,
      including the diagnostic procedures and the localization methods. In 15
      insulinoma cases only 6 patients had a positive arteriography, while all 11
      selective pancreatic vein samplings were positive. The immunoreactivity showed
      that, besides insulin, most tumors also contained other peptides. Of four
      gastrinoma cases the arteriography was positive in three, but the selective vein
      sampling localized the tumor in all. The tumor's content of peptides showed mixed
      patterns. In the four glucagonomas, the arteriography was positive in all and the
      venous sampling performed in three of the cases also was positive. In five
      pancreatic polypeptide-containing tumors (PP-omas) the arteriography was positive
      in four and sampling performed in two was positive in both. In the PP-omas the
      peptide pattern showed that these tumors frequently contain several peptides. We
      used selective pancreatic vein sampling in 21 cases with positive result in all.
      In the cases in which arteriography was negative, the sampling results helped the
      surgeon to find the tumor. The peptide pattern in the tumors varied greatly and
      most tumors were multihormonal.

PMID- 2241318
TI  - Localization and surgical treatment of occult insulinomas.
AB  - Management of patients with biochemical evidence of insulinoma and negative
      preoperative imaging studies (occult) tumors is controversial, varying from
      primarily medical management to aggressive, blind nearly total pancreatectomy to
      extirpate the tumor. Since 1982, 12 consecutive patients with occult insulinoma
      underwent preoperative portal venous sampling (PVS) for insulin followed by
      surgical exploration with intraoperative ultrasound (IOUS). Eleven of twelve
      patients (92%) had insulinoma removed and were cured. Portal venous sampling
      correctly predicted the location of the insulinoma in 9 patients (75%) and that
      no tumor would be found in another patient. A fourfold insulin gradient in the
      pancreatic tail of one patient correctly predicted that a distal pancreatectomy
      would remove the insulinoma despite the fact that neither palpation nor IOUS
      identified any tumor. Intraoperative ultrasound was the single best method to
      identify occult tumors because it correctly identified 10 of 11 insulinomas that
      were found, including five pancreatic head tumors that were not palpable.
      Palpation identified five insulinomas. Of the 10 tumors that were identified
      during operation by palpation or ultrasound, IOUS identified significantly more
      (100% versus 50%, p = 0.03) and guided the successful enucleation of each. The
      results support the strategy of preoperative PVS and operation with IOUS to
      localize and remove insulinoma in patients with occult tumors. Most tumors (75%)
      will be correctly localized to a specific pancreatic region by preoperative PVS
      and identified by IOUS (83%), allowing simple enucleation and biochemical
      correction of hypoglycemia. Morbid blind pancreatic resections are no longer
      indicated and long-term medical management of hypoglycemia should be reserved for
      the occasional patient (8%) who fails preoperative PVS and operation guided by
      IOUS.

PMID- 2241319
TI  - Does carotid restenosis predict an increased risk of late symptoms, stroke, or
      death?
AB  - The identification of carotid restenosis as an unexpected late complication of
      carotid endarterectomy has prompted concerns regarding its importance as a source
      of new cerebral symptoms, stroke, and death. To investigate these concerns, we
      analyzed a consecutive series of 507 patients undergoing 566 carotid
      endarterectomies, each documented as technically satisfactory. Post-operative
      duplex Doppler examination data at 3 days, 1, 3, 6, 12 months, and annually
      thereafter in 484 arteries (85.5%) permitted classification of these arteries
      according to the most severe degree of postoperative stenosis: normal (n = 306);
      1% to 19% (n = 89); 20% to 50% (n = 40); more than 50% (n = 49, including 8
      occluded). The incidence of more than 50% restenosis was 14.5% in female and 7.7%
      in male patients (p = 0.003). Life table analyses to 10 years revealed a
      significantly greater life expectancy among those with restenosis (p = 0.05).
      Stroke was also less likely in patients with restenosis, although this difference
      did not reach statistical significance. When survival and stroke were both
      endpoints, the likelihood of patients with more than 50% restenosis remaining
      alive and stroke free was also greater than the less than 20% stenotic group (p =
      0.03). Thus patients with carotid restenosis were less likely than patients with
      normal postoperative scans to have late symptoms, stroke, or early death.

PMID- 2241320
TI  - Anorectal carcinoid tumors: is aggressive surgery warranted?

PMID- 2241321
TI  - Risks of incidental cholecystectomy.

PMID- 2241322
TI  - Difficulties encountered in the treatment of patients who develop sepsis after
      esophageal perforation.

PMID- 2241323
TI  - Surgical management of chronic empyema: the role of thoracoplasty.

PMID- 2241324
TI  - Behavior of small bronchial carcinomas.

PMID- 2241325
TI  - Choreoathetosis as a complication of cardiopulmonary bypass.

PMID- 2241326
TI  - Thoracoplasty: current application to the infected pleural space.
AB  - Thoracoplasty, once commonly used in the management of cavitary pulmonary
      disease, continues to find application in the obliteration of infected pleural
      spaces. This study reports a series of 13 patients receiving thoracoplasty
      between 1976 and 1989. Five patients had chronic apical empyema spaces without
      prior resection of lung tissue. Two of the empyemas were due to tuberculosis, two
      were due to atypical mycobacteria, and one was due to postpneumonic empyema. All
      patients had extensive destruction of upper lobe tissue. Eight patients had
      undergone prior pulmonary resection; 3 had persistent infected spaces in the
      early postoperative period, 3 had development of empyemas and bronchopleural
      fistulas late (5 to 19 years) after pulmonary resection, and 2 had
      postpneumonectomy empyema. All patients had rigid cavity walls preventing space
      obliteration by rib removal alone and required concomitant resection of the
      thickened pleura and intercostal muscle tissues. Bronchopleural fistulas were
      present in 11 patients and were closed with adjacent nonintercostal muscle. All
      patients survived and had successful obliteration of the infected spaces with
      acceptable physiological and cosmetic results. We conclude that thoracoplasty
      remains a useful procedure in the management of the infected pleural space in
      select patients.

PMID- 2241327
TI  - Repair of supravalvar aortic stenosis: cardiovascular morphometric and
      hemodynamic results.
AB  - Supravalvar aortic stenosis is associated with normal systolic pressure in the
      aorta and its branches with the singular exception of the coronary arteries,
      which are hypertensive. This uncommon lesion has been treated by patch
      aortoplasty of several types. We examined hemodynamics and morphometrics in 13
      patients who underwent operation for supravalvar aortic stenosis from 1979
      through 1988. They ranged in age from 2 to 43 years (mean age, 14.5 +/- 3.8 years
      [+/- standard error of the mean]). There were no operative deaths. Preoperative
      and postoperative (1 to 5 years) catheterization or echocardiography or a
      combination of these was done in all but 3 patients (1 died late suddenly without
      a postmortem examination; 1 was lost to follow-up; and 1 has not yet been
      restudied). Pressure gradients across the stenosis in patients treated with a
      single-sinus patch (n = 4) were 65 +/- 18 mm Hg preoperatively and 5 +/- 3 mm Hg
      postoperatively (p less than 0.05) and in patients with a bisinus patch (n = 6),
      83 +/- 15 mm Hg preoperatively and 6 +/- 2 mm Hg postoperatively (p less than
      0.05); the two groups were not significantly different. Measurements of the
      diameters of the coronary arteries, aortic annulus, and descending aorta were
      made, and calculation of the ratio of the coronary artery and annulus diameters
      to the descending aortic diameters both preoperatively and postoperatively was
      possible in 5 patients. The left coronary artery was larger than normal before
      and after operation. Preoperatively there was a disproportionate increase in left
      coronary artery and annulus size during systole. Left ventricular wall thickness
      decreased significantly postoperatively (p less than 0.05). Repair of supravalvar
      aortic stenosis (localized and diffuse) by both single sinus and bisinus patch
      repair is safe and hemodynamic results are good.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241328
TI  - Strategy for lymphadenectomy in lung cancer three centimeters or less in
      diameter.
AB  - We have surgically treated 221 patients with a primary lung cancer 3.0 cm or less
      in diameter. There were 8 patients with a tumor 1.0 cm or less in diameter (group
      A), 84 with a tumor 1.1 to 2.0 cm in diameter (group B), and 129 with a tumor 2.1
      to 3.0 cm in diameter (group C). The incidence of N0, N1, and N2 disease was
      100%, 0%, and 0%, respectively, for patients in group A; 83%, 5%, and 12% in
      group B; and 62%, 12%, and 25% in group C (N0 versus N2, p less than 0.01). For
      the 63 patients with regional lymph node involvement, "skipping" metastasis was
      present in 28.6%. The 5-year survival rate was 80% for group A, 74% for group B,
      and 51% for group C (group B versus group C, p less than 0.01). Of the 121
      patients who underwent complete resection and were followed up for 5 years, 41%
      had recurrence, 8% with local recurrence and 33% with distant metastasis.
      Therefore, it is important to do as complete a resection as possible together
      with mediastinal lymphadenectomy. Efforts to detect systemic spread should be
      made at the time of preoperative evaluation, even when the lung tumor is small.

PMID- 2241329
TI  - Choreoathetosis after deep hypothermia without circulatory arrest.
AB  - In 8 of 758 patients undergoing an intracardiac operation under cardiopulmonary
      bypass and hypothermia, choreoathetosis developed 3 to 7 days postoperatively.
      Before the onset of choreoathetosis, varying degrees of neurological dysfunction
      were noted. Electroencephalography and neuroimaging failed to detect any
      responsible functional or structural changes. Six patients are alive 1 to 3 years
      postoperatively, and their condition is improving. Two patients died of
      aspiration or sepsis. All patients were grouped based on factors identified as
      being possibly causative: depth of hypothermia, cooling time, flow rate, and
      repeated hypothermia. The incidence of choreoathetosis was significantly
      different in group A (rectal temperature greater than 25 degrees C) compared with
      group B (rectal temperature less than or equal to 25 degrees C) (0/295 versus
      8/463; p = 0.02). Based on cooling time, the incidence of choreoathetosis was
      significantly different in group B1 (cooling time less than 1 hour) compared with
      group B2 (cooling time greater than or equal to 1 hour) (1/220 versus 7/243; p =
      0.05). Based on flow rate during cooling, group B2 was further divided into the
      low-flow group (less than 1,500 mL.min-1.m-2) and the high-flow group (greater
      than or equal to 1,500 mL.min-1.m-2). Although not significant, the incidence of
      choreoathetosis was higher in the high-flow group (6/153 versus 1/90; p = 0.22).
      In group B patients having reoperation, the incidence of choreoathetosis was
      higher than in patients operated on for the first time (5/54 versus 3/409; p less
      than or equal to 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241330
TI  - Prognostic determinants in extracorporeal membrane oxygenation for respiratory
      failure in newborns.
AB  - Extracorporeal membrane oxygenation (ECMO) is becoming an accepted therapeutic
      modality for newborn respiratory failure, but there is little information
      available regarding the prognostic determinants with this technique. One hundred
      thirty-five newborns treated with ECMO over a 4-year period were critically
      analyzed with regard to the influence that birth weight, gestational age, age at
      initiation of ECMO, best blood gases before ECMO, number of hours on ECMO, renal
      failure, intracerebral hemorrhage, and long-distance air transport had on
      survival. Infants with meconium aspiration and those undergoing long-distance
      transfer showed significant differences in blood gases before ECMO, with
      survivors having more normal pH and carbon dioxide tension values. Intracerebral
      hemorrhage and renal failure that developed during ECMO were grave prognostic
      signs, with few survivors in either group. These data show that ability to
      ventilate patients before ECMO, giving normal carbon dioxide tension and pH
      values, is an important prognostic sign in infants with meconium aspiration and
      undergoing long-distance transfer for ECMO, whereas renal failure and
      intracerebral hemorrhage are usually lethal complications of ECMO. Each center
      performing ECMO should continually reevaluate this invasive technique and its
      results and complications.

PMID- 2241331
TI  - Acquired benign esophagorespiratory fistula: report of 16 consecutive cases.
AB  - Sixteen cases of acquired benign esophagorespiratory fistula were treated in a 20
      year period. A delay in diagnosis was usual, and most patients were first seen
      with a pulmonary infection already developed. Contrast esophageal x-ray studies
      established the diagnosis in all patients. There were seven esophagotracheal and
      nine esophagobronchial fistulas. A fistula between the esophageal diverticulum
      and a bronchus considered to be of inflammatory origin developed in 7 patients. A
      fistula as the consequence of trauma developed in 9 patients, and these fistulas
      were situated at a higher level of the respiratory tree. All patients underwent
      surgical treatment; in 12 it was definitive, and in 4 temporary gastrostomy was
      performed to improve nutrition before definite repair. The definitive repair
      consisted of eventual diverticulectomy, division of the fistula, and suture of
      both esophageal and respiratory defects. Two patients required esophageal
      resection and later reconstruction with colon interposition. One patient died,
      creating an operative mortality of 8.3% in the definitive-repair group. The
      remaining 11 patients had a gratifying long-term result. There were two deaths in
      the gastrostomy group due to an extremely poor condition of patients and
      debilitating pulmonary infection. Early diagnosis of this rare condition is
      necessary if severe pulmonary complications are to be avoided. Early direct
      repair gives excellent results.

PMID- 2241332
TI  - Correction of truncus arteriosus with truncal valvar stenosis or insufficiency
      using two homografts.
AB  - Surgical correction of truncus arteriosus requires the creation of right
      ventricular to pulmonary artery continuity and closure of the ventricular septal
      defect. A variety of conduits have been used including valved and nonvalved.
      Despite a significant incidence of truncal valvar stenosis and insufficiency,
      this valve has seldom been replaced. We present 4 cases of truncus arteriosus
      with truncal valvar stenosis or insufficiency that were repaired using two valved
      homografts: one to create the pulmonary outflow tract and the other to replace
      the abnormal truncal valve. Two of these patients are doing well after 4 months.
      Another child survived the operation and did well for 2 months when she died
      suddenly. The last child died 14 hours postoperatively from low cardiac output
      syndrome secondary to diabetic hypertrophic cardiomyopathy. When truncal valvar
      abnormalities are present, the primary repair of truncus arteriosus in an infant
      should include replacement of the truncal valve. Total correction can be
      successfully achieved using two valved homografts, resulting in long-term
      palliation and freedom from thromboembolic events and the use of anticoagulants.

PMID- 2241333
TI  - Influence of prosthetic design on durability of the Liotta porcine valve in the
      mitral position.
AB  - From March 1979 to December 1984, the Liotta low-profile porcine bioprosthesis
      was employed for mitral valve replacement in 71 patients to avoid potential left
      ventricle-prosthesis mismatch occasionally observed with the standard, high
      profile, Hancock porcine xenograft. Follow-up of 61 operative survivors showed at
      10 years an actuarial survival of 67% +/- 7%, freedom from thromboemboli of 96%
      +/- 2%, freedom from structural deterioration of 63% +/- 11% and freedom from all
      Liotta bioprosthesis-related complications of 53% +/- 10%. Complications related
      to excessive protrusion of the stent into the left ventricular cavity were
      eliminated with the Liotta bioprosthesis; the peculiar stent configuration,
      however, was responsible for an increased rate of structural deterioration
      requiring reoperation in 10 patients (2.8% +/- 0.9%/patient-year) at a mean
      interval of 76 +/- 18 months after mitral valve replacement (range, 45 to 106
      months). Common findings in all explants were cusp prolapse, cusp tears, and
      commissural rupture related to various degrees of tissue calcification,
      constantly leading to severe prosthetic incompetence. As also shown
      experimentally, such structural changes have been attributed to increased
      systolic stresses on the closed cusps, favored by excessive reduction of the
      stent height. Our experience shows that the Liotta bioprosthesis used for mitral
      valve replacement does not provide any clear-cut advantage over standard porcine
      bioprostheses and that its long-term durability appears affected by the unique
      prosthetic design.

PMID- 2241334
TI  - Surgical management of pulmonary metastatic leiomyosarcoma with gross
      endobronchial extension.
AB  - Metastatic leiomyosarcoma occasionally is seen with gross endobronchial extension
      without invasion of the bronchial wall. These patients have major airway
      obstruction and partial or total atelectasis of the lung. Precise bronchoscopic
      assessment coupled with intraoperative bronchotomy allows the surgeon to
      determine the origin of the tumor and to save uninvolved pulmonary parenchyma.
      Our experience with 4 such patients illustrates the possibility of saving lung
      tissue despite total bronchial obstruction.

PMID- 2241335
TI  - Clinical performance of St. Jude and Medtronic-Hall prostheses: a randomized
      comparative study.
AB  - Newer and improved models of mechanical prostheses are regularly added to
      surgeons' armamentarium. This study was designed to compare the clinical
      performance of two of the most used current models of mechanical prostheses. From
      August 1983 through July 1985, 182 white patients were prospectively randomized
      to implantation of the St. Jude Medical (95 patients) or Medtronic-Hall (87
      patients) prostheses. There were 84 mitral, 85 aortic, and 13 double (mitral and
      aortic) valve replacements. There were no differences between the two groups with
      regard to sex distribution, age, functional class, emergency operation, and site
      of implantation. Early mortality was 3.2% for patients with the St. Jude valve
      and 5.7% for those with the Medtronic-Hall (p = NS). The survivors were followed
      for 3 to 5 years (mean, 4.2 +/- 0.6 years; cumulative follow-up, 559 patient
      years). Late mortality was 7.1%/patient-year for the St. Jude group and
      3.2%/patient-year for the Medtronic-Hall group (p less than 0.05). However, the
      valve-related mortality was equal (1.4%/patient-year) for both groups. Noncardiac
      causes accounted for most of the difference between the St. Jude and Medtronic
      Hall groups (2.5%/patient-year and 0.4%/patient-year, respectively). There were
      no cases of thrombotic obstruction, whereas serious systemic thromboembolism
      occurred at the rate of 1.8%/patient-year (5 episodes) for the St. Jude group and
      2.5%/patient-year (7 episodes) for the Medtronic-Hall group (p = not
      significant); there were another nine episodes of systemic embolism that left no
      sequelae. Three patients (St. Jude, 2; Medtronic-Hall, 1), all of whom had aortic
      valve replacement, required reoperation (0.5%/patient-year) because of prosthetic
      endocarditis, with two deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241336
TI  - Clinical experience with the Medtronic-Hall valve prosthesis.
AB  - Medtronic-Hall valves were implanted during 204 procedures performed between 1982
      and 1988. Mean population age was 54.4 years; 96% of patients were in New York
      Heart Association functional class III or greater. Emergency operations
      constituted 16% of the procedures. Rheumatic heart disease was the single most
      common indication for valve replacement. In 18% of patients, operation was
      performed to replace a previous prosthetic valve. The mean follow-up was 3.2
      years. Overall operative mortality was 10.3%, the highest mortality being for
      double-valve replacements (24%). Valve-related mortality, by position, was 5.3%
      for aortic valves, 6.0% for mitral valves, and 4.0% for multiple-valve
      replacements. Actuarial 5-year freedom from events were: survival, 68%;
      thromboembolism, 90%; prosthetic valve endocarditis, 98%; paravalvular leak, 95%;
      and reoperation, 92%. Complications with the highest mortality were
      thromboembolism (36%) and endocarditis (33%). The complication rates in this
      series are high but the patients were more severely ill than in other reports,
      and operative survivors experienced a considerable improvement in New York Heart
      Association functional class.

PMID- 2241337
TI  - Giant chest wall tumor resulting from tissue reaction to foreign bodies.
AB  - Three patients are reported in whom chest wall tumors developed 19 to 28 years
      after thoracoplasty and increased in size with time. The tumors could be removed
      operatively with good results. All tumors were composed of hematoma and necrotic
      material, and in all cases they revealed foreign bodies microscopically.
      Diagnosis and possible etiological factors are discussed.

PMID- 2241338
TI  - Air contamination in open heart surgery with disposable coveralls, gowns, and
      drapes.
AB  - The effect of a polypropylene coverall, replacing shirt and trousers, combined
      with sterile laminated gowns and drapes compared with an all-cotton system was
      studied in regard to the dispersion of bacteria and particles in a conventionally
      ventilated operating theater. The operations carried out were open heart
      procedures in 30 adult patients. Blood agar sedimentation plates were placed in
      the operative, anesthesia, and perfusion areas. The mean sedimentation values
      during 1 hour after the start of operation were as follows in the laminate group:
      63 colony-forming units (cfu)/m2 in the operative area; 77 cfu/m2 in the
      anesthesia area; and 143 cfu/m2 in the perfusion area. The corresponding figures
      in the cotton group were 350 cfu/m2, 364 cfu/m2, and 437 cfu/m2, respectively (p
      less than 0.0002). At the beginning of the operation, the mean values noted for
      colony-forming units in the air at the operative site were 8.0 cfu/m3 in the
      laminate group and 31 cfu/m3 in the cotton group. One hour later, the values were
      10 cfu/m3 and 22 cfu/m3, respectively (p less than 0.0002). At the end of the
      operation, the number of particles 5 microns or larger in the air at the
      operative site was 278/m3 in the laminate group and 592/m3 in the cotton group.
      It is concluded that the use of a polypropylene coverall and laminated gowns and
      drapes significantly reduces the particle and bacterial contamination of the air
      and the bacterial sedimentation during cardiac operations.

PMID- 2241339
TI  - Aortic dissection with the entrance tear in transverse aorta: analysis of 12
      autopsy patients.
AB  - Clinical and autopsy findings are described in 12 patients who had fatal aortic
      dissection with the entrance tear in the transverse aorta. The 12 patients
      represent 7% of 182 autopsies of spontaneous aortic dissection studied by us. The
      ages of the 12 patients at death ranged from 37 to 87 years (mean, 67 years).
      Eight were men; 8 had a history of systemic hypertension, and 10 had hearts of
      increased weight. Diagnosis of aortic dissection was made during life in only 4
      of the 12 patients. All 12 patients died of rupture of the false channel within 2
      weeks of onset of signs or symptoms compatible with dissection. The direction of
      aortic dissection from the entrance tear was entirely retrograde in 4 patients,
      entirely anterograde in 4 patients, and in both directions in 4 patients.
      Hemopericardium occurred in the first group, left hemothorax in the second group,
      and either in the last group. Of the 8 patients in whom the ascending aorta was
      involved, the retrograde dissection in each extended to the aortic root, 6 had
      pulmonary adventitial hemorrhage, and 4 had involvement of the arch arteries by
      dissection. In the 4 patients with strictly anterograde dissection, none had
      dissection in the arch arteries. Thus, tear in the transverse aorta causes a
      dissection that is usually fata, that often dissects retrogradely, and that may
      mimic dissection from a tear in ascending aorta. Aortic dissection from a tear in
      transverse aorta requires early operative intervention.

PMID- 2241340
TI  - Unusual opening of coronary sinus in atrioventricular septal defects.
AB  - The coronary sinus is an important landmark for the position of the atrial
      component of the atrioventricular conduction axis and, thus, assumes special
      relevance to the surgeon in the operating room. We describe here 2 patients with
      atrioventricular septal defect characterized by an unusual termination of the
      coronary sinus within the left atrium. We discuss the potential importance of
      this finding to the disposition and surgical avoidance of the conduction tissues.

PMID- 2241341
TI  - Myocardial preservation using lidocaine blood cardioplegia.
AB  - Prevention of ventricular fibrillation after aortic unclamping using lidocaine
      hydrochloride as an additive to cold potassium blood cardioplegia was studied
      prospectively in 46 patients undergoing elective myocardial revascularization.
      Patients were similar with respect to age, ventricular function, severity of
      coronary artery disease, cross-clamp time, completeness of revascularization,
      frequency of internal thoracic artery grafting, systemic temperature at the time
      of cross-clamp removal, and mean infusate volume and temperature. Patients
      receiving lidocaine blood cardioplegia (group 1, 23 patients) had a significant
      reduction in the incidence of ventricular fibrillation (22% versus 74%; p less
      than 0.0005) and in the mean number of cardioversion attempts required to
      defibrillate the heart (0.5 +/- 1.3 versus 1.9 +/- 0.97; p less than 0.0005)
      after cross-clamp removal compared with controls (group 2, 23 patients). There
      were no differences between the two groups postoperatively with regard to cardiac
      enzyme release, hemodynamic measurements, or clinical outcome. Patients receiving
      lidocaine blood cardioplegia tended to have a lower incidence of new
      postoperative atrial fibrillation (9% versus 26%). Ventricular function was
      preserved equally in both groups. We conclude that lidocaine is a safe additive
      to potassium blood cardioplegia and significantly reduces the incidence of
      ventricular fibrillation after aortic unclamping.

PMID- 2241342
TI  - Internal mammary artery revascularization in the patient on long-term renal
      dialysis.
AB  - Twenty-six patients on long-term renal dialysis underwent coronary artery bypass
      grafting. The patients were divided into two groups: group 1, (16 patients)
      saphenous vein bypass grafts, and group 2, (10 patients) internal mammary artery
      in combination with saphenous vein bypass grafts. Both groups were similar in
      terms of cardiac hemodynamics and previous number of myocardial infarctions,
      though more group 1 patients were in New York Heart Association class III or IV.
      Patients in group 1 received 2.9 bypass grafts per patient; patients in group 2
      received 4.0 bypass grafts per patient (4 with bilateral mammary arteries). No
      wound healing problems occurred in either group. Blood replacement was similar
      for both groups (group 1, 5.5 units/patient; group 2, 5.3 units/patient). More
      platelets were given to group 1 patients (16.2 units/patient) than group 2
      patients (3.1 units/patient). We conclude that use of the internal mammary artery
      in patients on long-term renal dialysis does not alter wound healing or increase
      blood loss in this subset of patients.

PMID- 2241343
TI  - Timing of operation for aortic regurgitation: relation to postoperative
      contractile state.
AB  - With angiography and pressure measurement, we determined left ventricular volume,
      wall stress, and systolic performance in 30 patients with aortic regurgitation
      before and after successful aortic valve replacement. End-systolic wall stress
      was greatly elevated preoperatively and decreased to normal postoperatively.
      Systolic pump performance assessed as ejection phase indexes was severely
      depressed preoperatively and improved to normal or near-normal postoperatively in
      most patients. The ratio of end-systolic wall stress to end-systolic volume index
      (ESS/ESVI), an index of myocardial contractility, was greatly decreased before
      operation. Postoperatively, the ratio increased in all patients, becoming normal
      in 12 of the 13 patients who had a preoperative ESS/ESVI of 2.9 or greater.
      However, 15 of 17 patients in whom the ESS/ESVI ratio was less than 2.9 still had
      subnormal ratios, which indicates the presence of irreversible contractile
      dysfunction. Stepwise multivariate analysis showed that preoperative ESS/ESVI was
      the only independent discriminator of postoperative normalization of the
      contractile function as assessed by ESS/ESVI. After aortic valve replacement,
      myocardial contractile state does not return to normal in a considerable number
      of patients. It is important to offer aortic valve replacement for aortic
      regurgitation before the chance for a good functional result is lost. The
      ESS/ESVI ratio may be a useful index in determining the timing of operation in
      patients with aortic regurgitation.

PMID- 2241344
TI  - Thoracoscopic treatment of spontaneous pneumothorax using carbon dioxide laser.
AB  - In an effort to improve the success rate of the previously described
      thoracoscopic electrocautery ablation technique of spontaneous pneumothorax, the
      carbon dioxide laser was evaluated in 12 patients. The recurrent (5 patients) or
      persistent (7 patients) spontaneous pneumothoraces were caused by rupture of (1)
      blebs in 6 patients, (2) intrapulmonary apical type II bullae in 3 patients, and
      (3) diffuse bullous emphysema, type III, in 3. The air leaks were successfully
      sealed in all but 1 patient with ruptured type II bulla. Surgical specimen from
      this single failure suggested that the entire inner lining of the bullae must be
      thermocoagulated. This technical modification led to successful outcome in 2
      subsequent cases. With the use of carbon dioxide laser, it was possible to treat
      not only small blebs but all types of bullae causing spontaneous pneumothorax.
      Laser thoracoscopy is effective and safe in treating spontaneous pneumothorax.

PMID- 2241345
TI  - Prolonged extracorporeal life support of pediatric and adolescent cardiac
      transplant patients.
AB  - Options for mechanical support of pediatric patients with severe heart failure
      who are awaiting transplantation or have undergone transplantation are limited.
      This report examines 3 patients placed on extracorporeal life support (ECLS)
      while awaiting transplantation and 3 patients who underwent transplantation and
      suffered subsequent heart failure due to rejection or postoperative myocardial
      dysfunction. The overall survival rate was 2 of 6. The 2 surviving patients had a
      failing transplanted heart. There were no survivors among the patients placed on
      ECLS as a bridge to transplantation. In each case a contraindication to
      transplantation developed before a donor heart could be obtained. The mean time
      of ECLS support was 147.5 hours (range, 70 to 370 hours). The ECLS circuit did
      not affect cyclosporin levels or antirejection therapy. Extracorporeal life
      support can be used to support pediatric cardiac transplant patients with
      biventricular failure due to acute rejection or postoperative dysfunction.
      Although the results have been discouraging, ECLS may still have a role as a
      bridge to transplantation. However, complications can develop during ECLS that
      may preclude transplantation.

PMID- 2241346
TI  - Pulmonary resection combined with cardiac operations.
AB  - Surgical management of patients with concomitant critical cardiac disease and
      resectable lung lesions is controversial. During a 7-year period (1982 to 1988),
      21 patients underwent combined cardiac and pulmonary operations. Patients had
      cardiac symptoms only; the lung lesions were found on preoperative chest
      roentgenograms. The pathological diagnosis was established in only 2 of the
      patients before operation. All underwent concurrent pulmonary resection during
      cardiac operations requiring extracorporeal circulation. The pulmonary operations
      included 17 wedge resections and four lobectomies. The final diagnoses in 8
      patients with stage I non-small cell lung cancer included epidermoid carcinoma
      (4), adenocarcinoma (3), and bronchoalveolar carcinoma (1). Postoperatively, 1
      patient required a permanent pacemaker and 1 patient died. The actuarial survival
      at 5 years for all patients who underwent combined procedures was 95%. The 5-year
      survival for the 8 patients with lung cancer was 88% compared with 100% for those
      with benign pulmonary pathology (p = 0.172). This experience suggests that
      combining pulmonary resection with cardiac operations is safe and offers a
      favorable prognosis to a select group of patients.

PMID- 2241348
TI  - Tension pneumopericardium as a complication of single-lung transplantation.
AB  - Tension pneumopericardium is distinctly uncommon in the adult population. We
      present a case of tension pneumopericardium as a complication of lung
      transplantation in a 54-year-old woman with thromboembolic pulmonary hypertension
      who underwent single-lung transplantation.

PMID- 2241347
TI  - Antimicrobial prophylaxis for open heart operations.
AB  - Between 1986 and 1988, 450 adults undergoing coronary artery bypass, cardiac
      valve replacement, or both were enrolled into a prospective, randomized,
      comparative trial of cephalothin versus cefamandole as perioperative prophylaxis.
      They were assessed during their hospitalization and at 6 weeks and 6 months after
      discharge for postoperative infectious complications. Eleven patients had major
      postoperative infections including 5 with sternal wound infections (three
      bacteremic), 6 with bacteremia, 1 with prosthetic valve endocarditis, and 3 with
      severe venous donor graft site infections. Eight major infections occurred in
      patients receiving cephalothin prophylaxis and three in patients receiving
      cefamandole, with all five sternal wound infections occurring in the cephalothin
      group. Postoperative pathogens responsible for the major infections included gram
      negative aerobes in 5 patients, Staphylococcus aureus in 4, and Staphylococcus
      epidermidis in 2. Preoperative colonizing staphylococcal isolates were not
      predictive of postoperative staphylococcal pathogens. Although there was no
      statistically significant difference in rate of major postoperative infectious
      complications using either cephalothin or cefamandole prophylaxis, there was a
      trend in favor of cefamandole. Gram-negative aerobes are becoming increasingly
      important pathogens in this setting.

PMID- 2241349
TI  - Vagal schwannoma.
AB  - A patient with a benign encapsulated intrathoracic vagal schwannoma is presented
      and the literature is reviewed. The right paratracheal tumor was identified
      incidentally on a chest film and excised using a right thoracotomy. Although
      rare, vagal schwannomas should be considered for any mediastinal mass along the
      vagus nerves especially when the paratracheal tumor produces minimal or no
      respiratory symptoms suggesting a slow-growing, encapsulated process.

PMID- 2241350
TI  - Catastrophic thrombosis of porcine aortic bioprostheses.
AB  - Hemodynamically critical thrombotic stenosis of porcine bioprosthetic valves in
      the aortic position without thrombotic predisposition is rare. Two patients at
      our institution abruptly manifested thrombotic stenosis of porcine bioprosthetic
      valves in the aortic position within 3 months of implantation without apparent
      predisposing factors. Clinicians should consider this rare but catastrophic
      complication in the appropriate setting.

PMID- 2241351
TI  - Combined repair of transposed great arteries and total anomalous pulmonary venous
      connection.
AB  - We report an unusual association of transposition of the great arteries and total
      anomalous pulmonary venous connection in the right atrium that was successfully
      repaired by a modified Mustard procedure.

PMID- 2241352
TI  - Circumflex artery ventricular fistula and pseudoaneurysm after mitral
      reoperation.
AB  - Prosthetic mitral valve reoperation complicated by atrioventricular groove
      pseudoaneurysm and circumflex ventricular fistula is presented. Ligation of the
      circumflex artery during mitral valve replacement is implicated after review of a
      previous cardiac angiogram.

PMID- 2241353
TI  - Mediastinal hibernoma, a rare tumor.
AB  - Hibernoma is an uncommon soft tissue tumor that is derived from the remnants of
      fetal brown fat. Review of the world medical literature revealed 90 cases, 6 of
      which were intrathoracic. We present the seventh case of intrathoracic hibernoma;
      in this case, the hibernoma was within the mediastinum without direct invasion of
      other structures.

PMID- 2241354
TI  - Acute hypercalcemic crisis after an open heart operation.
AB  - Acute hyperparathyroidism developed in a previously normocalcemic 64-year-old
      woman during the first week after a coronary operation. Prolonged QT interval in
      the electrocardiogram and hypercalcemia were documented on the fourth
      postoperative day. Neck exploration on the fifth postoperative day revealed a
      lower right parathyroid adenoma. Parathyroidectomy resulted in rapid and dramatic
      improvement of the clinical picture and normalization of laboratory values.

PMID- 2241355
TI  - Easy cardioplegia delivery, aortic venting, and reperfusion technique.
AB  - Myocardial preservation is an essential aspect of coronary revascularization as
      well as of other open heart procedures. As these procedures are becoming more
      complex, specifically myocardial revascularization, impeccable myocardial
      protection becomes imperative. Described is a technique that enables one to
      easily accomplish good myocardial preservation with minimal clutter using readily
      available materials.

PMID- 2241356
TI  - Mitral prosthetic replacement in small left atria.
AB  - A modified transseptal approach for exposure of the difficult mitral valve is
      described. This allows the surgeon to visualize the valve, especially during
      prosthetic replacement, in the presence of a small, friable, or noncompliant left
      atrium.

PMID- 2241357
TI  - Alternate method for revascularization of the posterior lateral coronary artery.
AB  - A technique is described for bypassing the posterior lateral branch of the right
      coronary artery by passing the vein graft beneath the inferior vena cava to avoid
      kinking of the graft.

PMID- 2241358
TI  - Collis gastroplasty: origin and evolution.
AB  - In 1957 J. Leigh Collis published his innovative operation for treating the
      difficult problem of the irreducible hiatal hernia, esophagitis, and stricture.
      The design of the operation was based on the relatively primitive understanding
      of hiatal hernia and the newly emerging concept of reflux esophagitis. A variety
      of antireflux operations by different surgeons emerged over the years to follow.
      The original Collis gastroplasty has been subsequently modified with the addition
      of both partial and complete fundoplication procedures. The place of the modified
      Collis gastroplasty-fundoplication operations in today's approach to the problems
      of hiatal hernia and gastroesophageal reflux disease remains unsettled.

PMID- 2241359
TI  - Blood conservation in cardiac surgery.
AB  - We reviewed current blood conservation techniques and their use in cardiac
      surgery. Avoidance of aspirin preoperatively is an important blood conservation
      measure. Patients scheduled for an elective operation should participate in
      autologous predonation programs. With careful monitoring, patients with major
      coronary artery disease can safely donate blood preoperatively. Intraoperative
      processing of blood withdrawn before cardiopulmonary bypass provides autologous
      platelet-rich plasma for infusion after reversal of heparin sodium. Blood
      collected from the field during operation and blood remaining in the oxygenator
      after bypass can also be processed to yield washed and concentrated red blood
      cells for reinfusion. Randomized, prospective studies document that postoperative
      autotransfusion is both safe and effective in reducing homologous blood use.
      Aprotinin reduces plasma protein activation and platelet damage during bypass.
      The integration of available blood conservation techniques into a comprehensive
      program combined with careful consideration of the indications for transfusion
      may allow more patients to avoid transfusion entirely.

PMID- 2241360
TI  - Coarctation of the aorta.

PMID- 2241361
TI  - Left ventricular outflow tract obstruction with aortic arch anomalies and
      ventricular septal defect.

PMID- 2241362
TI  - Diaphragmatic plication.

PMID- 2241363
TI  - Choice of surgical clips for mammary artery take-down.

PMID- 2241364
TI  - Free gastroepiploic artery graft.

PMID- 2241365
TI  - Oxygenator failure.

PMID- 2241366
TI  - Descending necrotizing mediastinitis.

PMID- 2241367
TI  - New technique for the arterial switch operation in difficult situations.
AB  - The technique described here, a modification of the Aubert operation, avoids
      coronary reimplantation and also eliminates the need to use artificial material
      to transfer coronary circulation.

PMID- 2241368
TI  - Transatrial approach revisited.
AB  - A surgical approach is described to provide excellent exposure of the interior of
      the left atrium and the mitral valve apparatus.

PMID- 2241369
TI  - Operative insertion of a transvenous left atrial pressure monitoring line.
AB  - We describe a technique for the insertion of a left atrial pressure monitoring
      line during open heart operations in infants. The procedure requires central
      venous cannulation with a long catheter, followed by intraoperative placement of
      the catheter tip through the interatrial septum into the left atrium. The
      technique has been used successfully in 35 infants.

PMID- 2241370
TI  - Postinfarction ventricular septal defect repair: retrospective thoughts and
      historical perspectives.
AB  - Evolution of surgical techniques for repair of postinfarction ventricular septal
      rupture initially involved differentiation of these lesions from prior experience
      with surgical approaches to congenital ventricular septal defects, which were in
      the main not applicable. Second, understanding of the differing anatomical
      locations of postinfarction ventricular septal defects required innovation in
      terms of the location of the cardiotomy and type of repair necessary to achieve a
      successful result in any given patient. The gradual appreciation of different
      clinical courses pursued by patients after postinfarction ventricular septal
      rupture both in terms of location of the defect and the degree of right
      ventricular functional impairment has led to increased urgency relative to the
      timing of surgical repair. The incorporation of specific anatomical concepts of
      surgical repair and better understanding of the time course of physiological
      deterioration of patients can ultimately lead to an integrated approach aimed
      toward improved salvage of patients suffering this catastrophic complication of
      acute myocardial infarction.

PMID- 2241371
TI  - Intraoperative echocardiography.
AB  - Intraoperative echocardiography has emerged as a new technique by which the
      cardiac surgeon can more precisely define the operative anatomy and physiology,
      immediately evaluate the results, and more accurately monitor left ventricular
      function in the operating room. This review summarizes the current applications
      of intraoperative two-dimensional and Doppler echocardiography in both the
      epicardial and transesophageal forms, and discusses the advantages and possible
      limitations of these methods in the practice of clinical cardiac surgery.

PMID- 2241372
TI  - Spasm of arterial conduits in aorta-coronary bypass grafting.

PMID- 2241373
TI  - Chest wall recurrence of lung cancer after transthoracic fine needle aspiration
      biopsy.

PMID- 2241374
TI  - Plastic struts for delayed sternal closure.

PMID- 2241375
TI  - Individual ligation technique.

PMID- 2241376
TI  - Cardiac transplantation for neonates with hypoplastic left heart syndrome.

PMID- 2241377
TI  - Surgical treatment of Wolff-Parkinson-White syndrome.

PMID- 2241379
TI  - Facile retrograde cardioplegia: transatrial cannulation of the coronary sinus.
AB  - The benefits of coronary sinus (CS) cardioplegia are well known, yet CS
      cardioplegia is not used widely owing to the need for bicaval cannulation,
      snares, and an atriotomy. We designed and used in 225 consecutive patients a
      catheter containing a flexible removable stylet that, when shaped into a hockey
      stick configuration, enabled blind intubation of the CS through a small
      pursestring in the right atrium, guided easily into the CS using a finger on the
      atrioventricular groove at the inferior vena cava. The CS was intubated in all
      patients; a pressure-limited balloon at the catheter tip was inflated after cross
      clamping. An integral distal pressure line measured CS pressure. Catheters were
      placed distally within the great cardiac vein beyond the posterior
      interventricular vein; the position did not alter cooling: right ventricular free
      wall, septum, and left ventricular free wall temperatures were 7 degrees +/- 2
      degrees, 8 degrees +/- 2 degrees, and 7 degrees +/- 2 degrees C, respectively,
      after an initial 10 mL/kg of blood cardioplegia. Transatrial CS cardioplegia was
      used in 45 aortic valve replacements, 22 mitral valve replacements, 4 triple
      valve replacements, 6 congenital lesions, and 148 coronary revascularizations,
      including 40 redo operations. Atheromatous material was routinely flushed
      retrogradely from cut old vein grafts during revascularization; 70
      revascularizations (47%) were performed urgently for acute infarction or
      jeopardized myocardium. No heart block or CS injury occurred, and inotrope use
      dropped to 10% of patients (from 38% in the previous 256 patients with antegrade
      blood cardioplegia). We conclude that the CS can be cannulated transatrially and
      that CS cardioplegia is more facile than antegrade cardioplegia.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2241380
TI  - Cardiac transplantation for hypoplastic left heart syndrome: a modified technique
      [see comment].
AB  - A modified technique of infant orthotopic cardiac transplantation with arch
      reconstruction using bicaval cannulation is described, and the results in 4
      infants with hypoplastic left heart syndrome are presented. This technique
      minimizes donor myocardial ischemic time and recipient circulatory arrest time.

PMID- 2241378
TI  - Treatment of postoperative infection of ascending aorta and transverse aortic
      arch, including use of viable omentum and muscle flaps.
AB  - Postoperative infection of the ascending aorta and aortic arch in 40 patients was
      treated by antibiotic therapy alone (4 patients) or by operation and lifelong
      suppressive antibiotic therapy (36 patients). Complications of infection included
      antibiotic-resistant infection, infected false aneurysm, rupture of suture line,
      aortocutaneous fistulas, aortic-right ventricular fistulas, arterial embolus,
      aortic valve insufficiency, aortobronchial fistula, mediastinal abscess, and
      chest wall problems. These were treated by a variety of operations including
      composite valve-graft replacement, graft replacement, patch-graft closure of
      false aneurysm, simple suture of disrupted suture lines and false aneurysm, and
      debridement of mediastinum and chest wall. The area of reconstruction was
      covered, and mediastinal dead space was reduced by mobilization of viable tissue,
      including local tissue and distant structures such as flaps of muscle and
      omentum. Thirty-three patients (83%) were early survivors, and 28 patients (70%)
      were alive and well at last follow-up 4 months to 6.5 years after operation.

PMID- 2241381
TI  - Tracheal reconstruction with polytetrafluoroethylene graft in dogs.
AB  - Use of prosthetic materials for long-segment tracheal reconstruction has been
      limited owing to infection, graft migration, ingrowth of fibrous tissue, and
      stenosis. Polytetrafluoroethylene (PTFE) is flexible and porous, and it may
      resist infection more than previously used materials. We evaluated PTFE for use
      in long-segment tracheal reconstruction. A 5-cm segment of trachea was resected
      in 9 dogs and replaced with a 20-mm reinforced PTFE graft using 4-0 Vicryl
      sutures. In 2 control dogs, one tracheal arch was resected and a primary
      anastomosis was performed. The animals were followed up with weekly bronchoscopy
      and endoscopic photography. Euthanasia was performed at 16 weeks or when signs of
      respiratory distress developed. At postmorten examination, the anastomoses were
      examined grossly and with light and scanning electron microscopy. In all 9 dogs
      that underwent tracheal replacement with PTFE, granulation tissue developed at
      the anastomoses resulting in airway obstruction after 3 to 8 weeks. No epithelial
      growth occurred over the graft between the anastomoses. The control animals did
      well. We conclude that granulation tissue formation at the anastomosis and the
      lack of respiratory epithelial ingrowth across the graft makes PTFE unsuitable
      for long-segment tracheal reconstruction.

PMID- 2241382
TI  - Role of perfusion pressure and flow in major organ dysfunction after
      cardiopulmonary bypass.
AB  - The role of perfusion pressure and flow during cardiopulmonary bypass with
      moderate hypothermia and hemodilution in the development of new postoperative
      renal or clinically apparent cerebral dysfunction was examined in 504 adults.
      Cardiopulmonary bypass flow was targeted at greater than 40 mL.kg-1.min-1 and
      pressure at greater than 50 mm Hg. Flows and pressures less than target occurred
      in 21.6% and 97.1% of patients, respectively. Fifteen patients (3.0%) suffered
      new renal and 13 (2.6%) new central nervous system dysfunction. Low pressure or
      flow during cardiopulmonary bypass, expressed in absolute values or in intensity
      duration units, were not predictors of either adverse outcome. Multivariate
      analysis identified use of postoperative intraaortic balloon counterpulsation (p
      less than 10(-6], excessive blood loss in the ICU (p less than 10(-4], need for
      vasopressors before cardiopulmonary bypass (p less than 10(-4], postoperative
      myocardial infarction (p less than 10(-3], emergency reoperation (p less than
      0.002), excessive postoperative transfusion (p less than 0.02), and chronic renal
      disease (p less than 0.03) as independent predictors of postoperative renal
      dysfunction. Independent predictors of postoperative central nervous system
      dysfunction were cardiopulmonary resuscitation in the intensive care unit (p less
      than 10(-6], intracardiac thrombus or valve calcification (p less than 0.02), and
      chronic renal disease (p less than 0.03). Age greater than 65 years (40.7% of
      patients) did not predict either outcome. We conclude that failure of the native
      circulation during periods other than cardiopulmonary bypass rather than the
      flows and pressures considered here is the major cause of renal and clinically
      apparent central nervous system dysfunction after cardiac operations.

PMID- 2241383
TI  - Ultrasonic debridement during mitral valve reconstruction for calcified mitral
      stenosis.
AB  - An ultrasonic device in conjunction with open mitral commissurotomy was applied
      in 8 patients with heavily calcified, stenosed mitral valves. In 6 patients,
      reconstruction of the mitral valve by debridement of the leaflet calcification
      with the device was successful. Two patients required valve replacement because
      of an increase in preexistent mitral regurgitation caused by excessive
      decalcification. The ultrasonic device proved to be a useful and effective
      adjunct for salvaging the heavily calcified mitral valve, which would otherwise
      have to be replaced.

PMID- 2241384
TI  - Repair of flail anterior leaflets of tricuspid and mitral valves by cusp
      remodeling.
AB  - We present an alternative approach to extensive rupture of the chordae tendineae
      leading to flail anterior leaflets. Resection of the affected cusp segment,
      suture of the cut edges, and extensive plication of the segment of annulus devoid
      of leaflets abolished massive regurgitation while maintaining an adequate valve
      orifice.

PMID- 2241385
TI  - Thoracic spinal fractures and aortic rupture: a significant and fatal
      association.
AB  - We analyzed the frequency of occurrence of traumatic aortic rupture (TAR) in
      patients with and without thoracic spinal fractures. Among 4,676 blunt chest
      trauma victims admitted to the hospital between 1972 and 1988, 148 (3.2%)
      suffered one or more thoracic vertebral fractures. There were 73 patients with
      one or more fractures of the first eight thoracic vertebrae (T1 to T8); of these
      73, 4 also suffered TAR (5.5%). There were 4,603 patients without fractures of T1
      to T8, and 64 of these patients also suffered TAR (1.4%). This difference was
      significant by the chi2 and Fisher exact tests, p = 0.00378 and p = 0.021003,
      respectively. Additionally, all 5 patients with TAR and thoracic vertebral
      fractures died. We conclude that patients with one or more fractures of T1 to T8
      have a statistically significant increase in the incidence of TAR.

PMID- 2241387
TI  - Pleuropulmonary morbidity: internal thoracic artery versus saphenous vein graft.
AB  - Although use of the internal thoracic artery (ITA) for coronary artery bypass
      grafting results in superior graft patency and improved patient survival, our
      initial clinical observations suggested an increased incidence of pleuropulmonary
      morbidity with its use. One hundred consecutive patients with left ITA grafts
      were studied prospectively and compared with a consecutive retrospective group of
      100 patients undergoing coronary artery bypass grafting with saphenous vein
      grafts only. Preoperative, postoperative day (POD) 2, POD 6, and postoperative
      week 8 chest roentgenograms were analyzed for atelectasis and effusion.
      Postoperative left lower lobe atelectasis was common in both groups on both POD 2
      (saphenous vein, 43%, versus ITA, 53%; not significant) and POD 6 (saphenous
      vein, 40%, versus ITA, 41%; not significant). There was a significantly higher
      incidence of pleural effusion on POD 6 in the ITA group (84% versus 47%; p less
      than 0.05) but most of these were small. There was more chest tube drainage
      (1,413 versus 1,028 mL; p less than 0.01) and a greater need for secondary
      thoracostomy or thoracentesis (4% versus 0%) in the ITA group. The left pleural
      space was opened in 67 of the 100 ITA patients but pleurotomy did not appear to
      influence postoperative morbidity. We conclude that use of the internal thoracic
      artery for coronary artery bypass grafting results in a small but significant
      increase in pleuropulmonary morbidity.

PMID- 2241386
TI  - Cardioplegia-induced damage to ischemic immature myocardium is independent of
      oxygen availability.
AB  - The known benefits of hypothermic pharmacological cardioplegia in protecting the
      ischemic adult heart may not extend to children. Protection of the ischemic
      immature rabbit heart with hypothermic Krebs-Henseleit bicarbonate buffer is
      better than with hypothermic St. Thomas' II cardioplegic solution. We
      investigated whether the availability of oxygen in the preischemic perfusate is
      responsible for the increased tolerance to ischemia of immature (7- to 10-day
      old) hearts perfused with Krebs buffer in comparison with St. Thomas' II solution
      immediately before ischemia. After obtaining preischemic control data in the
      "working" mode, we perfused hearts (n = 8 per group) for 3 minutes with
      hypothermic (14 degrees C) Krebs buffer or hypothermic St. Thomas' II solution
      saturated with 0%, 25%, or 95% oxygen. This was followed by 2 hours of global
      ischemia at 14 degrees C. Hearts were reperfused for 15 minutes in the
      Langendorff mode and 35 minutes in the working mode, and recovery of function was
      measured. For preischemic oxygen concentrations of 0%, 25%, and 95%, recovery of
      aortic flow in hearts protected by hypothermia alone during ischemia was 74% +/-
      9%, 82% +/- 4%, and 99% +/- 2% of preischemic values, respectively. In hearts
      protected by hypothermia plus cardioplegia, the values were 69% +/- 6%, 72% +/-
      3%, and 86% +/- 5%, respectively. Thus, at equal oxygen concentrations, recovery
      of postischemic function was better in hearts protected by hypothermia alone
      compared with hypothermia plus cardioplegia. We conclude that factors other than
      oxygen availability are responsible for the damaging effect of St. Thomas' II
      solution on the ischemic immature rabbit heart.

PMID- 2241388
TI  - Medical management of acute traumatic rupture of the aorta.
AB  - Surgical reconstruction is the treatment for acute traumatic aortic rupture and
      should be accomplished immediately in most patients. In patients in whom
      concomitant injuries or the development of life-threatening complications
      preclude safe and successful aortic reconstruction, pharmacological intervention
      to reduce the risk of free aortic rupture may be considered. Surgical
      reconstruction can then be more safely performed under controlled elective
      circumstances.

PMID- 2241389
TI  - Surgical epicardial ablation of left ventricular pathway using sling exposure.
AB  - We report our experience with 43 consecutive patients with left free wall
      pathways operated on since December 1988 using a modified direct epicardial
      approach through a medial sternotomy, without the adjunct of normothermic
      cardiopulmonary bypass. The left atrioventricular sulcus is exposed by
      dislocating the heart cephalad and to the right using a sling made of a large
      sponge passed around the ventricle through the transverse sinus. While the
      arterial pressure is monitored, the heart is positioned to obtain adequate
      exposure without compromising the ventricular function. The left atrioventricular
      junction is exposed using a direct approach. The epicardium is incised along the
      ventricular edge and a plane of dissection is identified and opened using blunt
      dissection over the ventricular wall. The entire left atrioventricular junction
      can be exposed. After dissection, electrophysiological testing is repeated to
      assess accessory pathway conduction. Epicardial cryoablation was used when
      accessory pathway conduction was not present (42 patients). Transmural
      cryoablation was used under normothermic cardiopulmonary bypass when accessory
      pathway conduction persisted after dissection (subendocardial pathway). In all,
      cardiopulmonary bypass was not used in 41 patients. There was one early relapse
      that required transmural cryoablation. There were no complications.

PMID- 2241390
TI  - Bronchial anomaly of the right upper lobe.
AB  - This case report presents a rare anomaly of right upper lobe bronchial anatomy.
      During routine right upper lobe resection for carcinoma, a common right upper and
      middle lobe bronchus was found. The resection was completed as a right upper and
      middle bilobectomy. Knowledge of this uncommon variant was beneficial in
      performing the pulmonary resection. A review of the literature is presented.

PMID- 2241392
TI  - Left recurrent laryngeal nerve paralysis: an unusual presentation of
      histoplasmosis.
AB  - A case of histoplasmosis seen as left recurrent laryngeal nerve paralysis in a 49
      year-old man is described. The patient had roentgenographic findings of a
      solitary, noncalcified left upper lobe mass and mediastinal adenopathy. Tissue
      diagnosis of histoplasmosis was obtained using a thoracotomy, allowing
      institution of appropriate treatment.

PMID- 2241391
TI  - Squamous carcinoma metastatic to the sternum.
AB  - A 63-year-old man had a 10 x 16-cm sternal mass 18 months after a second
      aortocoronary bypass operation. The resected lesion was a metastatic tumor of
      squamous histology. No primary tumor was found. The diagnostic work-up and
      treatment options are presented.

PMID- 2241393
TI  - Malignant thymoma presenting as intracardiac tumor and superior vena caval
      obstruction.
AB  - A case of malignant thymoma with intracardiac infiltration and intrinsic superior
      vena caval obstruction due to the tumor is reported. Intracardiac invasion by a
      thymoma is rare and for this reason is believed worthy of a report.

PMID- 2241394
TI  - Job's syndrome: a rare cause of recurrent lung abscess in childhood.
AB  - A clinical syndrome characterized by recurrent staphylococcal infection of the
      skin and respiratory tract from birth was described in 1966 and referred to as
      Job's syndrome. Marked hyperimmunoglobulinemia E was later found to be associated
      with this syndrome. This article describes a case of Job's syndrome as a cause of
      recurrent lung abscess during childhood necessitating lung resection.

PMID- 2241395
TI  - Easy dissection of hard and thickened pericardium on constrictive pericarditis.
AB  - The keys to successful pericardiectomy for constrictive pericarditis are early
      operation and as complete a pericardiectomy as possible. With the high-speed burr
      it is easy and safe to dissect the calcified pericardium and define the
      epicardium even in a small operative field such as the inferior or posterior
      portion of the heart. This method has the important ability to perform very
      complete pericardiectomy.

PMID- 2241396
TI  - [Follow-up studies on systemic arterial hypertension in Mexico].

PMID- 2241397
TI  - [The effect of gelfoam embolism in vascular conduction and critical pressure in
      the isolated canine lobe].
AB  - Pulmonary pressure-flow curves, hemodynamic and blood gas parameters in West's
      zone II condition were obtained in nine isolated in situ left lower lobes (LLL)
      before (condition A), and after 15, 30 and 60 minutes of lobar gelfoam
      embolization (GE) (condition B) in order to know the natural history of this
      model. After GE a decrease in PaO2 and lobar O2 were noticed (p less than 0.05).
      Vascular conductance (p less than 0.001) and lobar blood flow decreased (p less
      than 0.05), accompanied by a significant increase in the inflow (p less than
      0.01) and in the mean closing pressures (p less than 0.01). These parameters did
      not change during the time of observation at condition B. Nor the cardiac output
      or the minimal closing pressure changed in relation to condition A. LLL
      angiographic findings showed evidence of arterial occlusion and the pattern of
      obstruction was not homogeneous. Lobes histology showed occluded arteries of more
      than 300 micrometers of diameter. We concluded that in this canine model of
      increased pulmonary vascular resistance, pulmonary vascular conductance and mean
      closing pressure change, remain stable during 60 minutes after GE allowing us to
      know the natural history of the preparation. Condition than allow to perform and
      evaluate other interventions on lung vascular mechanics in the experimental
      setting of pulmonary embolization.

PMID- 2241398
TI  - [Transesophageal atrial stimulation].
AB  - Considering that catheterization of the esophagus is a relatively easy procedure,
      we studied the electrical transesophageal atrial stimulation in ninety patients
      (age range 15 to 75 years (mean 42 +/- 9 years). A multipolar electrode catheter
      was introduced through the nose into the esophagus of each patient and fixed in
      position at a site where the simultaneous recording of intraesophageal unipolar
      electrocardiographic derivations showed the greatest P wave potentials.
      Electrical atrial capture through the esophagus was obtained at frequency values
      higher than that of the heart, with lower voltages needed for atrial stimulation
      at the site in which the unipolar recording of the intraesophageal P wave was of
      highest amplitude. The difference of potential used was between 6 and 30 volts,
      with the highest values corresponding to patients with megaesophagus, whereas
      values below 15 volts were tolerated without major discomfort. Electric pulses of
      more than 10 ms duration did not significantly reduce the intensity of electric
      current needed to produce the atrial command. The stimulation bipole (area to be
      stimulated per pole, 0.72 cm2) had an interpolar distance of 22 or 30 mm, our
      overall experience showing that distances up to 44 mm did not require higher
      voltages. No cases of esophageal damage or severe arrhythmia were reported due to
      stimulation. In the present study, programmed transesophageal stimulation proved
      to be a good option for the evaluation of sinus node function and for the study
      and reversal of paroxysmal supraventricular tachycardia attacks by a reentry
      mechanism, representing in some cases an alternative approach for the study of
      atrioventricular conduction.

PMID- 2241399
TI  - [American trypanosomiasis and chronic Chagas cardiopathy at the "Ignacio Chaves"
      National Institute of Cardiology].
AB  - The cumulated experience at the Instituto Nacional de Cardiolog ia Ignacio Chavez
      during the period from 1977 to 1988 in regard of American Trypanosomiasis (AT)
      and its sequelae, chronic Chagasic Cardiopathy (CHC) was reviewed. There are 39
      cases. One was an acute myocarditis in a child 16 months old. Three, subacute
      diseases among young patients and 35 cases of chronic disease with severe heart
      compromise. Heart failure was the most important manifestation in 19 patients.
      Arrhythmia was the dominant one in 8 cases. Both conditions did occur in 8, 2 had
      Stokes Adams syndrome as presenting complaint and one had pulmonary embolism. The
      surface EKG was always abnormal and heart enlargement was noted in 36 cases on
      chest X rays. All patients had serologic evidence of antitrypanosoma antibodies,
      28 had heart reactive antibodies in their serum, 24 had polyclonal
      hypergammaglobulinemia and the same proportion had rheumatoid factor. Only the
      acute case showed another non-organ specific autoantibody. Echocardiography was
      useful to show dilatation of all cavities, left ones were more severely affected,
      abnormal movement was also detected with lower frequency, apical aneurysm and
      left ventricular hypertrophy were rarely detected. Fifteen out of 16 cases
      studied by angiogram did show normal coronary arteries, abnormal movement was
      demonstrated in 62% and apical aneurysm was present in 4 cases. Studies with EKG
      monitoring (Holter) and electrophysiology confirmed electrical abnormalities.
      Although once considered an exotic disease, CHC is probably underdiagnosed
      because the lack of methodic studies looking for epidemiologic, clinical and
      seroimmunologic features in patients with dilated myocardiopathy. Cardiologist
      practicing in south and southeast states in Mexico should be aware of this heart
      ailment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241400
TI  - [The diagnosis of perioperative myocardial infarction in heart surgery].
AB  - Fifty three consecutive patients undergoing open heart surgery were prospectively
      studied to assess current techniques for diagnosing perioperative myocardial
      infarction (PMI). All patients had preoperative and postoperative
      electrocardiograms, serial determinations of serum creatine phosphokinase (CK),
      myocardial fraction of CK (CK-MB) and scintigraphy with technetium-99m labeled
      pyrophosphate. Seven patients (13.2%) sustained perioperative myocardial
      infarction. Four of these patients exhibited abnormal Q waves, and one poor R
      wave progression. Three of them had a positive scintigram. Two patients with a
      non-Q-wave infarction had a abnormal radioisotopic imaging. The CK and CK-MB were
      higher in patients with infarction (818.1 U) than in those without this
      complication (349 U) p less than 0.05. The relative sensitivity and relative
      specificity of given variables in the diagnosis of PMI were as follows:
      electrocardiogram 71.4% and 97.5% respectively; scintigraphy 71.4% and 94.1%; and
      serum enzymes 100% and 71.8%. Age, incidence of prior myocardial infarction,
      unstable angina, elevated left ventricular filling pressure, number of diseased
      coronary arteries, and number of grafts per patient did not correlate with PMI.
      Duration of extracorporeal circulation and number of electric shocks during
      surgery were slightly higher in the infarction group, but the difference was not
      significant. These results indicate that the combination of these three
      diagnostic procedures is the best way to evaluate myocardial damage after open
      heart surgery.

PMID- 2241401
TI  - [Unstable angina: clinical and angiographic characteristics of 140 cases].
AB  - We conducted a study on the clinical and angiographic characteristics of 140
      patients with unstable angina. Average age of 57, male/female ratio 4 to 1. The
      most frequent risk factors: tobacco smoking (73%) and arterial hypertension
      (42%). They had old infarct (57%), and unstable angina at rest (37%). We did
      early submaximal stress test to 31% of them; in 38.6% test was stopped due to
      angina, 25% for fatigue. 91% had ischemic changes, there weren't any severe
      complications. Regarding significant coronary obstruction: 20% had one vessel,
      26% two, 50% three and left trunk 4%. Normal ventriculogram 43%. Eight patients
      died; the causes were: disease of the trunk (37.5%) and "active" angina (87.5%),
      25% during catheterization . All survivors responded to medical treatment. 54
      patients were not candidates for surgical treatment, among them 70.3% were
      released in class I (NYHA). At follow up 90% were in class I-II, 12% had unstable
      angina recurrence, 3% had acute infarct. In the pathogenesis of unstable angina
      intervene fixed atherosclerosis, obstructive lesions, repetitive spasms and non
      occlusive thrombosis, this physiopathologic behavior is responsible for the
      stages of ischemic activity. Treatment should be directed to maintain the balance
      between the distribution and the demand of O2, and also treating spasm and
      thrombosis.

PMID- 2241402
TI  - [Life style, family history and personal pathology in relation to arterial
      hypertension in students of the Medical Faculty of UNAM].
AB  - Arterial hypertension (HA) is a public health problem, 15 to 30% of adults in our
      country suffer it. There are different facts that influence its outcome. Among
      young people the main factors are: alcoholism, smoking tobacco, overweight,
      diabetes, family history, sedentarism and psychological aspects. The main object
      of this study, was to detect the risk factor for the development of HA in the
      students of the University. For this search 489 sophomore students class at the
      Medical School of the University of Mexico (UNAM), between 17 and 24 years old,
      were studied. Our results showed that positive family history was more prevalent
      among females. Among males life-style factors were more significant, the main
      factor was sedentarism, whereas lesser factor was overweight. The prevalence of
      HA was higher for diastolic hypertension than for systolic. We concluded there
      are many risk factors that influence the development of HA, which are distributed
      in a different way according to gender preventive measures are recommended.

PMID- 2241403
TI  - [Clinical development of the in-hospital phase of acute myocardial infarction in
      patients treated with intravenous streptokinase].
AB  - In order to determine the clinical in-hospital course of patients with acute
      myocardial infarction treated with intravenous Streptokinase (SK), 132 patients
      were studied divided as follows: Group I: 44 patients who arrived to the hospital
      within 6 hours from the onset of symptoms and received fibrinolytic therapy.
      Group II: 44 patients who arrived more than 6 hours delay and did not receive SK.
      Group III: 44 patients who arrived less than 6 hours delay but they did not
      receive SK. The overall hospital mortality was 2.2% in the SK recipients versus
      4.4% in the group II (Odd ratio 0.95, p = NS) and 13.6% in group III (Odd ratio
      0.79, p greater than 0.05). The incidence of hemorrhagic episodes was not
      increased in SK recipients. In-hospital period differences between groups were
      explained by protocol studies and postoperative complications in patients that
      needed further revascularization procedures.

PMID- 2241404
TI  - [Ventricular activation time of the fetal heart].
AB  - The prenatal risk determined by smoking pregnant woman was studied by a fetal
      electrocardiogram at different gestational ages. There were 28 low risk pregnancy
      women selected and qualified by means of an 80% completion of the Perechtl
      optimal criterion, 13 which smoked more than 5 cigarettes daily and 15 (53%) non
      smokers. A new computerized technique was defined and applied for recording a
      continuous fetal electrocardiogram for long periods of time. Measurements of the
      QRS complex, inscription time of the intrinsecoid deflection (TIDI) and
      intrinsecoid deflection (DI) lengths were taken and compared with the gestational
      age. It was observed that there is a relationship of statistical significance (p
      less than 0.005) between the gestational age and the QRS length in the nonsmoking
      women. This relationship was smaller in the smoking group and furthermore it was
      negative when comparing the gestational age with the TIDI. There was no
      statistical difference in the weight of the child at birth in both groups,
      nevertheless the fetal electrocardiogram is useful in determining the development
      of the ventricular mass. In the smoking group the lack of relationship between
      the QRS length and the gestational age is probably owing to the retarded cardiac
      development and expressed ahead of all other features in fetal growth including
      low weight at birth.

PMID- 2241405
TI  - [Tetralogy of Fallot with abnormal coronary arteries].
AB  - Between 1980 and 1989 nine patients with Tetralogy of Fallot with abnormal
      coronary artery underwent surgical treatment. In all but one, the abnormal
      coronary artery was identified at surgery. Seven (group I) had the anterior
      descending coronary artery arising from the right coronary artery; one (group II)
      with had the right coronary artery arising from the left coronary artery and
      finally, the only case of the group III had left coronary artery arising from the
      main pulmonary artery. Systemic-pulmonary anastomosis was done in two cases of
      the Group I, in one due to severe hypoplasia of the pulmonary ring and main
      pulmonary artery and in the other due to the anomaly of the coronary artery. In
      the case of the Group II the right coronary artery was accidentally cut and the
      patient developed right ventricular infarction and died. All surviving are in
      NYHA functional class I. Nowadays, the preoperative evaluation of Tetralogy of
      Fallot, can be done by echocardiography despite the possibility of its
      association with abnormal coronary artery. In special cases aortography or
      arterial coronarography should be considered.

PMID- 2241406
TI  - Effects of clonidine, yohimbine and eserine on the quantified EEG of rats.
AB  - The effects of three different classes of drugs were analyzed on the EEG of rats
      on two cortical derivations (parieto-occipital and fronto-occipital) and one deep
      structure, the locus coeruleus. Clonidine, an alpha 2-agonist (0, 0.10, 0.30 and
      0.50 mg/kg, i.p.), yohimbine, an alpha 2-antagonist (0, 2, 4 and 8 mg/kg, i.p.)
      and eserine, an anticholinesterase (0, 0.10, 0.30 and 0.50 mg/kg, i.p.), affected
      the EEG in different significant ways. Clonidine significantly decreased
      frequency in the theta-band (3.7-7.5 Hz) and increased it in the alpha-band (7.6
      13.5 Hz). A general significant increase in power was also observed. For
      yohimbine, there was a significant dose-dependent increase of power, particularly
      in the theta-, alpha- and beta-bandwidth. Moreover, its effects on EEG varied in
      accordance to the derivations analyzed. Finally, eserine significantly decreased
      power in the high frequency bandwidths. A synchronization, as a function of dose,
      with a peak at 5-6 Hz was observed shortly after its administration. The results
      are discussed in terms of the potentiality of the technique of quantitative
      pharmaco-electro-encephalography and drug interaction studies in the analysis of
      psychoactive substances.

PMID- 2241407
TI  - Ribavirin-induced behavioral, body temperature and electrocortical spectra
      effects in the rat.
AB  - Behavioral, electrocortical spectra and body temperature effects, following a
      single intracerebroventricular (i.c.v.) or intraperitoneal (i.p.) injection of
      ribavirin, were studied in male adult rats. Ribavirin, when administered i.p.,
      induced squatting posture, sedation, electrocortical synchronization,
      piloerection and a slight decrease of tactile and/or auditory stimuli/responses
      lasting from 45 min to 16 hr, as well as a longer lasting hypothermic effect.
      Following i.c.v. administration, ribavirin (50, 100 and 200 micrograms) elicited
      a soporific effect and produced changes in the electrocortical spectra.
      Pretreatment, 15 min before, with either prazosin (10 mg/kg, i.p.), an alpha 1
      adrenoceptor blocker, or piperoxan (20 mg/kg, i.p.) and yohimbine (1 mg/kg,
      i.p.), two alpha 2-adrenoceptor blockers, or naloxone (1 mg/kg, i.p.), an opioid
      antagonist, did not prevent the hypothermic and behavioral effects induced by
      i.p. or i.c.v. administration of ribavirin. The present findings exclude an
      involvement of alpha-adrenergic and opioid neurotransmission in mediating the
      hypothermic, electrocortical and behavioral effects induced by ribavirin.

PMID- 2241409
TI  - In vitro cardiac electrophysiological effects of prenylamine.
AB  - In order to get information on some of the effects of prenylamine (bradycardic
      effect, negative inotropic effect, triggering of "torsade de pointes"), we
      studied with intracellular microelectrodes its electrophysiological actions on
      guinea-pig sinus node and papillary muscle, on sheep Purkinje fibers and rabbit
      sino-atrial node isolated myocytes. Prenylamine (10(-6)-10(-5) M) reduced the
      firing rate of sinus node preparations. This effect was associated with a slowing
      of the rates of diastolic depolarization, of depolarization and of
      repolarization, and with a slight depolarization of the maximum diastolic
      potential. A dose-dependent decrease of the slope of the first 100 msec of the
      diastolic depolarization was observed. Prenylamine (10(-6) M) also reduced the
      amplitude of the pacemaker current (If) recorded using the patch-clamp technique
      from rabbit sino-atrial node cells. Prenylamine (3 x 10(-7)-3 x 10(-6) M) dose
      dependently reduced contractility of Purkinje fibers; the effect was associated
      with a lowering of the plateau, a decrease of the maximum rate of depolarization
      and a shortening of the action potential duration. Prenylamine was also able to
      abolish early and delayed after-depolarizations which are two kinds of calcium
      dependent electrical activities relevant for the genesis of triggered
      arrhythmias, such as "torsade de pointes". It is concluded that prenylamine, a
      nonselective calcium antagonist, presents an intriguing in vitro
      electrophysiological profile which makes any extrapolation to its in vivo
      pharmacology extremely complex.

PMID- 2241408
TI  - Cross-dependence on ethanol and pentobarbital in rats reinforced on diazepam.
AB  - Cross-dependence on ethanol and pentobarbital was studied in rats reinforced on
      diazepam, using an intravenous self-administration method. Five rats were allowed
      to self-administer diazepam 2.0 mg/kg per injection intravenously by pressing a
      lever on a continuous reinforcement schedule over a 20 day period. The total
      daily dose of diazepam delivered reached 50 mg/kg/day. Thereafter, ethanol (50 or
      100 mg/kg per injection) and then pentobarbital (6 mg/kg per injection) were
      substituted for diazepam for 3 and 2 days, respectively. During these
      substitution periods, responding for self-administration, food intake and body
      weight were recorded. When ethanol was substituted, self-administration
      responding increased and then decreased. Food intake and body weight also
      decreased during this period. These changes during the ethanol substitution
      session resembled those observed during withdrawal sessions. In contrast, when
      pentobarbital was substituted, no significant changes in self-administration
      responses, food intake or body weight were seen. These findings suggest that
      diazepam produces cross-dependence on pentobarbital, but not on ethanol at the
      doses used in this experiment.

PMID- 2241411
TI  - Effects of magnesium sulfate and nifedipine on regional cerebral blood flow
      during middle cerebral artery ligation in the rat.
AB  - The effects of magnesium sulfate and nifedipine on regional cerebral blood flow
      were compared after ligation of the middle cerebral artery in rats. Twenty-one
      rats were divided into 3 groups of 7 each. The groups were the magnesium group,
      the nifedipine group, and the control group. Animals were anesthetized with
      pentobarbital. The middle cerebral artery was ligated, and magnesium sulfate was
      infused at a rate of 16 mg/kg/min for 30 min in the magnesium group, and
      nifedipine was infused at a rate of 10 micrograms/kg/min for 45 min in the
      nifedipine group. Using [14C]-iodoantipyrine, regional cerebral blood flow was
      measured 1 hr after middle cerebral artery ligation in the ischemic cortex,
      contralateral cortex, thalamus, hypothalamus, pons, medulla and cerebellum. In
      the control group, the mean cerebral blood flow was 30.7 +/- 12.2 ml/min/100 g in
      the middle cerebral artery-ligated cortex, and 75.9 +/- 10.5 ml/min/100 g in the
      contralateral cortex. Nifedipine did not significantly alter the cerebral blood
      flow in any of the brain regions studied. However, in the magnesium group, the
      regional cerebral blood flow in the middle cerebral artery-ligated cortex was
      significantly higher (64.2 +/- 8.8 ml/min/100 g) than that recorded in the
      control and nifedipine groups, whereas the regional cerebral blood flow in the
      contralateral cortex was not significantly different from other groups. Our data
      showed that magnesium was effective and superior to nifedipine in improving blood
      flow in the ischemic area of the brain.

PMID- 2241410
TI  - Comparison of the cardiac electrophysiologic effects of amitriptyline and
      clomipramine in the dog after myocardial infarction.
AB  - The effects of the tricyclic antidepressants amitriptyline and clomipramine on
      intraventricular conduction, effective refractory period and incidence of
      ventricular arrhythmias induced by programmed stimulation, were studied in the
      dog heart after myocardial infarction. Amitriptyline, at doses of 1 to 3 mg/kg,
      significantly slowed ventricular conduction of the infarcted zones in a frequency
      dependent and a dose-dependent manner. Amitriptyline, at doses of 2 and 3 mg/kg,
      slightly slowed conduction in normal zones. The effective refractory period was
      prolonged by amitriptyline at a dose of 2 mg/kg. Amitriptyline increased the
      incidence of ventricular arrhythmias induced by programmed stimulation. On the
      other hand, the depressant effect of clomipramine, at doses of 1 to 3 mg/kg, on
      the conduction of infarcted zones was lower than that of amitriptyline, whereas
      the severely depressed conduction in the infarcted zone was obviously slowed by
      clomipramine. The incidence of ventricular arrhythmias did not significantly
      increase with clomipramine. From the present results, clomipramine seems to have
      a lower cardiac toxicity than amitriptyline, although clomipramine produces a
      slight depression of conduction in infarcted zones.

PMID- 2241412
TI  - Protective effect of KB-2796, a new calcium antagonist, in cerebral hypoxia and
      ischemia.
AB  - The protective effect of KB-2796, a new calcium antagonist possessing a selective
      vasodilator activity on cerebral vessels in cerebral hypoxia and ischemia, was
      investigated in both in vivo and in vitro. KB-2796 showed an apparent protective
      potency against complete ischemia induced by decapitation, normobaric hypoxia and
      KCN-induced death in mice. KB-2796 (50 mg/kg, p.o.) significantly prolonged
      survival time in gerbils with bilateral carotid ligation. In guinea-pig
      hippocampal slices, the amplitude of the population spike recorded from the
      dentate granule cell layers, in response to electrical stimulation of the
      perforant path, gradually decreased during mild hypoxia (20% O2 + 75% N2 + 5%
      CO2), with a tendency to recover to pre-hypoxic levels during reoxygenation (95%
      O2 + 5% CO2). Pretreatment with KB-2796, at a concentration of 1 microM,
      significantly accelerated the recovery of the population spike during the
      reoxygenation period. These results suggest that the protective effect of KB-2796
      in cerebral hypoxia and ischemia is due in part to a mechanism independent of its
      effects as a cerebral vasodilator.

PMID- 2241413
TI  - Effects of calcium entry blockers on KCl- and 5-hydroxytryptamine-induced
      contractions of human umbilical arteries.
AB  - The effects of Ca2+ removal and of the calcium entry blockers, nicardipine and
      nifedipine, on contractions of isolated human umbilical arteries, elicited with
      KCl and 5-hydroxytryptamine, were investigated. Withdrawal of Ca2+ caused
      inhibition of both KCl and 5-hydroxytryptamine responses, but the maximum effect
      of KCl in Ca2(+)-free medium was recuperated by increasing the KCl concentration.
      The maximum effect of 5-hydroxytryptamine, however, was recuperated only when
      Ca2+ was restored to the medium. Consistently with an inhibition in Ca2(+)-free
      medium, calcium entry blockers produced a concentration-dependent relaxation of
      human umbilical artery strips precontracted with KCl and 5-hydroxytryptamine, and
      inhibited the concentration-dependent contraction elicited by these stimuli. Our
      results indicate that contractile responses of the human umbilical arteries are
      dependent on extracellular Ca2+ for both KCl and 5-hydroxytryptamine. Although
      Ca2+ entry was sensitive to both nicardipine and nifedipine, the differences
      between the effects of these dihydropyridines with the two experimental
      approaches we used were not always conclusive.

PMID- 2241414
TI  - Antihypertensive and diuretic effects of NZ-105, a novel dihydropyridine
      derivative.
AB  - Studies on the antihypertensive and diuretic actions of NZ-105, a new
      dihydropyridine derivative, were performed in comparison with nicardipine. NZ-105
      and nicardipine (5, 10 and 20 mg/kg, p.o.) dose-dependently decreased systolic
      blood pressure in three types of experimentally hypertensive rats, including
      spontaneously hypertensive rats, renal hypertensive rats and deoxycorticosterone
      acetate-salt hypertensive rats and normotensive Wistar-strain rats. The
      hypotensive effects were larger in hypertensive rats than in normotensive Wistar
      rats. The hypotensive actions of NZ-105 were very slow in onset and long-lasting
      in all models, e.g., the hypotension by NZ-105 (10 mg/kg, p.o.) reached a peak (
      52 mmHg) at 3 hr and lasted for more than 9 hr in spontaneously hypertensive
      rats. The hypotensive action in spontaneously hypertensive rats was reproducible
      after repeated dosing twice a day for 29 days. The hypotensive action after i.v.
      injection of NZ-105 (0.1 mg/kg) in spontaneously hypertensive rats was also slow
      in onset (peak time: 10 min) and long-lasting (more than 120 min). The
      hypotensive potency of NZ-105 was about the same as that of nicardipine, but the
      increment in heart rate was smaller than in the case of nicardipine. Both NZ-105
      and nicardipine showed diuretic and natriuretic actions in spontaneously
      hypertensive rats. After repeated administration, these actions of NZ-105 were
      unchanged, whereas those of nicardipine were reduced. These results suggest that
      NZ-105 is a useful antihypertensive drug with concomitant diuretic effects.

PMID- 2241415
TI  - Effect of N-acetylneuraminic acid on respiratory tract secretion and inflammation
      in the bronchitic rabbit.
AB  - Long-term exposure of rabbits to SO2 gas caused the following changes in the
      respiratory tract system: decreases in the respiratory rate and pO2 blood level;
      an increase in the viscosity of sputum associated with increases in protein,
      unsaturated phosphatidylethanolamine and sphingomyelin; subacute rhinitis,
      tracheitis and multiple bronchopneumonia. Pretreatment with repeated
      administrations (inhalations) of N-acetylneuraminic acid remarkably prevented
      these inflammatory changes. The significance of this finding is discussed.

PMID- 2241416
TI  - Effect of saline cathartics on the adsorption of sulphamethoxazole to activated
      charcoal.
AB  - The effect of added saline cathartics (sodium sulfate and magnesium sulfate) on
      the in vitro adsorption of sulphamethoxazole to activated charcoal was
      determined. Sulphamethoxazole, at 0.00125, 0.0025 and 0.005 mg/ml, had a 56.77 to
      91.70 per cent adsorption to 50 mg and 200 mg activated charcoal. As the
      concentration of the activated charcoal was increased from 50 mg to 1000 mg,
      there was an increase in the amount of sulphamethoxazole adsorbed at 0.125, 0.25
      and 0.5 mg/ml. The amount of sulphamethoxazole (0.125-0.5 mg/ml) adsorbed ranged
      from 10.33 to 83.67 per cent with a B50 value of 472.33 mg. At 7.5 mg/ml, the
      common saline cathartics sodium sulfate and magnesium sulfate decrease the B50
      values to 274.65 and 41.20 mg, respectively. Both saline cathartics enhanced
      adsorption of sulphamethoxazole to activated charcoal.

PMID- 2241417
TI  - Effects of a perfluorochemical emulsion on L-tryptophan binding by human albumin.
AB  - The effect of a perfluorochemical emulsion on ligand binding by human albumin was
      studied using a site specific approach. L-tryptophan was used as a marker for
      binding to site II on human albumin. Centrifugation, followed by supernatant
      ultrafiltration at ambient room temperature, was employed to determine the per
      cent tryptophan free. The partitioning of tryptophan from pH 7.4 phosphate buffer
      into the pure perfluorochemical liquids was insignificant. Tryptophan was not
      significantly bound by the perfluorochemical emulsion droplets. Binding of
      tryptophan by buffer dilutions of human albumin demonstrated that, at the
      tryptophan concentrations examined, human albumin concentration had little effect
      on the per cent tryptophan free. Tryptophan binding by mixtures of the
      perfluorochemical emulsion and human albumin showed that, at sufficiently high
      concentrations of the perfluorochemical emulsion, one or more of the emulsion
      components is responsible for the direct and/or indirect displacement of human
      albumin-bound tryptophan. The individual perfluorochemical emulsion components
      were studied for their effects on the binding of tryptophan by human albumin.
      Results showed that oleic acid and, to a very small degree, Pluronic F-68, were
      responsible for the displacement of human albumin-bound tryptophan.

PMID- 2241418
TI  - Hypoglycemic action and disposition of gliclazide in normal and analbuminemic
      rats.
AB  - The hypoglycemic action and disposition of gliclazide, an oral antidiabetic drug,
      was investigated in normal and analbuminemic rats. Orally administered gliclazide
      exhibited a stronger hypoglycemic action in analbuminemic rats than in normal
      rats. However, the plasma concentration of the drug in the mutant was much lower
      than that in the normal. This apparent discrepancy may be clarified by measuring
      the plasma concentration of unbound gliclazide. Analbuminemic rats gave larger
      values for the total body clearance and steady state volume of distribution of
      gliclazide than normal rats. The biliary and urinary excretion rates of
      radioactivity after intravenous bolus administration of [3H]-gliclazide were much
      greater in the mutant than in the normal. The binding of gliclazide to serum in
      analbuminemic rats was much lower than that in normal rats. Furthermore, the
      radioactivities of some tissues after oral administration of [3H]-gliclazide were
      found to be significantly higher in the mutant than in the normal. These results
      clearly indicate that albumin plays an important role in the hypoglycemic
      activity and disposition of gliclazide in rats.

PMID- 2241419
TI  - The effects of a new cholinolytic--8018--and its optical isomers on the central
      muscarinic and nicotinic receptors.
AB  - 3-(2'-phenyl-2'-cyclopentyl-2'-hydroxyl-ethoxy)quinuclidine (8018), a new
      cholinolytic, is a racemic tertiary amine with two chiral carbonic atoms. It has
      4 optical isomers whose absolute configurations are RR', SR', RS' and SS'. These
      compounds showed potent pharmacological activity, blocking both central
      muscarinic and nicotinic receptors. Central muscarinic receptors, rather than
      nicotinic receptors, have a stereoselective specificity to these compounds. The R
      configuration of both substituted alkoxyl and alkalinic alcohol parts is more
      suitable to the stereostructure of the binding site of muscarinic receptors than
      the S configuration. These compounds can prevent soman-induced
      electroencephalographic seizures in rats by both their central M- and N
      cholinolytic actions.

PMID- 2241420
TI  - Autoradiographic localization of peripheral [3H]-hydergine binding sites.
AB  - The anatomical distribution of the ergot derivative [3H]-hydergine (co-dergocrine
      mesylate) was analyzed by the use of an in vitro autoradiographic technique on
      frozen sections of rat heart, mesenteric and renal arteries, adrenal gland and
      kidney. In the heart, [3H]-hydergine was bound by atria and by myocytes of
      ventricles. In the arterial wall, the drug was bound primarily by the adventitia,
      by the adventitia-media border and by the intimal layer. The density of
      adventitial and adventitial-medial binding sites has an inverse relation with the
      diameter of mesenteric or renal vessels. In the adrenal gland, [3H]-hydergine was
      bound primarily by the medulla and, in lesser amounts, by the zona glomerulosa.
      In the kidney, the drug was localized within the arterial tree as well as in
      cortical tubules and in medullary collecting tubules. The above findings suggest
      that [3H]-hydergine is bound by various structures involved in the regulation of
      cardiovascular homeostasis. Interaction with these sites probably accounts for
      the antihypertensive action of hydergine.

PMID- 2241421
TI  - Mechanisms of hexamethonium-induced tetanic fade in the isolated rat muscle.
AB  - The action of hexamethonium on neuromuscular transmission was investigated on the
      rat extensor digitorum longus muscle in vitro. Hexamethonium (5 x 10(-4) M)
      induced a complete fade of the tetanic contraction while leaving the twitch
      unaffected. At the same concentration, hexamethonium induced a significant
      decrease in the amplitude of the endplate potentials evoked at 50 and 100 Hz.
      Additionally, hexamethonium (5 x 10(-4) M) significantly increased the tetanic
      rundown of the endplate potential trains evoked at 100 Hz. The former effect was
      mainly the result of a frequency-independent decrease in the quantal size of the
      endplate potentials. This decrease seemed to be due to a postsynaptic blocking
      action of hexamethonium. The increase in tetanic rundown was due to a presynaptic
      action of hexamethonium. Such an action led to a frequency-dependent decrease in
      the quantal release of transmitter during repetitive stimulation of the motor
      nerve. It is concluded that both pre- and postsynaptic actions are necessary for
      hexamethonium to induce tetanic fade without affecting the twitch; and that, if
      it is accepted that the presynaptic action of hexamethonium is exerted on
      presynaptic receptors, these are not of the ganglionic type since the presynaptic
      effect of hexamethonium was less pronounced than the postsynaptic one.

PMID- 2241422
TI  - Metoclopramide on rat phrenic hemidiaphragm.
AB  - The effect of metoclopramide on skeletal muscle and its neurotransmission was
      studied employing innervated and denervated rat diaphragm. Metoclopramide, at
      concentrations from 0.035 to 0.14 mM, inhibited the twitch contractions of rat
      diaphragm stimulated either directly or indirectly. Inhibition was greater in
      indirectly stimulated preparations, at a given concentration of metoclopramide,
      than in directly stimulated preparations. Inhibition of indirect twitch by
      metoclopramide could be intensified by raising the concentration of magnesium
      chloride, but was unaffected by physostigmine or d-tubocurarine. Metoclopramide
      also inhibited the submaximal contractures of denervated diaphragm elicited by
      potassium chloride and acetylcholine. In calcium-free physiological solution,
      metoclopramide inhibited the caffeine-induced contractures of denervated
      diaphragm as a function of its concentration. It is suggested that metoclopramide
      possesses a calcium antagonistic action in the rat diaphragm.

PMID- 2241423
TI  - Effect of diisopropylfluorophosphate and atropine or mecamylamine on
      acetylcholine levels in the central nervous system of the rat.
AB  - The effect on acetylcholine levels caused by diisopropylfluorophosphate, either
      alone or in combination with atropine or mecamylamine, has been studied in the
      olfactory brain, medulla pons and cortex of the rat. At sublethal doses (0.25 and
      0.5 mg/kg), diisopropylfluorophosphate reduced the acetylcholine levels. This
      effect was completely antagonized by atropine in the medulla pons and by
      mecamylamine in the medulla pons, olfactory brain and partly in the cortex. These
      observations suggest that the reduction of acetylcholine levels at low doses of
      diisopropylfluorophosphate is mediated by a muscarinic system in the medulla pons
      and by a nicotinic system in the medulla pons, the olfactory brain and also, in
      part, in the cortex.

PMID- 2241424
TI  - Vasoactive intestinal polypeptides induce guinea-pig ileum contraction by causing
      release of endogenous acetylcholine.
AB  - Two vasoactive intestinal polypeptide (VIP) analogues were observed to induce a
      concentration-dependent contraction of guinea-pig ileum, which was blocked by
      atropine but not by tubocurarine. The analogue from guinea-pig, VIP [VIP(gp)],
      was the most potent inducer of ileum contraction, followed by human-porcine-rat
      VIP [VIP(hpr)], which differs from VIP(gp) by 4 nonpolar amino acid
      substitutions. VIP(1-15), composed of only the first 15 of the 28 amino acids of
      VIP(hpr), was without effect. The relative potency of VIP(gp), VIP(hpr), and
      acetylcholine was 50 to 100 times more potent in inducing contraction in ileums
      of which the acetylcholinesterase was inactivated by paraoxon than in the
      controls. The VIP analogues which induced contraction of ileum also induced
      secretion of endogenous acetylcholine. The secreted acetylcholine was quantified
      by high-performance liquid chromatography using electrochemical detection and an
      immobilized-enzyme column consisting of choline oxidase and acetylcholinesterase.
      The induction of ileum contraction by VIP(gp), from 10nM to 1 microM VIP, was
      correlated with the amounts of ACh secreted from ileum. VIP(hpr) induced less
      acetylcholine secretion than VIP(gp), and was also less potent in causing ileum
      contraction. VIP(1-15), even at 10 microM, caused neither acetylcholine release
      nor ileum contraction.

PMID- 2241425
TI  - Comparative studies of intracerebroventricularly administered cysteamine and
      pantethine in different behavioral tests and on brain catecholamines in rats.
AB  - In a passive avoidance test, intracerebroventricular administration (post-trial
      treatment) of the somatostatin-depleting compound cysteamine decreased the
      avoidance latency of the rats in a dose-related manner, while the effect of
      pantethine (which is metabolized to cysteamine) was less pronounced. In open
      field studies, both compounds decreased the motor activity (ambulation, rearing)
      of the animals 15 min after the injection followed by a subsequent recuperation
      of the locomotor depression. Following pantethine, the ambulation increased
      during the later tests (60 min, 240 min, 24 hr). Cysteamine decreased the
      noradrenaline and increased the dopamine and dihydroxyphenyl acetic acid content
      in the hypothalamus, whereas the effects of pantethine were less expressed. Both
      compounds slightly decreased the striatal noradrenaline and increased the
      dihydroxyphenyl acetic acid levels at 15 and 60 min after administration.
      However, contrary to pantethine, 4 hr after treatment with cysteamine, there was
      a decrease in dihydroxyphenyl acetic acid concentration in this brain region.
      These findings suggest that both pantethine and cysteamine attenuate passive
      avoidance latency after intracerebroventricular treatment. The different
      efficiency of pantethine and its metabolite cysteamine might be connected to the
      low pantetheinase activity of the brain tissue; however, some direct effects of
      pantethine cannot be excluded. The different effects of the two compounds on the
      open-field activity are possibly associated with the diverse effects of the
      compounds on the striatal dopaminergic neurotransmission.

PMID- 2241426
TI  - Effects of loreclezole on metrazol-induced phenomena in developing rats.
AB  - A potential antiepileptic drug, loreclezole, was studied in rats of 7, 12, 18, 25
      and 90 days old. Metrazol-induced motor phenomena served as a model. Loreclezole
      did not consistently influence isolated myoclonic jerks or minimal metrazol
      seizures (predominantly clonic with preserved righting ability). Major metrazol
      seizures, i.e., generalized tonic-clonic seizures, were suppressed by loreclezole
      in a dose-dependent manner in all age-groups, except in the 7 day old group where
      outlined changes did not reach statistical significance. Severity of seizures was
      significantly diminished at all developmental stages studied. Loreclezole
      exhibits nearly the same profile of action as phenytoin and carbamazepine in this
      model.

PMID- 2241428
TI  - Methyl parathion acute toxicity: prophylaxis and therapy with memantine and
      atropine.
AB  - Male rats administered with a single i.p. dose of 5 mg/kg methyl parathion,
      showed the toxic signs of hypercholinergic (anticholinesterase) activity with
      maximal severity, including muscle fasciculations and convulsions within 15 to 30
      min, persisting for about 2 hr. The time course of acetylcholinesterase activity
      in discrete brain regions (cortex, stem, striatum and hippocampus), heart and
      hemidiaphragm, indicated its maximal depression during 30 to 60 min after
      administration of methyl parathion. At this time, a marked reduction in
      carboxylesterase activity was also evident both in neuronal and nonneuronal
      tissues, suggesting a tremendous binding to nonacetylcholinesterase serine sites.
      Pretreatment with memantine hydrochloride (18 mg/kg, i.p.) 30 min, and atropine
      sulfate (16 mg/kg, i.p.) 15 min before methyl parathion administration,
      completely prevented the expected toxic signs and significantly (P less than
      0.01) attenuated the induced inhibition of acetylcholinesterase. When given
      therapeutically, this combined treatment completely reversed the clinical
      evidence of methyl parathion toxicity within 10 to 15 min and markedly reduced
      the acetylcholinesterase inactivation. These results suggest that memantine may
      counteract the acute methyl parathion toxicity by (a) protection of
      acetylcholinesterase from inhibition, (b) rapid reactivation of inhibited
      acetylcholinesterase and (c) rapid bioelimination of methyl parathion, in
      addition to cholinolytic effects of atropine sulfate.

PMID- 2241427
TI  - Proteoglycans in bones of streptozotocin-induced diabetic rats.
AB  - Insulin seems to regulate the biosynthesis of proteoglycans in some tissues such
      as growth plate and glomeruli. The present investigation was undertaken to assess
      the ex vivo influence of insulin on proteoglycan metabolism in bones. Mandible
      and femur bones were used. Xiphoid cartilage was used as a control tissue of high
      glycosaminoglycan content. Diabetes was induced by 0.12 mg/g b.w. streptozotocin
      in male Sprague-Dawley rats, a number of which was treated with insulin (1
      I.U./100 g b.w.) for 6 days. As compared with control animals, diabetic rats
      exhibited a decreased [35S]sulfate uptake as well as a shift to the right in
      Sephacryl S-500 chromatography. In addition, they showed lower density of
      proteoglycans in sucrose gradient and shorter glycosaminoglycan side chains in
      Sephadex G-200 chromatography. These changes were partly reversed by insulin.

PMID- 2241429
TI  - Antagonism of acetylcholine action in guinea-pig tracheal smooth muscle and
      epithelium by pirenzepine, 4-DAMP and atropine.
AB  - Acetylcholine-induced guinea-pig tracheal smooth muscle contraction and
      epithelium-derived relaxant factor release were evaluated using guinea-pig open
      tracheal rings and rat anococcygeus muscle bioassay to get insight into the
      participation of muscarinic receptor subtypes in these responses. There was a
      significant difference between the two pA2 values obtained in contraction and
      relaxation experiments for pirenzepine, but no difference was found either for
      atropine or for 4-DAMP. This difference seems to be due to the participation of
      M1-receptors in smooth muscle contraction.

PMID- 2241430
TI  - Electrocardiographic changes induced by levamisole hydrochloride in the rat.
AB  - The acute electrocardiographic effects of levamisole hydrochloride (2, 6, 10 and
      20 mg/kg) were examined in the anaesthetized rat. Levamisole caused a fall in
      heart rate which was greatest at 20 mg/kg. The P-R interval was increased and was
      longest during the first 2 min after administration of the drug. The Q-T
      interval, corrected for rate (QTc), was little affected but at 20 mg/kg, 2 of the
      5 rats presented 58% and 94% increases over the value at equilibration. Widening
      of the QRS complex did not occur at 2 and 6 mg/kg, but at 10 and 20 mg/kg a
      marked widening occurred in 1 out of 4 and 3 out of 5 rats, respectively. Cardiac
      dysrhythmias occurred even at 2 mg/kg. Severe bradycardia from sino-atrial
      depression or from A-V block, including Mobitz Type II A-V block, as well as
      ventricular tachycardia and fibrillation were observed.

PMID- 2241431
TI  - Effects of pimobendan and UD-CG-212 CL on calcium exchange and contraction in
      isolated rabbit aorta.
AB  - The effects of pimobendan and its O-demethylmetabolite UD-CG-212 CL on
      contractile responses and transmembrane Ca fluxes were studied on rabbit isolated
      aortic rings. Both pimobendan and UD-CG-212 CL (10(-7) M-5 X 10(-4) M)
      concentration-dependently inhibited the contractile responses induced by KCl (80
      mM) and noradrenaline (10(-6) M). This inhibitory effect was observed when these
      compounds were added either before or after the induced contractions, but was
      reduced in aortic rings after removal of endothelium. Pimobendan and UD-CG-212 CL
      shifted the concentration-response curve to noradrenaline downwards and to the
      right and inhibited the contractile responses elicited by addition of Ca (1-5 mM)
      to Ca-free high K solution. Pimobendan also inhibited the contractile responses
      induced by caffeine (20 mM) in aortic rings incubated in normal or in Ca-free
      medium. At 5 X 10(-4) M, pimobendan inhibited 45Ca influx in resting as well as
      in aortic rings stimulated by high K and noradrenaline and increased the rate of
      45Ca efflux in nonstimulated aortae. It is concluded that pimobendan and its O
      dimethylmetabolite UD-CG-212 CL exhibit vasodilator properties in the isolated
      rabbit aorta by their acting at multiple sites of action, thus decreasing the
      availability of Ca required for smooth muscle activation.

PMID- 2241432
TI  - Decreased modulation by endothelium of noradrenaline-induced contractions in
      aorta from stroke-prone spontaneously hypertensive rats.
AB  - Influences of endothelium on contractions of aortic ring preparations from 15 to
      17 weeks old stroke-prone spontaneously hypertensive rats (SHRSP) and age-matched
      Wistar-Kyoto rats (WKY) were compared. Noradrenaline-induced contraction was
      potentiated by endothelium removal; the potentiation was greater in the WKY
      aorta. Noradrenaline (10(-5) M) induced a biphasic contraction in endothelium
      intact WKY aorta, while endothelium-intact SHRSP aorta or endothelium-removed
      preparations of both strains showed a monophasic sustained contraction. The
      tension changes in high-K-induced contracture of the endothelium-intact
      preparation was less pronounced in both WKY and SHRSP aortae. The relaxation by
      acetylcholine (10(-5) M) of endothelium-intact aortae, precontracted with
      noradrenaline (5 X 10(-7) M), amounted to 78% in the WKY and to 44% in the SHRSP
      preparation. In endothelium-removed aortae, sodium nitroprusside induced a
      comparable relaxation in both WKY and SHRSP preparations. These results indicate
      that the endothelium plays an important role in controlling the noradrenaline
      induced contraction and that the lower influence of endothelium in the SHRSP
      aorta is most likely due to a decreased activity of this endothelium.

PMID- 2241433
TI  - The experience of house officers. An area deserving further study.

PMID- 2241435
TI  - Empiric treatment of fungal infections in the neutropenic host. Review of the
      literature and guidelines for use.
AB  - Persistent fever that is refractory to broad-spectrum antibacterials is common in
      neutropenic patients undergoing induction chemotherapy of acute leukemia.
      Clinical experience suggests that many of these patients are infected with fungi.
      Until recently, data supporting the role of empiric antifungal therapy in this
      setting were limited to small groups of patients or postmortem reports. Evolving
      evidence in larger patient populations supports data from smaller series: febrile
      neutropenic patients who have failed to respond to a 4- to 7-day course of broad
      spectrum antibacterials may benefit from the early initiation of antifungal
      therapy. Patients with fungal colonization or pulmonary infiltrates and adult
      patients who have not received previous fungal prophylaxis may especially benefit
      from the early use of antifungal drugs. Amphotericin B has been the "gold
      standard" for empiric antifungal therapy, although the newer azoles may be useful
      in certain situations.

PMID- 2241434
TI  - Caring for medical students as patients.

PMID- 2241436
TI  - Systemic therapy in metastatic colorectal cancer.
AB  - Fluorouracil-based chemotherapy regimens have been utilized in metastatic
      colorectal cancer for more than 30 years. Early attempts at defining an optimal
      treatment schedule and use in combination with other drugs failed to
      significantly improve results. In contrast, the clinical effectiveness of
      fluorouracil has been improved by continuous infusion administration and
      modulation with folinic acid. Both approaches have increased the response rate
      compared with results achieved with traditional bolus schedules; the effect on
      survival has been less significant. Unfortunately, expense and, in some
      instances, toxicity have also been increased, which detracts from their overall
      usefulness. Clinical studies that evaluate fluorouracil chemotherapy in
      combination with biological-response modifiers are ongoing and will be areas of
      intense research during the next few years.

PMID- 2241437
TI  - The on-call experience of interns in internal medicine. Medical Education Task
      Force of Henry Ford Hospital.
AB  - As part of an effort to examine the structure and content of our residency
      program in internal medicine, we assessed interns' activities on call to identify
      problems with workload scheduling, supervision, or learning. Eleven interns were
      observed continuously during a 34-hour on-call period. Interns averaged 5.6 hours
      at the bedside, with 57 minutes of that time under direct supervision of a
      resident or attending physician. Nearly half of new patient examinations
      continued after midnight despite a special night admission team that evaluated
      all patients admitted after 11 pm. The interns averaged 21 beeps per 30 hours.
      They slept an average of 2.5 hours with two interruptions. They read about their
      patients an average of 4 minutes during the 34-hour period. Most supervision was
      away from the bedside (82/139 minutes). Bedside supervision occurred
      predominantly during rounds (45/57 minutes). Attending physicians averaged only
      12 minutes of bedside interaction with the intern. Many of these findings were
      unanticipated. Structural defects in the training program were defined and are
      being addressed. Other training programs should consider similar analyses before
      making fundamental changes.

PMID- 2241438
TI  - Misdiagnosis in patients with amyotrophic lateral sclerosis.
AB  - To confirm our impression that a high percentage of patients with amyotrophic
      lateral sclerosis are initially misdiagnosed, we reviewed records of 33 patients
      with a definitive diagnosis of amyotrophic lateral sclerosis seen over 10 years.
      Fourteen patients (43%) were initially misdiagnosed. Mean time to correct
      diagnosis was significantly greater for the misdiagnosed group (16.0 +/- 9.3
      months) than for the rest of the patients (7.6 +/- 4.1 months). Two of three
      patients with an initial symptom of dyspnea were misdiagnosed. Three patients
      underwent laminectomies because of misdiagnosis. Age, stage of disease, and
      unusual presenting symptoms were not identified as causes of misdiagnosis. Most
      likely causes were physicians' failure to consider the diagnosis and lack of
      familiarity with the common clinical presentations of amyotrophic lateral
      sclerosis. Earlier diagnosis of amyotrophic lateral sclerosis may help prevent
      medical mismanagement and may benefit patients both medically and
      psychologically.

PMID- 2241439
TI  - Syncope and presyncope associated with probable adverse drug reactions.
AB  - The purpose of this study was to determine whether syncope and presyncope were
      associated with drug therapy in 70 patients referred to a tertiary care
      ambulatory clinic. Drug use information was obtained, validated, and classified
      by its potential to cause syncope and presyncope. Utilizing a standardized
      adverse drug reaction algorithm, nine (13%) of the 70 patients were rated as
      having probable drug-induced syncope and presyncope events. Overall, 12
      medications were implicated. Patients with probable adverse drug reactions were
      older, and taking more medications, or taking an antihypertensive. Seven of the
      nine patients with probable adverse drug reactions were previously classified as
      having syncope of unknown origin after their initial clinic evaluation. Syncope
      and presyncope are commonly associated with adverse drug reactions, especially in
      the elderly and those taking multiple medications.

PMID- 2241440
TI  - The relationship between sex hormones and high-density lipoprotein cholesterol
      levels in healthy adult men.
AB  - The objective of this study was to clarify the complex and uncertain relationship
      between endogenous sex hormones and high-density lipoprotein (HDL) cholesterol
      levels in healthy men. Fifty-five healthy adult men were consecutively recruited
      from an ongoing cross-sectional study of cardiovascular disease risk factors from
      a lipid research clinic at the University of Washington, Seattle. Subjects
      receiving medication were excluded. Multiple linear regression analysis
      identified several factors that correlated highly significantly with HDL
      cholesterol levels, including alcohol intake; frequency of strenuous exercise;
      age; levels of total cholesterol, low-density lipoprotein cholesterol, and
      triglyceride; and carbohydrate intake. Nearly 80% of the heterogeneity in HDL
      cholesterol levels could be accounted for by these factors. Despite finding
      significant correlations with factors known to influence HDL cholesterol levels,
      no correlation with estradiol level, testosterone level, or the ratio of
      estradiol to testosterone levels was apparent. In conclusion, endogenous sex
      hormones do not appear to influence HDL cholesterol levels in healthy adult men.
      Alternatively, a large proportion of the heterogeneity in HDL levels in this
      group of men can be accounted for by environmental factors. The disparity between
      this conclusion and others may be partially due to differences in accounting for
      these confounding variables.

PMID- 2241441
TI  - Health, homelessness, and poverty. A study of clinic users.
AB  - When seeking medical care, homeless persons often turn to health centers that
      were designed to treat the poor who have homes. To provide for effective medical
      care, personnel in such facilities need to know how the health care needs of the
      homeless are different from those of other clinic users. To compare the physical
      health of these two groups, we conducted a health survey and screening physical
      examination of 464 patients who attended the general adult and homeless clinic
      sessions of one of the main neighborhood health centers in Los Angeles County,
      California. As compared with the poor who have homes, homeless persons were more
      likely to have dermatological problems (32% vs 21%), functional limitations
      (median, 2 vs 0 per person), seizures (14% vs 6%), chronic obstructive pulmonary
      disease (21% vs 12%), social isolation, serious vision problems (22% vs 12%),
      foot pain, and grossly decayed teeth (median, 1 vs 0 per person). We conclude
      that to care more optimally for homeless adults, health centers must pay
      attention to their functional disabilities, substance abuse, skin abnormalities,
      vision impairment, dental problems, and foot problems.

PMID- 2241442
TI  - The influence of physician specialty on housecalls.
AB  - Despite growing numbers of frail elderly, physicians make housecalls
      infrequently. We surveyed 1000 primary care physicians from Virginia regarding
      their attitudes and knowledge about housecalls, and 389 completed questionnaires
      (response rate, 52%): 185 family physicians, 36 general practitioners, 101
      general internists, and 63 subspecialists. Despite similar proportions of
      homebound patients and practice demographics, family physicians (69%) and general
      practitioners (63%) were significantly more likely than either internists (53%)
      or subspecialists (37%) to make routine housecalls. Although all four groups
      thought the fee was rarely a motivation, internists and subspecialists suggested
      larger increases. Also, internists and subspecialists were less likely than
      family physicians or general practitioners to increase housecalls with increased
      payment. Internists and subspecialists also were more likely than family
      physicians or general practitioners to report that housecalls were often
      unnecessary, not "enjoyable," "inefficient," and unimportant. While improved
      reimbursement may lead to increased housecalls by family physicians, future
      strategies should include efforts to change internists' attitudes.

PMID- 2241443
TI  - Epidemiologic features of asymptomatic cerebral infarction in patients with
      nonvalvular atrial fibrillation.
AB  - We performed unenhanced computed tomographic scans on 141 asymptomatic patients
      with nonvalvular atrial fibrillation. Thirty-six patients (26%) had hypodense
      areas consistent with cerebral infarction. The majority of these were small deep
      infarcts, seen in 29 patients (21%), but 13 patients (9%) had cortical or large
      deep infarctions. Twelve patients had more than one infarct on computed
      tomographic scan. Increasing age and increased left atrial diameter were the only
      clinical features associated with asymptomatic infarction. Patients older than 65
      years with a left atrial diameter greater than 5.0 cm (n = 23) had a 52%
      prevalence of asymptomatic infarction. Patients younger than 65 years with a left
      atrial diameter less than 5.0 cm (n = 38) had an 11% prevalence of silent
      infarction. Patients with only one of these risk factors (n = 72) had a 24%
      prevalence of silent infarction. Infarction was more common in those with chronic
      (34%) as opposed to intermittent (22%) nonvalvular atrial fibrillation, but this
      difference was not significant. Hypertension, diabetes, duration of atrial
      fibrillation, congestive heart failure, history of myocardial infarction, and
      echocardiographic evidence of left ventricular dysfunction were not associated
      with asymptomatic infarction. A history of hypertension was present in only 35%
      of our patients with small-deep asymptomatic infarction, similar to the
      percentage in patients without stroke. Asymptomatic cerebral infarction is common
      in nonvalvular atrial fibrillation. The association with enlarged left atria and
      the lack of correlation with major cerebrovascular risk factors suggests a
      cardioembolic mechanism. Further study is needed to determine the functional and
      prognostic significance of these strokes.

PMID- 2241444
TI  - Seroprevalence of Helicobacter pylori in Seventh-Day Adventists and other groups
      in Maryland. Lack of association with diet.
AB  - To evaluate the possible role of diet in the transmission of Helicobacter pylori,
      we compared H pylori seroprevalence among Seventh-Day Adventists (who are
      vegetarian and abstain from alcohol, caffeine, and meat; n = 94) and two non
      Seventh-Day Adventist control groups (n = 168). With the use of an enzyme-linked
      immunosorbent assay H pylori antigen prepared in a French pressure cell, we found
      no difference in seroprevalence among these groups; however, seropositivity
      strongly correlated with age and black race.

PMID- 2241445
TI  - Profile of bronchospastic disease in Puerto Rican patients in New York City. A
      possible relationship to alpha 1-antitrypsin variants.
AB  - A high prevalence of asthmalike symptoms was noted among patients of Puerto Rican
      descent attending Beth Israel and North Central Bronx Medical Centers in New York
      City, as compared with other ethnic groups. An evaluation of family and medical
      histories, pulmonary function data, and alpha 1-antitrypsin phenotypes was
      undertaken in such Puerto Rican patients and control subjects without asthma. The
      patients showed a higher proportion of MS and MV phenotypes. All the patients in
      both MM and variant phenotype groups, with the exception of four MM patients, had
      features indicative of asthma, with labile airway obstruction, and elevated serum
      immunoglobulin E and eosinophil levels. The latter was significantly higher in
      the patients with variant phenotypes than in MM patients. Patients with alpha 1
      antitrypsin variants also had much shorter smoking histories as compared with the
      MM group, and all reported histories of asthma in first-degree relatives, as
      compared with 66% among the MM patients. We conclude that there is an increased
      incidence of asthma among Puerto Ricans in New York City, and that the
      antitrypsin variant phenotypes (specifically S and V) play a role in this
      incidence and its expression.

PMID- 2241446
TI  - Medical comorbidity of major depressive disorder in a primary medical practice.
AB  - Despite much speculation about the relationship between depression and medical
      comorbidity in primary care settings, few investigators have examined this issue
      empirically. Using a two-stage screening procedure, we assessed 618 patients aged
      18 to 64 years in an academic general medicine clinic. Forty-one patients (6.6%)
      suffered from a current episode of major depressive disorder (MDD). We compared
      this group with a 20% random sample of nondepressed patients. While patients with
      MDD were younger (mean age, 41.1 vs 47.2 years), they were assessed by the Duke
      University Severity of Illness Scale as having more severe medical illness.
      Patients with MDD were more likely to have malignant tumors and "ill-defined
      conditions" than nondepressed patients. The 18 patients with MDD (44%) who were
      correctly diagnosed by their physicians had less severe medical illness than
      those whose depression was clinically undetected. A logistic regression model
      predicting MDD group membership included female gender, younger age, higher Duke
      University Severity of Illness Scale score, and more frequent inactive ill
      defined diagnoses. These findings are consistent with assertions: (1) patients
      with MDD have more physical illness than nondepressed patients and/or (2) somatic
      symptoms and disability caused by MDD add to the burden of physical illness.

PMID- 2241448
TI  - Acute autonomic neuropathy. Two cases and a clinical review.
AB  - Acute autonomic neuropathy is an uncommon syndrome, usually affecting healthy
      young people. Presentation is often dramatic and initial misdiagnosis is common.
      We describe two young women with acute autonomic neuropathy who presented with
      gastrointestinal involvement heralding widespread dysautonomia and review 26
      additional cases of acute autonomic neuropathy from the English language
      literature. Acute autonomic neuropathy can be primarily cholinergic without
      orthostatic hypotension (26%) or pandysautonomic (74%) involving sympathetic
      adrenergic functions. Onset has been temporally related to viral syndromes in 20%
      of cases, with autonomic deficits usually evolving over 1 to 3 weeks.
      Gastroparesis (69%) and syncope (12%) are frequent presenting complaints. Spinal
      fluid protein levels are often (75%) elevated in pandysautonomic subtypes.
      Prolonged and incomplete recovery is the rule (60%), with persistent
      gastroparesis and orthostatic hypotension. Other specific diseases that
      occasionally mimic acute autonomic neuropathy include botulism, porphyria,
      amyloidosis, and paracarcinomatous neuropathies. Acute autonomic neuropathy
      shares several clinical features with acute idiopathic polyneuropathy (Guillain
      Barre syndrome), suggesting an immune-mediated pathogenesis.

PMID- 2241447
TI  - Diagnostic testing and return visits for acute problems in prepaid, case-managed
      Medicaid plans compared with fee-for-service.
AB  - Enrollment of Medicaid recipients into capitated, case-managed systems of health
      care has been advocated as a means to control costs. We studied the effect of
      such systems on care for urinary tract infection (UTI), pelvic inflammatory
      disease, and vaginitis among women enrolled in Aid to Families with Dependent
      Children in capitated demonstration programs in Santa Barbara County, California,
      and Jackson County, Missouri (prepaid), compared with similar but fee-for-service
      (FFS) counties in Ventura County, California, and St Louis, Mo. Structured
      abstracts were performed on 2382 outpatient charts with one of the three
      conditions in 1985. The proportion of cases with UTI in which a urine culture was
      obtained was similar in Santa Barbara (prepaid) and Ventura (FFS), 47% vs 46%,
      but greater in Jackson County (prepaid) than St Louis (FFS), 58% vs 32%. The
      proportion of cases with return visits for a UTI was: Santa Barbara (prepaid),
      40%; Ventura (FFS), 33%; Jackson (prepaid), 72%; and St Louis (FFS), 53%. The
      proportion of patients with pelvic inflammatory disease with cervical cultures
      for gonorrhea as Santa Barbara (prepaid), 81%; Ventura (FFS), 52%; Jackson
      (prepaid), 86%; and St Louis (FFS), 61%. The proportion of women returning for
      follow-up after pelvic inflammatory disease was similar across all counties at
      40% and 50%. The number of office diagnostic tests performed for vaginitis was
      greater in both demonstration counties. These data do not demonstrate any
      diminution in either diagnostic testing or follow-up visits for three common
      ambulatory problems in a Medicaid population enrolled in a capitated, case
      managed system, with some trends for more care in the demonstration sites.

PMID- 2241449
TI  - Sulfadiazine crystalluria revisited. The treatment of Toxoplasma encephalitis in
      patients with acquired immunodeficiency syndrome.
AB  - Toxoplasma gondii encephalitis is an important opportunistic infection in the
      acquired immunodeficiency syndrome, estimated to occur in 20,000 to 40,000
      patients with acquired immunodeficiency syndrome in the United States by 1991.
      The combination of sulfadiazine and pyrimethamine is regarded as the treatment of
      choice. Acute renal failure due to crystal deposition in the urinary tract was
      well described 30 to 40 years ago and is likely to resurface as a clinical entity
      if appropriate prophylactic measures are not taken. We describe two cases of
      sulfadiazine-induced crystalluria and renal failure in patients with acquired
      immunodeficiency syndrome, review the pertinent literature, and discuss the
      pathogenesis. Recommendations are made for the prophylaxis and treatment of
      sulfadiazine-related renal toxic reaction. Physicians using this "new" drug must
      be aware of the potential danger of sulfonamide-induced injury to the urinary
      tract.

PMID- 2241450
TI  - Pheochromocytoma presenting as rhabdomyolysis and acute myoglobinuric renal
      failure.
AB  - We report the case of a previously healthy young woman who presented with the
      sudden onset of rhabdomyolysis and myoglobinuric renal failure, requiring
      hemodialysis for 3 weeks. Common causes of rhabdomyolysis were ruled out; as
      renal function returned, severe hypertension was noted and a pheochromocytoma was
      diagnosed. We suggest that pheochromocytoma causes rhabdomyolysis and
      myoglobinuria via catecholamine-mediated vasoconstriction and skeletal muscle
      ischemia.

PMID- 2241451
TI  - Hyperammonemic encephalopathy in urinary diversion with urea-splitting urinary
      tract infection.
AB  - We present two cases of hyperammonemic encephalopathy secondary to urea-splitting
      urinary tract infection with urinary diversion. One patient had a
      ureterosigmoidostomy, the other an ileal loop diversion. Neither patient had
      significant underlying liver disease, but both had considerable muscle atrophy
      that may have predisposed them to develop hyperammonemia. Medical therapy did not
      provide long-term control of symptoms. In both cases, hyperammonemic
      encephalopathy resolved after revision of their urinary diversions. The probable
      mechanism of the metabolic derangements produced by urea-splitting urinary tract
      infections is reviewed. We suggest that patients with urinary diversion who
      develop hyperammonemic encephalopathy secondary to a urea-splitting urinary tract
      infection be treated with surgical revision of the urinary system to improve
      drainage and decrease bowel contact time.

PMID- 2241452
TI  - Recurrent meningitis in a patient with congenital deficiency of the C9 component
      of complement. First case of C9 deficiency in Europe.
AB  - We describe the first cases, to our knowledge, of C9 deficiency in Europe that
      were detected in a Swiss family, of which two members--one with a complete
      deficiency and the other with approximately half-normal C9 levels--experienced
      bacterial meningitis. The index patient, a 56-year-old white man with a history
      of purulent meningitis at the age of 23 years, presented with an acute
      meningococcal meningitis. No impairment of cellular immunity or immunoglobulin
      deficiency could be found. Complement assays showed a complete deficiency of the
      C9 component, while the other individual component levels were normal and the
      hemolytic activity (measured using the CH50 assay) was only slightly reduced. A
      family study revealed complete C9 deficiency in the patient's healthy brother and
      half-normal C9 concentrations in his sister, his son (who also had experienced an
      episode of bacterial meningitis), and his niece, consistent with an inherited C9
      deficiency. This first case of recurrent meningitis in a white patient with
      complete C9 deficiency suggests that this complement defect may also be a risk
      factor for bacterial, especially neisserial, infections.

PMID- 2241453
TI  - Thyrotoxicosis induced by topical iodine application.
AB  - We describe an elderly man who was admitted with congestive cardiac failure and
      found to have thyrotoxicosis. He did not have goiter, and he had normal
      radioiodine uptake in his neck. Serum iodine levels were elevated, explaining the
      lack of increase in radioiodine uptake in the thyroid gland. He had multiple
      pressure sores, which were treated with povidone-iodine (Betadine) soaks.
      Biochemical data were consistent with Graves' disease unmasked by topical iodine
      application. Povidone-iodine soaks are commonly used in decubitus ulcer care and
      warrant special attention in patients with preexisting thyroid disorders. We have
      reviewed the literature on this unusual complication.

PMID- 2241454
TI  - Treatment of severe reactive hypoglycemia with a somatostatin analogue (SMS 201
      995).
AB  - Reactive (or postprandial) hypoglycemia can sometimes represent a severe disorder
      refractory to conventional therapeutic measures. We present in this first
      individual trial, to our knowledge, that the administration of a somatostatin
      analogue (SMS 201-995) may alleviate the severity of complaints and does not
      appear to be diabetogenic. The effects of the somatostatin analogue were
      documented in a 5-hour oral glucose tolerance test, where not only the glucose
      induced and C-peptide rise was clearly attenuated, but also the blood glucose
      concentration did not fall low enough to induce hypoglycemic symptoms.

PMID- 2241455
TI  - Lovastatin. Warfarin interaction.
AB  - Two patients who developed hypoprothrombinemia and bleeding due to lovastatin
      warfarin drug interaction are described. Because of the wider use of lovastatin
      and warfarin, heightened clinical awareness of this potentially serious
      interaction must be publicized. Therefore, prothrombin time should be monitored
      diligently when warfarin is prescribed to patients receiving lovastatin.

PMID- 2241456
TI  - The Hypertension Prevention Trial.

PMID- 2241457
TI  - The value of fine-needle aspiration biopsy in nodular thyroid disease.

PMID- 2241458
TI  - Pulsus paradoxus, cardiac tamponade, and the pericardial 'window'.

PMID- 2241459
TI  - Inadequate barium enemas in elderly patients.

PMID- 2241460
TI  - Fine-needle aspiration biopsy of the thyroid.

PMID- 2241461
TI  - Failure to check references.

PMID- 2241462
TI  - Indomethacin in the treatment of lithium-induced nephrogenic diabetes insipidus.

PMID- 2241463
TI  - Less expensive is not always less effective.

PMID- 2241464
TI  - The effect of oral and parenteral typhoid vaccination.

PMID- 2241465
TI  - Infections and toxic syndromes from fish and shellfish consumption.

PMID- 2241466
TI  - [The tasks of psychiatry: the psychiatric experience].
AB  - This work pretends to show the necessity of psychiatry of knowing its grounds as
      medical knowledge in order to do justice to its history and to the concepts that
      have been traditionally used in the west way of thinking. By the idea of
      experience it is tried to search in psychopathology the motives of the
      transformation of psychiatry under the operative concept of 'life world'. The
      psychiatry tasks shall be those in connection with the development and
      appropriation of the ontological and methodological implications that the concept
      of 'life world' involves, always across a psychopathological theory.

PMID- 2241467
TI  - [Morphology of the posterior colliculus in epileptic hamsters].
AB  - In an inbred strain of Golden hamsters with audiogenic seizures, we have studied
      the collicular participation, planning a morphologic study of posterior
      colliculus central nucleus. The parameters used have been: number of neurons and
      glia, neuronal areas and area of all the colliculus. The measurement and the
      counts have been done in both sides and for to validate the results we have used
      an A.N.O.V.A.. In the epileptic group, there are a less number of neurons and a
      major correlation Nucleus/cytoplasm. The left-right correlations are positive for
      the neurons, while in the control group are for the glia. Although, the number of
      neurons in the epileptic animals are less, this are more active, which can be
      related to the participation of the colliculus in the audiogenic seizures.

PMID- 2241468
TI  - [Interhemispherical study of the activities of aminopeptidases, lactate
      dehydrogenase and glutamate-oxaloacetate transaminase in the rat brain].
AB  - Aminopeptidase activity has been assayed from both soluble and membrane bound
      fractions in eleven regions of the left and right hemispheres of the rat brain,
      using L-leucine-2-naphthylamide as substrate. Two other metabolic enzymes,
      lactate dehydrogenase and glutamate-oxalacetate aminotransferase activities were
      simultaneously determined in the same areas. When individual zones of the left
      hemisphere were compared with its corresponding right zones, soluble
      aminopeptidase activities were significantly higher in left frontal cortex and
      left hypothalamus than in right frontal cortex and right hypothalamus,
      respectively. No other significant differences were found neither in the
      remaining areas nor for the other enzymatic activities between both brain
      hemispheres.

PMID- 2241469
TI  - [Syndrome of rostral occlusion of the basilar artery].
AB  - Upper occlusion of the basilar artery ("top of the basilar" syndrome) causes
      ischemics lesions in brainstem, thalamus and occipital and temporal lobes,
      producing visual, oculomotor and behavioral disorders, with slight motor
      affectation concomitant. We expose a case with a typical clinical setting and
      infarctions in thalamus and both occipital lobes with an unusual symmetric
      distribution.

PMID- 2241470
TI  - [Reintervention in gliomas: the necessity of nuclear magnetic resonance].
AB  - The reoperation of patients with recurrence of cerebral glioma is a technique
      offering survival with a good quality of life. The accepted criteria are a
      Karnofski index until reoperation greater than or equal to 70, young age, and a
      favourable histologic grade of tumor. NMR offers better sensitivity than other
      neuroimaging techniques for the detection of tumoral extension, local and at a
      distance, and allows a good tumoral resection. We report a patient with
      recurrence of a cerebral astrocytoma grade II with the criteria for reoperation,
      but when we performed NMR a dissemination of the tumor to the posterior fossa was
      seen, and reoperation was consequently counter-indicated. We discuss the
      mechanism of the extension of cerebral gliomas, the value of neuroimaging
      techniques and the role of reoperation in this context. We consider it necessary
      to perform NMR prior to reoperation in this special group of patients with a
      cerebral glioma recurrence.

PMID- 2241471
TI  - [Myotubular myopathy linked to chromosome X. Pathological and clinical case
      study].
AB  - We present a case of X-linked myotubular myopathy in a boy who died neonatally
      because of respiratory insufficiency. Five biopsy revealed predominance and
      hypotrophy of type 1 fibres with central nuclei in the majority of them, without
      perinuclear ATPasa activity. Electron microscopic study corroborated these
      features and showed the absence of perinuclear myofibres. In the postmortem
      examination there was no involvement of others organs including the central
      nervous system.

PMID- 2241472
TI  - [The subacute and subchronic toxicity of chlorophacinone in Japanese quail
      (Coturnix c. japonica)].
AB  - Accordingly to the subacute toxicity of chlorphacinone to Japanese quail (LC 50:
      60 mg/kg feed), the uptake of Delicia-chlorphacinone-baits for several days can
      be lethal to birds as a matter of principle. A subchronic study resulted in a "no
      observed-effect-level" of 1 mg chlorphacinon/kg feed. Reproduction is not
      affected until dose levels which resulted in lethality or are accompanied by
      physiological changes (coagulability of blood, microcytic anaemia). Increased
      sensibility of descendants to chlorphacinone cannot be derived from the findings.

PMID- 2241473
TI  - [The effect of steroid hormone doses after ovariectomy on the peripheral hormone
      processes and uterine development in gilts. 2. Effects on gilts during early
      pregnancy].
AB  - Experimental studies were conducted into ovariectomized pregnant gilts to
      establish effects of exogenic hormone administration, with endogenic ovarian
      steroids excluded, upon uterus and fetus development as well as on hormone levels
      in blood plasma, endometrium, and allantoic fluid. Hormone concentrations in
      blood plasma were found to depend clearly on hormone doses applied after
      ovariectomy to preserve pregnancy. 2 to 3 weeks of smooth gravidity, following
      ovariectomy, were ensured on the 6th or 14th day after KB1 by daily application
      of very low doses of progesterone only (80 mg) or in combination with estrogens,
      the ratio being 480:1.

PMID- 2241474
TI  - Biochemical effect of steroid anaesthesia on some liver function tests in goat.
AB  - Saffan, as a type of steroid anaesthetic, was tested to demonstrate the effect of
      its administration on liver function in goat. For this purpose, 40 healthy
      animals were divided into 4 equal groups. The 1st 2 groups were given 2 or 4 mg
      saffan/kg body weight (B.W.), respectively. A mixture of saffan (1 mg) and
      xylazine (0.1 mg)/kg B.W. was given to the 3rd group. Xylazine alone was offered
      to the 4th group in a concentration of 0.1 mg/kg B.W. Serum samples from all
      groups were analysed to measure the quantities of glucose, total protein, total
      and direct bilirubin as well as the activity levels of transaminases. Increased
      glucose levels resulted from administration of saffan which evoked more
      hyperglycaemia than its mixture with xylazine or xylazine alone. The
      hyperglycaemic effect of both doses of saffan was equivocal beyond 2 hours. The
      effect then differed, and glucose elevation reached the 4 fold level by 2 mg
      saffan and the 3 fold level by 4 mg. Total serum protein, direct and total
      bilirubin as well as GPT and GOT were not changed in the 4 experimental groups.
      This was a good indication to normal liver function in the course of
      administration of steroid anaesthetics to goat.

PMID- 2241475
TI  - [The content of Hb and the hematocrit value in blood and the total proteins,
      urea, glucose, free fatty acids, Na, K, Ca, Mg, Pa, Fe, Fe-binding capacity, Cu
      and Zn in the blood plasma of Warmblood horses during feeding with oat-hay or
      barley-hay rations over a period of 9 months].
AB  - 4 horses (Group A) received an oat-hay ration, through 9 months running, while 3
      horses (Group B) were fed a barley-hay ration over the same period of time. Blood
      samples were collected and examined in 4-week intervals. All values considered,
      no differences were found to exist between the 2 groups with regard to Hb and
      haematocrit in blood as well as to protein, glucose, sodium, potassium,
      magnesium, iron fixation capacity, copper, and zinc in blood plasma. The urea
      level in plasma of Group A was higher than that in Group B, values being 5.76 +/-
      0.64 mmol/l and 5.14 +/- 0.72 mmol/l. The same applied to free fatty acids,
      values being 150 +/- 83 mumols/l in Group A and 95 +/- 42 mumols/l in Group B.
      Calcium was 3.10 +/- 0.27 mmol/l in Group A and 2.92 +/- 0.26 mmol/l in Group B,
      while the A-B difference in inorganic phosphorus amounted to 1.62 +/- 0.65
      against 1.99 +/- 0.77 mmol/l. Group A was inferior to Group B also with regard to
      iron in plasma, values being 28.6 +/- 2.42 mumols/l against 32.8 +/- 4.62
      mumol/l. Causes underlying these differences are discussed in some detail.

PMID- 2241476
TI  - Study into wild Egyptian plants of potential medicinal activity. Ninth
      communication: hypoglycaemic activity of some selected plants in normal fasting
      and alloxanised rats.
AB  - 31 desert plants belonging to 17 families were collected from different Egyptian
      localities. 21 plants extracts were orally given to normal rats, and 15 were
      tested on fasted and to alloxanised rats. The results were compared with a
      standard oral hypoglycaemic drug (Daonil, Hoechst) used as a positive control.
      The following findings were obtained: 8 plants exhibited persistent hypoglycaemic
      effects, Lycium shawii, Salvia (S.) aegyptiaca, Pergularia tomentosa, Convolvulus
      (C.) althaeoides, Haloxylon salicornicum, Ephedra alata, Scrophularia deserti,
      and Crotalaria aegyptiaca. Transient hypoglycaemic effects appeared only 1 hour
      after administration in response to 4 plants, Silena succulenta, Lygos raetam, C.
      lanatus, and Pulicaria incisa. In the cases of Ochradenus baccatus and
      Zygophyllum album, slow hypoglycaemic activity was produced and appeared 3 hours
      after administration. 5 plants showed hypoglycaemic effects viz, Thymus
      capitatus, Launaea nudicaulis, Conyza dioscorides, Nitraria retusa, and Limonium
      tubiflorum. Among the 15 plant extracts tested on alloxanised diabetic rats only
      4 showed hypoglycaemic effects more potent than those of the administered dose of
      Daonil. These were Matthiola livida, S. aegyptiaca, Astragalus species, and
      Arthrocnemum glaucum. The hypoglycaemic effect of S. aegyptiaca in fasting rats
      has been confirmed also in alloxanised diabetic animals. This emphasises the
      importance of conducting both experiments in order to obtain a reliable
      conclusion.

PMID- 2241477
TI  - [Clinical study results of the embryonic development in gilts and brooding
      performance of gilts and sows after HCG treatment on the 11th day of pregnancy].
AB  - Forty-four pregnant gilts were slaughtered on the 32nd and 33rd days of
      pregnancy, after 30 of them had received 100 or 400 IU of HCG on the eleventh day
      of pregnancy. Both doses had resulted in higher number of living embryos. Embryo
      survival rates of treated sows were up to 14.9 percent higher than those of
      untreated animals. Higher numbers of embryos had no adverse effect on their mass
      development. Fertility was measured of 77 HCG-treated and untreated gilts as well
      as of 54 adult sows. The number of non-pregnant sows which returned to oestrus
      was higher in the group of gilts and adult sows which had received treatment. The
      number of pregnant animals in the treated adult sow group was seven percent
      higher than that in the control group. Increased litter sizes were additionally
      recordable from those gilts and adult sows that had received HCG injections. Yet,
      those higher litter sizes were associated with lower weight of live-born piglets.
      In further studies more attention should be given to possible stimulation of LH
      secretion in early gravidity.

PMID- 2241478
TI  - [The content of Hb in blood and the protein, Fe, Fe-binding capacity, Cu and Zn
      in blood plasma of low parity sows before and after oral iron administration].
AB  - In investigations of 51 pregnant sows, blood Hb levels above 7.45 mmol/l (mean
      value of 8.94 +/- 0.88) were recorded from 43 animals (Group A), while levels
      below that margin were recorded from eight (Group B) (mean value of 6.73 +/-
      0.31). Iron levels in blood plasma of Group A were 36.9 +/- 8.07 and were thus
      higher (p less than 0.01) than those in Group B (28.9 +/- 5.19 mumol/l). No
      difference was found to exist between the two groups with regard to iron fixation
      capacity as well as copper and zinc in blood plasma. Oral uptake of 50, 500 or
      2,000 mg of iron in the form of FeSO4.7H2O with cereal shred as morning ration by
      17 or 15 sows failed to cause any increase in blood plasma iron levels, within
      360 minutes from uptake. Literature data as well as the results of these analyses
      have supported the recommendation that Hb variations between 4.96 and 9.93 mmol/l
      (8-16 g/dl) should be rated as physiological in the blood of pregnant sows. The
      GDR Standard TGL 35,423 on "Monitoring of Metabolism on Pig Breeding and
      Fattening Units" should be accordingly amended.

PMID- 2241479
TI  - [The effect of intravenous administration of arginine and glycine on the blood
      plasma content of glucose, insulin, free fatty acids and total alpha-amino-N
      compounds in lambs of different ages].
AB  - Intravenous infusion of 0.5 mmol/kg B.W. to lambs aged eight to 14, 15 to 21, 22
      to 28, and 29 to 35 days led to higher blood plasma levels of insulin and total
      alpha-amino-N. Rises were stronger and longer lasting after infusion of 1.25
      mmol/kg B.W. of arginine. Blood plasma levels of glucose and free fatty acids
      were temporarily decreased in response to infusion. Infusion to lambs aged
      between eight and 14 days of 0.5 mmol/kg B.W. of glycin did not change insulin,
      glucose nor free fatty acids, though total alpha-amino-N was very slightly
      increased for very short time. Infusion of 1.25 mmol/kg B.W. of glycin proved
      less effective than that of arginine with regard to higher levels of insulin and
      total alpha-amino-N.

PMID- 2241480
TI  - Use of dexamethasone for induction of parturition in goats.
AB  - Parturition was induced in 5 goats of Beetal and Beetal x Black Bengal cross in
      advanced stages of pregnancy, using intramuscular injection of 10 mg of
      dexamethasone. Goats required 47.7 +/- 1.26 hours on average after injection for
      parturition. There were no deleterious effects of induction on placental
      expulsion, kid weight, kid survival, and postpartum fertility of does. Plasma
      concentrations of progesterone and oestradiol 17 beta followed a similar trend in
      controls and treated animals. While plasma progesterone concentrations declined
      before parturition, the oestradiol concentration rose to its peak on the day of
      parturition.

PMID- 2241481
TI  - Pharmacokinetics and renal clearance of ampicillin in sheep.
AB  - Pharmacokinetics and renal clearance of ampicillin were investigated in 13 sheep,
      following one single oral dose of 750 mg. A peak concentration in plasma 0.38 +/-
      0.04 microgram/ml (mean +/- SEM) was achieved 95.3 +/- 5.95 min after drug
      administration. Absorption half-life was 44.4 +/- 4.4 min. The area under the
      plasma concentration curve was 94.6 +/- 4.5 micrograms.hour.ml-1, while in the
      case of urine it was 370.5 +/- 28.3 micrograms.hour.ml-1. Biological half-life of
      ampicillin was 110 +/- 3 min, with an elimination rate constant of 0.0064 +/-
      0.0002 min-1. The values for volume of distribution and total body clearance were
      8.2 +/- 0.71/kg or 52.0 +/- 4.2 ml/kg/min, respectively. The priming and
      maintenance doses, using MIC as 0.05 microgram/ml, were suggested to be 8.8 or
      8.4 mg/kg, respectively, at an 8-h interval. For MIC of 0.5 microgram/ml, this
      dose should be 10 times higher. Renal clearance of ampicillin seemed to involve
      active tubular secretion. Renal excretion indicated either extensive metabolism
      or excretion through routes other than kidneys.

PMID- 2241482
TI  - Evidence of identification of peste des petits ruminants from goats in Egypt.
AB  - Peste des petits ruminants virus was isolated from young goats in an outbreak of
      the disease for the first time in Egypt. Affected goats showed symptoms
      simulating rinderpest, disease in cattle. The mortality rate was about 30%, and
      morbidity reached 90%. History, clinical symptoms, postmortem lesions, and
      diagnosis were discussed.

PMID- 2241483
TI  - [The colonization of the upper respiratory tract and the bacteremic phases of
      enzootic pneumonia of calves].
AB  - Twenty calves, following their re-accommodation on a calf raising unit, were
      tested twelve days for presence of Pasteurellae and mycoplasms on the mucosa of
      the nasal pharynx and in blood. The same microorganisms were searched for in
      another 65 calves, yet, only at the beginning of pneumonia. Tests were applied to
      19 calves for presence of chlamydia in the blood. The nasopharynx of all 20
      calves was colonised by Pasteurellae, whereas mycoplasms were detected only in
      few cases. Neither Pasteurellae nor mycoplasms were isolated by blood culturing,
      though chlamydia were found in concomitance with pneumonia in three of 13
      evaluable cases.

PMID- 2241484
TI  - [The use of 60Co-gamma ray-sterilized calf serum in cell culture].
AB  - The use of 60Co-gamma-radiation-sterilised calf sera in cell culturing is
      reported in this paper. Evidence was produced to the effect that 60Co-gamma
      irradiation, using a dosage of 3 kGy and a dose rate of 8 kGy/h, of fetal calf
      serum, neonatal calf serum, and calf serum did not substantially alter the growth
      stimulating properties of those sera during 42-day tests. With almost all cell
      lines and sera used, for all practical purposes, they were identical with the
      properties of control sera. The following cell lines were used in the
      experimental programme: one human mammary tumor, MaTu, one human embryonic cell
      line--E VI, one bat lung cell line--Tb1-Lu, and one human rhabdomyosarcoma--A
      204. Growth stimulation was twelve percent below the control value only with Tb1
      Lu on Eagle-MEM culturing medium with 3-kGy-irradiation of neonatal calf serum.
      On the other hand, cell growth was stimulated by 28 percent in A 204 on RPMI 1640
      culturing medium, again with 3-kGy-irradiation of neonatal calf serum. Loss of
      activity by up to 30 percent, depending on the serum used, must be expected from
      irradiation doses of 10 kGy and 20 kGy which are capable of causing drastic
      reduction or even complete elimination of serum-borne microorganisms (Bender et
      al., 1989). Sera irradiated that way would be only conditionally applicable, when
      it comes to highly vulnerable cell strains.

PMID- 2241485
TI  - Pregnancy diagnosis by milk progesterone on days 18, 22, and 24 postbreeding in
      dairy cows.
AB  - Milk samples were collected from 91 dairy cows on days 18, 22, and 24
      postbreeding. The progesterone values of these samples were assayed, using enzyme
      immuno-assay for pregnancy diagnosis. These animals were classified by
      nonpregnant (low progesterone values, 5 ng/ml or less) and pregnant (high
      progesterone values, more than 5 ng/ml). The accuracy of diagnosis on days 18,
      22, and 24 postbreeding were 56%, 78%, and 79% for pregnant cows and 90%, 93%,
      and 93% for nonpregnant animals. The sampling date had a significant effect on
      diagnostic accuracy (P less than 0.05).

PMID- 2241487
TI  - [The pathomorphology and pathogenesis of acute cardiovascular failure in swine.
      1. Histopathologic findings in the myocardium of swine of different age groups].
AB  - Myocardia were histologically examined for the presence of pathomorphological
      processes in 143 pigs of varying age groups (one, three, seven to nine, and 24
      months). Some of them had been slaughtered in clinically intact condition. Others
      had died of non-cardial diseases. Numerous alterations were recorded, with the
      following among them being more suitable than others for quantitative assessment
      and thus objective appraisal of the myocardium: inflammatory infiltrations,
      granular or hyaline disintegration of fibres, fibre necrosis, dystrophic
      calcification of fibres, degenerative fat infiltration, and sarcosporidiosis.
      These parameters were increasingly detectable along with growing age of animals.
      Inflammatory infiltrations were among the most common findings from pigs for
      slaughter, aged seven to nine months (40.4 percent of myocardial samples or 58
      percent of hearts), followed by muscle fibre necroses (26.4 or 42.0 percent).
      Most of these disorders were but slightly manifest and were considered to be
      indicators of catabolic or reparative processes in the myocardium. Attention
      should be given to them, whenever it comes to pigs with cardiac or circulatory
      disturbances.

PMID- 2241486
TI  - [The effect of long term bentonite administration on mixed element metabolism in
      dwarf goats].
AB  - Pigmy goats were experimentally examined for the effects of subchronic oral
      applications of high doses of GDR-made bentonite on their mass element status
      (calcium, phosphorus, magnesium sodium, potassium). The argillaceous mineral
      caused slightly reduced incorporation of calcium in the bones. Bentonite-related
      reduction of alkaline phosphatase activity cannot be ruled out as a causative
      factor. Magnesium concentrations in blood serum and liver of bentonite-treated
      pigm goats were lower with significance than those recorded from controls.
      Phosphorus, sodium, and potassium metabolism was not substantively altered by
      bentonite application. A sodium substitution effect might possibly be achieved by
      admixture of bentonite to feed rations.

PMID- 2241488
TI  - [The pathomorphology and pathogenesis of acute cardiovascular failure in swine.
      2. Histopathologic findings in the myocardium of swine of different populations].
AB  - Histopathological alterations of the myocardium (inflammatory processes,
      fibrolysis, fibronecrosis, dystrophic calcification, fatty degeneration of
      fibres, sarcosporidia) were recorded for quantitative evaluation from 200 hearts
      which had been collected from clinically intact pigs for slaughter of different
      populations (Leicoma, land race, Schwerfurt breed, Belgian land race). Both
      incidence and severity of myocardial damage in pigs of stress-sensitive
      populations were higher with significance than those in the less stress-sensitive
      Leicoma population oriented to breeding. The highest rate of pathological
      processes was recorded from hearts of the Schwerfurt breed. These alterations
      were interpreted as objectively measurable expressions of breed-dependent
      differences in cardiovascular stability. In this context, rates of damage were
      higher in hearts of low absolute mass.

PMID- 2241489
TI  - [The pathomorphology and pathogenesis of acute cardiovascular failure in swine.
      3. Histopathologic findings in the myocardium of swine with transport-related
      cardiovascular insufficiency].
AB  - Quantitative pathohistological investigations were performed on 300 samples of
      five different myocardial regions from 50 pigs with had suffered stress-related
      myocardial insufficiency on their transport to the slaughterhouse (transport
      exhaustion). The findings were compared to 1,200 myocardial samples from 200
      clinically intact pigs for slaughter. Animals with transport-related damage
      exhibited with significance more and more severe inflammatory and degenerative
      myocardial alterations, such as round-cell infiltration, fiber necrosis,
      calcification, and fat infiltration. Many of these lesions had been manifest
      already prior to transport. Myocardially predamaged pigs were less capable than
      others of sustaining transport stress and were more predisposed to cardiac
      failure. Stress-related cardiovascular insufficiency, consequently, depended not
      only on direct stress but also on the general health condition of the myocardium.
      Causes and pathogenetic relevance of these alterations are discussed in some
      detail.

PMID- 2241490
TI  - [Respiration and motility of epididymal sperm from slaughtered bulls].
AB  - The simple method of retrograde flushing of spermatozoa from the epididymal cauda
      of slaughter bulls yielded an average of 2 x 10(9) spermatozoa from one cauda.
      The plasma membrane was intact in something between 80 and 85 percent of all
      epididymal spermatozoa. Respiratory rates and motility were clearly below values
      typical of ejaculated spermatozoa, though sizeable differences were found to
      exist for both parameters between individual preparations. The endogenous
      substrates available proved to be sufficient for such low metabolic activity,
      whereas higher energy turnover required the presence of exogenous substrates,
      such as lactate, pyruvate or fructose. Respiratory capacity, determined by
      uncoupling of oxidative phosphorylation in the presence of lactate, was
      comparable to that of ejaculated bull spermatozoa. The above findings are likely
      to suggest that the lower respiratory rates of epididymal spermatozoa were
      attributable to the fact that their consumption for motility of adenosine
      triphosphoric acid (ATP) was lower than that of ejaculated spermatozoa.

PMID- 2241491
TI  - Adaptability of buffaloes to climatic stress, as assessed by physiological
      reactions.
AB  - Among the physiological reactions to climate, the haematocrit value had a
      tendency to increase in the hotter months, though the increase observed was
      within physiological limits. Rectal temperature did not change to significantly
      higher levels, during the months with average ambient temperatures in the region
      of 25.1-31.6 degrees C. Similarly, pulse rates, too, increased in parallel to
      rising ambient temperatures.

PMID- 2241492
TI  - [Haemophilus somnus--properties and isolation].
AB  - An account is given in this paper of characteristic parameters of Haemophilus
      somnus, the aetiological factor of various cattle diseases. Morphological
      properties of the pathogen are described together with techniques for isolation
      and identification. Also discussed are its physiological, biochemical, and
      antigenic properties as well as its present position in taxonomy and the
      structure of the outer membrane.

PMID- 2241493
TI  - [The biomorphosis of the kidney in swine. 2. Kidney cortex and kidney medulla].
AB  - Information recorded from structural development of kidney in swine foetuses of
      different age and in piglets together with functional data has shown that,
      notwithstanding progressing maturation, the capacity of renal corpuscles and
      tubules in piglets was less developed than in other species. Milk deficit or
      insufficient drinking water or medication may be considerable burdens on the
      kidney of newborn piglets and may cause stress-related damage.

PMID- 2241494
TI  - Biochemical studies into variation and repeatability of glutathione
      concentrations in bovine and bubaline semens.
AB  - Repeatability (r) value of glutathione (GSH) content was estimated in semen of
      Tharparkar, Red Dane, their crosses, and Murrah buffalo bulls. Mean GSH values
      were higher in bovine bull semen as compared to mean GSH values in bubaline bull
      semen. The r of GSH concentration for the pooled data was 0.1278. This trait is
      12.78% repeatable. GSH value in semen of bovine and bubaline bull differed
      insignificantly. R estimates are expressed for selection of bulls of higher
      fertility and semen quality.

PMID- 2241495
TI  - Thermoregulatory effects and electrical conductivity in vagina of cow during
      oestrous cycle.
AB  - Measurement of vaginal temperature and electrical conductivity of cervicovaginal
      mucus were conducted in 20 dairy cows and were related to the phase of the
      oestrus cycle. Temperature and electrical conductivity in the anterior part of
      the vagina changed in synchronicity with phases of the oestrous cycle. About 12
      hours before ovulation, the vaginal temperature increased from 37.94 +/- 0.33
      degrees C to 39.00 +/- 0.64 degrees C, as compared to the pre-oestrus value. The
      occurrence of oestrus was accompanied by an increase in electrical conductivity
      of mucus in the anterior part of the vagina from 7.60 +/- 0.33 mS to 12.00 +/-
      0.54 mS. Vaginal temperature dropped to 38.50 +/- 0.29 degrees C, and electrical
      conductivity dropped to 10.00 +/- 0.55 mS at ovulation time. Rises in vaginal
      temperature and electrical conductivity in the anterior part of the vagina were
      additional symptoms of oestrus and were followed by decrease in these values,
      indicating ovulation in cows.

PMID- 2241496
TI  - Prenatal development of adenohypophyseal cell types, ovary, and uterus of
      dromedary camel.
AB  - The somatotrophic and thyrotrophic cells were originally developed in the
      adenohypophysis from undifferentiated chromophobic cells at the foetal age of 4-8
      weeks. The follicle-stimulating hormone cells appeared at a foetal age of 24-28
      weeks. Prolactin and luteinizing hormone cells were first seen at of foetal age
      levels of 32-36 and 40 weeks. The germinal epithelium of flattened and cuboidal
      cells in the ovary was changed to cubical and columnar types, 24-28 weeks of
      foetal age. The sex cords appeared at 8-12 weeks of foetal age. The primary and
      secondary follicles were observed at 8-12 and 20-24 weeks of foetal age,
      respectively. Follicular cavity was noticed at 32-36 weeks, while large follicles
      encapsulated by follicular sheath were seen in the 40th week of foetal age. Some
      ovarian follicles degenerated during or after their development. Surface
      epithelium in the uterus changed from cubical to columnar type at 8-12 weeks of
      foetal age. The endometrium was clearly distinguished from the myometrium at 16
      20 weeks of foetal age. The uterine glands appeared at 16-20 weeks as short and
      straight tubular glands, and they began to branch in the 40th week of foetal age.

PMID- 2241497
TI  - [The effect of long-term bentonite administration on the metabolism of selected
      trace elements (Fe, Cu, Zn, Mn) in the dwarf goat].
AB  - Experiments were conducted with dwarf goats to investigate effects of 160 days of
      oral application of high doses of bentonite on the trace element status (Fe, Cu,
      Zn, Mn). High levels of iron compounds in bentonite batches caused intensified
      incorporation of these elements into liver and kidney of dwarf goat. Copper and
      zinc incorporations were reduced but manganese incorporation was increased by
      oral application of bentonite.

PMID- 2241498
TI  - [The hormone profile in the blood plasma of heifers after cycle synchronization
      with prostaglandin F2alpha].
AB  - Highly sensitive radio-immuno assay (RIA) was used for 21 days to study the
      curves of several steroid hormones, progesterone (P), oestradiol 17 beta (E2),
      and testosterone (T), as well as of luteinizing hormone (LH) in peripheral blood
      of six heifers to which oestrus had been induced by prostaglandin F2 alpha. The
      validity of the authors' RIA for P, E2, and T determination in blood plasma was
      positively verified by two reliability criteria, correctness and accuracy, as
      well as by comparative determinations, using reference methods. Only four of the
      six heifers returned to oestrus, within 21 days from first oestrus induction. A
      typical cycle-related curve of the P concentration in peripheral blood with peak
      values between the 13th and 17th days of cycle (15-26 nmol/l) was recorded from
      four animals. The peak values of pre-ovulatory E2 and LH were between 33.0 and
      53.2 pmol/l or between 19.5 and 52.5 micrograms/l. Some of the T rises in
      peripheral blood were in parallel to E2 concentrations. All hormone curves are
      presented in detail and are discussed in relation to clinico-physiological
      findings.

PMID- 2241499
TI  - [Steroid hormone levels in follicular fluid of swine with spontaneous estrus and
      ovulation synchronization].
AB  - The steroid hormones oestradiol 17 beta, oestrone (E1), testosterone (T), and
      progesterone (P) were quantitatively determined in follicular fluids in the pre
      oestric phase of pigs with spontaneous oestrus and synchronised ovulation. As a
      whole, mean steroid hormone concentrations exhibited characteristic curves in
      spite of a relatively wide scatter of individual values. Drastic decline in
      oestrogen concentration in pigs with spontaneous oestrus and synchronised
      ovulation was accompanied by rise of P levels, while T values stayed relatively
      constant. As compared to spontaneous oestrus, treatment for synchronised
      ovulation caused significantly higher increases in follicular T levels. Positive
      (P) or negative (E1, T) correlations were found to exist between follicle size
      and steroid hormone concentration. Conclusions are suggested for further studies.

PMID- 2241500
TI  - Influence of general anaesthesia (thiopental sodium) on progesterone and cortisol
      levels in pregnant goat serum.
AB  - 6 pregnant Baladi goats underwent general anaesthesia, using thiopental sodium.
      Intravenous application of 10-15 mg/kg body weight of thiopental sodium in 2.5%
      solution produced light anaesthesia for about 20 minutes. The effect of general
      anaesthesia on progesterone and cortisol levels was studied before and during the
      application of anaesthesia as well as 1/2, 1, 4, and 24 hours after anaesthesia.
      Progesterone was determined by RIA and cortisol by competitive protein binding
      reaction. Decrease in progesterone and rise in cortisol were noticed during and
      after anaesthesia. 4 of 13 foetuses were aborted 1-2 weeks after the application
      of anaesthesia. 6 were born dead. 2 died few hours after birth, and 1 stayed
      alive.

PMID- 2241501
TI  - Sequential changes in plasma progesterone, total oestrogens and corticosteroids
      in cow throughout pregnancy and around parturition.
AB  - Blood samples were taken thrice a week for 2 weeks from 33 pregnant cows in 9
      groups, 1 month apart. In addition, blood samples were collected twice daily 1
      week from 8 cows before parturition. Plasma progesterone and total oestrogens
      were quantified by validated radioimmunoassays and total corticosteroids by a
      competitive protein binding technique. During the 1st 3 month of pregnancy, no
      remarkable changes were observed from the 3 hormones studied. From the 4th month
      on, concentrations of progesterone and total corticosteroids decreased
      significantly (P less than 0.05) and remained fairly constant until the 9th
      month. Values of total oestrogens increased significantly (P less than 0.05) from
      the 4th to 6th months and stayed unchanged afterwards. Progesterone levels in
      periparturient cows decreased linearly (P less than 0.01) during 3 days preceding
      delivery. Concentrations of total oestrogens rose sharply from day -5 and peaked
      at calving. Values of total corticosteroids increased dramatically on the 6th day
      and 24 hours before parturition. The results obtained suggest that in contrast to
      studies cited earlier plasma corticosteroids could play a key role for triggering
      parturition in cows.

PMID- 2241502
TI  - Relationships between central and autonomic measures of arousal at age 15 years
      and criminality at age 24 years.
AB  - Previous studies have indicated that criminality is in part genetically
      determined, but it is not clear how this predisposition manifests itself at a
      biological level. This prospective study tests the hypothesis that a
      psychophysiological predisposition to criminality partly manifests itself through
      autonomic and central nervous system underarousal. Psychophysiological measures,
      taken at the age of 15 years, were related to criminality status that was
      assessed at the age of 24 years. Criminals had a significantly lower resting
      heart rate, skin conductance activity, and more slow-frequency
      electroencephalographic activity than noncriminals. Differences were not mediated
      by social, demographic, and academic factors. These results constitute the first
      clear evidence that implicates underarousal in all three response systems
      (electrodermal, cardiovascular, and cortical) in the development of criminality.
      Although arousal variables correctly classified 74.7% of all subjects,
      psychophysiological factors alone cannot fully account for criminal behavior and
      do not negate the potential role of social variables in predicting criminal
      behavior.

PMID- 2241503
TI  - Ventricular enlargement in schizophrenia evaluated with computed tomographic
      scanning. Effects of gender, age, and stage of illness.
AB  - We evaluated ventricular-brain ratio with computed tomographic scanning in a
      sample of 108 DSM-III-diagnosed schizophrenic patients and 75 healthy normal
      volunteers. Significant differences were noted between the patients and controls,
      but our large sample size also permitted us to determine that the statistically
      significant difference was contributed primarily through the male patients.
      Ventricular enlargement occurs only in some schizophrenic patients. In this
      particular sample, only 6% of schizophrenics had ventricular-brain ratios greater
      than 2 SDs from the control mean, and 28% were 1 SD greater than the control
      mean. However, the corresponding figures for male schizophrenics were 19% and
      43%, indicating that there is much less overlap between normal individuals and
      ill subjects in the male population. First-admission schizophrenic patients also
      had significantly greater ventricular enlargement than did their age-equivalent
      normal controls, suggesting that ventricular enlargement in schizophrenia may
      antedate the onset of symptoms. Examination of ventricular size in schizophrenics
      and normal subjects from a broad age range suggests that ventricular enlargement
      does not progress over time at a greater rate in schizophrenic patients than in
      normal subjects.

PMID- 2241504
TI  - Pronounced reduction of total neuron number in mediodorsal thalamic nucleus and
      nucleus accumbens in schizophrenics.
AB  - Using a new and unbiased stereological technique, the total numbers of neuron and
      glial cells in the mediodorsal thalamic nucleus and the nucleus accumbens were
      found to be significantly reduced in schizophrenic patients compared with
      controls. The total neuron and glial cell number in the ventral pallidum and in
      the basolateral nucleus of amygdala did not differ in the two groups.

PMID- 2241505
TI  - The hippocampus and parahippocampus in schizophrenia, suicide, and control
      brains.
AB  - Recent postmortem studies in schizophrenia have shown abnormalities in medial
      temporal lobe structures, including the hippocampus and parahippocampus. We tried
      to replicate previous studies and to explore the specificity of this finding to
      schizophrenia. The anterior hippocampus and parahippocampal cortex were evaluated
      for area and shape in postmortem tissue from 12 schizophrenic, 17
      nonschizophrenic suicide, and 10 nonpsychiatric control brains. No significant
      differences were found in hippocampal area, but the parahippocampal cortex was
      significantly smaller in the schizophrenic group than in the control group. When
      parahippocampi from right and left sides were analyzed separately, both the
      suicide and schizophrenic groups had smaller parahippocampi on the right side
      than did the controls [corrected]. The suicide group exhibited greater
      parahippocampal areas in the left than in the right tissue samples within the
      group, while such a difference did not exist in the schizophrenic or control
      groups. This study demonstrated changes in temporal lobe structures in both
      schizophrenic and nonschizophrenic suicide groups.

PMID- 2241506
TI  - Structural brain abnormalities in bipolar affective disorder. Ventricular
      enlargement and focal signal hyperintensities.
AB  - Structural brain abnormalities were examined in a sample of 48 patients with
      bipolar affective disorder who were compared with 54 schizophrenic patients and
      47 normal controls. As in our previous work using computed tomographic scanning,
      lateral ventricular enlargement was due to a diagnostic effect. In this study,
      the effect was more prominent in the schizophrenic men, while a trend was seen in
      the bipolar men. Women in both groups did not differ significantly from normal
      subjects. This finding is possibly consistent with the fact that men have a
      higher frequency of birth anomalies such as hydrocephalus. Since one cause of
      such birth anomalies might be periventricular hemorrhage or infarction, we also
      evaluated all scans for the presence of small focal regions of signal
      hyperintensity. A significant increase in the number of focal signal
      hyperintensities was noted in the bipolar patients, in comparison with normal
      subjects, but not in the schizophrenics. The bipolar patients with focal signal
      hyperintensities had a trend toward larger ventricular size than those without.
      The pathophysiological significance of these findings is unclear.

PMID- 2241508
TI  - Neuropsychological assessment of monozygotic twins discordant for schizophrenia.
AB  - A comparison of monozygotic twins discordant for schizophrenia controls for
      genetic variance and reduces variance due to environmental circumstances, thus
      serving to highlight differences due to phenotypic-related variables. In this
      study, we assessed 16 such twin pairs on a wide range of neuropsychological
      tests. The affected twins tended to perform worse than their unaffected
      counterparts on most of the tests. Deficits were especially severe on tests of
      vigilance, memory, and concept formation, suggesting that dysfunction is greatest
      in the frontotemporal cortex. While manifest symptoms were not highly associated
      with neuropsychological scores, global level of functioning was. To address the
      issue of genetic liability, we also compared the sample of discordant unaffected
      twins with a sample of seven pairs of normal monozygotic twins. No significant
      differences between the groups were found for any neuropsychological test. In
      fact, the results suggest that neuropsychological dysfunction is a consistent
      feature of schizophrenia and that it is related primarily to the clinical disease
      process and not to genetic or nonspecific environmental factors.

PMID- 2241507
TI  - Structural and functional characteristics of the corpus callosum in
      schizophrenics, psychiatric controls, and normal controls. A magnetic resonance
      imaging and neuropsychological evaluation.
AB  - In 1986 Nasrallah and colleagues found that increased thickness of the corpus
      callosum may be specific to right-handed female schizophrenics. Male and female
      right-handed schizophrenics were compared with normal and psychiatric controls of
      comparable age, sex, education, and social class on measures of callosal
      thickness from a midsagittal magnetic resonance imaging cut and
      neuropsychological tests of interhemispheric transfer. The sex difference in
      anterior and posterior callosal thickness in normal controls was reversed in
      schizophrenics, with the corpus callosum being thicker in female schizophrenics
      and thinner in male schizophrenics. Similar findings were also observed in the
      psychiatric control group. These structural differences were not paralleled by
      evidence of impaired interhemispheric transfer on neuropsychological tasks. These
      results support the finding of sex-dependent callosal abnormalities in
      schizophrenia but indicate that these abnormalities may not be specific to this
      illness.

PMID- 2241509
TI  - In vivo DNA adduct formation by benzo(a)pyrene in mouse and rat epidermal and
      dermal fibroblasts after topical application of an initiating dose of
      benzo(a)pyrene.
AB  - In vivo adduct formation by benzo[a]pyrene (BP) has been compared in mouse and
      rat epidermal keratinocytes and dermal fibroblasts after topical application of
      an initiating dose of carcinogen. The BP-DNA adducts were analyzed by
      chromatography and acid hydrolysis of BP-deoxyribonucleoside adducts to BP
      tetrols. BP was dissolved in acetone and applied, at similar doses per unit area
      (100 nmol/mouse and 240 nmol/rat), to 50-day-old Swiss mice and 35-day-old Wistar
      rats. Epidermal and dermal cells were isolated twenty four hours later. Reverse
      phase HPLC of BP-deoxyribonucleoside adducts demonstrated the presence of three
      BP-deoxyribonucleosides adducts in mouse epidermal cells and one in mouse dermal
      cells. An unknown product (0.13 and 0.04 pmol/mg mouse epidermal and dermal cell
      DNA respectively) eluted before the BP-7,10/8,9-tetrol marker, at same relative
      position as 9-OH-BP-DNA adduct. The major adduct formed in mouse epidermal
      keratinocytes and dermal fibroblasts was dGuo modified by (+)-anti-BPDE and
      accounted for more than 70% of the adducts. Acid hydrolysis of the individual BP
      DNA adducts was used to identify the BP-DNA adducts formed in mouse epidermal and
      dermal cells as anti- and syn-BPDE-dGuo. Twenty four hours after topical
      application of BP, the total levels of modified deoxyribonucleosides and (+)-BPDE
      dGuo were 3 times greater in mouse epidermal cells than in dermal cells. The
      ratios of anti-BPDE to syn-BPDE was 17:1 and 12:1 in mouse epidermal and dermal
      cells DNA, respectively. This work provides the evidence that, at an initiating
      dose, 3H modified deoxyribonucleosides of rat epidermal keratinocytes and dermal
      fibroblasts are not detectable. This may be essential for the resistance of rat
      skin to the carcinogenic action of benzo[a]pyrene.

PMID- 2241510
TI  - Distribution of cisplatin in tumor-free versus tumor-bearing B6D2F1 mice.
AB  - In healthy as well as in leukemia P388- or melanoma B16-bearing B6D2F1 mice the
      platinum concentrations in liver, serum and kidneys were determined after i.v.
      administration of 10 mg/kg cisplatin. In a tumor stage related to about 40% of
      the mean survival time (MST) no differences in platinum distribution between
      tumor-bearing and healthy animals could be observed. In the tumor stage related
      to about 70% of the MST, elevated platinum levels in serum of both tumor models
      and in kidneys only in melanoma-bearing but not in leukemia-bearing mice could be
      found. These results confirm those of other authors that tumor stages less than
      50% of the MST exert no marked influence on the distribution pattern of cisplatin
      in rodents. Moreover, in advanced tumor stages distributional differences of
      antineoplastic agents may be expected between healthy and tumor-bearing mice as
      well as between animals bearing different neoplasias.

PMID- 2241511
TI  - [Intensification of hyperglycemic tumor hyperacidity by hypothermia].
AB  - On rats hypothermia of 22 to 20 degrees C and rewarming to normal body
      temperature leads to an amplification of the hyperglycemic tumor acidification.
      Mechanism and significance of this effect are discussed.

PMID- 2241512
TI  - [The relation between smear cytology, tumor differentiation, nuclear surface and
      cytoplasmic estrogen receptor content in cancer of the uterine body].
AB  - Forty-one histologically verified endometrial carcinomas were examined to reveal
      relationship, if any, between cytoplasmic receptor content and tumour
      differentiation, cytologic diagnosis and mean nuclear surface area. The latter in
      itself was found to be a reliable prognostic sign of the estrogen receptor
      positivity of the tumour.

PMID- 2241514
TI  - Causes of cancer and cancer prevention.
AB  - Current understanding of the complex processes of cancer causation through a
      study of the mechanisms of carcinogenesis have documented that there are several
      major steps each, with distinct quantitative risk assessment factors. The first
      series of steps, defined by genotoxicity, deal with the assessment of the type of
      genotoxic carcinogen and its metabolism, leading to a DNA- and macromolecular
      reactive species. A second area concerns the rate of cell duplication, important
      in leading to cell transformation to an early neoplastic state. The third key
      area explores agents that bear on a further development and growth of the
      transformed cells, an area that has quite distinct dose-response relationships
      from the first type. Therefore, modulation of the third area provides excellent
      means of control. In addition, of course, the optimal means is avoiding exposure
      to genotoxic carcinogens.

PMID- 2241513
TI  - [The usefulness of monthly breast self-examination for the early detection of
      breast cancer].
AB  - At present, the influence of BSE on mortality reduction from breast cancer is not
      yet clear. Within a larger case-control study in 195 cases and 390 controls, BSE
      practice, factors influencing BSE-frequency and the impact of BSE on tumor size
      as well as on the number of positive lymph-nodes have been investigated. 44% of
      women practised BSE monthly. Factors significantly positively correlated with BSE
      were older age, higher education, prior breast biopsy, participation in cervical
      cancer screening and regular physical breast examination. In comparison to non
      users, BSE users had a relative risk for breast cancer more than 3 cm in tumor
      size of 0.65 (0.35-1.21). The relative risk of BSE-users for breast cancer with
      more than 3 positive lymph-nodes at the time of diagnosis amounted to 0.62 (0.33
      1.18).

PMID- 2241515
TI  - Organization of cancer care in Great Britain.

PMID- 2241516
TI  - Ernest A. Codman, MD (1869-1940), the end result idea, and The Product of a
      Hospital. The challenge of a man ahead of his time and perhaps ours.

PMID- 2241517
TI  - Ernest A. Codman, MD, the end result idea and The Product of a Hospital. A
      commentary.

PMID- 2241518
TI  - The product of a hospital. 1914.

PMID- 2241519
TI  - The seven pillars of quality.
AB  - Seven attributes of health care define its quality: (1) efficacy: the ability of
      care, at its best, to improve health; (2) effectiveness: the degree to which
      attainable health improvements are realized; (3) efficiency: the ability to
      obtain the greatest health improvement at the lowest cost; (4) optimality: the
      most advantageous balancing of costs and benefits; (5) acceptability: conformity
      to patient preferences regarding accessibility, the patient-practitioner
      relation, the amenities, the effects of care, and the cost of care; (6)
      legitimacy: conformity to social preferences concerning all of the above; and (7)
      equity: fairness in the distribution of care and its effects on health.
      Consequently, health care professionals must take into account patient
      preferences as well as social preferences in assessing and assuring quality. When
      the two sets of preference disagree the physician faces the challenge of
      reconciling them.

PMID- 2241520
TI  - Appropriateness of medical care. Findings, strategies.
AB  - Concerns regarding significant levels of inappropriate medical services--as high
      as 20% or more--continue to influence discussions regarding medical care quality,
      utilization, and costs. The basis of these concerns are findings from a series of
      studies of the appropriateness of use of several medical and surgical services
      provided in the late 1970s and early 1980s--cardiac pacemaker implants, carotid
      endarterectomy, coronary artery bypass surgery, coronary angiography, and upper
      gastrointestinal endoscopy. More recent data from Medicare peer review
      organizations, however, indicate lower levels of unnecessary hospital admissions
      and medical services. Despite uncertainties regarding the extent of inappropriate
      care, additional efforts are required to better define appropriate medical care.
      A promising effort to meet this need is the development of practice parameters,
      which include practice guidelines and standards.

PMID- 2241521
TI  - Practice guidelines and outcomes. Where are we headed?
AB  - Major forces are at work within the health care system that drive the development
      of clinical standards or guidelines. This process must be tied in a "feedback
      loop" system to a more accurate assessment of patient outcomes. There is a major
      controversy at the foundation of the process that is pitting the opinions from
      consensus panels of experts against the inability of individual physicians to
      accurately estimate the outcomes of different options through implicit systems.
      In many instances, the quality of medical evidence is poor. Many groups within
      organized medicine are attempting to write guidelines, and at least four major
      challenges must be confronted before guidelines are widely adopted by clinicians.
      A new federal agency may provide the necessary resources to focus the debate on
      guidelines. Guidelines may eventually enhance the quality of medical care.

PMID- 2241522
TI  - Quality assurance measurements in departments of pathology and laboratory
      medicine.
AB  - Previously, characteristics of the quality assurance program in each department
      of pathology and laboratory medicine were the uniqueness of the monitors
      selected, the thresholds set for activity, and definitions of good performance.
      In 1989, members of the College of American Pathologists developed and
      implemented the first nationwide quality assurance program for pathology and
      laboratory medicine. This program, Q-Probes, has been expanded for 1990; after
      completion of planning under way for 1991, indicators will be in place for all
      steps in the total testing process. More than 1100 institutions had subscribed by
      the first quarter of 1990. Input forms for measurements of clinical indicators of
      quality are distributed to participants and, after completion, submitted to a
      central computer facility where keypunching and data manipulations occur. The
      interpretation of results is enhanced by peer comparisons of the participant data
      collected. In many circumstances studied, a large proportion of the data are
      aggregated at extreme ends of the distribution. Because data distributions are
      nongaussian for the indicators studied, it is recommended that peer comparisons
      use the 10% to 90% range and that the central tendency be described as the
      median. Despite large databases for some indicators that exceed by more than 10-
      to 100-fold those previously reported, extensive categorization may preclude
      percentile ranking of participants. Critiques are distributed describing
      practices and suggestions for improvement. Steady improvement of each participant
      and of nationwide practice patterns are documented by remeasurements.

PMID- 2241523
TI  - The process of quality assurance. Quality indicators in clinical pathology.
AB  - The process of developing and using indicators of quality performance in
      laboratory medicine presents significant problems for clinical pathologists.
      Although there have been many proposed indicators, many fail to provide
      meaningful information. Four types of quality indicators (data reliability,
      laboratory management, clinical utilization, and pathologist credentialing) are
      proposed and examples of their use are given.

PMID- 2241524
TI  - Quality assurance goals in clinical pathology.
AB  - Certain conditions must be fulfilled to meet quality assurance objectives in
      clinical pathology. Commitment to goals for improving quality and participation
      by everyone involved are prerequisites. Quality assurance is driven by
      information that is used to examine processes so that they can be improved.
      Inspection alone, however, does not produce quality; quality must be designed
      into the process to reduce the likelihood of errors and to produce long-lasting
      improvement. Specifications for meeting quality assurance goals should be
      determined by the expectations of users of the service. Accomplishments are
      measured by users' perceptions. Integration of laboratory and clinical
      information, together with communication links between all components of the
      health care processes, is critical for success.

PMID- 2241525
TI  - Managing for total quality in a large laboratory. Some examples.
AB  - A large laboratory, processing more than 30,000 requisitions every 24 hours,
      provides a unique opportunity to document the value of selected approaches to
      managing for total quality. Proficiency test errors are an important subset of
      this database. They can provide a quality control manager with essential
      diagnostic information if data are analyzed in a systematic fashion. There is no
      benefit to performing proficiency tests in duplicate or in handling them in a
      manner different from patients. In fact, error rates can be higher when
      proficiency tests are handled in a special manner. Finally, error is decreased
      when technologists receive real-time feedback on how well the process is
      performing.

PMID- 2241526
TI  - Quality assurance indicators in anatomic pathology.
AB  - Quality assurance indicators in anatomic pathology focus on both technical and
      cognitive processes that result in a written report. The written report serves as
      both an intermediate outcome, which, in part, determines patient care outcomes,
      and a source of information for quality assurance studies. General requirements
      of a program include procedures that meet Joint Commission on Accreditation of
      Healthcare Organizations requirements for data gathering, data analysis, action,
      and effectiveness evaluation; documentation; and personnel standards. Specific
      indicators in surgical pathology and cytopathology focus on timeliness of
      reports, diagnostic accuracy, relevance of information in reports to the care of
      the patient, and proficiency testing. Cytopathology requires some unique
      indicators because of its dual screening and diagnostic role, including detection
      of false-negative results and comparison of cytotechnologist and cytopathologist
      diagnoses. Quality assurance indicators for the autopsy include those for the
      autopsy pathology as a subdiscipline of pathology as well as those that integrate
      autopsy information into a program of clinical quality assurance.

PMID- 2241527
TI  - Quality assurance goals in surgical pathology.
AB  - The development, implementation, and evaluation of quality assurance programs for
      surgical pathology present special challenges, largely because of the subjective
      and consultative nature of the "test result" (the diagnostic report). The primary
      objective of quality assurance is the generation of an accurate, timely, and
      clinically relevant diagnostic report based on the interpretation of optimal
      technical preparations. This article defines the essential elements of a
      comprehensive quality assurance program for anatomic pathology, reviews the role
      of accrediting agencies in evaluating quality assurance, and describes the
      various contributions of professional organizations that may influence the
      achievement of our quality assurance goals. The major emphasis is on those
      activities that affect the quality of the "outcome" (completed diagnostic report)
      in surgical pathology and assess its contribution to patient management.

PMID- 2241528
TI  - A model for the autopsy-based quality assessment of medical diagnostics.

PMID- 2241529
TI  - Risk management in pathology and laboratory medicine.
AB  - An effective risk-management program focuses attention on and minimizes events
      that ideally should not occur. In the laboratory, risk-management issues can be
      divided along two major lines: (1) patient-care-related issues and (2) employee
      related issues (safety). The Joint Commission on Accreditation of Healthcare
      Organizations, Chicago, Ill, has established formal requirements for risk
      management programs for hospitals and clinical departments. These requirements
      include patient-care-related activities and management functions related to the
      safety-management functions. The concept of a formal risk-management program may
      be new to pathologists and laboratory professionals; the components of the
      program are traditional elements of laboratory policies and procedures. Key items
      identified as building blocks for risk management are these: (1) risk prevention,
      (2) risk identification, (3) risk assessment, (4) corrective actions, and (5)
      loss control. Through the systematic implementation of a comprehensive risk
      management program, laboratories have the opportunity to reduce liability
      exposure and improve the quality of care and services.

PMID- 2241530
TI  - Resource allocation and the cost of quality.
AB  - The costs of producing quality medical care and the proper allocation of
      resources to assure quality are major contemporary concerns. Minimalists attempt
      to improve quality and lower costs through the application of the theory, "less
      is more." Bureaucracies make the same attempt through the denial of payments for
      "unnecessary" services. Governments and insurers try to "improve quality" by
      impeding the flow of new technology so that costs will be restricted (presumably
      allowing society better access to current care modalities). All impose
      regulations and requirements on medical practice. Each of these approaches is
      examined individually and substantial problems with their application in actual
      practice are illustrated. Genuine quality is not a cost or resource allocation
      problem. Quality is free.

PMID- 2241531
TI  - Quality assurance. Sisyphean or sibylline?
AB  - Quality control and quality assurance are inseparable from the practice of
      anatomic and clinical pathology and are not new to either of these disciplines.
      Indeed, the laboratory comparison programs of the College of American
      Pathologists were founded on such principles nearly a half-century ago. The
      "rediscovery" of these principles has spawned an industry unto itself and in this
      event pathology is in danger of entangling itself in an expensive, parallel (not
      integral) process that may be Sisyphean.

PMID- 2241532
TI  - Synthesis and pharmacological studies of some (1,4)-naphthoquinono[3,2-c]-1H
      pyrazoles, 2-substituted amino-1,4-naphthoquinones, and related compounds.
AB  - Series of (1,4)-Naphthoquinono(3,2-c)-1H-pyrazoles and 2-substituted amino-1,4
      naphthoquinones have been synthesised and studied for their possible anticancer
      activity (animal tumours, Walker 256 carcinosarcoma), Influenza RNA transcriptase
      activity, antibiotic activity (C. neoformans, T. mentagraphytes, M. canis, A.
      niger, and C. albicans).

PMID- 2241533
TI  - Antilipidemic agents, III: Synthesis of some heterocyclic derivatives of beta
      sitosterol.
AB  - Four novel series of heterocyclic derivatives of beta-sitosterol were prepared by
      the reaction of 3-beta-sitosterol hemisuccinate with SOCl2 then with thiols,
      amines or phenols. These series are: 3 beta-[(3-substituted-4(3H)-quinazolinon-2-
      yl)thiocarbonylproprionyloxy]stigmast-5-ene; 3 beta- ([4-substituted-5-(4
      pyridyl)-4H-1,2,4-triazol-3-yl] thiocarbonylpropionyloxy)stigmast-5-ene; 3 beta-
      [(5-substituted-1,3,4-thiadiazol-2-yl)carbamoylpropionyloxy] stigmast-5-ene and 3
      beta-(substituted carbamoyl or oxycarbonylpropionyloxy)stigmast-5-ene. The
      antilipidemic activity of representative compounds was studied.

PMID- 2241534
TI  - [Drug analysis with polarographic methods. 33. Electroanalytic studies of a new
      benzodiazepine: [6(o-chlorophenyl)-2,4-dihydro-2-[(4-methyl-1-piperazinyl)
      methylene]-8-nitro-1H-imidazol[1,2-a][1,4]benzodiazepine-1-one (WHO)
      (loprazolam,1)] and content determination its drug forms].
AB  - Loprazolam (1) is a tricyclic benzodiazepine containing a new butazadiene moiety,
      which has not been investigated by polarography up to now. 1 is reduced in three
      waves at a DME over the whole pH-region. In BRP (pH 2-9) 10 electrons are
      consumed in this process. The first step is suitable for the determination of 1
      in Loprazolam tablets containing 1 or 2 mg. These tablets are on the
      pharmaceutical market in several European countries. The mechanism of the
      electrode process will be reported in the communication XXXIV.

PMID- 2241535
TI  - [Preparation of theophylline-sodium salicylate suppositories and determination of
      factors influencing the in vitro dissolution of the active agents].
AB  - Suppositories of theophylline-sodium salicylate were prepared with 10 different
      vehicles and also with tensids and softeners. With the dynamic diffusion method
      the drug dissolution and the in vitro diffusion were measured. It was established
      that proper choice of the vehicle is very important. The highest relative in
      vitro availability was measured in the case of glyceride base with low hydroxyl
      value. The diffusion of the active agent can be described by an exponential
      function.

PMID- 2241536
TI  - [Comparative study of the binding or iosarcol, iopamidol, iopromide, and iohexol
      to human serum albumin].

PMID- 2241537
TI  - Assessing suicide risk in stroke patients: review of two cases.
AB  - Poststroke depression can be accompanied by suicidal ideation, yet reports of
      suicide among stroke patients are rare. When untreated, depression can become
      prolonged and severe. Risk factors for suicide include depression, severe
      insomnia, chronic illness, and organic brain syndrome. Early clinical assessment
      of suicide risk factors is essential in the rehabilitation setting. Two patients
      who developed mood disturbances in the acute poststroke period and eventually
      committed suicide are presented. Neither patient openly expressed suicidal
      thoughts to staff or family members. Retrospective analysis of medical records
      was compared to established suicide risk factors reported in the medical
      literature. Indirect verbal cues and nonverbal behavior patterns indicating
      potential suicide risk may have been present. Strategies for evaluation and
      management of suicidal behavior are discussed. These cases emphasize the need for
      early assessment of suicide risk by the entire rehabilitation team.

PMID- 2241538
TI  - A new orthosis for central cord syndrome and brachial plexus injuries.
AB  - Proximal upper extremity weakness may develop secondary to central cord syndrome
      due to spinal cord injury or brachial plexus injury. Functional deficits, pain,
      decreased upper extremity arm swing during gait, and shoulder subluxation are
      common sequelae of these injuries. This report describes a new orthotic design
      that can be easily fabricated in two to four hours from readily available
      materials to compensate for these deficits. This orthosis allows for early
      participation in activities of daily living for patients with greater proximal
      than distal upper extremity weakness. The orthosis consists of a figure-eight
      shoulder harness and unilateral or bilateral forearm cuffs of orthoplast
      connected to the harness by flexible rubber tubing. The length of the tubing is
      adjustable through clamps connected to the forearm cuff to allow for variable arm
      positioning. Three patients, aged 14, 64, and 68, two with central cord syndrome
      and one with injury to the upper portion of the brachial plexus (Erb palsy) are
      described. Shoulder girdle musculature was less than 2, biceps less than 2,
      triceps less than 4, and hands less than 5 in all patients. Benefits from use of
      this orthosis may include improved arm swing and balance during ambulation,
      reduced shoulder pain and subluxation, and increased independence for tasks such
      as carrying lightweight objects, lower extremity dressing, bathing, light
      homemaking, and leisure activities such as gardening.

PMID- 2241539
TI  - Dilantin toxicity and depression.

PMID- 2241540
TI  - Six years unto the next century: the changing and constant faces of the academy
      and physiatry.

PMID- 2241541
TI  - Quantitative evaluation of sway as an indicator of functional balance in post
      traumatic brain injury.
AB  - The test of sway, using different conditions of stance with measurements of the
      average radial deviation of the center of pressure and its path length of sway
      per unit of time, has been shown to be a useful clinical tool in determining
      balance problems in traumatic brain injury (TBI) patients. Normative values were
      established to determine if an individual patient's sway values fell within the
      normal range (mean +/- 2SD). The tests have shown good test-retest reliability
      for TBI patients. In addition, it has been shown that the sensitivity of the test
      is sufficient to identify changes in patients' performances as their clinical
      conditions change. It has been demonstrated that the different stance conditions
      of the battery of tests become progressively more difficult to perform (from
      comfortable stance, eyes open and eyes closed, through narrow stance, eyes open
      and eyes closed, to tandem stance with right or left foot forward, eyes open and
      eyes closed). By using these subtests, it is easy to distinguish between the
      performances of able-bodied patients and TBI patients with very mild balance
      problems. The validity of the measure has been documented by correlating the sway
      performance with clinical functional performance tests. The test performance also
      correlates with the patient's own assessment of his or her gait difficulties. The
      limited data available suggest that the test of sway relates difficulties in
      static balance to the frequency of falls. Finally, subtests permit identification
      of specific problems in maintaining balance as a basis for therapeutic
      intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241542
TI  - Age effect on prognosis for functional recovery in acute, traumatic central cord
      syndrome.
AB  - The purpose of this study was to determine if age is significant in functional
      recovery in acute, traumatic central cord syndrome (CCS). Recovery of ambulation,
      ADL status, and bowel and bladder function were evaluated. A retrospective study
      tested the hypothesis that functional recovery in 51 consecutive CCS patients was
      better in younger patients than in older patients. Four patients, all more than
      50 years, died. Ability to ambulate independently at discharge was compared in 30
      patients younger than 50 years with 21 patients 50 years or older. Results showed
      that 29 of 30 (97%) of the younger patients were ambulatory compared to seven of
      17 (41%) of the older patients (p less than .002). The younger patients were also
      able to achieve independence in self-care and bowel and bladder function in a
      significantly greater proportion. The prognosis for functional recovery in acute
      traumatic CCS should consider the patient's age. The prognosis is less optimistic
      in older patients, but it is considerably more favorable in younger patients than
      previously reported.

PMID- 2241544
TI  - Sensory nerve evoked responses in spinal cord injury.
AB  - Previous studies have documented the presence of fibrillations, positive waves,
      and decreased motor evoked response amplitudes in spinal cord injury (SCI)
      subjects. The purpose of this study was to further evaluate sensory nerve status
      in this population. Twenty-eight subjects with SCI for at least five months and
      evidence of spasticity were included. Sural sensory and tibial motor evoked
      response amplitudes were measured. The mean sural sensory amplitude was 8.0 +/-
      5.9 microV (normal = 15.0 +/- 5.3 microV). The mean tibial motor amplitude was
      5.1 +/- 4.3 mV (normal = 11.7 +/- 3.8 mV). In six subjects with significantly
      reduced sural sensory amplitudes, more extensive electrodiagnostic testing was
      performed. These studies showed diffusely decreased lower extremity sensory and
      motor evoked response amplitudes and diffuse positive waves and fibrillations in
      no particular distribution. Thus, subjects with SCI may have sensory as well as
      motor nerve abnormalities. An intact connection between the second order and
      primary sensory neuron may be necessary for maintenance of axonal integrity of
      the primary neuron.

PMID- 2241543
TI  - Electric discharge patterns of ankle muscles during the normal gait cycle.
AB  - EMG patterns in ankle muscles were examined during normal gait cycles in 147
      healthy asymptomatic adults. In all subjects, the tibialis anterior (Ta) showed
      marked activities around the toe-off and before the heel-strike, and the
      gastrocnemius lateral head (Gl) showed marked activity during the midstance phase
      but no activity in the early part of the swing phase. The Ta activity contributed
      to ground clearance, prevention of foot-drop, and shock absorption at the heel
      strike. The Gl activity contributed to push-off from the ground and prevention of
      foot-drop. The Ta activity consisted of double bursts with (15% of subjects) or
      without (44%) electric silence in the midswing phase, continuous discharge (33%),
      and triple discharge patterns (8%). The Gl activity consisted of a single-peak
      (95%) pattern or double-peak (5%) patterns.

PMID- 2241545
TI  - Posterior femoral cutaneous nerve conduction.
AB  - The posterior femoral cutaneous nerve is a sensory nerve comprised of fibers
      originating from the anterior and posterior divisions of the first three sacral
      segments. It exists the pelvis distal to the piriformis muscle and proceeds
      distally, superficial to and between the medial and lateral hamstring
      musculature. The nerve's major cutaneous distribution is the posterior aspect of
      the thigh and a variable area of the posterior calf. An electrophysiologic
      technique to assess the peripheral axons of the posterior femoral cutaneous nerve
      is described. A recording electrode is placed 6cm proximal to the midpopliteal
      fossa and the nerve is stimulated supramaximally 12cm proximally on a line
      between the active electrode and the ischial tuberosity. A ground electrode is
      placed just proximal to the active recording electrode. The lower extremities of
      40 individuals with a mean age of 34 years (20 to 78 years) were examined. The
      mean peak latency of the response is 2.8 (2.3 to 3.4) msec +/- 0.2msec with a
      mean amplitude of 6.5 (4.1 to 12.0) microV +/- 1.5 microV. This technique may
      facilitate the proximal evaluation of lower extremity peripheral neuropathies,
      lesions of the posterior femoral cutaneous nerve, or the assessment of the
      peripheral nervous system in persons with lower extremity amputations.

PMID- 2241546
TI  - Myotonic dystrophy: quantification of muscle weakness and myotonia and the effect
      of amitriptyline and exercise.
AB  - The purpose of this study was to quantify the degree of muscle weakness and
      myotonia in 12 patients with myotonic dystrophy (MD), and to quantitatively
      determine the effects of a four- to six-month therapeutic trial of amitriptyline.
      Patients had exercised with weights for one or more years. Some had shown initial
      improvement in muscle strength, but had reached a plateau; others had not
      improved when the study began. Muscle weakness was quantified by comparing the
      five-second maximum voluntary contraction (MVC) in newtons (N) per kg (body
      weight) of 12 patients and 20 healthy subjects. Knee extensor, elbow flexor, and
      first dorsal interosseous (FDI) muscles were compared. Myotonia was quantified by
      measuring relaxation times (RTs) at the end of the five-second MVC produced by
      FDI, as the time taken for the MVC to decrease by 50% and 75% (referred to as 1/2
      and 3/4RT). The results were as follows: (1) the mean muscle strength of each of
      the three muscles of the patients was significantly (p less than .001) reduced
      compared with healthy subjects; and (2) 1/2 and 3/4RT means of the patients (vs
      healthy subjects) were significantly prolonged (p less than .01). Eight of the
      patients participated in a therapeutic trial of amitriptyline. Therapeutic
      effects were quantified by measuring muscle strength, 1/2 and 3/4RT, and percent
      change in evoked muscle action potential (MAP) from the FDI muscle after a ten
      second MVC, to determine change in excitability. Mean muscle strength of FDI
      improved from .27 to .33N/kg, (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241547
TI  - Foot placement angle and arch type: effect on rearfoot motion.
AB  - The purpose of the study was to describe the relationship between foot placement
      angle, arch type, and rearfoot motion during running. Twenty women were filmed in
      the frontal plane at 100 fps. Subjects displaying a variety of foot placement
      angles were chosen. Before data collection, arch indices were calculated. Each
      subject ran five trials at a pace of 3.5 m/sec. All subjects wore the same type
      of shoe. All trials were digitized to determine rearfoot angles throughout foot
      contact. The following mean values were obtained: total rearfoot was 10.09
      degrees, maximum pronation was -9.63 degrees, foot placement angle was 7.58
      degrees and arch index (AI) was 0.23 cm2. Non-linear regression was used to
      predict the relationship between maximum pronation and total rearfoot motion
      using foot placement angle and AI. Foot placement angle was the best single
      predictor of total rearfoot motion. When using both foot placement angle and arch
      type as predictors of total rearfoot motion, r2 was .35. Less abduction was
      associated with more total rearfoot motion. Arch type exhibited a quadratic
      relationship with total rearfoot motion. Normal-arched individuals (.21 cm2 less
      than AI less than .26 cm2) exhibited less total rearfoot motion than high-arched
      (AI greater than .26 cm2) and flat-arched (AI less than .21 cm2) individuals. For
      maximum pronation, foot placement angle was the only significant predictor (r2 =
      .13). Greater foot placement angles (more abduction) were associated with less
      maximum pronation.

PMID- 2241548
TI  - Asymptomatic ulnar neuropathy in carpal tunnel syndrome.
AB  - Quantitative assessment of the vibration threshold of the second and fifth
      fingertips at 125Hz was performed on 28 affected limbs of 17 patients with carpal
      tunnel syndrome (CTS) together with a median and ulnar sensory nerve conduction
      velocity (SNCV) study. Twenty-six limbs of 26 age-matched healthy subjects were
      used as controls. Both the vibration threshold elevation of the second finger and
      the delay of median SNCV were significant in CTS patients as compared with
      controls (p less than .001). Although the ulnar SNCVs of all affected limbs were
      within the normal range, ten affected limbs (36%) were found to have a
      concomitant vibration threshold elevation of the fifth finger, and eight of those
      limbs were found to be exposed to chronic occupational mechanical stimulation at
      the wrist. These findings appear to support the presence of subclinical traumatic
      damage to the ulnar nerve at the wrist. In summary, digital vibration measurement
      can elucidate subclinical ulnar neuropathy in CTS which cannot be detected by
      SNCV studies.

PMID- 2241550
TI  - On the supply of physicians.
AB  - The congressionally created Council of Graduate Medical Education is conducting a
      study to assess the adequacy of the current and future supply of physicians in
      six specialties. The study is revising and updating the needs-based method used
      by the Graduate Medical Education National Advisory Committee and using this
      method to project the requirements for physicians for the next two decades.
      Projections on the supply of physicians will be based on the latest data from the
      federal government's Bureau of Health Profession's health manpower model.
      Previous physician manpower studies are reviewed to provide a historic
      perspective and a frame of reference for the variables, data sources, and
      assumptions being considered by the Council of Graduate Medical Education study.

PMID- 2241549
TI  - Nobel Laureate: Joseph E. Murray, clinical surgeon, scientist, teacher.

PMID- 2241551
TI  - Heart transplantation in Jehovah's Witnesses. An initial experience and follow
      up.
AB  - More than 25 years of experience performing heart surgery on Jehovah's Witnesses
      has culminated in successful cardiac transplantation without administering blood
      products in five patients (mean age, 44.4 +/- 8.3 years) of this faith. The use
      of blood-conserving methods, iron supplementation, bone marrow-sparing
      maintenance immunotherapy, and brisk postoperative diuresis has added to the
      efficacy of cardiac transplantation in these patients. No perioperative deaths
      occurred, and early follow-up studies have shown that these patients have not
      been more susceptible to higher graft rejection rates due to the lack of
      pretransplant blood transfusions. As more Jehovah's Witnesses undergo heart
      transplantation in the future, comparison with other recipients who allow
      pretransplant blood transfusions may lead to a better understanding of rejection
      immunobiology. We conclude that cardiac transplants may be safely offered to
      Jehovah's Witnesses without fear of a uniformly poor outcome.

PMID- 2241552
TI  - Ambulatory cholecystectomy without disability.
AB  - This is a presentation of 200 consecutive outpatient cholecystectomies performed
      during a 4-year period in a small community hospital. This technique is performed
      with minor modifications of the usual cholecystectomy procedure so that it could
      easily be performed by general surgeons throughout the United States. The
      procedure has resulted in a large reduction in the short- and long-term morbidity
      associated with cholecystectomy, and in savings of up to one fourth the cost of a
      routine inpatient cholecystectomy. This procedure allows the general surgeon to
      treat patients with cholecystectomies in the fashion to which the surgeon is
      accustomed and still markedly reduce the hospital stay. The morbidity from this
      procedure seems comparable with laser cholecystectomy. Ambulatory cholecystectomy
      as described here does not require any special training or equipment.

PMID- 2241553
TI  - Postoperative complications in patients with disabling psychiatric illnesses or
      intellectual handicaps. A case-controlled, retrospective analysis.
AB  - The purpose of this study was to quantitate the operative risk and costs
      encountered in the surgical treatment of institutionalized patients. Operative
      complications and duration of hospitalization for 200 institutionalized patients
      were compared with those in a control group of patients matched for age, sex, and
      type of operation drawn from the general hospital population. Postoperative
      complications occurred in 53 (26.5%) of the patients in the study group compared
      with 15 (7.5%) of the patients in the control group. Elective laparotomy was
      followed by a complication in 48% of institutionalized patients compared with
      11.6% of matched controls. Emergency celiotomy carried a 75% complication rate in
      the study group. Atelectasis and pneumonia accounted for 50% of the postoperative
      complications and occurred with greatest frequency following intra-abdominal
      procedures. The median hospital stay for all institutionalized patients was 3
      days more than for matched controls. A strategy for postoperative treatment is
      presented, with particular emphasis on prevention of pulmonary complications.

PMID- 2241554
TI  - Needle-localized mammographic lesions. Results and evolving treatment strategy.
AB  - From January 1981 to December 1987, 932 needle-localization breast biopsies were
      performed at our institution for mammographically detected abnormalities. We
      reviewed 531 needle-localization breast biopsy procedures performed during two
      periods (January 1981 to June 1984, n = 311; and January to August 1987, n = 220)
      to compare results and treatment patterns, and to determine the prevalence of the
      missed lesions. Mammographic abnormalities detected on routine screening
      accounted for a larger proportion of needle-localization breast biopsies in the
      later series (94 [30%] of 311 vs 94 [43%] of 220). However, the rate at which
      carcinoma was identified remained constant at 29% as did the percentage of
      cancers that were invasive (46% vs 51%). Overall, the rate of malignant diagnoses
      after needle-localization breast biopsy was lowest in asymptomatic women
      undergoing routine screening mammography (44 [24%] of 188) and significantly
      higher in women undergoing mammographic follow-up of the contralateral breast
      after treatment for breast cancer (28 [43%] of 65). There were seven missed
      lesions in 531 needle-localization breast biopsies, necessitating a second
      procedure in six and interval mammograms in one.

PMID- 2241555
TI  - Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses.
AB  - The aerobic and anaerobic microbiologic characteristics of 584 wounds and 676
      skin or soft-tissue abscesses were studied and correlated with the infection
      site. In wounds, aerobic or facultative bacteria only were present in 223
      specimens (38%), anaerobes only in 177 specimens (30%), and mixed flora in 184
      specimens (32%). In total there were 1470 isolates, 558 aerobic and 912
      anaerobic, an average of 2.5 isolates per wound (1.6 anaerobic and 0.9 aerobic
      isolates). In abscesses, aerobic or facultative bacteria were recovered in 177
      specimens (26%), anaerobes only in 243 specimens (36%), and mixed flora in 256
      specimens (38%). In total there were 1702 isolates, 602 aerobic and 1100
      anaerobic, an average of 2.5 isolates per abscess. The highest rates of anaerobes
      in wounds were in the inguinal, buttocks, and trunk areas and in abscesses in the
      perirectal, external genitalia, neck, and inguinal areas. The predominant aerobic
      organisms were Staphylococcus aureus (363 isolates), group A streptococci (98
      isolates), and Escherichia coli (97 isolates). The predominant anaerobic
      organisms were Bacteroides species (986 isolates), Peptostreptococcus species
      (559 isolates), Clostridium species (153 isolates), and Fusobacterium species
      (109 isolates). The predominance of certain isolates in certain anatomical sites
      was correlated with their distribution in the normal flora adjacent to the
      infected site. These data highlight the polymicrobial nature of wounds and
      cutaneous abscesses.

PMID- 2241556
TI  - Reinforcement of colonic anastomoses with a laser and dye-enhanced fibrinogen.
AB  - The incidence of anastomotic leakage in colonic surgery is approximately 10%. We
      evaluated a technique of laser-fibrinogen reinforcement to strengthen
      experimental colonic anastomoses. The technique consisted of the topical
      application of indocyanine green dye-enhanced fibrinogen to the serosal surface
      of two-layer inverting anastomoses, followed by exposure with an 808-nm diode
      laser. In the 28 rabbits used for this study, mean bursting pressure at time 0
      was 108 +/- 13 mm Hg in the group receiving anastomoses with sutures alone and
      173 +/- 20 mm Hg in the group for which the sutured anastomosis was reinforced
      with laser-fibrinogen. The difference in bursting pressures between the two
      groups was statistically significant at time 0. However, at 1, 3, 5, and 7 days,
      the anastomosis became stronger in both groups and the difference in strength was
      reduced; the sutured group had more exceptionally weak (less than 110 mm Hg)
      bonds than the group treated by laser. Thus, laser-fibrinogen reinforcement
      significantly enhances the early strength of sutured colonic anastomoses. This
      technique may reduce the incidence of leakage during the first postoperative week
      and the associated complications in a clinical setting.

PMID- 2241557
TI  - Hepatic vein reconstruction for preserving remnant liver function.
AB  - Hepatic malignancies often infiltrate to the major hepatic vein. Recently, we
      performed hepatic resection combined with hepatic vein reconstruction for
      preserving remnant liver function in three such patients. One patient had a
      saphenous vein graft. Postoperative liver function of the patients who underwent
      hepatic vein reconstruction was compared with those of eight patients who
      underwent hepatic resection of segments VII and VIII. The right hepatic vein in
      four of them was resected and in the remaining four was preserved by
      skeletalization using an ultrasonic aspirator. Although four patients with right
      hepatic vein resection showed severe lowering of liver function after surgery,
      the postoperative course of patients with preservation or reconstruction of the
      right hepatic vein maintained good liver function. Liver regeneration of three
      patients with hepatic vein reconstruction was good on computed tomography.
      Besides this report, to our knowledge, there is no other report of hepatic vein
      reconstruction for preserving the remnant liver function. Problems with hepatic
      resection combined with hepatic vein reconstruction are discussed. We conclude
      that hepatic vein reconstruction is one of the means for extending indication of
      the malignant tumor resection of the liver.

PMID- 2241558
TI  - Evaluation of methods for detecting venous reflux. Perspectives in venous
      insufficiency.
AB  - Using 793 limbs with nonobstructive venous reflux, we evaluated a number of
      techniques used for the assessment of venous reflux. The venous Doppler
      examination was found to be a reliable screening tool with excellent sensitivity
      and good specificity. Photoplethysmography was 97% sensitive in patients with
      ambulatory venous hypertension; however, in milder forms of reflux, it was less
      sensitive. The major drawback of photoplethysmography was the large number of
      false-positive results obtained. Ambulatory venous pressure measurement and
      another pressure-based technique, Valsalva-induced foot venous pressure
      measurement, defined overlapping but different normal and abnormal limbs.
      Descending venography, when performed as described by Kistner et al, was found to
      be a reliable tool to assess reflux with more than a 90% sensitivity. The
      horizontal technique of performing descending venography and nucleotide
      descending venographies had unacceptably low sensitivity and were abandoned.
      Features of venous reflux as outlined by these modern technical tools are
      described.

PMID- 2241559
TI  - Does survival depend on the amount of autotransplanted splenic tissue?
AB  - Susceptibility to Streptococcus pneumoniae infection was studied in 11 groups of
      rats allocated to sham operation, splenectomy, or splenic autotransplantation of
      10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% of the removed spleen. Three
      months later, all rats were exposed intravenously to type 1 Streptococcus
      pneumoniae (median lethal dose, LD50, for control group). Survivors were killed
      13 days after the bacterial challenge. Autopsy showed that more splenic tissue
      was recovered in rats that received less than 50% splenic tissue compared with
      those that received 50% or more. More survivors were found among sham-operated
      rats (47.5%; 95% confidence intervals, 32 to 68) and rats that had 40% splenic
      tissue implanted (35%; confidence interval, 20 to 54) or those that were found to
      have regenerated 40% splenic tissue. We conclude that 40% of the spleen should be
      autotransplanted to protect the rat optimally against infection after
      splenectomy.

PMID- 2241560
TI  - Primary malignant peritoneal mesothelioma. A report of seven cases and a review
      of the literature.
AB  - Mesothelioma of the peritoneum is a rare malignant neoplasm easily mistaken by
      both surgeon and pathologist for one of the more common neoplasms of the abdomen.
      Review of our records from metropolitan-area hospitals for the past 15 years
      identified seven patients with primary peritoneal mesotheliomas. Their diagnosis,
      management, and survival is analyzed. We report a case of an extended survivor (7
      years) and one of a long-term survivor (15 years), as well as what we believe to
      be the only case in the literature presenting with a coexistent malignant
      neoplasm. Prevention of this commonly fatal neoplasm is linked to avoiding
      occupational exposure to asbestos; long-term survival for a few patients may be
      achieved with correct identification of the neoplasm and aggressive management.
      This report includes a review of the literature.

PMID- 2241561
TI  - Aortic occlusion and vascular isolation allowing avascular hepatic resection.
AB  - Occlusion of the supraceliac abdominal aorta and hepatic vascular isolation were
      employed in a series of 15 patients as a definitive method to allow avascular
      hepatic resection. The series was compared with an earlier group of patients
      treated conventionally. In the avascular hepatic resection group there was no
      mortality; hypotension did not occur at the time of hepatic vascular isolation;
      rapid, accurate excision of the hepatic lesions could be achieved in a bloodless
      field; resection of midline lesions and those involving the great veins was
      possible; and "segmentectomies," or resections crossing segmental boundaries,
      could be performed where previously formal hepatic lobectomies were required.
      Concomitantly, the greatest amount of uninvolved hepatic parenchyma remained in
      situ. There was increased ease of operative management, reduced blood loss, and
      reduced operating time (mean, 2.8 hours).

PMID- 2241562
TI  - Management of perineal wounds following abdominoperineal resection with inferior
      gluteal flaps.
AB  - Our experience treating perineal wounds secondary to abdominoperineal resection,
      either for inflammatory bowel disease or cancer, is presented. A total of 16
      patients were treated either on a delayed basis or at the same time as the
      abdominoperineal resection. All wounds were closed using the inferior gluteal
      myocutaneous flap. Fifteen of 16 patients have achieved healing, eight of whom
      had no complications. Only minor revisions or local wound care were required in
      the remaining patients, with only one patient failing to heal. Our results
      compare favorably with previous reports of treatment of this difficult problem.

PMID- 2241563
TI  - Antibiotic pharmacokinetics in surgery.
AB  - Pharmacokinetics is the study of variables that affect drug concentrations at the
      effector site. The descriptive terms peak concentration, elimination half-life,
      volume of distribution, and bioavailability are commonly used to express
      pharmacokinetic variability among drugs used in patient care. The pharmacokinetic
      characteristics of drugs are important for surgeons to understand because they
      represent differences that may assume clinical significance when selecting
      antibiotics for preoperative preventive indications. In addition, the changing
      hemodynamic pattern of the stressed and septic patient may result in changing
      pharmacokinetic patterns for an antibiotic, which, in turn, may require changes
      in the dosing regimen during the course of treatment.

PMID- 2241564
TI  - A history of the bilioenteric anastomosis.
AB  - The bilioenteric anastomosis has played an integral role in the surgical
      management of biliary tract disease during the past century. A wide variety of
      techniques for suturing a portion of the biliary tract to the digestive tract
      have been described since von Winiwarter's first cholecystoenterostomy. Many
      types of biliary stents have also been developed, although their exact role
      remains controversial. Many advances in preoperative and postoperative care have
      contributed to the low morbidity and mortality of current reconstructive biliary
      tract surgery.

PMID- 2241565
TI  - The papillary-cystic neoplasm of the pancreas. An increasingly recognized
      clinicopathologic entity.
AB  - The clinical course of the papillary-cystic neoplasm of the pancreas is
      contrasted with that of the pancreatic ductal adenocarcinoma. The former occurs
      predominantly in young women, has a low malignant potential, and is highly
      curable with surgical treatment. Three cases are reported that illustrate the
      typical clinical features and the indolent nature of the tumor. One case was
      discovered after blunt abdominal trauma resulted in rupture of the tumor and
      hemoperitoneum. All cases were treated by pancreatic resection with preservation
      of the spleen, an important consideration in younger patients. All patients were
      free of disease at long-term follow-up. Increasing awareness of this tumor has
      resulted in the reclassification of several tumors and should lead to better
      recognition by surgeons caring for patients with pancreatic diseases.

PMID- 2241566
TI  - Extrahepatic biliary obstruction by lymphoma.
AB  - Extrinsic compression of the common bile duct by enlarged lymph nodes is an
      unusual cause of obstructive jaundice. We describe two patients with such a
      manifestation of lymphoma and the use of endoscopic retrograde
      cholangiopancreatography in distinguishing this rare complication from other
      causes of jaundice in lymphoma. Patients may have rapid resolution of both
      symptoms and biochemical abnormalities by nonoperative biliary bypass combined
      with chemotherapy and/or radiotherapy. Lymphomatous obstruction should be
      considered a cause of potentially treatable jaundice in patients with known
      lymphoma; endoscopic retrograde cholangiopancreatography can be valuable as a
      diagnostic and therapeutic tool.

PMID- 2241567
TI  - Elective cholecystectomy after biliary lithotripsy: an indication for routine
      intraoperative cholangiography?

PMID- 2241568
TI  - Mathematical model for energy and protein balance simulation in broilers.
AB  - The authors used the empirical equations of mathematical modelling for the energy
      and protein balance simulation, with the view of calculating the body weight gain
      in broilers fed various diets. The results found by using the model were compared
      with the experimental data obtained by several authors. A standard deviation of
      +/- 1.20% and a mean error of +/- 0.28% and a mean error of +/- 0.28% which
      proved that the model average was a sufficient estimate of the experimental
      average were found. Furthermore, using the regression method, a significant
      correlation of variables was evidentiated.

PMID- 2241569
TI  - [The effect of increasing additions of low-esterified pectins in the diet on the
      metabolism of laying hens--tested by pair-feeding studies].
AB  - A series of trials was carried out with 32 laying hens in order to study
      metabolism after addition of low methylated citrus pectin in levels of 2% and 6%.
      The following results should be pointed out: Addition of pectic substances
      reduced feed-intake and stimulated water intake. The limited tolerance for
      pectins resulted in an increasing water-content of the excreta with a rise of the
      concentration of volatile fatty acids and an alteration of their spectrum. In
      consequence of supplementation with pectins a considerable loss of body weight
      could be established, which exceeded the expected effects of reduced energy
      intake. The egg production was impaired by addition of pectin. In the serum the
      level of total lipids, cholesterol, triglycerides, phospholipids, furthermore of
      bile acids diminished. These effects exceeded remarkably those induced solely by
      reduced feed-intake. The level of volatile fatty acids in the serum was elevated
      as result of the supplementation with pectic substances.

PMID- 2241570
TI  - Studies of the effect of supplementing protected methionine (HMM-Ca) to dairy
      cows on milk yield and fertility.
AB  - A trial with 90 cows was conducted to examine the effect of supplementing 30 g N
      hydroxymethyl-DL-methionine-calcium (HMM-Ca) from 14 days pre calving till 100
      days in lactation on the performance and some physiological traits. Cows were
      kept on four energy levels by feeding different amounts of concentrate. At each
      energy level, half of the cows were given a methionine supplement. Forage
      consisted of 1/3 corn- and/or beet pulp silage and 2/3 grass silage ad libitum.
      The amount of daily milk yield differed not significantly from 31.5 kg for the
      supplement group to 30.6 kg for the control group. No interaction between the
      methionine supplementation and energy level could be detected. Mean methionine
      content in blood plasma differed from 22.7 mmol/l for the supplement group to
      16.8 mmol/l for the control group. GOT, tau-GT, bilirubin and urea in blood serum
      and milk urea content did not indicate a positive effect of the methionine
      supplementation on the metabolism. Conception rate differed slightly from 87% in
      the supplement group to 73% in the control group.

PMID- 2241571
TI  - Effect of low level of dietary aflatoxins on baladi rabbits.
AB  - Aflatoxins B1, B2, G1 & G2 were administered in a low concentration (100 ppb of
      each aflatoxin (AN] in a mash offered to Baladi rabbits. An other group of
      rabbits were fed on the same contaminated mash in addition to 0.25% charcoal
      (CC). The two groups were compared to control animals fed on AN-free mash.
      Inclusion of AN in the diet decreased feed and water consumption, body weight and
      survival rate. Charcoal improved somewhat feed and water consumption and growth
      rate than AN-group. However, CC-group affected digestibility of organic matter
      more than AN-group. Relative weights of liver, kidneys, heart and adrenal glands
      were significantly higher in AN and CC groups than the control group. Blood
      haemoglobin content, packed cell volume percentage and sedimentation rate were
      lower in AN group. Although there were an increase in each of serum, calcium,
      inorganic phosphorus, cholesterol, phospholipids and glutamic-pyruvic
      transaminase in AN group, yet the serum nitrogen and glutamic-oxalacetic
      transaminase were reduced. Charcoal had alleviated AN-effects concerning N, GPT
      and phospholipids. Chemical analysis revealed elevation of water, ash and silica
      contents of liver and water content of muscles from AN-animals. On the other
      hand, fat content, GOT and vitamin A in the liver as well as muscles ash were
      reduced. Addition of CC to the diet reduced AN-effects on liver fat, ash and
      silica but resulted in a rise of the water content of liver and muscles and liver
      GPT activity. Charcoal also resulted in a sharp decrease in vitamin A content of
      the liver. Aflatoxin treatments (in AN and CC groups) reduced bone ash, silica
      and magnesium as well as bone volume. Charcoal administration increased Ca
      content of bones. Aflatoxin feeding (in AN group) resulted in a high residual
      percentage of AN in muscles, serum, liver, heart and kidneys with relationships
      of 51 :24 : 3 :2 : 1, respectively. Only 1.42% of the fed AN was excreted in the
      faeces. Charcoal usage had a good effect as it prevented AN to accumulate in the
      organs. Aflatoxin contaminated diets (in AN and CC groups) resulted in paralysis,
      disorder of fat deposition, discolouration and haemorrhages of some organs.
      Scanning electron microscopic examination revealed no ill effect on the surface
      structure of the small intestine due to either AN or AN + CC. Pathological
      examination showed that the main affected organs were liver, heart and spleen,
      respectively. The changes include hepatic round cell infiltration, irregularities
      of lobular plats, focal necrosis and periportal fibrosis.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 2241572
TI  - Transcription of feline calicivirus RNA.
AB  - We report here the cloning and 3' sequence determination of feline calicivirus
      strain F9. Subcloning the 3' terminus enabled the production of strand specific
      probes for RNA synthesis. We extend the number of virus specific RNAs detected
      intracellularly to 8, and show that numbers 1-5 are represented as negative
      strands which may serve as templates in the synthesis of these RNAs.

PMID- 2241573
TI  - Modified oligopeptides designed to interact with the HIV-1 proteinase inhibit
      viral replication.
AB  - The human immunodeficiency virus 1 (HIV-1) codes for a proteinase that cuts viral
      proteins at specific sites. We have tested 13 modified oligopeptides related to
      these cleavage sites to see if they inhibit viral replication. To indicate
      whether a decrease in replication could be due to a general inhibition of cell
      metabolism, we also measured the effect of the peptides on cellular protein
      synthesis. Three of the peptides tested (Ac-Gln-Asn-Sta-Val-NH2, Ac-Gln-Asn-Sta
      Val-Val-NH2, and Ac-Glu-Asn-Sta-Ile-NH2) inhibited HIV-1 replication at
      concentrations that did not inhibit protein synthesis. Ac-Gln-Asn-Sta-Val-NH2 was
      the most potent, causing an approximately 40% decrease in viral replication,
      measured as the synthesis of HIV-1 antigens and the formation of infectious
      particles.

PMID- 2241574
TI  - Mutational analysis of enhancer domains responsive to trans-activation by the X
      gene of human hepatitis B virus.
AB  - The X gene product of human hepatitis B virus (HBV) trans-activates the HBV
      enhancer. In order to identify domains responsive to trans-activation by the X
      gene, we introduced a series of mutations into the HBV enhancer and assayed the
      enhancer activities in the presence of the X gene product. Our results suggest
      that the EP domain of the enhancer is essential for trans-activation by the X
      gene.

PMID- 2241575
TI  - A diagnostic method to detect alcelaphine herpesvirus-1 of malignant catarrhal
      fever using the polymerase chain reaction.
AB  - A sensitive diagnostic method specific for alcelaphine herpesvirus-1, causative
      agent of malignant catarrhal fever, has been developed. Based on the nucleotide
      sequence of the alcelaphine herpesvirus-1 genomic DNA, a pair of 30 nucleotide
      primers was selected and synthesized for detecting the virus genome using the
      polymerase chain reaction (PCR). The virus genome was detected in crude cell
      lysate using the amplification reaction.

PMID- 2241576
TI  - Sequence homology between HIV gp120, rabies virus glycoprotein, and snake venom
      neurotoxins. Is the nicotinic acetylcholine receptor an HIV receptor?

PMID- 2241577
TI  - Comparison of the genomes of two sympatric iridescent viruses (types 9 and 16).
AB  - A map of the sites in the genome of Costelytra zealandica iridescent virus
      (CzIV), using the restriction enzymes BamHI, KpnI, and PstI, showed the genome
      size to be 170.2 kbp in length. It was found that the genome was cyclically
      permuted and that 39% of the genome of CzIV contained repetitive sequence
      elements. The genome was found to hybridize with the genome of another iridescent
      virus, type 9 (WIV), in DNA-DNA hybridization experiments. A region of the WIV
      DNA genome (23.4 kbp) did not hybridize with CzIV DNA and this region is similar
      in size to the total genomic size difference between CzIV and WIV (22.4 kbp). A
      unique repeat sequence from iridescent virus type 6 (CIV) was shown to be present
      in the genome of WIV but not that of CzIV. Finally, the positions of the major
      capsid protein genes, VP53 and VP52, in the restriction enzyme maps for type 16
      and type 9 respectively were determined.

PMID- 2241578
TI  - Electron microscopy, plaque assay and preliminary serological characterization of
      three ectromelia virus strains isolated in Poland in the period 1986-1988.
AB  - Three strains of viruses have been identified as ectromedia virus (EV) based on
      their origin, clinical features, morphology, size of virions (140 x 220 nm),
      replicative ability and specific cytoplasmatic fluorescence. The mean diameter of
      plaques produced by EV strains was 0.76 mm (range 0.5-1.0 mm). The neutralizing
      properties of the tested sera were evaluated by seroneutralization (SN) and
      hemagglutination inhibition (HAI) tests.

PMID- 2241580
TI  - [The treatment of chronic asthma and its long-term results].

PMID- 2241579
TI  - Cytotropism of Theiler's murine encephalomyelitis viruses in oligodendrocyte
      enriched cultures.
AB  - The cytotropism of two strains, GDVII and DA, of Theiler's murine
      encephalomyelitis viruses (TMEV) was studied in the oligodendrocyte-enriched
      murine neural cell cultures. Both GDVII and DA caused cytopathic effects in the
      neural cell cultures, and double immunostaining for galactocerebroside (Gal-Cer),
      a marker molecule for oligodendrocyte, and viral antigens disclosed a dual
      expression of Gal-Cer and viral antigens in over 80% of cells in both cultures 24
      h after infection with either GDVII or DA. The kinetics of cell-free and cell
      associated infectivity were not significantly different between two cultures.
      These in vitro observations suggest that neither replication in oligodendrocyte
      nor cell-associated infectivity is a sole factor in discriminating those two
      subgroups of TMEV with regard to the demyelinating activity, and that virus cell
      binding may play an important role in virus persistence and TMEV-induced
      demyelination.

PMID- 2241581
TI  - [Evaluation of venom specific IgE and total serum IgE among forest administration
      workers].
AB  - We used a questionnaire to investigate Hymenoptera hypersensitivity in 323 forest
      administration workers and measured total serum IgE and venom specific IgE
      antibodies against yellow jackets and paper wasps. The results were as follows.
      1) Most of the workers, including 69 (21.8%) hypersensitive workers, had been
      exposed to stings by yellow jackets or wasps. 2) The titer of RAST (p less than
      0.05) and RAST positive rate (p less than 0.01) were higher in the hypersensitive
      workers than in the non-hypersensitive ones. 3) There was a correlation between
      venom specific IgE titers to yellow jackets and paper wasps (rs = 0.818). 4) The
      titer of venom specific IgE increases with the frequency of sting exposure, and
      decreased gradually with the passage of time. 5) The higher the venom specific
      IgE titer, the higher the total serum IgE titer. 6) The titer of venom specific
      IgE, total serum IgE and atopy had no relation to the severity of clinical
      symptoms.

PMID- 2241582
TI  - [Long-term follow up studies of bronchial asthma in children. II. Prognosis and
      complications, treatment and allergic evaluations].
AB  - A questionnaire on the prognosis of bronchial asthma was sent in 1988 to 1592
      patients (1038 males, 554 females) averaging 20 years of age after 12 years'
      follow up. We reported on the prognosis and risk factors associated with
      asthmatic children in part I. The relation between prognosis and other allergic
      complications, treatment and laboratory data were investigated in this study.
      Eosinophil counts of more than 1000/mm3 and/or total serum IgE levels of more
      than 500 IU/ml (100 IU/ml in infants) indicated poor prognosis. However, the
      prognosis was not affected either by the allergens themselves or by the number of
      allergens determined by skin test and RAST. The prognosis was worse for patients
      with multiple allergic complications than for those without complications.
      Treatment may after the natural course of childhood asthma, but it has been
      difficult to evaluate the effect of each regimen over a long period. We compared
      the effect of hyposensitization (specific immunization) and non-bronchodilator
      antiasthmatic drugs (NBAAD), and found that hyposensitization alone gave better
      results than NBAAD and its combination. We had better results from
      hyposensitization over a period of 1 to 5 years than for less than 1 year or more
      than 5 years. We conclude that asthmatic children with risk factors should be
      kept under strict environmental control and given suitable therapeutic regimens
      to avoid the development of allergic diseases, the slow down of "allergic march",
      and to avoid intractable asthma.

PMID- 2241583
TI  - [Nationwide intradermal test with chironomid midge extract in asthmatic children
      in Japan].
AB  - Chironomidea (Insecta) is recently considered one of the most common inhalant
      antigen in Japan. Intradermal tests with Chironomus plumosus (CP) extract were
      undertaken on seven hundred and eighteen asthmatic children aged from 6 to 15
      years in 10 areas (11 medical institutions) in Japan. The number of cases who
      showed positive intradermal tests with CP extract was 200 (27.9%) and the
      positive rate increased in proportion to their age (p less than 0.005). In each
      of the 11 medical institutions the positive rates ranged from 12.6% in Akita to
      45.5% in Okinawa. There were no significant correlations between the results of
      the intradermal test with CP and those of RAST, prick test and intradermal test
      with mite, HD and silk, whereas correlation was noted in the prick test with silk
      (p less than 0.01). The CP positive asthmatics had significantly more attacks
      than the CP negative ones in the summer (p less than 0.01). The positive rate of
      asthmatics living near paddy or farm fields was significantly higher than that of
      those in urban residential areas (31.3% vs 23.8%, p less than 0.05). Chironomid
      midge is one of the most common and important allergen in Japan.

PMID- 2241584
TI  - [Clinical study on bronchial asthma patients whose bronchial hypersensitivity has
      been improved].
AB  - In order to determine which factors would affect the improvement of bronchial
      hypersensitivity in asthmatic patients, a clinical investigation was performed on
      42 cases whose bronchial hypersensitivity had been tested more than two times.
      The following results were obtained. 1) The numbers of bronchial hypersensitivity
      improved cases was 16 while there were 26 unimproved cases. There was no
      statistical difference in age, sex, type of asthma, severity of disease at first
      visit or type of therapy between the two groups. FEV1.0% in the bronchial
      hypersensitivity-improved group was significantly higher than that in the
      unimproved group (p less than 0.01). 2) In the improved group, all cases (16/16)
      were shown to have become free of symptoms, but this applied to only 38% (10/26)
      in the unimproved group. 3) In the 26 cases who had become free of symptoms, the
      improvement index in histamine test and the ratio of improved cases showed a
      tendency to increase as the period during which the patient showed no symptoms
      extended. It was suggested that bronchial hypersensitivity in cases with higher
      FEV1.0% would improve more easily, and that the induction and maintenance of a
      symptom free state is important for the improvement of bronchial
      hypersensitivity.

PMID- 2241585
TI  - [Pollinosis and airborne pollen in Fukuoka City].
AB  - We investigated the relation between the incidence of pollinosis and pollen
      counts in Fukuoka City from 1983 to 1989 to clarify the "cause and effect"
      relationship and to evaluate the severity of pollinosis in this district. We
      collected questionnaires on pollinosis from six otorhinolaryngology clinics in
      our city during the pollination seasons from 1983 to 1989. Cryptomeria j.,
      Cupressaceae and Gramineae pollens, which were sampled with Durham's samples from
      January to June, were sent from seven sampling locations in our city. The number
      of pollens was counted in our hospital. The total number of patients with
      pollinosis over the seven years was 4193. Females were numerous than males by one
      and a half times. The age group with the highest incidence was the thirties
      (41.9%), followed by the twenties (19.8%) and forties (18.4%). The incidence of
      Japanese cedar pollinosis was 92.6 percent and grass pollinosis 30.3 percent of
      all the patients because 23.0% of them overlapped. We found that the severity of
      nose and eye complaints and other symptoms of pollinosis in our study was milder
      than that in Tokyo and other Kanto districts. Annual changes in total pollen
      counts were remarkable, and a high incidence of Japanese cedar pollinosis was
      found as total pollen counts of Cryptomeria j. and Cupressaceae increased in
      Fukuoka City.

PMID- 2241586
TI  - [Studies on antibiotic skin testing].
AB  - Commercially available antibiotics for injection are supplied with test ampules.
      Users are instructed to dissolve them to make 300 micrograms/ml solution for
      intradermal pretests to avoid allergic reactions. Sometimes this concentration is
      too low to prevent anaphylactic reactions. In the present study, we tried to find
      the maximum concentration for the intradermal tests which would have high
      sensitivity without giving nonspecific, false positive reactions. We investigated
      intradermal tests with cephalothin (CET) in a patient who suffered from
      anaphylaxis after drip infusion with CET, although she was judged to be negative
      to CET by the usual intradermal test prior to the infusion. Her CET skin test was
      negative at a concentration of 150 micrograms/ml and positive at 300
      micrograms/ml 6 weeks after anaphylaxis, but negative at 300 micrograms/ml and
      positive at 1000 micrograms/ml 4 and 7 years after anaphylaxis. Prick tests were
      always negative, even with the maximum soluble concentration of CET, 200 mg/ml.
      Nonspecific reactions to intradermal tests at concentrations as high as 1000
      micrograms/ml were examined with 20 kinds of penicillins and cephems in 51
      healthy subjects without histories of drug allergies. Very few false positive
      reactions were observed, except in 5 out of 24 cases with cefotiam. Intradermal
      tests at 3000 micrograms/ml, however, frequently resulted in nonspecific
      reactions. We conclude that 1000 micrograms/ml, not 300 micrograms/ml solutions
      should be used for intradermal tests to prevent allergic reactions to the
      injection of antibiotics.

PMID- 2241587
TI  - [A case of suspected allergic granulomatosis and angiitis with a rapid clinical
      course of paraplegia].
AB  - A 68-year-old man with suspected allergic granulomatosis and angiitis is
      reported. He had received 10 mg of prednisolone daily since July 1988 for asthma.
      He abruptly developed muscle weakness of the lower extremities, followed two days
      later by paraplegia. Six days after the onset of the muscle weakness, he was
      hospitalized. He showed disturbance of recent memory, disorientation, neck
      rigidity, paraplegia, mild muscle fasciculation and hypesthesia. He also showed
      paralytic ileus. Laboratory findings showed leukocytosis (24580/mm3),
      eosinophilia (56% of the peripheral white blood cells and 19% of the cells in the
      cerebrospinal fluid), on erythrocyte sedimentation rate of 31 mm/h, and the IgE
      level of 1200 IU/ml. The ECG showed loss of the r-wave in V1 and V2. A
      granulomatous lesion anterior to the spinal cord was found on myelography and
      MRI. Prednisolone was given at a dose of 60 mg daily resulting in improvement of
      the clinical symptoms and eosinophilia. There was disappearance of the granuloma
      on MRI performed after prednisolone therapy. Despite the severe manifestation of
      allergic granulomatosis and angiitis, prednisolone therapy had a marked effect in
      this patient. The granulomatous lesion anterior to the spinal cord shown by MRI
      suggested an eosinophilic granuloma, and may have been the etiology of some of
      the neurological symptoms.

PMID- 2241588
TI  - Participation of granulocyte-macrophage colony stimulating factor, interleukin-1
      and dendritic cells in concanavalin A-induced T cell responses in human.
AB  - The effects of IL-1 and GM-CSF on accessory function of macrophages and dendritic
      cells (DC) in Con A-induced T cell responses were investigated. The accessory
      cells were separated from adherent cells of human peripheral mononuclear cells.
      The accessory function of DC was found to be stronger than that of macrophages.
      IL-1 and GM-CSF significantly enhanced the T cell responses by augmenting the
      accessory function of DC in a dose-dependent manner (p less than 0.01), whereas
      these monokines produced no augmentative effects on macrophages, nor facilitated
      T cell responses without DC.

PMID- 2241589
TI  - Effective therapy with low dose of oral cyclosporine A and prednisolone for
      alopecia universalis.
AB  - Although alopecia universalis is an incurable disease, we have obtained favorable
      results using a low dose of 2.5 mg/kg of cyclosporine A and 5 mg/day of
      prednisolone without adverse effects. We report our clinical experience of the
      treatment of two cases of alopecia universalis. Immunological examinations showed
      marked changes in the ratio of T cell subsets in peripheral blood. There was an
      increase of OKT8 positive cells and NK cells, reduction of IL-2R positive cells.
      These immunological changes following recovery from alopecia suggest a
      correlation between immunological disorders and the pathogenesis of this disease
      (alopecia universalis).

PMID- 2241590
TI  - Powerful or powerless: nurses in the work environment.

PMID- 2241591
TI  - Leadership in nursing--what do you think?

PMID- 2241592
TI  - [Ranitidine in duodenal ulcer. A Brazilian multicenter trial with a single daily
      dose].

PMID- 2241593
TI  - [Is it necessary to perform routine intraoperative cholangiography during
      cholecystectomy?].
AB  - The intraoperative cholangiography was carried out in 361 patients with gallstone
      disease. In 293 (81.16%) patients cholangiography was normal, in 68 (18.83%) was
      abnormal. Thirty-six (9.97%) patients had pre-operative asymptomatic common bile
      duct calculi and 20 (5.54%) patients had confirmed suspect of common bile duct
      calculi during cholangiography. Twelve (3.32%) patients were false-positive and
      one (0.27%) was false-negative. It is discussed the value of routine
      intraoperative cholangiography in patients with gallstone disease.

PMID- 2241594
TI  - [Non-coronary chest pain: esophageal evaluation in 27 patients].
AB  - The authors analyse the clinical features of 27 patients with non-coronary chest
      pain. They applied specific questionnaire and used esophageal function tests. The
      pain features were very similar to coronary patients, but there was a strict
      relationship with emotional stress. Esophageal symptoms were found in about 50%
      of patients. Eighty-five, one percent of the patients, presented with some
      abnormalities; 33.3% of the total group with esophagitis and 66.6% with motor
      disorders; some patients presented overlapping pictures. Three patients had
      duodenal ulcer. The patients were classified as having pain of proved (18.5%), or
      suspected (66.6%) esophageal origin. Twenty of these patients were followed and
      those with esophagitis and/or duodenal ulcer had a good response to specific
      treatment. The author stress the importance of showing the patients the benign
      nature of this disease. In the present group of patients, the actual diagnosis
      was more important in obtaining good therapeutic response than classifying the
      pain as above.

PMID- 2241595
TI  - [Single nocturnal dose of ranitidine in the treatment of duodenal ulcer: results
      of an open multicenter, comparative trial].
AB  - This prospective multicentric randomized open trial was designed to evaluate the
      efficacy of ranitidine 150 mg bid vs 300 mg nocte in the short-term (4 weeks)
      treatment of duodenal ulcer in 15 Brazilian centers. On the basis of a
      randomization table 190 patients with endoscopically confirmed duodenal ulcer
      were allocated to receive either ranitidine 150 mg bid (94 pts) or 300 mg nocte
      (96 pts). The 2 treatment groups were well matched for age, sex, duration of
      ulcer disease, number and size of ulcers, duration of current episode, intensity
      of ulcer pain, alcohol and coffee intake and smoking habits. They were
      endoscopically controlled at the end of the 4 weeks. At 4 weeks 78 of 94 patients
      (83.0%) had their ulcers healed with the 150 mg bid regimen as opposed to 79 of
      96 patients (82.3%) allocated to the 300 mg nocte dosage. This difference was not
      statistically significant. Ulcer symptoms diminished with treatment in both
      groups. The tolerability and compliance was excellent in both groups. The results
      show that ranitidine 300 mg nocte is as effective in the short-term treatment of
      duodenal ulcer as ranitidine 150 mg bid. Considering the greater simplicity of
      administration enhancing patient compliance, the treatment with 300 mg nocte is
      preferable.

PMID- 2241596
TI  - [Carcinoid of Meckel's diverticulum. Report of a case and review of the
      literature].
AB  - The presence of carcinoid tumor in a Meckel's diverticulum is a rare entity. This
      report describes a 56-year-old man who was admitted to hospital with symptomatic
      gallbladder stones. At laparotomy the gallstones were confirmed and routine
      exploration of the peritoneal cavity identified a small bowel diverticulum about
      60 cm of the ileocecal valve. Cholecystectomy and resection of a small bowel
      segment containing the diverticulum were performed. Histology revealed carcinoid
      tumour in Meckel's diverticulum.

PMID- 2241597
TI  - [Menetrier's disease in children: report of 3 cases and review of the
      literature].
AB  - Three cases of Menetrier's disease in childhood are reported and 38 other cases
      previously described in the literature are reviewed. The disease manifests in
      children as a protein-losing gastropathy and a characteristic hypertrophic
      gastric rugae is demonstrated by upper gastrointestinal radiographs or endoscopy.
      In contrast to the usual chronicity of the disease in adults, the course is
      usually benign in children and the symptoms resolve spontaneously in weeks or
      months. The possible etiology and differential diagnosis are discussed.
      Menetrier's disease in children may be more common than report.

PMID- 2241598
TI  - Effectiveness of push/pull hemodiafiltration using large-pore membrane for
      shoulder joint pain in long-term dialysis patients.
AB  - Long-term hemodialysis (HD) patients complaining of shoulder joint pain were
      treated by HD and by push/pull HDF using high-flux synthetic membranes with large
      pores (Asahi PAN 20CX2) for 2 weeks. The results showed no significant difference
      in Kt/Vurea between HD and push/pull HDF. Nevertheless, reduction of the plasma
      beta 2-microglobulin was greater during push/pull HDF than during HD. These
      findings can be explained by far more convective flux in push/pull HDF than in
      HD: nearly 30 L during push/pull HDF vs. 3 L during HD. In the present study,
      there was no alleviation of the shoulder joint pain during HD treatment, whereas
      marked relief of the symptom was found during push/pull HDF treatment. Since the
      two treatment modalities differ simply in their efficiency in removing larger
      molecular weight substances, the joint pain alleviation effected by push/pull HDF
      could well be ascribed to elimination of an unknown larger molecular weight
      substance causing this symptom. However, a considerable amount of beta 2
      microglobulin was removed both by HD and push/pull HDF. Therefore, the substance
      causing the joint pain might be larger than beta 2-microglobulin.

PMID- 2241599
TI  - Gas supply across membranes in bioreactors for hepatocyte culture.
AB  - The conditions required for hepatocyte cultures is a main topic in the
      development of bioreactors for hybrid liver support systems. The detoxification
      of ammonia and the synthesis of urea due to primary isolated hepatocytes was
      measured in order to compare two different models of gas supply in bioreactors:
      (a) indirect medium oxygenation and (b) direct membrane-contact oxygenation of
      the hepatocytes using polypropylene membranes. Increasing oxygen pressure
      promoted cell function. At day 6 of culture, urea synthesis was 0.8 +/- 0.3 mM in
      21% of O2 cultures and 1.5 +/- 0.1 mM in oxygenated cultures. Alkalosis due to
      CO2 loss decreased ammonia metabolism. The direct membrane-contact oxygenation
      resulted in enhanced cell metabolism in comparison to medium oxygenation: urea
      synthesis at day six was 1.42 +/- 0.2 mM in 21% O2 cultures. Polypropylene
      oxygenation membranes proved to be sufficient for hepatocyte adhesion. Two
      functions can be integrated in one element in liver support systems using the
      investigated polypropylene membrane and the direct membrane-contact oxygenation:
      oxygenation with physiological oxygen pressure in bioreactors due to gas supply
      across the membrane and adhesion of hepatocytes in bioreactors on the membrane.

PMID- 2241600
TI  - Selective removal of anti-acetylcholine receptor antibodies and IgG in vitro with
      an immunoadsorbent containing immobilized sulfathiazole.
AB  - Adsorption therapy, which treats the autoimmune disease by the selective removal
      of pathogenic substances from the blood, is an active subject. In this therapy,
      bioactive molecules such as antigen, antibodies and protein A are usually used as
      affinity-ligands. The disadvantages of using these substances as affinity-ligands
      are the availability, sterilizability, and ability to cause antigenic reactions.
      After surveying hundreds of synthetic compounds, it was found that polyacrylic
      beads [Eupergit C (EC)] immobilized covalently with sulfathiazole (ST) are an
      ideal biomimetic ligand for the selective adsorption of IgG (24.3 +/- 0.4 mg
      IgG/g wet beads). In an in vitro study, this adsorbent selectively removed the
      antiacetylcholine (AChR) receptor antibody of myasthenia gravis (MG) patients.
      Further experiments demonstrated that the Fab fragment was adsorbed three times
      more efficiently than the Fc fragment of IgG.

PMID- 2241601
TI  - A large-scale magnetic separator for selective cell separations with paramagnetic
      microbeads.
AB  - An improved magnetic separator has been developed for use in large-scale cell
      separations. This separation method uses paramagnetic microbeads coated with
      antibodies that selectively bind to target cells. The magnetic separator attracts
      the microbead-target cell aggregates and holds these aggregates at its surface
      while the suspending fluid and nontarget cells flow past. The optimum separator
      design was determined to be two magnetic assemblies in series along with a
      peristaltic pump. The assemblies consist of neodymium-iron-boron magnet bars
      sandwiched between steel bars (magnetic pole pieces). The size and pole spacing
      of the two magnetic assemblies are designed to be different, so that the first
      assembly, which captures greater than 99.99% of the microbeads, has good magnetic
      reach-out and a high magnetic holding force at its surface, while the second
      assembly has an even higher magnetic holding force at its surface. Studies show
      that the separator can remove 1 x 10(10) microbeads from a suspension of red
      blood cells processed at a flow rate of 9 ml/min, so that no microbeads are
      detected in the effluent.

PMID- 2241602
TI  - Quantification of perivalvular thrombus formation in blood pumps by polar
      coordinate mapping.
AB  - A polar coordinate mapping technique (PCMT) to quantitatively describe
      perivalvular thrombus formation was applied in the examination of prosthetic
      valves from paracorporeal assist devices. The method begins by photographing the
      upstream and downstream views of the freshly retrieved valves using transparency
      film. The valve images are then projected onto 10 x planforms of the valves, and
      the boundaries of the observable thrombi are traced. The radial thrombus length
      is then measured at 5 degrees increments and plotted on Cartesian coordinates as
      a function of polar coordinate. Mean radial thrombus length and incidence of
      thrombus are calculated. Statistical analysis can then be used to test for
      differences in the length, incidence, and pattern of thrombus formation between
      test groups. The effect of valve selection, anti-coagulant regime, and other
      factors that influence thrombus formation can be quantitatively compared with the
      PCMT. Consequently, the PCMT could be a valuable assessment tool for efforts
      being made to reduce thrombosis in prosthetic blood pumps.

PMID- 2241603
TI  - Endothelial cell seeding of small diameter vascular grafts.
AB  - This study examines, under flow conditions, the adhesion of endothelial cells to
      3 mm diameter fibronectin (Fn)-coated expanded polytetrafluoroethylene (PTFE)
      vascular grafts. Cultured ovine carotid artery endothelial cells were labelled
      with 35S-methionine. The grafts were seeded with endothelial cells (1.5 x
      10(6)/ml) by rolling for 1 h at 37 degrees C and then either cultured to
      confluence for 48 h or flow tested immediately. Cell attachment to grafts (n = 5)
      was evaluated in an in vitro flow circuit, using flows of up to 330 ml/min. Ex
      vivo studies (n = 5 grafts) were conducted without anticoagulant using autologous
      cells in a sheep model. Grafts were inserted into an externalized carotid-jugular
      shunt and exposed to blood flows of approximately 150 ml/min for 3 h. One hour
      seeded and 48 h cultured grafts demonstrated greater than 95% cell retention
      following in vitro flow studies. Ex vivo studies of 48 h cultured grafts gave
      endothelial cell retention of 81% with no sign of thrombogenicity. Furthermore, a
      preliminary 24 h ex vivo study has shown greater than 95% retention. This study
      demonstrates the firm attachment of seeded endothelial cells to Fn-coated PTFE
      grafts in the sheep model.

PMID- 2241604
TI  - A new multilayered composite hollow fiber membrane for artificial lung.
AB  - The gas transfer performances in a gas/membrane/liquid system were investigated
      in detail with various membranes. It was found that the oxygen flux in the
      gas/membrane/liquid system was saturated when the oxygen flux (Fg-g) in the
      gas/membrane/gas system became more than 1.0 x 10(-5) cm3 (STP) cm-2s-1cm Hg-1
      (Fcg-g). This was explained as follows: The resistance of a boundary layer at
      liquid phase is dominant, i.e., the membrane resistance is negligible in the
      region of Fg-g which is greater than Fcg-g. Consequently, Fg-g of the membrane
      should be designed to be greater than Fcg-g, in order to satisfy the gas transfer
      performance required for blood oxygenation. On the basis of the results above, we
      have developed a new three-layered composite hollow fiber membrane (MHF)
      consisting of an ultrathin polyurethane layer supported between two microporous
      polyethylene layers to prevent serum leakage. It was shown through the evaluation
      in vitro that MHF had good gas transfer performances for long-term perfusion, and
      no serum leakage was observed. These characteristics suggest that MHF is quite
      suitable for long-term usage such as extracorporeal membrane oxygenation (ECMO).

PMID- 2241606
TI  - Transesophageal echocardiographic findings of intracardiac events during cardiac
      assist.
AB  - Transesophageal echocardiography (TEE) is an easy, noninvasive and reproducible
      method for evaluation of left ventricular function, coronary flow patterns, and
      intracardiac blood flow patterns during cardial assist. TEE facilitated better
      management of the patients with LVAD and gave us the various information: (a)
      Observing the drawing catheter tip by TEE, it could be settled just above the
      mitral orifice to obtain the maximum bypass flow; in addition, dislocation of the
      catheter tip could be easily diagnosed. (b) The intracardiac thrombus could be
      clearly detected by TEE; it was removed without complications, weaning from left
      ventricular assist device (LVAD). (c) The left ventricular wall motion was
      periodically observed. The end systolic LV diameter (Ds) was decreasing and
      fractional shortening (%FS) was increasing as the natural heart recovery.
      Additionally, the preejection period (PEP) and the ejection time (ET) were
      measured. The ratio of PEP/ET was decreasing gradually. Ds did not alter with
      preload change during on-off testing unlike the other parameters. Ds seems to be
      the most reliable parameter for the natural heart recovery within certain amounts
      of bypass flow. (d) The flow velocity in the left anterior descending coronary
      artery could be measured by transesophageal Doppler method; it was clinically
      shown that counterpulsation produced a larger amount of coronary blood flow than
      copulsation.

PMID- 2241605
TI  - Noise level and perception of the closing click after heart valve replacement
      with St. Jude Medical and Bjork Shiley Monostrut prostheses.
AB  - The metallic click generated by the closure of mechanical heart valve prostheses
      may severely bother patients, but generated sound energy and the extent of
      complaints after implantation are not known. In 62 patients, after valve
      replacement with St. Jude Medical (SJM) (n = 35) and Bjork Shiley Monostrut (BSM)
      (n = 27) prostheses, sound energy was recorded with a calibrated noise level
      analyzer at 5, 10, and 100 cm distance from patients and correlated with their
      complaints. At a distance of 100 cm, the BSM valves produced a significantly
      higher sound pressure level, 30.5 +/- 5 db(A), compared to the SJM valves, 24.1
      +/- 4 db(A) (p = 0.0001). There was no significant difference at shorter
      distances. After splitting into frequency bands the highest sound pressure levels
      were observed in the high frequency ranges (8 to 16 kHz) representing the
      metallic click. BSM valves produced higher sound levels in all frequency ranges
      at 1 m distance. Seventy-three percent of all patients were aware of the noise
      generated by the valve; 20% had disturbed sleep; and 26% preferred a less noisy
      valve type. Twelve of 27 patients with BSM valves wanted less noisy valves,
      whereas only 4 of 35 patients with SJM valves wished to have a less noisy valve
      type (Chi-square p = 0.003). In patients who could hear their valve measured,
      sound level was higher than in patients who could not. In 9 of 27 patients with
      BSM (33%), versus 3 of 35 with SJM prostheses (9%), the clicking caused sleep
      disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241607
TI  - Analysis of clinical factors for survival after left and biventricular bypass
      using centrifugal pump following open heart surgery in infants and adults.
AB  - A total of eight patients, including three infants, received left or
      biventricular assist using centrifugal pump (CFP) following open heart surgery.
      Three infants, aged 9-11 months and with complex cardiac lesions, were supported
      by left heart bypass (LHB) using pediatric type CFP for 63 h, 64 h, and 13 days.
      All were weaned from LHB, but long-term survival was not obtained, mainly due to
      complications. In five adult patients, LHB alone was used in three, and
      biventricular support in two for 33-240 h with three survivals. The factors
      related to unsuccessful recovery were delayed start of support and multiorgan
      failure.

PMID- 2241608
TI  - Glued carbon fiber electrodes for diaphragm pacing.
AB  - Carbon fibers with fibrin glue were used as electrodes for diaphragm pacing. The
      electrodes were applied to three mongrel dogs and the effectiveness was tested.
      The carbon leads were glued to phrenic nerves by means of the fibrinogen and
      thrombin bilaterally. The tidal volumes and threshold current level for
      stimulation were measured at various time up to 9 weeks after implantation.
      Effective contraction of diaphragm were observed for 9 weeks. By using this
      electrode, the exfoliation of the nerve is not necessary, the nerve can be
      maintained in an intact state, and the risk of the implanting operation can be
      minimized.

PMID- 2241610
TI  - Strokes associated with cocaine use.

PMID- 2241609
TI  - Rolling chair sign.

PMID- 2241611
TI  - The practice of neurology.

PMID- 2241612
TI  - The influence of hyperglycemia and diabetes mellitus on immediate and 3-month
      morbidity and mortality after acute stroke.
AB  - Fasting serum glucose, glycosylated hemoglobin, and fructosamine concentrations
      were determined in 304 consecutive subjects admitted with acute stroke, within 48
      hours of ictus. Based on the medical history and these results, subjects were
      divided into known diabetics, newly diagnosed diabetics, subjects with stress
      hyperglycemia, and nondiabetics. The type of stroke was classified as lacunar
      infarct, cerebral infarct, or intracerebral hemorrhage, based on clinical
      examination by a neurologist and computed tomographic brain scan and/or autopsy.
      Immediate and 3-month outcomes were examined in relation to (1) fasting glucose,
      glycosylated hemoglobin, and fructosamine levels by stroke subtypes, and (2)
      glucose tolerance categories by stroke subtypes. A high fasting glucose level was
      associated with an increased mortality, but this was observed only among patients
      with intracerebral hemorrhage. Patients with stress hyperglycemia, but not
      diabetics, had increased mortality. In spite of having similar glucose
      concentrations to those patients with stress hyperglycemia, diabetics did not
      have a worse outcome compared with nondiabetics. It is concluded that the
      association between glucose concentration and outcome is a reflection of stress
      relating to stroke severity, rather than a direct harmful effect of glucose on
      damaged neurons.

PMID- 2241613
TI  - Circadian variation in onset of acute ischemic stroke.
AB  - A circadian pattern for the onset of myocardial and cerebral infarction has been
      identified. To evaluate this phenomenon further, we analyzed prospectively
      collected data from 151 patients with acute ischemic stroke. The number of
      strokes per 6-hour period were the following: midnight to 6 AM, 20 (13%); 6 AM to
      noon, 86 (57%); noon to 6 PM, 21 (14%); and 6 PM to midnight, 24 (16%). This
      pattern was not affected by previous use of aspirin. The most frequent time of
      onset was 6 AM to noon for all subgroups of ischemic stroke: small artery, 71%;
      cardioembolic, 62%; large artery atherothrombotic, 57%; large artery
      atheroembolic, 46%; and "other" or unknown cause, 40%. We also investigated the
      time between awakening and stroke onset in 145 patients and found that 24% of
      ischemic strokes occurred within the first hour after awakening. Our data
      demonstrate that an early morning peak exists for all subtypes of stroke. Our
      data also suggest that the most critical period is the first hour after
      awakening.

PMID- 2241614
TI  - Nontraumatic coma. Glasgow coma score and coma etiology as predictors of 2-week
      outcome.
AB  - In 1987 and 1988, we carried out a prospective study of patients older than 10
      years with nontraumatic coma in the intensive care units of Columbia-Presbyterian
      Medical Center, New York, NY. Of 188 patients with Glasgow Coma Scale (GCS)
      determinations within 72 hours, 61% were dead or in persistent coma by 2 weeks
      from onset. Age, sex, and ethnicity did not influence outcome. The 2-week outcome
      for patients with initial GCS of 3 to 5 was 14.8% awake; 85.2% were dead or in
      persistent coma. For the GCS 6 to 8 group, 53.1% were awake and 46.9% were dead
      or in persistent coma. Hypoxic or ischemic coma had the worst 2-week outcome (79%
      dead or comatose); coma caused by metabolic disease or sepsis (68%), focal
      cerebral lesions (66%), and general cerebral diseases (55%) were intermediate,
      while drug-induced coma had a favorable outcome (27% dead or comatose). The
      independent predictors of 2-week outcome were the first GCS and drug-induced
      coma. The predicted probability of waking at 2 weeks was eight times better for
      drug-induced coma than other causes when GCS was held constant. Patients with an
      initial GCS score of 6 to 8 were seven times more likely to waken than those with
      a score of 3 to 5. The motor subscore alone was a significant independent
      predictor of 2-week outcome. Modification of coma score to include etiology may
      give more accurate predictions of 2-week outcome after nontraumatic coma.

PMID- 2241615
TI  - Quantitative electroencephalographic correlates of cognitive decline in normal
      elderly subjects.
AB  - We obtained a topographic computer analysis of the electroencephalogram in 53
      normal elderly subjects. Normal aging was not associated with an increase in slow
      (delta) activity. However, cognitive performance correlated positively with fast
      (beta) activity particularly in frontal leads, even after controlling for age,
      education, occupation, and medication. Five subjects who showed early signs of
      cognitive decline, had all a marked reduction in beta activity suggesting that
      this may be an early indication of intellectual loss.

PMID- 2241616
TI  - Screening for early dementia using memory complaints from patients and relatives.
AB  - This study examined whether the subjective impression of memory function might
      differentiate healthy elderly subjects from patients with memory complaints, and
      whether memory complaints differed between patients with and without a dementing
      illness. Both self-assessment and relatives' responses on a new memory
      questionnaire differentiated patient groups from control subjects. The relatives'
      form measuring deterioration in memory function over time identified dementing
      individuals from those with non-dementing causes for their memory complaints.
      Factor analysis indicated that patients' memory complaints correlated with
      depression rather than objective memory performance, while relatives' ratings
      correlated with objective memory scores, not depression. Stepwise discriminant
      function analyses showed that objective memory testing greatly improved
      specificity but not sensitivity of the subjective memory questionnaire alone.

PMID- 2241617
TI  - Magnetic resonance imaging of the human lateral geniculate body.
AB  - We used magnetic resonance imaging to map the human lateral geniculate body. The
      optimal imaging plane was determined by obtaining axial and coronal scans in two
      normal brains obtained at autopsy. The brain specimens were then sectioned and
      individual slices were compared with matching magnetic resonance images. After
      the lateral geniculate body was identified using this correlative anatomic
      approach, the nucleus was imaged in four normal subjects.

PMID- 2241618
TI  - Variable expressivity in familial restless legs syndrome.
AB  - A 62-year-old man with a 20-year history of excessive daytime somnolence and
      kicking during sleep was an obligate carrier of the restless legs syndrome gene
      because his paternal grandfather, father, and all three of his children had
      symptoms of restless legs syndrome. The patient himself, however, denied motor
      restlessness after a careful and exhaustive medical history and he was originally
      believed to have periodic movements in sleep without restless legs. Close
      clinical observation did reveal nighttime motor restlessness, although the
      patient continued to deny its importance. Polysomnography showed frequent
      periodic movements in sleep. We conclude that there can be variable expressivity
      of the clinical features in familial restless legs syndrome and that there are
      probably some relatively nonrestless patients with prominent periodic movements
      in sleep who are carriers of the restless legs syndrome gene. Some sleep
      disordered patients who are believed to have only periodic movements in sleep may
      have a forme fruste of autosomal dominant restless legs syndrome. If one does not
      examine these patients carefully at night and take an adequate family history,
      one may miss the diagnosis of restless legs syndrome.

PMID- 2241619
TI  - Asthma and eczema in children born to women with migraine.
AB  - Migraine and asthma have been reported to occur in the same person more commonly
      than would be expected if they are independent. The large Collaborative Perinatal
      Project provided an opportunity to see if children born to women with migraine or
      with the group of disorders characterized by asthma and/or allergies were more
      likely to manifest asthma or eczema in the first 7 years of life. Among children
      whose mothers had neither migraine nor asthma/allergies, 3.2% had asthma. Of
      children whose mothers had migraine, but not asthma/allergies, more than 6% had
      asthma. The risk of asthma among children born to women who had both migraine and
      asthma/allergies was greater than the risk associated with each maternal disease.
      The risk of eczema in children was not appreciably influenced by the mother's
      propensity to migraine or asthma/allergies. The results of this first study of
      migraine in one generation and asthma in the next lead to the conclusion that the
      two disorders are probably related.

PMID- 2241620
TI  - Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984.
AB  - The incidence of hemifacial spasm in residents of Olmsted County, Minnesota, was
      studied by reviewing the medical records of patients residing in the community
      between 1960 and 1984. The average annual incidence rate was 0.74 per 100,000 in
      men and 0.81 per 100,000 in women, age-adjusted to the 1970 US white population.
      The average prevalence rate was 7.4 per 100,000 population in men and 14.5 per
      100,000 in women. The incidence and prevalence rates were highest in those from
      40 to 79 years of age.

PMID- 2241621
TI  - Temporoparietal cortex in aphasia. Evidence from positron emission tomography.
AB  - Forty-four aphasic patients were examined with (F18)-fluorodeoxyglucose positron
      emission tomography in a resting state to determine whether consistent glucose
      metabolic abnormalities were present. Ninety-seven percent of subjects showed
      metabolic abnormalities in the angular gyrus, 89% in the supramarginal gyrus, and
      87% in the lateral and transverse superior temporal gyrus. Pearson product moment
      correlations were calculated between regional metabolic measures and performance
      on the Western Aphasia Battery. No significant correlations were found between
      the Western Aphasia Battery scores and right hemisphere metabolic measures. Most
      left hemisphere regions correlated with more than one score from the Western
      Aphasia Battery. Temporal but not frontal regions had significant correlations to
      the comprehension score. The left temporoparietal region was consistently
      affected in these subjects, suggesting that common features in the aphasias were
      caused by left temporoparietal dysfunction, while behavioral differences resulted
      from (1) the extent of temporoparietal changes, and (2) dysfunction elsewhere in
      the brain, particularly the left frontal and subcortical areas.

PMID- 2241622
TI  - The Marinesco-Sjogren syndrome examined by computed tomography, magnetic
      resonance, and 18F-2-fluoro-2-deoxy-D-glucose and positron emission tomography.
AB  - The Marinesco-Sjogren syndrome is an autosomal recessive degenerative disorder
      characterized by congenital cataracts, cerebellar ataxia, spasticity, mental
      deficiency, and skeletal abnormalities. We studied two adult siblings with
      Marinesco-Sjogren syndrome using anatomic and metabolic brain imaging techniques
      to characterize the pattern and nature of abnormalities in the brain. Computed
      tomographic and magnetic resonance imaging showed diffuse brain atrophy of mild
      to moderate degree, involving primarily the white matter of the cerebrum,
      cerebellum, brain stem, and cervical spinal cord. The pattern of atrophy
      resembled that seen in diffuse leukoencephalopathies. Measurements of local
      cerebral glucose metabolic rates with positron emission tomography revealed no
      statistically significant differences from normal control subjects in most
      regions, but metabolic rate was decreased in the thalamus in one patient. The
      findings support a diffuse white matter disorder in Marinesco-Sjogren syndrome.

PMID- 2241623
TI  - Unusual cerebral manifestations in hereditary fructose intolerance.
AB  - Five children with hereditary fructose intolerance developed symptoms of
      neurological impairment. In three of them, neurological involvement was related
      to the acute hepatic toxicity of fructose (hypoglycemia, abnormal coagulation,
      cardiovascular collapse); in the other two, such a relationship could not be
      demonstrated. Neurological impairment is not classic in hereditary fructose
      intolerance, but its occurrence in the acute phase of the disease is possible and
      does not constitute an argument against the diagnosis.

PMID- 2241624
TI  - Background review and current concepts of reperfusion injury.
AB  - We define the concept of reperfusion injury, and we present a background
      chronology of experimental work supporting and questioning this concept. We
      identify several new influences, such as current clinical interest in
      thrombolytic therapy for acute ischemia of heart and brain and the growing
      recognition of endothelium as a regulator of homeostasis. We propose that these
      influences will encourage a reexamination of reperfusion injury as a factor in
      the ultimate outcome of tissue exposed to reversible ischemia. We briefly discuss
      the major mechanisms presently implicated in reperfusion injury--loss of calcium
      homeostasis, free radical generation, leukocyte-mediated injury, and acute
      hypercholesterolemia.

PMID- 2241625
TI  - Aplasia cutis congenita and arteriovenous fistula. Case report and review.
AB  - We describe a child with congenital aplasia cutis congenita of the scalp and an
      occult giant posterior fossa arteriovenous fistula. Previous case reports of
      central nervous system malformations associated with aplasia cutis congenita are
      reviewed. The exact incidence of such malformations is unknown. All patients with
      aplasia cutis congenita should undergo a neurologic evaluation, and their
      families should be examined for similar lesions. Early central nervous system
      imaging and other workup may be required, especially if plastic surgery in the
      head region is being planned.

PMID- 2241626
TI  - Retrovirus from human T-cell leukemia virus type I-associated myelopathy is the
      same strain as a prototype human T-cell leukemia virus type I.
AB  - A retrovirus was isolated from a T-cell line that was established from
      lymphocytes in the cerebrospinal fluid of a patient with human T-cell leukemia
      virus type I-associated myelopathy (HAM), and its genome was sequenced. The
      nucleotide sequence of the 3' half of the total genome was identical in 99.5% of
      the nucleotides to that of the prototype human T-cell leukemia virus type I that
      was derived from a patient with adult T-cell leukemia. These results indicate
      that the same retrovirus human T-cell leukemia virus type I is associated with
      both a neurological disease, HAM, and a lymphoproliferative disease, adult T-cell
      leukemia.

PMID- 2241627
TI  - Union amalgamations--what happens to nurses?

PMID- 2241628
TI  - About a peculiar disease. Interview by Gay Hudson.

PMID- 2241629
TI  - Uniform view.

PMID- 2241630
TI  - A visit to the Nightingale Museum.

PMID- 2241631
TI  - Occupational health v occupational diseases.

PMID- 2241632
TI  - The third age. How to get the best out of your SMTs.

PMID- 2241633
TI  - Metoclopramide--acute dystonic reactions.

PMID- 2241634
TI  - A nursing narrative.

PMID- 2241635
TI  - Current status of nuclear power in the United States and around the world.
AB  - Nuclear energy's share of the world electricity market has been growing over the
      past 35 years. In 1989, eight generating units entered commercial operation
      abroad and three new units were licensed in the U.S. In early 1990, Mexico became
      the 26th country to produce electricity from nuclear power. Currently the 426
      operating reactors supply one sixth of the world's total electrical capacity.
      Fourteen countries have now operated nuclear plants for 20 or more years. Since
      1980, France has been the leader in the use of nuclear power and currently
      generates three quarters of its electricity from 54 nuclear plants. The U.S. has
      112 nuclear plants, the largest number of any country in the world. These plants
      satisfy almost 20 percent of U.S. electrical energy requirements. Last year Three
      Mile Island, the would-be icon for everything that is wrong with the nuclear
      industry was rated as the most efficient nuclear plant in the world. The
      worldwide trend toward acceptance of nuclear is improving slightly, but many
      political and societal issues need to be resolved. Whereas recent polls indicate
      that a majority of the people realize nuclear must be a major contributor to the
      energy mix of the future, many are reluctant to support the technology until the
      issue of waste disposal has been resolved. Fears of another Chernobyl, lack of
      capital, and a new anti-nuclear campaign by Greenpeace will keep the nuclear
      debate alive in many countries. Additional stumbling blocks in the U.S. include
      the need to develop a new generation of improved reactor designs which emphasize
      passive safety features, standardized designs and a stream-lined federal
      licensing process. Nuclear power is really not dead. Even environmentalists are
      starting to give it another look. A nuclear renaissance will occur in the U.S.
      How soon or under what conditions remain to be seen. The next crisis in the U.S.
      will not be a shortage of energy, rather a shortage of electricity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2241636
TI  - Determination of total body water by Fourier transform infrared analysis.
AB  - A new technique for determining body water using deuterium isotope dilution and
      Fourier transform infrared (FTIR) analysis is described. The advantages of the
      FTIR over conventional dispersion and filter infrared instruments include greater
      flexibility through computer controlled operations and availability of 'on-line'
      analytical software. The technique was further improved by the development of a
      simple procedure for determining D2O concentration in untreated serum samples. A
      validation study of six normal adults showed that the fat-free-mass determined
      from the deuterium-space (total body water) correlated well with the results
      obtained by total body nitrogen (r = 0.997), total body potassium (r = 0.996) and
      anthropometric (r = 0.995) measurements.

PMID- 2241637
TI  - The production of body analogs for use in radiation physics.
AB  - Bone, muscle and lung analog materials have been produced in-house, and dosimetry
      phantoms have been produced. A method using computed tomography (CT) has been
      developed to check that the analogs produced match the radiation properties of
      body tissues. The relative electron densities and ratio of electron cross
      sections are calculated from elemental compositions of the analogs. Using these
      data the theoretical CT numbers are calculated and these numbers are compared
      with experimental CT numbers for the analogs produced. The experimental CT
      numbers are found by scanning the samples on a Siemens DRH CT scanner. Results
      show the maximum difference between theoretical and experimental CT numbers for
      the analogs is 18 Hounsfield units, which relates to a delta NCT of less than 1%.
      Comparison of analog CT numbers with CT numbers for the related patient tissues
      also shows a close match.

PMID- 2241638
TI  - Dual photon absorptiometry using a gamma camera.
AB  - The most common technique for bone mineral densitometry is Dual Photon
      Absorptiometry with a dedicated scanning device. In principle, a gamma camera
      could be adapted to perform the same function, but little work along these lines
      has been reported in the literature. Tests made using a standard gamma camera
      with a 153Gd source at the focus of a magnifying collimator show that
      satisfactory results can be obtained on water/aluminium phantoms. A calibration
      is used to help ensure long term precision and stability. Measurements made using
      the same equipment but 241Am/99mTc sources gave poor results.

PMID- 2241639
TI  - Comparative evaluation of chargers for wheelchair gel cell batteries.
AB  - This study was undertaken as part of our ongoing work to upgrade wheelchair
      quality. Laboratory tests were conducted to determine which battery chargers
      would ensure that the user's batteries are fully charged each night and also
      ensure that the battery lifetime was not diminished. Five commercial chargers
      were tested on a standardised pair of gel cell batteries of a type commonly used
      to power wheelchairs. Results of this study indicate a clear preference between
      chargers. As a result, we have changed the chargers we purchase. We anticipate
      that our clients will now experience longer life from their wheelchair gel cell
      batteries.

PMID- 2241640
TI  - Average occupational exposures.

PMID- 2241641
TI  - Percutaneous surgery and audit: a timely evaluation.

PMID- 2241642
TI  - Surgical options in ulcerative colitis: role of ileo-anal anastomosis.

PMID- 2241643
TI  - Criteria audit of percutaneous nephrolithotomies.
AB  - A criteria audit of percutaneous nephrolithotomy management is reported. One
      hundred consecutive patients who underwent percutaneous stone removal over a 3
      year period were examined. An analysis of the cases of this relatively new
      surgical procedure are presented. The audit demonstrated the surgeons' learning
      curve, the current standards achieved and changes in patient admission rate.
      Criteria auditing was used and assessed as a quality assurance activity.

PMID- 2241644
TI  - Surgical analysis and biological behaviour of 2277 basal cell carcinomas.
AB  - A total of 2277 basal cell carcinomas (BCC) treated by surgical excision over a
      twenty-year period has been followed and analysed into clinical and
      histopathological type. This paper documents the incidence of different BCC types
      and points to the importance of the infiltrating, morphoeic and multifocal types.
      Many BCC are of one homogeneous histopathological type, although others have
      important secondary characteristics which may not be obvious clinically. We
      reserve the use of the word 'infiltrating' for BCC types which show
      microscopically the following characteristics: areas with lack of palisading;
      small cell clumps; and spiky thin cords of cells projecting out with loose
      stroma. These may penetrate far and wide along tissue planes and nerves,
      producing recurrence and spread, despite apparently adequate excision. The
      infiltrating BCC may also occur secondarily with other primary BCC types,
      accounting for their--at times--unexpectedly severe effects.

PMID- 2241645
TI  - Early gastric cancer.
AB  - Eighteen cases of 'early gastric cancer' have been managed over a 14-year period.
      This represents only 3.5% of all patients diagnosed as having adenocarcinoma of
      the stomach. The symptoms of early gastric cancer are similar to those of benign
      peptic ulcer disease and differ from those of invasive disease. The pathology of
      the lesions is described and the morphology shown to be similar to that seen in
      Japan. The overall 5-year survival rate is 82% but no patient has developed
      recurrence within 5 years of surgery, confirming the biological behaviour of the
      lesion to be identical to that noted by Japanese researchers.

PMID- 2241646
TI  - Patterns of surgical treatment of breast cancer in Victoria.
AB  - We analysed data on admissions to Victorian public hospitals for surgical
      treatment of breast cancer over the period July 1985 to December 1988. Of the
      2993 women admitted, 28.7% received breast-preserving surgery. The probability of
      a woman being treated conservatively was dependent on age, with women aged less
      than 50 or more than 70 years more likely to receive breast-preserving surgery
      than women aged 50-69. There was an age-specific change, of marginal statistical
      significance, in the proportion of women receiving breast-preserving surgery over
      the period. The public hospitals admissions database is a potentially useful
      means of monitoring patterns of surgical treatment.

PMID- 2241647
TI  - Fine needle biopsy of thyroid nodules: the importance of technique.
AB  - Fine needle biopsy (FNB) is the most accurate method available for the
      investigation of single thyroid nodules. The exact technique employed, however,
      varies considerably among clinicians: in our institution the incidence of
      'inadequate' specimens produced ranges from only 13 to 62%, depending on the
      individual performing the biopsy. In a prospective in vivo study, a variety of
      biopsy techniques employing different gauge needles and differing numbers of
      passes with and without aspiration were assessed with respect to the quality of
      cytological specimen produced. Criteria assessed included the number of cells or
      sheets of cells, cell clumping, blood contamination, amount of colloid, and
      overall slide quality. Samples obtained with a 21 gauge needle without aspiration
      consistently gave best individual cell morphology. On the other hand, samples
      obtained with a 23 gauge needle with five aspirated passes through the nodule
      gave the highest yield of cells with an acceptable minimal increase in the degree
      of blood contamination and cell clumping. In order to achieve consistent yields
      from FNB of thyroid nodules, a combination of these two techniques is
      recommended.

PMID- 2241649
TI  - Villous adenomas of the duodenum and an unusual variant.
AB  - We report two cases of villous adenoma of the duodenum, one arising from the main
      papilla and the other from the accessory papilla. Both were managed by local
      resection. In one case endoscopic biopsies and intraoperative frozen sections
      were negative for carcinoma but histology of the locally resected specimen
      revealed a focus of invasive adenocarcinoma. Villous adenomas of the duodenum
      have a high risk of malignant change and foci of carcinoma can be missed on
      endoscopic biopsy. The literature is reviewed and the clinical, diagnostic,
      pathological and therapeutic aspects of villous adenomas of the duodenum are
      discussed.

PMID- 2241648
TI  - Sessile adenomas of the rectum: a personal series 1974-1984.
AB  - Sessile (villous) tumours of the rectum are uncommon and individual surgeons are
      unlikely to have wide experience in their management. A study was made of a
      unique personal series (AMC) of 104 cases encountered from 1974 to 1984; minimum
      duration of follow-up was 5 years. Clinically obvious rectal cancers were
      excluded from the study. Ages ranged from 42 to 89 years (mean 64.9 years) with a
      male:female ratio of 1.5:1. The commonest clinical presentations of sessile
      tumours of the rectum were rectal bleeding (45%) and altered bowel habit (38%).
      Hypokalaemia was a very uncommon presenting symptom (1%). These tumours ranged in
      longitudinal diameter from 1 to 9 cm, with 66% of cases greater than 3 cm and 33%
      of cases greater than 5 cm. The incidence of malignancy in sessile adenomas
      greater than 3 cm (27%) was more than triple that of adenomas less than 3 cm (8%)
      and the presence of induration on rectal examination was the most reliable
      clinical indicator of the presence of malignancy. Local transanal diathermy
      excision was a satisfactory form of treatment for most sessile tumours of the
      rectum (benign and malignant); especially if they were less than 3 cm (0%
      recurrence rate). It had the added advantage of preserving the anal sphincter and
      was possible in a higher proportion of sessile tumours in the lower half of the
      rectum (89%) than those in the upper half of the rectum (42%). The overall
      recurrence rate after local transanal excision was 8% for benign sessile adenomas
      and 33% for those containing invasive carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241650
TI  - Review of pyogenic liver abscess at the Royal Adelaide Hospital 1980-1987.
AB  - Pyogenic liver abscess is an uncommon condition which carries substantial
      morbidity and mortality if untreated. A review was undertaken of 31 patients who
      were admitted to the Royal Adelaide Hospital (RAH) between January 1980 and
      December 1987 and who were diagnosed as having pyogenic liver abscess. The aims
      of the study were to review the aetiology, current methods of investigation and
      treatment of the disease, and to formulate a management plan based on the
      findings. Hypoalbuminaemia, leukocytosis and elevated alkaline phosphatase were
      the most common findings. Hyperbilirubinaemia was not a usual feature.
      Computerised tomography (CT) scanning and ultrasound were the most useful imaging
      modalities in identification of the abscess. The sensitivity of CT scanning in
      evaluating the size of abscesses was lower than anticipated and this may lead to
      a higher than necessary rate of surgical drainage. A case is presented to
      illustrate this. Most abscesses were secondary and frequently due to extension of
      infection from biliary structures. Diseases causing diminished resistance to
      bacterial infection had a significant role in the pathogenesis. The overall
      mortality rate was 25%. Risk factors increasing mortality included advanced age,
      multiplicity of abscesses, depressed immune status and the presence of
      complications due to the abscess. Of patients who survived, four were treated
      with antibiotics alone, eleven with percutaneous drainage and antibiotics, and
      eight with surgery and antibiotics. We conclude that patients with hepatic
      abscesses should be managed initially by CT or ultrasound-guided aspiration. If
      pus is obtained a percutaneous drain should be inserted into the cavity and
      systemic antibiotics administered.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241651
TI  - Pancreatitis and pancreas divisum: aetiological and surgical considerations.
AB  - It has been suggested that acute pancreatitis occurs more commonly in patients
      with pancreas divisum and that these patients may respond to surgery aimed at
      improving pancreatic ductal drainage. We have studied the incidence of pancreas
      divisum in patients referred for endoscopic retrograde cholangio pancreatography
      (ERCP) and the results of surgical sphincteroplasty in a separate series of such
      patients. Twenty-three patients with pancreas divisum were identified among 336
      successful pancreatograms (Group A), an incidence of 6.8%. The incidence of
      pancreas divisum in patients having ERCP for documented pancreatitis was 13% (11
      of 86) compared with 4.8% (12 of 250) in those having ERCP for other indications.
      This difference was statistically significant (P less than 0.05). However,
      pancreas divisum was not the sole risk factor for pancreatitis in the majority of
      our patients; most also had one of the commonly recognized causes for their
      pancreatitis. There is dispute about the indications for surgery in patients with
      recurrent acute pancreatitis and pancreas divisum, but without any other risk
      factor. We have reviewed the results of operations on 13 patients with pancreas
      divisum (Group B) treated in four different hospitals. Surgical sphincteroplasty
      was carried out on 10 patients with documented pancreatitis and seven of these
      had good results. Three patients who had operations for pain without documented
      pancreatitis were not improved.

PMID- 2241653
TI  - Adult donor kidney transplantation in small children: a surgical technique.

PMID- 2241652
TI  - Surgical knowledge base augmentation by medical rotations: does it happen?
AB  - A study of 4 groups of fifth year medical students taking Surgery during the 4
      terms of 1989 at the University of Queensland was undertaken to determine whether
      there was assimilation of factual material relevant to the surgical knowledge
      base from the other specialty rotations done during the same year of the course.
      The records of multiple choice question (MCQ) examination results for the 210
      students were retrieved and reviewed. The performance of the same students during
      their fourth-year rotation in Surgery was checked to make sure that the 4 groups
      did not already display unusual surgical aptitude or incompetence. The questions
      were categorized in order to ascertain that the content of all the examinations
      was similar. The results of students doing Surgery during the first of the 4
      terms in 1989 were compared with subsequent groups. The difference between the
      groups was that those in the first term had not had the benefit of fifth year
      rotations through Internal Medicine, Psychiatry, General Practice and electives.
      Subsequent groups had increasing experience in the other specialties. The fourth
      and final group in the year had undertaken all four of the other rotations before
      doing Surgery. Significant improvement was found in the performance of each of
      the subsequent groups of students compared with the first-term group. This
      implies that there is an escalating accural of factual knowledge related to
      surgery from the fifth-year courses in Internal Medicine, Child Health and
      Psychiatry.

PMID- 2241654
TI  - Endoscopic management of intragastric migration of an Angelchik prosthesis.
AB  - The Angelchik prosthesis was devised as a simple surgical solution for reflux
      oesophagitis. Since 1983 there have been increasing reports of complications
      attributed to the prosthesis, the more serious being transmural erosion through
      the oesophageal or gastric wall. The majority of these have required repeat
      surgery, which is not without risks. A case report of an Angelchik prosthesis
      incompletely eroding into the stomach is presented. The prosthesis was tethered
      by a 1 cm-thick mucosal bridge which precluded simple extraction. Using an
      endoscopic sphincterotome, the bridge was divided and the prosthesis removed.
      Endoscopic methods of extracting intragastric Angelchik prostheses should be
      considered before surgery is undertaken for this complication.

PMID- 2241655
TI  - Carcinosarcoma: a rare tumour of the breast.
AB  - This report presents a case of carcinosarcoma, a rare tumour of the breast. The
      clinical and histological features and management are discussed.

PMID- 2241656
TI  - Treatment of recurrent desmoid tumour with tamoxifen.
AB  - A 30 year old woman with aggressive fibromatosis (desmoid) of the left upper arm
      and scapular region was treated with wide excision. Two years later she presented
      with extensive local recurrence of the scapular and deltoid regions. She was
      treated with tamoxifen (20 mg daily) and, over the next 6 months, the tumour
      regressed. She has been recurrence-free for the past year. We suggest that, in
      patients with desmoid tumours, hormone receptor determination and hormone therapy
      be attempted before subjecting patients to any form of radical treatment with
      surgery, radiotherapy or chemotherapy.

PMID- 2241658
TI  - Australia's Radiation Protection Standards (1989)

PMID- 2241657
TI  - Successive dislocations of a total hip arthroplasty complicated by acrylic cement
      interposition.
AB  - A case of two successive dislocations of a total hip arthroplasty in a single
      patient, complicated by acrylic cement interposition, is reported. Open reduction
      and removal of the cement was necessary in each case. This illustrates the
      importance of removing all cement debris at the time of prosthesis implantation.

PMID- 2241659
TI  - Computed tomographic assessment of coronary artery bypass grafts with fast
      dynamic scanning.
AB  - 28 coronary grafts in 12 symptomatic patients were studied at the time of graft
      angiography at Prince Charles Hospital. The grafts were studied using the Toshiba
      900S scanner with bolus injections of contrast agent into an anticubital vein.
      The assessment was carried out using fast incremental and continuous acquisition
      scanning with stepped reconstructions in the last 5 patients. Of the 27 grafts,
      16 were shown at angiography to be patent and of good calibre. 14 of these were
      similarly assessed at CT. 11 were either diseased or blocked at angiography, and
      these were graded also as small, stenosed or blocked at CT. This early study
      would support previous reports that CT does offer a reliable method of diagnosing
      good patent grafts. The study also suggests that with conventional fast dynamic
      scanning some information regarding graft quality can be obtained.

PMID- 2241660
TI  - The "Carpentier" thoracic aortic by-pass technique for management of descending
      aortic aneurysms and dissections--a radiological perspective.
AB  - The "Carpentier" thoracic aortic bypass procedure is a recently described and,
      until now, little used surgical technique for the treatment of descending
      thoracic aortic aneurysms and dissections. It involves the placement of a large
      conduit from the ascending aorta to the distal abdominal aorta through a midline
      sternotomy incision extended to the umbilicus and the subsequent interruption of
      the aorta just distal to the left subclavian artery via a left postero-lateral
      thoracotomy. As radiologists we should be aware of this alternative surgical
      option so that, in addition to diagnosing and classifying these aneurysms and
      dissections, we can assist our surgical colleagues in:-- a. The pre-operative
      assessment of the aorta for bypass grafting including the distal abdominal aorta
      b. The post-operative monitoring of the anticipated thrombotic occlusion of the
      descending thoracic aorta to the coeliac axis.

PMID- 2241662
TI  - Magnetic resonance imaging in herpes simplex encephalitis.
AB  - Four patients with clinical and serologically proven Herpes Simplex Encephalitis
      (HSE) were examined by Magnetic Resonance Imaging (MRI) following Computed
      Tomographic (CT) scans. MRI proved more sensitive at detecting the temporal lobe
      abnormalities than CT and invariably showed the lesions to be more extensive than
      suspected. The findings were consistent with an acute inflammatory process.
      Haemorrhage was present in only one patient. The sharp transition to normal at
      the lentiform nucleus previously described on CT was present in only one of the
      four patients, but was observed in a different patient with cerebral lymphoma and
      no evidence of HSE and is thus concluded to be less specific than previously
      thought. A repeat MRI scan at seven months on one of the patients showed
      persisting increased signal on T2 weighted images after resolution of the mass
      effect. The pathology and suspected mechanisms for the MRI appearances are
      discussed. MRI is concluded to be a valuable tool in the early diagnosis of HSE
      and in the longer term for further evaluation of residual disabilities.

PMID- 2241661
TI  - Radiologically controlled drainage of pleural and pulmonary collections.
AB  - Radiologically controlled catheter drainage is now accepted therapy for fluid
      collections in many parts of the body. While this is performed mainly in the
      abdomen, the chest is increasingly being drained percutaneously as an alternative
      to surgical drainage (van Sonnenberg et al 1984; Westcott 1985; O'Moore et al
      1987; Crouch et al 1987). This report outlines the experience with 31 chest
      collections treated by the intervention radiologist over a two-year period.

PMID- 2241663
TI  - Holoprosencephaly (a case report).
AB  - We describe here a rare entity of Holoprosencephaly. The embryogenesis and the
      diagnostic aspects of this condition are highlighted.

PMID- 2241664
TI  - Characteristic appearances of colonic lipomas on barium enema: a guide to
      conservative management.
AB  - The double contrast barium enema appearances of seven colonic lipomas are
      reviewed. These lesions have submucosal features: intact mucosa, sharp
      margination and obtuse angles between the lesion and the adjacent colonic wall,
      as well as features characteristic of lipomas: pliability and shape change, broad
      pedicles and spherical appearances en face. They can be differentiated from the
      more significant colonic adenomas and then CT scanned to establish a histological
      diagnosis. The need for colonoscopic or surgical excision of these predominantly
      asymptomatic lesions occurring in elderly patients can be considerably reduced.

PMID- 2241666
TI  - Primary sacral bone tumours in children (report of 16 cases with a short
      literature review).
AB  - 16 cases of primary sacral bone tumours in children are reported. These include
      13 patients with Ewing's sarcoma and 3 with very rare primary sacral bone tumours
      in childhood--chordoma, haemangiopericytoma and osteoblastoma. All sacral bone
      tumours, with the exception of Ewing's sarcoma are very rare in childhood. The
      possibility of a sacral tumour should be considered in a child with
      radiculopathy. CT and MR make the diagnosis of primary sacral bone tumours much
      easier with the added possibility of recognition of the true nature of the lesion
      in many instances. Reports of primary sacral bone tumours in children are scarce.
      Most of the patients are incorporated in adult series which do not specify the
      age of the child and the site of the tumour. The purpose of this paper is to
      describe 16 children with primary sacral bone tumours.

PMID- 2241665
TI  - Low dose intravenous urography: results and technique modifications.
AB  - 100 consecutive patients routinely referred for intravenous urography were
      examined using low doses of the low osmolar contrast medium Iohexol (Omnipaque
      350mgl/ml). Their dosage schedule was based on the physiological parameters of
      age, sex, body weight and renal function. Comparison with a control group using
      standard contrast doses revealed a 42% reduction in contrast could be used, and
      still produce diagnostic studies. Nephrographic quality was reduced in the low
      dose group requiring technique modification, in particular a delayed film
      sequence. Further reductions in contrast use are envisaged in patients over the
      age of 40 years.

PMID- 2241667
TI  - Malignant psoas syndrome: recognition of an oncologic entity.
AB  - From January 1985 to January 1989 four patients with advanced cancer developed a
      syndrome characterized by proximal lumbosacral plexopathy and painful flexion of
      the ipsilateral hip with positive psoas muscle stretch test. Malignant
      involvement of the psoas major muscle was confirmed radiologically in all cases.
      Pain was intractable in 3 patients until time of death. We have termed this
      presentation the malignant psoas syndrome (MPS) and retrospective review of 427
      oncology patients with "high risk" solid cancer culled no additional cases during
      the same 4-year period. We believe MPS to be a hitherto unreported complication
      of systemic cancer in which malignant involvement of the psoas muscle, in
      addition to producing severe nociceptive pain, contributes to the process of
      lumbosacral deafferentation. The clinical presentation, diagnosis and strategies
      of management of MPS are discussed.

PMID- 2241668
TI  - Percutaneous therapy for hepatic cysts. Case report and review of literature.

PMID- 2241669
TI  - Mesenteric giant lymph node hyperplasia--report of a case and review of the
      literature.
AB  - A case of hyaline vascular type of mesenteric giant lymph node hyperplasia
      (MGLNH) is presented. 15 previously reported cases were found in the literature
      with 14 belonging to the plasma cell type and one belonging to the hyaline
      vascular type. This is contrary to thoracic giant lymph node hyperplasia (TGLNH)
      where hyaline vascular type predominates. Like TGLNH, the hyaline vascular type
      of MGLNH produces no systemic symptoms but the plasma cell type is associated
      with various systemic symptoms and abnormal laboratory findings.

PMID- 2241670
TI  - Non fatal barium intravasation during barium enema.

PMID- 2241671
TI  - Free intra-peritoneal gas--an unusual aetiology.
AB  - The presence of free gas under one or both hemidiaphragms on an erect chest x-ray
      is most frequently the result of recent abdominal surgery or, in the absence of
      such surgery, is almost always indicative of a perforated abdominal viscus. A
      case is reported of a patient in whom pneumoperitoneum was discovered
      incidentally on a chest x-ray following extensive pelvic manipulation for acute
      inversion of the uterus.

PMID- 2241672
TI  - Sonographic recognition of pneumatosis intestinalis and portal gas in an 11
      months-old infant--case report.
AB  - Sonography was performed on an 11-month old infant who presented with intestinal
      obstruction. Pneumatosis intestinalis and portal venous gas were detected in
      addition to dilated small bowel loops. Preoperative diagnosis of small bowel
      gangrene was made which was proven at operation.

PMID- 2241673
TI  - CT demonstration of traumatic ventral hernia and diaphragmatic rupture. A case
      report.
AB  - Traumatic ventral hernias occur rarely. A case is presented where bowel has
      herniated through a traumatic defect of the anterior abdominal musculature,
      demonstrated by CT. This has not been previously reported in the literature.
      These loops of bowel showed mural thickening and high density indicating severe
      injury and were found at laparotomy to be ischaemic. The patient simultaneously
      suffered rupture of the right hemidiaphragm, also demonstrated by CT and also an
      uncommon injury.

PMID- 2241674
TI  - Subclavian artery aneurysm presenting with recurrent haemoptysis--a case report.

PMID- 2241675
TI  - Paget's disease of the thoracic spine. A case report.
AB  - A case of cord compression, secondary to Paget's disease, and responding to
      medical therapy is presented. The role of current imaging techniques in this
      condition is discussed.

PMID- 2241676
TI  - Melorheostosis of the toe: a case report.
AB  - A case of melorheostosis in a 57-year-old Japanese woman is presented. This case
      is noteworthy because of its unusual radiographic features and local findings and
      its unusually long follow-up period of more than 29 years. Melorheostosis
      progresses very slowly over a long period of time, and can show bizarre features,
      simulating malignant tumor.

PMID- 2241677
TI  - History of avian medicine in the United States. X. Control of coccidiosis.

PMID- 2241678
TI  - Virulence factors of avian Escherichia coli.
AB  - A total of 45 strains of Escherichia coli isolates from chickens with
      colisepticemia were examined for virulence factors commonly found in pathogenic
      groups of E. coli. These strains were studied for the following: pathogenicity in
      1-day-old chicks; toxin, hemolysin, and colicin production; cell invasiveness and
      adherence; hemagglutination for fimbriae detection; serum resistance; aerobactin
      production in iron-limited conditions; and plasmid content. The characteristics
      exhibited by virulent strains were invasion for HeLa and chicken fibroblast
      cells, serum resistance, colicin V, and aerobactin production. None of the
      isolates were toxigenic or positive in hemagglutination tests. The molecular
      genetic studies of the virulence factors by agarose electrophoresis showed that
      the plasmids of these strains are of high molecular weight.

PMID- 2241679
TI  - Comparison of enzyme-linked immunosorbent assay with dot immunobinding assay for
      detection of antibodies against Pasteurella multocida in turkeys.
AB  - A dot immunobinding assay (DIA) was developed to detect antibodies against
      Pasteurella multocida in turkey serum. Five coating antigens, namely, whole-cell
      (WC) antigen, sonicated cell lysate (SCL), crude capsular extract (CE), formalin
      extract (FE), and heat-stable antigen (HSA), were compared by enzyme-linked
      immunosorbent assay (ELISA) and DIA using reference antisera against P. multocida
      organisms. WC and SCL antigens showed higher sensitivity, whereas FE and HSA
      antigens were more specific coating antigens in both assays. The specificity of
      DIA was greater than ELISA by comparing the P/N ratios of HSA against serum
      prepared from heterologous serotype of P. multocida. The DIA had also several
      distinct advantages over the ELISA, which included reduction of the manipulation
      time and more uniform binding of coating antigens onto the nitrocellulose
      membranes compared with binding of coating antigens to microtiter plates for
      ELISA.

PMID- 2241680
TI  - Pathogenesis of Salmonella enteritidis infection in laying chickens. I. Studies
      on egg transmission, clinical signs, fecal shedding, and serologic responses.
AB  - Laying hens were inoculated orally, intracloacally (IC), or intravenously (IV)
      with Salmonella enteritidis phage type 8 isolates from a human (E700-87) eggs (Y
      8P2), or the ovary of a hen (27A). Oral or IV inoculation of 2 x 10(8) to 4 x
      10(8) colony-forming units (CFU) of E700-87 caused depression, anorexia, reduced
      egg production, diarrhea, and some mortality. Lower doses resulted in milder
      clinical signs. S. enteritidis was cultured from the shells of a few eggs but not
      from egg contents. Fecal shedding persisted for up to 6 weeks in some birds.
      Isolate Y-8P2 (10(6) CFU) also caused anorexia, diarrhea, and a drop in egg
      production. Hens inoculated orally or IC were less severely affected than those
      inoculated IV. Fecal shedding was intermittent and lasted up to 18 days.
      Eggshells from the IC-inoculated birds had the highest rate of contamination, and
      S. enteritidis was isolated from the albumen of 11 and yolk of three of 726 eggs.
      Oral inoculation of 10(6) CFU of isolate 27A resulted in a bacteremic infection
      with seeding of the liver, spleen, peritoneum, ovule, and oviduct. However, the
      birds remained clinically normal with normal egg production. S. enteritidis was
      cultured from the yolk and albumen of a small number of eggs until 11 days
      postinfection. Antigen prepared from S. enteritidis detected antibody in more
      sera than did commercially available S. pullorum antigen in agglutination tests.

PMID- 2241681
TI  - Possibilities of bacteremia and toxemia in death of chickens infected with
      Eimeria tenella.
AB  - The possibility that bacteremia and toxemia were the causes of death in cases of
      cecal coccidiosis was investigated. Germ-free and ordinary chickens with
      microflora were inoculated with sporulated oocysts of Eimeria tenella. At 5 days
      postinoculation, cecal lesions in ordinary chickens were more severe than those
      in germ-free ones. Cardiac blood, spleen, and liver were examined in ordinary
      chickens for bacteremia and endotoxemia, and small numbers of bacteria were
      recovered from both infected and uninfected birds. Endotoxin levels in plasma of
      E. tenella-infected birds were low and not different from the levels of
      uninfected controls. To examine unknown toxic factors, a large volume of serum
      from infected chickens was injected intravenously into uninfected birds. No
      significant clinical signs were observed. It is concluded that the intestinal
      bacteria increase the severity of coccidial lesions without bacteremia and
      toxemia.

PMID- 2241682
TI  - Toxicity of dietary monensin in quail.
AB  - Quail were fed monensin to determine liver damage, as measured by changes in
      activities of serum enzymes and liver microsomal enzymes. Monensin fed at a
      therapeutic level of 110 ppm for 2 weeks produced an increase in cytochrome P-450
      and cytochrome b5 and induction of the activities of benzphetamine N-demethylase,
      aminopyrine N-demethylase, and aniline hydroxylase, with no changes in the
      activities of serum sorbitol dehydrogenase (SDH), alanine aminotransferase (ALT),
      and aspartate aminotransferase (AST). On the other hand, quail fed 110 ppm, 220
      ppm, and 330 ppm monensin in feed for 6 weeks showed a significant rise in SDH
      and AST activities at 330 ppm but not at 110 ppm and 220 ppm. The manifestations
      of liver toxicity observed at 330 ppm were accompanied by a significant decrease
      in all the aforementioned hepatic microsomal mixed-function oxidases. In
      contrast, quail fed monensin at 110 ppm and 220 ppm for 6 weeks produced no
      change in these parameters except for benzphetamine N-demethylase, aminopyrine N
      demethylase, and aniline hydroxylase, which were significantly increased in birds
      fed 220 ppm of monensin.

PMID- 2241683
TI  - Evaluation of sodium dodecyl sulfate-polyacrylamide gel electrophoresis purified
      proteins of Mycoplasma gallisepticum and M. synoviae as antigens in a dot-enzyme
      linked immunosorbent assay.
AB  - Selected immunogenic proteins of Mycoplasma gallisepticum (MG) strain R and M.
      synoviae (MS) isolate F10-2AS were purified from sodium dodecyl sulfate
      polyacrylamide gels. Purified MG proteins of 65 to 63 (p64) kilodaltons (kDa),
      and 26 and 24 (p26/24) kDa, and purified MS proteins of 53 (p53) kDa, 41 (p41)
      kDa, and 22 (p22) kDa were evaluated as potential antigens for an enzyme-linked
      immunosorbent assay (ELISA). Chicken antisera to MG, MS, or oil-emulsion vaccines
      were used to evaluate these purified proteins as antigens in a dot-ELISA. MG
      antigen p64 detected antibodies 3 days after the serum plate agglutination (SPA)
      test and 7 days before the hemagglutination-inhibition (HI) test. Antigen p64
      detected antibodies to 12 MG isolates, and in sera from field outbreaks of MG. No
      cross-reactions with MS-positive antisera were seen with antigen p64. MG antigen
      p26/24 did not perform as well as p64. MS antigen p41 detected antibodies 5 days
      after the SPA test and at least 11 days before the HI test, and in sera from
      field outbreaks of MS. However, some MG-positive antisera reacted with p41. MS
      antigens p53 and p22 did not perform well.

PMID- 2241684
TI  - The relationship between the hemagglutination-inhibition test and the enzyme
      linked immunosorbent assay for the detection of antibody to Newcastle disease.
AB  - An assay of 364 chicken serum samples for Newcastle disease virus antibodies
      determined that a commercial NDV enzyme-linked immunosorbent assay (ELISA) had a
      98.2% sensitivity and a 91.7% specificity relative to the NDV HI test. The ELISA
      values regressed significantly (F = 930, df = 1/362, P less than 0.001) on the
      hemagglutination-inhibition (HI) titers. The correlational coefficient was 0.85.
      For individuals, two tests can have the same result based upon chance alone.
      Kappa is a measure of agreement between two tests that corrects for this chance
      agreement. The kappa between the ELISA and HI test was calculated to be 0.84 (Z =
      7.74, P = 0.00001), which indicates a highly significant agreement between the
      two tests.

PMID- 2241685
TI  - Influence of Campylobacter jejuni cecal colonization on immunoglobulin response
      in chickens.
AB  - The immunoglobulin response of chickens to colonization by Campylobacter jejuni
      isolates B-540 and Clin-1 was monitored. Chicken humoral IgG and biliary
      secretory IgA (sIgA) responses were assessed by enzyme-linked immunosorbent assay
      (ELISA). Samples were taken from 128 C. jejuni-colonized chickens and 104
      uncolonized chickens housed in a controlled environment. An indirect ELISA was
      performed using the homologous isolate of C. jejuni as the capture antigen and
      was developed with the specific goat anti-chicken IgG or IgA alkaline phosphatase
      conjugates. The ELISA absorbance values of the test samples at 405 nm (serum
      diluted 1:32 and bile diluted 1:10) were normalized in direct proportion to
      standard sera and bile sample values. In the colonized chickens, humoral IgG
      activities were highest at hatch, dropped to their lowest level after 2 weeks,
      and increased by 8 weeks to levels similar to those detected at hatch. The sIgA
      activity was lowest at hatch and increased by 4 weeks in colonized chickens while
      remaining lower in the control chickens. Chickens colonized with isolate B-540
      showed a primary sIgA response during the first 4 weeks and reached a plateau
      over the final 4 weeks. In spite of these limited humoral and secretory
      immunoglobulin responses, once the chicken ceca was colonized by C. jejuni, the
      organism persisted throughout the 8-week experiment.

PMID- 2241686
TI  - Influence of antibody treatment of Campylobacter jejuni on the dose required to
      colonize chicks.
AB  - This study was designed to clarify the role of antibodies in controlling chicken
      colonization by Campylobacter jejuni. Cecal colonization by C. jejuni was
      compared after the organism was exposed either to phosphate-buffered saline,
      normal rabbit serum, rabbit hyperimmune anti-C. jejuni serum, or anti-C. jejuni
      antibodies extracted from chicken bile. Antibodies from chicken bile were
      extracted by affinity absorption against outer-membrane proteins from the
      challenge organism. Sera were heated 1 hour at 56 C to destroy complement
      activity. Bacterial inoculum levels were enumerated after 1 hour exposure at 4 C
      to the various treatments. The heated sera and the bile antibodies were not
      bactericidal, and bacterial agglutination was not evident. Serial dilutions of
      the antibody-treated C. jejuni were given by gavage into 1-day-old chicks. Six
      days later, the ceca were removed from the chicks, and samples were cultured on
      Campylobacter-charcoal differential agar. The colonization dose-50% was increased
      by twofold to 160-fold when the organism was preincubated with hyperimmune
      antiserum or the bile antibodies as compared with preincubation with phosphate
      buffered saline. We conclude that antibodies inhibit chicken cecal colonization
      by C. jejuni.

PMID- 2241688
TI  - Factors affecting the development of respiratory disease complex in chickens.
AB  - Factors playing a part in the development of respiratory disease complex in
      chickens were investigated in a series of experiments. The experimental infection
      was produced by exposing chickens to Mycoplasma gallisepticum and the B1 vaccine
      strain of Newcastle disease virus and later exposing them to aerosols containing
      the O1:K1 serotype of Escherichia coli. Chickens became susceptible (pericarditis
      or death) to E. coli 8 days after mixed respiratory disease challenge. One day
      after respiratory disease challenge, lesions consisted of edema and infiltration
      with lymphoid cells and heterophils. At the time of susceptibility to E. coli,
      the lesions were strongly lymphoid with many dense follicular areas and very few
      heterophils. The incidence of pericarditis and death was similar when the
      concentration of bacteria in the aerosol inoculum ranged between 10(9)/ml and
      10(5)/ml. At the time of maximum susceptibility to aerosol challenge, chickens
      were less susceptible to intravenously administered E. coli than were the
      uninfected controls. Resistance of chickens that had been selectively bred for a
      high (HA) or low (LA) antibody response to sheep erythrocytes was compared. HA
      chickens were more resistant to respiratory agents and less resistant to E. coli
      than LA line chickens. When the lines were exposed to respiratory disease
      followed by exposure to aerosols containing E. coli, the HA line had the lowest
      incidence of pericarditis and death.

PMID- 2241687
TI  - Influence of host lineage on cecal colonization by Campylobacter jejuni in
      chickens.
AB  - The resistance to cecal colonization by Campylobacter jejuni was assessed by
      challenging three crossbred stocks of commercially available broiler chickens.
      These three stocks, designated A, B, and C, were related as follows: Offspring
      from four pedigreed grandparent flocks were used as progenitors. Stock B was
      derived by cross-breeding grandparent 1 with grandparent 3. Stocks A and C were
      crossbreeds from grandparents 1 and 2 and grandparents 3 and 4, respectively.
      Campylobacter jejuni were gavaged into 48-hour-old chicks, using the same levels
      of challenge dose for each of the different chicken stocks. Six days post
      challenge, the birds were sacrificed, and cecal contents were plated onto
      Campylobacter-selective media. Results from two replicate trials with three
      isolates of C. jejuni indicated that chicken stock A was colonized in only two of
      60 ceca, stock B in six of 60, and stock C in 19 of 60 chicken ceca. Statistical
      analysis of these data indicate that resistance to cecal colonization by C.
      jejuni was significantly (P less than 0.05) influenced through chicken host
      lineage.

PMID- 2241689
TI  - Restriction endonuclease analysis of Mycoplasma synoviae strains.
AB  - A diverse group of Mycoplasma synoviae strains from various hosts, pathological
      processes, and geographic areas collected over about 25 years were analyzed by
      restriction endonuclease analysis. The results suggest that restriction
      endonuclease analysis of M. synoviae strains may be a useful strain
      identification tool to study epidemiological problems.

PMID- 2241691
TI  - Biological control of Salmonella typhimurium in young chickens.
AB  - The effect of dietary lactose and anaerobic cultures of cecal microflora of
      mature chickens on the colonization of young broiler chickens by Salmonella
      typhimurium was evaluated. Newly hatched chicks were given either no treatment
      (controls), anaerobic cecal cultures, lactose (2.5%) in the drinking water, or
      both anaerobic cultures and lactose. Chicks were challenged per os at 3 days of
      age with either 10(6) or 10(8) S. typhimurium resistant to nalidixic acid and
      novobiocin. On day 10, the cecal contents of the chicks were examined for S.
      typhimurium, pH, short-chained volatile fatty acids (VFAs), undissociated VFAs,
      and lactic acid. Chicks given either lactose alone or cecal anaerobes alone had
      significantly (P less than 0.05) fewer S. typhimurium recovered from their ceca
      than the controls. Chicks given the combination of dietary lactose and cecal
      anaerobes had significantly fewer S. typhimurium recovered from their ceca than
      the chicks given dietary lactose or cecal anaerobes alone. Chicks given lactose
      had significant (P less than 0.05) increases in the lactic acid concentration of
      their cecal contents. Increased lactic acid concentrations were directly
      correlated to decreased cecal pH values and caused a reduction in the total
      concentration of VFAs but a significant (P less than 0.05) increase in the
      undissociated form of some VFAs.

PMID- 2241690
TI  - Effect of dietary lactose on cecal pH, bacteriostatic volatile fatty acids, and
      Salmonella typhimurium colonization of broiler chicks.
AB  - One-day-old broiler chicks were inoculated with volatile fatty acid producing
      cecal flora from adult chickens. The chicks were divided into four groups and
      provided 1) no lactose, 2) 2.5% lactose in water, 3) 5% lactose in feed, or 4)
      10% lactose in feed, until 10 days of age. All groups were challenged at 3 days
      of age with 10(6) or 10(8) S. typhimurium. At 10 days, the number of Salmonella
      in the ceca of the chicks challenged with 10(6) Salmonella was significantly
      decreased (P less than 0.01) in the groups provided lactose as compared with the
      controls. A significant decrease (P less than 0.01) in Salmonella numbers
      occurred in the chicks challenged with 10(8) Salmonella and provided 10% lactose.
      Providing 2.5% lactose or 5% lactose failed to inhibit Salmonella growth in
      chicks challenged with 10(8) Salmonella. The pH of the ceca of the groups
      provided lactose decreased significantly (P less than 0.05) and was accompanied
      by significant increases (P less than 0.01) in the concentrations of
      bacteriostatic acetic and propionic acids. Results showed that providing dietary
      lactose to broiler chicks and inoculation with normal cecal flora decreased cecal
      pH, increased the concentrations of bacteriostatic volatile fatty acids, and
      inhibited Salmonella colonization.

PMID- 2241692
TI  - Efficacy of maduramicin ammonium against coccidiosis in turkeys under laboratory
      and floor-pen conditions.
AB  - Experimental infections with field isolates of Eimeria meleagrimitis, E.
      adenoeides, E. gallopavonis, and E. dispersa in turkey poults were used to test
      the efficacy of maduramicin ammonium at 2.5-10 ppm in laboratory experiments.
      Infection with single or mixed species of coccidia reduced the weight gain of
      unmedicated infected controls and caused 18.1-65% mortality in two experiments.
      Maduramicin ammonium given at 5-7 ppm prevented mortality, significantly reduced
      droppings scores and oocyst passage, and improved weight gain to near that of the
      unmedicated uninfected controls. Maduramicin ammonium was tested at 4-7 ppm in a
      floor-pen trial lasting 10 weeks. Mortality from coccidiosis averaged 11.9% in
      unmedicated controls, compared with 0.6% with 4 ppm of maduramicin or no
      mortality with 5-7 ppm. Average weight gain and feed conversion at 10 weeks were
      significantly improved over unmedicated infected controls when maduramicin
      ammonium was given at 5-7 ppm. These results suggest that maduramicin ammonium is
      highly efficacious against field isolates of Eimeria in turkeys, especially
      within the range of 5-7 ppm in the feed.

PMID- 2241693
TI  - Evaluation of chicken heterophil adherence.
AB  - Adherence of chicken heterophils was evaluated at 37 C using preconstructed
      columns containing various weights of nylon fiber (75 mg, 100 mg, or 125 mg) and
      whole blood anticoagulated with sodium heparin or 10% disodium ethylenediamine
      tetraacetic acid (EDTA). Additionally, 50-mg and 75-mg nylon fiber columns
      incubated at 41 C were used to evaluate heterophil adherence at an increased
      temperature. The mean percent adherence for heparin-anticoagulated blood applied
      to 75-mg, 100-mg, and 125-mg nylon fiber columns at 37 C was 76%, 92% and 97.4%,
      respectively. Samples applied to 50-mg and 75-mg columns at 41 C had adherence
      values of 27% and 85%, respectively. When paired samples of blood anticoagulated
      with EDTA or heparin were evaluated, the EDTA samples had significantly decreased
      heterophil adherence (paired t-test). Results indicate that increased or
      decreased adherence of chicken heterophils would best be detected using 75-mg
      nylon fiber columns incubated 37 C and whole blood collected in sodium heparin.

PMID- 2241694
TI  - Serotyping of Haemophilus paragallinarum by the Page scheme: comparison of the
      use of agglutination and hemagglutination-inhibition tests.
AB  - Seventy-two isolates of Haemophilus paragallinarum were serotyped according to
      the Page scheme, using a new hemagglutination-inhibition (HI) test. The results
      were compared with the plate agglutination method conventionally used in the Page
      scheme. The HI test used washed cells of H. paragallinarum, glutaraldehyde-fixed
      chicken erythrocytes, and rabbit antisera originally produced for the
      agglutination method. For 49 of the isolates, there was complete correlation
      between the results of the HI serotyping test and the previously performed
      agglutination test--23 were serovar A, two were serovar B, and 24 were serovar C.
      The other 23 isolates were nontypable by the agglutination test, but 21 of them
      could be serotyped by the HI method--six as serovar A, two as serovar B, and 13
      as serovar C. Nine isolates required treatment of the bacterial cells with
      hyaluronidase for the expression of hemagglutination (HA) activity. Two isolates
      did not have HA activity despite hyaluronidase treatment and so could not be
      serotyped by the HI test.

PMID- 2241695
TI  - Chlamydiosis in captive raptors.
AB  - Chlamydia psittaci was isolated from four red-tailed hawks (Buteo jamaicensis)
      that died suddenly and from seven birds that survived at a raptor rehabilitation
      center in California in 1983. One hundred captive raptors representing 14 species
      in five families were subsequently tested serologically and by direct cloacal
      culture. C. psittaci was isolated from seven clinically normal birds. Forty-four
      percent of the raptors were considered positive using an enzyme-linked
      immunosorbent assay (ELISA), and 19% were suspects. The ELISA was repeated on 54
      raptors in 1986. Forty-one percent of the birds were considered positive, and 35%
      were suspect, indicating that C. psittaci is endemic in the population.

PMID- 2241697
TI  - Cystic testicular degeneration in furazolidone toxicosis of sexually immature
      ducks.
AB  - Cystic testicular tubular dilatation was seen in ducklings fed a ration
      containing furazolidone at 250, 400, 550, or 700 ppm for 28 days. Gross evidence
      of cystic testicular dilatation was observed at necropsy in 16% (32/203) of the
      ducklings that survived to the end of the study. Gross testicular lesions
      consisted of various degrees of enlargement with increased translucency in
      moderately to severely enlarged testicles. Histological evidence of cystic
      testicular dilatation was present in 45% (41/91) of the testicles examined.
      Histologically, the tubules were in various states of dilatation with attenuation
      of the seminiferous epithelium proportional to the severity of dilatation. In the
      most severely affected testicles, tubules were greatly dilated, distorted, and
      fluid-filled, with extensively flattened epithelium visible on the inner margin
      of the tubule as a thin rim of cytoplasm with a protuberant nucleus. Interstitial
      tissues were compressed to thin septa between the dilated tubules.

PMID- 2241696
TI  - Effect of dietary lactose on Salmonella colonization of market-age broiler
      chickens.
AB  - The effect of providing lactose in feed and inoculation with volatile fatty acid
      producing anaerobic cultures (AC) of cecal flora on Salmonella typhimurium
      colonization was evaluated in broilers. One-day-old chicks were divided into four
      groups and provided 1) no lactose, no AC; 2) AC, no lactose; 3) AC and lactose on
      days 1-10; or 4) AC and lactose on days 1-40. All groups were challenged per os
      with 10(6) Salmonella on day 3 and with 10(8) Salmonella on day 33. Salmonella
      growth in the cecal contents was significantly decreased (P less than 0.01) on
      day 10 in the chicks provided lactose from day 1-10. However, after the removal
      of lactose from the diet, the chicks were susceptible to Salmonella colonization.
      The number of Salmonella in the ceca was significantly reduced (P less than 0.05)
      in the chicks provided lactose throughout the 40-day growing period. Dietary
      lactose decreased the pH of the cecal contents and was accompanied by marked
      increases in the concentrations of undissociated bacteriostatic volatile fatty
      acids in the cecal contents.

PMID- 2241698
TI  - The relationship of Cryptosporidium sp. infection of the bursa of Fabricius,
      intestinal tract, and respiratory system of chickens in Georgia, 1974-1988.
AB  - During 1974-1984, cryptosporidiosis was diagnosed in slightly more than 1%
      (63/6050 = 1.04%) of histopathology reports on chickens and turkeys made at two
      Georgia diagnostic laboratories. During 1985-1988, cryptosporidiosis was
      diagnosed in almost 6% (157/2622 = 5.99%) of histopathology reports on chickens
      and turkeys made at the two laboratories. Intestinal and respiratory
      Cryptosporidium sp. infections have increased significantly (p less than 0.01)
      with time. During the same period, there was no statistical pattern for bursa of
      Fabricius Cryptosporidium sp. infections, and there was no relationship between
      the incidence of bursal infections and the incidence of either respiratory or
      intestinal infections.

PMID- 2241699
TI  - Recombinant DNA probes for Mycoplasma synoviae.
AB  - A genomic library was prepared from Mycoplasma synoviae (MS) strain WVU 1853
      cloned in plasmid vector pUC8 and transformed in Escherichia coli host JM83. In
      dot blot assays, four transformed E. coli clones hybridized with 32P-labeled
      chromosomal DNA of MS but not with 32P-labeled chromosomal DNA of M.
      gallisepticum (MG) strain S6. In Southern hybridization, each of the CsCl
      purified recombinant plasmid clones was shown to contain two MS DNA fragments
      between 1.0 to 2.3 kbp in length. 32P-Labeled probes prepared from each of the
      four recombinant plasmids hybridized in dot blot assays with MS strain WVU 1853
      and nine MS field isolates but not with MG strains S6, K810, F2F10, four MG field
      isolates, and 15 other species of avian mycoplasmas.

PMID- 2241700
TI  - Characterization of the toxicity of the mycotoxins aflatoxin, ochratoxin, and T-2
      toxin in game birds. I. Chukar partridge.
AB  - Chukar partridges were fed diets containing 1.25, 2.5, or 5 ppm aflatoxin; 1, 2,
      or 4 ppm ochratoxin A (OA); or 4, 8, or 16 ppm T-2 toxin. Toxin-induced mortality
      was seen during the third week with 4 ppm OA (12.5%) and 16 ppm T-2 toxin (15%),
      compared with the mortality in control chukars fed no toxin (2.5%). Body weights
      were significantly decreased by the highest level of aflatoxin at 3 weeks of age,
      by the highest level of OA by 2 weeks of age, and by 8 and 16 ppm T-2 toxin by 1
      week of age. Aflatoxin did not affect liver weight and OA did not increase kidney
      weight in 3-week-old chukars. There was a slight decrease in kidney weight in
      chukars fed 4 ppm OA; however, the decrease was related to the decrease in body
      weight produced by the toxin. Mouth lesions were seen at all levels of T-2 toxin
      fed.

PMID- 2241701
TI  - Chicken anemia agent: an electron microscopic study.
AB  - Particles of chicken anemia agent (CAA) negatively stained with uranyl acetate
      were found to be 26.5 nm in diameter. The surface detail evident on the particles
      indicated that the virus capsid was composed of 32 structural subunits arranged
      as in a class P = 3 icosahedron with a triangulation number of 3. Using mouse
      monoclonal antibodies to CAA and a gold-labeled goat anti-mouse IgG, CAA-specific
      structures were observed by thin-section electron microscopy in infected MDCC
      MSB1 cells and in thymic lymphocytes from experimentally infected chicks. These
      consisted of electron-dense, granular, non-membrane-bound nuclear inclusions,
      which were often ring-shaped, and cytoplasmic accumulations of microtubules.
      Aggregates of virus-like particles were sometimes observed in the nuclei of
      infected MDCC-MSB1 cells. The nucleolar involvement that is characteristic of the
      morphogenesis of parvoviruses was not observed with CAA.

PMID- 2241702
TI  - Intracloacal Salmonella typhimurium infection of broiler chickens: reduction of
      colonization with anaerobic organisms and dietary lactose.
AB  - The combined effect of treatments with dietary lactose plus anaerobic organisms
      on cecal colonization of broiler chicks by Salmonella typhimurium was evaluated.
      Chickens treated with a combination of anaerobic organisms and 7% dietary lactose
      were resistant to cecal colonization by S. typhimurium. The number of recoverable
      S. typhimurium cells per gram of cecal contents taken on days 10 and 15 after
      infection was significantly reduced. Treatment with anaerobes without the
      addition of lactose did not effectively control cecal colonization. Intracloacal
      inoculations with bacterial concentrations that varied by 10,000-fold resulted in
      roughly similar levels of colonization. The treatments resulted in reduced cecal
      pH and elevated levels of undissociated volatile fatty acids. Statistically
      significant correlations (P less than 0.01) were observed between the S.
      typhimurium concentrations in cecal material and the concentrations of
      undissociated fatty acids (r = -0.79, and between the bacterial counts and pH (r
      = 0.72).

PMID- 2241703
TI  - Use of a hypobaric chamber as a model system for investigating ascites in
      broilers.
AB  - In a series of experiments, broilers were reared at simulated altitudes of 3000,
      3500, and 5000 meters utilizing a hypobaric chamber. The purpose was to evaluate
      the chamber as a model for ascites syndrome and to further study the
      pathophysiology of this disease. Results show that this model can effectively
      reproduce the disease as it is seen in the field. Birds reared at the simulated
      altitude of 5000 meters had a statistically significant increase in EKG
      amplitude, packed cell volume, and heart-to-body-weight and lung-to-body-weight
      ratios when compared with controls reared at 366 meters. Additionally, there was
      a trend for birds dying of ascites to have larger-amplitude EKGs than survivors
      when reared at 5000 meters.

PMID- 2241704
TI  - Effect of exposure to a short-duration sound on the stress response of chickens.
AB  - Chickens were subjected to the sound produced by banging on a metal pail (104
      decibels) for 30 seconds. Heterophil/lymphocyte (H/L) ratios began to rise 18
      hours later, reaching their maximum value (0.62) in 20 hours and returning to pre
      stress values after 30 hours. Neither resistance to Escherichia coli challenge
      infection nor antibody response were altered.

PMID- 2241705
TI  - An ectopic wing in a wild black vulture (Coragyps atratus).
AB  - An approximately 5-month-old black vulture (Coragyps atratus) was presented with
      the chief complaint of cervicomelia. A full-sized ectopic wing, with its own
      pectoral girdle, was found attached to the dorsal surface of the last few
      cervical vertebrae. There was deformation (right dorsolateral narrowing) of the
      spinal canal at the point of attachment with a corresponding compression of the
      spinal cord.

PMID- 2241706
TI  - Sudden death syndrome in turkey hens.
AB  - A turkey breeder flock of 5600 31-week-old hens experienced an abrupt increase in
      daily mortality for a 2-day period. This higher mortality rate corresponded with
      the handling and moving of the hens 1 to 2 days before. No clinical illness was
      seen in the hens before carcasses were discovered. The four hens that were
      necropsied had small spleens, congested lungs, and enlarged livers. The most
      consistent histologic lesions were pulmonary hemorrhage and edema, and congestion
      of veins and capillaries in several visceral organs. One hen had subserosal
      hemorrhage of the oviduct and perirenal hemorrhage. The increased mortality
      pattern, the lack of clinical signs, and the histopathologic changes are
      consistent with a diagnosis of sudden death syndrome. The presence of concurrent
      inflammatory lesions in the lungs predisposed the hens to sudden death following
      the stress of handling and moving.

PMID- 2241707
TI  - Squamous-cell carcinoma of the pharyngeal cavity in a Jersey black giant rooster.
AB  - Squamous-cell carcinoma of the pharyngeal cavity was diagnosed in a 3-year-old
      Jersey black giant male chicken. Grossly, the carcinoma was round with irregular
      edges, yellow-tan, cauliflower-like with a crusty surface, and attached to the
      roof and sides of the pharyngeal cavity. Histologically, the surface of the mass
      was covered by a dense mat of necrotic mucosa and inflammatory cells. A broad
      front of neoplastic cords consisting of squamous epithelial cells extended into
      the lamina propria. There was no evidence of vascular invasion or metastasis.

PMID- 2241708
TI  - Characterization of a gram-positive bacterium from the proventriculus of
      budgerigars (Melopsittacus undulatus).
AB  - The cellular, cultural, and biochemical characteristics of eight isolates of a
      large gram-positive bacillus that are commonly observed as apparently normal
      flora in the proventriculus of budgerigars (Melopsittacus undulatus) were
      determined. The bacterium was highly pleomorphic and changed markedly in both
      diameter and length when subcultured on agar media. The bacterium was facultative
      anaerobic and capnophilic, hemolytic on blood agar, and formed flat colonies with
      irregular edges after incubation for several days. All isolates grew on sodium
      azide agar but did not grow on MacConkey agar. The isolates were catalase
      negative and oxidase-negative and did not reduce nitrate. All isolates failed to
      utilize arginine, lysine, ornithine or tryptophane but produced acid from
      glucose, galactose, levulose, maltose, melibiose, starch, and sucrose. All
      isolates produced acetoin from glucose and hydrolyzed esculin. The eight isolates
      could not be identified to either genus or species level based on the
      descriptions of currently classified organisms in the division Firmicutes as
      described in Bergey's Manual of Systematic Bacteriology.

PMID- 2241709
TI  - Small intestinal cryptosporidiosis in cockatiels associated with Cryptosporidium
      baileyi-like oocysts.
AB  - Four of six cockatiels died within a week after being purchased from a commercial
      breeder. A fifth bird was euthanatized and necropsied during this time, and
      tissues were collected for microscopic examination. The small intestine had
      moderate numbers of Cryptosporidium sp. parasites present. A few large,
      basophilic intranuclear inclusions were present in renal ductular epithelium.
      Cryptosporidium sp. oocysts were found in the feces of the surviving bird. Thirty
      oocysts were 7.2 by 5.5 microns. The shape index was 1.31. Morphological
      examinations of the fecal oocysts indicated that the Cryptosporidium species
      infecting the cockatiels was similar to C. baileyi, a parasite that is not
      usually associated with small-intestinal infections.

PMID- 2241710
TI  - Factors that determine medical interest in psychiatry.

PMID- 2241711
TI  - Effects on care-givers of special day care programmes for dementia sufferers.

PMID- 2241712
TI  - Damages for self-inflicted injuries.

PMID- 2241713
TI  - Compulsive and impulsive sexual offences.

PMID- 2241714
TI  - Decidedly pointing to central mischief.

PMID- 2241715
TI  - Australasian field trials of the Mental and Behavioural Disorders section of the
      draft ICD-10.
AB  - Field trials of the "Mental and Behavioural Disorders" section of the 1987 draft
      of the ICD-10 have been co-ordinated for the World Health Organisation by a
      number of regional centres. The design of the field trials and the major features
      of ICD-10 are briefly discussed. The results of the field trial in the Western
      Pacific region are described, and compared with the results of the original DSM
      III field trials. ICD-10 appears to be an acceptably reliable diagnostic system,
      and the ratings of its feasibility and utility by participating clinicians
      suggest that it will be seen as a distinct advance over ICD-9.

PMID- 2241716
TI  - The prevalence of emotional and behaviour disorders and patterns of service
      utilisation in children and adolescents.
AB  - This study compared the prevalence of emotional and behavioural disorders in
      children attending schools of different socio-economic class. In addition, the
      study compared the rate of service utilization by children with and without
      disorders. Using cutoff scores recommended for use with Australian children, the
      prevalence of disorders in schools of different socio-economic class ranged from
      2.3 +/- 2.2 to 13.9 +/- 5.3 per 100 children, with the highest prevalence being
      found in the lower socio-economic class schools. Although few children with
      disorders had been seen in a mental health clinic, advice had been sought from
      other services with regard to 66% of these children. This high rate of service
      utilization by children with disorders highlights the key role that general
      practitioners, school guidance officers and hospital services could play in
      facilitating the early identification and management of children with emotional
      and behavioural disorders.

PMID- 2241718
TI  - Treatment outlines for paranoid, schizotypal and schizoid personality disorders.
      The Quality Assurance Project.
AB  - Treatment outlines for paranoid, schizotypal and schizoid personality disorders
      were developed by having nominated experts consider their own views in the light
      of the treatment literature and the responses of practising psychiatrists. In the
      detailed recommendations it is clear that while patients with all three disorders
      often present for treatment in a crisis and often see no issue other than the
      resolution of the crisis, patients with schizoid personality disorder can use
      long-term psychotherapy to develop and change to the extent of no longer being
      handicapped.

PMID- 2241717
TI  - Child psychiatry in Hong Kong: an overview.
AB  - Hong Kong has a population of 5.5 million with 1.3 million below the age of 15.
      Child psychiatry has been very under-developed until recently. The brief history
      and development of child psychiatry in Hong Kong, and specifically that of the
      Child and Adolescent Psychiatric Unit at the Prince of Wales Hospital, the
      teaching hospital of The Chinese University of Hong Kong, are described.
      Traditionally psychiatric services for children in Hong Kong were heavily skewed
      towards neuropsychiatric and developmental conditions but in this Unit a full
      spectrum of child psychiatric conditions are seen. Relevant clinical statistics
      are used to illustrate these differences as well as to further highlight the
      philosophy and practice of the Unit. Other aspects, such as undergraduate and
      postgraduate teaching, and research are also mentioned. The magnitude of child
      psychiatric morbidity in Hong Kong is briefly illustrated with a three-stage
      epidemiological study done in a primary school in a lower middle social class
      area. It was found that 16.3% of the children were psychiatrically disturbed.
      Emotional disorder, with a prevalence of 8.8%, was the commonest condition.
      Finally, the future development of child psychiatry in Hong Kong is discussed,
      addressing the disconcerting facts of a huge population and very limited
      resources.

PMID- 2241719
TI  - Psychosocial effects on carers of living with persons with dementia.
AB  - A survey of members of the Alzheimer's Disease and Related Disorders Society
      confirmed high rates of psychological morbidity, though not of depression, and
      social isolation in family carers of persons with dementia. Psychological
      morbidity in carers was associated with having an affected person at home, the
      carer being a spouse, demanding problem behaviours, poor physical health in the
      carer, social isolation, dissatisfaction with social supports, greater use of
      psychotropic medication, and a deteriorated marital relationship. Carers and
      patients had high rates of consultations with doctors and other health
      professionals. There was a vulnerable group of carers who were impaired
      psychologically, socially and physically. The identification of risk factors to
      carer morbidity may lead to useful interventions.

PMID- 2241721
TI  - Health services research and the future of Australian psychiatry.

PMID- 2241720
TI  - A survey of dementia carers: doctors' communications, problem behaviours and
      institutional care.
AB  - A survey of carers belonging to the Alzheimer's Disease and Related Disorders
      Society (ADARDS) had three aims: (i) to investigate the process of health
      professionals providing information to patients and carers: (ii) to determine the
      nature of problems burdening carers; and (iii) to examine factors associated with
      institutional placement. Carers reported on deficiencies in the provision of
      information and indicated their preferences as to how the information should be
      given. ADARDS, general practitioners and other health professionals were
      reportedly helpful, with each appearing to have a role in providing information
      about dementia. Multiple problem behaviours were reported by most carers,
      especially difficulties with communication, the need for constant supervision and
      disruption to personal life. Institutional care was most highly correlated with
      dependency problems, severity of dementia and a non-spouse carer. Implications
      include the need for training of doctors in communication and education about
      dementia with particular attention to management of dependency problems.

PMID- 2241723
TI  - Australian suicide data and the use of "undetermined" death category (1968-1985).
AB  - There has been considerable recent debate about the impact that changes in the
      use of the "undetermined" death classification may have upon trends in national
      suicide statistics. This study focused on changes over time within each state in
      Australia in an attempt to determine the source of apparent patterns in national
      data. Considerable intra- and inter-state variability was revealed, and it was
      concluded that, apart from a general trend for decreasing use of the undetermined
      category, the data are not of sufficient quantity to warrant further
      interpretation. The suggestion that changes in classification practices by
      coroners may have contributed to the rise in young male suicides was not
      supported.

PMID- 2241722
TI  - Suicide from river bridges.
AB  - The opening of a new high river bridge in Brisbane allowed a naturalistic
      experimental testing of whether the sample engaging in suicidal behaviour from
      the new bridge was similar to that from the adjoining older bridge. Substantial
      differences were found for the two samples. This suggests that persons prevented
      from jumping from one bridge, for example by a barrier, will not automatically
      jump from the alternative bridge although a minority may do so.

PMID- 2241724
TI  - The power of mercy.
AB  - Throughout history heads of state have reserved for themselves the prerogative to
      exercise mercy and pardon not only for serious crimes but for lesser ones as
      well. The newly emerging state of Papua New Guinea is no exception. My experience
      as the psychiatrist member of the advisory committee on such executive clemency
      since its inception twelve years ago will be discussed.

PMID- 2241725
TI  - Can reliance be placed on a single meta-analysis?
AB  - Meta-analysis replaced statistical significance with effect size in the hope of
      resolving controversy concerning evaluation of treatment effects. Statistical
      significance measured reliability of the effect of treatment, not its efficacy.
      It was strongly influenced by the number of subjects investigated. Effect size as
      assessed originally, eliminated this influence but by standardizing the size of
      the treatment effect could distort it. Meta-analyses which combine the results of
      studies which employ different subject types, outcome measures, treatment aims,
      no-treatment rather than placebo controls or therapists with varying experience
      can be misleading. To ensure discussion of these variables meta-analyses should
      be used as an aid rather than a substitute for literature review. While meta
      analyses produce contradictory findings, it seems unwise to rely on the
      conclusions of an individual analysis. Their consistent finding that placebo
      treatments obtain markedly higher effect sizes than no treatment hopefully will
      render the use of untreated control groups obsolete.

PMID- 2241727
TI  - Community psychological effects following a non-fatal aircraft accident.
AB  - Following a non-fatal military aircraft accident, two of the authors interviewed
      the crewmen involved in the accident, their spouses, fellow squadron members and
      their spouses, and individuals from the fire crew and control tower on duty
      during the accident. A total of 37 respondents completed questionnaires which
      reported the presence of intrusive, avoidant, depressive/anxious, and post
      traumatic stress symptoms. Spouses reported more symptoms after the accident than
      their flying husbands. Intrusive symptoms were most common. Symptoms were
      correlated with various perceptions and experiences occurring prior to and
      following the accident. Several kinds of symptoms and experiences were
      significantly correlated with a perception of morale decline. This study suggests
      that even non-fatal aircraft accidents may have important psychological effects
      on those involved and on the surrounding community. Implications of these
      findings and recommendations for helping communities process traumatic events are
      discussed.

PMID- 2241726
TI  - Psychological consequences of spinal injury: a review of the literature.
AB  - The traumatic nature of spinal cord injury necessitates adjustments for the
      individual physically, socially, vocationally and sexually, as well as placing
      great strain on the family. Although one would suspect a high prevalence of
      psychological disruption following spinal cord injury, there is still much debate
      concerning the extent of the psychological reaction to such a trauma. This
      situation can partly be attributed to the lack of systematic research
      characteristic of most studies in this area. This paper reviews more recent
      literature which has investigated psychological morbidity in persons with spinal
      cord injury. The inadequacies of this research are discussed and suggestions for
      future research and psychological treatment for the spinal injured are provided.

PMID- 2241728
TI  - The heart rate spectrum in simulated flight: reproducibility and effects of
      atropine.
AB  - The heart rate spectrum (HRS) was computed on eight pilots during simulated
      flight. Although respiratory-coupled heart rate variability (i.e., that produced
      by vagal inputs to the heart) varied three-fold across volunteers, each
      individual volunteer's data were very stable on three test days (median
      coefficient of variation = 5.4%). Atropine rapidly reduced heart rate variability
      at the respiratory frequency to the noise level (i.e., 74% decrease from predrug
      levels). Although there was no significant difference in the reduction induced by
      a 2 mg or 4 mg dose, there was a tendency for variability at this component of
      the spectrum to return to normal faster following 2 mg injection than after 4 mg
      injection. By the morning after injection at either dose, heart rate variability
      at the respiration component of the HRS was back to normal--indicating complete
      washout of the drug. This study revealed no technical limitation to using the HRS
      in real life situations outside of the laboratory and suggests that the test can
      be used to test the efficacy of other treatments or manipulations that reduce
      vagal tone to the heart.

PMID- 2241729
TI  - Onset of behavioral effects in mice exposed to 10 Gy 60Co radiation.
AB  - The effects of 10 Gray (Gy) 60 Co radiation on social behavior, locomotor
      activity, and body weight were assessed in individually housed male Swiss-Webster
      mice. In Experiment 1, aggressive behavior was evaluated prior to irradiation and
      for 7 d postirradiation by placing an untreated intruder in the irradiated or
      sham-irradiated resident's home cage for 5 min. Offensive aggressive behavior was
      not affected significantly by radiation until day 7 postirradiation, when attack
      latency increased, the frequency and duration of fighting decreased, and the
      frequency of bites, lunges, and chases decreased. Untreated intruder mice paired
      with irradiated resident mice showed a decrease in the duration of defensive
      upright postures and a decrease in the frequency of defensive upright postures,
      squeaks, and escapes on day 7 postirradiation. In Experiment 2, locomotor
      activity and body weight were monitored for 7 d postirradiation. Body weight was
      decreased in irradiated mice beginning 4 d postirradiation. Locomotor activity
      was suppressed in irradiated animals 90 min after irradiation and remained
      depressed throughout the 7-d testing period.

PMID- 2241730
TI  - Instability of ocular torsion in zero gravity: possible implications for space
      motion sickness.
AB  - Inherent asymmetries of the gravity-sensitive otolith organs of the inner ear may
      be well-compensated in ordinary 1 G, but rendered unstable in novel gravitational
      states. Several aspects of ocular counterrolling and spontaneous eye torsion,
      reflexes governed by the otoliths, were examined during the hypo- and
      hypergravity in parabolic flight on the NASA KC-135 aircraft. Among the subjects
      were two astronauts, one who had suffered space motion sickness during his
      mission and one who had not. Using an observed separation of scores of torsional
      instability at 0 G as the criterion, we divided our 10 subjects into the 5
      highest and 5 lowest scorers, reminiscent of the approximately 50% who do and the
      50% who do not experience space motion sickness (SMS). The astronaut who had had
      SMS was in the high group; and the one who had not was in the low group. At 1.8
      G, the groups defined at 0 G were significantly different in the instability
      measure. They were also significantly different at both 0 G and 1.8 G in another
      measure, that of torsional variability. There were no differences between the
      groups in amplitude of eye torsion in 0 G or 1.8 G. None of the tests were
      significantly different in 1 G. The results suggest that these tests of eye
      torsion on the KC-135 might differentiate those who would experience SMS from
      those who would not. Proof of this speculation awaits replication of the study
      using only astronaut subjects.

PMID- 2241731
TI  - Rigid gas-permeable contact lens wear during + Gz acceleration.
AB  - This study was designed to determine how well rigid gas-permeable contact lenses
      maintain position on the cornea under high G forces, and the effect on visual
      acuity. One hyperopic and five myopic subjects were fitted with lenses made from
      Pasifocon C material (specific gravity = 1.07). Two lens diameters (8.8-9.4 mm
      and 9.6-10.0 mm) were compared upon the myopic subjects for centering on the
      cornea. Visual acuity was measured at + 1 Gz (baseline), +3 Gz, +4 Gz, +6 Gz, and
      +8 Gz in the straight-ahead, lateral, and up-gaze positions from three acuity
      charts mounted in the gondola. All lenses, as estimated from the videotape,
      decentered down the z axis 2-3 mm at high + Gz. Visual acuity was reduced at the
      higher +Gz levels to similar measurements in most subjects for both the contact
      lens and spectacle control rides. No lens displaced from the cornea or dislodged
      from the eye during any of the 25 centrifuge runs.

PMID- 2241732
TI  - Thermogenesis and thermoregulatory function of iron-deficient women without
      anemia.
AB  - Physiological responses at 16 degrees C were studied in 11 women, age 28 +/-
      2(mean +/- S.E.) years and 26 +/- 2% fat, after their body iron stores were
      depleted by diet (5.0 mg iron x 2,000 kcal-1 x d-1), phlebotomy and menstruation
      for about 80 d and were repleted by diet (13.7 mg iron x 2,000 kcal-1 x d-1) for
      about 100 d, including daily iron supplementation (50 mg of iron as ferrous
      sulfate) for the last 14 d of repletion. Iron depletion was characterized by a
      decline (p less than 0.05) in hemoglobin (12.0 +/- 0.2 g x dl-1), ferritin (5.5
      +/- 0.5 ng x ml-1) and body iron balance (-9.1 +/- 2.6 mg x 6 d-1). Iron
      repletion, including supplementation, increased (p less than 0.05) hemoglobin
      (12.6 +/- 0.1 g x dl-1), ferritin (9.5 +/- 0.4 ng x ml-1) and iron balance (+67
      +/- 6.7 mg x 6 d-1). Iron depletion reduced (p less than 0.05) metabolic heat
      production (49.6 +/- 1.1 vs 53.6 +/- 1.2 W x m-2) during acute cold exposure. The
      rates of cooling of the core and periphery were greater (p less than 0.05) during
      iron depletion than repletion. A shift in the lower core temperature threshold
      for shivering was paralleled by an earlier onset of shivering (p less than 0.05)
      in iron depletion indicating an adaptation in cold tolerance in an attempt to
      maintain core temperature. Iron depletion was associated with blunted post
      exposure increases in plasma thyroid hormone concentrations and greater (p less
      than 0.05) increases in plasma norepinephrine concentrations as compared to iron
      repletion. In a subsample of the women, no significant effect of calcium or
      ascorbic acid supplementation was found on responses to cold exposure.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2241733
TI  - Modulation of cutaneous flexor responses induced in man by vibration-elicited
      proprioceptive or exteroceptive inputs.
AB  - The effects of muscle tendon or skin vibration on the early and late components
      of polyphasic cutaneous responses elicited in the flexor carpi radialis by
      electrical stimulation of the radial nerve at the wrist were studied in the
      human, with all muscles at rest. Both early and late flexor responses were
      enhanced by flexor vibration and depressed by extensor vibration; facilitation
      was accompanied by a reduction of latency. Furthermore, when an "antagonist
      vibration response" was present, inhibition of the flexor reflexes was replaced
      by a facilitation. Palm skin vibration depressed both components of the flexor
      reflex, while dorsal or "back-hand" skin vibration induced either a facilitation
      or an inhibition. In addition, back-hand vibration modified the location of the
      sensations evoked by electrical stimulation of the nerve. In all cases, vibratory
      stimulus attenuated the perceived intensity of the electrical stimulus. These
      observations indicate that proprioceptive or exteroceptive information can
      modulate the gain of the cutaneous reflex loops in a flexible way, under
      supraspinal control. These data also suggest a possible impairment of the
      protective withdrawal reflex under vibratory environmental conditions at rest and
      eventually in active muscles.

PMID- 2241734
TI  - The effect of +Gz offset rate on recovery from acceleration-induced loss of
      consciousness.
AB  - The incapacitation resulting from +Gz-induced loss of consciousness (G-LOC)
      depends on the magnitude of the ischemic/hypoxic insult to the central nervous
      system (CNS). This magnitude is defined by the rate of onset of the +Gz, the +Gz
      level, the length of time at +Gz, the offset rate, and individual tolerance to
      +Gz. Offset rates have rarely been emphasized or even reported in +Gz research.
      This study compared the incapacitation between two groups of asymptomatic men
      resulting from generally similar rapid onset (greater than 3G/s) +Gz exposures to
      induce G-LOC but with different +Gz offset rates. For one group (N = 90) of G-LOC
      exposures the offset rate was 0.97 G/s and for the other group (N = 17) the
      offset rate was 2.75 G/s. The incapacitation following G-LOC with slower offset
      resulted in an absolute incapacitation period of 10.47 +/- 3 s, a relative
      incapacitation of 14.40 +/- 10.05 s, and a total incapacitation period of 25.04
      +/- 10.13 s. With the more rapid offset G-LOC exposures the absolute
      incapacitation was 7.59 (+/- 3.14)s, relative incapacitation 5.40 +/- 3.38 s, and
      the total incapacitation was 13.20 +/- 4.36 s. The rate of +Gz offset also
      affects the time following G-LOC before onset of myoclonic convulsions. Rapid
      offset G-LOC exposures had a shorter period from the onset of unconsciousness to
      the onset of convulsions as compared to slower offset rates. The convulsion
      period, however, remained essentially the same. The results strongly favor an
      ischemic/hypoxic mechanism for G-LOC. The results also document the importance of
      offset rates in determining the magnitude of the ischemic-hypoxic insult to the
      CNS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241735
TI  - Cervical dystonia following exposure to high-G forces.
AB  - Injuries to the cervical region have been associated with high-G loads sustained
      during air combat maneuvering (ACM) in high performance fighter aircraft. The
      spectrum of injuries ranges from mild neck pain to musculoskeletal strain, injury
      to the nerve roots or spinal cord, and fracture of the cervical spine. A 36-year
      old fighter pilot with 2,800 h in tactical jet aircraft developed progressive
      cervical dystonia (spasmodic torticollis), following an ACM flight. The patient
      was successfully treated with local intramuscular injections of botulinum toxin
      into the affected cervical muscles, resulting in total relief of his spasmodic
      torticollis. The aeromedical considerations of this rare complication of exposure
      to G forces in high performance aircraft are discussed.

PMID- 2241736
TI  - Flight crews with upper respiratory tract infections: epidemiology and failure to
      seek aeromedical attention.
AB  - A voluntary questionnaire was used to determine the epidemiology of upper
      respiratory infections (URI), and whether aeromedical attention was sought.
      Questionnaires completed by 256 of 276 eligible flight crewmembers revealed that
      over half, 61.7% (158), reported having greater than or equal to 1 URI during a 6
      month period, for a total of 272 URIs. No statistically significant associations,
      p greater than 0.05, were noted between the occurrence of URI and sex, age, pilot
      vs. enlisted, or smoking status. Subjects with children living at home with them
      were more likely to report having URIs than those with no children, p less than
      0.10. Aeromedical attention was not sought in 55.5% (151/272) of the URI
      episodes. An Aeromedical Concern (AMC) was determined to occur in 69.5% (105/151)
      of these representing 38.6% (105/272) of all URIs. The most common reason for AMC
      was taking self-prescribed medications. AMCs were more frequent among enlisted
      personnel than officers (pilots), p less than 0.05. Possible reasons why AMCs may
      occur are discussed. In summary, URIs are common in aircrews, as is the failure
      to seek aeromedical attention.

PMID- 2241737
TI  - Military aviation: a contact lens review.
AB  - The military aviation communities have benefitted from the development of
      advanced electro-optical avionics systems. One drawback that has emerged is an
      increasing system incompatibility with traditional spectacle visual corrections.
      An alternative solution to the refractive error correction problem that some
      services have been investigating is that of contact lens wear. Since this much
      debated topic is currently of command interest, a general overview of contact
      lens issues is presented as a framework for future discussions.

PMID- 2241738
TI  - MYCIN and NEOMYCIN: two approaches to generating explanations in rule-based
      expert systems.
AB  - The prototypical rule-based expert system is MYCIN, a computer program developed
      in the 1970's to diagnose and recommend therapy for serious infections. MYCIN is
      able to explain its reasoning at any point in a consultation by listing the rules
      it has under consideration at that moment. However, when MYCIN's rules were used
      as the subject matter for a computerized infectious disease tutoring system, it
      became apparent that these rules contained implicit knowledge about how to
      perform diagnostic tasks and that this knowledge was inaccessible to the
      explanation system and, therefore, to students. This paper briefly describes
      NEOMYCIN, an expert system that makes this implicit knowledge explicit, and shows
      the effect that this reconfiguration of knowledge has on generating explanations.

PMID- 2241739
TI  - The history of aviation medicine in Argentina.
AB  - Ascents in balloons were first performed in Buenos Aires in 1855, and this
      activity was later regulated through the "Argentine Air Club," founded in 1908,
      whose Vice President, Jorge Newbery, subsequently became officially known as the
      "Founder of Argentine Aeronautics." Airplanes appeared and the first pilots'
      licenses were granted on June 17, 1910. Medical advice was given for such feats
      as crossing The Andes Cordillera in a balloon in 1915. Medical requirements for
      flying activities led to the creation of the Psychophysical Fitness Center in
      1922, the first of its kind in Argentina and South America. There, selection and
      periodical check-ups were performed according to medical standards prepared by
      Agesilao Milano, M.D., the Founder of Aviation Medicine in Argentina. Sanitary
      aviation began in 1911, and was formally organized in 1940. The first paper in
      aviation medicine was published in 1924. Teaching and research in aviation
      medicine started in 1933, and continued after the creation of the National
      Institute of Aviation Medicine in 1945, taking as its basic objective the
      physical fitness qualification for all flying activities. The Institute has been
      recognized as a University Establishment and rules Argentine national policy in
      aviation medicine.

PMID- 2241740
TI  - Cases from the aerospace medicine residents' teaching file. Case #38. A navigator
      with nonischemic central retinal vein occlusion progressing to ischemic central
      retinal vein occlusion.
AB  - A case report of a young USAF navigator with nonischemic central retinal vein
      occlusion progressing to ischemic central retinal vein occlusion is presented.
      This young man was treated with hyperbaric oxygen therapy early in the course of
      his disease with complete resolution of his condition. Two years later his vision
      remained 20/17. This is the first known case of central retinal vein occlusion
      being treated with hyperbaric oxygen.

PMID- 2241741
TI  - Will world peace mean less PTSD?

PMID- 2241742
TI  - Effects of acute hypoxia on cardiopulmonary responses to head-down tilt.
AB  - Six male subjects were exposed on two separate occasions to simulated
      microgravity with 28 degrees head-down tilt (HD) for 1 h with baseline followed
      by recovery at + 17 degrees head-up. Pulmonary ventilation, gas exchange,
      spirometry, and central and cerebral blood flow characteristics were compared
      while breathing ambient air (PIO2 = 122 mm Hg) and reduced FIO2 equivalent to
      14,828 ft (PIO2 = 81 mm Hg). With hypoxia (HY), the increased tidal volume served
      to attenuate the drop in arterial saturation by reducing deadspace ventilation.
      Arterial and mixed venous PO2 values, estimated from peripheral venous samples
      and cardiac output (CO), were both maintained during HD in HY. Mixed venous PO2
      was elevated by an increase in CO associated with a reduction in systemic
      resistance. Changes in spirometric indices during HD were not accentuated by HY,
      making the presence of interstitial edema unlikely. Cerebral flow and resistance
      showed minor reductions with HD. Tissue oxygenation and cardiopulmonary function
      were not notably effected by HD during HY, but a combination of these two
      stressors may predispose subjects to subsequent orthostatic intolerance during
      initial recovery.

PMID- 2241743
TI  - Thermal status of Antarctic divers.
AB  - I studied 5 wet-suited scuba divers studied on 26 dives in the Antarctic. The
      median duration of dives was 29 min, during which divers were usually involved in
      sampling or observations for marine biology or chemistry projects. Rectal
      temperature (Tre) and seven skin site temperatures were measured with
      thermistors, and mean skin temperature (Tsk) and heat loss estimated. Divers
      usually heated up during changing and transport to a dive. By the end of
      immersion, Tsk decreased to a median of 22 degrees C, and finger temperature
      decreased to a median of 10 degrees C, while the median heat loss during
      immersion was 850 kJ. Tre below 36 degrees C was not recorded. This study shows
      that divers do not become clinically hypothermic, but that they are subject to
      severe cooling, and skin temperatures reach levels at which manual and mental
      impairment may occur.

PMID- 2241744
TI  - Anti-LPS antibodies reduce endotoxemia in whole body 60Co irradiated primates: a
      preliminary report.
AB  - Long periods in space may expose astronauts to the potentially harmful effects of
      ionizing radiation. We have used a primate model to evaluate any role of
      lipopolysaccharide (LPS, endotoxin) in radiation sickness. Vervet monkeys, which
      had been whole-body 60Co irradiated with an LD100 exposure, had periodic blood
      samples taken for the determination of LPS, anti-LPS IgG antibodies and
      bacteriological studies. On day 2 post-irradiation, primates were treated i.m.
      with either sterile 0.9% saline, or equine anti-LPS hyperimmune plasma (Anti
      LPS), or orally with tripotassium-dicitrato-bismuthate ("Denol"). Gram positive
      bacteria were evident in blood samples of all animals as early as 2 d post
      irradiation. Gram negative bacteria were found in the blood of saline- and Denol
      treated primates by days 5 and 8, respectively, but first appeared on day 13 in
      the anti-LPS-treated animals. The saline controls and Denol-treated animals
      showed insignificant rises in plasma LPS on day 3, which increased further
      thereafter achieving significance on day 8 (p less than 0.01). These elevated
      levels persisted until death. However, in anti-LPS-treated monkeys, LPS
      concentrations remained below baseline until day 9, after which they rose
      significantly until death, but, were significantly less than the concentrations
      in both other groups (p less than 0.001). The anti-LPS-treated animals survived
      significantly longer than both the other groups (p less than 0.005). Since LPS
      may cause nausea, vomiting, diarrhea, anorexia and headaches, Anti-LPS
      administration may be of value in reducing plasma LPS concentration in humans and
      improving their performance and survivability.

PMID- 2241745
TI  - The susceptibility of rhesus monkeys to motion sickness.
AB  - The susceptibility of rhesus monkeys to motion sickness was investigated using
      test conditions that are provocative for eliciting motion sickness in squirrel
      monkeys. Ten male rhesus monkeys and ten male Bolivian squirrel monkeys were
      rotated in the vertical axis at 150 degrees/s for a maximum duration of 45 min.
      Each animal was tested in two conditions, continuous rotation and intermittent
      rotation. None of the rhesus monkeys vomited during the motion tests but all of
      the squirrel monkeys did. Differences were observed between the species in the
      amount of activity that occurred during motion tests, with the squirrel monkeys
      being significantly more active than the rhesus monkeys. These results, while
      substantiating anecdotal reports of the resistance of rhesus monkeys to motion
      sickness, should be interpreted with caution because of the documented
      differences that exist between various species with regard to stimuli that are
      provocative for eliciting motion sickness.

PMID- 2241746
TI  - Intraocular pressure, retinal vascular, and visual acuity changes during 48 hours
      of 10 degrees head-down tilt.
AB  - Intraocular pressures, retinal vascular diameters, and visual acuities of nine
      men (ages 19-29), were repeatedly measured while the subjects were tilted 10
      degrees head-down for 48 h and while they were seated before (baseline), and
      after the tilt. An immediate increase in intraocular pressure, measured by
      pneumatonometer (4.7 +/- 0.6 mm Hg, p less than 0.001) was recorded when subjects
      assumed the head-down position, and diurnal variations in intraocular pressures
      were observed for the 48 h. The initial and final head-down intraocular pressures
      were not significantly different (18.9 +/- 1.2 mm Hg vs. 17.9 +/- 1.4 mm Hg,
      respectively). However, when subjects resumed the sitting position, intraocular
      pressures fell below the initial sitting values (14.2 +/- 0.9 pre vs. 11.2 +/-
      0.5 post, p less than 0.04). Computer image analysis of the retinal vasculature
      detected a 6% and 2% reduction in the caliber of arteries and veins,
      respectively, as compared with sitting baseline values. No changes in visual
      acuity were documented during the 48 h of head-down tilt. Our data suggest that
      the choroidal blood reservoir increases in volume over 48 h at continuous head
      down position with a compensatory decrease in aqueous volume. These findings may
      explain intraocular pressure changes noted in astronauts during previous space
      missions and in studies associated with change in body position.

PMID- 2241747
TI  - Changes in geometrical and biomechanical properties of immature male and female
      rat tibia.
AB  - Tibial geometry and mechanical properties in male and female rapidly growing rats
      were measured to provide comparative data for spaceflight, exercise, or disease
      experiments that use immature rats as an animal model. A total of 68 immature
      Sprague-Dawley rats (43-58 d of age) were divided into 8 groups according to age
      and sex. Tibial length and middiaphysial cross-sectional data were analyzed, and
      tibial mechanical properties were obtained via three-point bending tests to
      failure. Results indicated that tibial geometry and mechanical properties were
      changed significantly during this 15-d period of rapid growth, with male rats
      having greater increases than female rats. Both male and female tibial lengths
      nevertheless increased significantly during this growth period, as did
      middiaphysical cross-sectional area. Tibial flexural rigidity increased
      significantly for both sexes during this growth period. The male tibiae changed
      primarily in structural characteristics, but some material properties also
      changed with age. In the female rats, however, the major changes in mechanical
      properties of the tibia were attributable only to structural changes in the bone.

PMID- 2241748
TI  - Hormonal changes after parabolic flight: implications on the development of
      motion sickness.
AB  - Twenty-two different humoral parameters including stress-, gastrointestinal- and
      volume-regulating hormones were measured before and within 45 min after parabolic
      flight maneuvers of twenty healthy adult subjects. We compared hormonal data of
      motion sickness-affected participants with those unaffected. Changes in cortisol
      and vasoactive intestinal peptide plasma levels were significantly different (p
      less than 0.002 and p less than 0.004) between the two groups with increasing
      plasma levels of both hormones during motion sickness but decreasing levels
      within the control group. Growth hormone and prolactin plasma levels increased by
      400% and 115% within the motion sickness-affected group and to a smaller degree
      (120% and 40% increases, respectively) within the control group, while ACTH
      levels were almost unchanged within both groups. Pancreatic polypeptide and
      gastrin plasma levels as well as plasma levels of insulin and C-peptide were
      significantly decreased within both groups after the parabolic flight. Plasma
      renin, aldosterone, atrial natriuretic peptide and cyclic GMP levels were
      unchanged within the control group. Within the motion sickness-affected group,
      plasma renin and aldosterone levels were decreased and atrial natriuretic peptide
      levels increased after the flight. Humoral parameters of the thyroid gland were
      neither changed within the groups nor different between the groups. The present
      data confirm previous results that increases in plasma levels of certain stress
      hormones participate in motion sickness. Furthermore, increases in vasoactive
      intestinal peptide levels participate in motion sickness. These increases could
      explain some of the gastrointestinal symptoms in motion sickness and might serve
      as markers for a discrimination between regular stress and motion sickness.

PMID- 2241749
TI  - In-flight stabilization of oxygen saturation by control of altitude for severe
      respiratory insufficiency.
AB  - A 4,907-mile medical air transport recently took place between Vancouver, Canada,
      and London, England. The patient was a 6-year-old boy with multiple pleural,
      pulmonary, and pericardial hemangiomata who required heart-lung transplant.
      Because his respiratory function was so poor (including oxygen-induced
      hypercarbia and sleep-induced hypoxia), a Lear 35 was used. The aircraft made a
      low altitude flight possible, allowing adjustment of cabin pressure to overcome
      the child's sensitivity to any significant reduction in partial pressure and to
      minimize his need for supplemental oxygen. Clinical observation and monitoring
      using oximetry and transcutaneous blood gas measurements were carried out en
      route to warn of excessive altitude effects. Sequential increases in altitude
      were made once oxygenation had stabilized at each cabin pressure. Cabin pressure
      was not allowed to rise above 3,700 ft to ensure an oxygen saturation level of at
      least 80%. The transport was accomplished successfully with no requirement for
      intervention. This approach to in-flight management has applications for other
      aero-medical transports.

PMID- 2241750
TI  - Altitude decompression sickness: hyperbaric therapy results in 528 cases.
AB  - We reviewed 528 cases of decompression sickness (DCS) resulting from altitude
      exposure (either aircraft or altitude chamber) during the period 1 January 1977
      through 31 December 1986, and treated with hyperbaric therapy. Data collected
      include age, sex, date and place of origin, duty position, type of exposure,
      altitude, diagnosis, treatment, and result. Analysis of the data described
      maximum altitudes of exposure, time to onset of symptoms, diagnosis, and the
      treatment tables used. Significant results include an increased incidence of
      altitude DCS requiring hyperbaric therapy among females (relative risk for
      females is 4.3 times that of males), no significant difference in incidence rates
      between duty positions in the altitude chamber exposures reviewed, and
      confirmation of the efficacy of hyperbaric oxygen therapy.

PMID- 2241751
TI  - A case of left hypoglossal neurapraxia following G exposure in a centrifuge.
AB  - Isolated hypoglossal (XIIth cranial nerve) neurapraxia is a rare clinical
      presentation. We present a case of an isolated hypoglossal neurapraxia following
      exposure to +7.2 Gz in a human centrifuge. Although a variety of cervical spine
      injuries have been reported as a result of G exposure in an aircraft, no cranial
      nerve injuries have been reported. A review of the literature of isolated
      hypoglossal neurapraxia is presented with discussion of the probable cause of
      this nerve injury.

PMID- 2241752
TI  - Pregnancy outcomes among female flight attendants.
AB  - Flight attendants have been reported to be at increased risk for menstrual
      abnormalities and for spontaneous fetal loss. This study examined Washington
      State birth certificates for associations between adverse pregnancy outcomes and
      maternal employment as a flight attendant. Current pregnancy outcomes (low
      birthweight, prematurity, low Apgar scores, and abnormal sex ratio) were not
      significantly related to occupation. Flight attendants reported their preceding
      pregnancy resulted in a spontaneous fetal loss nearly twice as often as other
      women (relative risk = 1.9, 95% confidence interval = 1.3-2.7). However, when
      comparison was restricted to other employed women, the risk was lower (RR = 1.3,
      95% CI = 0.9-1.9). A clinically significant pregnancy risk among flight
      attendants cannot be excluded on the basis of this study, but the apparent excess
      risk of spontaneous fetal loss in this and particularly in a previous study could
      be explained at least in part by methodologic limitations.

PMID- 2241753
TI  - Positive pressure breathing for acceleration protection and its role in
      prevention of inflight G-induced loss of consciousness.
AB  - That pressure breathing for G protection (PBG) can improve both tolerance and
      endurance to high sustained +Gz acceleration is now well established. It is not
      surprising, therefore, that the undoubted potential benefits of PBG in an
      operational environment have been greeted with enthusiasm by aircrew and their
      commanders. In some quarters, the use of positive pressure breathing (PPB) during
      periods of high sustained +Gz acceleration is being hailed as a potential cure
      for the problem of G-induced loss of consciousness (G-LOC). We believe, however,
      that confidence in the technique for this purpose in modern, highly agile fighter
      aircraft is misplaced. This article reviews PPB's background and present use as
      protection against +Gz acceleration, and summarizes the physiologic basis for its
      effectiveness, before relating it to its undoubted role in support of other anti
      G strategies. From theoretical considerations supported by published evidence, we
      conclude that while PPB, if used correctly and when combined with other
      strategies, can enhance tolerance to +Gz acceleration, its principal influence on
      the occurrence of G-LOC will be by virtue of its ability to increase endurance by
      decreasing aircrew fatigue.

PMID- 2241754
TI  - Partial supination versus Gz protection.
AB  - Visual and loss of consciousness endpoints during 2 G/s onset G forces sustained
      for 5 s in 14 and for 10 s in 27 untrained pilots indicated high tolerances when
      upright, and increases of greater than 3 G when supinated to 60 degrees.
      Protection against visual symptoms of only 1.1 G when tilted 60 degrees and
      especially none when experienced subjects were tilted 45 degrees from vertical
      were unexpected results in 1942. Subsequent findings by others of slight
      decreases in tolerance at 30 degrees are contrary to hydrostatic basis of G
      tolerance. Presumably factors other than heart to brain distance (e.g., increased
      intracranial and intraocular pressures) affect G tolerance when subjects are
      supinated 30 degrees. We conclude that the apparent increased incidence of G-LOC
      since the incorporation of 30 degrees seat in F-16 and other fighters in mid
      1970's supports the current relevance of these data and suggests that all aircrew
      should follow the lead of veteran test pilots who sit upright in preparation for
      and during high G maneuvers (10).

PMID- 2241755
TI  - A new approach to the analysis of nystagmus: an application for order-statistic
      filters.
AB  - A computer program has been designed for the analysis of nystagmus. This program
      employs a class of nonlinear digital filters called order-statistic (OS) filters.
      Two OS filters and one linear filter are used. First, the eye-movement signal is
      smoothed using a predictive finite-impulse response (FIR), median hybrid filter.
      Then the smoothed signal is processed by a linear band-limited differentiating
      filter to calculate eye velocity. And finally, the slow-phase velocity (SPV)
      envelope is extracted from the eye-velocity signal using an adaptive
      asymmetrically trimmed-mean filter. This approach yields an evenly sampled SPV
      estimate without resorting to the various interpolation or extrapolation schemes
      generally used. The adaptive filter estimates SPV based on the local statistical
      properties of the eye-velocity signal. The adaptive strategy works under the
      assumption that, on the average, the eyes spend more time in slow-phase than in
      fast-phase. No assumptions are made about the direction of the nystagmus or the
      nature of the stimulus used to elicit the nystagmus. This method eliminates all
      the usual threshold tests and decision logic common to other nystagmus analysis
      programs. The robust performance of OS filters and the use of adaptive filter
      structures totally eliminates the need to custom "tune" the program parameters
      for atypical data sets.

PMID- 2241756
TI  - Update on possible health effects from exposure to galactic cosmic radiation.

PMID- 2241758
TI  - Dissociation of sexual arousal and sexual proclivity in the garden snail, Helix
      aspersa.
AB  - Sexual arousal (intensity of courtship) and sexual proclivity (tendency to court)
      in Helix aspersa can be reliably measured using externally observable correlates.
      Snails with sexual proclivity are significantly more likely to turn toward an
      anesthetized conspecific after contacting it than are sexually unreceptive
      snails. Sexual arousal can be inferred from the stage of a snail's genital
      eversion, which appears only during courtship. The higher the stage of the
      eversion, the shorter the time required to complete introductory courtship
      behavior and the higher the rate of successful copulation, the fewer the number
      of breaks and pauses during courtship, and the longer the time a snail will spend
      in contact with an anesthetized conspecific. Sexual proclivity has no effect on
      feeding or locomotory behavior; however, sexual arousal inhibits feeding and
      increases locomotor activity. Snails that were allowed daily contact with
      conspecifics required less time to complete introductory courtship behavior
      relative to snails that were isolated from conspecifics for 1 week. This suggests
      that daily contact increases sexual arousal. A greater percentage of isolated
      snails exhibited courtship behavior than did snails which had experienced daily
      conspecific contact. This suggests that isolation increases sexual proclivity.
      These differences indicate that sexual arousal is not merely due to an increase
      in sexual proclivity.

PMID- 2241757
TI  - Acetylcarnitine reduces the immobility of rats in a despair test (constrained
      swim).
AB  - Male rats forced to swim in a cylinder adopted an immobile posture. Immobility
      was reduced by acetylcarnitine (5, 10, and 20 mg/kg) and by antidepressant drugs,
      such as desipramine and iproniazid, injected 24, 5, and, again, 1 h prior to
      behavioral testing. Acetylcarnitine also potentiated the anti-immobility effect
      of antidepressant drugs in the despair test. Chronic (10 days) treatment with
      acetylcarnitine mimicked the effect found after acute administration. It is
      possible that the action of the acetylcarnitine on the despair test is indicative
      of an antidepressant activity of this drug that is dependent on a change in the
      sensitivity of monoamine receptors in the brain.

PMID- 2241759
TI  - Pavlovian conditioning of distinct components of Hermissenda's responses to
      rotation.
AB  - In two experiments with the nudibranch mollusk Hermissenda, distinct
      characteristics of conditioned and unconditioned responses to high-speed orbital
      rotation were examined. In Experiment 1, two principle unconditioned responses to
      rotation were identified, namely, reduced rate of locomotion and contraction of
      the foot. The magnitude of the foot contraction increased throughout a 20-s
      period of rotation, whereas locomotion was reduced immediately after the onset of
      the rotation and was maintained at this constant low rate throughout the stimulus
      presentation. These divergent response patterns suggest that the two responses
      emerge independently. In Experiment 2, a classical conditioning procedure was
      employed in which a light (CS) was paired with the rotation (US) employed in
      Experiment 1. In a subsequent test, it was found that the light had acquired the
      capability to evoke both foot contraction and decreased locomotion. Although the
      magnitude of these conditioned responses was reduced relative to the
      corresponding unconditioned response, the patterns of responding were virtually
      identical; that is, foot contraction developed gradually whereas locomotion
      decreased immediately. In contrast, animals that received unpaired presentations
      of the light and rotation, light alone, or no prior exposure to those stimuli
      exhibited foot extension in response to the light. These results illustrate a
      transfer of some of the response-evoking properties of the US to the CS as a
      result of conditioning, as well as the emergence of two independent conditioned
      responses. Moreover, these results suggest modulation of at least two distinct
      motor pathways as a function of learning.

PMID- 2241760
TI  - Rats with dorsal hippocampal lesions do react to new stimuli but not to spatial
      changes of known stimuli.
AB  - The effect of visual distracting stimuli upon the straight alleyway performance
      of dorsal hippocampectomized Wistar rats was investigated. In comparison with
      control animals it was observed that dorsal hippocampectomized animals (1)
      ambulated more during the preexposure phase, (2) acquired at the same rate a
      running response for food (training phase), (3) reacted similarly to a new visual
      stimulus (black cards) presented in a sector of the alleyway, and (4) habituated
      to successive presentations of that stimulus in the same place. (5) However,
      dorsal hippocampectomized rats did not react, unlike the controls, to the
      presentation of the same stimulus in another place of the alleyway but (6)
      reacted to the visual pattern change of the stimulus (now black/white check
      cards) in the same place. These results indicate that under certain experimental
      conditions, hippocampus-lesioned animals are capable of interrupting a running
      response for food in order to explore a new conspicuously located stimulus,
      habituate to repeated presentations of that stimulus, and to react to a new
      pattern of visual stimulation. They suggest that hippocampectomized rats do not
      lose the capacity to react to a new stimulus; the disruption seems to be related
      to the spatial context of stimulus presentation, supporting a spatial mapping
      hypothesis of hippocampal function.

PMID- 2241761
TI  - Social preference of female gerbils (Meriones unguiculatus) as influenced by coat
      color of males.
AB  - Female gerbils (Meriones unguiculatus) of three distinct coat colors (agouti,
      black, and sandy or pink-eyed dilution) were tested in a Y-maze whose arms led to
      compartments containing unfamiliar male gerbils of varying coat colors. The
      stimulus animals were separated from the females by a Plexiglas door. The trials
      lasted for 2 min and each female was exposed to the following four combinations:
      two males of the same coloring as the female; one male of the same color and
      another of a different color from the female; both males of different color from
      the female. The number of crossings to the left and right arms was relayed by
      photocells to an IBM PC computer. The results indicate that agouti females
      preferred visiting the arm occupied by agouti males while those of the other coat
      colors showed no preference for the "wild-type" males. Instead, sandy and black
      female gerbils preferred to be in proximity with those of non-wild types.

PMID- 2241762
TI  - Tolerance to the antinociceptive effect of intrathecal morphine in intact and
      chronic spinal rats.
AB  - The antinociceptive effect of daily acute intrathecal morphine injections on the
      tail-flick withdrawal response was compared in Intact rats and rats that were
      spinally transected 3 to 4 weeks prior to morphine administration (Spinal rats).
      Spinal rats became tolerant to repeated intrathecal injections of 5, 15, or 30
      micrograms of morphine within 3 days. Intact rats were not tolerant to these
      doses after 4 daily injections. Spinal rats, made tolerant to repeated
      intrathecal morphine injections, were not tolerant to a subcutaneous injection of
      6.0 mg/kg of morphine. These data suggest that, in intact animals, tolerance to
      the antinociceptive effect of spinal morphine is modulated by descending,
      supraspinal input.

PMID- 2241763
TI  - Effect of environmental complexity on size of the superior colliculus.
AB  - The present study examined effects of environmental complexity on the size of the
      superior colliculus, a subcortical structure involved in visuomotor functions.
      Long-Evans hooded rats raised together in a complex environment for 48 weeks were
      compared with their littermates housed in individual cages. The depth and area of
      the superficial gray layer of the superior colliculus were about 5-6% greater in
      the group from the complex environment, while the deeper layers of the superior
      colliculus showed no significant differences. The magnitude of the differences
      approached those reported for the neocortex, which has been considered to be
      distinctive in its morphological responsiveness to differential environmental
      complexity. The findings also extend previous observations that visual
      deprivation leads to shrinkage of the superficial gray layer and indicate that
      the morphology of this subcortical visual area is responsive to varying degrees
      of environmental stimulation.

PMID- 2241764
TI  - MVO2max of the heart cannot be determined from uncoupled myocytes.

PMID- 2241765
TI  - Hydrogen peroxide generation by mitochondria isolated from regionally ischemic
      and nonischemic dog myocardium.
AB  - We occluded the left anterior descending coronary artery of anesthetized, open
      chest dogs, for 1 or 2 h. Some hearts were reperfused for 1 h after 1 h of
      ischemia. We isolated mitochondria from the central ischemic zone (CIZ) and a
      surrounding nonischemic zone (NIZ) of the left ventricle, and assayed H2O2
      production using a horseradish peroxidase-dual wavelength spectrophotometric
      technique. Mitochondria, studied in the absence of exogenous respiratory chain
      inhibitors, generated H2O2 during State 4 respiration with succinate as the
      substrate. NIZ mitochondria in all groups produced ca. 1.5 nmols H2O2/min/mg
      protein (no significant differences between groups). The State 4 O2 consumption
      rates of NIZ mitochondria from hearts subjected to 1 h ischemia plus reperfusion,
      or 2 h of ischemia (ca. 30 nmols/min/mg) were significantly higher than that of
      NIZ mitochondria of hearts subjected to only 1 h of ischemia (23 nmols/min/mg).
      Thus, the ratio between H2O2 produced and State 4 O2 consumption fell from 6.5%
      to 5%. Mitochondria from all CIZ samples had State 4 O2 consumption rates that
      were not different from corresponding NIZ values. However CIZ mitochondria of
      hearts subjected to 1 h ischemia without reperfusion produced less H2O2 (1.1 +/-
      0.1 nmols/min/mg), and had a slightly reduced H2O2/O2 ratio (4.4 +/- 0.7%),
      compared with their NIZ samples (1.5 +/- 0.1 nmols/min/mg; 5.3%). Reperfusion
      after 1 h of ischemia abolished these regional differences. The CIZ mitochondria
      from hearts subjected to 2 h ischemia produced only 0.75 +/- 0.22 nmols
      H2O2/min/mg (2.5% of State 4 O2 consumption). These values were 50% of
      corresponding NIZ values, and were significantly less than for any other group or
      tissue region. If similar phenomena occur in conscious animals subjected to
      incomplete regional ischemia, especially of relatively brief duration or if
      accompanied by reduced intracellular defenses against oxidants such as H2O2, they
      suggest that mitochondria persist as H2O2 sources and so may contribute to the
      oxidant load and myocardial dysfunction.

PMID- 2241766
TI  - Glycolysis in heart failure: a 31P-NMR and surface fluorometry study.
AB  - Glycolysis is slow in the heart, especially in the cardiomyopathic heart.
      Glycolysis is partially rate-limited by phosphofructokinase (PFK), an enzyme
      which is inhibited by calcium (Ca2+)i and hydrogen ions (H+)i and activated by
      cAMP. (H+)i and (Ca2+)i are augmented in cardiomyopathy. With glucose as the only
      substrate (NADH)/(NAD) the phosphorylation potential and developed pressure were
      significantly lower, and concentrations of phosphomonoester sugars and hydrogen
      ions (H+)i were significantly higher in isolated cardiomyopathic hearts as
      compared to healthy hamster hearts. Pyruvate lowered diastolic (Ca2+)i in
      cardiomyopathic hamster hearts. With pyruvate as the substrate (NADH)/(NAD), the
      phosphorylation potential and developed pressure increased significantly and
      concentrations of phosphomonoester sugars (PME), (H+)i and diastolic (Ca2+)i
      decreased significantly in myopathic hamster hearts. The results suggest that
      late heart failure in the myopathic hamster is associated with calcium and/or
      hydrogen ion-induced inhibition of glycolysis.

PMID- 2241767
TI  - Left ventricular wall stress distribution in chronic pressure and volume
      overload: effect of normal and depressed contractility on regional stress
      velocity relations.
AB  - Regional stress-velocity relations were determined in a first group of patients
      (n = 15) with normal (five controls, five patients with aortic stenosis, and five
      patients with aortic insufficiency) and a second group of patients (n = 10) with
      depressed contractility (five patients with aortic stenosis and five with aortic
      insufficiency). LV circumferential wall stress was calculated from high-fidelity
      pressure and frame-by-frame angiocardiographic data using the Wong thick-wall
      model. Regional wall stress and shortening velocity were calculated from the endo
      to the epicardium, and from the equator to the apex at 35 points. Regional LV
      wall stress was in all patients lower at the epi- than the endocardium, and lower
      at the apex than the equator. Regional stress-velocity relations were downward
      shifted from the endo- to the epicardium and from the equator to the apex (family
      of curves) in both groups. At corresponding LV regions stress-velocity relations
      showed significantly smaller slopes and intercepts (downward depression) in group
      2 than in group 1. Thus, wall stress distribution is inhomogeneous in the normal,
      as well as in the pressure and volume overloaded left ventricle. Regional
      differences in stress-velocity relations within groups (family of curves) are
      probably related to changes in preload rather than to changes in regional
      contractility. Downward depression of the regional stress-velocity relations in
      group 2 is caused by depressed myocardial contractility.

PMID- 2241768
TI  - Ultrastructural damage and Ca2(+)-shifts in the canine myocardium subjected to
      regional incomplete ischemia.
AB  - The role of Ca2+ in the pathogenesis leading to ischemic myocardial cell death is
      still controversial. To gain insight into this phenomenon a cytochemical
      procedure, the phosphate pyroantimonate method, was used to localize different
      subcellular Ca2(+)-pools at the ultrastructural level. After 45 min of left
      anterior descending coronary artery (LAD) occlusion, the coronary arteries were
      perfused with triphenyltetrazoliumchloride staining (TTC) to identify viable
      ischemic and infarcted tissue. In non-ischemic tissue, Ca2(+)-deposits were
      confined to the sarcolemma, sarcolemma-derived vesicles, transverse tubules, and
      intercalated disks. In infarcted tissue (TTC-negative), the sarcolemma lost its
      Ca2(+)-binding capacity and mitochondria were either overloaded with Ca2(+)
      precipitate or they contained amorphous densities. In viable ischemic areas
      (determined with the TTC-technique) the sarcolemma was virtually devoid of Ca2(+)
      deposits. Mitochondria in this area frequently showed clumping of the cristae,
      associated with an accumulation of Ca2(+)-precipitate in between the clustered
      cristae. The results of this study indicate that Ca2(+)-shifts occur in ischemic
      myocardial cells before the occurrence of other ultrastructural signs of
      irreversible injury which, therefore, narrows the possibility that Ca2(+)
      overload is only a consequence of ischemic cell death.

PMID- 2241769
TI  - Determinants of infarct size in non-human primates.
AB  - To achieve a better understanding of the major factors that determine infarct
      size in non-human primates, a mathematical model was constructed using stepwise
      regression analysis. The model was developed on the basis of infarct size
      measurements, including the anatomical area at risk, regional myocardial blood
      flow measurements and hemodynamic determinants obtained in 23 control baboons
      undergoing up to 2 h of coronary artery thrombosis followed by thrombolysis. In
      this model, the size of the perfusion bed of the occluded coronary artery and the
      duration of coronary artery occlusion were found to be the only important
      predictors of infarct size (expressed as a percentage of left ventricular mass).
      R2 (square or the multiple correlation coefficient) was 70% in this model.
      Collateral blood flow and rate-pressure product were not identified as important
      predictors of infarct size. In a second group of eight baboons, atenolol (0.1
      mg.kg-1) was administered intravenously 15 min after the onset of coronary artery
      thrombosis. Predicted infarct size (based on the mathematical model obtained in
      the control group) was larger than the observed infarct size in seven out of
      eight cases. In four instances observed infarct size was smaller than the 95%
      lower limit of the predicted value. It is concluded that the determinants of
      infarct size in non-human primates differ from those in canine models with
      respect to collateral flow and estimates of myocardial oxygen consumption (rate
      pressure product). The developed mathematical model of infarct size prediction
      allows the detection of cardioprotective drug effects with an acceptable
      efficacy.

PMID- 2241771
TI  - [DNA extraction from body fluids of cadavers].
AB  - DNA of 1 ml Ascites, bile, liquor, pleural-exsudate, pericardial-fluid, synovial
      fluid, urine and vitreous humor of sixteen bodies of either sex was isolated.
      Applying dot-blot-hybridisation black spots were obtained by using total human
      DNA as DNA-probe (A), if the origin is human. Our results showed, that body
      fluids of dead persons contain human DNA, mainly. After rehybridisation with a
      sex-specific DNA-probe (Y) (pJA 1143) a determination of sex can be performed.

PMID- 2241772
TI  - [Program of the 68th annual meeting of the German Society of Forensic Medicine,
      September 19-23, 1989 and of the 1st International Symposium on Alcohol Survey,
      September 21-22, 1989, Salzburg. Proceedings].

PMID- 2241770
TI  - Lidocaine improves survival rate in diabetic rats submitted to acute left
      coronary artery ligation.
AB  - This study was designed to evaluate whether the decreased early survival rate of
      diabetic rats submitted to acute experimental myocardial infarction can be
      improved by pretreatment with lidocaine. Male Wistar rats (+/- 210 g) were
      rendered diabetic with i.v. injection of streptozotocin (50 mg/kg), and only
      those presenting 1 week later a tail-blood glucose value between 250-400 mg/dl
      were retained in the protocol. Eleven weeks after induction of diabetes, a bolus
      of lidocaine (2 mg/kg) was administered i.v. about 6 min prior to ligation of the
      left coronary artery under ether anesthesia in control (n = 54) and diabetic (n =
      48) rats; similar studies were conducted in 53 control and 55 diabetic rats
      without lidocaine pretreatment. Adequate occlusion was confirmed by an elevation
      of plasma CK-MB levels 4 h later or by a toluidine blue injection technique in
      rats which died earlier. Rats were followed over 48 h and comparison in the
      survival rate in each group established with the Fisher's exact test. Early
      survival rate (measured after 20 min) was significantly decreased in diabetic
      rats (27% vs 45%; p = 0.04). This was greatly improved by lidocaine pretreatment
      in diabetic (60% vs 27%; p = 0.0013), but not in control animals (50% vs 45%; p =
      0.348). Furthermore, the beneficial effect of prophylactic lidocaine observed
      early after coronary ligation in diabetic rats was maintained throughout the
      period of observation (48 h). These data suggest that the prophylactic use of
      lidocaine is able to reverse the increased incidence of sudden death following
      experimental myocardial infarction in chronically diabetic rats.

PMID- 2241773
TI  - [Regulations for autopsy and organ removal in Sweden].
AB  - In Sweden clinical autopsies are controlled by the autopsy law, which prescribes
      information to the relatives about the planned autopsy. Permission by the patient
      before death or by the relatives after information is mandatory. The performance
      of the autopsy is not regulated. For forensic autopsies no information or
      permission is prescribed. The performance and the documentation of the autopsy is
      strictly regulated and no partial autopsies are permitted. Forensic autopsies
      must be performed by forensic pathologists. A comparison is made of the
      legislation in the scandinavian countries and the Federal Republik of Germany.

PMID- 2241774
TI  - [Ethical aspects of forensic psychiatry expert assessment].
AB  - Psychiatrists working in forensic fields are confrontated with different ethical
      problems. In the following some problems are discussed. At present there is no
      need of special ethical guidelines for the German forensic psychiatrist.

PMID- 2241775
TI  - [Lung embolism caused by vaseline following insertion of a venous catheter].
AB  - Pulmonary embolism usually is due to natural causes, most often to obstruction of
      pulmonary arteries by blood clots breaking loose from venous thrombi forming in
      the leg or pelvis. Clots of other cellular material such as tumor fragments or
      fatty tissue (this especially in case of severe soft tissue and skeletal trauma),
      but also foreign material can give rise to this- often times lethal-condition.
      This is a report of foreign-body pulmonary embolism with obstruction of mainly
      the right lower lobe pulmonary arteries due to white vaseline embolism, probably
      responsible for the patient's premature surmise. Clinical history, therapeutic
      measures and course of disease--including radiographic and laboratory findings
      are being presented. Autopsy revealed massive pulmonary embolism to the right
      lower lobe due to a whitish greasy substance, which was chemically identified to
      be white vaseline. Additionally, this zone of infarction also showed signs of
      severe pneumonia with abscess formation resembling that of necrotizing infarction
      and therefore felt to be related to the foreign body embolism. Histology showed
      evidence of pneumonia and also inflammatory changes of the pulmonary arteries in
      form of additional formation of endothelium with involvement of the internal
      elastic layer. Finally, several possible causes for this case of pulmonary
      vaseline embolism are being discussed. The exact mechanism remains unclear; but
      in view of the course of disease, some radiographic findings as well as those of
      autopsy and histology, it seems most likely that the vaseline embolism was
      connected to transjugular catheterization rather than to the two other mechanisms
      also described.

PMID- 2241776
TI  - [Pressure damage of the hypopharynx caused by stomach tubes].
AB  - Analysis of 70 cases of death after intensive care of different survival time and
      various causes of death. All persons were intubated and had nasogastric feeding
      tubes. Bleedings into the PCA-muscles were found in 50% of all cases (especially
      in short-term survival: up to 80%). Bleedings in this region are not specifical;
      there are many possible causes. In 27 cases lesions of the hypopharyngeal wall as
      the result of pressure by the lying tubes were found up to ulcerations; sometimes
      just after about 1 day. Frequency and deepness of this lesions increased with the
      time of survival. Even if the hypopharyngeal wall was intact, there are often
      circumscripted (histologically detected) destructions inside of the PCA
      muscle(s), caused in part by the pressure of the tube.

PMID- 2241777
TI  - [Fatal air embolism following erroneous phlebotomy technique].
AB  - An 62 years old patient suffering of polycythemia was treated by phlebotomy. To
      accelerate the blood flow the collecting apparatus was connected to a pump
      supplying suction. Of the two pump outlets, providing suction and pressure, the
      one supplying pressurized air was connected erroneously. Air was insufflated into
      the arm vein causing cardiac arrest. Reanimation was unsuccessful. The findings
      are discussed, as well as the difficulties in interpretation.

PMID- 2241778
TI  - [Carbon monoxide poisoning caused by medical error. Fatalities in connection with
      medical measures in Leipzig and Hannover].
AB  - There are significant differences in the frequency of CO intoxication and its
      relation to other not natural causes of death between the autopsy cases of
      Leipzig (DDR) and Hannover (BRD). While the percentage of all autopsies in
      Leipzig runs up to 7.6%, in Hannover it runs up to only 1.5%. Beside the well
      known cases of not recognized CO intoxication at the autopsy with or without
      following intoxication of other persons, two concrete cases of not recognized CO
      intoxication with the survival of the victims discussed. The not noticed CO
      intoxication followed by the death of the victim is usually considered in
      medicolegal opinious as "medical malpractice". In cases of survived not noticed
      CO intoxications this opinion ist only supposed in special cases with longer
      anamnesis and a typical seasonal rythmic of symptoms.

PMID- 2241779
TI  - [HIV-1 prevalence in forensic medicine examination of fatalities (Hamburg and
      Munich 1989)].
AB  - All fatalities investigated at the Institutes of Forensic Medicine in Hamburg and
      Munich are screened for HIV-1-antibodies. The serological findings of 1,000
      consecutive cases in the year 1989 were compared concerning HIV-1-prevalence,
      riskgroup, age and sex distribution. The prevalence rate of HIV-1-antibodies was
      5% in Hamburg and 6% in Munich. The HIV-seropositives were mainly i.v.-drug users
      and homosexuals dying from unnatural causes. Unexpectedly HIV-infection was also
      present in two males of advanced age with myocardial infarction. The HIV-1
      prevalence rate of all drug related fatalities from 1985-1989 was investigated,
      too. The cumulated seropositivity in Hamburg was 14% and in Munich 18%. The
      development was unsteady; continuous monitoring of the HIV-status of drug deaths
      seems to be a worthful means to evaluate the spread of this disease among the
      risk group of intravenous drug addicts.

PMID- 2241780
TI  - [Prevalence of hepatitis B in fatalities in forensic medicine].
AB  - Serological screening investigations for hepatitis B were carried out on 1000
      sudden and unexpected fatalities from natural causes and non-natural deaths at
      the Institute for Forensic Medicine in Hamburg. The results were compared with
      the serological tests of the drug deaths from 1983-1989 and the HIV-infected
      bodies from 1984-1989. It was found that anti-HBc was positive in 19.2% of the
      unselected cases as compared with 46.1% in drug related deaths and 73% in the HIV
      infected group. HBsAg as a marker that expresses infectiosity was present in 15
      cases (1.5%) of 1000 unselected cases, 4.4% of the drug related deaths and 15.8%
      of the HIV-infected group.

PMID- 2241781
TI  - [Statistical study of alcohol intoxicated female victims of sex offenses].
AB  - Comparing 133 presumable rape victims who underwent blood sampling after the
      event with 2446 alcoholized female traffic offenders it was found that both
      groups had a delinquency maximum between midnight and 2 a. m. and a delinquency
      minimum between 6 a. m. and 6 p. m. Most of the rape victims, however, were
      approximately 5 years younger than the traffic offenders, most of whom were about
      25 years old. The time intervals between blood sampling and the event were longer
      in the case of the rape victims (4 to 20 hours) whereas most traffic offenders
      underwent blood sampling 1 to 2 hours after the event. At comparable maxima of
      the distribution curves of blood alcohol concentration (between 1.5% and 2%) that
      of the rape victims showed a shift to higher values. This is also illustrated by
      the mean values of blood alcohol concentration at the time of the event: the
      blood alcohol concentration of the rape victims was 2.24% and thus 0.45% higher
      than that of the traffic offenders, who averaged only 1.97%. The reason for this
      is probably to be seen in the different modes of back computation. By assigning
      38 offenders to 35 victims it was possible to set up and compare 35 pairs.
      Comparing the blood alcohol concentrations of all 35 pairs it was found that the
      blood of the victims contained on average 0.4% more ethanol than the blood of the
      offenders (1.41% vs. 1.01%).

PMID- 2241782
TI  - [Cause of death in severe acute ethanol intoxication].
AB  - A study of acute alcohol influence (heavy drinker) on sudden unexpected death
      were analyzed as to age, sex, cause of death and along with the lethal blood
      alcohol content. Excess alcohol abuse by adults or middle aged women causatived
      acute intoxication with actual toxic depression of brainstem function (high blood
      levels, means 3,6 mg/g). Others (alcohol abuse) die by drowning, trauma, sudden
      coronary death (drinking spirits), cardiomyopathy, hypothermia or hypoglycemia
      (Diabetes). The autopsy findings are discussed.

PMID- 2241783
TI  - [Alcohol in Turkish society].
AB  - Since the ruin of the Osmanic empire increased the consumption of alcohol in
      Turkey considerably. Besides the national drink Raki it concerns above all the
      consumption of beer in the last two decades. The reasons are alterations of the
      society in the urbanized regions, the consequences are mighty increasing problems
      with alcoholics, especially among those, who come from the country into the
      cities, and among women.

PMID- 2241784
TI  - [Sperm detection using monoclonal antibodies].
AB  - Monoclonal antibodies against sperm antigens detect specifically seminal stains
      in forensic casework. Different monoclonal antibodies resulting from the
      hybridoma technique allow by means of peroxidase test-system a direct marking of
      the trace.

PMID- 2241785
TI  - [Methanol and isopropanol as markers of alcoholism].
AB  - Car-drivers, who lost their licence on account of drunkeness, must be tested if
      the danger of alcoholism exists. The only criterion for this check is the level
      of bloodalcohol during this case. This check happens mostly one year later. It is
      proposed to analyse the blood sample immediately after measuring bloodalcohol for
      markers of chronic or acute abuse to differ alcoholics from persons consuming
      alcoholic beverages in normal mode.

PMID- 2241786
TI  - [Forensic medicine aspects of the Remscheid airplane crash].
AB  - In December, 1988, an American military pilot obviously losing his orientation
      brought down his jet fighter into a residential area of Remscheid, FRG. This
      paper reports on the medicolegal experiences gained during identification the
      victims. The officials plants for duty in case of disaster are discussed.

PMID- 2241787
TI  - [Accidents with fatal outcome in Finnish leisure boating 1986-1988].
AB  - All 291 fatal accidents (510 persons on board, 318 drowned) in water traffic in
      Finland in 1986-1988 were investigated by specific teams. Only some data of this
      extensive investigation are presented in this study. Staggering and falling in
      boat because of drunkenness, falling over and sinking of boat were the main
      causes of getting into water of the people aboard. Only 3.5% of the drowned had
      used life jackets and 9.7% of them could not swim. The reduced ability to swim
      because of alcohol and the exhaustion were in about half of the drowned the
      actual cause and the cold water in one third the background factor for drowning.
      The results indicate that fatal accidents in water traffic are a major problem of
      males (95.9%) and give important information for countermeasures.

PMID- 2241788
TI  - [Occasion and risk for detecting driving in alcoholic intoxication].
AB  - Detection of offenders driving while intoxicated (DW) (mandatory BAC limit at
      0.50%) in Finland was investigated. Almost every fifth offender was detected at
      road blocks and every tenth of them because of abnormal driving. Compared to the
      local police the national traffic police had arrested much more offenders for
      traffic violation (38% vs. 11%) but much less because of accidents (12% vs. 23%).
      The reason of detection was in a significant way dependent on the following
      variables: BAC, stage of inebriation, vehicle, day of week and hour of day. The
      risk of detection is very low, i.e. about 1 to 300. However, the risk has doubled
      from 1979 to 1984, but thereafter slightly declined. The study provides
      information for the strategy of the police in traffic supervision.

PMID- 2241789
TI  - [Diseases of stomach mucosa in the history of alcoholic traffic violators in
      street traffic].
AB  - 425 drunken drivers were examined for their driving sentability. The amount of
      persons with known diseases of digestion (or gastro-enteritis) among the drivers
      were higher than the average among the normal population. The patients with ulcus
      and gastritis showed higher nervosity, depression and emotional instability
      during the medical examination. In addition they showed a higher degree of
      openness and a tendency to lower blood alcohol concentrations at previous drunken
      driving. While judging their sentability (for driving) no differences could be
      made among persons with and without gastro-enteritis.

PMID- 2241790
TI  - [Alcohol risk in adolescent drivers--epidemiologic study of the Hannover region].
AB  - The traffic in the large cities requires special effort to young traffic
      participants and persons with just passed driving-license examination.
      Statistical investigations show an increasing partake of juveniles to alcohol.
      The results of the research of the protocols of the blood alcohol analyst's
      office at the Institute of Forensic Medicine of the MHH show an increasing share
      of drunken young traffic participants with blood alcohol concentrations below 1%.
      The special risk of juveniles by drinking and driving results not only of the
      reduction of the physical capacity because of the low alcohol tolerance, but
      especially of the reduction of the physical capacity and the personality in
      total.

PMID- 2241791
TI  - [Possibilities for individual identification of hair roots using DNA probes].
AB  - High-molecular weight DNA was extracted from hair roots. The obtained DNA was
      digested with Hae III and Msp I and transferred to nylon membranes by Southern
      blotting. The possibility of applying a probe for sex determination (pHY2.1) a
      "single-locus"-probe (YNH24) as well as a "multi-locus"-probe (M13) was
      examinated as a function of the amount of hair being supplied. In the laboratory
      experiment a single hair root was enough for a sex determination or individual
      identification. Because of methodical difficulties in practice this kind of
      profiling should only be done with several hair roots.

PMID- 2241792
TI  - [Significance of functional conclusions for "determination" of the cause of
      death].
AB  - On account of the usual expectation it is often assumed, that an autopsy allows
      the definitive determination of the manner and cause of death. This paper
      discusses in a critical way the problems associated with this endeavour. It is
      often the case, that extensive investigations, associated with structural
      functional conclusions and consideration of all available evidence are necessary
      to permit a retrospective interpretation of the course of death. This assumes a
      scientifically orientated approach to dynamic pathophysiological mechanism.

PMID- 2241793
TI  - [Premature craniosynostosis--cause of sudden death in children and young adults].
AB  - Primary premature craniosynostosis ordinarily leads to characteristic skull
      abnormalities, if the ossification of the sutures happens in early childhood and
      involves all sutures, the elevation of intracranial pressure may not cause severe
      clinical features and the head morphology may be normal. A disproportion between
      skull capacity and brain volume will be the result. Three cases are reported,
      where these preconditions combined with exterior effects like minimal trauma,
      physical activity or consumption of alcohol or medicaments caused sudden death.
      Important autoptic findings are ossified cranial sutures with the absence of
      suture lines and increased scalloping of the internal table of the skull
      (impressiones digitatae).

PMID- 2241794
TI  - [Spontaneous subdural hemorrhage of natural cause in metastatic renal cell
      carcinoma].
AB  - A 51 years old woman was complaining about pain in the back and headache. Because
      of sudden change in behaviour she was brought into hospital by her husband. At
      hospitalization she was unconscious, the first examination showed no hints for
      trauma. After diagnosis of a bifrontal subdural haematoma intracranial blood was
      removed twice by neurosurgeons. The woman died six days after hospitalization.
      The forensic autopsy showed rests of subdural blood and apart of medical
      intervention no injuries were seen. In the left kidney a carcinoma was found with
      metastasation in the adrenal glands, the liver, and the dura. The metastasation
      of the dura had led to destruction of the dural vessels with consecutive subdural
      bleedings. These hemorrhages probably had been supported by decreased coagulation
      because of metastasation of the liver. Although such spontaneous non-traumatic
      subdural bleedings are rare it is obvious that they can cause severe problems by
      delivering an expert opinion.

PMID- 2241795
TI  - [Waterhouse-Friderichsen syndrome in adults].
AB  - Only a minority of published cases of Waterhouse-Friderichsen-syndrome occurred
      in adults (Harms et al., 1973). At the autopsy of a 23 years old woman there were
      found sugillations of the eyelid, of the peri- and epicard, of the serosa of the
      small intestine and of the lung. In the region of the adrenal gland a brownish
      red mass was detectable. Histologically an adrenal apoplexy with necrosis and in
      liver, spleen and lung a lot of neutrophils were seen. Streptococcus viridans was
      pointed out in the blood.

PMID- 2241796
TI  - [A case of amyloidosis of peripheral arteries of the heart and liver in an
      elderly patient].
AB  - Cases of isolated cardiac amyloidosis and amyloidosis of the liver are seldom
      mentioned in the literature (Pitkanen et al., 1984). At the autopsy of a 85 years
      old woman we found a severe common arteriosclerosis, especially of the brain and
      heart. A pacemaker was regularly implanted. By staining with Kongo red there was
      histologically shown an isolated amyloidosis of the peripheral heart and liver
      arteries.

PMID- 2241797
TI  - [Myofibril degeneration of heart muscle: histologic picture and pathophysiologic
      significance].
AB  - Mechanical trauma to the heart induces a rhythmical transverse banding of
      adjacent myocytes. This finding is due to hypercontraction (true contraction
      bands) and it is different from the cross band type myofibrillar degeneration
      (MFD) which is characterized by disseminated foci of irregular transverse
      banding. This latter type is mainly found after temporary myocardial ischemia, in
      cases of reanimation using catecholamines and defibrillation as well as in severe
      brain trauma. Both types of cross banding can be identified in hematoxylin and
      eosin or in azan stains; a much better visualization is obtained using the PTAH
      or the Luxol Fast Blue (LBF) method. Moreover, LFB, giving a selective blue
      staining of the damaged cells, allows the identification of the recently
      described diffuse type MFD. Well developed contraction bands may indicate the
      vitality of a heart trauma, yet a supravital occurrence seems to be possible.
      MFD, diffuse or cross band type, clearly correlates with high blood catecholamine
      levels at the time of death.

PMID- 2241798
TI  - [Myofibril degeneration of heart muscle: diagnostic value of selected forensic
      pathology case material].
AB  - Information on the incidence of myofibrillary degeneration (MFD) was obtained by
      investigating the hearts of seven groups of cases with different forensic
      diagnosis using luxol fast blue as a staining method. The following diagnostic
      groups were examined: acute morphine intoxication, acute carbon monoxide
      intoxication, hanging, strangling by hand and/or ligature, drowning, acute
      hemorrhagic shock and sudden infant death syndrome. MFD positive cases were found
      in all diagnostic groups, but the morphologic expression of MFD as well the
      number of cases per group differed: The phenomenon of cytoplasmatic banding could
      be observed in nearly all cases of hanging, strangling and acute hemorrhagic
      shock; the phenomenon of diffuse cytoplasmatic staining in most cases of
      drowning. The diagnostic importance is discussed.

PMID- 2241799
TI  - [Sudden death of cardiac origin in childhood and adolescence].
AB  - In the autopsy material performed by our institute during the years 1979-1988, in
      the age group under 18 years (total 680 cases) 57 cases of sudden cardiac death
      (8%) were found. 49.1% of them were due to congenital heart malformations, 38.6%
      were due to myocarditis. The age distribution, the male:female--ratio and the
      conditions of occurrence showed significant differences. At heart malformation,
      the death frequently was due to ischemic damage of the myocardium. For the
      examination of sudden death cases as a main purpose of forensic medicine, general
      pathologic biopsy-diagnostic regimen did not seem to be fully apted. This is a
      challenge for establishing an international comparable general accepted
      nomenclature and methodology, that suits to this purpose.

PMID- 2241800
TI  - [Sudden cardiac death in mitral valve prolapse syndrome?].
AB  - Primary mitral valve prolapse is considered a rare cause of sudden cardiac death.
      Close to 100 cases are documented worldwide. The cause of death seems to be
      cardiac arrhythmia, so postmortal diagnosis is difficult and depends on severe
      changes of the mitral leaflets and--sometimes--on anamnesis. Three postmortem
      cases are presented, where a sudden cardiac death apparently was caused by mitral
      valve prolapse or its complications.

PMID- 2241801
TI  - [Sexual dimorphism of the corpus callosum?].
AB  - Morphometric studies carried out during the past years have led to the assumption
      that the splenium of the corpus callosum in the female brain is significantly
      larger in size and more bulbous than in the case of men. This result, obtained by
      the examination of a relatively small number of samples, was to be checked by
      investigations with a larger number of samples. Our own planimetric studies were
      based on a total of 70 dissection cases and 55 nucleal magnetic tomograms (NMR),
      both evenly distributed among men and woman. When applying the identical
      measuring parameters as those used by the above cited authors, a sexual
      dimorphism could not be confirmed. This result did also not change when
      additional modified measuring parameters were taken into consideration.

PMID- 2241802
TI  - [Computer-assisted identification and comparative studies of the human skull].
AB  - The comparison of reconstructed skull profiles with photographic or other
      patterns for identification up to the reply to questions for sex, age, and race
      by the help of image analysis represents a relatively new development in forensic
      medicine. Using a Robotron image analyzing system 20 human skulls of different
      races were analysed morphometrically. Standardized profile functions, which were
      put through a morphometric analysis, showed characteristic individual features.
      By the help of the computerbased identification method mathematic differences
      between skulls of varions races became veritable.

PMID- 2241803
TI  - [Quantitative studies of mast cell proliferation at the wound edge --rate of DNA
      synthesis in intravital and postmortem biopsy].
AB  - The number of DNA synthesizing mast cells in experimental induced wounds was
      calculated using bromodeoxyuridine as a DNA marker and naphthol AS-D
      chloroacetate esterase as a mast cell marker. After different survival times,
      specimens of the wound edge were taken before death and 24 hs after death. At a
      survival time of 48 hs in vital biopsy the number of DNA synthesizing mast cells
      peaked, at 72 hs and fell after a period of 8 days. Even though an identical
      kinetic course was demonstrable in cases of postmortal biopsies the percentage at
      each survival period was significantly lower than in vital biopsies.

PMID- 2241804
TI  - [Do bacteriologic-chemical drinking water studies of households with suspected
      SIDS have significance?].
AB  - In 30 households with SIDS the drinking-water was studied microbiologically and
      chemically regarding its bacteriological contents, also it was checked for Pb and
      Cu. Three test solutions of 45 bacteriologically researched samples revealed
      significant data. One sample showed 2400 cfu "colony forming unit" which is more
      than double the number of germs permissable in an drinking-water container
      according to the standards of drinking-water (TrinkwV) 1(3). Also Ps. aeruginosa
      were found. A further sample contained 3300 cfu Coliforme (E. cloace in 100 ml).
      The lower quality of a further samples with 2.6 x 10(6) cfu could be
      retrospectively explained by works done by the Berlin City Works (Berliner
      Wasserwerke). Enteric bacteria could not be revealed. The remaining 42 samples
      were within the criteria Section 1 [(1), (2), (3)] of the drinking-water
      standard. Samples which fulfilled the norms of Section 1 (3) TrinkwV for reserve
      containers with up to 1000 cfu can be explained by the known fact that water in
      pipes (containers) can easily be contaminated from outside, for instance through
      germs like Pseudomonades. In none of the samples a connection between water
      quality and bacteriological post-mortem findings could be found. In two groups
      concerning the research for heavy metal the amount of Pb did not surpass the
      limit of drinking-water standards. In several cases the amount of Cu surpassed
      that of Pb. Bacteriological-chemical water research in households with suspicion
      of SIDS are only useful if anamnestical, clinical and autoptic data can be
      brought into a close temporary and spatial order and if the findings can be
      controlled through repeated research.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2241805
TI  - [Morphometric studies of the lung in shock of various etiologies].
AB  - The early schocklung-syndrome was investigated by morphological and
      morphometrical methods in order to discriminate the influence of different
      etiological factors on shock. Survival times up to 11 days were included in the
      investigation. We compared lungs from polytrauma with and without lung contusion
      and lungs after hypovolemic shock due to sharp violence. Cases of immediate death
      after brain damage served as controls. Apart from well known parameters of the
      shocklung--interstitial edema with increase of lung weight, intravasal sticking
      of granulocytes etc.--lymphangiektasy proved to be a reliable parameter to
      differentiate the temporal and etiological development of shock.

PMID- 2241806
TI  - [Criminal circumstances and picture of intentional physical injuries (with
      special reference to the use of weapons)].

PMID- 2241807
TI  - [Non-strangulation-induced injuries of the larynx and hyoid bone].
AB  - Injuries of the larynx and hyoid bone resulting from forces other than
      compression of the neck were found in 129 of 5591 cases (2.3%) of medico-legal
      autopsies performed between 1978-1987. Victims of blunt trauma showed these
      fractures in 6.7%, victims of incides or stab wounds in 9.2%, other cases in
      0.4%. The results were compared with clinical observations of laryngotracheal
      trauma.

PMID- 2241808
TI  - [Recent developments of sex determination using various skeletal sections].
AB  - Sexualdimorphism of the skull characterized by morphological marks. Practical
      applications and the value represented. Epiphysial breadth of the long bones well
      qualified for difference sex of the bones, demonstrated by new measurements of
      314 bones from adult persons. Stepwise regressions- and discriminant-analysis
      verify the results. Reference of the influence of acceleration and type of
      constitution complete the study of identification. Analysis of pictures from
      living persons using also pattern of the lip and marks of the ear.

PMID- 2241809
TI  - [Massive pulmonary brain tissue embolism].
AB  - A 20 year old woman with a severe head injury and rapidly increasing brain edema
      died 46 hours after the accident. There was clinical evidence of protracted shock
      and disseminated intravascular coagulation. The autopsy revealed a macro
      embolization of brain tissue of the lungs with many central and intermediate lung
      artery branches occluded by cerebral tissue. Preconditions of the brain tissue
      embolism were a severe fracture of the skull including a traumatic rupture of the
      right sigmoid sinus, together with a local brain laceration and an extremely
      elevated intracranial pressure. Fibrin precipitations were prominent at the
      surfaces of the brain tissue emboli as well as in peripheral blood vessels of the
      lung; in the systemic circulation, intravascular coagulation was much less
      pronounced.

PMID- 2241810
TI  - [Myoglobin concentrations of cadaver blood in fatal electric injuries].
AB  - In cases of death due to electrical current frequently autopsies do not reveal
      makroscopic findings. Recent reports indicated, that an increased concentration
      of myoglobin in blood sampled from the heart and femoral vein as a sign of
      membraneous alteration related to electrical current passing the human body is
      applicable to prove death from electricity, as far as other factors extremely
      influencing myoglobin concentration can be excluded. Determination of myoglobin
      by radioimmunoassay performed on 5 cases of death caused by electrical current, 3
      cases of sudden death due to heart disease and several other causes of death did
      not verify any correlation between myoglobin concentration and causes of death.

PMID- 2241811
TI  - [Effect of various technical parameters on potential danger of an electric injury
      in the bathtub].
AB  - In contrast to common beliefs there is not strict necessity for lethal danger
      during electric shock in a bathtub. Measurements of the electric field
      demonstrates the ground conditions and water temperature are of vital importance
      as are a variety of other parameters. With an electronic amplifier especially
      designed for this problem measurement of the electric parameters in the water was
      made possible.

PMID- 2241812
TI  - [Heart current density as the most important biological parameter of
      electrocution in the bathtub].
AB  - The most important factor during electrocution in a bathtub is the amount of
      current flowing through a body, not the amount of voltage. A method of
      measurement is introduced which--under simulation of various electrical
      situations--provides the possibility to measure the current flowing through the
      heart and to determine it's direction and density in the tissue. Hereby a ranking
      of the different factors influencing electrocution can be set up.

PMID- 2241813
TI  - [Fatal shotgun use in peace time].
AB  - On the suggestion of Conzelmann et al. (1977) and Lerch (1982), 176 shooting
      fatalities with 249 shot wounds in the South Baden region were evaluated in a
      multi-dimensional analysis of such data as place of death, autopsy findings,
      forensic examinations, and police and court files. Data were collected on
      incident, victim, culprit, weapon used, motive and the special circumstances of
      each case. The greatest number of deaths are suicides of inebriated men using
      handguns of medium-size caliber (7.65 and 9 mm), followed by homicidal shooting
      deaths, some involving multiple shots at longer range, though one-third were at
      close range. 78% of the shots fired from rifles and shotguns were in connection
      with suicides, 50% involved small-caliber weapon, 86% of the victims were men.
      Only 7% of the 131 shooting suicides, but 36% of the 39 homicides, involved
      women. 58% of the women who died a shooting death were victims (not seldom
      followed by their mates committing suicide), men were victims in only 17% of the
      cases. 98% of the suicidal and one-third of the homicidal shots were fired at
      close range. Rifles or shotguns were used in 12% of the homicides, but also in
      27% of the suicides. Yet according to witnesses, every 10th victim, though
      mortally wounded in the head, chest, or abdomen, was still capable of action for
      some time. Every 7th suicides was still clutching the weapon after death. Half of
      the suicides involving unusual shots were committed by women. In 50% of the
      homicides, the killer was either the mate or a relative of the victim, was
      between 40 and 60 years of age, and committed suicide after shooting his mate. In
      78% of the cases, killer and victim knew each other. Two-thirds of all the
      suicides occurred in the home, with the bedroom being the preferred scene in 25%
      of the cases.

PMID- 2241814
TI  - [Case analysis of double or multiple homicides].
AB  - Thirty-six patients (the youngest was about one and a half years old, and the
      oldest 76 years old) were the victims of double or multiple homicides. These
      comprised a total of 16 homicides, exclusively involving one perpetrator. Seven
      of these could not be categorized in the group of "family tragedies". These
      crimes are of particular medical-criminalistic interest in view of their
      constellation. The way in which the murder weapon was used, the situation
      dependence as well as the behavior of the perpetrator after committing the crime
      are discussed in detail.

PMID- 2241815
TI  - [Theft with subsequent murder].
AB  - We studied 39 cases from autopsies made between 1978 and 1988 in the Institut fur
      Rechtsmedizin der Freien Universitat Berlin and the Landesinstitut fur
      gerichtliche und soziale Medizin Berlin in which the public prosecutor's office
      had investigated about robbery in coincidence with killing. The average age of
      the victims was 75 years, the average age of the perpetrators was 21 years. One
      third of the victims died because of bronchopneumonia. 5 victims only showed
      slight injuries, the autopsy showed no definite cause of death, but we found
      severe signs of illness of the organs resp. of the heart. In these cases we
      diagnosed a "psycho-physiological cause of death". One third of the victims had a
      severe stenosis of the coronary system and one third showed cardiac hypertrophy
      of over 450 g. Head and face had been the favorite target of the perpetrators.
      Most localisations of crime had been the apartments of the victims and the booty
      often was less than DM 100,-. 75% of the perpetrators had been previously
      convicted. In the cases with "psycho-physiological" cause of death the court
      condemned the perpetrators only because of booty but never because of killing.

PMID- 2241816
TI  - [Diurnal correlation of criminal behavior].
AB  - In order to study the correlation between criminal acts and time of day we
      analyzed reports of the Federal Police Department in Salzburg covering 2 months
      as well as our own psychiatric expert-opinius in cases of robbery and homicide.
      Offences against property have the same day-time rhythm as does regular labour.
      Alcoholic intoxication hardly occurs with offences against property, although the
      activity of burglars goes over into the early hours of night. Aggressive offences
      are commonly accompanied by alcoholic intoxication, they are mainly observed at
      night. Less aggressive offences such as maltreatment or fighting generally occur
      during the late afternoon until midnight. Whereas aggressive offences of
      alcoholized persist throughout later hours of the night. The delinquency of
      robbery and homicide continues into the early hours of the morning. In cases of
      homicide there are differences concerning the individual conflict-situation.
      Homicides in connection with family tragedies or partnership conflicts usually
      occur during the afternoon or the early evening and show just a minor connection
      with alcoholization. Homicides in the course of primitive conflicts appear highly
      correlated to alcoholization and to the night hours. In cases of homicide of
      mental-patients there is no general connection with alcoholization nor can there
      be seen a day-time correlation.

PMID- 2241817
TI  - [Autopsy of accident victims--incidence and criteria for selection].
AB  - In a first analysis the frequencies of autopsies in the area district of Karl
      Marx-Stadt (Chemnitz) are investigated in respect to types of accident, sex and
      age groups. Victims of traffic- and working accidents are dissected in far more
      than 50% of all cases (predominantly with forensic medicine) because of the
      obvious legal consequences; accident occurring at home or during leisure are paid
      less attention to. Possible criteria for selection are discussed.

PMID- 2241819
TI  - [Analysis of the mechanism of tibial injury in cases of automobile-pedestrian
      collisions].
AB  - The type and the mechanism of development of lower extremity injuries suffered
      during traffic accidents between cars and pedestrians were studied in 93
      accidents with frontal or almost frontal collision. Evaluation was based upon the
      facts of the investigation and the opinions of medical and technical experts. In
      28% of the cases lower extremity injuries were not demonstrable, in 21% of the
      cases there were only soft part injuries at the site of primary collision, while
      in 51% bone fractures were also diagnosed. The collision speed and the injury
      severity score (ISS) are in a statistically significant correlation. In the case
      of lower extremity injuries, in higher speed categories, such definite
      correlation was demonstrable only for injured persons over 60 years of age, and
      no such correlation existed for younger people. This difference is explained by
      age-related biological differences (osteoporosis, reduced elasticity).

PMID- 2241818
TI  - [Forensic-toxicologic detection of pholcodine in urine and hair].
AB  - Pholcodine (3-morpholinoethyl-morphine) is used in many countries as an
      antitussive without analgesic or addictive properties. It is of forensic
      significance that pholcodine interferes with opiate immunoassays. In this article
      a GC-MS procedure for the detection of pholcodine in urine and hair is described
      and its efficiency as a confirmatory test for fluorescence polarisation
      immunological and radio immunological results is reported.

PMID- 2241820
TI  - [Role of collision velocity in traffic accidents involving automobiles and
      pedestrians].
AB  - On the basis of facts of the investigation and medical as well as technical
      experts' opinion on traffic accidents that happened between cars and pedestrians
      in Budapest in 1986, the authors studied the role of the travelling speed and
      collision speed in the severity of injuries suffered. They concluded that a 20%
      reduction of the 60 km per hour speed limit currently valid in inhabited areas in
      Hungary, i.e. compliance with the European standard, would reduce the number of
      fatal traffic accidents by as much as 40%, and the mean severity score of
      injuries suffered would decrease from ISS 26.90 to ISS 19.96.

PMID- 2241821
TI  - [The pedestrian-automobile accident at lower velocity. Experimental studies of
      biomechanical and clinico-prognostic topics].
AB  - The influence of bumper configuration on injury patterns resulting from
      car/pedestrian collisions were analyzed. 18 experimental settings were carried
      out on the deceleration device of the Institute of Forensic Medicine of the
      Medizinische Hochschule Hannover using a middle class passenger car at collision
      speed of 32 km/h. Three modifications of the standard bumper design did not
      reduce the severity of injuries induced by collision. Comparatively promising
      results were given by another bumper construction consisting of an additional
      bumper relatively easy to deform attached to the standard variant at a level of
      12 cm below. Authors discuss findings regarding injury patterns, injury
      mechanisms and subsequent implications. Based on trauma surgeons' experience it
      is suggested not only to aim on reduction of bone injuries. Major attention has
      to be paid on improving rehabilitation prognosis and on reducing medical
      treatment expenses. According to data available soft tissue damage is of major
      importance and needs to be quantified before taking one particular bumper
      construction as pedestrian friendly design.

PMID- 2241822
TI  - [Driving fitness of female headache patients in tests of traffic medicine--a
      psychotechnical investigation].
AB  - To detect differences in psychophysical performance during pain attacks and pain
      free intervals, 30 female patients aged 21 to 58 years and suffering from attacks
      of headache were investigated intraindividually by means of established test
      methods (attention quotient according to Gruner, motorial accomplishment series
      according to Schoppe and achievement testing device). The patients were
      randomized and assigned either to Group A (first test while having pain) or Group
      B (first test without pain). The patients were also asked to assess the intensity
      of their headaches. The hypothesis that "headaches do not impair psychophysical
      performance" was refuted by the significant results obtained in all tests, the
      observed deficits concerned predominantly achievements in the field of
      concentration, achievements which are also required for operating a motor
      vehicle.

PMID- 2241823
TI  - [The carbon monoxide content of muscles].

PMID- 2241824
TI  - [Practical value of post-mortem electrical excitability in determining time of
      death].
AB  - In 35 cases (about 200 single excitations) electrical excitibility of mimic
      muscles was reexamined according to the method developed by Klein and Klein
      (1978) with subjective grading of muscular reaction according to the intensity
      and spread of movement. Instead of "rectangular-like impulses" of some ms
      duration in a repetition of 30 to 70/sec and 50 V constant-current rectangular
      impulse of 1 sec duration and 30 mA were used. Nevertheless the determination of
      the time since death is valid within the calculated 95%--limits of confidence.
      The 95%--limits of confidence are not valid for cases of fatal hypothermia: here
      are longer (and shorter) times possible for the special degree. In our opinion
      examination of electrical excitibility belongs to the minimal standard of methods
      to be used for determining the time since death in the early postmortem interval.
      This is discussed in 17 cases where the dates for the special degree of
      electrical excitability could narrow down the time period since death given by
      the nomogromn method.

PMID- 2241826
TI  - [Differentiation between in-life and post-mortem hemorrhage].
AB  - The determination of the time of haemorrhaging can be of substantial importance
      in the forensic practice. Histological, immunohistochemical and morphometric
      investigations were carried out on haemorrhages from animal experiments and from
      human pathological samples. Centrifugal topology, serum-erythrocyte
      discontinuity, topological arrangement of Fibrin formation and stabilisation of
      Factor XIII A were evaluated as criteria to define antemortal origin of
      haemorrhages.

PMID- 2241825
TI  - [Parameters for determining the time of death from post-mortem muscle contraction
      -precision of assessing time of death].
AB  - The objectified muscular contraction on excitation with rectangular impulses of 1
      sec duration and definite current intensity is in its postmortem course
      characterised by: 1. Change of the shape of muscular contraction (time-course of
      muscular contraction) from a two peak to a one peak shape 2. postmortem decrease
      of the maximum force of muscular contraction on definite current intensity 3.
      increase of the relaxation time of muscular contraction. On an random sample of
      fifty bodies decrease of the maximum force and increase of the relaxation time as
      criteria for extrapolating the time since death were investigated. The
      extrapolation was performed on the basis of the regression between ln of the
      maximum force and time using the mean values for slope and intercept and the
      regression between ln of the relaxation time and the ln of the time since death
      respectively using the mean values for slope and intercept too. On fifty bodies
      the calculated 95%--limits of confidence are +/- 2.85 h (decrease of the maximum
      force) and +/- 2.7 h (increase of relaxation time) up to 13 hpm. The calculated
      95% limits of confidence were examined on an independent random sample of 20
      bodies and proved to be reliable.

PMID- 2241827
TI  - [Two conspicuous findings in human tubular bones following longer exposure time].
AB  - A human skeleton was found in a forest after an aging time (laydays) of nearly
      three years. Surprisingly a larger number of living maggots crawled out of the
      medullary cavity of the humerus after sawing it longitudinally. Investigations of
      other long bones showed remnants of maggots, fly-pupas and maggot-excrements in
      similar cases. A humerus is found after an estimated aging time of over 100
      years. The presence of a remaining epiphyseal gap indicated an age of about 20
      years, whereas the extension of the medullary cavity showed a much higher age.
      After a long aging time, these structures show similar findings in other cases.
      Damage done by frost should be discussed.

PMID- 2241828
TI  - [Detection of drugs in sweat].
AB  - This study investigates the presence of drugs in apocrine sweat. The samples were
      collected from the axillary perspiration of 25 hs. The determination of the drugs
      was performed by radioimmunoassay. The concentrations measured represent the sum
      of drugs and there metabolites. Measurable drugs concentrations of THC,
      benzodiazepine, cocaine, barbiturate, morphine, methadone and cotinine were found
      in all samples. The presence of the drugs in the sweat was manifested also by
      GC/MS.

PMID- 2241829
TI  - [Preservation of human cadavers throughout history--a contribution to development
      and methodology].
AB  - From ancient times to nowadays man tried out of different intentions to keep the
      bodies of dead persons in the best possible state of preservation. The embalming
      procedures primary aim at avoiding or at least stopping rottness and autolysis.
      They have to change depending on the technical possibilities and further destiny
      of the embalmed bodies. Beside a short historical review we present the method
      used at our institute.

PMID- 2241830
TI  - [How to expose fraudulent expert witnesses].
AB  - In our courtrooms you can meet, up to this day, experts of dubious qualities if
      not mere shams and deceivers. They are found in all sciences, but also in pseudo
      sciences as paramedicine and parapsychology. In any case such expert pretenders
      must be exposed by the judge to prevent dangerous miscarriage of justice.
      Examples are given how to unmask the fraudulent rascals.

PMID- 2241831
TI  - [Expert systems in forensic medicine. Pilot project in the differential diagnosis
      of death caused by hanging].
AB  - The special field of legal medicine represents a very heterogeneous science,
      which makes it impossible, that a forensic pathologist could be an "expert" in
      all areas. The most recent achievements of computer-technology have opened up the
      possibility of being able to use a PC to produce an "expert system", for with
      large computer programs are needed. Therefore we wanted to test in a pilot
      project, if it was possible to establish an expert system, which was suitable for
      supporting forensic pathological diagnosis. We confined ourselves to the
      differential diagnosis of "death by hanging" where a clear line between vital and
      postmortal events, respectively suicide, homicide and accident was drawn. The
      discrepancy between the relatively scanty amount of statistically reliable data
      on the one hand and the complexity of the manifestation of death by hanging on
      the other hand proved to be the main problem. Although we are not yet able to
      make an expert system available which meets all our requirements, we are
      convinced, that in the future computer-aided diagnosis may be of great use for
      work in legal medicine.

PMID- 2241832
TI  - [WHO basic classification in forensic medicine].
AB  - The internationally used WHO-basic tabulation list of causes of diseases and
      death is presented in a modified version for forensic medicine. The findings of
      postmortems are to be indexed with this code and put into a database. We would
      like to suggest that as many institutes as possible use this code and collaborate
      to discuss further modifications.

PMID- 2241833
TI  - [Forensic medicine literature databank. Goals and uses].
AB  - In addition to existing, international database systems we started building up a
      forensic-medical database. Whereas the current systems offer a cross section of
      the newest medical knowledge, we wanted to reach a review over the most important
      journals specialized in forensic medicine, starting from their beginning. In this
      way one gets informations over empirical knowledge and casuistry, which are of
      great importance in forensic medicine. As technical basis we use a personal
      computer and the dBase III database system.

PMID- 2241834
TI  - [Calcium concentration in vitreous humor--a means for determining time of
      death?].
AB  - Several authors are in agreement that there is no relationship between calcium
      concentration in vitreous humor and time since death. Nowak and Balabanova (1989)
      however established such a relationship on a random sample of 19 cases suffering
      from heart disease (coronary occlusion) and quote Coe (1969, 1972) who "described
      also a correlation between PMI and calcium" which is completely wrong. The
      results of Nowak and Balabanova are compared to own results (n = 270, 69 deaths
      due to coronary artery disease), results of Sturner et al. (1972) and Schmidt
      (1988). In conclusion there is a statistically significant correlation between
      calcium concentration in vitreous humor and PMI (r = 0,356) but the range of
      scatter of the individual calcium values over the PMI is so great that it becomes
      clear that vitreous calcium is no aid in estimating the time since death.

PMID- 2241835
TI  - [Postmortem increase in the galvanic threshold].
AB  - The investigations of Joachim and Feldmann (1980) on the postmortem rise of
      muscular threshold were examined on a random sample of 20 bodies with known time
      of death. Muscular reaction on excitation was objectified using a sensitive force
      transducer pricked into the muscle (mostly thenar). The muscle was excitated
      (each half on hour) using rectangular impulses of 1 sec. duration with a current
      intensity which causes a muscular contraction of 2.5 mN until a current intensity
      of 80 mA doesn't reach this force any more. Ln of muscular threshold and time
      since death show a strong linear relationship (r = 0.965). Time since death was
      extrapolated with mean values for slope and intercept (calculated from the random
      sample) for all measured values of muscular threshold. Extrapolation from a
      single value with mean values also for the slope reveals a much more precise
      estimation of the time since death than extrapolation with an individual slope
      (according to Joachim) which requires repeated measurements of muscular threshold
      in an interval of 30 minutes. The procedure was examined at a random sample of 8
      cases. The real time since death war always within the 95% limits of confidence
      of the calculated time since death.

PMID- 2241836
TI  - [Injury patterns and roentgen findings in gunshot wounds with rare flint
      ammunition].
AB  - Smoothbore shotgun barrels can fire cartridges with common pellet loads as well
      as shotgun slugs and rubber bullets. Other than conventional shot, the
      cylindrical Brenneke-type rifled shotgun slugs sometimes cause perforating
      wounds. The shotgun ammunition for use in self-defence can have a single
      projectile or several rubber pellets. Where the propellant is black powder, short
      range shots will probably leave searing marks and intensive soot deposits. Fired
      at close range, rubber bullets can penetrate through the skin into the body,
      fired at greater distance they cause contusions. A case of homicide (repeated
      firing with a 12-ga. pump gun) is used to present and discuss the injury patterns
      and X-ray findings after impact of Brenneke-type slugs and rubber bullets as well
      as of "classical" shot pellets.

PMID- 2241837
TI  - [Comparative studies of drug detection using recent immunologic methods].
AB  - 150 urine samples which we received from the criminal investigation department
      were measured with EMIT cannabis 20 and EMIT cannabis 50 reagents by EMIT
      Autolabsystem and especially with the immunoassay analyzer ETS by Syva
      Diagnostica. The confirming analyses were performed by GC-MS. If only cases are
      considered which are positive with cannabis 20 containing at least 10 ng 11-Nor
      delta-9-THC-9-carboxylic acid in urine, there will be a negative result of 18.8%
      with EMIT 50. This appears to be unreasonably high. Some of these cases were also
      tested with Abuscreen ONTRAK-reagents. With this method the cut off for cannabis
      with 100 ng/ml urine is far too high but can be lowered essentially by taking a
      larger urine sample.

PMID- 2241838
TI  - [Ketotifen poisoning in infancy?].
AB  - A male baby aged 3 1/2 months died about 3 hours after application of ketotifen
      due to chyme aspiration. Apart from a mycotic napkin rash the post-mortem
      examination did not show any other pre-existing pathological findings. When
      analysing blood samples toxicologically we observed a remarkably high
      concentration of ketotifen whereas the urine level was comparatively low. The
      morphological and toxicological findings are presented and discussed in
      differential diagnosis with reference to sudden infant death syndrome.

PMID- 2241840
TI  - ["Alcohol associated" death in a forensic medicine autopsy sample at the Berlin
      Free University].
AB  - From 1978 to 1988 6431 forensic postmortem examinations have been made at the
      Freie Universitat Berlin. These are about 50% of all p. m. examinations in Berlin
      (West) of the corresponding period. 22% of these cases were associated with
      alcohol. On one hand there was an acute influence of alcohol, on the other hand
      there were indications of chronic alcoholism. A rise of alcohol associated cases
      or of alcohol concentrations could not be found out.

PMID- 2241839
TI  - [Urine analysis for legal confirmation in opiate addicts].
AB  - Urine samples of 31 probands who had come in conflict with the Dangerous Drugs
      act and therefore had to take part in urinalysis tests where analysed during a
      period of 34 months. The purpose of this study was to find out whether urinalysis
      testing can reduce drug abuse. The urine samples were tested on morphine/codeine,
      cannabis and barbiturates. 28 out of 31 persons were to be tested on morphine, 13
      on cannabis and 26 on barbiturates. 32% of the persons tested on morphine showed
      no positive results during the whole period of investigation. 3% had continuous
      relapses (greater than 30% positive results) during this time. A significant (x2
      = 28.98) decrease of positive samples at the end of the investigation period was
      found. The tests on barbiturates showed no significant (x2 = 0) influence of the
      urinalysis on the frequency of positive results. Tests on cannabis showed a
      slightly significant (x2 = 4.26) increase of positive results at the end of the
      investigation period. Most of the test persons showed an obvious improvement of
      their social and family conditions during this period.

PMID- 2241841
TI  - [Fatal intoxication following rectal instillation of alcohol].
AB  - A 62-year old man who had been living on a remote farm was found dead in his bed.
      Inserted in his rectum was a synthetic flexible tube filled with brandy (43 vol.
      %) and connected to a bicycle pump. Samples taken during autopsy from 3 different
      parts of the body showed ethanol concentrations from 4.87% to 5.35% in the blood
      and 6.73% in the urine. The ethanol concentrations in the small and large
      intestine were considerably higher (more than 29%) than in the stomach (9%). The
      decreased had a tumor as large as a tennis ball on the base of his tongue, almost
      completely filling the oropharynx, making swallowing very difficult, which
      probably was the reason of the rectal instillation of alcohol. The report deals
      with this unusual case of rectal alcohol instillation, and with the different
      ethanol and congener alcohol concentrations in the body fluids.

PMID- 2241842
TI  - [Suicidal electric fatalities outside the bathtub (with 3 case reports)].
AB  - Three cases of suicides due to electricity, which happened outside the bathtub,
      are presented. In favour of suicide there spoke farewell letters, the situation
      of discovery or known depressive personality changes. In all three cases it was
      about male persons at the age of 19, 30 and 50. Low-voltage electricity was used.
      The locations chosen for the employed electric cables were: right wrist/left
      ankle or right and left wrist. The electric marks showed a circular continuous
      form with different breadth, partly associated with carbonization. In one case
      over the normal clothes there were worn a ski suit and an integral helmet; the
      flow of electric current was regulated by a timer.

PMID- 2241843
TI  - [Sudden death of natural internal cause: endocarditis ulceropolyposa].
AB  - There is an increasing tendency amongst the general population towards rejection
      of conventional medical therapeutic measures, particularly certain types of
      medication such as antibiotics. Alternative modes of treatment, often undertaken
      independently by the patient, are favoured. Because of this, diseases that have
      become less frequent have acquired new significance as the cause of sudden
      unexpected death. This problem is illustrated with the case of a 20-year-old
      woman who died as a result of inadequate treatment of subacute bacterial
      endocarditis (endocarditis ulceropolyposa).

PMID- 2241844
TI  - [Serum testosterone concentrations in cannabis and opiate users].
AB  - The object of this study was to establish possible influences of long-term
      cannabis usage on plasma testosterone levels. The plasma testosterone levels of
      66 male Pakistani who for years had smoked cannabis daily or drank cannabis
      regularly where measured after chronic and acute intake of the drug and compared
      with a material of 41 normal controls, i.e. persons who did not use cannabis. An
      evaluation of the results showed that there were no significant differences
      between the two groups. No influence of long-term cannabis usage on plasma
      testosterone levels was found. Furthermore we wished to find out wether long-term
      heroin abuse showed an effect on plasma testosterone levels. The concentrations
      of testosterone in the plasma of 102 heroin addicts assigned to a Methadone
      Program were measured and compared with the values of 29 male healthy students as
      controls. Plasma testosterone levels were found to be significantly decreased in
      heroin addicts as compared to controls.

PMID- 2241845
TI  - [Iatrogenic cardiac tamponade in lung embolism].
AB  - A 65 year old man with diffuse pleural mesothelioma suffering from acute dyspnoea
      and chest pain underwent pericardiocentesis to withdraw pericardial effusion.
      After some mispunctures blood was withdrawn. Exitus in tabula. At autopsy cardiac
      tamponade with two cuts of the right ventricle. Pulmonary thrombembolism of the
      right lung. Advanced diffuse pleural mesothelioma with infiltration of lung,
      mediastinum, pericard, cuirrassing of left pulmonary artery and descendent aorta
      thoracica. The connection between iatrogenic cardiac tamponade and death couldn't
      be established without any doubt in the presence of a concurring cause of death
      (massive pulmonary thrombembolism).

PMID- 2241846
TI  - [Performing ability after kidney contusions and kidney ruptures].
AB  - 30 casualties who had sustained a kidney contusion (23 patients) or a kidney
      rupture (7 patients) were questioned about their posttraumatic possibility of
      action after their recovery. Essential result: Fundamental differences were
      detected between the two groups. The high degree of the ability to act for a
      longer period of time may be explained by the comparatively low acuteness of pain
      after kidney contusions and the impression of most casualties of not being
      seriously injured. In contrast to kidney contusions, kidney ruptures are
      generally accompanied by moderate to severe pain. Accordingly, the possibility of
      action in cases of kidney ruptures is restricted more frequently and to a greater
      extent than in cases of kidney contusions. The two groups had one thing in
      common: the casualties' mostly deliberate posttraumatic reaction; there were only
      3 patients in a state of helplessness.

PMID- 2241847
TI  - [Performance following liver, spleen and intestinal ruptures].
AB  - In order to extend the knowledge about posttraumatic possibility of action after
      blunt abdominal traumas, 34 patients mostly having sustained isolated ruptures of
      the liver, spleen and the intestines, were interviewed after their recovery; the
      results obtained were separated by the organs involved. Essential result: In
      general, there is a close correlation between the acuteness of pain, the
      patient's assessment of severity of the injury and the degree of the ability to
      act during the first posttraumatic minutes. In the further course of the injury,
      the capacity to act was limited by the extent and the developmental speed of the
      loss of blood into the abdominal cavity, provided that it was not limited or
      cancelled primarily by the acuteness of pain. No correlation could be detected
      between the extent of rupture and the acuteness of pain. The casualties'
      thoughtful, deliberate behavior was the predominant posttraumatic characteristic.
      There was a varying posttraumatic clinical picture ranging from freedom from pain
      to severe pain and non-restricted possibility of action to the inability to act.

PMID- 2241848
TI  - [Statistics of blunt abdominal trauma in an autopsy sample at the Institute of
      Forensic Medicine of the Wurzburg University].
AB  - The autopsy material of the Institute for Forensic Medicine of the University of
      Wuerzburg, comprising 2512 post-mortem examinations between 1981 and 1988, was
      statistically analyzed. Blunt abdominal traumas could be detected in 424 (= 17%)
      of the 2512 deceased. Essential results: In 3/4 of the cases a traffic accident
      was the harmful event, followed by occupational accidents and suicide. In 9 cases
      the blunt abdominal trauma was caused by resuscitative measures. 96.6% suffered
      from severe extraabdominal secondary injuries which, in 72% of the cases,
      occurred as craniocerebral traumas frequently determining the quoad vitam
      prognosis. In more than 90% death was caused by cranio-cerebral traumas,
      exsanguination, polytraumas as well as injuries of the cervical spine and the
      cervical spinal cord. Approx. 2/3 of the casualties died within 1 hour after
      having sustained the trauma. Only 31 injured persons did survive the harmful
      event more than 10 days; just 5 of them did not die before a period of more than
      30 days. Late death was predominantly caused by secondary injuries adding up,
      peritonitis, pneumonia or pulmonary embolism.

PMID- 2241850
TI  - [Electrical impedance and time of death in the animal model].
AB  - To study passive electric parameters of the rat skeletal muscles in relation to
      the time of death, investigations were carried out using the impulse distortion
      method of Pliquett. This measuring method enables the evaluation of the electric
      rectangular impulse distorted by the biological tissues, which contains any
      essential information on the passive electric properties of the object to be
      measured. The passive electric parameters change in the studied time interval up
      to 79 h post mortem in a characteristic fashion. The linear correlation of the
      evaluated impulse parameters at the time of death is closest (r = 0.75) between
      0.5-8.5 h post mortem, the scatter of single values in late postmortal periods is
      in part considerable. A further development of the measuring technique and
      standardization of the measuring method let the passive electric parameters
      appear to be appropriate magnitudes for estimating the time of death.

PMID- 2241849
TI  - [Post-traumatic hydrocephalus--result of repeated abuse of a young child].
AB  - Serious physical and psychic abuse of children is a much discussed theme in
      forensic, juridical and sociological literature. This paper deals with the
      pitiable case of a meanwhile four years old infant having been battered by his
      stepmother. At the age of two years the boy was unconscious admitted to the
      hospital. Computertomography of the brain did not show any pathological findings.
      Because of multiple effusions of blood of variable age located at the child's
      body the stepmother was noticed and accused of assault and battery, but the trial
      ended in acquittal. Two years later the boy suffered from serious neurological
      symptoms and computertomography showed high-pathological alterations such as
      hydrocephalus, parietooccipital hygroma and a damage of the brain.

PMID- 2241851
TI  - [Legal and moral objections to medical research on cadavers and cadaver parts].
AB  - The interpretation of Section 190 oStGB by jurisdiction and doctrine makes
      medicinal research more difficult. In contrary to the ruling legal arguments an
      responsible scientifically research-work with corpses or parts of corpses cannot
      realize the facts of the case provided that the comprehension of the related laws
      are interpreted proper and accurate.

PMID- 2241852
TI  - [Suicide '87. Suicide statistics of the year 1987 with regard to autopsy and
      inspection].
AB  - The suicides committed during the year 1987 in the catchment of the Institute for
      Forensic Science at the University of Vienna were analysed in regard to their
      sexual and seasonal distribution, emphasizing most of all the applied methods.
      This survey shows impressively the meaning of giving data as complete as
      possible, especially of including the coroner's inquest among the suicide
      statistics, which prove to be rather distorted as long as they are only based on
      post-mortem data.

PMID- 2241853
TI  - [Effects of "the embryo protection law" on "encapsulated" organ transplantation].
AB  - In order to create a capsula-protected homeotransplantat all manipulations which
      prevent the birth of the child or the growth of other "unwanted" organs will be
      done either on an egg or on an embryo (in vitro). Both is regarding the current
      Criminal Law not forbidden. The discussion concerning the Protection of Embryos
      and the in vitro fertilization in Austria and the Federal Republic of Germany
      shows, that human semen and eggs should be protected and any artificial variation
      of them, as well as manipulations on embryos, should be forbidden, even by penal
      law. If this becomes law in Austria, the capsula-protected homeotransplantation
      will be incompatible to the abortion allowed until the 3. month of pregnancy
      ("Fristenlosung").

PMID- 2241854
TI  - [Evaluation of results of breath alcohol determination].
AB  - Having determined the random errors (Standard deviation) on the Alcomat 9.2
      microns, experiments about influences by solvent-exposed persons on measured
      values are reported and about the determination of runaway-data; average-values
      of the decrease in breath-alcohol per unit of time are derived by graphs of
      catabolism after consumption of alcohol.

PMID- 2241855
TI  - [Screening and detection of nimetazepam and its chief metabolites].
AB  - The article describes analytical data for the screening and detection of
      nimetazepam and its major metabolites. The methods comprise thin-layer
      chromatography, gas chromatography, UV-spectrophotometry, infrared- and mass
      spectrometry.

PMID- 2241856
TI  - [Attempted infanticide with a happy ending. Report of infanticide in Tirol and
      Vorarlberg].
AB  - The paper presents an analysis of infanticides which happened during the last 20
      years, investigated by the Institute of Forensic Medicine at the University of
      Innsbruck. On the basis of some casuistries forensic and criminalistic aspects of
      infanticides will be discussed. Special attention is payed to two cases of
      "survived infanticides" with re-establishing of the relationship between mother
      and child.

PMID- 2241857
TI  - [Density of immunoreactive cells in the spleen in drug fatalities].
AB  - 66 autopsied drug-related death cases in the Institute of Legal Medicine of
      Cologne of the years 1979 to 1989 were morphologically examined to get
      information whether cytological investigations of the spleen reveal a damage of
      the immune system. The weights of the spleen were registered and immunoreactive
      cells, i.e. macrophages, B- and T-lymphocytes, were quantitative counted. Neither
      a significant alteration of the weights of the spleen nor an important change of
      the density of the immunoreactive cells could be registered.

PMID- 2241858
TI  - [Age determination based on the structure of the proximal parts of the humerus
      and femur].
AB  - Founded on known forensic material a diagram of 7 classes is presented, which
      allows age determination by means of proximal parts of humerus or femur. The
      method might be used on direct view of the bones or on x-ray photographs.
      Therefore it can be employed on the living as well. Factors which might affect
      the outcome are discussed.

PMID- 2241859
TI  - [Determining gunshot distance without bullet entry--a new source of error in
      determining gunshot distance from point of entry].
AB  - A court case lead to a quantitative determination of lead and antimony by atomic
      absorption at distances 10 to 20 cm from the bullet hole. As a surprising result
      at first the area-concentrations of lead and antimony increased with rising
      distance from the muzzle and reached a maximum, after that maximum like expected
      a decrease was found. The phenomena is of general interest because otherwise
      misinterpretations in chemical determination of gunshot firing distances would be
      possible.

PMID- 2241860
TI  - [Medical and technical aspects of the effect of weapons III. Black powder muzzle
      loading guns].
AB  - The report deals generally with ballistics and morphology of wounds caused by
      black powder muzzle loading guns. Two cases are reported.

PMID- 2241861
TI  - [Health risk caused by sulfur dioxide].
AB  - The short time lasting exposure to SO2 at a level of 1.24 mg/m3 and dust (0.11
      mg/m3) means a risk for the health of children, old persons and persons suffering
      from heart/lung diseases. An increase of asthmatic symptoms is expected. Moreover
      the risk is raised by inhalation of dust containing sulfates.

PMID- 2241862
TI  - [Rational control analysis within the scope of a methadone program].
AB  - To effectively control a methadone maintenance program a GC-MS-method was
      developed to simultaneously assay methadone, the opiates including
      monoacetylmorphine, cocaine and methaqualone. The automation of the GC-MS
      analysis including the evaluation made possible by suitable operators renders
      possible a procedure, which is cheaper than the corresponding immunoassays while
      allowing to differentiate between the opiates without the second step.

PMID- 2241863
TI  - [Cardioactive contaminants and actual active ingredient content of various
      digitalis preparations].
AB  - To establish possible cardioactive impurities which have not been totally
      separated while isolating the compound from plant material several preparations
      containing digoxin (NOVODIGAL = beta-acetyldigoxin, LANITOP = beta-methyldigoxin
      and LANICOR = digoxin) were analyzed by HPLC-chromatography after careful
      extraction. Impurities were found (digoxigenin, digoxigenin-monodigitoxosid,
      digoxigenin-bisdigitoxosid) which on the one hand occur as natural lanatosid
      derivates in digitalis leaves but on the other hand also are described as
      possible metabolites of digoxin in human organism. The experiments have shown
      that the results of studies in metabolization of digoxin without knowledge of
      purity of the substance applied have to be interpreted with care.

PMID- 2241864
TI  - [Chemical-toxicologic studies of the epidemiology of drug use (1.)].
AB  - During a long term program we secured when possible blood from a femoral vein of
      dead bodies. Until now 207 cases which were not selected have been investigated.
      The analyses were performed by high pressure liquid chromatography to prove
      extractable as well as by gas chromatography to determine volatile substances.
      These results are represented and correlated with the investigation of the CID or
      the Department of Public Prosecution respectively and with the results of
      autopsies if available and discussed.

PMID- 2241866
TI  - [The role of ozone within the scope of the "Figurella Program"].
AB  - The method given by the slimming institute "Figurella International", to lose
      weight without applying chemistry or dieting, is scrutinized critically. The
      ozone treatment, one of the compounds of the method, proves to be useless. To
      overcome the general problem caused by photochemical oxidants the company should
      be set under pressure to stand back from producing ozone, which proves to be a
      major air pollutant but not to have any effect on the result of the slimming
      programme.

PMID- 2241865
TI  - [Structural changes in the lung in the late stage of fatal paraquat poisoning].
AB  - Poisoning with Paraquat, an efficient weedkiller, causes a progressive
      interstitial fibrosis of the lung starting after about one week's latency. The X
      ray findings of a 30-year-old female patient who died 12 days after oral
      ingestion of Paraquat could be documented. We found a correlation between X-ray
      examination and microscopic post mortem findings of necrotizing alveolitis of the
      lung changing from exsudative to sclerosing alterations. This diffuse
      interstitial fibrosis was accompanied by an increase of contractile filament
      laden cells, characterized by an expression of alpha-smooth muscle actin, which
      could be identified by immunohistochemical methods. The substantial increase in
      alpha-actin containing cells has recently been observed in cases of Bleomycin
      injured lungs.

PMID- 2241867
TI  - [Autopsy technique and basic legal aspects of autopsy].
AB  - Dissection techniques and questions regarding the laws governing autopsy. Autopsy
      techniques vary. Hamperl's methods, in my opinion, best fulfil the demands of
      pathology as well as of forensic medicine. In order to obtain more conclusive
      findings, the dissection of internal organs in several so-called packages, e.g.
      throat and chest organs and kidneys in the urogenital system, is preferable.
      Severance of the heart as a means of achieving bloodlessness (Blutleere) should
      be tolerated only in isolated cases. Some comments on hygienic working methods
      are in order, not least because of frequent violations in this area. The dignity
      of the deceased demands hygienic conditions and that the external appearance of
      the body be reestablished. The removed organs should be returned to the body for
      burial. Burial should not be used as a means of waste disposal for the institute.
      The most common and well-known autopsy cases are also dealt with: legal and
      administrative autopsy. Only forensic autopsy is governed by Para. 87 StPO,
      albeit incompletely. The definition of the medical examiner is difficult.
      According to the law on the standardization in Public Health dated 3. 7. 1934
      (RGBl. I., p. 531), these tasks should come under the jurisdiction of the health
      authorities. Since these are not in a position, either from a personnel or
      material standpoint, to assume these tasks, it is customary, as is the case in
      the Frankfurt area, for a service contract to be concluded with the director of
      the institute for forensic medicine. This solution harbours two dangers.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2241868
TI  - [The natural history of scoliosis].
AB  - Adequate treatment of scoliosis requires from the managing doctor a detailed
      knowledge about the natural history of the disease for correct indication of the
      various possibilities for treatment and favourable influence of the spontaneous
      history. Essential prognostic factors of idiopathic scoliotic forms and
      congenital or neuromuscular scolioses will be demonstrated.

PMID- 2241869
TI  - [Personal experiences using the Cheneau brace].
AB  - Idiopathic scoliosis under 20 degrees were treated by physiotherapeut methods
      alone. At scoliosis with curves between 20 and 45 degrees a correction by means
      of Cheneau type orthosis; is additionally used during growing age. The over all
      results of this combined therapy are good.

PMID- 2241870
TI  - [Use of the halo-gravitation-extension in preoperative preparation in severe
      scoliosis].
AB  - Severe and fixed scoliosis needs a preoperative extension treatment to attain a
      good result of correction by spondylodesis. Halo-up-extension is a very simple,
      comfortable and successful method to prepare patients with a severe scoliosis for
      operation. From January 1981 to July 1989 we carried out the preoperative halo-up
      Extension treatment at 45 patients. 39 of them had a severe scoliosis with a cobb
      angle of more than 70 degrees. The correction by halo-up-Extension runs on an
      average of 35% of the total correction.

PMID- 2241871
TI  - [Indications for and results of surgical scoliosis therapy using VDS
      instrumentation (ventral derotation spondylodesis)].
AB  - The complications of 97 patients who were operated with anterior spinal
      instrumentation were frequent, but insignificant. 22 of these patients with
      lumbar and thoracolumbar curves in whom the VDS instrumentation was used were
      reviewed. A 79% correction was obtained in the coronal plane. Loss of correction
      was 11% in the first year and further 2% at 56 months average follow up. In the
      sagittal plane a mild tendency to increased kyphosis was found. A permanent
      "adding on" phenomenon occurred in one case. The VDS-instrumentation appears the
      apparatus of choice for treatment of thoracolumbar and lumbar scoliosis, other
      indications are discussed.

PMID- 2241872
TI  - [Indications for and results of the CD procedure (Cotrel Dubousset) in surgical
      scoliosis therapy].
AB  - At the orthopaedic University Hospitals of Mainz and Munster more than 200
      patients were treated surgically according Cotrel and Dubousset procedure. By
      means of this operation average corrections of the curves of 50.7% to 56.7% could
      be reached in the first 150 patients, depending of the localisation of the curve.
      Operative procedure, duration of operation and blood loss are adequate to known
      procedures. Pre- and postoperative CT's in 24 patients with idiopathic scolioses
      showed a mean correction of the rotation angle in the apex vertebra of 28.5% in
      relation to the anterior midline of the body and of 23.8% in relation to the
      sagittal plane. The best corrections could be observed in lumbar curves and in
      the lumbar curves of double major scoliosis. A postoperative therapy with cast or
      braces is not necessary.

PMID- 2241873
TI  - [Aseptic necrosis of the lunate bone. Etiology, clinical aspects, stage-adjusted
      therapy].
AB  - The development of the aseptic necrosis of the lunate bone is so far not fully
      understood. Therapeutical problems result from the very late discovery of the
      disease and from the central position in the carpal bone system. Bad long-term
      results come out of therapies not able to revitalize the lunate bone. Therefore
      the therapeutical goal attempted must be to keep the structures of the bone alive
      and to avoid major pathological changes of the whole carpal bone system. More or
      less good results could be shown for these patients with a total break-down of
      the lunate bone treated with the intercarpal-arthrodesis described by Graner.

PMID- 2241874
TI  - [Graner's intercarpal arthrodesis as therapy of aseptic lunate bone necrosis].
AB  - From 1978 till 1989 at the Department of Orthopaedics (University of Graz,
      Faculty of Medicine, Division of Surgery) 25 patients were operated for the
      reason of an avascular necrosis of the lunate bone when the bone structures were
      already destroyed. The form of therapy was the intercarpal-arthrodesis, developed
      by Orlando Graner 1966, in a slightly modified way. On the one hand through
      creating an intercarpal block it is possible to create more or less plain sides
      of the radiocarpal joint and on the other hand one can stop the carpal collapse
      what explains long-term-results rather acceptable. The most important
      disadvantage of this form of therapy is the often found loss of range of movement
      in the operated radiocarpal joint.

PMID- 2241875
TI  - [Tissue preservation in the DRG].
AB  - The conservation of tissue in GDR is an example system of superregional supply
      with tissue transplants, which was established with the foundation of the Central
      Tissue Bank at the Charite in 1956 e. g. with the following arrangement of tissue
      banks in Leipzig and Rostock in 1966 and 1969. The concept of this tissue banks
      is characterized by means of decentralised production of tissue material under
      conditions of section and the central preparation, conservation and storage
      (chemical or radiation sterilization, conservation on base of freeze-drying (or
      freeze-storage), aseptic packing and storage by room temperature). This system
      allows the consistent disposal of 30 various nonvital tissue preparations. Until
      1989 more than 170,000 allogeneic and xenogeneic tissue transplants have been
      produced in the tissue banks of country of which nearly 130,000 were used in 300
      clinics.

PMID- 2241876
TI  - [The development of the assortment and requirements of the tissue bank of the
      District Institute for Blood Donation and Transfusion Leipzig].
AB  - Since the foundation of the tissue bank at the District Institute for Blood
      Donation--and Transfusion Service of Leipzig in 1966 the range of production and
      the assortment of nonvital tissue transplants has considerably increased. The
      amount of clinical establishments and their requirements is considerably
      increased, in which the realization of demands is not always possible without
      waiting periods. The main tissue conservation method is the cryo-drying. Besides
      the extreme cooling and cryo-preservation were used. Problems of transportation
      of cooled tissue conserves were discussed.

PMID- 2241878
TI  - [Regeneration of bone following thermal injury].
AB  - In an animal experiment we could prove, that a spontaneous regeneration of
      periosteum on thermally injured bone is not to be seen within three month, when
      the bone is covered by soft tissue only. Using a periosteal flap to cover a
      burned bone, regeneration could be observed from the endosteum and the periosteum
      alike. After making the bone with a fluorescent labels, paths and velocity of
      bony regeneration could be defined.

PMID- 2241877
TI  - [Bone replacement using demineralized allogeneic bone in animal experiments].
AB  - The implantation of bone matrix in muscle bag or trepanation defects of rats with
      greatest reproducibility will induce osteogenesis and defect healing. The
      phenomenon of osteo-induction was possible to obtain only in first steps in
      higher developed mammals. Investigations in nude rats have shown a clear
      difference in biologic reaction on the matrix of various species. The osteo
      regeneration in replacement weak defect of ulnar bone in dogs showed a massive
      greater reactivity of autogenous spongiosa, whereas bank spongiosa and bone
      matrix produced not more new bone as the control. An increase of osteoinductive
      matrix potency is a supposition for practical use in case of severe bone defects.

PMID- 2241879
TI  - [Application possibilities of human bone-collagen substance as a transplant in
      skeletal surgery].
AB  - We present first results of our clinical trial with a demineralized-bone-matrix
      (DBM) not only as a transplant to fill up a defect of bone but above all to
      induce local osteogenesis. Indications and practical applications of the material
      of transplants are described. By help of the clinical progresses and the reports
      of laboratory examinations the biological compatibility is regarded in this
      paper. Roentgen morphologically fine structures of the transplants and their
      transplant beds are described in serial roentgenography and used as evaluation of
      processes of transformation and building in of bones. The in a relative good time
      appearing markings of trajectories of the fine structures in the sphere of the
      transplant as a sign of accelerated regeneration of "organic bony substance"
      allows the expectation on being released osteogenetic potencies by DBM for the
      induction of local bone regeneration.

PMID- 2241881
TI  - [The use of homologous spongiosa chips in the treatment of juvenile bone cysts].
AB  - Juvenile bone cysts are characterized by trials of hypothetic interpretations in
      case of aetiology and general disagreement in relation to indicated therapy. The
      therapeutic spectrum is ranging from primary conservative treatment till subtotal
      e.g. total cyst resections. Because in juveniles a quantitative limitation for
      gathering of autogenous material exists the use of allogenous cancellous bone
      chips has a definitive place in treatment strategy.

PMID- 2241880
TI  - [Clinical study on the application of demineralized bone matrix (DBM) in surgical
      orthodontics].
AB  - Demineralized bone matrix has been tested in a clinical study concerning the
      filling of bone defects in the surgical stomatology. It is reported on the
      clinical results and the X-ray evaluation of the replacement of bones by
      demineralized bone matrix. Fifty two implantations in the maxilla and mandible of
      51 patients were carried out to be able to evaluate the efficacy of demineralized
      bone matrix.

PMID- 2241882
TI  - [Long-term results following acetabuloplasty using cortico-spongiosa banked chips
      in hip dysplasia and dislocation].
AB  - Analysed are altogether 119 acetabuloplasties correcting acetabular fossae using
      corticospongiose bankchips. The operations of the years from 1975-1983 have been
      used for this analysis. Examined are by clinical progress and serial
      roentgenography the compatibility, the resistance to mechanical stress as well as
      building in and transformation of the corticospongiose bankchips. Finally is
      determined the progress of the socket by using the socket-roof- and centre-corner
      angle postoperative on an average of 10 years.

PMID- 2241883
TI  - [Autogeneic and allogeneic bone tissue transplantation in the profession of
      orthopedics].
AB  - In the time between 1981 to 1987 about 9,190 operations had been performed at the
      Orthopaedic Department of the Humboldt University Charite Berlin. In 1592 cases
      (= 17.3%) we transplanted autogeneic or allogeneic bone tissues. We report about
      the kind and selection of transplanted bone tissue with respect to availability
      and target function.

PMID- 2241884
TI  - [Methods for the preservation of soft tissue preparations for clinical use].
AB  - The demand for consistent supply of nonvital allogenous implants in tissue banks
      has the supposition for graft preservation. Besides of many logistic advantages
      the preservation methods are accompanied by the influence of original attributes,
      especially of biomechanic parameters in soft tissue preparations. A procedure of
      dura mater preparation, of fascia lata, tendons and skin is demonstrated which is
      preserving the required qualities of plasticity, softness and resistance.
      Biomechanic comparative investigations of other preservation procedures are done
      and first clinical results are demonstrated.

PMID- 2241885
TI  - [The effect of respiratory activity on the QRS complex in the ECG in clinically
      healthy horses and horses with chronic lung diseases].
AB  - Interrelations between respiration and changes in amplitudes of the QRS-complex
      of the ECG of horses were investigated. The value of the R-vector and both its
      components Rx and Ry decrease during inspiration and increase in the expiration
      phase. It means, that the R-waves in leads from cranial to caudal (y, II, aVF)
      and from right to left (I) become smaller with inspiration and larger with
      expiration. The difference of the amplitudes may be important, especially in
      horses with respiratory problems, so that it has to be noted when evaluating
      electrocardiograms. For that purpose it is not necessary to draw respiratory
      curves. It is proposed to evaluate the heart-cycle with the largest R-wave
      (expiration) only when there are differences in the R-amplitudes. Pulmonary air
      content is discussed as a possible cause.

PMID- 2241886
TI  - [Lip-jaw split in a calf. Comments on the article, "Cornea dermoids and double
      malformations of the nares in a calf," by C. Neophytou].
AB  - A case of Cheilognathoschisis in a bull calf is demonstrated. The author
      supposes, that the malformation, which Neophytou reported, was a
      cheilognathoschisis too.

PMID- 2241887
TI  - [Comparison of the effect of an alfaprostol-oxytocin combination and of
      carbamylcholine alone for the prevention of intrapartum mortality of piglets with
      regard to the body condition of the sow].
AB  - In a single large pig production unit of 6,000 breeding sows, 3 Groups of 100
      sows each were formed at random on the 110th day of pregnancy. Each Group was
      evaluated and divided according to body condition in three subgroups. The Groups
      were treated as follows: Group 1: received on the 113th day of pregnancy a 3 mg
      single intramuscular dose of Alfaprostol, 24 hours later a single intramuscular
      dose of 10 i.U. of Oxytocin. Group 2: received on the 113th day of pregnancy a
      0.2 mg single intramuscular dose of Carbamylcholin. Group 3: received a 3 ml
      intramuscular dose of physiologic NaCl solution on the 113th day of pregnancy.
      The parameter "intrapartal dead piglets" was evaluated. Group 1 and 2, especially
      in Subgroups KK3, showed significant less intrapartal death when compared to
      Group 3.

PMID- 2241888
TI  - [The pathogenicity of Campylobacter jejuni as a monoinfection and as a mixed
      infection with Escherichia coli 078:K80 in broilers].
AB  - Two week old broilers (n = 61) with a monoinfection with Campylobacter jejuni
      (0.5 ml of suspension containing 10(5) CFU/ml per os) showed reduced increase in
      weight during week 3 after infection compared to the control group. An other
      group of chickens (n = 31) was additionally infected with a suspension of
      Escherichia (E.) coli O78:K80 via drinking water from day 4 to 6 after the
      primary infection. This mixed infection provoked clinical signs of a disease and
      reduced increase in weight during the first two weeks of the experiment. Seven
      broilers of this group showed a fibrinous pericarditis and/or perihepatitis. Four
      of these chickens died. It can be concluded from the experiment that an infection
      with Campylobacter causes reduced weight gain and supports a systemic infection
      with E. coli.

PMID- 2241889
TI  - [Use of bacteriological techniques in the quality control of poultry
      slaughtering].
AB  - Factors influencing the bacteriological status of materials, treated on a special
      stage of processing, can be detected by analysis of the flow of production.
      Changing the design of equipment, change of the production flow and education of
      the personnel who is handling the equipment can eliminate or minimize the risks.
      The data are to be collected on the basis of the special conditions of the plant.
      The daily checks can be performed by visual inspection or by using physical
      techniques.

PMID- 2241890
TI  - [Osteosynthesis today].
AB  - Modern osteosynthesis has remarkably changed the fracture treatment in small
      animals with its aim to re-establish full limb function. The scientific basis is
      elaborated and the different surgical methods are clinically proved.
      Veterinarians who want to perform operative fracture treatment must have
      sufficient training in the different techniques, the possibility to perform
      aseptic surgery and suitable instruments and implants. As this type of surgery
      means severe stress to the trauma patient, surgery cannot be done before his
      condition is stabilized.

PMID- 2241891
TI  - Ultraviolet B radiation induction of ornithine decarboxylase gene expression in
      mouse epidermis.
AB  - The cellular effects of u.v. radiation have been studied by using a hairless
      mouse model in vivo. U.v. B radiation (u.v.B) induced the activity of the enzyme
      ornithine decarboxylase (ODC) in mouse epidermis. Maximal induction was noted
      after radiation with 90 mJ/cm2, and increased ODC activity was first detected 2 h
      after u.v.B exposure. U.v.B. also induced the expression of the ODC gene in a
      time- and dose-dependent manner, but did not induce the levels of actin mRNA
      transcripts. Cycloheximide treatment did not alter basal levels of ODC mRNA
      transcripts and had no effect on the u.v.B induction of ODC-gene expression. The
      results of these experiments demonstrate that u.v.B radiation induces both the
      expression of the ODC gene and the activity of the enzyme, and provides a useful
      'in vivo' paradigm for the analysis of the molecular effects of u.v.B radiation.

PMID- 2241892
TI  - Structure of the human sialophorin (CD43) gene. Identification of features
      atypical of genes encoding integral membrane proteins.
AB  - A human sialophorin (CD43) specific genomic clone was isolated, and a 6.5 kb
      fragment containing the 4.6 kb sialophorin gene was sequenced. The promoter
      region contains no TATA or CAAT boxes, but is highly enriched in G and C
      nucleotides and contains short repeat sequences similar to those found in the
      promoters of 'housekeeping' genes. S1-nuclease protection and primer-extension
      experiments established that the sialophorin gene has two major transcription
      initiation sites. There is a single intron of 378 bp that interrupts the sequence
      specifying the mRNA 5' untranslated region. The gene is therefore unusual in that
      the discrete extracellular, transmembrane and intracellular regions of the
      protein, including repeat sequences in the extracellular region, are not encoded
      by separate exons. Utilization of alternative polyadenylation signals was
      previously shown to generate two sialophorin mRNAs of 1.9 and 4.3 kb, which
      differ in the length of their 3' untranslated regions. Sequence analysis of the
      gene establishes that a single polyadenylation signal 2301 bp downstream of the
      first major transcription initiation site and five overlapping polyadenylation
      signals beginning a further 2290 bp downstream define the 3' termini of the 1.9
      and 4.3 kb mRNA species respectively. The gene contains potential Z-DNA
      structures, Aly sequences, and elements that may be involved in regulating mRNA
      stability.

PMID- 2241893
TI  - Solubilization and purification of a membrane-associated 3,3',5-tri-iodo-L
      thyronine-binding protein from rat erythrocytes.
AB  - 3,3',5-Tri-iodo-L-thyronine (L-T3) binding sites from rat erythrocyte membranes
      were solubilized in an active form by using the zwitterionic detergent CHAPS or
      the anionic detergent lauroylsarcosine. The binding protein was successively
      purified by Sephadex G-200 and affinity chromatography. The purified material
      retained its binding activity and exhibited high affinity and specificity
      compared with those displayed in the original membrane. Yield was about 10% of
      the starting activity. The specific binding activity was enriched by approx. 100
      fold, which represents a purity of only 0.1%. Analysis of the purified
      preparation on SDS/PAGE showed two major protein bands (Mr 64,000 and Mr 50,000),
      but these could not represent the binding protein since the purity obtained was
      low. However, affinity-labelling experiments with N-bromoacetyl-L-[125I]T3 in
      intact membranes showed that two proteins (also with Mr values of 64,000 and
      50,000) bound the hormone specifically, suggesting a co-migration of hormone
      receptors and contaminants on gel electrophoresis.

PMID- 2241894
TI  - Purification of two distinct proteins of approximate Mr 80,000 from human
      epithelial cells and identification as proper substrates for protein kinase C.
AB  - A Mr-80,000 acidic phosphoprotein ('80K protein') is a specific substrate for
      protein kinase C. We attempted to purify the 80K protein from a human squamous
      cell carcinoma cell line, Ca9-22, by the sequential use of heat treatment,
      (NH4)2SO4 precipitation, Mono Q column chromatography, proRPC column
      chromatography and gel filtration. The 80K protein was assayed by phosphorylation
      in vitro by using partially purified human type III protein kinase C, and was
      fractionated into two distinct molecular species with slightly different Mr
      values, designated 80K-L and 80K-H proteins. Phosphorylation occurred mainly at
      serine residues of these proteins. Two-dimensional phosphopeptide maps after
      trypsin digestion and kinetic profiles of phosphorylation were different from
      each other. Ca2(+)- and phospholipid-dependency of the phosphorylation in vitro
      confirmed that both 80K-L and 80K-H proteins are true substrates for three
      subtypes of protein kinase C. The 80K-L protein was a preferential substrate for
      type III protein kinase C, and the 80K-H protein was phosphorylated more
      effectively by type I and type II protein kinase C. The possible roles of these
      two distinct 80K proteins in signal transduction are discussed.

PMID- 2241895
TI  - Characterization of a high-affinity membrane-associated ornithine decarboxylase
      from the free-living nematode Caenorhabditis elegans.
AB  - Ornithine decarboxylase has been identified and characterized in the free-living
      nematode Caenorhabditis elegans. Unlike previously described ornithine
      decarboxylases, the enzyme activity is membrane-associated and remains in the
      membrane fraction after treatment with high salt, detergents or
      phosphatidylinositol-specific phospholipase C. Ornithine has an apparent Km value
      of 2.7 microM for ornithine decarboxylase. The enzyme is competitively inhibited
      by arginine and lysine with Ki values of 4.0 and 24.4 microM respectively. None
      of the other naturally occurring amino acids inhibited more than 10% of the
      enzyme activity at concentrations up to 1 mM. Agmatine, putrescine, spermidine
      and spermine inhibit ornithine decarboxylase in a non-competitive manner with Ki
      values of 10, 53.5, 59 and 855 microM respectively. A similar ornithine
      decarboxylase activity was also identified in membrane preparations from the
      parasitic nematode Haemonchus contortus.

PMID- 2241897
TI  - High specific induction of spermidine/spermine N1-acetyltransferase in a human
      large cell lung carcinoma.
AB  - The cytotoxic response of the human large cell lung carcinoma line NCI H157 to
      exposure to the polyamine analogue N1 N12-bis(ethyl)spermine (BESpm) is preceded
      by an extremely high induction of spermidine/spermine N1-acetyltransferase
      (SSAT). The human enzyme has now been purified greater than 300-fold to apparent
      homogeneity and found to cross-react with antisera raised against rat liver SSAT.
      Although other acetylases are capable of acetylating polyamines using acetyl-CoA
      as the acetyl donor, the greater than 600-fold induction within 24 h was found to
      be specifically SSAT, since essentially all activity was precipitable by the
      specific antisera. The human enzyme appears to be similar to the rat enzyme in
      subunit size under reducing conditions (approximately 20 kDa), substrate
      specificity and kinetic parameters. Preliminary results using actinomycin D and
      cycloheximide suggested that the unusually high induction by N1 N12
      bis(ethyl)spermine in the human lung cancer line result from new mRNA and protein
      synthesis. This hypothesis is further substantiated here by 'in vitro'
      translation experiments comparing poly(A) mRNA from control and treated cells.
      The large cell lung carcinoma line NCI H157 represents a useful system to produce
      large amounts of the SSAT protein and to study the molecular events responsible
      for the induction and control of this important polyamine-metabolic enzyme. By
      using this rich source of SSAT protein, a partial amino acid sequence was
      determined by N-terminal sequencing of endoproteinase Lys-C digestion fragments.
      Further, this system should be useful in determining whether there is an
      association between the unusually high induction of the acetylase and the
      observed cytotoxicity in the NCI H157 cells.

PMID- 2241896
TI  - 5'-S-(2-aminoethyl)-N6-(4-nitrobenzyl)-5'-thioadenosine (SAENTA), a novel ligand
      with high affinity for polypeptides associated with nucleoside transport. Partial
      purification of the nitrobenzylthioinosine-binding protein of pig erythrocytes by
      affinity chromatography.
AB  - Derivatives of N6-(4-aminobenzyl)adenosine (substituted at the aminobenzyl group)
      and 5'-linked derivatives of N6-(4-nitrobenzyl)adenosine (NBAdo) were evaluated
      as inhibitors of site-specific binding of [3H]nitrobenzylthioinosine (NBMPR) to
      pig erythrocyte membranes. Potent inhibitors were SAENTA [5'-S-(2-aminoethyl)-N6
      (4-nitrobenzyl)-5'-thioadenosine] and acetyl-SAENTA (the 2-acetamidoethyl
      derivative of SAENTA). SAENTA was coupled to derivatized agarose-gel beads (Affi
      Gel 10) to form an affinity matrix for chromatographic purification of NBMPR
      binding polypeptides, which in pig erythrocytes are part of, or are associated
      with, the equilibrative nucleoside transporter. When pig erythrocyte membranes
      were solubilized with octyl glucoside (n-octyl beta-D-glucopyranoside) and
      applied to SAENTA-Affi-Gel 10 (SAENTA-AG10), polypeptides that migrated as a
      broad band on SDS/PAGE with an apparent molecular mass of 58-60 kDa were
      selectively retained by the affinity gel. These polypeptides were identified as
      components of the nucleoside transporter of pig erythrocytes by reactivity with a
      monoclonal antibody (mAb 11C4) that recognizes the NBMPR-binding protein of pig
      erythrocytes. Retention of the immunoreactive polypeptides by SAENTA-AG10 was
      blocked by NBAdo. The immunoreactive polypeptides were released from SAENTA-AG10
      by elution under denaturing conditions with 1% SDS or by elution with detergent
      solutions containing competitive ligands (NBAdo or NBMPR). A 72-fold enrichment
      of the immunoreactive polypeptides was achieved by a single passage of
      solubilized, protein-depleted membranes through a column of SAENTA-AG10, followed
      by elution with detergent solutions containing NBAdo. These results demonstrate
      that polypeptide components of NBMPR-sensitive nucleoside-transport systems may
      be partly purified by affinity chromatography using gel media bearing SAENTA
      groups.

PMID- 2241898
TI  - Hydrogen-bonding in enzyme catalysis. Fourier-transform infrared detection of
      ground-state electronic strain in acyl-chymotrypsins and analysis of the kinetic
      consequences.
AB  - I.r. difference spectra are presented for 3-(indol-3-yl)acryloyl-, cinnamoyl-, 3
      (5-methylthien-2-yl)acryloyl-, dehydrocinnamoyl- and dihydrocinnamoyl
      chymotrypsins at low pH, where the acyl-enzymes are catalytically inactive. At
      least two absorption bands are seen in each case in the ester carbonyl stretching
      region of the spectrum. Cinnamoyl-chymotrypsin substituted at the carbonyl carbon
      atom with 13C was prepared. A difference spectrum in which 13C-substituted acyl
      enzyme was subtracted from [12C]acyl-enzyme shows two bands in the ester carbonyl
      region and thus confirms the assignment of the features to the single ester
      carbonyl group. The frequencies of the ester carbonyl bands are interpreted in
      terms of differential hydrogen-bonding. In each case a lower-frequency relatively
      narrow band is assigned to a productive potentially reactive binding mode in
      which the carbonyl oxygen atom is inserted in the oxyanion hole of the enzyme
      active centre. The higher-frequency band, which is broader, is assigned to a non
      productive binding mode in each case, where a water molecule bridges from the
      carbonyl oxygen atom to His-57; this mode is equivalent to the
      crystallographically determined structure of 3-(indol-3-yl)acryloyl-chymotrypsin,
      i.e. the Henderson structure. A difference spectrum of dihydrocinnamoyl
      chymotrypsin taken at higher pH shows resolution of a feature centred upon 1731
      cm-1, which is assigned to a non-bonded conformer in which the carbonyl oxygen
      atom is not hydrogen-bonded. Perturbation of the protein spectrum in the presence
      of acyl groups is interpreted in terms of enhanced structural rigidity. It is
      reported that the ester carbonyl region of the difference spectrum of cinnamoyl
      subtilisin is complicated by overlap of features that arise from protein
      perturbation. Measurements of carbonyl absorption frequencies in a number of
      solvents of the methyl esters of the acyl groups used to make acyl-enzymes have
      permitted determination of the apparent dielectric constants experienced by
      carbonyl groups in the enzyme active centre as well as a discussion of the
      effects of polarity. The ester carbonyl bond strengths of the various
      conformations were estimated by using simple harmonic oscillator theory and an
      empirical relation between the force constants and bond strengths. The fractional
      bond breaking induced by hydrogen-bonding was used to calculate rate enhancement
      factors by using absolute reaction rate theory.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2241899
TI  - The amino acid sequence of cytosolic aspartate aminotransferase from human liver.
AB  - 1. The cytosolic aspartate aminotransferase was purified from human liver. 2. The
      isoenzyme contains four cysteine residues, only one of which reacts with 5,5'
      dithiobis-(2-nitrobenzoic acid) in the absence of denaturing agents. 3. The amino
      acid sequence of the isoenzyme is reported, as determined from peptides produced
      by digestion with trypsin and with CNBr, and from sub-digestion of some of these
      peptides with Staphylococcus aureus V8 proteinase. 4. The isoenzyme shares 48%
      identity of amino acid sequence with the mitochondrial form from human heart. 5.
      Comparisons of the amino acid sequences of all known mammalian cytosolic
      aspartate aminotransferases and of the same set of mitochondrial isoenzymes are
      reported. The results indicate that the cytosolic isoenzymes have evolved at
      about 1.3 times the rate of the mitochondrial forms. 6. The time elapsed since
      the cytosolic and mitochondrial isoenzymes diverged from a common ancestral
      protein is estimated to be 860 x 10(6) years. 7. Experimental details and
      confirmatory data for the results presented here are given in a supplementary
      paper that has been deposited as a Supplementary Publication SUP 50158 (25 pages)
      at the British Library Document Supply Centre, Boston Spa, Wetherby, West
      Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated
      in Biochem. J. (1990) 265, 5.

PMID- 2241901
TI  - Studies on the origin of biliary phospholipid. Effect of dehydrocholic acid and
      cholic acid infusions on hepatic and biliary phospholipids.
AB  - The correlation between the secretion of biliary phospholipid (PL) and bile acid
      suggests a regulatory effect of bile acid on PL secretion. Bile acids may
      influence PL synthesis and/or the mobilization of a preformed PL pool. The
      objective of this study was to determine the contribution of these two sources to
      biliary PL, by using an experimental protocol in which dehydrocholic acid (DHCA)
      and cholic acid (CA) were infused to manipulate biliary PL secretion. In control
      rats, there was a steady state in bile flow. PL secretion and the biliary
      secretion of newly synthesized phosphatidylcholine (PC). The specific
      radioactivity of PC in bile was significantly higher than in plasma, microsomes
      and canalicular membranes. DHCA infusion decreased biliary PC secretion rate by
      80%, and secretion returned to normal values at the transport maximum of CA. The
      specific radioactivity of biliary PC was decreased by 30% by DHCA infusion and
      reached normal values during CA infusion. There were no significant changes in
      the specific radioactivity of PC in plasma or cellular organelles during infusion
      of bile acids. These data indicate that: (1) newly synthesized PC contributes a
      small percentage to biliary PC; thus a preformed pool (microsomal and
      extrahepatic) is a major source of biliary PL; (2) the contribution of the
      extrahepatic pool to the biliary PL may be more important than the microsomal
      pool.

PMID- 2241900
TI  - Differential down-regulation of protein kinase C selectively affects IgE
      dependent exocytosis and inositol trisphosphate formation.
AB  - Short-term treatment of rat basophilic leukaemia (RBL-2H3) cells with the phorbol
      ester 12-O-tetradecanoylphorbol 13-acetate (TPA) activates protein kinase C (PKC)
      and results in the inhibition of the IgE-dependent formation of inositol
      phosphates, but in the potentiation of serotonin secretion. Long-term treatment
      with TPA, which depletes the cells of their endogenous PKC, eliminates both
      Ca2(+)-ionophore- and TPA- as well as IgE-dependent secretion, but it potentiates
      by 1.7-fold IgE-induced inositol phosphate formation. Taken together, these
      observations strongly suggest that the dual actions of TPA on IgE-dependent
      responses are both mediated by PKC. The opposing effects of TPA are
      differentially down-regulated. Following TPA treatment, the rate by which the
      cells lose their ability to undergo exocytosis is faster than the rate at which
      inhibition of inositol phosphates formation is relieved and their production
      potentiated. In addition, both processes show different sensitivities to
      inhibitors of PKC action. Whereas IgE-dependent secretion is completely blocked
      by the PKC inhibitors K252a, H-7 and sphingosine [concns. causing 50% inhibition
      (IC50 values) = 25 ng/ml 80 microns and 30 microns respectively], these
      inhibitors do not relieve inhibition of inositol phosphate formation by TPA, nor
      do they potentiate this response. These results may imply that the bidirectional
      control exerted by PKC on IgE-dependent responses is mediated by its different
      isoenzymes.

PMID- 2241902
TI  - Expression of human liver arginase in Escherichia coli. Purification and
      properties of the product.
AB  - Arginase is an enzyme that catalyses the hydrolysis of arginine to urea and
      ornithine. It is abundantly present in the liver of ureotelic animals (i.e. those
      whose excretion is characterized by the excretion of uric acid as the chief end
      product of nitrogen metabolism), but its purification has hitherto not been
      simple, and the yield not high. Starting with a partially truncated cDNA for
      human liver arginase recently made available, we constructed an expression
      plasmid that had tandemly linked tac promotors placed upstream of a full-length
      cDNA. By selecting Escherichia coli strain KY1436 as the host micro-organism, we
      established an efficient system for the production of human liver arginase
      protein. Chromatographies on CM-Sephadex G-150, DEAE-cellulose and Sephadex G
      150, followed by preparative agar-gel electrophoresis, yielded 10 mg of
      apparently homogeneous enzyme protein from 1 g (wet wt.) of E. coli cells. E.
      coli-expressed human liver arginase had chemical, immunological and most
      catalytic properties indistinguishable from those of purified human erythrocyte
      arginase. However, E. coli-expressed arginase was a monomer of Mr 35,000, whereas
      the purified erythrocyte arginase was trimer of Mr 105,000. They differed also in
      pH- and temperature-stabilities. Gel-filtration experiments with these two
      purified arginases under various conditions, as well as with unfractionated human
      liver and erythrocyte cytosol preparations, indicated that the native form of
      human arginase should be of Mr 35,000, and that the trimeric appearance of human
      erythrocyte arginase after purification was an artifact of the purification
      procedures. It was thus concluded that, in Nature, the liver and erythrocyte
      arginases are identical proteins.

PMID- 2241903
TI  - The use of polyacrylamide-gel electrophoresis for the high-resolution separation
      of reducing saccharides labelled with the fluorophore 8-aminonaphthalene-1,3,6
      trisulphonic acid. Detection of picomolar quantities by an imaging system based
      on a cooled charge-coupled device.
AB  - Various monosaccharides, oligosaccharides and small polysaccharides were labelled
      covalently at their reducing end groups with the fluorophore 8-aminonaphthalene
      1,3,6-trisulphonic acid (ANTS), and the resulting fluorescent derivatives were
      separated by high-resolution PAGE. The electrophoretic mobilities of the labelled
      saccharides are related largely to the compounds' Mr values, but they are also
      influenced by the individual chemical structures of the saccharides. Various
      positional isomers and some epimers, for instance galactose and glucose, were
      resolved. Oligosaccharide and small polysaccharide derivatives, prepared from an
      enzymic digest of starch, each differing in size by a single hexose residue and
      with a range of degrees of polymerization from 2 to 26, were all resolved in a
      single gel. The method was relatively rapid and simple to perform. It enabled
      multiple samples to be analysed in parallel with high sensitivity. The
      fluorescent-labelling procedure was virtually quantitative. As little as 1 pmol
      of ANTS-labelled saccharide was detected photographically when the gels were
      illuminated by u.v. light. When the 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 carbohydrate moieties of
      glycoconjugates and other naturally occurring oligosaccharides.

PMID- 2241904
TI  - Purification and characterization of rat liver minoxidil sulphotransferase.
AB  - Minoxidil (Mx), a pyrimidine N-oxide, is used therapeutically as an
      antihypertensive agent and to induce hair growth in patients with male pattern
      baldness. Mx NO-sulphate has been implicated as the agent active in producing
      these effects. This paper describes the purification of a unique
      sulphotransferase (ST) from rat liver cytosol that is capable of catalysing the
      sulphation of Mx. By using DEAE-Sepharose CL-6B chromatography, hydroxyapatite
      chromatography and ATP-agarose affinity chromatography, Mx-ST activity was
      purified 240-fold compared with the activity in cytosol. The purified enzyme was
      also capable of sulphating p-nitrophenol (PNP) at low concentrations (less than
      10 microM). Mx-ST was purified to homogeneity, as evaluated by SDS/PAGE and
      reverse-phase h.p.l.c. The active form of the enzyme had a molecular mass of
      66,000-68,000 Da as estimated by gel exclusion chromatography and a subunit
      molecular mass of 35,000 Da. The apparent Km values for Mx, 3'-phosphoadenosine
      5'-phosphosulphate and PNP were 625 microM, 5.0 microM and 0.5 microM
      respectively. However, PNP displayed potent substrate inhibition at
      concentrations above 1.2 microM. Antibodies raised in rabbits to the pure enzyme
      detected a single band in rat liver cytosol with a subunit molecular mass of
      35,000 Da, as determined by immunoblotting. The anti-(rat Mx-ST) antibodies also
      reacted with the phenol-sulphating form of human liver phenol sulphotransferase,
      suggesting some structural similarity between these proteins.

PMID- 2241906
TI  - Inhibitors of phospholipase A2 block the stimulation of protein synthesis by
      insulin in L6 myoblasts.
AB  - Insulin at a concentration close to the physiological range (100 mu-units/ml)
      stimulated protein synthesis in L6 myoblasts by 17%. Pre-treatment with the
      phospholipase A2 inhibitors mepacrine or dexamethasone prevented this stimulation
      and decreased the release of prostaglandin F2 alpha, implicating the action of
      phospholipase A2 and the subsequent metabolism of arachidonic acid to
      prostaglandins in the stimulation of protein synthesis by physiological doses of
      insulin. Higher concentrations of insulin (500-1000 mu-units/ml) stimulated
      protein synthesis in the presence of mepacrine or dexamethasone, suggesting that
      an alternative pathway may become important in insulin action when phospholipase
      A2 is inhibited.

PMID- 2241905
TI  - Two cytochrome P-450 isoforms catalysing O-de-ethylation of ethoxycoumarin and
      ethoxyresorufin in higher plants.
AB  - The O-dealkylating activities of 7-ethoxycoumarin O-de-ethylase (ECOD) and 7
      ethoxyresorufin O-de-ethylase (EROD) have been fluorimetrically detected in
      microsomes prepared from manganese-induced Jerusalem artichoke tubers. Cytochrome
      P-450 dependence of the reactions was demonstrated by light-reversed CO
      inhibition, NADPH-dependence, NADH-NADPH synergism and by use of specific
      inhibitors: antibodies to NADPH-cytochrome P-450 reductase, mechanism-based
      inactivators and tetcyclasis. Apparent Km values of 161 microM for 7
      ethoxycoumarin and 0.4 microM for 7-ethoxyresorufin were determined. O-De
      ethylase activity was also detected in microsomes prepared from several other
      plant species, including wheat, maize, tulip, avocado and Vicia. ECOD and EROD
      were low or undetectable in uninduced plant tissues, and both activities were
      stimulated by wounding or by chemical inducers. Two distinct cytochrome P-450
      isoforms are involved in ECOD and EROD activities since (1) they showed different
      distributions among plant species; (2) they showed contrasting inhibition and
      induction patterns; and (3) ECOD but not EROD activity was supported by cumene
      hydroperoxide.

PMID- 2241907
TI  - Interaction of egg-white glycoproteins and their oligosaccharides with the
      monomer and the hexamer of chicken liver lectin. A multivalent oligosaccharide
      combining site exists within the carbohydrate-recognition domain.
AB  - Binding of egg-white glycoproteins and their oligosaccharides to hexameric
      solubilized form of the chicken hepatic lectin and the monomeric soluble fragment
      containing the carbohydrate-recognition domain has been investigated by several
      techniques. Ligand blotting revealed significant differences in binding to two
      forms of the lectin only for glycoproteins bearing multiple N-linked
      oligosaccharide moieties in their molecule (riboflavin-binding glycoprotein,
      avidin or ovomucoid). Inhibition studies indicated that inhibitory potency in a
      series of linear and branched N-acetyl-D-glucosamine-terminated oligosaccharides
      is critically dependent on the number and spatial arrangement of the terminal
      monosaccharide residues for both forms of the lectin. Direct binding of 4
      hydroxyphenyl-derivatized radioiodinated oligosaccharides measured by equilibrium
      dialysis and frontal affinity chromatography points to the existence of two N
      acetyl-D-glucosamine-combining sites per one subunit of the lectin, as has been
      recently reported for the rabbit and rat liver lectin [Lee & Lee (1988) Biochem.
      Biophys. Res. Commun. 155, 1444-1452]. Highly branch (penta-antennary)
      oligosaccharides interact with more than one subunit of the hexameric form of the
      lectin and thus resemble the more complex interaction of the whole glycoprotein.

PMID- 2241908
TI  - Chemical mechanism of lysophosphatidylcholine: lysophosphatidylcholine
      acyltransferase from rabbit lung. pH-dependence of kinetic parameters.
AB  - Lysophosphatidylcholine: lysophosphatidylcholine acyltransferase is an enzyme
      that catalyses two reactions: hydrolysis of lysophosphatidylcholine and
      transacylation between two molecules of lysophosphatidylcholine to give
      disaturated phosphatidylcholine. Following the kinetic model previously proposed
      for this enzyme [Martin, Perez-Gil, Acebal & Arche (1990) Biochem. J. 266, 47
      53], the values of essential pK values in free enzyme and substrate-enzyme
      complexes have now been determined. The chemical mechanism of catalysis was
      dependent on the deprotonation of a histidine residue with pK about 5.7. This
      result was supported by the perturbation of pK values by addition of organic
      solvent. Very high and exothermic enthalpy of ionization was measured, indicating
      that a conformational re-arrangement in the enzyme accompanies the ionization of
      the essential histidine residue. These results, as well as the results from
      previous studies, enabled the proposal of a chemical mechanism for the enzymic
      reactions catalysed by lysophosphatidylcholine: lysophosphatidylcholine
      acyltransferase from rabbit lung.

PMID- 2241909
TI  - Modulation of mannose receptor activity by proteolysis.
AB  - Macrophages express a receptor on the cell surface that functions to clear
      glycoproteins from the extracellular milieu. The activity of this receptor is
      sensitive to treatment with trypsin. In inflammatory situations, macrophages are
      activated and exposed to increased levels of extracellular proteases. Under these
      conditions, mannose receptor activity on the macrophages is diminished. We
      therefore decided to study the effects of trypsin treatment on the structure and
      activity of cell-associated and purified receptor that might contribute to the
      activation-associated receptor down-regulation. Trypsin treatment (1 microgram/ml
      for 3 h) resulted in the production of a 140 kDa, trypsin-resistant fragment from
      both intact cells and isolated receptor. This fragment was no longer able to bind
      ligand. The remaining 35 kDa fragment apparently is further degraded into smaller
      fragments, since no evidence of this domain was found on Coomassie Blue-stained
      gels. The 140 kDa fragment retained immunoreactivity and contained at least a
      portion of the iodinated tyrosine residues following surface labelling with
      Na125I. Neither calcium nor ligand protected the receptor from proteolysis. In
      addition, prior treatment with oxidants did not increase the susceptibility of
      the receptor to trypsin digestion. We conclude from these results that the
      macrophage mannose receptor is clipped by the serine protease trypsin at the cell
      surface, resulting in the release and further degradation of the binding domain,
      and the production of a membrane-associated 140 kDa fragment. This trypsin
      mediated down-regulation of receptor activity might be important in controlling
      glycoprotein clearance during inflammation.

PMID- 2241910
TI  - Insulin resistance of hind-limb tissues in vivo in lactating sheep.
AB  - 1. The effects of varying the plasma insulin concentration by infusion while
      maintaining euglycaemia by infusion of glucose on nutrient arterio-venous
      differences across the hind-limb and mammary gland in lactating and non-lactating
      sheep were investigated. 2. Insulin infusion increased the glucose arterio-venous
      difference across the hind-limb; this effect of insulin was decreased by
      lactation, suggesting that lactation induces insulin resistance in skeletal
      muscle. 3. Lactation increased but insulin infusion decreased the plasma
      concentrations of acetate, beta-hydroxybutyrate and non-esterified fatty acids.
      4. Insulin infusion decreased the arterio-venous differences of acetate and
      hydroxybutyrate across the hind-limb; this effect of insulin is probably
      indirect, resulting from the decrease in plasma concentrations of these
      metabolites. 5. Infusion of insulin had no effect on the glucose arterio-venous
      difference across the mammary gland, but did decrease the oxygen arterio-venous
      difference. 6. The results suggest that lactation results in insulin resistance
      in skeletal muscle, at least with respect to glucose utilization; this should
      facilitate the preferential utilization of glucose by the mammary gland.

PMID- 2241912
TI  - Contribution of glycerol and alanine to basal hepatic glucose production in the
      genetically obese (fa/fa) rat.
AB  - Increased hepatic glucose production has been reported to occur in the insulin
      resistant genetically obese fa/fa rats. The possible existence of an increased
      basal gluconeogenesis in obese rats was investigated, upon comparing the
      metabolic fate of glycerol and alanine in liver of fed anaesthetized lean and
      genetically obese (fa/fa) rats. Glycerol turnover rate in obese animals was 3
      times that of the lean. This increase in glycerol turnover rate was associated
      with an increase in blood glycerol levels in obese animals. The contribution of
      glycerol to glucose production was significantly increased in obese animals. In
      contrast, the contribution of alanine to the hepatic glucose production was
      similar to lean and obese animals. A higher incorporation of glucose, glycerol
      and alanine into hepatic lipids was observed in obese animals than in controls.
      It is concluded that in fed genetically obese (fa/fa) rats the high blood
      glycerol concentrations is a major driving force for the increased basal hepatic
      conversion of this substrate into glucose.

PMID- 2241911
TI  - The relationship of rat liver overt carnitine palmitoyltransferase to the
      mitochondrial malonyl-CoA binding entity and to the latent palmitoyltransferase.
AB  - 1. Confirming previous work [Murthy & Pande (1987) Proc. Natl. Acad. Sci. U.S.A.
      84, 378-382], malonyl-CoA-inhibitable carnitine palmitoyltransferase (CPT1) from
      rat liver was found to be localized in outer rather than in inner mitochondrial
      membranes. 2. Antisera were raised against a liver mitochondrial CPT of Mr
      68,000, which was presumed to be the latent from of the enzyme (CPT2). These
      antisera cross-reacted with solubilized CPT extracted from liver inner
      mitochondrial membranes and with polypeptides of Mr 68,000 and 60,000 in
      immunoblots of both inner and outer mitochondrial membranes. The antisera also
      precipitated CPT activity from detergent-treated total membrane and outer
      membrane preparations. 3. The antisera did not precipitate [14C]malonyl-CoA
      binding material obtained either from total membranes or from outer membranes. 4.
      It was concluded that liver CPT1 and CPT2 have some epitopes in common and may
      have a similar subunit size. In addition, CPT1 and the entity that binds malonyl
      CoA must be separated polypeptides.

PMID- 2241913
TI  - Recycling of glucosylceramide and sphingosine for the biosynthesis of
      gangliosides and sphingomyelin in rat liver.
AB  - It was previously shown that sphingomyelin and gangliosides can be biosynthesized
      starting from sphingosine or sphingosine-containing fragments which originated in
      the course of GM1 ganglioside catabolism. In the present paper we investigated
      which fragments were specifically re-used for sphingomyelin and ganglioside
      biosynthesis in rat liver. At 30 h after intravenous injection of GM1 labelled at
      the level of the fatty acid ([stearoyl-14C]GM1) or of the sphingosine ([Sph-3H])
      moiety, it was observed that radioactive sphingomyelin was formed almost
      exclusively after the sphingosine-labelled-GM1 administration. This permitted the
      recognition of sphingosine as the metabolite re-used for sphingomyelin
      biosynthesis. Conversely, gangliosides more complex than GM1 were similarly
      radiolabelled after the two treatments, thus ruling out sphingosine re
      utilization for ganglioside biosynthesis. For the identification of the lipid
      fragment re-used for ganglioside biosynthesis, we administered to rats neutral
      glycosphingolipids (galactosylceramide, glucosylceramide and lactosylceramide)
      each radiolabelled in the sphingosine moiety or in the terminal sugar residue.
      Thereafter we compared the formation of radiolabelled gangliosides in the liver
      with respect to the species administered and the label location. After
      galactosylceramide was injected, no radiolabelled gangliosides were formed. After
      the administration of differently labelled glucosylceramide, radiolabelled
      gangliosides were formed, regardless of the position of the label. After
      lactosylceramide administration, the ganglioside fraction became more radioactive
      when the long-chain-base-labelled precursors were used. These results suggest
      that glucosylceramide, derived from glycosphingolipid and ganglioside catabolism,
      is recycled for ganglioside biosynthesis.

PMID- 2241914
TI  - Computer program for the expression of the kinetic equations of enzyme reactions
      as functions of the rate constants and the initial concentrations.
AB  - A versatile computer program with an easy input method has been developed for the
      construction of the terms in kinetic equations of enzyme reactions. It allows the
      expression of the time-dependence of the concentrations of all of the species
      involved as functions of the kinetic parameters. The mathematical theory used in
      this paper, the program and examples of its use have been deposited as
      Supplementary Publication SUP 50159 (41 pages) at the British Library Document
      Supply Centre, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom
      copies can be obtained on the terms indicated in Biochem. J. (1990) 265, 5.

PMID- 2241916
TI  - Sensitivity of system A and ASC transport activities to thiol-group-modifying
      reagents in rat liver plasma-membrane vesicles. Evidence for a direct binding of
      N-ethylmaleimide and iodoacetamide on A and ASC carriers.
AB  - 1. In the present study we have examined the sensitivity of A and ASC amino-acid
      carrier activities in rat liver plasma-membrane vesicles to the thiol-group
      modifying reagents N-ethylmaleimide (NEM) and iodoacetamide (IA). To this end,
      the different Na(+)-dependent entities involved in alanine transport were
      assessed. 2. NEM inactivated Na(+)-dependent alanine transport as a result of the
      inhibition of both system A and ASC transport activities. The functional
      sensitivity of system A to NEM was greater than that of system ASC. 3. The
      presence of L-alanine (10 mM) during the exposure of vesicles to NEM afforded
      partial protection to system A, but not to the ASC, carrier. This effect was
      specific, since the presence of L-phenylalanine (10 mM) did not cause any
      protection. 4. Na+ did not protect A or ASC carriers against NEM inactivation;
      however, the presence of Na+ (100 mM-NaCl) and L-alanine (10 mM) during the
      exposure of the vesicles to NEM protected against inactivation of system A and
      ASC transport activities. The extent of protection was greater in the case of the
      system ASC transport activity than in the case of the A carrier. 5. IA also
      diminished Na(+)-dependent alanine transport by inhibition of A and ASC transport
      activities. Sodium and L-alanine afforded protection to both A and ASC transport
      activities from the inhibitory action of IA. The extent of protection induced by
      substrates was similar for both carriers. 6. It is concluded that there is one,
      or several, free thiol groups in A and ASC carriers, the integrity of which is
      essential for transport activity. Sensitivity to thiol-group-specific reagents
      and the pattern of protection with substrates against inactivation is different
      in A and ASC carriers. That suggests the existence of topological dissimilarities
      regarding the thiol-group containing site(s) in A and ASC amino acid carriers.

PMID- 2241917
TI  - N1N8-bis(gamma-glutamyl)spermidine cross-linking in epidermal-cell envelopes.
      Comparison of cross-link levels in normal and psoriatic cell envelopes.
AB  - N1N8-Bis(gamma-glutamyl)spermidine was found in exhaustive proteolytic digests of
      isolated cell envelopes from human epidermis at levels comparable with those of
      epsilon-(gamma-glutamyl)lysine. Significantly higher than normal amounts of these
      compounds, particularly the bis(gamma-glutamyl)polyamine, were observed in
      envelopes from afflicted areas (scales) of psoriatic patients. These findings
      support the notions that N1N8-bis(gamma-glutamyl)spermidine, like epsilon-(gamma
      glutamyl)lysine, functions in cell envelopes as an enzyme-generated protein cross
      link and stabilizing force and that individuals with the chronic, recurrent skin
      disease, psoriasis, exhibit in involved epidermis abnormal cell-envelope-protein
      cross-linking.

PMID- 2241918
TI  - Human hepatic N-acetylglutamate content and N-acetylglutamate synthase activity.
      Determination by stable isotope dilution.
AB  - N-Acetyl-L-glutamate (N-acetylglutamate) content and N-acetylglutamate synthase
      activity ranges were established in human liver tissue homogenates by stable
      isotope dilution. The methods employ N-[methyl-2H3]acetyl[15N]glutamate as
      internal standard, extraction of N-acetylglutamate by anion-exchange technique
      and its determination by g.l.c.-mass spectrometry by using selected ion
      monitoring. Hepatic N-acetylglutamate content in 16 different human livers,
      normal in structure and function, ranged from 6.8 to 59.7 nmol/g wet wt. (25.0 +/
      13.4 mean +/- S.D.) or from 64.6 to 497.6 nmol/g of protein (223.2 +/- 104.2
      mean +/- S.D.). In vitro, N-acetylglutamate synthase activity in liver tissue
      homogenate ranged from 44.5 to 374.5 (132.0 +/- 90.6 mean +/- S.D.) nmol/min per
      g wet wt. or from 491.7 to 3416.9 (1159.6 +/- 751.1 mean +/- S.D.) nmol/min per g
      of protein. No correlation was found between hepatic N-acetylglutamate
      concentrations and the respective maximal enzymic activities in vitro of N
      acetylglutamate synthase. The marked variability in this system among individual
      livers may reflect its regulatory role in ureagenesis.

PMID- 2241915
TI  - The structure and function of human IgA.

PMID- 2241919
TI  - Circulating C-terminal propeptide of type I procollagen is cleared mainly via the
      mannose receptor in liver endothelial cells.
AB  - The fate of the circulating C-terminal propeptide of type I procollagen (PICP)
      was studied. Trace amounts of 125I-PICP administered intravenously to rats
      disappeared from the blood with an initial t1/2 of 6.1 min. After 45 min the
      radioactivity was distributed as follows: liver, 36%; blood, 23%; kidneys, 18%;
      urine, 20%; spleen, 1%; lungs, 2%; heart, 0.4%. To prevent escape of label from
      the site of uptake, PICP was labelled with 125I-tyramine cellobiose (125I-TC),
      which is trapped intralysosomally. With this ligand a serum t1/2 of 8.7 min was
      recorded, and 70% and 20% was traced in the liver and kidneys respectively. The
      uptake per liver endothelial cell (LEC) was 1000 times that per parenchymal cell
      and twice that per Kupffer cell. At 1 h and 6 h after addition of 125I-PICP to
      cultured LEC, 15% and 45% respectively, had been endocytosed. Only ligands for
      the mannose receptor could compete with PICP for endocytosis. To study whether
      the same specificity was operative in vivo, 125I-PICP was injected along with an
      excess of ovalbumin, which is known to be endocytosed by the mannose receptor of
      LEC. The serum t1/2 was prolonged from 6 to 16 min, signifying that terminal
      mannose residues are an important signal for clearance of PICP. In conclusion,
      these studies show that LEC constitute the main site of uptake of circulating
      PICP. The uptake is mediated by endocytic receptors which recognize terminal
      mannose residues.

PMID- 2241920
TI  - A pH-dependent activation-inactivation equilibrium in glutamate dehydrogenase of
      Clostridium symbiosum.
AB  - 1. On transferring Clostridium symbiosum glutamate dehydrogenase from pH 7 to
      assay mixtures at pH 8.8, reaction time courses showed a marked deceleration that
      was not attributable to the approach to equilibrium of the catalysed reaction.
      The rate became approximately constant after declining to 4-5% of the initial
      value. Enzyme, stored at pH 8.8 and assayed in the same mixture, gave an
      accelerating time course with the same final linear rate. The enzyme appears to
      be reversibly converted from a high-activity form at low pH to a low-activity
      form at high pH. 2. Re-activation at 31 degrees C upon dilution from pH 8.8 to pH
      7 was followed by periodic assay of the diluted enzyme solution. At low ionic
      strength (5 mM-Tris/HCl), no re-activation occurred, but various salts promoted
      re-activation to a limiting rate, with full re-activation in 40 min. 3. Re
      activation was very temperature-dependent and extremely slow at 4 degrees C,
      suggesting a large activation energy. 4. 2-Oxoglutarate, glutarate or succinate
      (10 mM) accelerated re-activation; L-glutamate and L-aspartate were much less
      effective. 5. The monocarboxylic amino acids alanine and norvaline appear to
      stabilize the inactive enzyme: 60 mM-alanine does not promote re-activation, and,
      as substrates at pH 8.8 for enzyme stored at pH 7, alanine and norvaline give
      progress curves showing rapid complete inactivation. 6. Mono- and di-nucleotides
      (AMP, ADP, ATP, NAD+, NADH, NADP+, CoA, acetyl-CoA) at low concentrations (10(-4)
      10(-3) M) enhance re-activation at pH 7 and also retard inactivation at pH 8.8.
      7. The re-activation rate is independent of enzyme concentration: ultracentrifuge
      experiments show no changes in molecular mass with or without substrates. 8. The
      activation-inactivation appears to be due to a slow pH-dependent conformational
      change that is sensitively responsive to the reactants and their analogues.

PMID- 2241921
TI  - Acinar zonation of cytosolic but not organelle-bound activities of
      phosphoenolpyruvate carboxykinase and aspartate aminotransferase in guinea-pig
      liver.
AB  - In human liver, unlike in rat liver, there is no apparent acinar heterogeneity of
      total cellular activity of phosphoenolpyruvate carboxykinase [Wimmer, Luttringer
      & Columbi (1990) Histochemistry 93, 409-415]. Since the intracellular
      compartmentation of phosphoenolpyruvate carbonxykinase differs in rat and human
      liver, we examined the acinar heterogeneity of cytosolic and organelle-bound
      activities of this enzyme in the guinea pig, which shows a more similar
      intracellular compartmentation of enzyme activity to human liver than does the
      rat. Cytosolic phosphoenolpyruvate carboxykinase activity was higher in
      periportal than in perivenous hepatocytes, whereas the organelle-bound activity
      was similar in the two cell populations. Aspartate aminotransferase and alanine
      aminotransferase activities showed a similar distribution to phosphoenolpyruvate
      carboxykinase, with a higher cytosolic activity in periportal than in perivenous
      hepatocytes but a similar organelle-bound activity in the two cell populations.
      Data on the acinar zonation of enzymes determined in whole cells or tissue should
      be interpreted cautiously if the enzyme activity is present in more than one
      subcellular compartment.

PMID- 2241923
TI  - Glucose utilization by skeletal muscles in vivo in experimental hyperthyroidism
      in the rat.
AB  - In the fed state, hyperthyroidism increased glucose utilization indices (GUIs) of
      skeletal muscles containing a lower proportion of oxidative fibres. Glycogen
      concentrations were unchanged, but active pyruvate dehydrogenase (PDHa)
      activities were decreased. Hyperthyroidism attenuated the effects of 48 h of
      starvation to decrease muscle GUI. Glycogen concentrations and PDHa activities
      after 48 h of starvation were low and similar in euthyroid and hyperthyroid rats.
      The increase in glucose uptake and phosphorylation relative to oxidation and
      storage in skeletal muscle induced by hyperthyroidism may contribute to increased
      glucose re-cycling in the fed hyperthyroid state and to glucose turnover in the
      starved hyperthyroid state.

PMID- 2241922
TI  - A role for polyamines in glucose-stimulated insulin-gene expression.
AB  - The aim of the present study was to evaluate the possible role for polyamines in
      the glucose regulation of the metabolism of insulin mRNA of pancreatic islet
      cells. For this purpose islets were prepared from adult mice and cultured for 2
      days in culture medium RPMI 1640 containing 3.3 mM- or 16.7 mM-glucose with or
      without the addition of the inhibitors of polyamine biosynthesis
      difluoromethylornithine (DFMO) and ethylglyoxal bis(guanylhydrazone) (EGBG).
      Culture at the high glucose concentration increased the islet contents of both
      insulin mRNA and polyamines. The synthesis of total RNA, total islet polyamines
      and polyamines associated with islet nuclei was also increased. When the
      combination of DFMO and EGBG was added in the presence of 16.7 mM-glucose, low
      contents of insulin mRNA, spermine and spermidine were observed. Total islet
      polyamine synthesis was also depressed by DFMO + EGBG, unlike islet biosynthesis
      of polyamines associated with nuclei, which was not equally decreased by the
      polyamine-synthesis inhibitors. Total RNA synthesis and turnover was not affected
      by DFMO + EGBG. Finally, actinomycin D attenuated the glucose-induced enhancement
      of insulin mRNA, and cycloheximide counteracted the insulin-mRNA attenuation
      induced by inhibition of polyamine synthesis. It is concluded that the glucose
      induced increase in insulin mRNA is paralleled by increased contents and rates of
      polyamine biosynthesis and that an attenuation of the increase in polyamines
      prevents the increase in insulin mRNA. In addition, the results are compatible
      with the view that polyamines exert their effects on insulin mRNA mainly by
      increasing the stability of this messenger.

PMID- 2241924
TI  - An analysis of the reaction kinetics of the hexahaem nitrite reductase of the
      anaerobic rumen bacterium Wolinella succinogenes.
AB  - The reduction kinetics of both the resting and redox-cycled forms of the nitrite
      reductase from the anaerobic rumen bacterium Wolinella succinogenes were studied
      by stopped-flow reaction techniques. Single-turnover reduction of the enzyme by
      dithionite occurs in two kinetic phases for both forms of the enzyme. When the
      resting form of the enzyme is subjected to a single-turnover reduction by
      dithionite, the slower of the two kinetic phases exhibits a hyperbolic dependence
      of the rate constant on the square root of the reductant concentration, the
      limiting value of which (approximately 4 s-1) is assigned to a slow internal
      electron-transfer process. In contrast, when the redox-cycled form of the enzyme
      is reduced by dithionite in a single-turnover experiment, both kinetic phases
      exhibit linear dependences of the rate on the square root of dithionite
      concentration, with associated rate constants of 150 M-1/2.s-1 and 6 M-1/2.s-1.
      Computer simulations of both the reduction processes shows that no unique set of
      rate constants can account for the kinetics of both forms, although the kinetics
      of the redox-cycled species is consistent with a much enhanced rate of internal
      electron transfer. Under turnover conditions the time course for reduction of the
      enzyme, in the presence of millimolar levels of nitrite and 100 mM-dithionite, is
      extremely complex. A working model for the mechanism of the turnover activity of
      the enzyme is proposed which very closely describes the reaction kinetics over a
      wide range of substrate concentrations, as shown by computer simulation. The
      similarity in the action of the nitrite reductase enzyme and mammalian cytochrome
      c oxidase is commented upon.

PMID- 2241925
TI  - Two types of receptors for iron on mitochondria.
AB  - ATP, the major ligand for Fe in the reticulocyte's low-Mr chelatable pool,
      transfers Fe to a mitochondrial receptor from which the Fe is incorporated into
      haem. However, the utilization of Fe bound to this receptor for haem synthesis is
      slow in comparison with that bound to a second receptor that does not accept Fe
      from ATP, but does accept it from AMP. The major pathway by which Fe is delivered
      for haem synthesis may be through hydrolysis of cytosolic ATP-Fe to AMP-Fe.

PMID- 2241926
TI  - Calreticulin is a candidate for a calsequestrin-like function in Ca2(+)-storage
      compartments (calciosomes) of liver and brain.
AB  - In a search for the non-muscle equivalent of calsequestrin (the low-affinity high
      capacity Ca2(+)-binding protein responsible for Ca2+ storage within the terminal
      cisternae of the sarcoplasmic reticulum), acidic proteins were extracted from rat
      liver and brain microsomal preparations and purified by column chromatography. No
      calsequestrin was observed in these extracts, but the N-terminal amino acid
      sequence of the major Ca2(+)-binding protein of the liver microsomal fraction was
      determined and found to correspond to that of calreticulin. This protein was
      found to bind approx. 50 mol of Ca2+/mol of protein, with low affinity (average
      Kd approx. 1.0 mM). A monoclonal antibody, C6, raised against skeletal-muscle
      calsequestrin cross-reacted with calreticulin in SDS/PAGE immunoblots, but
      polyclonal antibodies reacted with native calreticulin only weakly, or not at
      all, after SDS denaturation. Immuno-gold decoration of liver ultrathin
      cryosections with affinity-purified antibodies against liver calreticulin
      revealed luminal labelling of vacuolar profiles indistinguishable from
      calciosomes, the subcellular structures previously identified by the use of anti
      calsequestrin antibodies. We conclude that calreticulin is the Ca2(+)-binding
      protein segregated within the calciosome lumen, previously described as being
      calsequestrin-like. Because of its properties and intraluminal location,
      calreticulin might play a critical role in Ca2+ storage and release in non-muscle
      cells, similar to that played by calsequestrin in the muscle sarcoplasmic
      reticulum.

PMID- 2241928
TI  - Quantitative control analysis of branched-chain 2-oxo acid dehydrogenase complex
      activity by feedback inhibition.
AB  - The potential for branched-chain 2-oxo acid dehydrogenase complex (BCOADC)
      activity to be controlled by feedback inhibition was investigated by calculating
      the Elasticity Coefficients for several feedback inhibitors. We suggest that
      feedback inhibition is a quantitatively important regulatory mechanism by which
      branched-chain 2-oxo acid dehydrogenase activity is regulated. The potential for
      control of enzyme activity is greater for NADH than for the acyl-CoA products,
      and suggests that factors that alter the redox potential may physiologically
      regulate BCOADC activity through a feedback inhibitory mechanism in vivo. Local
      pH may also be an important regulatory control factor.

PMID- 2241927
TI  - Glutathione transferase isoenzymes from human prostate.
AB  - By using affinity-chromatography and isoelectric-focusing techniques, several
      forms of glutathione transferase (GSTs) were resolved from human prostate
      cytosol. All the three major classes of GST, i.e. Alpha, Mu and Pi, are present
      in human prostate. However, large inter-individual variation in the qualitative
      and quantitative expression of different isoenzymes resulted in the samples
      investigated. The most abundant group of prostate isoenzymes showed acid (pI 4.3
      4.7) behaviour and were classified as Pi class GSTs on the basis of their
      immunological and structural properties. Immunohistochemical staining of Pi class
      GSTs was prevalently distributed in the epithelial cells surrounding the alveolar
      lumen. Class Mu GSTs are also expressed, although in small amounts and in a
      limited number of samples, by human prostate. The major cationic isoenzyme
      purified from prostate, GST-9.6; (pI 9.6; apparent subunit molecular mass of 28
      kDa), appears to be different from the cationic GST alpha-epsilon forms isolated
      from human liver and kidney as evidenced by its structural, kinetical and
      immunological properties. This enzyme, which accounts for about 20-30% (on
      protein basis) of total amount of GSTs, is expressed by only 40% of samples. GST
      9.6 has the ability to cross-react in immunoblotting analysis with antisera
      raised against rat liver GST 2-2, rather than with antisera raised against
      members of human Alpha, Mu and Pi class GSTs. Although prostate GST-9.6 shows
      close relationship with the human skin GST pI 9.9, it does not correspond to any
      other known human GST.

PMID- 2241929
TI  - Purification and characterization of 4-methylmuconolactone methylisomerase, a
      novel enzyme of the modified 3-oxoadipate pathway in the gram-negative bacterium
      Alcaligenes eutrophus JMP 134.
AB  - 4-Carboxymethyl-4-methylbut-2-en-4-olide (4-methyl-2-enelactone) isomerase,
      transforming 4-methyl-2-enelactone to 3-methyl-2-enelactone, was purified from a
      derivative strain of Pseudomonas sp. B13, named B13 FR1, carrying the plasmid
      pFRC2OP. This plasmid contained the isomerase gene cloned from Alcaligenes
      eutrophus JMP 134, which uses 4-methyl-2-enelactone as a carbon source. The
      enzyme consists of a single peptide chain of Mr 40,000 as judged by SDS/PAGE. In
      addition to 4-methyl-2-enelactone, the putative reaction intermediate, 1-methyl
      3,7-dioxo-2,6-dioxy-bicyclo[3.3.0]octane (1-methylbislactone), was a substrate
      for the enzyme, but kinetic data presented did not favour its role as a reaction
      intermediate. Isomeric methyl-substituted 4-carboxymethylbut-2-en-4-olides were
      neither substrates nor inhibitors. Possible reaction mechanisms are discussed.

PMID- 2241930
TI  - Denaturation studies on natural and recombinant bovine prochymosin (prorennin).
AB  - 1. Prochymosin in solution in the presence of 8 M-urea is fully unfolded, as
      indicated by its fluorescence spectrum, fluorescence quenching behaviour and far
      u.v.c.d. spectrum. 2. Equilibrium studies on the unfolding of prochymosin and
      pepsinogen by urea were carried out at pH 7.5 and pH 9.0. The results indicate
      that the stabilization energies of the two proteins are identical at pH 7.5, but
      that at pH 9.0 pepsinogen is significantly less stable than prochymosin. 3.
      Kinetic studies on the unfolding of prochymosin and pepsinogen indicate that the
      processes can be described by a single first-order rate constant, and that at any
      given value of denaturant concentration and pH the rate of unfolding of
      prochymosin is significantly greater than that of pepsinogen. 4. Unfolding of
      prochymosin by concentrated urea is not fully reversible, unlike that of
      pepsinogen. Kinetic analysis of the refolding of the proteins suggests the
      presence of a slow process following unfolding in urea; for pepsinogen this
      process leads to a slowly refolding form, whereas for prochymosin the slow
      process in urea leads to a form that cannot refold on dilution of the denaturant.
      5. The results provide a rationale for an empirical process for recovery of
      recombinant prochymosin after solubilization of inclusion bodies in concentrated
      urea. 6. In all respects studied here, natural and recombinant bovine prochymosin
      were indistinguishable, indicating that the refolding protocol yields a
      recombinant product identical with natural prochymosin.

PMID- 2241931
TI  - Synergistic control of Ca2+ mobilization in permeabilized mouse L1210 lymphoma
      cells by inositol 2,4,5-trisphosphate and inositol 1,3,4,5-tetrakisphosphate.
AB  - L1210 lymphoma cells were permeabilized with digitonin, and the ability of
      Ins(2,4,5)P3 and Ins(1,3,4,5)P4 to mobilize intracellular Ca2+ was studied. At
      high doses of Ins(2,4,5)P3 Ca2+ was rapidly released from intracellular stores,
      and prior or subsequent addition of Ins(1,3,4,5)P4 had no discernible effect.
      However, the Ca2(+)-mobilizing action of low (threshold or just above)
      concentrations of Ins(2,4,5)P3 was markedly enhanced by Ins(1,3,4,5)P4, which
      alone caused no mobilization of Ca2+; this phenomenon was shown not to be due to
      protection of Ins(2,4,5)P3 by the Ins(1,3,4,5)P4 against hydrolysis. The ability
      of the pre-addition of Ins(1,3,4,5)P4 to enhance subsequent Ins(2,4,5)P3-induced
      Ca2+ mobilization was always seen whether or not the free Ca2+ concentration was
      low (pCa = 7) or high (pCa = 6). However, at low Ca2+, Ins(1,3,4,5)P4 could cause
      a further mobilization if added after the Ins(2,4,5)P3, whereas at higher Ca2+
      values Ins(1,3,4,5)P4 was only able to affect Ca2+ if added before Ins(2,4,5)P3.
      These effects of Ins(1,3,4,5)P4 were not, at the same concentration, mimicked by
      a random mixture of InsP4 isomers obtained by partial acid hydrolysis of phytic
      acid, by Ins(1,3,4)P3 or by Ins(1,3,4,5,6)P5, and they were shown not to be due
      to enzymic generation of Ins(1,4,5)P3 from Ins(1,3,4,5)P4 by (a) the absence of
      any detectable production of Ins(1,4,5)P3 if radiolabelled Ins(1,3,4,5)P4 was
      used, or (b) the observation that Ins(1,3,4,5,6)P5 could mimic Ins(1,3,4,5)P4
      provided that higher doses were used; this inositol phosphate, when added
      radiolabelled, yielded only trace quantities of D/L-Ins(1,4,5,6)P4, which itself
      does not mobilize Ca2+. We interpret these results overall to mean that in these
      cells there is a small proportion of the Ins(2,4,5)P3-mobilizable Ca2+ pools
      which can only be mobilized in the presence of Ins(1,3,4,5)P4 [or at the least,
      Ins(1,3,4,5)P4 can help Ins(2,4,5)P3 to gain access to them]. The significance of
      this conclusion is discussed in the light of current concepts of the second
      messenger function of Ins(1,3,4,5)P4.

PMID- 2241932
TI  - Slow tight-binding inhibition of prolyl endopeptidase by benzyloxycarbonyl-prolyl
      prolinal.
AB  - Prolyl endopeptidase is a serine proteinase that specifically cleaves peptides on
      the carboxy side of proline residues. Wilk & Orlowski [(1983) J. Neurochem. 41,
      69-75] have shown that benzyloxycarbonyl-prolyl-prolinal (Z-prolyl-prolinal) is a
      potent inhibitor of prolyl endopeptidase. We show that Z-prolyl-prolinal is a
      slow-binding inhibitor of mouse brain prolyl endopeptidase with Ki 0.35 +/- 0.05
      nM. Kinetic analysis indicates that the mechanism is a simple, but slow,
      reversible equilibrium between free and bound enzyme (E + I in equilibrium EI)
      with rate constants for association (kon) and dissociation (koff) of 1.6 X 10(5)
      M-1.s-1 and approx. 4 X 10(-5) s-1 respectively. Slow-binding inhibition is
      dependent on the presence of the aldehyde group since the alcohol (Z-prolyl
      prolinol) is a rapid and 50,000-fold poorer inhibitor (Ki 19 microM). Prolyl
      endopeptidase from human brain is also inhibited by Z-prolyl-prolinal with
      kinetics similar to those of the mouse brain enzyme.

PMID- 2241933
TI  - Telomeres, telomerase and senescence.
AB  - Eukaryotic chromosomes end with tandem repeats of simple sequences. These GC rich
      repeats allow telomere replication and stabilize chromosome ends. Telomere
      replication involves an equilibrium of sequence loss and addition at the ends of
      chromosomes. Repeats are added de novo by telomerase, an unusual DNA polymerase.
      Telomerase is an RNP in which an essential RNA component provides the template
      for the added telomere repeats. Telomere length maintenance plays an essential
      role in cell viability.

PMID- 2241934
TI  - From cell membrane to nucleotides: the phosphate regulon in Escherichia coli.
AB  - Most of the essential cellular components, like nucleic acids, lipids and sugars,
      are phosphorylated. The phosphate equilibrium in Escherichia coli is regulated by
      the phosphate (Pi) input from the surrounding medium. Some 90 proteins are
      synthesized at an increased rate during Pi starvation and the global control of
      the cellular metabolism requires cross-talk with other regulatory mechanisms.
      Since the Pi concentration is normally low in E. coli's natural habitat, these
      cells have devised a mechanism for synthesis of about 15 proteins to accomplish
      two specific functions: transport of Pi and its intracellular regulation. The
      synthesis of these proteins is controlled by two genes (the phoB-phoR operon),
      involving both negative and positive functions. PhoR protein is a histidine
      protein kinase, induced in Pi starvation and is a transmembrane protein. It
      phosphorylates the regulator protein PhoB which is also Pi starvation-induced.
      The PhoB phosphorylated form binds specifically to a DNA sequence of 18
      nucleotides (the pho Box), which is part of the promoters of the Pho genes. The
      genes controlled by phoB constitute the Pho regulon. The repression of phoA (the
      gene encoding alkaline phosphatase) by high Pi concentrations in the medium
      requires the presence of an intact Pst operon (pstS, pstC, pstA, pstB and phoU)
      and phoR. The products of pstA and pstC are membrane bound, whereas the product
      of pstS is periplasmic and PstB and PhoU proteins are cytoplasmic. The function
      of the PhoU protein may be regulated by cofactor nucleotides and may be involved
      in signaling the activation of the regulon via PhoR.

PMID- 2241935
TI  - At the crossroads of developmental genetics: the cloning of the classical mouse T
      locus.
AB  - The discovery, more than 60 years ago, of a mutant mouse with a short tail led to
      the birth of the new field of developmental genetics. Over the years since,
      numerous investigators have probed the biology of the original short-tail
      mutation at the T locus, as well the naturally-occurring t haplotypes that were
      uncovered as a result of their interaction with this mutation. Although the T
      locus ranks among the best characterized developmental loci in the mouse, it was
      not among the first to be cloned. This situation has now been rectified with two
      recent reports from Herrmann, Lehrach and their colleagues. While the T locus is
      expressed uniquely in the embryonic tissues predicted from the mutant phenotype,
      the gene itself, as well as the predicted amino acid sequence of the T product,
      show no strong homology to any known sequence. For the moment, at least, the
      mystery behind the function of the T locus still awaits definitive resolution.

PMID- 2241936
TI  - Position effects, methylation and inherited epigenetic states.

PMID- 2241937
TI  - Traction and the formation of mesenchymal condensations in vivo.
AB  - Although the segregation of mesenchyme into distinct aggregates is the first step
      in the development of a range of tissues that includes bones, somites, feathers
      and nephrons, we still know very little about the mechanisms by which this
      happens. There are two obvious types of explanation: first, that there are global
      pre-patterns within the mesenchyme whose molecular expression leads to tissue
      fragmentation and, second, that the condensations arise spontaneously through the
      local morphogenetic abilities of the cells. The only known mechanism for the
      latter possibility is cell traction and this paper suggests that current studies
      are compatible with traction playing a primary role in the formation of
      nephrogenic condensations in the developing kidney and the separation of somites,
      but not for the generation of feather rudiments where there is evidence of a
      prepattern of adhesivity.

PMID- 2241938
TI  - The difference in murine CDC2 kinase activity between cytoplasmic and nuclear
      fractions during the cell cycle.
AB  - The mouse analog of yeast CDC2+ kinase was detected in the cytoplasmic and
      nuclear fractions of cultured mouse FM3A cells. Its activity in the nuclear
      fraction increased in the G2/M phase became seven times higher than that in the
      G1/S phase, while the activity in the cytoplasmic fraction remained was almost
      constant from the G1/S to G1 phases. The activity in the cytoplasmic fraction was
      similar to that in the nuclear fraction in the G2/M phase. The amount of the
      enzyme remained almost constant during the cell cycle in both the nuclear and
      cytoplasmic fractions. These findings suggest that the cytoplasmic enzyme might
      play an independent role in the cell cycle.

PMID- 2241939
TI  - Antioxidant activity of 6-phosphatidyl-L-ascorbic acid.
AB  - The antioxidant activity of 6-phosphatidyl-L-ascorbic acid was investigated in a
      homogeneous solution and a liposomal suspension. In an apolar solvent, one
      molecule of 6-phosphatidyl-L-ascorbic acid could trap one peroxyl radical. When 6
      phosphatidyl-L-ascorbic acid was included in multilamellar liposomes of egg yolk
      phosphatidylcholine, it could retard more effectively the aqueous peroxyl-induced
      peroxidation of phosphatidylcholine than L-ascorbic acid.

PMID- 2241941
TI  - Occurrence of transketolase abnormalities in extracts of foreskin fibroblasts
      from patients with Alzheimer's disease.
AB  - Foreskin fibroblast cell lines from healthy subjects and patients with
      Alzheimer's disease or other neurological disorders have been analyzed for
      transketolase, by means of isoelectrofocusing and specific immunostaining. The
      enzyme profile in 70% of Alzheimer cell cultures exhibits alterations which are
      not encountered in controls and in other neurological diseases examined. Enzyme
      abnormalities most frequently observed were the appearance of new transketolase
      forms having unusually high alkaline pI. Experiments carried out with intact
      cells and with cell extracts treated with and without phenylmethyl-sulphonyl
      fluoride, suggest that the peculiar transketolase abnormalities observed in
      Alzheimer fibroblasts are due to enhanced proteolysis occurring in these cells
      rather than to intrinsic enzyme lability.

PMID- 2241940
TI  - Inhibition of biological actions of big endothelin-1 by phosphoramidon.
AB  - Endothelin (ET)-1 and big ET-1 both caused contraction of isolated porcine
      coronary arteries, but the potency of big ET-1 was 1/100-1/200 that of ET-1.
      These responses were independent of the vascular endothelium. Phosphoramidon
      blocked the vasoconstriction caused by 30 nM big ET-1, but was ineffective on the
      action of 0.3 nM ET-1. Also in vivo, phosphoramidon had no effect on the ET-1
      induced pressor actions, but blocked the pressor and airway-contractile responses
      to big ET-1 in rats and/or guinea pigs. Thus, it is likely that the vascular
      responses to exogenous big ET-1 are at least in part due to its conversion to ET
      1 by a phosphoramidon-sensitive ET converting enzyme(s) in the vascular smooth
      muscle in vitro and in vivo.

PMID- 2241942
TI  - Induction of an altered DNA conformation by an inversion rearrangement in the 5'
      flanking DNA of a U1 RNA gene.
AB  - The anomalous electrophoretic behavior of a 686 base pair restriction fragment
      containing an in vitro-generated inversion mutation within the enhancer region of
      a chicken U1 RNA gene was investigated. This DNA fragment migrated with an
      abnormally slow mobility in polyacrylamide gels but migrated normally in agarose
      gels relative to the wild type fragment of identical size and base composition.
      In polyacrylamide gels, the degree of retardation was enhanced at low
      temperature, a phenomenon associated with bent DNA. A putative site of bending
      was localized at or near one end of the inverted region. These data suggest that
      the altered DNA conformation results from the juxtaposition of two normally
      remote DNA sequences.

PMID- 2241943
TI  - Protein kinase C activation selectively increases mRNA levels for one of the
      regulatory subunits (RI alpha) of cAMP-dependent protein kinases in HT-29 cells.
AB  - We have examined the effect of the protein kinase C activator, TPA, on mRNA
      levels for subunits of cAMP-dependent protein kinases in the human colonic cancer
      cell line HT-29, subline m2. Messenger RNA for the regulatory subunit, RI alpha,
      of cAMP-dependent protein kinases was shown to be present and regulated by TPA.
      Other mRNAs for subunits of cAMP-dependent protein kinases (RI beta, RII alpha,
      RII beta, C alpha, C beta) were also present in these cells, but revealed no or
      only minor changes upon TPA stimulation. When HT-29 cells were cultured in the
      presence of 10 nM TPA for various time periods, a biphasic response was observed
      in RI alpha mRNA levels with a maximal increase (approximately 4 fold) after 24
      hours. TPA stimulated RI alpha mRNA increased in a concentration-dependent manner
      and maximal response (4-8 fold) was seen at 3-10 nM. The TPA-induced increase in
      RI alpha mRNA was not obtained when cells were incubated with TPA together with
      the protein kinase C inhibitors, staurosporine or H7. The cAMP-analog 8-CPTcAMP
      alone induced RI alpha mRNA levels 50% more than TPA. Combined treatment with TPA
      (10 nM) and 8-CPTcAMP (0.1 mM) gave an increase in RI alpha mRNA similar to TPA.
      These results demonstrate an interaction between the protein kinase C pathway and
      mRNA levels for the RI alpha subunit of cAMP-dependent protein kinases in HT-29
      cells.

PMID- 2241944
TI  - The binding of ATP and AMP to Escherichia coli adenylate kinase investigated by
      1H and 15N NMR spectroscopy.
AB  - [N6 15N]ATP and [N6 15N]AMP, complexed with E.coli adenylate kinase (AKe), were
      observed with 15N isotope-filtered NMR pulse sequences and 1H[15N]
      heterocorrelated experiments to determine differences between binding sites based
      on chemical shifts and competition by substrate analogs. The chemical shifts of
      the N6 amino proton and nitrogen signals changed significantly after mixing with
      adenylate kinase. Differences in chemical shifts between the bound ATP and AMP
      signals are slight. The response of these shifts to further addition of other
      substrates or Mg2+ supports the view that the unchelated nucleotides can bind to
      both the sites, whereas the metal complexed species are restricted to the
      MgATP/MgADP binding site.

PMID- 2241945
TI  - Characterization and behaviour of 15-lipoxygenase during peanut cotyledonary
      senescence.
AB  - Lipoxygenase (EC 1.13.11.12) (LOX), a ubiquitous plant enzyme which catalyzes the
      hydroperoxidation of unsaturated fatty acids (PUFA), plays an important role
      during the course of leaf and cotyledonary senescence. In the present study,
      senescence related changes in chlorophyll and protein content and lipoxygenase
      activity have been examined in peanut cotyledons. The chlorophyll content of the
      cotyledons increased from the 2nd to 8th day followed by a steady decline. In
      contrast, protein content of peanut cotyledons decreased continuously during
      senescence. Lipoxygenase activity, on the other hand, increased in early stages
      of germination followed by a decrease in the later course of senescing peanut
      cotyledons. Analysis of the product profile, the lipoxygenase with arachidonic
      acid as the substrate on HPLC, has shown a single peak comigrating with standard
      15-Hydroperoxyeicosatetraenoic acid. The results on peanut cotyledonary 15
      lipoxygenase activity in relation to abscisic acid and kinetin are discussed.

PMID- 2241946
TI  - Inhibition of TGF alpha-induced second messengers by anti-EGF receptor antibody
      425.
AB  - Monoclonal antibody 425 binds to a protein epitope of the human EGF receptor and
      blocks EGF dependent functions such as EGF receptor phosphorylation and
      mitogenesis (1). We now show that MAb 425 blocks TGF alpha-induced second
      messenger signals, namely inositol 1,4,5 triphosphate and Ca2+ in two carcinoma
      cell lines, A 431 and SW-948. In this study we have further characterized the
      specificity of this antibody for inhibiting TGF alpha induced mitogenesis in MRC
      5, a EGF-receptor expressing fibroblast cell line.

PMID- 2241947
TI  - Removal of twelve C-terminal amino acids from firefly luciferase abolishes
      activity.
AB  - cDNA coding for the luciferase in the firefly Photinus pyralis was cloned using
      pcDV1 primer and Honjo linker containing SP6 RNA polymerase promoter. This
      enabled conditions to be established to produce mRNA, capped with m7 GpppG, in
      vitro and then translated to form light emitting protein. Full length recombinant
      luciferase produced by in vitro translation, was fully active, had the same
      isoelectric focusing point as the native enzyme and produced a similar, yellow
      emission. Removal of the coding sequence for the last 12 amino acids at the C
      terminus, containing the peroxisome signal peptide, by polymerase chain reaction
      resulted in greater than or equal to 99% loss in activity of the protein formed
      from mRNA in vitro. This has important implications for using this luciferase as
      an indicator or reporter gene in eukaryotic cells, and for identifying the active
      centre of the enzyme.

PMID- 2241948
TI  - Quantitative determination of deleted mitochondrial DNA relative to normal DNA in
      parkinsonian striatum by a kinetic PCR analysis.
AB  - Deleted mitochondrial DNA (mtDNA) was accumulated in the parkinsonian striatum,
      but the same deleted mtDNA was also detectable in the control striatum when
      cycles of polymerase chain reaction were increased. To discriminate between these
      pathological and physiological conditions, we quantitatively analyzed the
      proportion of deleted mtDNA to normal mtDNA by measuring the incorporation of
      alpha-[32P]deoxycytosine triphosphate into mtDNA fragments by using a laser image
      analyzer. To estimate the molar ratio of the deleted mtDNA to normal mtDNA, the
      radioactivity was normalized by each fragment size. By plotting logarithms of
      normalized radioactivities against PCR amplification cycles, straight lines were
      obtained with different slopes. By extrapolation of the line to the zero
      amplification, the proportion of mutant mtDNA to normal mtDNA in the original
      sample from the parkinsonian striatum was estimated to be ca. 5%, which was at
      least ten times higher than the proportion of ca. 0.3% in the control striatum.
      These results indicate that phenotype of the mutant mtDNA as Parkinson's disease
      is expressed when the proportion of deleted mtDNA to normal mtDNA exceeds a
      threshold of ten times higher value than in the normal subject.

PMID- 2241950
TI  - Autoantibodies specific for the 20-KDal ribosomal large subunit protein L12.
AB  - New antibodies reactive with a 20 KDal ribosomal protein of the large subunit
      were found in sera from two of eighty patients with systemic lupus erythematosus.
      This antigenic protein was identified as L12 by the mobility in two-dimensional
      gel electrophoresis. Both sera also contained anti-P activity against three
      acidic phosphoproteins (P proteins), but this activity was completely inhibited
      by preincubation with the isolated P proteins. Therefore, these anti-L12 can be
      useful for studying the function of L12 in protein synthesis.

PMID- 2241949
TI  - Identification of pristanoyl-CoA oxidase activity in human liver and its
      deficiency in the Zellweger syndrome.
AB  - The ability of human liver to oxidize pristanic acid was investigated. Liver from
      control subjects was found to contain pristanic acid oxidase activity, an H2O2
      producing enzyme activity not previously demonstrated in mammals. In livers from
      patients with the cerebro-hepato-renal syndrome of Zellweger, a genetic disease
      characterized by the absence of morphologically distinguishable peroxisomes,
      pristanic acid oxidase activity was found to be deficient. These results indicate
      that pristanic acid is oxidized in peroxisomes rather than in mitochondria as
      believed until now. Furthermore, our findings provide an explanation for the
      elevated levels of pristanic acid in body fluids from patients lacking
      peroxisomes.

PMID- 2241952
TI  - Isolation of three allergenic fractions of the major allergen from Olea europea
      pollen and N-terminal amino acid sequence.
AB  - A method to isolate the major allergen from olive pollen (Ole e I) in high yield
      is described. The allergenic fraction has been separated into 3 subfractions by
      reverse-phase HPLC. All these fractions were reactive to allergic sera from olive
      sensitized patients, giving similar responses. No significant differences were
      observed between the amino acid compositions of these three proteins. The amino
      acid sequence of the first 27 amino acid residues from the N-terminal end is
      given. No homologies have been detected between Ole e I and other known allergens
      obtained from pollen.

PMID- 2241951
TI  - An ATP, calcium and voltage sensitive potassium channel in porcine coronary
      artery smooth muscle cells.
AB  - There is increasing interest in the roles played by potassium channels of smooth
      muscle in protecting against ischemic and anoxic insults. Hence, potassium
      selective channels were studied in freshly dispersed porcine coronary artery
      smooth muscle cells using the inside-out variant of the patch-clamp technique.
      The most abundant potassium channel had a conductance of 148 pS in a 5.4/140 mM
      K+ gradient, at 0 mV, and was regulated by cytoplasmic ATP (0.05-3.0 mM),
      cytoplasmic Ca2+ (0.1-10 microM) and voltage. ATP and AMP-PNP (0.5 mM) reduced
      the probability of channel opening (Po) by 87 and 92%, respectively. This
      inhibition was partially reversed by the addition of 0.5 mM ADP. ADP on its own
      (2 mM) reduced Po by 46%. It appears, therefore, that this channel shares
      properties with both the ATP-sensitive and the calcium-regulated potassium
      channels, raising the possibility that it plays a central role in the regulation
      of coronary blood flow.

PMID- 2241953
TI  - Isolation and characterization of a metalloproteinase secreted by rat glioma
      cells in serum-free culture.
AB  - The isolation of a metalloproteinase secreted by a rat glioma cell line (BT5C) in
      serum-free media is described. After affinity purification, the activity was
      present as a double band with Mr 86000 and 76000 both of which required CaCl2 for
      activity. The enzyme was able to degrade gelatin but not casein. It was unable to
      degrade native types I, III, IV and V collagens but their denatured counterparts
      were degraded. Using a radiolabel release assay the enzyme was inhibited by EDTA,
      1:10 phenanthroline and TIMP confirming that it belongs to the family of
      metalloproteinases. Its activity was not affected by either serine or cysteine
      protease inhibitors. The proteinase was activated by APMA but was unaffected by
      trypsin treatment.

PMID- 2241954
TI  - Cultured astrocytoma cells inhibit platelet aggregation by releasing a nitric
      oxide-like factor.
AB  - Cultured astrocytoma cells were tested for their ability to generate a nitric
      oxide like factor using platelet aggregation as a bioassay. Incubation of
      astrocytoma cells with human washed platelets resulted in an inhibition of
      thrombin-induced platelet aggregation which was proportional to the number of
      astrocytoma cells added. The inhibition was potentiated by superoxide dismutase
      (SOD) and prevented by oxyhaemoglobin (oxyHb). The inhibitory activity of
      astrocytoma cells was also prevented by the NO biosynthesis inhibitor NG
      monomethyl-L-arginine (MeArg), an effect reversed by co-incubation with L
      arginine (L-Arg) but not D-arginine (D-Arg). These results demonstrate that
      astrocytoma cells release, independent of added agonist, a factor with the same
      pharmacological profile as NO, which is likely to be derived from L-arginine.

PMID- 2241955
TI  - Calcitonin gene-related peptide stimulates adenylate cyclase activity in trout
      gill cell membranes.
AB  - The physiological significance of calcitonin gene-related peptide (CGRP) was
      investigated by assessing the CGRP stimulated adenylate cyclase activity in
      various tissues of trout. The highest enzyme concentration was found in gill and
      stomach membranes. The maximal activity (190% of the basal value) was observed
      for a concentration of 53.3 nM CGRP I or II. In the presence of 58 nM sCT, the
      maximal enzyme activity represented 120% of the basal value. No additive effect
      was observed; this suggests that both CGRP and sCT activities are mediated
      through the same receptor. The present data are in favour of a role for this
      neuropeptide operating in branchial cell functions such as calcium transfer from
      the external to the internal milieu.

PMID- 2241956
TI  - Trehalose, the insect blood sugar, inhibits loading of diacylglycerol by
      lipophorin from the fat body in locusts.
AB  - Trehalose, the insect blood sugar, was found to inhibit diacylglycerol uptake by
      lipophorin from the fat body in vitro. Trehalose inhibited diacylglycerol uptake
      by about 40%-50% at various physiological concentrations. This suggests that
      trehalose may play a dual role in the hemolymph, i.e. serving as the insect's
      fuel and as a regulator in lipid transport.

PMID- 2241957
TI  - Neutral endopeptidase (EC 3.4.24.11) is highly expressed on osteoblastic cells
      and other marrow stromal cell types.
AB  - A series of cultured mouse marrow stromal cell lines of different phenotype
      characteristics were examined for their neutral endopeptidase (NEP) activity
      using the highly selective chromophoric substrate of enzyme, 3-carboxypropanoyl
      alanyl-alanyl-leucine 4-nitroanilide. All the cell lines tested contained
      appreciable amounts of NEP activity, but the cells expressing an osteoblastic
      phenotype, MBA-15, showed the high levels. Other non-stromal osteoblastic cell
      lines, MC-3T3-E1, ROS 17/2.8 cells derived from mouse long bone explants, were
      also rich in NEP. A four-fold stimulation of NEP activity was observed when
      certain MBA-15 clones were cultured in the presence of 1 alpha,25
      dihydroxyvitamin D3. Since NEP is an effective cell-surface endopeptidase, it may
      play a role in the dynamics of bone formation, via interaction with biologically
      active polypeptides.

PMID- 2241958
TI  - A T-to-A substitution in the E1 alpha subunit gene of the branched-chain alpha
      ketoacid dehydrogenase complex in two cell lines derived from Menonite maple
      syrup urine disease patients.
AB  - We cloned and sequenced cDNAs of the E1 alpha and E1 beta subunits of the
      branched chain alpha-ketoacid dehydrogenase complex (BCKDH) in two cell lines
      derived from two different Menonite MSUD patients (GM 1655, GM 1099). A T-to-A
      substitution which generates an asparagine in place of a tyrosine at amino acid
      394 of the mature E1 alpha subunit was present in both alleles in these two cell
      lines, whereas cDNAs of the E1 beta subunit in these cell lines were identical to
      that of normal human lymphoid cell line and that of the clone from a human
      placenta cDNA library. It is suggested that the Menonite MSUD is caused by the
      missense mutation of the E1 alpha subunit of the BCKDH complex.

PMID- 2241959
TI  - Insulin-like growth factor-I stimulates endothelin-3 secretion from rat anterior
      pituitary cells in primary culture.
AB  - Since we found relatively high concentrations of immunoreactive (ir-) ET-3 in the
      rat pituitary gland (190 pg/g tissue), we have investigated the possible ET-3
      secretion from the primary culture of anterior pituitary cells and the effects of
      various growth factors on the ET-3 secretion. The ir-ET-3 was detected in the
      incubation medium within 2 h, and 24 h of culture attained the concentrations of
      1.15 +/- 0.26 pg/well/6 x 10(5) cells. The ir-ET-3 secretion was stimulated by
      insulin, insulin like growth factor-II (IGF-II), and most effectively by insulin
      like growth factor-I (IGF-I) in a dose- and time-dependent manner, whereas the
      production of ir-ET-1 and ir-big ET-1 was slightly inhibited by IGF-I and IGF-II.
      In reverse-phase HPLC, the ir-ET-3 released into the culture media showed
      identical retention time with authentic ET-3. Although ir-ET-1 and ir-big ET-1
      secretion was stimulated by transforming growth factor-beta (TGF-beta), ir-ET-3
      secretion was inhibited. These results indicate that the anterior pituitary cells
      secrete ET-3 and the secretion is stimulated by IGF-I.

PMID- 2241960
TI  - Glutathione S-transferase in yeast: induction of mRNA, cDNA cloning and
      expression in Escherichia coli.
AB  - Glutathione S-transferase Y-2 mRNA synthesis was induced in yeast Issatchenkia
      orientalis approximately 37-fold by cultivation with o-dinitrobenzene. A cDNA
      library complementary to poly (A)+RNA of I. orientalis grown with o
      dinitrobenzene was screened by colony hybridization. Twenty positive clones were
      obtained from 6,000 clones and seven of twenty positive clones expressed
      glutathione S-transferase activity in E. coli. One of the expressing clones
      harboring plasmid pHT108 had 28 times more glutathione S-transferase activity
      induced by Isopropyl-beta-D-thio-galactopyranoside than a strain harboring
      plasmid pUC118. Expressed glutathione S-transferase Y-2 protein comigrated with
      yeast glutathione S-transferase Y-2 on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis as detected by immunoblot analysis.

PMID- 2241961
TI  - Protein kinase C and platelet inhibition by D-erythro-sphingosine: comparison
      with N,N-dimethylsphingosine and commercial preparation.
AB  - Sphingosine has been shown to be a potent and specific inhibitor of protein
      kinase C in vitro and in cell systems including human platelets. Questions have
      been raised as to the validity of commercial sphingosine as a protein kinase C
      inhibitor and whether sphingosine or N,N-dimethylsphingosine is the active
      species. In the present study, we compared the effects of synthetic D-erythro
      sphingosine, N,N-dimethylsphingosine and commercial sphingosine on purified
      protein kinase C in vitro and washed human platelets. These three compounds were
      found to be of high purity and well-defined structure based on [1H]NMR, FAB-mass
      Spectrometry, and TLC analysis. Both synthetic D-erythro-sphingosine and
      commercial sphingosine inhibited protein kinase C in vitro using vesicle as well
      as mixed micellar assays. N,N-dimethylsphingosine also significantly inhibited
      purified protein kinase C in vitro. Both preparations of sphingosine inhibited
      phosphorylation for 40 kD protein, a known substrate of protein kinase C in
      platelets. Similarly both sphingosine preparations inhibited aggregation and
      secretion of human platelets induced by 8 nM gamma-thrombin. These results
      indicate that sphingosine from commercial source, synthetic sphingosine and N,N
      dimethylsphingosine are equipotent in inhibiting protein kinase C. These studies
      also validate the utility of sphingosine as a phamarcologic inhibitor of protein
      kinase C in vitro and in cell systems.

PMID- 2241962
TI  - Specific interaction of a partially purified Xenopus transcription factor IIIC
      (TFIIIC) with frog tRNA gene.
AB  - Transcription factor IIIC (TFIIIC) from Xenopus has been partially purified and
      characterized. Footprinting analyses indicate that a partially purified TFIIIC
      fraction contains an activity which specifically recognizes the "B" block element
      of tRNA gene. In addition, two other regions located downstream from the "B"
      block sequence are also protected. Protection experiments on 5S genes by DNAase I
      with either TFIIIC alone or TFIIIA and TFIIIC produced a minimal change in the
      cleavage pattern implying that TFIIIC does not intimately associate with DNA. The
      implications of these findings in relation to the class III gene transcription
      are discussed.

PMID- 2241963
TI  - Spermine-like functions of N1, N12-bis(ethyl)spermine: stimulation of protein
      synthesis and cell growth and inhibition of gastric ulceration.
AB  - The spermine analogue N1, N12-bis(ethyl)spermine (BESPM) could mimic the
      functions of spermine in the following aspects: 1) BESPM could stimulate globin
      and ornithine decarboxylase synthesis in a rabbit reticulocyte cell-free system;
      2) the addition of BESPM to the culture medium could recover cell growth of
      polyamine-deficient bovine lymphocytes; 3) spermidine uptake by bovine
      lymphocytes was inhibited by BESPM and spermine to a comparable degree; and 4)
      stress-induced gastric ulceration was inhibited by subcutaneous administration of
      BESPM. Since BESPM was less toxic than spermine for mice, BESPM or its
      derivatives may be useful for diseases which can be cured by polyamines.

PMID- 2241964
TI  - Recruitment of GLUT-4 glucose transporters by insulin in diabetic rat skeletal
      muscle.
AB  - The cause of reduced insulin-stimulated glucose transport in skeletal muscle of
      diabetic rats was investigated. Basal and insulin-stimulated glucose uptake into
      hindquarter muscles of 7-day diabetic rats were 70% and 50% lower, respectively,
      than in nondiabetic controls. Subcellular fractionation of hindquarter muscles
      yielded total crude membranes, plasma membranes and intracellular membranes. The
      number of GLUT-4 glucose transporters was lower in crude membranes, plasma
      membranes and intracellular membranes, relative to non-diabetic rat muscles.
      These results were paralleled by reductions in D-glucose-protectable binding of
      cytochalasin B. Insulin caused a redistribution of GLUT-4 transporters from
      intracellular membranes to plasma membranes, in both control and diabetic rat
      muscles. This redistribution was also recorded using binding of cytochalasin B.
      The insulin-dependent decrement in glucose transporters in intracellular
      membranes was similar for both animal groups, but the gain and final amount of
      transporters in the plasma membrane were 50% lower in the diabetic group. The
      results suggest that insulin signalling and recruitment of GLUT-4 glucose
      transporters occur in diabetic rat muscle, and that the diminished insulin
      response may be due to fewer glucose transporters operating in the muscle plasma
      membrane.

PMID- 2241965
TI  - Constitutive and inducible expression of human cytochrome P450IA1 in yeast
      Saccharomyces cerevisiae: an alternative enzyme source for in vitro studies.
AB  - A cDNA of human cytochrome P450IA1 was expressed in yeast Saccharomyces
      cerevisiae on a multicopy plasmid under the control of the constitutive GAPFL or
      the inducible PHO5 promoter. Microsomes of transformed yeast contained
      substantial amounts of the heterologous enzyme as determined by reduced CO
      difference spectra (156-68 pmol/mg). Enzyme kinetics with 7-ethoxyresorufin as
      substrate resulted in a Km value of 92 nM and a Vmax value of 223 pmol/mg/min,
      which is comparable to data obtained with human liver microsomes. The antimycotic
      drug ketoconazole (Ki = 22nM) as well as the isozyme specific P450 inhibitor
      alpha-naphthoflavone (Ki = 1.2 nM) were shown to be strong inhibitors of human
      P450IA1. Taken together, these data show that heterologous P450 gene expression
      in yeast is a potent instrument for the study of enzyme specific parameters and
      might be used to answer further questions with regard to substrate specificity as
      well as drug interaction in a background with no interfering activities.

PMID- 2241966
TI  - Endothelin-1 and U46619 potentiate selectively the venous responses to nerve
      stimulation within the perfused superior mesenteric vascular bed of the rat.
AB  - The effects were examined of endothelin-1 and U46619 on the responses to
      perivascular nerve stimulation of the simultaneously perfused arterial and venous
      vessels of the superior mesenteric arterial bed of the rat. Stimulation of the
      nerves at 4-16 Hz for 30 s caused frequency dependent constrictions of both the
      arterial and venous vessels similar to those produced by bolus doses of exogenous
      noradrenaline (0.1-10 nmol). Infusion of either endothelin-1 (0.1 nM) or U46619
      (1-3 nM) caused small (less than or equal to 5 mmHg) increases in arterial and
      venous perfusion pressures and selectively potentiated the venous, but not
      arterial, responses to nerve stimulation. Conversely, endothelin-1 and U46619
      potentiated the responses of both the arterial and venous vessels to exogenous
      noradrenaline. Thus, as reported previously for the arterial vessels of the rat
      mesentery, the isolated venous vessels constrict to perivascular nerve
      stimulation in a frequency dependent manner. In addition, endothelin-1 and U46619
      potentiate selectively the effects of nerve stimulation on the veins.

PMID- 2241967
TI  - Interaction of insulin and phorbol esters on the regulation of DNA synthesis in
      rat hepatoma cells.
AB  - Insulin and phorbol esters stimulated DNA synthesis in rat H4 hepatoma cells.
      Insulin and phorbol ester induction of thymidine incorporation was dose
      dependent, with a maximal 4.2- and 3.0-fold increases at concentrations of 1 x
      10(-9)M and 1 microM, respectively. Phorbol esters in combination with increasing
      concentrations of insulin resulted in additive effects, but only at submaximal
      insulin concentrations. The combination failed to increase thymidine
      incorporation above the maximal effects produced by insulin alone. When cells
      were pretreated with phorbol esters for 24h to produce protein kinase-C (PKC)
      deficiency, basal DNA synthesis was depressed. Pretreatment with phorbol esters
      abolished the effects of phorbol esters to induce DNA synthesis but did not
      impair the magnitude of insulin-induced DNA synthesis. Thus, although phorbol
      ester-activatable PKC-activity was necessary for basal DNA synthesis, it was not
      necessary for insulin-induction of DNA synthesis in H4 cells.

PMID- 2241968
TI  - Evidence for increased translational efficiency in the induction of P450IIE1 by
      solvents: analysis of P450IIE1 mRNA polyribosomal distribution.
AB  - The potential for enhanced translational processing of P450IIE1 mRNA during the
      early phase of P450IIE1 induction by pyridine or acetone was assessed by
      hybridization analysis of polyribosomal P450IIE1 mRNA distribution in rat hepatic
      tissue. Optical absorbance profiles of polyribosomal fractions exhibited an
      apparent shift at 5 h following pyridine administration relative to control. Slot
      and Northern blot analyses for P450IIE1 mRNA in the cytoplasmic extracts isolated
      from 5 h pyridine-treated rats demonstrated a shift in distribution of P450IIE1
      message toward heavier polyribosomal fractions and Northern blot analysis
      suggested the presence of different populations of P450IIE1 mRNA. Slot blot
      analyses also demonstrated a shift in the polyribosomal distribution of P450IIE1
      mRNA at 12 h following pyridine treatment; in contrast, hybridization analysis
      for P450IA1 revealed no shift in polyribosomal distribution of P450IA1 mRNA.
      Acute acetone administration to animals also resulted in a similar shift in
      polyribosomal distribution of P450IIE1 mRNA as compared to control. These data
      suggest that P450IIE1 mRNA shifts toward larger polyribosomes following acute
      exposure of animals to pyridine or acetone and provide evidence that induction of
      P450IIE1 at early times following acute pyridine or acetone administration
      involves enhanced translational efficiency through increased loading of ribosomes
      on P450IIE1 mRNA.

PMID- 2241969
TI  - Regulation of LH/hCG receptor by gonadotropins in rat ovary.
AB  - To investigate the regulation of the LH/hCG receptor gene by gonadotropins, we
      examined the effect of PMSG and hCG on the expression of LH/hCG receptor in
      immature rat ovary. Northern blot analysis of ovarian RNA revealed a major mRNA
      of 5400 nucleotides and minor species of 7500, 3600, 2300, and 1200 nucleotides,
      and PMSG treatment slightly increased the intensity of all LH/hCG receptor
      messengers. Subsequently, hCG treatment decreased the number of LH/hCG receptor
      by day 2 and mRNA levels by 12h after injection. The level of mRNA recovered and
      increased 5-fold of control by day 6, then returned to control levels by day 10,
      followed by slower decline in LH/hCG receptor in plasma membrane. These studies
      demonstrate that the effects of PMSG and hCG on the number of LH/hCG receptor are
      closely related to the actions of these hormones on LH/hCG receptor messenger
      levels.

PMID- 2241970
TI  - Functional interactions between phage T4 and E. coli DNA-binding proteins during
      the presynapsis phase of homologous recombination.
AB  - The "protein machine" for phage T4 homologous recombination has begun to be
      assembled in vitro. A particularly heavily studied reaction has been the uvsX
      protein (a RecA-like strand transferase)-mediated homologous pairing reaction
      between single and double-stranded DNAs, a key step in the recombination cycle in
      vivo. A necessary prerequisite for uvsX protein-mediated pairing is the
      polymerization of this factor along the invading single strand, a process known
      as presynapsis. Recent work has indicated that at least two other T4
      recombination factors are involved in this process as well, the uvsY and gene 32
      products. These proteins are also ssDNA-binding factors and exhibit an affinity
      for UvsX and each other. In order to begin to sort out the potential functional
      roles played by these protein-protein interactions in presynapsis, I have
      examined the ability of the uvsX protein to form stable filaments along ssDNA in
      the presence of these proteins. It is shown that the uvsY protein relieves the
      inhibition to filament formation due to the presence of the gene 32 protein, but
      experiments with the E. coli SSB protein (the bacterial analogue of gp32) suggest
      that this effect does not involve a direct interaction between UvsY and gp32.

PMID- 2241971
TI  - Inositol trisphosphate and thapsigargin discriminate endoplasmic reticulum stores
      of calcium in rat brain.
AB  - ATP dependent Ca2+ accumulation into oxalate-loaded rat brain microsomes is
      potently inhibited by thapsigargin with an IC50 of 2 nM and maximal inhibition at
      10 nM. Approximately 15% of the total A23187-releasable microsomal calcium store
      is insensitive to thapsigargin concentrations up to 100 microM. Inositol-1,4,5
      trisphosphate (IP3) maximally inhibits 40% of the net Ca2+ accumulation by whole
      brain microsomes. Its effects are non-additive with thapsigargin suggesting that
      the IP3-sensitive Ca2+ pool is a subset of the thapsigargin sensitive Ca2+ pool.
      Marked regional differences occur in Ca2+ transport rates and sensitivity to both
      thapsigargin and IP3.

PMID- 2241972
TI  - High concentrations of guanidine chloride activate lactate dehydrogenase in low
      water media.
AB  - The effect of guanidine chloride on the activity of bovine heart lactate
      dehydrogenase transferred to a system that was made with toluene, phospholipids,
      Triton X-100 and 3.8% water (v/v) was studied. The activity of the enzyme in the
      latter system was about 30 times lower than in standard water mixtures. In the
      low water system, 1.5 and 2.0 M guanidine chloride increased the activity by
      approximately 20 times. These concentrations of guanidine chloride caused
      complete inactivation of the enzyme in conventional water systems. The activating
      effect of the denaturant was independent of enzyme concentration. It is suggested
      that the increase in activity produced by guanidine chloride was due to a
      facilitation of the protein-solvent interactions that operate in a catalytic
      cycle.

PMID- 2241973
TI  - Identification of a naturally occurring methyl-ester of phosphate, methyl
      phosphorylcholine (methyl-2-(N,N,N trimethylamino) ethyl phosphate), in the eggs
      of the sea urchin S. purpuratus.
AB  - A novel metabolite of choline, phosphorylcholine methyl ester, has been
      identified in the eggs of S. purpuratus wherein it is present at approximately 1
      mM concentration. To the best of our knowledge, this is the first instance of a
      phosphoryl-methyl-ester to be observed in nature. The compound appears to be
      species specific, since it has not been observed in other species such as L.
      pictus and P. depressus. In S. purpuratus its distribution is confined to the
      ovary, eggs and embryos, and is absent from young animals following
      metamorphosis.

PMID- 2241974
TI  - Conformation of proline residues in bacteriorhodopsin.
AB  - Proline, noted as a hydrophilic residue with helix-breaking potential,
      nevertheless occurs widely in putatively alpha-helical transmembrane segments of
      many transport proteins. Ligand-activated or enzyme-assisted trans/cis
      isomerization of an X-proline peptide bond (where X = any amino acid)--a dynamic,
      reversible event which could alter the orientation of a transmembrane alpha-helix
      -may provide the molecular basis for a protein channel regulatory process.
      Further elucidation of such a function requires knowledge of the isomeric status
      of the X-Pro bonds in native conformations of membrane proteins. We have used 13C
      nuclear magnetic resonance (NMR) spectroscopy to examine the conformation of
      intramembranous X-Pro peptide bonds in biosynthetically-labelled samples of a
      model transport protein, bacteriorhodopsin (bR) (purple membrane). Spectra of 13C
      Tyr-carbonyl labelled bR (in the solvent system CHCl3:CD3OD (1:1) + 0.1 M LiClO4)
      first established that all 11 bR Tyr residues were sufficiently mobile for their
      resonances to be detected and resolved, independent of their domain location
      within the bR sequence. By taking advantage of the known diagnostic chemical
      shifts of the isomers of Pro-C gamma carbon resonances, spectra of bR labelled
      with 13C gamma-Pro were then used to demonstrate that all 11 bR X-Pro peptide
      bonds--including those within the protein's membrane domain (Pro50, Pro91,
      Pro186)--are in the trans conformation in resting state bR.

PMID- 2241975
TI  - Retinoic acid inhibits the myristoylation of a membrane protein in HL-60 cells.
AB  - Incubation of nondifferentiated HL-60 cells with high specific activity myristic
      acid results in myristoylation of a 25 KD membrane protein. Myristoylation was
      inhibited by retinoic acid but not by DMSO, thus indicating that the
      nonmyristoylated state induced by retinoic acid is causal to rather than the
      result of the overall differentiation sequel induced. Similarly, incubation of HL
      60 cells with high specific activity retinoic acid results in specific
      retinoylation of a membrane protein of similar molecular mass. The two acylated
      proteins could however be separated by 2-D gel electrophoresis, thus indicating
      that inhibition of myristoylation by retinoic acid could not be accounted for by
      competition between retinoic and myristic acids for the same acylated site.

PMID- 2241976
TI  - Analysis of big endothelin-1 digestion by cathepsin D.
AB  - Digestion of big endothelin (ET)-1 by cathepsin D, which is the only
      substantially identified protease showing ET converting enzyme activity, was
      characterized. Increased doses of cathepsin D showed decrease of immunoreactive
      (ir-) ET produced from big ET-1. Time course of big ET-1 conversion showed marked
      increase of ir-ET in a relatively short period, but further incubation resulted
      in the decrease of ir-ET. Incubation at various pHs with different doses of
      cathepsin D revealed that low doses of cathepsin D yielded the maximum production
      of ir-ET at pH 3.5-4.0, but higher doses of cathepsin D showed a bimodal curve of
      ir-ET production, which may be due to degradation of ir-ET. HPLC analysis
      revealed that cathepsin D cleaves Asn18-Ile19 bond in addition to Trp21-Val22
      bond of big ET-1. These data suggests cathepsin D is not a physiological
      endothelin converting enzyme.

PMID- 2241978
TI  - Identification of a novel platelet-derived neutrophil-chemotactic polypeptide
      with structural homology to platelet-factor 4.
AB  - A novel protein, NAP-4, could be isolated from human platelet lysates. NAP-4
      preparations induced chemotaxis of human neutrophils with an ED50 near 400 ng/ml.
      Purification by anti NAP-1/IL-8 affinity chromatography and reversed phase HPLC
      revealed a single peak showing a single line upon SDS-PAGE corresponding to a Mr
      of 8000. NH2-terminal sequence analysis indicated an unique sequence showing
      strong homology to human platelet factor 4 and weak homology to tumor necrosis
      factor alpha as well. The most interesting finding is the absence of the first
      two cysteins, known to be strongly conserved in members of the family of platelet
      factor 4-like host defense cytokines.

PMID- 2241977
TI  - The triterpene celastrol as a very potent inhibitor of lipid peroxidation in
      mitochondria.
AB  - The inhibitory effect of the dienone-phenolic triterpene, celastrol, on lipid
      peroxidation in rat liver mitochondrial membranes induced by ADP and Fe2+ was
      studied. The anti-peroxidative effect of celastrol was very strong: its 50%
      inhibitory concentration was 7 microM, and it was about 15 times more effective
      than alpha-tocopherol. Celastrol scavenged 1.5 molar equivalents of radicals in
      homogeneous aqueous ethanolic solution, whereas cysteine and alpha-tocopherol
      scavenged one and two molar equivalents of radicals, respectively. The process of
      anti-peroxidation of celastrol was biphasic, possibly due to stepwise inhibitions
      of peroxidation in the outer and inner mitochondrial membranes.

PMID- 2241979
TI  - Myristoylation of heparan sulfate proteoglycan and proteins occurs post
      translationally in human colon carcinoma cells.
AB  - We have recently shown that the heparan sulfate proteoglycan of human colon
      carcinoma cells is acylated with both myristate and palmitate, two long-chain
      saturated fatty acids. In this study we show that cycloheximide did not
      significantly inhibit the incorporation of myristic acid into either proteoglycan
      or total protein pool. This lack of inhibition occurred under a condition in
      which protein synthesis was inhibited greater than 90%. Cycloheximide, on the
      other hand, did not affect the incorporation of [3H]myristic acid into fatty acid
      nor the intracellular interconversion of myristate to palmitate. Characterization
      of fatty acyl moiety in the proteoglycan and protein by reverse-phase HPLC
      revealed that approximately 60% of the covalently bound fatty acids was myristate
      and the remaining 40% was palmitate. These results indicate that in human colon
      carcinoma cells myristoylation of heparan sulfate proteoglycan and proteins
      occurs post-translationally, presumably in the Golgi complex.

PMID- 2241980
TI  - Purification of Trypanosoma cruzi surface proteins involved in adhesion to host
      cells.
AB  - We have identified four surface 83 kDa proteins of pI values 6.3, 6.4, 6.5 and
      6.6 in T. cruzi trypomastigotes which specifically bind to rat heart myoblasts.
      These proteins were purified by isoelectric focusing and anion-exchange
      chromatography in an FPLC system. These 83 kDa proteins inhibit the attachment of
      trypomastigotes to myoblasts in a concentration-dependent manner, indicating that
      these trypomastigote proteins mediate the attachment of trypomastigotes to heart
      myoblasts.

PMID- 2241981
TI  - High concentration of inositol 1,4,5-trisphosphate in sea urchin sperm.
AB  - We measured inositol 1,4,5-trisphosphate (InsP3) content of sea urchin gametes by
      using a specific protein binding assay, and found that a spermatozoon contains 4
      x 10(-19) to 1 x 10(-18) moles of InsP3 before the acrosome reaction. Since the
      acrosome reaction has previously been shown to increase the InsP3 content of
      sperm severalfold, our measurement indicates that a spermatozoon contains at
      least 2 x 10(-18) moles of InsP3 at fertilization, corresponding to a
      concentration in the spermatozoon of about 1 mM. The threshold for activation of
      eggs by injection of InsP3 dissolved in a much larger volume of solution has been
      found to be about 3 x 10(-18) moles, corresponding to a concentration in the
      injectate of 1 microM. This suggests that sea urchin sperm may contain enough
      InsP3 to activate eggs. With an electroporation method, we also showed that sperm
      extract acts on eggs only from inside, consistent with a primary messenger role
      for InsP3.

PMID- 2241982
TI  - Effect of ATP depletion and phenanthroline on the spermidine-mediated decay of
      ornithine decarboxylase in erythroleukemia cells.
AB  - Addition of spermidine to Friend erythroleukemia cells caused a rapid decay of
      ornithine decarboxylase (ODC) activity and the accumulation of a ODC-antizyme
      complex. The induction of antizyme only partially accounted for the decrease of
      ODC activity by a direct inhibition of the enzyme. However, the antizyme
      induction was accompanied by a marked reduction of the half-life of ODC. Shift of
      the cells to an ATP-depleting medium prevented the spermidine-elicited decay of
      ODC activity as well as the accumulation of ODC-antizyme complex. However, ODC
      appeared to be stabilized even when ATP depletion was performed 40 min after
      spermidine addition, in the presence of high levels of antizyme. Similar results
      were obtained by treating the cells with phenanthroline, a heavy metal chelator
      and protease inhibitor. These findings indicate that ATP and some
      metalloprotease(s) may be involved in the degradation pathway of ODC, even in the
      presence of high levels of polyamines.

PMID- 2241983
TI  - Transforming growth factor beta regulates cystatin C in serum-free mouse embryo
      (SFME) cells.
AB  - Differential screening of a cDNA library derived from mRNA of TGF beta-treated
      serum-free mouse embryo (astrocyte precursor) cells isolated a strongly TGF beta
      regulated mRNA that codes for cystatin C, a cysteine protease inhibitor. Increase
      in cystatin C mRNA level was observed within four hours after treatment with
      picomolar concentrations of TGF beta. The increase was reversible upon removal of
      TGF beta and was not prevented by cycloheximide. These results suggest that
      cystatin C expression may represent a developmentally regulated differentiated
      function of astrocytes, and also suggest that cystatin C expression may be
      involved in the response of brain cells to platelet release of TGF beta after
      trauma or injury.

PMID- 2241984
TI  - Anti-oxidant property of ethanolic extract of propolis (EEP) as evaluated by
      inhibiting the chemiluminescence oxidation of luminol.
AB  - Ethanolic extract of propolis (EEP) has remarkable medical properties, including
      protection of mice against gamma irradiation. Its anti-oxidative effect has been
      attributed to its radical scavenging ability. This manuscript demonstrates the
      ability of increasing amounts of EEP to inhibit luminol-H2O2 chemiluminescence in
      vitro, and suggests that its anti-oxidative capacity is partly due to its high
      content of flavonoids.

PMID- 2241985
TI  - Increased lipid peroxidation in kidney of vitamin B-6 deficient rats.
AB  - Lipid peroxidation in kidney of rats fed with vitamin B-6 deficient diet for a
      period of 12 weeks was studied with pair-fed controls. The basal lipid peroxide
      level as well as the degree of susceptibility to lipid peroxidation in presence
      of promotors such as NADPH, ascorbate, t-butyl hydroperoxide, Fe2+, Cu2+ and
      oxalate, were increased in vitamin B-6 deficient kidney. The observed increased
      lipid peroxidation in vitamin B-6 deficient kidney was correlated with high
      levels of lipids, copper, iron, calcium and oxalate, low levels of antioxidants
      and antioxidant enzymes and increased levels of hydroperoxides and hydroxyl
      radicals.

PMID- 2241986
TI  - Mechanism of polyamine spermidine uptake by Xenopus laevis oocytes.
AB  - In this study, the mechanisms of polyamine spermidine (Spd) uptake were
      investigated in Xenopus laevis oocytes. Spd uptake followed a sigmoidal kinetics
      with [S]90/[S]10 = 3 microM and Hill interaction coefficient (n) = 2. The order
      of magnitude of uptake and efflux was similar (t1/2 = 45 min). The equilibrium
      potential for Spd, calculated by Nenrst equation, was 90.78 mV. Free energy
      change for the uptake (delta G) was found to be 2.31 Kcal/mole of Spd. During
      efflux, Spd was not converted into putrescine or spermine. It seems that there
      are two types of Spd uptake pathways: Na(+)-dependent and Na(+)-independent since
      replacement of Na+ from incubation medium did not completely abolish the Spd
      uptake. The Na(+)-dependent component of Spd uptake was shared neither by system
      A nor by system ASC amino acids.

PMID- 2241987
TI  - Purification and properties of pyruvate kinase from Dictyostelium discoideum.
AB  - Pyruvate kinase (EC 2.7.1.40) from aggregating Dictyostelium discoideum cells has
      been purified to homogeneity. It has a monomeric molecular weight of 66kD and is
      tetrameric in low ionic strength buffers. The enzyme is not regulated by fructose
      1,6-bisphosphate or by alanine and appears to resemble the M1 isoenzyme from rat
      liver most closely, although its activity is not inhibited by ATP.

PMID- 2241988
TI  - Action of catalase on peroxyacetic acid. Kinetic studies.
AB  - The activity of catalase on peroxoacetic acid was studied by a kinetic point of
      view. The "inactivation-reactivation" sequence consists in two first order
      (intramolecular) one-electron redox reactions. In the catalytic cycle, the
      reaction producing Compound I is, as espected, a second order process rate
      determined by the enzyme-peroxide adduct formation step, whereas, surprisingly,
      the reaction restoring the enzyme resting state is a first order process in which
      the limiting step is the 0-0 linkage breaking inside the Compound I-peroxide
      adduct.

PMID- 2241989
TI  - Microfilament gel rigidity cooperates negatively with the binding of actin
      gelling proteins.
AB  - At 37 degrees C, in the presence of 0.1 M KC1 and 2 mM MgCl2, the binding of
      alpha-actinin to F-actin increases with the concentration of alpha-actinin but
      not with the concentration of F-actin. This implies that binding is determined by
      additional factors, beside the alpha-actinin - F-actin association constant. We
      propose that one of these factors is the rigidity of the gel, which cooperates
      negatively to the binding by increasing the work needed to bring two actin
      filaments at the reaction distance with alpha-actinin.

PMID- 2241990
TI  - Isolation and characterization of non-muscle tropomyosin cDNAs of human and mouse
      origin.
AB  - Several cDNA clones of human and mouse non-muscle tropomyosin have been isolated.
      All the human clones possess a common 23 bp sequence immediate 5' of the
      initiation codon. However, in the further upstream regions, the nucleotide
      sequences diverge. Two of the mouse cDNA clones pPSI-8 and pPSI-14 have identical
      nucleotide sequence in the coding region sequenced. However, 5' of the initiation
      codon these clones have only 40 identical nucleotides and further upstream the
      nucleotide sequences diverge. Analysis of the genomic DNAs of mouse cells
      indicated the possibility of a common gene giving rise to both the tropomyosin
      cDNAs differing in their 5' ends.

PMID- 2241992
TI  - Maturation-specific type II cyclic AMP-dependent protein kinase in goat sperm
      plasma membrane.
AB  - Highly purified plasma membranes (PMs) isolated by aqueous two-phase polymer
      methods from goat sperm undergoing epididymal maturation, have been analyzed for
      the isoenzymes of cyclic AMP-dependent protein kinase (RC). The mature and the
      immature spermatozoa showed profound differences in the profile of the isoenzymes
      of RC solubilized from the isolated PMs with 0.1% Triton X-100. The immature
      sperm PM consists of only type I RC in contrast to the mature sperm membrane
      which possesses both the type I and II isoenzymes. The type II kinase represents
      nearly 30% of the total membrane-bound RC of the mature cells. The analysis of
      the surface topography of these isoenzymes of the maturing spermatozoa by using
      diazonium salt of sulfanilic acid as the surface probe shows that the PM-bound
      RC(s) are oriented primarily on the external surface of these intact cells. The
      data demonstrate that type II RC is a maturation-specific ecto-kinase as it
      appears on the sperm surface specifically during the maturation of spermatozoa in
      the epididymis.

PMID- 2241991
TI  - Decrease of liver protein kinase C in streptozotocin-induced diabetic rats and
      restoration by vanadate treatment.
AB  - Effects of streptozotocin-induced diabetes and administration of the
      insulinmimetic agent, vanadate in rats on the liver protein kinase C-induced
      phosphorylation of exogenous C (Histone III-S) and endogenous substrates were
      investigated. Diabetes caused a significant fall (40-60%) in liver cytosolic
      protein C activity measured using both types of substrates. Vanadate treatment
      for a period of 5 weeks restored them to normal levels. Phosphorylation of
      cytosolic target proteins for protein kinase C followed a similar pattern in
      response to diabetes and vanadate. These treatments had no effect on particulate
      protein kinase C activity. Vanadate also had no effect in normal livers with
      respect to the protein kinase C system.

PMID- 2241993
TI  - Purification and characterization of high salt-soluble vicilin from mung bean
      (Vigna radiata).
AB  - We report a method for the purification of vicilin from mung bean (Vigna radiata)
      mainly on the basis of solubility of mung bean vicilin even in high salt. Mung
      bean vicilin remains in solution even after 90% relative saturation of ammonium
      sulphate. The resulting supernatant after dialysis was subjected to gel
      filtration (Sephadex G-150) to remove other contaminant polypeptides, and finally
      the protein was purified by DEAE cellulose chromatography. This purified fraction
      exhibited 3 bands on SDS-PAGE compared with vicilin from other legumes which
      exhibite more than 3 bands generally. The results raise the possibility that the
      presence of the two small polypeptides in vicilin preparations is the breakdown
      product of the major larger one of mol.wt. 52 K and that vicilin may be a
      tetramer of four subunits of Mr 52000. That the high salt-soluble protein
      containing 52 K subunit is vicilin has been determined by several criteria.

PMID- 2241994
TI  - Multiple forms of adenylate kinase in pig brain.
AB  - The rate of ATP formation from ADP by adenylate kinase is known to be easily
      followed by determination of the increase in fluorescence due to the NADPH that
      is formed by combined reactions of hexokinase and gluc-6-p dehydrogenase. We
      found that the rate of CTP formation from CDP also can be followed similarly by
      use of more units of hexokinase and extension of the reaction time. A crude
      enzyme sample containing most of the activity of adenylate kinase was prepared
      from pig brain and eluted from a CM-cellulose column. Enzymatic activity of ATP
      formation and that of CTP formation were compared for all the fractions. Two
      fractions were found in the eluate; one was rather specific for ADP as substrate,
      and the other was less specific for ADP and could form CTP at an appreciable
      rate.

PMID- 2241995
TI  - Polyclonal antibodies against rat liver cytosolic casein kinase II (CK-2) cross
      react with CK-2 from other tissues and nuclear form (PK-N2) of the enzyme.
AB  - Casein kinase II (CK-2) is a ubiquitous serine/threonine protein kinase, and is
      localized to both the cell nucleus and cytoplasm. Despite extensive biochemical
      similarities in their properties, there is evidence that the two forms of the
      enzyme exhibit certain distinctions (1). This prompted us to produce antibodies
      against CK-2, which could be utilized as a possible tool for investigations of
      the various forms of this enzyme. Specific polyclonal antibodies against the rat
      liver cytosolic CK-2 were raised in egg yolk of laying hens; the enzyme had
      repeatedly failed to elicit an immunogenic response in rabbits. The purified
      polyclonal antibody (egg yolk immunoglobulin, IgY) recognized all three subunits
      (42, 38, and 28 kDa) of the enzyme in immunoblots. The antibody when bound to a
      matrix was capable of removing CK-2 from solution, and the bound enzyme could be
      recovered from the immunoaffinity matrix with 0.1 M diethylamine. The antibody
      exhibited a high affinity towards CK-2 prepared from cytosol of liver, ventral
      prostate, and several other rat tissues, but no immunoreactivity was detected
      towards a number of other protein kinases tested. The subunits of the nuclear
      form of CK-2 (PK-N2) migrated differently when electrophoresed in parallel in the
      same gel. However, the antibody did cross-react with the various subunits of PK
      N2 suggesting a significant homology in the immunogenic domains in the various
      subunits of the two forms of the enzyme.

PMID- 2241996
TI  - Chemical modification reveals involvement of tyrosine in ligand binding to
      dopamine D1 and D2 receptors.
AB  - The effect of tyrosine-alkylating agents on the ligand-binding properties of
      bovine striatal dopamine D1 and D2 receptors was investigated. The tyrosine
      alkylating agents, p-nitrobenzenesulphonylfluoride (pNBSF) and tetranitromethane
      (TNM) caused a time-and dose-dependent loss of the binding of [3H]SCH-23390 and
      [3H]spiroperidol, ligands specific for dopamine D1 and D2 receptors,
      respectively. The two dopamine receptors, however, showed a differential
      sensitivity to inactivation by these agents. The mechanism of inhibition of the
      two receptors appears to be complex as treatment of membranes with pNBSF and TNM
      resulted in a decrease of both the Kd and the Bmax of ligand binding.
      Spiroperidol almost completely protected the TNM-induced inhibition of
      [3H]spiroperidol binding to dopamine D2 receptors whereas SCH-23390 afforded only
      partial protection of the [3H]SCH-23390 binding by TNM suggesting that more than
      one tyrosine groups may be involved in the D1 receptor binding activity.

PMID- 2241997
TI  - Inhibition of arylhydrocarbon hydroxylase and cytochrome P-450 by 20
      methylcholanthrene and phenobarbital in guinea pig on excessive doses of ascorbic
      acid.
AB  - Treatment of guinea pigs on adequate ascorbic acid (AA) with 20
      methylcholanthrene (MCA) and phenobarbital (PB) significantly increased hepatic
      arylhydrocarbon hydroxylase (AHH), cytochrome P-450 and cytochrome-b5 activities.
      In lungs, only MCA treatment significantly enhanced the activities of AHH,
      cytochrome P-450 and cytochrome b5. In animals on excessive doses of AA, there
      was inhibition of hepatic AHH, cytochrome P-450 and cytochrome b5 levels by
      treatment with these xenobiotics. Also, inhibition was observed in pulmonary AHH
      and cytochrome P-450 levels. The relevance of these observations in excessive AA
      fed guinea pigs to carcinogenesis requires further extensive investigations.

PMID- 2241998
TI  - Changes in erythrocyte glutathione peroxidase and glutathione reductase in
      alloxan diabetes.
AB  - Glutathione peroxidase and glutathione reductase activities were measured in
      erythrocytes from control, diabetic and insulin-treated diabetic rats. A
      significant decrease in the activity of glutathione peroxidase and an increase in
      the glutathione reductase activity were found with increase in the time of
      diabetes which may result in the alteration in the activity of the pentose
      phosphate pathway by the modulation of the levels of NADPH. Insulin
      administration reverses the change in the activity of glutathione peroxidase but
      does not reverse the glutathione reductase activity during diabetes. The overall
      changes may be due to changes in the levels of insulin, triiodothyronine and
      thyroxine.

PMID- 2241999
TI  - Fatty acid uptake and catecholamine-stimulated phospholipid metabolism in
      immortalized airway epithelial cells established from primary cultures.
AB  - The incorporation of [14C]oleic and [14C]linoleic acid into phospholipids and
      neutral lipids was compared in two recently immortalized airway epithelial cell
      lines. In addition, the effects of adrenergic stimulation on phospholipid
      turnover was examined. Both cell lines readily incorporated the fatty acids into
      all phospholipid and neutral lipid fractions. Isoproterenol (1 microM) induced
      Ca2+ transients in both cell lines, indicating a functional beta-adrenergic
      response. Epinephrine (10 microM; 15 min) stimulation of cells prelabeled with
      [14C]linoleic acid increased the percentage of label in phosphatidylcholine in
      one cell line. Lipid metabolism can now be extensively studied in human airway
      epithelia.

PMID- 2242000
TI  - Use of a hapten specific anti-dansyl antibody for the localization of ribosomal
      proteins by immuno electron microscopy.
AB  - The fluorescent reagent dansyl chloride has been used as an immunological marker
      for the electron microscopic localization of ribosomal proteins on the surface of
      50S ribosomal subunits. The proteins BstL1 from Bacillus stearothermophilus and
      EcoL1 from Escherichia coli were dansylated to various degrees and reconstituted
      into the L1-deficient E. coli 50S subunits from mutant MV17-10. Using antibodies
      specific to dansyl chloride, both proteins were mapped at the lateral
      protuberance near the peptidyl transferase center.

PMID- 2242001
TI  - Biogenic amine binding sites in rabbit spermatozoa.
AB  - The binding of the neuroleptic, [3H] spiperone, to rabbit spermatozoa was
      investigated. Binding was partially inhibited by haloperidol, mianserin or
      epinephrine. Mixtures of two of the three inhibitors reduced binding further, but
      binding of the radioligand to spermatozoa was lowest in the presence of all three
      inhibitors. Unlabeled spiperone eliminated binding. Cholinergic ligands, GABA,
      and beta-adrenergic ligands, had little effect on binding. Spiperone binding
      occurred to both heads and tails suggesting that alpha 1-adrenergic, D2-dopamine
      and S2-serotonin binding sites are present in the head and/or tail of rabbit
      spermatozoa.

PMID- 2242002
TI  - Phorbol esters augment spermidine transport without protein kinase C activation.

PMID- 2242003
TI  - Histamine as an intracellular messenger.

PMID- 2242004
TI  - Regulation of the adhesion of neutrophils to endothelium.

PMID- 2242005
TI  - Isoelectric focusing of isoenzymes of monkey platelet monoamine oxidase.
AB  - Monkey platelet monoamine oxidase (MAO) was preferentially found as the B-form of
      the enzyme as observed from differences in substrate specificities, as well as
      liver MAO. The isoelectric points and molecular weights of platelet MAO subunits
      were compared with those of monkey liver using sodium dodecyl sulfate-disc
      polyacrylamide gel electrophoresis and isoelectric focusing-disc gel
      electrophoresis. The pI value of monkey liver was a single peak at 6.5, but the
      pI values of monkey platelets were triple peaks at 5.5, 6.5 and 7.0. The
      molecular weight of MAO subunits in monkey platelets was similar to that of
      liver, and was found to be about 60,000. These results indicate that MAO-B of
      monkey platelets differs from MAO-B of the liver, and that it has different
      electrophoretic properties.

PMID- 2242006
TI  - On the mechanism of sodium 2-5-4 chlorophenylpentyloxirane-2-carboxylate (POCA)
      inhibition of hepatic gluconeogenesis.
AB  - Inhibition of hepatic long chain fatty acid oxidation by 2-5-4
      chlorophenylpentyloxirane-2-carboxylate (POCA) leads to decreased gluconeogenic
      rates from lactate or from low concentrations of pyruvate. The inhibitory effect
      is fully overcome by concentrations of pyruvate above 0.8 mM or by the
      simultaneous administration of a medium chain fatty acid. At low pyruvate
      availability the energy cost of gluconeogenesis is mainly supported by fatty acid
      oxidation and POCA-induced inhibition of glucose production is secondary to a
      decreased energy availability. This is supported by the following observations:
      (i) POCA decreases hepatic respiration and phosphorylation potential: (ii) the
      rate of pyruvate-induced respiration was the same regardless of whether
      gluconeogenesis was inhibited or not by POCA: and (iii) concentrations of
      pyruvate above 0.8 mM, at which gluconeogenesis is not inhibited, prevented the
      POCA-induced decrease in the phosphorylation potential. It is concluded that
      inhibition of long chain fatty acid oxidation by POCA leads to a switch of energy
      fuel, and results in the oxidation of more pyruvate to meet the cellular energy
      demands. When pyruvate availability is low and thus, presumably, its
      mitochondrial transport restricted, pyruvate carboxylation most probably becomes
      limiting as a result of the increased flux through pyruvate dehydrogenase, in the
      presence of POCA.

PMID- 2242007
TI  - Phase I and phase II xenobiotic biotransformation in cultures and co-cultures of
      adult rat hepatocytes.
AB  - The aim of this study was to measure the activity of phase I and II key enzymes
      in the biotransformation of xenobiotics and their inducibility by phenobarbital
      (2 mM) in two currently used in vitro models, namely adult rat hepatocytes,
      conventionally cultured or co-cultured with rat epithelial cells derived from
      primitive biliary duct cells. For phase I, the cytochrome P450 content and the
      enzymic activities of 7-ethoxycoumarin O-deethylase and aldrin epoxidase have
      been determined, for phase II glutathione S-transferase activity was measured. In
      conventional cultures, all phase I parameters investigated declined continuously
      as a function of culture time. Two mM phenobarbital had inducing effects on 7
      ethoxycoumarin O-deethylase and glutathione S-transferases but not on aldrin
      epoxidase. In co-cultures, after an initial decrease, a steady state situation
      developed for all the parameters measured, lasting for at least 10 days. The
      cytochrome P450 content, the 7-ethoxycoumarin O-deethylase, aldrin epoxidase and
      glutathione S-transferase activities were maintained from 3 to 4 days on at 25,
      100, 15 and 50%, respectively, of their corresponding value obtained for freshly
      isolated hepatocytes. After phenobarbital treatment, the parameters mentioned
      were significantly increased with the exception of the aldrin epoxidase activity
      of which the inducibility was nearly completely lost.

PMID- 2242009
TI  - The dispositional enantioselectivity of indobufen in rat and mouse.
AB  - The plasma pharmacokinetics and urinary elimination of the enantiomers of
      indobufen, a novel platelet aggregation inhibitor, have been studied in rats and
      mice given either the racemic compound or the individual enantiomers (rat 8 mg/kg
      racemate, 4 mg/kg enantiomers; mouse 25 mg/kg racemate, 12.5 mg/kg enantiomers).
      Enantiospecific analysis of indobufen in plasma and urine was achieved by HPLC of
      its L-leucinamide diastereoisomers. In rat, the two enantiomers have very
      different plasma elimination half lives (S, 3.9 hr; R, 12.2 hr), irrespective of
      the optical form administered. The plasma concentration-time curves of S
      indobufen were identical after racemic or S-indobufen, but the plasma levels of R
      indobufen were lower after the R-enantiomer than after the racemate. Urinary
      recovery of free and conjugated indobufen was less than 3% of the dose,
      independent of the optical form administered. In the mouse, R-indobufen was
      cleared from plasma more rapidly than its S-antipode (elimination T1/2 R, 2.5 hr;
      S, 3.8 hr) but differences were smaller than those seen in the rat. The plasma
      concentration-time curves of the S-enantiomer were the same after racemic or S
      indobufen, but levels of its R-antipode were much lower when it was given alone
      than after administration of the racemate. The urinary recovery of free and
      conjugated indobufen also exhibited enantioselectivity, with preferential
      elimination of the S-enantiomer.

PMID- 2242008
TI  - R 76713 and enantiomers: selective, nonsteroidal inhibitors of the cytochrome
      P450-dependent oestrogen synthesis.
AB  - The triazole derivative, R 76713 and its enantiomers R 83839(-) and R 83842(+)
      are effective inhibitors of the aromatization of androstenedione. For human
      placental microsomes, the (+) enantiomer (R 83824) is about 1.9- and 32-times
      more active than the racemate (IC50 2.6 nM) and the (-) enantiomer, respectively.
      R 83842 is about 30- and 1029-times more active than 4-hydroxyandrostene-3,17
      dione and aminoglutethimide. This potency might originate from its high affinity
      for the microsomal cytochrome P450 (P450). Indeed, R 83842, compared to R 76713
      and R 83839, forms a more stable P450-drug complex. Difference spectral
      measurements indicate that the triazole nitrogen N-4 coordinates to the haem
      iron. The reversed type 1 spectral changes suggest that R 76713 is able to
      displace the substrate from its binding place and the stable complex formed in
      particular with the (+) enantiomer suggests that its N-1-substituent occupies a
      lipophilic region of the apoprotein moiety. Kinetic analysis implies that there
      is a competitive part in the inhibition of the human placental aromatase by R
      76713. The Ki values for R 76713, R 83842 and R 83839 are 1.3 nM, 0.7 nM and 18
      nM, respectively. These results are indicative of stereospecificity for binding.
      Up to 10 microM, R 76713 and its enantiomers have no statistically significant
      effect on the regio- and stereoselective oxidations of testosterone in male rat
      liver microsomes. All three compounds have no effect on the P450-dependent
      cholesterol synthesis, cholesterol side-chain cleavage and 7 alpha-hydroxylation
      and 21-hydroxylase. At 10 microM, R 76713 has a slight effect on the bovine
      adrenal 11 beta-hydroxylase. This effect originates mainly from R 83839, the less
      potent aromatase inhibitor. On the other hand, the inhibition of the 17,20-lyase
      of rat testis observed at concentrations greater than or equal to 0.5 microM,
      originates rather from R 83842. However, 50% inhibition is only achieved at 1.8
      microM R 83842, i.e. at a concentration about 1300-times higher than that needed
      to reach 50% inhibition of the human placental aromatase.

PMID- 2242010
TI  - Hepatic subcellular localization of cresylbenzodioxaphosphorin oxide (CBDP)
      sensitive soman binding sites.
AB  - The toxicity of the organophosphorus poison soman
      (pinacolylmethylphosphonofluoridate) is attributable to its irreversible
      inhibition of the enzyme acetylcholinesterase. In addition, soman binds
      irreversibly to a number of noncholinesterase tissue binding sites which appear
      to be its major means of in vivo detoxification. This study was conducted to
      determine the hepatic subcellular localization of these sites. Subcellular
      fractions of liver from male Sprague-Dawley rats (200-250 g) were prepared by
      differential and isopycnic density gradient centrifugation. The binding of
      [14C]soman to these subcellular fractions was determined in the presence and
      absence of cresylbenzodioxaphosphorin oxide (CBDP), a compound that binds
      irreversibly to the noncholinesterase soman binding sites. Crude fractionation of
      liver homogenates into nuclear, mitochondrial, microsomal, and soluble fractions
      revealed that 78% of the total CBDP-sensitive binding activity was localized in
      the nuclear and microsomal fractions. Further purification of these fractions
      indicated that all of the homogenate binding activity could be accounted for in
      the purified microsomal fraction. When purified liver microsomes were solubilized
      and fractionated on linear sucrose gradients, 90% of the CBDP-sensitive soman
      binding activity cosedimented with carboxylesterase activity which suggests that
      these binding sites are carboxylesterase.

PMID- 2242011
TI  - Metabolism of nicotine by hepatocytes.
AB  - The profile of nicotine metabolites produced by freshly isolated hepatocytes from
      rats, hamsters, guinea pigs, mice and humans was investigated after a 30-min
      exposure to nicotine ([2-14C]pyrrolidine). Large species differences occurred in
      the extent of nicotine metabolism; these ranged from 95% metabolism in guinea pig
      hepatocytes to only 30% metabolism in human and rat hepatocytes. The spectrum of
      metabolites formed also varied widely in different species. In hepatocytes from
      obese human subjects, nicotine was metabolized most extensively in smokers, least
      in nonsmokers, and to an intermediate degree in exsmokers, suggesting that
      cigarette smoking enhances the rate of nicotine metabolism. Pretreatment of all
      nonhuman species studied with phenobarbital and beta-naphthoflavone and with
      Aroclor in rats produced distinctive inductive patterns. Phenobarbital
      pretreatment of nonsmokers for 2 days prior to liver biopsy doubled the extent of
      nicotine conversion to cotinine by their hepatocytes. Rat and hamster hepatocytes
      exhibited sex and stereoselectivity differences in nicotine metabolism.
      Collectively, these studies indicate that hepatocytes offer some advantages over
      in vivo systems in investigating certain aspects of nicotine metabolism.

PMID- 2242012
TI  - Differential effects of daily administration of cocaine on hepatic and cerebral
      glutathione in mice.
AB  - Twenty-four hours after acute administration of cocaine HCl (25 mg/kg, i.p.) to
      male C57BL/6ByJ mice, there was no hepatotoxicity as measured by plasma aspartate
      aminotransferase (AST) activity. In contrast, daily administration of cocaine (25
      mg/kg, i.p.) for 14 days induced marked hepatotoxicity, as characterized by a
      greater than 400% increase in plasma AST activity when assayed 24 hr after the
      last injection. Concomitantly, the liver had increased levels of cysteine, gamma
      glutamylcysteine, glutathione, cysteinylglycine, glutamate, methionine, taurine,
      and aspartate. The effect appeared to be selective for compounds of the
      glutathione metabolic pathways, because repeated cocaine exposure did not affect
      other amino acids such as leucine, isoleucine, phenylalanine, serine, and valine.
      There was a positive correlation between the magnitude of the elevation of
      cysteine and the extent of liver damage. Daily cocaine administration did not
      affect striatal or frontal cortex glutathione. A final cocaine challenge (50
      mg/kg, i.p.) did not affect either hepatic or cerebral glutathione metabolism.
      The increase in hepatic cysteine and glutathione upon daily cocaine
      administration is a potentially important compensatory mechanism against cocaine
      induced hepatotoxicity.

PMID- 2242013
TI  - Acute effect of thyroid hormone on insulin secretion in rats.
AB  - To elucidate the mechanism of thyroid hormone-induced hyperinsulinemia, the acute
      and direct effect of thyroid hormone administration on insulin secretion was
      investigated in rats in vivo and in vitro. In the perfused rat pancreas, the
      addition of thyroxine (10 micrograms/dL) or 3,5,3'-triiodothyronine (150 ng/dL)
      to the perfusing medium did not affect insulin secretion. The administration of
      thyroxine (40 micrograms/kg, s.c.) in vivo increased the plasma insulin level
      from 11 +/- 2 microUnits/mL (mean +/- SD) to 30 +/- 7 microUnits/mL, while blood
      glucose and plasma glucagon were unchanged. This phenomenon was inhibited
      completely by the preadministration of oxprenolol hydrochloride (2 mg/kg, s.c.),
      and inhibited partly by the preadministration of metoprolol tartrate (35 mg/kg,
      s.c.). These results suggest that thyroid hormone induces hyperinsulinemia via
      beta-adrenergic stimulation in the rat.

PMID- 2242014
TI  - Inhibition of ribonucleotide reductase and growth of human colon carcinoma HT-29
      cells and mouse leukemia L1210 cells by N-hydroxy-N'-aminoguanidine derivatives.
AB  - A series of N-hydroxy-N'-aminoguanidine (HAG) derivatives were studied and
      compared for their effects on ribonucleotide reductase activity in cell-free
      extracts; on nucleic acid synthesis and the growth of human colon carcinoma HT-29
      cells; and on mouse leukemia L1210 cells in culture. The HAG derivatives
      [RCH=NNHC(=NH)NHOH-tosylate] studied could be grouped as: (1)
      hydroxybenzylidines; (2) methoxybenzylidines; and (3) nitrobenzylidines
      substituted at the R position. 2'-Hydroxybenzylidine-HAG, the lead compound, was
      relatively active in both HT-29 cells and L1210 cells (20 +/- 5 and 13 +/- 4
      microM for 50% inhibition of HT-29 and L1210 cell growth respectively). The
      monohydroxybenzylidene compounds were generally more active than the dihydroxy-
      and trihydroxybenzylidene-HAG derivatives. The methoxybenzylidene-HAGs were as
      active as the monohydroxybenzylidene-HAGs. 2'-Hydroxy-4'-methoxybenzylidene-HAG
      was much more active than 2',4'-dihydroxybenzylidene-HAG. The
      mononitrobenzylidene-HAGs were more active than the dinitrobenzylidene-HAG
      compound. In general, L1210 cells were more sensitive to the effects of the HAG
      compounds than were HT-29 cells. There was good agreement between the
      concentration of drug required to inhibit the growth of HT-29 cells and that
      required to inhibit the growth of L1210 cells. There was also good correlation
      between the ability of HAG derivatives to inhibit ribonucleotide reductase
      activity and to inhibit tumor cell growth. Some derivatives, such as 2',3',4'-
      and 3',4',5'-trihydroxybenzylidene-HAG inhibited L1210 cell growth by 50% at
      lower concentrations (7.8 and 11.9 microM respectively) than the concentrations
      needed for 50% inhibition of HT-29 cell growth (196 and 234 microM respectively)
      and ribonucleotide reductase activity (122 and 188 microM respectively). The
      studies of nucleic acid synthesis in L1210 cells using [3H]cytidine as a
      precursor showed that 2',3',4'-trihydroxybenzylidine-HAG inhibited DNA synthesis
      at a lower concentration (29 microM for 50% inhibition) than was needed for the
      inhibition of RNA synthesis and formation of [3H]deoxycytidine nucleotides in the
      acid-soluble fraction (320 and 820 microM for 50% inhibition respectively). These
      results indicate that 2',3',4'-trihydroxybenzylidine-HAG inhibits DNA synthesis
      in L1210 cells through other mechanisms rather than exclusively through the
      inhibition of ribonucleotide reductase activity.

PMID- 2242015
TI  - Dissociation between protein kinase C content and biological responsiveness to
      phorbol esters in tumor promoter-sensitive (MCF-7) and resistant (RPh-4) cells.
AB  - A cell line (RPh-4) insensitive to the effects of phorbol esters has been
      isolated from MCF-7 human breast cancer cells. The growth pattern of RPh-4 cells
      in the presence of 50 ng/mL (80 nM) 12-O-tetradecanoylphorbol 13-acetate (TPA) is
      similar to that of parental MCF-7 cells in the absence of TPA. While phorbol
      esters inhibit MCF-7 cell proliferation and increase cell volume and protein
      content, no such effects are observed in RPh-4 cells. TPA affects MCF-7 but not
      RPh-4 cell cycle in two ways: a G1 block and a delayed passage through G2 phase.
      Profound alterations in protein kinase C content and activity are observed in RPh
      4 versus MCF-7 cells, i.e. (i) a dramatic decline in the cellular enzyme content;
      (ii) a loss of the capacity to translocate upon acute TPA stimulation for the
      remainder enzyme; and (iii) a lack of stimulation by phorbol esters of the
      endogenous Mr 28,000 substrate. However, these striking changes are only
      transient and rapidly reverse when RPh-4 cells are subcultured in TPA-free
      medium, with a 60% and an almost total recovery, respectively, after 15 days and
      3 months. By contrast, a much lower rate of reversion is observed in terms of
      cell growth responsiveness to TPA with a total insensitivity to phorbol ester
      after 80 days and a 50% inhibition of RPh-4 cell proliferation after 3.5 months.
      Our data clearly demonstrate an apparent dissociation between the cellular
      protein kinase C content and the biological responsiveness to phorbol ester in
      the variant RPh-4 cells. Moreover, they suggest that the Mr 28,000 protein
      phosphorylation event is not directly related to the cell growth arrest induced
      by phorbol esters in MCF-7 cells.

PMID- 2242017
TI  - An evaluation of the role of glutathione and its associated enzymes in the
      expression of differential sensitivities to antitumour agents shown by a range of
      human tumour cell lines.
AB  - Glutathione and its associated enzyme activities have been quantitated in a
      series of human tumour continuous cell lines expressing a range of in vitro
      sensitivities to certain antitumour agents. Fourteen different parental lines and
      15 various drug- and X-ray-selected resistant sublines have been studied.
      Quantitative relationships between total glutathione levels and related enzyme
      activities and sensitivities to six clinically-useful antitumour drugs or X-rays,
      as judged by colony forming assays, have been determined by linear regression
      analysis. A positive correlation has been identified between glutathione levels
      and sensitivities to cisplatin. Adriamycin, or to X-rays. In addition, positive
      correlations were noted between cisplatin sensitivities and glutathione
      peroxidase and reductase activities and for Adriamycin responses with respect to
      glutathione peroxidase activity, using cumene hydroperoxide as substrate.
      However, no positive correlations were noted for glutathione levels or these
      enzyme activities with differential methotrexate, etoposide, vincristine or 5
      fluorouracil cytotoxicities. Furthermore, no direct relationship was apparent
      between total glutathione S-transferase activities and any of these drug or X-ray
      sensitivities in this series of cell lines. These data appear to provide further
      evidence linking altered glutathione metabolism with differential cytotoxicities
      of certain clinically-useful antitumour agents.

PMID- 2242016
TI  - Blood-glucose-lowering activity of 2-(3-phenylpropoxyimido)-butyrate (BM 13.677).
AB  - A single oral or intraperitoneal application of 2-(3-phenylpropoxyimido)-butyrate
      (BM 13.677) resulted in a dose-dependent blood-glucose-lowering effect in fasted
      guinea-pigs. The threshold dose and the EC50 were estimated as 25 mg/kg and 63
      mg/kg, respectively, which is between that of the biguanides phenformin and
      metformin. A rise in blood lactate concentrations was observed only at high doses
      of BM 13.677, but was not related to an irreversible metabolic inhibition. Among
      several rodent species studied the potency of the drug decreased in the order
      guinea-pig much greater than mouse greater than rat = rabbit. Inhibition of
      hepatic gluconeogenesis by the drug was demonstrated in the perfused liver or
      hepatocytes of guinea-pigs. Inhibition of glucose production by the perfused
      liver in the presence of 0.1 mM BM 13.677 was dependent on the substrate and
      decreased in the order: lactate greater than pyruvate greater than alanine much
      greater than propionate greater than glycerol = fructose. This suggests a
      specific interaction of the drug with a mitochondrial key reaction of
      gluconeogenesis. Stimulation of glucose oxidation in rat diaphragm by the
      compound (EC50 = 0.85 mM) suggests that besides inhibition of gluconeogenesis
      also extrahepatic effects contribute to the blood-glucose-lowering effects of the
      drug.

PMID- 2242018
TI  - Vasodilator effects of sarafotoxins and endothelin-1 in spontaneously
      hypertensive rats and rat isolated perfused mesentery.
AB  - Sarafotoxins (SRTa, SRTb and SRTc) and ET-1 produced a potent vasodilator effect
      in spontaneously hypertensive rats in vivo and in rat isolated perfused
      mesenteries in vitro. Among these peptides SRTc demonstrated the most potent
      vasodilator activity, and was three times more active than SRTa in both
      preparations. These peptides induced endothelium-dependent vasodilatation in
      vitro and pretreatment with methylene blue inhibited this effect, while exposure
      to the antagonists of other vasodilators did not. In contrast,
      [nitrophenylsulfenylated Trp21]SRTc, SRTc(1-18) and reduced and S
      carboxymethylated SRTc caused no vasodilatation in either animal model; the
      vasodilator effect of acetylated SRTc was less potent than that of SRTc. These
      results suggest that (i) the vasodilatations of these peptides may be exerted
      through the release of endothelium derived relaxing factor; (ii) the C-terminal
      Trp21 and disulfide bonds are essential; and (iii) the N-terminal amino group
      plays an important role in vasodilator activity.

PMID- 2242019
TI  - Structure-activity studies with chiral isomers and with segments of the
      antimitotic marine peptide dolastatin 10.
AB  - Eighteen configurational isomers of the antimitotic peptide dolastatin 10 (Bai et
      al., Biochem Pharmacol 39: 1941-1949, 1990) derived from Dolabella auricularia,
      together with segments obtained as precursors in its synthesis (Pettit et al., J
      Am Chem Soc 111: 5463-5465, 1989), were examined as inhibitors of tubulin
      polymerization and as inhibitors of growth of L1210 murine leukemia cells in
      culture. Dolastatin 10 consists of four amino acids (in order from the amino
      terminus: dolavaline, valine, dolaisoleucine, and dolaproine), three unique to D.
      auricularia, linked to an unusual primary amine (dolaphenine, probably derived
      from phenylalanine) at what would otherwise be its carboxyl terminus. Dolastatin
      10 has nine asymmetric carbon atoms, and available isomers included alternate
      configurations at five positions (positions 9 and 10 in the dolaproine moiety and
      positions 18, 19 and 19a in the dolaisoleucine moiety). For tubulin
      polymerization, only alterations at positions 18 and 19 resulted in loss of
      inhibitory activity of the isomer. In addition, a tripeptide containing
      dolavaline, valine and dolaisoleucine with all asymmetric carbons identical
      configurationally to those in dolastatin 10 was found to be about 30% as
      effective as dolastatin 10 in inhibiting tubulin polymerization. Cytotoxic
      effects were much more sensitive to alterations in the dolastatin 10 structure.
      The only modification which did not lead to reduced cytotoxicity was reversal of
      configuration at position 19a in the dolaisoleucine moiety. Both this isomer and
      dolastatin 10 had IC50 values of less than 1 nM. Several other isomers had IC50
      values with the L1210 cells in the range of 30-90 nM, but these did not correlate
      well with their inhibitory effects on tubulin polymerization. The tripeptide
      effective as an inhibitor of tubulin polymerization had no activity against the
      L1210 cells.

PMID- 2242020
TI  - Effects of oxygen deficiency and calcium omission on carbon tetrachloride
      hepatotoxicity in isolated perfused livers from phenobarbital-pretreated rats.
AB  - The effect of oxygen concentration and Ca2+ omission on CCl4-induced
      hepatotoxicity was studied in a non-recirculating and hemoglobin-free liver
      perfusion system using phenobarbital-pretreated rats. With 95% O2-saturated
      perfusate, infusion of 0.5 mM CCl4 caused an instantaneous increase of
      thiobarbituric acid reactive substances (TBA-RS) in the effluent perfusate,
      accompanied by only a slight leakage of K+ and lactate dehydrogenase (LDH).
      CBrCl3 produced a far greater increase in the TBA-RS level, but again with slight
      K+ and LDH leakage. With 20% O2-saturated perfusate, CCl4 caused a marked LDH
      leakage, which was preceded by an early and considerable increase in K+ leakage
      coupled with Na+ uptake, Ca2+ uptake was initially slight, being enhanced
      concurrently with the LDH leakage. The TBA-RS level changed biphasically with an
      initial moderate and a succeeding greater increase coupled with LDH leakage. N,N"
      Diphenyl-p-phenylenediamine and promethazine suppressed the TBA-RS production,
      but improved neither K+ nor LDH leakage. Omission of the Ca2+ from the perfusate
      reduced the initial K+ leakage as well as the later TBA-RS release, and markedly
      delayed the LDH leakage. In retrograde perfusion under low oxygen supply with
      Ca2+, CCl4 produced essentially the same toxic manifestations as those observed
      in the anterograde perfusion. Hepatocytes of the periportal and pericentral areas
      were not stained with trypan blue in the antero- and retrograde perfusion systems
      respectively. Thus, oxygen deficiency, rather than lipid peroxidation by itself,
      and the essential role of extracellular Ca2+ may be important for CCl4-induced
      hepatic cell necrosis, in which plasma membrane permeability change may be an
      early and critical event.

PMID- 2242021
TI  - Lipid peroxidation and protein thiol depletion are not involved in the
      cytotoxicity of N-hydroxy-2-acetylaminofluorene in isolated rat hepatocytes.
AB  - Freshly isolated rat hepatocytes were used to study the mechanism of cell death
      induced by N-hydroxy-2-acetylaminofluorene (N-OH-AAF). Exposure to 1.0 mM N-OH
      AAF resulted in more than 90% cell death (as measured by LDH leakage) of
      hepatocytes isolated from male rats within 6 hr. Only 36% of the hepatocytes
      isolated from female rats died within this period. When inorganic sulfate was
      omitted from the incubation medium, a 6 hr exposure to 1.0 mM N-OH-AAF resulted
      in only 40% cell death of male hepatocytes. These findings are in accordance with
      the sex difference and sulfation dependence of N-OH-AAF hepatotoxicity observed
      in the rat in vivo. N-OH-AAF decreased glutathione (GSH) in male hepatocytes in a
      concentration-dependent manner. This GSH consumption was only partly dependent on
      the presence of inorganic sulfate. No lipid peroxidation was observed during N-OH
      AAF exposure; N-OH-AAF even prevented endogenous and diethyl maleate (DEM)
      induced lipid peroxidation. No reduction of free protein thiol groups was found
      after exposure to N-OH-AAF, even after 75% cell death had occurred. A reduction
      of protein thiols after N-OH-AAF exposure was observed in GSH depleted
      hepatocytes (obtained by DEM plus vitamin E pretreatment). Under these conditions
      N-OH-AAF-induced cell death occurred earlier. Therefore, GSH protects against
      protein thiol depletion by N-OH-AAF in control cells. N-OH-AAF-induced cell death
      was preceded by a loss of intracellular ATP. It is concluded, therefore, that
      neither lipid peroxidation nor depletion of protein thiols, but possibly loss of
      intracellular ATP, is involved in the sulfation-dependent cytotoxic mechanism of
      N-OH-AAF in isolated rat hepatocytes.

PMID- 2242022
TI  - Spermine toxicity and glutathione depletion in BHK-21/C13 cells.
AB  - Spermine, a polycationic amine, produced a dose-dependent inhibition of BHK
      21/C13 cell growth. This response was not due to the extracellular metabolism of
      spermine by an amine oxidase found in bovine serum, as the toxicity was observed
      when the cells were grown in medium supplemented with horse serum. Three indices
      were used to monitor cell growth, cell number, protein content and [3H]thymidine
      incorporation into DNA. Spermine (2mM) caused significant reductions in all three
      measurements after a 6-8 hr exposure. The amine was rapidly taken up into the
      cells reaching levels 15-16-fold greater than in control cells within 2 hr. There
      was a rapid loss of intracellular reduced glutathione following exposure to toxic
      concentrations of spermine, which occurred before any effect on cell growth.
      Three methods for the determination of intracellular glutathione content were
      compared in this system. The effect on both cell growth and glutathione was
      reversible following removal of spermine from the extracellular medium. The
      possible mechanisms involved in this toxic response are discussed with particular
      reference to the depletion in intracellular reduced glutathione.

PMID- 2242023
TI  - Multiple molecular forms and lectin interactions of organophosphate-sensitive
      plasma and liver esterases during development of the chick.
AB  - Liver and plasma acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and
      carboxylesterase activities of the chick embryo and adult chickens were separated
      by sucrose density gradient sedimentation and further differentiated by their
      lectin affinities and organophosphate sensitivities. Changes in plasma
      cholinesterases during development indicated a characteristic shift in tetrameric
      (G4) isoforms from a slightly larger G4 AChE in the embryo to G4 BChE in the
      adult. These changes were not reflected in isoform patterns of liver homogenates,
      however. Interestingly, the time course of an increase in plasma BChE activity
      corresponded to the time course of a decrease in liver BChE activity, as if this
      enzyme was being mobilized and released. The distribution of liver esterases
      included both monomeric (G1) and G4 BChE and a large p-nitrophenylacetate (p-NPA)
      esterase activity that was separated into two main peaks by density gradient
      ultracentrifugation. The effects of organophosphate inhibitors indicated that the
      two liver p-NPA esterase activities may be regarded as carboxylesterases;
      however, these enzymes showed very different sensitivities to paraoxon and
      diisopropylfluorophosphate (DFP), with IC50 values differing by 3 and 4 orders of
      magnitude. Lectin affinity studies with multiple esterase forms suggested a
      heterogeneous group of glycoproteins that were packaged at different sites in the
      liver cell and were consistent with the presence of an intracellular precursor
      form to plasma BChE.

PMID- 2242025
TI  - Characterization of repair inhibition by methotrexate of ethylmethanesulfonate
      and ultraviolet irradiation-induced DNA damage in Chinese hamster cells.

PMID- 2242024
TI  - Irreversible binding of heme to microsomal protein during inactivation of
      cytochrome P450 by 4-alkyl analogues of 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6
      trimethylpyridine.
AB  - The porphyrinogenicity of 4-alkyl analogues of 3,5-diethoxycarbonyl-1,4-dihydro
      2,4,6-trimethylpyridine (DDC) is related to the process of mechanism-based
      destruction of cytochrome P450 (P450) heme, accompanied by conversion of heme to
      N-alkylprotoporphyrins (N-alkylPPs). Certain DDC analogues (4-isopropyl, 4
      isobutyl, 4-hexyl) are weakly porphyrinogenic in comparison to the potent
      porphyrinogen, 4-ethyl DDC. We have examined the abilities of these DDC analogues
      to promote irreversible binding of radiolabeled heme to protein in rat liver
      microsomal preparations. The goals of this study were to determine whether DDC
      analogues with different porphyrinogenicities differ in the extents to which they
      cause heme adduct formation, and whether P450 isozymes differ in their capacities
      to catalyze heme covalent binding. Incubation of microsomes with NADPH alone
      promoted heme covalent binding, while loss of spectral P450 heme was minimal or
      absent. In microsomal incubations containing NADPH, the 4-ethyl, 4-isopropyl, and
      4-isobutyl analogues caused heme covalent binding to extents which paralleled
      their P450 destructive activities. In contrast, 4-hexyl DDC caused less heme
      covalent binding as a function of P450 loss than the other analogues in
      microsomes from untreated and beta-naphthoflavone (beta NF)-treated rats. Thus,
      the weakly porphyrinogenic DDC analogues do not cause greater heme covalent
      binding than 4-ethyl DDC. Weak porphyrinogenicity, therefore, cannot be explained
      by diversion of the heme moiety of P450 from conversion to N-alkylPPs towards
      utilization for formation of heme-derived protein adducts. Treatment of rats with
      P450 inducing agents altered the degree to which DDC analogues caused heme
      covalent binding. The greatest heme adduct formation occurred in microsomes from
      untreated and dexamethasone (DEX)-treated rats, whereas treatment with
      phenobarbital and especially beta NF reduced heme covalent binding as a function
      of P450 loss. Thus, these microsomal studies suggest that constitutive P450
      isozymes and members of the DEX-inducible P450IIIA subfamily appear to catalyze
      heme covalent binding, while beta NF-inducible forms such as P450IA1 (P450c) seem
      to be relatively inactive in this regard.

PMID- 2242026
TI  - Inositol 1,3,4,5-tetrakisphosphate and regulation of intracellular calcium.

PMID- 2242027
TI  - Receptor-mediated endocytosis of macromolecular conjugates in selective drug
      delivery.

PMID- 2242028
TI  - Phenothiazines inhibit copper and endothelial cell-induced peroxidation of low
      density lipoprotein. A comparative study with probucol, butylated hydroxytoluene
      and vitamin E.
AB  - The effect of two phenothiazines, chlorpromazine (CPZ) and trifluoperazine (TFP)
      on the copper and endothelial cell-induced peroxidation of low density
      lipoprotein (LDL) has been studied and compared to that of drugs previously shown
      to protect LDL against peroxidation: probucol (PBC) and butylated hydroxytoluene
      (BHT). Incubation with CPZ or TFP inhibited in a dose-dependent manner LDL
      peroxidation induced either by copper ions or by cultured endothelial cells. Both
      the electrophoretic mobility and the thiobarbituric reactive substance content of
      LDL returned to almost normal values in the presence of 50 microM CPZ or TFP. The
      two studied phenothiazines also strongly inhibited the hydrolysis of LDL
      phosphatidylcholine which accompanies copper or endothelial cell-induced
      peroxidation of the particle. CPZ and TFP were as effective as PBC and BHT in
      inhibiting the LDL peroxidation. Whereas copper or endothelial cell-oxidized LDL
      were recognized and rapidly catabolized by mouse peritoneal macrophages, CPZ- or
      TFP-, as well as PBC- or BHT-treated LDL were not. Moreover, it was found that,
      in contrast to vitamin E, neither CPZ nor PBC reacted with model peroxy radicals
      formed by gamma irradiation of aerated ethanol. The possible mechanisms
      underlying this protective effect of phenothiazines against LDL oxidative
      modification are discussed.

PMID- 2242029
TI  - Effects of ethanol and inhibitors on the binding and metabolism of acetaminophen
      and N-acetyl-p-benzoquinone imine by hepatic microsomes from control and ethanol
      treated rats.
AB  - Acetaminophen is metabolized by cytochrome P450 to N-acetyl-p-benzoquinone imine
      (NABQI). This metabolite reacts with critical cellular macromolecules to give
      toxicity. The administration of 10% ethanol in the drinking water to 100 g male
      rats for 6 weeks markedly increases the toxicity of acetaminophen. This increase
      was associated with a 71% increase in microsomal protein binding of acetaminophen
      [4.8 pmol/min/mg protein in control microsomes versus 8.2 pmol/min/mg protein in
      ethanol microsomes (P less than 0.01)] and a 131% increase in aniline hydroxylase
      [0.52 nmol/min/mg protein in control microsomes versus 1.20 nmol/min/mg protein
      in ethanol microsomes (P less than 0.001)]. On the other hand, cysteine
      conjugation of acetaminophen showed an increase of only 12% [2.8 nmol/min/mg
      protein in control microsomes versus 3.1 nmol/min/mg protein in ethanol
      microsomes (P less than 0.05)]. Ethylmorphine- and benzphetamine N-demethylases
      did not increase. In microsomes from both control and ethanol animals, imidazole
      (1 mM) inhibited the two N-demethylases, aniline hydroxylation and acetaminophen
      binding by 85-95% but inhibited the cysteine conjugation by only 50%. For control
      and ethanol animals, both 80% CO/20% O2 and SKF-525A (1 mM) totally inhibited
      cysteine conjugation but only inhibited the other activities by about 36-60%. KCN
      (1 mM) had no effect on any of the activities except protein binding (60-67%
      inhibition). Scavengers of reactive oxygen [mannitol (1 mM), dimethyl sulfoxide
      (1 mM), superoxide dismutase (15 micrograms/mL) and catalase (65 micrograms/mL)]
      had no effect on any of the reactions. Of all these treatments only CO/O2
      decreased the protein binding and cysteine conjugation of NABQI in the presence
      of either NADP+ or NADPH. The data from the inhibitor studies and the effect of
      ethanol on acetaminophen and NABQI metabolism would suggest that protein binding
      and cysteine conjugation are catalyzed by different isozymes of cytochrome P450.
      Finally, the current results indicate that the increased toxicity of
      acetaminophen observed with ethanol more closely parallels the increase in
      protein binding activity rather than cysteine conjugation.

PMID- 2242030
TI  - Effect of 3- and 4-thia-substituted fatty acids on glycerolipid metabolism and
      mitochondrial beta-oxidation in rat liver.
AB  - Treatment of normolipidemic rats by alkylthiopropionic acid (CETTD), resulted in
      a dose- and time-dependent increase in total dihydroxyacetone phosphate
      acyltransferase (DHAPAT) activity, in extent comparable to that of 3
      thiadicarboxylic acid (BCMTD) and alkylthioacetic acid (CMTTD). Thus, in CETTD-
      and CMTTD-treated rats, the specific DHAPAT activity increased in the microsomal,
      peroxisomal and mitochondrial fractions. In contrast, repeated administration of
      the peroxisome proliferator, BCMTD, decreased the specific DHAPAT activity both
      in the peroxisomal fraction and in purified peroxisomes. A three-fold increase in
      specific activity was, however, revealed in the mitochondrial fraction. Whether
      the variation of the DHAPAT activity in the mitochondrial and microsomal
      fractions among the feeding groups can be explained by increased number of
      enlarged and small peroxisomes sedimenting in the fractions, are to be
      considered. Subcellular fractionation studies confirmed previous findings that
      rat liver glycerophosphate acyltransferase (GPAT) was located both in
      mitochondria and the microsomal fraction. BCMTD was considerably more potent than
      CMTTD in stimulating the microsomal and mitochondrial GPAT activities.
      Administration of CETTD marginally affected the isoenzymes of GPAT.
      Diacylglycerol acyltransferase (DGAT) activity was increased by 35% in BCMTD and
      CMTTD treated rats, but by administration of CETTD the enzyme activity was
      decreased by more than 80%. The acyl-CoA cholesterol acyltransferase (ACAT)
      activity was marginally affected in animals treated with BCMTD, CMTTD and CETTD.
      Thus, the results indicate that the initial steps in the synthesis of
      triacylglycerols and ether glycerolipids as well as the last step in
      triacylglycerol synthesis could not be identified as mediating the fat
      accumulation or the lowering of triacylglycerol content in liver of CETTD, or
      BCMTD and CMTTD treated rats. On the other hand, CMTTD increased the palmitoyl
      CoA oxidation in mitochondria, and CETTD considerably inhibited the activity.
      Therefore, it is conceivable that the development of fatty liver with CETTD is
      mostly due to inhibition of mitochondrial beta-oxidation.

PMID- 2242031
TI  - Electron transport and protection of liver slices in the late stage of
      paracetamol injury.
AB  - Cell injury by chemicals takes place in two stages, initial chemical interaction
      between the material and cell components, and subsequent stages of adaptation or
      failure of response to chemical modification of some parts of the cell apparatus.
      Paracetamol toxicity was studied in an in vitro system using liver slices
      incubated in two stages. During the first 2 hr slices were exposed to 10 mM
      paracetamol and this was absent during the following 4 hr of incubation. Damage
      was quantified at the end by measuring leakage of lactate dehydrogenase (LDH),
      increase in water content and potassium loss. Treatment of slices with 10 microM
      DCPIP or 2 mM ethanol in the second period of incubation prevented paracetamol
      induced damage. The protective effect was not dependent on the activity of P450
      since the second stage of incubation was insensitive to SKF-525A. The protective
      effect of ethanol was blocked by the presence of 1 mM pyrazole suggesting that
      ethanol needs to be metabolized to exert its effect. The addition of 20 mM
      pyruvate reversed the protection provided by ethanol. Nicotinamide did not alter
      toxicity or protection by ethanol. These findings suggest an increase of NADH and
      NADH/NAD ratio as the most probable explanation for the protective effect
      observed. The role of reducing equivalents in detoxification of quinones such as
      NAPQI by formation of hydroquinones, is discussed in relation to the mechanism of
      cell injury by paracetamol.

PMID- 2242032
TI  - Effects of novel bile salts on cholesterol metabolism in rats and guinea-pigs.
AB  - Novel bile salts (quaternary ammonium conjugates) inhibited cholic acid binding
      and transport in everted ileal sacs in vitro. The cationic piperazine conjugate
      of lithocholic acid (di-iodide salt, compound 8, BRL 39924A) appeared most
      active, inhibiting binding by 29% and transport by 59% in guinea-pig ileum (200
      microM). BRL 39924A also inhibited taurocholate uptake into guinea-pig ileal sacs
      and cholate uptake into rat ileal sacs and was selected for further study in
      vivo. In hyperlipidaemic rats, BRL 39924A significantly raised cholesterol 7
      alpha-hydroxylase activity and decreased hepatic accumulation of exogenous cholic
      acid. HDL cholesterol concentration in the serum increased and the level of VLDL
      plus LDL cholesterol decreased. In hyperlipidaemic guinea-pigs. BRL 39924A
      lowered serum total cholesterol and triglyceride levels. Although metabolic
      changes were less than those achieved with the bile acid sequestrant,
      cholestyramine, the doses of BRL 39924A used were much lower (100-500 mg/kg body
      wt). Selective inhibition of receptor mediated bile acid uptake may be associated
      with local side-effects but these novel bile salts are useful pharmacological
      tools to examine the effects of receptor blockade on lipoprotein metabolism.

PMID- 2242033
TI  - Stimulation of human polymorphonuclear leukocytes potentiates the uptake of
      diclofenac and the inhibition of chemotaxis.
AB  - Diclofenac sodium, a non-steroidal anti-inflammatory drug, has been shown to
      impair the stimulation of human polymorphonuclear leukocytes (PMNs) by
      chemoattractants. To gain insight into the mechanism of action of this agent, we
      investigated the uptake of diclofenac by resting and activated PMNs and the
      effect of the drug on PMN locomotion. During incubation of resting PMNs at 37
      degrees in the presence of 78 microM (25 micrograms/mL) diclofenac, drug uptake
      reached a plateau in less than 2 min. The resulting cellular to extracellular
      diclofenac concentration ratio (C/E) was 1.01 +/- 0.13 (mean +/- SD). Stimulation
      of PMNs at 37 degrees but not at 4 degrees with the chemoattractant formyl
      methionyl-leucyl-phenylalanine (fMLP) or phorbol myristate acetate (PMA), induced
      a rise in diclofenac uptake, which was dependent on incubation time and
      diclofenac and stimulus concentrations. Maximal C/E was 1.83 +/- 0.18 and 4.40 +/
      0.60 (mean +/- SD) for PMNs stimulated with 10 microM fMLP and 0.16 microM PMA,
      respectively. The diclofenac associated with PMNs was predominantly present in
      the soluble fraction of disrupted cells. Interestingly, PMNs which were
      pretreated with diclofenac and stimulated with fMLP, exhibited impaired random
      and directional locomotion induced by activated serum, as compared to controls,
      i.e. PMNs treated with diclofenac alone or fMLP alone. Thus, stimulation of PMNs
      enhances diclofenac uptake and potentiates the drug impairment of chemotactic
      activity. These findings could explain, in part, the observed anti-inflammatory
      properties of this compound.

PMID- 2242034
TI  - Purification and characterization of 3-mercaptopyruvic acid S-conjugate
      reductases.
AB  - Three kinds of 3-mercaptopyruvic acid S-conjugate reductase (MPR-I, MPR-II and
      MPR-III) were purified from rat liver cytosol. These enzymes reduced 3
      mercaptopyruvic acid S-conjugates derived from cysteine conjugates and some
      endogenous alpha-keto acids to the corresponding alpha-hydroxy acids in the
      presence of either NADH (for MPR-I and MPR-II) or NADPH (MPR-III), while simple
      aldehydes or ketones did not significantly induce substrate activity. The
      molecular weight of the present enzymes was about 80 kDa composed of two subunits
      of the same molecular weight. Km values of MPR-I, MPR-II and MPR-III were 0.38,
      0.06 and 0.29 mM for S-(4-bromophenyl)-3-thiopyruvic acid, respectively, and 0.15
      mM for NADH (MPR-I, MPR-II) and NADPH (MPR-III). Vmax values of MPR-I, MPR-II and
      MPR-III for this substrate were 5.3, 20 and 13 nmol/min/mg, respectively. The
      sulphydryl-modifying agents inhibited the enzyme activities of all the three
      reductases. Based on the properties including substrate selectivity for alpha
      keto acids derived from aromatic amino acids, we assumed that MPR-II and aromatic
      alpha-keto acid reductase are the same enzyme, while enzymes similar to MPR-I and
      MPR-III have not been reported. From the viewpoints of metabolism of xenobiotics,
      these enzymes are likely to be important in biotransformation of cysteine
      conjugates to 3-mercaptolactic acid S-conjugates.

PMID- 2242035
TI  - Warfarin resistance in a Chicago strain of rats.
AB  - A warfarin-resistant strain of rats trapped in Chicago was studied to determine
      the mechanism of the warfarin resistance. The Chicago-resistant rats (CR) differ
      from a Welsh-resistant strain (WR) which has a vitamin K epoxide reductase that
      is insensitive to warfarin. The epoxide and dithiol-dependent quinone reductases
      of the CR rats were as sensitive to warfarin as the normal enzyme. Unlike the
      irreversible warfarin inhibition seen in normal rats, the warfarin inhibition of
      the epoxide reductase from the CR strain was partially reversible in vitro. In
      this respect, the CR rats appeared similar to a Scottish warfarin-resistant
      strain. The same steady-state level of warfarin (40 ng/mg protein) in liver
      microsomes could be achieved in normal and CR strain rats following a few days
      ingestion of a diet containing 50 ppm warfarin, but clearance of warfarin (1
      mg/kg) from the liver microsomes was more rapid in the CR strain than in normal
      rats, and the recovery of epoxide reductase activity and prothrombin levels was
      more rapid. The mechanism of warfarin resistance in the CR strain differed from
      the warfarin resistance mechanisms of both the Scottish- and Welsh-resistant rat
      strains. The combination of an increased rate of warfarin clearance and the
      partially reversible inhibition of the epoxide reductase would be sufficient to
      allow the rats to survive a limited exposure to warfarin.

PMID- 2242036
TI  - Purification and characterization of the human ovarian LH/hCG receptor and
      comparison of the properties of mammalian LH/hCG receptors.
AB  - Methods previously published by us [Wimalasena et al., J Biol Chem 260: 10689
      10697, 1985; Wimalasena et al., J Biol Chem 261: 9416-9420, 1986] were utilized
      to solubilize the human corpus luteal leuteinizing hormone/human chorionic
      gonadotropin (LH/hCG) receptor with 3-[(3-cholamide-propyl)dimethylammonio]-1
      propanesulfonate (CHAPS) and to purify the receptor by two steps of hCG-Sepharose
      affinity chromatography. The specific binding capacity (SBC) of the purified
      human receptor was 7510 pmol/mg protein, and KA = 2.2 x 10(9) M-1 when iodo hCG
      was competed by hCG; the yield was 4-7% of starting activity. When hLH was used
      in competition with hCG, specific binding capacity was 7900 pmol/mg protein and
      KA 1.0 x 10(9) M-1. Silver staining and autoradiography demonstrated a single
      protein of Mr 78,000 under reducing and Mr 58-62 x 10(3) under nonreducing
      conditions. Rat ovarian LH/hCG receptor was purified by similar methods and the
      KA of 3.5 x 10(10) M-1 for hCG was substantially different from the KA for hLH
      which was 2.1 x 10(9) M-1. Mr of the rat protein was 78-82 x 10(3) (reduced) and
      58-62 x 10(3) (nonreduced) when analyzed by silver staining and autoradiography.
      For the first time, human LH/hCG receptor has been purified to apparent
      homogeneity, and its Mr of 78,000 was essentially identical to the Mr values of
      purified rat and porcine receptors.

PMID- 2242037
TI  - [3H]mecamylamine binding to rat brain membranes. Studies with mecamylamine and
      nicotine analogues.
AB  - Mecamylamine, an antagonist to nicotine, does not compete at the nicotinic
      recognition site, but is believed to block the ion channel of the nicotinic
      receptor. The present study demonstrates specific, saturable [3H]mecamylamine
      binding in rat brain membranes. [3H]Mecamylamine binding was destroyed by heating
      at 100 degrees and trypsin. Scatchard analysis revealed the presence of two sites
      with Kd values of 9.6 x 10(-8) and 1.1 x 10(-6) M and Bmax values of 7 x 10(-12)
      and 3 x 10(-11) mol/mg protein respectively. A good correlation was observed
      between the Ki values for [3H]mecamylamine binding of a number of mecamylamine
      and related analogues and their ability to block nicotine-induced prostration in
      rats and seizures in mice. Inorganic cations, particularly divalent, and various
      ion channel blockers, such as phencyclidine and verapamil, exhibited a high
      affinity for the [3H]mecamylamine site. Although mecamylamine did not block
      nicotine binding, nicotine and its analogues exhibited a high affinity for the
      [3H]mecamylamine site, a finding which suggests that nicotine acts directly on
      ion channels as well as the nicotinic cholinergic recognition sites. The data are
      consistent with the notion that mecamylamine interacts with the open ion channel
      of the nicotinic receptor.

PMID- 2242038
TI  - Anti-oxidative profile of lobenzarit disodium (CCA).
AB  - The effects of lobenzarit disodium (CCA) on various species of activated oxygen
      were investigated in chemiluminescence experiments. CCA showed a quenching effect
      against hydroxyl radicals generated by Fenton reaction. The inhibition of CCA was
      much more intense than that of mefenamic acid which is an anti-inflammatory drug
      and an analogous compound to CCA. CCA also showed a quenching effect against
      singlet oxygen generated in enzymatic systems. However, CCA had no effect against
      superoxide anion radicals generated in the xanthine oxidase-hypoxanthine system.
      As a model of lipid peroxidation and protein alteration induced by activated
      oxygen, we examined the auto-oxidation of linolenic acid and the UV irradiation
      of immunoglobulin G (IgG). CCA inhibited the production of lipid peroxide;
      however CCA did not show a direct quenching action against lipid radicals which
      had been previously generated. CCA also inhibited the IgG alteration induced by
      UV irradiation. These results indicate that CCA has anti-oxidative actions with
      specificity for activated oxygen species and that CCA protects against lipid and
      protein damage induced by activated oxygen.

PMID- 2242040
TI  - Inhibition of protein kinase C by the tyrosine kinase inhibitor erbstatin.
AB  - We examined the tyrosine kinase inhibitor erbstatin and several derivatives for
      their ability to inhibit serine/threonine protein kinases in vitro. Erbstatin was
      found to inhibit protein kinase C (PKC) with an IC50 of 19.8 +/- 3.2 microM. A
      trihydroxy derivative of erbstatin inhibited PKC with similar potency, whereas
      the corresponding methoxy derivatives were inactive. Inhibition by erbstatin was
      competitive with ATP (Ki = 11.0 +/- 2.3 microM) and non-competitive with the
      phosphate acceptor, either histone or the synthetic peptide kemptide. Action of
      erbstatin at the catalytic site of PKC was further indicated by the findings that
      it inhibited the catalytic fragment of PKC but did not inhibit the interaction of
      phorbol ester with the intact enzyme. Erbstatin had a similar potency against
      three PKC isozymes (alpha, beta, and gamma) examined. In addition, erbstatin was
      found to inhibit other serine/threonine kinases (assayed at their Km for ATP).
      The greatest potency was observed versus the cyclic nucleotide-dependent kinases,
      while lower potency was seen versus myosin light chain kinase. These observations
      are discussed in terms of the structure and kinetic properties of PKC and the
      epidermal growth factor receptor tyrosine kinase.

PMID- 2242039
TI  - Mechanism of the microsomal demethylation of 1-aryl-3,3-dimethyltriazenes.
AB  - The metabolism of 1-aryl-3,3-dimethyltriazenes by phenobarbital-induced rat liver
      microsomes results in the formation of 1-aryl-3-methyltriazenes and formaldehyde.
      Intermolecular kinetic deuterium isotope effects for the reaction are found to be
      1.0 (+/- 0.03) in both Vmax and Vmax/Km, respectively. The intramolecular kinetic
      deuterium isotope effects in Vmax and Vmax/Km are found to be 4.8 (+/- 0.05).
      There is no correlation of Vmax or Vmax/Km with calculated ionization potentials
      of the triazenes. For 3-ethyl-3-methyltriazene comparison of values of Vmax and
      Vmax/Km for ethyl vs methyl loss give rise to values of 3.68 in Vmax and 2.02 in
      Vmax/Km. Thus, loss of an ethyl group is favoured. The results are discussed in
      terms of a mechanism in which the triazene undergoes direct hydrogen atom
      abstraction to form a carbon centred radical. This radical subsequently forms a
      hydroxymethyltriazene that collapses to formaldehyde and a monomethyltriazene.

PMID- 2242041
TI  - Short term treatment by fenofibrate enhances oxidative activities towards long
      chain fatty acids in the liver of lean Zucker rats.
AB  - Lean Zucker rats were dosed orally for 1 week with fenofibrate (100 mg/kg/day).
      Liver weights of treated rats, expressed as per cent of body weight, were
      increased, while protein, DNA and triacylglycerol contents were not changed to
      any great extent per gram of liver, but increased when expressed per whole liver.
      Compared with the control animals, activities of fatty acid oxidase, of the
      peroxisomal fatty acid-oxidizing system and of catalase were markedly enhanced by
      fenofibrate, both per gram of liver and per total liver, while urate oxidase
      activity was slightly depressed when expressed per gram of liver. The activity of
      cytochrome c oxidase used as a mitochondrial marker was only higher when
      expressed per total liver. Besides, fenofibrate treatment induced a pronounced
      increase in the mitochondrial activities of carnitine palmitoyl- and
      acetyltransferases, of palmitoyl-CoA dehydrogenase and of carnitine-dependent
      oleate oxidation. Fenofibrate also enhanced significantly the carnitine content
      in liver and hepatic mitochondria. Malonyl-CoA content per gram of liver was
      found to be twice as high as in control rats, while the sensitivity of carnitine
      acyltransferase I to malonyl-CoA inhibition was hardly altered. The drug enhanced
      the percentage of palmitic acid in lipids of liver, but not in adipose tissues.
      The present data show that fenofibrate induced greater oxidative activities
      towards fatty acids, even in the lean animal. This stimulation could be related
      to the energy used for building new cells. In turn, at the same time of
      treatment, an enhanced fatty acid synthesis would provide specific fatty acids
      for the formation of new membranes. This latter effect will eventually disappear
      and the maintenance of a higher fatty acid oxidation may explain part of the
      overall hypolipaemic effect of fenofibrate.

PMID- 2242042
TI  - Distribution of cytochrome P450 activities towards alkoxyresorufin derivatives in
      rat brain regions, subcellular fractions and isolated cerebral microvessels.
AB  - The regional and subcellular distributions of rat brain cytochrome P450 and
      cytochrome P450-dependent activities were examined. Cytochrome P450 was found to
      be mainly localized in mitochondria in all the six cerebral regions studied. The
      activities of the isoforms mostly implicated in drug metabolism, cytochromes P450
      b and c, were measured by the dealkylation of two alkoxyresorufins, that are
      sensitive probe substrates for these isoforms. These activities have been
      measured in microsomal and mitochondrial fractions obtained from six different
      regions in male rat brains, as well as in microvessels. Resorufin derivatives
      dealkylation specific activities were higher in brain microsomal fractions than
      in hepatic ones in all the six regions examined when results were expressed per
      cytochrome P450 content. These brain microsomal specific activities were also
      higher than in mitochondrial fractions. Olfactory bulbs showed the highest
      cytochrome P450 content and activities in both microsomal and mitochondrial
      fractions. A sex-linked difference in cytochrome P450-dependent activities was
      also found. After an in vivo inducing pretreatment of rats, only 3
      methylcholanthrene induced ethoxyresorufin O-deethylase activity, in the three
      preparations studied. These results provided (i) direct evidence that cytochromes
      P450 b and c isoforms are active in brain microsomal fractions, with regional and
      sex-linked differences, and (ii) the first demonstration of cytochrome P450
      dependent activities in isolated rat brain microvessels.

PMID- 2242043
TI  - In vitro effects of eight-carbon fatty acids on oxidations in rat liver
      mitochondria.
AB  - Sodium valproate, a commonly used anticonvulsant agent, is a simple branched
      chain fatty acid which interferes with beta-oxidation and ammonia metabolism in
      most patients, with hepatotoxic consequences in some cases. Rat liver
      mitochondria incubated with valproate displayed time-dependent inhibitions of
      state 3 oxidation rates with all the substrates tested, but most markedly with
      glutamate, pyruvate, alpha-ketoglutarate and acylcarnitines (Ki = 125 microM with
      glutamate and palmitoylcarnitine, and 24 microM with pyruvate). The inhibition of
      glutamate appeared to be specifically directed against the glutamate
      dehydrogenase pathway of this oxidation. Valproate was less effective when added
      to uncoupled mitochondria, suggesting the formation of an inhibitory species by
      an ATP-dependent mechanism. Mitochondria from clofibrate-treated rats were less
      sensitive to valproate inhibition. Neither fasting nor the presence of 1 mM L
      carnitine affected the inhibition of beta-oxidation. The branched-chain isomer, 2
      ethylhexanoic acid, had similar effects to valproate, but the straight-chain
      octanoic acid was totally different in its spectrum of actions on mitochondria.
      The data support the theory that valproate may inhibit by sequestration of CoA as
      valproyl-CoA, but also suggest that there are other mechanisms responsible for
      some of the inhibitions. Furthermore, it argued that while mitochondrial
      respiration is decreased, valproate is not an inhibitor of oxidative
      phosphorylation per se.

PMID- 2242044
TI  - Morphine-induced effects on hepatic metabolism in the male rat depends on an
      intact pituitary gland.

PMID- 2242045
TI  - Cytosolic phenol and steroid sulphotransferase activities are decreased in a sex
      dependent manner in streptozotocin-induced diabetic rats.

PMID- 2242046
TI  - Altered operant behavior of adult rats after perinatal exposure to a 60-Hz
      electromagnetic field.
AB  - Rats were sham exposed or exposed perinatally to a 60-Hz electromagnetic field,
      22 days in utero and the first 8 days post partum. Each of the 30 once-daily
      exposures was 20 h in duration. The electric component of the field was vertical
      30 kV/m rms, and the magnetic field component was 100 microTG rms. Later, as
      adults, male rats were trained to emit an operant response when reinforced with
      food on a multiple, random-interval schedule. Exposed rats (N = 21) gradually
      came to respond at significantly lower rates than did sham-exposed controls (N =
      20). This finding was confirmed and extended in a second, independently performed
      experiment. After a sequence including operant conditioning followed by
      experimental extinction of responding and then by a suspension of conditioning
      and finally by more than a month of reconditioning, slower rates of responding
      were found to persist in the adult animals. The evidence of altered behavior
      several months after combined, fetal-neonatal exposure to an electromagnetic
      field presents an interesting contrast with other findings: Field-exposed rats
      did not differ from sham-exposed rats in terms of body mass, physical appearance,
      grossly observed activity level, or incidence of disease.

PMID- 2242047
TI  - Magnetic resonance imaging: calculation of rates of energy absorption by a human
      torso model.
AB  - The three-dimensional impedance method was used to estimate specific absorption
      rate (SAR) in a human-torso model during exposure to the time-varying and static
      magnetic fields used in magnetic resonance imaging (MRI). Analytical data for
      discrete tissues as well as the entire torso are presented. Generalized equations
      were derived that enable calculation of whole-torso SAR over a broad range of
      conditions. In addition, the impedance method can generate data about internal
      distributions of SAR, which are needed to predict critical organs that might
      undergo excessive elevations of temperature. Fair to good agreement was found
      between impedance-method SAR and those predicted by simple phenomenological
      models.

PMID- 2242048
TI  - Dominant lethal studies in male mice after exposure to a 50-Hz electric field.
AB  - Male C3H/He mice were sham-exposed or exposed continuously for 2 weeks to a
      vertical, 50-Hz, electric field at 20 kV/m rms. Densities of currents induced in
      the testes are estimated to be near 100 microA/m2. After the exposure, each male
      was mated with two different female mice each week during a period of 8 weeks. By
      this schedule, female mice were impregnated with sperm that had been exposed to
      the electric field at different stages of the spermatogenic cycle. No significant
      differences as a function of exposure condition were observed in pregnancy rates
      or in survival of embryos before or after implantation. The absence of effects
      was not due to insensitivity of assays; other mice that were exposed to X-rays
      (dose to testes = 1.5 Gy) presented reliable evidence of mutagenesis.

PMID- 2242049
TI  - A model to assess personal exposure to ELF magnetic fields from common household
      sources.
AB  - Emission data are inadequate to characterize the contribution of a source to the
      total personal extremely-low-frequency (ELF) magnetic field exposure. In this
      paper, a simple model is proposed that takes into consideration the position of
      the subject with respect to the source and the duration of exposure. The magnetic
      field is spatially averaged over the whole body of the exposed subject and
      integrated over time. Exposure is regarded as significant if it approaches or
      exceeds 400 microT-h/year. By use of this method, the ELF magnetic fields
      generated by several household sources were compared with the levels of
      residential external sources, to assess their relative significance. Some common
      domestic electrical appliances are found to be responsible for an exposure
      comparable to that from power lines. When the model is used to assess exposure to
      electric blankets, apparently conflicting findings may be reconciled.

PMID- 2242050
TI  - Proflavin and microwave radiation: absence of a mutagenic interaction.
AB  - The potential ability of radiofrequency electromagnetic radiation (RFR) in the
      microwave range to induce mutagenesis, chromosomal aberrations, and sister
      chromatid exchanges in mammalian cells is being explored in our laboratories. In
      addition, we have also been examining the ability of simultaneous exposure to RFR
      and chemical mutagens to alter the genotoxic damage induced by chemical mutagens
      acting alone. We have performed experiments to determine whether there is an
      interaction between 2.45-GHz, pulsed-wave, RFR and proflavin, a DNA-intercalating
      drug. The endpoint studied was forward mutation at the thymidine kinase locus in
      L5178Y mouse leukemic cells. Any effect on the size distribution of the resulting
      colonies of mutated cells was also examined. The exposures were performed at net
      forward powers of 500 or 600 W, resulting in a specific absorption rate (SAR) of
      approximately 40 W/kg. The culture-medium temperature reached a 3 degrees C
      maximal increase during the 4-h exposure; appropriate 37 degrees C and convection
      heating temperature controls (TC) were performed. In no case was there any
      indication of a statistically significant increase in the induced mutant
      frequency due to the simultaneous exposure to RFR and proflavin, as compared with
      the proflavin exposures alone. There was also no indication of any change in the
      colony-size distribution of the resulting mutant colonies, neither, and there was
      no evidence in these experiments of any mutagenic action by the RFR exposure
      alone.

PMID- 2242051
TI  - Importance of alignment between local DC magnetic field and an oscillating
      magnetic field in responses of brain tissue in vitro and in vivo.
AB  - The frequency dependence of the electric and magnetic (EM)-field-induced release
      of calcium ions from an in vitro brain tissue preparation has been shown to be a
      function of the density of the local DC magnetic field (Bdc). In this study, we
      demonstrate that the relative orientation of the Bdc and the magnetic component
      (Bac) of a 315-Hz EM signal (15 Vrms/m and 61 nTrms) are crucial for the induced
      release to be observed. The induced release occurs only when the Bdc and the Bac
      are perpendicular, and not when they are parallel. This finding is consistent
      with a magnetic resonance-like transduction mechanism for the conversion of EM
      energy into a physicochemical change, and contrasts with the requirement for
      parallel Bdc and Bac components in the diatom-mobility experiments of Smith et
      al. A review of the exposure conditions in the rat behavioral experiments
      conducted by Thomas et al. identifies unhydrated calcium and zinc ions as
      alternatives to lithium ions as candidates for interaction under parallel
      magnetic-field orientations but fails to reject perpendicular orientations as an
      alternative basis for the phenomenon. Investigators that attempt to confirm the
      rat behavioral experiments should be aware of the conflicting exposure conditions
      that can be assumed to be operative, and they should design their experiments to
      test all conditions accordingly.

PMID- 2242052
TI  - Development of chicken embryos in a pulsed magnetic field.
AB  - Six independent experiments of common design were performed in laboratories in
      Canada, Spain, Sweden, and the United States of America. Fertilized eggs of
      domestic chickens were incubated as controls or in a pulsed magnetic field (PMF);
      embryos were then examined for developmental anomalies. Identical equipment in
      each laboratory consisted of two incubators, each containing a Helmholtz coil and
      electronic devices to develop, control, and monitor the pulsed field and to
      monitor temperature, relative humidity, and vibrations. A unipolar, pulsed,
      magnetic field (500-microseconds pulse duration, 100 pulses per s, 1-microT peak
      density, and 2-microseconds rise and fall time) was applied to experimental eggs
      during 48 h of incubation. In each laboratory, ten eggs were simultaneously sham
      exposed in a control incubator (pulse generator not activated) while the PMF was
      applied to ten eggs in the other incubator. The procedure was repeated ten times
      in each laboratory, and incubators were alternately used as a control device or
      as an active source of the PMF. After a 48-h exposure, the eggs were evaluated
      for fertility. All embryos were then assayed in the blind for development,
      morphology, and stage of maturity. In five of six laboratories, more exposed
      embryos exhibited structural anomalies than did controls, although putatively
      significant differences were observed in only two laboratories (two-tailed Ps of
      .03 and less than .001), and the significance of the difference in a third
      laboratory was only marginal (two-tailed P = .08). When the data from all six
      laboratories are pooled, the difference in incidence of abnormalities in PMF
      exposed embryos (approximately 25 percent) and that of controls (approximately 19
      percent), although small, is highly significant, as is the interaction between
      incidence of abnormalities and laboratory site (both Ps less than .001). The
      factor or factors responsible for the marked variability of inter-laboratory
      differences are unknown.

PMID- 2242053
TI  - Electric fields and surface charges induced by ELF magnetic fields.
AB  - A method is described for evaluating electric fields induced by ELF magnetic
      fields into electrically inhomogeneous, low-conductivity (less than 5 S/m)
      structures. It is applied to cylinders and spheres, and numerical results are
      given for electrical properties that are representative of some tissues, or of
      cells embedded either in saline solution or a tissue matrix. Surface currents on
      spherical cell boundaries are estimated and compared with thermal noise due to
      ion motion.

PMID- 2242054
TI  - [Cloning, structure and expression of the full-size lon gene in Escherichia coli
      coding for ATP-dependent La-proteinase].
AB  - Assembly of the full Escherichia coli K-12 lon gene from the EcoRI--SphI fragment
      of the bacterial DNA ("modified" gene) cloned and sequenced earlier and the PstI
      fragment of the same DNA containing 3'-terminal region of the lon gene has been
      performed. Both "modified" and full genes showed all phenotype properties of lon
      gene. The complete nucleotide sequence of the gene (2770 bp) coding for the 784
      amino acid sequence of protease La was determined. Location of catalytically
      active serine, histidine and aspartic acid residues was suggested, and ATP
      binding site found. The lon gene and protease La structures we found are compared
      with those described independently and differences observed are discussed.

PMID- 2242055
TI  - [Automated H-phosphonate synthesis of oligoribonucleotides using 2'-O
      tetrahydropyranyl protective group].

PMID- 2242056
TI  - [The structure of carbohydrate chains of riboflavin-binding glycoprotein from
      chicken egg protein. III. 1H-NMR spectroscopy (500 MHz) of neutral fucosylated
      oligosaccharides].
AB  - Using LiBH4/ButOH treatment, oligosaccharides were cleaved off the hen egg white
      riboflavin-binding glycoprotein. HPLC led to the isolation of four fucose
      containing oligosaccharide alditols, whose structure was elucidated by means of
      1H NMR 500 MHz spectroscopy. The main fucosylated oligosaccharide, also present
      in hen ovomucoid, was found to be a biantennary carbohydrate chain of N
      acetyllactosamine type.

PMID- 2242057
TI  - [The use of antibodies against DNA modified by trans-diamminedichloroplatinum for
      identification of specific DNA sequences].
AB  - DNA modified by trans-diamminedichloroplatinum (trans-DDP) is suggested as an
      effective probe for non-isotopic hybridisation. Highly specific anti trans-DDP
      DNA antibodies and peroxidase-conjugated antibodies to antirabbit Ig and protein
      A system have been used for the hybrids visualisation. This method allows one to
      detect 2 pg/mm2 DNA.

PMID- 2242058
TI  - The American College of Rheumatology criteria for the classification and
      reporting of osteoarthritis of the hand.
AB  - Clinical criteria for the classification of symptomatic idiopathic (primary)
      osteoarthritis (OA) of the hands were developed from data collected in a
      multicenter study. Patients with OA were compared with a group of patients who
      had hand symptoms from other causes, such as rheumatoid arthritis and the
      spondylarthropathies. Variables from the medical history, physical examination,
      laboratory tests, and radiographs were analyzed. All patients had pain, aching,
      or stiffness in the hands. Patients were classified as having clinical OA if on
      examination there was hard tissue enlargement involving at least 2 of 10 selected
      joints, swelling of fewer than 3 metacarpophalangeal joints, and hard tissue
      enlargement of at least 2 distal interphalangeal (DIP) joints. If the patient had
      fewer than 2 enlarged DIP joints, then deformity of at least 1 of the 10 selected
      joints was necessary in order to classify the symptoms as being due to OA. The 10
      selected joints were the second and third DIP, the second and third proximal
      interphalangeal, and the trapeziometacarpal (base of the thumb) joints of both
      hands. Criteria derived using the "classification tree" method were 92% sensitive
      and 98% specific. The "traditional format" classification method required that at
      least 3 of these 4 criteria be present to classify a patient as having OA of the
      hand. The latter sensitivity was 94% and the specificity was 87%. Radiography was
      of less value than clinical examination in the classification of symptomatic OA
      of the hands.

PMID- 2242059
TI  - Aspirin, hydroxychloroquine, and hepatic enzyme abnormalities with methotrexate
      in rheumatoid arthritis.
AB  - Levels of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic
      pyruvic transaminase (SGPT) in patients with rheumatoid arthritis from 5 centers
      involved in the Arthritis, Rheumatism, and Aging Medical Information System were
      correlated with the use of specific antirheumatic medications. Elevated levels of
      SGOT and SGPT were most frequent in patients taking salicylates and methotrexate
      (MTX) and least frequent in patients taking hydroxychloroquine. The combination
      of MTX and salicylates greatly increased the frequency of abnormal liver enzyme
      values. In contrast, the addition of hydroxychloroquine to a regimen of either
      MTX or aspirin essentially eliminated the SGOT and SGPT abnormalities. Results
      from all 5 centers were consistent and remained so after adjustment for age, sex,
      and disease duration. Knowledge of these important drug interactions may permit
      continuation of MTX therapy in patients in whom the drug might otherwise be
      discontinued.

PMID- 2242060
TI  - The post-occlusive hyperemic response in patients with systemic sclerosis.
AB  - We investigated post-ischemic hyperreactive cutaneous blood flow in patients with
      primary Raynaud's phenomenon and Raynaud's phenomenon secondary to systemic
      sclerosis (SSc). Reactive hyperemia was measured over a locally warmed area of
      skin, using a laser Doppler flowmeter, following 5 minutes of suprasystolic
      occlusion of blood flow. We found that patients with primary Raynaud's phenomenon
      had normal post-ischemic blood flow compared with normal controls. In contrast,
      patients with SSc had reduced levels of baseline and peak blood flow compared
      with either the primary Raynaud's phenomenon patients or the normal subjects.
      Infusion of carbaprostacyclin, a potent prostacyclin analog vasodilator, did not
      increase blood flow in the SSc patients, nor did it restore the reactive
      hyperemic response. These findings are consistent with the hypothesis that
      patients with the nonvasoconstricted condition of SSc have fixed structural
      defects that limit cutaneous microvascular blood flow.

PMID- 2242061
TI  - Diffusing capacity of the lung and nifedipine in systemic sclerosis.
AB  - Lung involvement in systemic sclerosis may be due in part to a functional
      abnormality of the pulmonary vasculature. To investigate the possible role of a
      pulmonary vasospastic process in this disorder, 21 non-smoking patients who had
      no evidence of cardiac disease or pulmonary hypertension were evaluated with
      pulmonary function tests prior to administration of nifedipine, 30 minutes after
      a single oral dose of nifedipine (20 mg), and after 4 weeks of treatment with
      nifedipine (10 mg 3 times daily). Treatment with nifedipine did not significantly
      change any of the pulmonary function values, except for the carbon monoxide
      diffusing capacity (DLCO). The linear trend between the individual DLCO values at
      baseline and their changes immediately following the initial 20-mg dose of
      nifedipine (r = -0.603, P = 0.02) and after 4 weeks of treatment (r = -0.636, P =
      0.01) showed that the lower the DLCO value at baseline, the greater the
      improvement caused by nifedipine. These findings support the hypothesis of a
      potentially reversible pulmonary vasospasm in systemic sclerosis and suggest that
      nifedipine may be useful in the treatment of lung disease in these patients;
      however, further studies are needed.

PMID- 2242062
TI  - A subluxing arthropathy associated with the anti-Jo-1 antibody in
      polymyositis/dermatomyositis.
AB  - Of 180 patients with polymyositis/dermatomyositis (PM/DM) seen at the University
      of Pittsburgh and affiliated hospitals since 1975, 21 of 100 tested positive for
      the anti-Jo-1 antibody. Sixteen of the 21 patients were women and 18 were white.
      Fifteen had adult PM, 4 had myositis in overlap with scleroderma, and 2 had adult
      DM. Evidence of interstitial lung disease was found in 12 of 18 anti-Jo-1
      positive patients (67%), but in only 15 of 79 anti-Jo-1 negative patients (19%)
      (P less than 0.0002). The 21 anti-Jo-1 positive patients were divided into 3
      separate groups based on the observed articular findings. Four patients had a
      deforming, predominantly nonerosive arthropathy with subluxations of the distal
      interphalangeal joints, especially the thumbs. Eight patients had a nondeforming
      arthropathy primarily affecting the small joints of the hands, wrists, shoulders,
      and knees. Those with deformities had a longer duration of arthritis compared
      with those with nondeforming arthropathy (mean 14.5 years versus 3.3 years). Nine
      anti-Jo-1 positive patients had no joint arthropathy. Three of 4 patients with
      deformities have required articular reconstructive surgery for subluxation, with
      2 having associated subcutaneous calcinosis.

PMID- 2242063
TI  - Evidence for impaired T cell DNA methylation in systemic lupus erythematosus and
      rheumatoid arthritis.
AB  - Procainamide and hydralazine inhibit T cell DNA methylation and induce
      autoreactivity in cloned CD4+ T cells. These drugs also induce an autoimmune
      syndrome, suggesting a possible relationship between DNA hypomethylation, T cell
      autoreactivity, and certain autoimmune diseases. To test this relationship, DNA
      methylation was studied in T cells from patients with rheumatoid arthritis and
      patients with systemic lupus erythematosus, and was found to be impaired. These
      results support a relationship between DNA hypomethylation and some forms of
      autoimmune disease.

PMID- 2242064
TI  - Association of labial salivary gland histopathology with clinical and serologic
      features of connective tissue diseases.
AB  - Focal sialadenitis is now widely accepted as an objective criterion for the oral
      component of Sjogren's syndrome (xerostomia). We investigated the association
      between labial salivary gland histopathologic changes and the clinical and
      serologic features of 192 patients with suspected connective tissue disorders. A
      retrospective review of the medical records of all patients was performed, and
      historical, physical, laboratory, histologic, and roentgenographic data were
      abstracted. Each patient had undergone labial salivary gland biopsy as part of a
      rheumatologic evaluation. There were significant associations between positive
      findings on lip biopsy and the presence of keratoconjunctivitis sicca (P =
      0.013), positive antinuclear antibodies (titer greater than or equal to 1:80) (P
      = 2 x 10(-8)), and positive Ro antibodies (P = 1 x 10(-8)). However, sicca
      symptoms and glandular enlargement were not statistically associated with
      positive findings on lip biopsy. Features predictive of a positive lip biopsy
      included Ro antibodies (P = 0.914), keratoconjunctivitis sicca (P = 0.700), and
      positive antinuclear antibodies (P = 0.590).

PMID- 2242065
TI  - Functional studies of soluble low-affinity interleukin-2 receptors in rheumatoid
      synovial fluid.
AB  - Since abnormal regulation of interleukin-2 (IL-2) has been demonstrated in
      rheumatoid arthritis (RA), the functional role of low-affinity soluble IL-2
      receptors (sIL-2R) purified from RA synovial fluids (SF) was studied. Picomolar
      levels of sIL-2R were detected in RA SF using an enzyme-linked immunosorbent
      assay. Levels were higher in serum and SF from RA patients than in controls (P
      less than 0.001) and higher in RA SF than in paired RA serum (P less than 0.01).
      Soluble IL-2R from RA SF had estimated molecular weights of 40-50 kd and 80-100
      kd by gel filtration analysis. The 80-100-kd peak is likely to be a dimer of the
      40-50-kd peak, since a single 45-kd peak was found after elution from sodium
      dodecyl sulfate-polyacrylamide gels. Since inhibitory activity for lymphocyte
      proliferation was found in the 80-100-kd range, the sIL-2R were purified with an
      anti-CD25 affinity column and further analyzed. The purified fractions did not
      interfere with the proliferation of mitogen-stimulated lymphocytes or with the
      binding of radiolabeled IL-2 to CTLL-2 cells, although direct binding of IL-2 was
      demonstrated. The affinity of sIL-2R from RA SF for binding IL-2 was in the range
      of 25 nM, which is similar to the affinity of sIL-2R purified from a human T cell
      clone, indicating that both sIL-2R are low-affinity receptors for IL-2. We
      conclude that the concentration and binding affinity of low-affinity sIL-2R
      purified from RA SF render them unable to interfere with IL-2-related activities.

PMID- 2242066
TI  - Interleukin-1-induced interleukin-6 is required for the inhibition of
      proteoglycan synthesis by interleukin-1 in human articular cartilage.
AB  - Cartilage from normal controls, patients with osteoarthritis, and patients with
      rheumatoid arthritis produced no interleukin-6 (IL-6) in culture. However, IL-1
      induced massive production of IL-6 (up to 135 ng/ml) in cartilage from all 3
      sources, in a dose-dependent manner (in some cases, a peak value was reached).
      The levels of induced IL-6 were similar to those found in rheumatoid arthritis
      synovial fluid. At IL-1 concentrations that induced almost complete inhibition of
      proteoglycan (PG) synthesis, IL-6 production could still be increased
      considerably. Exogenous IL-6 inhibited PG synthesis by up to 25%. IL-1-induced
      inhibition of PG synthesis was reversed by antibodies against recombinant human
      IL-6. These results suggest that IL-6 is required for the IL-1-induced inhibition
      of PG synthesis.

PMID- 2242067
TI  - Dermal mast cell degranulation in systemic sclerosis.
AB  - Paired biopsy samples from involved and uninvolved skin were obtained from 19
      patients with generalized scleroderma (11 with early, progressive disease and 8
      with late, improving disease). Skin biopsy samples were double stained for mast
      cell granules and for mast cell membrane. The number of mast cells was increased
      in patients with systemic sclerosis (SSc), in both involved and uninvolved skin
      and in both early and late disease. There was an increase in the number of
      degranulated mast cells in the involved skin of patients with both early and late
      disease and in the not-yet-involved skin of patients with early disease; however,
      there was no increase in the number of degranulated mast cells in areas of
      previously involved but now normal skin of patients with late disease. Increases
      in mast cell number and degranulation precede clinically apparent dermal fibrosis
      in SSc. These observations and the absence of mast cell degranulation in
      regressing skin suggest a participatory role of the mast cell in the clinical
      progression of skin changes in SSc.

PMID- 2242068
TI  - Spontaneous rheumatoid-like arthritis in a line of mice sensitive to collagen
      induced arthritis.
AB  - Twenty-eight percent of 13-month-old male mice of the high antibody responder
      line of Biozzi's selection I (HI) spontaneously developed a long-lasting
      inflammatory arthritis. This disease was clinically and histologically similar to
      human rheumatoid arthritis. The synovium of joints and some tendons was
      hypertrophied, with thickening of the synovial cell layer and infiltration by
      polymorphonuclear and mononuclear leukocytes. In some cases, synovial pannus
      formation led to destructive damage of articular cartilage and bone. Rheumatoid
      factor and antinuclear, anti-DNA, and anti-type II collagen (CII) antibodies were
      often found in the sera of both arthritic mice and clinically normal littermates.
      The presence of CII autoantibodies in this line of mice suggests that a
      potentially harmful anti-CII T cell autoimmunity can also develop spontaneously
      and lead to joint damage. Moreover, HI mice are also susceptible to collagen
      induced arthritis, while a closely related mouse line (HII) is resistant to both
      diseases. These data support the hypothesis that collagen-induced arthritis is
      pathogenetically related both to this spontaneous arthritis and to rheumatoid
      arthritis.

PMID- 2242069
TI  - Treatment of psoriatic arthritis with oral 1,25-dihydroxyvitamin D3: a pilot
      study.
AB  - We conducted a 6-month open-label trial in which 10 patients with active
      psoriatic arthritis received 2 micrograms of oral 1,25-dihydroxyvitamin D3 daily.
      Statistically significant improvement was noted in the tender joint count and
      physician global impression. Of these 10 patients, 4 had substantial (greater
      than or equal to 50%) improvement, and 3 had moderate (greater than or equal to
      25%) improvement in the tender joint count. Two patients were unable to receive
      therapeutic doses because of hypercalciuria. High-dose vitamin D may be a useful
      therapeutic agent for psoriatic arthritis.

PMID- 2242070
TI  - Nontropical pyomyositis as a cause of subacute, multifocal myalgia in the
      acquired immunodeficiency syndrome.
AB  - We report a case of nontropical pyomyositis in a patient with acquired
      immunodeficiency syndrome and disseminated Mycobacterium avium infection, in
      which severe myalgia was the presenting symptom over several weeks. Multifocal
      muscle lesions were identified by gallium scanning and magnetic resonance imaging
      techniques. The epidemiology, possible pathogenesis, clinical features,
      diagnostic imaging, and therapy are reviewed. Early suspicion of nontropical
      pyomyositis in severely immunocompromised patients with "cryptic" myalgia is
      recommended.

PMID- 2242071
TI  - Outbreak of spontaneous staphylococcal arthritis and osteitis in mice.
AB  - Staphylococcus aureus is the most common bacterial species found in association
      with nongonococcal bacterial arthritis in humans. We present here the first
      description of spontaneous bacterial arthritis and osteitis in mice. Clinically,
      the most obvious findings were swelling and/or ankylosis of hindpaws and nodose
      changes of the tail. The prevalence of arthritis and osteitis ranged from 0% to
      greater than 50% of the mice studied, depending on the mouse strain. The most
      prominent histopathologic feature of the arthritis was hypertrophy of the
      synovial tissue and destruction of cartilage and underlying bone. Most of the S
      aureus-infected mice displayed an identical phage type, which was also the only S
      aureus phage type found in skin isolates from clinically healthy mice. However, a
      few S aureus isolates were not typeable, indicating that an additional strain(s)
      might cause bacterial arthritis in mice.

PMID- 2242073
TI  - Subcutaneous cholesterol crystal deposition in the left index finger.

PMID- 2242072
TI  - Rescue of interleukin-1 activity by leucovorin following inhibition by
      methotrexate in a murine in vitro system.
AB  - We have recently shown that methotrexate (MTX) inhibits interleukin-1 (IL-1)
      activity in vitro. This effect may play an important role in the rapid
      antiinflammatory action of MTX in rheumatoid arthritis. In the present study, we
      showed that the inhibition of IL-1 activity in vitro by MTX is dependent on
      folate pathways since, after the addition of leucovorin, the inhibitory effect of
      MTX was abolished. These findings may shed more light on the mechanism of action
      of MTX in rheumatoid arthritis. They also point to the fact that some IL-1
      activities may be dependent on intracellular folate pathways.

PMID- 2242074
TI  - Anticonflict effects of low doses of chloroquine.
AB  - The effects of low doses (0.125-1 mg/kg) of chloroquine were investigated in a
      modified Vogel's conflict paradigm and in the light-dark transition box. In the
      Vogel's conflict paradigm, the compound was found to exert a marked dose
      dependent increase in the number of shocks accepted by rats in the conflict
      situation, thus indicating an anxiolytic-like action. In the light-dark
      transition box, chloroquine increased the number of transitions between the two
      compartments and the time spent in the lighted area by mice. Thus chloroquine
      exhibited anticonflict properties in two animal models of anxiety. It is
      therefore concluded that chloroquine might possess antianxiety-like properties in
      low doses.

PMID- 2242075
TI  - [Genotoxicity of a standardized Hypericum extract].
AB  - St. John's wort (Hypercum perforatum) contains hypericin and hypericin-like
      substances as well as flavonoids, of which particularly Quercetin has generated a
      wide-spread controversial discussion with respect to mutagenic action. The
      genotoxicity of a standardized aqueous ethanolic Hypericum extract (Hypericum
      extract Steigerwald, Psychotonin M) was verified in different in-vivo and in
      vitro testsystems with mammalian cells. The in-vitro investigations were
      performed with the HGPRT (hypoxanthine guanidine phosphoribosyl transferase)
      test, UDS (unscheduled DNA synthesis)-test and with the cell transformation test
      using Syrian hamster embryo cells. Both the in-vitro tests as well as the in-vivo
      tests--fur spot test of the mouse and the chromosome aberration test with the
      bone marrow cells of the chinese hamster--were negative, giving completely no
      indication of a mutagenic potential of Hypericum extract. These investigations
      lend support to the view that results from bacterial short-term tests are of very
      limited transferability to human.

PMID- 2242076
TI  - Effect of zonisamide on serum immunoglobulins.
AB  - Zonisamide (AD-810) was additionally administered to 19 patients with refractory
      epilepsy who had been receiving multiple antiepileptic drugs and the effect of
      zonisamide on serum immunoglobulins was investigated. Zonisamide was administered
      in daily dose of 200-700 mg (mean 389 mg) for the period of 82-1,470 days (mean
      863 days). The serum levels of IgG, IgA and IgM were determined before
      administration and at intervals of 3 or 6 months over the period of a maximum of
      48 months after initiation of administration. There was no significant change in
      immunoglobulin levels at any time after initiation of zonisamide treatment as
      compared with the pretreatment levels. No significant correlation was found
      between the dose or serum concentration of zonisamide and the immunoglobulin
      levels.

PMID- 2242078
TI  - Differences in ischaemic myocardial potassium leakage after treatment with the
      calcium antagonist anipamil or the beta-blocker atenolol.
AB  - The abilities of the new calcium antagonist anipamil as well as the beta-blocker
      atenolol to reduce the amount of K+ released into the extracellular space during
      the first minutes of acute coronary artery occlusion were investigated in
      anaesthetized pigs. [K+]e was continuously measured epicardially with ion
      selective electrodes. Immediately after starting an occlusion [K+]e rose steeply
      from normal plasma levels of 3.5 mmol/l to values about three times as high at
      the end of the 6-min occlusion. This was reproducible in a second and third
      occlusion in the untreated control group. In the treatment groups either anipamil
      (0.5; 1.0 mg/kg) or atenolol (0.3 mg/kg) were injected intravenously 10 min
      before the second occlusion. Anipamil inhibited K+ loss into the extracellular
      space dose relatedly and significantly throughout the 6-min occlusion period,
      whereas atenolol showed no protection. The cardioprotective effect of anipamil
      was also demonstrated in a third occlusion 60 min post application. This
      different profile cannot be explained by differences in the ability of the two
      drugs to lower myocardial oxygen consumption; indeed this was only achieved after
      atenolol. It is concluded that anipamil exerted a direct protective effect on the
      cardiac myocyte level during ischaemia.

PMID- 2242077
TI  - Dose effects of temazepam in transient insomnia.
AB  - A transient insomnia model, the "first night" effect in the sleep laboratory, was
      used to assess the dose range for the hypnotic and sleep stage effects of
      temazepam. 201 healthy, normal subjects (97 men and 104 women), 21 to 49 years
      old, with no sleep complaints were studied. Each was randomly assigned to receive
      either placebo, 7.5, 15, or 30 mg temazepam hard gelatin capsules (Restoril)
      administered double-blind 30 min before bedtime on their first night in the sleep
      laboratory. Over the 8-h polysomnogram total sleep time and sleep efficiency
      increased significantly in a linear fashion with increasing doses of temazepam.
      Sleep tendency was significantly reduced by increasing doses again in a linear
      manner. Wake time during the sleep period was reduced significantly only by the
      higher dose. The percentage of stage 1 sleep was reduced and the percentage of
      stage 2 sleep was increased, each linearly with increasing doses. These data are
      the first to demonstrate the hypnotic effects of a 7.5 mg dose of temazepam and
      also support previous studies of 15 and 30 mg temazepam administered to chronic
      insomniacs. They also illustrate the utility of the "first night" effect as a
      model of transient insomnia.

PMID- 2242079
TI  - [Effect of preoral and transdermal insulin preparations on blood glucose
      concentration in mice].
AB  - Effects of oral and transdermal insulin applications on blood glucose
      concentration were investigated in nonconditioned, healthy mice. Insulin was
      applied in a special lipid formulation which contained no chemical enhancers or
      protease inhibitors. In comparison to control applications with same volumes of
      insulin free lipid formulations significant and reproducible blood sugar lowering
      effects were found with the insulin-lipid formulation. Additional control
      applications of the same dosages of oral aqueous insulin solutions differed only
      slightly to the insulin free lipid formulations. Same dosages of s.c.- and p.o.
      applications of the insulin-lipid-formulation induced quantitatively comparable
      blood sugar lowering effects. The maximum oral effects showed dose dependence in
      a dose range of 0.7 to 9.5 IU/kg bodyweight. Maximal effects after oral
      application were seen 1-2 h after oral application. Investigations with
      transdermal insulin applications showed also significant effects in lowering
      blood glucose concentrations, but these effects were weaker than after oral
      application and showed a delayed onset.

PMID- 2242080
TI  - [Transdermal administration of insulin in type II diabetics. Results of a
      clinical pilot study].
AB  - In 6 type II diabetic patients, which showed no satisfactory blood sugar profiles
      under oral sulfonylurea monotherapy, a placebo controlled cross over pilot trial
      was performed to evaluate the effect of additive transdermal insulin application.
      In comparison to the monotherapy with sulfonylurea, the combination with
      transdermal insulin showed in 4 of the 6 patients a significant reduction of the
      daily mean blood sugar values as well as a slight increase of insulin serum
      concentrations. The 2 patients, who had no glucose reductions also showed a
      slight increase of insulin levels during the combination phase. Relevant adverse
      reactions were not seen. The results suggest, that in suited patients an
      improvement of sulfonylurea therapy by combination with transdermal insulin is
      possible.

PMID- 2242081
TI  - Radioimmunological determination of fenoterol. Part II: Antiserum and tracer for
      the determination of fenoterol.
AB  - A radioimmunological method for the determination of the concentration of
      fenoterol in biological samples is described. The mixture of antibodies against
      the enantiomers of fenoterol obtained with the selected hapten shows a high
      affinity for racemic fenoterol and for the monoiodo125-fenoterol used as a
      tracer, which is also present as a racemate. The limit of detection of the
      radioimmunoassay for fenoterol (racemate) in biological samples (plasma, urine)
      is 10-20 pg/ml. The precision and accuracy of the radioimmunoassay, in the
      presence of racemic fenoterol, are sufficient for an analysis and meaningful
      interpretation of samples from human pharmacokinetic studies. A relationship
      between the cross-reactivity of the antibodies against fenoterol and a preferred
      conformation of the fenoterol molecule in aqueous solution is discussed.

PMID- 2242082
TI  - [The effect of flupirtine, various analgesics and muscle relaxants on skeletal
      muscle tone in the conscious rat].
AB  - The influence of the skeletal muscle tone by flupirtine (D-9998, Katadolon; CAS
      56995-20-1), some selected analgesics and muscle relaxants was investigated in
      conscious rats after intraperitoneal administration. Benzodiazepines (diazepam
      and tetrazepam), baclofen, dantrolene and mephenesine reduced the tone of the
      skeletal muscle. Opiate analgesics, such as morphine, codeine and tramadol,
      enhanced the muscle tone. Flupirtine reduced the skeletal muscle tone at doses
      comparable with its antinociceptive effective doses. In this dose range no
      sedative side effects as ataxia or decrease of spontaneous motor activity could
      be observed. The mode of this muscle relaxing effect of flupirtine is not known
      in all details. It is, however, likely that flupirtine is able to inhibit the
      mono- and/or polysynaptic reflexes at the spinal level.

PMID- 2242083
TI  - Antioxidant activity of and interleukin production affected by honey bee venom.
AB  - Honey bee venom is found to inhibit significantly nonenzymatic lipid
      peroxidation. It also possesses a considerable hydroxyl radical scavenging
      activity, evaluated by its competition with dimethyl sulfoxide for HO.. These
      results, in relation to the in vitro suppression mainly of interleukin-1
      production offered by honey bee venom, may further support that antioxidant
      activity is involved in the anti-inflammatory activity of honey bee venom.

PMID- 2242084
TI  - Anti-inflammatory activity of some copper(II) complexes.
AB  - Anti-inflammatory activity of some copper(II) neutral complexes and complexated
      salts on different animal models of inflammation has been investigated. In a
      preliminary screening 5 complexes were selected for a more extensive study based
      on their capacity inhibiting the rat hind paw edema induced by carrageenin. These
      selected complexes showed inhibitory action on acute and subacute inflammation
      with an activity degree higher than that of indometacin. They were also effective
      inhibitors of primary and secondary lesions in the adjuvant-induced arthritis,
      with an activity similar to phenylbutazone. These complexes had no topical anti
      inflammatory effect.

PMID- 2242085
TI  - [Pharmacokinetics of the antirheumatic lonazolac-Ca in humans].
AB  - The pharmacokinetics of the non-steroidal, antiinflammatory drug lonazolac-Ca in
      man was investigated. Lonazolac-Ca (Irritren, arthro akut, Argun-L, Argun-300)
      (single doses 200 mg or 300 mg) was administered both to healthy, young
      volunteers and to patients with renal impairment, to elderly and arthritic
      patients and to nursing women. Serum concentrations were measured for lonazolac
      and its main serum metabolite M1, and pharmacokinetic characteristics such as
      Cmax, AUC and t1/2 were calculated after both single and multiple oral doses of
      film-coated tablets of lonazolac-Ca. In addition also suppositories of lonazolac
      Ca (single dose 400 mg) were tested after single and multiple administration. In
      a study in healthy, normal volunteers, total radioactivity in blood was followed
      after oral and i.v. administration of 14-C-lonazolac-Ca (-Na). Lonazolac and M1
      generally showed a biphasic pattern of elimination, their terminal half-lives
      being both ca. 6 h in young volunteers. In elderly patients the terminal half
      life was about twice as long. Nevertheless, no accumulation of lonazolac on
      multiple dosing was observed in either volunteers or patients due to the rapid
      alpha-phase. However, some accumulation occurred for the (pharmacologically
      inactive) M1 in elderly patients and in patients with renal impairment. Serum
      profiles were lower and flatter after administration of suppositories as compared
      to oral administration. Lonazolac concentrations in synovial fluid were about
      half of those in serum, no lonazolac could be found in breast milk although there
      was some transfer of M1.

PMID- 2242086
TI  - Development of a high performance liquid chromatography method for the
      simultaneous measurement of prednisone and prednisolone.
AB  - An improved high performance liquid chromatographic assay (HPLC) is presented for
      the quantitative determination of prednisone and its main metabolite
      prednisolone. This HPLC assay, employing a UV-detector and dexamethasone as an
      internal standard, provides a selective and sensitive determination of
      glucocorticoids in plasma. The advantage of this method is the possibility of
      simultaneously measuring exogenic and endogenic glucocorticoids. The lower limit
      of quantification is 5 ng/ml.

PMID- 2242087
TI  - In vivo studies with the stabilized epoprostenol analogue taprostene. Effects on
      platelet functions and blood clotting.
AB  - Like the native epoprostenol (prostacyclin, PGI2), the oxacyclic epoprostenol
      analogue taprostene affects platelet functions. In the rat taprostene inhibited
      in vivo induced ADP aggregation after i.v. bolus injection, i.v. infusion, s.c.
      and p.o. application with ED50 values of 4.6 micrograms/kg, 0.36
      microgram/kg/min, 190 micrograms/kg and approximately 760 micrograms/kg,
      respectively. In vivo induced collagen aggregation was inhibited with an ED50
      value of 17.1 micrograms/kg i.v. Referring to both bolus injection and i.v.
      infusion, taprostene was about 3 times less active than the native prostacyclin,
      but the antiaggregatory effect of taprostene was longer lasting. 5,6
      Dihydroepoprostenol inhibited ADP-induced aggregation with an ED50 value of 3
      micrograms/kg/min, being 10 fold less active than taprostene. Whereas
      epoprostenol induced a rebound effect by increasing in vivo aggregation after the
      end of infusion, no such effect could be seen after taprostene. In the mouse s.c.
      and p.o. application of taprostene inhibited aggregation with the same efficacy
      as in the rat. Intra-arterial infusion of taprostene into the rabbit inhibited
      ADP-induced aggregation ex vivo with an ED50 value of 0.49 micrograms/kg/min. An
      increased bleeding time was observed in rats in doses of 2.15 micrograms/kg i.v.
      and higher, corresponding to the antiaggregatory dose range of taprostene.
      Administered alone, taprostene did not prolong the clotting time in rats.
      However, in heparinized rats, the heparin-induced prolongation of clotting time
      was further increased by taprostene with a threshold dose of 21.5 micrograms/kg
      (= heparin sparing effect).

PMID- 2242088
TI  - Topical tolerability of salmon calcitonin assessed by mucociliary transport
      velocity investigation.
AB  - The topical tolerability of an intranasal salmon calcitonin spray preparation, of
      the excipients alone and of sodium taurocholate has been studied by assessment of
      the mucociliary transport velocity (MTV) on the frog's palate. The rate of mucus
      transport was investigated in 3 groups of animals (Rana esculenta; 6 frogs per
      group) in basal conditions and after a challenge with a salmon calcitonin
      intranasal spray preparation, with the excipients and with sodium taurocholate,
      respectively. The salmon calcitonin intranasal spray preparation and the
      excipients did not affect the mucociliary transport velocity on the frog's
      palate. On the contrary, sodium taurocholate produced severe impairments in the
      mucociliary transport velocity and histological lesions of the epithelial layer
      of the frog's palate. The comparison among the mean values of the mucociliary
      transport velocity before and after treatments showed a significant difference
      between controls and sodium taurocholate groups (p less than 0.05) as well as
      among the groups treated with sodium taurocholate versus salmon calcitonin and
      versus the excipients alone of the calcitonin preparation (p less than 0.05).
      These findings provide evidence that the salmon calcitonin intranasal spray
      preparation tested in the present ex vivo model does not affect the mucociliary
      transport velocity in the frog's palate, while this is markedly affected by
      sodium taurocholate. The use of sodium taurocholate as a promoter of absorption
      in intranasal preparations should thus be reconsidered.

PMID- 2242089
TI  - Factors determining the relationship between renal and hepatic excretion of
      xenobiotics.
AB  - Relation between kidney and liver in the excretion of drugs depends on the
      physicochemical properties of each substance tested. The calculations of this
      relationship are based on a so-called rank coefficient (0-100) calculated from
      molecular weight, lipophilicity, degree of dissociation under physiological
      conditions, and protein binding rate. The results of the correlation between one
      of these physicochemical values and drug elimination were stochastically.
      Experiments were performed with 9 test substances which were distinctly different
      concerning their physicochemical features. Substances with a rank coefficient
      less than 20 (low molecular weight, low lipophilicity, preferentially ionic at pH
      7.4) are eliminated effectively via the kidney. Compounds having an intermediate
      rank coefficient (40-60) were quantitatively excreted into urine as well. For
      drugs with high ranks greater than 60 (high values of molecular weight, protein
      binding, and lipophilicity, almost exclusively nonionic), renal excretion can be
      neglected. Quite inverse relations between ranks and hepatic excretion have been
      found: low ranks indicate an ineffective secretion of the respective drug into
      bile. With increasing ranks (40-60), biliary excretion increases and reaches a
      maximum (approximately 40% of supply). This maximum is caused by limited hepatic
      blood flow and by the capacity of hepatic uptake carriers. Blockade of one
      elimination pathway (bilateral nephrectomy or bile duct ligation) is followed by
      a sufficient compensation of drug excretion via the alternative elimination route
      only, if the test substance belongs to the intermediate group (ranks between 40
      and 60). For substances with high or low ranks a compensation of drug excretion
      can be excluded.

PMID- 2242090
TI  - Methodical and ethical aspects of nucleic acid diagnostics. A review.
AB  - Aside from the established enzymatic and immunodiagnostic procedures, an
      increasing number of diagnostic procedures for nucleic acid detection--i.e. for
      the detection of the primary genetic information--has been developed in recent
      years. For the routine use of these diagnostic procedures in central analytical
      laboratories or by the general practitioner, automated DNA analysis methods with
      integrated highly sensitive detection systems have been developed. The most
      important objective of these developments--aside from the elucidation of the type
      of genetic defect on the molecular level through basic research--is the
      generation of a quantitative nonradioactive signal in corresponding analyzers.
      Detection methods using the ELISA principle as quantifiable reporter system-
      analogous to the automatic immunodiagnostic procedures--have hence been developed
      in recent years. Owing to the increasing importance of this analysis procedure
      alternative to the detection of bioactive low molecular weight substances or
      proteins--i.e. nucleic acid diagnostics--the following is an attempt to provide a
      survey of the methods and possibilities of application. Moreover, possibilities
      for nonradioactive signal generation and amplification will be presented. The
      chances and risks of genome diagnostics will be discussed in a final section.

PMID- 2242091
TI  - Abnormalities in sex hormones are a risk factor for premature manifestation of
      coronary artery disease in South African Indian men.
AB  - The relation between sex hormone levels and myocardial infarction was studied in
      a case-control study among 117 Indian men with myocardial infarction aged 30-60
      years and in 107 healthy Indian male controls. The patients and controls were
      further divided into subsets defined by age in decades. In the total patient
      population, testosterone concentration was significantly lower than in the
      controls (P less than 0.01), whilst oestradiol (P less than 0.0005) and the
      oestradiol to testosterone ratio (P less than 0.0005) were significantly higher.
      Multivariate stepwise logistic regression analyses demonstrated that free
      testosterone index, the free oestradiol index, and the oestradiol to testosterone
      ratio were significantly associated with myocardial infarction, and that this
      association was independent of age, body mass index, smoking and serum lipids.
      Further analyses according to age subsets revealed that compared to respective
      control groups, patients in the 4th decade had both significant
      hypotestosteronaemia and hyperoestrogenaemia, whereas in patients of the 5th
      decade significant differences in total and in the calculated free oestradiol
      index were noted, and in the 6th decade a significant difference was detected
      only in the free oestradiol index. Hence, we conclude that aberrations in
      endogenous sex hormones are significantly associated with myocardial infarction,
      and that this association appears to be strongest in young men and diminishes
      with age, suggesting that these disturbances in sex hormones may be associated
      with premature manifestation of coronary artery disease.

PMID- 2242092
TI  - Arterial injury-induced smooth muscle cell proliferation in rats is accompanied
      by increase in polyamine synthesis and level.
AB  - Proliferation of smooth muscle cells (SMC), enhancement of polyamine biosynthesis
      and increase in polyamine level in response to deendothelialization in the rat
      aorta were studied. [3H]Thymidine incorporation into SMC in aortas denuded with a
      balloon catheter began 25 h after injury, and maximal incorporation occurred 33
      37 h after injury. Afterwards, [3H]thymidine incorporation declined, approaching
      the baseline level, but was slightly higher than that of sham-operated controls
      until 14 days after injury. Intimal thickening started 7 days after injury, and
      peaked at 21 days. Prior to these proliferative changes in aortic SMC, a rapid
      and transient increase in ornithine decarboxylase (ODC) activity was observed
      within 8 h after injury. There was no significant difference in ODC activity
      between injured and intact aortas after 4 days. The levels of polyamines,
      putrescine, spermidine, and spermine increased and were maximal at 48 h after
      injury, 8.1, 3.4 and 1.4 times the control levels, respectively. Increased levels
      of polyamines, in particular spermidine, continued until 7 days after injury.
      These results suggest that the enhancement of polyamine synthesis and the
      increased polyamine content of the aorta play important roles in the
      proliferation of SMC and in the development of intimal thickening, particularly
      in the initial proliferative response of medial SMC after deendothelialization.

PMID- 2242094
TI  - Characterization of LDL binding in TR 715-19 cells. A high capacity, stable line
      for evaluating the binding of LDL to the human LDL receptor.

PMID- 2242093
TI  - Effect of centrifugal force and catecholamines on glycosaminoglycans synthesis of
      vascular smooth muscle cells in culture.
AB  - To evaluate the effect of hypertension on glycosaminoglycan (GAG) synthesis,
      cultured vascular smooth muscle cells (CVSMCs) from the aorta of spontaneously
      hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) were exposed to centrifugal
      forces and catecholamines. GAG synthesis of CVSMCs was measured by the
      incorporation of [3H]glucosamine into GAGs which were secreted into the culture
      medium for 24 h. Basal level of GAG synthesis was much higher in SHR than in WKY,
      when expressed in terms of DNA contents. When exposed to centrifugal force,
      CVSMCs from rats of both strains synthesized more GAGs. GAG synthesis was
      enhanced by both noradrenaline (NA) and adrenaline (Ad) in WKY. The enhanced GAG
      synthesis in WKY by NA or Ad was prevented by pretreatment with propranolol, but
      not prazosin. In SHR, NA and Ad did not enhance GAG synthesis at this
      concentration of catecholamines. However, the effects of propranolol or prazosin
      on GAG synthesis in SHR, when incubated with either NA or Ad, were compatible
      with the phenomena observed in WKY. Adding dibutyryl cyclic AMP to the culture
      medium enhanced GAG synthesis in rats of both strains. These data suggest that
      not only the mechanical stress of high intra-arterial pressure but also beta
      receptor stimulation, via increasing cyclic AMP, enhance GAG synthesis of
      vascular smooth muscle cells in hypertension.

PMID- 2242095
TI  - Regulation of ACAT activity by a cholesterol substrate pool during the
      progression and regression phases of atherosclerosis: implications for drug
      discovery.
AB  - The regulation of aortic ACAT by a cholesterol substrate pool (CSP) was
      investigated in a rabbit progression/regression model of dietary-induced
      atherosclerosis. ACAT activity increased 25-fold during the 10-week progression
      phase of the study. ACAT activity decreased 8-fold during the 24-week regression
      phase of the study, however, it was still 14-fold greater than in normal aortas.
      ACAT activity assayed in the absence vs. the presence of exogenous cholesterol
      was used as a qualitative measure of the amount of cholesterol in the CSP. The
      CSP was filled to 28% of capacity in normal aortas, this increased to 75% during
      the progression phase. By the end of the regression phase, the CSP was filled to
      100% of capacity even though serum cholesterol levels had returned to normal. The
      data are discussed in terms of emerging concepts of intracellular cholesterol
      trafficking, ACAT inhibitors, and the types of atherosclerotic lesions which may
      be subject to amelioration by ACAT inhibitors.

PMID- 2242096
TI  - Plasma lipids, lipoproteins and apolipoproteins in two kindreds of
      hypobetalipoproteinemia.
AB  - Plasma lipids and apolipoproteins were quantified in two kindreds of
      hypobetalipoproteinemia. All affected members were asymptomatic but showed a
      decrease of 75% in apolipoprotein B and of 69% in LDL-cholesterol. There were no
      major changes in apo A-I and A-II but all affected family members had reduced
      levels of apo C-II (by 58%) and C-III (by 59%) without significant decrease in
      apo C-I and no specific decrease of apo C-III1. Apolipoprotein E is decreased in
      SDS-PAGE. The plasma level and phenotype of Lp(a) are not affected by HBL,
      suggesting that a catabolic rather than a synthetic mechanism is responsible for
      the disease. As shown by density gradient ultracentrifugation, HDL2 particles
      that contain essentially apolipoprotein A-I, cholesterol and phospholipids
      represent in affected subjects the major part of HDL. Due to the net reduction of
      apolipoprotein B-containing particles (VLDL and LDL) as acceptors of lipids in
      HBL, there is an accumulation of large particles rich in cholesteryl esters.

PMID- 2242097
TI  - Homocysteine and lipid metabolism in atherogenesis: effect of the homocysteine
      thiolactonyl derivatives, thioretinaco and thioretinamide.
AB  - In order to study the relation of homocysteine and lipid metabolism to
      atherogenesis, rabbits were fed a synthetic atherogenic diet and treated with
      parenteral thioretinaco (N-homocysteine thiolactonyl retinamido cobalamin),
      thioretinamide (N-homocysteine thiolactonyl retinamide) or homocysteine
      thiolactone hydrochloride. All three substances were found to increase dietary
      atherogenesis. Thioretinaco and thioretinamide increase total homocysteine of
      serum, but there is no effect of parenteral homocysteine thiolactone
      hydrochloride on serum homocysteine. The synthetic diet with corn oil
      significantly lowers serum homocysteine, compared either to baseline chow diet or
      to the synthetic diet with butter. Atherogenesis is correlated with total
      homocysteine, total cholesterol and LDL + VLDL cholesterol, and serum
      homocysteine is correlated with total cholesterol, LDL + VLDL, and HDL
      cholesterol in the total sample. Both synthetic diets elevate serum cholesterol,
      triglycerides and LDL + VLDL, but not HDL, compared to baseline values.
      Thioretinamide causes significant elevation of cholesterol and LDL + VLDL,
      compared to controls. The results show that increased dietary saturated fat and
      cholesterol cause deposition of lipids within the arteriosclerotic plaques
      produced by homocysteine, converting fibrous to fibrolipid plaques. Facilitation
      of atherogenesis is attributed to the effect of homocysteine on artery wall,
      either from parenteral homocysteine or from the increased synthesis of
      homocysteine from methionine, produced by thioretinaco and thioretinamide.

PMID- 2242098
TI  - The effects of nicotinic acid treatment on high density lipoprotein particle size
      subclass levels in hyperlipidaemic subjects.
AB  - Twenty-three consecutive hyperlipidaemic patients were treated with 4 g nicotinic
      acid daily for 6 weeks. The treatment resulted in the expected reduction of serum
      very low density (VLDL) and low density lipoproteins (LDL) and in the increase of
      high density lipoproteins (HDL). The cholesterol concentration of the latter
      fraction rose by 45%. The HDL fraction was isolated by ultracentrifugation and
      then subjected to gradient gel electrophoresis (gge), in order to determine the
      HDL particle size distribution, before and after treatment. The increase of HDL
      was almost exclusively confined to the largest HDL (gge) subclass HDL-2b, the
      protein content of which rose by 183%. In contrast, there was about a 25%
      decrease in the concentration of the smallest HDL(gge) subclasses, HDL-3b and HDL
      3c. The levels of HDL-2b and VLDL triglycerides showed a significant inverse
      correlation before, as well as after, treatment. Multiple partial correlation
      analysis demonstrated, however, that the nicotinic acid induced increase in HDL
      2b concentration showed a highly significant inverse correlation to the decrease
      in LDL cholesterol, but not to the decrease in VLDL triglyceride levels. Recent
      studies, in particular those regarding the negative correlation between both the
      degree and progression of coronary atherosclerosis and the HDL-2b concentration
      in young male myocardial infarct patients, suggest that the profound increase of
      HDL-2b levels by nicotinic acid treatment in hyperlipidaemic patients might be of
      considerable importance in the protection of coronary atherosclerosis.

PMID- 2242099
TI  - Rheological properties and membrane fluidity of red blood cells and platelets in
      primary hyperlipoproteinemia.
AB  - Lipid fluidity of the erythrocyte membrane and intact platelets was examined in
      32 male patients affected by types IIA, IIB and IV primary hyperlipoproteinemia
      and 15 control subjects. Lipid fluidity was determined by fluorescence
      polarization using two probes: DPH and TMA-DPH which are localized in different
      lipid areas of the cell membrane. Classical haemorheological tests were also
      performed including plasma viscosity, whole blood viscosity and erythrocyte
      aggregation. As compared to a control group, plasma viscosity and whole blood
      viscosity at low shear rate was significantly increased in types IIB and IV, but
      not in type IIA patients. In contrast, the increase in erythrocyte aggregation
      was significant in all HLP types. Concerning lipid fluidity, the results recorded
      with red cells and platelets were not significantly different for type IIA HLP
      compared to the control group. In contrast, erythrocyte membranes from patients
      with types IIB and IV HLP had a significantly higher level of fluidity in lipid
      regions characterized by TMA-DPH. Using DPH as a fluorescent probe, identical
      results were only noted in type IIB patients. Regarding intact platelets of IIB
      and IV patients, an increase in lipid fluidity was noted for two fluorescent
      probes. These findings suggest that HLP associated erythrocyte and platelet
      fluidity alterations are not related to hypercholesterolemia but to the
      triglyceride level.

PMID- 2242100
TI  - Internal elastic membrane in the internal mammary and left anterior descending
      coronary arteries and its relationship to intimal thickening.
AB  - The internal mammary artery (IMA) is less prone to intimal thickening than
      coronary arteries and is routinely used in coronary bypass surgery. To resolve
      whether morphologic differences can explain why IMA develops less intimal
      thickening, morphometric measurement of the left anterior descending coronary
      artery (LAD) and IMA was carried out in 62 autopsies from individuals of various
      age groups. The amount of intimal thickening, the degree of folding of the
      internal elastic membrane, and media thickness were estimated by appropriate
      indices. Intimal thickening of LAD was more marked, occurred earlier and could be
      demonstrated even below one year of age, but was not found before 21 years of age
      in the IMA. A fold-index of the internal elastic membrane was significantly
      higher in the IMA than in the LAD and correlated negatively with an intimal
      thickening index in both arteries (P less than 0.0001 for both). The fold-index
      decreased with age, most markedly in LAD. Negative correlation was also found
      between a media thickness index and the intimal thickening index in LAD (P less
      than 0.02). The fold-index may indicate the magnitude of tangential intimal
      tension during life and may be of significance for development of intimal
      thickening and atherosclerosis. Lower fold-index may in part explain the
      propensity of atherosclerosis in LAD compared with IMA. Also, reduced fold-index
      with age accompanied the occurrence of atherosclerosis with age.

PMID- 2242101
TI  - Dose-dependent effect on serum cholesterol and apoprotein B concentrations by
      consumption of boiled, non-filtered coffee.
AB  - The effects of boiled coffee (BC) and filtered coffee (FC) on serum lipoproteins
      were compared in 41 healthy subjects whose serum cholesterol concentration was
      less than 7 mmol/l. The subjects consumed in random order BC and FC for 4-week
      periods in a crossover design. The individual daily consumption ranged from 2 to
      14 cups (mean 5.7 cups per day) and was similar during both study periods. The
      serum total and LDL-cholesterol and apoprotein B concentrations were higher (P
      less than 0.001) and HDL-cholesterol lower (P less than 0.05) after BC than after
      FC. Bodyweight, apoprotein A-I and triglycerides remained unchanged. In the 16
      subjects who consumed coffee less than 5 cups per day the difference in serum
      total cholesterol between the BC and FC periods was non-significant (P = 0.16).
      The differences in serum total cholesterol and LDL-cholesterol between the
      periods showed significant linear correlations with the amount of coffee consumed
      daily (r = 0.52, P less than 0.001 and r = 0.33, P less than 0.05, respectively)
      but no association was found between the difference in HDL-cholesterol and the
      amount of coffee (r = 0.14, P = 0.39). The results indicate a dose-dependent
      increasing effect on serum total and LDL-cholesterol and apoprotein B
      concentrations of boiled coffee.

PMID- 2242102
TI  - Rapid development of atherosclerotic lesions in the rabbit carotid artery induced
      by perivascular manipulation.

PMID- 2242103
TI  - Psychotherapy training for the psychiatrist of the future.
AB  - There is uncertainty about the future role of psychodynamic psychotherapy in
      psychiatric practice and education. The Association for Academic Psychiatry and
      the American Association of Directors of Psychiatry Residency Training formed a
      joint task force to review the issue. It developed a rationale for continued
      training in expressive psychotherapy and a model curriculum for such training
      that is both effective and realistic in terms of the diverse demands and
      structures of modern residencies. A minimum curriculum was also designed for
      resource-poor programs.

PMID- 2242104
TI  - Drug therapy: The diagnosis and management of insomnia.

PMID- 2242105
TI  - Continuous spinal anesthesia with a microcatheter technique: preliminary
      experience.

PMID- 2242106
TI  - Phenobarbital for febrile seizures--effects on intelligence and on seizure
      recurrence.
AB  - Phenobarbital is widely used in the treatment of children with febrile seizures,
      although there is concern about possible behavioral and cognitive side effects.
      In 217 children between 8 and 36 months of age who had had at least one febrile
      seizure and were at heightened risk of further seizures, we compared the
      intelligence quotients (IQs) of a group randomly assigned to daily doses of
      phenobarbital (4 to 5 mg per kilogram of body weight per day) with the IQs of a
      group randomly assigned to placebo. After two years, the mean IQ was 7.03
      [corrected] points lower in the group assigned to phenobarbital than in the
      placebo group (95 percent confidence interval, -11.52 to -2.5, P = 0.0068
      [corrected]). Six months later, after the medication had been tapered and
      discontinued, the mean IQ was 5.2 points lower in the group assigned to
      phenobarbital (95 percent confidence interval, -10.5 to 0.04, P = 0.052). The
      proportion of children remaining free of subsequent seizures did not differ
      significantly between the treatment groups. We conclude that phenobarbital
      depresses cognitive performance in children treated for febrile seizures and that
      this disadvantage, which may outlast the administration of the drug by several
      months, is not offset by the benefit of seizure prevention.

PMID- 2242107
TI  - Clinical utility of serum tests for iron deficiency in hospitalized patients.
AB  - Serum iron and ferritin measurements lack the requisite sensitivity and/or
      specificity to accurately diagnose iron deficiency. To determine their utility in
      hospitalized patients, the authors compared the results of these tests with the
      presence of stainable iron in bone marrow aspirates of 301 patients. Forty
      (13.3%) had absent marrow iron. The serum diagnosis of iron deficiency was
      accepted on the basis of the following: iron less than 11 mumol/L, total iron
      binding capacity (TIBC) greater than 45 mumol/L, transferrin saturation (%Sat)
      less than 0.20, and ferritin less than 13 micrograms/L for females and less than
      25 micrograms/L for males. Using these criteria, iron deficiency was correctly
      diagnosed by serum iron in 41%, TIBC in 84%, %Sat in 50%, and ferritin in 90% of
      the patients. The serum ferritin is clearly the only useful serum test for
      diagnosing iron deficiency in hospitalized patients but is limited by a low
      sensitivity. The bone marrow examination is the most sensitive test for
      diagnosing iron deficiency in hospitalized patients.

PMID- 2242108
TI  - Dietary protein source and plasma lipid profiles of infants.
AB  - Total cholesterol and triglyceride concentrations were measured in plasma samples
      taken at 4 and 8 weeks of age from 40 full-term infants who had been fed either
      human milk or one of three formulas containing casein-to-whey ratios of 82:18,
      66:34, or 50:50 to investigate whether dietary protein influenced the development
      of plasma lipid profiles. Infants fed the formula with the casein-to-whey ratio
      of 82:18 had significantly higher plasma cholesterol levels at both 4 and 8 weeks
      of age compared with other groups of infants (P less than .05). Infants fed the
      high-casein formula also showed an increase in plasma cholesterol levels with
      time (P less than .001). Plasma triglyceride concentrations decreased as
      concentration of casein decreased (P less than .05) among the formula-fed groups
      and increased with time. Infants fed human milk had plasma triglyceride
      concentrations similar to those infants who had been fed the 82:18 formula at 4
      weeks of age; however, triglyceride concentrations eventually fell and were
      similar to those concentrations in infants who had been fed the 50:50 formula at
      8 weeks of age. Results indicate that constituent lipids of human milk or
      formulas were not determining factors for changes observed in plasma cholesterol
      levels and triglyceride concentrations among groups. Since formulas differed only
      in proteins and their constituent amino acids, further investigation of the
      impact of dietary protein (amino acids) on development of blood lipid profiles in
      infants is warranted.

PMID- 2242109
TI  - The efficiency of two-phase designs in prevalence surveys of mental disorders.
AB  - A two-phase survey of mental disorders uses a screening test to identify possible
      cases, thereby reducing the resources devoted to interviewing those not having
      the condition of interest. It is demonstrated using a mathematical model that in
      situations likely to be encountered in practice a two-phase design may lead to an
      increase in the efficiency of prevalence rate estimation, and also to an
      improvement in the efficiency of case detection. However, in certain applications
      the modest gain in efficiency may not warrant the additional complexity of a two
      phase approach to data collection. Data from a survey of mental disorders in
      Edmonton, Canada, which collected information on 3258 community residents using
      the Diagnostic Interview Schedule and the General Health Questionnaire, are used
      to demonstrate how two-phase methods would have changed the efficiency of an
      actual survey.

PMID- 2242110
TI  - Guns and violence in Australia.

PMID- 2242111
TI  - Neoplasia masquerading as periapical infection.
AB  - Seven examples of neoplasia which presented as periapical radiolucencies are
      described. These were all initially treated for presumed periapical infection.
      The atypical features that should alert dentists to the possibility of a tumour
      presenting in this manner are: a vital tooth with minimal caries, root resorption
      and an irregular radiolucent outline, tooth mobility in the absence of
      generalised periodontal disease, regional nerve anaesthesia, and failure to
      respond to good endodontic therapy. All material removed at the time of apical
      surgery must be examined histologically to prevent neoplasia being overlooked.

PMID- 2242112
TI  - Variant t(2;18) translocation in a Burkitt conversion of follicular lymphoma.

PMID- 2242113
TI  - Dyspepsia in general practice.

PMID- 2242114
TI  - Characterization with a simple clotting assay of the tissue factor inhibiting
      activity in serum.
AB  - The serum inhibiting activity on tissue factor (TFI) was evaluated as follows:
      normal human serum was incubated at room temperature with highly diluted rabbit
      brain thromboplastin (TF) and calcium ions; after 30 min. rabbit brain cephalin,
      calcium and normal human plasma were added to a small aliquot of TF/serum
      mixture; the clotting time at 37 degrees C was then recorded. With this assay TFI
      activity is proportional to the serum level; it is low for incubation periods
      shorter than 30 min., is missing at TF concentrations higher than 8%, is strictly
      connected to the presence of F VII and F Xa in the serum sample, depends upon the
      presence of calcium ions and finally, is independent of antithrombin III. This
      inhibiting activity also seems to be saturable and reversible.

PMID- 2242116
TI  - Congenital cataracts.

PMID- 2242115
TI  - Calcium leucovorin and 5-fluorouridine cytotoxicity.
AB  - The action of fluoropyrimidine (FP) drugs at thymidylate synthase (TS) is
      associated with enhanced chemotherapeutic response. Calcium leucovorin (CF)
      increases the cytotoxicity of the FP drugs, 5-fluorouracil and 5
      fluorodeoxyuridine, in human laryngeal carcinoma HEp-2 cells by directing the
      action of these drugs at TS. Thus, the effect of CF on the cytotoxicity and site
      of action of the FP, 5-fluorouridine (FUrd), was investigated in HEp-2 cells. The
      cytotoxicity of FUrd was unaffected by CF. Moreover, CF was unable to alter the
      growth-limiting target of FUrd to TS. HEp-2 cells convert FUrd to FdUMP, the FP
      metabolite that is the direct inhibitor of TS; thus, the inability of CF to
      modulate FUrd action is not due to lack of inhibitor formation. In addition,
      greater than 90 percent of TS activity is inhibited at concentrations of FUrd
      that inhibit HEp-2 cell growth by 50 percent. Thus, while TS is significantly
      inhibited by FUrd, it is not the growth-limiting target of this drug. It is
      likely that the RNA-directed effects of FUrd are so extensive that CF, which
      maximizes TS-directed action, is ineffective at reducing the cytotoxicity
      further. An approach to overcoming the RNA-directed effects of FUrd is suggested.

PMID- 2242117
TI  - Surgery and Salmonella.

PMID- 2242118
TI  - Psychological treatment for depressive disorder.

PMID- 2242119
TI  - Is there a preference for different ways of performing faecal occult blood tests?
AB  - Low compliance with faecal occult blood screening reduces the power of clinical
      trials, potential benefit, and efficiency. It has been proposed that the faecal
      manipulation required to perform conventional guaiac based tests may be an
      important factor in low compliance. The aim of this study was to evaluate whether
      use of a new method (vehicle) of stool collection for the faecal occult blood
      guaiac test would be preferred to the established standard. A novel self
      interpreted test, Early Detector (ED), requires the subject to apply a
      guaiac/peroxide spray to a stool sample collected simply by wiping the anus with
      a specimen pad. To determine whether this method would be preferred to the stool
      manipulation required by Haemoccult (HO) and to compare test validity, employees
      at a London company were invited to use both tests. Eight-hundred and fifty-seven
      subjects were shown both tests. Before use, 48% indicated a preference for the
      method of Early Detector; 24% chose Haemoccult (p less than 0.001), while 28%
      indicated no immediate preference. Seven-hundred and one performed both tests.
      After use, 74% preferred ED; 5% preferred HO (p less than 0.001); 21% had no
      preference (NP). The preference for the ED test method was consistent by sex
      categories, age groups and occupational class. Logistics, aesthetics, and
      immediacy of results were the main reasons indicated for choosing ED. Whether the
      preference for ED could result in higher compliance remains to be proven. Its
      high positivity (14%), however, would preclude its use as a sole test to
      determine the need for endoscopic and/or radiologic investigation in the screened
      patient.

PMID- 2242120
TI  - [Nicolau syndrome after ketazon injection].
AB  - Nicolau syndrome is a rare complication, which occurs after intramuscular
      injections of various drugs, particularly antirheumatic drugs. During one year,
      the authors observed this syndrome in three patients, who had received
      intramuscular injections of Ketazon. The aetiology of the syndrome is not yet
      known, but it is often caused by accidental intraarterial injections of the drug.
      Since there is no specific therapy for the syndrome, the authors insist on the
      possibility of preventing it.

PMID- 2242121
TI  - Radiography degrees and medical physicists.

PMID- 2242122
TI  - X-ray requests from nurse practitioners.

PMID- 2242123
TI  - Public-sector health spending may aid competitiveness.

PMID- 2242124
TI  - Undifferentiated vascular endothelial cells in coronary allograft
      atherosclerosis.

PMID- 2242125
TI  - Complications of i.v. therapy: Vialon vs. Teflon.

PMID- 2242126
TI  - Duration of meningitis therapy.

PMID- 2242127
TI  - Ultrasound mammography for the diagnosis of a ruptured breast implant.

PMID- 2242128
TI  - Removal of buccal fat pad by liposuction.

PMID- 2242129
TI  - Plasma progesterone concentrations in llamas.

PMID- 2242130
TI  - Fluoroquinolone drug interactions.

PMID- 2242131
TI  - Using the patient's history to estimate the probability of coronary artery
      disease: a comparison of primary care and referral practices.
AB  - PURPOSE: According to probability theory, the interpretation of new information
      should depend on the prior probability of disease. We asked if this principle
      applies to interpreting the history in patients with chest pain. We compared the
      prevalence of coronary artery disease (CAD) in patients who had similar histories
      but who came from populations with different disease prevalence. PATIENTS AND
      METHODS: We studied two high-disease-prevalence populations (patients referred
      for coronary arteriography) and two low-disease-prevalence populations (patients
      from primary care practices). We used clinical characteristics of one
      arteriography population to develop a logistic rule for estimating the
      probability of coronary artery narrowing. The number of clinical findings
      determined the logistic score, which was proportional to the prevalence of CAD.
      RESULTS: The prevalence of CAD was much lower in the primary care population than
      in the arteriography population, even when patients with similar logistic scores,
      and thus similar clinical histories, were compared. CONCLUSION: A clinician must
      take account of the overall prevalence of disease in the clinical setting when
      using the patient's history to estimate the probability of disease. Failure to
      observe this caution may lead to errors in test selection and interpretation.

PMID- 2242132
TI  - Depression and the menopause.

PMID- 2242133
TI  - Genital warts.

PMID- 2242134
TI  - Vision recovery in amblyopia.

PMID- 2242135
TI  - Doppler estimates of cardiac output.

PMID- 2242136
TI  - A fibrinolytic defect in the respiratory distress syndrome.

PMID- 2242137
TI  - What did our late paleolithic (preagricultural) ancestors eat?

PMID- 2242138
TI  - AST/ALT ratio and alcohol abuse.

PMID- 2242140
TI  - Response to Drs. Cohen and Barkin.

PMID- 2242139
TI  - The clinical utility of serum tests for iron deficiency in hospitalized patients.

PMID- 2242141
TI  - Variant t(2;18) translocation in a follicular lymphoma.

PMID- 2242142
TI  - Terminal care in general practice.

PMID- 2242143
TI  - The toxic shock syndrome.

PMID- 2242144
TI  - Central pain.

PMID- 2242145
TI  - Maternal and fetal screening for antenatal care.

PMID- 2242146
TI  - Diagnostic tests for Lyme disease.

PMID- 2242147
TI  - [Hospitalized with a double stigma].

PMID- 2242148
TI  - [Pseudohypoparathyroidism; where is the hitch?].
AB  - Pseudohypoparathyroidism is a condition in which for some reason the normal
      effect of PTH in the target organ fails to occur. In the Ia type here described
      the signal transmission is impaired due to abnormal genetic development of the
      stimulating G protein (Gs) in the cell membrane resulting in insufficient cAMP
      production after binding of PTH on the membrane receptor. The failure to occur of
      the normal PTH effect impairs the calcium homeostasis. In many cases this type of
      pseudohypoparathyroidism is associated with phenotypical characteristics such as
      short stature, round face, obesity, brachydactyly, subcutaneous and intracerebral
      calcifications and sometimes bradyphrenia. Since the Gs protein aspecifically
      also brings about production of cAMP after binding of other polypeptide hormones
      to this hormone-specific receptor, several hormone resistances may be present
      concurrently.

PMID- 2242149
TI  - Dietary sodium and osteoporosis.

PMID- 2242150
TI  - The use of topical cyclosporine in high-risk corneal transplants.

PMID- 2242151
TI  - More on birth order in multiple sclerosis.

PMID- 2242152
TI  - Comments on task force report on psychiatric residency.

PMID- 2242153
TI  - Carbamazepine and SIADH.

PMID- 2242154
TI  - Microcatheters for continuous spinal anesthesia.

PMID- 2242155
TI  - The carpal tunnel syndrome.

PMID- 2242156
TI  - Screening for colorectal cancer.

PMID- 2242157
TI  - Minimum reportable doses from personal monitors.

PMID- 2242158
TI  - Who should take vitamin supplements?

PMID- 2242159
TI  - Developing and maintaining a sound undergraduate clerkship curriculum.

PMID- 2242160
TI  - Multiple bandshift assay: rapid identification and cloning of DNA fragments
      containing specific protein-binding sites.
AB  - A new rapid method for the identification and cloning of DNA fragments containing
      specific protein-binding domains is based on the common bandshift assay. Cloned
      DNA is digested with a restriction endonuclease recognizing a particular 4-bp
      sequence, an aliquot of this digest is end-labelled and used in protein binding
      reactions with and without protein extract. The binding reactions are then loaded
      onto nondenaturing polyacrylamide gel. The main portion of the digest is run in a
      parallel lane and serves as a source of fragments for cloning. Autoradiography of
      the wet gel reveals loss in intensity of some bands from the restriction digest
      incubated with the protein extract. DNA fragments corresponding to these bands
      are cut out from the gel; DNA is eluted and cloned in the M13 vector, thus
      allowing rapid and simple sequencing of the inserts. The method, termed multiple
      bandshift assay, is especially useful when screening relatively long DNA
      fragments (of several kb) for potential protein-binding domains. The procedure
      was used to study interaction of HeLa-cell nuclear proteins with a 5.2-kb
      downstream region of pseudorabies virus immediate-early gene (C. Vlcek, Z.
      Kozmik, V. Paces, S. Schirm and M. Schwyzer, unpublished).

PMID- 2242161
TI  - gm: a practical tool for automating DNA sequence analysis.
AB  - The gm (gene modeler) program automates the identification of candidate genes in
      anonymous, genomic DNA sequence data. gm accepts sequence data, organism-specific
      consensus matrices and codon asymmetry tables, and a set of parameters as input;
      it returns a set of models describing the structures of candidate genes in the
      sequence and a corresponding set of predicted amino acid sequences as output, gm
      is implemented in C, and has been tested on Sun, VAX, Sequent, MIPS and Cray
      computers. It is capable of analyzing sequences of several kilobases containing
      multi-exon genes in less than 1 min execution time on a Sun 4/60.

PMID- 2242162
TI  - The single-minded gene of Drosophila is required for the expression of genes
      important for the development of CNS midline cells.
AB  - The single-minded (sim) gene of Drosophila encodes a nuclear protein that plays a
      critical role in the development of the neurons, glia, and other nonneuronal
      cells that lie along the midline of the embryonic CNS. Using distinct cell fate
      markers, we observe that in sim mutant embryos the midline cells fail to
      differentiate properly into their mature CNS cell types and do not take their
      appropriate positions within the developing CNS. We further present evidence that
      sim is required for midline expression of a group of genes including slit, Toll,
      rhomboid, engrailed, and a gene at 91F; that the sim mutant CNS defect may be
      largely due to loss of midline slit expression; and that the snail gene is
      required to repress sim and other midline genes in the presumptive mesoderm.

PMID- 2242164
TI  - Uniforms vs. business clothes for occupational health nurses. A needs survey.
AB  - The occupational health nurses' role has grown to that of manager. They work to
      achieve corporate goals such as cost containment through promotion of wellness.
      They are well suited to the changing technology of the corporate community. The
      changing role of the occupational health nurse has been accompanied by a change
      in what they wear to work. Uniforms are no longer standard, and business clothes
      are increasing in popularity. A uniform committee at AT&T Bell Laboratories was
      formed to assess the need for change in clothing. A non-random survey was used to
      investigate what others in the field were wearing. Nurses from 89 companies in
      eight states completed a total of 274 questionnaires. As a result of the survey,
      nurses at AT&T Bell Laboratories were given the option of wearing a uniform,
      street clothes and laboratory coat, or just street clothes as job function
      indicated.

PMID- 2242163
TI  - Regulation of the dnaQ gene of Escherichia coli in mutants expressing the SOS
      regulon constitutively.
AB  - Current models for the mechanism of SOS mutagenesis in E. coli propose the
      involvement of a new or modified DNA polymerase III holoenzyme in error-prone
      replicative bypass of bulky DNA lesions assuming an inhibited or excluded 3'---
      5' proofreading exonuclease function of DNA polymerase. By promotor fusion to
      galK, gene fusion to lacZ and Sl analysis the in vivo regulation of dnaQ coding
      the proofreading subunit of DNA polymerase III holoenzyme was analyzed under
      conditions of induced or constitutive SOS expression. The results presented here
      clearly show that, at least on the level of gene expression no regulatory event
      seems to contribute to the assumed decrease of proofreading activity during SOS
      mediated error-prone bypassing of bulky lesions. On the contrary, an increase in
      dnaQ gene expression was observed following treatment with some SOS inducing
      agents which produces bulky DNA lesions.

PMID- 2242165
TI  - Policies and practices used for the safe handling of antineoplastic drugs.
AB  - There is increasing evidence that exposure to antineoplastic drugs in the
      workplace has definite, measurable effects on health care workers. The literature
      supports the theory that use of proper protective practices and equipment while
      handling antineoplastic drugs will provide adequate protection from the effects
      of these agents. Many of the hospitals, physicians' offices, and health care
      agencies surveyed did not have comprehensive policies outlining safe practices
      and procedures when handling antineoplastic drugs. Use of gloves was the only
      consistently used method of self protection in any facility that responded to the
      survey. In spite of the known potential dangers associated with exposure to these
      drugs, the literature supports the theory that many health care workers still do
      not use available protective equipment and procedures. Research is imperative to
      determine the exact long term effects of exposure to antineoplastic drugs by
      health care workers and to develop ways to ensure proper, consistent use of
      safety measures.

PMID- 2242166
TI  - Understanding why some employees ignore worksite health promotion efforts.
      Refocusing the issue.
AB  - Corporations are beginning to examine exactly who is responding to health
      promotion programs offered at the worksite. Most findings indicate that those
      employees using most of the health care dollars are the least involved in health
      promoting efforts. When assessing why certain employees choose not to
      participate, application of a health promotion model will identify direct and
      indirect factors associated with this choice. Based on factors identified in the
      health promotion model, wellness programs are designed to fit the employees'
      level of readiness to adopt healthy behaviors. The three program levels build
      upon each other to achieve health promotion. The occupational health nurse has
      the skills necessary to identify this population which continues to live
      unhealthy lifestyles. The overall goal is to increase their participation in
      health promotion. This may be achieved by identifying their needs and designing
      programs accordingly.

PMID- 2242167
TI  - Occupational health nursing practice, education, and research. Challenges for the
      future.
AB  - The practice of occupational health nursing has expanded enormously and is
      influenced by company culture and forecasts as well as external factors such as
      population trends, technology, and the profile of the work force. Future trends
      include the provision of nurse managed occupational health services. Education
      and research in occupational health nursing must be strengthened to advance the
      practice of occupational health nursing. The occupational health nurse as the
      primary health care manager must take the lead in the development and
      implementation of a concept of health at the worksite.

PMID- 2242168
TI  - Health care records and the law. Balancing the employee's privacy with the
      state's regulatory power.

PMID- 2242169
TI  - Contact lenses in an industrial environment.

PMID- 2242170
TI  - Neurodevelopmental outcome of children with evidence of periventricular
      leukomalacia on late MRI.
AB  - Fifteen children, 8 months of age or older, from a neonatal follow-up program
      underwent magnetic resonance imaging and neurologic, cognitive, and language
      evaluations. Magnetic resonance imaging findings in all children included
      increased white matter signal on T2-weighted images and ventricular enlargement
      adjacent to regions of abnormal white matter. The extent of degree of abnormal
      white matter signal and the degree of sulcal prominence were variable. Twelve
      children had cerebral palsy; 5 children, 4 of whom had cerebral palsy, manifested
      significant sensory impairments. The median score on cognitive testing was 89;
      only 2 children exhibited severe-to-profound cognitive disability. Cognitive
      scores were stable on retesting. The degree of motor disability was correlated
      with the extent of white matter signal abnormality; however, cognitive outcome
      was not related to the extent and degree of white matter signal abnormality or to
      the degree of sulcal prominence. Despite the association of a major handicapping
      condition and periventricular leukomalacia, cognitive and language functioning
      may be relatively spared.

PMID- 2242171
TI  - Decrease in cerebral metabolic rate of glucose after high-dose methotrexate in
      childhood acute lymphocytic leukemia.
AB  - We measured changes in the regional cerebral metabolic rate of glucose (rCMRGlu)
      using 18F-fluorodeoxyglucose and positron emission tomography for the assessment
      of neurotoxicity in childhood acute lymphocytic leukemia treated with high-dose
      methotrexate (HD-MTX) therapy. We studied 8 children with acute lymphocytic
      leukemia (mean age: 9.6 years) treated with HD-MTX (200 mg/kg or 2,000 mg/M2)
      therapy. CMRGlu after HD-MTX therapy was most reduced (40%) in the patient who
      had central nervous system leukemia and was treated with the largest total doses
      of both intrathecal MTX (IT-MTX) and HD-MTX. CMRGlu in the whole brain after HD
      MTX therapy was reduced by an average of 21% (P less than 0.05). The reductions
      of CMRGlu in 8 patients were correlated with total doses of both IT-MTX (r =
      0.717; P less than 0.05) and systemic HD-MTX (r = 0.784; P less than 0.05).
      CMRGlu of the cerebral cortex, especially the frontal and occipital cortex, was
      reduced more noticeably than that of the basal ganglia and white matter. We
      suggest that the measurement of changes in rCMRGlu after HD-MTX therapy is useful
      for detecting accumulated MTX neurotoxicity.

PMID- 2242172
TI  - Rett syndrome: cerebellar pathology.
AB  - The cerebellar pathology at autopsy of 5 patients with Rett syndrome is
      described. The patients ranged in age from 7-30 years. All had markedly reduced
      brain weights with proportionately small cerebella. Microscopic examination
      revealed loss of Purkinje cells, atrophy, astrocytic gliosis of the molecular and
      granular cell layers, and gliosis and loss of myelin in the white matter.
      Cortical atrophy occurred focally along the folia and was often more marked in
      the tips of the folia. The 2 oldest patients had been treated with phenytoin
      which may have contributed to the morphologic changes. Atrophy and gliosis
      increased with age or in patients without phenytoin treatment; the youngest
      patient demonstrated only minor microscopic changes. In addition to the
      generalized alterations, 1 patient had several adjacent folia with severe
      atrophy. The results indicate that cerebellar changes in Rett syndrome consist of
      general hypoplasia with the addition of atrophy beginning in childhood and
      progressing over many years.

PMID- 2242173
TI  - Recurrent lateral rectus palsy in childhood.
AB  - Five patients with recurrent, lateral rectus palsy in childhood, examined at the
      University of Iowa Hospitals over a period of 22 years, are reported. During the
      same period, 131 abducens nerve palsy patients, younger than 18 years of age,
      were evaluated. Eighteen similar patients, most single case reports, are reviewed
      from the literature. All reported patients, including our own, shared the
      following features: spontaneous recovery within 6 months in the majority of
      patients, ipsilateral recurrence, and painless palsy. There is female and left
      sided preponderance. Etiology is undetermined. Hypotheses include viral etiology,
      neurovascular compression by aberrant artery, and migraine.

PMID- 2242174
TI  - Transient neurologic abnormalities and BAEPs in high-risk infants.
AB  - We examined brainstem auditory evoked potentials in 2 neurodevelopmentally
      different groups of high-risk premature infants during the first year of life.
      Our 77 patients were considered at birth to be at risk for neurologic
      disabilities, but were found to have normal development in the second year of
      life. The patients were divided into 2 groups on the basis of their neurologic
      findings during the first year of life; 24 of the 77 patients demonstrated
      transient neurologic abnormalities (group I) and the remaining 53 demonstrated
      normal neurologic findings through the first year of life (group II). Normative
      data of brainstem auditory evoked potentials were obtained from 60 low-risk and
      neurologically normal infants. Group I patients had prolonged III-V and I-V
      intervals at 2 months of age or younger and poorly detectable waves VI and VII at
      5 months of age or younger, compared with control subjects. Wave VI was poorly
      detected in group II patients only at 35-39 weeks of conceptional age. Brainstem
      auditory evoked potentials suggested that the patients with transient neurologic
      abnormalities had transient dysfunction or maturational delay in the brainstem
      and upper auditory pathway early in the first year of life.

PMID- 2242175
TI  - Ultrasonography and magnetic resonance imaging in Leigh disease.
AB  - An infant with Leigh disease, who was the younger sister of a similarly affected
      infant, had been examined before the onset of the disease. Ultrasonography
      revealed hyperechoic lesions in the putamen and caudate nucleus during the
      preclinical stage. At onset, these changes extended into the cerebral cortex and
      medulla. These lesions were also detected by T2-weighted magnetic resonance
      imaging (MRI) as areas of increased signal intensity. Her brother demonstrated
      the same ultrasonographic results; cranial computed tomography disclosed low
      density areas in the basal ganglia which were detected as hyperechoic lesions by
      ultrasonography. These findings suggest that ultrasonography is useful in
      detecting early intracranial lesions in Leigh disease.

PMID- 2242176
TI  - Subcortical visual function in the newborn.
AB  - Early behavioral visual function in infants may not depend upon the
      geniculocalcarine pathway but may be mediated through more primitive subcortical
      pathways. This subcortical visual system may exist in early life and be
      responsible for visual pursuit and perhaps fixation. In some infants with damage
      to the visual cortex, the subcortical pathway may persist beyond the neonatal
      period. Three infants with major defects in the visual cortex are reported. These
      infants displayed persistent preservation of visual pursuit movements without
      evidence of visual recognition. Limited behavioral expressions of vision in the
      infant with damage to the visual cortex may not always be an indicator of
      preserved function of the visual cortex.

PMID- 2242178
TI  - West syndrome associated with hyperlexia.
AB  - Two patients are reported with West syndrome associated with hyperlexia. They had
      peculiar linguistic and psychosocial development and autistic behavior, yet began
      to read Japanese and Chinese characters, numbers, Roman alphabet letters, and
      trademark letters at 3 years of age. Neuropsychologic, electroencephalographic,
      and radiologic studies were performed at 11 years of age in Patient 1 and at 10
      years of age in Patient 2. Although they were able to read fluently with correct
      intonation, their comprehension was significantly impaired. The neuropsychologic
      evaluation of both patients demonstrated selective, excellent ability in auditory
      memory in contrast to impairment of associational abilities, visual retention,
      and visual constructional abilities. These findings suggest that the functions in
      the nondominant hemisphere were also impaired. Although children with West
      syndrome frequently have associated mental retardation, patients with West
      syndrome associated with hyperlexia have never been reported. A neuropsychologic
      investigation of epileptic children with mental retardation is necessary for the
      detection of hyperlexia.

PMID- 2242177
TI  - Rett syndrome: findings suggesting axonopathy and mitochondrial abnormalities.
AB  - We report the histopathologic findings of 3 sural nerve biopsies and 1 muscle
      biopsy from 3 patients with Rett syndrome. The 3 sural nerve biopsies
      demonstrated a few ultrastructural abnormalities, including the presence of many
      Pi-granules and mitochondrial changes in the cytoplasm of Schwann cells,
      occasional bands of Bungner and onion-bulb formations, and mitochondrial
      alterations in myelinated axons. Morphometric analysis disclosed reduction in the
      number of large myelinated fibers with normal densities in comparison to those of
      an age-matched normal control. Light microscopic examination of the biopsied
      muscle from a 6-year-old patient with Rett syndrome revealed the existence of
      many small, dark, angulated fibers with NADH-TR staining. Ultrastructural
      investigation of the muscle confirmed the presence of the dumbbell-shaped
      mitochondria. Peripheral nerve involvement and the possibility of mitochondrial
      abnormalities in Rett syndrome were suggested by the results.

PMID- 2242179
TI  - [Site and incidence of multiple cancers in patients with squamous cell carcinomas
      of the upper aerodigestive tract].
AB  - The etiology of multiple primary cancers has not been clearly elucidated,
      although some pathogenic factors are known. The studies reported here include 796
      patients who, between January 1970 and March 1989, presented with a carcinoma of
      the upper aerodigestive system. The charts of 687 patients were analyzed
      retrospectively; 109 patients were studied prospectively by systematic
      pretherapeutic panendoscopy. Multiple primary cancers were found in 76 cases
      (9.5%), 33 patients had synchronous cancers, and 43 had metachronous cancers. In
      the prospective study, the incidence of multiple cancers was higher (13.7%) than
      in the retrospective group (8.8%). Synchronous primaries were more frequent in
      the prospective study (8.2%) than in the retrospective analysis (3.4%). Second
      primaries were mostly found in the esophagus, the hypopharynx, the buccal cavity,
      and the lung. The authors also examined whether the anatomic location of the
      second primary cancer can be related to the site of the first. The five-year
      survival rate among patients with synchronous cancers (18%) was lower than among
      patients with metachronous cancers (41%). The prognosis for synchronous cancers
      deteriorates if the planned treatment has to be modified following the discovery
      of a second primary. Systematic pretherapeutic panendoscopy should be used to
      help detect early asymptomatic second primaries which might be missed during
      clinical examination.

PMID- 2242180
TI  - [Incidence of epithelial neoplasms in the head and neck area in non-Hodgkin's
      lymphomas].
AB  - There is an increased risk of malignancy in patients with genetically determined
      or acquired immunosuppression. The authors report a case of a 70-year-old patient
      with a lymphoplasmocytic immunocytoma who developed 19 squamous-cell carcinomas
      (SCC) and nine basal-cell carcinomas (BCC) over a three-year period. This was the
      reason to review 100 cases of malignant lymphomas for evidence of additional
      malignancies. Of these patients, 15% had one or more SCC or BCC in the head and
      neck area. The age range was 59 to 79 years (mean, 71.7 years) and the
      male:female ratio 11:4. One or more SCC arose in 93% of these patients, 36%
      developed an additional one or more BCC, and BCC alone occurred in 7%. The usual
      ratio of BCC:SCC is 10:1; in the authors' patients, by contrast, this ratio was
      6:14. In 12 cases, SCC and BCC were located on the skin. The remaining cases of
      SCC developed in the oral mucosa, the tonsils and the hypopharynx. In 13 cases,
      low-grade malignant lymphomas were found and in two cases high-grade malignant
      lymphomas were found. The SCC were clinically aggressive. Thirty-six percent of
      the patients had recurrent lesions, 43% multiple neoplasms, and 50% metastases.
      Histologically, the SCC showed moderate to poor differentiation, a high degree of
      cell polymorphism and mitotic activity, and deep tissue infiltration. There are
      several explanations for the increased incidence of neoplasms in patients with
      immunodeficiency disorders. The surveillance function of the immune system may be
      impaired due to the disease itself or due to the treatment for immunosuppression.
      Immunosuppressive and cytotoxic agents are potential carcinogens.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2242181
TI  - [Imaging diagnosis of parotid diseases--a comparison of methods].
AB  - Thirty-five patients with parotid gland disorders were ultrasonographically
      examined with a "small parts" scanner, as well as with high-resolution computed
      tomography, and conventional and digital subtracted sialography. The results were
      compared with clinical, surgical, and pathomorphological data. In cases of
      parotid gland masses, the sensitivity of sonography, CT, and sialography was
      100%, 81%, and 70% respectively, while in cases of sialadenitis, sensitivity was
      38%, 50%, and 75%. The image-quality of digital subtracted sialography was
      superior to conventional sialography in 94% of cases, the same in 6%, and
      inferior in none of the cases. It is concluded that in all cases of parotid gland
      diseases ultrasound should be the first imaging method. If a tumor is confirmed,
      no further pretherapeutic imaging will be necessary in most cases. If a tumor is
      not confirmed, digital subtracted sialography should be employed to visualize
      inflammatory changes.

PMID- 2242182
TI  - [Extracorporeal piezoelectric lithotripsy in the treatment of a parotid calculus
      with recurrent parotitis].

PMID- 2242183
TI  - [Acute purulent parotitis as a sequela of alkylphosphate (E 605) poisoning].
AB  - Acute suppurative parotitis is a possible consequence of poisoning by
      organophosphates (E 605). The endogenous accumulation of acetylcholine results-
      as in the acute pancreatitis caused by poisoning with organophosphates--in
      massive hyperemia and an increased secretory activity with leakage of saliva into
      the tissue, in an activation of the kallikrein-kinin system, the phospholipase
      A2, and, ultimately, in toxic tissue lesions caused by lysolecithin and the
      superoxide-radical anion. In spite of antibiotic therapy this is followed by
      bacterial inflammation. Treatment consists in the administration of aprotinin
      (Trasylol) and corticosteroids. In the case of abscess formation surgical
      drainage is necessary.

PMID- 2242184
TI  - [The accuracy of subjective determination of auditory threshold in the range of
      0.5 to 18.0 kHz using different sound transducer systems].
AB  - This paper reports on the degree of accuracy of determinations of hearing
      threshold in the 0.5 to 18 kHz range. As far as possible, these hearing
      thresholds were compared with those of ISO 389. Furthermore, the study compared
      determinations of hearing thresholds measured on different days. Reproducibility
      was very good, particularly of the high-frequency thresholds. The two types of
      sound transducers used here (a quasi-free field system developed by the authors
      and a pair of professional headphones) showed an identical transmission of
      frequencies and good reproducibility of the results of measurements.

PMID- 2242185
TI  - [Relations between the summation potential and frequency selectivity].
AB  - In cases of inner ear diseases, e.g.m. Meniere, summation potential (SP) can be
      measured using the extratympanic elektrocochleographic method. This potential is
      a consequence of hydrops in the cochlea. In 128 patients with confirmed SP, it
      was also possible to measure frequency selectivity (FS) using the psychoacoustic
      method. Reduced FS was found to a greater or lesser degree in the basal and
      apical turn of the cochlea. It can be assumed that both phenomena are to be
      attributed to the same cause.

PMID- 2242186
TI  - [The latency behavior of early auditory evoked potentials in high frequency
      hearing loss].
AB  - We evaluated the auditory evoked brainstem responses of 53 patients with
      unilateral or bilateral (79 ears) high-frequency hearing loss of cochlear origin,
      to see whether the reduction of I-V latency difference in high-frequency hearing
      loss that has been described by several authors, was present in our patients. We
      were able to confirm that in high-frequency hearing loss wave I-latency is
      significantly positively correlated with the degree of hearing loss. The I-V
      latency difference is significantly negatively correlated with the degree of
      hearing loss at 2000 Hz.

PMID- 2242187
TI  - [Computerized tomography findings in neck abscess ].
AB  - Computed tomography was the diagnostic confirming method in two patients with a
      necrotic cervical phlegmon caused by an infection of streptococcus pyogenes and
      candida albicans. A cervical phlegmon is frequently caused by the lymphogenic
      transmission of diverse primary infections. The time between the primary
      infection and the appearance of a cervical phlegmon is very varied. In rare cases
      it is possible that the primary focus will have cured completely. The cervical
      fasciae separate the neck into three different spaces, which, together with their
      hypostatic abscess paths, can be visualized using CT. The use of the central
      veins (e.g., the jugular vein) to administer medication etc. means that the deep
      cervical phlegmone will continue to be a complication in intensive-care patients.

PMID- 2242188
TI  - [Modern imaging of the larynx].
AB  - Many diseases of the larynx can be diagnosed by clinical examination. In many
      cases, however, further diagnostic procedures are necessary to receive adequate
      information on the localisation and extent of the lesion. In the present paper
      the authors report on the different possibilities of diagnostic imaging of the
      larynx. The value of each technique is discussed to set adequate indications as
      well as to recommend an appropriate imaging for laryngeal lesions.

PMID- 2242189
TI  - [Differential diagnosis of otorhinolaryngologic pain syndromes].
AB  - As a guiding symptom, acute pain usually leads to the correct diagnosis. In most
      cases, chronic pain has lost its warning effect. It is often a diagnostic problem
      to localize the starting point of the pain. Thus, seeking the advice of a number
      of specialists has proved to be valuable. In more than half of the "pain
      patients", complaints of pain in the head and neck area are prevalent. The
      article deals with several pain syndromes which are of importance for the ENT
      physician. Pain in the ear can be caused by inflammation, tumor, or injury in the
      area of 5th, 7th, 9th, and 10th cranial nerves, and of the course of the cervical
      nerves 1-3. In facial pain, symptomatic reasons such as tumors along the involved
      nerves, Sjogren's, or styloid syndrome, have to be taken into consideration.

PMID- 2242190
TI  - [A short history of hearing research. II. Renaissance].
AB  - The history of basic research on the function of the hearing organ is revisited.
      The present, second part of the review covers the period between the renaissance
      of anatomical research in the 16th century and the beginning of modern hearing
      research at the end of the 19th century. Andreas Vesalius gave the two ossicles
      malleus and incus their names. His scholar Philippus Ingrassia found 1546 the
      third ossicle, the stapes. The cochlea was discovered 1552 by Bartholomeus
      Eustachius and denoted as cochlea 1561 by Gabriel Falloppio. Thomas Willis
      speculated 1672 that different "tones" (species audibilis) may excite different
      fibres of the nervus acusticus. In collaboration with the physicist Edme
      Mariotte, Joseph Guichard DuVerney developed in 1683 a theory of the tonotopical
      organisation of the cochlea, the encoding of acoustic information by mechanical
      spectral analysis. The scholastic dogma of Aristotle's aer implantatus was
      contradicted by Domenico Cotugno as late as 1760. DuVerney's theory was, together
      with Georg Simon Ohm's law on the applicability of the Fourier analysis to sound
      waves, the basis of Hermann Helmholtz' famous theory of hearing of 1863. Due to
      the lack of detailed knowledge about the function of nerves, however, no clear
      ideas were developed about the acoustical information carried to the brain by the
      acoustic nerve. Also in the 19th century, Alphonso Corti discovered the organ
      that was named after him by Albert von Kolliker, and Flouren's experiments
      demonstrated the function of the vestibular organs. Furthermore, the foundations
      of auditory psychophysics were laid by Alfred M. Mayer and others.

PMID- 2242191
TI  - [Reconstruction of the rudimentary external ear].

PMID- 2242192
TI  - Health maintenance organizations and medical education: breaking the barriers.
AB  - Academic medical centers (AMCs) are under pressure to increase ambulatory medical
      education, but their capacity for such teaching is limited. Health maintenance
      organizations (HMOs) are a large and growing institutional setting that could
      participate in clinical education. Until now, relatively few HMOs and AMCs have
      reached agreements about teaching, because traditional suspicions have blocked
      collaboration. Responding to a case prepared as the basis of discussion, about
      450 academics and HMO medical directors explored the barriers to and incentives
      for cooperation between AMCs and HMOs in clinical education. The two groups
      identified different issues as barriers to collaboration, leaving considerable
      room to negotiate agreements. AMCs, especially, need to be prepared to offer
      meaningful academic and financial inducements to attract HMOs to participate in
      teaching.

PMID- 2242193
TI  - Feedback in an objective structured clinical examination by medical students
      serving as patients, examiners, and teachers.

PMID- 2242194
TI  - New thoughts about medical students as effective searchers of MEDLINE.

PMID- 2242195
TI  - Using a computerized database to manage a decentralized ambulatory care
      clerkship.

PMID- 2242196
TI  - Developing a computer-based system to document and report students' clinical
      patient encounters.

PMID- 2242197
TI  - Human values versus animal rights.

PMID- 2242198
TI  - AIDS: just another disease?

PMID- 2242199
TI  - A survey of medical school teachers to identify basic biomedical concepts medical
      students should understand.
AB  - Insights from the cognitive sciences indicate a continuing need for physicians to
      understand conceptual knowledge from the basic sciences, despite recent concerns
      regarding the increasing amount of information in medicine and the growing
      emphasis on performance skills. A 1987 survey of selected basic science and
      clinical teachers in North American medical schools was undertaken to identify
      basic biomedical concepts that are important in the practice of medicine and to
      specify how difficult these are for students to learn, apply, or both. Responses
      from faculty (nominated by their deans to answer the survey) from 82% of the
      medical schools indicated considerable agreement between the basic science
      teachers and clinical teachers on the relative importance of a set of biomedical
      concepts, and showed relatively minor levels of disagreement on how difficult
      these concepts are. The judgments of these teachers could prove extremely useful
      in (1) determining concepts that--because of their importance--should receive
      special attention in curriculum efforts, and (2) determining concepts that-
      because of their difficulty--need "special handling."

PMID- 2242200
TI  - Predictive validity of the American Board of Family Practice In-Training
      Examination.
AB  - Most research into the validity of graduate medical education in-training
      examinations has focused on construct validity and concurrent validity issues.
      This study examined the predictive validity of the American Board of Family
      Practice In-Training Examination using multivariate analysis of all U.S. family
      practice residents who took the certification examination in either 1987 or 1988.
      Results of these two certification examinations were analyzed for the cohorts of
      physicians who had taken in-training examinations as first-, second-, and third
      year residents. Multiple regression analysis showed that the composite score, and
      all but one part-score, of each in-training examination were independently
      predictive of performance on the certification examination. This study also found
      that the older residents did less well on the certification exam, and that men
      and women each did better on selected portions of the examination. The
      implications of these findings for in-training examinations in other specialties
      and for program directors and residents are discussed.

PMID- 2242201
TI  - Medical and dental students' attitudes about the AIDS epidemic.
AB  - This study investigated changes, over a one-year period, in medical and dental
      students' attitudes toward various issues related to contact with AIDS patients.
      In 1988 and 1989, the authors surveyed second- and third-year medical and dental
      students at one medical school both before and after they completed a year of
      required clinical training. The dental students remained consistently more
      anxious and more restrictive in their attitudes toward treating patients with
      AIDS than did their medical student counterparts, and became more conservative
      (fearful) in their attitudes after working with AIDS patients, whereas the
      medical students became more liberal. Overall, both groups were more concerned
      about contracting AIDS in their professional lives than in their personal lives.
      Over one-third of the medical students and two-thirds of the dental students
      indicated that they did not wish to train in a specialty or hospital with a high
      percentage of AIDS patients, and a substantial minority of the students in both
      groups did not feel that they were responsible for treating all patients whom
      they were qualified to treat. These and related results suggest that AIDS-related
      anxiety may influence students' career choices and behaviors and the quality of
      care patients receive. Suggestions for educational strategies to address
      students' fears--both warranted and unwarranted--and the differences in attitudes
      between students of different health-care professions are discussed.

PMID- 2242202
TI  - The impact of an AIDS symposium on attitudes of providers of pediatric health
      care.
AB  - Following reports of concern among health-care workers regarding the occupational
      risk of infection with the human immunodeficiency virus (HIV), a symposium was
      designed in 1987 to demonstrate to health-care providers at three hospitals in
      The Bronx, New York, the low risk of occupational HIV infection and techniques
      for avoiding infection. After the symposium, 103 of the health-care providers who
      had attended it completed a questionnaire assessing the impact of the symposium
      on their attitudes; the responses from 100 of these providers were used in this
      study. Twenty-nine of the responding providers reported that the symposium had
      increased their concerns regarding their risk of HIV infection; this group was
      composed of seven of the 15 medical students who responded, 12 of the 36
      housestaff, seven of the 28 faculty, and three of the 21 other medical staff. The
      findings of the present study suggest that a symposium designed to decrease
      concerns of occupational HIV infection among health-care workers may have the
      opposite effect on some of those who attend it, especially medical students.
      Education alone may be inadequate to reassure some providers. The authors
      recommend small-group sessions addressing the emotional aspects of health-care
      providers' concerns.

PMID- 2242204
TI  - Medical and nursing students' attitudes about AIDS issues.
AB  - A 12-item questionnaire was administered in late 1987-early 1988 to 445 medical
      students, 133 medical school applicants, and 111 nursing students to assess any
      differences in their attitudes toward medicine-related AIDS issues. These groups
      were also given a 31-item test of their knowledge of AIDS issues. Significant
      differences by levels of knowledge were obtained for eight of the 12 attitude
      items. For example, the more knowledgeable the student, the less likely he or she
      was to refuse treatment to an AIDS patient, to require mandatory AIDS testing of
      physicians, or to require medical personnel to wear gloves. The findings strongly
      suggest that education has an important role in changing attitudes about AIDS in
      a direction that fosters better health care for AIDS patients.

PMID- 2242203
TI  - Attitudes of medical school faculty and students toward acquired immunodeficiency
      syndrome.
AB  - Attitudes of faculty and students will influence the success of educational
      programs to address acquired immunodeficiency syndrome (AIDS). In 1988-89, 170
      medical school faculty and 227 students completed needs assessment questionnaires
      at the University of Louisville, and the results were compared to assess the
      respondents' attitudes about AIDS. Both the faculty and the students were found
      to be fearful of infection, had strong negative attitudes toward AIDS patients,
      and had low levels of confidence in the current knowledge about AIDS. Both
      cognitive and affective training strategies are recommended to help learners
      distinguish unwarranted from warranted fears of infection and to increase their
      empathy for patients with AIDS.

PMID- 2242205
TI  - Predictors of medical and nursing students' levels of HIV-AIDS knowledge and
      their resistance to working with AIDS patients.
AB  - Among health professionals, knowledge about the human immunodeficiency virus
      (HIV) and acquired immunodeficiency syndrome (AIDS) is often limited, inaccurate,
      or both. Many health professionals also resist working with AIDS patients. This
      1988 survey examined exaggerated risk estimates for HIV contagion in relationship
      to HIV-AIDS knowledge and resistance to working with AIDS patients among medical
      and nursing students at a large Northwestern teaching hospital. The results
      indicate that among the respondents, exaggerated risk estimates were associated
      both with a lack of HIV-AIDS knowledge and with greater resistance to working
      with AIDS patients. Results from multiple regression analyses revealed that (1) a
      lack of clinical experience with AIDS patients and (2) antihomosexual attitudes
      were significantly associated with the students' lack of HIV-AIDS knowledge, even
      after controlling for the effects of exaggerated risk estimates. The first two
      variables also were shown to be significantly predictive of the students'
      resistance to working with AIDS patients, as was an intolerance of drug use and
      drug users, beyond the influence of exaggerated risk estimates. Specific
      approaches of developing effective HIV-AIDS educational programs for health
      professionals are proposed.

PMID- 2242206
TI  - Willingness of health-professions students to treat patients with AIDS.
AB  - This 1988-89 survey of 319 students in the medical, dental, nursing, and allied
      health-care professions revealed that over one-third had some reservations about
      treating acquired immunodeficiency syndrome (AIDS) patients. Most were unwilling
      to perform mouth-to-mouth resuscitation on patients with AIDS, and most also
      believed that health-care workers had the right to refuse care to AIDS patients.
      Unwillingness to treat AIDS patients was strongly associated with homophobic
      attitudes and concerns that patients with AIDS posed a risk to health
      professionals. AIDS education for health professionals should emphasize methods
      for the prevention of HIV infection among health workers, and include teaching
      strategies designed to deal with the irrational feelings that AIDS often
      engenders.

PMID- 2242207
TI  - Analysis of residents' performances on the In-Training Examination of the
      American Board of Anesthesiology-American Society of Anesthesiologists.
AB  - An analysis of the results of the In-Training Examination of the American Board
      of Anesthesiology-American Society of Anesthesiologists has been developed using
      a new question-categorization method and a new form of calculation, the resident
      index score. Resident index scores permit comparison of the performance of any
      program's residents with the performance of all U.S. residents who took the
      examination. This study analyzed examination results from eight residency
      programs for a five-year period, 1983-1987. Statistically significant differences
      in the residents' performances were found both within and among the residency
      programs during this time. Areas of educational strength and weakness were
      identified by levels of training for each program. The analyses of the individual
      programs' results were provided to the respective program directors on a
      confidential basis, and have been used to change curriculum content, modify
      lectures for residents, and provide structured review for residents. Similar
      analyses can be provided as a service to other residency program directors.

PMID- 2242208
TI  - Minority students' career choices and education five years after they completed a
      summer enrichment program.
AB  - The purpose of this follow-up study was to ascertain the career selections and
      college majors of 101 students from minority groups who had attended a summer
      enrichment program at the Medical College of Georgia (MCG) in Augusta from 1979
      to 1983, to determine whether the program had been successful influencing the
      students to choose a health-related career. All the students had completed high
      school within the previous five years; they were contacted by mailed
      questionnaires or telephone. The study was completed by contacting the colleges
      where the students had enrolled and through the use of the Student and Applicant
      Information System of the Association of American Medical Colleges. The findings
      showed that the students had enrolled in and graduated from college and that a
      significant number of the students had chosen medicine or another health-related
      career. The study suggests the importance of early academic intervention for
      students from minority groups to choose a medical career.

PMID- 2242209
TI  - The relationship of minority students' MCAT scores and grade point averages to
      their acceptance into medical school.
AB  - The authors identified relationships between quantitative academic variables-
      specifically, grade-point averages (GPAs) and Medical College Admission Test
      (MCAT) scores--and the admission decisions of 58 students from minority groups
      underrepresented in medicine. These students had participated in a summer
      enrichment program at the University of Virginia School of Medicine and had
      applied to medical school. A total of 49 of the students were offered admission,
      and ultimately enrolled in 17 different medical schools. Results of a stepwise
      multiple regression analysis indicated that scores on the Skills Analysis:
      Quantitative Subtest of the MCAT explained the greatest percentage of the
      variance related to medical school admission (26%); scores on the Skills
      Analysis: Reading Subtest contributed an additional 7% to the explained variance,
      and scores on the Physics Knowledge Subtest, another 5%. The overall GPAs did not
      contribute significantly to the explanation of the variance in admission
      decisions. These results differ from published findings based on data from
      minorities' admissions to individual institutions. Caution must therefore be
      exercised when using GPAs and MCATs as medical school admission predictors for
      students from minority groups.

PMID- 2242211
TI  - Assessing patients' satisfaction with care provided by residents in an academic
      HMO setting.

PMID- 2242210
TI  - Medical students' views of how the HIV-AIDS epidemic affects their education and
      choice of training programs.

PMID- 2242212
TI  - An interview technique to complement traditional criteria used in selecting
      internal medicine housestaff.

PMID- 2242213
TI  - Differences in teaching skills and attitudes among residents after their formal
      instruction in teaching skills.

PMID- 2242214
TI  - Evaluation of a case-oriented curriculum for an introduction to clinical medical
      course.

PMID- 2242215
TI  - Graduating medical students' debt and specialty choices.

PMID- 2242216
TI  - Guidelines for dealing with faculty conflicts of commitment and conflicts of
      interest in research. July 1990. Association of American Medical Colleges Ad Hoc
      Committee on Misconduct and Conflict of Interest in Research.

PMID- 2242217
TI  - The role of frontal neurons in pain and acupuncture analgesia.
AB  - To study the role of frontal neurons in pain and acupuncture analgesia,
      experiments were carried out on 4 monkeys (Macaca mulatta) during performing two
      tasks, the Heat Discrimination Response GO/NO-GO Task (Task I) and the Heat
      Delayed Discrimination GO/NO-GO Task (Task II). After a criterion of 90% of
      correct performances over three successive days had been reached, activity of
      single neurons was recorded from the frontal cortex. Of 276 Task I-related
      neurons, 211 responded to noxious and/or innocuous heat stimuli. Of 73 Task II
      related neurons, 59 responded to noxious and/or innocuous heat stimuli. During
      acupuncture, the nociceptive reaction time for lever release to avoid painful
      stimuli was increased, the percentage of correct performances was lowered, and
      the neuronal responses to noxious and/or innocuous stimuli were suppressed. These
      neurons were mainly located in a circumscribed area medial to the superior ramus
      of the arcuate sulcus in frontal cortex, including the prefrontal and premotor
      areas. It is suggested that neurons in this area may be related to the
      discrimination of noxious and innocuous stimuli. The suppression of the activity
      of these neurons during acupuncture may be involved in the whole mechanism of
      acupuncture to facilitate the production of analgesia.

PMID- 2242218
TI  - Synaptic inputs from rods and cones to horizontal cells in the tiger salamander
      retina.
AB  - Synaptic inputs from rods and cones to horizontal cells (HCs) were studied in the
      flatmounted isolated retinas of the tiger salamander. Voltage-intensity
      relations, spectral sensitivities and response waveforms of the rod, the cone,
      and the HC under dark- and light-adapted conditions were examined. HCs receive
      mixed inputs from rods and cones in both dark- and light-adapted retinas. The
      relative rod/cone input in HCs depends on the intensity of stimulus and
      background illumination, and it varies from HC to HC.

PMID- 2242219
TI  - Spectra properties of rat liver mitochondrial choline dehydrogenase.
AB  - Choline dehydrogenase contains the prosthetic group FAD, non-haem iron and acid
      labile sulfur. However, the absorption spectra of the purified enzyme do not
      change after adding substrate. The reduced absorption spectra of choline
      dehydrogenase can only be determined after the addition of dithionite. Those
      choline dehydrogenases situated in the mitochondrial inner membrane can be
      reduced by substrate and exist in the reduced state. When cholate was used to
      solubilize the substrate-reduced choline dehydrogenase, the reduced spectra will
      gradually disappear. However, if solubilization is carried out under anaerobic
      conditions, the reduced spectra can be retained, suggesting that the solubilized
      choline dehydrogenase can use oxygen as an acceptor.

PMID- 2242220
TI  - Preliminary crystallographic analysis of deshexapeptide (B25-B30) insulin.
AB  - Satisfactory single crystals of deshexapeptide (B25-B30) insulin for X-ray
      crystal structure analysis have been grown in citrate buffer by the method of
      hanging-drop gas phase diffusion. The crystal belongs to the monoclinic system
      with space group C2. The unit cell constants are a = 42.6 A, b = 37.9 A, c = 27.2
      A, beta = 125.4 degrees and there is only one molecule of deshexapeptide insulin
      in an asymmetric unit.

PMID- 2242221
TI  - Effects of deoxycorticosterone acetate on muscle electrolytes, resting potential
      and mitochondria in rats.
AB  - Deoxycorticosterone acetate, injected daily for 5, 10, 20 or 30 days, reduced the
      serum potassium levels of rats by about 25%, a decrease that was independent of
      the treatment period employed. Serum sodium concentrations were unchanged with
      treatment duration. The potassium concentrations in extensor digitorum longus
      (EDL) and soleus (SOL) muscles were significantly decreased, and those of sodium
      increased, after treatment. Accompanying these changes of electrolyte
      concentration, the resting membrane potentials of treated EDL and SOL were
      hyperpolarized in vivo, and showed depolarization with the decreases of external
      potassium concentrations in vitro. The mitochondria in the muscles of treated
      rats were damaged. The degree of damage was more serious in EDL than in SOL and
      was dependent on the duration of deoxycorticosterone acetate treatment.

PMID- 2242222
TI  - Presidential address 1990--coming in from the cold.

PMID- 2242223
TI  - Soothing techniques used in barium enema examinations.
AB  - This article is part of a research project being carried out to explore and
      develop stress reduction methods which can be used in x-ray departments. It
      describes the results of a survey which shows that a high proportion (90%) of
      those involved in barium examinations agree there is a relationship between the
      anxiety of the patient and the difficulty of the examination. Many of those
      involved in the examination (87%) report using methods which they think are
      effective in reducing patients' anxiety. There is little difference between the
      opinions of the various professional groups involved in barium enema
      examinations. From this research a list has been developed of the anxiety
      reduction techniques presently employed during barium enema examinations. The
      article endorses the need for further study of methods for reducing patients'
      anxiety during x-ray examinations.

PMID- 2242224
TI  - Ultrasound of the acute abdomen--Part IV.

PMID- 2242225
TI  - Bone density scanning for osteoporosis.

PMID- 2242226
TI  - Wrist arthrography.

PMID- 2242227
TI  - The DCR psychology course at Stoke.
AB  - This article describes the course developed at Stoke-on-Trent to cover the
      psychological aspect of patient care, inter-staff relationships and communication
      skills. Emphasis is placed on the recent developments in the content of course
      against a background of the continuing use of experimental learning methods. The
      importance of clinical experience is stressed together with the notion that
      students gain confidence in their own abilities by practising in a safe
      environment. The article is presented for the consideration of teachers engaged
      in this essential part of the syllabus and curriculum.

PMID- 2242228
TI  - Mitral valvuloplasty revisited.

PMID- 2242229
TI  - Emotionally and practically supporting those attending a radiotherapy department
      and radiographers working with them.

PMID- 2242230
TI  - The radiographer and the well-woman.

PMID- 2242231
TI  - Ultrasound of the acute abdomen--Part V.
AB  - Patients with an acute abdomen have complaints of brief duration which must be
      properly diagnosed and treated to reduce mortality and morbidity. There are a few
      instances, mostly involving massive haemorrhage, where the patient's condition is
      so poor that minutes count and a delay in operation will result in fatality.
      Imaging techniques have no role in these circumstances. In the majority of cases,
      however, there is time to make use of the various diagnostic imaging methods
      available to help arrive at the correct diagnosis. The role of ultrasound in this
      setting has been reviewed. Our own experience supports the view that it is an
      important modality for the investigation of patients with acute abdomen. It
      should be available on a round-the-clock basis.

PMID- 2242232
TI  - Multisite pressure ulcer prevalence survey.
AB  - The prevalence of pressure ulcers was 9.2% in the 148 hospitals included in the
      survey. Fifty-eight percent of ulcers were found in patients between the ages of
      70 and 89 years. The sacrum was the most common site of ulcers (38%), but the
      trochanter had the most Stage IV ulcers. Patients had an average of 1.7 ulcers,
      and Stage IV ulcers were more common in African-Americans and in hospitals over
      500 beds. The most commonly used support system was a purchased overlay, but 20
      percent of the patients with ulcers were lying on traditional hospital
      mattresses.

PMID- 2242233
TI  - Preventing pressure ulcers in institutionalized elders: assessing the effects of
      small, unscheduled shifts in body position.
AB  - This pre-test/post-test, two-week experimental clinical study compared the effect
      of small, unscheduled shifts in body position in preventing pressure ulcers in
      two groups of elders (n = 19) determined at risk by the Norton Scale. No
      statistically significant effects were found using these small shifts.

PMID- 2242234
TI  - Pressure relief characteristics of an alternating pressure system.
AB  - The pressure relieving characteristics of an alternating pressure mattress are
      compared to the characteristics of a traditional hospital mattress. The
      trochanteric pressures of 20 healthy volunteers had a mean of 95 (SD = 49) on a
      hospital mattress while the trochanteric pressures on the alternating pressure
      mattress had a mean of 67 (SD = 9) for the inflated cells and a mean of 23 (SD =
      7) for the deflated cells. Statistical analysis revealed significantly lower
      interface pressure for the alternating pressure mattress.

PMID- 2242235
TI  - Stage I in ebony complexion.

PMID- 2242236
TI  - Personality, social support, and psychological distress in later life.
AB  - A conceptual model was developed to address 2 issues that have received
      relatively little attention in the social support literature. First, an attempt
      was made to assess the interrelationships among 3 types or dimensions of
      supportive social relations. In addition, the impact of selected psychological
      and social factors on social support use was examined. Findings from a nationwide
      survey of older adults in the United Kingdom suggest that social contact tends to
      increase the amount of received support, and received support in turn tends to
      bolster perceptions of support availability in the future (i.e., anticipated
      support). With regard to the second issue, social roles (especially marital
      status) and social extraversion emerged as potentially important correlates of
      social support use in later life.

PMID- 2242237
TI  - Social control, health risk taking, and psychological distress among the elderly.
AB  - Most research on older adults' social networks has focused on the support
      providing function of social relationships. Little gerontological research has
      addressed social control, or the role of social bonds in regulating deviant or
      risky behavior. Drawing on sociological theory, this study examined the
      hypothesis that social control discourages risky health practices while provoking
      psychological distress. Structured interviews conducted with 162 community
      residing older adults assessed social control (direct attempts by other to
      influence participants' health practices and the existence of significant role
      obligations to others), health risk taking (medication misuse, alcohol
      consumption, cigarette smoking, and the overall level of unsound health
      practices), psychological functioning (depression, loneliness, and self-esteem),
      and interpersonal satisfaction (satisfaction with friends and family members).
      Analyses revealed little support for the hypothesis. Social control was only
      weakly related to participants' health practices and, contrary to expectation,
      was generally related to less psychological distress and to greater interpersonal
      satisfaction. Implications for social control theory and for further research are
      addressed.

PMID- 2242238
TI  - Choosing social partners: how old age and anticipated endings make people more
      selective.
AB  - Carstensen's selectivity theory, which explains age-related change in social
      behavior in terms of emotion conservation and increasing discrimination among
      social partners, was investigated in 2 studies. In Study 1, 80 people aged 14 to
      95 classified descriptions of people according to their similarities as social
      partners in terms of affect anticipated in the interaction and that this
      dimension was most important to older people. Study 2 showed how anticipated
      social endings influence partner selection: 380 people aged 11 to 92 chose
      familiar or novel partners under unspecified and ending conditions. Overall,
      older people chose familiar partners most frequently; yet when social endings
      were salient, younger people patterned the preferences of the elderly. These
      results suggest that social partner selectivity functions to conserve emotion
      resources in the face of limited future opportunities.

PMID- 2242239
TI  - Age differences in the enjoyment of incongruity-resolution and nonsense humor
      during adulthood.
AB  - This study tested a model of the development of incongruity-resolution and
      nonsense humor during adulthood. Subjects were 4,292 14- to 66-year-old Germans.
      Twenty jokes and cartoons representing structure-based humor categories of
      incongruity resolution and nonsense were rated for funniness and aversiveness.
      Humor structure preferences were also assessed with a direct comparison task. The
      results generally confirmed the hypotheses. Incongruity-resolution humor
      increased in funniness and nonsense humor decreased in funniness among
      progressively older subjects after the late teens. Aversiveness of both forms of
      humor generally decreased over the ages sampled. Age differences in humor
      appreciation were strongly correlated with age differences in conservatism. An
      especially strong parallel was found between age differences in appreciation of
      incongruity-resolution humor and age differences in conservatism.

PMID- 2242240
TI  - Ability correlates of memory performance in adulthood and aging.
AB  - The predictive relationships between an array of cognitive process and
      intellectual ability variables and text- and word-recall performance were
      examined. A sample of 584 men and women from 3 age groups (19-36, 55-69, and 70
      86 years) completed a battery of 23 tasks marking 2 latent criterion variables
      and 10 latent predictor variables. The results indicated that (a) individual
      differences in process and ability variables predict performance on text and word
      recall, accounting for approximately half of the variance; (b) the pattern of
      predictors is quite similar for text and word recall; (c) age-related differences
      in text and word recall can be substantially accounted for by individual
      differences in constituent abilities, particularly indicators of verbal speed and
      working memory; and (d) there is some evidence to suggest that the pattern of
      ability-performance relationships varies across age, but such interactions appear
      to be relatively small.

PMID- 2242241
TI  - Application of social skills training in a group of institutionalized aggressive
      elderly subjects.
AB  - A social skills training program consisting of instructions, modeling, role
      playing, and feedback was carried out with a group of 6 verbally aggressive
      institutionalized elderly patients. Dependent measures included confirmed
      incidents of verbal aggressive behavior monitored across an ABAB design with a 5
      month follow-up period. Results indicated that verbally aggressive behavior can
      be significantly decreased in a group-training setting and subsequently
      generalized to ward and other socialized behavior. Ancillary aspects of the study
      include the role of social reinforcement, participant modeling, and staff
      attitude, perception, and motivation. Implications for future research are
      discussed.

PMID- 2242242
TI  - Effects of aging on source monitoring: differences in susceptibility to false
      fame.
AB  - Older adults were less likely than young adults to spontaneously recollect the
      source of familiarity for previously read nonfamous names. Older adults were more
      likely to call old nonfamous names famous when subsequently encountered in a fame
      judgment task. Poor source monitoring by the elderly could not be accounted for
      by inability to recognize earlier read nonfamous names when specifically asked to
      do so. Both source-monitoring errors and recognition memory performance were
      based on attributions made about the experience of familiarity. Elderly subjects
      most prone to making familiarity errors recalled fewer items on a verbal learning
      task and were less likely to chunk information into semantic categories as it was
      recalled. This finding suggests that a decline in the tendency to spontaneously
      organize and integrate information underlies the poor source monitoring observed.

PMID- 2242243
TI  - Memory Functioning Questionnaire: concurrent validity with memory performance and
      self-reported memory failures.
AB  - Concurrent validity of factor scores from the Memory Functioning Questionnaire
      (MFQ; Gilewski, Zelinski, & Schaie, in press) with memory performance was
      investigated in 2 studies. Study 1 involved 198 adults aged 55-85; Study 2, 89
      adults aged 50-87. After effects of depression, education, and health were
      partialed out, MFQ scores predicted performance on laboratory memory tests in
      Study 1 and performance on clinical memory tests and diaries of memory failures
      over 2 weeks in Study 2. Additional variance in predicting performance and
      failures recorded in diaries is accounted for by MFQ scores after partialing out
      subjects' responses to a yes-no question about whether they have memory problems.
      Results suggest that the MFQ has moderate concurrent validity with memory
      measures and is preferable to responses to a single question about memory self
      perception in assessing memory complaints in normal adults.

PMID- 2242244
TI  - Using personal and fictional documents to assess psychosocial development: a case
      study of Vera Brittain's generativity.
AB  - Adult diaries and novels written by the British feminist and pacifist Vera
      Brittain (1893-1970) were content analyzed for Eriksonian themes of identity,
      intimacy, and generativity. Brittain's concerns with identity and intimacy
      decreased over time, while her generative concerns increased, suggesting that she
      expressed the issue of generativity vs. stagnation in her mid-life diaries and
      fiction. The large number of identity themes relative to both intimacy and
      generativity provokes speculations about Brittain's personality, the
      characteristics of writers, the influence of gender, the impact of society, and
      the possibility that the crisis of identity vs. role confusion involves the last
      major structural change in personality development. This archival case study is
      consistent with Erikson's notion of a sequence of concerns with psychosocial
      issues, although directions for theoretical revision and elaboration are
      discussed.

PMID- 2242246
TI  - Effects of increased processing demands on age differences in working memory.
AB  - Three studies investigated (a) the plausibility of the claim that increasing the
      processing demands in a memory task contributes to greater involvement of a
      central processor and (b) the effects of altering reliance on the central
      processor on the magnitude of age-related differences in working-memory tasks. In
      the first study, young adults performed versions of 2 tasks presumed to vary in
      the degree of reliance on the central processor. In the second and third studies,
      young and older adults performed versions of a computation-span task that were
      assumed to vary along a rough continuum of the amount of required processing. The
      results indicated that although a central processor appears to be involved when
      working-memory tasks require simultaneous storage and processing of information,
      age-related differences in working memory seem to be determined at least as much
      by differences in the capacity of storage as by differences in the efficiency of
      processing.

PMID- 2242245
TI  - Psychological distress and somatic symptoms after natural disaster: differential
      vulnerability among older adults.
AB  - In a panel study, more than 200 older adults were interviewed before and after a
      severe flood in southeastern Kentucky in 1984. The issue in this study was
      whether older adult flood victims were differentially vulnerable to increases in
      psychological and physical symptoms on the basis of their age, sex, marital
      status, occupational status, education level, and preflood symptom levels. Flood
      exposure was related to increases in depressive, anxiety, and somatic symptoms at
      18 months postflood. Within this older adult sample, men, those with lower
      occupational status, and persons aged 55-64 were at significantly greater risk
      for increases in psychological symptoms. Sociodemographic status did not moderate
      the impact of flood exposure on physical health. Implications for crisis
      intervention services to older adult disaster victims are discussed.

PMID- 2242247
TI  - Social support, life events, and stress as modifiers of adjustment to bereavement
      by older adults.
AB  - As part of a larger panel study, interviews were obtained from 3 samples of older
      adults: 45 persons who had recently lost a spouse, 40 who had lost a parent or
      child, and 45 who were not bereaved. Assessments were conducted before and after
      the deaths. In the widowed sample, health remained quite stable, but depression
      increased sharply, then remained elevated. Changes were minimal in the sample who
      had lost a parent or child and in the nonbereaved sample. Multiple regression
      procedures were used to identify factors that contribute to depression and health
      9 months after the spouse's death. Postbereavement depression was associated with
      higher prebereavement depression, higher financial pressures, higher global
      stress, fewer new interests, and lower social support. Health was a function of
      prebereavement health, new interests, financial pressures, and global stress. In
      general, life events and resources had stronger effects in the widowed sample
      than in the comparison samples.

PMID- 2242248
TI  - Structural equation models of relationships between exercise and cognitive
      abilities.
AB  - Data were obtained from 300 men and women aged 55 to 91. Separate structural
      equation models of relationships between physical exercise and 3 cognitive
      performance variables--reaction time, working memory, and reasoning--fit the data
      well. Other variables in the models were age, health, education, and morale. Age
      and exercise affected each performance variable directly; education had a direct
      effect on reasoning only. There were also indirect effects of age and health on
      performance variables, mediated through exercise. The main hypothesis of the
      study, that exercise contributes to performance, was supported. A large decrease
      in model fit resulted when the path from exercise to each performance variable
      was deleted. Hypotheses that age-related deficits are primarily accounted for by
      lack of exercise or by poor health were not supported.

PMID- 2242249
TI  - Goal instability and later life adjustment.
AB  - A series of analyses on the goal instability personality construct, as measured
      by the Goal Instability Scale (GIS), was conducted to establish the construct
      validity of goal instability as it relates to older adults. This construct was
      derived from Heinz Kohut's psychology of the self. The sample consisted of a
      total of 157 voluntary early retirees representing a cross section of worker
      types from a manufacturing industry. In the first analysis, a series of
      confirmatory factor analyses supported the hypothesis that the 10-item GIS
      measures a unitary construct. In the second analysis, GIS was found to be similar
      across age groups. These findings enhance the conceptual clarity of the goal
      instability construct and its relevance with regard to older adults. Goal
      instability may represent 1 negative aspect of a quest for self-continuity.

PMID- 2242250
TI  - Close friendships among senior adults.
AB  - The purpose of this research was to evaluate the relative contributions of
      personal, affective, and social exchange characteristics to satisfaction with the
      best friendship. Senior adults (N = 76) described and evaluated their best
      friendships in terms of positive and negative affect, equity, reciprocity of
      social support, and satisfaction. The individual's endorsement of communal and
      exchange orientations were included as personal characteristics. The study
      confirms that a communal orientation enhances satisfaction with a best friendship
      and that conflict and negativity detract from it. Social exchange characteristics
      were not related to friendship satisfaction. The need to reevaluate the role of
      social exchange in close relationships is discussed.

PMID- 2242251
TI  - Relationship of personal-social variables to belief in paternalism in parent
      caregiving situations.
AB  - Paternalism in family caregiving may jeopardize the older persons' autonomy; it
      needs to be better understood. Study objectives were to determine the
      relationship of belief in paternalism to personal-social characteristics and to
      determine the relative importance of these variables as predictors of belief in
      paternalism. Forty-six pairs of daughters (age 49.7) and mothers (age 77.7) were
      measured on belief in paternalism, dogmatism, attitude toward elders, affective
      feelings toward the other, and background and caregiving variables. Among both
      mothers and daughters, dogmatism and attitude toward elders were related to
      belief in paternalism; daughters' affective feelings was also related. Caregiving
      variables were unrelated, and demographic background was important only for
      daughters. Attitude toward elders was the strongest predictor. Results were
      interpreted in terms of a traditional family ideology.

PMID- 2242252
TI  - Cognitive complaints in elderly depressed and pseudodemented patients.
AB  - The cognitive complaints of 11 patients with depressive pseudodementia were
      compared with those of 22 patients with depression alone. Pseudodemented subjects
      were defined as depressed inpatients showing reversible cognitive impairment as
      measured by the Mini-Mental State Examination (MMSE); subjects with depression
      alone had no such impairment. For each group, cognitive complaints were highly
      correlated with depressive symptoms and were not related to MMSE scores. The
      pseudodemented group had significantly higher cognitive complaint scores,
      complaining more of difficulties with concentration and recent memory. Groups did
      not differ significantly in complaints of difficulties with remote memory.

PMID- 2242253
TI  - Nursing process: help or hindrance?
AB  - Many standard nursing texts effectively treat 'the nursing process' and 'nursing'
      as one and the same, yet there have been few attempts to critically analyse the
      concept and its implications. This paper seeks to do both.

PMID- 2242254
TI  - Individual rights vs institutional rights: nursing imperatives for the provision
      of aged care services.
AB  - This paper offers nurses a legal perspective on some of the major issues arising
      from the Federal Government's proposal to establish a standard form contract and
      a charter of residents' rights and obligations for elderly residents in hostels
      and nursing homes. In emphasising the significance of these proposals it suggests
      that nurses, individually or collectively, have the potential to make a
      significant contribution to the continuing user rights debate. The proposed
      charter and contract and the objectives sought to be achieved by this package are
      considered. While there are strong and persuasive arguments favouring the
      concept, it is suggested that as proposed the charter and contract would be
      largely unworkable and impractical. Progress of the consultation process between
      Government and other interested bodies and the effect of subsequent drafting
      changes is discussed. Finally, the manner in which members of the nursing
      profession with experience and expertise in the provision of aged care services
      may contribute to the ongoing user rights debate is addressed.

PMID- 2242256
TI  - Terminally ill patients' expectations of nurses.
AB  - This exploratory study was undertaken to discover what nursing behaviours
      terminally ill patients desire. To rank patients' attitudes and judgements a Q
      sort consisting of 70 cards was used. The statements covered three categories:
      physical and psycho-emotional care of patients and psycho-emotional care of
      significant other/s. "I would like the nurse to help me remain at home for as
      long as possible" was the most favoured statement and the least favoured was: "I
      would like the nurse to talk to me about death and dying." The overall theme was
      that responsive rather than directive nursing behaviours were desired. Analysis
      identified five Factors from which a model of responsive nursing care was
      developed. Interpretation of the Factors indicated patients desired responsive
      nursing care that enabled them and their families to bring their own resources to
      the dying process, rather than having imposed upon them care which nurses deemed
      appropriate.

PMID- 2242255
TI  - AIDS: attitudes and education.
AB  - The purpose of this study was to explore hospital employed health professionals'
      attitudes to AIDS and homosexuals. Questionnaires were distributed to all health
      professionals in a 250-bed paediatric teaching hospital in Perth, Western
      Australia. The results constitute a database for nurses involved in staff
      development and AIDS education. The findings indicate that such programs must
      deal with the personal domain of attitudes to AIDS and homosexuals as much as
      with factual information. Furthermore, meaningful differences between target
      groups must be accommodated within the design of the program.

PMID- 2242257
TI  - Physical assessment of people with AIDS.
AB  - Since the Declaration of Alma-Ata in 1978, primary health care (PHC) has been
      acknowledged as the most effective means of achieving "health for all". Promotion
      of the PHC model provides nurses with an excellent opportunity for professional
      growth and development. The PHC role of nurse practitioner is gradually emerging
      within the Australian health care system and if nurses are to fulfil this role
      adequately they need to equip themselves with additional skills. The art of
      performing competent physical assessment of clients is one such skill. As the
      concept of the AIDS nurse practitioner is being developed locally and overseas,
      this paper focuses on the physical assessment of people with AIDS. While the
      constellation of physical signs and symptoms they experience are all too familiar
      to those who work in the area, they are often unusual for those who do not.

PMID- 2242258
TI  - Continuing education in physical assessment: a pilot study.
AB  - This study examines the effectiveness of a five day educational program designed
      to teach registered nurses (RNs) comprehensive physical assessment techniques and
      associated skills. Tests and questionnaires measured nurses' knowledge and use of
      physical assessment skills before and three months after its completion. It was
      found that the group had increased its physical assessment knowledge and the
      majority were using the learned skills.

PMID- 2242259
TI  - Leiomyosarcoma of the sinonasal tract. A clinicopathologic study of nine cases.
AB  - The clinicopathologic features of nine cases of sinonasal tract leiomyosarcoma
      (SNTL) referred to the Armed Forces Institute of Pathology, Washington, DC,
      during the period from 1970 through 1988 are described. This report represents
      the largest study to date on SNTL, and our results are compared with the 21
      previously reported cases of SNTL. Of the nine cases described, patients ranged
      in age from 22 to 86 years (mean, 55 years). The most frequent clinical
      presentation was nasal obstruction unilaterally. The neoplasms were limited
      solely to the nasal cavity in four cases (44%) and involved both the nasal cavity
      and paranasal sinuses in the remaining five cases. Light microscopic,
      immunocytochemical, and ultrastructural features served to characterize these
      tumors as malignant neoplasms of smooth-muscle origin. In contrast with previous
      studies, immunocytochemistry was employed to differentiate SNTL from other
      spindle cell malignancies of the region, using newly available monoclonal
      antibodies to smooth-muscle antigens. Treatment was surgical. Radiotherapy or
      chemotherapy did not appear to affect the progression of the disease.
      Furthermore, no relationship was found between the aggressiveness of SNTL and
      morphologic parameters (eg, mitotic count and tumor size). Instead, prognosis was
      dependent on the distribution of disease at presentation. Of all 30 patients with
      SNTL described to date, 10 had the neoplasm confined solely to the nasal cavity.
      The 10 neoplasms did not recur. We conclude that SNTL may best be regarded as a
      locally aggressive neoplasm with only limited metastatic potential and that it
      could be curable by complete surgical excision.

PMID- 2242260
TI  - Improving diagnostic accuracy of cervical metastases with computed tomography and
      magnetic resonance imaging.
AB  - Elective neck dissection in patients with head and neck cancer continues to be
      controversial. The management of these patients would be greatly facilitated by
      improvements in predicting cervical metastases. Recent investigations have
      suggested that computed tomography and magnetic resonance imaging are more
      sensitive in detecting cervical metastases than physical examination. The
      Department of Otolaryngology at the Ohio State University Hospitals, Columbus,
      undertook a prospective study to compare the preoperative sensitivities of
      physical examination, computed tomography, and magnetic resonance imaging with
      pathologic findings in 27 patients undergoing neck dissections for head and neck
      cancer. The results indicate that computed tomography and magnetic resonance
      imaging were more sensitive (84% and 92%, respectively) than physical examination
      (75%), although the results did not achieve statistical significance. The
      sensitivity of combined computed tomography and magnetic resonance imaging was
      90%.

PMID- 2242261
TI  - The in vivo biologic effect of interleukin 2 and interferon alfa on natural
      immunity in patients with head and neck cancer.
AB  - Given the association of deficient natural immunity with the risk of metastatic
      disease, the ability to activate natural killer cell function may have a
      therapeutic significance. The effect of continuous infusion of interleukin 2 plus
      intramuscular interferon alfa on natural immune status was, therefore, analyzed
      in eight patients with head and neck cancer. Also evaluated was the effect of
      interleukin 2-interferon alfa therapy on lymphokine-activated killer cell
      activity as well as total lymphocyte count, percent of lymphocyte subsets, and
      levels of both circulating immune complexes and antibody classes. Both the
      percent and absolute number of natural killer cells (ie, CD56+ CD3- lymphocytes)
      within peripheral blood as well as natural killer cell activity against K562
      targets increased significantly with treatment. The remaining immune parameters
      were not significantly altered. The demonstrated capacity to modulate natural
      immune function supports the potential use of interleukin 2-containing regimens
      as a preventive measure against metastatic disease in patients with head and neck
      cancer.

PMID- 2242262
TI  - Distortion product otoacoustic emissions in normal and impaired adult ears.
AB  - Distortion product otoacoustic emissions (DPOEs) were recorded in a group of
      normally hearing subjects (29 ears) and a group of subjects whose conditions were
      diagnosed as sensorineural hearing loss (23 ears) to study any correlation that
      might exist between DPOE characteristics and hearing impairment of different
      configurations. Three different DPOE paradigms have been used to investigate the
      influence of different test parameters on the DPOE data for normal and hearing
      impaired ears. All normally hearing ears demonstrated detectable DPOEs, provided
      that the primary tone level was above a certain value. Hearing-impaired ears
      produced substantially reduced DPOEs compared with normally hearing subjects when
      the primary frequencies f1 and f2 corresponded to the region of hearing loss. Our
      data also suggested that, in general, more than one f2/f1 ratio is needed to
      examine any particular frequency region. The DPOEs provide frequency-specific
      information about cochlear function, which after further development, may form a
      basis for a noninvasive, objective method of evaluating cochlear function.

PMID- 2242263
TI  - A patient-oriented approach to perilymph fistula.
AB  - The subject of perilymph fistula is controversial in part because the
      preoperative diagnosis of perilymph fistula is difficult. Patients suffering
      auditory and vestibular symptoms secondary to perilymph fistula, therefore,
      present a dilemma to the practicing physician. In some instances, patients with
      auditory and vestibular symptoms in the absence of perilymph fistula will be
      subjected to middle ear exploration without benefit, while in other instances
      patients with auditory and vestibular symptoms secondary to perilymph fistula
      will be denied surgical treatment. Auditory and vestibular symptoms are a quality
      of life issue. Therefore, in an effort to provide care of the highest quality the
      patient must be actively involved in the decision process. Such involvement can
      be meaningful only after the patient is carefully counseled as to the pros and
      cons of surgery, as well as the alternatives. A prognostic paradigm based on the
      personal experience of one of us (W.L.M.) with perilymph fistula patients is
      described and is used in patient consultation in an effort to facilitate decision
      making.

PMID- 2242264
TI  - Relationships among loudness indexes in cochlear-implant patients.
AB  - The purpose of the experiment was to determine if the most-confortable-listening
      (MCL) levels and loudness-discomfort levels (LDLs) can be predicted from
      threshold measurements obtained from patients with cochlear implants using direct
      electrical stimulation. Psychophysical measurements of thresholds, MCLs, and LDLs
      with 125-Hz and 2000-Hz sinusoids were obtained from 16 patients with cochlear
      implants 1 month after the connection of their ineraid processor (an auditory
      prosthesis). In general, the correlation coefficients among the loudness indexes
      obtained with a 125-Hz stimulus were similar to those for a 2000-Hz stimulus.
      Correlations between thresholds and MCLs were moderate, whereas correlations for
      thresholds and LDLs were fair. Correlations between MCLs and LDLs were high. This
      suggests that LDLs cannot be predicted from thresholds. On the other hand, these
      preliminary data suggest that MCLs may be reliably predicted from thresholds or
      LDLs to set the gain on a cochlear-implant processor.

PMID- 2242265
TI  - Audiometric and subjective assessment of hearing handicap.
AB  - This study compares self-perceived assessment of hearing handicap with
      audiometrically derived measures of hearing handicap in a sample of elderly
      persons. Subjects were evaluated by traditional audiometric tests, the Speech
      Perception in Noise test, and the Hearing Handicap Inventory for the Elderly, a
      self-assessment questionnaire. Hearing handicap was also calculated by the
      audiometrically derived American Academy of Otolaryngology (1979) method. Our
      results are consistent with other studies that indicate a low correspondence
      between audiometric measures of hearing handicap and self-assessment of hearing
      handicap. Furthermore, if the Hearing Handicap Inventory for the Elderly is
      considered the true measure of hearing handicap, our data indicate that the
      American Academy of Otolaryngology method tends to overestimate handicap among
      persons with no self-perceived hearing handicap and underestimates handicap among
      persons with significant self-perceived hearing handicap.

PMID- 2242267
TI  - Chondrosarcoma of the larynx. Diagnosis with magnetic resonance imaging and
      computed tomography.
AB  - Chondrosarcomas are the most common sarcomas of the larynx. They are generally
      slow-growing lesions with insidious onset of symptoms. We are presenting a case
      of chondrosarcoma that recurred 10 years after excision of a presumed chondroma.
      Computed tomographic and magnetic resonance imaging (MRI) scans were performed.
      Both studies delineated the lesion nicely. To the best of our knowledge, this is
      the first report on MRI characteristics of chondrosarcoma of the larynx. A review
      of the literature regarding the use of computed tomography in the management of
      chondrosarcoma is presented. The MRI characteristics are discussed and the two
      scanning modalities are compared. Computed tomography is an excellent study in
      its ability to demonstrate the extent of the lesion within the laryngeal
      skeleton. Furthermore, it is more highly sensitive than plain roentgenograms in
      the detection of calcifications that are highly suggestive of chondrosarcoma.
      Alternatively, MRI can also demonstrate the lesion within the larynx but it has
      the added advantage of superior contrast resolution of the tumor and
      paralaryngeal tissues. When the three-dimensional imaging capacity of MRI is
      considered as well, MRI seems to be the superior study.

PMID- 2242266
TI  - Synovial chondromatosis of the temporomandibular joint presenting as an
      intracranial mass.

PMID- 2242268
TI  - Pathologic quiz case 2. Invasive Alternaria alternata.

PMID- 2242269
TI  - [Status of children's dental health care in Hillerod after 33 years of
      implementation].

PMID- 2242270
TI  - [Evaluation of a research project designed to improve nutrition of elderly
      persons who live at home].

PMID- 2242271
TI  - [Dental hygiene methods among 11-15-year olds from a health sociological point of
      view].

PMID- 2242272
TI  - Differential response of postischemic diabetic myocardium to a thromboxane
      mimetic.
AB  - The postischemic response of control, acute diabetic (48 h) and chronic diabetic
      (60 days) hearts was studied in isovolumically-perfused rat hearts. Isolated
      hearts were subjected to 20 min of total global ischemia with reperfusion at
      preischemic flow rates in the presence or absence of the thromboxane analogue, U
      46619. A low concentration (30 nM) of U-46619 which did not produce significant
      hemodynamic responses prior to ischemia caused significant decreases in
      isovolumic left ventricular developed pressure and increases in coronary vascular
      resistance during reperfusion of control but not acute or chronic diabetic
      hearts. Simultaneously, U-46619 stimulated an additional increment of
      prostacyclin release during reperfusion of control but not diabetic hearts. Thus,
      while diabetic hearts may be resistant to certain stimuli of postischemic injury,
      a caveat results in that the diabetic heart may be jeopardized by a failure to
      counter other potentially thrombotic or vasospastic factors in vivo by an
      inadequate compensatory increase in prostacyclin.

PMID- 2242273
TI  - Prostaglandin E2 evokes intracellular calcium rise in mouse osteoblastic cell
      line, MC3T3E-1.
AB  - The effect of prostaglandin (PG) E2 on the intracellular free calcium
      concentration ([Ca2+]i) in mouse osteoblastic clone, MC3T3E-1 cells, was
      investigated with the fluorescent probe fura-2. In the growing phase of MC3T3E-1,
      PGE2 evoked a transient rise of [Ca2+]i in a dose-dependent manner in the range
      from 0.28 microM to 5.6 microM of PGE2. The elevation of [Ca2+]i induced by PGE2
      was not affected by the presence of EGTA. Moreover, PGE2 (5.6 microM) evoked an
      acute accumulation of intracellular inositol-1,4,5-trisphosphate (InsP3). The
      absolute content of InsP3 increased from 5.8 pmole/10(6) cells to 19.2
      pmole/10(6) cells within 30 sec after the PGE2 treatment. The degree of [Ca2+]i
      elevation induced by PGE2 was dependent on the day after subculturing. At day 3,
      the response to PGE2 was the most pronounced during the 8-day experimental
      periods. These data suggest that PGE2 evoked a [Ca2+]i rise via a phospholipase C
      InsP3 pathway in osteoblasts, particularly in the growing phase.

PMID- 2242274
TI  - Stimulation of the 15-lipoxygenase in activated polymorphonuclear neutrophils.
      Influence of lipoxygenase inhibitors and hydroxyeicosatetraenoic acid
      derivatives.
AB  - Hydroxyeicosatetraenoic acids (HETEs) have previously been reported to stimulate
      the relatively inactive 15-lipoxygenase in A23187-activated human neutrophils to
      metabolize exogenously added arachidonic acid to 15-HETE. Several aspects of this
      HETE-induced activation process were examined. Pretreatment of intact PMNs with 3
      20 microM 15-HETE, A23187 and the 5-lipoxygenase inhibitor NDGA (or the dual
      cyclooxygenase/lipoxygenase inhibitor BW755C) followed by [14C]arachidonic acid
      addition resulted in an unexpected synergistic activation of the cryptic 15
      lipoxygenase activity. The ability of several HETE derivatives or analogues to
      stimulate the inactive 15-lipoxygenase was also investigated. The presence of the
      hydroxyl group but not its position was essential since 5-, 12- and 15-HETE were
      approximately equipotent and about ten times more effective than arachidonic
      acid. 5-HETE was more potent than 5-HETE methyl ester which suggested that a free
      carboxyl group was important. Both 5-HPETE and 5.15-diHETE were found to be less
      potent than 5-HETE. The C18 hydroxy fatty acid analogues 9- and 13-HODE were the
      least effective activators of the PMN 15-lipoxygenase activity that were tested.

PMID- 2242275
TI  - [Study on the estimation theory of genetic parameters--the estimation method when
      the parents were relative].
AB  - By decomposing the expected mean squares in variance analysis, the estimation
      methods of genetic parameters are suggested in sib analysis when the parents of
      the sibs are relatives. Two estimation examples are also given. The results
      indicate that the estimation values are greater than those estimated by supposing
      that the parents are not relatives. The closer relative the parents are, the
      bigger the biased would be. The computer programme PARESTH and PARESTF made it
      easy to apply the methods. Furthermore, the methods can also be used in variance
      analysis when the relationships between the levels of each factors are
      determined.

PMID- 2242276
TI  - [Characterization of the expression of LDH isozymes genes during non-hibernation
      Himalayan marmots].
AB  - The lactate dehydrogenase (LDH) isozymes from heart, liver, kidney and skeletal
      muscle in Himalayan marmots (Marmota himalayana robusta) in non-hibernation were
      investigated in the present experiment. The isozyme patterns were analyzed by
      means of disc electrophoresis and the ultraviolet enzymatic determination. The
      following conclusions were obtained: 1. It was found that two expression patterns
      of LDH genes presented in the skeletal muscle of Himalayan marmots. There was a
      LDH-B4 band only in one marmots and absent in others. The interindividual
      polymorphism of LDH isozyme patterns may be attribute to one or more regulator
      genes controlling synthesis of B-subunit of LDH. 2. LDH zymograms of various
      tissues of Himalayan marmots showed different subbands. This is presumably due to
      the existence of both symmetrical and asymmetrical conformers of this tetramer.

PMID- 2242277
TI  - [Cloning and expression of a promoter function fragment from Thiobacillus
      thiooxidans in Escherichia coli].
AB  - This paper reports a recombinant plasmid pSDR12 which is constructed through the
      substitution of the EcoRI-HindIII fragment of pBR322 by a specific fragment of
      chromosomal DNA of T. thiooxidans. After it was transformed into C600, the
      transformants revealed higher levels of Tc resistance. This result shows that a
      promoter function fragment from autotrophic bacteria is able to express in
      Escherichia coil.

PMID- 2242278
TI  - [Cloning and study on the replication origin of the integrated F plasmid in
      Escherichia coli].
AB  - The replication origin of the integrated F' plasmid was cloned by means of marker
      rescue. No difference in incompatibility and acridine orange sensitivity was
      found between the mini-F plasmid constructed from such an origin and the
      autonomous F' plasmid. Subcloning and comparative restriction enzyme analysis
      were carried out with the replication origin from the integrated F' plasmid and
      that from the autonomous F plasmid. No structural difference was found between
      them. These results suggest that the difference for the dependence of recA gene
      between the F and F' plasmids dose not come from any difference in structure of
      their replication origin, but probably from their site of integration on the
      chromosome.

PMID- 2242279
TI  - [Distribution of 8 blood group systems in Han ethnic group of Fujian Province,
      China].
AB  - The distribution of 19 red cell's antigens of 8 blood group systems in Han ethnic
      group in Fujian province, China was investigated. The gene and haloptype
      frequencies were as follows: p = 0.1936, q = 0.1766, r = 0.6298; p1 = 0.1427; Dia
      = 0.2830; m = 0.5695, n = 0.4305, S = 0.0339, s = 0.9661, MS = 0.0200, NS =
      0.0139, Ms = 0.5500, Ns = 0.4161; Fya = 0.8817; Jka = 0.4767; D = 0.9314, C =
      0.7617, E = 0.2357, r' = 0.0686, R1 = 0.6352, R2 = 0.1970, R0 = 0.0605, Rz =
      0.0388. Le (a +) phenotype frequency = 7.94%.

PMID- 2242280
TI  - [Molecular evolution and a speculative carcinogenesis mechanism for ras p21].
AB  - Ten of amino acid sequences of ras p21 which come from human, fruit fly, yeast,
      Dictyostelium and virus were collected and analyzed. Data analysis indicates
      that: 1. the mean duplicate rate of ras p21 is approximately 2.78 x 10(-9) per
      gene per year for concerted evolution; 2. the mean amino acid replacement of p21
      is about 2.23 x 10(-10) per year. It also shows that v-Has and v-Kis were derived
      from c-H-ras1 and c-K-ras2, respectively, and that c-H-ras1, c-K-ras2 and c-N-ras
      come from the same ancestor. These result are in accordance with the experimental
      results reported by other authors. According to the view of Fitch et al., we
      present here a speculative view for carcinogenesis mechanism the hypothesis for
      covarions and invarions, by which, the codon 12 or 61 mutated in p21 may be
      responsible for last one or more steps in carcinogenesis.

PMID- 2242281
TI  - [Genetic differentiation of red cell blood groups in fourteen populations of
      China].
AB  - Genetic differentiation among ethnic groups of China is analysed and discussed on
      the basis of gene frequency data of red cell blood groups. The degree of
      differentiation, measured by FST analysis of Wright, shows that the MNs system
      has much higher FST values than those of ABO system. This result is quite
      different from that calculated by Cavalli-Sforza (1966) on a worldwide basis.
      Generally speaking, the Rhesus, Lewis and MNSs systems are more useful in
      anthrological and human genetic studies on Chinese populations for they have a
      great variation. The genetic difference within and between 12 ethnic groups,
      namely, Han, Hui, Mongolian, Uygur, Zhuang, Yi, Korean, Manzu, Bai, Tibetan, Dong
      and Gaoshan, are also analysed. On the basis of gene frequencies of 15 blood
      group loci which are all polymorphic at least in one of 12 above-mentioned ethnic
      groups, the net coden difference between populations is calculated by method of
      Nei and Roychoudhury (1974), and phylogenetic dendrograms are constructed on the
      basis of net coden differences. Results obtained with the method of gene
      differentiation coefficient of Nei (1973) and that of Shannon information measure
      of Lewontin (1972), indicate that the genetic difference between ethnic groups of
      China accounts for only about 2% of the total genetic variation and is much
      smaller than that within ethnic groups. Genetic difference between three races of
      human being is also discussed by taking the Han living in northern China, as
      typical Mongoloids. On the basis of analysis of gene frequency data of 15 blood
      group loci, it is concluded that Mongoloids are genetically closer to black
      people than to white people.

PMID- 2242282
TI  - [Cytogenetic effects of attenuated live measles vaccine on male mice].
AB  - The cytogenetic effects of attenuated live measles vaccine on somatic and
      germinal cells of C57BL/6J mice were studied. The frequencies of micronuclei of
      polychromatic erythrocytes, nucleated cells, chromatid breaks, fragments in bone
      marrow cells, and micronuclei of spermatids in testes were increased, which have
      dose- and time-dependent relationship. However, there were no statistical
      difference between the treated and control mice in chromosomal breaks and
      fragments of spermatogonia primary and secondary spermatocytes. The results and
      their possible biological significance were also discussed.

PMID- 2242283
TI  - [Construction of promoter probe vector pFDC4 and gene expression vector pFDC11
      with high transformation efficiency in Bacillus stearothermophilus].
AB  - A 0.5kb fragment from Sau3A-digested total DNA of Bacillus stearothermophilus
      CU21 was cloned with the vector pPGV5, a derivative of pPL703. The insertion of
      this fragment can activate the expression of the promoteless cat-86 gene on the
      cloning vector in both B. stearothermophilus and Bacillus subtilis hosts. When
      the 0.54 kb fragment is present in pPGV5 in either orientation, the
      transformation efficiency of the plasmid is increased about 10(3) to 10(4) fold
      in CU21 protoplasts. Southern hybridization showed this 0.54 kb fragment was
      homologous with a 1.6kb fragment, which was shown by Imanaka et al. (1984, J.
      Gen. Microbiol. 130, 1399-1408) to originate in a cryptic plasmid resident in
      CU21 and to enhance the transformat on efficiency of another plasmid. With this
      0.54kb fragment a new promoter probe vector pFDC4 and a gene expression vector
      pFDC11 were constructed. Both can transform the CU21 recipient with high
      efficiency.

PMID- 2242284
TI  - [Purification of autographa californica nuclear polyhedrosis virus DNA and
      cloning of the polyhedrin gene].
AB  - Autographa califonica nuclear polyhedrosis virus (AcNPV) DNA from larvae of
      lepidopteran infected by AcNPV has been isolated. The EcoRI fragments of AcNPV
      DNA have been cloned using plasmid pBR325 as a vector. The polyhedrin gene
      fragment containing recombinant plasmid pAc-18 was isolated through in situ
      hybridization. For the convenience of further construction the EcoRI insertion
      fragment was cloned into pUC-8. Thus plasmid pUAc-2 was obtained. The results of
      restriction mapping of pAc-18 and pUAc-2 and part of the sequence were reported.
      The polyhedrin promotor was known to be one of the most effective promotor useful
      in the expression of foreign genes in the insect cells.

PMID- 2242285
TI  - [The construction of shuttle plasmid vector of Streptomyces and E. coli].
AB  - A shuttle plasmid vector, pSE-3 was constructed using the Streptomyces plasmid
      pIJ486 and E. coli plasmid pGEM-3 digested with BgIII and BamHI respectively. The
      shuttle plasmid pSE-3 could replicate and express its neomycin resistance in both
      Streptomyces and E. coli well. The pSE-3 has opposed promoters containing
      bacteriophage ST6 and T7, the restriction enzyme digestion showed that the pSE-3
      has a single site with HindIII and EcoRI respectively, it is very useful for the
      cloning and expression of the valuable gene inserts. The pSE-3 is stable in both
      of Streptomyces and E. coli after re-transformed pSE-3 is re-transformed from
      Streptomyces into E. coli and some 50 generations are propagated.

PMID- 2242286
TI  - Strategies for obtaining preventive services reimbursement.

PMID- 2242287
TI  - Paying for preventive care: moving the debate forward.

PMID- 2242288
TI  - The predictive value of forearm bone mineral content measurements in men.
AB  - Six hundred and fifty-four men had their bone mineral content (BMC) measured with
      single photon absorptiometry during 1970-1976. All roentgenograms 1975-1985 (11
      years) were registered and thus all falls requiring roentgen examinations. BMC
      was found to be of predictive value in ages below 70-80 with regard to future
      fragility fractures. Other characteristics were more falls, less grip strength,
      and weight. A history of previous vertebral fracture and cerebral disorder were
      also predictive. Men with only nonfragility fractures showed no differences
      compared to the nonfracture population.

PMID- 2242289
TI  - Increased mechanical strength of healing rat tibial fractures treated with
      biosynthetic human growth hormone.
AB  - The effects of biosynthetic human growth hormone on the biomechanical properties
      of healing tibial fractures and intact bones in the rat were studied after 20 and
      40 days of healing. Growth hormone, 2.0 mg per kg per day, was given
      subcutaneously in two daily doses. Control animals were injected with a
      corresponding volume of saline. After 20 days of fracture healing, there were no
      differences in mechanical properties between the healing fractures and intact
      bones. After 40 days, the ultimate load and maximum stiffness of the fractures of
      the b-hGH injected animals had increased to more than 400% of the corresponding
      values of the saline injected animals, and ultimate stress and energy absorption
      at ultimate load had increased to 270% compared with the saline injected animals.
      Ultimate load, stiffness, and energy absorption of the intact bones increased in
      the b-hGH injected animals, but no differences were found in ultimate stress
      values or normalized energy, indicating that the changes in the intact bones were
      quantitative phenomena.

PMID- 2242290
TI  - A computerised technique for the quantitative assessment of resorption cavities
      in trabecular bone.
AB  - A computerised technique is described for the quantitative assessment of
      resorption cavities in iliac trabecular bone. Using an Ibas II image analyser,
      the original bone surface, eroded by bone resorbing cells, is reconstructed using
      a curve fitting technique that maintains a smooth continuity with the trabecular
      bone on either side of the cavity. Resorption depths are measured using an
      interactive elastic circle; all identified cavities are measured regardless of
      whether or not resorption is complete, and the measurements made include mean and
      maximum cavity depth, cavity length, area, and adjacent trabecular widths.
      Results in 13 normal subjects are presented. The technique is reproducible,
      simple to operate, relatively rapid, and can be applied to less sophisticated
      image analysis systems.

PMID- 2242291
TI  - Prostaglandin E2 enhances cortical bone mass and activates intracortical bone
      remodeling in intact and ovariectomized female rats.
AB  - To assess the efficacy of prostaglandin E2 (PGE2) in augmenting cortical bone
      mass, graded doses of PGE2 were subcutaneously administered for 30 days to seven
      month old sham-ovariectomized (SHAM) and ovariectomized (OVX) rats. Both groups
      were operated at three months of age. Histomorphometric analyses of double
      fluorescent labeled tibial shafts were performed on basal control, OVX, and SHAM
      rats treated with 0, 0.3, 1, 3, and 6 mg PGE2/kg/d for 30 days. Baseline aging
      data showed increased cortical tissue and cortical bone area and reduced bone
      formation parameters at the periosteal and endocortical bone envelopes between
      three and eight months of age. The tibial shafts of OVX rats compared to SHAM
      controls showed elevated periosteal mineral apposition rate and endocortical bone
      formation parameters. PGE2 administration to OVX and SHAM rats increased cortical
      bone by the addition of new circumferential bone on the endocortical and
      periosteal surfaces, as well as woven cancellous bone in the marrow region.
      Stimulated osteoblastic recruitment and activity enhanced bone formation at all
      bone surfaces. The new bone was both lamellar and woven in nature. PGE2 treatment
      also activated intracortical bone remodeling (not seen in untreated eight-month
      old rats), creating a porous cortex. Thus, PGE2 administration activated cortical
      bone modeling in the formation mode (A----F), as well as intracortical bone
      remodeling (A----R----F). PGE2 administration to OVX rats resulted in more
      intracortical bone remodeling, periosteal bone formation, and new cancellous bone
      production than observed in PGE2 treated controls. The findings that PGE2
      administration to OVX and intact female rats increases cortical bone mass,
      coupled with observations that mouse, rat, dog, and man respond similarly to
      PGE2, suggest that PGE2 administration may be useful in the prevention and
      treatment of postmenopausal osteoporosis.

PMID- 2242292
TI  - The effects of the major vitamin D metabolites upon the resolution of
      osteomalacia in uremic adult rats.
AB  - We have previously shown that an osteomalacia dependent upon both a low
      phosphorus diet and uremia (five-sixth nephrectomy) can be produced rapidly in
      rats. This is associated with hypophosphatemia and elevated 1,25-dihydroxyvitamin
      D3 (1,25(OH)2D3). In order to investigate the role of exogenously administered
      vitamin D metabolites upon the resolution of this osteomalacia, 72 male Sprague
      Dawley rats weighting 320 +/- 20 g were subjected to a two-step, subtotal
      nephrectomy and subsequently fed a diet with low (0.03%) phosphorus (LP) for
      seven days. Groups of six rats each were then either continued on the LP diet, or
      switched to a nutrient-matched diet with normal (0.3%) phosphorus (NP) for an
      additional 10 days. During this time, the rats were infused daily with either: 27
      ng 1,25(OH)2D3; 81 ng 24,25 dihydroxyvitamin D3 (24,25(OH)2D3); 135 ng 25
      hydroxyvitamin D3 (25(OH)D3); both 27 ng 1,25(OH)2D3 and 81 ng 24,25(OH)2D3; or
      placebo. Dietary phosphorus repletion was found to reverse the osteomalacia by
      decreasing the growth plate thickness, the osteoid surface and volume, the
      osteoid maturation time, serum calcium, and plasma 1,25(OH)2D3, and by increasing
      the mineralizing surface, bone formation rate, and serum phosphorus. The
      osteomalacia was also reversed in phosphorus-repleted rats treated with
      24,25(OH)2D3, with no additional effects attributable to the 24,25(OH)2D3 itself.
      Osteomalacia in phosphorus-repleted rats treated with 25(OH)D3 or 1,25(OH)2D3 was
      only partially reversed; healing was interpreted to be impaired by the elevated
      plasma 1,25(OH)2D3 levels present in these rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242293
TI  - Distribution of type I and type II collagen gene expression during the
      development of human long bones.
AB  - The temporal and spatial gene expression of collagen type I and type II during
      the development of the human long bones was studied by the technique of in situ
      hybridization covering the period from the cartilagenous bone anlage to the
      formation of a regular growth plate in the newborn. Analysis of the early stages
      around the seventh week of gestation revealed for type II collagen a strong
      hybridization signal limited to the chondrogenic tissue. The surrounding
      connective tissue and the perichondrium showed weak type I collagen expression,
      while the zones of desmal ossification like the clavicle gave a strong signal.
      Beginning with the eighth week of gestation, type I collagen mRNA was detectable
      in newly formed osteoblasts at the diaphysis and appeared along with the
      formation bone marrow, in the areas of enchondral ossification. Parallel to the
      development of the different zones of cartilage differentiation, a specific
      pattern of type II expression could be observed: type II was mainly found in the
      chondrocytes of the hypertrophic zone and to a lesser degree in the zone of
      proliferation, while the resting zone and the zone of provisional calcification
      showed little activity. This segregation of type II expression was most
      pronounced in the early stages of cartilage calcification and in the growth plate
      of the newborn.

PMID- 2242294
TI  - A band of F-actin containing podosomes is involved in bone resorption by
      osteoclasts.
AB  - Isolated rabbit osteoclasts cultured on devitalized thin bone slices excavate
      resorption lacunae that can be visualized with brightfield or phase-contrast
      microscopy. Superimposition of the brightfield images of such resorption lacunae
      and the fluorescence images of the corresponding osteoclasts after fixation and
      staining with rhodamine-conjugated phalloidin revealed that a bright fluorescent
      band of F-actin-containing podosomes precisely outlined the resorption lacunae in
      stationary osteoclasts. When the resorption lacunae were being extended
      laterally, the clearly delineated band of podosomes corresponded to the advancing
      edge of the resorbing osteoclast and the most recently excavated part of the
      lacunae. Reshaping and reorganization of the bright bands preceded development of
      the lateral boundary of the lacunae. Podosomes forming these bands were highly
      dynamic, changed in size and location, and appeared and disappeared continuously.
      Their lifespan varied between 2 and 12 min. Similar bands were also seen in vivo
      in bone-resorbing osteoclasts on the endocranial surface of growing calvariae.
      Podosomes disappeared in osteoclasts treated with calcitonin, resulting in the
      disruption of the fluorescent bands. Our results suggest that podosomes are an
      essential part of the resorption apparatus of osteoclasts.

PMID- 2242295
TI  - Stimulation of bone formation in vivo by transforming growth factor-beta:
      remodeling of woven bone and lack of inhibition by indomethacin.
AB  - Local effects of transforming growth factor-beta (TGF beta) on bone have been
      investigated in growing mice. The influence of indomethacin on TGF beta effects
      was also examined. Five daily injections of TGF beta-1 or -2 were administered
      subcutaneously over the frontal and parietal bones of seven-week-old mice. In
      animals treated with TGF beta alone or TGF beta and indomethacin, then killed on
      day 19 (day 1 = day of first TGF beta injection), the combined frontal and
      parietal bones were heavier and the frontal bones were thicker than in controls.
      On day 4, multiple layers of differentiating osteoblasts were visible in the
      periosteum of calvariae from TGF beta-treated animals. On day 8, highly
      vascularised periosteal woven bone was seen in the calvariae of TGF beta-treated
      animals. On day 19 (14 days after the last injection) the woven bone had been
      partially remodeled into lamellar bone containing bone marrow, and was still
      actively being remodeled. The histological appearance of bones from animals
      treated concurrently with TGF beta and indomethacin was identical to that of
      animals treated with TGF beta alone, and there appeared to be no difference
      between TGF beta-1 and TGF beta-2. Thus TGF beta-stimulated bone formation in
      vivo is a long term effect that appears to be independent of prostaglandins.
      Osteoclast counts in sections of TGF beta-treated animals were not elevated on
      day 4, although at this stage effects on osteoblastic cells were already
      morphologically apparent. Osteoclast counts in TGF beta-treated bones were
      significantly increased over control values on days 8 and 19.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2242296
TI  - Patient education, the challenges and rewards.

PMID- 2242297
TI  - Hypersensitivity reactions and endotoxins.

PMID- 2242298
TI  - Primary nursing in a nephrology setting: the Credit Valley Hospital experience.

PMID- 2242299
TI  - Patient education, the challenges and rewards.

PMID- 2242300
TI  - Life in the slow lane ... proceed with caution.

PMID- 2242302
TI  - XXIV Annual Meeting of the European Society for Paediatric Nephrology. 30
      September-October 1990, Rome, Italy. Abstracts.

PMID- 2242301
TI  - Modulation of mammalian O6-alkylguanine-DNA alkyltransferase in vivo by O6
      benzylguanine and its effect on the sensitivity of a human glioma tumor to 1-(2
      chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea.
AB  - Experiments were carried out in mice and hamsters to determine whether the
      activity of the DNA repair protein, O6-alkylguanine-DNA alkyltransferase, in
      tissues and tumors was reduced by treatment with O6-benzylguanine in vivo.
      Following intraperitoneal injection of O6-benzylguanine, there was a rapid and
      complete loss of alkyltransferase activity in both livers and kidneys of mice and
      hamsters. The activity in mouse tissues was slowly restored, reaching
      pretreatment activities at 16 hr and 72 hr after injection of O6-benzylguanine at
      10 mg/kg or 126 mg/kg, respectively. The activity in hamster liver was restored
      at a significantly lower rate, reaching less than 20% pretreatment activity 72 hr
      after treatment with 100 mg/kg of O6-benzylguanine. The efficient reduction of
      alkyltransferase activity by O6-benzylguanine was in sharp contrast to the
      inability of O6-methylguanine to bring about similar reductions. Activities
      dropped to about 55% of pretreatment activities in several mouse organs 4 hr
      after treatment with 126 mg/kg of O6-methylguanine compared to a more than 90%
      reduction in activity in animals after treatment with O6-benzylguanine. The
      sensitivity of SF767 cells to meCCNU after treatment with O6-benzylguanine was
      increased substantially. Furthermore, treatment of nude mice carrying SF767 tumor
      with 60 mg/kg of O6-benzylguanine prior to either 7.5 or 15 mg/kg of meCCNU led
      to significant inhibition of tumor growth. These studies indicate that O6
      benzylguanine is a suitable compound for use in experiments to examine the role
      of the alkyltransferase protein in vivo in counteracting the effects of
      alkylating agents.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242303
TI  - Testicular function following cyclophosphamide treatment for childhood nephrotic
      syndrome: long-term follow-up study.
AB  - Testicular function of 17 males treated in childhood or adolescence for nephrotic
      syndrome (NS) with cyclophosphamide (CY) for a mean time of 240 days (mean total
      dosage of 16.4 g or 641 mg/kg body weight) was evaluated at a mean time of 11.8
      years after treatment. Five were azoospermic, 1 oligospermic, and 11
      normospermic. There was a significant inverse correlation of sperm density with
      CY dosage and duration of treatment. All patients had undergone normal pubertal
      development and had normal sexual characteristics. Both basal and gonadotropin
      releasing hormone-stimulated follicle-stimulating hormone (FSH) and luteinizing
      hormone (LH) concentrations were significantly raised in oligo- and azoospermic
      patients. Raised basal and peak FSH and LH concentrations in normospermic
      patients with a sperm count of less than 40 x 10(6)/ml were in keeping with
      impairment of two testicular components. However, mean basal plasma testosterone
      levels and mean peak plasma testosterone responses to human chorionic
      gonadotropin (HCG) did not differ significantly between patients and controls.
      Although LH responses to gonadotropin-releasing hormone suggested compensated
      Leydig cell failure in patients with testicular tubular damage, secretory reserve
      capacity of these cells, estimated by a HCG stimulation test, was preserved.
      Further follow-up is required to ascertain whether in these patients Leydig cell
      failure will develop with time.

PMID- 2242304
TI  - Pituitary-gonadal function in women following cyclophosphamide treatment for
      childhood nephrotic syndrome: long-term follow-up study.
AB  - Ovarian and pituitary-gonadal function was evaluated in 12 women who were treated
      with cyclophosphamide for nephrotic syndrome before or during puberty. The mean
      age at the start of treatment was 8.7 years; the mean total dose of
      cyclophosphamide was 439 mg/kg body weight; and the mean follow-up time was 12.3
      years. The investigations included detailed developmental, menstrual and
      fertility histories; general and gynaecological examinations; basal levels and
      follicle-stimulating hormone and luteinizing hormone responses to gonadotropin
      releasing hormone, and plasma oestradiol determinations. All patients had normal
      pubertal development and regular menstrual patterns. Two had borne healthy
      children. Although hormonal studies did not show obvious ovarian or pituitary
      gonadal dysfunction, further follow-up is required to ascertain whether the
      patients with the most prolonged treatment undergo a premature menopause.

PMID- 2242305
TI  - Evaluation of chlorambucil therapy in steroid-dependent and cyclophosphamide
      resistant children with nephrosis.
AB  - A prospective study was performed to evaluate the efficacy of chlorambucil in
      inducing long-term remission in children with steroid-dependent or
      cyclophosphamide-resistant primary nephrotic syndrome (NS). The 16 steroid
      dependent children had a relapse rate of 5.3/patient per year (range 4-8) and a
      mean age of 8.4 years (range 2-13). The chlorambucil dosage was 0.2 mg/kg per day
      for a total of 8 weeks. Nine patients (56%) remained in complete remission for an
      average of 39.2 months (range 16-70). The interval to the first relapse in the
      remaining 7 ranged from 4 to 41 months and the relapse rate decreased
      significantly to 0.6 relapses/patient per year (P less than 0.05). Five children
      had steroid- and cyclophosphamide-resistant NS, 4 with focal segmental
      glomerulosclerosis and 1 with mesangiol proliferative glomerulonephritis.
      Chlorambucil was given in a dose of 0.2 mg/kg per day for 8-16 weeks. Complete
      remission was obtained in 4 patients; 2 patients relapsed. No serious long-term
      complications were observed in our patients.

PMID- 2242306
TI  - Renal amyloidosis in juvenile chronic arthritis: evolution after chlorambucil
      treatment.
AB  - Over a 22-year period, eight patients affected with severe systemic or
      polyarticular juvenile chronic arthritis (JCA) developed systemic amyloidosis
      with nephrotic syndrome. They were treated with chlorambucil over 5-192 months
      (mean = 44 months). With treatment, an abrupt decrease in the severity of JCA was
      observed in six patients but two patients were chlorambucil resistant. After a
      mean follow-up period of 10 years from onset of renal symptoms, one chlorambucil
      resistant patient died of end-stage renal failure; two patients have a persistent
      nephrotic syndrome; and five patients are free from proteinuria, of whom one has
      developed hypertension. A good correlation was observed between the response of
      the rheumatic disease to chlorambucil treatment and the clinical course of renal
      symptoms. Fourteen renal biopsies were performed in these eight patients. In all,
      amyloid deposits were of the AA type, which persisted on repeat biopsies. In
      addition, 15%-60% of glomeruli had become globally sclerotic by the second or
      third biopsies. At the ultrastructural level, modifications in the structure of
      amyloid deposits and reparative changes of the glomeruli, characterized by
      partial restoration of glomerular architecture, were observed in three patients
      with a favourable clinical course.

PMID- 2242307
TI  - Pharmacokinetics of prednisolone in children with the nephrotic syndrome.
AB  - The aim of this study was to establish whether the criteria for the clinical
      effectiveness of steroids are correlated with the pharmacokinetics of
      prednisolone in children treated with prednisone during an attack of idiopathic
      nephrotic syndrome (INS). Thirteen patients with nephrosis were included.
      Prednisolone, prednisone and cortisol levels were measured using a specific high
      performance liquid chromatography assay after an oral dose of 1 mg/kg body weight
      of prednisone taken at the onset of the disease. All the pharmacokinetic
      parameters, including the conversion of prednisone to prednisolone were similar
      to the data already published in children with INS. No correlation was found
      between the values of pharmacokinetic parameters and criteria of clinical
      effectiveness. Hypo-albuminaemia was significantly correlated with the area under
      the plasma-concentration curve but not with the elimination half-life of
      prednisolone. Moreover, the prednisolone elimination half-life correlated with
      the urinary excretion of 17-hydroxycorticosteroids achieved in the first 6 h. The
      present study suggests that routine measurements of prednisolone kinetics do not
      help when assessing the treatment of children with INS.

PMID- 2242308
TI  - Ciclosporin treatment in children with steroid-dependent nephrotic syndrome.
AB  - We report our experience with ciclosporin (CS) treatment in 18 children with
      steroid-dependent nephrotic syndrome. CS was started at 3-5 mg/kg per day after
      the patients had attained remission with steroid therapy, and was adjusted to
      maintain a trough blood level of between 250 and 600 ng/ml, being administered
      for 6 months. Although 1 patient dropped out of the study because of renal
      dysfunction, the remaining 17 children completed the full trial. No relapse
      occurred during the 6-month period of CS treatment, and it was possible to
      discontinue steroid therapy in all patients. However, after discontinuation of CS
      treatment, nephrotic syndrome relapsed in 16 patients and 14 again had frequent
      relapses and became steroid-dependent, as before CS treatment. The effect of CS
      in maintaining remission from steroid-dependent nephrotic syndrome was thus
      dependent on continuation of CS treatment. Although several side-effects occurred
      during CS treatment, they were not so serious as to necessitate discontinuation
      of treatment, except in 1 patient, and all of these side effects were reversible.
      CS is therefore a new agent for the management of children with steroid-dependent
      nephrotic syndrome in place of corticosteroid and alkylating agents, although
      long-term maintenance therapy may be necessary for maintaining longer remission.

PMID- 2242309
TI  - Human leucocyte antigens in idiopathic nephrotic syndrome in children.
AB  - An association of the idiopathic nephrotic syndrome (NS) with certain human
      leucocyte antigens (HLA) has been reported repeatedly. The aim of this study is
      to characterize further the clinical and histological features of patients with
      NS in relation to their HLA phenotypes. HLA antigens were determined in 132
      paediatric patients with NS. In 91 steroid-sensitive patients (usually associated
      with minimal glomerular changes), the antigen frequencies of HLA-DR3, HLA-DR7,
      and HLA-B8, -DR3 combined were significantly increased compared with controls.
      The strongest association was observed with the combined occurrence of HLA-B8, 
      DR3, -DR7 (relative risk 21.5). This association and that with HLA-DR3 alone were
      strongest in the presence of frequent relapses and steroid dependence compared
      with children without or with infrequent relapses. The pattern of HLA antigens
      was similar in the 57 steroid-sensitive patients with biopsy-proven minimal
      glomerular changes. In 41 children with steroid-resistant NS (usually associated
      with focal segmental glomerulosclerosis) a similar trend for increased antigen
      frequencies was found but the data were significant only for the combined
      occurrence of HLA-B8, -DR3 and -DR7. In all patients combined the frequency of
      the HLA associations was significantly lower when the age of onset was greater
      than 8 years compared with that of younger patients. It is concluded that the
      immunogenetic background of the steroid-sensitive and steroid-resistant NS is
      different and age-dependent.

PMID- 2242310
TI  - Acute glomerulonephritis--changing patterns in Singapore children.
AB  - This study compared the pattern of acute glomerulonephritis (AGN), a disease
      known to be influenced by socioeconomic and environmental factors, in children 12
      years and under, for the years 1971 and 1985. All children admitted to the four
      major paediatric departments with haematuria and at least two of the following
      (oedema, hypertension or oliguria) had an initial diagnosis of AGN. A sample
      population from one unit from 1980 to 1984 showed that over 70% of these children
      had evidence of a post-streptococcal aetiology. In 1971, 411 children were
      admitted with AGN, as compared with only 58 in 1985. The age-sex-race
      standardized rates for 1971 and 1985 were 0.632 and 0.023/1,000 children 12 years
      and under, respectively (P less than 0.001). The mean age of presentation was
      lower in 1971. Over this period, Singapore saw a threefold rise in the gross
      national product, accompanied by rapid urbanization. On analysis of the housing
      pattern, only 31% of the children lived in high-rise apartments in 1971, in
      contrast with 86% in 1985 (P less than 0.001). The majority of non-apartment
      dwellers had homes in rural districts. From an epidemiological perspective,
      factors which could have led to the highly significant decline in prevalence of
      AGN in Singapore children included improvement in the socioeconomic status and
      health care system, and urbanization of the country.

PMID- 2242311
TI  - Quantitation of vesico-ureteral reflux by radionuclide cystography and
      urodynamics.
AB  - A method is described for the quantitation of vesico-ureteral reflux by
      synchronous combined direct radionuclide cystography and urodynamics.
      Intravesical pressures and volumes are co-ordinated with volumes of reflux. Peak
      reflux volumes in 11 children diagnosed as having severe (grades 3-4) reflux on
      conventional contrast cystography ranged from 1 to 50 ml/kidney. A number of
      different patterns of reflux were observed. Reflux may occur progressively
      throughout low pressure filling or incrementally with unstable bladder
      contractions. Reflux during voiding may be maximal as detrusor pressure falls.
      The method requires wider application to explore the potential for a functional
      classification of the reflux problem.

PMID- 2242312
TI  - The pattern of congenital renal anomalies associated with neural tube defects.
AB  - It has been suggested that there may be a consistent pattern of congenital renal
      abnormalities related to a particular sensory level in patients with spina
      bifida. In assessing 163 spina bifida patients by reviewing intravenous
      pyelograms (without knowledge of clinical details) and correlating with the level
      of sensory loss (without knowledge of radiological findings), the prevalence of
      renal abnormalities was similar, but a consistent pattern was not confirmed.

PMID- 2242313
TI  - Urinary oxalate and glycolate excretion in healthy infants and children.
AB  - The molar ratios of oxalate and glycolate over creatinine were determined in
      single urine samples of 26 infants and 27 children aged 1-5 years. In 135
      children aged 5-16 years, two urine specimens were collected, one before
      breakfast and one at noon. Oxalate was determined by oxalate oxidase, and
      glycolate was measured by a colorimetric method (improved chromatotropic acid-
      sulphuric acid assay after prior purification by cation and anion exchanger).
      Both ratios (expressed in mmol/mol creatinine and analysed on a log-normal basis)
      were highest in infants 0-6 months old [mean oxalate 147 (95% confidence
      interval: 60-360), mean glycolate 175 (72-425)]. The mean oxalate ratio was 72
      mmol/mol (29-174) at the age of 7-24 months, 44 (19-101) at the age of 2-5 years
      and 22 (12-40) in adolescents aged 16 years. Molar glycolate ratios were higher,
      but disclosed the same pattern. Oxalate and glycolate ratios in fasting urines
      did not differ significantly from those in noon samples (except glycolate in the
      oldest age group). Oxalate ratios correlated well with glycolate ratios in
      children up to 5 years of age only. Random urine samples are thus suitable for
      screening. However, interpretation of data requires use of age-specific reference
      values that are based on comparable methods.

PMID- 2242314
TI  - Why does deficiency of NaCl affect growth?

PMID- 2242315
TI  - One year's experience with recombinant erythropoietin in children undergoing
      continuous ambulatory or cycling peritoneal dialysis.
AB  - Fourteen patients (aged 5.9-22.1 years) undergoing continuous ambulatory or
      cycling peritoneal dialysis were treated with recombinant human erythropoietin
      (rhEPO), which was given intravenously once a week at a dosage of 300 units/kg.
      The mean haematocrit level increased from 18.5% to 27.5% and the reticulocyte
      count from 19% to 62% within 1 month. After an average time of 3.1 months rhEPO
      dosage could be adjusted to 100 units/kg per week to keep the haematocrit level
      at 30%. Only 1 patient had an exacerbation of hypertension, which required a
      dosage reduction; other side-effects were not noted.

PMID- 2242316
TI  - The renal functional and structural consequences of corticosteroid and
      angiotensin-converting enzyme inhibitor therapy in chronic puromycin
      aminonucleoside nephropathy.
AB  - Glomerular diseases are characterized by increased urinary protein excretion.
      Treatment of this abnormality frequently involves administration of
      corticosteroids and angiotensin-converting enzyme inhibitors. There has been much
      recent interest in the potential impact of these drugs on progressive renal
      dysfunction, since they have opposing effects on intraglomerular hemodynamics.
      Therefore, we investigated the effect of methylprednisolone or captopril
      treatment on animals with chronic puromycin aminonucleoside nephropathy. In rats
      given a single injection of puromycin aminonucleoside, 15 mg/100 g body weight,
      both methylprednisolone and captopril significantly reduced proteinuria at 6
      months [83 +/- 14 untreated (n = 7), 34 +/- 6 with methylprednisolone (n = 8),
      and 6 +/- 1 mg/24 h with captopril (n = 5), P less than 0.001]. Segmental
      glomerulosclerosis occurred with equal frequency in the untreated (7.8 +/- 2.3%)
      and methylprednisolone-treated rats (5.0 +/- 1.11%), but was significantly
      reduced by the administration of captopril (1.0 +/- 0.5%, P less than 0.001). We
      conclude that in chronic puromycin aminonucleoside nephropathy, treatment with
      corticosteroids reduces proteinuria without increasing the incidence of segmental
      glomerulosclerosis. Therapy with an angiotensin-converting enzyme inhibitor
      substantially decreases proteinuria and lessens the severity of glomerular
      scarring.

PMID- 2242317
TI  - Successive lectin-binding changes within the collecting duct during post-natal
      development of the rabbit kidney.
AB  - Histological sections of neonatal rabbit kidney of various ages were analysed to
      study the ontogeny of the collecting duct system. In addition, the sections were
      incubated with fluorescent wheat germ (WGA) and peanut agglutinin (PNA) to
      investigate the terminal differentiation of collecting duct cells. With both
      lectins we found different binding behaviours in the three segments of the
      collecting duct anlagen, the ampullary bud, the ampullary neck and the collecting
      duct. During the observed steps in development the lectin-binding pattern in the
      collecting duct and the ampullary neck appeared unchanged. In the collecting duct
      most cells reacted with WGA and only a few with PNA, while in the ampullary neck
      all cells bound both WGA and PNA. In the ampullary bud, however, the lectin
      binding pattern changed between unlabelled and completely labelled stages with
      both lectins. The results indicate that both intercalated and principal cells
      originate from a common precursor cell.

PMID- 2242318
TI  - Leukaemia-associated hypercalcaemia in a 10-year-old boy: effectiveness of
      aminohydroxypropylidene biphosphonate.
AB  - A 10-year-old boy with leukaemia-associated hypercalcaemia was treated with
      aminohydroxypropylidene biphosphonate (AHPrBP previously APD) in a total dosage
      of 60 mg over 5 days, when the condition failed to respond to rehydration and
      frusemide and no sustained effect was produced by haemodialysis with a calcium
      (Ca)-free dialysate. Bone films showed no lytic lesions, and AHPrBP, which is a
      potent inhibitor of osteoclast-mediated bone resorption was well tolerated and
      induced a rapid and sustained fall in plasma Ca (from 3.42 to 2.07 mM in 5 days).
      Plasma magnesium and alkaline phosphatase remained normal. The results could have
      been affected by other drugs [vincristine, cyclophosphamide, zorubicin
      (Rubidazone) L-asparaginase and prednisone] which were simultaneously
      administered. However, the observation that: (1) the response curve of plasma Ca
      was similar to that reported when AHPrBP was used alone, (2) there was complete
      inhibition of urinary Ca excretion and (3) hypocalcaemia occurred suggests that
      AHPrBP was the major cause of the reduction in plasma Ca. AHPrBP should be
      considered a potential therapy for hypercalcaemia in childhood malignancy.

PMID- 2242319
TI  - Assessment of tubular function in neonates using urinary beta 2-microglobulin.
AB  - Renal proximal tubular function was assessed in neonates by measuring urinary
      beta 2-microglobulin (beta 2M) concentrations on days 1, 4, 7, 14 and 28. Values
      were elevated in stable preterm low-birthweight (LBW) neonates but not in stable
      term LBW neonates, suggesting that proximal tubular maturation is related to
      gestational age rather than birthweight. The urinary beta 2M was significantly
      increased on day 1 in neonates with the meconium aspiration syndrome but was not
      significantly different from normal subsequently. This indicated that although
      the proximal tubular cells may be susceptible to perinatal hypoxia, they maintain
      a remarkable capacity to recover in a relatively short period. Neonates with
      transient tachypnoea of the newborn had normal urinary levels of beta 2M
      indicating their renal tubular function was not impaired.

PMID- 2242320
TI  - Ultrasonographic findings in congenital nephrotic syndrome.
AB  - This report documents a case of biopsy-proven congenital nephrotic syndrome,
      Finnish type (CNF), which was initially misdiagnosed as infantile polycystic
      kidney disease based on ultrasonographic findings. We report this to further
      describe ultrasonographic features of CNF, and to point out that these two
      diseases may have similar features on ultrasound.

PMID- 2242321
TI  - Nephrotic syndrome in Saudi children clinicopathological study of 150 cases.
AB  - The study includes 150 children with primary nephrotic syndrome (NS), aged 16
      months to 13 years with a median age of 5 years. The male to female ratio was 2:1
      and the familial occurrence was 6%. Amongst 48 biopsied patients, 19 (39%) had
      focal segmental glomerulosclerosis, 17 (35%) had diffuse mesangial proliferative
      glomerulonephritis (MesPGN) and 10 (21%) had minimal change nephropathy. About
      90% of patients responded to the initial prednisolone therapy. Subsequently 45%
      of steroid-sensitive patients had frequent relapses, 23% had no relapses, 21% had
      infrequent relapses and 5% became steroid resistant. Saudi children with primary
      NS showed no differences as regards age at onset, male predominance and response
      to initial prednisolone therapy when compared with published data from other
      countries. However, the higher incidence of familial occurrence, the relatively
      high frequency of MesPGN, the rarity of infection-related NS and a decreasing
      incidence of serious infections with improving socio-economic status were all
      noteworthy.

PMID- 2242322
TI  - Is it correct to supplement patients with nephrotic syndrome with vitamin D and
      calcium?

PMID- 2242323
TI  - Hypertension in Jordanian children: a retrospective analysis of 70 cases.
AB  - Seventy patients, aged 1-20 years, were seen at Jordan University Hospital with
      high blood pressure (BP) over a 3-year period. BP values ranged from 140 to 230
      mmHg for systolic pressure and from 90 to 130 mmHg for diastolic pressure.
      Essential hypertension was seen in only 6 patients (8.6%); secondary hypertension
      (n = 64 or 91.4%) was due to renal parenchymal diseases (RPD) in 46 patients
      (65.7%), reno-vascular lesions in 8 (11.4%), renal transplantation in 5 (7.2%),
      teenage pregnancy in 4 (5.7%), and phaeochromocytoma in 1 patient (1.4%). The
      aetiologies of RPD were as follows: end-stage renal disease requiring dialysis in
      14 patients, acute glomerulonephritis in 14, idiopathic nephrotic syndrome in 10,
      chronic renal insufficiency in 5, and polycystic kidney in 3 patients. Surgical
      cure of hypertension was achieved in 5 of the children with reno-vascular lesions
      and in the patient with phaeochromocytoma.

PMID- 2242326
TI  - The 1989 report of the North American Pediatric Renal Transplant Cooperative
      Study.
AB  - This report of the North American Pediatric Transplant Cooperative Study
      summarizes data contributed by 57 participating centers on 754 children with 761
      transplants from 1 January 1989 to 16 February 1989. Data collection was
      initiated in October 1987 and follow-up of all patients is ongoing. Transplant
      frequency increased with age; 24% of the patients were less than 5 years, with 7%
      being under 2 years. Common frequent diagnoses were: aplastic/dysplastic kidneys
      (18%), obstructive uropathy (16%), and focal segmental glomerulosclerosis (12%).
      Preemptive transplant, i.e., transplantation without prior maintenance dialysis,
      was performed in 21% of the patients. Dialytic modalities pretransplant were
      peritoneal dialysis in 42% and hemodialysis in 25%. Bilateral nephrectomy was
      reported in 29%. Live-donor sources accounted for 42% of the transplants. Among
      cadaveric donors, 41% of the donors were under 11 years old. During the first
      post-transplant month, maintenance therapy was used similarly for live-donor and
      cadaver source transplants, with prednisone, cyclosporine, and azathioprine used
      in 93%, 83%, and 81%, respectively. Triple therapy with prednisone, cyclosporine,
      and azathioprine was used in 78%, 75%, and 75% of functioning cadaver source
      transplants at 6 months, 12 months, and 18 months as opposed to 60%, 63%, and 54%
      for live-donor procedures, with single-drug therapy being uncommon.
      Rehospitalization during months 1-5 occurred in 62% of the patients, with
      treatment of rejection and infection being the main causes. Additionally, 9% were
      hospitalized for hypertension. During months 6-12 and 12-17, 30% and 28% of the
      patients with functioning grafts were rehospitalized. Times to first rejection
      differed significantly for cadaver and live-donor transplants. The median time to
      the first rejection was 36 days for cadaver transplants and 156 days for live
      donor transplants. Overall, 57% of treated rejections were completely reversible
      although the complete reversal rate decreased to 37% for four or more rejections.
      One hundred and fifty-two graft failures had occurred at the time of writing,
      with a 1-year graft survival estimate of 0.88 for live-donor and 0.71 for cadaver
      source transplants. In addition to donor source, recipient age is a significant
      prognostic factor for graft survival. Among cadaver donors, decreasing donor age
      is associated with a decreasing probability of graft survival. Thirty-five deaths
      have occurred; 16 attributed to infection and 19 to other causes. The current 1
      year survival estimate is 0.94. There have been 9 malignancies.

PMID- 2242325
TI  - The rheumatic poison: a survey of some published investigations of the
      immunopathogenesis of Henoch-Schonlein purpura.
AB  - Laboratory studies of the pathophysiology of Henoch-Schonlein purpura (HSP) have
      become more numerous in recent years with the recognition of the disease's links
      with the mucosal immune system in general and IgA nephropathy in particular.
      There are weak genetic associations with C4 null phenotypes and with HLA B35 and
      DR4. Studies of plasma proteins in HSP patients show an increased IgA
      concentration, activation of the alternative pathway of complement and
      consumption of factor XIII. High molecular weight (polymeric) IgA has been
      detected in affected individuals, which some investigators have called "immune
      complexes". Many patients synthesise an IgA rheumatoid factor in the acute phase,
      but other autoantibodies are largely absent. In vitro studies of lymphocytes from
      HSP patients have demonstrated an increased number of IgA-bearing and secreting B
      cells, with altered T-cell regulation of antibody synthesis. While these
      observations point to immune dysregulation--primarily of IgA production--as a
      consistent feature of acute HSP, there is as yet insufficient information
      available to allow a consistent theory of pathogenesis to be formulated.

PMID- 2242324
TI  - Alport syndrome, basement membranes and collagen.
AB  - Alport syndrome, an inherited disorder of the kidney, eye and ear, has fascinated
      nephrologists, pathologists, and geneticists for nearly a century. With the
      recent application of molecular biochemical and genetic techniques, this
      mysterious disease has begun to yield some of its secrets. Alport syndrome can
      now be viewed as a generalized disorder of basement membranes that appears to
      result from mutations in an X-chromosome-encoded basement membrane collagen
      chain. This chain, along with two other novel collagen chains, is absent from
      Alport basement membranes, in contrast to the classical chains of collagen IV.
      Phenotypic heterogeneity in Alport syndrome probably arises from allelic
      mutations at a single genetic locus. The phenomenon of post-transplant anti
      glomerular basement membrane nephritis may be a manifestation of specific
      mutations at the Alport locus that prevent synthesis of the gene's protein
      product and the establishment of immunological tolerance.

PMID- 2242328
TI  - Nephrosis, peritonitis and complement deficiency.

PMID- 2242329
TI  - Increased incidence of haemolytic uraemic syndrome in children who have a father
      who is either a physician or a lawyer.

PMID- 2242330
TI  - Intravenous methylprednisolone.

PMID- 2242331
TI  - Clinical quiz. Asphyxiating thoracic dystrophy (Jeune syndrome).

PMID- 2242332
TI  - Brain amino acid levels in audiogenic seizure-susceptible rats following
      habituation to the auditory stimulus.
AB  - Hippocampic and brain stem levels of amino acids were determined in audiogenic
      seizure-susceptible rats following habituation by repeated exposure to the
      acoustic stimulus. The biochemical determinations were performed in the brains of
      42 habituated animals and 23 not habituated seizure susceptible rats used as
      controls. It was found that the habituation process is associated with: a)
      increased levels of aspartate in hippocampus and pons; b) significantly decreased
      levels of glycine in the hippocampus and pons; c) decreased concentration of
      glutamate in the pons; d) no significant changes in the GABA concentrations in
      hippocampus and brain stem. The changes of the excitatory and inhibitory amino
      acids in the brain of the habituated rats cannot explain the fall in epileptic
      susceptibility associated with habituation.

PMID- 2242333
TI  - Parasomnias (non-epileptic nocturnal episodic manifestations) in patients with
      magnesium deficiency.
AB  - Twenty seven patients with parasomnias (night terrors, nocturnal motor
      automatisms, nocturnal verbal automatisms and sometimes with bruxisms) associated
      with magnesium deficiency were selected. In all of them marked hypomagnesemia,
      clinical, EEG and EMG signs of spasmophilic syndromes were found. The 8 hours
      polysomnographical recordings of all cases (monitored in a system with infra-red
      video-TV cameras) showed severe sleep disorders and EEG nocturnal abnormalities
      occurring in the SWS (especially in the I b, II and III stages) with
      disappearance in the REM sleep. The authors suggest that these clinical and
      polysomnographic anomalies may be the expression of the brain damage caused by
      magnesium deficiency or of the clinical electrographic manifestations of the
      reticulate neuronal hypersynchrony exacerbated by sleep.

PMID- 2242327
TI  - The pathophysiology of Sandimmune (cyclosporine) in man and animals.
AB  - Part I: The side-effects of Sandimmune that have been of most significance
      clinically are renal dysfunction, renal vascular damage and arterial
      hypertension. To examine the nature and the origin of such effects, the actions
      of Sandimmune on the renal tubule, the renal vessels and systemic vessels have
      been analyzed. To evaluate whether common vasoconstrictory systems may be
      involved, changes in the renin-angiotensin-aldosterone system and prostaglandin
      thromboxane system have been assessed. Comparison between animal and human data
      obtained in vivo and in vitro shows the actions of Sandimmune on the renal tubule
      to be modest and involve only a few specific effects. The major action of
      Sandimmune is on the vessels, vasoconstriction being the major cause of renal
      dysfunction and also the cause of arterial hypertension. Neither the circulating
      renin-angiotension-aldosterone system nor the prostaglandin-thromboxane system is
      clearly responsible for vasoconstriction. Although not itself a vasoconstrictor,
      Sandimmune seems to modulate the constrictory and dilatory response to other
      agents in several vascular beds.

PMID- 2242334
TI  - Alterations in brain-stem auditory responses induced by head down tilting in
      hypertensives with supine brain-stem disorders.
AB  - The influence of head down (HD) tilting on brain-stem auditory evoked responses
      (BAER) was studied in hypertensives with supine brain-stem disorders (occipital
      headache, vertigo, nausea, diplopia, blurred vision occurring after night
      recumbency), in hypertensives without such phenomena and in normotensives. In the
      latter two categories of subjects HD tilting had no effect on BAER. On the
      contrary, in hypertensives with supine brain-stem disorders the manoeuvre induced
      a constant prolongation of I-V and III-V intervals and a depression in the
      amplitude of wave V; the alterations of BAER produced by HD tilting reveal
      probably a dysfunction of the superior brain-stem area and might be due to the
      impaired cerebral venous draining subsequent to the manoeuvre. The study of BAER
      after HD tilting seems to be a proper means to attest the supine brain-stem
      disorders displayed by some hypertensives.

PMID- 2242335
TI  - Fibronectin.

PMID- 2242336
TI  - Spectral analysis of Doppler signal in the prophylaxis of ischemic
      cerebrovascular accidents in extra- and/or intracranial carotid and vertebral
      systems.
AB  - Using continuous-wave spectral analysis of Doppler signal (SADS) and/or pulsed
      wave transcranial Doppler ultrasonography (TCD-US) we examined 263 patients with
      ischemic cerebrovascular diseases (ICVD) symptoms in the carotid and
      vertebrobasilar (V-B) systems. The degree of stenosis was established by taking
      into consideration the parameters of the spectrum of frequency (systolic peak
      velocity--SV; end-diastolic velocity--DV); the ratio between SV of internal
      carotid artery (ICA) and common carotid artery (CCA); the ratio between DV of ICA
      and CCA as well as the value of the spectral broadening (SB) index. The
      diminution of DV in CCA with increased values of Pourcelot's circulatory
      resistance index (RP) and spectral broadening index (SB) as compared with the
      controlateral part, but with apparent increase (over 3.5 kHz) of SV in ICA was
      constantly observed in significant stenoses of extracranial ICA. Our observations
      have pointed out that when proximal ICA occlusion is being formed slowly and
      progressively, ECA (whose increased circulatory resistance under normal
      conditions reflects diminished diastolic velocities) gradually takes over the
      hemodynamic characteristics of ICA which is expressed by increased DV,
      approximating DV and ICA. This situation may give rise to erroneous
      interpretations.

PMID- 2242337
TI  - Children aged 10-17 of endogenous unipolar depressive parents and of normal
      parents. I. Psychopathology rate and relationship of the severity of the
      psychopathology to familial and environmental variables.
AB  - Seventy two children aged 10-17 of 42 endogenous unipolar depressive parents
      (proband children) and 72 children aged 10-17 of 66 normal parental couples
      (control children) were studied. Overall rate of psychopathology (disorders
      present at the time of investigation and one year before) reached 51% in proband
      children and 29% in control children. Depressive disorder rate reached 10% in
      proband children and 4% in control children. The sex of the depressive parent did
      not influence the psychopathology rate in offspring, while the early age of onset
      of the illness (under 30 years) in parent increased the psychopathology risk in
      children. The severity of the psychopathology in children defined as functional
      impairment was significantly dependent on the severity of the depressive illness
      in proband parent, the presence of psychopathology in the spouse of the
      depressive parent, the presence of psychopathology in the relatives of both
      parents, the socio-cultural level of the family and the violence expressed in the
      familial atmosphere.

PMID- 2242338
TI  - Granulomatous angiitis of the central nervous system. Case report.

PMID- 2242340
TI  - Proceedings of the 246th meeting of the Netherlands Society for Dermatology and
      Venereology. Rotterdam, 3 June 1989.

PMID- 2242339
TI  - Complex neuroradiologic diagnosis in unilateral exophthalmos.
AB  - This is a comparative study concerning diagnosis in unilateral exophthalmos. It
      was carried out in 40 patients admitted to the Neurosurgery Clinic of the "Gh.
      Marinescu" Hospital in Bucharest during 1986-1987. The patients were submitted to
      CT scan and other radiologic examinations with and without contrast media in
      order to improve reference to the neuroradiologic laboratory and increase the
      accuracy of the etiopathogenic diagnosis.

PMID- 2242341
TI  - Polyamine involvement in basal and estradiol-stimulated insulin-like growth
      factor I secretion and action in breast cancer cells in culture.
AB  - Recent evidence indicates that the polyamine pathway may play a significant role
      in the autocrine/paracrine control of breast cancer cell proliferation by
      hormones. To directly test this hypothesis, in the present experiments, we
      evaluated the polyamine involvement in immunoactive insulin-like growth factor I
      (IGF-I) secretion and IGF-I action using MCF-7 breast cancer cells cultured in
      serum-free medium in the presence and absence of estradiol (E2). Administration
      of the polyamine biosynthetic inhibitor, alpha-difluoromethylornithine (DFMO)
      induced a marked suppression of cellular ornithine decarboxylase (ODC) activity
      and polyamine levels which was associated with significant, although partial,
      inhibition of E2-stimulated growth. Exogenous putrescine administration repleted
      cellular polyamine pools and completely reversed the growth-inhibitory effect of
      DFMO. Despite these parallel changes in polyamine levels and proliferative
      activity, basal as well as E2-stimulated levels of immunoactive IGF-I measured in
      the conditioned media were unaffected by DFMO with and without exogenous
      putrescine administration. On the other hand, induction of polyamine depletion
      and repletion by the same treatments significantly (although partially) affected
      the proliferative action of exogenously added IGF-I. These findings indicate that
      polyamines, while not involved in immunoactive IGF-I production, play an
      important role, at least in part, in IGF-I action in this experimental system.
      Furthermore, we observed that the administration of a monoclonal antibody
      directed against IGF-I was able to partially block basal as well as of a
      monoclonal antibody directed against IGF-I was able to partially block basal as
      well as E2-stimulated MCF-7 cell proliferation. We conclude that immunoactive IGF
      I is an important but not sole mediator of MCF-7 breast cancer growth under our
      experimental conditions. The polyamine pathway plays an important role in the
      expression of its proliferative action.

PMID- 2242342
TI  - Characteristics of glucocorticoid-binding by inflammatory tissue of rats.
AB  - Glucocorticoid-binding activities of the granuloma cytosol were compared with
      those of the liver cytosol and of the serum in vitro. The granuloma cytosol bound
      cortisol (HC) about 4-fold higher than dexamethasone (DX) and triamcinolone
      acetonide (TA); the liver cytosol bound these two synthetic agonists more than
      HC. The kinetic parameters of the glucocorticoid-binding components of the
      granuloma and the liver cytosols were studied by the Scatchard method. The
      binding components of the granuloma cytosol had a single class of binding sites
      with high affinity for these three steroids, whereas the binding site of the
      liver cytosol had negative cooperativity or consisted of two distinct classes,
      because its Scatchard plot showed a hyperbolic curve. The granuloma
      glucocorticoid-binding components will be protein since their binding was
      prevented by a trypsin treatment and completely lost by heating at 60 C for 5
      min. Heating at 25 or 37 degrees C for 30 min did not affect the HC-binding
      activity of the granuloma cytosol, regardless of prelabeling with the steroid.
      The binding activity for DX and TA were heat-labile and completely lost by
      heating the cytosol at 37 degrees C for 30 min without the respective steroid.
      The results of thermal inactivation and ammonium sulfate fractionation show the
      granuloma HC-binding protein closely resembles corticosteroid-binding globulin
      (CBG). From enzymatic determination of hemoglobin in tissue cytosols, attribution
      of the contaminating blood to the HC-binding activity of the cytosol is
      considered to be negligible.

PMID- 2242343
TI  - Localization and regulation of estrogen, progestin and androgen receptors in the
      seminal vesicle of the rhesus monkey.
AB  - We have used monoclonal antibodies against the estrogen (E), progestin (P) and
      androgen (A) receptors (R) to study receptor localization and regulation in the
      seminal vesicles of rhesus monkeys under different hormonal conditions. The
      antibodies caused substantial shifts of the appropriately labeled receptors on
      sucrose gradients. ER levels were lower in intact males than in immature,
      castrate, and estrogen-treated castrates. With immunocytochemistry, ER were
      detectable only in stromal and smooth muscle cells, not the epithelium. The
      number of ER-positive stromal cells was significantly lower in intact males than
      in immature, castrate, and estrogen-treated castrates, and low in a DHT-treated
      castrate animal. Androgen receptors were localized in epithelial as well as
      stromal and smooth muscle cells, and the number of AR-positive stromal cells was
      highest in intact adults and lowest in castrated and immature animals. Estrogen
      treatment at the time of castration induced PR in the ER-positive stromal cells,
      prevented a decline in the number of AR-positive stromal cells, and caused
      stromal hypertrophy. In summary, in the seminal vesicle, as in the prostate, ER
      is restricted to the fibromuscular stroma, is suppressed by androgens, and can
      mediate induction of PR on estrogen treatment. Androgen receptors are present in
      epithelial as well as stromal and smooth muscle cells, but variations in hormonal
      state appear to affect regulation of AR more in the stroma than the epithelium.

PMID- 2242344
TI  - Metabolism of progesterone by avian granulosa cells in culture.
AB  - Previous studies have demonstrated that progesterone is the primary product of
      steroidogenesis in avian granulosa cells during short-term incubation. However,
      during more prolonged culture, lasting several days, the progesterone content in
      the medium was found to decrease progressively, indicating in vitro metabolic
      conversion. In the present study we have isolated and identified a number of
      progesterone metabolites. Granulosa cells, isolated from mature ovarian follicles
      of laying hens, were cultured in medium 199 supplemented with fetal calf serum
      and containing [14C]progesterone. After 4 days in culture, cells + media were
      extracted and the radioactive metabolites separated and identified by TLC, HPLC
      and GC-MS. Several of the metabolites were further characterized by
      derivatization and crystallization to constant specific activity. A total of 24
      radioactive substances was detected. Of these, 15 have been positively
      identified, 5 tentatively and the remaining 4 are unidentified. The principal
      metabolite, representing more than 45% of the total radioactivity, was identified
      as 3 alpha-hydroxy-5 beta-pregnan-20-one. In addition, significant amounts of 3
      alpha-hydroxy-5 alpha-pregnan-20-one (5.76%), 5 beta-pregnane-3,20-dione (3.05%),
      and 5 alpha-pregnane-3,20-dione (2.95%) were detected and identified. The results
      indicate that avian granulosa cells possess 3 alpha-hydroxy-steroid dehydrogenase
      (3 alpha-HSD), 17 beta-HSD, 20 alpha-HSD, 20 beta-HSD, 17 alpha-hydroxylase, C17
      20-lyase and 5 alpha- and 5 beta-reductase activities. These enzyme activities
      may convert progesterone to biologically inactive or less active metabolites.
      However, a functional role for some of these metabolites cannot be ruled out.

PMID- 2242345
TI  - Side-chain cleavage of cholesterol sulfate by ovarian mitochondria.
AB  - Mitochondria isolated from porcine corpora lutea and from the luteinized ovaries
      of gonadotropin-treated immature rats were found to efficiently cleave the side
      chain of cholesterol sulfate to produce 3 beta-hydroxy-5-pregnen-20-one sulfate
      (pregnenolone sulfate). When mitochondria were preincubated with cholesterol
      sulfate, the time-course for the side-chain cleavage of cholesterol sulfate was
      biphasic. With 200 microM cholesterol sulphate, the initial rate of the reaction
      was the same as that observed for 25-hydroxycholesterol. This rate was not
      increased when both cholesterol sulfate and 25-hydroxycholesterol were incubated
      together. The rate of side-chain cleavage by isolated mitochondria supplied with
      75 microM cholesterol sulfate as substrate was inhibited by 97% by
      aminoglutethimide, a specific inhibitor of cytochrome P-450scc. The slow phase of
      side-chain cleavage of cholesterol sulfate appeared to be limited by the rate of
      substrate movement to the mitochondrial site of the reaction. Cholesterol sulfate
      translocation rates were however up to 8 times greater than those observed for
      cholesterol when equivalent concentrations of the two substrates were added to
      the mitochondria. We conclude that cholesterol sulfate is a better substrate than
      cholesterol for side-chain cleavage by isolated mitochondria and that both
      reactions are catalysed by the same cytochrome P-450scc enzyme.

PMID- 2242346
TI  - Androstenedione is an important precursor of dihydrotestosterone in the genital
      skin of women and is metabolized via 5 alpha-androstanedione.
AB  - Androgen action is largely determined by the formation of dihydrotestosterone in
      target tissues. In women, androstenedione is the major precursor of
      dihydrotestosterone production in female genital skin. The present study was
      initiated to determine whether androstenedione is converted to
      dihydrotestosterone primarily via testosterone or 5 alpha-androstane-3,17-dione
      (5 alpha-androstanedione), and to examine the pathway of androstenedione
      metabolism in genital skin. Genital skin was obtained from 9 normal premenopausal
      women and 2 normal men. Each tissue was incubated with [3H]androstenedione in
      RPMI-1640 medium for 1 h at 37 degrees C in 95% O2/5% CO2. The metabolites were
      separated and purified by paper partition and thin-layer chromatography. The
      conversions of androstenedione to 5 alpha-androstanedione and to androsterone
      were similar (10.45 +/- 1.46 and 11.04 +/- 2.04%/200 mg tissue), and were approx.
      12, 8 and 23 times higher than the conversion of androstenedione to testosterone,
      dihydrotestosterone and 5 alpha-androstane-3 alpha,17 beta-diol, respectively.
      The male samples showed a similar pattern of metabolism. These data indicate that
      5 alpha-androstanedione is the most important intermediate in the conversion of
      androstenedione to dihydrotestosterone. The data also confirm the importance of 5
      alpha-reductase activity over that of 17 beta-hydroxysteroid oxidoreductase
      activity in the expression of androgen action in women.

PMID- 2242347
TI  - Adrenal P-450scc catalyzes deoxycorticosterone 6 beta-hydroxylase reaction.
AB  - Purified bovine P-450scc, the cholesterol side-chain cleaving P-450 in adrenal
      cortex mitochondria, was found to catalyze a deoxycorticosterone 6 beta
      hydroxylase reaction. A turnover number (moles of product formed/min/mol of P
      450) of 12 was found similar to that for cholesterol side chain cleavage
      activity. Conversion was dose-dependent in terms of P-450scc and no reaction took
      place when any one of the required electron donating components such as NADPH,
      NADPH-adrenodoxin reductase, or adrenodoxin was omitted. These results confirm
      and extend earlier observations that 21-hydroxypregnenolone is transformed into
      both deoxycorticosterone and 6 beta-hydroxydeoxycorticosterone by incubation of
      adrenal gland slices.

PMID- 2242348
TI  - Studies on anabolic steroids--4. Identification of new urinary metabolites of
      methenolone acetate (Primobolan) in human by gas chromatography/mass
      spectrometry.
AB  - The metabolism of methenolone acetate (17 beta-acetoxy-1-methyl-5 alpha-androst-1
      en-3-one), a synthetic anabolic steroid, has been investigated in man. After oral
      administration of a 50 mg dose of the steroid to two male volunteers, twelve
      metabolites were detected in urine either in the glucuronide, sulfate or free
      steroid fractions. Methenolone, the parent steroid was detected in urine until 90
      h after administration. Its cumulative urinary excretion accounted for 1.63% of
      the ingested dose. With the exception of 3 alpha-hydroxy-1-methylen-5 alpha
      androstan-17-one, the major biotransformation product of methonolone acetate,
      metabolites were excreted in urine at lower levels, through minor metabolic
      routes. Most of methenolone acetate metabolites were isolated from the glucuronic
      acid fraction, namely methenolone, 3 alpha-hydroxy-1-methylen-5 alpha-androstan
      17-one, 3 alpha-hydroxy-1 alpha-methyl-5 alpha-androstan-17-one, 17
      epimethenolone, 3 alpha,6 beta-dihydroxy-1-methylen-5 alpha-androstan-17-one, 2
      xi-hydroxy-1-methylen-5 alpha-androstan-3,17-dione, 6 beta-hydroxy-1-methyl-5
      alpha-androst-1-en-3,17-dione, 16 alpha-hydroxy-1-methyl-5 alpha-androst-1-en
      3,17-dione and 3 alpha,16 alpha-dihydroxy-1-methyl-5 alpha-androst-1-en-17-one.
      Interestingly, the metabolites detected in the sulfate fraction were isomeric
      steroids bearing a 16 alpha- or a 16 beta-hydroxyl group, whereas 1-methyl-5
      alpha-androst-1-en-3,17-dione was the sole metabolite isolated from the free
      steroid fraction. Steroids identity was assigned on the basis of the mass
      spectral features of their TMS ether, TMS enol-TMS ether, MO-TMS, and d9-TMS
      ether derivatives and by comparison with reference and structurally related
      steroids. The data indicated that methenolone acetate was metabolized into
      several compounds resulting from oxidation of the 17-hydroxyl group and reduction
      of A-ring substituents, with or without concomitant hydroxylation at the C6 and
      C16 positions.

PMID- 2242349
TI  - Growth stimulation by androgens, glucocorticoids or fibroblast growth factors and
      the blocking of the stimulated growth by antibody against basic fibroblast growth
      factor in protein-free culture of Shionogi carcinoma 115 cells.
AB  - Shionogi carcinoma 115 (SC115) has been accepted for 20 years as an androgen
      responsive mouse mammary tumor. We have established an androgen-dependent cloned
      cell line (SC-3) from a SC115 tumor. In a serum-free medium, testosterone (T) or
      fibroblast growth factors (FGFs) markedly stimulate the growth of SC-3 cells, and
      the T-induced growth was shown to be mediated through FGF-like peptide(s) in an
      autocrine mechanism. Since we used the serum-free culture including 0.1% bovine
      serum albumin (BSA), a partially serum-containing condition, putative roles of
      BSA- or serum-borne growth factors in growth stimulation of autocrine production
      of FGF-like peptide(s) could not be excluded. This paper reports findings
      performed in a protein-free medium including plating [Ham's F-12:MEM (1:1; v/v)].
      In the protein-free culture, the growth of SC-3 cells was significantly
      stimulated by the addition of greater than or equal to 10(-10) M T (up to 20
      fold), greater than or equal to 10(-7) M dexamethasone (Dex; up to 7-fold) or
      greater than or equal to 1 ng/ml basic (b) or acidic FGF (up to 10-fold); other
      various growth factors had no such effects. Furthermore, DNA synthesis of SC-3
      cells induced by T, Dex or bFGF was similarly and markedly inhibited by bFGF
      neutralizing antibody IgG. Therefore, the present findings seem to demonstrate
      that androgens or high levels of glucocorticoids induce the production and
      secretion of FGF-like peptide(s) from SC-3 cells for their growth even in the
      absence of additional support by other factors.

PMID- 2242350
TI  - Impaired development of mammary glands in scorbutic rats unable to synthesize
      ascorbic acid.
AB  - The effects of ascorbic acid (AsA)-deficiency on the development of mammary
      glands were investigated using mutant rats (osteogenic disorder syndrome rats;
      ODS rats) with hereditary inability to synthesize AsA. Female ODS rats of 21 days
      old were castrated and divided into two groups. One group was given AsA in their
      drinking water, and the other was not. All the rats received a daily injection of
      oestradiol-17 beta and progesterone (EP) from day 28 to day 49 of age. After EP
      treatment, the concentrations of AsA in the mammary glands of rats not given AsA
      were less than one tenth of those of rats given AsA and the contents of
      hydroxyproline in the mammary glands of the former rats were about half of those
      in the latter. Furthermore, the concentration of serum prolactin in rats not
      given AsA was reduced to about one third of that in rats given AsA. After EP
      treatment, whole mounts of mammary glands showed that in rats not given AsA the
      development of ducts was impaired and there was extensive accumulation of
      endbuds. Consistent with this finding, EP injections did not increase the area of
      parenchyma in the mammary glands of rats not given AsA, whereas they increased it
      about 2-fold in rats given AsA. Moreover, after EP treatment the amount of alpha
      lactalbumin was significantly less in the mammary parenchyma of rats not given
      AsA than in that of rats given AsA. On the other hand, AsA deficiency did not
      impair the response of the mammary cells to insulin or prolactin in terms of DNA
      synthesis and alpha-lactalbumin production. These findings indicate that AsA
      deficiency impaired the development of mammary glands. This effect may be partly
      attributable to a defect in collagen synthesis in the mammary glands and a
      decrease in the concentration of serum prolactin.

PMID- 2242352
TI  - Cytochrome P-450scc-catalyzed production of progesterone from 22R-hydroxycholest
      4-en-3-one by way of 20,22-dihydroxycholest-4-en-3-one.
AB  - Transient accumulation of a dihydroxylated steroid was found when 22R
      hydroxycholest-4-en-3-one was used as the substrate for a reconstituted
      cholesterol side-chain cleavage system derived from bovine adrenocortical
      mitochondria. The indications were that the accumulated steroid was an
      intermediate in the cytochrome P-450scc-catalyzed reaction. The retention time of
      the accumulated intermediate was identical with that of authentic 20,22
      dihydroxycholest-4-en-3-one on HPLC. When 22R-hydroxycholesterol and 22R
      hydroxycholest-4-en-3-one were incubated simultaneously, the total amount of
      reaction products was essentially the same as that observed with 22R
      hydroxycholest-4-en-3-one alone. Under the conditions employed, the apparent
      turnover number of cytochrome P-450scc for 22R-hydroxycholesterol was calculated
      to be 77 nmol/min/nmol P-450 from the amount of pregnenolone formed, whereas the
      apparent turnover number for 22R-hydroxycholest-4-en-3-one was 64 nmol/min/nmol P
      450 with respect to the intermediate formation and 77 nmol/min/nmol P-450 with
      respect to the progesterone formation. The apparent turnover number for 20,22
      dihydroxycholest-4-en-3-one was about 125 nmol/min/nmol P-450, which was not
      significantly different from that of 20,22-dihydroxycholesterol. The apparent Km
      for 22R-hydroxycholesterol was about 20 microM and those for 22R-hydroxycholest-4
      en-3-one and 20,22-dihydroxycholest-4-en-3-one were 50 and 40 microM,
      respectively. Thus, 22R-hydroxycholest-4-en-3-one was efficiently metabolized to
      progesterone by way of 20,22-dihydroxycholest-4-en-3-one by cytochrome P-450scc.

PMID- 2242351
TI  - Antibodies against synthetic peptides recognize the human and rat androgen
      receptor.
AB  - Antibodies against two synthetic peptides (aa 299-311 and aa 544-559) selected in
      different immunogenic domains of the human AR, were induced in rabbits. Antiserum
      reactivity against the native receptor was investigated by gel permeation
      chromatography and sucrose density gradient centrifugation using [3H]mibolerone
      labeled rat prostate cytosol and [3H]5 alpha-dihydrotestosterone-labeled T-47D
      cytosol as a source of AR. The absence of cross-reactivity of the antisera with
      estrogen, progesterone and glucocorticoid receptor was confirmed by density
      gradient centrifugation of rat uterus cytosol labeled with [3H]E2 or [3H]ORG 2058
      and rat liver cytosol labeled with [3H]dexamethasone. After partial proteolytic
      breakdown of rat prostate AR by endogenous proteases the steroid-labeled receptor
      was recognized only by the second peptide (aa 544-559) antibody. This proteolytic
      breakdown could be prevented to a large degree by addition of a high
      concentration of soybean trypsin inhibitor. The specific AR antibodies provide
      new tools for the functional analysis of AR, since they interact selectively with
      specific domains of the receptor.

PMID- 2242353
TI  - Anabolic steroid effects on immune function: differences between analogues.
AB  - As an untoward effect of chronic anabolic steroid use, immunologic alterations
      may be induced. To evaluate this possibility five commercially available steroids
      with various types of structural differences were studied in male Sprague-Dawley
      rats. Animals were divided into five groups and treated with testosterone (Group
      1), testosterone propionate (Group 2), testolactone (Group 3), oxandrolone (Group
      4), and stanozolol (Group 5). Androgenic anabolic steroids were administered
      daily, subcutaneously dissolved in oil, at a dose of 1.1 mg/kg. Immune
      alterations were assessed by skin-test responses to phytohemagglutinin. After
      five days of treatment (1.1 mg/kg/day) a significant immuno-suppression was
      observed with all groups. However, by day 10, groups 3, 4, and 5 showed an immuno
      stimulation. Using oxandrolone as the model stimulant, serum testosterone levels
      were significantly suppressed, while castration abolished the stimulatory effect.
      These observations indicate that immune alterations do occur with anabolic
      steroids which are immuno-suppressive when the steroid nucleus is intact and
      immuno-stimulatory with nuclear alterations. It appears that these changes are
      associated with altered gonadal testosterone release.

PMID- 2242354
TI  - In vivo evaluation of 7 alpha-[11-(4-[125I]iodophenoxy)undecyl]-17 beta
      estradiol: a potential vector for therapy of adrenal and estrogen receptor
      positive cancers.
AB  - 7 alpha-[11-(4-[125I]Iodophenoxy)undecyl]-17 beta-estradiol ([125I]IPUE2) was
      synthesized and its tissue distribution studied in immature female Fischer rats.
      Upon intravenous administration, [125I]IPUE2 was shown to accumulate in the
      adrenals and, to some extent, in the uterus and the ovaries. Coinjection with
      estrogen receptor (ER)-saturating quantities of unlabeled 17 beta-estradiol did
      not significantly reduce the uptake of [125I]IPUE2 in these tissues. The high
      adrenal uptake of [125I]IPUE2 is most likely associated with the lipophilic
      nature of the 7 alpha-substituted estradiol. The potential to use the 7 alpha
      undecylestradiol as a vector to direct therapeutic groups to adrenal and ER
      positive cancers is discussed.

PMID- 2242355
TI  - Sexual dimorphism characterizes baboon myocardial androgen receptors but not
      myocardial estrogen and progesterone receptors.
AB  - Using biochemical methods we established that estrogen receptor content and
      distribution and progesterone receptor content in female and male baboon
      myocardium did not differ between sexes. In contrast, myocardial androgen
      receptor distribution between cytosolic and nuclear compartments was sexually
      dimorphic. Female baboon myocardial androgen receptors were restricted to the
      cytosolic compartment, whereas male myocardial androgen receptors were
      distributed between the cytosolic and nuclear compartments. Using human estrogen
      receptor cDNA we showed that baboon aorta, myocardium and uterus contain a 6.3 kb
      estrogen receptor transcript. Analyses performed with human progesterone receptor
      cDNA established that baboon aorta and uterus contain an 8 kb progesterone
      receptor transcript; however, progesterone receptor transcripts were not
      demonstrable in baboon myocardial RNA preparations. Because relative
      hybridization signal intensity reflected known uterine and aortic progesterone
      receptor content, failure to detect progesterone receptor transcripts in
      myocardial preparations may reflect sensitivity limitations and the fact that
      aortic progesterone receptor content is 5-fold greater than that of myocardium.
      Immunocytochemical analyses demonstrated that baboon myocardial progesterone
      receptors were present in greater than 25% of myocytes and generally absent from
      other myocardial cells. Our studies establish that: (1) gonadal steroid hormone
      receptor gene transcription occurs in cells of the baboon cardiovasculature, (2)
      these steroid hormone receptors may be physiologically functional, and (3)
      gonadal steroid hormone receptors may be restricted to specialized cells of the
      cardiovasculature.

PMID- 2242356
TI  - Antiprogestagenic inhibition of uterine prostaglandin inactivation: a permissive
      mechanism for uterine stimulation.
AB  - The use of antiprogestins as abortifacients is more effective when antiprogestin
      priming is followed by the administration of a small dose of synthetic
      prostaglandin. This increased myometrial sensitivity towards PG has not been
      explained and experiments in the guinea-pig where no myometrial activity is
      observed after 48 h of antiprogestin administration together with measurements of
      PG metabolites in uterine vein blood have given rise to the suggestion that
      prostaglandin synthesis is inhibited by antiprogestins. We have treated groups of
      50 day pregnant guinea-pigs with 10 mg RU486 or vehicle alone and examined the
      ability of homogenised uterine tissues (myometrium/decidua, cervix, chorion and
      amnion) to metabolize PGE when given a large excess of substrate and sufficient
      cofactors. In addition we have examined the ability of these homogenates to
      synthesis PG. Antiprogestin treatment in vivo resulted in a 9-fold reduction in
      metabolic activity in chorion (P less than 0.02) and a 4-fold reduction in
      myometrium/decidua (P less than 0.02). Reduction in activity seen in amnion and
      cervix was not significant. The maximum metabolism was seen in the chorion and
      minimal metabolism in the amnion. Maximum PG production was seen in the amnion
      and minimum in the chorion. These results show that the effect of antiprogestin
      in reducing prostaglandin catabolism would reduce the threshold above which PG
      production would cause contractions which would in turn stimulate PG production.
      Thus an explanation is provided of how low doses of exogenous PGs or transient
      synthesis of endogenous PG within an antiprogestin treated uterus can led to a
      self sustaining cycle of stimulation which will lead to abortion.

PMID- 2242358
TI  - Pain relief in labour.

PMID- 2242357
TI  - Annual meeting of the American Society of Regional Anesthesia. Orlando, Florida,
      March 25-28, 1990. Abstracts.

PMID- 2242359
TI  - Perinatal bereavement.

PMID- 2242360
TI  - Genetic and familial predisposition to eclampsia and pre-eclampsia in a defined
      population.
AB  - Familial predisposition and patterns of genetic inheritance of eclampsia and pre
      eclampsia were investigated through three or four generations in 94 families from
      the homogenous island population of Iceland. The families descended from index
      women delivered in the years 1931-47 and who had either eclampsia (n = 38) or
      severe pre-eclampsia (n = 69). Inheritance was followed both through sons and
      daughters. The prevalence of pre-eclampsia and eclampsia in daughters was
      significantly higher (23%) than that in daughters-in-law (10%). No difference was
      noted in the prevalence of these diseases by whether the daughter was born of an
      eclamptic or pre-eclamptic mother or whether she was a first or later born
      daughter. There was a non-significantly higher occurrence of pre-eclampsia among
      grand-daughters than in grand-daughters-in-law. No difference was seen by whether
      grand-daughters descended through sons or daughters. With increasing numbers of
      affected daughters or grand-daughters the probability rose of finding more
      affected women in a family. Hypotheses of single recessive and dominant gene
      inheritance were compared and maximum likelihood estimates for gene frequency
      obtained. For a single recessive gene model this was 0.31 reflecting a population
      prevalence of 9.6%, whereas a dominant model with incomplete penetrance gave 0.14
      at 48% gene penetrance, corresponding to a population prevalence of 0.9%
      homozygous expression of severe disease and 11% heterozygous expression of milder
      disease. Either genetic model could fit the data.

PMID- 2242361
TI  - Pelvic floor damage and childbirth: a neurophysiological study.
AB  - Ninety six nulliparous women were investigated to establish whether childbirth
      causes damage to the striated muscles and nerve supply of the pelvic floor. The
      techniques used were concentric needle electromyography (EMG), pudendal nerve
      conduction tests and assessment of pelvic floor contraction using a perineometer.
      There was EMG evidence of re-innervation in the pelvic floor muscles after
      vaginal delivery in 80% of those studied. Women who had a long active second
      stage of labour and heavier babies showed the most EMG evidence of nerve damage.
      Forceps delivery and perineal tears did not affect the degree of nerve damage
      seen. We conclude that vaginal delivery causes partial denervation of the pelvic
      floor (with consequent re-innervation) in most women having their first baby. In
      a few this is severe and is associated with urinary and faecal incontinence. For
      some it is likely to be the first step along a path leading to prolapse and/or
      stress incontinence.

PMID- 2242362
TI  - Epidemiology of pelvic inflammatory disease in parous women with special
      reference to intrauterine device use.
AB  - Up to the end of 1989, 206 parous women in the Oxford Family Planning Association
      contraceptive study had been referred to hospital with a first episode of pelvic
      inflammatory disease. Of these, 65 suffered from definite disease described as
      acute, 81 from definite disease not described as acute and 60 from 'other
      disease'. Considering all forms of disease together, referral was less common in
      those aged 25-29 and in those aged 45 or more than in those aged 30-44. Referral
      was more common in those of low social class, in those who smoked and in those
      who married young. All these factors were taken into account in analyses
      considering the effects of contraceptive methods. In these analyses, women
      currently using the contraceptive pill, the diaphragm, the sheath, female
      sterilization or an intrauterine device (IUCD) were compared with those currently
      using other methods or no method of contraception. IUCD ex-users were, however,
      placed in a separate category, irrespective of their current method of
      contraception. The relative risks obtained in these analyses, with 95% CI, were
      as follows: contraceptive pill 0.5 (0.2-0.9), diaphragm 0.6 (0.3-1.2), sheath 1.2
      (0.6-2.4), female sterilization 0.7 (0.3-1.5), non-medicated IUCD 3.3 (2.3-5.0),
      medicated IUCD 1.8 (0.8-4.0), IUCD ex-users 1.3 (0.7-2.3). These data suggest
      that oral contraceptives, the diaphragm and female sterilization protect against
      pelvic inflammatory disease and that IUCDs increase the risk. Medicated devices,
      however, appear to carry only about half the risk of non-medicated devices, and
      the elevation of risks in IUCD ex-users appears to be small. Special analyses
      examined the risk associated with use of a Dalkon Shield. Among women currently
      using an IUCD (of any kind), those who had used a Dalkon Shield (at any time) had
      nearly five times as great a risk of hospital referral for pelvic inflammatory
      disease as those who had never used a Dalkon Shield (relative risk 4.7, 95% CI
      2.1-9.0).

PMID- 2242364
TI  - Middle cerebral artery flow velocity waveforms in fetal hypoxaemia.
AB  - In 81 small-for-gestational age fetuses (SGA) colour flow imaging was used to
      identify the fetal middle cerebral artery for subsequent pulsed Doppler studies.
      Impedence to flow (pulsatility index; PI) was significantly lower, and mean blood
      velocity was significantly higher, than the respective reference ranges with
      gestation. Fetal blood sampling by cordocentesis was performed in all SGA fetuses
      and a significant quadratic relation was found between fetal hypoxaemia and the
      degree of reduction in the PI of FVWs from the fetal middle cerebral artery.
      Thus, maximum reduction in PI is reached when the fetal PO2 is 2-4 SD below the
      normal mean for gestation. When the oxygen deficit is greater there is a tendency
      for the PI to rise, and this presumably reflects the development of brain oedema.

PMID- 2242363
TI  - The use of obstetric analgesia in Sweden 1983-1986.
AB  - The use of obstetric analgesia was investigated in a Swedish population-based
      prospective study of 335,207 births, which represents almost all women who had
      vaginal deliveries in Sweden between 1983 and 1986. Lumbar epidural analgesia
      (EDA) was used in 16%, paracervical block (PCB) in 12%, pethidine or morphine in
      49% and pudendal block in 62%. All four types of analgesia were much more
      commonly used by nulliparae than multiparae. Variables such as maternal age,
      smoking, nationality, relationship with the infant's father and gestational age
      had only moderate influence on the rates of different types of analgesia. EDA and
      PCB were more frequently used in larger than in smaller hospitals and in the
      daytime than at night. No such differences were found for pethidine or morphine,
      or pudendal block, which were administered routinely by midwives.

PMID- 2242365
TI  - Experience with a 'physiological' steroid replacement regimen for the
      establishment of a receptive endometrium in women with premature ovarian failure.
AB  - Eighteen women with a premature menopause underwent assessment of serial serum
      oestradiol (E2) and progesterone levels and endometrial histology and function.
      Patients received continuous transdermal E2, and progesterone either orally or
      vaginally for 14 days. Physiological levels of E2 were attained. Significantly
      higher levels of progesterone were achieved with vaginal progesterone (P less
      than 0.01). Endometrial biopsies obtained during E2 replacement demonstrated
      normal proliferative features. Expression of an oestrogen related antigen (ER-Ag)
      was localized in the cytoplasm of the epithelium. After 3 days of progesterone
      replacement the endometrium showed normal secretory features and expression of ER
      Ag in the stroma as well as in the glands. After 7 days of progesterone
      supplementation, vaginal administration produced a more consistent physiological
      appearance than oral administration. Thus transdermal E2 combined with vaginal
      progesterone is a highly satisfactory combination for establishing a
      physiological endometrium in women with premature ovarian failure.

PMID- 2242366
TI  - Reliability of colposcopy and directed punch biopsy.
AB  - A group of 118 women underwent laser cone biopsy. Data were collected routinely
      on proforma case notes and entered into a computerized database. The histology of
      the cone biopsies was compared with that of previous, colposcopically directed
      punch biopsies, with the cytology of smears taken in the clinic and with the
      colposcopic diagnosis. The punch biopsy had a 54% false negative rate and neither
      of the two microinvasive carcinomas biopsied in this way were detected by the
      biopsy. Ten of 24 women with negative punch biopsies had CIN III in the cone.
      When the punch biopsy showed CIN II or worse, the cone biopsy confirmed the
      presence of CIN in 86%. There was some evidence of false negative cone biopsies.
      The data suggest that management should not be based solely upon the punch biopsy
      result but should include consideration of the cytology and colposcopy findings.
      Excisional methods of treatment are more likely to reveal early invasion and
      adenocarcinoma-in-situ.

PMID- 2242367
TI  - Prediction of pregnancy-induced hypertensive disorders by angiotensin II
      sensitivity and supine pressor test.
AB  - An angiotensin II sensitivity test and a supine pressor test were done
      consecutively at 28 weeks gestation in 90 healthy, normotensive nulliparous
      women. None of the supine pressor tests was positive, applying the predefined
      threshold of a rise of 20 mmHg in diastolic blood pressure after rolling over;
      nine tests were positive using a corrected 9 mmHg cut-off level. Ten women had a
      positive angiotensin sensitivity test using a threshold of the effective pressor
      dose of 8 ng/kg/min; 22 women were positive using an effective pressor dose of
      less than or equal to 10 ng/kg/min. Later in pregnancy 12 women (13%) developed
      pregnancy-induced hypertensive disease (PIH). The specificity of both tests of
      predicting the development of PIH was about 90%. The sensitivity of the
      angiotensin sensitivity test at the 10 ng/kg/min level was 92%. Because of its
      low sensitivity of 25% the supine pressor test appears to have no value for the
      prediction of PIH. There was a significant positive association between
      angiotensin II refractoriness and birthweight.

PMID- 2242368
TI  - The management of primary fallopian tube carcinoma.
AB  - The outcome of 30 patients with primary fallopian tube carcinoma is described.
      Treatment varied over the 22 year period of accrual and included combinations of
      surgery, radiotherapy and chemotherapy. There was an apparent increase in stage
      at treatment with time which was probably related to more precise staging at
      laparotomy and the greater use of computerized tomography. The median survival
      for all patients was 28 months and the 5-year survival was 18%. Ten patients
      received postoperative chemotherapy for residual disease with an overall response
      rate of 80% and median progression-free and overall survival times of 14 and 21
      months respectively. The pattern of relapse was similar to that seen in ovarian
      carcinoma, with all but one patient having the pelvis or abdomen as the main site
      of recurrence. Primary fallopian tube carcinoma has a response to treatment and a
      tumour biology similar to that of ovarian carcinoma. It is recommended that the
      management of this uncommon malignancy should continue to be along the lines of
      ovarian carcinoma, with initial treatment by cytoreductive surgery followed by
      chemotherapy or radiotherapy for residual disease.

PMID- 2242370
TI  - The rate of rise of corticotrophin releasing factor and endogenous digoxin-like
      immunoreactivity in normal and abnormal pregnancy.
AB  - Maternal plasma concentrations of corticotrophin releasing factor (CRF) and
      endogenous digoxin-like immunoreactivity (EDLI) were estimated in 80 normal and
      88 abnormal pregnancies which were sampled sequentially from 24 weeks gestation
      to delivery. A slope was fitted for each woman's antenatal EDLI and CRF values,
      both of which rose significantly during gestation, and the mean of the slopes for
      the normal and abnormal groups for each value compared. There was no evidence of
      significant mean differences between groups for EDLI but there was evidence of a
      significant mean difference for CRF (P less than 0.05). After adjustment for
      other variables which may affect pregnancy outcome, the slopes for CRF were found
      not to be significantly related to outcome.

PMID- 2242369
TI  - Prostaglandin induced cervical ripening under tocolytic cover in primiparae:
      results of a double blind placebo controlled trial.
AB  - In a double blind trial, 60 nulliparae with a modified Bishop score of less than
      or equal to 5 requiring induction of labour, received either 8 mg of salbutamol
      or an identical placebo orally, 30 min before vaginal administration of 2 mg
      prostaglandin E2 gel. Women in the salbutamol group experienced less uterine
      activity over the subsequent 12 h compared with those given placebo, and fewer
      (35%) commenced labour compared with the placebo group (62%). However, the change
      in cervical score was significantly less in the salbutamol group (mean 3.0, SD
      3.1) than that in the placebo group (mean 5.8, SD 3.2), and the prostaglandin
      treatment to delivery time in the salbutamol group (mean 26.1 h, SD 6.49) was
      significantly longer than that in the placebo group (mean 19.3 h, SD 7.95). The
      first stage of labour lasted greater than 10 h in 11 women in the salbutamol
      group compared with five in the placebo group. Side effects attributable to
      salbutamol occurred in 10% of the treated women but in none of their fetuses and
      fetal outcome was satisfactory and similar in both groups. Our findings show that
      salbutamol can suppress prostaglandin-induced uterine activity during cervical
      ripening, which could be an advantage in induction of labour where a planned
      delivery is preferred. However, the poorer outcome of labour in salbutamol
      treated women mitigates against this approach.

PMID- 2242371
TI  - Antepartum to postpartum changes in transcapillary fluid balance.
AB  - During the puerperium significant changes occur in the body volume homeostasis.
      In the present study the transcapillary fluid balance was examined antepartum in
      nine healthy women. The interstitial colloid osmotic pressure was measured by the
      'wick' method, and interstitial hydrostatic pressure by the 'wick-in-needle'
      method in subcutaneous tissue on the thorax and at the ankle. From antepartum
      (gestational week 37-40) to postpartum (5th day), the following changes were
      observed: A significant increase in the colloid osmotic pressure both in plasma
      (mean 1.8 mmHg, P = 0.027) and in the interstitial fluid at the ankle (mean 2.9
      mmHg, P = 0.008). Neither colloid osmotic pressure gradient (plasma
      interstitium), interstitial hydrostatic pressure, nor haemoglobin and haematocrit
      changed. The observed rise in the interstitial colloid osmotic pressure must be
      caused by mobilization of fluid from the interstitium, probably due to a reduced
      capillary hydrostatic pressure. The increase in plasma colloid osmotic pressure
      is most likely caused by an increased albumin synthesis and/or transport of
      interstitial proteins back to the vascular compartment.

PMID- 2242372
TI  - Dipalmitoylphosphatidylcholine (L-alpha-lecithin) stimulates prostaglandin E
      production in human amnion.
AB  - The effect of dipalmitoylphosphatidylcholine (DPPC, L-alpha-lecithin), a
      substance not containing arachidonic acid, on prostaglandin E (PGE) production of
      amniotic membrane was studied. DPPC (3.125-800 micrograms/ml) stimulated PGE
      production of amniotic membrane (150-200%), suggesting that lecithin, the major
      surfactant component, is directly involved in the mechanism of human parturition
      as a stimulator of PGE production.

PMID- 2242373
TI  - Vitamin B6 in the treatment of the premenstrual syndrome--a review.
AB  - A search of the literature yielded 12 controlled trials on vitamin B6 in the
      treatment of the premenstrual syndrome. These are discussed with emphasis on
      methodological aspects. A major drawback of the trials is the limited number of
      patients included. The existing evidence of positive effects of vitamin B6 is
      weak, and some well-designed trials with positive results would be needed to
      change this view.

PMID- 2242374
TI  - Bilateral squamous cell carcinoma of the ovary. Case report.

PMID- 2242376
TI  - Anxieties in women undergoing colposcopy.

PMID- 2242375
TI  - Serum ionized calcium and intact parathyroid hormone levels during pregnancy and
      postpartum.

PMID- 2242377
TI  - Antenatal attendance and fasting of pregnant Muslims during Ramadan.

PMID- 2242378
TI  - Neonatal thyrotrophin and mode of delivery.

PMID- 2242380
TI  - Hyperthyroidism results in increased glycolytic capacity in the rat heart. A 31P
      NMR study.
AB  - We have investigated the metabolic adaptations that occur in the thyroxine
      treated rat heart. Rats were made hyperthyroid by daily intra-peritoneal
      injections of thyroxine (35 micrograms/100 g body weight) over seven days. 31P
      NMR investigations of isolated glucose-perfused isometric hearts showed that
      thyroxine treatment caused an increase in Pi (from 4.9 mumols.(g dry wt.)-1 in
      control hearts to 11.7 mumols.(g dry wt.)-1 in hyperthyroid hearts), a decrease
      in phosphocreatine (from 36.5 mumols.(g dry wt.)-1 to 21.8 mumols.(g dry wt.)-1)
      with no change in ATP or ADP concentrations under the same conditions of cardiac
      work. The unidirectional exchange flux Pi----ATP was measured by saturation
      transfer NMR in hyperthyroid rat hearts. This exchange (which has been shown to
      contain a significant glycolytic component) increased by 2.2-fold in thyroxine
      treated hearts in comparison to control hearts (to 3.6 mumols.(g dry wt.)-1.s-1,
      from 1.6 mumols.(g dry wt.)-1.s-1). In parallel experiments, NMR analysis of
      extracts from hyperthyroid rat hearts showed significantly elevated levels of
      glucose 6-phosphate, and fructose 6-phosphate. Measurements of enzyme activities
      isolated from hyperthyroid and control tissue showed a 40% increase in
      phosphofructokinase activity. These data together with the increased
      concentration of Pi show that both glycolytic and glycogenolytic fluxes are
      increased in the hyperthyroid rat heart. This metabolic adaptation may be
      necessary to cope with the increased number and activity of Na+/K(+)-ATPase pumps
      that occur in response to thyroxine treatment.

PMID- 2242379
TI  - Topical anaesthesia with lidocaine-prilocaine cream for vulval biopsy.

PMID- 2242382
TI  - Intracellular Ca2+ storage organelles in non-muscle cells: heterogeneity and
      functional assignment.

PMID- 2242381
TI  - A model for computer simulation of P-glycoprotein and transmembrane delta pH
      mediated anthracycline transport in multidrug-resistant tumor cells.
AB  - Anthracycline resistance in multidrug-resistant (MDR) tumor cells is due in part
      to a reduced cellular drug accumulation. Using a simple kinetic model and
      numerical computer simulations, we have analyzed mathematically the following
      possible mechanisms controlling fluxes of the membrane permeable anthracyclines
      in MDR cells: (1) active outward transport via a specific drug transporter (P
      glycoprotein), (2) exocytotic drug export via the endosomal vesicle system, and
      (3) pH-gradients across the plasma membrane. Model calculations were based on
      morphometric and kinetic data previously presented in the literature for
      daunorubicin transport in wild-type Ehrlich ascites tumor cells (EHR2) and the
      corresponding daunorubicin (DNR)-resistant cell line EHR2/DNR+. The results
      confirm the possible importance of the cell-surface pH in controlling DNR
      accumulation in the cells. With P-glycoprotein as the main efflux pump, a
      catalytic constant of the protein greater than 40 mol DNR transported/mol protein
      per min is predicted by the model calculations. Changes in the drug binding
      affinity of P-glycoprotein (Km = 10(-9)-10(-6) M) is of little importance in
      influencing its effectiveness to reduce DNR accumulation, which could explain the
      broad substrate specificity of the MDR efflux pump system. The conditions to
      evaluate unidirectional fluxes of DNR across the plasma membrane in cells with
      active P-glycoprotein are defined. An efflux mechanism which relies solely on pH
      dependent drug trapping in a pH 5 endosomal compartment by a simple diffusion
      process followed by exocytosis, appears inadequate to account for the high rate
      of DNR efflux in EHR2/DNR+ cells.

PMID- 2242383
TI  - High-affinity binding of thyroid hormones to neuroblastoma plasma membranes.
AB  - The binding of thyroid hormones to isolated plasma membranes was studied in
      NB41A3 neuroblasts. Saturable binding of L-T3, D-T3 and L-T4 was observed.
      Binding was time-dependent, with equilibrium reached in less than 60 min and
      maximal binding occurring between pH 7.4 and 7. Saturation experiments
      demonstrated two classes of sites for L-T3: a high-affinity site with Ka 8.4 X
      10(9) M-1 and a low-affinity site with Ka 7.3 X 10(6) M-1.L-T3 and D-T3 inhibited
      each other's binding, L-T3 being several-times more potent. Affinity labeling of
      isolated membranes with bromoacetylated thyroid hormones disclosed stereospecific
      binding to SDS-PAGE bands with approximate molecular masses of 27 kDa
      (preferentially labeled by BrAc-L-T3), 32 kDa (preferentially labeled by BrAc-D
      T3), and 48 and 87 kDa (preferentially labeled by BrAc-L-T4). Binding of BrAc-L
      T3 to the 27 kDa band accounted for 3.4% of total binding, was selectively
      inhibited by excess L-T3, and may be involved in intracellular transport of L-T3.

PMID- 2242384
TI  - Effects of alanine on insulin-secreting cells: patch-clamp and single cell
      intracellular Ca2+ measurements.
AB  - The effects of alanine, glucose and tolbutamide on insulin-secreting cells
      (RINm5F) have been investigated using patch-clamp and single cell intracellular
      Ca2+ measurements. When directly challenged with the amino acid L-alanine (2-10
      mM) the cells underwent a sharp depolarization, which led to the generation of
      Ca2+ spike potentials and an increase in [Ca2+]i. The L-alanine-induced
      depolarization was associated with a net inward membrane current but no
      measurable change in the resistance of the cell. The latter effect was found to
      be in contrast to the actions of glucose (5-10 mM) and tolbutamide (100 microM),
      both of which depolarized cells and raised [Ca2+]i by an increase in the input
      resistance of the cell membrane, due to the closure of ATP-sensitive potassium
      channels. In the complete absence of external Na+ (by replacement with 140 mM
      NMDG+), L-alanine had no effects on either the membrane potential or [Ca2+]i.
      Similarly, replacing Na+ with NMDG+ in the continued presence of the amino acid
      resulted in a repolarization of the membrane and an attenuation of the L-alanine
      induced rise in [Ca2+]i. The Na+ channel blocker TTX (1-2 microM) had no effects
      on the alanine-evoked electrical activity. Exchange of the L-form of the amino
      acid with the D-stereoisomer had similar actions to those of removing external
      Na+, since D-alanine had no effects on the membrane potential or [Ca2+]i. The
      actions of L-alanine were also found to be mimicked by the N-methylated amino
      acid analogue methylamino isobutyric acid (MeAIB) (2-10 mM), suggesting that the
      A-type electrogenic amino acid cotransport system operates in the RINm5F insulin
      secreting cell line.

PMID- 2242385
TI  - Effect of phorbol myristate acetate on processing of formyl peptide receptors by
      human neutrophils.
AB  - We examined the effect of phorbol myristate acetate on the ability of human
      neutrophils to process formyl peptide receptors. The receptor was affinity
      labeled and its extracellular localization assessed over time, by cleavage of
      extracellular labeled receptor with papain. Neutrophils were capable of
      internalizing (and/or recycling) affinity labeled formyl peptide receptor in the
      absence of extracellular calcium. This phenomenon was dependent upon stimulation
      with phorbol myristate acetate, suggesting a role for protein kinase C in this
      process.

PMID- 2242386
TI  - Barium mimics the effect of D-glucose on 86Rb+ fluxes in mouse pancreatic beta
      cells.
AB  - The interaction between Ba2+, furosemide and D-glucose on 86Rb+ fluxes in ob/ob
      mouse islets was investigated. Ba2+ (2 mM) significantly reduced the ouabain
      resistant 86Rb+ influx, without affecting the ouabain-sensitive influx. D-Glucose
      (20 mM) reduced the 86Rb+ influx in the absence of Ba2+ (2 mM) but not in the
      presence of the cation. Furosemide, an inhibitor of Na+, K+, Cl- co-transport,
      reduced the 86Rb+ influx and the effect was partly additive to the effect of 2 mM
      Ba2+. When the islets were preincubated with Ba2+ (2 mM) the specific effect of 1
      mM furosemide on the 86Rb+ influx was reduced, whereas, in acute experiments,
      Ba2+ (2 mM) did not affect the specific effect of furosemide on 86Rb+ influx.
      86Rb+ efflux from preloaded islets was significantly reduced by 2 mM Ba2+ and
      during the first 5 min of ion efflux the effect of the combination of 2 mM Ba2+
      and 1 mM furosemide was stronger than the effect of Ba2+ alone. The data show
      that Ba2+ reduces 86Rb+ fluxes in the beta-cells and suggest that this is mainly
      mediated by inhibition of K+ channels in the beta-cell plasma membrane. Long-term
      exposure to Ba2+ may also reduce the activity of the Na+, K+, Cl- co-transport
      system. The effect of Ba2+ on K+ channels may help to explain the stimulatory
      effect on insulin release in the absence of nutrient secretagogues.

PMID- 2242387
TI  - A pilot study of a neuroendocrine test battery in posttraumatic stress disorder.
AB  - Eight female patients who fulfilled DSM-III criteria for posttraumatic stress
      disorder (PTSD) took part in this study. They were each assessed using the
      dexamethasone suppression test, the desipramine/growth hormone stimulation test,
      which examines alpha-2-adrenoceptor functioning, and the buspirone/prolactin
      test, which is thought to examine 5-HT receptor functioning. A control group
      consisting of age- and sex-matched healthy subjects was also tested. For each
      subject the three tests were conducted over 5 days. Hormone assays were carried
      out blind to diagnosis. Overall no differences on any of the three tests were
      detected between the patients and controls. The results do not support a link
      between PTSD and major depression.

PMID- 2242389
TI  - A cross-sectional study of the effects of depression on REM latency.
AB  - In a cross-sectional design to address the effects of the course of depression on
      rapid-eye-movement (REM) latency, we have matched patients in their first-episode
      with (1) age-matched patients with recurrent depression, (2) onset-matched
      patients with recurrent depression, and (3) age-matched normal control subjects.
      Patients were also matched for sex and treatment site (inpatient or outpatient).
      No differences were found in REM latency for the three depressed groups, and all
      had lower REM latency than normals. This finding is taken as support for stable
      REM latency throughout the course of depression.

PMID- 2242388
TI  - Sleep, gender, and depression: an analysis of gender effects on the
      electroencephalographic sleep of 302 depressed outpatients.
AB  - Gender-related differences in electroencephalographic (EEG) sleep were examined
      in 151 pairs of men and women with major depression, all outpatients, matched for
      age and severity of depression. Across five decades (age 21-69), depressed men
      had less slow-wave sleep than did depressed women. Gender differences were small
      with respect to visually scored measures of slow-wave sleep time and percent, but
      moderate for gender differences in automated measures of slow-wave density. The
      time constant of the polygraph preamplifier significantly affected both visually
      scored and automatically scored slow-wave sleep. Other measures such as REM sleep
      latency, first REM period duration, sleep efficiency, and early morning
      awakening, showed robust age effects, but no main effects for gender or gender-by
      age interactions. Gender effects on slow-wave sleep and delta-wave counts in
      depression parallel gender effects seen in healthy aging. The possibility of
      occult alcohol use by depressed male outpatients cannot be definitely excluded as
      a partial explanation of the current findings. However, covarying for past
      alcohol abuse did not negate the statistical significance of the observed gender
      effects on slow-wave sleep and delta-wave density. The possibility of gender
      differences in slow-wave regulatory mechanisms is suggested, but similarity in
      temporal distribution of delta-wave density between the first and second non
      rapid-eye-movement (NREM) periods does not support gender differences in slow
      wave sleep regulation.

PMID- 2242390
TI  - Smooth pursuit eye movements of normal and schizophrenic subjects tracking an
      unpredictable target.
AB  - An experimental paradigm employed by several workers in the field of
      schizophrenic eye movements has involved finding sequences of stimuli that induce
      saccadic smooth pursuit in the eye movements of normal individuals. It is hoped
      that the identification of such stimuli will lead to clues concerning the
      etiology or nature of eye tracking dysfunction in schizophrenia. In this study,
      the pursuit eye movements of normal and schizophrenic subjects tracking an
      unpredictable target (composed of summed sine waves) were examined. Eye tracking
      performance was evaluated both qualitatively and quantitatively using percent
      root-mean-square (%RMS) error and pursuit gain scores. Schizophrenics are capable
      of tracking an unpredictable target. This finding has implications for our
      understanding of schizophrenic information processing during visual tracking.

PMID- 2242391
TI  - EEG and CT findings in patients with panic disorder.
AB  - Fifty-four patients with panic disorder were investigated using extensive
      electroencephalographic (EEG) recordings and computerized tomography (CT).
      Fifteen (28%) of these patients had previously been treated for temporal lobe
      epilepsy or were considered to have another neurological disorder. EEG recordings
      showed increased slow-wave activity in 13 (24%) patients and CT scan revealed
      incidental abnormalities in 6 (20%) of the 30 patients investigated. Taking into
      account the limitations of the methods applied, the present results indicate that
      clear-cut epileptic EEG patterns only rarely occur in panic disorder: the vast
      majority of panic patients exhibit normal EEG and CT findings.

PMID- 2242392
TI  - Chronic treatment with prolixin causes oxidative stress in rat brain.

PMID- 2242393
TI  - Polymers for biodegradable medical devices. V. Hydroxybutyrate-hydroxyvalerate
      copolymers: effects of polymer processing on hydrolytic degradation.
AB  - The effects of melt processing on those properties of polyhydroxybutyrate
      hydroxyvalerate copolymers that control hydrolytic stability were studied.
      Initial experiments using a non-thermal preparation technique enabled the
      relationship between initial molecular weight and rate of hydrolytic degradation
      to be established. This rate was conveniently expressed in terms of the time for
      10% by weight of the sample to be eroded. By varying melt processing conditions,
      the range of effects of processing on sample molecular weight and molecular
      weight distribution were investigated. These effects were found to be quite
      dramatic, with a reduction to 50% of the initial molecular weight being readily
      achieved. Temperature, shear rate and dwell time interrelated to control the
      extent of thermal degradation achieved during processing. The principal effect of
      copolymer composition resulted from the fact that an increase in hydroxyvalerate
      content led to a reduction in melting point and enabled milder processing
      conditions to be used. Enhanced crystallinity, resulting from more favourable
      processing conditions reduced hydrolytic degradation rates. As a result, melt
      processing produced a complex interrelation of effects, all of which influenced
      the hydrolytic stability of the fabricated specimen. In general, molecular weight
      effects predominated.

PMID- 2242394
TI  - Surface properties of copolymers of alkyl methacrylates with methoxy
      (polyethylene oxide) methacrylates and their application as protein-resistant
      coatings.
AB  - New polymeric surfactants, copolymers of alkyl methacrylates with methoxy
      (polyethylene oxide) methacrylates, were synthesized and characterized by gel
      permeation chromatography. They were studied as possible means to produce
      polyethylene oxide-rich surfaces by a simple coating treatment on common
      hydrophobic medical materials. They were further studied as cleaners for the
      removal of proteins preadsorbed on hydrophobic surfaces. The surface properties
      of the copolymers such as the adsorption properties of the copolymer on a
      hydrophobic surface, low density polyethylene, the protein-resistant character of
      the prepared polyethylene oxide surfaces and the effectiveness of the copolymers
      for removal of proteins pre-adsorbed on the surface, were investigated by X-ray
      photoelectron spectroscopy and by using 125I-labelled copolymers and 125I
      labelled proteins. The surface properties of the synthesized copolymers were
      compared with those of commercially available polyethylene oxide containing block
      copolymer surfactants.

PMID- 2242395
TI  - Radiation-induced graft copolymerization of methacrylic acid on to poly(vinyl
      chloride) films and their thrombogenicity.
AB  - Methacrylic acid (MAA) was radiation grafted on to poly(vinyl chloride) (PVC)
      films to improve the blood compatibility of PVC. The thromobogenicity of MAA
      grafted PVC was evaluated by thrombus formation, platelet adhesion and haemolytic
      activity in vitro. The hydrophilicity of grafted PVC films was investigated by
      contact angle measurement. Methacrylic acid grafted PVC film showed lower
      thrombogenicity than that of PVC. It was found that the weight of thrombus formed
      on grafted PVC was less than that of PVC and glass and decreased with the
      increase in the graft level. The adhesion of platelets on grafted PVC was
      retarded after grafting with MAA hydrogels.

PMID- 2242397
TI  - Soft prosthesis materials based on powdered elastomers.
AB  - A new class of soft prosthesis material has been developed, based on the
      combination of a powdered elastomer and a methacrylate monomer that polymerizes
      to an elastomer. Such systems are processable by conventional dental technology.
      This principle avoids the use of plasticizers. Natural rubber, butadiene styrene
      and butadiene acrylonitrile elastomers have been used, together with a number of
      higher alkyl methacrylates (C8-C13) and 2-ethoxyethyl methacrylate. Such systems
      have been evaluated with respect to mechanical properties, including tear
      strength, adhesion to denture base poly(methyl methacrylate), water sorption and
      visco-elastic properties. A number of potentially viable systems have emerged,
      which may be useful in external prostheses. Many have high long-term water
      absorption, which makes questionable their long-term usefulness interorally.
      Nevertheless, there is still considerable scope for development in this area.

PMID- 2242396
TI  - Barium sulphate-loaded p(HEMA) microspheres as artificial emboli: preparation and
      properties.
AB  - Poly(2-hydroxyethyl methacrylate) p(HEMA) microspheres of good spherical geometry
      (diameter 90-1500 microns) encapsulated with 40-50% barium sulphate to impart
      radiopaque properties were prepared by a solvent evaporation process. These
      microspheres were cross-linked by reacting with hexamethylene diisocyanate (HMDI)
      or by gamma-irradiation in the presence of ethylene glycol dimethacrylate (EGDM)
      in n-heptane. Microspheres with a porous structure and a rough surface were also
      made by the incorporation of NaCl along with BaSO4. The effects of concentration
      of the polymer solution, concentration of the stabilizing agent, concentration of
      BaSO4, viscosity of the dispersion medium and ratio of the dispersed phase to the
      dispersion medium on the formation, stability and particle size distribution of
      the microspheres were investigated.

PMID- 2242398
TI  - Fretting corrosion studies of universal femoral head prostheses and cone taper
      spigots.
AB  - Short-duration, cyclically loaded, axial, fretting corrosion tests were designed
      and performed to compare the fretting behaviour of different metal Howmedica
      universal heads connected to coated and uncoated metal cone taper spigots.
      Concurrent axial push-on and pull-off taper friction tests were also performed.
      There was no measurable fretting debris found in any test and SEM studies of the
      contact surfaces showed no evidence of fretting. It is concluded that no
      significant, long-term fretting corrosion of the Vitalium Co-Cr-Mo heads on the
      Vitallium or uncoated Ti-6AI-4V spigots, nor of the Orthinox stainless steel
      heads on the Orthinox spigots, is likely to occur in vivo.

PMID- 2242399
TI  - Mechanical behaviour of zirconia and zirconia-toughened alumina in a simulated
      body environment.
AB  - The mechanical properties of a zirconia-toughened alumina (ZTA) and three
      tetragonal zirconia polycrystal ceramics (TZPs), together with a biograde
      alumina, have been assessed in a simulated body solution (Ringer's solution). The
      hardness and fracture toughness of these materials were unchanged from the values
      in air when the tests were carried out in Ringer's solution; there was an
      instantaneous fall in strength in Ringer's solution but this was considered
      acceptable. However, ageing for long periods in Ringer's solution promoted a
      surface layer of monoclinic zirconia. This was accompanied by a strength
      decrement and it is concluded that these yttria-stabilized ZTA and TZP materials
      are unsuitable as implant materials.

PMID- 2242400
TI  - Studies of the solubility of different calcium phosphate ceramic particles in
      vitro.
AB  - In vitro solubility tests of hydroxyapatite, tetracalcium phosphate or tricalcium
      phosphate particles were performed in lactate, citrate, Gomoris or Michaelis
      buffer with pH 6.2 or 7.2 and in aqua destillata. The results showed that in
      general the solubility decreased in the order tetracalcium phosphate greater than
      tricalcium phosphate greater than hydroxyapatite, except for lactate or citrate
      buffer where the solubility order was tetracalcium phosphate = tricalcium
      phosphate greater than hydroxyapatite. The influence of the specific buffer used
      is much larger than either pH or specific calcium phosphate salt tested. The pH
      stability of lactate buffer and aqua destillata is very low, the other buffer
      solvents had a rather stable pH value.

PMID- 2242401
TI  - Behaviour of tricalcium phosphate and hydroxyapatite granules in sheep bone
      defects.
AB  - Granules of hydroxyapatite (HA) and tricalcium phosphate (TCP) were implanted in
      separate holes drilled in mandibular bone of sheep to check the bone growth and
      in vivo behaviour of the materials. The experiment was performed in three sheep,
      killed respectively at 4, 8, 12 month. Samples of bone with the materials were
      explanted, microradiographed and sectioned to evaluate the interface under
      optical and electron scanning electron microscope. The hole, left empty as a
      reference, showed no full repair; whereas 4 month after implantation the TCP
      granules induce total repair of the hole. HA granules crumbled and no new bone
      induction was seen even 12 month after implantation.

PMID- 2242402
TI  - Biocompatibility of elastin-fibrin material in the rat.
AB  - Biocompatibility and biodegradability of a new elastin-fibrin material were
      investigated in several organs and tissues of the rat. It has been demonstrated
      that the material was quite well tolerated in all cases, except in bone marrow.
      Its use is considered in several aspects of reparative or constructive surgery.

PMID- 2242404
TI  - Fibrous carbon implants for the maintenance of bone volume after tooth avulsion:
      first clinical results.
AB  - When the avulsion of the last teeth of a patient is necessary, we propose to
      maintain the bone mass in order to improve the prosthetic conditions. For this
      purpose, we use fibrous carbon which is a biocompatible material well tolerated
      by the surrounding tissues. The results are reported of 10 yr of clinical use of
      fibrous carbon roots implanted in 38 alveoli of 26 patients with a mean follow-up
      of 34 month. There were 26 accepted artificial roots and 12 failures. The causes
      of failure are principally: (1) absent external bone wall near implanted alveoli
      (presence of the four bone walls is necessary); (2) existing local inflammation
      near implant site area.

PMID- 2242403
TI  - Effect of cytochrome P-450 inhibition and stimulation on intensity of
      polyethylene degradation in microsomal fraction of mouse and rat livers.
AB  - Polyethylene (PE) is degraded in microsomal fractions of mouse and rat livers
      with the formation of carbonyl groups. Infrared spectroscopy demonstrated
      formation of predominantly ketone groups and to a lesser degree ester and
      aldehyde groups. The inhibition and stimulation of cytochrome P-450 in mouse
      livers affected the formation of oxidative groups on PE. Phenobarbital doses of 3
      x 0.05 mg per mouse increased the concentration of cytochrome P-450 and ketone
      groups on PE, whereas the vaccine Propionibacterium acnes (0.5 mg) and its
      pyridine fraction (0.5 and 1 mg) had the opposite effect. The coherence of
      cytochrome P-450 with oxidative changes on PE is compared and discussed with
      findings on implants in man.

PMID- 2242405
TI  - Sampling strategies for distances between DNA sequences.
AB  - An international effort is now underway to obtain the DNA sequence for the entire
      human genome (Watson and Jordan, 1989, Genomics 5, 654-656; Barnhart, 1989,
      Genomics 5, 657-660). This Human Genome Initiative will generate sequence data
      from several species other than humans, and will result in several copies per
      species of at least some regions of the genome. Although the project has
      generated much interest, it is but one aspect of the widespread effort to
      generate DNA sequence data. Published sequences are collected in common
      databases, and release 63 of GenBank in March 1990 contained 40,127,752 bases
      from 33,337 reported sequences (News from GenBank 3; Mountain View, California:
      Intelligenetics, Inc., 1990). Large though this database is, it is only about 1%
      of the number of bases in the human genome. Interpretations of data of such
      magnitude are going to require the collaborative efforts of biometricians and
      molecular biologists, and an aim of this paper is to show that there is also a
      role for readers of this journal in the design of surveys of DNA sequences.
      Discussion here will center on the use of sequence data in evolutionary studies,
      where some region of DNA is sequenced in several different species. The object is
      to infer the evolutionary history of that particular region, or of the species
      themselves. Statistical issues in the very important studies on sequences to
      locate and characterize regions responsible for human diseases will not be
      addressed here. We will discuss appropriate ways of measuring distances between
      DNA sequences and of predicting the sampling properties of the distances. There
      are procedures for inferring evolutionary histories for a set of elements that
      depend on a matrix of distances between each pair of elements, and the precision
      of resulting trees must be influenced by the precision of the distances. We will
      show that account needs to be taken of two sampling processes--the sampling of
      sequences by the investigator ("statistical sampling"), and the sampling of
      genetic material involved in the formation of offspring from a parental
      population ("genetic sampling").

PMID- 2242406
TI  - Logistic regression in capture-recapture models.
AB  - The effect of population heterogeneity in capture-recapture, or dual
      registration, models is discussed. An estimator of the unknown population size
      based on a logistic regression model is introduced. The model allows different
      capture probabilities across individuals and across capture times. The
      probabilities are estimated from the observed data using conditional maximum
      likelihood. The resulting population estimator is shown to be consistent and
      asymptotically normal. A variance estimator under population heterogeneity is
      derived. The finite-sample properties of the estimators are studied via
      simulation. An application to Finnish occupational disease registration data is
      presented.

PMID- 2242407
TI  - Approximate interval estimation of the difference in binomial parameters:
      correction for skewness and extension to multiple tables.
AB  - Recently, Beal (1987, Biometrics 43, 941-950) found Mee's modification of Anbar's
      approximate interval estimation for the difference in binomial parameters to be a
      good choice in small sample sizes. As this method can be derived from the score
      theory of Bartlett, it is easily corrected for skewness. Exact numerical
      evaluation shows that this correction is not as important for this case as for
      the ratio of binomial parameters (Gart and Nam, 1988, Biometrics 44, 323-338).
      The score theory is also used to extend this method to the stratified or multiple
      table case. Thus, good approximate interval estimates for differences, ratios,
      and odds ratios of binomial parameters can all be derived from the same general
      theory.

PMID- 2242408
TI  - Some covariance models for longitudinal count data with overdispersion.
AB  - A family of covariance models for longitudinal counts with predictive covariates
      is presented. These models account for overdispersion, heteroscedasticity, and
      dependence among repeated observations. The approach is a quasi-likelihood
      regression similar to the formulation given by Liang and Zeger (1986, Biometrika
      73, 13-22). Generalized estimating equations for both the covariate parameters
      and the variance-covariance parameters are presented. Large-sample properties of
      the parameter estimates are derived. The proposed methods are illustrated by an
      analysis of epileptic seizure count data arising from a study of progabide as an
      adjuvant therapy for partial seizures.

PMID- 2242409
TI  - Nonlinear mixed effects models for repeated measures data.
AB  - We propose a general, nonlinear mixed effects model for repeated measures data
      and define estimators for its parameters. The proposed estimators are a natural
      combination of least squares estimators for nonlinear fixed effects models and
      maximum likelihood (or restricted maximum likelihood) estimators for linear mixed
      effects models. We implement Newton-Raphson estimation using previously developed
      computational methods for nonlinear fixed effects models and for linear mixed
      effects models. Two examples are presented and the connections between this work
      and recent work on generalized linear mixed effects models are discussed.

PMID- 2242410
TI  - Testing nonlinear regression parameters under heteroscedastic, normally
      distributed errors.
AB  - Likelihood ratio tests for parameters estimated assuming normally distributed
      errors are examined under a variety of homoscedastic and heteroscedastic variance
      assumptions. It is assumed that gamma ij, the jth observation from the ith
      population, is distributed as N[mu(chi ij, beta i), (sigma i mu(chi ij, beta
      i)theta i)2]. By varying sigma 2i and theta i, this model contains the most
      obvious examples of homoscedastic and heteroscedastic variability. Under this
      model, the null hypothesis of equal beta i's can easily be tested using the
      likelihood ratio criterion. Also considered is the two-sample chi-square
      statistic, chi 2t = U'S-1 U, where U is the difference vector of nonlinear least
      squares parameter estimates and S is an estimate of the covariance matrix of U.
      Monte Carlo simulation using the von Bertalanffy growth curve as an example is
      used to evaluate several test statistics for Type I error rates under different
      sampling assumptions.

PMID- 2242411
TI  - Interpreting plots of a multidimensional dose-response surface in a parallel
      coordinate system.
AB  - The dose-response surface for a combination of drugs is a multidimensional
      figure. Consequently, it is not possible to view such a surface using orthogonal
      axes when the number of dimensions exceeds 3. Parallel axes have been used to
      represent hyperdimensional figures. This paper reports on the use of parallel
      coordinate axes to plot the dose-response surface and its contours of constant
      response (isobols) for a combination of drugs. It is shown that patterns formed
      by intersecting line segments in the parallel system can aid in the
      interpretation of the fitted dose-response surface. More generally, analytic
      results are developed that permit the ready visualization and characterization of
      interaction effects of a polynomial model.

PMID- 2242412
TI  - Efficient design for estimation of median lethal dose and quantal dose-response
      curves.
AB  - The results of quantal dose-response experiments are often summarized by an
      estimate of the "median lethal dose," denoted LD50, and many sequential designs
      have been proposed for efficient estimation of LD50. These designs strive to
      produce a sequence of trials at dose levels that get closer and closer to LD50.
      Consequently, they may not provide very good estimates of the overall shape of
      the dose-response curve. In this paper we propose guidelines for the design of
      experiments that estimate LD50 fairly efficiently and that also allow for
      efficient global estimation of the curve.

PMID- 2242413
TI  - Implementation of group sequential logrank tests in a maximum duration trial.
AB  - To control the Type I error probability in a group sequential procedure using the
      logrank test, it is important to know the information times (fractions) at the
      times of interim analyses conducted for purposes of data monitoring. For the
      logrank test, the information time at an interim analysis is the fraction of the
      total number of events to be accrued in the entire trial. In a maximum
      information trial design, the trial is concluded when a prespecified total number
      of events has been accrued. For such a design, therefore, the information time at
      each interim analysis is known. However, many trials are designed to accrue data
      over a fixed duration of follow-up on a specified number of patients. This is
      termed a maximum duration trial design. Under such a design, the total number of
      events to be accrued is unknown at the time of an interim analysis. For a maximum
      duration trial design, therefore, these information times need to be estimated. A
      common practice is to assume that a fixed fraction of information will be accrued
      between any two consecutive interim analyses, and then employ a Pocock or O'Brien
      Fleming boundary. In this article, we describe an estimate of the information
      time based on the fraction of total patient exposure, which tends to be slightly
      negatively biased (i.e., conservative) if survival is exponentially distributed.
      We then present a numerical exploration of the robustness of this estimate when
      nonexponential survival applies. We also show that the Lan-DeMets (1983,
      Biometrika 70, 659-663) procedure for constructing group sequential boundaries
      with the desired level of Type I error control can be computed using the
      estimated information fraction, even though it may be biased. Finally, we discuss
      the implications of employing a biased estimate of study information for a group
      sequential procedure.

PMID- 2242414
TI  - The Cox proportional hazards model with change point: an epidemiologic
      application.
AB  - In this paper, we develop the Cox proportional hazards model with special
      structured time-dependent covariates in the context of prospective epidemiologic
      studies. Our model possesses the following two features: (i) different relative
      risk parameters are allowed for early versus late onset of the disease of
      interest; (ii) an additional parameter is introduced so that specification is not
      required for the time (age) at which a change of the magnitude of the relative
      risks takes place, the so-called change point. Some difficulties with statistical
      inference for the proposed model are briefly discussed, and the large-sample
      distribution of a test for no change point is derived. As an illustration, we
      apply the model to a set of data gathered on a group of white male medical
      students of The Johns Hopkins Medical School enrolled between 1948 and 1964. We
      examine the hypothesis that the effect of reactivity to the cold pressor test may
      vary with early versus late onset of hypertension.

PMID- 2242415
TI  - A partially parametric estimator of survival in the presence of randomly censored
      data.
AB  - Many biological or medical experiments have as their goal to estimate the
      survival function of a specified population of subjects when the time to the
      specified event may be censored due to loss to follow-up, the occurrence of
      another event that precludes the occurrence of the event of interest, or the
      study being terminated before the event of interest occurs. This paper suggests
      an improvement of the Kaplan-Meier product-limit estimator when the censoring
      mechanism is random. The proposed estimator treats the uncensored observations
      nonparametrically and uses a parametric model only for the censored observations.
      One version of this proposed estimator always has a smaller bias and mean squared
      error than the product-limit estimator. An example estimating the survival
      function of patients enrolled in the Ohio State University Bone Marrow Transplant
      Program is presented.

PMID- 2242416
TI  - Estimates of absolute cause-specific risk in cohort studies.
AB  - In this paper we study methods for estimating the absolute risk of an event c1 in
      a time interval [t1, t2], given that the individual is at risk at t1 and given
      the presence of competing risks. We discuss some advantages of absolute risk for
      measuring the prognosis of an individual patient and some difficulties of
      interpretation for comparing two treatment groups. We also discuss the importance
      of the concept of absolute risk in evaluating public health measures to prevent
      disease. Variance calculations permit one to gauge the relative importance of
      random and systematic errors in estimating absolute risk. Efficiency calculations
      were also performed to determine how much precision is lost in estimating
      absolute risk with a nonparametric approach or with a flexible piecewise
      exponential model rather than a simple exponential model, and other calculations
      indicate the extent of bias that arises with the simple exponential model when
      that model is invalid. Such calculations suggest that the more flexible models
      will be useful in practice. Simulations confirm that asymptotic methods yield
      reliable variance estimates and confidence interval coverages in samples of
      practical size.

PMID- 2242417
TI  - Maximum likelihood estimation for the negative binomial dispersion parameter.

PMID- 2242418
TI  - Stratton lecture 1989. Thrombosis and inflammation as multicellular processes:
      pathophysiologic significance of transcellular metabolism.

PMID- 2242419
TI  - Regulation of human B-cell ontogeny.

PMID- 2242420
TI  - Silent infections with human immunodeficiency virus type 1 are highly unlikely in
      multitransfused seronegative hemophiliacs.
AB  - We used the polymerase chain reaction (PCR) to determine the frequency of silent
      human immunodeficiency virus type 1 (HIV-1) infections in seronegative high-risk
      individuals with hemophilia who had been exposed to contaminated blood products
      more than 3 years previously. In a cross-sectional study of a cohort of 57
      prospectively followed seronegative hemophiliacs who received multiple
      transfusions before 1986, HIV-1 proviral DNA was found transiently in only one
      patient. These data suggest that the rate of HIV infection among high-risk
      antibody negative individuals with hemophilia is very low to absent, in the range
      of 0% to 2%. These findings should provide considerable reassurance to
      seronegative persons with hemophilia and their sexual partners.

PMID- 2242421
TI  - Inhibition of interleukin-2-induced tumor necrosis factor release by
      dexamethasone: prevention of an acquired neutrophil chemotaxis defect and
      differential suppression of interleukin-2-associated side effects.
AB  - High concentrations of tumor necrosis factor (TNF) alpha have been detected in
      the plasma of patients undergoing immunotherapy with interleukin 2 (IL-2),
      suggesting that this cytokine may play a role in the fever and shocklike state
      induced by the administration of high-dose IL-2. Dexamethasone has been shown to
      inhibit the synthesis of TNF by monocytes activated in vitro by endotoxin. To
      determine if dexamethasone can exert a similar suppressive effect on IL-2-induced
      TNF synthesis in vivo, the concentration of TNF alpha was measured in plasma
      samples serially obtained (a) from cancer patients participating in a phase I
      dose escalation clinical trial with high-dose IL-2 administered in conjunction
      with dexamethasone (IL-2/Dex) and (b) from patients participating in concurrent
      studies with IL-2 alone. In contrast to the high plasma levels of TNF alpha
      detected in patients receiving IL-2 alone, TNF levels in most of the IL-2/Dex
      patients remained below the threshold of detectability of our TNF
      radioimmunoassay. The concurrent administration of dexamethasone also prevented
      the IL-2-induced increase in serum levels of C-reactive protein, a hepatic acute
      phase reactant whose synthesis is regulated by proinflammatory cytokines such as
      TNF. The steroid-treated patients also failed to develop the neutrophil
      chemotactic defect characteristic of IL-2 recipients. The concomitant
      administration of dexamethasone increased the maximum tolerated dose of IL-2
      approximately threefold and markedly reduced the hypotension and organ
      dysfunction ordinarily observed in these patients. These results demonstrate that
      dexamethasone inhibits the release of TNF into the circulation of patients
      undergoing immunotherapy with IL-2. They further suggest that the altered
      spectrum and reduced severity of IL-2 side effects observed in patients receiving
      dexamethasone may be attributable in part to the suppressive effect of steroids
      on IL-2-induced TNF synthesis.

PMID- 2242423
TI  - Development of antibodies to thrombin and factor V with recurrent bleeding in a
      patient exposed to topical bovine thrombin.
AB  - A 65 year old patient who was exposed to topical bovine thrombin during cardiac
      surgery developed markedly prolonged clotting times and a severe bleeding
      diathesis. Mixing studies with normal plasma failed to correct the clotting
      times. Platelet transfusions, immunosuppressive and immunomodulatory therapies
      were ineffective, but plasmapheresis was effective in decreasing clotting times
      and in the resolution of clinical bleeding events. The patient's purified IgG
      reacted with bovine thrombin by immunoblotting and enzyme-linked immunosorbent
      assay (ELISA). However, the IgG reacted minimally with human thrombin. In view of
      the severe bleeding, a coexisting inhibitor was sought. The patient's factor V
      activity was 1% of normal and was not corrected by mixing with normal plasma,
      demonstrating the presence of an inhibitor against factor V. The patient's IgG
      reacted with both bovine and human factor V. Immunoblotting localized the site of
      antibody binding to the light chain of activated bovine factor V. Detectable
      amounts of bovine factor V were found in commercial bovine thrombin preparations
      by ELISA. The data suggest that patients exposed to topical bovine thrombin may
      develop antibodies to thrombin and factor V. Anti-thrombin antibodies may mask
      coexisting factor V inhibitors responsible for clinical bleeding.

PMID- 2242422
TI  - Synthesis of transforming growth factor-beta 1 by megakaryocytes and its
      localization to megakaryocyte and platelet alpha-granules.
AB  - We have directly demonstrated that megakaryocytes are a major site of synthesis
      and storage of transforming growth factor-beta 1 (TGF/beta 1) by combined
      immunohistochemical, immunocytochemical, and in situ hybridization methods. The
      presence of TGF/beta 1 messenger RNA (mRNA) in mature megakaryocytes in adult rat
      spleen and bone marrow (BM) was established by in situ hybridization.
      Localization of TGF/beta 1 protein to intact alpha-granules of megakaryocytes,
      its putative storage site, was accomplished in glycol-methacrylate embedded
      porcine BM with an immunoperoxidase technique and light microscopy. The TGF/beta
      1 was sequestered in intracytoplasmic granules in a pattern virtually identical
      to that of another alpha-granule marker protein, fibrinogen. This observation
      strongly suggests packaging of TGF/beta 1 into this organelle within
      megakaryocytes. That TGF/beta 1 mRNA was localized to megakaryocytes suggests
      that the TGF/beta 1 found in the alpha-granules in platelets originates with
      megakaryocyte synthesis. The alpha-granule localization of TGF/beta 1, as well as
      fibrinogen, was also demonstrated in isolated platelets at the ultrastructural
      level by electronmicroscopy (EM) and postembedding colloidal-gold
      immunocytochemistry, thus directly demonstrating that alpha-granules are the
      final storage site for TGF/beta 1 in mature platelets.

PMID- 2242424
TI  - Analysis of platelet aggregation disorders based on flow cytometric analysis of
      membrane glycoprotein IIb-IIIa with conformation-specific monoclonal antibodies.
AB  - Normal primary platelet aggregation requires agonist-mediated activation of
      membrane GPIIb-IIIa, binding of fibrinogen to GPIIb-IIIa, and cellular events
      after ligand binding. PAC1 monoclonal antibody distinguishes between resting and
      activated states of GPIIb-IIIa, and other antibodies preferentially recognize
      GPIIb (PMI-1) or IIIa (anti-LIBS1) after the binding of fibrinogen or fibrinogen
      mimetic peptides, such as GRGDSP. Using these antibodies and platelet flow
      cytometry, we studied two distinct persistent platelet aggregation abnormalities.
      Platelets from a thrombasthenic variant, which contained near-normal amounts of
      GPIIb-IIIa, failed to aggregate or bind PAC1 in response to agonists. In
      addition, GRGDSP, which binds to normal GPIIb-IIIa without prior cell activation,
      failed to increase the binding of PMI-1 or anti-LIBS1 to the thrombasthenic
      platelets, suggesting a primary defect in ligand binding. Chromatography of
      detergent-solubilized platelets on a KYGRGDS affinity column confirmed that the
      patient's GPIIb-IIIa lacked the fibrinogen binding site. In another patient with
      myelofibrosis and defective aggregation, PAC1 failed to bind to adenosine
      diphosphate-stimulated platelets, but did bind when protein kinase C was directly
      activated with phorbol myristate acetate. Furthermore, the binding of PMI-1 and
      anti-LIBS1 increased in response to GRGDSP, confirming a defect in agonist
      mediated fibrinogen receptor activation rather than in fibrinogen binding or
      events distal to binding. These studies indicate that this immunochemical
      approach is useful in classification of clinical abnormalities of platelet
      aggregation as defects in either (a) fibrinogen receptor activation, (b)
      fibrinogen binding, or (c) postoccupancy events.

PMID- 2242425
TI  - Induction of in vitro graft-versus-leukemia activity following bone marrow
      transplantation for chronic myeloid leukemia.
AB  - We studied the in vitro effects of lymphokine-activated killer (LAK) cells from
      the peripheral blood of chronic myeloid leukemia (CML) patients after allogeneic
      and syngeneic bone marrow transplantation (BMT). LAK cells were generated by
      incubating peripheral blood mononuclear cells from patients post-BMT with
      recombinant interleukin-2 (IL-2) (500 U/mL) in 10% AB serum for 7 days. They were
      phenotyped and tested for activity in a standard 4-hour 51Cr release assay (n =
      37) and in a CFU-GM assay (n = 24). We found that the LAK cells were mainly
      activated natural killer cells, but some were CD3+ T cells. In the 51Cr release
      assay LAK cells from 20 of 33 (61%) allogeneic and 2 of 4 syngeneic recipients
      killed recipient CML cells and in 22 of 37 (60%) cases also killed the HLA
      disparate CML cells. In the CFU-GM assay the LAK cells incubated together with
      the CML cells in liquid culture before plating inhibited (P less than .05) colony
      growth in 16 of 22 allogeneic and 2 of 2 syngeneic recipients. Cell-cell contact
      was necessary for optimal effect. There was little or no inhibition of
      proliferation of donor marrow CFU-GM. This in vitro graft-versus-leukemia (GVL)
      effect could also be demonstrated after LAK effectors were depleted of CD3+ T
      cells. It was inducible in recipients of both T cell-depleted and T cell-replete
      donor marrow and in recipients with or without graft-versus-host disease. These
      results suggest that a major histocompatibility complex-unrestricted GVL effect
      is inducible following allogeneic and syngeneic BMT. The use of IL-2/LAK cells
      after BMT could reduce the risk of relapse.

PMID- 2242426
TI  - The effect of desferrithiocin, an oral iron chelator, on T-cell function.
AB  - Desferrithiocin is a new, potent, orally available iron chelator. To determine
      whether this drug might be useful not only for iron-overload but also for
      immunosuppression, we studied the in vitro effects of desferrithiocin on T
      lymphocyte function. Like deferoxamine, desferrithiocin inhibited, in a dose
      dependent fashion, mitogen- and lectin-induced proliferation of both human and
      murine T cells. It was active at a concentration of 10 micrograms/mL. The
      inhibition of proliferation was reversed by ferrous chloride, but not by other
      metal salts, recombinant IL-2, or conditioned medium. Desferrithiocin also
      inhibited proliferation of constitutively dividing, and factor-independent EBV
      transformed B cell and leukemic T-cell lines. Although desferrithiocin inhibited
      the induction of cytotoxic T lymphocyte (CTL) activity, it did not inhibit CTL-
      or natural killer-induced cytotoxicity. The agent did not inhibit the expression
      of activation antigens such as the IL-2 receptor on T cells, nor early measures
      of T-cell activation such as the influx of intracellular calcium. Thus,
      desferrithiocin, like deferoxamine, is a potent and reversible inhibitor of T
      cell proliferation. This anti-proliferative effect inhibits T-cell function.
      Bioavailability after oral administration is a unique property of
      desferrithiocin, and would make it an attractive alternative to deferoxamine. Its
      immunomodulating properties may therefore be exploited in vivo to inhibit graft
      rejection or autoreactive T cells.

PMID- 2242427
TI  - Deletion of the human retinoblastoma gene in primary leukemias.
AB  - As an initial step in evaluating the role of tumor suppressor genes in
      leukemogenesis, we surveyed primary leukemia cells from 130 patients for possible
      deletion of the retinoblastoma susceptibility (Rb) gene by Southern blot
      analysis. Two of them clearly showed homozygous deletion of Rb alleles. The first
      patient was a pre-B acute lymphoid leukemia (ALL) associated with a cytogenetic
      translocation: t(14;16)(q24;q22). The deletion was located at the 3' portion of
      the Rb gene, very close to the site of Rb gene deletion recently identified in an
      ALL cell line. The absence of Rb110 protein was further confirmed by Western blot
      analysis. The second patient was a chronic myelomonocytic leukemia (CMMoL),
      terminated in acute blastic transformation. Deletion of the 5' portion of Rb gene
      was found in leukemic cells in the chronic stage. The results indicated that
      inactivation of the Rb gene occurred in certain cases of leukemia. Its
      significance warrants further study.

PMID- 2242428
TI  - Association of bcl-1 rearrangements with lymphocytic lymphoma of intermediate
      differentiation.
AB  - Previous studies using classical cytogenetics have demonstrated the presence of
      the t(11;14) (q13;q32) chromosomal translocation in some cases of lymphocytic
      lymphoma of intermediate differentiation (IDL), a distinct type of low grade B
      cell lymphoma. This finding suggested that the bcl-1 region (located at band q13
      of chromosome 11) might be involved in this neoplasm. Using a genomic probe from
      the major breakpoint area of the bcl-1 locus, we identified rearrangements of the
      bcl-1 region in 10 of 19 cases, 2 of which comigrated with a rearranged allele of
      the immunoglobulin heavy chain gene joining region. In contrast, bcl-1
      rearrangements were not found in other types of low grade B-cell lymphoma,
      specifically in 36 cases of chronic lymphocytic leukemia/small lymphocytic
      lymphoma (CLL/SLL) and 27 cases of follicular lymphoma (FL). To further assess
      the molecular pathology of IDL, we analyzed these cases for rearrangements of the
      bcl-2 proto-oncogene, which is associated primarily with follicular lymphomas.
      None of the 19 cases of IDL had rearrangements. Furthermore, none of the 36 cases
      of CLL/SLL showed bcl-2 rearrangements, whereas, as expected, 21 of 27 cases of
      FL had rearrangements of the bcl-2 locus. Our findings demonstrate an association
      between a rearranged bcl-1 region with approximately 50% of IDLs and suggest that
      abnormalities of this locus may be important in the pathogenesis of IDL.

PMID- 2242429
TI  - Response patterns of hairy cell leukemia to B-cell mitogens and growth factors.
AB  - The effect of mitogens and/or recombinant B-cell growth factors (M/GFs) on the in
      vitro growth of hairy cells was examined. Tumor cells were isolated from the
      spleens of four patients with hairy cell leukemia (HCL) by Ficoll-Hypaque
      sedimentation and E-rosetting. Enrichment for tumor cells was confirmed with
      intracytoplasmic immunoglobulin (Ig) staining, tartrate resistant acid
      phosphatase (TRAP) staining, and staining using monoclonal antibodies (MoAbs)
      directed at B, T, myeloid, and monocytoid antigens (Ags) in indirect
      immunofluorescence assays. Tumor cells were B1(CD20)+ B2(CD21)- B4(CD19)+ IL
      2R(CD25)+ PCA-1 +/- TRAP+. HCLs neither synthesized DNA nor secreted Ig in
      response to culture with granulocyte-macrophage colony-stimulating factor (GM
      CSF), interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-2, IL-3, IL-4, IL-5, or IL
      6. However, a proliferative response (stimulation index greater than or equal to
      3.0) without Ig secretion was triggered in HCLs by mitogens or combinations of
      GFs. Specifically, DNA synthesis was induced at 3 days in three of four HCL
      samples cultured with Staphylococcus aureus Cowan A (SAC) or the combination of
      phorbol ester (TPA) and the calcium ionophore A 23187 (Ca2+); DNA synthesis was
      triggered later (day 7) by tumor necrosis factor (TNF) or by IL-4 and IL-5. In
      contrast, the fourth patient, a nonresponder to SAC or TPA/Ca2+, demonstrated
      increased DNA synthesis at day 3 when cocultured with IL-4 and IL-5. Both
      autoradiography and staining with antibromodeoxyuridine (BrdU) MoAb conjugated to
      fluorescein confirmed DNA synthesis by only a minority (5% to 23%) of tumor cells
      within each patient. Dual staining confirmed that responsive cells were both
      BrdU+ and TRAP+. DNA synthesis induced by TPA/Ca2+ was blocked specifically by
      anti-IL-6 Ab; in contrast, the HCL proliferative response to SAC, TNF, or IL-4
      and IL-5 was not inhibited by anti-IL-6 Ab. alpha-Interferon inhibited the
      response to TPA/Ca2+, TNF, or IL-4 and IL-5 without any effect on response to
      SAC. Finally, peroxidase-antiperoxidase staining demonstrated that HCLs are
      induced by TPA/Ca2+, but not by SAC, to produce intracytoplasmic IL-6. These data
      demonstrate IL-4, IL-5, and IL-6 mediated DNA synthesis by HCLs in vitro and
      suggest a possible in vivo role for these growth factors in the pathophysiology
      of HCL.

PMID- 2242430
TI  - The amino-terminal 29- and 72-Kd fragments of fibronectin mediate selective
      monocyte recruitment.
AB  - Proteolytic fragments of fibronectin (Fn) can possess properties not inherent to
      intact Fn. Previously, only mixtures of low molecular weight Fn fragments, and
      the 120-Kd fibroblastic cell-binding segment, but not intact Fn, were shown to be
      selectively chemotactic for human monocytes (MOs). In order to determine if other
      structural domains of Fn were responsible, we tested six Fn fragments. The amino
      terminal 72-Kd fragment at 1.5 microns was about 75% as potent as zymosan
      activated serum (ZAS). Its amino-terminal 29-Kd degradation product at 1.0 micron
      was about one third as potent as ZAS. Checkerboard analysis confirmed chemotaxis.
      Complexing gelatin to 72-Kd fragments reduced MO chemotaxis by 28% to 30%.
      Reducing disulfide bonds in 29- and 72-Kd segments had no effect. A synthetic
      peptide containing the thrombin cleavage site between the 29- and 50-Kd segments
      of the 72-Kd fragment was chemotactic. The 50-, 190/170-, 35-, and 160/150/120-Kd
      fragments, and intact Fn were not chemotactic for MOs. The data suggest that the
      72-Kd fragment and its 29-Kd subfragment are additional Fn fragments that mediate
      selective MO chemotaxis. We speculate that proteinases present at inflammatory
      sites can liberate such fragments that selectively recruit MOs.

PMID- 2242431
TI  - Effect of hemoglobin oxidation products on the stability of red cell membrane
      skeletons and the associations of skeletal proteins: correlation with a release
      of hemin.
AB  - Oxidative injury to hemoglobin (Hb) leads to formation of methemoglobin (MetHb),
      reversible hemichromes (rHCRs), and irreversible hemichromes (iHCRs). iHCRs
      precipitate and form Heinz bodies that attach to the red cell membrane causing
      injury that leads to hemolysis. The molecular mechanisms of this membrane damage
      have not been fully elucidated. We have studied the effect of Hb oxidation
      products on the mechanical stability of red cell membrane skeletons and the
      associations of membrane skeletal proteins. Hb and MetHb stabilized the isolated
      membrane skeletons, whereas further oxidation to rHCRs abolished this stabilizing
      effect. Crude iHCRs prepared by phenylhydrazine oxidation of Hb destabilized
      membrane skeletons by decreasing formation of the spectrin-protein 4.1-actin
      complex, the effect similar to that of pure hemin. Whereas virtually no hemin was
      released from Hb and MetHb, high concentrations of hemin were released from crude
      iHCR preparations. After removal of this hemin fraction by Dowex resin, the iHCRs
      lost their destabilizing effect. We conclude that as the oxidation of Hb
      proceeds, the stabilizing effect of Hb on the membrane skeleton is gradually lost
      and the deleterious effect increases. The destabilization of the red cell
      membrane skeleton in the presence of crude iHCR is caused by release of hemin,
      which lowers the stability of membrane skeleton by weakening the spectrin-protein
      4.1-actin interaction.

PMID- 2242432
TI  - Molecular and hematologic characterization of Scottish-Irish type (epsilon gamma
      delta beta)zero thalassemia.
AB  - The DNA deletion associated with an example of (epsilon gamma delta beta)zero
      thalassemia (Scottish-Irish type) was characterized. The deletion is
      approximately 205 kb in length and involves the epsilon, G gamma, A gamma, delta,
      and beta globin genes. The breakpoint is located 263 bp 3' to exon 3 of the beta
      globin gene. An LI (KpnI) repeat element approximately 320 bp in size is found at
      the 3' end of the novel DNA sequence. Different clinical phenotypes for three
      heterozygous neonates suggest that the deletion alone does not predict severity
      of (epsilon gamma delta beta)zero thalassemia at this age.

PMID- 2242433
TI  - Sickle erythrocytes inhibit human endothelial cell DNA synthesis.
AB  - Patients with sickle cell anemia experience severe vascular occlusive phenomena
      including acute pain crisis and cerebral infarction. Obstruction occurs at both
      the microvascular and the arterial level, and the clinical presentation of
      vascular events is heterogeneous, suggesting a complex etiology. Interaction
      between sickle erythrocytes and the endothelium may contribute to vascular
      occlusion due to alteration of endothelial function. To investigate this
      hypothesis, human vascular endothelial cells were overlaid with sickle or normal
      erythrocytes and stimulated to synthesize DNA. The erythrocytes were sedimented
      onto replicate monolayers by centrifugation for 10 minutes at 17 g to insure
      contact with the endothelial cells. Incorporation of 3H-thymidine into
      endothelial cell DNA was markedly inhibited during contact with sickle
      erythrocytes. This inhibitory effect was enhanced more than twofold when
      autologous sickle plasma was present during endothelial cell labeling. Normal
      erythrocytes, with or without autologous plasma, had a modest effect on
      endothelial cell DNA synthesis. When sickle erythrocytes in autologous sickle
      plasma were applied to endothelial monolayers for 1 minute, 10 minutes, or 1 hour
      and then removed, subsequent DNA synthesis by the endothelial cells was inhibited
      by 30% to 40%. Although adherence of sickle erythrocytes to the endothelial
      monolayers was observed under these experimental conditions, the effect of sickle
      erythrocytes on endothelial DNA synthesis occurred in the absence of significant
      adherence. Hence, human endothelial cell DNA synthesis is partially inhibited by
      contact with sickle erythrocytes. The inhibitory effect of sickle erythrocytes
      occurs during a brief (1 minute) contact with the endothelial monolayers, and
      persists for at least 6 hours of 3H-thymidine labeling. These results indicate
      that interaction between sickle erythrocytes and the endothelium may result in
      altered endothelial function. This altered endothelial function may contribute to
      the development of vascular occlusive phenomena in patients with sickle cell
      anemia.

PMID- 2242434
TI  - Evaluation of leukocyte removal filters modelled by use of HIV-infected cells and
      DNA amplification.
AB  - The concept of reducing cell-associated blood-borne viruses (BBVs) by filtration
      of the vector leukocytes from blood collected for transfusion has led to the
      development of high efficiency filters. Improved filtration technology demands
      newer methodology to accurately estimate the residual cells. We have developed an
      experimental model based on the hemocytometer counts and the polymerase chain
      reaction (PCR), performed on the lymphocytes derived from the units of red cell
      mass inoculated with marker cells (H9) persistently carrying cell-associated
      human immunodeficiency virus DNA (CA-HIV). We measured the efficiency of 6 units
      of a prototype filter using our model and found an estimated mean of less than 4
      residual cells per milliliter in the filtered blood. This represents a mean 5.84
      log10 reduction of normal PBMC and CA-HIV in pre- and post-filtration aliquots
      and exemplifies the application of our model for evaluating a new generation of
      blood filters. Our model illustrates that a biological tracer (ie, DNA) is a
      better measure of the efficacy of a leukocyte filter than the hemocytometric
      enumeration of pre- and post-filtration PBMC concentrates.

PMID- 2242435
TI  - Desferrioxamine provocative test: methodology for estimating iron and total iron
      binding capacity.

PMID- 2242436
TI  - Identity of Wegener's autoantigen (p29) with proteinase 3 and myeloblastin.

PMID- 2242437
TI  - Peripheral T-cell lymphoma associated with hemophagocytic syndrome and
      hemophagocytic lymphohistiocytosis of children: do they share something?

PMID- 2242438
TI  - A beta-thalassemia carrier with normal sequence within the beta-globin gene.

PMID- 2242439
TI  - Role of vasopressin in cardiovascular and blood pressure regulation.
AB  - At low concentrations and in physiologic states vasopressin is a potent
      antidiuretic hormone. Its cardiovascular effects have been more complex and their
      role in circulatory adjustments to hypovolemia and hypotension difficult to
      define with precision. Although recognized as a powerful vasoconstrictor, its
      pressor effect in intact animals, even at high concentrations, is minimal. The
      reasons for this blunted pressor response have been explored. This report is a
      review of previously published work from our laboratories which highlights the
      direct and indirect vasodilator actions of this hormone in animals and humans.
      The indirect vasodilator effect is caused by inhibition of sympathetic efferents,
      and facilitation of the baroreflex through a central action of the hormone and
      its sensitization of arterial baroreceptors as well as cardiac afferents.

PMID- 2242440
TI  - Mechanisms involved in serotonin-induced vasodilatation.
AB  - In vitro investigations have identified three major mechanisms which could
      contribute to the vasodilator action of serotonin (5-hydroxytryptamine, 5-HT):
      direct vascular smooth muscle relaxation; prejunctional inhibition of
      noradrenaline release from vascular sympathetic nerve terminals; and release of
      endothelium-derived relaxing factor (EDRF). In vivo studies have shown that in
      pig and cat common carotid circulations, rabbit hindquarter and mesenteric
      circulations, and rat systemic vasculature, direct vascular smooth muscle
      relaxation may be the predominant mechanism involved, but the contribution of
      EDRF release remains to be established. In other circulations in vivo (dog
      femoral and common carotid), prejunctional inhibition of vascular sympathetic
      tone is the predominant mechanism responsible for serotonin-induced
      vasodilatation. All of these actions are mediated by 5-HT1-like receptors, but
      different subtypes seem to be involved in each of these mechanisms. The
      prejunctional inhibitory receptor has been the most studied; depending on the
      tissue, these subtypes may resemble 5-HT1A, 5-HT1B, 5-HT1C or 5-HT1D binding
      sites, or the contractile receptor in dog saphenous vein.

PMID- 2242441
TI  - Decreased activity of the sodium-calcium exchanger in tail artery of stroke-prone
      spontaneously hypertensive rats.
AB  - The ability of the Na-Ca exchanger to modify vascular relaxation was studied in
      rings isolated from tail arteries of stroke-prone spontaneously hypertensive rats
      (SHRSP) and normotensive Wistar-Kyoto rats (WKY). The arteries were contracted
      with norepinephrine (NE) 1 microM and after stabilization they were transferred
      to a Ca-free physiological salt solution still in presence of NE. The time to 50%
      relaxation (T-50) in these conditions was significantly greater in SHRSP (78 +/-
      7 s) than in WKY (50 +/- 7 s). When the calcium pump was stopped with vanadate
      (VAN), the Ca uptake by the sarcoplasmic reticulum with ryanodine (RY) and the Na
      Ca exchanger with a Na-free PSS, the relaxation was slowed (T-50 increased to 198
      +/- 16 s in SHRSP and to 162 +/- 14 s in WKY). Releasing the Na-Ca exchanger only
      (i.e. still with VAN and RY but with normal Na in the bath) the T-50 for
      relaxation in Ca-free PSS was, in WKY, nearly as fast as in control conditions
      (54 +/- 8 s). However, the Na-Ca exchanger in SHRSP was not so effective, and the
      T-50 for relaxation was slower than in control conditions (122 +/- 10 s). We
      conclude that the activity of the Na-Ca exchanger is depressed in tail arteries
      of SHRSP. This abnormality in resistance vessels, would contribute to the
      enhanced vascular tone present in hypertension.

PMID- 2242442
TI  - Resistance artery tone is influenced independently by pressure and by flow.
AB  - The responses of rabbit resistance arteries to pressure and flow have been
      examined using two in vitro techniques--when mounted isometrically in a myograph
      and when perfused using a video system that automatically registers diameter. The
      latter approach allows pressure and flow to be independently controlled. Under
      such circumstances three responses were studied; myogenic contraction and flow
      dependent constriction and dilation. All responses occurred after endothelium
      removal and were unaffected by indomethacin (10(-60 M). The pressure and flow
      effects can be elicited separately and have different ionic bases. The effective
      stimulus for the myogenic response is stretch and that for flow is presumably
      shear stress. The mechano-transducers for these effects are different and are
      located either in the vascular smooth muscle cells or their surrounding
      extracellular matrix.

PMID- 2242443
TI  - EDRF in intact vascular networks.
AB  - X-ray microangiography was used to investigate the role of basal EDRF activity in
      the isolated rabbit ear, changes in perfusion pressure at different flow rates
      being correlated with simultaneous changes in diameter in resistance arteries 70
      1,000 microns in size. Under conditions of controlled-pressure but not controlled
      flow perfusion the preparations were shown to autoregulate flow, but only when
      EDRF activity was inhibited by haemoglobin or L-NMMA. The diameter data indicated
      that this phenomenon was mediated by a flow- and/or pressure-dependent
      constrictor response that is normally suppressed by EDRF activity. We also
      investigated the influence of basal EDRF activity on the geometrical 'optimality'
      of resistance artery branching, using four models which minimise respectively the
      total surface area, volume, shear stress (drag) or power losses at bifurcations.
      EDRF activity was found to maintain optimality in terms of minimum volume and
      power losses over a wide range of flow rates in pharmacologically constricted
      preparations. This may allow rapid changes in flow to occur with only small
      changes in central arterial pressure and also help to minimise cardiac work.

PMID- 2242444
TI  - Endothelium-derived hyperpolarizing factor.
AB  - Although nitric oxide appears to be the major endothelium-derived relaxing factor
      (EDRF), it cannot explain all endothelium-dependent responses of isolated
      arteries. Thus, acetylcholine causes an endothelium-dependent, transient
      hyperpolarization, which is due to the release from the endothelial cells of a
      diffusible substance (endothelium-derived hyperpolarizing factor, EDHF) other
      than nitric oxide. The muscarinic receptors on the endothelium that trigger the
      release of EDHF belong to the M1-muscarinic subtype, while those activating the
      liberation of EDRF are M2-muscarinic in nature. The importance of endothelium
      dependent hyperpolarization varies among different blood vessels. The
      hyperpolarization, and the resulting relaxation caused by EDHF can be attributed
      to an increase in K+ conductance in the vascular smooth muscle. Although the
      nature of EDHF remains elusive, it may be a labile metabolic of arachidonic acid.

PMID- 2242445
TI  - Mechanoreception by the endothelium: mediators and mechanisms of pressure- and
      flow-induced vascular responses.
AB  - Mechanoreception, a widely distributed sensory modality, has been shown to be
      present in certain blood vessels. Changes in physical forces, like sudden
      increase of transmural pressure or flow velocity (shear stress), trigger changes
      in blood vessel diameter; the former reduces it while the latter increases vessel
      caliber. These changes in diameter, which are the result of contraction and
      relaxation of vascular smooth muscle in the blood vessel media, can serve the
      purpose of physiological regulation of blood flow (autoregulation) and protection
      of the intima against damages from high shear forces. The precise location of
      mechanosensor(s) and the mechanism of mechanoreception and signal transduction
      are poorly understood. Accumulating evidence suggests that the endothelium may be
      a site of mechanoreception and that changes in the synthesis/release of
      endothelium-derived relaxing (EDRF, EDHF, PGI2) and contracting factors (EDCF)
      result in altered vascular smooth muscle tone and vessel caliber. Increased shear
      stress stimulates the release of EDRF and PGI2 probably via activation of a K+
      channel (inward rectifier) in endothelial cell membrane. Endothelium-dependent
      vascular contraction evoked by increased transmural pressure may be the result of
      (1) reduced release of EDRF (canine carotid artery) and (2) stimulation of the
      release of a still unidentified EDCF(s) (feline cerebral artery). Thus the
      endothelium can serve as pressure and flow sensor and is capable of transducing
      changes in mechanical forces into changes of vascular smooth muscle tone by
      modulating the release of endothelium-derived vasoactive factors. The
      physiological importance of the mechanoreception by endothelial cells in the
      intact circulation remains to be determined.

PMID- 2242446
TI  - Impaired dilatation of cerebral arterioles in chronic hypertension.
AB  - Several mechanisms impair cerebral vasodilatation during chronic hypertension.
      First, the external diameter of cerebral arterioles is reduced during chronic
      hypertension by structural 'remodeling'. Thus, both vascular hypertrophy and
      remodeling result in encroachment on the lumen. Second, endothelium-dependent
      dilatation of cerebral vessels is impaired during chronic hypertension. Third,
      blood flow through cerebral collaterals is impaired by chronic hypertension, so
      that an important compensatory mechanism is compromised. Impaired vasodilator
      responses, together with limitation of increases in collateral blood flow, may
      predispose to cerebral ischemia and stroke during chronic hypertension.

PMID- 2242447
TI  - Endothelium-dependent relaxations and chronic vasospasm after subarachnoid
      hemorrhage.
AB  - Endothelium-dependent relaxations are abolished in the canine basilar artery
      after subarachnoid hemorrhage. However, the release of endothelium-derived
      relaxing factor (EDRF) toward the lumen is not reduced. These findings suggest
      that the responsiveness of the smooth muscle to EDRF is impaired during chronic
      vasospasm after subarachnoid hemorrhage.

PMID- 2242448
TI  - Molsidomine.
AB  - Molsidomine is an established drug for the treatment of coronary heart disease.
      It acts via the metabolite SIN-1 through liberation of NO. Experiments have
      proven the identity of NO and EDRF. Investigation of the molecular mechanism of
      action of molsidomine/SIN-1 indicate that molecular oxygen initiates NO formation
      through a one-electron abstraction from the intermediate. Ex vivo experiments in
      rats and in vitro studies in human coronary arteries showed that marked tolerance
      is induced with glyceryl trinitrate, whereas prolonged exposure to SIN-1 does not
      cause tolerance. Responsiveness to SIN-1 is not modified in nitrate-tolerant
      human arteries. Stimulation of soluble guanylate cyclase underlies the
      antiaggregatory actions of EDRF. Likewise SIN-1 inhibits platelet aggregation in
      various models. In dogs and pigs with critical stenosis molsidomine reduced
      significantly the frequency and the severity of cyclical reductions of coronary
      blood flow.

PMID- 2242449
TI  - Mechanism of the vasodilator action of pinacidil.
AB  - The mechanism of the vasodilator action of pinacidil has been studied in rat
      mesenteric small arteries. The results show, first, that the use of flux studies
      to make measurements of ion permeability requires knowledge of the membrane
      potential, especially as regards K+ permeability. Second, the results confirm
      that the vasodilator effect of pinacidil is due to an increase in K+
      permeability. Lastly, the results suggest that the K+ channels involved are
      sensitive to glibenclamide.

PMID- 2242450
TI  - Peptidergic vasodilator nerves in the peripheral circulation and in the vascular
      beds of the heart and brain.
AB  - This overview focusses on the ubiquitous presence of immunohistochemically
      visible peptidergic nerves with vasodilatory function. The nerve fibres are
      primarily related to the parasympathetic system (vasoactive intestinal
      polypeptide or VIP), the sympathetic system including the adrenal medulla
      (enkephalins) and to the sensory system (substance P as well as calcitonin gene
      related peptide, CGRP). Substance P and probably also CGRP seem to be the
      mediators of antidromic vasodilatation. Enkephalins appear to be released both
      from nerve endings and from the adrenomedullary cells. The vasodilatory nerve
      fibres in the heart distribute both to the coronary vessels and to functionally
      important parts of the myocardium, where interesting relations exist between the
      peptidergic flow regulation and contractile force. In the brain the sensory and
      parasympathetic pathways for VIP and substance P/CGRP have recently been mapped
      in detail, and a new peptidergic intracranial ganglion has been discovered. The
      selective electrical stimulation of the sensory and postganglionic
      parasympathetic fibres, respectively, in the brain circulation has been found to
      evoke a pronounced flow increase which does not appear to involve cholinergic
      mediation. There is also experimental evidence that the mentioned systems of
      fibres may interact with each other and with the sympathetic nervous system by
      way of neuronal cross-talk.

PMID- 2242451
TI  - Cholinergic vasodilatation of coronary resistance vessels in dogs, baboons and
      goats.
AB  - Intracoronary infusion of acetylcholine produces a prompt increase in coronary
      blood flow in dogs, but a paradoxical decrease has been reported in baboons and
      cattle. The action of acetylcholine was reexamined in anesthetized dogs, baboons
      and goats, with the coronary circulation pump perfused at constant pressure and
      the heart rate held constant with electrical pacing. Intracoronary infusions of
      low doses of acetylcholine produced coronary vasodilatation and an increase in
      coronary venous oxygen tension without a change in cardiac contractility (dP/dt)
      or myocardial oxygen consumption in all three species. High doses of
      acetylcholine produced coronary vasodilatation only in dogs, but resulted in a
      decrease in cardiac contractility and myocardial oxygen consumption accompanied
      by a decrease in coronary flow in baboons and goats. It is concluded that low
      doses of acetylcholine produce coronary vasodilatation in all three species, and
      that the decrease in coronary blood flow observed in baboons and goats at high
      doses is probably due to local metabolic vasoconstriction secondary to the
      negative inotropic effects of acetylcholine.

PMID- 2242452
TI  - Safety and health in the construction industry.

PMID- 2242453
TI  - Diabetic autonomic neuropathy.

PMID- 2242454
TI  - Endothelins.

PMID- 2242456
TI  - Atenolol in essential hypertension during pregnancy.
AB  - OBJECTIVE: To determine the effect of atenolol on the outcome of pregnancy in
      women with essential hypertension. DESIGN: Prospective, randomised, double blind,
      placebo controlled study. SETTING: Hospital clinic. PATIENTS: 33 Women with mild
      essential hypertension (systolic blood pressure 140-170 mm Hg or diastolic
      pressure 90-110 mm Hg on two occasions at least 24 hours apart) consecutively
      referred to two obstetric medical clinics. Four patients in the placebo group
      were withdrawn from the study: control of blood pressure was inadequate in two,
      one developed breathlessness, and one changed her mind about participating. The
      mean gestation in the 29 remaining women on entry to the study was 15.9 weeks.
      MAIN OUTCOME MEASURES: Blood pressure and birth weight. INTERVENTION: 14 Women
      received placebo. 15 Women received atenolol 50 mg daily initially, increasing
      until either the blood pressure was less than 140/90 mm Hg or a dose of 200
      micrograms daily was reached. RESULTS: The mean blood pressure on entry was
      148/86 mm Hg in the group given atenolol and 144/86 mm Hg in the group given
      placebo. During treatment the mean diastolic pressure was significantly reduced
      by atenolol compared with placebo (to 74 v 81 mm Hg; difference in means (95%
      confidence interval) 7.0 (2.9 to 10.0) mm Hg) but the effect on systolic pressure
      was marginal (132 v 136 mm Hg; 4.0 (-1.4 to 8.6) mm Hg). Babies in the atenolol
      group had a significantly lower birth weight than those in the placebo group
      (2620 g v 3530 g; 910 (440 to 1380)g). CONCLUSION: Atenolol given from the end of
      the first trimester in patients with mild hypertension is associated with
      intrauterine growth retardation. When taken in conjunction with the results of a
      previous study in which methyldopa was given these findings indicate that benefit
      is unlikely to result from treating mild essential hypertension in pregnancy.

PMID- 2242455
TI  - Psychological outcomes of different treatment policies in women with early breast
      cancer outside a clinical trial.
AB  - OBJECTIVES: To assess outside a clinical trial the psychological outcome of
      different treatment policies in women with early breast cancer who underwent
      either mastectomy or breast conservation surgery depending on the surgeon's
      opinion or the patient's choice. To determine whether the extent of psychiatric
      morbidity reported in women who underwent breast conservation surgery was
      associated with their participation in a randomised clinical trial. DESIGN:
      Prospective, multicentre study capitalising on individual and motivational
      differences among patients and the different management policies among surgeons
      for treating patients with early breast cancer. SETTING: 12 District general
      hospitals, three London teaching hospitals, and four private hospitals. PATIENTS:
      269 Women under 75 with a probable diagnosis of stage I or II breast cancer who
      were referred to 22 different surgeons. INTERVENTIONS: Surgery and radiotherapy
      or adjuvant chemotherapy, or both, depending on the individual surgeon's stated
      preferences for managing early breast cancer. MAIN OUTCOME MEASURES: Anxiety and
      depression as assessed by standard methods two weeks, three months, and 12 months
      after surgery. RESULTS: Of the 269 women, 31 were treated by surgeons who
      favoured mastectomy, 120 by surgeons who favoured breast conservation, and 118 by
      surgeons who offered a choice of treatment. Sixty two of the women treated by
      surgeons who offered a choice were eligible to choose their surgery, and 43 of
      these chose breast conserving surgery. The incidences of anxiety, depression, and
      sexual dysfunction were high in all treatment groups. There were no significant
      differences in the incidences of anxiety and depression between women who
      underwent mastectomy and those who underwent lumpectomy. A significant effect of
      surgeon type on the incidence of depression was observed, with patients treated
      by surgeons who offered a choice showing less depression than those treated by
      other surgeons (p = 0.06). There was no significant difference in psychiatric
      morbidity between women treated by surgeons who offered a choice who were
      eligible to choose their treatment and those in the same group who were not able
      to choose. Most of the women (159/244) gave fear of cancer as their primary fear
      rather than fear of losing a breast. The overall incidences of psychiatric
      morbidity in women who underwent mastectomy and those who underwent lumpectomy
      were similar to those found in the Cancer Research Campaign breast conservation
      study. At 12 months 28% of women who underwent mastectomy in the present study
      were anxious compared with 26% in the earlier study, and 27% of women in the
      present study who underwent lumpectomy were anxious compared with 31% in the
      earlier study. In both the present and earlier study 21% of women who underwent
      mastectomy were depressed, and 19% of women who underwent lumpectomy in the
      present study were depressed compared with 27% in the earlier study.)
      CONCLUSIONS: There is still no evidence that women with early breast cancer who
      undergo breast conservation surgery have less psychiatric morbidity after
      treatment than those who undergo mastectomy. Women who surrender autonomy for
      decision making by agreeing to participate in randomised clinical trials do not
      experience any different psychological, sexual, or social problems from those
      women who are treated for breast cancer outside a clinical trial.

PMID- 2242457
TI  - Prevalence of symptoms of Raynaud's phenomenon in general practice.
AB  - OBJECTIVE: To investigate the prevalence of Raynaud's phenomenon in the
      populations of five general practices. DESIGN: Two populations studied. A
      questionnaire was given to all new patients attending five general practices over
      four weeks, and the same questionnaire was sent by post to a random sample of
      adults from two of the practices. SETTING: General practices in inner London,
      Merseyside, and Cheshire. SUBJECTS: 1532 Patients who completed questionnaires
      (1119 who attended the surgeries (response rate unknown) and 413 respondents to
      the postal survey (response rate 69%)). MAIN OUTCOME MEASURES: Response to
      questionnaire on symptoms of Raynaud's phenomenon: patients were regarded as
      having the disease if they had episodes of blanching of the fingers that were
      precipitated by cold and accompanied by sensory symptoms (pins and needles or
      numbness). Subsequent interview and clinical appraisal of patients with the
      disease according to their responses to the questionnaire. RESULTS: The
      prevalence of Raynaud's phenomenon was 11% (26/231) and 19% (34/182) respectively
      in men and women who completed the postal questionnaire and 16% (56/357) and 21%
      (157/762) respectively in those who completed the questionnaire when attending
      their general practice. Thus the overall rates were slightly higher in women, but
      there was no effect of age even after adjustment of the rates for practice and
      method of survey. CONCLUSION: The prevalence of Raynaud's phenomenon is high
      compared with the low number of patients who seek treatment for the disease.

PMID- 2242458
TI  - Immunisation in a curative setting.
AB  - OBJECTIVE: To study the uptake of vaccination offered to women and children
      attending a curative health facility. DESIGN: Prospective survey over eight
      months of the uptake of vaccination offered to unimmunised women and children
      attending a diarrhoeal treatment centre as patients or attendants. SETTING: The
      International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
      SUBJECTS: An estimated 19,349 unimmunised women aged 15 to 45 and 17,372 children
      attending the centre for treatment or accompanying patients between 1 January and
      31 August 1989. MAIN OUTCOME MEASURES: The number of women and children who were
      unimmunised or incompletely immunised was calculated and the percentage of this
      target population accepting vaccination was recorded. RESULTS: 7530 (84.2%) Of
      8944 eligible children and 7730 (40.4%) of 19,138 eligible women were vaccinated.
      Of the children, 63.8% were boys, 75.9% were aged under 1 year, and 23.0% were
      aged 1 to 2 years. The estimated number of missed opportunities for vaccination
      was 716 among the children (8.0% of the target population) and 11,408 among the
      women (59.6% of those eligible). CONCLUSION: It is possible to establish
      immunisation services at a health facility treating acutely ill patients.

PMID- 2242459
TI  - ABC of major trauma. Major maxillofacial injuries.

PMID- 2242460
TI  - Resuscitation of patients with cardiac arrest by ambulance staff with extended
      training in West Yorkshire.
AB  - OBJECTIVE: To investigate the results of resuscitation of patients with cardiac
      arrest by ambulance staff with extended training in West Yorkshire. DESIGN: Study
      of all such attempts at resuscitation over 32 months, based on the standard
      report form for each call made by the ambulance staff and the electrocardiogram
      that showed the initial rhythm in each patient. SETTING: Area covered by West
      Yorkshire ambulance service. SUBJECTS: 1196 Patients with cardiac arrests
      attended by 29 ambulance staff with extended training. MAIN OUTCOME MEASURE:
      Result of resuscitation. RESULTS: The initial rhythm was asystole or
      electromechanical dissociation in 740 patients and ventricular fibrillation in
      456 patients; overall 65 patients survived to be discharged from hospital. Sixty
      four of the 456 patients in whom ventricular fibrillation was the initial rhythm
      recorded, and 46 in whom ventricular fibrillation persisted after the ambulance
      staff arrived, survived. Only one of the 740 patients who initially had asystole
      or electromechanical dissociation survived. Factors associated with a greater
      chance of ventricular fibrillation occurring were: age less than 71, the arrest
      being witnessed by a bystander, resuscitation by a bystander, the arrest
      occurring in a public place, and a response time by the ambulance staff of less
      than six minutes. For patients found in ventricular fibrillation a shorter
      response time was associated with improved survival but resuscitation by a
      bystander was not. Additional skills learnt during extended training were used
      for 51 of the 65 patients who survived. CONCLUSIONS: Ambulance staff with
      extended training can save the lives of patients with cardiac arrest due to
      fibrillation, though asystole and electromechanical dissociation have a poor
      prognosis and should perhaps receive little attention during extended training.

PMID- 2242461
TI  - Dangers of neonatal intubation with the Cole tube.

PMID- 2242462
TI  - Population registers and public health.

PMID- 2242463
TI  - Sleep disorders in children.

PMID- 2242464
TI  - Impact of HIV on tuberculosis in Zambia.

PMID- 2242466
TI  - The Black report.

PMID- 2242465
TI  - Is antenatal selection for spina bifida possible?

PMID- 2242467
TI  - Management of severe burns.

PMID- 2242468
TI  - Occult ischemic necrosis of skeletal muscle.

PMID- 2242469
TI  - Whiplash injury.

PMID- 2242470
TI  - Terminal cancer care and patients' preference for place of death.

PMID- 2242471
TI  - Race and ethnicity in the European context.

PMID- 2242472
TI  - Chronic anaemia, hyperbaric oxygen and tumour radiosensitivity.
AB  - Anaemia is an important factor in the response of some human tumours to
      radiotherapy. The outcome is also influenced by whether the treatment is given in
      air or high pressure oxygen (HPO). The present study examined the relationship
      between anaemia and tumour response to radiation given in air or HPO in C3H mice
      transplanted with a mammary adenocarcinoma using a growth delay assay to assess
      the radiation response. Chronic anaemia was induced by the use of a low iron diet
      and was characterized by a significant reduction in host haematocrit and whole
      blood viscosity. In addition, anaemia was associated with a right shift in the
      oxyhaemoglobin dissociation curve and an increase in the volume doubling time of
      the tumour; but there was no change in the concentration of 2,3
      diphosphoglycerate in the red cells. Radiation studies with these anaemic mice
      demonstrated that the tumour radiosensitivity was decreased when treatment was
      given in air. HPO was successful in overcoming the increased radioresistance
      associated with anaemia. This result suggested that tumours grown in anaemic mice
      have a higher hypoxic fraction than those grown in control mice. Changes in host
      physiology with chronic anaemia may contribute to the benefit seen with HPO but
      such alterations per se may be inadequate to maintain tumour oxygenation when
      treatment is given in air.

PMID- 2242473
TI  - The relative biological effectiveness of fractionated doses of fast neutrons (42
      MeVd----Be) for normal tissues in the pig. II. Late effects on cutaneous and
      subcutaneous tissues.
AB  - The late effects of irradiation with single and fractionated doses of X rays (250
      kV) and fast neutrons (42 MeVd----Bc), on the cutaneous and subcutaneous tissues
      of the pig, have been evaluated from measurements of changes in relative field
      length. These were determined at intervals of 26-104 weeks after irradiation. For
      fractionated irradiation with X rays the average fractions exponent, N, obtained
      from a log-log plot of iso-effect dose (ED50) against fraction number was 0.41.
      This was independent of the period of assessment, with no significant indication
      of a time factor. However, the exponent N did vary with the level of effect and
      was in the range 0.33-0.51. It was greatest for a greater than or equal to 10%
      reduction in relative field length. Assuming the validity of the linear quadratic
      model of cell survival, the alpha/beta ratio was 1.95 Gy. However, this model
      fitted the data less well for the least severe levels of damage, and for these
      the alpha/beta ratios were not significantly different from zero. Irradiation
      with fast neutrons showed a small effect of fractionation for doses given in
      greater than or equal to 6 fractions compared with a single dose. There was no
      significant increase in iso-effect dose when the dose was given in 30 fractions
      compared with 6 fractions. The relative biological effectiveness for late
      cutaneous and subcutaneous damage for the energy of fast neutrons used did not
      vary with the period of assessment, i.e. 26-52 weeks compared with 65-104 weeks,
      and was not significantly different from that previously obtained for ischaemic
      dermal necrosis, seen after higher doses, at 12-20 weeks after irradiation.

PMID- 2242474
TI  - Quantitative gamma-ray computed tomography of the radius in normal subjects and
      osteoporotic patients.
AB  - A new design of gamma-ray computed tomography (CT) scanner was used to measure
      bone density in 516 normal adults and in 116 female patients with osteoporotic
      fractures. Trabecular bone density (TBD) was measured for a core of the
      ultradistal radius; cortical bone mass per unit length (MLS) and mass per unit
      volume (MVS) were computed for the radius shaft. TBD, MLS and MVS peaked at the
      age of about 40 in females and fell by 32%, 15% and 24%, respectively, by the age
      of 65. In males, TBD decreased from the third decade and MLS and MVS peaked in
      the fourth decade. The corresponding falls by 65 years were 20%, 6% and 7%. In
      patients with Colles' fracture TBD and MLS were reduced by 13% and 10%,
      respectively, relative to age matched normal female subjects. For patients with
      vertebral crush fracture the reductions relative to age matched normal females
      were 36%, 17% and 16% for TBD, MLS and MVS. In fracture patients the deficit in
      TBD was significantly greater than that for cortical bone but TBD was no better
      at discriminating normal and osteoporotic individuals because of its larger
      normal range. We conclude that gamma-ray CT may best be used for monitoring
      changes in bone rather than as a diagnostic screening tool.

PMID- 2242475
TI  - Choroid plexus cysts and chromosomal defects.
AB  - During a 4-year period, 83 pregnant women with fetal choroid plexus cysts were
      investigated in our unit. Abnormal karyotypes were found in 20 fetuses, including
      trisomy 18 (n = 16), trisomy 13 (n = 1), triploidy (n = 1) and translocation
      Down's syndrome (n = 2). All fetuses with chromosomal defects had structural
      malformations in addition to the choroid plexus cysts.

PMID- 2242476
TI  - Ultrasonography in patients with suspected acute appendicitis: a prospective
      study.
AB  - The diagnostic accuracy of high-resolution real-time ultrasonography was
      prospectively studied in 240 patients admitted to the hospital with suspected
      acute appendicitis. The criteria for ultrasound diagnosis of appendicitis
      included a sausage-shaped, aperistaltic, hypoechoic structure when imaged along
      its longitudinal axis, with a target-like appearance on transverse section. The
      ultrasonographic findings were correlated with surgical-pathological outcome in
      82 cases with proven appendicitis, with laparotomy findings in another 21
      patients and with clinical follow-up in the remainder. The overall sensitivity,
      specificity and accuracy of ultrasonography in the diagnosis of acute
      appendicitis were 78%, 92% and 87%, respectively. The positive predictive value
      was 84% and the negative predictive value was 88%. Ultrasonography may
      significantly improve the diagnostic accuracy in patients with suspected acute
      appendicitis and should be performed in all patients in whom the clinical
      diagnosis is equivocal. The ultrasonographic findings must be interpreted in
      light of the clinical findings.

PMID- 2242477
TI  - Sedation in children scanned with high-field magnetic resonance; the experience
      at the Hospital for Sick Children, Great Ormond Street.
AB  - Patient movement is the most common cause of image degradation when performing
      magnetic resonance scans in children. This is a particular problem scanning at
      high field, as noise levels of up to 90 dB may be reached. Movement can be
      reduced by adequate sedation. We present the results of two sedation protocols
      when scanning with a 1.5T Magnetom scanner. Optimal scan quality can be achieved
      in up to 85% of scans using Pethco combined with triclofos in children aged 1
      month-2 years, and trimeprazine combined with papaveretum in children over 2
      years. When heavy sedation is used, patient selection must be cautious, and there
      is a minimum acceptable level of monitoring including close physical observation,
      electrocardiographic and apnoea monitoring.

PMID- 2242478
TI  - A man with three knees? False "hot spot" with dual isotope imaging.

PMID- 2242479
TI  - Additive filtering.

PMID- 2242480
TI  - Computerized calculation of radiation dose to patients from radiography.

PMID- 2242481
TI  - Progressive systemic sclerosis (diffuse scleroderma) and radiotherapy.

PMID- 2242482
TI  - Spinal cord sarcoidosis with intramedullary cyst formation.

PMID- 2242483
TI  - Ultrasonic appearances of the early changes in fibrodysplasia ossificans
      progressiva.

PMID- 2242484
TI  - Cystic lymphangioma of the pelvis in childhood.

PMID- 2242485
TI  - Unusual presentation of non-Hodgkin's lymphoma of the small bowel.

PMID- 2242486
TI  - Ultrasound appearances of extramedullary haematopoiesis in the liver and spleen.

PMID- 2242487
TI  - A case of post-operative paresis.

PMID- 2242488
TI  - Mathematical models of repopulation and reoxygenation in radiotherapy.

PMID- 2242489
TI  - Contrast medium inhibition in osteoarthritic cartilage.

PMID- 2242490
TI  - Fracture risk: a role for compact bone.

PMID- 2242491
TI  - Long-term observations of vertebral fractures in spinal osteoporotics.
AB  - The changes in the number and distributions of vertebral fractures were studied
      from the long-term observations (average 7 years) of 21 spinal osteoporotic
      patients. Distribution of wedge fractures was biphasic with peak frequencies at
      the midthoracic and thoracolumbar spine. Biconcave fractures occurred
      predominantly in the lumbar spine. These patterns of distribution did not change
      during the period of observation. The rate of biconcave fracture increased, the
      rate of wedge fracture decreased, and that of collapse remained the constant in
      follow-up. The changes in the number of fractures were divided into three types:
      increasing, plateau, and unchanged type. With the advance of osteoporosis, the
      increasing type was considered to change into the plateau type, which is probably
      the terminal stage of spinal osteoporosis. The unchanged type, in contrast, was
      distinct from the other two types because of increased spinal bone mineral
      density and decreased urinary calcium, which suggests that spinal osteoporosis is
      heterogeneous with regard to calcium metabolism.

PMID- 2242492
TI  - Effects of salmon calcitonin on the bone loss induced by ovariectomy.
AB  - We present the results of a 12-month clinical study assessing the effects of
      synthetic salmon calcitonin (sCT) on a group of fertile white women who had
      undergone ovariectomy for uterine fibromatosis. The study was performed to verify
      whether CT can prevent the loss of bone mass and the changes in calcium
      phosphorus metabolism associated with acute estrogen deficiency. The study
      consisted of an initial double-blind phase of 6 months, followed by a 6-month
      open period. Treated patients were given 100 MRC U of synthetic salmon CT
      injected i.m. in the morning, every other day, starting on the 7th day after the
      operation and continued for 12 months. Control patients received a placebo
      injection for the first 6 months; subsequently, they too were treated with sCT
      i.m. every other day for 6 months at the same dose as the 12 month-treated group.
      All patients received 500 mg of elementary calcium p.o., b.i.d. Bone mineral
      content (BMC) was measured at the extreme distal radius of the nondominant arm by
      a dual photon bone densitometer which utilizes two radio nuclides, 241 Am and 125
      I, with energies of about 60 and 30 KeV. Biochemical parameters of the calcium
      phosphorus metabolism were also measured. After 12 months of study, no
      significant changes of BMC were observed in the 12 months sCT treated group,
      while control patients, treated 6 months after the ovariectomy, showed a
      significant decrease in BMC values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242493
TI  - Vertebral cortical bone mass measurement by a new quantitative computer
      tomography method: correlations with vertebral trabecular bone measurements.
AB  - Previous studies comparing axial and appendicular skeleton have shown that
      trabecular bone loss is greater than cortical bone loss. However, whether the
      same difference exists between the trabecular and the cortical compartments of
      the vertebral body remains to be determined. In this study, we used quantitative
      computer tomography (QCT) to simultaneously measure the cortical rim of the
      vertebral body as well as trabecular bone. In 99 Caucasian women (mean age 53.8
      +/- 13.0 years, range 26-79 years) we found a significant correlation between
      cortical mineral content (BMCC) and both single (SE) and dual energy (DE)
      trabecular mineral content (BMCT) (r = 0.62, P less than 0.0001 for both
      regressions). The cross-sectional rates of bone loss per year were 1.32%, 1.16%,
      and 0.59% for SE-BMCT, DE-BMCT, and BMCC, respectively. BMCC decreased at a rate
      that was 45-51% that of SE-BMCT and DE-BMCT, respectively. Our results indicate
      that (1) QCT may provide a useful means to selectively measure cortical density
      in vertebral bodies; (2) the decrease of cortical density over time in the spine
      appears to have been underestimated previously by extrapolation from appendicular
      bone measurements; (3) because measurements of the entire vertebral body
      (exclusive of the posterior elements) may provide information that is more
      representative of spine changes with age, a measurement that includes both areas
      might be more useful than one measuring only the trabecular region.

PMID- 2242494
TI  - Sodium fluoride does not increase human bone cell proliferation or protein
      synthesis in vitro.
AB  - The efficacy of sodium fluoride therapy for osteoporosis remains controversial.
      Evidence from clinical studies and from animals receiving fluoride has suggested
      that fluoride might act on bone to increase osteoblast numbers and matrix
      synthesis. In order to examine the hypothesis that fluoride has a direct
      mitogenic or anabolic action on the osteoblast, we tested the effect of fluoride
      on first passage human osteoblastic bone cells grown from collagenase-treated
      trabecular bone fragments. Under a variety of culture conditions, including both
      medium supplementation with serum and with a chemically defined medium, fluoride
      in doses ranging from 10(-6) to 10(-3) M did not alter cell proliferation as
      measured either by thymidine incorporation or by direct cell counting.
      Furthermore, exposure to fluoride under conditions of low serum supplementation
      did not alter either the total protein synthesis of the cells or their
      biosynthetic profile. These data suggest that fluoride does not act in vitro upon
      differentiated osteoblastic bone cells derived from adult human patients.

PMID- 2242495
TI  - Effect of 1,25(OH)2D3 and 24,25(OH)2D3 on calcium ion fluxes in costochondral
      chondrocyte cultures.
AB  - Vitamin D3 metabolites have been shown to affect proliferation, differentiation,
      and maturation of cartilage cells. Previous studies have shown that growth zone
      chondrocytes respond primarily to 1,25(OH)2D3 whereas resting zone chondrocytes
      respond primarily to 24,25(OH)2D3. To examine the role of calcium in the
      mechanism of hormone action, this study examined the effects of the Ca ionophore
      A23187, 1,25(OH)2D3, and 24,25(OH)2D3 on Ca influx and efflux in growth zone
      chondrocytes and resting zone chondrocytes derived from the costochondral
      junction of 125 g rats. Influx was measured as incorporation of 45Ca. Efflux was
      measured as release of 45Ca from prelabeled cultures into fresh media. The
      pattern of 45Ca influx in unstimulated (control) cells over the incubation period
      was different in the two chondrocyte populations, whereas the pattern of efflux
      was comparable. A23187 induced a rapid influx of 45Ca in both types of
      chondrocytes which peaked by 3 minutes and was over by 6 minutes. Influx was
      greatest in the growth zone chondrocytes. Addition of 10(-8)-10(-9) M 1,25(OH)2D3
      to growth zone chondrocyte cultures results in a dose-dependent increase in 45Ca
      influx after 15 minutes. Efflux was stimulated by these concentrations of hormone
      throughout the incubation period. Addition of 10(-6)-10(-7) M 24,25(OH)2D3 to
      resting zone chondrocytes resulted in an inhibition in ion efflux between 1 and 6
      minutes, with no effect on influx during this period. Efflux returned to control
      values between 6 and 15 minutes. 45Ca influx was inhibited by these
      concentrations of hormone from 15 to 30 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242496
TI  - Orientation of apatite and organic matrix in Lingula unguis shell.
AB  - The orientation relationship between apatite and organic matrix in shell of
      Lingula unguis (inarticulate brachiopod) was studied. The organic layers,
      mineralized layers, and decalcified mineralized layers were examined layer by
      layer using microbeam X-ray diffraction technique. Both organic layer and
      decalcified mineralized layer showed the diffraction pattern of beta-chitin. The
      degree of orientation of apatite showed correlation to that of beta-chitin: Well
      oriented diffraction patterns of apatite crystal and organic matrix were observed
      in the central part. In this part, the fiber axis of beta-chitin was parallel to
      the c-axis of apatite. A close relationship of unit cell dimension between
      apatite and chitin was indicated. These strongly suggest that the fibrous
      structure of organic matrix assists the orientation of apatite crystals in
      Lingula unguis shell.

PMID- 2242497
TI  - Effect of ovariectomy and prednisolone on bone mineral content in rats:
      evaluation by single photon absorptiometry and radiogrammetry.
AB  - The effects of ovariectomy and prednisolone were studied for 9 months in 3-month
      old rats on a moderately low calcium diet. Measurements were made by single
      photon absorptiometry of the femur at cortical and trabecular bone sites.
      Radiogrammetry was performed at the midshaft of the femur. During growth, body
      weight, bone size, and bone mineral content (BMC) increased in male rats more
      than in females. After ovariectomy, body weight increase was more pronounced, but
      bone mineral increase was lower than in controls. At the distal end of the femur,
      bone mineral density decreased after 3 months, and at the midshaft of the femur,
      medullary width increased significantly from 6 months on. Prednisolone in a dose
      of 0.5 mg/kg/day did not influence BMC. However, prednisolone treatment after
      ovariectomy induced a more pronounced effect on bone than ovariectomy alone. BMC
      increase was lower than in ovariectomy, and bone mineral density decreased
      significantly, especially at the distal end of the femur. After correction for
      differences in body weight, globally the same results were found. We conclude
      that (1) the combination of single photon absorptiometry and radiogrammetry
      allows the evaluation of growth and the effect of ovariectomy and prednisolone
      treatment in rats; (2) ovariectomy results in bone loss first at the distal end
      and later in the midshaft of the femur; (3) prednisolone in a dose of 0.5
      mg/kg/day alone did not affect bone mass; and (4) prednisolone profoundly
      enhanced the effects of ovariectomy.

PMID- 2242498
TI  - Calcitonin on osteoporotic bone fragility.

PMID- 2242499
TI  - Serum calcium in diabetes.

PMID- 2242500
TI  - Role of endogenously produced interleukin-6 as a second signal in murine
      thymocyte proliferation induced by multiple cytokines: regulatory effects of
      transforming growth factor-beta.
AB  - Previous studies have demonstrated that murine thymocytes proliferate in the
      presence of submitogenic concentrations of phytohemagglutinin-P (PHA-P) and
      various cytokines such as interleukin-1 (IL-1), interleukin-4 (IL-4), tumor
      necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6). We report that
      C3H/HeJ thymocytes stimulated with PHA-P and IL-1, IL-4, or TNF-alpha secrete
      significant levels of IL-6 as determined on B9 hybridoma cells. The possibility
      that thymocyte proliferation induced by these cytokines was mediated through IL-6
      was investigated utilizing a neutralizing monoclonal antibody against murine IL
      6, MP5 20F3.1. The results demonstrate that MP5 20F3.1 inhibited the
      proliferative response of thymocytes and B9 hybridoma cells to recombinant MuIL-6
      (but not HuIL-6) and neutralized the endogenous IL-6 produced in the thymocyte
      cultures, but did not have any measurable effects on the proliferative responses
      induced by IL-1, IL-4, or TNF-alpha. Although the level of endogeneously produced
      IL-6 did not play a measurable role in the proliferative response induced by TNF
      alpha, the addition of higher concentrations of IL-6 augmented the proliferation
      of murine thymocytes induced by rMu TNF-alpha. In addition, recombinant human
      transforming growth factor-beta 1 (rHu TGF-beta 1) significantly inhibited
      thymocyte proliferation induced by HuIL-1, rMuIL-4, rMuIL-6, and rMuTNF-alpha.
      The studies suggest that IL-1, IL-4, or TNF-alpha mediate a proliferative signal
      on murine thymocytes independent of IL-6 and that the proliferative signals
      provided by these cytokines as well as IL-6 are inhibitable by rHu TGF-beta 1.

PMID- 2242501
TI  - Culture and characterization of thymic epithelium from autoimmune NZB and NZB/W
      mice.
AB  - Autoimmune NZB and NZB/W mice display early abnormalities in thymus histology, T
      cell development, and mature T cell function. Abnormalities in the
      subcapsular/medullary thymic epithelium (TE) can also be inferred from the early
      disappearance of thymulin from NZB. It has also been reported that NZB thymic
      epithelial cells do not grow in culture conditions that support the growth of
      these cells from other strains of mice. In order to study the contribution of TE
      to the abnormal T cell development and function in NZB and NZB/W mice, we have
      devised a culture system which supports the growth of TE cells from these mice.
      The method involves the use of culture vessels coated with extracellular matrix
      produced by a rat thymic epithelial cell line. TEA3A1, and selective low-calcium,
      low-serum medium. In addition TEA3A1 cells have been used as an antigen to
      generate monoclonal antibodies specific for subcapsular/medullary TE. These
      antibodies, as well as others already available, have been used to show that the
      culture conditions described here select for cells displaying
      subcapsular/medullary TE markers, whereas markers for cortical TE and macrophages
      are absent.

PMID- 2242502
TI  - Stimulation of human interleukin 1 production and specific mRNA expression by
      microtubule-disrupting drugs.
AB  - The production of interleukin 1 (IL1), a pleiotropic monocyte-derived
      interleukin, can be induced in vitro by various stimuli. The present study shows
      that cytochalasins which inhibit actin filament polymerization in various cell
      types have no significant effect on IL1 production from human monocytic cells. On
      the contrary, microtubule disrupters such as colchicine, vinblastine, and
      vincristine dramatically potentiate (15- to 35-fold), in a dose-dependent
      fashion, cell-associated IL1 and to a lesser extent (2.5- to 7-fold) released IL1
      in the myelomonocytic THP1 cell line and in adherent peripheral blood mononuclear
      cells. The enhancing effect of the drugs was blocked by actinomycin D and by
      cycloheximide and was accompanied by an increase of specific IL1 beta mRNA
      expression as measured by Northern blot analysis, thus indicating that these
      drugs act at a transcriptional or post-transcriptional IL1 gene expression level.

PMID- 2242503
TI  - Expression of cellular effector functions and production of reactive nitrogen
      intermediates: a comparative study including T lymphocytes, T-like cells,
      neutrophil granulocytes, and mononuclear phagocytes.
AB  - The ability of various cell types to secrete reactive nitrogen intermediates
      (RNI) upon functional activation was comparatively assessed. Neither in T
      lymphocyte clones mediating MHC class I or class II antigen-restricted killing
      via alpha/beta T cell receptor (TcR) or MHC-unrestricted killing via gamma/delta
      TcR, nor in peripheral blood mononuclear cells expressing natural killer or
      lymphokine-activated killer activity, target cell lysis was associated with
      detectable RNI production. Also, activated neutrophil granulocytes did not
      secrete RNI. In contrast, bone marrow-derived mononuclear phagocytes, activated
      to express tumoricidal activity, secreted marked RNI activity.

PMID- 2242504
TI  - Influence of age on the rhythm in basal and forskolin-stimulated adenylate
      cyclase activity of the rat heart.
AB  - In male rats of three different ages (Group I: 7 weeks, Group II: 4 months, Group
      III: greater than 10 months) basal and forskolin-stimulated adenylate cyclase
      (AC) activity were investigated in rat heart ventricles of animals sacrificed at
      8 time points within 24 hours of a day. Maximum (Emax) and half-maximum (EC50)
      stimulation by a water-soluble forskolin (FOR; 0.1-100 mumol/l) were determined
      from dose-response curves. In young rats (Group I) significant rhythmicity was
      found in basal and FOR-stimulated AC activity, which was successively reduced or
      abolished with age by a reduction in amplitude. Mean basal AC activity increased
      about 2-fold from Group I to Group II/III. Mean maximum in FOR stimulation was
      about 12-fold in Group I and about 7-fold in Group II and III. EC50-values
      displayed neither a significant rhythmicity in either group nor an age
      dependency. It is concluded that the stimulatory potency of the catalytic subunit
      of the AC is reduced with age.

PMID- 2242505
TI  - Effect of chronic caloric restriction on the synchronization of various
      physiological measures in old female Fischer 344 rats.
AB  - A variety of physiological and behavioral parameters which relate to metabolism
      were continuously monitored in 18 month old female Fischer 344 rats which were
      maintained on either ad libitum or reduced calorie diets. Caloric restriction
      (CR) stimulated average motor activity per day, the duration of each feeding
      episode, food consumed per episode, and water consumed per gram lean body mass
      (LBM). However, CR limited total food consumption, feeding time, number of
      feeding episodes per day, total eating and drinking time, and the daily ratio of
      food consumed to water consumed, CR also decreased average body temperature per
      day, O2 consumption, CO2 production, and respiratory quotient. A variety of
      parameters concerning water consumption were not affected. CR rats ate their food
      immediately when food was presented during the light span, while ad libitum fed
      animals ate numerous small meals throughout the entire dark span. An anticipatory
      response to restricted feeding was also noted. Total motor activity, metabolism,
      and body temperature increased just prior to scheduled feeding and reached
      maximum values shortly after feeding, suggesting that these parameters were
      highly synchronized to feeding. Females and males were found to respond to
      caloric restriction in a similar fashion. Dramatic changes in respiratory
      quotient and body temperature suggest rapid shifts between metabolic pathways
      (glycolysis to gluconeogenesis) to obtain optimal efficiency. Lower body
      temperature and metabolism may provide protection against DNA damage, thereby
      increasing the survival potential of restricted rats. These responses may provide
      insight into the mechanisms by which caloric restriction acts to extend life
      span.

PMID- 2242507
TI  - Diurnal variations of beta-endorphin at rest and after moderate intensity
      exercise.
AB  - To determine the effect of time of day on circulating beta-endorphin
      concentrations 14 men exercised at 75% of their maximal capacity at 0600, 1200,
      1800 and 2400 hr. Each trial was separated by 3-5 days and preceded by a normal
      sleep cycle except for the 0600 hr trials which was preceded by 6 hr sleep.
      Resting physiological data indicated normal diurnal variations in heart rate,
      core temperature and oxygen uptake, being lowest during the 0600 hr trials and
      highest during the 1800 hr trials. Resting plasma beta-endorphin concentrations
      averaged 11.9 +/- 8.4 pmol/l during the 0600 hr trials, significantly greater
      than the 2400 hr trials (6.4 +/- 3.6 pmol/l; P less than 0.05). No other
      significant differences existed at rest. Post exercise beta-endorphin
      concentrations were elevated and found to be inversely related to time of day
      with the 0600 hr trials having the highest mean (25.7 +/- 14.7) and the 2400 hr
      trials the lowest (14.7 +/- 8.3). These data suggest that the plasma beta
      endorphin concentrations at rest and after exercise are affected by the time of
      day. The results also suggest that the changes in beta-endorphin associated with
      exercise are not major contributors to cardiorespiratory control or changes in
      psychological effect associated with exercise.

PMID- 2242506
TI  - Actigraphy: a means of assessing circadian patterns in human activity.
AB  - Twenty-three diurnally active (0705-2333), healthy persons between 22 and 54
      years of age and without history of sleep abnormality were monitored continuously
      for 120 consecutive hr (five days) by wrist actigraphy. Circadian rhythms of high
      amplitude were detected by cosinor analysis for each participant and for the
      groups of 10 males and 13 females with the average span of heightened activity
      timed between approximately 1330 and 1605. The circadian peak-trough difference
      in wrist movement was marked, equalling approximately 75% of the 24-hr mean
      level. In 19 of 23 participants, the 24-hr mean of wrist activity varied between
      140-180 movements/min, with four persons exhibiting lesser means of 110-140
      movements/min. With respect to the daytime span of activity, the mean wrist
      movement of individual participants ranged from 155-265 movements/min, with the
      majority (20/23) varying between 185-245 movements/min. During nocturnal sleep
      the mean wrist activity level was quite low, varying between individuals from 5
      to 25 movements/min for 21 of 23 persons. Wrist actigraphy proved to be well
      accepted and was a most reliable means of monitoring aspects of body movement
      during activity and sleep in ambulatory persons adhering to usual life habits and
      pursuits.

PMID- 2242508
TI  - Circadian variation in human performance evaluated by the Walter Reed performance
      assessment battery.
AB  - As part of a two clock-time (0830 versus 2030) evaluation of administration-time
      dependent effects of dexedrine (5 mg) and triazolam (0.25 mg) on human cognitive
      performance, placebo (control) studies were conducted on 12 diurnally active
      (0700-2300) male adults (23-38 yrs) using a double-blind, randomized crossover
      design. Testing was conducted hourly during a series of sleepless 13-hr spans
      commencing in the morning or evening, using the Walter Reed computer controlled
      and scored multi-task cognitive performance assessment battery. For the placebo
      condition, Single and Group Cosinor analyses documented circadian rhythms in
      performance for most tasks (reaction time, logical reasoning, serial add/subtract
      and spatial orientation) both for individuals and the group. Overall, performance
      was worse overnight, when sleepiness was greatest, and best between 1830 and
      2030. It was most variable around 0600-0700. The day-night variation in
      performance over all cognitive tests amounted to 21% of the 24-hr mean.

PMID- 2242509
TI  - Shiftwork and industrial injuries at a chemical plant in southeast Texas.
AB  - A historical retrospective study of 242 shiftworker (SW) and 224 non-SW (NSW)
      injuries at a chemical manufacturing plant in southeast Texas (U.S.A.) was
      performed. Data were collected on injuries that occurred between 1 January 1982
      and 31 December 1985. The SW schedule comprised an 8-hr, 7-day backward rotation
      program while the dayworker schedule consisted of a typical U.S.A. 40-hr work
      week. Injury records were matched against payroll/attendance records to
      substantiate the probability of isolating possible effects of the shiftwork
      rotation schedule on the rates, distribution and severity of injuries. Injuries
      in the SW sample were compared to those in the non-SW sample. The work
      responsibilities of dayworkers were not exactly the same as those of
      shiftworkers. However, the job responsibilities for males and females within the
      dayworker and shiftworker groups were equivalent. Overall injury incidence rates
      were not significantly different between SWs and non-SWs, although female SWs had
      significantly higher incidence rates than did male SWs and both male and female
      dayworkers. The occurrence of injuries, however, was not equally distributed
      during the day shift and the night shift, but was equally distributed during the
      evening shift and for non-SWs, suggesting that certain, yet to be determined,
      factors were affecting the distribution of injuries during the day and night
      shift. However, the average number of injuries was two-three times higher during
      the first four days of the day and night shift, yet were not elevated during the
      evening shift.

PMID- 2242511
TI  - A simple method for testing monthly statistical rates for normalization.

PMID- 2242510
TI  - Early onset and accumulation of REM sleep in depression: a study of the phase
      advance hypothesis.
AB  - Twenty-two depressed subjects who met criteria for major depressive disorder were
      grouped according to their initial REM latency. Subjects with short (less than or
      equal to 60 min) initial REM latency were separated from those with normal
      (greater than 60 min) initial REM latency. Subjects with short initial REM
      latency were found to have earlier onsets to at least two subsequent REM periods.
      The number of minutes of REM sleep accumulated were also plotted against elapsed
      time after sleep onset. The short-latency group accumulated REM sleep earlier
      than, but at about the same rate as, the normal latency group. These data support
      the phase-advance hypothesis of REM sleep in depression.

PMID- 2242512
TI  - Chronophysiology and ambulatory monitoring instrumentation.

PMID- 2242513
TI  - Continuous darkness stimulates body growth of the juvenile giant freshwater
      prawn, Macrobrachium rosenbergii de Man.
AB  - The effect of photoperiod on growth of juvenile giant freshwater prawns,
      Macrobrachium rosenbergii de Man, was tested. The prawns were divided into four
      groups and each group was reared under one of the following light-dark
      conditions: continuous darkness (L0:D24), 12 hr light: 12 hr dark (L12:D12), 16
      hr light: 8 hr dark (L16:D8), and 20 hr light: 4 hr dark (L20:D4). Body size was
      determined at the age of 45, 75, and 110 days by measuring total length, orbital
      length, and carapace length; body weight was determined at the age of 110 days.
      At 110 days of age, the prawns reared under L0:D24 photoperiod were significantly
      longer and heavier than those reared under other light-dark conditions. The
      survival rate of the prawns reared under L0:D24 photoperiod was also higher than
      that of other groups. This study indicates a positive effect of continuous
      darkness on growth and survival rate of juvenile giant freshwater prawns, M.
      rosenbergii.

PMID- 2242514
TI  - Current status of antitachycardia devices.
AB  - With the limitations of currently available modalities for treating clinically
      important tachycardias, the role of implanted antitachycardia devices will
      continue to expand. The challenge of the future will not only involve continued
      technological advances but the socioeconomic impact of this efficacious but
      expensive mode of therapy in an era of increasing financial restraints. Further
      studies to definitively prove the efficacy of more widespread use of
      antitachycardia device therapy will be needed.

PMID- 2242515
TI  - Pathophysiological insights into the cardiomyopathy of Chagas' disease.
AB  - The evidence gained from both human and animal studies of chronic chagasic
      cardiomyopathy suggests that the disease occurs as a consequence of several
      discrete and progressive pathophysiological processes occurring after infection,
      the ultimate expression of which depends on a host of unidentified factors.
      Collectively, the infection-associated events compromise microvasculature
      function and result in hypoperfusion, with consequences indistinguishable from
      those observed in other, nonparasitological cardiomyopathic diseases secondary to
      hypoperfusion. Therefore, chronic chagasic cardiomyopathy may share similar
      pathophysiological abnormalities with other chronic congestive cardiomyopathic
      states.

PMID- 2242516
TI  - Catheterization laboratory events and hospital outcome with direct angioplasty
      for acute myocardial infarction.
AB  - To assess the safety of direct infarct angioplasty without antecedent
      thrombolytic therapy, catheterization laboratory and hospital events were
      assessed in consecutively treated patients with infarctions involving the left
      anterior descending (n = 100 patients), right (n = 100), and circumflex (n = 50)
      coronary arteries. The groups of patients were similar for age (left anterior
      descending coronary artery, 59 years; right coronary artery, 58 years; circumflex
      coronary artery, 62 years), patients with multivessel disease (left anterior
      descending coronary artery, 55%; right coronary artery, 55%; circumflex coronary
      artery, 64%), and patients with initial grade 0/1 antegrade flow (left anterior
      descending coronary artery, 79%; right coronary artery, 84%; circumflex coronary
      artery, 90%). Cardiogenic shock was present in eight patients with infarction of
      the left anterior descending coronary artery, four with infarction of the right
      coronary artery, and four with infarction of the circumflex coronary artery.
      Major catheterization laboratory events (cardioversion, cardiopulmonary
      resuscitation, dopamine or intra-aortic balloon pump support for hypotension, and
      urgent surgery) occurred in 10 patients with infarction of the left anterior
      descending coronary artery, eight with infarction of the right coronary artery,
      and four with infarction of the circumflex coronary artery (16 of 16 shock and
      six of 234 nonshock patients, p less than 0.001). There was one in-laboratory
      death (shock patient with infarction of the left anterior descending coronary
      artery).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242517
TI  - An analysis of randomized trials evaluating the effect of cholesterol reduction
      on total mortality and coronary heart disease incidence.
AB  - The primary aim of this study was to estimate the relation between cholesterol
      reduction and total mortality and coronary heart disease (CHD) incidence.
      Secondarily, the clinical issues of whether the efficacy of cholesterol lowering
      is dependent on the treatment modality, presence of CHD at baseline, or the
      simultaneous introduction of other interventions was explored. All randomized
      clinical intervention trials of cholesterol reduction were used in an overview
      analysis of total mortality rate and CHD incidence; analysis was performed with
      weighted linear regression. The trials include those that used primary and
      secondary intervention, diet and drugs, and single or multifactor design.
      Nineteen trials were analyzed for total mortality, and of the 19, 16 were
      analyzed for CHD incidence rate. Net difference in cholesterol change between
      study groups was used as the independent variable, and the three previously
      mentioned dichotomous design characteristics were used as additional independent
      variables. For every 1% reduction in cholesterol, an estimated 2.5% reduction in
      CHD incidence is indicated (95% CL: 1.1, 3.9). With regard to CHD drug trials
      tended toward better efficiency in cholesterol lowering than did dietary trials.
      With regard to total mortality, this efficiency was higher in secondary than in
      primary preventive trials. The efficiency was also somewhat dependent on the
      baseline cholesterol level. This study shows that cholesterol reduction is
      effective in lowering CHD incidence, but cholesterol reduction must be at least 8
      9% to be effective in lowering total mortality.

PMID- 2242518
TI  - Intermittent claudication, heart disease risk factors, and mortality. The
      Whitehall Study.
AB  - In the Whitehall study, 18,388 subjects aged 40-64 years completed a
      questionnaire on intermittent claudication. Of these subjects, 0.8% (147) and 1%
      (175) were deemed to have probable intermittent claudication and possible
      intermittent claudication, respectively. Within the 17-year follow-up period, 38%
      and 40% of the probable and possible cases, respectively, died. Compared with
      subjects without claudication, the probable cases suffered increased mortality
      rates due to coronary heart disease and cerebrovascular disease, but the
      mortality rate due to noncardiovascular causes was not increased. Possible cases
      demonstrated increased mortality rates due to cardiovascular and
      noncardiovascular causes. This difference in mortality pattern may be due to
      chance. Possible and probable cases still showed increased cardiovascular and all
      cause mortality rates after adjusting for coronary risk factors (cardiac ischemia
      at baseline, systolic blood pressure, plasma cholesterol concentration, smoking
      behavior, employment grade, and degree of glucose intolerance). Intermittent
      claudication is independently related to increased mortality rates. It is not a
      rare condition, and simple questionnaires exist for its detection. The latter can
      be usefully incorporated in cardiovascular risk assessment and screening
      programs.

PMID- 2242519
TI  - Sotalol versus quinidine for the maintenance of sinus rhythm after direct current
      conversion of atrial fibrillation.
AB  - This open, parallel-group study compares quinidine and sotalol treatment for
      maintenance of sinus rhythm after direct current conversion of patients with
      chronic atrial fibrillation. The patients from 15 centers in Sweden were
      randomized to sotalol (98 patients) or quinidine (85 patients) after 2 hours of
      sinus rhythm after direct current conversion. According to primary efficacy
      assessment, 52% of the patients in the sotalol group and 48% of the patients in
      the quinidine group remained in sinus rhythm during the following 6-month
      treatment period (NS). Furthermore, 34% of the patients treated with sotalol and
      22% of the patients treated with quinidine relapsed into atrial fibrillation
      (NS). Heart rate after relapsing into atrial fibrillation was higher in the
      patients treated with quinidine (109 beats/min) than in the patients treated with
      sotalol (78 beats/min, p less than 0.001). Patients treated with sotalol were
      found to be less symptomatic at the time of relapse compared with relapsing
      patients in the quinidine group. In terms of safety, more patients were withdrawn
      from quinidine than from sotalol treatment (26% vs. 11%, p less than 0.05), and
      sotalol was generally better tolerated than quinidine. Twenty-eight percent of
      the patients treated with sotalol and 50% of the patients treated with quinidine
      reported side effects (p less than 0.01). The difference was primarily a result
      of early (within the first month of treatment) gastrointestinal and skin side
      effects in the group of patients treated with quinidine.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 2242520
TI  - A controlled clinical trial to assess the effect of a calcium channel blocker on
      the progression of coronary atherosclerosis.
AB  - To determine whether calcium channel blockers influence the progression of
      coronary atherosclerosis, 383 patients age 65 years or less with 5-75% stenoses
      in at least four coronary artery segments were selected at random within 1 month
      of coronary arteriography to participate in double-blind therapy with a placebo
      or nicardipine 30 mg three times daily. Coronary events (5 deaths, 22 myocardial
      infarctions, and 28 unstable anginas) occurred in 28 of 192 nicardipine patients
      and 23 of 191 placebo patients (p = NS). At 24 months coronary arteriography was
      repeated in 335 patients. Progression, defined as a 10% or more worsening in
      diameter stenosis, measured quantitatively, was found in 147 of 1,153 lesions
      (12.7%) in 168 nicardipine patients and in 170 of 1,170 lesions (14.5%) in 167
      placebo patients (p = NS). Ninety-two nicardipine patients (55%) and 95 placebo
      patients (57%) had progression at one or more sites (p = NS). Regression, that
      is, an improvement by 10% or more in diameter stenosis, was seen in 140 of 2,323
      lesions (6.0%) overall, with no significant intergroup difference. Among the 217
      patients with 411 stenoses of 20% or less in the first study, such minimal
      lesions progressed in only 15 of 99 nicardipine patients compared with 32 of 118
      placebo patients (15% versus 27%, p = 0.046). In this subgroup, 16 of 178 minimal
      lesions in nicardipine patients and 38 of 233 minimal lesions in placebo patients
      progressed (p = 0.038). By stepwise logistic-regression analysis, baseline
      systolic blood pressure (p = 0.04) and the change in systolic blood pressure
      between baseline and 6 months (p = 0.002) correlated with progression of minimal
      lesions. This suggested blood pressure reduction may account for the beneficial
      action of nicardipine. These results suggested nicardipine has no effect on
      advanced coronary atherosclerosis but may retard the progression of minimal
      lesions.

PMID- 2242521
TI  - A prospective, randomized, double-blind, crossover study to compare the efficacy
      and safety of chronic nifedipine therapy with that of isosorbide dinitrate and
      their combination in the treatment of chronic congestive heart failure.
AB  - We performed a prospective, randomized, double-blind, crossover study to compare
      the efficacy and safety of vasodilation with the calcium entry blocker nifedipine
      with that of isosorbide dinitrate (ISDN) and their combination as treatment for
      heart failure. Twenty-eight patients with New York Heart Association Functional
      class II or III chronic heart failure due to left ventricular systolic
      dysfunction were studied. All patients were maintained on a constant dose of
      digitalis and diuretics throughout the study. Eight weeks of therapy with
      nifedipine alone or in combination with ISDN resulted in a significantly higher
      incidence of heart failure deterioration necessitating hospitalizations and/or
      additional diuretics. Twenty-four percent of patients required hospitalization
      during nifedipine therapy and 26% required hospitalization during nifedipine-ISDN
      combination therapy in comparison to 0% requiring hospitalization during ISDN
      therapy alone. The total number of heart failure-worsening episodes was nine
      among patients on nifedipine, three among patients on ISDN (p less than 0.09
      versus nifedipine), and 21 among patients on nifedipine-ISDN combination (p less
      than 0.001 versus nifedipine, p less than 0.0001 versus ISDN). Premature
      discontinuation of drug administration due to clinical deterioration or other
      side effects occurred in 29% of patients during nifedipine therapy, 5% of
      patients during ISDN therapy (p = 0.05 versus nifedipine), and 19% of patients
      during the combination therapy. A comparison of eight patients who demonstrated
      clinical deterioration on nifedipine with the remainder of the patients
      demonstrated no significant difference in left ventricular ejection fraction
      (0.24 +/- 0.06 versus 0.23 +/- 0.07) or maximal oxygen uptake during exercise (13
      +/- 3 versus 14 +/- 2 ml/kg/min).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242522
TI  - Inotropic effects of angiotensin II on human cardiac muscle in vitro.
AB  - The direct effects of angiotensin II (Ang II) on human cardiac muscle were
      investigated using isolated trabecular muscles from failing and functionally
      normal hearts. Atrial and ventricular trabeculae were studied. Results
      demonstrated a positive inotropic effect of Ang II on human cardiac muscle.
      Comparison of the effects of Ang II among groups indicated that the
      responsiveness tended to be greater in atrial and normal muscle compared with
      failing muscle. Results of this study also demonstrated heterogeneity in the
      responsiveness to Ang II among human muscles, which was not correlated with
      patient age, sex, diagnosis, prior treatment with angiotensin converting enzyme
      inhibitor, or heart function. A significant correlation between response to Ang
      II and response to isoproterenol was demonstrated in failing ventricular
      trabeculae, which may suggest that defects in beta-adrenergic responsiveness in
      the failing human ventricle are accompanied by a loss of responsiveness to Ang
      II. Studies were extended to the Syrian cardiomyopathic hamster and its control.
      A dose-dependent inotropic response occurred in normal hamster ventricular muscle
      but was significantly diminished in cardiomyopathic muscle. Ang II did not
      shorten the timing of contraction, and pretreatment with adrenergic-blocking
      agents did not shift the dose-response curve, indicating that the response was
      not cyclic AMP mediated. This study demonstrates for the first time that Ang II
      can exert an inotropic effect directly on human cardiac muscle and confirms that
      there is a direct effect of Ang II on hamster cardiac muscle. The study further
      suggests, however, that the inotropic response to Ang II in cardiac muscle is
      heterogeneous and may be diminished by heart failure.

PMID- 2242523
TI  - Functional chiral asymmetry in descending thoracic aorta.
AB  - To determine whether rotational blood flow or chiral asymmetry exists in the
      human descending thoracic aorta, we established the ability of color Doppler
      ultrasound to detect rotational flow in a tornado tube model of a vortex
      descending fluid column. In a model of the human aortic arch with a pulse
      duplicator, color Doppler was then used to demonstrate that rotational flow
      occurs first in the transverse arch and then in the proximal descending thoracic
      aorta. With the use of color Doppler esophageal echocardiography, 53 patients
      (age range, 25-78 years; mean age, 56.4 years) were prospectively examined for
      rotational flow in the descending thoracic aorta. At 10 cm superior to retro-left
      ventricular position, 22 of 38 patients (58%) revealed rotational flow with
      obvious diastolic counterclockwise rotation but less obvious systolic clockwise
      rotation. At 5 cm superior to retro-left ventricular position, 29 of 46 patients
      (63%) revealed rotational flow with a tendency toward systolic clockwise and
      diastolic counterclockwise rotation. At the retro-left ventricular position, 47
      of 53 patients (89%) revealed rotational flow, usually of a clockwise direction,
      occurring in systole. Our data suggest that aortic flow is not purely pulsatile
      and axial but has a rotational component. Rotational flow begins in the aortic
      arch and is carried through to the descending thoracic aorta, where flow is
      chirally asymmetric with systolic clockwise and diastolic counterclockwise
      components. These data demonstrate an aortic rotational flow component that may
      have physiological implications for organ perfusion.

PMID- 2242524
TI  - Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy.
AB  - To investigate the incidence of abnormal exercise blood pressure responses in
      hypertrophic cardiomyopathy (HCM) and the potential role of hemodynamic
      instability as a mechanism of sudden death, 129 consecutive patients with HCM
      underwent maximal symptom-limited treadmill exercise testing with blood pressure
      recording. Four patterns of blood pressure response were observed. Forty-three
      patients had significant exercise hypotension, with either a continuous fall in
      systolic blood pressure (n = 5) from the start of exercise or a sudden fall in
      systolic blood pressure (20-100 mm Hg; mean, 40 mm Hg) from the peak value (n =
      38), 23 patients had a normal response during exercise but an abnormal blood
      pressure response in the recovery period, and the remaining 62 patients
      demonstrated a normal blood pressure response. Patients with exercise hypotension
      were younger (33 +/- 14 versus 46 +/- 14 years) and more of them had a family
      history of HCM and sudden death compared with those with a normal blood pressure
      response (15 of 43 versus 6 of 62 patients). Similarly, the 23 patients with
      abnormal recovery blood pressure responses were younger (43 +/- 16 versus 46 +/-
      14 years) and had a higher incidence of a family history of sudden death (10 of
      24 versus 6 of 62 patients). Left ventricular cavity dimensions were smaller in
      those with exercise hypotension, but 11 other clinical, echocardiographic, and
      arrhythmic variables were similar. To assess the mechanism of exercise
      hypotension, 14 patients who demonstrated exercise hypotension and 14 symptomatic
      patients with a normal exercise blood pressure response underwent invasive
      hemodynamic exercise testing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242525
TI  - Airway hyperresponsiveness in patients with microvascular angina. Evidence for a
      diffuse disorder of smooth muscle responsiveness.
AB  - Anginal chest pain in patients with angiographically normal coronary arteries may
      be caused by a limited coronary flow response to stress because of abnormal
      function of the coronary microcirculation (microvascular angina). Studies of
      forearm arterial function suggested that patients with microvascular angina may
      have a diffuse disorder of smooth muscle tone. Because dyspnea is common in these
      patients and seems disproportionate to the severity of myocardial ischemia, we
      studied air flow (forced expiratory volume in 1 second, or FEV1) in the basal
      state and after methacholine inhalation to determine whether bronchial smooth
      muscle is affected in this syndrome. Five of 36 patients with microvascular
      angina had a basal FEV1 of less than 70% of that predicted and did not receive
      methacholine. Of the remaining 31 patients, 14 (45%) had a more-than-20%
      reduction in FEV1 after methacholine inhalation (as much as 25 mg/ml), a response
      significantly greater than that of nine patients with heart disease (0%, p less
      than 0.025) and 24 normal volunteers of similar age and gender distribution (13%,
      p less than 0.025). Furthermore, the product of the methacholine dose inhaled and
      the magnitude of decline in FEV1 from baseline (methacholine response score) was
      significantly lower in patients with microvascular angina than in normal
      volunteers (16 +/- 8.6 versus 22.2 +/- 3.7, p = 0.026). We conclude that airway
      hyperresponsiveness is frequently demonstrable in patients with microvascular
      angina; these findings are consistent with our hypothesis that this syndrome may
      represent a more generalized abnormality of vascular and nonvascular smooth
      muscle function.

PMID- 2242526
TI  - Prostacyclin and acetylcholine as screening agents for acute pulmonary
      vasodilator responsiveness in primary pulmonary hypertension.
AB  - Epoprostenol sodium (prostacyclin) administered intravenously is considered the
      standard for assessing the ability of the pulmonary circulation to vasodilate. At
      present, epoprostenol sodium is an investigational drug that has limited
      availability. In contrast, acetylcholine, also a pulmonary vasodilator, is
      readily available. Therefore, we assessed the feasibility of using acetylcholine
      as an alternative to prostacyclin in testing for the capacity of the pulmonary
      vasculature to vasodilate. Twenty-three patients with primary pulmonary
      hypertension (mean pulmonary arterial pressure, 58.5 +/- 13.4 mm Hg) received
      incremental infusions of prostacyclin and acetylcholine to predetermined maximal
      infusion rates as part of a battery of vasodilator agents administered according
      to standard protocols (mean, 5.4 +/- 1.2 agents/patient; range, 3-8
      agents/patient); the administration of the different agents was timed to avoid
      synergistic effects. Of all the agents tested, prostacyclin and acetylcholine
      were most consistently effective in evoking acute pulmonary vasodilation, and
      both seemed to distinguish patients capable of manifesting acute pulmonary
      vasodilation from those who were not. However, at maximal doses set by protocol,
      prostacyclin generally elicited a greater vasodilator response than
      acetylcholine. The difference in magnitude of response may have been due to use
      of prescribed dosages of acetylcholine that were submaximal. In other respects,
      the two agents were similar; both were equally well-tolerated, and side effects
      were mild and resolved rapidly when the vasodilator infusions were stopped. We
      conclude that in the majority of patients with primary pulmonary hypertension,
      acetylcholine appears to be an effective and available substitute for
      prostacyclin in screening for pulmonary vasodilator responsiveness.

PMID- 2242527
TI  - Differentiation of ventricular tachyarrhythmias.
AB  - Implantable devices capable of several modes of therapy will require
      differentiation of various ventricular tachyarrhythmias. Three methods of
      arrhythmia analysis, magnitude-squared coherence, ventricular rate, and
      irregularity of cycle length were performed for 45 episodes of induced
      ventricular tachyarrhythmia in 15 patients. Differentiation of monomorphic
      ventricular tachycardia from polymorphic ventricular tachycardia and ventricular
      fibrillation was possible by mean magnitude-squared coherence, less possible by
      rate, and not possible by beat-to-beat irregularity. Faster monomorphic
      ventricular tachycardia overlapped with rates of polymorphic ventricular
      tachycardia and ventricular fibrillation. Differentiation of polymorphic
      ventricular tachycardia and ventricular fibrillation was not possible by rate or
      irregularity. A progressive decrease in mean magnitude-squared coherence from
      monomorphic ventricular tachycardia to polymorphic ventricular tachycardia to
      ventricular fibrillation strengthens previous observations that coherence is a
      measure of rhythm "organization."

PMID- 2242528
TI  - Adaptation to ischemia during percutaneous transluminal coronary angioplasty.
      Clinical, hemodynamic, and metabolic features.
AB  - The clinical, electrocardiographic, and coronary hemodynamic responses to
      sequential 90-second occlusions of the left anterior descending coronary artery
      in 12 patients undergoing elective percutaneous transluminal coronary angioplasty
      were examined. Transmyocardial lactate metabolism was examined in an additional
      group of seven patients with clinical and hemodynamic features similar to the
      first group. We noted that in comparison with the initial balloon occlusion the
      second occlusion was characterized by less subjective anginal discomfort, less ST
      segment shift (0.44 +/- 0.13 versus 0.21 +/- 0.07 mV, p = 0.01), and lower mean
      pulmonary artery pressure (25 +/- 1.0 versus 20 +/- 1.7 mm Hg, p = 0.005). In
      addition, for the same heart rate-blood pressure product, cardiac vein flow
      during the second inflation was significantly lower than that recorded during the
      first inflation (96 +/- 1.4 versus 83 +/- 2.4 ml/min, p = 0.005). Finally, there
      was significantly less myocardial lactate production during the second inflation
      (lactate extraction ratio: first inflation, -0.11 +/- 0.03; second inflation, 
      0.03 +/- 0.02; p = 0.04). We conclude that the lessened clinical,
      electrocardiographic, hemodynamic, and metabolic evidence of myocardial ischemia
      during the second of two periods of coronary artery occlusion during percutaneous
      transluminal coronary angioplasty supports the concept of adaptation to
      myocardial ischemia (ischemic preconditioning).

PMID- 2242529
TI  - Intracoronary urokinase for intracoronary thrombus accumulation complicating
      percutaneous transluminal coronary angioplasty in acute ischemic syndromes.
AB  - Intracoronary urokinase was used to treat flow-limiting intracoronary thrombus
      accumulation that complicated successful percutaneous transluminal coronary
      angioplasty (PTCA) during acute ischemic syndromes in 48 patients who were
      followed up through the acute phase of their illness. The study group comprised
      10 patients with unstable angina pectoris, 18 patients with an evolving acute
      myocardial infarction, and 20 patients with postinfarction angina. The initial
      mean percent coronary diameter stenosis for the entire population was 95 +/- 7%
      and decreased with initial PTCA to 41 +/- 20% (p less than 0.001), with improved
      corresponding coronary flow by Thrombolysis in Myocardial Infarction trial (TIMI)
      grade. However, thrombus accumulation then resulted in a significant increase in
      percent diameter stenosis to 83 +/- 17% (p less than 0.001); a corresponding
      significant reduction in coronary flow also occurred by TIMI grade. After
      administration of intracoronary urokinase (mean dose, 141,000 units; range,
      100,000-250,000 units during an average period of 34 minutes), with additional
      PTCA, mean percent diameter stenosis significantly decreased to 34 +/- 17% (p
      less than 0.001); a correspondingly significant improvement in mean coronary flow
      by TIMI grade occurred to 2.9 +/- 0.2. Overall, the angiographic success rate was
      90%. There were no ischemic events requiring repeat PTCA and no procedure-related
      myocardial infarctions or deaths before hospital discharge. One patient was
      referred for urgent coronary artery bypass graft surgery after a successful PTCA.
      Plasma fibrinogen levels were obtained in 15 patients, and in no patient was the
      level below normal for our laboratory.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242530
TI  - Coronary atherosclerosis is associated with left ventricular dysfunction and
      dilatation in aortic stenosis.
AB  - Patients with aortic stenosis develop widely variable patterns of left
      ventricular hypertrophy and dysfunction. We postulated that coronary
      atherosclerosis (CAD) may be associated with impaired left ventricular function
      and chamber dilatation in patients with aortic stenosis. Left ventricular mass
      and volumes were quantified from two-dimensional echocardiography and correlated
      with coronary angiography in 78 patients with severe aortic stenosis and no
      previous myocardial infarction or regional wall motion abnormalities. Eighteen
      patients (group 1) had smooth coronary arteries, 25 patients had irregular
      coronary arteries with 50% or less stenosis (group 2), and 35 patients had
      obstructive CAD (group 3). Even though the calculated valve area was similar in
      all three study groups, group 1 patients had higher values for ejection fraction
      (65 +/- 9%, 51 +/- 17%, and 48 +/- 13%; p = 0.0002), systolic mass-to-volume
      ratio (9.2 +/- 3.9, 5.6 +/- 2.8, and 5.2 +/- 2.2; p = 0.0001), and cardiac index
      (2.9 +/- 0.7, 2.5 +/- 0.7, and 2.3 +/- 0.6 l/min.min2; p = 0.015) than patients
      in groups 2 and 3, respectively (mean +/- SD). Mean circumferential wall stress
      was inversely related to severity of CAD. Multivariate analysis showed that CAD
      is an independent predictor of ejection fraction and mass-to-volume ratio in this
      group of patients. Thus, in an elderly population with severe aortic stenosis,
      patients with both obstructive and nonobstructive CAD have an increased incidence
      of left ventricular enlargement and systolic dysfunction.

PMID- 2242531
TI  - Left ventricular regional wall stress in dilated cardiomyopathy.
AB  - Left ventriculography with simultaneous pressure micromanometry was performed in
      11 normal control subjects and 17 patients with dilated cardiomyopathy (DCM).
      Left ventricular silhouettes in the right anterior oblique projection were
      divided into eight areas, and regional wall stress was computed by Janz's method
      in each area excluding the two most basal areas. Wall stress was higher in DCM
      patients than in control subjects (p less than 0.01). The percent area changes
      from end diastole to end systole in each area were lower in DCM patients than in
      control subjects (mean for six areas, 22 +/- 14% versus 54 +/- 9%, respectively,
      p less than 0.01), but the coefficient of variation for the percent area changes
      in the six areas of the left ventricle in DCM patients was greater than that in
      control subjects (32 +/- 17% versus 15 +/- 4%, respectively, p less than 0.01),
      indicating regional differences in hypokinesis. There was a significant negative
      correlation between end-systolic regional wall stress and percent area change (r
      = -0.60 to -0.86, p less than 0.05) in each area. Thus, excessive regional
      afterload may play an important role in causing regional hypokinesis in DCM.

PMID- 2242532
TI  - Body surface mapping of high-frequency components in the terminal portion during
      QRS complex for the prediction of ventricular tachycardia in patients with
      previous myocardial infarction.
AB  - To study the clinical significance of terminal QRS high-frequency components for
      the prediction of ventricular tachycardia, an 87-lead body surface signal
      averaged mapping was performed in 21 healthy subjects (control) and in 41
      patients with previous myocardial infarction (anterior, 20; inferior, 21).
      Mapping data were analyzed and averaged (129.7 +/- 26.5 beats) for 160 seconds,
      and the signal-averaged beat was filtered with a bidirectional bandwidth (80-250
      Hz) digital filter. J-point was determined from the 87-lead RMS voltage of
      nonfiltered QRS. For each lead, we calculated the sum of the absolute value of
      filtered QRS from 20 msec ahead of the J-point to the J-point (A-20). The body
      surface distribution of A-20 was expressed as A-20 map. The maxima in A-20 maps
      were mainly located on the upper sternal region in healthy subjects, on the left
      anterior chest in patients with previous anterior myocardial infarction, and on
      the central anterior chest in patients with previous inferior myocardial
      infarction. In the patients in both the group with anterior myocardial infarction
      and the group with inferior myocardial infarction, the value of maximum was
      significantly greater than in the subjects in the control group (0.181 +/- 0.086
      and 0.138 +/- 0.048, respectively, vs. 0.075 +/- 0.031 mV.msec; p less than
      0.01). In patients with myocardial infarction (n = 41), the value of maximum was
      significantly greater with ventricular tachycardia (n = 11) than without
      ventricular tachycardia (n = 30) (0.240 +/- 0.076 vs. 0.130 +/- 0.043 mV.msec; p
      less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242533
TI  - Long-term results of catheter ablation of idiopathic right ventricular
      tachycardia.
AB  - Ten consecutive patients with recurrent episodes of symptomatic, idiopathic,
      sustained monomorphic ventricular tachycardia (VT) originating in the right
      ventricle underwent an attempt at catheter ablation of the ventricular
      tachycardia. There were seven women and three men, with a mean age of 39 +/- 14
      years (+/- SD). None of the patients had any evidence of structural heart
      disease. The VT had a left bundle branch block configuration and an inferior axis
      in each patient, and the mean cycle length was 313 +/- 75 msec. Based on the
      methods of induction of the VT and the response of the VT to verapamil, the VT
      mechanism was presumed to be reentry in six patients, triggered activity in three
      patients, and catecholamine-sensitive automaticity in one patient. Sites for
      ablation were guided by pace mapping, and an appropriate target site was
      identified in the right ventricular outflow tract in each patient. From one to
      three shocks of 100-360 J (mean total, 336 +/- 195 J) were delivered from a
      defibrillator between the tip of the ablation catheter (cathode) and a patch
      electrode on the anterior chest (anode). An electrophysiology test 7-9 days after
      ablation demonstrated that VT was still inducible in only one patient, who was
      treated with amiodarone. One other patient had a recurrence of VT 3 weeks after
      ablation and was treated with verapamil. Eight of 10 patients were not treated
      with antiarrhythmic medications and have had no episodes of symptomatic VT during
      15-68 months of follow-up (mean follow-up, 33 +/- 18 months). There were no acute
      or long-term complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242534
TI  - Indium-111-monoclonal antimyosin antibody studies after the first year of heart
      transplantation. Identification of risk groups for developing rejection during
      long-term follow-up and clinical implications.
AB  - The long-term clinical course and results of biopsies in 21 patients studied with
      monoclonal antimyosin antibodies more than 12 months after heart transplantation
      according to the presence and degree of antimyosin-antibody uptake is described.
      Eighteen men and three women aged 20-52 years (39 +/- 9 years) were studied with
      antimyosin antibodies 12-40 months (mean, 22 +/- 9 months) after heart
      transplantation, and followed for a mean of 18 months (10-28 months). The number
      of biopsies performed during follow-up was 102. Results showed normal antimyosin
      antibody studies in nine patients and abnormal studies in 12 patients. Myocyte
      damage was identified in 18 of the 102 biopsies (17.6%), one in the normal
      antimyosin-antibody group of patients and 17 in those patients with myocardial
      antimyosin-antibody uptake. Patients who developed rejection comprised 11% and
      67% of each respective group; the mean number of rejection episodes per patient
      was 0.11 +/- 0.33 and 1.41 +/- 1.41, respectively (p less than 0.01). A trend was
      noted by which higher heart-to-lung ratios were associated with greater
      probability of rejection. Conclusively, 1) antimyosin-antibody studies performed
      after more than 1 year after heart transplantation indicate the presence and
      level of rejection activity, 2) groups of patients at risk for developing
      rejection at biopsy during long-term follow-up may be detected by antimyosin
      antibody study, and 3) surveillance for rejection and the degree of
      immunosuppression should be tailored to meet individual patient needs.

PMID- 2242535
TI  - Regional wall motion abnormalities after prolonged exercise in the normal left
      ventricle.
AB  - To determine whether regional wall motion abnormalities exist or contribute to
      left ventricular dysfunction, we obtained two-dimensional echocardiograms in 12
      athletes before (baseline), immediately after (race finish), and 1 day after
      (recovery) the Hawaii Ironman Triathlon (a 3.9-km swimming, 180.2-km bicycling,
      and 42.2-km running event). Left ventricular short-axis and apical four-chamber
      views were computer digitized and divided into six segments, and radial chord
      shortening and area ejection fraction were calculated. Global ejection fraction
      fell at race finish (51% versus 46%, p less than 0.05) but recovered by 1 day
      (54%, p less than 0.01 by repeated-measures analysis of variance). With the
      apical four-chamber view, midseptal and apical-septal motion were reduced at race
      finish but returned to baseline during recovery (midseptal radial chord
      shortening: 21%, 8%, 22%; apical-septal radial chord shortening: 27%, 12%, 25%;
      midseptal area ejection fraction: 39%, 30%, 40%; apical-septal area ejection
      fraction: 44% baseline, 33% race finish, 43% recovery; all p less than 0.01). In
      contrast, with the parasternal short-axis view, wall motion did not change at
      race finish but tended to be elevated during recovery and became significant for
      anteroseptal motion (radial chord shortening: 29%, 30%, 36%; area ejection
      fraction: 49% baseline, 51% race finish, 58% recovery; both p less than 0.05).
      Lateral wall motion was unchanged. In addition, an index of septal curvature was
      calculated using the ratio of the septal-lateral wall minor axis to the
      perpendicular anteroposterior minor axis. At all three data collections, this
      ratio remained close to 1.0 at end systole and end diastole.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 2242536
TI  - Effect of nontransmural necrosis on epicardial potential fields. Correlation with
      fiber direction.
AB  - The effect of nontransmural necrosis on epicardial potential distributions was
      studied in 13 dogs. In previous studies, left ventricular epicardial pacing
      generated epicardial potential maps at QRS onset with a negative central area and
      two positive areas that faced the portions of the wavefront propagating along
      fibers. Subsequently, the positive areas expanded in a counterclockwise direction
      by 90 degrees to 120 degrees. In those studies, the rotatory expansion of the
      positive areas was tentatively attributed to the spread of excitation through
      deep myocardial layers, where fiber direction rotated counterclockwise from
      epicardium to endocardium. To test this hypothesis, we tried to interrupt the
      counterclockwise expansion of the positive area by creating localized,
      nontransmural necrosis at various depths in the left ventricular wall by
      injection of formalin or application of laser energy. Epicardial potential maps
      were obtained from a grid of 12 x 15 electrodes on a 44 x 56-mm area. Epicardial
      pacing from selected sites generated epicardial maps in which some positive areas
      were missing compared with controls. The direction of the straight line joining
      the pacing site to the site of missing positivity correlated well with the
      average fiber direction in the necrotic mass (r = 0.82, p less than 0.01). Angle
      between epicardial fiber direction and the straight line described above
      correlated well with the average depth of the necrosis, expressed as percent of
      the wall thickness (r = 0.95, p less than 0.01). These data support the
      hypothesis that the counterclockwise expansion of the epicardial positivity
      occurring after epicardial pacing results from excitation spreading along deep
      fibers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242537
TI  - Strength-duration and probability of success curves for defibrillation with
      biphasic waveforms.
AB  - Certain biphasic waveforms require less energy to defibrillate than do monophasic
      pulses of equal duration, although the mechanisms of this increased effectiveness
      remain unclear. This study used strength-duration and percent success curves for
      defibrillation with monophasic and biphasic truncated exponential waveforms to
      explore these mechanisms. In part 1, defibrillation thresholds were determined
      for both high- and low-tilt waveforms. The monophasic pulses tested ranged in
      duration from 1.0 to 20.0 msec, and the biphasic waveforms had first phases of
      either 3.5 or 7.0 msec and second phases ranging from 1.0 to 20.0 msec. In part
      2, defibrillation percent success curves were constructed for 6.0 msec/6.0 msec
      biphasic waveforms with a constant phase-one amplitude and with phase-two
      amplitudes of approximately 21%, 62%, 94%, and 141% of phase one. This study
      shows that if the first phase of a biphasic waveform is held constant and the
      second phase is increased in either duration or amplitude, defibrillation
      efficacy first improves, then declines, and then again improves. For pulse
      durations of at least 14 msec, the second-phase defibrillation threshold voltage
      of a high-tilt biphasic waveform is higher than that of a monophasic pulse equal
      in duration to the biphasic second phase (p less than 0.05), indicating that the
      previously proposed hypothesis of stimulation by the second phase is not the sole
      mechanism of biphasic defibrillation. These facts indicate the importance of the
      degree of tilt for the defibrillation efficacy of biphasic waveforms and suggest
      at least two mechanisms exist for defibrillation with these waveforms, one that
      is more effective for smaller second phases and another that becomes more
      effective as the second phase is increased.

PMID- 2242538
TI  - Bleeding time prolongation with streptokinase and its reduction with 1-desamino-8
      D-arginine vasopressin.
AB  - The mechanism by which treatment with thrombolytic agents causes bleeding is not
      known. Recently, frequency of bleeding events has been shown to correlate with
      bleeding time, particularly in individuals treated with aspirin. We examined the
      effects of streptokinase (20,000-60,000 IU/kg) on bleeding time in 40 rabbits
      pretreated with aspirin, a model for fibrinolytic therapy. We then tested the
      effects of 1-desamino-8-D-arginine vasopressin (DDAVP) (0.3 microgram/kg), an
      agent known to reduce bleeding time in a variety of bleeding disorders, in 20
      rabbits and compared the results with those of a control group of rabbits
      receiving normal saline placebo. Aspirin increased the bleeding time from a
      baseline mean +/- SEM value of 119 +/- 15 to 191 +/- 34 seconds in the control
      group and from 114 +/- 6 to 188 +/- 18 seconds in the experimental group. The
      addition of streptokinase increased the bleeding time to 592 +/- 119 seconds in
      the control group and 810 +/- 114 seconds in the experimental group (p = NS).
      Subsequent infusion of DDAVP decreased the bleeding time in the experimental
      group to 302 +/- 29 seconds (p less than 0.01 versus streptokinase) compared with
      572 +/- 79 seconds (p = NS versus streptokinase) in the control animals given
      saline placebo. In a subset of rabbits receiving aspirin and streptokinase
      (40,000-60,000 IU/kg), samples were obtained for platelet aggregation (n = 16),
      von Willebrand factor antigen concentration (n = 17), and von Willebrand factor
      multimer distribution (n = 14). Maximal rates of ADP-induced platelet aggregation
      were not affected by DDAVP infusion, nor was the plasma concentration of von
      Willebrand factor antigen, quantified by an immunoradiometric assay,
      significantly affected by DDAVP infusion. Furthermore, the von Willebrand factor
      multimer ratio decreased with DDAVP administration. These findings indicate that
      aspirin and streptokinase combined result in a marked increase in bleeding time
      that can be reduced by DDAVP. This effect of DDAVP is not accompanied by an
      increase in platelet aggregation response, plasma von Willebrand factor antigen
      concentration, or von Willebrand factor multimer ratio.

PMID- 2242539
TI  - Area-at-risk determination by technetium-99m-hexakis-2-methoxyisobutyl isonitrile
      in experimental reperfused myocardial infarction.
AB  - In a canine model of reperfused myocardial infarction, we tested the hypothesis
      that after reperfusion, technetium-99m-hexakis-2-methoxyisobutyl isonitrile (Tc
      MIBI) tomographic imaging still reflects occlusion blood flow when the tracer is
      injected before reperfusion. Nine anesthetized dogs underwent 2 hours of coronary
      occlusion followed by 3 hours of reperfusion ending by being killed. Reference
      coronary blood flow was determined by radioactive microspheres injected during
      occlusion and after reperfusion. Biopsies in normal and ischemic myocardium and
      single photon emission computed tomography were obtained during occlusion and
      after reperfusion. Circumferential profiles were applied to axial slices divided
      into 5-degree sectors. The sectors were divided into 3 groups selected on the
      occlusion acquisition (normal, mildly reduced, and severely reduced) and compared
      with the postreperfusion acquisition. Tissular Tc-MIBI kinetics was assessed both
      by Tc-MIBI time-activity curves of normal and ischemic tissue obtained by biopsy
      and by the relative gradient between normal, ischemic, and necrotic postmortem
      tissue samples. In biopsy samples, Tc-MIBI content remained unchanged during
      occlusion and after reperfusion in normal as well as in ischemic tissue (4,662 +/
      2,237 counts/min/mg vs. 4,599 +/- 1,577 counts/min/mg in normal tissue, NS; 941
      +/- 903 counts/min/mg vs. 1,087 +/- 721 counts/min/mg in ischemic tissue, NS). In
      postmortem tissue samples, there was a good correlation between occlusion
      microsphere blood flow and Tc-MIBI activity (r = 0.91). In the necrotic samples,
      mean normalized Tc-MIBI activity (10 +/- 17%) was slightly higher than the
      normalized microsphere blood flow (3 +/- 3%, p less than 0.001) but markedly
      lower than the normalized microsphere reperfusion blood flow (63 +/- 31%, p less
      than 0.001). Comparing the single photon emission computed tomographic
      acquisitions before and after reperfusion, Tc-MIBI activity remained unchanged in
      normal as well as in mildly reduced or severely reduced segments. Thus, our data
      are consistent with the hypothesis that Tc-MIBI traces blood flow, does not
      redistribute significantly despite reperfusion, and can be used for imaging the
      area at risk.

PMID- 2242541
TI  - Significance of discordant ST alternans in ventricular fibrillation.
AB  - With the use of epicardial mapping, we investigated the electrical alternans of
      the ST segment during acute myocardial ischemia and studied the difference in ST
      alternans between dogs with resultant ventricular fibrillation and those without
      it. During the 7-minute occlusion of the left anterior descending coronary artery
      below its first diagonal branch, 60 epicardial unipolar electrograms were
      recorded simultaneously at 1-minute intervals by a computerized mapping system.
      ST alternans was found in the eight dogs we observed. The amplitude of ST
      alternans (difference in the ST segment elevation of two consecutive
      electrograms) was greater in dogs with ventricular fibrillation (n = 4) than in
      those without it (n = 4) (3.92 +/- 1.24 versus 0.58 +/- 0.49 mV, p less than
      0.05). Three of the four dogs with ventricular fibrillation demonstrated
      discordant ST alternans (i.e., adjacent leads were out of phase). Results from
      the present study indicate that an increased amplitude and discordance of ST
      alternans during acute myocardial ischemia are related to ventricular
      fibrillation and act as indicators of time and spatial unevenness of ventricular
      repolarization.

PMID- 2242540
TI  - Effects of brief coronary occlusion and reperfusion on porcine coronary artery
      reactivity.
AB  - The loss of coronary vasodilator reserve after ischemia-reperfusion may be due to
      endothelial injury, and this vascular dysfunction may contribute to functional
      alterations observed after ischemia. To determine whether endothelial dysfunction
      occurs after relatively brief periods of moderate low-flow ischemia in vivo, open
      chest swine were subjected to 15 minutes of critical, subtotal left anterior
      descending coronary artery occlusion (80%) followed by 60 minutes of reperfusion.
      Serial measurements of regional coronary flow were made with the radiolabeled
      microsphere technique. After 60 minutes of reperfusion, the left anterior
      descending coronary artery was excised together with a section of the normally
      perfused left circumflex coronary artery to examine in vitro the relaxations to
      the endothelium-dependent dilators ADP and bradykinin and to the endothelial
      independent dilators sodium nitroprusside and adenosine. Contractions to
      serotonin in quiescent rings were also examined. Endocardial and transmural blood
      flows recovered to preocclusion levels within 60 minutes of reperfusion, as did
      the epicardial-to-endocardial ratio. Vascular responses in isolated, reperfused
      left anterior descending coronary artery rings were significantly different from
      responses in control left circumflex coronary artery rings. Endothelium-dependent
      relaxations to adenosine diphosphate and bradykinin were significantly depressed
      in the left anterior descending coronary artery rings compared with left
      circumflex coronary artery rings (p less than 0.05). Serotonin-induced
      contractions were significantly greater in occluded-reperfused left anterior
      descending than in left circumflex coronary arteries (p less than 0.05).
      Relaxations to adenosine and sodium nitroprusside were not significantly
      different between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242542
TI  - Wenckebach periodicity in single atrioventricular nodal cells from the rabbit
      heart.
AB  - Previous studies have suggested that Wenckebach periodicity in cardiac tissues
      may occur because of discontinuous propagation across junctional areas in which
      there is high intercellular resistivity or different cell types. Under these
      conditions, the impulse may stop altogether at a given junction, or may renew its
      propagation but only after a step delay imposed by the diastolic time-dependent
      recovery in the excitability of cells distal to that junction. Accordingly,
      Wenckebach periodicity in the atrioventricular node may be explained in terms of
      electrotonically mediated delay in the activation of the nodal cells. To test
      this hypothesis, we have studied recovery of excitability, and susceptibility to
      rate-dependent activation failure in single myocytes isolated from the adult
      rabbit atrioventricular node. Recordings were obtained by using the patch
      technique in the whole-cell, current clamp configuration. Repetitive stimulation
      of single atrioventricular nodal myocytes with depolarizing current pulses of
      critical amplitude yielded frequency-dependent stimulus response patterns that
      ranged from 1:1, through various Wenckebachlike periodicities (e.g., 5:4 and 4:3)
      to 2:1 and 3:1. Both typical and atypical Wenckebach structures were
      demonstrated, as well as "complex" patterns (e.g., reverse Wenckebach or
      alternating Wenckebach) previously ascribed to multiple levels of block. The
      diastolic recovery of excitability curve, determined by application of repetitive
      stimuli at cycle lengths that were longer than the action potential duration,
      showed a monotonic function with a refractory period outlasting the action
      potential duration (i.e., postrepolarization refractoriness). Abbreviation of the
      stimulation cycle length to values below those of the action potential duration
      revealed the existence of a period of supernormal excitability during the
      repolarizing phase of the action potential. In either case, the stimulus response
      patterns obtained were a direct consequence of the shape of the recovery of
      excitability curve. The monotonic portion of the recovery curve was fitted to an
      empirical equation that when iterated reproduced the stimulus response patterns
      observed in the atrioventricular nodal cell. Our data demonstrate that recovery
      of excitability after an action potential is indeed a function of the diastolic
      interval, and that this slow process sets the conditions for the development of
      Wenckebach periodicity in the atrioventricular node.

PMID- 2242543
TI  - Increased endothelin in experimental heart failure.
AB  - Recent studies demonstrate that endothelin, a potent endogenous vasoconstrictor
      peptide, circulates in plasma of normal animals and humans. However, the role of
      this peptide in pathophysiological states remains unclear. The present study was
      designed to test the hypothesis that circulating endothelin concentrations are
      increased in experimental congestive heart failure (CHF), a pathophysiological
      state characterized by activation of vasoconstrictor mechanisms. In anesthetized
      dogs with CHF produced by 8 days of rapid ventricular pacing (n = 28),
      circulating plasma endothelin was increased compared with values for normal
      controls (n = 28; 20.4 +/- 1.4 versus 9.7 +/- 0.9 pg/ml, respectively; p less
      than 0.0001). A plasma endothelin level of more than 14.0 was a sensitive and
      specific indicator of significant CHF. Moreover, within the group with
      experimental CHF, right atrial pressure and pulmonary capillary wedge pressure
      correlated independently with circulating endothelin levels. Based on recent
      studies demonstrating the physiological actions of twofold increases in
      circulating endothelin, as observed in the present study, a possible role for
      endothelin in the pathophysiology of CHF is advanced.

PMID- 2242544
TI  - Coronary artery revascularization. Critical need for, and consequences of,
      objective angiographic assessment of lesion severity.

PMID- 2242545
TI  - Channel specificity in antiarrhythmic drug action. Mechanism of potassium channel
      block and its role in suppressing and aggravating cardiac arrhythmias.
AB  - Although work on class III antiarrhythmics remains at an early stage, these
      agents still appear to possess greater efficacy and less proarrhythmia than
      conventional class I agents in those experimental arrhythmia models considered to
      be most representative of the clinical situation. Although prolongation of
      repolarization carries with its own tendency for pause-dependent arrhythmogenesis
      (i.e., torsade de pointes), available data suggest that this may be a function of
      nonspecificity in potassium channel block rather than a general characteristic of
      class III activity. The availability of new and more selective blockers of
      specific cardiac potassium channels under development as class III agents have
      already helped to clarify basic questions about the ionic mechanism of
      repolarization in the heart, and one hopes that a growing clinical data base will
      eventually determine the relative safety and efficacy of these agents in
      preventing symptomatic and life-threatening arrhythmias.

PMID- 2242546
TI  - Balloon angioplasty for acute myocardial infarction. Was it buried alive?

PMID- 2242547
TI  - Peripheral arterial disease and subsequent cardiovascular mortality. A strong and
      consistent association.

PMID- 2242548
TI  - Calcium channel blockers and progression of coronary artery disease.

PMID- 2242549
TI  - Calcium channel blockers in chronic heart failure. The risks of "physiologically
      rational" therapy.

PMID- 2242550
TI  - Medical therapy of chronic stable angina pectoris.

PMID- 2242551
TI  - Flow in the descending aorta. A turn of the screw or a sideways glance?

PMID- 2242552
TI  - Catheter ablation of idiopathic right ventricular tachycardia.

PMID- 2242553
TI  - Electrophysiological testing in high-risk patients with previous myocardial
      infarction.

PMID- 2242554
TI  - Ticlopidine in unstable angina.

PMID- 2242555
TI  - 99mTc-MIBI and 201Tl as perfusion indicators.

PMID- 2242556
TI  - The academic life of a noninvasive test.

PMID- 2242557
TI  - Exercise standards. A statement for health professionals from the American Heart
      Association.

PMID- 2242558
TI  - ACC/AHA guidelines for the clinical application of echocardiography. A report of
      the American College of Cardiology/American Heart Association Task Force on
      Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee
      to Develop Guidelines for the Clinical Application of Echocardiography).

PMID- 2242559
TI  - Assessment of fetal lung maturity: in search of the Holy Grail.

PMID- 2242560
TI  - Lead poisoning mechanisms.

PMID- 2242561
TI  - Improved phenotyping of apolipoprotein E: application to population frequency
      distribution.
AB  - A simple procedure for phenotyping apolipoprotein (apo) E directly from plasma
      has been developed for use in the lipid clinic laboratory. In this new method, 10
      microL of serum or plasma is pretreated with neuraminidase (EC 3.2.1.18), which
      removes the sialic acid residues from apo E and eliminates additional bands,
      thereby ensuring correct phenotype assignment. After a rapid delipidation step,
      the samples are focused in vertical polyacrylamide mini-slab gels and
      immunoblotted with a polyclonal goat anti-apo E antibody, followed by a Protein G
      peroxidase conjugate. The accuracy of this method was confirmed by comparison
      with the established procedure of phenotyping by isoelectric focusing of
      delipidated very-low-density lipoprotein. In addition, sera from 203 subjects
      from Vancouver, selected without conscious bias, were used to determine the local
      distribution of the apo E alleles. We estimate that the relative frequencies of
      apo E alleles epsilon 2, epsilon 3, and epsilon 4 in this population are 0.086,
      0.761, and 0.153, respectively. The speed and convenience of using minigels make
      this procedure ideal for clinical laboratory applications and large population
      studies.

PMID- 2242562
TI  - Isolation and structural identification of 9hydroxy-9desmethyl-cyclosporine.
AB  - A metabolite of cyclosporine has been isolated and its structure identified
      through use of HPLC and tandem mass spectroscopy. Fast atom bombardment mass
      spectrometry of an HPLC fraction co-eluting with 1 eta hydroxy-cyclosporine (M17)
      indicated that the mass of this metabolite was 2 Da greater than that of
      cyclosporine. Further isolation by HPLC yielded a pure fraction, which we
      analyzed with tandem mass spectrometry. Linear acyl fragment ions originating
      from the metabolite under collision-induced dissociation were consistent with the
      difference in mass being associated with amino acid 9 in the cyclosporine
      backbone. We propose a nomenclature system for future discussion of cyclosporine
      metabolites.

PMID- 2242563
TI  - "VRA-GlcNAc": novel substrate for N-acetyl-beta-D-glucosaminidase applied to
      assay of this enzyme in urine.
AB  - We describe a new chromogenic substrate and assay for determining N-acetyl-beta-D
      glucosaminidase (EC 3.2.1.30; NAG) activity in normal and pathological human
      urine. The novel substrate, ammonium 5-[4-(2-acetamido-2-deoxy-beta-D
      glucopyranosyloxy)-3- methoxyphenylmethylene]-2-thioxothiazolidin-4-one-3-ethan
      oate (VRA-GlcNAc), is prepared by condensation of vanillyl N-acetyl-beta-D
      glucosaminide and rhodanine-3-ethanoic acid. The phenol released by enzyme action
      has an intense absorption peak at 492 nm (epsilon = 37,000 L.mol-1.cm-1). The Km
      for NAG in urine was 0.5 mmol/L at pH 4.5. The substrate solution may be stored
      at 4-7 degrees C for one week without any increase in the substrate blank. For
      optimal assay conditions, we used a substrate concentration of 3 mmol/L and a 15
      fold sample dilution at pH 4.5-5.0, with measurement at 505 nm, not significantly
      different from that at 492 nm. The sensitivity of the assay with VRA-GlcNAc as
      substrate is twice that of the MNP-GlcNAc [2-methoxy-4-(2'-nitrovinyl)-phenyl
      GlcNAc] procedure (Clin Chim Acta 1982;124:195-204) and can detect low amounts of
      minor NAG isoenzymes. This assay is an improvement on previously available
      colorimetric methods and could be easily incorporated into kits based on either
      an enzyme calibrant or the molar absorptivity of the phenol.

PMID- 2242564
TI  - Study of lipoprotein particles LpAI and LpAI:AII in patients before coronary
      bypass surgery.
AB  - Lipids, apolipoproteins, and LpAI and LpAI:AII particles were studied in 43 men
      (mean age 51, SD 7, years) 24 h before their coronary bypass surgery and in 54
      control men (mean age 46 SD 9, years). LpAI and LpAI:AII were analyzed by
      electroimmunodiffusion and by a noncompetitive enzyme-linked immunoassay,
      respectively. Concentrations of LpAI and LpAI:AII in the bypass patients were
      significantly lower (P less than 0.001) than those in the controls.
      Apolipoprotein AI was significantly correlated with LpAI (P less than 0.001) and
      LpAI:AII (P less than 0.01) in controls, but only with LpAI:AII (P less than
      0.001) in bypass patients. Discriminant analysis between controls and patients
      showed apolipoprotein AI to be the most powerful discriminant factor; the
      addition of LpAI and LpAI:AII did not improve discriminant power. We conclude
      that the determination of LpAI and LpAI:AII particles reflects metabolic
      disorders in patients but does not significantly influence the discrimination of
      such patients into risk groups.

PMID- 2242565
TI  - Quantitative and functional assays compared for determination of zymogen and
      activated human protein C.
AB  - We evaluated quantitative and functional assays for protein C, using either
      purified protein C samples or pooled normal plasma as assay standards. The
      purified protein C samples were examined as the zymogen form and after activation
      by thrombin. Mass concentrations of protein C were determined by amino acid
      analysis and confirmed by enzyme-linked immunosorbent assay (ELISA). Functional
      activity was assessed in both standard clot inhibition and amidolytic assays. The
      accuracy and precision of the ELISA was acceptable, with all three preparations
      of protein C having similar linear curves. The clot inhibition assay demonstrated
      marked variability when used according to the manufacturer's instructions;
      however, modifications to the protocol significantly decreased the CV, to less
      than 10%. Both activated protein C and the zymogen gave linear standard curves.
      Pooled normal human plasma gave a nonlinear curve, which contributed to
      inaccurate sample recoveries. We obtained the most nearly accurate recoveries
      when we used activated protein C as the assay standard. Amidolytic assays
      provided no insights into the appropriateness of the preparations for that assay
      format. A uniform, consistent source of protein C, e.g., recombinant activated
      protein C, would be useful for standardizing all assays of protein C.

PMID- 2242566
TI  - Flexibility of noncompetitive avidin-biotin immunoassay: immunoassay of lutropin
      applied to different signal detection systems.
AB  - I adapted the noncompetitive avidin-biotin immunoassay (NABA) of lutropin (LH)
      for use with radiometric, fluorometric, time-resolved fluorometric, and
      luminometric detection systems by changing the enzyme substrate or conjugating
      avidin with different labels. The corresponding methods were used to determine LH
      in 40 urine samples, and the results were compared with those obtained by an
      immunoenzymometric assay (IEMA), also based on the NABA principle. Scatter plots
      of the results showed a linear relation with high correlation coefficients (r =
      0.972-0.983), and bias plots showed good agreement between the four comparison
      methods and the IEMA. The results indicate that the effectiveness of the NABA of
      LH is independent of the signal detection system. This means good flexibility for
      the user in choice of instrument and signal detection system.

PMID- 2242567
TI  - Gradient centrifugation to isolate platelets for determination of trace elements
      by neutron-activation analysis.
AB  - A nonionic iodinated compound, Nycodenz, was used for density-gradient isolation
      of platelets before analysis for trace elements by instrumental neutron
      activation. The platelet samples were almost free from plasma and erythrocytes,
      and the trace element contribution from additives was insignificant for the
      elements investigated. The reproducibility of the trace element analysis in
      platelets attests to the usefulness of density-gradient separation. Platelet
      samples were obtained twice, three weeks apart, from 10 healthy young women (ages
      24 +/- 2 years). The mean (SD) concentrations were as follows: Se, 0.62 (0.16)
      mg/L and 4.7 (1.4) ng/10(9) platelets; Zn, 44 (10) mg/L and 333 (80) ng/10(9)
      platelets; Rb, 3.0 (0.5) mg/L and 23 (5) ng/10(9) platelets; and Cs, 24 (5)
      micrograms/L and 0.18 (0.04) ng/10(9) platelets.

PMID- 2242568
TI  - Evaluation of dialysis treatment in uremic patients by gel filtration of serum.
AB  - A group of substances of molecular masses between 300 and 1500 Da have been found
      to be toxic metabolites in patients with uremia. We determined the concentration
      in serum of these molecules in the following groups of patients: two hemodialyzed
      groups (one with cuprophane and the other with polyacrylonitrile dialyzers), one
      group treated with continuous ambulatory peritoneal dialysis, one group of
      nondialyzed azotemic patients, and one control group of healthy persons.
      Ultrafiltrates of the subjects' sera were fractionated on Sephadex G-15 followed
      by ion-exchange chromatography. Eluates were monitored by absorbance at 254 and
      206 nm. Partially characterized peaks P1 and P2, obtained by gel filtration,
      correlated with the concentration of creatinine in serum; their concentrations
      were significantly (P less than 0.01) larger in hemodialyzed groups than in
      peritoneal dialyzed or in nondialyzed azotemic patients. After ion-exchange
      chromatography, two peaks (P'5 and P'6) correlated with serum creatinine and also
      were larger in hemodialyzed patients than in the other groups. Apparently,
      adequate discrimination is obtained by gel-filtration analysis and further
      analysis by ion-exchange chromatography does not provide additional information
      in most of the affected patients.

PMID- 2242569
TI  - Impact of protein measurements on standardization of assays of apolipoproteins A
      I and B1.
AB  - In 1989 the Committee on Apolipoproteins of the International Federation of
      Clinical Chemistry and the Centers for Disease Control conducted an international
      survey of total-protein measurements of isolated low-density lipoproteins (LDL)
      and delipidated high-density lipoproteins (HDL), and of their relationships to
      the National Institute of Standards and Technology (NIST) bovine serum albumin
      (BSA) Standard Reference Material (SRM). Most of the 93 apolipoprotein
      laboratories surveyed use the Lowry total-protein method. Results reported with
      the LDL preparations demonstrated a large bias and variation among methods; those
      with delipidated HDL were not as great, but were similar to those for BSA.
      Performance improved appreciably with use of the Lowry-sodium dodecyl sulfate
      method and the NIST BSA SRM for protein measurement. The total CVs, including
      among-laboratory and within-laboratory errors, averaged approximately 50% and 23%
      for LDL, 17% and 11% for HDL, and 18% and 11% for BSA solutions by all methods
      and by the Lowry methods, respectively. Regardless of the methods used, greater
      variability of the protein measurements was seen with the normally occurring LDL
      than with the nonlipoprotein BSA or delipidated HDL. The mean CV values for all
      samples among laboratories averaged between 10% and 15% with the modified Lowry
      methods; the biuret method gave the highest among-laboratory CV, 34%; the
      Kjeldahl had the lowest, 7.7%. Use of the same methodology and primary
      nonapolipoprotein standard is essential for comparability of protein results for
      apolipoprotein primary standard solutions. This is especially true for
      apolipoprotein B, because its inherent properties and lability make protein
      analysis difficult. This study supports the use of a standardized selected Lowry
      sodium dodecyl sulfate method traceable to quantitative amino acid analysis as a
      point of reference for determining the protein concentration of primary
      calibration reference materials for apolipoproteins.

PMID- 2242570
TI  - Diet-related reference values for plasma amino acids in newborns measured by
      reversed-phase HPLC.
AB  - We have measured by reversed-phase HPLC concentrations of amino acids in plasma
      in groups of 80 normal appropriate-weight term babies fed from birth either a
      casein formula (WhiteCap SMA, n = 26), a whey formula (Gold Cap SMA, n = 26), or
      breast milk (n = 28). They were studied from day 11 to week 15 postpartum. The
      trend was towards an increase in amino acid concentrations in plasma with age,
      more marked in formula-fed than in breast-fed infants. Reference values were
      derived for each group. Both formula-fed groups showed several differences from
      the breast-fed group. Detailed examination indicated that tyrosine,
      phenylalanine, and methionine concentrations were increased in the casein-fed
      group greater than 20% of the time, but only threonine was similarly increased in
      the whey-fed group. Other amino acids, different ones for each formula group,
      were increased less frequently. There were no consistent correlations with any
      aspect of infant growth. Appropriate reference values are important for
      interpreting amino acid concentrations in plasma from newborns and for evaluating
      the effects of any future dietary modifications to infant formulas. HPLC analysis
      provides a suitable highly sensitive method for undertaking such studies.

PMID- 2242572
TI  - Particulate (high-molecular-mass) and soluble alkaline phosphatase in urine
      determined by high-performance liquid chromatography.
AB  - We detected in urine by HPLC two enzyme fractions of alkaline phosphatase (AP, EC
      3.1.3.1), soluble and particulate, analogous to those in serum. The second
      fraction was eluted with high-salt-content eluent at the same elution time as
      high-molecular-mass, or particulate, AP in serum. AP characterization in urine
      from a patient with acute rejection crisis showed a greater sensitivity of the
      particulate form to treatment with L-phenylalanine, which suggests a higher
      content of intestinal-type AP in the particulate form. The soluble fraction
      showed a more liver-type AP behavior. Changes in the chromatograms after the
      sample was treated with 1-butanol and Triton X-100 support a membrane origin of
      the particulate AP. Urinalyses from patients with acute renal disease showed
      increased activity of soluble and particulate AP, with a relatively greater
      increase of particulate AP.

PMID- 2242571
TI  - Ultrasensitive two-site immunometric assay of human lutropin by time-resolved
      fluorometry.
AB  - A rapid, sensitive two-site immunometric assay for human lutropin (LH), with two
      monoclonal antibodies directed against the beta subunit, has been developed with
      time-resolved fluorescence as the detection principle. The cross-reactivities
      with human thyrotropin and human follitropin are negligible and that with human
      choriogonadotropin is 1% in the standard two-step protocol. Free beta subunits of
      LH are also detected. Besides the standard procedure (45 + 15 min), more rapid
      alternative protocols (15 + 15 min or 30 min in one step) have also been
      evaluated. The minimum detectable dose per well is approximately 1 amol (10(-18)
      mol), corresponding to less than 0.01 int. unit/L, for a sample volume of 25
      microL and less than 0.001 int. unit/L for 200-microL samples. The intra- and
      interassay CV is less than 6% for LH concentrations from 0.2 to 250 int. units/L.
      With 200-microL sample volumes, intra-assay variation is less than 6% at 0.04
      int. unit/L and interassay variation is 7% at 0.05 int. unit/L. The very high
      sensitivity and reproducibility of the presented method enables assay of low
      prepubertal and of suppressed LH concentrations, and represents a clear
      improvement over currently available immunoassays.

PMID- 2242573
TI  - Enzymatic method for selective determination of 4-aminobenzoic acid in urine.
AB  - We developed a method for the selective determination of 4-aminobenzoic acid by
      use of 4-aminobenzoate hydroxylase (EC 1.14.13.27) to convert 4-aminobenzoic acid
      to 4-hydroxyaniline. The subsequent conversion of 4-hydroxyaniline to indophenol
      dye was quantified colorimetrically. The method is reproducible, and the assay
      response is linear up to 40 mumol/L. Selectivity exceeding that of the current
      colorimetric assays was demonstrated for these enzymatic determinations of 4
      aminobenzoic acid concentrations in urine samples from patients undergoing tests
      of pancreatic function with bentiromide. This method effectively minimizes
      interferences from drugs and diet, a problem in current colorimetric methods.

PMID- 2242574
TI  - Idiometric assay: noncompetitive immunoassay for small molecules typified by the
      measurement of estradiol in serum.
AB  - We report here a novel noncompetitive immunoassay applicable to the measurement
      of small-molecular-mass compounds and typified by the direct measurement of
      estradiol in serum. Two types of anti-idiotypic antibody recognize different
      epitopes within the hypervariable region of the specific primary antibody (e.g.,
      anti-estradiol). The first anti-idiotype (betatype) recognizes an epitope at the
      unoccupied binding site, which is masked in the presence of the analyte (e.g.,
      estradiol). The second (alphatype) recognizes an epitope close to the binding
      site and is unaffected by the presence or absence of the analyte, but is
      sterically hindered from binding to the primary antibody in the presence of the
      betatype. The use of these matched antibodies (primary antibody, alphatype, and
      betatype) has enabled the development of a method for determining antibody
      occupancy that is not based on a conventional two-site assay. An excess amount of
      purified monoclonal antibody against estradiol is immobilized onto the walls of
      microtiter wells. After the capture of analyte, the unoccupied antibody sites are
      blocked by the addition of an excess amount of betatype. Subsequently, analyte
      occupancy is determined by the addition of excess europium-labeled alphatype,
      incubation, washing, and time-resolved fluorometry. The method demonstrates good
      sensitivity, precision, and comparability with alternative competitive
      immunoassays.

PMID- 2242575
TI  - Candidate reference method for determining creatinine in serum: method
      development and interlaboratory validation.
AB  - We describe a "high-performance" liquid chromatographic (HPLC) method for
      accurately determining creatinine in serum. After prechromatographic
      precipitation of protein, we performed isocratic ion-exchange chromatography with
      ultraviolet detection (234 nm). Analytical results showed linearity up to 1770
      mumol/L, a detection limit of 22 mumol/L, an average analytical recovery of 101%,
      and a CV ranging from 3% to 11%. We used certified human serum (National
      Institute of Standards and Technology), and additional lyophilized serum pools
      also assayed by definitive isotope-dilution mass spectrometry, to validate the
      accuracy of the HPLC method. In addition, the isocratic HPLC results showed close
      agreement with those obtained with a step-gradient HPLC method. We also compared
      the isocratic HPLC method with alkaline picrate and enzymatic methods. Our
      findings with samples from nonuremic, uremic, and diabetic ketoacidotic patients
      confirmed the positive bias previously reported with the alkaline picrate method.
      Interlaboratory transferability of the method was demonstrated with various
      commercial instruments and analytical columns. We evaluated column stability and
      possible interference from endogenous or exogenous compounds. On the basis of our
      analytical findings, we recommend the isocratic HPLC method as a candidate
      Reference Method for determining creatinine in serum.

PMID- 2242576
TI  - Analysis of 8-methoxypsoralen by high-performance liquid chromatography.
AB  - We report a simple and rapid procedure for assaying 8-methoxypsoralen (8-MOP) in
      plasma by high-performance liquid chromatography (HPLC). The standard curve for
      the assay is linear for 8-MOP from 15 to 500 micrograms/L (y = 0.002x-0.01, r =
      0.99) with a lower limit of detection of 1.5 micrograms/L. Intra-assay precision
      (CV) was 6.0% at the 100 micrograms/L concentration and 10.0% at 50 micrograms/L
      (n = 30 each). Interassay precision was 6.4% at 100 micrograms/L and 7.0% at 50
      micrograms/L (n = 50 each). Extraction recovery of 8-MOP was 98%. Common
      antiarrhythmics, sedatives, and hypnotics were found not to interfere.

PMID- 2242577
TI  - Simple screening tests for the emergency identification of methanol and ethylene
      glycol in poisoned patients.
AB  - We have developed simple and rapid screening tests for methanol and ethylene
      glycol in plasma of poisoned patients, based on the Toxi-Lab alcohol screening
      test. The compounds are first converted to formaldehyde, which diffuses from the
      patient's sample into a glass-fiber test sheet impregnated with Schiff's
      formaldehyde detection reagent. Subsequent exposure of the test sheet to acid and
      heat distinguishes formaldehyde from acetaldehyde. We recommend that samples
      giving positive results be analyzed by another technique to confirm the identity
      and concentration of the poison for use in prognosis and treatment.

PMID- 2242578
TI  - Double monoclonal time-resolved immunofluorometric assay of beta 2-microglobulin
      in serum.
AB  - Previously reported immunochemical assays of beta 2-microglobulin (beta 2m) have
      usually been based on polyclonal antisera. We have developed a "sandwich"-type
      time-resolved immunofluorometric assay (TR-IFMA) for beta 2m in serum, based on
      two monoclonal antibodies against human beta 2m. Microtiter wells are coated with
      the capture antibody, and the tracer antibody is labeled with a europium chelate.
      In a simple and fast assay procedure, prediluted serum samples are incubated with
      the tracer for 1 h in the microtiter wells, after which the wells are washed and
      the fluorescence of Eu is measured. The mean analytical recovery was 101.8% and
      results by TR-IFMA showed a good linear correlation with those by an established
      radioimmunoassay. The analytical range of TR-IFMA is large and well suited for
      clinical purposes.

PMID- 2242579
TI  - Enzyme immunoassay for measuring antibodies against skeletal muscle in patients
      with myasthenia gravis.
AB  - We developed a highly sensitive enzyme immunoassay (EIA) for measuring IgG and
      IgM antibodies against human skeletal muscle (SM) component and tested sera from
      100 patients with myasthenia gravis (MG), 59 with thymoma and 41 without thymoma.
      We found that the frequency of anti-SM IgG antibodies was significantly higher in
      MG patients with (81%) than without (37%) thymoma. The titers of the anti-SM IgG
      antibodies measured by EIA correlated well with those measured by RIA (r = 0.81,
      P less than 0.01). We also found that 12% of the myasthenic patients with thymoma
      and 15% without it had anti-SM IgM antibodies. There was no correlation between
      the titers of the IgG and IgM antibodies. Our EIA provides a measure of anti-SM
      antibodies that is of comparable sensitivity to that of RIA.

PMID- 2242580
TI  - Abbott TDx monoclonal antibody assay evaluated for measuring cyclosporine in
      whole blood.
AB  - We report here the evaluation of the Abbott TDx assay with a monoclonal antibody
      for selectively quantifying cyclosporine (CsA) in whole blood. Over the
      clinically relevant concentration ranges, results with this assay demonstrated
      within- and between-run CVs of less than 2.5% and 5%, respectively; sensitivity
      of 25 micrograms/L; good analytical recovery (100.3%); and linearity with whole
      blood specimens. The percentage cross-reactivity of the major CsA metabolites
      varied from 15.3% for AM9 (M-1), 8.2% for AM1 (M-17), and 3.7% for AM4N (M-21),
      to less than 3% for the other metabolites tested. Results with the TDx assay (y)
      correlated well with those by the Sandimmune selective RIA (x; Sandoz) with blood
      specimens from 44 renal-transplant recipients (n = 44, x= 187.3, y = 198.9, y =
      5.49 + 1.03x, r = 0.987). The TDx values were on average 24% higher than those by
      HPLC (x') with the same patients' specimens (n = 44, x' = 159.9, y = 198.9, y =
      15.9 + 1.14x', r = 0.967). We conclude that the Abbott TDx monoclonal antibody
      assay provides a rapid, precise, and accurate means for quantifying CsA in whole
      blood.

PMID- 2242581
TI  - Evaluation of the PG-Numeric assay for semi-automated analysis for
      phosphatidylglycerol in amniotic fluid.
AB  - We evaluated the performance of the PG-Numeric (PGN; Isolab, Inc.) enzymatic
      assay for phosphatidylglycerol (PG) adapted for semi-automated analysis on the
      Cobas-Bio (Roche) centrifugal analyzer. We evaluated precision, linearity, and
      potential interference from endogenous glycerol. In addition, we compared the
      results of the PGN assay with those for two other PG assays. Amniostat-FLM (AFLM;
      Hana Biologics) and phosphatidylglycerol/sphingomyelin ratio (PG/S), on amniotic
      fluid samples from 51 patients. Within-run and total CVs for the PGN test (n =
      80) were respectively 8.6% and 11.4% for PG at 2.6 mumol/L, and 4.5% and 6.2% at
      7.3 mumol/L. The PGN test exhibited no significant deviation from linearity
      between PG concentrations of 0.4 and 15 mumol/L. Endogenous glycerol up to 500
      mumol/L did not affect PGN results significantly. Results of the PGN assay
      compared favorably with those of the other PG assays for tests of fetal lung
      maturation. The Cobas-Bio adaptation of the PGN test performed well analytically
      and clinically, and allowed the determination of PG in less than 1 h.

PMID- 2242582
TI  - Simultaneous measurement of two major prostacyclin metabolites in urine.
AB  - We describe a combined HPLC-RIA technique to measure both major metabolites of
      prostacyclin (PGI2): 6-keto PGF1 alpha and 2,3-dinor-6 keto PGF1 alpha. The
      measurement of the former, which originates from renal blood vessels, and the
      latter, from systemic vessels and the liver, may provide a better overall
      evaluation of production than measurement of one metabolite. An aliquot of
      acidified urine with added 3H-labeled metabolites is adsorbed and then eluted
      from a C18 Bond-Elut column. The sample is then passed through an HPLC system by
      use of an isocratic solvent combination that separates the two metabolites from
      known prostaglandins. The purified metabolites are then quantified by RIA. Using
      a logit-log10 transform, one can measure between 12 and 250 pg of either
      metabolite, with high accuracy and precision (CVs of 12% for a low concentration
      and 7% for a high concentration). Reference values for apparently healthy
      subjects were, respectively, 107 (SD 45) and 171 (SD 69) ng/g creatinine for 6
      keto PGF1 alpha and the dinor metabolite in men (n = 18) and 45 (SD 22) and 141
      (SD 28) ng/g creatinine, respectively, in women (n = 15). Indomethacin in
      standard doses reduced both metabolite values by 50%. Intravenous administration
      of angiotensin II (5 ng/kg of body wt per minute) did not alter excretion rates,
      but equipressor doses of norepinephrine (0.1 microgram/kg per minute) increased
      the production of both metabolites (6-keto greater than dinor).

PMID- 2242583
TI  - Effect of occupational lead exposure on lymphocyte enzymes involved in heme
      biosynthesis.
AB  - Lead exposure is a well-known cause of increases in urinary coproporphyrin and
      erythrocyte zinc-protoporphyrin, so these compounds are often used to monitor
      occupational lead exposure. The increased concentrations are usually assumed to
      result from lead inhibition of two of the mitochondrial enzymes of heme
      biosynthesis, coproporphyrinogen oxidase (EC 1.3.3.3) and ferrochelatase (EC
      4.99.1.1). We studied 88 subjects in whom the degree of occupational lead
      exposure was established by measuring erythrocyte lead and protoporphyrin. Assay
      of lymphocyte coproporphyrinogen oxidase and ferrochelatase activities showed
      that these enzymes were unaffected by lead exposure, as was a related enzyme,
      lymphocyte NADH-ferricyanide reductase. We propose alternative explanations for
      the increased concentrations of coproporphyrin and zinc-protoporphyrin seen in
      lead exposure.

PMID- 2242584
TI  - Development and evaluation of a simplified dot-blot method for detecting the
      delta F508 mutation in cystic fibrosis.
AB  - The recent discovery of the cystic fibrosis gene enables DNA-based testing for
      the direct identification of the deletion of three basepairs coding for
      phenyalanine at codon 508, the major mutation responsible for the disease. This
      mutation can be detected by analysis of amplified DNA with allele-specific
      oligonucleotide probes. We have simplified the procedure of Kerem et al. (Science
      1989;245:1073-80) so that the assay can be routinely completed in one working
      day, starting with an extracted DNA sample. Addition of salmon-sperm DNA to the
      product of the polymerase chain reaction greatly improved the quality of the
      hybridization signal. The precision of the method was evaluated by blind analysis
      and interpretation of results for 100 specimens from 25 patients. The same result
      was obtained for each patient analyzed separately four times, and four
      independent observers agreed on the interpretation of results for all 100
      specimens. No specimen required repeat analysis to produce interpretable results.
      We conclude that this method is reliable and convenient for routine clinical
      laboratory use.

PMID- 2242585
TI  - Determination of beta-carotene and its cis isomers in serum.
AB  - All-trans-beta-carotene was resolved from its cis isomers in human serum by
      reversed-phase "high-performance" liquid chromatography. Absorption spectra of
      the cis peak suggested that 13-cis-beta-carotene was the predominant cis isomer.
      Analyses and recovery studies of fresh and stored sera eliminated the possibility
      that isomerization had occurred in samples during handling or storage. The
      average analytical recovery was 101.9% for standards of the all-trans-, 9-cis-,
      and 13-cis-beta-carotene compounds in pooled serum samples. We also demonstrated
      that cis isomers had not formed after the blood was drawn and that cis isomers of
      beta-carotene are present at significant concentrations in the human circulation.

PMID- 2242586
TI  - Determination of magnesium in serum by the technicon SMAC with a calmagite method
      with blank correction.

PMID- 2242587
TI  - Long-term in vitro stability of cyclosporine in whole-blood samples.

PMID- 2242588
TI  - Markedly increased concentrations of ferritin in an AIDS patient with
      disseminated histoplasmosis.

PMID- 2242589
TI  - Unbound and transthyretin-bound retinol-binding protein in serum and urine from
      diabetic patients with nephropathy and proteinuria.

PMID- 2242590
TI  - Three-minute whole-blood cholesterol screening test evaluated.

PMID- 2242591
TI  - Enzymatic reagents for quantifying total plasma cholesterol from dogs, rats, and
      hamsters.

PMID- 2242592
TI  - Hyponatremia is not a regulator of serum thyroxin.

PMID- 2242593
TI  - Macro creatine kinase in a case of carnitine palmitoyltransferase deficiency.
AB  - A stout man was admitted to the hospital with acute rhabdomyolysis associated
      with macro creatine kinase (macro-CK, EC 2.7.3.2). This anomaly of CK was
      detected by gel electrophoresis as an atypical band between CK-MB and CK-MM,
      classified according to Stein's criteria (Clin Chem 1982; 28:19-24) as type 1,
      and identified by immunofixation electrophoresis as containing CK isoenzymes MM
      and MB and immunoglobulin A. Muscle biopsy showed that the etiology of
      rhabdomyolysis in this case was deficiency of carnitine palmitoyltransferase
      (CPT, EC 2.3.1.21) in the muscle. We report the first observation of macro-CK in
      a case of CPT deficiency; its presence may result from recurrent rhabdomyolytic
      attacks owing to CPT deficiency, and may suggest underlying enzymic abnormality
      in muscle.

PMID- 2242594
TI  - Atypical enolase isoenzyme in serum: a macroenolase formed from the alpha gamma
      hybrid form.
AB  - We report an abnormal pattern for enolase (EC 4.2.1.11) isoenzymes in the serum
      of a patient with squamous cell lung carcinoma. The alpha alpha-isoenzyme was
      present but the alpha gamma form was not detected, and near the point of
      application on the electrophoretogram was an abnormal band. We determined that
      the abnormal fraction corresponded to a macroenolase, composed of the alpha gamma
      isoenzyme complexed with IgG. From a practical point of view, the presence of
      such a macroenolase, containing gamma-subunits, results in falsely increased
      results for neuron-specific enolase (NSE) in procedures that determine only the
      NSE concentration without consideration of the enolase isoenzymes.

PMID- 2242595
TI  - Excess serum osmolality gap after ingestion of methanol.
AB  - Two cases of methanol ingestion and one case of combined methanol and ethylene
      glycol ingestion are presented to illustrate the large differences that exist
      between the serum osmolality gap and the measured methanol (plus ethylene glycol)
      concentration(s) before treatment of these poisonings. After treatment with
      intravenous ethanol and hemodialysis was initiated, the differences disappeared
      in all three cases. We speculate that one or more metabolites with osmotic
      activity are formed in cases of methanol intoxication where no ethanol has also
      been consumed. The possible identity of these compounds is discussed.

PMID- 2242596
TI  - Abnormal lactate dehydrogenase isoenzyme pattern in serum of a patient with a
      neuroendocrine tumor.

PMID- 2242597
TI  - Measurement of free choriogonadotropin beta-subunit in patients with testicular
      tumors.

PMID- 2242598
TI  - Advantages of initial population screen with determinations of total cholesterol
      in serum and of lipoproteins by electrophoresis.

PMID- 2242599
TI  - Fluoride affects Coomassie Brilliant Blue measurement of protein in cerebrospinal
      fluid.

PMID- 2242600
TI  - Glycerol-blanked triglyceride assays with laboratory animals.

PMID- 2242601
TI  - Concentrations of rare earth elements in plasma and urine of healthy subjects
      determined by inductively coupled plasma mass spectrometry.

PMID- 2242602
TI  - Variations in measured alkaline phosphatase activity: influence of isoenzymes and
      buffer systems.

PMID- 2242603
TI  - Strategies in antibody therapy of cancer.

PMID- 2242604
TI  - A novel strategy for targeting CD4+ PPD-reactive T cells against tumour cells
      using PPD monoclonal antibody heteroconjugates.
AB  - We have constructed PPD monoclonal antibody heteroconjugates specific for a
      tumour-associated antigen of C57BL/6 melanomas or for human complement component
      C3d fixed de novo to murine fibrosarcoma cells (MC6A). The ability of our
      heteroconjugates to target CD4+ PPD-reactive T cells against the appropriate
      tumour targets was then determined in vitro. Heteroconjugate-treated B16-F10 and
      MC6A tumour targets were both able to present PPD to the specific T cells,
      resulting in activation and concomitant lymphokine secretion. Secreted
      lymphokines were then demonstrated to cause significant tumour cytolysis and
      cytostasis in vitro. Preliminary experiments in vivo suggest that this targeting
      system may provide the basis for a future immunotherapeutic strategy.

PMID- 2242605
TI  - Autoantibodies to endothelial cells and neutrophil cytoplasmic antigens in
      systemic vasculitis.
AB  - The interaction of circulating autoantibodies with the endothelium may be an
      important mechanism in the pathogenesis of systemic vasculitis. In a prospective
      study, we looked for circulating antiendothelial cell autoantibodies (AECA) and
      anti-neutrophil cytoplasm autoantibodies (ANCA) in 80 patients with suspected
      systemic vasculitis. AECA were measured using an isotype-specific cellular ELISA
      incorporating human umbilical vein endothelial cells. ANCA activity was
      determined by indirect immunofluorescence and radioimmunoassay. Sequential
      studies were performed on sera from four cases with dual positivity, where
      autoantibody binding was compared with von Willebrand factor (vWF) concentration
      and disease activity. IgG AECA were significantly higher in the 27 ANCA-positive
      sera as compared with normal controls (P = 0.027) with IgG (P = 0.009) and IgA (P
      = 0.046) AECA isotypes correlating with ANCA positivity; in contrast, no
      differences were found between AECA levels in the ANCA-negative sera and the
      normal controls. Cross-inhibition studies pointed to the co-existence of two
      autoantibody populations. An association between autoantibody binding, disease
      activity and vWF concentration was found for both ANCA and AECA. Some patients
      with systemic vasculitis have detectable AECA that recognize different epitopes
      to ANCA and like ANCA, their titre correlates with disease activity and thus they
      may have a pathogenetic role in these conditions.

PMID- 2242606
TI  - Increased production of the third component of complement (C3) by monocytes from
      patients with systemic lupus erythematosus.
AB  - We measured in vitro C3 production by peripheral blood monocytes from patients
      with systemic lupus erythematosus (SLE), and found it to be significantly greater
      than that from normal controls. We also found that monocytes from SLE patients
      with active disease produced a markedly larger amount of C3 than those from SLE
      patients with inactive disease. Production of C3 by monocytes correlated with
      serum levels of anti-dsDNA antibodies and inversely correlated with serum C3
      levels in SLE patients. Serial measurement of C3 in the culture supernatant from
      each SLE patient showed that C3 production by monocytes fell in parallel with a
      decrease of disease activity. The effect of corticosteroids was ruled out as
      there was no relation between the level of C3 production by monocytes and the
      dose of prednisolone. This seems to be the first study in which the C3 production
      was assayed at a cellular level in SLE patients, and this study suggests that the
      local C3 production is increased in SLE patients.

PMID- 2242607
TI  - Anti-heparan sulphate reactivity in sera from patients with systemic lupus
      erythematosus with renal or non-renal manifestations.
AB  - Previously, we have shown that anti-DNA can bind to heparan sulphate (HS), a
      constituent of the glomerular basement membrane (GBM). We hypothesized that
      binding of anti-DNA to HS in the GBM plays a role in the onset of systemic lupus
      erythematosus (SLE) nephritis. To test this hypothesis we measured the anti-HS
      reactivity in cross-sectional and longitudinal studies of SLE patients with or
      without nephritis. In the transverse serum study single serum samples from 26 SLE
      patients were studied. We found no correlation between anti-HS reactivity and
      previously development of nephritis (anti-HS positive: seven out of 16 with
      history of nephritis, two out of 10 without nephritis). However, six of the seven
      anti-HS positive sera in the nephritis group were obtained within 1 month of the
      onset of nephritis, suggesting a temporal relationship between anti-HS reactivity
      and onset of nephritis. In the longitudinal serum study between six and 16 serum
      samples were studied from each of 10 SLE-patients. In five out of five episodes
      of nephritis we found anti-HS reactivity before the onset or exacerbation of the
      nephritis. In four non-renal manifestations anti-HS reactivity was found in only
      one episode; in none of the three patients who remained clinically stable did
      serum samples show anti-HS reactivity. Anti-HS reactivity was only found in sera
      positive for anti-DNA by Farr assay but the anti-HS titre was not a mere
      reflection of the reactivity measured in the Farr assay. This indicates that only
      a subpopulation of anti-DNA can bind to HS. We found a high correlation (r =
      0.99) between anti-HS reactivities in plasma and serum and we conclude that anti
      HS reactivity in serum samples from SLE patients is not due to in vitro complex
      formation during clotting. Although further prospective analysis is necessary,
      our data suggest that measurement of anti-HS reactivity in SLE patients might
      identify patients at risk for the development of nephritis.

PMID- 2242608
TI  - Thyroid autoantigens and human T cell responses.
AB  - We investigated the ability of T cells from patients with Hashimoto's thyroiditis
      and with Graves' disease as well as control donors to proliferate in response to
      thyroid peroxidase (TPO) and thyroglobulin using (i) lymphoid cells from
      different lymphoid organs; (ii) unfractionated or CD8- depleted lymphoid
      suspensions or T cells + autologous low density cells (LDC); (iii) 200
      microliters well cultures and 20-microliters hanging-drop microcultures; and (iv)
      intact TPO and thyroglobulin, denatured thyroglobulin and 12 synthetic peptides
      predicted on the basis of the amino acid sequence of TPO to be T cell epitopes.
      In 200-microliters well cultures, proliferative responses (assessed in terms of
      3H-thymidine uptake) to intact TPO or thyroglobulin, digested thyroglobulin or
      synthetic TPO peptides were not significantly different in unfractionated or CD8
      depleted lymphoid suspensions from blood, thyroid or lymph nodes of
      TPO/thyroglobulin autoantibody-positive patients, autoantibody-negative patients
      or control donors. In contrast, blood T cells from some high titre patients with
      Hashimoto's thyroiditis (but not from healthy individuals) proliferated in
      response to intact thyroglobulin or TPO presented by autologous LDC in hanging
      drop microcultures. Heat denatured thyroglobulin (with which thyroglobulin
      autoantibodies do not interact) did not stimulate proliferation and this
      observation, together with the ability of T cells from some patients to respond
      to intact thyroglobulin in the absence of LDC, indicated that thyroglobulin
      specific B cells may be involved in antigen presentation. As we were unable to
      demonstrate proliferation by blood T cells + LDC from all thyroglobulin antibody
      positive patients with Hashimoto's thyroiditis, our studies suggest that the
      presence of sufficient precursor T cells, as well as the number and type of
      antigen-presenting cells, are critical for T cell proliferative responses to
      human TPO and thyroglobulin.

PMID- 2242609
TI  - Patients with myasthenia gravis and thymoma have in their sera IgG autoantibodies
      against titin.
AB  - Patients with myasthenia gravis (MG) and thymoma have in their sera antibodies
      which react with non-receptor antigens from striated muscle. The purpose of this
      investigation was to characterize the antigen(s). Polypeptides in homogenates
      from rat skeletal muscle were separated by SDS-PAGE and trans-blotted to
      nitrocellulose. Sera from six patients with MG and thymoma stained a large
      (molecular weight greater than 500 kD) polypeptide, while no staining was
      observed with sera from 20 non-thymoma MG patients. Titin is one of the large
      (greater than 500 kD) polypeptides of striated muscle and the antibody containing
      MG sera have antibodies that bind to titin in a preparation of myofibrillary
      proteins from rabbit skeletal muscle. The staining pattern is identical to that
      obtained with antiserum to titin, showing that the antigen has the same
      electrophoretic mobility as titin. Antibodies from the sera of the patients with
      MG and thymoma, affinity-purified on the large polypeptide, reacted with skeletal
      muscle sections in a cross-striational pattern, near the A/I band junction but
      within the I band, corresponding to the localization of one of the epitopes of
      titin. Our findings therefore indicate that the muscle antibodies found in the
      sera from some MG patients with thymoma are directed against titin.

PMID- 2242610
TI  - Prolonged circulation of immune complexes due to various altered immune functions
      contributes to nephritis in MRL/lpr mice.
AB  - To gain some insight into the pathogenesis of proliferative lupus nephritis in
      MRL/lpr mice we investigated the kinetics of removal of immune complexes from the
      circulation, the carrier state of blood cells, the uptake of complexes by the
      mononuclear phagocyte system, and the localization of complexes in kidneys. In
      nephritic MRL/lpr mice challenged with a subsaturating dose of radiolabelled
      complexes (2.5 mg bovine serum albumin-anti-bovine serum albumin) liver uptake
      was profoundly decreased, removal of circulating complexes was delayed, and 12-h
      kidney localization of complexes was enhanced 7.3-fold, in comparison to control
      mice. The findings were not encumbered by differences in complement concentration
      and most likely are attributable to various altered immune functions: spontaneous
      polyclonal activation of B cells, enhanced production of endogenous immune
      complexes, delayed removal of complexes from the circulation, and decreased
      uptake of complexes by the mononuclear phagocyte system. In concert, such altered
      functions contribute to prolonged circulation of complexes to result in their
      enhanced deposition in the microcirculation.

PMID- 2242611
TI  - Adjuvant-induced arthritis in rats. Evidence that autoimmunity to homologous
      collagens types I, II, IX and XI is not involved in the pathogenesis of
      arthritis.
AB  - We examined the sera of arthritic outbred Wistar and Sprague-Dawley rats and
      inbred Fisher 344 and Wistar-Lewis rats for autoantibodies to rat type I, II, IX
      and XI collagens following the induction of arthritis with mycobacteria (MTB).
      Although many sera collected over an extended time were assayed in addition to
      acid eluates of arthritic joints, convincing evidence for autoimmunity to
      collagen could not be demonstrated. Instead, modest non-specific reactions were
      observed to collagen, irrelevant proteins, and buffer-treated plastic microtitre
      wells. In contrast, antibodies to purified protein derivative (PPD) were detected
      in the sera of rats developing adjuvant-induced arthritis, and antibodies to type
      II collagen, in the sera and joint eluate of rats developing experimental
      collagen-induced arthritis. Lastly, delayed-type hypersensitivity responses to
      collagen could not be detected, nor could adjuvant-induced arthritis be
      attenuated by soluble collagen injected intravenously before challenge with MTB.
      We conclude that adjuvant-induced arthritis and experimental collagen-induced
      arthritis are distinct models of rheumatic disease and that autoimmunity to
      collagen is neither prevalent in adjuvant-induced arthritis nor necessary for its
      pathogenesis.

PMID- 2242613
TI  - Macrophage procoagulant activity as an assay of cellular hypersensitivity to
      gluten peptides in coeliac disease.
AB  - Gluten and casein digests were tested for their ability to induce a cellular
      immune response on peripheral blood mononuclear cells (PBM) obtained from coeliac
      patients as well as healthy volunteers and disease control patients using the
      macrophage procoagulant assay. PBM from coeliac patients who had been on a gluten
      free diet for less than 2 years responded strongly to gluten peptides, while
      coeliac patients at diagnosis or who had maintained a strict gluten-free diet for
      longer than 5 years showed weaker responses. PBM from healthy volunteers did not
      respond to gluten or casein peptides, whereas those from patients with Crohn's
      disease displayed weak reactivity to gluten and casein peptides. Our study using
      the macrophage procoagulant assay confirms previous findings that lymphoid cells
      from patients with coeliac disease exhibit a specific cellular immune response to
      gluten. This assay represents an alternative measure for cell-mediated immunity
      and is technically much simpler than the previously described leucocyte migration
      inhibition assay. Macrophage procoagulant activity is measured using a simple
      plasma recalcification time assay or spectrophotometrically using commercially
      available chromogenic substrates.

PMID- 2242612
TI  - Participation of eosinophils in the toxic oil syndrome.
AB  - The participation of eosinophils in the Spanish toxic oil syndrome (TOS) was
      investigated. Eosinophil infiltration and degranulation in tissues from 52
      patients with the TOS were examined by immunofluorescence staining for the
      eosinophil granule major basic protein (MBP). Serum MBP levels were determined in
      sera from 323 patients. Eosinophil infiltration and degranulation were found in
      several tissues, especially during the acute phase of the TOS, and serum MBP was
      significantly elevated during all phases of the disease, suggesting that
      eosinophils play a role in the pathogenesis of the TOS.

PMID- 2242614
TI  - The effect of recombinant interferon-alpha on lymphocyte subpopulations and HLA
      DR expression on liver tissue of HBV-positive individuals.
AB  - Interferon-alpha (IFN-alpha) has been reported to be beneficial in the treatment
      of chronic active hepatitis occurring as a result of hepatitis B virus (HBV)
      infection. Treatment with IFN-alpha has been proposed as a means of reducing the
      high rate of allograft infection in clinical liver transplantation in patients
      transplanted for HBV-related chronic active hepatitis and cirrhosis who are
      positive for hepatitis B surface antigen (HBsAg). We obtained resected whole
      livers from two groups of patients who received liver transplants. Group A
      consisted of 11 patients who were HBsAg+ but were not treated with IFN-alpha, and
      group B consisted of 10 patients who were also HBsAg+ but received IFN-alpha
      therapy for 29.4 +/- 5.6 days prior to orthotopic liver transplantation. No
      differences between the two groups existed in terms of a variety of demographic
      and clinical characteristics. The liver tissue was stained with monoclonal
      antibodies to cell surface antigens unique to different mononuclear cell
      populations by the avidin-biotin-immunoperoxidase technique to determine the
      effect of IFN-alpha on the lymphocyte subsets as well as HLA antigen expression
      on liver-infiltrating mononuclear cells. The number of HLA-DR+ lymphocytes in the
      liver was significantly increased (P less than 0.005) within the portal areas in
      group B compared with that found in group A (84 +/- 14 versus 33 +/- 5 per one
      high-power field). Moreover, the intensity of the HLA-DR antigen expression on
      lymphocytes in the portal areas (P less than 0.02) and in the hepatic lobule (P
      less than 0.05) was greater in group B than in group A. The number of natural
      killer (NK) cells was increased in the portal areas (P less than 0.05) of group B
      compared with group A. These alterations in the lymphocyte and NK cell
      populations present in the liver in response to IFN-alpha therapy presumably
      reflect an IFN-alpha-induced enhancement of the immune response to virus-infected
      cells.

PMID- 2242615
TI  - Characterization of homologous restriction factor (HRF20) in human skin and
      leucocytes.
AB  - Homologous restriction factor with a molecular weight of 20 kD (HRF20) is a
      membrane protein that inhibits assembly of the membrane attack complex of
      homologous complement. Distribution of HRF20 in normal human skin was studied.
      The plasma membrane of keratinocytes was stained, and the intensity of the
      staining pattern was higher in the basal cell layer than in the granular layer.
      Endothelial cells of blood vessels in the dermis were also stained. The molecular
      weight of HRF20 on erythrocytes and epidermis is 16 kD, determined by Western
      blot analysis. Those of polymorphonuclear cells and lymphocytes appeared as two
      bands, a major band of 20 kD and a minor band of 16 kD. Susceptibility of HRF20
      to phosphatidylinositol-specific phospholipase C (PIPLC) was examined. After
      PIPLC treatment of the sections, HRF20 was not detected on the epidermis and was
      very slightly expressed on the blood vessels. These results indicate that HRF20
      attaches to keratinocytes and blood vessels via phosphatidylinositol, regulating
      the formation of membrane attack complexes of homologous complement on the cell
      membrane.

PMID- 2242616
TI  - Complement, complement activation and anaphylatoxins in human ovarian follicular
      fluid.
AB  - Functionally active complement was sought and detected in human follicular fluids
      obtained during the pre-ovulatory period. All the functional complement
      activities tested, including total haemolytic complement, classical pathway
      activity and alternative pathway activity were present in nine fluids from four
      different donors with values within the normal serum range. The immunochemical
      analysis demonstrated the presence of complement factors from C1 to C9, of B and
      of C1 INH, H, I. Complement anaphylatoxins were found employing RIA techniques in
      amounts significantly higher than in human plasma, thus demonstrating that
      follicular fluid complement, at least during the pre-ovulatory period, is
      partially activated. A possible role for urokinase-like substances in such an
      activation was indicated by further in vitro experiments. The presence of active
      complement in follicular fluid can be relevant for the function of the enzymatic
      multi-factorial mechanism of ovulation.

PMID- 2242617
TI  - Antibody repertoire against culture filtrate antigens in wild house mice infected
      with Mycobacterium bovis BCG.
AB  - Wild house mice (Mus domesticus) captured in a Flemish pigsty were infected
      intravenously with 4 x 10(6) variable units of Mycobacterium bovis BCG and
      examined by Western blot analysis for IgG secretion against BCG culture filtrate
      (CF) antigens. Wild mice showed a marked individual variation in antibody pattern
      when tested 4, 6 and 8 weeks after infection. Some animals reacted to a wide
      range of antigens and others only to a limited number. Most wild mice recognized
      preferentially antigens with molecular weight of 24 kD, 32 kD, 37-38-40 kD, 65 kD
      and 82 kD, i.e. the major CF antigens known to be recognized by sera from BCG
      infected inbred laboratory strains, BALB/c, DBA/2, CBA/Ca and C57BL/6. The 32-kD
      fibronectin-binding protein and the 65-kD heat-shock protein appeared as very
      immunodominant in wild mice. Furthermore, about 20-25% of the mice reacted
      strongly with a unique antigen of 35 kD estimated molecular weight, to which the
      tested inbred laboratory mice did not respond. Monitoring the size of the
      bacterial population in the spleen indicated that the BCG inoculum did not
      replicate in wild mice, suggesting that the Bcgr allele is expressed in this
      population.

PMID- 2242618
TI  - Cellular immunity in experimental Echinococcus multilocularis infection. I.
      Sequential and comparative study of specific in vivo delayed-type
      hypersensitivity against E. multilocularis antigens in resistant and sensitive
      mice.
AB  - Species- or strain-related differences in receptivity of intermediate hosts to E.
      multilocularis larvae could be related to differences in specific cellular immune
      response of the host. In order to test this hypothesis, we assessed the delayed
      type hypersensitivity (DTH) to E. multilocularis antigens (EmAg) in mice of three
      strains differing by their sensitivity (AKR and C57BL.6) or resistance (C57BL.10)
      to E. multilocularis infection. DTH was determined by measuring in vivo the foot
      pad response 24 h after an EmAg antigenic challenge. The level of positive
      response was evaluated in immunized mice; however, a typical DTH response was
      only observed by immunizing mice with a strong adjuvant schedule. Course of DTH
      in the immunized mice was shown to be somewhat different in sensitive and
      resistant mice. The differences were much more marked in mice infected with
      proliferative E. multilocularis larvae. The levels of the footpad response was
      significantly higher in resistant mice, although the peak of the reaction was
      obtained later than in sensitive mice. DTH, expressed by the foot-pad response
      against EmAg, remained significant for the entire period of observation in
      sensitive as well as in resistant mice. There was no correlation between
      receptivity of the murine hosts and levels of specific antibodies against EmAg.
      These results suggest a relationship between resistance to E. multilocularis
      infection and intensity and/or course of DTH in mice. The resistance could be
      mediated by some particularities of the in situ cellular immune response in the
      periparasitic granuloma.

PMID- 2242619
TI  - Cellular immunity in experimental Echinococcus multilocularis infection. II.
      Sequential and comparative phenotypic study of the periparasitic mononuclear
      cells in resistant and sensitive mice.
AB  - Cellular immune responses have been shown to be associated with differential
      evolutions of E. multilocularis infection in intermediate hosts. A relationship
      between course of delayed-type hypersensitivity (DTH) against parasitic antigens
      and receptivity of murine strains has been demonstrated recently. The aim of this
      study was to correlate resistance and sensitivity to E. multilocularis infection
      with the phenotypic patterns of cells within the periparasitic granuloma.
      Evolution of the ratios, macrophages/T lymphocyte and Ly1/Ly2 T lymphocytes, was
      associated with the receptivity of the strains. Persistence of numerous L3T4 + T
      lymphocytes and low numbers of macrophages and Ly2 + T lymphocytes were observed
      in the 'resistant' C57BL.10 mice. Comparison of the results with course of the
      DTH against E. multilocularis antigens showed that the particular phenotypic
      pattern observed in resistant mice was associated with a particular profile of
      DTH after infection. These results and similar observations in human alveolar
      echinococcosis suggest that cell composition of the periparasitic granuloma might
      be of crucial importance in controlling the spontaneous development of E.
      multilocularis larvae in the intermediate host.

PMID- 2242620
TI  - Intra-articular immunization induces strong systemic immune response in humans.
AB  - There is no information available about immunological interactions between the
      synovial tissue compartment and systemic immunity in health and in disease. The
      aim of the present study was to evaluate effects of intra-articular immunization
      on the systemic immune responses in humans. Control subjects were immunized with
      the same dose of immunogen subcutaneously. Peripheral blood lymphocytes were
      analysed by spot-ELISA with respect to numbers of immunoglobulin-producing cells
      and antigen-specific antibody-secreting cells before and 1 week after
      immunization. Serum and salivary antibody levels were measured by an ELISA before
      and 14 days after the antigenic exposure. In addition, serum levels of
      interleukin-6 (IL-6) were analysed before and after immunization. The results
      indicate that the influenza virus antigen deposited in the joint space induces
      strong systemic antibody response of IgG, IgA and IgM classes. This response is
      significantly higher (P less than 0.05) than that of control subjects immunized
      subcutaneously. In contrast, no significant differences were detected between
      intra-articularly and subcutaneously immunized subjects with respect to mucosal
      immune responses. Increased serum levels of IL-6 were observed 1-2 weeks after
      the vaccination in both experimental groups. We conclude that human joints
      possess very efficient antigen-presenting properties enhancing systemic B cell
      reactivity.

PMID- 2242622
TI  - Legal issues related to the right to die: implications for nursing education.

PMID- 2242623
TI  - [Distribution of skeletal muscle involvement in myotonic dystrophy--a computed
      tomographic study].
AB  - The computed tomography (CT) scan was performed on 8 myotonic dystrophy (MD) and
      3 congenital myotonic dystrophy (CMD) patients on the following seven levels; the
      jaw, the neck, the shoulder girdle, the abdomen, the pelvic girdle, the thigh and
      the lower leg. Muscle atrophy was shown as low density areas or a reduction in
      the cross-sectional area of the muscles. The earliest finding in the disease was
      severe atrophy of the sternocleidomastoid and mild atrophy of the masseter and
      the pterygoid medialis. In addition, spinal, abdominal wall and lower leg muscles
      were involved. The distal muscles were more markedly affected than the proximal
      in the lower limbs. These changes were characteristically observed in cases
      without apparent muscle symptoms. Levator scapulae, psoas major, rectus femoris,
      peroneal longus et brevis and tibialis posterior were relatively well preserved
      and were even hypertrophic in some cases. The shoulder girdle muscles were more
      markedly affected than the pelvic girdle muscles. There was no substantial
      difference in the CT findings between MD and CMD.

PMID- 2242621
TI  - Transforming growth factor-beta 1 inhibits activation of macrophage cell line RAW
      264.7 for cell killing.
AB  - Transforming growth factor beta-1 (TGF-beta) is a multi-potent immunoregulatory
      peptide that has effects on numerous cell types. Here we report that human TGF
      beta inhibits the activation of the macrophage cell line RAW 264.7 for killing of
      the L1210 tumour cell line. RAW 264.7 cells, like normal macrophages, require
      sequential interaction with priming and triggering stimuli for full activation of
      cytolytic activity. TGF-beta inhibits this cytotoxicity in a dose-dependent
      manner at both the priming and the triggering stage. Addition of as little as 1
      ng/ml TGF-beta when added with either the priming signal, recombinant interferon
      gamma (IFN-gamma), or the triggering signal, bacterial lipopolysaccharide (LPS),
      completely abrogated tumouricidal activity. Incubation with TGF-beta also
      inhibited the morphological changes normally observed in activated RAW 264.7
      cells. However, TGF-beta was unable to inhibit the cytotoxic activity of RAW
      264.7 cells against the target cell line WEHI 164, which is sensitive to tumour
      necrosis factor. In contrast to the effects on cytotoxic activity, the cytostatic
      activity of activated RAW 264.7 cells was not inhibited by TGF-beta at doses of
      up to 5 ng/ml. In addition, pretreatment of the L1210 target cells with TGF-beta
      made them refractory to both the cytostatic and cytotoxic effects of RAW 264.7
      cells. These data suggest that TGF-beta may be an important mediator in the
      regulation of macrophage tumouricidal activity.

PMID- 2242624
TI  - [Cerebrovascular disease in the elderly--clinical study of 31 cases with acute
      intracerebral hemorrhages].
AB  - Thirty-one consecutive cases of intracerebral hemorrhage (ICH) in the elderly
      (over 70 years at the onset) were reported with special reference to neurological
      evaluations, prognosis and mortality in the acute phase. There were 11 men and 20
      women with ICH, who were admitted to the Yokufukai Geriatric Hospital within 24
      hours after the onset of ICH. Their ages at the onset ranged from 71 to 93 years
      with a mean of 81.1 years. The lesion location showed 5 cases with thalamic
      hemorrhage, 4 cases with putaminal hemorrhage, 6 cases with subcortical
      hemorrhage, 7 cases with cerebellar hemorrhage, 8 cases with mixed hemorrhage and
      1 case with unclassified hemorrhage. 61.3% of all cases showed the onset during
      daytime but the remaining awoke in the morning with their symptoms or had the
      onset from the stage of the bedridden state. The classical prodromal symptoms
      headache and nausea or vomiting were found in 30% and 54.8%, respectively. Two
      cases with cerebellar hemorrhage were accompanied by vertigo. Twenty-four
      patients had consciousness disturbance at admission. There were 18 cases with
      right or left hemiparetic symptoms, 5 cases with tetraparesis, and 5 cases
      without motor dysfunction. The remaining already had hemiparesis due to old
      stroke. Patients with mixed hemorrhage usually exhibited conjugate deviation. In
      9 of 31 cases there were mental symptoms such as wandering or night delirium. The
      30-day mortality rate was 64.5% and sixty-five percent of them died within 6 days
      after the onset of ICH. Consciousness at admission was the overwhelming
      predictive factor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242625
TI  - [Local alcoholisation treatment of spasmodic torticollis].
AB  - Idiopathic spasmodic torticollis is a type of focal dystonia. Major muscles which
      rotate the neck are M. sternocleidomastoideus (SCM) and M. splenius capitis (Spl)
      on both sides. In torticollis patients, its clinical characteristics could be
      understood as a vectorial summing up of tonus in bilateral SCM and Spl at rest.
      There is not any curative treatment for dystonia yet. A variety of medications
      and many types of surgical interventions have been tried without consistent or
      satisfactory results. In recent days local injection of botulinum-A toxin has
      shown to be effective in weakening focal dystonias. We used pure ethanol for
      local injection. Fourteen patients aged between 20-77 years (mean 48.9) were
      treated by alcoholisation. Disease duration ranged from 5 months to 12 years
      (mean 4.9 years). All had torticollis alone or had segmental dystonia containing
      spasmodic torticollis. Patients were recorded electromyographically using surface
      electrodes to make sure which neck muscles were hypertonic, and were rated before
      and after treatment according to the stages (0; normal-5; most severe). On the
      bases of these recordings the two most active muscles were selected for
      injection. Into the motor point of these muscles 1 ml of 1% lidocaine, and then
      the same dose of 99% ethanol were injected. This procedure was repeated on the
      mean ten times (6-14 times) every other week. The number of times of injection
      was decided in each case. Using the paired Student t test, there was a
      significant (p less than 0.01) improvement of the stage for the patients after
      injection, with a mean of 3.7 before treatment and 2.3 after treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2242626
TI  - [Auditory brainstem response and somatosensory evoked potential in Machado-Joseph
      disease in Japanese families].
AB  - To clarify physiological aspects of Machado-Joseph disease (MJD), we studied
      auditory brainstem response (ABR) and somatosensory evoked potential (SEP) in 17
      clinically diagnosed patients with MJD aged 32-64 in Japanese families. ABR was
      recorded in 13 patients. In 8 patients, ABR were abnormal. In 5 patients, the
      latency of I wave was normal, but other waves could not be evoked. In the other 3
      patients, I-III interpeak latency was prolonged. SEP was recorded in 15 patients.
      In SEP of median nerve, 11 patients had abnormal findings, and SEP of posterior
      tibial nerve revealed abnormal findings in all 15 patients. In all patients,
      responses from Erb's point and popliteal fossa were normal in latency, but other
      peaks were low in amplitude or absent, and the latency and central conduction
      time (CCT) were prolonged. The result of ABR indicated the involvement of the
      brainstem auditory pathways in MJD, and the result of SEP suggested that
      somatosensory pathways, particularly central pathways, would be involved in the
      disease process. ABR and SEP can be potential diagnostic methods for detection of
      subclinical abnormality in MJD patients.

PMID- 2242627
TI  - [Gallstone and Parkinson's disease--ultrasound echography study].
AB  - Gastrointestinal symptoms caused by autonomic nervous system dysfunction has been
      well known in Parkinson's disease. This time we had a chance to see a patient
      with Parkinson's disease associated with acute abdominal pain because of
      gallstones. This study extended to examine abdominal findings in 79 cases of
      Parkinson's disease using abdominal ultrasound echography and also studied
      relationships between echographic findings and age, Hoen-Yahr stage and duration
      of the illness. Results were as follows: Echographic abnormalities were found
      53.2% of the cases. Among them, gallstone was the most frequent findings and the
      incidence was 29.1% which showed significantly higher than that of the gallstone
      holding ratio (16.6%) in a age matched Japanese autopsy study. Subsequent
      findings were renal cyst (16.5%), renal stone (8.9%), liver cyst, portal
      dilatation and so on. No remarkable relationship was found between Hoen-Yahr
      stage and gallstone, however good correlation was found between duration of the
      illness and gallstone. It was concluded that gallstone holding ratio in
      Parkinson's disease is considerably high compared to that of a age matched
      Japanese autopsy study, which might be of great use in our daily clinics.

PMID- 2242628
TI  - [A case of mitochondrial myopathy with mononeuritis multiplex].
AB  - A case of mitochondrial myopathy with mononeuritis multiplex was described. A 55
      year-old man was hospitalized because of blepharoptosis and muscle weakness. His
      mother also showed blepharoptosis in her elderly stage of life. He had been
      healthy until 46 years of age, when he first noticed difficulty of speech,
      followed by bilateral blepharoptosis, weakness of upper limbs, and sensory
      disturbance in the left occipital, and left upper and lower extremities. These
      symptoms progressed slowly. On admission, bilateral blepharoptosis was
      recognized. Slightly to moderate muscle wasting and weakness were observed in the
      face, neck, trunk, and extremities. Areflexia was observed in the upper
      extremities. Paresthesia was observed in the left occipital and left hip, and
      superficial sensation was impaired in the left upper and lower extremities.
      Electromyographic examination of extremities showed neurogenic changes in the
      distal muscles and myogenic changes in the proximal muscles. Motor conduction
      velocities were normal, but sensory conduction velocities decreased in amplitude
      on the left upper extremity and were not evoked on the left lower extremity.
      Muscle biopsy specimen revealed numerous "ragged-red" fibers. Cytochrome c
      oxidase stain showed a decrease in intensity of staining. A sural nerve biopsy
      showed slight axonal degeneration and slight loss of nerve fibers. Biochemical
      analysis on biopsy muscle showed partial deficiency of cytochrome c oxidase
      activity.

PMID- 2242629
TI  - [An autopsy case of HTLV-I associated myelopathy (HAM) with adult T-cell leukemia
      (ATL)].
AB  - An autopsy case of HTLV-I associated myelopathy (HAM) combined with adult T-cell
      leukemia (ATL) was reported. Although HAM and ATL are reported to be caused by an
      identical virus, a combination of these two conditions is extremely rare. This is
      the first report of an autopsy of the case. A 42-year-old female born in Kumamoto
      noticed gait disturbance at age 20. Dysesthesia in her lower limbs and bladder
      bowel disturbance (BBD) gradually appeared at age 29 and at age 39, respectively,
      and slowly progressed. Neurological examination revealed spastic paraparesis,
      sensory disturbance in her lower limbs in all modalities and BBD. Furthermore,
      titers of the anti HTLV-I antibody were increased both in serum and CSF. She was
      diagnosed as HAM at this stage. She responded to the oral administration of
      prednisolone. Ten months after the initiation of prednisolone therapy, a tumor
      shadow appeared in the right lung and characteristic ATL cells were found in the
      pleural effusion. She died with respiratory failure. ATL cells were not found
      either in the peripheral blood or CSF throughout the course of her illness.
      Autopsy revealed solid tumors in both lungs, liver, kidneys, spleen, thyroid
      gland and para-aortic lymphnodes, composed of ATL cells with extensive necrosis.
      The spinal cord showed a marked loss of myelin and axons, and perivascular
      fibrosis in the lateral and anterior columns. These changes were most severe at
      the 6th and 7th thoracic segments. No ATL cell was found in the spinal cord.
      Concerning the sensory system, the posterior root, ganglion and posterior column
      were preserved, whereas the axonal degeneration was found in the biopsied
      specimen of the sural nerve.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242630
TI  - [MRI pathology of the globus pallidus in a patient with oculogyric crisis and
      tremor].
AB  - A 24-year-old woman developed occasional attacks of oculogyric crisis at the age
      of 18. She also suffered from postural tremor, dystonic gait, pyramidal tract
      signs, and peripheral nerve damages. No history of encephalitis was elicited.
      Nerve conduction velocity revealed decreased velocity and amplitude. Needle
      electromyography showed a neurogenic pattern. Sural nerve biopsy showed marked
      Wallerian degenerations. Muscle biopsy revealed small grouped atrophies. It was
      unlikely that she suffered from juvenile Parkinsonism, and we failed to obtain an
      evidence of neuronal intranuclear inclusion disease. Recently, Furumoto et al.
      reported a similar case who developed oculogyric crisis at the age of 12. So far,
      some authors have reported about changes of MRI image in the putamen and the
      substantia nigra in extrapyramidal movement disorders. However, few have paid
      attention to the changes of the pallidum. The most characteristic finding in the
      present case was the restoration of signal intensity of the globus pallidus on T2
      weighted high-field MRI. It is known that pallidal damages produce dystonic
      disorders. However, the exact role which the pallidum played in pathogenesis of
      our patient's signs and symptoms is unknown at now.

PMID- 2242631
TI  - [Two cases of HTLV-I associated myelopathy (HAM) complicated with Sjogren's
      syndrome, T-lymphocyte alveolitis and arthropathy].
AB  - Two cases of HTLV-I-associated myelopathy (HAM) complicated with Sjogren's
      syndrome (SjS), T-lymphocyte alveolitis and arthropathy were reported. Case 1 was
      a 55-year-old woman. Since 40 years of age she had been suffering from repetitive
      pulmonary infection. She also noted polyarthralgia since 42 years of her age and
      was diagnosed as SjS at her age 43. She developed gait disturbance since April
      1988. Case 2 was a 65-year-old woman. She began to have gait disturbance at 62
      years of age. A right knee joint pain started in December 1988. The two cases
      have the following features in common: 1. The diagnosis of HAM is definite
      because of pyramidal signs and positive anti-HTLV-I antibody in both serum and
      cerebrospinal fluid. 2. The histological findings of the minor salivary glands
      are compatible with SjS. 3. Differential cell count in bronchoalveolar lavage
      fluid (BALF) showed an increase in lymphocytes which suggested the presence of
      clinical or subclinical T-lymphocyte alveolitis. 4. A mono-or polyarthropathy is
      observed. These findings are suggestive that HAM is not the disease restricted
      within the central nervous system but the disease with systemic involvement which
      may be caused by the activated T-lymphocytes. Thus the two cases are interesting
      for the understanding of the pathogenesis of HAM.

PMID- 2242632
TI  - [Intracranial multiple granuloma preceded by rheumatic disease--a case report].
AB  - In 1980, a 38-year-old man had remittent fever, swelling and arthralgia of the
      knee, ankle and wrist joints, as well as visual disturbance due to bilateral
      iritis. On his admission to our hospital, his laboratory data showed
      neutrophilia, normocytic normochromic anemia, hepatomegaly, hepatocellular
      damage, and a strongly positive RA test. All the microbiological examinations
      were negative. Thirty mg of prednisolone improved his symptoms and abnormal
      laboratory findings. Due to persistent mild arthralgia, he had continued to take
      5-10 mg of prednisolone and analgesics until 1985 when he was readmitted to our
      hospital. In 1983, he began to complain of a steady pain around his left eye, and
      he sometimes had double vision. In 1985, he began to complain of decreasing left
      visual acuity and sensory disturbance in his left face in addition to pain in and
      around the eye. On his 2nd admission to our hospital, the neurological
      examination revealed involvement of the 2nd and 3rd cranial nerves and the 1st
      branch of the 5th cranial nerves of the left side. Laboratory data showed a
      positive RA test with RAHA titer at 1:320 and IgM at 216 mg/dl, but he had no
      joint deformities. The computed tomography (CT) of the brain demonstrated a high
      density mass of his left cavernous sinus extending to the left orbital apex. The
      prescription of the high dose of prednisolone (100 mg/day) relieved ophthalmic
      pain and improved visual acuity and neurological involvement within a week.
      Prednisolone was then gradually decreased to 10 mg. In 1986, he had partial and
      complex partial seizures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242633
TI  - [A case of hemiballism successfully treated by sulpiride, caused by lesions of
      the striatum].
AB  - A case of hemiballism caused by infarction in the left striatum on MRI was
      reported. Hemiballism is generally associated with lesions in the subthalamic
      nucleus. However, hemiballism occasionally occurs as a result of lesions outside
      the subthalamic nucleus. Hemiballism is a benign condition with spontaneous
      recovery in most cases, but hemiballism caused by lesions outside the subthalamic
      nucleus is reported to tend to persist for a long term. In our case without
      involvement of the subthalamic nucleus, hemiballism so far continued for three
      months since the onset. Successful pharmacological treatments of ballism with
      haloperidol or phenothiazines were well known. In our case, the treatments of
      ballism with these drugs were unsuccessful due to drug-induced hepatic
      dysfunction. Instead of these drugs, ballism was improved by administration of
      150 mg of sulpiride per day with no side effects. Sulpiride may be beneficial for
      persistent hemiballism caused by the extra subthalamic lesions.

PMID- 2242634
TI  - [A new family of Machado-Joseph disease--an abnormal decrease in signal intensity
      of the putamen in magnetic resonance imaging].
AB  - The propositus (case 1) was a 40 year-old man. He had begun to note unsteady
      walking at age 26. He was found to have cerebellar ataxia and pyramidal signs in
      addition to minor features such as progressive external ophthalmoplegia, gaze
      nystagmus, bulging eyes, intention fasciculation-like movements of facial and
      lingual muscles, and limb dystonia. These findings were categorized into type II
      form of the disease. One sister (case 3) aged 37 years, and one brother (case 4)
      aged 44 years of the propositus had also type II form of the disease. His uncle
      (case 2) had the same cerebellar and extrapyramidal signs accompanied with
      peripheral nerve signs such as muscle wasting, weakness, hypo-tonus and decreased
      deep tendon reflexes, and a diagnosis of type III form of the disease was made.
      In the T2-weighted magnetic resonance imaging (1.5 T, TR 2000 or 3000 msec, TE
      120 msec) of the three patients (case 1, 3 and 4), dorsolateral part of the
      putamen showed decreased signal intensity. Although hypo-intensity of the putamen
      is often observed in normal elderly people over 50 years old, it is considered to
      be abnormal when it exists in relatively young people as in this family members.

PMID- 2242635
TI  - [Acute transverse myelitis associated with ECHO-25 virus infection].
AB  - A case of acute transverse myelitis associated with ECHO-25 virus infection was
      reported here with a brief review of the literature. The patient was a 42-year
      old house wife. Without any antecedent symptoms, weakness and paresthesia of
      bilateral lower extremities, and sphincter disturbance developed suddenly.
      Neurological examination revealed paraplegia of both legs, hyperreflexia of lower
      extremities, bilateral positive Babinski sign and impairment of all sensory
      modalities below Th4 level. No abnormality was found in myelography and CT
      myelography. Abnormal intensity area was found in lower cervical spinal cord on
      MRI. Serum antibody titer to ECHO-25 virus was elevated in the convalescent stage
      (X4096), and 7 month later from the onset of neurological symptoms, high value
      was continued (X128). We diagnosed her illness as acute transverse myelitis
      complicating ECHO-25 virus infection. In the literature, only 3 cases of
      transverse myelitis following ECHO virus infection (type 2, 5, 19) were found.
      This case seemed to be the first case of transverse myelitis associated with ECHO
      25 virus infection.

PMID- 2242636
TI  - [A case of cranial polyneuropathy presenting with prominent facial diplegia,
      elevated serum Borrelia burgdorferi antibody and lymphocytic pleocytosis].
AB  - A 54 year-old male patient developed acute cranial polyneuropathy including
      prominent facial diplegia and radicular++-neuritis. He was proven to have
      lymphocytic pleocytosis, and elevated serum Borrelia burgdorferi antibody to X800
      (normal; less than X200). A diagnosis of typical early neuro-borreliosis was made
      after these clinical and laboratory findings. This case is the first neuro
      borreliosis showing the triad of neurological manifestations (meningitis, cranial
      neuritis, radicular++-neuritis) in Japan. It is concluded that neuro-borreliosis
      should be considered to be a cause of acute cranial polyneuropathy, particularly
      of facial diplegia, even if the patient has no apparent history of a tick bite.

PMID- 2242637
TI  - [A case of transient bilateral primary oculomotor nerve paresis associated with
      head injury].
AB  - A 13-year-old boy, with no past medical history, was admitted after a car
      accident on October 29, 1989. On admission, he was alert. Physical examination
      revealed a bruise on the left frontal region, a fracture of right clavicula and
      right hemopneumothorax. He was treated with respirator due to dyspnea. On
      November 1, 1989, he was removed from respirator and expressed diplopia.
      Neurological examination showed bilateral ptosis, mild anisocoria, normal light
      reflex and horizontal gaze nystagmus in lateral gaze. Both eyes were deviated
      outward slightly in the primary position and showed inability to converge. The
      external ocular movements of both eyes were mildly limited in elevation and
      adduction. Ataxia was observed in bilateral upper extremities. Deep reflexes were
      normal and no pathological reflexes were observed. Brain CT scans showed no
      abnormality. On November 6, 1989, his ptosis and diplopia improved. On November
      8, he was completely recovered. A magnetic resonance imaging on November 10
      revealed no abnormality. We suggested that transient dysfunction of midbrain
      associated with head injury might cause transient bilateral primary oculomotor
      nerve paresis, nystagmus and ataxia.

PMID- 2242638
TI  - [Brainstem ptosis (midbrain ptosis) associated with mesencephalic hemorrhage].
AB  - We reported a patient with a brainstem ptosis (midbrain ptosis) associated with
      mesencephalic hemorrhage. A 57-year-old woman had the sudden onset of bilateral
      blepharoptosis and diplopia. On admission, computed tomography of the brain and
      magnetic resonance imaging disclosed a small hematoma in the left tegmentum of
      midbrain. She had no past history of hypertension of head trauma. Cerebral
      angiography gave no additional informations. The lesion involving the central
      caudal subnucleus of IIIrd nerve nucleus may be responsible for the bilateral
      ptosis, since this finding is consistent with current models of oculomotor
      organization in monkeys (Warwick 1953).

PMID- 2242640
TI  - Stuttering.

PMID- 2242639
TI  - [Intramedullary spinal cord metastasis documented by MR imaging].
AB  - A 63-year-old woman with progressive paraparesis was found to have an
      intramedullary spinal cord metastasis from the primary rectal cancer. Myelography
      and post myelography CT showed an enlargement of the spinal cord at level of the
      sixth to seventh thoracic vertebra. MR imaging disclosed a localized mass in the
      spinal cord at the same level. T2-weighted images showed an oval high signal
      intensity area with central low intensity, and gadolinium-DTPA-enhanced T1
      weighted images demonstrated a ring enhancement. Histological examination of the
      spinal cord revealed an intramedullary spinal cord metastasis with intra-tumorous
      necrosis at T7 to T8 cord level.

PMID- 2242641
TI  - Clinical management of port-wine stain in infants and young children using the
      flashlamp-pulsed dye laser.
AB  - The flashlamp-pulsed dye laser (FLPDL) at 585 nm, a wavelength well absorbed by
      oxyhemoglobin, causes highly selective vascular injury. In addition, the 450
      microsecond pulse duration produced by this laser approximates the thermal
      relaxation time for dermal blood vessels thereby confining the energy to the
      target. This new laser effects excellent lightening of port-wine stain (PWS) in
      infants and young children without the adverse complications of hypertrophic
      scarring, permanent pigmentation abnormality, or textural changes, complications
      often seen with conventional laser systems. The FLPDL now permits treatment of
      this patient population expected to gain the most benefit from early laser
      therapy in a much safer manner, before the psychological complications of being a
      "marked" person develop. The purpose of this report is to: (1) describe the
      theoretical considerations behind achieving selective removal of PWS that can be
      understood and used by a nonsurgically-oriented practitioner; and (2) describe
      the practical application of the device used in the clinical management of
      infants and young children.

PMID- 2242643
TI  - Blood pressure in children as determined under office conditions.

PMID- 2242642
TI  - Neurologic complications in chronic renal failure: a retrospective study.
AB  - We have retrospectively examined 324 patients with chronic renal failure and
      evaluated the probable underlying causes of neurologic complications, laboratory
      data and therapeutic interventions. The common neurologic problems in our
      patients were alterations in consciousness (40.7%) and convulsions (35.1%). When
      BUN concentration was above 135 mg/dl and creatinine clearance was below 8
      m/min/1.73 m2, alteration of consciousness was observed and when BUN
      concentration was 200 mg/dl and creatinine clearance was below 7 m/min/1.73 m2,
      abnormal convulsives appeared. Changes in deep tendon reflexes and pathologic
      reflexes were associated with hypertension. All of the patients with cortical
      atrophy using computerized cranial tomography aluminum hydroxide at least for 18
      months, and six of them had hemodialysis. Fourteen patients who underwent
      dialysis developed convulsions and were thought to have disequilibrium syndrome.
      These findings are consistent with the suggestion that the metabolic and
      biochemical derangements associated with CRF may be particularly detrimental to
      the still developing CNS of the child.

PMID- 2242644
TI  - Aerococcus viridans infection. Case report and review.

PMID- 2242646
TI  - Hepatic Burkitt lymphoma. Presentation with extremely rapid growth.

PMID- 2242645
TI  - Urinary tract infection in the male caused by Staphylococcus epidermidis
      associated with diverticulum of the bladder.

PMID- 2242648
TI  - "The rushes." A migraine variant with hallucinations of time.

PMID- 2242647
TI  - Clinical Fitz-Hugh-Curtis syndrome in an adolescent. Ultrasonographic findings.

PMID- 2242649
TI  - Zoster-like eruption associated with herpes simplex virus infection in children.

PMID- 2242650
TI  - Toxicity from topical administration of diphenhydramine in children.

PMID- 2242651
TI  - Epidemiologic aspects of toilet training.

PMID- 2242652
TI  - Sinusitis.

PMID- 2242653
TI  - Diseases that mimic meningitis.

PMID- 2242654
TI  - Scientific perspectives from the Sixth International Conference on AIDS.

PMID- 2242655
TI  - Treatment of Kawasaki disease.
AB  - The epidemiology, etiology, diagnosis, and treatment of Kawasaki disease are
      reviewed. Kawasaki disease, or mucocutaneous lymph node syndrome, is an acute,
      usually self-limiting, multiple-organ-system disease of childhood that occurs
      both epidemically and endemically worldwide. The etiology of the disease is
      unknown but may involve an infectious agent. To be diagnosed, a patient must be
      febrile for at least five days and show four of five additional clinical
      features: bilateral conjunctivitis, changes in the oral mucosa, changes in the
      extremities, rash, and cervical lymphadenopathy. The most important complications
      are cardiac; patients may develop aneurysms or thrombosis of the coronary
      arteries or myocarditis. Other complications include arthritis, conjunctivitis,
      and hydrops of the gallbladder. Aspirin, intravenous immune globulin,
      corticosteroids, and antithrombotic agents have been investigated for use in the
      treatment of Kawasaki disease with varying results. Current recommendations
      suggest therapy with aspirin 80-100 mg/kg/day every six hours for the first 14
      days after diagnosis and intravenous immune globulin 400 mg/kg/day for the first
      four days. The dose of aspirin should then be reduced and continued for six to
      eight weeks if no coronary artery abnormalities are present. Treatment guidelines
      for Kawasaki disease are being refined. Current evidence supports early use of
      aspirin and intravenous immune globulin to prevent cardiac complications.

PMID- 2242656
TI  - Management of elevated intracranial pressure.
AB  - The pathophysiology, clinical manifestations, monitoring techniques, and
      management of elevated intracranial pressure (ICP) are reviewed. The use of
      barbiturate coma to treat ICP is discussed in detail. Elevated ICP can be
      associated with severe head injuries and diseases of the central nervous system
      such as brain tumors and stroke. Symptoms of elevated ICP may be difficult to
      distinguish from symptoms of other disease states. ICP monitoring techniques such
      as the intraventricular catheter and the Camino fiber optic system are useful for
      determination of ICP elevations before any changes in vital signs or neurological
      status occur. Conventional treatment and control of ICP elevations includes
      general and physiologic management (cerebrospinal fluid removal, fluid
      restriction, controlled hyperventilation, sedation, and elevating the patient's
      head) and pharmacologic management. Osmotic diuretics, (e.g., urea, mannitol,
      glycerol) and loop diuretics (e.g., furosemide, ethacrynic acid) are first-line
      pharmacologic agents used to lower elevated ICP. Corticosteroids may be
      beneficial in some patients. Patients with elevated ICP refractory to
      conventional treatment may benefit from therapy with high-dose barbiturates.
      Pentobarbital has been used in the majority of the clinical studies.
      Pentobarbital serum concentrations should be determined every 24-48 hours when a
      patient is in a barbiturate coma because pentobarbital clearance increases with
      continued high-dose therapy. The treatment of elevated ICP requires aggressive
      therapy and intensive monitoring. In patients whose ICP is refractory to
      conventional therapies alone, survival rates have been improved by combining high
      dose barbiturates with conventional therapies.

PMID- 2242657
TI  - Influence of chewable sucralfate or a standard meal on the bioavailability of
      naproxen.

PMID- 2242658
TI  - Comparison of serum aminoglycoside concentrations produced by two infusion
      methods.

PMID- 2242659
TI  - Anticonvulsant drug withdrawal in seizure-free patients.

PMID- 2242660
TI  - Using population-based serum drug concentration cutoff values to predict
      toxicity: test performance and limitations compared with Bayesian interpretation.
AB  - The use of population-based serum drug concentration cutoff values for several
      commonly monitored drugs as tests to distinguish toxicity from nontoxicity was
      studied. Serum drug concentration and response data published in studies of
      theophylline, digoxin, aminoglycosides, vancomycin, and procainamide were
      analyzed to determine the prevalence of toxicity in each group of patients. Serum
      drug concentration cutoff values were then varied, and the following performance
      characteristics of the cutoffs as tests for predicting toxicity were calculated
      for each value: sensitivity, specificity, likelihood ratio, predictive value, and
      ratio of net consequences. At commonly accepted cutoff values, sensitivity was
      lower than desirable, positive predictive values were less than negative values,
      and the ratio of net consequences indicated that false-negative errors are
      implicitly weighted as more risky than false-positive errors. As the cutoff for
      each drug was increased, specificity increased but sensitivity decreased,
      positive predictive values increased but negative predictive values decreased,
      and the ratio of net consequences increased. Therapeutic drug monitoring would
      improve if practitioners and laboratorians collaborated to (1) conduct
      prospective studies of the test performance characteristics of drug
      concentrations, (2) estimate the pretest probability of toxicity for each
      patient, (3) combine the pretest estimate with the test characteristics to make a
      posttest estimate, and (4) develop a more patient-specific, Bayesian approach.

PMID- 2242661
TI  - Criteria for use of ciprofloxacin for infections in adult patients.

PMID- 2242662
TI  - Monoclonal antibody therapy.

PMID- 2242664
TI  - Spectrum and multiplicity of infectious complications in patients with AIDS: a
      microbiological perspective.

PMID- 2242663
TI  - Deterring the progression of HIV infection.

PMID- 2242665
TI  - Evaluation and treatment of mental disorders in patients with AIDS.
AB  - Mental symptoms are common in patients with AIDS. Optimal management involves the
      identification and treatment of underlying mental disorders rather than
      symptomatic treatment alone. Organic mental disorders are very frequent in AIDS,
      particularly with seriously ill patients who are medical inpatients. There is a
      high priori probability that such common symptoms as agitation, irritability, and
      insomnia will be caused by an organic mental disorder. Psychopharmacology in the
      patient with AIDS requires considerable caution. Lower doses and careful
      surveillance for subtle neuropsychiatric side effects are necessary. Routine
      medical contact with a compassionate physician may be of inestimable value to the
      patient in coping with the fear and dread that surround the illness.

PMID- 2242666
TI  - Diagnosis and treatment of osteomyelitis.

PMID- 2242667
TI  - Prevention and treatment of viral hepatitis.

PMID- 2242668
TI  - Psychopathology in later life.

PMID- 2242669
TI  - Every man desires to live long; but no man would be old.

PMID- 2242670
TI  - Renal function and the care of the elderly.

PMID- 2242671
TI  - Alcoholism in the elderly.

PMID- 2242672
TI  - Age-related changes in postural sway.

PMID- 2242673
TI  - Hyperkalemia in the elderly.

PMID- 2242674
TI  - Management of hypertension in the elderly.

PMID- 2242675
TI  - Current understanding of osteoporosis.

PMID- 2242676
TI  - Laser-Doppler flowmetry.
AB  - Laser-Doppler flowmetry is a new method of the continuous and noninvasive
      measuring of the tissue blood flow, utilizing the Doppler shift of laser light as
      the information carrier. The method has already proved its potential usefulness
      in the clinical assessment of blood flow within disciplines such as dermatology,
      plastic surgery, and gastrointestinal surgery. In experimental medicine, laser
      Doppler flowmetry has been used in the study of spontaneous rhythmical variations
      as well as in the study of spatial and temporal fluctuations in human skin blood
      flow. The method has facilitated further investigations of the nature of blood
      flow in a variety of tissue types. The method is rapidly spreading to many new
      applications in microvascular blood flow measurements. Several commercial laser
      Doppler instruments are available. This review article is a presentation of the
      state of the art of laser-Doppler flowmetry including theory, technology, and
      applications.

PMID- 2242677
TI  - Applications of time-varying magnetic fields in medicine.

PMID- 2242678
TI  - Orthopoxvirus genetics.
AB  - Genetic analysis of orthopoxviruses has contributed substantially to our
      understanding of the functional organization of the poxvirus genome, and
      individual mutants provide invaluable tools for future studies of poxvirus
      biology. Deletion and transposition mutants, localized primarily in the termini
      of the genome, may be particularly useful for studying virus host range and
      pathogenicity. Numerous drug resistant and dependent mutants provide keys to
      understanding a wide variety of virus genes. A large number of well-characterized
      ts mutants, clustered in the center of the virus genome, are taking on an
      increasingly important role in research on the function of essential poxvirus
      genes. Genetic characterization of orthopoxviruses has progressed rapidly during
      the past decade, and one can reasonably anticipate a time when mutants will be
      available for the study of any poxvirus gene. Considerable progress toward this
      goal can be achieved through organized attempts to integrate and further
      characterize existing mutant collections and through the continued isolation and
      characterization of deletion, drug resistant, and ts mutants using established
      techniques. The most exciting possibility is that soon techniques will be
      available for directed mutagenesis to conditional lethality of any essential
      poxvirus gene.

PMID- 2242679
TI  - Recombinant vaccinia viruses as vectors for studying T lymphocyte specificity and
      function.

PMID- 2242680
TI  - Posttranslational modification of vaccinia virus proteins.

PMID- 2242681
TI  - Regulation of orthopoxvirus gene expression.

PMID- 2242682
TI  - The role of telomeres in poxvirus DNA replication.

PMID- 2242683
TI  - The enzymology of poxvirus DNA replication.

PMID- 2242685
TI  - Choledochoscopy in management of retained biliary stones and recurrent lesions.
AB  - Postoperative choledochofiberscopy was performed in 188 patients with retained
      biliary stones and recurrent lesions. The following entrances to the biliary
      tract for choledochoscopy were used: the T-tube tract (129 patients), an afferent
      jejunal limb of a choledochojejunostomy (43), the jejunostomy tube tract of an
      efferent limb (12), an U-tube tract (2), and a ductal fistula after segmental
      liver resection (2). 380 choledochoscopic sessions were carried out, 2 sessions
      on the average for each patient. The overall success rate of stone removal was
      90.5%. No mortality was related to this procedure. Eleven patients developed
      fever and chills after manipulations but all responded to antibiotics. Two
      patients had perforation of the T-tube tract during the removal of stones and
      were reoperated on for abdominal drainage. They recovered eventually. Stone
      extraction with a flexible choledochoscope is a proven procedure. For residual
      intrahepatic stones, however, a satisfactory entrance into the biliary tree
      should be provided for subsequent stone removals. We believe that the jejunostomy
      tube tract of an efferent limb of an afferent jejunal limb of a
      choledochojejunostomy is a useful entrance for choledochoscopy because it is
      permanent in meeting therapeutic demands.

PMID- 2242684
TI  - HDV (delta factor) infection complicated with subacute fulminant hepatitis B. A
      morphological and immunohistochemical observation.
AB  - In 75 patients with subacute fulminant hepatitis B (SAFH), HDAg positive liver
      cells were observed in 14 cases (18.67%) by direct enzyme labelled method. It was
      found further that HDV (delta factor) infection was an important cause in
      producing massive necrosis of liver cells and superinfection of HDV with
      hepatitis B was identified as one of the causes of SAFH. This experiment also
      showed that the number of HDAg positive cells was in direct proportion to the
      area of liver necrosis. No obvious lymphocytic infiltrations and cytotoxic
      phenomena around the necrotic foci and HDAg positive cells could be found, while
      the cytoplasmic type HDAg positive cells showed distinct degeneration or even
      atrophy. Hence it was suggested that HDV could be a direct pathogenesis. No
      obvious characteristic changes in morphology of HDV infection could be found.

PMID- 2242686
TI  - [Reperfusion induced arrhythmias].

PMID- 2242687
TI  - [Diagnostic changes in serum creatine kinase MM isoenzyme sub-bands after the
      onset of acute myocardial infarction].
AB  - The authors quantified the change of CK-MM isoforms in the first available serum
      sample from 16 patients each with acute myocardial infarction (AMI) and angina
      pectoris and 16 normal individuals as well. The average MM3/MM1 ratio in the
      normal group was 0.24 +/- 0.12, in angina group 0.21 +/- 0.13, and in AMI group
      0.52 +/- 0.30 (P less than 0.001, as compare with the first two groups). The
      first blood sample of AMI was obtained in 3.0 +/- 1.9 hours after the onset of
      chest pain. Half of them (8/16) had a ratio of MM3/MM1 greater than 0.50 and the
      change occurred as early as 30 min after the attack. In contrast, the total CK
      and CK-MB in the three groups were within normal limits at the same time, they
      were 85.8 +/- 24.4 U/L for CK and 3.2 +/- 1.1% for CK-MB in patients with AMI,
      66.7 +/- 18.0 U/L, 2.7 +/- 1.6% in angina pectoris and 71.4 +/- 24.5 U/L, 3.0 +/-
      1.1% in normal subjects respectively. Accordingly, diagnostic change of CK-MM
      isoforms was the earliest among the enzymes after the onset of AMI.

PMID- 2242688
TI  - [Semi-quantitative estimation of serum myoglobin with rapid reverse passive latex
      agglutination (RPLA) test and its application in the early diagnosis of acute
      myocardial infarction].
AB  - By using monoclonal anti-myoglobin antibodies to sensitize new immunospheres,
      serum myoglobin (SMb) was semi-quantitatively estimated with a rapid reverse
      passive latex agglutination (RPLA) test. Its clinical value in the early
      diagnosis of acute myocardial infarction (AMI) has been evaluated in 56 patients
      with AMI, 7 of them being observed serially. There are 92 serum specimens of AMI,
      of which 19 were within 12 hours after the onset of symptoms. Meanwhile, serum
      specimens of 72 non-AMI patients were observed with the same method. All the
      specimens above were also quantitated with radioimmunoassay (RIA) and the results
      were compared with those of RPLA. RPLA test was negative in the specimens below
      100 ng/ml (81 specimens) and positive in those above 110 ng/ml (73 specimens).
      For specimens from 100 to 110 ng/ml, RPLA test could be either positive (9/10) or
      negative (1/10). This study confirms that RPLA test is a very sensitive indicator
      for acute myocardial infarction. It can yield a reliable semi-quantitative
      estimation of SMb within a few minutes. Because of its simplicity, rapidity and
      practicability. RPLA test is especially convenient for use in emergency room.

PMID- 2242689
TI  - [Percutaneous balloon exploration and plug closure of arterial duct].
AB  - Percutaneous plug closure of arterial duct (AD) was performed on 38 patients,
      with ages ranging from 6 to 54 years. The inside diameter of AD varied from 3.7
      to 11.6 mm and the shunt size of AD was 8-77% of the pulmonary flow. A combined
      technique was used in the closure operation, which employs a balloon catheter to
      explore the size of AD as well as its distensibility and a catheter scale to
      examine the compatibility of the foam plug with the AD to be closed. Total
      occlusion was achieved in all the 38 cases, the success rate being 100%.
      Immediately after the procedure, blood oxygen analysis showed an interruption of
      the left-to-right shunt and the pulmonary artery pressure decreased from 4.71 +/-
      0.80 to 3.34 +/- 0.53 kPa (P less than 0.001). Four to 7 days later, the
      cardiothoracic ratio reduced from 52.8 +/- 4.6 to 49.7 +/- 4.2% (P less than
      0.001) and the cardiac index decreased from 6.00 +/- 1.31 to 4.46 +/- 0.80
      L/min.m-2 (P less than 0.001). Random color Doppler flow imaging suggested no
      residual shunts. No major complications were observed in any of the cases and
      follow-up observations in 1 to 24 months showed no plug displacement or
      recanalization. IN CONCLUSION: the balloon exploration is able to make certain of
      the "occlusion diameter" of AD and the scale examination can surely sort out the
      plug most compatible with the AD to be closed, so that success of every step for
      the closure is ensured.

PMID- 2242690
TI  - [Diagnostic evaluation of frequency domain correlative cardiography in patients
      with coronary heart disease].
AB  - Frequency-domain correlative cardiography (FCG) is a new non-invasive technique
      for diagnosing heart disease. FCG was performed in 110 patients who also
      underwent coronary cineangiography. 12-lead ECG and treadmill exercise testing to
      determine its diagnostic role in coronary heart disease (CHD). In the group with
      CHD 61 had true-positive and 8 false-negative FCG results, while in the group
      without CHD 30 were true-negative and 11 false-positive. Its sensitivity is
      88.4%, specificity 73.2%, correct diagnostic rate 84.3% and predictive value
      84.7%. The diagnostic efficacy of FCG is better than those of 12-lead ECG and
      treadmill exercise test. These results indicate that FCG is a valuable
      noninvasive method for detecting patients with CHD.

PMID- 2242691
TI  - [Estimation of systolic pulmonary artery pressure with continuous wave Doppler
      pressure gradient method: a simultaneous Doppler and catheter correlative study].
AB  - To estimate more precisely the systolic pulmonary artery pressure (PASP),
      continuous wave Doppler pressure gradient method and catheter measurement were
      performed simultaneously in 85 patients. There were 30 patients with tricuspid
      regurgitation (TR), 35 with ventricular septal defect (VSD), and 20 with patent
      ductus arterosus (PDA). For maximal transtricuspid pressure gradient (TRPG)
      determined by continuous wave Doppler and catheter determined PASP in TR group,
      the correlation coefficient (r) was as high as 0.99. For Doppler determined PASP
      (subtracting pressure gradient across PDA from systemic arterial pressure
      measured by cuff sphygmomanometer) and catheter determined PASP in PDA group, r
      was 0.95. Doppler determined PASP in VSD group (subtracting pressure gradient
      across VSD from systemic arterial pressure) also correlated well with catheter
      determined PASP (r = 0.97). This study demonstrates that continuous wave Doppler
      pressure gradient method can accurately estimate PASP in patients with TR, PDA,
      and VSD.

PMID- 2242692
TI  - [Protective effect of colloidal bismuth subcitrate on gastric mucosal lesion
      induced by aspirin].
AB  - This study was designed to investigate the protective effect of colloidal bismuth
      subcitrate (CBS) on aspirin-induced gastric mucosal lesion 20 patients with
      arthralgia were allocated into this study. All of them were free of
      gastrointestinal symptom and their gastric mucosa were nearly normal under
      gastroendoscopic observation. The first group of 10 patients received orally
      aspirin 1.5 qid for 4 days. The second group also of 10 patients was treated with
      CBS 120 mg qid and after 2 days they received aspirin and CBS simultaneously in
      the dosage mentioned above for another 4 days. Before and after treatment, the
      patients of both groups were examined endoscopically. After treatment, the
      mucosal inflammation was much less in the second group than that in the first
      group. The prostaglandin E2 concentration of antral mucosa in the first group was
      reduced significantly after administration of aspirin alone, while that in the
      second group was slightly increased after a combined treatment of aspirin and
      CBS. The results demonstrate that CBS is an effective agent in prevention of
      gastric lesion induced by aspirin and prostaglandin E may be involved in this
      mucosal protective effect.

PMID- 2242693
TI  - [Study on urinary function and metabolism of water and electrolytes in primary
      hypothyroidism].
AB  - Water excretion in 16 patients with primary hypothyroidism was lower in amount
      and more delayed (P less than 0.05) than that in 5 normal controls after acute
      water ingestion. The mean plasma osmolality of the patients was lower than that
      of normal controls both before and after water loading. However, the mean urine
      osmolality was not decreased but rather elevated. The clearance of free water in
      the patients was lower than that in normal controls before loading, Although the
      clearance of osmolality in the patients was higher than that in the controls, the
      difference was insignificant. These two clearance rates were lower than those in
      the controls after loading. The fractional excretion of sodium (P less than 0.05)
      and chloride (P less than 0.01) in the patients was significantly higher than
      that in the controls before loading and both of them remained elevated after
      loading. Most of the parameters mentioned above improved in 9 patients after
      treatment with desiccated thyroid.

PMID- 2242694
TI  - A combined electromyographic and cineradiologic investigation in patients with
      defecation disorders.
AB  - Records from 20 patients on whom defecography and electromyography were performed
      simultaneously because of defecation disorders were analyzed. According to the
      electromyographic investigation, the patients could be divided into three main
      groups: 1) normal sphincter reaction; 2) paradoxical sphincter reaction; and 3)
      combined reaction. Group A was characterized by a marked reduction of muscular
      activity during emptying and a pronounced closing reflex after emptying. This was
      followed by return of normal tonic activity. Patients in group B had no
      relaxation of the sphincters during emptying but a pronounced increased activity
      in the external sphincter and the puborectalis muscle. They also had severe
      emptying difficulties at defecography. No closing reflex was seen. In group C the
      electrical activity in the sphincters increased during moderate straining and
      when emptying was complete a clear closing reflex was seen. In this study, a
      dynamic visualization of the defecation together with a registration of
      electromyographic activity in the striated anal sphincters was performed. It was
      shown that patients with paradoxical sphincter reaction were lacking a closing
      reflex after emptying was complete. This has not been reported previously and is
      important evidence for the paradoxical defecation pattern. It was also shown that
      the patients with rectoceles had paradoxical sphincter reaction.

PMID- 2242695
TI  - Perianal abscess and fistula-in-ano in children.
AB  - The authors present a retrospective review of 40 pediatric patients with perianal
      abscess and/or fistula-in-ano. The total patient population could be divided
      clinically into 2 broad groups. The first group consisted of 22 infants younger
      than 2 years of age, all of whom were males, and 10 of whom presented with
      recurrences after previous incision and drainage. Of the 14 infants presenting
      with an abscess, in 12 (85.7 percent), a fistula-in-ano was discovered at
      surgery. In contrast, in the group of 18 children older than 2 years of age,
      there were 7 females and 11 males, and fistulas were identified in only 7 of 13
      patients (54.8 percent) who presented with abscesses. Surgical treatment
      consisted of examination under anesthesia and a diligent search for a fistulous
      tract. Abscesses were primarily saucerized and fistulotomy and cryptotomy of the
      confluent crypt was performed if a fistulous tract was identified. The only
      recurrences with this form of treatment occurred in the two immunocompromised
      patients.

PMID- 2242696
TI  - Erythrocyte stearic acid desaturation in patients with colorectal carcinoma.
AB  - The erythrocyte stearic:oleic acid ratio (saturation index) was investigated as a
      means of differentiating between control subjects (n = 146) and patients with
      benign (n = 48) and malignant (n = 117) colorectal disease and patients
      undergoing postoperative follow-up after curative resection (n = 49). Erythrocyte
      fatty acid profiles were determined by gas liquid chromatography. Neither age,
      sex, Dukes' stage, nor degree of differentiation of the tumors had a significant
      effect on the erythrocyte saturation index. The erythrocyte saturation index was
      lower in patients with primary and recurrent colorectal cancer compared with
      control subjects and patients with inflammatory bowel disease or benign colonic
      polyps (P less than 0.0001). The erythrocyte saturation index was not found to be
      useful in the postoperative follow-up of these patients. Using both saturation
      index and age as a means of differentiating between patients with primary
      colorectal cancer and control subjects gave a sensitivity of 67 percent and a
      specificity of 81 percent.

PMID- 2242697
TI  - Colostomy irrigation in the elderly. Effective recovery regardless of age.
AB  - One hundred forty elderly cancer outpatients with colostomy in the authors'
      rehabilitation department were included in an analysis of the feasibility,
      effectiveness, and safety of periodic irrigation of remaining colon with lukewarm
      tap water with the aim of regaining full continence. Sixteen patients did not
      have a sufficiently long remaining bowel (cecostomy, transverse colostomy) and 17
      were considered unsuitable to learn the technique because of advanced neoplastic
      disease with poor life expectancy, intercurrent disease, or stomal problems. One
      hundred seven patients were proposed to perform the irrigation: 17 refused to do
      so with the remaining 90 able to learn the method without problems. Nearly all
      patients achieved full continence for at least 24 hours. Three patients refused
      to continue, and nine interrupted for minor complications. The median duration of
      irrigation in the whole group is 257 days (range, 1 to 2669 days): 32 patients
      have been irrigating from one to five years, and 9 patients for more than 5
      years. Based on these results, we recommend irrigation as standard rehabilitative
      treatment for elderly patients.

PMID- 2242698
TI  - Nitrite from inflammatory cells--a cancer risk factor in ulcerative colitis?
AB  - Elevated levels of luminal nitrite and a lowered luminal pH were found in 77
      percent of patients with acute ulcerative colitis. No luminal nitrite was found
      in healthy control subjects. Nitrites are a secretory product of activated
      macrophages and neutrophils of the lamina propria, whereas the lowered luminal pH
      is due to diminished bicarbonate formation by impaired colonocytes. A hypothesis
      is put forward that nitrites, lowered pH, and bacterial amines are conducive to
      formation of carcinogenic n-nitroso compounds, which reflect a cancer risk in
      patients with ulcerative colitis dependent on the type and extent of inflammatory
      cell activation as well as metabolic impairment of colonic epithelial cells.

PMID- 2242699
TI  - Passage of a colon 'cast' after anoabdominal rectal resection. Report of a case.
AB  - The authors report a case of the passage of a total colonic J-pouch "cast" per
      anus after anoabdominal rectal resection and colonic J-pouch-anal anastomosis.
      This occurred without development of cuff abscess and was not due to occlusion of
      the inferior mesenteric artery. This was successfully treated, with preservation
      of anal function, with resection of the colonic J-pouch by transanal approach.

PMID- 2242700
TI  - Sexually transmitted diseases of the colon, rectum, and anus. The challenge of
      the nineties.
AB  - During the past two decades, an explosive growth in both the prevalence and types
      of sexually transmitted diseases has occurred. Up to 55 percent of homosexual men
      with anorectal complaints have gonorrhea; 80 percent of the patients with
      syphilis are homosexuals. Chlamydia is found in 15 percent of asymptomatic
      homosexual men, and up to one third of homosexuals have active anorectal herpes
      simplex virus. In addition, a host of parasites, bacterial, viral, and protozoan
      are all rampant in the homosexual population. Furthermore, the global epidemic of
      AIDS has produced a plethora of colorectal manifestations. Acute cytomegalovirus
      ileocolitis is the most common indication for emergency abdominal surgery in the
      homosexual AIDS population. Along with cryptosporidia and isospora, the patient
      may present to the colorectal surgeon with bloody diarrhea and weight loss before
      the diagnosis of human immunodeficiency virus (HIV) disease. Other patients may
      present with colorectal Kaposi's sarcoma or anorectal lymphoma, and consequently
      will be found to have seropositivity for HIV. However, in addition to these
      protean manifestations, one third of patients with AIDS consult the colorectal
      surgeon with either condylomata acuminata, anorectal sepsis, or proctitis before
      the diagnosis of HIV disease. Although aggressive anorectal surgery is associated
      with reasonable surgical results in some asymptomatic HIV positive patients, the
      same procedures in AIDS (symptomatic HIV positive) patients will often be met
      with disastrous results. It is incumbent upon the surgeon, therefore, to
      recognize the manifestations of HIV disease and diagnose these conditions
      accordingly.

PMID- 2242701
TI  - Use of new retractor to facilitate mucosal proctectomy.

PMID- 2242702
TI  - Dilatation of radiation-induced sigmoid stricture using sequential Savary
      Guilliard dilators. A combined radiologic-endoscopic approach.

PMID- 2242703
TI  - Transitional mucosa.

PMID- 2242704
TI  - Colonoscopic screening.

PMID- 2242705
TI  - Renal response to furosemide in very low birth weight infants during chronic
      administration.
AB  - Renal response to furosemide following initial and chronic doses was investigated
      in premature infants with bronchopulmonary dysplasia. Seven infants (mean birth
      weight = 890 +/- 216 g, mean gestational age at birth = 27.7 +/- 2.6 weeks, mean
      postnatal age at the start of diuretic therapy = 2.7 +/- 0.9 weeks) were studied.
      Twelve-hour urine collections were performed after the initial dose, and
      following chronic doses after 1 week and 3 weeks of therapy. Volume of each urine
      sample was measured and concentrations of furosemide, sodium and creatinine
      determined. Linear dose-response relationships were found between the logarithm
      of the urinary furosemide excretion rate and diuretic/natriuretic response (urine
      output and urinary sodium excretion rate). The furosemide excretion rate required
      to achieve midrange diuretic and natriuretic responses was significantly greater
      during chronic dosing than following initial doses, indicating a decrease in
      renal responsiveness to drug with sustained use. Increasing postconceptional age
      was associated with a decrease in initial responsiveness to furosemide. These
      data demonstrate that in premature infants renal sensitivity to furosemide
      decreases with chronic use as well as with increasing postconceptional age at the
      start of therapy. The decrease in renal sensitivity to drug with chronic use is
      of much greater magnitude, and appears to represent renal compensation for drug
      induced diuresis and natriuresis.

PMID- 2242706
TI  - Thiopental efficacy in phenobarbital-resistant neonatal seizures.
AB  - The successful treatment with thiopental (10 mg/kg, i.v.) of 9 severely
      asphyxiated newborns, under artificial ventilation, with neonatal seizures
      resistant to phenobarbital, is reported in this pilot study. The clinical and
      electroencephalogram control of seizures was prompt and resolute. No adverse
      effect on cardiovascular function (heart rate, blood pressure) was observed. The
      terminal half-life of thiopental averaged 9 h, the total plasma clearance 0.20
      l/h/kg, and the steady-state volume of distribution 3.6 l/h/kg. The kinetic
      profile of the drug compared to phenobarbital and phenytoin in newborns suggests
      that its action is quicker and shorter lasting. Thus, from these findings,
      thiopental may offer a useful and handy approach for the safe and effective
      treatment of phenobarbital-resistant neonatal seizures.

PMID- 2242707
TI  - Effect of clonazepam on brain development of mice.
AB  - Twenty-seven Kun-Ming white mice were divided randomly into three groups of 9
      animals. One of these groups served as a control group. Clonazepam (CZP), 0.1 or
      0.5 mg/kg/day, was administered by oral gavage for 22 days. The water-maze test
      was performed before giving CZP and 10 and 22 days later. The step-down test was
      performed on the 1st and the 2nd day after discontinuing CZP treatment to
      determine toxic effects on brain development and learning-memory function. Body
      weights and brain weight were also recorded. Brain development and learning
      memory function, evaluated by water-maze and step-down tests, were not impaired
      by CZP. Although there was a trend toward lower weights in the higher-dose group,
      CZP treatment did not significantly affect either body weight or total or
      regional brain weight. The results of this study indicate that 4 weeks of
      treatment with CZP does not impair brain development and learning-memory function
      in baby mice.

PMID- 2242708
TI  - Increasing extracellular calcium concentration does not prevent hypotensive
      effects of verapamil in neonatal swine.
AB  - Effects of CaCl2 on cardiac function and regional circulatory responses to
      verapamil (V) infusion were studied in pentobarbital-anesthetized 2-week-old
      swine. V 100 micrograms/kg (n = 15) or 300 micrograms/kg (n = 15), given as a 2
      min intravenous infusion, was repeated after 30 min. Only V was given to 15 of
      these. The other 15 were given CaCl2 (15 mg/kg) over 2 min, pre-V (protocol A),
      and over 4 min, 2 min pre-V and during V (protocol B). Positive chronotropic and
      negative inotropic responses to V were attenuated by CaCl2; hypotensive effects
      were unaltered. Renal, but not mesenteric and femoral, vasodilation was augmented
      by CaCl2, CaCl2 alone produced marked positive inotropic and renal vasodilatory
      effects which contributed to maintenance of the hypotensive effect of V.

PMID- 2242709
TI  - Effects of prolonged fetal hyperinsulinemia on plasma catecholamines, circulation
      and oxygen metabolism in utero.
AB  - The effects of pharmacologic hyperinsulinemia on changes in plasma
      catecholamines, circulation and oxygen metabolism were examined in fetal sheep.
      Sequential incremental doses of 0.2 and 0.4 U.kg-1.h-1 of porcine insulin were
      infused into fetal sheep for 24 h each, for a total of 48 h; pharmacologic fetal
      insulin concentrations were achieved. Fetal hyperinsulinemia resulted in fetal
      hypoxemia on the basis of reduced umbilical venous oxygen content. Fetal oxygen
      extraction increased and oxygen uptake did not change. Prolonged fetal
      hyperinsulinemia with hypoxemia was also associated with hypoglycemia and a surge
      in fetal plasma catecholamine concentration. Heart rate and fetal body blood flow
      also increased. This increased blood flow to the fetal body resulted from
      increased blood flow to vital organs, including heart and adrenal glands, and
      insulin-sensitive tissues, including gastrointestinal tract and carcass, without
      reductions in blood flow to other fetal organs. These changes in regional
      vascular perfusion maintained oxygen delivery to individual fetal organs similar
      to values before insulin infusion. We conclude that the ovine fetus has a
      remarkable ability to compensate for pharmacologic hyperinsulinemia of 48 h
      duration, which resulted in hypoxemia, hypoglycemia, and a surge in plasma
      catecholamine concentration, and that appropriate fetal adaptations maintained
      fetal oxygen consumption and regional oxygen delivery to individual fetal organs.

PMID- 2242710
TI  - Prolonged infusion of atracurium in an infant.
AB  - Atracurium is a neuromuscular blocking agent that spontaneously degrades by
      Hoffmann reaction. This study of a prolonged infusion (7 days) in an infant of 6
      months shows an increase in infusion rate requirement from 0.7 mg/kg/h after 96 h
      of infusion to 1.8 mg/kg/h at the 7th day. The plasma laudanosine levels remained
      relatively constant (977-1,515 ng/ml) and well below the reported potent
      convulsive levels during the study despite a 3-fold increase in the atracurium
      requirement. No side effect or accumulation of the drug was observed. The reasons
      for the increase in atracurium requirement are discussed.

PMID- 2242711
TI  - Cerebrospinal fluid and plasma beta-endorphin-like immunoreactivity in full-term
      neonates and in preterm neonates with and without apnea of prematurity.
AB  - Beta-endorphin-like immunoreactivity (B-ELI) was measured in cerebrospinal fluid
      (CSF) and plasma from infants of postnatal age 24 h to 70 days. Three groups were
      examined: 17 were of postconceptual age greater than or equal to 37 weeks, 16
      were postconceptual age less than or equal to 35 weeks without apnea and 10 were
      of postconceptual age less than or equal to 35 weeks with apnea. All infants were
      clinically stable. Two-way analysis of variance between groups showed no
      difference in the concentration of B-ELI in CSF or plasma, or in the CSF/plasma B
      ELI ratio. Concentrations of B-ELI in plasma were significantly higher in infants
      of postnatal age 1-3 weeks and greater than or equal to 4 weeks, than in infants
      of postnatal age less than 1 week. We conclude that, in nonstressed infants,
      there is no relationship between the concentration of B-ELI in CSF or plasma and
      a concurrent diagnosis of apnea of prematurity. Our data indicate that a
      significant developmental increase occurs in the plasma concentration of B-ELI
      after the first week of life.

PMID- 2242712
TI  - Desipramine effects on cocaine self-administration by rhesus monkeys.
AB  - The effects of desipramine treatment (0.56-10.0 mg/kg per day) on cocaine self
      administration were compared to saline treatment in five rhesus monkeys. Cocaine
      (0.050 or 0.100 mg/kg per inj) and food (1 g banana pellets) self-administration
      were maintained on an FR 4 (VR 16:S) reinforcement schedule. Desipramine (or an
      equal volume saline control solution) was infused over 1 h each day through the
      second lumen of an intravenous catheter. After 5 days of baseline saline
      treatment, seven doses of desipramine each were administered for 5 days in an
      ascending order. Cocaine self-administration increased (P less than 0.01) or
      remained equivalent to base-line levels in 4 of 5 subjects during the first 15
      days of desipramine treatment (0.56 to 1.78 mg/kg per day). Three monkeys
      continued to self-administer cocaine equivalent to or significantly above base
      line levels (P less than 0.01) during days 16-30 of desipramine treatment (3.2
      7.86 mg/kg per day). The highest desipramine dose (10 mg/kg per day)
      significantly suppressed cocaine self-administration in only one of these three
      monkeys (P less than 0.01). Desipramine treatment (3.2-10.0 mg/kg per day)
      suppressed cocaine self-administration (P less than 0.01) without a concomitant
      suppression of food-maintained responding in one of five subjects. A generalized
      suppression of both cocaine and food-maintained responding (P less than 0.01)
      during desipramine treatment occurred in one monkey that took the highest base
      line levels of cocaine (6.3 +/- 1.03 mg/kg per day). Food-maintained responding
      remained equivalent to or significantly above (P less than 0.01) base-line levels
      in four of five monkeys during desipramine treatment. A transient decrease in
      food self-administration at desipramine doses of 1.78-5.62 mg/kg per day occurred
      in one monkey (P less than 0.01). Thirty days of desipramine treatment at the
      highest doses (5.62, 7.86 and 10.0 mg/kg per day for 10 days each) also did not
      suppress cocaine self-administration in a monkey that took an average of 4 mg/kg
      per day of cocaine during saline base-line treatment. These primate data are
      concordant with the extant clinical literature on the inconsistent effects of
      desipramine treatment; i.e., both stimulation of cocaine use and inconsistent or
      incomplete attenuation of cocaine abuse during desipramine maintenance have been
      reported.

PMID- 2242713
TI  - Risk characteristics associated with chronic unemployment in methadone clients.
AB  - Relatively few methadone programs emphasize vocational skills training in their
      service delivery protocols. As a result, this study was conducted to determine
      the contribution of background demographic, vocational and clinical
      characteristics in differentiating chronically unemployed methadone clients from
      those regularly or intermittently employed over a 3-year period of time. Three
      hundred eighty heroin addicts, from five urban methadone treatment programs,
      participated in the study. Using the multiple logistic regression approach, nine
      variables were found to be significantly related to unemployment risk.

PMID- 2242714
TI  - Intravenous self-administration of 4-methylaminorex in primates.
AB  - The reinforcing effects of (+/-)-cis-2-Amino-4-methyl-5-phenyl-2-oxazoline (4
      methylaminorex) were determined in two models of intravenous drug self
      administration in primates. In baboons, lever pressing was maintained under a
      fixed-ratio (FR) 80- or 160-schedule of intravenous cocaine delivery (0.32 mg/kg
      per injection). Each drug injection was followed by a 3-h time-out allowing a
      maximum of 8 injections per day. Vehicle or 4-methylaminorex doses were
      substituted for cocaine for a period of 15 or more days. One of the two 4
      methylaminorex doses evaluated (0.32 mg/kg per injection) maintained self
      administration behavior above vehicle control levels in all four animals. This
      dose of 4-methylaminorex maintained cyclic patterns of self-injection behavior
      across days and produced signs of psychomotor stimulant toxicity. In rhesus
      monkeys, 4-methylaminorex (0.0003-0.1 mg/kg per injection) was made available to
      animals trained to self-administer cocaine (0.01 or 0.033 mg/kg per injection)
      under an FR 10 schedule of reinforcement during daily 1-h sessions. Each of the
      three monkeys self-administered at least two doses of 4-methylaminorex at rates
      exceeding those maintained by vehicle injections. Taken together with reports of
      recreational abuse of 4-methylaminorex, the present results indicate that this
      drug has a potential for abuse similar to that of other psychomotor stimulants.

PMID- 2242715
TI  - Demonstration of naturalistic methods for cocaine smoking by human volunteers.
AB  - Five, healthy, adult, male research volunteers participated in up to four daily
      laboratory sessions while residing on a Clinical Research Unit. Two subjects were
      tested twice. Fifty milligrams of cocaine base was smoked one, two or four times
      each session with a 14-min interval between doses. Two subjects smoked cocaine
      placed in 'smoke-free' cigarettes, while the remaining subjects smoked cocaine
      placed in a modified tobacco pipe. Significant and biologically relevant cocaine
      venous blood levels were engendered most consistently using the modified tobacco
      pipe. Large, transient increases in heart rate, blood pressure and self-reported
      'stimulated' scores were observed during single dosing sessions. During multiple
      dose sessions, cardiovascular activity either increased, returning to near
      baseline levels between doses, or were sustained, while reported 'stimulated'
      scores peaked after the first dose and were lower following subsequent doses.
      Both cardiovascular and subjective effects were greater on the ascending limb
      than on the descending limb of the cocaine blood level curve suggesting acute
      tolerance. Although preliminary, these results demonstrate the usefulness of this
      relatively simple procedure requiring subjects to smoke in the manner they are
      accustomed, and suggest the importance of further research in this area.

PMID- 2242716
TI  - The use of flavor in cigarette substitutes.
AB  - Cigarette smokers identify flavor as an important factor in the pleasure derived
      from smoking and for their choice of cigarette brand. The issue of cigarette
      flavor has received a great deal of study by cigarette manufacturers but
      relatively little by academic investigators. The paucity of literature is
      particularly acute in terms of the importance of flavor in cigarette substitutes,
      which are used to help people to reduce or quit smoking. In the current study,
      five different types of flavors added to a plastic cigarette substitute were
      assessed in experienced smokers. There were two menthol-like flavors and three
      tobacco-like flavors. Two groups of smokers were tested: menthol smokers and
      "regular" (non-menthol) smokers. Both types of smokers liked the two menthol
      flavors significantly more than placebo and rated the menthol flavors and the
      cigarette flavor as significantly more satisfying than placebo. Craving was
      differentially reduced in the two groups of smokers. Menthol smokers showed a
      small reduction in craving with the placebo, with a significant enhancement of
      this reduction seen with the addition of the "EZ Quit" menthol flavor.

PMID- 2242717
TI  - Apolipoprotein distribution in plasma HDL subfractions in alcohol consumers.
AB  - Alcohol intake is known to increase plasma HDL subfractions and apo A levels. Few
      data are available, however, with regard to precise apoprotein composition of
      plasma lipoproteins in alcohol consumers. The aim of the present study was to
      examine the lipid and apoprotein distribution in plasma lipoproteins of subjects
      with different levels of alcohol intake. Thirty-six male regular drinkers were
      classified as social (n = 10, average daily consumption greater than or equal to
      5 and less than or equal to 20 g), moderate (n = 11, average daily consumption
      greater than 20 g and less than 70 g) and heavy drinkers (n = 15, average daily
      consumption greater than or equal to 70 g). Reference data were obtained from 11
      subjects, all lifelong abstainers. Lipoproteins were fractioned by sequential
      ultracentrifugation and apolipoprotein distribution in VLDL, HDL-2 and HDL-3 was
      determined by isoelectrofocusing in polyacrylamide-urea gel. HDL-2 cholesterol
      was significantly higher in heavy drinkers (P less than 0.005). A parallel trend
      for HDL-3 cholesterol was observed. In alcohol consumers HDL-2 particles were
      enriched in apos C, in particular apo C-II (P 0.005), displacing apo A-I. These
      data suggest that apolipoprotein distribution in the HDL-2 subfraction is
      influenced by alcohol intake even at the lowest level.

PMID- 2242718
TI  - Liver function tests in non-parenteral cocaine users.
AB  - To investigate the effect of cocaine on standard liver function tests (LFT), we
      studied 46 cocaine users with no history of parenteral drug use or homosexuality.
      LFT were similar in 21 users of cocaine only (Group A) and 25 users of cocaine
      and alcohol (Group B). Only three patients, two of whom were hepatitis B
      carriers, had an alanine aminotransferase level more than five units above normal
      limits. Group B patients were significantly more likely to complain of headaches,
      irritability, and loss of memory. We conclude that (1) non-parenteral cocaine use
      is rarely associated with significant LFT abnormalities and (2) alcohol may
      potentiate some adverse effects of cocaine.

PMID- 2242719
TI  - Using a drinking motivation scale to predict degrees of problematic drinking.
AB  - Much of the recent interest in the role of cognitive factors in decisions to
      drink has focused on alcohol beliefs and drinking motivations. In this study,
      male alcoholics in treatment, untreated problem drinkers and non-problem drinkers
      were studied using a variation of the Mulford and Miller Definitions of Alcohol
      Scale, which assesses personal-deficiency and social/celebratory reasons for
      drinking. The three groups of drinkers differed significantly on their mean level
      of endorsement of items comprising each drinking motivation subscale. The
      alcoholics scored highest on both personal-deficiency and social/celebratory
      reasons for drinking, followed by the problem drinkers and then non-problem
      drinkers. The problem drinkers and non-problem drinkers, relative to the
      alcoholics, rated their social/celebratory reasons for drinking stronger than
      their personal-deficiency reasons. A multiple discriminant analysis yielded a
      function which was moderately successful in classifying the alcoholics (70%
      correctly classified) and non-problem drinkers (67%). The problem drinkers were
      much more difficult to correctly classify (32% were classified as alcoholic, 49%
      as non-problem drinkers). The findings suggest that potentially important
      differences exist in drinkers' motivations to consume alcohol, motivations that
      vary as a function of problem drinking severity. These are results which might
      productively be used in assessment and treatment endeavors.

PMID- 2242720
TI  - "Experimenting" with drugs: a critical evaluation.
AB  - A group of adolescent drug "experimenters" as defined by the frequency of use (N
      = 496) were compared to non-users (N = 2417) and to "regular" users (N = 125) on
      a number of variables. These covered the patterns of use, attitudes to drug use,
      exposure to drugs and to drug use, and other behavioural correlates.
      Experimenting with drugs seems to indicate an unfavourable shift in adolescent
      behaviour. Experimenters were more likely to resemble regular users especially
      with respect to the behavioural correlates. In the light of the results observed,
      the various contexts in which the term "experimenting" is currently being used
      are examined with the conclusion that usage of the term remains to be ambiguous,
      over-inclusive, unjustified, and should be abandoned.

PMID- 2242721
TI  - Effect of ethanol on hepatic iron, copper, zinc and manganese contents in the
      male albino mouse.
AB  - Liver Fe and Cu contents (determined by atomic absorption spectrophotometry) were
      found to be higher in alcoholized male albino mice than in controls. Alcoholized
      animals killed at the 180th day of life also showed higher liver Fe and Cu
      contents than the alcoholized animals sacrificed at the 85th day of life. A
      significant correlation was established between liver Fe content and size of the
      pericentral hepatocytes and their nuclei. No differences between alcoholic and
      controls were obtained regarding liver Zn content, whereas Mn showed a clear
      tendency to be higher in the alcoholics.

PMID- 2242722
TI  - Habituation of skin conductance response in a methadone population.
AB  - By measurement of the habituation to the skin conductance response (SCR) no
      reduction of activation could be observed between stable patients in methadone
      maintenance therapy and healthy normal subjects, but significant differences were
      obtained between the well-performing group and poly-drug users treated with
      methadone. The findings are discussed within the context of previous research on
      outcome of methadone maintenance. Measurement of habituation to SCR is a useful
      instrument for detecting polydrug addicts in methadone maintenance programmes.

PMID- 2242723
TI  - The use of tobacco products among Nigerian adults: a general population survey.
AB  - This study was designed to investigate the incidence of cigarette smoking,
      cigar/pipe tobacco and snuff use in the Nigerian population. In a sample of 1271
      adult heads of household (1137 males, 134 females) the overall prevalence of
      regular smoking was 22.6%. The proportions of regular cigar/pipe tobacco and
      snuff users were 17.9% and 9.6% respectively. Among cigarette smokers, 60.6%
      smoked at least half a pack a day, 11.2% at least one pack a day. Males smoked
      more than females. The poor, uneducated respondents smoked more than the
      relatively rich and educated. Smoking was more rampant in the third decade of
      life than in other age groups. Smokers had a higher incidence of health problems
      and both nonsmokers and heavy smokers were less aware of the risk of smoking than
      light smokers. In light of the above it is suggested that health education should
      be a major component of tobacco and health policy in Nigeria.

PMID- 2242724
TI  - Cultural differences in the perception of magazine alcohol advertisements by
      Israeli Jewish, Moslem, Druze and Christian high school students.
AB  - This article describes the Israeli part of an international comparative research
      project conducted simultaneously in 1988 also in Australia and in the U.S.A., in
      order to determine the attitudes of high school students from different nations
      and cultures toward alcohol advertising. The Israeli study used a set of 64
      magazine alcohol advertisements from 10 countries and with the help of an open
      ended questionnaire examined differences and similarities in the perception of
      Israeli and foreign advertisements by Jewish, Moslem, Druze and Christian
      teenagers. Each response was coded twice. The first code indicated the general
      tone of the response and the second code indicated its theme. The article
      presents selected general results and conclusions. The results have implications
      for designing alcohol abuse education messages and can aid alcohol advertisers
      interested in responsible advertising to find advertising standards suitable to
      each culture.

PMID- 2242725
TI  - The role of alcohol-related problematic events in treatment entry.
AB  - This is an analysis of alcohol-related problematic events experienced by alcohol
      treatment clients in the year before treatment and the reporting of these events
      as major reasons for treatment entry. A probability sample of new intakes (N =
      316) of the 8 contracted alcohol programs of a California county was interviewed.
      Data were collected on demographics, drinking patterns and a series of ten
      problematic events. Events (N = 982) are the unit of analysis. The analysis
      examines the events reported as major reasons for entering treatment. Logistic
      regression is used to investigate the socio-demographic and drinking variables
      associated with that reporting. Drinking driving, relapses and serious drinking
      episodes were reported as being major reasons for entering treatment a
      significant proportion of the times they occurred. Public drunkenness and non
      traffic accidents had significant proportions of individuals reporting them as
      not being major reasons for treatment when they occurred. Age, gender, ethnicity,
      marital status, employment and frequency of drunkenness were predictors of some
      types of events being major reasons, but there was no pattern across all events.
      The variables associated with experiencing an event were not the same as those
      which predicted the event would be reported a major reason for treatment.

PMID- 2242727
TI  - [The Automicrobic System (AMS)--a new test method for the classification and
      susceptibility testing of bovine mastitis streptococci].
AB  - In the period of January 1987 to March 1988 15,800 quarter milk samples from cows
      of Lower Austrian problem herds were collected and 744 streptococci strains
      isolated. These 744 isolates were identified by means of the AUTO-MICROBIC-SYSTEM
      (AMS). As comparative methods the test system API 20 STREP as well as the
      comparison with the agar-diffusion test. Due to AMS 360 (=48.4%) of the 744
      isolates examined could be identified as streptococci and referred to following
      species: 16 (=4.4%) Sc. agalactiae, 205 (=56.9%) Enterococci; 74 (=20.5%) Sc.
      uberis; 61 (=16.9%) Sc. of the viridans streptococci and 4 (=1.1%) Sc.
      pneumoniae. Both test systems AMS and API 20 STREP showed a coincidence of 91.6%.

PMID- 2242726
TI  - Target animal safety test of a dexamethasone-prednisolone combination in horses.
AB  - The target animal safety of a dexamethasone-prednisolone combination was studied
      on 12 horses divided into two groups of six each. One group of horses received
      the therapeutic dose of the combination (25 mg/animal dexamethasone pivalate and
      75 mg/animal prednisolone) and the second group was given the threefold dose of
      it. The preparation was administered intravenously for 2 consecutive days. For
      assessment of safety a wide range of clinical, haematological, biochemical and
      urine variables were tested as laid down in the guidelines of the FDA. All horses
      treated by the therapeutic or the threefold therapeutic doses of the preparation
      remained in good health throughout the entire study. No signs of clinical
      abnormalities occurred in either group. The physiological variables tested failed
      to reveal any significant alteration as a consequence of the medications. Of the
      haematological and biochemical parameters leucocyte, neutrophil, eosinophil and
      lymphocyte counts, aspartate aminotransferase activity, glucose, phosphor, total
      and conjugated bilirubin and creatinine concentrations were significantly
      affected in both groups. In some animals a transient glucosuria occurred. From
      the direction and magnitude of these changes it was concluded that they did not
      reflect any toxic actions of the preparation. Nevertheless, the combination is to
      be administered only with exact therapeutic indications and the uncontrolled
      misuse of it must be avoided.

PMID- 2242728
TI  - [The effect of selected output parameters on the flushing results of MOET
      (Multiple Ovulation and Embryo Transfer)].
AB  - Superovulation responses from 299 Hessian donors were used to analyse the
      influence of selected traits and ovulation-parameters. The effects of the age of
      life were similar to those of other authors. Fat yield (phenotypic) showed a
      small positive influence on the number of collected embryos. Genetic value of the
      sire had no effect and using sperm of one or two bulls made no difference. A
      prediction of an individual MOET-response by a selected parameter is not
      possible.

PMID- 2242729
TI  - [Fertility controls as the measure of herd fertility of dairy stock].
AB  - Hormonal analyses have been conducted along with intensive clinical following-up
      of the animals of three dairy herds in the area of Thessaloniki/Greece for a two
      year period. The data and progesterone profiles collected by means of milk
      progesterone assay (EIA) contribute considerably towards confirming and/or
      correcting clinical diagnoses. The clinical findings and the fertility parameters
      illustrate the considerable burden of fertility problems present in the dairy
      herds. The authors assume that faults in nutrition constitute the cause of silent
      heat and the problems derived from it. Faulty management is mainly associated
      with difficulties in oestrus diagnoses owing to disorders of fertility, failure
      to keep precise fertility data and the effects of inconsistent servicing of the
      cows on the part of the state inseminators.

PMID- 2242730
TI  - [The effect of monensin, tiamulin and the simultaneous administration of both
      substances on the microsomal mixed function oxidases and on the peroxide
      formation in broilers].
AB  - The influence of Monensin, Tiamulin and the simultaneous administration of the
      two substances on the microsomal, mixed function oxidases was studied on
      cockerels. Monensin was seen to cause a slight depression in the amount of
      cytochrome P-450 and cytochrome b5 as well as in the activities of aniline-p
      hydroxylase, p-nitrophenol-hydroxylase and p-nitroanisole-O-demethylase. Tiamulin
      induced a moderate increase in the amount of cytochrome P-450 and in the
      activities of aniline-p-hydroxylase, p-nitrophenol-hydroxylase and aminopyrine-N
      demethylase. The combined administration of monensin and tiamulin resulted in
      marked induction of the microsomal enzymes; the amount of cytochrome P-450
      reduced by metyrapone or carbon monoxide increased 2.5 or 2-times, respectively,
      and the activities of the tested microsomal hydroxylases and demethylases showed
      also an expressed increase. At the same time the formation of lipid peroxides
      also markedly increased and the GSH concentration was reduced. In conclusion, the
      results of the investigations indicate that the simultaneous application of
      monensin and tiamulin cause a marked induction of the drug-metabolizing
      microsomal enzymes and a significant increase in the lipid peroxide formation.

PMID- 2242731
TI  - [Morphologic changes in the intestine of swine after infection with verotoxin
      producing Escherichia coli].
AB  - Spontaneous morphologic lesions are described in 12 of 66 pigs submitted for
      necropsy. All 12 pigs were culture positive for Verotoxin-producing E. coli
      (VTEC). 10 of them were weaned pigs, one a suckling piglet and one a fattening
      hog. In 6 cases E. coli serovar 0139:H1 and in one case each the serovars
      0139:H40; 0138:H-; 0125ac:H27 and 0154:H- were isolated. From the fecal samples
      of 2 animals E. coli ONT (O-group non typable):H- were cultured. Macroscopically
      there were cyanosis, edema of the eye lids, catarrhal enteritis and/or colitis as
      well as edema of the mesentery, swelling of the mesenteric lymph nodes and
      congestion of the lung to varying degrees. Histopathologic examination of 5
      animals was carried out. In 3 animals atrophy and edema of the villi in the
      jejunum and ileum were discovered. In one animal an additional infection with
      corona virus was confirmed electron microscopically. Furthermore there was
      disseminated necrosis of lymphocytes in Peyer's patches of the small intestine
      and in secondary follicles of the mesenteric lymph nodes. In one of the animals a
      hemorrhagic-necrotising ileitis, occurred characterized by necrosis of villi and
      thrombosis of blood vessels in the mucosa. The highest number of VTEC with seven
      out of twelve animals was found in weaned pigs in association with the E. coli
      serovar 0139.

PMID- 2242732
TI  - [The effect of the anesthetic Tilest in swine].
AB  - The clinical signs and effects on the cardio-respiratory system of Tilest were
      checked out in weaners. The intramuscular injection of 10 mg/kg BW Tilest caused
      a rapid immobilisation on an average duration of 33.7 +/- 15 minutes. The muscle
      relaxation was generally good. Analgesia could not obtained. Heart- and
      respiratory-rates increased during lateral recumbency. Blood pressure decreased
      initially. The influence on the arterial blood pH-value and the blood gases are
      insignificant. In connection with trials to get up the lactate value and the body
      temperature increased. The CK- and ASAT-activities increased 2 to 6 hours after
      injection with a wide individual variation. During recovery the pigs were excited
      and salivated.

PMID- 2242733
TI  - [Atrophic rhinitis in swine and other animal species].
AB  - Evidence that cattle, goats and rabbits may suffer from natural diseases
      equivalent to porcine atrophic rhinitis is presented. Etiology and course of the
      progressive (enzootic) and non-progressive (sporadic) forms of atrophic rhinitis
      in pigs are discussed and compared with known data about similar diseases in
      other animals. It seems that atrophic rhinitis caused by toxigenic strains of
      Pasteurella multocida may be a disease of different animal species.

PMID- 2242734
TI  - [Wedge-shaped vertebral formation as the cause of leg weakness syndrome in swine-
      a case report].
AB  - We report about two cases of hemivertebrae in pigs. The malformations appeared in
      the T2/3, respectively in the T10. One case showed clinical apparent signs,
      namely ataxia and leg weakness. The productivity of the affected pig was reduced.
      Both cases are of unclear genesis. A hereditary predisposition could not be
      proved.

PMID- 2242735
TI  - [Animal nutrition for veterinarians--recent cases of "cramping colic" in horses
      after feeding of spoiled oats].

PMID- 2242736
TI  - [Illustrated report: forestomach actinomycosis with partial obstruction of the
      dome of the rumen opening in a breeding animal].

PMID- 2242737
TI  - Inflammatory fibroid polyp of the stomach.
AB  - Among 3,200 polyps of the stomach, we diagnosed inflammatory fibroid polyp in 143
      patients (4.5%). The average age of the patients was 63.6 years (women) and 63.9
      years (men), the sex ratio being 1.6 women to 1.0 men. In 77.6% of the cases, the
      polyp was located within the antrum, in 9.8% in the angular notch region, 1.4% in
      the pylorus, and 0.7% each in the fundus and cardia. The characteristic
      histological feature of these lesions is an eosinophil-containing, loosely
      structured fibrous tissue comprising an onion-skin-like arrangement of reticular
      fibers with spindle-shaped nuclei localized in the submucosa and the base of the
      mucosa. The polypous bulging mucosa was eroded in 26.8% and ulcerated in 3.5% of
      the cases. A comparison of the 147 cases collected from the literature with our
      own 143 cases revealed no differences. The rarity of inflammatory fibroid polyps
      in the stomach, their predominant location in the antrum, the age distribution
      and the observation that, after removal, these lesions do not recur, all go to
      suggest that the lesion is a reactive process (allergic or foreign body
      reaction), possibly a residual state following infestation by a parasite larva.

PMID- 2242738
TI  - Endoscopic examination for fistula.
AB  - In 15 postoperative fistula cases, we performed endoscopic examination
      (fistuloscopy) and studied the clinical significance. The inside of the fistula
      was easily observed after irrigation with physiological saline. The drain was
      extubated in 6 cases in which cavities without abscesses were recognized. In a
      case of pancreatic fistula, the fistula was temporarily closed using fibrin glue.
      Re-operation was performed in a case in which recurrence of cancer was recognized
      by biopsy. On the other hand, in 9 cases in which cavities with abscesses were
      recognized, foreign bodies, such as suture threads, which were sources of
      infections were removed. Moreover, the drain was removed to the effective site,
      and the fistula then irrigated repeatedly. Consequently, with the exception of a
      death due to cancer and a case complicated by osteomyelitis, the fistula was
      closed in all cases. Fistuloscopy is a safe and easy technique. In addition, the
      method, which is less stressful for the patient, is considered to be effective
      for the examination and treatment of fistulas.

PMID- 2242739
TI  - Postoperative external and internal biliary fistulas, unassociated with distal
      bile duct obstruction: endoscopic treatment.
AB  - Endoscopic drainage was applied in 14 patients with either external or internal
      (bile ascites) postoperative biliary fistulas. Endoscopic sphincterotomy and/or
      insertion of a nasobiliary tube or an endoprosthesis was found to be a safe and
      effective treatment, achieving closure of fistula in all patients.

PMID- 2242740
TI  - Comparison of a new colon lavage solution (Iso-Giuliani) with a standard
      preparation for colonoscopy: a randomized study.
AB  - Iso-Giuliani is a new improved-taste isoosmotic PEG-electrolyte solution for
      colon cleansing. In a randomized study, we have compared the effectiveness,
      tolerance and patient acceptance of 3 dosage volumes of this solution with a
      standard preparation in 191 patients undergoing colonoscopy. Iso-Giuliani 3 1,
      and 4 1 proved better colonic preparations as compared with the standard
      preparation (P less than 0.01). However Iso-Giuliani, 21 was sufficient for
      satisfactory cleansing, especially in the rectosigmoid. Patients in the standard
      preparation group experienced more cramps than did those in Iso-Giuliani groups.
      Patient acceptance was significantly better for Iso-Giuliani than for the
      standard preparation. The ingestion of Iso-Giuliani represents a safe, effective
      and well-accepted method of colon cleansing, and is our elective method of
      preparation for colonoscopy.

PMID- 2242741
TI  - An investigation of an infrared ray electronic endoscope with a laser diode light
      source.
AB  - An infrared ray electronic video-endoscope with a laser diode light source was
      used to obtain information on the submucosal area. As contrast medium we employed
      indocyanine green, which has a light absorption peak in the infrared range. The
      wavelength of the laser diode was set to 810 nm as suggested by the results of
      the spectrophotometric study on the reflected light at fingertips after injection
      of ICG (3 mg/kg). Using this system we inspected the stomach under visible light
      and then continuously under infrared light before and after intravenous injection
      of ICG (2 mg/kg). A dendritic figure with fine ramifications emerged in the early
      stage after intravenous injection of indocyanine green, which was not seen under
      visible light. These features of the figure visualized by the infrared endoscope
      suggest that they have a close relationship with blood vessels and blood
      circulation beneath the mucosal surface. This infrared electronic endoscope
      system provides submucosal information more readily and at a lower cost than ever
      before, and also the infrared lighting method of this system could be applied to
      almost all available electronic endoscopes by modulating infrared cutting
      filters, so it could become a valuable clinical tool.

PMID- 2242742
TI  - A new technique in endoscopic ultrasonography of the upper gastrointestinal
      tract.
AB  - Endoscopic ultrasonography (EUS) of the upper GI tract was unsuccessful in 42 out
      of 274 patients (15%) due to inaccurate guidance of the probe to small, shallow
      lesions, or to difficulty in clearly demonstrating the surrounding layer
      structure and boundary of the lesion. We applied the saline injection technique
      in these 42 patients. Saline was injected into the submucosal layer of the
      esophagogastric wall. The ultrasonographic image of adjacent saline accurately
      guided the probe to the lesion. Injected saline enabled the mucosal layer to be
      distinguished from the muscularis propria surrounding the lesion and provided
      clear ultrasonographic imaging of the boundary between the lesion and the
      surrounding layer structure. This new method was found to be effective in 38 out
      of 42 patients in whom EUS was unsuccessful. A study comparing the depth of tumor
      invasion diagnosed by the saline injection technique with histological findings
      obtained in 12 cases showed good correlation. These results indicate that the
      saline injection technique would seem to be very useful as an adjuvant to
      conventional EUS.

PMID- 2242743
TI  - A new endoscopic method for managing food impaction in the esophagus.
AB  - Previously described methods for dealing with acute food impaction in the
      esophagus are not uniformly efficacious, are cumbersome, and often prove
      dangerous. This paper describes a new technique using an endoscope which is
      modified such that the endoscope itself becomes a direct-vision suction device.
      We have successfully used the technique in seven patients with meat bolus
      impaction in the esophagus. The method proved quick and safe, and no
      complications occurred. After relieving the impaction an adequate diagnostic
      examination was done in all patients. In four patients with a predisposing peptic
      stricture and one with Schatzki's ring, treatment of the lesion was possible
      during the same endoscopic session.

PMID- 2242744
TI  - Electrohydraulic lithotripsy of complicated choledocholithiasis.

PMID- 2242745
TI  - Fatal air embolism following endoscopy of a hepatic portoenterostomy.
AB  - The case reported is that of a 10-year-old girl born with congenital biliary
      atresia who had undergone a Kasai procedure in the first year of life. She
      presented with ascending cholangitis, and investigations revealed a stricture of
      her portoenterostomy with an intrahepatic stone above the stricture. At
      laparotomy there were numerous adhesions and dilated varices, so the descending
      loop of the Kasai was exteriorized to enable a subsequent percutaneous endoscopic
      manipulation of the stone. During manipulation of the stricture via a pediatric
      endoscope in the jejunal loop the patient collapsed and died. Post mortem
      revealed a massive air embolism and varices of the jejunal loop.

PMID- 2242746
TI  - Rectal pseudotumor due to Chlamydia trachomatis in a male homosexual.
AB  - Chlamydia trachomatis causes a wide spectrum of human genital infections
      including lymphogranuloma venereum. We describe an unusual case of Chlamydia
      trachomatis proctitis in a homosexual man presenting with a large, solid tumor in
      the distal rectum, which was treated successfully by long-term oral doxycycline
      therapy.

PMID- 2242747
TI  - Iatrogenic lesions of surgically treated papilla of Vater.

PMID- 2242748
TI  - Not a way to do esophageal bougienage.

PMID- 2242749
TI  - Biliary endoprosthesis in the treatment of large common bile duct stones.

PMID- 2242750
TI  - The bee: an unusual gastric foreign body.

PMID- 2242751
TI  - The relation between cycling time to exhaustion and anaerobic threshold.
AB  - This study investigated whether the anaerobic threshold (AnT) could be used to
      predict prolonged work capacity measured as cycling time to exhaustion (=
      endurance time) and which factors, in addition to relative exercise intensity,
      could explain variation in endurance time. Theoretical exercise intensities
      corresponding to certain endurance times were also calculated. The hyperbolic and
      exponential functions between cycling time and relative work rate (WR[%]), as
      well as between cycling time and relative oxygen uptake (VO2[%]) were fitted to
      the pooled data (n = 45) of 17 subjects. The WR(%) and VO2(%) were expressed as a
      percentage of the subject's own AnT- and maximum-values. At WR corresponding to
      AnT (i.e., 70% of WRmax) an average subject could cycle 60 min according to both
      AnT- or maximum-related exponential function. When prediction was done for an
      endurance time of 4 h, the AnT-related exponential function gave 2.9%-units (= 11
      W or approximately 0.15 O2 l.min-1) lower intensity level (51% of WRmax) than the
      maximum-related function (54% of WRmax). The WR(%) alone explained 54% and 70% of
      the variation in endurance time of the AnT-related and maximum-related
      exponential functions, respectively. Muscle fibre composition and initial blood
      lactate or relative muscle glycogen depletion (change in muscle glycogen as
      percentage) increased significantly the explanatory power of these models. The
      differences between the observed and expected exercise times correlated with
      blood lactate accumulation (r = -0.42; p less than 0.01), muscle fibre
      composition (r = 0.33; p less than 0.05) and relative muscle glycogen depletion
      (r = 0.67; p less than 0.01). It was concluded that the capacity for prolonged
      work measured as cycling time to exhaustion can be estimated by AnT-related power
      output, and that the exponential function model is the most suitable. Prediction
      power of the model can be improved by multiple regressions including muscle fibre
      composition, initial blood lactate level and relative muscle glycogen depletion.

PMID- 2242752
TI  - Fifth World Congress of Nuclear Medicine and Biology. August 26-31, 1990,
      Montreal, Quebec, Canada. Abstracts.

PMID- 2242753
TI  - Analysis of the immune-encodrine feedback loop in the avian system and its
      alteration in chickens with spontaneous autoimmune thyroiditis.
AB  - In both mammals and chickens, immunization with exogenous antigens results in a
      surge of serum glucocorticoid hormone levels concomitant with the antibody
      response. This effect is mediated by glucocorticoid-increasing factors (GIF)
      produced by cells of the immune system. In the avian system, GIF appear to act
      via the hypothalamo-pituitary axis and not directly on the adrenal gland.
      Interleukin 1 is the main active substance responsible for GIF activity, as shown
      by molecular sieve and immunoaffinity chromatography studies. In contrast to data
      from mammals, we found no evidence that interleukin 2 elevates chicken
      corticosterone. Obese strain chickens with spontaneous Hashimoto-like autoimmune
      thyroiditis are deficient in their in vivo GIF response. Because no differences
      were found between autoimmune and healthy chickens in the corticosterone response
      of the adrenal gland after ACTH administration, and since autoimmune animals are
      able to react normally to immobilization stress, it is assumed that this
      deficiency is due to a specific defect rather than a general disturbance in the
      endocrine system.

PMID- 2242754
TI  - In vitro human cytotoxic T cell responses against influenza A virus can be
      induced and selected by synthetic peptides.
AB  - Studies on human anti-influenza cytolytic activities have demonstrated that
      cytotoxic T lymphocytes (CTL) from HLA-B37 individuals react preferentially with
      the peptide corresponding to residues 335-349 of the nucleoprotein, whereas CTL
      from HLA-A2 donors recognize peptide 57-68 from the viral matrix as a dominant
      epitope. We studied the secondary CTL response, obtained from peripheral blood
      mononuclear cells, of an HLA-A2+,B37+ individual stimulated either by infectious
      virus or by synthetic peptides. Only an HLA-B37-restricted response was detected
      after stimulation by the whole virus, showing an immunodominance of this activity
      over that restricted by HLA-A2. Moreover, human cytotoxic cell lines were
      successfully obtained after stimulation of peripheral blood mononuclear cells
      with synthetic peptides. Under these conditions, it was possible to selectively
      reveal the existence of an HLA-A2-restricted activity directed against the matrix
      peptide. These results demonstrate that, at least in vitro, it is possible to
      stimulate a latent repertoire by using synthetic peptides. Nevertheless, we could
      not induce a response against the matrix or the nucleoprotein peptides in HLA-A2-
      or B37- individuals, suggesting that a finer selection of synthetic peptides
      would be necessary for their possible utilization to induce CTL during
      vaccination.

PMID- 2242755
TI  - The influence of S17 stromal cells and interleukin 7 on B cell development.
AB  - A clonal assay was used to study different stimuli involved in the progression of
      fetal liver B cell precursors to mature B lymphocytes. In this report we replaced
      fetal liver heterogenous feeder cells by a recombinant growth factor, interleukin
      7 (IL 7), and a clonal stromal cell line, S17. Under those conditions we could
      clone 1 in 10 B220+ B cell precursors from fetal liver and the cells could
      differentiate to a mitogen-responsive, immunoglobulin-secreting stage. We found
      that IL 7 stimulates proliferation of B220+ precursors but is not sufficient to
      support maturation of those precursors to a stage of mitogen responsiveness. We
      show further that the cell line S17 does not produce IL 7 at functionally
      detectable level but provides support for B cell maturation. We conclude that
      this cell line supplies an exogenous stimulus required by B cell precursors to
      become mature lymphocytes. We describe therefore two stages in pre-B cell
      development: (a) IL 7-dependent proliferation and (b) S17-dependent maturation to
      mitogen reactivity. Further studies demonstrate that S17 has a profound effect on
      B cells by increasing the clonal efficiency of lipopolysaccharide-responsive
      cells to nearly 1:1 B cell in the spleen of adult C57BL/6 mice.

PMID- 2242756
TI  - A new surface antigen on intraepithelial lymphocytes in the intestine.
AB  - A new surface molecule has been discovered on mouse intestinal intraepithelial
      lymphocytes (IEL) using a rat anti-mouse IEL monoclonal antibody, M290. It was
      expressed at high levels on nearly all IEL and on a majority of T cells in the
      gut lamina propria. M290 stained, with lower intensity, a small minority of T
      cells in other lymphoid tissues. Expression was biased towards the CD8+ subset.
      Stimulation of peripheral T cells with mitogens did not induce expression of the
      new antigen but addition of transforming growth factor beta to stimulated T cells
      had a marked inductive effect. Sodium dodecyl sulfate-polyacrylamide gel
      electrophoretic analysis of IEL surface components precipitated with M290 showed
      principal bands at 135, 120, 28 and 24 kDa (reduced) and 135, 100, 24 and 21 kDa
      (nonreduced). Precipitation with antibodies to integrin subunits showed that the
      new molecular complex was not a member of the beta 1, beta 2, or beta 3 integrin
      families although all of these were represented on IEL. A 13-amino acid N
      terminal sequence obtained from the 120-kDa beta subunit of the antigen prepared
      from an M290+ T hybridoma (MTC-1) did not show homology with integrins. Pulse
      chase studies using MTC-1 cells showed that the 135-kDa alpha subunit was derived
      from a 147-kDa precursor. The function of this new molecular complex is not yet
      known.

PMID- 2242757
TI  - Glycosylation of IgG, immune complexes and IgG subclasses in the MRL-lpr/lpr
      mouse model of rheumatoid arthritis.
AB  - The MRL-lpr/lpr (MRL/lpr) mouse spontaneously develops a disease syndrome which,
      in many respects, is similar to human rheumatoid arthritis. These mice developed
      joint inflammation, circulating rheumatoid factors and immune complexes. We now
      show that the parallel with human disease extends to a glycosylation defect which
      is observed on IgG from rheumatoid arthritis patients. Using the lectins ricin
      and Bandeiraea simplicifolia II we have found that terminal N-acetylglucosamine
      is clearly raised in MRL/lpr IgG. Increased exposure of galactose was also
      detected, indicating that a second glycosylation site must be present on these
      molecules. Polyethylene glycol-precipitated IgG complexes bound significantly
      more of each lectin than did free IgG, indicating that the changes in
      glycosylation were associated with complex formation. The sugar abnormality was
      most marked in the IgG2a/IgG3 fraction from protein A IgG subclass
      chromatography. Our results suggest that the IgG glycosylation defect seen in
      rheumatoid arthritis is apparent in the MRL/lpr mouse and may contribute, through
      complex formation, to the pathological processes in the rheumatoid syndrome.

PMID- 2242758
TI  - Characterization of an IgA receptor from group B streptococci: specificity for
      serum IgA.
AB  - Some strains of group B streptococci express a cell surface protein which binds
      IgA. This report describes some properties of such an IgA receptor and compares
      it with a previously described IgA receptor from group A streptococci. The group
      B receptor was released in an almost pure form from bacteria incubated at
      elevated pH, and could be isolated by IgA-Sepharose affinity chromatography. The
      sequence of the N-terminal 19 amino acid residues was unique. The receptor
      preferentially binds IgA of human origin, as shown in immunoblotting experiments
      with purified IgA from nine different species. The affinity constant of the
      purified receptor for serum IgA was determined to be 3.5 x 10(8) M-1, but for
      secretory IgA it was too low to allow determination. This result indicates that
      secretory component and/or J chain interferes with the binding of IgA to this
      type of bacterial receptor, which may be one of the physiological functions of
      these polypeptides. A reduction in affinity was also observed for another
      complexed form of IgA, alpha 1-microglobulin-IgA. The group B receptor is
      antigenically unrelated to the IgA receptor from group A streptococci (protein
      Arp), but competitive inhibition experiments indicate that they bind to the same
      region in IgA. The implications of these findings, and the biological role of
      bacterial IgA receptors, are discussed.

PMID- 2242759
TI  - Age-related decrement in cytotoxic T lymphocyte (CTL) activity is associated with
      decreased levels of mRNA encoded by two CTL-associated serine esterase genes and
      the perforin gene in mice.
AB  - The age-related decline in cytotoxic T lymphocyte (CTL) activity has been
      recognized for many years. Age-related alterations in several immunologic events
      have been suggested to be partly or completely responsible for this decline. We
      had previously demonstrated (Bloom et al., Cell. Immunol. 1988. 144: 440) in mice
      that a deterioration in the lytic mechanism may be at least in part responsible
      for the decline in CTL activity. We now report that this decline correlates with
      an age-related decrease in serine esterase activity released into the supernatant
      medium in the process of generating CTL. Northern analyses were then used to
      examine the effect of age on expression of genes encoding for perforin and two
      CTL-associated serine esterases. The products of all three of these genes have
      all been postulated to play roles in CTL-mediated lysis. We show that the
      expression of all three of these genes appears to decline with age in the process
      of generating allogeneic CTL. These alterations in gene expression correlated
      both with diminished cytolytic and released esterase activities generated by
      mixed leukocyte culture in spleen cells of old mice compared to young. The age
      related decline in gene expression could not be attributed to shifts in T cell
      subsets, but CD8+ cells generated by allogeneic stimulation of nylon wool-passed
      spleen cells from old mice expressed significantly less cytolytic activity than
      those from young. This report is the first demonstration of an age-related
      decrease in expression of a functionally related group of genes. In addition,
      these findings are compatible with the suggested roles for perforin and serine
      esterase release in CTL-mediated target cell lysis.

PMID- 2242760
TI  - Functional characterization of the antibody-mediated protection against blood
      stages of Plasmodium falciparum in the monkey Saimiri sciureus.
AB  - The squirrel monkey Saimiri sciureus is one of the World Health Organization
      recommended experimental models of Plasmodium falciparum blood stage infection.
      Anti-malaria antibodies developed by this host after a drug-controlled infection
      play an important part in the acquired protection against the P. falciparum blood
      stages. Furthermore, the use of two anti-Saimiri immunoglobulin (Ig) monoclonal
      antibodies (mAb) has permitted the differentiation between protective (mAb
      3A2/G6) and non-protective (mAb 3E4/H8) antibodies, as shown by transfer
      experiments to recipient monkeys infected with blood stage parasites. In the
      present study we have established that protection conferred by the 3A2/G6+
      protective Ig preparation is strictly associated with an in vitro opsonic
      activity. Such an opsonic activity is not detectable in the 3E4/H8+ non
      protective Ig population. In addition, results indicate that the 3E4/H8+ non
      protective Ig population competes with protective opsonic 3A2/G6+ Ig antibodies
      when co-incubated with parasitized red blood cells. Thus, it follows that
      protection can be directly correlated to the quantitative and qualitative
      fluctuation of the two Ig populations. When challenged with 1 x 10(8) P.
      falciparum-infected Saimiri red blood cells parasitemia occurred in 5 out of 12
      Saimiri who were lacking detectable 3A2/G6+ opsonic antibodies in their sera. By
      employing antibodies against the human Fc receptor for IgG (Fc gamma R) in an in
      vitro phagocytic assay, we have been able to show that the principal receptor is
      Fc gamma RIII. Finally, we also show that in contrast to the situation in man,
      this receptor is present on circulating monocytes. These findings could lead to a
      different strategy in designing malaria vaccine candidates and also allow the
      possibility of predicting the outcome of immunization trials in Saimiri monkeys.

PMID- 2242762
TI  - Leukocyte function-associated antigen 1 (LFA-1) is a signaling molecule for
      cytoskeletal changes in a human T cell line.
AB  - The HuT 78/2 clone is a human T cell clone which has an activated phenotype. When
      this line was stimulated with immobilized antibody to LFA-1, the majority of
      cells developed dendritic processes. These processes were demonstrated to contain
      cytoskeletal elements including microtubules and intermediate filaments. Phorbol
      myristate acetate synergized with and prolonged this effect. Thus, the LFA-1
      molecule may function as a signaling molecule for cytoskeletal reorganization in
      a human T cell clone.

PMID- 2242761
TI  - Generation of hen egg lysozyme-specific and major histocompatibility complex
      class I-restricted cytolytic T lymphocytes: recognition of cytosolic and secreted
      antigen expressed by transfected cells.
AB  - Syngeneic cells exogenously supplied with hen egg lysozyme (HEL) or endogenously
      synthesizing HEL were used as antigen-presenting cells to induce major
      histocompatibility complex class I-restricted cytotoxic T lymphocytes (CTL).
      Immunization of C57BL/6 mice followed by repeated stimulation of their
      splenocytes in vitro with trypsinized HEL peptides led to the generation of CTL
      lines specific for trypsinized HEL peptides and restricted by H-2K. Immunization
      of C3H mice with a mixture of soluble native HEL and irradiated syngeneic spleen
      cells followed by in vitro stimulation of immune spleen cells with soluble HEL
      could in a few cases result in HEL-specific CTL able to kill syngeneic
      transfectant L cells secreting HEL (HELs) or expressing cytosol-targeted HEL
      (HELc). The use of HELs or HELc transfectant L cells as in vivo and in vitro
      immunogens was a potent way for eliciting HEL-specific polyclonal CTL. These CTL
      and two CD8+ clones were found to be H-2K restricted and specific for the 1-17 N
      terminal HEL peptide. In addition, the anti-HEL CTL could also exhibit a
      significant cross-reactivity against unsensitized and HEL-untransfected targets
      expressing the K restriction element. This cross-reactivity was likely due to
      recognition of unidentified HEL mimicking peptides (self-derived?) presented by
      the MHC class I (H-2K or H-2K) molecule used as the restriction element for the
      specific recognition of HEL. The CTL raised after immunization with HELs or HELc
      transfectant cells were found to recognize both the HELs and HELc transfectant
      cells even though HEL was not detected in the latter after a 2- or 5-min
      radiolabeling pulse. Recognition of both HELs and HELc transfectant cells by a
      given CTL clone suggests that HEL subjected to two separate processing pathways,
      each depending on the initial subcellular localization, can ensure the generation
      of similar MHC class I peptide complexes.

PMID- 2242763
TI  - [Methodology for research on toxicity and its prediction].

PMID- 2242764
TI  - [Characteristics of F344 rats in a stand-point of naturally occurring neoplastic
      and non-neoplastic lesions].

PMID- 2242765
TI  - [Selective medium for Corynebacterium kutscheri and localization of the organism
      in mice and rats].
AB  - A new selective medium for isolation of Corynebacterium kutscheri (CK) from
      animals suffering subclinical infection was made by adding furazolidone,
      nalidixic acid and corimycin to the heart infusion agar base, this being named
      FNC agar. The FNC agar inhibited the growth of gram-negative rods, Pseudomonas
      aeruginosa, Proteus sp. and gram-positive cocci but did not affect the growth of
      CK. When this medium was used to isolate CK from the oral cavity and cecal
      contents of mice and rats, two of 6 conventional mouse colonies and three of 8
      conventional rat colonies were found to be infected, with isolation of the
      organism from 19 mice and 12 rats in total. The animals showed neither clinical
      signs nor lesions, but the antibody was positive in 11 mice and 10 rats. In mice
      and rats inoculated orally with 4 x 10(8) and 1 x 10(9) organisms, respectively,
      CK was isolated for 20 weeks post-inoculation by use FNC agar. The isolation rate
      of the organism was the highest in the oral cavities of both inoculated mice and
      rats, and also in the submaxillary lymph nodes of the inoculated rats. The
      organism was also recovered from the cecal contents of more than half of the
      inoculated mice and rats. Thus, it was considered that FNC agar was useful in
      isolating CK from the oral cavity and cecal contents of mice and rats with
      subclinical infection of the organism.

PMID- 2242766
TI  - Theiler's murine encephalomyelitis virus--characterization of newly isolated
      viruses from Japanese mouse colonies.
AB  - The hemagglutinating-inhibition (HI) test was used to detect antibodies for
      Theiler's murine encephalomyelitis virus (TMEV), and the virus was isolated from
      sero-positive mice derived from colonies in Japan. HI antibody was detected in
      conventional mice (38.7%; 137/354) at titers ranging from 1:8 to 1:512, but it
      not in SPF mice (0/90). To isolate the virus, weanling mice inoculated
      intracerebrally with samples obtained from sero-positive mice were sacrificed and
      10% brain homogenates were subcultured. New isolates designated as YOC and AB
      strains were obtained, and their physicochemical and biological properties were
      characterized. The results indicated that the new isolates were similar to
      Theiler's original (TO) strain according to the following observations of
      persistent paralysis of the hind limbs, resistance to ether treatment, a
      particles size of 10 approximately 50 nm in diameter, stability at pH 3, a
      density of 1.35 g/cm3 and three major and one minor viral proteins, (VPO; 38 Kd,
      VP 1; 33 Kd, VP2; 32Kd, VP3; 25 Kd). Immunoblotting analysis also showed that VP
      2 of YOC and encephalomyocarditis virus of the Cardiovirus group, reacted
      strongly with the antisera against the viruses as well as with the GDVII strain.
      These results suggest that TMEV infection does exist in conventional mouse
      colonies in Japan, and that these viruses resemble the TO strain of TMEV.

PMID- 2242767
TI  - Determination of an antigen suitable for enzyme-linked immunosorbent assay of the
      antibody to Bordetella bronchiseptica in guinea pigs.
AB  - To establish an enzyme-linked immunosorbent assay (ELISA) technique for the
      serological diagnosis of infections caused by Bordetella bronchiseptica (B.
      bronchiseptica) in guinea pigs, the authors recently assessed the usefulness of
      three antigen preparations derived from the bacterial cell components: sonication
      antigen (S-Ag), cell surface antigen (C-Ag) and lipopolysaccharide antigen (L
      Ag). The use of S-Ag for ELISA resulted in the most sensitive detection of the
      antibody to B. bronchiseptica from guinea pig sera immunized with killed bacteria
      and sera derived from naturally infected guinea pigs. Like C-Ag, S-Ag was highly
      specific, showing no cross-reactivity with Pasteurella multocida. Assessment of
      antibody formations in animals with experimentally induced infection using the
      three antigen preparations revealed that the antibody to S-Ag was formed earlier
      than antibodies to the other two antigen preparations following growth of the
      bacterium in the lungs. These results indicate that ELISA with S-Ag as an antigen
      is a useful tool for the serological diagnosis of infection by B. bronchiseptica.

PMID- 2242768
TI  - Arterial pressure and its variability in conscious rabbits at different ages.
AB  - Mean level and its variability of mean arterial pressure (MAP) were studied in 25
      unanesthetized rabbits aged 6, 12, 18, 24 and 30 months. They were selected from
      the same large colony and bred with an ordinary rabbit food under a given
      environmental conditions. MAP in the aortic arch was continuously monitored with
      a catheter-transducer system for 3 hrs. Mean (M) and variance (V) of MAP for 3
      hrs were not significantly altered with aging (p greater than 0.05, Kruskal
      Wallis' multi-sample test). Intra-animal variations of the M and SD were small.
      Most of histograms of MAP for 3 hrs shows an exaggerated mode at any age.
      Distribution pattern of the histogram was not specific to age. These suggest that
      responsiveness of the baroreflex system should not be affected by aging from 6 to
      30 months.

PMID- 2242769
TI  - [Visual function of cynomolgus monkeys with macula degeneration and peripheral
      retinal degeneration].
AB  - Using the simplified method for judging visual function of the cynomolgus monkey
      that was established by the present authors (Suzuki et al., 1988), forty-four
      cynomolgus monkeys with normal ophthalmoscopic findings, eleven monkeys with
      macula degeneration and thirteen monkeys with peripheral retinal degeneration
      were examined for their visual function. It was demonstrated that the monkeys
      with macula degeneration were inferior in their visual function to the monkeys
      with normal fundus. In addition, the degree of visual function varied with the
      degree of macula degeneration. The monkeys with peripheral retinal degeneration
      showed about the same degree in their visual function as the monkeys with normal
      fundus.

PMID- 2242771
TI  - Effects of mandibular gland ectomy and environmental temperature of dams on
      eyelid opening and body weight of pups in mice.
AB  - Effects of the mandibular gland ectomy and environmental temperature to pups in
      Jcl: ICR mice were studied. In normal environmental animal room (A room; Tem. 23
      +/- 2 degrees C, R. H. 50 +/- 10%), the mammary gland weights of lactating
      mothers and the body weights of pups in sialoadenectomized groups were slightly
      smaller than that of control groups during lactating period, whereas the eyelid
      opening of pups was not different between both groups and all pups exhibited
      complete eyelid opening on 14th day after birth. On the other hand, in cold
      environmental animal room (B room; Tem. 15 +/- 2 degrees C, R. H. 60 +/- 20%),
      the mammary gland weights of lactating mothers and the body weights of pups in
      sialoadenectomized groups were smaller than that of sialoadenectomized groups in
      A room and the eyelid opening of pups was considerably delayed when compared with
      that of control groups. The pups exhibited complete eyelid opening at 16th day
      after birth. These results were caused by mandibular gland ectomy and considered
      to be easily influenced by environmental conditions.

PMID- 2242770
TI  - [Spontaneous bone marrow granulomas in rats--effect of ovariectomy on granulomas
      formation].
AB  - Spontaneous granulomas developed frequently in the bone marrow of Slc: Wistar
      female rats over 19 weeks of age, whereas none did in JCL: SD and Slc: SD rats of
      either sex. These granulomas were composed histologically of epithelioid cells
      and macrophages clustered mostly in the center and lymphocytes and plasma cells
      located in the periphery, and they contained neither microorganisms nor foreign
      bodies. Ovariectomy of Slc: Wistar rats at 6 weeks of age resulted in a
      significant decrease in the incidence and size of bone marrow granulomas at 20
      and 24 weeks of age. It is concluded that two factors, the strain of rats and
      female sex hormone, contribute to the pathogenesis of bone marrow granulomas--the
      former as a hereditary disposition and the latter as a promoter.

PMID- 2242772
TI  - [Method of dissecting of ovarian bursal membranes using a bipolar coagulator in
      mice and rats].
AB  - Ovarian bursal membranes were dissected using a bipolar coagulator during embryo
      transfer to the oviducts of pseudopregnant female mice and rats. The bipolar
      coagulator allowed accurate, fine coagulation of small vessels and wide
      dissection of ovarian bursal membranes without damage to the oviducts or ovaries.

PMID- 2242774
TI  - Pathology of sternal deformity in the Sprague-Dawley rat.
AB  - Pathological examination of two 12-week-old male Sprague-Dawley rats revealed
      bending of the sternebrae. Grossly, the sternebrae distal to the third sternebra
      were bent towards the underside, and the episternal extremity was turned towards
      the head. Microscopically, the 4th sternebra was observed to have slipped behind
      the third sternebra, and fractures of the episternal cortex and slanting of the
      episternal cartilage were also observed.

PMID- 2242773
TI  - Antinucleolar autoantibody induced in mice by mercuric chloride--strain
      difference in susceptibility.
AB  - Eight inbred mouse strains were examined for their reactivity to the induction of
      antinucleolar autoantibody (AnuA) by mercuric chloride (MC). According to the
      positive ratio and titer of AnuA induced, the strains were grouped into high-,
      moderate-, low-, and non-responders. Since the susceptibilities to MC were
      different among strains having the same H-2 haplotype, involvement of H-2
      unlinked gene (s) in AnuA induction by MC was suggested.

PMID- 2242775
TI  - Hypoplasia of one kidney in a Sprague-Dawley rat.
AB  - Pathological examination of a 4-week-old male Sprague-Dawley rat revealed
      hypoplasia of the left kidney. Grossly, the left kidney exhibited hypoplasia
      associated with absence of the ureter on the same side. Histologically,
      components of the cortex and medulla were mingled in the tissue, and the
      glomeruli and convoluted tubules were scattered in disorder, and connective
      tissue proliferation was also observed. The papilla and pelvis could not be
      identified.

PMID- 2242776
TI  - Study on cross-reactivity to the para group.
AB  - In 80 patients, positive to at least one hapten of the para group (para
      phenylenediamine, diaminodiphenylmethane, benzocaine, PPD mix), patch tests were
      carried out with freshly prepared solutions of para-phenylenediamine (PPD) and of
      3 selected aromatic compounds related structurally to PPD (para-aminophenol,
      ortho-aminophenol, hydroquinone). The number of positive reactions correlated
      with the rate of decomposition of the substances as evaluated by high-pressure
      liquid chromatography. PPD, which was almost decomposed after 24 h, gave the
      highest number of positive reactions, followed by ortho-aminophenol and by para
      aminophenol, while hydroquinone, which was oxidized to the extent of 35%, did not
      give any reactions. To evaluate if a different rate of oxidation can modify the
      patch test response, in the same patients and in 10 normal volunteers, tests were
      carried out with PPD solutions containing the oxidizing agent silver oxide
      (0.1%). By this procedure a significant increase in the number of positive
      responses was observed. The results suggest that the rate of decomposition and
      therefore the amount of quinone(s) generated, might be the key to eliciting patch
      test responses to oxidizable aromatic haptens.

PMID- 2242777
TI  - Guidelines for histopathologic diagnosis of plantar malignant melanoma. Two
      dimensional coordination of maximum diameters of lesions and degrees of
      intraepidermal proliferation of melanocytes.
AB  - Detection of early lesions of malignant melanoma is highly important for the
      improvement of the prognosis. However, diagnosis of early malignant melanoma is
      not easy and is often discordant even among expert dermatopathologists. In this
      study, we propose guidelines for the histopathologic diagnosis of plantar
      malignant melanoma and malignant melanoma in situ on the sole. They are
      formulated with two-dimensional coordination of maximum diameters of the lesions
      and degrees of intraepidermal proliferation of solitary-arranged melanocytes. The
      guidelines are simple and reproducible, and surely contribute to the accurate
      diagnosis of early plantar malignant melanoma.

PMID- 2242778
TI  - Hair growth in human split-thickness skin grafts transplanted onto nude rats: the
      role of cyclosporin.
AB  - To date, there have been no descriptions of hair growth following transplantation
      of human split-thickness skin grafts (HSTSG) to congenitally athymic (nude) mice
      or rats. Recently, we noted hair growth in HSTSG from scalp skin (HSTSG-SS)
      transplanted onto rats treated with ciclosporin (CS). By definition, HSTSG-SS of
      0.4 mm had all the anagen hairs cut from the papillae. Two months after
      engraftment, there was histological evidence of the formation of new papillae.
      Density of hair correlated with thickness of HSTSG, i.e. there were more
      hairs/square centimeter in HSTSG-SS of 1 mm thickness than in those of 0.4 mm
      thickness. New hairs appeared on an average of 1 cm2/week in HSTSG-SS that were 1
      mm thick; by 10 weeks, the mean density was 7.9 hairs/cm2. In the thinner grafts,
      the density was 3.5 hairs/cm2 (p less than 0.025). The rate of growth in the
      thicker grafts ranged from 0 to 0.25 mm/day, with an average of 0.1 mm/day. At 10
      weeks after grafting, the hairs had a mean length of 4.4 mm in the thicker and
      1.7 mm in the thinner grafts (p less than 0.001). The average diameter of the
      hair shafts was 0.05 mm at the various times tested. These observations identify
      a previously unrecognized process of hair growth and present an in vivo model to
      study human hair growth process, including the role of CS in hair growth.

PMID- 2242779
TI  - Delusional parasitosis as 'folie a trois'.
AB  - Delusional parasitosis can apparently run in families. Three out of 9 members of
      a German family were fully convinced that their skin had been invaded by 'tiny
      running animals' even though there was no physical evidence of any infestation.
      Although the family was reluctant to be injected with neuroleptic drugs as this
      would have been an acknowledgement that their symptoms were in fact of
      psychological origin, they eventually agreed to be treated. When last contacted,
      3 years after diagnosis, they still believed in the existence of the parasites
      but admitted that some of their symptoms had improved.

PMID- 2242780
TI  - Nail biting and picking as a possible cause of longitudinal melanonychia. A study
      of 6 cases.
AB  - Examination of individuals affected by onychotillomania led us to describe a new
      cause of longitudinal melanonychia (LM) of the finger-nails. Damage of the finger
      nails was caused both manually and by chewing. The nail cuticles were usually
      pushed back, and biting caused pressure damage of the base of the nail. It is
      likely that finger-nails respond similarly to toe-nails and the matrix
      melanocytes can be stimulated by trauma. Such stimulation can apparently persist
      long after cessation of the trauma. Histological examination of the nail plates
      demonstrated that the pigment was melanin. In the matrix an increase in melanin
      content of melanocytes was found without melanocytic proliferation. LM due to
      onychotillomania should not be overlooked.

PMID- 2242782
TI  - Topical alpha-interferon in recurrent genital herpes simplex infection. A double
      blind, placebo-controlled clinical trial.
AB  - We conducted a double-blind placebo-controlled clinical trial on 98 subjects to
      assess the efficacy of two strengths of topical human leukocyte alpha-interferon,
      10(4) and 10(6) IU/g in a 1% nonoxynol-9 base, in the treatment of recurrent
      genital herpes simplex virus (HSV). The study medication was applied during the
      prodromal phase or at the first sign of recurrence of the infection. The high
      dose alpha-interferon was found to be significantly more effective than the low
      dose interferon and placebo with respect to the duration of viral shedding as
      well as in reducing the time to the end of all subjective symptoms, including
      pain, burning and itching. No difference between the three groups was found in
      times to crusting or healing. Further studies of topical interferon in the
      treatment of HSV and other viral infections are merited.

PMID- 2242781
TI  - Xeroderma pigmentosum group D patient bearing lentigo maligna without
      neurological symptoms.
AB  - A 35-year-old Japanese female patient with xeroderma pigmentosum (XP), registered
      as XP114TO, was assigned to complementation group D by the cell fusion
      complementation test. The patient had manifested moderate solar sensitivity and
      freckles by the age of 6 years. The skin phototest using 290- and 300-nm
      monochromatic ultraviolet (UV) light revealed slightly lowered minimal erythema
      doses at 24 h after irradiation. The XP114TO skin fibroblasts exhibited about the
      6-fold higher sensitivity to the lethal effect of 254-nm UV as did normal cells.
      Unscheduled DNA synthesis (UDS) induced in XP114TO cells by 254-nm UV (10 J/m2)
      was 33% of normal, falling into the group D range of 25-50% UDS. The patient
      developed lentigo maligna on the right side of the nose. Unlike the typical XP
      group D cases in the West, she showed no neurological abnormalities.

PMID- 2242783
TI  - Poikiloderma, alopecia, retrognathism and cleft palate: the PARC syndrome. Is
      this an undescribed dominantly inherited syndrome?
AB  - We report a clinicopathological observation concerning a man and his son affected
      by the same disease. The main cutaneous lesions included poikiloderma congenitale
      and generalized alopecia respecting the pubic area. These anomalies were
      associated with cleft palate and Robin sequence in the boy. The main histological
      changes consisted in a marked atrophy of hairs with persistence of sebaceous
      glands. In sun-exposed areas, we found colloid bodies, melanophages and
      hyperplasia of the elastic tissue network. Those features resembled those of the
      Rothmund-Thomson syndrome, but the phenotype and the apparent dominant mode of
      inheritance exclude this possibility. A new genodermatosis, related with, but
      distinct from the Rothmund-Thomson syndrome is suspected, for which the acronym
      PARC syndrome is proposed.

PMID- 2242784
TI  - Hereditary benign telangiectasia: a congenital type.
AB  - Hereditary benign telangiectasia (HBT) is inherited in an autosomal dominant
      fashion, and in all the cases reported in the past it developed after birth. We
      describe 3 congenital cases of HBT in the same Japanese family: a 29-year-old
      father and his 5-month- and 2-year-old daughters have had scattered erythematous
      patches of various sizes in diameter since birth.

PMID- 2242785
TI  - Hyperpigmentation induced by UVB at the application site of estradiol.
AB  - We report a case of a 48-year-old woman who presented with chronic essential
      pruritus and was successfully treated with the transdermal estradiol system
      because of menopausal discomfort. Suberythemogenic UVB phototherapy was proposed
      to the patient in order to control her pruritus. She developed hyperpigmentation
      at the application site of estradiol. To the best of our knowledge, this is the
      first report suggesting a direct relationship between estrogen and melanin
      synthesis in humans.

PMID- 2242786
TI  - Pigmented nail streak associated with Bowen's disease of the nail matrix.
AB  - We described a 59-year-old male physician with Bowen's disease occurring on the
      nail matrix of his right 5th finger. The rapid growth of the pigmented nail
      streak accompanied by nail deformity led us to consider the possibility of
      subungual melanoma clinically. Histologic features, however, were compatible with
      those of Bowen's disease accompanied by melanocytes with melanin-rich long
      dendrites in the nail matrix. We speculate that his occupational exposure to X
      rays for 25 years played an important role in the pathomechanism of the present
      case.

PMID- 2242787
TI  - Massive lymphomatous nail involvement in Sezary syndrome.
AB  - The case of a 65-year-old man affected by chronic erythroderma due to Sezary
      syndrome and massive lymphomatous infiltration of the nails is reported. The
      clinical features of the nail lesions, consisting in thickening and discoloration
      of the nail plates, were not diagnostic. The nail biopsy showed a typical
      epidermotropic T cell lymphomatous involvement of all the nail constituents.
      Immunohistochemical characterization of the nails and skin lymphomatous
      infiltration showed identical results, confirming the neoplastic etiology of both
      the chronic erythroderma and the nail dystrophy.

PMID- 2242788
TI  - Symmetrical interdigital hyperkeratosis of the hands with scrotal tongue and
      highly arched palate.

PMID- 2242789
TI  - Photochemotherapy plus squaric acid dibutylester in alopecia areata treatment.

PMID- 2242790
TI  - Water-induced itching.
AB  - In this paper the current knowledge on water-induced pruritus is reviewed. To the
      present, three forms, namely aquagenic pruritus (AP), aquagenic pruritus of the
      elderly (APE) and water-related itching in polycythemia rubra vera (PRV), have
      been recognized. Despite clinical similarities it appears that the
      pathophysiology is different in the three forms. The currently most effective
      treatment for AP is addition of sodium bicarbonate to the water, control of
      xerosis with emollients for APE and aspirin for water-induced itching in PRV.

PMID- 2242791
TI  - Frictional properties of human forearm and vulvar skin: influence of age and
      correlation with transepidermal water loss and capacitance.
AB  - The dynamic friction coefficient between skin and a Teflon probe and its
      correlation with age, body weight, height, transepidermal water loss and skin
      capacitance was studied in vulvar and forearm skin of 44 healthy female
      volunteers. The friction coefficient of vulvar skin was 0.66 +/- 0.03 (mean +/-
      SEM) compared to that of forearm skin of 0.48 +/- 0.01. The difference was highly
      significant (p less than 0.001). Multiple-regression analysis showed that the
      vulvar skin friction coefficient was significantly correlated with capacitance as
      an indicator of stratum corneum hydration (p less than 0.01) but not with age,
      weight, height or transepidermal water loss. It is concluded that the high
      friction coefficient of vulvar skin may be due to the increased hydration of
      vulvar skin. Age-related differences seem to exist for transepidermal water loss
      and friction coefficient in forearm but not in vulvar skin.

PMID- 2242792
TI  - Levels of soluble interleukin-2 receptors correlate with the severity of atopic
      dermatitis.
AB  - Levels of soluble interleukin-2 receptors (sIL-2R) were measured as a marker of
      lymphocyte activation in serum of 37 patients with atopic dermatitis (AD) and of
      16 patients with psoriasis vulgaris (PV), all individuals being hospitalized in
      the Zurich High Mountain Clinic of Davos-Clavadel (altitude 1,600 m above sea
      level). Measurements were performed at admission and at discharge. The PV
      patients served as a control group. As a further control, 20 AD patients from the
      Department of Dermatology in Zurich (altitude 400 m) were also evaluated. The
      serum sIL-2R concentration in AD patients at admission was significantly elevated
      in comparison with PV patients and was highly correlated with the severity of the
      cutaneous involvement. Comparing the 'extrinsic' and 'intrinsic' types of AD, no
      significant differences of sIL-2R levels were found. The sIL-2R concentrations
      dropped at discharge. These results suggest that the measurement of the sIL-2R
      level could be a marker of disease activity.

PMID- 2242793
TI  - Induction of labour: the effect of vaginal prostaglandin or i.v. oxytocin--a
      matter of time only?
AB  - Ninety-one pregnant women with unfavourable cervix (Bishop score no higher than
      6) were randomly allocated to induction of labour with either prostaglandin E2
      suppositories 2.5 mg 1-2 a day or i.v. oxytocin 4-32 mU/min. The induction
      procedure was carried on for 2 days. For statistical comparison of efficacy, life
      table analysis and the logrank test were used with vaginal delivery as the aimed
      'event'. Prostaglandin suppositories were more efficient after 12 h (p less than
      0.025) and 24 h (p less than 0.005), whereas no difference in efficacy was
      observed after 48 h. Vaginal delivery was obtained within 48 h in 74% of the
      women in the prostaglandin group and in 70% in the oxytocin group. No difference
      was observed in methods of delivery or neonatal Apgar scores, though, in neonates
      delivered vaginally within 2 days, lowered umbilical artery blood pH values were
      found after prostaglandin E2 suppositories (p less than 0.05). The patients
      attitude toward the method of induction was highly in favour of the prostaglandin
      suppositories. Prostaglandin E2 suppositories are considered excellent for
      induction of labour if delivery has to be within 24 h, whereas the two methods
      are equally effective after 48 h.

PMID- 2242794
TI  - Computerized analysis of antepartum fetal heart rate tracings in normal
      pregnancies (version 88/2.29).
AB  - A computerized system is developed for the interpretation of antepartum fetal
      heart-rate monitoring. Various parameters are described to define the
      cardiotocograms. The pattern of the tracing is defined as saltatory, undulatory,
      reduced undulatory or silent according to the results of the spectrum analysis.
      Three different baselines including simple average baseline, real baseline and
      basecurve are described for each tracing. Spontaneous and fetal movement related
      accelerations and decelerations are also defined. Tracings from 33 normal
      pregnancies with normal outcome were studied and the distribution of parameters
      for each gestational week (28th to 40th) was defined. The real baseline of fetal
      heart rate was 141.5 +/- 8.5 between the 28th and 40th gestational week. 75% of
      the cardiotocograms were found to obtain fetal movement. It has also been
      observed that in normal pregnancies the general pattern of the tracings is
      undulatory or undulatory/saltatory.

PMID- 2242795
TI  - Development and application of a simple expert system for the interpretation of
      the antepartum fetal heart rate tracings (version 88/2.29).
AB  - A simple expert system is developed for the interpretation of antepartum fetal
      heart rate tracings. The perinatal expert chose to use the phrase 'Fetal Reserve'
      to describe what the cardiotocogram is indirectly measuring. Our analysis program
      gives numerical values to each CTG such as 5, 4, 3, 2.5, 2 and 1 corresponding to
      the fetal reserve conditions of good, satisfactory, probably satisfactory with
      uncertainty, borderline, decreased, and critical respectively. This study
      consists of 33 normal pregnancies with normal outcome. Each patient is followed
      by our computerized system biweekly from the 28th to the 38th gestational week
      and weekly there after. The expert system's decision for 28th, 30th, 32nd, 34th,
      36th, 38th, 39th and 40th gestational weeks were 3.3 +/- 1.0, 3.8 +/- 0.7, 3.8 +/
      1.0, 4.1 +/- 0.9, 4.1 +/- 0.7, 3.6 +/- 1.0, 4.2 +/- 1.0, 3.8 +/- 0.9 and 3.4 +/-
      1.2, respectively. In this study, we have used confusion matrix to determine the
      normal, security, and danger zones according to the perinatal expert and the
      expert system and the discriminatory power of the system is found to be highly
      significant statistically (Q = 221). We also showed that the passive test (non
      stress test) in normal pregnancies has demonstrated false positive results in 4.2
      and 9.3% of the cases according to the evaluations of the perinatal expert and
      the expert system, respectively.

PMID- 2242797
TI  - Coexistence of spermatozoa morphological abnormalities in the semen of subfertile
      men with varicocele.
AB  - Spermatozoal morphology in semen specimens from 107 subfertile men with
      varicocele, aged from 18 to 50 years, were evaluated from Papanicolaou-stained
      smears, in order to investigate: (a) the frequency of abnormalities in the neck
      and tail of spermatozoa with an abnormal head; and (b) the ability of prediction
      of the morphology of one sperm part when the morphology of another is known. It
      was found that: (1) Morphological abnormalities in the neck are significantly
      more frequent (p less than 0.01) in spermatozoa with an abnormal head than in
      spermatozoa with a normal head. (2) Morphological abnormalities in the tail and
      cytoplasmic droplet are also more frequent, although not significantly, in
      spermatozoa with an abnormal head. (3) The proportional reduction in error (PRE)
      was low in all cases. Our results show that spermatozoa with abnormal heads
      present morphological abnormalities of their other parts more often than
      spermatozoa with normal heads. However, no prediction can be made on the nature
      of the morphology of a part of a spermatozoon on the basis of knowledge of the
      morphology of another of its parts.

PMID- 2242796
TI  - Chlamydial IgG and IgA in serum and follicular fluid among patients undergoing in
      vitro fertilisation.
AB  - The point prevalence of IgG and IgA antibodies to Chlamydia was analyzed in serum
      and follicular fluid in 63 patients undergoing in vitro fertilisation (IVF) in
      comparison to sera of 298 healthy women by the single serovar (L2) inclusion
      immunoperoxidase assay (IPA). The presence of specific IgG and IgA to Chlamydia
      in follicular fluid was demonstrated. No statistical association was found
      between the presence of specific Chlamydia IgG and IgA in serum and follicular
      fluid to oocyte fertilization. The positive predictive value for mechanical
      infertility of Chlamydia IgG at titers of greater than or equal to 128 and IgA
      titers at greater than or equal to 16 was 91 and 92%, respectively, in this high
      risk group for mechanical infertility. Multiple regression analysis singled out
      Chlamydia IgG levels as a major contributor to the variance between the groups of
      infertile patients.

PMID- 2242798
TI  - Carcinoma of the stomach associated with the pregnancy: two case reports.
AB  - Two case reports on carcinoma of the stomach associated with pregnancy are
      presented. In both cases, the main symptoms were persisting hyperemesis, nausea
      and weight loss. Both mothers succumbed within a year after their pregnancy, but
      the infants born by Cesarean section are doing well. The diagnostic and
      therapeutic difficulties which are encountered when a carcinoma complicates a
      pregnancy are discussed.

PMID- 2242799
TI  - Previous obstetric history and subsequent preterm delivery in Greece.
AB  - A total population sample of 6524 multigravid women who were certain of the date
      of their last menstrual period was obtained from the population-based Greek
      National Perinatal Survey of April 1983. The sample was used to determine the
      associations between features of the maternal obstetric history and preterm
      delivery. There were significant associations between preterm delivery and
      previous fetal losses, whether early (miscarriages and/or induced abortions) or
      late (stillbirths). For mothers who had experienced miscarriage(s), induced
      abortion(s) or stillbirth(s) the odds ratios were 1.40, 1.36 and 1.15,
      respectively, compared with mothers without any fetal loss. The odds ratio
      increased substantially with the increasing number of losses and reached 5.60 for
      the small group of mothers who had had prior miscarriage, termination and
      stillbirths. The results changed very little when the socioeconomic
      characteristics of the family were taken into account.

PMID- 2242800
TI  - Proceedings of the Consensus Conference on Therapeutic Endoscopy in Bleeding
      Ulcers. March 6-8, 1989.

PMID- 2242802
TI  - Endoscopic risk factors for bleeding peptic ulcer.

PMID- 2242801
TI  - Therapeutic endoscopy and bleeding ulcers. Clinical risk factors.

PMID- 2242803
TI  - Therapeutic endoscopy and bleeding ulcers: historical overview.

PMID- 2242804
TI  - Pathophysiology of bleeding lesions.

PMID- 2242805
TI  - Therapeutic endoscopy and bleeding ulcers. Efficacy criteria--outcome of therapy.

PMID- 2242806
TI  - Introduction to endoscopic therapy for bleeding peptic ulcers.

PMID- 2242808
TI  - Argon laser/CO2 treatment of bleeding ulcers.

PMID- 2242807
TI  - Therapeutic endoscopy and bleeding ulcers. Nd:YAG laser: the pro approach.

PMID- 2242809
TI  - Monopolar and electrohydrothermal treatment of upper gastrointestinal bleeding.

PMID- 2242810
TI  - Therapeutic endoscopy and bleeding ulcers. Bipolar/multipolar electrocoagulation.

PMID- 2242811
TI  - Heat probe for hemostasis of bleeding peptic ulcers: technique and results of
      randomized controlled trials.

PMID- 2242812
TI  - Injection therapy for the control of bleeding ulcers.

PMID- 2242813
TI  - Topical therapy for the control of gastrointestinal bleeding.

PMID- 2242814
TI  - Therapeutic endoscopy and bleeding ulcers: methodology.

PMID- 2242815
TI  - Consensus statement on therapeutic endoscopy and bleeding ulcers. Consensus
      Development Panel.

PMID- 2242816
TI  - Epidemiology of upper gastrointestinal bleeding.

PMID- 2242818
TI  - [The early development of Jacobson's organ in the nasal cavity of the rat before
      the inception of the secondary palatal development].
AB  - The early development of Jacobson's organ was studied by means of a series of
      embryos of the rat which were of various ages and exactly dated. Already at the
      youngest stage of those rats, the nasal cavity is just an open groove, the organ
      is a thickened epithelial layer at the medial nasal process. Only 15 h later,
      while the nasal grooves start to close from caudal to rostral, Jacobson's organ
      has acquired the shape of a deep, long cleft, situated within the broad nasal
      opening. On the 13th d of fetal life, a complete, caudally closed nasal cavity
      appears. By the means of fundamental growth changes, the already well developed
      organ has become shifted to a more caudal position and lies now above the primary
      palate. A shorter caudal part of the still cleft-like organ just starts to close
      itself thus forming its typical tube-like structure. Moreover strong nerve
      bundles running from Jacobson's organ to the brain indicate that in the meantime
      a sensory epithelium can be distinguished. Up to the 15th d of development, the
      tube-forming process of Jacobson's organ is completed. Parallel to this
      procedure, the surrounding nasal cavity acquires a caudal apertura nasalis
      interna by the rupture of the membrana bucconasalis while Jacobson's organ still
      lies above the rostral primary palate. Primary in the medial, somewhat later in
      the lateral part of the nasal cavity, first outlines of cartilage appear, visible
      as dense cell formations. Together with this, the paraseptal cartilage, in these
      stages closely connected to the septal cartilage, develops quite early. Between
      the 14th and 15th d of its fetal life, the flat, tube-formed Jacobson's organ of
      the rat gets turned from a primary horizontal into a vertical position, which
      brings its sensory epithelium to the medial side. It is assumed that this happens
      for functional reasons. Because of the obviously early and progressive
      development of Jacobson's organ within that of the nasal cavity, it seems to be
      probable that already the origin of the nose, the olfactory placodes, are
      determined in the directions both of the nasal cavity and of Jacobson's organ.
      Furthermore the results demonstrate an early preferential development of
      Jacobson's organ in comparison to that of the surrounding nasal cavity.

PMID- 2242817
TI  - [Craniogenesis in the laughing gull (Larus ridibundus L.). The reconstruction of
      the basic plan of the bird].
AB  - To contribute to the knowledge of the cranium of older bird embryos, the
      chondrocranium and osteocranium of the Black-headed Gull (Larus ridibundus) are
      described. The chondrocranium of the Black-headed Gull is compared with the
      chondrocranium of other bird species with special consideration of functional and
      phylogenetic aspects. As a result a "grundplan" of the bird chondrocranium is
      reconstructed. Most of the chondrocranial autapomorphies of birds are connected
      with the enlargement of the eyes, the development of a beak and a prokinetic
      skull, and the reduction of the olfactory system.

PMID- 2242819
TI  - [Preliminary study of an interdisciplinary examination of the body height
      proportions of Germans in the 19th century and of the influence of living
      conditions. I. Introductory justification, problems and preliminary studies based
      on authentic sources from the political districts from northern Germany to
      Wurttemburg].
AB  - Researches about the influences of the nutritional conditions on body-height need
      interdisciplinary co-operation of Anthropology, History, and Dietetics. Such a
      team will be difficult succeed in joining. Especially interesting for human
      sciences are nutritional-constitutional researches on German populations in the
      19th century, because in this century multifarious varieties exist within the
      German settlement. Author hopes, that preliminary original researches and first
      trends in results facilitate the joining of such an interdisciplinary team. In
      part I of this inquiry, the necessity for nutritional-constitutional researches
      are justified, problems are treated and mustering-statistics, the most important
      data-material, are collected for the political regions of that time from North to
      the kingdom Wurttemberg. The kingdom Wurttemberg of course is the political
      region with the most continuous data-series, but the data-material is poor on
      body-height-means and needs new statistical treatments. Less data are
      particularly available from the middle of the German settlement.

PMID- 2242820
TI  - On the origin of the so-called Meckelian ossicles in the nasal skull of
      odontocetes.
AB  - Although Cave (1987) accepts the theory that the Meckelian ossicles originate
      from the maxilloturbinals, evidence given in his study in fact supports the
      opinion of Klima and van Bree (1985) that the Meckelian ossicles arise from
      elements of the nasal floor, solum nasi, of the embryonic nasal capsule, in
      particular from the lamina transversalis anterior and the cartilago paraseptalis.

PMID- 2242821
TI  - [Metric studies of the dermal ridges of the palm in relation to handedness].
AB  - Palm prints of 394 right-handers and 356 non-right-handers (left-handers and
      ambidexters) were evaluated regarding distance ad, ulnar shift, and relative
      horizontal triradius distance. Comparison between handedness groups produced some
      significant differences. The "graded distinction of dermatoglyphic traits" which
      was found in an earlier study has been confirmed. It has been suggested a
      modification of terminology for the position of axial triradii.

PMID- 2242822
TI  - [The effect of morphologic variety on the biostatics of lumbosacral transition].
AB  - Variants shown by the orientation of the cover-plate and of the superior
      articular facets of the sacrum have a considerable influence on the lumbosacral
      biostatistics. This can be illustrated by parallelograms of forces. If we assume
      a certain force stressing upon the sacrum, we are able to calculate the
      distribution of stress upon the cover-plate and the articular facets by help of
      the size and the orientation of these weight bearing faces.

PMID- 2242823
TI  - [Comparative anatomic studies of the tongue of Pan troglodytes (Blumenbach, 1799)
      and other primates. I. The chimpanzee tongue].
AB  - This study was carried out on a comprehensive collection of tongues of Pan
      troglodytes. Material of tongues of Tupaia glis, Microcebus murinus, Chirogaleus
      major, Lemur catta, Galago crassicaudatus, Cebus apella, and Macaca mulatta were
      used for comparison of the different stages of the development of the papilla
      foliata. The tongue of Pan exhibits longitudinal growth correlated with the
      growth of length of the jaws and individual age. A typical foramen caecum as it
      occurs in man was gross anatomically not recognizable. Seldom a small circular
      depression appeared in the midline close to the papilla circumvallata centralis
      which could be the remnant of the foramen caecum. There is a remarkable
      accumulation of papillae filiformes and fungiformes at the apex linguae; the same
      seems to be true for other genera of primates. It is self-explanatory that the
      accumulation of papillae makes the tip of the tongue a particularly sensitive
      area; this has been found to be true even in man. One specimen of the prenatal
      age just before term was studied. It exhibited remarkably elongated, thread-like
      papillae, their function is unknown as yet. They are no longer present in a
      newborn specimen of 4 d of age. In the aboral part of the dorsum linguae, a
      special kind of papillae occur; they are flat lobes which carry moderately
      elongated, tiny processes at their free margin. The function of these papillae is
      unknown; taste buds are absent.

PMID- 2242824
TI  - Enhanced ristocetin-induced von Willebrand factor binding to platelet
      glycoprotein Ib in patients with steroid-responsive nephrotic syndrome.
AB  - To elucidate the mechanism of enhanced ristocetin-induced platelet aggregation
      (RIPA) in steroid-responsive nephrotic syndrome (SRNS), plasma levels of von
      Willebrand factor antigen (vWF:Ag) and ristocetin cofactor (RCof) were examined
      in 6 patients and the amount of ristocetin-induced vWF binding to platelets was
      determined. At the initial or relapse stage, the plasma vWF:Ag level was 415 +/-
      137% and the RCof level was 364 +/- 117%. The ratio of RCof/vWF:Ag was 0.90 +/-
      0.15 and no abnormalities of vWF:Ag multimers were observed, indicating that
      neither functional nor structural abnormalities were present in patient's plasma.
      The amount of ristocetin-induced normal vWF binding to nephrotic washed
      platelets, when ristocetin was used at concentrations of 0.5, 0.75, and 1.0
      mg/ml, was 152-163% above the binding to normal platelets. In addition, nephrotic
      washed platelets resuspended in either normal or nephrotic plasma aggregated at a
      low concentration of ristocetin (0.75 mg/ml) which did not induce aggregation of
      normal platelets. In accordance with these observations, the decrease of Alcian
      blue 8GX binding to platelets, reflecting diminished surface negative charge, was
      also observed. These results appear to indicate that the plasma vWF level and the
      altered surface-negative charge in platelets both contribute to heightened vWF
      binding to GPIb, thus lowering the ristocetin concentration required for RIPA in
      SRNS.

PMID- 2242825
TI  - Glycometabolic control and fibrinolysis in diabetic patients.
AB  - We investigated 148 diabetic patients with regard to their relationship between
      fibrinolysis (D-dimer and plasminogen activator inhibitor; PAI) and
      glycometabolic control (HbA1c, HbA1 and fructosamine). The percentage of
      moderately controlled patients as indicated by HbA1c, HbA1 and fructosamine is
      relatively high (29.7, 41.7 and 30.4%, respectively). Simultaneously, the D-dimer
      and PAI levels turned out to be enhanced in 30.8 and 22.4% of the patients. There
      was a positive nonsignificant correlation between D-dimer and HbA1c, a highly
      significant negative correlation between D-dimer and HbA1 and a nonsignificant
      negative correlation between D-dimer and fructosamine. According to the upper
      limits of the distinct reference ranges for HbA1c, HbA1 and fructosamine, we
      splitted up the D-dimer results and calculated the mean D-dimer values belonging
      to each category. Comparing the D-dimer means for each parameter, we separately
      obtained significant differences of the D-dimer means between the lower and
      higher HbA1 and fructosamine groups, whereas in the case of HbA1c the mean D
      dimer values of the categories under and over 9% showed no significant
      difference. For PAI, we found only weak nonsignificant positive correlations to D
      dimer and fructosamine and weak but highly significant correlations to HbA1c.
      These results are indicative for an increase of PAI with diminished
      glycometabolic control as measured with the HbA1c and fructosamine level. Both D
      dimer and PAI showed positive, highly significant correlations to the age of the
      diabetic patients, whereas HbA1c and fructosamine were age independent.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2242826
TI  - Structure-specificity of the genotoxicity of some naturally occurring
      alkenylbenzenes determined by the unscheduled DNA synthesis assay in rat
      hepatocytes.
AB  - A number of alkenylbenzenes related to safrole and estragole are known to be
      hepatocarcinogenic in rats and/or mice, apparently by a genotoxic mechanism.
      However, they are not bacterial mutagens in the Ames test. We have studied the
      ability of a series of carcinogenic and non-carcinogenic congeners to induce
      unscheduled DNA synthesis (UDS) in freshly isolated rat hepatocytes in primary
      culture. The cytotoxicity of these compounds was assessed by lactate
      dehydrogenase leakage. There was an excellent correlation between UDS induction
      and known rodent hepatocarcinogenicity, with safrole, estragole and methyleugenol
      all inducing UDS. Anethole, isosafrole, eugenol and allylbenzene, for which
      evidence of carcinogenicity is equivocal or negative, did not induce UDS. All
      compounds were markedly cytotoxic at concentrations between 10(-3) and 10(-2) M,
      irrespective of their structural features. The data are discussed with reference
      to the known structure dependence of the disposition of the alkenylbenzenes,
      notably their metabolic activation, with which there are excellent correlations.
      The demonstration of the genotoxicity of rodent hepatocarcinogenic
      alkenylbenzenes in cells cultured from the in vivo target organ will allow the
      direct investigation of factors influencing these processes and facilitate the
      safety evaluation of these important natural flavours.

PMID- 2242827
TI  - Urinary and bladder responses to immobilization in male rats.
AB  - Immobilization of groups of five to nine male rats for 2-5 days results in a 50%
      increase in urinary bladder fresh weight compared with normally caged controls.
      The increase in urinary bladder weight was not due to tissue oedema and was
      accompanied by epithelial hyperplasia in some urinary bladders. Immobilization
      did not alter total urine volume, but it did decrease the frequency of urine
      voiding and doubled the mean urine weight/voiding. Thus, bladder distention
      caused by the increased volume per voiding caused a rapidly induced increase in
      bladder tissue growth, and was accompanied by an increase in bladder epithelial
      cell division.

PMID- 2242828
TI  - Effects of Escherichia coli lipopolysaccharide on nitrate synthesis and on
      nitrosation of proline in rats.
AB  - Male Ola:SD rats were fed purified diets containing 5 or 20% lactalbumin as the
      protein source, with or without concomitant administration of Escherichia coli
      lipopolysaccharide (50-250 micrograms/kg, ip), and changes in 24-hr urinary
      nitrate excretion, plasma urea, plasma-nitrate pool size and 24-hr urinary
      nitrosoproline excretion were measured. Urinary nitrate and urinary 14C
      nitrosoproline excretion (after oral [14C]proline administration) were
      significantly greater for rats receiving the high-protein diet compared with
      those on the low-protein diet. The co-administration of lipopolysaccharide
      increased nitrate excretion in both diet groups (although the increase was
      greatest (relatively) in the animals fed 5% lactalbumin), but did not
      significantly alter urinary nitrosoproline excretion by either group. Plasma urea
      concentrations and plasma-nitrate pool size were increased by a high-protein diet
      and/or lipopolysaccharide administration. These findings suggest that treatments
      which alter the availability of nitrate in vivo are not necessarily associated
      with increased nitrosation of proline.

PMID- 2242829
TI  - Toxicological evaluation of morning glory seed: subchronic 90-day feeding study.
AB  - Diets containing 0.8, 2.53 and 8.0% field variety morning glory seed were fed to
      male and female rats (20 per group) in a 90-day subchronic feeding study. Gross
      clinical observations, body weight, and feed and water intake were recorded
      weekly. At 90 days, all surviving rats were autopsied, organs were weighed, and
      blood chemistry analyses, haematology, and bone-marrow evaluation for evidence of
      clastogenic effects were performed. Tissues from control (0% seed) and high-dose
      (8.0% seed) rats were examined histologically. Effects of morning glory seed were
      noted mainly in the high-dose group of both sexes. These included increases in
      mortality, feed consumption (on a body-weight basis), water consumption, serum
      alkaline phosphatase and potassium, white blood cell count, and brain and liver
      weights (as a percentage of body weight); body-weight gain and serum glucose were
      decreased. Significant changes seen in high-dose females alone were: increased
      haemoglobin, serum constituents (urea nitrogen, glutamic-pyruvic transaminase,
      glutamic-oxaloacetic transaminase, and ornithine carbamyl transferase), and organ
      weights (heart, kidney, spleen and pancreas as a percentage of body weight), and
      decreases in serum albumin, total protein, albumin:globulin ratio, and calcium.
      Significant changes occurring in high-dose males alone were: increased testicular
      weight (as a percentage of body weight), increased serum phosphorus, and
      decreased serum cholesterol. Liver degeneration in the high-dose females was
      greater than that in the controls. Mortality at 8.0% seed in the diet was 40% in
      males and 10% in females. At 0.8% seed, the only parameter that differed
      significantly from that of the controls was a final body-weight reduction in
      females without a corresponding reduction in feed consumption.

PMID- 2242830
TI  - Steric effects on the haemolytic activity of aromatic disulphides in rats.
AB  - Certain derivatives of diphenyl disulphide are known to cause haemolytic anaemia
      in rats, by a mechanism possibly involving intra-erythrocytic redox cycling with
      concomitant generation of 'active oxygen' species. In ring-substituted diphenyl
      disulphide derivatives, electronic effects of substituents have been shown
      markedly to affect the rate of 'active oxygen' production in vitro and toxicity
      in vivo. In the present study, the influence of steric effects of substituents on
      these parameters has been investigated. The severity of the haemolysis induced in
      groups of seven rats by oral dosing with 4,4'-dimethoxydiphenyl disulphide and
      4,4'-dimethyldiphenyl disulphide at doses of 500 mumol/kg/day for 6 days was
      greater than that of the 2,2' isomers and the haemolytic activity of a series of
      2,2'-dialkyl derivatives decreased with increasing size of the alkyl group. In
      vitro, the haematin-catalysed oxidation rates and the rates of redox cycling of
      the corresponding thiols in the presence of glutathione were similarly influenced
      by steric hindrance. The structure-activity relationships identified in the
      present investigation, together with knowledge of the electronic effects of
      substituents, should permit accurate prediction of the toxicity of new or
      untested aromatic thiols and disulphides.

PMID- 2242831
TI  - Regional distribution of dopamine beta-hydroxylase and monoamine oxidase in the
      brains of rats exposed to manganese.
AB  - The regional distribution of dopamine beta-hydroxylase (DBH) and monoamine
      oxidase (MAO) in rat brain was compared in control rats and rats given manganese
      in drinking-water (1 mg Mn/ml) for 30 days. In treated rats there was a
      significant accumulation of Mn in almost all regions of the brain except the
      hippocampus. Accumulation was highest in the hypothalamus, cortex and striatum.
      After Mn exposure, DBH activity was significantly decreased (in comparison with
      the controls) in the hypothalamus, striatum, mid-brain, cerebellum and cortex. A
      significant increase in MAO activity was found in the striatum, hypothalamus, mid
      brain, hippocampus and medulla. The effects of Mn on these enzymes suggests the
      involvement of biogenic amines like dopamine, norepinephrine and serotonin during
      Mn toxicity. The effect of Mn is region specific and in certain regions the
      action of Mn on DBH differs from that on MAO. These different effects of Mn on
      DBH and MAO in different regions of the brain might explain the variable symptoms
      seen in Mn-induced neurotoxicity in humans.

PMID- 2242832
TI  - Acute and sub-acute inhalation toxicity of germanium metal powder in rats.
AB  - An acute (4-hr) and a sub-acute (4-wk) inhalation toxicity study of germanium
      metal powder (purity 99.8%, mean particle size 2.0-2.4 microns) were carried out
      in young adult Wistar rats. Exposure of five male and five female rats to 3.86 or
      5.34 g/m3 for 4 hr resulted in the death of one rat at each exposure level. Four
      groups of five male and five female rats were exposed to 0, 9.9, 65.1 or 251.4
      mg/m3 for 6 hr/day, 5 days/wk for 30 days. Two additional (recovery) groups of
      five male and five female rats exposed to 0 or 251.4 mg/m3 were kept untreated
      for 31 days after exposure. At the end of the treatment period, fasting blood
      glucose was decreased in males exposed to the high concentration. In females of
      this group, blood creatinine and urea levels, and urine volumes were increased,
      but urine density was decreased. Increased blood creatinine levels and urine
      volume and decreased urine density were also observed in females exposed to 65.1
      mg/m3. The absolute and relative lung weights were increased in rats in the mid
      and high-concentration groups. Histopathological examination revealed:
      accumulation of particulate material in the lungs of all treated groups,
      accumulation of alveolar macrophages in the mid- and high-concentration groups,
      and alveolitis mainly in the high-concentration group. After the 4-wk recovery
      period, urine volume was increased in males that had been exposed to germanium.
      In exposed rats of both sexes, lung weights were still increased and
      histopathological changes were present, but to a lesser extent than at the end of
      the exposure period. It was concluded that the 4-hr LC50 value of germanium metal
      powder in rats is greater than 5.34 g/m3. The no-adverse-effect level in the 4-wk
      study was 9.9 mg/m3 air.

PMID- 2242833
TI  - Long-term toxicity/carcinogenicity of musk xylol in B6C3F1 mice.
AB  - The long-term toxicity/carcinogenicity of musk xylol, a synthetic nitro musk, was
      examined in B6C3F1 mice of both sexes. Musk xylol was administered at dietary
      levels of 0 (control), 0.075 or 0.15% for 80 wk. The overall tumour incidences in
      all treated groups of both sexes were significantly higher than those in the
      corresponding controls. Combined malignant and benign liver cell tumours were
      clearly increased in both sexes, and in males a positive significant trend was
      also noted for the occurrence of hepatocellular carcinomas. In males the
      incidence of Harderian gland tumours was also significantly greater in treated
      groups than in controls. Some other neoplasms, such as lung tumours in both sexes
      and Harderian gland tumours and lymphomas in females, occurred in greater numbers
      in the treated groups, although the differences were not statistically
      significant in comparison with the controls. In addition, the incidences and
      total numbers of malignant tumours were significantly increased in treated groups
      of both sexes, although the increases were not dose dependent. The results
      demonstrated that musk xylol is carcinogenic in B6C3F1 mice when given at dose
      levels of 0.075 or 0.15% in the diet for 80 wk.

PMID- 2242834
TI  - Meeting report: Bruce Ames lecture.

PMID- 2242836
TI  - Comment: chemical carcinogens and human cancer.

PMID- 2242835
TI  - The Sellafield leukaemia cluster: a milestone in the history of mutagenesis?

PMID- 2242837
TI  - [Drowning accidents in childhood].
AB  - This is a report on five boys aged between 1 and 5 years who, after prolonged
      submersion in cold water, were treated at our department. On being taken out of
      the water, all the patients were clinically dead. After 1- to 3-hour successful
      cardiopulmonary resuscitation, with a rectal temperature of about 27 degrees C,
      they were rewarmed at a rate of 1 degree/hour. Two patients died within a few
      hours after the accident. One patient survived with an apallic syndrome, 2
      children survived with no sequelae. In the event of a water-related accident
      associated with hypothermia, we consider suitable resuscitation to have
      preference over rewarming measures. The most important treatment guidelines and
      prognostic factors are discussed.

PMID- 2242838
TI  - [Focal liver lesions as incidental findings. 2: Diagnostic procedures in
      sonographically homogeneous echo-rich, echo-poor or inhomogeneous lesions].
AB  - Hemangioma is one of the most common incidental findings in the ultrasonographic
      image. In 80% to 90% of the cases, the hemangioma presents as a homogeneous
      lesion in the US image. In asymptomatic patients and a lesion diameter of less
      than 2 cm, further clarification additional to ultrasonography is not necessary.
      Major differential diagnoses are focal nodular hyperplasia, metastasis,
      hepatocellular carcinoma and liver cell adenoma. With exceptions, the biological
      significance of echo-poor or inhomogeneous lesions cannot be established on the
      basis of the US image. In such cases, additional diagnostic procedures are
      required.

PMID- 2242839
TI  - [First aid in animal poisons. 1: poisoning due to mussel consumption].

PMID- 2242840
TI  - [High-dosage oral magnesium therapy in arrhythmias. Results of an observational
      study in 1.160 patients with arrhythmia].
AB  - In the treatment of cardiac arrhythmias of varying genesis, an "observational
      study" in 1,160 patients showed that a high-dose oral magnesium preparation
      (Magnesium-Diasporal N 300 Granulat) was effective. In 82% of the patients
      observed, a dose of at least 300 mg magnesium/day produced good to very good
      results. Adverse effects of the drug were observed in only 1.6% of the patients.
      For all groups, the "success parameters" improved significantly. High-rate
      arrhythmias showed a better response to magnesium treatment than did low-rate
      arrhythmias, with a close correlation being found with the heart rate at the
      start of treatment. High-dose oral magnesium had a positive effect on concomitant
      hypertension. At a dosage of 300 mg treatment should be continued for at least 6
      weeks.

PMID- 2242841
TI  - [From Bergmanns' Hospital to university institution. Bergmannsheil Bochum-
      pathological institute].

PMID- 2242842
TI  - [Trans-vaginal sonography in gynecological practice].
AB  - Some 1,077 transvaginal ultrasonic studies performed in the gynecologist's office
      are reported. The US technique employed was particularly useful, since, in
      combination with the pelvic examination, it permitted rapid and accurate
      diagnosis. Patient acceptance was very high. Both in the gynecological and
      obstetric examinations, pathological findings were established in about 30% of
      the cases. In the diagnostic evaluation of both pre- and post-menopausal
      endometrium, and of the uterine cervix in advanced pregnancies, transvaginal
      ultrasonography opens up new diagnostic possibilities that can lead to a
      selective indication for D & C and cerclage.

PMID- 2242843
TI  - [A new tube for the endobronchial application of drugs].
AB  - During cardiopulmonary resuscitation, endobronchial administration of
      epinephrine, atropine and lidocaine is required as the initial step. This
      procedure provides a decisive time advantage, since it can be effected before
      venous access is established. The presently available techniques (direct
      application, catheter insertion, etc.), however, have disadvantages (interruption
      of ventilation, difficult catheter placement, time loss). For this reason we have
      developed a tube for endobronchial drug and gas application during resuscitation
      (EDGAR tube). It enables direct injection into the bronchial system via a
      separate injection canal within the wall of the tube that terminates at the tip
      of the tube. In this way, simple and safe application of the drugs to the
      appropriate absorption surface is ensured, without any loss of time. In view of
      these significant advantages, the use of the EDGAR tube is recommended for
      intubation for resuscitation purposes.

PMID- 2242844
TI  - [Rapid progression of the AIDS epidemic in eastern Africa].

PMID- 2242845
TI  - [First aid for animal poisons. 2: Poisoning due to fish consumption].

PMID- 2242846
TI  - [Cerebral insufficiency--treatment with Ginkgo-biloba extract. Time of onset of
      effect in a double-blind study with 60 inpatients].
AB  - Sixty inpatients with cerebral insufficiency and the leading symptom depressive
      mood, were treated in a double-blind study for 6 weeks with a daily dose of 160
      mg Ginkgo biloba extract or placebo. After 2, 4 and 6 weeks, changes in 12
      typical symptoms in comparison with the last examination, were evaluated. In the
      group receiving placebo, small, but progressive improvements were observed. In
      the Ginkgo-biloba group, the overall number of improvements was significantly
      larger. After 2 weeks the differences were marked for only a few of the symptoms;
      after 4 and 6 weeks in contrast, in 11 of the 12 symptoms. The largest number of
      improvements in the Ginkgo-biloba group was observed between the 2nd and 4th
      weeks of treatment. In this period, about two-thirds of the patients on Ginkgo
      biloba, and about one-fifth of the patients on placebo showed improvements.

PMID- 2242847
TI  - Viral myocarditis.
AB  - Evidence suggests that in susceptible individuals lymphocytic myocarditis is a
      virus-induced autoimmune disease which may progress to dilated cardiomyopathy.
      Its biopsy pathology, the application of the 'Dallas' criteria for diagnosis and
      the role of immunohistochemistry are discussed. The potential role for in situ
      hybridization in the detection of viral genomes is referred to. Pathogenesis may
      be related to persistence of viral RNA in tissues and may involve both cellular
      and humoral immune mechanisms. The effect may manifest itself at cellular level
      with myocytolysis or at sub-cellular level with interference in energy
      production, giving rise to considerable functional deficit with few morphological
      changes.

PMID- 2242848
TI  - Primary lymphoma of the thyroid: a clinical, histological and immunohistochemical
      study of 20 cases.
AB  - Twenty cases of malignant lymphoma arising in the thyroid gland were studied
      clinically, histologically and immunohistochemically. Nineteen cases were non
      Hodgkin's lymphoma (15 diffuse and four follicular lymphoma) and one was a
      plasmacytoma. Immunohistochemical analysis of the lymphomas using paraffin
      embedded sections disclosed that 17 lymphomas were B-cell type and two were T
      cell type. The plasmacytoma was of IgG kappa type. The large majority of the
      lymphomas were associated with an underlying chronic thyroiditis. The 5-year
      survival rate of the patients was 70%. An unfavourable diagnosis was more likely
      when the tumour was diffuse rather than follicular, when it was of diffuse large
      cell type or of immunoblastic type and when there was cervical lymph node
      involvement.

PMID- 2242850
TI  - A study of vesical adenocarcinoma, intestinal metaplasia and related lesions
      using mucin histochemistry.
AB  - Biopsy and autopsy material from the urinary bladder was studied using PAS and
      PAS-D techniques to identify glycogen and neutral mucins, the alcian blue/high
      iron diamine method to distinguish sialo- and sulphamucins and the PB/KOH/PAS
      technique to localize O-acylated sialomucins. All of 10 examples of normal
      urothelium and both of two cases of transitional carcinoma in situ contained
      glycogen, but no mucin. Other lesions displayed one of two patterns of mucin
      production: the extracellular mucin seen focally in 17 cases of cystitis cystica
      consisted of sialo- and/or neutral mucins only, a pattern also displayed by
      mucins produced in 10 of 13 examples of transitional cell carcinomas and by three
      of nine tumours purely or in part adenocarcinomas. The intracellular mucins
      expressed in five of the 17 cases of cystitis glandularis and in all of eight
      cases of frank intestinal metaplasia with goblet cells displayed a colonic
      phenotype, with production of O-acylated sialomucins. A similar profile was
      expressed by six adenocarcinomas and this included tumours likely to be of
      vesical and also of urachal origin. It is concluded that identification of O
      acylated mucins cannot distinguish between primary bladder tumours and metastases
      from a colonic primary, or between carcinomas of vesical and urachal origin.

PMID- 2242849
TI  - Mucin histochemistry and lectin binding sites in intestinal metaplasia of the
      urinary bladder.
AB  - We report a case of intestinal metaplasia of the bladder urothelium associated
      with dysplastic foci and a transitional cell carcinoma. A mixture of sialomucins,
      O-acetylated sialomucins and sulphomucins was found in the goblet cells.
      Neuraminidase resistant binding of the lectin peanut agglutinin was demonstrated
      in the brush border of columnar cells in intestinal metaplasia and diffusely in
      columnar cells in dysplastic foci. The histochemical findings are compared with
      those described in normal, dysplastic and neoplastic colonic mucosa.

PMID- 2242851
TI  - QBEND/10, a new monoclonal antibody to endothelium: assessment of its diagnostic
      utility in paraffin sections.
AB  - The immunoreactivity of a new monoclonal antibody to endothelium. QBEND/10, in
      formalin-fixed, paraffin-embedded sections from a variety of vascular and
      lymphatic tumours is described and compared to that of two other endothelial
      markers, von Willebrand factor and Ulex europaeus agglutinin, type 1. All the
      benign tumours of blood vascular origin showed immunoreactivity whereas only five
      out of eight lymphangiomas demonstrated a weak focal reaction with QBEND/10.
      Primitive lumina in epithelioid and spindle cell haemangioendotheliomas were
      highlighted in all the cases. Tumour cells in angiosarcoma forming vasoformative
      areas and solid areas showed immunopositivity to QBEND/10 in 17/23 and 13/24
      cases respectively, and complementary immunoreactivity for von Willebrand factor
      was observed. Proliferating vessels and the majority of spindle cells in Kaposi's
      sarcoma were positive in all 40 cases. Only one of 54 cases of carcinoma showed
      luminal reaction to QBEND/10. However, 17 of 45 spindle cell tumours displayed a
      positive reaction. QBEND/10 is an additional marker for demonstrating endothelial
      differentiation and has some advantages over currently available antibodies.

PMID- 2242853
TI  - Extraskeletal mesenchymal chondrosarcoma of the mediastinum.
AB  - Extraskeletal mesenchymal chondrosarcoma is a rare tumour with a predilection for
      the meninges and lower limb, especially the thigh region. This paper reports an
      extraskeletal mesenchymal chondrosarcoma occurring in the posterior mediastinum,
      a previously undocumented site.

PMID- 2242852
TI  - Atypical stromal cells of lower female genital tract.
AB  - Atypical stromal cells were identified in either the cervix or vagina in 27 (13%)
      of 205 autopsy specimens. They were more commonly observed in the vulva,
      occurring in 29 (78.4%) of 37 vulvar surgical specimens. In only seven patients
      were the cells present as a continuous band; five in cervix or vagina and two in
      vulva. Electronmicroscopic examination confirmed the fibroblastic nature of these
      cells. Although hormonal influences may be responsible for this stromal
      alteration, their occurrence in elderly patients and in males at other sites is
      not consistent with a specific hormonal profile. It is important not to
      misdiagnose these cells as malignant.

PMID- 2242854
TI  - Post-radiation malignant peripheral nerve sheath tumour: a report of two cases.

PMID- 2242855
TI  - Granulomatous inflammation of the spleen in infectious mononucleosis.
AB  - Granulomatous inflammation of the spleen has not previously been recorded in
      infectious mononucleosis. We report two cases and describe further morphological
      features more often associated with malignant lymphoid conditions.

PMID- 2242856
TI  - Symmetrical fibro-osseous dysplasia of rib--evidence for a traumatic aetiology.

PMID- 2242857
TI  - Gamna-Gandy nodules in a cardiac myxoma.
AB  - A 33-year-old female was admitted for surgery for removal of a left atrial
      myxoma. Histological examination of the tumour showed features characteristic of
      myxoma. Additionally, Gamna-Gandy bodies were present in the tumour. This is a
      rare finding.

PMID- 2242858
TI  - The histological and immunohistochemical evidence of squamous metaplasia from the
      myoepithelial cells in the breast.
AB  - Squamous metaplasia in the breast is well documented. However, the putative cell
      of origin for the squamous epithelium is not clear. This paper describes a case
      of fibroadenoma of the breast with myoepithelial hyperplasia and squamous
      metaplasia. The histological finding of transition between myoepithelial cells
      and squamous cells and the immunohistochemical expressions of actin and S-100 in
      the metaplastic squamous cells support the myoepithelial origin of squamous
      epithelium in the breast.

PMID- 2242859
TI  - Capillaria hepatica infestation in a 2-year-old girl.

PMID- 2242860
TI  - Before our time: half a century of histiocytic medullary reticulosis: a T-cell
      teaser?

PMID- 2242861
TI  - 'Skip lesions' in ulcerative colitis.

PMID- 2242862
TI  - Monocytoid B-cell lymphoma--a MALT tumour?

PMID- 2242863
TI  - Who was Sago?

PMID- 2242864
TI  - The benefits and drawbacks of managed care.

PMID- 2242865
TI  - Voluntary hospitalization and due process: the dilemma of Zinermon v. Burch.

PMID- 2242866
TI  - Implications of managed care for social work in psychiatric hospitals.

PMID- 2242867
TI  - Are England's psychiatric services for schizophrenia improving?

PMID- 2242868
TI  - Managed mental health care: myths and realities in the 1990s.
AB  - Managed care may be viewed as the most recent attempt to control the rate of
      increase of health and mental health care costs in the United States. The
      majority of people who receive insured mental health services do so through some
      form of managed care program. Now increasing concerns are being raised about
      whether managed care really reduces costs, whether it adversely affects the
      quality of care, and whether it restricts access to care. The author discusses
      the origins, actors, and major issues involved in managed health care in terms of
      prevailing myths and future realities. He calls for more and better research to
      answer important clinical and policy questions about managed care and for
      improved communication between mental health professionals and managed care
      organizations.

PMID- 2242869
TI  - Managed care: an approach to rational psychiatric treatment.
AB  - The author argues that rational mental health care delivery is possible through
      an appropriate managed care system of independent providers. The right model for
      delivery of care incorporates principles that include rational assignment of
      clinical functions, epidemiologic accountability, fiscal as well as clinical
      responsibility, open and direct patient access, incentives for preventive
      psychiatry, partnership between management and clinical providers, choice of
      services, outcome assessment, and interface between public and private providers.
      The author maintains that a link between what is good about private practice and
      what is good in rational managed care represents the best mental health care
      delivery system currently available.

PMID- 2242870
TI  - Managed care: a means of rationing psychiatric treatment.
AB  - Some form of patient care review has become an integral component of most health
      insurance plans. The author describes the numerous ways in which such review
      negatively affects the therapeutic relationship between the doctor and the
      patient. Pressured to cut costs, reviewers are unlikely to be objective in their
      evaluation of the need for treatment. Many are not qualified to review particular
      types of treatment. Avenues for appeal of reviewers' decisions are weak. The
      intensity and frequency of review are often disruptive both to the treatment and
      to the psychiatrist's practice. Some patients discontinue treatment after
      learning that their care is being reviewed because of fears about loss of
      confidentiality or other reasons. Informed consent procedures relating to release
      and protection of confidential information are inadequate. The author emphasizes
      the need for setting standards for review organizations that will help overcome
      these and other problems.

PMID- 2242872
TI  - Developing practice parameters: an interview with John McIntyre. Interview by
      John A. Talbott.

PMID- 2242871
TI  - Utilization management and the quality of care.
AB  - Utilization management is a mechanism for managing health care costs by assessing
      the appropriateness of care and influencing decisions about its provision to
      ensure the least costly but most effective treatment. Thus while primarily
      focused on reducing costs, utilization management also affects quality of care.
      The author reviews the historical development of utilization management,
      summarizes the review procedure, and suggests ways to enhance understanding of
      the effect of utilization management on quality of care.

PMID- 2242874
TI  - Characteristics of repeatedly assaultive psychiatric inpatients.
AB  - Investigations of assaults in psychiatric hospitals have found that a small
      proportion of inpatients are responsible for a large percentage of the violence
      that occurs. In a large state hospital patients who were repeatedly violent
      (recidivists) were compared with patients who were violent only once or twice
      (nonrecidivists), and the relationships between repeatedly violent behavior and
      gender, age, and diagnosis were examined. All reports of violent incidents over a
      six-month period for a population of 1,552 inpatients--a total of 497 incidents
      involving 313 patients--were reviewed. Seventy patients were involved in three or
      more incidents each and were responsible for 53 percent of all violence.
      Recidivist men inflicted serious injuries at a rate ten times higher than that
      for all the other violent patients. Recidivist women were significantly younger
      than nonrecidivist assaultive women and were about the same mean age as the
      assaultive men. Recidivist women were also more likely to have organic brain
      disorder or personality disorder.

PMID- 2242875
TI  - Gold Award. A public-private alliance to meet the needs of chronic mentally ill
      patients. Extended Care Program, West Central Human Service Center, North Dakota
      Department of Human Services, Bismarck.

PMID- 2242873
TI  - Treatment of depressed patients in general hospitals with scatter beds, cluster
      beds, and psychiatric units.
AB  - Records of 725 patients with a primary discharge diagnosis of depression were
      reviewed at nine general hospitals: three with psychiatric units, three in which
      patients were treated in beds grouped together on a medical or surgical floor
      (cluster beds), and three in which patients were treated in beds dispersed among
      medical and surgical beds (scatter beds). Patients treated in psychiatric units
      most commonly presented with suicidal or homicidal indicators, most frequently
      received antidepressants, and had the longest stays. Patients treated in scatter
      beds tended to present with somatic complaints, were least likely to receive
      antidepressants, and had the shortest hospital stays. Patients treated in cluster
      beds presented with intermediate symptoms and had stays of intermediate duration.
      Although dangerous or psychotic patients may be most appropriately treated in
      units, other patient groups may be safely and effectively treated at lower cost
      in less specialized inpatient settings.

PMID- 2242876
TI  - Gold Award. A multifaceted program for preventing and treating eating disorders.
      Programme for Eating Disorders, Department of Psychiatry, The Toronto Hospital,
      University of Toronto.

PMID- 2242877
TI  - Significant Achievement Awards. Treating the effects of trauma among Southeast
      Asian refugees--Indochinese Psychiatry Clinic, Department of Psychiatry, St.
      Elizabeth's Hospital, Boston.

PMID- 2242878
TI  - Significant achievement awards. Comprehensive mental health services for elderly
      citizens--Positive Aging Services, Massachusetts Mental Health Center, Boston.

PMID- 2242880
TI  - Significant Achievement Awards. Promoting renewed interest in ECT treatment,
      education and research--Electroconvulsive Therapy Program, Department of
      Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan.

PMID- 2242879
TI  - Significant Achievement Awards. A mental health program for juvenile offenders in
      state training school--Hawthorn Center Clinic for Adjudicated Youth, Northville,
      Michigan.

PMID- 2242881
TI  - Significant Achievement Awards. Patients helping themselves by helping the
      homeless--Share Your Bounty, the Friends of the Homeless Project, Bronx
      Psychiatric Center, Bronx, New York.

PMID- 2242882
TI  - Substance abuse and psychiatric disorders in prison inmates.

PMID- 2242883
TI  - Barriers to community treatment of patients with dual diagnoses.

PMID- 2242884
TI  - A process for do-not-resuscitate decisions in psychiatric hospitals.

PMID- 2242885
TI  - A model for successful job placement of residents in small board-and-care
      facilities.

PMID- 2242886
TI  - Psychiatric evaluation of competency in physically ill patients who refuse
      treatment.

PMID- 2242887
TI  - Reducing staff injuries.

PMID- 2242889
TI  - Britain's path.

PMID- 2242888
TI  - HIV positivity in inmates.

PMID- 2242890
TI  - Data watch. How many uninsured Americans are there?

PMID- 2242891
TI  - The new hospital CEO: many paths to the top.
AB  - A new kind of hospital CEO is beginning to emerge--one who has superior
      qualifications in a number of areas, including financial, operational, and
      interpersonal skills. As the position continues to evolve, its candidate
      requirements are shifting. The "traditional" hospital CEO, who advanced through
      mainly operations positions, is still in high demand and considered by many to be
      well prepared to meet current hospital challenges. But the emergence of chief
      executives from "alternative" backgrounds signals a new diversification in the
      field. We surveyed 556 hospital CEOs throughout the United States to get their
      views on selection, and we spoke with experts and leaders in the field with
      broadly divergent views. Who's on the inside track? The answers may surprise you.

PMID- 2242892
TI  - Experts offer differing views on the impact of a recession.
AB  - What are the risks of a prolonged recession for hospitals? Although health care
      would probably not be hurt as much as other industries by a lengthy downturn,
      financial experts are saying a continuation of the current soft economy would add
      to hospitals' already long list of financial woes. The coming recession "will
      exacerbate the problems for hospitals already facing fiscal stress," says Glenn
      Wagner, an investment banking consultant based in New York City.

PMID- 2242893
TI  - Lawsuits can pave rocky road to adequate Medicaid payment.
AB  - Wilder et al v. The Virginia Hospital Association is about to go to trial. Wilder
      is the case that resulted in the Supreme Court's June ruling affirming hospitals'
      right to sue state governments for inadequate Medicaid reimbursement. A federal
      court in Richmond must now decide whether Virginia's payment plan adequately
      reimburses the state's hospitals. And with momentum of their own, individual
      hospitals and state hospital associations are pressing hard for fair Medicaid
      reimbursements.

PMID- 2242894
TI  - Case study: quality improvement in a diversified health center.
AB  - Hospitals are beginning to apply industry models of quality improvement to their
      own, very different, health care settings, and some are achieving note-worthy
      success. Rush-Presbyterian-St. Luke's Medical Center, Chicago, is implementing
      the total quality management process originally developed by Minnesota Mining and
      Manufacturing (3M) Co., St. Paul.

PMID- 2242895
TI  - Managed care exec bridges gap between hospitals, employers.
AB  - An employer advocate can also be sensitive to provider needs, says Marsha
      Ballard. As CEO of Parkside Health Management Corp., Park Ridge, IL, Ballard
      develops managed care products that meet specific employer needs. Sensitivity to
      both providers and employers is crucial to Parkside's new national transplant
      network, she says.

PMID- 2242897
TI  - CEOs: Gulf crisis hits hospitals' bottom line.
AB  - Hospital CEOs say the Persian Gulf crisis could hit them hard where it counts. In
      fact, hospitals are already seeing some adverse impact from events in the Middle
      East. From fundraising to plant management to strategic planning, the
      confrontations in the Gulf are having an impact on the hospital's bottom line.

PMID- 2242896
TI  - Total quality management: steps to success.

PMID- 2242898
TI  - HDS (Health Data Sciences) enters patient care info systems market.

PMID- 2242899
TI  - Hospital to HMO: we don't need your business.

PMID- 2242901
TI  - AMA offers new service to simplify credentialing.

PMID- 2242900
TI  - Congress postpones HCFA's outpatient pay reform plan.

PMID- 2242902
TI  - Alzheimer's care: need outweighs financial risk.

PMID- 2242903
TI  - Homes doubt they can computerize per HCFA's request.

PMID- 2242904
TI  - Are some HIS (hospital information systems) alliances unfair to hospitals?

PMID- 2242905
TI  - Hospitals should pursue employer contracts.

PMID- 2242907
TI  - A brief history of injury.

PMID- 2242908
TI  - The art and science of editing.

PMID- 2242906
TI  - Rapid HLA-DPB typing using enzymatically amplified DNA and nonradioactive
      sequence-specific oligonucleotide probes.
AB  - A simple and rapid method for characterizing the polymorphism at the HLA-DPB1
      locus has been developed. The procedure involves the selective amplification of
      the polymorphic second exon of the DPB1 locus by the polymerase chain reaction
      (PCR), followed by hybridization of the amplified DNA with 15 nonisotopic
      sequence-specific oligonucleotide probes. There are no sequences within the
      second exon of the DPB1 locus that uniquely define an allele; rather, each allele
      appears to arise from the shuffling of a limited number of polymorphic nucleotide
      sequences in six regions of variability. Consequently, individual alleles are
      identified by the pattern of hybridization of the 15 probes. Two formats for
      typing are described. In Format I (the dot-blot), the amplified DNA is
      ultraviolet (UV) cross-linked to a nylon membrane and hybridized with the
      oligonucleotide probes which are covalently labeled with horseradish peroxidase
      (HRP). In Format II (the reverse dot-blot), the oligonucleotides, which have poly
      T tails, are bound to the membrane and the immobilized array of probes is
      hybridized to the PCR product which has incorporated biotinylated primers during
      the amplification process. In both formats, hybridization is detected by a simple
      colorimetric reaction. The application of this technology to the fields of tissue
      typing and individual identity is discussed.

PMID- 2242909
TI  - Military surgery.

PMID- 2242910
TI  - Supracondylar fractures of the femur.

PMID- 2242911
TI  - Arthroscopy.

PMID- 2242913
TI  - Injured ligaments of the knee.

PMID- 2242912
TI  - AO fixation.

PMID- 2242914
TI  - Traumatic perforation of the bowel.

PMID- 2242915
TI  - Thoracolumbar spinal injuries.

PMID- 2242916
TI  - Nerve injury.

PMID- 2242917
TI  - Preventing secondary brain damage after head injury: a multidisciplinary
      challenge.

PMID- 2242918
TI  - Skin loss of the lower limb.

PMID- 2242920
TI  - A review of parachuting injuries.

PMID- 2242919
TI  - Sports injuries.

PMID- 2242921
TI  - Resuscitation.

PMID- 2242923
TI  - Forensic medicine.

PMID- 2242922
TI  - Litigation in trauma.

PMID- 2242924
TI  - Management of disordered growth following physeal injury.

PMID- 2242925
TI  - Presence of IgA and IgG antigliadin antibodies in healthy adults as measured by
      micro-ELISA. Effect of various cutoff levels on specificity and sensitivity when
      diagnosing coeliac disease.
AB  - In this study a micro-ELISA (ELISA = enzyme-linked immunosorbent assay) was
      established and used to evaluate IgA and IgG antigliadin antibodies in 1,866
      healthy adults. There was a covariation between the level of IgA antigliadin
      antibodies and the total serum IgA concentration, probably due to an increased
      IgA response in some healthy subjects. We could not find any correlation between
      the presence of IgG and IgA antibodies in the healthy population using the 97.5th
      percentile as a cutoff value. The specificity of various cutoff levels was
      compared with the sensitivity of the test in a population of 40 patients with
      coeliac disease. IgA antigliadin antibodies had a high specificity (95%) at a
      cutoff value giving a high sensitivity (80%). This was not possible with IgG
      antigliadin antibodies which had a low sensitivity (40%) when the cutoff value
      was selected to give a high specificity. Due to the low prevalence of coeliac
      disease, a decrease in the specificity of the test will have a pronounced effect
      on the positive predictive value. The results indicate that only IgA antigliadin
      antibodies are useful markers when screening subjects with few typical symptoms
      for biopsy when diagnosing coeliac disease, whereas IgG antibodies are of low
      value because of their low specificity.

PMID- 2242926
TI  - Endotoxin-induced auto-immunity in mice. III. Comparison of different endotoxin
      preparations.
AB  - Six different endotoxin preparations derived from Escherichia coli and Salmonella
      typhimurium subspecies were compared as to their potencies to provoke auto-immune
      phenomena in mice. The numbers of spleen cells forming antibodies to bromelain
      treated isologous erythrocytes or anti-DNA antibodies, the serum levels of these
      auto-antibodies, and the circulating immune complex titres were determined. As
      far as comparison on a weight base was concerned, S. typhimurium Re-mutant
      lipopolysaccharide appeared to be the most active preparation in inducing auto
      antibody formation. Upon comparison of amounts with equal activity in the limulus
      amoebocyte lysate assay, however, S. typhimurium lipid A turned out to be the
      most potent. The contribution of O-type specific polysaccharides, phosphate
      groups, and the lipid A moiety to the potencies of the endotoxin preparations is
      discussed.

PMID- 2242927
TI  - Human IgE, IgG and IgA antibody responses to T101, a murine monoclonal antibody
      against human lymphocytes: implications for pathogenesis, risk and avoidance of
      adverse immunologic reactions.
AB  - To study immune responses that may play a role in immediate-type allergic
      reactions (ITAR) and serum-sickness-like reactions that have been reported with
      administration of monoclonal antibodies (MAb), we measured by enzyme-linked
      immunosorbent assay serum levels of IgE, IgG, and IgA human antimurine antibody
      (HAMA) to T101, a murine IgG2a antibody that has been used in the treatment of
      cutaneous T cell lymphoma (CTCL) and chronic lymphocytic leukemia (CLL). None of
      8 patients (4 with CLL, 4 CTCL) pretreated with T101 had elevated titers of any
      HAMA class tested as compared to normal control sera. All CTCL patients who had
      elevated total serum IgE levels, but normal total serum levels of other antibody
      classes, had significant rises in IgE, IgG, and IgA HAMA to T101 after
      intravenous MAb infusion. However, the CLL patients who were
      hypogammaglobulinemic failed to develop significant rises in HAMA. Three patients
      (2 CLL, 1 CTCL) had ITAR (e.g., urticaria, angioedema, bronchospasm) associated
      with infusion of T101; prophylactic medication regimens based upon the control of
      radiographic contrast media reactions were used with apparent benefit in
      subsequent infusions in these patients. All 8 patients had negative immediate
      intradermal skin tests (1 microgram/ml) to T101 prior to its infusion. Our data
      confirm that (1) non-IgE-mediated mechanisms cause ITAR from this MAb, possibly
      by a mechanism inherent in the action of this MAb against lymphocytes, and (2)
      that isotypic antibody responses to MAb vary with the type of malignancy being
      treated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2242928
TI  - Bronchial responsiveness to mite allergen in atopic dermatitis without asthma.
AB  - Eight patients with atopic dermatitis (AD) without a history of asthmatic
      episodes and 8 patients with mite-allergic bronchial asthma (BA) were subjected
      to bronchial inhalation challenge with a nonspecific stimulus (acetylcholine) and
      an immunologically specific stimulus (house dust mite allergen). AD patients had
      a significantly greater concentration of IgE (p less than 0.01) and antimite IgE
      antibody (p less than 0.05) than BA patients. Nonspecific bronchial
      hyperreactivities of AD patients distributed from normal to asthmatic range.
      After allergen challenge, all 8 AD patients and all 8 BA patients showed an
      immediate asthmatic response (IAR). The mite extract concentration to induce an
      IAR was significantly (p less than 0.01) greater in AD patients than in BA
      patients. A late asthmatic response was observed in 6 out of 8 BA patients,
      whereas it was not observed in any AD patient. Our results showed that AD
      patients are less reactive to a specific mite allergen than BA patients in spite
      of greater concentrations of antimite IgE antibody. They suggest that this
      difference in the bronchial reactivity to the allergen concerns the difference in
      the onset of clinical symptoms and that a certain level of bronchial
      hyperreactivity to the allergen is a prerequisite for the development of
      asthmatic symptoms.

PMID- 2242929
TI  - Shared allergenic activity in Asian (Blattella asahinai), German (Blattella
      germanica), American (Periplaneta americana), and Oriental (Blatta orientalis)
      cockroach species.
AB  - Whole-body extracts of the feral and peridomestic Asian cockroach (Blattella
      asahinai) and the three domestic cockroach species, German (Blattella germanica),
      American (Periplaneta americana), and Oriental (Blatta orientalis), were compared
      allergenically using an IgE serum pool from 4 German cockroach sensitive
      individuals. In crossover radioallergosorbent inhibition analysis, the Asian
      cockroach shared allergenic activity primarily with the German cockroach polymer
      and to a lesser extent with either the American or Oriental cockroach polymers.
      Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and thin
      layer isoelectric focusing analysis of the extracts showed similar although
      varying intensities of Coomassie blue stained banding patterns among five
      extracts analyzed. Electroblotting analysis with 12.5% SDS-PAGE of the whole-body
      German cockroach extract and IgE serum from individuals sensitive to German
      cockroach revealed eight allergenic components with apparent molecular weights of
      92, 80, 67, 48, 36, 27, 25 and 18 kD. Five components could be identified in the
      whole-body extract of the Asian cockroach corresponding to apparent molecular
      weights of 92, 67, 48, 40, and 32 kD. Analysis of individual serum by immunoblot
      analysis with each of the cockroach extracts showed considerable heterogenicity
      in the IgE-binding pattern. Although the Asian cockroach demonstrated
      considerable cross-reacting allergenic components to German and relatively fewer
      cross-reacting allergenic components to either the Oriental or American, it is
      too early to establish genus- or species-specific cockroach allergens. It is
      important to point out that German cockroach sensitive individuals should be made
      aware of the potential exposure of Asian cockroach aeroallergens both indoors and
      outdoors in areas with high infestations of Asian cockroaches.

PMID- 2242930
TI  - Characteristics of MTT as an indicator of viability and respiratory burst
      activity of human neutrophils.
AB  - In the present study, we have examined the suitability of 3-[4,5-dimethylthiazol
      2-yl]-2,5-diphenyltetrazolium bromide (MTT) for assessing the viability and
      respiratory burst activity of human neutrophils. MTT is a good indicator of the
      relative viability of neutrophils which have been in culture up to 24 h, if
      sufficient serum (10% fetal calf serum) is present in the medium and the cells
      being compared have been in culture for a similar period of time. However, it is
      not suitable for exact assessment of percent viable cells in a cell population
      with low viability. The effectiveness of MTT as an indicator of respiratory burst
      activity is demonstrated by the sharp increase in MTT reduction induced by
      respiratory burst stimuli and by the ability of superoxide dismutase to inhibit
      75% of MTT reduction by stimulated neutrophils. Unlike nitroblue tetrazolium
      (which is reduced primarily intracellularly) and cytochrome c (which is reduced
      extracellularly), MTT is apparently reduced both intracellulary and
      extracellulary by activated neutrophils.

PMID- 2242931
TI  - Identification of soybean allergens by immunoblotting with sera from soy-allergic
      adults.
AB  - Immunoblots were used to compare the IgE-binding proteins of various soybean
      products using sera from 7 soybean-allergic patients. Blotting results indicate
      at least two distinct individualistic patterns of IgE binding to soy proteins.
      Serum IgE from individuals allergic to both peanuts and soybeans binds to several
      proteins with molecular weights ranging from 50,000 to 60,000 daltons, while IgE
      from individuals allergic to soybeans, but not peanuts, binds strongly to a
      protein(s) with a molecular weight of 20,000 daltons. The soy products tested
      displayed varying amounts of IgE binding with sera from sensitive patients.

PMID- 2242932
TI  - Elevation of neutrophil chemotactic activity in the human serum and the decreased
      number of neutrophils after platelet-activating factor inhalation.
AB  - We previously reported a significant decrease in neutrophils at 5 min and an
      increased number of neutrophils at 15 min after PAF-acether inhalation. To
      investigate the mechanism, we measured the neutrophil chemotactic activity of the
      sera. Neutrophil chemotactic activity (NCA) of the serum at 5 min was greater
      than at baseline (p less than 0.01) or at 15 min (p less than 0.05). Furthermore,
      we investigated the correlation between the change in NCA and decreased number of
      neutrophils. A significant correlation was found between these two at 5 min (r =
      0.751, p less than 0.05). These data suggest that an elevation of NCA may play an
      important role in the decrease of circulating neutrophils after PAF-acether
      inhalation.

PMID- 2242933
TI  - Corneal modeling as an aid to radial keratotomy.

PMID- 2242934
TI  - Mathematical model for the computation of alveolar partial pressure of carbon
      monoxide.
AB  - A mathematical model is formulated for computing alveolar partial pressure of
      carbon monoxide (PACO) from that in the atmospheric air. The model takes into
      account parameters like inspired/expired air flow rates, diffusion capacity of
      the lung, concentration of CO in the atmospheric air, blood flow rate and the non
      linear CO dissociation curve. The effect due to the presence of O2 in the blood
      on CO dissociation curve is also incorporated. It is shown that for a given
      atmospheric CO concentration, PACO increases exponentialy with time and attains
      asymptotic value. Alveolar PCO increases further with the increase in the
      atmospheric CO concentration. The model can also be used to compute
      carboxyhaemoglobin levels in the blood as a function of exposure time and the
      results are comparable with the CFK equation and the values measured
      experimentally.

PMID- 2242935
TI  - Simulating functional interactions in the brain: a model for examining
      correlations between regional cerebral metabolic rates.
AB  - A computer simulation model was developed to investigate the use of interregional
      correlations of cerebral metabolic rates to analyze functional interactions in
      the brain. The model generates simulated metabolic data for individual brain
      regions in a specified number of subjects, where there are defined functional
      couplings amongst the regions. Random numbers provide the variability seen in
      measured metabolic data. Correlational analysis is performed on these simulated
      data sets. The parameters of the model can be chosen so that simulated and actual
      metabolic data are very similar. The model demonstrates that the change in the
      correlation coefficient between normalized metabolic data in two brain regions is
      related to the change in the strength of the functional association between the
      two regions. The model also is used to explore the relations between patterns of
      correlations and the underlying sets of functional couplings. The results
      indicate that correlational analysis provides more information about regional
      involvement in neural systems than does region-by-region comparisons of absolute
      metabolic rates.

PMID- 2242936
TI  - Computer-aided decision support in acute abdominal pain, with special reference
      to the EC concerted action.
AB  - This presentation describes the use of computer aided decision support in acute
      abdominal pain. The need for such support is explored and the feasability of
      providing support is described with reference to studies involving nearly 100,000
      patients. It is argued that the provision of computer aided decision support can
      lead to substantial and practical benefit in clinical care--but this is mostly
      due to the constant stimulus towards "doing it right". This in turn depends upon
      the provision of a consensus view of "good medicine" in the area concerned; and
      on an international level strongly argues the case for multi-national cooperative
      studies to define good medicine and make it available. One such study (the
      European Community Concerted Action on Acute Abdominal Pain) is described.

PMID- 2242937
TI  - Application of artificial intelligence techniques to a well defined clinical
      problem: jaundice diagnosis.
AB  - Jaundice is a very common medical condition, in which pathophysiological
      knowledge has been quite well assessed and clinical features are usually well
      known. However, incorrect conclusions are sometimes reached in medical practice
      which can lead to serious implications. Thus, jaundice diagnosis appears as one
      of the medical situations which might be substantially improved by computer
      assistance. The present study is aimed at describing and discussing in what way a
      computer program supporting medical decision making in jaundiced patients can be
      developed on the basis of advanced Artificial Intelligence methods. To this
      extent methodological problems concerned with the organization and the
      formalization of medical knowledge have been outlined with some detail. The
      resulting expert system is expected to become a well assessed and potentially
      useful tool for both medical decision making and medical education.

PMID- 2242938
TI  - Teaching field potentials: a microcomputer simulation of the nerve action
      potential in a bidimensional conductor.
AB  - A computer simulation of the extracellular field potential recording of nerve
      activity is presented. An experimental setup composed of an oscilloscope, a
      nerve, a conductive surface, and a recording electrode is graphically simulated.
      The user may study the influence of the position of the recording electrode and
      of certain nerve properties (membrane potential, velocity of conduction and
      action potential duration), on the action potential shape. The different waves
      which constitute the action potential may be analyzed and their peak values
      plotted as a function of the independent variable (e.g. electrode distance from
      the nerve). Three-dimensional plots of a set of action potentials as a function
      of the independent variable may also be obtained. The stimulation allows the user
      to study the basic factors which determine the configuration of an
      extracellularly recorded compound nerve action potential.

PMID- 2242939
TI  - Leukonychia. Review and classification.

PMID- 2242940
TI  - Treatment of subacute cutaneous lupus erythematosus.

PMID- 2242941
TI  - The reconstruction of skin. How and why.

PMID- 2242942
TI  - Patterns of directional growth in the epidermis.

PMID- 2242943
TI  - Acne keloidalis-like lesions on the scalp associated with antiepileptic drugs.
AB  - A man developed acne keloidalis-like lesions in the scalp during treatment with
      diphenylhydantoin and carbamazepine for epilepsy. These drugs were suspected to
      play a role in the pathogenesis of this skin disease in an unusual location,
      based on clinical evidence and on the in vitro test, mast cell degranulation
      (MCD).

PMID- 2242944
TI  - Clinicopathologic study of cutaneous plasmacytoma.
AB  - Eight patients with skin tumor lesions composed of dense, predominantly plasma
      cell infiltrates were studied. Primary cutaneous plasmacytoma can be reactive
      (polyclonal) or neoplastic (monoclonal). In four of the patients skin lesions
      were associated with multiple myeloma. Specific skin lesions usually consisted of
      reddish or purple nodules located on the trunk. In one case the cutaneous lesions
      developed at the site of previous herpes zoster. Histologically, the cutaneous
      plasmacytic infiltrate was mainly diffuse and monomorphous. Most of the plasma
      cells were mature, but in some cases immature immunoblasts and mitoses were
      observed. Serum immunoelectrophoresis findings correlated with the monoclonality
      or polyclonality of the plasmacytoma. Presence or absence of systemic involvement
      cannot be predicted from the appearance of clinical lesions or from maturity of
      plasma cell infiltration in the skin.

PMID- 2242945
TI  - Erythromelalgia.
AB  - Erythromelalgia, characterized by temperature-dependent redness, pain, and warmth
      in one or more extremities, may be a primary disease or occur secondarily to
      underlying illnesses. Myeloproliferative disorders (eg, essential
      thrombocythemia) and a number of other associations have been reported. Two cases
      are described: one associated with essential thrombocythemia and the other the
      first reported case associated with pernicious anemia.

PMID- 2242946
TI  - Malignant syphilis in HIV-infected patients.

PMID- 2242947
TI  - Staphylococcus aureus in atopic dermatitis and in nonatopic dermatitis.
AB  - Skin colonization with Staphylococcus aureus (S. aureus) was examined in 30
      patients with atopic dermatitis (AD), in 25 patients with nonatopic eczema (NAE)
      and in 30 individuals as healthy controls (HC). Bacteria growth was examined in
      aerobic cultures and the population densities per dish were estimated; S. aureus
      colonization was found in the eczematous skin of 24 of 30 (80%) AD patients and
      in 13 of 25 (52%) NAE patients (NS, p greater than 0.1). In nonaffected skin S.
      aureus colonization was found in 19 of 30 (63%) of all AD patients compared with
      6 of 25 (24%) in NAE patients and 1 of 30 (3%) in HC, respectively (p less than
      0.05). In nonaffected skin, coagulase negative strains of staphylococcus were
      found in 25 of 30 (84%) controls and in 18 of 25 (72%) NAE patients compared with
      12 of 30 (40%) patients with AD. It seems that colonization with S. aureus is not
      a characteristic feature for atopic dermatitis but is a frequent event in damaged
      skin; significantly elevated values were also observed in nonatopic eczema. The
      degree of colonization may depend on the severity and duration of the eczematous
      lesions.

PMID- 2242948
TI  - Malignant melanoma in a speckled zosteriform lentiginous nevus.

PMID- 2242949
TI  - Ulcerative secondary syphilis.

PMID- 2242950
TI  - Subacute cutaneous lupus erythematosus response to isotretinoin.

PMID- 2242951
TI  - The role of fish oil in psoriasis. A randomized, double-blind, placebo-controlled
      study to evaluate the effect of fish oil and topical corticosteroid therapy in
      psoriasis.
AB  - In a randomized, double-blind, placebo-controlled study, patients received 10
      fish or olive oil capsules three times daily for the whole study in addition to
      applying betamethasone diproprionate to their psoriatic plaques for the first 3
      weeks. Most patients gradually worsened upon discontinuation of corticosteroids.
      Using survival analysis methods, no significant difference was found between the
      fish and olive oil groups. The authors attempt to put the role of fish oil in the
      therapy of psoriasis into perspective and discuss the efficacy of fish oil when
      used alone versus in combination therapy.

PMID- 2242952
TI  - Requiem for smallpox. The demise of a disease.

PMID- 2242953
TI  - Intradermal immunotherapy in children with severe skin inflammatory reactions to
      Aedes aegypti and Culex quinquefasciatus mosquito bites.

PMID- 2242954
TI  - Points in question.

PMID- 2242955
TI  - Points in question. Genetic diversity in Echinococcus granulosus.

PMID- 2242956
TI  - Antibody-mediated cytotoxic effects in vitro and in vivo of rat cells on
      infective larvae of Brugia malayi.
AB  - Albino rat macrophages and neutrophils in the presence of immune serum adhered to
      and promoted killing of Brugia malayi infective larvae in vitro. At a similar
      cell-target ratio, macrophages were more potent than neutrophils in inducing
      cytotoxic response to the larvae. Eosinophils were also effective in killing but
      only at a high cell-target ratio. The activity in the immune serum could be
      absorbed to and eluted from a Protein A-Sepharose column suggesting involvement
      of IgG antibody in the reaction. An indirect fluorescent antibody test confirmed
      the presence of IgG on the surface of larvae incubated in immune serum. Infective
      larvae were attacked by host cells within micropore chambers 16-24 h after
      implantation into immunized rats. Further, a strong cytotoxic response to the
      larvae was seen when they were introduced intraperitoneally into immune rats
      indicating the role of antibody and cells in vivo. We suggest that antibody
      dependent cellular cytotoxicity may represent an important mechanism of parasite
      killing in an immune host.

PMID- 2242957
TI  - Isoparorchis hypselobagri: ultrastructure of the tegument and associated tissues
      in a digenean inhabiting a gaseous aerobic environment.
AB  - Adult I. hypselobagri live in the swim bladder of the Indian catfish Wallago
      attu, a gaseous environment with a relatively high oxygen content. The ventral
      tegument, which in life is applied close to the swim bladder wall, is relatively
      unspecialized, showing typical ultrastructural features of the digenean surface.
      The dorsal tegument, which is exposed to the oxygen-rich surroundings, has
      numerous pyriform extensions of superficial parenchymal cells closely applied to
      the base of the surface syncytium. These extensions bear numerous mitochondria
      and send finger-like processes deep into the basal cytoplasm of the syncytium
      where they interdigitate with corresponding infolds of the basal tegument
      membrane. The pyriform parenchymal extensions are connected with underlying
      nucleated cell bodies via irregular glycogen-filled tubular processes, many of
      which end blindly in the interstitial tissue or expand into glycogen-filled bulbs
      beneath the cell bodies. These superficial parenchymal processes associate at gap
      junctions with ramifications of a distinct deeper parenchymal tissue which
      contains lipid, residual bodies and glycogen. The dorsal tegument and associated
      structures may constitute a respiratory organ, taking advantage of molecular
      oxygen diffusing across the surface syncytium to carry out aerobic energy
      transduction in the superficial parenchymal extensions. ATP so generated may
      diffuse inwards for distribution throughout the body in the deep parenchymal
      tissue. The extensive network of ramifying cytoplasmic tubules is supported by a
      fibrous matrix of interstitial tissue.

PMID- 2242958
TI  - Population dynamics of Enterogyrus cichlidarum (Monogenea: Ancyrocephalinae) from
      the stomach of Tilapia spp. in Egypt.
AB  - In a 1-year seasonal study of the numbers of the stomach-inhabiting monogenean
      Enterogyrus cichlidarum in Tilapia nilotica in the River Nile, Egypt, prevalence
      and intensity reached a height in spring and infection levels were surprisingly
      high in winter. T. zillii harboured fewer parasites but seasonal changes were
      similar. No parasites were found in T. galilaea. The prevalence and intensity of
      the infection with E. cichlidarum rose significantly with increasing size of the
      host. Some of the possible reasons for these fluctuations are discussed. Immature
      enterogyrids were more abundant in the posterior sector of the stomach and adult
      enterogyrids showed a preference for the anterior sector. No significant
      difference was found in the numbers of enterogyrids in male and female hosts.

PMID- 2242959
TI  - Spermiogenesis and sperm ultrastructure in the monogenean parasite Acanthocotyle
      lobianchi.
AB  - The ultrastructural events of spermiogenesis and the ultrastructure of the mature
      spermatozoon of an acanthocotylid monogenean, Acanthocotyle lobianchi, are
      described. The early zone of differentiation (ZD) contains two roughly
      perpendicular centrioles which become parallel and produce two free flagella,
      although these later become incorporated into the same body of cytoplasm. No
      cortical microtubules were found supporting the ZD at any stage of
      spermiogenesis. Much of the length of the thread-like sperm contains two axonemes
      of the 9 + '1' pattern together with a nuclear and mitochondrial profile but the
      'posterior' region is occupied only by a single axoneme and the nucleus. A
      laterally situated electron-lucent vesicle with specialization of the adjacent
      surface membrane is found in the 'anterior' region of the sperm. The phylogenetic
      implications of these observations are discussed.

PMID- 2242960
TI  - Three new species of Monocotyle (Monogenea: Monocotylidae) from the stingray,
      Himantura uarnak (Rajiformes: Dasyatidae) from the Great Barrier Reef:
      phylogenetic reconstruction, systematics and emended diagnoses.
AB  - Three new species of Monocotyle were found on the gills of the coachwhip
      stingray, Himantura uarnak (Rajiformes: Dasyatidae) collected at Heron Island,
      Great Barrier Reef, Australia (23 degrees 27' S, 151 degrees 55 'E). Monocotyle
      helicophallus new species, Monocotyle multiparous new species and Monocotyle
      spiremae new species all have a single testis and are distinguished from other
      described Monocotyle species by size of body and hamulus and number of coils of
      the sclerotized male copulatory organ (21-22, three to four and 29-42,
      respectively). Monocotyle helicophallus new species is characterized by several
      muscular genital papillae, one of which is traversed by the ejaculatory duct; M.
      spiremae new species is distinguished by a sclerotized accessory structure
      associated with the distal end of the male copulatory organ, a vaginal sclerite
      and a conspicuous spherical, ejaculatory bulb; M. multiparous new species is
      distinguished by a large number of retained, thin-shelled eggs, many of which
      contain a fully developed oncomiracidium. A phylogenetic analysis of the 14
      described species of Monocotyle utilizing 13 characters (11 binary and two
      multistate) produced the most parsimonious cladogram involving 18 steps with a
      consistency index of 0.78, two homoplasies and four unresolved polychotomies.
      Emended diagnoses of the Monocotylinae and Monocotyle are provided.

PMID- 2242961
TI  - The subcutaneous attachment of the monogenean Heterobothrium elongatum
      (Diclidophoridae) in the gills of Torquigener pleurogramma (Pisces:
      Tetraodontidae).
AB  - Heterobothrium elongatum predominantly occurred on the most anterior pair of gill
      arches of infected pufferfish, Torquigener pleurogramma. Juvenile and immature
      stages attached to gill lamellae and were concentrated on the ventral regions of
      the anterior pair of gill arches. Following penetration of subcutaneous tissues,
      young adult worms formed a subcutaneous channel either directly above or below
      the transverse septum, a tissue layer connecting the bases of adjacent gill rays.
      Large, sexually mature worms extended for most or all of the length of the gill
      arch where they filled the area normally occupied by the longitudinal lymphatic
      vessel (branchial vein) or lay adjacent to the efferent branchial and colateral
      arteries. Subcutaneous attachment by the parasite induced a marked inflammatory
      reaction in the host. During growth, the mid-region of the parasite became
      markedly elongate and formed a stalk connecting the haptor lying in the dorsal
      region of the gill and the body which emerged from the lower margin of the gill
      where penetration began.

PMID- 2242962
TI  - Introduction of a Brachylaima species (Digenea: Brachylaimidae) to Australia.
AB  - A Brachylaima species recorded previously from the house mouse (Mus domesticus)
      in South Australia is shown to use the introduced European snails Cernuella
      virgata and Cochlicella barbara as first intermediate hosts, and the same two
      species and Theba pisana as second intermediate hosts. The life cycle is typical
      of Brachylaima species. The parasite is capable of infecting at least two species
      of native Australian rodent, Rattus fuscipes and Leporillus conditor. Because of
      the intermediate hosts used, it is hypothesized that this trematode species has
      been introduced from Europe. The parasite may be conspecific with one of a number
      of described European species but difficulties with the literature concerning
      these species have required that the present form be designated only as
      Brachylaima sp.

PMID- 2242963
TI  - Routine screening for potential babesicides using cultures of Babesia bovis.
AB  - A procedure for screening of potential anti-malarial agents, based on the
      incorporation of [3H]hypoxanthine by the parasite, was adapted for the testing of
      anti-metabolites against Babesia bovis (Lismore and Samford isolates) cultured in
      vitro. A close correlation was found between [3H]hypoxanthine incorporation in a
      standard assay and percentage of parasitized cells as determined by microscopic
      examination. The concentrations of compounds causing 50% inhibition of
      [3H]hypoxanthine incorporation (ID50 values) for the established babesicides,
      Imidocarb and Amicarbalide, were determined to be 3 ng ml-1 (8.6 nM) and 5-10 ng
      ml-1 (17-34 nM), respectively. A variety of other anti-metabolites were tested in
      the system. ID50 values for some of the more effective compounds were tubercidin
      (75 nM), tetracycline (25 microM), menoctone (100 nM) and TN 108, a di-Mannich
      base derived from 4-(7'-trifluoromethyl-quinolin-4'-ylamino)phenol (0.13 microM).
      No significant differences between results with the two isolates of B. bovis were
      observed.

PMID- 2242964
TI  - Correlation between beta 2-microglobulin and soluble interleukin-2 receptor
      levels in plasma of individuals living in a malarial endemic region.
AB  - beta 2-Microglobulin (beta 2m) levels were related to the expected
      immunoprotection in 81 individuals living in a malarial mesoendemic area near
      Bobo-Dioulasso (Burkina Faso), who were longitudinally followed. Soluble
      interleukin-2 receptor (sIL-2R) levels were positively correlated to those of
      beta 2m (r = 0.44; n = 237; P less than 0.001). This suggests that most of the
      beta 2m could have originated from activated T and B cell membrane turnover. In
      our study, both beta 2m and sIL-2R were inversely related to IgG antibodies (Ab)
      against somatic antigen of Plasmodium falciparum (Som-Ag). Therefore, these
      molecules at high levels could have a down regulating activity, directly or
      indirectly, on B cells producing this kind of Ab.

PMID- 2242965
TI  - Protagonism of the arterial circulation in the preservation of the pig's liver by
      simple perfusion and hypothermic storage.
AB  - A modified technique to perform the successive perfusions of the liver that are
      necessary for its preservation by the simple perfusion method and hypothermic
      storage is presented. This technical variety has been tested on Large White pig's
      livers and consists in doing the successive perfusions of cooling, preservation
      and washout, first through the hepatic artery and there after through the portal
      vein. The macroscopic and biochemical characteristics of the effluents obtained
      through the infrahepatic inferior vena cava during the perfusion-washout of the
      livers at the end of the period cold ischemia shows its effectiveness. Likewise,
      the hepatic perfusion-washout begun via the arterial vein and finished via the
      portal one avoids post-revascularization hyperpotassemia in the receptor animals.
      It is hypothesized that the arterial protoganism of perfusions, when the simple
      perfusion and hypothermic storage method of hepatic preservation is used, could
      be a prophylaxis against complications of a post-transplant biliary origin.

PMID- 2242966
TI  - Delaying rejection in discordant heart xenografts in the rat: efficacy of
      cyclosporin, prostaglandin I2 and exchange transfusion.
AB  - If effective modes of prevention of hyperacute rejection were available, the
      problem of the absence of enough suitable donors could be solved by the use of
      organ xenografts. Organ xenograft rejection is principally mediated by preformed
      antibodies which are responsible for the hyperacute pattern of rejection. We
      decided therefore to study various methods of prevention of rejection in the
      guinea pig to Lewis rat combination (donor-recipient discordant species) in which
      hyperacute rejection is particularly intense. Three series of experiments were
      performed. In the first series immunosuppression of the recipient was induced
      using an oral solution of cyclosporin A. In the second series antiplatelet
      aggregation therapy was administered to the recipient, using intravenous
      prostacyclin (PGI2). In the third series antibody depletion of the recipient was
      attempted using exchange transfusion with or without prostacyclin perfusion. The
      most significant (p less than 0.01) prolongation of graft survival time was
      observed when combining exchange transfusion (8 ml) and PGI2 infusion (620
      ng/kg/min). This observation suggests that, if antibody depletion in the
      recipient is the primary goal, measures aiming at reducing the consequences of
      the antigen-antibody reaction are also necessary to improve the results of organ
      xenografting.

PMID- 2242967
TI  - Diagnosis, management and complications of oesophageal and airway foreign bodies.
AB  - A five-year experience at the University of Ilorin Teaching Hospital with 52
      patients with oesophageal foreign bodies, six patients with airway foreign bodies
      and two patients with both oesophageal and airway obstruction from foreign bodies
      is presented. Our use of jet anaesthetic ventilation for endoscopic removal of
      airway foreign bodies, clinical features and management problems of foreign body
      patients are also presented. Oesophageal diameters at six levels including those
      known conventionally as constrictions and dilatations were measured at autopsy in
      40 foetuses and neonates constituting a randomized quarter of a larger series.
      Oesophageal diameters were found to be wider just below the cricopharyngeus
      muscle than at the bronchoaortic constriction or midway between this constriction
      and the cricopharyngeus. The conclusion is drawn that the frequent impaction of
      foreign bodies at the so-called superior oesophageal constriction has little or
      no anatomical basis referrable to oesophageal diameters as measured in the
      cadaver.

PMID- 2242968
TI  - Reasons behind surgical failures in thoracic outlet syndrome.
AB  - Possible reasons for surgical failures in TOS were investigated. The importance
      of accurate clinical diagnosis is pointed out and differential diagnostic
      problems are reported. Transaxillary first-rib resection is recommended,
      supplemented by further intervention, if necessary. The term "surgical failure"
      is explained, ways of avoiding intraoperative complications detailed and the
      importance of complex post-operative treatment emphasized.

PMID- 2242969
TI  - Immediate transposition of a latissimus dorsi muscle for correcting a
      postquadrantectomy breast deformity in Japanese patients.
AB  - With the aim of improving cosmetics after quadrantectomy, an immediate
      transposition of latissimus dorsi muscle was carried out. Cosmetic breast changes
      in transposed and non-transposed patients were evaluated by a Moire topography
      camera. To date, the breast deformity in five patients has been corrected only by
      conization of the residual breast tissue, and the breast deformity in the other
      five patients has been corrected by transposed latissimus dorsi muscle.
      Postoperative appearance and topography showed satisfactory symmetry of breasts
      in the transposed patients, when compared with the non-transposed patients. We
      conclude that the immediate transposition of latissimus dorsi muscle is useful
      for preventing post-quadrantectomy breast deformity.

PMID- 2242970
TI  - Treatment of parotid gland tumors.
AB  - A clinical review has been made of 55 patients who underwent surgery for parotid
      tumors between 1972 and 1987. The incidence of pleomorphic adenomas was 61.8%.
      The F.N.A.B. permitted us to reach a correct preoperative diagnosis in 94% of the
      cases. The surgical procedures we used were: enucleation in eight cases,
      enucleoresection in five cases, superficial parotidectomy in seven cases, total
      conservative parotidectomy in 28 cases, total parotidectomy sacrificing the
      facial nerve in four cases, extended surgery in three cases. For these last three
      patients a cycle of postoperative radiotherapy for a total of 6000-6500 R. was
      carried out. As regards complications and sequelae, we must report: temporary
      lesions of the facial nerve (12.76%), permanent lesions (17%), Frey's syndrome in
      10.61%, while a salivary fistula arose in 6.38% of the cases. The follow-up of 47
      patients allowed us to observe three recurrences in cases of pleomorphic adenomas
      (two after enucleoresection and one after superficial parotidectomy), three
      recurrences in malignant tumors treated with surgery and one recurrence after
      combined treatment surgery and radiotherapy.

PMID- 2242971
TI  - The role of selective beta 1-blocker in the preoperative preparation of
      thyrotoxicosis: a comparative study with propranolol.
AB  - Subtotal thyroidectomy was performed for hyperthyroidism on 130 patients; 95
      treated before surgery with propranolol (Group I) and 35 given only metoprolol
      before surgery (Group II). These patient groups were compared with reference to
      preoperative medication, operative and immediate postoperative course, and late
      results with follow-up for one to five years. Clinical response was 100% in group
      II and 94.7% in group I. The median length of preoperative treatment was 7.96 +/-
      1.84 days in group I and 6.25 +/- 1.73 days in group II (P less than 0.05). There
      were no serious adverse effects of the drugs in either treatment group. No
      anaesthesiologic or cardiovascular complication occurred during operation in
      either group. Ten patients in group I (10.5%) and six patients in group II
      (11.4%) observed hyperthyroid manifestations in the immediate postoperative
      period, eliminated by the administration of the propranolol/metoprolol, and no
      case of thyroid storm occurred. One patient in group II developed clinical
      hypocalcaemia. Two patients, one in each group, presented temporary unilateral
      recurrent laryngeal nerve paralysis. There were two recurrences of toxicity in
      group I (2.1%) and none in group II. Hypothyroidism occurred in 3 patients (2.3%)
      two of them were from group I and one was from group II. The postoperative
      hospital stay was 4.62 +/- 1.61 days in group I and 2.81 +/- 1.32 days in group
      II (P less than 0.05). One patient from group I died on the third postoperative
      day due to pulmonary oedema. The results suggest that metoprolol can be safely
      used and offers the advantages of desired clinical response, shorter preoperative
      preparation time, simplicity of dosage and shorter postoperative hospital stay in
      comparison to propranolol for preoperative treatment of hyperthyroidism.

PMID- 2242973
TI  - Use of adhesive tape for primary closure of surgical skin wounds.
AB  - Although, during the last half century, there has been plenty of evidence that
      the healing of skin wounds is hindered by suture closure and fostered by the use
      of surgical tapes, the latter technique has not been widely practiced, because
      the adhesiveness of surgical tapes has been deemed too unreliable. When used at
      all, tapes have generally been applied only over subcuticular and subcutaneous
      sutures. The author describes his experience in using a new transparent adhesive
      tape for primary wound closure of 37 surgical incisions without underlying
      sutures. The series involved a wide range of surgical wounds, in various portions
      of the body. In all cases, the results were excellent; neither major nor minor
      complications were observed. Compared with suture closure, this method was
      associated with a reduced potential for infection, faster renewal of tensile
      strength, greater cost effectiveness, and better cosmetic effects.

PMID- 2242972
TI  - Preventing postoperative deep venous thrombosis in gynecological surgery with
      defibrotide.
AB  - This was an open, fully randomized clinical study designed to compare the
      effectiveness and tolerability of defibrotide and calcium heparin as prophylactic
      agents for preventing postoperative DVT of the lower limbs in patients scheduled
      for gynecological surgery for nonmalignant disease (100 cases) or for tumoral
      pathology (60 cases). Defibrotide was administered by intramuscular injection in
      doses of 400 mg b.i.d., starting one day before surgery and continuing for seven
      postoperative days (n = 80); calcium heparin was given by subcutaneous injection
      in doses of 5000 IU t.i.d., starting two hours before surgery and continuing
      likewise for seven days (n = 80). DVT was to be diagnosed by computerized
      impedance plethysmography. Not a single case of DVT occurred in either treatment
      group; nor were there any significant differences in the magnitude of surgical or
      postoperative bleeding or in pertinent laboratory test returns. The Authors
      conclude that defibrotide can be used to advantage instead of calcium heparin as
      a measure for preventing DVT of the lower limbs in patients undergoing major
      surgery for gynecologic disorders including malignancy.

PMID- 2242975
TI  - Frozen section diagnosis: a quality control study.
AB  - In a quality control study we reviewed six hundred and eighty one frozen section
      specimens sent to our department from 1981 to 1989. Accuracy was 98%. Diagnosis
      was deferred in 1%. False positive diagnosis for malignancy was made in one
      (0.15%) case and false negative diagnosis for malignancy in thirteen (2%) cases.
      Most of the inaccurate diagnoses concerned the female breast and the omentum.
      Incorrect diagnoses were due to interpretation of the pathologic findings (50%),
      to microscopic sampling (36%) and to gross sampling (14%). Some of the lesions
      are difficult to diagnose even in permanent sections. Technical skill and
      diagnostic expertise are essential for high diagnostic accuracy in the method of
      frozen section.

PMID- 2242974
TI  - Emergency large-bowel surgery in a tropical environment: approach and outcome.
AB  - In 87 of 90 consecutive patients aged between 24 hours and 72 years operated upon
      for large bowel emergencies, 79.3% were for acute obstruction and 20.7% for
      perforation. Following a management policy of safety first, 46 (52.9%) patients
      had primary colonic resection with 25 (54.3%) of these primarily anastomosed
      (treatment group I), and 21 (45.7%) exteriorized (treatment group II). Twenty one
      (24.1%) patients with simple obstruction had reduction (treatment group III) and
      27 others (31.0%) had colostomy alone after laparotomy (treatment group IV). In
      treatment group I, the mean hospital stay was 21 days, and the clinical leak rate
      was 8%. The mean hospital stay for treatment groups II-IV were, respectively, 36,
      13, 69 days. There were nine (10%) deaths in hospital, six (6.9%) of these
      postoperatively, 11 (12.6%) septic complications and three (3.4%) wound failures
      in the series. The hazards of large bowel surgical emergencies can usually be
      minimised by primary resection, anastomotic integrity, avoidance of primary
      anastomosis or closure of laceration when hazardous and a judicious use of
      systemic and topical antibiotics in a well resuscitated patient.

PMID- 2242976
TI  - Parotid gland metastasis from renal carcinoma.
AB  - The salivary gland most frequently involved with secondary cancer is the parotid
      gland. Metastases are responsible for 21-42% of malignant parotid tumors.
      Malignant melanoma and squamous cell cancer are the two most common tumors to
      metastasize to the parotid gland. Metastatic adenocarcinoma to this site has
      rarely been reported. Secondary renal cell carcinoma has been reported in many
      structures, including the brain, sinonasal tract, lungs, abdomen, genitourinary
      tract, bone, soft tissue, and lymphatics. Histologically proven parotid
      metastasis has been previously reported in only one patient. Two patients have
      recently been diagnosed and treated at our institution for this rare disease. The
      clinical presentation of each patient was quite different. One patient presented
      with parotid and pulmonary metastases seven years after resection of a renal
      tumor. Another patient had resection of a parotid mass revealing an occult
      metastasis from a renal cell carcinoma. Further evaluation revealed a locally
      extensive asymptomatic hypernephroma. The survival from the time of discovery of
      the parotid metastasis was 46 months for the former patient, while the latter
      patient is alive after 20 months. Differentiation of these tumors from vascular
      disorders (aneurysm or arteriovenous fistula) required selective angiography and
      computed tomography. Surgical excision via superficial parotidectomy with facial
      nerve preservation is necessary for palliation, particularly to avoid massive
      hemorrhage which may occur upon tumor extension into the oropharynx.

PMID- 2242977
TI  - [Continuing education. Tachycardic arrhythmias].

PMID- 2242978
TI  - [HIV infections].

PMID- 2242979
TI  - [HIV-associated opportunistic diseases: diagnostic and therapeutic possibilities
      in the clinic and general practice].

PMID- 2242981
TI  - [Integrated management of the HIV positive patient--medical, psychological and
      psychosocial aspects].

PMID- 2242980
TI  - [HIV infection of the central nervous system: clinical relevance].

PMID- 2242982
TI  - [Possibilities and limits of the epidemic regulation in relation to the control
      of AIDS].

PMID- 2242983
TI  - [New aspects in HIV diagnosis].

PMID- 2242984
TI  - [Therapy and immunologic prevention of HIV infection].

PMID- 2242985
TI  - [Septic temperatures and throat pain in a patient with hyperthyroidism].

PMID- 2242986
TI  - [33-year-old patient with recurrent bouts of fever and splenomegaly after foreign
      travel. A contribution to diagnosis and therapy of brucellosis].

PMID- 2242987
TI  - [A 65-year old jaundiced patient with weight loss, fever and sicca syndrome].

PMID- 2242988
TI  - [Endemic sprue--a case of "baker's intestine"?].

PMID- 2242989
TI  - [Comment on the contribution by R. Ziesche and H. Matthys: "Diagnosis of pleural
      effusions" in Internist, volume 31, April 1990, p. 272-6].

PMID- 2242990
TI  - Selective binding of a 30-kilodalton protein to disposable hydrophilic contact
      lenses.
AB  - To investigate the accumulation of tear proteins on disposable extended-wear
      contact lenses (42% Etafilcon A and 58% hydration), a technique involving sodium
      dodecyl sulfate-polyacrylamide minigel electrophoresis combined with a sensitive
      silver-staining method was used. Besides the binding of large amounts of tear
      lysozyme the authors found an accumulation of an as yet unidentified 30
      kilodalton (kD) protein. Longitudinal experiments showed lysozyme binding after 1
      day of lens wear. The 30-kD protein was detected after a 2-day wearing period.
      The fact that protein deposition occurs during the relatively short wearing
      period of these lenses (1 week) may explain the unexpectedly high incidence of
      contact lens-associated conjunctivitis observed with these lenses.

PMID- 2242991
TI  - The role of class II antigen-expressing cells in corneal allograft immunity.
AB  - The goal of this study was to investigate the relationship between the presence
      of Class II antigen-expressing cells (Class II+) cells in the cornea and the
      generation of allograft immunity. Wistar/Furth (W/F) rat Class II+ cells were
      injected in various numbers (0.01, 0.1, 1.0, 5.0, 10.0, and 20.0 X 10(6) into the
      corneal stroma of Fischer 344 (F344) rats. For comparison, the same numbers of
      W/F Class II+ cells were injected directly into the peritoneal cavity of F344
      rats. Also, W/F cells were injected into the corneas of F344 rats and the corneas
      were "grafted" intraperitoneally in F344 hosts. The results showed that up to 20
      X 10(6) class II+ cells injected in situ into the corneal stroma did not elicit a
      serum cytotoxic antibody response or a splenic or blood cytotoxic T-cell response
      against donor Class II antigens. In contrast, systemic immune responses were
      elicited by both direct intraperitoneal injection of large numbers (10 or 20 X
      10(6] of allogeneic Class II+ cells and by intraperitoneal grafting of syngeneic
      corneas carrying similar numbers of allogeneic Class II+ cells. F344 recipients
      of a syngeneic cornea containing 10 or 20 x 10(6) W/F Class II+ cells or a
      suspension of W/F cells exhibited an accelerated rejection of W/F skin allografts
      (13.3 versus 9.0 days, first- versus second-set rejection). These results
      indicate that the number of Class II+ cells required to elicit a systemic immune
      response is larger than the number of Class II+ cells present in the normal
      cornea.

PMID- 2242992
TI  - Low-dose ultraviolet-B irradiation of donor corneal endothelium and graft
      survival.
AB  - Donor rabbit corneal endothelium was pretreated with different doses of
      ultraviolet (UV-B) irradiation (302 nm) before grafting to test whether allograft
      survival could be favorably affected in comparison with untreated corneas grafted
      into the same recipients. Endothelial rejection was observed in 19 of 32 (59%)
      eyes that received no treatment compared with five of 32 (16%) eyes that received
      UV-B (P less than 0.001), and increasing doses of UV-B were associated with lower
      rejection rates (P less than 0.05). Although exposure of donor endothelium
      significantly reduced endothelial rejection at all doses tested, it resulted in
      primary graft failure in a substantial proportion of corneas treated at high
      doses. Class II (Ia) antigen staining of corneal tissue was present in
      conjunction with clinical evidence of rejection, and the magnitude of staining
      correlated with the histologic extent of inflammation. Scanning electron
      microscopy revealed various endothelial cell surface irregularities and membrane
      defects in high-dose UV-treated corneas. Endothelial cell cultures exposed in
      vitro to UV-B light showed a dose-dependent loss in cell viability. These data
      suggest that UV-B pretreatment of donor corneal endothelium prolongs graft
      survival but that toxic side effects must be carefully controlled.

PMID- 2242993
TI  - Movements of cultured corneal epithelial cells and stromal fibroblasts in
      electric fields.
AB  - The effects of an externally applied direct-current electric field on the
      movement of cultured rabbit corneal epithelial cells and stromal fibroblasts were
      studied. After a latency of approximately 20 minutes in an electric field, both
      epithelial cells and stromal fibroblasts became spindle shaped and underwent
      galvanotropism by aligning their long axes perpendicular to the applied electric
      field. The electric field stimulus thresholds for galvanotropic movements in
      epithelial cells and stromal fibroblasts were 4V/cm and 6 V/cm, respectively.
      After an additional latency of 30 minutes, both cell types manifested
      galvanotaxic movements: epithelial cells commenced migration in the cathodal
      (downfield) direction and stromal fibroblasts in the anodal (upfield) direction.
      For both types of cells, ruffled membranes and lamellipodia were abundant at the
      leading edges of migrating cells and cell processes underwent retraction at the
      trailing edges. At field strengths of above 10 V/cm, evidence of cellular damage
      (manifested by cellular rounding and detachment), attributable to the electric
      field treatment, was observed after 4 hours. These preliminary results suggest
      that galvanotaxic responses could be exploited clinically in the enhancement of
      corneal wound healing.

PMID- 2242994
TI  - Rod visual fields in cone-rod degeneration. Comparisons to retinitis pigmentosa.
AB  - Dark-adapted visual fields to short- and long-wavelength stimuli were obtained
      from 20 patients with cone-rod degeneration, 20 patients with retinitis
      pigmentosa, and ten normal subjects. Patients were selected because they retained
      rod electroretinographic (ERG) function over a sufficient range for the Naka
      Rushton analysis of retinal illuminance versus amplitude functions. Patients with
      cone-rod degeneration retained a relatively normal field topography although
      overall sensitivity was reduced. The mean sensitivity loss was consistent with a
      small elevation in ERG semisaturation constant and minimally delayed rod b-wave
      implicit times. Rod visual fields from patients with retinitis pigmentosa
      retaining rod ERG function were consistent with log sensitivity profiles reported
      previously for type 2 patients. Sensitivity loss was greatest in midperipheral
      regions, with most patients showing least loss in the far periphery.
      Disproportionate loss in the midperiphery is consistent with a large elevation in
      the ERG semisaturation constant and prolonged rod b-wave implicit times.

PMID- 2242995
TI  - Quantitative analysis of retinal hemodynamics using targeted dye delivery.
AB  - A new method designed to allow repeated mapping of retinal hemodynamics on a
      macro- and microcirculatory level was evaluated in the primate eye. The method,
      called "targeted dye delivery," consists of encapsulating a fluorescent dye in
      temperature-sensitive liposomes, injecting the liposomes systemically, and using
      a light pulse from an argon laser to release a bolus of dye in a targeted retinal
      vessel. The follow-up of the well-defined dye front thus generated allows
      calculation of the blood flow and capillary transit time. Evaluation of targeted
      dye delivery in a monkey indicated that centerline blood velocity and the vessel
      diameter can be measured with a reproducibility of 10% and 4%, respectively, in
      vessels that are 40 microns and larger. These measurements yielded flow values
      that had a reproducibility of 10% on the same day and 13% on different days. The
      normalization of flow rate by the vessel diameter was consistent with theoretic
      estimates and promises to be a circulation indicator independent of variations
      between individual and species. The transit time across capillary beds at
      different locations was found to be similar, thus indicating that the method
      could be used to evaluate the local viability of the microcirculation.

PMID- 2242996
TI  - Thrombin contracts isolated bovine retinal small arteries in vitro.
AB  - The effect of thrombin was tested in vitro on rings of bovine retinal small
      arteries (internal diameter approximately 200 microns). Cumulative addition of
      thrombin (0.001-10 units/ml) induced a variable concentration-dependent
      contraction of the retinal arteries. The contractions were slow in onset and
      reached a plateau after 5-8 minutes when thrombin was added cumulatively to the
      organ bath. Two vessels remained contracted greater than 1 hour after wash-out of
      thrombin. Maximum vessel contraction induced by thrombin was equal to 43% of the
      vessel Emax (1.36 N/m), with an effective concentration at the 50% level of 0.04
      units/ml. Vessel contraction induced by 1 unit/ml of thrombin was, in contrast,
      transient, reaching a maximum within 2-4 minutes. Thereafter the vessel tension
      declined again almost back to baseline within the next 10-20 minutes.
      Contractions to thrombin could not be repeated nor could it be elicited with
      thrombin inactivated with heat or antithrombin-III. Treatment of vessels with 10(
      6) M phenoxybenzamine had no effect on the thrombin-induced vessel response.
      These findings indicate that the contractile effect of thrombin depends on its
      catalytic activity. Indomethacin at a concentration of 10(-5) M did not affect
      the thrombin-induced vessel response. Methylene blue at a concentration of 3 X
      10(-6) M potentiated the thrombin-induced response in the larger, greater than
      200-microns diameter retinal arteries. The ensuing relaxation of the arteries,
      after maximal tone was reached, was slower than in the control.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2242997
TI  - Shedding of rod outer segments is light-driven in goldfish.
AB  - Rod outer segment (ROS) shedding in goldfish was quantified by measuring the
      number of phagosomes in the retinas of goldfish that were maintained under
      natural or artificial cyclic light, constant light, or constant dark conditions.
      Fish maintained in cyclic light, whether natural or artificial, had robust daily
      rhythms of ROS shedding. The ROS tips were shed primarily during the light phase
      of the cycle, and maximum shedding occurred 2-4 hours into the light period. Fish
      maintained for 1, 3, or 7 days in constant light or constant dark had no daily
      rhythms in ROS shedding. In these fish, ROSs lengthened, on average, 2.3
      microns/day in constant light and 1.5 microns/day in constant dark. After 3 days
      in constant light, shedding was induced by placing fish in darkness for 2 hours,
      then returning them to light. Placing fish in darkness for 0.5 hours did not
      induce shedding, nor did placing them in darkness for 3 hours without returning
      them to light. ROS shedding thus appears to be goldfish is completely dependent
      on changes in ambient illumination; no circadian or endogenous components were
      found. Previous observations of circadian changes in behavioral visual
      sensitivity therefore cannot be due to endogenous changes in ROS length.

PMID- 2242998
TI  - Rod outer segment length and visual sensitivity.
AB  - Detection threshold for the rod system was measured psychophysically in adult
      goldfish before and after exposure to constant illumination of 340 lux (91
      microW/cm2) for 7 days. As shown in the previous paper, rod outer segment (ROS)
      length increases an average of 60% under these conditions. The present work shows
      that visual sensitivity also increases, in approximate proportion to the
      additional optical density predicted by the longer ROSs. These results are the
      first to show that exposure to constant light can enhance visual sensitivity.
      They imply further that detection threshold is related to ROS length. Apparently,
      the photopigment in the ROS tips that is normally shed on a daily basis retains
      its photon-catching ability.

PMID- 2242999
TI  - The safety of intravitreal hyaluronidase. A clinical and histologic study.
AB  - The authors previously developed a new model of preretinal neovascularization in
      the rabbit eye using hyaluronidase for enzymatic vitreolysis. The purpose of this
      study was to evaluate the safety of intravitreal injections of hyaluronidase.
      Concentrations of 1, 15, 30, 50, and 150 IU of hyaluronidase in 0.1 ml of 0.9%
      saline were injected intravitreally and aspirated repetitively until the vitreous
      was partially liquified. The animals were examined with indirect ophthalmoscopy,
      fundus photography, and fluorescein angiography before injection and on days 1
      and 7 after injection. Light and electron microscopic retinal sections were
      prepared from enucleated eyes at days 1 and 7. All concentrations of
      hyaluronidase were effective in producing partial vitreolysis. Eyes treated with
      1 IU showed no abnormalities on days 1 or 7. Eyes treated with 15 IU showed no
      retinal abnormalities on day 1, but on day 7 histologic abnormalities were
      present in two of four eyes. At higher concentrations, clinical and histologic
      changes were seen in proportion to the concentration and included focal
      whitening, edema, vitreous haze, vascular abnormalities, and retinal necrosis at
      the highest doses. Histologic evaluation of the retina revealed marked
      destruction in all layers at the higher concentrations. The authors conclude that
      1 IU of intravitreal hyaluronidase is sufficient for partial vitreolysis and
      nontoxic to the rabbit retina.

PMID- 2243000
TI  - A longitudinal study of the relationship between intraocular and blood pressures.
AB  - The relationship between intraocular and systemic blood pressures was
      investigated in a prospective study of 572 middle-aged men. There was no
      consistent relationship between intraocular pressure at first visit and age.
      Subjects with an intraocular pressure greater than 20 mm Hg had a significantly
      higher systolic blood pressure than controls matched for age. An autoregressive
      model was used to examine the relationship between change in intraocular pressure
      and initial intraocular pressure, age, and blood pressure. When the authors
      compared data obtained 1 or 2 years apart, a change in intraocular pressure was
      positively correlated with a change in systolic blood pressure. Thus, the results
      of this study indicate that changes in intraocular pressure over time are
      associated with changes in systolic blood pressure and that intraocular pressure
      does not necessarily increase with age.

PMID- 2243001
TI  - The influence of intraocular pressure on visual field damage in patients with
      normal-tension and high-tension glaucoma.
AB  - There have been several reports to suggest that the type of visual field damage
      in open-angle glaucoma is influenced by intraocular pressure (IOP). This study
      was undertaken to determine the extent to which patients with normal-tension
      (NTG) and high-tension glaucoma (HTG) could be differentiated on the basis of
      some features of their visual fields. The results from 40 pairs of NTG and HTG
      patients were matched closely for the extent of visual field damage, pupil size,
      and visual acuity. Using this pooled material, the authors increased the IOP
      difference between the two groups in either direction, ie, by either
      progressively lowering the highest recorded IOP allowed for inclusion in the NTG
      group or by progressively increasing that required for inclusion in the HTG
      group. They compared the normal areas of the patients' visual fields by using
      simple visual field indices designed to quantify the undisturbed field. Using
      receiver operating characteristics (ROC) analysis, they showed that changing the
      inclusion criterion in the NTG group resulted in no better separation between the
      groups. However, when the inclusion criterion was changed in the HTG group, the
      two groups tended to become more separable. In this case, the degree of
      separation appeared to be related to the difference in the highest recorded IOP
      between the two groups although the separation was not complete. These findings
      show that pressure has a greater influence on the type of visual field damage at
      the higher end of the IOP spectrum encountered in open-angle glaucoma and suggest
      that there is no common single pathophysiologic mechanism in this disease.

PMID- 2243002
TI  - A study of variance in densitometry of retinal nerve fiber layer photographs in
      normals and glaucoma suspects.
AB  - The main object of this research was to develop a reliable method of screening
      glaucoma suspects and patients for early loss of or changes in the retinal nerve
      fiber layer (RNFL). This study quantifies the variances due to photography,
      digitizing, and analysis of red-free photographs of the RNFL. The influence of
      pupil size, optic disc position and eye movements, film processing, digitizing,
      and intra- and interphotographic-session and intra- and interoperator variances
      were established. It was found that pupils needed to be dilated to at least 6 mm,
      that the optic disc had to be positioned in a standardized area in the negative,
      that the head of the subject had to remain still during photography, and that
      film processing and digitizing of the negative needed to be strictly controlled
      to minimize the variance in collection of densitometry data from RNFL red-free
      photographs. It was established that focusing of the negatives during
      digitization was not crucial. Criteria were defined for acceptable negatives.
      Interphotographic-session and intraoperator variances were not significant in
      most cases when negatives were digitized to these criteria. Analysis of
      interphotographic-session variance showed that there were still some factors in
      photography, film processing, and/or image digitizing that were not sufficiently
      controlled for long-term follow-up without normalization of the data.
      Densitometry data gathered using the established protocol, from negatives of 71
      subjects were analyzed; best sensitivity and specificity rates of 80% and 100%,
      respectively, were achieved for the diagnosis of glaucoma.

PMID- 2243003
TI  - Absence of time-dependent facility increase ("washout") in the perfused
      enucleated human eye.
AB  - During the course of constant-pressure anterior chamber perfusion experiments in
      eyes from a number of species, measured outflow facility increases progressively
      with perfusion time. One possible explanation for this phenomenon has been that
      the technique of perfusion induces a loss of extracellular material from the
      outflow pathway. Therefore, this general observation has been termed the "wash
      out" effect. Data from the authors' laboratories demonstrate that although
      outflow facility increases in cynomolgus monkey eyes by 26% and 42% from baseline
      over 90 minutes in vivo and in vitro, respectively, this does not occur in the
      enucleated human eye. The absence of washout in the human eye probably cannot be
      explained by postmortem conditions since enucleated monkey eyes undergo a similar
      magnitude of washout as the monkey eye in vivo. Furthermore, since washout does
      not occur in the perfused human infant eye, the age of the donor cannot explain
      the difference in washout properties between human and other primate eyes. The
      monkey eye in vivo is a valuable model in the study of outflow physiology.
      However, the difference in washout behavior between human and other primate eyes
      may point to a potentially important fundamental difference in the biology of the
      outflow pathways in these two species.

PMID- 2243004
TI  - Factors affecting therapeutic concentration of topical aminocaproic acid in
      traumatic hyphema.
AB  - Epsilon-aminocaproic acid (EACA) decreases rebleeding in traumatic hyphema
      through antifibrinolytic activity. Therapeutic levels were achieved in aqueous
      humor of rabbits after topical application. Aqueous humor EACA levels were
      significantly higher after pretreatment with 0.5% proparacaine. Use of EACA (60%)
      in a carboxypolymethylene (CPM) vehicle (0.5%, 1%, 2%, 3%, and 4%) was examined.
      Aqueous humors levels at 4 hours ranged from 6.18-20.42 micrograms/ml. The 2% and
      3% formulas achieved the highest concentrations in aqueous. Use of EACA (15%,
      30%, 40%, and 60%) in 4% CPM was also studied. At 2 and 4 hours after treatment,
      the 30% EACA solution most effectively achieved therapeutic levels. Velcro
      closure devices were attached to the rabbit's eyelids, and 200 microliters of 30%
      EACA in 2% CPM was administered. After 3 hours the patched eyes had a mean
      aqueous EACA level of 60.09 micrograms/ml compared with 8.97 micrograms/ml in
      unpatched eyes. When dose size was studied in patched eyes, 200-microliters doses
      achieved aqueous levels of 60.09 micrograms/ml, and 100-microliters doses
      resulted in levels of 10.40 micrograms/ml. Since epithelial toxicity was observed
      in eyes that had been patched, the optimum topical regimen appeared to be 200
      microliters of 30% EACA in 2% CPM every 6 hours in unpatched eyes.

PMID- 2243005
TI  - Enhancement of differentiation of human lens epithelium in tissue culture by
      changes in cell-substrate adhesion.
AB  - Differentiation of human lens epithelial (HLE) cells cultured in vitro was
      drastically accelerated when the cells were cultured on cell-substrate adhesion
      free surfaces. Spontaneous differentiation of the lens epithelial cells in
      monolayer cultures could be recognized with the appearance of lentoid bodies
      after 40-50 days if maintained without further passage. Although dissociated HLE
      cells reconstituted into monolayers consistently on the haptotactic substrates
      (either gold-coated biopore membrane or regular plastic dishes), the cells from
      the same batches exclusively formed cell aggregates when cultured on either
      biopore membrane or agarose-coated plastic dishes (nonhaptotactic). The cells on
      nonadhesion substrate first aggregate, then synchronously develop into lentoids
      by the 10th day of culture. The differentiation of HLE cells into lentoid
      structures with lens-fiber characteristics was documented by both ultrastructural
      and biochemical markers, such as loss of cytoplasmic organelles, formation of gap
      junctions, and the expression of gamma-crystallin and MP26. The system, in which
      differentiation of epithelial cells can be induced predictably in a short period
      of time, provides an excellent model for the study of differentiation and gene
      expression in human lens cells cultured in vitro.

PMID- 2243007
TI  - Prevalence of anisometropia in volunteer laboratory and school screening
      populations.
AB  - For 10 years our laboratory has conducted, a longitudinal study of focusing and
      motor behavior of a volunteer population of 686 subjects aged 3 months to 9
      years. Its purpose is to characterize normal refractive development in infants
      and children and to relate refractive anomalies to subsequent visual problems.
      Using age-related criteria for anisometropia adjusted to detect the most unusual
      5% of the refractions on a test battery, we have found 19 nonstrabismic,
      anisometropic subjects (2.8% of total subject population). Of these, eight were
      either seen once or their anisometropia appeared at their last visit. Of the
      remaining 11 subjects, all had a reduction of their anisometropia to within
      normal limits on subsequent visits. Thus our current best estimate of persistent
      infant anisometropia is 0%, a startling result. By comparison, we found ten
      strabismic subjects (1.46%), two of whom had persistent anisometropia. Although
      we did not believe that anisometropic subjects could self-select and not
      participate in the study, it was possible that the volunteer laboratory
      population had characteristics atypical of the county at large. Thus we conducted
      a screening of 374 Head Start and first-grade pupils throughout the county, using
      the same methods. We found virtually no difference in the average refractive
      conditions between the laboratory and school populations and no significant
      difference in the prevalence of visual disorders. The very low prevalence of
      anisometropia in infants and young children in both populations has important
      implications for the etiology of anisometropic amblyopia.

PMID- 2243006
TI  - Ciliary muscle muscarinic binding sites, choline acetyltransferase, and
      acetylcholinesterase in aging rhesus monkeys.
AB  - Choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) activity, and
      the affinity and number of muscarinic binding sites (as reflected by specific 3H
      quinuclidinyl benzilate binding) were determined in the ciliary muscle of rhesus
      monkeys ranging in age from 1-34 years. No age dependence was evident for any of
      these parameters. Within the limits of their specificity and precision, the data
      indicate that biochemical alterations in ciliary neuromuscular mechanisms do not
      account for the age-related loss of ciliary muscle configurational responses to
      topical pilocarpine and electrical stimulation of the Edinger-Westphal nucleus in
      the rhesus monkey.

PMID- 2243008
TI  - Diurnal variations in tonic accommodation.
AB  - It has been established that many aspects of visual function undergo diurnal
      changes, but accommodation is an apparent exception. The authors studied tonic
      accommodation in three subjects to challenge this assumption. The measurements
      were done in complete darkness with a modified Hartinger refractometer whose
      light source was replaced by a red photodiode. This allowed exposure of the
      refractometer mark for a short duration and thus eliminated the accommodation
      stimulus. The measurement were taken every 4 hours five times a day starting from
      8 AM. Before each measurement the subjects were kept in darkness for 10 minutes.
      To obtain a measure of tonic accommodation the authors used the method of limits.
      The results showed that tonic accommodation varied over the studied period of the
      day in a predictable manner characteristics for each individual--one subject had
      his peaks and troughs displaced compared with the other two subjects. The
      amplitude of the daily variation was on the order of approximately 1.0 D, but the
      day-to-day values were relatively stable within +/- 0.5 D. Results were compared
      with other published data and showed that tonic accommodation may be subject to
      diurnal variation.

PMID- 2243009
TI  - Short-term fluctuation as an estimate of variability in visual field data.
AB  - The short-term fluctuation index (SF) is one of several values that provide an
      indication of a patient's response reliability during an automated perimetry
      examination. The authors investigated the number of visual field locations used
      and the number of determinations per location as factors affecting the SF
      estimate. A computer simulation program for perimetry was used to measure the SF
      index for 350 normal visual fields with various levels of response fluctuation.
      As expected, the variability of the SF estimate decreased as the number of
      locations used to estimate SF increased. There was a more important finding that,
      for an equal number of threshold estimates, a larger number of determinations at
      a smaller number of locations produced greater consistency in the SF estimate
      (eg, ten determinations at two locations instead of two determinations at ten
      locations). However, it is also important to sample from a representative spatial
      distribution of visual field locations. These results suggest that five
      determinations at four locations in the visual field is optimal for most clinical
      perimetric testing situations.

PMID- 2243010
TI  - Effects of prostaglandins F2 alpha, A2, and their esters in glaucomatous monkey
      eyes.
AB  - The effect of prostaglandin (PG) F2 alpha-isopropyl ester (IE), PGA2, or PGA2-IE
      on intraocular pressure (IOP) was tested in eight cynomolgus monkey eyes with
      argon laser-induced glaucoma. Dose-response testing and baseline IOP measurements
      were done. For multiple dose testing, 5 micrograms in 25 microliters (0.02%) of
      each PG was topically applied twice daily for 5 days. The IOP was measured at 30-
      or 60-minute intervals for 6 hours after the morning dose each day. A significant
      (P less than 0.05) reduction of IOP peaked at 5-9 mm Hg below baseline values on
      the 5th day of treatment for each PG. The ocular hypotensive effect of these PGs
      progressively became more pronounced during the course of twice-daily dosing,
      with a significant reduction maintained at least 17 hours after some doses. No
      more than trace aqueous flare and no cells were observed in any eye during the
      course of treatment. These findings demonstrate that PGs other than F2 alpha are
      potent ocular hypotensive agents in primates.

PMID- 2243011
TI  - Angiotensin-II contracts isolated human posterior ciliary arteries.
AB  - The effect of angiotensin-II (A-II) was studied on ring segments of the terminal
      extraocular branches of the posterior ciliary artery isolated from human
      enucleated eyes. It induced a potent concentration-dependent contraction on top
      of the spontaneous myogenic tone of all arteries studied from five patients with
      the concentration required to give half-maximal response equal to 51 nM. The
      spontaneous tone and maximal increase in vessel wall tension induced by A-II was
      equal to 51% of Emax. The relative response and sensitivity to A-II was unchanged
      in three endothelial denuded vessels, but the spontaneous tone increased. The
      arteries became completely insensitive to A-II after one exposure. These results
      show an immediate direct contractile effect of A-II on human posterior ciliary
      arteries, but the development of pronounced tachyphylaxis indicates that A-II is
      probably not an important factor in reducing blood flow to the optic nerve head.

PMID- 2243012
TI  - Decreased dopamine in the retinas of patients with Parkinson's disease.
AB  - Dopamine and it metabolites dihydroxyphenylacetic acid and homovanillic acid were
      measured in the retinas of eight patients with Parkinson's disease who died. They
      were divided into two groups according to their last dose of levodopa therapy.
      One group of three patients had not received levodopa therapy for at least 5 days
      before death, and the other group of five patients had received therapy 2-15
      hours before death. Each patient was matched with controls for delay between
      death and freezing. In the three patients without levodopa therapy, the retinal
      dopamine content was lower than normal. In the five patients who received
      levodopa therapy before death, the retinal dopamine content was similar to that
      in the controls. This study is the first direct evidence to the authors'
      knowledge that retinal dopamine concentration is decreased in Parkinson's
      disease, as it is in the nigrostriatal pathway.

PMID- 2243013
TI  - Square arrays in early cortical lens opacities.
AB  - A combined freeze-fracture and scanning electron microscopic study of early
      opaque spots in the aging human lens showed the absence of gap junctions and the
      presence of square arrays in the membranes of disturbed fibers and neighboring
      unaffected fibers. Square arrays, with membrane particles of 6-7 nm, are
      considered as rearranged gap junctions and/or intramembranous particles, with
      particle sizes between 8.5-9.5 nm; they are a sign of electric and metabolic
      uncoupling. These ultrastructural observations lend support to the idea of an
      uncoupling mechanism in the aging human lens, conserving the transparency of
      unaffected parts of the lens, as postulated previously.

PMID- 2243014
TI  - The health policy and public health directorate of the Scottish Home and Health
      Department.

PMID- 2243015
TI  - Medicines regulation in the United Kingdom.
AB  - Modern society seeks pharmaceutical products which are safe, effective and of
      good quality. Many health workers may be unfamiliar with the licensing system for
      human medicines which attempts to ensure that those goals are attained. In the
      United Kingdom the legislative framework to attain these objectives is the
      Medicines Act 1968, together with relevant European Community Directives. This
      paper briefly describes an outline of the licensing structure, explains the steps
      by which a new human medicine may reach the market and gives an indication of
      current licensing procedures by describing some considerations in the handling of
      an application for a product licence.

PMID- 2243016
TI  - Delays in admission of patients with acute myocardial infarction to coronary
      care: implications for thrombolysis.
AB  - Of 408 patients presenting to a coronary care unit over a six month period 237
      had an acute myocardial infarction. Two-thirds presented to hospital within three
      hours of the onset of symptoms. The median delay between arrival in hospital and
      admission to the Coronary Care Unit was 60 minutes. Only a minority of patients
      with acute myocardial infarction were eligible to receive thrombolysis, the most
      common exclusion criteria being an electrocardiograph that was not diagnostic of
      infarction at presentation. In-hospital transfer delay has increased considerably
      since 1972. It did not exclude many patients from receiving thrombolysis but it
      caused delayed thrombolysis.

PMID- 2243017
TI  - Introduction of an appointment system in a general practice: surveys of patients
      and staff.
AB  - To aid discussion on the introduction of an appointment system in an inner city
      practice with a 'walk-in' (non-appointment) system, we surveyed, firstly,
      patients' and staff members' attitudes to appointment systems, and secondly,
      aspects of the functioning of the current system. Of 250 patients in the first
      survey 73 per cent were against appointment systems while 24 per cent indicated
      that they would consider registering with another practice if such a system were
      introduced. Adverse comments about appointment systems greatly outweighed
      favourable ones. Staff members perceived clear advantages and disadvantages of
      both methods of consulting e.g. the 'walk-in' system was thought to be stressful
      due to the unpredictable workload but thought to reduce the demand for
      housecalls. Appointment systems were seen as giving staff more control over
      consulting but as less flexible for the patient. In the second survey of 352
      patients, 17 per cent estimated a wait of 10 minutes or less for their
      consultation, 62 per cent estimated it as 10 to 20 minutes and 21 per cent as
      more than 30 minutes. Further, 68 per cent of patients estimated that their
      consultation lasted five minutes or less and 27 per cent indicated that the
      doctor seemed rushed. As a compromise between the wishes of patients and the
      needs of staff, 'walk-in' morning surgeries and appointment-only evening
      surgeries are now offered.

PMID- 2243018
TI  - Glasgow Council on Alcohol: trends and developments in a community based
      voluntary organisation (1968-1989).
AB  - Since 1968, Glasgow Council on Alcohol has steadily increased the scope and
      variety of its efforts to help problem drinkers and their families. Apart from a
      large increase in client numbers over the last 20 years, there has been a number
      of interesting developments in identifying 'at risk' groups and directing them
      into the helping process. Prevention of alcohol problems has also become a major
      issue for this agency.

PMID- 2243019
TI  - Evaluation of a Fife 'Novopen' clinic held within a diabetes patient education
      centre.
AB  - In common with other hospitals throughout the United Kingdom, a diabetic patient
      education centre has been established at the Victoria Hospital, Kirkcaldy. Many
      activities now take place within the centre including a 'Novopen' Clinic at which
      insulin requiring diabetic patients are converted to a multiple injection method
      of delivering soluble human insulin. An evaluation of the Novopen Clinic,
      including the first 60 patients attending, has demonstrated a statistically
      significant fall in random blood sugar estimations (mean fall 2.0 m.moles 1(-1),
      95 per cent confidence intervals 1.5 m.moles 1(-1) to 2.5 m.moles) since
      conversion at the Novopen Clinic. Changes in mean daily insulin intake (mean
      increase of 1.6 units per day) and glycosylated haemoglobin (mean fall of 0.88
      per cent) were not significant. One hundred per cent of patients surveyed
      described the Novopen Clinic as 'helpful' or very 'helpful'. Staff see the clinic
      offering significant opportunities for patient education. The estimated cost of
      the clinic per new patient was 147 pounds.

PMID- 2243021
TI  - Workshop for researchers in community care.

PMID- 2243020
TI  - The validation of a language and communication assessment procedure for use with
      adults with learning difficulties.
AB  - The aim of the research was to investigate the validity of a new procedure for
      assessing the communication skills of adult mentally handicapped people. At
      present there are no communication assessments designed for this client group.
      The procedure, known as the Communication Assessment Profile (CASP) was used with
      202 adults selected from eight hospitals and 15 community placements. Results
      have shown that CASP is a reliable clinical tool, able to measure communication
      skills with accuracy, and sensitive to differences between adults living in
      hospital and community settings. This report provides a summary of the findings,
      the details of which are published elsewhere.

PMID- 2243022
TI  - General practitioner minor surgery.

PMID- 2243024
TI  - Preventing and detecting unique complications in the spinal cord injured.

PMID- 2243023
TI  - Behavioral management of urinary incontinence in homebound older adults.

PMID- 2243025
TI  - The Unna boot makes a comeback.

PMID- 2243026
TI  - Home care of the elderly alcoholic.

PMID- 2243027
TI  - Impaired skin integrity: a nursing diagnosis--a nursing challenge.

PMID- 2243028
TI  - Nursing management of the undeflatable Foley catheter balloon.

PMID- 2243029
TI  - Avoiding professional negligence: a review.

PMID- 2243031
TI  - The veterinarian as victim.

PMID- 2243030
TI  - The veterinarian's role in animal welfare.

PMID- 2243032
TI  - Hyperkalemic periodic paralysis in horses.
AB  - Eleven horses (3 mares, 7 stallions, 1 gelding) with clinical and biochemical
      evidence of hyperkalemic periodic paralysis were studied. Each horse had history
      of episodic weakness, muscular tremors, or collapse, which lasted for periods of
      a few minutes to hours. Diagnosis was based on hyperkalemia in association with a
      spontaneous episode of paralysis or by precipitation of an episode by oral
      administration of potassium chloride. Clinical and biochemical events were
      documented during spontaneous and induced episodes of muscular weakness. During
      episodes, electrocardiographic findings were consistent with hyperkalemia.
      Electromyography performed between episodes revealed fibrillation potentials and
      positive sharp waves, complex repetitive discharges, and myotonic discharges.
      Histologic changes in muscle biopsy specimens varied from no overt changes in
      some horses to vacuolation in type-2B fibers with mild degenerative changes in
      other horses. Electron microscopy of myofibers revealed dilatations of the
      sarcoplasmic reticulum. Analysis of blood samples taken serially during induced
      attacks in 5 horses revealed marked hyperkalemia (5.5 to 9.0 mEq/L), with normal
      acid-base status, hemoconcentration, and modest changes in muscle-derived
      enzymes. Close correlation (r2 = 0.882) between total plasma protein and plasma
      potassium concentrations was observed and indicated a shift of fluid out of the
      extracellular fluid compartment. Treatment of either spontaneous or induced
      episodes by IV administration of calcium, glucose, or bicarbonate resulted in
      rapid recovery. Dietary management or daily administration of acetazolamide
      effectively controlled episodes. An affected mare was bred to an affected
      stallion, and 3 affected offspring were produced by embryo transfer. Blood
      samples from another extended family of affected horses were analyzed for
      identification of a genetic marker.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243033
TI  - Patterns of uterine prolapse in dairy cows and prognosis after treatment.
AB  - A 12-month study was undertaken in a 9-veterinarian dairy practice to determine
      patterns of uterine prolapse and factors associated with posttreatment survival.
      Of 220,000 cows in herds visited by veterinarians from the practice, 200 (0.09%)
      developed prolapses mostly (155/169 with data) in the first 24 hours after
      calving. Most cows (130/200) had prolapses during fall and winter months, and
      assistance was required in 47 of 200 calvings that resulted in prolapses.
      Treatment of affected cows (n = 196) consisted of cleansing and replacement of
      the uterus, insertion of perivulvar retention sutures, local and systemic
      administration of antibiotics, and parenteral administration of dexamethasone and
      oxytocin. Calcium was administered to cows with milk fever (n = 117) and to
      multiparous cows without milk fever attended by veterinarian 9 (n = 8). Crude
      recovery rate after 2 weeks was 72.4%, but recovery was significantly better if
      the calf was born alive (P = 0.001), the cow was primiparous (P = 0.03), the cow
      did not have stage-3 milk fever (P = 0.003), or if the cow was attended by
      veterinarian 9 (P = 0.01). Time to treatment was not significantly associated
      with recovery, but affected cows were treated mostly (127/156) within 2 hours of
      occurrence of the prolapse. By multivariable analysis, presence of a liveborn
      calf, parity, and lack of stage-3 milk fever, but not attending veterinarian,
      were significant (P less than 0.05) prognostic indicators of 2-week survival.

PMID- 2243034
TI  - Comparison of the effect of pneumonia detected during lifetime with pneumonia
      detected at slaughter on growth in swine.
AB  - Pneumonia in swine has been studied mainly at slaughter or necropsy. However,
      when performing slaughter or postmortem examinations, assessment of the true
      prevalence or lifetime extent of pneumonia is at best speculative. Radiography
      was used to evaluate lungs from pigs 21 to 150 days old. Follow-up slaughter
      examination was performed on pigs 180 days old. Individual percentage of
      pneumonia observed over the life of each pig and at slaughter were added to yield
      lifetime pneumonia scores. A significant (P = 0.0001) negative effect of lifetime
      pneumonia on growth rate was found. By comparison, slaughter examination proved
      to be a poor indicator of lifetime pneumonia; lesions were found to progress and
      regress dynamically throughout the life of pigs.

PMID- 2243035
TI  - Idiopathic granulomatous disease involving the skin in a horse.
AB  - Clinical signs of generalized granulomatous disease in a horse included
      depression, generalized lymphadenopathy, scaly skin, and dependent edema.
      Diagnosis was confirmed histopathologically by diffuse granulomas in more than
      one organ system (lymph nodes and skin), and by ruling out etiologic agents.
      Response to treatment with corticosteroids was favorable. The clinical features
      and response to treatment in this horse were different from classic textbook
      descriptions of equine generalized granulomatous disease. Equine granulomatous
      disease appears to be comparable to human sarcoidosis. To avoid confusion between
      human medical and veterinary medical terminology, the authors suggest that the
      equine disease be referred to as equine idiopathic granulomatous disease and that
      a complete diagnostic description should include a reference to the organ systems
      involved.

PMID- 2243036
TI  - Granulosa cell tumor in a mare with a functional contralateral ovary.
AB  - A functional corpus luteum was found in the ovary contralateral to the ovary with
      a granulosa cell tumor in a 24-year-old Standardbred mare. The mare was
      ovariectomized because she was to be used as a jump mare for collection of semen
      from stallions. The blood concentration of progesterone was 2.2 ng/ml, and the
      luteal tissue progesterone concentration was 6.3 micrograms/mg. Atrophy of the
      contralateral ovary is one of the major signs used in diagnosis of granulosa cell
      tumor; however, our findings indicate that the ovary contralateral to a granulosa
      cell tumor is not invariably nonfunctional.

PMID- 2243037
TI  - Congenital Neospora caninum infection in a calf with spinal cord anomaly.
AB  - Neospora caninum was identified in a calf with spinal cord anomaly in Australia.
      The calf was full-term and born dead. The caudal cervical and cranial thoracic
      segments of the spinal cord of the calf were asymmetric because of marked
      unilateral reduction of ventral gray matter and focal cavitation. Mild focal
      disseminated nonsuppurative encephalomyelitis was associated with N caninum
      tissue cysts. Tissue cysts were 16 to 35 microns X 10 to 27 microns, and the cyst
      walls were 1 to 3 microns thick. In an immunohistochemical test, the parasite
      stained with N caninum serum but not T gondii serum.

PMID- 2243038
TI  - Prednisolone and danazol for treatment of immune-mediated anemia,
      thrombocytopenia, and ineffective erythroid regeneration in a dog.
AB  - Immune-mediated anemia and thrombocytopenia were diagnosed in an 8-year-old
      spayed Miniature Schnauzer. The initial CBC indicated poor erythroid regeneration
      and concurrent leukopenia. The results of a Coombs test and ANA titer were
      strongly positive. Examination of a bone marrow specimen revealed
      erythrophagocytosis and a maturation arrest in the RBC series. Treatment with
      transfusion plus prednisolone and an attenuated androgen (danazol) resulted in
      stabilization of the PCV and the development of reticulocytosis.

PMID- 2243039
TI  - Double cervices in two llamas.
AB  - Double cervices were diagnosed in 2 female llamas that were infertile. The
      condition is uncommon in other species. The condition results from the failure of
      fusion of the mullerian ducts during embryonic development. Diagnosis was
      facilitated by vaginoscopy. One case was verified as didelphia, with 2 uterine
      bodies and 2 cervices.

PMID- 2243040
TI  - Prophylactic use of dantrolene associated with prolonged postanesthetic
      recumbency in a horse.
AB  - Dantrolene, a drug used in the prevention and treatment of malignant
      hyperthermia, was believed responsible for prolonged postanesthetic recumbency in
      a horse. Prophylactically, dantrolene was given orally before induction of
      anesthesia. Dantrolene has been recommended for use in horses at risk of
      developing postanesthetic myopathy. Side effects, including ataxia, may result
      from dantrolene administration.

PMID- 2243042
TI  - Accuracy of radiography of the reticulum for predicting surgical findings in
      adult dairy cattle with traumatic reticuloperitonitis: 123 cases (1981-1987).
AB  - Radiographic and surgical findings were compared in 123 cattle suspected of
      having traumatic reticuloperitonitis. Radiography of the reticulum proved to be a
      sensitive test for detection of a foreign body (FB). An abnormal FB position on a
      radiograph was a good predictor of FB perforation. If an FB was fully attached to
      a magnet, it was unlikely to be perforating the reticular wall. When abnormal
      reticulum size, abnormal reticulum location, and gas shadows adjacent to the
      reticulum were found simultaneously on a radiograph, hepatic or perireticular
      abscess was likely. Reticular radiography proved to be a useful diagnostic aid in
      cattle suspected of having traumatic reticuloperitonitis.

PMID- 2243041
TI  - Cardiac arrhythmias identified in horses with duodenitis/proximal jejunitis: six
      cases (1985-1988).
AB  - During a 3 1/2-year period, cardiac arrhythmias were identified in 6 of 67 horses
      diagnosed with duodenitis/proximal jejunitis (DPJ). Arrhythmias were detected by
      auscultation of irregular cardiac rhythm and subsequently were characterized by
      electrocardiographic evaluation. Arrhythmias included frequent second-degree
      atrioventricular block, ventricular ectopic depolarizations, and atrioventricular
      conduction disturbance. In 4 horses, arrhythmias resolved with recovery from the
      primary problem. One horse died suddenly 66 hours after admission, and another
      was euthanatized at 72 hours after admission. Clinical and laboratory data from
      horses with DPJ and cardiac arrhythmias (group 1) were compared with findings for
      horses with DPJ and without arrhythmias (group 2). Group-1 horses had
      significantly (P less than 0.05) higher serum bicarbonate concentration and serum
      creatine kinase activity. Normal sinus rhythm returned in all 4 group-1 horses
      that recovered from DPJ, suggesting a causal relationship between DPJ and the
      arrhythmias. Two group-1 horses were necropsied, and both had myocarditis. The
      cause of these lesions was not determined.

PMID- 2243044
TI  - Comments on a multiple-choice ethics examination.

PMID- 2243045
TI  - Informing health officials of reportable diseases.

PMID- 2243043
TI  - What is your diagnosis? Focal, ovoid, smooth-bordered, osseous proliferation
      compatible with an osteoma of the parietal bone.

PMID- 2243046
TI  - Comments on the specialty of internal medicine.

PMID- 2243047
TI  - Curbing hunger: veterinarians play role in global development.

PMID- 2243048
TI  - FDA-CVM asks for veterinary input on responsible compounding of drugs.

PMID- 2243050
TI  - US Army veterinarians stationed in Thailand.

PMID- 2243049
TI  - Veterinary biologic issues addressed by USDA.

PMID- 2243051
TI  - Make your voice heard.

PMID- 2243052
TI  - Blood transfusion: a historical review.

PMID- 2243053
TI  - Culture of endocrine pancreatic cells in protein-free, chemically defined media.
AB  - Cell suspensions prepared by collagenase digestion of pancreata obtained from
      21.5-d-old rat fetuses were preincubated in RPMI medium containing 10% fetal
      bovine serum (FBS), to ensure cell adhesion. Twenty hours later, this medium was
      replaced by a chemically defined medium. Dulbecco's modified Eagle's (DME)-F12
      was used alone or supplemented with various combinations of transferrin, sodium
      selenite, or Ultroser G. The evolution of the culture and the islet
      ultrastructure were similar in defined and serum-containing media. However, in
      the defined medium, the neoformed islets seemed less numerous, and the fibroblast
      layer less dense, when compared to the RPMI + 10% FBS control medium. At Day 7,
      in defined media, the total insulin content per dish was half that of control
      cultures. None of the tested additives improved the yield of the cultures. The
      fractional insulin release per day was elevated in defined media. In subsequent
      incubations, glucose and leucine stimulated insulin release in a way
      characteristic of these cells of fetal origin. The labeling index of islet cells
      cultured in DME-F12 reached 10.7%, which is not far from that observed in RPMI +
      10% FBS. Such a defined medium is useful to study B cell physiology, avoiding the
      possible interaction of serum components with substances to be tested.

PMID- 2243054
TI  - Culture of isolated rat hepatocytes after prolonged storage on ice--a better use
      of cell resources.

PMID- 2243055
TI  - HBL-100 cells do not secrete casein and lack prolactin and estradiol receptors.

PMID- 2243056
TI  - Co-culture of two-cell rat embryos on cell monolayers.
AB  - Monolayers of 2 different populations of uterine cells and of fetal fibroblasts
      were evaluated for the support of rat embryo development in vitro. Compared to
      controls, cultures performed in Earle's buffered saline solution (EBSS) alone,
      the cleavage rate of 2-cell embryos to the 4-cell stage was significantly
      increased when the embryos were cocultured for 24 h with mixed uterine stromal
      and myometrial cells (70.7 vs. 56.0%; P less than 0.01). Coculture of 2-cell
      embryos with either uterine epithelial-stromal or stromal-myometrial cells in
      medium TC 199 (M199) for 24 h significantly increased the cleavage rate to the 4
      cell stage compared to controls in the same medium (respectively, 78.3 and 77.6
      vs. 49.9%; P less than 0.01). The development was not improved when fibroblasts
      were used as feeder cells. After 48 h, the proportion of 4-cell embryos showing
      cellular fragmentation was significantly decreased in the presence of either
      epithelial-stromal or stromal-myometrial cells in M199 compared to controls
      (respectively, 18.4 and 20.0 vs. 43.8%; P less than 0.01). Coculture in EBSS or
      with fibroblasts failed to prevent embryo degeneration. In one coculture with
      stromal-epithelial cells in M199, 6/11 embryos proceeded beyond the 4-cell stage,
      two of them reaching the 8-cell stage. No embryo developed beyond that stage in
      our study. Although considerable efforts remain necessary to achieve further
      growth, these results suggest that coculture offers promise as a means of
      supporting the in vitro development of rat embryos.

PMID- 2243057
TI  - Establishment of a macrophagelike cell line derived from U-937, human histiocytic
      lymphoma, grown serum-free.
AB  - A human macrophagelike cell line which grows in serum-free medium was established
      from a histiocytic lymphoma cell line, U-937. U-937 cells failed to differentiate
      into macrophagelike cells in serum-free medium plus 12-O-tetradecanoyl phorbol 13
      acetate (TPA). Fibronectin and albumin in serum were necessary for
      differentiation of U-937 cells into macrophagelike cells in enriched RDF medium
      supplemented with insulin, transferrin, ethanolamine, selenite, egg yolk
      lipoprotein (eRDF-ITESL medium). The established cell line exhibited several
      characteristic properties of macrophage such as nitroblue tetrazolium reduction,
      phagocytic and alpha-naphthylbutyrate-esterase activities, and tumor necrosis
      factor and interleukin 1 production. At present the cells have been continuously
      maintained in eRDF-ITESL medium through over 150 passages.

PMID- 2243058
TI  - Long-term maintenance of primary myogenic cultures on a reconstituted basement
      membrane.
AB  - We describe a simple technique for maintaining highly contractile long-term
      chicken myogenic cultures on Matrigel, a gel composed of basement membrane
      components extracted from the Engelbreth-Holm-Swarm mouse tumor. Cultures grown
      on Matrigel consist of three-dimensional multilayers of cylindrical, contracting
      myotubes which endure for at least 60 d without myotube detachment. A Matrigel
      substrate increases the initial plating efficiency but does not effect cell
      proliferation. Large-scale differentiation in cultures maintained on Matrigel is
      delayed by 1 to 2 d, compared to cultures grown on gelatin-coated dishes. Long
      term maintenance on Matrigel also results in increased expression of the neonatal
      and adult fast myosin heavy chain isoforms. Culturing of cells on a Matrigel
      substrate could thus facilitate the study of later events of in vitro myogenesis.

PMID- 2243059
TI  - In vitro culture of tissue from the tunicate Styela clava.
AB  - Pharyngeal explants and circulatory hemocytes from the tunicate Styela clava were
      cultured in a medium containing tunicate plasma, artificial seawater, RPMI 1640,
      and antibiotics. Pharyngeal tissue remained viable and proliferated for up to 72
      d in vitro. Proliferative activity maintained the pool of hemocytes within
      explants and facilitated the migration of pharyngeal hemocytes from explants into
      culture supernatants. The diversity of morphologically distinct cell types within
      the hemocyte pool of pharyngeal cultures indicated that cell division was
      followed by regulated differentiation. In contrast to pharyngeal cultures,
      suspensions of circulatory hemocytes did not survive for prolonged periods in
      vitro. Proliferative activity could not be detected in circulatory hemocyte
      cultures. These results are discussed in terms of the differentiation state of
      hemocytes and the efficacy of culture conditions.

PMID- 2243060
TI  - Characterization of malignant mesenchymal cell line (UISO-RS-3) derived from a
      human rhabdomyosarcoma and inhibition by pharmacologic doses of estrogen.
AB  - A new tumor cell line has been established from a malignant pleural effusion in a
      28-yr-old female patient with a primary alveolar rhabdomyosarcoma of the left
      buttock. The in vitro and in vivo growth characteristics, morphologic features,
      abnormal karyotype, and immunohistochemical staining pattern indicate that this
      cell line is comprised of primitive malignant mesenchymal cells derived from a
      human rhabdomyosarcoma. Receptor studies done on tumors grown in male athymic
      mice revealed a single class of high affinity saturable cytoplasmic estrogen
      receptor (Bmax 2.6 fm/mg cytosol protein, Kd 0.34 nM). Likewise, sucrose density
      gradient analysis demonstrated specific low-capacity, high-affinity estradiol
      binding predominately in the 8S region. Cell growth in monolayer culture and on
      soft agar in the presence of estradiol was inhibited by pharmacologic
      concentrations of estradiol in a dose-responsive manner compared with control. We
      describe a newly characterized malignant mesenchymal cell line derived from an
      alveolar rhabdomyosarcoma that is inhibited by pharmacologic doses of estradiol
      in vitro. These findings suggest further investigation into the mechanism(s) of
      this estrogen-induced inhibition in rhabdomyosarcomas.

PMID- 2243061
TI  - Long ultradian rhythms in red blood cells and ghost suspensions: possible
      involvement of cell membrane.
AB  - Oscillations in glyceraldehyde-3-phosphate dehydrogenase (GAPD) and glucose-6
      phosphate dehydrogenase (G6PD) activities were recorded in suspensions of intact
      human red blood cells (RBCs) exposed to various light regimens. The periods of
      these oscillations, defined as "long ultradian," ranged between 13 and 18 h
      regardless of light regimen. The patterns of enzymatic activities were the same
      when assayed at each time point, in full hypotonic hemolysates, and membrane-free
      hemolysates. However, if hemolysates were prepared by sonication the activity
      pattern did not exhibit significant oscillations and the activity was higher than
      that recorded in hypotonic hemolysates. The observed rhythms may reflect a time
      dependent attachment and detachment of enzyme molecules from cell membrane,
      suggesting that at the bound state the enzyme molecules are (temporarily)
      inactive. Oscillations with similar long ultradian periods were also observed in
      Ca++ concentration of suspended RBCs and in the binding of Ca++45 to human RBC
      ghosts. Treatment of the RBCs with A2C or Diamide before the preparation of the
      ghosts changed or distorted the rhythmic pattern of Ca++45 binding. These results
      point to the role of the membrane in processing the long ultradian oscillations.
      The relation between this type of oscillations to circadian rhythm is discussed.

PMID- 2243062
TI  - Influence of initial collagen and cellular concentrations on the final surface
      area of dermal and skin equivalents: a Box-Behnken analysis.
AB  - Our laboratory has been involved in finding optimal conditions for producing
      dermal and skin equivalents. As an original approach, a Box-Behnken experimental
      design was used to study the effects of the initial collagen and fibroblast
      concentrations and the initial gel thickness on the contraction of dermal and
      skin equivalents. The final surface area of dermal equivalent varied
      significantly with the initial concentration of collagen and fibroblast, whereas
      the initial thickness of gel had no appreciable effect on the contraction of the
      dermal equivalent. When keratinocytes were grown on these dermal equivalents they
      produced a very severe contraction, to an extent that all skin equivalents had a
      similar final surface area. This severe contraction was independent of collagen
      and fibroblast concentrations. Models for the prediction of the final percentage
      contraction of dermal and skin equivalents as a function of the initial
      concentration of collagen, the logarithm of fibroblast concentration, and the
      initial gel thickness were obtained and analyzed. Keratinocytes grown at the
      lowest seeding density did not contract the equivalents. However, histologic
      analysis has shown an incomplete coverage by these cells of the equivalents. The
      extensive contraction of the skin equivalent presenting adequate morphology is a
      major drawback toward its clinical utilization for burn wound coverage.

PMID- 2243064
TI  - A medium-format photographic protocol to aid in the management of dysplastic nevi
      syndrome.

PMID- 2243063
TI  - Inhibition of psoriatic cell proliferation in in vitro skin models by amiprilose
      hydrochloride.
AB  - Amiprilose hydrochloride, a 3-substituted glucose derivative, was found to
      inhibit the proliferation of human fibroblasts and keratinocytes originating from
      psoriatic lesions. Fibroblasts and keratinocytes were obtained from skin biopsies
      of normal donors, and from the biopsies of active/involved and uninvolved sites
      of psoriatic donors. The cells were cultured as monolayers or as components of
      tissue equivalent models. Keratinocytes and fibroblasts originating from biopsies
      of psoriatically involved areas were shown to proliferate at a significantly
      higher rate than those derived from uninvolved areas. The antiproliferative
      effect of amiprilose hydrochloride was not observed with normal keratinocytes or
      fibroblasts from the skin of healthy donors or from uninvolved areas of psoriatic
      donors. Amiprilose hydrochloride was not cytotoxic to any of these cells at
      levels below 0.1%. The combination of the low cytotoxicity and the selective
      antiproliferative effect indicates that this compound may be a useful
      antipsoriatic agent. The use of monolayer cultures and tissue equivalent models
      in this study illustrates the utility of such a progressive strategy in the
      evaluation of potential topical pharmaceuticals.

PMID- 2243065
TI  - Louis Schmidt award presented to Raymond E. Lund, RBP, FBPA.

PMID- 2243066
TI  - H. Paul Newman, RBP, FBPA receives Creer award.

PMID- 2243067
TI  - The redesigned Advanced Biomedical Photographic Communications program at
      Rochester Institute of Technology.

PMID- 2243068
TI  - Check your references or rediscovering the wheel.

PMID- 2243069
TI  - Computer-assisted calculation of film processing solution replenishment rates.

PMID- 2243070
TI  - The development of a photogrammetry service at the Royal Children's Hospital,
      Melbourne.

PMID- 2243071
TI  - RBP #1: an interview with Howard E. Tribe. Interview by Robert Turner.

PMID- 2243072
TI  - The production of one-piece, full-color scientific displays.

PMID- 2243073
TI  - Treatment of asthma: a comprehensive approach.

PMID- 2243074
TI  - Chemoprophylaxis in asthma.

PMID- 2243075
TI  - Environmental controls and immunotherapy in the treatment of chronic asthma.

PMID- 2243076
TI  - Asthma in New Zealand children.

PMID- 2243077
TI  - The pattern of skin test reactivity to aeroallergens in asthmatic children in
      Riyadh.

PMID- 2243078
TI  - Minimum substrate sequence for signal peptidase I of Escherichia coli.
AB  - The minimum substrate sequence recognized by signal peptidase I (SPase I or
      leader peptidase) was defined by measuring the kinetic parameters for a set of
      chemically synthesized peptides corresponding to the cleavage site of the
      precursor maltose binding protein (pro-MBP). The minimum sequence of a substrate
      hydrolyzed by SPase I at a measurable rate was the pentapeptide Ala-Leu-Ala
      decreases Lys-Ile. The rates of hydrolysis of this substrate, however, were
      several hundred-fold lower than those observed for the maturation of MBP in
      Escherichia coli, suggesting that in addition to these minimal sites involved in
      recognition, other features of pro-MBP are also needed for the optimal rate of
      signal peptide cleavage by SPase I. One parameter may be the length of the
      polypeptide chain. Studies of the synthetic peptides showed that decreasing the
      length of the polypeptide chain of substrates decreased the substrate efficiency
      measured as kcat/Km. However, in one case a decrease in the length of a peptide
      corresponding to -7 to +3 positions of pro-MBP to a nonapeptide (-7 to +2)
      increased the substrate efficiency by about 900-fold. The nonapeptide is the most
      efficient substrate for the enzyme in vitro so far reported. It is speculated
      that better peptide substrates are the ones which are able to adopt folded
      structures.

PMID- 2243079
TI  - Immunochemical analysis of the exposure of high mobility group protein 14 and 17
      surfaces in chromatin.
AB  - Antisera were elicited against synthetic peptides corresponding either to regions
      common to all members of the high mobility group 14 and 17 protein family protein
      or to distinct domains of the HMG-14 or HMG-17 subgroup. The antisera were used
      to probe the accessibility of various HMG domains in chromatin. Competitive
      enzyme-linked immunosorbent assays indicate that the central region of the
      proteins, which contains their DNA binding domain and is positively charged, is
      exposed to a smaller degree than the C-terminal region of the proteins, which has
      a net negative charge. The C-terminal regions of the HMG-14 and HMG-17 proteins
      are exposed and available to interact with other proteins.

PMID- 2243080
TI  - Isolation of subtilisin pro-sequence mutations that affect formation of active
      protease by localized random polymerase chain reaction mutagenesis.
AB  - In order to analyze the role of the pro-sequence in folding of the alkaline
      serine protease subtilisin, localized random mutagenesis using the polymerase
      chain reaction with Taq DNA polymerase was employed to obtain mutations in the
      pro-sequence which prevent production of active protease. The unique aspect of
      this procedure is that random mutations can be easily generated in vitro over
      large but defined regions of a specific gene. The method was applied to a 458
      base pair fragment encompassing the coding region of the pro-sequence of
      subtilisin, a region of the protein which has been shown to be required for
      proper folding. Protease-deficient mutants containing a variety of amino acid
      substitutions were isolated with a frequency of 4.3%. From analysis of these
      mutants, four independent amino acid substitution mutations in the pro-sequence
      were identified. The present results demonstrate that polymerase chain reaction
      is an efficient and simple method for obtaining random mutations within a
      localized region of a given gene.

PMID- 2243081
TI  - HIV-1 tat gene induces tumor necrosis factor-beta (lymphotoxin) in a human B
      lymphoblastoid cell line.
AB  - The tat protein from human immunodeficiency virus type 1 (HIV-1) activates viral
      gene expression and is essential for HIV replication in vitro. It has also been
      shown that the tat gene product specifically inhibits antigen-induced
      proliferation of human peripheral blood lymphocytes. In order to understand the
      growth and immunomodulatory roles of HIV-1 tat, we have examined the effect of
      the tat gene on the expression of tumor necrosis factors in a human B
      lymphoblastoid cell line (Raji). We report here that the HIV-1 tat gene
      introduced into Raji cells by retroviral-mediated transformation induces
      production of tumor necrosis factor-beta (TNF-beta). The tat-mediated induction
      of TNF-beta seems to be both at the transcriptional and post-transcriptional
      levels because, concurrent with a 30-fold increase in the levels of TNF-beta
      protein, an approximate 8-fold increase in mRNA was observed in tat-transformed
      Raji cells. It is recently reported that tat protein of HIV-1 stimulates growth
      of cells derived from Kaposi's sarcoma lesions of AIDS patients (Ensoli, B.,
      Barillari, G., Salahuddin, S.Z., Gallo, R.C., and Wong-Staal, F. (1990) Nature
      345, 84-86). Since TNF has been shown to function as a growth factor for several
      cell types, our results showing induction of TNF-beta by tat indicate the
      possibility that a growth-stimulatory role of HIV-1 tat on Kaposi's sarcoma cells
      is mediated through TNF-beta.

PMID- 2243082
TI  - Alpha-dendrotoxin acceptor from bovine brain is a K+ channel protein. Evidence
      from the N-terminal sequence of its larger subunit.
AB  - High affinity acceptors for alpha-dendrotoxin, a selective probe for certain fast
      activating voltage-dependent K+ channels, were purified approximately 4,000-fold
      from synaptic plasma membranes of bovine cerebral cortex. Although the
      preparation possessed a low content of high affinity sites for beta-bungarotoxin,
      antagonism of alpha-dendrotoxin binding by the latter required high
      concentrations; this indicates that more than one acceptor subtype has been
      purified. After deglycosylation of the acceptor, the sizes of its subunits were
      determined electrophoretically to be Mr 65,000 and Mr 39,000. Solid phase
      microsequencing of these isolated subunits showed that the smaller one had a
      blocked N terminus, but the Mr 65,000 protein gave a sequence of 27 residues.
      This is virtually identical to the N-terminal sequence deduced from cDNA of RCK
      5, a K+ channel protein from rat brain known to be susceptible to alpha
      dendrotoxin. This first report on the partial sequence of any K+ channel protein
      confirms that the extensive information acquired to date on the alpha-dendrotoxin
      acceptors is pertinent to functional neuronal K+ channels.

PMID- 2243084
TI  - Hormone-free mouse glucocorticoid receptors overexpressed in Chinese hamster
      ovary cells are localized to the nucleus and are associated with both hsp70 and
      hsp90.
AB  - In this work, we examine the cellular localization and protein interactions of
      mouse glucocorticoid receptors that have been overexpressed in Chinese hamster
      ovary (CHO) cells (Hirst, M. A., Northrop, J. P., Danielsen, M., and Ringold, G.
      M. (1990) Mol. Endocrinol. 4, 162-170). We demonstrate that wild-type unliganded
      mouse glucocorticoid receptor, which is expressed in CHO cells to a level
      approximately 10 times that of L cells, is localized entirely to the nucleus by
      indirect immunofluorescence with the BuGR antireceptor monoclonal antibody.
      Overexpressed receptors that have either no hormone binding activity or no DNA
      binding activity because of point mutations also localize to the nucleus,
      providing genetic proof that the nuclear localization cannot reflect a steroid
      mediated shift of the receptor from the cytoplasm to the nucleus and that DNA
      binding activity is not required for nuclear localization. Like unliganded
      progesterone receptors, which also associate in a loosely bound "docking" complex
      with the nucleus, the mouse glucocorticoid receptor overexpressed in CHO cells is
      associated with both hsp90 and hsp70. This is in contrast to the untransformed
      mouse glucocorticoid receptor in L cell cytosol, which is associated with hsp90
      but not hsp70. The difference in hsp70 association between cell types could
      reflect overexpression of the receptor in CHO cells. However, like receptors in
      CHO cells selected for very high levels of overexpression, receptors in CHO cells
      selected for an intermediate level of receptor expression that is comparable to
      that of L cells are also bound to hsp70. This observation argues against an
      explanation of hsp70 association based purely on receptor overexpression, and we
      speculate that association of the unliganded glucocorticoid receptor with hsp70
      might be a consequence of its nuclear localization in the CHO cells. Although
      there are differences between the mouse receptor in CHO cells and L cells, the
      nuclear localization signal of the untransformed mouse receptor reacts
      equivalently with the AP64 antibody against NL1 in cytosols prepared from both
      cell types.

PMID- 2243083
TI  - Sorting of peroxisomal membrane protein PMP47 from Candida boidinii into
      peroxisomal membranes of Saccharomyces cerevisiae.
AB  - A gene encoding PMP47, a peroxisomal integral membrane protein of the
      methylotrophic yeast Candida boidinii, was isolated from a genomic library. DNA
      sequencing of PMP47 revealed an open reading frame of 1269 base pairs capable of
      encoding a protein of 46,873 Da. At least two membrane-spanning regions in the
      protein are predicted from the sequence. Since the 3 amino acids at the carboxyl
      terminus are -AKE, PMP47 lacks a typical peroxisomal sorting signal. No
      significant similarities in primary structure between PMP47 and known proteins
      were observed, including PMP70, a rat peroxisomal membrane protein whose sequence
      has recently been reported (Kamijo, K., Taketani, S., Yokota, S., Osumi, T., and
      Hashimoto, T. (1990). J. Biol. Chem. 265, 4534-4540). In order to study the
      import and assembly of PMP47 into peroxisomes by genetic approaches, the gene was
      expressed in the yeast Saccharomyces cerevisiae. When PMP47 was expressed in
      cells grown on oleic acid to induce peroxisomes, the protein was observed
      exclusively in peroxisomes as determined by marker enzyme analysis of organelle
      fractions. Most of the PMP47 co-purified with the endogenous peroxisomal membrane
      proteins on isopycnic sucrose gradients. Either in the native host or when
      expressed in S. cerevisiae, PMP47 was not extractable from peroxisomal membranes
      by sodium carbonate at pH 11, indicating an integral membrane association. These
      results indicate that PMP47 is competent for sorting to and assembling into
      peroxisomal membranes in S. cerevisiae.

PMID- 2243085
TI  - "Suicide" inactivation of thromboxane A2 synthase. Characteristics of mechanism
      based inactivation with isolated enzyme and intact platelets.
AB  - "Suicide" inactivation occurs during catalysis by thromboxane synthase. Loss of
      enzymatic activity, accompanying thromboxane B2 formation, was proportional to
      the substrate concentration. Inactivation was directly related to product
      formation: for several different experimental protocols 50% loss of thromboxane
      synthase activity corresponded with formation of 454 +/- 79 ng of thromboxane
      B2/mg protein. The time course of inactivation was pseudo-first-order and obeyed
      saturation kinetics. Inactivation (KI) and first-order rate constants (ki) were
      18 microM and 0.18 s-1 for prostaglandin H2. Prostaglandin H1, a poor substrate
      for turnover, was also a site-directed inactivator with KI = 28 microM and ki =
      0.09 s-1. Competitive inhibitors, typified by U63557a and U46619, preserved the
      enzyme activity by slowing the rate of inactivation from 0.18 to 0.05 s-1. Loss
      of the hemoprotein Soret absorbance did not correlate quantitatively or
      temporally with the loss of thromboxane synthase activity. A similar,
      irreversible inactivation accompanied thromboxane formation by intact platelets.
      Loss of activity was proportional to substrate concentration and catalytic
      activity. For a pool of 25 separate donors, thromboxane synthase activity
      declined exponentially as a function of thromboxane B2 formation: 50% loss of
      activity corresponded to 23 ng of thromboxane B2/10(7) platelets. The data
      conform to criteria for a specific, mechanism-based process in which thromboxane
      synthase participates in two parallel reactions, one leading to thromboxane
      formation and the other to suicide inactivation. The specific, rather than
      indiscriminate, nature of the process, and its occurrence in intact platelets may
      have implications for the cell biology of thrombosis. Depletion of thromboxane
      synthase activity may be a factor in the choice and effectiveness of
      antithrombotic agents.

PMID- 2243086
TI  - Protein factors that bind to the murine 2',5'-oligoadenylate synthetase ME-12
      gene 5' upstream regulatory region.
AB  - The murine 2',5'-oligoadenylate synthetase ME-12 gene regulatory region AB forms
      six complexes with protein factors in murine BALB/c 3T3 cells as demonstrated by
      the mobility shift electrophoresis assay under the reaction conditions used. The
      complexes, designated C1-C6 in order of their decreasing electrophoretic
      mobility, showed three distinctive specificities with regulatory region AB,
      element A, and element B as probes or competing DNA: 1) C1 is region AB-specific
      (this complex did not form with either element A or B used alone or as a
      mixture); 2) C5 formed both with element A and element B; 3) C2, C3, C4, and C6
      formed with element B, but not A. The protein factors that give rise to these
      complexes show differential DNA binding activities in various buffer solutions at
      different pH values. The C4-forming protein factor is the interferon (IFN)
      alpha/beta-stimulated response factor (ISRF) which shows element B specificity.
      It preexists in the cytoplasm. ISRF appears to be complexed to an inhibitor
      (ISRFI) in the cytoplasm and to dissociate from the inhibitor and to translocate
      into the nucleus upon treatment of cells with IFN-alpha/beta. We propose that IFN
      alpha/beta treatment of BALB/c 3T3 can trigger at least two events: 1) loosening
      of a tight inhibitor-ISRF complex with the release of free ISRF; this may be
      mediated via phosphorylation of ISRF or ISRFI; 2) translocation of ISRF into the
      nucleus and binding to the enhancer element B, which results in the activation of
      2',5'-oligoadenylate synthetase gene expression.

PMID- 2243087
TI  - The effect of phosphate and calcium on force generation in glycerinated rabbit
      skeletal muscle fibers. A steady-state and transient kinetic study.
AB  - The effect of varying concentrations of Pi and Ca2+ on isometric force and on the
      rate of force development in skinned rabbit psoas muscle fibers has been
      investigated. Steady-state results show that the three parameters that define the
      force-pCa relation (Po, pK, and n) all vary linearly with log [Pi]. As [Pi]
      increases, Po and pK decrease while n increases. The kinetics of force generation
      in isometrically contracting fibers were studied by laser flash photolysis of
      caged phosphate. The observed rate of the resulting tension transient, kPi, is
      23.5 +/- 1.7 s-1 at 10 degrees C, 0.7 mM Pi, and is independent of [Ca2+] over
      the range pCa 4.5-7.2. By contrast, kTR, the rate of tension redevelopment
      following a period of isotonic shortening, is sensitive to [Ca2+] and is slower
      than kPi (kTR = 13.6 +/- 0.2 s-1 at pCa 4.5, 0.7 mM Pi). The results show that
      [Ca2+] does not directly affect the Pi release or force-generating steps of the
      cross-bridge cycle and show that the observed rate of force development depends
      on how the measurement is made. The data can be interpreted in terms of a model
      in which strong cross-bridges activate the thin filament, this activation being
      modulated by Ca2+ binding to troponin.

PMID- 2243088
TI  - Mouse beta thalassemia, a model for the membrane defects of erythrocytes in the
      human disease.
AB  - The present study describes the pathophysiology, at the cellular level, of the
      mouse beta thalassemia and shows the pertinence of this model for the human
      disease. The homozygous state of mouse beta thalassemia is characterized by a
      clinical syndrome similar to the human beta thalassemia intermedia, but it cannot
      be explained by the small deficiency in beta chain synthesis. The small pool of
      unpaired and soluble alpha chains present in mouse reticulocytes contrasts with
      the large amount of insoluble alpha chains in erythrocytes which is induced by
      the high instability of mouse alpha chains and the absence of significant
      proteolysis. The amount of insoluble alpha chains associated with red cell ghosts
      is similar in human and mouse disease of similar severity. The study of membrane
      protein defects showed a decreased amount of spectrin (alpha and beta chains) and
      dramatic changes in the distribution of the most reactive thiol groups of
      membrane proteins. These results were similar to that previously described in the
      human disease (Rouyer-Fessard, P., Garel, M. C., Domenget, C., Guetarni, D.,
      Bachir, D., Colonna, P., and Beuzard, Y. (1989) J. Biol. Chem. 264, 19092-19098).
      Abnormal density distribution curves of erythrocytes and oxidant-induced lysis of
      red blood cells used as functional tests were similar in the human and mouse beta
      thalessemia. We conclude from the present study that 1) mouse beta thalassemia is
      an excellent model for the membrane defects occurring in the human disease; 2)
      disease expression is not the reflection of the globin chain unbalance only nor
      of the soluble pool of alpha hemoglobin chain but mainly is a reflection of
      insoluble alpha chains; and 3) the rate of proteolysis and instability of alpha
      chains are important factors which must be taken into consideration in the
      pathophysiology and the clinical heterogeneity of the disease.

PMID- 2243089
TI  - Biochemical study of a recombinant soluble interleukin-2 receptor. Evidence for a
      homodimeric structure.
AB  - A truncated soluble form of the human interleukin-2 receptor p55 chain (T-S-IL
      2R) was expressed to high levels in RODENT (mammalian) cells and affinity
      purified. Its biochemical behavior was analyzed by polyacrylamide gel
      electrophoresis (PAGE), gel filtration, and sucrose gradient centrifugation. It
      migrated as a single 40-kDa band on sodium dodecyl sulfate-PAGE (reducing or
      nonreducing conditions), whereas it ran as a 80-kDa component on native PAGE or
      as a 86-kDa component on gel filtration. The combination of gel filtration and
      density gradient sedimentation gave a Stokes radius of 4.0 nm and a sedimentation
      coefficient of 3.72 S. The deduced molecular mass was 67 kDa, and the fractional
      ratio was 1.516. These data therefore indicated that the T-S-IL-2R was secreted
      as an homodimer of two noncovalently associated 40-kDa subunits. Cross-linking
      experiments using bifunctional reagents enabled the materialization of the
      dimeric structure on sodium dodecyl sulfate-PAGE. Stoichiometric binding studies
      using two monoclonal antibodies (mAbs 33B3.1 and 11H2) reacting with separate
      epitopes on the p55 chain also strongly supported the dimeric structure. Indeed,
      there was one binding site for the 33B3.1 mAb (and Fab fragment) per T-S-IL-2R 40
      kDa subunit, whereas the 11H2 mAb (or Fab fragment) could bind only half a site
      per subunit, a result which could only be explained when assuming more than one
      subunit for the native T-S-IL-2R. Soluble interleukin-2 receptor species were
      also purified from culture supernatants of either L cells transfected with the
      full-length p55 cDNA or a normal alloreactive T cell clone. Similar biochemical
      behavior and reactivities with the two mAbs were found. Finally, cell-surface p55
      chains expressed either by pgL21 or 4AS cells bound the 33B3.1 and 11H2 mAbs in a
      2:1 ratio, suggesting that the p55 chains are also associated as homodimers when
      imbedded in the membrane.

PMID- 2243090
TI  - Stereoselectivity of lipases. I. Hydrolysis of enantiomeric glyceride analogues
      by gastric and pancreatic lipases, a kinetic study using the monomolecular film
      technique.
AB  - In the present study, porcine pancreatic lipase, rabbit gastric lipase, and human
      gastric lipase stereospecificity toward enantiomeric glyceride derivatives was
      kinetically investigated using the monomolecular film technique. Pseudoglycerides
      such as enantiomeric 1(3)-alkyl-2,3(1,2)-diacyl-sn-glycerol, enantiomeric 1(3)
      alkyl-2-acyl-sn-glycerol, or enantiomeric 1(3)-acyl-2-acylamino-2-deoxy-sn
      glycerol were synthesized in order to assess the lipase stereoselectivity during
      the hydrolysis of either the primary or the secondary ester position of these
      glycerides analogues. The cleaved acyl moiety was the same in both enantiomers,
      thereby excluding the possibility of effects occurring due to fatty acid
      specificity. We observed a porcine pancreatic lipase sn-3 stereoselectivity when
      using the enantiomeric 1(3)-alkyl-2-acylamino-2-deoxy-sn-glycerol (diglyceride
      analogue) which contrasted with the lack of stereoselectivity observed when using
      the enantiomeric 1(3)-alkyl-2,3(1,2)-diacyl-sn-glycerol (triglyceride analogue).
      The gastric lipases, in contrast to the pancreatic lipase, preferentially
      catalyze the hydrolysis of the primary sn-3 ester bond of the enantiomeric
      monoakyl-diacyl pair tested. From these kinetic data, high hydrolysis rates and
      no chiral discrimination were observed in the case of rabbit gastric lipase,
      whereas low rates and a clear chiral discrimination was noticed in the case of
      human gastric lipase during hydrolysis of the acyl chain from the secondary ester
      bond of 1(3)-alkyl-2-acyl enantiomers. It is particularly obvious that in the
      case of human gastric lipase decreasing the lipid packing increases the lipase sn
      3 stereopreference during hydrolysis of the primary ester bond of the
      enantiomeric 2-acylamino derivatives (diglyceride analogue).

PMID- 2243091
TI  - Stereoselectivity of lipases. II. Stereoselective hydrolysis of triglycerides by
      gastric and pancreatic lipases.
AB  - In the present study, porcine pancreatic lipase, rabbit gastric lipase, and human
      gastric lipase stereospecificity toward chemically alike, but sterically
      nonequivalent ester groups within one single triglyceride molecule was
      investigated. Lipolysis reactions were carried out on synthetic trioctanoin or
      triolein, which are homogenous, prochiral triglycerides, chosen as models for
      physiological lipase substrates. Diglyceride mixtures resulting from lipolysis
      were derivatized with optically active R-(+)-1-phenylethylisocyanate, to give
      diastereomeric carbamate mixtures, which were further separated by high
      performance liquid chromatography. Resolution of diastereomeric carbamates gave
      enantiomeric excess values, which reflect the lipases stereobias and clearly
      demonstrate the existence of a stereopreference by both gastric lipases for the
      sn-3 position. The stereoselectivity of human and rabbit gastric lipases,
      expressed as the enantiomeric excess percentage, was 54% and 70% for trioctanoin
      and 74% and 47% for triolein, respectively. The corresponding values with porcine
      pancreatic lipase were 3% in the case of trioctanoin and 8% in that of triolein.
      It is worth noting that rabbit gastric lipase, unlike human gastric lipase,
      became more stereoselective for the triglyceride with shorter acyl chains
      (trioctanoin). This is one of the most striking catalytic differences observed
      between these two gastric lipases.

PMID- 2243092
TI  - Structural and functional analysis of the human thymidylate synthase gene.
AB  - The complete nucleotide sequence of the human thymidylate synthase (TS) gene was
      determined. The biologically active unit spans about 16 kilobase pairs (kbp) and
      is composed of seven exons and six introns. The promoter region and the major
      transcriptional start sites were located within about 400 base pairs (bp) and 160
      180 bp, respectively, upstream from the ATG initiation codon. A minigene
      consisting of a 5'-flanking sequence of about 4 kbp, a coding sequence of about
      1.7 kpb was sufficient for cell cycle-dependent expression of TS when introduced
      into a TS-deficient mutant of rodent cells. The 5'-flanking region does not
      contain a "TATA," "CAAT," or the consensus sequence for Sp1 binding (GC box),
      whereas intron 1 contains three GC boxes. The gene is G + C-rich and the CpG-rich
      region extends from 5'-flanking region to intron 1. These sequence
      characteristics were compared with those of the mouse TS gene and other cell
      cycle-regulated genes.

PMID- 2243093
TI  - Cellular factors involved in transcription and Tax-mediated trans-activation
      directed by the TGACGT motifs in human T-cell leukemia virus type I promoter.
AB  - Human T-cell leukemia virus type I (HTLV-I) encodes a 40-kDa nuclear protein,
      Tax, which stimulates transcription from three 21-base pair (bp) repeats in its
      U3 region. Tax trans-activation is mediated via cellular factors that interact
      with the TGACGT motifs in the 21-bp repeats. Gel mobility shift assay and UV
      cross-linking analysis show that two proteins of 52 and 46 kDa in size bind the
      21-bp repeat specifically. Base substitutions in the TGACGT motif which abolished
      Tax trans-activation abrogated factor binding whereas the repeats containing
      mutations that did not affect Tax trans-activation supported factor binding as
      the wild-type repeat. The 52- and 46-kDa factors are present in human T-cell
      lines Jurkat and MT4 (HTLV-I transformed) and in HeLa cells but are undetectable
      in a human placental cell line JEG-3, which gave a reduced level of trans
      activation. JEG-3 extracts contain a distinct DNA binding activity that shows
      analogous sequence requirements as the 52- and 46-kDa proteins in interacting
      with the various 21-bp repeats. c-Jun and CREB (cAMP-responsive element binding
      factor) can stimulate transcription from HTLV-I long terminal repeats in JEG-3
      cells. At least two copies of the 21-bp repeats are required for optimal trans
      activation by c-Jun and CREB. Most single point mutations in the TGACGT motif
      that abolished Tax trans-activation, however, did not affect c-Jun- or CREB
      directed transcriptional enhancement. These data indicate that many transcription
      factors including c-Jun and CREB exert stimulatory effects on HTLV-I
      transcription although they do not directly respond to Tax. The 52- and 46-kDa
      cellular proteins most likely are involved directly in Tax-mediated trans
      activation, and they are tentatively named Tax activation factors I and II,
      respectively.

PMID- 2243094
TI  - Studies on the mechanism of oxidative phosphorylation. ADP promotion of GDP
      phosphorylation.
AB  - The process of ATP or GTP synthesis by bovine heart submitochondrial particles
      involves the binding of ADP or GDP to 3 exchangeable sites I, II, and III, and
      only upon substrate occupation of site III does rapid ATP or GTP synthesis take
      place. The dissociation constants determined for ADP were KADPI less than or
      equal to 10(-8) M, KADPII approximately 10(-7) M, and KADPIII (equivalent to
      apparent KADPm), approximately 3 x 10(-6) M in the low Km mode and KADPIII
      approximately 150 x 10(-6) M in the high Km mode. For GDP, these constants were
      KGDPI approximately 10(-6)-10(-5) M, KGDPII approximately 10(-4) M, and KGDPIII
      approximately 10(-3) M when NADH was the respiratory substrate (Matsuno-Yagi, A.,
      and Hatefi, Y. (1990) J. Biol. Chem. 265, 82-88). Because of its low affinity for
      the above binding sites, GDP at micromolar concentrations does not lead to GTP
      synthesis. However, as shown in this paper, micromolar [GDP] undergoes
      phosphorylation in the presence of micromolar concentrations of ADP. Under these
      conditions, both ATP and GTP are synthesized. GDP inhibits ATP synthesis with
      KGDPi congruent to 7 microM, while ADP promotes GTP synthesis in a reaction that
      requires inorganic phosphate (apparent KPim = 2-3 mM) and is inhibited by
      uncouplers and inhibitors of the ATP synthase complex. The ADP-promoted GTP
      synthesis exhibited an "apparent" KGDPm = 4 microM and an "apparent" Vmax = 11
      nmol of GTP (min.mg of protein)-1. These results were interpreted to mean that
      (a) micromolar [ADP] occupies sites I and II, allowing site III to bind and
      phosphorylate GDP, and (b) the KGDPm and Vmax calculated under these conditions
      represent values for the low Km-low Vmax mode of GTP synthesis, which in the
      absence of ADP is not detectable because of the positive cooperativity phase of
      GTP synthesis with the high KGDPII approximately 10(-4) M.

PMID- 2243095
TI  - Intracellular Na+ kinetically interferes with the rotation of the Na(+)-driven
      flagellar motors of Vibrio alginolyticus.
AB  - To understand the mechanism of Na+ movement through the force-generating units of
      the Na(+)-driven flagellar motors of Vibrio alginolyticus, the effect of
      intracellular Na+ concentration on motor rotation was investigated. Control cells
      containing about 50 mM Na+ showed good motility even at 10 mM Na+ in the medium,
      i.e. in the absence of an inwardly directed Na+ gradient. In contrast, Na(+)
      loaded cells containing about 400 mM Na+ showed very poor motility at 500 mM Na+
      in the medium, i.e. even in the presence of an inwardly directed Na+ gradient.
      The membrane potential of the cells, which is a major driving force for the motor
      under these conditions, was not detectably altered, and consistently with this,
      Na(+)-coupled sucrose transport was only partly reduced in the Na(+)-loaded
      cells. Motility of the Na(+)-loaded cells was restored by decreasing the
      intracellular Na+ concentration, and the rate of restoration of motility
      correlated with the rate of the Na+ decrease. These results indicate that the
      absolute concentration of the intracellular Na+ is a determinant of the rotation
      rate of the Na(+)-driven flagellar motors of V. alginolyticus. A simple
      explanation for this phenomenon is that the force-generating unit of the motor
      has an intracellular Na(+)-binding site, at which the intracellular Na+
      kinetically interferes with the rate of Na+ influx for motor rotation.

PMID- 2243096
TI  - Dissociation of the DNA polymerase III holoenzyme beta 2 subunits is accompanied
      by conformational change at distal cysteines 333.
AB  - The beta subunit of DNA polymerase III holoenzyme is in a dimer-monomer
      equilibrium at physiological beta concentrations. Dissociation is accompanied by
      the fluorescence enhancement of a fluorophore attached to a unique sulfhydryl
      group of beta (Griep, M. A., and McHenry, C. S. (1988) Biochemistry 27, 5210
      5215). Sequencing of the isolated tryptic peptides of beta revealed that the
      fluorescent maleimide group was attached to cysteine 333. The 2 residues, lysine
      332 and glutamate 334, that flank this residue are hydrophilic and may place
      cysteine 333 on the surface of beta, explaining its high reactivity. Fluorescence
      energy transfer permitted us to locate the uniquely labeled cysteines 333 of beta
      at the distal ends of the beta dimer. When the beta dimer was dissociated to
      monomers, the accompanying alteration of the conformational state was reported by
      the fluorescein-5-maleimide (fluorescein)-labeled cysteines which were located
      far from the dimer interface. The carboxyl of fluorescein had a fluorescence pKa
      of 6.9 when beta was in its dimeric state. The pKa decreased by 0.3 pH unit upon
      dissociation to monomers and resulted in the fluorescence enhancement that was
      observed when the signal was monitored at constant pH. The adjacent glutamate 334
      apparently increased the pKa of the attached fluorescein when beta was in its
      dimeric state. Movement of either the adjacent lysine 332 amino side chain to a
      closer position or glutamate 334 to a position further away could lower the pKa
      upon beta monomerization. Thus, beta undergoes a conformational change
      concomitant with dimer dissociation that was transmitted to the opposite ends of
      the beta dimer. The pKa of fluorescein attached to the distal cysteines was
      shifted, leading to greater ionization and enhanced fluorescence.

PMID- 2243097
TI  - Isolation and primary structure of PARP, a 24-kDa proline- and arginine-rich
      protein from bovine cartilage closely related to the NH2-terminal domain in
      collagen alpha 1 (XI).
AB  - A protein rich in proline and arginine (proline/arginine-rich protein (PARP] has
      been isolated from dissociative extracts of bovine nasal and articular cartilage,
      and its primary structure has been determined. The protein has 218 amino acids,
      giving a calculated protein Mr of 24,075. In nasal cartilage, this protein is in
      molar concentrations equivalent to 1/20-1/10 that of the link protein of
      cartilage proteoglycan aggregates. PARP has also been isolated from bovine
      articular cartilage, bovine fetal epiphysis, and nonossified human tarsal bones.
      PARP is similar to various collagen NH2-terminal domains. It is 49% identical to
      the NH2-terminal end of collagen alpha 1 (XI), 17% identical to the NC4 domain of
      collagen alpha 1 (IX), and 14% identical to the NC3 domain of collagen alpha 1
      (XII). Four cysteines are conserved between type XI collagen and PARP, and these
      form two disulfide bonds. Two of the cysteines are also conserved between PARP
      and collagens IX and XII. The homology between the collagens and PARP makes it
      possible to speculate on the likely disulfide bond pattern in the collagen NH2
      terminal domains. It is probable that PARP is a collagen fragment removed during
      processing in a manner analogous to chondrocalcin (the C-terminal propeptide of
      type II collagen).

PMID- 2243098
TI  - Disruption of active site interactions with pyridoxal 5'-phosphate and substrates
      by conservative replacements in the glycine-rich loop of Escherichia coli D
      serine dehydratase.
AB  - We have used site-directed mutagenesis to examine the function of three putative
      active site residues (C278, G279, and G281) of the vitamin B6 enzyme D-serine
      dehydratase. These residues lie in or adjacent to a conserved glycine-rich loop
      that is known to interact with the pyridoxal 5'-phosphate cofactor in several B6
      enzymes and that resembles the GXGXXG loop of nucleotide-binding sites. The
      cofactor affinity, catalytic properties, and spectral properties (UV, CD,
      fluorescence, and 31P NMR) of alanine variants C278A, G279A, and G281A were
      measured as well as the susceptibility of each variant to thiol modification by
      5,5'-dithiobis(2-nitrobenzoic acid). The specific thiols modified in each variant
      and wild type D-serine dehydratase were identified by amino acid sequencing of
      labeled tryptic peptides. C278A, G279A, and G281A displayed 10-, 33-, and 22-fold
      lower affinities for pyridoxal 5'-phosphate than did wild type D-serine
      dehydratase and turnover numbers with D-serine that were 50, 6, and 60% of
      normal, respectively. The introduction of a methyl side chain into G281 enhanced
      catalytic efficiency with the substrates D-threonine, D-allo-threonine, and L
      serine, whereas the methyl side chain at position 279 impaired catalysis of all
      substrates as well as cofactor affinity. The 31P NMR spectrum of D-serine
      dehydratase was minimally perturbed by the alanine substitutions, consistent with
      the view that neither G279 nor G281 interacts with the phosphate group of the
      cofactor (in contrast to the arrangement found in several other B6 enzymes). C311
      was the single thiol modified by 5,5'-dithiobis(2-nitrobenzoic acid) in wild type
      D-serine dehydratase. Two normally inaccessible thiol groups, C233 and C278, were
      rendered susceptible to modification as a consequence of either G----A
      substitution, and modification of C278 was associated with inactivation of G279A
      and G281A. These observations suggest that small perturbations in the glycine
      rich loop induce conformational changes spanning a considerable area around the
      active site.

PMID- 2243099
TI  - Beta spectrin in human skeletal muscle. Tissue-specific differential processing
      of 3' beta spectrin pre-mRNA generates a beta spectrin isoform with a unique
      carboxyl terminus.
AB  - Spectrin, an important component of the mammalian erythrocyte membrane skeleton,
      is a heterodimeric protein with alpha and beta subunits of 280 and 246 kDa,
      respectively. Spectrin-like proteins have also been demonstrated in a wide
      variety of nonerythroid cells. To examine the hypothesis that nonerythroid beta
      spectrins may be encoded by the "erythroid" beta spectrin gene, we have isolated
      cDNA clones from a human fetal skeletal muscle library by hybridization to a
      previously described red cell beta spectrin cDNA. Detailed comparison of muscle
      and erythroid beta spectrin cDNAs has revealed sequence identity over the
      majority of their lengths, confirming that they are the product of the same gene.
      However, there is a sharp divergence in sequence at their 3' ends. A consequence
      of this divergence is the replacement of the carboxyl terminus of erythroid beta
      spectrin with a different, longer carboxyl-terminal domain in skeletal muscle. We
      hypothesize that tissue-specific differential polyadenylation leads to the
      selective activation of a donor splice site within the beta spectrin coding
      sequence, splicing downstream nonerythroid exons into the mature muscle beta
      spectrin mRNA. We predict that replacement, in nonerythroid cells, of the beta
      spectrin carboxyl terminus, known to participate in spectrin self-association and
      phosphorylation, has significant functional consequences. These data may explain
      previously reported nonerythroid beta spectrin isoforms that resemble red cell
      beta spectrin by immunochemical analysis.

PMID- 2243100
TI  - Characterization of human 3 beta-hydroxysteroid dehydrogenase/delta 5-delta 4
      isomerase gene and its expression in mammalian cells.
AB  - Three beta-hydroxysteroid dehydrogenase/delta 5-delta 4-isomerase (3 beta-HSD)
      catalyze the oxidative conversion of delta 5-3 beta-hydroxysteroids to the delta
      4-3-keto configuration and is therefore essential for the biosynthesis of all
      classes of hormonal steroids, namely progesterone, glucocorticoids,
      mineralocorticoids, androgens, and estrogens. Using human 3 beta-HSD cDNA as
      probe, a human 3 beta-HSD gene was isolated from a lambda-EMBL3 library of
      leucocyte genomic DNA. A fragment of 3 beta-HSD genomic DNA was also obtained by
      amplification of genomic DNA using the polymerase chain reaction. The 3 beta-HSD
      gene contains a 5'-untranslated exon of 53 base pairs (bp) and three successive
      translated exons of 232, 165, and 1218 bp, respectively, separated by introns of
      129, 3883, and 2162 bp. The transcription start site is situated 267 nucleotides
      upstream from the ATG initiating codon. DNA sequence analysis of the 5'-flanking
      region reveals the existence of a putative TATA box (ATAAA) situated 28
      nucleotides upstream from the transcription start site while a putative CAAT
      binding sequence is located 57 nucleotides upstream from the TATA box. Expression
      of a cDNA insert containing the coding region of 3 beta-HSD in nonsteroidogenic
      cells shows that the gene encodes a single 42-kDa protein containing both 3 beta
      hydroxysteroid dehydrogenase and delta 5-delta 4-isomerase activities. Moreover,
      all natural steroid substrates tested are transformed with comparable efficiency
      by the enzyme. In addition to its importance for studies of the regulation of
      expression of 3 beta-HSD in gonadal as well as peripheral tissues, knowledge of
      the structure of the human 3 beta-HSD gene should permit investigation of the
      molecular defects responsible for 3 beta-HSD deficiency, the second most common
      cause of adrenal hyperplasia in children.

PMID- 2243101
TI  - Granulocytic differentiation of HL-60 cells is associated with increase of poly-N
      acetyllactosamine in Asn-linked oligosaccharides attached to human lysosomal
      membrane glycoproteins.
AB  - HL-60 cells were induced to differentiate into granulocytic cells by dimethyl
      sulfoxide, and structures of Asn-linked oligosaccharides attached to lysosomal
      membrane glycoproteins (lamp-1 and lamp-2) were elucidated before and after
      differentiation. Lamp-1 and lamp-2 were immunoprecipitated from the cells after
      labeling with radioactive sugars, and glycopeptides were prepared. The structures
      of glycopeptides obtained after serial lectin-affinity chromatography were
      elucidated by endo-beta-galactoside and methylation analysis. Glycopeptides bound
      to tomato lectin-Sepharose were found to be tetraantennary oligosaccharides that
      contain two or three poly-N-acetyllactosaminyl chains, of which one side chain
      contains three or more N-acetyllactosaminyl repeats, whereas those bound to
      Datura stramonium agglutinin-Sepharose were found to be tetraantennary
      oligosaccharides containing one or two short poly-N-acetyllactosaminyl side
      chains. Glycopeptides that were not bound to concanavalin A, tomato lectin, or D.
      stramonium agglutinin were found to be triantennary oligosaccharides with a
      negligible amount of poly-N-acetyllactosaminyl side chains. Comparison of Asn
      linked oligosaccharides from undifferentiated and differentiated HL-60 cells
      reveals the following features. First, the number of Asn-linked oligosaccharides
      containing poly-N-acetyllactosaminyl side chains increases dramatically with a
      concomitant decrease in less complex Asn-linked oligosaccharides after
      differentiation. Second, the number of poly-N-acetyllactosaminyl side chains per
      Asn-linked oligosaccharides increases significantly. These increases in poly-N
      acetyllactosamine were associated with increased activity of UDP-GlcNAc:beta-D
      Gal-beta 1----3-N-acetylglucosaminyltransferase "extension enzyme," a key enzyme
      in the formation of poly-N-acetyllactosamines. Furthermore, the increased amount
      of poly-N-acetyllactosamine in lamp-1 and lamp-2 resulted in longer half-lives of
      lamp-1 and lamp-2 in differentiated HL-60 cells. These results suggest strongly
      that the differentiation of HL-60 cells into more phagocytic cells is associated
      with an increase in the complexity of Asn-linked oligosaccharides attached to
      lysosomal membrane glycoproteins, which in turn may play a role in stabilizing
      lysosomes.

PMID- 2243102
TI  - The polylactosaminoglycans of human lysosomal membrane glycoproteins lamp-1 and
      lamp-2. Localization on the peptide backbones.
AB  - Lysosome membrane glycoproteins, lamp-1 and lamp-2, have been shown to contain 18
      and 16 N-glycans, some of which are modified by poly-N-acetyl-lactosamine. We
      have localized the polylactosaminoglycans to specific sites on lamp-1 and lamp-2
      purified from human chronic myelogenous leukemia cells. Polylactosaminoglycan
      containing glycopeptides, obtained by trypsin, pepsin, and V8 protease digestion
      of the glycoproteins, were isolated by Datura stramonium agglutinin affinity
      chromatography, gel filtration, and reverse phase high performance liquid
      chromatography. The poly-N-acetyllactosaminyl structures of isolated
      glycopeptides were confirmed by the susceptibility of their released
      oligosaccharides to endo-beta-galactosidase. Amino acid analysis and sequencing
      demonstrated that polylactosaminoglycans were located at Asn-34, Asn-93 and/or
      Asn-102, and Asn-195 and/or Asn-200 in lamp-1, and at Asn-4 and/or Asn-10, and
      Asn-279 in lamp-2. These results indicated that only certain glycosylation sites
      can be selectively modified by poly-N-acetyllactosamine, and those sites may
      confer the requirement by beta 1----3-N-acetylglucosaminyl transferase.

PMID- 2243104
TI  - The species-specific cell-binding site of the aggregation factor from the sponge
      Microciona prolifera is a highly repetitive novel glycan containing glucuronic
      acid, fucose, and mannose.
AB  - Species-specific adhesion of dissociated cells from the marine sponge Microciona
      prolifera is mediated by a Mr = 2 x 10(7) proteoglycan-like aggregation factor
      (MAF) via two highly polyvalent functional domains, a cell-binding and a self
      interaction domain. Glycopeptide N-glycosidase F release of a major glycan of Mr
      = 6.3 gamma 10(3) (G-6) from the MAF protein core resulted in the loss of cell
      binding activity, indicating a role of this polysaccharide molecule in MAF-cell
      association. The G-6 glycan was isolated and purified after complete Pronase
      digestion of MAF using gel electrophoresis, gel filtration, and ion exchange
      chromatography. Quantification of the amount of carbohydrate recovered in G-6
      showed that one MAF molecule has about 950 repeats of this glycan. In its
      monomeric state G-6 did not display any measurable binding to cells (K alpha less
      than or equal to 10(3) M-1). Intermolecular cross-linking of the G-6 glycan with
      glutaraldehyde resulted, however, in the concomitant recovery of polyvalency
      (about 2200 repeats of G-6 per polymer of Mr greater than or equal to 1.5 x 10(7)
      and species-specific high cell binding affinity (K alpha = 1.6 x 10(9) M-1) but
      not of the MAF-MAF self-interaction activity. Thus, the G-6 glycan is the
      multiple low affinity cell-binding site involved in cell-cell recognition and
      adhesion of sponge cells. The G-6 glycan has 7 glucuronic acids, 3 fucoses, 2
      mannoses, 5 galactoses, 14 N-acetylglucosamines, 2 sulfates, and 1 asparagine.
      Such a unique chemical composition indicates a new type of structure which
      includes features of glycosaminolycans and N-linked polysaccharides.

PMID- 2243103
TI  - Minimal sequence and factor requirements for the initiation of transcription from
      an atypical, TATATAA box-containing housekeeping promoter.
AB  - We have established the minimal sequence and factor requirements for both
      constitutive and viral-induced transcription from an atypical, TATATAA box
      containing human housekeeping promoter. Utilizing a transient cotransfection
      protocol, we have found that efficient transactivation of triosephosphate
      isomerase (TPI) gene transcription by the immediate early proteins of adenovirus
      and pseudorabies virus is dependent upon the same assembly of sequence elements
      that collectively confer minimal TPI promoter function in the absence of viral
      protein. These elements span TPI promoter positions -65 and -6 (where +1 is the
      transcription initiation site) and include not only a TFIID-responsive TATATAA
      box (-27 to -21) but a single GC box (-53 to -48) that binds Spl, and a novel cap
      proximal element (-18 to -6) that binds a 110-kDa nuclear factor that is present
      in HeLa cells. We demonstrate that these elements function in an interdependent
      fashion; deleting either GC box 1 or the cap proximal element completely or
      nearly abolished both basal transcription and viral transactivation. Therefore,
      these elements and their cognate factors represent the basal transcription
      initiation complex through which the immediate early protein of adenovirus or
      pseudorabies virus mediates the stimulation of TPI gene transcription. We discuss
      the implications of these data for both constitutive and viral-induced
      transcription.

PMID- 2243105
TI  - OXBOX, a positive transcriptional element of the heart-skeletal muscle ADP/ATP
      translocator gene.
AB  - Three positive transcriptional control regions have been identified in the
      promoter of the human heart-skeletal muscle adenine nucleotide translocator gene
      (ANT1). By transfecting promoter-chloramphenicol acetyltransferase fusion
      constructs into C2C12 myogenic cells, each positive region was found to increase
      transcription 2-3-fold. The first region spans from -123 to -674 base pairs (bp),
      the second from -2.6 to -3.1 kilobases, and the third from -3.1 to -8.8
      kilobases. Linker-scanning mutants generated using the polymerase chain reaction
      and modified oligonucleotides have identified the OXBOX (5'-GGCTCTAAAGAGG) as the
      positive element within the -123 to -674-bp region. This element enhances
      transcription in muscle cells but not in HeLa cells, suggesting that it is muscle
      specific. Gel retardation experiments have revealed a factor from C2C12 cells
      which specifically binds to a 40-bp piece of the ANT1 promoter containing the
      OXBOX. Since the OXBOX is also found in the promoter of the human ATP synthase
      beta subunit gene, it is the first tissue-specific element identified which could
      coordinately regulate mitochondrial oxidative phosphorylation genes.

PMID- 2243106
TI  - Expression of wild-type and mutated forms of the catalytic (alpha) subunit of
      Caenorhabditis elegans casein kinase II in Escherichia coli.
AB  - A full-length Caenorhabditis elegans cDNA that encodes the alpha subunit of
      casein kinase II was inserted into the inducible bacterial expression vector
      pET3a to generate the plasmid pCK alpha. Escherichia coli DE21 lysozyme S that
      was transformed with pCK alpha expressed soluble, catalytically active casein
      kinase II alpha upon induction with isopropyl beta-D-thiogalactopyranoside. The
      expressed alpha subunit was purified to homogeneity with a 60% yield by
      chromatography on CM-Sephadex, P-11 phosphocellulose, and heparin-agarose. The Mr
      values estimated from sodium dodecyl sulfate-polyacrylamide gel electrophoresis
      (Mr = 42,000) or calculated from hydrodynamic measurements (s20,w = 3.3 S, Stokes
      radius = 2.8 nm, Mr = 37,000) were similar, thereby indicating that the expressed
      enzyme is monomeric. The native holoenzyme and the expressed alpha subunit
      exhibited several similar properties including the utilization of both ATP and
      GTP as substrates and the susceptibility to inhibition of phosphotransferase
      activity by low concentrations of heparin. However, the kcat for E. coli-derived
      alpha was only 9% of the kcat for the native holoenzyme, and catalytic activity
      was not stimulated by polyamines. Recombinant casein kinase II alpha aggregates
      at low ionic strength, and the aggregation is partially reversible. A mutant
      alpha subunit in which Lys74 and Lys75 were substituted by glutamic acid residues
      was constructed by site-directed mutagenesis. The mutant enzyme was not inhibited
      by typically effective concentrations of heparin (e.g. IC50 = 0.3 micrograms/ml)
      because the affinity of modified recombinant casein kinase II Glu-74Glu-75 for
      heparin decreased approximately 70-fold. Thus, Lys74 and Lys75 are implicated in
      the heparin binding, inhibitory domain. The successful expression of casein
      kinase II alpha in E. coli will facilitate the analysis of the structural basis
      for functional domains in this enzyme.

PMID- 2243107
TI  - Apolipoprotein B messenger RNA editing is developmentally regulated and widely
      expressed in human tissues.
AB  - Apolipoprotein B (apoB) messenger RNA (mRNA) undergoes posttranscriptional (C to
      U) editing, producing tissue-specific forms of apoB from the unedited (apoB100)
      and edited (apoB48) transcripts. ApoB mRNA editing is developmentally regulated
      in human fetal small intestine, producing parallel changes in the synthesis and
      secretion of apoB100 and apoB48. Neither fetal nor adult liver contained
      detectable levels (less than 1%) of edited apoB mRNA. By contrast, apoB mRNA is
      incrementally edited during development in several extraintestinal fetal tissues.
      These tissues demonstrated significant differences, however, in both the extent
      and developmental profile of apoB mRNA editing. Additionally, while apoB100
      synthesis and secretion was demonstrated in these tissues, apoB48 synthesis was
      confined to the small intestine. Thus, although the molecular mechanism
      underlying this process remains unclear, the capacity to edit apoB mRNA is widely
      distributed among both fetal and adult tissues. We speculate that the
      asynchronous and developmentally modulated induction of apoB mRNA editing may
      provide a novel mechanism for regulating lipoprotein biogenesis in both the
      developing fetus and adult human.

PMID- 2243109
TI  - Identification of the keratan sulfate attachment sites on bovine fibromodulin.
AB  - The small keratan sulfate-substituted proteoglycan (fibromodulin) from articular
      cartilage was shown to contain keratan sulfate linked to the core protein through
      N-glycosidic linkages to residues Asn-109, Asn-147, Asn-182, and Asn-272.
      Biosynthetic experiments with articular chondrocytes in the presence of
      tunicamycin, an inhibitor of N-linked oligosaccharide synthesis, demonstrated a
      specific inhibition of [35S]SO4 incorporation into fibromodulin. Under the same
      conditions no effect on the addition of keratan sulfate to the large aggregating
      proteoglycan was detected. Fibromodulin substituted with keratan sulfate was
      purified from bovine articular cartilage extracts by density gradient
      centrifugation, ion-exchange chromatography, and gel-permeation chromatography.
      Isolation of glycosylated peptides from tryptic digests of fibromodulin by ion
      exchange chromatography and reversed-phase high performance liquid chromatography
      revealed four separate hexosamine-rich species, that were also immunoreactive
      with monoclonal antibody 5D4. Sequence analysis of these glycopeptides gave blank
      cycles at positions which corresponded to Asn followed by X-Ser/Thr in the
      sequence derived from cDNA (Oldberg, A., Antonsson, P., Lindblom, K., and
      Heinegard, D. (1989) EMBO J. 8, 2601-2604). Hence, all four Asn residues in the
      leucine-rich region of the fibromodulin core protein can serve as acceptor sites
      for keratan sulfate addition.

PMID- 2243108
TI  - Association of cell surface heparan sulfate proteoglycans of Schwann cells with
      extracellular matrix proteins.
AB  - The terminal differentiation of Schwann cells is dependent on contact with
      basement membrane. The present study was undertaken to investigate the role of
      cell surface heparan sulfate proteoglycans (HSPGs) in mediating Schwann cell
      responses to extracellular matrix contact. Phosphatidylinositol-specific
      phospholipase C-releasable cell surface HSPGs purified from cultures of neonatal
      rat Schwann cells were subjected to affinity chromatography on immobilized
      laminin and fibronectin. Binding of the HSPG to both affinity matrices was
      observed. The strength of the association, however, was sensitive to the ionic
      strength of the buffer. In 0.1 M Tris-HCl, HSPG binding was essentially
      irreversible whereas in physiological ionic strength buffer (e.g. 0.142 M NaCl,
      10 mM Tris), weaker binding was detected as a delay in elution of the HSPG from
      the affinity columns. Further studies of HSPG-laminin binding suggested that the
      binding was mediated by the glycosaminoglycan chains of the proteoglycans.
      Results of equilibrium gel filtration chromatography provided additional evidence
      for a reversible association of the HSPG and laminin with a Kd of approximately 1
      x 10(-6) M. When Schwann cells were plated on plastic dishes coated with laminin,
      the cells attached and extended long slender processes. Inclusion of heparin, but
      not chondroitin sulfate, in the assay medium resulted in partial inhibition of
      process extension, but at concentrations of heparin which were higher than that
      needed to disrupt laminin-HSPG association in vitro. Addition of anti-integrin
      receptor antibodies resulted in more extensive inhibition of laminin-dependent
      process extension. Anti-integrin antibodies plus heparin essentially totally
      inhibited laminin-dependent process extension. These results demonstrate that
      cell surface HSPGs are capable of reversible association with extracellular
      matrix molecules and suggest that HSPG-laminin interactions play a role in
      laminin-dependent Schwann cell spreading.

PMID- 2243110
TI  - A new Acanthamoeba myosin heavy chain. Cloning of the gene and immunological
      identification of the polypeptide.
AB  - An Acanthamoeba myosin heavy chain has been identified whose tail domain amino
      acid sequence distinguishes it from Acanthamoeba myosins IB, IC, and II. The gene
      for this novel myosin heavy chain spans approximately 6.8 kilobases, is split by
      17 introns, and encodes a 177-kDa polypeptide. While the amino-terminal
      approximately 90 kDa of this polypeptide is highly similar to the globular head
      sequences of myosins I and II, its approximately 87-kDa tail domain shows
      essentially no similarity to the tail sequences of either type of myosin. The
      only exception to this is the carboxyl-terminal approximately 50-amino acid
      region of the polypeptide, which is homologous to the carboxyl termini of the
      myosins I. Interestingly, this approximately 50-residue segment has been shown to
      exist in a diverse family of cytoskeleton-associated proteins that include
      nonreceptor tyrosine kinases, phospholipase C gamma, and fodrin (Rodaway, A. R.
      F., Sternberg, M. J. E., and Bentley, D. L. (1989) Nature 342, 624). Sequence
      analysis indicates that the tail domain of this new myosin is incapable of
      forming a myosin II-like coiled-coil structure, implying that the protein is
      single-headed and nonfilamentous. For this reason we have tentatively classified
      it as a high molecular weight form of myosin I (HMWMI). To determine if HMWMI
      exists in cells, antiserum was raised against a bacterially expressed fusion
      peptide made using a cDNA clone encoding most of the unique HMWMI tail domain.
      This antiserum does not recognize Acanthamoeba myosins IB, IC, or II but does
      recognize a single polypeptide in whole cell extracts with the mobility predicted
      for the HMWMI heavy chain. This protein is precipitated from crude extracts using
      F-actin and released from the pellet by ATP, supporting its classification as a
      member of the myosin family of proteins.

PMID- 2243111
TI  - A novel adenylylation process in liver plasma membrane-bound proteins.
AB  - Rat liver plasma membrane contains five distinct polypeptides of apparent
      molecular mass of 130, 120, 110, 100, and 86 kDa which are labeled upon
      incubation with [alpha-32P]ATP as well as with [gamma-32P]ATP. Covalently bound
      adenosine 5'-monophosphate to some of the polypeptides was identified using
      nonhydrolyzable analogues of ATP. Chase experiments of alpha-32P-nucleotide
      labeled polypeptides with different nonradiolabeled phosphocompounds and
      sensitivity to different inhibitors demonstrate that the 86-kDa polypeptide is a
      phosphoesterase, forming a catalytic intermediate. On the other hand, the
      comparative slow rate of turnover of the polypeptides of higher molecular mass
      (130, 120, 110, and 100 kDa) suggests that the bound AMP could play a regulatory
      rather than a catalytic role. Using the nonhydrolyzable ATP analogue [alpha, beta
      methylene]ATP and dilution experiments with Triton X-100-solubilized membranes,
      it has been possible to identify the 130-kDa adenylylated polypeptide as a
      possible target of an adenylylating system. These polypeptides, except the 86-kDa
      phosphoesterase, are affected in their electrophoretic mobility in the absence of
      beta-mercaptoethanol. An intercatenary disulfide bond(s) appear(s) to link the
      polypeptide(s) of 120 kDa and/or 110 kDa in a dimeric structure of apparent
      molecular mass of 240 kDa. All five polypeptides labeled with [alpha-32P]ATP are
      glycoproteins bound to the cell plasma membrane.

PMID- 2243112
TI  - Isolation of four core histones from human sperm chromatin representing a minor
      subset of somatic histones.
AB  - Using high performance liquid chromatography we have successfully purified four
      core histones from mature human sperm chromatin. The H2A variants present in
      sperm (H2A.X and limited H2A.Z) have been shown previously to be minor variants
      in somatic chromatin. The histones are highly modified as evidenced by extensive
      acetylation and an as yet uncharacterized multicharge modification of H2B. Based
      on our data, we conclude that histone proteins are a minor component of each
      mature spermatozoa. Given the unique nature of the histone variants present in
      sperm, we propose that this chromatin component has a specific function and may
      possibly facilitate the programming of genes which will be active in early
      development.

PMID- 2243113
TI  - Zinc-induced secondary structure transitions in human sperm protamines.
AB  - Using CD we show that human group II protamines undergo novel zinc-dependent
      secondary structure transitions. The CD spectra of protamine is characteristic of
      random coil proteins with a large minima at 197 nm. Upon the addition of 1 mM
      zinc, the magnitude of this minima is decreased by 44%. This spectral change is
      not induced by 1 mM calcium or magnesium. Cadmium, which has chemical properties
      similar to zinc, can also induce the structural transition although not as
      effectively as zinc. The spectral changes that accompany zinc binding are
      indicative of an increase in beta-turn and anti-parallel beta-sheet structures.
      This is consistent with the predicted secondary structure for protamines which is
      dominated by beta-turns. Our data support a model in which protamine adopts a
      folded structure in the presence of zinc. We propose that a zinc-modulated
      structure is physiologically significant considering the relatively high levels
      of zinc in human sperm.

PMID- 2243115
TI  - Several regions of human estrogen receptor are involved in the formation of
      receptor-heat shock protein 90 complexes.
AB  - Several mutants of the human estrogen receptor (ER) were transiently expressed in
      Cos 7 cells in order to determine the regions involved in the formation of
      complexes with the heat shock protein Mr approximately 90,000 (hsp 90). The
      formation of the cytosol non-DNA binding 8-9 S complexes (8-9 S ER) was monitored
      by glycerol gradient ultracentrifugation. It was established that the N-terminal
      region of the receptor, including the two zinc fingers of the DNA binding domain
      (DBD), is not required for the formation of the 8-9 S ER complexes. Conversely,
      deletion of the entire ligand binding domain (LBD) produced truncated receptor
      mutants that are constitutive transcriptional activators and did not form 8-9 S
      ER complexes, confirming results obtained previously with the glucocorticosteroid
      receptor (Pratt, W.B., Jolly, D.J., Pratt, D.V., Hollenberg, S.M., Giguerre, V.,
      Cadepond, F., Schweizer-Groyer, G., Catelli, M.G., Evans, R.M., and Baulieu, E.E.
      (1988) J. Biol. Chem. 263, 267-273). However, no limited subregion of the LBD was
      found to be uniquely involved in hsp 90 binding. A highly positively charged
      region situated at the C-terminal extremity of the DBD (between amino acids 251
      and 271) also appeared to be implicated. Although not sufficient, this sequence
      is necessary for the formation of the 8-9 S ER; it also corresponds to the NL1
      nuclear localization domain of steroid receptors. Taken together, these results
      suggest that the formation of complexes with hsp 90 involves several receptor
      regions, and they are consistent with the proposal that hsp 90 inhibits receptor
      function and can be released by hormone binding to the LBD.

PMID- 2243114
TI  - Cellular processing of the interleukin-2 fusion toxin DAB486-IL-2 and efficient
      delivery of diphtheria fragment A to the cytosol of target cells requires Arg194.
AB  - We have used site-directed mutagenesis to examine the role played by Arg191,
      Arg193, and Arg194 of the fusion toxin DAB486-IL-2 in the intoxication of high
      affinity interleukin-2 receptor-bearing T-lymphocytes. These arginine residues
      are positioned in the proteolytically sensitive 14-amino acid loop subtended by
      the disulfide bond between Cys187 and Cys202 in this fusion toxin. DAB486-IL-2
      was formed by the genetic substitution of the native diphtheria toxin receptor
      binding domain with human interleukin-2 (Williams, D.P., Parker, K., Bacha, P.,
      Bishai, W., Borowski, M., Genbauffe, F., Strom, T.B., and Murphy, J.R. (1987)
      Protein Eng. 1, 493-498). We demonstrate that substitution of Arg194 with Gly
      results in a 1000-fold loss of DAB486-IL-2 potency. Since trypsin "nicking" of
      the Gly194 mutant restores biologic activity, we conclude that Arg194 is required
      for the cellular processing of the fusion toxin which results in the release of
      fragment A into the cytosol.

PMID- 2243116
TI  - Arginine 127 stabilizes the transition state in carboxypeptidase.
AB  - Crystallographic studies suggest that Arg-127 is a key amino acid in the
      hydrolysis of peptides and esters by carboxypeptidase A. The guanidinium group of
      Arg-127 is hypothesized to stabilize the oxyanion of the tetrahedral intermediate
      formed by the attack of water on the scissile carbonyl bond. We have replaced
      this amino acid in rat carboxypeptidase A1 with lysine (R127K), methionine
      (R127M), and alanine (R127A), in order to define the role of Arg-127 in
      carboxypeptidase catalyzed hydrolysis. The wild-type and mutant enzymes were
      expressed in yeast and purified. Kinetic studies show that Arg-127 substitution
      decreases kcat for both ester and amide substrates, whereas Km is relatively
      unchanged; for R127M and R127A this corresponds to a 6 kcal/mol decrease in
      transition state stabilization of the rate-limiting step. The binding affinity
      for the phosphonate transition state analog, Cbz-Phe-Ala(P)-OAla, was decreased
      by 5.4 kcal/mol, whereas binding affinity for the ground state inhibitor, DL
      benzylsuccinic acid, was decreased by only 1.7 kcal/mol for R127M. Electrostatic
      calculations employing a finite difference solution to the Poisson-Boltzmann
      equation predict that the positive charge of Arg-127 should stabilize the
      transition state by 6-8 kcal/mol. Therefore, the experimental and theoretical
      data suggest that the primary role of Arg-127 is stabilization of the transition
      state through electrostatic interaction with the oxyanion.

PMID- 2243117
TI  - Computer-assisted liquid chromatography for automated qualitative and
      quantitative analysis of toxic drugs.
AB  - A computer-assisted liquid chromatographic system (MCASYST) is evaluated for
      automatic qualitative and quantitative analysis of toxic drugs in poisoned human
      fluids. The system performance is confirmed by the actual analyses of several
      cases of poisoning. The results indicate that the accuracy of identification by
      retention prediction and UV spectral search is very high, and quantitation by the
      memorized calibration curves can be performed very conveniently. However, it is
      difficult at present to identify all peaks that appear in chromatograms for human
      urine and serum because the drugs may be changed to their metabolites in those
      fluids. Metabolite identification will be the next step to improve the
      performance of this system.

PMID- 2243118
TI  - Antibiotic proteins of human neutrophils.

PMID- 2243119
TI  - Expression of human bone-related proteins in the hematopoietic microenvironment.
AB  - Given the intimate relationship between bone and bone marrow, we hypothesized
      that the human bone marrow may function as a source (or reservoir) of bone
      forming progenitor cells. We observed a population of cells within the bone
      marrow which produce bone-specific or bone-related proteins. The production of
      these proteins was developmentally regulated in human long-term bone marrow cell
      cultures; the bone protein-producing cells (BPPC) are observed under serum-free,
      short-term culture conditions, respond to bone-related and not hematopoietic
      growth factors, and are derived from a population of low-density, nonadherent,
      My10-negative (or low My10 density), marrow cells (My10 is an antigen found on
      most hematopoietic progenitor cells). Cultivation of marrow-derived BPPC in
      secondary, serum-containing cultures results in their differentiation into
      osteoblastlike cells. At this stage of development, BPPC produce an extracellular
      matrix which incorporates both bone-related proteins and radiolabeled calcium.
      Human bone marrow BPPC thus represent a newly described cell phenotype important
      to both bone and hematopoietic cell biology.

PMID- 2243120
TI  - Whole-body lipolysis and triglyceride-fatty acid cycling in cachectic patients
      with esophageal cancer.
AB  - Whole-body lipolytic rates and the rate of triglyceride-fatty acid cycling
      (reesterification of fatty acids released during lipolysis) were measured with
      stable isotopic tracers in the basal state and during beta-adrenergic blockade
      with propranolol infusion in five cachectic patients with squamous cell carcinoma
      of the esophagus, five cachectic cancer-free, nutritionally-matched control
      patients, and 10 healthy volunteers. Resting energy expenditure and plasma
      catecholamines were normal in all three groups. The basal rate of glycerol
      appearance in blood in the patients with cancer (2.96 +/- 0.45 mumol.kg-1.min-1)
      was similar to that in the nutritionally matched controls (3.07 +/- 0.28 mumol.kg
      1.min-1), but 48% greater than in the normal-weight volunteers (2.00 +/- 0.16
      mumol.kg-1.min-1) (P = 0.028). The antilipolytic effect of propranolol and the
      rate of triglyceride-fatty acid cycling in the patients with cancer were also
      similar in the cachectic control group and approximately 50% greater than in the
      normal-weight volunteers, but the differences were not statistically significant
      because of the variability in the data. We conclude that the increase in
      lipolysis and triglyceride-fatty acid cycling in "unstressed" cachectic patients
      with esophageal cancer is due to alterations in their nutritional status rather
      than the presence of tumor itself. Increased beta-adrenergic activity may be an
      important contributor to the stimulation of lipolysis.

PMID- 2243121
TI  - Uroporphyrinogen decarboxylase: a splice site mutation causes the deletion of
      exon 6 in multiple families with porphyria cutanea tarda.
AB  - Uroporphyrinogen decarboxylase (URO-D) is a cytosolic heme-biosynthetic enzyme
      that converts uroporphyrinogen to coproporphyrinogen. Defects at the
      uroporphyrinogen decarboxylase locus cause the human genetic disease familial
      porphyria cutanea tarda. A splice site mutation has been found in a pedigree with
      familial porphyria cutanea tarda that causes exon 6 to be deleted from the mRNA.
      The intron/exon junctions on either side of exon 6 fall between codons, so the
      resulting protein is shorter than the normal protein, missing only the amino
      acids coded by exon 6. The shortened protein lacks catalytic activity, is rapidly
      degraded when exposed to human lymphocyte lysates, and is not detectable by
      Western blot analysis in lymphocyte lysates derived from affected individuals.
      The mutation was detected in five of 22 unrelated familial porphyria cutanea
      tarda pedigrees tested, so it appears to be common. This is the first splice site
      mutation to be found at the URO-D locus, and the first mutation that causes
      familial porphyria cutanea tarda to be found in more than one pedigree.

PMID- 2243122
TI  - Skeletal muscle metabolism is a major determinant of resting energy expenditure.
AB  - Energy expenditure varies among people, independent of body size and composition,
      and persons with a "low" metabolic rate seem to be at higher risk of gaining
      weight. To assess the importance of skeletal muscle metabolism as a determinant
      of metabolic rate, 24-h energy expenditure, basal metabolic rate (BMR), and
      sleeping metabolic rate (SMR) were measured by indirect calorimetry in 14
      subjects (7 males, 7 females; 30 +/- 6 yr [mean +/- SD]; 79.1 +/- 17.3 kg; 22 +/-
      7% body fat), and compared to forearm oxygen uptake. Values of energy expenditure
      were adjusted for individual differences in fat-free mass, fat mass, age, and
      sex. Adjusted BMR and SMR, expressed as deviations from predicted values,
      correlated with forearm resting oxygen uptake (ml O2/liter forearm) (r = 0.72, P
      less than 0.005 and r = 0.53, P = 0.05, respectively). These findings suggest
      that differences in resting muscle metabolism account for part of the variance in
      metabolic rate among individuals and may play a role in the pathogenesis of
      obesity.

PMID- 2243123
TI  - Immunogenicity in animals of a polysaccharide-protein conjugate vaccine against
      type III group B Streptococcus.
AB  - The native capsular polysaccharide of type III group B Streptococcus elicits a
      specific antibody response in only 60% of nonimmune human subjects. To enhance
      the immunogenicity of this polysaccharide, we coupled the type III polysaccharide
      to tetanus toxoid. Prior to coupling, aldehyde groups were introduced on the
      polysaccharide by controlled periodate oxidation, resulting in the conversion of
      25% of the sialic acid residues of the polysaccharide to residues of the 8-carbon
      analogue of sialic acid, 5-acetamido-3,5-dideoxy-D-galactosyloctulosonic acid.
      Tetanus toxoid was conjugated to the polysaccharide by reductive amination, via
      the free aldehyde groups present on the partially oxidized sialic acid residues.
      Rabbits vaccinated with the conjugate vaccine produced IgG antibodies that
      reacted with the native type III group B streptococcal polysaccharide (3/3
      rabbits), while rabbits immunized with the unconjugated type III polysaccharide
      failed to respond (0/3 rabbits). Sera from animals receiving conjugate vaccine
      opsonized type III group B streptococci for phagocytic killing by human
      peripheral blood leukocytes, and protected mice against lethal challenge with
      live type III group B streptococci. The results suggest that this method of
      conjugation to a carrier protein may be a useful strategy to improve the
      immunogenicity of the type III group B Streptococcus polysaccharide in human
      subjects.

PMID- 2243124
TI  - Transforming growth factor-beta activity in sheep lung lymph during the
      development of pulmonary hypertension.
AB  - Chronic pulmonary hypertension is associated with extensive structural remodeling
      of the pulmonary arterial bed. The structural changes in the arterial walls
      include increased production of extracellular matrix components and smooth muscle
      cell hypertrophy, changes that have been similarly induced by transforming growth
      factor-beta (TGF-beta) in culture. In the present study, experiments were
      performed to determine whether TGF-beta is present in sheep lung lymph, and
      whether TGF-beta levels were altered in an animal model of chronic pulmonary
      hypertension induced by continuous air embolization. Several standard biological
      assays for TGF-beta activity were used for these determinations including soft
      agar assays, inhibition of epithelial cell proliferation, and a TGF-beta-specific
      radioreceptor assay. In each case, control lung lymph contained high
      concentrations of TGF-beta (100 ng/ml) which required transient acidification for
      detection. Samples of lung lymph from hypertensive sheep showed a transient and
      early two- to threefold increase in concentrations of latent TGF-beta. This
      activity could be partially blocked by TGF-beta antibodies. These studies
      indicate that sheep lung lymph contains TGF-beta and that the level of TGF-beta
      increases early during the development of pulmonary hypertension. Thus, TGF-beta
      may contribute to the development of the structural changes in the pulmonary
      arteries that occur during the onset of chronic pulmonary hypertension.

PMID- 2243125
TI  - A mutation in the gene for type III procollagen (COL3A1) in a family with aortic
      aneurysms.
AB  - Experiments were carried out to test the hypothesis that familial aortic
      aneurysms, either thoracic or abdominal, are caused by mutations in the gene for
      type III procollagen (COL3A1) similar to mutations in the same gene that have
      been shown to cause rupture of aorta and other disastrous consequences in the
      rare genetic disorder known as Ehlers-Danlos syndrome type IV. A family was
      identified through a 37-yr-old female captain in the United States Air Force who
      was scrutinized only because many of her direct blood relatives had died of
      ruptured aortic aneurysms. The woman was heterozygous for a single-base mutation
      that converted the codon for glycine 619 of the alpha 1(III) chain of type III
      procollagen to a codon for arginine. Studies on cultured skin fibroblasts
      demonstrated the mutation caused synthesis of type III procollagen that had a
      decreased temperature for thermal unfolding of the protein. The same mutation was
      identified in DNA extracted from pathologic specimens from her mother who had
      died at the age of 34 and a maternal aunt who died at the age of 55 of aortic
      aneurysms. Examination of DNA from samples of saliva revealed that the woman's
      daughter, her son, a brother, and an aunt also had the mutation. The results
      demonstrated that mutations in the type III procollagen gene can cause familial
      aortic aneurysms and that DNA tests for such mutations can identify individuals
      at risk for aneurysms.

PMID- 2243126
TI  - Mechanism of acid-induced release of secretin in rats. Presence of a secretin
      releasing peptide.
AB  - In fasting rats, intraduodenal infusion of dilute hydrochloric acid results in
      significant increases in both pancreatic exocrine secretion and plasma
      concentration of secretin. To test the hypothesis that acid-induced release of
      secretin is mediated by a secretin-releasing factor (S-RF), anesthetized rats
      were prepared with pyloric ligation, duodenal and jejunal cannulas, and
      pancreatic duct cannulas. Donor rats were infused intraduodenally with 0.01 N
      HCl, 0.15 M NaCl, or a combination of 0.01 N HCl and 0.05 N NaHCO3 at 0.3 ml/min
      for 1.5 h, and the perfusates were collected via jejunal cannulas. The perfusates
      with pH adjusted to 6.0 were concentrated threefold and infused into the duodena
      of recipient rats. The concentrate of acid perfusate (CAP) significantly
      increased both pancreatic volume flow and bicarbonate output and plasma
      concentration of secretin, whereas concentrates of the saline perfusate (CSP) or
      the perfusate of a combination of 0.01 N HCl and 0.05 N NaHCO3 (CABP) did not
      influence pancreatic secretion or plasma concentration of secretin. The increased
      pancreatic secretion by CAP was attributed to increased circulating secretin
      because when secretin was immunoneutralized by a rabbit antisecretin serum, CAP
      stimulated pancreatic secretion was abolished. The bioactivity of CAP was trypsin
      sensitive and heat stable. The active substance in CAP had a molecular weight of
      less than 5,000 and greater than 1,000, as determined by ultrafiltration and
      bioassay. In conclusion, dilute HCl releases an S-RF into the upper small
      intestinal lumen to stimulate release of secretin. This substance, with molecular
      weight of less than 5,000, is heat stable and trypsin sensitive. Thus, the acid
      stimulated release of secretin is mediated by a secretin-releasing peptide in the
      upper small intestinal lumen.

PMID- 2243127
TI  - Elevated insulin receptor content in human breast cancer.
AB  - The growth of breast cancer cells is under the regulation of hormones, growth
      factors, and their receptors. In the present study, we have employed a new,
      sensitive, and specific radioimmunoassay for the direct measurement of insulin
      receptors in surgical specimens of breast cancers. In 159 specimens the insulin
      receptor content was 6.15 +/- 3.69 ng/0.1 mg protein. This value was more than
      sixfold higher than the mean value found in both 27 normal breast tissues
      obtained at total mastectomy (0.95 + 0.68, P less than 0.001) and in six normal
      specimens obtained from reduction mammoplasty (0.84 +/- 0.78, P less than 0.001).
      The insulin receptor content in breast cancer tissues was also higher than in any
      normal tissue investigated including liver (Pezzino, V., V. Papa, V. Trischitta,
      A. Brunetti, P.A. Goodman, M.K. Treutelaar, J.A. Williams, B.A. Maddux, R.
      Vigneri, and I.D. Goldfine, 1989. Am. J. Physiol. 257:E451-457). The insulin
      receptor in breast cancer retained its ability to both bind insulin and undergo
      insulin-induced tyrosine kinase activation. Immunostaining of the specimens
      revealed that the insulin receptor was present in malignant epithelial cells, but
      was not detected in stromal and inflammatory cells. Univariant analysis revealed
      that the insulin receptor content of the tumors correlated positively with tumor
      size (P = 0.014), histological grading (P = 0.030), and the estrogen receptor
      content (P = 0.035). There were no significant correlations between insulin
      receptor content and the age, body weight, menopausal status, and nodal
      involvement of the patients. These studies indicate, therefore, that the insulin
      receptor content is increased in breast cancers and raise the possibility that
      the insulin receptor may have a role in the biology of these tumors.

PMID- 2243128
TI  - Two different point G to A mutations in exon 10 of the porphobilinogen deaminase
      gene are responsible for acute intermittent porphyria.
AB  - Two mutations of the porphobilinogen (PBG) deaminase gene resulting in cross
      reacting immunological material (CRIM) positive forms of acute intermittent
      porphyria (AIP) have been identified by in vitro amplification of cDNA and
      cloning of the amplified products in a bacterial expression vector. Both
      mutations resulted from G to A transitions in exon 10 of the gene and produced
      arginine to glutamine substitutions in the abnormal protein. Expression of mutant
      cDNA in Escherichia coli reveals that one but not the other of these amino acid
      changes results in a striking decrease of the optimal pH of the mutated enzyme.
      One or the other of these two mutations accounted for the defect causing AIP in
      six unrelated patients among the eight patients evaluated with the CRIM positive
      subtype of this disorder.

PMID- 2243129
TI  - Angiotensin and thromboxane in the enhanced renal adrenergic nerve sensitivity of
      acute renal failure.
AB  - The roles of intrarenal angiotensin (A) and thromboxane (TX) in the vascular
      hypersensitivity to renal nerve stimulation (RNS) and paradoxical
      vasoconstriction to renal perfusion pressure (RPP) reduction in the
      autoregulatory range in 1 wk norepinephrine (NE)-induced acute renal failure
      (ARF) in rats were investigated. Renal blood flow (RBF) responses were determined
      before and during intrarenal infusion of an AII and TXA2 antagonist. Saralasin or
      SQ29548 alone partially corrected the slopes of RBF to RNS and RPP reduction in
      NE-ARF rats (P less than 0.02). Saralasin + SQ29548 normalized the RBF response
      to RNS. While combined saralasin + SQ29548 eliminated the vasoconstriction to RPP
      reduction, similar to the effect of renal denervation, appropriate vasodilatation
      was not restored. Renal vein norepinephrine efflux during RNS was
      disproportionately increased in NE-ARF (P less than 0.001) and was suppressed by
      saralasin + SQ29548 infusion (P less than 0.005). It is concluded that the
      enhanced sensitivity to RNS and paradoxical vasoconstriction to RPP reduction in
      1 wk NE-ARF kidneys are the result of intrarenal TX and AII acceleration of
      neurotransmitter release to adrenergic nerve activity.

PMID- 2243130
TI  - Physiological measurements of luminal stirring in the dog and human small bowel.
AB  - The resistance to absorption resulting from poor stirring of luminal contents
      (RLum) is considered to be equivalent to an unstirred layer of greater than 600
      microns in the human small intestine. We measured RLum in the jejunum of
      conscious dogs by assessing the absorption rate of two rapidly absorbed probes,
      glucose, and [14C]warfarin. When RLum was expressed as an unstirred layer, the
      maximal thickness of the unstirred layer (assuming negligible epithelial cell
      resistance) was only approximately 35 and 50 microns for perfusion rates of 26
      and 5 ml/min, respectively. Maximal unstirred layer thickness for the human
      jejunum, calculated from previous studies of glucose absorption, yielded a mean
      value of only 40 microns (range: 23 to 65 microns). Since epithelial resistance
      appears to be negligible during absorption of low concentrations of glucose, the
      maximal unstirred layer of 40 microns should be close to the true value for
      glucose in the human small intestine. We conclude that the unstirred layer for
      rapidly absorbed compounds in dogs and man are less than one-tenth of previously
      reported values, but this layer still may remain the rate limiting step in
      absorption of rapidly transported compounds.

PMID- 2243131
TI  - Inactivation of beef brain alpha-ketoglutarate dehydrogenase complex by valproic
      acid and valproic acid metabolites. Possible mechanism of anticonvulsant and
      toxic actions.
AB  - The anticonvulsant valproic acid (VPA, 2-n-propylpentanoic acid) causes
      inhibition of the citric acid cycle and elevations of central nervous system
      (CNS) gamma-aminobutyric acid (GABA) levels, which correlates with anticonvulsant
      action. No unifying mechanism for these actions of VPA has won general
      acceptance. alpha-Ketoglutarate dehydrogenase complex (KDHC) is a critical
      control enzyme in the CNS. We hypothesized that VPA may be an inhibitor of this
      enzyme since decreased KDHC activity would reduce substrate flux through the
      citric acid cycle and may increase flux into GABA synthesis. To test this
      hypothesis, inhibition of purified beef brain KDHC by VPA and its metabolites 2-n
      propylpent-2-enoic acid (delta 2,3 VPE) and their coenzyme A (CoA) derivatives
      were studied. Preincubation of the NADH-reduced enzyme with delta 2,3 VPE, VPA
      CoA, and delta 2,3 VPE-CoA caused time-dependent inactivation, reversible by
      addition of CoA. Under steady-state conditions, delta 2,3 VPE and VPA-CoA were
      competitive inhibitors of KDHC and delta 2,3 VPE-CoA was a mixed inhibitor. These
      observations have implications for the molecular mechanisms of VPA action. VPA
      derivatives cause inactivation and inhibition of KDHC, which may explain the
      anticonvulsant and some toxic actions of VPA.

PMID- 2243132
TI  - Pathogenesis of hyperadrenergic orthostatic hypotension. Evidence of disordered
      venous innervation exclusively in the lower limbs.
AB  - The pathogenesis of hyperadrenergic orthostatic hypotension was studied in eight
      patients. Correction of the abnormal orthostatic changes by an inflated pressure
      suit (MAST) confirmed previous evidence of excessive gravitational pooling of
      blood in the leg veins. Intravenous L-norepinephrine infusion raised diastolic
      blood pressure in the same relationship to the infusion-induced increments in
      plasma norepinephrine concentrations as in normal subjects, indicating normal
      arteriolar responses. Contractile responses of the veins to infused L
      norepinephrine were measured with a linear variable differential transformer
      (LVDT). The venous responses of hand veins in the patients fell within the 95%
      confidence limits of the responses of normal hand veins, as did the responses of
      foot veins in the seven normal subjects. However, foot veins of the patients with
      hyperadrenergic orthostatic hypotension, and both hand and foot veins of patients
      with "diffuse" autonomic failure, were supersensitive to norepinephrine, as
      reflected by a steeper slope of the regression of log (norepinephrine infusion
      rate) on percentage reduction in venous distensibility, and a significantly lower
      ED50 (i.e., norepinephrine infusion rate that induced 50% reduction in venous
      distensibility). The findings suggest anatomical or functional postganglionic
      denervation of lower limb veins causing excessive gravitational blood pooling
      with consequent orthostatic hypotension in these patients.

PMID- 2243133
TI  - Pearson's marrow-pancreas syndrome. A multisystem mitochondrial disorder in
      infancy.
AB  - Pearson's marrow-pancreas syndrome (McKusick No. 26056) is a fatal disorder of
      hitherto unknown etiology involving the hematopoietic system, exocrine pancreas,
      liver, and kidneys. The observation of high lactate/pyruvate molar ratios in
      plasma and abnormal oxidative phosphorylation in lymphocytes led us to postulate
      that Pearson's syndrome belongs to the group of mitochondrial cytopathies. Since
      rearrangements of the mitochondrial genome between direct DNA repeats were
      consistently found in all tissues tested, our results show that this disease is
      in fact a multisystem mitochondrial disorder, as suggested by the clinical course
      of the patients. Based on these observations, we would suggest giving
      consideration to the hypothesis of a defect of oxidative phosphorylation in
      elucidating the origin of other syndromes, especially those associated with an
      abnormal oxidoreduction status in plasma.

PMID- 2243134
TI  - Reduced beta-cell glucose transporter in new onset diabetic BB rats.
AB  - Previous studies from our laboratories have suggested a defect in glucose
      transport in islets isolated from BB rats on the first day of overt diabetes. To
      quantitate by immunostaining the glucose transporter of beta-cells (GLUT-2)
      before and at the onset of autoimmune diabetes we employed an antibody to its
      COOH-terminal octapeptide. On the first day of overt diabetes, defined as the day
      the daily blood glucose first reached 200 mg/dl, the volume density ratio of GLUT
      2-positive to insulin-positive beta-cells was only 0.48 +/- 0.06, compared to
      0.91 +/- 0.02 in age-matched nondiabetic diabetes-resistant controls (P less than
      0.001). In age-matched nondiabetic diabetes-prone rats, most of which would have
      become diabetic, the ratio was 0.85 +/- 0.02, also less than the controls (P less
      than 0.05). Protein A-gold labeling of GLUT-2 in beta-cells of day 1 diabetic
      rats revealed 2.17 +/- 0.16 gold particles per micrometer length of microvillar
      plasma membranes compared to 3.91 +/- 0.14 in controls (P less than 0.001) and
      2.87 +/- 0.24 in the nondiabetic diabetes-prone rats (P less than 0.02).
      Reduction in GLUT-2 correlates temporally with and may contribute to the loss of
      glucose-stimulated insulin secretion that precedes profound beta-cell depletion
      of autoimmune diabetes.

PMID- 2243135
TI  - A novel X-linked combined immunodeficiency disease.
AB  - A novel X-linked combined immunodeficiency disease was found in five living males
      in an extended family in the United States. The age of the affected males ranged
      from 2.5 to 34 yr. The most prominent clinical abnormalities were a paucity of
      lymphoid tissue; recurrent sinusitis, otitis media, bronchitis, and pneumonia;
      severe varicella; and chronic papillomavirus infections. The principal
      immunologic features of the disorder were normal concentrations of serum
      immunoglobulins but restricted formation of IgG antibodies to immunogens; normal
      numbers of B cells and NK cells but decreased numbers of CD4+ and CD8+ T
      lymphocytes, particularly the CD45RA+ subpopulations; diminished proliferative
      responses of blood T cells to allogeneic cells, mitogens and antigens; and
      decreased production of IL-2 by mitogen stimulated blood lymphocytes. Thus,
      affected males in this family carry an abnormal gene on their X chromosome that
      results in a combined immunodeficiency that is distinct from previously reported
      disorders.

PMID- 2243136
TI  - Epidermal growth factor regulates the in vitro sensitivity of human ovarian
      carcinoma cells to cisplatin.
AB  - Cisplatin (DDP) is the most effective drug for the treatment of human ovarian
      cancer, but the mechanisms that determine sensitivity to the cytotoxic action of
      DDP are not well understood. Treatment of two human ovarian carcinoma cell lines
      with epidermal growth factor (EGF) simultaneously increased sensitivity to DDP
      and caused a persistent change in morphology in the absence of any mitogenic
      effect. Sensitization to DDP was shown to be dependent on both EGF concentration
      and EGF receptor number in C127 mouse fibroblasts expressing the human EGF
      receptor after transfection with a pBPV plasmid construct containing the human
      EGF receptor gene under control of the transferrin receptor 3'-inducible
      regulator. Sensitization of human ovarian carcinoma cells to DDP was not blocked
      by inhibition of protein synthesis. EGF did not enhance sensitivity to DDP or
      alter morphology in DDP-resistant human ovarian carcinoma cells despite the
      presence of functional EGF receptors on these cells. These results showed that
      elements of the signal transduction pathway activated by EGF determined cellular
      sensitivity to DDP, and that a DDP-resistant phenotype is associated with a
      defect in this signal transduction pathway.

PMID- 2243137
TI  - Extracellular matrix gene expression increases preferentially in rat lipocytes
      and sinusoidal endothelial cells during hepatic fibrosis in vivo.
AB  - Whether parenchymal or nonparenchymal liver cells play a predominant role in the
      pathophysiology of hepatic fibrosis has not been firmly established in vivo. We
      have addressed this question by quantitating the relative abundance of specific
      mRNAs for collagen types I, III, and IV, and laminin in purified populations of
      hepatocytes, sinusoidal endothelial cells, and lipocytes from normal and fibrotic
      rat liver. In normal liver, type I collagen gene expression was minimal in all
      cell types; mRNA for types III and IV collagen were apparent in endothelial cells
      and lipocytes, but not in hepatocytes. Laminin mRNA was present in all cell
      types. Induction of fibrogenesis by either bile duct ligation or carbon
      tetrachloride administration was associated with a substantial increase in mRNA
      for types I and III collagen in nonparenchymal cells. Lipocytes from fibrotic
      animals exhibited a greater than 30-fold increase in type I collagen mRNA
      relative to normal lipocytes, and greater than 40-fold relative to hepatocytes.
      Type III collagen mRNA reached 5 times that in normal lipocytes and greater than
      120 times that in hepatocytes. Endothelial cells exhibited an isolated increase
      in type I collagen mRNA, reaching five times that in normal liver. Type IV
      collagen and laminin gene expression were not significantly increased in
      nonparenchymal cells during fibrogenesis; in fact, mRNA for type IV collagen and
      laminin decreased by up to 50% in endothelial cells. Despite the pronounced
      changes that occurred in matrix gene expression in nonparenchymal cells during
      fibrogenesis, no change was noted in hepatocytes. We conclude that nonparenchymal
      liver cells, particularly lipocytes, are important effectors of hepatic fibrosis
      in vivo.

PMID- 2243138
TI  - A phosphatase activity present in peripheral blood myeloid cells of chronic
      myelogenous leukemia patients but not normal individuals alters nuclear protein
      binding to transcriptional enhancers of interferon-inducible genes.
AB  - Cytoplasmic protein from peripheral blood myeloid cells of chronic myelogenous
      leukemia (CML) patients altered the electrophoretic mobility of complexes formed
      between nuclear proteins and interferon-inducible transcriptional enhancers.
      Immature myeloid marrow cells (blasts and promyelocytes) have a higher level of
      this activity than do mature myeloid marrow cells (bands and polys). This
      activity, which is not detectable in the peripheral blood cells of normal
      individuals, is at least 50-fold higher in CML marrow blasts and promyelocytes
      than that found in marrow blasts and promyelocytes of normal individuals. This
      activity was inhibited by in vivo incubation of immature myeloid cells with the
      phosphatase inhibitor, sodium orthovanadate (0.2 mM), and by adding orthovanadate
      (20 mM) directly to cytoplasmic proteins of myeloid cells. Interferon-alpha
      (1,000 U/ml) reduced the effects of the CML myeloid cell cytoplasmic protein on
      the electrophoretic mobility of nuclear protein-DNA complexes. These data suggest
      that a unique phosphatase may be involved in the abnormalities in CML which are
      modulated by interferon-alpha.

PMID- 2243139
TI  - CD4-Pseudomonas exotoxin conjugates delay but do not fully inhibit human
      immunodeficiency virus replication in lymphocytes in vitro.
AB  - The CD4 molecule is a high affinity receptor for the human immunodeficiency virus
      (HIV) envelope glycoprotein (gp160 or gp120). This glycoprotein is expressed on
      the surface membrane of cells infected with HIV. It has, therefore, been
      suggested that a soluble form of CD4 might be used as a targeting agent to
      deliver toxins selectively to cells infected with HIV. We demonstrate that CD4
      Pseudomonas exotoxin A (PE) conjugates inhibit the proliferation of gp160
      transfected Chinese hamster ovary cells and block HIV replication in virus
      infected H9 cells. However, this inhibition of HIV replication appears to be
      incomplete since virus replication occurs following removal of the toxin
      conjugates from these cultures. Moreover, CD4-PE conjugates delay but do not
      inhibit HIV replication in human peripheral blood lymphocytes. These studies
      suggest that such conjugates should be assessed only as potential adjunctive
      therapies in the acquired immunodeficiency syndrome.

PMID- 2243140
TI  - Arginine-glycine-aspartic acid- and fibrinogen gamma-chain carboxyterminal
      peptides inhibit platelet adherence to arterial subendothelium at high wall shear
      rates. An effect dissociable from interference with adhesive protein binding.
AB  - Arg-Gly-Asp (RGD)- and fibrinogen gamma-chain carboxyterminal (GQQHHLGGAKQAGDV)
      peptides inhibit fibrinogen, fibronectin (Fn), vitronectin, and von Willebrand
      factor (vWF) binding to the platelet glycoprotein IIb-IIIa complex (GP IIb-IIIa).
      GP IIb-IIIa, vWF, and Fn are essential for normal platelet adherence to
      subendothelium. We added peptides to normal citrated whole blood before perfusion
      over human umbilical artery subendothelium and evaluated platelet adherence
      morphometrically at high (2,600 s-1) and low (800 s-1) wall shear rates. We also
      examined the effects of the peptides on platelet adhesion to collagen in a static
      system. At the high wall shear rate, RGDS and GQQHHLGGAKQAGDV caused dose
      dependent reduction in the surface coverage with spread and adherent platelets.
      Amino acid transposition and conservative substitutions of RGD peptides and the
      AGDV peptide significantly inhibited platelet adherence at 2,600 s-1. By
      contrast, the modified RGD peptides and AGDV do not affect adhesive protein
      binding to platelets. None of the native or modified RGD- or fibrinogen gamma
      chain peptides significantly inhibited either platelet adherence to
      subendothelium at 800 s-1 or platelet adhesion to collagen. Our findings
      demonstrate that peptides that interfere with adhesive protein binding to GP IIb
      IIIa inhibit platelet adherence to vascular subendothelium with flowing blood
      only at high wall shear rates. Platelet adherence to subendothelium at high wall
      shear rates appears to be mediated by different recognition specificities from
      those required for fluid-phase adhesive protein binding or static platelet
      adhesion.

PMID- 2243141
TI  - Human neutrophil cytochrome b light chain (p22-phox). Gene structure, chromosomal
      location, and mutations in cytochrome-negative autosomal recessive chronic
      granulomatous disease.
AB  - A membrane-bound cytochrome b, a heterodimer formed by a 91-kD glycoprotein
      (heavy chain) and a 22-kD polypeptide (light chain), is an essential component of
      the phagocyte NADPH-oxidase responsible for superoxide generation. Cytochrome b
      is absent in two subgroups of chronic granulomatous disease (CGD), an inherited
      disorder characterized by the lack of oxidase activity. Mutations in the
      cytochrome heavy chain gene, encoded by the CYBB locus in Xp21.1, result in the X
      linked form of CGD. A rare subgroup of autosomal recessive CGD also lacks
      cytochrome b (A- CGD), but the genetic defect has not previously been identified.
      In order to search for possible mutations in the cytochrome light chain locus,
      CYBA, the structure of this gene was characterized. The CYBA locus was localized
      to 16q24, and the approximately 600-bp open reading frame determined to be
      encoded by six exons that span approximately 8.5 kb. Three unrelated patients
      with A- CGD were studied for evidence of mutations in the light chain gene. One
      patient, whose parents were first cousins, was homozygous for a large deletion
      that removed all but the extreme 5' coding sequence of the gene. The other two
      patients had a grossly normal light chain transcript on Northern blot of
      mononuclear cell RNA. The light chain transcript was amplified by the polymerase
      chain reaction and sequenced. One patient was a compound heterozygote for two
      alleles containing point mutations in the open reading frame that predict a frame
      shift and a nonconservative amino acid replacement, respectively. The second
      patient, whose parents were second cousins, was homozygous for a different single
      base substitution resulting in another nonconservative amino acid change. These
      results indicate that A- CGD can results from defects in the gene encoding the 22
      kD light chain of the phagocyte cytochrome b.

PMID- 2243142
TI  - Cholesterol synthesis is required for cutaneous barrier function in mice.
AB  - Previous studies have shown that topical acetone treatment results in the removal
      of stratum corneum lipids and disruption of the permeability barrier. This
      disruption stimulates epidermal lipid synthesis which is associated with the
      rapid restoration of stratum corneum lipids and barrier function. The aim of this
      study was to determine the role of cutaneous cholesterol synthesis in the barrier
      recovery. Here we show that topical lovastatin, a competitive inhibitor of HMG
      CoA reductase, inhibits cholesterol synthesis. After acetone disruption of the
      barrier, the normal rapid return of cholesterol to the stratum corneum and
      recovery of barrier function is impaired in animals treated topically with
      lovastatin. When lovastatin animals are simultaneously treated topically with
      either mevalonate, the immediate product of HMG CoA reductase, or cholesterol,
      the final end product of the pathway, the recovery of the barrier is normalized.
      Lovastatin resulted in the delayed secretion and abnormal appearance of lamellar
      bodies. These results provide the first evidence demonstrating that cholesterol
      synthesis is required for the maintenance of barrier structure and function and
      suggests a crucial role for cholesterol synthesis in allowing for terrestrial
      existence.

PMID- 2243143
TI  - Insulin regulates apolipoprotein B turnover and phosphorylation in rat
      hepatocytes.
AB  - Our laboratory has previously shown that insulin inhibits the secretion of newly
      synthesized and immunoreactive apo B from rat hepatocytes. We have also shown
      that apo B is secreted as a phosphoprotein and that phosphorylation is increased
      in hypoinsulinemic nonketotic diabetes. The present studies were conducted to
      determine whether the ability of insulin to inhibit apo B secretion is related to
      alterations in apo B turnover and whether insulin itself affects apo B
      phosphorylation. Pulse-chase studies with [35S]methionine in primary cultures of
      hepatocytes from normal rats in the absence and presence of insulin show that the
      secretion of apo B100 and apo B48 are inhibited by insulin and that this
      inhibition may be due in part to enhanced intracellular degradation. In addition,
      there is a second intracellular apo B48 pool which is not insulin regulated or
      degraded. In experiments in which hepatocytes were incubated with
      [32P]orthophosphate, insulin decreased 32P incorporation into apo B100 (42%) with
      only small effects on apo B48 (11%). The small insulin effect on apo B48 may
      relate to an insulin-insensitive apo B48 intracellular pool. These studies show
      that insulin can affect the intracellular turnover, secretion, degradation, and
      phosphorylation of apo B and emphasize the differential regulation of apo B100
      and apo B48 with regard to these parameters in rat liver.

PMID- 2243144
TI  - Schindler disease: the molecular lesion in the alpha-N-acetylgalactosaminidase
      gene that causes an infantile neuroaxonal dystrophy.
AB  - Schindler disease is a recently recognized infantile neuroaxonal dystrophy
      resulting from the deficient activity of the lysosomal hydrolase, alpha-N
      acetylgalctosaminidase (alpha-GalNAc). The recent isolation and expression of the
      full-length cDNA encoding alpha-GalNAc facilitated the identification of the
      molecular lesions in the affected brothers from family D, the first cases
      described with this autosomal recessive disease. Southern and Northern
      hybridization analyses of DNA and RNA from the affected homozygotes revealed a
      grossly normal alpha-GalNAc gene structure and normal transcript sizes and
      amounts. Therefore, the alpha-GalNAc transcript from an affected homozygote was
      reverse-transcribed, amplified by the polymerase chain reaction (PCR), and
      sequenced. A single G to A transition at nucleotide 973 was detected in multiple
      subclones containing the PCR products. This point mutation resulted in a glutamic
      acid to lysine substitution in residue 325 (E325K) of the alpha-GalNAc
      polypeptide. The base substitution was confirmed by dot blot hybridization
      analyses of PCR-amplified genomic DNA from family members with allele-specific
      oligonucleotides. Furthermore, transient expression of an alpha-GalNAc construct
      containing the E325K mutation resulted in the expression of an immunoreactive
      polypeptide which had no detectable alpha-GalNAc activity.

PMID- 2243146
TI  - Role of endothelium-derived nitric oxide in the bleeding tendency of uremia.
AB  - Endothelium-derived relaxing factor, now identified as nitric oxide (NO), is a
      labile humoral agent formed by vascular endothelial cells from L-arginine. NO
      mediates the action of substances that induce endothelium-dependent relaxation
      and plays a role in regulating blood pressure. In this study we investigated
      whether NO is involved in the pathogenesis of the bleeding tendency associated
      with renal failure. Rats with extensive surgical ablation of renal mass develop
      renal insufficiency due to progressive glomerulosclerosis. Like uremic humans,
      rats with renal mass reduction and uremia have a bleeding tendency that manifests
      itself by a prolonged bleeding time. We found that N-monomethyl-L-arginine (L
      NMMA), a specific inhibitor of NO formation from L-arginine, completely
      normalized bleeding time when given to uremic rats. L-NMMA injection also
      increased ex vivo platelet adhesion but did not affect ex vivo platelet
      aggregation induced by adenosine diphosphate, arachidonic acid, and calcium
      ionophore A23187. The shortening effect of L-NMMA on bleeding time was completely
      reversed by giving the animals the NO precursor L-arginine, but not D-arginine,
      which is not a precursor of NO. It thus appears that NO is a mediator of the
      bleeding tendency of uremia.

PMID- 2243147
TI  - Changes in the steady-state pharmacokinetics of theophylline during treatment
      with dirithromycin.
AB  - The steady-state plasma concentrations and pharmacokinetic characteristics of
      theophylline were studied during intermittent treatment with dirithromycin. The
      addition of dirithromycin (500 mg orally once daily at 7:00 AM) to a sustained
      release theophylline dosing regimen (200 mg every 12 hours) elicited small
      changes in the steady-state pharmacokinetics of theophylline. Mean steady-state
      plasma theophylline trough concentrations (Cmin) were invariant before, during,
      and after dirithromycin treatment; however, mean average steady-state plasma
      theophylline concentrations (Cav) declined by 18% during dirithromycin treatment
      (P less than .05), and mean peak plasma concentrations (Css,max) declined by 26%
      (P less than .01). Theophylline clearance (CL/F) exhibited an increase of
      comparable magnitude during dirithromycin treatment, although the increase in
      CL/F was not statistically significant (.05 less than P less than .1).
      Dirithromycin treatment alters the steady-state pharmacokinetics of theophylline;
      however, the magnitude of the changes is small and is not likely to modify
      treatment outcomes.

PMID- 2243145
TI  - L-tryptophan implicated in human eosinophilia-myalgia syndrome causes fasciitis
      and perimyositis in the Lewis rat.
AB  - Tryptophan-associated eosinophilia-myalgia syndrome (L-TRP-EMS) is a newly
      described syndrome which occurred in epidemic fashion in the United States in the
      summer and fall of 1989. Epidemiologic data has linked the syndrome to intake of
      L-tryptophan (L-TRP) from one specific manufacturer, but the precise etiologic
      compound(s) must be established by replication of the syndrome in an appropriate
      animal model. In this study, implicated L-TRP, United States Pharmacopeia (USP)
      grade L-TRP, or vehicle was administered by gavage in a blinded fashion for 38 d
      to female Lewis rats at doses comparable with those ingested by patients who
      developed the eosinophilia-myalgia syndrome. Animals receiving implicated L-TRP,
      but not those receiving USP grade L-TRP or vehicle, developed histologic signs
      consistent with fasciitis and perimyositis, specific pathologic features of human
      L-TRP-EMS. Peripheral blood eosinophilia was not observed. Hypothalamic
      corticotropin releasing hormone mRNA levels were lower and plasma corticosterone
      levels tended to be lower in the animals that received implicated L-TRP. Plasma L
      kynurenine was higher in both L-TRP-treated groups compared to the vehicle
      treated animals. The female Lewis rat is known to be susceptible to a wide
      variety of inflammatory diseases. Identification of specific inflammatory changes
      in this rat following exposure to implicated L-TRP indicates that this animal
      model will be important in subsequent investigations into the etiology,
      pathogenesis, and treatment of human L-TRP-EMS.

PMID- 2243148
TI  - Antihypertensive effects of a new sustained-release formulation of nifedipine.
AB  - The blood pressure response to a new sustained-release formulation of nifedipine
      was evaluated in an 8-week, double-blind, placebo-controlled study. Twenty-nine
      patients with mild essential hypertension were randomized to receive placebo (N =
      9), 30 mg nifedipine (N = 10), or 60 mg nifedipine (N = 10). During treatment, 30
      mg and 60-mg doses of nifedipine administered once daily decreased office blood
      pressures from 137/98 +/- 8/2 mm Hg and 141/98 +/- 15/2 mm Hg at baseline,
      respectively, to 126/89 +/- 9/7 mm Hg and 126/86 +/- 6/7 mm Hg (P less than
      .005). Noninvasive automatic ambulatory blood pressure monitoring demonstrated a
      marginally significant (P less than .10) reduction in the mean 24-hour blood
      pressure of 2/6 +/- 8/8 mm Hg and 5/6 +/- 9/9 mm Hg for patients taking 30 mg and
      60 mg nifedipine once daily, respectively. Diastolic blood pressure load (the
      percentage of ambulatory diastolic blood pressure readings greater than 90 mm Hg)
      during 24 hours was decreased by 41% and 35%, with 30 mg and 60 mg nifedipine
      administered once daily, respectively. No significant dose response to nifedipine
      at these dose levels was observed. Although the once-daily formulation of
      nifedipine achieved effective control of office blood pressure, similar control
      was not observed in awake and 24-hour periods in all patients.

PMID- 2243149
TI  - Acute and steady-state pharmacokinetics and antihypertensive effects of
      felodipine in patients with normal and impaired renal function.
AB  - Eighteen patients (14 men and 4 women, aged 36-74 years) treated with metoprolol
      for a month were included in the study. Twelve had impaired renal function (IRF)
      with a glomerular filtration rate (GFR) of 7.5-77.1 mL/min and six having normal
      renal function (NRF) with a GFR of 84.9-113.0 mL/min. Plasma and urine
      concentrations of felodipine and metabolites, heart rate, and blood pressure were
      recorded over 24 hours on day 1 after an oral dose of 10 mg felodipine and 0.04
      mg 3H-felodipine IV and repeated on day 29 during continuous treatment with
      felodipine, 10 mg bid. The bioavailability of the oral dose on day 1 and day 29
      was 13% and 12.5%, respectively. The terminal plasma half-life (t1/2) on day 29
      was 22 hours and systemic clearance was 490 mL/min on day 1 and 434 mL/min on day
      29 (NS). There were no differences in these parameters between NRF and IRF. The
      protein binding determined by equilibrium dialysis in the six patients with the
      lowest GFR was 99.74% on day 1 and 99.73% on day 29 and did not differ
      significantly from previously reported values in healthy subjects. The mean
      supine blood pressure before the acute dose of felodipine was 164/96 mm Hg in the
      IRF patients and 145/95 mm Hg in the NRF patients. A maximum decrease of 37/22 mm
      Hg and 32/19 mm Hg, respectively, was seen within 1.5 hours after dose and at 12
      hours the reduction was 12/9 and 15/10 mm Hg, respectively, compared to baseline
      values. At steady state the morning blood pressure before dose was 152/87 mm Hg
      in the IRF patients and 129/86 mm Hg in the NRF patients. Similar maximum
      decreases and effects at 12 hours were seen after dose on day 29 as on day 1.
      Data on the effect on diastolic blood pressure and plasma felodipine
      concentrations were well fitted to the Emax model. The maximum reduction in
      diastolic blood pressure using this model was 27% and the plasma concentration
      leading to 50% of the maximum effect was 6.2 nmol/L. In conclusion, renal disease
      does not affect the pharmacokinetics of felodipine. The pharmacokinetic and
      pharmacodynamic effects of felodipine are not altered during steady state. The
      renal excretion of inactive metabolites is reduced in IRF. However, the
      accumulation of metabolites in the blood does not affect the protein binding or
      the clearance of felodipine. No dosage adjustment of felodipine seems to be
      necessary in patients with hypertension and renal impairment.

PMID- 2243150
TI  - Metabolic effects of the combination of captopril and hydrochlorothiazide in
      hypertensive subjects.
AB  - The medium-term (16 weeks) effects of the combination of captopril and
      hydrochlorothiazide (HCTZ) on some metabolic indexes, particularly on plasma
      lipoproteins, were evaluated in 20 mild to moderate hypertensive outpatients.
      After a 4-week wash-out period, the subjects were given one tablet of a new
      commercially available fixed combination once/daily (i.e., captopril 50 mg + HCTZ
      25 mg). The dose could be titrated to a maximum of one tablet twice daily
      according to individual blood pressure responses. Both systolic and diastolic
      blood pressure significantly decreased at week 4 and showed a further decrease
      thereafter; the rate of responders (diastolic blood pressure at or below 90 mm Hg
      at the end of the study) was very high (90%). The only metabolic change was a
      small though significant increase in HDL cholesterol (P less than .05), almost
      entirely due to an increase in the denser HDL3 subfraction. The atherogenic
      fractions, namely total cholesterol, LDL cholesterol, and apoprotein B, showed no
      significant changes. Plasma triglycerides underwent a transient increase at week
      8 (P less than .05) but thereafter fell. Plasma glucose, creatinine, uric acid,
      and potassium were unchanged. The fixed combination of captopril and HCTZ seems
      highly effective in lowering blood pressure and seems devoid of untoward
      metabolic effects. Its overall impact on the coronary risk profile in
      hypertensive subjects seems therefore to be favorable.

PMID- 2243151
TI  - A simple method for the estimation of interaction bias in crossover studies.
AB  - The crossover trial is considered the most powerful means of determining the
      efficacy of new drugs. However this study design is frequently invalidated by
      treatment-by-period interaction. If, for example, the effect of the first
      treatment period carries on into the next one, then it influences the response to
      the latter period (carryover effect). A second problem is that there are no
      reliable statistical methods to test for this potential bias. This article takes
      issue with these problems and gives an alternative method for the detection of
      interaction simply by looking at the data. In a crossover without interaction the
      second period should be a true reflection of the first. If, however, the data of
      a treatment are better in the second period than in the first, a carryover effect
      is probable. If worse, a rebound phenomenon or a negative carryover effect is
      likely. If both treatments are better or worse, a time effect or some other
      external influence might be present. The authors illustrate this simple method by
      a summary of a few selected trials that have been published recently. This method
      enables not only the detection of interaction but also the differentiation
      between different types of interactions. Therefore, investigators are advised to
      use it in order to make sure that there are no unexpected problems.

PMID- 2243152
TI  - Clinical evaluation of diphenhydramine hydrochloride for the treatment of
      insomnia in psychiatric patients: a double-blind study.
AB  - The usefulness of the antihistaminic agent diphenhydramine hydrochloride was
      evaluated using a double-blind procedure at sleeping doses of 12.5, 25, and 50 mg
      in 144 psychiatric patients with insomnia. The general condition of the patients
      with insomnia was at least "slightly improved" in 62.5% (12.5-mg group), 60% (25
      mg group), and 67.4% (50-mg group) after treatment with the test drug for 2
      weeks. Side effects were observed in a total of 11 patients (7.6%) but were not
      severe. No symptoms suggestive of drug dependence were evident. Global
      improvement was not influenced by patient background factors except for the
      presence or absence of previous treatment for insomnia. The hypnotic effect of
      diphenhydramine hydrochloride was significantly greater in patients who had not
      been treated previously. A dose-dependent increase in the hypnotic effect was
      also seen in patients who had not received any previous treatment.
      Diphenhydramine hydrochloride thus appears to be effective in the treatment of
      insomnia, but the appropriate dosage will depend on previous medical treatment of
      insomnia.

PMID- 2243153
TI  - The correlation between predicted and measured patient specific analgesic
      concentrations after intravenous titration: a guide for initial maintenance
      requirements with methadone.
AB  - The relationship between the analgesic methadone concentrations measured and
      those predicted using a pharmacokinetic approach were assessed in 22 patients
      referred for long-term management of severe pain with intravenous methadone. Five
      milligrams of methadone were administered IV every 10 minutes until the patient
      reported a visual analog scale (VAS) pain score of less than or equal to 2.
      Initial maintenance infusion rates were chosen based on the number of 5 mg doses
      required to produce satisfactory analgesia. Overall, the methadone concentrations
      predicted using pharmacokinetic modeling were in excellent agreement with those
      actually measured. Over 95% of the variance in the data was explained using this
      model (r2 = 0.9704). Using the rapid titration paradigm described here, one can
      obtain a reasonable estimate of patient specific analgesic (target) concentration
      as well as initial infusion requirements for methadone.

PMID- 2243154
TI  - The CAST results.

PMID- 2243155
TI  - Pharmacologic therapy for arrhythmias: attention to the benefit-risk ratio.

PMID- 2243156
TI  - Globalization of the pharmaceutical industry: the physician's role in optimizing
      drug use.
AB  - In this new era of globalization, the physician must consider cultural
      differences in choosing methods of disseminating information so that
      practitioners in diverse settings may optimize drug usage. In addition,
      increasing competition, stimulated by the imminent unification of the European
      market in 1992, demands that the industry physician be concerned with developing
      possible new indications and cost-effective applications. These factors will
      enhance roles for the medical affairs physician in the pharmaceutical industry.

PMID- 2243157
TI  - Globalization of the pharmaceutical industry: the physician's role in evaluating
      drug safety.
AB  - The trend toward uniformity of drug registration procedures due to imminent
      European Economic Community globalization has encouraged pharmaceutical companies
      to conduct studies on a worldwide basis. This standardization of methods will
      facilitate the "poolability" of efficacy and safety data generated by these
      international studies into a common database. With the internationalization of
      the pharmaceutical marketplace, physicians in industry may be required to collect
      and interpret such reports from all over the globe. The globalization of the
      pharmaceutical industry will thus broaden the opportunities for physician
      involvement in safety detection.

PMID- 2243158
TI  - Intraperitoneal administration of acyclovir in patients receiving continuous
      ambulatory peritoneal dialysis.
AB  - In subjects with normal renal function, acyclovir is rapidly removed from the
      body via the kidneys. In subjects with end-stage renal disease, the half-life is
      significantly prolonged. The half-life in subjects receiving hemodialysis and
      continuous ambulatory peritoneal dialysis (CAPD) is similarly prolonged (10.0 +/-
      2.2 and 13.2 +/- 4.7 hours, respectively). After intravenous dosage, peritoneal
      clearance was 3.4 +/- 0.2 mL/min. Intraperitoneal dosing in subjects receiving
      CAPD resulted in a bioavailability of 61 +/- 10% and drug levels sufficient to
      inhibit herpes simplex virus (HSV) and varicella zoster virus (VZV).
      Intraperitoneal administration is an alternative route of administration in
      patients with poor vascular access.

PMID- 2243159
TI  - Visual receptive field organization and cortico-cortical connections of the
      lateral intraparietal area (area LIP) in the macaque.
AB  - The visual receptive field physiology and anatomical connections of the lateral
      intraparietal area (area LIP), a visuomotor area in the lateral bank of the
      inferior parietal lobule, were investigated in the cynomolgus monkey (Macaca
      fascicularis). Afferent input and physiological properties of area 5 neurons in
      the medial bank of the intraparietal sulcus (i.e., area PEa) were also
      determined. Area LIP is composed of two myeloarchitectonic zones: a ventral zone
      (LIPv), which is densely myelinated, and a lightly myelinated dorsal zone (LIPd)
      adjacent to visual area 7a. Previous single-unit recording studies in our
      laboratory have characterized visuomotor properties of area LIP neurons,
      including many neurons with powerful saccade-related activity. In the first part
      of the present study, single-unit recordings were used to map visual receptive
      fields from neurons in the two myeloarchitectonic zones of LIP. Receptive field
      size and eccentricity were compared to those in adjacent area 7a. The second part
      of the study investigated the cortico-cortical connections of area LIP neurons
      using tritiated amino acid injections and fluorescent retrograde tracers placed
      directly into different rostrocaudal and dorsoventral parts of area LIP. The
      approach to area LIP was through somatosensory area 5, which eliminated the
      possibility of diffusion of tracers into area 7a. Unlike many area 7a receptive
      fields, which are large and bilateral, area LIP receptive fields were much
      smaller and exclusively confined to the contralateral visual field. In area LIP,
      an orderly progression in visual receptive fields was evident as the recording
      electrode moved tangentially to the cortical surface and through the depths of
      area LIP. The overall visual receptive field organization, however, yielded only
      a rough topography with some duplications in receptive field representation
      within a given rostrocaudal or dorsoventral part of LIP. The central visual field
      representation was generally located more dorsally and the peripheral visual
      field more ventrally within the sulcus. The lower visual field was represented
      more anteriorly and the upper visual field more posteriorly. In LIP, receptive
      field size increased with eccentricity but with much variability with in the
      sample. Area LIPv was found to have reciprocal cortico-cortical connections with
      many extrastriate visual areas, including the parieto-occipital visual area PO;
      areas V3, V3A, and V4: the middle temporal area (MT); the middle superior
      temporal area (MST); dorsal prelunate area (DP); and area TEO (the occipital
      division of the intratemporal cortex). Area LIPv is also connected to area TF in
      the lateral posterior parahippocampal gyrus.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2243160
TI  - Ultrastructure of the electrotonic and chemical components of the lateral-to
      motor and medial-to-motor synapses in crayfish nerve cord.
AB  - Lateral-to-motor and medial-to-motor synapses in crayfish nerve cords are
      composed of an electrical and a chemical component. The presynaptic terminals
      showed localized clusters of synaptic vesicles, electron-dense areas, coated
      pits, and coated vesicles. In thin sections, active zones were defined by
      electron-dense regions where synaptic vesicles attached and, in freeze-fracture
      replicas, by clusters of intramembrane particles localized in bands with vesicle
      openings on the sides of these bands. The cytoplasmic surface of the postsynaptic
      membrane opposite the active zones was coated with electron-dense material that
      in freeze-fracture replicas was seen as an increase in intramembrane particles
      located in the external leaflet (EF-face). This specialization of the
      postsynaptic membrane may correspond to the neurochemical receptor. Also, pre-
      and postsynaptic membranes were separated by a wider extracellular gap than those
      of adjacent nonsynaptic regions and electrical synapses or gap junctions.
      Synaptic vesicles were located exclusively at the synaptic regions by means of a
      cytoskeleton that was different for the electrical and the chemical components.
      The vesicles associated with the electrical component were anchored to a
      cytoskeleton composed of a beaded layer of densities located parallel to the
      membrane. This cytoskeleton maintained the synaptic vesicles separated from the
      presynaptic membrane by a distance of 13 +/- 2 nm. The synaptic vesicles
      associated with the chemical component were anchored to electron-dense regions
      formed by filaments arranged in bundles, anchored to the presynaptic membrane.
      Vesicles lined both sides positioned to discharge their contents into the
      extracellular space and to replace the discharged vesicles.

PMID- 2243161
TI  - Failure of the subcallosal sling to develop after embryonic X-irradiation is
      correlated with absence of the cavum septi.
AB  - During embryonic development of the rodent forebrain, a cavity normally appears
      at the midline just below the corpus callosum. This cavity, the cavum septi, is
      present in mice by gestational day 18, but is subsequently obliterated by growth
      of the septal nuclei and neuropil. After x-irradiation of pregnant mice with 125r
      on gestational day 14.5, the cavum septi did not develop. This dramatic
      developmental abnormality was accompanied by delayed fusion of the septum, and a
      reduction in the population of subventricular cells that normally migrate to form
      a sling of cells extending from the medial aspect of the lateral ventricles to
      the midline. In normal animals formation of the cavum septi involves degeneration
      of this subcallosal sling of SV cells. Thus absence of the cavum after x
      irradiation may be due to the premature killing of subventricular cells before
      their migration toward the midline.

PMID- 2243162
TI  - Distribution of lumbar dorsal root fibers in the lower thoracic and lumbosacral
      spinal cord of the rat studied with choleragenoid horseradish peroxidase
      conjugate.
AB  - Spinal cord projections from lumbar dorsal root ganglia (DRGs) were investigated
      in adult rats following injections of choleragenoid horseradish peroxidase (B
      HRP) into each of the six lumbar DRGs. This method is known to label primarily
      thick fibers. Labeling was found in all laminae except in the outer part of
      lamina II. Labeled fibers and terminal-like structures were found 8-13 segments
      rostral and 1-5 segments caudal to the injected DRGs. A somatotopic organization
      was revealed in laminae III, where the labeling seemed to be organized in
      mediolateral zones. Some of these protruded as fingerlike processes through
      segments rostral and caudal to the root entry level. An interdigitating pattern
      for these fingerlike processes was seen between some DRGs, while an extensive
      overlap was found between other DRGs. Many zones were found to correspond to the
      known central projections of peripheral sensory nerves supplied by the injected
      ganglion. This suggests that the central projection of a DRG is highly related to
      the projections of the peripheral nerves included in the DRG. The projections to
      lamina IV were organized in a similar manner as in lamina III, even though the
      projections showed a higher degree of overlap than in lamina III. No clear
      somatotopic organization was found in laminae V-IX. Provided that the
      topographical relationship between central projections of single peripheral
      nerves and of DRGs correspond to their peripheral projections, the results of
      this study, together with results of earlier studies suggest that the outlines of
      dermatomes are highly related to the territories of peripheral nerves included in
      the dermatomes.

PMID- 2243165
TI  - The Indiana pouch: a continent urinary diversion.

PMID- 2243164
TI  - Skin care considerations in the neonate for the ET nurse.

PMID- 2243163
TI  - Ultrastructure of cholinergic synaptic terminals in the thalamic anteroventral,
      ventroposterior, and dorsal lateral geniculate nuclei of the rat.
AB  - The principal relay nuclei of the thalamus receive their cholinergic innervation
      from two midbrain cholinergic groups: the pedunculopontine tegmental nucleus and
      the laterodorsal tegmental nucleus. The different thalamic nuclei exhibit
      populations of cholinergic axons which vary in density and morphology when
      examined at the light microscopic level. However, the ultrastructure of the
      cholinergic terminals in different thalamic nuclei has not been described. This
      study was undertaken to confirm that synaptic contacts are formed by cholinergic
      axons in several principal thalamic relay nuclei, to describe their
      ultrastructural morphology, and to identify the types of postsynaptic elements
      contacted by cholinergic synaptic terminals. The thalamic nuclei examined in this
      study are the dorsal lateral geniculate nucleus, ventroposteromedial nucleus,
      ventroposterolateral nucleus, and anteroventral nucleus. Our results confirm that
      cholinergic axons form synaptic terminals in these thalamic nuclei. Cholinergic
      synaptic terminals contact structures outside the characteristic synaptic
      glomeruli, are never postsynaptic, and have morphologies and postsynaptic targets
      which differ among the thalamic nuclei. In the ventroposterior nuclei,
      cholinergic terminals form asymmetric synaptic contacts onto larger dendrites in
      the extraglomerular neuropil. In the anteroventral nucleus, cholinergic terminals
      form both symmetric and asymmetric synaptic contacts onto dendrites and somata.
      Cholinergic terminals in the anteroventral nucleus are larger than those in other
      nuclei. In the dorsal lateral geniculate nucleus, cholinergic terminals contact
      both somata and dendrites in the extraglomerular neuropil, but the synaptic
      contacts in this nucleus are symmetric in morphology.

PMID- 2243166
TI  - Universal pressure sore precautions.

PMID- 2243167
TI  - A collaborative study: evaluation of a postoperative pouching system.

PMID- 2243168
TI  - Teaching ostomy care to nursing students.

PMID- 2243169
TI  - Stresses produced during application of ostomy pouches.

PMID- 2243170
TI  - Enhanced degradation of carbofuran in Pacific Northwest soils.
AB  - Persistence of 14C-carbonyl carbofuran was measured in Pacific Northwest soils
      that had received 1-14 applications of the insecticide for root weevil control on
      perennial crops. Insecticide decay curves were obtained in nonautoclaved soil and
      several autoclaved soil samples from previously-treated fields and in
      nonautoclaved soils from paired control sites not previously treated with
      carbofuran. The insecticide usually degraded faster in soil from previously
      treated fields than in soil from corresponding control fields. Among 26
      previously-treated fields, the pseudo half-life (time for 50% loss) of carbofuran
      was less than one wk in 11 soils, 1-3 wks in 8 soils and greater than 4 wks in
      the remaining soils. Among the nontreated control fields the pseudo half-life was
      greater than 2 wks in all cases and greater than 15 wks in 5 of the soils. The
      carbofuran decay curve always possessed an initial lag phase where soil mixing
      enhanced insecticide decline. Carbofuran degraded very slowly in autoclaved soil
      samples. The half-life of carbofuran exceeded 16 wk in all autoclaved soils
      tested and in most instances 85-90% of the original dosage remained when the
      tests were terminated 112 days after treatment. These results provided evidence
      that many of the soils which received applications of carbofuran over the past
      several years have developed a capacity to degrade carbofuran very rapidly.

PMID- 2243171
TI  - Sorption mechanism of DDT from aqueous phase.
AB  - Sorption is one among the many techniques available for the removal of organic
      materials from potable water and waste water. Use of locally available Wood
      Charcoal (WC) is essential in place of costly activated charcoal to make the
      process more economical and lucrative. The vital objective of this investigation
      was to assess the performance of WC for the removal of DDT from the aqueous
      phase. The influence of important factors like, particle size, pH, and time of
      contact, which affects the sorption process was studied in this investigation
      using batch experiments. The removal kinetics were carried out under the
      temperature 27 degrees +/- 1 degrees C (room temperature) and the sorption
      kinetics constants were evaluated. Sorption equilibria study has also been
      carried out to develop the Freudlich's sorption isotherm equation from which the
      ultimate sorption capacity of WC for sorption of DDT was calculated.

PMID- 2243172
TI  - Bioaccumulation of endosulfan (Thiodan insecticide) in the tissues of Louisiana
      crayfish, Procambarus clarkii.
AB  - The bioaccumulation potential of endosulfan was determined by constantly exposing
      male and female adult crayfish, Procambarus clarkii to 100 ppb Thiodan
      insecticide for 8 wks. The crayfish were removed at 2 wk intervals and the uptake
      by tissues (whole-body) was determined by electron capture gas-chromatography.
      The same number of pre-exposed crayfish (100 ppb Thiodan) were transferred to
      endosulfan-free water after 8 wks, and insecticide loss (depuration) was
      similarly quantitated. The maximum amount of insecticide and its metabolites
      detected after 8 wks were 197 ppb endosulfan II, 18 ppb endosulfan I and 3 ppb
      endosulfan sulfate. During the first 4 wks of depuration, endosulfan loss from
      cryfish tissues occurred rapidly, and only 3 ppb endosulfan I remained. No
      endosulfan II and sulfate were detected beyond 4 wks. The residues in male vs
      female were not significant statistically. Bioaccumulation factor (BF) for
      endosulfan II for crayfish tissues was 1.97, which is considerably lower than for
      other aquatic invertebrates (26 for scallop, Chlamys opercularis and 600 for
      mussel, Mytilus edulis. The presence of endosulfan sulfate in the tissues cannot
      be considered as 'detoxification' which is as toxic as the parent compound.

PMID- 2243173
TI  - Yielding to age: when the elderly can no longer drive.
AB  - Loss of ability to drive because of declining health is a symbolic and concrete
      representation that the person is no longer capable of performing as he or she
      once did. Grieving the loss of the ability to drive is complex in that driving is
      associated with many interactions, such as freedom, esteem, identity, and
      control. Families may be reluctant to address the ability to drive safely because
      of fear of confrontation and their own grieving at the loss it symbolizes.
      Resolution of the loss of the ability to drive depends on the family's and
      individual's ability to work through the grieving process, concurrent losses,
      cognitive abilities, and the availability of resources.

PMID- 2243174
TI  - Behavior management training for nurse aides: is it effective?
AB  - Nursing assistants are responsible for 80% to 90% of all direct resident care in
      nursing homes, but are the least well trained personnel. Even with currently
      mandated training, specific skills to meet mental health needs are not taught.
      Training in behavior management skills prepares aides to observe and respond to
      problem behaviors more effectively. Aides view their own use of skills as
      increased by this training. To be practically useful, mental health training
      programs for nurse aides should be provided by professional personnel in brief,
      concrete, self-contained units that model the skills they present.

PMID- 2243175
TI  - Essential factors in a community college-nursing home partnership.
AB  - The community college-nursing home partnership has two major objectives: to
      develop nursing potential in long-term care settings and to influence the
      redirection of associate degree nursing education to include active participation
      in long-term care settings. Successful partnerships are built on a commitment to
      high quality education for students and high quality service for patients. Other
      essential factors to a successful partnership include collaborative planning,
      pragmatic goal setting, clear communication, and mutual respect.

PMID- 2243176
TI  - A challenge for nursing: promotion of self-care among the elderly.

PMID- 2243177
TI  - Discovering the secret. Nursing assessment of elderly alcoholics in the home.
AB  - Comprehensive functional assessment of the older alcoholic is needed because of
      the complex needs of the aged. Signs of alcohol abuse may be more obscure for
      older drinkers than for younger age groups. Signs of alcohol abuse are often
      accepted as signs of aging. Older drinkers remain socially isolated more often
      than younger drinkers. Many older alcoholics will eliminate or moderate their
      drinking once they understand how abuse will affect their well-being.

PMID- 2243178
TI  - Nursing home placement: the daughter's perspective.
AB  - The decision for nursing home placement of a parent has been identified as one of
      the most difficult decisions for adult children to make. These decisions are made
      in a family context and are characterized by moral dilemmas. Expressions of loss
      of attachment or bonding, desires to maintain affective roles with parents
      following admission, and hurt avoidance for parents, family, and self appear in
      the decision for nursing home placement and are carried through into the actual
      admission. Knowledge about adult daughter's perceptions surrounding the decision
      for nursing home placement can aid nursing staff in anticipatory socialization
      for daughter and parent. Involvement of daughters in the decision for placement
      and the period immediately after admission could promote family interactions,
      foster trust in building relationships with the staff, and possibly decrease the
      incidence of relocation to other nursing homes.

PMID- 2243179
TI  - Role of breast-feeding in the prevention and treatment of diarrhoea.
AB  - Recent studies have again shown the beneficial effects of breast-feeding in
      preventing morbidity and mortality from diarrhoea in infants. A case-control
      study in Brazil has shown that young infants who are not breast-fed have a 25
      time greater risk of dying of diarrhoea than those who are exclusively breast
      fed. A longitudinal study in the urban slums of Lima, Peru found that exclusively
      breast-fed infants have a reduced risk of diarrhoeal morbidity when compared with
      infants receiving only water in addition to breast-milk. Both these studies,
      along with numerous others in developing countries, point to the need to extend
      the duration of exclusive breast-feeding to at least 4-6 months. A review of
      concerned studies throughout the world shows that even in malnourished women,
      breast-milk output is sufficient to maintain growth of infants up to this age.
      The addition of early food supplements to infants fed under prevailing
      environmental conditions in developing countries leads to their increased
      diarrhoeal attacks and associated reduced food intake. This results in worsened
      nutritional status of the affected infants. Breast-feeding helps maintain
      hydration status during diarrhoeal episodes. Studies in Peru, India, and Nigeria
      have shown that breast-feeding can be continued during diarrhoea when the infants
      often refuse other foods, specially non-human milk. Thus, breast-feeding is
      important in providing necessary calories and protein during a time when a loss
      of appetite for other foods is common. Diarrhoeal disease control programmes need
      to modify service delivery to ensure that breast-feeding mothers are not
      separated from their infants while being treated with oral rehydration therapy
      (ORT) as inpatients or outpatients. Oral rehydration solution (ORS) should be
      given to infants with cup and spoon rather than bottles, in order not to
      interfere with suckling. When in a health system bottles are used for treatment,
      an implicit credibility is given to their role in modern treatment. Programmes
      also need to include breast-feeding promotion as a part of their activities. This
      should comprise hospital practices supporting and ensuring breast-feeding
      immediately after delivery of the infants and subsequently while they are treated
      in the hospital: immediate breast-feeding after delivery; Mothers and infants
      rooming together; On demand breast-feeding; No bottle feedings of water or infant
      formula; No pre-lacteal feeds. In addition, health professionals need to
      understand the skills for the management of breast-feeding, so that mothers are
      given appropriate advice on how to breast-feed and counteract breast-feeding
      problems.

PMID- 2243181
TI  - Rotavirus infection in children hospitalised with diarrhoea in Sri Lanka.
AB  - Seasonal and clinical aspects of rotavirus-associated diarrhoea in 98 of the 326
      children hospitalised for diarrhoea are described. Rotavirus infection was
      detected (30% overall) throughout the year from May 1980 to April 1981, but the
      prevalence was higher during the rainy season (40-50%). The age group in which
      rotavirus was detected most frequently was from 4 months to 2 years (34.6%).
      Watery diarrhoea and vomiting were significantly commoner in children with
      rotavirus diarrhoea (75% and 71% respectively) than those with non-rotavirus
      diarrhoea (54.2% and 60.8% respectively; p less than 0.05). Although about 15% of
      the children with rotavirus-associated diarrhoea showed blood or mucus in stools,
      the invasive nature of rotavirus infection cannot be drawn since the study did
      not include tests to detect other diarrhoeal pathogens.

PMID- 2243180
TI  - Comparison of latex agglutination test with an ELISA to diagnose rotavirus
      associated diarrhoea in infants and young children.
AB  - An agglutination (LA) test, using latex beads sensitised with anti-rotavirus
      immunoglobulin G, was evaluated to detect human rotavirus in 200 stool specimens
      by comparing its results with those of an ELISA (Rotazyme, Abbott Laboratory,
      Diagnostic Div., North Chicago, IL). The specimens were collected from a
      systematic sample of 200 infants and pre-school children attending the Diarrhoeal
      Disease Research and Rehydration Centre at the Bab-El-Sha'reya University
      Hospital, Egypt. Of the 200 stool specimens tested, 79 were positive by the ELISA
      and 68 were positive by the LA test. Taking the ELISA as the standard, the LA
      test showed 11 false-negative and six false-positives giving a sensitivity and
      specificity of 86% and 95% respectively. Using 48 stool specimens positive for
      rotavirus by both the tests, the degree of positivity of the LA test roughly
      showed a linear relationship with the degree of rotazyme optical density. Thus,
      the simple and inexpensive LA test may be useful as a screening procedure to
      detect rotaviruses in the stools of children with diarrhoea.

PMID- 2243182
TI  - A cholera outbreak associated with eating uncooked pork in Thailand.
AB  - In a village near Chiangmai, Thailand, during October 1987, there was an outbreak
      of cholera following a funeral in which 264 attendants were served food. The
      present article is a report of an epidemiological study performed to identify the
      source of infection and the mode of its transmission. All the attendants were
      screened for infection by bacteriological examination of their rectal swabs and
      were kept under diarrhoeal surveillance. Of them, 20 patients and 40 matched
      controls were interviewed about the details of their eating foods served at the
      funeral. Vibrio cholerae 01, Inaba, El Tor was detected from 24 persons (9.1%),
      15 of whom suffered from mild diarrhoea and the rest 9 had inapparent infections.
      There was no death. Except one butcher whose rectal swab was positive for the
      same strain of V. cholerae, 3 other butchers and 4 women who had prepared food
      were free from the infection. Food remnants were not available for culture. The
      water used for cooking and the water from the cement well used for slaughter were
      negative for the organism. The only significant association (p less than .01,
      odds ratio = 15) was found between an attack of cholera and eating laebmoo--an
      uncooked pork preparation with Thai spices and chili. The transmission of cholera
      appeared to have occurred through eating the uncooked pork presumably due to its
      contamination with V. cholerae shed by the infected butcher. He was known to have
      earlier visits to Chiangmai where cholera epidemic was going on.

PMID- 2243183
TI  - An outbreak of food poisoning due to Salmonella typhimurium in the People's
      Republic of China.

PMID- 2243184
TI  - Multi-drug-resistant Shigella infections in Fujian Province, China.

PMID- 2243185
TI  - [Experiments of contamination with bacteria while transfusion between the newly
      developed porous polymer plug and by air needle plug].
AB  - We newly developed a transfusion plug that has an air passage of polymer porous
      material (I Cap). This porous polymer material theoretical does not pass the
      infectious microorganisms. We experimented contaminations during the transfusions
      by I Cap and that using air needles. Trypticated soy broth was used for the
      experiments. Experiments of transfusion in a dusty environment revealed that the
      transfusions by air needles got 100% contamination and that by I Cap was 0%. The
      experiments in a clinic room transfusions also revealed that air needle resulted
      in 30.3% contamination but on the contrary 0% with the I Cap. Dusty air was flown
      under high pressure (1.5 atmospheric pressure) through the same filter of I Cap
      for 30 minutes into the trypticated soy broth. These experiments revealed that
      the filter did not permeate bacteria and that transfusions with air needle was
      contaminated with dust.

PMID- 2243186
TI  - [A case of Legionnaires' disease, the first case in Hokkaido Prefecture--an
      experience of isolation of Legionella pneumophila and identification by indirect
      immunofluorescence antibody method].
AB  - Although 18 cases of Legionnaires' disease have been reported in Japan, these
      have included none from the northern areas of Japan. The first confirmed case of
      Legionnaires' disease in Hokkaido district, a northern island of Japan, is
      reported. A 48 year-old male was admitted for fulminant pneumonia, and died the
      next day. Legionella pneumophila, serogroup 1, was cultured and determined from
      the sputum and lung tissue obtained at autopsy. Postmortem examination by means
      of the indirect immunofluorescent method, using group specific antisera against
      Legionella pneumophila as a primary antibody, revealed phagocytized bacilli in
      the alveoli of the lung.

PMID- 2243187
TI  - [Comparison between two systems for assaying the level of antibody against
      Streptococcus agalactiae (GBS) type III].
AB  - Levels of antibody against GBS type III in pregnant women have been determined
      using ELISA assay method that we originally deviced. Toyo Jozo Co. have also
      introduced an assay system (the Toyo kit) that resembles ours. The present study
      was performed to compare our system with the Toyo kit. Correctivity between the
      two systems was good, giving a regression curve of Y = 1.18X - 0.60 and a
      correlation coefficient of r = 0.794. Antibody levels in pregnant women were
      determined by the Toyo kit, and were found to be less than 10 micrograms/ml in
      almost all samples. Among 19 serum samples from vaginal carriers of GBS type III,
      the antibody levels ranged from 1.5 to 93.8 micrograms/ml. Among seven maternal
      serum samples in cases of GBS type III infection, the maximum level was 6.0
      micrograms/ml. Thus, the Toyo kit showed satisfactory sensitivity for determining
      the level of antibody against GBS type III. Hereafter, we intend to use the Toyo
      kit for determining antibody levels in pregnant women.

PMID- 2243188
TI  - [Investigation of Chlamydia trachomatis pneumonia in children].
AB  - A neonatal pneumonia caused by Chlamydia trachomatis (C. trachomatis) is well
      known. But it is uncertain whether C. trachomatis causes pneumonia in a patient
      over 1 year of age. Therefore, a search for serologic and cultural evidence of C.
      trachomatis infection in patients suffering from acute pneumonia over 1 year of
      age was made. We studied 183 children ages 1 to 5 year-old suffering from acute
      pneumonia admitted to Kousei General Hospital to assess the relation between
      acute pneumonia and C. trachomatis. We investigated the serologic evidence of
      acute C. trachomatis infections in 73 children with a persistent cough and
      wheezing, detecting specific IgG antibodies and IgM antibodies by
      microimmunofluorescence test. Serologic results signifying acute infection were
      observed in 4 cases (2.2%). Then we tried to isolate C. trachomatis from the
      cultures of nasopharyngeal swabs, specific inclusion bodies of C. trachomatis in
      2 cases (1.1%) were found. Our study suggests that C. trachomatis might cause
      pneumonia in children over 1 year of age.

PMID- 2243189
TI  - [Studies on relationships between the inhibition of human neutrophil NADPH
      oxidase by anti-inflammatory drugs and development of bacterial infections].
AB  - The effects of anti-inflammatory drugs (acetylsalicylic acid, ASA; salicylic
      acid, SA; indomethacin, IM; hydrocortisone, HC) on the respiratory burst oxidase
      (NADPH oxidase) from human neutrophils in both whole cell and fully soluble (cell
      free) systems were investigated. These drugs were found to inhibit the superoxide
      generation by human neutrophils exposed to phorbol myristate acetate in a whole
      cell system and the activation of superoxide-generating NADPH oxidase by sodium
      dodecyl sulfate in cell-free systems. Concentrations of these drugs required for
      50% inhibition of the oxidase (ID50) were; ASA (more than 3.0 mM in the whole
      cell system and 1.35 mM in the cell-free system), SA (more than 3.0 mM in the
      whole cell system and 1.30 mM in the cell-free system), IM (180 microM in both
      systems) and HC (50 microM in the whole cell system and 40 microM in the cell
      free system). In addition, these drugs time-dependently inhibited the activation
      of NADPH oxidase in cell-free systems. In the cell-free system, all of the drugs
      did not change the Km values for NADPH of the oxidase. These results suggest that
      these anti-inflammatory drugs, especially HC and IM, inhibit the reconstitution
      (activation) of neutrophil NADPH oxidase enzyme in the cell-free (whole cell)
      system.

PMID- 2243190
TI  - [Clinical studies on mycosis especially deep-seated candidiasis in blood disorder
      patients].
AB  - Deep-seated mycosis is prominently increasing as a terminal infection in
      compromised hosts with malignant blood disorders or malignant tumors. Moreover,
      localized candidal abscess of visual organs has recently been reported in several
      laboratories. We investigated the occurrence of deep-seated mycosis in 105
      autopsied cases with blood disorders in our clinic from 1980 to 1987. Forty-four
      of those cases had died of various infections, and 80% of them were fungal
      infections. More than half of the fungal infections were aspergillosis. Deep
      seated candidiasis was recognized in 10 cases, 6 of which were systemic
      candidiasis, the average duration of neutropenia below 500/mm3 was 19.7 days that
      of lymphopenia was 36.5 days. Two cases were complicated with GI-tract ulcer, and
      involved with hepatic candidiasis. On the other hand, in the 4 cases of localized
      candidial abscess, the duration of neutropenia was 58.5 days and that of
      lymphopenia was 28.8 days. These four cases were complicated with GI-tract ulcer.
      Histologically, Candida spp. were recognized at the bottom of the ulcer and
      invasion by inflammatory cells or tumor cells was found in the portal vein. We
      surmised that GI-tract ulceration is a very important complication of hepatic
      candidiasis or liver abscess, and the occurrence of localized candidiasis seems
      to depend on the duration and severity of neutropenia.

PMID- 2243191
TI  - [Human respiratory tract infection by Pasteurella multocida subsp. multocida
      presumably derived from the cat].
AB  - Pasteurella multocida is a Gram-negative short rod-shaped bacteria that has been
      recognized as a pathogen of hemorrhagic septicemia and fowl cholera in the
      veterinary medicine. Infections by this microorganism as seen in the foreign
      literature vary widely from local infections due to bites and scratches by
      animals to general infections such as infections of the respiratory tract,
      sepsis, and meningitis. In Japan, reported cases of P. multocida infections are
      predominantly local infections, followed by respiratory infection. Recently,
      death of diabetic patients due to septicemia by this pathogen has also been
      reported. In this study, we experienced a case of respiratory tract infection in
      which the pathogen P. multocida subsp. multocida was suggested to have been
      transmitted from a pet cat by the agreement of the serotype of the bacterial
      isolates between the patient and the cat. This case was evaluated from the
      zoonotic viewpoint. The patient was a 68-year-old male who had been followed up
      since 1982 with a diagnosis of bronchiectasis. After his referral to our
      hospital, P. multocida subsp. multocida was isolated from his bloody sputum and,
      then, from the cat kept by the patient. The tow isolates were identical in terms
      of the biochemical properties, drug susceptibility profile, and serotype (-:1),
      and the derivation of P. multocida subsp. multocida infection from cat was
      established for the first time in this report. The incidence of P. multocida
      infections is increasing in Japan, and particular attention is considered to be
      needed about these conditions as zoonoses as indicated in "Preventive Measures
      against Zoonoses Derived from Pet Animals (Dog, Cat)", an official communication
      from the Ministry of Health and Welfare to related institutions in 1989. Also, to
      check whether the patient keeps any pet at the clinical inquiry is a practice of
      bacteriological importance in all fields of medicine.

PMID- 2243192
TI  - Maternally derived antibodies to Japanese encephalitis virus in cattle.
AB  - Serum samples were collected from 55 pairs of calves that had not passed the
      first summer and their dams reared in Kagoshima from 1983 through 1985. They were
      investigated for the HI antibody to Japanese encephalitis virus (JEV) in calves
      and for the correlation of antibody levels between calves and their dams. The
      maternally derived antibody was detected in 35 of 55 calves (63.6%), showing the
      mean antibody titer of 12.4. A significant negative correlation (p less than
      0.01) was noted between the age of calve and titer of passively acquired
      antibodies. The regression equation suggested that the maternal antibody
      disappeared from the calf serum at about 3 months of age. On the other hand, 37
      of 55 dams (67.3%) were positive for HI antibody to JEV, and the mean titer of
      the antibody was 12.7. There was a significant correlation (p less than 0.01) in
      serum antibody titers between dams and their calves.

PMID- 2243194
TI  - [Studies on respiratory infections in primary care clinic (IV). Antibiotic
      sensitivity of bacteria isolated from patients with respiratory infections
      visiting 21 private clinics in the Tohoku District of Japan].
AB  - We determined the MICs of ampicillin, methicillin, cefaclor, cefixime, cefteram,
      ofloxacin and ciprofloxacin against a total of 1,448 strains from 11 species: 464
      strains of Staphylococcus aureus, 306 strains of Streptococcus pneumoniae, 114
      strains of Streptococcus pyogenes, 37 strains of Branhamella catarrhalis, 329
      strains of Haemophilus influenzae, 32 strains of Escherichia coli, 66 strains of
      Klebsiella pneumoniae, 26 strains of Enterobacter cloacae, 20 strains of Serratia
      marcescens, 12 strains of Pseudomonas aeruginosa and 42 strains of Acinetobacter
      calcoaceticus, isolated from the throat swab and the sputum of 2,539 patients
      with respiratory infections who visited 21 private clinics in Tohoku district of
      Japan during the period from January to April in 1989. Ciprofloxacin and
      ofloxacin were more active against S. aureus, B. catarrhalis, P. aeruginosa and
      A. calcoaceticus than other antibiotics. Ampicillin and cefteram were more active
      against S. pneumoniae and S. pyogenes than other antibiotics. New-quinolones and
      cephems of new-generation were active against H. influenzae, E. coli, K.
      pneumoniae, E. cloacae and S. marcescens. Of 30 strains of S. aureus which were
      resistant (MIC greater than or equal to 12.5 micrograms/ml) to ampicillin, only
      one strain was resistant (MIC greater than or equal to 12.5 micrograms/ml) to
      methicillin. Twenty strains (6.5%) of S. pneumoniae and 49 strains (14.9%) of H.
      influenzae were resistant (MIC greater than or equal to 1.56 micrograms/ml) to
      ampicillin. Of 101 strains of H. influenzae of which their beta-lactamase
      activity was determined by Nitrocephin-method, 27 (26.7%) were beta-lactamase
      positive strains. The above results indicated that MRSA is only rarely found in
      primary care clinics but the incidence of ampicillin-resistant H. influenzae in
      primary care clinics is almost the same as that of the intensive care clinic,
      i.e. medical school-affiliated hospitals. Therefore caution should be exercised
      as regards antibiotic resistance of the causative organism even in primary care
      clinics.

PMID- 2243193
TI  - [Studies on respiratory infections in primary care clinic (III). Distribution of
      bacteria isolated from patients with respiratory infections visiting 21 private
      clinics in the Tohoku District of Japan].
AB  - The bacteriology of the isolates from the throat swab and the sputum respectively
      of 2,539 patients with respiratory infections visiting 21 private clinics in
      Tohoku district of Japan during the period from January to April in 1989 was
      documented. Of the 2,539 patients, 1,694 had an acute upper respiratory
      infection, 609 had acute bronchitis, 46 had acute pneumonia, 84 had acute
      exacerbation of chronic respiratory infections and 106 had respiratory infections
      without diagnosis registered. 1887 (74.3%) strains of potential pathogens were
      recovered from 1507 (59.4%) of the 2539 cases. The rate of recovery of potential
      pathogens was very high in patients of the younger age. These patients had
      elevated body-temperature. There were statistically significant differences in
      recovery rate when classified by diagnosis, prefecture and the period of
      investigation. Of the 1,887 strains, 996 (52.8%) were gram-positive and 891
      (47.2%) were gram-negative bacteria. The rate of recovery of gram-negative
      bacteria was high in patients who were less than 10 years old and more than 51
      years old, in patients with pneumonia and chronic respiratory infections, and in
      patients with fever. Of the 1,887 strains, those which exceeded 100 were
      Staphylococcus aureus (481 strains), Haemophilus influenzae (340 strains),
      Streptococcus pneumoniae (329 strains), Streptococcus pyogenes (117 strains) and
      Acinetobacter spp. (100 strains). Species other than those mentioned above had
      less than 100 strains. In this group there were 39 strains of Branhamella
      catarrhalis, 32 strains of Escherichia coli, 97 strains of Klebsiella spp., 40
      strains of Enterobacter spp., 25 strains of Serratia spp., 12 strains of
      Pseudomonas aeruginosa and 43 strains of Pseudomonas putida. There was a
      remarkable difference in recovery rate of each species when classified by
      diagnosis, age class, prefecture and the period of investigation, respectively.
      The above results indicated that gram-positive bacteria are more frequent than
      gram-negative bacteria, that enterobacteriaceae and glucose-non-fermentative gram
      negative bacteria are only rarely found in primary care clinics, and that the
      bacteriology in primary care clinic is different from that of medical school
      affiliated hospitals.

PMID- 2243196
TI  - [Two cases of psittacosis accompanied with rhabdomyolysis].
AB  - We experienced two cases of atypical pneumonia accompanied with rhabdomyolysis
      and diagnosed them as psittacosis based on the results of investigation of paired
      serum samples. Rhabdomyolysis may be associated with some kinds of viral or
      bacterial infections, but no report was found in the case of psittacosis as far
      as we searched and such a description was not found in textbooks. Heretofore, the
      elevation of GOT and LDH as the laboratory findings in psittacosis was considered
      as the reflection of liver injury, but that might be brought about by
      rhabdomyolysis. Although the mechanism(s) of the occurrence of rhabdomyolysis in
      psittacosis is unknown, when the elevation of muscular origin-enzymes including
      CPK is recognized in cases of atypical pneumonia, it may be the clue of diagnosis
      of psittacosis.

PMID- 2243195
TI  - [Type-specific antibody to type Ia, Ib, II and III group B Streptococcus in
      maternal and neonatal sera measured by ELISA].
AB  - In order to determine the type-specific antibody to group B streptococcus (GBA)
      type Ia, Ib, II and III, the ELISA system was established in Research
      laboratories, Toyo Jozo Co., Ltd. We assayed type-specific antibody by this ELISA
      system in both maternal and neonatal (or cord) sera. The cut off levels were
      determined by the antibody levels of maternal and neonatal sera of 26 infected
      cases and 90 GBS carriers, that type Ia, Ib, II were 0.20 and type III was 0.15.
      Prevalence of type-specific antibody levels were studied in 356 maternal sera (14
      affected cases, 100 GBS carriers and 242 non carriers). Antibody levels were
      positive in 47.2% of maternal sera to type Ia, 34.0% to type Ib, 46.9% to type II
      and 45.5% to type III. Antibody levels to type Ia, Ib, II and III were positive,
      respectively, in 100%, 88.2%, 25.0% and 42.9% of the sera of carrier mothers
      whose infants were not affected. Antibody levels in 50 pair sera of maternal and
      cord blood were well correlated.

PMID- 2243197
TI  - [Biological significance of alternative translation].

PMID- 2243198
TI  - [Anabolic roles of peroxisomes].

PMID- 2243199
TI  - [Ganglioside as a potential immune modulator: selective CD4-modulation and
      inhibition of human immunodeficiency virus infection].

PMID- 2243200
TI  - [Adult T-cell leukemia derived factor/human thioredoxin (ADF/hTx)].

PMID- 2243201
TI  - Lesions of the petrous apex.
AB  - While lesions of the petrous apex are uncommon, they may present significant
      morbidity to the patient. The symptoms elicited by these lesions are usually
      vague and nonlocalizing in the early stages but progress to include multiple
      cranial neuropathies. Early diagnosis requires a high index of suspicion and use
      of appropriate imaging modalities. Thorough preoperative assessment with use of
      CT, MRI, and carotid arteriography is essential to plan the optimal surgical
      approach. Previously considered inaccessible, technical advances in skull base
      surgery have made this region more approachable.

PMID- 2243202
TI  - Psychiatry in the 1990s.

PMID- 2243203
TI  - Obsessive compulsive patients: familial frustration and criticism.
AB  - Familial factors such as attitudes toward illness, knowledge of disease process,
      and criticism of patients often play an important role in patient compliance and
      outcome in general medical practice as well as in psychiatric settings. As part
      of the initial assessment in a psychoeducational group for obsessive compulsive
      disorder patients and their significant others, nonpatients completed the
      Relative's Reactions Questionnaire and the Control of Symptoms Schedule. The
      patients completed the Perceived Criticism Measure. Results suggest that
      significant others experience frustration with the symptomatic behavior of their
      friend or family member with obsessive compulsive disorder and may respond too
      frequently with verbal criticism. The patients themselves reported a moderately
      high level of criticism from significant others at home. Further research is
      needed on a larger sample size and with nonpsychiatric and nonobsessive
      compulsive disorder psychiatric controls.

PMID- 2243204
TI  - Psychiatric disorders in the medically ill.
AB  - Psychiatric disorders commonly coexist in patients with medical illness. Three
      disorders encountered frequently are anxiety disorders, depression, and delirium.
      The authors discuss these psychiatric disorders and their treatment in medically
      ill patients. Psychiatric consultation may be helpful in such cases.

PMID- 2243205
TI  - Premenstrual syndromes.
AB  - Premenstrual Syndrome and Late Luteal Phase Dysphoric Disorder are two commonly
      cited premenstrual syndromes. Some of the problems in research include
      prospective vs retrospective rating scales, lack of confirmation of treatment
      response by double-blind studies, and a large placebo response. Treatment is
      still largely empiric. Many patients who present with premenstrual complaints may
      benefit from psychiatric referral.

PMID- 2243206
TI  - Reflections on malpractice liability.

PMID- 2243207
TI  - ECG of the month. Horns of a dilemma. Normal electrocardiogram.

PMID- 2243209
TI  - Radiographic demarcation of the acetabular bone-cement interface. The effect of
      femoral head size.
AB  - Between 1983 and 1988, 182 total hip arthroplasties were inserted using modern
      cement techniques including metal-backed acetabular components. Femoral head size
      was 32 mm in 84, 22 mm in 98. Radiographic analysis revealed three-zone
      demarcation of acetabular bone-cement interface in 56% of the 32 mm group as
      compared to 5% of the 22 mm group at 19 and 24 months mean follow-up period,
      respectively. When a subgroup of women under 60 years of age was created to
      control variables, the high-grade demarcation rates were 67% and 18%,
      respectively. Although Charnley hip scores remain similar between the two groups,
      these results emphasize the adverse effects of large femoral head prostheses on
      cement-bone interface and underline the need for alternative methods of fixation.

PMID- 2243208
TI  - Rapid recovery in mice after combined nasal/oral immunization with killed
      respiratory syncytial virus.
AB  - Based on the concept of a common mucosal immune system, the murine
      gastrointestinal tract was inoculated (oral) with three doses (5, 20, and 40
      micrograms) of UV-inactivated respiratory syncytial virus (RSV) in order to
      elicit a virus-specific immune response in the respiratory tract. Only the 40
      micrograms dose induced significant (P less than 0.01) anti-RSV-IgG rises in
      serum and lung wash compared to controls. To improve the immune response, mice
      were immunized intranasally under light anesthesia with the same 40 micrograms
      dosage regimen of killed RSV so that each dose passed through the nose and was
      swallowed. This combined nasal/oral immunization stimulated anti-RSV-IgG in
      serum, lung wash and nasal wash (P less than 0.001) and anti-RSV-IgA in lung and
      nasal wash (P less than 0.001) that were comparable to levels after infection
      with live RSV. Three days after challenge with live RSV, mice given combined
      nasal/oral immunization showed suppressed nasal virus shedding (P = 0.025). Nasal
      virus shedding correlated inversely with concentrations of anti-RSV-Ig in nasal
      secretions but did not correlate with concentrations in serum.

PMID- 2243210
TI  - Tc-99m-MDP scintigraphy not informative in painful total hip arthroplasty.
AB  - In 61 painful cemented total hip arthroplasties the diagnostic specificity was
      0.7 for plain radiography and 0.46 for scintigraphy. The diagnostic sensitivity
      was 0.97 for radiography and 0.77 for scintigraphy. False negative radiology
      occurred in 0.05 and false positive in 0.23. False negative scintigraphy was
      encountered in 0.27 and false positive in 0.49. Seven of thirty-nine hips were
      operatively explored because of false positive scintigraphy. In conclusion, Tc
      99m-MDP scintigraphy could not used as a complementary diagnostic measure in our
      hands.

PMID- 2243211
TI  - An analysis of screw fixation of the femoral component in cementless hip
      arthroplasty.
AB  - A cementless hip stem that allows screw fixation of the collar to cortical bone
      in the calcar region was found to achieve enhanced rotational stability when
      implanted in preserved cadaveric human femora. Although the implants with screws
      showed less tendency for subsidence than the implants without screws, rotational
      micromotion was not found to be statistically different under light loading
      conditions. When implanted in composite bone, the addition of screws in the
      configuration tested was associated with significant metal-on-metal wear during
      combined compression and rotational cyclic loading. This finding is of concern
      due to potential wear particle toxicity and possible lowered fatigue life of the
      prosthesis. Therefore, specific design changes are recommended.

PMID- 2243212
TI  - A comparative study of closed-wound suction drainage vs. no drainage in total hip
      arthroplasty.
AB  - One hundred consecutive primary total hip arthroplasties performed by the same
      surgeon over 4 years were retrospectively reviewed. In the first 50, closed
      suction drains were used; the following 50 were not drained. Comparison between
      the two groups revealed no statistically significant differences in wound
      problems, postoperative pyrexias, or other short-term complications. No wound
      infections occurred. A mean of 2.6 units of blood per patient was transfused to
      the nondrained group. In the drained group, a mean of 3.4 units of blood per
      patient was transfused. This difference was not statistically significant. The
      mean postoperative fall in haemoglobin concentration was 2.4 g/dl in the
      nondrained group, and 1.9 g/dl in the drained group. This difference was not
      statistically significant. This study demonstrated no advantage to the use of
      suction drains in uncomplicated total hip arthroplasty, and perhaps their routine
      use should be questioned.

PMID- 2243213
TI  - Allograft-implant composite reconstruction following periacetabular sarcoma
      resection.
AB  - Ten patients with primary periacetabular sarcomas were treated with internal
      hemipelvectomy and allograft-implant composite reconstruction. Three patients
      developed local recurrences, one of which was salvaged with repeat resection. One
      patient underwent hemipelvectomy for infected wound recurrence. At a mean follow
      up period of 25 months (range, 7-85 months; median, 18 months), six of nine
      patients assessed with the Musculoskeletal Tumor Society functional assessment
      had satisfactory results, with scores of 21 or better (of a possible 35).
      Although complications were frequent and functional scores were often limited by
      the muscle resection required for adequate tumor removal, we remain cautiously
      optimistic about the early results of this procedure.

PMID- 2243214
TI  - Interlocking femoral components for revision arthroplasty with allografts.
AB  - The use of interlocking screws has been advocated to fix major proximal femoral
      allografts to femoral prostheses. This study examines the effect of interlocking
      screws on strength of the component. Model femoral components were tested in
      axial compression. Drilling one hole diagonally (lateral to medial), drilling one
      hole anterior to posterior, or drilling one diagonal hole plus one anterior-to
      posterior hole did not significantly decrease failure load compared to controls
      with no holes. However, two diagonal holes or horizontal, medial-to-lateral holes
      were weaker. Four cases have been done with proximal femoral allografts fixed to
      porous-coated femoral components with proximal and distal interlocking screws.
      Initial results in these cases are good.

PMID- 2243216
TI  - The effect of retention of the femoral neck and of cement upon the stability of a
      proximal femoral prosthesis.
AB  - Radiological measurements of downward femoral component migration are reported
      for 203 hips in the first 2 years following total hip arthroplasty. The femora
      differed with respect to the retention of the femoral neck--in 167 it was
      retained and in 36 it was damaged--and to the use of cement--142 hips were press
      fits and 61 were cemented. Multivariate analysis demonstrated that both retention
      of the neck and the use of cement retarded migration (ie, increased stability) of
      the femoral component (P = .0003 and .0037, respectively).

PMID- 2243215
TI  - Revision of aggressive granulomatous lesions in hip arthroplasty.
AB  - Fourteen patients had revision arthroplasty for aggressive granulomatosis in 16
      previously replaced cemented total hips. The revision was performed on average 8
      years (range, 6-13 years) after the primary arthroplasty. Twelve patients had
      multifocal granulomatous lesions. Pain was the first clinical sign of the
      aggressive granulomatosis, beginning on average 1.7 years (range, 0.8-3.8 years)
      after the primary operation. One patient had a fracture of the femur due to large
      granulomas while waiting for revision. The patients were under follow-up
      evaluation for an average of 5.4 years (range, 4-7 years) after revision. Two
      patients had recurrence of aggressive granulomatosis at the original sites 4.5
      and 6.5 years after revision. Eleven patients had good or excellent results of
      revision.

PMID- 2243217
TI  - Injury to the external iliac artery during hip arthroplasty for old central
      dislocation.
AB  - Injury to a major vessel is an uncommon but well recognized and serious
      complication of total hip arthroplasty. An increased risk of such injury has been
      reported in rheumatoid patients, in revision surgery, and with the injudicious
      use of particular instruments, especially the sharp Hohmann retractor. The
      authors report the case of a patient who sustained a laceration to his external
      iliac artery during the course of a hip arthroplasty for osteoarthritis secondary
      to old central dislocation. The cause of the injury is discussed and the relevant
      literature reviewed.

PMID- 2243218
TI  - A posterior approach to the hip joint with complete posterior capsular and
      muscular repair.
AB  - A posterior approach to the hip is described, which preserves the posterior hip
      capsule and short external rotators. These structures are reflected during
      exposure and are securely repaired to bone as a single capsulomuscular flap
      during wound closure. This approach has been used exclusively since December 1986
      for uncomplicated primary hip arthroplasty. In 259 consecutive cases, there have
      been only two dislocations, both associated with significant trauma.

PMID- 2243219
TI  - The effect of a metal-back without a stem upon the fixation of a tibial
      prosthesis.
AB  - Three methods of tibial component fixation without cement (as part of TKA) have
      been used at the London Hospital. All three methods have used the same
      polyethylene component fixed with two HDP (Day) pegs. A metal-back without a stem
      was added to the HDP in group 1. Group 2 consisted of an HDP-only component. In
      group 3 a stem was added to the metal-back used in group 1. Radiological
      comparison showed the fixation of the polyethylene component with metal back but
      no stem to be inadequate; the component tilted into varus more frequently than
      the other configurations. It is suggested that failure was due to the increased
      rigidity of the metal-backed component (as compared with the HDP only) and that
      the rigidity (and the resultant tendency to rock) can be offset by a stem. It is
      concluded that rigid (ie, metallic) tibial components should have a stem.

PMID- 2243220
TI  - Revision surgery for stiff total knee arthroplasty.
AB  - Thirteen stiff total knee arthroplasties were studied in 12 patients who did not
      have a stiff knee prior to the index arthroplasty. The reasons for replacement
      were osteoarthritis in seven knees, post-traumatic arthritis in two, and
      inflammatory collagen disease in four. Four knees were revised for fixed flexion
      deformity and nine for poor arc of motion. The cause of stiffness in eight knees
      was malpositioned components. Following postoperative revision for stiffness,
      three knees received excellent ratings, two received good ratings, four received
      fair ratings, and four received poor ratings. Satisfaction was achieved in 11 of
      12 patients because of pain relief. Improved motion was achieved in patients with
      primary osteoarthritis and patients with malposition of components. Poor motion
      occurred in those with patella baja and inflammatory collagen disease. A V-Y
      patella turndown helped prevent patella ligament complications.

PMID- 2243221
TI  - Revision of a loose glenoid component facilitated by a modular humeral component.
      A technical note.
AB  - Revision of a glenoid component can be difficult in the presence of a humeral
      component. Removal of the humeral component is generally required, which adds
      significantly to the difficulty of the procedure and increases the risk of
      complications. This report describes revision of a loose glenoid component that
      was greatly facilitated by the presence of a modular humeral component.

PMID- 2243222
TI  - Capitello-Condylar total elbow arthroplasty for rheumatoid arthritis.
AB  - Twenty-one total elbow arthroplasties using the Capitello-Condylar design of
      Ewald were performed at the Denver Orthopedic Clinic from 1977 to 1986.
      Indications for operation included intractable pain unrelieved by medical therapy
      as well as late state III or IV rheumatoid arthritis. The average total elbow
      score at 48 months after operation was 89.5 points, including excellent pain and
      function ratings. Modest gains in motion occurred with lesser gains in patients
      with juvenile rheumatoid arthritis than those of the adult variety. Forty percent
      of the elbows suffered some type of complication although most are successfully
      manageable. There was one clinical failure due to deep infection in a renal
      deficient patient.

PMID- 2243224
TI  - The spontaneous spinal epidural hematoma. A study of the etiology.
AB  - From the literature 199 cases of spontaneous spinal epidural hematoma (SSEH) are
      analyzed. With these data and the vascular anatomical characteristics of the
      spinal epidural space, the theories on the etiology of the SSEH are discussed.
      There seems to be no relationship between the SSEH and arterial hypertension. The
      age highly affects the level-distribution of the SSEH. The authors have the
      opinion that the posterior internal vertebral venous plexus plays an important
      part in the etiology of the SSEH. In the literature the role of a vascular
      anomaly in the etiology of the SSEH is overestimated. The cluster-type dural
      artery can easily be mistaken for a vascular anomaly.

PMID- 2243223
TI  - Utilization and effectiveness of autologous blood donation for arthroplastic
      surgery.
AB  - Autologous blood predeposit before elective surgery is a rapidly expanding
      transfusion practice. The authors have conducted a 3-year analysis of an
      autologous blood predeposit program to assess its impact on orthopaedic joint
      surgery. The authors conclude: autologous blood donation has resulted in a
      reduction of homologous blood transfusions in patients undergoing elective hip
      and knee procedures from 73% to 18% and from 71% to 12%, respectively. In
      addition, autologous blood preoperative donation in elective orthopaedic joint
      surgery has increased dramatically, so that while previously this practice was
      considered underutilized, autologous blood as an alternative to homologous blood
      transfusion now represents a standard of practice for elective orthopaedic joint
      arthroplasty at University Hospitals of Cleveland.

PMID- 2243225
TI  - Proteolytic enzyme activities during regeneration of the rat gastrocnemius
      muscle.
AB  - The enzymatic activity of creatine phosphokinase and the lysosomal enzymes
      cathepsin D and acid phosphatase was followed during skeletal muscle regeneration
      after partial excision to the gastrocnemius muscle in the rat. For each time
      interval (1, 2, 5, 14 and 45 days) following injury, the activity of the
      regenerated muscle was compared with the activity in the contralateral sham
      operated muscle. The specific activity of creatine phosphokinase of the
      regenerated muscle showed a significant decrease (25%) during the first 2 days
      post injury and thereafter was comparable to that of the uninjured control
      muscle. The activity of cathepsin D was 2.3-4-fold significantly higher in the
      regenerated muscle than in the control intact muscle from day 1 until day 14 post
      injury. At 45 days after partial excision, the activity of this enzyme was
      comparable to a normal muscle. However, the activity of another lysosomal enzyme
      (acid phosphatase) did not show any distinct changes from the level of this
      enzyme in the uninjured muscle during the course of muscle regeneration. It is
      suggested that elevation of lysosomal enzymes in skeletal muscle may not be
      confined to conditions of muscle wasting and degradation but also to
      differentiation and development processes such as during muscle regeneration
      following injury.

PMID- 2243227
TI  - Aneurysms and vacuolar degeneration of cerebral arteries in late-onset acid
      maltase deficiency.
AB  - We present a case of late-onset acid maltase deficiency (AMD) with pronounced
      involvement of the liver and skeletal muscles. In addition, and in contrast to
      other adult cases of AMD, the case presented here shows CNS pathology with
      hypodense and hyperintense white matter areas on CT and MRI scans, and myelin
      changes ranging from focal areas of demyelination to necrosis. Neuropathologic
      changes seem to be related to unusual vascular pathology consisting of vacuolar
      degeneration of small and large arterial blood vessels. Vacuoles of varying size,
      partly filled with granular PAS-positive material, were found in pericytes and
      smooth muscle cells of arterial vessel walls. Electron microscopy revealed
      lysosomal and cytoplasmic free glycogen in smooth muscle cells in the intima of
      large cerebral arteries as well as in pericytes of arterioles and capillaries.
      Accumulation of glycogen locally was associated with severe cellular damage and
      necrosis. The formation of a great number of small aneurysms of intracerebral
      arteries is thought to be the result of cell damage in the vessel walls.

PMID- 2243226
TI  - Degradation of connectin (titin) in Fukuyama type congenital muscular dystrophy:
      immunochemical study with monoclonal antibodies.
AB  - Connectin (also called titin) is a myofibrillar elastic filament which links a
      thick filament to a neighbouring Z line in a sarcomere and thus contributes
      significantly to the elasticity of myofibrils. In a previous study, we
      demonstrated by Western blot analysis of the biopsied skeletal muscles using an
      anti-connectin monoclonal antibody that connectin was degraded extensively after
      5 years of age in Duchenne muscular dystrophy (DMD), while it was degraded mildly
      in Becker muscular dystrophy and only minimally in myotonic dystrophy, limb
      girdle dystrophy, amyotrophic lateral sclerosis and Charcot-Marie-Tooth disease.
      In the present study, we investigated the degradation state of connectin in
      Fukuyama type congenital muscular dystrophy (FCMD) by a similar method using 2
      distinct anti-connectin monoclonal antibodies. In FCMD, connectin degradation
      began much earlier than in DMD: Definite degradation was already observed in 5-8
      month-old patients. It was presumed that connectin degradation would play an
      important role in the myofibrillar degeneration in the early stage of FCMD.

PMID- 2243228
TI  - Antimitochondrial autoantibodies of primary biliary cirrhosis as a novel probe in
      the study of 2-oxo acid dehydrogenases in patients with mitochondrial myopathies.
AB  - Autoantibodies present in the autoimmune disease primary biliary cirrhosis react
      by immunoblotting with four human skeletal muscle mitochondrial antigens of 70
      kDa, 52 kDa, 50 kDa and 45 kDa, identified as the lipoate acetyl transferases
      (E2) of the pyruvate dehydrogenase, component X of E2 pyruvate dehydrogenase, E2
      of 2-oxo glutarate dehydrogenase and E2 of branched-chain 2-oxo acid
      dehydrogenase complexes respectively. These autoantibodies have been employed as
      a novel probe to study whether there is a defect in the synthesis of the 2-oxo
      acid dehydrogenase complexes in patients with mitochondrial respiratory chain
      disorders. The reactive antigens are present normally in four patients with
      oculomyopathy in whom partial deletions of the mtDNA have been detected, and in
      two patients with MERRF and MELAS encephalomyopathy. Thus, unlike in the yeast
      Saccharomyces cerevisiae, there appear to be no regulatory interactions which
      coordinate the assembly of the mitochondrial respiratory chain with the
      development of the pyruvate dehydrogenase complex, which plays an important role
      in regulating the flow of metabolic intermediates to oxidative energy metabolism.

PMID- 2243229
TI  - Emotional facial paresis with striatocapsular infarction.
AB  - Emotional facial paresis (EFP) refers to hemifacial paresis of emotionally evoked
      or spontaneous smiling or weeping with preserved volitional movements of the
      face. The anatomical location for this phenomenon has been controversial. We
      report a 15-year-old boy with EFP. Follow-up MRI demonstrated infarction limited
      to the head of the caudate, putamen and anterior limb of the internal capsule on
      the contralateral side. This case lends support for selective damage at a
      striatal or capsular site in the production of EFP.

PMID- 2243230
TI  - Prognosis of asymptomatic carotid occlusion.
AB  - Ninety-four asymptomatic patients with internal carotid artery occlusion were
      followed for a mean of 44 months, 16% suffered strokes and 11.7% reported
      transient ischemic attacks (TIA). The annual stroke and TIA rates were 4.4% and
      3.2%, respectively, the annual mortality was 11.3%. In 27 asymptomatic patients
      progression of extracranial arterial disease to occlusion was observed: 7.4% of
      these patients suffered from stroke and 18.5% reported TIA's during that period.
      Thus the annual stroke rate was lower (1.9%) but the TIA rate higher (4.7%) than
      post-occlusive rates. These data reflect an increase risk in patients with
      progressive high-degree carotid stenosis which continues after occlusion. This
      may favour carotid endarterectomy for selected patients in the pre-occlusive
      state because medical treatment has not been shown to prevent progression of
      stenosis to occlusion.

PMID- 2243231
TI  - Hormonal changes in cerebral infarction in the young and elderly.
AB  - Fifty-one patients with CCT verified cerebral infarction were submitted to serum
      and CSF radioimmunoassay of FSH, LH, estradiol (E2), progesterone, testosterone,
      cortisol and T4. The results were compared to those of 82 matched controls. Our
      findings suggest that (1) high serum E2 is a risk factor of stroke in males; (2)
      low serum T4 is a risk factor in males; (3) serum testosterone is reduced in
      acute stroke in males confirming that it is stress sensitive; (4) serum LH was
      higher in hypertensive thrombotic males when compared to normotensive ones, and
      (5) FSH, LH, E2 and T4 are undetectable in CSF of patients and controls.

PMID- 2243232
TI  - Tangier disease: central nervous system impairment in a case of syringomyelia
      like syndrome.
AB  - A neuroradiological investigation of the central nervous system (CNS) in a case
      of Tangier disease presenting as a syringomyelia-like syndrome is reported. No
      syringomyelinic cavities were found. However, MRI showed cervical spinal cord
      atrophy and scattered foci of greater density with T2 weighted images in the
      white matter of the frontal, parietal and occipital lobes. Cerebral and cervical
      spinal cord involvement in the course of Tangier disease is now shown for the
      first time. The authors postulate that the MRI detected alterations are related
      to the underlying illness.

PMID- 2243233
TI  - Determination of manganese concentrations in the spinal cords from amyotrophic
      lateral sclerosis patients by inductively coupled plasma emission spectroscopy.
AB  - Continuing analytical studies on environmental factors in the foci of amyotrophic
      lateral sclerosis (ALS) in the Kii Peninsula of Japan and Guam, and metal
      analysis using neutron activation analysis in central nervous system (CNS)
      tissues from ALS cases indicate that chronic exposure to metals such as aluminum
      and manganese, together with a deficiency of minerals such as calcium and
      magnesium, may play a causative role in the neurodegeneration seen in ALS. An
      accurate and simple method for detecting minerals and trace metals in small,
      fresh samples of CNS tissue is necessary in order to follow the pathogenetic
      behavior of these elements. In this paper, we describe a method for measuring
      manganese (Mn) content in CNS tissue samples taken from mouse brain using
      inductively coupled plasma (ICP) spectroscopy and present results of the
      determination of Mn contents in spinal cord samples from ALS cases using the same
      method. ICP emission spectroscopy is considered to have great advantage for the
      simultaneous determination of elements in small, fresh CNS samples because of its
      simplicity and convenience, and the elimination of the necessity to use
      potentially dangerous acids. Results showed that the mean concentration of Mn in
      a mouse brain (0.56 microgram/g) and in human spinal cords (0.39 microgram/g wet
      weight in the anterior horn, 0.37 in the lateral fasciculus, 0.39 in the
      posterior horn and 0.28 in the posterior fasciculus) were compatible with results
      previously reported using other methods. In ALS spinal cords, the mean content of
      Mn was similar to that of controls, but the distribution differed. In the ALS
      cases, Mn contents were higher in the anterior horn and lateral fasciculus than
      in the posterior horn.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243234
TI  - Congenital cerebellar hypoplasia and hypogonadotropic hypogonadism.
AB  - The association of cerebellar ataxia and non-neurological syndromes is a well
      known phenomenon. A 20-year-old male patient presented with a longstanding and
      non-progressive ataxia. Magnetic resonance examination revealed marked inferior
      vermian-cerebellar hypoplasia. He also showed a hypogonadism with low serum
      gonadotropin and prolactin levels. Chronic pulsatile gonadotropin-releasing
      hormone (GnRH) administration resulted in a small non-pulsatile luteinizing
      hormone (LH) increase and no follicle-stimulating hormone (FSH) elevation. This
      hormonal pattern suggests a primary deficiency of the gonadotroph and lactotroph
      cells, rather than a hypothalamic lesion. This is the first report where
      cerebellar hypoplasia of congenital origin is associated with hypogonadotropic
      hypogonadism. Because of consanguinity, autosomal recessive transmission is
      considered.

PMID- 2243235
TI  - Mast cells in neuromuscular diseases.
AB  - The lectin Dolichos biflorus agglutinin has been used to identify mast cells in
      normal skeletal muscle and to investigate changes in their number in a wide range
      of human neuromuscular diseases and in rat muscle damaged by the local
      anaesthetic bupivacaine. Few mast cells were found in the perimysium of normal
      skeletal muscle but numbers were increased in human muscle biopsies which showed
      necrosis and regeneration of fibrosis. In bupivacaine-induced muscle damage,
      increased mast cell counts occurred during the necrotic phase and particularly
      during the phase of active regeneration. In addition, increased numbers of mast
      cells were observed in the underlying histologically normal muscle. These results
      show that mast cells are influenced by pathological changes in skeletal muscle
      and, in view of the known functions of mast cells in other tissues, it is
      possible that they are capable of modulating disease processes in muscle.

PMID- 2243236
TI  - Kinetics of production of a novel growth factor after peripheral nerve injury.
AB  - In response to transection injury, the distal segment of sciatic nerve produces a
      soluble factor which stimulates neurite outgrowth from 15 day embryonic rat
      dorsal root ganglion (DRG) neurons, and PC12 cells. This activity enhances
      survival of large sensory neurons, promotes myelination and has been designated
      SN. The expression of SN, undetectable in the perineurium and proximal segments,
      occurs solely in the endoneurium distal to the site of permanent transection.
      When the distal portion is removed immediately after transection, homogenized and
      the supernatant tested, there is little neurite promoting activity in the normal
      nerve. For the first 10 days after transection the major soluble factor present
      in the distal segment is NGF. The amount of neurite promoting activity increases
      after 10 days and appears to plateau at 30-35 days while the proportion that is
      inhibited by anti-NGF decreases. In a competitive receptor binding assay, SN does
      not compete with 125I-NGF for receptors on either DRG or PC12 cells. Separation
      using polyacrylamide-agarose followed by HPLC demonstrates that SN migrates with
      polypeptides of molecular weights 17.2 and 19.1 kDa.

PMID- 2243237
TI  - Enhanced CNS uptake of systemically administered proteins through conjugation
      with tetanus C-fragment.
AB  - No other exogenous protein enters the central nervous system from the circulation
      as readily as tetanus toxin. We examined the capability of the non-toxic binding
      fragment of tetanus toxin (C-Fragment) so serve as a vehicle for transport of
      other proteins into the mouse CNS. Using periodate oxidation of the enzyme
      horseradish peroxidase (HRP), we synthesized two separate macromolecular
      complexes, one containing C-fragment and HRP, and the other C-fragment, HRP and a
      third "test" protein-human IgG. The distribution of C-fragment-HRP was typical of
      blood borne proteins including native C-fragment, with labeling of all neurons
      with known projections outside the blood-brain barrier, particularly large spinal
      motoneurons. C-fragment-HRP conjugates showed superior neuronal labeling to over
      100-fold greater quantities of free HRP. Complexes containing C-fragment, HRP and
      human IgG were internalized by neurons from both intramuscular and
      intraperitoneal injections. The efficiency of neuronal uptake of IgG in the C
      fragment conjugated form was enhanced over 40-fold compared to free IgG. Linkage
      of a large protein to C-fragment probably leads to enhanced endocytosis of that
      protein by neuronal terminals projecting outside the blood-brain barrier. C
      fragment can serve as a vehicle to allow selected proteins to bypass the barrier
      and enter the CNS.

PMID- 2243238
TI  - Ultrastructural abnormalities of myelinated fibres in the tibial nerve of
      streptozotocin-diabetic rats.
AB  - In this paper we have examined the ultrastructural changes in myelinated fibre
      structure after the administration of streptozotocin to Sprague-Dawley rats which
      had passed the rapid growth period. Myelinated fibre size in the tibial nerve was
      found to be less in diabetic animals 4 and 6 months after the induction of
      diabetes, when compared to age-matched controls, but not less than onset. The
      relative contributions of axon and myelin to this reduction in fibre dimensions
      were examined. When myelin area was plotted against axon area (derived from
      perimeter) it showed that the pathological insult of diabetes had a greater
      effect on the rate of myelin production. The incidence of axonal glycogenosomes
      was also assessed. These results are discussed in detail.

PMID- 2243239
TI  - Cocaine-induced stroke: first Jamaican case.

PMID- 2243240
TI  - An unbiased estimation of the total number of synapses in the superior cervical
      ganglion of adult rats established by the disector method. Lack of change after
      long-lasting sodium bromide administration.
AB  - Previous physiological and morphological studies suggested that sodium bromide
      promotes synaptogenesis of implanted cholinergic nerves in the superior cervical
      ganglion of adult rats. To check whether sodium bromide also modifies synaptic
      numbers in the intact ganglion, quantitative electron microscopy was used to
      determine the total number of synaptic junctions in the superior cervical
      ganglion of adult rats. Untreated controls were compared with animals which drank
      water containing 280 mg ml-1 sodium bromide for 7 days. The disector method, an
      unbiased estimator of volume density of certain particles, has been adapted to
      this particular case. To accomplish the task, an on-line counting procedure was
      developed, which permitted the efficient adaptation of the disector method for
      the superior cervical ganglion, in which the synapses are known to be distributed
      sparsely. Three pairs of (control and treated) ganglia have been completely
      processed by three independent examiners. The estimated number of synapses in the
      ganglia ranged from 4 to 8 million while the volumes of the ganglia varied from
      0.65 to 0.90 mm3. Evaluation of the results showed that variations in the total
      number of synapses were in each case proportional to differences in ganglionic
      volumes. This suggests that: (1) sodium bromide does not lead to changes in
      density of intrinsic synapses; and (2) the morphogenetic action of sodium bromide
      on principal ganglion cells previously described is essentially postsynaptic and
      requires additional presynaptic elements to increase the number of synapses.

PMID- 2243241
TI  - Development of the ultrastructural features of neuropeptide Y-immunoreactive
      neurons in the rat visual cortex.
AB  - Immunohistochemical studies have localized neuropeptide Y into a small population
      of non-pyramidal neurons in the mammalian cerebral cortex. In the rat, these
      cells are distributed in layers II-VI and are characterized at the
      ultrastructural level by an abundance of cytoplasm containing a plethora or
      organelles, most conspicuous of which are cisternae of granular endoplasmic
      reticulum stacked in parallel arrays. In the present study, we used electron
      microscopic immunocytochemistry to examine the ultrastructural development of
      neuropeptide Y-labelled neurons in the rat visual cortex from birth, when they
      first appear in this cortical area, until postnatal day 32. At birth and in the
      subsequent few days, neuropeptide Y neurons, found exclusively in layers V and
      VI, often show a deeply infolded nucleus and little cytoplasm containing few
      organelles. At the end of the first postnatal week, labelled cells are still
      restricted to layers V and VI and display immature features. However, at this
      stage, cells often show irregularly enlarged proximal dendrites filled with
      organelles. During the second postnatal week, neuropeptide Y-immunoreactive cell
      bodies appear for the first time in layers II and III, and at the end of this
      week they have a distribution similar to that observed in the adult. Labelled
      cells are overall more differentiated than at earlier ages showing some of the
      ultrastructural features which distinguish them in the adult. No differences in
      maturation are evident between immunoreactive neurons located in the superficial
      layers and those in the deep layers, suggesting that the neuropeptide Y neurons
      in the more superficial layers express the peptide after having completed their
      migration and have acquired their characteristic ultrastructural features.
      Maturation proceeds during the third postnatal week. At the end of this stage,
      neuropeptide Y-containing cells acquired their mature nuclear and cytoplasmic
      features and an adult complement of synapses.

PMID- 2243242
TI  - Antigenic staining patterns of human glioma cultures: primary cultures, long-term
      cultures and cell lines.
AB  - The immunocytochemical staining patterns of cultured glioma cells were
      investigated. Fifty nine individual cases were stained at different in vitro ages
      for glial fibrillary acidic protein, fibronectin, galactocerebroside, HNK-1/Leu
      7, A2B5, vimentin, factor VIII and A4. Histologically, the cases were composed of
      eight low-grade astrocytomas, 11 high-grade astrocytomas, four low-grade
      oligodendrogliomas, seven high-grade oligodendrogliomas and 29 glioblastomas. The
      45 cases were analysed within the first 3 weeks of culture, many of them as
      primary cultures. In 11 cases stainings were performed repeatedly at intervals of
      up to 6 months. Glial fibrillary acidic protein staining was positive in most of
      the early cultures of astrocytomas (low and high grade) and glioblastomas;
      expression in more than 50% of the cells was found in 1 of 5 low-grade
      astrocytomas, 5 of 11 high-grade astrocytomas and 14 of 29 glioblastomas. Two of
      the high-grade astrocytomas were stained once more after 6 weeks in culture and
      were found to be only 1% positive for glial fibrillary acidic protein but
      strongly positive for fibronectin. The same was true for five of the glioblastoma
      cases. Two of these cases remained glial fibrillary acid protein positive and
      developed into stable permanent cell lines. Only one case started with 1% of
      glial fibrillary acidic protein positive cells and later developed into a 99%
      glial fibrillary acidic protein positive cell line. Neither HNK-1/Leu 7
      expression nor A2B5 staining appeared to have a relationship to the glial
      fibrillary acidic protein staining. It was observed that glial fibrillary acidic
      protein and HNK-1/Leu 7 were both 100% in some cases but that later one of the
      two antigens disappeared but not the other. The amount of glial fibrillary acidic
      protein staining does not allow the prediction of A2B5 staining. The study shows
      that initiation of primary cultures on an extracellular matrix yields more glial
      fibrillary acidic protein positive cells in primary cultures than have been found
      in other studies. It is concluded that only a rigid standardization of culture
      conditions will ensure the validity of comparisons of in vitro data obtained in
      primary cultures.

PMID- 2243243
TI  - Identification of all GABA-immunoreactive neurons projecting to the lobster
      stomatogastric ganglion.
AB  - The stomatogastric ganglion of lobsters (Homarus or Jasus) contains a large
      number of gamma-aminobutyric acid-immunoreactive processes originating from ten
      fibres in the single input nerve, the stomatogastric nerve. The cell bodies and
      axonal pathways of these ten fibres have been identified using gamma-aminobutyric
      acid immunohistochemistry in combination with Lucifer Yellow staining (double
      labelling) and nickel chloride backfilling (selective gamma-aminobutyric acid
      immunoinhibition). It is shown that eight gamma-aminobutyric acid-immunoreactive
      neurons project to the stomatogastric ganglion: gamma-aminobutyric acid neurons 1
      and 2, found posterior to the oesophageal ganglion, entering the stomatogastric
      nerve via the oesophageal nerve as well as sending an axonal branch into each
      superior oesophageal nerve; gamma-aminobutyric acid neurons 3 and 4, found
      anterior to the oesophageal ganglion, each sending an axonal branch into each
      inferior oesophageal nerve to reach the stomatogastric nerve via the commissural
      ganglion and the superior oesophageal nerve; and gamma-aminobutyric acid neurons
      5 and 6, found in each commissural ganglion, projecting into the stomatogastric
      nerve via the inferior oesophageal nerve, the oesophageal ganglion and the
      oesophageal nerve. These gamma-aminobutyric acid-immunoreactive neurons were also
      characterized by electrophysiological methods coupled with Lucifer Yellow
      labelling, and their picrotoxin-sensitive effects on several stomatogastric
      ganglion neurons were demonstrated. The present results provide a firm basis for
      further studies concerning the physiological significance of one class of
      neurochemically-defined input neurons to stomatogastric ganglion networks.

PMID- 2243244
TI  - Serotonin-like immunoreactivity in the retina of the clawed frog Xenopus laevis.
AB  - Using an antiserum directed against serotonin, we have studied the morphology and
      distribution of serotonin-containing and serotonin-accumulating neurons in the
      retina of Xenopus laevis. Endogenous serotonin-like immunoreactivity was found in
      two classes of amacrine cell, one class of bipolar cell and a few centrifugal
      fibres. Kainic acid-induced depletion of serotonin, under various conditions,
      enabled us to determine the distribution of stained bipolars, amacrine cells and
      centrifugal fibres within the meshwork of serotonin-like immunoreactivity
      labelled processes. Kainic acid-induced release of serotonin by bipolar cells is
      calcium dependent. Stimulation of release by kainic acid as well as the fact that
      all serotonin-like immunoreactive bipolar cells ramify in sublayer 1 of the inner
      plexiform layer suggest that serotonergic bipolars are OFF centre cells. Release
      of serotonin from amacrine cells is largely calcium independent. Serotonin
      containing amacrines send primary dendrites into layer 1 of the inner plexiform
      layer; short off-shoots from the primary dendrites descend into sublayers 3-5 in
      which they ramify into a fine network. Serotonergic amacrines have an uneven
      distribution in the Xenopus retina. Their highest density occurs in the
      posterolateral quadrant, whereas large portions of the anteromedial quadrant lack
      serotonin-like immunoreactivity altogether. The uneven distribution of serotonin
      containing elements in the Xenopus retina with its peak falling onto the retinal
      area which generates binocular vision, suggests its involvement in binocular
      perception.

PMID- 2243245
TI  - Structure, distribution and number of surface sensilla and their receptor cells
      on the olfactory appendage of the male moth Manduca sexta.
AB  - Distribution and neuronal organization of sensilla on the surface of the annulate
      flagellar segment of the antenna of the male Manduca sexta were studied by
      scanning and transmission electron microscopy. Nine types of sensilla were
      identified and their bipolar neurons ascribed to specific sensory modalities on
      the basis of their cuticular and dendritic morphology. Cuticle morphology
      identifies two types of sensilla trichodea, two types of sensilla basiconica and
      one type of sensillum coeloconicum. Certain of these olfactory sensilla are
      further subdivided on the basis of their dendritic structures. One type of
      sensillum chaeticum was interpreted as a contact chemoreceptor. A second type of
      sensillum coeloconicum and a styliform sensilla complex were interpreted as
      bimodal hygro- and thermosensilla. A second species of sensillum chaeticum serves
      mechanosensation. Counts from annuli situated about midway along the flagellum
      revealed a total of about 2200 sensilla supplied by approximately 5160 sensory
      neurons. A conservative estimate suggests that a male antenna with 85-90 annuli
      provides the flagellar nerve with at least 3.6 x 10(5) receptor axons, a number
      that exceeds previous estimates by almost 50% Each species of receptor has a
      characteristic location on the annulus. Of the 2100 or so sensilla situated on
      the dorsal, ventral and the leading edge surfaces, about 800 consist of male
      specific type-I trichoids containing pheromone-sensitive receptors. Arciform
      arrays of these sensilla on the upper and lower surfaces of each annulus
      presumably optimize the capture and absorption of odour molecules. The trailing
      edge of the flagellum, which is thickly covered by scales and was assumed until
      now to lack receptors, contains both mechanosensitive and contact chemoreceptors.
      The modality of non-olfactory receptors is considered with respect to similar
      elements that have been functionally identified in other species. The coexistence
      of non-olfactory sensilla with olfactory elements is discussed with respect to
      current knowledge of the organization of olfactory centres in the brain.

PMID- 2243246
TI  - Ultrastructure and synaptology of neurons immunoreactive for gamma-aminobutyric
      acid in the myenteric plexus of the guinea pig small intestine.
AB  - Immunoreactivity for gamma-aminobutyric acid is located in one morphologically
      defined class of nerve cell body in the myenteric plexus of the guinea pig small
      intestine. These are a subgroup of the Dogiel type I nerve cells, characterized
      by their lamellar dendrites, about 1 micron thick and flattened in the plane of
      the myenteric plexus, and one (or rarely two) long axonal process that extends to
      either the longitudinal or the circular muscle. At an ultrastructural level the
      dendrites were characterized by their open cytoplasm in which were scattered
      granular vesicles, pale mitochondria, Golgi apparatus and endoplasmic reticulum.
      A large proportion of the dendritic surface was in direct contact with the extra
      ganglionic space. In the cell body region, which was away from the ganglion
      surface, the nucleus was surrounded by a thin rim of cytoplasm. The cytoplasmic
      features are quite distinct from those of Dogiel type II neurons but they were
      shared by many other non-immunoreactive neurons. Synaptic inputs, which were all
      non-immunoreactive, were found on the dendrites, cell bodies, axon hillocks and
      axons of the gamma-aminobutyric acid-immunoreactive neurons. The predominant
      vesicle type in the presynaptic elements was the small clear vesicle, 40-60 nm in
      diameter. Based on two gamma-aminobutyric acid-immunoreactive cells that were
      examined in serial section, about 40-50% of synapses are dendritic, 20-25% are
      somatic, and 30-35% are on the axon hillock or first 50-70 microns of the axon.
      No synapses formed by immunoreactive varicosities were found on non
      immunoreactive neurons or in the neuropil of the myenteric ganglia. Moreover, the
      lamellar dendrites or soma of gamma-aminobutyric acid neurons were never
      presynaptic elements forming relationships with other elements in the ganglia. It
      is concluded that the gamma-aminobutyric acid reactive Dogiel type I neurons are
      motor neurons providing inputs to the circular and longitudinal muscle layers.

PMID- 2243247
TI  - Highly sialylated N-CAM is expressed in adult mouse optic nerve and retina.
AB  - The localization of the neural cell adhesion molecule (N-CAM) and its highly
      sialylated form, which is prevalent in young tissues and has therefore been
      called embryonic neural cell adhesion molecule, was studied in the developing and
      adult mouse optic nerve and retina immunohistologically and immunochemically. At
      embryonic and early postnatal ages, neuroblasts and young postmitotic neurons,
      Muller cells and astrocytes in the retina, and retinal ganglion cell axons and
      all glial cells in the optic nerve express highly sialylated neural cell adhesion
      molecule. Beginning with the third postnatal week, highly sialylated neural cell
      adhesion molecule disappears from retinal ganglion cell axons in the optic nerve
      and from neuronal cell bodies and processes in the retina. In addition, it is not
      detectable on oligodendrocytes in 3-week-old animals. However, highly sialylated
      neural cell adhesion molecule continues to be expressed in the adult optic nerve
      and retina by astrocytes and Muller cells. On these cells it is only absent from
      cell membranes contacting basal lamina. Weakly sialylated neural cell adhesion
      molecule, in contrast, is expressed by all cell types of retinal and optic nerve
      during development and in the adult. The loss of highly sialylated neural cell
      adhesion molecule from neurons and oligodendrocytes must therefore be considered
      as a cell type-specific conversion of the so-called embryonic to the adult form
      of neural cell adhesion molecule and does not simply reflect the disappearance of
      neural cell adhesion molecule from these cells. Weakly sialylated neural cell
      adhesion molecule, however, is absent from outer segments of photoreceptor cells
      and, as is the case for the highly sialylated form, from glial cell surfaces
      contacting basal lamina. Thus, the expression of highly sialylated neural cell
      adhesion molecule by pre- and postmitotic neurons and by oligodendrocytes is
      restricted mainly to the period of histogenetic events in retina and optic nerve,
      i.e. cell division, cell migration, dendritic and axonal growth and
      synaptogenesis. In addition to the observation that this form of neural cell
      adhesion molecule is less adhesive than the weakly sialylated, adult form, it is
      likely that highly sialylated neural cell adhesion molecule plays an important
      role during dynamic morphogenetic events. Furthermore, the expression of highly
      sialylated neural cell adhesion molecule by astrocytes and Muller cells in adult
      optic nerves and retinae suggests some histogenetically plastic functions for
      these cells in the adult mouse visual system.

PMID- 2243248
TI  - Effects of colchicine on central and peripheral nerve terminals of the locust
      Schistocerca gregaria.
AB  - The treatment of locusts (Schistocerca gregaria) with colchicine leads to various
      changes in the ultrastructure of both central and peripheral nerve terminals.
      These changes include a marked reduction in synaptic vesicle density, which is
      further enhanced following stimulation. There are also increased numbers of
      coated pits and membraneous cisternae together with enlarged terminal areas and
      disruption of mitochondrial ultrastructure. The capacity of isolated central
      nerve terminals (synaptosomes) to take up the radiolabelled transmitter precursor
      [3H]-choline is enhanced following in vivo treatment of locusts with colchicine,
      whilst in vitro treatment leads to a reduction in choline uptake. The results are
      discussed with regard to the postulated effects of colchicine on axoplasmic
      transport.

PMID- 2243249
TI  - Different kinds of axon terminals forming symmetric synapses with the cell bodies
      and initial axon segments of layer II/III pyramidal cells. II. Synaptic
      junctions.
AB  - Four different types of axon terminals form symmetric synapses with the cell
      bodies and initial axon segments of pyramidal cells in layer II/III of rat visual
      cortex. One type belongs to chandelier cells, and the other three kinds of
      terminals have origins that have not been established yet. These latter are
      referred to as large, medium-sized and dense terminals. The purpose of the
      present study was to examine the synaptic junctions formed by all four types of
      terminal. The synapses formed by the chandelier cell terminals are readily
      recognized in thin sections because of the characteristics features of both the
      terminals and the initial axon segments, which are the neuronal elements
      postsynaptic to them. In en face views of these axo-axonal synapses the junctions
      can be seen to have presynaptic dense projections that form a grid in which they
      are triagonally spaced, and have an average centre-to-centre spacing of 84 nm. As
      an ensemble the projections form the presynaptic grid, which usually has an oval
      or round outline, but may be notched on one side where projections are absent.
      The synaptic junctions of the large, medium-sized and dense terminals were
      examined by making reconstructions of the terminals from serial thin sections. It
      was found that at the interfaces between the axon terminals and the cell bodies
      of pyramidal cells, several separate synaptic junctions may be present, in
      addition to a number of puncta adhaerentia. Thus, there may be as many as five
      separate synaptic junctions and as few as one.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243251
TI  - Chronic illness and depressive symptoms in the elderly: a population-based study.
AB  - A cross-sectional study of the distribution of depressive symptoms and
      association between depressed mood and chronic illness was conducted in a
      geographically defined population in southern California of 1617 men and women
      aged 65 years and older. The prevalence of depressed mood for the total
      population was 5.2%. Women exhibited a significantly higher mean depressive
      symptom score and a prevalence rate almost twice that of men. Depressive symptoms
      were associated with several risk factors in both sexes, including age, self
      perception of current health status, number of reported chronic diseases and
      medications and amount of exercise. However, the relationship between physical
      illness and depressive symptoms appeared to differ by sex with respect to the
      nature of the disease or disability and the type of medication currently used.
      These findings indicate that the risk of depression does not diminish with age
      among the elderly as other studies have suggested.

PMID- 2243250
TI  - The validity of single-item, self-assessment questions as measures of adult
      physical activity.
AB  - Individual energy expenditure (kcal/kg/day) was calculated from a detailed set of
      questions from the Health Promotion and Disease Prevention Supplement of the 1985
      National Health Interview Survey. Responses to three single-item, self-assessment
      questions were compared to the energy expenditure variable to test criterion
      validity. Spearman's correlation coefficient revealed moderate correlations
      between energy expenditure and corresponding levels of self-assessed leisure-time
      physical activity for each single-item question (r = 0.14 to 0.41). For purposes
      of measuring prevalence of physical activity, the energy expenditure variable was
      used to categorize individuals into activity levels. The single-item questions
      were found to have Spearman's correlations with the categorical measures ranging
      from 0.11 to 0.37 for leisure-time activities. Generally higher correlations were
      found for males and younger age groups (18-34 years). The relationships were
      interpreted as being weak relative to an expected correlation of 0.75 for
      criterion validation. However, the single-item questions show promise for
      obtaining proxy estimates of the degree of leisure-time physical activity in a
      population.

PMID- 2243252
TI  - The relation between the plasma lipoprotein pattern and the waist/hip ratio in
      non-diabetic individuals.
AB  - Relations between lipoprotein indices and the waist/hip ratio (WHR) were examined
      in normoglycemic subjects (124 women and 63 men). Among women, an atherogenic
      lipoprotein pattern was strongly associated with WHR. The relation was greater
      than that of the lipoprotein pattern with either the body mass index or the
      subscapular/triceps ratio, and was independent of these adiposity measures. The
      association between low-density-lipoprotein cholesterol (LDL-cholesterol) and WHR
      was much stronger in thinner women than in those more obese (r = 0.64 vs r =
      0.22, p = 0.001 for difference). Men had a more atherogenic lipoprotein pattern
      than women; however, with allowances for WHR the lipoprotein patterns were
      similar. These findings suggest that: (1) WHR is more strongly related to plasma
      lipoproteins than other adiposity measures; (2) there is effect modification by
      the extent of adiposity for the relation between LDL-cholesterol and WHR; and (3)
      the adipose distribution may be important in explaining lipoprotein differences
      between men and women.

PMID- 2243253
TI  - Random assignment in clinical trials: issues in planning (Infant Health and
      Development Program).
AB  - Various options available for the randomization of subjects into groups in a
      clinical trial are discussed, emphasizing the issues of logistics given less
      focus in more mathematical treatments. We discuss advantages and disadvantages of
      total randomization, of Zelen-type randomization procedures, of Efron-type
      procedures vs more classical blocking procedures to control the balance between
      groups, and of Simon-Pocock-type procedures vs more classical stratification for
      controlling possible biases in prognostic factors. Finally, we discuss issues
      related to choice and implementation of randomization procedures. The discussion
      is illustrated with the processes of decision-making in a national collaborative
      randomized clinical trial, the Infant Health and Development Program.

PMID- 2243254
TI  - Characteristics of individuals and long term reproducibility of dietary reports:
      the Tecumseh Diet Methodology Study.
AB  - Food frequency reports in 1967-1969 were compared to frequency reports of the
      same foods asked retrospectively in 1982-1983 and 1967-1969 for 1184 respondents
      aged 45-64 years in the Tecumseh Community Health Study. The kappa statistic for
      concordance of the retrospective and baseline reports was used as a summary
      measure of the individual's ability to reproduce his or her earlier diet report.
      Reproducibility was estimated for total diet, represented by 83 foods, and for 9
      subsets of foods of epidemiologic interest. In bivariate and multivariate
      analyses, reproducibility was strongly related to stability of diet; those whose
      diets changed least over the 15-year period had greatest diet reproducibility.
      Greater total diet reproducibility was also found among men with higher
      education, among women of less than 110% desirable weight reporting no special
      diet and among women reporting no medications. Consistent with current models of
      memory, the retrospective report of diet was strongly related to the current
      report of diet. Agreement between the retrospective and baseline diet reports was
      greater than agreement between the current and baseline diet reports. This
      indicates that, as a proxy for past diet, the retrospective report of diet is
      superior to the current report. Similar relationships were found for the 9 subset
      of foods.

PMID- 2243255
TI  - An analysis of gestational age, neonatal size and neonatal death using
      nonparametric logistic regression.
AB  - The relationship between gestational age, neonatal size and neonatal death is
      complex. To date, most authors have used birth weight as a proxy for neonatal
      size and have neglected to examine head circumference and crown heel length. In
      addition, they have assumed the size and gestational age were linearly related to
      neonatal death. In this study we use nonparametric multiple logistic regression
      to examine the relationship between gestational age, neonatal size and neonatal
      death. On its own, gestational age was nonlinearly associated with neonatal
      death. This nonlinearity disappeared with the addition of birth weight, crown
      heel length and head circumference. Birth weight, head circumference and crown
      heel length all had significant nonlinear associations with neonatal death in
      univariate analysis. With all factors in the model, birth weight and head
      circumference were nonlinearly associated with neonatal death and crown heel
      length was linearly associated with neonatal death. The complex relations between
      gestational age, neonatal size and neonatal death were explored with greater ease
      with nonparametric logistic regression.

PMID- 2243256
TI  - Quality control practices in centralized tumor registries in North America.
AB  - A survey of quality control practices was mailed to 73 central registries in the
      U.S. and Canada. The response rate was 88%, with respondents representing a wide
      range of registry characteristics and reporting strategies. While registries
      expressed different priorities in data use, 80% of respondents felt quality
      control data were important in the identification of problems. The most common
      method of quality control was acceptance sampling (used by 97% of respondents),
      and took the form of visual review, recoding and edit checking. Computer-based
      edit checks were almost universally used (95%). Process control methods of any
      sort were used by only 22% of respondents with less than 4% of registries
      reporting formal quantitative criteria. Sixty-one percent of respondents reported
      conducting one or more designed studies (e.g. reabstracting or casefinding
      studies) but only 20% of those made the results public. Greater emphasis should
      be placed on development of quantitative process controls, experimental design of
      quality control studies, and formal analyses and reporting of study results.

PMID- 2243257
TI  - Prepaid versus traditional Medicaid plans: effects on preventive health care.
AB  - Prepaid, case managed systems have been proposed as a method of controlling costs
      in Medicaid populations. We investigated the utilization of preventive services
      in two prepaid Medicaid Competition Demonstration programs in Santa Barbara
      County, Calif., and Jackson County, Mo. (containing the city of Kansas City).
      Care in the demonstration sites was compared with care given in similar counties
      functioning under a traditional fee-for-service Medicaid system--Ventura County,
      Calif., and St Louis, Mo. We tested the hypothesis that preventive care would be
      less in the capitated demonstrations. 2735 Children's and 3389 adult's charts
      were abstracted for care received during the calendar year 1985, after the
      prepaid demonstration had been in place for more than 1 year. No significant
      differences were found between the demonstration and comparison counties in the
      proportion of children with complete DPT or OPV immunizations at 1 year of age,
      with 56% complete in both California counties and 69 and 65% complete in Jackson
      County and St Louis, respectively. Regression analysis demonstrated a slight, but
      statistically significant trend towards more immunizations in the demonstration
      counties. Pap smear use in women of 15-44 years of age was little different in
      the California counties, but significantly greater in the Jackson County
      demonstration in Missouri (64 vs 45%). Physician breast examinations were
      somewhat more likely to occur in the prepaid, case managed demonstration
      counties. Capitated, case managed systems for the AFDC Medicaid population appear
      to result in no diminution of preventive services. Substantial problems exist in
      this, as in other poor populations, in childhood immunizations.

PMID- 2243258
TI  - Adverse mortality experience of a southwestern American Indian community: overall
      death rates and underlying causes of death in Pima Indians.
AB  - As part of an ongoing epidemiologic study, the death rate and causes of death
      during 1975 through 1984 were determined in Pima Indians who resided in the Gila
      River Indian Community (GRIC) in 1965 and later. Death certificates were
      available for 677 of the 681 deaths. In 78% of the deaths, the underlying cause
      recorded on the death certificate agreed with the cause determined after review
      of all available relevant records. The age- and sex-adjusted average annual death
      rate for the GRIC population (1639/100,000) was 1.9 times (95% CI 1.7-2.0) the
      1980 rate for the U.S. all races (878/100,000). In Pima males, whose death rate
      was substantially higher than that of Pima females, the age-adjusted death rate
      was 2.3 times that in U.S. males, all races. Moreover among males 25-34 years of
      age, the Pima death rate was 6.6 times that for the U.S. all races. Diseases of
      the heart and malignant neoplasms caused 59% of U.S. deaths in 1980, but only 19%
      of GRIC deaths. By contrast, the age- and sex-adjusted mortality rate in the GRIC
      Pima was 5.9 times the rate of the U.S. all races for accidents, 6.5 times for
      cirrhosis, 7.4 times for homicide, 4.3 times for suicide, and 11.9 times for
      diabetes. Tuberculosis and coccidioidomycosis were important causes of death in
      the Pima, for whom infectious diseases was the tenth leading cause of death. The
      findings indicate that programs to improve the adverse mortality experience of
      the GRIC population should emphasize factors related to fatal accidents,
      alcoholic cirrhosis, homicide, suicide, diabetes mellitus, and infectious
      diseases. Young Pimas, especially the males, should be the primary focus of such
      preventive efforts. These findings and recommendations probably apply to many
      Native American populations.

PMID- 2243260
TI  - Is baldness a risk factor for coronary artery disease? A review of the
      literature.
AB  - A literature search identified eight articles containing data on both baldness
      and coronary artery disease (CAD). Three of these articles described case-control
      studies that showed a positive relationship between baldness and CAD when
      controlling for CAD risk factors. Three other case-control studies showed no such
      relationship, but these did not control for CAD risk factors. The results of two
      cohort studies were inconclusive. Insufficient data were available from these
      studies to analyze possible relationships between baldness and CAD risk factors
      themselves. Overall, the data reviewed suggest that a small risk of CAD due to
      baldness may exist, but this risk is smaller than that of well-known CAD risk
      factors such as smoking and hypertension. Future research should emphasize proper
      control for age and CAD risk factors.

PMID- 2243259
TI  - Health status reports in the care of patients with rheumatoid arthritis.
AB  - We examined the use of formal health status reports every 3 months over 1 year in
      the clinical care of patients with rheumatoid arthritis (RA). The reports
      consisted of single-page, computer-generated summaries of scores derived from
      either the AIMS (Arthritis Impact Measurement Scales) or the MHAQ (Modified
      Health Assessment Questionnaire) health status questionnaires. A total of 1920
      subjects from 27 community practice sites were randomly assigned to three study
      groups in each practice: intervention, attention placebo and control. Results
      showed that 55% of the physicians found the reports to be at least moderately
      useful as an aid to patient management, primarily for improving the doctor
      patient relationship. However, no detectable differences among the three groups
      were seen in terms of medication compliance, number of physician visits, number
      of referrals, frequency of major medication changes, attitudes towards the
      physician, patient satisfaction or change in health status over 1 year. The
      failure to demonstrate objective benefits of health status reports in this study
      may be due to physician unfamiliarity with health status scores, failure to link
      the report with an office visit, the relative stability of clinical status in the
      subjects over 1 year and the relatively short time-frame of the study.

PMID- 2243261
TI  - Shortcut method to calculate the sample size in trials of screening for chronic
      disease.
AB  - One of the first questions arising in the planning of a randomized trial to
      evaluate mortality reduction by screening concerns the sample size of the trial
      required to detect an expected mortality reduction in the study group for given
      significance level alpha, and power 1 - beta. If estimates exist of the
      underlying average annual incidence rate of the disease ra and the annual
      mortality rate delta a or survival data for patients in the population under
      consideration before screening started, then a simple formula for the probability
      of dying from the disease within T years after entry into the trial can be given
      for the control group. Standard formulas may then be used for sample size
      calculations in randomized trials, which compare the risk of death from the
      disease in the control and the study group accrued at T years after entry. A
      simple correction for loss of follow-up, due to mortality from other causes or,
      for instance, migration is possible.

PMID- 2243262
TI  - Epidemiologic science and public health policy.

PMID- 2243263
TI  - A clinical ladder for the community health-care setting.

PMID- 2243264
TI  - The impact of health education on health status: an experimental program for
      elderly women in the community.
AB  - Until recently, little research has been conducted on the effect of health
      education and promotion programs on older adults. As the number of older adults
      increase and costs for health care skyrocket, educational efforts aimed at
      delaying the negative effects of chronic illness will become increasingly
      important. In this study, a pretest-posttest design was used with a 3-month
      follow-up assessment to determine whether participation in a teacher-directed or
      learner-paced health education program was related to changes in health-risk
      status, cholesterol levels, blood pressure readings, or life satisfaction. The
      program, sponsored by a community health department, enrolled 78 women with a
      mean age of 71 living in the suburban areas of a large metropolitan county. Women
      who were randomly assigned to one of the intervention groups were more likely to
      reduce their stress levels, decrease salt consumption, and decrease their
      systolic blood pressure.

PMID- 2243265
TI  - Decision-making authority for family caregivers of the cognitively impaired
      elderly.

PMID- 2243266
TI  - Eating behaviors, weight loss methods, and nutrition practices among high school
      wrestlers.
AB  - Wrestlers lose weight frequently, using rapid weight reduction methods in order
      to qualify for a certain weight classification. Under these conditions, the
      potential for developing eating disorders seems apparent. A questionnaire was
      used to evaluate binge eating and bulimic behaviors, nutrition practices, and
      weight loss methods in 716 wrestlers. Subjects lost 4.0 kg, on average, to
      certify, and cycled (lost and regained) 2.3 kg weekly. Two-thirds gained weight
      in the postseason. The most frequently used weight loss methods included
      increased exercise, food restriction, gradual dieting, and heated wrestling
      rooms. Subjects relied primarily on coaches and fellow wrestlers for sources of
      weight management. Using symptom severity levels by Hawkins and Clement (1980)
      and the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III;
      American Psychiatric Association, 1980) criteria, 2.8% of subjects were
      classified as bulimic; 1.4% using DSM-III-R (3rd ed.; rev; American Psychiatric
      Association, 1987); and 1.4% met both DSM-III and DSM-III-R. There were
      significant differences between the diagnostic (DG) and nondiagnostic groups
      (NDG) in weight lost to certify, weekly weight fluctuation, postseason weight
      gain, and severity of binge eating. The DG used fasting, food and fluid
      restriction, dehydration methods, and laxatives significantly more often to
      promote weight loss. They also experienced significantly more negative feelings
      during and following binging. Implications for nursing research and clinical
      practice are also discussed.

PMID- 2243267
TI  - Changes in maternal characteristics are predictive of changes in maternal
      perception of infant temperament.

PMID- 2243268
TI  - Factors associated with inadequate prenatal care.

PMID- 2243269
TI  - Cost categories, behavior patterns, and break-even analysis.
AB  - Nurse executives budget and control costs, use those budgets and other management
      tools to control departmental costs, identify existing programs to drop or
      change, target new programs and services, and determine fees for nursing
      services. Knowledge of costs and their behavior patterns assist nurse executives
      in all of these activities. The author identifies the two cost categories (direct
      and indirect), explains the basic cost behavior patterns (fixed and variable),
      and helps nurse executives identify these cost categories and behavior patterns
      in their own departments.

PMID- 2243270
TI  - Expanded nurse autonomy. Models for small rural hospitals.
AB  - Individual nurse autonomy in hospital settings seems an elusive goal. Models for
      increasing autonomy appear to have bypassed many small rural hospitals. The power
      and politics model of organizations helps describe impediments to and
      opportunities for power that can support autonomous practice. Expanded clinical
      ladders and modified shared governance are offered as models that can increase
      nurse autonomy in small rural hospitals that lack the human resources of large
      urban centers.

PMID- 2243271
TI  - Physician bonding. The role of the nurse executive.
AB  - Nurse executives know the significant contributions physicians make to patient
      care revenues. Healthcare agencies are in fierce competition to attract and
      retain physicians. The development of a physician "bonding" program is an
      innovative strategy to build physician loyalty and insure use of agency services.
      The nurse executive plays a key role in physician relationships. The author
      presents the role of the nurse executive in the strategic development and
      implementation of a physician bonding program.

PMID- 2243272
TI  - Collaborative management. A nursing practice model.
AB  - The authors discuss an innovative, collaborative management model intended to
      promote optimal patient care, personal and professional nurse satisfaction, and
      cost-effectiveness. The model delineates the role components of the nurse
      manager, the clinical nurse specialist, and the clinical nurse. Although the
      model is applied to a high-risk antenatal unit, staff members and managers can
      easily adapt the model to any unit.

PMID- 2243273
TI  - Chief nurse executive incentive compensation.
AB  - More and more chief nurse executives (CNEs) are receiving incentive compensation
      plans. The authors report trends in incentive compensation and discuss what 184
      CNEs in multihospital systems said about their incentive compensation plan.

PMID- 2243274
TI  - What we need to change about nursing. Staff nurses share their ideas.
AB  - New ways of structuring the delivery of nursing care, recruitment strategies, and
      retention programs are consistently needed if quality healthcare is to be
      preserved. The experience described in this article suggests that staff nurses
      propose creative and pragmatic solutions that enhance those of their managers.
      The author presents the recommendations of a task force designed to address the
      challenge of the nursing shortage in order to stimulate similar innovative
      activities in other settings.

PMID- 2243275
TI  - When less is more.

PMID- 2243276
TI  - Management time: who's got the monkey?
AB  - In any organization, the manager's bosses, peers, and subordinates--in return for
      their active support--impose some requirements, just as he imposes upon them some
      of his own where they are drawing upon his support. These demands on him
      constitute so much of the manager's time that successful leadership hinges on his
      ability to control this "monkey-on-the-back" input effectively.

PMID- 2243277
TI  - Ultrastructural aspects of oogenesis and oocyte growth in fish and amphibians.
AB  - Oogenesis, the early events of primary oocyte growth (meiotic arrest, synapsis,
      ribosomal gene duplication), and folliculogenesis can be seen to particular
      advantage in the germinal ridge of the syngnathan ovary. After budding off the
      germinal ridge (a compartment of the luminal epithelium), nascent follicles then
      enter into a linear array of developing follicles within which temporal and stage
      specific events can be correlated with spatial distribution. Prominent features
      of the later phase of primary oocyte growth include intense transcriptional
      activity and the formation and subsequent dispersal of the Balbiani vitelline
      body (mitochondrial cloud) concomitant with an increase in cytoplasmic organelles
      and volume. Further oocyte growth is characterized by a period of cortical
      alveolus (in teleosts) or cortical granule (in anurans) formation, in which Golgi
      elements play a predominant role, and finally vitellogenesis. The latter process,
      which is responsible for the preponderance of oocyte growth, includes the hepatic
      synthesis and secretion of vitellogenin (VTG), the uptake of VTG from the
      bloodstream into the oocyte by receptor-mediated endocytosis, and the transport
      of VTG via endosomes and multivesicular bodies to forming yolk platelets. In the
      process, VTG is proteolytically cleaved into the yolk proteins, which assume
      either a monoclinic (in cyclostomes) or orthorhombic (in teleosts and amphibians)
      crystalline array. Other structures associated with the growing oocyte are also
      briefly discussed, including nuage, the vitelline envelope, intercellular
      junctions between the oocyte and overlying follicle cells, pigment,
      intramitochondrial crystals in ranidae, and annulate lamellae.

PMID- 2243278
TI  - Transformation of the amphibian oocyte into the egg: structural and biochemical
      events.
AB  - Amphibian oocytes, arrested in prophase I, are stimulated to progress to
      metaphase II by progesterone. This process is referred to as meiotic maturation
      and transforms the oocyte, which cannot support the early events of
      embryogenesis, into the egg, which can. Meiotic maturation entails global
      reorganization of cell ultrastructure: In the cell cortex, the plasma membrane
      flattens and the cortical granules undergo redistribution. In the cell periphery,
      the annulate lamellae disassemble and the mitochondria become dispersed. In the
      cell interior, the germinal vesicle becomes disassembled and the meiotic spindles
      form. Marked changes in the cytoskeleton and mRNA distribution also occur
      throughout the cell. All of these events are temporally correlated with
      intracellular signalling events: Fluctuations in cAMP levels, changes in pH,
      phosphorylation and dephosphorylation, and ion flux changes. Evidence suggests
      that specific intracellular signals are responsible for specific reorganizations
      of ultrastructure and mRNA distribution.

PMID- 2243279
TI  - Modification of the Polaron sputter-coater unit for glow-discharge activation of
      carbon support films.
AB  - We describe a modification of the Polaron sputter-coater unit series 11 HD
      enabling activation of carbon support films for electron microscopy of
      macromolecules and macromolecular assemblies. The modification is simple and the
      device can be used in two modes, for sputter-coating of SEM samples and for glow
      discharge activation of carbon support films. Examples of protein-free spreading
      of DNA and negative staining of bacteriophage particles on activated carbon
      support films are presented.

PMID- 2243280
TI  - Transmission electron microscopic x-ray quantitative analysis of human dentin at
      200 kV accelerating voltage.
AB  - Qualitative and quantitative x-ray energy dispersive spectroscopy is now used
      successfully to analyze many features and processes in inorganic samples. When
      applied to inorganic samples, however, the results are often less satisfactory
      due to problems of preparation of organic samples, difficulty of measuring x-rays
      from organic samples, damage of the sample by the electron beam, and other
      practical problems. In the present study we used a high voltage transmission
      electron microscope equipped with an energy dispersive x-ray spectrometer to
      examine accurate quantitative standardless analysis of thin sections of an
      organic sample, human dentin. Based on our experiments we found the important
      parameters for quantitative analysis were sample thickness and appropriate choice
      of model sample. Further, we show that the method of Cliff and Lorimer can be
      used with biological samples at 200 kV, and we show that quantitative analysis of
      human dentin can be carried out at 200 kV. Finally, we show that areas of human
      dentin can be differentiated by their morphological characteristics and x-ray
      analyses obtained in the transmission electron microscope.

PMID- 2243281
TI  - The preparation of cross-sectional transmission electron microscopy specimens of
      Nb/Al multilayer thin films on sapphire substrates.
AB  - We have developed a technique for preparation of cross-sectional transmission
      electron microscopy samples of reacted and unreacted Nb/Al multilayer thin films
      on sapphire substrates. The choice of substrate was found to be extremely
      important. Sapphire sputters more slowly than Nb and Nb-compounds and therefore
      makes it possible to obtain the electron transparent regions in the thin films
      rather than in the substrate. However, the brittle nature of the sapphire
      restricts the types of thinning techniques that can be used, requiring extensive
      ion thinning as a final stage.

PMID- 2243282
TI  - The need for accurate nutrition survey methodology: the South Carolina
      experience.
AB  - Assessment of two nutrition-related risk factors, obesity and fat intake, was
      completed on a representative sample of South Carolina adults. Obesity estimates
      determined from self-reported heights and weights were less than prevalences
      determined from direct measurements (white males 21.4% vs. 28.2%; white females
      20.8% vs. 24.5%; black males 29.2% vs. 30.1%; black females 43.6% vs. 50.6%; and
      total 24.9 vs. 29.8%). Nine fat-intake habits were identified from dietary
      mannerisms involving the consumption of red meat, fat on meat, fried
      fish/chicken, butter, eggs, whole milk, bacon/sausage, and cheese and the use of
      solid fats when cooking vegetables. The mean number of the nine habits exhibited
      was four. The total number of habits did not correlate well with serum
      cholesterol, as 27% of the individuals with none of the nine fat intake habits
      had blood cholesterol values greater than 6.2 mmol/L (239 mg/100 mL), while only
      17% of the individuals with seven habits had the high level of cholesterol. These
      nine habits explained less than 10% of the variability of serum cholesterol
      values.

PMID- 2243283
TI  - Nutrition monitoring: interface of science and policy.
AB  - Information collected through nutrition monitoring efforts is an essential
      component in the process of effectively translating scientific evidence into
      public policy. This paper reviews the uses of nutrition monitoring data for
      policy and program decisions, describes recent progress to strengthen the
      National Nutrition Monitoring System, and outlines challenges that lie ahead in
      the nutrition monitoring arena.

PMID- 2243284
TI  - Selection of nutrition status indicators for field surveys: the NHANES III
      design.
AB  - Planning a multipurpose survey in which nutritional status is assessed requires a
      series of scientific and practical decisions that are constrained by available
      resources of money and time and by the limits to what can be expected from the
      respondents. This paper describes the planning process for a multipurpose survey
      using our experience with the third National Health and Nutrition Examination
      Survey (NHANES III) as an example. Ideally, the goals and objectives are well
      defined at the outset, and these guide the development of the survey content and
      statistical design. Because the needs for information are so great, criteria need
      to be developed for evaluating which topics will be included in the survey and
      what tests will be used. In planning the NHANES III, the evaluation criteria used
      were the scientific merit of the topic, its public health importance, its
      practical utility to the government, and the feasibility of implementing it
      within the survey's mode of operation. After the topics to be covered in a survey
      have been selected, questionnaires and examination protocols are developed, pilot
      tested, and revised prior to implementing the survey. Procedures are established
      for providing for informed consent and assuring the confidentiality of findings.

PMID- 2243285
TI  - Field issues for the plan and operation of the laboratory component of the Third
      National Health and Nutrition Examination Survey.
AB  - The design of the laboratory component of a mobile examination survey such as the
      National Health and Nutrition Examination Survey requires that the physical
      limitation of the mobile examination center be balanced against the requirements
      of the laboratory analyses needed to fulfill the goals of the survey. In order to
      include an analysis in the survey, the scientific merit of the laboratory test
      must be established and a consensus must be reached on the appropriateness of the
      technology for the six years of the survey. The public health importance of the
      analysis and the subsequent results are also evaluated before inclusion into the
      laboratory protocol. Finally, the feasibility of incorporating the analysis into
      the protocol is reviewed. The laboratory component of NHANES III is discussed,
      addressing these points with descriptions of the reasons for inclusion and
      exclusion of key analytes.

PMID- 2243287
TI  - Dose-response tests in field surveys.
AB  - Single static biochemical measures that are commonly used in field surveys often
      do not capture the dynamic metabolic situation that is most closely related to
      nutritional status. In contrast, short-term dose-response tests provide more
      reliable information about nutritional status for some nutrients, but not for
      others. In vivo response tests for vitamin A and for iron are promising, and in
      vitro enzyme stimulation tests for thiamin, riboflavin, pyridoxine, and selenium
      have been widely used. In vivo response tests are constrained by the needs for a
      waiting period, often for two or more biological samples, and usually for
      sophisticated instrumentation. In large field surveys, dose-response tests may be
      best used on a subsample of the population studied.

PMID- 2243286
TI  - Quality control in planning and operating the laboratory component for the Third
      National Health and Nutrition Examination Survey.
AB  - Successfully acquiring high-quality laboratory data for a long-term nutrition
      survey such as the Third National Health and Nutrition Examination Survey (NHANES
      III) requires rigorous quality-control procedures throughout the entire design
      and implementation of the laboratory component. We discuss selection of
      nutritional biochemistry analyses, proper specimen collection, and the critical
      need for continuity of protocol during the entire survey. The NHANES III
      laboratory procedures are described, including specimen collection, processing,
      shipment to laboratories, and analyses.

PMID- 2243288
TI  - Methods for assessment of vitamin A status.
AB  - Assessment of the relative level of vitamin A nutriture in human populations when
      clinical signs and symptoms of deficiency or of toxicity are absent has presented
      methodological difficulties. Commonly used indicators include dietary intakes of
      the vitamin, serum levels, and dark adaptation, all of which have limitations in
      their precision, especially when applied to individuals and to young children.
      New and developing nonclinical indicators include the relative dose response
      (RDR) test or a modification (MRDR) of it, conjunctival impression cytology
      (CIC), and isotope dilution to estimate total body reserves. These methods, all
      of which are promising, require additional work to verify their sensitivity,
      specificity, and predictive power as indicators of relative states of vitamin A
      depletion for individuals and populations under the many varied conditions
      commonly associated with an inadequate vitamin status. Currently, the most
      reliable assessment of vitamin A nutriture is likely when a combination of
      methods is used.

PMID- 2243289
TI  - The use and interpretation of assays for vitamin D and its metabolites.
AB  - Vitamin D is essential for the maintenance of calcium and bone metabolism in
      humans. The recommended daily allowance (RDA) for vitamin D in the United States
      of 200 IU (5.0 micrograms) is reasonable for adults who receive some exposure to
      sunlight; however, in the absence of any exposure to sunlight, this
      recommendation may be 2 to 3 times lower than that actually required to satisfy
      the body's needs. Vitamin D was first measured by bioassays. However, bioassays
      became obsolete in light of the revelation that vitamin D must be activated first
      in the liver to 25-hydroxyvitamin D (25-OH-D) and then in the kidney to 1,25
      dihydroxyvitamin D [1,25(OH)2D] before becoming biologically functional. Current
      assays measure circulating concentrations of vitamin D, 25-OH-D or 1,25(OH)2D.
      The serum vitamin D concentration is of value for determining the role of
      sunlight in producing vitamin D in skin and as a provocative test to determine
      the absorption of vitamin D in patients with malabsorption syndromes. The serum
      concentration of 25-OH-D is most valuable for determining the overall vitamin D
      status of an individual, since it is an average of dietary and sunlight-induced
      vitamin D. The measurement of the serum 1,25(OH)2D concentrations has been most
      useful in evaluating disorders in calcium and bone metabolism related to acquired
      and inborn errors in the conversion of 25-OH-D to 1,25(OH)2D.

PMID- 2243290
TI  - Assessing calcium status and metabolism.
AB  - Currently, there is no commonly practiced tool for assessing calcium status of
      individuals or populations. Few biochemical markers reflect calcium status.
      Fasting urinary calcium:creatinine ratios may hold promise as an easy,
      inexpensive method to indicate recent calcium status. Calcium status may best be
      assessed by integrated measures of calcium assimilation, such as total-body
      calcium. Although bone-mass measurements do not correlate well with recent
      dietary intakes of calcium, long-term adequacy of calcium intake influences bone
      mass. Whether low calcium intakes lead to calcium deficiencies depends on one's
      ability to adapt and conserve calcium. The relationship between calcium status
      and a particular disease state, such as osteoporosis, hypertension, or colon
      cancer, cannot be established until a reliable indicator of calcium status is
      found.

PMID- 2243291
TI  - Assessment of zinc status.
AB  - Plasma zinc concentration has been denigrated as a measure of zinc status because
      it responds to metabolic conditions unrelated to zinc status and because it is
      insensitive to changes in dietary zinc. The insensitivity of plasma zinc to
      reductions in dietary zinc reflects the tremendous capacity of the organism to
      conserve tissue zinc by reductions in zinc excretion and/or reductions in the
      rate of growth. Changes in plasma zinc concentrations do not seem to occur until
      the capacity to reestablish homeostasis by reducing excretion and/or growth has
      been exceeded. Reductions in dietary zinc beyond the capacity to maintain
      homeostasis lead to utilization of zinc from a small, rapidly turning over pool.
      This pool is located, at least in part, in the bone, liver, and plasma. Loss of a
      small, critical amount of zinc from this pool leads to the rapid onset of both
      biochemical and clinical signs of zinc deficiency. Thus, plasma zinc is a valid,
      useful indicator of the size of this exchangeable pool of zinc. Plasma
      metallothionein concentrations may prove useful for identifying poor zinc status.
      Plasma metallothionine concentrations reflect hepatic concentrations and,
      therefore, are reduced when the dietary zinc supply is low. However, since
      hepatic metallothionein concentrations rise in response to stress, plasma
      metallothionein concentrations are increased in this state when the plasma zinc
      concentrations are also likely to be low. Thus, measurement of both plasma
      metallothionein and plasma zinc concentrations could differentiate a low plasma
      zinc due to dietary zinc deficiency from a low concentration due to stress,
      infection, or other metabolic conditions.

PMID- 2243292
TI  - Assessment of human vitamin C status.
AB  - Since no reliable functional markers of human vitamin C status have been
      demonstrated, determination of vitamin C levels in blood plasma and/or leukocytes
      remains the current choice for individual and population assessments. Newer
      analytical techniques, especially high-performance liquid chromatography, allow
      determination of reduced (ascorbic acid), oxidized (dehydroascorbic acid), or
      total amounts of vitamin C in biological specimens or foods. Plasma levels of
      vitamin C forms are easily determined but may not reflect tissue content as well
      as leukocyte levels. The vitamin C content of leukocyte cell types varies
      severalfold and, unlike plasma, leukocytes may contain an appreciable fraction of
      dehydroascorbic acid. The effects of sex, age, cigarette smoking, drugs, and
      physiological factors on vitamin C levels are better known for plasma than
      leukocytes. To realize the potential of leukocytes as measures of vitamin C
      status, continued work is needed in standardizing the methodology and
      interpretive guidelines and simplifying the technique for blood processing. The
      search for specific functional markers of vitamin C deficiency should continue.
      Candidate markers may involve pathways of carnitine or collagen metabolism,
      immunocompetence, or antioxidant defense.

PMID- 2243293
TI  - Iron: nutrition monitoring and nutrition status assessment.
AB  - The majority of anemias in the United States are characterized by low mean
      corpuscular volume and thus are classified as microcytic. Iron deficiency,
      chronic disease and thalassemia traits are the three leading causes of microcytic
      anemia. The true cause of anemia must always be sought so that the prevalence
      estimates of iron deficiency are accurate and so that appropriate treatment can
      be initiated for the anemic individual. In both the clinical setting and in
      surveys, the most frequent differential diagnosis of microcytic anemia will
      involve distinguishing between iron deficiency and chronic disease. Erythrocyte
      sedimentation rate (ESR), zeta-sedimentation rate (ZSR), and C-reactive protein
      (CRP) are elevated in a variety of diseases. These indicators may help
      differentiate the anemia of chronic disease from iron deficiency, so that iron
      deficiency is not overestimated in hospitalized and aged populations. The red
      cell distribution width (RDW) appears to be elevated to a greater extent in iron
      deficiency than in chronic disease or thalassemia traits. RDW and CRP are two of
      several indicators of iron status in the third National Health and Examination
      Survey (NHANES III).

PMID- 2243294
TI  - A review of field techniques for the assessment of energy expenditure.
AB  - The assessment of energy expenditure in free-living subjects is central to a
      complete understanding of the etiology of obesity, malnutrition, coronary heart
      disease, and osteoporosis. Laboratory-based methods that rate high with respect
      to validity and reliability do not lend themselves to this task because they are
      restrictive, expensive, or both. Investigators have therefore developed survey
      methods, physiological markers, and mechanical or electrical monitors for use in
      the field. The development of the doubly labeled water method for measuring
      energy expenditure and increased availability of room indirect calorimeters has
      recently made it possible to evaluate these field techniques. Some of the
      recently developed mechanical and electrical monitors have been found to be valid
      for the measurement of energy expenditure, but even the best provide measures
      that are too variable to be useful on an individual basis.

PMID- 2243295
TI  - Assessment of protein nutritional status.
AB  - An evaluation of protein status can be approached by use of anthropometric,
      clinical, and biochemical data, either singly or in combination, and further
      aided with dietary data. Each of these approaches has advantages and limitations.
      Biochemical evaluation has the potential of being the most objective and
      quantitative. Indicators that have been or might be used include plasma hormone
      responses to reduced protein intake, plasma levels of specific proteins or
      specific amino acids, urinary excretion of specific amino acids and other
      nitrogen-containing compounds, anthropometric and physical measurements of body
      muscle mass, and functional tests of muscle strength. Several measurements can be
      combined to produce nutritional indices of broader potential value. The
      importance of concomitant infection and inflammation, with its many effects on
      protein metabolism, cannot be ignored in making these assessments. Unfortunately,
      no single test or group of tests can be recommended at this time as a routine and
      reliable indicator of protein status. Nonetheless, our increasing knowledge of
      the metabolism and functions of proteins, together with the recent use of
      noninvasive stable isotope techniques and of sophisticated physicochemical
      measurements, provides encouragement that more appropriate indicators are in the
      offing.

PMID- 2243296
TI  - Vitamin B-6: a status report.
AB  - Over the past 50 yr there has been an increased awareness of the importance of
      vitamin B-6 in human nutrition. The knowledge base for evaluation of vitamin B-6
      status has also increased. Indices for vitamin B-6 status can be separated into
      direct and indirect measures. Among the direct measures, plasma pyridoxal 5'
      phosphate (PLP) is considered the most relevant. However, measurement of plasma
      pyridoxal or total vitamin B-6 and urinary 4-pyridoxic acid are also recommended.
      Indirect measures of vitamin B-6 include the assessment of urinary excretion of
      xanthurenic acid following a tryptophan load. This is a valid functional index
      for otherwise healthy persons. Evaluation of erythrocyte transaminase activity
      and stimulation with PLP provide an estimate of vitamin B-6 intake over an
      extended period of time. In addition to biochemical measures, determination of
      vitamin B-6 and protein intake are necessary. Present evidence suggests plasma
      PLP, urinary 4-pyridoxic acid, at least one indirect measure, and the intake of
      vitamin B-6 and protein are needed to properly assess vitamin B-6 status. The
      levels of plasma pyridoxal and erythrocyte PLP are newer measures of status and,
      with further refinement of methodology, may provide additional insight into
      vitamin B-6 status.

PMID- 2243297
TI  - Folate status assessment.
AB  - This paper is a review of established methods of folate status assessment and the
      primary factors that increase the risk of folate deficiency, including
      physiological life cycle changes. The first stage of folate depletion can be
      assessed by measuring serum folate levels, which drop prior to tissue depletion,
      and which are paralleled by a reduction in red blood cell (RBC) folate.
      Functional changes associated with abnormalities in biochemical pathways can be
      monitored by the deoxyuridine suppression test. Cell division, including
      erythropoiesis, becomes impaired in the same time sequence as changes in
      biochemical functions, as evidenced by abnormal erythrocyte morphology and a
      reduction in hemoglobin concentration. In addition to inadequate dietary folate
      intake, key factors that may impair folate utilization and thus status include
      alcohol consumption, smoking, and specific drugs. Folate requirements may
      increase during various phases of the life cycle due to physiological stresses
      such as pregnancy and lactation. Folate status may also be compromised during
      adolescence and in senescence for diverse reasons that require special emphasis
      on factors such as biological maturity and socioeconomic status, as well as
      chronic use of alcohol, drugs, and smoking.

PMID- 2243298
TI  - The importance of context in choosing nutritional indicators.
AB  - Nutritional indicators are used to screen, diagnose, and evaluate interventions
      in individuals. They are also used in populations to ascertain and place under
      surveillance the magnitude of nutritional problems, their location and causes,
      and to evaluate the impact of programs and policies. Nutritional indicators are
      also used for research to make inferences about biological and social mechanisms
      affecting or being affected by nutrition. All these activities include
      measurements of nutritional indicators, but the choice of indicators, their
      measurements, analyses, and the need for other data can be very different for
      inferences from research, for patient management, for making public policy, or
      for planning or evaluating programs. There is no best indicator, best measure of
      an indicator, or best analysis of an indicator in a generic sense. The definition
      of "best" depends ultimately on what is most appropriate for the decision that
      must be made. This paper gives examples.

PMID- 2243299
TI  - Dietary intake methodology I. USDA surveys and supporting research.
AB  - Nationwide food consumption and dietary surveys have been conducted about every
      10 yr by the U.S. Department of Agriculture (USDA) since the mid-1930s to fulfill
      responsibilities for monitoring dietary patterns among the nation's population.
      Survey findings have implications for policies and programs related to food
      production and marketing, food safety, food assistance, and nutrition education.
      Until 1965, these surveys measured household food consumption only, but
      subsequent surveys were expanded to include food intakes by individuals in the
      sample households. Since 1985, small-scale continuing surveys of food intakes by
      individuals have been conducted during the years between the large decennial
      surveys. The 1-d recall was used in the first dietary intake survey. Then, to
      capture day-to-day variation in diets, 3 d of intake data, 1-d recall and 2-d
      records, were collected in 1977-1978, 1987-1988, and 1989. Prior to the 1977-1978
      dietary intake survey, USDA embarked upon an intensive program of extramural
      research that was designed to improve methodologies for surveying individuals'
      dietary intakes. Since 1975, many major investigations have been completed and
      results have been incorporated in current survey procedures. Studies included
      testing of varied recall and diary methods, approaches for validating survey
      data, debriefings of survey respondents and interviewers, intersurvey
      comparisons, and testing of panel approaches with in-person, telephone, and mail
      contacts.

PMID- 2243300
TI  - Dietary intake methodology. II. USDA's Nutrient Data Base for Nationwide Dietary
      Intake Surveys.
AB  - The U.S. Department of Agriculture's (USDA) Nutrient Data Base for Nationwide
      Dietary Intake Surveys is specifically organized and maintained to analyze data
      from nationwide dietary surveys within the federal government's National
      Nutrition Monitoring System. These surveys include the Nationwide Food
      Consumption Survey and the Continuing Survey of Food Intakes by Individuals
      conducted by USDA, and the National Health and Nutrition Examination Survey
      conducted by the Department of Health and Human Services (DHHS). Each public
      release of the data base covers one or more specific surveys. The data base
      contains data for energy and 28 components for over 5000 food items. Data are
      based on the latest information from USDAs National Nutrient Data Bank, the
      computer-based system used to update USDAs standard reference on food
      composition, Agriculture Handbook No. 8. An automated system is also used to
      update the survey nutrient data base with new information released from the
      Nutrient Data Bank. This system includes three supplementary data sets (primary
      nutrient data set, recipe file, and table of nutrient retention factors) and a
      computer program for calculating nutrient content of mixed food items based on
      nutrient content of their ingredients. Updates are performed at the beginning of
      new surveys to incorporate the most up-to-date nutrient values.

PMID- 2243301
TI  - Nutritional assessment of homebound rural elderly.
AB  - Approximately one quarter of Americans aged 65 and older live in rural areas.
      Homebound rural elderly are a hard to reach, often poor and frail population.
      Failure to include homebound rural elderly in nutritional studies may bias
      representativeness of samples of elderly persons. This paper discusses some
      challenges in recruiting homebound older persons to participate in nutritional
      studies and in establishing quality control procedures in a field setting.

PMID- 2243302
TI  - In-home nutritional assessment of inner-city elderly.
AB  - Aims of this research have been to obtain aggregate data on reported problems in
      food access that are experienced by homebound, inner-city elderly; to
      disaggregate the data to show which subgroups of elderly are at highest risk for
      these types of food insecurity; and to assess whether these elderly differ
      socioeconomically, medically, or nutritionally from homebound elderly who report
      that they eat regularly. Instruments were designed to measure population-based
      food insecurity and to ask respondents to provide information about their
      socioeconomic status and disabilities as well as the extent to which they have
      formal or informal assistance in obtaining food. The need to collect this
      information has been linked to a state-wide effort to target city nutritionally
      needy elderly for home-delivered meals. Findings have been that food insecurity
      in the inner-city homebound is linked to loss of mobility as well as to poverty
      and lack of in-home food assistance. Minority elderly whose questionnaire
      responses indicate food insecurity include diabetics whose disease control is
      adversely affected by irregular eating. When methods of home assessment have been
      used to examine the extent to which a home-delivered meals program meets the
      nutritional needs of recipients, it has been possible to demonstrate that meals
      recipients show less food insecurity than a comparison group on waiting lists to
      receive meals.

PMID- 2243303
TI  - Development of indicators to assess hunger.
AB  - Despite widespread concern about hunger in America, efforts to monitor and assess
      the extent of hunger have been hampered by lack of consensus on an appropriate
      meaning for the term hunger and by the lack of valid indicators to assess it. The
      first phase of the research used qualitative methods to derive a socially
      appropriate definition of hunger. Thirty-two women in Upstate New York were
      interviewed regarding their experience with food problems and hunger. The
      interviews were analyzed using the constant comparative method. Results indicated
      that women had a narrow and a broad concept of hunger. The narrow concept focused
      on going without food for a specified period of time and the physical sensation
      of hunger. The broad one included two dimensions: household and individual
      hunger. Each had quantitative, qualitative, psychological, and social components.
      The second phase of the research used survey methodology to examine the validity
      and reliability of items designed to measure the conceptual definition of hunger.
      The survey was administered to 189 women in Upstate New York who participated in
      programs designed for low-income households or households in need of food. The
      second phase confirmed the conceptualization of hunger developed in the first
      phase. A subset of valid and reliable items that represented each of the major
      dimensions and components of hunger was identified as being useful for monitoring
      and assessing hunger.

PMID- 2243304
TI  - Progress in the development of a nutritional risk index.
AB  - The development of a 16-item nutritional risk index (NRI) is chronicled from its
      inception through its application in three studies designed to assess its
      reliability and validity. Study I involved a survey of 401 community-dwelling
      elderly in St. Louis, Missouri who were interviewed at baseline, 4-5 mo later,
      and 1 yr later. Study II involved a cross-sectional survey of 377 male
      outpatients attending two clinics at the St. Louis Veterans Administration
      Medical Center. Study III involved a cross-sectional survey of 424 community
      dwelling elderly in Houston, Texas. Internal consistency reliability coefficients
      ranged between 0.47 and 0.60, and test-retest reliability coefficients ranged
      between 0.65 and 0.71. Validity was established by using the NRI to predict the
      use of health services, as well as by correlating it with a variety of
      anthropometric, laboratory, and clinical markers of nutritional status. The
      utility of the NRI for future applications is discussed.

PMID- 2243305
TI  - Core indicators of nutritional state for difficult-to-sample populations.
AB  - Previous expert working groups have concluded that common descriptors and
      measurements are needed for all types of population groups to provide improved
      and expanded coverage and comparable and compatible data among surveys monitoring
      the nutritional and dietary status of the U.S. population. This report summarizes
      the discussions of an ad hoc Expert Panel charged with identifying core
      indicators to assess the nutritional status of difficult-to-sample populations.
      Members of the Expert Panel had wide research experience including survey design,
      food security, food consumption, nutritional status, health-related conditions
      associated with nutritional status, and nutrition and public policy. The varied
      backgrounds of the Panel members led to consideration of the concept of core
      indicators of nutritional status from a broad perspective. Early in their
      discussions the Expert Panel recognized that public health officials and
      policymakers use information on nutritional status for the purposes of problem
      identification, program planning and resource direction, and program and policy
      evaluation. This recognition raised several issues which formed the conceptual
      framework for subsequent discussions, study conclusions, and research
      recommendations. These issues centered on the following concepts: the purpose for
      which data are used determines the suitability of indicators; the scope of
      information required varies for the purposes identified above; a broad range of
      indicators is needed to supply information useful for public policy decisions on
      nutrition; that is, assessment of the nutritional status of populations by
      measurement of dietary intakes of nutrients and anthropometric, biochemical, and
      clinical indices can provide only a portion of the information needed for these
      purposes in the United States; nutritional problems in the U.S. general
      population may signal some, but not all, anticipated nutritional concerns for
      difficult-to-sample populations; and, adequate coverage and suitable sampling
      methods are overriding concerns for obtaining interpretable data and appear to be
      a larger issue than suitable measures for nutritional assessment in the case of
      difficult-to-sample populations. Guided by consideration of these issues, the
      Expert Panel recognized that they could not provide a comprehensive design for
      the evaluation of nutritional status for all difficult-to-sample populations that
      would be appropriate for all public health and policy purposes. Therefore, the
      Expert Panel concentrated their discussions on enumeration of the various issues
      that must be considered in planning any effort to evaluate the nutritional
      concerns for such populations.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 2243306
TI  - Clinical evaluation of elastomeric hydrogel peripheral catheters during home
      infusion therapy.

PMID- 2243307
TI  - Impact on patient care. 2652 PIC catheter days in the alternative setting.
AB  - Management of parenteral therapies in the home or nonacute setting is essential.
      Peripherally inserted long-line catheters establish venous access in patients in
      a safe, cost-effective, and improved manner. Data were collected on 130 cases
      from 24 offices in 16 states. The most frequently occurring types of therapies
      used were antibiotic, pain control, and parenteral nutrition. Average length of
      therapy was 20.4 days. The major reasons for catheter removal other than
      completion of therapy (58%) were occlusion (14%), breakage (5%), and phlebitis
      (4%).

PMID- 2243308
TI  - Home pain management. Continuous infusion of narcotics.
AB  - Home pain management is a complex and challenging therapy for the home infusion
      nurse. A thorough knowledge of pain assessment, therapeutic approaches, and
      pharmacology of narcotics; management of side effects; and a recognition of
      individual variations in response are necessary for successful pain control.
      Continuous infusions of narcotics can be safely administered in the home setting,
      thus leading to an improved quality of life for patients with intractable pain. A
      retrospective chart review of 20 patients cared for by Deaconess Home Health Care
      Corporation in Boston, Massachusetts, illustrates the wide variation in
      individual narcotic requirements necessary to achieve pain control. Three case
      studies are also included to provide further comparison.

PMID- 2243309
TI  - Advanced central venous access. Selection, catheters, devices, and nursing
      management.
AB  - The increased need for intravascular access in the care of a variety of patients
      is, in part, responsible for the diversity of central venous access devices.
      Various nontunneled catheters, tunneled catheters and implantable ports are
      available on the health care market. As the availability of these devices
      increases, so must the nurse's knowledge base in order to provide optimal safe
      care to patients using different devices. Learning which device is best suited
      for each patient and which has the fewest known complications can be a tedious
      process for the nurse specialized in venous access care.

PMID- 2243310
TI  - Intraperitoneal therapy via the Tenckhoff catheter. Prevention and management of
      complications.
AB  - Mathematical modeling and clinical trials have increased the use of
      intraperitoneal (IP) therapy in cancer care. A direct result of this increase in
      IP therapy research is an increasing use of access devices. One of the most
      commonly selected access devices is the Tenckoff catheter. The prevention and
      management of complications of IP therapy via the Tenckhoff catheter are
      nursing's responsibility. Complications include peritonitis, catheter occlusion,
      exit site infections, leakage of fluid from around the catheter, and chemical
      peritonitis. Nurses' expertise in this area as clinicians and patient educators
      contributes to the success of IP therapy.

PMID- 2243312
TI  - Journal of Cardiology. Cumulative index. 1971-1987.

PMID- 2243311
TI  - A neonatal home intravenous antibiotic therapy program.
AB  - Home intravenous therapy offers many benefits for children as well as adults.
      Infants less than 1 month old may also benefit from home I.V. therapy. Neonates
      are a unique group of home I.V. therapy recipients, and providing safe home I.V.
      therapy for them requires changes in standard home I.V. policies and procedures.

PMID- 2243313
TI  - The HIV cytopathic effect: potential target for therapy?
AB  - HIV kills activated infected CD4+ T cells after a burst of replication and the
      release of large numbers of virions. From a review of the literature on HIV
      regulatory genes and from preliminary mathematical models of HIV dynamics at four
      levels (host population epidemiology, the immune system, gene regulation within
      infected cells, and selection of mutants) we have arrived at the theory that in
      the etiology of HIV the HIV cytopathic effect may actively be caused by a viral
      regulatory gene product. The most likely candidate is the rev regulatory protein.
      Rev and the analogous rex protein from HTLV-I (human T cell leukemia virus) both
      have two active sites with similar function: one site locates the protein in the
      nucleus/nucleolus, and the other site interacts with viral mRNAs, facilitating
      their export from the nucleus to the cytoplasm. Rev seems to have a third
      functional site near the 3' end. We conjecture that this site may be responsible
      for the cytopathic effect. We think that rev acts on cellular genes that normally
      induce senescence and cell death during development, or T-cell maturation, or on
      terminal differentiation. We propose that mathematical and computer models of the
      immune system could be used to explore whether suppression of the cytopathic
      action of the rev protein could be of therapeutic benefit in restoring the
      ability of the immune system to clear HIV or at least to extend latency. We also
      suggest how immune deficiency disease might be created as laboratory artifact in
      animal populations.

PMID- 2243314
TI  - Mathematical models of HIV infection. I. Threshold conditions for transmission
      and host survival.
AB  - This is the second in a series of papers modeling human immunodeficiency virus
      (HIV) infections at four levels: transmission, interaction with the immune
      system, gene regulation, and selection of mutants. In the previous paper (1) we
      described and presented a theory of the HIV cytopathic effect based upon the
      models (and a review of the literature). In this article we give mathematical
      equations of threshold conditions that connect infectivity, length of host
      survival, and frequency of acts conducive to transmission. The formula is derived
      not only for homogeneous populations but also for populations of an arbitrary
      number of subgroups with varying frequencies of risk behavior, varying rates of
      infection and latency periods, and varying frequencies of interaction with other
      groups.

PMID- 2243315
TI  - p21rex protein of HTLV-1.
AB  - Virion protein expression of the human T-cell leukemia virus type 1 (HTLV-1) is
      regulated by p27rex. This protein is expressed by a doubly spliced mRNA encoding
      an additional protein, p21rex. p27rex has been shown to increase the amount of
      unspliced viral mRNAs encoding envelope and capsid proteins. To assess a possible
      contribution of p21rex to the rex regulation, a point mutation was introduced
      into the p21rex initiation codon. Expression of env and gag plasmids, transfected
      in Jurkat cells, was dependent only upon p27rex expression and was not affected
      by the absence of p21rex. Consequently, the rex regulation of the HTLV-1
      structural genes can be solely attributed to the p27rex protein.

PMID- 2243316
TI  - Isolation of HIV-1 from the blood of seropositive adults: patient stage of
      illness and sample inoculum size are major determinants of a positive culture.
      The Walter Reed Retroviral Research Group.
AB  - Results of HIV-1 blood cultures from 609 seropositive adults across all stages of
      illness at the Walter Reed Army Medical Center were reviewed. HIV-1 was isolated
      by coculturing of patient peripheral blood mononuclear leukocytes (PBMCs) with
      normal blood donor target PBMCs that had been stimulated with phytohemagglutinin
      and interleukin-2. The HIV-1 isolation success rate at Walter Reed increased
      progressively each year from 1986 to 1989. In 1989, HIV-1 was isolated from a
      single blood specimen from patients in Walter Reed stages 1-2, 3-4, and 5-6 in
      75% (49/65), 90% (37/41), and 97% (30/31) of cases, respectively. None of 22
      blinded negative control specimens was positive. PBMC cultures from late stage
      patients regularly became positive within 7 days (92%), compared to only 46% of
      positive cultures from early stage patients. For most patients, the lowest number
      of serially diluted PBMCs that resulted in a positive culture was 30,000 patient
      PBMCs, but the range was 300 to 3 million cells. HIV-1 was isolated less
      frequently from plasma (5/18, 28%). Plasma viremia was detected only in patients
      with relatively high titers of infected PBMCs. Forty-six blood specimens from "at
      risk" seronegative adults were also cocultured; none was positive.

PMID- 2243317
TI  - Tracking the spread of the HIV infection epidemic among young adults in the
      United States: results of the first four years of screening among civilian
      applicants for U.S. military service.
AB  - Because the period from infection to clinically apparent disease is long,
      variable, and changing as new therapies are developed and applied, AIDS data are
      inadequate for tracking current values of critical parameters of HIV infection
      epidemics: prevalence of infection, rate of acquisition of new infections
      (incidence rate), and direction and rate of change of infection incidence over
      time (acceleration). These "vital signs" of infection epidemics can be tracked
      using serial cross-sectional seroprevalence data, however. From October 1985
      through September 1989, more than 2.3 million applicants for U.S. military
      service were screened for antibody to HIV. The overall seroprevalence was 1.31
      per 1,000 (3,014/2,300,675). Seroprevalences were highest near urban centers of
      the AIDS epidemic and were independently associated with age, race/ethnicity, and
      gender. Based on age seroprevalence trends, it was crudely estimated that at
      least one of 2,000 young men and one of 7,000 young women are infected with HIV
      annually in the U.S. Infection incidence rates, estimated from age and temporal
      trends, were estimated to be highest among black males (1.40/1,000/year) and
      lowest among white females (0.03/1,000/year). Poisson regression analysis of
      seroprevalence trends suggested that infection incidence rates accelerated among
      black females during the first 3 years of screening. Since selection factors
      undoubtedly changed over the period, estimates based on these data probably
      underestimate actual values in the general population, particularly near urban
      AIDS epicenters. Nonetheless, even crude estimates of these critical values,
      particularly among adolescents and young adults, are useful to guide policy
      development, to allocate resources, and to monitor program effects.

PMID- 2243318
TI  - Relapse from safer sex: the next challenge for AIDS prevention efforts.
AB  - Prevention campaigns to reduce sexual transmission of human immunodeficiency
      virus (HIV) typically emphasize the initial adoption of safer sex techniques. We
      present data from a 5-year prospective study to show that the vast majority of
      resident gay men in San Francisco have made these initial risk reductions.
      Rather, relapse from safer sex techniques is now the predominant predominant kind
      of high-risk sex, accounting for approximately two thirds of all prevalent high
      risk sex in the 1988 wave of data collection. Predictors of relapse from safer
      sex are identified, and these are discussed in terms of their implications for
      preventing relapse from the exclusive practice of safe sex. In communities that
      have already manifested widespread behavioral risk reductions and in which HIV
      infection is highly prevalent, finding ways to prevent relapse of behavioral risk
      reductions will be the next important challenge in the fight against acquired
      immune deficiency syndrome.

PMID- 2243320
TI  - Does HIV cause AIDS?

PMID- 2243319
TI  - Seroprevalence of HIV-2 infection in Greece (Crete).
AB  - The seroprevalence of HIV-2 was evaluated in 20,407 consecutive normal blood
      donors, 100 homo- and/or bisexuals, and 7,020 heterosexuals presenting for an HIV
      test using an EIA test. Sixty-seven sera were revealed to be repeatedly positive.
      Analysis by Western blot confirmed the infection in four cases, an indeterminate
      (antibodies against only the gag-encoded proteins) pattern was revealed in 25
      cases, whereas 38 sera were negative. Three of the four HIV-2-positive sera also
      reacted with two distinct, but close, synthetic peptides homologous to viral
      gp36. The fourth serum, which did not display antibodies against gp36 on Western
      blot, did not react with gp36-derived synthetic peptides. None of these sera
      reacted with native HIV-1 antigens or synthetic peptides homologous to gp41. Sera
      with an indeterminate HIV-2 Western blot did not react with gp36-derived
      synthetic peptides. Although 10 of them also displayed an indeterminate HIV-1
      Western blot, no serum sample reacted with two gp41-derived synthetic peptides or
      proved to be positive when they tested for p24 antigen. One bisexual and one
      heterosexual HIV-2 positive subject reported sexual contacts with West Africans,
      whereas two other heterosexuals had had multiple sexual partners from different
      countries.

PMID- 2243321
TI  - HIV-1 and HTLV-1 infections among intravenous drug abusers in Belgrade,
      Yugoslavia.

PMID- 2243322
TI  - Spontaneous lymphocyte proliferation in vitro characterizes both HTLV-I and HTLV
      II infection.

PMID- 2243323
TI  - Toward a concept of triage for labor and delivery: staff perceptions and role
      utilization.

PMID- 2243324
TI  - The effects of rocking, diet modifications, and antiflatulent medication on
      postcesarean section gas pain.

PMID- 2243325
TI  - Obstetric and gynecologic abdominal wound infections: a comprehensive nurse
      managed program.

PMID- 2243326
TI  - Prevention of Preterm Labor Project in a public hospital: breaking down barriers
      to prenatal care.

PMID- 2243327
TI  - Ostomy care for the infant with necrotizing enterocolitis: nursing
      considerations.

PMID- 2243328
TI  - Hyperviscosity-polycythemia syndrome: a case study.

PMID- 2243329
TI  - Mentorship: the key to the future of professionalism in nursing.

PMID- 2243330
TI  - Caring for the NICU parent.

PMID- 2243331
TI  - L-tyrosine potentiates the anorexia induced by mixed-acting sympathomimetic drugs
      in hyperphagic rats.
AB  - The effects of L-tyrosine (L-TYR) on the anorectic activity of several mixed
      acting sympathomimetics were determined during the dark cycle in rats made
      hyperphagic by food deprivation. L-TYR (200 mg/kg) significantly potentiated the
      anorectic activity of phenylpropanolamine, (-)-ephedrine and (+)-amphetamine by
      48, 50 and 37%, respectively. When the dose of L-TYR was varied (25-400 mg/kg), a
      significant dose-dependent relationship was noted. The observed potentiation was
      positively correlated with increases in brain TYR concentrations; blockade of L
      TYR uptake into the brain by the coadministration of L-valine prevented this
      potentiation. Various other L-amino acids, as well as D-TYR, failed to mimic the
      potentiating action of L-TYR. As determined by alpha-methyl-p-TYR pretreatment,
      the L-TYR-induced potentiation was dependent upon increased catecholamine
      synthesis. Although various other mixed-acting sympathomimetic anorexiants were
      similarly potentiated by L-TYR, the direct-acting beta-2 adrenoceptor
      anorexiants, salbutamol and methoxyphenamine, were not. These results indicate
      that L-TYR specifically potentiates the anorectic activity of the studied mixed
      acting sympathomimetics and are consistent with the requirement of the central
      conversion of L-TYR to catecholamines via TYR hydroxylase for this response. The
      possibility that the effect of mixed-acting sympathomimetics is normally limited
      by the availability of L-TYR is suggested.

PMID- 2243332
TI  - Suppressive effects of morphine pellet implants on in vivo parameters of immune
      function.
AB  - Chronic morphine treatment elicits a variety of immunosuppressive effects in
      mice. Most of the work describing this immuno-suppressive activity of the opioid
      is based on in vitro assessments of the performance of certain components of the
      immune system in morphine-treated animals. Relatively little has been done by way
      of tracking the effects of chronic morphine treatment on immunologic parameters
      in the intact animal. Therefore, this study used several classic in vivo
      determinations of immune function in mice treated chronically with morphine.
      Morphine pellet (75 mg) implantation led to a significant inhibition (91%) of paw
      swelling in a picryl chloride-induced delayed type hypersensitivity response.
      Uptake of iododeoxyuridine in an in vivo lymphocyte proliferation assay and
      splenomegaly in a graft vs. host reaction were also significantly suppressed by
      morphine pellet implantation (34 and 52%, respectively). Coimplantation of a
      naltrexone pellet (10 mg) completely reversed the suppressive responses to
      morphine in each assay. Naltrexone alone had no significant effect in any of the
      assays. The suppressive effects of morphine were less pronounced in
      adrenalectomized mice in the graft vs. host assay (51% vs. 9% reduction in
      morphine-pelleted shams relative to morphine-pelleted adrenalectomized mice).
      These findings indicate the pathophysiologic significance of the previously
      reported suppression of in vitro correlates of immune function in morphine
      pelleted mice. The results further demonstrate that the immunosuppressive effects
      observed after morphine pellet implantation are naltrexone reversible and suggest
      that activation of the adrenal is one potential mechanism for this effect.

PMID- 2243333
TI  - CRE 10904 [2-(p-fluorophenoxy), 1-(o-hydroxyphenyl)-ethane]: a new diuretic and
      antihypertensive drug acting by in vivo sulfation.
AB  - CRE 10904 [2-(p-fluorophenoxy), 1-(o-hydroxyphenyl)-ethane, the leading compound
      of a new family of loop diuretic and antihypertensive agents: 1-aryl, 2-aryloxy
      ethanes] induced high-ceiling natriuretic action in dogs and rats, but was
      completely inactive in pigs. High-performance liquid chromatography
      determinations revealed that all CRE 10904 (p.o. or i.v. administered) was
      rapidly sulfo-conjugated in dogs and rats, and glucurono-conjugated in pigs. The
      (O-sulfonyl)-CRE10904 metabolite (or simply CRE 11296) rapidly appeared in
      plasma, reached a concentration peak at about 40 min and disappeared with a half
      life time of about 3 hr. The urinary excretion of CRE 11296 was correlated with
      the natriuretic activity of CRE 10904. Moreover, CRE 11296 was a powerful
      natriuretic compound in rats and dogs and, even in pigs, i.v. CRE 11296 induced
      transient natriuresis (just before its rapid hydrolysis and glucurono
      conjugation). Studies in human red blood cells revealed that: 1) CRE 11296 was a
      potent inhibitor of the [Na+,K+,Cl-]-cotransport system (IC50 of 1.5 +/- 0.3 x
      10(-5) M; mean +/- S.E.M. of 5 experiments), slightly more powerful than
      furosemide (IC50 of 2 x 10(-5) M), 2) it was the only diuretic drug potently
      inhibiting the [K+,Cl-]-cotransport system (IC50 of 2.1 +/- 0.6 x 10(-5) M; N =
      3) and the [Cl/HCO3-] exchanger (IC50 of 4.5 +/- 1.0 x 10(-5) M; N = 3) and 3)
      CRE 10904 and its glucuronide were much less potent Cl- transport
      inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243334
TI  - Calcitonin gene-related peptide is the endogenous mediator of nonadrenergic
      noncholinergic vasodilation in rat mesentery.
AB  - In the isolated perfused rat mesenteric vascular bed pretreated with guanethidine
      and precontracted with methoxamine, periarterial nerve stimulation elicited a
      frequency-dependent and endothelium-independent vasodilation. The sustained
      vasodilation was slow-onset and reversible. It was resistant to propranolol or
      atropine but sensitive to tetrodotoxin and capsaicin suggesting that this is a
      nonadrenergic-noncholinergic vasodilation and is a neurogenic response. The
      vasodilation was abolished by anti-serum against calcitonin-gene related peptide
      (CGRP) in a concentration-dependent manner. These data suggest that the non
      adrenergic-noncholinergic vasodilation is mediated by endogenous CGRP released
      from the primary sensory nerve terminals upon electrical stimulation. In addition
      to the vasodilator action, CGRP also inhibited nerve stimulation-induced and
      norepinephrine-induced vasoconstriction at extremely low concentrations. The
      inhibitory action of CGRP appeared to be mediated by postsynaptic mechanisms
      inasmuch as evoked norepinephrine release was not affected by CGRP when the
      vasoconstriction produced by norepinephrine or periarterial nerve stimulation was
      attenuated greatly by CGRP. These observations suggest that the vascular tone of
      the resistance vessels can be regulated by primary sensory nerve-derived CGRP.

PMID- 2243335
TI  - Modulation of ATP-sensitive K+ channel activity and contractile behavior in
      mammalian ventricle by the potassium channel openers cromakalim and RP49356.
AB  - We have investigated the effects of potassium channel opening drugs on the ATP
      dependence of ATP-sensitive K+ channel activity and on contractile activity in
      rat and guinea pig ventricular myocytes. The results show that cromakalim
      (BRL34915), and RP49356, agents reported to open ATP-sensitive K+ channels, do so
      by shifting the intracellular [ATP] required to cause half-maximal inhibition of
      channel activity (ki) to higher [ATP]. In guinea pig ventricular myocytes at 37
      degrees C, the ki was shifted from 79 to 152 microM by 40 microM cromakalim and,
      in rat myocytes at room temperature, the ki was also shifted to higher [ATP] by
      50 microM RP49356. The effect of externally applied RP49356 on the contractile
      activity of intact rat ventricular myocytes was investigated. At 100 microM the
      drug was without effect in the presence of normal bathing solution containing 10
      mM glucose. When glucose in the bathing medium had been replaced by 2
      deoxyglucose for 84 +/- 2 min, 100 microM RP49356 decreased the twitch amplitude
      to 23 +/- 4% of control. The negative inotropic effect of 100 microM RP49356
      increased with time after perfusion with 2-deoxyglucose, and the negative
      inotropic effect diminished on reperfusing with glucose; 83 +/- 3 min after
      reperfusing with glucose, twitch amplitude was decreased by only 52 +/- 6% on
      exposure to 100 microM RP49356. These results suggest that the effect of the
      potassium channel opening drugs on contractility and electrical behavior will
      depend critically on the intracellular [ATP]. The results provide an explanation
      of how potassium channel openers may become clinically useful as cardioprotective
      agents without interfering with normal function.

PMID- 2243336
TI  - Opiate-receptor antagonist improves metabolic recovery and limits neurochemical
      alterations associated with reperfusion after global brain ischemia in rats.
AB  - Opiate-receptor antagonists improve behavioral, electrophysiologic and/or
      histologic outcome in various experimental models of central nervous system
      ischemia. To address the potential mechanism(s) by which opiate-receptor
      antagonists may exert their protective actions in cerebral ischemia, metabolic
      and biochemical changes were measured in brain of rats pretreated with the opiate
      receptor antagonist nalmefene or vehicle and subjected to 60 min of global
      ischemia followed by 2 hr of reperfusion. 31P and 1H magnetic resonance
      spectroscopy were used to follow the metabolic changes during ischemia and
      reperfusion, after which brain tissue was frozen in situ. Biochemical assays
      included free fatty acids, thromboxane B2, ascorbate, vitamin E and amino acids.
      Nalmefene-treated animals showed more rapid and complete recovery of cellular
      bioenergetic state (as indicated by the phosphocreatine to inorganic phosphate
      ratio), tissue acidosis and lactate levels during reperfusion than placebotreated
      controls. Ischemia/reperfusion caused significant increases of fatty free acids
      and thromboxane, associated with significant decreases of ascorbate and
      glutamate; nalmefene pretreatment limited each of these changes. The degree of
      metabolic improvement as reflected by recovery of high energy phosphates and
      reduction of lactic acidosis were highly correlated with changes in tissue levels
      of arachidonate and glutamate. Thus, the beneficial effects of opiate-receptor
      antagonists in cerebral ischemia may be due, in part, to an ability to enhance
      metabolic recovery with associated, reduction in phospholipid hydrolysis and
      excitotoxin release.

PMID- 2243338
TI  - Protective effect of a novel calcium blocker, S-312-d, on ischemic acute renal
      failure in rat.
AB  - The effect of the calcium blocker S-(+)-methyl 4,7-dihydro-3-isobutyl-6-methyl-4
      (3-nitro-phenyl)thieno[2,3-b]pyridine- 5-carboxylate (S-312-d) on ischemic acute
      renal failure (ARF) was studied in rats. Ischemic ARF was induced by temporary
      (30-60 min) clamping of the left kidney 2 weeks after contralateral right
      nephrectomy. Plasma creatinine, creatinine clearance, urinary osmolality and
      fractional excretion of sodium were used to test the effectiveness of the drug. S
      312-d (0.01-0.1 mg/kg b.wt. i.v.) administration before ischemia offered dose
      dependent protection against the functional impairment induced by ischemia. This
      effect was accompanied by an increase in the survival rate of ischemic rats. S
      312-d given after ischemia was not effective. The renal cortical edema induced by
      ischemia was significantly reduced by pretreatment with S-312-d. The increase in
      renal tissue calcium content observed after ischemia was also suppressed by S-312
      d. Comparison with other established calcium blockers indicated S-312-d to be a
      good candidate for protection against ischemic ARF. These findings indicate that
      S-312-d may be clinically useful against renal ischemia.

PMID- 2243337
TI  - Endothelium-mediated effects of N-substituted arginines on the isolated perfused
      rat kidney.
AB  - Endothelium-derived relaxing factor (EDRF) has been suggested to be derived from
      the metabolism of arginine or an arginine-containing moiety. We have compared the
      vascular effects of arginine and some of its N-substituted derivatives on the
      perfusion pressure (Pp) of the isolated rat kidney preparation preconstricted
      with phenylephrine. Irrespective of the stereochemistry, high doses (10(-4) mol)
      of L- and D-arginine HCl produced a slight vasodilation. In contrast L- and D
      arginine free base, at similar doses, further increased renal Pp. N-substituted L
      arginine compounds, however, decreased Pp dose-dependently. Their order of
      potency (ED50) was as follows: N-alpha-benzoyl-L-arginine ethyl ester (BAEE, 3.8
      x 10hm6 mol) greater than N-alpha-benzoyl-L-arginine methyl ester (2.5 x 10(-5)
      mol) greater than L-arginine ethyl ester (2.7 x 10(-5) mol) greater than L
      arginine HCl (10(-4) mol). Methylene blue (10(-5) M), hemoglobin (10(-5) M) and
      NG-mono-methyl-L-arginine (5 mumol) antagonized the vasodilation elicited by
      infusion of BAEE. Similarly, injection of xanthine oxidase/xanthine (100 mU)
      reversed BAEE-induced renal vasodilation, but had no effect on dilation elicited
      by infusion of atrial natriuretic peptide. These data demonstrate that
      substituted arginine compounds are more potent renal vasodilators than L-arginine
      and their potency depends on the nature of the substitution. These compounds
      exert their effect, at least in part, via an endothelium-dependent mechanism. We
      conclude that exogenous L-arginine is a poor substrate for EDRF generation in the
      kidney, and that it may cause release of EDRF by another mechanism, possibly
      related to a change in the pH of the medium.

PMID- 2243339
TI  - Renal disposition and effects of naproxen and its l-enantiomer in the isolated
      perfused rat kidney.
AB  - Renal handling, metabolism and effects on kidney function of naproxen and its l
      enantiomer were examined in the isolated perfused rat kidney (IPK). Urinary
      excretion rate of naproxen was much lower than the filtration rate, indicating
      extensive reabsorption. Naproxen is accumulated considerably in the IPK. This
      accumulation is concentration-dependent and is probably the result of active
      secretion of naproxen. Considerable amounts of desmethyl-naproxen were formed in
      the IPK. The kinetic behavior of the l-enantiomer of naproxen did not differ from
      naproxen. Addition of 37.5 to 3750 micrograms naproxen caused a decrease in
      urinary flow, glomerular filtration rate and fractional excretion of sodium,
      chloride, potassium, magnesium and calcium. The presence of prostaglandin E2 in
      the perfusate fully opposed the effects of naproxen on kidney function. Addition
      of 375 micrograms l-enantiomer of naproxen did not influence kidney function.
      Addition of very high doses (1 x 10(5) micrograms) of naproxen and its l
      enantiomer to the IPK caused diuresis and increased the fractional excretion of
      sodium, chloride, potassium, glucose and calcium. We conclude that the
      pharmacokinetic behavior and the metabolism of naproxen in the IPK is probably
      not stereoselective; that relatively low doses of naproxen exert a specific,
      stereoselective effect on kidney function caused by inhibition of the
      prostaglandin E2 synthesis and that high doses of naproxen exert a
      nonstereoselective effect on kidney function.

PMID- 2243340
TI  - Pharmacology of pravadoline: a new analgesic agent.
AB  - Pravadoline is a new chemical entity with analgesic activity in humans. This
      report describes the pharmacology of pravadoline and compares the activity of
      pravadoline with that of two major classes of analgesics, the opioids and the
      nonsteroidal anti-inflammatory drugs (NSAIDs). Like the NSAIDs, pravadoline
      inhibited the synthesis of prostaglandins (PGs) in mouse brain both in vitro
      (IC50, 4.9 microM) and ex vivo (ED50, 20 mg/kg p.o.) and displayed
      antinociceptive activity in rodents subjected to a variety of chemical, thermal
      and mechanical nociceptive stimuli. Administration of pravadoline prevented the
      writhing response induced by i.p. administration of acetylcholine (ED50, 41 mg/kg
      p.o.) or PGE2 (ED50, 24 mg/kg p.o.) and prolonged the response latency induced by
      tail immersion in hot water at a temperature of 55 degrees C (minimum effective
      dose, 100 mg/kg s.c.). In the rat, treatment with pravadoline prevented acetic
      acid-induced writhing (ED50, 15 mg/kg p.o.), brewer's yeast-induced hyperalgesia
      (Randall-Selitto test) (minimum effective dose, 1 mg/kg p.o.), the nociceptive
      response induced by paw flexion in the adjuvant-arthritic rat (ED50, 41 mg/kg
      p.o.) and bradykinin-induced head and forepaw flexion (ED50, 78 mg/kg, p.o.). The
      antinociceptive activity of pravadoline cannot be explained by an opioid
      mechanism, because pravadoline-induced antinociception was not antagonized by
      naloxone (1 mg/kg s.c.) and pravadoline did not bind to opioid receptors at
      concentrations up to 10 microM. However, like the opioid analgesics, pravadoline
      diminished the electrically induced twitch response of mouse vas deferens
      preparations, but, in contrast to opioids, this action of pravadoline was not
      attenuated by naloxone. The possibility is discussed that this effect of
      pravadoline upon isolated tissues may contribute to its antinociceptive activity.
      In contrast to NSAIDs, pravadoline was more potent ex vivo as an inhibitor of the
      formation of PGs in brain vs. stomach. In addition, pravadoline failed to produce
      gastrointestinal lesions when administered p.o. to rats or mice, and did not
      possess significant anti-inflammatory activity at antinociceptive doses. Also
      unlike NSAIDs, pravadoline inhibited rat gastrointestinal transit when
      administered at doses similar to those which were antinociceptive. The overall
      pharmacologic profile of pravadoline suggests that the compound may be capable of
      managing more diverse or more severe pain than is achieved by anti-inflammatory
      analgesics, without producing side effects commonly associated with either the
      opioid or the nonopioid analgesics.

PMID- 2243341
TI  - A comparison of the effects of cholinergic and dopaminergic agents on scopolamine
      induced hyperactivity in mice.
AB  - The effects of cholinesterase inhibitors, cholinergic agonists, dopaminergic
      agonists and dopaminergic antagonists on the hyperactivity produced by the
      muscarinic cholinergic antagonist scopolamine were evaluated in mice. Scopolamine
      (0.3-10 mg/kg) produced a dose-related increase in locomotor activity, with a
      peak effect at 3.0 mg/kg. The cholinesterase inhibitor physostigmine (0.03-0.175
      mg/kg) was without effect on locomotor activity when administered alone, whereas
      the cholinesterase inhibitor tetrahydroaminoacridine hydrate (0.3-10 mg/kg)
      decreased locomotor activity. Both physostigmine and tetrahydroaminoacridine
      hydrate attenuated the effects of scopolamine. Administered alone, the
      cholinergic agonists oxotremorine (0.01-0.3 mg/kg) and RS86 (0.1-3.0 mg/kg)
      produced dose-related decreases in locomotor activity, whereas pilocarpine (0.3
      10 mg/kg) had no effect on locomotor activity. None of these three muscarinic
      agonists significantly attenuated the hyperactivity produced by scopolamine.
      Administered alone, the dopaminergic agonists quinpirole (0.003-0.1 mg/kg), S-(-)
      3-(3-hydroxyphenyl)-N-n-propylpiperidine (0.3-10 mg/kg) and SKF 38393 (8-64
      mg/kg) had no significant effect on activity, whereas apomorphine (0.3-10 mg/kg)
      and d-amphetamine (0.1-3.0 mg/kg) increased activity. Quinpirole, apomorphine and
      S-(-)-3-(3-hydroxyphenyl)-N-n-propylpiperidine produced dose-related reversals of
      the increases in locomotor activity produced by scopolamine. The hyperactivity
      effects of d-amphetamine were approximately additive with scopolamine, whereas
      SKF 38393 did not significantly affect scopolamine. The mixed D1/D2 dopaminergic
      antagonist haloperidol (0.003-3.0 mg/kg) and the selective D1 antagonist SCH
      23390 (0.01-0.3 mg/kg) produced dose-related decreases in locomotor activity when
      administered alone, and also produced dose-related reversals of the hyperactivity
      produced by scopolamine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243342
TI  - On the metallothionein, glutathione and cysteine relationship in rat liver.
AB  - Stress and starvation increased liver metallothionein (MT) and decreased liver
      glutathione (GSH) levels. Serum cysteine plus cystine levels were increased by
      stress. The exogenous administration of GSH, while not modifying hepatic GSH
      content, increased liver MT levels in basal and starved rats but not in stressed
      rats. Liver and serum cysteine levels were increased by GSH administration, a
      process partially reverted by the irreversible inhibitor of gamma-glutamyl
      transpeptidase, alpha-amino-3-chloro-4,5-dihydro-5-isoxazoleacetic acid. Mouse
      and rat liver MT levels were also increased by buthionine sulfoximine, an
      inhibitor of GSH synthesis, indicating that GSH is not a necessary precursor of
      MT. In addition, the hepatic MT content was increased by the administration of
      cysteine in a dose-response manner. These results suggest that hepatic MT
      synthesis is elevated by increased cysteine pools, and that MT, GSH and cysteine
      levels are somehow inter-related. MT, besides GSH, may be contemplated as a
      putative intracellular reservoir of cysteine in the liver of adult rats.

PMID- 2243343
TI  - Effect of aging on hepatic biotransformation in female Fischer 344 rats: changes
      in sulfotransferase activities are consistent with known gender-related changes
      in pituitary growth hormone secretion in aging animals.
AB  - The effect of aging on hepatic drug conjugation in 5- to 6-, 12- to 13- and 22-
      to 23-month-old female Fischer 344 rats was examined. The overall disposition of
      acetaminophen including the formation and elimination kinetics of its sulfate and
      glucuronide metabolites were used as in vivo probes. The effects of aging on
      selected in vitro drug metabolizing enzyme activities and on the pattern of
      phenol and bile salt sulfotransferase isoenzymes were also determined. Aging
      decreased the total clearance of acetaminophen and the partial clearance of
      acetaminophen to acetaminophen sulfate by 36 and 47%, respectively. Increasing
      age also resulted in a reduced partial clearance of acetaminophen to the
      glucuronide- (24%) and to the glutathione-derived conjugates (29%). UDP
      glucuronosyltransferase activity toward 1-naphthol, morphine and testosterone was
      unaffected by advanced age, whereas there was a significant correlation between
      increased age and increased UDP glucuronosyltransferase activity toward estrone.
      Cytochrome P-450 concentration and glutathione-S-transferase activity toward 1
      chloro-2,4-dinitrobenzene were unchanged by aging. Oxidative demethylase activity
      toward p-nitroanisole was decreased 18% and sulfotransferase activities toward p
      nitrophenol, acetaminophen and glycolithocholate were decreased 27, 12 and 12%,
      respectively, in the 22- to 23-month-old rats, compared to the 5- to 6-month-old
      animals. In contrast to the age-related feminization in the pattern of
      sulfotransferase isoenzyme activities that occurs in male rats, there was no
      effect of aging on the pattern of phenol and bile salt sulfotransferase isoenzyme
      activities in female rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243344
TI  - Functional studies of nonpeptide angiotensin II receptor subtype-specific
      ligands: DuP 753 (AII-1) and PD123177 (AII-2).
AB  - DuP 753 and PD123177 are two nonpeptide angiotensin II (AII)-specific ligands,
      which show high affinities for two respective and distinct subtypes of AII
      binding sites, i.e., AII-1 and AII-2 sites, respectively, in the rat adrenal
      gland, brain and uterus. The objective of this study is to identify the functions
      of these subtype binding sites in the adrenal, sympathetic ganglia, brain and
      vascular smooth muscle. In conscious rats, DuP 753 at 1, 3 and 10 mg/kg i.v. but
      not PD123177 at 30 and 100 mg/kg i.v. inhibited the AII-induced aldosterone
      increase. In the isolated perfused rat adrenal gland, DuP 753 at 10(-6) and 10(
      4) M but not PD123177 at 10(-3) M blocked the AII-induced epinephrine secretion.
      In control and chemically sympathectomized pithed rats, the pressor and
      tachycardiac responses to AII were blocked by DuP 753 at 10 mg/kg i.v. but not by
      PD123177 at 100 mg/kg i.v. In conscious rats, DuP 753 at 10 mg/kg s.c. but not
      PD123177 at 100 mg/kg s.c. inhibited the AII-induced water drinking. In the
      rabbit aorta, DuP 753 at 10(-6) M but not PD123177 at 10(-4) M inhibited the
      contractile effect of AII. In conscious renal artery-ligated hypertensive rats,
      DuP 753 but not PD123177 at 0.1 to 10 mg/kg i.v. lowered blood pressure. In
      summary, a function of the PD123177-sensitive AII binding site (AII-2) has not
      yet been identified. However, the DuP 753-sensitive site (AII-1) appears to
      mediate the AII-induced responses such as adrenal aldosterone and catecholamine
      secretion, release of catecholamine from sympathetic ganglia, drinking and
      vasoconstriction.

PMID- 2243345
TI  - Dipyridamole inhibition of HCO3(-)-Cl- exchange in human erythrocytes.
AB  - Effects of dipyridamole (DP) on Band 3-mediated HCO3(-)-Cl- exchange were
      investigated in human red cells at 37 degrees C. The kinetics of net HCO3(-)-Cl-
      exchange were monitored using a stopped-flow rapid reaction apparatus, under
      conditions in which HCO3(-)-Cl- exchange was rate-limiting for pH equilibration
      across the red cell membrane. DP was found to be a rapidly acting, potent
      inhibitor of HCO3(-)-Cl- exchange, with an apparent I50 of 4 microM. DP produced
      a mixed competitive-noncompetitive inhibition of HCO3-Cl- exchange. Greater than
      50% of the inhibitory effect occurred within 20 msec of DP-red cell interaction,
      consistent with DP binding to an outward-facing site on the cell membrane.
      Interaction of red cells with DP was associated with a pH-dependent decrement in
      the equilibrium Donnan H+ ratio. Because HCO3(-)-Cl- exchange is crucial in vivo
      for ensuing rapid pH equilibration across the red cell membrane, these effects of
      DP may have important implications, particularly in the development of high-dose
      DP regimes for use as an adjunctive agent in cancer chemotherapy.

PMID- 2243346
TI  - Evidence that peptidoleukotriene is a prerequisite for antigen-dependent
      thromboxane synthesis in IgG1-passively sensitized guinea pig lungs.
AB  - Lungs from guinea pigs passively sensitized with an affinity-purified IgG1
      antibody produce both leukotriene (LT)D4 and thromboxane (Tx)B2 upon ex vivo
      antigen challenge. This study was undertaken to determine the possibility of
      endogenously generated peptido-LTs being a prerequisite for Tx synthesis. In
      immunoglobulin G1-sensitized lungs, exogenous LTD4 induced TxB2 production with a
      median effective dose of 4.1 nM, whereas the response to LTE4, LTB4 or platelet
      activating factor was relatively weak. Although LTC4 was as potent as LTD4 in
      stimulating TxB2 generation, LTC4's dose-response curve was shifted significantly
      to the right by AT-125, an irreversible gamma-glutamyl transpeptidase inhibitor,
      suggesting that at least a part of LTC4 sensitized lungs with antigen (0.01-30
      micrograms/ml ovalbumin) for 20 min precipitated a significant amount of LTD4
      production. The levels of LTD4 range from 8 to 26 nM (without taking LTD4
      recovery into consideration). This level is 2- to 7-fold greater than the median
      effective dose value observed with exogenous LTD4. Moreover, pretreatment of
      sensitized lungs with ICI-198,615 a specific LTD4 antagonist, blocked equally
      both antigen (IC50 = 0.01 microM)- and LTD4 (IC50 = 0.017 microM)-induced TxB2
      production. When sensitized lung fragments were treated with 5 mM AT-125, ICI
      198,615 was effective in preventing not only antigen-but also LTC4-dependent
      production of TxB2 (IC50 = 0.018 and 0.021 microM, respectively). In contrast,
      neither WEB-2086, a platelet-activating factor antagonist, nor pyrilamine, a
      histamine antagonist, inhibited antigen and LTD4 responses (IC50 greater than 30
      microM). Unlike its effect on antigen response, ICI-198,615 was unable to block
      Ca2+ ionophore-induced TxB2 production.2

PMID- 2243347
TI  - Stable circadian mechanisms of toxicity of two platinum analogs (cisplatin and
      carboplatin) despite repeated dosages in mice.
AB  - The toxicities and tissue uptake of cisplatin (CDDP) and carboplatin (CBDCA) vary
      largely according to the time of injection of a single dose. Repeated dosages may
      alter the mechanisms involved with such circadian-dependent toxicity. Weekly i.v.
      injections of CDDP (5 mg/kg) or CBDCA (50 mg/kg) were given over 2 months to 288
      male B6D2F1 mice standardized by an alternation of 12 hr of light and 12 hr of
      darkness at any one of three circadian dosing times (0, 8 or 16 hr after light
      onset--HALO). Survival; body weight; complete blood cell counts; histologic
      lesions in kidney, liver, spleen, bone marrow and intestinal tract; platinum
      concentration in kidney, spleen and colon were determined every 2 weeks
      throughout treatment. Thrombocytopenia was 10-fold larger following CBDCA as
      compared with CDDP. Severe bone marrow necrosis was cumulative following CDDP,
      but reversible following CBDCA. Leukopenia and bone marrow lesions were,
      respectively, half as severe following the dosing of either drug at 16 HALO
      compared with 0 or 8 HALO. Cortical tubular necrosis was observed in CDDP-treated
      mice. It was cumulative and half as extensive after drug dosing at 16 HALO, as
      compared with 0 or 8 HALO (P less than or equal to .05). Total Pt accumulation in
      all three tissues was 3- to 4-fold higher following repeated dosages of CDDP as
      compared with CBDCA. Tissue Pt uptake was halved after CDDP or CBDCA dosing at 16
      HALO as compared with 8 HALO (P less than or equal to .01). Dosing either Pt
      complex at the appropriate time is even more critical if administrations are to
      be repeated. Mechanisms appear to involve the circadian rhythm-dependent ability
      of target tissues to take up the drug.

PMID- 2243348
TI  - Both d-cis- and l-cis-diltiazem have anti-ischemic action in the isolated,
      perfused working rat heart.
AB  - The effect of diltiazem (d-cis-diltiazem) on the ischemic myocardium was compared
      with that of l-cis-diltiazem, an optical isomer having less potent calcium
      channel-blocking action, in the isolated, perfused working rat heart. Ischemia
      decreased mechanical function and tissue levels of ATP and creatine phosphate,
      and increased tissue levels of nonesterified fatty acids (NEFA), AMP and lactate.
      Reperfusion did not restore mechanical function, but restored incompletely the
      levels of metabolites (except NEFA) that had been altered by ischemia. The
      ischemia-induced changes in NEFA were prevented by d-cis-diltiazem completely and
      by l-cis-diltiazem incompletely. Other metabolic changes induced by ischemia were
      attenuated by d-cis-diltiazem but not by l-cis-diltiazem. In heart pretreated
      with d-cis- or l-cis-diltiazem, both the mechanical function and the levels of
      metabolites recovered during reperfusion, the degree of recovery with both drugs
      being similar. These results indicate that not only d-cis-diltiazem but also l
      cis-diltiazem has an anti-ischemic action probably due to inhibition of the
      tissue NEFA accumulation. These results also suggest that the mechanism of the
      protective effect of d-cis-diltiazem on the ischemic myocardium is not entirely
      due to the calcium channel-blocking action. Treatment with low Ca2+ (1.0 mM
      CaCl2) also attenuated the ischemia-induced changes. The interval between
      reoxygenation and start of function in the reperfused heart that had been treated
      with low Ca2+ was significantly longer than that with d-cis- or l-cis-diltiazem.
      The effect of these isomers to shorten this interval may contribute to their
      common anti-ischemic action.

PMID- 2243349
TI  - Influence of chronic alcohol administration on representative indices of puberty
      and sexual maturation in male rats and the development of their progeny.
AB  - The effects of chronic alcohol administration on reproductive endocrinology in
      the developing male rat were examined. Prepubescent male rats (25 days of age)
      were maintained on an alcohol liquid diet or were pair-fed a control diet until
      early adulthood and selected indices of sexual maturation were examined at weekly
      intervals. To determine whether sexually immature animals were more sensitive to
      the effects of alcohol than adults, fully mature male animals were exposed to an
      identical period of alcohol exposure and comparisons were made between the two
      groups. The results demonstrated that alcohol significantly affected many of the
      primary indices of puberty and sexual maturation. The normal pubertal increases
      in serum testosterone levels, the weights of the testes and secondary sex organs
      and beta-endorphin levels in the hypothalamus were substantially reduced in
      alcohol-exposed animals compared with controls. In contrast to these results, the
      effects of alcohol on reproductive endocrinology in the fully mature animal were
      transitory and of considerably less magnitude. After a 2-week alcohol-free
      period, male rats exposed to alcohol during development were bred with drug-naive
      primiparous females. Although the same number of pregnancies resulted from
      matings between alcohol-exposed males and drug-naive females compared with
      controls, litter sizes were significantly smaller in alcohol-derived offspring
      than in controls. In all other respects, such as body weights, sex ratios,
      mortality rates and gross developmental features (eye opening, incisor eruption
      and testes descent), alcohol-derived offspring were identical with controls. Upon
      closer examination, however, significant disturbances were detected in alcohol
      derived male offspring.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243350
TI  - Acute opioid physical dependence in humans: effect of varying the morphine
      naloxone interval II.
AB  - Previous studies have demonstrated antagonist-precipitated withdrawal from 45 min
      to 24 hr after acute opioid administration in nondependent human subjects. The
      purpose of this study was to examine longer postagonist intervals and to
      determine the maximum interval between agonist administration and antagonist
      challenge at which precipitated withdrawal can be observed. During this study 6
      nondependent male volunteers who reported using opiates an average of 4 times per
      week received naloxone challenges (10 mg/70 kg i.m.) at 6, 12, 24, 36, 48, 60, or
      72 hr after single i.m. injections of morphine (18 mg/70 kg or 30 mg/70 kg). Each
      interval was tested independently in random order. Naloxone reliably precipitated
      withdrawal signs and symptoms at 6 and 12 hr postmorphine. Withdrawal symptoms
      were greatly diminished in intensity at 24-hr postmorphine and were not elicited
      at postmorphine intervals longer than 24 hr. Withdrawal precipitation persisted
      somewhat longer than pupillary constriction because pupils had returned to
      predrug diameters by 24 hr postmorphine but, generally, there appeared to be
      correspondence between offset of agonist effects and dissipation of precipitated
      withdrawal. This study extends observations about the time course of acute
      physical dependence effects which begin within minutes after acute morphine
      exposure, dissipate within 36 hr, are associated with the onset and offset of
      agonist effects and do not require chronic opioid administration.

PMID- 2243351
TI  - Augmentation of morphine-induced changes in brain monoamine metabolism after
      chronic naltrexone treatment.
AB  - To investigate the role of opioid mechanisms in the regulation of cerebral
      monoaminergic neurons, male Wistar rats were continuously infused with naltrexone
      via an Alzet osmotic minipump, or were sham-implanted, for 14 days. Twenty-four
      hours after removal of the pumps or sham implants, the rats were given s.c.
      morphine (3, 10 or 30 mg/kg) or saline and were sacrificed 2 hr postinjection.
      Eight brain regions were assayed for dopamine, 5-hydroxytryptamine, noradrenaline
      and their respective metabolites. Chronic naltrexone treatment per se caused only
      small changes in cerebral monoamines. Morphine elevated dose-dependently the
      cerebral concentrations of the acidic dopamine metabolites, 3,4
      dihydroxyphenylacetic acid and homovanillic acid, as well as that of the 5
      hydroxytryptamine metabolite, 5-hydroxyindoleacetic acid, and that of the
      noradrenaline metabolite, free 3-methoxy-4-hydroxyphenylethyleneglycol. In
      naltrexone-pretreated rats these elevations were significantly larger.
      Furthermore, in the naltrexone-pretreated rats 10 mg/kg of morphine significantly
      decreased the concentration of the dopamine metabolite 3-methoxytyramine both in
      the striatum and in the limbic forebrain, whereas in the control rats the 3
      methoxytyramine content fell first after the 30-mg/kg dose and only in the
      striatum. Thus, both the stimulatory and the inhibitory effects of morphine on
      cerebral monoaminergic neurons seem to be potentiated by chronic naltrexone
      treatment. These data suggest that the activity of cerebral monoaminergic systems
      is to some degree regulated by an endogenous opioid input. When that input is
      chronically blocked, the basal metabolism of monoamines is not much altered but
      the systems' responsiveness to agonist challenge is increased.

PMID- 2243352
TI  - Fate of tritiated 6-fluorodopamine in rats: a false neurotransmitter for positron
      emission tomographic imaging of sympathetic innervation and function.
AB  - In evaluating positron-emitting analogs of dopamine (DA) as imaging agents for
      visualizing tissue sympathetic innervation and function, we assessed the
      metabolic fate of systemically injected [3H]-6-fluorodopamine [( 3H]-6F-DA) in
      plasma, in sympathetically innervated tissues (left ventricle, spleen and
      salivary glands) and in excretory organs (liver and kidney) of rats. By 5 min
      after intravenous bolus injection of a physiologically inactive amount (450 ng,
      10 microCi) of [3H]-6F-DA, 3H was concentrated in all the organs compared with
      that in blood or plasma. In the sympathetically innervated organs, most of the
      radioactivity was in [3H]-6F-DA and [3H]-6-fluoronorepinephrine [( 3H]-6F-NE),
      whereas in the blood, plasma and excretory organs most of the radioactivity was
      in noncatechol compounds such as O-methylated and conjugated metabolites. In
      sympathetically innervated organs, tissue/blood ratios exceeded 1.0 at all time
      points between 5 and 120 min after injection of [3H]-6F-DA and increased
      progressively (from 8 to 60 in myocardium), whereas the tissue/blood ratios in
      the kidney and liver increased by less than 2-fold during this interval. In all
      the studied tissues, the proportion of total tissue 3H that was due to [3H]F-NE
      increased progressively while that due to [3H]F-DA declined, consistent with
      conversion of [3H]F-DA to [3H]F-NE in vesicles in sympathetic nerve
      endings.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243353
TI  - Autoradiographic characterization of (+-)-1-(2,5-dimethoxy-4-[125I] iodophenyl)-2
      aminopropane ([125I]DOI) binding to 5-HT2 and 5-HT1c receptors in rat brain.
AB  - The 5-HT2 (serotonin) receptor has traditionally been labeled with antagonist
      radioligands such as [3H]ketanserin and [3H]spiperone, which label both agonist
      high-affinity (guanyl nucleotide-sensitive) and agonist low-affinity (guanyl
      nucleotide-insensitive) states of this receptor. The hallucinogen 1-(2,5
      dimethoxy-4-iodophenyl)-2-aminopropane (DOI) is an agonist which labels the high
      affinity guanyl nucleotide-sensitive state of brain 5-HT2 receptors selectively.
      In the present study, conditions for autoradiographic visualization of (+/-)
      [125I]DOI-labeled 5-HT2 receptors were optimized and binding to slide-mounted
      sections was characterized with respect to pharmacology, guanyl nucleotide
      sensitivity and anatomical distribution. In slide-mounted rat brain sections (+/
      )-[125I]DOI binding was saturable, of high affinity (KD approximately 4 nM) and
      displayed a pharmacologic profile typical of 5-HT2 receptors. Consistent with
      coupling of 5-HT2 receptors in the high-affinity state to a guanyl nucleotide
      regulatory protein, [125I]DOI binding was inhibited by guanyl nucleotides but not
      by adenosine triphosphate. Patterns of autoradiographic distribution of [125I]DOI
      binding to 5-HT2 receptors were similar to those seen with [3H]ketanserin- and
      [125I]-lysergic acid diethylamide-labeled 5-HT2 receptors. However, the density
      of 5-HT2 receptors labeled by the agonist [125I]DOI was markedly lower (30-50%)
      than that labeled by the antagonist [3H]ketanserin. High densities of [125I]DOI
      labeling were present in olfactory bulb, anterior regions of cerebral cortex
      (layer IV), claustrum, caudate putamen, globus pallidus, ventral pallidum,
      islands of Calleja, mammillary nuclei and inferior olive. Binding in hippocampus,
      thalamus and hypothalamus was generally sparse. Of note, choroid plexus, a site
      rich in 5-HT1c receptors had a high density of [125I]DOI binding sites but
      [3H]ketanserin binding in this region was low. Studies in which [125I]DOI binding
      to 5-HT2 receptors was blocked with spiperone revealed persisting robust
      [125I]DOI binding in choroid plexus, which was guanyl nucleotide-sensitive and
      displayed a pharmacologic profile consistent with its binding to 5-HT1c
      receptors. These studies suggest that [125I]DOI may be useful as a radiolabel for
      visualizing the agonist high-affinity state of 5-HT2 receptors and for
      visualizing 5-HT1c receptors.

PMID- 2243354
TI  - Protection against gentamicin-induced early renal alterations (phospholipidosis
      and increased DNA synthesis) by coadministration of poly-L-aspartic acid.
AB  - Coadministration of polyaspartic acid protects against functional and
      pathological signs of gentamicin-induced nephrotoxicity in rats without reduction
      of drug accumulation in renal cortex (Williams et al., J. Pharmacol. Exp. Ther.
      237: 919-925, 1986; Gilbert et al., J. Infect. Dis. 159: 945-953, 1989). We have
      assessed the influence of polyaspartic acid on the early alterations induced in
      kidney cortex by gentamicin, namely the lysosomal phospholipidosis and the
      increase in cell turnover. We used an infused rat model in which animals received
      a total dose of 100 mg/kg of gentamicin over 12 hr. Renal cortex was examined 2
      hr (day 0) and 48 hr (day 2) after treatment. All animals received an injection
      of [3H]thymidine (200 microCi i.p.) before sacrifice. Coadministration of
      polyaspartic acid (drug-polypeptide mass ratio 1:2.5) did not modify the drug
      serum levels, as recorded during or shortly after the infusion. Yet, it was
      associated with 1) an increased (approximately 35%) drug cortical content at day
      0; 2) a significant protection against both biochemical (decrease of
      sphingomyelinase activity at day 0; increase of lipid phosphorus content at day
      2) and morphological (enlargement of lysosomes and deposition of myeloid bodies
      at day 2) signs of lysosomal phospholipidosis in proximal tubular cells; and 3)
      an almost complete protection against increased cell turnover (mostly in proximal
      tubules) in cortex at day 2, as assessed by the measurement of [3H]thymidine
      incorporation into DNA and the enumeration of S-phase cells after
      histoautoradiography. In addition, morphological studies revealed a larger number
      of apical vacuoles in proximal tubular cells of animals receiving polyaspartic
      acid alone (but not in combination with gentamicin), and the deposition of
      osmiophilic, homogenous material in the lysosomes of animals receiving the
      combination of gentamicin and polyaspartic acid. Together with the results
      reported in two companion papers (Kishore et al., J. Pharmacol. Exp. Ther. 867
      874, and 875-885, 1990), these results provide evidence that protection afforded
      by polyaspartic acid extends to the earliest cellular alterations described in
      kidney for gentamicin, namely the lysosomal phospholipidosis, suggesting that
      this protecting agent exerts blocking effect from this step in the cascade of
      events relating drug cortical accumulation to renal toxicity.

PMID- 2243355
TI  - Mechanism of protection afforded by polyaspartic acid against gentamicin-induced
      phospholipidosis. I. Polyaspartic acid binds gentamicin and displaces it from
      negatively charged phospholipid layers in vitro.
AB  - Coadministration of polyaspartic acid protects rats against aminoglycoside
      induced nephrotoxicity, with respect to functional and pathological changes as
      well as to early signs of renal alterations (lysosomal phospholipidosis of
      proximal tubular cells, increased proliferation of proximal tubular and
      peritubular cells), without reduction, but actually by increasing the drug
      cortical content (Williams et al., J. Pharmacol. Exp. Ther. 237: 919, 1986;
      Gilbert et al., J. Infect. Dis. 159: 945, 1989; Beauchamp et al., 1990). Because
      aminoglycoside accumulation in kidney cortex involves their segregation in
      lysosomes, we have examined the possibility of formation of intracellular
      aminoglycoside-polyaspartic acid complexes that would render the drug less toxic.
      We found that in vitro polyaspartic acid (MW 9-15,000) 1) binds gentamicin with
      an optimum at acidic pH (5.4), 2) displaces it from negatively charged liposomes
      and 3) restores the activity of gentamicin-inhibited lysosomal phospholipase A1
      toward phosphatidylcholine included in negatively charged liposomes. In parallel,
      we also observed that at pH 7.0, polyaspartic acid binds and displaces gentamicin
      from purified brush-border membrane vesicles, causing an apparent decrease of
      affinity of gentamicin for these membranes, which was falsely interpreted by
      Williams et al., J. Pharmacol. Exp. Ther. 237: 919, 1986 as "competition for a
      common membrane binding site." Assuming that, after its administration in vivo,
      polyaspartic acid gains access to lysosomes of proximal tubular cells, as many
      low molecular weight proteins and polypeptides do, our results suggest that
      protection against gentamicin-induced nephrotoxicity is obtained by the binding
      of the aminoglycoside to the polyanion in lysosomes, preventing thereby the
      development of phospholipidosis and therefore interfering with the cascade of
      events leading from drug accumulation to nephrotoxicity.

PMID- 2243356
TI  - Evaluation of cationized rat albumin as a potential blood-brain barrier drug
      transport vector.
AB  - The present investigations evaluated the effects in rats of repetitive
      administration of cationized rat albumin over an 8-week period with the future
      aim of using this modified protein as a vector to transport drugs across the
      brain capillary endothelial wall, i.e., the blood-brain barrier. Rat albumin was
      cationized at pH = 7.8 with hexamethylenediamine, and the isoelectric point of
      the protein was raised from 5.5 to approximately 8. The cationized protein was
      monomeric based on mobility during sodium dodecylsulfate polyacrylamide gel
      electrophoresis. After radiolabeling, the cationized rat serum albumin (RSA) was
      taken up by isolated rat or bovine brain microvessels, whereas radio-labeled
      native RSA was not taken up by the capillaries in vitro. The brain volume of
      distribution of the 3H-cationized RSA increased linearly over a 5-hr period after
      an intravenous injection of the isotope and reached a value of 46 +/- 3
      microliter/g (mean +/- S.E.) by 5 hr, whereas the brain volume of distribution of
      the 125I-native RSA was constant during the 5-hr time period (9.3 +/- 0.7
      microliter/g, which is equal to the brain blood volume). The cationized and
      native RSAs were administered daily (Monday through Friday) at a dose of 1 mg/kg
      subcutaneously to groups of rats for 4- and 8-week periods. This dosage regimen
      resulted in no discernible toxicity, based on the findings of normal weight gain,
      normal tissue histology and normal serum chemistry. Therefore, cationized rat
      albumin may be used in future studies that use the repetitive administration of
      cationized rat albumin chimeric peptides for the evaluation of the transport of
      these substances through the blood-brain barrier in vivo.

PMID- 2243357
TI  - Prevention of hippocampus neuronal damage in ischemic gerbils by a novel lipid
      peroxidation inhibitor (quinazoline derivative).
AB  - We investigated the effect of a novel quinazoline derivative (KB-5666), a lipid
      peroxidation inhibitor, on ischemic neuronal damage using Mongolian gerbils. The
      animals were sacrificed 7 or 30 days after 5 min of forebrain ischemia induced by
      bilateral common carotid artery occlusion. Morphologic changes, a microtubule
      associated protein 2 (MAP2) immunohistochemical study and quantitative
      autoradiographic study using [3H]phorbol 12, 13-dibutyrate ([3H]PDBu) were
      evaluated in the hippocampus after ischemia. KB-5666 (3-50 mg/kg, i.v.) showed
      protective effects against neuronal death of the CA1 subfield 5 min before
      ischemia, immediately or 1 hr after ischemia, but not 4 hr after ischemia. KB
      5666 (i.p.) also showed protective effects in a dose-dependent manner immediately
      after ischemia. Furthermore, KB-5666 dose-dependently prevented a marked decrease
      in microtubule-associated protein 2 immunoreactivity in the dendritic fields of
      the CA1 pyramidal cells after ischemia. The [3H]PDBu binding activity in the
      stratum oriens and the stratum lacunosum-moleculare of the CA1 subfield was
      reduced by 19 and 30%, respectively, 7 days after ischemia. [3H]PDBu binding
      sites were unchanged in the stratum oriens in the CA3 subfield. By contrast, in
      the molecular layer of the dentate gyrus, the [3H]PDBu binding activity increased
      by 15%. KB-5666 (i.v.) prevented a decrease in the [3H]PDBu binding activity in
      the stratum oriens and stratum lacunosum-moleculare of the CA1 subfield and an
      increase in the molecular layer of the dentate gyrus. These histologic,
      immunohistochemical and receptor-autoradiographic data indicate that KB-5666
      protects the brain from both cellular and functional consequences of ischemia.

PMID- 2243358
TI  - Levodopa delivery from controlled-release polymer matrix: delivery of more than
      600 days in vitro and 225 days of elevated plasma levels after subcutaneous
      implantation in rats.
AB  - Parkinson's disease is commonly treated with orally applied levodopa (l-dopa).
      However, because this treatment modality is associated with a number of
      undesirable side effects, some due to plasma fluctuations, we have developed a
      slow-release polymer system that can be used to deliver l-dopa continuously for
      extended periods of time in vitro (greater than 600 days) and in vivo (at least
      225 days) in rats. In vitro l-dopa release was evaluated using polymer matrices
      with appropriately selected parameters (loading and geometry), and zero-order
      (linear) release of l-dopa was observed for more than 600 days (in highly loaded,
      noncoated material first-order kinetics), in some instances in mg quantities per
      day. This was achieved even in polymer matrices, which did not possess a
      dissolution limiting barrier. Scanning electron-microscopic analysis suggests
      that the mechanism of release is dissolution through channels and pores within
      the polymer matrix. To assess in vivo release, l-dopa was quantified in plasma
      from rats given s.c. implants of l-dopa polymer matrices using high-performance
      liquid chromatography. We observed release of l-dopa for a period of at least 225
      days after an initial burst of release. Continuous release of l-dopa from s.c.
      implanted slow-release polymer matrices has several advantages over oral
      delivery: 1) l-dopa plasma fluctuations are eliminated, 2) patient compliance
      issues are reduced and 3) the gastrointestinal tract is circumvented, thus
      requiring a lower dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243359
TI  - Resiniferatoxin: an ultrapotent selective modulator of capsaicin-sensitive
      primary afferent neurons.
AB  - Resiniferatoxin (RTX) has been shown to function as an ultrapotent analog of
      capsaicin. It is reported here that RTX, like capsaicin, acts selectively on
      primary sensory neurons in rats to produce ultrastructural alterations and
      calcitonin gene-related peptide depletion. To evaluate RTX actions on capsaicin
      sensitive nociceptors of vagal origin in the lung, the activation and
      desensitization of the pulmonary chemoreflex in both rats and cats were examined.
      In rats, RTX (2 ng-5 micrograms/kg i.v.) failed to elicit the full reflex triad
      (apnea, systemic hypotension and bradycardia); RTX did, however, desensitize the
      pulmonary chemosensitive receptors to capsaicin and phenyldiguanide. This effect
      is not achievable upon acute capsaicin treatment. RTX pretreatment (300
      micrograms/kg s.c.) of rats also abolished the neurogenic edema formation,
      another response mediated via capsaicin-sensitive vagal fibers, in rat trachea to
      challenge either by capsaicin or ether. The effect of electrical stimulation of
      vagal nerve was not impaired after RTX injection, indicating that RTX
      desensitized only the capsaicin-sensitive pathway whereas the parasympathetic
      pathway remained unaltered. In cats, unlike in the rat, the full pulmonary
      chemoreflex occurred in response to 0.1 micrograms/kg RTX. It is concluded that
      RTX is a selective probe for capsaicin-sensitive neural pathways but the spectrum
      of action of the two compounds is not identical. The failure of RTX to provoke
      the pulmonary chemoreflex in the rat, which is the main limiting factor in the
      use of capsaicin, suggests a further advantage to the use of RTX for probing
      capsaicin-sensitive neural pathways.

PMID- 2243360
TI  - Analysing and sorting human chromosomes.
AB  - Analysing and sorting human chromosomes by flow cytometry is a powerful tool in
      the hands of the molecular biologist. Because of the large number of chromosomes
      analysed by flow, typically 10(5) for each sample, estimates of the distribution
      of DNA throughout the chromosome complement of an individual can be made to
      within three megabase pairs. Rearrangements of DNA in this size range can often
      be clearly seen and measured by flow cytometry in situations where it was not
      obvious by traditional cytogenetics. The production of enriched samples of a
      particular chromosome by flow sorting and the subsequent construction of DNA
      libraries has played an important part in mapping genes to particular hereditary
      diseases. Techniques now exist which allow the hybridization of a few thousand
      sorted chromosomes with characterized or uncharacterized DNA probes to give
      relatively quick answers about specific chromosome genes. The process of
      obtaining a sorted chromosome sample from a growing population of peripheral
      blood lymphocytes or lymphoblastoid cells is compared with other methods of
      achieving similar results in molecular biological terms. Advances in flow
      cytometric techniques, which include slit-scanning and hybridization of DNA
      probes in suspension, are likely to improve the enrichment quality of specific
      sorted human chromosomes.

PMID- 2243361
TI  - Flow cytometric evaluation of DNA digestion with micrococcal nuclease on isolated
      HeLa nuclei.
AB  - Flow cytometric assessment of DNA digestion with micrococcal nuclease has been
      performed on isolated HeLa nuclei by determining the relative reduction in
      stainability with the DNA-specific fluorochrome, propidium iodide. At the
      nuclease concentrations used, DNA histograms of digested nuclei showed the
      typical bimodal pattern, when the enzymatic reaction was performed in a medium
      maintaining chromatin in its native (i.e. condensed) or partially decondensed
      from. In contrast, when nuclei were digested in a buffer lacking both the mono-
      and divalent cations K+ and Mg2+, an extensive decrease in fluorescence
      intensity, with loss of the histogram shape, was observed. In nuclei with native
      chromatin, DNA stainability decreased as a function of time and enzyme
      concentration, to reach a lower limit of about 46%, as compared with undigested
      control samples. Removal of the histone H1 induced a significant increase
      (approximately by a factor of 2) in the extent of digestion, although only in
      nuclei with partially decondensed chromatin. These results suggest that the
      sensitivity of DNA to digestion with micrococcal nuclease can be quantitatively
      monitored with flow cytometry when appropriate reaction conditions are chosen.

PMID- 2243362
TI  - Flow cytometric analysis of the functional ability of neutrophils from patients
      with autoimmune neutropenia.
AB  - Flow cytometry has been used to evaluate the functional ability of neutrophils
      and the expression of IgG Fc receptors (FcRII and FcRIII) in autoimmune
      neutropenia. Quantification of the neutrophil oxidative burst was made by
      assaying the production of 2'7'-dichlorofluorescein (DCF) from non-fluorescent
      2'7'-dichlorofluorescein trapped within the cell, by flow cytometric analysis of
      cellular fluorescence. In the present study the DCF assay was used to examine the
      response of neutrophils to stimulation by opsonized and non-opsonized
      Staphylococcus aureus. In addition, the rate of uptake of S. aureus labelled with
      the red nuclear dye propidium iodide was determined. The presence of surface
      bound immunoglobulin, which may affect the phagocytic capacity of the neutrophil,
      was also measured. No correlation between the neutrophil count and level of
      membrane-bound IgG or the rate of bacterial uptake was found. The studies were
      performed on twenty patients with autoimmune neutropenia, twelve with other
      autoimmune disorders and fourteen normal controls. The rate of uptake of bacteria
      was considered in relation to the expression of FcRII and FcRIII. Good
      correlation was found with the level of expression of FcRII, the major receptor
      for neutrophil activation, and the rate of uptake of bacteria (r = 0.64).

PMID- 2243363
TI  - x-y-recording in transmission electron microscopy. A versatile and inexpensive
      interface to personal computers with application to stereology.
AB  - An interface for IBM XT/AT-compatible computers is described which has been
      designed to read the actual specimen stage position of electron microscopes. The
      complete system consists of (i) optical incremental encoders attached to the x-
      and y-stage drivers of the microscope, (ii) two keypads for operator input, (iii)
      an interface card fitted to the bus of the personal computer, (iv) a standard
      configuration IBM XT (or compatible) personal computer optionally equipped with a
      (v) HP Graphic Language controllable colour plotter. The small size of the
      encoders and their connection to the stage drivers by simple ribbed belts allows
      an easy adaptation of the system to most electron microscopes. Operation of the
      interface card itself is supported by any high-level language available for
      personal computers. By the modular concept of these languages, the system can be
      customized to various applications, and no computer expertise is needed for
      actual operation. The present configuration offers an inexpensive attachment,
      which covers a wide range of applications from a simple notebook to high
      resolution (200-nm) mapping of tissue. Since section coordinates can be processed
      in real-time, stereological estimations can be derived directly "on microscope".
      This is exemplified by an application in which particle numbers were determined
      by the disector method.

PMID- 2243364
TI  - Estimation of surface area and length with the orientator.
AB  - The orientator is a new technique for the estimation of length and surface
      density and other stereological parameters using isotropic sections. It is an
      unbiased, design-based approach to the quantitative study of anisotropic
      structures such as muscle, myocardium, bone and cartilage. A simple method for
      the practical generation of such isotropic planes in biological specimens is
      described. No special technical equipment is necessary. Knowledge of an axis of
      anisotropy can be exploited to optimize the efficiency. To randomize directions
      in space, points are selected with uniform probability in a square using various
      combinations of simple random, stratified random, and systematic random sampling.
      The point patterns thus produced are mapped onto the surface of a hemisphere. The
      mapped points define directions of sectional planes in space. The mapping
      algorithm ensures that these planes are isotropic, hence unbiased estimates of
      surface and length density can be obtained via the classical stereological
      formulae. Various implementations of the orientator are outlined: the prototype
      version, the orientator-generated ortrip, two systematic versions, and the smooth
      version. Orientator sections can be generated without difficulty in large
      specimens; we investigated human skeletal muscle, myocardium, placenta, and gut
      tissue. Slight practical modifications extend the applicability of the method to
      smaller organs like rat hearts. At the ultrastructural level, a correction
      procedure for the loss of anisotropic mitochondrial membranes due to oblique
      orientation relative to the electron beam is suggested. Other potential
      applications of the orientator in anisotropic structures include the estimation
      of individual particle surface area with isotropic nucleators, the determination
      of the connectivity of branching networks with isotropic disectors, and
      generation of isotropic sections for second-order stereology (three-dimensional
      pattern analysis).

PMID- 2243365
TI  - Projection of topographic maps from curved brain surfaces into a plane.
AB  - The environment is represented in the brain by topographic maps. These maps and
      their interrelationship form a dominant feature in the brain, but unfortunately,
      they are often projected onto surfaces which are variously curved. It would be
      useful to be able to compare the topography on these surfaces quantitatively with
      the origin of the map. This comparison would be possible if the curved brain
      surfaces could be represented in planes. Therefore, it was necessary to develop a
      procedure for unfolding maps on convex structures like the retina and the optic
      tectum of the chick. For this purpose a unit sphere was constructed whose origin
      was close to the centre of gravity of the curved brain structure. The surface of
      this structure was then projected into the sphere. From its representation on the
      spherical surface it was unfolded into the plane using a polar azimuthal radially
      equidistant projection. Our method can safely be applied to convex structures
      only. However, it is not limited to the visual system. The mathematical procedure
      is formulated in such a way as to be easily implemented. It is exemplified by
      experiments on the optic tectum and the developing retina of the chick.

PMID- 2243366
TI  - A direct method for fast three-dimensional serial reconstruction.
AB  - A method for accurate three-dimensional reconstruction of openly connected porous
      structures is described. The method is based on embedding of a specimen in a
      contrast coloured epoxy resin and serial sectioning in a standard hard tissue
      microtome. A PC-based image processing system is used for direct digitization of
      the cut surface, and by thresholding two-phase images are obtained. The process
      is fully automated, and about 170 sections can be produced, digitized,
      dichotomized, and stored per hour. As an example of its applications, the method
      is used on trabecular bone, which is an anisotropic porous structure.

PMID- 2243368
TI  - The 17th Annual Meeting of the Japanese Society of Toxicological Sciences. June
      13-14, 1990, Nagoya, Japan. Proceedings.

PMID- 2243369
TI  - Distribution of cerebral infarcts on computed tomography.
AB  - Locations of cerebral infarcts on computed tomography were analyzed on all
      patients admitted for ischemic stroke or status lacunaris in 1984. Patients who
      had only one symptomatic infarct, without histories of strokes or transient
      ischemic attacks, were allocated to group A, the rest made up group B. Group A
      showed that 47.6% of symptomatic infarcts were lacunes with similar percentages
      in the following areas: lenticular nucleus (12.7%), internal capsule (12.7%), and
      subcortical white matter (11.1%). In group A, the cortex (49.2%) was the most
      common site of infarction, while in group B, it was the subcortical white matter
      (31.7%). However, if the structures supplied by the basal perforating arteries
      (basal ganglia, thalami, and internal capsules) were considered as a whole, this
      area (41.8%) was the most common site for infarcts in group B. Thus, asymptomatic
      infarcts and those of status lacunaris contributed greatly to the overall
      distribution of cerebral infarcts.

PMID- 2243367
TI  - In vitro toxicity test of poisonous mushroom extracts with isolated rat
      hepatocytes.
AB  - Effects of poisonous mushroom extracts on isolated rat hepatocytes were studied.
      Though no significant decrease in the cell viability was observed during the
      incubation of hepatocytes with the extracts at a concentration of 5% (v/v) of
      Amanita abrupta, A. gymnopus, and A. virosa caused marked decreases in the
      intracellular glutathione content in sharp contrast to the extracts of A. volvata
      and A. flavipes. Comparative toxicity tests were carried out for the effects of
      the extract of A. abrupta, dl-propargylglycine, and alpha-amanitin. The extract
      of A. abrupta at a concentration of 1% (v/v) caused a marked decrease in the
      glycogen content, a noticeable elevation in the phosphorylase alpha activity, and
      a slight acceleration of lipid peroxidation in the hepatocytes. Although dl
      propargylglycine decreased the intracellular glutathione content progressively
      with the incubation time, a significant effect of the chemical on lipid
      peroxidation and the glycogen content was observed only after prolonged
      incubation at a concentration of 5 mM. On the other hand, alpha-amanitin exerted
      a little effect on the hepatocytes at 1 microM. These results have indicated that
      the intoxication by the extract of A. abrupta on the hepatocytes might not due to
      independently each component, dl-propargylglycine and alpha-amanitin, but
      combined effect of these components or unidentified substances.

PMID- 2243370
TI  - Color stability of composite resins.
AB  - The color stability of seven visible light-cured and three chemically-cured
      composite resins was investigated while being subjected to UV light irradiation
      and storage in an aqueous environment at elevated temperatures. Color shift was
      evaluated visually and by colorimetric measurements. Significant correlation was
      found between visual scoring and colorimetric readings. When subjected to UV
      light, a wide deviation in color change existed from brand to brand in photocured
      composite resins. The color shift of chemically-cured composite resins was less
      than but fell within the range of photocured composite resins. When stored in
      water at elevated temperatures, photocured resins exhibited better color
      stability than the chemically-cured composite resins.

PMID- 2243371
TI  - [A modified technique of obturator fabrication for cleft palate infants].
AB  - Cleft palate is a commonly observed congenital maxillofacial defect. The first
      problem to be faced is the interference of feeding. It is a hard challenge for
      both the parents and the dentist. A cleft palate infant is unable to produce
      negative pressure in the oral cavity, thus resulting in feeding difficulty. The
      maxillary obturator resolves feeding problem and induces better maxillary growth
      patterns before operation. The maxillary obturator should be applied as early as
      possible to avoid the post surgical problems. The material for traditional
      obturator is tough and often injures the soft tissue. In order not to interfere
      with the growth of the dental arch, the border of the obturator must be trimmed
      regularly, until the retention becomes insufficient. In this paper, a modified
      technique of obturator fabrication was presented. The new method uses silicone
      relining material instead of ortho resin, as the packing of the obturator. It has
      been applied to dozens of patients. After a long follow up and comparison with
      the traditional method, the advantages of the new design can be summarized as
      follows: (1) Silicone is softer and does not injure the soft tissue. (2) It does
      not require the trimming of the border of obturator. (3) It has better retention
      and comfort for the patients.

PMID- 2243372
TI  - The effect of pitressin and glypressin in variceal bleeding--a preliminary
      clinical trial.
AB  - Effects of hemostatic and various side effects were compared between glypressin
      and pitressin. Fifty-five episodes of esophageal variceal bleeding in 29 patients
      were studied. Although the glypressin group included more patients in Pugh's
      classification C than the pitressin group, the result of hemostasis was not
      influenced. The effect of hemostasis was evaluated in 24 episodes receiving
      either glypressin or pitressin. The hemostatic effects of glypressin and
      pitressin were 6/11, 54.5% and 7/13, 53.8% respectively. Eighteen episodes in six
      patients, with multiple episodes, were used to observe the effect of these two
      drugs in the same person. No difference was observed. The number of side effects
      in the glypressin group and the pitressin group were 5 and 10 respectively.
      Although the side effects of glypressin might be fewer than those of pitressin,
      chest pain was observed in patients receiving glypressin treatment. The use of
      glypressin in the patients with cardiac diseases should be studied further.
      Glypressin is more convenient in clinical use. However, pitressin doses is easily
      modified. Both drugs might be selected in the control of variceal bleeding.

PMID- 2243373
TI  - [Clinical studies of neonatal hyperbilirubinemia treated with blood exchange
      transfusion].
AB  - From April 1984 to November 1989, 194 cases of neonatal hyperbilirubinemia
      treated with blood exchange transfusions (BET) were studied. The patients
      included 127 male and 67 female neonates, with an age ranged from 13 hours to 16
      days. The most common cause was idiopathic (52.6%), followed by G-6-PD deficiency
      (23.7%), and sepsis (12.9%). Most of the neonates received BET at the 4th day of
      birth (23.2%), but there were still 30 cases (15.5%) that received BET after 1
      week of age. There were 17 cases (8.8%) with maximum serum bilirubin lower than
      20 mg/dl before receiving BET, five of them were LBW infants; 11 cases (5.7%)
      were greater than 40 mg/dl. The mean of maximum serum bilirubin was 26.9 +/- 7.96
      mg/dl. Most of the cases received BET once (145 cases) or twice (33 cases). There
      were two cases that received up to six BET's. One was G-6-PD deficiency and one
      idiopathic in etiology. No significant difference of BET frequency between sex or
      body weight (p greater than 0.05) was found. Newborns with higher serum bilirubin
      due to G-6-PD deficiency, received more BET (p less than 0.05). No significant
      differences of the pH value (7.33 +/- 0.08 vs 7.35 +/- 0.10) and bicarbonate
      values (21.20 +/- 3.99 vs 22.00 +/- 3.83 mM/L) occurred before and after blood
      exchange transfusion (p greater than 0.1). The serum calcium decreased
      significantly after BET (3.88 +/- 0.91 vs 3.15 +/- 6.97 mEq/L, p less than 0.05).
      There were 11 deaths in this series, the mortality rate was 5.7%. Three cases
      (1.5%) were dead within 6 hours after BET.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243374
TI  - [The correlating factors affecting nursing personnel resignation in an university
      hospital].
AB  - Demographic characteristics of 1080 university hospital nursing personnel were
      studied from January 1979 to December 1987. These characteristics included age,
      marital status, number of children and educational background. Among them, 457
      nurses have resigned, while others remain in service. We evaluated the
      correlations between resignation and various demographic characteristics and the
      reasons for resignation. This would provide valuable references for nursing
      recruitment and hospital administration. Our analysis revealed that the reasons
      for resignation are in the following order: Transfer to governmental hospital,
      advanced study, marriage, change of occupation, transfer to teaching, personal
      problems, medical corps to Saudi-Arabia, family responsibilities, and relocation
      to other cities. Regarding to demographic characteristics, both educational
      background and marital status affected the reasons for resignation. The average
      length of service time for nurses who resigned was 30.0 +/- 29.59 months. There
      are significant differences among the age, marital status, number of children and
      educational background. The nurses between the age of 21 and 30 years old, (79%)
      had the highest rate of resignation (45.64%). Those below the age of 20 had the
      shortest service time, while those above 30 years old had the longest service
      time. The married nurses also had a longer service time than the single ones.
      Those who had children had a longer service time compared to those without
      children. In view of their educational background, those with a bachelor degree
      had the shortest service time (16.8 +/- 10.3 months) and the highest rate of
      resignation (71.1%). Our analysis indicates that professional license and
      location of residence also affected the reasons for resignation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 2243375
TI  - Identification of individual human immunodeficiency virus type 1 gp120 amino
      acids important for CD4 receptor binding.
AB  - The binding of the CD4 receptor by the human immunodeficiency virus type 1 gp120
      exterior envelope glycoprotein is important for virus entry and cytopathic
      effect. To investigate the CD4-binding region of the gp120 glycoprotein, we
      altered gp120 amino acids, excluding cysteines, that are conserved among the
      primate immunodeficiency viruses utilizing the CD4 receptor. Changes in two
      hydrophobic regions (Thr-257 in conserved region 2 and Trp-427 in conserved
      region 4) and two hydrophilic regions (Asp-368 and Glu-370 in conserved region 3
      and Asp-457 in conserved region 4) resulted in significant reductions in CD4
      binding. For most of the mutations affecting these residues, the observed effects
      on CD4 binding did not apparently result from global conformational disruption of
      the gp120 molecule, as assessed by measurements of precursor processing, subunit
      association, and monoclonal antibody recognition. The two hydrophilic regions
      exhibit a strong propensity for beta-turn formation, are predicted to act as
      efficient B-cell epitopes, and are located adjacent to hypervariable,
      glycosylated regions. This study defines a small number of gp120 residues
      important for CD4 binding, some of which might constitute attractive targets for
      immunologic intervention.

PMID- 2243376
TI  - Characterization of the gag/fusion protein encoded by the defective Duplan
      retrovirus inducing murine acquired immunodeficiency syndrome.
AB  - Murine acquired immunodeficiency syndrome is induced by a defective retrovirus.
      Sequencing of this defective viral genome revealed a long open reading frame
      which encodes a putative gag/fusion protein, N-MA-p12-CA-NC-COOH, (D. C. Aziz, Z.
      Hanna, and P. Jolicoeur, Nature (London) 338:505-508, 1989). We raised a specific
      antibody to the unique p12 domain of this gag fusion precursor, Pr60gag. We found
      that Pr60gag was indeed encoded by the defective viral genome both in cell-free
      translation reticulocyte extracts and in infected mouse fibroblasts. Pr60gag was
      found to be myristylated, phosphorylated, and attached to the cell membrane, like
      other helper murine leukemia virus (MuLV) gag precursors. Pr60gag was not
      substantially cleaved within the nonproducer cells and was not released from
      these cells. However, in the presence of helper MuLV proteins, it formed
      phenotypically mixed particles. In these particles, Pr60gag was only partially
      cleaved. In helper MuLV-producing cells harboring the defective virus, a gag
      related p40 intermediate was generated both intracellularly and extracellularly.
      In these cells, Pr60gag appeared to behave as a dominant negative mutant,
      interfering with proper cleavage of helper Pr65gag. Our data indicate that
      Pr60gag is a major (and possibly the only) gene product of the defective murine
      acquired immunodeficiency syndrome virus and is likely to harbor some
      determinants of pathogenicity of this virus.

PMID- 2243377
TI  - Identification and characterization of a baculovirus occlusion body glycoprotein
      which resembles spheroidin, an entomopoxvirus protein.
AB  - A 37-kDa polypeptide specified by Autographa californica nuclear polyhedrosis
      virus was found to share significant homology with Choristoneura biennis
      entomopoxyvirus spheroidin protein, which is the major component of
      entomopoxvirus occlusion bodies. Antibodies raised against spheroidin cross
      reacted with the 37-kDa protein and confirmed its expression in the late phase of
      wild-type baculovirus infection. Immunoblot analysis and fluorescence microscopy
      demonstrated that the protein was associated with purified A. californica nuclear
      polyhedrosis virus occlusion bodies and was absent in purified virions.
      Immunofluorescence studies localized the protein to the periphery of occlusion
      bodies and the internal membranes of cells infected with wild-type baculovirus.
      The open reading frame encoding this spheroidinlike protein was inserted into a
      baculovirus expression vector, and recombinant protein was synthesized under
      control of the polyhedrin promoter. Studies of the recombinant protein
      demonstrated that it was heterogeneous in molecular mass as a result of N-linked
      glycosylation. Tunicamycin inhibited carbohydrate addition and yielded proteins
      of 34 and 33 kDa.

PMID- 2243378
TI  - Analysis of sequence diversity in hypervariable regions of the external
      glycoprotein of human immunodeficiency virus type 1.
AB  - Nucleotide sequences in three hypervariable regions of the human immunodeficiency
      virus type 1 (HIV-1) env gene were obtained by sequencing provirus present in
      peripheral blood mononuclear cells of HIV-infected individuals. Single molecules
      of target sequences were isolated by limiting dilution and amplified in two
      stages by the polymerase chain reaction, using nested primers. The product was
      directly sequenced to avoid errors introduced by Taq polymerase during the
      amplification process. There was extensive variation between sequences from the
      same individual as well as between sequences from different individuals.
      Interpatient variability was markedly less in individuals infected from a common
      source. A high proportion of amino acid substitutions in the hypervariable
      regions altered the number and positions of potential N-linked glycosylation
      sites. Sequences in two hypervariable regions frequently contained short (3- to
      15-bp) duplications or deletions, and by amplifying peripheral blood mononuclear
      cell DNA containing 10(2) or 10(3) proviral molecules and analyzing the product
      by high-resolution electrophoresis, the total number and abundance of distinct
      length variants within an individual could be estimated, providing a more
      comprehensive analysis of the variants present than would be obtained by
      sequencing alone. Sequences from many individuals showed frequent amino acid
      substitutions at certain key positions for neutralizing-antibody and cytotoxic T
      cell recognition in the immunodominant loop. The rates of synonymous and
      nonsynonymous nucleotide substitution in the region of this and flanking regions
      indicate that strong positive selection for amino acid change is operating in the
      generation of antigenic diversity.

PMID- 2243379
TI  - The upstream factor-binding site is not essential for activation of transcription
      from the adenovirus major late promoter.
AB  - An adenovirus major late promoter (MLP) has been constructed with a 4-bp
      alteration in the sequence which binds the transcription factor known as USF or
      MLTF. This upstream element has often been considered necessary and sufficient
      for maximal transcription of the MLP. A duplex oligonucleotide containing the
      mutant sequence was not capable of binding specific proteins in a band shift
      assay, nor was it capable of inhibiting such binding by the wild-type sequence.
      In an in vitro assay, the mutant sequence was incapable of inhibiting
      transcription from a duplex sequence containing the MLP, whereas the wild-type
      sequence could. These two pieces of evidence suggest that the sequence is
      functionally impaired. Surprisingly, a virus containing the mutant MLP had a
      normal replication phenotype. On more detailed examination however, we show that
      the mutant viral MLP was deficient in transcription at 9 h postinfection but that
      the rate of transcription was close to normal by 20 h postinfection. An inverted
      CAAT box located immediately upstream of the USF-binding element was not
      previously thought to be of importance to the functioning of the MLP. However, a
      single point mutation in the CAAT box, placed in the USF mutant background, had a
      marked effect upon transcription from the MLP. This result suggests that the MLP
      may exhibit functional redundancy in which either the USF-binding site or the
      CAAT box can serve as an upstream promoter element. Neither of the mutant viruses
      displayed any change in the levels of the divergent IVa2 transcription unit,
      suggesting that the levels of divergent transcription are not determined by
      competition for limiting transcription factors.

PMID- 2243380
TI  - Hepatitis B virus transactivator X protein is not tumorigenic in transgenic mice.
AB  - The hepatitis B virus X protein acts as a transcriptional transactivator in
      vitro. To elucidate possible biological effects of X protein on liver cells in
      vivo, we generated four lines of transgenic mice carrying the X gene open reading
      frame under the control of the human alpha-1-antitrypsin regulatory region. The
      plasmid construct used to introduce the transgene was shown to encode a 16-kDa X
      protein with transactivating capability. The expression of X protein was
      detectable in liver tissue of transgenic animals of three of the lines by
      immunoblot analysis; levels of expression were highest in the first month after
      birth of the animals. Over 80 animals from the expressing lines were examined
      histologically. Most transgenic mice, some of which were observed for up to 2
      years, remained normal. However, a few transgenic animals developed mild focal
      hepatitis, nuclear pleomorphism, focal necrosis, and/or nodular hyperplasia in
      the liver. Increased mitotic activity of hepatocytes also was observed. We
      conclude that, at the level of expression achieved in these transgenic mice, the
      hepatitis B virus transcriptional transactivator X protein alone does not appear
      to mediate the development of serious liver damage or hepatocellular carcinomas.

PMID- 2243381
TI  - Generation of hybrid genes and proteins by vaccinia virus-mediated recombination:
      application to human immunodeficiency virus type 1 env.
AB  - The ability of poxviruses to undergo intramolecular recombination within tandemly
      arranged homologous sequences can be used to generate chimeric genes and
      proteins. Genes containing regions of nucleotide homology will recombine to yield
      a single sequence composed of portions of both original genes. A recombinant
      virus containing two genes with a number of conserved regions will yield a
      population of recombinant viruses containing a spectrum of hybrid sequences
      derived by recombination between the original genes. This scheme has been used to
      generate hybrid human immunodeficiency virus type 1 env genes. Recombinant
      vaccinia viruses that contain two divergent env genes in tandem array have been
      constructed. In the absence of selective pressure to maintain both genes,
      recombination between conserved homologous regions in these genes generated a
      wide range of progeny, each of which expressed a novel variant polypeptide
      encoded by the newly created hybrid env gene. Poxvirus-mediated recombination may
      be applied to map type-specific epitopes, to create novel pharmaceuticals such as
      hybrid interferons, to study receptor-binding or enzyme substrate specificities,
      or to mimic the antigenic diversity found in numerous pathogens.

PMID- 2243382
TI  - Human immunodeficiency virus rev protein recognizes a target sequence in rev
      responsive element RNA within the context of RNA secondary structure.
AB  - Human immunodeficiency virus type 1 Rev protein modulates the distribution of
      viral mRNAs from the nucleus to the cytoplasm by interaction with a highly
      structured viral RNA sequence, the Rev-responsive element (RRE). To identify the
      minimal functional elements of RRE, we evaluated mutant RREs for Rev binding in
      vitro and Rev response in vivo in the context of a Gag expression plasmid. The
      critical functional elements fold into a structure composed of a stem-loop A,
      formed by the ends of the RRE, joined to a branched stem-loop B/B1/B2, between
      bases 49 and 113. The 5' 132 nucleotides of RRE, RREDDE, which possessed a
      similar structure, bound Rev efficiently but were nonfunctional in vivo, implying
      separate binding and functional domains within the RRE. Excision of stem-loop A
      reduced Rev binding significantly and abolished the in vivo Rev response. The B2
      branch could be removed without severe impairment of binding, but deletions in
      the B1 branch significantly reduced binding and function. However, deletion of 12
      nucleotides, including the 5' strand of stem B, abolished both binding and
      function, while excision of the 3' strand of stem B only reduced them.
      Maintenance of the native RRE secondary structure alone was not sufficient for
      Rev recognition. Many mutations that altered the primary structure of the
      critical region while preserving the original RNA conformation were Rev
      responsive. However, mutations that changed a 5'..CACUAUGGG..3' sequence in the B
      stem, without affecting the overall structure abolished both in vitro Rev binding
      and the in vivo Rev response.

PMID- 2243383
TI  - Use of a cell-free system to identify the vaccinia virus L1R gene product as the
      major late myristylated virion protein M25.
AB  - A 25-kDa vaccinia virus (VV) virion protein, designated M25, is modified in vivo
      by covalent addition of myristic acid. The predicted amino acid sequences of all
      VV open reading frames which have been reported were searched for the sequence M
      G-X-X-X-(S/T/A), which has been proposed to be the consensus recognition signal
      for cotranslational modification of proteins by N-myristyltransferase. This
      conserved signal was found at the amino terminus of a single locus, which
      corresponded to the leftmost rightward-reading open reading frame (L1R)
      initiating within the VV HindIII L DNA fragment. By using synthetic
      oligonucleotides in concert with polymerase chain reaction techniques, a chimeric
      gene consisting of open reading fram L1R fused to a bacteriophage T7 promoter was
      constructed and cloned into a plasmid vector. Transcripts derived from the wild
      type expression plasmid (designated pL1G1) were translated in vitro in a wheat
      germ extract to yield a polypeptide with an apparent molecular mass of 25 kDa.
      This polypeptide was labeled with either [35S]methionine or [3H]myristic acid and
      comigrated with in vivo-labeled protein M25 on sodium dodecyl sulfate
      polyacrylamide gels. Polyclonal antiserum generated in rabbits against a trpE:L1R
      fusion protein immunoprecipitated a 25-kDa protein labeled either in vitro (the
      L1R gene product, designated protein L1) or in vivo (from purified VV, protein
      M25), identifying the M25 protein as the gene product of open reading frame L1R.
      Chromatographic analysis of the protein L1-bound fatty acid moieties liberated
      after acid methanolysis resulted in recovery of greater than 99% of the fatty
      acid as myristate-associated label. Cell-free translation of proteins derived
      from a set of deletions from the carboxy terminus of the open reading frame L1R
      suggested that the site of myristylation maps near the amino terminus of protein
      L1. This hypothesis was supported by cell-free translation of mutant L1R
      transcripts in which the penultimate glycine codon had been altered by site
      directed mutagenesis to encode either an aspartic acid (pL1D1) or alanine (pL1A1)
      residue. In both cases, the mutant transcripts were translated into a 25-kDa
      protein which could be labeled in vitro with [35S]methionine but not with
      [3H]myristic acid. These data demonstrate that VV open reading frame L1R encodes
      a myristylated protein and provide evidence that the site of modification of
      protein L1 is the amino-terminal glycine residue.

PMID- 2243384
TI  - Different sites of interaction for Rev, Tev, and Rex proteins within the Rev
      responsive element of human immunodeficiency virus type 1.
AB  - We have analyzed the action of the Rev and Tev proteins of human immunodeficiency
      virus type 1 (HIV-1) and of the Rex protein of human T-cell leukemia virus type I
      (HTLV-I) on a series of Rev-responsive element (RRE) mutants. The minimum
      continuous RRE region necessary and sufficient for Rev function was determined to
      be 204 nucleotides. Interestingly, this region was not sufficient for Tev or Rex
      function. These proteins require additional sequences, which may stabilize the
      structure of the RRE or may contain additional sequence-specific elements.
      Internal RRE deletions revealed that the targets for Rev and Rex can be
      separated, since mutants responding to Rev and not Rex and vice versa were
      identified. Tev was active on both types of mutants, suggesting that it has a
      more relaxed specificity than do both Rev and Rex proteins. Although Rev and Rex
      targets within the RRE appear to be distinct, the trans-dominant mutant RevBL
      prevents the RRE interaction with Rex. RevBL cannot inhibit the function of Rex
      on RRE deletions that lack the Rev-responsive portion. These results indicate the
      presence of distinct sites within the RRE for interaction with these proteins.
      The binding sites for the different proteins do not function independently and
      may interfere with one another. Mutations affecting the RRE may change the
      accessibility and binding characteristics of the different binding sites.

PMID- 2243385
TI  - Structural analysis of wild-type and mutant human immunodeficiency virus type 1
      Tat proteins.
AB  - We expressed the human immunodeficiency virus type 1 transactivator protein, Tat,
      in the wheat germ cell-free translation system and found it to exist as a
      monomer. The first coding exon (residues 1 to 72) of wheat germ-expressed Tat was
      resistant to trypsin digestion, indicating that it is a highly folded,
      independently structured protein domain. Several mutant Tat proteins were
      dramatically more sensitive to trypsin than the wild type was, suggesting that
      their reduced transactivation activities are the result of destabilized
      structures. Mutant proteins with single-amino-acid substitutions were also
      identified that had reduced transactivation activities but wild-type structures
      in the trypsin assay. These mutants clustered in two regions of Tat, at acidic
      residues 2 and 5 in the amino terminus and between residues 18 and 32. These
      mutants, wild type in structure but reduced in activity, identify residues in the
      wild-type protein that may directly contact other molecules during Tat function.

PMID- 2243387
TI  - Mutational analysis of a vaccinia virus intermediate promoter in vivo and in
      vitro.
AB  - The expression of the vaccinia virus intermediate I3 gene depends on trans-acting
      factors which are present in an active state prior to DNA replication. However,
      activation of transcription requires DNA replication in cis (J. C. Vos and H. G.
      Stunnenberg, EMBO J., 7:3487-3492, 1988). We have made deletion and linker
      scanner mutations of the I3 promoter to determine the sequence requirements for
      transcriptional activity and the dependence of DNA replication. The I3 promoter
      appears to consist of two elements which are essential and sufficient for
      accurate transcription initiation both in vivo and in vitro. An upstream and a
      downstream sequence element were defined ranging from -20 to -9 and +1 to +9,
      respectively. The upstream element appears to be highly homologous to a sequence
      in the intermediate I8 promoter. A 3-bp substitution in the upstream I3 promoter
      element resulted in a change of transcriptional specificity from intermediate to
      late. Finally, the mutations did not result in an activation of the intermediate
      promoter prior to DNA replication.

PMID- 2243386
TI  - Analysis of efficiently packaged defective interfering RNAs of murine
      coronavirus: localization of a possible RNA-packaging signal.
AB  - We have previously shown that most of the defective interfering (DI) RNA of mouse
      hepatitis virus (MHV) are not packaged into virions. We have now identified,
      after 21 serial undiluted passages of MHV, a small DI RNA, DIssF, which is
      efficiently packaged into virions. The DIssF RNA replicated at a high efficiency
      on its transfection into the helper virus-infected cells. The virus released from
      the transfected cells interfered strongly with mRNA synthesis and growth of
      helper virus. cDNA cloning and sequence analysis of DIssF RNA revealed that it is
      3.6 kb and consists of sequences derived from five discontinuous regions of the
      genome of the nondefective virus. The first four regions (domains I to IV) from
      the 5' end are derived from gene 1, which presumably encodes the RNA polymerase
      of the nondefective virus. The entire domain I (859 nucleotides) and the first
      750 nucleotides of domain II are also present in a previously characterized DI
      RNA, DIssE, which is not efficiently packaged into virions. Furthermore, the
      junction between these two domains is identical between the two DI RNAs. The
      remaining 77 nucleotides at the 3' end of domain II and all of domains III (655
      nucleotides) and IV (770 nucleotides) are not present in DIssE RNA. These four
      domains are derived from gene 1. In contrast, the 3'-most domain (domain V, 447
      nucleotides) is derived from the 3' end of the genomic RNA and is also present in
      DIssE. The comparison of primary sequences and packaging properties between DIsse
      and DIssF RNAs suggested that domains III and IV and part of the 3' end of domain
      II contain the packaging signal for MHV RNA. This conclusion was confirmed by
      inserting these DIssF-unique sequences into a DIssE cDNA construct; the in vitro
      transcribed RNA from this hybrid construct was efficiently packaged into virion
      particles. DIssF RNA also contains an open reading frame, which begins from
      domain I and ends at the 5'-end 20 bases of domain III. In vitro translation of
      DIssF RNA and metabolic labeling of the virus-infected cells showed that this
      open reading frame is indeed translated into a 75-kDa protein. The structures of
      both DIssE and DIssF RNAs suggest that a protein-encoding capability is a common
      characteristic of MHV DI RNA.

PMID- 2243389
TI  - Analysis of the role of brome mosaic virus 1a protein domains in RNA replication,
      using linker insertion mutagenesis.
AB  - Brome mosaic virus (BMV) belongs to a "superfamily" of plant and animal positive
      strand RNA viruses that share, among other features, three large domains of
      conserved sequence in nonstructural proteins involved in RNA replication. Two of
      these domains reside in the 109-kDa BMV 1a protein. To examine the role of 1a, we
      used biologically active cDNA clones of BMV RNA1 to construct a series of linker
      insertion mutants bearing two-codon insertions dispersed throughout the 1a gene.
      The majority of these mutations blocked BMV RNA replication in protoplasts,
      indicating that both intervirally conserved domains function in RNA replication.
      Coinoculation tests with a large number of mutant combinations failed to reveal
      detectable complementation between mutations in the N- and C-terminal conserved
      domains, implying that these two domains either function in some directly
      interdependent fashion or must be present in the same protein. Four widely spaced
      mutations with temperature-sensitive (ts) defects in RNA replication were
      identified, including a strongly ts insertion near the nucleotide-binding
      consensus of the helicaselike C-terminal domain. Temperature shift experiments
      with this mutant show that 1a protein is required for continued accumulation of
      all classes of viral RNA (positive strand, negative strand, and subgenomic) and
      is required for at least the first 10 h of infection. ts mutations were also
      identified in the 3' noncoding region of RNA1, 5' to conserved sequences
      previously implicated in cis for replication. Under nonpermissive conditions, the
      cis-acting partial inhibition of RNA1 accumulation caused by these noncoding
      mutations was also associated with reduced levels of the other BMV genomic RNAs.
      Comparison with previous BMV mutant results suggests that RNA replication is more
      sensitive to reductions in expression of 1a than of 2a, the other BMV-encoded
      protein involved in replication.

PMID- 2243388
TI  - Coordinate enhancement of cytokine gene expression in human immunodeficiency
      virus type 1-infected promonocytic cells.
AB  - A promonocytic cell model was used to investigate cytokine gene transcription in
      U937 and U9-IIIB cells chronically infected with human immunodeficiency virus
      type 1 (HIV-1). The production of interferon (alpha-1 interferon [IFN-alpha 1],
      IFN-alpha 2, and IFN-beta), interleukin (interleukin 1 alpha [IL-1 alpha], IL-1
      beta, and IL-6), and tumor necrosis factor alpha (TNF-alpha) mRNA was
      characterized by quantitative polymerase chain reaction mRNA phenotyping in U937
      and U9-IIIB cells following coinfection with Sendai paramyxovirus or stimulation
      with lipopolysaccharide (LPS). Chronic HIV-1 infection of U9-IIIB cells resulted
      in a low constitutive level of transcription of TNF and IL-1 genes but not IFN
      genes; however, when the cells were coinfected with Sendai virus, 10- to 20-fold
      higher levels of IFN-beta, IL-1 beta, IL-6, and TNF-alpha mRNA were observed in
      U9-IIIB cells than in similarly induced U937 cells. The enhanced levels of
      cytokine RNA in virus-infected U9-IIIB cells were also accompanied by higher
      levels of IFN antiviral activity and TNF secretion than in U937 cells. Transcript
      levels for IFN-alpha 1 and IFN-alpha 2 were equivalently induced in virus
      infected U937 and U9-IIIB cells, indicating that a generalized derepression of
      cytokine gene expression did not occur as a consequence of HIV-1 infection. When
      LPS was used as an inducer, a distinct pattern of cytokine gene expression was
      detected in U9-IIIB cells. TNF-alpha and IL-1 beta but not IFN-alpha or IFN-beta
      transcripts were induced by LPS. These results suggest that HIV-1 infection of
      promonocytic cells may prime or sensitize cells such that subsequent antigenic
      challenge leads to coordinate enhancement of cytokine gene expression.

PMID- 2243390
TI  - The arginine-rich domain of hepatitis B virus precore and core proteins contains
      a signal for nuclear transport.
AB  - Precore and core proteins are two related co-carboxy-terminal proteins of
      hepatitis B virus. Precore protein contains the entire sequence of core protein
      plus an amino-terminal extension of 29 amino acid residues. Both proteins can
      display a common antigenic determinant known as core antigen (HBcAg). Clinically,
      HBcAg is detected in the nucleus, cytoplasm, or both of hepatitis B virus
      infected hepatocytes. In order to understand the mechanism that regulates nuclear
      transport of HBcAg, various portions of precore and core proteins were linked to
      a reporter protein, human alpha-globin, and expressed in mammalian cells. Our
      results indicate that the precore protein-specific sequence, although important
      for nuclear transport, does not contain a nuclear localization signal. Instead, a
      signal for nuclear transport is located near the carboxy termini of precore and
      core proteins in the arginine-rich domain. This signal is made up of a set of two
      direct PRRRRSQS repeats and is highly conserved among mammalian hepadnaviruses.

PMID- 2243391
TI  - The viral envelope gene is involved in macrophage tropism of a human
      immunodeficiency virus type 1 strain isolated from brain tissue.
AB  - Human immunodeficiency virus type 1 (HIV-1) strains isolated from the central
      nervous system (CNS) may represent a subgroup that displays a host cell tropism
      different from those isolated from peripheral blood and lymph nodes. One CNS
      derived isolate, HIV-1SF128A, which can be propagated efficiently in primary
      macrophage culture but not in any T-cell lines, was molecularly cloned and
      characterized. Recombinant viruses between HIV-1SF128A and the peripheral blood
      isolate HIV-1SF2 were generated in order to map the viral gene(s) responsible for
      the macrophage tropism. The env gene sequences of the two isolates are about
      91.1% homologous, with variations scattered mainly in the hypervariable regions
      of gp120. Recombinant viruses that have acquired the HIV-1SF128A env gene display
      HIV-1SF128A tropism for macrophages. Furthermore, the gp120 variable domains, V1,
      V2, V4, and V5, the CD4-binding domain, and the gp41 fusion domain are not
      directly involved in determining macrophage tropism.

PMID- 2243392
TI  - A novel mechanism for the initiation of Tacaribe arenavirus genome replication.
AB  - The ends of arenavirus genome and antigenome RNAs are highly conserved and where
      determined directly, always contain a 3' G (referred to as position +1). However,
      primers extended to the 5' ends of Tacaribe virus genomes and antigenomes extend
      to position -1. When genomes and antigenomes are annealed either inter or
      intramolecularly and treated with RNase A or T1, there appears to be a single
      unpaired G at the 5' ends of the hybrids. A single extra G is also found by
      cloning the 5' ends of S antigenomes, and studies with capping enzyme detect
      (p)ppG at the 5' ends of genome and antigenome chains. A model is proposed in
      which genome replication initiates with pppGpC to create the nontemplated extra
      G. In contrast, the nontemplated bases at the 5' ends of the N mRNAs, which
      extend to positions -1 to -5, were found to be capped and also heterogeneous in
      sequence.

PMID- 2243393
TI  - Monoclonal antibody protection from age-dependent poliomyelitis: implications
      regarding the pathogenesis of lactate dehydrogenase-elevating virus.
AB  - Over 90% of cyclophosphamide-treated, 6- to 7-month-old C58/M mice developed
      fatal paralytic disease after infection with a virulent strain of lactate
      dehydrogenase-elevating virus (LDV), with a mean onset of paralysis of about 16
      days. Passive immunization with polyclonal antibodies or with a group of anti-LDV
      monoclonal antibodies (MAbs) with single-epitope specificity 1 day before or at
      the time of LDV infection prevented the development of paralytic disease without
      interfering with the replication of LDV in permissive macrophages, the primary
      host cells of LDV. In situ hybridization of spinal cord sections with an LDV
      specific cDNA probe indicated that the MAb specifically prevented the cytocidal
      infection of motor neurons by LDV without blocking the infection of smaller
      nonneuronal cells in the spinal cord. The protective antibodies recognize at
      least two different epitopes on the glycoprotein of LDV, VP-3. Passive
      immunizations with other anti-LDV MAbs, which recognize at least three other
      epitopes on VP-3 of LDV, afforded no protection. In contrast to the protective
      effect of anti-LDV MAb injection before or at the time of LDV infection, their
      administration postinfection exerted relatively little protection, though it
      delayed the appearance of paralytic symptoms. However, repeated injections of
      MAbs until at least 7 days postinfection also afforded a high degree of
      protection. The results indicate that protective MAbs may interfere with two
      stages in the development of LDV-induced paralytic disease. When administered at
      the time of LDV infection, they prevent the initial infection of spinal cord
      motor neurons. After this initial event, repeated injections of MAb are required
      to inhibit the spread of LDV between neurons until the endogenous production of
      protective anti-LDV antibodies in these mice.

PMID- 2243394
TI  - Analysis of long terminal repeat circle junctions of human immunodeficiency virus
      type 1.
AB  - Circle junctions of unintegrated human immunodeficiency virus type 1 strain IIIB
      were analyzed after polymerase chain reaction amplification. Among the 28
      colonies sequenced, eight unique circle junction species were detected. Five of
      the eight species resulted in circle junctions with larger inserts than
      predicted. A majority of these could result from heterogeneity in generating the
      U5' long terminal repeat terminus.

PMID- 2243396
TI  - Changes in the transmembrane region of the human immunodeficiency virus type 1
      gp41 envelope glycoprotein affect membrane fusion.
AB  - The charged amino acids near or within the membrane-spanning region of the human
      immunodeficiency virus type 1 gp41 envelope glycoprotein were altered. Two
      mutants were defective for syncytium formation and virus replication even though
      levels of envelope glycoproteins on the cell or virion surface and CD4 binding
      were comparable to those of the wild-type proteins. Thus, in addition to
      anchoring the envelope glycoproteins, sequences proximal to the membrane-spanning
      gp41 region are important for the membrane fusion process.

PMID- 2243395
TI  - Intracellular interaction of human immunodeficiency virus type 1 (ARV-2) envelope
      glycoprotein gp160 with CD4 blocks the movement and maturation of CD4 to the
      plasma membrane.
AB  - The envelope glycoprotein of human immunodeficiency virus type 1 (HIV-1) plays a
      major role in the down-regulation of its receptor, CD4. Using a transient
      expression system, we investigated the interaction of the HIV-1 envelope
      glycoprotein with CD4 during their movement through the intracellular membrane
      traffic. In singly transfected cells, the envelope glyprotein gp160 was
      synthesized, glycosylated, and localized predominantly in the endoplasmic
      reticulum. Only a minor fraction of gp160 was proteolytically cleaved, producing
      gp120 and gp41, and gp120 was secreted into the medium. On the other hand, the
      CD4 molecule, when expressed alone, was properly glycosylated and transported
      efficiently to the cell surface. However, when gp160 and CD4 were coexpressed in
      the same cell, the cell surface delivery of CD4 was greatly reduced. In
      coexpressing cells, CD4 formed a specific intracellular complex with gp160 as
      both proteins could be immunoprecipitated by antibodies against either the gp160
      or CD4 (OKT4) but not by OKT4A, a blocking antibody against CD4. The specific
      gp160-CD4 complex was localized predominantly in the endoplasmic reticulum, and
      the CD4 in the complex did not acquire endoglycosidase H resistance. The present
      studies demonstrated that a specific intracellular interaction between gp160 and
      CD4 was responsible for the cell surface down-regulation of CD4 in cells
      expressing both the envelope glycoprotein of HIV-1 and its receptor, CD4.

PMID- 2243397
TI  - Parental influenza virion nucleocapsids are efficiently transported into the
      nuclei of murine cells expressing the nuclear interferon-induced Mx protein.
AB  - The interferon-induced murine Mx1 protein, which is localized in the nucleus,
      most likely specifically blocks influenza virus replication by inhibiting nuclear
      viral mRNA synthesis, including the mRNA synthesis catalyzed by inoculum
      (parental) virion nucleocapsids (R. M. Krug, M. Shaw, B. Broni, G. Shapiro, and
      O. Haller, J. Virol. 56:201-206, 1985). We tested two possible mechanisms for
      this inhibition. First, we determined whether the transport of parental
      nucleocapsids into the nucleus was inhibited in murine cells expressing the
      nuclear Mx1 protein. To detect the Mx1 protein, we prepared rabbit antibodies
      against the Mx1 protein with a CheY-Mx fusion protein expressed in bacteria. The
      fate of parental nucleocapsids was monitored by immunofluorescence with an
      appropriate dilution of monoclonal antibody to the nucleocapsid protein. The
      protein synthesis inhibitor anisomycin was added to the cells 30 min prior to
      infection, so that the only nucleocapsids protein molecules in the cells were
      those associated with nucleocapsids of the parental virus. These nucleocapsids
      were efficiently transported into the nuclei of murine cells expressing the Mx1
      protein, indicating that this protein most likely acts after the parental
      nucleocapsids enter the nucleus. The second possibility was that the murine Mx1
      protein might act in the nucleus to inhibit viral mRNA synthesis indirectly via
      new cap-binding activities that sequestered cellular capped RNAs away from the
      viral RNA transcriptase. We show that the same array of nuclear cap-binding
      proteins was present in Mx-positive and Mx-negative cells treated with
      interferon. Interestingly, a large amount of a 43-kDa cap-binding activity
      appeared after interferon treatment of both Mx-positive and Mx-negative cells.
      Hence, the appearance of new cap-binding activities was unlikely to account for
      the Mx-specific inhibition of viral mRNA synthesis. These results are most
      consistent with the possibility that the Mx1 protein acts directly to inhibit the
      viral transcriptase in the nucleus.

PMID- 2243398
TI  - CD4-independent infection by human immunodeficiency virus type 1 after phenotypic
      mixing with human T-cell leukemia viruses.
AB  - Although human immunodeficiency virus (HIV) is the causative agent of the
      acquired immunodeficiency syndrome and related disorders, it has been suggested
      that viral cofactors may accelerate the progression of the disease. We present
      evidence that human T lymphoid cells productively coinfected by HIV type 1 (HIV
      1) and human T-cell leukemia virus type I (HTLV-I) or HTLV-II generate a progeny
      of phenotypically mixed viral particles that allow the penetration of HIV-1 into
      previously nonsusceptible CD4- human cells, including mature CD8+ T lymphocytes,
      B lymphoid cells, epithelial cells, and skeletal muscle cells. The infection is
      independent of the major HIV-1 receptor, (i.e., the CD4 glycoprotein) since
      OKT4a, a neutralizing anti-CD4 monoclonal antibody, fails to block the
      penetration of HIV-1. Similarly, infection is not inhibited by monoclonal
      antibody M77, directed toward the neutralizing loop of the gp120 envelope
      glycoprotein of HIV-1. In contrast, pretreatment of the virus stock with HTLV-I
      neutralizing human serum completely abolishes the penetration of phenotypically
      mixed HIV-1 into CD4- cells. These results suggest that HTLV-I or HTLV-II may
      increase the pathogenicity of HIV-1 by broadening the spectrum of its cellular
      tropism and, thus, favoring its spread within the organism of coinfected hosts.

PMID- 2243399
TI  - Strains from both Theiler's virus subgroups encode a determinant for
      demyelination.
AB  - The GDVII strain and other members of the GDVII subgroup of Theiler's murine
      encephalomyelitis viruses (TMEV) cause an acute lethal neuronal infection in
      mice, whereas the DA strain and other members of the TO subgroup of TMEV cause a
      chronic demyelinating disease associated with a persistent virus infection. We
      used GDVII/DA chimeric infectious cDNAs to produce intratypic recombinant viruses
      in order to clarify reasons for the TMEV subgroup-specific difference in
      demyelinating activity. We found that both the GDVII and DA strains contain a
      genetic determinant(s) for demyelinating activity. No demyelination occurs
      following GDVII strain inoculation because this strain produces an early neuronal
      disease that kills mice before white matter disease and persistent infection can
      occur.

PMID- 2243400
TI  - Presidential address: quality assurance and medical economics--their impact on
      the practice of surgery.

PMID- 2243401
TI  - Interruption of critical aortoiliac collateral circulation during nonvascular
      operations: a cause of acute limb-threatening ischemia.
AB  - In patients with aortoiliac occlusive disease interruption of critical
      collaterals during another nonvascular or cardiac operation may threaten limb
      viability. This occurred in four patients whose limb-threatening ischemia was
      precipitated by radical cystectomy with bilateral hypogastric artery ligation,
      left colon resection, or coronary artery revascularizations by means of the
      internal mammary artery. Important collateral pathways, the interruption of which
      may account for this phenomenon, are detailed, and approaches are outlined for
      prevention and management of acute ischemia in this setting.

PMID- 2243403
TI  - One hundred percent oxygen reverses muscle hypoxia in a rat hindlimb model of
      acute arterial occlusion.
AB  - Significant morbidity results from extremity ischemia after acute arterial
      occlusion. Reestablishment of arterial flow is considered to be the ideal
      treatment, yet substantial tissue loss can occur before this is accomplished.
      Using a rat hindlimb model we investigated whether the administration of 100%
      oxygen would decrease tissue hypoxia from acute arterial occlusion. Adult male
      Sprague-Dawley rats were used, and Po2 recordings were taken from the
      gastrocnemius muscle by use of an oxygen electrode. Baseline muscle Po2 was
      recorded, and then the femoral artery was occluded. Repeat recordings were made
      after 20 minutes of ventilation with room air and after an additional 20 minutes
      of ventilation with 100% oxygen (N = 10). Control groups consisted of animals
      undergoing occlusion but continued on room air (N = 3) and animals undergoing
      sham occlusion but receiving the period of 100% oxygen ventilation (N = 3).
      Femoral artery occlusion produced a reduction in muscle Po2 from 28.0 +/- 1.4 to
      6.1 +/- 2.0 (mean +/- SEM, p less than 0.001). Ventilation with 100% oxygen
      reversed the tissue hypoxia produced by occlusion (27.3 +/- 2.0, p less than
      0.001). The administration of 100% oxygen without femoral artery occlusion
      resulted in a higher tissue Po2 than the occluded + oxygen group (94 +/- 12 vs
      27.3 +/- 2.0, p less than 0.001). Mean arterial blood pressure increased in the
      experimental group concomitant with the administration of 100% oxygen, but there
      was no correlation between final blood pressure and final tissue oxygen
      tension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243402
TI  - Atheroemboli to the lower urinary tract: a marker of atherosclerotic vascular
      disease--a case report.
AB  - Atheroemboli to the lower genitourinary tract may serve as a marker for
      disseminated atheroembolic disease, a highly lethal condition. A case
      presentation and review of our institional experience is presented.

PMID- 2243404
TI  - Does the end-to-end venous anastomosis offer a functional advantage over the end
      to-side venous anastomosis in high-output arteriovenous grafts?
AB  - This study explores the hemodynamics, mechanics, and biologic response of end-to
      end versus end-to-side venous anastomoses in a canine arteriovenous graft model.
      Femoral polytetrafluoroethylene grafts were implanted bilaterally in a paired
      fashion (n = 22). Detailed local hemodynamic measurements were made by use of
      color Doppler ultrasound imaging at 1, 4, 8, and 12 weeks after implant.
      Measurements included volumetric flow rate and Doppler-derived spectral window
      (percent window) as a measure of turbulence. Amplitude and velocity of vessel
      wall movement were also measured. Volume of perivascular tissue vibration
      quantitated kinetic energy transfer through the vessel wall. Volumetric flow rate
      (end to end, 1013 +/- 70 ml/min; end to side, 1015 +/- 72 ml/min), percent window
      (end to end, 6.6% +/- 0.6%, end to side, 5.6% +/- 0.4%) and volume of
      perivascular tissue vibration (end to end, 19.6 +/- 1.2 ml, end to side, 16.3 +/-
      1.8 ml) were statistically equivalent in the two graft types (end to end vs end
      to side p greater than 0.05). Both graft types developed venous intimal-medial
      thickening of a similar magnitude: end to end, 0.35 +/- 0.05 mm, end to side,
      0.43 +/- 0.09 mm, normal vein 0.070 +/- 0.004 mm (analysis of variance [ANOVA] p
      less than 0.001, p less than 0.01 for end to end or end to side vs control, end
      to end vs end to side p greater than 0.05 by Student-Newman-Keuls test). The best
      correlations with venous intimal-medial thickening were obtained from inverse
      percent window (r = 0.84, p less than 0.001) and volume of perivascular tissue
      vibration (r = 0.68, p less than 0.001). In the end to end configuration the
      relative amplitude of venous wall movement decreased, and the relative velocity
      of wall motion increased over time. We conclude that in the circumstances of this
      high flow arteriovenous graft model the end-to-end venous anastomosis does not
      significantly differ from the end-to-side venous anastomosis in terms of flow
      stability, turbulence, or kinetic energy transfer. The magnitude of the
      hyperplastic response is statistically equivalent for the two anastomotic types,
      but the pattern is somewhat different, possibly providing evidence for
      differences in stress distribution. Differences in the relative amplitude and
      velocity of vessel wall movement suggest that anastomotic geometry may affect the
      way in which kinetic energy is dissipated at the graft/vessel interface.

PMID- 2243405
TI  - End-stage renal disease--is infrainguinal limb revascularization justified?
AB  - Reports of reconstructive surgery for peripheral vascular disease have been
      relatively uncommon in patients with end-stage renal disease. Between 1980 and
      1989, 39 patients with end-stage renal disease underwent revascularization of 56
      limbs. Fifty-two primary infrainguinal and four secondary infrainguinal bypass
      grafts were performed. In addition, nine thrombectomies were performed. At the
      time of surgery 37 patients were on dialysis; three had functioning kidney
      transplants. The indications for revascularization were gangrene, rest pain, or
      ulceration in all except three limbs with disabling claudication. Reversed,
      nonreversed, or in situ vein was used in 25 of the 52 primary infrainguinal
      revascularizations performed. Polytetrafluoroethylene was used in 25. Two
      procedures used a combination of polytetrafluoroethylene and vein. The primary
      patencies for all infrainguinal procedures at 1 and 2 years were 77% and 68%,
      respectively. Four perioperative deaths occurred in the infrainguinal group
      (7.7%). An additional death occurred after thrombectomy for late graft closure.
      Three deaths were a result of myocardial infarction. One patient on peritoneal
      dialysis developed uncontrolled sepsis. At 3 years 39% of patients were alive,
      and 84% of the limbs were salvaged. Among the cases studied no group was
      identified that represented unacceptable operative risk. Results compared well
      with reported patencies for patients subjected to infrainguinal revascularization
      procedures. Limb revascularization in patients with end-stage renal disease may
      be performed by use of similar criteria to those used for other patients with
      peripheral vascular disease.

PMID- 2243406
TI  - Transaortic endarterectomy of renal visceral artery lesions in association with
      infrarenal aortic surgery.
AB  - The complexity of infrarenal aortic reconstruction increases when bypass grafts
      to revascularize associated renal and visceral arteries are needed. Lesions in
      these vessels, however, are usually limited to their aortic orifices and
      therefore are amenable to retroperitoneal transaortic endarterectomy. A combined
      infrarenal aortic reconstruction and transaortic endarterectomy of the
      renal/visceral vessels was used in 18 (16%) of 120 patients undergoing elective
      infrarenal aortic reconstruction over a 2-year-period. Transaortic endarterectomy
      was performed primarily for renal preservation in 11 patients with bilateral,
      high-grade renal artery stenoses and abnormal renal function (serum creatinine
      greater than or equal to 1.9 mg/dl). In seven patients transaortic endarterectomy
      was performed as a secondary procedure during the course of complex
      reconstruction of aneurysmal or occlusive aortic disease. Mean serum creatinine,
      which was elevated preoperatively in 14 (78%) patients (3.3 mg/dl), decreased
      significantly after the operation (2.0 mg/dl, p less than 0.01). A single death
      occurred in the 18 patients undergoing transaortic endarterectomy. Renal function
      preservation can be achieved by renal revascularization in patients with
      bilateral renal artery stenoses and decreased renal function. The retroperitoneal
      approach to aortic reconstruction and the use of transaortic endarterectomy
      allows correction of most renal/visceral vessel involvement in complex aortic
      revascularization procedures.

PMID- 2243407
TI  - Combined aortic and visceral arterial reconstruction: risks and results.
AB  - The indications, morbidity, and efficacy of combined reconstruction of the
      abdominal aorta and visceral arteries (renal and superior mesenteric; excluding
      suprarenal aortic aneurysms) were analyzed retrospectively in 29 consecutive
      patients who underwent surgery from June 1984 through February 1990. Seventeen
      men and 12 women ages 32 to 76 years (mean, 66 years) were studied. Follow-up was
      complete in all patients to either death or calendar year 1989 to 1990 (mean,
      31.9 months; range, 2 to 66 months). All patients underwent bypass of
      angiographically proven severe lesions of one renal artery (19 patients), both
      renal arteries (8 patients), or the superior mesenteric artery and renal arteries
      (2 patients), in concert with synthetic distal aortic replacement for occlusive
      disease (10 patients) or aneurysm (19 patients). Indications for renal artery
      repair included severe hypertension in 13 patients, ischemic renal insufficiency
      in 8 patients, and lesion morphology alone in 8 patients. Operative mortality
      rate was 3 of 29 (10.3%), and each death was the result of multisystem organ
      failure. Nonfatal complications occurred in 11 of the 26 survivors (42%), and
      this group differed significantly from the uncomplicated 15 patients only in
      having a higher mean preoperative serum creatinine (2.5 +/- 1.1 mg/dl vs 1.6 +/-
      0.9 mg/dl, p = 0.04, t test). The mortality rate of patients with preoperative
      serum creatinine greater than or equal to 2.0 mg/dl, was 15.4% (2/13 patients),
      compared to 6.2% (1/16) in patients with creatinine less than 2.0 mg/dl. Three
      late deaths occurred (2 stroke, 1 cancer). Hypertension control improved in 64%
      of patients overall, and in 7 of 9 patients whose major operative indication was
      renovascular hypertension. Renal function remained stable or improved in 12 of 15
      patients (80%) with renal insufficiency, but 3 patients progressed to require
      dialysis. Long-term graft patency was demonstrated by angiography or on duplex
      scan in all studied survivors (21 patients). Although operative risks are clearly
      increased compared to less complex vascular procedures, careful patient selection
      and management will yield a favorable outcome in most patients with such combined
      lesions.

PMID- 2243408
TI  - The role of carotid screening before coronary artery bypass.
AB  - Five hundred thirty-nine patients with no symptoms of cerebral ischemia
      undergoing coronary artery bypass were preoperatively evaluated for presence of
      carotid stenosis by noninvasive methods (duplex scanning and ocular
      pneumoplethysmography-Gee). Overall prevalence of carotid stenosis greater than
      75% was higher (8.7%) than that generally reported. Age greater than 60 years was
      significantly related to presence of carotid stenosis greater than 75% (11.3% vs
      3.8%, p = 0.003). Risk factors such as hypercholesterolemia, hypertension,
      diabetes mellitus, and smoking were not predictive for carotid stenosis,
      postoperative stroke, or death. Carotid stenosis greater than 75% (odds ratio
      9.87, p less than 0.005) and coronary artery bypass redo (odds ratio 5.26, p less
      than 0.05) were both independent predictors of stroke risk. Patients were divided
      into four groups: group 1, minimal or mild degree of carotid stenosis (less than
      50%), not submitted to prophylactic carotid endarterectomy (432 patients, 80.1%);
      group 2, moderate degree of stenosis (50% to 75%), no prophylactic carotid
      endarterectomy (60 patients, 11.2%); group 3, severe carotid stenosis; (greater
      than 75%), submitted to prophylactic carotid endarterectomy (19 patients, 3.5%),
      group 4, severe carotid stenosis (greater than 75%) no prophylactic carotid
      endarterectomy (28 patients, 5.2%). Patients in group 4 had significantly higher
      stroke rate (14.3%) compared to the other three groups (1.1%) (p = 0.0019). The
      finding of carotid stenosis greater than 75% in patients over 60 years of age was
      associated with occurrence of stroke in 15% of cases. Carotid screening is
      helpful to determine patients at increased risk of stroke and should be performed
      in patients greater than 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243409
TI  - Carotid endarterectomy: a ten-year analysis of outcome and cost of treatment.
AB  - Between 1978 and 1988, 215 patients with an average age of 67 years, underwent
      246 carotid endarterectomies. Two hundred ten (85.4%) patients were symptomatic,
      and 36 (14.6%) were asymptomatic. Six patients (2.4%) had a postoperative stroke,
      and all had immediate reoperation. One of these patients died (30 day mortality
      rate, 0.4% for the series), and two (0.8%) recovered completely, whereas three
      (1.2%) had a mild permanent neurologic deficit. Two patients (0.8%) had nonfatal
      myocardial infarction. Mean follow-up of 42.2 months (range, 1 to 126 months) was
      achieved. At 5 and 8 years actuarial survival rates of 82% and 66% and stroke
      free survival rates of 67% and 37% were observed. Actuarial stroke free rates of
      90% at 5 and 8 years were noted. By introducing and observing guidelines that
      required preoperative study of most clearly defined classes of patients before
      admission for surgical treatment, the average length of stay for carotid
      endarterectomy was lowered from 9.5 days in the first 5 years of the study to 5.8
      days in the second 5 years (p = 0.001). Average hospital charges, expressed in
      constant dollars, decreased from $3113 in the first 5 years to $2620 in the
      second 5 years (p = 0.02) despite an 88% inflationary increase in medical
      consumer price index. This experience shows that the length of hospitalization of
      patients with carotid endarterectomy can be reduced and the cost of admission
      lowered without untoward effect on perioperative morbidity and mortality rates.

PMID- 2243410
TI  - Steady and pulsatile flow fields in an end-to-side arterial anastomosis model.
AB  - We investigated the flow field within a rigid-walled in vitro model of an end-to
      side 45 degree anastomosis in an attempt to identify possible hemodynamic factors
      that may contribute to the pathogenesis of distal anastomotic intimal
      hyperplasia. A high-resolution photochromic tracer technique was used to
      visualize the flow in orthogonal planes and to determine the axial wall shear
      stress profiles for both steady and pulsatile flows over a range of
      physiologically relevant conditions. The flow field showed qualitative
      similarities to those seen in curved vessel: rapidly moving fluid from the graft
      section affects the bed of the host vessel, that is, the wall opposite the
      anastomosis, eventually advancing down the host vessel in a spiraling motion. A
      small mobile separation zone was noted at the toe of the anastomosis. Comparison
      of wall shear stress profiles with previously reported preferential sites for the
      development of intimal hyperplasia supported a low wall shear stress and/or flow
      separation pathogenesis hypothesis. One notable exception was the bed of the host
      artery that appeared to be subjected to a complex hemodynamic environment.

PMID- 2243411
TI  - The value of pulmonary artery and central venous monitoring in patients
      undergoing abdominal aortic reconstructive surgery: a comparative study of two
      selected, randomized groups.
AB  - One hundred two patients undergoing abdominal aortic reconstructive surgery were
      prospectively, randomly allocated to two groups, one of which was monitored with
      a central venous catheter and the other with a pulmonary artery catheter.
      Patients with uncompensated cardiopulmonary or renal disease were excluded from
      the study. General anesthesia was administered for the surgical procedure, and
      the patients were followed through hospital discharge. No statistically
      significant differences occurred between the two groups with regard to morbidity
      (perioperative cardiac, pulmonary or renal sequelae), mortality rate, duration of
      intensive care, postoperative hospital stay, or cost of hospitalization. The one
      statistically significant difference between groups was the professional fee
      charged for anesthetic care, which was higher for patients with pulmonary artery
      catheters than for those with central venous catheters. In conclusion, we
      prospectively gathered data from most patients presented for abdominal aortic
      reconstructive surgery. Our data seem to indicate that the choice of central
      venous catheter or pulmonary artery catheter monitoring makes little difference
      in outcome after abdominal aortic reconstructive surgery, and that for many
      patients pulmonary artery catheters are not necessary to give appropriate,
      adequate care. Because of the size of the sample, however, declarations of
      epidemiologic significance would be unfounded. Therefore large-scale, multicenter
      studies addressing such outcomes remain necessary.

PMID- 2243412
TI  - Composite femoropopliteal bypass: a new method of centered end-to-end anastomosis
      between polytetrafluoroethylene and autologous vein with a diameter discrepancy.

PMID- 2243413
TI  - Expanded indications for laser-assisted balloon angioplasty in peripheral
      arterial disease.

PMID- 2243414
TI  - Institute of Medicine to restaurants: serve up nutrition information.

PMID- 2243415
TI  - Cholesterol 'war': dietitians, physicians team up.

PMID- 2243416
TI  - Medical students to receive food for thought.

PMID- 2243417
TI  - Youngsters dialing up cholesterol levels?

PMID- 2243418
TI  - Nursing: new power, old problems.

PMID- 2243419
TI  - From the Centers for Disease Control. Factors related to cholesterol screening,
      cholesterol level awareness--United States, 1989.

PMID- 2243420
TI  - Myopathy and rhabdomyolysis with lovastatin taken with gemfibrozil.

PMID- 2243421
TI  - Increases in creatine kinase after exercise in patients treated with HMG Co-A
      reductase inhibitors.

PMID- 2243422
TI  - Lymphadenopathy associated with severe hypertriglyceridemia.

PMID- 2243423
TI  - Hypothermia precipitated by ice-cold beverages in a wasted dialysis patient.

PMID- 2243424
TI  - Oxybutynin for diabetic complications.

PMID- 2243426
TI  - Prevalence of Alzheimer's disease.

PMID- 2243425
TI  - Nursing homes and fax machines.

PMID- 2243427
TI  - A piece of my mind. The poetry of medicine.

PMID- 2243428
TI  - Regression of coronary atherosclerosis during treatment of familial
      hypercholesterolemia with combined drug regimens.
AB  - We conducted a randomized, controlled trial in 72 patients with heterozygous
      familial hypercholesterolemia to test whether reducing plasma low-density
      lipoprotein levels by diet and combined drug regimens can induce regression of
      coronary lesions. Four hundred fifty-seven lesions were measured before and after
      a 26-month interval by computer-based quantitative angiography. The primary
      outcome variable was within-patient mean change in percent area stenosis. Mean
      low-density lipoprotein cholesterol levels decreased from 7.32 +/- 1.5 to 4.45 +/
      1.6 mmol/L. The mean change in percent area stenosis among controls was +0.80,
      indicating progression, while the mean change for the treatment group was -1.53,
      indicating regression (P = .039 by two-tailed t test for the difference between
      groups). Regression among women, analyzed separately, was also significant. The
      change in percent area stenosis was correlated with low-density lipoprotein
      levels on trial. We conclude that reduction of low-density lipoprotein
      cholesterol levels can induce regression of atherosclerotic lesions of the
      coronary arteries in patients with familial hypercholesterolemia. The
      anticipation of benefit from treatment applies to women and men alike.

PMID- 2243429
TI  - Beneficial effects of colestipol-niacin on coronary atherosclerosis. A 4-year
      follow-up.
AB  - The Cholesterol Lowering Atherosclerosis Study (CLAS) was a randomized, placebo
      controlled, angiographic trial testing combined colestipol-niacin therapy in 162
      subjects. Two-year results (CLAS-I) showed decreased atherosclerosis progression
      and increased regression. We now describe a subgroup of 103 subjects treated for
      4 years (CLAS-II). Changes in blood lipid, lipoprotein-cholesterol, and
      apolipoprotein levels were maintained, and at 4 years significantly more drug
      treated subjects demonstrated nonprogression (52% drug- vs 15% placebo-treated)
      and regression (18% drug- vs 6% placebo-treated) in native coronary artery
      lesions. Significantly fewer drug-treated subjects developed new lesions in
      native coronary arteries (14% drug- vs 40% placebo-treated) and bypass grafts
      (16% drug- vs 38% placebo-treated). These results confirm CLAS-I findings and
      indicate that regression can continue for 4 years. They reaffirm the need for
      early initiation of vigorous long-term lipid lowering therapy in coronary bypass
      subjects.

PMID- 2243430
TI  - Relationship of atherosclerosis in young men to serum lipoprotein cholesterol
      concentrations and smoking. A preliminary report from the Pathobiological
      Determinants of Atherosclerosis in Youth (PDAY) Research Group.
AB  - Investigators in eight communities collected aortas, right coronary arteries,
      blood, and associated information from 390 males, 15 to 34 years of age, who died
      of violent causes. Pathologists at central laboratories graded the arteries for
      atherosclerotic lesions, and serum lipoprotein cholesterol and thiocyanate
      concentrations were measured. The percentage of intimal surface involved with
      atherosclerotic lesions in both the aorta and the right coronary artery was
      positively associated with serum very low-density lipoprotein + low-density
      lipoprotein cholesterol concentration and negatively associated with serum high
      density lipoprotein cholesterol concentration. The serum thiocyanate
      concentration, a marker for smoking, was strongly associated with prevalence of
      raised lesions, particularly in the abdominal aorta. The effect of smoking was
      not explained by lipoprotein levels. Blacks had more extensive total surface
      involvement of the aorta after adjustment for lipoprotein cholesterol levels and
      smoking. These associations indicate that serum lipoprotein cholesterol
      concentrations and smoking are important determinants of the early stages of
      atherosclerosis in adolescents and young adults.

PMID- 2243431
TI  - Use of cholesterol measurements in childhood for the prediction of adult
      hypercholesterolemia. The Muscatine Study.
AB  - This article describes the validity and utility of screening tests for total
      cholesterol levels in school-age children to predict those who, when adults, will
      have cholesterol levels that the National Cholesterol Education Program suggests
      need continuing surveillance and intervention. Two thousand three hundred sixty
      seven children aged 8 to 18 years were examined on several occasions and were
      followed up to ages 20 to 30 years. Of children with cholesterol concentrations
      exceeding the 75th percentile on two occasions, 75% of girls and 56% of boys
      would not qualify for intervention as adults by the National Cholesterol
      Education Program criteria. Of children with cholesterol levels exceeding the
      90th percentile on two occasions, 57% of girls and 30% of boys would not qualify
      for intervention as adults. Because the efficacy, safety, acceptability, and cost
      of treatment for high cholesterol concentrations in childhood is evolving, the
      need for universal screening of childhood cholesterol levels must be considered
      carefully in view of the number of children with high levels of cholesterol who,
      as adults, do not meet the criteria for intervention suggested by the National
      Cholesterol Education Program.

PMID- 2243432
TI  - The case against childhood cholesterol screening.
AB  - Because some authorities have proposed blood cholesterol screening for children
      to prevent coronary heart disease, we reviewed published studies to estimate the
      potential risks and benefits of such screening. Childhood cholesterol levels are
      a poor predictor of high cholesterol levels in young adulthood and will be an
      even poorer predictor of coronary heart disease later in life. There is no
      evidence that blood cholesterol levels can be lowered more easily in children
      than in adults, and it seems unlikely that cholesterol reduction in childhood
      will be much more effective at preventing coronary heart disease than cholesterol
      reduction begun in middle age. Screening and interventions to lower blood
      cholesterol levels for millions of children would be expensive, could lead to
      labeling and family conflicts, and may cause malnutrition and increased
      noncardiovascular mortality. Because the benefits of cholesterol screening are
      unlikely to exceed these risks, we conclude that children should not be screened
      for high blood cholesterol levels.

PMID- 2243433
TI  - A single cholesterol measurement underestimates the risk of coronary heart
      disease. An empirical example from the Lipid Research Clinics Mortality Follow-up
      Study.
AB  - In prospective epidemiologic studies of coronary heart disease, a single
      measurement of cholesterol is made to assess its relationship to the risk of
      coronary disease. Statistical theory states that if this measurement is subject
      to within-individual variability, the strength of the relationship will be
      underestimated. This is empirically shown for the example of plasma cholesterol.
      For the Lipid Research Clinics Follow-up Study population (comprising 2170 white
      men over 30 years of age), the age-adjusted coronary heart disease mortality
      regression coefficient increases from .453 to .496 if the average of two
      cholesterol measurements is used instead of a single measurement. Since the
      correlation between the two repeated cholesterol measurements is .815, an
      increase in the regression coefficient up to .556 would be expected if the true
      cholesterol values were available. Thus, epidemiologic studies have substantially
      underestimated the strength of the relationship between cholesterol levels and
      the risk of coronary disease by calculating the relationship on the basis of a
      single cholesterol determination.

PMID- 2243434
TI  - Lipoproteins and atherogenesis. Current concepts.
AB  - The frontiers in atherosclerosis research are moving from lipoprotein metabolism
      and control of hyperlipidemia to the cellular events in the artery wall. Emerging
      hypotheses, including the oxidative modification hypothesis, are already
      suggesting new approaches that could complement and be additive to control of
      hypercholesterolemia in the prevention of atherosclerosis.

PMID- 2243436
TI  - Cholesterol redux.

PMID- 2243435
TI  - Cholesterol and coronary heart disease. Future directions.
AB  - The importance of high serum cholesterol levels as a risk factor for coronary
      heart disease and the benefit of lowering cholesterol levels for reducing risk
      are being increasingly accepted. A broad consensus to this effect has led to the
      establishment of the National Cholesterol Education Program. Although the
      available evidence fully justifies this program, its practical application to the
      American public has generated a series of new questions that must be explored.
      For example, it can be questioned whether reduction in coronary risk through
      lowering cholesterol levels extends to both sexes and all age groups. For people
      with high cholesterol levels, dietary modification is undoubtedly the first step
      of management, but the fraction of people responding adequately to dietary change
      remains to be determined. Finally, indications for drug therapy and choice of
      drugs need further exploration, particularly in the area of cost vs benefit.
      Thus, continuing research must be carried out in parallel with clinical and
      public health application of cholesterol education.

PMID- 2243437
TI  - Treatment of a low HDL cholesterol level.

PMID- 2243438
TI  - Cholesterol values and the fasting state.

PMID- 2243439
TI  - Innocent enzyme elevations.

PMID- 2243440
TI  - Phil Sokolof fights the 'fatting' of America.

PMID- 2243441
TI  - DNA ploidy level and S-phase fraction as prognostic factors in breast cancer.
AB  - Imprint smears from sixty cases of breast cancer made after mastectomy were
      stained by the Feulgen method and the nuclear DNA content measured by a
      cytofluorometer equipped with an incident illumination system. After logarithmic
      transformation of the fluorescence intensity, the ploidy level and S-phase
      fraction (SPF) were calculated with a microcomputer and the correlation between
      the ploidy level or SPF and the clinicopathological prognostic factors studied.
      Patients with tumors of a larger diameter and more extensive lymph node
      involvement had higher levels of ploidy and SPF and the ploidy level in the
      metastatic lymph nodes was higher than that in the primary lesion. Moreover, a
      significant increase in SPF was observed in the metastatic lymph nodes and a high
      ploidy level found to be associated with tumors having a negative estrogen
      receptor. When the tumors were divided into a diploid group and an aneuploid
      group, the diploid group showed a significantly better prognosis than the
      aneuploid group, in 6-year survival. Similarly, the groups in which SPF was less
      than 20.0 per cent had significantly better prognoses than the group in which SPF
      was 20.1 per cent or more. These prognostic factors were evaluated with Cox's
      proportional hazard model and a significant correlation observed in lymph node
      status, ER status, ploidy level and S-phase fraction. It was thus concluded that
      ploidy level and SPF are important and independent prognostic factors for
      predicting the postoperative course of breast cancer patients.

PMID- 2243442
TI  - The clinical features and prognosis of rhabdomyosarcoma: follow-up studies on
      pediatric tumors from the Japanese Pediatric Tumor Registry 1971-1980. Part II.
      Committee of Malignant Tumors, Japanese Society of Pediatric Surgeons.
AB  - A retrospective study was conducted on 126 patients with rhabdomyosarcoma
      enrolled in the Japanese Pediatric Tumor Registry between 1971 and 1980. The age
      of the patients ranged from less than 1 year to 15 years, and the male to female
      ratio was 1.3:1.0. Primary sites included the pelvis (37.3 per cent), abdomen
      (23.8 per cent), head and neck (21.4 per cent), thorax (9.5 per cent),
      extremities (6.4 per cent) and unknown (1.6 per cent). According to the staging
      system of the Japanese Society of Pediatric Surgeons, the extent of disease was
      classified into stages Ia (26.2 per cent of the total); Ib (14.6 per cent); II
      (12.6 per cent), III (29.1 per cent) and IV (17.5 per cent). The clinical stage
      was significantly correlated with survival outcome in this series (p less than
      0.05). Age, sex, histology and primary site per se had no independent prognostic
      influence on tumor-free survival. With regard to treatment modalities, surgery
      was performed in 94.0 per cent of the patients, and radiotherapy at a mean dose
      of 37 Gy, and/or multi-agent chemotherapy in 41.7 per cent and 80.0 per cent,
      respectively. The patients who underwent total excision had a better survival
      outcome than those who did not (p less than 0.05). Combination chemotherapy such
      as VAC was more commonly administered in the latter study period. The overall 2
      year tumor-free survival rate (2YTFSR) significantly improved from 24.0 per cent
      in the former period between 1971 and 1975 to 48.7 per cent in the latter period
      between 1976 and 1980 (p less than 0.05).

PMID- 2243443
TI  - Flow cytometric DNA analysis of thyroid carcinoma.
AB  - Abnormal DNA content has been considered as an additional criterion for
      determining the biological behavior of a tumor. Flowcytometric DNA analysis was
      done on 121 patients with thyroid carcinoma encountered during the period between
      1975 and 1987. Tumor tissues were sampled from paraffin-embedded blocks and the
      histology of thyroid carcinoma found to consist of 91 papillary, 23 follicular, 2
      medullary, 1 squamous cell and 4 anaplastic carcinomas. The incidence of
      aneuploidy in thyroid carcinoma was 7.4 per cent (9 patients) while that of
      diploidy was 92.6 per cent (112 patients). The aneuploid specimens consisted of 6
      papillary, 1 follicular, 1 medullary and 1 anaplastic carcinomas and, of 4
      anaplastic carcinoma patients with subsequent death within 6 months, only 1 was
      aneuploid. As an indicator of proliferative potential, S-phase fraction (SPF) was
      also determined by flow cytometry, but this could not be used as an independent
      prognostic factor. The aneuploid patients showed a significantly decreased
      survival rate (p less than 0.01). Thus, although DNA measurement proved useful
      for predicting the survival of aneuploid patients, there is some discrepancy
      between DNA content and the biological behavior of the tumor.

PMID- 2243444
TI  - Duodenal tuberculosis: a review of the clinicopathologic features and management
      of twelve cases.
AB  - A retrospective analysis of twelve cases of duodenal tuberculosis is presented
      herein. The average age of the patients was 31.4 years with a male to female
      ratio of 2:1. The presenting complaints were duodenal obstruction in six patients
      and subacute intestinal obstruction in three. None of the patients had associated
      pulmonary tuberculosis. Eight patients had isolated duodenal tuberculosis, two of
      whom were successfully treated with antitubercular drugs. In four patients, the
      diagnosis was established at laparotomy by the presence of tubercles over the
      duodenum. Five patients required a bypass procedure for obstruction caused by the
      duodenal tuberculosis and one patient was operated on for uncontrollable bleeding
      from a tubercular duodenal ulcer. All patients remained symptom free after
      treatment, whether medical or surgical. Thus, in areas where tuberculosis is
      endemic, even in the absence of pulmonary tuberculosis, duodenal tuberculosis
      should be suspected in patients with upper gastrointestinal obstruction or in
      patients with peptic ulcer like symptoms not responding to medical therapy.

PMID- 2243445
TI  - A clinicopathological study on intrahepatic cholesterol gallstones.
AB  - In order to clarify the pathogenesis and process of the formation of intrahepatic
      cholesterol gallstones, we examined the clinical features, cholangiograms and
      pathological findings of eight patients with intrahepatic cholesterol gallstones.
      When examining the clinical features, one patient was found to have developed
      intrahepatic cholesterol gallstones 3 years after a complete lithotomy. The
      cholangiograms of two patients revealed small gallstones in the peripheral bile
      ducts of the lateral segment of the liver, and these bile ducts showed localized
      cystic dilatation and were tightly filled with gallstones. Conversely, their
      other bile ducts which contained no gallstones showed an entirely normal
      cholangiogram. Pathologically, these two cases showed mild chronic cholangitis,
      and cholesterol crystals in the peripheral bile ducts. The other six cases showed
      moderate or severe dilatation of the bile duct and severe chronic proliferative
      cholangitis. From the above results, we proposed the following theory to explain
      the pathogenesis and process of the formation of intrahepatic cholesterol stones:
      The cholesterol crystals in the peripheral intrahepatic bile ducts may be a
      primitive form of intrahepatic cholesterol gallstones, and the formation of
      intrahepatic cholesterol gallstones may precede and cause such deformities of the
      bile ducts as strictures or dilatations.

PMID- 2243446
TI  - Bone mineral analysis and X-ray examination of the bone in patients with biliary
      atresia.
AB  - Investigations of bone mineral content, X-ray of the radius and ulna and serum
      biochemical analysis were performed in 10 children with biliary atresia (B.A.)
      and 150 healthy children. The patients were classified into 2 groups, namely;
      group A, comprised of 5 patients whose postoperative courses went well, and group
      B, comprised of 5 patients who developed various degrees of liver disturbance
      postoperatively. The ratio of bone mineral content (BMC) to bone width (BW)
      (BMC/BW) increased in accordance with age in the healthy children and the
      patients of group A, but was relatively slow in the patients of group B. Signs of
      rickets were found on the X-rays of 4 of the 10 patients, while serum levels of
      calcium and 25-OH-vitamin D in the group B patients were significantly lower than
      those in the group A patients or healthy children. Serum levels of alkaline
      phosphatase (Alp) fluctuated, but serum Alp was elevated in all the patients with
      rickets.

PMID- 2243447
TI  - The clinical significance of venous invasion in cancer of the stomach.
AB  - Specimens from 235 surgically treated cases of gastric cancer were examined for
      venous invasion in order to investigate its clinical significance. A total of 87
      (37.0 per cent) cases showed histologic evidence of venous invasion, with the
      incidence being 48.3 per cent of 180 cases, after the exclusion of 55 cases where
      cancerous invasion was limited to the mucosa. The frequency of venous invasion
      varied with the gross type of tumor, the depth of penetration and the degree of
      differentiation, being highest in tumors of type 2 and moderately differentiated
      adenocarcinoma. It increased proportionately depending upon the depth of
      penetration and the incidence increased in cases where there was evident
      lymphatic invasion or lymph node metastasis. The long term survival rate
      significantly decreased in patients with venous invasion when compared to those
      without it. In this report, we also discuss the marked difference in the
      incidence of liver metastasis between gastric and colorectal carcinomas in
      relation to venous invasion of the primary tumor. Double staining with Victoria
      blue and hematoxylin-eosin for elastic fibers proved useful for detecting venous
      invasion in the carcinomatous tissue, though endothelial markers have great
      specificity for differentiating small veins from lymphatics.

PMID- 2243448
TI  - Does H2-receptor antagonist alter the renal function of cyclosporine-treated
      kidney grafts?
AB  - Histamine-type 2 antagonists (H2-blockers) as represented by cimetidine have been
      shown to adversely affect renal allograft function, particularly when
      coadministered with cyclosporine, currently a major immunosuppressant. To
      determine whether or not a newer and more powerful H2-blocker, famotidine, would
      produce similar adverse effects, we assessed seven cyclosporine-treated renal
      allograft recipients with regard to changes in their renal function on or off the
      H2-blocker over a one-week period. Neither the administration nor withdrawal of
      famotidine (20-40 mg/day) resulted in any significant changes in serum creatine,
      BUN, urine output or cyclosporine trough levels, suggesting that famotidine can
      be safely administered as an H2-blocker to cyclosporine-treated renal allograft
      recipients.

PMID- 2243449
TI  - Thymic carcinoid--a case report and review of the literature.
AB  - We report herein a case of a patient with thymic carcinoid who was operated on
      twice and has been followed for 9 years. In 1979, the original tumor was removed
      through an emergency left thoracotomy incision done for a hemothorax caused by an
      anterior mediastinal biopsy. Tumor recurrence was found 6 years later and removal
      carried out through a median sternotomy. The patient has been working and
      enjoying life following radiation and chemotherapy for a total of 9 years after
      his first operation. Recurrent thymic carcinoid has been thought to carry a poor
      prognosis, but this successfully treated case has been followed up for a long
      time after the removal of his recurrent tumor. We present this case and discuss
      other such cases reported in the Japanese literature.

PMID- 2243450
TI  - Hiatal herniation of the colon with digestive tract bleeding--a case report.
AB  - A 71 year old woman with hiatal herniation was admitted to our hospital with
      anemia and melena. A barium enema revealed hiatal herniation of the transverse
      colon in conjunction with the stomach, which seemed to be strangulated by the
      esophageal hiatus. She underwent surgery, for which Hill's gastropexy method was
      employed and has had no signs of bleeding since. By presenting this case, we
      stress the importance of marking a careful differential diagnosis due to the
      variability in symptoms of digestive tract bleeding.

PMID- 2243451
TI  - Pilonidal disease of the umbilicus--a report of two cases.
AB  - Two cases of umbilical pilonidal sinus are reported herein. Both patients were
      young adult males aged 21 and 27 years, respectively. The predisposing factors
      are briefly discussed, however, the exact etiology of this disease remains
      unknown. Umbilectomy is the most commonly offered treatment and although it is
      rare, this entity probably goes undiagnosed in the majority of cases.

PMID- 2243452
TI  - Cervical thymic cyst as a cause of acute suppurative thyroiditis.
AB  - A case of acute suppurative thyroiditis following a perithyroidal abscess, which
      was thought to have resulted from infection of a cervical thymic cyst, is
      reported herein. The patient was an 8 year old asthmatic Japanese boy who
      originally presented with tender swelling of the left anterior neck in July,
      1986. Although pharyngography could not clearly demonstrate the pyriform sinus
      fistula, a hypoechoic area around the left lobe of the thyroid gland was noted on
      ultrasonography. Incisional drainage revealed Streptococcus milleri. A diagnosis
      of acute suppurative thyroiditis was established, and a cystic tubular mass was
      surgically resected from the left perithyroidal space some time later.
      Histopathological examination of the specimen revealed partly cystic thymic
      tissue along with parathyroid tissue. These observations suggested that acute
      suppurative thyroiditis in this case was caused by a perithyroidal abscess and
      that a perithyroidal abscess may also result from infection of a cervical thymic
      cyst.

PMID- 2243453
TI  - A case of middle lobe syndrome occurring in two sisters.
AB  - We report herein a rare case of middle lobe syndrome, occurring in two sisters.
      Since selective aspirations of sputum under bronchoscopic guidance proved
      ineffective, a middle lobectomy was performed in both cases. Histological
      findings of the resected specimens showed overgrowth of the bronchial glands,
      lymphocytic infiltration around the alveoli and glandular metaplasia of the
      alveoli in both cases. Based on the allergic diathesis, we suggest that in these
      2 sisters, middle lobe syndrome was caused by chronic inflammation.

PMID- 2243454
TI  - Experimental transcatheter hepatic subsegmentectomy using absolute ethanol in
      dogs.
AB  - In this study, we evaluate the effect of an intraportal injection of absolute
      ethanol in the canine liver and discuss how to introduce it in clinical
      application. The intraportal injection of ten milliliters of ethanol using a
      balloon occlusion catheter created an evident and well-demarcated necrotic lesion
      in the right central lobe. Histological examination showed a typical coagulation
      necrosis with fibrous bands, which became thicker day by day. The weight of the
      necroses ranged from 5 to 55 grams with an average of 26.0 +/- 5.5 grams (mean +/
      SE), which was approximately 20 to 40 per cent of the right central lobe.
      Complications resulting from the ethanol injection were minimal and although more
      studies need to be done to clearly establish its safety for cirrhotic patients
      with hepatoma, this technique may be an easier and less invasive substitute for
      operative hepatic subsegmentectomy.

PMID- 2243455
TI  - [Terminal pulmonary infections in autopsy cases that died of lung cancer].
AB  - To elucidate the predisposing factors of terminal pulmonary infection in patients
      with lung cancer, we reviewed the case record of 251 autopsy cases that died of
      lung cancer in Kyushu University Hospital from 1976 to 1987. The incidence of
      mycobacteriosis was significantly more frequent in cases treated with
      antineoplastic therapy and corticosteroid (Group III) than in those with
      antineoplastic therapy but without corticosteroid (Group II), while the incidence
      of common bacterial and nonbacterial infections was not significantly different
      between the two groups. In patients with lung cancer treated with antineoplastic
      therapy, corticosteroid administration of relatively short duration (less than a
      month) induced fatal mycobacteriosis. In cases with lymphocytopenia, the
      incidence of fatal mycobacteriosis was significantly more frequent in Group III
      than in Group II, whereas the incidence of fatal nonbacterial infection was not.
      In cases with monocytopenia, both fatal mycobacteriosis and nonbacterial
      infection were significantly more frequent in Group III than in Group II. In
      Group III, the incidence of mycobacterial and nonbacterial infections was not
      different significantly between cases with and without lymphocytopenia or
      monocytopenia. Thus, in patients with lung cancer, administration of
      corticosteroid has greater influence on the development and exacerbation of
      mycobacteriosis than lymphocytopenia or monocytopenia. On the other hand, the
      influence of corticosteroid on the development and exacerbation of nonbacterial
      infection was significantly different from that of lymphocytopenia. The
      administration of corticosteroid and antineoplastic therapy do not increase the
      incidence of terminal common bacterial infection in patients with lung cancer.

PMID- 2243456
TI  - [Effect of erythromycin on the generation of neutrophil chemiluminescence in
      vitro].
AB  - In order to elucidate the therapeutic mechanisms of low dose-long term
      erythromycin (EM) therapy in patients with diffuse panbronchiolitis (DPB), the
      authors evaluated the effect of in vitro EM treatment on neutrophil (PMN) oxygen
      radicals production. EM has potent capacity to suppress PMN chemiluminescence
      (CL) induced by the N-formyl Met-leu-phe (FMLP), opsonized zymosan, and calcium
      ionophore A23187 stimulation. In marked contrast, phorbol myristate acetate (PMA)
      induced PMN CL were much less affected by EM treatment. The suppressive activity
      of EM was dependent on the EM concentration and at a EM concentration of 25
      micrograms/ml, FMLP-induced PMN CL were suppressed by 45.3 +/- 5.6% (n = 7), but
      PMA-induced CL were suppressed only marginally, 11.9 +/- 3.7% (n = 7). The onset
      of inhibitory activity of EM is rapid and at 5 min., 60.1% of the maximum
      suppression at 60 min. was observed. This EM-induced suppression was found to be
      reversible and dependent on the EM-pretreatment temperature since the suppressive
      activity of EM were observed only at 37 degrees C but not at 0 degrees C. These
      results suggest that actively transported intracellular EM exerts its suppressive
      activity by inhibiting the process of Ca++ transfer or Ca++ utilization by cells.
      In addition, these results were consistent with the concept that EM might act as
      an anti-inflammatory agent in chronic bacterial airway infections such as
      bronchiectasis and DPB where the PMN appear to play an important role in the
      generation of airway destruction.

PMID- 2243457
TI  - [Analysis of immunoglobulin G subclasses in chronic respiratory tract
      infections].
AB  - To analyze the immunological aspects of chronic respiratory tract infections,
      immunoglobulin G (IgG) subclass patterns were investigated in 20 patients with
      diffuse panbronchiolitis (DPB) and 20 patients with cystic bronchiectasis (CBE).
      All IgG subclasses were increased in both diseases in comparison to the normal
      group. Increased levels of IgG1 and IgG2 were recognized more dominantly in DPB,
      whereas IgG4 level was elevated in CBE. Furthermore, analysis of the ratio of IgG
      subclass to total IgG showed increase of IgG1 and decrease of IgG2 in both
      diseases, and increase of IgG4 only in CBE. On the other hand, the increase of
      IgG1 correlated with infection by P. aeruginosa while increase of IgG4 was
      recognized in the group of non-P. aeruginosa infections. These results indicate
      that increased IgG1 and IgG2 levels are common characteristic phenomena in
      chronic respiratory tract infections such as DPB and CBE, reflecting the
      pathophysiological aspects based on respiratory tract defense mechanisms against
      microorganisms, and demonstrated that differences of IgG subclass patterns are
      observed among DPB and CBE, and also according to causative agents.

PMID- 2243458
TI  - [Respiratory malignancies induced by asbestos exposure and evaluation of cases
      with typical pleural malignant mesothelioma and lung cancer with asbestosis].
AB  - Asbestos exposure induces lung fibrosis, i.e. asbestosis, and furthermore,
      pathological changes of pleura, i.e. asbestos pleurisy of pleural plaque.
      Generally, asbestosis is induced by massive exposure to asbestos and pleural
      changes are induced by low dose exposure to asbestos. The most important diseases
      which are induced by asbestos exposure are malignancies, especially malignant
      mesothelioma and lung cancer. Two cases, one malignant mesothelioma, the other
      lung cancer with asbestosis induced by asbestos exposure received almost the same
      dose of asbestos, as estimated from the period of asbestos exposure and
      occupational history and the same kind of asbestos (crocidolite) and had a
      smoking history. We do not know which elements may induce malignancies under
      asbestos exposure. Recently, some reports described that asbestos mediated the
      transformation of genes and this action induced malignancies. We should extend
      our study to the gene problem in cases of malignant mesothelioma and lung cancer
      induced by asbestos exposure.

PMID- 2243459
TI  - [Plasma DNA level as a tumor marker in primary lung cancer].
AB  - The plasma level of human DNA was determined by the dot-hybridization method
      using human Alu-family DNA as a probe in 45 patients with primary lung cancer, 54
      patients with benign pulmonary diseases, and 59 healthy controls. The mean plasma
      DNA level was significantly higher in the patients with lung cancer than that in
      the patients with benign pulmonary diseases or in healthy controls. The mean
      plasma DNA level in the patients with benign pulmonary diseases was also
      significantly higher than that in healthy controls. There was no significant
      difference in mean plasma DNA level in each histologic type of lung cancer. The
      plasma DNA level was elevated above the cut-off level of 80 ng/ml in 71% of the
      patients with lung cancer, 37% of the patients with benign pulmonary diseases and
      none of the healthy controls. The serum CEA was positive in 38% of the patients
      with lung cancer and thus when plasma DNA and serum CEA were used in combination,
      78% of the cases with lung cancer could be detected by these two markers. In the
      patients with lung cancer who responded to treatment, the plasma DNA levels were
      significantly decreased after treatment, while its levels were elevated in the
      patients whose treatment was unsuccessful. These findings indicate that plasma
      DNA may be a useful marker in patients with lung cancer.

PMID- 2243460
TI  - [A case of spontaneous regression of malignant lymphoma, complicated with miliary
      tuberculosis, liver dysfunction and pancytopenia].
AB  - An 82-year-old woman was admitted to Iwamizawa Rosai Hospital, Cardiovascular
      Medicine, for detailed examination of an aneurysm of abdominal aorta. CT scan
      revealed marked swelling of para-aortic lymph nodes which regressed spontaneously
      in three months. She was re-admitted to our hospital because of general malaise
      and gait disturbance. Her chest X-ray on the second admission revealed miliary
      disseminated shadows, which were confirmed to be tuberculous granuloma by lung
      biopsy. She was initially well controlled with anti-tuberculosis drugs, followed
      by severe liver dysfunction and pancytopenia, and died of respiratory and cardiac
      failure. At autopsy, wide-spread malignant lymphoma and miliary tuberculosis of
      the lung were found. The cause of liver dysfunction was strongly suspected to be
      due to infiltration of the lymphoma cells to portal triads of the liver.
      Hemophagocytosis found in the bone marrow, spleen and liver might be consistent
      with clinically so-called "hemophagocytic syndrome", causing pancytopenia,
      associated with infection.

PMID- 2243461
TI  - [Three patients with typical sandblaster's silicosis proven by mineralogical
      analysis].
AB  - Three family members who had worked as sandblasters in their own sandblasting
      factory showed innumerable small nodularities in both lung fields of their chest
      radiograms. One of those showed conglomerate shadows in the upper lung fields.
      Those shadows seemed to be consistent with those of silicosis. One of the
      patients was examined by transbronchial lung biopsy (TBLB) and showed typical
      silicotic nodules. Mineralogical studies were done on the abrasive particles and
      the deposited particles in the lung tissue specimen obtained via TBLB and
      bronchoalveolar lavage fluid sample (BALF) using polarized microscopy, X-ray
      diffraction and analytical electron microscopy. The particles which had
      accumulated on the floor of the factory mineralogically consisted of mostly (over
      90%) silica quartz containing small amount of chlorite, and the deposited
      particles in the lung tissue and those in the BALF showed similar composition.

PMID- 2243462
TI  - [A case of sarcoidosis demonstrating spontaneous production of interleukin-1
      alpha and beta by alveolar macrophage].
AB  - A 44-year-old man was admitted for evaluation of dyspnea on exertion and
      subcutaneous nodules. The chest X-ray on admission revealed bilateral hilar lymph
      node swelling and diffuse micronodular shadows throughout both lung fields. Ga
      scintigram demonstrated diffuse abnormal uptake. Serum angiotensin converting
      enzyme was elevated significantly (86.6 IU/I). The TBLB specimen confirmed the
      diagnosis of sarcoidosis. The cell numbers in bronchoalveolar lavage fluid was
      increased (4.4 x 10(8), the percentage of lymphocytes was elevated (64%) and the
      ratio of Leu 3a+/Leu 2a+ was very high (16.07). We further evaluated the
      spontaneous IL-1 release in vitro by alveolar macrophages obtained by
      bronchoalveolar lavage. The results showed that large amounts of IL-1 alpha and
      beta were produced spontaneously by alveolar macrophages before therapy, followed
      by a decrease in production after corticosteroid treatment. Previously, the
      authors reported that no significant amount of IL-1 alpha and beta was detected
      in 5 normal volunteers and 6 other active sarcoidosis cases which improved
      without therapy. Therefore, significant amounts of spontaneous release of IL-1
      alpha and beta in vitro from alveolar macrophages in sarcoidosis might be
      considered as an index for the necessity of systemic corticosteroid treatment.

PMID- 2243464
TI  - [A case of summer-type hypersensitivity pneumonitis with bronchoalveolar lavage
      performed 4 years before onset].
AB  - A 51-year-old man with chief complaints of cough, fever, and dyspnea was admitted
      to our hospital. Based on a home provocation test, transbronchial lung biopsy
      specimens, and a serum antibody, we diagnosed summer-type hypersensitivity
      pneumonitis. In 1983 when the patient was 46 years old, thymectomy was performed
      for thymoma. Prior to surgery, bronchoalveolar lavage (BAL) was performed. Total
      cell count and neutrophils had already increased in BALF. Furthermore, the
      increase in BALF cell neutrophil count was also seen at the time of admission and
      after the home provocation test. Because an increase of neutrophils in BALF cells
      was seen not only at onset but before onset, further studies are required to
      clarify the role of neutrophils and the factors that increase them in
      hypersensitivity pneumonitis.

PMID- 2243463
TI  - [A case of tracheal calculus in the pathogenesis of which fungal infection was
      probably involved].
AB  - A 63-year-old woman with a past history of bronchial asthma was admitted to our
      hospital with a diagnosis of status asthmaticus. Examination revealed a ring
      shaped, calcified stone within the trachea immediately below the vocal cords. As
      the patient complained of increasing difficulty in breathing, emergency
      tracheotomy was performed in an attempt to save her life, with success. Bronchial
      calculus (broncholithiasis) has been occasionally reported, and it is
      hypothesized that the calculus is mostly caused by intra-bronchial perforation of
      calcified lymph nodes around the bronchus. Tracheal calculus is a rare disease,
      and our case is only the third ever reported in Japan. However, perforation of
      calcified lymph nodes was probably not responsible for this case, which probably
      resulted from repeated chronic inflammation and fungal infection.

PMID- 2243466
TI  - [Phacoemulsification. Why?].
AB  - Improved by both technology and new surgical procedures, phacoemulsification of
      the nucleus has become increasingly important in extracapsular cataract surgery.
      Phacoemulsification within the capsular bag has proved to be a valuable surgical
      technique, yielding predominantly good results. In the hands of a carefully
      trained, critical surgeon, this procedure results in safe in-the-bag fixation of
      an intraocular lens. In intravitreal surgery it is almost indispensable. In
      special cases, such as congenital coloboma, hydrophthalmia in adults,
      pseudoexfoliation syndrome, risk of expulsive hemorrhage, or in cataract surgery
      following penetrating keratoplasty, phacoemulsification of the nucleus may be
      surgically safer than expression of the nucleus through a large corneoscleral
      incision.

PMID- 2243465
TI  - [A case of long-term survival of a patient with complicated diffuse metastatic
      leptomeningeal carcinomatosis secondary to lung adenocarcinoma].
AB  - A case of long-term survival of a female patient with complicated diffuse
      metastatic leptomeningeal carcinomatosis (DMLC) secondary to lung cancer is
      reported. A 36-year-old woman, hospitalized with a chief complaint of headache
      and unproductive cough, was diagnosed as having primary lung adenocarcinoma
      (T4N1M1 oss) and was given systemic chemotherapy. Although progressive
      deterioration of her headache continued, repeated neurological examination,
      cerebrospinal fluid (CSF) examination, and cranial CT scans failed to show
      evidence of metastasis to the central nervous system, and the only finding
      suggesting CNS involvement was an elevated CEA level in CSF. Later in the course
      of her treatment, the patient suddenly lost her vision and subsequently
      consciousness due to acute increased intracranial pressure, and emergency
      ventricular drainage was performed for therapeutic and diagnostic purposes.
      Malignant cells were found in CSF obtained from a ventricular drainage and she
      was treated successfully by systemic and intrathecal chemotherapeutic agents. She
      was discharged after a ventriculoperitoneal shunt operation for hydrocephalus; a
      double-dome reservoir was used for continuous intrathecal administration of the
      anticancer drugs, and a shunt filter was located in the tube to prevent the
      dissemination of cancer cells. In addition to methotrexate and cytosine
      arabinoside, ACNU and interleukin-2 were administered intrathecally without
      serious adverse effects, but no apparent therapeutic effects were noted either.
      She survived over 2 years after DMLC was first diagnosed. At autopsy DMLC
      secondary to lung adenocarcinoma was confirmed, but no evidence of
      leukoencephalopathy due to aggressive intrathecal chemotherapy was found. Current
      therapy for patients with DMLC and its clinical problems are discussed in
      relation to our experience in this case.

PMID- 2243467
TI  - [Initial experience with autologous conjunctiva/limbus transplantation in
      pterygium].
AB  - The present paper reports on the technique and results of conjunctiva/limbus
      transplantation in 13 eyes with primary or cicatricial pterygium (12 cases and 1
      case, respectively). In all cases the pterygia were located nasally. The
      operation was performed by bare sclera excision, covered with a free graft from
      the superotemporal conjunctiva and limbus. After a mean follow-up time of 5
      months there was only one recurrence. On the basis of a new understanding of
      limbal diseases the authors believe that conjunctiva/limbus transplantation is an
      encouraging and appropriate technique for ideal anatomic reconstruction and low
      recurrence rates in pterygia.

PMID- 2243468
TI  - [Pre-basal vitreous body after subtotal vitrectomy of aphakic eyes].
AB  - The anterior axial vitreous body of aphakic eyes is often severely liquefied. In
      a vitrectomy case, it was removed easily and completely. The behavior of the
      prebasal vitreous cortex after the procedure was not predictable. The
      postoperative biomicroscopic examination resulted in two different findings, are
      reported on here.

PMID- 2243469
TI  - [Does silicone oil improve the prognosis of severe proliferative diabetic
      retinopathy?].
AB  - We report on a series of 135 consecutive cases of pars plana vitrectomy for
      proliferative diabetic retinopathy (average period of observation was 13 months).
      BSS was used in 69 eyes and silicone oil was used in 66 eyes as a vitreous
      substitute, the indications for silicone oil in these cases were the presence of
      several retinotomies or retinectomies as well as sharply increased risk for
      rebleeding. Postoperatively and after a minimum follow up of 6 months (55 eyes)
      the two groups with BSS or silicone oil achieved comparable functional results
      despite the different anatomical preoperative situation. Thus 18 out of 23 eyes
      of the silicone oil group, originally with detached macula and visual acuity of
      HM or FC, achieved a visual outcome of greater than = 0.02, showing the best
      postoperative result. In the BSS-group, with attached macula prior to the
      operation and same visual acuity, this result is attained by 27 out of 35 eyes.
      We interpret these figures as meaning, that silicone oil in proliferative
      diabetic retinopathy reduces some of the problems connected with more advanced
      retinal changes like retinal detachment and rebleeding thereby allowing a visual
      outcome which corresponds to the macular condition.

PMID- 2243470
TI  - [Congenital fibrosis syndrome. Considerations on etiology, genetics and surgical
      therapy].
AB  - Fibrosis syndrome has been a well-known clinical entity for more than a century.
      Nevertheless, there are still some unresolved questions concerning its etiology,
      chronological course, and optimal timing of surgery. On the basis of their
      experience in 12 cases (2 unilateral, 10 bilateral, 7 with eye muscles and/or lid
      surgery), the authors attempt to help answer these questions.

PMID- 2243471
TI  - [Normogenesis of the cornea and its modification by cyclophosphamide in the
      animal experiment].
AB  - Animal experiments serving as models have hitherto been indispensable in order to
      explain pathogenetic processes in the development of malformations. The results
      presented here are contribution to studies on the normogenesis of the cornea in
      defined animal material (albino mice of Agnes Bluhm Jena-Halle stock). A single
      application of cyclophosphamide during embryogenesis caused inhibition
      malformations. Of these, different degrees of corneal hypoplasia and Peters'
      malformation are discussed in detail.

PMID- 2243472
TI  - [Sub-choroidal implanted Greene melanoma: an animal experiment model for
      malignant choroid melanoma].
AB  - A modified technique for subchoroidal transplantation of amelanotic Greene
      melanoma cells and the intraocular growth patterns of this tumor in rabbit eyes
      are described. Tumor fragments were implanted via a scleral tunnel in 71 rabbit
      eyes, with 64 successful tumor growths, producing a prominent, circumscribed
      choroidal mass within 12-14 days of surgery. Choroidal Greene melanoma in rabbits
      resembles human epithelioid uveal melanoma in both its growth patterns and
      morphologic characteristics. The authors' implantation technique guarantees
      reliable growth of choroidal tumors with easily reproducible size and location.
      The experimental choroidal melanoma model is particularly valuable in clinical
      studies where a large number of tumors, with limited variation, is necessary for
      different experimental groups.

PMID- 2243473
TI  - [Suitability of different procedures for the sterilization of microsurgical
      instruments. A review of current and future procedures].
AB  - A review of common methods of sterilization is presented. The principles of
      operation of steam, hot-air, and gas sterilizers, as well as that of a completely
      new method which uses H2O2 plasma, are described. The suitability of these
      methods for sterilizing microsurgical instruments was studied. This paper deals
      in particular with hot-air sterilization, which is preferred because of the low
      humidity involved. This method was investigated by recording temperature curves
      during sterilization. Sterilization with hot steam (autoclaving) has been shown
      to damage instruments by causing corrosion, to which the types of steel used to
      make these instruments are highly susceptible. A H2O2 plasma sterilization method
      is described which operates at low temperatures and with very low humidity. Its
      suitability for microsurgical instruments has been investigated.

PMID- 2243474
TI  - [Emmetropization. A statistical study].
AB  - The relations between bulb length and the refractive power of the cornea were
      investigated in 3358 eyes of nonselected patients. There was a negative
      correlation between corneal refraction and bulb length in the range 19 to 29 mm.
      However, the data do not support the recently advanced hypothesis that corneal
      curvature and bulb length are regulated by means of optimal retinal contrast. The
      mean bulb length in males was 23.83 mm, in females 23.25 mm.

PMID- 2243475
TI  - [Clinical aspects and histopathology of the Cogan-Reese syndrome].
AB  - The present paper reports on a 55 year-old patient who had been suffering from
      progressive essential iris atrophy in her left eye since the age of 24. Ten years
      later she developed partial secondary angel-closure glaucoma that failed to
      respond to repeated surgical treatment. Twenty years after onset of the disease,
      pigmented nodules appeared on the left iris, leading to the diagnosis of Cogan
      Reese syndrome. Finally, 30 years after onset of the disease, the blind and
      painful eye was enucleated. The typical histologic findings in Cogan-Reese
      syndrome were confirmed by light and electron microscopy.

PMID- 2243476
TI  - [Paraneoplastic retinopathy simulating cone dystrophy with achromatopsia].
AB  - A 72-year-old woman developed recurrent blindness on exposure to bright light
      (sunlight). Examination revealed total achromatopsia; bilateral central scotomas,
      predominant suppression of the cone response by electroretinography, and
      narrowing of the retinal arteries on ophthalmoscopy. The general examination
      revealed a pelvic tumor that later proved to be a pleomorphic carcinoma of
      presumed uterine origin. The patient died of metastatic disease 9 months after
      the ocular symptoms developed. Histopathologic examination of the eyes revealed
      loss of the photoreceptors, most extensive in the macular regions, and selective
      loss of the cones from the rest of the retinas. No ocular metastases of
      inflammation were found. The changes described are interpreted as paraneoplastic
      retinopathy of autoimmune origin.

PMID- 2243477
TI  - [Birdshot chorioretinopathy: systemic therapy with corticosteroids and
      nonsteroidal anti-inflammatory drugs].
AB  - The symptoms and clinical course of a case of birdshot chorioretinopathy are
      described. The patient was a 40-year-old woman. The condition can be treated with
      two types of medication, i.e., steroids and nonsteroidal anti-inflammatory drugs.
      Both appear to have a beneficial effect. Overall, however, the prognosis for this
      rare disease of unknown etiology remains uncertain. Given the slow progressive
      course, with spontaneous remissions and exacerbations, it is extremely difficult
      to evaluate the success of different forms of therapy.

PMID- 2243478
TI  - [Histopathology of the retina, optic fascicle and lateral geniculate body in
      chronic, bilateral symmetric ischemic Schnabel's cavernous optic atrophy].
AB  - The paper is a unique pathological description of a bilateral, symmetric,
      anterior, temporal ischemic optic neuropathy with the morphological
      characteristics of cavernous optic atrophy initially described by Schnabel in
      glaucomatous eyes. The 80-year-old woman had suffered from cardiac insufficiency
      and diabetes mellitus for many years. She died from sepsis and circulatory
      collapse due to ischemic colitis, intestinal perforation, and peritonitis. There
      was widespread arteriosclerosis but no evidence of giant-cell arteritis. Cell
      loss was demonstrated in both retinas, the chiasm, and in the central lateral
      geniculate body. These represent a retrograde, descending and ascending optic
      atrophy, with transsynaptic degeneration in the LGB. A small craniopharyngioma
      was found by chance in the infundibulum. Neither clinically nor morphologically
      were there any signs of glaucoma.

PMID- 2243479
TI  - [Fundus hemorrhage in malaria tropica].
AB  - The case is presented of a 20-year-old tourist with mild falciparum malaria and
      bilateral preretinal and intraretinal hemorrhage, including a macular hemorrhage
      with reversible visual loss, which developed during his return flight from West
      Africa. The diagnosis was initiated by the university eye hospital originally
      consulted. Possible pathogenic mechanisms, ocular findings in malaria, and the
      increasing problems of imported malaria are summarized and reviewed.

PMID- 2243480
TI  - [Bacterial pathogen and resistance spectrum of the non-irritated conjunctiva.
      7,845 preoperative smears at the ophthalmologic clinic of the Erlangen
      university].
AB  - The type and extent of bacterial colonization of the conjunctiva at the time of
      an intraocular operation may have a major influence on the risk of post-operative
      endophthalmitis. Between March 1986 and December 1988 a total of 7845
      preoperative conjunctival smears were therefore examined by culture of Erlangen
      University Eye Hospital, in cooperation with the Department of Clinical
      Microbiology. Altogether, 1221 (15.6%) of the smears were classified as positive.
      Surgery on the patients concerned was postponed and gentamicin eye drops were
      administered for decontamination of their conjunctivae until the smears were
      negative. From the positive smears 1393 strains were cultured, identified, and
      submitted to a resistance test. The present paper reports the frequency
      distribution of the species of bacteria isolated and their resistance behavior,
      and compares the results with those of other authors. The value of preoperative
      cultures in the prevention of postoperative endophthalmitis and the importance of
      resistance tests in the context of topical application of antibiotics are
      discussed.

PMID- 2243481
TI  - [Laser therapy of diabetic maculopathy. A comparative study of the argon green
      laser and dye red laser].
AB  - One hundred eyes with (pre)-proliferative diabetic retinopathy underwent central
      laser treatment for macular involvement. Fifty eyes were treated with the dye red
      630 nm, the other 50 with the argon green 514 nm laser. Eighty of the eyes had
      previously undergone panretinal photocoagulation; in the other 20 this was
      performed 1.5-3 months after treating the macula because the central retinal
      changes were predominant. In accordance with the clinical angiographic
      classification of diabetic maculopathy, into an exudative, an edematous, and an
      ischemic type, three photocoagulation techniques were employed as appropriate,
      i.e., focal coagulation, (modified) grid coagulation, and extensive centripetal
      panretinal coagulation. Neither postoperative visual acuity, nor the fluorescein
      angiogram, nor fundus color photography revealed any significant difference in
      the results obtained with the two laser wavelengths.

PMID- 2243483
TI  - [Ophthalmopathologic findings in bog victims].
AB  - More than 1800 corpses found in European bogs have been described. Most were
      found in northwest Germany and Denmark. The 2700-year-old corpse of a young woman
      found in the Borremose fen in Denmark is described. The face was crushed, though
      injury during cutting of the peat was ruled out. Light and scanning electron
      microscopy revealed vessels both in the choroid of one eye and in one ear, with
      intravascular corpuscles--probably erythrocytes--but no extravascular hemorrhage.
      This means that the face was almost certainly crushed post mortem and during the
      winter. The cause of death is unknown. Very few of the other bog finds in Europe
      are well preserved, and even fewer have been pathologically studied or
      radiocarbon-dated. Interpretation of their fate is a very difficult, complex
      problem. One reason for this is that the corpses often remained buried for
      several thousand years, and they are often poorly preserved. The first
      descriptions of it were Roman, in particular Tacitus' Germania, which appeared in
      98 AD--it is thus much younger than most of the corpses so far found. Tacitus
      talks of hanging, drowning, and ritual sacrifices. As regards future bog finds,
      it is suggested that an archaeologist, an anthropologist, a forensic expert and a
      taxi-dermist should be called in as soon as excavation begins. International
      cooperation between experts could prove very fruitful.

PMID- 2243482
TI  - [Pre- and postoperative non-contact tonometry].
AB  - The AO II non-contact tonometer (NCT) was compared with the Goldmann applanation
      tonometer (GAT) in 50 patients preoperatively and on the first day after cataract
      surgery. After pooling the preoperative and postoperative values, the
      relationship between NCT (y axis) and GAT (x axis) was described by the following
      regression: y = 1.01x - 0.69, where 1.01 is the slope and -0.69 (in mm Hg) is the
      y intercept of the regression line. The standard deviation (SD) in relation to
      the regression line was 2.19 mm Hg (y values). After separating the preoperative
      (n = 100; pressure range 6-21 mm Hg) and postoperative values (n = 47; pressure
      range 6-30 mm Hg) the following equations were obtained: preoperatively: y =
      0.89x + 0.82 (SD 2.2 mm Hg); postoperatively: y = 1.06x - 1.15 (SD 2.24 mm Hg).
      Since the postoperative regression line comes close to that required for legal
      verification, the NCT may - with limitations - also be recommended for measuring
      IOP after cataract surgery. Both preoperatively and postoperatively, a
      significantly linear relationship was found between corneal thickness and the
      difference GAT minus NCT readings. This implies that in normal eyes with thin
      corneas the NCT tends to underestimate IOP, while in eyes with thick corneas
      there is a tendency to overestimate IOP. Even slight corneal edema
      (postoperatively) reduces this effect.

PMID- 2243484
TI  - [Color vision of animals. Views from Carl von Hess to today].
AB  - In 1912 Carl von Hess, Professor of Ophthalmology in Munich, published the first
      comprehensive monograph on color vision in animals. He concluded that fish and
      all invertebrates are color-blind. At the same time, Karl von Frisch demonstrated
      that fish and honeybees can see and distinguish colors. The theory of trichromacy
      (Young-Helmholtz) is valid only for primates and some (e.g., bees) but not all
      insects. Almost all animals can see colors, and the eyes of some invertebrates
      contain up to 11 types of spectrally different receptor cells. Most animals -
      with the exception of mammals and cephalopods - can see ultraviolet and/or far
      red light. Therefore, many animals perceive more colors than human beings.

PMID- 2243486
TI  - Fictive ills: literary perspective on wounds and diseases.

PMID- 2243487
TI  - The great empty cup of attention: the doctor and the illness in the Wings of the
      Dove.
AB  - James confers on his characters his deepest fears and truths. He incorporates
      within his writing both his stunning and at times crippling intellectual powers
      and his dark inchoate mournful passion and remorse. The very events that made him
      a casualty are the experiences he grants to his characters to endure, to grapple
      with, and to master. In Wings James settles with his characters and with his
      readers the effects of these two deaths in his life. He was flattened by Minny's
      and Fenimore's deaths. He, like Marcher, cannot grasp the extent of his
      paralysis. It dawns on him like the sadness of a winter dawn but also like the
      explosive epiphany of Marcher at the grave that he has not lived. The words of
      Howell quoted by Sturges, the events of Wings, The Ambassadors, "The Beast in the
      Jungle" all reinforce what he knows to be true. He has not lived, he has not had
      what that man had to make him, by the loss of it, so bleed and yet live. What,
      after all, is more important in any life than the ability to love and the
      capacity to face death? This is the heart of the matter that James takes on in
      Wings. In the structure of the novel, to become conscious is to be in danger.
      Milly, the patient, achieves what eludes the other characters. Kate, Maud,
      Densher, Susan all are unable to raise their heads above their own lives. Only
      Milly is aware of herself within and beyond the book. Perhaps Densher begins in
      the very end to raise his head similarly, and in the sequel of "Beast," he
      achieves it.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243485
TI  - Illness and exile: Sophocles' Philoctetes.

PMID- 2243488
TI  - Philoctetes' wound.

PMID- 2243489
TI  - Fierce privacy in the Wings of the Dove.

PMID- 2243491
TI  - The wisdom of pain: a responsive reading.

PMID- 2243492
TI  - The whole story.

PMID- 2243493
TI  - Death labors.

PMID- 2243494
TI  - His and hers: mental breakdown as depicted by Evelyn Waugh and Charlotte Perkins
      Gilman.

PMID- 2243495
TI  - Madness and medicine: the graphomaniac's cure.

PMID- 2243496
TI  - John Donne as a patient: Devotions upon Emergent Occasions.

PMID- 2243497
TI  - Distance on the look of death.

PMID- 2243499
TI  - Disease and cure in "Janet's Repentance": George Eliot's change of mind.

PMID- 2243500
TI  - Disease as device: the role of smallpox in Bleak House.

PMID- 2243501
TI  - Bleak House: the social pathology of urban life.

PMID- 2243503
TI  - Specific in vitro amplified probe detects the E2A gene rearrangement in the
      t(1;19) acute lymphoblastic leukemia.
AB  - Molecular studies have recently demonstrated that the E2A transcription factor
      gene was consistently located on chromosome 19 at the breakpoint of the
      1;19(q23;p13) translocation, which characterizes a number of leukemias harboring
      a pre-B cell phenotype. Using a specific E2A gene probe spanning the DNA binding
      and dimerization domain obtained by PCR methodology, we were able to detect the
      rearrangement of the E2A gene in four cases (three patients and one cell line) of
      pre-B acute lymphoblastic leukemia with t(1;19) translocation.

PMID- 2243504
TI  - Chromosomal translocation t(14;19) as indicated by bcl-3 rearrangement is a rare
      phenomenon in non-Hodgkin's lymphoma and chronic lymphocytic leukemia: a
      molecular genetic analysis of 176 cases.
AB  - Using a probe for the newly described bcl-3 gene near the breakpoint of the
      t(14;19), 176 cases of non-Hodgkin lymphoma and B cell chronic lymphocytic
      leukemia were analyzed. Rearrangement of the bcl-3 gene was found in only one
      case; a follicular lymphoma involving the salivary gland that had progressed to a
      diffuse large cell lymphoma. We conclude that rearrangement of the bcl-3 gene as
      detected by our method occurs rarely in mature B or T cell neoplasms.

PMID- 2243502
TI  - Induction of genes for transcription factors by normal hematopoietic regulatory
      proteins in the differentiation of myeloid leukemic cells.
AB  - Induction of differentiation to macrophages in two different clones of myeloid
      leukemic cells by the hematopoietic regulatory proteins interleukin-6 (IL-6), or
      by granulocyte-macrophage colony-stimulating factor (GM-CSF) or interleukin-3 (IL
      3), is shown to be associated with sustained accumulation of c-jun, jun-B, and c
      fos mRNA that code for proteins that form complexes that are transcription
      factors (AP-1). In one but not in the other of these leukemic clones,
      differentiation is also associated with sustained accumulation of mRNA for the
      putative transcription factor zif/268. The results indicate that differentiation
      of myeloid cells by normal hematopoietic regulatory proteins is associated with
      induction of sustained elevated levels of mRNA for transcription factors that can
      regulate and maintain gene expression in the differentiation program, and that
      zif/268 gene expression is not essential for differentiation to macrophages.

PMID- 2243505
TI  - Intracytoplasmic detection of the Tac (p55) chain of interleukin-2 receptor in
      pre-B leukemic cells associated with a constitutive expression of Tac mRNA.
AB  - The pre-B Reh-6 leukemic cells do not express membrane interleukin-2 (IL-2)-R
      alpha (Tac or p55) chain; however, their incubation with PMA induces the
      expression of both high and low affinity IL-2-R. Northern analysis of
      nonstimulated Reh-6 as well as leukemic cells from patients with acute B cell
      precursor lymphoblastic leukemia displayed a constitutive expression of p55 mRNA
      transcripts, which could be enhanced by PMA. Both actinomycin-D and cycloheximide
      could abrogate PMA-induced p55 membrane expression, suggesting the need for de
      novo mRNA and protein synthesis. The increased PMA-induced p55 mRNA accumulation
      was an early event (4 hr) and could be enhanced, specifically, by rIL-2 because
      anti-Tac moAb inhibited this rIL-2-mediated effect. Immunofluorescence and cross
      linking studies using 125I-rIL-2 failed to reveal membrane-associated p55 protein
      on both Reh-6 and patients' leukemic cells. Conversely, immunogold staining and
      electron microscopy studies, revealed p55 immunoreactive molecules in the
      cytoplasm but not in the nucleus of all Reh-6 cells. Using a sensitive EIA, p55
      molecules could be detected in cell lysates but not the culture supernatants of
      Reh-6 cells, suggesting that p55 was not released into the culture medium. These
      results indicate that constitutively expressed p55 mRNA on pre-B leukemic cells
      is translated into a relative immunoreactive protein that cannot be expressed on
      cell surface for unknown, yet, reasons.

PMID- 2243506
TI  - Kinetic rationale for cytokine-induced recruitment of myeloblastic leukemia
      followed by cycle-specific chemotherapy in vitro.
AB  - In patients with acute myeloblastic leukemia incomplete response to induction
      chemotherapy and short disease-free survival may be related to cell kinetic
      quiescence of leukemic cells. In this in vitro study, we tested the hypothesis
      that treatment with cytokines and subsequent chemotherapy (ARA-C, daunorubicin)
      can increase proliferation and enhance leukemic cell kill. We evaluated the
      effects of recombinant human interleukin-3 (rh-IL-3), granulocyte-macrophage
      colony stimulating factor (rhGM-CSF) and granulocyte colony stimulating factor
      (rhG-CSF) alone and in combination on AML (N = 11) and blastic phase CML (N = 3)
      samples. Cellular DNA and RNA, incorporation of bromodeoxyuridine (BrdU), cell
      growth fraction, cell viability, and differentiation markers were evaluated in
      vitro. A decrease of the quiescent cell population (p = 0.003) and an increase in
      S-phase cells (p = 0.001) was observed in 8/11 AML samples treated with cytokine
      combinations. Pronounced heterogeneity or proliferative response was seen between
      individual cases and different cytokines, but in the majority of the samples IL-3
      was most effective. Significantly increased Ki67 expression (p = 0.009) and BrdU
      incorporation (p = 0.01) were also found after exposure to cytokines indicating
      an increase in growth fraction. DNA synthesis time was unaffected. Eight samples
      of AML were treated for 24 hr with ara-C following 2 days of in vitro cytokine
      incubation. Evaluation of leukemic cell kill showed increased cytotoxicity in
      three of those five samples which had significant depletions of G0 cells and
      increases in S-phase. None of the leukemic samples without recruitment from G0
      had an increase in ARA-C cytotoxicity. This study provides detailed cell kinetic
      analysis of cytokine effects on AML blasts and provides a rationale for a novel
      approach to the treatment of AML.

PMID- 2243507
TI  - A phase I study of intermittent continuous infusion high dose cytosine
      arabinoside for acute leukemia.
AB  - We previously administered ara-C at a dose rate of 250 mg/m2/hr for 36-72 hr to
      patients with leukemia. Gastrointestinal toxicity was dose-limiting. This regimen
      was modified to an every other day schedule, administering 24-hr periods of high
      dose continuous infusion ara-C, each followed by a 24-hr rest period. Sixteen
      patients with relapsed/refractory acute myeloid leukemia (AML) (N = 4), secondary
      AML (N = 2), relapsed/refractory acute lymphoblastic leukemia (N = 7), or CML in
      blast crisis (N = 3) received this regimen of three 24-hr infusions with two
      intercurrent 24-hr rest periods. Grade 3 gastrointestinal toxicity was
      encountered in 57% of the courses, and hypoplasia was achieved in all patients.
      Three of the patients died while hypoplastic, two with septicemia and another
      with intracranial hemorrhage. There were five responding patients (2 CRs, 3 PRs).
      Median steady-state plasma ara-C levels were 24 microM, 22 microM, and 20 microM
      during the first, second, and third 24-hr infusions, respectively. Ara-C levels
      ranged from 4-118 microM during the infusions and were always below 4.5 microM
      during the rest periods. A significant level of ara-C incorporation into DNA was
      detected in each of the five patients studied, thus demonstrating that (ara-C)DNA
      formation is detectable in blasts from patients receiving high dose continuous
      infusion ara-C therapy. These findings suggest that alternate day continuous
      infusion ara-C may be useful in the treatment of acute leukemia and CML in blast
      crisis.

PMID- 2243509
TI  - DNA-fingerprint changes compared to karyotypes in acute leukemia.
AB  - Chromosomal analysis is routinely used in follow-up studies of acute leukemia,
      but it cannot be used in patients who do not have karyotypic abnormalities in
      blastic phase (10-46% of all cases). Recently we have demonstrated that
      unspecific DNA-fingerprint (DNA-F) changes can be detected in blastic phase of
      leukemia by DNA-F analysis. These changes can be used as molecular markers of the
      disease and in the follow-up studies of acute leukemia karyotyping and DNA-F
      analysis are complementary. The comparative analyses of leukemia samples with
      both these methods could help to localize minisatellite loci in chromosomes and
      reveal new DNA areas related to leukemia. New, more specific probes targeted to
      specific chromosomes could consequently be developed. We compared the DNA-F to
      the karyotypes of 50 acute leukemia patients. In blastic phase, 19 patients had
      DNA-F alterations and 31 patients abnormal karyotypes, 12 patients had both DNA-F
      alterations and karyotypic abnormalities. DNA-F changes were detected in six of
      the 16 patients with normal karyotypes and 19 patients with normal DNA-F had
      abnormal karyotypes at the time of diagnosis. Eleven patients showed neither DNA
      F changes nor abnormal karyotypes in blastic phase. Three acute myeloid leukemia
      (AML) patients with DNA-F changes in blastic phase had trisomy eight as a sole
      abnormality or combined with balanced translocation, which suggests that there
      might be AML associated minisatellite locus in chromosome 8. In other cases the
      karyotypes were complicated and no clear evidence of the relationship of DNA-F
      changes with other chromosomes could be found.

PMID- 2243508
TI  - Isotype switch and idiotype variation in hairy cell leukemia.
AB  - Hairy cell leukemia (HCL) cells are B lymphocytes expressing monoclonal surface
      bound immunoglobulins, B cell specific antigens, and activation markers. Based on
      immunophenotyping analysis, HCL cells have been reported to express
      simultaneously multiple Ig heavy chain isotypes. This is in contrast with the
      majority of other B cell malignancies. To analyse the tumor cell Ig in more
      detail, we have prepared somatic cell hybridomas from two patients with HCL. In
      both cases we found that the tumor cell derived hybridomas secreted IgM, IgG, or
      IgA indicating that a class-switch event does occur within the monoclonal tumor
      cell population. However these hybridomas expressed only single isotypes. The
      clonal relatedness of the tumor-derived Ig was shown by Ig gene analysis and by
      reactivity with a panel of idiotype specific antibodies. The tumor Ig of one
      patient analysed showed a striking variability in idiotope expression, indicative
      of somatic mutations of the expressed Ig genes. To our knowledge this is the
      first example of HCL and of a B cell malignancy other than follicular lymphoma
      for which somatic mutations have been demonstrated. This finding might be
      important for the therapeutic approach based on monoclonal anti-idiotype
      antibodies.

PMID- 2243510
TI  - Clinical applications of 3'-azido-2',3'-dideoxythymidine (AZT) and related
      dideoxynucleosides.

PMID- 2243511
TI  - 5-HT3 receptors.

PMID- 2243512
TI  - New developments in drug delivery systems.
AB  - The rate-controlled drug delivery systems outlined above have been steadily
      introduced into the biomedical community since the middle of the 1970s. It is the
      author's belief that many more of the conventional drug delivery systems which we
      have been using for many decades will be gradually replaced, in coming years, by
      these high-tech-based rate-controlled drug delivery systems.

PMID- 2243513
TI  - Potent inhibitors of de novo pyrimidine and purine biosynthesis as
      chemotherapeutic agents.

PMID- 2243514
TI  - Family cancer syndrome: a study of the kindred of a man with osteogenic sarcoma
      of the mandible.
AB  - Several familial cancer syndromes have been identified. The syndrome of sarcomas,
      breast cancer and other neoplasms, known as Li-Fraumeni syndrome, is
      characterized by several different neoplasms presenting at young ages with
      autosomal dominant transmission and a high incidence of second primaries. In this
      paper, we studied six generations (51 people) of the family of a 24-year-old man
      with osteogenic sarcoma of the mandible. Twelve malignancies in 11 people,
      including several rare tumors, were revealed. Mean age of presentation was 24
      years old. Nine of the 11 patients died of disease. One developed a second
      primary. Two tumors presented in the head and neck. Transmission was autosomal
      dominant. The karyotypes of two family members were normal. Identification of Li
      Fraumeni syndrome in a family is important in determining appropriate follow-up
      for the patient and family. Such families are models for studying carcinogenesis.

PMID- 2243516
TI  - The surgical management of chronic parotitis.
AB  - Chronic parotitis is a disorder characterized by recurrent painful swelling of
      the gland with purulent sialorrhea. Occasionally, the condition fails to respond
      to medical management and definitive surgical therapy is necessary.
      Sialolithiasis is the usual etiology in cases of parotitis, although occasionally
      severe recurrent parotid infections are superimposed on underlying Sjogren's
      disease. Total parotidectomy with facial nerve dissection has been used in such
      cases in our department and has proved to be an excellent way to manage this
      disease. A summary of our results indicate that the recurring infections were
      eradicated and that the complication rate is tolerable, considering the magnitude
      of the problem. We feel that it is better to use surgical management early rather
      than wait for the formation of fistulae or abscesses.

PMID- 2243515
TI  - Gadolinium-enhanced magnetic resonance imaging in Bell's palsy.
AB  - Inflammation of the facial nerve in Bell's palsy can be demonstrated on
      gadolinium-enhanced magnetic resonance imaging. We have studied a series of 17
      Bell's palsy patients with gadolinium-enhanced magnetic resonance imaging, and
      the purpose of this paper is to report our findings and discuss their
      significance. Most acute Bell's palsy cases demonstrate facial nerve enhancement,
      usually in the distal internal auditory canal and labyrinthine/geniculate
      segments. Other segments demonstrate enhancement less often. Gadolinium
      enhancement occurs regardless of the severity of the paralysis and can persist
      after clinical improvement of the paralysis. The findings of this study
      corroborate other evidence that the segments of the facial nerve most often
      involved in Bell's palsy are the only segments that are most often enhanced with
      gadolinium-enhanced magnetic resonance imaging. The role of gadolinium-enhanced
      magnetic resonance imaging in the management of Bell's palsy patients is
      discussed.

PMID- 2243517
TI  - Small fenestra stapedotomy using a fiberoptic hand-held argon laser in
      obliterative otosclerosis.
AB  - Obliterative otosclerosis has been a challenge since the advent of stapes
      surgery. "Drill-out" procedures have had a generally poorer prognosis than
      conventional stapes surgery because of excessive bleeding, acoustic trauma from
      the burr, and reclosure of the oval window by otosclerosis. In this report, we
      describe our early experience using a hand-held fiberoptic argon laser for small
      fenestra stapedotomy in 10 cases of obliterative otosclerosis. Closure of the air
      bone gap to within 10 dB was seen in 100% of the patients. There was no
      significant sensorineural hearing loss, vertigo, or facial weakness. Argon-laser
      stapedotomy using a hand-held fiberoptic system is a safe and effective
      alternative to drill-out stapedotomy in cases of obliterative otosclerosis.

PMID- 2243518
TI  - Avoiding a wrapped endotracheal tube in laser laryngeal surgery: experiences with
      apneic anesthesia and metal laser-flex endotracheal tubes.
AB  - Ninety-one laser laryngeal procedures using the apneic technique of anesthesia
      were performed in 28 patients between 2 months and 64 years of age. Seventy-two
      procedures (79%) were performed on children and 19 on adults. There were no
      complications. Eight laser laryngoscopies were performed using a new metal Laser
      Flex endotracheal tube. Obstruction of the endotracheal tube with a mucous plug
      occurred in one case. The apneic technique described in this paper provides a
      laser operative field free of an endotracheal tube, virtually eliminating the
      danger of a laser fire. It is a relatively safe and effective means of performing
      laser laryngeal surgery. In addition, the Laser-Flex endotracheal tube appears to
      be an acceptable alternative to a metallic tape-wrapped endotracheal tube.

PMID- 2243520
TI  - Chondrogenic potential of tragal perichondrium: a cause of hearing loss following
      stapedectomy.
AB  - Tragal perichondrium is a widely used tissue seal in the oval window following
      stapes surgery. Autogenous and easily accessible, it is a suitable substance to
      cover the vestibule in total stapedectomy, and to seal around the prosthesis in
      small-fenestra stapedotomy. The incidence of complications from the use of
      perichondrium in this manner is exceedingly low. We report a case where tragal
      perichondrium in the oval window resulted in the proliferation of cartilage. The
      cartilage displaced the stapes prosthesis, resulting in a conductive loss.
      Although the chondrogenic potential of perichondrium is known, we are not aware
      of other reports implicating this as a cause of failure in stapes surgery. The
      pertinent clinical and experimental literature regarding chondrogenesis is
      reviewed. This information suggests that the formation of cartilage from
      perichondrium in the oval window might be influenced by mechanical trauma and
      tissue orientation.

PMID- 2243519
TI  - Pediatric penetrating head and neck trauma.
AB  - Penetrating head and neck trauma in children causes uncommon and potentially life
      threatening injuries. We reviewed the charts of 21 patients who sustained
      penetrating injuries to the face or upper neck. Seventeen males and 4 females,
      aged 32 weeks' gestation to 19 years (mean = 10.2 years) comprised the study
      population. There were 15 gun-shot wounds, 1 shotgun injury, and 5 stab wounds.
      Significant problems included 7 vascular injuries, 6 central nervous system
      injuries, 5 ocular injuries, 3 airway compromises, 2 facial nerve injuries, 1
      cervical esophageal penetration, and 2 cases of pneumothorax. Three deaths
      occurred, but the majority of the patients survived and sustained minimal
      permanent disability. Included in this review is a unique case of an intrauterine
      gunshot wound to the face at approximately 32 weeks' gestation. The treatment
      protocol, differences from adult patients, and management highlights are
      reviewed.

PMID- 2243521
TI  - The use of gadolinium-enhanced magnetic resonance imaging to determine lesion
      site in traumatic facial paralysis.
AB  - Gadolinium-enhanced magnetic resonance imaging has been used to evaluate 20
      patients with surgically confirmed facial nerve lesions. When the nerve could be
      seen, gadolinium-enhanced magnetic resonance imaging accurately revealed the
      lesion site as well as the known extent, which in some cases was not predicted by
      topognostic testing. This technique appears to provide accurate lesion-site
      testing and may have importance in surgical planning. Currently used topognostic
      tests of facial nerve function are frequently inaccurate and can only determine
      the most proximal lesion site when there are multiple or extensive lesions. The
      focal nerve enhancement seen in nerve injury, globally increased signal intensity
      within the temporal bone after trauma, and increased signal intensity within the
      dura after surgery can occasionally mask nerve lesions and may be confused with
      tumors.

PMID- 2243522
TI  - Chondrosarcoma of the head and neck.
AB  - Chondrosarcoma is a malignancy rarely encountered in the head and neck. In an
      attempt to define this tumor's characteristics and response to therapy, all cases
      of chondrosarcoma treated at the University of Michigan over the past 25 years
      were retrospectively studied. Fourteen cases originating in the nose and
      paranasal sinuses, mandible, temporal bone, and larynx were reviewed. Aggressive
      surgical resection was the mainstay of treatment, and resulted in an overall
      survival of 70%, with an average follow-up of 3.5 years. Survival was highest in
      primary temporal bone lesions, and lowest in paranasal sinus lesions.
      Unresectable lesions were not cured by other modalities. This study, therefore,
      continued to support the crucial role of wide surgical resection in the treatment
      of head and neck chondrosarcoma, but conservative resection, when needed to
      preserve important structures, has resulted in long-term survival.

PMID- 2243523
TI  - Selective management of early glottic cancer.
AB  - Seventy patients with stage I and II glottic cancer were treated at the
      University of Utah School of Medicine hospitals from 1980 through 1987. Forty
      four patients had stage I cancer and 26 patients had stage II. The overall
      survival in the stage I group was 82%. Primary site control was 93% with only
      three deaths due to laryngeal cancer. Local control rates were 93% with CO2 laser
      excision, 80% with CO2 laser and irradiation, and 67% with radiation alone. Stage
      II glottic patients had an overall survival of 61.5% with a local control rate of
      76%. Twenty-one of 24 patients were treated by full-course irradiation. Of the
      eight patients who recurred at the primary site, all were irradiation failures
      who had initial bulky disease and impaired vocal cord mobility. Selective CO2
      laser excision was highly effective, whereas radiation therapy results were
      somewhat disappointing. Open partial laryngectomy should be considered in bulky
      stage II disease patients.

PMID- 2243524
TI  - The melanocyte and melanoma.
AB  - This paper reviewed some of the interesting biological aspects of melanocytes and
      their relationship to the nevus and to melanoma. It also proposed a rationale for
      "adequate" surgery in the management of melanoma according to level, depth,
      margins, and trends in treatment. These propositions were derived from an
      analysis of 995 cases of melanoma of the head and neck.

PMID- 2243525
TI  - Allograft tympanoplasty: predictive value of preoperative status.
AB  - The functional and anatomical results of a series of 181 consecutive allograft
      tympanoplasties for ears with drum perforation and an intact ossicular chain were
      retrospectively reviewed and related to preoperative factors. Drum closure was
      realized in 92% (166 of 181 cases evaluated 1 year after surgery), and 96.6% of
      the reconstructed drums were still intact 3 years after surgery (118 cases
      evaluated). An air-bone gap of less than 21 dB was reached in 79.6% (of a total
      of 162 cases) 1 year after surgery, and in 78% (of a total of 118 cases) 3 years
      after surgery. Age, contralateral pathology, the wet or dry status of the ear
      preoperatively, and the preoperative air-bone gap had no influence on anatomical
      results. The preoperative air-bone gap did not predict the postoperative air-bone
      gap. The influence of age and existence of contralateral pathology on hearing
      gain was only visible in some of the strictly defined patient groups. The wet
      preoperative status of the ear generally predicted lower functional gain.

PMID- 2243526
TI  - Computer-aided three-dimensional reconstruction and measurement for multiple
      electrode cochlear implant.
AB  - To assist surgeons in performing multiple-electrode cochlear implant operations,
      the spatial relations between middle and inner ear structures in six normal
      temporal bones were studied using the computer-aided 3-D reconstruction method.
      When viewed through the external auditory canal, the approach used for electrode
      insertion, and the relation of the malleus to the helicotrema or the scala
      vestibuli in the second turn of the cochlea were found to vary considerably. In
      contrast, when viewed from the same transmeatal approach, both the direction and
      the distance from the stapes footplate to the scala vestibuli of the second turn
      of the cochlea and helicotrema were found to be quite stable. We concluded that
      the stapes footplate was a better landmark than the malleus when approaching the
      helicotrema and scala vestibuli of the second turn of the cochlea during multiple
      electrode cochlear implant surgery.

PMID- 2243527
TI  - A palmar dermatosis linked to occult carcinoma of the upper thorax, head and
      neck: Bazex's syndrome and tripe palm.
AB  - An unusual, persistent, corregated-to-honeycombed thickening of the palms
      accompanied by tenderness around the fingernails was found to be a cutaneous
      marker for internal malignancy. This combination of signs and symptoms has been
      reported under two clinical entities: Bazex's syndrome and tripe palm. This
      paraneoplastic syndrome is of interest to head and neck surgeons due to the
      location of the primary tumor, the site of metastatic disease, and the ability to
      cure the cutaneous disease by surgical removal of the primary tumor. In our
      patient, a squamous cell carcinoma of the lung not detectable on chest x-ray
      presented as a cervical mass accompanied by cutaneous changes on the palms and
      fingernails. Recognition of the relationship of the dermatologic changes to
      malignancy of a specific body region eventually led to the detection of the
      primary tumor. The characteristics of these paraneoplastic syndromes were
      reviewed in this report.

PMID- 2243528
TI  - Otologic disease in AIDS patients: CT correlation.
AB  - The contrast-enhanced computed tomographic (CT) scans of the temporal bone and
      brain in 18 patients with otologic disease and acquired immunodeficiency syndrome
      (AIDS) were retrospectively reviewed. Seven scans revealed middle ear and mastoid
      disease; three scans were consistent with central nervous system (CNS) pathology;
      and eight scans demonstrated no abnormalities. CT scanning was found useful in
      localizing otopathology and diagnosing CNS toxoplasmosis, aural polyps,
      osteomyelitis, mastoiditis, and middle ear effusion due to hypertrophic lymphoid
      tissue. The authors conclude that AIDS patients with sensorineural hearing loss
      should undergo contrast-enhanced brain CT scans to rule out CNS pathology; AIDS
      status does not alter criteria for CT scanning in patients with conductive
      hearing loss; and that images of the nasopharynx should be included on temporal
      bone CT scans of patients with conductive hearing loss in order to exclude
      eustachian tube obstruction by hypertrophic lymphoid tissue.

PMID- 2243529
TI  - Isolated congenital stapes ankylosis: surgical results in 32 ears and a review of
      the literature.
AB  - Isolated congenital stapes ankylosis is described in 32 operated ears from 28
      patients. In 27 ears, a regular stapedectomy was performed. In the remaining 5
      ears, 2 had stapes gushers, 2 had bony stapedial tendons, and 1 had an aberrant
      facial nerve crossing the oval window. The average individual hearing gain was 20
      dB. The mean hearing gain for the 24 successful stapedectomies was 29 dB. In 24
      of 32 ears (75%), an essential hearing gain of at least 15 dB Fletcher's index
      hearing threshold could be achieved. A Fletcher's index not exceeding 30 dB could
      be achieved in 19 of 32 ears (60%), in spite of several cases with a
      sensorineural component in the hearing loss. A review of the literature and
      overview of longer series with isolated congenital stapes ankylosis is presented.

PMID- 2243530
TI  - A comparison of class II antigenicity of human tracheal allografts stored in
      cialit and in merthiolate.
AB  - This report deals with some of the immunological aspects of the transplantation
      and preservation of human tracheal grafts. The immunological behavior of the
      transplanted graft depends largely on the interaction of the preservatives with
      the tissue proteins. Using monoclonal antibodies and the immunoperoxidase
      staining technique we have investigated the effect of Merthiolate, Cialit,
      formaldehyde/Merthiolate, and formaldehyde/Cialit preservation techniques on
      monomorphic determinants of class II transplantation antigens in human tracheal
      allografts. Unpreserved grafts were found to express class II antigens. These
      antigens were totally destroyed after 7 days in formaldehyde and 42 days in
      Cialit and Merthiolate. Preservation in Cialit and Merthiolate showed a gradual
      disintegration of the histological structures. In contrast, buffered formaldehyde
      did not appear to alter the histological structure of the tracheal graft.
      Irrespective of the mode of preservation, the cartilaginous tissue appeared to
      persist virtually unaffected. No essential differences were observed between the
      immunological staining of tracheal grafts preserved in Cialit and Merthiolate.

PMID- 2243531
TI  - The inferiorly based superior tympanomeatal flap for removal of congenital
      cholesteatoma.
AB  - We believe that the IB-STMF is preferable to the P-TMF for removal of a
      congenital cholesteatoma from the anterior superior portion of the mesotympanum.
      Though developing an IB-STMF may require extra time and special care to avoid
      tearing the flap, the exposure that is achieved affords the best chance for
      complete removal of the mass, thus decreasing the chance for persistence or
      recurrence of the lesion.

PMID- 2243532
TI  - The endoscopic approach for revision dacryocystorhinostomy.

PMID- 2243533
TI  - Severe epistaxis: protecting the nasal ala.

PMID- 2243534
TI  - Effect of alpha interferon on glucose and alanine transport by rat renal brush
      border membrane vesicles.
AB  - To investigate the pathogenetic mechanisms of interferon nephrotoxicity, we
      studied the effect of recombinant interferon alfa-2b on the uptake of 14C-D
      glucose and 14C-L-alanine by rat renal brush-border-membrane vesicles. Interferon
      significantly inhibited 20 sec. sodium-dependent and 5 and 10 min. equilibrium
      uptake of both glucose and alanine. The inhibitory effect was dose dependent with
      maximum effect achieved at interferon concentration of 5 X 10(-8)M in the uptake
      media. The half-maximal inhibitory concentrations, IC50, of interferon on glucose
      uptake was 1.8 X 10(-8)M, and 5.4 X 10(-9)M on alanine uptake. Dixon plot
      analysis of uptake data was consistent with pure non-competitive inhibition. The
      inhibition constants, Ki, 1.5 X 10(-8)M for glucose uptake, and 7.3 X 10(-9)M for
      alanine uptake, derived from Dixon plots were in close agreement with the IC50s
      calculated from the semilog dose response curves. These observations reveal that
      direct interactions at the proximal tubule cell membrane are involved in the
      pathogenesis of interferon nephrotoxicity, and that its mechanism of
      nephrotoxicity is similar to that of other low molecular weight proteins.

PMID- 2243535
TI  - Different turnover of rat fetal and placental ornithine decarboxylases.
AB  - The half-lives of ornithine decarboxylase (ODC) and S-adenosylmethionine
      decarboxylase (SAMDC) have been studied in fetuses and placentas from 18-day
      pregnant rats. While the turnover of fetal and placental SAMDC were slightly
      different (t1/2 = 38 and 75 min, respectively) the half-lives of fetal and
      placental ODC differed markedly. T1/2 of fetal ODC was 15 min, similar to other
      mammalian ODCs, but placental ODC showed a relatively high half-life, about 160
      min. According to that, placental ODC was more resistant than the fetal enzyme to
      in vivo hyperthermic treatment (40 degrees C, 1 h). Our results suggest that the
      degradative mechanisms for ODC in rat placenta could be regulated differently to
      those in other mammalian tissues.

PMID- 2243536
TI  - Possible mechanism of gastric mucosal protection by epidermal growth factor in
      rats.
AB  - The mechanism of the protection by human epidermal growth factor (hEGF) against
      the gastric mucosal lesions induced by acidified ethanol was studied in rats. At
      different times following the subcutaneous administration of hEGF (30
      micrograms/kg), intragastric acidified ethanol (EtOH: 0.125 M HC1 = 50:50 v/v%)
      was administered to induce an experimental gastric mucosal lesion. Mean length of
      the lesion in the gastric mucosa was used as a lesion index. Extravasation of
      intravenously injected Evans blue into the gastric wall and gastric contents was
      used as an indicator of vascular permeability. Pretreatment with hEGF decreased
      both the gastric mucosal lesions and the increase of vascular permeability caused
      by acidified ethanol with similar time profiles relative to pretreatment with
      hEGF. Maximal protective actions of hEGF occurred about 10 to 30 min after the
      observed peak plasma concentration of hEGF. Indomethacin and N-ethylmaleimide,
      but not iodoacetamide, blocked the protective action of hEGF, indicating that
      endogenous prostaglandins and/or sulfhydryls may participate in the protective
      action of hEGF. The content of endogenous nonprotein sulfhydryls in the gastric
      mucosa decreased markedly after acidified ethanol. However, pretreated hEGF did
      not restore the sulfhydryl contents. Thus, it seemed that endogenous
      prostaglandins, but not sulfhydryls, are the probable mediators for protection
      against gastric mucosal injury caused by acidified ethanol.

PMID- 2243537
TI  - Elevated cytosolic calcium in cerebrocortical nerve terminals of rats during
      prolonged ethanol ingestion.
AB  - Increases in cytosolic free calcium concentrations ([Ca++]i) may underlie acute
      neuronal degeneration during ischemic or anoxic episodes, seizures and
      excitotoxin treatment. With quin-2 and fura-2 fluorescent probes, we have
      obtained evidence for elevated [Ca++]i in cerebrocortical terminals of adult rats
      following chronic consumption of ethanol-containing liquid diets for "neurotoxic"
      durations. Compared to isocaloric carbohydrate-fed controls, ethanol-fed rats had
      significantly higher [Ca++]i in P2 synaptosomal fractions after 4 months of diet
      intake, and in purified cerebrocortical synaptosomes after diet ingestion for 10
      months. In addition, [Ca++]i in the synaptosomal fractions of ethanol-fed rats
      from either exposure time were markedly resistant to K(+)-dependent potentiation.
      Persistently increased synaptic [Ca++]i and a blunted response to K+
      depolarization following chronic ethanol ingestion lead us to associate impaired
      Ca++ homeostasis in the neurodegenerative processes of alcoholism.

PMID- 2243538
TI  - In vitro vasoconstriction induced by calcium in renovascular hypertensive or old
      rats.
AB  - We studied the changes in calcium-induced vasoconstriction in isolated tail
      arteries from young (2 months) and old (12 months) normotensive, and young
      renovascular hypertensive rats (3 months old, with unilateral renal artery
      clipping at 6 weeks), pretreated with reserpine. The tail artery was removed and
      perfused/superfused with either a high potassium Krebs depolarizing solution or
      Krebs solution plus phenylephrine. Concentration-response curves to calcium were
      produced. Old rats had a low plasma renin activity and their depolarized tail
      arteries showed a weak vasoconstrictor response to calcium. Renovascular
      hypertensive rats had a high mean blood pressure and plasma renin activity.
      Responses of their depolarized tail arteries to calcium were greater. Responses
      to calcium in tail arteries perfused with phenylephrine were similar in all
      groups. We conclude that age and renovascular hypertension produce opposite
      changes in vasoconstriction induced by calcium in depolarized tail arteries.

PMID- 2243539
TI  - Estradiol processing by pituitary cells in culture: an examination of the
      influences of various exposures to progesterone.
AB  - Dispersed, estradiol (E2)-treated pituitary cells were used to examine the
      cellular mechanisms underlying progesterone (P) suppression of GnRH-stimulated LH
      and FSH secretion. When cells were exposed to 10(-9) M E2 for 48 h prior to GnRH
      challenge, P (10(-7) M) treatment for the last 24 h suppressed gonadotroph
      responsiveness to GnRH for both LH and FSH secretion (gonadotropin
      released/intracellular stores of gonadotropin available for release). To
      determine if P acts by blocking E2 processing and/or uptake, we exposed cells to
      2,4,6,7-3H-E2 +/- P and monitored the level and distribution of 3H-estrogens
      bound to estrogen receptors salt-extracted from nuclear pellets purified by
      sucrose density centrifugation. At 1, 4 and 24 h, P had no effect on the level of
      3H-estrogen+receptor complexes or on the distribution of receptor-bound 3H-E2, 3H
      estrone and 3H-estriol. The results indicate that chronic influences of P to
      suppress the responsiveness of E2-treated gonadotrophs to GnRH cannot be
      explained by alterations in estrogen receptor occupation as is the case in
      reproductive tract tissues.

PMID- 2243540
TI  - Differential effects of sex steroids on uterine and renal ODC activity in
      ovariectomized rats.
AB  - Many hormones are known to induce the activity of ornithine decarboxylase (ODC),
      the first and rate-limiting enzyme for polyamine biosynthesis, in their target
      tissues. Using ovariectomized rats, we have compared the effects of sex hormones
      on ODC activity in the uterus and the kidney which contain estrogen and androgen
      receptors. The results show that 1) both estrogen and androgen stimulate renal
      ODC activity, 2) estrogen but not androgen effectively increases ODC activity in
      the uterus, 3) estrogen at higher dosage can stimulate renal ODC activity to an
      extent similar to that in the uterus, 4) daily treatment with estradiol for 5
      days results in the desensitization of uterine ODC activity, but not that of
      renal ODC activity to the hormonal stimuli. Although both uterus and kidney are
      targets of sex hormones, our results indicate that estrogen and androgen have
      differential influences on the ODC activity in these two organs.

PMID- 2243541
TI  - Buprenorphine-induced pupillary effects in human volunteers.
AB  - The pupillary effects of the partial opiate agonist buprenorphine were studied in
      16 male subjects who were heroin dependent at the time of admission to the study.
      Sublingual buprenorphine (8 mg) was administered daily for 18 days and continued
      either daily or on alternate days from study days 19 through 36. On days 37
      through 56, all subjects received buprenorphine placebo. Compared to placebo,
      buprenorphine decreased pupil size and diminished the constriction and dilation
      velocities of the light reflex. These effects occurred within 5 hours of
      buprenorphine administration. Following placebo administration during alternate
      day dosing of buprenorphine, pupil size increased and constriction and dilation
      velocities of the light reflex were significantly greater than after
      buprenorphine administration in the same subjects. This pattern of effects was
      observed after buprenorphine was discontinued (day 37). The results indicated
      that buprenorphine has pupillary effects like those of full opiate agonists. The
      time course of these effects was similar to previously-reported effects of
      buprenorphine on the electroencephalogram but not to the time course of
      subjective effects.

PMID- 2243543
TI  - A brief treatise on the academic committee.

PMID- 2243542
TI  - A microcomputer system for residents.

PMID- 2243544
TI  - The Cancer Prevention Reminder System.
AB  - The Cancer Prevention Reminder System is a computer-based system designed to
      increase the delivery of periodic health maintenance procedures. The program
      provides printed reminders that identify patients' overdue procedures, prints
      summary reports of the percentage of patients who are eligible and overdue for a
      procedure, and prints mailing labels for patients. We performed a randomized,
      controlled trial in which the effects of computer-based reminders were compared
      with those of two other interventions among residents in a university-based group
      practice.

PMID- 2243545
TI  - A computerized laboratory alerting system.
AB  - A computerized laboratory alerting system (CLAS) has been developed as part of an
      ongoing effort to improve the quality of care at LDS Hospital. The system
      identifies potentially life-threatening conditions on the basis of laboratory
      findings and then generates appropriate warnings and transmits them to
      clinicians. Use of the system has led to a significant increase in the proportion
      of patients in life-threatening situations who have received appropriate care
      (50.8% before implementation vs. 62.5% afterward, P less than 0.05). Among
      patients with hypokalemia, falling potassium levels, hyperkalemia, hypokalemia
      during treatment with digoxin, hyponatremia, falling sodium levels,
      hypernatremia, hypoglycemia, or hyperglycemia, the average length of time spent
      in the life-threatening situation has decreased from 30.4 to 15.7 hours (P less
      than 0.05) and the average length of stay has decreased from 14.6 to 8.8 days (P
      less than 0.05). There has been little change in the proportion of patients with
      findings indicating metabolic acidosis who have received appropriate care (32.3
      vs. 34.6%). We conclude that CLAS has an important role in patient care at our
      hospital.

PMID- 2243546
TI  - Information retrieval in medicine: state of the art.
AB  - Conventional information retrieval systems usually involve searching by terms
      from controlled vocabularies or by individual words in the text. These systems
      have been commercially successful but are limited by several problems, including
      cumbersome interfaces and inconsistency with human indexing. Research on methods
      that automate indexing and retrieval has been performed to address these
      problems. The three major types of automated systems are vector-based,
      probabilistic, and linguistic. This article describes these systems and provides
      an overview of the field of information retrieval in medicine.

PMID- 2243547
TI  - Choosing the software for an office computer.

PMID- 2243550
TI  - Different drummers: Neil Pappalardo.

PMID- 2243548
TI  - Computer-based support for clinical decision making.
AB  - Although computers are now commonly used for financial purposes in hospitals and
      physicians' offices, most physicians do not routinely use them in patient care.
      And in hospitals where laboratory data are provided on computer terminals, the
      displays are often difficult to use and programs that offer assistance in
      interpreting the data are usually unavailable. We have developed decision support
      programs that are widely used with the clinical computing system at our hospital.
      This paper describes the programs and how the clinicians use them.

PMID- 2243549
TI  - An update on the resident office management program.

PMID- 2243551
TI  - Speech recognition as a user interface.

PMID- 2243552
TI  - Oxygen therapeutics.

PMID- 2243553
TI  - Choice of cephalosporins.

PMID- 2243554
TI  - Trends in lung cancer incidence and mortality--United States, 1980-1987.
AB  - Lung cancer is the most common fatal malignant neoplasm in the United States.
      Based on current smoking patterns, the substantial public health burden of
      smoking-related lung cancer will continue during the next several decades. This
      report describes trends in lung cancer incidence from 1980 through 1986 and lung
      cancer mortality from 1980 through 1987.

PMID- 2243555
TI  - Gallstone lithotripsy--ready or not?

PMID- 2243556
TI  - Assisted reproductive technologies at the UNC hospitals. An update.

PMID- 2243558
TI  - Congenital syphilis. Resurgence of an old problem.

PMID- 2243557
TI  - The child with a tracheotomy. A review of the surgical options in airway
      reconstruction.

PMID- 2243559
TI  - Reliving the early days of neurosurgery.

PMID- 2243560
TI  - Arthritis.

PMID- 2243561
TI  - Managed care contracts. Dangerous liaisons?

PMID- 2243562
TI  - Carolina Doctors Care IPO.

PMID- 2243563
TI  - Pain clinic looks at the "single digit sign".

PMID- 2243564
TI  - Two comments on Dr. Sanders's and Dr. Nemeroff's articles on prescribing
      addictive drugs.

PMID- 2243565
TI  - Renal response to ureteral obstruction in early development.

PMID- 2243566
TI  - Beta-2-microglobulin generation rate and clearance rate in maintenance
      hemodialysis patients.
AB  - We analyzed the rebound pattern of plasma beta 2-microglobulin (beta 2-m)
      concentration from 4 h after completion of hemodiafiltration until the start of
      the next treatment according to the one-pool beta 2-m kinetic model so as to
      determine beta 2-m generation rate and whole-body beta 2-m clearance. Next, we
      obtained the whole renal beta 2-m clearance as the product of renal creatinine
      clearance and the glomerular sieving coefficient of beta 2-m. Then, extrarenal
      beta 2-m clearance was calculated as the difference between whole-body beta 2-m
      clearance and whole renal beta 2-m clearance and renal beta 2-m clearance due to
      tubular absorption was taken to be the difference between whole renal beta 2-m
      clearance and renal beta 2-m clearance due to urinary excretion. The results
      showed that the higher the patients' plasma beta 2-m concentration was, the lower
      was the whole-body beta 2-m clearance. Moreover, in the present study, an inverse
      correlation was found between the following respective factors: plasma beta 2-m
      concentration and whole renal beta 2-m clearance; plasma concentration and renal
      clearance due to tubular absorption; plasma concentration and renal clearance due
      to urinary excretion. However, there was no correlation between plasma beta 2-m
      concentration and extrarenal beta 2-m clearance. The findings indicate that the
      variation of plasma beta 2-m concentration with the individual patient is solely
      attributable to the variation in residual renal function in terms of beta 2-m
      elimination.

PMID- 2243568
TI  - Hypertensive exercise responses in ciclosporin-treated normotensive renal
      transplant recipients.
AB  - Although many patients taking ciclosporin (CS) for the long term develop
      hypertensive side effects, a proportion do not. We have studied the blood
      pressure response to graded upright bicycle exercise while continuously recording
      the metabolic rate in 18 normotensive renal transplant recipients whose mean age
      was 30.8 years (range 16-54). Nine were treated with CS alone and 9 with
      azathioprine and a steroid, prednisolone (AzS). Both groups performed a
      progressive exercise test, with work increasing by 25 W every 4 min from rest.
      All patients completed a workload of at least 75 W during the test. A group of 8
      normal subjects whose mean age was 29 years (range 19-44) were exercised with the
      same protocol. The CS group had a significantly higher mean systemic blood
      pressure at both 50 and 75 W (124 and 132 mm Hg, respectively), compared with the
      AzS group (103 and 108 mm Hg; p less than 0.01). The blood pressure response to
      exercise in the AzS group was similar to that observed in the normal group. This
      was despite a higher metabolic rate at each stage of work in the AzS group as
      compared with the CS or normal groups. Despite being normotensive at rest, renal
      transplant patients who are treated with CS have evidence of a vasopressor
      effect, with systemic vascular resistance inappropriately high for exercise,
      implying reduced compliance of the vascular bed.

PMID- 2243567
TI  - The renal hemodynamic response following a meat meal in children with chronic
      renal failure and in healthy controls.
AB  - The renal hemodynamic response to a meat meal (2 g/kg BW) was studied in 11
      healthy children and in 10 children with a mean plasma creatinine concentration
      of 2.6 +/- 0.1 mg/dl due to chronic renal failure (CRF) of various etiologies. In
      the healthy status, after a meat meal, the glomerular filtration rate (GFR)
      increased significantly from a baseline value of 119.0 +/- 5.0 to a peak of 159
      +/- 5.8 ml/min x 1.73 m2; in CRF baseline GFR averaged 49 +/- 4.0 and at peak
      76.6 +/- 7.2 ml/min x 1.73 m2 (p less than 0.005). The peak GFR response was
      reached earlier in healthy subjects than in CRF (p less than 0.05) and did not
      correlate with age or with baseline GFR. Renal plasma flow (RPF) in healthy
      controls increased from 532 +/- 32 at baseline to 646 +/- 42.9 ml/min x 1.73 m2
      after the meal (p less than 0.005). Also in CRF after a meat meal there was a
      significant increase in RPF from 278 +/- 51 to 65 +/- 66 ml/min x 1.73 m2 (p less
      than 0.005). The filtration fraction was not affected. The percent increase over
      baseline values of GFR and RPF at the peak was significantly higher in diseased
      children. Renal reserve averaged 28.1 +/- 5.3 ml/min in diseased children and
      39.7 +/- 5.2 ml/min (p less than 0.01). The data indicate that (1) a meat meal is
      a suitable method to recruit renal reserve in normal children and in children
      with chronic renal failure, and (2) the renal reserve is normal in chronic renal
      failure.

PMID- 2243569
TI  - Kidney transplantation in systemic lupus erythematosus nephritis: a one-center
      experience.
AB  - Eight patients with end-stage renal disease secondary to systemic lupus
      erythematosus (SLE) received 8 cadaveric renal allograft. Patient and graft
      survival was 100 and 87%, respectively. None of them showed extrarenal
      manifestations of SLE or recurrence of lupus nephritis after grafting. One graft
      was lost because of chronic rejection. In another patient, an episode of graft
      function deterioration due to bad control of arterial hypertension was observed.
      Three patients were transplanted during their first year on hemodialysis. Two
      women became pregnant after successful kidney transplantation; one suffered a
      spontaneous abortion and the other had a successful delivery. In neither of them,
      was SLE observed during or after pregnancy. Morbidity was low in this series, and
      infections were the most frequent complication. In summary, our experience with
      renal transplantation in SLE patients compares, favorably with the general
      nodiabetic transplanted population.

PMID- 2243570
TI  - Soluble interleukin 2 receptor and tissue polypeptide antigen serum
      concentrations in end-stage renal failure.
AB  - Serum concentrations of soluble interleukin 2 receptor (IL-2R) were measured in
      65 hemodialysis patients and compared with serum levels of beta 2-microglobulin
      and tissue polypeptide antigen (TPA). Elevated IL-2R levels, found in 85% of
      examined patients, correlated with elevated TPA serum concentrations (p less than
      0.05). Patients with high IL-2R levels were significantly younger (p less than
      0.05) than patients with low levels. Primary renal disease and residual renal
      function had no significant influence on TPA or IL-2R serum concentrations. In 16
      patients with carpal tunnel syndrome, increased serum concentrations of IL-2R (p
      less than 0.005) and TPA (p less than 0.001) were found. We conclude that a non
      specific dialysis-induced activation of epithelial and lymphoid cells rather than
      a specific immune response could explain the concomitant elevation of IL-2R and
      TPA serum concentrations in hemodialyzed patients. Patients with pronounced cell
      turnover, reflected by elevated IL-2R and TPA levels, may show an increased
      susceptibility to dialysis-associated amyloidosis.

PMID- 2243571
TI  - Uremic serum inhibits monocyte-dependent, but not interleukin-2-dependent steps
      of T cell proliferation.
AB  - We examined the influence of uremic serum on antigen receptor triggered T cell
      proliferation in dialysis patients with impaired immune function, i.e., 12
      nonresponders to hepatitis B vaccination. The dialysis patients showed a monocyte
      dysfunction and an increased responsiveness to interleukin 2 (IL-2) according to
      our previous findings. In vitro the addition of IL-2 completely reconstituted the
      defect. Uremic serum inhibited monocyte-dependent T cell proliferation of
      patients and of healthy controls. Contrary, monocyte-independent steps of T cell
      proliferation were not impaired by uremic serum. When IL-2 was added to cultures,
      the T cell proliferation in the presence of uremic serum was even enhanced. We
      conclude that uremic immunodeficiency may be enhanced by soluble factors present
      in uremic serum which inhibit monocyte-dependent steps of T cell proliferation.

PMID- 2243572
TI  - Paired filtration dialysis: optimizing depurative efficiency with separate
      convection and diffusion processes.
AB  - To overcome reciprocal interaction between convection and diffusion occurring in
      hemodiafiltration, we separated the two processes in a new dialysis technique
      called paired filtration dialysis (PFD). In this technique, convection and
      diffusion take place separately on two capillary membranes: a polysulfone
      hemofilter and a hemophan dialyzer. The depurative effectiveness of PFD with
      respect to small (blood urea nitrogen, creatinine, uric acid, phosphate) and
      large (beta 2-microglobulin) molecules was acutely assessed in 6 patients on
      maintenance acetate hemodialysis. Despite a 3-hour treatment time, a high mass
      removal of small and large solutes was found in PFD without high ultrafiltration
      rates or blood flows in excess of 300 ml/min. There was no significant difference
      in solute removal between the two different depurative sequences adopted in PFD,
      i.e., convection followed by diffusion or vice versa. A significant reduction in
      beta 2-microglobulin serum levels was observed in both PFD modes. Twenty
      patients, on a 12-month period of 3-hour PFD treatment, maintained an unaltered
      metabolic, clinical, and acid-base status, and cardiovascular stability was not
      affected. PFD thus provides excellent depurative results, along with simple
      technical features that are particularly useful in treating patients with high
      depurative needs and yet are unable to tolerate high-flux techniques.

PMID- 2243573
TI  - Effect of heparin and prostacyclin/heparin infusion on platelet aggregation in
      hemodialyzed patients.
AB  - The number of circulating platelet aggregates determined according to the method
      of Wu and Hoak and the platelet morphology revealed by scanning electron
      microscopy were investigated in 10 patients (8 males, 2 females) age 28-58 years)
      with end-stage renal failure treated by repeated hemodialysis. The examination
      was carried out twice: during a 4-hour hemodialysis session with the use of
      heparin alone and 1 week later during the course of another dialysis in the
      presence of both heparin and prostacyclin. During each dialysis session the
      platelet system was examined three times: prior to, after 90 min, and at the end
      of the procedure. As compared with the situation prior to dialysis, the number of
      platelet aggregates assessed after 90 min of dialysis and after its termination
      insignificantly rose following the treatment with heparin, but significantly fell
      after the use of the prostacyclin/heparin combination. The differences were also
      significant when the effects of both treatment types were compared. As revealed
      by scanning electron microscopy, during the course of hemodialysis with the use
      of heparin alone, the platelets showed signs of activation manifested by
      increases in number and length of cytoplasmic processes and by a tendency to
      aggregate. When both prostacyclin and heparin were used during dialysis, platelet
      activation was minimal or absent. Thus, the combined treatment with prostacyclin
      and heparin protects platelets from activation induced by their contact with
      artificial surfaces and may lower the risk of microthrombosis, making thereby
      hemodialysis safer and more effective.

PMID- 2243574
TI  - Zinc and copper metabolism in nephrotic syndrome.
AB  - The effect of proteinuria on urinary zinc and copper excretion was studied in
      children with nephrotic syndrome (NS). Clearance, fractional excretion, and
      urinary excretion of zinc and copper were significantly higher in children with
      relapse of NS than in the same children with remission of NS or in healthy
      children. A linear correlation was found between proteinuria and urinary zinc and
      copper excretion in relapse of NS. The results of this study suggest that zinc
      and copper deficiency in NS may be related also to increased urinary zinc and
      copper losses.

PMID- 2243575
TI  - Toxic acute renal failure and hepatitis after ingestion of raw carp bile.
AB  - The raw carp bile has both nephrotoxic and hepatotoxic effects which are not well
      known. Recently, we studied 13 patients who had toxic acute renal failure and
      toxic hepatitis after ingestion of raw bile of carp in 3, grass carp in 8 and
      silver carp in 2 cases. The purpose of this report is to alert physicians to this
      very rare cause of toxic acute renal failure and hepatitis. All patients
      presented initially with gastrointestinal upset after eating. These symptoms were
      followed by oliguria in 7 patients (54%), hematuria was noted in 10 (77%) and
      jaundice in 8 patients (62%). Elevation of blood urea nitrogen, creatinine and
      transaminases lasted for about 3 weeks. The severity of the symptoms depended on
      the amount of bile ingested. All the patients recovered with conservative therapy
      and hemodialysis. Biopsy of the kidney revealed findings compatible with acute
      tubular necrosis similar to that produced by other nephrotoxins. Biopsy of the
      liver revealed findings consistent with acute toxic hepatitis. Both suggest toxic
      effects of carp bile as a cause of toxic acute renal failure and hepatitis.

PMID- 2243576
TI  - Renal blood flow and glomerular filtration rate during the heterologous phase in
      passive Heymann nephritis in rats.
AB  - When passive Heymann nephritis (PHN) is induced by infusion of antibodies (anti
      Fx1A), an acute fall in renal blood flow (RBF) and glomerular filtration rate
      (GFR) has been reported. Activation of the complement cascade by the local
      antigen-antibody reaction might be involved in this reaction. We therefore
      studied RBF and GFR during acute infusion of anti-Fx1A and after 3 days when
      heterologous antibodies are no longer present in the circulation. Two groups of
      rats were infused with 2 mg anti-Fx1A antibodies into the left renal artery; RBF
      was measured by the microsphere method and GFR by 125I-Na-iothalamate clearance.
      In the first group, the measurements were made 40 min after the infusion, and in
      the second group after 3 days. A third group was studied 3 days after infusion of
      1 mg anti-Fx1A. Animals infused with normal IgG were used as controls. Forty
      minutes after infusion of 2 mg anti-Fx1A, GFR in the left kidney was reduced from
      1.16 +/- 0.07 to 0.41 +/- 0.16 ml/min/g in the controls (p less than 0.05). Three
      days after the infusion, GFR was 1.04 +/- 0.07, not significantly different from
      control. RBF was reduced to 3.97 +/- 1.11 ml/min/g after 40 min, compared to 7.53
      +/- 0.73 in controls (p less than 0.05), and was normalized after 3 days. The
      effect of 1 and 2 mg anti-Fx1A antibodies was not significantly different after 3
      days. Anti-Fx1A antibodies were detected in serum in the acute stage, but not
      after 3 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243577
TI  - Effect of drug additives to peritoneal dialysis solutions on the viability and
      function of mouse peritoneal cells.
AB  - Peritoneal dialysis (PD) solutions and therapeutic drugs frequently added to PD
      solutions in clinical practice have been shown to reduce the viability and to
      impair the function of mouse peritoneal cells. The cytotoxicity of PD solutions,
      directly related to the dextrose concentration, was more marked towards resident
      than elicited peritoneal cells. None of the drug additives, heparin and insulin
      amongst them, were cytotoxic when tested alone or combined with 4.25% PD
      solution, with the exception of phosphatidylcholine which markedly enhanced the
      cytotoxicity of the PD solution. While the function of mouse peritoneal
      macrophages as measured by their hydrogen peroxide production was largely
      unaffected by PD solutions and drug additives when tested separately, the
      combination of 4.25% PD solution with any of the drug additives resulted in
      complete abolition of macrophage respiratory burst. The results should caution
      against the indiscriminate addition of drugs to PD solutions in dialysis
      patients.

PMID- 2243578
TI  - Renal disease in a patient with hereditary complete deficiency of the fourth
      component of complement.
AB  - Hereditary complete deficiency of the fourth component of complement (C4) is an
      extremely rare disorder with 17 cases reported so far. Twelve of these patients
      suffered from a systemic-lupus-erythematosus-like illness. The patient we here
      describe presented with severe Henoch-Schonlein purpura (HSP) at the age of 17.
      Immunofluorescence of a kidney biopsy showed granular deposits of IgG, IgA, IgM,
      C3 and fibrinogen in the mesangium and segmentally along the basement membrane.
      Six years later, the patient developed hypertension and nephrotic syndrome. Renal
      function deteriorated rapidly. He was on hemodialysis for 12 months and then
      received a cadaveric kidney graft. After 2 years of uncomplicated course,
      microhematuria and proteinuria developed. Immunofluorescence of a transplant
      biopsy was virtually identical to the pattern in the patient's own kidneys. We
      thus conclude that the patient had recurrence of his primary disease in the
      graft. Three and a half years after transplantation hemodialysis had to be
      restarted. This unique case supports the current view that deficiency of
      classical pathway components predisposes to the development of immune complex
      diseases and that the complement system is activated via the alternate pathway in
      HSP. Furthermore, we assume that complete C4 deficiency was the major cause for
      the recurrence and unfavorable outcome of HSP in the graft.

PMID- 2243579
TI  - Sternoclavicular joint infection in hemodialysis patients.
AB  - Infection of the sternoclavicular joint due to Staphylococcus aureus occurred in
      2 hemodialysis patients. Good results were achieved in both cases by applying
      appropriate antibiotic therapy. Sternoclavicular joint sepsis is rare. However,
      it is often associated with underlying conditions, and hemodialysis must be
      recalled as one of the possible predisposing factors.

PMID- 2243580
TI  - Chronic nephritis, sensorineural deafness, growth and developmental retardation,
      hyperkinesis, and cleft soft palate in a 5-year-old boy. A new combination?
AB  - A 5-year-old Japanese boy showed nephritis similar to, but distinct from, that in
      Alport syndrome. Nephrotic syndrome without hematuria was noticed at age 2,
      although renal biopsy at age 4 revealed widespread irregular thickening of the
      glomerular basement membrane with splitting of the lamina densa on electron
      microscopy, characteristic of nephritis in Alport syndrome. Sensorineural
      deafness was noticed at age 4 weeks by no auditory brain stem response, unusually
      early for Alport syndrome. Goodpasture antigen and amyloid P component were found
      in the glomerular basement membrane. Thus, the antigenicity of the glomerular
      basement membrane was different from that in male patients with X-linked Alport
      syndrome. In addition, growth and developmental retardation, hyperkinesis, and
      cleft soft palate were seen. These features are a hitherto undescribed
      combination. The family history was negative for any of the features of the boy.

PMID- 2243581
TI  - Different answer to recombinant human erythropoietin in anephric and non-anephric
      haemodialyzed patients.

PMID- 2243582
TI  - Increased activity of the autonomic nervous system and increased sensitivity to
      angiotensin II infusion after therapy with recombinant human erythropoietin.

PMID- 2243583
TI  - Hydrocephalus associated with malignant hypertension and renal failure.

PMID- 2243584
TI  - Reactivation of hepatitis B virus by corticosteroids in a case of idiopathic
      nephrotic syndrome.

PMID- 2243585
TI  - Weight reduction in massive obesity associated with focal segmental
      glomerulosclerosis: another evidence for hyperfiltration?

PMID- 2243586
TI  - Mechanism of hemodialysis-associated subclavian vein stenosis.

PMID- 2243587
TI  - Effects of visual deprivation on the postnatal development of the
      geniculocortical projection in kittens.
AB  - In kittens reared with either monocular, binocular or reverse suture, beginning
      before the physiological eyelid opening (around one week of age) and lasting
      until after one month, the cortical laminar distribution of geniculocortical
      afferents to area 17 was examined by using orthograde transport of wheat germ
      agglutinin conjugated with horseradish peroxidase, and compared with that in
      normal kittens. In normal kittens, at birth, the afferents were distributed most
      densely in layer I and, to a lesser extent, widely from the upper part of layer
      II to layers V or VI. After one month, the afferents were found mainly in and
      around layer IV and very sparsely in layer I. Neither binocular nor monocular
      suture affected this normal development. In contrast, when the present procedure
      of monocular suture had been followed by opening the sutured lid and suturing the
      other lid (reverse suture) for one week, the distribution was altered. The
      density of the afferents in layer I was increased while the labelled terminals in
      deeper layers were as segregated in and around layer IV as observed in normal
      kittens. Such increase in density of the afferents resulted only when the
      injected tracer covered the medial or intermediate part of the C complex of the
      lateral geniculate nucleus. To confirm these findings, geniculate neurons
      retrogradely labelled by horseradish peroxidase injections into layer 1 of area
      17 were examined in normal and reverse-sutured kittens. In both kinds of kittens,
      the labelled neurons were dense in the C complex, and absent or sparse in the A
      laminae. But, the number was higher in reverse-sutured kittens. These results
      suggest an involvement of geniculocortical layer I projections in reorganization
      of neuronal circuits in the visual cortex.

PMID- 2243589
TI  - Ionic dependencies of tetrodotoxin-resistant action potentials in trigeminal root
      ganglion neurons.
AB  - Action potentials recorded in vitro from the perikarya of trigeminal root
      ganglion neurons (guinea-pig) were examined for their sensitivities to blockers
      of specific ion channels or to removal of certain ionic species in the bathing
      media. The majority (approximately 65%) of the 137 neurons exhibited action
      potentials following application of the Na(+)-channel blocker, tetrodotoxin. This
      group of neurons was selected for further investigation under conditions of
      extracellular K(+)-channel blockade with tetraethylammonium and 4-aminopyridine.
      Long-duration action potentials consisting of two distinct components could be
      evoked under such conditions. The fast component of the spike was abolished in
      Na(+)-deficient perfusion media and was sensitive to blockade by extracellular
      lidocaine or intracellular QX-222 applications. It is likely that the slow
      component was mediated mainly by Ca2+, but in Ca2(+)-deficient media. Mg2(+)
      influx may have contributed to the small voltage response. The amplitude and
      shape of the slow component was unaffected by applications of lidocaine or QX
      222. Self-sustained repetitive firing was also observed in 11 neurons in the
      above conditions. This activity persisted even under conditions of severe
      deficiencies in extracellular [Ca2+] or [Na+]. Two distinct but overlapping K(+)
      conductances that were sensitive to blockade by internal Cs(+)-application and
      insensitive to applications of tetraethylammonium and 4-aminopyridine, appear to
      mediate the afterhyperpolarization of the long-duration spike. One portion of the
      afterhyperpolarization was 60-150 ms in duration and was unaffected by removal of
      Ca2+ from the extracellular media, while the other had a time-course lasting 150
      250 ms and was abolished by removal of external Ca2+. In some neurons, these K(+)
      conductances were blocked by high doses of doxorubicin or cisplatin. The results
      show that at least two ion species (Na+ and Ca2+) contribute to the formation of
      the tetrodotoxin-resistant, long-duration action potential in trigeminal root
      ganglion neurons during selective K(+)-conductance blockade and also provide
      evidence for Mg2+ involvement in the generation of this voltage response.

PMID- 2243590
TI  - Effects of microdialysis on brain metabolism in normal and seizure states.
AB  - The effect of intracranial microdialysis on brain glucose metabolism in control
      and kainic acid-treated rats was assessed by semi-quantitative [14C]2
      deoxyglucose autoradiography. A dialysis fiber loop was implanted into the
      piriform cortex or a horizontal Vita fiber into the hippocampus, and 24 h later,
      fibers were perfused with Krebs-Ringer bicarbonate solution before and after
      injection of kainic acid (16 mg/kg, i.p.) [14C]2-Deoxyglucose was injected i.p. 3
      h after the injection of kainic acid. Rats injected with kainic acid were
      initially lethargic and then proceeded through behavioral phases of staring, "wet
      dog shakes", Straub tail, rearing, forepaw clonus, and, in some cases, tonic
      clonic convulsions. Three hours after kainic acid, the fiber presence in the
      piriform cortex enhanced kainic acid-induced metabolic activity in areas adjacent
      to the fiber assembly, whereas the fiber in hippocampus attenuated kainic acid
      induced metabolic activity in areas adjacent to the fiber assembly. The results
      indicate that intracranial microdialysis alters the already abnormal brain
      metabolism in a kainic acid-induced seizure state, but has no significant effect
      in the non-seizure control state.

PMID- 2243588
TI  - Dopamine high-affinity transport site topography in rat brain: major differences
      between dorsal and ventral striatum.
AB  - Investigations were conducted to determine the topography of the high-affinity
      dopamine uptake process within the rat striatum. [3H]Dopamine uptake into crude
      synaptosomes prepared from micropunch samples was found to be two- to three-fold
      higher in dorsal caudate-putamen relative to nucleus accumbens septi. In
      contrast, the concentrations of dopamine in the two regions were equivalent. The
      recognition site associated with high-affinity dopamine uptake was labeled using
      [3H]mazindol, and the binding of this ligand was also found to be two- to three
      fold higher in homogenates from dorsal caudate-putamen samples relative to
      nucleus accumbens septi. Regional differences in uptake of [3H]dopamine or
      binding of [3H]mazindol were shown to be due to variations in Vmax or Bmax, not
      to differences in apparent affinity. Autoradiography of [3H]mazindol binding in
      rat striatum revealed a decreasing density of the site along the dorsal-to
      ventral axis, with the highest binding occurring in the dorsolateral caudate
      putamen, lower binding in the ventral caudate-putamen, and lowest levels in the
      septal pole of the nucleus accumbens septi. Quantification showed that the extent
      of this gradient was two-fold. Further autoradiographic studies revealed less
      striatal heterogeneity in the pattern of binding of [3H]ketanserin, another
      radioligand associated with the striatal dopaminergic innervation but not linked
      to the dopamine uptake process of the plasma membrane. The findings suggest that
      the dopaminergic fibers of the ventral striatum, especially the medial nucleus
      accumbens septi, may be relatively lacking in their capacity for dopamine uptake
      following its release. This organization may result in regional differences in
      the time-course of of extraneuronal dopamine following transmitter release and
      may render the dopamine-containing terminals of the ventral striatum less
      susceptible to the degenerative influences of neurotoxins that are incorporated
      by the high-affinity dopamine uptake process.

PMID- 2243591
TI  - Distribution of glutamate decarboxylase-containing neurons in rabbit medulla
      oblongata with attention to intramedullary and spinal projections.
AB  - Functional studies in the rabbit suggest that GABA is an important inhibitory
      neurotransmitter in the control of cardiovascular, respiratory and neuroendocrine
      functions by the medulla oblongata. The present work was undertaken to provide a
      description of the distribution in the rabbit medulla of neurons containing
      glutamate decarboxylase, an enzyme present in GABA-synthesizing neurons. Combined
      retrograde axonal transport and immunohistochemical studies were carried out to
      determine intramedullary and spinal projections of immunopositive neurons located
      in regions particularly relevant to the interpretation of functional studies.
      Neurons containing glutamate decarboxylase, putatively GABA-containing neurons,
      were found in all nuclei of the rabbit medulla with the exception of somatic
      cranial nerve nuclei and the lateral reticular nucleus. The immunopositive cells
      were distributed throughout individual nuclei and their morphological appearance
      was similar to that of neighbouring immunonegative neurons in the nucleus. An
      exception was encountered in the dorsal motor nucleus of the vagus where the
      glutamate decarboxylase-containing neurons belong to a population of small
      neurons easily distinguished from the larger vagal preganglionic cells. Many
      immunopositive cells in the raphe nuclei, in the medial reticular formation and
      in the vestibular nuclei have axonal projections to the spinal cord and
      presumably represent sources of inhibitory bulbospinal control. Within the
      medulla there were glutamate decarboxylase-containing neurons in the nucleus
      tractus solitarius with projections to caudal but not to rostral regions of the
      ventrolateral medulla. These neurons could provide a GABAergic input to
      respiratory, cardiovascular and neuroendocrine neurons in the caudal
      ventrolateral medulla. Immunopositive cells projecting from the caudal to the
      rostral ventrolateral medulla could form part of the population of inhibitory
      vasomotor neurons known to be present in the caudal ventrolateral medulla. Some
      glutamate decarboxylase-containing neurons just medial to the nucleus ambiguous
      in the rostral medulla, in the region containing the Botzinger group, project to
      the caudal ventrolateral medulla and could therefore provide an inhibitory input
      to caudal respiratory cells.

PMID- 2243592
TI  - A pontine call site in the domestic cat: behavior and neural pathways.
AB  - Electrical stimulation of the brain of the domestic cat elicited vocalizations
      from a site in the ventrolateral pons in the region of the medial lemniscus. The
      evoked vocalizations were analysed by means of sound spectrographs and classified
      as meows, growls, hisses and meow-growls. The neural pathways associated with
      these call sites were traced by following the pattern of fiber degeneration
      resulting from lesions placed at these sites. A descending fiber pathway was
      traced to the magnocellular tegmental field, the facial nucleus and the
      retrofacial nucleus, while an ascending system terminated in the zona incerta,
      the red nucleus, contralateral oculomotor nucleus, the ventroposterior lateral
      nucleus of the thalamus and inferior colliculus. It is concluded from these
      findings and the nature of the behavior evoked that the ventrolateral pontine
      call site lies on common pathway for a majority of vocalizations in the cat.

PMID- 2243593
TI  - Regulation of the post-translational conjugation of amino acids to rat brain
      proteins.
AB  - Post-translational conjugation of arginine (but not other amino acids) to
      proteins has been reported to occur in a high speed supernatant fraction of rat
      brain homogenates from which molecules of less than 5000 mol. wt have been
      removed. In the present study we report that removal of molecules of less than
      1000 mol. wt by dialysis, does not result in incorporation of arginine into
      protein in amounts significantly different than in the undialysed supernatant.
      The addition of molecules with molecular weights greater than 1000 and less than
      5000 to the active fraction, inhibits the incorporation of arginine into proteins
      in a concentration dependent manner suggesting that the post-translational
      incorporation of arginine into brain is regulated by a molecule(s) of greater
      than 1000 and less than 5000 mol. wt. Incorporation of lysine into proteins did
      not occur following removal of molecules of less than 5000 mol. wt, but did occur
      in the void volume fraction of a Sephacryl S-200 column (molecular weight cut-off
      125,000), suggesting that the incorporation of lysine into proteins is regulated
      by molecules retained by the S-200 column but greater than 5000 mol. wt. When
      experiments were repeated using the void volume of a Sephacryl S-300 column
      (molecular weight exclusion, approximately 200 k), leucine and proline were
      incorporated in amounts similar to arginine and lysine and serine, alanine,
      valine, phenylalanine and histidine were incorporated at lower but measurable
      levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243594
TI  - Opioid antagonist (naltrexone) stimulation of cell proliferation in human and
      animal neuroblastoma and human fibrosarcoma cells in culture.
AB  - Endogenous opioids play a role in carcinogenic events by serving as inhibitory
      growth factors that alter cell proliferative events by interaction with opioid
      receptors. The present study addresses the question of whether endogenous opioid
      systems function tonically in tissue culture. Using S20Y neuroblastoma, a cell
      line that produces a growth-related opioid peptide (i.e.[Met5]enkephalin) and
      contains the zeta receptor known to be associated with growth, the effects of
      opioid receptor blockade by naltrexone, a potent opioid antagonist, was examined.
      Drug concentrations of 10(-4) to 10(-8) M naltrexone stimulated cell
      proliferation, with 32-86% more cells found in the naltrexone groups than control
      from 12 to 48 h after initiating drug exposure; drug concentrations of 10(-9) to
      10(-13) M had no effect on growth. Evaluation of labeling and mitotic indices
      revealed that both DNA synthesis and mitosis were increased by naltrexone, as
      were the number of cells with process lengths greater than 40 microns. Naltrexone
      (10(-6) M) also stimulated the growth of N115 murine neuroblastoma, SK-N-MC human
      neuroblastoma, and HT-1080 human fibrosarcoma. These results indicate that
      endogenous opioids function in vitro to regulate growth by inhibitory mechanisms,
      and do so actively. This autocrine mechanism in tissue culture also occurs in
      other animal neuroblastoma cell lines, as well as for human neuroblastoma and
      fibrosarcoma cell lines.

PMID- 2243595
TI  - Modifications of the responses of barrel field neurons to vibrissal stimulation
      during theta in the awake and undrugged rat.
AB  - In partially restrained but awake and undrugged rats, excitatory unit responses
      of the somatic cortex barrel field to vibrissal stimulation, were recorded in two
      conditions: during spontaneous episodes of theta and in the absence of this
      rhythm. Two main variables were considered: a signal-to-noise ratio and an index
      of the "afferent inhibition". Both measures were extracted from peristimulus time
      histograms. "Theta effects" were characterized by an increase in signal-to-noise
      ratio and afferent inhibition. They were most important in neurons located in
      infragranular layers of the cortex; they went in the same direction but only
      approached significance in supragranular neurons; neurons of the granular layer
      were not affected. Spontaneous unit activity and latencies were not modified in
      any group. These data were obtained during a preliminary step of a sensory
      sensory conditioning procedure which in some cases modified the receptive field
      of the neurons. Theta effects were less marked in future "conditioned" than in
      future non-conditioned neurons but this was probably due to the fact that
      conditioned neurons had significantly higher signal-to-noise ratio and afferent
      inhibition. The origin of these "theta effects", hippocampal versus non
      hippocampal, and their functional significance, relation to selective attention,
      are discussed.

PMID- 2243596
TI  - Separate finger representations at the human second somatosensory cortex.
AB  - We recorded neuromagnetic responses of the second somatosensory cortex in healthy
      humans. Cutaneous electrical stimulation of fingers elicited a response around
      100 ms, with a field pattern agreeing with activation of the second somatosensory
      cortex in the upper bank of the Sylvian fissure. In an oddball paradigm, with
      standards presented to the thumb and deviants (10%) to the middle finger, or vice
      versa, the second somatosensory cortex responses to deviants were almost three
      times as high in amplitude as those to standards. A similar amplitude enhancement
      was obtained when the deviants were presented in the absence of the intervening
      standards but with the same interstimulus interval. The results indicate that an
      accurate functional representation of different body areas is maintained at the
      human second somatosensory cortex.

PMID- 2243597
TI  - Biosynthesis and expression of ependymin homologous sequences in zebrafish brain.
AB  - Ependymins are unique, brain specific glycoproteins, which are major constituents
      of the cerebrospinal fluid. Originally, they were discovered in goldfish and are
      thought to be involved in synaptic plasticity. In the present study two
      transcripts were characterized in Brachydanio rerio originating from a single
      gene possibly by alternative splicing. These transcripts differ only in the
      length of their 3'-non-coding-regions and the encoded protein shares 90 and 88%
      homology with the two corresponding goldfish proteins, respectively. In situ
      hybridization revealed the expression of ependymins exclusively in the
      leptomeninx including its invaginations but not at all in the ependymal layer
      surrounding the ventricles. An initial developmental profile showed that
      ependymins first appear before hatching, i.e. between 48 and 72 h
      postfertilization.

PMID- 2243598
TI  - "On-line" measurement of acetylcholinesterase release from the substantia nigra
      of the freely-moving guinea-pig.
AB  - Acetylcholinesterase is released from dopaminergic cells within the substantia
      nigra. The functional significance of this phenomenon has been studied in the
      freely-moving animal by a novel system for measuring acetylcholinesterase release
      from the substantia nigra "on-line" and in vivo. In the unanaesthetized guinea
      pig the amount of acetylcholinesterase released was significantly greater than
      during anaesthesia, and release occurred in a more pulsatile manner. In addition,
      release of acetylcholinesterase could be evoked by either pharmacological or
      physiological manipulations, i.e. (1) a depolarizing concentration of potassium
      ions administered locally; (2) metamphetamine, administered systematically, which
      also resulted in increased locomotor activity; (3) drinking behaviour, elicited
      by presentation of a water bottle. Although all three treatments were accompanied
      by an increase in acetylcholinesterase release within the substantia nigra,
      potassium-evoked release did not cause any detectable change in behaviour. It is
      therefore suggested that release of the protein acetylcholinesterase within the
      substantia nigra is not necessarily a direct cause of locomotor activity: rather,
      it reflects diverse sensorimotor events.

PMID- 2243599
TI  - Afferents to the median raphe nucleus of the rat: retrograde cholera toxin and
      wheat germ conjugated horseradish peroxidase tracing, and selective D
      [3H]aspartate labelling of possible excitatory amino acid inputs.
AB  - Afferents to the median-paramedian raphe nuclear complex, which contains the B8
      serotonergic cell group, were investigated in the rat with neuroanatomical and
      transmitter-selective retrograde labelling techniques. Injection of sensitive
      retrograde tracers, cholera toxin genoid or wheat germ agglutinin conjugated
      horseradish peroxidase into the median raphe resulted in labelling of neurons in
      a large number of brain regions. Projections from 26 of these regions are
      supported by available orthograde tracing data; the cingulate cortex, bed nucleus
      of stria terminalis, medial septum and diagonal band of Broca, ventral pallidum,
      medial and lateral preoptic areas, lateral hypothalamus, dorsomedial nucleus of
      hypothalamus, lateral habenula, interpeduncular nucleus, substantia nigra,
      central (periaqueductal) gray, and laterodorsal tegmental nucleus seem to
      represent major sources of afferents to the median-paramedian raphe complex.
      Retrogradely labelled cells were also observed in a number of regions for which
      anterograde tracing data are not available, including the perifornical
      hypothalamic nucleus, ventral premammillary nucleus, supramammillary and
      submammillothalamic nuclei and the B9 area. Possible excitatory amino acid
      afferents were identified with retrograde D-[3H]aspartate labelling.
      Microinjection of D-[3H]aspartate at a low concentration, 10(-4) M in 50 nl,
      resulted in retrograde labelling of a limited number of median raphe afferents.
      The most prominent labelling was observed in the lateral habenula and the
      interpeduncular nucleus, but retrogradely labelled cells were also noted in the
      medial and lateral preoptic areas, lateral and dorsal hypothalamus, ventral
      tegmental area, laterodorsal tegmental nucleus, medial parabrachial nucleus, and
      the pontine tegmentum. After injections of 10(-3) M D-[3H]aspartate selective
      labelling also appeared in more distant afferent regions, including cells in
      cingulate cortex, and in some regions located at shorter distances, such as the
      supramammillary nucleus. Injections of D-[3H]aspartate at high concentration, 10(
      2) M, resulted in the appearance of weakly to moderately labelled cells in most
      afferent areas which were devoid of labelled cells after injections of lower
      concentrations, suggesting that this labelling may be non-specific. It was
      concluded that the median-paramedian raphe receives afferents from a large number
      of forebrain and hypothalamic regions, while relatively few brain stem regions
      project to this nuclear complex. The selectivity of retrograde labelling with D
      [3H]aspartate was found to be concentration dependent, and it is suggested that
      the connections showing high affinity for D-[3H]aspartate may use excitatory
      amino acids as transmitters. Excitatory amino acid inputs from lateral habenula
      and interpeduncular nucleus may play predominant roles in the control of
      ascending serotonergic and non-serotonergic projections originating in the median
      and paramedian raphe nuclei.

PMID- 2243600
TI  - Peripheral innervation of Opsanus tao (oyster toadfish).
AB  - Dual innervation, two morphologically distinct axons ending on the same endplate
      of white muscle, has been observed in some 'primitive' fish but not 'higher'
      teleosts. A representative of the order Bachtrachoidiformes, Opsanus tao, was
      examined using histological sectioning and silver impregnation to determine the
      innervation of its white muscle. The results demonstrate for the first time, dual
      innervation in the distributed pattern (innervation along the entire length of
      the white muscle fibers) in a 'higher' teleost. This indicates that Opsanus tao
      may represent a species of 'higher' teleosts that has either retained its
      ancestral mode of innervation (dual innervation) while exhibiting the derived
      distributed pattern or convergently evolved mode and pattern of innervation.

PMID- 2243601
TI  - Electron microscopic immunogold cytochemistry reveals chromogranin A confined to
      secretory granules of porcine Merkel cells.
AB  - By ultrastructural immunohistochemistry using the immunogold technique,
      immunoreactive (ir) Chromogranin A (CGA) was found to be confined to the
      secretory vesicles of porcine Merkel cells. CGA was present predominantly in the
      periphery of the electron-dense core and on the clear halo. These findings
      indicate that CGA is a regular constituent of Merkel cell secretory granules but
      probably not exclusively responsible for their electron opacity.

PMID- 2243602
TI  - Modification of olfactory bulb synaptic inhibition by early unilateral olfactory
      deprivation.
AB  - Early unilateral olfactory deprivation produces large structural and
      neurochemical changes in the olfactory bulb, the first central relay for
      olfactory information. The functioning of deprived bulbs was examined in the
      present report by using paired-pulse stimulation of the lateral olfactory tract.
      Paired-pulse stimulation reflects interactions between mitral/tufted cells and
      granule cells, as well as the modulatory effects of centrifugal and intra-bulbar
      association fibers. Paired-pulse stimulation produced inhibition of mitral/tufted
      cells in control animals at PN20-PN22. This inhibition was significantly enhanced
      in littermates deprived of olfactory input from PN1 to PN20-PN22. Suppression of
      mitral/tufted cell single-unit spontaneous activity following single-pulse
      stimulation of the lateral olfactory tract (LOT) was similarly enhanced in
      deprived bulbs. These results suggest that early olfactory deprivation
      significantly modifies subsequent olfactory system function.

PMID- 2243603
TI  - Basal dendrites are a regular feature of hippocampal granule cells in flying fox
      hippocampus.
AB  - The morphology of hippocampal granule cells was studied in two species of
      megachiropteran bats. In general the morphological appearance of megabat granule
      cells corresponded to that of other mammals. However, with respect to the regular
      presence of basal dendrites the majority of granule cells resembled their
      counterparts in primates, but differed from rodents and carnivores where basal
      dendrites are absent in adults. Due to the laminar segregation of hippocampal
      afferents basal dendrites are presumed to be functionally significant by
      receiving synaptic input from projections to the hilar region.

PMID- 2243604
TI  - Serotonin-synthesizing nerve fibers in rat and cat cerebral arteries and
      arterioles: immunohistochemistry of tryptophan-5-hydroxylase.
AB  - Nerve fibers synthesizing 5-hydroxytryptamine (5-HT or serotonin) were
      demonstrated in rat and cat cerebral blood vessels by immunohistochemical
      localization of the rate-limiting enzyme catalyzing the biosynthesis of 5-HT,
      namely tryptophan-5-hydroxylase (TPOH). TPOH-immunoreactive fibers were present
      in all parts of the circle of Willis with a somewhat less intense distribution in
      the vertebro-basilar segment. Single, small nerve fibers intermingled around the
      vessel wall were found in both species but clear TPOH-immunoreactive varicosities
      were observed predominantly in the rat. The most striking observation was the
      dense network of TPOH-positive fibers innervating some but not all small pial
      arteries, and, to a lesser extent, pial arterioles. These results provide the
      evidence that, at least in these species, the cerebrovascular bed is innervated
      by authentic serotonergic fibers which can synthesize their own 5-HT.

PMID- 2243606
TI  - A four-day period of bimodality auditory and visual experience is sufficient to
      permit normal emergence of the map of auditory space in the guinea pig superior
      colliculus.
AB  - Previous work has shown that if guinea pigs are deprived of simultaneous visual
      and auditory experience during a 4-day period 26-30 days after birth (DAB), this
      prevents the normal emergence of an auditory space map in the superior
      colliculus. The present work reports that if this 4-day period is the only
      developmental period in which the animals have simultaneous bimodality
      experience, the auditory space map appears at the normal time. Apart from this
      time-window animals were deprived of either visual experience (by dark-rearing)
      or of normal auditory experience (by rearing in an environment of omnidirectional
      masking noise). We conclude that the period 26-30 DAB is a crucial developmental
      period during which coincident auditory and visual experience is utilized in the
      initial formation of the collicular map of auditory space.

PMID- 2243605
TI  - Bis-oxonol experiment on plasma membrane potentials of bovine adrenal chromaffin
      cells: depolarizing stimuli and their possible interaction.
AB  - Changes of plasma membrane potential of isolated bovine adrenal chromaffin cells
      were monitored by fluorescent probe, bis-[1,3-diethyl
      thiobarbiturate]trimethineoxonol (bis-oxonol), which responds to depolarization,
      resulting in increase of its fluorescence. Excess K+, gramicidin D, veratridine
      and ouabain all increased bis-oxonol fluorescence. Cells challenged with
      acetylcholine (ACh) or gamma-aminobutyric acid (GABA) produced a steady-state
      increase of bis-oxonol fluorescence, reflecting that averaged depolarization
      occurred continuously. Both effects were dependent on concentration with similar
      range, and mediated via nicotinic ACh receptor and GABAA receptor, respectively.
      Application of GABA with ACh or veratridine not only simultaneously but also
      pretreatedly caused an additive increment of bis-oxonol fluorescence. These
      results suggest that chromaffin cells in vitro reveal an additively enhanced
      change of plasma membrane potential in response to the combination of
      depolarizing stimuli.

PMID- 2243607
TI  - Ascorbic acid: a useful reductant to avoid oxidation of catecholamines in
      electrophysiological experiments in vitro?
AB  - The actions of the reductant ascorbic acid on rat neocortical neurons in vitro
      was investigated by means of intracellular recordings. At a concentration (500
      microM), which reduced the magnitude of dopamine degradation in oxygen-saturated
      saline solutions by about 50%, ascorbic acid reversibly depressed synaptic
      potentials and enhanced direct excitability of cortical neurons. The latter
      effect was not reversible within the observation period. Ascorbic acid did not
      alter membrane potential and input resistance of the neurons. On the basis of our
      results we conclude that ascorbic acid is not a useful reductant to avoid
      oxidation of catecholamines in oxygen-saturated solutions used in
      electrophysiological experiments in vitro.

PMID- 2243608
TI  - Depressant effect of raphe stimulation on inspiratory activity of the hypoglossal
      nerve: in vitro study in the newborn rat.
AB  - Respiratory activity was recorded from the hypoglossal nerve and cervical ventral
      roots of the superfused isolated brainstem and spinal cord of the newborn rat in
      order to investigate the effects of serotonin (5-HT). Three experimental
      procedures were used: (i) brainstem superfusion by exogenous 5-HT (previously
      reported), (ii) electrical stimulation of pontine midline structures, and (iii)
      pressure microejection of L-glutamate at the same sites. Each of the experimental
      procedure increased respiratory frequency and depressed the amplitude of the
      discharge of the hypoglossal nerve more than that of the cervical roots. These
      results indicate that 5-HT acts centrally to modulate the activity of the
      respiratory generator and inhibits the hypoglossal activity. A possible
      involvement of 5-HT mediated inhibition in obstructive apnea is discussed.

PMID- 2243609
TI  - Morphological and electrophysiological properties of C-cells in bullfrog dorsal
      root ganglia.
AB  - Dissociated bullfrog dorsal root ganglion cells were voltage-clamped in the whole
      cell configuration. Small spheroidal C-cells had a mean diameter of 14-30 microns
      and shared about 10% of the total population of the cells. The C-cells were
      characterized by a prominent calcium-activated potassium current underlying a
      hyperpolarization following the action potential. In contrast, a
      hyperpolarization-activated cationic inward rectifier was missing in all C-cells
      tested. These properties were completely different from those which have been
      observed for large spheroidal A-cells.

PMID- 2243610
TI  - Diurnal rhythms of immunoreactive melatonin in the aqueous humor and serum of
      male pigmented rabbits.
AB  - Using specific radioimmunoassays, melatonin was quantified in the aqueous humor
      and serum of male pigmented rabbits adapted to 12L:12D with lights on at 06.00 h.
      Melatonin concentrations in the aqueous humor at 08.00 and 16.00 h were similar
      (mean: 5.23 pg/ml) and significantly lower than those at 22.00 and 01.00 h (mean:
      22.06 pg/ml). A parallel rhythm was also demonstrated in the serum with higher
      melatonin concentrations (daytime mean: 75.26 pg/ml; nighttime mean: 168.94
      pg/ml). We propose that the aqueous melatonin rhythm is associated with the
      rhythmic change in aqueous flow.

PMID- 2243612
TI  - Histamine H1-receptor-like binding sites in the locust nervous tissue.
AB  - The histamine H1-receptor-like binding sites in the nervous tissue of the locust
      Locusta migratoria were investigated with a conventional radio-receptor assay
      using [3H]mianserin as the radio ligand. Binding of [3H]mianserin to the binding
      site is sensitive to proteases and heat treatment. It shows the characteristics
      of ligand-receptor interactions. The single binding site has high affinity for
      mianserin (KD = 7.05 nM) and is present in high concentrations (Bmax = 1.53
      pmol/mg) in the whole nervous tissue. All tested antihistamines have a high
      affinity for the binding site, which suggests that it represents an insect
      histamine receptor. Nevertheless, it shows its peculiarities distinguishing it
      from vertebrate histamine H1-receptors.

PMID- 2243611
TI  - Protection from cerebral ischemic injury in gerbils with the spin trap agent N
      tert-butyl-alpha-phenylnitrone (PBN).
AB  - N-Tert-butyl-alpha-phenylnitrone (PBN), a spin trap agent, reduced ischemic
      hippocampal damage and the associated locomotor hyperactivity in Mongolian
      gerbils. Cerebral ischemia was induced in unanesthetized gerbils by a bilateral 5
      min occlusion of the carotid arteries. PBN (100 mg/kg, i.p.) administered 30 min
      prior to carotid occlusion, prevented the increase in locomotor activity observed
      in saline-injected ischemic animals and significantly reduced damage to the
      hippocampal CAI pyramidal cell layer observed 5 days post-ischemia. These
      findings support the hypothesis of an involvement of reactive free radicals as a
      significant cause of ischemia-reperfusion-induced cerebral injury and suggest
      that PBN may be a useful agent for the prevention of cerebral ischemic damage.

PMID- 2243614
TI  - Muscarinic receptors mediate direct inhibition of GABA release from rat striatal
      nerve terminals.
AB  - The effects of acetylcholine (ACh) on the depolarization-evoked release of
      [3H]gamma-aminobutyric acid ([3H]GABA) have been investigated using synaptosomes
      prepared from rat corpus striatum and depolarized by superfusion with 9 mM KCl.
      Acetylcholine inhibited the [3H]GABA overflow in a concentration-dependent
      manner. The maximal effect was about 50%. The IC50 value (concentration producing
      half-maximal effect) amounted to 1 microM, in the absence of acetylcholinesterase
      inhibitors. The effect of ACh on the K(+)-evoked [3H]GABA release was
      counteracted by the muscarinic receptor antagonist atropine, but not by the
      nicotinic receptor antagonist mecamylamine or by the selective M1 antagonist
      pirenzepine. The data show that muscarinic receptors with low affinity for
      pirenzepine are localized on GABAergic nerve endings in rat corpus striatum where
      they may directly inhibit the release of GABA.

PMID- 2243613
TI  - Neural influence on the action of insulin in the adrenomedullary catecholamine
      content in the pigeon.
AB  - Insulin-induced (4 IU/100 g b.wt.) changes of adrenomedullary catecholamines (CA)
      were investigated in unilaterally splanchnic denervated pigeons 0.5, 4, 12, 24,
      72, 144 and 216 h after injection. Insulin caused depletion of more
      norepinephrine (NE) from the denervated glands 0.5 h after treatment. This
      indicates that the splanchnic nerve prevents early phase of insulin-induced
      depletion of NE. Accelerated resynthesis of NE exceeding the control value was
      more in the innervated glands 24 h after administration. Insulin brought about
      augmented synthesis of epinephrine (E) surpassing the control value in the
      innervated glands 72 h after treatment. The findings point out that the
      splanchnic nerve stimulates resynthesis of NE and synthesis of E induced by
      insulin.

PMID- 2243615
TI  - The effect of acetylcholinesterase inhibition on the release of acetylcholine
      from the striatum in vivo: interaction with autoreceptor responses.
AB  - The release of acetylcholine from the rat striatum is under inhibitory control of
      muscarinic autoreceptors. Since in vivo release studies are generally performed
      in the presence of an acetylcholinesterase inhibitor, modifications of responses
      to muscarinic receptor agonists and antagonists may be expected. In this study we
      show that the addition of 0.1 microM neostigmine bromide to the perfusion Ringer
      in a dialysis experiment attenuates the responses obtained by infusion of 100
      microM oxotremorine and potentiates the effect of infusion of 1 microM atropine.
      Furthermore it is shown that under physiological conditions the muscarinic
      autoreceptors are not fully occupied, since infusion of 1 microM atropine did not
      affect the release of acetylcholine when no acetylcholinesterase inhibitor was
      added to the perfusion Ringer.

PMID- 2243616
TI  - Age-related changes in the uptake of calcium channel blockers by brain capillary
      endothelial cells and synaptosomal fractions.
AB  - The effects of aging on the uptake of calcium channel blockers through brain
      capillaries to brain parenchyma were investigated. Two different piperazine
      derivatives, flunarizine and 1-[bis(fluorophenyl)-methyl]-4-(2,3,4
      trimethoxybenzyl)piperazine (abbreviated as KB-2796), were orally administered to
      young and aged rats. The concentrations of the blockers in plasma, endothelial
      cells of the brain capillaries and synaptosomal fractions of the three brain
      regions were determined by high-performance liquid chromatography. Flunarizine
      was more incorporated into brain tissues than KB-2796 in both young and aged
      rats. The uptake efficiency of KB-2796 from the circulation to the brain
      decreased more remarkably than that of flunarizine in aged rats. The partition
      coefficients between n-octanol and water indicated that KB-2796 was less
      hydrophobic than flunarizine. These results suggest that the uptake of the
      chemicals seems to be influenced by their hydrophobicity and the age of animals
      given.

PMID- 2243617
TI  - Inhibition of human brain aromatic L-amino acid decarboxylase by cooked food
      derived 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2) and other heterocyclic
      amines.
AB  - A carcinogenic, food-derived heterocyclic amine, 3-amino-1-methyl-5H-pyrido[4,3
      b]indole (Trp-P-2), was found to inhibit aromatic L-amino acid decarboxylase
      isolated from human brainstem. Trp-P-2 inhibited the enzyme activity toward L
      DOPA more markedly than that toward 5-hydroxytryptophan. The inhibition was
      competitive to a cofactor of the enzyme, pyridoxal-5-phosphate, and the Ki value
      of Trp-P-2 was 163 microM. The enzyme activity could be fully recovered after
      removal of Trp-P-2 by gel filtration, which indicates that the inhibition was
      reversible. Among a series of heterocyclic amines examined for their effects on
      the activity toward L-DOPA, Trp-P-2 was the most potent inhibitor, followed by 2
      amino-1-methyl-6-phenylimidazo[4,5-b]pyridine, then Trp-P-1. Another heterocyclic
      amine, 2-amino-3-methyl-9H-pyrido[2,3-b]indole also inhibited the enzyme. The
      inhibition of the decarboxylase activity by these heterocyclic amines may affect
      the catecholamine metabolism in human brain.

PMID- 2243620
TI  - Infectious diseases. Salmonella: what risk?

PMID- 2243618
TI  - Non-invasive brain stimulation reveals reorganized cortical outputs in amputees.
AB  - EMG responses to non-invasive electromagnetic brain stimulation (EMS) were
      recorded from arm muscles of congenital amputees. Responses were obtained with
      lower thresholds on the amputated than on the intact side and were evoked from a
      larger cortical area. Contracting muscles showed increased responses to EMS; the
      increase was more pronounced on the amputated side. Similar findings were
      obtained in one traumatic amputee who suffered an early amputation, but not in
      another patient with a late amputation. We conclude that in congenital amputees
      there is substantial reorganisation of the corticospinal system and that this may
      also occur in early traumatic cases.

PMID- 2243619
TI  - Cryptic Met-enkephalin in adrenal and portal vein during splanchnic artery
      occlusion shock in cats.
AB  - Adrenal vein (AD), portal vein (PV), and femoral artery (FA) plasma levels of
      immunoreactive (IR) Met-enkephalin pentapeptide (ME) and extended ME-IR forms,
      obtained after sequential incubation of plasma with trypsin and carboxypeptidase
      B, were examined in 4 cats during splanchnic artery occlusion shock at baseline
      (S1), during early shock (S2), late shock (S3), and after naloxone (1 mg/kg,
      i.v.) administration (S4). Early shock (S2) led to a significant increase in
      levels of extended and fully processed Met-enkephalin IR at all 3 collection
      sites (AD, PV, FA) without a change in proportional levels of extended Met
      enkephalin IR to the pentapeptide IR (ME). Naloxone administration during late
      shock (S4), however, resulted in a disproportionate increase (150-fold from
      baseline) in adrenal vein plasma levels of extended Met-enkephalin IR forms, as
      compared to ME IR (23-fold). In contrast, no changes in plasma levels occurred in
      PV and FA.

PMID- 2243621
TI  - Infectious diseases. Aspects of isolation care.

PMID- 2243622
TI  - Infectious diseases. Moving an infectious patient by air.

PMID- 2243623
TI  - Infectious diseases. The role of the specialist health visitor.

PMID- 2243624
TI  - The importance of fitness.

PMID- 2243627
TI  - It's not all doom and gloom for merged schools of nursing.

PMID- 2243625
TI  - Courses in health promotion.

PMID- 2243626
TI  - The Mersey beat: alive and well.

PMID- 2243628
TI  - Setting standards for primary nursing.

PMID- 2243630
TI  - The invisible nurse.

PMID- 2243631
TI  - Infectious diseases. Principles of microbiology.

PMID- 2243629
TI  - Managers under threat.

PMID- 2243632
TI  - 12th Taniguchi international symposium on visual science. Katata, Japan, November
      27-December 1, 1989. Proceedings.

PMID- 2243633
TI  - The light-suppressible K+ conductance and evaluation of internal messenger
      candidates in the molluscan extraocular photoreceptor.
AB  - A photoreceptor potential produced by a decrease in membrane conductance was not
      thought to occur in any invertebrate photoreceptors. However, we have found that
      the molluscan extraocular photoreceptor, A-P-1 responds to light with a
      depolarizing receptor potential due to a decrease in K+ conductance, so that the
      photoresponse associated with a decrease in membrane conductance is not unique to
      the vertebrate photoreceptor. The properties that the light-suppressible K+
      conductance is time- and voltage-dependent are explained by comparison with those
      of the single channel conductance obtained in patch-clamp of both vertebrate and
      invertebrate photoreceptors. The noise analysis of the light-induced current
      suggest that this macroscopic light-suppressible conductance consists of
      channels. It is concluded that the light-suppressible K+ conductance is mediated
      by hydrolysis of cGMP which reduces internal cGMP, in agreement with the cGMP
      hypothesis of vertebrate phototransduction and that the hydrolysis may be
      modified by IP3.

PMID- 2243634
TI  - Effects of ions and drugs on the responses of sensory axon terminals of
      decapsulated frog muscle spindles.

PMID- 2243635
TI  - Calcium inhibition of ATP-dependent inactivation of rod disk phosphodiesterase in
      isolated rods and membrane suspensions.

PMID- 2243636
TI  - Forward and reverse transduction in the mammalian cochlea.

PMID- 2243637
TI  - Mechano-electrical transduction and muscarinic cholinergic responses in the chick
      hair cell.

PMID- 2243638
TI  - Results of treatment of cancer of the cervix in Wellington 1980-4.
AB  - A review was undertaken of all 115 women with invasive carcinoma of the cervix
      referred for treatment to the Wellington regional centre during the period 1980
      4. In comparison with the previous five year period, there were 31 (37%) more
      patients, and a higher proportion of patients had stage I and II disease. The
      incidence of disease was significantly greater in Maori compared with nonMaori.
      Treatment was by various combinations of surgery and radiation according to
      agreed protocols. The actuarial survival at five years was 73% for the whole
      group, 89% for 64 stage I patients, 65% for 28 stage II patients and 45% for 19
      stage III patients. The actuarial risk of a major treatment complication within
      the first five years was 8.8%. These results confirm that regional centres in New
      Zealand employing a multidisciplinary approach to patient assessment and
      treatment can achieve high cure rates with an acceptable incidence of treatment
      complications. However, prevention of the disease by effective cervical screening
      programmes should remain an objective of health services in New Zealand.

PMID- 2243639
TI  - Domestic unintentional injuries presenting to the accident and emergency
      departments in the Wellington region.
AB  - A prospective descriptive study of domestic unintentional injuries attending
      accident and emergency (A & E) departments in the Wellington region is presented.
      In a three month period there were 2207 such attendances. There was no difference
      in the proportion of males and females seen. A disproportionate number of the
      very young (under five years of age) and the elderly (65 years and over) attended
      A & E departments for these injuries. Approximately one-quarter of the
      attendances were for cuts or lacerations (26.6%) and one-fifth were for fractures
      (18.0%). Crude estimates of distance indicate that, on average, people travel
      greater distances for fractures than for other injuries. General practitioners
      referred one-tenth (10.6%) of all the attendances. Outcomes from the A & E
      attendances were: 70.4% were discharged, 7.7% were admitted to hospital, 14.6%
      were referred to outpatient clinics, and 7.2% were referred back to their general
      practitioners. There were no deaths in A & E departments.

PMID- 2243640
TI  - Passive smoking in childhood.

PMID- 2243641
TI  - A questionnaire survey of symptoms in a hypertension clinic.
AB  - OBJECTIVE: to assess symptoms of patients on antihypertensive therapy. SETTING:
      hospital hypertension clinic. DESIGN: self administered questionnaire (sent and
      returned by mail) listing 23 symptoms; four grades of response (none, mild or
      seldom, moderate or sometimes, severe or frequent); special scale for nocturia
      and appetite. PATIENTS: 302 patients completed the questionnaire (87% of those to
      whom it was sent); 109 of these patients completed it a second time, after an
      interval of four months, so that repeatability could be assessed. REPEATABILITY:
      scores were high, ranging from 0.92 to 0.99, for all symptoms except flushing
      (all grades 0.91), nausea (all grades 0.90) and sleepiness (severe, 0.82) (method
      of Bulpitt et al). RESULTS: overall prevalence of symptoms was high, but most
      were mild or infrequent. Women had significantly greater prevalence of oedema,
      flushing and insomnia than men and tended to assess their symptoms more often as
      severe or frequent. Nocturia was the only symptom more common in those above
      median age (62 yr) than in those below. Lack of energy was the only symptom more
      prevalent in the treated than in the untreated. No difference in prevalence of
      symptoms was detected between those taking or not taking a specific type of drug
      (beta blocker, diuretic, ACE inhibitor, calcium antagonist). CONCLUSION: in
      patients whose antihypertensive therapy has been carefully adjusted to try to
      avoid symptomatic side effects, the burden of such side effects appears to be
      very small.

PMID- 2243642
TI  - Important features associated with acute anterior cruciate ligament injury.
AB  - The mechanism of injury and the signs and symptoms associated with initial injury
      to the anterior cruciate ligament were investigated in 23 subjects. The subjects
      had injured only their anterior cruciate ligament with no other clinically
      definable laxity to other major ligamentous structures. The results showed that
      70% of subjects had injured their anterior cruciate ligament at footstrike during
      noncontact situations. In 53% of these subjects the mechanism of injury was
      internal rotation of the tibia with the knee in slight flexion. A shifting
      sensation occurring between the tibia and femur was noted by 61% of subjects,
      while 30% recalled a crack or popping sound at the time of injury. Only 17% of
      subjects could continue in sports activity immediately following the injury, all
      with difficulty.

PMID- 2243643
TI  - The helpless dying.

PMID- 2243644
TI  - Importance of advanced surgical training.

PMID- 2243645
TI  - The state and general practice.

PMID- 2243646
TI  - Hyperbaric oxygen chamber at Devonport.

PMID- 2243647
TI  - AIDS awareness.

PMID- 2243649
TI  - Local anaesthetic allergic reactions.

PMID- 2243648
TI  - Tobacco and biotoxins.

PMID- 2243650
TI  - Targeting early detection of malignant melanoma of the skin.
AB  - Incidence and mortality rates, and clinical stage at diagnosis were analysed for
      malignant melanoma of the skin in recent years to assist in identifying high risk
      groups. Over 12 years to 1985-6 age standardised melanoma mortality rates in the
      nonMaori population increased 90% among men and 16% among women. In most age
      groups the male death rate was twice the female rate. Almost half the deaths from
      melanoma in 1983-6 were in men aged 45 or older. Age standardised incidence
      rates, for each sex, continued to increase to 1983-4. Among older age groups
      melanomas were less likely to be localised at diagnosis. This fall in
      localisation occurred at much younger ages (about 40) among men than among women.
      Middle aged men and older men and women are important target groups for education
      about the early detection of melanoma.

PMID- 2243651
TI  - Reactive arthritis, infection and antigens.

PMID- 2243652
TI  - The Nelson general practice prescribing project. Part I: A pilot audit of the
      regional prescribing profile.
AB  - The Nelson general practice prescribing project has been set up to develop a
      model for cost effective prescribing in general practice. A pilot audit of
      regional prescribing patterns and trends for February 1989 was conducted to test
      data acquisition and presentation for the project, based on 12,690 scripts. There
      was marked variation in medicines choice, cost and number of scripts between
      general practitioners. The cost of prescriptions ranged from $2.20 to $127.70,
      median $10.77. Cardiovascular medicines were most frequently prescribed and most
      costly. Extemporaneous prescribing accounted for 20% of the February inventory
      and was highly individually variable. Benzodiazepine prescribing was not in line
      with current guidelines and was high, mean 6.7% of all prescribing, indicating an
      urgent need for unbiased drug information. Audited prescription data allows
      definitions of educational and pricing strategies.

PMID- 2243653
TI  - The Nelson general practice prescribing project. Part II: Prescribing reports for
      self audit.
AB  - A special format is described for individualised feedback of audited prescribing
      information to practitioners. The format has been developed for general
      practitioners participating in the Nelson prescribing project (part I), and has
      been successfully trialed in conjunction with a preferred medicines list,
      specifically compiled for the Nelson region. The unbiased, reliable information
      is seen as a practical means of regular prescribing update and modification of
      medicine choice, as yet unexploited.

PMID- 2243655
TI  - Changing patterns of referral to an eating disorders clinic.
AB  - A decline in overall referrals was noted at the eating disorders clinic,
      Manawaroa centre for psychological medicine in 1987. At the same time a
      proportional increase in referrals for bulimia was observed. To gather more
      information on these apparent changes, data on the clinic's referral pattern were
      collected and general practitioners in the area health board district were
      surveyed. The results suggested a relatively stable referral rate from 1983-9,
      with an average of 31 referrals per year. However, there appears to have been a
      decrease in anorexia nervosa, from over 50% of referrals in 1983 to approximately
      5% of referrals in 1988-9, and a corresponding rise in bulimia from 8% in 1983 to
      49% in 1988 and 35% in 1989. Responses were received from 61 general
      practitioners, 78% of those surveyed. Most general practitioners indicated that
      they perceived a need for an eating disorders clinic, but only 40% had referred
      to the clinic. The main reasons given for not referring were: no appropriate
      patients (33%), the general practitioner was unaware of the clinic (29%), and the
      patient was being maintained by the general practitioner (25%).

PMID- 2243654
TI  - Random urine albumin:creatinine ratio measurements as a screening test for
      diabetic microalbuminuria--a five year follow up.
AB  - Serial random urine samples have been collected from 167 insulin treated diabetic
      patients attending the Waikato diabetes clinic from 1984 to 1989 and
      albumin/creatinine ratios measured as a screening test for diabetic
      microalbuminuria. The group ranged in age from 12 to 50 years and comprised 79
      males and 88 females. Where the initial test was normal (less than 2.5), as found
      in 117 patients, 86.7% of all tests over the five year period (1032) remained
      normal. Of 50 patients with an initial elevated value, 39% of a total of 575
      values taken over the five year period were subsequently normal. CONCLUSION: a
      random urine albumin measurement taken at yearly intervals is an adequate
      screening programme for patients with an initial normal value.

PMID- 2243656
TI  - Fetal and placental weight as predictors of adult hypertension.

PMID- 2243657
TI  - Overwhelming influenza B infection in an infant.

PMID- 2243658
TI  - Fenoterol prescribing and asthma severity.

PMID- 2243659
TI  - AST/ALT ratios.

PMID- 2243660
TI  - Double gloving during surgery: a technical tip.

PMID- 2243661
TI  - Hot water cylinders.

PMID- 2243663
TI  - Serum levels of tumor-associated glycoprotein (TAG-72) in digestive cancers.
AB  - Serum levels of tumor-associated glycoprotein (TAG-72) were measured using a two
      step sandwich radioimmunoassay kit in 281 patients with digestive cancers and 135
      patients with benign digestive diseases. The positive rates of TAG-72 with the
      cut-off values of 2.2 and 4.0 U/ml were high in pancreatobiliary (56%, 38%),
      gastric (49%, 37%) and colorectal (62%, 29%) cancers, while the false-positive
      rate in benign diseases was 11%, 0.7% respectively. Very high levels were found
      in patients with advanced cancer. TAG-72 was positive in 17 (greater than 2.2
      U/ml) and 7 (greater than 4.0 U/ml) out of 60 CEA-negative patients, and in 7
      (greater than 2.2 U/ml) and 3 (greater than 4.0 U/ml) out of 17 CA19-9-negative
      patients. TAG-72 might be a useful serum marker for digestive cancers, especially
      gastric and colorectal cancers.

PMID- 2243662
TI  - Use of a fully implantable drug delivery system in the treatment of acute
      leukemias and disseminated lymphomas.
AB  - In an open study, 42 venous Port-A-Cath systems (PAC) were implanted in 40
      patients with AML (12), ALL/AUL (11), NHL with bone marrow infiltration (8),
      Hodgkin's lymphoma (3), solid tumors (5) and severe aplastic anemia (1). Mean
      duration of system use was 212 days. The cumulated duration of use of all systems
      was 8.883 days. 1,627 blood samples were taken from the PAC. Blood sampling was
      possible on 8,696 of 8,883 days of cumulated access (98%). A total of 522 blood
      transfusions were administrated. Fifty-two episodes of neutropenia (granulocyte
      counts less than 0.5 x 10(9)/l) with a mean duration of 17 days were observed in
      the group of the 23 patients with acute leukemias. A total of 25 complications
      were registered. The incidence was 2.8/1,000 days of access. Twelve complications
      were regarded as severe. Venous thrombosis was observed in 3 cases. In addition,
      there were 2 disruptions of the catheter, 1 disconnection, 1 looping and 4 local
      infections. The rate of systemic infection could not be accurately estimated
      because the catheter was always left in place and antibiotic treatment was
      started immediately in case of fever with or without bacteriemia. The overall
      rate of catheter-related complications in patients with acute leukemia was not
      higher than in patients with solid tumors.

PMID- 2243664
TI  - Medical history, diet and pancreatic cancer.
AB  - The relation between various aspects of medical history, selected indicator foods
      and the risk of pancreatic cancer was analyzed in a hospital-based case-control
      study conducted in Northern Italy on 247 patients with cancer of the pancreas,
      and 1,089 controls in hospitals for acute, nonneoplastic or digestive conditions.
      There was a significant association with history of pancreatitis (relative risk,
      RR 3.2, 95% confidence interval = 1.3-7.9), which was however reduced when the
      condition was first diagnosed at least 5 years previously. The point estimates
      were slightly, but not significantly, above unity for diabetes (RR = 1.5),
      gastrectomy (RR = 1.1) and cholelithiasis (RR = 1.3), and no association was
      found with liver disease or drug allergy. In relation to diet, there was some
      tendency for the risk to decrease with more frequent fruit consumption, but the
      results were largely inconsistent in relation to various indicators of meat,
      animal protein or fat intake. Although no important associations were found in
      this study with various aspects of medical history or diet indicators and
      pancreatic cancer risk, on account of the size of the dataset and the statistical
      power, this study contributes usefully to the debate on a common cancer whose
      causes are still largely undefined.

PMID- 2243665
TI  - Multiple malignant neoplasms in patients with nasopharyngeal carcinoma.
AB  - The records of 759 patients with nasopharyngeal carcinoma were reviewed. Fifteen
      of them also suffered from another malignant neoplasm. All patients had
      histological confirmation of the nasopharyngeal carcinoma and the other malignant
      neoplasm. There was no predilection for the second malignant neoplasms to arise
      from the bronchus. Although the observed number of second malignant neoplasms was
      not significantly different from the expected number (p greater than 0.05)
      computed by the patient-month approach, in 1 patient the second malignant
      neoplasm may be causally related to the previous treatment of nasopharyngeal
      carcinoma by radiotherapy.

PMID- 2243666
TI  - Induction of tumor necrosis factor in human peripheral-blood mononuclear cells by
      proteolytic enzymes.
AB  - We could demonstrate that polyenzyme preparations as well as bromelain and papain
      stimulate the production of tumor necrosis factor-alpha in human peripheral-blood
      mononuclear cell cultures in a time-dependent manner. We give evidence that
      immunomodulation and especially the release of cytokines may contribute to the
      therapeutic effect of these preparations.

PMID- 2243667
TI  - Flow-cytometric analysis of colorectal cancer with hepatic metastases and its
      relationship to metastatic characteristics and prognosis.
AB  - Studying the DNA ploidy patterns of 52 primary tumors, diploid tumors accounted
      for 48.1% and aneuploid tumors for 51.9%. Out of 31 patients with liver
      metastases, 35.5% had diploid tumors and 64.5%, aneuploid tumors. Heterogeneity
      (difference in DNA ploidy pattern between the primary lesion and liver
      metastases) was found in 20% of the patients examined. In 28 of the patients, the
      liver metastases were unresectable, and their prognoses were such that the 1- and
      2-year survival rates from the diploid tumors were 42.9 and 14.3%, respectively,
      while 1-year survivors from aneuploid tumors died within 2 years. In resected
      cases of hepatic metastases, the DNA ploidy pattern of the metastatic lesions did
      not correlate with the metastasis period, extent of spread or number of lesions.
      The recurrence rate of aneuploid tumors in the residual livers was 50%, which was
      slightly higher than the rate of 36.4% for diploid tumors. The prognoses in
      patients with diploid tumors were significantly better than those in patients
      with aneuploid tumors: 5-year survival was 71.1% in diploid tumor patients,
      compared with 21% in aneuploid tumor patients.

PMID- 2243668
TI  - Generation and characterization of a low-degree drug-resistant human tumor cell
      line.
AB  - A 2780 human ovarian cancer cells, obtained from an untreated patient, have been
      exposed to a relatively low, clinically maintainable dose (10 nmol/l) of the
      anthracycline doxorubicin (DX) to derive a low-degree (5-fold) drug-resistant
      subline (A2780-DX1). Compared to parental cells, these DX-resistant cells have
      increased size (+60% of cell volume) and contain a greater number of cytoplasmic
      vacuoles as determined by electron microscopy. When exposed to several other
      antiproliferative drugs, A2780-DX1 cells were highly cross-resistant (greater
      than 10-fold) to epirubicin, mafosfamide and cisplatin and slightly cross
      resistant (2- to 3-fold) to navelbine and bleomycin, while they retained the
      original sensitivity to vinblastine, Ara-C and fluorouracil. Gel electrophoresis
      of cytoplasmic membrane proteins showed differences between the pattern of
      parental A2780 sensitive and A2780-DX1 cells as far as low-molecular-weight
      proteins (less than 45 kD) are concerned, while no clear overexpression of P
      glycoprotein (P-170) could be detected. Membrane modifications yielding a
      decrease of both DX uptake and retention, increased content of intracellular
      glutathione (+32%) and reduced DNA double-strand breaks seem to be involved in
      the resulting multidrug-resistant phenotype of A2780-DX1 cells.

PMID- 2243670
TI  - Update on stromal puncture technique.

PMID- 2243669
TI  - Effect of alterations in permeability by nonionic surfactants on adriamycin
      cytotoxicity in murine tumor models in vitro.
AB  - Differential effects of adriamycin cytotoxicity and its cellular uptake were
      assessed in murine tumor models utilising adriamycin alone and in combination
      with nontoxic concentrations of nonionic polyoxyethylated lauryl ether
      surfactants Brij 30 and Brij 35. Parental P388 murine leukemia cell line
      sensitive to adriamycin, subline of P388 murine leukemia resistant to adriamycin,
      sarcoma-180 and Ehrlich ascites tumor were employed in this study. The results
      indicate an enhanced DNA biosynthesis inhibition by adriamycin when used in
      combination with Brij 30 or Brij 35 in all the murine tumor models. The increase
      in adriamycin cytotoxicity was due to an increased accumulation of adriamycin
      observed in the tumor models used. The present investigation demonstrates the
      necessity of utilising surface-active drug-response modulators to enhance the
      cytotoxicity of anticancer drugs and circumvent drug resistance.

PMID- 2243671
TI  - Efficacy of adding dipivefrin to a beta-blocker.

PMID- 2243672
TI  - Effectiveness of hyperbaric oxygen in treating radiation injury to the optic
      nerves and chiasm.

PMID- 2243673
TI  - Implications of decision analysis for ophthalmic practice.

PMID- 2243674
TI  - Prophylaxis of aphakic cystoid macular edema without corticosteroids. A paired
      comparison, placebo-controlled double-masked study.
AB  - Prior investigations have reported that topical nonsteroidal anti-inflammatory
      drug (NSAID) therapy prevents the development of postoperative angiographic signs
      of angiographic cystoid macular edema (CME). However, these studies include
      concurrent use of corticosteroids. The current study reports therapeutic efficacy
      for ketorolac ophthalmic solution (an NSAID) in the prophylaxis of angiographic
      aphakic CME (ACME) after cataract surgery without concurrent corticosteroids for
      the first time. Fifty patients with bilateral cataracts were enrolled in this
      placebo-controlled, paired-comparison, double-masked study. Eleven patients had
      evidence of angiographic ACME on postoperative day 40. Two of these patients
      demonstrated bilateral ACME, one patient had ACME in the NSAID-treated eye, and
      eight patients demonstrated ACME in the placebo-treated eye. This is a
      statistically significant difference favoring drug treatment. The signs of
      anterior ocular inflammation were greater in the eyes with ACME. This study
      suggests prophylactic treatment of ACME may be possible without the risks of
      concurrent corticosteroid toxicity. In addition, a higher incidence of ACME in
      black patients (22%) is observed in this study than has been recognized
      previously.

PMID- 2243675
TI  - Rapid determination of intraocular lens tilt and decentration through the
      undilated pupil.
AB  - The apparent optical axis of an implanted intraocular lens (IOL) can be located
      by alignment of the examiner's hand light with the third and fourth Purkinje
      images from the front and back surfaces of the IOL. Tilt of the IOL can be
      estimated (or measured with an arc perimeter) by the angle between the apparent
      optical axis and the patient's line of sight (actual tilt approximately 0.85 x
      apparent tilt). Decentration of the IOL is easily detected, equal to the distance
      of the IOL optical axis from the center of the pupil. This simple technique can
      be used through the natural pupil with posterior chamber IOLs, providing the
      optical axis of the malpositioned IOL still passes through the pupil.

PMID- 2243676
TI  - Sports-related ocular trauma.
AB  - A prospective evaluation of all patients presenting with a sports-related ocular
      injury during a 1-year (4-season) period was conducted. Of the 202 patients
      evaluated, 28 (13.8%) required hospitalization and 11 (5.6%) required intraocular
      surgery. Twenty-six patients (12.8%) sustained permanent ocular sequelae
      including seven (3.5%) who suffered visual loss. Basketball accounted for 28.7%,
      baseball/softball 19.8%, and racquetball 11.4% of all injuries. At the time of
      injury, 5.1% of patients had worn protective eye wear, whereas on follow-up only
      31% had used eye protection. These results indicate that sports trauma remains a
      significant cause of ocular morbidity.

PMID- 2243677
TI  - Ki-67 immunostaining in uveal melanoma. The effect of pre-enucleation
      radiotherapy.
AB  - The reactivity of 33 choroidal and ciliary body melanomas with monoclonal
      antibody Ki-67, which recognizes a proliferation associated nuclear antigen, has
      been assessed and compared with clinicopathologic parameters. In 23 cases, 8 Gy
      irradiation was given 2 days before enucleation. Nonirradiated melanomas had a
      significantly higher proliferation rate as defined by staining with monoclonal
      antibody Ki-67 as compared with irradiated tumors (P = 0.007). Similarly, a
      strong relationship was found between pre-enucleation irradiation and low mitotic
      activity (P = 0.001). There was no significant correlation between the presence
      of Ki-67-positive nuclei and histologic classification, largest tumor diameter,
      localization of the tumor, age, sex, scleral invasion, pigmentation, and
      lymphocytic infiltration. The relevance of Ki-67 immunohistochemistry for the
      assessment of the life prognosis of patients with uveal melanoma has to be
      studied prospectively.

PMID- 2243678
TI  - Ocular syphilis.
AB  - The ability of syphilis to mimic different ocular disorders can lead to
      misdiagnosis and delay in appropriate antimicrobial therapy. The authors describe
      their experience over the past 5 years with the ocular manifestations of syphilis
      in 25 patients who comprised 2.45% of 1020 new patients. Uveitis was the most
      common ocular manifestation seen. All patients had positive results from FTA-ABS
      tests, whereas only 68% had reactive serum VDRLs. Two of five patients tested for
      human immunodeficiency virus (HIV) antibody were reactive. The authors recommend
      routine FTA-ABS and VDRL screening in patients with uveitis or unexplained ocular
      inflammation. They also recommend testing for HIV antibody in luetics and
      aggressive treatment with high-dose aqueous penicillin for syphilis.

PMID- 2243679
TI  - Acute syphilitic posterior placoid chorioretinitis.
AB  - Six patients with evidence of secondary syphilis presented with visual loss in
      both eyes caused by large, placoid, yellowish lesions with faded centers at the
      level of the pigment epithelium in the macula and juxtapapillary areas. All eyes
      had vitreitis. All of the lesions showed a similar fluorescein angiographic
      pattern of early hypofluorescence and late staining. Five patients had
      mucocutaneous lesions typical of secondary syphilis. All five patients treated
      with antibiotics had prompt improvement in visual function and resolution of the
      fundus lesions. The ophthalmoscopic and angiographic appearance of these
      posterior fundus lesions was sufficiently characteristic to suggest a diagnosis
      of secondary syphilis. Modification of the host response to syphilis by human
      immune deficiency virus (HIV) infection may be partly responsible for this
      peculiar fundus picture. Three of the four patients tested positive for HIV.

PMID- 2243680
TI  - Indications and results of relaxing retinotomy.
AB  - The authors report their results of a consecutive series of 40 eyes undergoing
      relaxing retinotomy during vitrectomy to achieve retinal reattachment for the
      following indications: proliferative vitreoretinopathy (PVR), 21 eyes (52%);
      trauma, 10 eyes (25%); diabetic retinopathy, 6 eyes (15%); and expulsive
      choroidal hemorrhage, 3 eyes (8%). Thirty eyes (75%) had undergone previous
      vitreoretinal procedures. Extended tamponade was achieved in all cases with
      either silicone oil (27 eyes, 68%) or long-acting gas (13 eyes, 32%). Retinotomy
      size ranged from 45 degrees to 360 degrees. Intraoperative retinal attachment was
      possible in all eyes with 33 (83%) achieving total or subtotal retinal attachment
      including the macula for 5 months or more. Twenty-seven eyes (68%) achieved 3/200
      visual acuity or better and 10 (37%) achieved 20/400 or better. Thirteen eyes
      (32%) failed to achieve 3/200 visual acuity secondary to recurrent detachment
      (18%), corneal decompensation (8%), macular dysfunction (5%), and glaucoma (3%).

PMID- 2243681
TI  - Extensive peripheral retinectomy combined with posterior 360 degrees retinotomy
      for retinal reattachment in advanced proliferative vitreoretinopathy cases.
AB  - Posterior 360 degrees retinotomy in conjunction with extensive peripheral
      retinectomy was necessary for retinal reattachment in 18 eyes. A visual acuity of
      20/400 or better was achieved in 22% of the patients; in patients with rubeosis,
      regression was found in 89%. Of the hypotonus eyes, preoperatively 78% were
      normotensive postoperatively after removal of anterior proliferative
      vitreoretinopathy (PVR) covering ciliary epithelium. The major intraoperative
      complication was hemorrhage, which could be readily controlled. Recurrent retinal
      detachment (RD) occurred in 39% and reproliferation in 50% of the patients.

PMID- 2243682
TI  - Experimental retinal branch vein occlusion in miniature pigs induces local tissue
      hypoxia and vasoproliferative microangiopathy.
AB  - In miniature pigs, retinal veins were experimentally occluded using argon laser
      coagulation. Microvascular modifications leading to retinal hemorrhages and
      retinal edema were observed some hours after the occlusion. These lesions
      resolved progressively within 3 weeks after the occlusion, but in most cases
      ischemic retinal territories persisted. Preretinal partial pressure of oxygen
      (PO2) measurements, using double barrelled O2-sensitive microelectrodes, showed
      that all the ischemic areas were indeed hypoxic. In half of the experiments,
      preretinal and intravitreal new vessels grew on the ischemic territories. Tissue
      hypoxia appears to be a key step in triggering neovascularization. However, the
      critical level of hypoxia was not determined.

PMID- 2243683
TI  - Scatter photocoagulation restores tissue hypoxia in experimental
      vasoproliferative microangiopathy in miniature pigs.
AB  - Experimental retinal branch vein occlusion using argon laser photocoagulation in
      miniature pigs induced the development of ischemic retinal territories associated
      with preretinal neovascularization. Preretinal partial pressure of oxygen (PO2)
      measurements on the ischemic territories, using O2-sensitive microelectrodes,
      established that the ischemic retinal areas were hypoxic. Scatter
      photocoagulation of these ischemic hypoxic territories restores the local PO2 to
      the normal values within 2 weeks. Hence, the reported inhibitory effect of
      photocoagulation on the development of retinal neovascularization could be due to
      a reversal effect on tissue hypoxia.

PMID- 2243684
TI  - Longitudinal study of lesions of the posterior segment in onchocerciasis.
AB  - Onchocerciasis is a major cause of blindness, and much of the blindness due to
      onchocerciasis is caused by chorioretinitis. Little is known about the
      progression of lesions in the posterior segment in either untreated or treated
      disease. The authors studied the progression of onchocercal chorioretinitis in 57
      patients from 1 to 3 years. Changes were documented from detailed ocular
      examinations, fundus photographs, and fluorescein angiograms, and included live
      intraretinal microfilariae, intraretinal hemorrhages, cotton-wool opacities,
      intraretinal pigment, white and shiny intraretinal deposits, retinal pigment
      epithelial window defects, and atrophy. Depigmentation at the edge of
      chorioretinal scarring progressed at a rate of up to 200 microns per year.
      Ivermectin or mebendazole treatment did not appear to alter the progress of
      depigmentation at the edge of chorioretinal scars. These observations suggest
      that onchocercal chorioretinitis is associated with early changes in the retina
      and retinal pigment epithelium, and that disease in the posterior segment may
      progress rapidly.

PMID- 2243685
TI  - Toxoplasma gondii retinochoroiditis and optic neuritis in acquired immune
      deficiency syndrome. Report of a case.
AB  - A 29-year-old man with acquired immune deficiency syndrome (AIDS) was found to
      have a retinochoroiditis and optic neuritis of his left eye. Results of fundus
      examination showed inflammatory and hemorrhagic retinal lesions consistent with
      retinitis due to cytomegalovirus infection. A computed tomographic (CT) scan
      demonstrated enlargement of the optic nerve. The eye was enucleated and results
      of histopathologic examination showed retinal necrosis with underlying
      choroiditis and an optic neuritis. Numerous encysted Toxoplasma gondii organisms
      were present in the retina and tachyzoites were present in the optic nerve. To
      the authors' knowledge this is the second histologically documented case of
      Toxoplasma optic neuritis in a patient with AIDS.

PMID- 2243686
TI  - Computed tomography in the assessment of the postenucleation socket syndrome.
AB  - To gain a deeper insight into the cause of the postenucleation socket syndrome,
      high-resolution computed tomography (CT) was performed in 22 anophthalmic
      patients before insertion of an intraorbital implant. The anatomy of the normal
      and the anophthalmic orbits was compared. Computed tomographic scans were made
      either in the sagittal and the coronal plane or in the sagittal and transverse
      plane. The authors discovered a sagging and retraction of the superior muscle
      complex and a downward and forward redistribution of orbital fat. Finally, an
      upward displacement of the distal end together with a retraction of the inferior
      rectus muscle was found. These phenomena were measured and appear to cause a
      rotatory displacement of orbital contents from superior to posterior and from
      posterior to inferior which is best demonstrated in the sagittal plane. This
      redistribution of orbital contents can explain the sequelae of the anophthalmic
      orbit. No signs of orbital fat atrophy could be demonstrated. With this
      knowledge, the proper treatment of patients with a postenucleation socket
      syndrome is ascertained.

PMID- 2243687
TI  - Immunoblastic T-cell lymphoma presenting as an eyelid tumor.
AB  - A 59-year-old white man presented with an ulcerating mass of the left upper
      eyelid of 6 months' duration. A biopsy specimen of the tumor was diagnosed as an
      immunoblastic T-cell malignant lymphoma. The lesion completely regressed after
      4000 cGy of cobalt-60 radiation therapy. In the ensuing 33 months, multiple,
      widespread skin nodules of the same neoplasm developed including a right upper
      eyelid tumor. To the authors' knowledge, this is the first reported case of an
      immunoblastic T-cell lymphoma initially manifesting as an eyelid neoplasm.

PMID- 2243688
TI  - Lateral wall advancement in orbital decompression.
AB  - Treatment of dysthyroid orbitopathy can be enhanced with a modified craniofacial
      approach using a lateral wall osteotomy, and anterolateral advancement and
      osteosynthesis in conjunction with medial and inferior wall orbital
      decompression. The technique of lateral wall advancement is described, and the
      results are discussed. While the authors advocate orbital decompression for
      dysthyroid optic neuropathy, advancement of the lateral orbital wall can easily
      be performed as an adjunct to the two- or three-wall decompression procedure.
      Advancement appears to increase the overall decompressive effect by providing a
      potential space where lateral expansion can occur and by enlarging the bony
      orbital volume. It also appears to lessen lid retraction and facilitates (and in
      some cases, obviates) the need for further lid retraction surgery.

PMID- 2243689
TI  - Assessment of tear drainage after canalicular obstruction using fluorescein dye
      disappearance.
AB  - Assessment of tear drainage impairment after monocanalicular obstruction can be
      difficult. The authors used fluorescein dye disappearance to evaluate tear
      drainage after experimental obstruction of upper, lower, neither, or both
      canaliculi in 20 subjects. Marked impairment was noted in all subjects when both
      canaliculi were occluded (P less than 0.004). Monocanalicular obstruction (either
      upper or lower) generally resulted in minimal or no impairment, though 10% of
      subjects showed marked impairment. Fluorescein dye disappearance proved a
      reliable, rapid method for assessing tear drainage and detecting lacrimal
      obstruction.

PMID- 2243690
TI  - The incidence of liability claims in ophthalmology as compared with other
      specialties.
AB  - Ophthalmologists continue to share in the professional liability claims that
      plague the medical profession. Data have been extrapolated from the April 1987
      publication of the United States General Accounting Office (GAO) entitled,
      "Medical Malpractice Characteristics of Claims Closed in 1984." This document
      presents information pertaining to the comparative incidence of professional
      liability claims of ophthalmologists with other specialties.

PMID- 2243691
TI  - Seven hundred medicolegal cases in ophthalmology.
AB  - Seven hundred medicolegal claims in ophthalmology were reviewed by one
      ophthalmologist who served as an expert for four decades. The ophthalmologist was
      personally involved in 620 claims. The 700 cases have been categorized and
      analyzed. The reasons for the claims and some lessons derived from them are
      presented. Familiarity with the claims encountered by others may enable
      ophthalmologists to avoid similar claims.

PMID- 2243692
TI  - Ophthalmology personnel in risk management. What office personnel need to know to
      keep you out of trouble.
AB  - The performance of staff in the ophthalmologist's office will influence the risk
      that an individual patient may someday file a medical malpractice complaint.
      Areas of identified risk include improper triage of emergency patients,
      abandonment, problems in confidentiality, improper maintenance of medical
      records, and perceived lack of compassion and skill on the part of staff members.

PMID- 2243693
TI  - The expert witness.
AB  - The rewards for suits for medical negligence have generated a service industry
      for plaintiff's lawyers. The provision of "experts" for a contingency fee and the
      solicitation of plaintiff's attorneys by some physicians to serve as "experts"
      for large fees may result in highly biased and inaccurate testimony. Ethical
      expert witness testimony involves knowledge of the commonly accepted principles
      of treatment at the time of the alleged negligence, recognition of possible
      multiple accepted avenues of therapy, and testimony that educates the court and
      jury rather than obfuscates and distorts for personal gain.

PMID- 2243694
TI  - [The importance of Doppler echocardiography in the differential diagnosis of
      causes of neonatal cyanosis].
AB  - The authors report 329 dopplerechocardiographic examinations performed on 167
      term and preterm newborn babies presenting cyanosis. Seventy-six congenital heart
      defects were detected among their patients, 12 of whom were operated without
      heart catheterization, according to the ultrasound finding. The diagnosis of ten
      inoperable heart diseases established without hemodynamic examination was
      confirmed by autopsy. Cyanosis due to cardiac and pulmonary abnormalities without
      congenital heart defect was diagnosed in 38 patients. Persistent ductus
      arteriosus was found in 45 very lowbirth-weight premature babies. Doppler
      echocardiography proved to be a major advance in the differential diagnosis of
      newborn cyanosis and in choosing appropriate therapy.

PMID- 2243695
TI  - [Lymphogranuloma venereum].
AB  - A young couple's case of Lymphogranuloma venereum was reviewed by the authors.
      They described the case's medical history and then they reviewed those tissue-
      cultural and immunological--methods which made sure the assumed diagnose by
      clinical and histological datas. The symptomless and painless wife's
      subclinically process was discovered. They called attention for that in spite of
      correct diagnose rareness the illness occurs more often. On the pathological
      process was influenced therapeutical by tetracyclin. We can treat successfully
      with tetracyclin the so called "blind-cured' cases. This situation made
      comfortable the diagnostics activity and it contributed to the wrong surface that
      the illness occurs rarely.

PMID- 2243696
TI  - [Prenatal diagnosis of cystic fibrosis based on DNA analysis].
AB  - 25 families at risk of having a child with cystic fibrosis have been counselled
      about prenatal diagnosis by the use of linked DNA probes (xV-2c, pCS.7, Met D,
      Met H, pJ3.11 and KM 19). In 20 families one or more informative probes, in 3
      cases only partly informative probes were found, and in 2 families there was no
      informative probe at all. In 9 cases prenatal diagnosis have been performed, 6
      children have been born and confirmed to be free from cystic fibrosis and 3
      terminations were carried out because of prenatal prediction of cystic fibrosis.

PMID- 2243697
TI  - [The role of intraoperative angioplasty performed simultaneously with
      reconstructive vascular surgery].
AB  - 21 arterial lesions were dilated intraoperatively in conjunction with primary
      vascular reconstructive procedures. Of these, five involved the iliac vessels,
      fourteen the femoropopliteal segment, one the subclavian artery and one the
      common carotid artery. 19 intraoperative balloon dilatations were successful and
      two were unsuccessful. Only one catheter-related complication were noted, it was
      a perforation of the wall of the artery caused by guidewire. No deaths occurred
      as a result of the combined procedure. Attention is drawn to the advantage of the
      intraoperative balloon dilatation and the authors recommend it on adequate
      conditions and correct indication.

PMID- 2243698
TI  - [A case of hybrid acute leukemia in a a child].
AB  - Hybrid acute leukaemia is characterized by the presence of lymphoid and myeloid
      markers in a single cell or in different blast cell subpopulations of the same
      patient. Authors report on a case of a 14-yr-old girl with hybrid acute
      leukaemia. Immunofluorescent analysis revealed CD 14, CD 10, CD 19 and HLA-DR
      antigens in the cell suspension isolated from peripheral blood of the patient.
      Because of the excess of FAB M1 type blast cells, the patient was treated
      according to IGCI-1984 protocol. Remission was not achieved despite combined
      cytotoxic treatment and patient died within 4 weeks following admission. The poor
      outcome of the disease agrees well with literature data. Hybrid acute leukaemia
      represents a challenge for the clinical science.

PMID- 2243699
TI  - [The effect of Hungarian pediatrics on the international medical sciences].

PMID- 2243701
TI  - [Forecasting in medical meteorology].

PMID- 2243700
TI  - [How did Tamas Jordan discover the cause of the 1577 disease outbreak in Brunn?].

PMID- 2243702
TI  - [Myasthenia gravis: results of thymectomy in 550 patients].
AB  - Report is giving on 550 myasthenic patients who underwent thymectomy during the
      last 18 years. Results of thymectomy are analysed in separate groups and
      according to different aspects, including thymic tumours (13.63%), operations in
      childhood (9.64%), and combined cases (11.1%). The results are evaluated
      according to Disability Status Scale based on a point-system. Successive
      improvement was observed in the three series concerning the results of operation.
      Childhood myasthenia gravis gave the best results but thymectomy was beneficial
      in the combined group, in long-lasting myasthenia and in tumourous cases, too.
      There are quite a few factors influencing the results, such as the interval
      between the disease onset and thymectomy, the patients' age, thymoma, crisis
      danger and the activity of the thymus gland reflecting in the number of the
      germinative centres. The more active the thymus, the better the results.

PMID- 2243703
TI  - [Diagnosis and treatment of non-immune hydrops foetalis].

PMID- 2243704
TI  - [Survival rate and follow up studies of very low birth weight (less than 1000 g)
      premature infants].
AB  - The Neonatal Intensive Care Unit (NICU) at the Department of Pediatrics,
      University Medical School Pecs had been established 11 years ago. 219 premature
      infants who weighed 1000 g or less were admitted to the NICU between Jan. 1978
      and Dec. 1988. The authors analysed the hospital records of there patients and
      found a marked increase in survival rates during the last five year period. The
      data presented strongly suggest that improvement of obstetric care, development
      of respiratory and fluid therapy, the increasing experience of hospital staff
      caring for the infants are the main factors contributing to improved results. At
      the same time the adverse effects of transportation from the referring
      institution are well demonstrated. The main causes of death remained the same
      over the 11 years studied. The number and severity of acute and late
      complications decreased markedly. The intensive care of very low birth weight
      infants is becoming increasingly expensive. However the growing expenditures are
      justified by increasing life expectancy of patients and the expected better
      quality of life among survivors.

PMID- 2243706
TI  - [The beginnings of ethno-psychological and socio-psychiatric studies of the
      ethnic groups of Transylvania at the turn of the century].

PMID- 2243705
TI  - [Management of gas gangrene in Hungary during 1979-1988 based on data from Public
      Health Centers].
AB  - Authors present data on the therapy of 223 gas gangrene cases between 1979-1988,
      a ten years period, based on the reports of Public Health Stations in Hungary. Of
      the 223 patients 150 died, thus lethality was 67.3%. In lack of surgical
      intervention there was no chance of survive. Merely wound exposure resulted in a
      much higher fatality rate than necrectomy of the wound. Local hydrogen-hyperoxide
      treatment improved survival essentially. Specific antitoxin therapy did not
      influence the survival rate. The effect of a single antibiotic was poor; combined
      antibiotic treatment gave a significantly better result. As for combination, the
      most effective were erythromycin, the lincosamids and chloramphenicol. According
      to the data presented, it would be possible to reduce to the half the fatality
      rate of gas gangrene in Hungary.

PMID- 2243707
TI  - [Who was the first Hungarian translator of Hahnemann's "Organon"?].

PMID- 2243708
TI  - [Changes in the stress-provoked septal Q wave].

PMID- 2243709
TI  - [Creation of a gastric pouch during total gastrectomy. Remarks on a journal
      summary].

PMID- 2243710
TI  - [Letter to a future colleague (guidelines of radiology)].

PMID- 2243711
TI  - Diagnosis--100% accurate; treatment--100% successful.

PMID- 2243712
TI  - New president emphasizes unified action.

PMID- 2243713
TI  - A review of horse-drawn buggy accidents.

PMID- 2243715
TI  - Practice parameters in medicine. Subcommittee on Practice Parameters, Council on
      Medical Economics.

PMID- 2243714
TI  - Preprocedure review changes.

PMID- 2243716
TI  - Benefits of antiretroviral therapy.

PMID- 2243717
TI  - Your office manager: new key to success. The Health Care Group.

PMID- 2243718
TI  - Debunking myths in indigent health care.

PMID- 2243719
TI  - Little-known methods effective on stress.

PMID- 2243720
TI  - Regression to the mean in medicine.

PMID- 2243721
TI  - Position paper on AIDS/HIV infection. Pennsylvania Public Health Association.

PMID- 2243722
TI  - How many rich doctors are there?

PMID- 2243723
TI  - Three-dimensional assessment of surgical excision margins in skin tumor resection
      biopsies.
AB  - A new technique for the assessment of adequacy of surgical margins of excision in
      skin tumor resection biopsies is described. The technique essentially consists of
      staining the whole fresh or fixed biopsy tissue in eosin followed by Mayer's
      hematoxylin. Following staining, the epidermal perimeter of the skin ellipse and
      the deep surgical margin can be assessed using a stereo-microscope. Should areas
      suspicious of inadequate excision be identified these may be confirmed by
      directed frozen or paraffin section.

PMID- 2243724
TI  - Exaggerated reaction to insect bites in patients with chronic lymphocytic
      leukemia. Clinical and histological findings.
AB  - We report three patients with chronic lymphocytic leukemia with unusual vesiculo
      bullous skin eruptions on exposed areas which were more commonly noted in spring
      and summer. The lesions appeared to be due to insect bites and could be
      differentiated from other causes on the basis of histological, immunohistological
      and clinical features. There was no correlation between the occurrence of the
      skin eruptions, disease status and treatment modalities. Exaggerated cutaneous
      reaction to insect bites should be considered as a cause of vesiculo-bullous
      lesions in patients with chronic lymphocytic leukemia.

PMID- 2243725
TI  - A study of serum free medium culture on the cloning efficiency of human bone
      marrow myeloid and erythroid progenitors.
AB  - Thirteen different combinations of serum-free media were tested to assess their
      suitability to replace serum containing medium for in vitro culture of human
      hemopoietic progenitors (CFU-GM and BFU-E). Bone marrow samples from patients
      with and without hematological diseases were tested. All tested media supported
      the growth of CFU-GM and BFU-E colonies, however our results have shown that the
      cloning efficiency of all commercially available serum-free media tested was
      lower (mean 18% and 12% of controls for CFU-GM and BFU-E respectively) and the
      colony size was smaller than those in serum-containing medium. In the serum-free
      cultures, there was no linear relationship between the colony numbers and cell
      concentration plated. Depletion of T-lymphocytes and monocytes did not improve
      the cloning efficiency of the serum-free medium culture. Furthermore, the
      addition of high concentration of insulin, transferrin and other supplements to
      the serum-free media did not improve the cloning efficiency. These results have
      indicated that the currently available commercial serum-free media do not provide
      optimal requirements for hemopoietic progenitor cell cultures and that other
      factors contained in serum are essential for their optimal growth.

PMID- 2243726
TI  - Red cells suspended in a phosphate-fortified additive: biochemical enhancement
      and longer storage.
AB  - When compared to our current storage regime, an additive solution, with 75 mM
      inorganic phosphate, improved certain biochemical and morphological parameters
      measured in suspensions of packed red cells throughout 49 days of liquid storage.
      In particular, the mean ATP level of 20 donations stored with the high phosphate
      additive was consistently and significantly higher than in standard (n = 6)
      suspensions. The increased amount of inorganic phosphate and the higher pH of the
      new additive stimulated ATP production and provided better pH buffering than the
      standard solution currently in use. Although survival study results indicated
      adequate 24h survivals for erythrocytes stored for 42 days with the new solution,
      after 49 days storage, the mean 24h survival of autologous erythrocytes was only
      58 +/- 7% (n = 6).

PMID- 2243728
TI  - An improved screening technique for isolation of Nocardia species from sputum
      specimens.
AB  - Three selective isolation media and the paraffin baiting technique were compared
      with conventional culture (Sabouraud dextrose agar without antibiotic supplement)
      for the ability to grow and detect nocardiae from simulated sputum specimens.
      Modified Thayer-Martin medium, incorporating vancomycin, colistin, nystatin and
      trimethoprim as selective agents, produced the highest recovery rate and with the
      greatest suppression of normal respiratory tract flora. A clinical evaluation
      using a screening programme devised for a busy diagnostic microbiology laboratory
      was performed on 1600 sputum specimens. Inoculating sputum on modified Thayer
      Martin medium and extending the initial incubation period of 3 days at 35 degrees
      C under 10% carbon dioxide to a further 3 weeks at room temperature in a candle
      jar, led to the diagnoses, which otherwise would have been missed, of pulmonary
      nocardiosis in 3 patients and pulmonary infections due to Neisseria meningitidis,
      Pseudomonas cepacia, and Serratia marcescens in a further 22 patients.

PMID- 2243727
TI  - Lymphocyte subsets in granulomas of human tuberculosis: an in situ
      immunofluorescence study using monoclonal antibodies.
AB  - The immunophenotypic characteristics of lymphocyte subpopulations in tissue
      lesions of human tuberculosis were investigated in 18 cases. Frozen sections of
      affected cervical lymph nodes were stained with a panel of monoclonal antibodies
      using avidin-biotin immunofluorescence technique. The mean percentage of cells
      staining with different antibodies was as follows: CD3 44%; CD4 43%; CD8 36%; HLA
      DR 86%; and IgM 29%. The mean CD4/CD8 ratio was 1.3:1. Leu7 and CD1 staining
      cells were very sparsely distributed in the granulomas. Thus, infection with
      tuberculosis is associated with a predominantly T cell infiltrate in lesional
      tissues. The proportion of CD4 positive (helper/inducer) cells at these sites is
      much lower than that seen (i) in the normal circulation, (ii) in reactive lymph
      nodes and (iii) at the site of purified protein derivative (PPD) injection in
      healthy tuberculin-responsive individuals.

PMID- 2243729
TI  - Evaluation of a selective medium for the isolation and differentiation of
      Haemophilus influenzae and Haemophilus parainfluenzae from the respiratory tract
      of chronic bronchitics.
AB  - Respiratory tract specimens from chronic bronchitic patients were cultured for
      Haemophilus species on conventional chocolate agar and a modified sucrose medium
      in order to determine the accuracy of the new medium in differentiating
      Haemophilus influenzae from Haemophilus parainfluenzae strains. Haemophilus
      influenzae biotypes II and III and Haemophilus parainfluenzae biotypes I and II
      were found to be the predominant strains isolated from the respiratory tract. The
      modified sucrose medium was found to be a rapid and reliable means of
      differentiating Haemophilus influenzae from Haemophilus parainfluenzae by sucrose
      fermentation, on initial isolation.

PMID- 2243731
TI  - Ki-1 positive anaplastic large cell lymphoma.

PMID- 2243732
TI  - Child health in 1990: the United States compared to Canada, England and Wales,
      France, the Netherlands, and Norway. Proceedings of a conference, Washington, DC,
      March 18 and 19, 1990.

PMID- 2243730
TI  - Experience of a molecular genetics service in prenatal diagnosis by DNA analysis.
AB  - Prenatal diagnoses of the genetic disorders alpha, beta thalassemia, HbS, Hb
      Lepore, hemophilia and cystic fibrosis were sought in 88 cases. Six unsuccessful
      attempts at diagnosis resulted from DNA polymorphisms which were only 50%
      informative (four cases) and prenatal diagnoses which had been undertaken before
      it was known whether DNA polymorphisms in family studies were informative (two
      cases). The most frequent indications for prenatal diagnosis were the
      hemoglobinopathies although requests for exclusion of cystic fibrosis formed the
      majority during 1989. Strong linkage disequilibrium between the cystic fibrosis
      defect and its associated DNA polymorphisms facilitated detection of this
      disorder. Late presentations among patients with beta thalassemia and hemophilia
      and the necessity for more specialised genetic counselling were the commonest
      problems encountered.

PMID- 2243733
TI  - Child health in Canada.

PMID- 2243734
TI  - Child health services in England and Wales: an overview.
AB  - Child health services in England and Wales are rendered largely through the
      National Health Service and Social Security. The activities of local authorities
      are also important to child health. The structure and scope of services offered
      children by each of these is presented and discussed, with special attention to
      changes anticipated during the next 2 years. The care of children is integrated
      into the system serving all ages, so that services are difficult to evaluate and
      resources are shared with other groups. Health policy for children is
      fragmentary, although encouraging trends are visible in the evolution of existing
      policy. The impact of impending changes in hospital, community, and general
      practitioner services on the care of children is unclear at this time.

PMID- 2243735
TI  - Child health care policy and delivery in France.
AB  - Medical and social protection of mothers, infants, and children began in France
      more than a century ago. A number of laws and regulations have improved the
      system, which is discussed in detail. The discussion includes an overview of
      health policy, service delivery, and the financing of care. Is the current French
      system of Maternal and Child Health responsible for the good health of today's
      children? This question is addressed through selected examples. Finally, failures
      and short-comings of the system are described, including the persistence of
      underserved groups, unequal access to care, and other problems. Solutions are
      feasible, and some are now being implemented.

PMID- 2243736
TI  - Youth health care in The Netherlands: a bird's eye view.
AB  - In the context of the conference on cross-national comparisons of child health, a
      short overview is given of youth health care in the Netherlands. After a brief
      explanation of the financing of the Dutch health care system, trends in child
      mortality are shown. A short description is presented of obstetrical care, which
      features independent midwives and 35% home deliveries; the organization of well
      baby clinics, which provide for 10 visits in the first 15 months and care for 95%
      of all children; and the school health services, which cover nearly all children.

PMID- 2243737
TI  - Children in the Norwegian health care system.
AB  - Norway is a large, sparsely populated country with a long tradition of socialized
      health care. The health status of Norwegians is good, with life expectancy among
      the highest in Europe. Indicators of infant health are also good, although not
      among the best. Health services in Norway are in principle free of charge to all
      citizens, and the current health expenditure is about 6.8% of the Gross National
      Product. Preventive and curative pediatric services account for only 3% of this
      total. The structure of Norwegian health and social services is presented in this
      discussion, both in general terms and with particular attention to services for
      children.

PMID- 2243739
TI  - Preventive care for children: immunization in England and Wales.
AB  - Immunization rates against common, notifiable diseases of childhood have improved
      steadily in England and Wales, although the 90% target rates for 1990 have not
      been achieved. The organization of the immunization program is described, with
      attention to service delivery, mechanisms of assurance, and consideration of the
      remaining barriers to further improvement in coverage.

PMID- 2243738
TI  - Immunization coverage among preschool children: the United States and selected
      European countries.

PMID- 2243740
TI  - The national immunization program of The Netherlands.
AB  - After a brief explanation of the immunization policy in the Netherlands, the
      national immunization program is described, with special attention given to
      coupling of the municipal population records with a computerized database of
      individual immunization records at the provincial level. The Dutch program
      achieves coverage rates greater than 90% for all routine immunizations.
      Participation in the program is free of charge to every child living in the
      country up to the age of 13 years, but there is no obligation or requirement to
      be immunized. Financing of the program is also discussed.

PMID- 2243741
TI  - Immunizations in the United States.

PMID- 2243742
TI  - Excess injury mortality among children in the United States: comparison of recent
      international statistics.
AB  - Using data from the National Center for Health Statistics and the World Health
      Organization, child injury death rates in the US were compared to those of
      Canada, England and Wales, France, Netherlands, and Norway. Except for the 1981
      Canadian figure, overall US childhood injury mortality was greater than childhood
      injury mortality rates of all countries studied during each year from 1980 to
      1986. Injury mortality steadily declined in most other countries, whereas the US
      rate appears to be increasing. Attention to specific causes reveals that much of
      the difference is explained by motor vehicle injuries and homicide, but in every
      childhood age group US death rates due to drowning, firearms, homicide,
      poisoning, and fire are among the highest. Excess US injury mortality is largely
      attributable to deaths among children younger than 5 and older than 14 years of
      age, the most vulnerable groups in all countries. Especially high rates among US
      minorities account for little of the observed differences; for many injuries, the
      mortality rate of US nonblacks is several times those reported by the comparison
      nations. Behavioral strategies are inadequate to deal with excess death rates of
      this magnitude. Limiting exposure through regulation of handguns, greater use of
      public transportation, and affordable and accessible day care are among the
      measures that should be implemented.

PMID- 2243743
TI  - Unintentional injury mortality in Canada.

PMID- 2243744
TI  - Unintended injuries in children: the French situation.
AB  - The French situation with respect to mortality from unintentional injuries in
      children is far from satisfactory. International comparison is made difficult by
      statistical bias, but although excess injury mortality is decreasing in France,
      rates are higher than in most advanced European countries. Many regulations have
      been enacted during the past 30 years to reduce the economic and social burden of
      injuries, but political will is insufficient to establish a consolidated national
      program and enforcement of existing legislation is inadequate. Evaluation of
      preventive and educational programs is less than optimal; many attempts have not
      met basic methodologic requirements. The situation is improving, partly because
      of growing social concern. New regulations are in preparation, but solution of
      this major public health problem also demands behavioral change, which is much
      more difficult to effect than other measures. Greater commitment to research,
      proper evaluation of sound programs, and enforcement of existing law doubtless
      would reduce the excess morbidity and mortality resulting from unintended
      injuries to children.

PMID- 2243745
TI  - Childhood injuries: where we are.
AB  - In this paper we present the leading causes of fatal childhood injury in the
      United States. We examine three types of explanations for why injury rates are so
      high in the United States compared with what they could be and actually are in a
      number of industrialized European countries. Our conclusions are based on what we
      learn when we look at specific injury problems and apply that knowledge to the
      field of childhood-injury prevention as a whole. To decrease the number of fatal
      injuries to children, we should: 1. Recognize injuries as a major public health
      problem. Injuries have been perceived not as problems to be solved but as
      "accidents" which are determined by fate, not understandable, and consequently
      not preventable. In addition, injuries have not been addressed in the
      multidisciplinary fashion that typifies the successful public health approach to
      other problems. 2. Address intentional injury as part of the problem. Intentional
      injury has been treated as a separate field entirely and not addressed
      scientifically as a public health problem. One consequence of this is that
      injuries due to firearms have been addressed most frequently as a problem of
      "unintentional injury." As a result, 93% of all firearm injuries, ie, those which
      are intentional, have not been studied or addressed adequately. This situation is
      like studying motor vehicle injuries but excluding drunk driving and speeding as
      contributing factors, or like studying acquired immunodeficiency syndrome but
      ignoring anal intercourse or intravenous drug use. 3. Develop and support
      organizations that can plan and coordinate effectively a national approach to
      injury control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 2243746
TI  - Postneonatal mortality in the United States: an international perspective.
AB  - The international standing of the United States in postneonatal mortality has
      deteriorated from third in 1950 to sixteenth in 1986. The high rate among United
      States blacks is not the reason for the poor United States standing: ten other
      countries had lower rates than that for United States whites. Recent trends show
      a slowdown in the decline in postneonatal mortality between 1970 to 1981 and 1981
      to 1986 in Canada, England and Wales, Netherlands, and the United States. Norway
      actually experienced increases during the latter period. Only France showed an
      acceleration in its decline during the 1980s. Canada has maintained the most
      rapid rate of decline between 1950 and 1986. Although all countries examined here
      reported Sudden Infant Death Syndrome as the leading cause of postneonatal
      deaths, there was twofold variation among the countries in the Sudden Infant
      Death Syndrome rate. Similarly, congenital anomalies, the second leading cause of
      death, showed a 50% range in mortality rates. Infections accounted for less than
      10% of all postneonatal deaths. A reasonable approach to assessing the magnitude
      of preventable mortality in the postneonatal period is to use mortality from all
      causes except congenital anomalies among normal birth weight infants. United
      States whites had a lower "preventable" postneonatal mortality rate than Denmark,
      England and Wales, and Scotland, but a higher rate than Sweden. United States
      blacks, on the other hand, had by far the highest rates. Disaggregating the
      United States rates further into three broad maternal risk groups, there was a
      doubling of rates with increasing level of maternal risk. About half the
      postneonatal deaths among normal birth weight infants could be prevented if the
      entire population experienced the rates of the lowest maternal risk group.

PMID- 2243747
TI  - Postneonatal infectious disease mortality: the French situation.
AB  - Mortality caused by infectious and parasitic diseases represents a limited part
      of all postneonatal deaths in France, which have been stable for the past decade.
      This component is worthy of careful analysis because it is at least partially
      preventable. Statistics are presented and interpreted, with discussion on which
      disorders should be included in assessing the impact of infection on morbidity
      and mortality. Figures and international rankings change according to the
      inclusiveness of the definition chosen. There is need for epidemiologic and
      statistical research to make comparisons of mortality more clear. Morbidity is
      also important because of high incidence, frequent hospitalization, and a heavy
      social cost. Policy and services in France that relate to control and treatment
      of infection are described, as are shortcomings that call for further efforts.

PMID- 2243748
TI  - Postneonatal mortality in Norway: a study of recent trends and comparison with
      other mortality rates in Norwegian children.
AB  - Postneonatal mortality in Norway decreased rapidly from 1956 to 1980 but
      subsequently remained stable. In recent years the postneonatal death rate appears
      to be increasing, primarily due to greater numbers of deaths attributed to the
      Sudden Infant Death Syndrome. During the same period, mortality among older
      children has also decreased, with the decline evident in all leading causes. Only
      among people aged 15 to 19 years have recent trends been less than encouraging,
      with the number of fatal traffic accidents in particular remaining stable or
      increasing. Although there is room for continued improvement, the widely held
      belief that the health status of Norwegian children is good is supported by the
      trends in mortality.

PMID- 2243749
TI  - Postneonatal mortality: a performance indicator of the child health care system.

PMID- 2243750
TI  - Children with special needs in England and Wales: the care of hearing impairment,
      myelomeningocele, and adolescent pregnancy.
AB  - Services for children with special needs in England and Wales are described
      briefly, with attention to the services provided by the National Health Service,
      local authorities, the social security system, and voluntary organizations. For
      illustrative purposes, particular reference is made to children with hearing
      impairments and myelomeningoceles. A separate account is given of the provision
      for pregnant adolescents, again addressing services provided by all major sources
      of assistance.

PMID- 2243751
TI  - Children with special needs in The Netherlands: impaired hearing, adolescent
      pregnancy, and myelomeningocele.
AB  - In the Netherlands, treatment and management of children with special needs is
      characterized by the absence of financial barriers to care and the existence of a
      number of specialized services. For hearing-impaired children, there are special
      audiologic centers and special schools. Adolescents at risk of unintended
      pregnancy are protected through education and a dedicated system of family
      planning clinics. Children with multiple handicaps, such as those associated with
      myelomeningocele, face greater difficulties but still have an array of services
      available to them at little or no cost. Families are sheltered from excessive
      expense through social insurance.

PMID- 2243752
TI  - Children with special health needs: a United States perspective.

PMID- 2243753
TI  - Hemispheric differences are found in the identification, but not the detection,
      of low versus high spatial frequencies.
AB  - The processing of sine-wave gratings presented to the left and right visual
      fields was examined in four experiments. Subjects were required either to detect
      the presence of a grating (Experiments 1 and 2) or to identify the spatial
      frequency of a grating (Experiments 3 and 4). Orthogonally to this, the stimuli
      were presented either at threshold levels of contrast (Experiments 1 and 3) or at
      suprathreshold levels (Experiments 2 and 4). Visual field and spatial frequency
      interacted when the task required identification of spatial frequency, but not
      when it required only stimulus detection. Regardless of contrast level
      (threshold, suprathreshold), high-frequency gratings were identified more readily
      in the right visual field (left hemisphere), whereas low-frequency gratings
      showed no visual field difference (Experiment 3) or were identified more readily
      in the left visual field (right hemisphere) (Experiment 4). Thus, hemispheric
      asymmetries in the processing of spatial frequencies depend on the task. These
      results support Sergent's (1982) spatial frequency hypothesis, but only when the
      computational demands of the task exceed those required for the simple detection
      of the stimuli.

PMID- 2243754
TI  - Spatial contingency and the McCollough effect.
AB  - On the basis of a conditioning analysis of the orientation-contingent color
      aftereffect (McCollough effect, ME), orientation stimuli become associated with
      simultaneously presented chromatic stimuli. This account suggests that decreasing
      the contingency between the grid orientation and color should decrease the
      strength of the aftereffect. Results of previous research indicate that
      decreasing the temporal contingency (by presenting homogeneous chromatic stimuli
      between presentations of chromatic grids) does not decrease the ME. However, it
      has been suggested that the appropriate contingency-degradation procedure would
      involve decreasing spatial (rather than temporal) contingency. That is, the
      illusion should be attenuated by extending the color beyond the confines of the
      grid. Contrary to this hypothesis, the results of the present experiments provide
      no evidence that decreasing the spatial contingency between grid and color
      decreases the ME; rather, the aftereffect is increased by such a manipulation.

PMID- 2243756
TI  - Perceptual integration of tertiary taste mixtures.
AB  - Integration psychophysics was used to explore the taste perception of mixtures of
      sucrose, fructose, and citric acid. Three levels of each stimulus were varied in
      a 3 x 3 x 3 factorial design. Subjects rated total intensity, sweetness, and
      acidity of the 27 mixtures on graphic rating scales. Consistent with earlier
      work, the perceived total intensity of the tertiary mixtures was found to be
      dictated by the intensity of the (subjectively) stronger component alone (i.e.,
      either the integrated sweetness or the acidity, whichever was the more intense).
      In contrast, the sweetness and acidity of the mixture were susceptible to mutual
      suppression: Sweetness suppressed acidity, acidity suppressed sweetness. There
      was, however, a difference between sucrose and fructose in their interactions
      with citric acid, fructose being the more susceptible to suppression. This
      selectivity of suppression indicates that the two sweetnesses could not have been
      inextricably integrated. Implications for taste coding are discussed, and the
      findings are reconciled in terms of two separate coding mechanisms: one for taste
      intensity, another for taste quality.

PMID- 2243757
TI  - Identifying contours from occlusion events.
AB  - Surface contours specified by occlusion events that varied in density, velocity,
      and type of motion (rotation or translation) were examined in four experiments.
      As a fourth experimental factor, there were both figure-motion trials (the
      occluding surface moved over a stationary background) and background-motion
      trials (the background moved behind a stationary surface) in each experiment.
      Displays contained line patterns and rotary motion (Experiment 1), line patterns
      and translatory motion (Experiment 2), textured surfaces and rotary motion
      (Experiment 3), and textured surfaces and translatory motion (Experiment 4).
      Results indicate that contour identifications are more accurate with translation
      than with rotation, and that background-motion trials are generally easier than
      figure-motion trials. Although density in all experiments affected
      identifications in both background- and figure-motion trials, velocity did so in
      Experiment 4 only. In Experiments 1, 2, and 3, velocity affected identifications
      in background-motion trials but not in figure-motion trials. In Experiments 3 and
      4, the rate of accretion and deletion of texture was a poor predictor of
      identification accuracy. These results are not consistent with previous accounts
      of contour perception from occlusion events, and may reflect an involvement of
      ocular pursuit as a mechanism for registering contour information.

PMID- 2243755
TI  - On the perception of speech from time-varying acoustic information: contributions
      of amplitude variation.
AB  - The cyclic variation in the energy envelope of the speech signal results from the
      production of speech in syllables. This acoustic property is often identified as
      a source of information in the perception of syllable attributes, though spectral
      variation can also provide this information reliably. In the present study of the
      relative contributions of the energy and spectral envelopes in speech perception,
      we employed sinusoidal replicas of utterances, which permitted us to examine the
      roles of these acoustic properties in establishing or maintaining time-varying
      perceptual coherence. Three experiments were carried out to assess the
      independent perceptual effects of variation in sinusoidal amplitude and
      frequency, using sentence-length signals. In Experiment 1, we found that the fine
      grain of amplitude variation was not necessary for the perception of segmental
      and suprasegmental linguistic attributes; in Experiment 2, we found that
      amplitude was nonetheless effective in influencing syllable perception, and that
      in some circumstances it was crucial to segmental perception; in Experiment 3, we
      observed that coarse-grain amplitude variation, above all, proved to be extremely
      important in phonetic perception. We conclude that in perceiving sinusoidal
      replicas, the perceiver derives much from following the coherent pattern of
      frequency variation and gross signal energy, but probably derives rather little
      from tracking the precise details of the energy envelope. These findings
      encourage the view that the perceiver uses time-varying acoustic properties
      selectively in understanding speech.

PMID- 2243759
TI  - Inhibitory tagging in visual search: a failure to replicate.
AB  - Klein (1988) reported that increased reaction times for the detection of small
      light probes could be used as an indicator of inhibitory tagging of rejected
      distractors in serial visual search tasks. Such a paradigm would be very useful
      in the study of the mechanics of visual search. Unfortunately, we cannot
      replicate the result. In this study, we found that probe reaction times were
      elevated at all distractor locations, relative to empty locations, following both
      parallel and serial search tasks. This appears to be a forward masking effect.

PMID- 2243758
TI  - The size-weight illusion in 2-D nonlinear psychophysics.
AB  - An extension of unidimensional nonlinear psychophysics is postulated by using
      forms of cross-coupling between the parameters of the two single-channel
      recursions, which have already been shown to model some perceptual phenomena. The
      size-weight illusion is shown to be reproducible in the topology of its
      relations, and it is suggested that some so-called illusions are in fact the
      natural consequences of nonlinear cross-coupling. The conditions that produce the
      illusion involve partially compensating the cross-coupling of sensory dimensions,
      and a second equilibrium with no cross-coupling, resembling simpler veridical
      perception, also exists in the behavior of some subjects.

PMID- 2243761
TI  - The Bourdon illusion occurs with straight-, right-angle-, and parallel-edge
      figures.
AB  - The Bourdon illusion is the apparent bentness of the straight edge of a figure
      consisting of two elongated triangular components arranged apex to apex. In three
      experiments, the illusion was shown to occur in the opposite direction, with the
      components arranged base to base. It was also shown to occur with the component
      edges at right angles and parallel. With the edges at right angles, the illusion
      also occurred in one direction when the components were apex to apex and occurred
      in the opposite direction when they were base to base. Supplementary observations
      indicated that the illusion is stronger when the components are relatively small
      and widely separated and eliminated when one of the two edges is curved.

PMID- 2243760
TI  - Image rotation of misoriented letter strings: effects of orientation cuing and
      repetition.
AB  - Three experiments were designed to investigate whether the characteristic
      function relating response time to stimulus orientation reflects the observer
      imagining the rotation of the stimulus to upright (the "image rotation"
      hypothesis) or rotation of an internal reference frame in response to the
      misoriented stimulus (the "frame rotation" hypothesis). Identification times in
      response to misoriented words were measured in Experiment 1, whereas in
      Experiments 2 and 3, lexical decision times in response to misoriented letter
      strings were measured. Trials occurred in blocks; words within a block were
      presented at the same orientation. It was argued that this mode of presentation
      would facilitate the use of a frame rotation strategy by allowing for a gradual
      readjustment of an internal reference frame. The characteristic "mental rotation"
      function was observed in all three experiments. However, the data indicated that
      observers continued to imagine the rotation of the word to upright in each trial;
      there was no evidence of readjustment of an internal reference frame. An
      additional finding of interest occurred in Experiment 1, in which observers
      identified the same set of misoriented words across two sessions. The
      identification times were faster, and the slope of the mental rotation function
      was lower, in the second session. These results are discussed as in relation to
      the image rotation hypothesis of mental rotation and to "instance-based skill
      acquisition" (Masson, 1986) in word recognition.

PMID- 2243762
TI  - Evidence for early selection: precuing target location reduces interference from
      same-category distractors.
AB  - In this study, we evaluated whether uncertainty about target location and
      category overlap between the target and the flankers played a role in recent
      findings (Miller, 1987) of semantic interference of irrelevant stimuli. In each
      of four testing conditions, subjects were required to identify a target letter
      surrounded by irrelevant flankers whose identity predicted the correct response.
      We varied (1) whether or not the target location was precued, and (2) the
      flanker's category (digits vs. letters). We found a substantial effect of letter
      flankers when subjects were uncertain of the precise target location. However,
      this effect was greatly attenuated when attention was predirected to the target
      location. Similarly, a reduced flanker effect was observed when the flankers
      (digits) belonged to a different semantic category than the target. However, when
      the target location was precued, no effect of the semantic congruity of target
      and flankers was found. Coupled with previous research, these findings converge
      in establishing that both failures to maintain attention on the target location
      and the semantic congruity of target and flankers modulate the size of the
      effects from irrelevant stimuli. These results are discussed in the context of
      early and late selection views of selective attention.

PMID- 2243763
TI  - Electrocutaneous spatial integration at threshold: the effects of electrode size.
AB  - Five experiments were carried out to investigate the effects of electrode size on
      threshold for current pulses that flowed between the ventral and dorsal sides of
      the right forearm. The main result was that the total current threshold decreases
      as the size of the cathode and anode increases at least up to 15 mm in diameter.
      To account for this finding, a neural summation model was proposed, assuming that
      the central nervous system sums up neural impulses discharged near the conduction
      paths under electrodes. It was also found that the current flowing from the
      dorsal to the ventral side provided lower thresholds and more stable localization
      than the opposite flow of current did. This finding suggested that current
      threshold and its perceived locus are determined by both the body site on which
      electrodes were placed and the relative polarity that was assigned to electrodes.

PMID- 2243764
TI  - Negative priming in same-different matching: further evidence for a central locus
      of inhibition.
AB  - Responses to recently ignored information may be slower or less accurate than
      responses to information not recently encountered. Such negative priming effects
      imply that the mechanism of selective attention operates on unattended, as well
      as attended, information. In the present experiment, subjects judged the second
      and fourth letters of five-letter strings (e.g., BABAB) as "same" or "different."
      Responses were slower when a target letter was identical to the distractors
      presented in the immediately preceding trial. This effect did not depend on which
      response was required on the current or preceding trial. The results suggest that
      ignored information is functionally disconnected from the response system as a
      whole, rather than from a specific response.

PMID- 2243765
TI  - Relationship of induced motion and apparent straight-ahead shifts to optokinetic
      stimulus velocity.
AB  - Induced motion (IM) of a fixated spot stimulus and shifts of the apparent
      straight-ahead (ASA) from the objective median plane were studied as a function
      of the velocity of a full-field optokinetic background stimulus. Both IM and ASA
      were influenced similarly by changes in stimulus velocity. The magnitude of both
      responses, averaged across subjects, increased to a peak level with background
      velocities of 40-80 deg/sec and decreased at higher velocities. Individual
      subjects differed with respect to the precise functions by which IM and ASA
      shifts were related to stimulus velocity. However, for individual subjects, the
      effects of velocity on IM and ASA shifts were typically highly correlated.
      Although IM is correlated with shifts of ASA in the opposite direction, the
      magnitude of the ASA shift is insufficient to account for the observed IM.

PMID- 2243766
TI  - [Tumors of the posterior hard palate].
AB  - The palatal mucosa is a representative area when reviewing etiology of the wide
      variety of oral tumours. The most important are of cystic, neoplastic or
      inflammatory nature. A case of malignant lymphoma occurred as a firm, painless
      swelling in the lateral posterior hard palate in a 69 year old woman. The tumour
      was initially diagnosed and treated as an abscess. Weeks later the swelling
      persisted and the patient was referred to the Department of oral surgery and oral
      medicine. University of Bergen. Incisional biopsy revealed the true nature of the
      process. Following cytostatic and radiation therapy, total regression of the
      tumour took place. The prognosis is considered favourable. The paper surveys the
      etiology of tumours of the posterior hard palate.

PMID- 2243767
TI  - A sensitive method for the determination of protein-DNA binding specificities.
AB  - We describe a sensitive and rapid method for determination of the sequence
      specificity of DNA binding proteins. The method allows recovery of specific sites
      using the small amounts of protein present in crude cell extracts or produced by
      cell-free translation reactions. Extract proteins are incubated with a pool of
      random sequence oligonucleotides, complexes purified by immunoprecipitation, and
      bound DNA amplified by the Polymerase Chain Reaction (PCR). This DNA is then used
      in further rounds of binding, immunoprecipitation, and amplification, until
      specific binding is detectable. With the transcription factor SRF as a model
      system, we demonstrate that authentic high affinity binding sites are recovered,
      and show that epitope tagging can be used to allow recovery of sites when
      specific antibodies are unavailable. We also show that specific sites bound by
      the Fos protein, which binds DNA with high affinity only when complexed with
      other polypeptides, are easily recovered by this technique.

PMID- 2243768
TI  - The rejoining of double-strand breaks in DNA by human cell extracts.
AB  - A double-strand DNA break was introduced at a specific site within the lacZ gene
      of plasmid pUC18 using one of several restriction enzymes, and the plasmid
      exposed to nuclear extracts from human cell lines. Physical rejoining of DNA was
      monitored by Southern analysis after gel separation, and the fidelity of
      rejoining by expression of the lacZ gene after bacterial transformation with the
      treated plasmid. Breaks at the SalI and EcoRI sites were rejoined by extracts to
      form circular monomers, but the efficiency of rejoining was much higher at the
      SalI site. Measurement of rejoining at several adjacent sites having different
      types of termini, consistently showed a range of efficiencies with 5' 4-base
      greater than 3' 4-base overhangs and 4-base greater than 2-base greater than no
      overhang. Similar efficiencies were found for nuclear extracts from transformed
      cell lines, both from a 'normal' individual and an ataxia-telangiectasia (A-T)
      patient, and from a non-transformed normal cell culture. In contrast at some
      sites, especially those with a low rejoin efficiency, the fidelity of rejoining
      was very much lower for the A-T extracts than for normal cell extracts. Mis
      rejoining was, however, unrelated to rejoin efficiency at other sites, suggesting
      that factors such as the exact sequence at the break site on the molecule may
      also influence the fidelity of rejoining.

PMID- 2243769
TI  - Size and physical map of the Campylobacter jejuni chromosome.
AB  - The chromosome of Campylobacter jejuni is circular and approximately 1700 kb in
      circumference. The size of the genome was determined by field inversion gel
      electrophoresis of restriction endonuclease fragments using lambda DNA
      concatamers and yeast chromosomes to calibrate the size of the fragments. In view
      of the low (32-35%) G + C content of the campylobacter genome, enzymes that
      recognizes GC-rich sequences were used. Of the enzymes tested BssHII (G/C(G)CGC),
      NciI (CC/CGCG) and SalI (G/TCGAC) appeared to be usable. Hybridization of labeled
      fragments with two or more fragments from digests with a different restriction
      enzyme gave the information to order the fragments on the C jejuni chromosome.
      The localization on the genome of the flagellin and ribosomal gene clusters was
      determined.

PMID- 2243770
TI  - Gene F of plasmid RSF1010 codes for a low-molecular-weight repressor protein that
      autoregulates expression of the repAC operon.
AB  - The repAC operon of plasmid RSF1010 consists of the genes for proteins E, F, RepA
      (DNA helicase), and RepC (origin-binding initiator protein) and is
      transcriptionally initiated by a promoter called P4. We have studied the
      expression of the repAC operon in vivo by using fusions to the lacZ reporter
      gene. The results show that the product of the second gene, F, autoregulates the
      operon by inhibiting transcription from P4. To verify its properties postulated
      from the in vivo studies and to initiate its biochemical characterization, we
      have purified the F protein from an overproducing E.coli strain constructed in
      vitro. Purification was based on a gel retardation assay for detection of P4
      specific DNA binding. Subsequent DNase footprinting of the F binding sites showed
      clear protection around two partially symmetric P4 sequences of 16 bp, each of
      which matches the symmetric consensus sequence, GCGTGAGTACTCACGC, in at least 13
      positions. The native repressor, as judged from gel filtration, velocity
      sedimentation and crosslinking studies, exists as a dimer in dilute solution; its
      monomeric subunit, as predicted from DNA sequence and N-terminal protein sequence
      data, consists of 68 amino acids and has a calculated M tau = 7,673.

PMID- 2243771
TI  - Human DNA polymerase alpha catalytic polypeptide binds ConA and RCA and contains
      a specific labile site in the N-terminus.
AB  - The catalytic polypeptide of DNA polymerase alpha is often observed in vitro as a
      family of phosphopolypeptides predominantly of 180 and 165 kDa derived from a
      single primary structure. The estimated Mr of this polypeptide deduced from the
      full-length cDNA is 165 kDa. Immunoblot analysis with polyclonal antibodies
      against peptides of the N- and C-termini of the deduced primary sequence
      indicates that the observed family of polypeptides from 180 kDa to lower
      molecular weight results from proteolytic cleavage from the N-terminus.
      Antibodies against the N-terminal peptide detect only the 180 kDa species
      suggesting that this higher molecular weight polypeptide may be the result of
      posttranslational modification of the 165 kDa primary translation product. The
      catalytic polypeptide is not only phosphorylated but is also found to react with
      lectins ConA and RCA. N-terminal sequencing of the isolated catalytic polypeptide
      from human cells and of the recombinant fusion proteins indicates that the often
      observed 165 kDa polypeptide is the in vitro proteolytic cleavage product of the
      modified 180 kDa protein at the specific site between lys123 and lys124 within
      the sequence -RNVKKLAVTKPNN-.

PMID- 2243773
TI  - Generation of small mutation in large genomic fragments by homologous
      recombination: description of the technique and examples of its use.
AB  - We have developed a technique of homologous recombination in bacteria which
      allows the mutagenesis of large genomic fragments cloned in cosmids. The desired
      mutation is first introduced into a plasmid clone and is then transferred to the
      appropriate cosmid clone by the means of double antibiotic selection coupled with
      phenotypic selection. We describe three different types of construct made by this
      technique.

PMID- 2243774
TI  - The signal for growth rate control and stringent sensitivity in E. coli is not
      restricted to a particular sequence motif within the promoter region.
AB  - Hybrid promoter constructs were used to determine the DNA sequence requirements
      for stringent and growth rate control within a promoter region. The promoters
      were obtained by fusing complementing sequence regions located upstream and
      downstream from the GCGC discriminator motif of the growth rate regulated rRNA P1
      promoter and a non-regulated tac promoter variant. The activities and the
      regulatory response of the hybrid promoters were determined in vivo using a
      promoter test vector system with the chloramphenicol acetyltransferase (CAT)
      reporter gene. Measurements were made at different growth rates and after
      starvation for isoleucine to induce the stringent response. Neither the upstream
      nor the downstream sequence of P1 relative to the GCGC discriminator motif
      conferred comparable regulatory features when fused to the complementing
      sequences of the non-regulated mutant tac promoter. A minor response to amino
      acid deprivation or changes in the growth rate was noted for the hybrid promoter
      with the rrnB P1 upstream segment and the tac downstream element, pointing to a
      slightly different importance of the two sequence elements for regulation. The
      parallel effects for stringent as well as growth rate regulation of the hybrid
      promoters supports the view of a common mechanism for both types of control.
      However, none of the promoter sequence elements on its own was able to restore
      the complete regulatory behaviour of their 'parent' promoters.

PMID- 2243772
TI  - A highly conserved enhancer downstream of the human MLC1/3 locus is a target for
      multiple myogenic determination factors.
AB  - A potent muscle-specific enhancer element, originally described in the rat myosin
      light chain (MLC) 1/3 locus located downstream of the coding region, is found in
      an analogous position in the human MLC1/3 gene. When linked to a CAT reporter
      gene and transfected into muscle or non-muscle cells, the human MLC enhancer
      directs high levels of muscle-specific gene expression from homologous or
      heterologous promoters, irrespective of position or orientation relative to the
      CAT transcription unit. A significant degree of sequence homology (over 85%) in
      the 3'-flanking regions of the two MLC genes is restricted to a 200 bp sequence
      which lies approximately 1.5 kb downstream of the polyadenylation site in both
      species. The human enhancer sequence includes binding sites for human myogenic
      determination factors containing a common basic helix-loop-helix motif, and it
      can be trans-activated to varying degrees in non-muscle cells by these factors.
      This study establishes the MLC enhancer as an evolutionarily conserved, integral
      component of the MLC1/3 locus which constitutes a novel target for the action of
      myogenic determination factors.

PMID- 2243775
TI  - Drosophila RNA polymerase II elongation factor DmS-II has homology to mouse S-II
      and sequence similarity to yeast PPR2.
AB  - DmSII is a Drosophila RNA polymerase II elongation factor which suppresses
      pausing by RNA polymerase II at specific sites on double stranded templates.
      Using antibodies produced against the purified protein, a Drosophila cDNA
      expression library was screened and a cDNA was isolated which encoded a portion
      of DmSII. When this cDNA was used to probe Kc cell mRNA the predominant species
      was found to be 1.4 kb in length. The original cDNA was used to screen a
      Drosophila Kc cell cDNA library resulting in the isolation of a 1.4 kb cDNA which
      was then sequenced. The deduced protein sequence for DmSII exhibited high
      similarity to mouse SII protein sequence. In addition, significant sequence
      similarity was found with the protein encoded by the yeast gene PPR2, which is
      involved in regulation of URA4 gene expression. The comparison of amino acid
      sequences suggests that DmSII is comprised of two domains homologous to mouse SII
      separated by a flexible, serine rich region of low homology. The shorter yeast
      protein has sequence similarity only to the carboxy terminal domain.

PMID- 2243776
TI  - Field inversion gel electrophoresis with different pulse time ramps.
AB  - The influence of different pulse time ramps on the separation of yeast
      chromosomes with field inversion gel electrophoresis (FIGE) was investigated by
      the means of two dimensional gel electrophoresis. The problem of band inversion,
      which makes it difficult to distinguish DNA molecules of different size, has been
      solved by using double randomized pulse times. A major disadvantage of the field
      inversion technique is thereby overcome, making this system comparable to other
      pulsed field techniques.

PMID- 2243777
TI  - Fourier methods for biosequence analysis.
AB  - Novel methods are discussed for using fast Fourier transforms for DNA or protein
      sequence comparison. These methods are also intended as a contribution to the
      more general computer science problem of text search. These methods extend the
      capabilities of previous FFT methods and show that these methods are capable of
      considerable refinement. In particular, novel methods are given which (1) enable
      the detection of clusters of matching letters, (2) facilitate the insertion of
      gaps to enhance sequence similarity, and (3) accommodate to varying densities of
      letters in the input sequences. These methods use Fourier analysis in two
      distinct ways. (1) Fast Fourier transforms are used to facilitate rapid
      computation. (2) Fourier expansions are used to form an 'image' of the sequence
      comparison.

PMID- 2243778
TI  - Construction of a human chromosome 3 specific NotI linking library using a novel
      cloning procedure.
AB  - Two new diphasmid vectors (lambda SK17 and SK22) and a novel procedure to
      construct linking libraries are described. A partial filling-in reaction provides
      counter-selection against false linking clones in the library, and obviates the
      need for supF selection. The diphasmid vectors, in combination with the novel
      selection procedure, have been used to construct a chromosome 3 specific NotI
      linking library from a human chromosome 3/mouse microcell hybrid cell line. The
      application of the new vectors and the strong biochemical and biological
      selections resulted in a library of 60,000 NotI linking clones. As practically
      all of them are real NotI linking clones (no false recombinants) the library
      represents approximately 3,000 human recombinants (equal to 10-15 genomic
      equivalents of chromosome 3). Previously published methods for construction of
      linking libraries are compared with the procedure described in the present paper.
      The advantages of the new vectors and the novel protocol are discussed.

PMID- 2243779
TI  - On the movement and alignment of DNA during 120 degrees pulsed-field gel
      electrophoresis.
AB  - The displacement per pulse of lambda, T4, and G DNA during pulsed-field agarose
      gel electrophoresis has been measured for a fine mesh of pulse durations T
      between 0.02 and 120 s. The slopes of these curves show that the DNA moves by two
      distinct processes, designated 1 and 2, depending upon the pulse duration T.
      Process 1 operates at short T and causes dx/dT to decrease gradually with
      increasing T. This process is independent of molecular weight M. Process 2 is
      effective at longer T and causes dx/dT to rise sharply in sigmoidal fashion at a
      value of T which increases as M1.2, finally reaching a plateau of 1.4 microns/s
      for E = 4 V/cm. The shape of the dx/dT curve and its dependence on M lead
      directly to 4 zones of separation in plots of mobility vs M for different T. The
      alignment of the 3 DNAs during PFGE was measured by fluorescence-detected linear
      dichroism for E between 4 and 10 V/cm. These results are used in developing a
      molecular understanding of the mobility data.

PMID- 2243780
TI  - Circular dichroism studies of an oligodeoxyribonucleotide containing a hairpin
      loop made of a hexaethylene glycol chain: conformation and stability.
AB  - An oligodeoxyribonucleotide, d(GCTCACAAT-X-ATTGTGAGC), where X represents a
      hexaethylene glycol chain, was studied using circular dichroism spectroscopy. Its
      conformation and conformational stability were compared to those of compounds
      where X was replaced by four thymines and to the duplex of same sequence without
      loop. The compound with the hexaethylene glycol chain can form a hairpin looped
      structure as well as a bulged duplex structure. In both cases the duplex region
      of the oligodeoxyribonucleotide exhibits the same conformation. In similar
      conditions the oligodeoxyribonucleotide with a four thymines loop forms
      exclusively a hairpin structure. Comparison between the thermodynamic parameters
      (delta H, delta S, delta G) associated with the formation of the structure of the
      three compounds are presented. In the case of the compound with the hexaethylene
      glycol chain it is shown that the large increase in its melting temperature (by
      about 35 degrees C in our experimental conditions) when compared to the non
      looped structure is mainly due to the fact that its melting process is
      intramolecular (monomolecular) whereas the other one is bimolecular.

PMID- 2243781
TI  - The enhancers and promoters of the Xenopus laevis ribosomal spacer are associated
      with histones upon active transcription of the ribosomal genes.
AB  - The presence of histones on the enhancer-promoter region of the X.laevis
      ribosomal spacer has been studied in embryos at stage 40, where the ribosomal
      genes are actively transcribed. Isolated tadpole nuclei were either fixed with
      formaldehyde or irradiated with UV laser to crosslink histones to DNA. The
      purified protein-DNA complexes were immunoprecipitated with antibodies to the
      histones H1, H2A and H4 and the DNA fragments carrying the respective histones
      were analyzed for the presence of spacer enhancer-promoter sequences by
      hybridization to specific DNA probe. The two independent crosslinking procedures
      revealed the presence of these DNA sequences in the precipitated DNA. The
      quantitative analysis of the UV laser-crosslinked complexes showed that histones
      H2A and H4 were associated with enhancer-promoter DNA in amounts similar to those
      found for bulk DNA, whilst the content of H1 was reduced.

PMID- 2243783
TI  - Optimization of the annealing temperature for DNA amplification in vitro.
AB  - In the polymerase chain reaction (PCR) technique, DNA is amplified in vitro by a
      series of polymerization cycles consisting of three temperature-dependent steps:
      DNA denaturation, primer-template annealing, and DNA synthesis by a thermostable
      DNA polymerase. The purity and yield of the reaction products depend on several
      parameters, one of which is the annealing temperature (Ta). At both sub- and
      super-optimal Ta values, non-specific products may be formed, and the yield of
      products is reduced. Optimizing the Ta is especially critical when long products
      are synthesized or when total genomic DNA is the substrate for PCR. In this
      article we experimentally determine the optimal annealing temperature (TaOPT)
      values for several primer-template pairs and develop a method for its
      calculation. The TaOPT is found to be a function of the melting temperatures of
      the less stable primer-template pair and of the product. The fact that
      experimental and calculated TaOPT values agree to within 0.7 degree C eliminates
      the need for determining TaOPT experimentally. Synthesis of DNA fragments shorter
      than 1 kb is more efficient if a variable Ta is used, such that the Ta is higher
      in each consecutive cycle.

PMID- 2243784
TI  - Nucleotide sequence of rice dwarf virus genome segment 3.

PMID- 2243785
TI  - Nucleotide sequence of the Adh gene of Drosophila lebanonensis.

PMID- 2243782
TI  - Nuclease mapping and DNA sequence analysis of transcripts from the dihydrofolate
      reductase-thymidylate synthase (R) region of Leishmania major.
AB  - Trypanosomatid protozoan parasites utilize a number of nonstandard mechanisms in
      expressing their genes. To probe these phenomena in a genetically accessible
      system, we have mapped termini of eight transcripts arising from the amplified R
      region including the DHFR-TS gene of methotrexate-resistant Leishmania major.
      Poly(A)+ RNAs transcribed from the DHFR-TS-coding strand exhibit features similar
      to those observed around other trypanosomatid protein-coding genes. These include
      close spacing, the presence of a transpliced miniexon on the 5' termini,
      heterogeneity at both 5' and 3' ends, and in some cases S1 nuclease protection of
      intertranscript regions. Other than the splice acceptor site, no consensus
      sequence elements associated with either 5' or 3' ends were detected, although
      polydinucleotide tracts tended to be near inter-transcript regions. Two poly(A)+
      RNAs transcribed from the opposite strand of the upstream flanking regions lacked
      the miniexon. Sequencing of DNA encoding the overlapping 1.7 kb opposite strand
      transcripts (one bearing and one lacking the miniexon, both found on polysomes)
      revealed no reading frames likely to encode proteins, suggesting that at least
      some of these RNAs could be nonfunctional by-products of RNA processing.

PMID- 2243786
TI  - Cloning and nucleotide sequence of a cDNA encoding the mink growth hormone.

PMID- 2243787
TI  - DNA sequence of the gene encoding the Zc1 protein from Zea mays W64 A.

PMID- 2243788
TI  - Sequence analysis of a genomic clone encoding a Zc2 protein from Zea mays W64 A.

PMID- 2243789
TI  - Nucleotide sequence of the genes encoding tRNA(his), tRNA(pro) and tRNA(gln) in
      the mitochondrial genome of Schizosaccharomyces pombe strain EF1.

PMID- 2243790
TI  - Nucleotide sequence of a porcine insulin-like growth factor II cDNA.

PMID- 2243792
TI  - Nucleotide and deduced amino acid sequences of chicken lactate dehydrogenase-A.

PMID- 2243791
TI  - Sequence of a lipase gene from the antarctic psychrotroph Moraxella TA144.

PMID- 2243793
TI  - Nucleotide sequence of the gene for a metalloproteinase inhibitor of Streptomyces
      nigrescens (SMPI).

PMID- 2243794
TI  - Complete nucleotide sequence of the PvuII restriction enzyme gene from Proteus
      vulgaris.

PMID- 2243795
TI  - Nucleotide sequence of the nodG gene of Azospirillum brasilense.

PMID- 2243796
TI  - DNA sequence of lipoprotein lipase cDNA cloned from human monocytic leukemia THP
      1 cells.

PMID- 2243797
TI  - Nucleotide sequence of Coxiella burnetii superoxide dismutase.

PMID- 2243798
TI  - The sequence of the Kluyveromyces lactis BiP gene.

PMID- 2243799
TI  - Nucleotide sequence between the fadB gene and the rrnA operon from Escherichia
      coli.

PMID- 2243800
TI  - Nucleotide sequences of two genes CAH1 and CAH2 which encode carbonic anhydrase
      polypeptides in Chlamydomonas reinhardtii.

PMID- 2243801
TI  - The nucleotide sequence of greA, a suppressor gene that restores growth of an
      Escherichia coli RNA polymerase mutant at high temperature.

PMID- 2243802
TI  - Cloning, sequence and expression of rat cathepsin D.

PMID- 2243803
TI  - Nucleotide and amino acid sequences of the conidium-specific SpoC1-C1D gene from
      Aspergillus nidulans.

PMID- 2243804
TI  - The lumazine protein gene in Photobacterium phosphoreum is linked to the lux
      operon.

PMID- 2243805
TI  - Porcine growth hormone receptor cDNA sequence.

PMID- 2243806
TI  - Nucleotide sequences of psbB and psbH, the plastid encoded genes for CP47 and the
      10 kDa phosphoprotein of photosystem II in Oenothera hookeri and argillicola.

PMID- 2243807
TI  - Cloning and sequence analysis of the cDNA for murine interleukin-6.

PMID- 2243808
TI  - cDNA sequence of a human heat shock protein HSP27.

PMID- 2243809
TI  - A novel protein (suef) programmed by the leftwards strand of a chimeric cDNA
      stops the expression of several proteins in E. coli.

PMID- 2243810
TI  - DNA polymers of protein binding sequences generated by PCR.

PMID- 2243811
TI  - Incorporation of multiple reporter groups on synthetic oligonucleotides.

PMID- 2243812
TI  - A rapid DNA isolation procedure from petri dish grown clinical bacterial
      isolates.

PMID- 2243813
TI  - Improved synthesis of full-length RNA probe at reduced incubation temperatures.

PMID- 2243814
TI  - New nucleotide sequence data on the EMBL File Server.

PMID- 2243815
TI  - [Predicting the incidence of malignant neoplasms in Cracow in the year 2000].
AB  - In connection with the data of the Cracov Tumor Registry concerning the 1970-1985
      period and the population prognoses of the city of Cracov the expected incidence
      and the number of patients with most common malignant neoplasms in the year 2000
      has been estimated. One can foresee the continuance of the decrease of the risk
      and incidence of malignant neoplasms of the stomach in both sexes and of cancer
      of the lung and breast in women. The incidence of malignant neoplasms in general
      as compared with the year 1985 will in the year 2000 increase by ca. 60% in men
      and by ca. 39% in women.

PMID- 2243816
TI  - [Malignant lymphoma (non-Hodgkin's)--principles of oncological management].
AB  - Principles of diagnostic and therapeutic management of malignant lymphoma
      patients have been presented, accounting for a variety of histologic types,
      clinical staging, and risk factors. The role of chemotherapy, radiotherapy, and
      surgery has been outlined up to the range necessary for planning of combined
      treatment of diverse clinical types of lymphomas.

PMID- 2243818
TI  - Montpellier Cancer Institute strategy and experience in surgical treatment of
      multi-bilateral hepatic metastases from digestive tract cancers.
AB  - Montpellier Cancer Institute strategy and experience in surgical treatment of
      multi-bilateral hepatic metastases from digestive tract cancers is presented
      based on retrospective case by case analysis of survival time of 38 patients. The
      mean age was 46.2 years and the primaries were colorectal (22 patients) and
      endocrine (16 patients). Liver surgery was synchronous to the resection of
      primary lesions in 8 patients and metachronous in 22 patients. Two-step liver
      surgery was performed in 8 patients. Overall thirty-days postoperative mortality
      was 7.8% and morbidity 15.7% (wound sepsis, subphrenic abscess, transitory
      jaundice, biliary fistula). The analysis of survival time evidenced that with
      reasonable risk-benefit ratio the aggressive surgical approach can be justified
      especially in patients with endocrine primaries.

PMID- 2243817
TI  - [Chronochemotherapy of neoplasms].
AB  - The problems of chronobiology in chemotherapy are discussed in connection with
      experimental and clinical experience. Special attention is payed to selected from
      most commonly applied cytostatics cis-platinum and doxorubicin, their toxicity in
      different hours of the day and efficacy in treatment of malignant neoplasms in
      human.

PMID- 2243819
TI  - [Sacrectomy at the level of S2 in schwannoma of the sacral region. Case report
      and review of the literature].
AB  - Rare case of highly differentiated malignant Schwannoma of the sacral region is
      described. The patient, a 30 year old woman, underwent sacrectomy at the level of
      S2. Postoperative course was uneventful. She has lived more than two years
      without any complaints or signs of disease. Technical details of surgical
      procedure are presented and discussed.

PMID- 2243820
TI  - [Evaluation of the experimental program of teaching about neoplasms in Warsaw
      schools].
AB  - The study was to test the cancer education curriculum offered by teachers in 3
      types of schools in Warsaw. The knowledge of cancer grew by 6% in the
      experimental schools and by 2% in control schools. Similar results were obtained
      in schools of Lodz, where the subject was also taught by teachers. A considerable
      greater knowledge increase, by 27% on the average, was obtained in schools of
      Lublin, where the subject was taught by professional oncologist. This seems to
      indicate still insufficient qualification of school teachers as regards teaching
      about cancer, despite a handbook on the subject which has been prepared for them.

PMID- 2243821
TI  - Bronchoscopy in critically ill patients. When is it appropriate?
AB  - Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic tool for use in
      carefully selected patients with serious pulmonary disease. The authors review
      the benefits and risks of fiberoptic bronchoscopy and discuss the essentials of
      nursing care before, during, and after the procedure.

PMID- 2243823
TI  - The persistent vegetative state.

PMID- 2243822
TI  - Repetitive strain injuries. How to deal with 'the epidemic of the 1990s'.
AB  - Occupational trends, especially the mushrooming of computer use in the United
      States, have brought with them a virtual epidemic of repetitive strain injury of
      the upper limb. What can you as a primary care physician do to stem the tide? In
      this article, the authors fill you in on treatment of the most common injuries as
      well as remark on the ramifications for business and industry.

PMID- 2243824
TI  - Evaluating hematuria in children. Where to start and how to proceed.
AB  - Bleeding from somewhere along the urinary tract is not unusual in children. Of
      the many causes, systemic infection and trauma are among the most common. History
      taking and physical examination should be careful and complete, because the
      results obtained help direct the laboratory evaluation. Diagnostic testing always
      begins with urinalysis but may progress to intravenous urography, voiding
      cystourethrography, endoscopic procedures in the upper and lower urinary tract,
      sonography, arteriography, or renal biopsy. Some cases remain unexplained and
      require follow-up to assess renal function.

PMID- 2243825
TI  - And you think you have it bad? Try $360 a month!

PMID- 2243826
TI  - Operation Desert Shield.